[
  {
    "patient_message": "Suggest alternative medication for knee pain apart from Naproxen post arthroscopic surgery\n\nWhat can I take in place of Naproxen or Ibuprofen for my knee pain? I had arthroscopic surgery in August and was taking Naproxen. Caused issues with my hearing. Now I can hear but sitting or walking for long periods of time make it painful to move afterward.",
    "doctor_response": "Hi welcome to HCMDear , I can understand your concern For your info , all medications have side effects  ,good or adverse . You can contact your doctor for right advice .Meanwhile , I suggest Homeopathic  ARNICA 30  /2 drops in a table spoon water / Twice a day / for 2 days and once a day for a week  , for  fast healing  & relief from pains after surgery .A level spoon of Turmeric powder in a cup of hot cow's milk at bed time serves as natural antibiotic and anti inflammatory agent , helps get rid of pains & accelerate healing process ..Hope this helps solve your query .Take care don't hesitate to get back if have any further query .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy?\n\nhello.i just gave birth last august 22. my daughter is two months old right now. i breastfed my daughter for one month. my husband and i had unprotected sex today. i still have not had my period. what are the chances of me getting pregnant? will emergency contraception work since 24 hours had already passed?",
    "doctor_response": "Hello mam, thanks for trusting health care magic.in 10-20% of cases ovulation occurs within a couple of months of delivery in case patients stops breastfeeding her baby. emergency contraception works within 72 hours of unprotected sex.you can take it as soon as possible but switch to a safe method of contraception from next cycle. In case you have further questions you can consult me on health care magic forum and i will be happy to help My URL is  care and wish you all the best.Dr Manisha Jain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for impaired urinary and sexual function after an injury\n\nimpaird bowel/urinary/sexual function after injury. Help please. as stated above in the subject heading I have all of these problems. I'm trying to get a second opinion on behalf of my doctors choice getting mri of my genital rectal area. I'm going to be very descriptive in my message in hopes to solve my problem so bare with me. I had an injury about a year ago and I'm still having problems. I've been to multiple doctors with multiple tests and they're still no conclusive answers. tests such as cat scans MRI and physical examination of the rectum with no answer.  I was going mountain biking and I crashed on the bike frame on my groin and I felt a pop. But i thought nothing of it and walked it off. ( im now going to be semi explicit about my intimate relations with my partner).  during intercourse i felt that same \"pop\" in left side in my perineum and felt a horrible pain in my left testicle shooting down my leg and in my lower left abdominal/sigmoid area. this immediately stopped my erection and my genitalia shrunk drastically. i panicked and thought i may have ruptured something. went to the hospital that day and had an ultrasound on my testicles. they were still getting blood. so i thought nothing of it. i did a self rectal exam and found a small pea sized green lump around my perineum/anal area, thought it might be a hemmroid. but it just got worse over time. so here i am a year later with no answers. since this episode it has triggered major depression and psychological symptoms which im proud to say have subsided tremendously. but im now single because of the incident. so here are the tests that ive been through: cat scan, to see for any internal bleeding or hernia/ results negative. mri of spine /results nerves are completely unharmed. plenty of rectal exams/ results feels normal and same with prostate. checked for ininguil hernia/ no hernia except some minor swelling in spermatic cord. ultrasound of bladder/ results slight urine retention which is abnormal for my age given no enlarged prostate. physical exam and probing of abdominal area/ results no feelings of protruding organs. multiple blood tests/ results normal. Here are the symptoms im having to this day/ throbbing pain in left abdominal/ left testicle that radiates down my inner left leg. muscle spasms in lower left abdominal/ left inner leg/ rectal area/ bladder/ perineum/ penis. urinary dysfunction- hard to push ou",
    "doctor_response": "Hello, It may be due to trauma or injury. For further assessment you may require MRI back, nerve conduction studies and ultrasound scrotum after surgeon consultation. Till then you can take sildenafil after consultation. You can take syp cital and may require antibiotics after urine culture sensitivity test Hope I have answered your query. Let me know if I can assist you further. Regards, Dr Shyam Kale, Family and general physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower back pain and constipation\n\nhello im a 49 y/o woman with no history of back pain yet 10 days ago i developed a stiffness and pain in my lower back more prominent on my left side. i saw a chiropractor for sim treatments and adjustments and it improved but i noticed constipation symptoms and increasing soreness in lower left. could this be a gastro issue- over last two days i've incresesd water really pushed it today and got somwe walking in but only produced liquid stool, pain is increasing.",
    "doctor_response": "Hello I have gone through your question and appreciate Your concern. For constipation u can try some laxatives like cremmaffin syrup.Back pain and constipation doesn't seems to be related.For back pain ucan use local Analgesic gel. Analgesic tablet can also be tried. Muscle relaxants and analgesics will help you. Lie on flat hard bed. Hot fomentation thrice a day. Avoid bending forward and lifting heavy Weights. Thanks. U can write me back for any query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pigmentation problem with skin on both legs, dry and itchy. Any solution ?\n\nI have problem with my skin on both legs. On rt leg, there is a distinct round shape, centrally pigmented (same as my skin color) and outer circle has less pigmented than my skin color and its bit shiny but not itchy. Initially, about a 6 months back, it was round, very dry, very itchy and when I scratch it used to become white in color and the skin in the area would fall as flakes. I started using steroids but I still have this problem. On the other leg, it was just the same but there were two circles. Now the two circles have joined and became like an elongated shape. It has similar characteristics: shiny, centrally pigmented (same as my skin color) and the outer regions have lighter skin color. I feel it is spreading outwards. Please advise. i appreciate any response. Thank you.",
    "doctor_response": "Hello,Welcome to health care magic.From your description, the possibilities of your skin problem include psoriasis and dry discoid eczema. You need to consult a dermatologist to confirm the same. A skin biopsy may also be required.Both the conditions benefit fom a topical steroid for a few days and also moisturisers. Both have remissions and relapses. However, psoriasis can become more widespread.Hope this helped.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please guide me with the treatment for urinary tract infection.\n\nHello doctor, I was diagnosed with urinary tract infection (E.coli) three months back. I took Ciprofloxacin for 10 days, but there is no sign of improvement. Now I have a dull pain in the back region, waist, and sometimes at flank. There is complete body weakness, mild fever, tingling sensation at hand and feet. Are these all symptoms of a kidney infection? Please guide me.",
    "doctor_response": "Hello. It looks like an upper urinary tract infection. Get your urine test done in a place where they check whether it is E.Coli (Escherichia Coli) or ESBL (Extended-spectrum beta-lactamases). Also, do an ultrasonography for the bladder to check post void residue. Start tablet Levoflox (Levofloxacin) 500 mg after giving urine for culture. Consult your specialist doctor, discuss with him/her and take the medicines with their consent. For more information consult a nephrologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome masturbation addiction?\n\nHi Doctors, I am 26years old and mustarbation addicted individual from long time. As now condition is totally worst, if I do mustarbation than I feel very dull and hopless also my hands are shaking at times and I can t do any hard lifting job. please advise",
    "doctor_response": "Thanks for asking in healthcaremagic forum    I understand your problem.  Masturbation is harmless and is not the cause for your tremors. But it should be made a habit.    So, please send details regarding the frequency for further suggestions.    You can divert your mind for playing games, socializing and involving in busy activities and by not sitting in your room alone.     All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes leg cramps in the nights despite taking Hydroxychloroquine?\n\nI have legs cramps (night time) my dr prescribe hydroxychloroquine 200 mg tab 2 tablet twice a day for two week than 1 tablet twice a week An I don\u2019t feel good,when I take it I\u2019m 70 y and never took medication on my life my pharmacy is on my back yard garden what I do ? I try to contact him n/a",
    "doctor_response": "Hi Went through your post, you have mentioned that you are 70 years and on hydroxy chloroquine for leg cramps. I would suggest you1. stop hydroxy chloroquine as it is known to cause eye damage after 65 years and is not given after 65 2. Hydroxy chloroquine is given in autoimmune arthritis which you don't have 3.Do your vitamin D level if low can cause cramps and Start calcium supplements with good sun exposure daily to your body, things will be better. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for allergic cough\n\nmy nephew(10 Yrs) and i ( 26 yrs) are suffering from  cough and even after treatment of antibiotics medicine we still dont feel any relief. its been nearing three weeks to a month. the doctors have said we have an allergic cough. please recommend some remedies.",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your history. I would like to ask both you and your nephew a few questions like - whether both of you have similar episodes in past? Do you have any symptom other than cough? Did you have fever in the initial days? etc.If you are not having repeated similar episodes, I would first think of post-infectious cough. I would like to suggest you as follows:1. Were I treating you, I would prescribe both of you daily montelukast and levocetirizine/cetirizine and a cough syrup containing guanphensin & terbutaline for at least 7-10 days (depending upon response).2. I would also suggest both of you daily warm saline gargles.3. Please try to avoid exposure to dusts, smokes and air pollution as much as possible. If you are having repeated episodes of similar type, I would suggest you to go for allergy skin testing, which will help you to know and avoid the substances that are causing troubles to you.Hope above measures will help you.Wish both of you a very good recovery and the best of the health.Should you have any query, please feel free to ask at HCM.Thank ou & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a hematoma under the knee cap be treated?\n\nWent to a orthopedic clinic for huge hematoma under knee cap but he wanted to wait three weeks and if it were still there aspirate. Put me on crutches with instructions to ice, wrap and elevate. I\u2019m miserable and soon as the ice is taken off starts swelling immediately. Should I go elsewhere or is there something I can do?",
    "doctor_response": "Hello, Hematoma is nothing but a collection of blood under the skin. If the size is large or the swelling persist for long, you can consult an orthopaedician and drain the swelling preferably under ultrasound guidance. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling inside mouth and between molars?\n\nDr. over the years, I have observed a small annoying swelling inside my mouth and between my molars. It appears suddenly and stays for a day or two at times, and dissapears without treatment. I have observed that my appears when I eat or swallow certain cold food or when I drink very cold water. I use my tongue to probe it and its painless. when I notice it, I usually will start drinking hot fluids and within hours it dissapears on its own. What is this, and what is the cause. should I be worried?",
    "doctor_response": "Thanks for your query. I have gone through your query.The swelling between the molars can be because of the tooth or gum infection. Nothing to be panic, consult a oral physician and get it evaluated.Mean while you can take a course of antibiotics like amoxicillin and metronidazole(if you are not allergic). If it is a tooth infection, it can be treated with root canal treatment. If it is a gum infection, it can be treated with scaling and root planing.I hope my answer will help you. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Medical tips on chances of pregnancy\n\nHi! I had a foreplay session with my boyfriend and we didn t have intercourse but we were rubbing against each other and he did ejaculate but it was above and a little around my vagina. Is there a chance that I can get pregnant? My last period was on 24th July and we did it on the last day of my period. The periods last for 6-7 days and I usually get them a week earlier so my next period should be 17th august.",
    "doctor_response": "Hello, and I hope I can help you today.Is extremely unusual for women to conceive without having intercourse because semen dies when exposed to air.  However, if there were any drops a semen that were directly connected by liquid to your vaginal fluid, there is a possibility that the sperm could swim into your vagina theoretically putting you at risk for pregnancy.In addition, it is unusual for women to ovulate before day seven of their menstrual cycle.  Most women ovulate about two weeks before their period starts, so counting backwards, you probably ovulate around the 10th to the 12th of the month, so you did not have sex during a time where ovulation typically takes place.So in summary, you are theoretical risk for pregnancy, however the actual likelihood giving your situation is extremely low. I would not worry about conceiving in the situation, however if your menstrual cycle is late this month, I would confirm with an over-the-counter urine pregnancy test to make sure your results are negative.I hope I was able to adequately answer your question today, and that this information was helpful.Best wishes,Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low grade fever and face flushing?\n\nHi.  I seem to run a steady low-grade fever and I often have a great deal of face flushing.  It creates redness and actual heat coming off my face.  I stay tired and when this happens regularly, i often develop a few small sores on my back.  My dad called it jungle rot when he got them.  He was in vietnam and korea.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Fever with facial rash may be seen in mums or measles or Acute viral pharyngotonsillitis or thrombocytopenia or associated with acne or boils etc..Until examination is done it is difficult to say what it is.Drink plenty of water, take rest. Eat soft diet .Please use tablet Pantoprazole thrice a day for five days, if symptoms not improved please consult your doctor he will examine do blood investigation and treat you accordingly.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain under right rib,elevated bilirubin and fatty liver?\n\nHello..I am a 29 year old female...5ft2 100lbs..the past couple months I have been getting chest pains ans pain uner my right rib that some times goes to my back...sometimes the pains go to my left side as well..I have had ekgs..and a ultra sound..and blood  work..blood work came back fine but bwilirubin Was 2.5 and US showed mild fatty liver what could be wrong with me ?",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You have fatty liver.  It may be due to consumption of alcohol.  You may have some taken some drugs or may have some inflammation in liver.  You should go for complete liver function test. 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Light headedness, blurry vision, no concentration, out of control actions, shortness of breath. Help\n\nHi doc..i. Had this constantly feeling of light headedness , blurry vision , shortness of breathing , hard to concentrate with any kind of discussion \uff0csometimes feeling like running out of control w/c i dnt know why and it triggers everyday sometimes while driving , working, watching movie . I really dont know what to do pls help.. Tnx",
    "doctor_response": "Hi Thanks for writing to health care magic The symptoms u are describing could most commonly  be due to a panic attack. In this u will have short lasting periods of dizziness, severe anxiety, restlessness, palpitations, excessive sweating, shortness of breath, tingling and numbness, confusion and difficulty concentrating in any work. These occur for 15 mins and start without any reason. They cause a lot of distress. Other conditions like hypoglycaemia, hyperventilation syndrome, thyroid disorders could cause similar symptoms. Hope this helps u Thanks and regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mole on belly that itches, breathlessness. Is it die to stress?\n\nI have a lot of things that is going on. I have not had my cycle since December 28th. I have continue to take pregnancy test mail come back negative. I have mole that s on my belly that continues itches. I had chest pains that I think it s mostly due to stress . Went to the ER and they sent m e home. Stay out of breath. Littl exercise &I Just a little bit overweight 15 lbs.",
    "doctor_response": "Hello and welcome to Healthcare Magic. Thanks for your query. Stress and anxiety can manifest with not only psychological symptoms, but also with a variety of physical or somatic symptoms. However, a mole or an itchy skin lesion is a dermatological problem and is unlikely to be the direct result of stress. You will need a proper physical examination to determine the nature and cause of your skin lesion. Irrespective of this, it appears that you are going through a lot of stress, and so, it would be worthwhile to seek professional help for the same. There are effective psychological therapies which can help you aquire better stress management techniques and coping skills. Wish you all the best. Regards, Dr. Jonas Sundarakumar Consultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can asthma cause muscle soreness?\n\nI am a 52 year old male, 6-0, 175 lbs, in relatively good health with a history of asthma as a child/adolescent.  I do have very infrequent attacks as an adult which are usually well controlled by Proventil.  I exercise daily and my lung capacity is pretty good.  However, the last several times that I've had an asthmatic episode I wake up with extreme general (and very painful) muscle soreness that lingers for at least 24-48 hours.  Does this sound like an unrelated problem or is there some reason that they might be linked?  Thank you very much.",
    "doctor_response": "Hi,Thanks for the follow-up query,Asthma is a chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction and bronchospasm, mostly episodes comes in the night time.Asthma may trigger the oxygen deprivation in tissues by which causing decreasing blood supply,one can have the symptoms of  muscle pain or weakness but there is nothing to worry much because it will end with the immediate asthma medications.The chronic inflammation is associated with airway hyper-responsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness and coughing particularly at night or in the early morning.You must go for spirometry (pulmonary function tests) to measure peak expiratory flow rate and which will help to make a clear diagnosis along with your symptomatology.Treatment is mainly symptomatic which might require inhalational steroids,beta agonists,anticholinergics as MDI or rotahaler as a regular treatment.To decrease the inflammation of bronchi and bronchioles,you might be given oral antihistamines with mast cell stabilizers (montelukast) and steroids (prednisolone) with nebulization and frequently steam inhalation.Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I continue with Lisinopril?\n\nHad blood pressure checked and doctor decided to prescribe lisinopril. This is the first time I 've had to use medication. I'm an otherwise healthy 54 year old man. My type of hypertension is borderline as my BP has been normal as recently as one year ago. No other history of chest pains and I had an EKG last year during my annual physical that was normal. Not sure if I want to continue with the drug, took the first dosage last night before bed, I am physically active, working out 3 times plus per week. Do not have any pain or shortness of breath while excercising. Have a good diet.",
    "doctor_response": "Greetings. Welcome to HCM and thank you for your question. I understand your concern. Lisinopril is a safe and effective drug to lower your blood pressure. Normal blood pressure standardized worldwide is: systolic 100-139 mmHg and diastolic 60-89 mmHg. Figures higher than this, found on three consecutive measurements in both arms, in three different times of day, can be considered as hypertension. Although, this means cannot be precise, but a 24-hour blood pressure monitor is. You can discontinue the lisinopril, if you feel like you do not need it, but based on blood pressure figures. If you discontinue it, you should take the upper mentioned measures, to confirm or exclude the diagnosis of hypertension precisely. It is a good thing that you are physically active, but I would suggest you to engage in physical activity for 60 minutes a day, seven days a week, like walking, swimming, biking etc. Also, a diet low on salt. I hope I was helpful with my answer. Take care. Kind regards, Dr. Meriton",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment to follow after renal failure?\n\nMy husbands blood sugar is 385. He usually keeps it in a normal range with diet and oral meds, Actomet- plus, Janumet, and Prandin. He was recently hospitalized with acute renal failure due to dehydration and chronic use of Cataflam. The doctor stopped the Actomet-plus, and Janumet. He is continuing the Prandin and added Januvia. Would this warrant a visit to the ER or could it wait until office hours in 8 hrs?",
    "doctor_response": "Hello and welcome to HCM.As a specialist,i must assure you that your husband's sugar is very high.It's not safe to wait for 8 hours. Ideally, he should be getting insulin injections, to control the blood sugar.His age and other medications being taken,should be mentioned.He should be checking urine routine, ketones, and micro-albumin,blood ,hemogram,creatinine,HbA1C,FBS,uric acid,sodium,potassium,PP2BS,CXR,and ECG. According to reports,specific treatment will be advised.  Wishing him a speedy recovery.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having lower back pain on left side, CT scan resulted kidney stone, not blocking anything. What should be done?\n\nI started about a month ago having lower back pain on my left side. My doctor advised a cat scan of my pelvic area for possible kidney stone . A kidney stone was discovered but not blocking anything. I was advised no kidney infection with a sample given at the doctors office. My doctor suggestion possible back issues from a 1996 surgery of the L4 and 5 disk. No problems since 96. I started with a chiropractic physician about a month ago. He had a back x-ray taken, told me he could help, after a month I am not so sure. I now have no back pain, but consent pain on my left lower side of my stomach in front with an occasional sharp pain. My body is telling me something is wrong, where do I go from here?",
    "doctor_response": "Welcome to Health Care Magic       Symptoms from the stone may vary \u2013 depending on the size, movement, infection, obstruction and so on.  Urologist is the one to assess and assist         If that is not the reason, Gastroenterologist may have to look at the colon\u2026         Discuss with your doctor - The treating doctor alone can suggest further based on his assessment of the situation.  Wishing well",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of using andrex 40 mcg?\n\nSir, I am using andrex (androxon 40 mcg) for last one month on my dr prescription, when I went to my dr, according to test my testosterone is 4.9. For some days I felt very better, and my growth and weight increased but now I feel acne and hear loss on head, is it reaction of medicin ? Should I use it whole the life ?",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms seem to be related to side effects of the Andrex 40 mg.Some of the common side effects can be:abdominal pain.acne.aggressive behaviour.changes in sexual desire or drive.enlarged prostate.hair loss, thinning hair, or baldness.loss of appetite.mood changes.Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should nausea be a matter of concern while suffering from kidney stones?\n\nI was diagnosed with kidney stones last Friday. I was out of work with them Monday-Wednesday and went bCk yesterday...thinking they had passed. I am still however, very bloated and am actually getting / staying very nauseas, along with not compeletly cleared of the pain. Should I be concerned that I still feel nauseas?",
    "doctor_response": "Hello, It\u2019s part of the stone disease. The stone can cause spams and congestion which will stimulate vomitinv centres and can cause vomiting. You can take over the counter available antiemetic like domperdone for symptomatic relief. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain, General & Family physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes staph infection in stools?\n\nA friend of mine was admitted to hospital after he blacked out and three weeks later after having shoulder surgery contacted a staph infection that they found in the stool.  They think he may have contacted this in  emergency.  What caused this and nothing is clearing it up.  He is 78  6'2 and in good health outside of this blackout which they have diagonsed  as syncope?  Very frustrating.",
    "doctor_response": "Hello and thanks for posting.Sorry to hear about your friend. As far as the infection is concerned, we do not always have the answers why certain infections are found in the intestinal tract. There are many reasons (one of them certainly being in hospitals as you have eluded to). Since you state that he is still having problems with the staph infection, please make sure this gets addressed this week to eradicate and sometimes you can also recommended a probiotic which provides beneficial bacteria to help balance the microbial population in the gut after the acute infection has been successfully treated.Best of luck to your friend.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back nerve pain,and small round bruises which spread quickly\n\nLower back nerve pain , and small round bruises which spread quickly I am 34, female, about 175lbs with minor herniation of discs in lower back (no major health issues).first syptom was sever lower back nerve pain, similar to sciatic pain, but more severe and usual stretches and positions did not relieve it. Pain is constant, sitting, standing, walking.. a few hours later, I saw, small bruises forming all over my knee , then more bruises, all small and round (like I was poked with a finger ). Larger bruising, and visible veins(not notmally visible) on my feet. Bruses seem to quickly spread...knees, legs, ankles, feet, arms, hands. no other pain than the back... I went to an urgent care center for the back pain , noticed the bruising in the doctor s office, mentioned it to the doctor and she said it was nothing and gave me muscle relaxers. Now the bruising has spread.I did not take the muscle relaxers.",
    "doctor_response": "Welcome to Healthcare MagicAre you allergic to anything you would have taken recently. Any itching over the bruising. It can be an urticarial reaction but if there is frank bleeding spots it could be bleeding disorder. Any fever, trouble in urination, abdominal pain. It warrants proper checkup and investigation. Avoid any new drug you may have started under medical supervision as well, after confirmation that a drug as such that may be causing a reaction. Get a second opinion if it gets worse or any abdominal pain, pain in the sides of the back and blood in urine. Take plenty of fresh fruits and vegetables. Drink plenty of water. Consult your Doctor as soon as possible.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the CT scan result indicate?\n\nI had a ct scan done with contrast I m 31 yr old female findings were hypodense lesion in medial midpole right kidney measuring 1.1cm punctuate 1mm non obstructing calculus in lower right kidney. I have a history of kidney stones. Also small amount of physiologic cul-de-sac fluid. Also umbilical hernia containing fat measures 1.1 cm. and cystic lesions on the left side of Scilla with largest measuring 1.8 cm. there is a lobular rim-enhancing cystic lesion in left adnexa likely representing degenerating follicle measuring 1.7cm. I am have severe pain in lower pelvic area. What would be recommended.",
    "doctor_response": "Hello, The scan results indicate a small benign cyst in kidney and a small calculus. The pain in the pelvis can be related to the calculus or a urinary infection that can be diagnosed after a urine test. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for continued heavy cough\n\nHi, I've had cold like symptoms with a heavy cough for a few days now and have started to get stomach pains from coughing, I think?..is there anything i can have apart from the normal cold/flu remedies and cough mixtures to ease this..i'm reluctant to go to the Drs as i don't want a wasted journey to be told to have paracetamol, hot drinks and keep warm...thanks",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .* Primary working tips in your case- deep breathing exercises .- avoid exposure to atmosphere containing pollen , dust ( use face mask)- maintain hydration .- gargles with salted lukewarm water added peppermint oil 3 times a day .- consume honey and basil leaves as ayurvedic healers .- consult later your doctor as per the requirement . Hope this clears your doubt  .Wishing you fine recovery .Welcome for any further  assistance .Regards  take care .Dr. Bhagyesh ( MS , FMAS - consultant surgeon )",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child has increasing lice in hair. Advised neem oil, smells bad. Remedies?\n\nHello, doctor i am nishrin sadriwala from rustumpura  area. I am a worried and concerned mother about my   daughter hair, She  has  got growth of  hair  but  since  last six  months  the  problem of lice has increased rapidly. I  try  my best to clean her hair everyday  but it is in vain .One of my relatives told me about  neem ( limbodi oil) i brought that oil from  Hakim Chichi pharmacy but  the smell of that oil is terrible my daughter is very reluctant to put that oil in her head . pls suggest me some remedies to cure this problem  I  will be grateful .",
    "doctor_response": "Hallo, Head lice are a common problem with preschool and school childrens Head lice bites may cause a child's scalp to become itchy and inflammed and persistent scratching may lead to skin irritation and even infection. Head lice are spread by personal contact or the sharing of combs, brushes, caps and other clothing. Remedies, Holy Basil [ TULSI ] leaves grinded with neem leaves applied on the scalp before taking bath destroys head lice.After that apply coconut oil or any herbal oil  to prevent bad odour. Putting neem leaves and basil leaves under the pillow helps to overcome hair lice problem. Rubbing a lemen piece or applying lemen juice with coconut oil before taking bath helps to destroy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a very faint line in the pregnancy test indicate?\n\nI have missed my periods by 3 days and the test on the strip came weakly positive ( very faint line). I also feel some kind of pain on either sides of pelvic regions since last 2 days and sensation of period like tendency could I be pregnant?",
    "doctor_response": "Hi I will try my best to answer your query. The urine pregnancy test kit is 99.9% accurate.  Almost all urine pregnancy tests will give you accurate results if you test at around the time your period would normally be due; about two weeks after you ovulate. As you have some doubt in your mind regarding the reading i advice you to repeat it after two days. Hope my answer will be helpful for you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are high ast and alt results indicative of liver or pancreatic cancer?\n\nJust received my AST (SGOT) results. 287 which was flagged high. ALT (SGPT) 96 also flagged high. My dad, uncle, grandma all died as a result of liver and pancreases cancer. Should I be worried? I have been taking testosterone treatment and I am young at 56 years old. Could taking testosterone cause this type of symptom? I drink liquor occasionally and maybe a few glasses of wine during the week. I have been advised to see my doctor for further testing. What should I do? Worried in Hawaii",
    "doctor_response": "HiHigh alt and as test indicate liver cancer.You must do a ct scan of whole abdomen and  a biopsy test to rule out cancer.RegardsDr de",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on armpit of an infant?\n\nDear Doctor, I found a lump under my 5 months baby left armpit about 2 months ago. I also notice a significant appetite decrease at about the same time. Her birth weight is 3.2 kg, on exclusive breastfeeding and gained weight pretty well until last month. She has been 6.9 kg since last month, didn t gain an ounce. I have heard that BCG vaccine might have caused this. Is that mean my baby is infected by TBC?",
    "doctor_response": "Hello, I appreciate your concern.                        What your baby has is called a BCG lymphadenitis (swelling of the lymph node in her armpit). Her weight gain so far has been good and if there is no weight loss or fever or pus from the swelling, there is no need to investigate. It should resolve in the next few weeks.When you should take her to a doctor:1. High fever2. Prolonged cough3. Pus from the swelling4. Increase in size of the swellingIt does not mean your child has TB (M. tuberculosis). M. bovis is a type of mycobacterium that is used for the BCG vaccine, and is nothing to worry about. Hope this helps you!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest prerequisites for liver transplantation\n\nmy close friend's brothers has suffered from spleen swelling and enlarged,By Doctor's advice, his spleen was removed. but now he is suffered from liver failure. doctor asked them to change his liver immediately.His family was very poor, they dont know, what to do. Doctor ask them to register his name where the transplantaions are done.please give us the  instruction what  we have to do...?",
    "doctor_response": "Hi and welcome.You have to find hospital that performs liver transplantation in your land and this should be FREE completely. This cant be charged. Doctor who did splenetcomy should advice you about more detailed steps. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I pill cause irregular periods or missed periods?\n\ni did not get periods from september 2011 and i am scared if iam pregnant. but i took i pill within 24 hours of unprotected sex and is it due to the i pill, the irregularity caused. coz i have been using i pill every month atleast twice from few months.",
    "doctor_response": "Hi,Yes, it may cause either. The emergency contraceptive pills like I-pills contain high levels of hormones, so taking them repeatedly could lead to uncomfortable side effects, like headaches, nausea, irregular or delayed periods. Hence, avoid taking these pills frequently.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing pain and discomfort in lower abdomen, painful sex, pelvic area pain, burning sensation. Help?\n\nHi. I have a question. I am experiencing pain and discomfort in my lower abdomen area/pelvic area. It is bloated and it hurt after and a littlw during sexual intercourse. When i push on the pelvic area it hurts and pain goes up to my chest almost a stinging burning sensation. My husband and i have only been with each other sexually so what could it be?",
    "doctor_response": "Hello, and thank you for using Healthcare Magic! In order to precisely answer your question, I would need to ask you a great deal of questions, and examine your abdomen myself.  But I will try to give you some general ideas about what could be causing these symptoms. Fibroids - these are benign tumors that grow in the wall of the uterus.  They are uncommon in women of reproductive age.  If they become large enough they could cause the bloating and lower abdominal pain you are describing Endometriosis - this is caused by tissue that is normally only found lining inner wall of the uterus growing outside the uterus.  This pain is in the region you describe, frequently is worse w/defecation and during sexual intercourse, and also should be worse around the time of your menstrual cycle. Ovarian mass/cancer - These most commonly happen to women after menopause, but the symptoms you describe are consistent with an ovarian mass of some kind.  I am not saying that this is the most likely cause!  It is much more likely something else. The best course of action would be to make an appointment with your family doctor or gynecologist to be examined.  It is possible that if they suspect a mass of some kind they will order a transvaginal sonogram, which is the best way to take pictures of the pelvic organs. I hope I have given you some useful information, and wish you the best of health. Sincerely, Dr. Kinney",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump behind the right ear indicate?\n\nSkull lump hairline behind rt ear -has grown from sz of quarter to length & width 3 fingers -tender to touch -mild painBout week later was very hot to touch bout 3 daysNow extremely itchy rash (looked similar to chicken pox @ first now slightly raised & red still ex itchy)Week before this started -dentist visit -x-rays showed infection lower rt jaw under gum line -no antibiotics given -dentist did 'deep cleaning on 2/3 of teeth avoiding this areaReturning 3 weeks to finish cleaning & removing back molarMentioning dentist visit because I feel maybe relatedThis visit dentist did NOT pretreatment with antibiotics  (as all life been since heart murmur) questioned & was told 'no longer necessary'Again mentioning -feel relatedI am on many medications but no charges for over yearHave auto-immune disorder since cancer & chemo 2001Plz any information would be helpfulAgain feel related this week feel slight pain in ear (like pressure -possibly ear infection -just guessing) but feel it's related to lumps & rashNo new hair products -body or cleaning productsNo recent injuriesAgain...any info appreciated Thank you in advance Sheila May YYYY@YYYY",
    "doctor_response": "Hello,According to my clinical experience, it seems to be of different issues as post-infection lymph node enlargement, sebaceous cyst, or other. If possible, kindly provide a photo picture of the same to evaluate further precisely.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest permanent cure for coccyx in grown hair infection\n\na friend of mine has had several episodes of severe infection of the coccyx.  he said the cause was because of hair growing on the coccyx turning inward and causing it to become infected.  He has lately had another bad infection causing a huge boil.  he went to the doctor again and had it lanced and packed. He was given antibiotics.  I am concerned about his condition. How can this be treated to prevent it from happening again..How can the hair be removed?",
    "doctor_response": "HiWelcome to HCM.I appreciate your concern for your friend.Apparently your friend is suffering from recurrent pilonidal sinus infection.Ingrown hair on the coccyx area (pilonidal sinus) needs to be excised and removed completely to prevent its recurrence. If it is not removed completely then a tract is formed and that gets infected again.A course of antibiotics is just sufficient to control the infection, however the incompletely removed tract or sinus should be excised thoroughly to prevent the recurrent infection.He should consult an expert surgeon to properly assess the length of the tract and to be removed completely with histopathological evidence.Hope this answers your query.A feed back is appreciated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Ferritin level has decreased in spite of taking iron supplements. Should I worry?\n\nHello doctor, I am a 21 year old female. Yesterday, doctors have checked my blood. I am visiting a hospital frequently as I have iron deficiency anemia. The thing I am scared about is, my doctor asked me why my ferritin has not increased (just the opposite, it has decreased from 5.79 to 5.77) after three months of taking iron supplements. My other iron levels are at 39 which has increased considering those references. But, that was probably because I did not use the medicine correctly, I was only taking 5 mg a day. Another thing I am worried about is, my lymphocytes kind of got increased in my blood: (52.8) - the reference is 19.4 to 44.9, and the other one is 3.57. My neutrophils kind of decreased too (36.9) and the reference was between 41.0 to 73.0. In the last week, I had a viral infection as both my parents were sick. Is it why my levels got high? My WBC is 6.77 and RBC is 4.52. My hemoglobin is also increasing actually, last time I checked, it was 11.0 and now it is 11.2. Still low, but it was good to see that it was increasing. My thrombocyte levels got higher again, unfortunately. The first time I was told that I was anemic, my thrombocyte levels were on 485, then in my second blood test (after using iron supplements correctly it decreased to 380. And yesterday, when I checked, it increased to 435 (reference is 156 to 373). I was also told that I have an infection in my urinary system and he gave me antibiotics. Honestly, I have been always getting suspected about it since my anemia has started. Should I be worried about my condition or is it normal?",
    "doctor_response": "Hello. In viral infection, lymphocytosis means increased lymphocytes and neutrophil is relatively low because of increased lymphocytes. Platelet can be high in iron deficiency anemia. It is not a matter of worry just now. You can provide your reports to guide you further. Your hemoglobin level is mildly low and you should be given a good iron-containing medication like Ferrous ascorbate (brand name Orofer that contains 100 mg elemental iron). It should be taken without break for the prescribed duration. The underlying cause for iron deficiency anemia also should be ruled out like bleeding, parasites infestation, etc. Repeat your CBC after a few days. For more information consult a hematologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have Acute myeloid leukemia(AML) and spleen enlargement. How to manage a spleen rupture (if it occurs)?\n\nI am a 70 year old man diagnosed with AML and in a stable condition.  My spleen is severely enlarged and painful treated with morphine 2x daily and hydrocodone every 4 hours.  My spleen has been measured in excess of 30 cm and is very hard and extended.  My concern is the possibility of a rupture of the spleen.  How much pain will be associated with this occurrence and what action should I immediately take.  My Dr has ruled out a splenectomy (sp) as he doesn't think with my very low blood cell counts that I would  survive the surgery.    If you would please advise on the possibility of a non-traumatic rupture.  Thank you, Craig Phillips",
    "doctor_response": "Hi,I read your query very carefully and would like to say:If the spleen rupture did occur than you should go immediately to the hospital, because of the sharp pain in the left superior abdomen.The surgery is the best way to treat spleen rupture.Hope i answered to your question?Dr. Benard",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could it be a gallbladder issue if having sharp pain, heaviness in upper stomach?\n\nhi i started having period like cramping two days ago with sharp stabing pain in my stomach the next morning i got up to more stabbing pain and hardly could walk early the next morning i woke to sever pain in my right side also the night before i had lower back pain im now having heavy ness in my upper stomach area and hurts when walking could be a gallbladder problem",
    "doctor_response": "Yes it could be a gall bladder inflammation( swelling) or a gall bladder stone. You need to consult your doctor and get an ultrasound of your abdomen done to look for gall bladder and pancreas problems.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for muscle and joints pain\n\nMy body is sore everyday. my knees hurt, my shoulders hurt, my hands, my back, my wrists, my feet my neck. It seems the pain is not just coming from my joints but also my muscles. I often wake up with clenched fists in the morning and pain all over. It feels like the pain you get from working out in the gym except it never goes away. My knees are popping audibly. Any advise is appreciated.",
    "doctor_response": "Hello, I have studied your case with diligence.If not relieved then possibility of polyarthritis needs to be consideredRheumatoid arthritis may involve small joints and early morning stiffness in joints, do you have such complain?Ankylosing spondylitis typically involve spine and hips with other large joint also. There is reduced chest function in this disease. Stiffness in spine is increased do you have such stiffness in spine? When such patients come to our hospital I advise them blood test like RA factor, ACCP, ESR, complete blood count, HLA B27Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe nerve pain in backbone, body pain. Surgery prescribed. Alternative treatment?\n\nDear Dr. My father s age is 55+ and is suffuring from sever nervouse pain at the backbone side which creates other nerves pain in the body all the time.we have consulted with the several doctors but all have suggested for the surgery but its too risky as suggested by others dr. as well. kindly suggest thanking you",
    "doctor_response": "Hello Raju and thanks I understand your problem but if all medical therapy fails than we have no option other than surgery. It is not so risky if done by a qualified spine surgeon. If you are scared from surgery than follow some instructions that helps you in maintaining painless spine: 1. Do alternate hot and cold fermentation. 2. Use hard bed to sleep, avoid pillow. 3. Can apply anti-inflammatory gel gently to reduce pain. Use analgesic drugs in worse condition. 4. Do regular physiotherapy and exercise by consulting you physiotherapist. 5. Avoid all long term sitting, standing and driving and wear Lumbrosacral belt. 6. Avoid jerky movements of back. 7. Complete bed rest is best treatment in worse condition. Hope this will help you and if this fails than go for surgery. Do not feel scared as every surgery has its own risk. This surgery has as much risk as other general surgery has. Best Wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reddish itchy rash on the arm. Using a fungal cream. Could this rash be due to the blood draw?\n\nOn the inside bend of my left arm I have a reddish itchy rash . I went to the grocery pharmacist and they thought it might be a fungus and recommended athletes foot cream. Does that sound okay? The area began itching just a little bit, about a month ago. No visual redness or rash until this week. If I am not mistaken, my left arm was the arm where they drew blood for blood work a little over a month ago. would it take this long to develop a rash if it is related to my blood being drawn? Thank you, Lisa",
    "doctor_response": "Hi Lisa, It is very unlikely that you would have a delayed reaction to a needle stick to your arm more than one month after the episode. I feel that this problem is much more acute and might be related to some infection or allergy. It is best to get this evaluated by your doctor before applying any anti-fungal ointment over the area since the cause might be other than a fungal infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is lightheaded, nausea and occasional headaches related to moderate cervical spondylosis ?\n\ni was diagnosidas having moderate cervical spondylosis with multi level posterir disk bulging , with msderaate coprssion to spinal cord and both nerve roots , somstimes i feel ligheheadness and nausea,ossassinaly headaches,please is those symptoms due to the the bulging,thank you.",
    "doctor_response": "Hi, Though cervical spondylitis may results in cervicogenic headache, your symptoms, however, more likely seems to be because of migraine rather than cervicogenic headache. Get an MRI of the brain done to rule out other possibilities.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jaideep Gaver, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of blister at the head of penis?\n\nHi, may I answer your health queries right now ?  Please type your query here... I have a friction blister right at the head of my pennis. It doesnt hurt, however, optically bothers me. If I see it under a strong light I can make out that it has a clear liquid.  This happened right after I had masturbaed without any lubrication and may have been aggressive with my self.  I had controlled masturbation for a month and the blister became smaller but did not go away completely.  I masturbated again and it has filled with liquid again. How can I treat this. I am currently applying Betadine ointment on it and hoping that it will dry quickly.  Could you please tell me what topical cream I can apply on my pennis so that this drys up quickly since I am abstaining from sex with my wife because of this.",
    "doctor_response": "Hi, If you had unprotected sex with unknown person need to think of Sexually transmitted infection. If not it can be bacterial / fungal infection ( share a picture for better understanding). Application of antibiotic/anti-fungal can help you. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the white chunk wedged up in the clitorial area of my daughter?\n\nMy 5 year old daughter complained of her vagina being uncomfortable, when I like I saw a white chunk wedged up in her clitoral area that looked like a white chunk from a tonsil rather than toilet paper... I m VERY concerned and it didn t readily come out so I didn t mess with it.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It seems that there might be collection of some dirt and some secretion from vagina due to not properly cleaning the part.Make a habit of cleaning local part properly while giving her shower. Do not allow her to play outside on ground with dust. Go for urine check up to rule out urinary tract infection as well.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Ramesh M. Vachharajani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication to stop coughing\n\nI have been told I have COPD. I have been having problems for 2 months. I am now having trouble coughing until I throw up, I am on Advair , Albuterol, Sinus medicine, and Muscus relief. Is there anything that will stop this coughing. My broncial tubes are very sore.",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. But COPD ( Chronic Obstructive Pulmonary Disease ) is a disease in which due to airway inflammation,  sputum production is continuous. If infection is there then sputum production is more. So antibiotic may be needed in your case.I also advise you to enroll in pulmonary rehabilitation center where Chest physiotherapy and deep breathing exercise Are done. This will help you in clearing your secretions easily. You can also try mucolytic and expectorant like N acetyl cystine (NAC), Ambroxol and guifenacine.Zince all these are prescribed drugs, you should consult pulmonologist and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes prolonged cough?\n\nHi my son is 4 years old and has had a cough for 2 months. I took him to a doctor 4 days ago and they suspect asthma and has been given an inhaler. However his cough has gotten worse over the past two days especially at night. I rang the doctor today and she said the inhaler will take two weeks to work but thats too long to wait it out. He hasn t slept well for over 2 months and hasn t eaten properly in 2 months. What do i do",
    "doctor_response": "Hellowelcome to hcmwell there is no point in giving inhaler blindly on hitand trial basis without making a PRECISE AND ACCURATE DIAGNOSIS moreover inhaler is meant for IMMEDIETE RELIEF and its wrong to say that it takes 2 weeks to work....anyways first and foremost the root cause of your sons cough and for that you need to get the following tests done(1) CH WITH ABSOLUTE EOSINOPHILIC COUNT(2) ESR(3) PFT i.e PULMONARY FUNCTION TESTS(4) XRAY OF CHESTOnce you  get these tests done kindly send me the scanned copy of your reports so that i can evaluate to make a precise diagnosis and start the appropriate treatmenttake caredr rahul..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat dark brown rash that turns red is also itchy on hands?\n\nMy 32 year old daughter developed a flat dark brown rash that turns dark red and is not itchy. It is on both sides of her hands and up one thumb. . Has been there for 2 weeks and is non changed . She works in Many Daycares daily , could this be a virus ?",
    "doctor_response": "Hi, It could be a contact dermatitis that occurs due to the contact with several materials at work or at home, materials that we make contact in our everyday life. She should meet an allergist or dermatologist and do a Patch test. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gjustina Loloci, Allergist and Immunologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Am hypothyroidism patient. On Levothyroxine. Had chest pains. Increased the dose. Now feel some sensations in throat. Treatment?\n\nHello. I was am a hypothyroidism patient and I was taking Levothyroxine for about 7 years with my dosages going up and down but mostly up. Well, about a month and a half ago, I had to see the ER Doctor because I was having chest pains..caused by my recent (higher) dosage prescribed by doctor. I was on 75mcg of Levothyroxine and my doctor increased my dosage to 100mcg. After about 13 days I started having the chest pain like mentioned and went to the Emergency Room. I told the doctor about my chest pain, about the new dosage raise and about in time past that another doctor tried to raise my prescription to 100mcg and it done the same thing...gave me bad chest pain. I told the ER Doctor I was tired of the Levothyroxine cause it would only work for 2-3 months and would begin to stop working and when other doctors would raise me up to the 100mcg mark it would cause my chest to hurt. So, I asked if he would prescribe me Armour Thyroid to see if it would be better. So the ER doctor prescribed it for me with a dosage of 60mg equal to the 100mcg in Levothyroxine. After only maybe 5-6 days of taking Armour Thyroid 60mg I started having this funny sensations in my throat around abouts where my thyroid would be. It's a feeling of like there is something in my throat or something and sometimes I get twinges of pain. I went back to my family doctor and his nurse saw me and she felt of my throat to see if my throat had any swelling...which she said she couldn't feel any swelling. And she thought it could be allergies causing my throat to feel like this...but after those several days taking the Armour, my throat has been feeling like this.  I just don't know what to do or what's going on. I am really scared over it. There are times my throat feels worse than other times..but most of the time it's a constant feeling of \"something there\". Is this the Armour Thyroid medication causing this??? I breathe okay but this funny feeling in my throat scares me because I get afraid of that my throat will close off. It scares me so bad sometimes that it gives me a panic attack. Please Help! I'm so scared!",
    "doctor_response": "THE DOSAGE OF THYROID MEDICINES HAVE TO BE ADJUSTED AFTER THREE MONTHS AND IT CAN DECREASE OR INCREASE DEPENDING ON THE TSH LEVELS I HAVE MAY PATIENTS WHO ARE ALLERGIC TO THYROID MEDICINES AND SALTA ALSO CAN CAUSE THESE PROBLEMS YOU SHOULD CONSULT YOUR DOCTOR TO ADJUST SALTS AND DOSAGE ACCORDINLYTHERE CAN BE GERD FROM THYROID SALTS AND CAN CAUSE THROAT SENSATIONSNEED TO ADD LIQUID ANTACID TO PREVENTFOR BREATHING PROBLEMS YOU CAN ADD ANTIALLERGIC MONTELUCAST 10 MG CAN BE TAKEN SAFELY AS LONG AS YOU LIKE AND OFF AND ONBRONCHODILATOR SYP ALSO CAN HELP OFF AND ON",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe back pain. Unable to sit, stand for long, trouble in sleeping. Will surgery help?\n\nHi, I ve been having back pain since 2006 and just know got an MRI the MRI says disc desiccation with an anular disc bulge and a left paracentral disc protrusion with an anular tear minimally displace the left S1 nerve root , create minimal bilateral neural foraminal narrowing and minimal central canal stenosis at L5-S1. I m a cop in the navy and I can barely walk, sit, stand for long periods of time without being in pain and I have trouble sleeping due to all the pain as well. Would surgery be the best thing to do and will/should I continue to do my job with all this pain?",
    "doctor_response": "hi decision surgerydegenerated disc depends on many factors i.e. what kind of excercises and physiotherapy you are doing at present and are you exhausted with it? secondly, how much  leg pain do you have weather it is equal ,more or less then the backpainand is there any neurodeficit? lastly your age, weight , general condition and preexisting risk factors like diabetes hypertension etc. pain relief after surgery and long term outcomes depend upon what kind of surgery is planned like just decompression or decompression with fusion or decompression with disc replacement etc? general idea is if your exhuasted with  all kind conservative approach  then only think of surgery unless you have neurodeficit in your lower limbs take one more opinion of good spine surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pus filled gum?\n\nhiya i cracked a tooth bout 3 months ago and have had to keep pain down with paracetamol it stoped hurting for about 2 months and today i have noticed a puss filled pimple like thing on my gum next to the tooth in question and it has a bad smell to it iam a bit concerned and terifyed of dentists what could it be and what can i do ?",
    "doctor_response": "hi thanks for consulting HCM..your history suggest that your tooth was cracked deeply enough to involve the pulp and would have got infected afterwards to cause this pimple like pus filled swelling..i would suggest you to go to your dentist and get a thorough examination and intraoral radiograph done of the concerned teeth..there is no need to fear from dentist as this examination does not hurt..the probable treatment may be Root canal treatment if the root of tooth is sound for rct... he will prescribe you some antibiotics for infection...hope this will help you..",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to control high level of Eosinophils?\n\nIn blood test carried our yesterday, the value of Eosinophils came out to be 19.6 against normal 0-6. What are the risks involved if not controlled in time. How do we control this high level and what do we eat or do to bring the level to normal range.Thanks,Rais Ahmed Farooqui",
    "doctor_response": "High eosinophil count may be due tobmany reason like allergic condition parasitic infection, immune disorders, asthma.or may be idiopathic or some other reason. So first search the cause for eosinophilia and treat accordingly.  DEC Is the useful drug to lower the level.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes flattened thecal sac with severe bilateral foraminal stenosis?\n\nI have flattened thecal sac at c6/7 and c7/t1 with severe bilateral foraminal stenosis at C6/7. C5/6 were fused in 2009. My symptoms are left arm and hand (primarily middle finger and pointer) pain. Is this serious? I also have developed frequent sporadic episodes of numbness down slightly left to center of left leg. also at ankle - not necessarily both at the same time. Recently I have also had a few episodes of dizziness, especially when lowering head, and it feels like something is pushing me to the right. This last symptom comes and goes, last few days it has been better. Can you tell me if any of this is serious, and if this correlates with the MRI findings. Thank you.",
    "doctor_response": "Yes in my opinion your pain related symptoms and MRI findings are matching. However dizziness cannot be explained based on MRI findings alone. If the pain is severe and affecting your daily routine , it should be taken up as a serious issue and will need evaluation. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant headache after tooth extraction?\n\nI had three teeth extracted on thursday. they have since healed up nicely but since friday evening I have had a constant, horrible headache (moving my head, bending over, etc... is excruciating). When I am able to sleep for a few hours I am covered in sweat.",
    "doctor_response": "Hi..Thanks for the query..Headache after tooth extraction can be due to radiating pain from extraction site..But if there is no pain at the extraction site then the headache can be unrelated to the dental extraction..You can take painkillers to relieve pain but in case if there is no improvement or recurring episodes of headache then consult an Emergency room and get evaluated..Hope this helps..Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on right breast with a thick cord attached?\n\nI have a chickpea sized lump on right breast with a thick 'cord' attached. The cord travels down breast into top of rib cage. Had mammo and ultrasound. Will see surgeon soon, but in meantime, could this be a non-malignant condition? I've never had cancer.",
    "doctor_response": "I would like to know your age? and whether anyone of your relatives (maternal side preferably) had breast cancer or ovarian cancer..?? or whether u have had ovarian mass too...?? so get a pelvis Ultrasound done too. yes obviously it could be a Non-malignant condition like for example fibroadenosis..but i can comment on that only after knowing the above details and if you can tell me the Mammo & Ultrasound reports.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lupus disease\n\nI haveeen diagnosed with lupus (sle). I was diagnosed quite a while ago, but no doctors seem willing to give me predict. I know why...but when I took it 2.5 mom once a day,it helped. This is a very conservative town. I know the problems associated with predict, nut now I am having unbearable symptoms...probably a flare. What can I do?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have lupus positive. It is autoimmune disease. You should go for complete ANA profile test.  It will give you exact type. Then you should take treatment accordingly. Steroids will help you.  It is immunosuppressive drug. It will suppress your immunity so symptoms of autoimmunity is relieved. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe pains in the belly button\n\nI am a 16 year old male. I am having severe pains right in my bully button. I cant stand up straight up or else it hurts. I can hunch my back and barely feel it at all. I was urinating today and the pain was excruciating and I felt like I was going to pass out. It happens a couple times a month and the pains subsides after a couple f hours. Please help! Thanks",
    "doctor_response": "in my opinion you have a rare condition called Urachal Cystyou need to see an urologist you will probably be given antibioticsGood Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do I need to get surgery done for my anteriorlisthesis?\n\nHi, i have been diagnosed with L5 S1 anteriorlisthesis of Grade 1. I am 36 years old and maintain a very healthy lifestyle and fitness regimen. I have experienced lower back pain only once which lasted for 3 days. Do i need a surgery or will regular and proper exercise keep this condition from getting worse?",
    "doctor_response": "Hello!My name is Dr. Aida and I am glad to attend you on Healthcaremagic!At this stage of listhesis, considering your complaints, I would not recommend surgery. Avoiding heavy weight lifting and prolonged standing up or sitting position is necessary to avoid the progression of the disorder. Periodical follow ups with lumbar CT scan or MRI are necessary to investigate for possible progression. In case of increased pain or limited physical activity, surgery may be needed. Hope to have been helpful to you!Best wishes!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Did I have a groin pull?\n\nI fell off my bike and landed hard on my hip. I think i have a groin pull but need confirmation. Groin hurts. Hip flexor hurts. Under right buttcheek hurts. What do you think? Its been 10 days. Still limping. Getting better with range of motion but feeling more.",
    "doctor_response": "Hello, As you fell from a bike I suspect you have a muscle and ligament injury at the hip joint due to which the healing is getting delayed and most muscles around the hip joint are painful. I will advise you to take maximum bed rest where the muscle and ligament can heal. Post 2 weeks of rest you can slowly start exercising the hip muscles in static exercises and core stability exercise for the abdomen. Post which range of motion will be advised and then later the strengthening exercises. Balance board training should be a part of the exercise program to improve muscle Imbalance and joint stability. In my clinical practice of over 12 years, most cases respond well to the above-mentioned procedure under a guided physiotherapist. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Prolonged periods. Sharp pains in abdomen. Had ovarian cyst, cervical cancer previously. Cancer relapsed?\n\nhi I am 24 years old I have been on my period for a month and 4 days it has not stopped. in the past I have had ovarian cyst and cervical cancer (stage 2) which my doctor told me she got back that was back in april, Could the cancer maybe back or the cyst or could it be something else that is causing me to bleed? I have been having really sharp pains in my stomach today and in the lower area. I do not have much of energy. I would go back to my doctor, but now I do not have any insurance and I do not have the money to go back.",
    "doctor_response": "Hi, I can understand your concern. You should have to mention the details of treatment you have received. Anyway cervical cancer has  a chance to relapse. excessive bleeding is warning sign. you have to mention your cervical cytology report that is the pap smear report . If anything suspicious was found then you should proceed with a biopsy to rule out recurrence. Please do not delay . Consult your doctor immediately.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes brown spot on the hard and soft palates?\n\nI m a 57 yr old female, 5 6 , 140 lbs. Have never had any health issues, and am seldom sick. I have a brown tint to my hard and soft palate and a yellow spot on the throat part behind my last bottom tooth. What could this be. The brown tint has been there for 3 yrs or more but I just noticed the yellow spot. Thank you",
    "doctor_response": "thanks for your query, i have gone through your query. the brown discoloration could be a normal melanin pigmentation or it can be ectopic eruption of sebaceous glands(fordyces spots) or secondary to smoking habit(if you have). nothing to worry it will not harm you. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red spots with pain on the penis?\n\ni am 29 , 3 months before only i maaired, after 2 months of marriage one day i noticed i have some problem in my pennis like fungas infection, small red dots and liite pain........same time i use some cream on pennis contain Beclomethasone Dipropionate, Clotrimazole and Neomycin cream, i got some relif for one week afer that i went back to my job in UAE , but now again i am facing the same problem... since last one month i am not doing any sexual intercourse , because wife is not with me she is at my home in India,  how can i solve this infection.... give me a soilution",
    "doctor_response": "Hello, I am afraid it could be due to some sexually transmitted infections. I suggest you visit your doctor for your complete checkup and treatment if needed. If it's proven to be STI, you have to take oral/intravenous antibiotic treatment. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. SAMEEN BIN NAEEM, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach cancer which is spreading towards omentum & on erib\n\none of my relative have Stage IV - Signet cell adenocarcinoma Stomach cancer and also spread in omentum  & one rib, our doctor have initiated chemotherapy (pallative) - 1 cycle completed and ask us to wait till two more cycles to complete to come on to conclusion. please suggest me what is the survival chance?? is it completely curable or how to increase her survival??",
    "doctor_response": "the 5 year survival rate for stage 4 stomach cancer is only 4%.The intent of treatment is palliation not cure and improving quality of life.Chemotherapy combinations like cisplatin and capecitabine can keep the tumour under control.After 3 cycles CT scan of whole abdomen needs to be done to response of chemotherapy to tumour.If it is partial response or stable disease then 3 more cycles can be given but if disease progresses then second line chemotherapy has to be givenRegardsDR De",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Do I need an injection for a dog bite?\n\nHi doctor, I am 18 years old. I was playing with my friend's dog yesterday. By mistake, the dog's teeth touched my hand, and a little drop of blood came out. Do I did need an injection?",
    "doctor_response": "Hi. If your friend has done a vaccination to the dog, then there is no problem. Keep the bitten site clean, wash with warm water and soap. Apply Oxygenated water and Betadine (Povidone Iodine) locally. You can take them over the counter, and there is no need for a prescription. As you are 18 years old, and if still, you are getting your scheduled vaccines, then there is no need for getting another Tetani injection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the use of hCG injection?\n\nHi doctor, In the last two months my period span was 34 days. As I am trying to get conceive I went to gynecologist to know is there any wrong. She asked me to get CBC (complete blood count), hormone test and urine test.\u00a0My blood sugar and all other are normal. My LH 6.31, FSH 7.91 and prolactin 53.92. During\u00a0my next visit she did pelvic test and started transvaginal USG. She did four set of T-USG and yesterday she gave me hCG 5000 injection. I am very much confused because she told me if my RH ovary value become minimum 2 then it will be fine to conceive. Yesterday it was 3 and still she gave injection.\u00a0I got married before one and a half year and I am trying to conceive only for the past three months. Why is she doing all these tests? Are these\u00a0really required?\u00a0We can wait still one year to conceive naturally.\u00a0Please find the attached T-USG result and give me some advice.",
    "doctor_response": "Hi. I have read your problem and seen the pictures (attachment removed to protect patient identity). For further information consult an infertility specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tiredness after allergic reaction to ant bite?\n\nI had a severe allergic reaction to an ant bite about a week and a half ago. Blood pressure dropped to 70/63 and was rushed to the ER and was given loads of Benadryl, went through 2 bags of fluid and had to be put on oxygen. I m still very tired though, I have this running exhaustion feeling. My question is- how long is this supposed to last? Is it normal for me to be feeling so tired?",
    "doctor_response": "hi,see allergic reaction can be immediate,late and/or delayed from which the later can be last for more than 2 days,so u might have delayed hypersensitivity/Allergic reaction due to ant bite.If this problem remains even after few weeks uand u still feel exhaustion or tired then there will be some other cause.u need to see your physician for correct diagnosis but dont worry nothing serious,u will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yellow and white dotted stools in babies?\n\nmy sister in lows baby s is about a month old when she poops its yellow with white dots her doctor say there nothing they can do about they also changed her furmala two time and she went back to breast feeding.is it normal that shes pooping yellow with white dots and runny",
    "doctor_response": "Hi... this is quite common in this age group. You need not worry about this type of motion.Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I concieve if I have a chocolate cyst in my left ovary and fibroids in my uterus ?\n\nI m 31yrs, It has been 3 yrs since we got married. I conceived twice but in my first conception I had bleeding in 5 week then I had D&C in 12th week as my child had no heart beat.In the next conception again I had bleeding and it aborted naturally in 2nd month.After this I didnt conceive for a year inspite of several follicular studies and natural contact. This year 2011,I had laparoscopy in the month of april it was found that I had chocolate cyst of 3*.3cm in my left ovary and a fibroid 1*2cm in uterus.Right and left tube are normal and the spill is mild positive on both sides.In the month of May I had IUI but I didn t conceive. This month(June-2011) on my 4th day of periods I had Lupride depot injection. Inspite of many problems, Are there possibilities for me to conceive, please do clear me. My husband has 30 million sperm count and 65% mobility.",
    "doctor_response": "Well,your husband's counts are ok .In your case,the fibroid is very small,and should be a cause for infertility.The chocolate cyst is pretty significant in size and i believe should be removed.Now,chocolate cyst generally cause endometriosis which results in difficulty in conception sometimes.But in your case,conception doesnt seem to be the problem.Its the maintaining of the pregnancy that is.At least in the earlier one.Im guessing that the chocolate cyst has developed in the last few months causing difficulty in conception.I suggest getting that treated first and then see a fertility specialist again for ovulation studies.Lupride is a drug to treat endometriosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat excessive fatigue while having enlarged liver and hiatus hernia?\n\nHi, I have gone to the doctor and have been told that I have an enlarged liver. It is palpable. I have extreme fatigue, bloating, and foamy urine. I am a perimenopausal 54 year old woman. I have a healthy diet, am 5 8 and 147 lbs. I am a moderate drinker but never to excess. Never smoked, don t do drugs. My enlarged liver presses on my stomach and makes it difficult to,eat much at a time and causes discomfort after eating.I am so,tired of feeling bad. I have had an endoscopy, a colonoscopy and a CT scan. They found,a small heital hurnea and the enlarged liver.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Usually, liver enlargement may indicate some types of hepatitis or fatty liver diseases, and in most cases, it doesn't require any specific treatment.If this is caused by diet, obesity and diabetes then dietary and lifestyle changes will be beneficial in every case. Alcohol and viral hepatitis are most common causes, and in this case, medical evaluation is required.Also, if there is infectious disease or biliary duct disorders then you need to do some tests to rule out more serious issues which require specific treatment.You need to check your viral markers and do liver biopsy if necessary.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Ivan R. Rommstein",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for nightfall\n\nis frequent nightfall hazadious for health...m  22 year old,62 kg weight..i hv been sufering from nightfall since five years...my penis n sperms hv become so thin...nightfall occurs 2-3 times in week...sometimes 1 time in 10 days...please tl me docter what shud i do to overcome this problem",
    "doctor_response": "Hello, Please understand nightfall is not unhealthy. Night fall is a natural phenomenon and there is nothing to worry about it. You can contact me for treatment options. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Semen leakage while sitting, clear urine without pain. What to do?\n\nhello sir, im 31yrs old working as an accountant my problem that was started from 18/06/12 till today onwards i observed from my pennis leakages a sperm while sitting. but i cant realised while getting out from my pennis. urine is going clear without any pain. but problems that leakage of white sperm from my penis . pls advise what to do ? thnk nazee",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry. Semen is a waste product. Body produces sperm whenever it is sexually aroused. Such semen needs to be thrown out of body. If we do not do it through masturbation or sex, body finds other ways. Emission as droplets through urine, night fall etc are body procedures. Small amounts of semen escape through penis is quite normal and there is nothingn to worry about. Worry only if there is any pain or burning sensation.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low LDL levels with abdominal ectasia\n\nI have taken medication for abnormal cholesterol for a numbe of years. I am now 81 and was diagnosed by CT scan with a small abdominal aectasia and extensive plaque along most of the aorta.  I have been taking Crestor 5 mg for a few months.  It was increased to 10 mg.  Tests yesterday show that LDL had decreased from 70 to 17. What is the treatment?",
    "doctor_response": "Hello ,Small abdominal ectasia can be because of atherosclerosis and both are due to age related wear and tear . As such there is No lower limit for Ldl.  Studies have found Ldl even lower than 50 had no side effects and decreased atherosclrotic progression . The guidelines recommend that Ldl should be kept below 70 . I would recommend that you may decrease the dose of Crestor to 5 mg . That should suffice and would give you optimum benefit . More than by all means is not required . Regards Dr . Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does flaky belly button lead to cancer?\n\nHello, A few months ago, my belly button became itchy and flaky. When I scratched it, it became red. Also, I don t really clean it as often as I should so there is a lot of black build up in my belly button. However, there is no discharge; just itchy (when I aggravate it) and flaky. I ve just read an article saying that a dermatologist had a flaky belly button and it ended up being cancer. I have set up an appointment with my doctor but just wanted to ask someone on here first what it could be. Thank you for all your help!",
    "doctor_response": "Thanks for your question on HCM.Yes, you are right. Continuous irritation of any skin part can lead to skin malignancy.  But chances are very rare.Belly button is common site for this. As alot of perspiration accumulate in that area. Ans you told that your hygiene for this part was not good. Which again is a risk factor.And constant rubbing, friction, blackening, irritation lead to skin infection mostly and rarely malignancy.So I advice you to check1. sugar levek as diabetes can cause similar skin condition.2. Wear cottin clothes. Avoid tight clothings.3. Maintain proper hygiene of this part.4. Consult dermatologist for proper clinical examination.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe abdominal pain?\n\nI have a dr apt tomorrow, but am trying to decide if I should go to the emergency room tonight. I ve had uti in the past and bladder infections but this feels much different than that. the pain is severe in my lower right abdomen and back. it has gotten progressively worse in the last few hours. I ve suddenly developed a case of diarrhea...and I don t know if it s a kidney infection. appendicitis, or something else. my dr is a country dr that hasn t been real knowledgable and helpful with other medical conditions I have .what are your thoughts. I; m 41 female.. ask what you need to if you need more info.i cant afford this i m on ssi and ssdi",
    "doctor_response": "HI.Thanks for your query and an elucidate history. The most probable cause of such a pain in right power abdomen and back with the known history of UTI in the past and sudden development of diarrhea are :Appendicitis as the most probable cause.Severe intestinal infection can also cause same things. Infection in the right kidney or a stone in the ureter - but less likely to give diarrhea.I would advise you the following:Rush to ER to check for the vitals and to get urgent ultrasonography, blood and urine checked to get an idea so that further steps and decisions can be taken fast. A course of antibiotic, metronidazole, probiotic ans symptomatic treatment should solve the problem,IF no relief further investigations and specialist's opinion can be sought.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does herbal supplement reduce the effectiveness of contraceptive pills?\n\nIm 40 years old ,female,married with four children. My query is about contraceptive pills and herbal supplement i should avoid that it may affect or lessen the effecriveness of the pills,another thing is it  ok to take chlorella even im taking my contraceptive pills?",
    "doctor_response": "Welcome to HealthcareMagic,It would have been helpful if you could provide more detail about the contraceptive pill and herbal medicine you are taking. To answer you question in general herbal supplements do not interfere with the contraceptive action of the contraceptive pills, so the herbal supplements can be taken.Chlorella is an antioxidant and it not interfere with the contraceptive pill and hence can be taken. Hope that answers your question.Regards, Dr.Imaad.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated blood urea levels?\n\nMy father age 63, weight 53.he tested creatitine,blood urea and pottosaium 3weeks back.it is 1.1, 35, 6 and after 3weeks he again tested it is 1.2, 94, 5.4. why there is sudden increase in blood urea,my father is diabetic and heart patient.He is under medical management and using medicines for that and doctor said to take only 1litre per day.what further tests needed and y sudden raise in urea what is the reason.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. In your father's case it may have happened due to his issues or medication.Hi must stay hydrated at the moment. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tooth extraction, antibiotics, heavily bleeding. Blood poisoning?\n\nhi, i just had a tooth extraction on a tooth that was absessed for the past month. I have been on 3 different antibiotics until I could get into see dr. The dentist took over 1hr to pull the tooth however hasnt prescribed any more antibiotics even though the absess was actually still there. Its been three hours since the extraction, my tooth is still heavily bleeding and my heart has not stopped pounding. Should I be concerned with blood posioning?",
    "doctor_response": "hi welcome to hcm forum as oper your description you had abscess and the teeth extract. after the teeth extract there will be bleeding for 1-2 days you should not panic for this the bleeding would be minimal, this will stop. you donot have to be concerned about blood posioning.. if uyou want to clarify more doubt  i will advised you to meet your dentist who extract the tooth he will give you futhur guidance . wishing you for early recovery DR ROSHAN BHANDARI",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with epilepsy, taking Epilem. Had seizures and test showed low levels like body not absorbing medicine. Cause?\n\nGood day Doc  I'm a 35yr old male ,dx with epilepsy both grand mal  & generalised / partial.I've been on the epilim for 6 weeks however had a seziure last week & when test was done it showed my levels where so low as if i'm not compliant with meds.I was on 300MG morning & 600mg at night doctor now uncreased to 600mmg X 2 for PD.What would be the reason for epilim not taking to body?",
    "doctor_response": "HelloWelcome to HCMEpilim or sodium valproate is a nice medicines for seizures. It is a broadspectrum anti-epileptic drug with good effect in grand-mal epilepsy. You have been taking the medicine in 900 mg per day dose and there occur one seizure episode. The levels of medicines came in lower range. Best thing that can be done is to increase the dose of epilim and that the doctor has done already. Normal doses of the drug depends upon the body weight. For a healthy male with average built the doses are about 1000 mg per day, so if the levels came in low range there is no need to worry. At optimum doses the levels will come in therapeutic range.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is problable left ventricular with cough concerning?\n\ni recently had a ecg which showed probable left ventricular I was told I was fine but I still experience the pain and symptoms which are worsening and now are associared with a cough can you help explain and what should I do??? I am 42 year old female",
    "doctor_response": "Thanks for your question on HCM.In my opinion you should consult cardiologist and get done1. Stress test2. 2D echoTo rule out cardiac cause.As many times ECG can come normal or minimal changes.But actual cardiac damage is more than what see on ECG.You are also in perimenopausal age. In this age,the cardio protective effect of estrogen is decreasing. So women are at increased risk in this age group.So better to consult cardiologist and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it safe to take more than one P2 pill after unprotected sex?\n\nHi doctor, My fiance and I were fooling around yesterday and I had semen smeared all over my vagina. He was not wearing a condom. We did not have penetrative sex. However, after the encounter, I got nervous and got emergency pills. All this happened about 14 days after my last period. I assumed I was highly fertile and was at risk for pregnancy. P2, I took one about three hours after my vagina was smeared with semen. I took the next pill 12 hours after the first. Here are my questions: 1. I really do not want a pregnancy right now. Is it wise if I take a second dose of the pill to completely reduce chances of implantation? Is it safe to take a higher dose of pills to completely eradicate any possibility of pregnancy? 2. What else can I do to make sure I am completely out of the woods? 3. Also, after seven days, is it okay for me to start taking antibiotics to eradicate any infections passed? Can general antibiotics like Amoxil treat the treatable STI? 4. When is the most prudent time to take an HIV test? 5. How effective is P2 when taken during ovulation? I did a little research and some said that P2 will not help if it is taken during ovulation. 6. How can I (in case I get pregnant) make the uterus inhospitable for the growth of the embryo? 7. When should I take a pregnancy test? 8. What is the safest mode of getting rid of a fertilised egg within the first few weeks? 9. My period should be in two weeks or 15 days from now. Is it guarantee that if it delays I am pregnant? Is it also possible for me to have my period yet still be pregnant? 10. Lastly, what are the chances in terms of percentage that I might be pregnant without necessarily having penetrative intercourse?",
    "doctor_response": "Hi. How are you doing? That is a lot of questions, but all leading to the same answer. An emergency pill is high dose Progesterone, best taken within three days of sex. Best results if taken within 24 hours of sex. Being a high dose Progesterone, the uterine lining becomes very unfavorable for a possible embryo implantation. The lining suddenly becomes very thick. As it is a single dose, the lining cannot stand on its own and it falls off. But you rightly said success depends on which phase of the cycle you took it. If ovulation had just occurred that day, still there are equal chances of pregnancy and miscarriage. About the questions: 1. You should have the second dose. It will improve chance of embryo not getting implanted. 2. Only after you reach the other end you can confirm that you are out of the woods. You will have to wait for the period. 3. You can have antibiotics anyday, Azithromycin, Doxycycline would be a better choice. 4. HIV can be tested any time now and after six months repeated. 5 and 6 already answered. 7. The pregnancy test can be done earliest one day after the expected period. 8. If positive, you will need a scan to confirm intrauterine pregnancy after two weeks, then MTP (medical termination of pregnancy) can be used. 9. Emergency pill disturbs the hormones, so only the pregnancy test will give you some information. 10. Sperms can swim up even from your thighs into the vagina, so the chance of pregnancy is still there.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i stop using Levonorgestrel and Ethinlyl estradiol tablets as it is causing severe abdominal pain?\n\ndear sir, my wife is using Levonorgestrel + Ethinlyl estradiol tablets from last two days. From tha last two days, she is complaining severe pain in the aabdomen, is this may be due to this dosage form? what should i do? may she discontinue the same? please suggest",
    "doctor_response": "Hi,Thanks for writing to HCM.If they are causing severe pain then you can discontinue them. But you need to see your gynecologist for an alternate method of contraception.Dr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low urine output in a child\n\nMy baby girl is 10 months old and she is urinating less these days. she doesn t pass urine throughout night and after waking up also she doesn t pass urine soon. I give her water, feed and then after an hour or so she passes urine that to less. she is passing urine every 4-5 hours or u can say 3-4 times in a day. pls. help",
    "doctor_response": "Good morning..!!Normally infants should urinate atleat 5-6 times a day. Your girl passes 3-4 times, that's bit on the lower side, but ok. Not to worry much.Continue breast feeding, give her more fluid (juices) containing diet.Thank you, have a nice day..!!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for excessive night urination after surgery for prostatic cancer?\n\nCan you please tell me how many robotic surgeries dr. Singal performed.  Our son  had prostatic cancer and had the surgery Dec. 19/13.  He lives in toro ton and I, his mother , lives in alberta.  Emotionally he does not seem to be doing that we'll even after having no cancer spreading.  I am so concerned about him and he is having constant leakage even at night.  I don't know what to tell him.",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern, if this is case of malignancy of prostrate gland and had gone under the surgical procedure then medicine has got the very little role or no role in the nocturnal enuresis, stop drinking the water from evening is the best way some molecules are available but their roles are doubtful because of the malignancy process, your son has to discuss it with the surgeon have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent chest pain with dizziness?\n\nHi, may I answer your health queries right now ? Please type your query here...I have gone to the doctor plenty of times for the same problems. Its chest pain, majority wise on the right side at the end of my ribs. The first time they diagnosis me they told me I had a swelling of cartilage in my chest cavity causing pain. It went away for a week or so then got worse. The next time they told me I had anxiety and put me on depression medicine, the pain went away for a while but came back. I went again and they told me I had an infection on the lining of my lungs, called pleurlyis. The medicine is almost done and i STILL have chest pain. Now along with that I have dizziness, mostly occuring at night, it used to go away when I sit, and now it doesn t go away at all. I eat regularly, I have had my eyes checked and have 20/20 vision. Why am I still in pain. Every time I went to the doctor, it was for the same reason, and every time they tell me I have something else. I have a chest cave in and they are saying I need surgery on it, if so why is it happening when I am 18, and now out of all the years I have had it, they said it is pushing on my heart and liver..then why do I have pain on the right side?",
    "doctor_response": "Hi, According to the history you provided, I would recommend you to do a chest CT to be completely sure about the lungs. Please discuss with your doctor. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jnikolla, Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for muscle pain & dizziness\n\nI am 14 and had muscle pain and dizziness and headache and back pain non stop for the past 4 years. I have been to almost every type of doctor we can think of and nobody can find anything. I ve had a muscle biopsy that showed nothing wrong. this past month my symptoms have gotten way worse. I m running out of options I need a diagnosis.",
    "doctor_response": "Hi, Chronic fatigue syndrome characterised by headache, muscle pain, dizziness, back pain will aggravated on exercise not relieved by rest at least for the last 6 months. Cause is mostly genetic and environmental. No definitive treatment is available, stress relieving exercise and anti-depressants will help. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Krishnakanth. K., Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itchy ear, throat and congested nose. Is it an infection or allergy?\n\nHi, I woke up a couple days ago with my left ear quite itchy. The left side of my throat also seems to be itchy. Just today, my left nostril is congested and runny. I am a woman of 21 years of age and I have never had allergies before. Could this be the start? Or is it an infection. I swim occasionally, but not enough for swimmer s ear.",
    "doctor_response": "Hi, Ahuong, Thanks for query. It seems that you are having infection in your left ear and congestion in the throat as ell. Most probably due to swimming you might got the infection. Take some decongestant medicine,do warm salt water gargles or Listerine gargles. If needed you may go for antibiotic medicines. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain in a 4 year old?\n\nDear Sir My son is 4 year 6 months old. From last three weeks he is complaining about stomach pain, with two to three bowl moments on daily basis. We have consulted paediatrician, he tested and said he dont find a problem, he recommended a stool test for my child, I did t go for the same. But what are main causes for child suffers with stomach pain? Please help out for some suggestions to take care my child.",
    "doctor_response": "Hi Dear Welcome to the HCM,Changed junky Food habits of new generations is main cause of such recurrent pain in abdomen.Avoid kurkure,chips , excess intake of cold drinks.Some PPi drug like like lansoperazole  daily for a month empty stomach helps in reliving the gastritis caused by such food.Combination of ofloxacin with metronidazole with adequate doses and duration will eliminate the stomach infection if any.Hope the query is answered.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Though we are having protected sex, my partner is getting delayed period. Why?\n\nHello doctor, I and my partner are sexually active. Although we take precautions (using two condoms at a time) there is always a sense of fear when it comes to her. Each time she gets her period it is delayed by two weeks or 10 days at least and less discharge in terms of flow. Last time she had a normal flow (6 days) according to her but had a little abdominal pain, with watering mouth and a bit of headache. May I know the cause for why her periods get delayed and a reduced discharge because it creates an impression as if it is of implantation bleeding and leading to pregnancy. Request your understanding of how things work as it creates daily confusion and stress. Also, does she require to seek a personal doctor inspection? She is 25 years old.",
    "doctor_response": "Hi. No, there is no need for inspection. You can go for pregnancy tests with home testing kits. This change in periods (duration and flow) is normal for her as she is active sexually and there are emotional and hormonal changes that cause all of this. If there are no flow, excess flow, missing periods unbearable and sustained pain in her abdomen, back and thighs then there is a need for a gynecologist visit for checkup.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is EZorb ideal for normal calcium levels?\n\nHELLO THERE, THERE SO MANY OPINIONS REGARDING CALCIUM THE I FEEL THAT MOST DOCTORS ARE WORKING FOR COMPANIES AND NOT GIVING AN HONEST ANSWER TO THE CALCIUM QUESTION. I BROKE MY HIP 1 1/2 YEARS AGO AND HAVE HAD THERAPY FOR THE LAST FOUR MONTHS OF WHICH I AM VERY GRATEFUL. I NOW WALK WITHOUT A LIMP/ I HAVE BEEN TAKING E-ZORB FOR ABOUT EIGHT MONTHS NOW AND WONDERING IF THIS IS THE PROPER THING TO DO? THE DOCTORS AT KAISER CA WANTED ME TO BE ON FASOMAX. I SAID NO. WHAT S YOUR OPINION?",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.If you has low bone mineral density with osteoporosis then you can take fosamax, otherwise there is no advantage of taking this.You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach infection followed by weakness and vomiting?\n\nI m 21 year old. 3 months my blood report show typhiod infection.i complite my treatment.before 3 weaks ago i m suffring from stomack infection   then i am addmitead in a hospital.but now i m felling extrem weaknes and vometing  like felling.my blood culture report is normal.",
    "doctor_response": "HelloI have gone through your question and understand your concern.  It appears to be symptoms arising from complication of typhoid fever involving gastro intestinal tract or a relapse due to antibiotic failure or resistance. To confirm relapse blood culture test negative is not sufficient as in 30-40% sensitivity to blood culture is low. Another method to test the relapse is testing antibodies in blood known as Widal test or IgM antibodies against specific typhoid antigens.If all the above mentioned test confirms no ongoing infection the symptoms of gastritis must be considered to be complication of typhoid fever which is not uncommon. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pains in the stomach and kidneys?\n\ni woke in the middle of the night last night with horrible pains in my stomach and kidneys. I was nauseated but could not throw up. this lasted all night and into this morning where I was finally able to puke. the only thing that came up was some mushrooms from the pizza I had last night. after half the day at work the nausea went away but my whole body aches from the inside. feels like my bones hurt. and my kidneys still hurt . I feel a throb in them when I move too fast. no fever but my skin aches like I have one. my whole body is weak like I have no strength and have no energy at all.",
    "doctor_response": "I am sure you can judge your stomach is paining but it is very difficult to judge about kidneys yourself if you are not a medico.It seems you suffered from gastritis last night . this might have been the cause of your vomiting & nausea& the sick feeling. You should take pantoprazole & domperidon combination empty stomach & after about an hour eat some thing light & take paracetamol 500 mg.Mashrooms are also known for causing allergy if you ate them for first time add one anti allergic tablet. You should drink lots of fruit juices slowly to counter your weakness. If your condition persists like this after about two days see a doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling and numbness on fingers after wrapping hair band on wrist?\n\nI went to sleep with a hair band on my wrist. I actually wore it all day yesterday and overnight. When I woke up this morning my hand was tingling and numb like it was asleep and the hair band was very tightly indented into my wrist. I removed it and still 12 hours later my thumb, index finger, and middle finger, as well as half of my hand and wrist are still partially numb and tingly. the indent from the hair band is gone, but a red welt is still visible most of the way around my wrist... Will the feeling come back to my hand and wrist?",
    "doctor_response": "According to your narration, it seems to be due to compression effect of band. Blood supply and neural supply may be impaired due to this compression. Persistence of numbness in thumb, ring and middle finger points to median nerve compression at carpal tunnel. In my opinion this may be temporary and will recover on its own if no swelling at wrist present and no distal skin changes in hand.  If symptoms persists you may have to undergo nerve conduction study for carpal tunnel syndrome. At present you may take Aceclofenac plus paracetamol and methylcobalamin for 4-5 days with rest of involved limb.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bruising on legs, slow to heal, upper back pain. Should I be concerned?\n\nHello....I have been experiencing unexplained bruising on both my legs since the middle of August. They are VERY slow to heal and there appears to be a lump under a couple of them. Two days ago, my upper back...on the right hand side, starting aching. When I looked at my back with the help of a handheld mirror, I have noticed a bruise is now starting to appear there too. I have also been sleeping longer than normal. I have always averaged 5-6 hours each night and over the past month, I have now been sleeping 9-11 hours and still waking up tired. Should I be concerned?",
    "doctor_response": "hiThanks for your queryi can feel your concernsyes ,you should take it seriouslyyou have not mentioned your age?is there any history of trauma?do you have any family history of blood disorder?spontaneous bruises are usually either due to low platelet count or any cogulation disorderi recommend you to have a proper clinical examination and routein complete blood count and coagulation profile after consulting your doctori am available for your help regardsDr.Amna",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What should be done for cloudy vision after cataract surgery?\n\nHi doctor, In case of cloudiness and pains at night after cataract surgery,\u00a0what should be done?",
    "doctor_response": "Hello. After a cataract surgery, the patient is put on a steroid and antibiotic drops to reduce the reaction in the eye, the swelling of the cornea if any and to prevent infection. You have mentioned that you experience cloudiness and pain at night after cataract surgery. If you have pain and cloudiness, which is more at night, then you may be having a recurrent reaction in the eye or increased pressure in the eye. It is best to show your treating ophthalmologist at the earliest. I will be able to answer better if you provide me with more details and a photograph your eyes. Revert back with the photos to an eye care ophthalmologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shoulder pain\n\ni am 38 years old female i have pain in my left shoulder joint for the last 3 months i am not able to move my hands back nor lift it high sometimes there is continuous pain hot water fermentation gives me some releif please suggest me some solutions",
    "doctor_response": "Hello, As what I see from history is that your shoulder muscles are weak due to which you are getting pain. Please make assure that joints do pain there the muscles surrounding it becomes weak and joint space reduced. Since history doesn't mention about any specific type of pain this looks to be totally the shoulder muscle weakness pain. Doing regular shoulder exercises to strengthen the muscles of the shoulder girdle will of optimum help. Please feel free to contact me if you have any other questions. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the effects of Wal Phed overdose ?\n\nwhat is gonna happen",
    "doctor_response": "Hi, , Nothing much is going to happen, you can land up with nausea, vomiting, dizziness, nervousness, headache, irritability etc. Drink plenty of liquids avoid products with caffeine and chocolates. Take care Regards Dr. Naveen Kumar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain on standing, sitting, swelling in genitals. Vericocele operation done. Treatment?\n\nhi Doctor, i got vericocele operation in 2009 both sides. From then onwards, when i stand or sit for more hours i feel discomfort and swelling is happening(with little pain). so what should i do now? is not there any permanent solution for my problem? would i have to live with this pain only. please provide me permanent solution to my problem. thanks in advance.",
    "doctor_response": "Hi,From history it seems that you might be having inguinal hernia giving this type of feeling and swelling.Consult surgeon and get examined.Avoid weight lifting.Avoid constipation.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is marijuana causing the complications?\n\nI was just released from hospital diagnosed with Pericarditis and WPW I am not a user of Tobacco nor alcohol I use marrijuanna at least 3 times a day do you think that the marijuanna is causing complications I told the doctors I m a heavy user but not one doctor told me to stop the marijuanna",
    "doctor_response": "Hi,I did review your concern, Marijuana can cause lot of complications when used in excess amount, can cause lung problems including chronic obstructive lung disease like illness and also increases chances of lung cancer according to recent studies. Your WPW and pericarditis may not be related to marijuana use but i would advice you to cut down on your marijuana and eventually quit it. It is advisable to join a cessation program as they help in overcoming withdrawal and dependence and will help increase your will power.i hope this helpswish you a very healthy life ahead.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Extreme fatigue, blank minded, on cipralex for depression. What can be done?\n\nDEAR DOCTOR IN FEBRUARY 2011 I TOOK CIPRALEX FOR FEAR AND LIKE DEPRESSION STAGE AFTER ONE OR TWO WEEKS I AM ALRIGHT AND TOOK MEDICINE FOR TWO MONTHS. THEN AGAIN IN JULY SAME HAPPEND AND TAKEN MEDICINE FOR ONE MONTH. AGAIN LIKE SITUATION HAPPEND AND TAKEN FOR ANOTHER ONE MONTH AND GONE. NOW FROM FEB-25TH I FELL IN DEEP DEPRESSION AND FEAR AND STARTED TAKING CIPRALEX TILL NOW I AM ALWAYS TRIED AND BLANK MINDED NO INTEREST IN ANY THING. PLEASE HELP ME WHAT TO DO",
    "doctor_response": "Hello and welcome to Healthcare Magic. Thanks for your query. You seem to be in the midst of a depressive episode. I would advise you not to sef-medicate yourself without a proper consultation and evaluation. Moreover, anti-depressants should not be taken on a \"as required basis\", but should be taken for continuous periods as advised by your doctor. So, I would advise you consult a psychiatrist for a detailed evaluation and further treatment. There are effective treatment options - in the form of medication or counselling / psychotherapy which will help you overcome your problems. Wish you all the best. - Dr. Jonas Sundarakumar Consultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have puss pocket at gum line that bleeds slightly. Had crown put on teeth. Related?\n\nAbout 3 months ago I had a root canal and then a few weeks later a temporary and then finally a crown put on one of my bottom back teeth . There is a little puss pocket at the gum line that bleeds slightly. I was at my detist last week and he took a new xray . There was nothing on the xray that he was concerned about but said we would keep an eye on the gums. Would an xray show if the tooth under the crown is infected? Or is this an issue with my gums?",
    "doctor_response": "Hi, Thanks for asking the query, After successful root canal treatment th etooth is completely devitalised, disinfected and sealed to the apex , so there are no chances of pain. Sometimes due to food lodgement between the tooth and the crown surface there is accumulation od bacteria , plague, calculus and other irritants in the pocket leading to infection and abscess formation. As the x-ray is normal there is no problem with the root canal treatment. I would suggest you to go for deep scaling and polishing followed by curettage. Maintain a good oral hygiene, use chlorhexidine mouthwash gargles twice daily. Hope this helps out. Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I had pain while urinating after unprotected sex. Am I having HIV?\n\nHello doctor, I had unprotected sex four months back and after a week I got pain while urinating and greenish fluid came out of the penis. The doctor gave me Doxycycline. Now I checked for HIV. The last test method was HIV 1 and 2 screening test, serum, and HIV 1 and p24 combo. Can I now be relaxed that I am HIV free?",
    "doctor_response": "Hi. Yes, the negative results of these test (attachment removed to protect patient identity) on repeat after four months indicates that you are not infected with HIV. Nowadays, fourth generation tests are able to pick up the antibody if you are infected with HIV. HIV if negative after three months, then chances of HIV is very rare, and few guidelines recommend that you repeat it after six months again. For more information consult a sexologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for pain in back due to a fall\n\nhi my husband has on going back problems. he fractured his back last year. hes had another fall and is in pain. what pain killers will be best for him to take? hes stubborn and wont go back to the doctor as hes scared he will lose his job as he will be a liability.",
    "doctor_response": "Thanks for your query, I have gone through your query.As far as the pain in the back is concerned, it can be secondary to the inflammatory response to the trauma or a fractured bone. You need to consult an orthopedician and get it evaluated. Mean while you can take a course of analgesic like ibuprofen or diclofenac(if you are not allergic). You need to get a radiograph done to confirm the diagnosis. Later once the diagnosis is confirmed, we can manage accordingly. Do not neglect.I hope I have answered your query, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest solution to deal with problematic drinking habits\n\nMy brother is a problem drinker, but not yet an alcoholic. I am considering writing him a letter to let him know how concerned, worried, scared I am about his health. I also want him to know that I am aware of how much he is drinking - sneaking drinks during the day, hiding alcohol in his luggage, etc. Is this a good idea?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Yes, the idea is great. Your brother should definitely know that an authority is watching him and this authority happens to be his elder brother, who has concerns about him, loves him and want to guide him.Second thing you have to do is - You need to divert his energy into more useful things such as career, education, health, games etc. Motivate him to participate in games without mentioning the health effects of drinking. Motivate him to work extra time for the sake of his career or education without mentioning anything about drinking. Once his time and energy is diverted and divided among more productive means, he finds less and less time and energy to drink. Works well if practiced 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cerebral cavernous malformation\n\nIn the last year my dad has been diagnosed with a genetic brain disease called CCM type 3 and I have been diagnosed as well. But i do not necessarily have the same symptoms. Earlier this year they found a tumor on his brain stem and it has caused his social skills, reasoning skills to go downhill, and it has changed his personality. I am afraid that this will happen to me as well. If so I don t ever want to get married and put my spouse through what my mom goes through. What do i do?",
    "doctor_response": "Hello. I hbe been through your question and understand tour concern.Your fathers diagnosed lesion in the brainstem is not responsible to none of the symptoms you described. It seems more a personal reaction to the finding which is hard to face and it is considered a \"normal\" reaction, but in case you have the same finding (which is not for sure) you might react not the same way.hope this helps. wish you the best helth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does Motikity: 20%,Dead sperm: 5%,Epithelial cells:1-2/hpf from sperm test suggest?\n\nmy age is 30 height 165cm weight 57kg the report is viscosity :normalreaction : alkalinquantity - 1 \"cc\"motility - 20%active motilityu 05%sluggish sperms : 10 %dead sperms : 5% total count 12 milliion /ml epithelial cells - 1-2 / hpfkindly advice is it ok to get a baby",
    "doctor_response": "hiii.i have gone through your reports.normal  semen volume is 1.5cc.it is decreased in your case.sperm count,motility,morphology everything is abnormal.still you can get a child.methods like IUI,ICSI  are available.you can consult with your infertility specialist for this.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am i having joint pains?\n\nmontsh. Started with hp infection, then night sweating, and chills. Now warm and joints pain. I did...montsh. Started with hp infection, then night sweating, and chills. Now warm and joints pain. I did...montsh. Started with hp infection, then night sweating, and chills. Now warm and joints pain. I did...",
    "doctor_response": "Hello, The joint pains that you are having are suggestive of polyarthritis. This can be post-infection arthritis also. Proper anti-inflammatory medicines and regular exercise can help in reducing these pains. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lethargy and fuzziness in head after getting hit on head?\n\nI hit my head on a steel fence post last week and had to have two stitches. I was told the cut went to the bone. Since then I feel like I have no energy and at times my head feels fuzzy or like there is fluttering movements inside my head. I don t want to see a doctor if it is not necessary. So what could this feeling I am having be?",
    "doctor_response": "Hi,Thanks for writing in.Since you had ahead injury and still having fuzziness, it will help to get a brain scan if not done earlier. Please consult your doctors explaining your symptoms in details and ask for a scan if you can get one. Since you had to get two stitches, the wound might have been significant and there can be occasional confusion and fuzziness even with a slight head injury. If your scan is normal and your symptoms persist then you are having concussion injury. This takes time over a few weeks to recover completely. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "After taking AKT what are the chances for me to conceive ? I also have rashes on my Vagina\n\nHi doctor ...i m 23 yrs old n i m married for last 2 nd a half year my 1st question is i have tb in uterus i m on akt 4 for last one nd a half month after 15 days i will be on akt 3 i want to know my chances of getting pregnent i got pregnent twice before but i had to abort so i want to know when shopuld i try to concieve i have pressure from my in lawsmy second question is i have vaginal rashes and they hurt so much whenever i have sex with my husband rashes occurs and stay for 5 6 days it is very frustrating is this a serious problem the day when my gynea did a biopsy of my uterus this problem started what should i do",
    "doctor_response": "Hi welcome to health care magic Tuberculosis of Uterus is  curable condition...  infertility is one of the  problem in this disease. rashes in the vagina may be due to reaction of the body to drug.. but you must continue the AKT 3 for six months.. after the complete treatment then you can concieve..",
    "dialogue_context": ""
  },
  {
    "patient_message": "How should arachnoid cysts in the brain causing tremors be treated?\n\nI have had an arachnoid cyst on the left side of my brain for about 6 years. There is a hole there as well. Just had an MRI and now I also have an arachnoid cyst on the right side. What s going on? What should I do? What should I expect? I do have tremors and have depression. Recently diagnosed with diabetes. I am 74 yr old woman.",
    "doctor_response": "Hello, I have gone through your question and understand your concern.Arachnoid cysts are common findings in MRI and considered incidental, generally not responsible for any symptoms at all.The tremor you are having is probably an essential type of tremor and not related to the arachnoid cyst, nor does the depression has anything to do with it.Thus, the arachnoid cyst does not need any treatment.Hope this answers your question, I wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the thighs?\n\nI have been having pain in my left thigh for about 6 weeks now. The pain feels like something is stabbing my leg. It started out just hurting in the middle front of the thigh. I first noticed that pain when my laptop was on my lap. Recently, the pain has been moving from the front to the outer side and then the back of the thigh. No real pattern, just increasing in frequency. Used to only hurt when sitting for long times, but now I notice the pain when standing too. Saw a chiropractor yesterday and he said things are not aligned and left side is uneven. Could that be the only cause? Could it be from using laptop, or something worse?",
    "doctor_response": "Hi i am Dr Ahmed Aly    thanks for using healthcaremagic site ,I had gone through your question and understand your concerns ..     In ,y opinion i dont think you should worry , that is a kind of sciatica due to sitting alot on hard sufaces that causes pressure on your nerves coming from your spine it is common and increases with age and weight . avoiding lifting heavy object and spinal straightening excersizes and positions even while sitting and walking will be helpful . spinal nerve compression causes this kind of neuropathic pain due to disc herniation nerves going to your legs releived by relaxing , physiotherapy by your chirpractor , hot massaging your back twice daily with topical gels and even yoga , painkillers  like advil ,muscle relaxants are recommended if no releive happened the i would suggest my patients for Xrays and CT for proper evaluation  Please click THANK YOU and consider a 5 star rating with some positive feedback if the information was helpful. Hope the above information helps you,Any further clarifications feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for having stomach pain and vomiting after an accident?\n\nWhy does she has stomach pain after the accident and Why is it vomiting every time she eat? She went to the ER when the accident happned. Did run many tests included CT SCAN MRI CAT SCAN. The results came out was normal. Is there any way to help her to get better? Thank you.",
    "doctor_response": "Do a course with Roles-D(RABEPRAZOLE+DOMPERIDONE) for 4 wks.you may add Tab Zofer, if vomiting persist.after 4 wks if the problem persist you should consult a gastroenterologist, you may need a upper gi endoscopy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe psoriasis, liquid is oozing out of the scales, burning sensation. Any treatment?\n\nHello.. I have severe psoriasis and have been taking ayurvedic treatment for the last one year. It has worked on most infected parts other than my leg. In the last 3-4 days, the scales have dramatically thickened and now some liquid is oozing out all the time which is really worrying me. Its burning a fair bit. The infected area looks really red and black. Skin looks very flaky. Have stopped my medicines for a couple of days now. Dont know what to do.",
    "doctor_response": "Hi friend, Welcome to Health Care Magic See a Dermatologist.. The treatment  is fairly advanced nowadays / there is  a choice of drugs / and you have a good chance of improvement. Local applications and systemic drugs like immuno suppressants are very helpful - in reducing the flare up and delaying complications... Take care Wishing speedy recovery God bless Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there permanent cure for seizures?\n\nMy son was having seizure almost one & half year back & second after 8 months of the first while discontinuing medicine with Dr. advice. Heis now 20, taking 3 doses of Eptoin regularly. How long he is to continue the same or there is any permanent treatment. Pl. advice.",
    "doctor_response": "Hello,Permanent treatment depends on cause. If cause is reversible then yes, patient gets relieved of medications. General principle  for withholding medicines for epilepsy is that if patient is fit free for past 3 years the medicines can be tapered off slowly.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Muhammad Faisal Bacha, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to recover from varicocele?\n\nHi I discovered pain in my left testes about four years ago and when I contacted a physician he asked me to do an ultrasound Which revealed vericocoel. Docter suggested me that vericocoel dont need any medical attention and I can live my life as usual. But I dont feel good at all, I am always sensing a pain which starts from the left testes and goes till left leg and lower abdomen. Plz advise me what to do",
    "doctor_response": "HiI had gone through your query.Yes ultrasound is the choice to diagnose vericocele.Varicocele itself has no complication.It wont lead to any other problem.Just need to consider Sperm production which will affect in vericocele.Semen analysis is necessary to look sperm count.If you are married and planning to make child then it is must to go for semen analysis for better evaluation.And if it will less or affected then make family planning as per your doctors advise.If your family is completed then no need to worry.It wont cause any problem beside decrease sperm production and infertility.So take your doctors advise.Still if you have query then feel free to ask me directly.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. The beta hCG levels of my wife are very high. Does this signify a healthy pregnancy?\n\nHello doctor, My wife is 25 years old and she has PCOD. We are trying to conceive for 2 years. We had done an IUI which failed. We did IVF, but it ended with a chemical pregnancy. Last month, our doctor did Frozen Embryo Transfer (FET). He transferred 2 embryos on that day. We got a positive result through urine test. We did serum beta hCG test. The report shows hCG level of 1,50,000 mIU/ml. The value looks like very high. Does this value signify a healthy pregnancy? Does it mean a twin pregnancy?",
    "doctor_response": "Hello. The normal hCG levels in a singleton pregnancy as follows: In a twin pregnancy, the levels are 30% higher than the singleton hCG levels. Generally, during the Frozen Embryo Transfer, 3 to 4 embryos are being transferred, and hence the levels can be as high as this 1,50000 IU. But, as you are sure that there were only two transfers, then according to that the value is still higher for a twin pregnancy. Considering the present scenario, this may indicate a molar pregnancy. It would be important to get an ultrasound pelvis done to identify multiple gestational sacs, and if molar pregnancy is suspected, then an MRI would be warranted. You can follow up with the USG report, and I would be able to guide you better after seeing the reports.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from weakness, lethargy, body stiffness and low sex drive. Cause and cure?\n\nI am 34 year old. I am suffering from weakness, letharginess and body stifness. If I stand for a while my back body start getting stiff. Even though I take good sleep, I feel sleepy entire day. Due to all this my sexual desire is also decreasing everyday which is effecting my newly married life. Kindly suggest the cure. Thanks in advance.",
    "doctor_response": "Hi there ~ Firstly you might need to consult an psychiatrist to find out if you have any difficulties in your libido or have other mental health concerns like depression. Otherwise, you have a very common problem of erectile dysfunction and / or premature ejaculation and it can be easily treated with medications available during this time. The class of medication is called phosphodiesterase 5 inhibitors (PDE5Inh) selective serotonin reuptake inhibitors and it also helps with decreased libido which is a result of depression if you are going through one. I advise you to consult with a qualified psychiatrist who might be able to help in this regard. I hope this helps. Take care and have a lovely day!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Some roots and pieces left while pulling teeth, might suffer from bone infections. Can the doctor be held responsible ?\n\nDentist pulled 28 teeth left some roots and pieces of broken teeth in there sewed it up gave me dentures and sent me home .. I became bad bad infected he looked said don't no gave me a prescription sent me home I went back a day or 2 later he looked and sent me to a really good friend of his that is a oral surgeon looked at me n put me in hospital I was there almost a week they lanced infection spots and then sent me home . Go back to surgeon he cuts the inside of my jaw to get more infection out and sees that the infection is comin from my gums that's already healed he recuts it open to find pieces of broken teeth .. He removes the pieces and sewn it back up.. Still have complications and the oral sergeon thinks that I have a bone infection now but says it cost too much to do the test .. I'm wondering if the original dentist should be responsible for these bills so I can be treated properly .",
    "doctor_response": "Hello, Its difficult to evaluate the cause of gum infection after multiple tooth extraction. I would suggest you to get a thorough clinical as well as radiological examination. The remaining root pieces has to be removed if present. Take complete course of antibiotics-analgesics too. Maintain good oral hygiene. Please discontinue the use of dentures until the socket heals completely. Rinse frequently using warm saline and betadine. Bone filing has to be done if there is any bony protrusions. I wish you good health. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Numbness, pins and needles in left, pain from shoulder down to hand after 3 back surgeries\n\nI had three back surgeries within one months time last surgery March 3, 2013. Sciatica. The surgeon nicked my dura sac, he did not realize just how bad I was until he went in for the surgery. I ended up with a hematoma and had my second surgery. Then I got sepsis and had my third surgery. It has been a little over a year now and I am in a lot of pain. Back, buttock and down the leg on the right side. I did have pain in both legs before the surgery. The pain is unbearable most of the time. I saw him today and he said there is nothing I can do for you. He said the hematoma caused nerve damage. My life is pretty much nonexsistence. I also have arthritis in my back and have fibromyalgia. Just how much of this is it the doctors fault for what happened to me? I also developed ulnar neuropathy and my rotator cuffs are bad. I have tingling, numbess, pins and needles in my left hand pretty much all the time. What they cannot figure out is why I have pain from my shoulder down to my hand. They say it is not caused from my neck.",
    "doctor_response": "First off let me tell you how sorry i am that you are suffering like this.To answer your question my best guess would be it is the fibromayalgia along with the ulnar neuropathy which is amplifying your pain as is proven with this condition.You need to focus on medications and exercises to improve this condition",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back pain on and off in a 50-year-old woman?\n\nI m a 50 yr old female. 7 times in the past year I ve had sudden onset of pain low in my back. Each time I was treated for a uti but there is no bacteria, only large amounts of microscopic blood in my urine. I also don t experience common symptoms seen with a uti. No painful urination, burning, or visible blood. Any thoughts?",
    "doctor_response": "Hi I am Dr Gopal Goel Orthopedic Surgeon. Presence of blood in urine indicates ether infection( which is very common in ladies) or a damage to urinary system like renal stones. I suggest you get ultrasound of abdomen to assess the cause of repeated blood in urine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a hard lump in buttock?\n\nDear doctor, my mom recently found a hard lump under her butt cheek, one month ago was a bean size, right now its like a thumb size, when you press it, its a bit painful, I am worried, what can it be? will it be something serious?? and which kind of doctor she should visit? thank you very much",
    "doctor_response": "Hi,Good Morning-from INDIA.I am Dr.Savaskar M.N.here to take of your health query from HCM virtual Clinic. Thanks for your Health-query to HCM Clinic.-I studied your query in-depth and I understood your concerns.-My opinion-Its a infection of the hair follicle of the butt cheek, caused in the bruised ,frictioned butt tissue there.-It painful on pressure due to the cellulitic spread around the hair follicle.-Its not much serious as it could be treated and would go away in 2-3 days time after treatment with your family doctor.-Advise-Right doctor to consult is -Surgeon- whou  would treat after clinical examination accordingly-a-tb-NSAIDs-To reduce the cellulitis and pain associated with it.b-Antibiotics-according to the severity or mildness of the infection in the boil.So dont worry -this boil or/ infected hair follicle will recover soon.-Still if it worries you, Consult your family doctor or Surgeon which would re-assure you.Hope this would help you recover fast out of the butt cheek  Lump anxiety.Wellcome to HCM again for better Health and Living.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anaerobic infection and autoimmune disorders\n\nI ve had a low grade fever for 2.5 months now along with headaches lasting a few days to a week and fatigue. The low grade fever is 99-100.2. I ve seen my PCP and had blood with ruling out infection including anaerobic infection and autoimmune disorders. He has referred me to an infectious disease specialist but the wait is a few weeks and I m worried to wait that long. There has been no mention of what it could be. OTC pain management doesn t help the headache or bring down the fever. Does this sound like cancer? All I can think of at this point is chronic fatigue syndrome or cancer. I also spoke to a nurse and told her about the fever and she simply said I don t have a fever and to take Tylenol even though I told her it doesn t work. The headaches are from a dull ache to throbbing. I recently even got glasses to try to help the headaches and nothing changed. Please give me advice.",
    "doctor_response": "Fever is defined as temperature greater than 100.1 Fahrenheit.  Check to see how high the temperature is and if it is highest during daytime,  nighttime, or every couple of days.  Have you travelled anywhere during the last 2 months? Some infectious diseases are more common in certain areas.  Have you taken any new medications?  There is a possibility of drug fever. Chronic fatigue does not cause a fever,  so that can be ruled out.  Do you have any other symptoms such as rash,  itching,  stomach pains,  etc.  You are correct that some types of cancer do cause a fever,  but those conditions are pretty rare. Best regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had panic attacks, left arm pain, headaches, anxiety, blurred vision, insomnia. How can I handle it?\n\nHi there...My boyfriend through he just had a panic attack... symptoms are light pain in left arm (during the attack), headache (entire day), feeling anxiety (during and after attack), random blurry vision (after/before attack), insomnia (after attack)...We are afraid it might be something series... but in the case of a panic attack, what is the best way to handle it?Thank you for your time.",
    "doctor_response": "HelloSudden onset headache, severe anxiety, blurred vision followed by insomnia can occur in panic attack. The attack usually last for about 10-15 minutes and cause sense of doom to patient. Most likely he was having panic attack and there is need for evaluation and to make the diagnosis of panic. Kindly visit a Psychiatrist for expert opinion. Many medicines like of SSRI or SNRI group help in controlling the symptoms. Apart from medicines behavior therapy and relaxation exercises help in controlling the symptoms.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does urea of 250 and creatinine of 2.2 suggest?\n\nmy father had his bypass surgery and 2 days later, due to improper blood circulation he underwent kidney failure and was comatose. the doctors re opened him and did ballooning. now after a lot of medication and antibiotics, his urea and creatinine are rising, currently his urea is 250 and creatinine is 2.2. is he in danger or is this reversible. he is diabetic too and his sugar levels are reaching higher than 500...please answer",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.These indicates kidneys disorders which may be caused by diabetes which is more probable or by medications that you take. These are still not critical values but it should be closely monitored since this may be very serious if not treated. 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.DR. Ivan Rommstein",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for elevated ALT and AST levels\n\n45 year old male with elevated alt 144 / ast 58. These numbers have been going up since 2012. I had been taken Lipitor for over 12 years and Dr. Changed my Med to Zentia after discovered elevation of alt/ast. I recently was diagnosed with Hyperthroidism and T3 andT4 and TSH numbers were all out of wack. Question, will Thyroid problem make Cholesterol / Liver Enzymes# s be out of wack or did the long term use of Lipotor elevate? I ve been on Zentia for better of 6 months now and Cholesterol numbers are coming down a little but Liver count is not also had a ultrasound done of liver and Suggestion was Fatty Liver Elevated LFT s. I do drink beer and wine but nothing harder that that and not that often. What advise do you have? I m scheduled to see my family doctor in a week.",
    "doctor_response": "Well, both of the above-mentionned drugs can cause liver transaminases elevation, Lipitor as a statin being \"more accused\" of this side effect. Anywhere even Zetia could be interrupted for a month remaining only in a low fat diet, because it's not a \"sine qua non\" medicine for you, and then repeating another time the AST and ALT. I don't know about your virological tests if you have excluded hepatitis causes (B,C,D, E) of your abnormal LFT-s. Even autoimmune causes are to be excluded and drinking should be stopped before blaming liver steatosis for your high transaminases level. So a long way away, but be patient because there's nothing of an urgent situation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a lump in the anus and scrotum?\n\nOver the past two weeks, I have felt a lump under the skin between my scrotum and anus, slightly towards the right side.  Painless, and not visible, I only know it's there when I exert slight pressure.  Bean-shaped I guess.  49 Year old male.  I also find I am constantly tired, listless, completely without energy, total contrast to my normal self.",
    "doctor_response": "Hi,Dear,Thanks for the query to HCM. I studied your problem in depth and I understood your concerns.Treatment-In my opinion your perineal lump for 2 wks has caused systemic effects of infection with in and has lead to listless life for you.I would Suggest you to consult ER surgeon- and to take antibiotics / anti-inflammatory with hot fomentation locally or/ infra-red locally for the early recovery of the bean sized perineal lump.Cause of it is mostly a folliculitis with boil formation with cellulitis and induration in it.Leave it to ER Surgeon who would treat it accordingly for that lump.If it grows in size consult ER Surgeon.So consult your doctor and don't worry.So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you, but just ask a query to HCM and be comfortable to resolve your health issues.Welcome for any more query in this regard to HCM.Write good resume and Click thanks if you feel satisfied with my advise.Have a Good Day.Dr.Savaskar M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why child is complaining of stomach pain right before bed time?\n\nmy seven year old son has recently been complaining of stomach pain only right before bed time lately...We are feeling like it is related to a new baby sister and getting used to a sibling being in the home.. but are there any things we should look for to make sure it is not something more serious?",
    "doctor_response": "Hi,thanks for writing to hcm.i understand your problem. your son could be experiencing sibling rivalry since he was the only child or a long time. kindly ask time the nature of pain ,site of pain and whether associated with fever. also ask him if he experiences it at school or not. usually children when they come home need parental attention as they are not occupied with friends after school hours . probably you could give him equal attention as the baby sister. engage him in more sports activities in the evening and other extracurricular activities to divert his min. counsel him and make him understand both children are equally important. if the pain occurs at other times also then kindly take him to paediatrician to rule out common causes like pain due to worm infestation . you could probably give him a deworming tablet.take careDr.Aseem Rai",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does alcohol exacerbate the pain of shingles?\n\nDoes alcohol exacerbate the pain of shingles ? Have been out for Xmas drinks and now pain unbearable ... Want it to stop.I thought I had a trapped nerve in L3 ... Since Monday, have had pain in lower back, stabbing pain but also numbness in outer left thigh and left side of abdomen. This morning a rash appeared across hip and abdomen ... I assumed mozzie or midge bites but by midday, the spots hurt when clothing touched rash. Is this shingles or have I got a trapped nerve ?",
    "doctor_response": "Hello!Welcome on Healthcaremagic!Your symptoms are suggestive of Shingles. Alcohol may exacerbate your symptoms.  The skin rash is not typical of any trapped nerve.Coming to this point, I recommend going to the ER for a physical exam. If the diagnosis of Shingles is confirmed, treatment should be started as soon as possible. Hope you will find this answer helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Am bed wetting, dizzy, stressed. Going to start IVF\n\nThis morning i woke up to find that i had wet the bed, this has never happened before, i also have period pains but i,m not due on. A few days ago i woke up and was very dizzy and was stumbling around (like i d had to much to drink) it lasted a few minutes then went, later that same night i was sat in bed and became very dizzy again (i put it down to the heat) but the bedwetting was the final straw, if i ever need the toilet while sleeping i always wake up, and the unine was cold so it must have happened awhile before i woke up, i am quite stressed out at the moment as next month i will be starting i.v.f.",
    "doctor_response": "Hello....you had a bed wetting episode... There can be many reasons for it...first you had a large dose of alcohol as it cause deep sleep and can cause bed wetting,,,,second you may had just a deep sleep and in due to cold weather you may have done it ,,,in that situation also you need not to worry... Third and very important thing to notice is , that is it secondary to any seizure.... As you have mentioned you had episodes of dizziness and it happened two three times you need to consult regarding it and this matter should be resolved before conceiving as treatment can have negative effect on baby And last it may happen during stressful period in some people.. You need to evaluate which one appear most appropriate cause for you and act accordingly Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to avoid recurrence of HBsAg virus?\n\nDEAR DOCTOR! EIGHT MONTHS AGO I MET WITH HBSAG POSITIVE. MY CONSULTANT DOCTOR SAID THAT IT IS ACUTE HEPATITS B. IT IS CURABLE. FORTUNATELY NOW IAM HBSAG NEGATIVE. MY QUESTION IS THERE ANY CHANE TO GET BACK THIS VIRUS? MY WIFE IS CHRONICLE HEPATITIS B CARRIER. PLEASE TELL ME THE STEPS WHAT WE TAKEN TO BETTER LIVELYHOOD?",
    "doctor_response": "Hi welcome to HCM...Let me know you 95% case acute hepatitis b infection resolved by itself with the time by our immunity ...If after six month hbsag positive than chance of carrier is there ..But now you have HBSag negative so no chance of Carrier stage but your wife us HBSag carrier so you might acquire infection but in future.  ..So you can take vaccine for that ....(HBSag vaccine 0,1,6 month )Try to avoid unprotected intercourse ....Use condom while having sex with her...The sharing of object avoided. ...Utensil washed properly ....0.5% bleach solution  can be used for that.....This is what best advise I can give ....Take care ....If still needs advise consult gastroenterologist for that ...",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat abnormal ECG levels?\n\ni had an abnormal ecg when my eltroxin medication was introduced at too high of a dosage. that was 15 months ago. all tests were done on my heart at the time and everything was fine. i have now had another abnormal ecg having had my medication reduced by half for the past week. should i be worried. i hope to fly to chicago on saturday",
    "doctor_response": "Hello, After going through your medical query I understand your concern and I would like to tell you that if your heart analysis came back normal then you need not worry about your cardiac health. Check your TSH level and consult a physician with reports. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Family member diagnosed with jaundice. Is it contagious and precautions should I take for my kids?\n\nHi, one of my family members (age 27) has been diagnosed to have jaundice during the laproscopy procedure that she underwent for pregnancy tests . My kids (5 years and 1 year )are also in the same house. Will it spread to them as well. Should I be caucious of it and not allow my kids to be handled by them. Please advice.",
    "doctor_response": "Hi Dinesh You have to tell you what is the cause of the jaundice. If it is viral hepatitis like A and E it is spread by food and water, if someone in your family is affected make sure you take boiled water and properly cooked food.  If it is something like hepatitis B- it is spread by bodily fluids. So your kids are not going to get that so dont worry. If something else is the cause of the jaundice other than hepatitis it is non contagious. So dont worry , your kids are not going to get the jaundice from your family member. Regards Dr. Om Lakhani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in the arm?\n\nHad a labrum tare repaired in my right shoulder two months ago and going though physical therapy now. my right arm feels like a truck is running it over. Pain is getting worse. My orthopedic dr says he dont know why and its nothing. Its even making my pinky and ring finger draw up on my right hand should i see a new dr? Pain is getting almost un barrable",
    "doctor_response": "Hi,Thanks  for  your query.Due to compression of nerve root in cervical spine there is tingling numbness and pain associated with it.I will advise you to MRI cervical spine for better diagnosis.For these symptoms analgesic and neurotropic like pregabalin and methylcobalaminmedication can be started consulting your doctor.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i get pimples and scar treatment in Mumbai?\n\nhi my name is raja and i am 27 years old from mumbai...i got these frustrating problems of pimples and acars with pores for 12 years...i have never been to any doctor ...so now i am trying to permanently solve this problem...i need suggestions on which is the best dermatologist in mumbai for treatment",
    "doctor_response": "Hi!, Welcome To HealthcareMagic forum, Raja its important that you first take treatment for your acne and then try for the scars .I am not in mumbai ,but have friends in mumbai who are doing good in dermatology.They even have lasers in their practice .One of the dermatologist whom you can contact is Dr.jitesh shetty..his contact number is 9820980639...You can  give my reference if you want.He is quite a busy doctor as he has his branches in mumbai,bangalore ,udupi and mangalore. You can contact hi,m and discuss in detail. regards, Dr.Bharat chawda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My eye looks blood red. It is itchy and dry. Could this be a bacterial conjunctivitis?\n\nHello doctor, I was diagnosed with blepharitis. I also have seborrhoeic dermatitis (perhaps rosacea as well), and my condition has improved greatly. Recently, I got very bad allergy symptoms, my eyes and nose became extremely itchy, causing me to sneeze a lot. This morning when I woke up, I had trouble in opening one of my eyes due to a dark yellow eye discharge. Apart from being itchy, my eye was blood red and dry (only one eye). I have never had this much discharge before, especially after I started cleaning my eyelids for treating my blepharitis. It really terrified me. Could this be bacterial conjunctivitis due to the color of the discharge and the fact that only one eye was affected? What are other possible explanations?",
    "doctor_response": "Hi. I have gone through the attached pictures (attachment removed to protect patient identity). Yes, it is nothing but common bacterial conjunctivitis. Since you have blepharitis, you are more likely to get conjunctivitis. Also, blepharitis, in turn, is related to seborrhoeic dermatitis. What I can assure you is bacterial conjunctivitis is treated easily with antibiotic eye drops. Try using Gatifloxacin eye drops initially half-hourly on the first day and later you can taper to hourly dose next day and 2 hourly on the third day and so on. Just continue for 5 days, and you will be fine.  My only concern is that you have associated blepharitis. This can be treated well by cleaning the eyelids with baby shampoo daily, for a few months. Once blepharitis is controlled, your eye irritation, watering, and itching will come down.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why there is a drop in the SGOT and SGPT level?\n\nhi doctor. my son is 19 years old, last month his weight was 208lbs; sgot was 200 and sgpt was 300. Then he cut down his fat intake and when he got his sgop it was only 100 and sgpt was 200; his weight went down to 202 lbs. what can you advice us to do? please help",
    "doctor_response": "HelloHe likely has what is know as fatty liver syndrome and it can be treated with a low cholesterol/low fat diet and weight loss.  If he continues to do well with his diet and loses about another ten pounds, the SGOT and the SGPT levels may well get into the normal range",
    "dialogue_context": ""
  },
  {
    "patient_message": "Take sprintech birth control, but missed dosage. Started periods. Further?\n\nYes, I take sprintech 28 birth control, and on my last packet I missed pills but took them the next day. I then started my period a week before I should've. Well I've been taking my pill regularly but I've been on my period for 28 days now. My dad is a RN and has been for 20 something years, I'm on my last week of blue pills, then next week I started my period so could I just go ahead and replace this week with my period week? And see if that helps?",
    "doctor_response": "Hello ma'am.First of all, the irregularity of your pill taking schedule will have to be reported and secondly, there is a reason why this regimen exists. I would advice you against experimenting and to visit your doctor at the earliest to find the safest and most logical solution.Hope this helps.Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Took sleeping injection for severe nausea, pulse stopped brain not getting oxygen, making loud noises. Is it coma ?\n\nhello sir i wanted to consult about my uncle he is a kidney paitent and three days before due to sevear u neasyness he took sleeping injection and painkillers in large quntity his pulse had stopped doctors here tried hard and got his pulse back but now he is not responding they say oxygen didnt reach his brain for three minute he is showin unusual breathing pattern and only responding to very loud noises by opening eyes is this state of koma can he come back from here he actually also requires dialysis frm time to time plus he is a diabetic paitent",
    "doctor_response": "It looks like coma , but if his other blood examination is normal ,his blood pressure is normal and he is to be ventilated for 24-48 hrs hten if his sensorium not improved then outcome will not be good.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should I do for my back pain?\n\nhi my name is Pamela narlock and I have been having severe back pain for the last 7 yrs and it gets worse every day to where I can barely even take care of my kids or even walk and go about my every day activeity and I desperately need a dr to get my pain under control! what do I do and who should I see?",
    "doctor_response": "You are suffering from back pain. Mostly it is simple backache. Treatment of it is rest and analgesic (Such as diclofenac) followed by exercises. You can also take VITAMIN D3, if it is low on blood testing. MRI  LUMBAR SPINE WILL exclude other causes . You can see orthopedic surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have mixed emotions and unable to concentrate on my work. What can I do?\n\nHi doctor, I have mixed emotions. Sometimes I am overwhelmed with emotions. But sometimes I am entirely emotionless. I am unable to concentrate on my studies as I am extremely drained mentally. Nothing is making me feel better. If I feel better for some time, at the end of the day, I feel completely numb. I am sleeping a lot nowadays. I am unable to do my work. Please help me.",
    "doctor_response": "Hi. I have gone through your problem, and I can understand your concern. It can be due to mood disorder and depression. You need to consult a psychiatrist soon as depression can present with a sleep problem, a decrease in energy, numbness, unable to concentrate on work, and low mood. In such situations, taking SSRI (selective serotonin reuptake inhibitor) can help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will I be able to conceive if I have irregular menstrual cycle and had taken treatment for mild PCOS ?\n\nhello doc i am 28 yrs old married for last 2 yrs at the age of 21 i was having mild pcos but it was cured by medicines but recently after my marriage i started getting irregular periods i consulted doc n did my sonography but now it shows i dont have pcos i want to get pregnant but due to irregular menstural cycle i am not able to get pregnant i have sum harmonal problem so doc suggested me to take well woman for sumtime still i get irregular periods n i get little pain in my left brests i did sonography found out it is due to harmonal imbalance now i am away from my country so i cant consult the same gynec what shud i do will i be able to conceive my weight is 54 kgs and my height is 5 feet",
    "doctor_response": "Hello; welcome to HealthcareMagic Irregular periods can be due to hormonal imbalance;anaemia;stress;and even PCOS is one of the cause which you do not have right now.In any case you need to consult a doctor to regularize your periods.The main criteria to get pregnant are:- -regular periods -proper ovulation -patent fallopian tubes -normal semen analysis of the husband. Most of the time if these criteria are fulfilled you will get pregnant sooner or later but please consult a Gynaecoogist for further management. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does pain in the lower back on the right side indicate?\n\nHello, I have had back pain on my lower right side for the last 4 days or so. I think it is due to my mattress possibly being too firm however, it isn t old and I wouldn t think something like this would come on so sudden and with so much pain. My back is very stiff and any sudden movement triggers a painful spasm that stops me in my tracks for a moment or 2.",
    "doctor_response": "Hello -While many times this is a musculoskeletal issue, one can have a \"pinched\" nerve in the lower back that can cause similar symptoms.If the pain persists for more than several weeks, your doctor would order further imaging tests for you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause pain and swelling on the shin after an injury?\n\nI had a fall last week and went to an urgent care facility. x-rays were taken and no broken bones were identified. my right shin is still VERY sore and swollen. When I push on the skin, it creates a dent and remains for some time, like slicing your finger into Play-Doh.",
    "doctor_response": "Hello, Injury to the shin without causing fracture can cause damage to the soft tissues that can be even more painful than the fracture itself.  There is usually some oedema at the site of injury which produces a pit on pressure. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Nirmal Chander Gupta, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and numbness above the ankle?\n\nI am overweight ... last night my left thigh began feeling very warm - i actually thought i must be sitting over a heat vent, and it moved down to just above my knee. this morning that area was numb. tonight, when i touch or rub it, it is tingly but still a little numb. no pain. and i rode a stationary bike tonight and walked around all day with no problems. is this something to worry about? Friends cautioned me about possible blood clots .. or bad vein problems ... i wasn t going to worry about it but those made me second guess. your thoughts?",
    "doctor_response": "Hello, Consult an orthopaedician and get evaluated. He might require an MRI scan to look for possible fracture or contusion. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the right thigh area?\n\nI have had some anatomy/physiology. I have been experiencing some pain in my right thigh in the area of what I believe is the adductus longus muscle. When I sit down, the pain recedes as if to open up and pinched nerve (?). If I stand or walk for a few minutes, the pain returns. I thought it could be the sartorius muscle but I don t think so. Could it be varicose veins? Could it be something involving the sacroiliac nerve? I have had a diagnostic test to see how the circulation is in the area, results negative. Any clues?",
    "doctor_response": "hi,thank you for providing the brief history of you.As you have pain in the adductor region it could be a spasm of the muscle for which a thorough clinical assessment is advised.Also the test for venous insufficiency is performed and is negative then nothing to look into the worry factor with venous hemodynamics.Also, this kind of pain can be due to pinched nerve in the lumbar spine as due to which the symptoms can arise.An MRI of lumbar spine will help assist further the soft tissue statues and help us planning the treatment.Also undergoing physcial therapy will help to Improve the strength in the muscles and also will improve the flexibility.In my clinical practice such cases respond well to physical therapy.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child have cough and vomiting continuously\n\nsir my 12 months baby was diagonised with bronchopneaumonia.she treated with monocef antibiotic but after she had given monoclav syrup but stil discharge she still vomit n coughing.heavly.plz help sir .im from varanasi.my baby is suffering for last 14 days",
    "doctor_response": "Sorry to hear the condition. Bronchopeumonia has been correctly treated with Monocef. Once on antibiotics the pneumonia resolves and the secretions present in the lungs starts to come out with cough. Thus at present you baby is trying to clean up his lung through cough. Please not be concerned with it. Give MAXTRA drop 0.5 ml three times daily, it will relieve some of the cough. Be patient your treatment is in right tract, just give some time. Vomiting will decrease when cough decreases.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could rapid thumping of heart be due to anxiety?\n\nHello Dr Gopi, My name is Teresa, I am 52 yrs old I weigh around 13stone 5ft 5in tall. I am a little concerned about my problem which arose about 3 yrs ago. I worked in a nursing home, when this day I let a nurse take my blood pressure and it was 140/90 and she told me that that was very high, this got me very worried so I ended up going to doctor and then proceeded to have a monitor fitted, all was ok, but over the past year I have been feeling my heart beat fast on occasions and this worries me sick, I am constantly feeling my pulse, and I am now totally frightened every time I go to doctors and they go to read my blood pressure and I know its going to be so high before they start, because when I enter the surgery I can feel my heart thumping out of my chest and beating so fast, I was there yesterday and it was 200/110. I feel this is all down to the origional fright I got 3 yrs ago, and I have never settled since, and I am so anxious and nervous. Please can you tell me if this is like a white coat syndrom, or maybe the reason for all this could be anxiety or could it be due to me have hot flushes and high temperature and night sweats from the menaupause, I have not had a period for nearly 3 years. I am not on HRT and I eat healthy, I dont smoke or drink, I eat lots of fruit and veg and drink beetroot juice now and again. Please could you advise me what is happening to me.......Thank you.  Teresa Belfast.",
    "doctor_response": "Hello thanks for asking from HCMYou are a 52 years old female with average height and weight. You have started feeling that your heart beats fast and this is making you sick. You have palpitations, and when ever you go to doctor your BP comes in higher range. Most likely the high BP is due to White Coat Hypertension. This is psychological rise in BP while entering a hospital and it may also present with other symptoms of anxiety. But you are having palpitations, restlessness which couldn't be explained by anxiety alone. Most likely the reason for such symptoms is panic attacks with anxiety. You are already on HRT for menopausal syndrome and this also increases the risk of such symptoms. I would advise you to consult a psychiatrist for such symptoms. Some medicines like Propranolol, Atenolol which are beta blocker drugs are used to reduce the palpitations and this will also help to decrease BP. Instead of HRT for hot flashes medicines like Duloxetine can be used. The medicine will help to reduce mood swings and will also help in anxiety.Visit a psychiatrist for prescription of these drugs.Thanks, hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I have rashes at night ?\n\ni have nocturnal rash in my body for 2 months ! they re just at night not during a day ! plz help me !? it s necessary to check liver anzyme or anything else ?! i m so worry about this , also i m student in medicine too",
    "doctor_response": "hi Shaghayegh. Welcome to Healthcaremagic. As u says u are student of medicine; Kindly provide further Details about regional location of rash, is it asso with ithching ? Are u Allergic to any drugs / Food ? Can u please provide further detail elaboration about rash ? (since u r medical student) Nocturnal rash with Itching on particular site is Commonly seen in scabies. Sometime parasitemia may get aggrevated at night prsenting as a rash . Please elaborate further details about rash & associated aggrevating / releiving factor so that i can help u in better manner.. === Get Well Soon :) Always Happy to Solve ur Query :) Take Care : Dr.Vaibhav A. Deshpande",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is my blood pressure 177/95 a causes of worry?\n\nI am 58 and on atenolol and avapro for blood pressure. Recently my blood pressure has been rising last night I woke up with my heart beat pulsing in my ears and my blood pressure was 177 over 95.  Is it okay to wait until 3 days until I can get into my regular physican or should I go to a weekend clinic now  I weigh 190",
    "doctor_response": "Hi,It's a matter of worry but it's not emergency, you can certainly wait for three days if you are not any symptoms like chest pain or shortness of breath. Doctor will optimize your medicine and you should maintain healthy lifestyle like Avoid fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. Regular exercises like brisk walking, jogging according your capacity at least 30 min a day and 5 days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn't abdominal fat deposition or obesity. Get your lipid profile and sugars tested once.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cavovarus foot\n\nmy son 12 yrs of age height 5ft 3in weight 45 kg has been diagonsed with cavovarus foot due to cerebral palsy since birth ,doctors also suspect dmd .They have suggested tendon transfer surgery but r not sure that wether he will b completely cured or not plz help.",
    "doctor_response": "Hello, Surgical correction is required. Consult an orthopedic and get evaluated. Splint or special footwear are also be tried. Hope I have answered your query. Let me know if I can assist you further. Wishing all the best. Thanks. Regards, Dr. Shinas Hussain General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for loose motion\n\nHi we are in Siem Reap, we are leaving tonight but last my 2 year old son has had diarrhoea and stomach pain, has has passed a few loose bowel movements this morning but now seems happy and is hungry and wanting to eat, we are travelling to Thailand to spend a week on Koh Samui, should we be giving him medication? Or is it ok to wait for it to subside?",
    "doctor_response": "Hi Dear Welcome to the HCM,Child has contacted some infection.Oral rehydration solution is of utmost importance  .To be given in plenty.If available easily with the chemist one can have syrup ofloxacin .Can be given atleast 5ml twice daily to stop the infection.Hope the query is answered.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have itchy rash on both feet. What is that?\n\nHello doctor, I developed a rash on my foot yesterday afternoon. I have not changed soap and I do not wear new clothing. While taking a shower this morning, I washed the area well and applied a steroid (Mometasone). It is still bothering me.\u00a0I am healthy except for folliculitis under my arms and a branch duct IPMN in the pancreas, for which the doctors are following.",
    "doctor_response": "Hi. Revert back with the answers to the above questions to a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal for the foreskin to be struck after retraction?\n\nlast night i retracted foreskin of my penis for the first time , it retraced easily but got stuck ,then i had to pull it back manually with the help of  ice and applying pressure on the head of penis.is it normal for the foreskin of penis to get stuck like that.I am 27 year old male.",
    "doctor_response": "Hi,As an Urologist, I can understand your anxiety. The foreskin should be retracted daily to maintain penile hygiene. It should be pulled back up without getting stuck at any level. If you're experiencing this problem daily, see an Urologist or a surgeon. You'll be shown the right way to retract the foreskin completely. You may even use some vaseline to lubricate the inner foreskin. If you've any doubts, send me a direct question.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Matthew J. Mangat",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is macular degeneration?\n\nHi doctor, I am 68 years old. I have just been diagnosed with macular degeneration. The doctor basically stated that there was nothing that could be done as this was just a part of aging. He did suggest to eat more green leafy vegetables. When I suggested Kale and dark leaf vegetable powder, he laughed and called me a dreamer. I simply cannot believe that there is anything else I can do. I am healthy with low blood pressure and a good weight. I would appreciate your medical opinion. Thank you.",
    "doctor_response": "Hi. As you stated that you have been diagnosed with macular degeneration that is ARMD (age-related macular degeneration). Now, let us know what ARMD is. For further information consult an eye care ophthalmologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the fluid filled lump on the sole of leg?\n\nHi I have a 3 month old baby who has got lumps on the sole of her big toes they seem to be getting slightly bigger and not sure what they are. When I press them they seem to feel like they have fluid in them have you any idea what it could be. Thanks Samantha Anderson",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Mostely it should be some benign cystic lesion like sebaceous or dermoid cyst. He need examination. then go for excision and histopathological examination.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hallucination about bad happening\n\nI feel scared of something bad happening so much sometimes that I don t even want to move out of my bedroom to go to the toilet, I can t sleep because I imagine bad things that could happen and I get horrible images in my head of things I don t want to see and struggle to get rid of them. Does anyone know why I get this?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Though it is difficult to diagnose your problem from the given description, I presume that you are stressed and anxious. You are disappointed due to some life events which you never expected to happen. Such a disappointment makes you lazy, intolerant, mildly depressed, tired, sleepy, low self esteem and low self confidence. Hallucinations are normally byproducts of obsessive negative thinking. From the description, I also note that you have a lot of spare time which makes you idle and thinking too much. Ignore those halucinations for a week or so and they vanish.  I agree that your condition is a bit complicated, but I sincerely think that this condition is common and hundred percent curable. Understanding life and learning how to enjoy life are the keys. You can learn these by observing your past experiences, elders, surroundings etc. You can also visit a psychological counselor for further advice.If you feel that I can be of help to you, feel free to post a direct question to me and am obliged to serve your cause.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life expectancy for a stage 4 esophagus cancer patient?\n\nmy mom is in stage 4 esophagas cancer . she has a big mass behind her panceras and a tumor in her esophogas, and a trace in her lymphoid. how much time does she have? they are going to do chemo to try to shrink the tumor in her esophogas so she can eat..",
    "doctor_response": "Hi,Thanks for writing in.Sorry to know about stage 4 cancer esophagus in your mother. Unfortunately the tumor has grown to a large size and the mass behind the pancreas is a lymph  node. Chemotherapy and radiation therapy are the treatments recommended. Surgery is not possible in stage 4 cancer.If the tumor has grown in to the lumen of esophagus then putting a bare metallic stent might open up the lumen but this is only a temporary solution. Chemotherapy and radiation therapy are used in many patients to reduce the size of tumor. The life expectancy of stage 4 cancer is about 2 years from the date of detection and with proper response to treatment and good supportive care most patients can survive. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pain below rib cage?\n\nMy wife has intense pain in her upper right abdomen, just below the rib cage.  She can't take deep breaths.  Bending over greatly intensifies the pain.  If she lays/reclines into just the right position, it helps some.  She has had gastric bypass surgery and is recently getting over the flu/ possible pneumonia.",
    "doctor_response": "thanks for your question i completely understand your question actually pain at rt hypochondrium/ lower rt rib cage / central abdominal can be due to variety of reasons like gastritis , peptic ulcer , cholecystitis etc.consult a general surgeon who can request for an usg abdomen to rule out certain causescontinue with the medications for pneumoniadont panicthanks feel free to ask more questions may god bless your family with good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in abdomen. Elevated esr. Suffering from hypothyroid, spondylitis. Suggestions?\n\nI have recently done my blood test and esr level was found 48 (0-20). I  feel pain in upper abdomen area. what can be the reason of increase in esr. other pathological test reports were normal. Moreover I am suffering from Hypothyroid test result was found to be 7.68 and also suffering from spondylitis ..the disc space is reduced at c5-6 level. can u please suggest  me what should i do ...Mantu dey, Digboi, AssamAge 35 Yrs",
    "doctor_response": "Hello,Thanks for posting to HCM,Thyroid hormone (e.g., levothyroxine) is taken by mouth to replace the missing thyroid hormone. Treatment is usually life-long.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dizziness,headaches and erectile dysfunction\n\ni am 56 and in great health.  i have occassionaly low grad headaches that are not getting worse.  i also have a pattern of erectile dysfunction that seems to have started in the last 2 years with these headaches.  i get dizzy when standing especially working in the heat.  i also have low blood pressure like 108/65 at the dr office.  i do take a light dose of Benicar.  i am suspecting that all of my symptoms are from too low blood pressure.  your thoughts?",
    "doctor_response": "Hello, Consult a urologist and get evaluated. Detailed evaluation is required to find out the exact cause. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe abdominal pain?\n\nMy sister is having very severe pain in upper abdomen from last 7 days. Now its increasing day by day. we are giving 2 medicines namely decolic and pantocid. We did few tests also like ultra sound, X-Ray, Endoscopy... All the reports are alright except doc said in Endoscopy, the result is saying that it is Antral Gastritis.After giving these medicine also she is not getting any relief. Every now and then she go to toilet for stool. She said every time she go to toilet she get 1% relief in pain.Whole night she either sit in the toilet or in the room. You can now understand the severity of her pain. She is complaining for some short of constipation and germs in stomach which she observed in her stool.",
    "doctor_response": "Hello! Welcome to HCM.This seems to be due to worm infestation as these are observed in stool.Gastritis will take time to settle. Continue same medicines. Avoid late night meals, hot/spicy food, alcohol & smoking. Try to reduce stress if any with meditation & yoga. Do regular exercise.I will advise stool routine & CBC.Consult your doctor for albendazole & further management.Hope this helps.Wish you speedy recovery.Thanks.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Endometrioma, had surgery for bowl cancer, heavy bleeding, blood transfusion, hysterectomy\n\nHi I Have a endmetroma close to my abdominal wall down near my ceaser scar my gno wants to get it out i had surgery for bowel cancer june last year and am having a lot of trouble with heavy bleeding so much so that had to have blood transfusion a month ago there talking hysterectmy as well do you think the pain i get with the endometreoma will go away after a hysterectmy and and the endo taken away",
    "doctor_response": "Hello. Thanks for writing to us. Endometrioma is often a very painful condition and surgery is the only effective treatment. Hysterectomy and removal of the tumor will take care of the pain as well as the excessive bleeding that you are having now thus reducing your chances of having a blood transfusion. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Small sore spot on lower part of my gums\n\nThere's a small sore spot on the lower part of my gums, it's hard to see but it almost looks like a tiny hole. Hurts when i eat food or touch it. Should I be concerned or is it just something that should go away?",
    "doctor_response": "Hi, It could be an abscess which is draining through the gums. Consult your dentist to determine the infected tooth and treatment should be obtained.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for vomiting and cough due to liver problem?\n\nhi sir,         myself is shubhendu banerjee my father hasbeen sufferinf from liver problem for 7 days. with vomiting tendency whenever he wants to take some food. two day onwards he is not even able to take some solid food. he has also a deep cough inside. what to do sir? i am in hyderabad and he resides in calcutta. please reffer some good gastroenterologist in kolkata.",
    "doctor_response": "Hi I have gone through your query....In liver hepatitis there can be anorexia , vomitting , fever , muscleache etc ...These are some constitutional symptoms that can occur in hepatitis....Here you can have sub acute or early stage hepatitis....Following investigation done....1.Serum bilirubin for jaundice 2.USG for hepatomegaly3.liver enzymes sgpt and sgot raised in hepatitis 4.Urine urobilinogen and bile pigment for distinguish obstructive and hepatocellular jaundice....5.if needed viral marker....Meanwhile for jaundice low fat diet.Fruits more...There is anorexia in hepatitis but try to take semisolid food and  apple juice or carrot juice .....Gradually solid diet taken...Avoid alcohol.....One tsp licorice powder with honey can be taken....Consult gastroentetologist in your city with keeping my advise in mind....Take care....Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for the closed fracture of the Fibula?\n\nI have an undisplaced closed fracture of the fibula. The pain was slight initially and is now non existent, I have never used a single painkiller and even touching the area doesn t cause discomfort and I can weight bear. Despite this and orthopaedic specialist insisted on a cast non weight bearing for 6 weeks. It seems so superfluous as I am willing to use compression bandages with a high boot support. Obviously you cannot see the X-rays but they showed to me an oblique non displaced fracture about 2 inches above the malleus. Is he over cautious or I am just a stubborn moron (an opinion offered by my spouse) ?",
    "doctor_response": "Hi, You have a fracture of fibula two inches above lateral malleolus. In any fracture immobilization is required for proper healing, so I would suggest you to go for cast immobilization. As far as the non weight bearing is concerned , now a days we have casting material where you can start weight bearing ASAP. Pl contact your orthopedic surgeon for the choice of cast.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the effects after gall bladder removal?\n\nI have dull pain in my left ear (inner and outer).  I have acidity reflux problem.  My gall bladder has been removed. Some fluid fell from my nose to throat resulting in accumulation of cough like thin in my throat.  For this, sometimes I gargle with Tantrum.  Two years back when I visited my doctor for this problem, he advised me to take zinetac, vozet and local application of neosporin-H.  Due to some non-specific changes reflected in my ECG, Cardiologist has prescribed me to take Metolar-25, Pantodac, Storvas-10 and Ecosporin-75.",
    "doctor_response": "hi.thanks for posting query at HCM.read your question thoroughly and understood your concern.gall bladder primary role is to store \"bile\".when gall bladder is intact, bile is usually secreted after having a meal rich in fat; bile plays a vital role in fat digestion.after gall bladder is removed, bile is continuously being secreted in small intestine and may reflux into stomach. as a result, gastric inflammation may occur causing pain and discomfort.moreover, high fat meal induces more bile secretion further affecting gastric mucosa.advise:NO or minimum fat intake/oily foodNO junk foodNO beveragesingest small mealsOTC proton pump inhibitor (40mg omeprazole, pantoprazole)to combat gatritis ( after discussing with treating physician)hope to answer your concern wish you good and sound health.regardsDr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain?\n\ni have a chest pain since one month back and this pain has started only when i started the treatment of black magic.before consulting to my moulana i was having pain in left hand and pressure like feeling in chest and the pain started only when i started consulting moulanas .please guide me what should i do.",
    "doctor_response": "Hey there,First of all stop showing to maulana for now,Get done chest X-ray and EKG and rule out cause related to lung and heart.Mostly it would be muscle pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could kidney conditions cause hip to navel swelling?\n\nOne month S/P PCNL and I still have swelling from about my hip almost to my navel.  I originally had numbness and pins and needle feeling in that area but that has subsided.  No pain or discomfort.  My docotor never felt it or looked at it however said it was fluid and it could take up to a few months to go away.  Could you explain this a little further?  Is it my kidney that would actually be swollen or fluid around the area?  Thank you.",
    "doctor_response": "Hello and welcome to HCM. As an Urologist,i can understand your anxiety.After a PCNL,some irrigant fluid may have leaked into the surrounding area.This is best confirmed by doing an ultrasound scan of the abdomen.The fluid will get absorbed into the body systems,very gradually.Your kidney will not get affected by this fluid collection,as function is normal.No fluid collects inside your kidney.So you don't need to worry at all.If you have any other doubts,send all your reports to me,as a direct question.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from abdominal pain. Ultrasound done. What does report mean?\n\ndear sir my son is suffering with pain than i took him to doctor for that they suggested me for ultrasound abdomen now the result is like this liver:normal in size. gallbladder:it show normal echotexture.no mass /focal leison is seen. pancreas:it show normal echotexture.no focal leison is seen pancreat duct is normal. spleen:it show normal in size and echotexture.no focal leison is seen. Rt kidney :it show normal echotexture.no mass /focal leison is seen. Lt kidney: moderate hydronephrosis with proximal hydroureter . u.Bladder: its normal in size and echotexture,no focal leison is seen. thick gastric wall,may be consistent with gastritis . impressions:thick gastric wall,may be consistent with gastritis. in the left kidney moderate hydronephrosis is noted along proximal hydroureter. ----------------------------clinical evaluation required.",
    "doctor_response": "Hi Welcome to HCM. The scan and the pain are suggestive of stone in the ureter. He needs 1. Blood tests to look at kidney function. 2. Plain xray and CT scan of the kidneys and urinary tract. Based on the report an clinical progress, treatment is necessary. Till then he needs 1. Pain killers. 2. Oral fluids liberally if there is no vomiting. Wishing him best health, Regards DR GS",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to increase my baby s weight?\n\nHi Doc.. My daughter is 10 months old and her birth weight is 6.2lbs and now she is 15 lbs. she looks so lean. I am giving her mothers milk and rice, even then she did not put on much weight. Can you give me any advice to increase her weight. She is very active girl, thought this might be the reason. Thank you so much for your time. Dolly.",
    "doctor_response": "Hi mam,  one thing which I would suggest is formula milk. Because baby would definitely require additional calcium which is not sufficient with breast milk, hence formula feed has to be given. There is a nutrition dip at this weaning age, hence nutritional supplements has to be given till this dip is sufficed with natural food.One should ensure that the infant takes fruits, vegetables and rice dal everyday. Do visit your doctor and check for anaemia .So the kid has to be put on calcium, iron and multivitamin syrups.Well, hope it improves your kids health.Tc",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bumps on vagina?\n\ni have two normal colored bumps on my vagina, the one on top is about the size of a pea and the one right under that one is about half that size. Its right in between where the lips first split. Its not oozing or pussing and no white head, I noticed them like two weeks ago not soon after i shaved, sometimes they itch. Is this a disease or something? Im freaking out or what can I take for it to go away? I also read about sebaceous cyst and im thinking maybe its that? I got a papsmear a little after i first saw it but didnt think much just ingrown hair or from shaving but its still here.",
    "doctor_response": "Hi,these are Psuedofolliculitis Barbae-lumps  and develop after shaving Preshave antiseptic use would reduce its recurrence.Consult a dermatologist.Else Contact with a Followup Premium question to ME.Will appreciate your Hitting  thanks and writing  excellent review comments to help needy patients like you. Welcome with any other further query in this regard.Good Day!!Dr.Savaskar,Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Large area of redness on knee, spread down half of right leg, antibiotics has no cure. Any ideas ?\n\nI have a large area of redness that started on my knee and has spread down half of my right leg. I am being treated with antibiotics but really it looks like large spreading bruises. Any ideas what this could be. One doctor said that is was atypical cellulitus but it is not hot, swollen or painful. Any ideas what this could be?",
    "doctor_response": "Hi there. Dermatology is a visual field. One needs a photograph or to look at the lesion. Please feel free to upload a clear digital photo of the lesion using the 'upload data' icon to the right of your screen. Alternatively feel free to use the premier 'ask-a-specialist' feature & get in touch with me. It may just be a simple 'fungal infection' or 'deramtophytosis' or 'tinea corporis'. Have the doc or any Gp do a scraping & examine under a microscope using 10% 0r 20% KOPH (potassium hydroxide) to help look for fungus. It may alternatively be one of a group of skin disorders called granulomatous cutaneous erythemas A skin biopsy & histopathology will further help clinch the diagnosis. I hope have pointed you in the right direction to make an informed choice! Cheers & here's to a clear skin!! Dr Praveen Rodrigues MD Dermatologist, Cosmetologist, Venereologist Vikram Hospital, Bangalore, India",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have swollen round bits under jaw each side, dull pressure, pain, choking throat, smoker. Cancer?\n\nI have these two swollen round bits under my jaw on each side, and I feel this dull pressure that is hard to describe. It feels like something is caught in my throat and at the same time it's just a little achy. I can talk fine and I have no issue swallowing. Im worried this might be due to my smoking? How can I tell if it's cancer?",
    "doctor_response": "Hi and welcome to HCM. Only biopsy can show for sure what it is, but usually this is just a swollen lymoh node due to respiratory infection. But if there is redness around it or it is fixed to background or growing fast then you hsould visit specialist. If this is soft and movable then it can be lymph node or lipoma. To be sure you can do ultrasounds with needle biopsy and see exact casue. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes discomfort during urination while on Amoxi-clav?\n\nI am on amox-clav 875mg for pneumonia. I have been on this for a week. However, I am developing discomfort similar to what would be a UTI. My urine is the color of tea. Is this normal. My urine is not cloudy - just occasional discomfort and the dark urine. Sometimes I feel as if the amount of urine is less than what it should be. I am staying hydrated due to pneumonia but something doesn t seem right. Thank you for your help.",
    "doctor_response": "Dark colored urine is a known serious side effect of using Amoxclav.I recommend stopping th drug immediately and visiting your doctor ASAP. A renal function test may be required to check if there is some abnormality in the functioning of your kidneys.Hope this answers your question, thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the cervical vertebrae condition indicate?\n\nWhat does c5-c6 mild to moderate decreased disc signal, mild decreased disc height and endplate spondylitic change, bulge and Left paracentral-forminal disc herniation, 3mm AP by 4mm mL, with mild uncinate osteophytes and right more than Left facet arthrosis. Moderate canal stenosis, 10mm, with Right foramen and mild inferior Left formaminal stenosis mean in human terms?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. It means there is degenative disc and cervical column disease affecting mechanically ( compressing) your cervical spine and nerves. Hope this answers your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lump on testicle, can it be a cyst ?\n\nHello, I would like to ask a question about a friend...he has been complaining abouta lump on his testicle for some time now. Earlier today a doctor he met did a quick examination at his job and told him he may have a cyst but thinks it is testicular cancer (no major exams were done, just a basic exam with his hands) my friends father had testicular cancer and now he is nervous. He also does not have any health insurance...what is his best option? the doctor who examinied him gave him his number and said he would cut him a deal doing a scan and further medical help... or should he just go to the hospital as he is in some pain. Thank you!",
    "doctor_response": "Testicular lesions require proper clinical evaluation. This is followed by abattery of blood and radiological investigations which support the diagnosis. However the diagnosis of cancer can only be done by formal surgical procedure called Chevassu's manuever.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the suggestion for an infection 5 weeks post surgery?\n\nI had foot surgery approximately 7 weeks ago to remove a bone spur and cyst on the top of my foot. It went well until 2 weeks ago, 5 weeks post surgery go infected. I am on my second round of antibiotics. It is healing but I still have fluid and swelling around the incision. Do you think this time frame of healing an infection is normal? At what point would you consider getting a second option?",
    "doctor_response": "HiThere should be culture and sensitivity test of fluid for suitable antibiotic and identifying the microbe causing it...a bone scan can help know if it's osteomyelitis or bone infection.Rigrous antibiotic therapy for now...in case any dead bone sequestrant is located in x-ray or bone scan, it may require removal..presuming it to be sift tissue infection now, two to three weeks of antibiotics alone should heal infection,do not worry...Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes BP fluctuation when on medication for stage III kidney disease?\n\nI have been on Coumadin for a4 months following a slight stroke and now recent blood work indicates stage III kidney disease. I take 40 mg of quinapril and recently added 5 mg of amlodipine for better control of blood pressure which runs around 147/65 UPON arising, but fluctuates significantly. Age 83, almost!",
    "doctor_response": "helloI think you need to consult your treating doctor again to change the dosage  after monitoring BP regularlly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for severe abdominal pain in a child?\n\ni took my 6 yr old to the ER tonight, because of lower left front side abdominal pain. They did an xray and a urine and a strep test. They said all the test came back normal. Is her apendix still a possibility even though she isnt screaming in pain. It started today around 12 and has been there ever since. She had a 101.1 fever today and now she is at 97.4",
    "doctor_response": "Hi....by what you say I feel that acute appendicitis is the first possibility. I suggest you get an ultrasound done and consult a pediatric surgeon please.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and loose stools in a child\n\nMy baby boy is 16mos old...he started to have a soft to watery, brownish stools 4-5 times a day, 5 days ago.. He started to have on and off low grade fever 2 days ago....The odor is on and off... Generally my son is not acting like sick, except that he s irritable at times...",
    "doctor_response": "Hi Thanks for contacting us.Your son is 16months old and now has loose stools,low grade fever and irritability.There is no red signal in your history except for duration (5days).May be u need to start with antibiotics covering aerobic and anaerobic bacteria with probiotics under a paediatrician guidance because if it has been of viral oetiology it should have got settled.keep feeding the kid with bland diet and replenish with fresh fruit juices with no added sugar and tender coconut water",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest  treatment for shoulder pain\n\ni fell hard in the bathtub and had no bruises anywhere.. but i couldnt touched one of my shoulder blade as i tried to massaged it and its painful to touch.. but im able to moving around with no problem.. except my hips hurted sometimes.. should i go doctor or will it go away on its own",
    "doctor_response": "Hello,I think that you should see an orthopedic doctor. Even though you can move your arm, still there are some conditions that you can have some range of motion but not complete one. For example, you may have rotator cuff tear which is a tear of group of muscles that lift up the arm in some degree. MRI can show this condition and proper treatment should be carried out.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Edvin Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does increased homogeneous texture in liver form 22x20mm to 30x25mm suggest?\n\nHi doctors, great site that i hope everybody get benfit of it.My wife has a Homogenous Texture in the liver which increased from 22X20MM to 30X25MM from 16/10/2010 until 3/3/2012.It is seen in right Lobe echogenic focal lesion with the above mentioned measure, no billiary radicle dilatation were detected.",
    "doctor_response": "hi.noted history of liver lesion on imaging study. is your wife experiencing any abdominal symptoms (like pain, fullness, nausea, vomiting) or systemic symptoms (like weight loss, fever, fatigue)? does she have any history of hepatitis or other types of liver infection? it is best if you tell your wife to consult with a doctor, preferably a general surgeon or a gastroenterologist, for physical examination and clinical evaluation. benign vs malignant tumor lesions must be ruled out. one important thing to rule-out is hepatocellular carcinoma. other diagnostics (such as ct-scan if not yet done, liver function tests, bilirubins, tumor markers, blood count, etc.) and management (medical and/or surgical if indications are found) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring low-grade fever?\n\nI've had a periodic low-grade fever for the past three weeks (approximately half of the days my temperature will be between about 99-99.5; normal temperature for me is around 98.0).  I'm not otherwise experiencing symptoms of illness.  About two weeks ago a doctor said that a fever without other symptoms wouldn't be concerning unless it was above 100.4.  Should I seek a second opinion?  What might be causing this?",
    "doctor_response": "Hello, Welcome to HCMI am Dr Rakesh Sharma answering  your query.I can understand your concern following are few causes of low grade fever,Cold, flu, or other viral infectionsEar infectionGastroenteritis (infection of the digestive tract)Lung infections, such as bronchitis, pneumonia, and tuberculosisMononucleosis (viral infection)Parasitic infectionSinus infectionUrinary tract infections.If you have thing of this it must be treated.Before considering your temperature 99 as normal, you should be investigated properly.You can seek a second opinion ,there is no harm in it.Hope this suggestion will help you.Good Luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does posterior osteophytes seen from C5 to C7 associated with effacement of neural exit foramens mean ?\n\nThe x-ray report says posterior osteophytes seen from c5 to c7 associated with effacement of neural exit foramens what does this mean please help? I am a old lady from kenya aged 62 years. my names..Hadijah Hajj",
    "doctor_response": "hi  Hadijah Hajj, oseophytes of cervical regions means your vertebral body got degenerated as a result beek like or lip like structure develop at that area. this also known as lipping or beeking of vertebra. neural exit foremen are the openings which help the spinal nerves to come outside from spinal cord through the vertebral canal. due to the degeneration and the inflammation develop at this area this foreman get narrowed and as a result the nerve which passes through will get congestion and pain along with numbness is the result thanking you christyjoseph1@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump on the jaw\n\nHi my boyfriend knocked me unconscious to the ground last week and there is a huge lump in my jaw that just wont go down...and a piece of my back tooth or feeling came out and it hurts to chew anything. Can you tell me what to do about both of these situations because the lump still hurts and my tooth is in pain im scared to go seek help i know i have to but i just want to know what can i do before i go. Thanks",
    "doctor_response": "Welcome to health care magic. 1. There is a history of trauma / hit and lump on the jaw - the possible cause could be hematoma formation / subcutaneous oedema. 2.In this case i can advise you to apply diclofenac cream - will give the symptomatic treatment.3.However you need to visit your GP and get examined and treated accordingly. 4.Mean while do not disturb the lump - as it will only complicate or delay in healing process. Good luck.Hope i have answered your query,any thing to ask ? do not hesitate to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cough and breathing problem\n\nMy son age 4 yrs is having cough and flum (breathing problem) problem. He is having breathing problem during nights, he is continuously coughing and unable to spit the flum out. Kindly suggest best antibiotic to dilute the flum. We have used buxol, ambroxil, azitrol, but no use. Kindly suggest best medicine. We are living in Shahabad, Gulbarga District, Karnataka",
    "doctor_response": "Hello,It count an upper respiratory tract infection. Consult a pediatrician and get evaluated. Antibiotics must be started.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of vertigo?\n\nI was diagnosed with vertigo in early june..although I am much better than I was I still have a spinning room when I lay down and sit up in the am.if I look up too or reach up too long I can feel the dizziness coming on. Same with leaning over.i seem to loose my balance easily. Can this be something else and should I see someone?",
    "doctor_response": "Hi, welcome to our site. I am Dr Saumya Mittal, MD.Read your query. That is a very significant question and i appreciate your problem. I will try my best to answer your queryThis sounds very much like Benign Positional Vertigo. In this, if you change the head position suddenly and quickly, you will develop the vertigo.You need to be careful to change the position of the head slowly so that you do not have the sudden vertigo.The medicines are always there and are quite effective especially betahistidine. However taking medicines for a long time is not always a good way.I suggest you attempt to learn the Brant Daroff exercises, which are very effective in healing and improving the vertigo.An MRI brain would be good to make sure there is no intracranial or brain problem.I hope this helps you. Inform the reports mentioned above/if any other so I can be of help further. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you. You can upload them on the site.You can upload them with the query, or if you have a problem, send them to attachments@healthcaremagic.com with Sub: ATTN 'Your Name'. Once we receive the photos or diagnostic reports, my team will send reports / pictures to me.Please do understand that some details could be extracted from a detailed history and examination.Please click on Thanks/Helpful if found useful.Please feel free to ask another query. I would be glad to help you. Looking forward to your return query with the details asked so that I can help you further. (If the answer has helped you, please indicate this by clicking on HELPFUL)Best of luck.Dr Mittal.MBBS, MD (Internal Medicine), CC (Diabetes Mellitus), DNB (Neurology)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pimples after using acutane contraceptive pills. Changed the tooth paste. Is that the reason?\n\nHi, i have had clear skin for about 3 years now since seeking professional help when i was younger. I was put on accutane and contraceptive pill and it cleared up within 3 months, therefore i stopped taking them. However, now my skin is so bad, and i seem to get reoccuring pimples on my lip line which are extremely painful and in the crease of my chin. Pleaseeee help, i have changed my toothpaste to flouride free since thinking that could be the problem and i cant afford to go see the dermatologist again. Thanks, Anon",
    "doctor_response": "Hello, Accutane helps to release less amount of oil from your skin, and it is very clear that since you've withdrawn the drug your pimples recurring, kindly go for external applications for your skin problem so that you can maintain your skin texture. Almonds, honey, tomato, potatoes, carrot, milk cream are very good for skin complexion and helps the skin to glow. thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please recommend some treatment for jock itch.\n\nHi doctor, I am having an abscess on my balls. It is reddish and painful, but not much. I have jock itch right now. I saw terrific images on the internet, but it is not like that. Please help.",
    "doctor_response": "Hi. Please put up two to three clear photos of the affected area for proper evaluation and guidance. Revert back with the photos to a\u00a0dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for nightfall?\n\nhi am 21 years old ,i am suffuring from nightfall from 5 years .i havent take any medicine to cure nightfall but tried all ways to stop nightfall(i.e not watching bad movies ,yoga,excercise ),but it doesent help me,and my confidence is also become low,so please help me,thanks",
    "doctor_response": "Hello, The best method to stop nightfall is to masturbate once in three days. You don't have to worry about nightfall because it is never unhealthy for your body. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could painful cheat,ear and throat with breathing difficulty suggest?\n\nI can t get to a hospital because I live in a very small village and they don t have a reliable clinic here and I need to know what I have cause my chest hurts my ears my throat hurts and its hard to breathe and I keep sneezing and puked a few times n feeling tired and I am trying to figure out what is going on its been 2days now and it just got very worse today and I need to know what it is",
    "doctor_response": "Thanks for your question on HCM.In my opinion you are having respiratory tract infection.starting from nose till the lungs.So better to start these treatment. 1. Avoid oily and spicy food.2. Drink plenty of water.3. Start macrolide group of antibiotic. 4. Also take antihistamines drug5. Also take anti inflammatory drugs.If not improve in 5 days better to get done Chest x ray to rule out lower respiratory tract infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My soles and fingertips are red. Could this be a side effect of my steroid medication?\n\nHello doctor, I had been put on Prednisone steroids for 21 days because of an allergic reaction to poison ivy. I have been off them for almost three weeks and I still feel withdrawal symptoms. The latest side effect, tonight, was red finger tips with white palms. The soles of my feet\u00a0are also very red. Should I go to the hospital or wait it out? I do not want to lose my hands and feet due to a medication I have been given.",
    "doctor_response": "Hello. I read your query and understand your concern. You received Prednisone for 21 days and have stopped them three weeks ago. Let me explain about steroids. Steroids are tapered slowly if taken for a duration longer than a week. The withdrawal symptoms have a dramatic presentation in the first 48 hours characterized by vomiting, loose motions, low blood pressure and shock. This is a medical emergency with high mortality rate when left untreated. That is the reason why you need to be taken off the steroids slowly. However, new symptoms of withdrawal cannot occur a week after stopping the drug because the hypothalamic-pituitary axis recovers by that time. So, the redness of the soles and fingertips are not withdrawal symptoms and possibly an allergic reaction. I would suggest taking antihistamines for a few days. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Suffering from hair loss due to scalp psoriasis. What to do?\n\nHi doctor, I am suffering from scalp psoriasis. I have yellow flakes appearing predominantly on the frontal and middle portion of the scalp. After shampooing, it is accompanied by hair loss. What can I do to prevent flaking and to reduce my hair fall? I am using Ketocare shampoo with Topisol 6 % lotion and a Revilus multivitamin.",
    "doctor_response": "Hi. I have gone through your attachment (attachment removed to protect patient identity). I would recommend you use Salytor shampoo (Coal tar with Salicylic acid) twice weekly and continue with Topisol 6 % lotion (Clobetasol with Salicylic acid). If it is associated with itching, take tablet Levocetirizine 5 mg once daily at bedtime. For hair fall, take tablet Follihair A (Folic acid with Biotin) once daily.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for over functioning liver and bugs in stomach\n\nHi Dr, I was on antibiotics and two other medicines to treat tummy bugs last week and had a bad reaction to those medicines, afterwards told by GP that my liver is overfunctioning after a blood test. I am worried, what will happen now, what does it mean ?PratibhaSorry, I thought it was free, I can not pay.",
    "doctor_response": "Hi thanks for asking question.You have not mentioned which antibiotic you are using??There is no terminology like over functioning of liver.Your liver profile might be altered with high value of sgpt or sgot....USG done for fatty liver.For rule out viral hepatitis viral marker done.If you have malabsorption like because of celiac disease then also enzymes value can be high.If you are using drug for long time then liver can be affected and values high.For your gastric problem if you provide detail history of pain, diarrhea or any other complain then further guidance to you van given.Take care.....",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red dot on eyeball of a baby having viral fever?\n\nHi Dr. Santosh, my 10month old had viral fever since last three days we kept her on tylenol and motrin every four hrs, vice versa.... when we checked with peditrician here they said she has ear infection... now that she is on that ear infection medicine since last three days... i noticed red dot on her right eye ball... wht could be the reason",
    "doctor_response": "Thanks for posting your query at HealthCareMagic. I am sorry that your daughter is not well. The red dot you are talking about is probably is a subconjunctival haemorrhage. It is not a cause of concern and should resolve spontaneously in around 7 days. It often happens on forceful coughing though other things may also be responsible. Do not worry about it. Read more about it at  hope that your query is resolved. Feel free to revert back in case of further queries if any.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the normal blood pressure for adults?\n\nMy uncle is 62 year old and has problems with his blood pressure. Yesterday he was at the hospital and he s blood pressure was fine... a little high but okay. Now, however, it s under 100. for example: the lowest was 84/ 45. The highest was 99/ 62. He is on medication but don t think there working right. On top of that problem he has diabetes and CANCER.... stage 4.... and losing weight. Now that you have this information.... my question is... what is a normal blood pressure for a 62 year old male? And if the cancer and/ or the diabetes are causing it to drop?",
    "doctor_response": "Hello,      I can understand your concern for your uncle and had gone through your question thoroughly.      First of all, i would like to tell you that a 62 year old male should have BP lower than 130/80 mm of Hg and its normal for your uncle.  Diabetes usually will increase the blood pressure rather than lowering the BP. Cancer can increase or decrease the BP, depending on so many things.      I would like to tell you that your uncle's BP is quite lower than usual and it can create few serious problems sometimes. If you can tell me what kind of medications your uncle is taking, then i can guide you further.      Hope this will help you and let me know your further queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for irregular heartbeat, dry heaves and hair fall\n\nI have been silent sick for about a year or more now..I feel that I am dying. I've felt this for awhile, and kept it a secret. but I believe ppl reallty do know when they are. I have no insurance. But I don't want to die. I'm scared, and I have no idea what I'm suppose to do. My family has no clue. but please, is there anyone who can help me? I know you need money. but im somebodys daughter, and one day she's going to be crying while she burries her daughter. I have an irregular heartbeat, rapid, I am short of breath, I've had horrible dry heaves for the past 2 years. Now there to the point it makes my brain feel like it's going to burst, and my heart. I have been forgetful and always tired. I never have energy and when i do, it runs out quick. Sometimes it feels like theres a water bubble or something that needs to pop in my chest. and when i lay on my left side it puts painful pressure on my heart. My heart will speed real fast up to 200+ at some times just by vacuuming a floor. I get wore out fast. i'm only 28 years old. I've been urninating a lot more and my periods are horrible. When I don't have make up on, I look bad. My circles are dark and I just don't look well. my hair is thinning and falling out. My feet get swollen and hurt all the time sometimes they get red and my veins stick out real bad. I just know something is wrong. Oh, plus i have had ulcers for years...I just need help and don't know where to go. I'm a good person. And never once has anyone ever just been there for me...I just don't know what to do. I'm scared. I know that",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. I have gone through your all symptoms. All these symptoms are more suggestive of stress, anxiety, depression and panic disorder. So in my opinion, you should first consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on it's solution. You may need anxiolytic and antidepressant drugs too. Counselling plays very important role along with drugs for control of symptoms. Don't worry, you will be alright. Avoid stress, tension, fear and panic. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach cramps with runny green poo\n\nI have been having slightly runny green poo and it smells for the last 4 days and now running a temperature, with a few stomach cramps. SHould I be worried",
    "doctor_response": "Hi. . You are most likely having an intestinal infection. You need antibiotics to control your loose stools.Meanwhile continue taking plenty of fluids and light easy to digest food. Dr. Rakhi Tayal",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am suffering from normospermia. Suggest me\n\ni have carried out semen analysis and realised tha am suffering from normospermia, so what should i do so that my sperm should be normal?",
    "doctor_response": "it will be better if complete report is attached or mailed. For improving sperm status you can have cap. addyzoa 1 bd.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of depression?\n\nI don t know if I am depressed or not, I m not religious and I feel like there is no point in really trying hard in school or stressing about it because we all die anyway so whats the point? I m tired basically all the time but I might just be a tired person so I don t know... I also feel like there isn t much to look forward to in life because you just work and work all your life until you finally retire and die. space is huge and on the large scale a human life is just a blip and was all so I don t know... dispensible? I don t know if I m just cynical or depressed",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.\u00a0\u00a0\u00a0\u00a0\u00a0Depression can affect anyone and you can overcome it completely. This is a phase and it will go. Depression symptoms include feeling low all the time, loss of interest in the previous pleasurable activity, feeling lonely, low in energy, hopeless, helpless, worthless feeling and sometimes even suicidal ideas. Few of them or all can be present at a time. Consult a nearby psychiatric clinic. Make sure you are not alone trying to be with someone close to you, share your thoughts, sleep for an adequate time, have healthy meals on time, involved in activities you used to enjoy earlier. Hope I have answered your query. Let me know if I can assist you further.Regards, \u00a0\u00a0\u00a0\u00a0\u00a0 Dr. Rohit Kothari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurrent pulsations in the heart?\n\nMy boyfriend and I can t afford health insurance so therefore he can t go to the doctor. I m very concerned about some heart issues he has been having. He said it started when he was about 17 years old. It s an everyday issue when he gets hot or just tired his heart feels like it s skipping beats. It seems like it s happening more often. Even when he s not worked up or hot or stressed out we can just be sitting here and it ll start bothering him.",
    "doctor_response": "kindly hve routine ix...cbc...rft lft...tsh....rbs .ecg ..n cxr ...n consultant examination by physician at least......low hb....thyrotoxicosis ..anxity ...sexual pleause...n so many reason that can b present in such condition.....do consultwith report",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can hair removal cream cause any harm to fetus during pregnancy?\n\nSo i just used nair on my bikini area, but having not paid attention to the warning label, I used inisde my perianal and vaginal areas. I clearly as a result have horrible irritation and burning. I know this will eventually go away but I m 99% sure I m pregnant. CouldI have hurt the fetus?",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic.I have gone through your query. I think I have understood your concern, I will try to suggest you the best possible treatment options.First of all do not panic.Even if you are pregnant, it will be very early pregnancy.As such locally applied hair removal cream, should not cause harm to pregnancy.I will suggest you to apply good quality moisturizer on the affected area.Keep parts dry and clean.I hope my answer helps you.Thanks.Wish you good health.With regardsDr Purushottam Neurgaonkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a cracking sound in upper part of the spine\n\nDear Sir, Good morning. Since 2 years I have the problem of panting for breathe while walking briskly. But absolutely there is no pain anywhere in my body. I am a female aged 35 years and from NJ USA. And recently I have also developed cracking sound in the upper part of my spine just in the neck, back portion of my head. I can hear and sense the sprain of a nerve while i turn my head to another direction. Please reply. And also suggest a good government hospital in Edison, NJ Awaiting your reply. Daisy",
    "doctor_response": "Hello!Welcome on HCM!I carefully read your question and would explain that your symptoms are related to chronic degeneration of the cervical spinal columns. You should know that occipital nerves originate in this region and occipital neuralgia can also occur. I recommend consulting with your attending physician for a careful physical exam and perform a cervical spine X ray study. A cervical spine CT scan or MRI may be needed to examine better this portion of the spine.  Hope to have been helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recurring bad breath, prone to dental plaque, swollen gums, good dental hygiene. Remedy?\n\nhello doctor, i have been facing foul breath for many years now. Though, some days it is there and some days it is not. I am prone to dental plaque and occasionally my gums also swell . I do not have any other problems like diabetes or constipation . But i do experience flatulence . I brush my teeth twice a day and scrape my toung every time. What should i do to stop bad breath? And also how can i check myself, if i have bad breath?",
    "doctor_response": "Hi, Thanks  for  asking  the  query, Bad  Breath  can  be  because  of  various  reasons, Plague  and  calculus  deposition ,  periodontal  infections,  tongue  coating  ,  xerostomia  ,  faulty  restorations  retaining  plague  and  bacteria ,  oral  pathologic  lesions ,  mouthbreathing  habit,  fasting  and  starvations, eating  of  food  like  onions  ,  garlic Diseases  of  GIT ,  GERD  ,  Nasal  infections  like  rhinitis,  sinusitis. Pulmonary  infections  like Bronchitis   , pneumonia Systemic  conditions  likediabetes  ,  dehydration  ,   fever. Vist  to  a  Dentist  and  get  checkup  done  . Go  for  complete  mouth  scaling  and   polishing. Drink  lots  of  water  . Use  chlorhexidine  mouthwash  gargles   twice  daily. visit   to  a  GP  and get  checkup  done. Maintain  a  good  oral  hygiene . Hope  this  helps  out. REGARDS...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for headache and degenerative disc disease\n\nI have severe headaches but I only get the in 1 spot or a another at one time, like in the top right of my forhead piercing pain, then I will get them on the left back side of my head, my doctor says its due to the degenerate disc disease in my lower spine, but I don t feel like that is it, my legs and hips hurt alot most of the time,wrists and fingers, I have dry cracked feet like a diabetic only i m not diabetic or even pre diabetic, can all of this be related? short term memory loss like forgetting what I was doing while I was in the middle of it like completely forgot",
    "doctor_response": "Hello!I read your question and understand your concern.In my opinion the way pain on your back, problems with feet and headache may be related to a cervical disc problem. But trouble with memory is not caused by cervical disc. I would recommend a cervical spine CT scan and a head CT scan for the memory problems.A full blood work for inflammation would be helpful in rheumatic pain.Hope to have been helpful!Thank you for using HCM!Best wishes Dr. Abaz Quka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why did I suddenly cough up after inhaling from the inhaler?\n\nHi Dr mlkm, don't mind if I ask a quick question? I've just attempted to take an ashthma inhaler and something must have been in the plastic case as i believe I have inhaled a large solid object. I immediately started coughing but nothig has came up. Any advice?",
    "doctor_response": "Hi,RELAX.  This may be the drugs due to inhaler or sputum since you don't have any other problem. Just get checked whether air entry is good in both sides of chest just to rule out any foreign body.If any breathlessness,  chest pain or other sighs visit your doctor once for examination.wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for a lump on the back\n\nHi, may I answer your health queries right now ? Please type your query here...my husband has had a quarter size lump in the middle of his back for years...last night a very large amount of pus came out of it with no pain. today he has pain.. what could this have been and should he do anything about it. Thanks",
    "doctor_response": "hi.based from your description, it could be a sebaceous or keratinous cyst. physical examination and clinical evaluation is best by a general surgeon. medical (proper antibiotic regimen) and surgical (excision of cyst) management will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant cough in the night in children?\n\nmy 5 year old will start coughing every night close to bed time. She is not always laying down when this happens. She also has this every morning. She has had tubes in her ears, tonsils and adnoids already removed. I hate the thought of giving her cold meds every night....thoughts.",
    "doctor_response": "Hi,Welcome to HCM,The symptoms you quoted are suggestive of a hyperactive airway disease which in simple terms means allergic symptoms something similar to asthma. The cough can be due to hyperreactivity of your child's airways. Her adenoids and tonsils been removed puts her in the list of highly sensitive child because her immunity power would have been decreased. Your child needs to see a pediatrician and If I were him, would have started you child on inhalers which can be of great help for her in reducing her discomfort. Happy to help with any further queries. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does knee pain due to loose grissle take to get cured?\n\nMy son has just been to the doctor with severe pain in his knee. Said there is loose grissle and air bubbles due to too much sport. He is 14.has been referred to a sports doctor. How long will he have to lay off of sport for. He has a football match coming up in 12 days",
    "doctor_response": "Hi, Four to six weeks is usually required for complete recovery. Early mobilization might aggregate the symptoms. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause persistent chest pain?\n\nI have experienced chest pains for two weeks now on and off. during the day at work i'm usually okay but when i get home (usually whilst sitting on the sofa) I expirence a pain just to the left of the centre of my chest. This mostly spreads to the left side of my chest (heart area). I have had blood tests and an ECG all coming back normal but the problem has persisted. The pain can also move up to my left shoulder and bicep and up the left side of my throat. VERY worried but embarassed to tell anyone because I know it's probably nothing. It is a nightmare thinking about it constantly. please advise.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.No need to worry for heart diseases as your ecg is normal.Your pain is associated with specific position (sitting on sofa), so possibility of musculoskeletal pain is more likely.So avoid sitting on sofa or sit with proper back support.Avoid movements causing pain. Apply warm water pad on affected areas.Take simple painkiller like paracetamol or ibuprofen.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can scalp scabs, baldness with edges hair loss be treated?\n\na few yrs ago, i developed scabs on my scalp/edges, i thought it was from gel i was using, so i did peel it off, and it left permanent baldness, i also had a clear liquid forming, coming out, but it was only on my edges, one side not as bad as the other. im a blk afr amer female, age 28, i stopped getting perms and went all natural since then, but i mainly keep my hair n braids with a wig over top. the rest of my hairs been growing fine but my edges wont. i need help! please give ur advice...",
    "doctor_response": "Hello, I suggest you use a minoxidil solution. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Kakkar S., Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe cough with yellow mucus causing breathing difficulty and pain in shoulder and back\n\nI got a could and was sick for tho weeks and after  I felt better I star to have a cough symptons in the firt week was fine, but ont the second week got very bad, now I fill pain in my lower back, in my rigth side and pain in my right shoulder, I am coughing a lot w/ yellow mucus and the mucus small bad, when I cough I have dificult to breath, I am taking medicine to supres the cough and last nigth I was able to sleep a little better, but still have a lot pain om the back and rigth shoulder.",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. In my opinion,  we need to rule out 2 conditions in your case.1. Bronchitis2. Lung infection (pneumonia ). In both these conditions, cough with yellowish expectoration and chest pain are seen. Breathing difficulty is more seen in bronchitis. So better to consult pulmonologist and get done1. Clinical examination of respiratory system. 2. Chest x ray3. PFT ( pulmonary function test ). Chest x ray is needed to rule out lung infection ( pneumonia ). PFT is needed to diagnose bronchitis. You may need inhaled bronchodilators and antibiotic.So consult pulmonologist and first diagnose yourself and then start appropriate treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tooth extracted due to swelling. On clyndamycin, augmentin and arythmycin. Swollen gums persisting. Why?\n\nHi, my name is Mandee. I had a tooth extracted about two weeks ago due to extreme swelling . I have been on two antibiotics since including Clyndamycin and Augmentin and I am curently on Arythmycin. The swelling is actually getting worse and the pain is almost unbearable. The pain has increased on the gumline where the skin meets the gum and the swelling has doubled in the past two days when prior it was going down. Since I have ruled out infection due to the antibiotics, what else could be going on?",
    "doctor_response": "Hello & welcome, Since you extracted your tooth due to extreme swelling, means there was severe infection in surrounding tissue & tooth being the main focus of the infection. What so ever  may be the reason, you first need to undergo incision & drainage if the swelling has been from more than two weeks. Remember one important thing, Long term use of Antibiotics drugs without swelling being drained properly with an incision or after extraction, makes that swelling to indurate or become hard ( called as Antibioma ) which then will take more than 3 months approximately to resolve completely. Get an x-ray done by visiting to your dentist to check whether there is any remaining root piece which might get infected & cause swelling & pain. If there is any remaining root piece in the socket, removal of the same would resolve the condition immediately, but if no root piece is there, then ideally incision & drainage should be properly done. For the same reason, you can visit Oral & Maxillofacial surgeon who may help you regarding this issue. Since swelling is doubled in past two days, that clearly means you cant rule out infection due to oral antibiotics. You may need Antibiotics given through intra venous rout which will have faster results in your case. But off course these drugs will be given to you only by your Oral surgeon or dentist. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the link between concussions and nigtmares?\n\nHi, I ve got a concussion. I was wondering if you could tell me about any links between nightmares and concussions? The nightmares have nothing to do with how I got the concussion. But this is my second concussion in a span of two months and I remember have nightmares after both.",
    "doctor_response": "HiThanks for using healthcare magicNightmare is due to unconscious stress. May be due to concussions, you are tense and getting nightmare. In that case, you can use low dose benzodiazepine for few days and try some relaxation exercise that would keep you calm. These drugs are not available over the counter, so better consult a physician or psychiatrist.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes parenchymal disease after treated TB?\n\nmy son is 7 years old and he was dignosed with TB one year before. on 10.8.2011 his medicined were stopped and sonography was done some parachymal disease were found. what is cause of it,and how can it be treated please guide us in this. we have already conducted haemogram, copper test and blood test for immunity.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. No need to worry if your son is asymptomatic and clinically improving after treatment. Actually these current parenchymal lesions are fibrotic, scar lesions. Tuberculosis in lungs heals by any of the following mechanism. 1. Fibrosis (most common) 2. Calcification 3. Rarely Complete resolution. Since he has completed 1 year of treatment, fibrotic lesions are likely to develop as a healing process. So these parenchymal marks are nothing but healed fibrotic scars. So if he is asymptomatic then no need to worry. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent stabbing pain in the pelvic area?\n\nLeft ovary started hurting about a month ago. Got pretty rough day before yesterday just on the left side. That night a burning stabbing pain shot through my entire pelvic area. Yesterday I woke up and every single movement hurts. Mainly on the left side but it s all in pelvic area. Then today is a lot more painful. I am fatigued. My discharge is heavy(no smell). Hurts in pelvic area when I pee and have a bm. Bms went from once every two days to 3 times a day, to almost water like this morning.",
    "doctor_response": "Hello, As a first line management you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist better to consult a neurologist and get evaluated. An MRI scan is required for further assessment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause swelling around the navel and pain below the ribcage?\n\nI have swollen abdomen around belly button, about 5in diameter and moderate to severe pain bellow ribs and lower back. also have indentation on left below ribs about 1in deep. Had gallbladder removed last year. are they connected or what could cause this?",
    "doctor_response": "Hi, Please understand that this is not related to gallbladder directly. I advise you to undergo X-ray lumbar spine AP and lateral view to rule out lumbar spine disease. Also get ultrasound abdomen to rule out any pancreatic disease. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Varinder Joshi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the procedure for dental implants in place of fixed prosthesis?\n\nHello doctor,I lost my upper incisor after a childhood injury which later on was replaced by a dental bridge by a dentist who damaged my three healthy teeth to fix the bridge. It has been 15 years now and I want to go for implants. So, I have questions about what would be the whole approach? My bridge will be removed along with the teeth it is fixed on? And after how much time implants will be done?",
    "doctor_response": "Hello. Basically, getting implants is a surgical procedure where the dentist would be putting an implant in your bone through a small surgery under local anesthesia. After that you will have to wait for a few months for the implant to osseointegrate inside the bone means it will adapt itself inside the bone like the natural root. After that, there will be a second stage surgery, a very small procedure. After a few months, you will be getting the crown or the artificial tooth permanently. But before all of this, you need to get your bridge out, the teeth will not be removed with the bridge. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce severe pain in knee even after using dome difflam and icing?\n\nHi, my name is hannah and I am a  young athlete. I have my athletics carnival this week where i am competing in the 200 400 800 and the 100m relay. However yesterday i was starting to feel some pain around my right knee. This morning i woke up and it is still extremelly painful, whenever i squat, when standing back up from the squat there is a huge amount of pain, the it goes away. It hurst when i run too. I cant pinpoint exactly where the pain is though, its around the outer right of the right knee, but there is no exact spot. I have used dome difflam, and iced it for 2 hours, but it is still extremely painful. Im really worried as what to do because i normaly win everything at sportsday. What do i do???",
    "doctor_response": "HiThank you for asking HCMI have gone through your query.If you are getting a severe pain then a meniscal or ligament injury can be suspected.By physical examination by an Orthopedician you can rule out that.If he suspects then you will be send to CT or MRI to rule out that.If it is that then you need immobilization of knee for some days.Analgesics may give you pain relief.So it is better to consult an Orthopedician before you go for your sports event.Hope this may help you.Let me know if you have any further query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for the mental issues?\n\nHI , I am wondering about myself were im at  , I think I burnt out at work just pire 2009 and throwing a big contract away as I was working huge hours .so there maybe issues there relating to struggling with work .. ..I broke my leg 2009 not long after throwing contract and ended up in bed for 4 months   and I pretty certain I got a hypoactive disorder .I hv changed a lot and don't understand wats going on  , my marriage fell to bits but I think it was going anyway ..was married 14 years  11 good  last 3 go worse  moved out  meet a lady 1 month after moving out and she turned out to hv adhd. I been with her for 15 months  constantly breaking up  n getting back together .she really trys to change  but she has major jeliously  and anger issuses..I find I am upset and angry with her behaviour of accusing me of things I am not doing all the time , she accuse me of trying to hook up with all other woman all the time   wen im only interested in her . I sent her to her sisters once   she turned up back at my place and slit her wrist in front of me .that was 8 months ago .2 months ago she attacked me and scratched my face quite bad , she been back up north by her mum since .I am alone hwere in nelson  im drinking quite alote again  I can do 5 jugs 2-3 nights a week . im struggling to go to work . not because of drink but I feel depressed don't care .I love this woman but dangerous to hv her back. I got her on to 4 different medicartions , pysho specailists , docters etc  ,, I cant help her .not even sure I can help myself  . I never talked to anyone before how I feel  I just work thro stuff   .could I need help",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Your wife seems to be psychic and manic patient. There is no alternative than to continue the medications your psychiatrist prescribed. In addition, love and affection can cure her. You know her well. Forget your past. Your past can do nothing to your present if you ignore them. But if you don't ignore them, they shall haunt you. You are experiencing the haunting. Therefore, ignore your past, live in present, love your wife and live a happy life with her and she shall be alright.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.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the hard bump on my son's knee?\n\nMy 16 year old son hit his knee about a month and a half ago. He had xrays at first and there was nothing broken.  Now he has a hard bump in that place.  It only hurts when pressure is put on it.  What do you think that hard bump is? Thanks so much for your help!",
    "doctor_response": "Hello,Thank you for using Healthcaremagic.I read your question and understood your concern.I think this bump is a hematoma ( blood collection) that the body did not absorbed and it is hardened now. We call it organized hematoma or ossified hematoma. It will need masage and give more time the body to absorbeDr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My last HIV risk exposure was three to four years back. Am I safe now?\n\nHello doctor, I am a 65-year-old white male and tested negative for HIV 1 and 2 in a one-time test three to four years ago. I am not sure if it was a third or fourth generation test. I tested negative with a fourth generation test four months back because I thought I might be having some symptoms. And I remembered the flu-like illness about six months after exposure. I weighed 204 kg three months back and now I weigh 191 kg. I have worried a lot (pacing the floor, sleep loss) for past five months, took Paxil, and realized my worry could account for some weight loss. Shortly, after the test, I had the following symptoms:  I started having a small patch of 8 to 10 pinpoint sized pink-light red dots under the skin of my left wrist that have been there for two to three weeks. I also had a smooth, flat spot about 3/8 inch in diameter that appeared on the back of my right hand about a week ago, that has now faded to a pinkish brown. I have read about Kaposi sarcoma being a definer of AIDS, but do not understand how that could happen with a non-reactive fourth generation test four months back. Three months back, I had sinus type headaches multiple times that would sometimes be severe. After three rounds of antibiotics and a CT scan two months back that showed shadowing in a sinus, my ENT doctor just told me this week that there is something in my sphenoid sinus. He is treating it with a rinse for inflammation for three weeks before I see him again. I have had blood in my mucous from my nose for past three months. It dries out in my nose and causes blood almost every time I pick at it. The ENT doctor said that the lining of my nose had been worn down from this, but did not seem concerned about it. I do mess with it a lot, and blow my nose a lot. My PSA elevated quickly in the last six months, going from 1.2 to 3.5. A biopsy two months back showed an early cancer in one of the 12 regions biopsied. I had a lithotripsy on an 8 mm kidney stone this month and I am still passing dark urine. I was told that I do have several small stones still in each kidney. I have had multiple stones over the years. I have a swelling sensation all the way around my waist down into my groin at times that has been there for about two months, but no noticeable swelling. Several doctors have felt in my abdomen and detected nothing abnormal. A CT scan with no contrast 10 days ago showed no abnormalities other than a ",
    "doctor_response": "Hi. Your test done before four months is certainly conclusive and final. A three months intervening period/window period between risk exposure and a fourth generation HIV screening test is good enough for it to be considered conclusive. 95 % of those infected with HIV will have detectable antibodies by four weeks and by 12 weeks, or three months 100 % of HIV infected individual will have detectable antibodies. Antibodies once formed will remain detectable by screening tests. In fact, antibody based HIV screening tests are the gold standard tests for the diagnosis of infection whereas an HIV RNA PCR test is more commonly utilized as a measure of response to antiretroviral therapy in HIV AIDS patients rather than as a diagnostic or screening test. For more information consult a HIV AIDS specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluid in the chest cavity after thorascopic wedge resection?\n\nI just had a therascopic wedge resection of center right lobe of Lung , 24 hrs after suregery chest tube was removed and waited 4 hrs did a chest x-ray all looked very good sent me home have been home 2 days and I can hear fliud in chest cavity, is this a problem",
    "doctor_response": "Thanks for your question on HCM. In my opinion you should first get done repeat chest x ray.Post procedure pleural effusion can be seen in many conditions ,but the common ones are1. Reactionary effusion. 2. Infective effusion.3. Leakage from bleeder (small arteries may left open by mistake and slow blood trickle can be seen.So better to get done chest x ray again. If fluid quantity is more than you may need diagnostic aspiration. And treatment according to the cause. So better to consult pulmonologist and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to stop melanoma spreading to lungs, liver and brain?\n\nMy father in law had a melonoma cut out a couple of years ago, it has spread to lungs, liver, and brain, it is obviously terminal, today he has been unable to eat, he is diabetic, and has been throwing up which has been a dark brown colour, it he getting near the end ? Thanks",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Melanoma is rapidly spreading cancer with very poor prognosis.  He has spread in lung and brain so it is stage 4 cancer.  Chemotherapy is the treatment of choice.  It is only palliative care.  It can not cure the disease.  Prognosis remains very poor  despite of treatment.  Life expectancy is not good.  One should not expect much from this. Sorry to say but it is fact. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have difficulty in taking a deep breath. What can I do to normalize it?\n\nHi doctor, I have difficulty in taking a deep breath. I feel uncomfortable. My uric acid and cholesterol levels are at a higher range than normal. What can I do to normalize my breathing?",
    "doctor_response": "Hi. I have gone through the attachment (attachment removed to protect patient identity). You have an LDL (low-density lipoprotein) cholesterol of 161 mg/dL. You can manage it by taking tablet Atorvastatin or tablet Rosuvastatin 20 mg at night for a month and see for improvement. Also, have a walk for half an hour a day. It helps you. You can have difficulty in having deep breathing due to thickened pleura. You can take a painkiller for a week. Please consider taking these drugs after consulting your local physician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cyst on my back\n\ni got acyst on my back .i am 25 years old female.i had it for 1year,initially it was very small so i didnt care and no pain also...but now adays it is slightly paining and the size was increased.could u please suggest to which specialist i have to approach..?can i go to dermatologist?do i have to  go through surgery?i am so worried of scar after surgery.....is there any other way?",
    "doctor_response": "Hello!Thank you for the query.Most of such lumps are benign and there is no urgency in removing them. However as they like to grow, can cause a discomfort and for such reason can be removed.To do that you should consult general surgeon. And yes, small surgery will be necessary if you want to get rid of it.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is red spotting after IUI normal ?\n\n2 weeks post my first iui i can c red disharge . what do i conclude with it ?? i had my iui done on 16th and 17th feb, my periods r due on 3rd feb.",
    "doctor_response": "Hello, If you have spotting now,and are due on march 3rd then this should be your periods.If you get a proper period then you IUI failed.If you only get spotting,get a pregnancy test after few days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever and chills every day at same time?\n\nwhy is it that my boyfriend gets a fever of 103 everyday for last week at the same time with extreme chills after?? he went and got blood work done and everything was normal except his white blood cells were elevated. and the area around his liver was tender but liver tests were normal",
    "doctor_response": "Hi. Thank you for writing to HCM. Your boyfriend seems to be presenting a pattern of fever that is typical in malarial infections. I would recommend that you have his blood tested for QBC malaria or a peripheral smear (whichever is available). The fever spikes when the parasites enter the blood and subsides when they hide inside an organ. Liver being tender is also suggestive of malaria (Liver function tests may be normal in early stages).Also since his WBC's are elevated it does indicate an infections. It would be useful to know the differentials such as if neutrophils are raised then it suggests a bacterial infection and in that case typhoid must be ruled out. If lymphocytes are elevated then it may be viral and dengue must be ruled out. Therefore it is my opinion that you have him evaluated for this fever of unknown origin by a physician for a detailed work up, blood tests and ultrasound of the liver or may be CT scan of the abdomen. Based on the results appropriate management may be indicated. Currently paracetamol to reduce fever is the only symptomatic option. Management for malaria, typhoid and dengue vary considerably.Hope this helps. Do let me know if you have any other questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Yellow pigment in hands, bright yellow urine, jaundice infection. Taking cipro for diarrhea. Treatment for infection?\n\nI am taking cipro for travelers diarrhea I got in XXXXXX when they were -- unknown to me -- having a problem with their water. This problem might have started before then, but I have yellow pigment in my hands and bright yellow urine . The bright yellow wiped off on towel and pillow case. My doc said she s never heard of jaundice associated with liver issues wiping off on a pillow. What do you say?",
    "doctor_response": "Do your liver enzymes and ultasound abdomen and urine test.If they come out to be normal then nothing to worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are my chances of getting pregnant?\n\nI took primolut n to delay my menstruation which is supposed to be on 1.3.14. Started 2tabs 2 times a day on 23.2 till 28.2. However I had unprotected sex on the night of 28.2. So after 42hours, i took escapelle to prevent of getting pregnancy. What are the chance?",
    "doctor_response": "Hi.The earlier an emergency contraceptive pills (ECP) is taken the better. But as you took it within the first 48 hours, your chances of preventing conception are about 85 %. This should be good enough to avoid it.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shortness of breath and chronic dry cough\n\nI have had a chronic cough for 28 years. Dry and productive. It is set off by wind, talking, after eating, air temp too cool or too hot, talking on a phone, etc. I have had all testing and diagnoised with Laryagospasm Spamadic Dysphonia. I also believe I have allergies that contribute to it. Now, since my colonoscopy under Propofol, I now have PVC s, along with a jumpy feeling in my upper stomach. Usually set off after eating or resting. Although sometimes it is non stop. I had a cardiac treatmill w/echocardiogram and all was fine. My dad had his 1st heart attack at 57 & I am now 58.(Female). Donnatol did help the jumpy stomach and calmed the PVC s but not taking now. I also sometimes, have alittle shortness of breath when I lay down in bed, or brush my teeth, towel dry from shower, etc. Valium sometimes will help. I also have an elevated HS CRP. The cardiologist doesn t seem to think I need to worry about anything. Any ideas of what I can do or take to help any of the above issues. Somehow, I feel that they are all linked together! Janice",
    "doctor_response": "The cause for dry and productive cough needs to be evaluated with a pulmonary function test which will tell us about your lung function and also give us an idea if you will benefit with inhaled bronchodilators.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain, abdominal pain, swelling, chills. What is it?\n\nhi, im a 16 year old male my lower back hurts on a daily basis but today it started with severe abdomen pain and then my lower left back started hurting severely no matter if i was bending over reaching to get something or walking a certain way. over the course of about 6 hpours my lower left back has swollen up and im starting to get the chills and feel like im confused a little bit",
    "doctor_response": "Hello and Welcome to HCM, Thanks for writing to us. Lower back pain, abdominal pain, swelling, chills seems to be related to some infective pathology in area. It could be paraspinal abscess or renal infection.I suggest you to get it evaluated by physician and definitive treatment according to that. Hope this helps you. Wishing you good health... Regards. Dr Saurabh Gupta. Orthopaedic Surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on wrist after having Intravenous injection?\n\nhi! i got a a small lump on my wrist where my pulse is, same line with my vain i noticed this right after my iv test for ct scan. until now my veins in my left arm where my lump is, is still seems angry compare to my veins on my right hand. is this related to to the iv given to me for my ct scan?",
    "doctor_response": "Hi,Based on the facts of your query,you seem to have contrast induced thrombophlebitis with clot lumps of the vein used for Contrast CT study.There is no ambiguity about this cause.Would suggest you to treat it with your PCP guidance, and would resolve in 8-15 days time after proper treatment.Hope this reply would help you to plan treatment with your doctor.Will appreciate your Hitting  thanks and writing  excellent review comments to help needy patients like you. Welcome with any other further query in this regard.Good Day!!Dr.Savaskar,Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Gums bleeding, bruising. Headaches, night sweats, appetite loss, constant cold, iron level less. Cure?\n\nHave had bleeding gums, and easy bruising of late. I have also started getting really bad headaches and night sweats and for the past three days have lost my appetite. I am constantly getting sick with colds, flues and bronchitis and I am so tired all the time. My iron won t go up much it is currently sitting at 11. I just want to be well. I am currently studying my Bachelors of nursing and I really want to complete it. Please help.",
    "doctor_response": "Hi dbuckley....going thrrough your symptoms i diagnosed that you are anemic....increase your iron intake,take fresh fruits especially apple,banana and oranges....as oranges are rich source of vitamin c so it will helps to cure bleeding gums...keep good oral hygiene and go for scaling too. For  one month take follic acid 5mg per day. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat tightness around foreskin?\n\nFirst of all, i need to know which doctor sholud i consuld, i have a problem related with the foreskin. it is very tight and it has developed a ring like structure on the inside which actually makes it tight. it is impossible to retract it over the head. who will solve my problem - skin specialist, general physician or someone related to sexual health? Detail description : age 28, never engaged in sexual activity except masturbation,the skin used to pull back(still it was tight) when i was teenager, then sometime during college i developed this condition. the while white skin looks like dead skin. now there is some part of glans where the foreskin connects to the glans which also has become while in colour and appears dead. major part of foreskin looks healthy and the problem lies with little area only",
    "doctor_response": "Hello, PHIMOSIS is a congenital narrowing of the opening of the foreskin so that it cannot be retracted. Phimosis is a very common problem. In most of the cases you can clear the problem yourself. Phimosis could cause moderate to severe pain while having vaginal intercourse. Apply oil on your foreskin and on the glans. Move the foreskin forward and back slowly without hurting you much. Because the oil is lubricant, it will be easier than without oil. Do this forward and back movement 20 times several times in a day. Repeat the same every day for around one month. You will get the elasticity and you will be able to retract the foreskin completely. In case if there is no result from the above massage, you can always go for a minor surgical procedure called circumcision. Therefore I suggest consulting a skin specialist for physical examination, diagnosis and treatment. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. K. V. Anand",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white matter on the parietal lobe and signal changes in a child with CMT?\n\nMy 7 year old son has Charcot Marie Tooth (CMT) 1a. He had his first MRI in 2011 which showed white matter on his Parietal lobe and signal changes but other than that a normal scan. He had it repeated in 2013 which reported a partial resolution of the matter and less prominent signals, again rest of the scan normal. We were told this is a positive thing that there had shown to be partial resolution in the two year gap between scans. Don t you agree? His neurologist now wants to repeat the MRI as she feels it s not related to his CMT diagnosis...",
    "doctor_response": "Hi, Yes, MRI repeat can be done to see the progress, CMT usually involves peripheral nerves, CNS involvement at this level is unusual, it might be due to some other cause. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. SHEHLA USMAN, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to heel cut knees quickly\n\nHi. A couple of months ago i fell over on astroturf and cut my knees. They are healing quite well now but are still fairly red. I'm going on holiday in a few weeks and wondered if there was anything I could do to speed up the healing process. Someone recommended sunbeds, but i'm worried they'd do more worse than good!",
    "doctor_response": "**1.  After an injury, the knee is never \"normal.\" thus for expert guidance kindly consult an orthopedic Surgeon or Sport Medicine Specialist for necessary instructions and rehabilitation2. The heat of a sun bed can increased the flow of blood through the skin, diverting blood from the main vessels and reducing the pressure in them and may cause postural hypotension, otherwise you can use it without any hitch.3. You can Practice Utkatasan (chair pose),Trikonasan (triangle pose), Utthita Parsvakonasan (extended side angle pose) to strengthen your Knees,thighs, hips and ankles but only after consulting.4. If your knee takes a while to heal, see a doctor, so that it is professionally treated",
    "dialogue_context": ""
  },
  {
    "patient_message": "How serious is cord around baby's neck?\n\niam pregnant and its my sixth month i had an ultrasound two days before it was showing that the cord is around my babys neck pls tell that if there is anything serious about it.",
    "doctor_response": "HiI have gone through your complaint.dont worry .you are just 6 months and cord around neck is quite commonly seen.single or double loop if it is loose nothing to worry.these umblical cord usually wil go off by the time it reaches term, near to delivary.go for scan after 36 wks if umbulical cord is there ,there is less chance of go,then it needs to know is it loose or tight.if tight one dont take risk for normal delivary.there are so many people who delived by normal delivary with umbulical cord around fetal neck.Thank youRegardsVasundhara",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain and frequent urination?\n\nmy 19 year old son who has high blood pressure for years due to solitary kidney , with only small amount of kidney damage is complaining of left side back pain along with urine frequency, but no pain to urinate.... a complete feeling of not well..... he tested his sugar ( 15 ) but after a light meal..... im very concerned as there is a strong history of diabeties in the family .... he is also spills a lot of protein in his urine..... im trying to get him to call his kidney specialist but he refuses and says he will test sugar in morning.... concerned mother",
    "doctor_response": "Hi. welcome to HCM.Looking to your son's history, it seems that he has high BP due to kidney problem.Protein leakage in urine require quantification by 24 hour urine protein measurement. Check S. creatinine and sonography.Diabetes can be ruled out by fasting blood sugar and HbA1c measurement.Back pain may be due to other problem also- like spine related.if sonography of kidney is normal, you can do spine xray and consult orthopedician for that.I think this would be helpful to you.Best wishes. TC.Dr Jay Patel.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for numbness on the forehead after injury?\n\nI just hit my head very hard on the centre near my forehead on a metal shelf. I m feeling tired and I know just in case I shouldn t go to sleep. It instantly hurt but it went away, now it feels numb and I just feel very tired. Should I go to the emergency or get an ice pack?",
    "doctor_response": "Hello, As due to direct impact there will be mild cerebral edema and due to which you will feel tired and numbness. Wait and watch for any symptoms of brain injury like redness of eye, clot formation at the forehead, etc. If the symptoms of brain Injury are negative then with rest and good fluid consumption you should be fine. I don't think about the history you need to visit the ER. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cirrhosis with fluid retaining in tissues?\n\nMom has been diagnosed with Cirrhosis. There is no known cause for it. Her liver and spleen are enlarged and she is retaining a large amount of fluid. The Dr. s attempted to do a paracentesis on her today, but were unable to due to the fact that the fluid is in her tissues not in an open area where they are able to drain it. Could she possibly have cancer? Her lab values are fantastic except for low hematocrit, low platelet count, and low hemoglobin. She s also anemic.",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. No, it is not cancer.2. Cirrhosis causes portal hypertension, which can result in ascites, which results in accumulation of fluid in abdomen.3. Anemia requires correction, along with improvement in platelet count. Possible associated Vit B12 deficiency needs evaluation.4. In cirrhosis, internal bleeding is common. Enodoscopy for oesphageal varices and stool examination will be helpful.5. Ultrasound guided aspiration maybe done. Fluid aspirated can be sent for cytology study, to confirm its benign nature.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in neck of a 4 year old?\n\nhi, my 4 yr. old daughter is complaning of pain in her neck behind her ear it s hurting her when she moves her neck. she was diagnosed with fluid in that ear a week ago. she is still on meds. for her cold. gave her motrin any other suggestions on what to do? we were at park and she was climbing up the rock wall and she said that she had a crick in her neck and started crying. thanks for your help",
    "doctor_response": "Hi,This is most probably due to super added infection on top of the fluid collection that she had. She might need an antibiotic if the infection is bacterial. Your doctor should know about this.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Salah Saad Shoman",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this MRI report of back indicate?\n\nsir i hav tremendous pain in my lower back whch later stresses on the entire back , i hav been asked 2 do a MRI , whch i hav done . it says i have posterocentral protrusion of l4-5 disc indenting thecal sac . diffuse posterior bulge with small posterocentral protrusion of l5-s1 disc effacing epidural fat . no nerve root compression or impingement is seen . ths is wat the conclusion of the mri report says . i wanna know d meaning of the above ..",
    "doctor_response": "Hello. I have been through your question and understand your concern.The MRI result is normal with no correlation to your symptoms. The protrusions are definitely not the cause of your complaints. Basically the MRI was not of a great help, but it definitely ruled out some of the serious conditions that are progressive, like stenosis, disc herniations, tumors, or spinal anomalies.I suggest you to do a final dynamic XRay, which is simple and rules out spondilolysthesis, which MRI does not help.Wish you the best health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hypertension\n\nHi im a over weight 31 year old african americsn and my blood pressure recently was 156/100 but went down in a couple days to 133/98. Ive changed my eating habits since the first reading. Is it possible i can cure myself before prehypertension set in?",
    "doctor_response": "Yes you can,,as you see you can control your blood pressure by just changing your feeding habits without any medication..keep going on by only food",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for OCD\n\nMy son who is 27 has suffered from OCD the last 5 years. He has been in an inpatient exposure response program and private therapy with an OCD specialist for over a year. His obsessions and compulsions are mostly mental. However, spending and returning things seems to be a problem. The past 2 years he has not been able to hold a job in his field-civil engineering (about 8 jobs total). He quits, usually between 2 days to 2 weeks after getting the job, because he has doubts and uncertainty about the job-will he get fired, can he do the job, is it a permanent job. These are just a few. My question is-do we encourage him to stay with the job no matter how anxious he is. He does OK at jobs like busing tables, but says he wants more out of life. But this is a constant Merry go round that he is on. We are trying to courage him to seek therapy again, but is adamant because it has not helped in the past. He is on medication.",
    "doctor_response": "HiI admire you for positive outlook.OCD is one of the anxiety disorder which disturb daily routine and impairment in social life.OCD require treatment.There is two type of therapy.1st is drug therapy OCD can be treated with Medicine like fluoxetine or fluoxamine or clomipramine.but treatment depends upon clinical presentations.2nd is psychotherapycognitive behavior therapy (CBT) is most useful to treat OCDit is multi session therapy given by specialist.Try to consult as early as possible .Early treatment in OCD will bring good results.So consult psychiatrist and get help.Get well soon.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for frequent nasal congestion in a child\n\nGood morning, my daughter is 9 years old, she has always suffer of a lot of nose congestion, she has a lot of mucus at all times, i have taken her up to many doctors and all they do is give her antibiotics in excess, the mucus stops for a while but comes back, her teeth have some stains due to the antibiotics the dentist says. I had the same problem when I was little, at the age of 21 I had a tonzelectomy and my problems almost disappear, I also try to keep her away from milk products, I am desperate do not know what else to do. Thanks",
    "doctor_response": "Hi, I have gone through your question and I understand your concerns but please stop giving antibiotics as the symptoms are probably due to allergy. give her a mast cell stabilizer as Singulair. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold and cough during pregnancy\n\nI am a pregnant women of 3.5 months.I have cough and cold for around 1 month.Eventhough I am taking asthelin spray i am not getting relieved from cough.Can you please give me advice to get remedy from cough.I am afraid because of cough since i am pregnant may affect my baby.",
    "doctor_response": "Hi cough and cold more than 1 month in early pregnancy need evaluation and further clinical examination and why you are using asthalin spray, do you have previous history of asthma.Consult chest physician for further evaluation.Take azy 500 once daily and Allegra M twice daily",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump under the abdomen skin?\n\nhi i am a 19 year old female. about 6 months ago i noticed a lump under my skin in my lower left abdomen. i can not see it through my skin but i can feel it under my muscle. recently i noticed similar smaller lumps around it. it is not painful just tender to the touch. any advice on what this could be?",
    "doctor_response": "hi.based from your description, it could be any of the following lesions: a fibroma (fibrous tissue deposit), a lipoma (fatty deposit) or a cystic lesion (sebaceous or keratinous type). other tumor lesions must also be ruled-out. diagnostics (such as imaging and a tissue biopsy) may be recommended. management (medical and/or surgical) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing painless non-movable lump on neck?\n\nHi doctor I am a 31 year old female, I have a pea sized, painless non moveable lump on the left side of my neck. It is not on my skin I can move my skin while the lump stats in place. I have had a full blood count which came back normal. What cld this be?",
    "doctor_response": "Hi. This could be a lymph node attached to the muscle and hence not movable.The best way to get a diagnosis is not the blood work; it is ultrasonography and FNAC= fine needle aspiration cytology that will give the diagnosis. Please go for this and you will get the perfect diagnosis. Another way is to get the excision biopsy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes reddish skin in between breasts and face?\n\nmy husband is 40 yrs old, family history of heart disease, taking metoprolol and others he SHOULD be taking but doesn't, has felt like he has a sunburn the last 2 days - without being in the sun. His skin is reddish between his breasts and on his face ...the rest of the body is aprickly red without the raised bumps. I'm a nursing student...any ideas?",
    "doctor_response": "This reddish skin could be due to allergy, stress factor,alcohol,spicy foods,sun exposure or genetic.Treatment is mainly depeand upon the underlying cause but you can take oral or topical antibiotics ( cephalosporins, macrolides,antiprotozoals) with antiallergic drugs with vitamin supplements.The important thing is to diagnose first and for that you must go to dermatologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the itchy rash on the nostril?\n\nHi, My daughter has a litttle rash beside her left nostril, and not matter what we put on it topically it will not go away completely. If she doesn't use anything, it flares up. She has had this rash for over a year now, and no other syptoms besides a little itching. No dryness.Any suggestions?",
    "doctor_response": "Hi Dear,Understanding your concern.As per your query your child have symptoms of itchy rashes which can occur due to bodies response to the trigger factor. The most important thing is to find the trigger factor. Need not to worry. I would suggest you to give cold compresses to rash several times a day to prevent from itching and take over the counter antihistamine drug like benadryl. If symptoms still persist then consult dermatologist for proper examination. Doctor may perform skin test to find out the trigger factor. Doctor may prescribe other steroid cream ( mometasone) , anti inflammatory drug or drugs that can suppress immune system.Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having gall bladder pains. No help from Tramadol injection. Solution?\n\nI m having intense gall bladder pains. I was in hospital 5 nights ago & they considered doing emergency surgery because I have had this pain every few months for 2 years. The next doctor said no gave me numbing stuff and sent me home the next day. Today I have had it again. I have ha endone & 2 hours ago a tramadol injection from my doctor. Still I am in pain. Walking around, in & out of shower, heat pack...nothing s working what should I do",
    "doctor_response": "Hi As you are suffering from pain since 2 years,it is better to undergo surgery. You didn't mention whether you are having gallbladder stones or not? If you are having gall stones,go for surgery . If there are no stones,then the pain will be relieved by Antibiotics,Anti inflammatory drug and smooth muscle relaxant like Dicyclomine. Wish you speedy recovery Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What will be the best treatment for pulled tendons in the knee?\n\nHello doctor, I went to a doctor, who told me that I have pulled some tendons in my right knee. It hurts when bent and if I run or walk.\u00a0What would be the best way forward with the healing process? Can I still use the exercise bike at the gym?\u00a0I am currently using Voltarol gel to help ease the pain.",
    "doctor_response": "Hello. As the doctor said, it is a tendon pull, which means it is due to overstretching of the\u00a0tendon.\u00a0So, I suggest you follow the following steps: Follow these instructions for at least a month.\u00a0Consult me again after a month.\u00a0Thank you. Revert after a month to a physiotherapist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are these medicines the apt ones for keratitis?\n\nHi doctor, I am suffering from stromal viral keratitis. My doctor mentioned in my report as stromal keratitis (herpes?). Is that herpes? Also I was prescribed Pred forte, Add Tears and Acivir ointment. Are these right medicines? This is the second episode after five years. Please help.",
    "doctor_response": "Hello. Let me share some facts about viral infection of eye. For further information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pigmentation on forehead, bumpy skin. How can facial skin tone be improved?\n\nI have pigmentation mainly on my forehead.... Uneven bumpy skin due to spots. How can I improve my facial skin tone? I've read lemon juice, potato, rose water, basil, orange rind, cream you eat all works, but what's the best combination? I'm confused! I'm a white female... Tan never burn, age: 41. I'm a chef so my face gets hot at work too.",
    "doctor_response": "Pigmentation on forehead is mainly due to photodermatoses.use depiwhite cream or any kojic acid preparations.as far bumpy skin usre evion cream.to improve skin tone use biotin 10mg daily and take fruits daily",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes trouble in breathing in a child?\n\nHi.My 14yo son is complaining of having trouble breathing recently.i brought to ER last night and we were sent home due to their normal findings,clear air entry no throat problems.I.just wanna know if having an adams apple is one of the causes of his problems?",
    "doctor_response": "Hello dear,welcome to HCM forum.Adams apple will not cause such problem.As the findins were within normal limits,you need not worry.Just wait for few days,let's see whether its coming down or not.if persisting, kindly have a review appointment.Hope this answer will help.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "On copper iud, missed periods, spotting, sore and painful stomach. Solution?\n\nHi I have the copper iud for over 3 years now and had no problems untill recently I missed my period 2 weeks ago in turn I has very very light brown spotting/ discharge . Pain in left side goes from dull ache almost like cramp to very sore. Doctor sent medor smear which all came back clear. I have started spotting again and have slot if pain again. Please help. K",
    "doctor_response": "Hi,In the current scenario, I would ask for a trans-vaginal sonogram along with a blood test for pregnancy to know the status. If pregnancy or any other pelvic pathology has been ruled out, you should test for blood profile as well as hormonal imbalances. Any weight changes, stress and medications are also possible causes for the irregular menstrual pattern. If the IUD is found to be causing it, it needs to be removed and an alternate contraceptive method planned. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a small lump on the knee?\n\nHi my name is Delina and i have a problem. I was walking in my apartment, when suddenly, my knee locked and a small lump appeared on the outer side of my right knee. It hurts to move and I cannot bend my knee or walk. I work-out regularly and go to the gym. please help me identify my injury for I cannot afford to go to the doctor right now. thank you in advance.",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query. Possibly your knee got sprained due to sudden bending kind of action during your walk, following which you developed a hematoma (collection of blood) around your knee, which could have been also due to a tear in the ligament/cartilage in your knee. If I were your doctor, after a physical examination, I would initially prescribe you with an anti inflammatory drug along with a proton pump inhibitor and apply a pressure bandage over your knee. If it does not subside in 48 hours of time, or if the hematoma increases in size along with an increase in the pain in knee with increasing restriction of movement, I would advise you for an MRI of the affected knee to rule out cartilagenous or a ligamentous injury which would require specialist treatment.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What treatment is available to manage deranged SGOT, lead, and uric acid levels?\n\nHello doctor, My SGOT level is 62.6. Lead level in my blood is 196.96, uric acid level is 7.5. Please suggest me better treatment.",
    "doctor_response": "Hello. I can understand your concern. I have gone through the reports you have attached (attachment removed to protect patient identity). Your uric acid and lead level are slightly high. So I would suggest you drink plenty of fluids orally, take fewer proteins in the diet and get done repeat uric acid and lead levels in one month. Please let me know if you have joint pain. Your SGOT is slightly elevated. Your lipid profile is also showing elevated total triglycerides and cholesterol levels. All these are suggestive of obesity and treatment is weight reduction and lipid-lowering drug (Rosuvastatin 10 mg once a day at night before going to sleep) for two months. Get done repeat SGOT and lipid profile after two months. Diet and aerobic exercise like running, cycling, swimming, etc., are also beneficial for weight loss. Do let me know if you have joint pains.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i eat a cheeseburger after the crown sets?\n\nOK so I just recemented the crown on my front maxillary incisor. (the tooth that was holding it in place broke, so I'm getting a implant put in on thursday.) Do you think, after the crown sets for an hour, I'll be able to eat a cheeseburger? That's all I really care about right now.",
    "doctor_response": "Hi,   Here is Dr. Priyanka tiwari answering your query ,    As per your query , dont worry, yes you can eat chesseburger after one hour after recementation of crown .    Hope I answered your query ,   Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Ecosprin be taken in the third trimester of pregnancy?\n\nI am in my third trimester.. 7th month pregnancy now.. my bp was normal but I m gaining weight. My height is 5.1 and I am now 75 kg. Doctor suggested to use ecosprin 75 now to avoid chance of blood pressure even though I have normalnow. But on the strip it was written that it should not take in third trimester. I am so confused.could u pls clarify?",
    "doctor_response": "Hi, You can benefit from taking low dose aspirin in pregnancy to prevent blood clots and hypertension.You should stop it two weeks before due date. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cough and pain while breathing & body movements?\n\nI have been coughing and had pain in my right side (rib/chest area) for the past 5 weeks. Seen a GP last week and was diagnosed with pleurisy then prescribed a 10 day course of antibiotics (ending tomorrow). I sneezed today and felt/heard a pop/cracking sound from my mid rib area. It is now really painful to breath and move e.g walk, lift my right arm, turn etc. I was just wondering if it would be worth making an appointment to see the Dr again?",
    "doctor_response": "the infection is probably in the resolving state leaving a pleural scar/adhesion and fibrosis / consolidation in the lungplease go for a chest X-ray and it will tell you what happened actuallysputum testing also important as this will detect tuberculosis if it is thereget well soon!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rashes on my elbow?\n\nI have a rash on my left arm near my elbow. Under the rash is muscle that feels very sore. It appears to look bruised, blue almost. It feels as though its hot & burning, doesn t really itch. When I took a picture and zoomed in I could see little blisters.",
    "doctor_response": "Hi, Perhaps it is shingles. The rash in shingles is red, blistery and associated with symptoms like aching pain and burning. It is usually distributed along a dermatome i.e along the distribution of a spinal nerve. I suggest you to kindly visit a dermatologist in your region for a confirmation of diagnosis. If it is indeed shingles, you would need oral antivirals like either Acyclovir and Valacyclovir for a week. You would also require an OTC painkiller for symptomatic relief from pain. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat dry and uneven skin?\n\nI Am a Dark Chocolate Girl And I Have A Big Problem With My Face. My Face Is Very Dry And When I Put Even A Tiny Lotion On My Face It Gets Very Oily, Uneven Skin Tone. Also My Pores Are Open And My Skin Feels So Rough. It Makes me Feel Uncomfortable With My Skin And Unhappy. Please Help Me",
    "doctor_response": "HIWell come to HCMI really appreciate your concern skin color in human being are genetically decided and this can be changed with any means neither any medicines available for this, but this can be alter with cosmetic product for time being, hope this information helps, take care have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have mucus on nose, congestion, hard to breathe, drinking medicines for asthma, antihistamine. What is wrong with me?\n\ngood morning! I already have consulted to medical practitioner and tests results showed that all my internal organs are functioning well but still I have mucus on my nose, congestion and hard to breathe. Been drinking medicines for asthma, antihistamine and colds & cough remedy and nothing is happening. What is wrong with me?",
    "doctor_response": "Hi, thanks for the query to H.C.M.C. Asthmatics allergic bronchitis is a most common disease but this is a precursor of asthma. Running nose , watery discharge from nose , redness in the eyes,stuffy nose , difficulty in breathing are commonly troubles which patients encounter due to this disease. Some tests are done as for allergy test, but exact treatment of this disease  (asthma) is not yet known. Symptomatic treatment is given and that causes relief in most of cases. If you thing that you are not getting relief from present  tt , change the treatment , after the advice of doctor. Still no relief change the doctor and consult a pulmonologist. Good luck . Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bleeding anal tags during pregnancy\n\nI am 34 weeks pregnant and have had a few issues with skin tags near my genitals, and i recently noticed a larger what seemed to be a skin tag near my anus, and thought nothing of it, but it just tore while i was in the shower and now i am bleeding quite a bit, what should i do?",
    "doctor_response": "Hi, Dr Purushottam Neurgaonkar here. I welcome you to HCM VIRTUAL CLINIC. I have gone through your question, and I think I have understood your concern. I will suggest you the best possible treatment options. 1 ) First of all do not panic. 2 )  apply pressure with clean cloth or cotton swab at the bleeding point.  Once bleeding stops after 3 to 4 minutes , you can apply local antiseptic ointment.  3 ) Skin tag near vaginal opening is normally seen in many women,  but please get it confirmed from your doctor if tag near anal  area is not a thrombosed pile  Please take care not to pull out these ski. Tags.I hope this answer helps you. Thanks Dr Purushottam Neurgaonkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "SEX DURING JAUNDICE\n\nIS IT SAFE TO DO SEX WITH A LADY SUFFERING FROM JAUNDICE OR HAVING KIDNEY PROBLEMS. AGE -24 GENDER-FEMALE",
    "doctor_response": "Hi,Welcome to HCM.It depend on what is the cause of Jaundice. If it is infective hepatitis then there is a possibility that you may get the infection. In other cases if you have minor abrasion and her blood comes in contact with your wound then again the risk is more.Risk involved in Kidney problem also depends on what kind of kidney problem she has. If it is pyelonephritis or urinary tract infection you run a risk of getting infected.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain when you climb the stairs?\n\ni am having a stable RBBB which is asymptomatic. do i have to treat it? my TMT & echocardiogram tests are normal but, i feel chest pain in climbing stairs after a meal. The pain subsides soon after i finish climbing stairs. my cariologist suggested an angiography. what do i do?",
    "doctor_response": "hellothanks for posting here. RBBB does not need any treatment. only newly occurring RBBB neds evaluation. I guess you have got RBBB from long back. your symptoms are very typical for effort angina. therefore you must go ahead with an angiography. i agree that your TMT is negative, but TMT head a sensitivity of 70% i.e. it will diagnose only 70 out of 100 positive cases. so please go ahead with s cautionary angiography.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes soft lump on inner butt cheek?\n\nI have this relatively soft lump located on my inner butt cheek. It is slightly red and had a consistent round shape.I thought it was a normal pimple but it never went away, I just didn t think it was a big deal but now I am worries about it.. A bit of Information about what it could be would be greatly appreciated.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have soft lump on inner butt cheek . Well there can be many reasons for symptoms you mention in query like  pilonidal cyst , external hemorrhoid , boil , perianal abscess or ischio-rectal abscess . I would suggest you to consult dermatologist for proper examination . Doctor may prescribe antibiotics along with anti inflammatory . Doctor may also remove it surgically in case of severe infection . For now apply warm compresses on it , keep the area clean and dry and clean it with betadine . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic prostatitis\n\nI was diagnosed with chronic prostatitis with no bacteria being found in my urine as well as all stds negative, I have completed 4 weeks of bactrim and then 6 weeks of cipro and neither have had much effect in helping my symptoms. What treatment options are still available?",
    "doctor_response": "Hi thanks for asking question in HCM.Here you might have chronic non bacteria prostatitis.It may be because of previous attacks of prostatitis.Here is some suggestion for you.To relax the prostate muscle alpha blocker can be taken like ex.tamsulosinTo reduce prostate swelling and inflammation antiinflammatory drugs helpful like NSAIDS.Use stool softner to avoid constipation.Eat more fruits and healthy nutritional diet.Warm bath is helpful.Relaxation exercise is helpful.For exact confirmation fluid exprssed from prostate by massage can be sent for culture.I hope my suggestion will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to fight hair fall?\n\nHi Dr, My brother is 31 yrs old and having hairfall in the top of the head. the density of hair is less compared to other area. He is having healthy diet and doing yogas. COuld you please suggest some advice? He lives in Bangalore. Please also suggest whether he can go to skin doctor.ThanksSK",
    "doctor_response": "Hello. Thanks for writing to us at healthcaremagicAndrogenetic alopecia is the likely reason for his hair fall and decreased hair density.I would suggest that he consults dermatologist for a prescription because treatment of androgenetic alopecia produces good results if initiated early in the course before it is too late.Minoxidil and finasteride are US FDA approved treatments for androgenetic alopecia. Treatment is long term and usually produces noticeable improvement within 3 months of initiating.Other treatment option for androgenetic alopecia is PRP (Platelet Rich Plasma) therapy and hair transplant.In PRP patients own blood is centrifuged under controlled conditions and the platelet rich plasma fraction is separated from the rest of it. This platelet rich fraction is then injected into the are affected by hair loss. The principle of this therapy is that human platelets are rich in growth factors which promote hair growth and even reverse hair loss.Sessions of PRP can be repeated every 2-3 months for a total of 3-4 sessions.I would suggest him to consult a dermatologist in his region regarding the best form of therapy for his kind of hair loss.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have severe pain due to abscess in cracked tooth. What has to be done?\n\nHello doctor, I had a cracked tooth that developed an abscess under it. It took two weeks to wait for the endodontist appointment, so I started taking an antibiotic when the abscess started to grow. Finally had my appointment today and the endodontist is keeping me on the antibiotic one more week, and injected something into the abscess but did not lance it. Now it is huge and the pressure is terrible and causing a lot of pain. I am unsure what to do and if it will now drain on its own. Is this normal, because I can only find information about lancing abscesses, not injecting them with medicine. Currently I am taking Clindamycin.",
    "doctor_response": "Hi. Antibiotics for the abscess is always not the first choice to do actually. Moreover, you had mentioned that it is a cracked tooth. I wonder how deep is the crack so that it fits the criteria for root canal treatment. With all these kept in mind, I guess your endodontist has opened up the tooth which is the first step of root canal treatment and packed the canals with medicated paste which will help to heal the abscess. Not all dental abscesses are meant to be lanced off as you think. The endodontic treatment itself is an intraoral approach to reducing the infection of the tooth. Since the tooth pulp chamber is opened up, the pus from the abscess would drain through it. As far as you are not in pain, it is definitely safe to do. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will gums heal itself after retrieving bone underneath a tooth?\n\nI had a tooth pulled a week ago and before he pulled it he had to remove a protruding bone underneath my gum above the tooth that was pulled. The hole where my tooth is removed is ealling nicely but the bone above it is still fully exposed. Is this normal? Will my gums grow back over the exposed bone? Thanks!",
    "doctor_response": "Thanks for your query, I have gone through your query.The exposed bone can be because of the tensed soft tissue over it. During the extraction procedure, if the soft tissue flaps have been approximated under tension, then it can result in exposure(dehiscence) of the bone. If it gets infected, then it can result in osteomyelitis. So consult your oral maxillofacial surgeon and get the bone reduced and induce bleeding and close the wound with flap covering over it with the help of sutures. It is not normal. consult your dental surgeon.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Had sex after 11 days of abortion and had plan B pill. How likely is it that I am covered?\n\nHi doctor, I am a 31-year-old female who just had a surgical abortion. It was my first and only pregnancy. I started taking the pill immediately (the same day as the procedure) and have taken it religiously at the same time daily ever since. I was put on Doxy as an antibiotic to make sure I did not get an infection after the procedure. I finished the full course of antibiotics. I had sex with my boyfriend 11 days after abortion and took the Plan B pill the next morning within 15 hours. Between my regular pill and the emergency contraceptive is taken so soon, how likely is it that I am covered?",
    "doctor_response": "Hello. Thanks for the query. Firstly as you had a surgical abortion, it was any way sure that you would not ovulate soon in this cycle and your menses would be delayed. But, you chose to be on the oral contraceptive, which was correct, but at the same time, Doxycycline as an antibiotic would have reduced the efficacy per se. So after 11 days of abortion when you had sex, it is unlikely that you would have ovulated for another four to five days. But, to cover up, you took a Plan B pill (emergency contraceptive pill) which is again protective towards pregnancy in your case. So, overall you are protected, and I suggest you should stop your daily contraceptive pill as of now and wait for a early withdrawal bleed and then can restart the pills from day 2 of bleeding. You are pregnancy safe. Relax.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pockets in the gums after root canal\n\nFIRST I HAD A CROWN IN JANUARY 2014, THEN A MONTH LATER THE DENTIST ROOT CANAL THE TEETH BECAUSE IT WAS GIVEN ME PROBLEMS. NOW MY GUN ARE GIVING ME PROBLEMS. I WENT TO THE GUM SPECIALIST AND HE SAID I HAVE SOME POCKETS THAT NEED TREATING. BEFORE HE DEAL WITH MY POCKETS PROBLEM, HE SAID I NEED TO DEAL WITH THE PRESSURE PAIN THATS COMING FROM THE ROOT CANAL. WHAT TO DO?",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,  I have gone through your query, as you have undergone root canal treatment now you pain pain in crown , yes this pocket formation is seen in 60 percent of patients with crown as there is accumulation of food debris and proper cleaning is not maintain . I will suggest you to go for  currettage of pocket and if you wont get relief then go for Re Rct .Hope this will help you. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with colon cancer, metastasized to his liver. Fading very fast and trouble in eating. Life expectancy?\n\nHi. My husband was diagnosed with colon cancer 10cm tumor , metastasized to his liver . The liver is speckled throughout. He is waiting for a call, in about a week, we were told, for his first appt with oncologist . He sleeps about 15 hrs/day and is having alot of trouble eating. He is fading very fast. I need a realistic timeline and our family doctor doesn t know. Can you help?",
    "doctor_response": "Hello, For long time,patients with liver metastases from colorectal cancer were considered to be incurable and their prognosis was considered to be very dismal. Things have changed dramatically now. Chemotherapy has become standard treatment for most patients with colorectal liver metastases. Although patients cannot be cured with chemotherapy alone, median overall survival has increased from less than 1 year in untreated patients to more than 1 year, and even to 18 months or more in recent trials with multidrug chemotherapy. New, more effective chemotherapy drugs are available, including irinotecan and oxaliplatin, and other new drugs are becoming available. Although these are all important achievements, they cannot be considered sufficient because most patients still die from their disease. However my advise to you is to forget about the time span left and try to get him the best medical treatment along with your love and affection so that whatever time is left for him,he remains happy and contented. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for rash?\n\n60 year old female, took ibuprofen for three days and all three days had facial rash and tightness in the throat. Stopped taking ibuprofen, must be allergic reaction. How to treat the rash? How long will the rash last? She has appointment with dermatologist a week from now. Thank you.",
    "doctor_response": "Hi.As per your case history the patient is having urticaria and angioedema.My treatment advice is \u2013 1. Avoid fast food and food with artificial colors for 2 months.2. Apply a soothing lotion like calamine twice daily when lesions appear.3. Take an antihistamine like levocetirizine for 7-10days .4. Other treatment options are oral steroid and hydroxyzine given only after consulting a dermatologist.Thanks.Dr.Harshit Bhachech.MBBS, DDVL.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain, shortness in breath and pain while breathing?\n\nI thought maybe it's just a pulled muscle from swimming......but not sure, I'm 33 white female, a smoker, drinker, otherwise healthy......severe lower back pain in lower right side, shortness of breath, sharp pains when taking deep breaths, unable to lay on left or right side only flat when sleeping???",
    "doctor_response": "Welcome to HCM,I had gone through the case and found that it might be muscle spasm.So avoid swimming for a time. Take bed rest and any mild painkiller with apply muscle relaxant gel and heating pad. Pain will disappear 3-4 days.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic heel pain\n\nMy heel has been hurting for about six months now and is getting worse. I have flat feet and have insoles. I had planter pacidus. I m only 12. I have iced it every night and have tried to stay off of it. Do I have to see a doctor and wear a boot or use crutches. Whats wrong",
    "doctor_response": "hiHope this msg finds u in good health. i have gone through your complaints and under stand your concern. u might be having plantar fasciitis or a bony spur under ur heel that might be causing pain and inflammation. i suggest u get an xray done to find out whats wrong. nothing to worry about..Hope your question has been answered. if u have any follow up queries, feel free to consult me anytime. thanks Take care god bless",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for erectile dysfunction\n\nI am 28 yeas old. I am into the habbit of Masturbate for the past 12 yrs..... And now i feel that my penis erection is very bad. I am getting married next year. Is it possible to get my penis erection back. If not, i can take action to stop the marriage.... Kindly advice me....",
    "doctor_response": "Hello dear,First of all remove all myths & misconceptions from your mind about masturbation. In fact, Masturbation is completely normal & doesn't have any bad effect to the body and mind.Regarding the problem of Erectile dysfunction, it is due to decreased blood supply to the penis.And medications like Cialis & Viagra increase blood flow to penis & maintains erection. It can also be improved by having a diet rich in fruits, vegetables, fish, nuts & honey.Avoid stress...practice meditation..this helps in improving concentration & builds up the confidence level. Avoid smoking & alcohol. You can also do oil massage of the penis...it increases blood flow & maintains the erection.Despite these measures, if you experience difficulty, it will be better to rule out other causes like high blood pressure, blood sugar and other local causes that impair blood flow to the genital organ.There is no need to worry.Wish you a Happy Married Life. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of labor?\n\nHi, may I answer your health queries right now ? Please type your query here...hi im 29weeeks pregnant, an im carrying really low, when he kick or moves i feel it more down below in my vagina.is this normal as 8yrs ago when i had my son i never experienced this",
    "doctor_response": "HI,    I understand your concern.    At 29 weeks of pregnancy fetal movements are nicely felt.In 2nd delivery, the maternal body is already loose due to previous delivery.. so baby can sag down in pelvis  & when it moves you get the feeling.    Another thing the pubic symphysis gets separated due to loosening of ligaments between them.. this also facilitates the downward decent of baby   .. feeling it right down in pelvis   later weeks of pregnancy.    * but this no way suggests labour. Excessive vaginal discharge, loosing mucus plug, getting labour pains form the signs of labour.     Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for skin allergy\n\nHi my daughter is 18 months old and she got skin allergy and doctor prescribed 'Atogla' cream. After applying that on her body skin allergy is cured and skin is shining and smooth and got little fair colour. Is it good to use for my kid and how long that can be used.",
    "doctor_response": "HiFor allergy, treatment should be used till the symptoms subside. That is a good drug. So you should stop applying the cream if there are no features. Avoid allergen to prevent any further problem.regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cervical degenerative disc disease\n\nI have a degenerative neck condition, but recently, my head has an intense pressure-feeling, and I want to know if this is directly related or something else. I also have a swollen area behind my left ear, right at the bottom of my hairline, and that lymph node feels a little swollen as well. The head pressure makes me feel disconnected and disoriented, and makes my head hurt. Thank you.",
    "doctor_response": "Hi, I value your concern regarding the symptoms. I have gone through your symptoms, and in my opinion your symptoms are not probably due to your degenerated discs, but the swelling behind ear is definitively a thing to be concerned about, please visit an ENT surgeon in your area to see what that swelling is all about.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.Special note-  Any medication prescribed needs to be taken after consultation with your personal doctor only.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat small clots of blood in phlegm?\n\nLately, I've been seeing light to small clots of blood in phlem, like in the morning or when I gather flem from deep in my throat as to spit. It is more prominent, the next morning after drinking at most times 1-2 glasses of red wine. What should I do?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. You are having hemoptysis (blood in phlegm). Hemoptysis is commonly seen in lung conditions like pneumonia, tuberculosis, bronchitis and lung cancer. So better to consult pulmonologist and get done clinical examination of respiratory system, chest x ray and PFT (Pulmonary Function Test). Chest x ray is needed to rule out infection and cancer. PFT is needed to rule out bronchitis. If both these are normal than no need to worry much because you might be having friction bleeding due to coughing. So anti histamine and cough suppressant drugs are needed. But better to first rule out lung pathology. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for slow heart rate\n\nI am 23 3 weeks ago my heart rate was normal 70-80 beats per minute. Now my heart rate has been between 50-60 beats per minute for the last two weeks. I am not athletic the only thing that i can come up with is i just got off of clonazepam ( a benzodiazepine ) could that cause the decrease in my heart rate or should i go get it checked out at the hospital? I do not have palpitations, but do feel tired..",
    "doctor_response": "Hello, A heart rate between 50-60 is not too low, but if you feel tired and the heart rate continues low, I suggest you to do a 24 h ECG Holter monitoring. This can be from not taking clonazepam now. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Anila Skenderi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes left sided abdominal pain?\n\nHello I started having a sharp pain in my left side of my abdominal,  if I bend down or turn a certain way it gets worse, like a stabbing pain.  Had some nausea last night, pain started yesterday afternoon.   Some gas, no none fever.  Normal bowel movements.  No vomiting.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. For acute phase of the recurrent diverticulitis antibiotic therapy is required but once the acute phase settles down severe and drastic lifestyle modification changes have to be followed by the patient for many months to avoid recurrent attacks. So I'm sorry my dear but if you are sure its diverticulitis then broad spectrum antibiotic have to be taken for 5 to 7 days.I would suggest you take Clindamycin once daily with Metronidazole thrice daily for 5 days.They would cover both bacteria as well as protozoa, however, you would need a prescription for the same as antibiotics are not over the counter.Probiotic etc would help but if its diverticulitis then you have to take antibiotics.Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I went through a mental shock for which my nervous system has got affected, kindly help me\n\nrecently I went through a mental shock because of my financial conditions. due to which my digestion of food has become bad. i keep vomiting everytime and my periods have also got affected and skipped. i feel drowsy throughout the day and cannot sleep at night. my nervous system has also got affected.",
    "doctor_response": "Thanks for the query This can happen in distress. I have seen many patients like these. It is easily treatable and with medications you will feel a lot better Please meet a psychiatrist for it Have a healthy living",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can skin rashes be treated?\n\nHi. My son has a rash all over his body similar to scarlet fever rash, but he has no fever! He also developed 2 pimple puss on his lips and he has a very stuffy nose. He is not itchy and is acting like his usual self! Hyper and very active! What do you think?",
    "doctor_response": "Hi, It may be hives or prickly heat. You can apply aleo vera lotion for symptomatic relief. If symptoms persist, better to consult a dermatologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My father is diagnosed with acalculous cholestytis and was admitted in hospital for 4 days and was given antibiotics and is fine now. I wanted to know is surgery required or will it be cured by antibiotics. He does not have pain in abdomen now",
    "doctor_response": "Hi.. Acalulous choecystitis secondary to infection can be treated with antibiotics alone. Surgery in such cases is indicated if there are any impending complications developing.\u00a0 However if the cause has been some other factor, then surgery is mandatory folllowing a course of antibiotics... So\u00a0 leave it to the treating doctor to decide it surgery is essential in your dad....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in pelvis, tailbone, scrotum and sternum. What is it?\n\nhi my name is brittney and i am having sharp pains in my lower area such as pelvis , tailbone, scrotum and sternum. i get these sharp pains once in a while, when i sit, stand up, or move wrong. but not always.",
    "doctor_response": "Hi brittney,Thanks for writing in.I understand you experience the pain only sometimes and when you are doing activities like sitting, standing or moving.The pain you have mentioned could be arising due to a small problem with the nerves supplying your lower back.I would like you to meet an orthopedic surgeon and get examined. He may give you medicines that will improve your pains.Hope it helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I had three anxiety attacks last night because of ringing sound in my ears. Please help.\n\nGood day  My situation started yesterday after taking a shower yesterday. I climbed out of the shower and noticed I had this high pitched ringing sound in my ears. This sound is really causing me to panic ; last night I has 3 anxiety attacks because of it and I took 50mg Sressam tablet but it did not work. I still have the ringing in my ears today and I've taken another stressam about 1 and a half hours ago but it's not seeming to work. I'm afraid I might have an anxiety attack again tonight because of it. I've recently been placed on Acnetret for my Ance (7 days ago) but my Dr told me to stop it for a few days because I have been experiencing extreme back pain which I am still experiencing right now. I have been off the tablets for about 2 or 3 days and I dont know If this could be causing the high pitch (silence sort of noise) in my ears. Its causing extreme anxiety and unfortunately all Dr's rooms are closed right now.   Age: 15 Male 176 cm 164.8 kg",
    "doctor_response": "Hello First of all, please know that ringing sensation is very common and prevalent. There are many suspected causes for ringing sensation in the ear. The most common ones being - wax impinging on the ear-drum, sudden, loud noise, moving into a quiet room from a noisy environment and so on. You say it started after a bath. Even water, soap, hair follicles within your ear, when come in contact with the ear-drum can cause such ringing sensation, although for a short duration. This might have even attracted your attention to a symptom which might have been there even before, but was not noticeable. Sometimes, the medications you are on also can cause this ringing sensation. To be honest, there are lots of causes but no sure way of evaluating it. So, my suggestion - try diverting your thoughts away from this and try concentrating on some other work. When your thoughts are deeply immersed in something else, you will realise that you can hear the ringing sensation only if you think about it. You can also listen to music with ear-phones, with the volume of your device between 30-60% to get your mind off it. But please don\u2019t do this all day. Give a gap of atleast an hour after listening for about 30 minutes. Also, it will probably not bother you when you are involved in a conversation with somebody, keeping your mind off it. All said, there are certain rare causes also, which require systematic treatment, but I wouldn\u2019t want you to worry about them right away. This symptom of yours has started all of a sudden and in all probability might disappear spontaneously as well. Do not get anxious reading about all the causes of ringing sensation on the Internet as it is bound to frighten you. Try the above methods and tell me after 24 hours if there was any improvement at all.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to get pregnant of unprotected sex after having a regular period?\n\nHi, I had unprotected sex on 22 of February, seven days before my period was due. I took an emergency contraceptive within 4 hours and 7 days later I got my period on time. It lasted about 4 days starting with heavy bleeding and an abrupt decrease after two days. I am currently waiting for my next period and want to know what the chances of being pregnant at this stage are?",
    "doctor_response": "Hi. Thanks for consulting us. If you have not had any unprotected intercourse during this cycle then pregnancy is extremely unlikely at this stage. Emergency contraception if taken within 72 hours of sex can prevent 86% of expected pregnancies & you had a period after that. So, this is a new cycle. Don't worry & think about using a regular birth control method to avoid such anxieties in future. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I had sex with condom before some years with no symptoms. Will I get HIV?\n\nHello doctor, I had sex with condom. Is there any chance to get affected with HIV? Until now, there are no symptoms. Generally, how many days will it take to identify HIV after sex? Please suggest, and I am a bit worried. Generally, in my company, they conduct medical tests yearly and in that it shows negative.",
    "doctor_response": "Hello,  Welcome to icliniq.com.  Doing sex with condom is safe unless it has torn or leaked. Was your partner a known case or later diagnosed to be HIV positive? Company tests that you have done, if it was for HIV and if it is negative, then you need not worry about it as test results will be positive in four to eight weeks after exposure.  And the symptoms and presentation may be late and vary depending on the patient's immunity and other things. It is present with some symptoms be delayed even up to a decade or more.  If you are already tested for HIV, and it is negative, then I do not think there is any reason to worry about your incident. If not yet tested and you want to clear your doubt, get it checked after this Covid period. It is not an emergency. Be careful and take safety measures.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dark pigmentation on forehead, neck, arms, avoiding sun. Prescribed steroid based cream. Suggestions?\n\nhi ,m a 25 yr unmarried girl.i had got dark pigmentation on my forehead and neck and on arms.it was like tan earlier but i took treatment for that and the ointment doctor suggested was steroid based.so it got wosened .earlier it was hardly visible but nw it looks ugly .can u please suggest me sumthing . i avoid sun but i dnt use any sunscreen because it contains chemicals",
    "doctor_response": "Hi kavita, Thanks for writing in. Skin lightening cream contains 2% hydroquinone and a very potent steroid mometasone. This ingredients can cause permanent depigmentation of skin leading to white spot. It is not advisable to use it for long time. My advise to you would be - Stop using steroid based creams. Use a good sunscreen during day time. You can apply a cream called kozimax cream at night over dark spots. it is safe and effective. Fairness will come back but process is slow may take 2-3 months of treatment. Take a lot of Vit C in diet. Avoid sunexposure. Color will come back but process is slow may take 2-3 months of treatment. Avoid any HQ and steroid based creams in future. Hope this helps. I will be available for follow up. Regards. Dr Sud",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low sperm count\n\nHi, may I answer your health queries right now ? Please type your query here... Sir My age is 19 and i want to know how to recover sperm ! i have lost too much sperm!!! please help me iam very helpless ...my chicks are inside i want them healthy again please help me......",
    "doctor_response": "HelloMasturbation doesn't lead to low sperm count.It is a myth.Sperm loss due to masturbation is readily made in testis as it is a normal physiological process.It is also not related to weakness.You should try to get rid of masturbation because its obsession is bad.You should avoid provocative literature and videos.Try to concentrate in your job.If you find any problem in coping the situation then you may consult psychologist also.Take healthy and nutritious diet.You are fine.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful lump on the tooth gum?\n\nI have a small marble sized lump on the top right gums of my mouth where it meets the cheek. It's very sore to touch on the outside and on the inside. It's making it hard for me to chew anything on that side. Do you have any idea of what it may be or what I could do to ease the pain associated with it?",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain it seems more like a dental abscess in case if the tooth is decayed over which the lump is present..It can occur due to infection reaching below the root tips of the tooth leading to pus formation..In case of tooth is not infected other causes can be gum infection leading to gum or Periodontal abscess..I would suggest you to consult an Oral Physician and get evaluated and he can do a thorough clinical evaluation and investigations like X-ray if needed..On case of Dental Abscess either Root Canal Treatment or extraction of tooth can help..In case of Periodontal abscess or gum abscess Scaling, curettage and antibiotics will relieve..As of now you can take anti-inflammatory painkillers like Ibuprofen and apply a numbing gel over it for relief..Do warm saline gargles..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What causes sweet taste after recovering from COVID-19?\n\nHello doctor, I was COVID 19 Positive on 25th April 2020 while on 11th May 2020 my repeated test of COVID19 was negative. After that I feel all the time sweetness taste in my mouth upon that I myself went for blood sugar random and hbA1C, today on 15th May 2020 I received the results of my blood sugar random which is 92 while hbA1C is 6. Please do advise any medication for it. My age is 45 years and weight 73 kg.",
    "doctor_response": "Hi. It is a great news that you recovered and doing well after COVID-19 infection. Considering the current medical reports, your HbA1c is suggestive that you are in pre-diabetic stage. And your fasting sugar is absolutely normal. You do not need to start any medicine for diabetes. Sometimes recent infection may also lead to high sugar levels. Repeat tests after 1 month. And from now on I would suggest you adapt more healthier lifestyle choices. Good nutrition diet, regular exercises, quit smoking if doing are the basic ways. Take care of yourself. FBS/PPS hbA1C Lipid profile Vitamin D levels ?Pre diabetes Healthy life style modifications. Achieve 5 % weight loss from current status and maintain. After 1 month with reports.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swelling and pain in knee\n\nI am a female age 50 my left knee has been hurting for the last couple of weeks, past two days knee has been swollen and severe pain, at night pain gets worse and is through out my entire leg, I ve tried ice and take ibuprophen for pain. Just last night I noticed a ball on my calve area about the size of a quarter. having a very hard time walking. I am diabetic and do have high blood pressure. I am not overweight and I try to keep active (walk 3-5 miles a day). Not sure if this is something I should go to urgent care to see what is going on. I do not have health insurance so they tend to make you feel like you are not worth the time to check out thouroghly. If I go is there any questions or test I should ask them to run on me.",
    "doctor_response": "Dear patient you.may be having early osteoarthritis. This means age related degenerative changes in knee. Overweight persons tend to get it early. There will be difficulty in squatting. Diagnosis  can be confirmed by xray of the left knee anteroposterior lateral.and skyline views. Please get it done from radiology centre nearby you. Meanwhile start tab ultracet twice a day for pain relief. Avoid squatting and crossed leg sitting. If xray is abnormal please visit orthopedic surgeon nearby you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Cerophen to conceive. Ultrasound shows mature follicle. Should I continue Neodepar for high serum insulin?\n\nHye Doctor, i am sadia from pakistan i want to concieve from last one year but no positive results obtained. i am using cerophen from my last cycle and also have ovarian ultrasound results showed that right ovary have one mature follocle of 21mm and lafet ovary have small ones but there is no apparant abnormaility.. i am usning neodepar 500 mg twicw a day to lower down my insuline level as per doctor s advise, though i am not diabatic but have serum insuline level high... plzzzzzzzz advise me what i need to do should i need to continue neodepar and cerophen cycle again. as i want to concieve as early as possible.i am so much depressed on having periods again today.",
    "doctor_response": "Hi, you need to continue with your drugs. Thes drugs are hormones and have roles in the growth of the follicules. Its all but normal.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am diagnosed with NPD and ASPD. How to get it treated?\n\nHello doctor,I am dangerously sadistic. I enjoy it when others are suffering in any form, from stubbed toes to life-threatening injuries and torture. I have been diagnosed with NPD, though with traits from ASPD. The research on how treatable this kind of thing seems pretty inconclusive. Where do I go from here?",
    "doctor_response": "Hello. First of all, I have to appreciate you for asking this question. It takes a huge amount of courage to question ourselves, and especially in cases of NPD (narcissistic personality disorder) and ASPD (antisocial personality disorder). Where the individual lacks the insight of his issues and often only sees problems in others. Personality disorder, in general, is a difficult entity to be treated, but continuous long term therapy (cognitive behavior therapy) and psychotherapy help wonderfully in stabilizing if not curing completely. Instead of working on changing yourself, you should focus on managing your thought patterns and behavior. The good thing in your case is that you already have some level of awareness, which would help you out. So I would suggest starting therapy as soon as possible. Also, I want to know if you are taking any meds currently? You can follow-up with the same doctor as keep your medicines on track. I hope this helps. I would need more information to help you better and in specific ways which work for you. Let me know if you have any questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do you suggest for low testosterone with mood changes?\n\nHello, I have recently had labs drawn for low testosterone. I am a30yr old male, RN. Symptoms are fatigue, mood changes and no motivation. Went too my pcp: T level was 0.81 on scale of 0.95-4.30 (free testosterone). I am just looking for recommendations, I am a healthy active person and don t know why my levels are low at such a young age. Had total T levels drawn as well but no results yet. My pcp is not much help. Thank you!",
    "doctor_response": "HiI understand your concern.Yes there are reviews that low testosterone is associated with mood changes and anxiety features.Antidepressant with testosterone supplement will helpful.Consult endocrinologist as well as psychiatrist for further help.Antidepressant like low dose sertraline will help to regulate mood and motivation in such kind of patients.So consult and get help.Still have a query then feel free to ask.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can gallbladder removal resolve lactose intolerance?\n\nI am female, 22 years old, approx 180 pounds. I was lactose intolerant, or at least doctors told me that I was. I used lactaid pills everytime I had cows milk in any form (milk, cheese). I could eat goat milk products without problems.  I recently had my gall bladder removed. The surgeon said that the gall bladder removal would solve my lactose intolerance problem. I have since been able to eat cow milk products.  Was the surgeon correct, or was my lactose intolerance before really a gall bladder problem all along.",
    "doctor_response": "Dear friend, greetings from HCM. Lactose intolerance is due to absence of lactase enzyme in the intestine. It is not related to gal bladder at all. May be that milk fat digestion and absorption requires bile salts which is stored in gal bladder. Its good that gall bladder is removed but I don't think that was the reason for your lactose intolerance!. Thanks and do contact us for more queries thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Should I continue Synthroid or change to homeopathic medicine?\n\nHello doctor,A few months ago I was diagnosed with Hashimoto disease. The doctor that treats infertility put me on Synthroid, started with a smaller dosage (75 mcg), but since my results were worse after being on the low dosage, they increased it to 112 mcg. I was first unsure if I want to be on Synthroid since I do not believe in prescribed medications that may have side effects. I was told since my spouse has infertility issues (not me) and since I am trying for a baby, natural way or through IVF or IUI, then I have to be on Synthroid forever and Hashimoto cannot be cured. I have been taking all natural homeopathic Vitamins and even when I get sick I also buy natural medicine that was recommended by my Naturopath doctor. I continue to take Synthroid, I lose a lot of hair in my shower even prior to taking Synthroid. What do you suggest I should do? I do not want my body to be dependent on Synthroid for the rest of my life. He also said if I get pregnant I need to stay on Synthroid. I wanted to know from a professional if I am better off taking homeopathic medicine or should I continue on Synthroid?",
    "doctor_response": "Hi. Great that you are open to trying complementary systems of medicine. I would recommend that you shall consult a homeopath and start appropriate medication. I would also recommend you to take up Yoga practices on a regular basis. I would like to emphasis few points that might be helpful. According to Yoga philosophy, the mind plays a vital role in manifestation and vitiation of a disease. So, it is of prime importance that you voluntarily suggest yourself not to get worried or think of anything negative thing repeatedly. The simplest way to do that would be breathing practices. I have listed a few breathing practices that might help in balancing the hormonal imbalances. 1.Deep breathing - Please ensure that the duration of exhalation is longer than that of inhalation. Longer the better. And strictly a big no to breath holding. Practice for 5 to 7 minutes. 2.Abdominal breathing: Inhale completely such that the abdomen bulges out stretching your diaphragm completely and then exhale completely. Even ten minutes of this practice decreases oxidative stress and promotes vagal tone (responsible for relaxation). 3.Bramari pranayama: Close your ears with index finger so that you do not hear any external sound. Inhale completely and while exhaling produce a mild humming sound. Keep your concentration on the humming sound. Try to observe where the sound comes from and where all it spreads. It relaxes the entire body and regulates thyroid functioning. For more information consult a naturopathy specialist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in lower right abdomen?\n\nI am a 53 year old female. im been haveing pain in lower right abodomen for about 4 days now almost like a pulsating pain sometimes beginning to hurt when i walk also. i had a partial hysterectomy about 20 years. Have also been diagnosed with diverticulitis and had a colon resection about 8 months ago, but that normally hurts on lower left",
    "doctor_response": "Hello.. the pain could be due to many reasons, chiefly being appendicitis, right illiac fossa colitis, torsion of right fallopian tube, ovarian cyst or some ureteric calculus . Since u are already diagnosed with diverticulitis , i suggest you to get an abdominal ultrasound scan done to rule out the causes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had unprotected sex. Have light bleeding. Negative HPT and ultrasound. Could I still be pregnant?\n\nHi...i had an unprotected sex on Aug 18,the next month had a light bleeding... After that month didn't had period...i.e this month....I am in 59 th day now....had urine pregnant test...its negtv...but I am trembling that I am pregnant... Ultrasound test showed a report as no significant abnormality observed.... Weather I am pregnant or not... If so how to abort it",
    "doctor_response": "Namaste Welcome to Healthcare-Magic Greetings of the day Ultrasound is one of the confirmatory test for pregnancy. If the Ultrasound does not show pregnancy and the uterus and ovaries are normal then there is no cause of concern.  Taking withdrawal pills like Norethisterone will get your periods. Wishing you a healthy life Take care Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the white mist patches on lungs causing breathing problem?\n\nmy husband is working in kuwait and he has been coughing non stop he coughed so much he couldnt get his breath back and was rushed to hospital they xrayed his chest and found white mist patches on his lungs he was given an inhaler? he is 30years old non smoker?he was also given an antibiotic that was 3 days ago and he says he doesnt feel ant better but feels worse and the breathlessness is getting worsre?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, possibility of worsening of underlying pneumonia is more in your husband's case. White patch on chest x ray is suggestive of pneumonia. His symptoms are not improving, rather getting worse after antibiotic. So his pneumonia is not improving and it is worsening. Best treatment of pneumonia is identification of causative organism and start appropriate antibiotics. For this he should consult pulmonologist and get done clinical examination of respiratory system and sputum culture and sensitivity report. Culture will isolate the causative organism and sensitivity report will guide about effective antibiotic treatment. Don't worry, with appropriate treatment, his cough and breathlessness will also improve. Hope I have solved your query. I will be happy to help you further. Wishing good health to your husband. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "E-pill postinor 2, first pill taken, second pill after alcohol, still effective ?\n\nhello..my question after taking the first E-pill (postinor 2) then we go out with friends and i drink alcohol then later take the second pill. will the pills still work??",
    "doctor_response": "Hello,E-PILL will be same effective after drinking alcohol as there is NO known interaction with alcohol and E-pill. If you take the pill (first one) within first 24 hrs of sex, then it will give protection more than 95% and around 85% within 24 to 48 hrs. Second pill should be taken with 12 hrs gap for highest protection.Practice safe sex in future. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump in the neck\n\nYes , I been dizzy  for over fine days now and I just notice a knot on my artery of the neck.  I notice a little of a cough and blurry eye sight. I  went to hospital emergency had chest e-rays, eye checked and blood work not abnormal.  What could be wrong?  P.S.  I didn't notice  the neck until today.",
    "doctor_response": "Welcome to health care magic. 1.The possible cause win this case could be lymph nodal enlargement, and vascular pathology in next place.2.Lymph nodal enlargement can be seen in infection/inflammation/malignancy any where in the body.3.In any case i would recumbent to get an ultrasound examination done.4.Ultrasiound will exactly tells where the lump is taking up from, nature of the lump and its extensions, also if vascular - which vessel is involved. 5.In case of mass lesion - an FNAC - fine needle aspiration cytology to assess the nature of the lump. Good luckHope i have answered your query.Any thing to ask do not hesitate Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How is 2D-echo test done in a child?\n\nwe are currently searching for a 2D-echo clinic and we need help. should a 2D-echo test for a 6year old boy be done by a doctor? or is it ok for a techinician to do it in the presence of a pedia cardio doctor who will also read the results? it seems that the price is double when a doctor actually do it. thanks!",
    "doctor_response": "Hello, An echocardiogram is usually performed by echo technicians and the results will be analyzed by a cardiologist and then the only report will be released, you can go ahead with echo technician, please. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair thinning\n\nhi I am 27 yrs old girl ,height 5ft 3 inches and my weight is 54  kgs and am facing problem of hair thinning and from sumtime i have also gained sum weight..I am also undergoing the treatment for Polycystic ovarian disease.Kindly help as I am afraid if this continue i would go bald.",
    "doctor_response": "\"Hi!Welcome to Healthcaremagic. com.I have read your query in detail and do understand your concern.Excessive hair fall in your case is due to hormonal imbalance caused by PCOD.Treatment of PCOD will help gradually in regaining healthy hairTake a nutritious and protein rich diet(pulses, milk products, eggs).Avoid routine application of gels or frequent blow drying of your hair. Use a sulfate free shampoo for your hair twice a week. Biotin containing hair supplements can be taken for 3-6 months. Hope this helps!Good luck!\"",
    "dialogue_context": ""
  },
  {
    "patient_message": "Detected A typical cell in right breast.  Suggested biopsy and removal of cell.  History of breast cancer, lumpectomy, on tamoxifen for 4 years.  Guide\n\nI had breast cancer 13 years ago - it was confined in the milk duck and I had a lumpectomy and 31 treatments of radiation and took the drug tamoxifen for 4 in a half years.  Now recently I went for a mamagram and they found something in the right breast they said very tiny I had an ultra sound and they found that it is an A typical cell - another biopsy and they are removing the cell.  What will happen to me?",
    "doctor_response": "Hi and welcome to Healthcare magic.Thank you for the query.It seems like you are lucky that it was discovered in early phase. So it should be removed and if malignant, you need to do frequent check ups in next 1 year. If there are no signs of extension or positive axilar lymph nodes,you dont have to be concerned. There wnt be any serious consequances.Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes slow heart beats and heavy stomach?\n\nHi, This morning I wake up after feeling my heart grinding to very very slow beat for a few second and then back to normal. It freaks me out. Then I would feel my stomach feel heavier then normal..Really worried...please help. I m 30 yrs old, don t smoke but weekend drinks and not obese/fat.",
    "doctor_response": "Hello, After going through your medical query I understand your concern and I would like to tell you that your symptoms can be because of gastritis happened due to binge drinking. Kindly take some antacid available over the counter and avoid alcohol or decrease the amount. If symptoms doesn\u2019t go away then kindly consult a physician for proper physical and diagnostic evaluation. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause chest congestion in a 3 months old child?\n\nI have a 3 month old girl that started coughing, chest congestion, stuffed up nose about 3 weeks ago. Took her to the dr. then. He said it was a cold and to suction her nose, use nasal saline, , vics rub, elevate her head, etc. we have been doing all of that plus 1/4 teaspoon of robitussin twice a day. It seemed to be clearing up until yesterday. She came home from daycare with red watery eyes, stuffed up nose, cough. Everything from her nose is clear and thin. And this morning she has had 2 loose bowel movements. Do I need to do anything different from what my dr. told me to do? Does it just take a while for this to clear up?",
    "doctor_response": "HiWelcome to HCMI appreciate you for the treatment you are following. You can continue the same for the time being.In case she doesn't respond even after 3-5 days or runs a high grade fever, breathlessness, fast breathing, ear discharge or lethargy , then in my opinion an antibiotic will help. You may start amoxycillin or azithromycin after a clinical check up. Also chest X Ray, Ear examination advisable.In case you have any questions, do call back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dull ache in my chest with nausea?\n\nI have got a dull aching pain in my chest along with a nausious feeling in my throat. I feel spaced out and weak. I have been to A&E for an ecg and the results were fine, but my heart rate was a little fast and blood pressure was a little high. They put this down to the anxiety and panic of A&E. They did blood tests for thiroid funcion. I am still worried that this is a serious illness. Im a 24 year old smoking male.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. Since you are smoker and having slightly elevated heart rate and blood pressure, better to get done 2d echo and stress test (trade mill test) to rule out heart diseases. If both these are normal than no need to worry for heart diseases. Smokers are known to have gastritis and acid reflux. Both of these cause nausea and central chest pain. So first of all quit smoking as soon as possible. It is the main cause for your symptoms. Then take proton pump inhibitors for gastritis. Avoid stress and tension. Avoid hot and spicy food. Avoid junk food. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Penis has become weak and hard after having byandhiyanath vita gold. How to rectify?\n\ndoctor i am 27 year boy, past 10 year my penis was becoming hard daily while sleeping upto morning wakeup, before 6 months i had taken a tablet byandhiyanath vita x gold 1 tablet, after that my penis become week is there any problem will come for future",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.No, this ayurvedik medication never cause eraction problem.I suspect that this problem has arise from the your thinking problem and not because of the medication.You can make thinking in your mind that this is not the reason for the impotence. You can achieve good eraction, such a thinking can cure your problem.If you can't solve your problem with this home remedy than you can go for sildenafile citrate tablet. This tablet can give you good eraction. Please take it under your doctors guidance as overdose can harm your penile tissue.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does cypon and feris syrup has any side effects?\n\nDear Doctor, My son is 9 yrs 8 mths. and weighing 27.5 kgs. Since he is underweight and frequently prone to cold and cough (due to allergy) the doctor has prescribed Cypon and Feris, 2.5 ml two times a day each. Does these syrup has any side effects ? Thanks.",
    "doctor_response": "Hello,Cyphon syrup may cause nausea, vomiting, dry mouth, dark stools and drowsiness. But don't worry every body may respond differently. Les 5% may get these side effects.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is muscular pain in throat related to vitamin D deficiency?\n\nMy husband was diagnosed with vitamin D deficiency 4 months ago. His level was 20. He took a 50,000 supplement weekly for 3 months. When his level was retested, it had dropped to 19. Although his back and muscle pains have lessened over the past months, is it typical for the level not to rise? He has also developed some throat pains over the past month, not a sore throat, but more of a muscular pain. Can this also be related to the vitamin d deficiency?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Yes, vitamin D deficiency can cause muscle pains anywhere in the body.You need to get adequate sun exposure and vitamin D supplements to increase its level gradually. As it comes to normal pains will subside.do not panic. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dark circle around outer edge of eyes, shaking hands, weakness in arms and legs, slow reaction time. MS?\n\nI have a dark circle around the outer edge of my eyes. The right one is worse than the left. I have had this going on since May, and it betters and worsens at times. It is hard for me to read, but it isn't blurry, it just strains my eyes. I have been to numerous doctors, none of which have any idea what this could be. The black circle is not completely solid, but close to it. I researched and found a disease called Retinitis Pigmentosa, which in turn led me to read about Multiple Scleroses. As I read about MS, I came to realize that I do have other symptoms of MS, such as shaking of my hands, weakness in arms and legs, slow reaction time. Do you have any suggestions as to what this might be? Could my age of 14 years old have anything to do with this?",
    "doctor_response": "Hello,Welcome to Healthcare Magic.Common causes of dark circles around eye are stress, overwork, vitamin deficiency, poor sleep and dehydration. It is very less likely due to MS in your case. MS diagnosis is not very simple to make. It will need examination from neurologist and imaging studies like MRI brain to confirm it. Your other symptoms (shaking of hands, weakness in arms and legs, slow reaction time) can also occur due to stress/anxiety and vitamins deficiency. So evaluation by general physician and psychiatrist will help you.Wish you good health and all the best.Regards,Dr Ashish Kumar Mittalwww.99doctor.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long homeopathic treatment takes to cure subserous fibroid?\n\nIam suffering subserous fibroid which is of 15 cm and Dr has ask me to go for surgery I am unmarried of 34 years and I am engaged and now I am going Homeopathy  treatment and Dr has said it will be curable by the homeopath medicine and no need of surgery shall i go for surgery or how much time i will take to cure by homeopath whether I will face any problem in my married life plz advice me",
    "doctor_response": "Subserous Fibroids are growths outside the uterine cavity.They can cause uterine displacements,which can hinder conception or can cause recurrent abortions.A 15 cm fibroid, is a big one.Time is relative to the problem.Considering your age and marriage option ,and tumor size,surgery would be more suitable,according to me,giving 4-5  yrs of maximum time for the tumor to recede,and the time to complete your family,before chances of menopause set in.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is gastric sleeve surgery safe for lymphedema?\n\nHi I have hypercalcemia. I now have kidney damage from it. I am finally working with about 75% of my kidneys again after about 2 years of suffering and near death. I was never put on dialysis for it. I was also told that I do not have any sort of cancer. They think I got it from having an almost complete sedentary lifestyle. I am also in a wheelchair due to my right knee needing to be replaced and having lymphedema in both legs. My thighs are the size of tree trunks. I have lost almost 200 pounds on my own in the last year and a half and I have found a gym that has equipment, classes and water aerobics for people in a chair. I am still however hovering at about 400 pounds. I do not ever want to go back to where I was, but I still need to lose over 200 pounds. Finally, my question is, do you think it would be ok to have the gastric sleeve surgery done? If so, after I am healed from that and well on my way to being done with the weight loss, do you know of any surgeons that would remove these huge sacks of hanging skin from the insides of my thighs left from the lymphedema? I was told that the area was very vascular and hardly any surgeon would touch me to do that. After all of that I would finally get the knee replacement and skin removal surgery. Sorry this is so long. Thanks so much for your time and GOD bless you and yours for doing this. Melia Hicks",
    "doctor_response": "Hello, You can safely proceed with gastric sleeve surgery. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat fever and sores on tongue/gums/cheeks?\n\n4 days ago my mouth started hurting slightly the next day I started to get a fever of 100 n started to get sores on my mouth tong  gums and cheeks, the next two days I  I had the same symptoms except with 103 degree temp then the fever has gone away however the sores n swelling have not gone away and they are very pain full, I thought it might be thrush.",
    "doctor_response": "Hi, It can be due to stomatitis or gingivostomatitis or gingivitis that causes your soreness over the mucosa of mouth.You can take antibiotics (cephalosporins group  preffered)with analgesic, antiinflammatory and vitamin B complex with folic acid,Chlorhexidine oral mouth wash would also help.Just see your family physician or ENT surgeon. You will be alright after this.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the ways to stop masturbation?\n\nI am mastrubating since 13 age. Now I am 17 years old. In middle of 14 & 16 I used to mastrubate 3 times a day. And came down slowly. I feel like a old man lost interest in everything. Now I am going to attempt 12th examination. But I dont have enough confidence. Please suggest me something that will stop mastrubation.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Let me assure you that moderate masturbation practice is not unhealthy. Every youngster indulge in masturbation and is natural. At the age of 14 to 16,  thrice masturbation is also normal. As age increases, the priority is changed and masturbation naturally reduces. Up to 25, masturbation once a day, is considered healthy. Therefore you have nothing to worry. Your lack of confidence is due to your negative feelings about masturbation. Forget the negatives. Concentrate on your education.If you require more of my help in this aspect, Please post a direct question to me in this URL.  Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be worried of abnormal erythrocytes in blood test?\n\nhello i just had a blood test ad urine test today, and got my results already, havnt seen my dr yet however i just received the results by e mail. everything seems normal except Erythrocytes ...2-5 got worried a little, but after reading on wikipedia, they say it could be a result of kidney stones actually, i have kidney stones 2 years ago and i am followed every year buy my urologist. Should I be worried?? i am 50 years old and feel very well except low blood pressure. Thank you",
    "doctor_response": "Hi,Thanks for consulting HealthcareMagic!Sorry, but the information given by you is not clear. Erythrocyte are red blood cells which are normally present in blood.    Normal range of erythrocytes in blood is - Male: 4.7 to 6.1 million cells/mcL, Female: 4.2 to 5.4 million cells/mcL.Please clarify your query with readings.Hope I have answered your query. Let me know if you have have any clarifications. If you like my answers and wish me to answer in future, bring it to my attention: Dr Vasanth. Url link is as follows: you good health!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intermittent increase in blood sugar and BP levels with nausea?\n\ngood morning so my mom is a 58 year old black female, she has had a double bypass, COPD, Diabeties, and a hx of blood clotsShe has am mystery diagnose no one knows what it is. her blood sugar increase, her B/P gets extreamly high, she gets confused and she feels as if she have to vomit. please help",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. If I understood your right, you said your mom's blood pressure and sugar raises on and off and during that episodes she feels like vomiting. If that's your question, please provide answers to the following questions?1) How frequently does this happen? I mean daily? weekly? 2) Are those episodes associated with head ache, palpitations (heating of one's own heart beat) sweating or breathing difficulty?3) What medications she is on for her COPD? any steroids?4) Are these episodes usually associated with panic or fear?Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Samuel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sleeplessness and over heating in body?\n\nI try to go to sleep at night, but have trouble falling asleep because I feel like my body is overheating. I end up falling asleep on top of my covers, eventually. Once I fall asleep I wake up looking for my covers because I am cold. I am 30 years old, 5 4 145 lbs and female. I had a stroke 9 years ago but otherwise I am healthy and my doctors are not worried about another stroke. What could be going on?",
    "doctor_response": "Hello,In my opinion, yours may be a problem caused by hormones imbalance. I think that it is necessary for an evaluation of the levels of thyroid hormones, cortisol levels, and pituitary hormones. Discuss with your Doctor for these issues.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do weight loss supplements hinder pregnancies when a person has PCOD ?\n\nHi docotor, I am trying to reduce weight,so thought of doing some workout and along with that i like to have Amway product Positrim .I am trying to conceive and i have pcod my age is 25. Can i take this weight reduction suppliment.will this affect in any way for conceiving. Please suggest",
    "doctor_response": "Hi Priyadharshini, the best way to reduce weight is to watch your input(i.e. quality and quantity) of diet and output(activity, exercise etc). I am always sceptical about nutritional supplements advertised as making a dramatic change to one's weight. Good Luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Corgard suggested to cure pressure sensation in neck?\n\nRecently when I get mad or strain to have a bm I get pressure in my head andintense pressure in my neck, seeming to come from my jugular veins. No headachs. Female w/3 kids. Last was born feb 2014. Had problems w/ my hr getting to like 220 with ambulation. Was on corgard to control it. Went Way p birth. I don t know why but it makes it feel a little better if I tuck in my chin durring the episode.",
    "doctor_response": "Main use of cogard is hypertension and angina pectoris. Off label uses are arrythmia , Migraine, Aggressive behavior hepatic impairment and renal impairment etc. Pressu re sensation in neck is a symptoms to be evaluated with other findings and necessary tests must be done. If you can upload your health records then I can help you for sure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long is Epidural injection safe?\n\nThank you . I have been diagnosised with spinal stensosis from an MRI I am to have treatment soon. The dr is going give me an Epidermal injection every three months. My question how long is it safe to have the injection. And if the injections don t work having surgery is very scary to me . So is the surgery real invasive or is there anything else could help. The Dr said if nothing is done then I will loose my ability to walk Scares me to death I a a female 72 yrs . Sue",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Epidural injections for spinal stenosis are used for symptoms and don't treat the condition itself. They can be used up to three times. It is true that surgery may have some risks, but in most of cases ( around 90%) there are good results. Surgical techniques vary from minimally invasive ones ( discectomy, laminectomy ) to multilevel decompression and stabilization, it depends on the degree and  the spreading of the stenosis. Discuss with a Neurosurgeon about these issues. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Persistent cough, rhinitis , low grade fever , and is pale\n\nMy 5yr old son has a persistent cough, rhinitis , low grade fever , and is pale. I lightly squeeze his arm and there is no color change either. Is that normal? He s very fair skinned and his paleness is really startling sometimes.",
    "doctor_response": "hi your son has URI , for anaemia go for anaemia typing and see what is the cause for it. consult paediatrician. regards dr namrata",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could fibrous clots on lungs in autoimmune individuals suggest?\n\nI have autoimmunity. I have a lupus like syndrome that I m still being worked up for. I was recently put on Plsquenil and am starting to feel better but still have occasional shortness of breath and a recent flare that caused phlebitis with bruising. I have vasculitis. Today I sneezed and a fibrous blood clot came out of my lungs. I m wondering if I should be concerned and what if anything I should do. I go to the dr a lot and don t want to go again for no reason.",
    "doctor_response": "Thanks for your question on HCM. You are having Hemoptysis ( blood in sputum ).  It is common in autoimmune vasculitis like SLE ( Systemic Lupus Erythematosus).And Hemoptysis suggest pulmonary involvement. Pulmonary lesions in SLE are1. Fibrosis2. Interstitial pneumonia3. Ground glass opacification4. Nodules5. Pulmonary embolism.  EtcSo better to consult pulmonologist and get done CT THORAX with contrast to rule out all these. It is advisable to consult doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause and remedy for pigmentation on the inner corner of the eyes in one not using spectacles ?\n\nHi, I have a skin discoloration/pigmentation on the inner corner of the eyes. When people look at it, they thought that it was the mark that i got it from wearing glasses, but i never wear glasses before (i have very good eye sights). I never had it when i was a kid, but when i was about 15 years old, the discoloration then slowly becomes more and more visible. I m 20 right now so it s very visible. I just want to know what is the cause of it and how can i treat it?",
    "doctor_response": "hello friend...you are suffering from periorbital melanosis..it is  multifactorial and the exact cause still remains a mystery..However on avoidance of stress,a good sleep of about 6-8 hours at night and taking plenty of fluids will provide some relief..it can be treated by topical vitamin k and retinoid preparations used as a combination therapy..you may need laser treatment if it is resistant to topical treatment alone..kindly meet a good dermatologist for the treatment..wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Cipro advisable for swollen hands?\n\nI have a friend along with her husband that is travelling to Tennessee getting back to Texas. Her husband has been treated for swelling hand and is diagnosed cellulitis. He s in such great pain. Shouldn t he be hospitalized? He s currently taking Cipro for it.",
    "doctor_response": "Hi, Cellulitis is caused due to a bacterial infection caused commonly when the bacteria enters the skin through cuts, surgical sites, lacerations, areas of insect bites etc. Ciprofloxacin is an appropriate antibiotic for the same and he should continue with it. In case if there is the pain he can take stronger painkillers like Ultracet [Tramadol] and even go for a painkiller injection. He can also alternate with anti-inflammatory painkillers like Ibuprofen to help reducing inflammation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Honey Arora, Dentist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in arms\n\nI ve been experiencing a strange dull ache in my left arm. Initially it was just on my wrist around the carpal tunnel area, but now my entire arm feels void of energy. When I leave my arm to hang by my side it soon feels like there is a pressure build up and my veins stand out more than they usually would. Other than feeling run down I also have a slight chest pain that comes and goes, but I m not sure whether that is due to anxiety. Any help would be very much appreciated. Thank you for your time.",
    "doctor_response": "Hello,A hanging arm can cause the veins to bulge and a numbness due to compression in the armpit. Changing the posture will help in preventing this.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "High WBC after tested positive on widal with fever and sore throat\n\nmy 12 yr old son tested positive on widal in aug and then again in nov 3 had fever and tested positive on typhii igm test. he's been having high wbc and last week he had total eosinophil count as 1650 and was given hetrazan for 2 weeks...he's down with fever again and back on taximo 200mg for 5 days as he has sore throat ...am concerned abt high wbc...his igg was slightly elevaterd too...and LAP was ok",
    "doctor_response": "High WBC is because of Underlying infection. It will take some time to come down. so till that time continue your treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I get rid of acne ?\n\nHI im eunice i have acne since i was in sixthgrade and s not that severe but sometimes very streesful and i dont have so much confidence about it the wqursion is when does acne dissapears d oes it reay dissapearswhat can i do to make it dissapear i have lost self esteem and is so heart braking im ninthgrade right now",
    "doctor_response": "hi eunice dont lose ur hope now such medicines are there that will surely control and remove acne u need to consult dermatologist u need to evaluate for hormonal problem drink more water and avoid oily and spicy food dont pick or popped it",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in the fingers post a carpal tunnel surgery?\n\nmy fingers and hands are numb on both hands. i can feel hot and cold but otherwise cant feel much from the wrist. i have had carpal tunnel surgery three months ago in one hand but has not brought feeling back. i am diabetic and this numbness has been coming on for a year. my a1c was 6.6 five months ago but sugars have been elevated lately from bronchitis i had recently. seems numbness is getting worse. what should i do? this is scaring me. i think its getting worse.",
    "doctor_response": "Hello As there is no relief with CTS surgery ,there is possibility of associated tenosynovitis.Tenosynovitis is due inflammation and swelling of tendon .swelling on tendon may not reduce with medication alone.Local steroid injection can give good results added with physiotherapy protocolUse of machine can reduce your pain and swelling, you can ask your physio for wax bath therapy Use ice packs to reduce swelling, inflammation and pain.Physiotherapy with ultrasound and Tens will help you,For early healing you can take Tab celin [vit C] and antioxidant with anti-inflammatory [Tab enzomac plus ].MRI cervical spine will help you.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am taking Celexa and Xanax for OCD without any improvement. Should I change my treatment?\n\nHi doctor, I am a 36-year-old male who has suffered from OCD for the majority of my life. My psychiatrist has changed Celexa to 40 mg, and I am taking this dose for two months now. I have a feeling of mania, anxiety and I am unable to deal with it. I also feel impulsive, and sometimes I feel great, and I can accomplish a lot. I also have a feeling like I have been traveling in a roller coaster for a few months. It happened to me several times in my life. Do I need to seek another psychiatrist's opinion? I also take Xanax 0.5 mg whenever required.",
    "doctor_response": "Hi. Please mention about your OCD (obsessive-compulsive disorder) symptoms. Please say about the type of obsessions and compulsions you have. You can take tablet Prozac (Fluoxetine) 20 mg for a week and gradually increase it to 40 mg. Prozac helps for OCD as well as for impulsivity. Along with it, take tablet Olanzapine 10 mg. It helps for the current mood stability you are experiencing now. Also, consider going to therapy such as exposure and response prevention. It also helps for OCD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a large lump on neck lead to herniated disc?\n\nI have a sprained neck but going into the doctor i though it was bulging disk because i have a large bump on my lower neck. I have been in physical therapy for 6 weeks and i got better for a week and now it hurts like it did before i started treatment. i really think its a bulging disk. Reagan Turmon 15 95pounds 5 4",
    "doctor_response": "Hi! Good morning. I am Dr Shareef answering your query. No - the large bump on your lower neck might not be due to a bulging disc and could be an independent entity, possibly benign which could be known by a clinical examination and other investigations like an FNAC  if indicated. The pain in  your neck could be due to other problems related to the spine like a cervical spondylitis which is more common especially if your job involves staring at computers for long hours without any break. If I were your doctor, I would advise you to continue physiotherapy from a qualified physiotherapist along with use of a cervical collar, go for a short course of anti inflammatory along with a proton pump inhibitor for a symptomatic relief. In case of no relief, you could consult an orthopedic surgeon in your area, who might advise you for an MRI to rule out a disc prolapse or otherwise.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My prolactin level is 30.16ng/ml. How to control?\n\nHi....I am 24 years old..... n from more than 1 year we are trying ....We dont have babies till now....I have undergone hormone tests last week and found my prolactin level is 30.16ng/ml.......may i know how to decrease it ??n what is the good level of prolactin to concieve becoz my dr. say it okay !! plez help..",
    "doctor_response": "Hi Normal prolactin levels in non pregnant women is less than 20ng/l.Your levels are on the higher side.High prolactin levels may cause irregular cycles and related infertility.You should be treated for this with medication and get your prolactin levels normal before you concieve.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed difficulty in balancing the left leg\n\nI woke up this morning and hoped out the bed when I went into my closet my left leg gave out making me fall to the ground I got back up and walked to the kitchen to grab some water and my left leg felt like it feel asleep should I go to the doctos office?",
    "doctor_response": "Hello,I think if this problem you are experiencis does not go away within 5 minutes then is a serious problem and you should see a doctor.The giving away of the lag and numbnes happens if you slept in a akward postion compressing the sciatic nerve, but that will resolve within 5 minutes after you change position and walk.If not then there are some other causes more serious such as bleeding on the brain or stroke or brain tumor etc which need a doctor evaluation.i wish it is the first case and not the later option.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can be the cause of pain in the upper back and neck?\n\nHello doctor, I was advised to take Naproxen, Gabarich 300 mg and Pantop 40 mg for my upper back and neck pain. Can you please tell me if Gabarich is a painkiller and with what to substitute for Naproxen and Gabarich for pain in my upper back and neck? I must remind you that I am on antidepressants.",
    "doctor_response": "Hello. Addressing your pain would involve identifying the cause of the pain first. I hope this helps. For more information consult a family physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility\n\nHi doc;I m 22 years old.this is my marriage 3rd year.I was miss carriage my baby just after 2 months of pregnancy.I m still trying for preg from last 2 years bt I got unlucky.what should I do?my ultrasound all blood test is clear and have no problem.",
    "doctor_response": "Hi my dear, I am sorry to hear that you've been unable to conceive during your first 3 years of your marriage. If you did all tests and they resulted alright, then, it is time to get your partner checked too. Stress (especially when you urge to be pregnant) is another factor that should be avoided or at least, get under control. Good luck!Dr.Albana",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can shingles be treated?\n\nI had shingles back in August, I am 55 years old. IT was along my rib cage. I just had a bout that I was back in the ER and now it looks like they are coming back. What are my chances that it is shingles again and can I when well again get the shingle shot or not",
    "doctor_response": "Hi,To say if it is shingles it needs a good physical examination.I would advise you to go and see a physician. If its shingles then you can take one of the antiviral medications for it.Usually shingles are very painful and follows a certain distribution.Wishing you good health.Hope it helps,Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling dizzy and pain in the head after getting wisdom teeth removed. On antibiotics. Do I need to go to doctor again?\n\nI went to the dentist about 5 days ago because of a tooth infection and I have to get 3 wisdom teeth pulled and 3 more pulled or fixed. They gave me antibiotics because I have an infection. Should I get an appointment to get the teeth pulled while taking the antibiotics or after I have taken them all? Also my head hurts and I feel dizzy and sick almost constanly and think it s related to the infection. Is this serious?",
    "doctor_response": "Hi, Thanks for asking query, As you are having infection, it would be better if you get tooth extracted after completing the course but it is not a hard n fast rule , you can have the extraction according to your convenient . Dizzy and sick feeling might be due to antibiotics, avoid taking medicine empty stomach, have plenty of water and food. hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for passing stool with white film with stomach cramps\n\nI have a 6 year old girl who the last few days has passed stools which had a whitish film around them. The last two stools she had looked mouldy. She has not complained about stomach cramps and has been eating and behaving normally. She weighs around 20 kilo, and in good health",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for infection in throat\n\nMy sons symtoms started with a bad headache followed by the chills, fever of 103 over the weekend, spitting up mucus,fatigue,difficulty swallowing and all this has taken it's course. Now white pus patches on the right gland has appeared and now no fever. He's doing the warm water with salt to gargle, plenty of liguids and is able to tolerate solids some. He's been seen by the doctor with similar symtoms and has taken over the counter Mucinex and no actual signs of strep. Please advise. Thank you.",
    "doctor_response": "Hello,Welcome to HCM,The history and symptoms of your son suggest me that he is having upper respiratory tract infection along with acute tonsillitis.It should be managed properly with1.Salt water gargling2.Steam inhalation with Vapocaps3.NSAIDs like tab Ibuprofen to reduce pain and fever.4.A course of antibiotics like Syp Bactoclav, twice daily for atleast five days.If the symptoms are not subsiding he should be tested for CBC, throat swab culture and blood culture.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for head spinning, lightheadedness which lasted 10 seconds while driving?\n\nI was driving yesterday and all of a sudden I felt a strange feeling in my head like my whole brain spun around one time and then I felt a little lightheaded. The whole thing only lasted only about 10 seconds but it especially  scared me because I was driving",
    "doctor_response": "Sudden and unexpected vertigo which resolves quickly can sometimes be a premonitory sign of what is technically referred to as VERTEBROBASILAR INSUFFICIENCY (i.e. stroke).  If this is what happened then, you suffered what we call a TIA (transient ischemic attack).  Others refer to this as a \"mini-stroke\".  Of course, there are other possibilities for what happened.  I only give you this one to think about as it is the most important reason for you to get checked by either your doctor or better yet, a neurologist who will find out more information from you and decide whether in fact, this is what happened or something else was to blame.  You should do this soon.  TIA's usually don't happen a 2nd or 3rd time before an actual stroke sets in.  Best to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Telekast and Budecort inhaler cause any side effects in kids?\n\nMy son is 3 years old and is quite healthy and active .His weight is 17.5 kgs. For the last 10 days he is suffering from coughing and a hissing sound while coughing. He has been prescribed Telekast syrup and Budecort inhaler as well as levolin inhaler twice a day. I havee been told that these inhalers are usually prescribed for Asthma and contain steroids. Is it advisable to give this to children of 3 years or there is an alternative. Will there be side effects. Kindly advise.",
    "doctor_response": "yes telekast and budecort are given children in bronchail asthamalevoilen inhailer is also ment for the same theease medicines are safe in children with least to nil side effect ( in asthma there no alternate) nebulisation is a better way but the drugs used are the same",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can stiffness and pain in the legs be treated?\n\ni am having continued stiffnes and pain in my leg leg/hip. It radiated from my hip down through the knee and lower leg. It feels tight throughout entire leg. i am able to walk on it however to left my leg (i am not able sit with legs cross or to lift leg up to put on a sock or tie a shoe). Along with these symptoms I have had unexplained itchiness in legs (Top of thighs, back of knees and tops of feet) I did see my family dr She ordered Hip x-rays that showed no fractures and slight narrowing in hip joints. Blood test were done: Erythrocyte Sedimentation Rate was 44 mm/mr RA Quant (CPAL) was ANA Screen (CPAL) was negative. The dr s diagnosis was that I have bursitis in my hips. I was given a cortizone injection yesterday afternoon. No follow-up. I ve been takeing Aleve daily and Aleve PM at night for the last 4 months - no relief HELP!",
    "doctor_response": "Hi, I wish you gave us some other important information such as your age, your sex, the duration of the symptoms, whether you have concomitant low back pain or not, whether you feel any weakness in your legs. Erythrocyte Sedimentation Rate of 44 can be normal or abnormal according to your age. Anyway, based on your provided information, it seems there are some other possibilities which are more probable than bursitis of the hip (which is actually not a common finding). I will summarize some of them for you: - A disk protrusion between the lower lumbar vertebra sometimes causes pain which is felt in the hip and the legs but not at the low back itself. One simple test is that you can lie down on the floor with both legs stretched and then raise one of your legs slowly (with extended knee), up to about 70 degrees, if you felt a pain radiating to the back of your thigh or leg, the test is positive and there's a possibility to have a lumbar disk problem (We call this test as SLR): plan: A more detailed exam and possibly a lumbosacral MRI (according to findings) - A trigger point (some sort of muscle tightening) in one or more of your hip muscles. The pain of hip trigger point can refer to the lower limb and sometimes mistaken by disk problem. Plan: A detailed exam by a neurologist, orthopedist or physiatrist then physiotherapy: if positive for trigger points you need repeated stretching of those muscles as well as some physiotherapy sessions. Dry needling ( a technique that the therapist pierces tiny needles into the muscle repeatedly) could be of great help. - Irritation or local inflammation of the soft tissues at hip region could also become problematic sometimes. This also can be diagnosed easily during your exam.: plan: a few days of rest as well as taking an anti-inflammatory medication such as Ibuprofen, Diclofenac. My Overall suggestions: 1- Provide me with the other information that I mentioned above 2- Do the SLR test that I explained earlier 3- see if there are one or more points in your hip, gluteal area or low back that are sensitive to pressure and become painful: if you have some, report them 4- If you already have taken a lumbosacral MRI or EMG test, give me the results. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Hooman Mahmoudi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do about loose tooth at front?\n\nI have a bottom front tooth that is very loose. In fact it gets in the way of eating. I can't bite down of course. Also when chewing sometimes if it makes contact with my top teeth it causes great pain. I have no insurance and no dentist. What can I do?",
    "doctor_response": "HiWith your query, it is confirmed that your teeth had lost their support and to rule out the treatment you must visit your dentist without which one cannot decide the treatment plan. If they are hopeless you have to get it extracted and replace the sane either fixed or removable and at the same time get your periodontal health status checked inorder to prevent further loss of teeth and be aware of oral hygiene instructions along with brushing techniques.Hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Persistent cough. Prescribed foracort inhaler. X-ray shows acute bronchitis. Symptoms of asthma?\n\nHi, I am 25 Year old, I had cough from 1 month and consulted few doctors. I got an X-ray done and manul testing for TB. X-ray indicates Acute Bronchities, so doctor has asked me to take Foracort 200 Inhaler for 3 months with regular visits. Though After using the Inhaler as prescribed , I do not have cough. Is this an indication of Asthma? Should I be using it on a long run?",
    "doctor_response": "Hi, Welcome to HCM, you are having Acute bronchitis and which is commonly seen after viral infection and it makes airways hyper responsive and accompanied inflammation and mucus causes narrowing of airways which is similar to asthma but this is short lasting and once it  clears off you will have normal lung function. If you are comfortable with inhaler then it is good as it gives minimum possible dose of steroids and can be taken in case of emergency and side effects are nil or negligible. In very few patients this type of reactive bronchitis is some time persistent. I hope you will not be required to take it in long run. Please be aware that bronchitis is mainly due to smoking so please do not smoke . Take care Good Luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a renal cyst or a low density stone in the left kidney a cause for concern?\n\nHi im juvy from Philippines just want to ask if it is critical, my KUB ulatrasound report says consider small renal cyst with wall calcification versus a calyceal dilatation with a tiny low-density stone left. that is left kidney and the right kidney is normal thank you.",
    "doctor_response": "Hello. Thanks for asking on Healthcaremagic. From your report it suggests that you have renal calculi along with cyst formation. Kindly look for the size of the calculus if mentioned. If not then I suppose it will be very small. Go in for increased fluid intake daily along with juices etc to expedite the process of stone elimination. Consult a urologist if any stone dissolving meds are given in your area. Hope I helped you with your query.  Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "When I drink water or eat vegetable my body become very heavy.\n\nproblem in my stomach when i drink water or eat vegetable i have problem in my stomach when i drink water or eat vegetable my body become very heavy and my mind is so upset and not good working i used omprazole because i have injure stomach",
    "doctor_response": "You seems to have some indigestion problem.Eating vegetable or drinking water is not responsible for this.Take your diet regularly,avoid spicy foods,very late eating at night,long hours of fasting.If you are having any addiction stop it immediately.Take food quantity of salad and fruits daily.Do not attempt any medicine without any medical advise.Again your anxiety and stress if you have any has for direct relation with your stomach so try relaxation like meditation etc.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat allergies like fatigue, nasal irritation and nausea?\n\nCongestion, nausea, fatigue. I ve been suffering with allergies for the last two years and continuously taking Zyrtec or Benadryl. I stopped all meds for the last 4 months but for about 6 weeks now I cannot breath through my nose. My nose is a little runny in the morning but no other symptoms. However, I started nasal irrigation the last two days, twice a day and now feel worse!!! I feel very tired with nausea and no relief from my congestion.",
    "doctor_response": "HelloYou mentioned that you were taking zyrtec or benadryl tablets for allergy and no relief.Still you are feeling nausea, fatigue, running nose, difficulty in breathing. In my opinion all these symptoms are due to bronchoconstriction caused by  some allergen . Bronchoconstriction causes breathlessness ( difficulty in breathing) ,while allergy causes running nose , wheezing , fatigue ( allergy produces fatigue ) .When such patient visit my clinic with such type of symptoms I advise my patient to take montelukast+ bambuterol tablet once or twice in day .Usually they don't require any medicine except this.Steam inhalation and hot coffee also provide relief.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will radiculopathy causing tightness and burning sensation in shoulders heal on its own?\n\nI got hurt four years ago, they told me that I have c6 radiculopathy. I went to a neurologist and he said that it will cure up on its own, but I still hurt, I can t turn my head, my neck is tight on the left side, burning sensations in both of my shoulders, how can I get rid of this pain?",
    "doctor_response": "hi. c6 radiculopathy usually radiates to arm and is unilateral. i suggest s you to take analgesics,muscle relaxants, gabapentin and physiotherapy. if still no improvement in 7-10 days go for an mri and consult an orthopedician.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dull pain in lower abdomen?\n\nHi there, am in alot of pain tonight, i have a very dull pain in my lower abdomen, similar to getting hit in the testicles. This pain resides in my testicles, right side of near the base of my penis and the right side left love handle. This is extremely painful. I am rather worried as to what it may be. If it helps in the diagnosis i had diarrhoea an hour after the pain started. This however is not a digestive system pain.",
    "doctor_response": "HI Thanks for posting your query .    It seems like the pain is either coming from your testicles which could be due to infection or there might be a stone in your urethra ( tract from where urine comes out )   I advise you to get Ultrasound Abdomen pelvis and scrotum and Urine routine tests done and revert back .    You can take Anti spasmodic drug like Meftal spas , ask your local doctor for a prescription . Any clarifications feel free to ask . Happy to answer . Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden pain in back?\n\nHi, 48Hours ago I felt sudden pain in my back. I feels, as if I have sore muscles on my upper back (just below the nape of my neck). Any sudden movement is very hard for me and if I am in the wrong position, it really hurts. Adding to that: It is very hard to take a deep breathe and to swallow food. My Question: Should I go to the doctor immediatly or should I wait till next morning? And what could these signs indicate? Emile (I m male, 27 years old, a bit overweight, but I started going to the gym since two months and I practice badminton for three years now)",
    "doctor_response": "Hi Thanks for posting your query.     Sudden onset of pain at the site mentioned by you is most likely due to two possible cause. 1. Acute Muscle spasm: It is sustained strong contraction of muscles of your neck or upper back muscles due to exertion or faulty posture especially while sleeping . 2. Cervical disc disease: Working out in gym in improper posture can cause disc problem at your neck region.    Among these two muscle spasm is a simple problem which will relief by itself in a day or two. But disc problem needs medical attention.     If it has been more than 2 days of pain and no improvement then better you consult your doctor.Any clarification feel free to ask . Happy to answer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for erectile dysfunction caused by masturbation\n\nHi Am 27 years male.. Am having bad habit of mastrubation daily..i want to control it but i cant...now am going to get marry,...i feel that my penis is not strong enough to get into vagina...plz help me what can i do to get strength and satisfy my wife",
    "doctor_response": "Dear friend, Greetings from HCM. I understand your concern. You first note that you dont have any problem , masturbation is a usual practice and its not at all harmful.First quit smoking / alcohol/ tobacco. take nutritious food with more of green leafy vegetables, fruits, oats, and protein rich food stuff.Di exercise and reduce weight . more than physical erection depends on the mind and liking the particular partner. You will not have any problem take care and all the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could erection problems during intercourse be due to ED?\n\ni am 25 m i do get erection while wathcing porn and at early morning ,, but while having intercourse with my grl frnd i was not able 2 get an erection i had done foreplay 4 around 3 to 4 hours but nothing happened aas i am a virgin an wanted 2 know tht am i suffering from ED",
    "doctor_response": "Well... obviously yes since that is what ED means. However, the ED that viagra helps is Two entirely different disorders:on the one hand it is poor circulation. I have had one patient not much older than you who had: 1) 7 months of ED, 2) gone back to cigarettes....wait for it.......7 months ago!!! and 3) tips of fingers that went white with any cold. One of very very few people who quit cigarettes just by will cold turkey.......On the other hand minor anxiety is treatable 95% by viagra (even if you don't take it; just by knowing you are very very close to guaranteed to have things work if it were taken). get checked for hypertension and cholesterol since those correlate highly with ED. AND get viagra (just don't feel you HAVE to take it).",
    "dialogue_context": ""
  },
  {
    "patient_message": "Left foot and both knees swollen and bruised after falling. Need to take X-ray?\n\nI fell down a week ago, my left foot and both knees became very swollen, bruised. I did not x-ray my foot yet?! Could not step on it. All the toes, especially the big and secondary, and half of the foot were extremely swollen and painful, discolored. Now I can walk slowly putting my weight on the heel. Swelling is going down slowly, but I cannot bent the big tow yet. It s painful to touch. Pain has subsided, unless I touch. Should I still X-ray it? I thought the radiation may slow the healing process?! Thank you.",
    "doctor_response": "HiThere should be x ray of foot to rule out fracture.If it's non united fracture it will be tender to touch and may need immobilisation further in a cast.A displaced fracture will be malunited and more troublesome in walking in future.Get in touch of an orthopedic surgeon soon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump in armpits?\n\nhello doctor,im 22 years old girl and i noticed lump in my armpit with pain little.i thought it is just a small lump may not be harmful,and it disappeared in few days,but similar kind of lump have appeared on my armpit a few times but only on one arm but now im noticing similar lump again on another armpit.Is this symptom of any disease ?I usually get lot of sweat in there i use powder and deo a lot.Is this any problem ?",
    "doctor_response": "hi.it is best if you consult with a doctor, preferably a general surgeon, for medical and physical examination. based from your description, it could be hidradenitis suppurativa. these lesions usually occur on the underarm, especially after shaving or plucking and/or usage of deodorants with strong chemical contents. hair follicles get infected. inflammation and subsequent abscess formation occur.  medical (proper antibiotic regimen) and surgical (excision or incision and drainage) management will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is delayed periods along with abdominal cramps and breast pain a symptom of pregnancy?\n\nAm I pregnant? I have been using this period tracker for the past 5 months and it has always been very well accurate maybe my period would be a day earlier than it said it would but that s about it. In mid April I took antibiotics for bv My period was due may 11 and now it is may 15 my app keeps reminding me I m late. However I thought it might be the antibiotics but asked my doc and said it was no way it should have interfered. I have been feel constant cramps and sharp pains on breast slightly tired than usual pretty much regular PMS symptoms but no period I already tested on may 14 but both test were negative Keep in mind we use withdrawal method",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Usually menstrual cycle with duration of 21 to 35 days can be considered as normal. The possible causes of delayed periods in your case is bacterial infection leading to some stress and strain which can affect the hormonal balance and sometimes few antibiotics can also affect the hormonal balance in the body especially production of estrogen and can delay the periods according to few studies. As as you took the tablets in the first half of the cycle there is possibility that antibiotics might have affected estrogen which is the hormone of the half. As your pregnancy test kits came negative result  the possibility of pregnancy is less. So you can wait for 3 to 4 days possibly by that time you may get your periods.  If you do not get periods even after that you can take tablets for withdrawal bleeding with your doctor's advice. Hope I have answered your query and  I will be happy to answer any further follow-up queries. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause for the rash?\n\nHi, I had a rash that is slowly going away for about 3 weeks, not sure if it is related or not. Now I have a a very severe cough to the point of puking, I was very light headed for a few days, I have felt very weak and tired, I'm have a harder time breathing, have a bad taste in the mouth that doesn't go away. Any idea what it may be?",
    "doctor_response": "Hi, Both these symptoms could be related. It seems to be related to a viral infection which can cause both the rash as well as other symptoms. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of potential HPV?\n\nI had genital warts removed 17 years ago and way before the hpv shots were given out...I have never had them since...I have had 5 children since...my husband has never had them and we have been together for 16 years...should I worry?how would I know if I have hpv",
    "doctor_response": "Thanks for contacting HCM. I am sorry to hear that you had genital warts as a young adult. Genital warts are by definition an HPV infection. You have been symptom free for over 16-17 years so you have produced your own antibodies. If you no longer have warts and your husband has not had any outbreaks then the chance for him getting the is very low. I feel I can reassure you that you do not need to worry. Hope this answers your question. Please contact us again for any of your medical questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the purpose of devry tablets in case of infertility?\n\nHi, I am suffering from PCOD & trying to concive. My doctor have put me on Metmorfin & injected me with HCG on 12th day my period. Now she has asked to take devry 10 mg 2 times a day till 28 day of my period. What is the reason for using devry tablet?",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.You are suffering from pcod ( polycystic ovarian disease) so prescribed metformin. Hcg to stimulate follicles.Deviry contains medroxyprogesterone a progestin derivative, prescribed to regularize cycle and make uterine wall favorable for implantation.Hope i have answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in breathing & heart racing?\n\nHi my name is Kate, last night, i got home and i had trouble's breathing and my heart was racing... but it really hurt. and the faster it got, the harder it was for me to breathe... it went on for 20 mins then i fell asleep and when i woke up i wad fine.",
    "doctor_response": "Respected   Kate  , hiThanks for using Healthcaremagic.comI have evaluated your query thoroughly .* This is in relation with psychosomatic manifestation of underlying stress    or  anxiety issue .* You will be able to trace back  it with the events or thought  you had    passed  through in the whole day specifically  in the evening  or  night .Hope this clears your query .Welcome for any further doubts .Regards dear .",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure a swollen scrotum on one side ?\n\nHi, I just noticed that my 8 year old boy s scrotum is swallow on one side. He does not have any pain and it does not feel hard. he is not sure how long it has been swollen. The bump seems to be separate from his testicles, but is on the left side. Any idea what could cause the the swelling?",
    "doctor_response": "Hi...it could be epidymorchitis. Some times it can lead on to testicular torsion....I suggest you consult your nearest pediatric surgeon at the earliest. I urge you not to ignore it.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Unable to conceive, had miscarriage, suffer irregular periods\n\nhello dr. i am 32 year women and i married 7 years ago .in the first month i was pragnent but on 6th week baby groth was stop and i suffered with DNC .Till the time i am trying a lot but no baby i have we trying medicines and a lot but no baby my weight is increase 79 now and my height is 5.3 my husband test r normal but my period date change some time more then 45 days some time just 8 days but last 4 periods date change but periods r normal flow so what to do .am really worry and upset plz help me and solve my prob .thanks a lot",
    "doctor_response": "Dear member,Thanks for writing to healthcare magic.You have mentioned irregular cycles. That means either you are not ovulating . Weight gain causes polycystic ovarian syndrome and difficulty in conceiving.Your fallopian tubes also need testing for patency.I would recommend following tests.COMPLETE HORMONE PROFILEThyroid profileHSG to check the fallopian tubes.Ultrasound scan on 2nd day of periodWrite back with reports.ThanksDr Bhagyashree",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hypothyroidism, diabetic, dealing with anxiety, severe stress, have palpitations. Do I need to worry?\n\nI am 63 and have a heart rate of 108.. I have been under much stress lately and have a problem with anxiety . I am pre type two and also hypo thyroid patient. My endo doctor did increase my synthroid a while back and I am wonder if I am getting to much. I have also been having some palpitations which I also can have if I am getting too much synthroid. I have know pain but I have had a virus this week that really put me down. I think I am answering my own question!LOL! I need to get my thyroid tested and see the doc. Do I need to worry about my HR of 108.. my blood pressure is 118/77",
    "doctor_response": "Hi there ~  The symptoms and their chronology suggest that you probably are getting a little too much of your thyroid hormone.  It may be a good idea to get your Thyroid Function Tests (TFTs) done as soon as possible.  Your blood pressure is also related to stress and high thyroid levels, if the case might be.  Hope this helps.  Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I have burning sensation in stomach, throat and chest?\n\nI'm am 17 about 5ft3 118lbs. Just moved to the states. I have been having migraines for about 5 years now. For the past week I have been burping, having migraines, almost throwing up, burning sensation in stomach,chest, and throat. I also feel too tired. What may be wrong with me?",
    "doctor_response": "Hi. This is due to hyperacidity, This has given you the symptoms of GERD and migraine; needs a few investigtions::CT scan Brain for evaluation of headache and consultation with a Neurologist.Upper GI Endoscopy for the symptoms you have .Ultrasonography as a preliminary investigation. You need to take PPI, Domperidone, antacid gels, an a anxiolytic. Consult a Gastroenterologist for review and treatment accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for extreme acidity, hair loss and loss of penis size\n\nhi doctor i m 35 years old and single.i have got a extreme acidity from many years.if i take famotodine or omeraprazol i feel relief or short time.i m losing hair as well losing size of my penis and its fatness.i m 83 by weight and 5.6 1/2 in height.i hope to be guided by u to have cure of my health",
    "doctor_response": "Dear userWe understand your concernsI went through your details. Acidity problems are usually due to sedentary life style. Keep an eye on the food you take and avid stress and anxiety. Penile size never decreases unless you get too old or aged. This is just psychological feeling. Hair loss could be attributed to many other external things. Stop worrying and your problems will be solved. I suggest you to go for anxiety treatment. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How many days will take to recover the bump cased by falling down?\n\nMy 2.5 years son had fallen from bed while asleep and got big bump on fore-head. I immediately took hom to doctor and he gave a medicine for swelling and asked to apply some ice pack on swelling. Its been 2 weeks now but the minor bump still remains but there isn t any pain. My worry is, is the bump going to stay or will take some more days to heal? He is behaving normally though.",
    "doctor_response": "Hello. I just read through your question. This is very common in this age group. It can take days to weeks for these bumps to disappear. As long as he is otherwise well and behaving normally, you do not have to worry and there is nothing to do.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a painful lump above the collar bone while suffering from neck stiffness be treated?\n\nmy neck is very stiff. it appears a knot above collar bone, back side. its painful,have trouble sleeping. when i try to massage it, a small sharp shock occurs and slightly clicks years ago i was t boned, and had trigger point injections. 2.that was over 12/ 14 years ago. im trying ice. can you help me please.",
    "doctor_response": "Hello, If you are suffering from an acute bout of cervical pain that was not really there before recently (even though you do have the remote history of the accident) and you believe there is a lump of some sort above the collar bone then. I would recommend you see a doctor and have that looked at to make sure it is not a mass that is impinging upon one of the cervical nerves causing the pain and electric shock-like sensation. Ice is an acceptable intermediate therapy but this should be looked at by a doctor with possible imaging studies to define the knot a bit more precisely. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest dosage of AKT-4 while having 1 capsule of rifampicin 450 mg\n\nPlease tell me the dosage of AKT-4. How ideally it should be taken. Presently i am taking 1 capsule of rifampicin 450 mg empty stomuch in morning, 1 tablets of pyrazinamide 750 mg after lunch and rest 1 in evening after breakfast and 1 tablet of ethambutol 800 mg plus isoniazid (INH) 300 mg in Night after dinner.",
    "doctor_response": "Hey there,See ideally all drugs to be taken in the morning only.Rifampicin before breakfast and rest after breakfast.and if you are more then 60kg weight then rifampicin should be 600mg",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat muscle pain during push up?\n\nwhen I am in a push up position i get an extreme pain in my right hand from the lower thumb knuckle up around to my lower index finger muscle.   The pain also occurs in other types of postions but predominately in the push up type position.  any ideas of what might be causing this?",
    "doctor_response": "Hello,For Such Complaints, we need to cut down the Stress over fingers by Wearing proper Cushioning for Hands.If you further gets the same problem, then I Suggest to get these Lab tests done:1) CBP2) SERUM CALCIUM3) VIT-D3 (25-OH)As your Condition is more related to the involvement of bone and Ligaments, So I suggest an orthopaedician consultation after getting these tests done.You may require MRI of the Wrist region, if the Pain does not subside with the Good Analgesics, Calcium and Multivitamin Drugs.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mohammed Abdullah",
    "dialogue_context": ""
  },
  {
    "patient_message": "hey, ive had this happen four times in my life, all at random times, ive no clue what it could be but its very scary. first, my stomach starts hurting really bad, then i get sweats, then my ears get really hot, then i am barely able to walk, then my eyesight goes almost completey. this lasts for about 5 mins. what might it be? also the thing that usually helps is cold air from outside or a fan blowing on me..",
    "doctor_response": "You are facing something similar to the blackouts. Such problems could be due to problems with your heart, blood pressure, blood sugar levels and could just \u00a0be a vestibular dysfunction as such.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatments for Liver cancer\n\nRESPECTED SIR  MY MOTHER IS 53 YEAR OLD AND SHE WAS DIAGNOSED WITH LIVER CANCER 4TH STAGE. WE KNOW ABOUT THIS DISEASE FROM A MONTH AGO. CANCER IS ALSO IS IN HER GOL BLADDER. DAUGHTER SUGGEST HER FOR CHEMOTHERAPY. IS THERE ANY OTHER OPTION. AND APPROXIMATELY HOW MUCH LIFE MY MOTHER HAVE",
    "doctor_response": "Welcome to Healthcare Magic.. Your Mother has Stage 4 gall bladder cancer... The usual treatment for this is chemotherapy only...  The prognosis is not good and she is unlikely to live beyond a few months... The best treatment will be symptomatic care and palliative chemo...  Hope this answered your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do alkaline phosphatase have anything to do with cancer?\n\nI had a routine blood test because of a few health issues that were happening around the same time: thigh pain, knee pain, painful bump on a finger and rough skin that appeared on my left toes but not right toes. All occurred within a month of each other (normally, I am in good health but did have breast cancer 6 years ago resulting in a mastectomy and chemotherapy). My primary physician wanted my oncologist to look at the Alkaline Phosphatase level was was 180 to I think make sure it wasn't anything to do with cancer but my oncologist just had her secretary call to refer me back to the primary without wanting any more info from me. Do I need to be concerned? What is my next step?",
    "doctor_response": "Hi,Thanks for writing in.Alkaline phosphatase is an enzyme that is found in the liver in good amounts. Its levels show a state of health and disease and is considered an important liver function marker.In conditions of the liver, damaged liver cells release increased amounts of the enzyme into the blood. This test is often used to detect blocked bile ducts because alkaline phosphatase is in cells of bile ducts. In jaundice patients the alkaline phosphatase levels are raised.In some cancers the sudden rise of alkaline phosphatase by more than 120 units over 4 to 6 weeks is a concern and might require more detailed evaluation. If your earlier alkaline phosphatase was less than 60 and now it is 180 then it is a concern. If past reports show the enzyme almost same as the present level then there is no serious concern. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for hair fall problem\n\nhello doctor. i am 20 year old and i have hairfall for 6 years. but for the past 1 year i had pcod problems, but i got it cured. i have pimple problems too for about 3 years. my parents don t have this hairfall problem. Is this hairfall due to my pcod problems or any other reasons?",
    "doctor_response": "Hello, PCOD could be one of the contributory factors for hair fall and thinning. hormone treatment for PCOD would also help hair fall. In addition i suggest you to use Minoxidil 5% solution for your hair fall. I also suggest you to take finasteride tablet. It is an anti-androgen and would help hair fall due to hormonal imbalance in PCOD. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Kakkar S., Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the permanent solution for painful hip caused by an injury?\n\nI slipped on the ice and landed on my left hip almost a year ago. The pain has never gone away. I have no insurance and not enough money to see a doctor so I never went. Then I was sledding this past weekend and now the pain is so bad I can hardly stand. I have tried ice, hot baths, laying flat for days, nothing is working. What do you recommend for an at home remedy?",
    "doctor_response": "Hi there.Painful injuries around the hip joints should not be\u00a0ignored like this. It might be due to a fracture or arthritis. . Taking regular painkillers is not the solution. Firstly you need to get an Xray done of the injured area. Kindly post it on the site for me to give a permanent solution. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes deficiency of potassium?\n\nI have been very sick with lack of oxygen, dehydrated, phnemonia, and more, was in the hospital for almost a month in April. I had no potassium either. Now I m trying to get better, but my legs seem so weak !! I can barely walk 10 steps ! What s causing that ?",
    "doctor_response": "Hello, Thank you for your contact to health care magic. I understand your concern. If I am your doctor I suggest you that all your weakness is because of the low pottasium level. As you had been in the ICU for critical illness all your potassium got utilized. You should potassium supplement either in the drug form or naturally like coconut water, ORS etc.I will be happy to answer your further concernYou can contact me. Dr Arun Tank. Infectious disease specialist. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What diet should I follow to reduce the HBV DNA level ?\n\nhi sir, Am 24 year old, Am suffering from hbsag +ve since 4 yaers, and Am taking treatment from that time, The HBV DNA level At that time is 7,50,000 copies/ml, after treatment 6 months ago its value was 1,20,000 copies/ml, but recently again i have done the test and present level is 10,00,000copies/ml, even though as per doctor( gastroenterologist ) suggetion am using tablets, the level is not coming down, doctor suggested that there is no food restriction for this desease, and also recent tests showing hbeag +ve, What is the solution for this, what is the food diet i have to take... Thank you.",
    "doctor_response": "Dear Bhaskar, There is no restriction in diet in Hepatitis B. But as liver is affected, you may take more carbohydrates and less fats. It seems your medicines are not working. You may ask your Gastroenterologist to change the medicines or you may contact an INFECTIOUS DISEASE SPECIALIST.",
    "dialogue_context": ""
  },
  {
    "patient_message": "White patches on head with white hair of a 26 years old boy\n\nMy son aged 26 is having white patches on head ,and so white hair at these places (only on head ) 2-3 places for last 4-5 years .Treatment ???",
    "doctor_response": "Hi! varughese, Welcome To HealthcareMagic forum, White patches with white hair over it indicates VITILIGO.This is a auto immune condition where in our own cell destroy our melanocytes (color producing cells),thus leading to white patches.Treatment depends whether the lesions are active(spreading) or stable(not spreading).If the lesion is spreading then we put the patient on oral steroids to stop the activity.Along with this one has to start phototherapy also .There are two types of phototherapy : one is PUVA  therapy and other is NARROW BAND UVB therapy.These are light chambers which patient has to expose to .This would help in repigmentation.Apart from this one has to apply topical creams too. vitiligo is a chronic problem and presence of white hair delays the process of repigmentation .So consult a dermatologist who has above facilities. regards, Dr.chawda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes popping, freezing, stuck joints, slight swelling of knuckles?\n\nMy husband has been having issues with his knuckles. They are popping, freezing, joint getting stuck and slight swelling. He said it feels like he smashed his hand, but it is happening in both hands, especially in his middle fingers. What could be going on?",
    "doctor_response": "Hi,Thanks  for  your query.Repeated joint pains can be due to multiple causes at this age the commonest being poly arthralgia. Other causes can be rheumatoid arthritis, gout, inflammatory diseases like SLE, bursitis, fibromyalgia, etc. For proper diagnosis, some of the 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.he need a thorough clinical examination followed by investigations under the guidance of an orthopedician.Till then for symptomatic relief, he 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",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having pain in the centre of the upper part of his neck towards his left arm\n\nhi. i just saw my dad s mri report and i m concern what to do because he is having pain in the centre of the upper part of his neck towards his left arm. day by day i m noticing his left arm is getting weaker than the other, this change is getting really visible day by day this is what his mri report is saying please help me i would be really thankful.. \\this is what my dad mri is saying please leme know whenwvwe ppossible straighteing of normal cervical curve is seen. disc degeneration is seen at multiple level. Reduce disc height seen at level of c5 and c6.At c5 and c6 there is right paracentral and central diffuse diskosteophyte complex causing anterior thecal effacement with a bilateral foraminal stenosis which is served on the right side a.At c4 and c5 level there is a diffuse disc bulge causing thecal indentation twith mild bilateralforaminal encroachment.At c6-c7 level there is a broad based diffuse disc protrusion causing thecal compression with encroachment of the neural foramina on either side.",
    "doctor_response": "hello, as u have explained the MRI report the condition is severe.. as there is stenosis and disc buldging... its better to consult a ortho surgeon.he needs surgery to be done... then physiotherapy treatment.....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for staph infection in the montgomery gland\n\nthe montgomery gland was taken off lifting grandchild. now it has infection leakage have had mammogram and ultrasound and consulted oncologist biopsy was not necessary and now scab comes off and does not completely heal the gland was swabed and was told it was a staph infection. worried all the time",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have staph infection.  No need to worry.  Just take antibiotics effective against staph.  If you don't get response then go for culture and sensitivity test and tale appropriate antibiotics.  You will get benefits. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause ejaculation dysfunction?\n\nI have a problem with being able to ejaculate. I'm usually fine if its been a few days between the times me and my girlfriend have sex. But when we do i can never the same night or the next morning and even sometimes the next night. If i help myself out i can usually do it a few times a day. I don't understand why that is. It's not causing any problems between us but i know she sometimes feels like it's her fault. Is there anything i can do or any medication for this? I've read also that it could be something mental but i really enjoy my sex life with my partner and there's a lot of times i feel like that i can finish, and i get that sensation but nothing happens.",
    "doctor_response": "Give me a brief  what is your actual problem in my WhatsApp number  seven three nine eight seven one two one two zero",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need treatment for chronic cough with asthma and allergies\n\nHi My son of 13 year old has allergies and asthma related condition. it is been 5 months now that he has a chronic cough, I took him to pulmonologist and long doctors, we tried taking albuterol, allergy pills, it helps but nothing seams to be good enough to cure him from that cough. we live in Maui hawaii, he had to change his lifestyle, he was an outdoor boy and now he always has to stay inside......please can u help? I did some researches on line and came across sensory neurophatic cough, or cough-variant asthma how can be diagnosed? . What about Xolaris Omalizumab can it help?",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your son's history and can understand your concern.I would like to make suggestions for him as follows:1. There are many causes of chronic cough. I would like to know more about him like - a. Has he ever had wheezing/breathing difficulty? b. Has he ever required nebulization? c. Does he have nose symptoms like running nose, nose obstruction, sneezing, etc? d. Does he have regurgitation of sour fluids after taking heavy/spicy foods? e. Does he have headache, post-nasal drip, facial heaviness, etc? f. Does he have any family member with allergies/asthma? g. Is he routinely exposed to dusts, smokes or air pollution? h. Does he have weight loss, loss of appetite, etc?Above details would help me to think of possible causes of chronic cough. Further investigations could be suggested based on the details.2. As your current diagnosis is asthma, I would like to mention that asthma can be diagnosed by spirometry with post-bronchodilator reversibility test. 3. I would also suggest him allergy testing, which will help you identify the substances he may be allergic to and also to know the measures to avoid them.4. Based on allergy testing, an Allergist-Immunologist may prescribe him allergen specific immunotherapy which gradually improves allergy symptoms by working on immune system.5. For asthma, I would also suggest him taking montelukast regularly as a controller medication.6. Personally, I would not suggest him to avoid outdoor activity and restrict him life for many reasons - a. physical activities are very important for improving immunity and lung capacity, which help improve asthma control. b. Restrictions at his age of 13 could have psychological consequences. c. With proper use of controller medications and management of allergies, most of the asthma patients can live life without any limitations.7. Sensory neuropathic cough or cough variant asthma are better diagnosed by experts, usually pediatric pulmonologists. I would suggest you not to be confused by the ocean of information that is available on internet. Thorough history taking, physical examination and prompt use of investigations is required for making diagnosis of a chronic cough.8. Omalizumab can be helpful in some subsets of allergic asthma/rhinitis, but it is not the first drug to be used. It should be used only by experienced doctors when common drugs are not effective/cause side effects. 9. In general, I would suggest him to avoid exposure to dusts",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take plan B to avoid pregnancy when having liver tumor?\n\nI have focal nodular hyperplasia. I had sex and the condom broke, I need to take plan B but I'm not sure if I can. I know that my liver tumor is benign but any medication with estrogen is bad for me. I can't get pregnant and want to take plan b. Can I take it?",
    "doctor_response": "Hi yes  you can take plan B. there is no problem for one time  with estrogen  but  be careful, try do not repeat again. wishing you best regards Dr.Klerida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe pain in lower abdomen, diarrhea, vomitting, blood in vomit and stools. History of bloody stools. Serious?\n\nMy husband has been really sick for the past couple of days. He has had really bad diarrhea and has been throwing up. There is occasionally blood in his vomit and there is quite a bit of blood in his stools. He has had blood in his stools off and on for the past couple of months but it has never been this bad. He has really bad pain in his lower abdomen/upper pelvic region. It hurts for him to laugh, cough, or bend over. What could be wrong with him?",
    "doctor_response": "Hi and thanks for the query, I suggest he deserves a proper clinical evaluation. Blood in stool deserves, especially when chronic in elderly men deserves exclusion of a tumour of the colon. A colonoscopy and testing for occult blood in stool might be appropriate. Depending on whether its bright red or dark blood, we could have an idea of the source of the bleeding, whether upper gastrointestinal tract bleeding or lower tract infection. Stool examinations could help exclude to the possibility of amoebiasis. A proper clinical evaluation to exclude peptic ulcer disease, a fibroscopy could be useful. an abdominalultrasound could also be useful to evaluate the state of abdominal organs. I suggest you consult an internist or gastrointestinal for a proper clinical evaluation. Thanks and best regards, Luchuo, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat severe hair loss in 24 year old?\n\nhi doctor im 24 female unmaried my hairs having thin day by day or enough haor fall froms roorts which is white my scalp shows alot & when my head get sweat my scalp shows alot im very much poor i work for 120$ per month i cant afford hair transplant or other treatment kindly tell me the better way plz",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concern..As per your complain hairfall can occur due to a number of causes like nutritional deficiency like Anaemia, hormonal imbalances like Thyroid disorders and polycystic ovarian syndrome, other causes like side effects of any medications or hair products or hair treatments, long standing illness, chronic heavy stress as well as genetic causes.I would suggest you to consult a Trichologist and get evaluated and he can advise you investigations like hormonal assy, complete blood picture, Trichogram and Dermoscopy..You can be advised to apply Minoxidil 5% lotion over the scalp..You can also take Biotin supplements along with a combination of Multivitamin and Mineral supplements..You can also apply warm coconut oil over the scalp and gently massage the scalp..You should drink plenty of water and take a combination of green leafy vegetables and fruits in diet..Avoid vigorous brushing or rubbing the hairs..Keep the hairs dry and clean..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain around the hips and knees be treated?\n\nPhebalith on my femor,with a hemangeome,it s been extremely painful. It had been mistaken at first for cancer. I just started physical therapy. Doctors say surger not an option because I could bleed out&they didn t do biopsy to be 100% sure no cancer because I could bleed out because of the hemangeome that starts from my hip wraps around my femor goes behind my knee and in front of my knee. Any ideas for pain? Is thing going to keep getting bigger & more painful",
    "doctor_response": "Hello, Consult an orthopedician and get an MRI done to rule out possible neurological causes. As of now, you can take analgesics like Gabapentin for pain relief. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce medicine induced sleep?\n\ni m pation of hepatitus c dr. gais-un-nabi advised me to take EVION ,FOLIC ACID and CHEWCAL(CALCIUM+VITAMIND). I M STUDENT of F.Sc. this cause me to sleep even in my class room I can not study well is this due to this medicine? if so plz tell me the solutoin....",
    "doctor_response": "HitThese medicines contain vitamin D, vitamin E, calcium and folic acid and do not cause increased sleepiness. However, long standing hepatitis C complicates & can cause increased sleepiness, depending upon the stage of the disease.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard spots on jaw bone?\n\nMy son has a tooth that cracked in 3 places.  He saw anew dentist who referred him to a dental surgeon because he has hard spots on his jaw bone.  What are these and what can be done to prevent any more?  His old dentist wasn' t concerned about these spots.",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain Hard spots on jaw bone can be due to swollen lymph nodes which can be due to infection and inflammation in the tooth as your son already has a history of a cracked tooth and it is possible that it has got infected and there is infection in the regional lymph nodes leading to swelling and hard appearance..You need not to worry and consult an Oral Physician first as most probably it is swollen lymph node due to infected tooth for which an X-ray and clinical examination can very well give a correct diagnosis..A course of antibiotics can be given to him along with warm compresses over the lymph nodes for resolution of lymph nodes..In case of infected tooth either root canal treatment or extraction of tooth followed by antibiotics and painkillers will relieve..Hope this information helps..Thanks and regards..Dr.Honey Nandwani Arora..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain?\n\nhi i m 23 yrs old male.my height is 6 feet.weight is around 80kgs.i am healthy and dont have ant  health issues.there is a chest pain mostly in left half portion.and it increases when i think or when i get axcited by watching some porn material or think about that.it is more at night",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Basically you are having left sided chest pain when you are excited. Excitement causes sympathetic stimulation and this can cause heart damage. So we should first rule out heart diseases in your case. So get done ecg and 2d echo first. If both are normal then no need to worry for heart diseases. Sometimes stress and anxiety can also cause similar symptoms. So avoid stress and tension. Be relax and calm. Consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden jerks in the hands while on medication for anxiety and high BP?\n\nI take a variety of medications for high blood pressure to anxiety meds. . My problem is in the past month my hands jump , it is hard to hold things like type on my i-pad Or hold a glass of water, I am worried.",
    "doctor_response": "Hi, It may be tremors related to anxiety. As of now, try to avoid unwanted stress and anxiety. If symptoms are severe, then consult a neurologist and get evaluated to rule out neurological causes. Once neurological causes has been ruled out, you might require anti anxiety drugs for further management. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe lower back, butt, leg pain specifically on the opposite side of kidney tube. Have a catheter inside post bladder surgery. Cause of pain?\n\nMy husband had bladder surgery and a kidney tube put in a few weeks ago. He was sent home with a catheter and still has it in. But now he is experiencing severe low back/butt/leg and calf pain, pain is on the opposite side as the kidney tube. Could it be just from walking a little different with the catheter in? Or sciatica?",
    "doctor_response": "hi, difficult to answer your question without knowing the surgery details, why was it done? what is pathology? was it an open surgery? etc. His symptoms  could be related or unrelated to his surgery. they could be due to sciatica , however post surgery, any fluid collection in the abdominal cavity , also deep vein thrombosis needs to be ruled out. please consult his treating doctor. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain in the lower back and difficulty in bending be treated?\n\nI was dry heaving this morning and believe I pulled something in my lower back.It is a very sharp and quick pain, but very relevant. I am not able to bend backwards to much as forwards? I am wondering what I can do at home as I do not have time to take off to look into this right now.",
    "doctor_response": "Hi, This is common to have a backache. It's mostly because of muscle stretch. Though it's not serious yes it can be very painful. Generally, we advise applying some heat pads, and massage with warm oil. Besides you also can take some over the counter painkiller like Ibuprofen. However, if the pain is too severe, or you have weakness in your legs you should go to your doctor. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mahboob Ur Rahman, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for abdominal spasms?\n\nHi, i went to emergency 3 days ago due to room spinning, nausea, severe head &neck pain, seeing stars (silver dots)  , passed out after i vomited, very weak for days... They gave me antivert, zofran and zantac; in which none are working and now i have severe pain in my abdomen in between my rib cage into my back, along with abdominal spasms that you can clearly see... Ready to go back to er due to not being able to function.....please help",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query. From your history, it seems to be a colic type of pain due to a stone in gall bladder or CBD, an attack of pancreatitis (specially if you consume any alcoholic beverages. Whatever it could be, this needs to be worked up with proper clinical examination at the time of attack and related investigations like a complete blood count, a liver function test, serum amylase and lipase, and an ultraound/CT scan of abdomen if need be. So you have taken the right decision of going to the ER for proper management. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cerebral palsy with facial seizures after tooth extraction?\n\nMy daughter has a mild case of cerebral palsy, she is ampulatory and recently had a tooth pulled under sedation by a local dentist as she is unable to be maintained with iv sedation. the dentist prescribed Amoxillin at 500 mg take four times a day, for which I was unable to give to her more than twice a day due to motor skills and inability to swallow a capsule down with out giving her lots of water to drink....after about a week she complained of stomach pains, having heavy episode of heavy diarrhea, and what frightened me lately for the last two day at night time she seemed to have a one to three minute episode of her right side of her face (dental work was done upper right side) like a seizure time convusion, frozen in movement and I tried to contact the dentist but since it is a holiday I am unable to reach him...I am going to reach time after the holiday is over what should I do under these circumstances? Sharon F/",
    "doctor_response": "Hi, I passed carefully through your question and would explain that these episodes could be related to an electrolyte imbalance, probably caused by the diarrhea. They are not related to the tooth extraction, but the antibiotics may have caused diarrhea (which is a normal adverse effect of antibiotics). For this reason, I would recommend giving her a lot of fluids and rehydration solutions. If these episodes persist, I would recommend bringing her to the ER and performing an EEG to investigate for seizures. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatments for high blood pressure\n\nPlease help my mom has just been hospitalized with high blood pressure, meds are not helping. Primary care physician and endocrinologist are not sure what to do. Please help !!!!!! Her small grandchild who has lost one grandparent is in tears. Please Help !!!",
    "doctor_response": "Kindly mention the age of the patient and the current medications she is taking with the duration. It should always be remembered that undue emotional or psychological stress for prolonged periods in type A personality people is a contributory factor in poor control of blood pressure. In my opinion the patient also needs empathetic psychological support by professionals along with optimising her blood pressure medications. For any further assistance feel free to ask the details. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain in center of palm?\n\nin the morning I have a sharp pain in the center of my palm, left hand it feels like I have a splinter crossing the lifeline of my palm, when I make a fist or grab something. This pain dissipates as time goes by, and reappears next morning. Had ultra sound, found nothing. Should I be concerned. My doctor says to leave it alone and see where it leads.",
    "doctor_response": "Hi Hope this message finds you in good health.I have gone through your complaints and understand your concern.U seem to have some sort of soft tissue inflammation in muscle layer of palm that causes stiffness.Get an Mri done to find out the cause.Nothing to worry about.\u00a0\u00a0\u00a0\u00a0\u00a0I hope your question has been answered.If you have any follow-up queries,feel free to consult me anytime.Thanks,Take care,God bless.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the side effects of radiation used in lithotripsy?\n\nHello doctor, I am 24 years old. I had my kidney stone removed a year ago for causing mild hydronephrosis at my right kidney. During the treatment, I was exposed to full of radiation, abdominal CT scan, lithotripsy, fluoroscopy, and another fluoroscopy during stent insertion. I am not sure how the doctor manages the radiation. I did my treatment abroad and it is not really a well-developed country. He might not even care bout it. I studied some about radiation when I was in dental school so I am very scared of the side effects. So if I am to have another case of hydronephrosis, should I just remove the kidney rather than undergoing such radiation which may cause me high risk of future cancer? Because as you can see, I am still so young and I just started my career. What do you suggest? Do the pros outweigh the cons or vice versa? Is there another less risky treatment in terms of radiation? How about invasive treatment? Is the risk higher aside from the slow healing? And I am serious about the removal if indeed it has lower radiation risk, even though I know kidney is very important. Please suggest.",
    "doctor_response": "Hello. There are enough studies and literature which prove that though there is radiation exposure during CT (computed tomography) scan in the removal of kidney stone it is in low dose and chances of cancer do not increase. So do not worry about that. I do not think removing kidney to escape from radiation exposure is a good option. You should not think of that. If there is again stone formation then there is a treatment called ultrasound-guided lithotripsy (ESWL) which can break your stone from outside without any radiation exposure. So you can do ESWL (extracorporeal shock wave lithotripsy) if required later but no need to remove the kidney.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pin like sensation in chest and pain during deep breath?\n\nHi aim 41 years of age and for the last few days I ve been feeling pins like sensation in my left chest side Also when I breath in deep I can feel that pin in my left side I m guessing in the heart Should I be conserened or is it just a side effect from stress",
    "doctor_response": "Hi thanks for contacting HCM....According to your complaint few possibility is present...First if you are taking excess stress then it can occur..Rest done...Avoid stressful situation...Yoga helpful...If needed counselling done by psychiatrist....Second it could be simple musculoskeletal pain...Rest with analgesic useful...Avoid heavy weight lift and strenous exercise...Take proper sleep posture while at bed...Thirdly if you have still problem and cause not clear detailed history and examination needed to do further work up...To rule out respiratory causes pulmonary function tests and chest x ray useful...Hope your concern solved...Take care...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes grey color penis after unprotected anal sex?\n\nok so... i got realy drunk one night and had unprotected anal sex, i have been woried about this for a while and dont know what to do. this may be me just being parinoid but the tip of my penis is turning slightly grey but not the whole thing just the underside of the tip.",
    "doctor_response": "Hello,Thank You for consulting HealthcareMagic!History of unprotected oral sex is concerning and carries the risk of  STDs. There may possibility of some sexually transmitted infections like chlamydia, gonorrhea etc. I suggest to get STD screening tests as some present late. However, a Physical examination is mandatory to assess this since there are variety of other causes that needs to be ruled out.Stay healthy and thank you for consulting! You can contact me again anytime, if you need clarifications or further assistance in future. Kindly rate the answer if you are satisfied.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hello miss or mister doctor! I Well I have a question that can sounds stupid or dangerous, but I d like to have an answer based on proofs if it s possible. What are the side effects of adderall? Does it create a dependency? If yes, is it hard to get out from it? Thank you very much.",
    "doctor_response": "Hi,As of date Adderall has been approved to treat attention deficit hyperactivity disorder and narcolepsy. Its common side effects include insomnia, loss of appetite / weight, increased heart beats / blood pressure, dry mouth, headache, nervousness, irritability, impotency, and both physical and psychological dependence. Its withdrawal may cause unpleasant symptoms the severity of which will depend upon the average amount of drug being used / abused, amongst other variables but on the whole, they are typically less dangerous than the risks posed by continued abuse.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How will i stop doing masturbation?\n\nHi,i m 21, 6feet,healthy guy, i m masturbating since last three years like twice in a week and rightnow i m facing alot of problem like hairfall, tiredness,and my face and body ve become great to avrage , how am i supposed to get over with this bad habit?",
    "doctor_response": "DearWe understand your concernsI went through your details. Please understand, the health problems you are facing like tiredness and hairfall are not directly due to masturbation.These health problems are due to stress and the reason for your stress could be including the negative thoughts about your masturbation habits. masturbation is normal, natural and never unhealthy even if you do masturbation daily. in fact, you are masturbating only once or twice a week and is quite a healthy choice. i suggest you to continue like this and never worry about thios habbit because this habit is not unhealthy. If you still need my assistance in this regard, please use this link.  Please remember to describe the whole problem with full detail.Hope this answers your query. Please feel free to post follow up queries. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rash and itching on thighs and arms\n\nHi on the 26th of July I noticed itchy pimple like bumps around my vagina.  I saw a doctor on the 30th.  She prescribe me Miconazole Nitrate Vaginal Cream USP 2%.  Use for 7 days, itchiness stopped but after the 7th day new break out occurred.  Saw another doctor on Aug 9th.  She prescribe me Clotrimazole 1% cream and Fluconazole Tablet USP 150mg.  Seemed to help, but then new breakouts down my inter thighs started and also started breaking out under the arm pits with a red itchy rash.  The rash started under the arms went down my arm to the top of my hands.  Saw the same doctor which I saw the second time on the Aug. 13.  She then prescribe me Diphenhybramine 25mg Capsule and the allergy shot.  By the end of the day the itchiness had stopped and the rash wasn't so red under my pits and the rash started going away down my arm, So I thought it was working.  Then by Thursday night new rashes started forming on my inter thighs and itchiness and reddness started back on under my armpits.  (the doctor I had seen the last two times recommend me coming in to the doctor on call for walk ins)  So I saw another doctor on Friday 17th (yesterday).  She prescribe me Permethrin Cream 5% and Hydroxyzine HCL 25mg Tablet.  I had applied the cream last night and washed it off this morning.  The rash is worse then before and itches worse then ever in the inter thigh area and the armpit.   and arms.  What should I do?  Should I wait it out.  Never had anything like this before.",
    "doctor_response": "Hello, It looks like your rashes are getting chronic. You have taken antihistamine tablets & shots, it reduces but then again gets flared up. Presently your rashes & itching are worse after the application of Permethrin, a drug of choice for scabies. Since you have bumps in the vagina & rashes spreading all over the body, it looks like Herpes infection. Herpes infection can cause rashes all over the body. Bumps in the vagina are suggestive of genital warts or genital herpes. You should visit a GP at the earliest. Get clinically examined & assessed. You may need to get STD test done. Your treating doctor will treat you with antibiotics / antivirals. Take care of your hygiene. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nupur K, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain behind the left shoulder and left arm?\n\nHelp. I am in severe pain from behind my left shoulder blade all the way down my left arm and tingling fingers. I have previously been diagnosed with a couple discs out and arthritis. In 2007. This pain began a month ago and I have tried everything I know of. Starting to effect my breathing. Wake up in major pain. Thank you, Shannon",
    "doctor_response": "Hello welcome to 'Ask A Doctor' service.I have reviewed your query and here is my advise.You can have Compressive neuropathy and by nerve compression pain and tingling can occur. MRI scan can be done to rule out it. Pregabalin prescribed for neuropathic pain. If needed surgical management done for nerve compression. Investigate with vitamin B12 and blood sugar as well. Investigate with chest x ray as some dyspnea also present. I suggest you to consult physician for examination.Hope I have answered your question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "When does to get pregnant after a miscarriage?\n\nAt last I got my first prega news on 30th march 2014.im happy.but after 10th week pregnancy I see in ultrasound that my baby has no heartbeat. Unfortunately I had got missed abortion on 4th may 2014.and now aftrer 15th day I want ans from you for help.so pls give me an ans for my question.now! Which time is safe and good for i got my next healthy pregnancy.when should I trying to concive.because the next time I want a perfectly healthy pregnancy..",
    "doctor_response": "Hallow Dear,After abortion, theoretically, the egg release may start anytime after 5 weeks. However, whether to go for next pregnancy so immediately is a question; particularly when you had missed abortion. I feel primarily after any type of abortion, due time of about 3 months should be given for the organs and tissues of reproductory system to regain normalcy. After that pregnancy may be attempted. However, since you had missed abortion, I would advise you to consult a foetal medicine specialist to find out the probable cause behind the missed abortion. May be both of you might have to get your chromosomal study done. If any cause is detected and is curable, first get it treated before you attempt next pregnancy. Right from now, in the preconception stage, start taking Folic acid tablets daily and high protein diet also. This will help release of healthy egg and healthy implantation of fertilized ovum. Please consult your Gynaecologist before attempting the pregnancy. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to self-inject B12?\n\nI need to self-inject B12. I was told sub q in your arm , but that s impossible. I have read that I can inject it into my buttocks, or my arm, or my thigh. Are these injection sites correct, and if it s sub q wouldn t the fat part of the butt be the simplest? Easy to reach, etc.",
    "doctor_response": "Hello, Yes all the injection sites are correct. But thigh is better site for self injection. Thigh: Specifically, the muscle injected is known as the vastus lateralis muscle. The thigh is a strong muscle appropriate for vitamin B-12 injections, and it is most appropriate for newborns and infants because it is one of the most developed muscles in youth. The thigh can also be appropriate for adults because it's so easy to self-administer injections there. The needle is usually 2.5 centimeters in length and is inserted at a 90-degree angle. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Arup Majumdar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes palpitation?\n\nmy thyroid levels are T3- 2.72, T4- 143.8, TSH- 2.52. I am facing problem of palpitation and feeling very lethargic. palpitation is more while lying dowm or whn i m stressed. my haemoglobin is 11 gms now, earlier i was aneaemic. my ECG shows sinus tachycardia which always remain since long. ECHO is normal. i am short height 5 ft and wt is 70 kgs. generally my B.P. remains low and pulse remains v high",
    "doctor_response": "your thyroid profile looks normal, your hemoglobin is on lower side. So continue iron supplements and all whatever you are consuming. Sometimes low hemoglobin can cause palpitations, anyway you can your local doctor for tab ciplar LA 20 mg once which will control your anxiety and palpitations. Many times even if all parameters are normal some person get tachycardia and it's called inappropriate sinus tachycardia which can very well be controlled with ciplar. Dose can be increased to 40 mg after you tolerated. Monitor your blood pressure while being on it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should i give for appetite after fever?\n\nHi doc, my 20month old baby gal had fever on this Sat and Sunday, I showed to doc and they advised Crocin ds syrup.frm Monday she is having no fever, but she is refusing food totally and want to have my milk and wants to be in my lap always,. What shud I give for her appetite and is this normal in kids?",
    "doctor_response": "HI...it is very normal kids to loose some appetite during recovery form illness or convalescence. Do not worry. They will regain the appetite in another 1-2 weeks. If the kid is otherwise active you need not worry.I take this opportunity to tell you certain scientific facts and relieve your distress - 1. An active is a well kid even if she/ he is not eating well. 2. Development of a kid is as important as or I would say even more important than growth alone.3. As the kids grow their interest in food decreases and interest in play activities increases so that they eat small quantity and run away to play. As parents we need to be more patient and feed than less quantity but more aliquots per day.4. This age rather than the quantity of the food I suggest you concentrate more on the number of times you feed her and also make whatever you feed her calorie dense by adding good amount of ghee to it.5. I suggest you not to use appetite stimulants on long run as they may cause drowsiness.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for numbness & tingling in arms with blurry vision\n\nI am having pain numbness and tingling down both arms, hands feet and legs, mostly left side. My vision goes blurry periodically throughout the day, I have headaches with pressure in ears, and severe fatigue. Every time I eat, which I don t have much of an appetite, I have diarrhea and have a lot of heart burn.",
    "doctor_response": "Here there are couple of possibilities with your symptoms,You have symptoms of numbness and tingling in your hand, arm and feet more on left side of body, also headache, and heart burn after you eat, severe fatigue, as well some times blurry vision for entire day. As per this you need to take following steps.1. Check your eye sight and no. It can also cause hedache if there is weak eaye sight.2. Check your blood pressure and blood sugar. This can be resion for headache as well fatigue.3. Visit a neuro physician for proper examination for headache issue. If needed go ahead for MRI scan.4. Visit a orthopedic in case if numbness is also associted with pain in neck and back spine. Orthopedic will do certain physical test and may ask for some more scaning or x-ray and will give you treatment as per that.5. If you always get tired withblittle walk and it use to be along with breathinh difficulty then you need to do ECG and treadmill test for checking out heart health. If there is any issue then visit cardiologist.6. If nothing wrong with heart then heart burn could be just due to acidity and have anta acid tablet as oer your physician suggestion.You can also improve your lifestyle by having food at right time and changing food preferance ti healthy and balance diet. also do regular walking exercise.I am sure you will feel better when you follow all abive things with proper evaluation and treatment.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for severe back pain?\n\nI was sick a week before Christmas, my back was achey and I was getting nauseous about 2 hours after eating. I thought I had the flu. I felt better for a few days and then got lower and mid back pain and burning pain under my right breast over my ribs. It feels puffy there as well. That came and went and lasted for a couple of days. I feel better now, but am unsure if i should contact my doctor anyways.",
    "doctor_response": "Hi Welcome HCMThank you for your inquiry and appreciate your consentBrief answer:  It is called referred pain from the abdomen .Detailed answer: The abdomen have a couple of organs which response to physiological changes constantly. And is always expose to stressful situations. The can manifest as pain that can be referred to the skin dermatome corresponding to nerve innervation of the organ. Thus once stress is gone the symptoms disappearsHope my proposed will help answered your questionThanks for using HCMGood Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to prevent fungal lesions on body and in mouth?\n\nhi Dr im 19yrs old, 2yrs ago i went on a camp nd when i came bck home i started getting fungal lesions ever since then i get them every single year  around summer and they cover up my body nd i also get them in my mouth. there was a time where i was osolated for about a week because of them nd i could not evn eat solid food because they were sore now i need to know  what i can i do to prevent myself from getting them again",
    "doctor_response": "Hi.Thanks for your query in HCM. I am Dr.Aliem, and I am pleased to answer your query.Fungal infection in the body, especially in groins, is a fairly common skin condition, especially among youngsters. It just goes off with the application of certain anti-fungal ointments or medicated powder. Whitfield's ointment is a time tested remedy for this. It is availabe in the pharmacy over the counter. But it causes the formation of a whitish layer over the applied area, which disappears in a short time. Better medications are available, please consult your physician or dermatologist. I have a few suggestions for you:1. Keep the area dry as far as possible. Especially, avoid getting wet with sweat.2. Keep the area cool.3. It spreads by contiguity. Avoid sharing clothes/undergarments.Fungal infection in mucosal areas, like mouth, may be indicative of some conditions which will suppress your immunity, like Diabetes. So please consult your physician, who will order some blood tests for you. If you have difficulty or pain on swallowing, an upper G.I endoscopy may be needed. Hope this helps. Feel free to send further queries if any. I wiil be glad to answer.Dr.Aliem",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can jaw pain and swelling in throat be a result of consuming methylone?\n\nI did methylone last night and my jaw hurt this morning from the grinding I did with my teeth. Later on in the afternoon my throat swelled up. I can t eat. It hurts to talk and it feels like I burnt the roof of my mouth. Should I be worried? I heard sore throats are common, but will this affect my tonsils?",
    "doctor_response": "Hello,Actually methylone does not causes these kind of allergic symptoms. It can be possible that you are having sore throat which is causing these problems   as there will be pain while swallowing and tonsils will also be affected.According to me you should visit an E.N.T. specialist for the treatment.Hope it will help you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I feeling excessively fatigue or sleepy with low heart rate?\n\nHi doctor, I am wondering about the connection seen between my excessive fatigue or sleeping issue with cardiac insufficiency. I have excessive sleepiness due to mild sleep apnea. But I have a strange disconnect regarding exertion. Even, a slight anaerobic activity reduces my breath and it takes time to have a standard respiration rate. When I use an elliptical machine, I have trouble in getting my heart rate up to 110 beats per minute. However, when I take Vyvanse, I can easily hit a heart rate of 125 beats per minute. I recover immediately after stopping it. I have a blood pressure of 130 by 88 mmHg. Currently, I am taking Enalapril, HCTZ, Amlodipine, Levothyroxine, and Prozac. These problems preceded my daily alcohol intake and minor cannabis use. Please suggest.",
    "doctor_response": "Hi. Yes, daytime sleepiness occurs due to sleep apnea. If it is present in its severe obstructive form, it can cause a host of cardiac diseases like atrial fibrillation, coronary artery disease, and heart failure. The exercise intolerance initially develops the consequence of early heart failure. Also at your age, you may be suffering from chronotropic incompetence, that is, the inability to increase heart rate with exercise, and regular graded exercise will help you. Stay off from alcohol and cannabis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will frequent masturbation affect my health and future sex life?\n\nhi doctor, i m 26 years male.. i m doing daily hand job is it bad for my health and or effect my future sex with partner.. sometimes after handjob i feel headache. also my mentality feels vulgar mostly is this will make any mental caution for me. many thank.",
    "doctor_response": "hi masterbation is a natural process in teenage people.i think it does not effect the health and future life but the anxiety associated may effect ur health.even then do not masterbate more than 3 times a day.masterbation is only indicate of production of sexual hormones in male.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I see doctor for my daughter who has runny nose and cough?\n\nMy 2 year old daughter who weighs about 23 pounds. Has had a green runny nose for about 2 weeks, and a cough as well that occasionally will make her cough so bad she will vomit. Now she has a temperature of 99.6 which I know isn t too high, but I m just concerned because she doesn t seem to be getting better. Could this be a cold or allergies, we recently had a warm spell and the pollen was quite high, and should I call her doctor by now since its been so long, or wait it out?",
    "doctor_response": "HelloWelcome in H.C.M.In reference to your query regarding cough and cold with fever to your daughter of only 2 years old, and having green nasal discharge, Here I would like to tell you that these all are symptoms are of upper respiratory tract infection along with allergy. Such child may land up over complications like pneumonia.Keeping this in mind it will be better to get you child examine by your doctor and accordingly treatment may be plan.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red spots on penis after an intercourse?\n\nSir I had a sex with my girl friend one month ago and I had some red spot in my penis I was scared so when to the doctor after one month .did the test for vdrl and made my girl test for hiv and vdrl both result was negative I took a course of 30 days medican and now its ok .doctor told its some type of fungnal infection now as its ok is it possible I might suffer again should I use condom everytime  while having sex please advice me",
    "doctor_response": "HiThank you for asking HCMI have gone through your query. The problem you had could be most likely fungal infection. Local anti fungal ointments like clotrimazole or terbinafine and oral fluconazole will clear that. As you have taken 30 days there is no need to worry. If your partner have infections/STD or you want to prevent pregnancy then better use condom. But for STDs condom is not 100 percent protection. For preventing pregnancy if you use abstinence along with condom it is a very effective contraception.Hope this may help you. Let me know if anything not clear.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a baby s heartbeat not be heard despite normalcy in the pregnancy?\n\nHello Dr. Nirja. I am at the ninth week of pregnancy and the doctor says that he doesn t hear the baby s heart beat. since this is my second pregancy, I was wondering if there is any chance that he might be wrong or if there are case in which you can t hear the heart beat. thank you.",
    "doctor_response": "Hello. By 9th weeks of pregnancy all embryos should have a visible and audible heartbeat by Doppler Ultrasound. At 9 weeks the embryo should measure about 2.3 cm and must always have a heartbeat 120-180 beats per minute. If frequency is less than 80 bpm prognosis is no good and there could be a pregnancy loss within the next few weeks. if the embryo size is 9 weeks and there is no heart activity you are certainly facing an early pregnancy loss and uterine evacuation, pregnancy termination, is indicated. If the embryo is less than 3-5 mm there could be a mistake in pregnancy dates (wrong last menstrual period date) and the patient should be seen in about 2 weeks to confirm embryo health and growth. Good luck!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the whole body?\n\nRespected Sir,My wife,Mrs. Madhumita Banerjee,aged approximately 26 years,is bedded,feeling severe pain in lower parts of the body.Details of the case is furnished below:History:1.Went through severe jaundice on March'092.During cesarean delivery of child,was applied spinal anaesthesia on January'113.Had a fall from a running bike on October'11,which didn't result in any immediate after effect.CASE HISTORY:Symptoms started showing up one and a half month earlier,when she felt unbearable pain in right side of waist.Mainly she was having problems while trying to move after rest.General physician suggested COMBIFLAME,what she continued for almost 3 weeks,but it was not any good except for some temporary reliefs.Having some medical suggestions,with a Lumbo Fractal Digital X ray report(which was absolutely fine),we moved on to an Orthopaedic.He advised her 'Lenox Plus',which reduced the pain of the right waist,but the pain shifted to the thigh area(from groin to upper thigh).On intimating the doctor,she was prescribed 'Zerodol MR'.It reduced the pain to some extent,but the left ankle showed signs of swelling and black patches.Then she started taking Altraday(1 tablet per day) as per medical expert's advice.As now,the left feet and right knee are showing clear signs of swelling,she is feeling unbearable pain in those areas along with in hip joint.The pain has got no burning feelings and grows unbearable as she tries to move from rest.Meanwhile,as per medical advice,a blood culture is done,which is showing only haemoglobin(10%) and ESR(38),fluctuating out of normal limits.Complete USG of lower abdomen is also perfect as per latest reports received.Your diagnosis and advice in this critical situation will be of great help.Please mention if any more tests need to be done for better scope of diagnosis in future.Regards,Preetam BanerjeeWest Bengal",
    "doctor_response": "Hi the problems of generalized pain and the waist pain and now thigh pain after the jaundice , while 1. first is related to nutritional deficiency. Has to be treated with vitamin and folic acid supplimentation. the vitamins particularly vit B complex. No investigation are required and you may start vitamin supplement like Recharge plus or Neurobion forte, once daily.2. second is related to disc herniation in the lower back. This may not at all be related to jaundice, but poor muscle tone in back may lead to this. You must get an MRI of the lower back and consult a pain specialist in your city.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white spots from tip of the tongue to the back of the tongue?\n\nMy 16 month old girl has all these whites spots starting from the tip of her tongue covering also the middle and back of her tongue also, she won t eat, won t take her antibiotics nor the panadol or nerofun she has a high temperature also, and has the shakes. She has been to the doctors but was just prescribed antibiotics etc. I don t have a clue on to what I should do, being a first time mother and single at that too. Next visit might just be to the hospital but before hand, can anyone enlighten me on what it may be? And does anyone have any home remedies or medications I should consider?",
    "doctor_response": "HIWell come to HCMThis could be leukoplakia and in my opinion the condition can be best treated with tannic acid local mouth application  if this is painful otherwise the condition is self limiting if the symptom does not improved then you need to see the dentist, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for neuropathy\n\nHello, I am a 72 year old neuropathy patient. Do you know of any cure for neuroapthy? Mine is very severe. I am numb from my knees down and numb from my elbows down, but the pain is terrible !! Also I have charlie horses along with the pain. Is there anything to help besides opids? Thank you in advance for your answering me. Sunshine",
    "doctor_response": "your symptoms are neuropathic pain. Medicines effective for it are-1) Gabapentin2) Pregabalin3) Duloxetine4) AmytryptylineAlso you need to get Nerve conduction test and few more tests to find out cause of neuropathy. further treatment depend on cause of neuropathy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Molar pain, gum sensitivity, bad taste in mouth. Broken wisdom tooth. Safe to have deep cleaning?\n\nI went to Dentist because I was experiencing upper right molar pain, gum sensitivity & bad taste in my mouth from this area. I was told I had a broken wisdom tooth & needed to have it and 2 other wisdom teeth extracted. She also said I needed to schedule a deep cleaning. She referred me to an oral surgeon for removal of wisdom teeth. I'm scheduled for a scaling & root planning with dentist prior to oral surgeon consult. Is it safe to have this deep cleaning with my broken wisdom tooth issues? I feel I have an infection. Thanks for your time.",
    "doctor_response": "Hello,Thanks for writing to us.There is nothing harm in cleaning teeth prior to extraction of broken wisdom tooth.If there is heavy gum inflammation,scaling can be postponed after tooth extraction.Meanwhile,maintain oral hygiene well.Gargle frequently with lukewarm saline.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need treatment for irregular ejaculation after years of masturabation\n\nHello doctor. I m 21 year old. I really have some doubts about my reproductive organ. I used to masturbate for the past 6 years and I do it at least 3-5 times a week. I really don t have control in ejaculation, it occurs within a minute after arousal during masturbating and sometimes its ejaculates in sleep by itself. My penis is shaking and pain a lot while doing it. And also am worried about is, the Outer skin is not getting down the penis head and feel its small to my age. Is this immature growth or is a normal one. Will these thing affect if i have an intercourse.??? If there is a real problem please suggest me a natural remedy. Thank you.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.No, it sounds normal to you.Ejaculation period can range from few minutes in various individual.So two to three minutes can be normal in you.You should increase your frequency for masturbation. Because of the decrease frequency of masturbation you are facing the nightfall. As you increase the frequency night fall will disappear.Masturbation is not the abnormal thing not it will harm you. So you can do it and enjoy it.Your organ size is normal and need not to worry. Retraction of foreskin is some what tough in erect penis. So if you are having this problem than you are normal and need not to worry.You can do intetcourse with this organ. You will do it successfully. Please wear condom while doing sex this will help in prevention of STDs.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does my foot and ankle not work normally?\n\ni shattered my foot and ankle and it does not move like it did , tramadlol works part of the time but so does 1600 mill grams of ibprofomium but some times loratabs stopps it faster. i try to keep the useage down to a mininmun the last was 10/325 and 50mgl on the tram. the hospital releasesed me and i dont have a reg doc ececpt for deppression and it dont seem to help anymore i seem to seem stuch",
    "doctor_response": "hi you had a shattered foot and ankle and now it does not move as it did and you are having pain. In my practice i would put a splint on the leg to support the bones, give you painkillers and avoid prolonged walking at present. I would suggest you to use a crepe bandage + regular pain killers. Also please upload what medicines / treatment your doctor has given.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a non productive cough and feeling of cold air while breathing?\n\nHi, I ve been feeling very bad for the last 5 days. At first I thought it was a normal flu, so I took paracetamol, but even when I feel a bit better now, I still have a lot non productive cough and when I breathe in I have the feeling that the air is too cold... I m wondering if I have pneumonia or bronchitis...",
    "doctor_response": "Hi Dear !! Thanks for your query to HCM .Read and reviewed your query and health concerns. You seems to suffer from-Acute on Chronic Pharyngitis.Recurrent dry cough could come from Viral / bacterial infection, in cases with past history of Chronic Pharyngotonsillitis.Due to chronicity,phelgma produced is minimal or nil, as in your case.The coolness of the inhaled air,is from the blast of comparatively cool air on the inflamed pharyngeal mucosa.Gargling and enough drinking of fluids and enough steam inhalation would resolve this cool feeling.Though the inhaled air is warm, the speed of air hitting the inflamed wall makes it feel more cold,as the inflamed mucosa is stuck with fast moving incoming air flow/blast.No chance of pneumonia and bronchitis in your case.But would suggest for check up and Consults for Second opinion from Physician.X-ray Chest with it would resolve your worry for bronchitis and pneumonia.Other causes- like Acid Reflux with lower Esophagitis,TB granular pharyngitis,dust allergy etc need to be ruled out.Hope this would help you to plan further care of this complex illness of yours.If need be, update any health issue 24 x 7 by a direct question to ME, at following HCM link-Dear, if satisfied,Don't forget to close this query with YOUR pleasing feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at HCM services.If you want to update more details and ask more update queries ,You are most Welcome herewith !!Good Day!!Wishing Good Healthy Life in time to come!!Dr.Savaskar M.N.Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Continuous discharge of sour, bitter saliva between teeth and hard palate. Unable to diagnose. Cause?\n\nFrom the upper hard palate , along the gumline between the teeth and hard palate, there is a continuous discharge of saliva which is sour and bitter. With the tip of my tougue, I could feel the sponge texture along the gumline between the teeth and hard palate. On the worse day, I can physically feel the discharge dripping from a tube/duct or spiral discharge to the hard palate. I feel like I have two sets of nose. I have seek helps from ENT, dentist , and oral surgeon, but no one can diagnose what is causing it for the past two to three years.",
    "doctor_response": "Maxillary sinus may be accidentally opened during tooth extraction/dental work and can lead to bitter taste in mouth and leakage in mouth. Roots of upper teeth are close to the sinus and mouth sinus communication could have occurred during tooth extraction. This complication is more common when teeth project into sinus when there is considerable bone present between floor of sinus and root apices. In most cases, opening which occurs is small and blood clot filling the extraction socket will close the openings unless the sinus is infected. If opening is of considerable size, then sutures are placed across the socket to approximate gingival tissues.  Some absorbable material may also be used. Large openings can be closed with buccal flap. You can visit an oral surgeon for evaluation and treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Red rashes on legs, thighs, ankles, warm to touch, raised bumps. Due to drug usage?\n\nhi, i have a slightly red rash on my legs from my thighs to my ankles on the back and front of the legs. It is tender to touch and warm/hot feeling when you touch it. It doesn t itch at the moment though but is slightly bumpy/raised. Could this be because of smoking ice over the weekend? It happened last time I took drugs aswell so i thought there may have been a connection. Should I be worried about this?",
    "doctor_response": "Hi i think it is allergic vasclittis.it is caused by drugs.food allergry etc.it presents as bumps all over the lower legs which are hot to touch and non itchy.rule out other associated features like abdominal pain .vomiting .haematemesis to rule out any internal bleeding.it should be cured by vitamin c chewable tablet..a antibiotic twice daily and application of calamine lotion.use short course of steriods like wysolone 30 mg tapered to 10mg can cure it",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest psychiatric help for stress & depression\n\nI m 38, high stress, in a bad relationship, work hard, make decent money, but have 3 kids by 3 different relationships! 23 yr old son on 7/24, 19 on 4/11, and 15 on 8/16. been with the same guy for 18 years, we are not married, but have our 14 yr old together, and would have had a 16 year old. Bbut he died from SIDS at 5 weeks...I lost weight in 2004, (when I was 29), now its creeping... and even though I haven t had time to work out in a month... I know what I need to do. You are not a psychiatrist... but I m concerned for my health! I refuse hbp meds because I am situational, but I need something...anything FAST!!",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Many researches and researchers confirm that medicines alone cannot cure mental disorders. Life style changes, change in thinking pattern, relaxation etc are as essential as medicines. Psychotherapy can help you changing your lifestyle and thinking patterns. Yoga and meditation help you to streamline your metabolism and neurological balance. Please consult a psychologist for further information.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Seizure attack with fever. Taking levipil syrup. How long it takes to cure?\n\nHi, My Son (09+ years) had a Seizer Attack with fever around 5 days back. there was three seizer up to age 3 year . & this seizer was after 3 year age. in between three year & 9+ no any seizer. Doctores Recommended Levipil Syrup (Main composition: Levetiracetam 100mg) 6ml a day . we are worried about long-lasting Side effects of the same. & also want to know that this general seizer effect on body or not. and how many time taken to settled.",
    "doctor_response": "Hi, Thank you for posting your query. Levipil (levetiracetam) is a good drug for seizure disorder. It is free of any major side effects. Medicines should be continued for at least three seizure-free years. However, the exact duration would depend on the clinical condition, MRI and EEG findings. Children with seizures do not have any adverse effects on the body, if they take regular medications. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a painful anal lump be treated?\n\nHi. Approx 2 years ago I #d my coccyx in a fall downstairs.I don t know if it s a coincidence but since then every now and again I get a sore red lump ( anal fistula ?) which is very painful. It eventually goes away but every time it comes back it lasts longer and is more painful than the previous time.",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You may have fistula or fissure or some abscess.  You should go for examination.  Thenbypu should go for surgery.  Complete removal of fistulous tra t is required.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for asthma bronchitis symptoms?\n\nI went to immediate med last Friday, the medicine for my bronchitis is not working. I CALLED MY DOCTORS OFFICE AND CAN T EVEN GET A CALL BACK. Went to the emergency room and waited 4 hours and never got seen so I left. Called my doctors office today and she won t be back until Monday, in the meantime how am I ppose to treat the asthma bronchitis symtons.",
    "doctor_response": "Hi, if u have diagnosed correctly that asthmatic bronchitis and u are suffering severe symptoms then one should not wait for that doctor who will come after few days,see its not big deal to treat asthmatic bronchitis as many good medicines available in market in different formulations,u go to another pulmonary physician and get prescribed, take it on a urgent basis but don't bother.u will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying for baby. On folic acid tablets, fertyle, injection ti rupture follicle. What does triple line mean?\n\nHi, I am 28 years old ..been married since 1year and 2 mnths. We are trying for a baby. Doctor gave me fertyl from 3rd day till 7th day and M2tone,Folic acid tablets. I am getting my ovulation studies done. On 11th day my LT.OV is 15 mm and 13mm RT.OV is MSF and ET is 9.3mm Triple line.She plans to give me an injection to rupture my egg once it reaches the desired size. I wanted to know what does triple line mean? What are the chances of pregnancy in cases where we take injections to rupture the follicle.Thanks",
    "doctor_response": "HelloThanks for your quer.Triple line means that the endometrium is of good and perfect size.The development of the egg follicles is also satisfactory.Once the egg reaches size of 18 - 20 mm, injections are given to rupture the follicle.After taking medications for ovulation induction, almost 80 % of women ovulate, and around 50 % conceive within 6 months.Once you fail to conceive within 3 - 6 months, you should have assessment of patency of fallopian tubes, and your husband's semen analysis.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "low RBC\n\ndear sir  i had been suffering from fever for two months, i tried many doctors finally i am told that it is due to kidney infection. i have taken medicine for two months but my rbc count is still very low at 6 %-7%. please help me.",
    "doctor_response": "Hello.welcome to HCM.Unless and until we know the exact picture of what happened in past 2 months and your body profile,very difficult to advise.Best would be to consult a nephrologist also.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome withdrawal symptoms of ativan?\n\ninteraction of methadone and ativan. also ativan withdrawal symptoms i am a 43 year old male and am currently prescribed 150 mg of methadone daily also 4 mg of ativan and for high blood pressure tribenzor 40mg/10mg/25mg . ive been on the methadone for approx 5 years, the ativan 2 years but until 6 months ago was taking about 2mg a day and the tribenzor for a year or more. ive always taken a blood pressure md for about 10 years. im finding that if i happen to run out of the ativan for even a few days in between appointments or refills, im having extreme panic attacks and anxiety. also the methadone seems to be in effective when not combined with the ativan. ive now come to the point that im terrified of running ut of ativan becouse not only do i feel the sleeplessnes,anxiety but also the methadone seems in active. Is this all common and if i were to stop taking the ativan how lng will these symptoms last? or will i get worse and worse until i have a seizure or start passing out or shaking with panic? is there anything i can do to ease the symptoms when or if i run out of ativan again?",
    "doctor_response": "Hi,You should opt for the detoxification process if your medical condition allows. Detoxification is the process of allowing the body to rid itself of a drug. It's often accompanied by withdrawal, which is the set of symptoms the body experiences when long-term use of a drug is abruptly discontinued. The unpleasant symptoms (anxiety, insomnia etc.) can arise throughout the period of withdrawal. It can also impart a high risk of relapse for people undergoing detoxification. Hence, Self-detox is not recommended.Ativan's potential for extreme withdrawal symptoms, and the risk of relapse, detoxification should be closely monitored by medical professionals. Detoxing under close medical supervision can ensure that you have quick access to medical care if you experience rebound anxiety during the withdrawal process. This can help you make it through detoxification without going back on the drug.4-10 weeks is standard for a detoxification schedule, during which your doctor will likely choose to decrease your dose by a set amount each week. Some time flumazenil is used to counter symptoms of Ativan withdrawal. Taking methadone and Ativan is not recommended unless there is a medical indication and prescribed by your doctor. You need to consult your doctor for an alternative approach.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mahendra Shivram Thakre, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to get sound sleep without Alprazolam?\n\nHello doctor, I am a 34 year old male. My weight is 68 kg. I am married and have two kids. Because, of the disturbance made by my kids, I was not able to sleep well sometimes. So, I just started taking tablet Alprazolam 0.25 mg. Now I have been trying to gradually stop taking the medicine. So, I had 0.25 mg on the alternate days and in between 0.5 mg twice a day. I have a feeling that my body has got addicted to tablet Alprazolam. Because, from the day I stopped taking the tablet, I am not able to sleep even a little bit. Yesterday too, I tried without medicine. But, I could not sleep. Then at midnight, I had 0.5 mg and then slept for 4 hours. Please help. Thank you in advance.",
    "doctor_response": "Hi.I can understand your concerns. Alprazolam is a habit forming drug. I would suggest you to take Zolpidem for disturbed sleep. Zolpidem is less addictive compared to Alprazolam. I will suggest you the following measures to get a sound sleep. Please try.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for severe right buttocks pain\n\nI am now having severe right buttocks pain, which has gotten worse after two cortisone shots, physical therapy for 11 sessions and an xray was taken in the begginning. Do you think my next step will be an MRI to determine what the pain is coming from?",
    "doctor_response": "hi,thank-you for providing the brief history.As the history suggest that this is more of a lumbar spine disc degenerative disease. As due to nerve root impingement in the lumbar spine the sciatic notch in the gluteal region will have a severe pain and needs a thorough clinical examination and an MRI to understand the pathology of the lumbar spine.Infact with 11 session of physical therapy the pain can not come down and may need more sessions as well. Taking therapeutic ultrasound therapy and TENS therapy should help control the pain symptomatically and exercises will play an important role in stabilizing the spine and also improving the muscle strength to hold the spine without leading to nerve root impingement.In my clinical practice most patients need more than 15 session of physical therapy and they respond well.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly explain whether MRI brain and CSF studies show any relation to NPH.\n\nHello doctor,Can you please give the diagnosis of the uploaded MRI brain and CSF studies with a detailed report? Please advise on the action plan as to how to get the CSF findings treated. The MRI report is enclosed. Does the enclosed report co-relate with your findings? The MRI report CSF studies report shows CSF hyperdynamic flow of absolute stroke volume of 110 microliters per second against the normal of 50 microliters per sec per cardiac cycle. Also, my treating neurologist wanted an opinion on the following. Are there signs of NPH? But do the findings of brain atrophy, ventriculomegaly, hyperdynamic CSF flows suggest of idiopathic hydrocephalus and are some intervention required?",
    "doctor_response": "Hi, Welcome back to icliniq.com. The findings in the report and the images are matching and acceptable (attachment removed to protect patient identity). The term NPH is usually applied in cases where there is abnormal CSF hyperdynamic circulation with gait problems or without gait problems if incontinence is there. Confirming NPH without typical features is difficult in your case. There are controversies regarding NPH and CSF hyperdynamic values and different researchers have come to variable conclusions. Since gait problems are most common in NPH, therefore, most researches have mentioned the importance of gait problems when confirming NPH or incontinence if gait problem is not there. Treatment with shunting might help only when NPH is confirmed. If there is no NPH then the diagnosis is likely due to neurodegenerative disorders and the symptoms can be treated by medicines. There are many different and complicated types of neurodegenerative disorders and a clinical emphasis is more important than only MRI findings when confirming a condition.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe blinding toothache\n\nHi my friend has a severe blinding tooth ache. He says that when his braces where removed at the age of 15, a whole was left from the removal process that was never repaired. As the years went by his tooth decayed but he felt no discomfort.  Now at the age of 32 half the tooth has fallen out and the root of the tooth is completely black. Just a week ago he start to get sharp pain shooting through his mouth originating from said tooth. All over the counter medications that used to help with the pain no longer help. And the pain is now blinding accompanied with severe headaches,  fever and the inability to sleep due to pain. What should he do? And is there a possibility of the infection from the rotten tooth getting into his blood system and or compromising his over all health due to infection?",
    "doctor_response": "Dear,don't afraid.You can go to your local doctor and root canal treatment would done by him.Then build up the tooth and make a cap over that.But it will be costly. Or if you want to solve the problem in low cost, remove the affected tooth and make a fixed or removable denture.If you have need any help you can email me in this address: tdahsc@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can fungal rashes on the chin, neck, back, stomach be treated?\n\nI have a 5 \u00bd month old boy who just developed a rash under his chin last week. It has now spread to around his collar bone, back of his neck, all down his back (although very sparse down his back you can still feel bumps) and some down his stomach. It doesn t bother him, in fact he doesn t even notice. I have been keeping it clean and patting dry, tried vaseline, sudocreme (for nappy rash), and have now tried a cream a pharmacist recommended as he said he looked like a fungal rash due to him not being able to hold his head right up. The cream should make a difference after 1-2 days, however I don t think it s making any difference and has now spread. The spots are small and concentrated mainly under his neck. They look like they are little white spots, not like a zit or anything, but almost a light to white colour. Any idea what this is and how to treat it?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could a triple bypass and stroke be detromental to health?\n\nMy mother is 76 years old, and was recently hopitalized with congestive heart failure. In the past she has had 1 heart attack which resulted in a triple bypass, then a stroke, then another mild heart attack, could all of this be detromental to her health?",
    "doctor_response": "Hi,Thanks for writing to Health Care Magic, I am Dr Asad Riaz, I have closely read your question and I understand your concerns, I will hereby guide you regarding your health related problem.What your mother had was coronary artery disease which means blockage of arteries that supply blood to heart muscle. This led to her heart attack which damaged a portion of heart muscle leaving it unable to function. The pumping ability of heart was this reduced which led to lesser blood enteringthe heart being ejected out into the system. This leads to back pooling of this blood into lungs which is the main featuee of a congestive heart failure. A stroke is a similar blockage in arteries but it happens in those supplying the brain leading to damage to a part of brainAs for your question, both heart failure and stroke affect the quality of life significantly. She has to be on meds lifelong, will require restriction of salt, a restriction of water intake beyond 1.5 litres a day and may need to be hospitalized for destabilization of her condition if her body comes under any kind of physical stress or illness.You need to follow with her cardiologist and make sure she follows the advice to the letter so that she may live a healthier life without any further complicationsAlso if she is diabetic-it is extremely imparative to have a good control of her sugarsI hope this answered your question, if you have more feel free to ask.Regards.Dr.Asad Riaz.General and Family Physician..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for thigh pain while walking\n\nI am 70 year old female. Broke my femur in a fall two years ago. Everything healed well and had no residule pain for two years. For the last two months I have been having pain in my thigh. Seems to start in the lower right area and radiate up my leg. I had an X-ray recently by my surgeon and he said the rod and pins were in tact. It hurts whenever I am walking and especially when going down stairs. I am taking ibuprofen everyday to cope. What could it be?",
    "doctor_response": "Hi, If fracture united and implants are intact, the reason for pain after 2 years of surgery can be an infection. Early infection is difficult to diagnose. An X-ray of the right femur may show lysis around nail and screw may back out. Serum levels of C-reactive protein and ESR should be done. If they are increased, there is a possibility of an infection. If the pain is around the knee joint, it may be due to osteoarthritis at this age. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jayesh Vaza, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can cystic fibrosis and poor lung capacity cause death?\n\nI wonder if my body is \"trying\" to die in my sleep. I'm 33 years old, I have Cystic Fibrosis, my lung functions are very bad, I'm going through the process of getting listed for double lung transplant, and I sleep with oxygen.Sometimes I wake up feeling as though I just barely escaped dying in my sleep. I feel a sudden lurch, like a thud in my chest, accompanied by the realization that I'm not breathing at all (or am just barely breathing), and I feel some kind of electrical surge.Maybe it's just a vivid dream?",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .*  Cystic fibrosis or poor lung capacity do not necessarily cause death in    every case when taken care properly .*  It is panic and anxiety on your part which is making you more nervous .Hope this  will help  to clear your doubt   .Wishing you fine recovery .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes small lumps near the thighs?\n\nHi, during the hot weather my inner thighs have been rubbing together a lot and I have noticed 3 little red skin tag like lumps appear next to my testicle on the inside of my thigh, its not painful or doesn t itch but after applying sudocrem to them they start to sting after being touched. Do you have any idea what this could be and if I should get it looked at? Thanks",
    "doctor_response": "Hi,It seems that these are friction bumps, aggravated with lots of perspiration.Apply triple action cream locally.Reduce weigh if you are over weight.Wear cotton inner wear so that it will absorb sweat and help part remain dry.Keep local part clean, dry and airy.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause mild itching in left testicular ball after surgery of left thigh due to puss accumulation?\n\nHello doctor..Clinical examination of y urine and semen yielded infection with Proteus vulgaris and Stap aureus respectively.How much time it will take to resolve?? Secondly, I underwent for surgery of my  left thigh where puss was accumulated. Left ball of my testicular gland is larger than right one and having some mild itching.",
    "doctor_response": "Hello, It could be a minor fungal infection. As a first line management, you can apply topical antifungal like Clotrimazole after cleaning with soap and water. If symptoms persist better to consult a dermatologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be concerned about swollen itching foreskin of penis and itching inner thigh?\n\nhi there, I m a 6 3 male 27 years old a 196 lbs. the past few months I have developed an itch under my foreskin. At first there was a thick build up that would form after a day. Now there isn t as much discharge but the head and foreskin of my penis are a bit swollen has dry skin comparable to sunburn lips before the crack and peel. My left inner thigh itches every once and a while but no marks or rash",
    "doctor_response": "Hi,I have gone through your query.Discharge under foreskin you have mentioned is smegma. You need to clean it frequently as it may be associated with fungal infection over foreskin and inner thigh.Keep the area clean and dry. Ointment containing clotrimazole or miconazole can be applies over the area of itch. In a week time it will resolve.You can contact me on my page  you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can gall stone attack happen at day and night?\n\nI have just been diagnosed with gallstones.My  manager at work does not believe gallstone attacks should happen during the day whilst at work.She believes attacks are at night and to do with acid reflux!!i say attacks can happen any time in  the day.Who is correct? As i get attacks both day and night",
    "doctor_response": "Hi,Thanks for posting your query.I am Dr.R.K and I am pleased to assist you.Though gallstone attack can occur anytime, it is more common during the evening and night. The pain usually lasts for  few hours. It is usually felt in the right upper abdomen and may radiate to the right shoulder and to the area between the shoulder blades.I hope that answers your question.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain\n\nHello I have a constant pain in my lower left back. It feels like I was hit with a line drive from a baseball. The area of the pain is the size of my fist. I d feel the pain during walking, sitting, lying down it never goes away and has been hurting for 3 weeks with no improvement. There is no bruise I have had no trauma or impact to that area. It hurts worse if you put pressure on the area. I have no other symptoms?",
    "doctor_response": "Hello, Thanks for your query.From description , it seems you might developed muscular or ligamentous strain over back .Now after 3 weeks if pain is severe ,I would suggest getting this evaluated by an orthopedician for an accurate diagnosis and appropriate management. You may get the MRI of the area affected under his/her guidance.Meanwhile following measures will help with the pain\u2022 Lie on a hard bed.\u2022 Anti -inflammatory drugs like Tablet Motrin 1 tablet as and when required \u2022 Avoid forward bending.\u2022 Avoid strenuous activity & lifting heavy weights.\u2022 Apply diclofenac gel on the affected area. Warm compresses will also help.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause fever in a 6 months old child?\n\nhi doc, my baby is 6months old.  she 's having a fever for a few days now. her body temp ranges 38 to 39.2 c. But she's active, she drink her milk normally, play actively and sleep normally. Im worried, but my sister says its maybe she teething.... Is it normal to get fever thats high?",
    "doctor_response": "Hi,Thank you for asking question on health care magic.Teething will not cause fever.It may be some minor infection either bacterial or viral.ASOM and UTI should be ruled out.Paracetamol 15 mg/kg/dose 6 hourly will reduce fever.Better  consult pediatrician.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stoppage in defecation?\n\nhi.my baby gisl is 6months old n she does not poo daily ,she is motherfed n with rice cerelac .how many times should she pass her stool.before she was eating cerelac but now from past two days she is not interested so i tried other solid food but she is not eating,she is exclusively motherfed.she had this not passing stool problem from before starting solid foods.",
    "doctor_response": "constipation may be due to lack of enough fluids or lack of fibers in her foodin the meanwhile you can give her glycerin suuppository or lactulose syrup a 6 month old baby should start eating fruits and vegetables, minced chicken , soft cheese, cooked plain rice and pasta.. you should administer only one new type of food per week , start with small amounts then increase graduallyoffer orange juice daily it will help very much in regulating the bowel movements of the baby",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the reason for bad smell from nose while breathing?\n\nHello doctor, I have had this problem for years where a bad smell comes from my nose when I breathe. I am desperate for any type of help. It started after I got sick in high school. My tonsils were infected and enlarged. The infection came back a few more times until I was unable to get sick again. I have not gotten sick in a couple years, but I still get infections sometimes.",
    "doctor_response": "Hi. Do you smell the bad odor? Or the others only smell this odor? Please capture a photo of your throat using your mobile phone camera and send it to me. If you do not smell the bad odor, you may have atrophic rhinitis. If you can smell the bad odor, the problem can be in your throat or mouth. So I need a picture of your throat. Tell me about any other symptoms you have and your medical history as any chronic diseases. Chronic sinusitis can cause the bad smell too. Chronic sinusitis is characterized by a persistent headache, head heaviness, and persistent postnasal discharge.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedies for throat infection\n\nHi, I'm 19 and I think I may have a throat infection. For the past four nights, when I sleep in the night I wake up before the end of the night due to pains when I try to swallow. The situation seems to be getting worst since i now get the pain throughout the day as well and I am wondering if I should visit the Doctor. I also feel a bumpy surface at the back of my tongue which might be the cause of the pain. Are there any home remedies which I can try or is it a situation for the Doctor?",
    "doctor_response": "hellooo..read thru ur query...u can try this remedies for few days and still if pain persists meet an ent surgeon.1)do warm salt water gargle as many times as possible2)avoid cold drinks and cold stuffs(icecreams etc)..drink lot of warm water.3)after brushing ur teeth scrape ur tongue nicely(tongue harbors millions of microbes harmful to throat).follow this and still after few days pain persists meet an ent specialist..hope ur benefitted something from this..have a healthy day!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of a yellow tooth with dark lines?\n\nWell I have a one year old  child her two front teeth came in about a 2 months ago. But I have a concern about One of her tooth on the top Its kind of yellow with dark small little lines. What could that be a sign ? She  has  milk protein allergy . she stills breastfeeds no bottles or pacifiers",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,    I have gone through your query, as you have mentioned that you have small child she has yellowish lines on tooth , it can be due to Noctournal breastfeeding , or do to Flourosis ,     I will suggest you that you should consult Pedodontist and go for Oral examination    Maintain good oral hygiene of her by doing toothbrush ,   Hope this will help you.   Wishing your child good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to stabilize a low BP level?\n\ni have a question i pasted out and i went to the hospital and they checked for a stroke and they said that was clear they done a ct and a ekg that came back clear but im still doing it and now i went to have ultra sound of my neck and that was fine so what else could it be my blood pressure is low",
    "doctor_response": "hello,I have gone through your query.Thanks for using HCM.Since CT scan and EKG are normal one  need to find out the cause of your symptom by looking at possible block in carotids i.e. your neck vessels which may give clue to cause of your symptoms.My best wishesDr.Rajesh Teli,MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain and swelling in the ankle?\n\nhey my head feels so numb everytime i wake up and my right legs hurts alot for long time off and on and my right ankle been swollen off and on and both feets hurts so bad when its very cold and i have been to dr and hospitals they cant find whats wrong with my leg and ankle i have been doing all the tests",
    "doctor_response": "Hello,I would explain that the numbness in the head is not related to the leg and ankle pain. It could be caused by a wrong position during sleep. I recommend changing your pillow and performing regular physical activity. Regarding the leg and ankle pain, I would recommend checking vitamin D plasma levels, inflammation tests and an ankle MRI. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do i have red dandruff like spots on nose ?\n\nhi........i complain from red spots and some things like dandruff on my nose..is there a treatment? male-60 years old complain from red spots on my nose .i used alot of creams but the problem once i stop them it come back again,,so is there a treatment?",
    "doctor_response": "hello tell me please it is itching or not.its is type of allergy.i advice you to go for skin prick test.because there are lot of reason for being a red spot in skin thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe stomach pain even after removal of gallbladder?\n\nHi, may I answer your health queries right now ?  Please type your query here... My 12 yr old son has been having severe stomach pains for months. He had his gallbladder removed 3 yrs ago, because the dr. thought that was casusing the pain then they thought it was chrons disease, then they thought it was acid reflux, now we are going to his 4th GI doctor today. He cries in pain and so do I because I do not know what to do. We live in Chattanooga and I took him to Vanderbilt 2 yrs ago to a doctor and they said it was IBS, I have that nad I do not hurt nearly like what he does. PLease tell me what I can do.",
    "doctor_response": "Hi.Thanks for your query.This is a bit odd problem. It is difficult to understand why the gall bladder was removed so early. Was there gall stones or gall bladder infection or wall thickness ?The causes of such severe pains in such a small child can be :IBS again is rare in such small children unless there is a broken family or so, which he does not have, as he has such a caring Mother like you. Another causes can be abdominal epilepsy... Appendicitis.Internal herniaIntestinal obstructionRecurrent intususception. I would advise you the following:CT scan of the abdomenBarium studies.Stop all the foods and beverages which you have noticed to have increased his problems till now. Have a second opinion of a Pediatric Surgeon .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high BP even with medicines?\n\nHi Doctor, I am 50 years old and  a B.P. patient. I have been taking solekin 25mg, cardace h 5mg and envas 5mg. My B.P. was maintained at 140/90. For the last one week it has gone very high and is maintaining 160/110.  There is no specific change in lifestyle. Please suggest.",
    "doctor_response": "hello,I have gone through your query.Thanks for using HCM.first of all you should not combine cardace H and Envas as both belong to same group.If your BP is still high you may add Tab.Amlodipine 5 mg once a day along with seloken and cardace H.Also get yourself investigated for kidney functions .My best wishesDr.Rajesh Teli,MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing strange sensation in right abdomen, sensation seems to move. Suggestion?\n\nHi there, I have been experiencing a strange sensation on the right side of my abdomen . I wouldn t class it as pain more like twinges and a presence of something?? Had this for around 4-5 weeks. The presence/sensation seems to move, as in if I am sitting I feel it higher towards my ribcage on the right hand side of my abdomen. Have had a poke around and don t feel any obvious lumps or bumps. Just a bit worried about this and of course I am thinking the worst! I am a healthy 25 year old female. Any advice information would be appreciated. Thanks, Kate",
    "doctor_response": "Hello Kirsty, It is difficult to tell from your description what you might be having. Sensation could be as result of a floating mass which could be as a result of an ovarian cyst ( very large one). Also it could just be your nerves playing tricks on you ( abnormal nerve stimulation) and could be nothing to worry about. An intrabdominal mass of unknown origin could be responsible (maybe uterine fibroids). My suggestion is get an abdominal scan done and get doctor to examine it closely. Hope this helps Dr Nsah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it to be concerned about the tooth damage in child?\n\nhi doctor. I hope you can help me. I have a son he is 5 becoming 6 in October. When he was 2 years old he was getting truble with his tonssils, and therof he was very much on antibiotics, and when he was 4 years old I was letting his tossils get out, by the time that happens he toothes wat all damaged. Last year I was also going to the dentist to get his tooth out(all 20) because he had to go to school this year. And he also has n problem to go to the toilet but I did give him pegicol on a daily basis now he goes out every day. My problem is that a doctor at our camise told me to give my son on a daily basis 1 topaz, but im not sure if this is gonna help because I do understand that my sons body is very low that s why im giving him scotts emulcion. im really hellples and hope you can help, and his coughing most of the time. Tanx",
    "doctor_response": "Your son's secondary teeth will come in over the next years.  The dentist can confirm with an X-ray the presence and to some extent the conditions of the teeth.  Unless he had tetracycline, other antibiotics should not have caused damage.  Scotts emulsion, cod liver oil and vitamins with calcium, is a good source of some vitamins but should not be used excessively.  Follow the directions. I am not sure what you mean by Topaz.  If you are referring to a source of fluoride, that is a good thing if your water does not already contain fluoride.  If it will help, you could post in your original language to make your question clearer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any harm if prescribed prednisone is not taken after root canal?\n\nI just had a root canal, my first. The Dr. prescribed medrol for inflammation. Unfortunately, the pharmacist only had prednisone to substitute. I took prednisone once before and did not have a good experience. Will there be any harm if I do not take the prescribed prednisone?",
    "doctor_response": "Heloo pt-Don't wory about this.you continue prednisone substitute.and visit your dental surgeon.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and severe itching around the penis?\n\nFor about a month my penis was extremely itchy and stayed a reddish color. About two weeks ago i started pulling with coconut oil. Couple. Days later i decided to bath with it. Later that night my penis had swelled just a little bit and itched a lot more. Swelling went away after i took an allergy pill. Two days ago blisters appeared in my mouth and a large 3/4in blister on my penis. The one on my penis popped. It is very sensitive and hurt/burns if anything touches it.",
    "doctor_response": "Hello I share  your concernthus could be due to STI, allergic reaction or a manifestation of systemic  disease like diabetesi see such patients in my clinic and i would advise you for urine culture and sensitivity test as well as culture of the discharge from the blistersYou should be worried but not so muchit may be due to friction or wearing tight undergarments so if you can update me about your weight and working culture I will be able to guide you better meanwhile maintain good hygiene by washing it with antiseptic solutionschange the undergarments and wash and dry it regularly and properlyHAVE PLENTY OF FLUIDS hope this helps youregards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bumps on back of tongue and white color?\n\nHello, I have had the feeling of a lump in the back of my throat the past day or so and after looking in the mirror i found three large red bumps on the back of my tongue. My tongue is also sort of white, and the bumps do not hurt.Any ideas as to what they could be?",
    "doctor_response": "HelloI hv read ur query.plz specify ur age and do you hv any short of tobacco intake habit.if it is so den go to a dentist and get it checked.and for the whitish tounge it may due to poor oral hygiene. clean ur tongue propely and use a gud mouthwash.sumtimes it can be due some fungal infection .in that case u hv take sum medicines.Hope this ans ll be helpful.take careRegardsDr.shesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "Aged person, stopped smoking, now tongue, gums bleeding. Dentist says normal. Cure for symptoms?\n\nhi im a man of 51 yrs old i packed in smoking 6mths ago and in the last month or so my tongue and gums have started bleeding - mainly at night - my dentist says this is normal for people stopping smoking is this correct? Also i suffer with the skin behind  my ear splitting from time to time what is the cause of this please? thank you",
    "doctor_response": "Hello,we are happy to reply you and I appreciate your concern about your health.First of all I want to congratulate you for two reasons : 1) stoppage of smoking 2) is for the sign of bleeding upon stoppage of smoking because it shows that your gummy tissues are healthy and they are getting good nutritional supply,as time passes the bleeding will automatically stop and the healthy tissues will grow up.As per skin related problem you should show the area to the skin specialist,he would be able to recognise it accurately after observing the area.hope you are satisfied by the answer.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes twitching feeling on left side between rib cage?\n\nHi! I m 22 years of age and since this morning I am feeling a twitching sensation on my left side in between my rib cage. I can also compare the twitching sensation as if a baby is kicking me in that area. I m not sure what could be the cause for that. It is an on and off occurrence.",
    "doctor_response": "Hi,It seems that you have muscle twitches or fasciculations. These are small, local, involuntary muscle contraction and relaxation visible under the skin arising from the spontaneous discharge of a bundle of skeletal muscle fibers. You might consult your doctor who can order 1. a few blood tests including thyroid function tests, 2. Serum electrolytes including Serum calcium and potassium levels. 3. Serum B12 levels In case the above tests are normal further testing can be done including - nerveconduction studies, Electromyography, etc. These tests might help to diagnose any underlying neurological issues.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could it be if had low pulse, blurry vision while having BP?\n\nMy pluse is 73 and I m 23 years old I have a head and for Luke a few mins my vision was blurry I do have bloodpersure what could be my issue some one said some kind of anal problem someone else told me a mingrain what do you think it it is please help and what should I do",
    "doctor_response": "it can be  a condiotion called PRESYNCOPE..where u dont lose your consciouness but blurring of vision and a feeling as if you will fall will be there for few secondsas you have problem with blood pressure ,if you are on medication it can be because of your medicines alsomigraine without headache is a posibility but rare things are rare so firstly rule out presyncopeadvisedHUTT test2D echocarotid doppler( to rule out that blood flow to brain is normal or not)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for sore nose caused by allergy?\n\nHi, I had septoplasty, turbinate reduction and balloon sinus surgery 13 mo. ago. After 2 weeks, I couldn t breathe anymore so 6 weeks ago they removed my turbinate bones. I took antibiotics for several weeks and rinse with ocean nasal spray. My nose is very sore now and feels inflamed inside (more so than several weeks ago) and I don t feel well, but no fever and I have to take advil for the pain. I went to the ent today, saw his PA and he said it was just allergies, and prescribed Flonase and Claritin. I have never had nose pain with allergies before and am a little worried about infection. What do you think? Thanks, Rick",
    "doctor_response": "Hi RickThe soreness in the nose could be either due to dryness of the nasal mucosa following extensive surgery or some associated infection.You can try taking a course of broad spectrum antibiotics, short course of oral steroids, continue with saline nasal spray and use saline nasal ointment to prevent dryness. These above measures can make you feel better.Wish u good health.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for large cysts in kidneys\n\nIm searching info.for recently diagnosed with multiple simple cysts on my right kidney with the right kidney measuring 10.5\u00d74.8 & left kidney measuring 11.3\u00d75.7 unremarkable on left but largest cyst on right measures approximately 17mm within mid to upper right kidney. I m searching treatment options or if I should be concerned with kidney problems.",
    "doctor_response": "Cysts in kidney is not always dangerous. First of all age is very important as in old age having few cysts is common and then is there any family history present? Then serum creatinine and urinary protein should be measured. According to all these parameters proper plan will be chosen. consult good nephrologist. Best of luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What caused a hot rash on my son's leg\n\nhello, my four year old son has a rash which is hot to the touch on his legs.  it started yesterday on his arms and now its on his legs, his diet remains the same and all his habits .  The only thing different that he has done is going to the beach, and its not sun burn.  could you shed some light on what is could be?",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms seem to be related to rash dur ti overheating. I suggest using Calamine lotion for local application. I also suggest giving liquids and Pedialyte solution. Aloe vera gel can also be very soothing. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bleeding with low hemoglobin levels after blood transfusion?\n\nMy father's hemoglobin levels are way low and have not went up to \"normal\" range in over a year doctors can not find out why he is bleeding and he has already had one blood transfusion. Is it true that in some people their bodies end up not producing blood like it should and If that does happen can it start to harm their internal organs and start to cause other harmful problems because there isnt enough blood going to those organs?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Your father has anemia not responding to treatment.  He should go for ultrasound abdomen.  There may be some bleeding in gastrointestinal tract.  So you should search the cause of that.  Also go for complete anemia profile to know the type of anemia.  Then he should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes panic attacks while driving?\n\nhi I have been having panic attacks while driving. It is been going on since August after a came back from a long trip (from Arkansas to Florida). I tried many medication prescribed by my doc but it doesn t seem to help. i also tried Dramamine because when the panic gets me, i get dizzy. Am i missing anything? Could it be hormonal? I had partial hysterectomy.",
    "doctor_response": "in  my  opinion  please  check  hemoglobin,  ecgpanic  attacks  can  be  treated  with  low  dose  benzodiazepinesand  anti  anxiety  medication   serta  25mg  hs",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it possible to repair damaged, frizzy and rough hair?\n\nHi doctor, I have taken smoothening fourth time with a gap of a one-year interval between each session. But, this time I have taken keratin treatment also. My hairs from the ends are damaged, frizzy and rough. Is it possible to repair them?",
    "doctor_response": "Hello. Keratin treatment is for damaged, rough and frizzy hair. You should always take keratin treatment for hairs. Take biotin supplements for proper growth and good texture of hair. Get regular trimming of hair at the ends as weathering leads to dry and frizzy ends. Avoid excessive heating procedures on hairs like straightening or dying of hair especially those that damage the hair. For now, I will suggest you do a little bit of trimming at the ends and keratin treatment will help in solving problems.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for getting pregnant\n\ni have been on tetralysal for 4 months due to acne, stopped taking it at the end of last month. i no its bad in pregnancy but what about after uve stopped taking it? how long should i wait until i try for another baby? cause i want a bay now but not sure how lon g it stays in your system? eloise",
    "doctor_response": "Hi , If you have given 1 month gap after stopping medicine , you can try for pregnancy. Usually these medicines are excreted from body within few days , to be on safer side leave 1 month. Maximum problem is if you take it during pregnancy, when the baby is growing. Do start Folic acid tablets 1 month before trying for pregnancy,to avoid fetal problems. This is independent of tetralysal. Am sure I have clarified your query, do write back if any more queriesAll the bestDr.Balakrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for constant vomiting in a child\n\nMy 5 year daughter weight 20kg coughs badly until she vomit mucus with the food she ate. This happens usually at night or early morning almost as per my observation 3 times a week one of child specialist suggested Romilast 5mg daily i am afraid if she is having asthama as one of my close friends told me of the same finding for her daughter.",
    "doctor_response": "Hi,I have gone through your query.From the symptoms you have mentioned, she may be suffering from asthma. As she coughs in night and early morning, there may be some allergans triggering the attack. Take Romilast 5mg, as advised by your doctor. It will resolve after it, and if not, try changing her room where she sleeps and you may consult an ENT surgeon for throat examination.Let me know if you have any further questions.You can contact me on my page  you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and headache\n\ngood day Dri would have gone to the hospital now, but today being Sunday i just have to wait till tomorrow, but as a medical student the little knowledge i have i suspect i have sinusitis...i have fever,headaches, little blunt pain around my right cheek bone, the mucus from my right nostril stinks like rotten egg..... i smoke cigarettes regularly, and i smoke marijuana like 3-4 times daily. some of my friends say that nicotine is really really bad for sinusitis and i believe them and i have already stopped, but i dont want to believe that marijuana is also the same situation.",
    "doctor_response": "Thanks to HCM I can understand your concern Sinusitis is aggravated by smoking ,exposure to cold environment and cold items .so try to avoid theses things my dear moreover now you need to take antipyretics like paracetamol 5oo mg thrice daily along with antihistamincs like cetrigine 10mg once daily , plz use nasal drops if there is nasal blockage inhale steam or vapour from boiled water as it relieves ur headache .making feeling of light don't worry be away from bad habits whch spoil your health ,you should be ideal to others being a medical student . ok",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am newly married and suffering from early ejaculation. Please help.\n\nHi doctor,I am newly married, and we both are first timers. We tried penetration a lot of times, but the moment I come close to her, I lose the erection. Also, I am ejaculating within 20 seconds. I do not have any health issue and morning erection is positive.",
    "doctor_response": "Hi. You seem to be reporting of premature ejaculation. It is very common among this age group during the initial part of sex life. I will explain, try to engage more in foreplay during sex like for at least 20 minutes. During intercourse try to go very slow, when you feel that you are about to come, stop and slow down for a minute and then continue. By this way, you can prevent rapid release. You may need medicine temporarily. Use it when required like one hour before sex and maximum once per day. Kindly avoid heavy food before taking a tablet. There are no major side effects except a mild headache rarely. And, you should not be having any cardiac problems. Do a thyroid function test (TSH) to rule out thyroid disorders. I suggest tablet Tadalafil when needed, and the problem will gradually improve.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the high HPF WBC in the semen report indicate?\n\ni am 30 years old married man since 18 months,my wife got pregnant before 6 months but miscarriage happened..i did semen analysis before 2 days and everything were normal except for the 8-10 hpf WBC,can i know what does this mean?will it affect my fertility?and whether my wife should administer any Antibiotic tx  at the same time am taking ABs??",
    "doctor_response": "high wbc count in the semen may indicate an infection.kindly consult your infertility specialist for this problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bruising and soreness in leg\n\nI fell 2 weeks ago and badly bruised my shin. The swelling has gone down and the bruising is resolving, although it has spread down my leg to my foot. I am having no pain walking. It is only sore if I lean on it.I continue to have an area on the shin that is hard and kind of numb.I assume this is a contusion with a bad bone bruise.Should I see my PCP or is this just running its course.Thanks",
    "doctor_response": "hiyou may apply thrombophob gel, keep leg elevated on front stool, avoid exertion.It takes some more time for resolve .You may see a doctor if any doubts, but do not worry, such injuries usually heal on ownthanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sebaceous cyst.\n\nHi I went to see a doctor and he said I had a sebaceous cyst in my back so he gave me antibiotics. After a month the cyst is gone, he says i should still have surgery remove it, but I dont feel it anymore or even see it at all. Should i have the surgery",
    "doctor_response": "HelloLet me explain about sebceous cyst so that you will understand whether it require surgery or not .Sebaceous cyst follows obstruction  to the mouth of a sebaceous duct. It can occur anywhere in body except PALM & SOLE ( devoid of sebaceous cyst).If infection is there in the cyst it require antibiotics .Treatment .1 Incision avulsion under local anesthesia .2 Dissection is necessary for the cysts which  have been previously  inflamed.In your case if your cyst were inflamed ( when you took antibiotics ) then you should get surgery .Hope this information will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to do a hernia repair surgery while suffering from liver cirrhosis?\n\ni was referred to a surgeon for hernia surgery. he said he could not do it because i have cirrohsis of the liver and other complications such as low platelets and fluid built up in my abdomen. this was in corpus christi, tx. he is going to refer me to methodist hospital san antonio, texas. should i live with it or take a chance on surgery? it s pretty bad.",
    "doctor_response": "Hi, I suggest you avoid surgery unless you absolutely have to, i.e. if a hernia becomes incarcerated and you risk bowel gangrene. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Anders Mark Christensen, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get electric shock like sensation in neck due to prolonged use of tab. Please help.\n\nHello doctor, I am a 16-year-old male. For the past few months, I have been getting sudden electric shocks (a little bit more than calm) in my neck when I move it. These are not at all frequent. I get them once in a while. I am not that fit and I use my tab (for studies) while sleeping a bit relaxing almost 4-5 hours a day. Please help.",
    "doctor_response": "Hi. As you described, using the tab for 4-5 hours a day will make your neck bent forward to see the tab continuously for long hours. That might be the reason for your neck pain. As all elders advice, sit straight, keep your books or tab at an elevated location while reading so that you need not bend your neck much. And do some exercises for your neck daily while sitting free. Move your head up and down, sideways, and slow rotatory movements clockwise and anti-clockwise. Neck sprain. Neck exercises as advised.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any chance of pregnancy from pre-ejaculation fluid?\n\nI am 22 and me and my girlfriend had some sexual activities (not intercourse) and some pre ejaculation fluid might enter in her vagina. that happened just after one day after period ended, and out of fear she took a pill of unwanted 72. Now is there any chance of her getting pregnant?",
    "doctor_response": "Hello dearI understand your concernThere is no chance of the pregnancy because1. You have did sex just day after period and it is completely safe period of the cycle. During this time there is no ovulation so there is no chance of fertilization2. Again you took Unwanted 72: that is highly effective in preventing the pregnancy.To become pregnant, penetrative sexual intercourse in fertile period of the cycle is require.Your next cycle could be earlier/delayed and with excessive bleeding.Meanwhile avoid stress, take healthy diet, drink plenty of water and do regular exercise.Use condom in future to prevent the unwanted pregnancyHope this may help youContact further if follow up needed.Best regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anxiety and stress\n\nI started taking adderall 30mg XR at the beginning of last month and my menstrual cycle seems to have been thrown off. Is this possible or could it be something different? I am having my period but it just seems different. I don t know if its because I ve been feeling a lot of anxiety and stress lately along with not eating much because of the adderall. I also have been drinking a lot more caffeine then I had been.",
    "doctor_response": "HiThanks for using healthcare magicAdderall is a stimulant and in few patients, it increase anxiety symptoms. Better to consult your physician or psychiatrist about it. If possible either decrease its dose or stop it. That would give to better result. You can try some antidepressant like paroxetine or escitalopram. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should medication for stuffy nose and sneezing be taken during night?\n\nI have had stuffy nose and sneezing for past couple days. In the morning I had green but it gets clear after I clear sinus. I was taking mucus relief day and night sinus congestion medicine since 1st. Today I went to pharmacy and got Wal-itin D (loratadine 10mg pseudophedrine 240 mg) and its 1 dose per 24hr. I took it at 3pm. It did not help the sneezing/itchy sinus or runny nose. Can I take the night time( acetaminophen, guafensin 200 mg and phenylephrine5mg) or day time (acetaminophen, diphenhydramine chi 25 mg , phenylephrine hci 5mg) medicine? It seemed to stop the itchy and runny nose.",
    "doctor_response": "Hi,You might have sinusitis or allergic rhinitis or upper respiratory tract infection with congestion which actually causes all this symptoms.You can do some routine blood tests with sputum examination and chest X- ray to have confirmed diagnosis.Anyway,you should be given oral antibiotics (quinolones or macrolides) in full course for about 4 to 5 days with antihistaminic syrup or mast cell stabilizers and nebulizers with steam inhalation to get rid off complete infection from sinus or nose.Don't for self medication despite they are OTC drugs but always consult your doctor to get it diagnosed first.So,better to consult ENT specialist for further treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the scrotum of a child?\n\n10 year old grandson has been having pain in scrotum for 2 weeks. A culture showed no infection, but pain is persisting. It is intermittent pain and not severe, but still concerning to him and us, his grandparents. What could it be? YYYY@YYYY",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It may be due to inflammation of epididymis . Epididymis are cord like structures around testis . Ultrasound scan can identity the condition. Child may need oral antibiotics for the same . Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes clicking sound in leg while 10 month baby standing?\n\nHi, may I answer your health queries right now ? Please type your query here... Hi my daughter is 10 month old she like to stand with support and bottom shuffle aswell.I have noticed recently every time she straight her right knee .I can hear clikcing noise.Athough she donot seem to be in pain with it.She was breech and born by Emergency Cesarian.She had U/S of hip when born which was normal",
    "doctor_response": "Good afternoon..!!A click noise while your baby tries to straight her right knee might be normal due to strecthing of tendons or might indicate a problem in her knee joint.So it's better to visit pediatric orthopedician for further evaluation and management.Thank you, have a nice day..!!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Early ejaculation, erectile dysfunction, want to increase penis size. Is there any surgical method available?\n\nHello Dr, I am 33 years and got married 5 years back, have 2 kids. I have problem where my errection does not occur like before and I have sex once in 2 months that too my sperm gets very soon. My wife is totally dissatisfied and while we had casual chat she said she like bigger pennis and wants my pennis to be bigger. I want to have my problems cured and also need to increase my pennis size. Please advice me and I am ready to go for any surgical method too for making my pennis size bigger. Thank You, Kevinraj",
    "doctor_response": "DearWe understand your concernsI went through your description. I suggest you not to worry much. You are just 33 years. Premature ejaculation is often not a physical problem, rather it is psychological. Penis size is also not a matter of worry. During casual chat ladies tell so many things. Some say they wanted to marry super stars, can we arrange for that after marriage? Take those things are passe and concentrate on your life and  love. Penis enhancement treatment is available but for you it is not necessary.You might need psychotherapy and other cognitive behavioral therapies. I can help you through telephone. Please do contact me through customer care of www.healthcaremagic.com for a telephonic consultation session. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for eye allergy\n\nFor weeks have been suffering from Allergie eyes. I was seen by my Opthalmic Md twicw. He tells it is allergies. Put on antibiotic/antiinflammatoru combo with almost complete relief only to return in 3 days, Placed on Fasticaft with no relief, then Ophcon A, nothing, now on PatadAY FOR FOUR DAYS WIYH LITTLE IMPROVEMENT. should I go to a Opthamologist? I have macular degeneration and receive intraocular injections on a regular basis. Help",
    "doctor_response": "Hi and thanks for the query,This shall depend on the cause and intensity. In your case, topical anti histaminic drugs, topical steroids and systemic anti inflammatory drugs like injectable Triamcinolone could be very helpful. Careful considerations based on notification of eventual side effects must be carefully considered by your treating physician.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it normal to not want to go anywhere near your husband?\n\nHello doctor, Is it normal to not want to be anywhere near your husband? He is not abusive in any way, he just belittles everyone around him. I do not want to go to work or anywhere, I just want to stay home while he is not at home.\u00a0I am unhappy and I do not feel like myself. I just want to feel normal again.\u00a0I need advice on what I should do to feel normal again. The medicines I am on are\u00a0Spironolactone, Amitriptyline, Clindamycin gel, Finacea foam, Allegra, and Zantac.",
    "doctor_response": "Hello. I can understand your concern. It is painful to have such feeling. Revert with more information to a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i take 2 tablets of letroz 2.5 mg at a time?\n\nHI I am a PCOd Patient.I have taken treatment for that.I have been prescribed letroz 5mg from day3 to day7. can i take 2 tabs of letroz 2.5 mg at a time? when should it be taken-morning or night? thank you.",
    "doctor_response": "Hello Welcome to health care magic forum Letroz is used for ovulation induction in infertile women.2 tablets of 2.5 mg can be taken for five days from day 3 today 7.All tablets ideally be taken at the fixed time .So you can adjust time as per your convenience.Take all tablet at that time only.Morning or evening is immaterial. Wish you good health Disclaimer",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can protected oral sex transmit HIV or STD?\n\nHello doctor, I had a protected oral sex with transgender yesterday. Before we started the oral sex, she showed me her STD and HIV test results and they were negative (I have doubts about the results as it was sent to here by SMS and there was no date on it). At the start of the oral sex, I sucked her cock with a condom (she was wearing a condom) and then she sucked my cock and I was wearing a condom as well. There was no pre-cum, no cums, no transmission of body fluid, nothing, just the scenario above. I have a simple blood clot in the sublingual salivary glands for the past six months and I am still taking medicine for it. Is there any chance to get STDs or HIV based on the scenario above? I need a direct answer to my situation and no general information, please.",
    "doctor_response": "Hi. To be clear, HIV will not transmit through oral sex. No possibility for HIV infection. Coming to STDs, there is no transmission of STDs through a protected act. So, there is no possibility for STDs also (including syphilis, chlamydia, gonorrhoea, herpes). Finally, no chances of transmission of either STDs and HIV.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it possible to fill the adjacent tooth without extracting the wisdom tooth?\n\nHello doctor,My wife's dentist says that my wife has to get a tooth pulled in order for him to do dental work on my wife's adjacent tooth. My wife lost a piece of a filling and the dentist says he needs to take out the remaining filling, and then re-fill it. But in order to do that, he needs to pull the adjacent tooth. Could you please tell me if my wife really needs to have this tooth pulled? I will send you a picture.",
    "doctor_response": "Hello. How are you doing? First of all, there is nothing to worry. I have seen the pictures (attachment removed to protect patient identity). The tooth that the dentist is mentioning for removal is the upper wisdom tooth. It has not erupted completely. The age for its eruption ranges between 18-25 years. Mostly, in such cases or after this age, we recommend for its removal because, in the future, this might cause an infection, cheek bite, or other problems. I can guide you more about this if you can provide me with an X-ray (OPG or IOPA. OPG will be better). Now, regarding the filling, I think it must be towards that wisdom tooth side and that is why the doctor is asking for its removal so that he can properly contour and fill the tooth. Otherwise, it will be difficult (I cannot visualize much of the broken filling in the image). I will need an image from occlusal (chewing surface) aspect. Again, I need an X-ray of that tooth for a proper diagnosis. You do not have to worry. The tooth removal will be done under local anesthesia only. She will be fine. You can revert back with image and X-ray for further information. Feel free to ask further queries. Take care. Revert with more information to a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be worried about the cyst in  neck?\n\nMy 4-year-old son has a bump (around 3.5 cm in diameter & raised about 1 cm) at the base of his head just to the right of the divot above where his head and neck meet. His pediatrician said, it s a cyst. we ll keep an eye on it , but it s been there for over a year w/no change. I am quite concerned. Should I see another pediatrician?",
    "doctor_response": "Cyst in a child? Please don't worry at all!Hi! thanks for writing to us and describing your son's health/physical problem with us! Yes, please keep your eyes on it...just cosmetic problem? enlarging? pain? throbbing? pus? discharge? and see his pediatrician!Well, these are very common, cysts on lower side of neck; these are generally lymphatic cysts, branchial cysts or a dermoid cyst!They actually are removable or one can aspirate them causing them to collapse..etc. but they won't disappear on their own!therefore see a surgeon to determine the line of treatment suitable for him if you are worried too much!regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes diarrhea, nausea, weight loss when having elevated liver function/bilirubin?\n\nI have had diarrhea, severe nausea, and weight loss for three weeks. Bloodwork showed slight elevation in liver function and bilirubin. Stool samples were negative. Ultrasound was normal. Dr. Put me on cipro and flagyl. Feeling awful...still nauseous and diarrhea. Lost 11 pounds. Going for endoscopy Friday. Any thoughts.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You may have some liver disease. You should go for complete liver function test. Your nausea and diarrhea may be due to altered liver function. you should avoid high fat diet. Just go for endoscopy and liver function test. It will give you exact diagnosis then you should take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medication is suggested for pain in knee ?\n\nMy 5 yr. old son injuerd his kneecap last sunday while playing ping pong. He slide over the wet tiles. He ve been limping since then. I even thought he was just pretending. He can move around his leg but he is lmping when he try to walk and can t put pressure on that leg.... Does he have a hairline fracture? Is he gonna be ok? What do I need to do?",
    "doctor_response": "Hello,Your son is suffering from soft tissue injury to knee. If he is able to walk around with little difficulty and able to bend his knee without pain then he may not have a bone injury. The best thing is to get an X-ray done to rule out bone injury if it\u2019s easily accessible. Otherwise, just ask him to go slow for next couple of days and if the limp does not improve to get an evaluation done. In the meantime, you can give paracetamol if the pain bothers him.Wishing him a speedy recovery. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Santosh S Jeevannavar, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can type 1 HSV blisters on penis is consistent with warts?\n\nFor a few years I have been using a vibrator (designed for muscle massage) against my penis during masturbation.  The last two times I used it, I immediately developed small blisters (3 to 9) in the area of contact.  I have had a blood test for the HSV antibody.  Negative for type 2 and positive for type 1.  I have had type 1 for many years and occasionally I will have a fever blister.  I'm over 40.  I realize I may have developed type 1 in the genital area.  I don't believe my condition is consistent with warts based on what I have read and the images I have seen.  Are there other possibilities?  Could it be strictly mechanical?  Thanks",
    "doctor_response": "Hi, If you had unprotected sex - need to rule out sexually transmitted infection. If not it can be due to friction caused by vibrator caused ulcer. Yes once HSV positive always positive. If you had oral sex with a HSV 1 infected person then you can get HSV 1 genetal rash. Warts are more related to HPV not HSV. HSV causes ulcers with mild pain. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of potential pregnancy?\n\nI was recently seen in the ER for lower abdominal pain, and was diagnosed with an acute urinary tract infection. My abdominal pain wasn't diagnosed, but I was given an antibiotic for the UTI. I took it twice a day for 7 days, and then about 3 days after I stopped taking it I began to vomit uncontrollably all day every day, and I'm still doing it. I was given blood tests at the hospital and would assume they would inform me if I was pregnant.Do u have any idea what else it could be?",
    "doctor_response": "Hallow Dear,The first cardinal symptom of the pregnancy is missing a period, which you have not. So the chances of pregnancy are out of consideration. The nausea and vomiting you had is due to the antibiotics you were taking for urinary infection. You should not have discontinued antibiotics as the urinary infections are very nasty infections. By discontinuing he antibiotics, you have invited the resistant stains of the bacteria causing urinary infection. You should have continued it with some antacid like Pantoprazole and anti-vomiting medicine like stemetil.Now take Pantoprazole to control the acidity and stemetil to control vomiting, but complete the course of antibiotics. Please report to your doctor and follow the medical advice religiously. Hoe you got the message. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "PTSD after being raped, anxiety disorder, taken Xanax and adderol. Treatment?\n\nI have ptsd after being raped and a bused for 3 yearn by the girlfriend after me. I have general anxiety disorder too. last week i was beat up by my boyfriend so my panic attacks have got worse. i did t expect this to happen and the xaxanx isn't really working because o;m in a pretty constant state of panic. i also have add and took myself off the adderol months agoit wont let  click continue",
    "doctor_response": "HelloYou have PTSD after rape trauma and multiple abuse episodes. You are taking xanex or alprazolam for that. You have multiple panic episodes and they got really worse after you were beaten by your boyfriend. Xanex failed to provide relief. You are continuously experiencing panic symptoms. See although xanex provide good control of symptoms of panic still it is not a drug for definitive treatment. Various other medicines like SSRIs especially sertaline, fluoxetine etc are mainly used in panic and PTSD. Apart from medicines non-medicinal treatment in form of Psychotherapy is used in PTSD. Consult a Psychiatrist for expert management of these symptoms. You have stopped adderal several months ago so there is no risk of withdrawal symptoms. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Regular periods after intake of krimpson 35. Trying to conceive. Recommended waiting for natural periods?\n\nHi i am sxxxx had a miscarriage on dec 6th  ,used to have irregular periods so my doctor prescribed me krimpson 35 for 3 months ,i finished the 3 months course and my periods were regular during its usage.i stopped krimpson 35 last month and i got my last period on april 10th ,now i want to concieve .shall i have to wait for one more natural period to come and then plan for kids or can i plan this month itself,pls answe my querry......",
    "doctor_response": "Hello. Thanks for writing to us. After you stop taking the birth control, it may take 1-2 months for your periods to return to their natural rhythm. It us best to start planning for the baby from the next cycle. You need to watch your this cycle first.I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain, abdominal pain and constipation?\n\nHi, may I answer your health queries right now ? Please type your query here...i have bein suffering pain in my central back region for over a week i was prescribed antibotics as blood showed up in urine sample.pain hasnt eased much and is in my front left side region of my abdominal and around my bowel area. Iwas very constipated and had to take ducolax until the moved. That was last thurs and they havnt moved since but i still have sharp pain radiating up and down my left side down into abdominal area and left back area. What could this be.i am very anxious as i fear bowel problems. I am 42 yr old single mum of three kids my mum died from a preforated bowel and i am anxious if its heriditary i would be very grateful for you advice",
    "doctor_response": "Dear madam,your pain in central back has nothing to do with your other problems.infact,amongst many causes,blood in urine can be because of urinary tract infection which ,i know from my daily practice,can cause abdominal pain.apart from that,constipation can cause your pain in the bowel region of abdomen.as far as bowel perforation concerned this is not at all hereditary.so there is nothing much to worry.wish you a healthy and happy life.thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a painful heel spur be treated?\n\nI have had a painful L heel spur for over 3 months; can t get into see my podiatrist till first week in June. Trying different shoes and supports and even orthotics isn t helping! So unable to do my fast walks as before! I am also dealing with bulging discs in lower back so the two really don t go together but create more pain. What do you suggest?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Heel spur can cause intense pain. Since you have tried almost all non surgical measures, it is better to go for surgery now. Nothing to worry as it is a simple procedure and complications are very minimal. You can consult an orthopedic and he will explain the procedure in detail. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes restricted movements after undergoing total knee replacement?\n\n11 weeks ago I had a total knee replacement. Therapy got my rom to 125 (last measurement ). And the rom was not by being pushed back. My knee just by me bending it..bends.. My leg bends well, stretching, sitting, everyway....until I stand up and try to walk. My knee will not bend except a little. Stiff walking with a stiff peg leg..I still feel a tight band along the outside from below kneecap to the top. The inside tightness is only half way up around my knee. What s up with this? Seems like all systems should be go..until I walk",
    "doctor_response": "Hi, I value your concern regarding the symptoms. I have gone through your symptoms, and in my opinion bending and walking are stenous exercises for the knee, continue with your physio, see if you have any pain, continue muscle strengthening exercises, and wait for some more time, may be your symptoms settle.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.Special note-  Any medication prescribed needs to be taken after consultation with your personal doctor only.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is sharp pain at the end of spine after long journey possibly be manifestation of existing sciatica?\n\nI have had sciatica for a while now.  I am having a different kind of pain in my lower back.  It is a sharp pain on the right side of my lower back, right about the area of the dimple at the bottom of the spine.  It began yesterday at the end of a school bus ride of 1 1/2 hours duration.  Is this just a new manifistation of the sciatica or do I need to seek further medical attention?",
    "doctor_response": "Hi,Thank you for posting your query.Yes, your back pain is a part of your old sciatica, due to disc disease in the lumbar region.you should continue back extension exercises under the guidance of a physiotherapist. In addition, IFT and ultrasound would also help.If pain is severe, you may take diclofenac or ibuprofen for pain relief.There is no need to worry at present.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can OCD and borderline personality disorder be managed?\n\nMy wife has had mental health issues for several years now. They started getting progressively worse in her late teens, and now that she s in her late 20 s they gotten to an almost unsafe level. She was diagnosed with OCD and possibly borderline personality disorder and was prescribed Lexapro several years ago. This does not seem to be helping as well anymore and her episodes are increasing in frequency and severity. We need advice on what exactly we should do.",
    "doctor_response": "Hi, First, identify what kind of obsession is there. It is for cleaning, counting or something else. According to obsessional thought, we go for pharmacotherapy and psychotherapy. In my opinion, exposure and response prevention with relaxation therapy may help her a lot. For borderline personality, we have to go for management of the target symptoms and emotional control. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever in a child\n\nDear Sir/Madam,My son has fever for the past 2 days and the doctor has diagnosed it to be viral fever an he has been on P125 for th epast 2 days.Yet the fever is not settled ........should we wait for one more day as the dr has adviced before proceeding?",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your son's history and would like to make suggestions for him as follows:1. Viral fever usually takes 3-7 days and then subsides by itself. There is no specific medicine for viral fever. So as long he as fever, I would suggest him paracetamol (P125).2. If he has not developed any new symptom after starting treatment, I would suggest you to wait and give him medicines a suggested by your doctor. If he has developed any new symptom or his symptoms have been worsened, I would suggest you to get him examined by his doctor.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish your son the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of numbness and tingling in the finger on waking up in a diabetic ?\n\nBeen having intermittent numbness/ tingling in right thumb and index when I wake up from sleep for 4 months. Adjusted my head at night lying flat which helped for a while( no pillow). At various times, the numbness/tingling has also been in the right side of the right hand and around the kneecap. This morning, I woke up and couldn t feel my left foot untill I stood up. These things only happen when I m sleeping, when I stand up, it goes away(not circulatory). I am a 40 year diabetic and 51 yrs old. My a1c is always 6.5 or better. Had a slight stroke 4 months ago which affected my speech and a little on my right side, but speech and movement are fine now. Take Hyzaar, aspirin , flomax and zocor (saw doctor 4 days before stroke and blood pressure was 123/83, since stroke, it s high but now manageable. Chloresterol was never over 190 before stroke, and still isn t ( not reason for stroke). Anyway, the doctor just had me take a spinal XRAY after I told him I thought it was the nerves around the neck so I can get referred to a Nuerologist. Does it sound like c6 or c5 nerve to you",
    "doctor_response": "Hi, Your doctor is right. There might be a problem at the level of these nerve. You need to see a neurologist or neurosurgeon. An MRI of the cervical spine will be required to rule of a disc prolapse. also we need to see whether you are suffering from carpel tunnel syndrome, by getting a nerve conduction studies.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will Penicillin help with tooth and mouth swelling?\n\nHello im a 33 year old female and i have a bad tooth act had it for two days now scard to go to the dentist because they mit have to cut my gum to get my tooth out an now my mouth is swolling and it hurt vary bad i wont to take this penicillin vk 500 mg tablet that i have but i dont know if its ok to take what can i do? Please let me know?",
    "doctor_response": "Thanks for your query, I have gone through your query.The pain and swelling could be because of the tooth infection secondary to decay. Consult a oral physician and endodontist to get the tooth filled or removed. You can take a course of antibiotics like amoxicillin 500mg and metronidazole 400mg tid for 5 days (if you are not allergic). But the medicines are temporary solution, you have to get the tooth treated.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain behind the knee with redness\n\nThank you. I got a call from my mom because she has been experiencing pain behind her knee. When I went to assess, there was swelling and hardness that covered about 3 x2 behind the knee. (Hard upon pulsation) It did not feel like the hardness had an exact shape or form, (like a bakers cyst) Now, there was about a half inch line of what resembled a bruise. Almost reminded me of varicose vein, but this just appeared 3 days ago. She was hoping it would go away, but there is a bit of redness around the bruised line area. She was feeling like something had bitten her, but its hard to tell. Any suggestions that could explain the sudden hardness, and pain? I assessed for DVT by having her flex foot and checking for pain in calf, but I m not sure at all what it could be. She was diagnosed with diabetes 1 year ago, and is diet controlled.",
    "doctor_response": "HelloI have read your query. There is possibility of DVT .I will advise you colour doppler of calf. Till time take neurotropic medication like methylcobalamine. Another possibility of knee osteoarthritis. Physiotherapy like ultrasound and Tens may give you relief. bruising can be due to associated skin involvement. I hope I have answered your questions. If you have further questions please feel free to contact us. I will be happy to answer. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have weird line shaped rashes when I scratch. What is causing this?\n\nHi doctor, Since last week, I have been feeling itchiness around my body, especially arms, feet, abdomen, and back. At first, it started every night, but it starts to feel itchy in the afternoon too. Now, the itch kind of calmed down, but every time I scratched, my skin tends to form weird raised lines which look like rash bumps, but in a weird line shape which is not really caused by how I scratched it. Just like the pictures below, the rash can either look like weird shapes or like red scars which form in order for some reason. Also, the rash does not go away after a while, sometimes it just stays there. Now it mostly forms around my back, breast, legs and arms. Is there any cause of this? Please advice.",
    "doctor_response": "Hi. I saw your clinical picture (attachment removed to protect patient identity), it is called dermographism. Usually, it is seen in 4 to 5 % of the normal population. Dermographism is a form of physical urticaria. Scratching, rubbing, or any kind of physical pressure can cause this type of rash. We don't treat this condition unless it is symptomatic like irresistible itching and causing distress for the patient. I suggest: For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain above temple, blurred vision and watery eyes?\n\nI ve had dull pain above my left temple for a week now and also feels like my brain is swaying back and forth. Like discombobulated. Other symptoms include visible red and yellow lines on my eyes, right eye is always watery, increased fluid or something in my left ear, can hear clicking on left side of head, numb feet and especially big toes (both), it feels like something is stuck in my throat, blurry vision and lack of coordination. Also sometimes it s hard to grip with my left thumb & index finger with loss of feeling. The constant head pain along with the other symptoms is concerning me. I am getting blood work done in 2 days. I am female, 27years old, 135lbs and a bulging disk in my neck.",
    "doctor_response": "you can take a help by taking advise from a close by neurologist and an ortho specialist for the same issues. you shouldn't neglect your symptoms. kindly get an appointment with an opthalmologist also which will be of added benefit. post all this you can take an appointment with a physical therapist for your neck pain. a simple exercise should help you relief and get strength in your weaker zones.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have Implanon implanted in arm. When can I have sex without worry of pregnancy?\n\nI received my period on Sunday 24th February, and I had the implanon implanted in my arm on the 26th which was day 3 of my period. I m wondering how long would it take for full control of the implanon take to become use in the body? I researched it so many times and I m getting worried! When will I be able to have sex without worries of being pregnant?",
    "doctor_response": "Hello,If a female is not using any contraceptive in past one month then implanon is inserted between 1st and 5th day of your periods,as you have inserted it,then you can have sex it hour gettinging worried of being pregnant.Similarly if the female is using birth control pills in the previous month,then implanon is inserted on next day of last active tablet taken.In such a case again one can have risk free sex.However,if you deviate from this protocol,then an additional method of contraception is required for at least one week after implanon insertion.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stiff neck and knee pain after being treated for bronchitis?\n\nI took this med 3 doses in 24 hr. intervals for Bronchitis . i felt lousy on it now 3 wks. later my knees hurt thigh muscles ache and now i have a stiff neck. i never finished the regime .being a nurse i know thats a no no . how long are these symptoms last .I am 81 yrs. old always felt and looked 70 until now . take the drug off the market.",
    "doctor_response": "DEAR FRIEND, I HAVE UNDERSTAND YOUR CONCERNS, SEE THIS STIFFNESS IN JOINTS AND BODY ACHE IS NOT ONLY DUE TO BRONCHITIS BUT MAY BE RESULT OF AGING, USE OF DRUG, MAY BE DUE TO BRONCHITIS EFFECTS, MAY EFFECT OF ENVIRONMENT AND SEASON, OR LAKE OF EXERCISE AND DAILY ACTIVITIES... BUT ACCORDING TO YOUR AGE.. 81 SOME MOBILITY MAY REDUCE.... NEED NOT TO WORRY JUST MAINTAIN YOUR ACTIVITY AND YOU SHOULD BE INDEPENDENT IN ALL THE ASPECTS...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to give lactogen for a 2 week old baby?\n\nhello am gettng problems in breast feedng my baby is just 2 weeks and 6 days, i was been advised by the nurse 2 give lectogen milk to my son the he was born as i was not getting breast milk to feed him. i started getting it withtin this week but then my son is stuborn to have it plus my nipples pain alot when he sucks, my milk supply is not too much so that i can pump out wit the help of breast feeding milk please help me what to do",
    "doctor_response": "Hi, Welcome to HCM. I have read your question in detail and I know that you are very concerned about your child. Yes, you can give lactogen to 2 week baby. It is safe for the baby. But, you should try to breastfeed baby as much as possible because it's best for baby. I hope this will help you. Wishing your child good health. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any chances of cancer if pelvic ultrasound shows endometrial thickening and mild dysplasia in pap smear ?\n\ni'm married with 2 kids. i recently had a pelvic ultrasound which shows endometrial thickness of 3.6mm is it normal? i've sticky white discharge and my recent papsmear shows mild dysplasia and trichomonas infection.  there is any chance for cancer???????",
    "doctor_response": "Hello and welcome to HCM,The Pap smear shows infection with trichomonas vaginalis.It is possible to get reactive and atypical cells on Pap smear in the presence of infection.You need to take treatment for trichomonas and then get Pap test done again.If there are no abnormal cells on releat Pap smear, they were probably due to infection.If they still persist then you need to follow up.A thickened endometrium can be due to hyperplasia or due to cancer.You can get endometrial curettage/ endometrial biopsy to look for hyperplasia, atypia or malignant change.You need to consult your gynecologist with the reports.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does amoxicillin or ibuprofen liquid cause skin allergy?\n\nhi my name is brandy and my daughter has recently taken medication for an earache and now has red bumps with a white circle around it and I don t know what it is...it started on her feet and hands and now it has worked its way to her size the back and front .also on her back and stomach. the medicine she s taking is amoxicillin.also ear drops for an earache.I stopped using the ibuprofen liquid that she was prescribed because I thought that s what started it..that was about 3 days ago and it has continued since then and gotten worse. she says they do not itch and she has no fever she s acting perfectly fine just with a rash.I hope that you can help because I m very scared she has doctors appointment on Friday but want to know information sooner.thank you so much and God bless",
    "doctor_response": "Hello.Thank you for asking at HCM.If fact, amoxycillin & ibuprofen - both can cause skin rashes. So it is difficult to say which actually cause this. Not only medications, but sometimes excipients or other additives in a liquid formulation can also cause skin rashes.As your daughter is perfectly fine apart from skin rashes, I would not suspect any serious drug reaction here.So please don't worry. Your consultation with your doctor on Friday will help you even more.Hope this was helpful to you.Wish your daughter the best of the recovery.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pressure in the chest and shortness of breath be treated?\n\nMy chest is tight / heavy right under my sternum. I am finding it a little hard to breath without making an conscience effort to do so. I have taken 2 otc benadryl several hours ago. I have also used my pro air inhaler 3 times now. I just want to lay on the couch. My head feels like it is wrapped in a tight towel.   I am allergic to cats and did move 5 this morning. Hence taking the benadryl.",
    "doctor_response": "Hi, * The issue seems to be acute allergic bronchitis. * Needs immediate evaluation with peripheral oxygen saturation, vital parameters of respiratory and cardiac regions. * Till that time period, deep breathing exercises with the preference of semi-reclining position when resting is best. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be worried about an indentation?\n\nHi, my 2 yr old daughter just fell from chair and smacked the front of her head on the lenolium (sp) it;s been about 30 minutes and shes playing like normal and jumping around, but at first there was a very small indentation, should i be worried or should i just make an appt for monday morning with our PCM",
    "doctor_response": "Thanks for following up. I understand your concern. You just observe for your child. She looks normal. If nausea, vomiting,headache or other neurological symptomatic will appear then you should consult neurosurgeon, in other cases you apply thrombophob.  Take care,  Grow quicker   Dr.Svetrlana Shrivastva",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sternum pain right over the heart in children?\n\nMy son is 7 years old and has a bump..or a raised sternum right over his heart. The last time they called me from school saying he felll on the ground in pain..We went to Childrens hospital and they did ekg and found nothing. Said he is fine..it just may cause pain if he is real active. He has been complaining about it hurting lately..Is this something he will always deal with?",
    "doctor_response": "hi, pain over sternum region can be due to lung infection involving the pleura, heart involvement. Muscular spasm can also lead to pain over sternum area. And X Ray chest should be done, ECG at the time of pain should be done, complete blood count and CRP levels should also be done. further treatment we depend upon the reports. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can one get pregnant by accidentally rubbing semen containing hands on vagina?\n\nI was out with boy friend he musterbsted I got huge amount if semen on my hands I wipe it off and after 45 I felt I need to go toilet, I went and I washed my Virginia and rubb it from out side . 1.is it possible to have semens under my nail and it didn t dry after 45 minutes? 2.So I can get pregnant? 3. Incase if it was under my nails is that amount enough for pregnancy? I was done from my period and I was on day 9 after period I got period on17 feb and this happened on 25 feb , is it possible ?",
    "doctor_response": "Hi,I understand your concern. Do not worry. There is no chance of pregnancy.1. Semen will not remain under the nail. It will dry in 45 minutes. If it will be present still it can not pass in the vagina without seminal fluid. 2. You can not become pregnant.3.  If it will remain in the nail still can not pass into vagina and quantity is not enough to become pregnant. Again you did this act 5 day after period and it is completely safe period of cycle. To become pregnant, penetrative sexual intercourse with or without ejaculation during fertile period of cycle is required. Avoid stress, take healthy diet, drink plenty of water and do regular exercise.Hope this may help you. Contact further if follow up needed.Best regards,Dr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could granulomatous lymphadenitis be cancer?\n\nHi, may I answer your health queries right now ?  Please type your query here... My brother has just had a lump removed from his lymph node in his neck (despite CT scan and biopsy no diagnosis given) and has been told that the needle test found granulomatous lymphadenitis ...is this likely to be cancer?",
    "doctor_response": "hello dear. As per your details, granulomatous lymphadenitis is not cancer. it is a reaction of nodes to certain infections like tuberculosis. But if on the basis of history and examination doctors are suspecting cancer, then a repeat biopsy can be under taken or a review by another doctor of the initial biopsy. Hope that you understand now.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does unintentional weight loss indicate diabetes?\n\nMy 21 year old daughter is concerned because she's losing weight without a any change in diet or exercise.  She's gone from 117 to 113 which because she's 5'2\" is significant for her. That's the chief complaint. I told her it may be diabetes and if it continues she should get checked out.",
    "doctor_response": "HelloI have gone through your question and understood your concern.Glucose levels in our body are controlled by a hormone called insulin, which is made in the pancreas. Type 1 diabetes usually appears during childhood or adolescence.So if your doughter has diabetes it is more likely that it is type 1.In type 1 diabetes, the pancreas does not make enough insulin and this condition produce evident symptoms.Type 1 diabetes signs and symptoms can come on quickly and may include:-Increased thirst-Frequent urination-Extreme hunger-Unintended weight loss-Irritability and other mood changes-Fatigue and weaknessSo my answeris is Undiagnosed or untreated type 1 diabetes can cause weight loss but if your daughter has not other symptoms of the list,maybe the diabetes is not the culpit of her weight loss.Anyway, my advice is to check a fasting and random blood glocose or a Glycated hemoglobin (A1C) test.For a personalized comprehensive evaluation, treatment recommendations, and individual therapy,you can ask me at HealthCareMagic at my private link: bit.do/hcm-Dr-Xhardo.Hope i have answered to your question.If you have other doubts,feel free and ask.I will be happy to help.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can an arm lump with soreness and itching be treated?\n\nhi, approx 7 years ago i found a lump on the inside of my upper arm and went to the doctors who said ot was a cyst and if it wasnt bothering me could be left and it would hopefully go away by itself. it is now considerably bigger and extremely sore to touch and is also itchy. could this be something serious should i go get it checked out",
    "doctor_response": "welcome to Health care magic.1.Symptoms suggest an infective aetiology - but duration of the lump suggest lipoma ( fat content).2.The most possible chances are Infective in relation to symptoms.3.If you are my patient i would have examined and ask for the ultrasound lesion - to find out the nature, origin and extensions of the lesion.4.Depending upon the size - a course of antibiotic may help, in bigger size a small incision and drainage may be necessary.Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does irregular bleeding and smell while on birth control indicate?\n\nFor almost a month now I've been having on and off bleeding I believe it is from my birth control depo. But I've been having a smell that smells really bad almost like something dead but its coming from the discharge and blood. Could you tell me what's wrong",
    "doctor_response": "hello user.birth control pill has to be taken regularly and on time.Smell can be due to infection.you can have a local check up from your gynecologist.and take antibiotics accordingly.thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have memory loss and forgetfulness. How to deal with it?\n\nHi doctor, I am a 22-year-old and have had memory problems for the last five years. It started back in high school and I would wake up and not remember what was going on in my life, but not just for a few seconds, it would stay like that. I would know the friends I have, but I was not able to remember what was happening to me right now, if I am mad at anybody right now, do I have some guy that I am talking to, etc. When I would check my messages I would see approximately what was going on in my life, but I would still not remember when was the last time I saw some of my friends do I have some special birthday gifts planned for them, do we have a special joke for something at a time. I would just remember they are my friends and maybe like 30% of our time together. It was the same about school and I could not remember what we were doing and what I already studied so I had to do it from the beginning again. The situation got worse when I went to college, and now it is even worse for me because it happens that I wake up and everything that is happening to me feels so distant like it was a few months ago, and not yesterday. Previously, it would usually only happen every couple of months over the night, but for the last three nights, it keeps repeating. I would like to say that I have no problems with drugs, marijuana, etc. I have never used. All of this I already told to my doctor but she did not take me seriously enough. They did take photos of my brain and I do not have injuries. I would also just like to mention that I have very low sugar so do not know if it could be related to my memory, my doctor advised me nothing about that, she only said that she does not know how I am alive with such low sugar, but that it did not matter because I am young. Please help.",
    "doctor_response": "Hi. First of all, a good memory needs a balanced diet, which contains all essential vitamins and minerals such as vitamin B complex, carbohydrates, proteins, and a small amount of fat. Moreover, some drugs like oral contraceptive pills can lead to decrease in vitamin B complex in your body. Stress, pollution, and junk food have a negative impact on memory. The brain needs glucose to work properly, but too much glucose can disturb the memory and the whole brain function. Vitamin B complex deficiency. Patient may have memory problems related to lifestyle. The patient should take vitamin B complex once per day after meals and Benfotiamine 40 mg twice per day after meals. The patient should eat healthy food and avoid too much fat, sugar, and salt in her diet.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am worried about perforated uterus after my abortion. Can I conceive again?\n\nHello doctor, I did an abortion seven years before, and I have not got any complications since then. But I was reading about the perforated uterus, and now I am worried. I do not have any medical issues, and my concern is that I am getting scared I might not be able to conceive again.",
    "doctor_response": "Hello.  Thanks for sharing your concern, and it is quite understandable. Uterine perforation usually occurs if abortion is being performed by the use of sharp instruments and vigorous curettage. If the abortion was undertaken with medicines only then, there is no such chance of perforation. Secondly, if perforation was being there, it might have caused your symptoms like pain, fever, bleeding, etc., if it was of considerable size. So if there was not any problem after the abortion at that time, it means that there were no complications associated with it. So you need to relax now as there is nothing to worry about your fertility. I hope it has helped you. If you require any further queries, please do not hesitate to contact me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in upper abdomen and blood in vomit?\n\nHello, my wife has IBS and recently been fine. Just recently she threw up with a little bit of bright red blood. She had severe pains in her abdominal region. The main pain was mainly in the upper abdominal region. When i asked her how much it hurt she said 8 out of 10. Then the pain lessened to a 4 out of 10 within about 2 minutes. She said the pain was somewhat stabbing and pulsating. She is still feeling pain on both sides of her stomach but it is a low pain. What is going on and should i take her to the E.R?",
    "doctor_response": "Take Her to the ER.Blood in vomit ( Hemetemesis) is a symptom that needs to be investigated urgently.She needs to be admitted for observation, blood transfusion if necessary. Upper GI Endoscopy will give the diagnosis ; the causes can be Esophageal varicesCancer of StomachUlcer and related diseases of the stomachUltrasonographyA proper diagnosis will lead to the proper treatment",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes occassional cough for 3 year child during Fever?\n\nmy 3 yr old has fever for the past 1 week which is around 101-102F.Also she would have one or two night coughs ending in throwing up then she sleeps well.last night she slept with her mouth open resulting in occassional coughs.disturbing her sleep. No cold as such no day cough.please help",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.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 15mg/kg/dose (maximum ceiling dose of 500mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high blood pressure?\n\nmy husbands blood pressure is 206/93 and I am trying to persuade him to meet me at the er. He saw his family dr today and she gave him a bp med but it is still over 200.  He is taking suboxone and thinks It may be related to this.  Should he go to the er? What should I watch for tonight if he won't go.Tarah",
    "doctor_response": "Hello,Thanks for writing to Health Care magic, I am Dr , Muhammad Ahmad , I have read your question closely, I understand your concern and will be helping you with your health related problem.With this blood pressure he should visit the ER he needs his med to be changed and possibly the work up should be done to see the cause of the problem, he should also keep a check on his weight and salt intake, I would suggest you to take him to ER ..this Blood pressure can be dangerous.I hope this answered your question, If you have more queries I am happy to answer you.Regards.Dr.Muhammad Ahmad",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome the inability to raise the arm after a hit between elbow and shoulder?\n\ni fell and hit my arm between elbow and shoulder. It now is hard to lift my arm. My hands and mobility below elbow is fine. Is it possible that I bruised a muscle. I have no black and blue and no cut. Does not look swollen but difficult to raise arm.",
    "doctor_response": "Hi, This treatment is being suggested on bases of the information provided. However, I would like to examine & investigate the patient in detail. Control hypertension, diabetes or any other metabolic disorder, if there is any. Any way it may be tried: - Dolokind Plus (Mankind) [Aceclofenac + Paracetamol] 1 tablet OD & SOS for 5 days. - Caldikind plus (Mankind) 1 tablet OD for 10 days. (You may need help of your local doctor to get these medicines.) - Fomentation with warm water. Let the part not be exposed to cold air. - Sleep on a hard bed with soft bedding. - Use no pillow under the head. - Avoid painful acts & activities. - Do mild exercises for neck and shoulders and hips and knees and ankles. (Take help of a  physiotherapist.) - Do not ignore, let it not become beginning of a major problem. - Do ask for a detailed treatment plan. -  Make sure, there is no allergy to any of these medicines. - For emergency treatment visit nearest hospital. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nirmal Chander Gupta, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for mental health problem\n\ni feel like my brain is telling me to walk to one side im feeling dizzy at times . I saw a MD and now she is sending me for a MRI. 10 yrs ago i had a menningoma removed and had scan every year with no regrowth. To ruled this out, the doctor is sending me for a MRI. YYYY@YYYY",
    "doctor_response": "HiiYes it is necessary to look for any secondary or regrowth.MRI will best suggest it.To take any further step MRI is essential.So go for it and do according to its report.Revert back with report or consult your doctor for further assistance.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have to vomit berore having bowel movement, kindly help me\n\nI have to vomit berore having bowel movment, I am shaking, also I feel my breathing is iratic I have sever pain also and haven't had bm for a week",
    "doctor_response": "Hi. Lack of bowel movement with pain and vomiting is are an omnious signs of a concerning problem.. Get to the doctor as early as possilbe, if you are having these symptoms..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent hair fall while on Estradiol and Finesteride?\n\nMy hair has been constantly falling out, not just shedding for a year or so and can t find out what is causing it. I have seen several doctors with no solution to date. I currently take oxybutin 5mg, estrodial 5mg. finestride 5mg and vitiamin D 2000mg and have for the last 3 years. Any suggestions?",
    "doctor_response": "Hi, Female pattern hair loss is commonly due to hormonal problems. As you are Estradiol and Finasteride, I feel that your hair fall may be due to hormonal imbalance. Consult with your Dermatologist and Endocrinologist to tailor a treatment plan for both hormonal issues and hair loss. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat thyroid problem in babies?\n\ni have one baby.she is 3yaears old.she have thyroide problem form her birth.unfurtunately we find her 3 months.after we take treatment.but her developent will be slow.her docter she has milestone mentel development.take occupational tharaphy.but she do every think what we say.pls give suggession some time saliva falling to her",
    "doctor_response": "hypothyroid is a major health threat during childhood especially in a new born if missed the diagnosis. Level of damage will be known as time passes.At present you are already taking treatment and therapy which shall be appreciated. Continue with them.You will have to be very persistent and patient with the child.This will help her in future and with time she may attain almost normalcy as well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tummy bulging, how do I find out whether it is fat accumulation or gas ?\n\nActually, my body type is very slim. But since the past 6 months or so I find that my tummy is bulging a lot....I have a strong feeling that this is a result of gas accumulation...So how do I find out whether it is fat accumulation or gas ?",
    "doctor_response": "Gas distension you come to know because you will have lot of burp or farting along with it. In fat this does not happen. Also the size fluctuates with gas but this is not the case with fat accumalation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have diabetes. Have mental stress. Personal desire for negative events. Very emotional. Help?\n\nHi. I m quite young. But I ve always felt like I ve had a disease. I don t believe I m depressed, because I am very happy. But even if something small happens that makes me mad or sad, and I wish bad things will happen to me. I know that I will NEVER go through with anything, so thats good. But I kinda wish that something slightly bad happens, just to see what my friends & family will do. If they even care. I also think I have diabetes . But thats another story. I frequently feel like I m someone else, but myself, I fell like Im gonna make a difference in the world. I had bacterial meningitis when I was born, and I have a very low immune system . I ve always had migraines too. And I cry over almost anything. Please help. I scare myself.",
    "doctor_response": "Hi and welcome to Healthcare Magic. Thanks for your question... You seem to have an anxiety-related or a personality-related problem. Many of your symptoms are indicative of borderline personality traits. You will need a detailed psychological assessment to plan therapy accordingly. There are good psychotherapy / counselling techniques which can help you handle your emotions better. Please consult a psychiatrist in your area for help. Wish you all the best. - Dr. Jonas Sundarakumar Consultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure anemia and folate deficiency?\n\nHi, I've got a posterior fibroid 4cm. is this located near the cervix?age:47, 59kg. 10 years ago I have been diagnosed with abnormal cells on cervix and had laser treatment but all pap tests came normal after that. Although my periods are not very heavy I've revcently been diagnosed with (iron) anemia and folate deficiency",
    "doctor_response": "Hello,Thank you for your contact to healthcare magic.I understand your health concern, if I am your doctor I suggest you that you should start with tablet Livozen Z for the treatment it includes all the vitamins, irons and all other necessary minerals. It will gradually increases your haemoglobin. But as you have fibroid your bleeding will also be little high so to compensate it you require to take three tablet a day. It is a long treatment and should not be withdrawn earlier. Once you reach the optimum level of haemoglobin take three month more treatment to replenish the iron.I will be happy to answer all your future concern. Thank you,Dr Arun TankInfectious disease specialist.Wish you a best health at health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold and cough in an infant\n\nhi, my 19 months old daughter is running fever in the range of 99.5 to 103F for last 4 days. Earlier the fever was coming every 5 to 6 hours and we treated her with Ibugesic and Calpol. She also has cold & cough with yellow cough. Now the fever is coming in 8-10 hrs. but she is still getting Fever. What can we do further to help relieve her cold and cough?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Your infant has a cold and cough which seems to be due to viral infection and could be common flu due to poor immunity.Need not to worry. I would suggest you visit pediatrician once and get it examined completely and start treatment after proper examination. It generally due to an allergic component which can be relieved by the use of antiallergics like syrup Relent once daily for a few days. Till then take the proper course of antibiotics and go for mild steam inhalation, which will be very helpful. Give your baby diet that will improve immunity. Hope I have answered your query. Let me know if I can assist you further.Regards, \u00a0\u00a0\u00a0\u00a0\u00a0Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for balance and memory problems\n\nApproximately two years ago I felt a slight itch on my scalp near the crown gave it a scratch thought nothing of it. Within 24hrs a small painful lump developed at the site. I worked outside with old transport tires picking up/delivering probably mosquito it will go away. It did not and it became larger more painful very itchy. Went to my Doctor who could not feel it told me to return in two weeks if there was no change.The lump felt like half a golfball and the entire right side of my scalp became inflamed underneath. And yes I returned every two weeks for 4 or 5 appointments until she consented to an ultrasound the tech found it instantly and yes he said there was definitely something there. The doctor said she did know what it was and that it may return. The scalp on the right side now has ridges the other side does not and the lump did recede. But my memory is impaired and my balance and spatial awareness is also off. What do I do?",
    "doctor_response": "DearWelcome to HCMWe understand your concernsI went through your details. Your brain is covered with a solid skull which never permit any sort of contaminants into your brain. Whatever affected your scalp skin or the area between skin and skull, could never infect your brain. In that case, your loss of impaired memory, loss of balance or spatial awareness (if it is true) cannot be attributed to the lump or further scenarios. I suggest you to consult a neurologist at the earliest for treatment.   If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white pigmentation on the feet and how is it treated ?\n\nmy daughter 18 years old, he has white spot on foot from five years, we gave many medicine and puva therapy but no result, one person told melono cell can fill where lose the cell, so pl suggest how can it be possible or other like patches or any fast process, i will be thankful whole life. we live in india state punjab city ludhiana contact 09815435800 and email is jindalsuresh@rediff.com",
    "doctor_response": "hi it is possible to transfer melanin or skin from one part of body to other.. skin grafting give best result. but for surgery some criteria are there -it should be stable. -not new lesion from one year -have realistic expectation better to consult dermatologist . when medicine dont work,surgery do miracle",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for poison ivy as allergic to prednisone\n\nI was prescribed Prednisone for poison ivy and after taking it for 5 days, I stopped taking it because of the way it made me feel. NOW I have this horrible skin rash all over my stomach, areas on my legs and my back. This rash is almost as bad as the poison ivy if not WORSE! What can I do?",
    "doctor_response": "HI, thanks for using healthcare magicThe rash is  likely related to the allergic response that you were using the prednisolone to treat.If you are not able to tolerate the prednisolone, you may want to try oral anti histamines to see if one of these may help.If the oral anti histamine on its own is not helpful then you may need to try steroids in another format.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of kidney stones?\n\nstabbing knife pains from stomach all the way to my back. .Heart burn from throat to stomach throwing up in my sleep. I have fibromylgia and have had it for 12 years.I I have had the scope down my throat and biopsies on my the parts. I just recently been in the hospital for a busted kidney stone, while at the hospital I died 3 times I had a fever of 104.7 my blood was septic. I was inkabated for 10 days. I have had 2 kub tests the last one came out ok. I have had a pap smear and mammogram they came out good. Everything I eat or drink makes me sick. I am always in pain. Can you please tell me what may be wrong with me?",
    "doctor_response": "Hi and welcome to HCM.Most small stones as in your case, or in patients with relatively mild hydronephrosis can be treated with observation and acetaminophen. More serious cases with intractable pain may require drainage with a stent or percutaneous nephrostomy. Treatment of nephrolithiasis involves emergency management of renal (ureteral) colic, including surgical interventions where indicated, and medical therapy for stone disease.In emergency settings where concern exists about possible renal failure, the focus of treatment should be on correcting dehydration, treating urinary infections, preventing scarring, identifying patients with a solitary functional kidney,.Kindly regards. Wish you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chest pressure on bending arms, forehead pain on bending legs. Nerve problem?\n\nHello Doctor, When I bend my arms for very long, I feel pressure in my chest . Recently I notice that when I sit for very long, with legs bent (obviously), I get a sharp pain in my forehead . My doctor says my blood pressure and other vitals are fine. I had a nerve conduction test performed and it showed no nerve damage from a recent breast augmentation . Do you have any idea what it could be? Thank you",
    "doctor_response": "Hi.i do not thick it is nerves dysfunction.i think it is only myositis due to excessive strain.use flexon-mr and antacid to get cured",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen lymph nodes in neck and under the jaw?\n\nI travelled to New York 5 days ago and the day after arrival the right side of my neck felt very swollen, I could feel it pulsating. I noticed that my lymph node under my jaw was swollen, but only on the right side. Besides the irritating feeling there was no pain related. This morning while at church I began having extreme shooting pains just above my right collar bone and the slightest movement caused it to pop. I have not done anything recently to injure it that I can remember. I have a history of shoulder injuries including fracturing my scapula in multiple places as well as many other injuries (bull riding injuries) throughout the shoulder area. I am used to having a constand ache and pain throughout the shoulder, but never sharp and radiating pains from the collar bone area. I'm just wondering if the swollen neck lymph node and the collar bone pain are related in some way?",
    "doctor_response": "hithanks for questionIt is unlikely that you have any problem of collar boneI might be wrong as I am assuming this without clinical examination based on your symptomsHowever in neck there are not a single lymph nodeclassically lymph nodes in face and neck are divided into 7 region with 3,4,5 lying in neckthese lymph nodes are connected to each other also via ductsYou have already swollen one lymph node which can happen with any urti, sinusitis or any other related infectionAnd these infection could have spread to other nodes leading to infection and inflammationResulting in pain and sweelling in neck near clavicleDo Luke warm water gargle if suffering from urtiAlso drink lot of fluids.And please do visit your physician so that he can clinically examine you and confirm diagnosisAnd can prescribe appropriate antibiotics if required",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swollen gum behind wisdom tooth. Painful. No relief from antibiotics. What could it be?\n\nHello, I have had a swallon gum around and mainly behind my wisdon tooth . My wisdon tooth is though and I have had an x ray and everything looks fine. It is very painful and have had the pain over over three weeks now. I have been given two different types of antibiotics and they are not doing anything. My dentist said my glands are also swallon. Can you give me an idea of what it could be?",
    "doctor_response": "Hello and welcome to hcm, The pain and swelling is due to the impacted wisdom tooth which is erupting. The flap overlying tooth has inflammed causing pain. An x-ray will help to rule out the condition of tooth. The erupting tooth has to be either extracted or flap overlying tooth has to be removed to enhance tooth eruption. Frequent warm saline gargle may relieve the infection. Maintain good oral hygiene. The pain will stop once the above mentioned treatments has done. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for leg and hand pain\n\nMy 8 year old son has had problems with his feet and hands falling asleep quite often regaurdless of how he sits or lays. He is now complaining of pain in his legs, feet and hands. He had an MRI and it showed to be normal. What should our next step be?",
    "doctor_response": "Hello, As a first line management you can take analgesics like paracetamol or aceclofenac for pain relief. We have to rule out possible causes like arthritis. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it advisable to take Vitamin D injections in a grade II breast cancer patient?\n\nHi, My mom had grade II breast cancer and every thing is completed including chemo and radiotherapy. Now she is having vitamin D deficiency. Doctor is recommending vit D injections. Is it okay to take those injections because i heard injections are painful and have side effects apart from its cost. Thank you",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  She had breast cancer. She completed the treatment.  But if she has vitamin D deficiency then she should take vitamin D supplements.  Because low level can leads to weakned bone. So go for vitamin D level once and then take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump on head indicate?\n\nHi, my name is Rikie. I have a lump on top of my head. It is not hurting, just sometimes it feels itchy. When I pick it, pretty easy like zit, it looks like small bundle of fat, but when I do that it causes bleeding. I can send you a picture. Please help.",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern.  Most probably you have some dermoid cyst. You may have some skin tumour.  Please send me the picture so that I can help you further.  You should go for fine needle aspiration cytology study of lump.  Then you should take treatment accordingly.  Excision is the treatment of choice for mostof the benign lump.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes joints pain and throat infection despite taking Neurofen and Ibuprofen?\n\nHi it s me Imran from Dublin.A week before I have cold and flu and after that got throats infection and a high temperature along with pain in my joints and some other parts of the body , since then I used anadine , neurofen and ibrufen tablets but still not felling well, any advice in this regard will be highly appropriate, could you suggest me any medicine that I can purchase it in the pharmacy .Regards Imran",
    "doctor_response": "hello, They are 2 possibilities for your problem. One thing is , it is possible you have viral infection called infectious mononucleosis. It would 2-3 wks for total symptom relief.But you have to reduce heavy works until 4 wks. its a self limiting disease. adequate rest. taking plenty of fluids with good meals. together with paracetamol / ibuprofen is enough. usually we don't give antibiotics unessl bacteria also in 2ry infection. There are tests to diagnose this disease. other thing is you are having viral sorethroat 2ry inflected with bacteria. Best thing is to get a full blood count and CRP done . If they show bacterial count better to get an antibiotic like amoxycillin.   But if the count is like viral but fever is more than 5-7 days. better to have an antibiotic like azithromicin.Thank you. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will 'bactroban' help in treating bumpy rash on the face?\n\nI have for four months had a bumpy rash in the crease of one side of my nose which seems to now have spread underneath in the form of pimple looking spots and lumps. I was given several steroid creams months back which one seemed to work ok but when I stop using it it flared back up. I decided to abort all steroid creams after reading up about perioral dermatitis. My dr has given me bactroban to apply which I have for two days. Do you think this is what I should be doing? I am using cetaphil wash n where possible avoiding makeup.",
    "doctor_response": "Hi, It seems to be perioral dermatitis. I would recommend you to continue applying bactroban cream along with cetaphil wash. If possible take a course of tablet azithromycin.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower level of hemoglobin?\n\nmy father having problem of HB. B'for 15 days it was 5.00 and than we have supply VITCOFOL injection 5 times. But no such progress HB remain same. After that we have supply 3 bottles of blood and HB was 6.1. What may be reason..? what will be your advise..?",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.There are many reason for such a high degree anemia.There is need for detail investigation to diagnose the exact cause. I advice you should attend nearby doctor to diagnose exactly.Though you have taken the blood transfusions, such a low HB requires some time to come to normal level.So from now your can start the injectable iron therapy. Continue it until your HB reaches a over 10 gm there after oral iron therapy till HB reaches to normal level is suffice.I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathlessness and sore throat without physical exertion?\n\nI experience breathlessness without physical exertion, sore throat that worsens in the evening and often wake up with headache which remains inspite of taking paracetamol/iboprufen. I underwent chemo and radiotherapy for breast cancer six years ago and have had mild leucopenia since. My lungs are fine, having been tested for pulmonary fibrosis, but I have cold symptoms and cold shivers almost everyday.  Is this normal when the immune system has been affected?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Yes, recurrent throat infections are common after chemo radio therapy because of immunosuppression. So oral hygiene (antiseptic mouth wash) is very important for this.For your breathlessness without exertion, you should definitely consult pulmonologist and get done PFT (Pulmonary Function Test) to rule out bronchitis.Bronchitis is very common after chemo radio therapy. If PFT is suggestive of obstructive defect then you will need inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure swelling and bleeding caused by crowded teeth?\n\nI have severely crowded teeth and I have a tooth that sits directly behind on of my front teeth. The gums surrounding that back tooth are very swollen and it bleeds daily. I have also noticed pus lately. Is is possible to just get this tooth removed?",
    "doctor_response": "Hello:)Welcome to HCM.Crowded teeth are responsible for your infection of your gums. Get a complete scaling(cleaning) done.I strongly recommend, get a consultation from a orthodontist for straightening your teeth.Straightening your teeth will reduce crowding and improve gum health in your case.He will check your x-rays and will decide if the tooth can be removed.You did not provide your age either.Gargle warm salt water twice daily. This will help maintain your gum health.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a reddish bump in the ankle?\n\nI am a 50 year old male, 6 4 , 250 lbs. location New Mexico. I have a round bump, 1 dia., purplish center 3/8 round, red from there out. Located medial side 4 above ankle. Painful to touch and off and on without. It has been there ten days that I know of, and about 10 days ago I remember feeling like a sting or bite in that area in the morning. Bug bite?, do I need to see an MD?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some hematoma or abscess formation as result of secondary infection.  You should consult your doctor and go for examination. If needed go for biopsy.  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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in abdomen on working out after eating. Reason?\n\nI m a 14 year old male at a height of 70 inches and 155 pounds. In my lower left abdominal area, i get medium pain when i start working out. I noticed this happens more after after eating. It has enough pain so i can stop the work out. It happens around appendix area. It usually only happens when I workout after eating by 4-8 hours.",
    "doctor_response": "hello dear abdominal pain after eating may be related to infection of colon usually by amaeba. hence you may need stool examination for ova and cyst. you are also telling pain around appendix possibility of appendicitis can not be ruled out. for this you need ultrasuond abdomen. if it is amaebic colitis antiamaebic treatment is suffice. if it turned out to be appedicitis you may need laparoscopic appendicectomy. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching in penis after masturbating?\n\nhi may name ram i have tody morning after mastrubution finish itching on the inside pensis.itching stay only two three mints then no problum.and other things my wiffe got viginal thrush (canndin yeast) two three weeks before and i have been on singapore iam sexly contact with two girls ibit worry about i got std",
    "doctor_response": "Dear userWe understand your concernsI went through your details. The itching could be due to smegma accumulated inside your inner portion of penis foreskin. I suggest you to consult a doctor for physical investigation. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had wisdom teeth removed, white skin tag connected to the side, painful. Is this normal?\n\nI had all four of my wisdom teeth removed just over two weeks ago. A few days ago, I noticed what I would describe as a white skin tag connected to the side of where one of my teeth were removed. Today I noticed a similar tag on the opposite side of my mouth. It has been a bit painful. What could this be and is it normal?",
    "doctor_response": "Hi and welcome, As you have mentioned you have got your wisdom teeth extracted two weeks ago so i can expect normal healing and closed socket at the extraction site.  White skin tags with pain are may be due ulceration at the extraction site or super infection of the healing tissue due to food lodgement or other debris. i suggest you to maintain good oral hygiene by regular tooth brushing and gentle flossing of the area. Use antiseptic mouth wash like betadine or chlorhexidine for 2 to 3 times in a day which will promote faster healing and will prevent infection. These white tags will subside in coming 5 to 7 days. You can apply oral antiseptic anesthetic ointment like mucopain topically over the affected area to relieve the pain. i hope this helps you , take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rapid heart rate when i wake up?\n\nFor several months I wake to a faster and harder heart rate, I can feel on waking my heart rate pulsating in my Feet and hands. I also experience pins and needles, along with numbness in my hands and feet. This numbness and pins and needles can also happen when I am awake in the day. I feel pain also radiating up my legs on occasions as well. I find that I feel unable to do any exercise as on exertion my legs feel very heavy and clumsy, along with a raised heart rate almost jumping out of my chest at times. Last week I went to a beach area where I had to walk down about 100 steps to the beach, going down was fine but coming back up I was completely exhausted and my legs felt heavy and clumbsy.",
    "doctor_response": "Hello and thanks for writing.I can understand your concern and would try to help you in the best possible way. The problems you are facing could be summarised as having palpitations, neuropathy, shortness of breath and fatigue. These can be due to diabetes, heart conditions, anemia, vitamin B12 deficiency or anxiety disorder or any other cause.I suggest you get yourself worked up for the same. You may need to answer a few questions pertaining to your problems to help understand the nature of your illness. You may also require a complete physical examination including some tests like complete blood count, peripheral smear, fasting glucose levels, vitamin b12 levels and other tests.Once a diagnosis is made a comprehensive management plan may be started for you which may include dietary advices, lifestyle modifications, medication and physical therapy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Asthmatic, taken anti-tetanus shot, dealing with severe breathing problems. Safe to take Co-amoxiclav and ac-nex syrup?\n\nim given anti tetanus last week with diff doctor that if i get colds i can only take paracetamolafter 4dys now im having hard time breathing because i have asthma my new doctor prescribed co amoxiclav and ac-nex syrup. is it okay if i take this? my upper part of my stomach aches when i start coughing is it related of what am i taking meds.? hope you can help me. thanks",
    "doctor_response": "Hi, Co Amoxiclav can be safely taken in Asthma. Regarding ac-nex syrup (its an anti cold syrup), I would recommend that you check if it contains an ingredient called phenylpropanol amine and can discuss with your doctor regarding its need. This is so because different countries have different policies regarding this ingredient. Pain in abdomen may sometimes be related to vigorous coughing and should subside on the relief of chest symptoms. You may take an antacid tablet for symptomatic relief in consultation with your doctor. Regards Dr. Gyanshankar Mishra MBBS MD DNB Consultant Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to use slendertone belts for kidney transplant patients?\n\nHi, I had a kidney transplant 6 years ago and keep in good health. I struggle to do sit ups due to the various operations I have had over the years. I was wondering if it was safe to use a Slendertone Belt? This belt send electric shocks to the stomach muscles and supposedly replicates the work situps do.",
    "doctor_response": "Hello and welcome to HCM.As an Urologist, i'll not advise you to use 'slendertone' belt. This's purely from kidney transplant point of view. There're so many exercises you can do, to remain in good shape, without using belts. You can do stretches and bends, which are not causing any pressure over the graft in the pelvic area.A belt causing abdominal pressure with ?electric shocks, is certainly not one for you.   Play it safe. Wait till some others have used it and certified it to be safe for your use. Cycling is a permitted exercise in your case. Keep healthy.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the swelling in legs and feet be due to kidney issue?\n\nhi my husband is 67 years and has had bladder and prostrate cancer Dr Ronald Moore removed the bladder and took 2 feet of the bowel and replaced his bladder with. He was told that he has a one old kidney the other normal but now his feet and legs are so sollen and he is very uncomfortable could this be his kidneys",
    "doctor_response": "Hi,I firmly thank you for the details provided . Yes i would recommend you to do a renal function test and a ultrasound for complete analysis of the kidneys under your family doctors supervision.Thank You",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes depression and insecurity while on Venlor XR?\n\ni am 41 yrs old...am on venlor xt 150 since 3 years...of late i feel v depressed and am insecure in all my relationships especially with an intimate friend..i feel i am going to lose that rship and life seems bleak if it happens...i have a son 13 yrs old....i feel overwhelmed",
    "doctor_response": "Hello Thanks for askingYou are taking Venlafaxine 150 since 3 years and still having depression, feelings of insecurities, poor relationships and bleak future symptoms. As you are on this drug and there is no relief so as per my opinion there is need to increase the dose of drug or to change the drug to some other antidepressant drug. SSRIs like Fluoxetine, Paroxetine etc can prove useful. These drugs in optimal doses will help in improving symptoms.Addition of supplements like Omega 3 Fatty acids, Vitamin B12 will help in improving the symptoms of resistant depression.If symptoms still persist then lamotrigine, lithium can be added with proper consultation of a psychiatrist. These drugs are reserved for resistant depression.Cognitive therapy will help in early recovery.Thanks, hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will ingesting alcohol or taking Lexapro affect a pregnancy?\n\nI am pregnant. The father is a big pot smoker.... is there a chance of problems with baby from a mans sperm who is a pot smoker? Also I didnt know I was pregnant and I am 8 weeks. I have drank a few weekend ans took lexapro for a while, what affect can that have?",
    "doctor_response": "HelloWelcome here.I understand your concerns.Pot smoking in father will not affect the developing fetus.In your case, regular alcohol can definitely affect the baby's development. There is a risk of lexapro causing effect of baby development but only on regular use.Hope this answers your query.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bump on the lower right leg getting bigger. Cancer?\n\nHello, I have this bump on my lower right front leg for the past 6 months. It has been getting bigger and when I look at it today it seems to be breaking off and 3 smaller bumps are forming. They all look glossy in appearance and I m worried that it might be cancer . I do feel an ache every once in a awhile, but it never itches. What should I do?",
    "doctor_response": "Hi, From this limited information it is difficult to comment upon the diagnosis. It is not clear to me what treatment you have received in the last six months. Clinical examination of the lump to assess the size, shape, consistency, margin, fixity to underlying and overlying structures are mandatory. A simple imaging like X-ray may be helpful. Consult surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is sitting in floor during winter harmful to kids?\n\nHi, There. I have two girls, one aged six years and the other two. Both of them go to creche during the day as I am a working mom. At the moment it is winter. The children get snacks at the creche about three o'clock in the afternoon, they are told to sit on the cold brick floor outside. Is this harmfull to them?",
    "doctor_response": "Hi,Thanks and welcome to healthcaremagic .Sitting on a cold brick floor is not harmful normally.If it is intolerably cold out side then it is wise to eat inside sitting on a bench or on a warm carpet.Hope this relply serves your purpose .Please feel free to ask further queries if any.Dr.M.V.Subrahmanyam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain i the chest?\n\nI have sharp sometimes knife like pain in my right side of chest or lung while I strain, breathe in, and pain afrer I swallow food and beverages no sickness or fever or cough I m 35 I do have copd and have blebs but I don t know what is wrong with me it s been like 4 days now can anyone help me please",
    "doctor_response": "Thanks for your question on HCM.Pain on inhalation, coughing is seen in pleuritic pain. Pleurisy (inflammation of pleura) can cause this type of pain.Causes of pleurisy in COPD patient are1. Infection like pneumonia.2. Pleural effusion.3. Pneumonthorax4. Pulmonary contusions.So please get done chest x ray first to rule out these causes.If chest x ray is normal than it must be muscular pain only.So avoid painful movements and take good pain killers and muscle relaxant.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes palpitations of heart with oral thrush and diarrhea?\n\nHi im 25 years old and have always thought there was somthing not quite right i have a number of on going problems which are getting me down......im under weight, i feel sick a lot and loss of appetite, seriously tired all the time and thirsty, heart palputations, shakey, always cold, i get diahorria every day, no energy at all",
    "doctor_response": "Hi, i have gone through your question and understand your concerns. I suggest you should have complete check up (Physical examination and labs testing). If i am your treating doctor i would like to have complete history of your symptoms and tests like CBC,Lfts , Rfts, ESR,CRP,CXR,USG ABDOMEN,Stool R/E,C/S, montoux and HIV rapid testing. By than you should improve your intake of protein and healthy diet. Hope i have answered your concerns. if you have any query do not hesitate to ask.Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause penile bruising?\n\nhallow doctor,how ar u?i have a problem with my health,when i sex then my penis get bruise.this start just two years now and i went to hospital but what they told me is prepare someone whom i sex with but that is my ususally business before having sex,but still the problem exist.what wrong with my penis skin is it so soft or what actually i fail to enjoy my sex.i had reach a time i run way of my wife when i discover tht she want me fuck her .help pls",
    "doctor_response": "Hello Thank you for trusting HCM Many causes for bruising of the penis some of them mentioned below. 1.Entrapment in clothing- appear as a simple  cause and many of times neglected. 2.Thrombosed lymphatic vessel - Lymphatic vessels can be found all over the body - they are responsible for delivering lymphatic fluid. Masturbation, sex, and the use of erectile enhancement devices such as vacuum pumps can lead to bruising of this tissue.3.Trauma to the penis- Any type of trauma, or sudden injury, to the penis may cause bruising, which is characterized by discoloration of the skin, soreness, and in some cases, inflammation.4.Fractures- Unfortunately, the penis really can be fractured; this occurs when the erectile tissue in the penis is ruptured, usually during sexual activity where the partner is on top. 5.Injection of drugs- Injecting drugs into the penis - whether for treating erectile issues or for other reasons - can result in bruising and soreness around the injection site.Vigorous Masturbation, priarpism etc... Please consult your doctor (sexologist he will guide you in right way).",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and tenderness in abdomen?\n\nHi I'm a 23 yr old female,I had a miscarriage nearly a year ago and since then I've had nothing but problems with my digestive tract which my gp pits down to ibs caused by the stress of it all, I go through bouts of constipation rarely diarrheoa and very occaisonally lower abdominal cramps they put me on buscopan and colofac which do little for me my concern at the moment however is my abdomen has swollen to the point I look 4months pregnant n feels quite heavy it's been this way for a month doctor said its constipation but I'm not constipated at the moment and the swelling is constant it's solid n quite tender in places and nothing seems to reduce it there's no other pain apart from my back where it seems to be pulling around the sides I just wondered if this could be ibs or if it's something more serious? I should mention my dad is currently being tested for crohns disease. Any answers would be very much appreciated thank you. Steph",
    "doctor_response": "HIWell come to HCMAbdomen distension could be likely due to collection of flatulence, because of the stress condition this may be likely it is advisable go for exercise aerobic exercise would be fine, I would suggest the following medicine for this condition.1) Tab Clinidium with Chlordiazepoxide three times in day 2) Tab Omeprazole 40 mg once in day3) Tab Domperidone 30 mg once in dayHave a fiber diet, drink more water, have good sleep, hope this information helps take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the BP of about 150/100 suggest?\n\nhad a heart attack august 2010.  on plaxic, crestor, ecotrin metotoprolol.  this week my blood pressure has been 150/100 consistently.  going to my cardiologist friday.  not feeling well. a lot of pressure in my head.  should i go  to the doctor earlier???",
    "doctor_response": "hello,I have gone through your query.Thanks for using HCM.your BP is on higher side I suggest you to start Tab.Ramipril 1.25 mg for its control.You need regular follow and cardiac check up,though you need not rush for BP of 150/100.my best wishesDr.Rajesh Teli,MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal for the pediatrician to check the private parts?\n\nHi, I m a 15 year old girl. I had a physical yesterday at my pediatrician and it kinda freaked me out. It was me and the doctor (a guy) and a nurse (girl). He did normal stuff, but then I had to undress to my underwear, he touched my breasts, and looked in my privates. Is this normal?",
    "doctor_response": "Hi, welcome to HCM. Can understand your concerns. It is not normal but the doctor has examined in front of Nurse so there must be some reason for that. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any centers for the IVF treatment in shimoga ?\n\nhi , are there IVF treatment centers in shimoga",
    "doctor_response": "Hi Khushi, Welcome to HCM. Try google search for \"IVF treatment centers Shimoga\"",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it to be concerned about sudden numbness from neck to finger due to an accident?\n\nMy husband and I were horsing around and I accidentally kneed him in the neck. He said that his right arm felt numb and he couldn t feel anything from his elbow down to his fingers. He says the feeling is slowly coming back but it s been about 7-8 minutes. Should we go to the ER to get it checked out?",
    "doctor_response": "Hello,His symptoms could be related to a pinched nerve. I would exclude any possible stroke, considering the description of the numbness. Coming to this point, I recommend waiting and trying to move his arm as much as he can. If the situation does not improve, going to the ER for a physical exam.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is aciclovir effective for herpes viral infection?\n\nHi,I am suffering with harpies viral infection in my left side of neck till shoulder. Today is the 4th day. I have started taking aciclovir 400 tablet 5 times a day and applying aciclovir cream 3-4 times a day. Is it the correct way to cure it? Do i need to take anything more? How many days will it take to cure it (approx)?",
    "doctor_response": "Aciclovir is a specific treatment for the harpies viral infection. You have to take the medicine for 7 days. The vesicular lesions may disappear after 2-3 weeks. However, if the pain is very severe you may need additionally corticosteroids medicine for 1-2 weeks after which this can be stopped  gradually by tapering the dose for 1-2 weeks. In some people the pain will persist for 6 months to 1 year ( post -hypetic neuralgia). In such a case drug like amitriptyline may be useful in relieving the pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes folliculitis?\n\nI believe what I have as told by a doctor, is folliculitis in my genital area. I wasn't sexually active over summer and it went away, but with my new girlfriend it came back a few days after having sex. i don't want this to ruin my relationship:( i don't shave or anything and it doesn't matter if i wear a condom or not, it still comes back. i am 23 years old, 5'11 and 173 pounds no bad medical history",
    "doctor_response": "Hello,Welcome to HCM,Folliculitis is a group of skin conditions in which there are inflamed hair follicles which result in a tender red spot. It may be superficial or deep and it can affect anywhere there are hairs including genital area.Folliculitis is caused by a large number organisms,irritating substances, environmental variations, any anatomical defects and drugs.It is confirmed by cytology and culture.Identifying the  causes is very important to treat the condition successfully.It is best treated with topical antibacterial clindamycin lotion and oral antibiotics like cephalexin for 5-7 days.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I see a clear blood clot come out every 6-8 weeks after being fitted with a mirena coil?\n\nI have had the marina coil fitted over a year and o have always got cramps. I am in a long term relationship. I have what looks like a blood clot in belittle clear/ white film come out of me a nit bigger than a bean every 6 to 8 weeks, and wondered what it was???  If you could help me I would be very grateful.  Thankyou",
    "doctor_response": "Hi, I think it is a side effect of mirena. It will go away with time. There can be irregular bleeding in between. So don't worry about it.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cough, sound while sleeping. Montek LC a steroid? Wheezing?\n\nHi doctor, My son is suffering from cough for the last three days.He had the cough for him 3 weeks later and got subsisde and started agin 2 days b4.Whn he starts sleeping there is aslight sound that can be heard but whn he goes to sound sleep its not there.Today whn i went to consult doctor he has put him on Montek LC kid .I just want to know if it is a steroid and is he sufferingfrom asthma or Weezing .Please do help",
    "doctor_response": "Hi , welcome to H.C.M.Forum. don't worry it not a steroid, it is a drug to reduce the allergy which is causing this cough. he needs to take antibiotics and decongestants for the complete relief. blood test is to be done and if there is eosinophelia it is also to be treated. but as a whole there is nothing to worry about it. thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it necessary to take rabipur after dog licks on bite wound?\n\nHi I m Ian I was bitten by a rabid dog since year 2012 and I ve completed my rabies vaccination and by the next year I ve bitten again by rabid cat and my physician gave 2 doses of rabipur on april 15 and 18.. and by the next month on may 4 a stray dog licked my wound ..my question is do I need to take rabipur again or any anti rabies vaccines? Best regards to your answer..",
    "doctor_response": "Hello,Welcome to HCM,Rabies is 100% fatal but it is 100% preventable by proper and adequate treatment.As your wound was licked by the stray dog according to WHO it is categorized into Cat III. As you have taken post exposure prophylaxis last year and Re-Exposure prophylaxis last month, you will be having protective rabies virus neutralizing antibodies (RvNAb) titres which will protect you from getting rabies.But you need to undergo Rapid fluorescent focus inhibition test (RFFIT) to know your RvNAb titres.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Uncomfortable feeling under ribs. Hurts to press. Occurs randomly. What could it be?\n\nhmm, i have this uncomfy on my chest , it started a year ago, location is just slightly under my ribs and on the right side, not sure if thats the liver , but should be around there. at first it was very uncomfy and if i press it , it hurts. but when i go see the docs when they press my chest its nothing. or should i say, this uncomfy feeling im not sure why but if i take a dump they it will disappear soon after, but when ever this uncomfy feeling show up, when ever i use strengh, that area will kinda ache.",
    "doctor_response": "Hi and welcome to Healthcare magic.Thank you for the query.It sounds like liver or gallbladder issue so you need to check your liver tests and do abdominal ultrasound.This would reveal is there any disorder in these 2 organs. Also,you need to avoid alcohol and fatty food till your symptoms subside. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lipoma?\n\nI saw a Surgeon today regarding a lump in my lower back around my SI region. I have felt a softer mass and also a harder ball like mass near each other. I also have NF 1. The surgeon today only felt the softer mass which I believe to be a Lipoma(he did too) should I be concerned about the harder ball type mass?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have NF1.  You habe high chance of neurofibroma.  Lipoma is the benign tumour of fatty tissue & neurofibroma is the benign tumour of neural tissue.  Both the lesions are benign.  No need to worry.  Treatment is excision. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had therapy for abuse and self harm, depression, hear people who are not there, insomnia, tired\n\nI just turned 16 and am female. I think I have something wrong. I'm too scared to ask for actual help but i do crave help. I have been in and out of therapy twice, the first for abuse and the second for self-harm. I just stopped going 10 months ago I think and even though another appointment was scheduled, i never went back. she asked me if I wanted meds and i think they were keeping important stuff from me because i know im not right. i started to self-harm again and i make it look like accidents but they sting and i feel guilty and ashamed about it but not really. im mostly fine with it and just do it out of boredom now. i did it out of depression the other day though but i do it worse when im bored. I feel like im always being watched and talked about and i hear people say my name when no ones there or they say they never said it. i hear people or things follow me but when i turn around or look towards them, they aren't there. i hear knocks on the walls when no one makes them and i am home alone. i get angry a lot and confused and ive got memory spots that are these like gaps between stuff. i remember getting kicked and sexual abuse but theres other things that went on that mom says i forgot. she wont tell me what happened. i know stuff without being told like when i randomly asked out of the blue if my dad had abused my mom. no one ever told me but i said it and it was true. i forget things on purpose sometimes but then i cant remember. mom says i \"switch\" sometimes. she says sometimes ill act like a little girl and sometimes an adult. sometimes i act like a boy but then i act like me. i just started getting insomnia but im really tired. im scared of the nightmares im scared of how vulnerable i am when i am sleeping. im afraid someone will come and kill me. i have nightmares of it and im never able to scream. no one comes to save me. no one can save me. sometimes im affection and like hugs and scream and run and sometimes i want to be left alone but not alone alone. i dont want to be alone but i dont want to talk or have physical contact. i get angry sometimes, a rage that makes me want to scream and fight the source but im smart i learned not to. if i do i get yelled at and i dont want to get yelled at. every time i do i cry and my mom scream at me that im faking but im not. i learned fast. ive always been like this but not really this bad. i get empty whe",
    "doctor_response": "Hi,Yes, there indeed is something wrong and should be treated well. The problems that you have described make me feel that you need to be assessed for borderline personality disorder with possibly a co-morbid depressive episode and it will be good if you could see a psychiatrist or a trained therapist. Since you mention that you liked your second therapist better, you can discuss this possibility with her and see what her views are. Ask her if she would be willing to see you in a place other than the church, as you do not feel comfortable there. You have not mentioned why you expect to go blind in future, but if you think that it will be a punishment for all the mistakes you made, just get rid of the notion. All human beings make mistakes, but God is very forgiving. Please do not feel uncomfortable about being in a church. It is a place of love and not punishment.Hope you get better soon. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump at top of stomach\n\nI felt a lump at the top of my stomache about a week ago. I have had severe nausea for 3 days with vomiting today. I have only eaten a slice of dry toast and drank about 20 oz of Sprite over the past 3 days. I called my pcp on Fri last week, but could not get in till tomorrow, Wed.",
    "doctor_response": "Hi,understood your query facts.With  a lump on top of your stomach with 1 week history,if you have 3 days nausea/vomitting,You should consult your ER Surgeon and get hospitalised for further treatment,as things are serious.You seem to have-Obstructed Epigastric Hernia-Don't wait for your PCP till tomorrow.Keep Nil By Mouth.Get the USG of the lump in stomach.If its not reducible,Surgeon would plan emergency Hernia repair for reduction of the obstructed Epigastric Hernial Contents.This reply would help you to plan treatment with your ER Surgeon urgently and immediately.Keep updated and Contact with a Followup Premium question to ME if need be.Will appreciate your Hitting thanks and writing excellent review comments to help needy patients like you. Welcome with any other further query in this regard.Good Day!!Dr.Savaskar,Senior Surgical SpecialistM.S.Genl-CVT",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent pain in the wisdom tooth despite taking antibiotics?\n\nI had an infection in or around my wisdom tooth. I was prescribed antibiotics which I took (even the refill) but the pain is still there & still bad as ever. I've finished the antibiotics 3 days ago. Shouldn't it have helped already? Why do I still feel pain? My right side of my mouth hurts, my ear feels like I have a ear infection it's hurts bad & my throat is swollen on the right side. I have been dealing with this pain for over a month already :(",
    "doctor_response": "Hi,Welcome to Healthcaremagic.com. I had gone through your question I can understand your concern about your tooth related infection. As per your history it seems to me you have 3rd molar infection which I can understand is because of pericoronitis of the related tooth. As you know 3rd molars are not functionally important you need to get your tooth extracted. Because of the recurrent infection it can involve the upper part of throat, ear and limit your mouth opening. Antibiotics can provide you relief only for some days and you will get another reinfection and this vicious cycle will continue. For pain relief you can take medication like Ibuprofen if you have no problem with it. Or you can take broad spectrum antibiotics but the only solution is extraction. My opinion is get your tooth removed. Hope my answer will help you and write to us in case you want any further assistance. Regards Dr Muzaffer Hussain Parray.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are fincover, follihair, ketafung shampoo and tugain good for hair regrowth?\n\nsir I asked the doctor for treatment to hair loss and  to regrowth of the losed hair.He suggested me to use following medicine that is 1.fincover  2.follihair 3.ketafung shampoo  4.tugain 10%. He told to use three months. By using these medicine any side effect will occur and whether these medicine will be effective for hair growth of losed .Can i apply hair oil before using the shampoo.sir explain in detailed.",
    "doctor_response": "Hi Dear,Understanding your concern. As per your query you have symptoms of severe hair loss which is due to improper hygiene, genetic factor , fungal infection, nutritional deficiencies and hormonal changes.Need not to worry. You should take Indian gooseberry powder with water once a day and use olive oil for massage. Yes fincover, follihair, ketafung shampoo and tugain is advisable as it will enhance hair growth. I would suggest you to consult dermatologist for proper examination. Doctor may order skin patch test, blood test and physical examination. Doctor may prescribe you drug like finpecia at least for 3-4 months or antifungal treatment along with minoxidil spray. Take diet rich in multivitamins.Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause of rashes on neck?\n\nMy daughter (age 29) developed a rash on the RT side of her neck 2 days ago with swollen areas near her ear/jawline.  It was a spotty type rash that was barely visible.  (She was immunized for mumps as a child.)  NO signs of a cold or sore throat and the rash has gone away for the most part, but she has areas of swelling in the area in front on her LT ear and 2-3 areas on the back of her neck on one side.  Are there lymph nodes on the back of the neck?  Do you think she could have been bitten by a spider or some other insect?",
    "doctor_response": "Hello and welcome to HCM,A rash with swelling on the neck is suggestive of an allergic reaction.Allergy can be due to an insect bite, spider bite, exposure to some poisonous plant or chemical in the environment, etc.Is there history of any of these complaints?If yes, then anti-histaminics are a group of drugs which are commonly used for allergic reactions.A lymph node enlargement causes a lump like swelling which is discrete and mostly mobile.A clinical examination of the rash and swelling is required for more definite opinion.Viral infections can also cause rash however, viral infections are usually associated with fever and malaise.You need to consult your doctor for clinical examination and further management.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for nail infection\n\nMy big toenail is coming off! I think I had a nail infection because in December, my nail really hurt. I soaked it in water, and the pain went away, but a few weeks later, I noticed the nail was coming off on the right side a little. I wore heels a week ago, and now the entire right side is coming off. There is an outline around the nail like it's gonna fall off.  What do I do?",
    "doctor_response": "Hi,It seems that you might be having nail bed infection, producing detachment of nail.Go for one course of antibiotic medicine for 5 days.Nail might be survived if infection cured completely.Nothing to worry if nail came out.There will be eruption of new nail.continue dressing with antibiotic cream.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for fever,dark red gums and sore in inside of lower lip\n\nMy 2 year old has run a fever for 3 1/2 days, she is cranky will not eat or drink much, she has dark red gums and 1 canker sore on the inside of her bottom lip that I just saw this morning, she had a strep test Sunday also a urine test and both came back negative, ears looked fine but she complained that her eye hurt for The first 2 days? Any thoughts",
    "doctor_response": "Hello..Welcome to HCMI am Dr Jigar( ID specialist). I totally understand your concern.U must have consulted a doctor for this. I can advice following things in this situation.1. In this kind of lesion i would go for gram stain and culture to rule out candidial lesion.2. There is high possibilty of herpes labialis if we go by your words, and if it is you should immediately start treatment of it after consulting pediatrician.3. Last possibility which you can help to rule out is that see your child is not having habbit of lip smacking and chewing which can be infected after self  injury.I hope this will help you. Please be in touch for further queries.Dr jigar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is sensitive & stiff arms a side effect of TB shots?\n\nI just took a TB test about 3 days ago. Right after my test, I noticed my arm felt funny. I figured after any shot your arm will feel a little weird. During these past 3 days, I have still felt this weird feeling. It started at the area the shot was given and moved up to my bicep. My arm is sensitive, somewhat weak, stiff, and it feels pressured (like when you use the inflating arm band to check your blood pressure.) I have had no other side effects.",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.These symptoms which are described by you may be due tubercular shot in the arm as it cause inflammation in the arm due to mild sub clinical infection by these shots. This will be Okay after  nearly 2 weeks. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes an infant to grab its ear?\n\nMy grandson is 81/2 months old and has been teething for several months. He has cut the front bottom two at 6 months and recently the front top two have come in. He cries and pulls at his little ears a lot. Our Ped doctor said that it is normal for teething babies to grab at their but I don t recall any of my three kids grabbing at their ears. He is not ill in any way that we are aware of, I feel that my daughter should have him looked at. Any ideas?",
    "doctor_response": "Hello. I just read through your question. I agree with your pediatrician that babies frequently pull at their ears when teething. However, it is always worth a look in the ears just to make sure.  Though the diagnosis is most likely teething, I would consider consulting with the doctor and having the ears checked.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest an OTC antihistamine for rashes and fever in an adolescent\n\nSigns began this afternoon for A rash around 2:00 pm this afternoon. She is 14 years old, I asked her to take her shower around 3:00. She had a fever of 102 and was given Tylenol, Fever was reduced to 101. She has had 2 Oatmeal baths which she says she feels better now. I'm giving her Juicy Juice Orange / Tangerine and Ocean Spray Cran/Grape. (Can I treat her at home as long as her fever doesn't spike any higher.)What over the counter Antihistamine would you suggest? I will pick up Epsom Salt, Ensure, Calamine Lotion and fruits tomorrow. Please be advised it's only been 10 hours so far /(Treat her at home)Sincerely, Tammy Dee",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I suggest you to give her Cetirizine once daily. You can continue using calamine lotion and Epsom salt. If she doesn't improve in 3-4 days, she might need Prednisone injections. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do dairy products cause tiredness,numbness in tongue and thick vaginal discharge?\n\nHi. I have an intolloerence to gluten and maybe dairy. I have noticed at times I get very tired, a numb tongue and more than usual white thick vaginal discharge. Is this likely to be the dairy such as milk products in packaged foods cos I avoid main dairy products.",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.Yes, this can very well cause the problems you have noted. The intolerance with a particular thing can cause reactions anywhere in the body.On the safer side I would advise to seek Gynecologist's opinion to see the cause of your problem and get treated before more complications occur.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is Lumbar spondylosis?\n\nmy x ray report Cervical spine. (Ap/lat views) *reduced c5-C6 and C-C7 inter-vertebral disc spaces are noted with lack of cervical curvature due to muscle spasm. No cervical rib seen on either side. Lumbo sacral spine(Ap/lat views) *marginal osteophytes are seen in the bodies of lumbar vertebrae with reduced inter vertebral disc spaces , A rounded radio opaque shadow is also seen anterior to the spine in RHC and could be a gall calculus. Advised: USG on empty stomach Opinion: Lumbar spondylosis",
    "doctor_response": "Hello sir. spondylosis is a degenerative disease affecting spine in old age.This will affect bony structure of spine and later the spine causing radiating type of pain.This disease has to be identified and graded.Depending on severity of disease treatment is decided.Kindly consult an orthopaedician for your problem.I hope you get well soon.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen lymph nodes?\n\nI have swollen Lymph nodes, I have had this for the second time. First time they took one out and found it was normal, but not normal. ??? My symptoms are, Hot spells especially at night, not assoiated with hot flashes, extream fatigue, pain in lower abdomine that travels any time any where, worse at night. Nausious all the time especially after eating, over weight and can t loose weight even though I eat almost nothing. I do eat healthy, veggies and fruit don t seam to trigger it any different than any other food. I have seen a few Drs and am to see a colon specialist on the 4th. My nodes started swelling last night making it unbearable to sleep. worse ones are in abdomine. Last time I went to the hospital they did basiclly nothing, the meds they gave me made me sick. There has to be a reason for this. No one seams to be able to or want to help. Any ideas?",
    "doctor_response": "Thanks for your query at HCM!I am Infectious Disease Specialist! I went through your query!There are various causes of lymphadenopathy (Viral, bacterial, tubercular infection), lymphoma, lukemia, etc.You need thorough examination and set of investigations(ZN stain from FNAC and cytology) to come to diagnosis whether viral, bacterial or tubercular in nature.In your case as you have evening rise it is likely \"Tubercular\" in nature pulmonary or extra-pulmonary.But I recommend take a course of antibiotic for 2 weeks to see if it resolves before you get investigated for other causes.You will need antibiotic prescription.Happy to take more queries! You can also write a review for me. If you would like some more information, I will be happy to provide.Take care!Dr. Sheetal VermaInfectious Disease Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tests done on detecting architectural distortion, no lymphadenopathy. Result says Bilateral fibroadenosis. Explain?\n\nThis examination was performed after detecting architectural distortion at the left breast in a previous mammogram dated February 26, about 2 weeks ago. The current examination revealed no mass lesion or cyst at either breast in both T1 and fast T2 pulse sequences. The body coil axillary views revealed no significant lymphadenopathy at either side. The post IV contrast injection series show diffuse glandular enhancement estimated to be about 60% as the examination is performed during the last week of menstrual period. Focal intense enhancing spot is seen at the medial aspect of the left breast lower down at the junction of the anterior and middle thirds. The time intensity kinetic curve over this spot shows dye accumulation and delayed rapid washout segment. Impression: Bilateral fibroadenosis with suspicious area at the left breast medial aspect lower down at the junction between the anterior and middle thirds,BIRADAS 4. could You dr explain to me this report .....???",
    "doctor_response": "Hi there, It seems MRI is picking up an abnormality which needs further evaluation. The report BIRADS 4 means there is some probability of being malignant (range from 3% to 94%) which literally means that biopsy has to be done. Most probably your doctor will recommend a biopsy by needle to look into it.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does grapes thicken the blood?\n\nMy mom who is 86 has been on Warfarin now for 18 years.  All of a sudden recently, her blood has been either way too thin or she is at the extreme opposite of being way to thick.  I would like to know if grapes are a blood thickener because she craved grapes for about 2 weeks and ate them all day long.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.No, it's your belief that grapes can thicken your blood.Warfarin is usually given to thin the blood as in your mothers case. If excessive warfarin is taken on the blood than blood can be thinned out.If blood goes much thin than Vitamin K can be taken to revert the effect of the warfarin. Please take the above treatment under your doctors guidance as its requires constant monitoring of INR value of anticoagulant.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My lip is turning black, what could be the reason and how to solve this problem ?\n\nHii just turned 20 and i have noticed that my lips are starting to turn black Im really worried Ive a fair complexioni dont smoke i dont apply lipstick everydayi dont drink coffee i dont even remain in sun for too long then what could be the reason and how to solve this problem . what do i do?",
    "doctor_response": "Hi, Lips turn black due to many reason like smoking,unhealthy diet,dehydration,cracks and sun exposure.You should exfoliate your lips every day with a brush.You also need to improve your diet,avoid alcoho,smoking,coffee,tea.Also avoid lipstick.Increase vit E and use a balm containing it.Vaseline will also do.Water is very important.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can emergency contraceptive, Plan B, cause gas and bloating?\n\nI Had protected sex(also my first time ever having sex) about 1-2 weeks before my period and took plan b within 15 hours just In case I am 99.9% sure the codom didn t break but it was dark and was not able to tell for sure so I took it just in case and then had sex againthe next day but I made my boyfriend put 2 condoms on the second time and its been about a week now and I m feeling really gassy but I normally am before my period just not this gassy.... could this be a symptom of plan b?",
    "doctor_response": "Hello dearUnderstand your concernYes plan B pill cause gas and bloating as it contain high dose of progesterone.Progesterone causes relaxation of smooth muscle of gastrointestinal tract lead to decreased motility and cause gas and bloating after taking Plan B pill.So it is common problem after post plan B pill.It may be due to indigestion along with the Plan B pill.Take following advice:Take small frequent meal rather than large meal. Avoid spicy/fatty/oily food.Also avoid items made up of milk items. Also avoid chocolate, tea and coffee.Take over the counter drug: Tablet OmeprazoleTablet Gaviscon and Citrucel. capsule ginger.Do regular exercise like walking and yoga.Hope this may help youBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back pain along with pain in ribs?\n\nI have lower back pain and go to therapy 3 times a week. Had a MRI and waiting for results. My question is that my ribs are starting to hurt in the front and my tummy hurts also. Sometimes I ever run a low grade temp. Show I see my doctor now instead of waiting for the MRI results? The ex-rays they took 3 months ago show that my lower L4 is damaged.",
    "doctor_response": "here i suggest to wait for mri report because it will hardly take one day now as per your problem for the lower rib pain it can be related to your spinal issue or else you must be having calcium as well as vitamin d deficiency and so that you have a weakness in your bones. low grade temperature also be due to the persistent consistent pain in your body and inflammation in your body and that is usually so do not worry for that. here U also told about your tummy pain in case if you have difficulty in passing urine or stool as well burning sensation while passing urine and along with that if you are developing fever then you may need to visit a physician because it could also be a urinary tract infection. and you need to do urine test stool test and may need to take medication.for your back pain based on mri dr will definitely advise you on conservative management with medication and physiotherapy or with surgical management if there is a severe damage in your spine.i suggest in any case do visit a physiotherapist to have physiotherapy treatment which will relax your soft tissues as well take proper spinal exercise program which will help to improve spinal strength and stamina.you can also use hot and cold pack at your painful area to have some more relaxing and healing effect on your soft tissues.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is my heart healthy with cholestrol 128 and blood pressure 122/80?\n\nI have done heart health checkup. Below is my complete report details for your supportI am 30 yrs old unmarried male having 77Kg wt and 172 cm ht.1) my cholesterol level is 1282) fasting sugar is 90 and pp is 1103) tsh level is 2.3 4) chest x ray pa is clear and normal5) ecg show sinus tachycardia6) echocardiogram show concentric lvh with Gr. I diastolic dysfunction.7) blood pressure is 122/808) anxiety, stess level is high9) total veg, non smoker, non drinkerIs my heart is healthly, how much I worry about my heart. I feel chest pain with palpitation when I got excite or sad or happy etc...",
    "doctor_response": "Hi, welcome to our site. I am Dr Saumya Mittal.Read your query. That is a very significant question and i appreciate your problem. I will try my best to answer your queryYour reports are normal to a large extent. However your echocardiography does suggest lvh or left ventricular hypertrophy. This usually happens when your heart is pumping blood against a resistance to the flow of blood. It  is usually a feature of hypertension, but you have mentioned a normal blood pressure.However you have also indicates that you have a type A personality- anxiety and stress. This may be causing an undue load on the heart.I would seriously suggest that you meet a local doc to prescribe you a medicine from the group of ACE-I or ARBs. And do try relaxation techniques.To really make sure all is fine with the heart, you may want to try a stress test- treadmill/dobutamine.I hope this helps you. Inform the reports mentioned above so i can be of help further. Best of luck.I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you.Please do understand that some details could be extracted from a detailed history and examination.Looking forward to your return query with the details asked so that I can help you further.(If the answer has helped you, please indicate this)",
    "dialogue_context": ""
  },
  {
    "patient_message": "How effective are trigestrel contraceptive pills?\n\nHi, I ve been using trigestrel contraceptive pills for a month now. I had an unprotected sex with my partner last night and I m a little bit scared that I might fall pregnant cause I don t know how this pills work. How effective are this pills? Do they stop the sperms from going to the egg or what? Must I just wait and see what will happen or do you suggest that I buy the morning after pills?",
    "doctor_response": "hello dear.understand your concern.don'tbe panic ,its safe You can take it ,its totally safe not to take another pills ,u cant be pregnantOral contraceptive is highly effective in preventing the pregnancy. After regular use, its failure rate is only 0.5-1 %. It prevent the pregnancy by inhibiting the ovulation (in inhibit the release of gonadotropin hormone) and make the cervical mucus tick so sperm can not enter in to the uterus. It should be taken at the specific time (at bed time) everyday without missing the pill.(make habit to take daily by putting the reminder in the mobile). If you will miss one tablet then take missed pill as early as possible or on the next day with that day of tablet. If you will miss the two tablet then you have to use barrier contraception for next 7 days.So if you had used very regular without the missing any pill then you have no need any morning after pill. Wait for your period. It will definitely come.Hope this may help youContact HCM for further health issue.Best regardsDr. Sagarbesty regards dr.sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abnormal behavior in child\n\nwere can parents go for treatment for an 11 year old boy who is oppositionally defiant? The parents and child live in Pasadena California. Is there a treatment center that espouses Janet Lehman s The Total Transformation near Pasadena California? I am the grandmother of the child. YYYY@YYYY",
    "doctor_response": "Dear, Welcome to HCMWe understand your concernsI went through your details. Sometimes it's difficult to recognize the difference between a strong-willed or emotional child and one with oppositional defiant disorder. It's normal to exhibit oppositional behavior at certain stages of a child's development. I think this is the stage the child goes through at his age of 11.There are certain therapeutic guidelines given by American Psychiatric Association. According to those criteria, the child is assessed psychologically by a clinical psychologist or psychiatrist. If the child is diagnosed Oppositional Defiant Disorder (ODD), the child will be treated with Parent training, Parent-child interaction therapy, Cognitive problem-solving training etc. Medicines are used for impulse control and anger and aggression.Please review this web link for clinical psychologists near Pasadena. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Happy New Year. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe pain after multiple tooth extractions with pain medications offering no relief. How to manage this?\n\nHello. I had 3 teeth extractions (lower right side) 5 days ago and the pain I am feeling is still the same, there appears to be no let up in the amount of pain I am suffering. I am finding it very difficult to sleep as the pain either keeps me awake or wakes me up. I haven't been back to my dentist because I thought with having 3 extractions at once it would be normal to feel some pain, but no over the counter pain releif is working. Today is Friday (night) and my dentist isn't open until Monday. What options do I have between now and then? Thanks Matt",
    "doctor_response": "Hi and thank you so much for this query.I am so sorry to hear about this severe pains you are feeling. Given the number of teeth extractions and the degree of your pain, I very much think that over the counter pain medications would not be able to help enough. Please, talk with your doctor to get stronger pain medications like codeine/oxycodone to get this pain controlled. Unfortunately, these drugs can only be obtained with a prescription as they are regulated substances.For now, I will recommend that you get a combination of Tylenol and ibuprofen at least 3times/day and if it doesn't help, please visit the ER for appropriate management. Toothache I a terrible thing to have to deal with alone.I hope you find this helpful. Thank you so much for using our services and feel free to ask for clarifications if need be. I wish you the best of health.Dr. Ditah, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain, urine frequency. Taking Aleve. Have diabetes\n\nHi my husband is experiencing rt lower back pain ,he's been border diabetic for sometime,last yr he was medically treated in the hosp for 1wk.put on meds,he changed his diet ,his nubers were very good,per the Dr. he stopped all meds.Since last week he had urine frequency,and his last reading was 2 days ago was 257 I gave him aleve for the pain.",
    "doctor_response": "Hi, He has diabetis again, and he should get treatment for that, The pain he had could be due to urinary tract infection, or stones in the iriter, or kidney. I advise you to consult a surgeon for diagnosis and treatment .                               He may need to have blood and urine examination and MRI for confirmation of the condition. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful swelling on lower back?\n\nHi, I have a large, very painfull swelling on my lower back (sacral area I think) after a fall over a week ago. The bruising is starting to go but the pain is quite unbearable to touch although I have no problem with mobility. Should I get it checked out or will it simply resolve itself?",
    "doctor_response": "Hello,Thanks for your query.After going through your query I came to know that you got injury to your sacral area  and you got hematoma ( bruising).  Hematoma gradually resolved by itself .Thrombophob gel local application three times a day over it(no rubbing) can help in resolving it. You have sever pain in this area so you need  to do your x-ray done to exclude fracture. For pain analgesics (Diclofenac three times a day after meals is effective). Sometimes strong analgesic(such as ultracet three times a day after meals) is required. OMEPRAZOLE  before meals  prevent acidity caused by analgesics . You can discuss with your treating Doctor about it. I do hope that you have found something helpful. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this semen analysis report indicate?\n\nSemen Analysis resutlsColour : Greyish White Reaction : Alkaline Viscosity : Normal Liquifaction time : Within 30 minutes Sperm count : 60 millions/ml Motility Active motile : 60% Sluggish : 25% Immotile : 15%Pus cells : 8 - 12 / hpf RBc Cells : NilMorphology 85% shows normal form 15% abnormal (giant head, pin head, swallen neck, amorphous form, double tail) Impression : NORMOSPERMIA WITH INFECTIONSCan you please tell what the above means, especially what is the interpretation of impression?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice.Brief answer: Interpreted as a normal study (in terms of fertility).Detailed answer: In my opinion, overall semen analysis is fine except the pus cells, above 10 which may indicate an underlying asymptomatic infection of the prostate, seminal vesicle, or the urinary tract. However, it doesn't play a significant role in affecting the fertility. So you need not be much concerned. You can have a course of antibiotics after getting doctor's prescription or even without which it returns to normal (i.e., pus cells up to 3) in future semen analysis. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Senduran Narayanasamy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Less beard, moustache, elevated FSH and LH levels after losing the only right testis for germ cell tumour.\n\nhi my problem is that i had germs cell tumor in 2009 and lost my only right testis, now cancer is gone, and i am fine now, but facing a problem that less beard and moustache, i have checked my testosterone level that is normal, but FSH and LH level is high, and more than normal level. and my hair is thinning day by day,",
    "doctor_response": "HIThank for asking to HCMI really understand your concern, and let me tell you that even in normal person those are  not having such history as you have may not be having hair of beard and moustache this could be normal one some time, if your hormone level is normal then no need to worry have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for change in voice after a tantrum episode\n\nHello. Yesterday my 16 month old son had a tantrum. I took something away from him and he screamed and cried for a few minutes and shortly fell asleep. Later that evening he started sounding hoarse. Had a honking like cough. We have been using vapor rub, motrin, steam shower, lots of warm drinks. He has had a little mucus come up He still sounds hoarse. He is eating again and drinking fine. He has a cough but not like it was yesterday.",
    "doctor_response": "Hi...I feel this change in voice or hoarseness is due to overuse of the larynx and it is causing laryngitis or mildly swollen vocal cords and this is the reason for this hoarseness. The best treatment for this is voice rest which is not possible in this age group. Vapor rub, motrin, steam shower, warm drinks are not going to help.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "History of asthma, cervical cancer, scoliosis. Problem with balance, having dizziness and chest pain\n\n25 yo female, 5'5, 205lb. No major excercise reg, but I do working the healthcare field walking on my feet all day. Health history of asthma, cervical cancer and scoliosis. For the past month I have been have\\ing problems with balance, sometimes resulting in a fall. But now I am having episodes of SOB, dizzyness, and chestpain, sometimes I feel I am going to have syncope. My normal resting heart rate is between 80-100, I have been able to check my heart rate during the episodes and it is in the low 60's by the time I am coming out of the episode and able to check it. These episodes happen at anytime, sitting down, mid walk. I know that it is not an ortho static problem because it never happens when I change position from laying to sitting or standing.",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for choosing H.C.M.F. You are 25 yr age, 5.5, 205 lb, You had asthma, cervical cancer, and scoliosis. For the past month you had problem of balancing called vertigo.Your pulse is varying from time to time. Vertigo is a common problem with many people, it could be due to internal ear infection, any structural changes in the brain, gastric hyper acidity , or anemia etc. The malignant cells , scoliosis due to increase in curve could be the cause. I advise you to consult a physician for diagnosis and treatment. If treatment of the underlying cause is not possible it can be treated by beta histine, or cinnerzine till you can get relief. Wishing for a quick recovery. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any chance of pregnancy if there is spotting after taking duphastone?\n\nSir my period had started on second jan and ended on eleventh jan than on 15th jan doctor had provided me duphaston for seventeen days I have eaten that medicine my next period started on 29th jan as iam a fibriod patient but its only few drops now doctor has given me folinz for 60 dy want to is there chance of getting pregnant",
    "doctor_response": "Hi,I guess your concern is about getting pregnant after spotting of taking Duphastone and in spite of having fibroid. Right my straight forward answer is - YES. THERE IS CHANCES OF GETTING PREGNANT.Firstly, I want to tell you that in case of fibroid usually there is excessive or prolong bleeding during menses as you had. For that your treating doctor gave you duphastone for 17 days to regulate the menses, which is usually given. Spotting usually occurs after this medication. Its no big deal.Secondly, let us discuss about you fibroid. Fibroid have a role in infertility but it's depends on it's size, number, it's position in uterus. You didn't give information regarding this, so it's difficult for me to comment on this.With above information you can try out my suggestions:1. Try to do coitus during fertile period ( it's from 10th to 16th day of mense cycle), during this period ovum is rupture and fertilization occurs when sperm meet the ovum. So try to do more coitus during this period.2. Usually spotting occurs after stopping the Duphastone. So KEEP PATIENCE.3. If you are in hurry then visit nearby infertility specialist. He/she can help you.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Sudha Rani Panagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling on nose and below eyes along with itching?\n\nI am a 58 year old female in otherwise good heath. I ve been camping in public campgrounds for the last two weeks. Woke up this morning with the bridge of my nose and above and below eyes very noticeably swollen and it s sore to touch. A pharmacist suggested I use Nasocort and Benedryl which I started this morning but haven t seen an improvement yet. I do have a few mosquito bites which seem to bother me more than my husband who was with me in the same campgrounds. I have been using Cortisone and Afterbite to cut down on itching. Could this be a sinus infection, allergy to mosquitos, something in the air, etc?",
    "doctor_response": "Hi,Welcome to health care magic,If there is pain or swelling over bridge of nose and below eyes then it is most likely due to mosquitoes bite or some kind of allergic reaction.It must be examined by dermatologist by his naked eye to have a clear diagnosis.Meanwhile you may take antihistamines orally and apply topical gel or ointment or cream of analgesics,antiinflammatory and antibiotics combination to reduce pain,swelling and inflammation.Consult skin specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blue gums in 11 month kid?\n\nmy 11 month old son is teething he has got 8 teeth through so far 4 on top and 4 on bottom his gums are very swollen on the right side at the top near the back. i have noticed his gum is blue just on that one side. he hasn't got a temp and isn't any more irritable than he was with his other teeth cominhg through. will a doctor help or will i have to take him toa dentist?",
    "doctor_response": "thanks for your query, i have gone through your query. The blue color over the gum could be because of the erupting tooth or it can be a eruption cyst. consult a pediatric dental surgeon and get it ruled out if it is just a erupting tooth, then no treatment is required. If it is a cyst then the cyst has to be excised under local anesthesia. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is the enamel cap hurting with puss formation in it ?\n\nI had a root canal done on my front tooth about 5 years ago. It has an enamel cap on it. It has 3 puss pockets over it and hurts. What could be wrong with it? I am 73 years old, 6 3 tall. I am currently taking an antibiotic. Bill",
    "doctor_response": "Hi, It looks like the root canal treated tooth is infected. A retreatment of the tooth is required which will hep in resolving the infection.  Antibiotic will temporarily remove the infection but it will reappear if the treatment is not done",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why enamel is falling off from child's teeth?\n\nmy son  is two and a half years old. his  up front four teeth are damaged . the enamel started falling off since they were formed and now only stubs are left with a blackish appearnce on the inside. all other teeth are normal. what could be the reason behind this and what can i do?",
    "doctor_response": "Hello,This can be a defect in the enamel while tooth was forming. It can be a deficiency or a medication or illness affecting the enamel structure that was not present when other teeth were forming. These tooth buds form diring pregnancy. These are teeth that come in first and if a baby if left with a bottle with milk or juice acids, the enamel can be weakened and destroyed. It can appear as you describe. The tooth will decay and appear dark. If left untreated, the teeth can become infected. Root canal and crown placement would be an option if enough tooth remained. Early treatment could be a bonding, but your description sounds like a full crown would be needed if possible. If teeth need to be removed, temporary removable teeth can be made. You should have your child seen by a dentist. A pedodontist specializes in dental care for children. It may be 4-5 years until the adult teeth erupt. The baby teeth are important to keep the correct room needed for the adult teeth and help keep the sequence in order. There are speech and cosmetic concerns. Options are best discussed with the dentist after an exam to diagnose your child's dental health. Other teeth may have decay no visible to you.Thank you for your inquiry. I would be glad io answer any additional questions. I hope the information provided is helpful to you and you are able to visit the dentist soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tooth abscess\n\nI am showing symptoms of have an abscess and so I am visiting the dentist as soon as possible. If my tooth needs to be removed, would I be able to be put to sleep? I have a massive phobia of needles and drills so I don't want to turn to root canal treatment. Also, if my tooth is removed, will I be able to get braces to close the gaps? I have had braces before and the abscess has made me unable to wear my retainer therefore my teeth have moved back to their origanally place. I am a child so I am not sure",
    "doctor_response": "Thank for your query.  I have gone through your query. As far as the abscesses tooth is concerned, it is better to save the tooth with root canal treatment rather than extraction. Because once you get the tooth removed it's very difficult to close the gap with braces. Nothing to worry about injections and drilling, it's a simple procedure. Get it done. I hope my answer will help you. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Unstable angina, prostate cancer, diabetic type 2. Do I have grounds to claim DLA?\n\nHad an heart attack and stent fitted 8 years ago. I now have unstable angina . Other health conditions are prostate cancer and I am diabetic type 2 but no medication. Do I have grounds to claim DLA?. I get a pension which is above the threashold for ESA and JSA so cannot get benefits. I am 57 years old and not really fit to work, especially full time.",
    "doctor_response": "Hi and welcome to Healthcare magic.Thank you for the query.These are not usualy indiactions for DLA. Only heart angina pectoris may cause sgnificant reduce in physical activity and work capability,but it should be verified by cardiologist and it must be refracter to medical therapyWish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can ragi porridge be given to a 5 month old kid who has diarrhea?\n\nMy baby is passing the stools from the last 20 days in green color. he is 5 month 5 days old boy baby he going motion in every feeding along with mucus and in water consistency . We Did the motion test and the result is normal doctor gave antibiotic For 5 days.though it s not cured.pls help me wat to do and shall I start to give ragi porridge as he is loosing his weight...",
    "doctor_response": "Hi, It seems your kid is having viral diarrhea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting, you need not to worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic-associated diarrhea. I suggest you use zinc supplements (Z&D drops) & ORS as hydration is a very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron (as prescribed by your pediatrician). Regarding diet - You can use cerelac, any flavour will do. Avoid fruit juices as they might aggravate diarrhea. You can give zinc supplements & ORS apart from normal vegetarian porridges & soups. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could excruciating abdominal pain with bloating indicate?\n\n3 different times in the past year, I have had a strange thing occur.  My lower stomach started to hurt and than my body started filling with gas.  It hurt so badly that I almost passed out.  It's hard to move and breath at times.  Lying flat on the ground stretched out helps, but when I get up it's excrutiating.  It last 2-3 hrs.  Any thoughts?",
    "doctor_response": "Hi.The possible causes of distension of abdomen with excruciating pain which lasts for 2 to 3 hours are ::Stomach volvulusVolvulus of the Sigmoid colon ( a part of the large bowel which is loose and mobile).Intestinal obstruction. I would suggest you the following :Get an X-ray of the abdomen in standing position. This is the easiest diagnostic tool to be done at the time of attack .This gives perfect diagnosis and gives plan for treatment . One can have a Contrast enhanced CT scan to get other diagnosis or ruling some out. The treatment will depend upon the diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a treatment for my brother who forgets an event that just happened 1-2 hours back ?\n\nDear Sir, My brother who is a Doctor aged 55, stays in France. In 2004 he had a heart attack and he went into a coma for some 4-5 days. Upon regaining conciousness, he looked fine with no physical abnormality. Then Doctors concluded that he had a problem to remember things that just happened. For example he forgets an event that happened just 1-2 hours back.But he remembers everything about his past, his childhood, his marriage, etc. Doctors have condemed him that he will never recover. He is actually staying in a \\",
    "doctor_response": "yes,it happens,In such case recent memory loss is there but past memory is o.k.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes scabies infection?\n\nI went to a dr. He said he's sure I have a case do scabies?? How would I have contact it I live alone don't go out much , I checked my 2 grandchildren they are fine ?? And after applying the cream he game & then 7 days later again is it going to go away , and if I am confined to be home now ???",
    "doctor_response": "scabies is caused due to itch mite commonly called,, its the infestations of mite,,,, wind can blow the mites,,,, can infest in beddings, lenins , n wooden furnitures also.... compromise in hygiene can lead to infection...u need to continue tretament for 21 days,,, recurrence is possible,,common predisposed  in overcrowding,,, hostels,, feel free to post any query,, regards, Dr Shyamala",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am not getting energy with low metabolic rate, inspite I am gaining weight. Why?\n\nHello doctor, I feel my metabolism rate is slow. When I have food, I am not getting energy. But my stomach and buttock fat level are increasing gradually. My weight is also increasing and stamina is also very low. Please help.",
    "doctor_response": "Hi. Your symptoms look more like hypothyroidism. I would suggest you to check for the same and review back. Take syrup Zincovit 5 ml once daily for one month. CBC (complete blood count). RBS (random blood sugar). Free T4, TSH (thyroid-stimulating hormone). ? Hypothyroidism.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the treatment and precaution to increase haemoglobin level?\n\ni have recently gone under complete blood count. my hb is 9.5, pcv 29.5, mcv 67.1 mch 21.6 and rbc count 4.39. rest all readings are normal stool test revealed that no occute blood is there.  why i am losing hb. my diet is normal and so other physical activities. what treatment should be taken to improve the hb at the earliest",
    "doctor_response": "Hello and welcome to HCM,Low hemoglobin can occur due to decreased blood production, increased blood destruction and increased blood loss.Negative occult blood in stools suggests that there is no blood loss from gastrointestinal tract.However, other causes of blood loss have to be looked for like increased destruction of red blood cells and decreased production pf red blood cells.A peripheral blood smear has to examined to know the type of anemia.Treatment can be planned once type of anemia and cause of anemia is known.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Intense pain in the abdomen around the heart after drinking anything\n\nStarted this morning after chugging a morning smoothie. While drinking fast, an intense pain in the abdomen, around the heart and a little to the left occured. The same feeling, yet less intense occured when I drank water throughout the day... It all ties back to drinking the smoothie very fast this morning...",
    "doctor_response": "Hi,Thanks for writing to health care magic.I can understand your concern.That could be because of esophagial reflux. A physical examination followed by investigations are required to arrive at a diagnosis. Your doctor may even ask for a procedure to look into your esophagus. He may advise antacids etc if the diagnosis is confirmed.Continue to ask further queries as required.Hope this helps.Take care.Dr Y V Siva Sankara MurtyM.D.(Pediatrics)Associate Professor of Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from obesity and stress. Family history of cerebral hemorrhage and heart attack so check up required?\n\nMy sister is 54 yrs of age and obese. Has not been to a doctor for a number of years. Has had detached retina surgery around the age of 40. Is under a great deal of stress with her job. Father and older sister died of cerebral hemorrhage, other parent of obdominal annyorism, and an older brother of a heart attack. Should we head to the doctors or hospital?",
    "doctor_response": "Hi,,yes, it is good to take her to your Doctor. Your Doctor will do clinical examinations, Investigations specific to her need. If there would be any warning symptoms or Signs, he or she will refer her to the specialist or Hospital. If everything comes out normal, her stress level will reduce, and will have to concentrate on healthy way to reduce weight by diet and regular exercises. Her retinal detachment at early age indicates also some chronic disease like Diabetes, hypertension or vascular disease, specially Aneurysm.Better to be proactive, rather then stay in fear.Wish her good healthDr H Hamdani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent fever and pain in eyes due to typhoid\n\nHi...my daughter (3 yrs) had a very mild form of typhoid a few weeks ago (we live in Indonesia) but recovered fully. Today almost a full three weeks later she has a temperature of 39.4 fluctuating and has mentioned her eyes hurt. We are monitoring but need some reassurance. Waiting times in Jakarta for doctors are obscenely long so generally we monitor at home unless things go pear shaped. Any suggestions? Her food intake has dropped but she is still eating a little with no signs of vomiting.",
    "doctor_response": "HiWelcome to the HCM I understand your concerns. Sometimes, typhoid fever can relapse leading to recurrence of fever. Also, there is always a possibility for  self limiting viral infection or other coincident infection. So, I would recommend you to get her WIDAL test, complete blood counts and urine routine test done at a laboratory. You may post the reports for my reference, so that I may guide you in best possible way. In the meanwhile, you may give her acetaminophen for relief of fever spikes and repeat the dose every 6-8 hours if fever persists.Hopefully this will be helpful.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat lump under knee cap?\n\nI fell yesterday going up some rock steps.  I developed bruising about 2 hours after and a lump just under the knee cap.  It s sore to touch.  I can walk on it but to put any pressure like climbing in the bed hurts badly.  My leg is tingling just below the knee.",
    "doctor_response": "HI,Welcome  to HCM.Based on the facts of your query,you  seems to have -Traumatic Edema with Post-Patellar Bursitis of the knee Cap with Contusion of the Tibial upper end.Treatment Suggested-Orthopedic Surgeons Opinion with Xray of the KneeRest / Cold Compresses.Anti-Inflammatory drugs x 5 daysIF no relief, your orthopedic doctor would re-assess the case and would treat it accordingly.Possibility of the bony injury needs to be ruled out by Xray and Usg of the lump and by Orthopedic Surgeon's Second Opinion if the lump does not regress in 5 days time.Hope this reply would help youWelcome for any further query in this regardWill appreciate writing your feedback review comments,to help the needy patients like you at HCM.Good Day!!\u00a0\u00a0\u00a0\u00a0\u00a0Dr.Savaskar,Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for typhoid fever\n\nSir,i have been battling with Typoid fever for a long period am afraid wether am infected with HIV.i have been diagnosed 3 times but the result shows negative but  for the past 3 years i cannot spend good 1month without having typoid fever.what is the maximum window period for an infected person?",
    "doctor_response": "Hello You are in panic , first of all be brave , you are HIV NEGATIVE and this is proved as all three tests are  NEGATIVE. Now about typhoid fever , please upload latest report of Widal TEST and also serology test , which confirm that you are having typhoid.Since , you mentioned that you are having typhoid fever and this is assumed , so I am mentioning the complete treatment for typhoid fever.Ciprofloxacin 500 mg twice in day for 14 days is the most effective for susceptible organisms. If resistant ( for ciprofloxacin ) then take CEFTRIZONE 2-3 gm/day  7-14 days ).Alternatively Azithromycin1 gm/day orally for 5 days .This is most accurate and standard treatment for typhoid fever.So for this consult your doctor and get his opinion.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat hard pimple like bumps on an infant s butt?\n\nHi, my daughter is 17 months old and has these hard pimple like bumps on her butt, in the crack and has spread to her vagina, inner thighs and legs. She has had these bumps since before Christmas. Her doctor said it was a swollen gland from the dipar, but that was said when there was only 2. Know there are at least 10 and they are hard and bleed sometimes. Can you please help, my daughter shouldn t have these things on here private area and I don t know what to do anymore. I have tried every dipar rash cream on the market, neosporen and even bacteria cream.",
    "doctor_response": "Hi...by what you quote this seems like an infected eczema and it is going into secondary bacterial infection. I suggest you get the lesions examined a dermatologist or paediatrician and your daughter might require oral and topical antibiotics.Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for rashes in body of 9 month old\n\nMy almost 9 month old has a rash/hives around the edges of her diaper, armpits, belly and backs of her legs. We just started introducing solid foods. We introduced oatmeal yesterday. She had a virus a week ago. No fever, just vomiting for about 8 hours. She s had a bit of loose stool this week. is this a food allergy or a continuation of whatever she had last week?",
    "doctor_response": "HI ...this is not suggestive of food allergy. This is classically fitting into eczema as it is involving the flexural surfaces of the body. The trick of the management is keeping the skin moist and never allowing it to be dry. For this oil massage and lotions like Oilatum will help. But usually kids grow out of it...that is as the age progresses, they become better starting from 6 months of age and they gradually get better.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can you get Hep C from a sewing pin?\n\nCan You Get Hep C from a Sewing Pin? I was walking around TJ MAXX looking at clothes on the racks, and as I was looking I felt a sharp prick on my finger. It was a sewing pin sticking out of a dress shirt. The pins they put in the dress shirts to make them look nice. Is there a chance of getting HEP C that way?",
    "doctor_response": "Hello, Thnx to contact us. I understand your concern. If I am your doctor I advice you that Hepatitis C Virus (HCV) is transferred by Blood borne route. Such a blood borne virus wont live in atmosphere for long period. So untill a Hepatitis C patient is recently pricked on that needle, there is no possibility for you to got HCV. But you can take primary precaution as of hand washing, antiseptic application, Tetanus Toxoid Vaccination etc. This primary measures will reduce your further chance of transmissionI will be happy to answer more of your concerns, kindly know me,Wish you a very good health at health care magic. Dr. Arun Tank. Infectious Disease.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red bumps on legs up to stomach?\n\nMy sister is 8 years old. She has red bumps all over legs up to her stomach. Some of the bump gets big and some are already big. She says it hurts but it dosen t itch She says it bothers her and its rough. I don t think chicken pox because it dosen t look blisterish",
    "doctor_response": "Hi...by what you quote it could be HSP - Henoch Scholein Purpura. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does a short minor electricity shock cause long term infertility?\n\nCan a short minor electricity shock cause long term infertility in men? I went straight to the hospital afterwards just to get a general check, after all the checks the doctor said everything is normal and that I might have some muscle sorenes that should be gone soon. I m just forgot to ask if it would affect me trying to have a baby in the future being a minor shock being only expose for no more than a second. Thank you",
    "doctor_response": "Hi,No,a short minor shock will not affect your fertility in any way,especialy since it was not for more than a few seconds.You need not worry.Smoking and drinking can affect fertlity and you should avoid them if you drink or smoke.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to fly having diagnosed with bradycardia?\n\nHi..i'm 28yr female, 5ft 3\", 8st 5lb, very fit and active. I've recently had an ECG scan as i was getting panic attack symptoms but these attacks happened when i was at rest/in bed and not in a state of panic. My ECG came back and heart rate was 38 beats per minute. My doctor has referred me to a cardiologist to check this out further but I'm meant to be flying to Australia 11 september for 6 weeks...is it safe to fly if it turns out I have 'bradycardia' or a similar heart condition? I would like you to bear in mind i'm very active and run at least 40k a week.",
    "doctor_response": "Hi,If you are active and have no complaints, then there is no contraindication for the flight. Anyway you will need to see a cardiologist afterwards when you are back to have some examinations.Take careCome back if you have any further questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can genital herpes induce fever & cold?\n\nHello, I was diagnosed to have genital herpes this year. I had two outbreaks and that was not so bad. The ting is that last few months i feel like fewer or shaking some thimes byt hawe normal temperatyre. I hawe normal imune sistme byt i suffer from colds from time to time. Could this filing like fever be related with genital herpes that I hawe",
    "doctor_response": "Hello,Welcome to HCM,Genital herpes is a genital infection caused by the herpes simplex virus.In this  infection there will clusters of genital sores consisting of papules and vesicles on the outer surface of the genitals.These usually appear 4\u20137 days after sexual exposure to HSV for the first time.The symptoms of low fever and cold for longer duration will not be there in case of herpes genitalia. These symptoms are due to some other viral infection.Drugs like acyclovir, valacyclovir and famciclovir can shorten outbreaks and make them less severe or even stop them from happening and these drug reduces the pain and the number of lesions in the initial case of genital herpes.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heaviness in chest and shortness of breath?\n\nI am a 40 yr old \"healthy\" woman (as far as I know).  5'1 .. 145lbs.  Normal blood pressure.  slightly overweight.  currently on Birth Control.  On Thursday evening, experienced horrible headache, sharp uncomfortable pain in left side of back of neck and shoulder blade, pain in left arm, numbness, shortness of breath.  It woke me up.  Only lasted hour or so after taking some Aleve. ??  I didn't pay much attention. However, I continue to have severe headache, fatigue, nausea, shortness of breath or heavy chest ??  Everyone panics with \"chest pain\" mentioned ... not me.  But is this something to be concerned about?  In general, I feel terrible and can't seem to catch my breath or get rid of this headache and hot/cold feeling.  No flu.  No fever.  No cough...",
    "doctor_response": "Hi,According to history as you are having left sided chest pain and pain in shoulder as well as in arm. Hence ischemic heart disease like angina or myocardial infarction has to be ruled out first although your blood pressure is normal For that work up done as follow:-Auscultation - EKG - Echocardiography - Tread mill - x ray and spirometry only done If respiratory cause is suspected after examination According to cause specific treatment plan is decided. Stress induce panic attack can lead to chest pain. But usually doesn't lead to referred arm pain. Avoid stress. Consult physician or pulmonologoist  for examination and further work up accordingly.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for maintaining normal liver functions\n\nMy SGPT level is 232 mg/dl. and SGOT is 228 mg/dl. My weight is 120 kg. Height is 5 feet and 11 inches. I am taking Atorvastatin 40 mg/day for the last 2 months. Also takes Ranitidine 150 mg BD with tab Motilium thrice a day half hour before meal to avoid gastritis.  How my Liver functions come to normal",
    "doctor_response": "Hello, Welcome to Health Care Magic. I read carefully your query and I understand your concern.From your weight and height I calculate your BMI and you are obese, this is a risk factor for having a fatty liver that cause the elevating level of liver function test also you take atorvastatin that is a drug that increase the liver function blood test.So  you should lose weight gradually by changing your lifestyle doing more physical activity, minimally 30 minutes of brisk walking and you should eat a healthy diet, avoiding fatty product and sugar product choosing high fiber foods that are in fruits, vegetables, whole grain avoiding animal product like red meat instead of it you can eat fish, white meat, you should avoid cheese etc, this regime treat also the problem of your elevated lipid blood level and decrease or help to stop the atorvastatin.The other problem that you have is gastritis and you treat it with ranitidine, it is also a problem that can be solving choosing the right diet, the right diet decreases the frequency of ranitidine use.To lose weight and begin a healthy diet as begin I recommend you to go to a specialist dietitian and chose a gym instructor to help to adapt the right behavior minimally for 6 month and also consult your doctor for the drug you take.For both of problems you need a specialist dietitian to help you chose the right foods for your health minimally for 6 month the time to adopt the right behavior.     Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Kind regard,Dr .Marsida Janko",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe cramps and swelling in the legs?\n\nI am having severe leg cramping in my legs mostly at night. I shoot our of bed because they wake me and try to work them out. My feet, ankles, legs are swollen to the point that my skin feel stretched and I have itching behind my left knee. I have swelling of my face, around eyes. I just had back surgery, extensive, so if I stay on my legs too long they swell, etc. I also have angioedema, the Osmoalality of my blood is 310 & my vasopressin is low, my thyroid is swollen on rt. side with a 2mm and 6 mm nodule. I have Diabetes with delayed Hypothalamic reactions of abt. 4 hours. I just stared taking Desmopressin. This happens every night & I m not getting any sleep. Just had EKG that was OK. Blood work showed high Myoglobin (87) and CPK of 184. I also had a skin biopsy that shows leukocyto classtic Vasculitis, and my leg looks like and upside down coke bottle. Anyway, the Lasix doesn t work, nor does the Dyizide sine my back surgery. Oh. I also fell twice recently effecting both sides. I m exhausted, cry when pain meds wear off, feel wobbly when I walk, disoriented. I looked at a long list of possibilities, but and confused. What do I have? A Heinz 57?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. This can be related to electrolyte imbalance or a nerve related cause. Few investigations and consulting a neurologist will help. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with brain tuberculoma, has low appetite, dizziness, imbalance, difficulty in walking, no improvement with treatment. Suggestion?\n\ndoctor , i dont know how to explain the diseases of my grandmother as doctor declared she has brain tuberculoma? and on that basis they treated her but their is no use of any kind of medicines so please help me she as such symptoms loss of apetite, dezziness, loss of balance and she likes to sleep as she feels well in that condition my grand father is so worried about my grandmother so they changed the doctor for second opinion but their is no improvement in her health , she is not able to walk now please reply as early as possible",
    "doctor_response": "Hi Thanks for your query. I dont know what mediactions your grandmother is taking. If it is clearly proved to be tuberculoma then anti-tubercular therapy with proper drugs and dosages should be continued along with close monitoring of her symptoms, physical well being and blood parameters especially liver function testing. For that i will suggest you to consult a pulmonologist for better opinion. Again it is better to also fix an appointment to a neurologist to exclude other neurological causes of such symptoms like cerebellar disorders. An MRI brain should be done if not done yet. If the symptoms are persistent irrespective of adequate treatment then surgical excision of tuberculoma should be considered. Our approach should be step by step. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What was the painful lump in my breast that made me feel nauseated?\n\nI had a partial hysterectomy several years ago. I found a lump in my breast last week that is painful. Had a mammogram and ultrasound and they came back normal. I am still in pain, I m nauseated. I noticed last night that my nipples were purple. But this morning they were normal color. I am on lisinopril and topomax. I do not understand what this could be.",
    "doctor_response": "you must have had infection of breast. Infection need not be picked up on scan. if your breast is tender and if you are feeling feverish, infection is a strong and only possibility and seek treatment for it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What measures can I take to get fair skin ?\n\nThe thing is i have a dark complexion and i want to have a fairer ones so what r the remedies and procedures could you please tell me ?",
    "doctor_response": "If you are looking at going fairer than your original complexion; you need expert guidance. A diet full in Antioxidants like Vit C and Sunprotection will help you fight tanning and regain your original colour back. Lots of water and physical protection like full sleeves; hats etc. also play a good role in Sunprotection in addition to regular Sunscreen application. For removing the tan and skin lightening you can opt for a programme of chemical peels under the guidance of your dermatologist. Also avialable are intravenous lightening agents which you can discuss with your dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any permanent solution for wheezing?\n\nsir, my wife,whos is teacher has veezing for the last 8 years.. having two kids, she is 35 yrs now,..pls advise for a a permanent solution for this veezing.. am taking budamate inhaler now...she started practicing yoga now...please advise me sir..",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your wife's situation and problem. Wheezing since 8 years is commonly seen with asthma or bronchitis. So better to consult pulmonologist and get done PFT (Pulmonary Function Test) for the diagnosis of asthma and bronchitis. PFT will also tell you about severity of the disease and treatment is based on severity only. She is taking only budecort . It contains budesonide. It is inhaled corticosteroid (ICS).  Along with ICS, inhaled bronchodilators are also useful for control of wheezing. Oral antihistamine and anti allergic drugs are also beneficial. So better to consult pulmonologist,  get done PFT and  discuss all these. Don't worry, she will be alright. Hope I have solved your query. I will be happy to help you further. Wishing good health to your wife. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe back and hip pain\n\nhello sirmy cousin is been sufferig from severe back pain near the hips since 5 years.in the beginning the problem wasnt serious but now he cant sit for minutes.he is always lied down on the bed because of the pain.we have tried a lot of scans and consulted a neurologist who has adviced him to take tablets for 6 months.but inspite the pain has not been cured.is it possible to do any type of surgery or back bone disc surgery??",
    "doctor_response": "Hi,I have noticed that his symptoms have gotten worse of late to the point that it pains to sit for a few minutes too. Also you have mentioned that scans were done. Was it a MRI scan of the lower back? If yes, and it shows a normal study then you would need to do dynamic X-rays to search for any disk slippage. On the other hand if it shows a disc protrusion or compression of spinal cord or nerve roots, you would require microdiscectomy surgery after a careful and thorough neurologic examination. Initially you can also go for physical therapy where your pain can be managed with ultrasound therapy and interferential therapy. Hope this has answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for heart enlargement, speechlessness and anemia\n\nMy name is Regina, I have my mum who is seriously sick almost a month now. She is 80 years, she is now speechless, even her vision is not good. She was addimitted because of heart enlargment problem, she is again anemic. Under the consultation of the Doctors the situation is still worse. can you help me?",
    "doctor_response": "hi her age is 80- yearsshe must be having congestive heart failure  ,as the age progresses the systems of body becomes week the muscles etc tears down this process is called aegingher 2 d echo report is very essential to look for the pumping of heart ,and  condition of the muscles of heart before making any comment her lvef  should be knownif dr is saying condition is still worse then you have to wait and watchwithout her medication chart ,her echo reports its very difficult to makle a comment at such a old agethanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat loose motion for 1.5 years old?\n\nMy baby boy is 1 year 5 months.. From last week his stool is in semiliquid state and in yellowish green colour...I think the leafy veg we are giving to him is also not digesting. Today he was having loose motion for three times.. The food he is consuming is also less... But he is active playing.... He had once affected bacterial infection",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.Diarrhoea usually takes 3-7 days to resolve . since it is more than 7 days , you need to be concerned to find cause of prolonged diarrhoea ,  do  consult your doctor .In what amount you are offering leafy vegetable , if bulk is more it itself can cause freq motions . You have to maintain good hydration of your child to prevent and treat dehydration by plenty of fluids, and ORS , frequent feeding .Hope this answers your question. If you have additional questions then please do not hesitate in writing to us.Wishing your baby good health.\u2022DISCLAIMER: - All the information provided here is for information purpose only , it is not a substitute for the advice of a physician after physical examination , it is not intended to replace your relationship with your doctor. This information in no way establishes a doctor-patient relationship. Before acting anything based on this information do consult your doctor. I recommend that online users seek the advice of a physician who can perform an in-person physical examination",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes backache and rashes on the chest of a toddler?\n\nmy two year old has been warm/hot (don t have a thermometer) since about 2. gave him ibuprofen at 2:30. still warm at 6, so gave him tylenol. he is just a bit warm but certianly fussier than normal. he has slept a bit. says his back hurts. he does have some small red dots on his chest, neck and face, but not a lot of them. they look like small bug bites, so i didn t htink much of them. any thoughts? thanks!",
    "doctor_response": "Hello and Welcome to 'Ask A Doctor'.  I have read your query and here is my advice.  With these symptoms your toddler most likely has a viral illness.  Many viruses can cause fever, a red rash of different sizes, and muscle inflammation(back pain).  Should he have a viral sickness, it ought to run its course in 3-5 days.  Hope I have answered your query.  If you have any further questions, I will be happy to help.  Arnod Zedd, MD, FAAP",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest diet plans for high urea and creatinine level\n\nthank you sir, iam 49 years old hyper tensive patient for the past 15 years. now my urea level is 78 and the creatinine level is 2 iam taking b.p tablets, telma 40mg and concor am 5 mg along with nefro safwe forte.  what foods i should strictly avoid and what foods i take",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. You are having hypertensive nephropathy (kidney damage due to long standing hypertension). You should follow these steps for better prognosis. 1. Strict control of hypertension is needed. 2. Avoid excessive dietary salt. 3. Avoid oily and fatty food. 4. Avoid fruits and fruit juices as they are rich in potassium and excess potassium is harmful in kidney patients. 5. Take high protein diet like pulses, protein powder etc. 6. Avoid excessive water and fluid. Take only 1.5 liters fluid per day. 7. Start antioxidants and multivitamin tablets. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent backache\n\nI have been having back pain that is hard to pinpoint. For a month or more it was in my upper back, but lately that seems to have gotten a little better. Now the main source of pain is in my lower back. The pain decreases substantially when I take 2 or 3 ibuprofen tabs. I m afraid of taking too many pills for a long period of time. What do you suggest?Forget it. You have wasted my time. I already have a doctor, I was just hoping to find another way to find a solution to my problem. Apparently this is a scam to make money.",
    "doctor_response": "First of all you have not mentioned your age which is very important in case of back pain. For treatment take some pain killer preferably biozobid-plus or osteonac-th along with some calcium supplements like toscal-gem or shalcal-d once daily. You can do some physiotherapy exercises after an expert opinion of physiotherapy. I will also advice you to sleep on plain surface.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for the loss of 2/3rd of blood?\n\nMy husband lost 2 thirds of blood. .Went to hospital and hey did a bone marrow test and 4 days later they still have no clue what is going on. He needs chemo but they can t start it until they know the true cause... Leukemia. However, they don t know what kind and the treatment for it. Help!",
    "doctor_response": "Hello,Thank you for your contact to healthcare magic.I understand your health concern, if I am your doctor. I suggest you that Until you diagnose your husband's disease it is necessary to give a blood to them. I advice a blood pint to your husband other wise the condition will be very lethal.I will be happy to answer all your future concern. Thank you,Dr Arun TankInfectious disease specialist.Wish you a best health at health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lumps and pain in my underarms after using hair removal cream?\n\nhi. i just bought veet hair removal cream and i used it for my underarm yesterday night. it was ok for awhile but after i wash it clean with the spatula, it started to feel like burning and it was so stingy and i cant describe the situation i was in :( so today morning i checked them out again and i have redness and lumps etc. and it was so pain. i dont know what to do. please help. ;( its my first time using the hair removal cream.",
    "doctor_response": "Hi,It seems that this might be due to allergic reaction to hair removal cream.Apply calamine lotion or triple action cream locally after proper washing with plane water.Take some antihistamine like Cetrizine or Benadryl.Within a day or two it will be alright.Now before using any cream, go for sensitivity test.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for itching and swelling caused by a poison ivy outbreak\n\nMy name is Heather and I went to the emergency room for poison ivy outbreak,doctor prescription of a form of hydrocortisone was $200 , couldn t afford, my question is can I use proctors ol he 2.5 for my outbreak which includes itching,swelling and blisters",
    "doctor_response": "Allergies occur when your immune system reacts to a foreign body. Foreign body may medicine like pollen, animal dander, dust and poison ivy etc. The severity of allergies varies from person to person and can range from minor rash to anaphylaxis. Advice1.\u00a0\u00a0\u00a0\u00a0\u00a0Tablet levocetirizine 5 mg \u2013 1 tablet once daily for 5 days2.\u00a0\u00a0\u00a0\u00a0\u00a0Tablet dexamethasone (Dexona) 0.5 mg \u2013 1 tablet twice daily for 5 days3.\u00a0\u00a0\u00a0\u00a0\u00a0Do not scratch too much as it will caused skin damage and infection4.\u00a0\u00a0\u00a0\u00a0\u00a0Apply calamine lotion \u2013 three times daily locally Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in arm due to shingles\n\nHello, I have had shingles since April 2, 2014. I have no leasions, but the pain and stinging is just awful. It goes from my left arm to my armpit and over my breast. Also my back. I have been on gabapatin for a long time for siasures, and have tryed the patch, now my neuroligist has suggested tigament. Will there be a problem with the gabapatin?",
    "doctor_response": "Hi,Thanks for writing in.Post herpetic neuralgia or pain after shingles is a known entity and distressful to the patient. The recommended treatment for pain after shingle is Lidocaine skin patchesCapsaicin skin patchesAnticonvulsantsAntidepressantsOpioid painkillersYour doctor has given gabapentin which is an anticonvulsant to help control burning and pain. Side effects of these drugs include drowsiness, unclear thinking, unsteadiness and swelling in the feet. However these are temporary and will stop after you discontinue taking the medications. There is another medication called pregabalin and this is also an anticonvulsant.Please do not worry about any long term problems due to medications. Treatment might still take sometime in your case.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are asthalin and budecort inhalers recommendable for a 11 months old child?\n\nMy baby is 11 months old and she was having cold and fever 1 month back , then it was given antibiotics and she got well in 7 days. Now again she is suffering from acute congestion and cough for past two days and doctor has advised us to go for asthalin and budecort inhaler with Spacer.Is it safe to use this at this age and i mean she should not be getting addicted to this inhalers .I am concerned about this , please suggest",
    "doctor_response": "Hi,  As mentioned by you baby had acute congestion ( ie bronchospasm) which is a emergency condition which must  be treated on urgent basis and def requires broncodilator with steroids . Through inhaler these drugs act localy and have least systemic side effect . as baby cannot co ordinate with inhaler so spaced is prescribed . Once your baby is fine doc may taper it n stop .  So have faith in ur paediatrition and continue treatment.Thanks n regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for diarrhea and rash all over the body?\n\nSunday late evening I had severe diarrhea and when I got up I was covered with a rash/hives all over my body. I went to my doctor but my vitals were fine and the rash had disappeared. today friday, again I had severe diarrhea last night and at 3:42 AM had hives/rash all over my body. Being my doctor s office doesn t open early I went to the Urgent Care center. they too, can t figure it out. They gave me a steroid shot with antiitch cream. I am trying to get as many answers as I can to what is happening to my body.",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms seem to be related to food allergy. I suggest using antihistamines such as Cetirizine 10 mg daily. I also suggest using Hydrocortisone cream for local application. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from nausea due to high altitude\n\nI m taking multaq while I m skiing at high altitude. I m not consuming alcohol, and I believe I m drinking enough water. Today, on the second day of this ski trip, I m suffering from nausea. I had no nausea for the last four months at sea level. Could the Multaq be the cause?",
    "doctor_response": "yes multaq used for AF some cases causes, loss of appetite; nausea; vomiting; fever; feeling unwell; unusual tiredness; itching; yellowing of the skin or the whites of the eyes; unusual darkening of the urine; right upper stomach area pain or discomfort.IMP:: pl contact the nearest medical facility for futher advice.without delay",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure broken bone at the tip of the right middle finger?\n\nbroken finger I am a 46 year old male. I broke the tip of my right middle finger bone all the way across. When I went to urgent care at the beginning of May, they took an xray. I went to an orthopedic surgeon right away afterwards where the doctor applied a splint. I was supposed to keep it on for 6 weeks, but it was way too difficult, so I made another appointment. The same doctor removed the splint and recommended surgery to pin the bones together through my finger. It would take about an hour and I d be knocked out. I decided to get a second opinion and scheduled an appointment with a more senior doctor in the same practice. He reviewed another xray of the finger and gave me his take on the situation. His conclusion was that if this were him, he would not have the surgery. So, now after around two months since the injury, I m still in pain. My finger is still swollen and it is bent and slightly deformed. Every time I use this finger it hurts. Every day there s pain because anything I do with my hand involves putting pressure on the wound. The doctor s suggestion was to flex the tip of my finger, holding the majority of the finger, allowing the tip to be exercised. At work I just irritate the injury by typing the keyboard of my computer. Every time I write, open a door, lift my son, grab items, use silverware, tie a shoe, etc. it becomes painful. I don t know how to alleviate the pain and stop the swelling. What can I do? How can I prevent permanent damage? Should I see another doctor? Should I just accept the fact that it s never going to heal properly and the pain will continue? What other options do I have? I m tired of the non-stop dilemma I face consistently. Please help!! Thanks for any help you can provide!",
    "doctor_response": "Hello, As the history indicates there will be an avulsion fracture of the phalanges for which the splint was advised. as in most cases, the bone heals with the immobilization and doesn't need surgery. In case if the patient insists more for other options than surgery is guided. But as per my clinical practice of over 12 years, most of the cases with a fracture to phalanges have to be resolved well with conservative management. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for atrial fibrillation\n\ndiagnosed with afib 3 years ago put on flecanide 50 mg for the next 3 years with no recurring afib irregularities. have taken all heart related tests, ecco, mri, catsacan stress test and blood workup to determine if amyloid is the problem. doctor took me off flecanide and put me on a betablocker to help heart functon. i am also on a bloodthinner coumadine, and the results have been satisfactory. my question for you is it possible that the flecanide could have done damage to my heart thereby possibly eliminating the amyloid theory. many thanks, ronald silverman",
    "doctor_response": "Hello Ronald! Thank you for asking on HCM! I would like to explain to you, that flecainide is generally well tolerated, and doesn't seem to be the cause for any possible amyloid disorders. On a theoretical and practical point of view, flacainide has not been accused of being the cause of such a complication. So relax!Amyloid disorder can easily be examined by performing a skin or other soft tissue biopsy.Hope to have been helpful to you. Greetings!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fluctuating SGPT, diagnosed with fatty lever, gall stones. Guidance?\n\nHi My SGPT Level is varring from 110 to 60 month over month after sonography doctors have diagnosed fatty liver and gall stones my weight is 81 and I am 36 years /Male. I had a pain before 7 years of stone , I am not being able to loose weight even I have stopped eating fatty food however had significant inch loss pls guide forward",
    "doctor_response": "Hi, You need to be treated for the fatty liver followed by surgical intervention for the gall stones. A combination of tricholine citrate/sorbitol along with a ornithine compound should help in treating the fatty liver. Once that is controlled then  intervention for  stones if present can be contemplated. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Emotional fluctuations, irritation, anger, depressed, self injury. Whats wrong with the mental health?\n\nHello I am a female 18 years of age. I m having a lot of highs and lows related to my emotions and often feel annoyed,irritated,angry and depressed and after a few days I have sudden bursts of happiness and this is very extreme as when I am feeling down I sometimes hurt myself for reasons I myself don t understand and sometimes have thoughts of dying but I know I wouldn t kill myself but the thought is still there I am normally a fun loving , adventurous person but with these ups and downs I feel like there is something wrong with my mental state I want to know if I need to see a doctor",
    "doctor_response": "Hello and welcome to Healthcare Magic. Thanks for your query. You definitely need to seek help for your mood fluctuations, suicidal thoughts and self-harming behaviour. Your symptoms could be indicative of a dosorder of emotional instability. You need help to deal with this problem and control your emotions and mood fluctuations. I would strongly advise you to consult a psychiatrist for a detailed psychological assessment and for planning further treatment. Wish you all the best. - Dr. Jonas Sundarakumar Consultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with jaundice.I have diabetes,can I eat Pista and banana ?\n\nI have been diagnosed last week for Viral Jaundice . My bilrubin total is 3.26 & SGPT 331. Can I eat Pista and Banana? My age is 35. I have diabetes since 2006. Last week I have done my HBA1C test and my result is 7.",
    "doctor_response": "Hi Shabana, It appears that your liver enzymes are returning to normal limits gradually. Do Get back to your anti diabetic drugs once you are cured of hepatitis A. Wish you a speedy recovery Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have PCO, bleeding, lower abdominal pain, low potassium. Done pregnancy test. Taken ovulet and duphaston. What now?\n\nIts been about a year since ive first used cocaine and i have probably only done it a handful of times from then until about 4 months ago only doing about a line or two at a time, i have had to EKGs done in the past year and both were fine and okay, my blood pressures fine, and so is my blood minus a little low on potassium but has since been taken care of, i have developed anxiety badly due to this thinking im going to die any minute and that i have done irraversible damage to my heart, sometimes i get weird feelings and it scares me to no end i have been to the emergency room twice in the past 2 months, i need some advice as to what you might think",
    "doctor_response": "Hello,Thanks for posting to HCM,Over the short-term, with self-limited illnesses like gastroenteritis with vomiting and diarrhea, the body is able to regulate and restore potassium levels on its own.Oral suppliment pill also given in mEq measurment.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am getting lumps in both armpits. Are these lumps serious?\n\nHi doctor, I am a 22 year old female. I am getting lumps in my armpits and they are painful. I sweat a lot. I have dark underarms and it is itching too. Are these lumps something serious? Should I consult a doctor?",
    "doctor_response": "Hi. I have read your query in detail and viewed the attached picture (attachment removed to protect patient identity) and do understand your concern. These could be enlarged lymph nodes. They may occur when there is a source of infection in the body. Another possibility is secondarily infected fungal infection. 1. A course of oral antibiotics is required for one week. You can take Co-Amoxiclav (combination of Amoxicillin and Clavulanic acid) 625 mg thrice daily for five days. 2. Along with that, you may take tablet Serratiopeptidase which will help to control the pain and inflammation. 3. Topical antibiotic like Fusidic acid to be applied over it twice daily for one week. After one week, we will access the condition and further treatment will depend on that. Try to keep this area dry. You can use Aldry lotion (Aluminium chlorohydrate) overnight for the same or use an antifungal dusting powder. Revert back after a week to a dermatologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from abdominal pain and nausea, feel knot below rib. Is this normal after Macrobid?\n\nI just finished a week of macrobid on wednesday night. during which I had a lot of abdominal pain , nausea . Now I still have nausea a black hard stools . And feels like a knot below my right rib. During macrobid my stools were all different colors, green, reddish brown , brown, and now black. When I wake up after hard night trying to sleep, a lot of black stinky stool. Now its hard to lay down the knot feeling below rib makes me sick and nauseous. Is this normal after macrobid? I thinky I had gallbladder issues before but this is lasting almost all day.",
    "doctor_response": "Hello! Thank you for the query. If your stool is black like a tar and has strange smell (not like regular stool, more like digested iron) this can indicate bleeding from peptic ulcer. Macrobid is mild antibiotic which like every medicine can irritate digestive tract. However bleeding from peptic ulcers seems to be unrelated. Upper right abdominal pain can be also caused by gallstones, however usually it radiates to the back, gives nausea and vomiting. It appears after a meal. I suggest you to visit your doctor as soon as possible. Bleeding should be ruled out (blood work and upper GI endoscopy should be done). Abdominal ultrasound should be performed in case of gallstones possibility. Hope this will help. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why does my daughter get bumps on her buttocks when she sweats a lot?\n\nHi doctor, My child keeps getting these bumps. The doctor tested for bacteria and fungus, but both were negative. Any ideas on what this could be? It does not bother her at all. It is itching now, but it goes away when I put Triamcinolone ointment on it. But, I do not want to keep using that since it thins the skin. Any thoughts on this? The child is highly active. She plays hockey and sweats a lot. It seems to be worse after hockey.",
    "doctor_response": "Hi. I need the following information: Regards. Revert with more information to a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen and painful lower legs\n\nmy lower legs have been swelling for the last couple of days. Today my feet are very swollen and changing colors, right new they are both red from my toes almost to the top of my feet. both of my ankles are very swollen. I ve not any type of accident, my blood pressure is normal?",
    "doctor_response": "Hi Thanks for your query and Welcome to Healthcare Magic. I am Dr Akshay from Fortis Hospital, New Delhi.There are many causes of swelling in the legs. Most common reason is postural and many patients develop it when they stand for a long time, but as soon as they elevate their leg up , the swelling subsides.It can happen after any injury which is a priority to diagnose and treat accordingly. Also there could be infection or inflammation which can lead to swelling. Sometimes heavy physical activity may also lead to swelling in your calf muscles .But we have to look at medical causes as well, chronic cardiac conditions can lead to swelling, any pathology which leads to low proteins in the body like deranged LFT, KFT etc can also lead to swelling.Hypothyroidism can also lead to generalized swelling like appearance in the body.Also red discoloration can be due to inflammatory/ infective pathology, or it also be die to an underlying vascular cause but unless a thorough physical examination is done, no comment about the aetiology of your condition can be made.For accurate diagnosis we also need to clinically evaluate and get appropriate tests :CBC, ESR, CRP, LFT, KFT, Serum Electrolytes and Thyroid profile .Please get back to me should you need more information or with test results.  Do not hesitate to contact me if you need any further assistance.You can also discuss your case and treatment plans with me in a greater detail in a private consultation.Thanks & RegardsDr Akshay Kumar SaxenaConsultant Orthopaedics Fortis Hospital, New Delhi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the odd in my chest x-ray and liver scan report.\n\nHi doctor, I am done with my chest x-ray. But, I am\u00a0worried and I do not want to wait a week for my doctor's opinion. So, I have attached it. Please convey your opinion. Thanks.",
    "doctor_response": "Hi. I have seen your chest x-ray (attachment removed to protect patient identity). For further information consult a radiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red leg rashes?\n\nHi my child is 4 yrs old & developed red rashes on her both legs below knee ,mostly on the front side , doctor has prescribed azithral xl 200 dosage ,so hw much time approx it will take to recover & what could be the cause for the same . Thanks shekhar",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. There are multiple causes for rashes on leg and in my opinion your description is not enough for me to arrive at an diagnosis. As your doctor had already prescribed Azithral XL, do continue it for prescribed duration and follow your doctor's advice. You can also consult a Dermatologist. But do not delay treatment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Siva Subramanian",
    "dialogue_context": ""
  },
  {
    "patient_message": "How safe is taking prednisone for polyomyositis?\n\nmy 37 year old daughter is experiencing severe muscle weakness, and pain. It started in her legs and then her arms. She has trouble lifting her arms . She recently had a muscle biopsy and we just learned that the biopsy did not show anything, as the Radiologist put it, it may have been a bad biopsy?? My daughter is being treated for polyomyositis, and was prescribed Prednisone steroids, she has been taking the steroids for a period of three weeks but there does not seem to be much improvement. Just a thought: she took a heated 113 degree yoga class a couple of months back, would that somehow exhaust her musceles? My daughter lives in Colorado. Do you have any recommendations? Thank you.",
    "doctor_response": "Dear Sir/MadamI have gone through your query and read your symptoms.In my opinion, if a course of steroids for 3 week has shown no improvement, the diagnosis of polymyositis needs to be reconsidered.I hope that answers your query. If you want any more clarification, contact me back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can cause vaginal discharge after three months of delivery?\n\nHello doctor, Three months ago, I had a forceps delivery. Now, I am experiencing heavy vaginal discharge. I guess that comes from below my clitoris. I can see mucus like discharge in and around clitoris. When I sit, I feel a gush below clitoris. My doctor said there is no problem and I am normal. But, I am so tensed and the discharge is in light yellow color. I am often affected by urinary tract infection too. Please help.",
    "doctor_response": "Hi. Revert back with the answers to the above questions to an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from Blood vomiting, memory loss, weight loss. Variation in liver function test. Is it Cirrhosis?\n\nMY HUSBAND IS HAVING SYMPTOMS OF LIVER PROBLEMS...HE WAS TOLD BY AN EMERGECY DOC THAT HE HAS LIVER DAMAGE...HOWEVER DID NOT MAKE ANY BIG DEAL ABOUT IT AND IT WAS JUST MENTIONED HOWEVER AFTER RESEARCH I HAVE FOUND THAT ALL OF HIS SYMPTOMS ARE CONNECTED TO THE LIVER ISSUE...I WANT TO KNOW IF HE HAS CIRROHOSIS OR ALCOHOLIC HEPATITIS??? AST 169 ALT 39 BILI 1.8 ALK 277 5 YRS AGO THE BLOOD WORK SHOWED AST 205 ALT 186 BILI .07 ALK 91 SYMPTOMS: STARTED ABOUT 6YRS AGO... VOMITING BLOOD (A FEW TIMES) VOMITING 1-20 TIMES PER DAY MUSCLE WASITING WEAKNESS/ NO ENERGY (OUT OF BED 1 HR BEFORE GOING BACK TO BED) MEMORY LOSS - SHORT TERM DIZZINESS / FAINTING BRUISING BLOOD NOT CLOTTING PROPERLY YELLOW EYES AND SKIN PALENESS INSOMNIA TREMORS IN HANDS AND ARMS CHILLS NOSE BLEEDS STOMACH PAIN UNDER RIB CAGE RIGHT SIDE WEIGHT LOSS CONFUSION DARK URINE TESTICLES SHRINKING DIMINISHING SEX DRIVE",
    "doctor_response": "Hi, The features which you described are typical of liver failure. The patient requires admission to hospital immediately under the services of gastroenterology  followed by aggressive investigation and treatment to improve the survival of the patient. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent bowel movements and sweating after taking Rexipra?\n\nhai i m suffering from anxiety and depression. i m taking lonazep 0.25 in morning n 0.5 in night. and also taking rexipra 10 mg in morning. i m getting motion problem often. sweating often. is these because of the meditions. is there any alternative medition with less side effects.",
    "doctor_response": "Hello,Rexipra may cause constipation and decreased urine output. But it may not cause sweating, it may be due to hot climate or cardia problem or hypothyroidism etc. Until examination is done it is difficult to say what it is. Please consult with your physician he will check for above conditions with ECG and thyroid profile then treat you accordingly.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Posterior cervical swollen, scab on lower back of head, rash on face, sore throat, fatigue, loss of appetite. Reason?\n\nPosterior cervical is swollen on the left side and I have a scab on my lower back of head. I had a rash on my face. Then a little sore throat which went away. Then runny nose and sneezing , thought it was allergies. I have been congested & breathing through my mouth when sleeping. Left side of tongue gets dried while sleeping. Prior to all of this I was fatigue , loss of appetite, etc.",
    "doctor_response": "THESE ARE ALLERGIC AFFECTS THE ALLERGIES ARE AFFECTING YOUR DIFFERENT ORGANS AND LOSS OF APITITE AND FATIGURE SHOW YOU ARE ALLERGIC TO FOODS MAY BE MILK WHEAT POTATO RICE NUTS AND CHANA ANTI ALLERGICS MONTAIR FX BD TAKEN CONTINOUSLY CAN SUBSIDE ALLERGIC SYMPTOMPS APPLY NEOSPORIN H EYE OINTMENT IN NOSE BD AND SEA WATER 2 DROPS IN EACH NOSE AT NIGHT THIS WILL PREVENT NOSE BLOK AND DRYNESS ADD LIQUID ANTACD BD YOU CAN TAKE IT TILL YOU GET BLOOD TEST FOR FOOD SPECIFIC ANTIBODIES FOR MILK WHEAT AND OTHERS FOODS WRITTEN ABOVE AND START WITH PERMANENT RX FOR ALLERGIES",
    "dialogue_context": ""
  },
  {
    "patient_message": "Blood taste in mouth. Done radiotherapy for HPV pos tonsil cancer. Normal?\n\n34 year old female non smoker. 12 weeks post radiotherapy for hpv pos tonsil cancer stage 1 no nodal involvement. Pet scan showing small activity but oncologist is not concerned and will repeat in 8 weeks. I keep getting a blood taste in my mouth is this normal? I m still sore in my tonsil area it s been 3 months post treatment Is this normal",
    "doctor_response": "Hi, test alteration may be due to radiotherapy. PET  scan at 12 week is a good indicator of disease assessment. mild activity does not signify anything. follow your oncologist's advice. blood test will not be very helpful only for prognostic purpose HPV titre can be done. anyway you will be fine. do not worry. I Think you have cured from disease.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a horizontal cut on eyebrow of an infant?\n\nHi, my 15 month old son fell and cut horizontally through his eyebrow 2 days ago, it was glued back together and 2 steristrips were placed over the wound. They are understandably beginning to peel off as they're stuck to his eyebrow and he rubs his face when he's tired. If they fall off should i be concerned/take him back or do nothing?",
    "doctor_response": "The doctor had done the right thing in fixing it that way. Generally steristrips, dermafix strips or dermabond glue is used to appose the skin properly. The healing occurs spontanously without leaving much scar if the apposition is proper. If the steristrips get peeled off, you would have to assess, how much healing has already occurred. If the wound has already closed reasonably and there seems less chances of gaping, you need not worry and can leave it like that. But if you feel that there are chances of separation, you can take the child back to the doctor who can put steristrips back again. The maximum difference that can be there is in the amount of scarring and nothing else.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pityriasis rosea\n\nI have pityriasis rosea and have been told by my family MD that there is nothing that can be done I am 2 months in and no sign of slowing down, it is taking over my life! For the past month I have been eating a raw vegan diet and juicing also taking oregano oil daily. Is there anything else at all that might help??",
    "doctor_response": "Hello, Pityriasis rosea\u00a0usually clears up in 8 to 10 weeks. I recommend using an over-the-counter topical medication such as calamine lotion or zinc oxide. I recommend using antihistamines for the itching such as Cetirizine 10 mg. Hope my answer was helpful. If you have further queries feel free to contact me again. Regards, Dr. Dorina Gurabardhi General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in flank caused by stones\n\nI have MSK and constantly have flank pain. I ve had a lithrotrisy Sept 2014. I just had a CT and my results show I have two 3mm stones non obstructing. therefore i m told I shouldn t have pain. This is so frustrating. I pass gravel all the time as well. I am currently in a MSK group online and so far is the only place I can go to where i m not made to feel like i m crazy. does anyone know of a doctor in the Florida area that knows about this disease. my left kidney is has the most calcification. any information will help thank you",
    "doctor_response": "Hi, You can take analgesics/antispasmodic combination like Acetaminophen/Hyoscine combination for symptomatic relief. If symptoms are severe, you can consult a urologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for diabetes and high BP\n\nhi  dr.. shankdhar i am 62. i am diabetic and have and bit high chlestrol but not taking any medication yet. I have high blood pdressure. In couple years my physician has tried couple medications i suffer from side effects. At present i am taking amplodepine and i am suffering with effects in my legs which is making my walking so difficullt. please advise me medication for blood pressure which has no side effects or least side effects with which i can live.",
    "doctor_response": "It would be helpful to provide medications and side effects of prior medications tried because we may suggest medications that cause harm. I would however hope that you are placed on ACE Inhibitor since you are diabetic. And also how high are your blood pressure measurements.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes darkened pharyngeal wall?\n\nHello, I have a darkened pharyngeal wall, almost turning dark purple, also pain around my eyes, and my heart beat is noticiable faster and strong even when just sitting and doing nothing, lots of stomach noises, no diahrreah but interminttent light pain. Also to the side of liver different kind of pain but inttermitent as well. Could be all because a tooth infection?",
    "doctor_response": "Hi thanks for asking question.Here are few possibility.1.If you have toothe ache with abscess over gum then it might lead to bacteremia and affection of multiple organ.antibiotic needed for it.2.Second if you have abdominal pain, anorexia,weight loss like symptoms viral hepatitis could be cause.serum viral marker or ultrasound examination done for it.3.If you have associated cough and fever then respiratory cause like rhinitis , cold,bronchitis etc.has to be thought.antihistaminic with antibiotic needed for it.4.If predominate bowel problem then gastroenteritis may be the cause.Do your complete blood examination.If neutrophilia bacterial infection thought and if lymphocytosis viral infection might be cause.If bacterial infection suspected antibiotic needed.I hope my suggestion will help you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful red spots at the bottom of the foot?\n\nMy friend is 66. He has many red dots on the bottom of his right foot,  arch area,  and  the skin is peeling off on the bottom of this foot. This has gone on several weeks.   WE did soak his foot in Epsom salts.   Now he says it is getting painful to walk on.    He had polio in his other leg as a child.",
    "doctor_response": "HelloWelcomeI am have read your concern carefully. The history you have presented me with is not sufficient for me to understand what exactly happened and when it happen. Red dots as history is inconclusive of any condition. Skin peeling is a natural phenomenon, however in some cases it very significant. FOR PAIN you can give him diclofenac sodium once daily till the pain persists and then stop its intake and apply volini spray whenevr it hurts. AND I KINDLY REQUEST YOU TO PLEASE POST ANOTHER QUERY WITH MORE SPECIFIC DETAILS.We are always here for your help.TAKE CARE",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for an indentation in a leg?\n\nHi. I had an injury to my right shin over 15 years ago. I hit a fire hydrant as I was riding my bike which caused my chin to get caught in between the two. My chin was facing outwards and the fire hydrant smashed my shin which caused in to push my skin in, as a result I had a slight indentation and severe swollen. Over the years I was told I had nerve damage due to the accident, and I always had a very slight indentation. A few days ago I noticed my shin was very sore. It has been sore for a while but it went away and never thought twice about it. Just recently I go to rub it because it was sore, and I realized I have a massive indentation in my leg. It is very noticeable especially when you feel it. I am confused because it was many years ago and now it is taking affect. Thank you",
    "doctor_response": "Hi you had a minor accident  injuring your right  shin about 15 yrs ago and you feel indentation on your shin which is  increasing now. At that time you were told that you have nerve damage . In my clinic practice , for this kind of unilateral swelling with previous history of injury , i will investigate on the lines of Deep Vein Thrombosis, by getting a color Doppler as a first step. Also I would  give you compression stockings , anti inflammatory pain killers and limb elevation for a few days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does getting mensus through intake of tab divery safe?\n\nmy co sis has taken tab.divery for getting her menses which she had not got since 2 months....her pregnancy test was negative n on intake of divery tab for 5 days she got her menses but the flow is not like usual menses.... is it normal or any problem ?",
    "doctor_response": "Hello,I have gone through your query and here is my advice. As per your history you have taken tab divery only once so it is safe to get menses through these tablets. As no medicine is completely safe, and if you have any side effects then immediately consult your gynecologist. Watch for symptoms like dizziness, excessive bleeding, abdominal pain. Till then keep your self hydrated and eat healthy diet. Hope I have answered your query, let me know if I can assist you further. Regards, Dr Shyam Kale. General and family physician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for having painful lump on back of head\n\nHi, I Have small lump on back of my head it is painful wen a put presure on the lump , i have had it for 3 years now , the lump is like size ov a pee but it has got bigger over the years it did start off really small but naw its bigger . do u know what i should do about it .",
    "doctor_response": "Hi,Dear,Thanks for the query to HCM. I studied your problem in depth and I understood your concerns. Cause and plan of Treatment-In my opinion on the given data,you seem to have Sebaceous Cyst,which is painful from the combing trauma.Treatment is by-Cold compresses/Voltaren Gel locally / antibiotics 5 days time.IF it is reduced good, if not go to ER Surgeon.So I would advise you to consult a ER Surgeon.Hope this would resolve your issues.Act fast.So keep cool and Consult your  ER Surgeon, if need be , who would treat it accordingly.So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you, but just ask a query to HCM and be comfortable to resolve your health issues.Welcome for any more query in this regard to HCM.Write good reviews and Click thanks if you feel satisfied with my advise.Have a Good Day.Dr.Savaskar M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent tenderness in the front upper tooth?\n\nI'm 45 years old, 6ft tall and I weigh 160lbs. I went to the dentist because I thought I may have an abscess tooth (tenderness, tooth felt loose and a small swollen vein coming from the tooth). After an x-ray, they determined the upper front tooth looked healthy, but my teeth needed a deep cleaning. I was given a full pan x-ray and a deep cleaning at my next visit. I was informed I needed one back tooth pulled and my wisdom teeth extracted. Otherwise, they saw no problems. Three weeks later, the upper front tooth is still bothering me .... same symptoms only not as uncomfortable as it was before the cleaning. What could the problem be?",
    "doctor_response": "Hello,I can understand your concern. It seems that the investigations and treatment procedure your dentist has followed is correct as the x-ray showed no pathology with the tooth and the deep cleaning has made you feel somewhat less uncomfortable. What you have is periodontitis or inflammation of the tissues surrounding the tooth including gums etc. Periodontitis or Pyorrhea is a kind of problem that only dentist cannot solve it for you. It requires equal efforts from the patient at home. I would advise you to start using a mouthwash that contains Chlorhexidine (Chlohex). You can take about 15 ml of this liquid and should squish it around mouth undiluted for about a minute and then spit. No food or drinks should be taken for 30 minutes after its use and do not use it immediately after toothbrushing.In addition, you can use gum paint (Gumex). It is a bottle containing oil like liquid. You should take about 2-3 drops of it and should massage your gums in the circular motion in the area that is bothering you. This should be done for 10 minutes every day. You should also brush twice a day, floss every night and should gargle after each meal. Visit your dentist after 21 days of the initial appointment for follow up cleaning. Gum diseases take time to heal but proper care at dentist's office and at home can surely provide good results.I hope this information helps you. Thank you for choosing HealthcareMagic. I wish you feel better soon.Best,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Has dementia, unhappy with life. On pristiq, finished radiation for prostate cancer, no side effects. Solution?\n\nBrother has dementia not real bad but very unhappy all time don't like his life has a caretaker and dog lives at his country eats lunch in town very day goes to church has what I think s good life lot of relatives living close. He is on pristiq  in excellent health except recently finished radiation for prostrate cancer had no side effects. Don't know how to help.",
    "doctor_response": "HIThank for asking to HCMFor dementia there is certain medicine available but that does not give satisfactory result, I think if the dementia is due to the geriatric age then it is untreatable only thing you can do is the moral support, give long company, talk with him, have nice days with your brother.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the suggested dosage and side effect of zyncet syrum?\n\nhi my name is hodan and i would like to find out about zyncet syrum and its side effects and dossage. my daughter is about 2.5 and is taking this medications. she has tonsils and thats what was prescribed for her but i have my doubts as she has no allergies. thank you",
    "doctor_response": "Hello,I read carefully your query and understand your concern. Zyncet 5 MG Syrup is a very effective and potent medication to treat allergic symptoms.So,if the symptoms are related to an allergy, this medication is correct. In other case,the medication may only help in relieving the symptoms. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get THC out of the body before surgery?\n\nhi i smoke pot on a regular basis, just found out today that i got into surgery a lot quicker than planned. theres no doubt in my mind thc will still be in my system by this time, but will i be okay? should i exercise vigorously and drink lots of water etc.?",
    "doctor_response": "Hello, Yes, exercising & taking plenty of water will help THC get washed out of the body system. But in the meantime, you will have to make healthy, nutritious homemade food in plenty. It effectively helps to do away with THC. If your metabolic system is good, you are young & have not been smoking pot for years (for a long duration). It will come out of the system faster. In case you are a chronic smoker of pot for years, you are suggested to get connected to a detox center, you may have withdrawal symptoms that will require to be managed urgently for a successful detox. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Nupur K, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a cyst under penis indicate?\n\nI have a cyst under my penis. It showed up when I was 14. Long before sexual activity. I m 35 now, it was always small, and never hurt or annoyed me, just this last week it became larger, swollen and red. It kinda hurts. Been applying warm water frequently, it seems to help. But looks like it wants to pop. I don t have health insurance. So is it an expensive procedure to have removed? Or is there something I should do?",
    "doctor_response": "Hi. It seems to be a sebaceous cyst. That is the commonest swelling in that area. You should see your GP or a Surgeon and get it removed if it is causing problems. If not then you can leave it alone. Its a minor surgery and can be done on OPD basis. No hospital admissions required. Do let us know if we can help you with any other query. You can contact me directly by leaving a Specialist question. Take care. Dr Rishi, New Delhi, India.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could recurring chest pain indicate?\n\nLast month lasting for around a week i had slight chest pains every now and again. This month i've had the same chest pains but also my heart is hurting - not all the time but most of the day. I'm a 25 yr old female. This has only happened over the last 2 months but i'm worried about my heart. What could this be and what do u recommend?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Chest pain in any age should be investigated for heart diseases first. So first get done ecg, 2d echo and stress test (trade mill test). If all these are normal then no need to worry for heart diseases. Stress and anxiety can also cause similar kind of chest pain. So avoid stress and tension, be relax and calm. Don't worry, you will be alright but first rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes redness on face of a child?\n\nMy 19 month old son got the top part of his ear lobe pinched pretty bad under the ottoman of a chair. He never acted like he was in so much pain :( a purple spot about the size of a nickel instantly showed up and that whole side of his face is red. do I take him to the hospital?",
    "doctor_response": "Hello. I just read through your question. Sounds like he has a bruise as a result of The injury. This is generally nothing to worry about. It resolves on its on after a few days, sometimes a couple of weeks. There is no need to go to an ER.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for meningitis\n\nI just had a spinal tab to diagnose meningitis. Within 15 minutes had horrible abdominal and uteran cramping. Shortly after followed by large clots as if my period had started but it is not due for 3 weeks and I am extremely regular. Can lumbar punctures induce menstruation.? It was not a smooth nor successful procedure.",
    "doctor_response": "Hello Thank you for trusting HCM Dear lumbar puncture won't cause early cycle induction, may be stress or hormonal changes can cause this problem. Treatment for meningitis depend on the cause. Is it bacterial or fungal etc. Please consult your doctor he will examine and treat you accordingly. I think I answered to your question if you have more questions please feel free to ask me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Mupirocin ointment better than the nasal version prior to a surgery?\n\nI am having knee replacement for the second knee. My surgeon prescribed mupirocin to be used in the nostrils for 5 days before surgery for the second surgery. I noticed that the pharmacy had filled the rx with Mupirocin Ointment not the nasal version. Is it acceptable to use it again or should I get a new rx with the nasal version?",
    "doctor_response": "Dear patient you should read the instructions on the label of ointment. If it is not intended for internal use like nasal mucosa then you should not use it. If only clearly mentioned on the label that mupirocin ointment can be used internally then you can apply it on nostrils. otherwise you need to change prescription.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to control high blood pressure without medicine?\n\ni am aged 62 and  have blood pressure 100-160. the doctor prescribed to take olmighty 20 every day morning after breakfast. My question is - if it is possible to  control the pressure whether i take any exercise or  change my food habit instead of taking the olmighty medicine?",
    "doctor_response": "hello ,thank you for writing in to hcm.Since you are 62 years old, the hypertension is essential hypertension due to advancing age. Hence only exercises and diet control will not help you attain the normal Blood pressure levels.You need to take the medication Olmesartan Medoxomil 20 mg  (olmighty) as this will protect your heart and blood vessels from the ill effects of hypertension.Also along with medications, a low salt diet, exercise like brisk walking daily, eating a healthy non fatty diet consisting of good amounts of fruits and vegetables will help you control your BP well.Regards ,Dr.Riyanka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be concerned if having a hypodense lesion/cyst in kidney?\n\nHello, about a month ago I was in the hospital for an abdominal problem. That was resolved but I noticed on the ct. scan it showed a 1cm hypodense lesion in my left kidney. The notes said it was possibly a cyst. No one addressed that. Should I be concerned and bring it to the attention of my dr?",
    "doctor_response": "Hi,Thanks for writing in.It is in most probablility a harmless cyst. These are thin walled fluid containing balloon like structures. After age of 50 years one or two cysts are expected and taken as normal. If the size is more than 3 cms then it is best to get review ultrasound scan after 3 months to 6 months. There is an international classification of kidney cysts and any cyst above 3 cms might have a rare possibility of being dangerous. Since your cyst is 1 cm in diameter, there is no need to worry and you can get an ultrasound scan after 1 year for peace of mind. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is swollen and ripped frenulum in tongue after piercing serious?\n\nMy girlfirend had a piercing in tonuge in the frenulum... She changed the piercing 5 days ago, and the new one wasn't very good, the frenulum swelled, and now it rippid, she says it torn the frenulum and now she is scared.. can you please help us and tell us what to do? will it heal from itself or should she visit a doctor?",
    "doctor_response": "Thanks for asking in healthcaremagic forum   As she is having swelling, either it is inflammed or infected. SO, if I were your treating doctor I would have prescribed you oral ans local antibiotic mouth washes for relief. Please consult your doctor at the earliest. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does it take to produce a healthy sperm after taking testosterone?\n\nI was born September 1970 I was on Testosterone Cypionate 200mg/cc. The weekly injection is .75cc I STARTED TAKING TESTOSTERONE ON 3-25-11 I STOPPED TAKING TESTOSTERONE ON 7-13-11 On 6-24-11 my estradol was 69. My total testosterone was 639 , my free testosterone was 149.5. How long after stopping testosterone will it and estradol go out of my system. In what month will I have normal healthy sperm ready to be used for ICSI IVF.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You have not given semen analysis report and details of FSH LH TSH etc. Testosterone will not increase sperm count . Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the preventive measures in case of slippage or breakage of condoms?\n\nHi doctor, I am a 37 year old heterosexual male. I am HIV negative with no known STD.\u00a0I always have safe sex.\u00a0I always have very safe sex with girls who are not sex workers. But may have casual sex with others. Generally, I would imagine that they too would be practicing safe sex with their regular boyfriends, then really I do not see statistically being any real chance of contracting HIV or any other STD. I too have had casual sex with a number of such girls. If I continue these activities with multiple partners of the same profile then chance of contracting HIV or STDs should be next to zero. Is this correct?\u00a0In two situations like condom coming out or breaking, but the sex act being stopped immediately, what would be the chance of my contracting HIV or any other STD?\u00a0What other immediate preventive measure should I take if the condom breaks or comes out other than stopping the act?\u00a0Should I take Truvada immediately? If yes,\u00a0for how many days should I take it to become effective? Does it become effective from day one? Can one take it few days before sexual intercourse and stop it in between and again restart it?\u00a0Do I need to do any blood test for HIV or other STDs in case the condom breaks or slips out? If so, what are the blood tests that I need to do and with how many days gap?\u00a0Is there any STD one can get from skin to skin contact without genital contact.\u00a0Is there any STD one can get from accidental genital contact and what preventive measures should be taken if this happens?\u00a0Can one get an STD from kissing? Only once in my life, around two to three years back, I had intercourse without a condom. I had myself tested for HIV six months later and it turned out to be negative. I have not had any symptoms of any STDs, but should I still get myself tested for any STDs and if so, which test should I do? Which condom size should I use? My penis is 7 inches in length and 7.5 inches in girth. Do I use XL or XXL? I do not find any condom which supports 7.5 inch girth. What should I do in this case?\u00a0It seems that if the partner is HIV+ then it would be a statistically low probability that with one sex act with protection?\u00a0Would it not be better to take Truvada regularly to be on the safer side? What are the side effects of taking Truvada regularly even if one is not at high risk?\u00a0Should I use any lubricant with the condom?\u00a0Should I get a hepatitis B shot? I am not sure whether I hav",
    "doctor_response": "Hi. An unsafe sex increases the chance of contracting STDs (sexually transmitted diseases) as well as HIV (human immunodeficiency virus). As you mentioned that the status of your partners are mostly not known, so this puts you in risk of contracting STD or HIV if you get involved in unsafe sexual practices with such partners. In case of slippage of condoms or breakage of condoms, puts you at risk, which cannot be neglected while having sexual intercourse. First and foremost important thing to do is, to stop the act and wash your genitals with mild soap under running water. Avoid applying any cream or lubricant that can cause irritation to genital skin. Besides this avoid promiscuous behavior. There is no need to take Truvada (Emtricitabine and Tenofovir Disoproxil Fumarate) until and unless you know the HIV status of the partner with whom you have had unprotected sex. Viral infections such as genital warts and herpes can be contracted by even skin to skin contact. For accidental genital contact, firstly get the STD profile done, and then if required start the treatment for the respective STD that is detected on testing. In your case you should use XL size condoms (extra large), which can be procured from a medical store. Having an unprotected sexual intercourse with a partner who is HIV+ then there is always a risk of contracting HIV, you cannot neglect it or can take chance of not contracting HIV by having sex only for once with such person. If you are not sure about vaccination and as you are involved in unhealthy sexual practices then you should get your hepatitis B done. For further clarification consult a sexologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for child having bit larger chest bone on left side?\n\nHi, My 13 yr old son's chest bone is quite a bit larger on the left side. It is hard to touch, and he says there is no pain but is adamant that he does not want to see a GP. He is usually healthy and recovers quickly from colds etc. He is often very pale even though he takes multi vitamins with iron. It really is quite worrying, and I will drag him to see a doctor next week, but in the mean time can you shed any light on this? Thank you from a very concerned Mum!",
    "doctor_response": "Hello,I think this enlargement is osteochondritis of the ribs joint in the sternum. Happens in teenage while growing. It is not dangerous as it does not compress the heart and lungs but sticks out. It is more of a cosmetic issue.Your doctor may send you to orthotic center to use a course (custom made body brace) for a while until gets straight.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Edvin Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for warts on the hand\n\nHello I am a 50yr old white male. I having an issue with my right hand, I have a sore on it that looks like a wart. But what so funny is that it hurts so bad. When I hit against something and pump it against things. It is hard and has a red ring around it. what is this problem.",
    "doctor_response": "Hello dearWarm welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  Suggestions for possible wart on hand-  Better insight would be there if you attach one photo pic herewith as an    attachment .-  Soak hand in lukewarm water 5 minutes each session 3 times a day .-  Local application of polymycin cream 3 times a day .-  Surgery may be one of the option where all remedies do not give    satisfactory  results .Hope this will help you .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does flank pain in left side with burning sensation in back indicate?\n\nI have left side flank pain that radiates to the front. I have bad burning in the back under the lower rib and slowly radiates up. I also have pain under the front left rib. The pain never goes away and has been getting worse for the past couple of months. The flank pain is going to drive me insane.",
    "doctor_response": "Hello, I have studied your case.Your  flank and back pain can be due to muscle strain or renal calculi.You may need x ray and Ultrasonography.And also check your vit B12 and vit D3 level.Medication like methylcobalamine and analgesic will reduce pain.You can do yoga exercises and focus on spine extension exercises.You may consult physiotherapist for guidance. He may start TENS, or ultrasound which is helpful in your case.Hope this helps. Wish you a speedy recovery.  Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can I get free from the habit of smoking?\n\nHello doctor,Give me a suggestion to free from smoking. I am very upset about smoking.",
    "doctor_response": "Hello. It is very difficult to quit smoking in a heavy smoker. Gradually you should decease the quantity of daily smoking. Suppose, if you are taking 10 to 15 cigarettes per day, then decrease it to 3 to 4 per day and then gradually 1 to 2 per day and finally stop it. You might have its withdrawal symptoms, Nicotex (Nicotine) like tablet will be beneficial to quit smoking. You can drink more water and perform an exercise like swimming during smoking withdrawal. Be confident and sure enough to leave smoking habit. I suggest you consult a good smoking de-addiction programme. They will help you through a counseling session as well.  For more information consult a general practitioner online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes muscle cramps after changing BP medication?\n\nHi, my mom is having muscle cramps every night now for the past four to five weeks. This started after her doctor started changing her blood pressure medication, everytime he has changed this she has had an allergic reaction to them, (swelling of th lips and throat), now she can t sleep through the night and sh has no energry whatso ever. This is all the way out of the park for my mom to feel this drained. Could her electrolytes be out of order or could it be Hypocalcemia? Any suggestions would help",
    "doctor_response": "Dear patient Muscle cramps can be caused by electrolyte imbalance and hypocalcemia. If your mother was prescribed  diuretics class of antihypertensive ,  they may lead to electrolyte imbalance and subsequently  cramps.  I would like to advise blood checked for serum electrolyte level. Get it checked from reputed lab nearby you. You  need to consult your physician with report. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any danger in using alcohol before stent replacement?\n\nMy husband is due to have a stent fitted tomorrow in one of the arteries to his heart, he does drink everynight and I am worried he will struggle not to have a drink as he uses alcohol as a painkiller from when he broke his back so he can relax it when he goes to bed,",
    "doctor_response": "You have made an important observation. Make sure that the doctor knows of your concern. Withdrawal from regular alcohol use can be very dangerous. There are a host of medicines, family members of valium, that can be used or made available to him. After all is done, try to get your doctor's help to get him some help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please suggest medicines for cough in a 4 month old.\n\nHi doctor, My 4-month-old baby girl is coughing from the last five to six days. It enhances at night. Please suggest medicines. She is taking Visyneral-Z.",
    "doctor_response": "Hello. I understand your concern. The baby's age is 4 months. At this early age, cough medicine is not advisable. Usually, at this age, babies are breastfed and have nasal block which can lead to breathing difficulty including cough sensation. During feeding times, ensure the baby is held in the upright position and given proper burp. You can give Nasoclear drops (Saline) to be put in each nostril (nose) one or two drops, and this can be repeated three to four times a day especially at night. If fever is there, you need to show her to a doctor. For more information consult a paediatrician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the pain and tiredness in legs be due to PAD?\n\n2.5 years ago I had an ankle replacement and last year was treated for Hodgekins Lymphoma. Chemo and radiation successful. Tried not to gain too much weight back but have gotten back to 250lbs about where I started. A couple of months ago tried to return to gym and walked on eliptical machine. Legs got tired very quickly. Since then any extended walking for just a few minutes leaves my legs hurting and I get tired very easy. Could it be PAD?",
    "doctor_response": "Hi you had ankle replacement 2.5 yrs ago , have put on weight , return to gym caused tiredness which is persisting now. In my patients , I would advise them against any active sports activity or any unusual load on ankle to prolong the life of implants. I suggest that you get an X ray to assess the position of implant and avoid abnormal loading of ankle joint.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have missed my periods, what could be the reason ?\n\nhi doctor i have missed my periods by 6 days i have done test twice but both were negative.....even my blood report is negative i even have vomiting............m i pergnant or not and if not what is the reason of this delay",
    "doctor_response": "1. test done to detect pregnancy should be done after 10 days, when zygote is formed forming an outer layer of Trophoblast which secrete hCG around 14th day. 2. prior to it, either implantation is not there or the body is not producing enough hCG to be detected in pregnancy test. 3. if pregnancy is not +ve then other causes can be STRESS, rapid gain or loss of weight, recent change in diet.or use of birth control methods. 4. unless you're pregnant,chances are her cycle will return to normal next month.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathing difficulty, chest pain and left arm pain?\n\nhave recently had problems with breathing, chest pain, left arm pain, jaw pain and crushing chest pains my stress test did not show anything wrong with the heart. my gp thinks its my gall bladder i strongly disagree and am still having the symptoms apart from the jaw pain whichwas a one off. The hospital suggested angina but my gp refuses to send me to a consultant as the stress test was clear. I need to know what I can do, feel like I was hit by a bus, its taken four weeks to get back on my feet",
    "doctor_response": "Stress test can be normal too. It's the symptoms that has the top priority. I suggest that you need to get a diagnostic coronary angiogram if you have this typical symptoms, but you need to get an Echocardiogram first,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to confirm conception time if having irregular periods?\n\nI am 23 weeks pregnant and my due date is 6th April 2011. Before i got pregnant I was not having a monthly period. I had the coil inserted approx August 2009 and had it taken out due to problems in October 2009 and after this my period did not return. I am therefore not sure of when i concieved?",
    "doctor_response": "Hello,Thanks for the query.I have gone through your query and I can understand your concerns.You can make rough idea about your fertilization date by looking at your first trimester scan. The approximate gestational age is written in the scan, you can subtract the age in weeks from the scan date and thus you will get the conceiving date.Keep in mind this not 100 percent accurate, a five to seven days correction is expected.Hope I have answered your query.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could raised bumps in spine be?\n\nMy son is 5 and he has developed a raised bump on his spine. It is mid was down. This spot is also discolored and the skin feels different. The color is almost a greenish color. He has had it for about 4 months now so I am sure it is not a bruise. Any ideas what it may be?",
    "doctor_response": "Hello, Most probably it will be a bruise or skin rash. It will be better if you attach a picture in the follow-up query. Consult a dermatologist and get evaluated. Rarely congenital problems like spina bifida May manifest like this. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can wisdom tooth cause eye pain and headache?\n\nim a 24 year old man who has eye pain behind the right eye. I also have a wisdom tooth growing in on the same side. I get headaches that start in my right temple...and make its way behind my right eye. When i massage  my eye i feel the pain worse. But when i massage the nerves on the right side of my neck it feels a tad better. I thought it may be cluster headache, except for the fact that i get this pain every single day not once or twice a month. Can it be my wisdom tooth causing this pain?",
    "doctor_response": "A wisdom tooth can result in referred pain to the head, ear, side of the face. Pl consult a dentist to identify if the pain is related to the wisdom tooth.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this ECG report indicate?\n\nwhat is beside the code, an nonspecific abnormal electrocardiogram, Diagnosis: benign hypertension, hyperlipidemia, obstructive sleep apnea, unspecified hypertensive heart disease with heart failure, pure hypersholesterolemia, type 1 diabetes - vitals 144/88BP, 57 Pulse, Height 5'6, weight 310, BMI 50.04 -lost 40ilb in past 3 months with gastric sleeve, age 58",
    "doctor_response": "HelloI can understand your concer.These prescription mean that the person suffers from as follows:HTAHeart failureDislipidemiaDMThe treatment should be according to relevant specialists,cardiologist and the endocrinologist.Wish you good health.Thank youDr.JolandaPulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in hip and numbness in foot?\n\nI am experiencing severe pain in my left hip that travels down my leg, also numbness in my left foot. I have MS, but have never had pain like this before. I find it difficult to walk and stand. Also have lower back pain, doctor says its degenerative disc in my back. Had x-rays on my hip 2 weeks ago..no fractures. Doctor thinks its a pinched nerve. Tylenol is not helping. Any suggestions please.",
    "doctor_response": "Hi,thank you for providing the brief history of you.A thorough neuromuscular assessment is advised, post which an MRI may be needed to take assistance for seeing the pinching of the nerve or the soft tissue status.Also, due to ageing factor there is always a degenerative change happening in the spine and may lead to disc degeneration and pinch of the nerve. Since the symptoms are classical for the disc degeneration and pinched nerve, your doctor is right. Also, you need to undergo physical therapy like, therapeutic ultrasound therapy and TENS therapy for the same which will help to reduce the pain instantly. Post which exercises will be taught to strengthen the spine and the stabilizing the spine to avoid recurrent pain.In my clinical practice, patients recover 99% with the combination of medicine and physical therapy.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for Immune hepatitis\n\nHello. I have auto immune hepatitis and I take azathioprine and solupred for several years now. Now all these chinese natural diet pills came out and they don't have any side effects,I would like to know if it's possible to take something like apple lighting pills or super slim.Thank u",
    "doctor_response": "Hi thanks for asking question.Noted you have autoimmune hepatitis.You are taking immunosuppressive drug for it..Chinese products can be tried as you have mentioned..But here you have to do is regular follow up with LFT whenever needed.Continue using azathioprine...Meanwhile to prevent progression avoid alcohol ...Take low fat diet.More fruits taken...Avoid trans fat diet like cheese, burger , meat etc...If jaundice occurs immediately consult doc for investigation.Take care....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for tooth infection\n\ni needed to get a root canal. they started but could not finish because of infection. my face swelled up really big and they said they were going to take tooth out but needed infection to go away. im on my 3rd round of antibiotics. it reswelled but inside my mouth then rubtured 2 days ago. i have been sick to my stomach and diarreah ever since. went back to dentist yesterday to have it removed and they say give it couple more days still had infection. at this point i am pretty worried. my teeth do not hurt but my cheek bones feels like it is broken. over a month seems to long to me and i dont feel good. any suggestions",
    "doctor_response": "Hello, Thanks for consulting HCMRead your query, as you have infection in tooth still after root canal treatment means this swelling can be due to formation of Abscess at apex of root of infected tooth .Diarehoea can be antibiotic induced dont worry I will suggest you to consult your dentist and tell symptoms of pain and diarehoea and go for antibiotics combination like oznidazole or tinidazole for swelling and after proper course of antibiotics go for removal of tooth.Hope it will help you. Wishing you good health.Regards Dr. Priyanka tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pregnant, pain in left side of jaw after wisdom tooth extraction. Treatment options?\n\nFor about a month now I get pain on the left side of my jaw. It seems to radiate from where I had my wisdom tooth pulled and goes all the way into my jaw bone. It happens when I drink something cold , but a warm or hot compress will help when the pain starts. I had my wisdom teeth pulled better than 10 years ago, with no problem until now. I also am 3 months pregnant. The pain is getting worse and is so bad sometimes I feel like I m gonna pass out. It don t seem to last but just a few minutes at a time.",
    "doctor_response": "Hi, Thank you for the query. Pain when cold drink is taken or hot compress may be because of caries in the adjacent molar involving dentin  or pulp  . First trimester is not a safe period for any procedures to be done , second trimester (3 to 6 months of pregnancy)  is a safe period for procedure to be performed . See your dentist to diagnose the exact cause for the pain. Hope this information helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in perineal area during coughing?\n\nwhen coughing hard or sneezing i get a cramp in the perineal area. I have had this for many years and it sometimes goes away for months and then comes back again. Any ideas if i should get it checked or if it's just one of those things you just live with?",
    "doctor_response": "hicoughing increases the intrathoracic pressurewhile sneezing increases both intracranial as well as intrathoracic pressure.this crampy pain will be due to the stretching of all the related organs mostly vaso vagal,wherin all these structures are interrelatedtake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a vaginal skin tag in a child\n\nmy daughter is 21 months old. No problems throughout pregnancy, and born term, vaginally. She was born with a small skin tag slightly inside the vagina. Recently i had noticed it becoming larger in size. It doesnt seem to bother her a whole lot. I had asked her doctor about it a few months ago and he said he doesnt think i have anything to worry about. Now to me it seems like her vaginal hole is slightly bigger than it should be and im not real sure if its from the skin tag growing and stretching. Right now we currently dont have health insurance until the beginning of july and i dont have a whole lot of money to take her back to the doctor.",
    "doctor_response": "Hi.... by what you say I feel that your kid might be having a condition called vaginal synechiae. This is a very very common condition and it can be most of the times relieved by using Premarin cream as external application on the skin tag. But it has to be done under a specific technique and it needs to be taught by a pediatrician or physician. If the Premarin cream is not working then only we need to release the synechiae surgically. This is also is a day care procedure and is not major procedure. So you need not worry about it. I suggest you consult your pediatrician regarding this with the tip I have given.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am getting shooting tooth pain. Shall I opt for extraction?\n\nHi doctor, I have got problems with four different teeth. My front tooth is extremely sensitive and painful most of the time. A molar has had a deep filling that was done about a month and a half ago. Still, it hurts, and my dentist said it is nothing to worry. It feels as if shooting pains and sometimes, the pain spreads to my jaw, eyes and nose and I cannot eat on this tooth. Shall I opt for the tooth just to be extracted? It causes a lot of trouble. Also, my back two teeth have one complete filling that covers both teeth. It bleeds and hurts very much if I used in between brushes to clean my teeth, which my dentist advised me to use. I just cannot use that because it is too painful. I experience shooting pains in a lot of my teeth and the deeply filled tooth is the worst. If the tooth were to be extracted, is it possible to get a bridge? What is the longevity of dental bridges? Please refer the photos attached.",
    "doctor_response": "Hi. I just have gone through the photos (attachment removed to protect patient identity). For further information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dizziness, confusion, memory loss, unable to remember names, events, death of family members. Treatment?\n\nGood afternoon, my father became very dizzy and confused whilst watching television this morning. He could not remember all his family names, that my mothers mother had died and various other questions my mum put to him. She said he was very confused, white and feeling very dizzy; after a couple of hours had past we where sitting talking and we moved onto the subject of her breast cancer and was describing the method in which she had had her cancer removed from the left breast on Thursday - he could not remember taking her into to hospital or the fact that she had just been operated on. What should I do??????",
    "doctor_response": "Hi..looks like he is having Alzheimer's... better show to a physician for proper diagnosis and management...Dr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Difficulty in reading, unable to concentrate. History of seizures, had appendectomy. Took keppra, depacote. Any ideas?\n\nAny thoughts as to what may cause someone to start having trouble with reading, says he cannot concentrate and it looks like the words are moving around on the page as he reads. Also says that sometimes he has trouble getting out in words what he is thinking and wants to say. Male 21 years old. History of seizures, on Keppra and Depacote. Has something called Syndham Chorea as well. Had an appendectomy a week and a half ago! Any thoughts would be appreciated.",
    "doctor_response": "Dear FriendWelcome to Healthcare MagicI read your concern and and I would like to share my thoughts about his present symptom of difficulty in reading .1) Is this symptom arises at present or he has difficulty in reading since seizure .If symptoms arises at present then it can be due to progression of seizure complication involving parietal lobe . As you know parietal lobe is meant for  touch perception, the integration of sensory information and in visual perception of spatial relationships among objects (visuospatial processing). Parietal Lobe epilepsy is rare to happen but I would suggest you to do repeat CT imaging study and consult a Neurophysician to get his heath back to normal .You can ask me if you have furthur queries ... I am here to health you ..RegardsDr.J.Kingson John David",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. After a fracture, my finger looks bent and swollen. Should I go for a surgery?\n\nHello\u00a0doctor, I broke the top joint of my right pinky finger, two and a half months ago, late the night, before I was leaving for a two-month trip abroad. I tried to splint it, but it did not work, and it bent down by about 45 degrees, and now the joint is swollen. After getting an X-ray, now that I am home, the specialist said that I could try to splint it religiously for six weeks, to see if it works, with results of a 10-degree bend and a slight bump. He said it has a 50 % chance of working given the time lapse. If it does not work, I will need surgery, where he will clean up the extruded bone, and put something between the joints, and a pin, that will need to be removed. I will wear a splint for six weeks after and need some physiotherapy. The other option is just to have surgery now, and avoid the six-week test. It seems like the surgery now might be the better option to provide a better long-term solution, versus the results of the splint if it were to work. What do you suggest?",
    "doctor_response": "Hello. Kindly follow up with your X-ray for further discussion. Revert with more information to an orthopaedician and traumatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a heart disease\n\nHi, my fiance is getting ready to have an angio gram. With his past history of one mild stroke, blood thinners, ongoing chest pains and numerous test, finally he has been advised for the above immediately! What are his chances? He also has slight high blood pressure and thyroid issues. Was recently told his gallbladder had to be removed, but the 2nd opinion ruled it out, sending him to his cardiologist. He maintains good weight for his height (6'1\") at around 185lbs. Caucasian.",
    "doctor_response": "Hi,Welcome.Angiography is just a test to rule out presence of any blockage in arteries of heart. Final treatment will be based on the results of angiography.So any conclusion will be done after the test.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing pain and soreness under the ribs\n\nI have two very sore ribs and one that goes under my breast gives me pain once on a while.  I was lifting very heavy boxes bending to the far left and lifting up and over.  Went to a chiropractor who gave me adjustments and said I was very inflamed.  Using ice and aleve.  Still hurts, not as much but constant.  Should I go for exrays?",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. By your history and description, you are mostly having musculoskeletal pain due to lifting of heavy box. Follow these steps for better symptomatic relief. 1. Avoid heavyweight lifting. 2. Avoid strenuous exercise. 3. Avoid bad postures in sleep. 4. Avoid painful movements. 5. Start painkiller and muscle relaxant. 6. Apply warm water pad on affected site. It gives more relief then ice. By doing all these for 1 week if you are still having pain then get done chest x ray to rule out internal damage.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling lonely, irritated, mood swings, tension about future, unable to concentrate. How to recover?\n\ni sachinjeet kumar i m pursuing my Mba but from sometime i am facing a problem of being loanly in crowd i thnink noone is my friend. I feel irritated with fake people, i used to get angry very soon dat too very furious. I assessed myself with problem of moodswing. I take too much tention for my career and future. I stated prefering being alone. I AM not fedup with my life but still i thnink is wrong and i am ignoring. Moreover everytime when i take to somebody after a minute i start thinking that what should i say now this happens even when i talk with my parents my brother and frnds. I dream too much. I can t concentate, i forget things as well sometimes. Please suggest me something.",
    "doctor_response": "hello welcome to health care magic You have symptoms of depression with obsessions. Forgetfullness is also a part of depressive episode (pseudodementia). Consult a psychiatrist for Medication, psychotherapy and relaxation exercises. You will be alright soon. Wish you good health Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to use Adrucil and Leucovorin together for GI cancer?\n\nMy brother has been diagnosed with a GI Cancer and will begin chemo treatments next week. I was researching the drugs and have found that two have a major drug reaction---major being described as risk outweighs the benefit! The drugs are Adrucil and Leucovorin; what would be the reason for using the two together? Do I keep quiet or ask him?",
    "doctor_response": "Dear, I think you have wrongly been informed about the side effects of these drugs. They are safe and can be given conveniently. i will say the reverse benifit overweighs the risk. At least with first 4 or 5 cycles of chemotherapy there will absolutely be no problem. Dr. Ticku",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is blood pressure of 139 over 104 a matter of concern?\n\nMy blood pressure currently 139 over 104.  I just had a severe panic attack late Thursday night.  I am jittery and weak.  Do I need to go to ER for this blood pressure?  I am 53, 5'3\" 175 lbs.  Have a history of panic attacks but this latest was the worst I've ever had.",
    "doctor_response": "Hijnc criteria of hypertension Normal\u00a0\u00a0\u00a0\u00a0\u00a0Prehypertension\u00a0\u00a0\u00a0\u00a0\u00a0120-139\u00a0\u00a0\u00a0\u00a0\u00a0Or 80-89Stage 1 hypertension\u00a0\u00a0\u00a0\u00a0\u00a0140-159\u00a0\u00a0\u00a0\u00a0\u00a0Or 90-99Stage 2 hypertension\u00a0\u00a0\u00a0\u00a0\u00a0\u2265160\u00a0\u00a0\u00a0\u00a0\u00a0Or \u2265100so you are in  stage 2 diastolic and  stage 1 systolic hypertension.though you need not to go to ed but start some antihypertensive medicationsanti hypertensive medications should be started as early as possible meet you cardiologist to  start with beta blockers and calcium channel blockers initially.monitor bp every third day so doses can be increased or decreased in accordance to it .thank you.panic attacks also add as a additive in increasing your blood pressuresevere life style modiofication should be followed avoid fatty foods no over oily  spicy foodexercise daily for 45 minutes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the throbbing in the chest be due to stress?\n\nHI - i am female , 46 years old. fairly fit and run regularly. i have had no issues with health and my screenings are all clear. I am under a little bit a stress currently due to some personal issues but other than that,. nothing unusual. Recently , i noticed a very mild throb in my chest which has been consistent for the last week. Not really painful but it is there. ( very slightly to the left of the central chest area ). Anything to be concerned about ?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  If you are fairly sure that all your screenings regarding your health came normal, then there is nothing to worry. Small small pains do occur across the body at different times. Especially chest and stomach regions. These are mostly due to acidity. I sincerely think that the throbbing pain you noticed could be due to acidity. Acidity pressurizes diaphragm upwards and lungs and heart regions come under pressure. Blood carrying arteries, due to its pulsation, gives you pulsating pain sensation. Control your food intake. 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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can HCV be transmitted through a needle prick?\n\nDear Sir, my mother is HCV + . She was given an IM injection and after 16 hours my wife has got a very little prick from IM injection. There was no blood on that injection. Can it is possible that my wife also get HCV from that . Moreover,after how much time , we should got her lab test on ICT Kite ?",
    "doctor_response": "HI, thanks for using healthcare magicIf the syringe was previously used then there could be small amount of blood on it that may not be easily seen.Since the syringe was accidentally stuck hours after, however this would significantly reduce the chance of any transmission.The window period of hepatitis c is 8 to 12 weeks.This means that a test can definitively detect the virus by this time and give an accurate result.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Guilty, sad feeling due to inability to get a better job, had taken cipralex. How can I overcome this?\n\nI lost job a some times ago, after that I couldn t get a job same or better one. Now I feel so guilty concious and sad. And this thoughts always disturbing me as I can t make a jump for a new job. Feeling unhealthy like this. Is this dippression and anxiouty? Pls give me a valuable advice and save me from this troubel? I had cipralex 10 mg for 2 months before 4 months",
    "doctor_response": "hi..you are just suffering from pessimism..what we call negative automatic thoughts..they are creeping in and making your life tremulous..losing a job is not the end of the world as you will certainly get better options if you have some things within which I presume you have..so just consult a psychiatrist for some medication for anxiety, if needed and a psychologist to address your thought what we call cognitive therapy..so just get rid of blues..best of luck..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I feel severe pain from tummy to vagina. What can it be?\n\nHello doctor,I am having severe pain from my tummy to my vagina and anus area. I feel exhausted, and my hands are cold. My flank hurts on my left-hand side, and the pain radiates to that area too. What can this be? I am also having vaginal bleeding. My symptoms are chronic, and the pain is on and off. A couple of weeks ago, I had this sharp pain in my belly, but I never did anything for that. I had pain medicine, but they did not seem to work. My urine test was normal. Please help.",
    "doctor_response": "Hi. Revert with the reports to an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the painful lump near the lumber region of my spine?\n\nI have a lump near the lumbar region of my spine about the size of a small grape.. My GP said it was a cyst. For years I had no symptoms. However, lately, I have mild pain under it constantly, especially if I cough or sneeze. and occasionally severe stabbing pain that can drop me to my knees with no apparent trigger. What do you think?",
    "doctor_response": "thanks for sharing your health concerns with us!well, it seems that these are some kind of COLLECTION within the swelling and possibly it is a sebaceous cyst but it could be a neurofibroma also! not to worry much but not to poke it as it can be infected......... an FNAC TEST IS THE BEST WAY TO CONFIRM IT!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it advisable to conceive having diagnosed with congenital cardiac anomaly?\n\nHello I don't know whether you will answer this e-mail or not but this is really important for me:( I am from Turkey. a 25 year old female and married. I have a bicuspid aorta and consider pregnancy.It is a congenital cardiac anomaly. Of course in Turkey I asked lots of cardiologist whether I should do it or not but they have said me that there are risks but noone can't know what may happen during the pregnancy because there isn't lots of person like me. so I can't decide:( After describing my situation briefly I will try to write something from my last echocardiography test. Peak Gradient(mm Hg):65.00 Mean Gradient(mm Hg):37.00 Now I will try to translate my doctor's comment on my test. I don't know lots of the terms. Heart blanks are normal. Aorta is thick and bicuspid. It's expansion is limited. Aort radix is 2.5 cm. The other valves are normal. Light-middle aorta insufficiency and tricuspid insufficiency. I don't whether I could explain it. What do you advise me? I am looking forward to hearing from you.",
    "doctor_response": "hi, it looks like you are bicuspid aortic valve and other other abnormalities in your body.There is 9% risk of similar disease in first degree relatives. So there is 1 in 10 probability of your child having the same.I think it's worth to this much risk and go ahead with pregnancy but pregnancy being a stressful condition you should discuss with your gynaecologist whether you ll be able to tolerate it or not.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does a baby reject bottle feeding?\n\nHi, my 17.5 week old baby will not take a bottle. I exclusively breast feed. We have been trynig several times with the bottle and she refuses. She did take a couple ounces one time and since then will not. She may play with it in her mouth or else she just gets increasingly frustrated. We have tried myself giving it to her, my husband, we ve tried different bottles and nipples - nothing works. Do you have any suggestions? Also.... I have been told that some babies will go right from breast to sippy cup. Is there any harm in this and how old must she be before we try breast milk in a sippy cup? Is this harmful in any way? Someone told me ia baby doesn t ever use a bottle it can cause speech problems as the muscles of the mouth don t develop proply. Is this true? Thanks!",
    "doctor_response": "Hello, thanks for asking on healthcaremagic. It is recommended to exclusively breastfeed a baby uptil 6 months of age and then start weaning foods while continuing to breastfeed. The longer you breastfeed the better it is for the overall child development. Since the technique of feeding from breast and from a bottle is different for a baby, it finds it difficult to easily switch from one to another. Some babies totally refuse bottle if they have been exclusively breastfed before and there s no harm in that. The only thing is that mother finds it difficult to leave the baby with someone else for going to work or elsewhere. What is suggested is to try different nipples and someone other than mother to give the bottle. Since you have already tried all this it seems it wont work. You can start the sippy cup after 6 months along with semisolid foods with a spoon. There is no disadvantage of not using a bottle at all. In fact bottle can cause health problems like diarrhoea since the nipples might harbour bacteria if not cleaned and sterilised properly",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a decayed tooth?\n\none of my tooth is getting decayed. I have consulted a dentist, he said we need to remove the decayed part by grinding and we can fill it off or root can. treatment need to be done if necessary. along with ceramic cap it will take around 5k. am i getting cheated anywhere? please suggest",
    "doctor_response": "Thanks for your query, I have gone through your query.The decayed tooth can be filled with a normal tooth color restoration(composite), if the decay is not involving the third layer that is pulp where the blood vessels and nerves are present. If the decay is involving pulp then the tooth has to be treated with RCT.Ya, the cost of the RCT with crown varies from 5000 t0 8000rs depending upon the material used (either metal crown or ceramic crown).I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tooth ache?\n\nI have CIDP. For the last 11 years. I take a steady course of ivig   I have been scared to see.the dentist even though i am under pain manage ment . One what will the pain be like   two have the cidp , ivig,  or pain meds have desired my teeth. Normally I get 1 cavities a decades but they are now very yellow. I will be 60",
    "doctor_response": "Dear sirAs you have mentioned that you are suffering from immunocompromised disease. In any immunocompromised patients there is increased risk of developing dental caries and other problems related to gums. So special care should be taken to avoid dental problems.U can use chlorhexidine mouthwash regularly to minimize the risk of developing dental problems.  If you are experiencing pain in any of your teeth please visit dentist to to investigate the cause and do the needful treatment.Take care.. Thank You",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my new born baby s knees not bending?\n\nwe have a neborn baby boy 15 days old, his knees are not bending, right knee is angled towards left, and foots are torned, what should i do, we consulted an ortho, he says that his ligament and soft tissues are not developed, what sould i do, i am very much about him,,,,,,,,,, please help me",
    "doctor_response": "Hi,The orthopedic opinion is correct.  Sometimes new born babies take a little while in developing the joints stiffness. You can start very mild exercise at that joint,  like physiotherapy.  It will help.  Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Zeeshan Sajjad",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes irregular shaped hard knots in the nape of the neck?\n\nI have three irregular hard knots come up on the back of my head. All on the right side. No injuries to blame except old falls. They are very sore to touch and causing headaches and dizziness. Should I see a doctor or wait it out. I have rods in back S1 to T10, plate in neck all due to degenerative disk disease and joint disease. I have an artificial left TM joint. Suffer from arthritis and fibromyalgia. Recently has esophageal ulcers and treated for them. Monday of this week had another scope and found two white areas this time and took biopsies. Ulcer biopsies were okay. Don t expect anything to worry about the recent biopsies taken.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.As you are having headaches and dizziness associated with hard lump on neck, you should definitely seek advice from neuro surgeon.Probably it can be due to vertebral artery aneurysm or having other cervical vertebral abnormality. Best way to rule out is MRI cervical spine.I hope you will get proper diagnosis and treatment soon.RegardsDr. Hiren Hirpara",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is feeling sleepy normal after taking novelon?\n\nI have irregular menstrual cycles due to increased thyroid levels and PCOS, hence my gynae suggested I take Novelon for 21 days to regularise the cycle. yesterday night i took the first one and today morning i feel extremely sleepy. is this normal or should i talk to my doctor?",
    "doctor_response": "HiDizziness or fatigue can occur with Novelon. Watch the pattern for the next few days and if the dizziness continues,it could be because of the drug.Side effects may reduce in the subsequent cycles and hence continue the drug for few more days. Incase of severe allergy to the drug such as rashes or swelling of face or lips or difficulty in swallowing ,the drug should be stopped.Hope I have answered your query. Let me know if I can assist you further. RegardsDr.Saranya Ramadoss, General and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I had miscarriage and ectopic pregnancy in the last six months. Is it endometriosis?\n\nHi doctor, I am recently trying to get pregnant and in the past six months, have had a miscarriage and an ectopic pregnancy. I am wondering if there is a chance I have endometriosis. I am wondering this because I have no other risks/causes that could have caused the ectopic. There is no chance I could have an STD because my husband and I both waited until after we were married. I am young, just 29. I have never smoked, had an abortion, had fertility treatments, or have had surgery. I also do not have an IUD. Do you think the chance I may have it is big enough that it should be brought up with my gynecologist? I forgot to mention I have had one successful pregnancy two years ago. Also, I recently had a Pap smear two months ago and everything was normal. I have never had a bad result from a Pap smear. When it comes to symptoms, it is tricky because I feel they are very similar to menstrual cycle symptoms. I do have painful cramps on the heaviest day of my period. The cramps last for a couple of days. I have bad mood swings and bloating. I do have painful intercourse more recently. It always hurt occasionally in the past, but recently it is much worse. I also have spotting right before my period and right after.",
    "doctor_response": "Hi. How are you doing? From your history, the only problem I feel is the problem which could happen to the tube. Your history of having a tubal pregnancy and severe pain during sex, that is dyspareunia, means that there is some problem which is happening around the uterus and the tubes. So, it could be endometriosis or could be a pelvic inflammatory disease. It need not always be an STD (sexually transmitted disease), it can be common pelvic inflammatory diseases (PID) too. You definitely have a good chance to get pregnant, keeping in mind your previous pregnancy and history of tubal pregnancy. If I may suggest: I would give more chances for infection. Infection can cause the embryo to get stuck in the tube (ectopic), unhealthy implementation in uterus and miscarriage and also severe pain during sex. Also, it is associated with vaginal discharge and itching after sex and around periods. Hope I have clarified your query. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to increase the penis size\n\nI have qualified medical entrance exam and sure to have admission for MBBS.   bt I m in a tough condition. bcz recently I have got to know that during admission in medical fitness test genitals are also checked. . due to prolonged masturbation I have a deformed penis. . it is very small in flaccid condition , wrinkled and with enlarged glans penis... plz plz help me out is there any way to pass medical fitness test? ? plz help me other wise I m thinking to commit suicide. ...",
    "doctor_response": "HelloThanks for query .You have doubt about the size and length of your penis to be smaller that what you expect it to be .Please note that length and size of the penis in flaccid sate has no significance at all.In flaccid state it serves as tube to pass urine out of the body .As such during physical fitness test there is no incidence any where in the world that a candidate has been declared unfit for having small penis .Do  not worry it is your anxiety that is making you uncomfortable .Concentrate on your preparation for test and I am sure you will go through it successfully .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Anbesol be safely applied on a tooth while on Hydrocodone-Acetaminophen for pain?\n\nHi, I am taking hydrocodone- acetamin 5-325mg for pain from PDT (photodynamic therapy) treated with topical levuin yesterday, Mytooth just broke, is it okay to use over the counter anbesol on my tooth. Don t usually use medications and that is severaldifferant meds in 24 hours,",
    "doctor_response": "Hi, Anbesol Gel contains benzocaine, a local anesthetic for application to  gums. Hence, it can be taken with pain killer - Hydrocodone/Acetaminophen (5/500mg). There is no known drug interaction. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Tushar Kanti Biswas, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Symptoms of brief seizure.  History of severe epilepsy stopped after taking levilpil.  Any side effects?\n\ni am taking levil 1000mg  . i had severe epilepsy, after taking levilpil 500 mg i the morning  the epilepsy  has almost stopped , Now i am having symptoms of brief/absence  seizure, I am not getting  any epilepsy/fits as earlier. I did not get any fits for one year after taking levpil and zonisep . Doctor advised to take levipil 1000mg in morning and evening . whether it will have any side effect and whether brief  seizure will  be reduced",
    "doctor_response": "Hi,Thank you for posting your query.Levipil (levetiracetam) is a safe and effective anti-epileptic drug. The dose of 2000 mg per day (1000 mg two times a day) is the normal therapeutic dose and we do not expect any side effects with that.Yes, with the current dose, we expect a reduction in the seizure frequency and the minor seizures would stop or reduce.So, I suggest you to continue your anti-seizure medications regularly as advised by your neurologist.I hope it helps. Please get back if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for shooting pain in my spine?\n\nI've been suffering with shooting pains up my spine for a few years now, but recently the pain has started to feel trapped between my shoulder blades but on my spine. I normally have to crack my back to get rid of the horrible pain it causes but sometimes it doesn't go and I am stuck with this pain for hours on end. there are certain things that trigger it off. And I was wondering if you have any idea what it could be?",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.There appears to be a spinal degeneration problem. You need to get a spinal MRI done and identify the exact cause of such a pain. As of now regular physiotherapy should be good.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, or need any further details about the same query you can use the below mentioned link:bit.ly/dr-srikanth-reddyWish you good health,Kind regardsDr. Srikanth Reddy M.D.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is rabies vaccination advisable for the contact of dog's saliva?\n\none dog was lying on the road side in the morning and when i was going back the same way in the afternoon the dog was still lying. My friend,myself and one person tried to help it.My friend and me tried to open the dogs mouth and  pour some water.but the dogs mouth was stiff.i think we might got contact with little bit of saliva.we dont have any bruies and cuts on our body.after that we washed our hands and we taken bath.i have gone through some rabies videos and think that animal has rabies.so do u suggest me to take rabies vaccine?if yes what will be the cost?",
    "doctor_response": "HiThanks for your query.I appreciate your concern for exposure to dog's saliva.The virus responsible for the rabies is found in the salivary secretions and the brain tissue of the rabid animals like dogs, cats, bats, etc.In view of the direct contact of saliva and apparently you had some abrasions on you hands and since the animal was having jaw stiffness (suspected to be suffering from rabies)  so you have to take the anti rabies vaccine on the following schedule  0, 3, 7, 14, and 28 days. Day\"0\" is the first day of your vaccination.Regarding the cost, you may inquire in the nearby pharmacy or the primary health center/hospital.Hope this answers your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to stop taking depo provera injections and what risks are involved?\n\nI have a new pt that has been on depo provera for 18 years. She does not want any other procedures for permanent sterilization. Any suggestions to taking her off the injections and what risks are there to leaving her on the injections other than bone loss?",
    "doctor_response": "Hello,Thanks for sharing your health concern with us. Bone loss or osteoporosis, is one long term side effect of hormone use. However, regular monitoring is needed to assess the hepatic function, coagulation profile, breast condition, cardiovascular function, uterine state and blood counts, since there is a systemic influence. If your patient needs to be transferred from depo shots, if she is fit to continue hormones, you can try an implant or other forms of topical applications, if oral pills are to be avoided. If hormones are to be avoided, barrier methods are to be used with double protection. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Azithral helps in treating the condition of the Hydrocele?\n\nhellow sir my self sushil and i have one issue that my right testical is bigger than left it's look like a hydrocele i had consult to doctor and he say try to take Azithral 500mg twice a day for 15 days and see if this can cure me or not other wise only i have to operate please sugges me it can help me or not",
    "doctor_response": "HelloThanks for query .You have noticed your Rt testicle to be increased in size and your family Physician has diagnosed it to be Hydrocele and prescribed Azithral .The antibiotic (Azithral) will have its effect only if there is active infection of Testicle .It will not have any positive result in established and long standing hydrocele .Please consult qualified General Surgeon for clinical evaluation .The only best treatment option for Hydrocele is to get it operated .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do lumps form around the head?\n\nMy four year old son has three lumps at tge base of his skull on the left side and two My four year old son has three lumps at tge base of his skull on the left side and two behind his ear and one in his side of the neck..what could that be from? Should we get some tests done",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. He may have some enlarged lymphnode. It may be due to reactive hyperplasia, tuberculosis or lymphoma. You should go for fine needle aspiration cytology. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then feel free to ask me. I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "White rings on finger, pins and needles effect in limbs, swollen. What might it be?\n\nhello, my mother has just noticed numerous white faint rings on the inside of her index finger and the finger beside it, no bigger than 1cm in diameter. they have only occured on the one hand which is considerably cold in comparison to her right hand, and she is currently experiencing a pins and needles effect in both her hands aswell as her feet . they also appear to be swollen considerably. any idea on what it might be?",
    "doctor_response": "HiThank you for your question.From what you have described it does not seem to be related to spine. Coldness of the hand, skin changes and swelling of legs are all signs of vascular pathology. The blood vessels may be narrowed for some reason or the vessel walls may have pathology. It is advisable to consult a vascular surgeon.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pain in the lung area?\n\nHi I am a 37 yr old female. For the last two weeks I have had a really strange pain in the right back of lung area. It occasionally goes to the left side. It is worse when I am really hungry . it hurts to take a deep breath . Only occasionally I have been getting breathless with it and sometimes the pain moves to the middle chest area. I do suffer from high blood pressure which I take Losartan 50mg once daily , simvistain 40mg for high cholesterol and salbutamol and seretide 100 inhaler for mild asthma. I was taking Ramipril 10mg up until 5 weeks ago when I was switched to Losartan due to a chronic dry cough. The cough has since gone away and is now only occasional . I have been suufering with indigestion a lot more than normal too",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. By your history and description, in my opinion you are mostly having GERD (gastroesophageal reflux disease). Your symptoms like indigestion, central chest pain, right sided back pain, more on empty stomach etc are suggestive of GERD more. You are also taking drugs like simvastatin, losartan, inhaler etc. All these can also cause GERD. So better to follow these steps for better symptomatic relief in GERD. 1. Avoid stress and tension. Avoid hot and spicy food. 2. Avoid large meals, instead take frequent small meals. 3. Start proton pump inhibitors and prokinetic drugs. 4. Go for walk after meals. Keep 2-3 pillows under head in the bed to prevent reflux. Since all these are prescribed medicines, you need to consult doctor for their prescription. Don't worry, you will be alright. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have bad breath, smelly nose. Explain my problem\n\nhi.. i am toyosi i want to tell you that i am having bad breath and smelly nose ..when i am outside..even the people is far from me they will cover their nose..i dont know where it comes from because even i do not open my mouth , the smelly things come from me. people will cover their nose when they are near me even after i brush my teeth . can you explain about my problem because it affect with my social life..i don t confidence in myself and make my life miserable",
    "doctor_response": "Hi, Thanks for asking the query, Bad breath can be because of various problems like sinusitis, oral infections, tongue coating, eating of food stuffs like onion, cumin, starvation, GIT disturbances. According to your clinical history it appears to be sinusitis. I would suggest you to visit ENT specialist and get the checkup done. Go for symptomatic treatment of complete mouth scaling and polishing. Maintain a good oral hygiene. Use antiseptic mouthwash gargles twice daily. Hope this helps out. Regards....",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in my lower abdomen?\n\nI am experiencing moderate pain in my lower abdomen. I have a Mirena IUD and have previously had ovarian cysts. I am not pregnant. I had sex two nights ago and it was painful and quit once I stopped. I had sex last night and it was extremely painful and hasnt gone away. I have taken Motrin and used a heating pad on my abdomen. I do not have health insurance to go see a doctor.",
    "doctor_response": "Hello...there is a problem with your IUD...it must have been displaced which is causing pain,specifically during sex...u need to get a URGENT ULTRASOUND done to see the displaced IUD n get it removed immedietly",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cheaper alternative to Seroquel\n\ndear doctor:I called my doctor today in deep distress and she prescribed Seroquel.  when I arrived at the pharmacy an order for latuda (spelling) was there and the cost with my prescription plan was over 800 dollars.  I am unemployed and cannot afford that medication.  I called my doctor and described what was happening but had to leave voicemail.  I am in a very deep depression and my current meds are only making my condition unbearable as I am thinking of my end.",
    "doctor_response": "Hi,Seroquel (quetiapine) and Latuda (lurasidone) are two different drugs but are both antipsychotics. I expect Seroquel to be cheaper than Latuda. In addition, the generic form of Seroquel is also available, which will be even cheaper. But you'll need to contact your doctor and discuss this. You mentioned not receiving much benefit from your medicines. Since you are depressed, you will need treatment with anti-depressants. Antipsychotics like Seroquel can augment the action of antidepressants but not replace them. There are things other than medicines that also help, like cognitive therapy etc. Please do not lose hope. Inform your doctor and family members immediately if you feel a desire to harm yourself.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on back of ear, headache and fever?\n\nHello,i'm a 22yrs old female.Since last week Thursday, i have noticed a lump at the back of my ear(not behind but directly on my ear). I also noticed that i had headaches with low fever and since then it has increased in size,the headaches has gone but the low fever still persist.Thanks",
    "doctor_response": "Hi and welcome to HCM.This can be caused by swollen lymhh nodes due to ear or throat infection so you need to s ent doctor for further evaluation. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the lower back radiating to the spine and neck?\n\nHi I have problems walking, lower back pain which flows the outer sides of my spine and into my neck. My tailbone feels slightly higher than it used to be and when I try to do a sit-up it feels like I am rolling over bones as if they are all sticking out. The tail bone is enlarged as if the bone has actually grown into what feels like a cube in my back. I also have wobbly walking and I stumble somewhat when walking making it very uncomfortable and embarrassing. Physios do not seem to have any idea what is wrong and my GP keeps sending me for blood tests and x-rays which show nothing.",
    "doctor_response": "Coccydynia... take one sacrococcygeal spine xray AP and Lateral view... Sitz bath,Ring pillow, sleep in lateral position",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I have pain in both knee and ankle with swelling?\n\nHello doctor, I am 60 female, having pain in both knee and ankle, swollen up, does not bend knee, the pain starts from upper thigh to knee.",
    "doctor_response": "Hi. I think you should get your blood test done for cholesterol, uric acid, and blood urea. Apart from this, you should always wear a knee cap. Put your feet in a bucket of warm water with salt and sit for half an hour daily. It will sooth down the pain and swelling. Please do the same exercises of the knees and legs so that the circulation does not stop. Take Shelcal 500 daily and Vitamin B12 also for boosting up the immunity.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for penile discharge in a child\n\nhi my son is 10 months old he is not circumsized and i went to change his diarper and went to pulll his skin back so i culd clean his penis and this yellowish greenish liquid dischare was comming from his penis what should i do and his penis looks a little swollen",
    "doctor_response": "Hello, Your child has an infection called Balanitis/Balanoposthitis. It is a mild illness only. no need to worry. Regularly clean the foreskin while bathing. oral antibiotics enough to treat the condition. you can do circum if the symptoms recur often. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Rajmohan, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat fever in a 2 years old child?\n\nI have a 2yr old daughter. She is running a low-grade fever (99.9), not eating, not wanting to play, and tells me she doesn't feel good. She is normally VERY sassy and full of energy. She is also complaining of a headache. Should I seek immediate medical attention or can this wait until Monday?",
    "doctor_response": "Hi your child has all the symptoms due to fever she had.If she continues to have this symptoms for more than 3 days, it is better to show her to a  child specialist and try to givr her adequate fluids and soft diet",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes allergy to sulfa medications?\n\nI am allergic to sulfa drugs. Yesterday I had my teeth pulled and dentures put in. The fixodent they gave me said it contained persulfates. There is big red warning on the box--- do not use if allergic to persulfates. Are they related and should I not use the fixodent?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. They are of same sulphur containing compounds so it would be advisable to avoid any sulphur containing products if you have proven allergy for the same.Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is frequent occurrence of strep infection detrimental to overall health?\n\nI have been diagnosed with strep following a swab taken by the gp. I was prescribed anti biotics and recovered fully. Having had sexual intercourse with my partner, the infection reoccurred. The gp will not prescribe a further course of anti biotics as she believed it will not improve the situation. I have a thin white milky discharge which is slightly smelly, but no other symptoms. I am becoming increasingly concerned that this maybe damaging to my overall health as I feel tired all the time and I'm coughing up stuff each morning when I rise.... can you please advise?",
    "doctor_response": "Hello to healthcare magic!First I have a couple of questions do you have pain when having sexual intercourse, is your white flow having bubbles ( like fizzy water or soda) or is it like cottage cheese? what is the color of the fluid? Also remember that  in STDs  ( sexually transmitted diseases) both partners are treated!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tell me the details about Bio Bust\n\nHi Good Morning, I would like to enquire about a product called Bio Bust, I have a history of brast cancer in my family and i have Fimafibroses or Breast Mouse, i would like to know if a product such as this will put me at risk for breast cancer? and if it will influence ones Menstruation cycle? Kind Regards Alicia",
    "doctor_response": "Hi Welcome to Healthcaremagic Biobust is a herbal product We do not have  any long term studies of its  benefits and sideeffects. But as you are genetically predisposed if it is running in 1st degree  blood relations you are required to get an annual check up by your doctor.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is 3 mg of Melatonin advisable while on Intuniv for ADHD in a child?\n\nMy 7 year old son is on Intuniv 1 mg., extended release prescribed to him for ADHD. He also takes Focalin XR 15 mg. Per day. He has problems falling asleep at night. Can he take 3 mg. Of melatonin at night when he takes the Intuniv? I would ask his doctor but she is out of town for a week.",
    "doctor_response": "hi, u can take melatonin 3 mg only once in a night. i suggest u will give focalin in morning if he took in evening because it affect our sleep also.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What has caused redness and cut like lesions in groin immediately after sex?\n\nHello doctor, Redness and cut like lesions on groin immediately after sex. I noticed burning and irritation immediately after sex. I do not know if it is herpes or just skin irritation from contact or friction.",
    "doctor_response": "Hi. These are fissures, usually in groin area infection can present in the form of fissures and cuts. Other causes can be Crohn disease but your complaint is acute one so most probably this is an infection. Do not worry, it will get better with proper medication and treatment. Try to maintain hygiene of the area and avoid sexual contact until you get better. I would like to know if your partner has any such problem? Infection. Bacterial infection. Tablet Co-Amoxiclav 1 gm BD for one week. Apply Fusidic acid ointment BD over the lesions. Take pain killer tablets like Ibuprofen for pain relief. Maintain hygiene of area, wash with soap and water, avoid using Dettol and other irritants.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on right arm pit\n\nI've had a lump in my right armpit for quite awhile now I'm currently a 15 year old female and I've had this lump for almost over a year now it started out small about the size of a marble and was slightly painful to hold the doctor told me it was nothing, I saw the doctor again after some months  since it seemed to get slightly bigger he said to get an ultrasound of it but nothing was seen, currently its slightly big and it feels like a piece of fat that's slightly firm about 3-4 cm big I'm just worried since its still there any advice?",
    "doctor_response": "hi.it is best if you consult with a doctor, preferably a general surgeon, for medical and physical examination. based from your description, it could be hidradenitis suppurativa. these lesions usually occur on the underarm, especially after shaving or plucking and/or usage of deodorants with strong chemical contents. hair follicles get infected. inflammation and subsequent abscess formation occur. other possibilities are cystic lesions, fibroma or lipoma (fatty deposit). medical (proper antibiotic regimen) and surgical (excision or incision and drainage) management will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low grade asocytoma\n\nhello my father is a patient of low grade asocytoma (tumor) and he is taking tegral and rivotril for 10 years now.he also has been infected by hypitytices c but in the pcr test the virus is not found.he also is anemic with hemoglobin of about 9.7.so in that scenerio what you people suggest him",
    "doctor_response": "A negative PCR means that your father does not have active hepatitis C virus infection.Treatment of choice for Low grade astrocytoma is safe surgical resection. If tumor is located in such eloquent area of brain that it cannot be removed safely then radiation therapy is the treatment.I hope it helps. Please discuss it with your treating oncologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it alright to marry someone with the same blood group as you?\n\nHello doctor, I am planning to get married. But my partner and I have the same B+ blood group. In this case, when we plan a baby, is it harmful? I have heard that the same blood group cannot conceive a baby together. Please advice me regarding the same.",
    "doctor_response": "Hello. Every individual has a unique ABO and Rh blood group. It remains same throughout the life. You and your partner having same blood group will not lead to any problem in conception or harm to you or the baby. If your blood was negative, and the fetus had a positive blood group than further workup is needed especially Anti D injection. Take care. For more information consult a hematologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why having abdominal pain after colon removal?\n\nI had a colectomy 11 months ago-- About 3-4 inches of the colon were removed to take out a flat sessile polyp. I have a four inch incision above my navel and a one inch incision on the right side of my abdomen. I am a weight trainer and returned to the gym about 10 weeks after the procedure. For the past three months I have either reoccurring or constant pain in several places in my right abdomen. The surgeon says no sign of hernia and offers no other possible cause. The only time it doesn t hurt is when I m working out . What could be the problem????",
    "doctor_response": "Hi.Go for CT scan , Enteroclysis and endoscopies and if required for Diagnostic Laparoscopy or laparotomy. This will hep you to get a reason and a proper treatment. There may be associated IBS as you are not getting pain when you are working.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of red spot on the top of the back of my head after fallen off from a horse?\n\nI took a fall from a horse today and now when I go to lay down for instance to watch tv I have spinning...  So I am staying upright to say the least.  I didn't think I hit my head as theres no pain but I now see a red spot on the top of the back of my head which I was unaware of.  I am protective of my back as it seems inflamed and have taken Ibuprophen.  I did have a slight case of the wind knocked out of me. As long as I'm upright I seem ok.  I am a 56 yr old female.",
    "doctor_response": "madam i would like to know from when was that that you noticed this spinning,and is your neck movements painful,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to conceive after having normal reports\n\nAge 30Height 5.1 weight 52Merriage two and half yearDoctor we are trying for pregnancy from last two months but not got pregnent my doctor duggested me one tablet Letryl2.5 from the first day to seventh day of my menstrual period should itake this tablet or not please advice. Doctor before one year i got missed abortion .we did all the tests which doctor suggested like Torch test, thioride test and all the other but all the test are normal so please tell me what should we do .",
    "doctor_response": "Hi,Welcome to HealthcareMagic. Letryl is given to induce good ovulation.  I suggest you to discuss with your doctor regarding use of ovulation inducing drugs like clomephine . This will help multiple follicles to mature and rupture . Thus increasing chances of pregnancy .This has less side effects compared to  letryl . While using ovulation inducing drugs you need to get serial ultrasound from day 9 to track the growth of follicle .Hope I have been helpful .Regards Dr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i work out after treatment for jaundice?\n\nrespected doctor, from last one moth i sufferd from jaundice.at starting my total bilirubin is 7.30 .now it came to normal(1.10).i used to take only liquids(sugarcane juice,coconut water and butter milk) when jaundice.can i  eat non veg and oil foods now....i have a habit of doing workout with heavy weights..can i continue doing workouts...and what diet should i take now.?",
    "doctor_response": "hi.thanks for posting query at HCMif all lab values are in normal limits ( including liver enzymes) and you have NO symptoms , the normal diet maybe restored. You may workout also.wish you good n sound health.you may recheck liver function test after 6 to 12 monthsregardsDr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can intake of coffee cause any problem in stress test?\n\nI have a stress test tomorrow at 8:00 a.m. and had coffee at 5:00 p.m.  Should I reschedule my appt?  The first procedure is CD/ED/794.31/LXA and the next procedure is ED/CD/794.31/LXA.  I am 50 yrs old, 5 ft. tall, weigh 128 and have a family history of heart problems.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. No need to worry for coffee intake. You had taken it before 15 hours of test. So it will metabolize in the body and excreted into urine and stool. So it won't cause any effect of your stress test report. So don't post phone or reschedule your stress test date. Don't worry, you will be do great I'm stress test. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain & nausea\n\nHi, for the last 10-11 days i have been experiencing stomach pain, stomach cramps, nausea (which can be severe enough to wake me from my sleep), I have a loss of appetite and i am experiencing mood swings.I have been to the dr twice, the first time I was told it was a suspected early pregnancy, however it was to early to do a home test.   On my second appointment my dr told me to come back in 3 days if my symptoms had not gone, and my period had not arrived.  Neither has happened.  However I am wondering if there is another possibility other than pregnancy?",
    "doctor_response": "Hi,First thing is to rule out pregnancy.Secondly there might be possibility of having jaundice where you got nausea, pain in abdomen and loss of appetite.Observe that color of urine is deep yellow and has yellowish sclera.Thirdly there might be having gastritis or acid reflux.If require go for urine and blood check up if doubt of jaundice is there.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Starting to lose control over age. Is it eye related or mental issue?\n\nHello, i have a question. My grandmother has started to lose control of herself 2 days ago. I dont really know how to describe it but i think it s not too severe. The problem is she somehow can not open her eyes or not wanting to do so, and they look cloudy too. Aside from that she can t seem find her way around the house anymore which i assume is related to her eyes problem. We are going to get her checked out at a hospital soon when it s not too hot out side, and in the meantime i want to find out as much about this as i can.",
    "doctor_response": "Hi Forum. it appears that she had raised or lowered BP or sugar. she should be taken to hospital as early as possible. there she may have to go for blood sugar c.t scan and other tests for diagnosis. in the meanwhile give her glucose water{10 spoons in one glass of water. she must be shown to a neurologist for diagnosis. if she is able to eat give her semi solid diet. first ask her then give any thing to her. never insist her to take any thing if not in a position to take. thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling in the testicle post an injury\n\nI was kneed in my groin really hard 6 days ago. It knocked me down for a few minutes but I was able to continue playing basketball. There was immediate swelling above my left testicle around the veins that are connected to it right to the left of my penis. There was no visible bruising, just some minor discomfort the following days. A few days after, there is now a lump either in the veins or around them above the left testicle. Its not really hard but its not soft. It doesn t really hurt unless pressure is applied to it. Any idea what this could be?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. This might be post traumatic hydrocele. But nothing could be said without getting physical examination. I would advice you to visit urologist and take an opinion. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does a bee sting cause jaw lock?\n\nCan a bee sting cause lockjaw?  My wife was stung approx. 2 hrs ago on her thigh.  She has never been stung before.  There is no sign of swelling other then a small red spot where the sting occurred, her jaw is beginning to hurt a bit.  A sensation similar to having an anesthesia shot in the jaw from a dentist...",
    "doctor_response": "Thanks for posting your query to HCM.After going through the history, I would like to tell you that there is no correlation between bee sting and jaw pain.You should consult an oral surgeon for the jaw pain.Till then you should give your wife Vasogesic MR 2 times a day for relief from pain and reduce inflammation.Hope my answer will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Do you have any idea about my undiagnosed flares?\n\nHi doctor, I have been having undiagnosed flares for the past five years. The symptoms are usually similar, but during each flare I have a few different ones that seem to take the lead. They almost always start with pain in my legs. First it starts with shin, then calfs, thighs and butt. The pain usually spreads randomly, but this time it started and sets in as a longer crushing pain. The pain spreads to the joints, muscles and the eyes. It seems like organ pain. I also get muscle spasms throughout the body. I get very strong headaches that usually start behind one eye and feel like a tension headache. I also get long and short stabbing pains in my head. During my current episode and two previous ones, I also have very apparent neurological symptoms such as vertigo, brain fog, etc. I have gastro symptoms as well, such as constipation, diarrhea, abdominal pains and upper right quadrant pain. I also have frequent urinary symptoms and sharp random pains in my groin, testicle and penis. I have also had blood in my urine. I have heart palpitations too. This is not happening with this flare for some reason. My random symptoms are hives, especially in one patch on my left rib cage only, rapid weight loss (I have lost 10 lbs in one week and 30 total during the first episode), interrupted sleep, red irritated eyes, occasional sore throat, nasal drip, strong fatigue and occasional mouth sores. I have had MRIs, ultrasounds and CT scans, which were all negative. I am going for another brain MRI and ECG by next week. My blood test shows ESR - 3 x negative, CRP - 3 x negative, CBC - 7 x always in range, metabolic panel - always in range, cortisol - negative, RA and lupus serum - negative, Lyme (ELISA) - negative, HIV - negative, ANCA - negative, ENAS - negative, Ferritin - slightly elevated, celiac panel - all negative except gliadin AB, IgG positive, TSH and free T4 - in range. Biopsies for celiac and Crohn's were negative. Do you have any ideas of what this syndrome could be? Please help.",
    "doctor_response": "Hello. I am sorry that you have been through so much in such a young age. I am thinking of Behcet's disease, also known as Behcet's syndrome. It is a relatively rare disorder that causes blood vessel inflammation throughout the body. Unfortunately, there are no classical laboratory tests in Behcet\u2019s syndrome. The diagnosis is clinical. In the absence of other systemic diseases (as you had a negative work up), the Behcet\u2019s syndrome is diagnosed in patients with recurrent oral aphthous ulcers and two of the following clinical features: The mild elevation of ferritin could be an indicator of inflammation since it is an excellent acute phase reactant. For further information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for throat pain and hoarse voice in a child\n\nI have a 12 year old son who had a nose bleed a couple of days ago but now he,s spitting up blood with his mucus. He lost his voice or i should say very horse. His throat hurts only a little bit, on a scale from 1 to 10 it,s a 2. He has no headackes and no temperture and feels pretty good otherwise. Do you think he needs antibiotics?",
    "doctor_response": "HelloI don't thin there's an indication for antibiotics at this point but if he has blood in his mucus he may still be having a posterior nosebleed and for that reason he needs to have a doctor check this out.Laryngitis--the hoarseness--is generally a viral condition and doesn't require antibiotics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for social anxiety disorder\n\ni have a problem of nervousness....i feel nervous while speaking to someone...moving outside of my house..from these nervousness i giggling in my mind...i am felling problem in travelling bus or train...because of abnormal mind laughing.....my age is 27+...and i am suffering this disease for past 4 years",
    "doctor_response": "dear,I would advice an initial course of  a small dose of propranolol half an hour before the social performance.0.5 mg of tab alprazolam in case if you anticipate anxiety may be very helpful.however, cognitive behaviour therapy will greatly help you in a long run.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Did tamoxifen cause shoulder pain?\n\nI started tamoxifen Tuesday and on Thursday morning I started having severe pain in my right shoulder radiating down toward my shoulder blade and sometimes up onto my neck and sometimes down in my left arm , would this be a sued effect of this medication?",
    "doctor_response": "HiThis isn't a reported side effect of TamoxifenIt could be from a pinched nerve in your neck so you need an MRI of the cervical spine to check for a ruptured disk",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should we go to the emergency if child has fever after appendectomy 9 days ago?\n\nmy son had an appendectomy 9 days ago. we saw the surgeons nurse yesterday for a post/op visit he had a fever of 99.6 they sent us home. today we returned to his ped doctor do to headache and vomiting. she gave him an IV drip and sent us home three hours later. He is feeling much better but his temp has gone up to 100.3 should i take him to ER now?",
    "doctor_response": "Hi,Thanks and welcome to healthcare magic.After appendisectomy fever should not continue beyond 4-5 days.If the fever is persisting probably there is secondary bacterial infection.Better to take the child to ER as soon as possible.Hope this reply serves your purpose .Please feel free to ask further queries if any.Dr.M.V.Subrahmanyam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stoppage in menstruation?\n\nhello im a 24 year old female and i am really woried and a bit scared i dont know what to do i have a 4 year old girl and dont remember my pregnancy much but my question is i havent had my period since october and have taken (hpt) and even a blood test and they have all been negitive but im showing all the signs of having a bun in the oven i have gotten sick my breast have filled out some and are tinder my nipples are sore i have mood swings i have been eating more i have backachs im an insoniac and have been sleeping alot but my question is could i still be pregnant? and my hcg levels are just to low to pick up yet or could something be wrong with me can you please help me and tell me something that could help i am really woried and if i am pregnant i dont want to lose the baby i am rh-neg and need to catch it quick so if i need to i can get a Rhogam shot and be safe for me and the baby please help thank you very much",
    "doctor_response": "If Hpt is negative then chances are very rare that you are pregnant.  you might have some harmonal imbalance that causes missed periods. Consult your gynaecologist for checkup  and usg and blood tests",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does night fever with shivering and blood test (leukocyte - 19500, neutrophil - 88) indicate?\n\nmy friend has been suffering from fever for 15 days...tests for typhoid n malaria negative...fever occurs at night with shivering...almost normal during daytime...blood tests show 19500 leukocyte count and neutrophil count at 88...what should be done...doctors at a loss",
    "doctor_response": "dear friendyou certainly seem to be having an infection or in rare cases chronic myeloid leukemia.if nothing else a leukemoid reaction from an infection but your white cell count does reach the lower limits of CML range.you also need to rule out a lung infection or an UTIplease discuss these possibilities with your doctor and before a diagnosis is made please request for a peripheral smear to be examined by a haemato-pathologist to at least screen for CML",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful lump on forehead?\n\n3 days ago a lump formed on my forehead between my right temple and right eye; just at the edge of the eye brow.  it is painful at time, but not all the time.  it does not itch, but it is beginning to blur vision in my right eye.  i am beginning to get concerned",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have angular dermoid or some soft tissue tumor or cyst.  You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Surgical excision is the treatment of choice. Once its excised you vision gets clear. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with expansible mass enlarging and eroding the left neural foramen. Surgery recommended\n\nmy husband has been diagnosed with an expansile mass enlarging and eroding the left neural foramen at C2-C3. It extends into the spinal canal and is not clearly distincly visualizd from the spinal cord on CT.  Surgery is recommended to remove.  How can we know the best available neurosurgeon in our market, El Paso, TX?  Or, should we have it done  in a larger market such as Dallas or Phoenix with more experienced neurosurgeon?",
    "doctor_response": "Hi,Thank you for posting your query.The mass or tumor in the cervical spine can be best visualised on MRI. So, please get a cervical spine MRI with contrast.Regarding the best neurosurgeon, you can visit the websites of local university hospitals, and then, find out the best neurosurgeon. It may be better to get it done in larger market such as Dallas or Phoenix. This is because they would have more experience in dealing with these surgeries.I hope it helps. Please get back if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from bronchitis allergy. Wheezing issues. Will homeopathy help?\n\nMy sister is 14yrs old n she is suffering frm bronchitis allergy. she is taking homeopathy medicine for last 3yrs frm reputed doctor. Sometimes it feels like that she is getting better,bt suddenly ther comes a problem. Now a days, she complains of not able to breathe properly ,pain in throat , wheezing problem, so we have to give her router inhaler so as to breathe properly .Can u suggest a solution for this problem? should we continue with homeopathic medicine ?",
    "doctor_response": "hi vishal welcome hcm as your sister is taking homeopathy for three years she would  have got better i think there is something missing.  remember homeopathy homeopathy has no specific medicine for any disease .homeopathy is personality based treatment so to treat a patient  a homeopath needs all physical and mental symptoms of including her habits  etc. a classical homeopath will be great help for her i suggest you to continue homeopathic medicine with good homeopath i wish your sister good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes congenital brown spots all over body?\n\nHej , I have a doter that she was barn with brown dots on her skin and I am affred of them and she is now 4 years old and they do for her eye test to detect if there is some dots , and the result was good nothing of dots. pleasecan you tell me what are ythose dots ,they have different sizes tiny , small ,mediam ,adn large and they more than 20 dots and alloround her body sorrounding her neck legs ,back , hands , abdomen .... Please help me with your answer",
    "doctor_response": "a picture of these dots will be very helpful, there are a few diseases that present with the above described dots, one of them is neurofibromatosis which is a neurocutanous disease in which there is other findings with that such as seizures , developmental delay . but in order to confirm this diagnosis a brain CT is needed because this disorder is associated with benign brain tumors . some children with this disorder can have the brown spots but without any seizures or developmental delay . I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling in fingers\n\nHi, My index finger and the tip of two other fingers have been swelling for about two or three weeks. They don t feel painful or itchy at all and there is no peeling skin or bruises. I went to see a doctor a few days ago and have soaked my hand in hot water (hottest I can bear without causing skin burn). I was told they should turn blue and that should relieve the swelling, but after soaking for a few times there hasn t been any difference so far. Just wondering what might be the cause of the swelling and what should I do? Thanks, Lydia",
    "doctor_response": "Hi, There could be multiple causes including carpal tunnel syndrome (which makes you feel that you have swelling) or venous congestion. I suggest you visit the Orthopedic Surgeon for detailed examination and treatment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can you take hormones after having carcinoids? Had a hysterectomy, ovarectomy. Suggest?\n\ncan you take hormones after having carcinoids? had a hysterectomy in 99 and had ovarectomy in 12...had carcinoid that had eaten thru the appendix in 11. the docs here werent real sure what to do with me after carcinoid in 11 ... and for some reason i am under the impression it may not be a good idea to use hrt??? ty",
    "doctor_response": "Hi and welcome to HCM. There is no reported bad correaltion between carcinoids and hormonal therpay. Hormones from carcinoids are different then those ones used in HRT.  So i dont see a reason not to take it. Also you should know is there any relaps of carcinoid. DO frequent check ups made of imaging tests and hormone measurments. WIsh you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and loss of appetite\n\nI am suffering from fever for last 10 days.Initial 7 days fever use to stay in night and go in morning. From last sunday I am taking antibiotic gudcef on doctors advise. This has reduced the intensity of fever. However I have two added problems now. Fever timing got changed; now I have mild fever (upto 100 'F ) both in night and morning time. Also I cannot eat anything. My hunger sensation has died. Whenever I am eating I am vomitting. Today after vomit I found slight traces of blood in my spootum. Please advise as to what disease I am suffering and is this happening as side effect of antibiotic I am taking.Thanks Suvojit",
    "doctor_response": "Welcome to HCM.I Understand your concern.As per history given by you you could be suffering from viral /bacterial infection or a combination of both.Antibiotic course given to you have taken care of the bacterial infection and it has resulted in the intenstiy of fever going down but it is not effective against viral infection.To confirm presence of viral infection you need to undergo haemogram with blood smear test.Along with it you need to take rest,antipyretics like crocin three times a day to keep fever in check.Follow up with the lab reports with local doctor.Thanks and regards.No need to worry.Viral infection subsides by its own.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness followed by loss of focus?\n\nafter walking into the kitchen felt wonderful ...normal all of a sudden the room and everything in it was spinning and couldn t focus scared me to death my husband walked me into the living room to sit in chair it was ok for about 45 sec then everything was spinning again in the room I was o terrified I was screaming my sugar was 88 blood pressure was157/85 pulse 67",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I passed carefully through your question and would explain that your symptoms could be related to an inner ear disorder. For this reason, I recommend consulting with an ENT specialist for a physical exam and labyrinthine tests to investigate for an inner ear disorder. If these tests result normal, I would recommend performing a brain MRI to investigate for any possible stroke. It is also important performing a cervical spine X ray study and checking thyroid hormone levels. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to regularize menstrual cycles when not taking any birth control pills?\n\nI have very irregular menstrual cycles. I can go two months without one then once I menstruate it will be for instance I'll start the beginning of the mnth then the next month start in the middle of the month then I' ll start at the end....Then go without for a few months. Is this normal since I dont currently take birth control and haven't in five years.",
    "doctor_response": "hi, It is not normal to have irregular cycles and you cannot keep taking pills to regularize cycles lifelong .So i will advice you to get THyroid profile tested i.e. Free T3, T4, TSH and Serum FHS, Serum LH and Serum Prolactin as thyroid and hormonal imbalance are common causes of irregular menses. Also you need to get a sonography of your pelvis done to rule out any fibroid as a source of irregular bleeding",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is stomach virus contagious?\n\nMy boyfriend had the stomach virus..he fell ill on Thursday night and stop vomiting around 4am Friday morning.  We were together last night (Sunday evening) and were kissing.  Does this put me at risk for contracting the virus?  I have read that the stomach virus is only transmitted via fecal-oral transmission OR by particles in the vomit...is this correct or can it also be transmitted via saliva from kissing a couple days after as well?",
    "doctor_response": "Thanks for following up. Stomach flu is caused by swallowing different viruses. Infected people can spread the virus through their secretions, sometimes even before their symptoms begin. The virus can be spread by direct contact with an infected person (for example, kissing or shaking hands) or by sharing food, drink, or eating utensils.  You can try to boost your immunity with ginger, lemon and turmeric powder tea, drink some sorbents as charcoal(1 tablet/10kg) for prophylaxis and absorption of viruses.     Take care!   Wishing you a good health   Dr.Sagar Gaurav Shrivastva",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe headache during 38th week of pregnancy?\n\nI am 38 weeks pregnant, I am on day 7 of the most intense headache I can remember having in a very long time. I was seeing spots. I have been to labor and delivery 2 times, blood pressure is normal for me (117/68), there were no proteins in my urine, my blood work was fine. 1000mg of tylonel did nothing at all to releive the pain. What else could this be?",
    "doctor_response": "Hi.Headaches during pregnancy are common and associated with hormonal imbalances, in your case this could  be the cause or it could be a migraine headache. I would think that a hormonal cause is more likely, and if that is the case then we cannot really do much about it until you deliver. I am sure you already know that we cannot really prescribe pain medication for you, and as you are close to your term you should be rid of them really soon. Wishing you loads of luck and congratulations in advance.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe acne, large infected cysts, oily skin. Taking melatonin. Causes and treatment?\n\nHi, I am 30 and just started having major acne , i beleive its caused from taking melatonin . its now been 6 months since i stopped taking it and it doesnt seem to be getting better. i have never had acne before and now have severe very large infected cysts and very oily scin for the first time. how can i get my system to go back to normal? Thanks",
    "doctor_response": "Hi, Since the problem is hormone induced you can start on T.Diane35 from day5 of menstrual cycle for 21days for consecutive 3months along with topicalDerivaCMS in the night.Topical medicine can cause drying effect.So use Acnemoist or any other moisturiser by day.Continue this and report to me later.If not responding let us consider starting on oral Isotretinoin.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My teeth become yellow after 15 days of scaling. Why?\n\nHello doctor, I am 19 years old. After scaling there is temporary removal of yellowness but after 15 days it becomes yellow again. I want a clean teeth like pearls. I am using Patanjali toothpowder.",
    "doctor_response": "Hello. I believe you are referring to scaling only, and not teeth whitening procedure. The scaling procedure only removes debris and calculus from the surface of the tooth and gums. For getting pearl type white teeth, you need to do teeth whitening procedure or bleaching. But still, after some time, the teeth will become more yellowish. You need to do brushing at least two times a day. A little bit of yellow teeth is normal. For permanent white teeth you can do teeth lamineering procedure which is a costly procedure where the front side of the tooth is slightly cut and a pure white ceramic layer is put over it. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain due to fitting of upper dentures\n\nHello,I am a 64yr old woman,189cm tall,50.4kg,no known diseases.I have just had an upper denture fitted,& took for pain Panadol &Ibuprofen for inflammation,until I had to cut them down & virtually out, as I was getting weak & shaky with hypoglycaemia. Have had this occasionally over a number of years,but largely control it with diet.I was wondering if there is safer pain control for this condition?Thankyou for taking the time to reply.",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concern...As per your complain and presentation of symptoms hypoglycemia is not being caused due to wearing of dentures and in your case as you had this problem since years which you have controlled with diet and as now you are having recurring episodes of hypoglycemia it is an alarming condition and you need proper medications for controlling the condition..You should immediately consult an ENDOCRINOLOGIST and get evaluated for the exact cause of the hypoglycemia and get treated accordingly..As far as pain due to denture is concerned there may be some sharp elevation towards the tissue surface of the denture that may be causing injury to the gums leading to pain and discomfort..Consult your dentist and get it evaluated and get proper corrections done to relieve pain..You can apply numbing gel containing Lignocaine over the sore areas of gums and can take Ibuprofen for pain and inflammation relief..Do cold water gargles and suck on ice pops for relief. Hope this information helps..Thanks and regards..Dr.Honey Nandwani Arora..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the reason for itching between thighs and genital organ?\n\nHello doctor, I have high itching between thighs and genital organ.",
    "doctor_response": "Hello. I have gone through your query and I have noted your concern. You seem to have a fungal infection, that is tinea cruris. I suggest oral Fluconazole 150 mg tablet, once a week for four weeks. Topically, you may use Luliconazole 1 % cream, twice daily. I also suggest you take a tablet of Cetirizine for symptomatic relief from itching.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest methods to handle mental illness with frustration\n\nsir this is about my sister, sometimes when she gets angry or get frustrated she start acting like a different human being shouting, running and making faces are her symtoms... and after few moment she faints and doesn't remember any thing which she has done in feet of her anger.it only started few months ago and her age is 14 years and this case occur only few times not every time when she gets angry.kindly tell me what should I do ...",
    "doctor_response": "HHi dear. I had gone through your query. There are two possible diagnosis of her clinical presentation. 1st is dissociative disorder in which identity disturbances along with amnesia occurs .means inability to recall events.It is stress related and can be treated with medicines.2nd is it may like siezure episode most likely TLE. means temporal lobe epilepsy. To differentiate this conditions you have to consult psychiatrist/neurologist and require investigation like EEG. So after proper diagnosis, we are able do reach proper conclusion. So consult and get help. Still if you have a query then feel free to ask. Happy to help you further. Get well soon. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can ashwaganda brahmi combo cause anxiety symptoms during periods?\n\nI've tried ashwaganda brahmi combo and the first week I felt so much better,had more energy ...etc,then when I got my period had very intense anxiety simptoms.Do you think this might be do to those supplements.I started those to help with stress!Thank you",
    "doctor_response": "hithanks for using care magicAshwaganda brahmi is herbal product and it is effective in reducing anxiety. In ur case anxiety cannt be due to this. Sometime, few female feel anxiety and irritability due to menses. It is called premenstrual syndrome. It happens due to hormonal imbalance. If again u have such symptoms then consult a psychiatrist for further treatment. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pregnant with inflamed gums, infection around the wisdom tooth. Not able to open the mouth. Taking zinnat. Worried\n\nHi I've just started zinnat last Thursday because my gums are inflammed and infected around my wisdom tooth. I wanted to know if this would cause the gums to go down and the muscles to relax so that my mouth can open. It's hard not having mobility of my mouth especially when your pregnant. I fear that not being able to eat is goin to cause a problem for my baby.",
    "doctor_response": "Hi,Thanks for asking the query,I would like to tell you that special care should be taken while performing dental procedures, as you are pregnant. Visit the Dentist get a checkup done. Avoid taking x-rays. Best treatment for pericoronitis will be extraction of wisdom tooth, you can postpone the treatment until your delivary till then you can take a course of antibiotics and analgesics consulting your OBGYN.Take lukewarm saline and antiseptic mouthwash rinses.Maintain a good oral hygiene.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it it normal to have staph infection after undergoing surgery for cancerous tumor?\n\nA friend of mine had surgery on Monday the 10th of this month, It was for a cancerous tumor in her ovary. She went home on the 13th and by Friday the 14th was in much pain, By Monday morning a week after the surgery she was in so much pain she went to the ER and she was admitted to the hospital. The took tests and It came back positive for staph infection. They inserted a vacuum pump and put her on antibiotics. She was told today that she does have staph and the antibiotics are not helping, either from the radiation pills she has taken because of the cancer or she is immune to them.  She will go back into surgery today to replace the sponge type thing from her stomach and they will assess her, Do you know of anything else they could do to help her? She is a great friend and I am concerned about her SO MUCH! Thank you!",
    "doctor_response": "It sounds like she is getting the appropriate treatment for a wound infection - the vacuum device will accelerate the speed of wound closure while helping with drainage.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for severe lower abdominal pain?\n\nHi I keep getting pains I the lower side of my stomache it's happens all the time my belly seems to bloat everytime I eat something the pain seems to be getting worse every hour of the day I can't seem to be able to sleep eat drink or walk without the pain starting",
    "doctor_response": "HelloLower abdominal pain may be due to many reasons like liver  problem,kidney problem,pelvic causes,colitis etc.You may need clinical correlation and few investigations like routine hemogram,random blood sugar,liver function test,renal function test,lipid profile,urine and stool RE/ME,ultrasound of abdomen.Ultrasound of abdomen is very important in your case and it can exclude many causes.Proper treatment depend upon findings.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for painful lumps all over my body while suffering from ankylosing spondylitis?\n\nmy husband has ankolising spondylitis diog 2000- crones disease diog 2013, just diagnoses with sciatica last Monday 2014 , on humira for AS, prednisone for latest bout of crones, pain control tramadol, morphine, hydrocodone . He is breaking out in painful lumps all over his body , knee, head, foot , neck upper leg , temp 38.5 , bp 167/91 . bp has been low last few days",
    "doctor_response": "Hi,Thank you for posting your query regarding your husband.It is unfortunate that your husband is suffering from multiple medical problems. He needs to be examined to find out the reason for multiple painful lumps. As he is on steroids, the most likely cause could be infections such as furunculosis.Please meet a dermatologist or an internal medicine specialist for confirmation of diagnosis.There is no need to worry, as it can be well treated with medications.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are lump on color bone and shortness of breath related?\n\ni use to do lots of pushup in my exercising routine where the area between my color bone and chest developed a swelling or lump visiting two doctors they told me it was not a problem but i still continue to get a shortness of breath they havent even given me nothing for the swelling what is my problem",
    "doctor_response": "Hello,The lump in the collarbone is commonly related to a reactive lymph node. The enlarged lymph nodes are related to an infection in the system. I suggest to do a complete blood count and a chest X-ray for further evaluation. I also suggest using anti inflammatory medications to relieve inflammation.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Mabendazole cure infection?\n\ndoes mebendazole kill worms under the scalp and brain? i had a worm from a dead deer leg caruss that my kids dog brought in the worms were fast intering and can hardly see them ..theyre in my scalp and skin ,they feel like slivers going through my body biting and leaving pimple like marks",
    "doctor_response": "hi . I did review your concern. Mebendazole is a orally taken drug to kill certain types of helminths in body. I dont think they would work as a local application in the form they are manufactured. better would be to use something like a BHC paste as they can act locally and potentially kill the parasites without much harm to your skin.I hope this helps.thank you. have a great day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest me multivitamin tablet\n\nI am a 14yr old, I need a multivitamin tablet can you please suggest me one?",
    "doctor_response": "Hello Welcome to HCM Thanks for your query There are many multivitamin tablets available in the market. But the best is Amway's Nutrilite daily Multivitamin Tablets. You should take 1 tablet daily with milk. Along with this, you should drink milk & eat fruits and green vegetables. You should do exercise and yoga daily. I hope this will help you. Thank You",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What causes white vaginal discharge?\n\nHello doctor, I am witnessing a discharge of white substance. It discharges during pee and also normally it is happening from the last two days. Please tell me what is the problem and solution for it.",
    "doctor_response": "Hi. Females normally have some white discharge during the cycle. If you do not have burning sensation, pain or itching. And the discharge is not foul smelling, then no need to do anything. It is normal. If it is abnormal, then you will have to take medicines accordingly. For tablets ease consult nearby physician, let the doctor see what type of discharge you have and take antibiotics accordingly. Some precautions: Drink more water, keep the lower area dry, change pads more frequently during your period, wear cotton underwear, if possible. Wash with plain water and urinate everytime after sex.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My grandma eats very little after an episode of fever. I am worried. Please advise.\n\nHello doctor, My grandmother is 65 years old. She had a fever last week. She was taking Zerodol-P and Azio 500. Now, there is no fever\u00a0but, her eating capacity has greatly reduced. After taking only a bite or two,\u00a0she feels full and does not want to eat further.",
    "doctor_response": "Hello. Hope this helps you. Get back if you have any doubts. For more information consult a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I feel lethargic and sleepy after lunch. Will taking multivitamins help?\n\nHello doctor, I am a 33 year old software professional. I have a lot of work pressure and also loads of stress and tension in my personal life. I sleep around seven to eight hours a day and stick to a very healthy and disciplined lifestyle with respect to timely food habits and taking a balanced diet. My problem is that I feel very lethargic and sleepy for three to four hours post lunch. I also feel a lack of energy sometimes to the extent that it hampers my daily work and duties. It is worth mentioning that I am taking a mild dose medication for epilepsy treatment and was under OCD treatment prior to that.",
    "doctor_response": "Hello. What epilepsy treatment are you on? Drugs prescribed for epilepsy as well as OCD (obsessive compulsive disorder) can cause sedation. If it is not due to the drugs, you can try changing your meal schedule. It is normal for everyone to feel sleepy after a heavy lunch. But, if it hampers your work, you should change your lunch timings. Take a heavy breakfast and skip lunch or take it around 11 AM. Also, take up a daily exercise that activates the reward centers of your brain. This will keep you fresh and awake. For lethargy, you can take multivitamin and multimineral tablets for a month. Revert with more information to an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does statin cause muscle pain like side effects?\n\nHello. I was just put on a statin, Fenofibrate 145 mg. I have tried many other statins in the pass to bring down my levels but because of severe leg and muscle pain stopped. Are the side effects from this particular statin cause the same symptoms? Also I m wondering why my doc started me on such a high mg.Thanks",
    "doctor_response": "hiYour doctor may be the best judge.Not all statins give such side effects unless in large doses.Wait and watch, hopefully this one shall not produce muscle pain.have good control on fat diet especially saturated fats in diet,regular exercises should be donebest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will depo shot cause infertility?\n\nhi, i was on depo and i had my last injection in december, me and my fiancee have decided we would like to start a family. I have started having my period its been normal for about 8-9 months now but still nothing, could of the depo made me infertile?",
    "doctor_response": "Dear member,Thanks for writing to healthcare magic.The return to fertility is delayed after depot preparation compared to other contraception. After a year if you have not conceived then you will need detailed infertility analysis and your partner semen analysis.Usually most patients conceive in a year. Use ovulation detector kits from day 12 of cycle for 3-4 consecutive daysThus timed intercourse can give better success.ThanksDr Bhagyashree",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lower abdomen pain after delivery\n\nHi, I am writing from DOha, Qatar. I am an expat from India. Delivered my second baby in 2012 october. I missed all my appointments with gynecologists afterwards. I have this strong pulsating feeling in my stomach on the left hand side of my tummy. Is it something serious? I have a feeling of pain inside my lower abdomen. Also there is no sensation just under my belly button",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query.Considering the pulsating feeling inside your abdomen, I would suggest you to get yourself clinically assessed by your family physician followed by an ultrasound of the abdomen at the earliest to rule out a vascular problem in the abdomen. Further management would depend on the reports. In case the pain is severe, you could go for an anti inflammatory along with a proton pump inhibitor drug.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and swelling in leg after an injury?\n\nA week ago I was hit very hard in the front of my shin. A large lump swelled up right away and a softball sized bruise. The lump is now smaller and hard. Im on my feet a lot and its a little painful when standing or walking but extremely painful once I sit down. Im on fixed budget and am unsure if I should get an xray or just give it more time to heal.",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.You are likely to be having hematoma which will gradually resolve. You can take analgesic such as ibuprofen for pain relief. Thrombophobe gel local application helpful in resolving it early. Vitamin B and C are helpful in recovery. You can get its x ray to rule out any mild fracture however I don't think that you have fracture. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i continue taking montek LC for allergy and cough?\n\nhello doctor,I am having problems with allergy and cough for long time but now i m taking Montek LC for nearly six months and it resolved but as soon as i leave this medication it again comes back, I think i am getting dependent on it. what should i do.  should i continue taking it or what? please suggest me?",
    "doctor_response": "hello, thanks for ur query, as ur already on tab Montek-lc for d past 6 months . do not stop abruptly. stopping should be in tapering manner. u comeback to 5 mg dose for 1 month, then, alternate dose for 1 month. see for symptoms. if symptoms persistent u need to take some more months.all d best. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does progressive thoracic endplate discogenic and facet degenetation with small disc herniations mean?\n\nHi there I had a Mri done the other day because of burning back pain and right side rib pain. My report reads as follows sounds like a lot of things are going on. Made an Appt to see my Doc on the 24th of this month. here is my report a mild upper thoracic levoconvex curvature. There is a mild kyphosis at the T11-12 level. The cord demonstrates normal size and signal characteristics. Mild acute, Modic type I endplate degeneration is seen about the anterosuperior endplate of T12. No suspicious marrow infiltration is seen. There is mild lower thoracic endplate degeneration including small Schmorl's nodes. Multilevel disc desiccation is seen within the thoracic spine with mild loss of height.At T2-3, left greater than right facet arthropathy is seen without spinal canal narrowing. Mild left- sided foraminal stenosis is seen without nerve root impingement.At T6-7, a tiny right central disc protrusion is seen which flattens the right paramedian thecal sac without cord compression or foraminal stenosis.At T7-8, a tiny right central disc protrusion is seen which indents the thecal sac without cord compression. Facet arthropathy is seen without foraminal stenosis.At T9-10, a central disc protrusion is seen with an annular disc fissure. This indents the thecal sac and gently contacts the ventral thoracic cord without compression. Facet arthropathy is seen without foraminal stenosis.T11-12, a tiny disc bulge is seen with flattening of the thecal sac but no lower thoracic cord compression or foraminal stenosis.Review of the remaining levels reveals less prominent discogenic and facet degeneration without significant spinal stenosis, cord compression or nerve root impingement. In comparison to the 2009 study, degeneration has progressed.Evaluation of the paraspinal soft tissues is unremarkable.IMPRESSION:Progressive thoracic endplate, discogenic and facet degeneration including small disc herniations, notable at T9-10 where a central disc herniation and annular disc fissure contacts the ventral cord without compression or nerve root impingement.",
    "doctor_response": "Hi,Thank you for posting your query.I agree that the MRI spine report is long and reports a lot of abnormalities. However, they are minor in nature and there is no need to worry about them.These abnormalities are due to degeneration of vertebral bodies and discs (located in between the bones over back). As a result, there is mild compression or pinching of nerves in the back. This is giving rise to the pain.Treatment would require medications such as pregabalin capsules for pain relief. In addition, physiotherapy with back extension exercises would also help.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does growing knot on back of neck indicate?\n\nI have a knot that has came up on the back of my neck. I had an ultrasound an they said it was a Hypoechoic focus on or in the Lympnode and now want me to have a catscan. Other people say they have a knot and it s nothing to worry about. Some days it really bothers me some days it doesn t. Any ideas if I should just wait till it grows bigger or would that be a bad idea?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have growing knot on back of neck . Well there can be many reasons for symptoms you mention in query like infected Boil, Carbuncle ,  reactive hyperplasia, tuberculosis or lymphoma. Do not try to even touch or pinch the area as can cause more aggravation of the problem and spread of the infection. This area is quite common to get infected very easily because of sweating and high bacterial proliferation. Consult dermatologist for proper examination . Doctor may check tenderness and consistency ,order ultrasound and take sample for lab test . Doctor may prescribe antibiotics like clarithromycin along with anti inflammatory .Doctor may also recommend surgical excision . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest alternative medication for itchiness and inflamed skin\n\nI bought a skin care system at a nice yard sale. I guess it is old and hadn;t been used in awhile. I know for sure it was these products because the itching and redness started later after using it. My face seems to be okay, but my neck is red and it itches like crazy and i can t help but scratch it. HELP! What can I do?",
    "doctor_response": "Hi, It may be irritant contact dermatitis due to cosmetic you applied. Consult the dermatologist for the perfect diagnosis and proper treatment. Apply mild steroid cream on affected areas. Take antihistaminics like Cetirizine daily till you get improvement. If needed, oral steroid may be taken in tapering dose. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilyas Patel, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden unusual behaviour and dizziness?\n\nMy three-year-old grandson had a strange sensation this week. Suddenly crying out and climbing on a chair, he said the floor was moving, and later he described, as best he could, how the floor had started to fall and said that the whole house had begun to move. The episode lasted a few moments, but it was repeated the next day. He had been to the mountains the day before the first episode. Could it have anything to do with an imbalance in his inner ear or something like that?",
    "doctor_response": "unusual behaviour or altered sensorium after a mountain trip is mostly due to tick or insects bite.. examine the child whole body to find out any bite marks or rashes on body, mostly rickketssial or scrub typus will cause like this symptoms along with fever, malasie, ect.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does it means when you have knot feeling in heart along with twisting pain?\n\nHello Dr.Samuel N.Grief,i want to know what it means when you feel like there is like a knot feeling in your heart and it feels like its twisting its a bit painful and happens to me almost ever other day and on those days i have it continuously throughout that day?",
    "doctor_response": "Hi Welcome to HCM,I understand your concern.Your symptoms could be related to underlying pathology in the heart.So I advise you to get an ECG,2D Echo ,lipid profile immediately.Monitor blood pressure and heart rate immediately.Drugs like Antiplatelets can be started once diagnosis confirmed.Exercise daily for 30 min.Avoid smoking and alcohol if any.Consult cardiologist for expert management.Post your further queries if any,Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause loss of control on feet after sitting on toilet?\n\nmy wife sits on the toilet for 15-to 20 minutes. When she get up she loses control of her legs to the point she cannot stand to her feet. I have to lift her, hold her up until she can stabd on her own. What can be the cause of this and how to prevent it?",
    "doctor_response": "Hello, As she is sitting for a long time there is a numbness due to compression of the nerve. If she continues to sit for 15-20 minutes using a small stool and keeping the feet on it will release the pressure and she won't feel the loss of control. Also, she can do on a regular basis simple lower limb strengthening exercises. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are Dubagest and Progesterone effective in the treatment of infertility?\n\nHi I am 30yrs old underwent iui (3rd cycle) doc advised me to have Clomid 100mg from day 3 to 7 and had got injection on the alternative days on 3, 5 and 7 and had my iui on day 18th and advised to have dubagest progesterone 300mg. I had slight spotting on yesterday exactly 10 after iui and slightly bleeding from mrng. Do i have chance to get pregnant.",
    "doctor_response": "Hello,Thank you for your query. If your bleeding was light and has stopped within a few hrs, you could be pregnant. Please wait till your period due date and take a pregnancy test. If negative, you may need a blood test to confirm. If you had bleeding for more than a few hours, then it's like that your period is on its way. If you feel anything out I'd the ordinary, please see your fertility specialist right away to check any causes for concern. Hope this helps. Please let me know if there is anything else you I can help you with. Wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which hospital is the best for the treatment of thyroid cancer ?\n\nsir, i am from bangladesh,my sister is thyroid cancer patient age 35yrs. 19th may 2011 CT scan report was thyroid cancer level iii, now doctor in bangladesh saying to take operation.then take chemotherapy .5th may 2011 she got one thyroid operation. now what can we do . if we come india which hospital will be better for us .",
    "doctor_response": "You can contact Indo American Cancer Institute at Hyderabad. Many clinical trials take place there - and you might even get free treatment if the chemotherapy trial is ongoing. Just google it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, weight gain. History of medical abortion. Treatment?\n\nhellp Doctor. My problem is im not able to conceive, i got pregnent 3 yrs back i was 2 month pregnent, i took a tablet for abortion which i dont remember the name, after few days i got heavy bleeding .. that time i didnt want a baby, but now im not able to conceive, will i ever be able to conceive?? i have also put on weight, around 20 kg more compared with 3 yrs back. i weigh 77 kg now. please reply.",
    "doctor_response": "Hi, Welcome to HCM, I am Dr. Das As you have a pregnancy previously it is proved that you are not primarily infertile. you are facing secondary infertility. From you history putting on extra weight indicates to a polycystic ovarian disease which must be confirmed by USG whole abdomen alongwith a total hormonal profile including FSH, LH, TSH. These will clear what you actually have . Then it can be said whether you can able to concieve or not.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I have excessive sweating after stopping the habit of alcohol drinking?\n\nHi doctor, I am a 36-year-old male. I was a daily drinker of hard alcohol for the past four years. I am in depression and anxiety. I consulted a doctor. The doctor gave me Zoloft and Propranolol. Before few days, I have removed a large ganglion cyst from my right wrist. I made a step to stop the habit of drinking alcohol. I started to have sweating from my head profusely and consistently. I had it for two weeks. Now, the sweating from my head has got subsided, and it moved to my legs. I tested for STD and HIV. It came negative. Why do I have sweating like this? Please help.",
    "doctor_response": "Hi. I have gone through your problem, and I can understand your concern. Yes, these symptoms are due to alcohol withdrawal. As you have stopped drinking alcohol, you can have these symptoms along with other symptoms such as tremor, palpitations, anxiety, and other severe withdrawal symptoms such as seizure and delirium. Withdrawal symptoms usually decrease in intensity by one to two weeks. You can take Thiamine and Benzodiazepine. Benzodiazepine help in reducing these symptoms and promote good sleep. Thiamine is vitamin which is usually deficit in an alcoholic. As you have abstinent around two weeks, you need only a low dose of Benzodiazepine. It will provide adequate sleep and also cause a decrease in sweat. Take tablet Trazodone. It also helps in sleep. You can consult a doctor for a prescription.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe knee pain\n\nHi I am 53 years old and having severe knee pain to the point where I am afraid I could fall simply by walking The pain is only when I walk and I can hear grinding.Sometimes I run approx 1 to 2 miles at a time and don t feel the pain This came on suddenly. I also have body aches and lower back pain but only when I am horizontal and sleeping or trying to...other symptoms include cold sores in my mouth and very stiff and tired",
    "doctor_response": "Hi,Thanks  for  your query.Although it isn't possible to diagnose your condition without an examination and a few tests, your history is suggestive of osteoarthritis  knee. Often called wear-and-tear arthritis, osteoarthritis occurs when the protective cartilage on the ends of your bones wears down over time. Osteoarthritis treatments can slow the progression of the disease, relieve pain and improve joint function.I would suggest getting this evaluated by an orthopedician for detailed examination. You may get the X-ray/MRI, some blood tests and joint fluid analysis under his/her guidance to reach the accurate diagnosis.The following measures will help with the painDo regular Exercise. Exercise can increase your endurance and strengthen the muscles around your joint, making your joint more stable. Stick to gentle exercises, such as walking, biking or swimming. Lose weight if you are obese- Being overweight or obese increases the stress on your weight-bearing joints, such as your knees and your hips. Even a small amount of weight loss can relieve some pressure and reduce your pain.Use heat and cold to manage pain. Both heat and cold can relieve pain in your joint. Heat also relieves stiffness and cold can relieve muscle spasms.Apply over-the-counter pain creams. Creams and gels available at the drugstore may provide temporary relief from osteoarthritis pain.Take diet rich in calcium, vitamin d3 and minerals.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is naturatherapy a viable alternative in fertility treatment?\n\nMy sister in New Zealand has recommended Naturatherapy as a fertility treatment. I am 37, my husband 60. Following a 'successful' vasectomy reversal (sperms 'sluggish and clumping') we started IVF but I couldn't cope with the needles. Would this form of therapy be a viable alternative? We live in Kent.",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.After successful reversal of vasectomy sperm should have 50% motility, 20 million /ml count.According to my opinion natural therapy has not advisable for you at this stage.Consult a urologist with semen report. And ivf specialist/gynecologist for ivf.Hope i have answered your question.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for large lump on the cheek of a child\n\nHey my 3 year old daughter had a submoucs cleft palate repair four weeks ago an since has had a large lump in in her right cheek brought her to gp he don t know what it is and.has referred me back to kids hospital appointment could take months and ideas??",
    "doctor_response": "HI,Dear.Very Good NOON from India.Thanks for your query.I understand your concerns.I studied your query in depth.-I would advise you not to worry still.In my opinion your granddaughters cheek lump- is -mostly a -post-surgical organising-hematoma-of the cheek and would take another may be 2-4 wks to resolve.-Treatment-Would be to Consult a Plastic Repair Surgeon with  ER Paediatrician as a team would help its management.-Syr-NSAIDs,-Syr-Antibiotic for 5 days time.-Syr-Serropeptidase-Proper liquid feeds supplements by RTube feeding.-This would resolve this cheek lump to recover fast.-Hope this relieves your worry-some query. Wellcome for anymore queries in time to come.Have a Good Day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why one of the legs feels slightly numb,pins and needles due to the use of tight socks?\n\nHi, I got off an 8 hour flight yesterday morning and one of my legs feels slightly numb/ pins and needles. Pacticularly behind my knee and lower thigh. It is not painful and I am not in a risk group for DVT (I am 23, not overweight,on no medication) but I was wearing long socks under my jeans, which got a little tight and uncomfortable so I took them off about 3 hours in. My legs were a little swollen but that has now gone down. What would you recommend?",
    "doctor_response": "Hello, In lengthy flights, due to immobility recurring pain, numbness or swelling in the legs are indicative of a circulatory problem, clotting disorders, varicose veins, family history of obesity. You are suggested to do simple stretch exercises. Foot & knee lifts, ankle flexes & rotations. While in long flights take seats with extra leg room so that you can be more comfortable. Wear light fitting clothes while on a flight. Avoid caffeine and alcohol or addictions if any. You are suggested to visit ER & get physically examined, your treatment will depend upon the pathology detected. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nupur K, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How is the final stage of oral cancer?\n\ndoes oral cancer, end stage, painful and agonising ? My sisterinlaw has mouth cancer, she was told about 2 months ago the surgery to remove her tongue and jaw was not possible due to the advanced state of the cancer. Now she is at home has gangrene of the neck, dark green stuff coming out of her trach , from her nose down is totally unrecognisable. her demise seems to be long and very slow. is that common ?",
    "doctor_response": "Hi,Thanks for writing in.Sorry to hear about your sister in law who is fighting cancer of the oral cavity in the advanced stage. Cancer causes uncontrolled proliferation of abnormal cells in a region of a body. If there is gangrene then there is an infection which is there in the nose.In such situations, it is better to provide supportive care and treatment. Antibiotics are required to reduce the severity of infection and pain relief is important to keep her comfortable. Though we know that nothing much can be done, please provide her adequate nursing care so that she lives with dignity and in peace. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cerebellar atrophy\n\nI was mis-diagnosed for a year following my 1st MRI. My 2nd showed cellebellar atrophy 3 1/2 years ago. I will be 50 in November, my mother has now moved in with me, I use a wheelch say theyair and have seen 6 neurologists who say they agree with my diagnosis after they see the MRI. my question is: in my research there ARE some drugs for improvement. Am I eligible? Lisa Lancaster in NC",
    "doctor_response": "Hello,It depends on the diagnosis, inherited disorders are not treatable, acquired disorders of cerebellar atrophy improve at least partially with therapy. Discuss with your Neurologist for these issues. He can decide if you are eligible for treatment or not.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bumps on tongue after taking Metronidazole?\n\nAfter Taking metronidazole Treatment, I Have Had Round Bumps on the back of my tongue and tiny bumps in the back sides on my mouth on both sides and down my tongue, i also have had a break out down by my penis hairs, pink circle spots, no bumps, is it the medicen?",
    "doctor_response": "Hello,The symptoms seem to be related to an allergic reaction to the medication that you are using. I suggest to take an antihistamine medication such as Loratadine daily. I also suggest using Betahistine cream for local application.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does medication for thrush take to be effective in children?\n\nMy son is a year and a half and he is about 21 pounds. He has had a fever on and off for about 4 days now. I took him to the ER and they said he has thrush. I've been giving him the medicine for a little over 24 hours. The medicine is Nystatin or something like that. He take a teaspoon every 3 hours. But he still seems miserable and can't close his mouth because it still hurts too bad. About how long does it take for the medicine to work and help wit the pain?",
    "doctor_response": "Oral thrush is a self limiting disorder and sometimes painful especially he can't eat. It will last for 3-5 days and you can mix nystation with xylocaine to alleviate pain during feeding.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does reddish brown mucus like diarrhea indicate?\n\nMy 18 month old daughter was diagnosed on Monday with a hand, foot and mouth virus. She has been running a fever off and on since then but has been eating and drinking normal. Today she has had several reddish brown mucus like diarrhea. She has drank raspberry crystal light and had pasta with red sauce. Should I be alarmed or is this normal?",
    "doctor_response": "I dont think there is anything to worry about if the baby is all right except for the stool. Reddish stool could be due to colouring agents in the food. If that would have been blood that would continue to come for days together. Blood in stool uasally comes in dysentry which causes pain abdomen , repeated stool and fever. If there is no other signs then its not dysentry.. Its normal.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Uncle having diabetes and high Level of creatinine in his blood, kindly suggest\n\nUncle Having Diabetes and high Level of Creatinine in his blood Hello Sir, My uncle is suffering from diabetes and high level of creatinine in his blood. For your reference to study this case i m giving details of his recent report as below: Haemoglobin- 11.6g/dl RBC- 3.83mil/cmm PCV- 36.7% WBC- 5200/cmm Macrocytosis- Mild Glucose (Sugar) Fasting- 101.9 mg/dl Blood Urea Nitrogen (BUN).serum - 54.0mg/dL Blood Urea,serum [Urease] - 116.0mg/dL CREATININE,serum-6.11mg/dL Sodium,serum[ISE-IP] - 137 mmol/l Potassium,serum[ISE-IP] - 4.2 mmol/l Chloride,serum[ISE-IP] - 104 mmol/l Urine examination : Chemical examination-Proteins:+ , Glucose-Trace Microscopic Examinations Leukocytes(Pus cells)/hpf:1-2 Epithelial Cells/hpf:0-1 Sir please suggest us proper treatment or else any reference for proper doctor one who can treat and cure it. Thanking You Krupali Thaker",
    "doctor_response": "Dear Krupali,thanks for writing things in detail.This reports are suggesting that diabetes has affected his kidneys and he need further evaluation and treatment.Please see a nephrologist in your city and take his advise.Please make sure he takes proper and regular treatment other wise he will lend up in more problems.take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for attention deficit problem\n\nMy 20 year old, university going son has attention deficit issues. Retalin has been prescribed which helps a great deal but causes sleeping problem. What are the side effects if taken for several years. Can he ever overcome the attention deficit problem and stop taking this drug. What can be done to alleviate sleeping problem.",
    "doctor_response": "HiThanks for using healthcare magicIn ADHD, retalin is treatment of choice. Normally, in ADHD, symptoms decrease with age. There is nothing to worry about it. You have to just consult his psychiatrist for the severity of the symptoms and whenever, he will have mild symptoms, you can try to stop it. Rest, depends upon him, how he manages without medicine. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Symptoms of attention deficit disorder.  Frequent losing things, forgetting, unstable mind, lack of concentration.  Have thyroid, hairfall.  Diagnosis?\n\nMy friend has tendicies of attention deficit disorder.  she is not a a child.  How can she be diagnosed if she has this problem.  Lori is her name,  She is constanly losing things, forget things at work and said her mind is going in all directions.  I think some of this is worrying.  Her early years in life  she rarely went to school her father had her stay home.  Her mother died when she was 3 and her brother died at 15 playing basketballl.  Her sister had some disorder but she was able to pay attention.  I never know if she is listening to me or not and most of the time I repeat what i told her the following day.  I feel terrible when she says her concentration is really bad.  She actually learned on her own and her father kept her home from school. she really cannot concentrate.  I have noticed this with her work.   What should she do?  What type of doctor should she see. Her PCP just seems to ignore her when she see him.  she does have thyroid problems and her hair is falling out,  she see a specialist for the thyroid but she does not know how to get diagnosed if she has a disorder or not.  I think her time is spent trying to find things she forgets about.  she is at this point when she feels she cannot concentrate on one thing.",
    "doctor_response": "Hello. Attention deficit disorder can occurs in adults but usually are people who have suffered attention deficit disorder during childhood. It is recommended that  your doctor request thyroid hormone levels (TSH and T4) because memory and concentration problems and hair fall may be secondary to thyroid hypofunction.If thyroid hormone levels are normal she should be seen by a neurologist.I wish you good health. (If the answer has helped you, please indicate this)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does timely back pain in 30 year old man indicate?\n\nmy uncle namely m.shafi has a problem from past 3 months he always suffer in pain at time 7pm.some times he just become a frestate and he does not talk in an well behaviour with others.he tells me that i mind about the pain and in few minutes and i really suffers in back pain but he has not married his age is 30.he has consulted with many doctos.but he does'nt become well.",
    "doctor_response": "hi he can use hot water pack to relief pain.and moist heat to relief pain use wash wet cloth to relief and make sure it must not too hot so that it can burn you. and back strengthening exercise. and take physical therapy wish him good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the lump inside the foreskin without any pain?\n\nHello, I have a bb sized lump right underneath the foreskin on the right side of my penis.. It is within the skin and if you pull the foreskin away from the shaft you can feel it. No pain at all but was a little swollen in the area when I first noticed it. Any idea what this could be?",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have small lump on under surface of foreskin.Mostly this could be a sebaceous cyst .However this can be confirmed only on clinical examination by a qualified General surgeon or Urologist.Penile skin is rich in sebaceous glands hence more prone to get sebaceous cysts due to accumulation of sebum beneath the skin.Normally it fades away without treatment however need to be excised in Toto if it increases in size .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to improve concentration\n\nSir, i am a b.Tech student of final year. But due to mental stress(due to some unavoidable family problems and study pressure for getting a job), i am unable to concentrate on my study. And when i sit for study, within 5-10 minutes some unexpected topics come to my mind and i start discussing very seriously myself like a group discussion.i saw Aamir khan s satyamev jayate show on this topic and i got conclusion that it is curable by taking drugs. Please give me any solution so that i can concentrate on my study for my career.",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.Meditation and yoga helps in improving concentration. Also you need to have a good sleep and participate in aerobic exercises. The place of your work/stduy should be cozy and comfortable with good lighting. 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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will Pantocid 40mg effect pregnancy?\n\ni am 28 years old and i am trying to conceive. I had acidity problem and my head was spinning so i consulted my doctor. she said might be its acidity and advised me to take Pantocid 40mg. Please advise can i take as i am trying to conceive from past 4months.",
    "doctor_response": "HI.You can certainly take Pantocid. This will not affect the fertility.You can be get  pregnancy, nothing to worry about.It is better to control you acidity now as it is advisable to stop all medicines in the first three months of pregnancy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump on the head?\n\ni have a lump on my head that hurts i have been to the doctors and he said it was nothing but the lump has got bigger and more sore my mum died 2 years ago with some thing that happened in her head i dont no what to do as this scares me could it be the same thing",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query.The doctor who examined you might have commented so as it might have been a benign swelling. If I were your doctor and I found a swelling/lump in your head, I would advise you for a FNAC (fine needle aspiration cytology) to know the nearest diagnosis, and treat it accordingly. However, I would also advise you not to be scared of such benign lesions. Further management would depend on the physical examination and related investigation reports. Till then you could go for an anti inflammatory drug and a proton pump inhibitor drug for a symptomatic relief.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes throbbing pain and sensitivity on the scalp after an injury?\n\nHi, I hit my head at work about 2 or 3 years ago on the edge of a desk. I went to the doctors immediately and then a few weeks later got a CT scan (it was either that or an MRI - but I forget). The odd time, I ll notice it throbbing very lightly and then it ll go away. Other times, it ll be sensitive if I touch it lightly. Is this normal? Should I go back to get a referral for another scan? Thanks! -Julia",
    "doctor_response": "Hi, I don't think it's necessary for another CT scan after all that time.Probably nerves of the scalp were compressed/crushed. If the symptoms are bothersome, drugs (simple painkillers initially) could be used. Nerve block injections also may be of help. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have nightfall after masturbation also\n\nI used to masterbate earlier 4 to 5 times a day ,past an year i am not doing it but still if i watch any sex sceen or if i have a dream of so i starts flowing from my pennis ,mainly in sleep how can i solve it.......",
    "doctor_response": "having sex is the only solution. once you get married you can have sex with your partner daily which will solve your most of the problems of flowing in the pennis at night",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood in semen?\n\ni noticed a dilute amount of blood in my semen (a little). It has scared me and got me worried as to what could have caused it. I have been sitting for hours on end of late and experience some pain in my testicles last night when i was in bed. I also take aspirin now and then for its health benefits. Wondering if you could help me and should I be worried as I am about to sleep but cant and left the wife in bed to worry by myself",
    "doctor_response": "Hi. It could be due to Aspirin or any recent exertion. You can get a Semen analysis and culture done to be sure. Have lots of water and fluids. It should be normal in a few days. If not then please consult your Doctor and get the above test done. Do not worry its not a very grave problem. You should be fine. Stop Aspirin for a few weeks. Take care. Dr Rishi, New Delhi, India.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest nutritional supplements for low appetite in pancreatic cancer patients\n\nmy brother has pancreatic cancer and he had yellow watery poop and today he has grey watery poop and has eaten in 2 days he drank a glass of lemon water and a half cup of carrot juice all organic. what do I need to give him to increase his appetite. he surgery 3 or 4 weeks ago and wear a colostomy bag.",
    "doctor_response": "Hello. He can eat any diet but fatty meals should be avoided. Pancreatic cancer leads to defiviency of fat dissolving enzymes. Thanks and regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does it take to cure minimal ptb?\n\nhelo, Im Merlinda 23 years old,height 5'3, weight 50kilos.Last January 19 I consulted to a doctor and I found out that I have minimal PTB in my upper lobe.right away I undergo medication. After six months of medication I was shock to know that I'm not cured. Im worried now...pls help!",
    "doctor_response": "Hello, Thanks for using Healthcaremagic. i had gone through the data at you have posted, sorry that you had to undergo all this..some things need further clarification likehow was your diagnosis  of PTB made?was it by sputum or CTchestif it was by sputum, after 2 months of therapy was sputum AFB repeated?Normally we diagnose TB with sputum smear examination for AFB, then started on intensive phase which contains four drugs. this phase is for 2 months after which we recheck sputum AFB. if AFB is positive we need to continue 4 drugs for another month and repeat Sputum AFB. if still positive we need to go for drug sensitivity testing to rule out MDR TB.if Sputum AFB is negative after 2 or 3 months then drugs changed to 2 or 3 drug regimen.if there is good compliance with medications and you had drug sensitive TB it is unlikely that you are not cured. Hope this helps...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to use nebulizer for baby?\n\nhi doctor my name is chiranjiv n my son is 1 yr 7 mnth old n he every mnth sufers 4m cold n cough. even he was hospitalized 4 this. now whenever he suffers 4m cold n cough we nebulize him with asthalin n budecort .n after that he feels good.so i want to know that is it harmful for my son??",
    "doctor_response": "Welcome to health care magic.I have gone through ur query  it will be related to allergic cause.I would like to ask some  question to reach nearer to the cause,_have this increase more with  weather change?_has fever during cough and cold?_any breathlessness or any type sound from chest?_what is duration and  frequency  of these symptoms ? recurrent cough and cold are syptoms its  to be hard to control.indentify allergic substance which one get his syptoms inceases  , avoided it.do allergic test for  air borne allergy and some food allergen .this will helpful to find out cause of syptoms.about nebulisation no any harm from continue using nebulisation .nebulisation with asthalin and budecort is helpful  only when wheezing sound  in chest , breathlessness.when above syptom will be present then u will be using nebulisation .ashalin have some side effect like tremor, tachycardia, hypokalemia.consult pediatrics chest specialist if any sever problems.hope I answered ur query ,any  further query  dont hesitate  to ask me  .regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for pain and pus accumulation in pierced nipples\n\nInfected nipple piercing... I ve had my nipples pierced for about 5 months. They both seemed to get more crusty and painful at the same time. My right one is getting better, but the left one hurts so bad. Just wearing a bra or the jewelry moving. There s a little bump right above the pierced hold and it s filled with puss then blood. I popped it with a sterilized needle. Now what??",
    "doctor_response": "HelloThank You for contacting HCM.As the site has become infected with formation of abscess so i would recommend you to visit a surgeon. He will put an incision and drain all the pus and you will improve quickly. If you will continue to live with this then it will progress more and later will cause sever problem. Meanwhile for pain you can take acetaminophen twice daily.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of developing fat on my chest?\n\nhello I have been facing a problem since my early teenage days while i was in class 7 i started developing fat on my chest and it increased gradually. By time i noticed i was not comfortable in wearing a good fitting T-shirt only! Since then the problem has been same, I have tried everything.. trained my chest hard in gym, ate right, not underweight or overweight at all. But m now fed up with this problem and cannot carry it anymore... Please please help",
    "doctor_response": "Thanks for your question on HCM.I can understand your situation and problem.By your history and description, I think you are having Gynecomastia. It is enlargement of male breast due to fat deposition.There are many causes for gynecomastia. But the common causes are1. Hormonal imbalance2. Genetic disorders like klien felters syndrome3. Drug induced like spironolactone,bromocriptine etc 4. FamilialSo better to consult endocrinologist and get done hormone study. Discuss about these possible causes and start treatment accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for blood clot in leg\n\nHello, I have a blood clot in my right leg. Have been going to the VA but they cannot prescribe anything but warrafin which I have a bad reaction to. Blood pressure increases to ~ 180 and blurred vision. All the local Drs I call tell me to go to emergency room, but I have already been to emergency room twice at the VA. How can I get a prescription for an anti coagulant other than Warafin? Currently I am taking asprine, flax seed oil, niacin, i.e. herbal blood thinners. I took Luvanox shots for one week, then warrafin for 3 weeks. swelling in leg is reduced, but not back to normal. INR on 5 mgs warrifin s 1.1, kidney function 1.4 . It would seem to me I need a anticoagulant metabolized by liver, but VA can t get through the red tape . I have no insurance, can t afford several thousand dollars at emergency room.",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. INR should be maintained at a higher rate.2. If you are having reacting to warfarin, better to go for heparin or other new anticoagulants like razaxaban, idraparinux etc.3. Being mobile is the most important thing to avoid blood clot in leg or deep vein thrombosis. Meet your doctor to get a prescription for heparin.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for genital warts on the penis\n\nHello, My boyfriend went into the doctors as he felt some bumps down in his genitalia area. He got it tested and it came back as genital warts, he says that i am the only person he has slept with for the past 4 years, and he is the only person i slept with. His doctor told him that he is a dormant carrier and that some times they can go years with out it popping up then one day its there. Not to sure what i should do.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You should also go for examination. You may have sexually transmitted disease. Go for examination and make sure that you are safe. If you have infection then take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever,fatigue,dizziness,swelling in lower abdomen and legs turning purple and swelling?\n\nI am 12 weeks pregnant and im not sure if any of these are normal. I feel tired and dizzy all the time i can t shake it. On my left lower abdomen is kinda swollen and when i lie or sit there is a huge visible pulse there also my legs will turn purple and swell. On another note i keep getting and off and on again fever?",
    "doctor_response": "Hi,Dilated veins on lower leg, with fever, point towards deep vein thrombosis, which is known to occur in pregnancy.This should be evaluated as it can lead to a very serious condition called pulmonary embolism, which could be life threatening.I would like to know if you have any family history of diseases called thrombophillias? Did you have varicose veins before pregnancy.?You need to get a ultrasound of both your legs called Compression Duplex ultrasound and consult a physician immediately.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic back pain\n\nPlease sir/madam. I have suffered from chronic back pains since 1990. Cant place my hand on the cause but i have taken several treatments including acupuncture,all to no avail. Its so painful that sometimes, i cant even stand up from where i am sitting. Thank you sir. Paulo",
    "doctor_response": "Hi,I understand your concern regarding the back ache. Since you have mentioned that you have as chronically suffered back ache for about 26 years it has to be related with any defect in the spine with nerve compression or due to diabetic neuropathy or lack of nutrients like Cobalamine.This occurs mostly due to our lifestyle habits like usage of computers, watching lot of TV, bending while reading.1) You can use analgesics like Paracetamol/Tylenol to relieve from pain.2) Do not use analgesics excessively. It is harmful to our body when in excess.3) You need to keep an erect straight posture of your back and neck.4) Do stretching exercises, when you wake up lie on your chest then using two hand lift yourself up, in a arc like position and then lie down slowly. Repeat his at least ten times daily. This will surely relieve back pain. You can watch online videos for such exercises.5) Take Tablet Neurokind once daily, anlagesics only if you have severe pain.6) If your problem aggravates you need to get yourself physically examined and investigated through radiological methods like X ray followed by MRI only if suggested by an orthopedician.Since you have chronic pain, it is most probable that you have undertaken radiological examinations. So I request you to send your reports next time so that we can plan a better treatment method.Hope these suggestions help you. Contact for further follow up.Thanks with best regards,Dr. Suhas Chauhan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can I control the habit of excessive masturbation?\n\nHi doctor, I am 22 years old male. I am suffering from excessive masturbation problem for the past three years. I have the habit of masturbation for the past six years. I am worried. I think I need to undergo counseling sessions to control it. Now, I masturbate at least once daily. Without doing it, I am unable to sleep. I tried getting myself involved in other activities. But it does not help. Sometimes I masturbate three times a day. I am unable to concentrate properly on the other parts of my life. I understand that my habit has turned into an addiction. I want to get cured. I feel shy to visit doctor physically. Kindly help me.",
    "doctor_response": "Hi. Sex thoughts, sex addiction, masturbation addiction, and porn films addiction come under behavior addiction. Behavioral addiction is a form of addiction that involves a compulsion to engage in a rewarding non-drug-related behavior. Sometimes it is called as a natural reward as it does not cause any adverse consequences to the persons physical, mental, social or financial well-being. Behavior addiction needs to be cured or controlled using your self-willpower. Diverting your mind and body away from the circumstances with the help of physical exercises, games, and entertainment can help you. Never sleep alone. Be always with your family even at night are some other tips. Willpower is the key forever. Behavioral therapy also works well. For more information consult a sexologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Acne with scars, does regular masturbation, has tried many drugs but in vain,worried about masturbation causing acne. Solution?\n\nhi doc i m 18 years old and i masterbate alot and thing which annoys me a lot is that i have acne and i believe that my acnes are because of masterbating please tell me am i right or not ? and also tell me what to do to avoid having acne ? i tryed alot of drugs and no result and i m afraid of the scars please just tell me a way i can do thank u very much for ur help doc",
    "doctor_response": "hi  na , masturbate cant cause acne. as you know, in puberty there is increasing of testosteron level. testosteron as androgenic hormone can cause acne, but masturbate has no related with acne because testosteron level increased due to puberty periode it doesnt matter you do masturbate or not. to avoid acne these are what you can do : 1. avoid stress 2. keep your face clean ,wash your face with good mild cleansing soap with warm water twice a dayto remove deadskin or excess oil in surface skin especialy before go tobed. dont washing your face to frequently with cleansing soap,it may dry your skin and stimulate your skin produce more oil. 3. wash your hair to  avoid oil in your hair rub in your skin 4.drink a lot of water about 2 lt (8 glass of water) aday to hidrate your skin 5. avoid eating greasy food, junk food, alkohol,soda,chips,chocolate and eat more fresh vegetables or fruit that rich with vitamine A and C such as carrot,kiwi,grapefruit,broccoli, orange. 6. moistuized your skin with good skin moisturiser to avoid more oilly skin 7.avoid sun rays to much,use good sun block 8. if you are using cosmetic (for female) avoid overuse or try using cosmetic that not oily based 9. dont use medication that can cause acne such as birth control medication 10.avoid share towel with your friends or sibling that have acne,that may cause acne bacteria spread to your skin i dont know what kind of drugs you already tried, but wrong treatment may cause your acne worst and can cause scars. if you see your acne is annoying you, i suggest you better consult with dermatologist for acne treatment.dermatologist will give medication based on your condition. well na, i hope this answer can help you solve your problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itching in private parts. Blood test showed bacterial infection, elevated liver levels\n\nHi hope you can help my daughter is 21 doesn t drink, smoke or take drugs. She had blood test done as she was itchy in her private section. The results showed she had a bacterial infection which the dr prescribed antibiotics to clear it. The test also showed she had an elevated liver and she is to go back in 3 weeks for another blood test. What do you think this could be. She is a gym junkie, very fit and lean and a clean eater. Thanks Diane",
    "doctor_response": "Hello, Diken, It would be helpful to know if all the liver enzymes were elevated and how high. It is possible this could be secondary to the infection she had. If the liver enzymes were detected to be high after she finished the antibiotics, that may be a side effect of the drug. I am glad that she does not drink and is fit. If the enzyme levels stay abnormal at three weeks re-test , she may need complete Hepatitis blood tests to rule out Hepatitis B and C. I would not be very much concerned at this point. I wish her well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are my chances of getting pregnant at this time?\n\nI recently had sex with my boyfriend. we were fooling around for awhile then he started rubbing his penis on me and he inserted it for no longer then 10 seconds, he didn't ejaculate but there is a chance he pre-came, what are the chances I'm pregnant?",
    "doctor_response": "Dear, We understand your concernsI went through your details. Whether precum contains sperm cells or not, is a million dollar question. But for sure, the sperm cells contained or come out alongwith precum, is not strong enough or liquid enough to travel through the vagina and reach the egg within you. Therefore, the chances of pregnancy is bleak in the given scenario.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for orange vaginal discharge\n\nI have orange discharge and have had it for a couple months now and ive been to the doctors and they keep telling me that it is an infection....and they have treated me for different infections and nothing seems to help.  Im scared that something is seriously wrong!",
    "doctor_response": "Hello dear,Do not worry.You are suffering from bacterial vaginosis or trichomonas vaginosisTake following advice.1. Wash your vagina with this water twice a day for two to three days with warm water2. Apply Apple cider vinegar: it has excellent antibacterial and antifungal properties3. Salt Bath- Wash your vagina with concentrated salt water whenever you feel the itch. This will give you great relief instantly and prevent further multiplication of bacteria. 4. Antibacterial/fungal talcs: apply candid powder5. Keeping The Vagina Dry (Not wet, clean well)6. Wear Loose Clothing7. Also take antibiotic You should use following single dose treatment:1. AZEE 1000 mg (AZITHROMYCIN) 2. TINI 1 G (TINIDAZOLE) 3. ZOCON 150 mg (FLUCONAZOLE) or you can take tablet metronidazole 400 mg three times a day for three dayAvoid sex and avoid douching till you get better.Hope this may help you.Take care and stay healthy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swelling and tenderness in lymph node\n\nI recently got an industrial piercing done, and I have 10 others and so know how to care for them properly, however yesterday I noticed that my preauricular lymph node was swollen, hard and tender to the touch. I ve never had this happen with my other cartilage piercings. What is happening?",
    "doctor_response": "Hi,It seems that there might be having infection at the site of piercing causing enlarged painful lymph node.Clean the site with antiseptic lotion and apply antibiotic cream.If require go for one oral antibioitic medicine course for 3 days.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why did sgpt level increased by having legalon madaus?\n\nhi, i'm 25 years old male height 160cm weight 60kg i'm having problem with my sgpt level previously my sgpt level 35 and ggt level 210 and doctor gave me legalon madaus now after take legalon about 3 months the ggt level decrease become normal, but the sgpt level increased to 60. i have checked also the hep. AB&C and the result is negative. should i need to continue consuming legalon or i need to stop?",
    "doctor_response": "hey there yes you can continue taking legaron.However sylimarin like potent liver rejenuvators should also be taken by you.Milk of thisltle will be good for you",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of mole on the stomach?\n\nI have more of a beauty question, not a pain or disease question. I m just embarassed by a mole that I have on my stomach which is around the side o a pencil eraser. How can I get rid of it ASAP without having to go to a doctor, and asting any money?",
    "doctor_response": "hi..you have mole on the stomach...i am sorry to say that you will have to go to the doctor...there are two procedures by which this mole can be removed..one is laser for which you will have to go to a laser therapist with specific laser available,,2nd is the surgery,,very minor surgery,,day case surgery under local anaesthesia..excision of the mole will be done..if the mole is since birth then don't go for any beauty cream as i don't know such creams which can remove such moles..thanksDR IHSAN",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should the ER be visited for weakness in the fingers after a shoulder injury?\n\nI broke my neck Oct 2016 5 & 6 or 7 vertebra, cage was put in and is a little crooked Unable to determine if fusion has transpired due to no insurance. Everything was fine except for some small cramps is hands and pain in neck for a year 1/2 I was told after exam that I has severe carpal tunnel in both hands had surgery but things are progressively geting worse now after I bumped my shoulder several months ago. I cant hardly squeeze my fingers or light a lighter. Should I go to ER I fear being paralyzed",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The weakness in the fingers after an injury can be due to a nerve compression. You need a medical attention for this. I hope this information has been helpful for you. Regards, Dr. Praveen Tayal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Persisting pain, infection, bruising outside cheek post root canal, advised antibiotic. When will it subside?\n\nI have had a root canal and a crown completed on a tooth . I am still having pain and a current infection. I have been referred to a specialist but the specialist cannot see me for another two weeks. I was given an antibiotic of cephalexin 500 mg four days ago. When should my tooth begin to feel better? I have a bruise and swelling on the outside of my cheek from the infection.",
    "doctor_response": "Hello Welcome to HCM, I went through your history & it suggests that your root canal treatment is not proper.This has led to infection which resulted in inflammation.You need to go for crown removal followed by Re-RCT. Before that you go for proper investigation like get an IOPAR done of associated tooth & consult your dentist. Meanwhile you start with few medicines for 5 days as prescribed:- -Amoxy-clav(650mg) combination-twice a day -Diclofenac+paracetamol+serratiopeptidase combination-thrice a day -Multivitamin capsule-once daily -Rabeprazole(40mg)-once daily(if gastric problem persist) Precautions to be taken:- -Avoid hot compresses over swelling -Do cold compresses over swelling -Do warm saline rinses-3 to 4 times a day -Maintain proper oral hygiene by proper brushing & regular use of mouthwash. Go for proper investigation as soon as possible. Take Care Regards Dr.Neha",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI shows annular tear, diffuse disc bulge with postero-central protrusion, bilateral neural foraminal narrowing. Advised surgery. Alternative?\n\nI am male, 44years, 177cm ht& 79kgs wt. my MRI shows that Annular tear at L4-L5 & L5-S1, and Diffuse disc bulge with postero-central protrusion at L4-L5 with bilateral neural foraminal narrowing(L R), and Diffuse disc bulge with left paracentral protrusion at L5-S1 indenting on thecal sac & bilateral neural foraminal narrowing. My doctor advised Laminectomy/ discectomy surgery. can I use alternate means such as accupressure/yoga/homeopathic medicine to avoid surgery. many people advising me not to prefer sufgery.",
    "doctor_response": "Hello, Considering the fact that you are having diffuse disc bulge at L4-5 and L5-S1 along with narrowing of neural foramina,you are a fit case for surgery as there seems to be absolutely nil chances of getting Any benefit from the alternate medicine approaches ,as mentioned by you. Surgery these days is very advanced and there least possible chances of complications now. Consult a good spinal surgeon attached with a super speciality hoital. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does broad based annular disc bulge at L5/S1 with anterior theca distortion in CT spine mean?\n\nHello, I have had a CT done of the Lumbosacral spine. What does a broad based annular disc bulge at L5/S1 with anterior theca distortion mean? There is disc material seen impinging onto the exiting S1 nerve root. Also disc bulge at L3/4 and L4/5. I frequently have quite severe pain across my lower back and this creates sciatic nerve pain through my legs. I have pulling, pinching sensations. I can have intense burning in the back of my thighs, pain on the outer part of my calf and pain shooting intensely into the middle of my heal. I can also experience some loss of feeling in my legs. I would greatly appreciate it if I could get a more detailed explanation of what is happening inside me and what kind of exercises could best help me manage this problem. Thankyou, AAAAA",
    "doctor_response": "HI, thanks for using healthcare magicBetween the vertebra (the bones in the back), there are discs. These discs are made up of an outer ring called the annulus fibrosis and an inner part called the nucleus pulposus.The bulge that was seen between L5 vertebra and S1 vertebra was a bulging of the outside ring or annulus.The theca is a sheath covering the spinal cord, due to the bulging of the annulus, there is also is distortion of this sheath.The imaging also saw bulging between L3 and L4 vertebra and L4 and L5 vertebra.The bulging disc is compressing the nerve that is exiting from the S1 vertebra or bone at the level of S1.These results would definitely contribute to your pain. Your doctor would likely suggest referral to the physiotherapist.The physiotherapist would be able to demonstrate exercises that may help you.You may also need medication to help reduce your symptoms.It can sometimes take a months,sometimes up to a year for improvements to be seen.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is itchy skin with swelling sign of psoriasis?\n\nA part of my skin is really itching since the last 2 months. I bought a product named Psoriasis to try to cure it but it didn't change anything. Now i'm getting scared cause the itching part just get's bigger and bigger (about 7inches by 4 inches). I'm not sure it is psoriasis but i saw pictures of that and it seemed the same. Hope you will help me as fast as possible . :) thanks.",
    "doctor_response": "hi1.psoriasis is usually not that itchy as you are saying but rarely it can be.2. most characteristic feature of psoriasis is well defined, erythematous and scaly plaque particularly in scalp , elbow, knee, palm and soles.3. dont use any OTC product as they can harm you and further complicate the psoriasis.4.consult local dermatologist for confirmation of diagnosis.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I experience stomach cramps, excessive gas, belching and bad taste. Please help.\n\nHello doctor, I am a 42-year-old male. My height is 5' 11\" and I weigh about 120 kg. I do not do any exercise. Just a month ago, I experienced painful stomach cramps, diarrhea, excessive gas, sweating, and belching with bad taste which lasted for one night. I rested up for two days and felt much better but a cold sore appeared on my lip which again only last a few days. I am not sure if it is related but quite shortly the aforementioned incident I noticed enlarged papillae slightly apart from the others. I was naturally curious so rubbed it with my finger and it did not feel any pain so I just forgot about that. Shortly after I started to feel pain in my tongue, the pain would change location throughout the day and often move to my hard palate. I then noticed my tongue appeared white coated. I started to use oral thrush lozenges, rinse my mouth with mouthwash, gargle with warm water and salt, brush my teeth and tongue before bed (I never used to). After a few weeks, my tongue appeared pinker but the pain is still on and off. I finished the lozenges hoping that would be the end of it but I have noticed today that my tongue again appears white-coated and I now feel sore on the hard plate near the front teeth, also a new cold sore has appeared. I have read and looked at the photos about oral thrush, hairy tongue and so on but really I have no idea what my condition is. I have not been to see a doctor or dentist because quite honestly I am very scared. Reading that white-coated tongue causes can be anything from excessive alcohol, tobacco use right through to HIV or cancer is simply terrifying me. I did purchase a diabetes home test kit (urine) which did not show any traces. I drink and vape once a week but on that day I consume both excessively. Please shed some light and guidance. Photos run in chronological order.",
    "doctor_response": "Hi. First of all, thank you for the detailed history of your symptoms and photos which you have attached. (attachment removed to protect patient identity).  Before I discuss further about possible diagnosis let me assure you that your symptoms or the photos you have sent do not show anything sinister in your mouth or tongue. Analysis of your symptoms are suggestive of a condition known as laryngopharyngeal reflux disorder (LPRD) where backflow of digestive acid causes significant injury to throat and mouth structures including tongue and palate. In your case symptoms seems to be triggered by an initial attack of acute gastritis and reflux, which may have caused significant injury. Acid can injure tongue papillae causing a coating of tongue, multiple small ulcerations, inflammation of tongue papillae. If the reflux continues to occur it can keep injuring different areas of tongue and mouth leading to migration of symptoms. Occasional binge drinking and vaping seems to be causing further damage to already injured tissue. You may need to take a few week course of anti-reflux medications and avoid drinking and vaping while on treatment to facilitate the healing process. Other than this I do not see anything dangerous as per the photos you have attached. Also, it does not look like oral thrush (oral candidiasis). So antifungal lozenges may not be of much use.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes respiratory distress despite taking Azithromycin and Cipro?\n\nI suffer 3 to 4 times a day with lung distress and take pain pill and xanex to relieve discomfort. However it gets worse. It is almost impossible to get rid of my thick mucus. I take two scalene treatments a day and two vest treatments a day. It helps sometime but more often not. I take azithrimycin 14 days first of the month and cipro the next month alternately. Your suggestions would be appreciated.",
    "doctor_response": "hi, your progressive course suggest that infection may not be under control.you are taking azithromycin and ciprofloxacin for infection.here are chances that there are bacteria that may be resistant with these antibiotics.from the culture and sensitivity testing of respiratory secetion,one can know the sensitive antibiotic .so there can be switched to a sensitive antibiotic for better result.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain on the left side of the ribs?\n\nI have had severe pain on my left side below my ribs but it has now traveled to my lower back and I actually feeling inflammation on my left side and my back verdabrae which is now left my left hand feeling numb but I have feeling its like it is asleep and now its traveling into my left food. I also get off and on sweats",
    "doctor_response": "Hello, As a general rule, an ECG has to be taken at the earliest as the pain is on the left side and is radiating in nature as well. Once the cardiac causes have been ruled out, other possibilities like spine-related problems like prolapsed disc and nerve compression must be addressed. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does the typhoid fever lasts?\n\nmy daughter is detected with thphoid it stared from 12th of sept she is not been hospitalised but under doctors care but fever isnot coming down .she had 104 fever.now with other medicines and 4 crocins a day fever is come down to 102 .how many days does the fever last and do i have to hospitalise her?our family doctor who is mbbs only says that there is no equirement of her hospitalisation.i am worried........my daughter is 27 years old.if i shieft her to hospital now they will start all the medicine once again.........what should i do ? should i keep keep faith on my mbbs family doctor or take her to some  big hospital?",
    "doctor_response": "Hello,If your treating doctor says that your daughter doesn't need admission,then it must be a correct observation.In general patients with typhoid fever are treated as OPD patients and admission is done only in few cases where there are complications present.After a proper antibiotic therapy typhoid fever may take 4-6 days to normalise,however you should make sure that a complete antibiotic course for 2 weeks must be completed,lest relapse occurs.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can perinatal depression be treated?\n\nHi During 4th month of pregnancy, i started taking nexito 10 for antenatal depression. Once i started feeling positive . I reduced the dose and then kind of stopped taking it. The last dose (one tablet)i took was on 7th of march. But now same negative thoughts are coming in my mind again.currently in my 29th week, i am getting up every two hour at night. Also, last scan (28 weeks) increase my worry because my cervix length was 26mm in normal lower range. Having anxiety about labor as well. Is this normal or should i consider taking nexito again. Please suggest... thank you",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Perinatal depression so common a problem and you should not be alarmed about it because the more you are alarmed and the more you are worried about it, the more it disturbs you. Do not fight it. I suggest you to work with your gynecologist to overcome. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause severe stomach ache and nausea?\n\nEach month, for about a year or more now, I experience severe stomach pain that induces nausea, and it is starting to concern me. It feels like a blunt kind of pain, and at times I think it\u2019s gas or a need to use the bathroom for number two, not to be gross. I struggle with constipation and it often resolves itself in the form of painful diarrhea. These past two months, I noticed that this pain came the same day I tried new foods that did not particularly sit well with me. I think that may have something to do about it, but what about the other months? I just noticed today that I\u2019m mid-cycle and ovaluating, which made me wonder if PMS has something to do with this? I never get these pains when I\u2019m having my period or on the days surrounding it. I would appreciate input, as this is starting to overwhelm me.",
    "doctor_response": "Hi, The most likely issue of altered gut flora mechanics with hormone imbalance. Upper GI endoscopy and basic lab tests including thyroid hormone levels are mandatory here to get checked completely. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is high TLC in blood dangerous?\n\nMY mother was having food poisoning and had numerous vomiting a week back , after that her tummy was not clean for last 6 days , doc diagnosed obstructions in X-ray report have given medicine thru nose after which tummy was clean yesterday, but her TLC was quite high 21000. Can u suggest further",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I would advise her to do a blood culture sensitivity test. If bacteria is found then sensitive antibiotics needs to be given. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should we go to the emergency if child is having high fever, nausea?\n\nmy daughter is 6 she will b 7 in a week.. She has been running a fever for the last 2 days.. she is drinking and trying to eat but isnt doing good with it.. she hasnt been throwing up but has nausea and she hasnt had diarrhea.. her temp has been 100 to 103, i have given her sprite and Tylenol but it goes down then right back up.. she has a dr appointment tomorrow at 11 should i wait and take her then or take her to er?",
    "doctor_response": "Hi Dear welcome to the HCM, High grade fever with nausea to be tackled initially as a viral fever. Needs to be go for the tap water sponging vigrously when is required.. Paracetamol @ 15 mg/kd 4 to 6 hourly is suffienct to reduce the fever. Contnue to givwe her plenty of liquids. Post rainy season is season of insect borne disese like dengue. Should be taken care of accordingly. Hope the query is answered. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from Asthma, Using Fullform 200. Is Formonide better than Fullform?\n\nHi,I live with asthma for past 15Yrs. I have been asked to use Full form 200 daily by doctor. Though I couldn t use daily, I use whenever I feel asthma symptom. Recently my doctor asked me use formonide 200 instead of Fullform.I feel Fullform is better than Formonide. Can you suggest which one is better? Manikandan.G, Chennai",
    "doctor_response": "Hello Manikandan.G 1. Full form 200 contains Beclomethasone (a cortico steroid) + Formoterol (a broncho dilator). 2. Formonide contains Budesonide(a cortico steroid) + Formoterol (a broncho dilator). Both the preparations act in the similar way to provide relief in Asthma....i.e. by reducing the inflammation & causing broncho-dilation (dilating the smaller airway passages, relieving the obstruction & increasing airflow to lungs. However, if you feel that you get better relief with the use of Fullform, then you can consult your treating physician & discuss regarding this matter. Wishing you a Healthy Life. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Had Duralast for premature ejaculation and felt drowsy. Is there any alternate medicine?\n\nHi doctor,I am a patient of premature ejaculation, and today I have taken my first dose of Duralast 30 mg. There was no significant improvement in the ejaculation time, and after a couple of hours I felt drowsy and kind of drunk. Should I continue with the medicine? If yes, for how long and what dose?",
    "doctor_response": "Hello. At your age, it is unusual to have premature ejaculation. PME is called when intravaginal ejaculation time is less than 1 minute, and there is a lack of satisfaction from coitus. Yes, Dapoxetine is an effective drug for premature ejaculation. 30 mg is the dose to begin with, which can get increased gradually. Besides Dapoxetine, Paroxetine can also be used. Once started it needs to be continued for a period of about four to six months, then after gradually stopped over a period. If taken for a more extended period, its efficacy decreases, cardiac and GI symptoms can also occur. Before starting it on your own, do consult a psychiatrist. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any side effects for Istamet and Glimaday?\n\nhii my mom is 55 yrs old and diabetic since 7 yrs, recently his doctor changed his medicines from Euglim MP2 (twice a day ) and voglistar md 0.3(twice a day) to(sitagliptin phosphate nd metformin hydrochloride tablets) i.e istamet 50/500 mg 1 tab before lunch and glimaday- P2 twice a day before breakfast nd dinner... do these drugs cause any harm to kidney or cause any side effect... please give me a brief",
    "doctor_response": "Hello, Side Effects of Istamet are Nausea, vomiting, stomach upset, diarrhea, headache, or a metallic taste in the mouth may occur. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr AJEET SINGH, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "ESR level is 46mm & suffering from fever,back pain & coughing\n\ngood evening sir/mamI am 24 year old female. and my ESR level is 46mm ,i also suffer from fever ,back pain and coughing .. I am worried about high ESR.. please suggest me what are possible actions to overcome this problem and please tell me the reason of this problem.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. ESR (erythrocyte sedimentation rate) is marker of infection and inflammation. So possibility of infection is more in your case because of high ESR. You are also having cough, fever and back pain. All these favour possibility of lung Infection (pneumonia) more.. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x ray. Chest x ray is must for the diagnosis of lung Infection. You may need antibiotics, antihistamines and anti inflammatory drugs. Once your infection is controlled, your symptoms will go away and ESR will also come to normal. So get done chest x ray to rule out lung infection. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How the delayed spill in bilateral tubes can delay pregnancy?\n\nWe are trying for a child since last 7 years. Based on the doctor suggestion today my wife has gone through the  laparoscopy with chromotubation. Reports shows that she is having normal bilateral tubes but showed extremely delayed spill. Doctor has given the appointment for next week but this point created doubt in our mind.Please let us know what is this and how it is impacting.",
    "doctor_response": "hello...thanks for trusting the healthcare magic doctors for ur health related queries.I guess ur concern is about..how delayed spill in bilateral tubes can delay in pregnancy..right.my answer is..there is no direct relation between delayed spill from the tubes n delay in pregnancy. once there is spillage from the tubes means the tubes are patent that means there is no blockage in the tubes.so DON'T WORRY..KEEP PATIENCE. ur wife can be became pregnant in future.delayed spillage may be due to some flimsy adhesions or any infections etc. but after chromotubation( that means dye injected inside the uterus which comes out through the tubes into the peritonium) this types of conditions may clear and it will help to getting pregnancy.so RELAX...nothing to worry.with the above discussion u can try out my suggestions-1. RELAX..everything will be alright. just keep patients.2. feel free to ask ur treating doctor regarding this matter. he /she can help u.3. if u r in hurry then visit nearby infertility specialist. they are expert in this field. he/she can help u.I hope the above information is useful, informative and helpful for u.regards-Dr sudha rani panagar(i can understand ur tense-full situation, DON'T WORRY..be happy.I pray the God that u will be blessed with a cute n healthy baby..hopefully TWINS)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why duphaston is banned in USA? I am from Poland and I am 12 weeks pregnant. I got 3x1 tab perscription from my doctor. I am worried as duphaston is banned in USA, UK. In Poland they still use this. I ve got haematoma 21x12mm under the placenta. This is my second pregnency. First one was 100% delivered on time with no issues.",
    "doctor_response": "Hi, Based on the evidence duphaston is banned in UK as well as in US for the commercial reasons. If you are residing in US then ask your doctor for an alternate effective drug to support and maintain the pregnancy as well as to prevent miscarriage and preterm delivery for which Duphaston has been widely used. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mohammed Taher Ali",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment to get pregnant?\n\ni got married for the year 2007 and just after one month i had conceved,but after two months missed my child. dr told me i had infection. after one year I had again conceved pregnacy and in the second month got rectificed ectopic pregnacy. Dr had removed my left philopin tube and thereafter rectified rubella test positive. sir i want to know can i conceive easily pregnacy again and what tests are required before planing the pregnacy",
    "doctor_response": "Rubella test  has no impact on the ability of pregnancy. you could get hysterosalpingogram  to detemrine the status of your rt.tube if it patent or not.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the possible treatment for Lumbar spondylitis ?\n\nHi My father who is 75, suffers from lumbar spondylitis , which also results in numbness of his feet, with pains running down his legs and causing him to hunch a bit when walking. He does not wish to risk surgery . Is this irreversible problem..and what are the best treatments? Thx",
    "doctor_response": "Hello Thanks for your query. As this is an advanced case of lumbar spondylitis because of numbness,& pain .If conservative treatment of analgesics,multivitamins,calcium , intermittent  pelvic traction   ,ultrasonics fail then surgery is the only alternative.Keeping in mind age conservative treatment is better. \u2018Hope I have answered your query, I will be available to answer your follow up queries, \u201cWish you Good Health and trouble free speedy recovery\u201d",
    "dialogue_context": ""
  },
  {
    "patient_message": "Adenoma carcinoma, lesion in left ovary, pain, unable to walk, bloating, vomiting. Which doctor to consult?\n\nOncologist needed: I am a 49 yr. old cancer survivor. I had an adenoma carcinoma pulp of the colon stage 0 when I was only 35, 1998..  I need help now: My most recent breast biopsy results were not benign. The microcacifications were: Adenosis with columnar cell changes and hyperplasia. Also, Flat epithelial atypia , and PASH cell changes. I was told to have a lumpectomy, or double mastectomy. I would like the later of the two. That was my 6th breast biopsy and my risk for breast cancer is very high. Next, a lesion in my left ovary was just found on my current ultrasound. 4.0/2.7/3.7.  I  have severe gyn pain doubled over, unable to walk, stand. I have bloating, vomiting, frequent urination. I want to seea GYN oncologist  now. Hard to find. Next, I really need and want to go to a Cancer treatment Hospital but only told I was not diagnosed with cancer yet. Which organ goes first? Thanks, Anita",
    "doctor_response": "Hello and welcome to HCM,Your history suggests that you had a cancerous adenoma of colon 15 years back. What treatment did you receive for this problem. I guess the cancerous adenoma along with apart of adjoining colon was surgically removed.Secondly, the breast biopsy suggests changes of malignany in the lining epithelium of the ducts of the breast. Bilateral mastectomy is a better option as compared to lumpectomy.Thirdly, an ovarian tumor is detected on USG.Associated bloating, vomiting, and frequent urination are also present.Bloating and vomiting appear to be due to indigestion.Frequent urination can be due to urinary tract infection.It could also be due to ovarian tumor compressing the bladder neck.The ovarian tumor needs to removed first.Histological examination of the ovarian tumor needs to be done to know its nature = benign or malignant, its histological subtype, and its stage.Further management, radiation therapy and/or chemotherapy will depend on the histological subtype and its stage.Mastectomy can be performed after removal of the ovarian tumor.If the ovarian tumor turns out to be malignant, a genetic test also needs to be done.Since, multiple tumors are present, a genetic cancer syndrome is suspected.Cossult your oncologist for genetic testing.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in conceiving a child?\n\nGood Evening,I am 24years old and my height is 5.3 my family members are saying you are very thin. but I am not getting proper sleep and i cant eat food. i got married but i dont have kids what is the cause for that. can you please me out of this situation.With Regardsmamatha.A",
    "doctor_response": "Hello welcome to HEALTHCAREMAGIC.I have gone through your question.As you are very thin and problem with sleep and hunger and also having problem in conceiving.then I wouldadvise to go for thyriod profile, routine blood reports like complete blood count, hemoglobin, esr etc. And consult gynecologist with these reports. And if needed do ovulation profile, and histosalpingography HSG.After these reports picture clear that where the problem is and treated accordingly.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to make up mind for an abortion?\n\nI recently found out that I was pregnant, I told my boyfriend about it.  He always jokes about me getting pregnant so was not expecting his answer.  He wants me to have an abortion.  I went through the consultation for the abortion and just strongly disagree with it.  I told him about this feeling and continually have nightmares about it.  He does not want to hear this and is gong ho about this abortion.  I feel even if it was an accident why are we killing this baby, it was not its fault it was conceived and now i feel its my job to protect it but I am scared about just up and leaving, he has threatened that if i leave he will find me and take my baby that he does not want and raise it with his ex.  what should I do",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  The cause of your fear is due to conflict of opinion. That is normal. Also you have a good human view point towards this issue. But you must also understand your husbands view. He could be compelling you to abort because of some compelling issues. Talk to him about this. Understand his feelings and points. Do not argue. Arguments always provides no result. Discuss. Discussions always produce results, decisions.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden dilation in eyes with pale lips and headache in children?\n\nWe just moved and I don t have insurance in this state yet. My 11 yr old daughter just woke up...came into kitchen, eyes dilated to the point of no color, lips pale, said head hurts and felt like she was going to throw up,she couldn t even talk to me. Her eyes rolled in the back of her head and then she fell to the floor.. Eyes still dilated. I got her to stand up and I said Mikayla what s wrong and she said momma I don t know I don t feel good. Please help me.",
    "doctor_response": "HI your child might have a fits like episode based on your description as she felt pale and fallen down,but you didnt mention when she became conscious.If she is able to woke up immediately with your voice , then she might have a syncope due to decreased blood flow to brain due to skipping of food",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent urination while suffering from diabetes?\n\nif I tested glucose at 112 and a1c at 5.1 with symptoms over two years of frequent urination during the night at least every two hours with dry mouth and sores that don t heal for long periods of time that has same time line how would a doctor find out if I had diabetes and what type? I also have had swollen ankles every day.",
    "doctor_response": "Hello,There are points that are not mentioned in the message and these points will answer your query:1, what is your age?2, what is the age at which diabetes was detected?3, what are the medications you are on for diabetes?4, what were the levels of sugars when diabetes was detected?5, what type of sugar test is 112? Fasting, PP, or random?The features of dry mouth, frequent urination are 2 important symptoms that suggest the testing for diabetes. As for the ankle's swelling you will need to get your kidneys tested- urine microalbuminuria should be ideal if this is a recent symptom.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Saumya Mittal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication to improve chances of conception\n\nHi, may I answer your health queries right now ?  Please type your query here...hello doctor, I will be 30years in sept this year, I had a baby when I was 28years and started taking pills. I lost my baby in march last year and stopped taking the pills to have another baby but its a year since I stopped and still haven't conceived. Am really very confused",
    "doctor_response": "Hi, I think you should go for evaluation first.  Do a thyroid profile and prolactin levels and a ultrasound for your uterus and ovaries.  If everything is fine, you can take some medicines like clomiphene for the growth of your follicles and track your follicles growth by repeated ultrasound.  When follicles reach a size 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.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for kidney stone removal\n\nMy best Friend sufferd kidney stone from last two month he had done all treatment like Ayurvedik,Alopathic,Homiopathy as well but there is no effect still he has problem .In the Sonograpy report the kidney stone showing 9 mm wht is ur opinion  please tell me..",
    "doctor_response": "Hello, 9mm kidney stone can be reomved medically by a procedure called as hydrotherapy. In which lots of fluids is rushed in body and then diuretic medication is given which helps many patients of kidney stone to pass the stone naturally by urine. You can consult your doctor about the same. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment and diet for typhoid\n\ngood day, my son 15 yrs of age diagnosed with typhoid , he take medicine chloramphenicol for almost 5 days, on and off his fever 39 degree celcius, is there any medicine  to take aside chlorampenicol,he suffered stomach ache and watery stool, what are the diet for him ?",
    "doctor_response": "Hi,Typhoid fever is a bacterial infection of intestine.In typhoid there will be small ulcers in intestine.So stomach ache and watery stool are common symptoms in typhoid.Along with chloramphenicol you may give paracetamol if temperature is high.I suggested to follow strict diet for atleast one month.Diet you may follow are curd rice,idly,gravies without or very less oil,bland diets with low salt and no spicy,totally avoid pickles.If you follow strict diet only intestinal ulcers will heal soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and a skin rash in children\n\nMy 3 year old has a mild fever and a rash all over his body, some red splotchy patches and others covered in little bumps. These are his only two symptoms and both appeared at the same time. No cough or runny nose, no complaints of head ache or stomach ache. Has a normal appetite and is somewhat tired and crabby but has been playing and acting fine for the most part.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Different viroses can cause fever with rash or red spot into the body especially in children. So my advise to you is: use paracetamol for the temp and warm baths from time to time to help your baby and the situation with turn right in few days. Anyway in case this situation doesn't change you should consult a doctor. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a loose lump on the knee?\n\nI had surgery on my knee about four years ago. The skin behind my knee-cap broke and was irritating it. Now I have a ball of some sort on the side that I can move around anywhere in my knee. It doesn t seem to be attached to anything. It s just a loose body of something. What is this?",
    "doctor_response": "Hi! thanks for sharing your health queries with HCM!Well, this is a common post-surgical condition and whenever somebody presents to me like this, I consider the following possibilities:1. an inclusion cyst2. a post-operative stromal nodule inflamed chronically3. lose bodied like fragments of bone/cartilage!4. blood-filled sac termed as hematoma Overall, this is a benign or inflammatory or degenerative condition and not to worry at all!Therefore kindly consult your surgeon for some tests like x-ray, CT scan and FNAC to determine the line of management!Hope got the answer to your question; please don't hesitate to write to me in case any more queries/clarifications.Wishing you good health!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can paxil usage cause Dystonia?\n\nMy nephew took Paxil for 2 weeks in 2003. He developed - what they now call Dystonia - a muscle problem that affected his jaw and neck. The physicians denied that the disorder came from the Paxil. Now Paxil has a disclaimer for this problem. Anyway, after years of visiting physicians, psychiatrists, NIH, Sloan Kettering, etc they came up with Lyrica. This does help the best but it only lasts for months. Then he has to go off of it for a few months before it seems to work again. Do you have any other suggestion?",
    "doctor_response": "Hello,90 to 95% there is no such side effects with Paxil. Please check his/her serum calcium levels.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mohammed Abdullah",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes kid to pass acidic smelling stool?\n\nMy 18mth old grandson is passing acidic smelling furry poos.what could be the reason for this? He is having at least 2 motions a day. As an infant he was lactose intolerant and was put on soy milk but is now having full cream milk with cereal and a little yoghurt and cheese in his diet. Thank you for your help.",
    "doctor_response": "Hello. As your grandson is lactose intolerant i would suggest you to take out the dairy products for a week and see if there is any progress. The number of motion is not a bad indication so you should not be worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can increase in BP cause development of goitre?\n\nI am 38 with high blood pressure in the past 2 months. Current meds of lopresser 100mg vitamin D 6000 Prozac 20mg, 325mg of iron daily. All labs perfect except thyroid, but endo Dr does not want to treat. Average bp of 165/98-64. I could lose at least 20lbs, I am very active and eat balanced. I think my all of a sudden elevation of BP is thyroid related. My goiter in my neck is getting bigger",
    "doctor_response": "Hello,Raise blood pressure does not cause goiter, on the contrary, thyroid dysfunction may cause raised blood pressure. As for as your goiter is a concern it occurs due to Iodine deficiency in your food.Hope I have answered your query. Let me know if I can assist you further.Regards,     Dr. RS Gulati",
    "dialogue_context": ""
  },
  {
    "patient_message": "Problems in process of ovulation,prescribed stimulant medication,total motility 55%,pus cells 15-18 hpf,no children\n\ni have some problems in the process of ovulation and i take Stimulant medication for the physical size of egges and it sucess in making the egg reach to the size of the natural but my husband has some problems as his normal form is 20% and abnormal form is 80% and thefirst hour total motility 55% and the pus cells is from 15 to 18/ hpf we have married for one year and have but we dont have any childern yet",
    "doctor_response": "Well, young couple thanks for to have kind advice for of your troubles and after going through your history of complaints I am of the opinion that you both need help and counselings from of Infertility clinics and more specialized help can be availed of by reaching to XXXXXand wish both of you for to enjoy life free from any stress..............",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in lower back radiating to hip?\n\nI have a couple things going on start in low back down thru hip and in thigh it s a deep pain hard hard to get comfortable when I do dosnt last long also I have a pain in my lower abdomen when breathe in it a sharp pain and when I have bowel movement and pee pushing hurts I can push down and it hurts then gos away I have had this pain in adomen an leg 2 days now the pain is close to the bone that has like a ball on it coming into bikini line",
    "doctor_response": "dear,welcome to HCMas i can understand from your complaints you are having low back pain radiating to thigh, a vague discomfort in lower abdomen.i Suspect following conditions1) herniated intervertebral disc, lumbar canal stenosis2) spondylitismy questions for you are1) difficultly in sitting for long, pain on bending forwards?2) fatigue of legs on small distance walking?3) history of fall or injury on back?4) details of weight, height any medications,etcmy advice for you1) tab voveran 75 mg as an when required, max thrice a day2) an xray lat spine, it will help to know the cause and conditionkindly follow up for further queries and detailed answer at me Dr Pankaj Borade.Regards,Dr Pankaj Borade",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does the tB medication affect future pregnancy?\n\nAfter someone has been treated with lymph node TB and has completed the medication 1) What is the chance of relapse 2) how can the patient be sure that the TB does not exsit anymore 3) Does the tB medication affect future pregnancy 4) If someone who has completed TB medication happens to have a miscarriage could it be related/associated due to TB medication",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the TB can be cured with correct regular treatment.Relapse is common in those who have taken irregular treatment.The treatment is based on the category of patient.The TB can affect various organs in the body apart from lungs.If the reproductive organs are effected then the infertility might be the problem.It might also cause miscarriage.Yes certain medicines given in usual treatment are not given during pregnancy.Completion of course of TB treatment results in clearance of infection.You can consult pulmonologist for physical examination and relevant blood tests to know about the clearance of infection.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having high platelets, is my husband already advanced to the accelerated stage or blast crisis?\n\nMy husband has cml and has for 10 years he is allergic to all of the chemo drugs including all the new ones.  He is presently on hydrea to control the platelets but his wbc is very high this weeks labs show 76. something. he also has an enlarged spleen. his platelets with the hydrea are 167,000. He is also on prednisone for his RA, because of severe flare-ups.  All of the other blood tests on the cbc are either high, very, or somewhat low, especially the rbc. has he already advanced to the accelerated stage or blast crisis?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. He has CML. Accelerated phase of cml depends on percentage of blast cell.  If he has blast percentage of more than 5 then it is called as accelerated phase.  If not treated iit ultimately end up with blast crisis and acute leukemia. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Should I see a doctor for a constant headache?\n\nHello doctor, I am 26 years old male, for the last month and a half, I feel a pressure on the back of my head. It sometimes causes mild pain in different parts of my head, like the sides of my head. It makes me feel hot sometimes as well. I also have some neck pain, but it is not much. This headache is not very painful, but it is just an annoying pressure that has not gone away in six weeks. When I wake up in the morning, I do not feel anything, and then around 11 AM, the pressure is, there, and it will get worse until I lay down in the evening. And it pains a lot at night. I think about it all the time, so I am sure that does not help with the feeling. I think that I have a brain tumor. Should I see a doctor? I do not want to waste my time and have them say do this or try this without doing an MRI. I have only taken Ibuprofen a few times to help with the pain, and that seems to work.",
    "doctor_response": "Hello. I would like to know some details about your problem.\u00a0 Revert with investigations mentioned above and response to this medication. Revert with more information to a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes an unusual feeling while on Pristiq and Cymbalta?\n\nHi there my name is Gianna. I was recently put on Pristiq 50mg only in the morning. I also was put on Cymbalta 60mg Am. & Pm. One of them is making me sick. My Neurologist I saw this morning he told me that I cannot take the Pristiq with the Cymbalta, that\u2019s why I was having some side effects but my pharmacy didn\u2019t catch that. I stopped the Pristiq after 3 days because that Doctor was on vacation. Can you help me out with this?",
    "doctor_response": "Hi, Can you specify your question since it seems that you are already aware your neurologist has recommended you not take Pristiq with Cymbalta due to drug to drug interactions?  It is true that these 2 medications taken together could cause symptoms of serotonin excess and feeling \"sick\" or nauseous is certainly one possible symptom. You should check with the prescribing physician to discuss alternative medications since this combination doesn't seem to be working for you. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a painless hard lump leads to cancer?\n\nMy 14 year old son has a hard lump on top of his shoulder. It s about the size of a grape and we just noticed it, he s not sure how long it s been there. . He says it s painless and it seems to be stationary. I made a dr appt for next Monday. I m very worried it could be some sort of cancer. What could it be?",
    "doctor_response": "Thanks for your question on HCM.In my opinion you should not worry much about this swelling. By your description of swelling,  I think your son is having either dermoid or lipoma.Both are soft tissue swelling commonly occuring.Both are painless, non itchy and non tender. Almost 100% benign.Dermoid contains fibrous tissue while lipoma contains fatty tissue.So no need to worry much. Get done excision biopsy from the swelling. This will give you correct diagnosis.  It seems dermoid mostly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Do I need to continue Arpizol and Pacitane for schizophrenia?\n\nHi doctor, I was diagnosed with schizophrenia before 7 years. I used to take Sulpitac early in the treatment and then I was prescribed Nexipride for a year. For the last three years, I am taking Arpizol 10 mg and Pacitane 2 mg. My age is 30 now and I want to get out of schizophrenia as soon as possible. My parents are worried about my marriage. Every time when I ask my psychiatrist, he says keep taking Arpizol and Pacitane. I am tired of this. Is the treatment right?",
    "doctor_response": "Hi. I can understand your concern. Schizophrenia is a chronic neuropsychiatric illness with changes in behavior, thought, perception and a lot of other psychiatric symptoms. Sulpitac (Amisulpride), Nexipride (Levosulpiride) and Arpizol (Aripiprazole) are antipsychotic drugs and help to treat psychotic symptoms. If you are symptom free with Arpizol for the last few years, then in my opinion you can consider reducing the dose of the drug. There is no use of continuing Pacitane (Trihexyphenidyl) with Arpizol because the drug at this dose does not cause extrapyramidal symptoms. Consult your specialist doctor and ask for re-evaluation and get your dose reduced. For further information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for palpitation and shortness of breath after injection shot\n\nMy name is Ken Karson, I am an inner city hospital which is often the sight of emergency treatment for IV users. I have a history of using whatever needles I can get o injections and often am not careful about the cleanliness of his skin at injection sights. Some of the symptoms I have experienced are Rapid irregular heart beat marked shortness of breath petechial lesions of the skin conjunctiva and the oral mucosa weight loss back pain night sweats urine abnormalities.",
    "doctor_response": "Hellothanks for posting here. Given your history and symptoms, you have high probability of infective endocarditis. It is a disease of the heart valves. IV users are most likely to get right sided infective endocarditis of heart valves because of unsterile methods by which bacteria gain direct access to the heart endocardium. And also please get your HIV HbsAg and HCV checked which are transmitted by blood, given your history of iv use. To evaluate infectious endocarditis, you must do a blood culture which is a blood test and a 2 D echo which will demonstrate bacterial growth on the valves of the heart. take care.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does high ESR during viral fever indicate?\n\nThis is for my wife, Last week she got fever and bulge her lower lip and last tooth. Then we met a doctor ,he told this is due to viral fever and bacterial attack from last tooth. suggested to test blood .The result shows esr 40 and vrs16 and all other tests are normal level.then treatment started for reducing the fever and bacterial infection. Now two week finished ,no fever and pain ,but lip wound not completely recovered. doctor said it may take another 2 weeks to come in normal stage ,and after that he recommended for more investigations including biopsy (skin). we are too much worried . Why esr level is increased ? Is any major test required ?",
    "doctor_response": "HelloESR is normally 5-15 mm of 1st hours . 40 mm is not so specific and even a minor bruise or abrasion or bacterial infection elevated ESR ,so this is not a cause of concern .As you mentioned that there was bacterial infection in the tooth and there is a wound on the lower lip , so why are you bothering as this common.I would like to say one thing that there is wound or bulge on lower lip so consult one more specialist ( surgeon ) and get his opinion regarding wound but before biopsy test.In my opinion all things are normal ,so 2nd opinion is important .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes panic chest pains in night?\n\nAs of recently I ve been suffering from some very scary chest pains, typically at night. Tonight for instance I had such an episode that lasted almost 2 hours. I was just lying in bed when I began to feel weird. I had a rapid heartbeat, my chest felt heavy, I felt woozy & was really shaking. I almost called 911 but a friend I called assured me it was probably just a panic attack. I am afterall a somewhat healthy 26 yr old male. I exercise regularly, eat somewhat healthy & quit smoking just over a year ago. However, while looking into causes for chest pains on WebMD I read up on Myocarditis which sounds very similar to my current symptoms. Last November after having unprotected sex I showed symptoms of chlamydia such as pain while urinating & a milky discharge. I was given medication through Planned Parenthood. Symptoms appeared to stop for several weeks & then returned very mild, to the point where it took months to notice. This concerns me very much because Myocarditis, an inflammation of the heart muscle can occur when a viral infection such as chlamydia is left untreated. It reads to seek medical attention immediately. However as a server with no insurance I am reluctant to see a heart doctor immediately so I have requested an appointment with planned parenthood to have a blood test asap & then go from there. Any addition advice would be tremendous. I am somewhat concerned.",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. In my opinion you are having anxiety and panic disorder mostly. But better to rule out cardiac cause first for your symptoms. So get done ecg. If ecg is normal then no need to worry much for myocarditis or other cardiac  causesYou are mostly having anxiety and panic disorder related chest pain. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. Avoid stress and tension. You may need anxiolytic drugs too. Don't worry, you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurrent viral infection in a child living in humid climate?\n\nHi My Baby is turning 2 this sunday. we live in new zealand- auckland a very humid city.. he was born in nov 2012 (which is spring-summer) season this year he joined daycare in april (winter season here) and since then started getting sick every second week.. he gets a virus and then a viral induced wheeze. but since 6 weeks he got a virus and since then he has been suffering with an on and off viral wheeze every week.. not sure why.. as he never was like this for the past two years (since he was born) each week he is given redipred for 3 days with ventolin, getting better, then next week bad again Can you please tell me why and what to do? is this allergy or asthma? or is it because he is teething, and so getting the flu and then a viral induced wheeze? till when he will be like this, will he grow out of it?",
    "doctor_response": "Hi... I just went through your query. By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze. I have a few questions for you -Questions:1. How many days per month does he cough or feel breathless?2. How many nights per month does his sleep get disturbed due to above symptoms?3. Does he feel breathless when he runs around or plays with other kids?4. Are the symptoms when there are seasonal changes?5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?6. Is the cough always associated with fever?If your answer is yes for any of the above questions, your kid might be having viral associated wheezing or multi triggered wheezing and I suggest you meet a pediatric pulmonologist who is near your place. Otherwise get back tot me with answers to the questions above and I wil be glad to help you.You can approach me at the following link. Please find the link below.www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for panic disorder,and how can it be avoided?\n\nhi there been suffering for panic disorder for years now...always feels like having a heart attack...is it possible to be cured?i heard this is for lifetime?is it true?what are the factors to be avoided for me not to panic?and foods to be avoided?tn in advance i have no budget to go to a private doctor thats why im looking for alternative meds by the way im only 25 im only 21 when i was diagnosed with it...im 5 2 ive got allegic conjunctivitis and i am acidic..im always making such sounds like ehem just to clear my throat coz it feels like i have phlegm but im not",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Panic disorder could be cured completely with the help of medicines and psychotherapy. The approach depends on the severity of the case and pathogenic. To diagnose the severity, I need a detailed description. Once the detailed description is handy, I shall advice you about the psychotherapy methods to be used. Meanwhile you can do the following:Step 1 - Practice Deep and full breathing whenever possibleStep 2 - Drink plenty of water and fruit juices. Step 3 - A Tomato a day keeps anxiety at bayStep 4 - Exercise regularlyStep 5 - Avoid red meat and spicesIf 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recommend anti-fungal medications for athlete s foot\n\nI have been having problems with athlete s foot and toenail fungus for about 15 years. The soles of my feet have black scars, peeling skin and roughness. I have tried just about every antifungal medication there is. is there anyway to get rid of this fungal infection as well as the scars. This is very embarrassing and as a female I am too ashamed to wear sandals because my feet look awful.",
    "doctor_response": "Help, thank you for your contact to healthcaremagic. If I am your treating doctor I would like to ask you whether it is conform fungal infection.? You should be diagnosed with Gram's stain. It may actinomycosis. If you are confirm with the diagnosis, go with fluconazole 150 Mg under your doctors guidance. Continue for 1 month followup after a 1 month. If you want to ask me anything you can ask me. Thank you. Dr Arun Tank. Infectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What causes pain in leg with tingling sensation?\n\nHello doctor,My uncle 52 years old, complains of pain in the right leg for one month. The pain starts from the lower back and radiates to toes. Sometimes pain occurs from knee to toes only. There is a tingling sensation in sole after the movement for some time.",
    "doctor_response": "Hi. This is typically a radicular pain which could be due to compression in the lumbar spine. There are three ways of treatment. First is medications. I am sure you have not taken the proper dose of Pregabalin. If not responding to medications, then we can give a transforaminal injection. If not responded to both, then the third option is surgery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What should be followed when a medicine is recalled?\n\nHello doctor, What people should do when their medicine is recalled?",
    "doctor_response": "Hello, Welcome to the icliniq.com. Whenever a particular drug is recalled, it can be due to it is hazardous side effects. When such recall occurs, it is advisable to stop the medication. You can take alternate medicines for that. In such situation decisions regarding changing the drug taken only after your doctor consultation. I hope I have answered your question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medicine for muscle pain near sciatic nerve\n\ngood day the muscle near my sciatic nerve is pressing on it and causing extreme (i have below tolarance to pain) I started taking meicicam 15mg and tramadil 50 mg but i only had a few pills and they worked great i ran out and my dr called in a script torizanidine 2 mg 48 hours later and it is not helping. i cant sit stand or lie down for mor than a few minutes. can i double the torizanidine and i also have hydrococone acetiminephen 10/325 what combination can i take until i get to dr on fri Please help i am in extreme pain",
    "doctor_response": "Its better go to physiotherapy or occupational therapy and have sciatic mobilization and manual mulligan traction and have TENS machine",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes soreness in the mouth and throat after using partial dentures?\n\nI got a new partial denture. It seems to be too deep in the inner mouth in the back, I now have a sore throat and am sore in back of mouth. It feels like the glands are sore on the one side where the denture is too long. I have tried to wear the denture for 2 days but can not endure. My mouth and throat continues to be sore. What can be causing the pain?",
    "doctor_response": "Hi..Thanks for the query..It is very clear that your depth of the denture is the cause of sore throat as the plate of the denture must be touching deep behind the soft palate over the throat.as the denture is new there must be some sharp areas over the tissue side of the denture that is causing the mouth mucosa to get injured and making it sore..Nothing to worry as both these problems can be very much resolved by adjusting the denture.You should consult your dentist again and he can trim the excess length of the denture so that it does not go beyond the  post palatal seal area that is just behind the junction of hard and soft palate.Also he can smoothen the sharp areas over the denture so that it does not hurt the mucosa..Once the adjustments are done you can continue wearing the denture..For now if you can see any ulcerated areas over the mucosa inside mouth you can apply pain relieving gels like Oragel.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stronger penis\n\nHello Doc, I am Kamal, 40 years of age male. I want to ask that i do sex once in a every night. I want to do more sex in a night. Which medicine i can take. My penis not look strong during the intercourse. Please advice, i will be highly abliged ans thankful to you.",
    "doctor_response": "Strong penis doesn't always state a satisfactory sexual act. Penis to hold on strong mainly lies your psychological approach. Be confident that you can perform the act. If it doesn't work, you can use sildenalfil, the drug for erectile dysfunction.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes memory loss, leg pain and loss of balance with slurred speech?\n\nYes im 47, have very bad cognitive issues, lesions on the brain, white mater loss that is significant, memory loss, leg n arm weakness, extreme leg pain, balance issues, trouble getting my words that I want to say out. I m sure I m forgetting things. The onlyi had was a negative lp. I was told this mean I don t have ms but from what I m reading, tells me different. I have an emg on the 30th. Any advice reg the LP?",
    "doctor_response": "It may be ms, proper in estigation is required.for the problem withenia som ifera& ginkgo biloba are the best homeopathic medicines.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pulmonary embolism\n\nI was recently in car accident about two years ago got ejected from vehicle and fractured a lot of bones an had pulmonary embolism,subdue all hematoma,well my question is I fell in my back yard landed on my chest and it feels like I broke a few ribs,I have been in some excruciating pain this happened about eight days ago,and the pain is still hurting pretty bad,I know there is nothing they can do for broke rib ,should I go to the doctor or just wait and let it heal on its on?thank you your input will be greatly appreciated",
    "doctor_response": "Thanks for your question. I can understand your concern. As your history goes it would be advisable to get a chest x ray and an examination done just to rule out any lung contusion or any other injury. Also probably a chest harness will help you for the same. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get pregnant?\n\nI have been diagnosed  with small anterior intramural fibroid last month. I am planning for a kid for last 1.5 yrs still not successful. I m so worried don't know what should i do as my FSH,TSH reports are normal even Ultrasound of my pelvic region is normal too. pls help!!",
    "doctor_response": "Hi,    Thanks for query.I understand your concern.  *   Consult your gynecologist .. if she find the size of fibroid  would not interfere with pregnancy .. you can plan conception stat.  -  Get your husband's semen analysis to be normal.   -confirm your ovulation day by LHSurge test &have unoritected sex for 5-6 days when you get tge test +ve.    -start taking folic acid&vitamine E (both of you).    -pregnancy testafter 8 days of delay in period would be +ve after conception. *In case you don't conceive in 6 months.. gi for detailed investigations of sterility.  *If the fibroid is bigger you need to remove ot as per yiur dictor's advise.    Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fluttering around the liver or gallbladder\n\nI have a fluttering feeling where my liver or gallbladder is. Its been going on for months.",
    "doctor_response": "Hi welcome to HealthcareMagic Do, not get confused... some times the gurgling sound of the stomach can be heard so... the feeling of fluttering is felt due to peristaltic movement of stomach and duodenum.. hence get examined clinically evaluated and get USG done to rule out any cause... Hope I have answered your question.. TakeCare..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold and an ear infection\n\nHi, I have3 year old daughter who has repeated colds atleat 1 cold a month or sometimes 2. Had ear infection in May last year. pediatric Doctor treated her with amox. Now again in month of jan she had another, again treatedwith amox. After 15 days she had a cold again with ear infection. This was treated with omnicef . Immediately had a cold again after the15 day. pediatric doctor said she is having a viral cold again. So this cold seems like it is there for a month now since it was back to back. Now the cold is gone for 7 days now, but she wakes up with a stuffy nose every morning.Also compalins of itchy ears every now and then",
    "doctor_response": "Hi,Your daughter might need tonsillectomy with or without adenoidectomy if:1) she has difficult breathing while she a sleep 2) 3 rounds of ear infection per year 3) 5 common Cold that required antibiotics per year she need a careful evaluation of her adenoids and tonsils to avoid the development of rheumatoid fever due to recurrent infection as for now she could use an anti histaminic to cure the runny nose and the itchy ears as Citrizine once daily before going to bed.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Salah Saad Shoman",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a fever , tiredness , backaches and cold?\n\ni have a temperature of 34.9, but dont feel poorly, other than tiredness, backaches and a constant groggy type headache and feeling the cold in my hands and feet, where i usually am very hot. i have had a thyroid test, and it is low, but only just so i am not on any treatment for it, (i have started taking sea kelp after reading it can help stabalise the thyroid) should i be worried that my temp is so low, with no fever?",
    "doctor_response": "Hi welcome to HCM.Absolutely your symptoms can be attributed to under functioning of thyroid.Hypothyroidism is known to cause low body/extremity temperature which can result in sensation of tiredness and fatigue.I strongly recommend you to get a complete full picture of your thyroid gland by blood tests like T3,T4,TSH plus an ultrasound thyroid.This can help to evaluate any nodules in the thyroid which can cause such symptoms.Eating sea kelp will not offer you much advantage.Its strongly recommended that you take external thyroxine supplementation in the form of tab thyronorm daily for six months.This can offer you permanent cure in most cases.Consult an endocrinologist with regards to above.Post your further queries,if any.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have back pain. Took ibuprofen. Uses hot shower, heating pad\n\nHave been having back pain for 5 or 6 days, pain is below my shoulder blade on the left side of my back towards my middle back.  I have been taking ibuprofen for the pain, however I am getting little relief.  I feel the best in the morning after I get up, however after 4 hrs or so the aching/burning Is back.  Heat seems to help, heating pad and hot shower...  Should I be concerned? It bothers me that the ibuprofen is not working.. Thanks for your inputDawn",
    "doctor_response": "Apply  muscle relaxant/anti-inflammatory  creams  locally  after hot fomentation  and take  complete  rest in  bed for  3 days  to relax the  muscles.  avoid  bending  and  lifting  objects  within  the  rest  period.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I have deteriorating memory, paranoia and deja vu?\n\nHello doctor, I have the following symptoms:  Deteriorating memory. Depersonalization or dissociation. Unable to articulate well. Jumbled thoughts. Lack of appetite (despite hunger). Depression or unmotivated. Paranoia, like someone is watching me through my phone or how my friends are talking about me behind my back. Hard to express emotions. Seeing things, movement out of the corner of my eyes. Hearing things. Deja Vu or Jamais Vu.  Odd thing is that I do not feel like there is anything wrong or it does not feel real to me. It is happening for approximately three to four months on-and-off.",
    "doctor_response": "Hello. The symptoms could be due to severe anxiety. Progressive loss of memory, dissociation feeling, difficulty in articulation, racing thoughts, depressed mood, paranoia, difficulty in expressing, etc., could be due to anxiety.  But, if you are hearing voices which others cannot hear, and have a suspicion that someone is watching you, then that could be due to some underlying psychosis. This should be evaluated properly. Please visit a psychiatrist for an opinion. Try to remain relaxed and if possible ignore these symptoms.  For more information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have nervousness, increased heartbeat, tremors. Taking Prodep. Complete solution?\n\nDear sir when i was studying 10th i got severe current shock.Due to that i got skin burns and nervousness .At that time i didn t take any treament for that.when i was studying +1 and +2 my father didn t pay the school fees for 2 years.Due to that daily i stood in front of the prayer.in that 2 years daily i fought with my parent and didn t take food properly.Due to that nervousness keeps on increasing which resulted low mark in +2.Then i joined engg but i got loan for that.Anyhow the depression effects continued in the 4year engg and i was passedout in 2010 and still now i m unemployment due to nervousness,increased heartbeat , sudden tremors through the body,pain in the backhead, confusion,poor memory , tongue twitching and can t able to write well due to shaking of hands.For the past 11 months i am taking prodep60mg,lonacep1mg,tolezmd2.5and migrabeta tr-40 but still im nervousness.the tablet power lasts for that day only.so i humbly request you to give me a complete solution for this problem",
    "doctor_response": "Many of the problems you deal with can also be due to chronic use of medications. I would advise you to consult a neurolgist or psychiatrist and cut down or taper down your medications gradually. Meanwhile you can practise 'mindfulness' which will help in reducing your anxiety and improving your confidence. More info on it can be obtained from internet. Wish you good luck. Thank you for using HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair thinning\n\nI have noticed thinning in my hair at the top and along the from hair line. I am a 57 year old female.  I take Azor for blood pressure and did notice some shredding when I first started taking it.  I am also \"addicted\" to nicotine lozenges.  If I stop the medication will my hair start growing back?",
    "doctor_response": "Hi,You seem to have telogen effluvium. There are many causes of telogen effluvium. Kindly consult the dermatologist for the perfect diagnosis and proper treatment.After thorough examination and investigations,your doctor might give proper medicines. Nicotine addiction should be stopped immediately,which will improve your condition of scalp.I would suggest...- biotin 10 mg tablet once  daily for few months- iron and B complex vitamins - vitamin E - apply mild steroid lotion on the scalpRegular shampooing and oiling of the scalp might improve condition of hair structure.If any internal disease like thyroid dysfunction is found, take treatment.I hope this would help you..Thanks.Dr.Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taken Amikacin for dry, smelly mouth and white tongue. Negative VDRL, TPHA, HSV. Redness on penis tip\n\nI had e coli sti 0000 .wbc 9400. Dry and smelly mouth white tongue.dr adviced amikacin 500 mg for 5 days.but still i have white tongue and taste bad.secondly i had tested for vdrl tpha hsv 1&2 ,30 days post exposure ,everything negative.hiv dna rna p24antigen negative 20 days.kindly advice how conclusive are these hiv,std tests.also i have redness on the vein tip of penis.",
    "doctor_response": "Hello,Thanks for posting your query.Dry smelly mouth can be either due to leukoplakic lesions on oral cavity or due to pericoronitis as a result of wisdom tooth impaction.Apply topical steroid on the affected area.Brush and floss your teeth as well as tongue daily.Gargle with chlorhexidine gluconate mouthrinses,twice daily.Salivary substitutes has to be administered to prevent dry mouth.I would suggest you to take plenty of fluids as well as nutritious diet.Discontinue the habit of tobacco or pan chewing.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to have the blood group changed?\n\nHi,Till last year I donated blood in various blood banks and my blood group was confirm to A RH +ve.However, last year I came to know that it is A -Ve. Since then I donated blood three times and it is now A RH -ve.Is it possible to have bllod group changed?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.It is not possible to have blood group changed. You may have some misdiagnosis or false report either in past or now.You should consult a standard laboratory. confirm your blood group. If required go for Du test to confirm negative blood group.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can beer be consumed if suffering from hepatitis-A?\n\nI was suffering from jaundice 3 months back, 2 months back my bilrubin was 3.1 and i was suffering from hepatitis A. From last 2 months I am regularly having Liv-52 and polybion. My age is 25. I just wanted to know as now its been almost 3 months ,Can i have one or 2 beers in a week or i should still stay away from it?",
    "doctor_response": "hi.thanks for posting query at HCM.yes you may ingest beer now but be sure its NOT poisonous or expired and liver enzymes are in the normal range,hope to answer your concern.regardsDr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Ibuprofen a good option for the treatment of pain in the neck?\n\nMy husband, 78 yo, has had back & 2 neck fusion surgeries. Last surgery was 13 months ago after he fell and broke C1 C2. He often is in severe pain still; even at night he wakes from pain in his hand or neck or back or feet. he wants to take 800 mg Ibuprophen. He currently takes acetaminophen, as recommended by his original surgeon. Would this be a good option as Ibuprophen is supposedly fast acting. He wants fast.",
    "doctor_response": "Hi, Both Ibuprofen and Acetaminophen are a similar group of drugs, NSAIDs (non-steroidal anti-inflammatory drugs). But Ibuprofen is having a faster onset of action as compared to Acetaminophen. So yes, you are right. He can definitely take Ibuprofen for faster pain relief. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Kaushal Bhavsar, Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the signs of seizure?\n\nmy son injured his hand and was afraid the injury was worse than it turned out to be. following the incident he blacked out for a period of abot 10-15 secs. he Is 8 yo and was treated for epilepsy when he was 2-4yo. could this have been a sezure or just trauma reaction?",
    "doctor_response": "Hi, Welcome to HCMI am Dr.J.Mariano Anto Bruno Mascarenhas. I have gone through your query with diligence and would like you to know that I am here to help you.The following symptoms following Head injury require evaluation by a Neurosurgeon1. Loss of Consciousness2. Fits 3. Headache 4. Vomiting / Nausea5. Dizziness6. Giddiness7. Double Vision 8. Blurring of Vision 9. Numbness10. Weakness 11. Bleeding from Nose 12. Bleeding from Ears13. Bleeding from throat14. Pain Of which your son has had 1In addition he already has history of seizuresHence you have to immediately consult a NeurosurgeonBest Wishes for Speedy Recovery Let me know if I can assist you further.   In the future, for continuity of care, I encourage you to contact me directly in HealthCareMagic at  Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does lack of sleep cause fatigue and dizziness?\n\nHi doctor, I am a college teacher. I feel fatigue and dizzy for past one year. I slept very late one night and the next day while taking class had a dizzy feeling for a second. I felt that my head was reeling and on that afternoon I took off. It did not happen again but I felt myself weak with less energy, as if I am about to fall if I do not sit somewhere. I was unable to stand or walk for a longtime because of fatigue and lack of energy.\u00a0Nerves were twitching sometimes. I saw several doctors but I was unable to convey my symptoms properly. Sometimes, I get a sudden panic too, with increased heartbeat, dizziness, etc., with a frightful feeling that something is going to happen. An MRI scan was done which is alright. Hypertension, thyroid, and sugar tests were done and that too fine. The doctor said it may be a\u00a0stress reaction and he gave a tablet for fatigue. After having that tablet for a while, fatigue was gone, but other symptoms of panic attack, occasional tiredness still continues. Please help.",
    "doctor_response": "Hi. I have read your complaints very carefully. But what are the causes for other symptoms? Well. There is an explanation. Revert back after a month to an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the sore numbness in my mouth?\n\nI have a had a sore numbness inside my mouth for about a week.  Inside my lips, my tongue,and the roof and sides of my mouth feel swollen and a little numb and are very sensitive to spices and acid, like diet coke.  There are random reddish spots, and it feels a little rough, but not bumpy.  It's pretty uncomfortable.",
    "doctor_response": "Hello!Welcome to HCM.You did not mention your age and your general health status.Coke and other acidic beverages are detrimental to the teeth.Please reduce your intake of these gas filled beverages.You did not mention if you used any new tooth brush, paste or mouth wash recently.Change it to regular one if you changed it.Burning can also be a cause in lichenplanus and other lesions, which has a autoimmune cause.Topical  steroids are used for this.I advice you to see your dentist for a definitive diagnosis if this persists.Maintain a good oral hygiene.Use mild chlorhexidine gargle once daily for two weeks.If you are suferring perimenopause discomfort, you must get this treated with your gynaecologist.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for kidney infections and traces of blood in urine\n\nHello I have been on Artovastatin 10 mg / day for 3 years and in the last 2 years have had issues with my kidneys. I am about to have a ct scan as i have had kidney infections and have had traces of blood in my urine. I also feel generally unwell. Any thoughts ? Thank you.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Atorvastatin does not cause any kind of kidney infection. The recurrent urinary tract infection you are facing may be due to some other causes. Check your fasting blood sugar level as undetected diabetes can cause recurrent UTI. Do a urine culture and sensitivity and start on antibiotics and you will be fine soon. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sharp chest pain\n\nI have been having chest pains for the past 6 years or so.  It started out as a sharp pain that I could control by stopping breathing for a minute.  It became so regular that I stopped breathing without thinking about it.  There would be times I would get the pains while sleeping and would just stop breathing while sleeping to get the pain to go away.  Over the years, the pain progressed.  It would radiate throughout the back, ribs, and full chest.  The pains would not always be on a certain side of the body.  I can no longer stop the pains.  The pains have gotten so bad that they paralyze me anywhere from a few seconds to 20 minutes (the pain is so bad that I can't move).  Recently, I have noticed that if I lay down on my left side, I immediately get a pain in my upper left chest as if it were in the heart.  I am 21 years old and do not smoke.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Possibility of stress and anxiety related chest pain is more likely. But better to first rule out heart diseases because you are having left sided chest pain. So get done ecg and 2d echo. If both these are normal then no need to worry for heart diseases. Better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic drugs too. Don't worry, you will be alright with all these. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chills with pain in kidney?\n\nHi,  I have had constant chills going on 3 weeks ever since a ct scan to check for kidney stones. 2 very small stones that wouldn't cause the issues I was having. so I am scheduled for a cystoscopy.  But my question is why the constant chills with a pins and needles sensation at times? No fever",
    "doctor_response": "Hello and welcome to HCM.As an Urologist, i would be able to give you better advice, if you had written your age, and other medication being taken.You must have urine culture done .Why a cystoscopy.   What's the indication.If you send your CT scan, and other reports here, in my name, i'll give you proper advice.  Drink 10-12 glasses liquids daily.Wish you well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Extreme soreness in gums with bleeding on brushing or eating, increasing bump behind teeth. Treatment?\n\nHello, I have had extremely sore, tender gums for about 3 months now and they breed a lot. Not only when I floss and brush but also when I m just siting in the car not eating or drinking anything. I also wake up with blood on my shirt that I have drooled in the night. Now, about a week ago, a squishy prink bumb appeared directly behind my top front two teeth . It is very sore tender and painful. It hasn t gotten better in a week, and it seems to be increasing in size. Can you please help me to find a doctor",
    "doctor_response": "Dear friend. Thanks for sharing your concern. your history suggests that you have developed periodontitis,which requires immediate attention and treatment. for this i would suggest you to visit your periodontist so that thorough cleaning along with curettage and proper root planing procedures can be done. this should subside your symptoms. also make a routine blood examination done to rule out any increased blood sugar level as it serves as  nidus for infection. hope it helps. take care. thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does my blood pressure shoot up when having fear about going to office?\n\ni am a working men, working in a mnc from last 20 years. from last few days donot know why i have a fear of going to office, my blood pressure shoots up to 160/ 100 with a thought of going to office. normally my blood pressure is at 130/80. i am unable to understand the problem. my family doctor suggested to take 2  Librium tablets a day... but i think its not working ,,,as still after taking it for 2 -3 day the problem persist. plz suggest",
    "doctor_response": "Hello , any form of anxiety  ( in your case going to the office ) will push in hormones like cortisol and more importantly adrenaline and many other in the blood stream . These hormone will result in constriction of the blood vessels and making your heart pump more vigorously pushing your blood pressure UP. By all means you will have to sort out the reasons why you have suddenly started hating your work . Remember stress will only harm your health and nothing else. Medication like librium act as anti anxiety pills and will help you tide over temporary crisis by calming your nerves . However as I said you yourself have the answer to all your problem.  Avoid stress , avoid blood pressure.  Regards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for new born baby having mild tremor in hands\n\nhey my son was born 8 weeks early & I have just been told that he has got a mild tremor in his hands but have been given no information on this nor had it explained to me either is this something that I should be worried about or will it correct itself in time???",
    "doctor_response": "hi.. you have a pre-term baby.. the tremor is due to hypothermia, in which baby tries to generate heat by shivering. if baby is getting still after providing warmth care, plz let me know.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Gum Disease\n\nIs watching/cleaning by dentist is the only solution for Gum disease?",
    "doctor_response": "Hi, the treatment of gum disease depends on the disease, its severity and the age of the patient. Please consult a dentist, a periodontist should be preffered. He will decide the course of treatment depending on your periodontal condition.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Slightly itchy, pale red, blotchy rash on cleavage, reoccurring and spreading. Home remedy?\n\nHello,I have a minor slightly itchy, pale red, blotchy rash in my cleavage.  I have had it for a while, but would come and go, and now I have it but it is spreading up a little higher than before.  I am also starting to notice some dry skin coming off which didn't happen before.  It's not too itchy, just annoying.  My gynecologist saw it on Thursday and said it is probably just a yeast infection, and said I should see a dermatologist.  I am wondering if there is anything I can do at home so that I dont have to hunt down a dermatologist in NYC.  Thoughts?",
    "doctor_response": "Hi, Welcome and thanks for posting your query to HCM. It appears from your problem that you are having fungal infection of the area. For the remedy part 1.\u00a0\u00a0\u00a0\u00a0\u00a0Do  sitz bath of the area ( luke warm saline water in bath tub and sitting for 5-10 minutes) two time a day 2.\u00a0\u00a0\u00a0\u00a0\u00a0Change your undergarments two times day 3.\u00a0\u00a0\u00a0\u00a0\u00a0Keep yourself away from hot and humid environment 4.\u00a0\u00a0\u00a0\u00a0\u00a0Apply antifungal dusting powder 2-3 time /day 5.\u00a0\u00a0\u00a0\u00a0\u00a0Do not scratch or rub the area and maintain local hygiene If your problem is not soled by above measures then can take topical antifungal such as sertaconzole or oral antifungal tablet with guidance of your doctor. Hope the information will help. Dr Sanjay K Kanodia MD ( Dermatology and STD/ Venereology)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My 6-year-old son complains of shin pain in left foot. Why does he get such pain?\n\nHello doctor, I have a 6-year-old son who complains of shin pain in the left foot once in every month before going to sleep. He is generally hyperactive. The next day when he wakes up he tells me that it does not hurt anymore. We did x-rays and blood tests all are fine. Please help.",
    "doctor_response": "Hello, Welcome to iclinq.com. Lower limb pains in growing children are usually benign. Normal blood tests and normal x-ray reports also point towards the benign nature of pain. Most probably your child is having growing pains. Can you please recall anything that is common before the pain starts like excessive physical activity or specific footwear? Please share the x-ray image and blood test reports. Start calcium supplements and regularly massage the legs before bedtime.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fatty liver\n\nhi, sir i am having udiliv300 & bycozyme cforte due to problem in liver. my pt is 108 (required 67) , albumin is on border line. ot is normal. fatty liver. i am also having digiplex t. i drink scotch once in 15 days. now question is that what i do to become my liver normal. is there any medicine which can reduce fat from liver & my all reports can be normal?",
    "doctor_response": "Hello,      I read your question very carefully and appreciate your concern for your health.      I would like to tell you that there is no medicine which can reduce fat from liver, so don't even think about it.       Only way to reduce fat from liver is to reduce your body weight and for that you will have to do regular brisk walking, have healthy diet, avoid oily and fatty food, avoid alcohol and smoking, do regular meditation to remain stressfree, etc.      I would also advise you to check your fasting lipid profile and repeat it every 3 to 4 months. Also repeat SGPT after 3 months to check the effectiveness of these modifications and medications. So have patient and buy some time to get back your reports to normal.      Hope this answers your question and let me know any of your further relevant queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe back pain after child birth. Surgery advised to repair spinal problem. What is the recovery period?\n\nMy daughter is almost 19 years old. She had a baby 9 months ago. She has been suffering from severe back pain . Exrays show she has a 13th rib. Also told that her L5 is messed up and she has no spacer between A1 and S2. She has been told she will need back surgery. Apparently to repair the spine and remove the extra rib which is attached badly. Any idea what the recovery time should be following such a surgery? She is alone with a 9 month old baby.",
    "doctor_response": "Hi,  I empathize with your daughters problems and hope the surgery helps her get back to normal life. As far as recovery from spine surgeries is concerned, the period varies individually. 3 months is usually the average period. This would include the time when she will be on absolute bed rest and rehabilitation. It is always better to discuss this and other issues about surgery, complications, benefits of the surgery before hand with the operating surgeon. Hope this answers your query. Wish her good luck!!!! Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Though I did not penetrate, is there a risk for HIV?\n\nHi doctor,I recently had a contact with a sex worker. I am sure that there was no penetration at all, but I am worried since I was not wearing a condom. Is there any risk for HIV? Do her secretions contain virus?\u00a0I am very scared. Please help.",
    "doctor_response": "Hi. Revert back with the answer to the above question to a sexologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can difficulty in getting up after a knee injury be treated?\n\nI fell Wednesday of last week, I went to urgent care they took X-rays nothing broken. But it is hard to get up can the fibula be bruised he said knee was bruised. I can not put weight on it. Can I do anything, or if bone is fractured would it allow me to put any weight on it. It is easier getting up with higher chairs.",
    "doctor_response": "Hello, It will be a minor contusion. Nothing much to worry and the symptoms will settle in a couple of days. As a first line management, you can take analgesics like Tramadol or Aceclofenac for pain relief. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having recurring belly pain along with leaking belly button which smells awful. What could it be?\n\nFor about 3 years now I've been dealing with a pain in my belly button. Its not always constant. It will happen for a few weeks and the go away for awhile and come back again. While this pain is here my bully button leaks what looks like blood, pus, and some other form of a liquid that smells very awful. I was wondering if you could possibly give me a ballpark of ideas at what this could be.",
    "doctor_response": "Hi and thank you so much for this query.I am so sorry to hear about this recurrent belly pain and discharge. From the information you have provided, you probably have an infection that is never really treated completely(Abscess). Recurring infections often have favoring factors and one of the is a foreign body. So long as this predisposing factor is not addressed entirely, the infection would keep recurring. I will suggest that you consult with your doctor and get this condition addressed entirely to identify the favoring factors and address them. Only after doing this would you be able to confidently expect that the problem is over. It may need imaging tests to locate the infection pocket and map out the possible predisposing factors. A culture of the secretion should be strongly considered as well.This infection is certainly just below the skin and does not involve any structures in the abdomen.I hope you find this helpful. Thank you for using our services and please feel free to ask for more information if need be. I wish you the best of health.Dr. Ivo, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there chances of pregnancy after having unprotected sex post periods ?\n\n:) Good Day Doc, My period was March 19, 2011 and ends March 23,2011 then i had unprotected sex on april 20,27,28.. it is possible to get me pregnant? is there s a chance that Im pregnant and how many percent?",
    "doctor_response": "Hi Good Day, Welcome to HCM. If your periods are regular, you should already have had your next period by 28th of April. Since that did not happen, your ovulation could have been delayed, in which case you could be possibly pregnant. There is no way of being sure that you are not pregnant until you have your next period. Meanwhile you could get your serum / urine pregnancy test done to confirm pregnancy, though Negative result does not exclude pregnancy, it only means that pregnancy is not of minimum duration which is required for the test to become positive. Telling in percentage will be pure speculation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Decreasing platelet levels. Giant platelets noted. Non-reactive HIV and HCV reports. What is the disease?\n\nHi doctor, my platelets are decreasing and are now only 40,000 against the minimum level of 150,000. Some giant platelets have been detected via the peripheral smear blood test.Doctor had also advised tests for HIV, HCV, Anti Nuclear Antibody and Anti DNA Antibody DS Tests, which have already been conducted. Reports for HIV and HCV are non reactive. However, Antibodies test results have not come yet.Please suggest or atleast help me out with your opinion, as to what disease the doctor is actually suspecting and do we need to really worry or not. Thanks a ton for your help...!!",
    "doctor_response": "Hello friend,Thank you for choosing Health care magic. I am a Homoeopath and so will be answering your question in the view point of Homoeopathy. The lab investigations of your blood give value of platelets as below normal. Any biochemical change occurring  in your body is not the disease. It is the result of disease or the self defence mechanisms body takes up to keep you healthy. By administering chemical drugs we should not try to bring about changes in the blood picture also.Here you have not mentioned what made you to do a routine blood study. What symptoms were there that prompted you to do so? Or since how long you are suffering from that particular symptom? Then you will give a particular event in your life that made you sick. It can be one psychological conflict that made you sick in the organ level. It can also be like this that you had a comparatively innocent symptom in a less serious organ and that was treated by suppressive chemical drugs and thus affected the contents of the blood. It can either be an affection in the ectodermal layer which constitutes skin or an affection in the endodermal layer which constitute mucus membranes of Upper Respiratory tract , Gastro intestinal tract or Urogenital tract. The changes in the blood content is an affection more severe than the other two layers because the blood is a connective tissue developing from mesoderm. This usually happens in the treatment of simple fevers by suppressive chemical drugs. Conventional medicine has no understanding about this hierarchy of different organs or systems and so not agreeing with suppression. As a Homoeopath, I have to suspect such things also as causative factors.A detailed case taking will reveal the course of the disease and will give light to the exciting cause. The fundamental causes are MIASMS, which is the genetic understanding of disease production according to Homoeopathy.Therefore my advise is to consult an expert Homoeopath at the earliest. There is no mistake in doing all possible investigations to make the disease diagnosis. But do not take any medication only to bring back your altered blood picture. There should be radical correction of your constitution which Homoeopathy can do for you. Homoeopathy is the best holistic medicine which takes into consideration your body and mind at the same time.My best wishes for a speedy recovery through Homoeopathy.Dr. C. J. VargheseHomoeopathdrcjvarghese@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "side affects of lesuride od 75..\n\nwhat for lesuride od 75 is prescribed for what are its side effects",
    "doctor_response": "Hi, Lesuride contains Levosulpiride and this is a prokinetic, which means that it increases the speed of emptying the stomach. It reduces gas formation and due to faster emptying the acidity problems. It is comparitively safe drug. Rarely it can lead to allergy, headacke , etc. levosulpiride is an effective and safe drug in the treatment of dysmotility-like functional dyspepsia and non-erosive reflux disease. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain and vomiting in infants?\n\nHello, my 31 month old woke up at about 1am with stomach pain, then vomited up some Mac and cheese he had for dinner but was mostly liquid. Then again at 4:30am, and vomited all liquids and then some yellow mucus and white foam! He has a chesty cough, what do u think?",
    "doctor_response": "It is gastritis/gastroenteritis due to infection. Refer to gp or FM or pediatrician and it will be cured by antibiotic/just conservatively.cough can be due to inflammation or aspiration.But it can turn aggressive if not properly treated if it also has diarrhea.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying for second baby. Pregnancy test shows faint lines. Pregnancy chances?\n\nHi we have been trying for our 2nd baby and i am due on in 3 days but took 2 pregnancy tests today and they are very faint. for the past 3-4 days ive been taking tests and it should nothing. do u think i could be pregnant? and as my period is due in 3 days is there a chance its a incorrect result or i could go on period anyway?",
    "doctor_response": "Hello, The pregnancy tests done before showed nothing and now started showing a faint line indicates that you might be pregnant. You are still 3 days for periods, so the faint line more likely indicates the low levels of pregnancy hormones. So, just wait till you miss periods and repeat the test again for confirmation. Start taking folic acid tablets. Hope this information is helpful. Dr. Mrs. Sumeet Baheti",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can an extended bone cause swelling on forehead?\n\nI have a small pea sized bump on my forehead. I noticed this about 10 years ago. At that time I had it checked by my doctor and a specialist who both said it was nothing and not to worry about it. Over the years I ve noticed it get bigger..not so much in size ..just more out of my head. I had x-rays done on it and they told me it was a bone. Again not treating it as anything life threatening. I done understand how a bone could grow out like a bump. Could this be something other than my bone? It causes me no pain.I m just worried it s something else and the doctors are wrong.",
    "doctor_response": "kindly show me X rays & photograph of the bump on your forehead before I can give any opinion.It could be anything ranging from a subacious cyst to a osteoma.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My 2-year-old child has a yellow mark in his back. Please advice on his CBC reports.\n\nHello doctor, I found a yellow mark on my 2-year-old child. I did his complete blood count and have attached the reports. Kindly advice.",
    "doctor_response": "Hello, Welcome to the icliniq.com. In the mentioned CBC report, there is nothing to worry as per my opinion (attachment removed to protect patient identity). The total count, red blood cells count, platelet count all is within the limit. The lymphocytes can be high in this age group, so you need not worry about that. So nothing is abnormal in the mentioned report. I hope I have answered your question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On dialysis, disfunctioning of liver, diagnosed with pneumonia, confusion, hep C. History of drug use and alcohol drinking. Chances of recovery?\n\ni have a cousin who is in hospital & we arent getting much answers from hospital staff. If a person has hep C, a drinker of alcohol & drug use what is the hope of him recovering. His liver has shut down for about a week & he is on dialysis. at first it was round the clock but now its every 2 days for 4 hours. He was diagnosis with having pneumonia & was on breathing machine but now is breating on his own. He is very confuse, tries to talk. Is there a web site that will give me any straight answers",
    "doctor_response": "Hi, of course the condition is critical, as he is improving let us hope he will improve completely, but it will take time . So many systems are to be recovered, nervous system, kidney, liver etc, liver will be left with residual pathologies. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had uncontrollable shaking from pelvic area with abdominal and pelvic pains. Had happened before. Reason?\n\nHi, I recently had an attack that lasted about 2 hours.  It was uncontrollable shaking stemming from pelvic area.  Down the legs, cold chills with extreme abdominal & pelvic pains.  And also my penis felt painful as well. No joking here.  This type of attack happened one other time, but I was pretty sure that was triggered by a prescription nasal spray with some steroid",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for choosing H.C.M.Forum. You had uncontrolled shaking from pelvic area, down the legs, cold chills with extreme abdominal and pelvic pains. It appears to be a urinary tract infection, with or without stone in the urinary tract. It may be malaria also where these pains may be secondary to the chills. I advise you to consult a physician for diagnosis and treatment. wishing for a quick and complete recovery. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for jaundice having low bilirubin  and SGPT values?\n\nmy wife is a patient of Hereditary spherocytosis, now a days she is suffering from jaundice treatment as her Bilirubin and Sgpt level history is belowFirst Test Diagnosed as jaundice SGPT       =      103Bilirubin   =        2.3Treatment Jetepar  500 Ml repeated 5 days continueslyand some other Test Repeated after 12 daysSGPT       =      115Bilirubin   =        2.6only syrup and food TreatmentTest Repeated after 10 daysSGPT       =      287Bilirubin   =        3.2now again after 14 days test performSGPT       =      296Bilirubin   =        3.7please advise what to do",
    "doctor_response": "Hi thanks for contacting HCM.Noted she has persistent high liver enzymes and bilirubin ...Hereditary spherocytosis present...So if spherocytosis not controlled partial or full splenectomy may might need for treatment of it....If needed rcc transfusion and folic acid supplementation useful....Meanwhile cutt of oil in diet to rest liver.Fruits taken more..Avoid alcohol...Green leafy veg and adequate protein taken..Regular follow up needed...Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of pain in the abdomen during a bowel movement?\n\nI have been getting very sharp pains in my abdominal area (left side - mid area between waist and hip - in front). The pain usually takes place when I get up from the commode after having sat there for a while (5 or 10 minutes) trying to have a bowel movement.",
    "doctor_response": "This happens in case of Colitis or IBS- Irritable Bowel Syndrome. You may have to take a course of an antibiotic, metronidazole, probiotics and supportive symptomatic treatment for 5 days. If there is no result I would advise you to undergo Colonoscopy and CT scan of the abdomen to see that you do not Have gastrointestinal Cancer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I remove cut mark from my face ?\n\ncan i remove cut marka from face i do not have lot of money pl give me any cream name touse on my face",
    "doctor_response": "Hi, Welcome to Healthcaremagic! You have not described the cut marks fully. Are they hypertrophic, do they itch & how old? Still you may use Hexilak gel 2-3 times a day. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest palpitations, discomfort with heavy breathing and lightheadedness?\n\nJust took online quiz...I am lightheaded...Have slight discomfort in upper body...Feel pounding in chest...Breathing is a bit heavier than normal..(I have apnea and use a machine to sleep)...Little to no appetite...Woke up this way and am feeling better...but not great....Heart?...Just a not so good day?",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. Yes, your symptoms can be due to cardiac problem. Since you are having sleep apnea and using BiPAP machine, you are at increased risk of cardiac diseases. So better to consult cardiologist and get done 1. Ecg 2. 2d echo 3.  Stress test 4. Coronary Angiography if required. Possibility of early cardiac failure is high in your case. So first diagnose yourself and then start appropriate treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Meaning of MRI results of periventricular small vessel ischemic changes?\n\nI am 52 y/o female. Recently I have been waking up with headaches every morning at the same time with migraines. My blood pressure has gone up lately with no apparent reason. I use to take one pill a day now uts three. Went for a mdi and my results are (white matter)periventricular small vessel ischemic changes? What does this mean? Also at night my hands only become so numb they hurt terribly",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your complaints as well as the MRI brain report.First of all, I would like to reassure you that there is no need to worry about the MRI brain findings.These findings mean that there is slightly reduced blood supply to the brain.The underlying reason for that could be high blood pressure.Treatment would consist of controlling your BP and taking aspirin tablets (blood thinner).I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and chest tightness post BP medication withdrawal?\n\nHi, I have had elevated to high BP for year. I stopped taking my meds few months ago as I am working out with trainer 2-3 week. Recently feeling light headed, dizzy, almost fainted and chest tightening. (same symptoms as I felt when I found out it was elevated) I went to DR just to get blood test & my bottom # was 90 top think 136 or 146. So I knew I had to get back on the meds. Waiting to get blood test results. My ? is how do I know I am not experiencing something worse?",
    "doctor_response": "Hello,Abruptly stopping anti-hypertensive medications will lead to an increase in blood pressure and symptoms of headache,\u00a0nausea, sweating its suggested to restart the medications with lifestyle modifications.\u00a0\u00a0Hope I have answered your query. Let me know if I can assist you further.Regards,\u00a0Dr. Ponnambalam V",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for nausea\n\n53YOF, post-menaposal, Med Hx: Psoriatric Arthritis, High B/P & Non-Insulin dependent Diabetes. I have been taking Victoza for approx 4 months. Before that I had been taking Metformin for approx 1-1/2 years without any real change in BG levels. My last A1C a month ago was 6.2 - down from 7.1 before starting Victoza. I have also been able to lose 20 lbs which is helping me feel better. The last 2 weeks, I have been experiencing nausea in the mornings when I wake up. Sometimes it clears up but other days it lasts until the afternoon - it is just kind of there in the background at varying degrees of severity. I am wondering whether this would have anything to do with the Victoza. I did experience nausea at first until the dose was adjusted but not like this. I am also on diovan daily which has my b/p controlled, and ultram daily & humira bi-monthly for arthritis which is doing well. I have been on these meds for several years. I will be seing my arthritis doctor in 2 weeks but since this was available online, I thought I would ask. Any thoughts?",
    "doctor_response": "Dear Friend, greetings from HCM... I understand your problem s .. Victoza can cause nausea and vomiting in some patient s .. Your HbA1c is now OK .. But I do not know why did you stop metformin .. You please meet your doctor and tell your problem s and take other class like gliptins with metformin .. Which is an excellent drug.. Plus your lifestyle change s both dietary modification s and exercise is must which helps to keep your sugar and BP in check .. Take more of green leafy vegetables, and fruits .. .. Thank you and do contact us for more questions ..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have hypocalcemia, levels low right now, back tightening. Can that be why I am having this intense chest discomfort?\n\nI feel like I have a charlie-horse in my chest and down my arms. I have hypocalcemia and I know that my levels are slightly low right now. Can that be why I am having this intense chest discomfort? It will not go away..I've had it really bad for about 3 days now. There is a tightening feeling in my back too. Please help! I am a 30 year old female with two small boys to take care of!",
    "doctor_response": "yes my friend, hypocalcemia can cause muscle aches and chest discomfort. If your calcium is extremely low and you are symptomatic, you should consult her doctor as soon as possible and get your calcium as well as her magnesium and potassium checked. It is unlikely with chest discomfort that you will have heart disease at your age, however there are some rare causes of chest and back pain that can happen in younger women including pericarditis, pancreatitis, and aneurysms, which can cause chest pain radiating to the back. Probably consult the doctor as soon as possible to rule out more serious causes and do not assume it is just because of the hypocalcemia.have a great day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for back pain after fall from stairs?\n\nHi I had a fall down some concrete stairs last night. Sense the accident iv had lower back pain on the right hand side and all so have stomach pain on the right side. Iv have a bad bad on my left hand side just under my rib cage. I can't go for a wee.",
    "doctor_response": "Hello,I have gone through the case and found that it might be simple muscular spasm or any fracture. So I will advise if there is inflammation increases then immediatego for X-ray of thoracic and lumbar vertebrae.Meanwhile take Necoxia 120 mg for two times a day and apply muscle relaxant gel and hot water bag for relief.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the signs that show the presence of throat cancer?\n\nHey i'm 21 years old and im afraid that i might have throat cancer. I've smoked as much as 5 cigs a day, but I mostly smoke just one a day for the most part. But now I've been feeling like i got something stuck in the bottom of my thoart, close to the collar bone. or maybe right at the base of my throat, where my mouth ends and my throat starts. it's been like that for more than a month. should I be freaking out?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You have habit of smoking but you don't have any symptoms of throat cancer.Symptoms of throat cancers are difficulty in swallowing, pain while swallowing, mass or lump etc. You should go for endoscopic examination once to rule out fear of cancer. Stop cigarette smoking. Consult your doctor and plan accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am pregnant and suffering from dry cough. How to get treated?\n\nHello doctor, I am 12 weeks pregnant. From the last three days, I am suffering from a dry cough. My doctor prescribed me Ambrolite D syrup 10 mL at bedtime and Vozet tablet once in a day. He said that it is an allergic cough. But, after consuming the medicine for two days, my cough does not improve. I am still coughing. I was advised to take the treatment for five days. Can I wait for more?",
    "doctor_response": "Hello. Thanks for writing your query to me. A dry cough for more than three days in the absence of breathing difficulties usually suggests viral pharyngitis. You do not need to take antibiotics unless you have a fever. At the same time, you said you are 12 weeks pregnant, so you should try to avoid taking over-the-counter medicines for a cough. It may affect the growing child in your womb. So, I advise you to do gargles with any good mouthwash three times a day and finish three days of Vozet (Levocetirizine) tablets. If you continue coughing for more than a week, then you should take an expert opinion. For me, it looks just like a sore throat. Thank you. For further information consult an allergy specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from shooting nerve pain, please advise\n\nMy mother is suffering a shooting nerve pain which starts from her face and runs down till her neck. Though we have visited some neurologists in Mumbai, we havent been able to get a medicine that has worked on her .She is 60 years of age and she is NOT a diabetic. She is not suffering from any other ailments",
    "doctor_response": "it sounds like a condition called trigeminal neuralgia .it is a very very painful condition .there are some tablets which will give relief.if that doesnt come down then you have options like alcohol injections-  or go in for a surgery .essentially the aim of the many surgery procedures is to either damage or destroy the part of the trigeminal nerve that's the source of your pain.: so it can cause  numbness of the area of nerve supply to a varying degree- as this nerve is the responsible for most of facial sensation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could fever, sore throat and body aches be due to mold exposure?\n\nHello, I work at a site which has large amounts of black mold spores in the AC units and even on some walls. I have contacted our work health and safety to no avail. Myself and others noted increased respiratory irritation while at work but now I am very sick with fever, sore throat, body aches... Could this be a result of mold exposure? Should I return to work with continued mold exposure?",
    "doctor_response": "Hello,This is Dr. Papaqako answering your query.Mold allergy symptoms can include Sneezing; Runny or stuffy nose; Cough and postnasal drip; Itchy eyes, nose and throat; Watery eyesMold allergy symptoms vary from person to person and range from mild to severe.Fever and sore throat are not symptoms of a mold exposure, but most commonly happen in viral upper respiratory tract infection, which is the most possible diagnoses in your case.If I was your caring doctor, I would recommend to continue with symptomatic treatment for fever or aches, drink plenty of fluids,  and stay home if you have fever. Otherwise, its ok to return to work, but mold exposure may be a problem in the long term, so you should take care of it anyway.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can the optic disc asymmetry and swelling around eye be due to glaucoma?\n\nHello doctor, There is optic disc asymmetry 0.5 and 0.7. Normal vision is 6 by 5. I am 30 years old male. Normal BP. I have a complaint of severe headache migraine like when a headache starts, there is swelling around the eye. What can this asymmetry be due to? Can this be glaucoma?",
    "doctor_response": "Hello. I have gone through what you have mentioned. There are several causes which cause an asymmetry of optic cup to disc ratio, but glaucoma is the main disease that we try to rule out as it sometimes manifests without any pain and hence can go undetected. Migraine headaches are due to blood flow abnormalities in the region of the face and inside the cranium (skull bone). Hence, there is a chance that this eyelid swelling could be due to a migraine. My advice to you is: 1. Since you have been detected to have optic disc asymmetry, kindly follow up with your ophthalmologist every six months or as instructed by him or her. You may also be offered additional testing to confirm if your disc asymmetry needs to be treated or if it should just be monitored. 2. Continue with your anti-migraine medication and watch for any changes in your eyelid puffiness. In case there are changes such as longer duration or if you have an itchy sensation or feel like rubbing your eyelid, then please bring it to the notice of your ophthalmologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden change in behaviour of child?\n\nMy son is normally very active and specially when i pick him from kindy but today he was very down and did not want to eat anything. It is not his usual self... he slept without eating even. He just could not stand also... he was happy and chirpy when i dropped him in the evening. What could be cause for this?",
    "doctor_response": "Hello,Thankyou for your quiry.Brief...It could be because of hypoglycemia and poor diet.detailed answer....As sometime it happens when child does not get quantity of  food matching with calories spent and sugar becomes less to get energy.Keep make him eat something every 3 hours according to his choice and make him relax after sternous exercise.Hopefully my answer is helpfull.Regards,dr.Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain and swelling in mouth after wisdom tooth extraction?\n\nI just got my wisdom teeth (all four)  removed on Tuesday. Swelling was minimal until Sunday when it was the absolute worst. Now it's Tuesday and there's still some pain, swelling and there's a hard bump on my jaw on the side that hurts and is still swollen.",
    "doctor_response": "Hi..Welcome to HCM..As per your complain pain and swelling can last for about a week and at times even more after wisdom tooth extraction and it is not abnormal if it continues to go down gradually..But in case if the swelling and pain is exaggerating then you need to get evaluated for infection in the extraction socket or dry socket..The hard lump that is present is due to Hematoma formation that occurs due to rupture of blood vessels during extraction and leads to formation of a harmless tumor of blood due to accumulation of blood into the soft tissues..You should do alternate warm and cool compresses over the hard lump and it will help in regression..Do warm saline gargles..Avoid hard foods..Hope this helps..Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for 80% blockage below the stent in distal region of LAD\n\nI had a stent inserted in the mid lad 2 years ago. A few months ago I started having the same symptoms that I had before the heart Cath that showed a 90 percent blockage. After another heart Cath 2 months ago, I have 80 percent blockage below the stent in the distal region of the lad. I m going to cardio on Friday to learn the game plan. What are your ideas?",
    "doctor_response": "as i understand , the reason of having a redo cath was you were symptomatic , so the lesion warrants some treatment .depending how large is the LAD and the territory supplied by it , most importantly you should optimise your anti anginal medication , beta blockers , nitrate s sos nicorandil , ranolazine or trimetazidine depending on the country you reside . it the territory supplies is significant an redo angioplasty and if yo are diabetic and other features of coronary angiogram shows high rate of restenosis , a LIMA bypass to Lad should be the option.Regards Dr. Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have SLE. Had seizures, weight gain. Reason?\n\nI am 57 years old - 5 ft 9 in and have had 3 normal childbirths.  I never gained more than 25 lbs when full term.  My weight after pregnancy returned with little effort.  For at least the last 35 - 40 years my weight was never a vanity issue.  I was a size 6 easy.  However In the last 9 years I have been diagnosed with an autoimmune disease (SLE).  It has dramatically affected my activities with fatigue but my body seemed to adjust.  A year and a half ago I had a series if severe seizures and was basically very still or did no exercise as it worstened my symptoms.  About 8 months ago I just started gaining weight at a pace that I could order jeans and they would be too tight by the time I received them.  What, besides the above info can you tell me as to why I am gaining weight.  I do feel like all parts of my body are inflamed at times and it seems to be getting worse. Janet",
    "doctor_response": "Hi,Thank you for posting your query.The most important causes of weight gain is reduced physical activity and eating more than required.Reduced physical activity can be on account of your illness (SLE and seizures).When your lifestyle requires less physical activity, then, the food intake should also be proportionately reduced. If not, then, the weight tends to increase.In addition, the medications used for SLE such as steroids also lead to weight gain. In any case, diet control coupled with regular exercises, would lead to your weight becoming normal again. I hope it helps.Please get back if you require any further information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for epididymitis in a child\n\nmy 9 year old son has been on cipro for epididymitis and has only 3 days left. he just saw doctor yeaterday and they did a urine sample cause he is still having pain and burning when urinating. the swelling of his testicle has gone down though. the doctor said that all this will just take more time. there was also still a timy timy bit of blood in urine the doctor said but less than the first test when this first happened. so i guess i am asking you if the doctor is corrct in saying that he just need more time to recover?",
    "doctor_response": "Dear Friend,      the epididymiitis is a internal infection which takes time to go.so it is good to know that your son is taking Cipro after seeing a doctor.so the decrease in swelling is because of good effect of this antibiotic.blood in the urine,i hope will be absent within a few days and your son will be free of epididymitis very soon.so I would like to say your doctor is quite true that he just need some time to recover.thank you and wish your son a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in tooth in lower jaw?\n\nI have a pain in a tooth in lower jaw. That tooth is holding a bridge. I have headache on that side and my eye on that side feels weird. However I have muscle spasms on my neck and shoulders due to stress. Could the pain be due to the spasms or could it be an abscessed tooth?",
    "doctor_response": "Spasms could be causing pain if resulting in tooth clenching or grinding, or it could be caused by abscessed tooth.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for length difference in legs due to polio\n\nDear Team, Am Shilpa from Bangalore. I need your kind guidance. My husband age 30. He had polio attack when he was in the age of 3rd. He can able to walk, drive without pain and support. He is perfect, but while walking he will lift his left leg heel for 3-4 inches, means his leg his little short compare to his another leg Some of the doctors suggested if we get polio surgery done, it will be cure, So that they can make proper length for both legs. But still we are getting scare for surgery. Kindly need your valuable suggestion If we get it done can his heel 3-4 inches will be reduce to 1-2 inches please suggest if you other remedy. I agree we cant get it complete cure but reducing numbers is also fine.. please help us.... Regards Shilpa 0000",
    "doctor_response": "try for a while adding a heel under the shoe of the shorter leg. if he is ok so, you can avoid surgery",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower back pain and buttock pain\n\nI fell a few days ago and it was light, nothing serious or hurting. But recently, I started to have pain on my right butt, right side, lower right back and leg. It kind of feels like straining and aching. I am okay but it usually starts hurting after I lay down for awhile and then get up. It hurts and I often feel breathless or teary, trying to get up. I am only 15 and had ACL surgery on my left knee about eight months ago. I am 5 3 and about 270 pounds. I hope this is enough info for you to answer.",
    "doctor_response": "Seems blunt trauma that may go easily and pain will go easily. If not take 1 sos brufen adult.You may use turmeric powder in warm milk or water 1/2 tsp once or twice daily. It's natural antiinflammatory.If doesn't stop, may be nerve is compressed. You have to take lumbar support. Don't bend. Don't lift heavy wt. As the trauma subsides ( except that inter vertebral disc spaces should not have reduced), pain will go. Otherwise physiotherapy and Yoga postures will correct you. But not during pain.Hope it helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will triphasils as contraceptive create any problems in future?\n\nHi I m a woman who is 33 years of age turning 34 in July. I was using triphasils as contraceptive and stopped using them last year in August cause I m trying to get pregnant but nothing is happening so far until now. Do I have to worry or is this gonna take time before I conceive.",
    "doctor_response": "Hello dearI understand your concernTripahsils is third generation contraceptive and it dose on affect problem in furture pregnancy.After stopping pill, once you got your period regularly for 2-3 cycle then pregnancy is possible.If you unable to get conceived  then consult gynecologist and undergo reproductive hormone analysis, USG scan ovarian follicle study, HSG to rue out any cause.Make sure that semen analysis of male partner is also with in normal rangeIf you have regular period, patent fallopian tube, normal luteal phase, normal maturation and rupture of follicle.Avoid stress, take healthy diet, drink plenty of water, do daily intercourse in fertile phase of periodHope this may help youContact further if follow up neededBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having pimples despite doing chemical peel, dermabration and applying adalane nano gel, clinsol gel. Oily skin. Any permanent cure?\n\nhelow doctrs. First of al very gud mrng to al of u.  My age is 24+. I took laser treatment like chemical peel , drmabration nd lot of creames like deriva bpo gel, adalane nano gel, clinsol gel,depiwhite mask, epifazer,triglow, clin3 gel, clindap, zyclin, fusin-b, keracnyl, retino, tablets are minoz50, acnestar20. Bt i have pimples nd a lot of scars on my face. My skin is oily. Wt i have to do? I m totaly disapointed by these qualified docters.",
    "doctor_response": "helow kiran. Iam Dr. sanjay k. Nandi answer your question.First of you should avoid above said cream and   gel.Wash your face with kito soap after that you applly persol 2.5% cream apply on your face.Avoid  direct sun light,heat,spicy food and alcohol .Get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes segmental limb pressures?\n\nWhat would cause segmental limb pressures in a healthy 17 year old with BP of 133/88 to significantly decrease post exercise..overall score post exercise of 0.67.  Reason for test was bilateral cyanosis intermittently from mid thigh to mid shin bilaterally",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Generally difference in limb pressure (segmental) is due to decrease blood supply to that particular segment. Most likely you are suffering from blockage of blood vessels if it's significant difference. Please report to a vascular surgeon as soon as possible. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can having unprotected sex while being on Rigevidon for a week for the first time cause pregnancy?\n\nHi! I am first time taking Rigevidon (21 tab.). Started on day one of my period and keep taking the pill daily at a fix hour. I had unprotected sex on day 7 since being on the pill.... is any chance of getting pregnant? I am very scared..Some people say you are protected straight away, some say after the first blister, or a month later... I ve read the leaflet, but couldn t find the answer. I am 26, 1.75 cm, 62 kg, generally healthy, had operation on the right knee but long ago, wearing glasses just for tv and PC.",
    "doctor_response": "HelloThanks for writing to us with your health concern.During the first month of oral contraceptive pill use, for practical purposes, consider yourself as unprotected against pregnancy.Particularly in the first week of pill usage, the hormones have just not yet started kicking in and exerting the effect.Hence, some kind of backup contraception is always recommended during the first initial month or two of pill usage.Right now, you can take an emergency contraceptive pill ( ECP ) to increase the protection against pregnancy.The side effects would no doubt be enhanced due to the double hormonal dosage.Also your period might get irregular, this is because with ECP the normal cycle can be preponed or postponed to a great extent.USe an ECP right now if it has been less than 120 hours since unprotected sex.Continue using condoms for the rest of the month, until the next pill pack is started.All the best.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can explain pain in pelvis?\n\nOver the past 3 days, my pelvis has been painful to touch, mostly on my right side as if there is a bruise just under the skin, although I haven't done anything that may have caused this. I have no other symptoms or pain, just a lot of tenderness in that area, around a golf ball sized area.",
    "doctor_response": "Hi,from history it seems that you might be having appendicitis pain giving this tenderness at lower right abdomen.Consult surgeon and get examined.Meanwhile take some antispasmodic like Meftal spas for pain.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to give Wikoryl for nasal congestion?\n\nHi doc. My son is 3 years old. Has a nasal congestion and thick nasal discharge with high temperature. I have been giving him wikoryl oral 3 times a day and crocine when fever is going above 101. Is it safe for giving wikoryl and crocine at the same time as both has paracetamol?",
    "doctor_response": "Hi,Both contain paracetamol but after giving Wikoryl temperature remains or increases you can give Crocin syrup after 2-3 hours as it has only action to reduce fever.There is no problem if crocin given after few hours.Give enough water.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does birth control cause infertility?\n\nIm trying to get pregnant but u was on the depo shot birth control and my last shot given was october 6th 2013 last year. I was scheduled to get another on January 6th 2014 this year. Its been 8 months since and I still havent conceived. Im worried. Please help.",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.Depo shot prevents pregnancy for 12-14 weeks.After that time period if not conceiving then i would suggest reports for you 1. Ovulation profile2. Thyroid profile3. Histosalpingography HSGTo rule out any pathology.Make confirm your partner s semen report is ok.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes Arachnoiditis myalgia & Myositis?\n\nI have been to see 3 doctors. My whole body is in pain. These are what the doctors say I have. arachnoiditis myalgia and myositis What can the underlying cause be? They have given me gabapentin and lidoderm. They seem to be working but when I start to do activities such as baking I hurt .",
    "doctor_response": "Arachoiditis myalgia is one of long treated diseases with painful symptms. There is no rapid treatment. The prescribed drugs for you are good but it need some time to be effective.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Lyme disease cause elevated PSA?\n\nCan Lyme disease cause elevated psa? My husband is a 65 year old man, very healthy but was diagnosed with Prostate Cancer 10 years ago and had a radical prostetectomy. Recurrance indicated via PSA 5 years later and underwent radiation. Most recent PSA indicates a rise in PSA and doctor wants to retest in a month. We are looking for other factors that might have elevated PSA.  He has been treated for Lyme in the past and might have it again. Height = 6', weight = 156",
    "doctor_response": "Hello,Lyme disease or the treatment for lyme disease  would not elevate the PSA. Unfortunately the most likely reason for an elevated PSA is recurrent prostatic cancer. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in right and left foot heal\n\ni have rigth & left foot heal too much pain last more than years.i was put it there before couple of months 3 pain injections course.when i feel pain in the morning so,everyday get one pain killer after 16/18hrs. later again pain start and i get again pain killer. i was spent too much money to reduce my heal pain.but nothing diffrence every day same happen.now please give me some solution to relief my pain.",
    "doctor_response": "Hello,It looks from your details that you may be suffering from planter fasciitis. Some time it become chronic.I shall advise you following to have relief in this:- Do daily warm fomentation for at least 2-3 times a day- Take help of a physiotherapist- There are some recent taping techniques which are helpful in relieving this problem.Ask from your orthopedic consultant for this- Some supplements like hyaluronate, collagen can be helpful, if taken for at least 1 month. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mukesh Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe twinging sensation in the legs\n\nI am experiencing twinges, similar to a static electricity shock, in my lower legs. This is at night,when I have already been sleeping for some time. I am 58, and have no outstanding health or weight issues - 5 3, 115 pounds. A family membber has recently been diagnosed with celiac disease, and at my doctor s urging, I have had that blood panel done, but have not gotten results back. Ideas?",
    "doctor_response": "hiconsult an orthopedic doctor.If there is some impending nerve pain due to back spine, should rue out, secondly a doppler ultrasound for circulation in lower limbs.Conservative treatmnt consists of high doses of vitamin E and injection neurobion  and calcium supplements and vitamin D.if you smoke then quit it.Do olemessa oil massage after hot water fomentation of legs before bedtime.Also have your lipid profile done for any atherosclerosisbest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yellowish discharge and tingling sensation at the tip of the penis?\n\nHi, I would like to ask, a couple of days ago in the morning I went to take a shower, and I noticed some yellowish small stains on my underwear, I was confused since I have never seen anything like that, after that I changed my underwear, but the following morning I again got the stains on my underwear. During that day I had been feeling a bit of tingling sensation at the tip of my penis sometimes, but not burning. So im guessing it\u2019s a discharge of some substance. I have no other symptoms or issues. But I ALWAYS use protection, so I don\u2019t know how could I get it. Please any help!",
    "doctor_response": "Hi, If it happen only during night and you can identify after sleep. It can be due to nocturnal emission (sperm ejaculated during sleep). Masturbation or sex previous night can prevent this issue. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pinching sensation on right side of the head?\n\nI have been having pinching sensation on right side of head, anywhere from jaw to back of head, almost felt liek it was on the right side of my throat in the beginning. Sometimes I wonder if m imagining it but then I ll get a shap pinching sensation on right side. seems to come and go",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, it seems to be muscular symptoms and it may be spasm or twitching but may not be due to any disease but it could be due to stress it self so try to come out of this condition,  and hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes muscle pain, dizziness and breathlessness?\n\nI can not lean forward to put on socks or tie shoes without dizziness and shortness of breath - also my muscles ache and lock up doing this - foot pain is extreme sharp jolts for days at time & then stops for days - blood sugar is normal - stress test 5 years ago was normal - can not exercise anymore - feel like will pass out just walking - getting worse and has been going on for several years - also retaining fluid - lower legs swollen daily",
    "doctor_response": "Welcome to Healthcare Magic, Muscle pain , dizziness, breathlessness and swelling in legs should be taken seriously . In such features I will suggest urine complete. After the tests,  visit a general physician or come back to Healthcare Magic, I will help you . If you find my answer helpful then please mark my answer as helpful .  With regards, Dr Varinder Joshi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have muscle weakness and mild pain on the forearm and hip. What could this be?\n\nHello doctor, I am a 41 year old male. My\u00a0creatine phosphokinase is mildly elevated. The reports came as 220 twice and as normal thrice. And, there was hemoglobin in my urine test. I constantly have muscle weakness and mild pain on my left side, at the forearm and hip. The weakness started suddenly or probably it was so slow that I did not feel any change during these four years. The symptoms started one day morning when I was 37. I feel the weakness much more in the mornings rather than at nights. What disease could this be?",
    "doctor_response": "Hello, I read your query and understand your concerns about muscle weakness and raised muscle enzymes. For more information consult a rheumatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. 2. 5 year old suffering from stomach ache. Which medicine has to be given?\n\nHi doctor, My son is 2.5 years old. For a week, he is complaining of stomach pain. After farting he is fine. Our family doctor recommended one antibiotic for five days and a medicine to avoid vomiting. He had small vomits twice, but later it was fine. Now, after completing the course of medicine he again complaints the same. His diet is almost nothing and he is not ready to take any food. He just has few mL of milk. He does not have fever. His stool was watery, but it is normal now. Can you provide any recommendation on diet and medicine? Please give me a solution to the problem. Thank you.",
    "doctor_response": "Hi. I can understand your concerns. Complain of abdomen pain with vomiting suggests that your child probably has acute gastroenteritis or food poisoning. Since, antibiotic is already given and now there are no loose stools or vomiting, there is no need to give antibiotic again. For abdomen pain, you can give syrup Cyclopam (Dicyclomine hydrochloride and Paracetamol) 5 mL on SOS basis (as and when required) that is when abdomen pain occurs. Whenever a child becomes sick, there is decrease in his appetite which improves as child recovers. Now, you should give him all the foods that you were giving him earlier. If he is not eating then you can start Glucon-D in water thrice a day for one or two days. Start a multivitamin like syrup Bevon 5 mL once a day for 15 days. Keep patience. Child will eat properly now as he has recovered from illness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair loss\n\nHello Doctor,Myself Sakshi , I am 26 years old and I am suffering from hair loss from past few days. I suffered from hair loss few months back as well following which I visited the doctor who recommended few tests (sugar, thyroid and iron), tests came normal, besides he also advised mulitvitamins &  iron tablets along with Mintop forte 2%. . I applied the lotion for around a month and it helped in controlling the hairfall.However the problem has recurred. Please help!",
    "doctor_response": "Hi, The medicines prescribed to you are fine but they need to be continued for at least 4-5 months to see significant results. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chills with no fever?\n\nyes my brother had a heart attack oct 13th of this year and is with me now on vacation he had 3 stints put in and it was determined he had 30% damage to his heart. He is and has had chilling can t seem to get warm for off and on the last two days but doesn t seem to have a fever? What could it be and what should we do?",
    "doctor_response": "Hello There After going through your medical query I understand your concern and I would like to tell you that urine infection or stomach infection are common causes of fever with chills on vacations.It\u2019s recommended for you to consult a physician personally for proper physical and diagnostic evaluation and treatment.Hopefully this information will guide you properly Kind Regards Dr Bhanu Partap",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest shivering and shaking, throat discomfort with heart palpitations?\n\nMy wife has these symtems for the past ten days fine shivering shaking in the chest, werd feeling in the throat and when the attacks occure heart goes fast and has palpatation. She gets panic attacks when the symtems come on, blood pressure normal 117 over 70 and had thyroid test came in negetive.",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query for your wife in details  .*  This is in relation with psychosomatic manifestation of underlying  stress anxiety  disorder .Wishing  her  fine recovery .Welcome for any further  guidance .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is itchy skin with eczema on arms and legs due to intake of cipralex?\n\nHi, I hav started taking cipralex prescribed 10mg from my doctor for postpartum depression and have really itchy skin and what appears to be exema on my arms and legs. Not sure what cream I should use and if I am needing to see my doctor to have the medicine changed?",
    "doctor_response": "Hello,The symptoms can be related to an allergic reaction to Cipralex. So, I recommend using antihistamines such as Cetirizine 10 mg to relieve the itching. I also suggest using Hydrocortisone cream for local application.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the average time of erection before ejaculation?\n\nIm 24 healthy single male 185 pounds my question is quite a few months back i lost my virginity at a late age i know, my question is how long should i last normally when having sex with a female companionsince i have not had alot of experience and i lost it to a friend and we done it a few times since, but she did say i need to last longer so what is the average time a guy should last before he ejaculate sor orgasms and how to i go about lasting longer in the future?",
    "doctor_response": "Dear user,Thanks for writing.I can understand your concern about delaying the ejaculation (orgasm).You reported that your partner was not satisfied and you ejaculated.This happens sometimes when one starts engaging sexual activity with partner.There is no fixed time or number of sex strokes of vaginal containment which is considered NORMAL. Basic KEY is both of the partners should be satisfied. It does not matter 2 minutes or twenty minutes.You can use start stop method, double condom, female on top with active role and Kegel's exercise to delay the ejaculations.Medicines are usually not required for you.Kindly have a consultation with psychiatrist near your area.good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for nightmares and difficulty in staying alone\n\nrecently my house was robbed and i walked in on the robber and he pretended to pull out a gun on me and said he was sorry and ran out of my house ever sense i have been afraid to be alone and have been having nightmares and flashbacks of that day, what should i do?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. The incident happen is an accident and I think you are in a state of shock and disbelief. Body and mind takes some time to relieve itself off the shock. In the mean time you also should be able to assist it positively. Why don't you get yourself engaged in some tasks or hobbies? That way you will be able to forget the shock much more easily than being at your home and thinking about it.If you require more of my help in this aspect, Please post a direct question to me in this URL.  Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment can be given to my mother who loses consciousness post 2 to 3 days of ventilator treatment for reducing CO2 ?\n\nIn my mother case she is being put in ventilator to reduce the CO2 , but she is not able to recover , as soon ventilator is off for one or two days CO2 percentage goes up and she start going into unconsious sitution.",
    "doctor_response": "u need to give home ventilation if co2 still rises and she becomes drowsy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will being an x-ray technician lessen my chances of conceiving ?\n\nI am an x-ray tech and i am also trying to conceive? will being an x-ray tech lessen my chances of conceiving? or are there any tips or advice you can offer me? thank you",
    "doctor_response": "hello...well since you r a xray technician...your radiologist can guide u properly abt the things. One has to wear the protecting suit during exposure  that absorbs the rays and prevents your body to have side effects. As far as my knowledge is concerned.....mild exposures of xrays may not have any effect on the activity of reproductive organs including fellopean tubes... take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have swollen lymph nodes and sore throat even after a month of wisdom tooth removal. Why?\n\nHello doctor, I had aggressive damaged wisdom teeth removal about a month ago. And since then I have a swollen lymph node in my neck on the side of the removal which sometimes it hurts and feel swollen and sometimes normal but it does not go away. But for the last two days, both sides are swollen and my throat is sore and hurts when I swallow or smoke. Is this something serious?",
    "doctor_response": "Hello. I have seen the image. (attachment removed to protect patient identity). It is showing right follicular tonsilitis with keratitis of the right buccal mucosa and attrition of the teeth with discoloration of the teeth present. For tonsillitis, you have to use antibiotics like Amoxicillin and Clavulanic acid 625 mg twice a day for five days, and tablet Azithromycin 500 mg first day followed by 250 mg once a day for five days. Avoid cool drinks and alcohol. Avoid smoking and tobacco chewing. Use water vapor inhalation and salt water gargling thrice a day. For keratitis, avoid smoking and use capsule vitamin A once a day for one week. Eat green leafy vegetables and fruits. Please consult with your oral pathologist, he will examine and if possible will take a biopsy and treat you accordingly.  I would like to some details. How old are you? Since when you are smoking? Is lymph node feeling hard or soft? It is possible that lymph node enlargement in case of any infection in the oral cavity, nose, or ears. If the lymph node is soft, painful, and easily moving means it is inflammatory pathology. But if it is hard, matted, and non-movable means a malignant pathology.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I take plan b after having unprotected sex?\n\nHello, I had unprotected sex 2 nights ago and took plan b yesterday morning. I had unprotected sex again last night...do I need to take another plan b? Or is the pill I took yesterday morning still in effect where I wouldn t need to take another one?",
    "doctor_response": "Hallow Dear, Plan B pills a are emergency post coital contraceptive pills which contain some Progestational medicine like Levonorgestrel. These medicines acre active in the body up to 3 days. They should be taken within 72 hours of the unprotected sex.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lumps in my neck?\n\nAfter my initial discovery of \u00e0 small lump in my neck I had an ultrasound (result: infiltration of subcutaneous fat), a fine needle biopsie (result: inconclusive) after which the hospital removed the whole lump (result: you are ok). After the operation I soon felt \u00e0 big lump forming which is still in my neck. It is really big. Scar tissue? I am deeply worried. You can actually see the lump. I was so happy for being ok. Do I have cancer after all?",
    "doctor_response": "Hi,Welcome to HCM.If the lump has formed soon after the surgery, then it could be a hematoma (blood clot) due to a minor bleeding following the surgery.It will resolve in few weeks, depending upon the size.Keep a watch over it, if it gets painful or red, it means it has got infected and then it needs evacuation and antibiotics.Its not a cancer.RegardsDr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rapid heart rate\n\nI took an illicit substance. A stimulant. And my heart rate is around 120-130 beats per minute. Is this dangerous? Or will I be okay and am i panicking for no reason? I do realize the risks and am aware of the affects of using these substances and do not intend to do so again in the future given this experience. Please answer FAST! I am concerned.",
    "doctor_response": "Hi there. You should be concerned. The high heart rate is quite dangerous. I do not know your age. If its higher your risk is higher. Do you have any other symptoms like sweating etc. What did you take? Its good to know since you may need an antidote. Please see a doctor at once. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rise in temperate after getting hit on head?\n\nHi , my daughter,she is 5years old, hit her head to another girl yesturday at school, and she had a very big soft lump on her forehead,I kept on eye and she was fine, but this morning she have a 39.9 temperature  and I dont know or I need to worry about it, or is just kind of infection. Thank you very much.Regards Asta",
    "doctor_response": "Hi... I think your kid has got a viral illness. The trivial head injury which she has undergone doesn't seem to be related to this fever.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.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pressure in the testicles after workouts?\n\nI have an 11 year old boy who is starting to go into puberty. He is very active in Tai Jitsu and Judo. Tonight after Tai Jitsu (with lots of kicking tonight), he is complaining of a pressure in his left testicle. He denies getting hurt during practice tonight, has normal urination, and no other pain, nausea, etc. I gave him Tylenol and it has helped a little, but has not relieved it like Tylenol typically does for his aches from workouts or minor injuries. I examined him briefly and see no discoloration, swelling, or abnomality.",
    "doctor_response": "HelloThanks for query .In absence of any injury to testicle discomfort in Testicle that your son is having after Tai Jitsu is mostly due to pulled muscle and strain of cremastic muscle of the spermatic cord .He needs to take anti inflammatory medication like Diclofenac twice daily for 5 days .Refrain him from exercise for few days till pain subsides completely .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in heart?\n\nhi i feel some pain in my heart from last 4 5 months but frm some couple of days i am suffering too much due to to this pain i consult a doctor he check my blood pressure and and advice for ECG and he said it is normal if it is normal  so y i feel this pain again and again",
    "doctor_response": "hello,  I need to know more about the symptoms, like precipitating factors, factors that increases pain etc.   Mostly it's a gastritis and reflux disease. Do you upper abdominal pain, nausea, bloating, burping, increase in pain on food, sour water feeling in throat or chest burning, if yes it further supports the diagnosis. You should avoid fatty, oily and high calorie diet. Have some walk after having food instead of taking rest. Have multiple small meals instead of heavy meals. Have regular sleep habits and avoid stress. Lots of green leafy vegetables, fruits. Avoid smoking and alcohol if any. You can get prescribed tab Pan DSR 40 mg beforebreakfast once a day for 2 weeks.     Secondly does this pain increases on applying pressure over the area, if yes it could be costochondritis and it's a musculoskeletal type of pain and needs prolonged nsaid therapy.   Does this pain increases on deep breathing and coughing etc. if yes it a pain arising from lining of lungs, and needs nsaids treatment and evaluation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back pain which radiates to the testicles?\n\nHi doctor i am 67 years old for the last week i have started sudden pain on my lower right back, which moves to my testicle (right one) i have done the ultrasound for any kidney problem, but its clear, i also done Urine RE and blood tests all are clear, with the pain i have also noticed constipation than i have eaten medicen for costipation relief and when it went off my pain also went off. after 2 days now it again started my lower back right side and than some times in my testicle and some time lower abdomen",
    "doctor_response": "HI Well come to HCMI really appreciate your concern, the most common cuase of lower back pain which radiates to testes would be renal stone, if this is not being detected in ultrasonography then better to get done the plain x-ray of kidny ureter and bladder, till then pain can be managed with \"Tab Diclofenac 50 mg sustain release once in day\" Tab Acetaminophen with Dicyclomine\" three times in day, drink more water,  hope this information helps, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce severe trapezius muscle pain along with inflammation?\n\nI have sever trapezius muscle pain along with severe inflammation and I can t afford to see a specialist to see what this is. The pain is so bad that it hurts of and on and it flairs up the pain and the inflammation as well I can t even afford to go to chiropractor what should I do",
    "doctor_response": "You can start with non prescription analgesics and local cream (e.g voltaren gel).If the symptoms didn't get better,  you can go to see your GP who can perform physical examination or order simple tests to exclude any serious problem. For any further concerns please write us immediately.Thank you for choosing HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cramps under ribs after gall bladder removal?\n\nHi my name is Tami! I had my gall bladder removed Aug. of last year and the reason cause I was having cramps underneath my ribs and back and my lining of my gall bladder was very hard and my liver enmzes were high! Well this morning at 1am I woke up to the same cramping under my rib cage and cramps in my back and same problem as before my removal if my gall bladder! My question is how is this suppose if my gall bladder is gone? Can I still develop gall stones?",
    "doctor_response": "hi.what you're probably experiencing is post-operative pain or discomfort. this usually occurs on the first few days after your surgery and will eventually subside. the pain/discomfort after gallbladder surgery occurs not only the post-operative site area, but also over your flanks and sometimes back region. complete your antibiotics as prescribed and take your pain medications as needed. a follow-up with your surgeon is also best for clinical evaluation.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe taking antibiotics and painkillers after teeth removal while planning to conceive ?\n\nDear sir, I have a small problem with my teeth for which my dentist has adviced that the teeth be removed. I am planning to concive before one day of the teeth removal process. Is it safe to take antibiotics and pain killers during this period ??? Please help on this....",
    "doctor_response": "HELLO BHARGITHANK YOU FOR SHARING YOUR CONCERN ON HCMIT IS ADVISABLE TO FINISH DENTAL TREATMENT FIRST AND THEN CONCEIVE.SOME ANTIBIOTICS AND PAINKILLERS ARE SAFE IN PREGNANCY.AND FOR TREATMENT 2ND TRIMESTER(4TH , 5TH AND 6TH MONTH)IS SAFE PERIOD.PLEASE LET YOUR DENTIST KNOW ABOUT YOUR PREGNANCY.REGARDS.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome the problem of passing urine after a back surgery?\n\nI had back surgery about 1.5 months ago and my back feels great now but I am feeling lifeless--can hardly go--had urine and blood, stool sample work done and was fine except my Fe level was low but now at 11 What could be making me feel so bad--have had other blood work done but nor heard",
    "doctor_response": "for what condition you had back surgery is important. see surgery causes relief in symptoms of pain immediately, but the neural recovery takes a long time. it depends on what neural problems you had before surgery. please be patient, neural recovery will take something around 6 months.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can low sperm count lead to infertility?\n\nI am a 21 year old female and my partner is 36 years old. We are trying for a baby but nothing has happened yet. Could this be down to a low sperm count? I have been pregnant before and had a termination. He has 2 children. So i know we can both concieve, but i think he may have a low sperm count, what is the best thing to do?",
    "doctor_response": "HelloInfertility may be due to many reasons.It is important to evaluate both partners.Besides clinical evaluation,both of you need routine investigations.It include routine hemogram,random blood sugar,liver and renal function test,urine RE/ME,thyroid profile,ultrasound of abdomen.Additionally your husband may need semen analysis and you may need follicular study.Hormone estimation may be advised after evaluation.Avoid alcohol and smoking.Wish you all the best.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My pregnant wife noticed blood in her vomit. What is the reason?\n\nMy doctor,My wife is pregnant and this is her third month. During vomiting, she noticed blood. What is the reason? Kindly suggest me.",
    "doctor_response": "Hi. 1. Vomiting induced esophageal ulcer or tears 2. Acute GERD (gastroesophageal reflux disease). CBP (complete blood panel), ultrasound abdomen and gastroenterologist consultation for upper GI endoscopy. Doxinate-P (Doxylamine and Pyridoxine) thrice a day For further information consult an internal medicine physician online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from anxiety, seratonin syndrome. Taking pristiq, lexapro. Safe to increase medication dosage?\n\nI am taking 200 mg of Pristiq and 30 mg lexapro and 450 wellbutrin. i need to raise my lexapro up to 40mg because i have alot of anxiety and it helped so much when i took 40 mg before i started the pristiq but now that pristiq has been added i m afraid to up it because of seratonin syndrome . what is your opinion on this? is it safe to up it to 40mg?",
    "doctor_response": "Hello...... Thanks for your query. Simultaneous administration of three antidepressant that too at higher doses is not advisable. At the maximum only two antidepressants are recommended to be combined together.It definitely carries the risk of serotenergic syndrome. Self medication is not advisable. Request your psychiatrist to minimise number of medication and optimise the dosage. Wish you speedy recovery. Regards Dr Sundar Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is surgery possible for prostate cancer spread to spine?\n\nMy father-in=law has beeb suffering from prostrate acncer for 10 years and up until late last year it was controlled. Now it has been discovered that the cancer has spread to his spine in several places. He has already undergone radiotherapy on two occasions but still suffers with acute pain in his back and now down his legs and around his ribcage. He was told yesterday that his spine is crumbling and an operation is not possible. I am looking for answers to the consequences as I feel he does not ask the appropriate questions when he is with the surgeon/consultant. This could be because he does not wish to know but as a close relation I want to know.",
    "doctor_response": "Hello dear. Your father is suffering from stage 4 prostate cancer. At this stage surgery cannot be done for prostate. However he requires either surgical removal of testes or medical management for inactivation of testosterone produced by the testes. Then he will be requiring chemotherapy and hormonal therapy as a part of treatment. he also requires bone strengthening agents 9 bisphosphonates) Hope that solves your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe anxiety, depression and paranoia\n\nI need some help. I do have an apoitment with mental health but not until December. I was in detox for alchole about a month ago. Upon returning home my boyfriend took my 3 year old twins and will not let me see them much. Not only is this man my x now but he also is my boss at work. For years now i have had anxiety paronia and depression. Now lately its 100 times worse. I dont want to leave my house. I have been missin time at work. My work has told me to go to the dr and get put off of work so i can get myself right. I do not know how to ask my dr that? Im actually terrified to even go to him. My x and my family this im being stupid but i cant help the way i feel. Its like i know what i have to do but my mind wont let me. How do i ask my dr for help? What could be wrong with me ? I do not understand why 24 hours a day i am feeling like im failing. I keep my doors locked and my curtins closed. I do not want to leace the house. I feel like ppl are talking about me and judging me. Im sad all the time. Nervous amd stressed out all the time. I find it so hard always feeling this way.",
    "doctor_response": "Hello! Welcome to HealthcareMagic! Presently your in depressive state. So, now you're suffering with all the depressive symptoms like feeling low and sad, wanting to stay alone, unable to concentrate on work, low self esteem, etc. I guess you also feel hopelessness and guilt along with sleeplessness. It indicates that you're in a moderate to severe depression state, which ought to be treated with a psychiatrist. Mostly, they prescribe medications like SSRIs and TCAs. I recommend you to consult a psychiatrist immediately. Also, start practicing relaxation exercises like mindfulness, meeting friends, going for a walk in the morning, which will help relieve your stress. Hope that clarifies your concerns. Thank you for the question. Take care Regards, Dr. Bhagawan Rajana, Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fast heart beat while having tuberous sclerosis?\n\nI am 30 year old female with tuberous sclerosis I have never had any heart problems before the other day my heartbeat was 140 but since then it has slowed down a little im not sure if it's my thyorid or my cyst on my heart I would really like to know.",
    "doctor_response": "Hi ThereYes dear it can be a possibility of Rhabdomyoma( tumour of heart muscle ) generally associated with Tuberous Sclerosis. It is advisable , you should get  your Echocardiography done which will help you to find out if tumour is there.Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes skipping of heartbeat while deep breathing?\n\nListen to my heart with my sethascope with beats going wish wash wish wash beep beep beep wish wash wish wash. I know their messed up which is weird. But when I take a deep breath and hold it I cant hear my heart beat at all. I can feel it on my neck.when I touch the main artery. But can t hear it with the sethascope. Its really weird",
    "doctor_response": "Thank you for the question.There is something called sinus arrhythmia that means normal variation of heart beats while breathing.Rate increases on inspiration and comes down on breathing out.This effect is more pronounced in children and young adults.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could lump in neck be cancerous?\n\nim a 21 year old female and i have no medical problems, but i have had this hard lump in my neck for  2 months already and it did not grow any bigger or even get any smaller, but when i touch it it feels like it is bruised,no fever or any other sickness but i do feel like i have mucus stuck in my throat i also smoke 10 cigarretes to a pack a day. should i be worried? could it be cancer?",
    "doctor_response": "Hi,Good Morning,Thanks for your query to My-HCM Clinic.I studied your query in depth.I understood your concerns.My opinion on the painless but sore lump is mostly a-Lymphadenitis due to the Smokers Throat.Your cigarrete smoking history confirms it.-Cancer lumps are not sore to touch.Hence its certainly not a CANCER.-You should be worried for the Smokers Throat -with chronic pharyngitis.-Treatment -would be-a-Consult a Surgeon and confirm its diagnosis.b-Excision Biopsy would reduce your worry totally.-Hope this would help you  to recover from worry-some query.Wish you a Fast Recovey.Wellcome to HCM again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the chances of developing a heart attack in a GAD patient?\n\nHello,I am a 28-year-old female. I always worried about her heart. I have GAD specifically focus on health anxiety and often experience heart attack symptoms so much so that I have gone to my doctor and the ER many times (always to be cleared). I continue to worry whenever the symptoms come back. I have been cleared so many times, but still, fear that something could go wrong or something might have been missed. Is there a chance that I could develop a risk of a heart attack without making any major changes?",
    "doctor_response": "Hello. A heart attack usually occurs in those with risk factors for ischemic heart disease such as high BP, high sugar, high cholesterol, family history of a heart attack in young age, etc. Your tests are normal thats good. To estimate the lifetime risk of development of atherosclerotic diseases such as stroke and heart attack, have a fasting lipid profile done and send to me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could pain below the back with yellow urine be kidney related problem?\n\nI have a sharp about number 6 pain right below my back on my right side and no matter how much cranberry juice or water I drink I still pee dark yellow with alot of bubbles in my urine about 28 times a day. Also i get a fever at night. I am also prescribed to hydrocodone/soma/xanax and have been for the past four years for a broken back. Could have that given me kidney damage? Or what does that sound like",
    "doctor_response": "Dark yellow discolouration of urine does not point to Kidney problem. What it MAY point to is probably a liver disease. Backache medications like hydrocodone generally do not affect kidneys. But the NSAIDS do have detrimental effect on kidneys in a long run! Make sure you do not have them in combination with the hydrocodone. Also get your liver checked.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it effective if took ipill after unprotected sex and had unprotected sex again?\n\nI had unprotected sex last night (around 1 am) and took I-pill after 13 hours (around 2 pm),this afternoon. Latter after taking I-pill I again had unprotected sex after 4 hour(around 6 pm,this evening). Am I safe now or do I need to again take another I-pill? Would appreciate your expertise..",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. In case of an unprotected intercourse to prevent pregnancy emergency contraceptive pill has to be taken within 72 hour of exposure. As per the mentioned event no need to take further I pill as 72 hour has not been passed. But You have to be careful and if needed condom like barrier method can be used to prevent pregnancy. I pill is very effective in preventing pregnancy but still if your next period is delayed than rule out pregnancy by urine HCG card test. Hope this provided information will be beneficial to you and let me know if I can assist you further. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting and headache after taking solpadol?\n\nHi ,my husband took two salpadol in the morning ,...very first time but after that he had vomiting 7 to 8 time he took with the antibiotic because he having a soar throat since last 2 days ....now what we should do now he feel really weak b/c of vomit and having a headache what we should do now?",
    "doctor_response": "HiCodeine can cause nausea,vomiting as a common side effect.Avoid using 2 tablets at a time.You can use other painkillers without opioids to reduce the side effects.Avoid dehydration by taking plenty of fluids.Incase of severe vomiting and inability to take orally,iv fluids may be required.Hope I have answered your query. Let me know if I can assist you further. RegardsDr.Saranya Ramadoss, General and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in conceiving despite taking Goodova?\n\nI m trying to have baby for around a year after I delivered a still born child of nine months on 9th July of 2016...recently for the last two months I am taking Goodova50 during the first few days of menstrual cycle(as per my doc s advice).me n my husband is doing the deed every alternate day till 18th day of my menses...In the last few menses of mine(after I lost my baby)I have checked that the menses date is preponing 3-5days of the last month s...(n my cycle lasts every month for only 3days) Please n please help me in advising me whether I can become mom following the above said ritual... Me broken into pieces n shattered... PLEASE HELP... PLEASE..",
    "doctor_response": "Hi, I think you should go for evaluation first.  Get a thyroid profile and prolactin level done. You can try with goodova for 3 to 6 cycles. It is given to induce ovulation.  Get repeated ultrasound done to see the growth of the follicles and take injection hcg for rupture when follicle reaches a size more than 18 mm.  Be in contact with your husband for next 2 days.  are progesterone for 2 weeks after rupture is confirmed on ultrasound. Talk to your doctor regarding these things.  Hope it helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pinching sensation in chest with dizziness?\n\nI am a 37 year old woman with history of heart disease on my father's side of family. lately, I feel a pinch in my heart, preceeded by palpatations and then exhaustion. This has occured a few months ago and last year. A few months ago I went a week having dizzy spells so strong unable to lift my head, then irregular heart beat that caused lost breath. Last week the pinching in my heart last for 3 mins. then palpatations or racing of the heart and I've been exhausted ever since. Tired even though I sleep 8-9 hours per night.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.Since you are having strong family history of heart diseases, we should definitely rule out cardiac cause for your symptoms.So consult cardiologist and get done blood pressure monitoring, ecg, 2d echo, stress test (trade mill test) and Holter monitoring (24 hours continuous recording of Ecg).If all these are normal then no need to worry for heart diseases.Stress and anxiety can also cause similar symptoms. So avoid stress and tension, be relax and calm.Don't worry, you will be alright but first rule out heart diseases.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any ingredient in instaflex that would cause problem?\n\nI have been on warfarin for many years due to blood clots in my left arm. Is there any ingredient in Instaflex that would cause me a problem? My email address is YYYY@YYYY ..I am seventy five and have both Ostio and Rhumatoid arthritis and still have to work.",
    "doctor_response": "Hello, The ingredients of Instaflex are not documented to produce any change in Prothrombin time or INR. However, it would be advisable to check your PT and INR after 10 days of taking them together. If there is a change in the PT or INR, it would not be advisable to take it. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Noble Zachariah, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling sensation in the face, back of the head and the ears?\n\nexperiencing tingling (NOT pins and needles) onleft side of face from back of head around to face, concentrated in the ear area. Does not hurt but can get stronger. Comes and goes. has an electrical shock feel to it and sometimes comes around to the corner of the mouth and the eye.",
    "doctor_response": "Hello!Welcome on HCM!Regarding your concern, I would explain that your symptoms seem to be related to trigeminal nerve compression. The electrical shock pain seem to be caused by the irritation of this nerve (also called trigeminal neuralgia). For this reason, I recommend consulting with a neurologist for a physical exam. A brain MRI is necessary to exclude a possible intracranial cause (a cyst, a tumor or a vascular compression of the nerve). Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can chicken pox be treated?\n\nMy daughter has been diagnosed with Chicken pox and she\u2019s absolutely covered. I\u2019ve had chicken pox when I was younger but this evening I\u2019ve noticed that I have about 6 red blistery spots on my stomach. Is it possible to get it twice? I have a very low immune system. Thankyou.",
    "doctor_response": "Hello,Chickenpox generally resolves within a week or two without treatment. There is no cure, but a vaccine can prevent it.A doctor may prescribe medicine or advise on how to reduce symptoms of itchiness and discomfort, and also on how to prevent the infection from spreading to other people.Pain or fever: Tylenol (acetaminophen), which is available for online purchase, may help with symptoms of high temperature and pain. It is important to follow the instructions provided by the manufacturer. Aspirin containing products should NOT be used for chickenpox as this can lead to complications. Acetaminophen (Tylenol) can be used at any time during pregnancy.Avoiding dehydration: It is important to drink plenty of fluids, preferably water, to prevent dehydration. Some doctors recommend sugar-free Popsicles or Pedialyte for children who are not drinking enough.People can get chicken pox twice if immunity goes down. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sanjay Kini",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could Tolol cause laziness and dullness all during the day?\n\nI am having hypertension my pulse rate is also high. My doctor prescribed Tolol XR 50 mg. I am taking it regularly since the last one year. I am becoming lazy and dull all the day by taking the tablet. Please give me proper suggestion so become active so that i can do my work wihtout laziness.",
    "doctor_response": "Hello. I am Dr. Praveen and I will be answering your question today. Its unlikely you are experiencing this due to the drug for hypertension. Strange as it may seem you will begin to feel active only if you put your mind to it and start off. It may be the lightest workout but start. Once you do, you will gain the energy and motivation to do more. There is sadly no magic pill but the wish to become fitter. Please check your pulse rate. If its low you will need tolol to be titrated.Wishing you good health. Please feel free to drop in any more queries if need be.Take care. Warm regards,Dr Praveen Jeyapathy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for enlarged prostate gland and cyst in lobe of liver\n\n1. My prostate gland mildly enlarged in size. It measures about 4.4 cmx3.5 cmx3.3 cm & volume is 27 cc which is equals to 27gm. PVR is 35 ml. 2. There is a bright echogenic structure giving faint shadow measuring about 9 mm seen in the lower part of left kidney. Another cortical cyst measuring about (2.4x 2.2) cm in the lower pole of right kidney. 3. I also have a hepatic cyst (1.7x1.3) cm in the right lobe of liver with mild fatty change. How serious is my condition and what will my treatment.",
    "doctor_response": "Hi,Thanks for writing in.Your prostate gland is mildly enlarged in size. It is not too enlarged and medical treatment will work. There is small amount of post void residual urine and not a concern.The cysts in lower pole of right kidney and liver cyst are a usual finding if you are in elderly age group. Few cysts are expected in kidney and liver at your age. Fatty liver needs to be considered with liver function tests. This will tell if the liver enzymes are raised or not. Doing a lipid profile will show any raised cholesterol levels. You might need to take medications for it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be wrong having itching on top of penis, dryness in urethra that goes after a while?\n\nHiI am married. After three months in Marriage I started experiencing challenges of  some kind of itching on top of my penis, dryness of top of my urethra and cracking of urethra every time I had sex with my wife. After Crack I take some days without sex and my penis normalizes but the next morning after having sex, experience the same challenges. Doctor, what could it be and what should I do?",
    "doctor_response": "You need to rule out a fungal infection and urethritis.You and your wife both need to undergo local/oral antifungal therapy to eliminate passing the infection to and fro.You need to take the medication for 2-3 weeks to eliminate recurrence.A urine examination and ruling out prostatitis may help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluttery feeling in the heart after a surgery for gall bladder?\n\nhii im 9 and have just recently had a baby 2 months prem as i had eclampsia , i then found out i had gall stones and had to have an emergancy operation to get my gall bladder out as i had pancretitis , im now getting fluttery feelings in my heart and am getting scared as to what it could be",
    "doctor_response": "Your question cannot be answered easily in this forum. After ecclampsia and an operation, you've had quite a brush with medical care. Your recovery may be punctuated by periods of palpitation that offer no great concern but only someone with more detailed knowledge can answer. You let your doctor know of concern and follow his or her suggestion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What problems does overdose of iodine cause?\n\nI take iodine, 4 drops in the evening for my thyroid. I mistakenly to about 30-40 drops, the bottle is very simular to my cleanse. What should I do? Are there any health risk? What symptoms should l be looking for that would be related to overdose of iodine. Should I go to the hospital?",
    "doctor_response": "Hi,Observe for its side effects. When taken in larger doses iodine can cause metallic taste, increased salivation, swelling of the lips, tongue, and/or throat, severe headache, joint pain, irregular heart beats, tingling and numbness sensation, and decreased urine output. You must visit the emergency room of the nearby hospital if you experience the above side effects.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for the discomfort in the butt when walking or standing long?\n\ni go for mri of pelvic friday ive had surgery in 2012 had bowel reconstruction and have perment colosty bag and last 3 weeks my butt feels as tho theres presure and its hard to walk or stand long been sick at my stomach last 3 days no vomit but weak to stomach",
    "doctor_response": "Hello thank you for writing us here. What your symptoms suggests is of piriformis syndrome which is due to inflammation of the the muscle present in the buttock. You can get an injection of botox which would relax the muscle and you'll get relief. God bless youBest regards,Dr Gunjan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the correct measure to give asthalin?\n\nmy son ( 4 yrs old) is suffering from bronchitis. mostly in rainy and winter season. as precaution I give him asthalin nebulization. what is the correct measure to give asthalin.? (currently - 2 drops of asthalin with 0.5 ml asthalin with 10 drops of sterilsed water.) IS there any other way. how to permanently cure this problem?",
    "doctor_response": "Hello, .5 ml is the correct dose for his age. Nothing much to worry and your treatment is on the right track. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Getting ferrlecit iron infusions for chronic anemia. Joint pain. Hiatus hernia diagnosed. Taking prilosec. Suggestions?\n\nI'm currently getting Ferrlecit iron infusions for chronic anemia, I notice I have more joint pain now than before the infusions. I had a colonoscopy & edg and they found bleeding from a hiatal hernia, my doctor put me on Prilosec 20mg twice a day.  This testing was just 2 weeks ago.  I know  I will have monthly CBC tests, which determine if the Prilosec will stop the bleeding.  My hgb is 9.7.    thank you for your opinion",
    "doctor_response": "Hello, Thanks for  the  query to H.C.M. Forum.When iron infusion or injections are given, there develops few side effects of iron therapy.These are Fever with chills, joint pain,general weakness,general pain all over body.You mentioned in query  that there is hiatus hernia ( cause of bleeding) , which  causes blood loss. So have a treatment of hiatus hernia ( root cause of anemia).In my opinion at this level of Hemoglobin (9.7 gm/dl), oral iron therapy will cure.Hope I have answered your query. If further any question I will be happy to help. Good luck for speedy recovery. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best way to get rid of eye bags ?\n\nHi Doc, I am a 53 year old man from New Delhi, India. I don t have any known medical condition and am quite fit owing to regular workouts and sensible diet . I am here to ask you the following: I have prominent under eye bags, they dont give me any problem apart from making me self conscious. Please advice me as to what is the best way to get rid of the eye bags. Thanks and regards. Anil.",
    "doctor_response": "HI u need to find out reason for it it may be due to internal cause also avoid stress ,smoking,alcohol . drink more water avoid direct sun exposure apply good sunscreen lotion twice a day",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause severe dark skin around scrotum with stinky smell?\n\nmy skin around scrotum part and jocks is black like as if it is burnt and it smells very stinky when it sweats previously i had itching problem and i have consulted a doctor skin specialist it was rid when i have used the cream but slowly the skin turned black in color even pennis too my skin is white in color but that part is looking very black please tell me some remidies for it",
    "doctor_response": "HelloThanks for query.Are you Diabetic?Black scrotal skin with stinky smell can be due to what is called as Fornier's Gangrene and needs urgent consultation and confirmation by clinical examination by a qualified General Surgeon. Please consult General Surgeon and get your blood sugar levels test done to rule out Diabetes.In the mean while take broad spectrum antibiotic like Cefexine along with anti inflammatory drug like Diclofenac twice daily.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes extreme pain in the legs?\n\nI have extreme pain in my upper leg muscles and forearms. This has progressively gotten worse. over the last couple years. There is no correlation to injury or physical activity. When I do try to go for my walk sometimes my legs feel intense pain. I also have lost a lot of physical strength the last 6 months",
    "doctor_response": "Hi, I had gone through your question and understand your concernsI were your treating doctor I'd like to ask you some questions,your age ?daily activities?any medical disorders?..I prefer doing DEXA scan to assess bone density to assess osteoporosis.I advise you to receive NSAID when needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have a lump on my vagina lip that hurts when i squeeze it\n\ni have a lump in my vagina lip that hurts when i squeeze it. It appears then disappears but then the process begins again in 3 months and will appear. It is about the size of a nickle, and sometimes turns into the size of a quarter. What is this? What causes it? I am 17 and it is truly scary.",
    "doctor_response": "Hi.This can be due to sebaceous cyst or cyst of any sort. The best treatment is get this checked and removed by a Surgeon.This will get you rid of the problem before it goes into complication and you get a histological diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat enlarged lymph nodes in the groin area?\n\nBrief as I can be; I have been sick for the greater part of my life starting with my first hospitalization at 19 months, that was in 1968. They diagnosed at the time double pneumonia, pleurisy and noted a torn tricuspid in the right atrium. Throughout most of my teen's I came down with what appeared to be flu like symptoms as well as diarrhea. Usually within a few hours to a day I was running again.  In my late teens and early twenties I was hospitalized so many times with microbacterial pneumonia's, again a dose of antibiotics and fluids, running again. Then in my 30's I started having real bad cramps in my lower stomach as well as enlarged lymphnodes in my groin area. Stools have been dark and fluid with mucous present. Wipples disease has been considered and I do believe thats on the right track. However athe biopsies were done in my small intestine with some damage to the villi, (unknown) as well as a flattened duodenum but what showed up was h-pylori that they couldn't eradicate on 4 occasions. I have had lots of episodes of bile being brought up, nausea and of course continued fatty like stools. I wake up with dislocated knee's and recently my left leg was somewhat out of socket on the outer hip/leg. My optic nerves have noted atrophy/degeneration noted and I have a spot under the right eye that has stayed with me for about a year now. Its red and flakes with white dead skin daily. My nose and cheeks often show hyper-pigmentation or seemingly fast skin growth(?) Going for the morning ritual for the last three years is excruciating to the point of crying, remember its mostly liquid coming out although a rare hard stool is the worse, almost to the point of passing out. I am treated at present with ms-contin long release, 1000mg twice daily and 10 mils per mg, 3-5 mils every 4 to 6 hours as needed of the liquid morphine. The ytried to used gabapentine but that didn't og over too well and Lyrica doesn't touch it. The liquid morphine lets me do the morning thing with very little pain and formed stools, most of the time no blood and little mucous. in 2008 I contracted MRSA which prevented the treatment for Whipples. All I know is I am exhaustedc within an hour or two of being awake but I deal with it and try to live and work normally as possible but some days are a write off. I am not depressed just bothered with it all. My doctors are giving up, that bugs me but I understand. I also receive lidocane th",
    "doctor_response": "WITH YOUR SYMPTOMS AND COMPLAINS CLINICALLY IT IS QUITE POSSIBLE THAT YOU DO HAVE WIPPLES DISEASESINCE NO BIOPSY AND CONFIRMATION OD DIAGNOSIS HAS BEEN DONE IT CANNOT BE SAID THAT YOU HAVE IT FOR CERTAIN.STILL SINCE ITS AN INFECTION AND IF IT IS PRESENT TRIAL OF A COURSE OF ANTIBIOTIC SHOULD NOT HARM MUCHYOU CAN TRY TAB DOXICYCLLIN 150 MG ONCE A DAY AND TAB HYDROXY CHLOROQUIN 200 MG ONCE A DAY FOR A FEW SAY MAY BE 10 DAYS AND SEE IF IT GIVES YOU SOME RELIEF.THESE MEDICATION CAN CAUSE SOME GASTRIC IRRITATION SO TAKE THEM AFTER MEALS NOT ON EMPTY STOMACH IN ANY CASEALSO TAKE TAB RANITIDINE 150 MG TWICE A DAYTO EASE YOU BOWEL MOVEMENT WOES TRY USING BULK LAXATIVES LIKE ISABGOL PULV TO BASICLY INCREASE THE BULK OF STOOL AND KEEP IT SOFT DO LET ME KNOW IF IT HELPS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I have a small rash on my lower part of my face?\n\nrashI have a small rash on my lower part of my face . i got it when i was in the shower and i use a wash cloth on my face that had my shampoo on it , i used as body wash . i have been putting baby rash otiment and alovara on it . i have also be sick and on anibiodics . its been dry and red and itchie for 3 days , what should i do ?",
    "doctor_response": "Hello,Thank you for posting on HCM.I can understand your concern regarding the skin lesions but its difficult to point specific diagnosis in absence of clinical examination.Therefore, I insist you to post good clinical pictures to me so that I can help you in a better way.You can mail pictures to attachments@healthcaremagic.comwith subject titled ' ATTN Dr Hardik Pitroda'.ThanksDr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for knee pain?\n\nHi I feal and I way about 275 and right after I could not bend my right knee it swelled up and doct said nothing broken but its been sense last wed and still can t bend it I can put straight but not bend a lot of pain over knee cap help me pleas thanks jennie",
    "doctor_response": "Hello,Since your doctor said that there is not a fracture, I assume that they did x-ray of your knee. Your complains look like you have some meniscus injury or cartilage damage. Both of these problems cannot be seen on x-ray but only in MRI. So, I advise you to get an MRI of the knee and see an orthopedic surgeon.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Edvin Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fluttering in scrotum, perineal area, strenous. What does it mean?\n\nHi, My husband is 28 years old and has been feeling a slight fluttering underneath his scrotum before his perineal area. It has been going on for 2 weeks now. He works as mechanic and no strenuous heavy lifting once in a great while. He feels that his scrotum is a bit cold at times, and lifts weights everyday for 30 minutes. It has not happened before. Is this something that we should be concerned about?",
    "doctor_response": "Hi! I do not think that there is anything much of concern about about the symptoms of your husband. This may be a hyper activity of the muscles of the scrotum. He does not have any pain, or redness, and so we can exclude any infective pathology. However, he should use proper scrotal support garments whenever he lifts weights and does any kind of strenous work. A proper re assurance will help him. If the symptoms persist or increases with any other problem, he should consult the family physician for a routine check up. Hope this helps your husband.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I having hairline crack in my skull and left hip bone?\n\nI have what feels like a hairline crack in my skull, above my left eye going from my forehead into my hairline. It s only a small indent, but is noticeable to touch, approx. 3 inches long. I ve not suffered any head trauma to cause this, and I ve not been suffering from any headaches, dizziness etc. I had a Cat scan & found this lesion & also one on my left hip bone. I have RA (Arthritis) & wondering if this would attribute to that? Also what are other possibilities?",
    "doctor_response": "Hello, What I understand is this shouldn't happen in cases with RA. But then it depends upon the bone calcium levels too. Have you ever spoken to a rheumatologist about this issues? Having a DEXA scan should help understand the bone mineralisation status and also make us understand why these hairline cracks have occurred. Hope you contact a good rheumatologist so that we can understand the bone mineralization and direct the treatment accordingly. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does depo shot affect fertility? Trying to be pregnant. Had used depo shot in the past\n\ni used the depo shot as birth control for 3 months (1 shot) and never returned for my second shot in feb 2011, i have been trying to conceive since feb 2012 and still no luck! has the depo shot affected my fertility? its starting to stress me out! also when i came off the shot my periods returned after 2 months but i bled twice a month for about 4 months? any help would be greatly appreciated.",
    "doctor_response": "Hello,Depot shot is very much effective in preventing unwanted pregnancy and to be taken once in 3 months.But there are several side effects like irregular period including long time amenorrhoea,prolonged infertility(9-12 months) after discontinuation, wt change, headache etc.So consult with your doctor for physical examination and initial investigation like husband semen analysis, hormone assay (LH/FSH, estrogen & Progesterone level), Thyroid profile, Test for ovulation & tubal patency, One ultrasound for pelvic pathology.Proper treatment depends on underlying causative factor. Also use ovulation prediction kit to predict ovulation which occurs 14 days before due date. Proper timing of ovulation & unprotected sex is essential to conceive.Avoid stress,take healthy diet with Vit-E & Folic acid supplements,control body wt and proper sleep.Be well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain and severe fatigue\n\nI started getting chest pain yesterday, pretty much under my left breast. It felt as though there were cylinder blocks squeezing down on my chest. It lasted about 15 mins, then the pain decreased from an 8 to about a 4-5 on and off accompanied with sob and tiredness and pounding and irregular heartbeat. I chewed an aspirin and also swallowed one. I then realized that laying down on my back and even more so on my right side made the pain on the left more severe. I am somewhat hesitant to go to the hospital and just praying the pain will subside. But my only relief seems to be sitting up and resting while doing so. Please advise..",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, possibility of cardiac chest pain is more. Your pain is squeezing in nature,  on left side of chest, with irregular heart beats and associated with orthopnea (breathing difficulty in lying down). All these are characteristic features of cardiac chest pain. So without wasting time, you should definitely consult cardiologist and get done ecg, 2d echo and stress test. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pit edema. Kidney biopsy done. On corticosteroids. Is kidney transplantation an option?\n\nMy father is 80 and has lived a healthy great life never even being hospitalized once. Over the last few months he gained 50 lbs and had pit edema. After a kidney biopsy his diagnosis is focal global glomerulsclerosis. He was started on corticosteroids and lost the 50 lbs rapidly.  If and when he is in end stage renal failure,  would a kidney transplant be an option at age 80?",
    "doctor_response": "Hi, Probably it is not a life threatening disease, he must have improvement with the medication. As he is already 80 the acceptence of the kidney by the body may be less due to lack of vascular sufeciency.                              In my openion he can manage with the medicines, for rest of the life. Give him juice of palatable vegetables daily as a suppliment it may help him recover.  Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having large cruise on lower back. Diagnosed with degenerative disc disorder and osteoarthritis. Cause?\n\nHi, I have question about large cruise on my lower back. I've been involving in to car accident 5 years ago . Its finish with whip splash. After that I was diagnosed with degenerative disc disorder and osteoarthritis in my lower back. About month ago my lower back started bruising without reason and its very stiff. At my work I am very careful ( personal support worker) and I never had any injury related to my job. What can caused that weird bruising?",
    "doctor_response": "Hello and Welcome to HCM, Thanks for writing to us. The sudden onset of a bruise of unknown cause should not be taken to lightly, this could be an indication of either a blood clotting problem (low platelet production or increased rate of removal of platelets from blood), a reaction to any medications you could be taking (eg. aspirin, coumadin, some pain management medication, etc.), accidental ingestion of a poisonous substance (eg. rat poison, etc.). It is best you just visit a doctor for a blood work up, once all the results return normal, there should be absolutely nothing to worry about, and this bruise could have been caused accidentally (like scratching yourself while you were asleep, etc.). Hope this helps you. Wishing you good health... Regards. Dr Saurabh Gupta. Orthopaedic Surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for extreme mood swings, irritation and itchy, tingling body\n\nirritation feels like my skin is crawling, angry lost my temper three times today already, started tidying with music on and then just turn it off stopped cleaning n layed down shoutin at my cats they are annoying me. want people to leave me alone? i keep feelng like this im not going to my doctor because he is not nice. my whole body is itching or tingling.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  Even though your symptoms do correspond to anxiety disorder in one look, you should also understand that these symptoms can also come fore because of disappointment. I sincerely suggest that you could be a victim of your own negative thinking. Disappointment which arises out of unforeseen life events do bring such symptoms like sadness, irritation, anger, lethargy, lack of interest, lack of appetite etc. Please understand this fact and make sure to introspect. Talking to your friends, out door activities and being creative should give you relief. Find the reason for your disappointment and consult a psychologist if need be. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child showing signs of petite mal-seizures, low appetite, has crossed most of the milestones, had status epilepticus, MRS showed strokes in lobes\n\nMy Daughter is 21 months old. At 3 weeks she had open heart surgery for Shones Complex. After an attempted extubation following surgery she went into cardiac arrest and the doctors performed CPR for 2 1/2 hours on and off. She was in status epilepticus and an MRS showed a strokes in 3 lobes. Her seizure meds(phenobarb and dilantin ) were stopped 1 year ago- when she was about 9 months. She had some mild gross motor delays but from a neurological standpoint, overall she is doing great. She has now been diagnosed with acquired microcephaly . She has always been Failure to Thrive with no known GI issues. Her HC is 17 1/4, height is 31 3/4 and weight is 19lbs. I have started noticing signs of possible petite-mal seizures with the worst lasting about 15-20 sec. My question is: Does Acquired microcephaly tend to be degenerative or regressive in nature? She has hit most milestones to date, but is it possible that she will regress? Also, are the petite mal seizures a result of the microcephaly and can these turn into grand-mal? I have read that the severity of microcephaly and its relationship with developmental delays can correlate with overall growth percentiles. Is it possible that her lack of appetite is caused by the microcephaly and be making it worse at the same time?",
    "doctor_response": "Hello and welcome to Healthcaremagic.com. This is going to be a rather long answer.  Please bear with me as I talk through this.  I will also quote a study on this disease process from a journal, Pediatrics.  The article is entitled Acquired Microcephaly: Causes, Patterns, Motor and IQ Effects, and Associated Growth Changes. Acquired (also known as progressive) microcephaly is a condition in which a child's head circumference is within the normal range at birth and for an undefined period thereafter but then does not increase as fast as normal and, as a result, crosses percentiles to below the second percentile. In our experience, this is a relatively common form of microcephaly. Although there is extensive literature on microcephaly, there is little on this subtype. Recognized causes include acquired brain damage as well as Rett syndrome, Angelman syndrome, Down syndrome, and other rarer syndromes, but these account for a minority of cases. There are also differing head growth patterns for children with microcephaly, which have not been studied. As a result, there is no currently available information to give to most families whose children show acquired microcephaly. This is the first attempt to study acquired, or progressive, microcephaly systematically. Causes were divided initially into multiple subgroups, but a final review allowed these to be simplified into 5 groups, defined as follows: (1) idiopathic, that is, no cause could be recognized from the history, examination, or investigations, and there were no other abnormal findings; (2) familial, that is, a parent and/or sibling had a head circumference at or below the second percentile; (3) syndromic, that is, with associated anomalies; (4) symptomatic, that is, following a pathogenic event; or (5) mixed, that is, \u22652 of the aforementioned. My understanding of this disease process as it relates to your daughter is that she falls under the category of symptomatic.  Following her cardiac event and the subsequent CPR, she developed a brain injury.  This is evidenced by the MRI showing lesions in three lobes.  The brain injury most likely resulted in the epileptic state.  Her petite mal seizures are a result of the injury.  Her acquired microcephaly is most likely also caused by the brain injury. The microcephaly your daughter has does not appear to be regressive in nature.  There is a correlation between acquired microcephaly and a failure to thrive.  The study shows there is a correlation between head ",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for the lower abdomen pain?\n\nhi!im having on/off sets of pain in my lower right abdomen,doctors found some blood in my urine.my lower belly,right under my navel towards right ,feels very hard,...what could it be?some doctors have sugested catscan and ultrasound...but i would like to know what are the causes for these symtoms",
    "doctor_response": "Hi.The on/ off pain in the right lower abdomen with blood in urine and hardness in the area you have mentioned is suggestive of appendicitis or an impacted stone in the right ureter. Ultrasonography helps to get a proper diagnosis and also the CT scan helps to confirm the diagnosis. Once this is done and you get a proper diagnosis , a proper treatment - medical or surgical can be started. Hence the need of investigations. This is not to misdiagnose the case. Go for these investigations ...",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat lump on my head as i hit myself?\n\nI fell over about a month ago. I knocked myself out and apparently had 2 seizures while I was being carried to my bed. I ended up with a very large lump on my head as I hit a tile floor just above my right eye. About a week after the incident I have been getting pain in my head and a feeling as if something is moving around in my head. I am very worried as it is now a pain that moves from the point I hit around my head in waves.",
    "doctor_response": "hi.it is best if you follow-up with your doctor, preferably a neurologist, and ask for a skull x-ray or head ct-scan just to be sure that there's no lesion (such as hematoma or contusion) in the area. management will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can shortness of breath and uncontrolled hypertension be related?\n\nmy granny has been operated for CABG IN 2007 at the age of 75. at present she is having shortness of breath, with uncontrolled hypertension. she is on tb.clopivas 75mg, tb. catdace 2.5mg,  tb. betaloc 50 BD, tb zivast 10mg. her BP is consistantly high as 190/110mmhg.what should i do?",
    "doctor_response": "Hello,First of all her hypertension is very high which requires treatment. Her shortness of breath might be due to congestive heart failure. She needs to be investigated (blood tests, chest xray, echocardiogram) for it and treated if positive for heart failure. Suggest seeing a cardiologist for both the hypertension and the shortness of breath.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes black spot below neck after recovered from staph infection?\n\nI had a staph infection that cleared up two weeks ago using four weeks of a sulfur drug. now i found a similar looking thing just below my neck, it has a little black spot that looks like puss around it and very redit is also itchy. what should i do?",
    "doctor_response": "HI, thanks for using healthcare magicIf the infection has recurred then you may need to take another course of antibiotics.The presence of the infection can be confirmed by visiting your doctor for an assessment.You may need a swab of the area.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Small white round spot on the right side of nose with some itching\n\nHi! I have this small white round spot on the right side of my nose. The edges around the spot are slightly brownish and sometimes it does itch quite a bit... I also feel like it grows at times...I've had it now for a while at least 1 year. It's hard to see but I can defiantly see it even thru my make up at times. Thank you for your help - Claudia",
    "doctor_response": "Hello,Thanks for the query,You might have developed fungal infection.Please get a KOH mount done,This can confirm the fungal etiology.Treatment can be with oral antifungals as well as with topical antifungals.Please meet a dermatologist for exact diagnosis.Let me know if you have any other doubt.you can ask a direct question to me on this forum, following the below link.  you a good health.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I donate kidney in diet controlled hypoglycemia condition ?\n\nI have diet controlled hypoglycemia (before I knew what it was I had a few seizures ), can I still donate a kidney?",
    "doctor_response": "Hi,thanks for query.For  kidney donation  there has to be both normally functioning kindeys.Your doctor will do a series of testing before arriving at conclusion.Diet controlled hypoglycemia is not a routine thing,you should talk to your doctor about possible reasons. wishing you good helath.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does sluggishly progressive-20% mean in a semen analysis?\n\nHello doctor my semen analysis as follows liquefaction time >1hr color greywhite,volume 4.0ml viscosity-increased,reaction ph -8.0 sperm comcentration 36mill/ml motality rapid progressive - 25% moderately progressive-25% sluggishly progressive-20% nonmotile-30%agglutonation-nil,morphology -normal,fructose -present. is this normal?",
    "doctor_response": "Hi, Total motility of sperm is decreased with increased liquefaction time and viscosity. You need to get a direct check up with a urologist to rule out any infection or varicocele. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr B. Radhakrishnan. Nair, OBGYN",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy rash type bumps on chest,legs and back arms?\n\nMy husband has recently started getting itchy rash type bumps on his back arms chest, legs etc. they are random and sporadic. He has not changed soaps, was doing glucosamine but has done it for years, but he started really chewing tobacco alot (though he has in the past) it hasn't really left him with a really weird and unpleasant body odor. Could that also cause the rash?",
    "doctor_response": "Hi  i did review your concern. Smoking is a lot injurious health but it generally does not cause skin lesions. I would recommend you to consult a dermatologist and get the lesion evaluated as it might be indirectly related to smoking. smoking is bad for health and you can ask him to meet a counsellor for cessation program meanwhile. I hope this helpsGood luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white discharge from penis of a 17 month baby?\n\nI have noticed a white discharge from my baby boys penis this morning. It is not liquid but more like sticky sugar granules. The penis also seems red on the end. He has been grabbing his crotch lately but he is recovering from chickenpoxs and he often indicated that he needed a change because of the itching. He is 17 months old.",
    "doctor_response": "Hello, White discharge from the penis in a 17-month-old child can be due to urethritis, and urinary tract infection is sexually transmitted infections like chlamydia and Gonorrhea.-However, since the child is very small, the chances of sexually transmitted infection can be easily ruled out. We should investigate the child for urethritis or urinary tract infection.-Kindly do urine for routine microscopy test, and urine culture test.-Give more fluids to a child. An examination by a doctor is also necessary so that we may not miss any important findings.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Deepak Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in the feet and legs despite taking Gabapentin?\n\nI have been having severe pain in my feet and legs. I am a diebetic and been dianosed with nurophopy. I saw dr. salles in tullohoma for the first time and let him know of the pain i have been going through .i have been on gabapentin 600 mg. three times a day .He told there was no change in my condition from the last time i was there when Dr Capps was was there and to keep taking the medicine I was perscriped.That dianosis did not help my pain. Can you suggest my next step?",
    "doctor_response": "Hello,Welcome to Healthcare Magic.I have read your question fully and understand your concerns.Instead of gabapentin, you could try Pregabalin. Start with 75 mg once a day and then increase it to 75 mg twice a day. Based on pain relief, you could increase the dose up to a maximum of 300 mg twice a day. As you have tolerated gabapentin well, you should not find much difficulty in tolerating Pregabalin too.Another option is Amitriptyline; you could start at the smallest dose of 10 mg at bed time. Based on pain control, gradually increase to 50 mg at night. If you are still able to tolerate without side effects, you could go up to maximum of 75 mg at night. Side effects from Amitriptyline are dry mouth, sedation, gastric upset, light headedness etc. Many people are able to tolerate lower doses well.Both the tablets are prescription only medications, hence you would need to see a doctor for the prescription. I hope this answer has helped you.Thank youRegardsDr Sunita Sayammagaru",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can I control the hairfall and initiate regrowth?\n\nHello doctor, I am a 54-year-old woman. Around four to five months, I have been experiencing heavy hair fall in the frontal and lateral region. Since the past one year, I am also experiencing thyroid conditions (hypothyroid 6.40) along with stress and menopause (menopause onset was seven months before). I can notice new hair follicles but very less in number compared to hair fall (more than 100 at times). I have taken multivitamin tablets for a month. Now, I am taking menopause tablets. I have been applying onion, aloe vera, and ginger oil for the past two to three months. Also, I am consuming yogurt, milk, dry fruits. Kindly suggest some measures to arrest the hair fall and initiate hair growth. Also, suggest dietary restrictions and additions if any. I am a housewife and mainly do household chores, though nothing significant.",
    "doctor_response": "Hello. I understand your concern. Thyroid issues and stress causes hair to fall. Please send me images of your scalp to assess your hair loss better and help you accordingly. Meanwhile, you can start using this. Kindly consult your doctor to discuss and take the treatment with consent. 1. Anaboom anti-hair fall serum on the scalp once a day. 2. Tablet Keraglo Eva once a day. 3. Keraglo-AD shampoo thrice a week apply on the hair for 10 mins and wash off. Also, get the following tests done 1. Hemoglobin. 2. Serum ferritin. 3. Vitamin D levels.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes asymmetrical rib cage in children?\n\nMy 13 year old daughter just showed me that the bottom of her rib cage is not symmetrical. It seems that in the lower portion of both sides, the ribs are curving inward a bit more than what is normal and on one side the exaggerated inward curve starts about one rib higher than the other side. I don t know if this is a change in her rib cage or something we have never noticed before. Her dad has a rib cage deformity on one side, closer to his mid-chest that is nothing like this (his is more of a protrusion) and was told it was from years of breathing difficulties from childhood asthma. I can t imagine they are related, but I thought I d provide the info anyway.",
    "doctor_response": "You are correct in assuming that the condition in the father and in the daughter are probably unrelated. What your daughter has, to use jargon, is pectus excavatum - or, in English, an excavated chest. This is probably present since birth, and has got exaggerated now that she is growing fast. You shouldn't worry about it, as it is just a minor disfigurement, and will not affect her in any functional way. Regards.Dr. Taher",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could pain in penis glans and ring with darker penis colour indicate phimois or ballanitis?\n\nI consulted a doctor here and he said I may have Phimosis. I am also experiencing pain over my penis glans and the position where the foreskin rests after stretched back (Ring). Doctor said that it can be Ballanitis. (No itching and no pain while urination) I apply coconut oil twice a day after stretching my foreskin. (As per the advice of Urologist) also he gave me these two tablets: Pregabalin Capsules IP and Vitamin E. I never used to monitor the penis color seriously but after applying coconut oil, it feels that penis is turning dark. Is it due to pain? or tightness of foreskin? I am just too bothered. I am having a very bad fear of cancer of penis by which I am very depressed. Family doctor said without inspection that penis color is usually darker than normal body color. Please help me to come out of dangerous depression. Thank you",
    "doctor_response": "HIThank for asking to HCMYou have became too much conscious for your genital, in fact what ever the thoughts that are coming in your mind that could be because of you fear, in fact that is not true, this is not any kind of disease, stop applying the oil this could cause fungal infection, just keep the area very much clean, your problem will go away soon, hope this information helps you, take care and have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Undergone lung surgery, recovery slowed due to enlarged liver. Safe to stop pain killers?\n\nI am into 3rd month after lunge surgery, I had stage 3 small cell cancer, surgically removed via 3 small incisions. my recovery is slowed down now because of enlarged liver, iam still on pain killers. tec 3 was on high doses of tramadol with accetiminephen.... I think its the accetimeniphen ,am I safe to stop pain relief? or switch to ibruprofen??",
    "doctor_response": "Hello; Are you sure your tumor is small cell lung cancer? Because recommended treatement for small cell lung cancer is radiotherapy and chemotherapy not surgery. And are you receiving these treatment. Small cell lung cancer has high chance of spread to liver- have you undergone  test like ultrasonography or CT scan of abdomen for test of liver? Regarding pain medication if  your pain is well controlled you can stop tramadol/acetaminophen and switch to ibuprofen. Discuss with your oncologist regarding changing drugs. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for baby having low hemoglobin count/high pressure in lungs\n\nHi, I have a new born kid of 42 days old. He is having problem of 1. Lungs pressure is high average 60 to 70 - could not trace the basic cause 2. Low haemoglobin count - which is 7 currently We are based in Kerala and have consulted in Amratha Hospital. Please advice as we are worried.",
    "doctor_response": "HelloWelcome to health care magicis there any breathing problem in new born baby? is there any bleeding from any site?wether baby is sick or active.it may be physiological anemia of infancy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Mitomycin C 80mg appropriate for me?\n\nHi This past December I gad a turbt for low grade superficial bladder csncer I was told then no further treatment was necessary except the cystoscopes q3momthsy My first one inarching was negative. No sign of recurrance My second cysto in June showed a 1 cm area of inflammation I had that biopsied .that came back as the same. Pappillary superficial Now he has me on mitomycin c instillation every week for 6 weeks My dose is 80mg. Is that. Lot. What s the average amount",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have superficial bladder carcinoma with recurrence.  So you should take chemotherapy or radiotherapy.  Mitomycin is useful chemotherapy in bladder cancer.  Dosage  depends on many factors.  Consult your doctor and take accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does difficulty in remembering the names of long-standing people indicate?\n\nI seem to have had a brain problem - I have not remembered what happened, all I know is that I find it very difficult to remember --- It seems that my mind has caused it extremely difficult for me to remember peoples names that I have known for a very long time. I know in my mind the people names, but I cannot say that person s name. Does that sound weird?",
    "doctor_response": "hi and thanks for question. memory r two types: short term and long termshort memory lasting from 10 sec to 10 days.long term memory is lasting from 10 days to years. if u r doing repetition of something than it goes in long-term memory. but sometimes it will difficult for us to find that thing in memory because it lost connection in mind or we not remembered the word which associated with it.so don't be panic, just try trick to store memory which will helpful very much. trick r make a numeric, story, arrange in some pattern that easily remember. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for swelling & bruise on arm due to an injury\n\nHi. I had a chair thrown into me last night to my arm and it is now swollen, brushed & grazed. I have cleaned the graze with tap water and coated it in Germolene, it stops hurting when that is applied but without it, it starts to hurt. What is the best way to treat it? Thankyou.",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain it seems that due to sudden blow here has been injury to the soft tissues of the arm along with laceration of the skin..Swelling is due to inflamed soft tissues along with accumulation of inflammatory fluid while bruising occurs due to rupture of superficial blood vessels due to trauma leading to accumulation of blood in soft tissues causing bruising and hematoma formation..I would suggest you to clean the lacerated area with antiseptic solution and apply a combination of antibiotic and steroid ointment over it..Do cool compresses over the swelling..You can take anti inflammatory painkiller like Aleve or Motrin..You can also apply Heparin gel over the bruise to fade the bruising faster..In case if you got the laceration that was contaminated with dust or dirt you should get a Tetanus Toxoid injection..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for chest pain due to bumps on lungs and kidney?\n\nhi my friend had tuberculosis last year he was in hospital for 3 months he got over but this year he started getting some chest pain he did a scan on his chest they said he has some kind of bumps on his lungs & kidney has this every happen to any of your patients  & how did u deal with it",
    "doctor_response": "Hi,As you have explained the history, it depends on what kind of bumps are they.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Jnikolla",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can be the reason for low Hb in a 65 year old?\n\nHi doctor, My mother is 65 years old. She got tested for hemoglobin and fasting blood sugar. The results are 5.20 g/dL and 123 mg/dL respectively. The hemoglobin level is alarming. Three years ago, she had same hemoglobin level. She was admitted for a week and two units of blood were transfused.\u00a0What to do now? Please guide.",
    "doctor_response": "Hi. I can understand your concerns. Follow up with further information to a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intense pain in the right wrist?\n\nI am a 60 year old male. I ve been having a problem with my right hand. I m experiencing a lot of pain in my wrist for a couple of days, especially on the palm side and my hand is numb and tingling. The hand wants to rest in a semi closed position and it hurts when I open it or try to make grip anything.",
    "doctor_response": "Hi, there!Your description makes me think about carpal tunnel syndrome (CTS).You can suffer from burning sensation at night and finger numbness.Electromyography scan can measure nerve conduction and confirm diagnosis for choosing further treatment (physiotherapy or surgery)I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the following semen analysis report suggest?\n\nlHaii sir good afternoon iam arun and iam married it has been 3years we are trying for baby so we consulted a doctor so i done my sen analysis finally Report came as motility ass 20% and non moltile 70% sluggish 10% and concentration as 22milions per ml and now iam intaking progeniex tablets is it gives better performance in my case please guide me to have a baby and is it iui gives best result if we go for that process",
    "doctor_response": "Hello,In your case sperm count is fine but problem is with motility. Usually, if period of abstinence before you produce the sample is too long there might be chances of sample being less motile. I hope you have given this sample with abstinence of 2 to 4 days and not more than that and we cannot conclude semen analysis with just one sample.Coming to present report if it is right, for any treatment for abnormal semen analysis medication should be taken for 3 months as production of sperms take 3 months treatment for increasing motility should include vitamin E, vit C, zinc and co enzyme Q10.And yes IUI is one of the best option if the motility is low or have low count as the sample is washed and processed so that good swimming sperms are chosen and debris is discarded and this sample is directly placed inside the uterus, definitely, increasing chances of pregnancy when compared to natural method.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Avanti Sathineedi",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to avoid smoking while being asthmatic?\n\nI have asthma and have to avoid smoke. My family who knows this don t believe asthma is that serious and as long as they smoke outside I shouldn t complain. they smoked outside an open door Thanksgiving and I am still suffering. I wonder if I will ever recover. As soon as I realized there was smoke I left, but it was too late.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. So basically you want to prevent second hand smoking. Best for this is to wear face mask all the time people around you are smoking. Take those smokers to rehabilitation center for smoking deaddiction. Take your asthma drugs regularly. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes night fall?\n\ni am 31 years old, height is 5 ft. 8inch, weight is 75kg if i am suffering night fall or day fall due to over excitement, watching romantic movie, is there any problem i masturbated before 10 years ago but now without masturbating i have discharging automatically 2 to 3 times in a month so i want to is there any problem",
    "doctor_response": "Dear userWe understand your concernsI went through your details. A NIGHT FALL / nocturnal emission / wet dream or involuntary leakage is an involuntary ejaculation of semen that occurs during sleep or along with urine while urination. Studies show that approximately 83% of men experience a nocturnal emission or leakage at some point in their lives. There is nothing wrong with a person if he or she experiences a nocturnal orgasm or nocturnal emission or leakage, as they are normal and healthy experiences. If you have experienced a wet dream, you should not feel ashamed. There is no way to prevent nocturnal orgasms or emissions from happening. If you require more of my help in this aspect, please use this URL. XXXX. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bony lump on collar bone?\n\nI am a 63 yr. old woman, 5\"9\" and 140 lbs with very slight osteopenia in the lower spine.  Otherwise no health1 issues.  About a year ago I started to n0tice a bony lump on my collar bone .  The doctor did a scan on it and said it was a sort of arthritis.  The lump is getting larger.  Should I be worried?  It doesn't hurt but is unsightly.",
    "doctor_response": "Hi,Thanks for the query to HCM.-I studied your query in depth and understood your concerns.-Cause and Treatment-of the bony  lump on collar bone-is mostly due to arthritis as told by CT scan report.As its growing -a-use cold compressesb-Tb NSAID x 10 daysc-Tb Pan 20 mgc-Orthopaedic consultation -to resolve any worry for TumourThis would help you to plan treatment with your doctor.Don't worry and things will settleHope this would resolve your query.Welcome further for any query in this regard.Wishing you a fast recovery.Don't forget to Write a good review ASAP.Have a Good Day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of lump right in the middle of the chest?\n\nMy son has a hard quarter sized lump right in the middle of his chest.  We just noticed it and he has said that his chest hurts of and on for some time.  He plays soccer and he says lately he can't do things like chest the ball without pain.....butT other everyday things don't bother him.  He is sixteen and he does lift.",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.Since your son is a player and young he may not be remembering the minor injury over the chest ( they are not expected to ) . This causes the scar , as you have described. Your Doctor may give anti-inflammatory medicines to start with . He may need a local injection of steroid. This helps a lot and may resolve the problem for ever.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dizziness, MRI showed vitamin d.  Cure for symptoms?\n\nI have been suffering from dizziness for 6 months now and iv had an MRI that's come back clear and lots of blood tests that's only shown I have low vitamin d but have pills for that and iv seen a ENT consultant but he didn't do any tests on me or anything he just said there's nothing to be done but I was wondering if there's anything else I can do to find out what the dizziness is and how to cure it it's getting me really depressed now to the point that I can't cope?",
    "doctor_response": "HIThank for asking to HCMIt is not the cause of dizziness that you have low level of vitamin D, this could be functional one, the MRI and ENT opinion does not ruled out any thing so it can be said that this may be due to some depression, you better consult to psychiatric for better management, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What infection of testis my son is having?\n\nmy 10 years son was having pain on the right side of his femur, first my son say the pain will start by hip joint/pubis symphysis and going down to his knee so yersteday I took him to his pedratician and she say he had an infection around his testis. she told me the name but I forgot. can you tell me the name of the infection, it was something like sperm...... the skin around that was kind of red and swollen but he can t remember being kicked by someone or playing rough. what can I do to avoid him having the same prblem, and is it going o affect him later im life like having kids? thaks for your answers, Florence",
    "doctor_response": "Boys have a cord like structure that is in the groin and called spermatic cord.It carries the blood vesses and the tube for the sperm.Ther are 3 possibilites,your son has a bacterial infection in the testis,structure above testis or this cord which causes swelling and pain..Right now the doctor will give him pain killeers and antibiotics .its a must and he should rest .You can have a simle ultrasound done and in case swelling persists may need CT .Best of luck .should subside soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bump under the eye after removing the cyst?\n\ni just got a small cyst removed under my left eye. 7 stitches. got them  Stitches removed after 3 days. There is a little bump on each side  where the stitches started and ended or where they the scare starts and ends. is that normal if so will it go down after time?",
    "doctor_response": "Hi,Nothing to worry, this type of swelling or bumps on wound site is common due to some induration and healing process going on.After about 5-7 days all swelling will subside.If there is pain, redness or swelling is there then consult your doctor to rule out any local infection.Apply antibiotic cream locally.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for wheezing in chest\n\nhi.my mother is 80 years old she dont have a asthma attacks. but she is sick with breathing problem like veezing constentley veezing sound please help us what to do she is a high blood preasure problem plus once she gol a low sugr problem tn this case take her to the emergency please dr. tell us what to do",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Wheezing in an old (80 years), hypertensive female can be due to hypertensive heart failure and bronchitis. So better to consult doctor immediately and get done 1. Blood pressure monitoring, ecg and 2d echo to rule out heart failure. 2. PFT (Pulmonary Function Test) to rule out bronchitis. If it is heart failure then she needs strict control of blood pressure, diuretics and other cardiac drugs. But if it is bronchitis then she needs Inhaled bronchodilators and inhaled corticosteroid (ICS). So don't wait at home, consult doctor and discuss all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant pain in the arms while suffering from sciatica?\n\nBoth my arms for the past 2-3 weeks feel like there is a blood pressure cuff on them and some one is squeesing them and won t let go. It is constant with verying degrees of pain. I work out somewhat on a regular basis and don t remember doing anything at the gym that would cause an injury. My core is good but I do have a sactic nerve problem for the past 2 years that comes and goes. Any ideas?",
    "doctor_response": "Hello,It looks like you have a problem in the neck where the nerves of the arms have the origin. You may have a cervical herniated disc that compresses the nerves and causes numbness in the arms. I suggest that you do an MRI of the neck to rule out or confirm this diagnosis.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Edvin Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes an enlargement of the spleen?\n\nMy granddaughter who is 9 (Type 1 Diabetic) was recently admitted/discharged diagnosed with a kidney infection.  While ruling out appendicitius, they found evidence of an old legion (maybe from an enjury ? ) on her liver. Her liver emzymes were abnormal.  Yesterday me SIL went to the hospital and got results from a ultrasound.  They found that her spleen was enlarged, she has gallstones, some mention of sphreositosis (SP?) and her uterus is small. Diagnosis consistent with sicle cell anemia.  We do not know if her doctor is even aware of these reports yet.Could you please explain the meaning of the report?",
    "doctor_response": "Hi there,I'm sorry your granddaughter is having some health issues. Let me explain each item in the report with the information you've provided me.   Spherocytosis are abnormal types of blood cells that are round instead of the usual disc shape. This can be quite common in patients with sickle cell anemia, as the body pushes out immature red blood cells due to the shortage of normal functioning blood cells. The spleen digests red blood cells that are normal, and in cases of sickle cell or other hematologic disease, can become enlarged due to the fact that it is working harder.  If your granddaughter is very anemic or having low platelets, sometimes a splenectomy (removal of the spleen is warranted). If she's not having any difficulty with anemia or bleeding, then leaving the spleen in is an option. When red blood cells get broken down at an increased rate, this can cause gallstones to form in the gallbladder, which can also cause liver enzymes to be elevated. I don't believe that her kidney infection or type 1 diabetes are related to her sickle cell anemia, but if she's having recurrent abdominal pain (sickle cell crisis) and gallstones, it may not be a bad idea to consider having her gallbladder and spleen removed at the same time.Finally, a small uterus is nothing to be concerned about in a 9 year old. This sounds like an incidental finding.  I hope I have answered your questions. Please feel free to contact me should you have any further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest fluttering intermittently?\n\nI have a fluttering in my upper chest all day yesterday unless I was active usually could tell when I was sitting, today not as bad but still notice it, I had these all my life usually come and go pretty fast but last todays it has stayed has me concerned..",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.Chest fluttering should always be evaluated for arrhythmia (rhythm disturbances in heart).So consult cardiologist and get done ecg, 2d echo and Holter monitoring (24 hours continuous recording of Ecg).You may need anti arrhythmia drug if Holter report is showing abnormal rhythm.If all these are normal then no need to worry for arrhythmia or other heart problems.Sometimes stress and anxiety can also cause similar symptoms.So avoid stress and tension, be relax and calm.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure black spots at the roof of the mouth?\n\nMy son is 17 months old. He has black spots in the roof of his mouth. I saw them the other day and just thought it was from an M&M he had just eaten, but today he was laughing and I saw them again. They are not near his teeth. they are in the pockets on the roof of his mouth.",
    "doctor_response": "Hello Dear,I have gone though your query, I will try to give my best possible advice. First of all be relaxed.Nothing to worry about now, It may be due to pigmentation or bruishes or it can also  be birth mark which you didnt notice yet. What you have to do is to just keep a watch over that black spots regularly, if they change in shape, size or color, they need to be evaluated by a dentist.\u2022 Hope this will help you. If there is any more query or question regarding this in your mind, you are welcome to ask me any time. Take CareRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does faint fetal heartbeat mean?\n\nI have just had an ultrasound where they said I am 7wks 2days pregnant. They had trouble seeing as there was a lot of bowel gas & initially said that the baby had no heart beat but eventually found a faint heartbeat. Wot does this mean? Am I at a greater risk o losing the baby. I have had no pain or bleeding.Also is 7weeks 2days the lenght of time since the first day of my last periiod? As I am almost positive my period was earlier. It s so hard for me 2 work out the conception date as I do not alwasy have 28day cycles? Please help?",
    "doctor_response": "Hi,welcome to HCM,first of all congratulations on this new adventure in life. sometimes while doing a scan you might not be able to appreciate heart beat due to bowel gas and other interferences. That can cause such finding but I would suggest you to not get any negative feeling and a repeat scan after 2 weeks is needed to make any confirmation. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes increased RBC count?\n\nI am 24 yo female and 5'1 in height, last week i am under prednisone theraphy for my allergy.. and i am also taking Multivitamins + iron, i had a Medical exam last friday and they found out that i have RBC result of 6.63, that makes my Medical pending.i am applying abroad..",
    "doctor_response": "Hello, Thnx to contact us. I understand your concern. If I am your doctor I advice you that this is polycythemia, a medical condition where RBC count and hemoglobin increases. There are many causes of polycythemia it is necessary to have full history and examination to rule out the exact cause of the disease. kindly visit nearby doctor to rule out the condition.I will be happy to answer more of your concerns, kindly know me,Wish you a very good health at health care magic. Dr. Arun Tank. Infectious Disease.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the recurrent red spots and fever in a child?\n\nMy baby has lots of red spots all over the body that faded and has came back within a couple of hours...has been running a fever of100.5 since yesterday morning... I first thought chicken pox but when they faded I didn t think so anymore...what could it be?",
    "doctor_response": "Hi....this could be a viral exanthem. Its very common for viral infection to cause red rashes like this. Unless she's very lethargic, not passing urine well or having respiratory distress or having generalized body swelling you need not worry. Just give paracetamol in the appropriate dose and give her plenty if water to drink. She will get better.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mother gets angry, shouts unnecessarily suddenly. On Donplus. Reason for such behaviour?\n\nhii sir my name is ajay.my mother name is van,actually my mom has a problem mentallyy,she will talk unnecesarly and shouts suddenlyy,in some times she would be very normal condition,and in some times she behaves very anger,,my dad take her to some doctor,,but she behaves like that onlyy,,,my dad is giving a tablet to her the tablet name is DONPLUS,,IS there any solution to cure her,,and whgat is the problem to my mom,,from my child hood she is not like that in the middle she became like that,,please help us sirr,,",
    "doctor_response": "It needs detailed history. The information you are giving is insufficient. Nearby psychiatrist may answer your query. It may be a part of personality or the illness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for growing boil on tongue\n\nheloo sir..mu mum has a liitle white boil in her side of the tounge..before i month it was very small but now the boil has been growning liitle bit from the last time..we could nt find the proper solution..is surgery is required ? plz help me..and give me ur suggestion",
    "doctor_response": "Thanks for your query, I have gone through your query.The white boil or lump could be a traumatic fibroma or a frictional keratosis secondary to chronic irritation by the sharp cuspal edges of the teeth. Nothing to worry consult a oral maxillofacial surgeon and get it removed surgically. it is a simple procedure, done under local anesthesia.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medication for cough\n\nHi my name is Velita I've had a bad cough and my ribs have been hurting a lot. Well just a few minutes ago my ribs on my right side made a pop sound and now i'm in a lot of pain. It hurts to move and kind of hard to breathe. So i'm wondering what I should do and what the seriousness of it is",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. By your history and description, possibility of either bronchitis or lung infection is more in your case. So better to consult doctor and get done clinical examination of respiratory system, chest x ray and PFT (Pulmonary Function Test). Chest x ray is needed to rule out lung infection. PFT is needed to rule out bronchitis. You may need antibiotics, antihistamines and inhaled bronchodilators with inhaled corticosteroid (ICS). So better to 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is an adenocarcinoma?\n\nMy father was diagnosed with adenocarcinoma of the colon with mucin-secreting signet ring cells with malignancy, at the age of 63 and was immediately advised to undergo surgical resection, but unfortunately passed away 3 days after surgery due to cardiac arrest. He did not have any other medical conditions such as diabetes, hypertension, or such. I am 36 years old and I am worried if this is a genetic condition and will I be inheriting it? Please advise what precautions I should take.",
    "doctor_response": "Thanks for your question on HCM.Adenocarcinoma of colon do have genetic tendency but not as much as testis and prostate and breast cancer have.So no ned to worry much.I am giving you some investigation s that you should regularly get done once in a year.1. Stool for occult blood2. Ultrasound of abdomen3. CEA level4. Colonoscopy Eat healthy, avoid junk food and drink plenty of fluids. No need to worry much.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should the bilirubin be  having been detected with jaundice?\n\nI have been detected jaundice before 15 days and my Bilirubin serum was 5 and SGPT was found to be 600.Yesterday I had a blood test in which SGPT was found to be 100 and boilirubin serum was reduced to 2. I have to join the hostel from 16 th august 2011 and my diet is surely going to be disturbed. Will it be suitable to take the hostel food???",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. you have jaundice with high sgpt level. It is improving but still you should take of your diet. Because diet is ghe main treatment of it. You should take high protein and low fat diet. So you should avoid hostel food for few days. Once your liver came back to functioning properly then you can take it. So take of ypur diet for fee days.Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I dream about the same guy every night from two years. I am scared. Please help.\n\nHello doctor, I have been having a dream about a guy since two years. Every day it is the same. I wake up in the middle of the night even before I can see his face and am unable to fall asleep after that. I am scared, but do not know where to go or ask for help. No one will understand me if I tell them about this. Please help me.",
    "doctor_response": "Hello. You are having bad dreams also known as nightmares. It is a type of sleep disorder which is treatable. Maintain proper sleep hygiene, that is, maintain a proper routine. If you still having the same problem, you can take tablet Zolpidem after consulting a psychiatrist. For more information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe pain in the area between testicles and anus\n\nHello,I have a great amount of pain in the area between my testicles and my anus.  The muscle there from about the end of my butt to the bottom of the scrotum in extremely sore and swollen.  May even be some slight bruising.  It hurts to walk, lay down, and sit.  The only time I don't really feel anything is when I'm standing.  I have no idea how this occurred.  I began playing basketball on monday and wednesday of last week and I did not stretch.  I just started running.  I did not feel any pain afterwards.  Then, on thursday afternoon I began feeling some discomfort and then beginning friday afternoon I began experiencing a lot of pain, tightness, and swelling and since then it has been a progressing or steady pain and the area is still swollen.  I'm not sure what happened.  Do you have any idea?  Or any idea how I can get better by myself because I currently don't have the insurance to cover me and anything I can do on my own to relieve this pain will be greatly appreciated.  Also, do you know what that muscle is called?  I don't think its the groin because my inner thigh or the muscle that is between my leg and torso are fine.  It basically feels like a pulled muscle under my scrotum and in front of my anus and on the left side of the line of skin that runs from the bottom of the scrotum toward the anus.  Please Help! :)",
    "doctor_response": "Hello, We have to rule out possible causes like peri-anal abscess. Consult a general surgeon and evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest appropriate treatment for typhoid\n\nsir i was suffered typhoid 10 days earlier and doctors was suggested me to admit in a hospital because in widal test he found typhi o 1:160 positive and typhi h 1:80 and i was admitted . after given 6 days treatment they discharge me and was also suggested me to take oflox 400 tablets for 7 days. after taking 7 days course i felt illness , weakness , headache and constipation etc. sir, i am really very disappoint and i didn t understand what to do i just want to know whether my treatment is wright or not can you suggest me any test or tablets so that i can overcome with these disease.",
    "doctor_response": "Hello,Thank you for your contact to healthcare magic.I understand your health concern, if I am your doctor I suggest you to do typhidot test. It will diagnose whether you have active typhoid or you are treated with typhoid. Ig M antibody band shows it to be active infection and IgG antibody band shows it to be the treated infection. If you have active infection I suggest you to do culture and sensitivity testing from stool and blood for salmonella. Take the treatment according to the sensitivity report. Many bacteria have resistant to many antibiotics prescribed. Once you take the treatment according to report your infection will be treated gradually. Take the complete treatment that will help you for complete cure.I will be happy to answer all your future concern. Thank you,Dr Arun TankInfectious disease specialist.Wish you a best health at health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the meaning of homogenous density and fibrolinear densities shown in chest X-Ray?\n\nMy friend had undergo medication for about 9 months.on her findings she has a PTB on her right upper lungs.on her rescent chest xray,the doctors findings,homogenous density and fibrolinear densities are seen in the right upper lung,the right costrophenic sulcus is shallow.is this mean that her lung gets worst?",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your friend's situation. His x ray report is suggestive of old, healed lesion.He has taken 9 months of anti tb treatment. So the lesions on x ray must be healed.In lung tuberculosis,  healing occured in the form of fibrosis and calcification. So fibrolinear densities in his recent chest x ray are mostly due to healing of old tb lesions.But better to get done sputum examination for AFB and bronchoscopy to rule out active tuberculosis.  If both are negative for tuberculosis then no need to worry for worsening of tuberculosis. Opacities are due to healed tb lesion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for fever\n\nHi My child is 4 1/2 years old.He had a fever of 101 at 4pm so we gave him crocin 8ml.After giving crocin also the fever came up again to 101.5 at 8pm.So we gave him a dose of Meftal 6ml.At 12:30 am now there was a high fever of almost 102.05 so we sponged him and also gave another dose of Meftal.The fever has still not gone down below 100 and is changing frequently.He is breathing heavy as well.Can u suggest what should i do incase the fever rises up again.",
    "doctor_response": "Hello,Fever of a 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 two fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably a viral illness and it doesn't require antibiotics at all. Once the viral fever comes it will there for four to seven days. So do not worry about the duration if the kid is active. Paracetamol can be given in the dose of 15mg/kg/dose (maximum ceiling dose of 500mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.Hope I have answered your query. Let me know if I can assist you further.Regards,      Dr. Sumanth Amperayani",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat chronic liver disease?\n\nmy father aged 70 years. first he was diagnosed jaundice and later tuberculosis n now doctor says chronic liver disease. frm past two months he is tkng treatmnt. he is a non alcholic. doctor treated him with giving albumin. antibiotic. is it continue witha alopathy or change to ayurvedic. pl suggest",
    "doctor_response": "Hi thanks for asking question.You have not mentioned cause of chronic liver disease.Alopathy treatment can be good if specific RX given...You have diagnosed with TB .It can affect liver also.So AKT treatment for tuberculosis must be completed for required duration ..approx.six month .Meanwhile rest your liver with low fat diet.Fruits taken more...Do you have done your viral marker study??As hepatitis B or C can lead chronic liver disease.If apart from tuberculosis other cause suspected then liver biopsy might needed....Consult surgeon if required.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do cysts in head indicate?\n\nI have pancreatics due to a gallstone lodged in the common bile duct. This und happened last year and I have since had the body and tail removed, the spleen and the gall bladder. I am still having cysts on the head. they have found a leason on my liver. THe doctor had asked me to have a CA 19-9 and a MRI of the pancreas and liver. What could the docs be looking for?",
    "doctor_response": "Hello!Welcome on Healthcaremagic! I would like to review your brain MRI findings. Cysts can be related to different possible causes: -they can be congenital- related to infections like toxoplasma or ecchinococcus- brain metastasis can also mimic cysts- primary brain tumors cam mimic this image. Ca19.9 is a tumor marker, which helps investigate for cancer in the gastro-intestinal tract. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in walking after cervical epidural injection?\n\nI recently had a cervical epidural between my 6 & 7 vertibrea for help with headaches and pain in my arms and neck. I didn t know i had an adversion to steroids and since the shot 10 days ago i have become crippled. i cannot walk without the aid of a cane or help from another person. My whole body from the neck to my ankles feels as if my body is being crushed. i am loosing grip strength in my hands and my arms cannot hold any weight. i ve had to cut my hair off because the weight of it wet felt like my neck was breaking. My doctor cannot explain what happened or how to stop it. can you offer any advice?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. I think you should discuss with your treating Doctor the possibility of Arachnoiditis after epidural injection of steroids. It happens with accidental intrathecal injection ( a rare complication of the procedure). Treatment is symptomatic and very difficult. Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy rashes on the body along with diarrhea, cold sweats and nausea?\n\nMy son is 16 yrs old. This morning he woke up with a itchy rash all over his body.Now he is complaining that he has diarrhea, cold sweats, and nauseated.Took him to the doctor this morning, but they didnt know what was wrong.They gave him a Z pack steroids meds to take.Any suggestions?",
    "doctor_response": "HI, thanks for using healthcare magicThe most likely cause is a viral illness. Many viral infections can be associated with a skin rash, called viral exanthem which normally resolves with or soon after the other viral symptoms.Viral infections can cause diarrhea, nausea and cold sweats. In some persons, antibiotics such as the z pak may worsen diarrhea and nausea though this may not be the case for himI hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hollow sound in neck and stiff back?\n\nIf I move my back or neck from side to side it literally sounds like my spine is hollow and it is rubbing against something inside of it. Very hard to describe because the sound is faint and the sensation is strong. It is like a saw cutting wood the back and forth motion but in my neck and back. It is my spine. My back is in pain but not severe pain and only after not moving for long periods of time. It always feels stiff though; like I need to crack it to loosen up.",
    "doctor_response": "Hello,In my opinion, this could be a beginning of arthritis in your spine and I am afraid that you are used to cracking your spines for long time as this causes arthritis. Currently the solution is strength. Your muscles should be strengthened and your back and neck curves should be restored if there is any muscle imbalance due to weakness or tightness. A physiotherapist can assess you and give you a home exercise program with some manual techniques. Hope I have answered your question. Let me know if I can assist you further. Regards, Ayman Darrag, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes increase in creatinine levels while on Cefspan?\n\nHi My father is 82 years old and he is suffering from benign prostatic hyperplasia (BPH) since 2005. BPH of size 68 grams with vesical stone of size 37 mm. Last month he was attacked by hydronephrosis with UTI and his creatinine was 3.1 which was reduced to 1.7 after 30 days by inserting foley catheter. After 30 days his renal DTPA scan revealed that \u201cmarkedly reduced blood flow to both kidneys scintigraphically. The cortical phase images show markedly reduced tracer uptake in both kidneys. The delayed images show minimal clearance of tracer from both the kidneys in response to Lasix stress.\u201d Right Kidney GFR 15.7ml/min 42% Left kidney GFR 21.5 ml/min 58% after next 15 days creatinine was reduced to 1.2mg/dl and BUN was normal (before surgery). then doctor performed open surgery to remove stone.after surgery he was attacked by chest infection with wheezing cough and mucus.father was feeling so weakness even cannot sit. after 15 days of surgery he can walk and go washroom to pass stool but cathete is still inserted due to weakness. after 1 month of surgery last day father labs reports are these. serum urea is normal but his creatinine is elevated slightly 1.4mg/dl. his urine is cloudy with pus cells many 300 HPF, red cells 20-25 HPF and epithelial cells are a few. crystals are amorphous urates+ and protein is + question is why his creatinine elevated again? is thats because of UTI? he is taking medicine cefspan 400mg tablet daily since after surgery prescribe by Doctor.",
    "doctor_response": "As the age advances, the kidney function also will gradually diminish. After age of 65 years, kidney function will be reduced by 1/3 rd. Further, your father's UTI and BPH might also aggravate deterioration of kidney function. That is why there is a rise in creatinine level; anyway the persent creatinine level of 1.4mg/dl is not a very serious one; however your father has to be carefully followed to avoid kidney failure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for generalized anxiety disorder\n\nI am a 34 year old woman, in good health, except for being overweight (which I am working on through diet and exercise).  Lately I have been experiencing what I think are heart palpitations (either a fluttering feeling in my chest or, other times, feeling a strong pulse in some part of my body - temple or arm or stomach, etc), but (based on either taking my pulse manually or using an exercise heart rate monitor) there is nothing seemingly abnormal about my pulse - resting HR varies from about 57 to 67, and if I've been active just beforehand, near about 78-81.  I also get headaches, a sort of foggy brain feeling like I can't quite concentrate properly, knots in my upper traps which cause pain in my neck and sometimes down the back of my arm, and occasionally a fluttering feeling in my upper stomach.  Is this all just anxiety?  (I have been treated for generalized anxiety disorder in the past, but have not had problems with that for some time.) Or are these symptoms something to worry about?  I just had a physical and am waiting for blood test results, but my physician seemed to think there was nothing wrong.  I'm getting scared because these feelings won't go away.  Mostly, it's the palpitations that are so frightening - I'm young and don't want to die from a heart problem!  Thank you!",
    "doctor_response": "Hifirst of all i suggest you not to worry too much, as your physician thinks that you have no cardiological problem. mental stress will increase your symptoms. the symptoms that had given suggest you may have generalized anxiety disorder with panic attack. in panic attack some people have symptoms like sweating,increased urge for urination, feeling of impending doom, feels like dying and there is no way to escape.treatment- relaxation exercise propranolol, benzodiazpine like clonazepam, SSRIplease consult your psychiatrist/psychologist   Hope this clarifies  Regards  Dr Samrat",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of diabetes?\n\nWhat are symptoms of diabetics. I am a 63 year old black male in good health. A little overweight 5 11 tall 265 lbs, and I workout at the gym at least 3 times a week. My workout consist of heavy lifting deadlifts, squats, bench press, and some cardio. I sometimes experience blurred vision, uncomfortable eye feelings, eyes feel like they are buldging out of my head and I feel irritable and not my normal self.",
    "doctor_response": "Hello,Whatever symptoms you are talking about may be due to eye sight problem. Please get eye sight checkup and eye examination by a local doctor.Get assessed your sugar level through FBS (Fasting Blood Sugar), RBS (Random Blood Sugar) and HbA1c tests. Diabetes symptoms are excessive fatigue or urination or increased appetite.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Varinder Joshi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes green color stool in a child?\n\nhi doc, my name is hardeep, my baby girl is 6 months old i m giving her semi solid food and past 2 days she is passing green stool once a day, today i gave her pomegranate juice mixed with apple juice and she passed dark green stool few days i have been giving her dalya in tetra pack milk and she is consuming that milk once, she is passing lots of stool and its watery at times and she applies pressure, do i need to worry about this, she is not sleeping properly in the night, plz help",
    "doctor_response": "HiThanks for writing to healthcare magic.No need to worry.Watery stools is usually due to viral infection.ORS and zinc needs to be given for loose stools.Ensure she passes urine atleast 6 times dailyWishing your child speedy recoveryRegardsDr Arun",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are these bumps on my tonsil?\n\nHi doctor, I have two yellowish tint flesh colored bumps are connected on my tonsil. They form an alphabet \"B\" if you look at the side of them. They do not hurt and it is smooth with no irritation. I have had allergies and stuffiness for months now. I am really scared of HPV. I am a hypochondriac. I do not know when they showed, but I noticed them recently. I am currently on birth control pills and Claritin. I went to a dentist and he did not think that it is related to HPV. Please give your opinion.",
    "doctor_response": "Hi. Revert back with the answers to the above questions to an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chip fracture in foot\n\nMy daughter got an x-ray on the side of her left foot. They said that she had chip fragments. She is a level 10 competitive gymnast. They are having her do physical therapy for 6 weeks. I need to explain this to her coach, but not sure what to call this. Thanks Debbie",
    "doctor_response": "Chip fractures usually heal by 6 weeks still to confirm healing repeat fracture can be done. And since she is a professional we need to be doubly sure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain and numbness in knee?\n\nI keep getting sharp pain on the outside of my knee on my right leg. The pain feels similar to a tooth ache pain when a nerve has been exposed. The pain only lasts for a few seconds but is very sharp and painful. When i touch the area, it has a numbness feeling.",
    "doctor_response": "Hello,Your symptoms are suggestive of a pinched nerve (peroneal nerve). For this reason, I recommend consulting with a neurologist for a physical exam and performing nerve conduction studies. Surgery may be needed.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long will Trochanteric Bursitis take to cure\n\nI just found out that the pain in my hip is Trochanteric Bursitis and would like to know what to expect from this and how long does it usually last. This is what my doctor thinks I have, I also have a back problem. Does this have anything to do with that? He wants me to come back in a month and if I still have the pain he wants to give me a cortisone shot. Thank you, Margie",
    "doctor_response": "HiHope this msg finds you in good health.I have gone thru ur msg & understand ur concern. it usually takes a lot of time to heal.last option is cortisone shotFeel free to ask me a FOLLOW UP query",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does white substance in stools of new born mean?\n\nmy daughter is 10 weeks old and today (while my mom was watching her) she had a bowel movement. In the poop (which was brownish green in color) were flecks of white. She has been sick (a cold that required nebulizer treatments for several days and she had her 2 month shots and tylenol on Wed.) Is this something I should be concerned about? Should I take her to urgent care tonight?",
    "doctor_response": "Hi... this seems like a normal phenomena, do not worry.Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rashes on testicle?\n\nHi I have a bright red rash on my left testical that has appeared over the last week. It went from a slight red imflamation to now nearly a shiny blisterlike rash but is not raised. What could this be and how should I treat it until my dermatologist apt on THursday?",
    "doctor_response": "Hello and thanks for your question. The most common rash on the testicles is a yeast type rash. You could try some over the counter medication for yeast like tinactin or any other medication that says it is for \"jock itch\". It will not hurt anything to try this until you see your dermatologist. Good luck to you in finding a cure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are the cancerous sores in throat causing bumps in upper back?\n\nMy 15 year old son has a bunch of cancer sore type sores in his mouth and down his throat. This has gotten progressively worse since Monday. Now today he has developed a bunch of bumps that look kind of like Mosquito bites on his upper back (100 or more)",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. He has sores in his mouth.  It can be due to some infection or ulceration.  Chances of cancer sores are rare at age of 15.  He should go for biopsy of buccal mucosa to rule out any chance of cancer.  His bumps on back has no relation with sores.  It can be due to skin problems or other disease and it needs examination. Consult your doctor and go for examination. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pale eyes and skin rash patient with jaundice history?\n\nage:30years, height:5.3feet, weight:56kg medical history: mild jondouce, hypertension, current bio chemical values: hb 10.8, mcv 74, mch 20, mchc 28, ESR 35, LFT: T.billi 1.99, T.pro 8.4, Globulin 3.7, Hcv -ve, Hbsag -ve, LIPID PROFILE: NORMAL clinical signs: pale eyes, skin rash, acne from 2 to 3 years.",
    "doctor_response": "Hi welcome to HCM...Here you have microcytic hypochronic picture according to indices...Jaundice is also present....So here strong possibilities is presence of hemolytic anemia....There are various causes for it like thalesemia,sickle cell , spherocytosis , g6 PD deficiency , PNH etc.....For that peripheral blood smear examination done...Retic count also done...According to PS finding specific test needed like electrophoresis for hemoglobinopathy....Consult gastroenterologist for examination and subsequent investigation...Take care.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain during the blood transfusion after the plasma was taken out?\n\nmore than 6 months ago i attempted to donate plasma. when the blood was being put back, i was in such pain. the lady told me some pain may occur but after screaming in pain another woman came over and took the needle out. my vein had been ruptured and all the blood had just been distributed into my arm. the blood bank told me i would be fine and to not lift anything heavy. for months my arm was every shade possible. they kept on saying it was typical and that i was fine but now im having difficulty moving my arm after a long day of movement. i dont know what to do",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Such incidents never happens in blood or plasma transfusion.It is unusual incident that has happened with you.There is no treatment available for the blood being on the hand.It will be drained by its own without doing anything else. But please do not stressed the hand by weight lifting and other such condition.Please maintain good hygiene as it can prevent the infection. I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is tugain foam and finast together effective for hair fall?\n\nmy hairs on the scalp have started falling and thining a great deal..I worry them losing permanently ..Hence, i have started using Tugain foam(5%) along with finast 5mg(i tab). Will this turn out to be effective to the problem faced...How long do i need to continue with above medication.. rgds sunill",
    "doctor_response": "Hi,It seems that you may be having androgenetic alopecia. It is a hereditary disease. There may be hair loss from temporal areas and occipital area. The hair may be thin. You are taking finesteride 1 mg , continue it. You may apply 10% solution of minoxidil twice a day. Use shampoo of ketoconazole to cleanse the scalp. You may take biotin containing tablets like biot forte or biopecia forte.You consult dermatologist for firm diagnosis and perfect treatment.Have positive attitude and keep patience for the good result.I hope you got my answer.Thanks.Dr. Ilyas patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Depression, alcoholic, talks nonsense, thinks family is his enemy. Treatment for poor mental health?\n\nmy mama is got a mental depresion, he used to drink he drank for about 32years and now from past 5 months he left drinking after he under went de adiction treatment ,he is single now. The problem now is he at times talks things which are not related and thinks his sisters husband to b his enemy only when he is abnormal or else he is fine no other problems,he is an ex servise man",
    "doctor_response": "Hello Prabash, Please consult with a psychiatrist as your mama appears to be  suffering from a delusional disorder (delusion of persecution). This could be due to alcohol withdrawal.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recurring itchy, red swollen bumps, temporary relief with medicines, history of blood transfusion. Could that be related?\n\nHi I have itchy red swollen bumps like hives that keep coming back.have been to the doctor numerous times,and just get told its an allergy and given a dose of anti histamines.bumps are not itchy while takin the meds but are back as bad as ever once I m finished them.had a blood transfusion two and a half years ago following a c section,just wondering would it be anything to do with this??this is an ongoing thing for a year or more now.",
    "doctor_response": "Hello, A reaction (infectious usually) following a blood transfusion taken 2.5 yrs ago is unlikely and your urticaria will be controlled on long acting non-sedating antihistamines that need to be taken for 6 weeks at least. Blood tests such as CBC LFT TSH (thyroid profile) followed by Hepatitis infection screen (only if LFTs altered or clinically jaundiced) is indicated. Allergy testing is unhelpful in 80% of patients with urticaria. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have history of fatty liver. Started feeling pain in right side. What is causing this?\n\nHi, I m 25+yr, male . height 5ft 7inch, weight 56-57 kg. !.5 years back I had a liver prob. Doc. said that i have a fatty liver . Now I am staying outside home. and I m a s/w engineer. I sometimes feel a slight pain in my right side when there is any misroutine of diet and normal everyday life. Do I HAVE ANY PROB IN MY LIVER?? pLEASE HELP",
    "doctor_response": "Welcome to HCM!After reading your question, I can say  from my clinical experince that you should get an ultra sounds abdomen, liver function test, thyroid test, lipid profile, sugar levels done once again. Some times increased cholesterol and reduced thyroid can also cause fatty liver, so by treating these it can be cured. The symptoms of pain at right side when ever there is disturbance form routine diet, suggest that there can be a liver problem, may be fatty liver. Fatty liver also increases with consumption of alcohol, consumption of oily food, and junk food too.  Please take precaution while eating food outside, avoid spicy  and oily food ( there is significant oil/ fat in cakes, bread, sweets etc, read the ingredients to check!).Only after physical examination,  tests and investigation we can tell ten exact cause and treat it appropriately.For occasional pain and discomfort one can take -- Omeprazole twice a day, half an hour before meals, as and when needed or for a week. However, this is just symptomatic management and not curative.You don't need to be fearful, as fatty liver can be successfully treated even when you are staying alone with medicines and taking precautions in diet.Please meet a doctor.Hope the reply is useful for you and get well soon!Feel free to  ask more queriesDr. Manisha Gopal",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce the eosinophil count?\n\nHow to reduce eosinophil count ?  Eosinophil count in my blood is 4 which is out of range,As per text it should be 3 it seems,I am getting skin rashes and cough quite often,PLease suggest me some medicines and please let me know if I can do anything with my food habits. -gurdeep",
    "doctor_response": "Dear gurdeep,you have to be vigilant which food causes the allergy. If you identify any stay away from it. Count of 4 in eosinophil count is not alarming. you should also rule out any contact allergy. cough is because you are inhaling some allergens. You have to rule them out one by one. in the mean time you can use long acting anti allergic tablet available on the counter to relieve your symptoms.Dr. J. Ticku",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the difference between an acoustic neuroma and vestibular neuritis?\n\nWhat is the difference between an acoustic neuroma and vestibular neuritis. I was diagnosed with vestibular neuritis and had an MRI. It showed alight prominence of the nerve root complex in the IAC. My question is how does a inflamed nerve look compared to an acoustic neuroma. I have no symptoms of a neuroma and my VN symptoms have disappeared. Thank you",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. Acuostic neuroma is a benign tumor arising from nerve sheath of VIII- th cranial nerve occurring commonly at cerebello-pontine angle, vestibular neuritis is viral infection of the VIII-th nerve. Both have similar symptoms( disfunction of VIII-th nerve) but acoustic neuroma has also symptoms related to mass effect on brain structures. They are easely distinguishable on MR imaging (diffusion restriction signal in vestibular neuritis, acoustic neuroma grows into cerebello-pontine angle and is definitely bigger than the swelling of the nerve etc.) Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for abdominal pain and cramps\n\nhello, I have pain and cramping on my right side. it is mostly when I am standing? I had my gallbladder removed about 14-15 years ago. the pain is in about the same spot and wraps around my back. it happens sometimes when sitting but mostly when standing, it eases some when I sit. I am a 42 year old female.",
    "doctor_response": "Hi.Read and understood that you had gall bladder removal surgery 14-15 years back. You have pain at the same spot and wraps around your back. increases on standing and eases on sitting. This is due either to Disc compression on the spine or Costo-chondritis. This can be diagnosed by MRI of the thoracic spine and of the ribs at the costal areas.Once diagnosed the treatment can be carried on likewise.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for weakness in knuckles?\n\nHello. I'm 14 I have a habit of playing with my knuckles. I move them from right to left with my fingers making my bones crack where my knuckles are. I feel that since I do this my bones are getting weaker, now I think my fingers are being affected by this act. My mom has told my Doctor for a long time since, this habit has gone for a very long time. My knuckles now have a distinctive color. Anyways when I ever do a grip I can never go longer because the front side of my elbo begins to feel ticklish inside and weak. It's weird because, I still have lots of strength.",
    "doctor_response": "In my opinion First you should do a urine analysis to make sure your kidneys are safeSecond you should do blood electrolyte test for calcium/magnesium balance ,zinkThird you will need cervical and lumber MRI (x ray would be sufficient for me ) to check for spondylitis which could be aggrevated by common cold Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will it be safe enough to give soy milk for a 1year old baby?\n\nMy one year old just started taking soy milk and is having soles stools every day and very smelly gas. She was on soy formula bc she didn t tolerate regular formula. We tried whole milk but she vomited with that not allergic to milk though so now she is on soy. Are these bowel movements normal",
    "doctor_response": "Hi,Thanks and welcome to healthcare magic.Soya milk is given temporarily during diarrhea as it causes temporary lactase deficiency.If there is established milk allergy or primary lactase deficiency.As the child is one year old better give normal foods like boiled rice with milk,buttermilk ,curd or moong dal.Youmay also try vegetable soups, fruit juices,biscuits and even soft bread.Hope this answer serves your purpose .Please feel free to ask further queries if any.Dr.M.V.Subrahmanyam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the early signs and symptoms of pregnancy?\n\nThis is my first month starting my birth control back up in a long time. I started on a wednesday. My boyfriend ejaculated in me on tuesday. I started to bleed when I got to the blue pills. I called my pharmacy and they stated that it was because I doubled up one day. I have been feeling some cramping and the bleeding has stopped. I didn t get day after pill because I figured my bc would do the trick. Is it a possibility I could be pregnant?? If so, what s the percent chance? I am 22 years old and I have a 19 mth old baby. I suffer with fibroid tumors so I cramp alot anyway but when taking bc that usually calms it down.",
    "doctor_response": "Early signs of pregnacy are , nausea , change in the taste of food, frequency of urination and breast tenderness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdomen and back pain with white discharge and blood?\n\nHello doctor, I am Simi, 30 years old. I am 5.4\" tall and weigh 67kgs. I am  a spondyloarthritis patient. Recently I hadd my urine test done whihc revealed WBC-10-12/hpf, RBC 30-35/hpf, Blood ++, Leukocytes +. Doctor, what does this report state. I feel very tired all the time. I also get abdomen and back pain at times. When I get these pain, I find white discharge along with some blood. I have copper-t inserted. Thank you.",
    "doctor_response": "Hello! Welcome to HCM.Blood & leukocytes in urine indicate urinary tract infection.As you have mentioned about abdominal & back pain, there can be a stone causing this and acting as nidus for infection.Stone in ureter causes obstruction to urine outflow, smooth muscles in ureter contract excessively to overcome this obstruction & so is the pain.Ca-oxalate stones are quite common & these stones have spikes on their surface. These spikes cause mucosal trauma in urinary tract producing blood in urine.To such patients in my clinic, I advise ultrasound abdomen & pelvis, X-ray KUB, renal function tests, CBC, urine routine & BSL.Treatment is done accordingly.For temporary pain relief, smooth muscle relaxants like drotaverine, pain killer..diclofenac, tamsulosin are prescribed.Hope this helps.Wish you speedy recovery.Thanks.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be worried about the blood report with typhoid?\n\nHi, My son who is 5 years old has fever and his blood report included Blood Widal test turned as:SALMONELLA TYPHI \"O\" 1:320 Dilution Positive SALMONELLA TYPHI \"H\" 1:320 Dilution PositiveDoctor has mentioned he is having typhoid and recommended for few more tests. Is this serious? Is it curable?",
    "doctor_response": "Hi,Looking at the reports of your son, I would definitely say he is suffering from typhoid fever.It is not serious and curable. Further tests of blood culture and urine culture is necessary.Reducing titres in widal test indicates cure.You can get a stool examination done for your son, after three months to rule out carrier state.Any further queries, happy to help you again Dr. Prakash HM",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high blood pressure and nausea?\n\nI just got back from ER. Had hgihg bllod pressure and nausea. Catscan cam back normal. I have been on blood pressure meds for years. I rec d an injection. Blood pressure returned to normal. I was sent home.Now I am in bed with same symptoms. What could it be?",
    "doctor_response": "If your BP is not well controlled,  you may have High or fluctuating reading.  Titrate your meds to achieve steady state BP.  Nausea is some times associated with hypertensive urgency,  where by your BP suddenly shoots up,  mostly in between time to two dosage or you happen to miss a tab (rebound) .  However Nausea as a result of gastritis itself may increase your BP transient you as part of reactionary increase. Some more detailed history and with your existing medication list would help me help you betterRegards Dr priyank mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "Non-obstructing calculus in inter-polar region of kidney, peripheral mass on right lobe of liver. What can I expect after EWSL?\n\ni have a 2 mm nonobstructing calculus in the interpolar region of the right kidney . My doctor is planning on removing it. What can i expect from having EWSL done. I also have some swelling going on with my hands and just had a ultrsound done that showed i have a 2.6 x 3.5 cm peripherally mass on the right lobe of my liver .",
    "doctor_response": "Hi, many thanks for the query!Well, a 2 mm calculus in interpolar region of kidney need not be removed surgically, if there is no hydronephrosis/hydroureter.ESWL would be un-necessary in your case.You should do- USG KUB, X-ray KUB, RFT, LFT, Urine (R&M).Take Stone Conservative Treatment including- antispasmodics, pain killers, diuretics, potassium-magnesium citrate, urine alkalinizing agents with your doctor's opinion.Drink plenty of water so that at least 2 litres of urine is voided in 24 hrs.Wish you a good health.Take care.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment for back pain due to lumps in spine?\n\nHi there thanks for asking, I'm just looking up lumps on spine. I have had three MRI's and they found lumps in different areas. I did a front crush on my T12 and fracture almost 2 yrs and they have noticed lumps on my spine. My back tends to hurt in other places, not as much where the brake is. I am a little worried like everyone that is told this I'm sure. Dr has called and wants to see me Tues. I'm sure it's not something you can comment on but would love to here what you may think thanks Darlene",
    "doctor_response": "It looks to me from  your history  that you are suffering from weak bone disease.  It can be due to lack of calcium. Because of fracture,  curve of spine change  and multiple  bumps are formed.  You have not mentioned  your mri report but this could be the most common cause.  I would recommend  you to start taking calcium to strengthen your pain. Also you can wear belt to support your back.  Let me know if I yoo want to know any thing else.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Depressed due to being over weight. Supplements failed. What can help?\n\nwell i am 12 years old and am weighing 67 kg am really depressed about it i dont feel happy at all am always ashamed to go out with others cause they are all slim am the only one odd it sickens and troubles me alot i really want to get slim and think like a naturally slim girl i ve tried alot of supplement but it dosent really works with me i need your help i know you are speacialist i just need the right tips ,answers ,vidoes and all those stuff you know please i really need your help please.............. sobs,,,,",
    "doctor_response": "hi..well, obesity per se is distressing..so please consult a dietician and a physician..then a psychiatrist..also bariatric surgery may be needed if required..so mental health issue may be addressed later following all these..have a healthy life..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is 1ml dose of Crocin safe to treat a toddler s fever?\n\nHi doc I have a concern, my baby is down with fever and I gave him crocin drops and baby puked immediately as the taste was bitter so I have another dose of 1ml , so my concern is , have I given crocin overdose and also as I just opened new bottle of crocin but the taste was bitter ( pappermint flavour) . Manufacturing date Feb 2017 of the crocin bottle , was it old enough to change the taste of crocin drops and also I gave twice same same dose of crocin as baby puked first time is it safe plz advice",
    "doctor_response": "Its completely fine. You can give dose of 3ml to 4ml for around 3-4 times depending on the intensity of fever. On the other hand you can go for other flavours of crocin I.e. strawberry or mixed fruit. And if the fever doesn't subside better give him an antibiotic. along with crocin you can give him a probiotic i.e. ENTEROGERMINA OR ENBIOS SUSPENSION",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome behavioral changes in a child?\n\nMy 6 year old granddaughter has difficulty sitting in kindergarten, finishing work we know she can do and following teacher instructions. Parents have punished, talked to her, rewarded the few times she comes home with a good report. We have no idea how to help her with this problem.",
    "doctor_response": "Sorry about that.I advice you see a paediatrician to rule out an Attention Deficit and Hyperactivity Disorder, ADHD.in the interim, try to reinforce the behaviour you like in your grandchild.I hope this help..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What sort of daily medications should I stay away from to avoid kidney stones ?\n\nI am a young woman who suffers from kidney stones. What sort of daily medications should I stay away from? I want to start taking phentermine for weight loss but I m not sure if it will cause a build up also I want to take a daily vitamin but I am scared of building up calcium.",
    "doctor_response": "1 avoid acess salt in diet 2 include plenty of water 3 dont resrict calcium these three things will definately lessen chances of stones medications which can lead to stones r triamteine and indinavir",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the fractured bone of hand?\n\nI broke the bone on the side of my hand (under my pinky finger) the dr. At urgent care wrapped it until I can get in to see a orthopedic dr. He said my bone is split about 2 mm apart. I m wondering what they will do...pin it with surgery, numb it and fuse it back together?",
    "doctor_response": "Hello, As the fracture is just 2mm apart I don't think the surgery will be taken as a choice. It will be treated with an immobilization using the plaster and wait for 4-6 weeks of time. In this duration, multiple x-rays might be taken to check the healing of bone. Once the healing is optimum then the cast will be removed and you will be advised to undergo physiotherapy to improve the range of motion of the finger joints and improve the strength of the hand muscles. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does nausea, fever and pains/aches indicate flu?\n\nHey! I'm 18, and have had a stuffed nose since friday, accompanied by a cough. However, the past two days have also brought on nausea, weakness, fever, aches and pains, and tonight, thirst. Could this just be a bad case of the flu? The last time I had this it was malaria; which isn't possible in the USA...right?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have symptoms of nausea, fever and pains/aches, stuffy nose which is due to upper respiratory tract infection leading to common cold infection. Chances of malaria are less as then you will have high grade fever. Steam inhalation is very effective for you. Take diet rich in vitamin B12. I would suggest you to consult pulmonologist/ ENT specialist and get blood test done.You should take antibiotics along with decongestants and mucolytic agents. You should get an x ray of the chest and pulmonary function tests done as well. You should avoid hot, sharp and spicy foods. You should take expectorants. You should use throat lozenges and go rinses with warm saline water. You should do tepid sponging if fever is of high intensity. Maintain basic hygiene to prevent any further infection.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for the left ribs which is sticking out with sharp pain?\n\nMy left rib has been sticking out of my body for the past 4 years now, and there is sharp pain every couple of days but when I went to my doctor she told me my left rib was out like that because it was extra fat but I don t understand how, when my ribs are very hard..help?",
    "doctor_response": "Hi, If you feel that left ribs are protruding out then there has to be a reason. Generally, the reason is a curvature in the spine. I suggest orthopedic consultation to find out the cause. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching on the testicle?\n\nHi I am a 26 year old male 6'3 230 lbs and I have had some itching problem mainly around my jock. I have had itching and when I am normally up and doing something I dont seem to have much itching at all but when I want to lay down and take an easy I seem to itch more. On my sack I have red bumps or lumps dont know what to call them but they keep popping up and have a tingle to them and can itch and I have to rub them to get relief. I dont know what they are but I was wandering if you had any clue to what they could be. The isnt any discomfort but just have some irritation in my sack and a itch that wont go away.",
    "doctor_response": "Hi, It may be scrotal dermatitis most probably. Consult the dermatologist for the perfect diagnosis and proper diagnosis. The disease may be due to some irritants like perspiration, soap, detergents, clothes, deodorant etc. I would recommend you to take antihistaminics like cetirizine. Apply mild steroid cream. If needed, a short course of antibiotic may be taken. Do not apply soap while bathing. Keep the area dry. Wear cotton clothes. Avoid worries and stress. Mental upsets might exacerbate the disease. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilyas Patel, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach ache and fever in 8 year old?\n\nMy 8 year old daughter has been complaining about her stomach hurting since yesterday, and she is not one to really complain very often, this morning I also noticed she was running a fever. She has not been vomiting and she is eating ok. I am not sure what is going on.",
    "doctor_response": "hi, symptoms of pain abdomen and fever can occur in stomach infection, acute gastroenteritis. Give syrup Paracetamol for fever. An examination by doctor should also be 10. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bad headache, disturbed sleep followed by mini seizures with episode of face twitching, leg tremors, diagnosed as migraine. Is it right?\n\nHello My name is Zak Born, I am 16 years old and i suffer from bad headaches , but these headaches do not feel normal. they either keep me from falling asleep at night or wake me up after a few short hours of being asleep i keep having mini seizures and i like to call them, and my limbs move on there own sometimes as well as my face like to twitch a lot and i say words that i did not even know i was going to say. Normally i would go to my GP but i have been to her before and she did not listen to me and just told me is was migraines and i was not satisfied with her diagnosis because i thinks there is more to this condition of mine then meets the eye so i have had these headaches for three years nearly since i was 14 years old so my question is this. I have told you everything i know so can leave it up to you, What is wrong with me do you think? Thank You For Your Time Zak Born",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your symptoms and appreciate the details provided.I agree that you have migraine, as severe headaches are part of that.However, in addition, we need to exclude seizures such as myoclonic epilepsy, which can cause jerks of arms or leg.You need to be seen by a neurologist. In addition, MRI of brain and EEG may be required to make a final diagnosis. I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat severe chest pain, have been taking Alzolam for stress?\n\nI had been in coma for 3 days and was in ventillation for 7 days due to ARDS in the last february but since then after my recovery I started having severe pain in my chest accompanied with breathing problem. Doctor has advice me to go thruogh a chest x-ray, it shows little congestion in lungs. But doctor has told me that it cant be the cause of chest pain. I am an field executive and had to work through the entire day in the field. I used to take alzolam 0.5mg every night because I have severe sleeping disorder and tremendous pressure of work. May I please know how can I get relief of the pain?",
    "doctor_response": "Hello, Once fully recovered from ARDS, there should not be severe chest pain interfering with the daily activities. On the reverse, minor congestion will also be not responsible for the intense pain. I recommend deep breathing exercises, inhalation therapy and assisted chest physiotherapy at present for primary relief till your expert guides you further. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce pain caused by bruised spinal cord?\n\nWHAT SHOULD I EXSPECT WITH MY BRUISED SPINAL CORD. I AM IN CONSTANT CHRONIC PAIN. I AM NOW POST OP 5 WEEKS TODAY HAD FUSION C5 C6 THE DISC WHAS SHATTERED, 3 BONE SPURES AND 2 MORE HERNIATED DISC STILL REMAIN IN MY CERVICAL AREA.MY LEFT ARM CONTINUES TO GO NUMB FROM THE NECK DOWN JUST PASS THE SHOULDER. THE PAIN IS SO BAD IT S TAKING OVER MY LIFE. I TAKE 4 OXYCODONE A DAY LIDACAINE PATCHES FOR 12 HRS AT A TIME. i ALSO HAVE TO TAKE NUEROTIN. HOT AND COLD PACKS ALL THE TIME.VERY DIFFICULT TO DRIVE OR USE MY LEFT ARM FOR ANYTHING. THANKS SANDY",
    "doctor_response": "hello there.. welcome to health care magic , thanks for your query, 1st thing i like to emphasise is that you are not supposed to do driving in your 5th post op weeks.. you have to avoid such activities which increases stress on your cervical spine.. like driving for atleast 12 weeks post op, secondly if you are having bony spurs also called osteophytes  indicates soft tissues inflammation around the cervical spine, so your symptoms and history suggest that your are having a radicular pain in shoulder  due to bony spur and herniated discs are contributing to the symptoms.  may be your doctor didnt remove the spurs and didnt operate on herniated discs cause may be they are not severe enough,, i think you should start doing round the clock physiotherapy for neck like short wave diathermy and interferential therapy. along with tab prelogic 75 mg once at night and not neurotin. and get a test done called nerve conduction study of left upper limb. follow this for about a month and let me know. thank you..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes soreness and pain in arms and legs during day time?\n\nI have soreness and acheness in both legs and arms during the day but not at night. When awake this probllem arises an continues,but diminishes slightly towards the end of the day. This has been going on for quite some time. Any advise would be helpful.",
    "doctor_response": "Hello, It could be a peripheral vascular disease. We have to rule out other causes like neuropathy also. As first-line management, you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist better to consult a physician and get evaluated. A vascular Doppler will be a good option. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having upper right abdominal pain. Feeling nausea. Taken paracetamol and nurofen. Suggestion to reduce the pain\n\nhi, I have been suffering with upper right abdominal pain for 3 days now, it became worse Thursday afternoon for around an hour causing great discomfort. It has now ceased to a dull ache with pain underneath the right rib. Although there has been a feeling of nausea but has been no vomit . The colour of my urine has also darkened. I have tried paracetamol which offer no relief and neurofen which offer a little more relief, is there a suggestion of what can be taken to ease the pain, Thankyou, Julie",
    "doctor_response": "Hi Julie, Upper right abdominal pain with nausea  is indicative of cholecystitis i.e gall bladder inflammation. I would suggest you to consult physician for ultrasound gall bladder. In that case, you will need to take antibiotics. Even trauma to ribs can cause pain, but in your case this history is not present. Even kidney or gall bladder stone can produce such pain. Sometimes it can gas problem. In females two more possibilities are ovarian cyst and ectopic pregnancy. You need to consult physician, get examine. Physician can decide about ultrasound and further treatment. I hope I have answered your query. In case of doubt I will be happy to help you. Best regards, Dr . Neelam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from anxiety and taking Xanax for longer period. Will it cause withdrawal effect?\n\nHello doctor, I am 51 years old female and suffering from anxiety for decades. Recently it became debilitating, and I ended up in the ER and had an EKG because of heart palpitations. My doctor prescribed me 10 mg of Escitalopram and 1.5 mg of Xanax. The Xanax was supposed to be taken as needed, but I misunderstood and have been taking it three times a day (5 mg every eight hours). After six weeks, the SSRI is not helping much. My doctor has increased the dosage to 15 mg. I took the new dose at night and felt awful nauseous, depressed, and lethargic in the morning. Is this the wrong drug for me, or should I go through the side effects? My goal is to feel well enough to start weaning myself off the Xanax. I have not been able to eat solid food for weeks.",
    "doctor_response": "Hello. Escitalopram is an effective medication for managing anxiety disorder. The usual dose is between 10 to 20 mg daily. You are currently on 15 mg. Side effects can occur commonly in the first two weeks of starting the medication or increasing the dose, and then it tends to settle. Take your medicine after food to minimize nausea. Depression and lethargy can take up to two to four weeks to get better. Taking Xanax (Alprazolam) regularly for more than a month can lead to dependence, and it will cause a withdrawal effect. Consult your doctor and discuss the earliest to gradually taper off Xanax in a safe manner. Do breathing exercises and muscle relaxation exercises.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and stiffness below the knees?\n\nDear sir I am having pain and stiffness ibelow my right knee. Dr prescribed Renerve inj and sammy 400 tablets. please let me know what for these medicines are prescribed and any possibility of increaseng BP? Because after using these medicines my BP increased and is remaining in the same state. Pl advise",
    "doctor_response": "Hello, Renerve Plus is a multi-vitamin/multi-mineral oral supplement used for nerve damage. Based on evidence studies, this medication does not cause high blood pressure. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Patches on the abdomen and back. Tender lymph nodes in the armpit and groin area. Could it be due to poison ivy?\n\nI have two patches of what I think is poison ivy on my right side; one patch on the front middle abdomen and one on the back.  I noticed this morning now I have two tender lymph nodes; one in the right armpit and one in my right groin.  The patch on my front right abdomen is about a quarter size with little small raised red bumps.  The patch on my back is about 2 inches wide and doesn't appear to be little bumps like the front, but they itch like MAD! Just wondering what I should do.",
    "doctor_response": "these are chronic alleries with food or drugs fixed spot reactions in which whenever you take allergic food drg only that spot is infected and react after long time these start developing lymph nodes in drainage area try to get allergy tests for food and drugs so that you can avoid them for recurences",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My son has nearsightedness. What can be done ?\n\nHello doctor, My son is 14 years old. He has nearsightedness with -3 diopter and he goes for computer programming classes regularly. His aim to be a computer engineer. Can he go for it or if his myopia gets worse in future or affects his vision in the future, can he work on computers?",
    "doctor_response": "Hello. Sure, he can go for glasses. Myopia can progress but that may progress even if he is not doing computers. Just make sure he uses his glasses most of the times while using computers also. Get his vision tested regularly at six months. Get his power changed whenever he feels there is any change. Make sure to get the adequate prescription from an ophthalmologist, not from an optometrist only. For more information consult an eye care ophthalmologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this ultrasound report indicate?\n\nHello Doc USG of Liver reveals 18.6*16.6 ecogenicity found. Fatty liver spare. D/D- Haemenagioma\\ fical hyperplasia.... What does it mean that a woman having liver tumor? Her age is 29 yrs.married ,having 2 kids and no habit of alcohole consumptions....",
    "doctor_response": "Hello, Both the mentioned condition in the liver is Benign tumour and so don't worry about that. But for further workup, you need to get investigated with MRI scan of the abdomen. If needed CT guided biopsy can be planned for confirmation of diagnosis if your doctor found it. You need to consult a gastro surgeon for detailed evaluation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in chest?\n\ni am 45. i have had a chest infection in april and turned into pneumonia.  i have been left with pains in right hand side which are mainly in the chest but shift around. the pains go up and down the right hand side. i have had a gamma scan, chest xrays, blood tests, ultra sound. the gamma scan was to look for a blood clot (all ok, not one found). ultra sound (for goul stones, not found). the doctors do not know what could be causing it.",
    "doctor_response": "Hi and thank you for choosing HCM to post your concern.I read carefully your question and my opinion is as follows:I think your chest pain is not a sign of a serious lung disease since all the lung diagnostic studies and other test resulted good.It doesnt have the characteristics of a cardiac chest pain.It seems to me that the most possible cause of your chest pain is Costochondritis since the pain changes locations and after pneumonia muscle strain from violent cough can result in musculoskeletal inflammation and costochondritis.I would suggest painkillers such as ibuprofen if pain is intolerable.Hope my opinion is worth.Wish you good health.Kind regards Dr.Dushi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of survival after both kidney failure?\n\nhi doc, my friend's wife who is 28, is suffering from both kidney failure. He consulted with the doctors at Escort hospital, Delhi, but still no improvement. I want to know is there a chance of her survival if she gets a proper donor? How fatel is both kidney failures? She is on dialysis right now.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Kidney transplant is the only option left as both kidneys are not functioning properly. As you know kidney transplant is a complicated surgery chances for failure is there but nowadays the results are very good. Selection of donor is an important factor and if the donor is a blood relative the chances for rejection is very low. Consult your nephrologist and he will explain about the procedure better. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can gum bleeding happen due to the new tooth brush and paste?\n\nhi, today i got a dizzy spell after brushing my teeth, i was using a new tooth brush and a new types of tooth paste if that helps in any way, i was wounding what might have casued it, i brushed my teeth as normal, there was a little bit of gum bleeding but nothing major, but once id finished i suddenly felt very faint as if i i was about to pass out",
    "doctor_response": "Thanks for using Health Care magic.Read your query.Using a new tooth brush and a tooth paste will not cause any bleeding.Bleeding while brushing will be because of gingivitis(gums inflammed) or u may have put more pressure on the gums so it caused a little bleeding.Get your teeth cleaned with the local dentist and use a mouth wash.As for the faint feeling that should not have any relation with the brushing and maybe because of some other issues.If worried or is persistent consult a doctor.Hope this was beneficial and u recover soon.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen lumps under ear and underarms.\n\nHi, i have 2 (one on each side) under my ear beside my jaw. they are very hard and have been there for nearly 2 months. When they first appared i also had swollen lumps under my underarms which were very painful. i saw a doctor who did a FBC blood test and said everything looked normal but the havent gone away. should i be concerned?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You may have enlarged lymphnode. It can be due to reactive hyperplasia, tuberculosis, lymphoma or metastatic carcinoma. You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the neck after spine being hit. Sore spot on head, swollen bruised spine, dizziness and headache. What should be done?\n\nI went to the fair the yesterday and got on a ride that rolled you around in a cage. I smacked my spine off of a wood piece and slammed on the seat with my butt. The back of my head also bent back and hit the top on the wood piece. I woke up today with pain in the front and back of my neck . I have a soft spot on the back of my head that is sore. I also have swollen and bruised sections on my spine that are very painful. It hurts to bend my back at all and I get very dizzy and mild headaches at times. Upon this dizziness I become sick to my stomach . I put ice on my back but nothing seems to help. What should I do about this?",
    "doctor_response": "Hello, Sudden bending of spine (forward or backward) can cause injuries to the ligaments and muscles of spine, which are responsible for holding the bones of spine together. Apart from the external bruises that you have, there is possibility that spine and/brain may have suffered minor injuries (because you have dizziness, nausea and headache). I would suggest you to consult doctor immediately to detect any minor injuries that you may have suffered. For external injuries pain killer medications and antiseptic ointments may be sufficient for a few days. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this chest x-ray while having heart palpitation indicate?\n\nI had bronchitis and was on zpac, steroid pack, inhaler for wheezing. Dr ordered chest x-ray and it showed hazing in lower lung. It was said it could be a calculi annulus. I have a heart murmur and it could be in the V alve or lung. Is this serious?",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!Regarding your concern, I would explain that it seems to be a calcification in your chest X ray study, probably related to the heart valves. Considering your heart murmur and this possible calcification, which could be in the heart valves, I would recommend performing a cardiac ultrasound to examine your heart function and structure. Hope to have been helpful to you!Wishing good health, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is one testicle larger than other in a child?\n\nMy two year old has one testicle much larger than the other we have seen the doctor a year ago and he said it would clear up by the time he is 2 probably, but it hasn t. We ve got to go back and see the doctor again today and i want to know what the outcome may be?",
    "doctor_response": "HelloSlight difference in testicular size is normal.But if the difference is more one should consult a physician to rule out hydrocele(collection of fluid),varicocele(engorged veins),infection or enlarged lymph vessels(due to filarial infection).Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sensitivity and pain in shoulder?\n\nI have a very sensitive right shoulder, right where the arm connects to the shoulder. I thought maybe it was a bruised bone, as I spent many hours sleeping on it while traveling on plane. However, this is not a bone. The sensitivity as at the surface or just under. Any sort of touch to the affected area results in serious burning pain, enough to make me tear eyed. I have a strong threshold for pain, so I fear that I might have torn a muscle or something of that nature.",
    "doctor_response": "Hi, take some rest, do not check if its paining by putting pressure on it, and take some analgesics like diclofenac 100mg SR tab daily for 3 weeks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart palpitations?\n\nMy son is 15 and last year had several episodes of heart palpitations. Doctors at the time could find no reason for them but I have since been told that they can be linked to growth spurts - he grew approximately 20cm last year. Could this be possible?",
    "doctor_response": "No it is not related to growth spurt.Palpitation occur when heavy exercise,walking is done.which is physiological.AFter cardiac check up and ECG normal then here no need to worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the recurrent mild pain in my chest?\n\nhello doctor for a past 2 months i hv been feeling mild pain which comes and goes, the pain is sometimes in middle and sometimes in left chest area. i also feel a pinching in my chin and sometimes pain in collar bone and left arm. do i hv a heart problem",
    "doctor_response": "Hello dearWelcome to Healthcaremagic.comI have gone through your query thoroughly .*  This seems in relation with psychosomatic manifestation of underlying  stress and anxiety  disorder .*  Still  for  confirmation  once  EKG  is  necessary  to  rule  out  any  other    minor  cardiac  ailment .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain, fever, vomiting. What is it?\n\nHi my name is sinai, my little 5 year old Brandon has had stomach pain for about a month and a half, he had a fever and vomit, cough last month and was give antibiotics because doctor said it was a virus that turned bacterial... his tummy hurt almost every day, specially when food gets in the stomach pain starts i took him to the doctor last week because he started vomiting and had diarrea literaly like water and could not retain anything inside so doctor said he needed IV and stayed there 2 days, first night he had a slight fever 101.3, doctor found salmonella tifico in reacciones febriles blood test at 320 number and took a stool sample gave him antibiotics for 7 days for salmonella he continued to have stomach ache and diarrea, stools are getting more formed now, pasty but stomach ache is persistent and little appetite , he looks very thin and pale so i wonder if we are missing something here, appendicities? hope not, pain was coming from the belly bottom area, lots of rumbling noise in the tummy... roundworms? what can i do? we are from seattle but came to puerto vallarta for a year and i feel like the level of knowledge is less here and also the fancy tests in the USA are better... i am willing to take him to the states if needed, but could you advise me please?",
    "doctor_response": "Hi His gastrointestinal tract got infected due to contaminated food or water.It is Gastro enteritis. In appendicitis,loose motions are rare. Rumbling noise is due to intestinal movements. He should be given antibiotics like Ofloxacin,ornidazole/metronidazole,antispasmodic like dicyclomine,Pre and probiotics.Add paracetamol for fever. His symptoms will come down gradually. Nothing to worry. Regarding shifting to states,it depends on the response that he is getting here. Wish him good health and speedy recovery Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can we treat deep burns?\n\nHi doctor, My eight-year-old daughter has got metal burn on her cheek left side less than 1 inch above the mouth left side and nose top. The doctor advised Silverex ointment, tablet Taxim-O, and Flexon. But it was so dry and turned black when we applied the cream. Is it normal? How long will it take to heal?",
    "doctor_response": "Hi. I have gone through the pictures (attachment removed to protect patient identity). It looks like a profound third-degree burn with black eschar present.  I would recommend you see a plastic surgeon. Deep burns take more than 21 days to heal, and they will improve with scarring and contractures.  It is recommended to remove the eschar and cover the wound if it is a deep burn. For more information consult a plastic surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can tubercular lymphadenitis causing reoccurring glands be treated?\n\nhi i hav tb of glands.tubucular lympadentitus. have been taking medicines for 1 and half months.also had developed pericardial and plural effusion during course of treatment. fluid was removed and now my doctor says its clear. however, glannds keep re appearing for example under the armpits and near it and is slightly painful as i cant lift my arms up. have taken nucosia 90 and some relief. these glands have not appeared before its been only a week now.",
    "doctor_response": "Hello.My name is Dr Talal Hussain . i completely understand you concern. Well tuberculous Lymphadenitis is a common condition that present to my clinic . But here i would like to know how was your tuberculous lymphadenitis diagnosed as only then will the treatment be effective .As far as the treatment is concerned, it usually lasts for around 9 months so problems associated with it will be there for couple of months but eventually improve . Just keep in mind that on-time medication with no skipping is absolutely important to get rid of this condition. One other thing that is important for TB treatment is that with vitamin B6 is also taken along with TB medication  and after 2 months a followup with your physician is mandatory as after 2 months some changes are made in the medication.I hope the answer was helpful . If you have any further questions feel free to contact in writing . Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. A vein is blocked in heart and there is chest pain while walking far. What has to be done?\n\nHello doctor, A vein is blocked near the heart. The doctor told that he checked up today and there is a pain in the chest when he walks far. He is 45 years old, what should be done?",
    "doctor_response": "Hi. Blocked artery in the heart causes pain especially when one is engaged in activities like walking due to increased heart rate during activity which reduces blood supply to the heart muscles leading to ischemia and pain. This condition is called angina pectoris. It is a problem with the coronary arteries which supplies the heart muscle. The doctor to see is the cardiologist. Do ECG, do clotting time. Take Isorsobide Dinitrate 5 mg three times daily will help to open the heart arteries and relieve the pain. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does small, sensitive bump inside urethra oozing blood mean?\n\nI have a small bump that I didn't notice until today. I have no idea how I got it. Its located inside my urethra. I've been looking for any pictures that could at least put Name on my symptoms. But I had no luck. Its iterating a little. Both the fact I cant find out what  this bump is. And the bump. its very sensative too.  I tried examenating it with my finger and the moment I put any pressure on the bump it bled. So any thoughts? (So just incase I'm still getting tested for any stds)",
    "doctor_response": "Welcome to health care magic. 1.It could be an infective aetiology, can be present infection or followed by some previous infection. 2.So as i can think of there is a lesion at the tip of urethra ( as any thing internally one can not see in to it)3.This case if you are my patient i would have examine and ask for a RGU - retrograde urethro-gram which will delineate the urethra in whole length and shows as a filling defect if there is any lesion / narrowing of the path.4.And if required treating doctor after examination might clear the swell in if possible and followed by a course of antibiotics.5.Suggest you to get an appointment and ket it get examined and needful treatment. Good luck.Hope i have answered your query.Any thing to ask do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for dry feeling of the brain inside the head after s shower?\n\nHello, so after showering, in about 10-15 minutes after showering my Brain feels very dry like i can feel the inside of my head being dry like my eyes feel like i have steam or some sort of heat exerting from my eye s. This happens everyday and my Father tells me reduce the heat during showers (which i do and it does not help) it dossnt help until i have it on cold water. This has been going on for a year. my father wont listen to reason and refuses to take me into the doctor. Whats wrong with me?",
    "doctor_response": "Hello My name is Dr. Aida and I am glad to attend you on Healthcaremagic! Your symptoms are not indicative of any serious medical condition. Low blood pressure or orthostatic hypotension could explain your symptoms. For this reason, I recommend you to monitor your blood pressure values in standing up position after the shower. Avoiding hot shower is necessary. But there is no need to worry about! Hope to have been helpful!Kind regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat urine infection?\n\nmy teenage daughter had urine infection few days back where her pus cells were 60-80/hpf and WBC was 16500 but now i did a test again where the pus cells are 1-2/hpf urine report is clear but wbc count is increased to 21200, what is the reason for the elevated WBC when there is no urine infection now",
    "doctor_response": "HI, thanks for using healthcare magicA significant quantity of white blood cells in the urine usually indicate the presence of an infection.The fact that she still as a high quantity would either mean that it is a lab error and the test bears repeating or the infection is unresolved.You may want to consider having another sample assessed, the cells are high again in the repeat then some form of infection is present.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for the clear swelling behind the upper molar and the cheek?\n\nHi.. So theres a clear swelling behind my upper right molar and my cheek. My wisdom tooth there was extracted 5 years ago, and i dont have any tooth ache. Im also able to chew properly from the molar and it doesnt hurt. HOWEVER, the pain happens when i smile too wide or try and press that side of my cheek. Can u suggest whats wrong?",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. This swelling which you are mentioning can be because of some infection in gums or in your salivary gland,  as you are describing that you got your wisdom tooth extracted then ot can not be associated to that, but it can be related to gums or salivary gland as, they can cause this kind of swelling. There is dull pain in gums swelling,  but in salivary gland swelling,  there will be pain while food intake. Better that once you should visit your dentist and get a properly examined.Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does prior risk 1:870 for down syndrome on pregnancy scan suggest?\n\nsir my wife is 29 year old. last time my wife has undergone with MTP on 27 sep 2010.during her first pregnancy because feature of limb body wall complex of the fetus of 15-16 weeks of gestational period.(during Obstratic ultrasound Level 2). she is 11 week5 day pregnant today .weight 54 kg .today we got the dual test report but we were not able to consult the doctor as she was out station.Will u tell us that this time what will happen as we both are too upset because of last time and tell us whether this report is positive or negative.In report which shows ---------------------------------------------------- hCGb 25.881ng/mL corr MoM is 0.35 PAPP-a 869.23mU/L corr MoM is 0.87 --------------------------------------------------- disorder down syndrome result low prior risk 1:870 posterior risk 1:12000 cut off 1:250 risk type isk at term ----------------------------------------------------------- disorder edwards syndrome result low prior risk 1:7800 posterior risk 1:58000 cut off 1:100 risk type risk at term ---------------------------------------------------- disorder patau s syndrome result low prior risk 1:23000 posterior risk 1:58000 cut off 1:100 risk type risk at term report is duly siggned by DR. g kaur consultant in charge GMCH chandigarh",
    "doctor_response": "Hi,The above reports suggest that your wife is at a very very very low risk to carry an abnormal baby.The cut off to do further testing is 1 in 250 for downs(nowadays, we take the cut off as 1/150),anyhow, but your wife's values are very safe at 1/870.This is  a very reassuring result. So please do not worry. Everything seams to be fine at the moment.You should keep calm and look forward to the rest of the pregnancy.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for allergic and continuous cough\n\nI am suffering from allergy cough (dry cough no mucus). I continously coughing. I am taking bezo pearl, cetrizine, pentaprozole and cough syrung. There is one more medicine, I do not know the name correctly its is muco fast, Dr. said you cough is now chronic. I am coughing for the last one month. I got done all the test, like TLC, DLC, ESR, Sputum test, CT scan, chest X-Tay. All tests are OK. My hameoglobin is 13.9. Please suggest what should I do. Regards, Shashi, New Delhi, India",
    "doctor_response": "Hello Shashi,Thank you for asking at HCM.I went through your history and would like to make suggestions for you as follows:1. As your investigations like TLC, DC, ESR, Sputum, CT scan, Chest Xray are normal, I would suggest you spirometry with post-bronchodilator study. This will help to diagnose asthma.2. If you have symptoms like headaches, facial heaviness, constant tricking in throat, recurrent need to clear throat, etc, I would think of chronic sinusitis and would suggest you to consult an ENT surgeon who will examine nose from inside and also may suggest you CT scan of sinuses.3. If you have symptoms like burning in chest, nausea, feeling of fluid into mouth, especially after a heavy or spicy meal, I would think of GERD and suggest you an antacid for at least 4-6 weeks.4. If you are a smoker or you are exposed to passive smoke, it may be reason for your cough. Likewise, if you are exposed to air pollution significantly, it may be cause of your cough. I would suggest you to use personal protective measures like mask while exposed to smokes/air pollution.5. I would also like to review your other medications, some of which might be causing cough to you.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could bad cold lead to blurry vision?\n\nAs of yesterday i suddenly noticed when i left work i could'nt drive due to severe blury vision. The blury vision has continued into today. For the last  four days prior to this condition , I had symptoms of dry mouth night and day and had to drink water every half hour accompanied with frequent urination every hour during the night and every two hours during the day. I have been fighting a bad cold for about a week during which time  I have been killing my constant thirst with water and orange juice, alternating each,.These symptoms are still here, all of them. I borrowed my fathers blood sugar tester and tried it three times, the tester says my blood sugar is at 551. I am a male aged 5' 10 \" ,   48 yrs old  and  overweight for last 6 years, aprox 330 lbs, and one more thing, today i noticed somehow i've lost 20lbs.thanks in advance,  Domingos",
    "doctor_response": "The symptoms you describe are consistent with the onset of diabetes. It sounds like it has been quickly getting worse over the last few days. A blood sugar of 551 is extremely high. This is an emergency. You need to be seen and treated for this immediately. It may cause brain damage, coma, and death if not promptly treated. Go to emergency or call an ambulance. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Round red mark on the bottom of leg, itching goes after scratching, no bugs. What can this be due to?\n\nFor the past few nights my husband wakes up with a round red mark toward the bottom of his leg. I sleep in the same bed and dont have any marks. Once he scratches it no longer itches. We ve checked the bedding and mattress and have not found any bugs. What could the marks be from?",
    "doctor_response": "Hi,After reading your history it appears that you might have developed allergic dermatitis to some contact allergen. I advise you to not pinch or pop the area otherwise these areas are very prone for getting secondary infection. You can apply an steroid cream such as cortisone cream. If itching is present then can take benadryl accordingly. Apply a plenty of moisturizers over the affected area.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does recurring pain in right side of abdomen mean?\n\nI had right side adbominal pain for the last four days.(14yrs.Female) It started during the first basketball practice of the winter break. I got dizzy during the first few min. into practice then I'd feel like vomitting, a little vomit did come up then the pain set in whenever I rested from the drills and  after I had a water break it sometimes came back stronger, it made it harder to breathe, the pain eased during practice but came back during or after I eat, when I  moved around even when I standed still and when I sit down sometimes Should I be worried?",
    "doctor_response": "Hi ! Good morning. I am Dr Shareef answering your query.From the history of pain, it looks to be of some inflammation inside abdomen. If I were your doctor, I would go for  blood tests like a CBC, ESR, LFT, serum amylase and lipase, and an ultrasound of whole abdomen to rule out any calculi disease in gall bladder and urinary tract. In addition, with the physical examination of the abdomen and the investigations, I would also try to rule out any chances of an appendicitis. Till then I would prescribe an anti spasmodic and a proton pump inhibitor drug for a symptomatic relief. Further management would depend on the result of the clinical assessment and reports of related investigations.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infected sebaceous cyst on thighs\n\nI have an infected sebaceous cyst on my right thigh an have been on antibiotics for almost 10 days now; I am waiting to see a surgeon this week...it is extremely painful, and began oozing today...is that a good thing or should I return to my family doctor????",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern.after 10 days of antibiotics still you have pain and oozing, then you need incision and drainage. this is only option for you.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes aching sensation in the abdomen having diagnosed with Hiatal hernia?\n\nHello, 28 yo male. I have had a strange tugging / aching sensation in my lower right abdomen. The location is about two finger widths to the right of my belly button. I have had this sensation for a few months now but it was very subtle, it is now growing stronger and is accompanied by nausea. I find that if I push on the location the nausea mildly subsides but returns after release. There is a flutter sensation as well as tugging and it is very isolated. I have been diagnosed with a hiatial hernia a year ago, lymphatic hyperplasia and a spermatocele but besides that no other illnesses. Blood work shows no signs of infection or peaked numbers that would cause concern as well as ultrasound could not find any noteworthy masses or obstructions. I have had an endoscopy and a colonoscopy and gallbladder test. The gallbladder test shows its within optimal paramaters as well as no stones or obstructions. Diet is low carb low sugar with no stimulant intake other than a cup of coffee every once in awhile. No alcohol or smoking as well as any other recreational stimulants. I have noticed no weight loss or substantial changes in physique however when I am feeling nauseous I also feel very faint and weak. My Primary care Dr as well as my Gastroenterologist believe I am fine and experiencing an upset stomach from diet induced reflux or agitation however given the prominence of the symptoms and the demand of attention from the very specific location and the growing level of fatigue and nausea I am beginning to become quite concerned. I am not one to jump to conclusions or make hasty decisions and will continue doing research on this as much as I can but I would like to know if you or anyone has any thoughts on what may be causing this as well as some tests or requests I could ask my Drs to see if we can diagnose what is causing these symptoms?I am most grateful for your time and thank you for any insight or thoughts you may have.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice I can understand your situation. Since you have done endoscopy .colonoscopy, scan  and few blood tests there may not be any organic lesions.However stone's in the kidney or ureter can at times cause similar symptoms.Ultrasound scan may not detect small stones at times.Rarely ultrasound scan can miss. You can get a urology consultation.second reason could be subacute appendicitis. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Brain hemorrhage, diagnosed with glanzmann s, no antibodies or antigens in blood. What can be done?\n\nMy son a brain hemorrhage which resulted in a diagnosis of glanzmanns except when they checked the genetic there was eno mutation, and there are no antibodies or antigens prevent in his blood which could have caussed it? Are there any other causes of glanzmann's, I'm waiting on a refer to a specialists but no -one is ale to present another cause as of yet",
    "doctor_response": "Hello,Welcome to Healthcaremagic.I have gone through your query and understand your concern.Glanzmann thrombasthenisia is a genetic platelet disorder. Doctors and scientists are researching what exactly causes Glanzmann\u2019s disease and how it can best be treated. If you have a family history of Glanzmann\u2019s disease or related disorders, you have an increased risk of inheriting the disorder or passing it on to your children.But  very few case reports says it can be acquired.Thus spending time and money in identifying the cause is not worthy.My advise is to have regular health check up and blood investigations.As your son have brain hemorrhage, follow your neurologists advice and take care of him.Hope this helps.Wishing you good health.Please reply for further queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is xanax recommended while suffering from high blood pressure?\n\nmy 24 nephew died he had high blood pressure and a bypass in his  stomach when he was 11 years old.Small blood vessels and 95% clogged.He was on blood pressure meds just had a mra and got a good report.He did take zanex 2mg,then started doing speed.His heart was enlarged and calified when the autopsy was done.Still no report to determine what he died of.",
    "doctor_response": "hi and very pleasedYour nephew was dead due to a Ventricular tachycardia that can easily born in his Heart with all the damage already present, mostly 95 % CORONARY STENOSIS.Xanax (zanex) is usually prescribed during myocardial infarction and therefore cannot be the cause of death except when taking an excessively high rate of this medication.There is no link between STOMACH BYPASS and your nephew death. accept My condolences for your nephewbest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take montair lc for long duration of time?\n\nMy daughter who is 12 years old has been asked to take montair lc (cipla)(Montair-Lc Montelukast 10 mg, Levocetirizine hydrochloride 5 mg) once a day for 2 months and after that when needed for her allergy problem. Is it safe to take the drug for such a longer duration? Are there any side affects of the same?",
    "doctor_response": "Hello,It is my pleasure to help you,You can give this medicine as long as recommended by your doctor even if you feel better.This drug is considered as medication for long-term control of asthma.Like any other medicine it also has side effects, but the advantage over weighs the side effects.Most common side effects are increased bleeding behaviour, Mood related changes, diarrhoea, dyspepsia, nausea, vomiting, dizziness and drowsiness.Hope I have answered your query.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On clomid for unexplained infertility, pain in ovary, feels bloated, ovulation test positive. Pregnant?\n\nHello, I am on clomid for the first time. I ovulate on my own days 32-35 been ttc for 4yrs with no lucky so been prescribe clomid for unexplained infertility I started my first clomid pill on 5/05/12 day 5-9 so i finished my last pill on 09/05/12 been feeling pain on both sides of my ovaries for the past 3 days in a role and very bloated I have been doing ovulation test from 11/05/12 with afternoon urine got a strong positive and since then been getting positive test for the past four days and been baby dancing for all the days i got a positive could I be pregnant? or there is something wrong with me please HELP!!",
    "doctor_response": "Hello, As you have mentioned, you took medicines and are doing a ovulation test which you are getting positive. This just means that ovulation has occured and this is the most fertile period. This does not mean that you are pregnant. If you miss your period this time or around the time of your expected period, do a urine pregnancy test using early morning urine sample. good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for headaches with leg pain due to gluten and soy allergy\n\nHi, thanks. Patient is 8 years old, sensitive to gluten and soy... history of frequent headaches, turns into a migraine maybe once a month, constipated - goes every 3-4! days, night tenors, talks in sleep a lot, complains of sore legs, restless legs, often irritable.. thanks x",
    "doctor_response": "thank you for asking!  The best option here is avoiding triggers to these migrainous headaches.Alcohol - Particularly wine and beerCaffeine overuse or caffeine withdrawalChocolateAspartame - eg, NutraSweet and EqualMonosodium glutamate (MSG) - May be found in Asian food, canned soup, frozen or processed foods, and the seasoning product AccentFruits - Citrus fruits, bananas, avocados, and dried fruitNuts - Peanuts, soy nuts, and soy sauceTyramine, a biogenic amine that accumulates in food as it ages, may provoke migraine. Sources include the following:Dairy - Aged cheeseMeat - Bacon, sausage, luncheon meat, deli meat, pepperoni, and smoked or cured meatPickled foodsHeavily yeasted breads - Eg, sourdoughVinegars - Especially wine vinegarSome types of beans Seek a paediatric neurologist if the symptoms persist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taken antibiotics for gall bladder inflammation. Have C diff infection. History of heart surgery\n\nMy 95 y.o. Grandmother is in the hospital stemming from a gall bladder attack.  She was told that she had inflammation in the gall bladder and was put on high dose of antibiotics through IV.  They said they were not going to do anything about the gall stones but just treat the infection and send her home if all goes well.  Now after 3 days of antibiotics they are saying she has C Diff.  Why wouldn't they do something to treat the gall stones instead of giving her massive amounts of antibiotics which most likely caused the C Diff.  ?  As for her history she had open heart surgery at 83 which consisted of a triple bypass and a valve replacement (pig valve).  She had a rotator cuff replacement two yrs ago as well and had to intubate (sp?) during surgery.  They said they \"lost her\" twice during that procedure.  This is the reason they gave for not doing gall bladder surgery.  They said that shockwave therapy is \"not very effective\" so they are not going to do that either.  Any thoughts on all of this?",
    "doctor_response": "Hello and welcome to HCM,The gall bladder inflammation ( acute cholecystitis) is precipitated by the gall stones.The acute cholecystitis is managed by iv fluids and antibiotics.Surgery is done at an interval when the inflammation has cleared away.gall stones may be complicated by infection.The biliary tract (gall bladder, bile ducts, common bile ducts) is free from any kind of infection.Infection enters the biliary tract from gastrointestinal tract or formation of abnormal communication between gall bladder and intestine (fistula).Since, your grandmother is suffering from Clostridium difficale infection, it is important to control the infection before perform any surgical procedure.After controlling infection, surgery will be performed after checking the fitness for the surgery.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomitting, vold and sore throat?\n\nHi, I just had a few questions about some of my symptoms that I have been having. Last night I started off with a sore throat that kind of turned into a cold and I went to see my boyfriend last night and once I got over there I started feeling worst. I felt like I was running a little fever, my body was hurting more, and I was really tired. But he was sick on saturday. I think he had some type of stomach virus and he might have passed it on to me. This morning I felt sick and I tool some equate, it was kind of like tylenol and i had taken half of my multivitamin and some cranberry juice. like a minute later I started throwing up. so i tried to eat some cereal, honeynut cheerios, and I could not finish all that becasue I threw that up as well. Do you have any clue what I might have or what is going on?",
    "doctor_response": "Hi, Thanks for posting in HCM. I understand your concern. What problem you are facing is nothing serious but a upper respiratory tract infection (URTI). Your condition needs to be treated in the following way: 1. Take Tablet Domperidone for vomiting. 2. Decongestant syrup containing Ambroxyl and Chlorpheniramine maleate for cold. 3. Salt water gargling with warm water for sore throat. 4. Consumption of medicated lozanges for sore throat. 5. Steam inhalation twice a day to clear congestion in the sinus.Your symptoms should get better in about 3 to 5 days. Avoid cold items like cold drinks and ice-creams till you your symptoms subside.Hope the information provided would be helpful. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause slimy stools and regular vomiting in a breastfed infant?\n\nHi I have a 7 week old baby girl. She always falls asleep on feeds and most evening when she vomits its slimy. Sometimes her poo is also slimy. She is always crying and hardly ever stays asleep in her back or even on her bed. Please help. Email me on YYYY@YYYY",
    "doctor_response": "Thanks for asking I gone through your question and understand your concern    Falling asleep on feeds is normal for infant. your should interact while feeding . your one hand should be free while you feed. With the free hand your should massage lighly on scalp and soles.  But this interaction infants take good feed ( appox 10-15 min) and good nap for 2-3 hours. Sliimy vomit and stool is normal. When she feed for good time ( appox 10-15 min) she should sleep for  2-3 hours.   hope i answer your question  wish happy parent hood .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What causes swollen lymph nodes and tenderness in neck with hoarse voice?\n\nHello doctor, I am not currently taking any medication. I am a female, 18, of a healthy weight as I am very sporty. I woke up at 3 this morning due to discomfort in my throat, yet no actual pain. I also had a headache. Upon waking up again for the second time, I realized that on the right-hand side of my throat, my gland was very swollen, yet still feel no pain. I am not aware that whether I have an infection with no cold and due to feeling no pain, no sore throat. My neck, however, is tender when touched or turning my head or facing upwards. My cheeks have been very red and I have had very short breath all day. The gland is noticeably bigger than the left, and when I look in my mouth it almost looks like there are two glands there, instead of one, on the right-hand side. The gland is noticeable and visible when just looking at my neck also, despite not being too skinny and having quite a chubby neck and face. There is only pain when touched, and only slight discomfort when swallowing food or water. My voice sounds a bit hoarse sometimes.",
    "doctor_response": "Hi. Lymph nodes (glands) are located in many areas all around the body, including numerous nodes in the neck and jaw area. Lymph nodes typically swell or enlarge when there is an infection close by to their drainage area as they form an important part of the bodies immune response by storing immune cells. Enlarged or painful nodes are thus often a sign that one has an infection in the area. From the symptoms, you describe some of the most likely possibilities are: 1. Tonsilitis (infection of the tonsillar glands at the back of the throat). Tonsillitis is quite common and often requires treatment with antibiotics so that the infection does not spread down the airway causing pneumonia. 2. Mumps (viral infection of the parotid gland). Mumps is most commonly caused by a virus and is treated symptomatically and monitored for complications. 3. Other bacterial or viral infection, most likely of your upper airway that might be spreading down your airway. I would strongly advise that you consult with a trusted physician so that he or she can examine you clinically and confirm or exclude any of the above and treat accordingly to prevent complications. Once treated, the glands typically return to normal within a few days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the early signs and symptoms of pregnancy?\n\nHello Doctor,I got my period delayed by 3 days. From last few days, I am getting temperature high in a certain period of the day and after sometime it recedes. I feel heavy inside, even getting headache. Unable to sit in a certain position,Food craving is there. So am I pregnant?",
    "doctor_response": "you should visit your   gynecologist  and get blood pregnancy test done. that will give you a definite diagnosis of pregnacy. you should be examined what is causing the fever.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible after follicle ruptures?\n\nhi i'm elakkiya i'm 25 years old i check my ovary in foliculary study test after 12th my both right and left side ovary developed then me and husband contact on the next day again i take scan in that scan the result is ruptured. my question is after rupture is it any possible to get an pregnancy",
    "doctor_response": "Hi,Yes pregnancy is possible after rupture of the follicle. In fact pregnancy is possible only after rupture of the follicle. Now let me explain you this.A follicle ruptures to release egg. Usually the eggs released from the follicles of size between 18 mm and 21 mm are the healthiest eggs having maximum possibility of successful pregnancy. An egg has a life of 24 hours while the sperms are active for 3 days. Hence, sexual intercourse even 3 days before the rupture of a follicle (or release of an egg) can cause pregnancy. Since the egg has a life of 24 hours, sexual intercourse within 24 hours of the rupture of follicle can result into pregnancy. I am sure that now you are convinced that unless the follicle is ruptured, egg cannot be released and thus pregnancy is not possible. The pregnancy is possible only after rupture of a follicle. From your history, it appears that you had sexual relations on the day of the follicular rupture, so you have maximum chances of pregnancy. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness, shortness of breath and shaking hands?\n\nI am a 15 year old African American teenage girl with a 32-35 bmi. Sometimes when I take a shower I get a dizzy feeling after maybe 6-8 minutes of showering. I also have shortness of breath and my hands shake. I feel absolute miserable while this is happening and today I had to hurry up and finish for fear that I might faint. What is happening to me?",
    "doctor_response": "Hello. I have been through your question and understand your concern.Sometimes, while taking a hot bath, especially after a meal, you can have blood sequestration in the skin due to the high temperature of the bath and in the stomach if you are having the bath after the meal. This causes less blood going in your brain causing the symptoms described.There is nothing to worry about, because it is quite common. Just be sure you take the bath three to four hours after the meal and take the bath at a lower temperature. You will see it will not happen again.Hope this helps, please feel free using MHC for further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dark toes, pain in the small toe. No injury\n\nHi, My toes on both of my feet are darker than the rest, around the little joint (on the pinky toe) and it hurts sometimes when i wear my sneakers. I don't really engage in much exercise and i don't think i hurt my toe with any gym activities. I am an African American teenager and don't want to have nasty looking feet. What can i do to make my pinky toes look like the rest of my toes?",
    "doctor_response": "Welcome to healthcare magicI feel that the pigmentation that you have is because of constant friction. Use a shoes which is one size larger. Because of shoe bite it will pain and leave behind a pigmentation.Apply a moisturiser containing 10 % urea. Even salicylic acid 5-10% containing creams also will help.Trichloroacetic acid chemical peels one by cosmetologist will help decrease the pigmentation. Hope this helpedTake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant pain under the left jaw bone?\n\nI just had a CT Soft Tissue Neck with Contrast because of pain and swelling under my left jaw line. The results Mild bilateral submandibular gland prominence is present. Normal Neck CT. However, the swelling and pain ache like a tooth ache, I can t even lay on my left side. All glands are normal, No treatment from my doctor, although I am in constant pain under my left jaw bone, what can I do?",
    "doctor_response": "It may be related with infection and swelling in mandibular gland tissue, it can also be a toth related issue. I suggest to check with dental and if everything is fine with tooth then start taking anti biotic( amoxicillin) and pain killer,anti inflammatory tablets along with hot and cold pack use at painful area below jaw.Also do not eat any thing hard on affected side and even do use only warm water to drink as well as for doing gargling after brushing teeth. And keep cotton in your ear while traveling. Do not get expose to cold environment as well do not have cold drinks.If there is infection or inflammation it will be over with this. But if it does not get over then I suggest to talk to your doctor and take a MRI scan for further evaluation. But I am sure if its just swelling at mandibular gland then it will be fine with this. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cancerous lump in neck\n\nMy wife was diagnosed with breast cancer two years ago and we got the surgery done and also done chemotherapy and radiation and we were of the opion that everything is taken care but now we realised that there is a lump on her neck after which we got biopsy done and we came to know that it has become metastasis and that our doctor who was treating her told us that we have mere 6 - 9 moths in our hand and that the only treatment on it is to take another sessions of chemotherapy but it is not gauranteed that it will be cured. My question to you is that can my wife be treated in Dr. Balaji`s clinic and what would be the line of treament. Please revert us as early as possible.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. She has history of breast cancer.  She was treated with surgery followed by chemotherapy and radiotherapy.  Now she has lymphnode metastasis.  Treatment depends on spread.  She should go for ct scan and PET scan.  First check the whole body for any other metastatic lesion.  Then start treatment accordingly. Chemotherapy is needed.  Dosage and schedule depends on spread.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in chest and shoulder after an injury?\n\ni got into an accident and i believe got some whiplash. i had gotten some xrays done at the hospital the day of the accident and the doctor said nothing was broken. im getting alot of pain in my chest and shoulder and sharp pains running down my right arm. what should i do?",
    "doctor_response": "Hello, As of now, you can use analgesics/anti-inflammatory combination like Aceclofenac/Serratiopeptidase for symptomatic relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for swollen lymph node above collar bone?\n\ni have a swollen lymphnode lower right side above collar bone fo about 4 months, taking antibiotics for almost ten days still no change and its not painful, also right side nodule on thyroid 9mm, having biopsy next week on single nodule and lymphnode...very worried!",
    "doctor_response": "HelloWelcome to Healthcare MagicIt may be primary nodule in thyroid and spread to collar bone so it ma be malignant or problamatic.You should first consult your doctor for biopsy. It will clearly rule out the disease because antibiotics are not working.Thank you anf take care...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes skinny wrists and flexible fingers?\n\nHello sir, I am 22 years old.. All my body parts are better in muscle content or fatty except my wrists..  why are my wrists so skinny (thin)..am i suffering from any disease??my fingers are so flexible.. i can bend my fingers back to touch the back portion of my palm..",
    "doctor_response": "Hi,You have hyperlaxity in your body.You need physiotherapy, stretching exercise only, nothing to worry.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for erectile dysfunction and premature ejaculation\n\nSir i m 26 years old. from last one year i am suffering from erecticle dysfunction.during foreplay i gets erection, but after some time water type discharge comes from my pennis and i losses my erection which results in soft erection as well as premature ejaculation",
    "doctor_response": "HelloYour symptoms may be due to overexcited state,inadequate emptying etc.Your age doesn't support true erectile dysfunction and premature ejaculation.You should avoid provocative literature and videos.You should try to be calm and try to engage yourself in your job.You may need routine hemogram and random blood sugar estimation.You should take healthy and nutritious diet.You will be fine.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had damage on upper lip of mouth. Painful, swollen. Healing time, home treatment?\n\nHi there. My frenulum (I believe it's called) in the upper lip of my mouth was damaged by accident about 3 days ago when I accidentally got the edge of a folder right to the top of my mouth when trying to look down whilst holding the folder. It's quite painful and is noticeably worse today, to the point where I found it extremely painful to even smile or chew. It's slightly swollen, and I think brushing my teeth doesn't help the situation. Any advice on healing time/home treatment I can do to ease pain and speed the healing? Thank you! Sorry for the long text.",
    "doctor_response": "Hello,   well.your query is posted to an allopathy doctor,I am away from natural home remedies.anyway I suggest that the untreated injury in the upper lip leads to severe brain infection.moreover pain swelling during eating Hence you ha e to put injection TT followed by oral antibiotic and antiinflamatory drugs for five to seven days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Ay treatment for rashes in the thigh?\n\nI have thigh rashes (seems infection because they are increasing in a shape).burning,itching are the symptoms,i also have a ringworm on my face so i am using candid-b and terbinafine. can i use same for the my thigh if not what should i use? is there any effect of alcohol during treatment?",
    "doctor_response": "Hello,Welcome to HCM,As you are having fungal infection of the face, you would transmitted the infection to the thigh also.But the physical examination has to be done before confirming that the lesion on your thigh is a fungal infection, even though the symptoms and the history are suggesting of fungal infection.As you are using terbinafine and candid-b, same thing can be continued and the local application of candid-b, will help you to bring down the symptoms.Daily use of alcohol when on antifungal treatment may increase your chance for serious side effects.I would suggest you that in addition to aforementioned medications, you can follow.1.Trim your nails and maintain the personal hygiene.2.Oral Antihistamines3.Oral Antibiotics to prevent secondary bacterial infections.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from prostrate. Prostrate is moderately enlarged. What are the findings from the report?\n\nI AM S    UFFERING FROM PROSTATE. FOLLOWING TESTS HAVE BEEN CARRIED OUT .RESULT AS FOLLO. WED.Prostate is moderately enlarged in size and measures 29.9ccin volume weight(in grams).It shows speck of calcification. Bladder Prevoid volume 111cc Post void volume 3.5cc.  Right kidney 10.9cm Left kidney 11.3cm.            Uro flow results as follows Peak flow rate 8ml/sec Time to peak flow 26 sec. Voided volume 152ml. Flow time 42/sec. Average flow rate 4ml/sec. CREATININE 1.0 Prostate specific antigen 0.98.Pl. give me your advice.Thank you.",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum. The average weight of prostate is 11 gm ( 7-16 gm or cc ) according to few books. In your case , you are right , moderately enlarged prostate.Mild retention or urine is there ( 3.5 cc).Serum creatinine level is very good .Average flow rate is mildly slow ,but this may be due to age factor. In my opinion the cause of concern is speck of calcification . Prostate specific antigen is very good in your case , this is not a cause of concern, rather favorable. Get in one more opinion from a urologist .Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a lot of white spots on the back of palate. Could this be cancer?\n\nHi doctor, I discovered a lot of white spots in the back of the palate and I am super afraid that this could be cancer. I do not know if it is possible to upload a picture. I am 29 years old, non-smoker but I do drink alcohol sometimes. I am currently on L-Thyrox 75 mg.",
    "doctor_response": "Hello. Since how many days have you noticed these spots? Is there irritation while eating hot or spicy food? It might be just starting of a throat infection and definitely not cancer. Are you taking any medicines? Did you take any specific food items or very hot drinks, etc? Use warm salt water gargle twice a day for a week.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Toes numb, muscle pain in legs, stiffness, change in eyesight after hurting S5 area. Suspecting cyst in head. Suggestions?\n\nfall onto back at s5 area, now my toes are numb, feet feel like walking on rocks or like a wire is being pulled to my heal, sciatica (never had before) both hands and arms are a painful numb sporaticaly, muscle pain in both legs, pain in r s5 area, mid back and neck are stiff and at times painful, i can barely walk now, my body spasams in pain now, my eyesight changed right after the injury  5 months ago.  at one point on the mri they thought there might be a tarlovs cyst at the area of impact.  now  im being told theres not a break so it must be in my head.   any ideas?",
    "doctor_response": "Hi, it appears to be due to the injury to the cervical spine, and compression, hence showing the symptoms. You may need to have M.R.I.for diagnosis. So i advise you to consult a neurologist for diagnosis and treatment.                              I to my patient with such symptoms advise to lye down on the back only for at least a month.                              I to my patient with such symptoms prescribe neurotropic injections for 10 consecutive days, and antiinflamatories. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bleeding and uneasiness during motions?\n\nmy baby name is, geethika is feeling uneasy ,while is going 2 motin, when is going to motion , in that blood also coming why it is causing ? she is 10 months baby only, only when she is going to motion she is feeling uneasy , otherwise she is good, why it is going like that? pls answer to my querstion sir",
    "doctor_response": "HiI understand your concerns but don't worry. The most likely reason can be an anal fissure in your baby. It can be easily managed. I would recommend you to visit a pediatric surgeon for proper clinical evaluation and definitive treatment.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in getting pregnant?\n\nwhy after 5 years of marriage never having pregnant... never event once,also never abort... there's any something that i should know about my self... me & my husband has been told by doctors that we are normal couple after been checked by them 2 years ago, already done IUI twice but nothing happens... what should i know regarding this problem?",
    "doctor_response": "Hi,Thanks  for writing to HCM. You and your husband are diagnosed as normal couples. There are still many problems which can cause infertility.  Like problem in fertilisation of egg or problem in implantation.  Since you are trying from 5 years I would suggest you to go for IVF I.e in vitro fertilization.  Here the problem of fertilisation is solved as in this procedure they fertilise egg outside and then they place them into uterus . They place 3 to 4 fertilised egg into uterus . So chances of conceiving increase . This will help you. You can discuss with your doctor. Hope I have been helpful .RegardsDr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Should I take bed rest for soft cervix during pregnancy?\n\nHello doctor, My age is 31 years and weight is 65 kg. I have 4 years 3 months old son. In my first pregnancy, I did not have any complications until my delivery date. Regarding my cervical length or cervix softness, no other issues. My delivery type was C-section first time. Now I am five months pregnant and my doctor did PV and told that I m having a soft cervix and advised me to take bed rest till the eighth month and suggested me to take Hydroxyprogesterone (maintenance 500 mg) for every 15 days till the eighth month and told to take tablet Optogest 200 mg daily twice. I climb about 30 steps in the morning and evening. So is it advisable to work for at least six hours for one more month and then take rest for remaining three months (that is for seventh, eighth and ninth months)?",
    "doctor_response": "Hi. How are you doing? I do not see any reason for rest. What your doctor is worried is about cervical insufficiency or incompetence. This condition can be diagnosed only by seeing a cervical length of less than 2.5 cm with funneling of the internal OS (internal orifice) or by a history of previous painless delivery. I do not see any of these in your history. In present pregnancy too, I do not see any risk factors. Every pregnant uterus will have a soft cervix. This does not mean that it has incompetence. Your cervical length has always been more than 3 cm. You can follow the advice of having those medications. They keep the uterus silent and will prevent any sudden progress of pain. You can definitely work, avoid too much physical stress and avoid any infections like urinary infection (avoid filthy public toilets, have a lot of water and do not hold back urine for long), respiratory infection (keep away from people with fever, cold), gastrointestinal infections (avoid unhygienic food) at 28 weeks. Have a glucose challenge test to rule out pregnancy induced diabetes. Better not to use Progestins for too long. They can cause mild growth restrictions. You can definitely have a routine regular life. After all, pregnancy is not a disease. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for red spots on feet\n\nSuggest treatment for pins and needle feeling and rashes on feet I have the\u00a0pins\u00a0and needle feeling on the bottom of my\u00a0feet. I also have\u00a0red\u00a0spots\u00a0or rash on\u00a0feet. My hands have two\u00a0spots\u00a0and numbness on the side of my little fingers and one thumb. ...",
    "doctor_response": "Hi, u didn't mention since how long u are having rashes or needle pin feeling over sole.doctor need to see this rash by his named eye rather dignosing only on history. U should consult dermatologist for the same, i n the meantime antihistamines will help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bouts of sneezing with watery eyes?\n\nHi i am tushar age 23 , every mornin i get up i sneeze 4 to 5 times ... sometimes sneezing doesn't stop & eyes start watering and its even worst .. i avoid taking medicine but when i can't control the sneezing i take allegra & after that then its fine ...please suggest what is wrong with me ...",
    "doctor_response": "Hello Tushar,Thank you for asking at HCM.I went through your history and would like to make suggestions for you as follows:1. From your history, I would first think of allergic rhinitis. I usually prescribe my such patients combination of montelukast and an antihistamine like fexofenadine (Allegra that you are taking).2. It is important to mention here that above medicines can only \"control\" your symptoms, they basically do not \"cure\" allergies.3. I would suggest you allergy testing which will help you identify the substances you may be allergic to and also to know the measures to avoid them.Based on your allergy testing, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which works on immune system to improve your allergy symptoms on a long term basis.4. I would especially think of allergy to house dust mites or indoor molds as you have early morning symptoms.5. In general, I would suggest you to avoid exposure to dusts, smokes and air pollution as much as possible.6. I would also suggest you to take a healthy diet rich in vitamins & minerals (adequate amounts of green leafy vegetables, fruits, sprouts, etc) which will improve your immunity and will be helpful in a long run.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why my 2.5 years old staggers while walking?\n\nI have baby 2.5 yrs of age.He got operated when he was born from his back due to a small fluid rash.He is also a sufferring from hydrocaphlus.When he was born his right foot was a little bit tilt.I massaged and exercised his tilt foot daily and now its a little bit good.My baby learned walking very late at age of 2.25 than a normal child.Now sir the problem is whenever he walks he does not place his right foot in proper position and staggered during walk.Also he does not get stand at his own.Whats the reason and problem sir and whats your opinion?",
    "doctor_response": "your son is lucky , he had what is called myelomeningocele which is fluid filled sac in the back , and hydrocephalus which is the accusation of the fluid inside brain ventricles.  most of these children can't walk , or have control on bladder or rectum because of the damaged and incomplete formation of the nervous system . the fact that your son can walk is amazing , physiotherapy which you did help a lot in that if we need the child to stand by his own , physiotherapy to the back muscles is very helpful , when that happens , he can balance well .any small improvement in his walk is very great success for you as a mother .continue with legs physiotherapy , if you notice a spastic joint especially in the ankle joint , concentrate on that one and request a help from a nearby physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How is the result after using menogon injection for follicle maturation?\n\nhi. i m sahar my age is 33 i m taking injection menogon for 5 days as my dr suggest for conceive baby it is powerful injection for follicles mature & how is the result after used & during this injection used no need to intercourse or yes it is necessary please reply me thanks",
    "doctor_response": "Dear Valuable Patient,as per the case study of yours.i would suggest to get better result using Menogon ,you need to intercourse which will give you the better results.I hope this information will be helpful Thank you very muchDr.Shubhangi T",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever, vomit and diarrhea?\n\nMy 3 months old baby is having fever around 102 F and her urine has WBC in it... We are giving Panadol and Burana every six hours but the temperature is not going down permenantly. It since 4 May morning she is suffering from fever, vomiting and dairrhea.",
    "doctor_response": "With such presentation in my clinic I will exclude UTI infection, by performance of ultrasound of kidneys and urine bladder, cytology of urine,enterocolitis  by giving stool culture and sensitivity to antibiotics. You should start to give Cefixime(Taxim)syrup 4 mg/kg/dose twice for 5 days after meal.Hope it helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can seizures be healed?\n\nMy son who is 41 years old started having seizures last October. The doctors have not determined what has caused him to start having them. he has them one the average of 1 - 2 per month He is taking keppra. When he has these seizures he passes out. I live in Texas and he lives in Washington State. He has been seeing an neurologist but nothing seems to be helping. He has had CT and MRI s but nothing is showing up. He is loosing his memory with these seizures. He forgot my parents died 3 years ago when I just spoke with him and he asked me the same questions 3- 4 times. I would like for him to see someone else but living so far away, I am not sure what I can do or who I should turn to in Washington State. He lives in Richland. Do you have any suggestions what to suggest him to do or where to go for more help. Money is a concern as he has not been able to work, nor drive and he does not have any insurance. Thanks",
    "doctor_response": "Hi, 41 yrs old patient with seizure disorder  on tab keppra  is having recurrent seizures .So antiepileptic should be changed or its dose should be increased .If seizures are controlled by this then it should be continued for 3 yrs .Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for the swollen retro molar which is very painful?\n\nHello, I have a swollen retromolar (trigone?) on my left side and it's very painful. I'm 30 and have never had any of my wisdom teeth pulled and most are almost out but the one on the bottom left is only about two-thirds out. The area around these molars has been sore before every once in a while, but this time it is extremely painful. My questions are: 1) is this pain likely to go away eventually like in the past? 2) if I do have to see the dentist, is it important to see someone right away (including ER if necessary), or would it be okay to wait a couple of days?Thank you!",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM   I have gone through your query, as you have asked for pain yes it can be netter for few days but then again after sometime it can cause pain.  I will suggest you that you should consult dentist and go for extraction it will be best for you. Hope this will help you",
    "dialogue_context": ""
  },
  {
    "patient_message": "How much time does it take to remove 7 mm stone from uv junction?\n\nI have a 7 mm stone at u.v. junction and another 8mm at right distal ureteric stone. I have taken homeopathy treatment. This is very painfull at back side. My faimily force to laser treatment.Whats I do, how many time it will takes to through out stone.",
    "doctor_response": "Hello and welcome to HCM. As you have 1 stone 7mm at the UV junction and a R. distal 8mm. stone, it's best that you undergo an endoscopic lithotripsy operation,using Laser or ultrasound.Both the stones can be treated in one session. The patient's usually discharged the next day, if there're no complications like, fever, bleeding or any other medical problem. your pain due to the stone will be relieved at once, and there won't be need of any other treatment like homeopathy.remember to drink minimum 12 glasses of liquids per day.  wish you a speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathlessness in mornings?\n\nI have been experiencing breathlessness for a few mornings - it goes off later in the day.  I am at a fairly high altitude (6000ft) but have been here for a couple of weeks.  I haven't slept particularly well for a few nights because of noisy neighbours.  I'm 57, reasonably healthy although I could do with losing 15 pounds, female. No pain and no other symptoms.",
    "doctor_response": "Hi,If you experienced breathlessness after you didn't sleep well for couple of days, then it is relayed to it. Don't worry, just regulate your lifestyle and it will disappear, otherwise see a doctor to perform chest X Rays if you continue to have further breathlessness.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes confusion and disorientation?\n\nA friend (66) thinks someone is going in her house and  stealing from her. When something turns up, she says they just returned it. She has started hiding things (hence more confusion) and taking bags and leaving them in her car. She is ADD (not diagnosed but very obviously) and not well organized. What can this indicate?",
    "doctor_response": "hi, if it is sudden onset it might be a vascular dementia with delirium in which sudden onset of disorientation along with confusion along with some time presence of psychotic features like someone is coming, harm him. with sleep disturbance. for that kindly admit or for first aid kindly give tab.tolaz (5) 0-0-1 .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can medicines taken for MDR tuberculosis cause diarrhea?\n\nHello doctor, My mother is 51 years old with DM and thyroid and is suffering from MDR tuberculosis. She is on medication for 15 months. Recently her medicine has been changed due to diarrhea. Her new medicine are Elox OZ, Rabifit DSR, Calvit 500 mg, Doxid 50 mg, Trixid-H, Petril MD, Rejunex CD3, Ativan 1 mg, Zenoxa 300 mg, Censpram plus, Redotil, Combutol 1000 mg, Augmentin 1000 mg, Pzid 750 mg, lcin 500 mg, Ethide 250 mg, Linox 600 mg, Econorm sachet, QPAS. Does any of the above-mentioned medicine can cause this problem?",
    "doctor_response": "Hi. This contains a big list of medicines including anti-TB medicines, antibiotics, antidepressants, anti-diarrhea medicines, etc. Few of them are the same compounds, especially antidepressants containing Clonazepam. Rabifit-DSR contains Domperidone, which can cause increased gut motility. You can substitute it with plain Rabeprazole. Augmentin has the potential to cause antibiotic-induced diarrhea by altering the gut flora. Your list contains Econorm which helps in relieving diarrhea. All the antidepressants can alter gut motility but mostly decrease it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does the mole near my breast affect breastfeeding?\n\nI have a raised mole (about 7mm wide) at the bottom of my clevage and have noticed that the area around it is numb. I have recently been pregnant and now am breastfeeding my 6-wk old boy. Is this anything to be concerned about or is it quite normal due to the pregnancy hormones?",
    "doctor_response": "it should interfere with the breast feeding. But it will be better if you will consult a dermatologist for sure to determine the diagnosis of the mole , what is the nature of this.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lost feeling on right side due to TIA. Have a bad disk in back along with sciatic nerve\n\nI have deteriorating disks in my back and they cant operate and a siatic nerve on the right side the disks are L3 L4 L5 and i go to a neurologist .I also have had 2 TIA in OCT and they tell me to go to a heart Dr but why did I loose feeling all on the right side and it tingles and i drop things im weak on the right side and there is nothing they can do i dont understand whyIM sorry I have no income and trying to get on disability, sorry for taking up your time",
    "doctor_response": "HIThank for asking to HCMI really understand your concern, as long as the TIA is concern I would advise you to take care of blood pressure if you have high blood pressure then be on medicine regularly, if you do not have it then measure it regularly, watch for blood glucose level, for the disc problem the best way to deal with it is physiotherapy, and some NSAID this will give good relief to you nothing to worry it will be alright soon have nice day (It would be much better if you would have mentioned your age and gender)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump between thigh and vagina?\n\nHi, i'm a 14 year old girl. 3 days ago i found a lump, as big as a grape. its red nd has small white spots on it. it is between my thigh nd vagina. i researched nd most of it said its ingrown hair but there is hair growing on it. i m absolutely terrified nd i dont wanna talk to my parents about it. it hurts when i touch it :( pls help.",
    "doctor_response": "Hi, dear plz take following steps to treat your bump inear vagina-a- tb diclofenac for 5 daysb- antibioticsx5 daysc - take rest  if need beAnd do this with help of your doctor who would treat it accordingly.font worry, it will go in 3-5 days time.Wishing fast recovery.Feel free to ask further querry in this regard.Have a good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the dosage of Amlodipine?\n\nI am an otherwise healthy 65 year old male, who just recently developed high blood pressure. My doctor prescribed 5mg. Of Amlodipine which seems to be working with no side affects. However it brought the bp down to roughly 140/90. Would a higher dosage help more? Keith Whinnery",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I would like to tell you that dosage of blood pressure medicine depends on your blood pressure how high it is. If your blood pressure is under 140/90, then you should continue with the same dose of Amlodipine. Taking higher dose than this can cause you hypotension so higher dose as of now isn't recommended for you as of now. Hope to have been helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does 120 over 100 BP levels indication of high BP?\n\nhi i have anxiety disorder for almost 10 years now,also hv shoulder and neck muscular inflammation and about 4 months ago my bp raised up to 170 over 110 then became normal 3wks after..my last bp was the other day 120 over 100.is this an indication that i am high blood too?or just because of the vein inflammation?pls i need some advice..tnx",
    "doctor_response": "Hi ThereI've read your query and understanding your concern.I would like to tell you BP more than 140/90 is an indication for high blood pressure. But , what time you are checking your BP that matters. During any inflammation , temperature, anger and anxiety BP raises up to some level.It's advisable for you to check your BP at different times everyday after relaxing yourself for 10 min. If it generally stays more than 140/90 then you need to start with dietary modifications and Antihypertensive meds.Hopefully I answered all your queries.Wish You Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain after mitral valve repair\n\nI am Sabapathy aged 68 having MItral valve prolopse from birth. More that 25 Years i have taken Betablocker. During 2006 Valve repair surgery done and the leakeage minimized from moderate-severe. In mid Nov 2013 i had giddines, palpitation,sweating and breathlessness. Immediatly cardio version done. Further Electro Physiologist consulted and studied. Study revealed the reason is becase of scar in the heart mustles caused by Mitral valve repair.(Cutting the heart) in 2006 . Then RF ablation done and ICD was implanted on precautionary for VT and not to reduce the pulse less than 60. Now iam feeling dizzines at times and pinning pain (Very much tolerable) discomfort. Some time mild giddiness also experienced. Please suggest me appropriate to do for eliminating pinning pain discomfort. Medicines taken Selcon 25 mg (Metoprolal tratrate) one per day Warfaring 3 mg.ONE PER DAY cARDARONE 100MG-ONE PER DAY Regards, Sabapathy",
    "doctor_response": "You have been treated for your problem perfectly well. But as you still have pain, if muscular in origin pain killers will suffice. At times the icd implanted may be the cause for pain. Just get checked with ur cardiologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pins and needles under the arms with anxiety attacks?\n\nDear Doctor, I have had anxiety for sometime now but I fear it may be more than anxiety now. Under my left arm I feel like needles are poking me the sensation comes and goes I dont know if it is normal for a 19 year old to feel this with anxiety. Also the left brast (male) has been getting bigger than my right so is my left arm. It use to be my right side was bigger. I dont have any blood thinning problems but is there a chance of this being a heart attack?",
    "doctor_response": "Hi  dear. I had gone through your query. I understand your concern. You are in much stress and require relaxation. It is all anxiety symptoms and require treatment. Anxiety symptoms mimic like heart attack. But heart related problems can be ruled out by investigation like ECG and ECHO.Consult physician for routine check up. Anxiety can be treated with medicine like anxiolytic. Etizolam can be useful. But ddo take advise from your treating doctor before taking this medicine. Still if you have a query then feel free to ask. Happy to help you further. Get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be the normal sperm count to get a baby?\n\nhi doctor im 28 yrs old.and normal..i want to have a baby how much for the sperm?because i am lesbian and really want to have a baby and im virgin never experience any intercourse to a man.where do i get sperm bank in the philippines?thanks so much.hope you understand",
    "doctor_response": "hiii.you can  get baby using artificial insemination techniques.IUI,ICSI techniques are also available.you can consult with your infertility doctor for this problem.for men,atleast 20 million sperm per ml of semen should be there to fertilise a ovum.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for weird lump on collar bone?\n\nI have a weird lump on my collar bone that moves around when pushed. It can be moved almost completely around but cannot outside and cannot go under the collar bone. It is hard but can be manipulated like a flexed muscle. Its about two centimeters accross. What is this and should I be concerned.",
    "doctor_response": "Hi! after going through your description I could summarize the supraclavicular lump measures 2x2 cm, hard, mobile but restrcited and duration or any symptoms not mentioned!Well, this is fairly common to get a nodule in this area and as per my experience from fine needle aspiration biopsy, the possibilities are as follows:1. an enlarged lymph node due to infection in axilla, lungs, throat or viral infection, tuberculosis or cancer in rare cases!2. benign skin tumor like conditions like lipoma, neurofibroma, dermatofibroma of some cysts!Therefore it could be a reason of concern and you have to see a physician for an examination and needle biopsy for confirmation if necessary to decide if any treatment is needed!regards,your",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the best facial creams & diet suggested for black marks?\n\nsince i was sixteen on that days appear black marks on face i used garnier pimple and black marks are disappear. now i  'am 23 my face appear lot of pimples and black marks . i use lot of cream and also consult many doctor but no use pimple black marks and pores   are as it is.please doctor say which cream is best to use ? and diet",
    "doctor_response": "hi...........to remove the black marks and spots .use the following ;[ one teaspoon of shell fish  powder +one teaspoon of chicpeas [garbanzo beans ] .+one teaspoon of   fuller's earth + one egg white  ]. ... mix all the ingredient  and put the mask  for 1 to 2 hours  with complete  rest......... after washing  it apply olive oil to your face .......... you can use this daily for one week .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does pain in abdomen like pulled muscle or gas mean?\n\nHi I have abdominal pain around my navel started yesterday above pelvic line and has gotten worse. Feels like a pulled muscle or like severe wind but can urinate and have bowel movements fine just feels like huge pressure down there. I'm mid cycle and apart from this I feel fine.",
    "doctor_response": "This pain may be due to gastritis. you can take pantoprazole 40 mg OD in morning 30 minutes before breakfast. if I were your treating doctor then I will prefer for investigation like USG",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for greenish yellow color of the semen?\n\nim 24, 5ft 10 and weight about 85kg.  i noticed today that when i ejaculated i had a greeny yellowish area of my seamen, most of it was the normal cloudy white colour, but there was the one bit that was like jelly and greeny yellow colour, could this be related to hiv or any sexual transmitted diseases? and what other possibilities could it be related to?",
    "doctor_response": "Hi, If you had unprotected sex then need to think of sexually transmitted infection. If not it can be dehydration, prostate infection, urinary tract infection. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will Gabapentin relieve pain in the lower back and bottom of the foot?\n\nI am experiancing extreme lower back pain, sciatica with this spot on the bottom of my foot that hurts briefly when the sciatica gets really bad. Is gabapentin a nedication that might help ease this pain...I ve tried almost everything OTC. Taking alot of nsaids worries me. I went to an urgent care and after taking 20mg of flexirol I was able to relax a little, but of coarse it just makes me tired and only takes the edge off of the pain it doesn t seem to be addressing it.",
    "doctor_response": "Hi i am Dr Ahmed Aly    thanks for using healthcaremagic site ,I had gone through your question and understand your concerns ..   In my opinion yes gabapentin will help as a long acting analgesic but it also have series side effects that you have take in your consideration .    It is an anti-epileptic medication, also called an anticonvulsant. It affects chemicals and nerves in the body that are involved in the cause of seizures and some types of pain ,Gabapentin is used in adults to treat nerve pain .   Try B12 supplementation , physiotherapy , hot massages with topical gels , muscle relaxants and avoid heavy lifting and vigorous movements and you will be fine .Please click and consider a 5 star rating with some positive feedback if the information was helpful. Wish you good health,Any further clarifications feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can mental illnesses with death anxiety be treated?\n\nHi, may I answer your health queries right now ?  Please type your query here... hello sir/mam I am dhiraj kumar goyal from India. I have a problem of mental sickness and fear of death. thats y i have no confidence. please help me. i will be highly obliged to you",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Across the world, Every one has fear of death. No body wants to die. No body wants diseases. Still people are normal. Why?. Because they have so many other things to do or to think. You are a young person, I hope, though you have not given your age. Fear about death and health is called health anxiety. Counseling should cure you. Just consult a counselor.If you require more of my help in this aspect, Please post a direct question to me in this URL.  Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I have shooting pain in my calves after walking?\n\nHello doctor, I am a 60 year old known diabetic. Since two years, I am having severe leg pain when I walk even for a small distance. I have shooting pain in my calves after just 10 minutes of walk. Doctors have diagnosed it as calcification of nerves. I have attached my reports for your reference. Please help.",
    "doctor_response": "Hi. You are having intermittent claudication due to a peripheral arterial disease as demonstrated by your arterial ultrasound (attachment removed to protect patient identity). I am hoping it is a Doppler ultrasound. It appears that your diabetes is under control and you do not have heart failure. I understand that you have no history of heart attack either. Peripheral vascular disease, less likely but sciatica is also possible. You have normal EMG, but there is no MRI and nerve conduction study available. If ankle-brachial index is normal, then nerve conduction study has to be taken. Peripheral vascular disease. 1. Increase the Cilostazol to 100 mg twice daily if there is no history of heart failure, heart attack and not taking two blood thinner agents together. 2. If taking Aspirin only, then it is safe to increase the dose to 100 mg twice daily. 3. I would encourage you to take 81 mg of Aspirin daily. 4. Also, do exercise grading. It is a three month program that will gradually build your exercise tolerance. Follow up in a month to an internal medicine physician online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "High ALT level, ultrasound shows fatty liver, history as heavy drinker. Could I have cirrhosis ?\n\nI have had a high alt level in the 70s for 5 years or so now. US shows fatty liver, all other enzymes are normal and no hep. I used to drink heavy from age 15 to 25 i am 29 now and no longer drink. Could i have cirrhosis or would my blood work look different? Gi doc says we should do a biopsy just to see what's in there but i would rather not. Please help with any thoughts. Thank you.",
    "doctor_response": "hi.. you have high liver enzymes levels, and USG shown the fatty change.. as your doctor has rightly said.. biopsy is needed for the diagnosis of cirrhosis... since you have fatty change in USG, which is the early stage of liver injury due to alcohol intake... but fatty change is reversible if you abstein from the alcohol.. wish you best of luck for the stopping of alcohol intake...",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have had a persistant cough, Should I worry ?\n\nHI, I am a 39 year old woman and have had a persistant cough since August. Someone told me that I could have developed asthma or emphasyma. The paramedics came and told me after checking my chest and oxygen intake (100%) that I didn t have either. Is it possible to develop asthma in your 30 s because I thought you would know from childhood. Can I trust what the paramedics told me or do I have to have further tests to know if I ve develope asthma ( peak test or chest x-ray ). Someone else thinks that I have a sinus cough. Not sure what to do now. Should I worry about asthma? Thank you very much, Ramona",
    "doctor_response": "Hello. . Having asthma with 100% oxygen saturation is not likely . You are having an allergic cough. You can be relieved by having Tab. Montelukast and a steroid inhaler which will both be helpful under medical supervision. Dr. Rakhi Tayal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is the spot on my lip indicating cancer?\n\nHello doctor, I am suffering from an awkward spot on my lower lip. It is like a basic symptom of lip cancer. Please give your valuable suggestion.",
    "doctor_response": "Hi. I have gone through your case. There are many causes and clinical presentation of lip cancer. You should provide a complete history of the lesion for how long it has been there and also send picture as well. Or please see dermatologist personally.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for multiple ailments\n\nI have a multitude of symptoms and can't find anyone to look at all of them. My lab work doesn't seem to be leading doctors anywhere yet. I have petechiae on my earlobes intermittently, especially when I'm going to be sick or am extremely stressed. Sometimes it shows up elsewhere too. I have extremely heavy menstrual cycles, which are every 3 weeks, not four. I was diagnosed with severe food allergies ten years ago, but can't afford new testing (and I know your allergies can shift). I have the symptoms of hypothyroid, but my initial test shows that I'm in the normal range. I am fatigued, even when I am regularly exercising. I have a hard time not being overweight, though I eat well and am active. Could this be an autoimmune issue, a thyroid one, a blood disorder, a bunch of things. Who should I go and see? My resources are limited, so I want to use them as wisely as possible.",
    "doctor_response": "Hi I would suggest you to see a gynaecologist. An ultrasound scan and a couple hormone tests which will give an idea about the heavy menstrual bleed. Having periods once every 3 weeks is normal. I don't understand what you mean by allergies shifting. When you are found allergic to certain food unfortunately it lasts life long and the only thing you can do is to avoid foods that you know you are allergic to. A couple of explanations for your symptoms are Anemia and PCOS. These are only possibilities, you need a test or two to confirm whether you have this or not(CBC and Ultrasound Abdomen). Donot allow the internet to mislead you and donot take undue stress by what you see online. Many patients with hypothyroidism donot have half the symptoms mentioned online. So see a gynaecologist who will be able to help you figure out what is wrong ( if anything is wrong at all :) ) . You can be active and eat well but being stressed out can also cause you to gain weight. Practice relaxation exercises. Skin in the ear lobes are very thin and a capillaries can burst with little pressure it is not an indication of anything serious. Do not worry. I hope this helps. Take care :)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for weak legs when on Metaxalone\n\nI have been taking 800 mg of metaxalone daily for 10+ days. For the past 3-4 days my legs are very weak, almost to the point of not supporting my weight. Plus my buttox hurts when setting., I have noticed my left back side of my neck is now painful. I have very little energy and even walking short distances with very little speed my chest feels like I have been exercising outside on a very cold day. 3 days ago I had a severe panic attack that resulted with a write to the ER. I had urine and blood tests, along with a CT and MRI all of which showed normal. My DR. Seems to be at a loss. Is there any inlightenment you can share with me.",
    "doctor_response": "helloIt is not clear why metaxalone has been prescribed to you.Muscle relaxants are prescribed when there is painful muscle spasm due to sprains or arthritis in spine when muscle stiffness and pain are predominating symptoms.If you are getting weakness i legs, you may lower the dose or stop it and rely more on heat, physical therapy and local application of muscle relaxant gels to neck or back wheever its paining with muscle spasm or stiffness.If very necessary, soma(carisoprodol) is an alternative. consult an orthopedic doctor for prescriptionbest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red itchy spots on the upper half of the body?\n\nI woke up with red non itchy spots on top half of body,not a large amount and fairly spaced out, but there is one group on my upper chest. Recently got new pillows, and the day prior had played with a strangers dog and also help to vaccinate 30+ pigeons",
    "doctor_response": "Hello dear,The symptoms as mentioned in your post can be due to:1. Ringworm (tinea) infection2. Urticaria3. Insect bite4. Contact dermatitisSymptomatic relief can be obtained with:1. Application of Calamine lotion for symptomatic relief.2. Intake of antihistamine preparations like Allegra3. Application of topical steroid & anti-fungal ointment.4. Antibiotics to prevent secondary bacterial infection.If symptoms still persist, kindly visit a Dermatologist & get a proper clinical examination done to find the exact cause.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I use Kojivit gel to get fair skin?\n\nHi doctor, I am a 22 year old female. I have a dusky skin that is brown skin. I want to become fair. Can I use Kojivit gel? Or any other dermoatology cream can I use? My hands are also brown in color and full of tan. Do you suggest any creams to get fair? I want to become fair as my marriage is going to get fixed by next year. Please suggest me some creams, so that it should not show any side effects. Also, how long I should use it? If I use anything, then will it have any effect in case of pregnancy, etc? Please help me. Thanks in advance.",
    "doctor_response": "Hi. One's skin color has 2 components. First one is genetic, which cannot be changed. Every skin color is beautiful in its own way and we should learn to love our skin color and augment it and not hide or lighten it. The second component is acquired, which is due to the influence of environment, sunlight, hormones, aging, etc. We can only target the acquired component of fair skin color while attempting lightening procedures. I suggest you antioxidant capsules like capsule Antoxid HC (Beta-carotene) and apply sunscreen lotion Lashield gel at 8 AM and 12 PM. Also, you can apply Glyaha koj lotion (Hydroquinone) at night time. Start with an alternate night application initialy as it may irritate your skin a bit and after a week or so, shift to daily night application. Consult your specialist doctor, discuss with him or her and take the treatment with consent. You can go for chemical peeling or microdermabrasion from your dermatologist which will help in exfoliating and give you a clearer skin tone. All these treatments are free of side effects. You may use them for three months. For further information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes warm sensation on left side of foot?\n\nfor the past 2 wks i have been getting a warm sensation on the left side of my foot. it lasts for about 30 seconds to 1 miniute. was happing about once or twice a day and now it is becoming more frequent. is it something i should be worried about? its not painful, just strange feeling.",
    "doctor_response": "Hello, As seen in history this could be possibly due to two factors - uric acid levels increased or nerve entrapment. For uric acids levels, you can get your urine examined for an increase in the levels of uric acid. if that turns out fine than a nerve entrapment should be considered. It needs a physical examination and exercises for core and lower limbs which will help ease the symptoms. In my clinical practice of 12 years both types of patients have responded well to physical therapy and with a simple exercise, they are better. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hello,my name is Daniel and I am 18.A few days ago I've noticed that my pee turned white,milky white while I was peeing.Today I've noticed this again.What is the cause of this?Is it lymphatic fylariosis or chyluria ?Please help.",
    "doctor_response": "After a night of drinking alcohol when I wake up to pee my urine is a stringy white,what is this?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling in feet after an injury\n\nI hit my foot against an Iron gate. There was no bleeding at that time. Only a slight hit. The outer layer of the skin came out a little. But after that i didnt feel any pain. After 2 days I started feeling pain while standing and walking. My foot is swollen now. What is the reason for this? What should I do now?",
    "doctor_response": "Hi thereThanks for your question at HCM. The pain associated with foot and ankle injuries usually subsides in 2 to 3 days with analgesics medicines, rest, ice application and a compressive bandage. If the pain persists after 48 hours, it suggests slightly more severe form of soft tissue for bony injury.If you have any pain when you stand or walk on your injured feet, it suggests severity of injury and warrants further work up which will include an X ray at the least. But you are not expected to have pain on standing or walking in mild injuries. Such pain should suggest you to take your injury seriously to avoid long term ligament related pains. Hope this helps All the best. Regards.Dr.SBK",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to avoid pregnancy after unprotected sex\n\nMe and my friend had unprotected sex because the condom broke while he was tryin to put it on, but he did not ejaculate in me. He and I fear that I can be pregnant from his pre-cum and we arent ready to become parents yet. If I am, what are some safe natural home remedies i can use to terminate it?",
    "doctor_response": "Hello dearI understand your concernThere is no natural remedies that prevent the pregnancy.You can take emergency contraception pill like I pill to prevent the pregnancy up to 72 hour after sex (but better to take as early as possible)If 72 hour has been crossed then you have to wait for period.If your period will delay by the 8-10 days then go for pregnancy test and or blood HCG to confirm the pregnancy.If pregnancy will be there then still you can terminate the pregnancy by the  abortion pill  under the advice of gynecologist.Hope this may help youContact HCM for further health queryBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fatigue, back pain and productive cough?\n\nI have been sleeping, tired, only to be able to stay up for more than a few hours at a time. Can barely keep up with food and liquids, doing dishes, laundry. Pretty extreme now for almost 3 months. I am 67, 03/20/1950 and have FMS, back pain, hip pain, IBS-C, Low Thyroid and none of these are worse than typical of a woman my age who used to be very active. I have just developed coughing up thick tan colored mucus.",
    "doctor_response": "thick tan with coloured mucus clearly indicates upper respiratory tract infection regard to your age its better to start antibiotics as early as possible for your proper rcovery",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause a unclustered pimple like bumps on underside of penis shaft?\n\nI have two small, unclustered pimple-like bumps on underside of my penis shaft -- one fairly close to close to base of shaft, the other about a half-inch away from the first bump.  The bumps have a white lymphy center.  I first noticed them after having vaginal intercourse with a woman with a condom.  The woman has no known STD history.  The bumps are not painful, but can be itchy.  At first, I thought I could pop them, but only a very small amount of clear fluid came out, and lympy centers remained.  I've had these for about 10 days, and they haven't gone away yet (although I have continued masturbated during those 10 days).  The bumps have not crusted, even after squeezing them.  I have not gotten flu-like symptoms since developing the bumps, although I did have a moderate head cold for a few days during the period. No painful urination.  NOTE:  I have recently had bad bouts of follucilits afer shaving in the groin area, and developed bad boils in the pelvic area.  (I've been seeing a dermo about them.)  I had also shaved the penis shaft before sex, but had not gotten boils in this particular area,  I'm thinking the bumps could be lymphoceles caused by the condom-ring friction, or very small folliculitis boils. But does this sound like herpes?",
    "doctor_response": "HelloThanks for query.Two bumps with whitish center on the shaft of the penis are most likely to be Sebaceous cysts .The penile  skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin.Normally they fade away without treatment however they need to be treated if increase in size or get infected.Please consult qualified General Surgeon for clinical evaluation and further treatment(If required ).Take antibiotics like Doxicycline along with anti inflammatory medicine like Diclofenac twice daily .If they do not subside within a week you may need to get them excised in Toto (Completely along with the sac) .Dr.Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I having pain while clearing throat and coughing?\n\ni fell 2 days ago face down on concrete. my head is fine but have very sore ribs mainly left side. Very bad bruising to my left under from elbow to shoulder. Had X-rays and doc said nothing broke. I have a hard time clearing my throat and coughing. Could this be due to a damaged spleen.",
    "doctor_response": "Hello, This is not an injury to the spleen. I would suspect this to be the weakness of the respiratory muscles which have tend to be painful and not allowing the sputum to come out easily. I will advise taking hot water fermentation at the injured site like the elbow and the rib cage. This will help the muscles to relax. Do steam inhalation so the lungs get moisturized. Simple breathing exercises will help to ease the pain and symptoms. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause continuous pain in chest?\n\nI have continuous chest pain which increases to unbearable at night. By 9 am the pain subsides to dull again. Echocardiogram came back clean. chest xray the same. it was found that the right side of my heart was slightly enlarged, No ephsophogus problems found. Bone scan bothing Doctor says it is in my head and told me to wait a few months and he will check again.",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern. You should not worry about. I will try to explain you something and give you my opinion. You should know that typical heart pains have some characteristics. They usually are retro-sternal pains like squizzing ,tightness or heaviness. They may irradiate to both arms, neck and jaw. They last from 5 to 20 minutes. Pains that last all night are not typical heart pains. The first and most important thing is to exluce ischemic heart desease.The fact that you already have done echo and its normal its a very good thing. If I was your treating doctor I would recommend a strees test to definitely exclude ischemic heart disease. The fact that you have excluded any skeletic problem is also a good thing.The other thing to exclude is a gastro intestinal problem that sometimes are resposible for this kind of pains. So, I would recommend a fibrogastroscopi.After excluding this we can be shure thats nothing to worry about. Hope I was helpfull. Best regards, Dr.Ervina.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can bariatric surgery be done for a type 2 uncontrolled diabetes?\n\nHi doctor, I am having type 2 uncontrolled diabetes. My endocrinologist is asking me to undergo a bariatric surgery. Kindly advise. Can you explain if it is required and how is it going to help control my diabetes and hypertension?",
    "doctor_response": "Hi. Bariatric or metabolic surgeries help to achieve long term remission from type 2 diabetes. These are scientifically proven, very safe and highly effective. They result in long term weight loss in individuals suffering from an excess weight problem, and also lead to long term remission from co-morbid medical conditions such as high BP and sleep apnea. Bariatric or metabolic surgeries alter hormones which control body fat stores and reset set value for fat storage to a lower level. Same hormonal changes are responsible for remission from problems like diabetes. Depending upon your weight, presence or absence of other medical problems, I choose different surgeries.  Sleeve with bypass combination surgeries is more powerful and durable.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any side of taking Orphenadrine for pain?\n\nI have an online friend who has a very painful condition, I am not sure what it is but she does not want to use opiates and will not use them though they were prescribed. I have read about Orphenadrine which apparently, according to Wikipedia, has effectiveness in treating all or most types of pain. Could anyone give an approximation of how effective one dose unit of orphenadrine (I think it is either 60 or 100mg) might compare to 10mg hydrocodone? Would it even come close to hydrocodone s effectiveness? I know this is likely a difficult question but if anyone could help, I d be thankful.",
    "doctor_response": "The two aromatic rings with a tail is shared with flexeril. Both are muscle relaxants that are NOT narcotic nor controlled substances but certainly not going to be over the counter.As such, comparison to narcotic or even aspirin is not really going to make any sense. Great if there is muscle spasm. Lousy for an infected tooth.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there an alternative to breast milk?\n\nhi there, i have a question to ask you please.I have my son he is 10 months old i want to stop breastfeeding him,so i am looking for some kind of beverage that is nutritious for him to take i don't know if horlicks malted beverage will be a good choice",
    "doctor_response": "Hi, welcome to HCM. Breast milk is superior to all available formula feeds in market. The most comparable to breast milk at this age is lactogen 2, you should give lactogen 2 in specified quantity. Horlicks and other supplements like this should not be given before 2 year of age. In my opinion, you should breast feed as long as possible and if it's not possible then change to lactogen 2.I hope this will help you. Take care. Regards:Dr Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for advanced hydronephrosis in the right kidney\n\ni have been experiencing a right sharp pain in the stomach for abt 5 mnths and i consulted a doc who referd me for a uss abdomen scan which then the results showed that there is an advanced hydronephrosis in the right kidney??I was advised to consult a urologist which i did he then said we shld remove the kidney because its non-functional.Isnt there any test to be done before declaring the kidney nonfunctional?Isn't there any other way of dealing with it rather than removing the kidney.",
    "doctor_response": "Hi there , Thanks for your query.Functionality of kidney detemined by Isotope scanning and blood estimation of creatinine with or without Intravenous pyleogram . Urologist will advice nephrectomy( removal of kidney) only when the other kidney is normal in function.If those test suggest that its non functional and associated with hydronephrosis its better to go head with the surgery to remove it as cause complications in the future which might prove life threatning like pyelonepritis and pyonephritis( pus in kidney).",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen ankles\n\nI am a previous frequent flyer (20+years). In recent years my ankles would swell during and after trips. My doctor prescribed Hydrochlrotiazide 25 mg 1/2 tab a day as needed. It works well on my right leg, not so good on my left. Why does the swelling persist in my left leg?",
    "doctor_response": "Hi, Consult a general physician and get an ultrasound scan for further assessment. We have to rule out conditions like cellulitis and DVT. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe sweating, dizziness and headache upon exertion?\n\nI started out having to run to the bathroom more frequently for a couple of days. The the last two days Ifelt hot while at work yet with only the back of my head sweating and my arms cold (which is not usual for me). My temp was 96.8. I ve been light headed and having headaches upon waking. But I have vertigo if I use my CPaP. 55 yo female - obese and laundry list of problems",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I understand your concern and would explain that your symptoms could be related to an urinary tract infection. For this reason, I recommend consulting with your attending physician for a physical exam, a urine analysis, a urine bacterial culture, complete blood count, PCR and ESR for inflammation. You should discuss with your doctor on the above tests. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe lower back pain\n\nI fell on my lower back folded from doing straight leg crunches with my iron gym used for pull-ups . I hit my right lower back bone I m assuming it might be a sprain or a bruise of some kind . What should I go about doing to quickly alleviate the pain",
    "doctor_response": "First of all you have not mentioned your age which is very important in case of back pain. For treatment of severe lower back pain you can take some pain killer like biozobid-plus or osteonac-th only when the pain is worse or disturbing your daily work along with some calcium supplements like shalcal-d or toscal-gem once daily. Do some physiotherapy exercises after an expert opinion of physiotherapist. I will also advice you to sleep on plain surface.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have started to get lots of acne on my face, particularly on my forehead. Please help me.\n\nHi doctor! I used to have clear skin but since I moved to a new place, I started to have lots of acne on my face particularly on my forehead. I thought it would disappear once I went back home, but it only got worse. I did some research and assumed that it was caused by drinking too much cow's milk, but it has been since since I stopped and they would still not go away. I also noticed that I get deep acne whenever I'm nearing my period, along with the usual small red bumps. I bought an acne soap and have been using it for a month now but I'm not sure if it works. I hope you can help me because it has been affecting my mental state lately :((((",
    "doctor_response": "Hi there Acne has multifactorial etiology. Only acne soap does not improve if ypu have grade 2 or more grade acne. You need to have oral and topical medications. This before writing medicines i need to confirm your grade of acne. For mild grade topical clindamycin or retenoic acud derivative would suffice whereas for higher grade acne you need oral medicines aluke doxycycline azithromycin or isotretinoin. Acne vulgaris Cleansing face with antiacne face wash",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes metallic taste in the mouth with abdominal pain?\n\nHi....I have recently had a bad chest infection with bad coughing fits. Had antibiotics from doctor, then some diff tablets as after a week the infection hadn t completely cleared witch I m still taking. Past week I ve had this dull pain under my rib cage on my right side, I thought this was muscle strain due to my coughing fits. However, it s got worse, like a sharp stabbing pain, it hurt to breathe. It has calmed down after a day but still some pain there. I also have a metallic taste in my mouth and lower abdominal pain. Also experienced a sharp pain on my left side in my back. Not sure to this is related, but I ve just had my period, this was very light and only lasted a few days? Do you have any advice?",
    "doctor_response": "Hi greetingsthere are various reasons to have metallic taste in mouth ranging from dental problems to the drugs if you had anycertain antibiotics like metronidazole clarithromycin causes metallic tasteas you had  medicines for the chest infection so drug induced gastritis may be a cause of abdominal pain please consult your doctor for detailed examinations and anti acidity medicinesHope I have answered your question. If you have any further questions I will be happy to helpwish you good healthregards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having sciatica, neuralgia and migraines. Are these due to epidural anesthesia?\n\nHello doctor, 12 years ago I gave birth to my first baby. I was healthy when I walked in and then, not even for a single day I felt well. When I was given my epidural, my heart rate shot up to 150 and you could see it beating from the outside. They took it out and replaced it. The anesthesiologist said he must have hit a blood pocket. What does that mean? The epidural caused my BP to drop every time I lay on my left side. My baby's heart rate dropped every time I lay on my right side. After what felt like an hour, they made me lay on my left and gave me a shot to keep my BP up. Is that normal? Because I stayed on my left side, I could not move or feel anything on that side but could feel everything on my right side. I now have migraines, glossopharyngeal neuralgia, peripheral neuropathy, sciatica, and fibromyalgia, all on my left side. Could the issues I have now have been caused by the issues with the epidural? Please help me.",
    "doctor_response": "Hi. Maybe unintentionally epidural needle must have hit a blood vessel in epidural space and so needle was withdrawn and reinserted in order to place it in epidural space avoiding blood vessel. Hypotension in pregnancy may be caused by supine hypotension syndrome and also due to regional anesthesia. So you were placed in left lateral position and you were given an injection to keep your BP up. It is not unusual to have these situations and are treatable. The issues you have mentioned are due to a spine problem most likely prolapsed intervertebral disc, etc., and very less likely due to epidural. May require MRI of the lumbosacral spine to diagnose. Need to consult an orthopedic surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to determine pregnancy after having unprotected sex for a month?\n\nI had my last mensuration on 28 feb and generally next mensuration comes before 5 days. Since 28 feb we are not using any precaution during sex. From last week i have started taking pregnanacy test, as i eagrly want to know about it. I had my last test on 19th evening and 20 th morning. On 19th it was showing negative. And on 20th morning its showing invalid. I have taken 2 test few daz before also, one in evening and other in moring. And same thing happened. I am not able to make out the final result. Please guide me in this regard. Why it is happening so ?",
    "doctor_response": "Hi there,My opinion after reading your question is:1) A home urine pregnancy test comes positive only 2 to 3 days after a missed period at its earliest.2) If you want to know sooner, you can get a blood test called serum beta HCG which can give positive results by 3-4 weeks.3) Watch out for symptoms of pregnancy like vomiting, nausea, breast tenderness etc., but they are not reliable signs of pregnancy.4) My suggestion is that you wait till at least till 1st and then get a urine pregnancy test. Till then, just sit back and relax and let nature take its course. If you are really anxious, you can take the blood test mentioned above right now.I wish you all the very best for your pregnancy.Regards,Dr. Shikha Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly help me understand the medicines prescribed by my doctor.\n\nHello doctor, I have mild pain in my right lower leg and spondylosis. Kindly help me out with the medicine prescribed by my doctor. I want to understand which medicine is used for what purpose. See the prescription attached.",
    "doctor_response": "Hello. I have gone through the prescriptions (attachment removed to protect patient identity). One of the medicines, the third in the first prescription is not legible. Do you have a strip of the medicines? For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful and persistent sores in mouth?\n\nI have sores in my mouth that wont go away, very painful. I recently took 2 strong antibotics for a spider bite that became infected. what are the sores any why are they so painful and persistant? did not realize I had to pay for this . sorry but NO THANKS",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.Mouth ulcers are indeed painful.If I were the treating dentist ,I would advice you to apply mucogel/dentogel ointment on the lesion two or three times a day till the symptoms subside.Paracetamol can also aid in the pain relief.Antiseptic mouthwash can be used.Avoid spicy food and take the antibiotics on full stomach.The ulcers should heal within a week or so.If still persistent,consult your local dentist.Hope this was useful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headache and chest pains?\n\nHead and chest pains   I have sickle cell disease  and I keep having sharp pains in my chest in my head I'm wondering if he has anything to do with my sickle cell.... I been having these pains for the last four or five days... when I have the pain in my chest feels like I'm kinda having a heart attack that's how bad pain is...  what could be the problem what could be wrong",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. The main problem in sickle cell disease is obstruction of minor vessels due to sicklling of RBCs (red blood cells). These RBCs clumped togather and obstruct the blood supply to that part of organ. This is common in lung and brain vessels. So chances of small Pulmonary infarction and brain infarction are more in sickle cell disease. And these cause similar kind of sharp chest pain and headache. So better to get done CT Pulmonary Angiography and MRI brain for the diagnosis of these complications. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What causes respiratory problem in a 36-year-old?\n\nHello doctor, My mother is 36 years old, and she is suffering from the respiratory problem from last two days, her hemoglobin count is 9.6, can you please tell what causes this problem?",
    "doctor_response": "Hello. I have read through your question and would like to tell you that respiratory problems can be due to allergic or due to infection. Her Haemoglobin could be due to dietary deficiency. Give her iron-rich diet like dates, banana, and green leafy vegetables. If the respiratory problem is due to infection, then she may need an antibiotic course. For now, steam inhalation will help to relieve her. Steam inhalation with menthol twice daily. If her condition does not improve in two days, get her checked by a physician. If her Hemoglobin does not improve in one month, get a complete blood profile done to know the cause of anemia. I hope that answers your question. If you have any further questions, please feel free to write.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Little dots on the bottom of feel, feeling of pins and needles on walking, same on hands and penis, white bumps in mouth. Treatment?\n\nI have these little dots that have Covered the bottom of my feet and feel like pins and needles when I walk. They are also showing up on my hands and penis . I ve noticed that I have these white bumps forming in my mouth too. The bumps on my feet hands and penis have shown up over the past couple days. The mouth has gradually became worse over a week or so.",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.Its difficult to understand the nature of the bumps that you have mentioned. They probably seem to be allergic lesions but its would be too early to make such comments. I would like to advice you to take a snap and send it with a premium query so that we can have a look at the lesions.Hope I am able to answer your concerns.If you have any further query, I would be glad to help you. You just need to contact me on this below mentioned link:bit.ly/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe tooth pain\n\nI went into a dental webmd area. I have an extremely sensitive front tooth.  I have in general sensitive teeth, I only use sensydyne toothpaste.  I am staying away from high acid foods and beverages.  Abesol works some. Any remendy till I can see a dentist?",
    "doctor_response": "Thanks for your query. I have gone through your query.The sensitivity in the teeth can be treated with desensitising tooth paste like senolin or sensoform.  You need to apply the tooth paste over the teeth and leave it for two minutes and later brush with normal brush. Then the tooth paste will be effective. Otherwise it will not work.I hope my answer will help you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What causes constant pressure around ear and nerve twitches?\n\nHello doctor, I have ear pain going all the way down to my foot. I also have vertigo and tinnitus. It has been two years. I feel constant pressure around ear and nerve twitches in whole body. Please help.",
    "doctor_response": "Hi. I understand your problem. As you say you have radiating ear pain along with pressure around the ear and vertigo and tinnitus. There can be many reasons to this. Have you got any checkup done? If not I feel right away you will need the following investigations: Based on the results of these two investigations, I can further guide you as to need for any more tests or treatment. Meanwhile, I will suggest you the following medicines: If symptoms does not resolve; you may need a neurologist's opinion as well. However, as of now get the above tests done. Revert back after the tests to an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "White substance around inner cheeks on waking up, peeling inside lips, follow good dental hygiene. Remedy?\n\nHi I have a white substance around my inner cheeks when I wake up in the morning. It is easily scraped off. It isn t on my tongue therefore I don t believe it s thrush. It isn t painful, just annoying. I brush my teeth and floss 3 times a day and have been using peroxide as a mouthwash lately hoping it would go away. The inside of my lips peel as well.",
    "doctor_response": "Hello, Thanks for posting your query. Sounds pretty typical. I would not worry about it too much. Have you recently switch products such as a new mouthwash or toothpaste? Sometimes that will create your body to react to the new product and your tissue can slough off. The appearance of the tissue will resemble a thin coating or film that wipes off easily. Hope I have answered your query. Wishing you good health. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "After recovering from TB, what could recurring evening fevers and cough indicate?\n\nHi, I had taken treatment for TB thrice i.e. in 1997 (6 months), 2000(8 months) and 2004 (6 months). In 2009, I once again became sick with the symptoms of fever and dry cough. At last, I went for Ayurvedic treatment and taken medicines for 1 year and became fully cured. Now, I am again suffering with fever since July and dry cough for last 15 days. I have again started Ayurvedic treatment. But fever comes everyday in the evening with dry cough. ESR is 65. What are the chances. Am I again infected with the TB?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. Yes, possibility of recurrence of tuberculosis is more in your case. You are having past history of tuberculosis thrice, having high ESR (erythrocyte sedimentation rate) and fever with cough, all are suggestive of recurrence of tuberculosis. So you should consult pulmonologist and get done clinical examination of respiratory system and chest x ray. If chest x ray is suggestive of tuberculosis than you need sputum or BAL (bronchoalveolar lavage) culture and sensitivity to rule out MDR (multi drug resistant) tuberculosis as rusk of MDR tb is high in recurrence cases. So consult pulmonologist and discuss all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can hay fever cause red itchy spots?\n\nI'm on vacation in the US right now and have been suffering badly from effects of hayfever, despite taking very powerful anti-allergen tablets.  This morning, I've woken with wheezy breathing and large red bumps (which itch) on my shoulder. Are they related?",
    "doctor_response": "HI, thanks for using healthcare magicThese lesions would be part of the allergic response that you are experiencing.If you can determine the source of your reaction and reduce your exposure to it then this would be best.In addition to the antihistamines that you are using, you may need a course of steroids to help fight your reaction.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest tretament for small bump on the neck with discharge\n\nHello I am 15 and I have a tiny white bump on my neck. Sometimes it is my skin color. I have had it as long as I could remember. Sometimes some clear liquid comes out of it and at other times it feels crusty. And there seems to be something long and circular attached to it that seems to go farther into my neck than I can feel. Can you tell me what it is and if I should go get it checked out?",
    "doctor_response": "Hi,dear thanks for the query to my HCM virtual online clinic.My diagnosis-Cold abscess with lymphadenitis / or / Boil with discharging mouth with swollen follicle underneath?.I would advise to get it checked with ER Surgeion.Treatmenit-a-Consultation with Surgeon, b-Tb NSAIDs , c-Antibiotics  or anti-TB Drugs with Surgeons diagnosi and under his advise.Dont worry and act fast.This would solve your worrysome query.Hope this would solve your query.Wellcome to my HCM clinic once again.Have a Good Day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fluctuating heart beat, stomach problem in a child. Diagnosed stomach migraines. Gymnastic, reason?\n\nMy 8 year old complains of her heart stopping and then going really fast. Often ask is she going to die when this happens. She has stomach problems on a regular basis and has lately developed trouble with being able to get a deep breath. The stomach issues started Thanksgiving a year ago and were diagnosed at the time as stomach migrains. She became very aware of her heart about 2 to three months ago and tells me that she feels it stop beating and then sometimes complains of a sour, lemony feeling around her heart. Her heart rate is variable from around 70 bpm to 115 during these complaints. The breathing problems started about 4 to 5 weeks ago and has sent us racing to the urgent care , emergency room , doctors office and specialist. We have recently even had an ambulance at the house. Her heart rate is often racing and she will begin to hyperventilate as a result of trying to catch her breath. She has normal blood pressure and O2 sat. is 98-100. Her family doctor put her on a steriod inhaler , and feels she is not getting air in the bottom of her lungs so she feels that she is not breathing although her oxygen intake is good. The Xrays of her lungs show a small amount of flem and some inflamation in the bottom two lobes. The Cardiac specialist said the original EKG showed one side of her heart larger than the other but the ECG did not give evidence of this. A 24 hour heart monter did show that her heart skipped two beats in a row two seperate times during the 24 hours, but nothing the doctor considered significant. She has been taking the steriod for two weeks and the breathing seems to be better, although she still feels that it is difficult to taking a full breath. They gave her tums to take when she feels like she is having a heart attack and told us to go home. She has always been extremely healthy and is 53lbs. She is slender for her height but very muscular. She participates in competitive gymnastics and works out 4 times a week for 3.5 hours each time. I am not very satisfied witht he heart Doctors lack of concern for the skipped heart beats and get very concerned when my 8 year old tells me her heart is racing and ask is she is dying! Should we seek a second opinion? No one seems to feel that the symptoms are related but us. Is there something we are missing? Could these symptoms be indicative of something more? What should we be looking for?",
    "doctor_response": "LOOK TOWARD FOOD THEORY SPECIALLY TOWARDS MILK AS IT STATES THAT CHILD NEED ONLY BREAST MILK FOR 2 YEARS AND NO MILK AFTER THATIF YOU ADD ANIMAL MILK THEY CONTAIN ANIMAL PROTEINS WHICH  ARE NON COMPETIBLE WITH UMAN PROTEINS AND CHILD START GETTING VARIOUS PROBLEMS LIKE HEART DISEASE ANAEMIA ASTHMA STOMACH AND OTHER SYSTEM PROBLEMSWITHDRAW MILK AND DIARY PROTEINS COMPLETELY ADD VEGETABLES FRUITS AND CEREALS INSTEAD OF MILK CXHILD WILL RECOVER FROM ALL PROBLEMS IN FEW WEEK TIMEGET BLOOD SERUM TEST FOR SPECIFIC ANTIBODIES OF MILK WHEAT CHANA POTATO RICE NUTS EGG AND OTHER FOOD YOU TAKE DAILYAND ELIMINATE ACCORDINGLY I AM SURE TO GET BENEFIT FROM THIS THEORY",
    "dialogue_context": ""
  },
  {
    "patient_message": "Got off from Yasmin, have cystic acne on chin that hurt. Advise?\n\nHi, I came off Yasmin a few months ago, it was great for my skin but seemed to be giving me a dark patch around my mouth (cholasma), which I have since been to a dermatologist to get lasered off. My GP has now put me on Cerazette , but I m really worried about what it will do to my skin- in the time I have been off the Yasmin I do seem to be getting the odd breakout of cystic acne on my chin , usually hard lumps under the skin which really hurt, the rest of my skin is fine though. What would you advise? I know everyone reacts differently, but if its a toss up between a dark mark on my upper lip or big lumps under my skin im not sure which is worse! Would really appreciate your help.",
    "doctor_response": "Hi, Melasma and acne both are distressing because of their occurrence over face. Had I been suffering from these diseases, I would have gone for the treatment of acne first, because malasma is a notorious disease which frequently relapses and takes long time for treatment. Acne, most of the times show early improvement and is more predictable. Another option is to use the medication which helps in both acne and melasma like retinoids, peeling agents, azaleic acid etc. Visit a dermatologist, so that he/she can decide which drug combination suits you the most. Regards, Dr. Ajit Singh MD - Skin & VD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for child suffering from headache, eye/joint pain and sickness\n\nHi Doctors, My six years old daughter is sick since three days back. First two days she was having headache and eye pain, now she is having headache, eye pain, joins pain, with very high fever and throat pain. I am very much worried please advice me.",
    "doctor_response": "thanks for asking i gone through your question, and understand your concernyour 6 year old daughter is suffering from headache,eye pain, joint pain, fever and throat pain.commonest cause of fever is viral illness, body cures it in about 5 days time, give tab/syp paracetamol 15 mg per kg per dose . may be given up to 4 times per day,like to know that is there cough or running or blocking nose with throat pain, is there any pain during urination? is there any swelling in joints with hurts.it she not improve in next 2 days , visit to paediatrician for check upwith your child speedy recovery",
    "dialogue_context": ""
  },
  {
    "patient_message": "Felt electric shock when raised arm near thermostat, fainted. Had body shaking. CT scan normal. Have RA and colitis\n\nwent to turn up the air conditioning as i was standing there felt like i was going to faint.  Raised my arm to the thermostat and felt something like an electrical shock above my eye on forehead.  NEXT found myself on the floor on my backside with my arms, legs and whole body shaking.  Went to walk-in dr (my DR on vacation) had a CT scan of my head.  They said it was ok.   I have RA and ulcerated colitis.  Have to see my own dr. next week.  Did i have a seizure?",
    "doctor_response": "Hi, there could be an electric shock to your hand probably due to short circuit in that place of your touch.                         Any how there is nothing like head injury according to the attending doctor. The seizure may not be a cause but it may be syncope, due to some reason. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "hi. I have a MRI report with below message. Is it dangerous or any comment: Mucosal thickening at maxillary and ethmoidal sinuses",
    "doctor_response": "Hi! The most probable diagnosis is Infection from chronic irritation leading to sinusitis which presents as mucosal thickening most commonly seen in maxillary and ethmoid sinuses. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain between armpit and waist while coughing\n\nI am female, 52 and have a sharp pain when I move or cough.  It's located on my left side in between my arm pit and waist.  I had a case of Shingles last June and the pain area is similar but this is much more painful.  Could it be the same thing, meaning wait it out?",
    "doctor_response": "Hi there! A sharp pain in the left edge of the chest which worsens on moving or coughing could indeed be due to post-herpetic nerve damage (shingles=herpes) though I'd still recommend a chest xray to look for lung infection or fluid in the chest which might cause similar symptoms. Do write in with your reportsAll the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Caroli's syndrome genetic?\n\nhi, our 3 month old son has been diagnosed wit Carolis syndrome,my partners dad passed away from liver problems and we know that it is genetic,my partner is been checked for the same thing but we want to know if our son is going to suffer the same path as my partners dad?",
    "doctor_response": "Hi I can understand your concern...Yes, caroli disease is genetic disease.It may be simple dilatation of bile duct or it is associated with hypertension and fibrosis known as caroli syndrome.....Let me know you condition is dangerous .you can consult surgeon for treatment....Ursodiol can be used.If limited to one lobe then lobectomy might done.Liver transplantation is also another option...Patient usually die by complications like repeated cholangitis....Death usually within 5 to 7 year according to various literature...Take care...Dr.Parth....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for severe back pain in child?\n\nMy son has terrible back pain he is 13 was outside playing basketball shot the ball and felt like something snapped in his back and states that it hurt to breath Also said that when it happened he couldnt breath for a short time. He woke up this morning with slight back pain as well.",
    "doctor_response": "HiThanks for writing to us.The back pain could be due to muscle or rib injury.I would suggest you to take him to your nearby doctor.He may need chest Xray to rule out bony injuryWishing your child good healthRegardsDR Arun",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedy for wrist and joint discomfort\n\nFor about a month off and on, I have been having mild discomfort in my wrist, mainly on the thumb side joint. Now this week, I have been having a shooting pain and some numbness up my arm to my elbow. Are there any exercise or home remedies I can try to alleviate the discomfort.fm",
    "doctor_response": "HiDo hot fomentation and apply anti inflammatory gel twice a day.Take Motrin twice after meals.wear a wrist band for support.avoid working the wrist for 3 days it will help",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could abdominal cramps be a result of swallowing mercury fillings while having them refilled?\n\nI had two mercury fillings removed today and new fillings put in. I noticed the dental assistant was doing minimal suction during the entire procedure so I was swallowing a lot. This evening I m having severe abdominal cramps. What could be causing this from my dental appointment today.",
    "doctor_response": "Hi.The mercury for fillings is in the form of an amalgam and supposed to cause no harm. Yet on a safer side you can contact ER and give the history. You would also be examined to see that you are not suffering from something else. ( this also is a possibility).",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chronic back pain with stomach growling. Diagnosed with cyst. Is there a chance that it changed the position?\n\nI was told a while back that i have cysts , i did not see the results though. now i m listening to my stomach growl but on my left side only. did the cysts, push it to the left and is ocupying that space to the right? i find that when i lay down i always feel mor comfortable on my left. even though i try to sleep on my right, i always end up on my left. i also have chronic back pains. of course no insurance at this time.",
    "doctor_response": "u have not mentioned about the kind of cyst u were diagnosed with . probably anxiety is the cause of your stomach growls",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to increase protein intake while having pancreas deficiency and on kidney dialysis?\n\nI have pancreas deficiency. I am on kidney dialysis & my dr wants me to increase my protein to 100 g a day. Is this safe? Since I started trying to do this I have been vomiting. So I know I am not getting the protein out of what I eat. Oh by the way I am on Creon to help with the digestion.",
    "doctor_response": "As an Urologist and kidney transplant surgeon,i understand your anxiety.In people on dialysis,protein intake is restricted to 40gm/day.If your body weight is more,depending on B.P.and electrolytes,it may go up.It's best decided,in consultation with your nephrologist.The vomitting may be, due to increase in creatinine,electrolyte imbalance or even insulin deficiency.The insulin dosage will need to be adjusted.Creon is pancreatic enzymes supplement,given with caution in renal failure.Your nephrologist may ask to stop it.You may send doubts to me directly.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can medical cannabis be used for persistent back pain despite taking steroid shots?\n\nMy wife has constant back pain. Has fused vertebrae from birth. Surgeon has recommended she not undergo surgery. She has had two steroid shots, the first of which was helpful for a few weeks, the second was not helpful. She suffers from drop foot and damage to sciatica nerve on the left side. Exercises regularly. Is under the direction of a physical therapist. We re wondering about the relief from medical marijuana.",
    "doctor_response": "that's will addict.instead of all that you tell her to take Ayurvedic safe medicine like.tab simhanada gugglu 2bdcap neurowin 1 tds.mahanaryana taila for application",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Angiogram needed when cholesterol, blood pressure and sugar is under control?\n\nmy husband is 49 yrs,5.4 ft tall. his cholestral test is normal and bp is under control.,140/80 and sugar level is 97 during fasting , but the doctore says that he has problem in v4 and v6 and he has to go in for angiogram.his total cholestral is 140,tryglycerides is 100, ldl is 80 and hdl is 41. twice ecg was taken, still the doctor insists for angiogram",
    "doctor_response": "no even if lead v5and v6 show some unspecified problem(u have not mentioned)angiography is not at all indicated2d echo cardiogarphy should be done to see the blood supply to heart walls and a tread mill test should be done to see the response of blood supply to exerciseangiography is never indicated in asymptomatic patients with mild changes in two leadsin case some ischemia is seen in tmt or 2d echo....stress thallim test should be done....if some thing is still reflected itsxa indication of angiographydont worry get a 2d echo and tread mill test done thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for the kidney tumor which affects the surrounding veins?\n\nHi am seeking medical help on a kidney tumour which affects the sorrounding veins,can i access surgery in your hospital and at what cost.Thanks penninah kenya,Am female 36 yrs,5.9 ft tall,60kgs and had a DVT on the left leg under medication for the last two months.",
    "doctor_response": "Hi,Thanks for writing in.It appears that your renal cell cancer is involving the renal vein and probably the inferior vena cava which carries blood from legs to heart. Previous reports have shown that total surgery of tumor affords the best chance of cure and long-term survival when no distant metastases are present. Presently surgery is offered even in the presence of disease spread.It does not matter if you have disease spread or not. With the advances in immunotherapy, survival is higher in your case if aggressive surgery is combined with immunotherapy. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for red spots on my penis?\n\nHello Doctor! My name is Cristi and I''m from Romania. I have a problem with my cock (penis) becauze I have some red spots on my penis head.I heva this spots for about 1 month.I don''t have any kind of pain. I must to tell you that few time ago,about 1mont ago,or 1 and a half month ago,I did make non protected sex.I don''t have pains of any kind.No head aichs,no penis aichs,nothing. I''m fine.I have just that red spots on my penis.Do you know what can that be? I don''t have another color of my piss,I don''t have pains of any kind when i  piss...nothing abnormal,but that red spots.If you want,I can send you a picture.Thank you Doctor for your answer and your advise.Best regards!",
    "doctor_response": "Hello,It may be due to allergic reaction. For that you may apply hydrocortisone ointment locally. For itching you can take tablet loratidine. Avoid sweating and latex condom. Avoid harsh cosmetic products. Watch for symptoms penile discharge, severe itching... Hope I have answered your query...Let me know if I can assist you further.Regards,Dr Shyam kaleFamily and general physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for myelofibrosis\n\nMy dad has myelofibrosis. His platelet count is ridiculously low. His spleen is enlarged and he s been complaining his left side below his ribs are hurting. I think its his liver. His doctors are doing great but his pain keeps getting worse. He was diagnosed last April. Do you think with these signs he s getting close to the end? I dont want him to go but dont want him suffering either. Any info will help my family. Thank you",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Myelofibrosis is one type of bone marrow cancer.  In that blood producing cells are replaced by fibrosis. Treatment options are stem cell transplantation.  Other options are splenectomy, androgen and alkylating agents.  Despite of treatment prognosis remains poor. Life expectancy is not good. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of pain in legs after stopping anti-tubercular drugs?\n\nI have pleural effusion tuberculosis in the Right lung. I have been advised Pyrazinamide, combutol & R-cinex. Now I have completed 3 months course and stopped pyrazinamide & combutol, but I feel leg pains after stopping these medicines. Similar pain was there before I started this course",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Anti tubercular drugs can cause myalgia, arthralgia and arthritis. These drugs can cause rise in uric acid level as a side effect. So this high uric acid level causes pain in muscles and joint. So better to get done serum uric acid level. If raised, you need to avoid high protein diet and start other drugs to decrease uric acid level like allopurinol or febuxostat etc. So consult your doctor and discuss all these. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment to get pregnant?\n\nhi my name is abeer , i try to get pregnant almost one year, i had ovarian cyst with endometrioses , my doctor recommended luperon injection for 6 months after that i start taking clomid 150 mg for 2 months, now i miss my period for 7 days then on day 8 i start my period i think may be iam pregnant? so can you give me any advice or evaluated my case....thank you",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options. 1] First of all to confirm your doubt, you need to get morning's urine tested for pregnancy.2] As you are already on egg forming tablets, if your bleeding is not like routine menses, then urine test will help to know pregnancy status.I hope my answer helps you.Thanks.Wish you great health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for rash/bumps on rib cage\n\nHello, I have this rash like bumps (I m not sure how to describe it) alongside my rib cage and above my pelvic bone. They re like little bumps. I m not sure what it is or how to get rid of it. I thought maybe it was heat rash, but a much less severe case. They ve been there for over a week now. What should I do?",
    "doctor_response": "Hi, The rash could be a miliaria (Prickly) or drug induced papular rash or a viral exanthem. The treatment varies entirely for all these conditions and final diagnosis could be made only after proper clinical examination. So, I recommend you to consult your Dermatologist for proper management. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for panic attacks\n\nHi I am suffering from anxiety attacks. Something happened last week and I cannot talk think or write about it without getting an attack. I feel dizzy like I am going to lose consciousness and I get palpitations. I lose sensation in my arms and legs and I get a feeling of dread come over me. I have also recently started on b12 loading injections for pernicious anaemia",
    "doctor_response": "DearWe understand your concernsI went through your details. Palpitation and breathlessness are typical panic disorder and anxiety disorder symptoms. Panic attackes are due to underlying anxiety disorder. You need to get educated about anxiety and Anxiety disorder in order to manage it. Psychotherapy, counseling, life style changes along with psychiatric meditations should help you. You should talk to your physician regarding anxiety and get the appropriate treatment from a psychologist / psychiatrist. Don't worry.If you still need my assistance in this regard, please use this link.  Please remember to describe the whole problem with full detail.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will she become pregnant from little bit of sperms?\n\nhello siractually i had sex wid my partener on suunday at around 3pm but actually from last weak i was drinking too much n when i was having sex my sperms dont fall as much as it falls before but but i dout that it may leacked a little bit but i m not sure bez i didnt feel so so i not sure i wanna know is she become pregnant",
    "doctor_response": "hi thanks for writing to useven  little bit of semen contains millions of sperms which can cause pregnancysince ,under the influence of alcohol ,the picture may not be very clear as what had happenedthere are chances of pregnancy even with very little semen in the vaginahope this information was useful",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for back pain especially during indigestion\n\ndear doctor i am 22 years  old guy i am getting back pain, not regularly but i observed that i am getting pain  when there is indigestion.two yers back i met with an accident and and fell down directly on my waist but i ignored the pain then. the same pain i can notice when there is indigestion. can you please suggest the remidies diagonising the cause.",
    "doctor_response": "Its tramatic back pain due to injury....u have to avoid forward bending..need to take multi vitamin and calcium..dont run and avoid prolong setting.. using lumba sacral belt..u can also contact to physiotherapist...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does low G6PD level cause hemolytic anemia?\n\nHi doctor, Recently, I did a series of blood tests to check my pre-existing G6PD deficiency. The results showed low G6PD levels of 0.4 units/gram of hemoglobin. I have read that anything below 10 % of the normal range can cause hemolytic anemia. Please suggest.",
    "doctor_response": "Hi. I have gone through the attachment (attachment removed to protect patient identity). Your G6PD (glucose-6-phosphate dehydrogenase) level is low. But clinical correlation is needed in your case. I suggest you investigate with CBC, reticulocyte count estimation, and peripheral smear examination to check whether there is a presence of hemolysis or not. If there is no hemolytic episode, then there is no need to worry. In G6PD deficiency, you have to be alert when you have typhoid and pneumonia. It can lead to oxidative damage and can result in hemolysis. Drugs like Primaquine, Sulpha drugs, Aspirin, and Vitamin K analog should be avoided. Fava beans should be restricted in your diet.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Thyroid cancer treatable with medicines alone?\n\nHello Sir, This is vignesh.My mom is a cancer patient.She got diagonised by the Thyroid cancer.Now we are giving a treatment in Vadamalayan hospital in Madurai. Can we able to save her by giving medicine alone?. I m eagerly awaiting for your response.",
    "doctor_response": "Thyroid cancer have different histologies.  Most commonly papillary, follicular which are less aggressive and they have to be treated by surgery followed by radio iodine if required. Anaplastic carcinoma if operable can be treated by surgery. Only in lymphoma of thyroid chemotherapy can be given.othrrwise surgery is the answer. No oral medications ate Goin to help. Bye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a small itchy bump on the penis\n\nIve having a constant battle with jock itch. I work outdoors so i sweat hevily throughout the day. Yesturday while showering i noticed a small itchy bump in the shaft of my penis. No pain or leaking any fluids and not pus filled. I do have masquito bites on my arms from work and the bump looks and feels like a bite also.",
    "doctor_response": "Hello dear,Considering the case history that you have recurrent infection with jock itch, the lesion as mentioned in your post can be attributed to contact dermatitis or any fungal infection.Application of ointment like Lobate GM (pharmacologically Clobetasol + Miconazole + Neomycin) will reduce the symptoms.1. Clobetasol being a steroid will reduce the inflammatory process2. Miconazole being an anti-fungal agent will take care of any fungus causing the symptoms3. Neomycin being an anti-bacterial agent will prevent secondary bacterial infections.In addition, keep the area dry & avoid too much exposure to water or sweat formation.Wishing you a Good Health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can dizziness, blurred vision, weight gain and weakness be a sign of diabetes?\n\nI have SLE diagnosed in 1983during my pregnancy. Also have renal tubular acidosis, Medulary Sponge Kidneys, shorten syndrome. I have a very inactive life. Last three days having severe edema in legs, dizziness, blurred vision, and weaker then usual. I take 10mgs prednisone a day plus a host of other medications. Over the past 2 years my weight has gone up higher then it s ever been, even during my pregnancies. I m 5 6 weight @187lbs. I m worried about diabetes since it runs in the Family. Could this be what s causing these symptoms?",
    "doctor_response": "Hello, Since you have a history of Diabetes running in your family you should get Blood sugar (F) & (PP) done at the earliest. Uncontrolled blood sugar levels may trigger & worsen the symptoms of the other illnesses from which you are suffering. Avoid a sedentary lifestyle, it is very unhealthy. Do regular exercises & walking. Maintain healthy weight. Stay away from junk & oily food. Since you have a history of SLE, dizziness, headache, blurred vision are due t it. Get treated. You have a history of Renal tubular acidosis and severe edema in the legs at present, you are suggested to get a follow-up treatment done to detect & get evaluated for the degree of the kidney disease from which you are suffering from. Get physically examined & treated at the earliest. In the meantime, restrict your salt intake, take plenty of water, veggies, fruits & berries. Stay away from addictions & stress. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nupur K, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of chest pain while suffering from hypertension and high cholesterol?\n\nhello I am a 45 year old woman with type diabetes, high cholesterol and a slightly elevated high blood pressure.  For the past month and a half every time I go up stairs or go up a hill or force after something heavy my heart feels like it's going to pop out of my chest giving me extreme pain and tightens my throat.  I sweat alot and my blood pressure gets higher than it usually is. Also, my heart tends to skip a beat (which ordinarily happens in all) but I get chest pain on the left side and out of breath.  Today, I drank a slush (which gives brain freeze) but my chest hurt sooo badly I had to stop drinking and eating for a few minutes and the pain was strong and constant until it went away after maybe 5 to 7 minutes.  What is happening? I went to see a doctor 3 weeks ago and has given me a blood test for thyroid problems but I have no results yet.  Should I be concerned?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Your chest pain after drinking slush is mostly due to acute gastritis. But your chest pain and breathing difficulty on exertion (climbing stairs), popping of heart etc are more suggestive of heart diseases. So better to consult cardiologist and get done 1. Blood pressure monitoring 2. Ecg 3. 2d echo 4. Stress test. Possibility of heart failure or coronary artery disease (CAD) is more in your case. You will need cardiac supportive drugs. Strict control of diabetes and hypertension are needed. Don't worry, with appropriate treatment, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pulsation visible in abdomen. Worried about abdominal aortic aneurysm. Ultrasound required?\n\nI m a 31 year old male. 6 2 186 lbs. I have had a pulsation visible in my abdomen for some time. I m worried about an abdominal aortic aneurysm due to this pulsation. I asked my GP about it, he listened to it, and then pressed into my stomach to feel the aorta . He said normal size, nothing to worry about . That made me feel better at the time, but the pulsations are still there. I have had panic attacks in the past and I think my GP might not be taking my concerns seriously anymore. I smoked (stupidly) a bit in my twenties, but only a couple cigs (like literally 2-4) at night on and off through the years. I had high triglycerides a couple times (probably due to drinking) but they are normal now. I don t drink, I don t smoke at all anymore. I had my appendix out a couple years ago, they did an abdominal/chest x-ray and they performed a CT scan . Would an AAA have been spotted during these procedures? or should I get an ultrasound of my abdomen? thanks",
    "doctor_response": "Hi, Welcome to HCM, If abdomen is thin wall and weak musculature and does not more collection of fat many a time this pulsation can be seen or heard. If you had aortic aneurism is there you might have symptoms or it might have noticed during CT scan. But to be on safe side go for CT scan, if recently occurred. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause black spots on penis and itching in the groin?\n\nHi I have notice black spots on my penis and itching in my groin for about a month. Thought it was jock itch but still hasn't stopped. I've been with my fianc\u00e9 for almost 7 yrs and we both have been tested for everything in the past and both of us were negative for anything.",
    "doctor_response": "Thank you for query.It may be due to fungal infection.Please take following precautions.Use loose cotton clothes.Keep area dry.Apply antifungals like terbinafine which is fungicidal.Once subsides use regularly antifungal dusting powders like candid or absorb powder to prevent recurrence.Treat the partner also to prevent recurrence.consult doctor if does not subside.You can get back to me for any clarifications with the photos.Dr Bharatesh D Basti Dermatologist and Venereologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes foul smelling brown discharge from mouth after burping?\n\nHi, my periods are delayed for 4 days. for the last two days I dreamt  crazy dreams a  lot plus felt hungary as soon as I woke up. today I saw very slight brown discharge with rotten egg like smeel coming to my mouth after burping. Please help me what's going on.Thanks",
    "doctor_response": "Thanks for your query, I have gone through your query.The brown discharge could be the blood along with saliva or pus from infected tooth or gum.The possible causes for the bad breath could be the gum infection or deposits, pus discharge. Consult a oral physician and take a opinion to rule out these causes. these causes can be treated by getting your teeth cleaned and maintaining oral hygiene.If these causes are not there then, it can be secondary to respiratory disorders like sinusitis or gastrointestinal disorders. Consult a ENT and Gastroenterologist to rule out these causes.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever, headache and swollen armpits?\n\nSandra presents to her physician complaining of fever, headache, and painful swellings in her armpits. During the physical examination, the doctor notices that her hands are covered with scratches. He asks about these, and Sandra says they re from a kitten that she found wandering along a country road 2 weeks earlier and adopted as a pet . What disorder do you think her physician might suspect?",
    "doctor_response": "Hi ThereSandra is suffering with Cat Scratch Disease. As she got scratches on arms and lymph nodes of nearest area that is underarms are swollen and painful. It generally happens in between 2 weeks of inoculation. She should be treated with antimicrobials.Wish Her Good Luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the MRI report indicate?\n\nsir my son 17 years old last sunday he has fell down and unconscious 3-4 seconds after that i went doctor and as per doctor advice done mri in that report Mucosal polpy is seen left maxillary antrum. impression Mild cerebral atrophy pl. guide me what medication i should take or any suggestion patil mysore",
    "doctor_response": "Hello MRI findings suggests mild cerebral cortical atrophy.Generally this is a age related finding but this is earlier in your son's case as he is only 17 years old.Cause of mild cerebral cortical atrophy should be investigated.It may be sequel of past infection,generalized ischemia etc.You should consult neurologist.Mucosal polyp is left maxillary sinus may be due to sequel of chronic sinusitis.Long standing infection may lead to polyp formation.Surgical removal of polyp can be considered after evaluation. Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause and treatment for severe pain in ribs after an injury?\n\ni am 350 pounds but very strong and can easily touch my toes and lift my own wieght, i fell flat on my back 2 weeks ago, it felt like i broke my ribs but exray said no broken bones, but in the morning i feel not to bad just a bit of pulling on my left side ribs, but by night time im almost in tears, i ve been off work for 2 weeks and dont know what to say anymore when asked when i can return to work ...i lift on 50 pounds hoses and drive tank trucks pls help, how long should this pain stick around",
    "doctor_response": "Hello,It may be due to rib fracture. For further assessment you may require chest x ray, pulmonary function test after chest physician consultation. For pain you can take tablet acetaminophen. Further treatment mainly depends upon the underlying condition. Continue breathing exercises. Hope I have answered your query...Let me know if I can assist you further.Regards,Dr Shyam kaleFamily and general physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe lower back pain\n\ni got hurt at work which caused pain in my back that radiated to my hip and down my right leg. Then the pain stopped in my right leg and went into my left leg I got a cortisone shot in my right lower back area. The pain stopped in both legs. Then all of a sudden my left arm went numb and was tingling then it traveled into my shoulder blade and neck.The pain is excuriating. I am losing feeling in my left hand and the pain in my cervical area is so bad it hurts to hold my head up. I ve been prescibed Gabapentin and Norco. But there is no treatment plan for the pain. What do I do. I can t handle all the pain. I cannot use my left arm. At times when I raise my left hand it will just randomly hit me in the face. Please tell me what I should do..",
    "doctor_response": "Hello, I have studied your case. Due to compression of this nerve root there is pain in your back and leg.I will advise you to do MRI  whole spine screening.For these symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.I will advise to check your vit B12 and vit D3 level.If not relieved then you may need surgical decompression.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment to be taken for the Lump under the jaw bone?\n\nI noticed a hard but small lump on the underside of my jaw bone right in the center of my chin and was curious if I should be concerned. It seems attached, doesn t move when I touch it but also doesn t really hurt. I can tell there is sensitivity to it when I push on it but not really bad.",
    "doctor_response": "hello thanks for the consult at hcm..it could be submental lymph nodes enlargement at the centre under the chin area,,plz chck for tooth problm for any infection..did u hav any recent trauma in that region???kindly chk with ur dentist/oral medicine specialist ..hope t helps,,tc..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in upper stomach along with vomiting?\n\nMy 2year old boy was complaining about upper stomach pain and so I gave him Enterogermina... After a while i gave him some milk which he vommitted (foul smelling) and so i gave him coliza D suspension 5ml... Its been 4 hours now and he has no stomach pain but he drank milk right now which he again vomitted... Please tell me how can make him feel comfortable P.s::: is it indigestion?",
    "doctor_response": "Hi, the child could be suffering from Indigestion or gastritis. This causes pain abdomen and vomiting and indigestion. Give your child Syrup Rantac 1 ml twice daily before feeds. Syrup Ondem 5 ml once daily to prevent nausea and vomiting. Give plenty of fluids in form of juice and ORS solution to keep his hydration adequate. Avoid spicy and oily food. Semi solid feeds like mashed banana, curd, probiotics like Bifilac syrup. If he continues with these symptoms, give him antibiotic course like Oflox-Oz twice daily(depending on his weight) for 3-5 days. Keep a check on his drinking water. try giving him bottled water only as dirty water supply can cause such an episode.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for having left testicle lower than right?\n\nim 14 years old boy and im getting a little worried cause lately ive been feeling like a small ball on my left testicle vein and my left testicle is lower thqn the right and sometimes it takes me longer to pee than usual should i be worried or it isnt anything serious",
    "doctor_response": "DearWe understand your concernsI went through your details. There is nothing to worry about that. Testicles are kept in a sac and the elasticity of the sac determines the looseness or tightness of scrotum. Sagging of the sack is quite normal process and left may sag more than right or vice versa. This has nothing to do with the urination procedure and testicles are not involved at all. Don't worry.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing pins & needles also noticed swelling in hand due to insect bite\n\nI have been bitten by an insect just lower than my elbow. I noticed it this morning and have taken piriton 3 times today and applied savlon sting n bite cream. The swelling is now 4 inches plus in length and I now am experiencing pins n needles into my hand. What else can I do ???",
    "doctor_response": "Good day and thanks for your question. Sorry about the insect bite, the feeling could be irritating. I wont suggest piriton because it could cause drowsiness and you might need to drive or go to work. Kindly switch to Loratadine 10mg daily and apply a cream that contain diphenhydramine/allantoin ( about 3 to 4 times daily). Hope it helps. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will i be able to conceive?\n\nI m having pcod...29 yrstrying to conceive since one year....LH level on eleventh day of my period was 15....i had taken clofert100 in the iinitial days of that cycle...doctor told me dat it was on higher side..could nt conceive dar month....now on contraceptives pills nd metformin frm d last two months....i m worried....will I b able to conceive?",
    "doctor_response": "hiyou can conceive with drugs or hormonal injection.you need proper evaluation before that.tubal patency test ,and follicular study reveal your tube status and ovulation.consult an infertility specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be done to get pregnancy with irregular periods and pcos,on thyronorm 100mcg,ovacare[A+B] and metformin\n\nHi, I had irregular periods, and i consulted and undergone Ultrasound scan,  ultrasound report shows pcosAm already on thyronorm 100mcg tab let, docttor suggested me to take Ovacare[A+B], and Metformin,I am trying for pregnancyKindly ReplyMy email address:  YYYY@YYYY",
    "doctor_response": "Hello,You should take above medicines as prescribed to regularize your period cycle. Take low carbohydrate diet, do regular moderate exercise to control or reduce body weight and take folic acid & Vitamin-E for 3 months during preconception stage.You need to do regular unprotected sex during fertile period (11th to 18th day of 28 to 30 days cycle). You can use ovulation prediction kit in the middle of cycle to track down the ovulation. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is a good painkiller for nerve pain?\n\nHello my husband has been having nerve pains in his back. It started in his right side and after a couple of months it just sort of stopped itself. The doctor was going to do surgery but his insurance wouldn t cover it so they wouldn t do the surgery. I s now on his left side. I can rub his back rather hard and he says he feels it clear down his left arm. His insurance won t pay for a preexisting condition. Can you maybe give me some ideas as to what may help him?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. TREATMENT: Some general guidelines can help you to reduce lower back pain. These are as follows:1) Take adequate bed REST with maintaining posture. Individuals who do not regularly exercise to build strength and flexibility are more likely to experience recurrent or prolonged lower back pain. 2) Alternate Hot water bottle or Ice pack can help to relieve most types of low back pain by reducing inflammation.3) Non-Steroid Anti-Inflammatory Drugs (NSAIDs) are quite useful to reduce inflammation and back pain. You need proper prescription from your doctor.4) Exercise for Lower Back Pain : It is a key element of almost any lower back pain treatment plan. You may contact with Physiotherapist regarding this. It includes 3 components: aerobic conditioning, stretching, and strengthening. The exercises are done through a controlled, progressive program to build more strong and flexible spine.5) Epidural Steroid Injections - deliver steroids directly into the painful area of the lower back to reduce inflammation. It doesn't heal the components of the back, but often provide enough pain relief to allow patients to move, exercise and heal. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Krislow effective for Parkinson s disease?\n\nHi, I am a resident of CA, USA and my father-in-law is visiting me from India. He s been diagnosed Parkinson in April 2011 and he s been taking medicines for Parkinson like Krislow 100, Pramipex 1 ml, Parkin, Rasalect. IO want to know if Krislow is effective?",
    "doctor_response": "Hi,Parkinson's disease is a degenerative neurological disorder due to deficiency of dopamine. Pramipex, Parkin and Rasalect are the medicines commonly prescribed to treat the signs and symptoms of Parkinson's disease. Krislow contains an anti-oxidant (coenzyme Q10) which appears to slow the progression of Parkinson's disease, however there is no clinical study done to confirm its efficacy.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "CT scan showing kidney stones. Pain in the stomach. can you explain my blood test report?\n\ni HAD A cAT SCAN DONE THAT REVEALED SOME KIDNEY STONES BUT ALSO REVELED SOM ISSUES IN MY SMALL INTESTINES.I have been having pains in my stomach for a while and have put it off. I went to a Gastro DR and he did an upper and lower and a series of blood test. The blood test revealed RDW 18.9% Chromogranin A, ECL 1.2 and the Lipase a 63. everything else in range.",
    "doctor_response": "Hello, Thanks for  the query to H.C.M. Forum. Query about blood tests as note , R D W ( Red cell Distribution Width)  18.9% ( normally it is 11.5-14.5 %). It is high. Chromium E C L ( Erythrocytes life span ) 1.2 in your case ( normally it is 25 -35 day) very very low, may be a  cause of anemia, if present. Lipase  63 a pancreatic  enzyme 63 ( normally it is 0-160 U/L.Pancreatic lipase enzyme is in normal limit. Hope I have provide you desired information. Is further any question I will help. Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fussiness with cough after esophagram?\n\nMy toddler swallowed a penny we just found out it s been stuck in his esophagus for seveal weeks (Mom was at chemo and when I returned after 3 weeks noticed the toddler was acting funny) Took to ER, did X-ray, found penny and pediatric ER doc did endoscopy with follow-up barium swallow a week later. My question is now 3 days after esophagram - my toddler is fussy again, getting up at night and coughing quite a bit, what is wrong with him now?",
    "doctor_response": "Hi....even though the foreign body is removed, sometimes the inflammation caused by it for staying so long can still linger on. The other possibility is that there could be a minor injury at the site of lodgement of the coin and it could have got fibrosed. This could be the reason for the fussy behavior as the pain and feeding difficulty can linger on. I suggest you get the consultation of a pediatric Gastroenrerologist.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shoulder blade pain and gall bladder swelling?\n\nhi, i am 50yrs old male. in 2009, my right kidney has been amputed due to formation of malignant tumor over it. last year when i undergone my routine checkup in chennai apollo where i got my operation done, formation of multiple calculi of size 4mm in gall bladder was seen in USG report. since last few days i am having pain near my shoulder blade. now when i went through ultrasonography i found my gall bladder wall is swollen and the size of stone is 8mm. my local doctor has given me antibiotics to cure the swollen.next month i will be going for my scheduled checkup to chennai .what should i do now. should i immediately move to my doctor or having the antibiotics i can go after a month?",
    "doctor_response": "Hello Your findings suggests acute calculus cholecystitis.Acute infection is indicated by swollen wall of gall bladder.You need definitive treatment of gall bladder calculus i,e surgical removal of gall bladder(cholecystectomy).Gall bladder calculus is prone to infection and obstruction,so it is advised to get rid of calculus early.Operation can be done after stabilizing conditions like alleviation of pain,infection.Surgery can be done even in acute condition after evaluation.Right shoulder blade pain may be related to gall bladder calculus.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have cramps, brown discharge, weird smelling. Taking birth control pills irregularly, had unprotected sex. What is it?\n\nI recently started takin birth control but I hace been very irresponsible with it...I also had unprotected sex a couple of times...8 days afrer I noticed light red bleeding it lastef a few days then I started getting cramps so I took a pregnancy test and it came out negative ..now I've been cramping and I have dark brown discharge and it smells weird..this has been goin on for a week now..my period is supposed to come tomorrow ...what do u think it could be?",
    "doctor_response": "HelloThanks for your query.The irregular spotting and cramping and the abnormal discharge is due to the erratic intake of pills.Once your period starts, please start a new pack and take it on schedule, otherwise it is best to avoid birth control altogether.Have a gynecological evaluation anyway to rule out pelvic infection or any other pathology causing the irregular bleeding.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dark urine, thick semen discharge and yellow cast on whites of eyes?\n\nHi, lately I've noticed that my urine is very, very dark, and my discharge of seamen is unregularily thick. Also, when I wake in the mornings, I'm very queezy n have been vomiting. And I've also noticed that the whited of my eyes have a yellow cast to them. This has all happened within the last three weeks. I am 36, 180 pounds with no past medical history.",
    "doctor_response": "Hello, SirWelcome to healthcaremagic.I can certainly understand your concern.I have worked through your query in detail.As per your symptoms the possibility of significant urinary tract infection is very high.This can cause significant change in seminal parameters causing thick or foul smelling semen with or without urinary disturbances.It's important to get few tests to determine further course of action-urine examination, scrotal ultrasound Doppler to look for any infection of the testicles or epidydimis.A short course of antibacterial antibiotics will help to clear the infection and improve the seminal parameters.Repeat testing after 2 weeks will help to assess the outcome.Please check with your physician if he shares my view and if can prescribe these medications to you.Post your further queries if any.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a mildly enlarged liver with mild hepatomegaly with Grade III fatty infiltration be treated?\n\nAs per my ultrasound report Liver is mildly enlarged (15.12cm) markedly raised parenchymal echotexture indicating mild hepatomegaly with Grade III fatty infiltration. There is also presence of left renal cortical cyst 1.8 x 1.7 cm. at middle pole of kidney. prostate is mildly enlarged est. wt. 27.18 gms. I do not take much liquor but consume slightly highly oily food. Is my lever leading towards cirrhosis and any problem in my kidney and prostate. My age is 63 yrs. I am presently taking tab. Urimax D (Tamsulosin Hydrochloride & Dutasteride tab) . Please advice course of action",
    "doctor_response": "Hi, For your benign prostate hyperplasia you can continue with prescribed medication which will relieve your Prostatic problem. You have grade 3 fatty liver for which lifestyle modification needs to be done. It's advisable to take a low-fat diet and regular one hour exercise is indicated for you. Avoid refined foods and high oily foods. You can take udiliv for your liver problem. Take sugar cane and apple juice more. With the above advice mostly in a few months, your fatty liver problem will be resolved. Don't worry about cirrhosis. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Indentations on injection site. Taken Corticosteroid injection. How to get relief?\n\nWas given a corticosteroid injection in left and right hip and now i have golf ball sized indentations on injection site... What can be done about this?",
    "doctor_response": "Hi indentations at the injection site is most common side effect of corticosteriod injections .first stop the injections and then supplementation of vitamin e tablets can cure the indentations within one or two months.sometimes indentations can be cured by themselves within course of time.nothing to be worried due to them",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could bump on top of forehead indicate bone cancer?\n\nHi - I saw my family doctor in October and showed him a small bump at the top of my forehead, where the hairline starts. He ordered an x-ray of my skull which showed density changes suggesting possible metabolic bone disease, and has ordered a bone densitrometry test and extensive bloodwork. He is ordering these as he thinks it could be that the parathyroid gland is overactive, and if that is the case, that would be removed. I asked him if there is any possibility of cancer, and he said possibly, but that he feels it is more related to the parathyroid gland. I asked him if I am diagnosed with cancer, what type of cancer could it be? He told me it would bone cancer. What are your thoughts?",
    "doctor_response": "Hello and welcome to HCM,Overactive parathyroid glands lead to formation of brown tumor in the bones.Brown tumor are formed due to over activity of bone forming cells.'Brown tumor' is a misnomer since it is not a tumor and it is a manifestation of metabolic disturbance caused by hyperparathyroidism.A couple of investigations are required before diagnosis can be made and management can be done.An aspiration cytology of the swelling is required and this investigation can differentiate between a bone tumor and brown tumor caused by hyperthyroidism.Thereafter, blood tests for calcium and parathormone also need to be done to assess the function of parathyroid gland.In case these investigations suggest any abnormality of parathyroid gland, specialized scan for parathyroid will be required to assess whether there is enlargement of all parathyroid glands or enlargement of single parathyroid gland.You need to consult an orthopedician for these investigations and thus further work up.Thanks and take careDr Shailja Puri",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a broken nose be treated?\n\nbones in My nose were fractured due ro fall. My left half of nose were broken out.docror stitches the skin of nose and they provided with cover inside nose to make the fractured bones in position.now i does not feel any smell. Please answer me sir how long it need to recover my shape of nose? How long it take to heal my bones in proper position? How much time required to completely remove stitching marks?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Nasal bone will recovered in 2 weeks ,stitches will remove in  one week . I hope this information has been helpful for you. Regards, Dr. Praveen Tayal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there continuous bleeding while brushing after removal of braces?\n\nHi doctor, I just got my braces removed today and have been getting some heavy bleeding when brushing my teeth, should I continue to brush my teeth while it bleeds or just stop?",
    "doctor_response": "Hi. I can understand your concern regarding the dental health. Bleeding gums after removal of braces is a very common problem among all. So first of all, consult your dentist for scaling to remove local inflammatory factors. Till the time do gargles with mouthwash after every meal to maintain oral hygiene and avoid brushing to not allow bleeding.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fatigue and emotional stress\n\nI am experiencing fairly severe fatigue when mildly exercising outdoors in a warm environment. Drinking more water does not seem to help. I only recover by resting in a cool environment. I have been experiencing stress relating to emotional problems.",
    "doctor_response": "Dear userWe understand your concernsI went through your details. Please let me know, is there any other occassions, where you feel the same set of symptoms? Usually Stress and anxiety do induce physical symptoms like breathlessness, fatigue etc. Needs to be evaluated. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to ascertain that one is pregnant?\n\nhi, if i m doing the hcg injections (for 2 days) and got a blood pregnancy test and it came back positive with an 8, would that just be the injections giving it a positive result or am i really pregnant? i have had very tender breasts for about 5 days and had sex a day before i was supposed to ovulate. i should be starting my period on Monday.",
    "doctor_response": "Hallow Dear,If you are hCG, it is better to confirm the pregnancy by ultrasonography as external hCG may misguide the urine pregnancy test. You history of intercourse around the day of ovulation and heavy tender breasts with positive urine pregnancy test is suggestive of pregnancy; however, confirm by scan. All the best,Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to gain stiffer mustache and beard\n\nweak moustache and beard...hw much it will coast the treatment for stimulate the growth and get a stiffer moustache and beard...i'm 29 year old. i feel my testes and penis are also smaller when compared with my friends...pls let me knw the treatment coast..",
    "doctor_response": "hii.welcome to healthcare magic.i understand your problem.my opinion is that,1.take nutritious foods.2.have good sleep of about 8 hours a day.3.avoid stress.4.take multivitamin tablets once daily in night.5.apply eucalyptus oil in beard area to get thick beard.thank you.hope my answer will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause for pain in the lower left side?\n\n\"I have had severe hiccups throughout the day lasting about 20 mind and at least 11 times since this morning. And now, for the past housr Ive had a sever sharp pain on my lower left side. Almost breathtaking.... Have no idea what it could possibly be..? Thinking about going to the Er..?\"",
    "doctor_response": "Hi! Good morning. I am Dr Shareef answering your query.I would advise you to seek help in the ER of your nearest hospital, as it won't be possible to opine on your condition without a physical examination and related investigations. Take care and good luck.Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with enlarged liver after having pain, pain eased now with healthy diet. Is it serious ?\n\nHi Doctor, My name is AAAAA and I have a friend/housemate who has recently been diagnosed with an enlarged liver. She appears to have had it for only a week or thats atleast how long she has had pain in her side for but has no other symptoms and now the pain has appeared to ease over the past 2 days. The doctor she saw couldnt really tell her why her liver was enlarged and she has a specialist appointment next week but i was just wondering if there is anything dietry or enviromentally etc that can cause this to happen or if it necessariliy means the beginings of liver failure or hepatitis etc? She does have quite a healthy diet and is a dance instructor but we would just like to get some idea of wether its necessariliy serious?!",
    "doctor_response": "Hi, Thanks for using HCM.there are many reasons for enlarged liver, could be due:InfectionMetabolic disordersDrugs or toxins effectStorage disorderMalignant condition.She needs to get complete blood counts, liver function test and Ultrasound of liver can reliably detect a dilated biliary-duct system, which helps distinguish parenchymal liver disease from extrahepatic bile-duct obstruction. Ultrasound can also detect the characteristic texture of a cirrhotic liver, and can guide fine-needle aspiration of cysts, abscesses and tumours.Computed tomography (CT) can help obtain more accurate anatomical information,  as a first line of investigationConsult your doctor for examination and management.Hope I answered your question. Feel free to ask me if you have any further queries.Wish you good health. Take care.RegardsDr. Vidya",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurrence of non-hodgkins lymphoma?\n\nMy husband was diagnosed with non-hodgkins Lymphona one year  ago, after 6 months of treatment a pet scan showed he was cancer free.  5 months later he was diagnosed with pancreatitis, now after an MRI the say the lymphoma is back.  why did this happen?",
    "doctor_response": "No specific cause  unless the diisease has been treated inadequeteltly leaving behind the residual disease. Problems or the causesntal  called co incidental factors which caused the lymphoma remain there as they have not vanished after the treatment. Dr. J. Ticku",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in my feet ans ankles?\n\nhad heart stent put in 4 months ago due to heart attack that was brought on by severe pnemonia that put me on life support.a week ago my feet and ankles started to swell, getting less swelling,but still there.called my doctor,won't prescibe water pill,till he see's me sometime next week,any over the counter suggestions",
    "doctor_response": "Hello and thank you for your question. There are no over the counter pills that you can take but there are some things you can do to decrease the swelling. Cutting out all salt in your diet is very important. This means not adding salt to your food but also avoiding prepared foods such as processed meats, canned foods and eating out at locations that do not use salt restrictions. Propping your feet up so that they are above the level of your heart can help also using support hose or compression stockings can decrease the swelling. Walking or just moving your legs around while you are sitting around get help get the fluid moving out of your legs as well. If you develop shortness of breath or chest pain you need to go to EmergencyBest regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of yeast infection?\n\nI have thick white discharge which i have never had before, i occasionally get very very little and light. (i know it's not plesant, think how i must feel!) But i am not due to ovulate nor come off or on my period, what could it be?? Yeast infection? Or normal?",
    "doctor_response": "HiThis definitely sounds like a yeast infection or possibly a bacterial vaginal infectionYou can try Lamisil or Monistat to see if it clears, and if it doesn't, see a doctor for an exam and culture",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I feed my child with cerelac?\n\nhello dr im suman shankar from mumbai....my son is about 4 months old ,can i give him cerelac....as i feel the milk what i feed him is not sufficient ...so just wanted to know about it .\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0thanking u ,\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0regards ,                                      suman shankar                                 w/o lieutenant commander.                                   mumbai .",
    "doctor_response": "Thank you for asking querry.First can i know the weight gain pattern of the child, means whats the birth weight and current weight?How much weight he is gaining in a month?If he is gaining enough weight,passing stool 6 times and urine 10-12 times and playful and active,then there is no need to give cerelac .Continu breastfeeding till 6 months of age and start complementery feeds after 6 months.Hope you find this helpful.Rate the above answer if you like it.Regards,Dr rushikesh kute",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes warm sensation in the neck and head?\n\nHello I have been experiencing a rush of warmth from my neck into my head, I have never fainted but I feel light headed, and the warmth radiates into the pelvic area. I feel pressure in my forehead. I am not on any meds and am 58 years old. BP has always been low to normal.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Pressure in head may be due to tension type headache. You need to decrease stress. Drugs like Amitriptyline , Sertraline or Duloxetine can be helpful. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i walk on tredmill and do rope skipping while conceiving?\n\nHi, I had an abdomen surgery (a 8*12 inch dermoit cyst) 8 months ago. but now my weight has gained. As I want to do rope skipping & walking in the treadmill. Is it harmful for me. I am married & 27 Years old, have no baby. Is it harmful for my conceiving.",
    "doctor_response": "Hi, Thanks for using HCM..i understand your concern..There is no problem with rope skipping and walking in the threadmill. There is no harm as long as you are not pregnant. From the month you are trying to conceive, it is better to avoid heavy exercises. But walking and upper body exercises can be continued. There is no proven clinical evidence to support early trimester abortion due to heavy exercises.. hope i have answered ur queries.. Good day..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pain in tail bone?\n\nI have been having pain in my tailbone.  I do not remember injuring it.  Xrays show no fracture.  It was diagnosed as tendinitis.  I take Mobic and Ultram for the pain.  I am unable to sit for very long.  Could there be another diagnosis or treatment?",
    "doctor_response": "This is a pretty common set of symptoms. There can be practically anything in the area and MRI's are done to evaluate if there is a growth (blood blisters common these are called hemangiomas) generally of normal tissue. This can be removed. There can be irritation or fracture of the area this can be addressed. Or nothing is seen. Medicines that damp down nerves like anti-epileptic medications are most commonly used.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with exercise induced asthma, inflamed lower muscle, ACHES. Taken steroid inhalers, DOO for back and adequate rest. No improvement. What else can be done?\n\nHi, I m an endurance athlete.While training for Ironman last summer, I developed pain in the lower right area of my back. I figured it to be from over training. When the season ended, I rested for about 6 weeks. Minor aches were still in my back but the pain had decreased significantly. When training started for the 2012 season, I started having sharp right to middle abdominal pain . Severe congestion also set in. I went to the doctor and was diagnosed with three issues: exercise enduced asthma , enflamed lower back muscle , and what is known as Abdominal Cutaneous Nerve Entrapment Syndrome or ACNES. I was given steroid inhalors, referred to a DOO for my back, and ordered to rest for the nerve issue. It s been five months and nothing has changed. I m going back to my doctor in about a month but wanted to hear any suggestions of something different??",
    "doctor_response": "exercise induced asthma is allergic and as we exercise more pollens go in lungs causing problemas the history suggests might be some food allergy as the medicines are not workingwhen nothing works then we should think of foodsmostly happens in wheat or glutenadvise you to get blood serum test for specific antibodies for milk wheat rice potato chana egg nutseliminte then on the basis of tests and you will recover",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and blackening of area after splinter removal?\n\ni just got a splinter a few weeks ago and when the docter was doing surgry he accidently cut the splinter in half so the next week i had to go back to get the rest out and a week later i saw a  black kind of area and it hurt a little bit does that still mean i have a little bit of the splinter stuck in thier and it dosent even hurt rightnow.what does it mean ,what should i do?",
    "doctor_response": "Hello,There is nothing to worry as it is a normal reaction of the body following any trauma. It is unlikely that a part of the splinter is still remaining.The black area is due to some blood leaking into the area, that releases iron. The pain is part of the process and these should disappear over the next 3-4 days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anxiety, mood swing and headache\n\nhi my father has multiple anxiety like being anxious, mood not good,light pain in head,headache,warming of head.loss of weight in legs..wat will i do? this problem is going on for last 7 yrs...multiple doctors we have visited.. can you give me some advise?",
    "doctor_response": "HelloGo for a thyroid test and blood sugar.You can start giving him tablet escitalopram 10mg in morning daily alongwith tablet rivotril 0.5mg. I think this will work.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itchy rash between the crease of leg and private parts, sensitive, tender lymph node in front of pubic bone. Reason ?\n\ni have two problems. number one is that there is an itchy rash between the crease of my leg and my private parts. its only on my leg though. it has a redish sensitive look to it. its only itchy and nothing else. there is no weeping, bleeding or anything else. problem number two is that it seems that i have a small lump or tender lymph node on the right front of my public bone. its not at all sore though",
    "doctor_response": "Hi,Welcome and thanks for posting your query to HealthcareMagic.As per your query you have itchy rash between the crease of leg and private parts with sensitive, tender lymph node in front of pubic boneThe characteristic feature appears to be problem Intertrigo. This is a common problem due maceration of skin of folds ladin to bit redness. The lymph node can get swollen because of this mild redness and inflammation itself.Do not scratch or even try to touch the area unnecessarily, apply any antibacterial cream such as fucidin or mupirocin or gentamicin with mild steroid. You can take a course of antibiotic such as ciprofloxacin or cefadroxil for 5 days.The things will be totally alright by simple measures so do not worry.I hope these information's will help you. If you have further queries I will be happy to help.\"Wish you good health\"Regards,Dr Sanjay Kumar KanodiaMD (Dermatology and Sexually Transmitted Diseases)",
    "dialogue_context": ""
  },
  {
    "patient_message": "is homeopathy advisable for piles and heart related problems?\n\nHello Doctors, I underwent Angeoplast on 1st Feb 2011 for 99% blockage. I am on medication (Storvas, Clopitab, Ecosprin, Pantadoc, Acerevelol). Post this, piles which were there earlier worsened and started bleeding heavily. in the month of April I underwent banding for my Grade2 piles since main suregery is not possible. Bleeding stopped for about 20 days and started again. I underwent banding surgery once again a week back. I am using Sitcom tablets, deltiact gel right now. Can I go for homeopathy treatement while I continue using above mentioned medices of piles and heart problem? Do i get result in homeopathy?",
    "doctor_response": "For piles there are good medicines in homeopathy.depending upon character of symptoms.u can go for homeo medication.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe lower back pain radiating to legs. MRI normal. What could it be?\n\nhio my name is kavita and i am 36 yrs old i have a severe pain in my lower back and the pain has worsed from lower back to right leg and my back , my doc told me to take an mri and the reports r normal so can u pls suggest what can i do to find out why this pain is occuring what could be thwe reason and waht treatment shud i take. thank you.",
    "doctor_response": "Welcome to HCM. Sever leg pain could be due to number of reasons however most common musculoskeletal reasons  are disc prolapse, hip joint pathology or sacroiliac joint arthritis? need to know more about the pain. what was the MRI done? I would suggest to get examined by an orthopaedic surgeon to pin point the problem. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taken extended-cycle birth control pills. Started bleeding, having headache. LH and FSH found non existent. What to do?\n\nI take extended cycle BC pills . I started bleeding in the middle of the pack...and continued for 4 weeks. Now the bleeding has almost stopped but now I am having frequent headaches. My lab work for LH and FSH were almost non existent. My TSH is 6.2. My reg. DR. Is sending me to an endocrinologist but I am sure it s necessary. I don t want to create big bills. What should I do?",
    "doctor_response": "Hi and welcome,I understand your concern. However the continuous bleeding, raised TSH and low FSH, LH indicate that you may have hypothyroidism. So a visit to an endocrinologist is warranted.Hypothyroidism leads to weight gain, headaches, lethargy and lack of energy and menstrual irregularities. Your raised TSH is well beyond the upper limit of 5.5. If you feel that the result is a false positive one you may retest it after a month and then go. Meanwhile eat iodinated salt in food [ it is mentioned on the salt pack if it is iodinated] as iodine deficiency is a cause of hypothyroidism. Hope this satisfies your query. Thanks for using HCM.\u00a0\u00a0\u00a0\u00a0\u00a0Feel free to ask any more questions that you may have. Dr Madhuri BagdeConsultant Obstetrician and Gynecologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will body's immune system fight against the semen in body?\n\nHey there!I am a gay, me and my mate have a daily penetration, he cums inside me...my question is, if i have hommeroids and his sperms goes inside my blood, will my immunity system consider semen as a intruder and fight it then,if yes, what about the semen which is in my body(my testicles), will be fought as well?thank you",
    "doctor_response": "Hi! semen is nothing but a protein-rich secretion that must generate immunity in your body if somehow inoculated; actually it is not against semen as a whole but against some protein components of it! the sperms die soon and only digested/residual proteins will initiate some allergic/immunities in your body!there is no communication of blood with semen due to blood-testes barrier and not to worry!Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. all the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes body ache along with headaches after an accident?\n\nmy 16 yr old son was hit by a oncoming vehicle last wednesday evening..... the car left the site. My son turned 2x around in circles fell to ground face down tried to get up couldnt fell again face down, then was able to get up as the car left, he ran away assuming he was in trouble. I just found out today. Last couple of days he stated to me his body was aching, i assumed he was getting ill as change of weather. This morning he woke up shaking nonstop, headache couldnt stand on his own and a bad headache, so i sent himn to bed and gave him dayquil, he just woke up states his face is numb, right arm numb, headache, small stomach pain, right side rib ache when breathes",
    "doctor_response": "Hello,It is the rule that head injury needs to be kept under observation or couple of days because anything may happen during this time period like vomiting, giddiness, (Alter sensorium), if this happens, then CT imaging is must, but it is the trend nowadays that all the head injury cases being sent for CT imaging.Here in your case it is the case of head injury so it is advisable to get done the CT imaging to rule out the cerebral injury (Brain Injury) present symptoms may not be due to head injury but it can not be taken as granted for anything, once it is the history of head injury, then CT imaging is must, I is advisable not to treat the symptoms without consulting the doctor.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Akhtarhusain",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red cheeks inspite of having antibiotic drops for pink eye?\n\nHello. My 3 year old is on antibiotic drops for pink eye (since Fri eve); eyes are not only seemingly worse (redder) but this afternoon she developed red cheeks too. Wondering if it could be an allergic reaction to the drops... She s using Sulfacetamide NA 10%. Thanks for your help.",
    "doctor_response": "Hi...it could be an allergic reaction to the drops. It is a sulfa drug. The most common side effects of sulfacetamide are local irritation and contact dermatitis. Sulfacetamide should not be used by individuals who have a sensitivity to sulfur or sulfa. Please stop it.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take udiliv for liver function problems?\n\nHi, I recently got my liver function test done and the numbers are not pleasant. A friends doctor has suggested that i should start taking Essential L, which is Lecithin 350 mg, but my family doctor has suggested Udiliv 300 mg twice a day. Is it a good prescription? And what is a better medication for me?",
    "doctor_response": "Hi thanks for asking question.You have not mentioned which abnormalities of liver function test present???If I would know your detailed report can answer still better.As far as your doubt is concerned both this drug are good.But udilive is good drug that contain ursodeoxycholic acid that help in dissolving cholesterol in bile.So prevent gall stone formation and it is used to treat gall stone induce jaundice it in cholestasis cases.Meanwhile if you have jaundice or altered liver function test then along with drug take good dietary habit ...like more fruits, less fatty diet, green leafy food more, avoid refined sugar ,loose weight and exercise...I hope your concern is solved.Dr.Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bleeding after renewing the implant, having brown discharge, feels dizzy and weak. What's wrong ?\n\nHello. Ive been on the implant for over 3 years and had it renewed in October however for the last 3 weeks ive been bleeding not to much to use anything but when I wipe there is either blood or a browny colour discharge . Ive alwmso had a head ache for a week feeking dizzy and sick. I feel tired too. Wjats wrong with me? :(",
    "doctor_response": "Hello, Implant is sub dermal hormonal contraceptive method, used for 3 yrs and effective more than 99%. It has some side effects & it varies from woman to woman like irregular period, headache, Weight change, DVT, abdominal discomfort, nausea, fatigue, mood swing etc. Do a USG lower abdomen & some hormone test to rule out underlying pathology if any. Take some analgesic for headache and multivitamin supplements with your diet. Avoid stress, control body wt by regular light exercise, drink plenty of water and need proper sleep. If you need further consultation with me,then you can visit  Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the absence of cervical mucus affecting my fertility ?\n\nHi Doctor , I am trying to concive since last few months. My period are quite regular but I dont find cervical mucus during and after ovaluation. Can you pls suggest if this is affecting my fertility and chances to get pregent. Do you suggest any medication.",
    "doctor_response": "Hi' Welcome to healthcare magic, Get your follicular study done to know if you are ovulating& husband's semen analysis done if both reports are normal then get HSG done to know patency of tubes if it is normal then don,t worry you will conceive. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for side effects of breast hickeys\n\nCan repeated hickeys on breasts cause damage to tissues and nerves and blood vessels? My breasts feel firmer and harder and very sore. When in love the tissue around it feels clumpy, like I can feel the nerves clumped up and move around. They aren t soft and squishy like the other parts (bottom half) of my breasts.",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. Well, obviously there is damage to blood vessels, that's why there are hickeys. There is the short term inflammation which is helped by icing at first 12 hrs then hot water bottles, and then the long term scarring. This is not common at all but then, your situation is not that common either. So, I cannot say the texture will return or there may be some visible scars and further deformity. I don't think there are treatments as preventives once the hickeys happen. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Matt Wachsman",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can any online doctor please suggest me about my chances of getting pregnant\n\npcod irregular periods 37x31mm cyst in LT ovary on11july its my first day. 7x7mm inRTovary and 11x12mm inLT ovary on22 july 12day. 11x12mm inRTovary and 8x9mm inLT ovary on27july 17day. 1 what does this mean? 2 IS ovulation happen this time? 3 slow and late growth of follicle as in my case .ISany chance of getting preganant? 4 what to do now? 5 plssssssssssss answer soon",
    "doctor_response": "Hi, The follicle in yr left ovary on 11th july -is not seen in next reading on 22nd July.that means it has ruptured to release ovum some time in between the readings.there is a  possibility of conception this time,if you had sex arround 11th to 15th july. Actually PCOD is charactorised by slow,irregular or no ovulation. still you do have a chance to conceive-there are medicines to correct the problem.so don't worry. consult a gynac for proper investigations &treatment. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "pain under the right rib, pain while breathing. Appendix and gall bladder removed. Problem?\n\nI was in the hospital yesterday for a really bad pain in my right side almost under my ribs and going into my back. Ive had both my appendix and my gaul bladder out last year and the doctor couldnt pinpoint exactly what was wrong. Ive been doubled over in pain, hurts to breathe its killing me. Its not sharp either its a long dulling pain like what I felt when I had gaul stones. If anyone has any suggestions as to what it could be I would really appreciate it.",
    "doctor_response": "Hello,Post abdominal surgery patient present with complaints of abdominal pain.After proper evaluation if the cause of the pain can not be found the it is more likely that the pain may be due to adhesions of the internal structures.In this situation I would advise my patient to take antispasmodic for control of pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Medicine for pimples\n\ni want to know that is there a cream or medicine that removes pimple i am 15 years old",
    "doctor_response": "Hi! alexander007alex, Welcome To HealthcareMagic forum, There are lot of creams available in the market for acne right from over the counter(OTC) medicine to prescribed medicines.I wouldn't recommend you any OTC preparation because they don't have any good effect .For prescribed medicines you need to consult a dermatologist .Commonly used medicines are  clindamycin ,adapelene ,nadifloxacin creams etc.If acne is sever then you also need oral tablets .Along with this you should use anti acne soaps daily,avoid use of moisturizers on face or any oily stuff on face and never  squeeze your pimples. regards, Dr.chawda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the presence of blood in urine in a 1 year old?\n\nMy son who is just more than 1 and a half year old suddenly caught fever followed by presence of red/blood in the urine. Our family often heard of such illness but never really in our family. I am a father of four children (2 boys and 2 girls). My son who is now having this illness is the youngest among the four. This happens on the 17 April 2011 in the evening. Me, my wife and family members are really worried. We need medical advice and all the possible help we can get. Please help us.",
    "doctor_response": "hi! recent onset fever with blood in urine is a sign of acute glomerulonephritis or urinary tract infection.  it is a common condition in children of this age group. get her investigated. also monitor her blood pressure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen skin breakouts all over body\n\nI ve had (3x in 3 months) itchy, swollen weltish skin outbreaks that appear over several days on my upper arms and neck, and take several days to resolve. They are red like a bug bite in a way, but lack the raised, 1/2 - 1 cm distinct bite area. They develop a corona about 3 cm in diameter, so my body is clearly having an immune response to whatever this is. PA examined today at my Derm s and ruled out bed buts, scabies, prescribed topical steroids. I have no known allergies, at 59 enjoy good health! HOWEVER it has dawned on me today, I have had no trouble with them but do have silicone breast implants that were installed in 1997. YIKES. Get a mammo every July so one coming up, last one both sonogram plus xray and no leaks detected. I am wondering if some failure of the implants is leaking wierd chemicals into my body and that is the foundational issue. How can I check out whether this is the problem causing my inflammatory skin response? Yikes. again.",
    "doctor_response": "hellodont worry.this is nothing but impurities of blood.u need ayurveda treatment from a good expert.for now take tab.haridrakhandayog 3tab 3times a dayu will feel good.for more u can contact me again",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rashes on shoulder\n\nHi my husband 46 yrs old living in Singapore out of sudden had rashes like acne over his shoulder.Not much itch but reddish n can see little yellow fluid in each centre.Had seen family doctor  not given anything to apply but was ask to take tab Keteconazole.",
    "doctor_response": "Hi, With your history it seems like your husband is having acneform eruption with few infected lesions as well. Ketaconazole is an antifungal which has no role in this unless there is a case of Pityrosporum folliculitis but still other antifungals are used in that caseSo I suggest him to visit a Dermatologist because he needs oral antibiotics like Minocycline or might need Isotretinoin Therapy depending upon the severity along with topical preperations containg benzoyl peroxideAlso important is that a sudden acne eruption can be side effect of few oral medications like steroids,anti depressants,Painkillers etc . So he must stop those if there is any history",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a hollow red spot on the gums?\n\nI have an area of my upper left gum where there is a dark purple and red spot running from the base of the gum up to the very top. I am missing a tooth in this area beside my front teeth. The purple/red area seems hollow when i run my finger across it.",
    "doctor_response": "Thanks for your query, I have gone through your query.The hallow red spot could be a echhymosis or hematoma secondary to any trauma to that site or it can be arterovenous malformation. Consult a oral physician and get it evaluated. It can also occur secondary to any bleeding disorder like thrombocytopenic purpura.You need to get a complete blood investigation along with BT, CT, and INR to rule out bleeding disorder.If it is a hematoma it will heal or reduce by its own. If it is a arterovenous malformation or thrombocytopenia then you need to consult a oral physician for the treatment.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this total bilirubin level indicate while on Vyvanse indicate?\n\nMy 17 year old son recently had a well check with his pediatrician. All lab results from blood work were normal EXCEPT his total bilirubin level which was 1.4. The Md is concerned and has ordered a specific bilirubin blood test...... My son is very active, plays football for his high school and lifts weights regularly.... He is otherwise healthy and rarely gets sick with nothing more than a cold every now and then.. The only medication he takes is vyvanse for A.D.D. but he only takes it when he needs to study for an exam.... Not understanding how there could be a problem with his liver giving his health status.",
    "doctor_response": "Hi  First it's not that high second it can be due to some genetic reason like Gilbert syndrome.Your doctor has to compare Liver function test and scan.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pale red and hard bump on the gums?\n\nI have a lump on my gums, its whitish red. ive had it for over a month now, sometimes it not even there and sometimes it about a quarter of an inch big, when i eat it gets bigger, i just tryed to pop it thinkig it was an abcess and it didnt pop it just stayed the same size and bled a small amount where i poked it. is this CANCER??",
    "doctor_response": "Hello, Thanks for consulting HCM, Read your query, as you have bump on the gum this can be Abscess for due to Periodontal problem or due to carious tooth may be formation of Periapical Abscess or this can be Pyogenic granuloma also. Dont be worried it is not cancerous condition but I will advise you to consult oral surgeon and go for visual examination of swelling on gum if needed go for Investigations IOPA xray of tooth then go for its proper treatment .  Inmeantime do warm saline rinses two - three times a day , Do chlorhexidine mouthwash , brush your teeth twice daily .Hope it will help you.  Wishing you good health. RegardsDr.  Priyanka tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to use grocapix gel on hair while planning for pregnancy?\n\nHi Doctor,I am a female and have hair thinning on top of head and it is becoming very noticeable. So I am thinking of using grocapix gel? We are planning for pregnancy. Is it safe to use this gel at this time? Will there be any side affects?Can you also mention safe treatments for hair growth while I am planning for pregnancy.Please suggest.",
    "doctor_response": "hithanks for using healthcare magicGrocapix gel is capixyl gel. It is basically a peptide which induces hair growth by acting at molecular level and also blocks conversion of testosterone to 5 DHT, but its safety in pregnancy is not sure.  During pregnancy try to avoid allopathic drugs. Any drug can effect hair growth. for the hair grow you should use the amla (Gooseberry) oil and coconut oil and almond oil. above mentioned three oil most powerfully care for your hair you can choose any one of them and you get surety difference within month, within month you can feel the change in your hair smooth, silky, easier more grow able you can find more benefit of above mentioned oil thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Constant gurgling in stomach, loud and uncomfortable, have tightness, have gas. Tried ginger tea. What can do done?\n\nI have a constant gurgling in my stomach. It's quite loud and not only uncomfortable but also very embarrassing. This gurgling is typicall accompanied by a tightness in my stomach. I was told it was gas, however it's literally 24 hours a day, and I rarely have the sensation that I need to pass gas. It's sometimes quite painful and other times just uncomfortable. It doesn't matter if I'm hungry or just ate, if I ate a lot or a little, or if I ate super healthy or slightly less healthy. I've tried everything I could think of from ginger tea to gas x to culterelle to antacids. It's beginning to give me anxiety and it seems the more nervous I get about it, the worse it gets. What can I do??",
    "doctor_response": "Hi,You may be in the initial stages of Irritable Bowel Syndrome. Please consider getting a colonoscopy done.I understand that you have done everything about your diet. Please remain patient; consult a medical Gastroenterologist who can guide you more closely.I am sorry; but I hope you find a solution to this problem soon.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedy for plantar fasciitis\n\nI had hit myself with a nail gun at work on my ankle the tibia.  already went to doctor because the next day my oppisite foot was in lots of pain as well.   They determined I have planter fascinates in the right Foot and if the medication did not seem to work for my left ankle. There is no swelling or bruising. It feels ok for a little whilr the after a day at work it hurts bad. I was just wondering if there was any home remedies thT could help with this or your personal opinionThant you very much for your time.Matthew",
    "doctor_response": "i would advise you taila dhara on both painful ankles,ver light massage is ok.then some hot fomentation with cloth ball heated over a hot tawa or tolerable hot steam.a lepa of dashang lepa should followed.give complete rest to both ankles for few days .let the injured part recover.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for watery blisters on the penis forehead\n\nI have developed waterly blisters on the outside of my foreskin. The blisters are located on the front part of the skin that covers in the foreskin. Am not circumcised. These come and go but I have noticed they are becoming regular. Also about 2 weeks ago I experience some burning sensation in the urethra on the end of the penis. Please help me",
    "doctor_response": "HelloThanks for query .You have not mentioned about sexual history Based on your symptoms you seem to have acquired Herpes 2 infection and needs to get following basic tests done to establish diagnosis .1) Swab test and culture of fluid from blister 2) Fluroscent test 3) Urine routine and culture Take antibiotic like Doxicycline along with anti viral drug like Acyclovir twice daily .It should get cured within 10 days .\\Dr.patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for large bruise on trochanter area\n\nHi Dr. I slipped and fell pretty hard on my right side a month ago. The bruises have resolved, but I now have two hard ball feeling things under my skin around the greater trochanter area, where I had a large bruise.  It is still tender to the touch.  What is this?",
    "doctor_response": "Hi...Sorry to hear about the fall..Thanks for choosing us to answer your query...Your lump and swollen area could be a haematoma that could have been due to fall...Now it is healing...since it is over the bone it is tender to touch..If I were you...I would have iced it frequently on that painful area....Gently knead the area surrounding the painful spot...In case I have any Anti inflammatory gel I would apply over it twice daily...Hope this is helpful for you...Kindly revert back in case you need any further help in this regard....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain post vocal cord surgery\n\nhey dr. this is anju gautam my father had a  sugery for tumur near his vocal  and in that surgery his vocal cord also got cut a little now again he has some problems after 15 years . he has to pressurise himself in the morning for his voice to come out . please suggest me something",
    "doctor_response": "hiinjury or resection of the vocal cords, these are the problems more commonly encountered,please take him to a speech therapist, who make them get adapted to several self accomodating exercises for phonation &  speech.he should be careful also during swallowing due to the risk of micro-aspiration , because of the inadequate closure of the vocal cords.please go for repeat direct laryngoscopic test,with an ENT speciaist to find out for any newer problems on the vocal cords.all the besttake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathlessness and the feel to yawn?\n\niv had a feeling of breathlessness for the past 2an half years now constanly feel the need to yawn and some times im unable to wich leaves me breathless seems worse round the time when im due on i cough up clear sticky stuff and have a tight feeling in my throat sometimes this breathlessness feeling is worse than others im a little worried as my gdad has just died from emphysimia an copd iv heard it could run in families iv had test done for asthma an they are normal",
    "doctor_response": "Hello dear , hiWelcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This is in relation with respiratory drive related issues manifested by     underlying stress , anxiety .*  Needs intensive respiratory  training in form of deep breathing  exercises  YOGA  ,  meditations  to  relieve  stress , anxiety for  better  results .Hope this will help you for sure .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can spots on liver be symptom of liver cancer?\n\nMy dad had colon cancer 23 yrs ago and had his colon removed and has been cancer free ever since. He went in to have his gallbladder removed and they found spots on his liver but all bloodwork was normal. They are doing a biopsy, but I m too anxious for the results. Are his odds higher for liver cancer?",
    "doctor_response": "Hi. The biopsy will clear the doubt. There are chances of having spread (metastasis) from his old treated cancer as well as metastasis fron some other cancer and liver cancer itself. If his blood tests of alpha fetoprotein (AFP) and CEA are normal, odds of liver cancer and metastasis from colon cancer are low. Biopsy is the recommended procedure to make things clear. Hope I have answered your query. If you have any further question, I will be happy to help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in upper thigh near the groin\n\nI have a pain in my upper right thigh on the inside near my groin its dull and aching but very painful and consistent I was either stung by a jellyfish on my right Achilles tendon or bit by a bug and now they both hurt badly. I was scuba diving but only at a depth of 5 feet",
    "doctor_response": "Hi, The way you have described it appears to be due to some insect bite causing inflammation of lymphatic system. I would suggest visit to your doctor ASAP. Hope I have answered your query. Let me know if I can assist you further. Thank you. Regards, Dr. Gopal Goel Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to get even skin color to a 6 month baby\n\nSir, my six months old baby has 3 colours on her body ,face is fair and legs and knees are very dark..and if we see we can recognize two lines exactly one on buttock and other on neck which are deviding the body colours. Please suggest me how to even out the skin colour.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. After taking I-pill, my period is irregular. Why?\n\nHi doctor, My regular period comes 24th of every month. I had taken I-pill on the 15 of last month and after that my period came on 24th. Again, I took I-pill on 28th and got period on 5th of this month. Now, again, I am bleeding in a gap of 10 days. Please advise whether it is normal or something serious.\u00a0Please help me.",
    "doctor_response": "Hello. After taking the second I-pill, the withdrawal bleed started on 5th, which again marked the onset of a fresh cycle. So, the next bleeding could have been due to an early ovulation and possibly an ovulation bleed. Also, sometimes intermenstrual bleeding is common to experience if I-pill is frequently used. Please do not use I-pill often as it has progesterone side effects. Presently, if the bleeding has stopped, then nothing to worry and just observe your cycle. Your next cycle may be delayed by a week or so. So, you need to stay informed. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a high tsh cause infertility?\n\nhi, i got married in 2007, since then i haven't got pregnency, i have checked so many docs regarding this i have irregular periords problem during my check i came through tsh test and it is 7.48 now is this is a problem for not getting pregnency, please suggest me to overcome through this",
    "doctor_response": "Hai welcome to hcm thyroid is an important hormone in metabolism. Hypothyroidism with high tsh  should be treated with thyroxine in order to conceive. Consult an infertility specialist to evaluate reason for infertility. Regards Dr. Vanitha devi.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Coronary angiography report says LMCA normal artery, LAD stenosis, double vessel disease. Is it serious?\n\nmy coronary angiography report says LMCA norma artery LAD  is type3 long segment50 % stenosis extendin from proximal LAD to amild segment LCX normal& non dominent artery OMI is small sized artery with 80 % stenosis   RCA dominent artery chronic total occlusion IMPRESSION_ CRITICAL DOUBLE VESSELDESEASE IN RCA & OMI",
    "doctor_response": "Hi,Thanks for writing in.From your angiography findings, it looks like you need to be under medications to control progress of coronary vessel disease. 80% stenosis in OMI and chronic total occlusion in RCA dominant artery are something serious and can precipitate problems in future if you are not taking regular treatment.Hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Very sharp painful burning sensation in the back of my head/neck, why is that ?\n\nVery sharp painful burning sensation in the back of my head/neck area. why? i play volleyball and basketball and when i serve the ball i sometimes get very sharp painful aches in the back of my head/neck area. why is that ?",
    "doctor_response": "Hi Welcome to HealtrhcareMagic The causes and pathology of neck pain and back pain are complected however the major contributory factor is back postural habits. There are some causes of pain are 1. Ligament and Capsular stability 2. Disc lesion 3. Degenerative Changes 4. Repeated muscular strains It is necessary to identify and rule out the cause of back/neck pain.consult a Orthopaedic Doctor and start neck/spinal exercises.postural guidance during rest and work is very important. Wish you Good Health Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which medicine and care regimen should one follow to get rid of acne ?\n\nI am suffering lot Pemples on My Face ..Its Looking So ugly..please give some suggestions and instruct some medicines",
    "doctor_response": "Hi,Kiran, Welcome to HCM, Wash your face with face wash 3-4 times a day, Apply branded pimple cream, Go for antibiotic medicine avoid applying face cream or powder. Avoid stress, Avoid fried and junk food. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of ejaculating red semen?\n\nHello docs n experts, Since yesterday I m ejaculating red semen. I noticed it yesterday while masturbating, even today I seen same thing when I was trying to confirm was it a normal one day case or a serious issue. Now I think it is a serious problem for me. Please help me.",
    "doctor_response": "high you may have some bleeding in your genital tract thats why yoyr semen get mixed with that blood and you get ejaculation og red semen. consult your doctor because examination of your genital tract is required.thanks for using health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sensitiveness and pain in frenulum after an intercourse?\n\nMy frenulum gets over sensitive, sometimes painful and red after sex with my wife. My frenulum was always sensitive but this sensitivity increased after multiple sex with my wife on one day on a number of occasion. I tried giving weeks of no-sex break throughout the last couple of months. The breaks did not seem to help. The latest break I had was 3 weeks. It looked like my frenulum is normal again but after first sex it was again red and painful. I also tried retracting my shaft and toughening the frenulum - it worked for some time but then it became sensitive again. I tried to apply cold chamomile tea onto the area - no help. I can t see any tear, it just feels like my frenulum is over used/exhausted. But now we I don t even have more sex more than once a day. Any tips?",
    "doctor_response": "HiFrom your description i feel that you have a tight frenulum which is getting injured repeatedly and becoming sensitive. Only a full examination with confrm this.I would advice you to see an urologist for examination and if the frenulum is tight then it can be cured by a simple operation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I need your suggestions on which sunscreen to use.\n\nHi doctor, I am in a little trouble. Summer has started where I live, and I am addicted to playing cricket, whatever the weather or climate be. From last two weeks, I have noticed that my face color has become darker due to the\u00a0sun. So, I am a little confused about which sunblock cream to use. I need your suggestion on which cream to use. I do not understand the concept of SPF 25, 30, 50 and 60.",
    "doctor_response": "Hi. Sun protection factor or SPF blocks damaging UV rays, which are responsible for skin aging, darkening, sunburn, and malignancy. I would advise you to use sunscreens that are a multi-spectrum or broad spectrum, which blocks both UV-A and UV-B rays. Select Sunscreen according to SPF value. SPF number not less than 30 and not more than 50 will serve the purpose. While going to play, you may apply a generous layer of SPF 50, and for the routine purpose, you may use SPF 30. Do drink plenty of fluids and wear protective cotton clothing particularly light-colored clothes. Take care. Have a nice and safe game. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is mild hepatomegaly and minimal pelvic ascites and its remedy?\n\nDEar Doctor sir My daughter was 5 yrs old and suffered in jaundice in monthof feb -2013. In that time Total bilurubin was 2.0 .SGOT was 110 and SGPT was 437.Alkaline phosphatase 351. After 15 days it was tested Total bilurubin 0.7. and SGOT 35.0 and SGPT was 14.0 and Alkaline phosphatase was 200. But after 8 month some temes she is telling pain in stomach . after that I tested USG. Report told that mild hepatomegaly and minimal pelvic ascites. What is it meaning and what is its remedie. pl tell me. thanking you",
    "doctor_response": "Jaundice due to hepatitis A.is a mild illness.But can show such complications.at present no active treatment.observe.it should settle down gradually.repeat usg after 2 weeks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Spotting after stopping birth control. Headache, cramps, nausea, sensitive breast. Pregnant?\n\nI didn't get my last shot for a month and a half. I spotted for that whole month. Everyday. I had sex a couple times in the last two weeks. The last time, the day after I felt cramping and then I started having headaches, nausa, feeling hot , sensitive breast and cramps. I went to my dr to get bc pills and told her what was going on and took a test. Came out negative but she said it could be cause my hormone s levels aren't up and early stage of pregnancy. So take a test in a month. This was on last week on Wednesday and start my pills that day too. Two days after I completely stop spotting and spotted light brown and once red pink color for three days and went away. Now my breast feel heavier and hurt when touched. Every time I eat I feel nauseous. Could I be pregnant or is it bc symptoms?",
    "doctor_response": "Hi,Thanks for using healthcare magic.I have gone through your available history.Your symptoms might be due to - Pregnancy if you had unprotected intercourse- Impending mensesYou should go for urine pregnancy test after 5 days of delay of regular menstrual cycle. You may consult your gynecologist for the same.I hope It will help you.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could light, red, round patches on body be side effects of MT pill taken for abortion?\n\nI am female 34 yr. i have light red round patches on body. i contacted skin doctor, he advised allergic medicine but no benefit, one month ago i got m t pill and prostoll for abortion of 45 days pregnancy. whether is this the side effects of m t pill. please guide me.",
    "doctor_response": "Hello, I do not think it's due to pill for abortion but to another allergy problem (insect bite, or any other allergy reason), or any intestinal parasite. We should check it out, you need to run a series of diagnostic tests first: - complete blood count - IgE - stool examination for ova/parasites - allergy testing. Take antihistamines orally and apply calamine lotion locally. Keep regular follow up with a dermatologist. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Albana Sejdini, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dry skin, mild rash on the abdomen, circular and long, no change in routine activities\n\nI have a rash on my abdomen . I m not sure if rash is the right word, because there are two distinct parts to it: one is a quarter-sized circular patch, the other is a 3 long streak. Both are uniformly bright red with no bumps or scales. They are mildly itchy but not painful. I ve done nothing out of the ordinary (no new clothes, foods, detergents, soaps) so I don t think it s an allergy . I ve had it for 3 days now and, with the exception of the affected skin getting dry, it hasn t changed much. Any idea what it could be?",
    "doctor_response": "Hello. Thanks for writing to us. The rash you have described could be due to eczema or an allergic dermatitis. Most of such minor rashes do improve spontaneously or on application of steroid based ointments. In case the rash is persistent, an examination by a dermatologist will be helpful. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can extreme shivering in a child while swimming be due to low body weight?\n\nMy little one is small for her age (used to have a feeding tube and eats on her own now, but not enough when she is sick. She has been sick a lot this spring). Anyway, she loves to swim but gets so cold. She has to get out after 5 or 10 min. b/c she is shivering so badly. I let her stay in 15 min today b/c teh water was warm, but she scared me b/c of how badly she shivered. Is shivering this badly b/c of her low weight or could there be something else wrong? She is 2.5 years old, normal height, 24 lbs.",
    "doctor_response": "Low weight is not the cause of shivering.The weight of baby is not so low.You should go for thyroid profile of the baby.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Not able to conceive. Report saying no fluid in the pouch of douglas, no follicle, small ovary and thickened parametrium. Can you explain?\n\nfrom the last 1 year my friend is unable to get a baby...today she got checkup the report says that....no fluid is seen in the pouch of douglas....no dominant follice noted.left ovary is small and localized with diffculty.thickened parametrium noted.left ovary could not be clearly localized?10x8mm it indicates what...kindly let me know pls dr....",
    "doctor_response": "Hi, Thanks for the query. You didn't mention anything about right ovary. Her left ovary is showing the signs of hypoplastic ovary. If both ovaries are hypoplastic, there there is possibility of some genetical problem. So better to go for through examination and genetical analysis once. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest better chances of fertilization\n\nAge 40, 6'0\", 183 lbs. healthy. Recent fertility sperm test shows normal morph, motility and concentration, but viscosity is high, liqeufaction 90 min and agglutination moderate.  What supplements or changes to lifestyle may help to reduce viscosity and a liquefaction for better chances of fertilization?",
    "doctor_response": "HiAfter how many days of abstinence  you collected the semen sample for test. If it is 5 days or more it can cause increased viscosity. So repeat test after two days of abstinence. Infection can cause increased viscosity. See andrologist and get semen culture sensitivity test and treatment accordingly.Take Antioxidants tablets. If still persistent you may need  the help of intrauterine insemination with sperm washing",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should a nephrologist be consulted for blood in urine due to a kidney stone?\n\nI just had a physical where doc found trace protein and trace bllod (3-10) in my urine. I am diabetic type 2 and have a kidney stone. protein has been a trace for a while but occult blood is new. Doc is not concerned sonce i have a stone but I am worried. shoudl I go to kidney doc?",
    "doctor_response": "Hi, Blood in urine is definitely an alarming sign and it needs to be investigated and addressed. As you have other issues like diabetes, stones and these can cause it. You are therefore advised to get consulted by a nephrologist for proper examination and accordingly you would be treated. You may be required for an ultrasound, blood tests to see the level of urea, uric acid and creatinine to find functions of kidneys. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Soheel Hussain Zargar, Dentist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for patches of dry skin under the breasts\n\nodd skin condition I have recently discovered a series of perfectly circled patches of dry skin. It started as a few small spots under my right breast and soon spread up into my cleavage. And now there are 6 visible spots. They are tiny, maybe a quarter inch at best. There are very very slightly raised, no itch, no burn...they dont bother me at except for the fact that they are there. Light in color almost not visible maybe 1 pigment darker than my usual caucasian flesh color. However when I shower they tend to darken momentarily.",
    "doctor_response": "Hello and welcome to healthcaremagicI would keep a possibility of Erythrasma. Erythrasma is a chronic superficial infection of the intertriginous areas of the skin.The incriminated organism is Corynebacterium minutissimum.Dark discoloration associated with erythrasma is usually limited to body folds that are naturally moist and occluded. Infection commonly is asymptomatic, but it can be pruritic.The typical appearance of erythrasma is well-demarcated, brown-red macular patches. The skin has a wrinkled appearance with fine scalesTreatment is with oral erythromycin Or topical erythromycin Or with topical clindamycin for 2 weeksregards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, bleeding without cramps, cervix closed, breast pain. Have pregnancy symptoms, test negative. Pregnancy chances?\n\nI am 22 years old, my husband and i are trying to a baby and  i have been having bleeding without cramps that is dark brownish red and really stringy looking and yet my cervix is closed. my normal period are 28 days, and when they come i always cramp pretty badly ( never do i spot before my period it always comes full force, cramps and all) and my breast hurt for two weeks prior to the start of my period but never during and now with the bleeding they hurt even with or without a bra. i am also having symptoms of pregnancy even have the montgomery tubercles around my nipples. my lmp was june 3rd. at the end of june on the 28th i spotted for five days. i missed my regular cycle for july 1st & 29th, the on the 31st of july i started spotting then bleeding the dark brownish red blood. i took a pregnancy test when my cycle for the 1st didnt show and it was negative. my cervix is high and closed and feels like puckered lips, als have veins visible on breast, tummy, arms and hands, experiencing heartburn ( never had before), metallic taste in mouth sometimes and sore tender breast and nipples seem larger but not sure. is there a chance i could be pregnant even though i am experiencing bleeding with a closed cervix?",
    "doctor_response": "Welcome to HCM.If there is regular bleeding than there is no chances of pregnancy although your symptoms are suggestive of pregnancy.Sometime spotting may occur even in early pregnancy during cycle date.Go for urine pregnancy test after 7th day of missing cycle and also confirn it by blood hcg level,USG.If there is no pregnancy than go for certain investigations like cbc,urine,fbs,ppbs,thyroid profile,torch profile and usg for ovuation study and abdomen.Semen analysis of your husband.Start hemitinics,b12 and calcium supplement.Consult your gynecologist for better guidance and proper medical management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Burning in the lips and sore throat upon exposure to deodorant, laundry agents. Allergy? On medication for GERD\n\nI have terrible burning lips , hoarse sore throat and sometimes sore mouth, seems to be caused by fragrances, my husbands deodorant, laundry powder I use, some shampoos, doctors have given me medication for GERDS, sent me to dentist , but Im thinking allergy to fragrances ... not chemicals, have changed a lot of products I use and it seems to be fragrances. I wake up every morning feeling like my lips are sunburnt and it gets worse when Im in contact with any fragrances",
    "doctor_response": "Hello, If your symptoms are definitely after contact with perfumes, you need to get a patch testing done. This test looks at delayed hypersensitivity to chemicals. A list of chemicals is chosen from the Standard Battery or from the Cosmetic series, applied at the back, kept for 48hrs, and reveiwed to see the reaction. Depending on the grade of reaction, 1 to 4+ and the type of chemical, you are given specific advice. Antihistamines and lip balms will help until you can get this test and see what the chemical is. Best Wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can metformin cause distress in the liver a short while after eating?\n\nmy doctor is concerned with my enlarged liver. when I take the 500mg once in the morning and once at nite.. before I ate.. but not long after I have a lot of pain in the liver area.. I am going to stop taking it and see how I feel .. I will also call my doctor.. I was just wondering if the metformin is causing distress in the liver really I have to pay for you to tell me ?",
    "doctor_response": "HI, thanks for using healthcare magicMetformin does not cause or worsen liver disease. In fact in some persons with fatty liver, metformin is one of the drugs that is used as part of the treatment protocol.You can consider continuing the metformin. Your doctor will consider other possible sources of your liver disease. Liver function blood tests, blood tests checking for infective agents would need to be done.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do you suggest for inflammatory breast cancer with dementia?\n\nMy mother was just diagnosed with inflammatory breast cancer. If untreated, the doctors say she has 6 months to live. But, she has dementia and may not even be able to handle chemo and the surgery. If she goes untreated, what will the progression of the cancer bring?",
    "doctor_response": "Inflammatory breast cancer is a very aggressive disease. If left untreated it soon sends metastases(secondaries) to other parts of body including liver, lungs, bones, brain, etc. This disease is fatal in 5 to 6 months if not treated aggressively.Please discuss with the treating oncologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I ejaculate soon with low semen quantity?\n\nHello doctor, I am getting ejaculated early within 8 to 10 shots. Semen quantity is also less than before. I am a married male of age 30, my height 5'5\" feet and weight 65 kg.",
    "doctor_response": "Hi. A lot of males when start doing sexual intercourse suffer issues like early ejaculation. This occurs because of a lack of experience and over-excitation. But with time your timing will improve and you will start to have pleasure in sex. But if your time does not improve with this then you can use drugs to improve the time. Paroxetine can be used to delay the time and this will help you. The drug in 10 to 20 mg doses if used regularly will help to increase the time. You can talk with a doctor for that. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the chest and left arm?\n\ni have high blood pressure im already on medication.BENDROFLUMETHIAZIDE,AMLODIPINE,LOSARTAN. lately been gtting pain in chest like and elastic band being stretched then tightened, just wondering is this serious, have had slight pain inleft arm at the same time to.",
    "doctor_response": "Hello if you are more than 40 years , have risk factors like obesity , irregular lifestyle , if you are a smoker along with hypertension,  and the symptoms you describe happens when you walk or are exerting , it's wise to rule out underlying cardiac issues . A treadmill stress test along with stress echo if possible would be ideal test to do so . If normal you can safely rule out any serious heart problem , in which case  it may be plain muscular pain or gastritis  due to weak stomach . Regards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest suitable medication for chest infection\n\nI am 27 yrs old and 30 weeks pregnant i have a chest infection and was prescribed calvepen tablets 3 times daily and paracetomol. is this safe to take? As i was also on moxolon tablets in my first trimester for severe nausea im worried all the medication will take effect on the baby",
    "doctor_response": "Hello Welcome to HCM Thanks for posting your query. I understand your concerns. Calvepen tablets are penicillin group of antibiotics which are very much safe to take during pregnancy. Paracetamol is the drug of choice during pregnancy. It is also very much safer for your baby. Your doctor has prescribed the right drugs. No need to worry. Complete full course of antibiotics. Moxolon tablets are also considered to be safe. Enjoy your pregnancy. Hope this helps you. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excessive sweating, anxiety & rapid heartbeat?\n\nhi during the past months i have been noticing that every while i suffer from these types of attacks, where i swet alot, anxiety, heart beating faster and breath control . But from around a month ago these attacks have been happening more often for example i had one on sunday were i even lost conusiness for a few seconds and one this morning. what do you think it might be?",
    "doctor_response": "Hello, Your symptoms could be related to a panic disorder. Anyway, I would recommend performing some tests before coming to this conclusion: - An ambulatory 24-48 hours ECG monitoring in order to exclude cardiac arrhythmia - Blood electrolytes for possible imbalance - Thyroid hormone levels for thyroid gland dysfunction - Complete blood count for anemia. If all the above tests result normal, you should consider anxiety as the main cause of your complaints. Hope you will find this answer helpful. Let me know if I can assist you further. Regards, Dr. Ilir Sharka Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for gas pressure and pain after gallbladder surgery?\n\nhi i had gallbladder surgery 9 days ago im not feeling good i feel really weak and lost 10 pounds in this time period now my left side hurts under my ribs and it pulses and in my back shoulder up in my neck my belly is full of gas pressure i cant stand to eat besides chicken noodle i ate bread and it hurt me sooo bad at night i couldnt sleep",
    "doctor_response": "Hi,Thanks for writing in.It can take few weeks to recover completely after a gall bladder surgery. If it is 9 days and the surgery was laproscopic then it is expected to cause abdominal fullness and discomfort. Though the gall bladder is on the right side of abdomen, a laproscopic surgery involves inflating the abdomen with gas and this causes bloating and pain in some patients.Please have foods which are natural like fruits and vegetables. Bread and noodles are processed foods and cause problems in digestion. Drinking adequate amounts of water and juices is suggested. You can include small amounts of processed food in your diet in few days and continue to have natural foods for some time. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest side effects of cerazette tablets\n\nHi I am worried about taken Cerazette after reading so many negative reviews. I ve been taken off Mircogynon because I ve gained a lot of weight, so I have changed the pill to hopefully lose the weight with a better diet & exercise. I am a 20 year old woman with no medical problems but in need of some reassurance. Thanks!",
    "doctor_response": "Hi, Side effects of Cerazette include: - Changes in menstrual period, for example, irregular bleeding, more frequent or less frequent periods, or sometimes stopping of periods - Mood changes including feeling depressed, reduced sex drive - Headache - Acne - Breast tenderness and - Weight gain Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Ajeet Singh, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back surgery. Taking loratabs, oxycotins, not helping pain. Change medicine?\n\nI have had back surgery & I've bn taking loratabs & now oxycotins but none of these r working for my pain any more.my sister gave me a few of her blue pills called Roxicodone & they really worked for my pain.Do u think over a period of 9years my body has just gotten use to the perscriptions my doctor has bn prescribing me & I now just need something stronger.",
    "doctor_response": "HIThank for asking to HCMIt is not the stronger medicine but it should work in that way, all the analgesic are same more or less in mode of action only matter is it should work in your body, some psychological factors plays the role behind this, any way you can try celecoxib this will give relief from Pain have nice day",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of lower back pain?\n\nhi , i am 29 years old i have lower back pain from last one year, i go to the doctors they treat me well but still the situation is the same after physico and also MRI. i dont know why its not recovering. i am very worried about it. kindly suggest me how i can get rid from this disease.",
    "doctor_response": "Hello, I had gone through the case and found that if MRI report is normal then it might be due to deficiency of vitaminD3.So go for the investigation and take Vitamin D3 once a week.Do not bend forward and long time sitting.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Would Betnesol Forte help cure alopecia areata when taken twice a week?\n\ndr I have alopacia areata of 4 bald spot for atleast 25 days since I have noticed and my hair is falling much and my doctor had suggested me to use betnesol forte 3 tablet 2 day in a week can yu tell me is it right and still how much time it will take and can yu suggest me any another thing to stop hair fall and",
    "doctor_response": "Hello,You can use Manitol hair solution 5 percent solution, apply 2 to 3 times a day. You can also take grow up tablet once a day for 7 weeks.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Purva Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for psoriasis\n\nHi, may I answer your health queries right now ?  Please type your query here...my sister has been diagnosed with psoriasis arthritis & she has shortness of breath & chest pain.  They checked her heart, but it's ok.  What should she do for treatment?",
    "doctor_response": "Hello,Welcome to healthcare magic.I understand from your query that your sister is having psoriatic arthritis and you are look for treatment options for the same.Psoriatic arthritis could be quite debilitating if left untreated and requires prompt treatment.A drug which has got a good safety and efficacy record for psoriatic arthritis is Methotrexate.This has to be prescribed by a dermatologist/ rheumatologist and has to be monitored for side effects regularly.Other options include biological drugs which are a newer class like Infliximab. These are very expensive and also require regular monitoring for side effects.Shortness of breath and chest pain are usually not associated with psoriasis. If a patient has been on methotraxate, shortness of breath could indicate a side effect of methotrexate called as interstitial pneumonitis. Please check with your treating doctor about the possible treatment modalities I have discussed.Take care and I wish your sister good heath.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain while sex and its treatment naturally ?\n\nHi, I am 25 yr old, I have some nerve problem while doing sex and i cant able to produce sperm not much. I cant do sex normally. i feel pain left side of my stomatch and my abdomins. I want get cure naturally by foods and doing excersice. please let me know what should i need to do get comfort sex with my partner.",
    "doctor_response": "**1. pain in abdomen could be some sort of ailment that is brought on by the physical aspect of sex, or consult an urologist for detailed examination [structural] and investigations [semen examination]2. Divert the mind to non-sexual activities like sports or business matters.3. In my Clinical Practice I usually treat the patient on line of \": Shukragat Vata\" which is characterized by a group of clinical presentations either with the impairment of ejaculation or with seminal abnormalities.i. The line of treatment  should be based on 'vrishya', 'medhya', 'shukrastambhaka', and 'vatahara' properties. You may Consult a good Ayurveda Physician in and around your place.PS. Tentex forte tablets [Himalaya]:  2 tablets twice daily for 3-4 weeks. treatment may be prolonged depending upon the response.PS.  is a non hormonal and safe sexual stimulant and acts on higher brain centers to improve libido, the antis tress, adaptogen action of tentex forte helps alleviate anxiety associated with sexual desire.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my abdomen bloated with pain in it ?\n\nWell , I m 15 years old & recently I ve been having pains around my stomach , for exampleive been bloated but extra bloated it almost looks like I m pregent , & I ve been very gassy , & have a feeling that I want to throw up but never really comes out . Also I know its not because I m pregnant because I m not sexually active . So I am wondering what it is that is wrong with me & if there is anything I can take to get ride of this ?",
    "doctor_response": "Hello; welcome to HealthcareMagic The bloating;gas;and vomiting sensation you feel may be due to Gastritis which you may be having due to stress or eating meals at wrong time or heavy meals.You can take antacid by getting it prescribed by a doctor along with medicine for vomiting sensation and continue the antacid for 2 weeks and you should be fine. Take care Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a better alternative to Livolin from future liver diseases?\n\nJust did a test on hepa B n C in which hepa B is +ve while hepa C is -ve. Other tests such as liver function and Hepa B antigen were also carried out. Hepa B antigen is -ve while the liver test shows non reactive. I have seen d doctor who gave me livolin for now. Is there any other drugs that I can work very faster than livolin in preserving my liver from diseases in the future? Pls advise me about my current health status I m sincerely worried. Tnx",
    "doctor_response": "if you are found to be hepatitis B positive and liver functions are normal, you don't have to worry. get an ultrasound scan of liver to know is there already any damage to liver. also get an endoscopy done. now there are other blood tests to be done to assess the virological status. all this can be done if you consult a gastroenterologist. following all these tests proper treatment can be started. there is no major advantage with livolin. of course alcohol has to be discontinued",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for itching and redness in groin area\n\nhello doc i m having red marks on both sides in groin area which keep increasing also having redness and circular marks on penis foreskin which causes itching on foreskin i went for checkup to skin doc he said these are strech marks and for itching gave me lulifin cream tobuse and terbinafine tab 250 mg to use, im worried can usuggest the marks arevfrom 3,4 months and itching from 2 months i used onabet and betamil cream also before but not working i think . can u suggest and help, thanks",
    "doctor_response": "Hi, it could be a Fungal infection. You can take ointments like Clotrimazole or Miconazole. Try it for two weeks an let us know. You should see good results with it. Also, continue the Trabinafine for 4 weeks.All the best. Do let me know. you could leave me a Direct or a Specialist query.Take care,Dr Rishi, New Delhi, India.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have vomiting, loose motion and fever. What kind of fever do I have?\n\nHi doctor,I have a vomit, loose motion, fever, and body ache. I want to know what kind of fever I have. What are the medicines I can use? And what are the health tips I can follow?",
    "doctor_response": "Hello. I will surely help you out. From the symptoms, you have described you most probably have food poisoning. So for vomiting and nausea you need Ondansetron or Domperidone. For fever, Paracetamol will suffice and for body ache, you should have Diclofenac with Ranitidine. Also, antibiotics need to be started. Empirical antibiotics are Ofloxacin and Ornidazole but for definite antibiotic stool culture and sensitivity is required. If you get repeated infection then some serology testing and anti-parasite drugs are required. There is no specific type of fever in food poisoning but for details, you can visit a nearby hospital and get your work up done and attending doctor will help you out with more details. For more information consult a family physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "History of opiate abuse and anxiety. CT scan shows fluid at base of spine. Taking Methyl prednisone. Help\n\nA friend with history of opiate abuse, followed by severe anxiety related to her behaviour while on opiates, treated with antidepressants with no pos effect( serenely, lexapro, lyrica). Past hx. Of asthma, smoker, surgery for congenital malformation of foramen magnum.  Mood improved following rivotril commencing. Shortly after that developed resp infection which progressed rapidly requiring antibiotics, steroids. Became very aggressive and manipulative and non compliant with hosp staff, condition continued to deteriorate became more psychotic, hypertensive, paranoid, increased resp distress.,uncoordinated movements. Ct brain showed fluid a base of brain. Bp treated I've labetalol. Steroids stopped( ? Cause of psychosis). Became more lethargic, eyes closed. MRI showed vasculitis with multiple mini strokes at front and base of brain. Commenced on methyl prednisone and anti cancer drug. Now a week later minimal improvements. ( has aspergillosis in sputum which is being treated) lumbar puncture neg.",
    "doctor_response": "HIThank for asking to HCMNothing is left in disease and nothing is left in investigations every thing seems working in nice way even after having such fatal kind of pathologies your friend still fighting it is great job, you did not ask for any specific help or advise, still I would say that with such health problems having functional elements is very likely, there should be no problem in future just keep it continue whatever going on say good luck to your friend",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are sensitive, swollen testicles after hernia operation normal?\n\nI had a hernia operation eight weeks ago (left side) and I still have swollen testicles which hurt and it is very sensitive in that area. When can I expect this pain and swelling to dissipate? Is there something you can suggest the alleviate these symptons.",
    "doctor_response": "HelloThanks for query.It is common to get testicular swelling after Hernia surgery .It is due to trauma to the testicle while separating hernial sac from the testicle.It gets resolved gradually over a period of 2-3 months.You need to take broad spectrum antibiotic like Cefexime along with anti inflammatory drug like Diclofenac twice daily.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility\n\nI am 26 years old.I am married for 3 and half years. After one year of my marriage i was diagnosed with PCO and within 3 months I conceived.I delivered a baby last July, but within 15 minutes baby died due to heart problem. I started treatment after 6 months of my delivery, still i didn't conceive. I took letrozole, glucophage and follic acid tab for first 3 months, but i was not getting big follicle.then i took clomid, glucophage and follic acid tab now also am getting only small follicle.nowadays mentally i am very tired.Please help me to know how much chance is there to get a healthy baby?.",
    "doctor_response": "Hi welcome to hcm.I have gone through your question.Clomid is generally preacribed to stimulate follicle size.Glucophage to reduce blood glucose level.If your follicles dont mature upto the size that can rupture then i would suggest to change the medicines and you can go for injections also after consulting your gynecologist.If follicle develop properly then you can conceive.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be the reason for chest pain and burning sensation after urination?\n\nI have chest pains and feel like my heart can't calm down after I urinate. Its like a burning feeling. I am 41 and diabetic and overweight. I am also hypertensive. I also have had unpretected sex in the last four weeks. I was first started feeling this pain about 3 weeks ago.",
    "doctor_response": "Hi thanks for contacting HCM...The burning chest pain could be from gastroesophageal reflux ...For which omeprazole given on empty stomach before meal.Head elevation while sleeping....Excess spicy food and smoking avoided....Avoid stress....Coffe, chocolate , pastries less....Here get your urine routine examination.If pus cell present antibiotic given...By unprotected intercourse STD can be transmitted ...For that physical examination done and clinical history taken.....You are under high risk group as having hypertension, diabetics and obese ...Probably your cholesterol also can be high....This can be metabolic syndrome .So investigate with......./ECG/tread mill test /fundoscopy /urine albumin /neurological examination etc.....Consult physician for examination....If needed medication for hypertension and diabetics started.Take care ...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can brain eating bacteria enter the body through a tree branch?\n\nHello I am somewhat of a hypochondriac but I would like to know. I recently walked into a tree branch by accident and I might have gotten a part of the branch up my nose. I was worried for a while if there is some sort of virus that I could possibly contract. I have heard about certain brain-eating amoebas in the soil and water I wonder if I could get one of these in my head from the branch. Currently a relative of mine has the flu and I have a headache. Not sure if it could be early signs of an amoeba or if I could possibly have the flu or other allergies. I have not been sneezing though.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It is quite likely to get infected by the tree branch. If you have a headache, then it might be due to stress, lack of sleep, allergy, migraine, etc. Take Paracetamol and watch for the impact. Hope this helps. Warm regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I had a massive heart attack 15 years ago. Now, I have right sided chest pain. Please help.\n\nHello doctor, I had a massive heart attack 15 years ago. I am 54 years old now with a height of 173 cm and weight 64 kg. Within two weeks, angioplasty was done for me in LAD (left anterior descending) coronary artery. After four years, I had undergone bypass surgery for four vessels. Every year, during the medical check-up, my TMT result was showing negative. This year also my TMT is negative and the report is as follows: Total exercise period was 12 minutes and achieved 88 % of maximum predicted heart rate with a calculated workload of 14.30 METs. There was no significant respiratory symptom related to exercise. The exercise was terminated due to fatigue and the achievement of target heart rate. The resting blood pressure and response to exercise were normal. Resting ECG was normal. Exercise ECG: ST depression during exercise 4 stage, ST level was -0.90 mm in V5. Maximum HR is 88 %. Maximum workload 14.30 METs and the conclusion is good exercise capacity and negative TMT. My other reports are EF as per echocardiogram is 55 %. Blood sugar and cholesterol reports are normal. My current medication is as follows. Tablet Nikoran 5 mg twice a day, tablet Tenolol 12.5 mg once a day at night, tablet Rosuvastatin 10 mg once in a day and tablet Clavix 75 mg once in a day. My problem is that I am getting pain and heaviness on the right side of my chest since 10 years after bypass surgery. Because of this, I am feeling shortness of breath and heaviness in the chest while walking. I consulted a heart specialist and gastroenterologist. Sonography, CT scan reports for chest and abdomen are normal. Colonoscopy and endoscopy reports are normal. During barium x-ray, reflux was detected. The gastroenterologist has prescribed me anti-reflux tablet Nexpro Fast 40 mg, which I have been taking since five years. I am very strict about consuming less oil, less fat and less sugar in my diet. My problem has come down but not got eliminated. One physician has advised me to go for angiography to rule out the right side pain and heaviness problem. But my cardiologist is not suggesting an angiography because of negative TMT report and said a right side chest problem is not related to the heart. What is your opinion? Could you please advise me what can I do now? What is the solution for this?",
    "doctor_response": "Hi. I read through your entire case history. You are lucky that you have a good cardiac output. Your EF (ejection fraction) is all right and as per your stress test, there is nothing going in opposite and your heart is still doing well. Frankly speaking, heaviness on the right side of the chest is not at all related to cardiac issues. In my personal experience, I have seen many patients who feel pain in the chest or heaviness after CABG (coronary artery bypass grafting) or bypass or open heart surgery. The reason being opening of the chest during surgery. I am sure after checking your stress exercise and ECG, your heart is doing well. There is no ischemic zone responsible for your problem. This heaviness has nothing to do with your heart. Whenever we open the chest for surgery, we advise for chest physiotherapy. This is related to the bony cage of the chest and soon after some exercise or physiotherapy, you will be relieved from your problem. This is not a rare problem, because if once the chest is opened surgically, then the person has to suffer some kind of problems like heaviness of chest or pain in the chest or chest discomfort. Continue your regular medications. For further follow up consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is small head size of fetus sign of downs syndrome?\n\nI have just had a 23 week sccan and the baby s head measured small in the bottom 5 percentile at 198.6mm. The BPD was 55.4, AC 182.8 and FL 38.1. The tummy is the only part that is showing on track, although the head measurment is the most worrying. The baby presented in the breech position and my doppler results were RI 0.58 and my RI 0.77 and the cerebral artery was PI 1.26. Its all very worrying. I have a 0.83 percent chance that my baby has downs. Is this confirmation of this fact with the head and femur measurement? Could it be another disorder or is it restricted growth? I am being seen for another scan in 3 weeks which seems so long away. Thank you",
    "doctor_response": "diagnosis of down syndrome prenataly includes the measurement of something called Nuchal translucency it's Measured around the 20th week of gestation , serum levels of inhibin, B-HCG , alpha feto protein , and estradiol are very helpful microcephaly (small sized head ) alone is not diagnostic of down syndrome , it's associated with a lot of disorders which is best diagnosed postnataly.  I hope your child has nothing of these disorders I hope this answers your question",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a fib from 2 ablations and myectomy\n\nDaughter has  a fib from 2 ablations and myectomy in 2001.  Age now 31.  See Dr Mann, L'ville.  Mayo did the ablations and surgery.  Started rythmal time release yesterday after rythmal 3 times a day.  Terrible problems unable to work.  Need help and a Dr. we can get hold of.  Unlike Dr. Mann.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. AFib has mainly 2 treatment - one is prevention of stroke, which is treated by blood thinner called as anticoagulants. Second is the rate control, which is done by group of drugs which decrease the heart rate. There are also advanced treatment available for the same. I suggest you meet an electrophysiologist. He would be a doctor, who specializes in rhythm disorders. Hope this helps. If any other queries, do let me know. Will be glad to help you out.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is white liquid accumulation in the Jackson-Pratt Drain due an infection?\n\nmy husband has had a surgery and has a JP drain in Yesterday I noticed that the color in the JP drain was turning to a whiter color instead of the red from the blood. Was wondering if it could be an infection? He has no fever and is not complaining of any pain.",
    "doctor_response": "Hello,It could be from infection. It would be best for you to get this checked out with the surgeon that placed the drain. Call their office today and report this finding.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get joint and muscle pain with positive ANA test and normal ESR and CRP. What is my problem?\n\nHello doctor, I get frequently sick with joint and muscle pain and burning legs sometimes feel difficulty walking and climbing stairs. I consulted a physical, he tested ANA and it came back positive but since ESR and CRP are normal he said no need to test further and I am perfectly healthy. But my pain never subsided, I cannot go to the office due to AC and joint pain. It is affecting my work and quality of life due to frequent sickness and unable to do normal activities. After consulting a rheumatologist he further tested ANA profile and anti ds DNA. That also came perfectly alright. I am confused with my body why my joints are paining so much without any disease?",
    "doctor_response": "Hello. I would like to ask you a few more queries. Is your sleep pattern normal? Do you have morning fatigue? How long did the viral last? Any hair fall, oral ulcers, dry eyes, or dry mouth? Any recent irritability or forgetfulness? It more appears to be chronic fatigue syndrome which usually has a previous viral illness. But let me know these queries and would guide you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for severe pain in cheek area?\n\nHi I am having severe pain in my cheek area...not sure if its a toothache as I cannot identify any one tooth that is hurting.  But right across the top are of my cheek hurts severely with a throbbing pain. Someone mentioned that it could be sinus infection as I am just recovering from a cold.",
    "doctor_response": "Hi,As you are recovering from cold, pain over cheek can be due to maxillary sinus infection. Inflammation due to root of teeth may also cause infection. Better to get a clinical examination done by a local doctor. A course of antibiotic like cexifime and NSAIDs will be helpful.Do consider a positive feedback as a credit to my work. Let me know if you have any further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause drastic weight loss?\n\nMy name is Cyril from nigeria,,,,,,,,,,,,,,,,About six months ago I started noticing drastic weight loss,,, I am used to drinking lots of water I urinate more often At day and night,,, I eat very well sleep well I dont fell anything at all,,,Ants recently gather round my urine,,,,Please assist me with your observations what could be wrong with me,,, And lastly I fell my left hand can t hold or grabheavy things tightly Pls adice",
    "doctor_response": "Dear Cyril,Please check your blood sugar levels, from your description it is likely that you have developed diabetes.Please check your fasting blood sugar (FBS), post prandial blood sugar (PPBS), and HbA1C. Eat a healthy and balanced diet, exercise regularly. If the sugar levels are not controlled by diet and exercise, you will have to start with medication.TC",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is alopathy or homeopathy best for child for cold and sickness?\n\nDear sirMy child used to get often cold and sickness, as per the doctor's consultation they want me to check isnophilia for her. If so to give medicine and cure, what is the best shall i go for Homeo or Alo. Need your suggestion to come out of this problemFrom : Chennai",
    "doctor_response": "Dear friend,I have gone through your querry. I wanted to know some more information regarding the duration and frequency of such episodes. Can you kindly explain what you meant by 'sick'. Is it just tiredness or does she fall ill frequently. Both these must be managed and treated differently. I hope you are getting my point.When such cases approach me in my clinic, i would suggest a blood test initially to rule out possibilities for allergy. It can be temporary susceptibility to infections also. In either case, i can assure you complete recovery. The treatment plan may depend on the details of your daughter's case. I usually go for Agraphis Nutan Q to be taken with water to begin with and have found tremendous relief in patients. My opinion is to take get an appointment with a homeopathy expert near you. The medicines are also easy to administer to children.I hope my answer has solved your querry,Wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe pain in upper abdomen and chest\n\nI m an RN. I m having esophageal, upper abd and wide chest pain severe. It comes and goes. my bp is good and hr norm. no skips auscultating my heart? I can t afford an er trip. I took Pepcid,,, no help. I know I should go to er but, I want your opinion",
    "doctor_response": "Hellokindly get a urgent ECG and XRAY OF CHEST And send me the scanned copy of your reports as soon as possible....",
    "dialogue_context": ""
  },
  {
    "patient_message": "When can Godex dose taken for elevated SGPT be decreased?\n\nHi,my brother has been having elevated sgpt and showed fatty liver by ultrasound. His doctor prescribed godex tab tid.and he s been taking it for a week. How should he take the medicine before a rot sgpt is done and when can he decrease the dose? Thank you",
    "doctor_response": "Dear FriendWelcome to HCM.I am Dr Charu Bansal. I understand your concern.Important here is to find the cayuse of fatty liver.You can take this medicine but you should get following investigations:1. Viral Markers2. Liver Function Test3. Lipid Profile.4. Blood Sugar levels.If you have any further query please ask me.Stay Healthy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hallucinations\n\nThis is more of a psychological thing but, I keep seeing things like dead people hanging from trees, psychotic murderers, blood dripping down walls and young woman in white gowns with blood all over them. But they're not there and I'm the only one who sees them so... What's happening? Am I mad?",
    "doctor_response": "Hello and thanks for writing in.I understand that the strange experiences of seeing non existent things / people must be causing you a lot of distress. Now, it is important to differentiate whether you are seeing them in front of your eyes (like you see normal things) or whether you are seeing them as mental images. If it is the first case, then you are experiencing hallucinations, which can be due to a psychotic illness or illegal drugs or sometimes due to neurological problems. If it is the second case, then these could be due to stress-related disorders, obsessive compulsive disorder, etc. A detailed history and psychological assessment is required to arrive at the correct diagnosis. So, I would advise you to consult a psychiatrist and have a detailed psychological assessment in order to confirm the diagnosis and start appropriate treatment. I would also suggest that you avoid alcohol, drugs or caffeine as these can worsen your symptoms. You can also try to practice relaxation techniques like deep breathing, yoga, meditation, etc.as these can definitely help you to relax and calm your mind.Best wishes,Dr. Jonas SundarakumarConsultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a sensation of glass pieces in skin?\n\nI have the sensation that I have pieces of glass in my skin. Nothing comes out and the sensation is there for a while (weeks) and then it goes away. It use to be on the bottom of my feet and at the top of my head. Now it is on the top of my foot, along the underneath side of my left arm between my wrist and elbow, and all over my head. When I lay down to sleep or rest my head against a piece of furniture it really hurts. The same is true when I put on socks or clothing over the affected areas. I have been checked for MS in the past but the doctors didn t see enough symptoms. These symptoms have developed since that time. When I was checked, they did not do a spinal tap, we just answered questions and I had an MRI, which showed a non-specific lesion in the brain. Other symptoms were pain on the right side of my body, memory issues, speech issues, overall pain, fatigue, etc.",
    "doctor_response": "Quite a lot of possiblities. First, there is the possibility of having glass in there. But generally something would be visible .Sick nerves in localized areas can occur from nerve poisons. It is more typically at the ends of nerves and on both sides evenly, BUT B12 deficiency, thyroid level low, or lyme disease or syphillis or some metal poisonings can do this. Cannot say which is in your case and sometimes a biopsy is needed.MS typically goes for years prior to diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat abdominal pains causing dizziness?\n\nHello I have had stomach pains for nearly four years running its more constant in the past year or so I have been to the hospital nearly every time as I couldn t cope with the pain but lately the past week or so I have been getting dizzy spells and feeling sick at night could you help me on what this may be ?",
    "doctor_response": "Hi. Since you have visited the hospital so many times and you are suffering for 4 years , you would have posted the previous reports and findings and Doctors' suggestion . This would have helped me to help you. Mere mentioning pain in abdomen does not help much . Dizziness can be due to severity of the pain itself.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any treatment to increase penis length?\n\nI'm dashmeet singh. Actualy I ws very fat ws suffering frm obesity.. So my penis ws smal nd is small nw also.. I hve losd my al weight nd I'm nw my weight is acc 2 my bmi.. But my penis is small yet is dere ny 1 2 mke it grw.. As it must b 3.5 or 4inch.. Pls help me out or suggest me sme medicine whch r easily available",
    "doctor_response": "Dear user,Thank you for writing to HCM.It is good to listen that you have improvement in obesity and successfully reduced your weight.There is no MUST length for penis.It greatly varies from person to person.The fact is that the size of penis has no relationship with sexual satisfaction of female partner by experiencing genital sensations during intercourse. This is very rampant myth. The lack of knowledge causes fear and apprehension.Let me explain how this happens.Only outer one third and the front wall of vagina have nerve fibers and hence sensitive to stimulation. Rest of inner two third is largely insensitive. So if you want to arouse your partner during sex, you should focus on the areas of maximum nerve endings hence clitoris and inner lips or labia minora, the outer wall and outer two third of vagina.So for female sexual gratification, the size of erect penis could be anything from two inches or more! You are fit to satisfy your partner by intercourse.You remember that what important is strength and not the length! Entry and to and fro continuous movements are adequate. It is men's technique, not his penis size that characterizes the lover in him.\"Bigger is better\" logic does not fit here.For personal preference you may consult urologist for increasing the size by implants and surgical techniques.Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pea size knot on the back of hand?\n\nI have a pea size knot on the back of my hand.  It's like it's attached to the tendon of my middle finger.  When I bend that finger, it moves forward.  When I straighten the finger, it moves back where it started.  It doesn't move when I bend the other fingers.  What is it?",
    "doctor_response": "Hi,This is likely to be a ganglion. This is a cyst-like swelling in the tendon. It is not serious. If it is causing pain, it can easily be removed by a minor surgical procedure. Regards,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get muscle twitches in my quad and calf muscles often with no pain. Could this be due to anxiety?\n\nHello doctor, I am a 41-year-old male who is 5'10\" and in pretty good shape. However, last week while I was sitting on the couch at night I noticed muscle twitches in my quad muscles. I ignored it thinking maybe I walked or exercised more than normal. But since then they have not gone away and I notice them in all different parts of my body but mostly the legs (calves, shins, quads) of both legs. I feel them every few minutes or so while sitting or laying down. They are not painful. I have not lost any strength while doing pull-ups, lunges, or dumbell curls. I do not drink coffee nor alcohol and I do not take any medicines. I took a magnesium supplement for the last few days and it did not help my symptoms. I started googling stuff and became very afraid. Could this be caused by anxiety? I did have some restless nights last week. Please help.",
    "doctor_response": "Hello. Such muscle twitching can happen in few medical conditions like anxiety, motor neuron disease, nerve injury, benign fasciculation syndrome, and hyperthyroidism. If you do not have any weakness or muscle thinning, it may be due to anxiety. I suggest to observe it. Get T3, T4, and TSH (thyroid-stimulating hormone) test. If you are anxious, you need to overcome that too. If it persists, then it may need some further investigations.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruised feel and soreness in the neck while treating cough?\n\nI had a colonoscopy and upper Gi this morning, now my neck is super sore on both sides-feels bruised. I did cough a lot after waking and felt wheezing and burning in my lungs. The cough and wheeze have calmed down some but still there. Should I be concerned?",
    "doctor_response": "Hello,Most probably it is an injury during the procedure and post-procedure complications developed. In my opinion:1. Go for the chest x-ray posterior-anterior view to rule out any lung injury 2. Cbc and bleeding and clotting time 3. Till take tablet trenaxa twice and tablet levofloxacin for 3 days Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Chandra Shekhar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause recurring fever in a child?\n\nhi, my 4year old son had fever aroung 38-39 with cold and cough, 2 weeks ago. we did blood n urine check up but it was normal DR. said it's Viral infection no need of medicine.after 10 days today again he is having fever aroungd 38. what may be the reason? this is worrying  me cause in last 4 year first time he is this much sick .",
    "doctor_response": "Hi...by what you say I feel that your kid might be having a recurrent viral illness.I will explain you how a viral illness behaves so that you can be more confident.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.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning pain in knee and from thigh to buttocks?\n\nI fell yesterday after tripping over a shoe. I tried to correct my balance but couldn t. I ended up on my left knee with carpet burn and a bruise on the anterior surface of my left knee. I am on Coumadin so am prone to bruising. my kids got me back on my feet (despite my weight of 306) and I walked down the hallway to my chair in the livingroom with no difficulty whatsoever. about 45 minutes later I went to stand and had an intense searing pain in my left knee that I fell back into the chair fully aware that I would be completely unable to get myself up. my knee then was in pain (10 out of 10 with movement 7 at rest) and has not changed since. I can not put weight on it despite the pain med I received from a subsequent er visit. xray was normal and I was diagnosed with a knee sprain after very little actual assessment by the PA on duty. I do not remember a popping noise with the injury, only fear, and some pain with the fall. I cannot lift my leg up and my pain when I try is in the posterior lateral aspect of my knee. I also have aching down my anterior knee about 3 inches distally and a burning pain posteriorally (spelling?) up my my thigh (sciatic nerve area).to my buttock. what does this indicate?",
    "doctor_response": "Hello, The symptoms are more likely suggestive of neuropathic pain like sciatica. Consult a neurologist and get evaluated. Analgesics like Gabapentin and oral steroids like Deflazacort are the mainstay of the treatment. In persistent cases spine related problems like prolapsed disc and nerve compression also be ruled out. Hope I have answered your query. Let me know if I can assist you further. Wishing you all the best. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does preterax cause infertility in a woman?\n\nDOES PRETERAX CAUSES FOR INFERTILITY FOR A WOMEN I AM A HYPERTENSIVE PATIENT AND BEFORE ECTOPIC PREGNANCY 2001 THEY REMOVE MY RT. OVARY AND THE REMAINING ONE IS BLOCKED I DONE 2TIMES IVF BUT SAD SAID NOT SUCCESSFUL ALL FAILED IS THERE ANYN CHANGE FOR ME TO BECOME PREGNANT 1AM NOW 52 YEARS AND NO BABY",
    "doctor_response": "Hello, thanks for your query.Preterax doesn't cause infertility. There are few reasons why you are not able to conceive.1. Age is the first and fforemost. Unfortunately, the number of eggs in the ovaries are constant and keeps getting depleted from the time of menarche. At 52 years of age, the number of remaining eggs in the ovary is very very less that even with ivf it is difficult to harvest a good number.  Age also compromises the quality of eggs which is very important for the success of ivf.2. Blocked fallopian tube makes it almost impossible for pregnancy to happen in natural way. Its unfortunate that one of your tube is blocked and the other has been removed.3. In such a scenario, your doctor might have offered embryo donation as an option which you may like to consider if you wish.4. You must also be aware of the possible effects of pregnancy on your health and take caution if pregnancy happens. Hope this helps. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of bruise and pain?\n\nSeveral months ago I would get a pain in my right leg and maybe a day after brusies would show up, this went on for about 3 months.  The leg pain stopped for maybe a month and now my right are was paining me and I have 2 litte red bruises.  What could be wrong?",
    "doctor_response": "Dear patient thank you for your question. Here are a few causes of spontaneous bruising and some tips to help you figure out what you migh t have1) Blood disorder:a. Von willibrand's disease/ Haemophilia: A blood disorder due to lack of coagulation factors. It results in spontaneous bruising and is easy to rule by a simple blood test called COAGULATION PROFILE.b. Thrombocytopenia: Low platelet count can result in such symptoms. A coagulation profile will help diagnosing this condition as wellc. Leukemia: My intention is not to scare u but practically speaking it is a possibility especially if u feel fatigued and have bone pain or headaches.Please get a complete blood profile done2) Liver disorderMost of your coagulation factors come from your Liver hence a Liver disorder mostly cirrhosis can result in such symptoms. Get a LFT done. Yellowing of your eyes/jaundice may hint at a Liver disease however it is not a rule3) Vitamin deficiency: Vitamin C and b12 deficiency can result in bruising as well. The test is time consuming and expensive so just take a multivitamin tablet every day and see how u feel after 2 weeks4)Grace's disease: This is a thyroid disorder and may be accompanied by excessive sweating feeling hot increase appetite yet wt loss. A thyroid profile is warranted. More common in females5) Excessive medication/ Injury: If you are taking any medication please read the label to see if hematoma or bruising is a mentioned side effect.Also if you go to the gym or run a lot this can happenI strongly urge you to discuss this with your go and reach a diagnosis. in the meantime for your pain here is what you can do1) Ibuprofen 800mg twice a day2) Cold compression over the bruising3) Elevation of the leg while sitting downHope this helped.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause mild heart pain?\n\n1st week of intensive running- energy in upper torso suddenly seized (as in a panic attack although i was not frightened by anything) and assumed to be consumed by body when pushing my limit and then body drew from heart with one loud thud or dong sound, literally felt like energy bubble or whatever collapsed in on itself, then went to sleep 4-6 hours later for about 4-6 hours, after awakening felt like heart had been bruised and was healing. The wk end of the same week had about 3 or four stings in center of heart. None of these seemed to serious but, the following week or this week i had mild heart pains at bottom center of heart about 2 and 1 half hours later with shortness of breath. I figured it was only fatigue and it only lasted for a few seconds. Im convinced it acted in relation to me walkin while not having recovered from the morning workout.",
    "doctor_response": "hellothank you for posting hereyour complaints seem to be non worrisome. because the sumptoms are not typical. since you have startrd intensive running, these symptoms maybe related to inadequate calorie supply to the body. i advice you to plan a diet rich in proteins and small amount of fat so as to supplement your body during exertion. also dont start intensive just in a day. go forward in gradual steps so that the body and its organs gets accustomed. in case you still find these issues a treadmill test (stress test) can be done to detect heart disease. thank youwishing you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for controlling high blood pressure\n\nMy musles ache . I have been o n Edarbi for about 1 month. Was taking 80mg. Dr. said divide in half and see if that helped. It might have helped alittle but my musles still ache. Is their another medicine I can take for High Blood pressure that will keep my blood pressure down and not cause me to ache?",
    "doctor_response": "hi dear.. yes there are a lot of drugs to lower your bp without any side effects.kindly visit your docter and get a complete body check up done to evaluate your kidneys and liver so as to which drug will suit you. try salt resitriction and reduce your weight if obese. add some cardio workout to your day. hope my answer helped you. thank you. please do rate my answer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for muscle cramps during hemorrhoids\n\nMy husband is 51 and has been diagnosed several times in the past with Anemia,he has had excesive bleeding from the rectum for years,he has had iron and blood infusions and last year had a hemroidectomy. That almost stopped the bleeding for 3 months,now he is bleeding bad again,has rapid heart beat, occasional chest pain,if he s not moving around he s sleeping,restless legs and shoulder twitching and muscle cramps and headaches. Can you help me, I need to know where to take him and what I can do to help him. Thank You, Donna Crews",
    "doctor_response": "Dear DonnaHaemorrhoids are notoriously known to recur (come back) after treatment. it sounds like it is likely  his haemorrhoids are back and his other symptoms are likely due to significant anaemia. This is what I suggest you do :1. if he is significantly bleeding and uncomfortable right now please take him to your closest hospital's emergency department and there he will be seen by an emergency physician who will examine him and decide on the course of next action(stabilization of the patient and referral to a colorectal surgeon)2. if he isn't bleeding at the moment and he is comfortable please schedule an urgent appointment with a colorectal surgeon. this should happen tomorrow or as soon as possible",
    "dialogue_context": ""
  },
  {
    "patient_message": "How do I get rid of itchy allergic rashes on my face?\n\nHi there, I made the mistake of using an expired collagen facemask on my face. I had a terrible allergic reaction which started with a rash and now my skin has a bumby extremely dry barrier, I have tried everything :( can you give me an idea of how to calm this dry skin and clear this up?",
    "doctor_response": "Hi, If you suspect that the allergic rash is due to collagen mask, you should avoid using the mask strictly. If you have itching, you can take an antihistamine tablet. Dry skin can be treated with application of emollient creams such as Cetaphil DAM moisturizing cream. For the management of rash, I request you to consult your Dermatologist. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Siva Subramanian, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How does my recent MRI report vary from the one taken eight years ago?\n\nHello doctor, From the last\u00a0eight\u00a0years, I have a numbness in my toe, the one next to the big toe. Now, it slowly spread to just above the knee, and in the area above the ankle which is below the knee on the\u00a0right leg. There is no sciatic pain on either side. I have mild diabetes from 10 years. My MRI result eight years ago was as follows: Degenerative disk disorder between L3-L4, L4-L5 and disk prolapse and disk herniation in L5-S1 and mild compression noted in L5-S1. Tarlov cyst at the level of S2. Yesterday's MRI result was as follows: L2-L3, diffuse disk bulge noted causing anterior thecal sac indentation. L3-L4, diffuse disk bulge noted causing anterior thecal sac indentation and compromise of bilateral recesses. L4-L5, diffuse disk bulge noted causing anterior thecal sac indentation and compromise of bilateral recesses. L5-S1, diffuse disk bulge noted causing anterior thecal sac indentation. Nerve conduction study: Bilateral moderate sural sensory axonal neuropathy in lower limbs.",
    "doctor_response": "Hello. I have read your query, seen the attached pictures (attachment removed to protect patient identity), and understand your concerns about the compression of nerves and diffuse disc prolapse at the\u00a0lower lumbar region. I hope this helps you. Feel free to write back to me if you have more questions. Thanks and regards. For more information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathing difficulty and sneezing in an infant?\n\nhi my child is 40 days old. while feeding him and when he crys different sounds is heard as if he is having breathing problem. that sound is not heard when he is playing or sleeping. he sneezs 5 to 6 times per day and suddenly coughs 2 times per day. today some sticky substance came from his nose. whether its common. plz advice.",
    "doctor_response": "hi, thanks for your question. from your history it looks your child might be having laryngomalacia, a condition which improves by itself as the child grows. you can give your child calcium syrup.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I get pregnant after taking folic acid and evion tablets?\n\nHi dr my age is 30 I am married since 6 month but I cant concieve my dr said all test is clear she asked me use folicacid 5mg one month and evion 600 mg fifteen days now this mmonth I missed my period can I pregnent I am very upset please rep, y me",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. Please do not get upset. I will not assure you that this time you will definitely be pregnant at this time. When period is delayed by more than 7 days then go for urine pregnancy test to confirm the pregnancy. If you have failed in your normal trial then you and your partner both should be well investigated and properly take medicine.Folic acid and evion both help in improvement of fertility. Folic acid should be start 3 months before the planning of the pregnancy. Evio also help to improve the fertility. You can also ask for duphaston that will make the uterine environment favorable to become pregnant and support the implantation and fertilization. Avoid stress, take healthy diet, drink plenty of water and do regular exercise. Hope I have answered your query. Let me know if I can assist you further.All the best!Best regards,Dr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child having pain in lower abdomen, increases on putting pressure or strain\n\nMy 5 year old son has been complaining that his \"hips\" hurt, all day. When I further examined him this evening, his pain seemed to be from hip to hip, with a more localized area of pain below his belly button and above his genitals. No fever, vomitting, or diarrhea present. He does have a decreased appetite the last couple of days, but nothing I would consider out of the ordinary. My first thought was appendicitis, but the pain does not worsen upon release of pressure to his right lower abdomen. The pain does increase, however, when I add pressure to the area below his belly button. Should I be worried? He says it hurts when he tries to lay down. To me, it seems like he complains about it when there is any sort of strain to the lower abdomen. He had no pain when I made him cough, but he had pain when I asked him to lie back on his bed for me to check him out, and when I lifted him up earlier around his waist. I thought it might be gas, but he started complaining this morning before school, and while it doesn't seem to be worse, it isn't any better??? :/",
    "doctor_response": "Hello..Thanks for Using HCM..I read your query and it seems that your 5year old boy likely to suffer from Constipation resulting from bowel disturbance which can cause decreased appetite with no fever symptoms or vomiting.. Also Urinary tract infection can cause abdomen pain .Do not be worried consult a Pediatrician and get checked for urine and stool test to diagnose earlier .Other minimal possibilities :1) Appendicitis (inflammation of the appendix)2) Bowel blockage or obstruction3) Inflammatory bowel disease (Crohn's disease or ulcerative colitis)Intussusception, caused by part of the intestine being pulled inward into itself4) Urinary tract infectionsAvoid :Caffeine ,Carbonated beverages ,Citrus ,Dairy products ,Fried or greasy foodsHigh-fat foodsTomato productsDo not give aspirin, ibuprofen, acetaminophen (Tylenol), or similar medicines without first asking your child's health care provider.I suggest your 5 year child to  Drink plenty of water each day.Eat small meals more often.Make sure that meals are well-balanced and high in fiber. Eat plenty of fruits and vegetables.Hope this information is useful for you.Thanks & Take Care..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I use Kojivit gel to get fair skin?\n\nHi doctor, I am a 22 year old female. I have a dusky skin that is brown skin. I want to become fair. Can I use Kojivit gel? Or any other dermoatology cream can I use? My hands are also brown in color and full of tan. Do you suggest any creams to get fair? I want to become fair as my marriage is going to get fixed by next year. Please suggest me some creams, so that it should not show any side effects. Also, how long I should use it? If I use anything, then will it have any effect in case of pregnancy, etc? Please help me. Thanks in advance.",
    "doctor_response": "Hi. One's skin color has 2 components. First one is genetic, which cannot be changed. Every skin color is beautiful in its own way and we should learn to love our skin color and augment it and not hide or lighten it. The second component is acquired, which is due to the influence of environment, sunlight, hormones, aging, etc. We can only target the acquired component of fair skin color while attempting lightening procedures. I suggest you antioxidant capsules like capsule Antoxid HC (Beta-carotene) and apply sunscreen lotion Lashield gel at 8 AM and 12 PM. Also, you can apply Glyaha koj lotion (Hydroquinone) at night time. Start with an alternate night application initialy as it may irritate your skin a bit and after a week or so, shift to daily night application. Consult your specialist doctor, discuss with him or her and take the treatment with consent. You can go for chemical peeling or microdermabrasion from your dermatologist which will help in exfoliating and give you a clearer skin tone. All these treatments are free of side effects. You may use them for three months. For further information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high liver readings?\n\nHI Doc i'm male 26 years old weight is 84kgs and i recently had a high liver reading and hav since had more test to fing out why..I'm going crazy wondering wat is wrong!!..wen i had the high liver and kidney test i was sick with pnemonia but had not started medication so the meds couldnt be the problem...i hav never done drugs ive been with the same partner for 4 years and had a baby in the last 2 years and nothing was wrong with my partner...i was also sick before i got pnemonia and am constintly tired...i get 3 or four day hangover wenever i drink even if its a small amount im sick the next day!! pls any help would be much appreciated!!",
    "doctor_response": "Thank you for posting your query at HCM.history of increased liver enzymes. further evaluation needed.increase in the level of liver enzymes(AST,ALT) reflect an INJURY to the Liver. medically, the condition is know as \"Hepatitis\". it maybe caused by:1. Virus (A, B, C, D, E) 2. Alcohol 3. drug induced (medication)4. Gall bladder or common bile duct pathology 5.\"Fat excess\" further evaluation neededdo following test:1. Viral serology ( hepA, B and C) anti HAV, HBsAg, anti HCV2. lipid profile3. ultrasound abdomenHepA virus is a common cause and self limited disease.You may visit hepatologist and results of above tests as soon as possible.advice:abstinence from \"Alcohol and drugs\" - LOW fat diet should be followed- NO red meat- vegetables should be ingested daily- Moreover, less activity should be carried out (no sports). - use lemon juice (lemonade) once in a day- walk 30 to 40 minutes everyday.- or swimming is alternative to walking- NO sports and NO jogging-\"recheck liver enzymes after 6 to 8 weeks\".if any further questions, feel free to ask.Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health.regards,Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Have PCOS. HMG shots prescribed. Is there a chance of miscarriage when I stop taking the hormones?\n\nDear Doctor, TTC for 2 years with pcos , this cycle my dr prescribed HMG shots from day4 to day9, then trigger Hcg shot on day 12, i ovulated day15, then he put me on cycloprogenova 2 white pills daily and told me to take it for 2 weeks bec my endo was 9mm. am on day 18 now, but am worried bec cycloprogenova is category x, and when i stop it would my hormones become low and if there s pregnancy i would have miscarriage? Thank you",
    "doctor_response": "Hi, As your endometrium should be enhanced for proper implantation should you conceive in this cycle, you would need the medication. Yet, estrogens are contraindicated when pregnancy is contemplated. Effect of hormones on the embryo has been seen after 45 days, so your doctor may have prescribed this now. Once implantation has occurred, you may not need the medication and supportive treatment is ensued, so as to prevent a miscarriage.  Please discuss with your doctor if you do not wish to continue the drug. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of swelling in knee and leg and numbness?\n\nHi Dr. Grief, I injured my knee a few days ago. The area around the knee cap, above and below became very inflamed and hot to the touch. Today, the swelling has traveled down my leg and my calf, all the way around is 2 to 3 times the size of my other leg. I am also experiencing numbness, but it is not too bad. Can you help?",
    "doctor_response": "Hi,Thank you for providing the brief history of you.A thorough clinical assessment is advised along with the understanding of the mechanism of the injury.As the swelling is a protective mechanism of the body, so if the ligament injury occurs the pain and swelling is common, also the pain down the legs can be due to muscular pain due to strain. After a thorough assessment treatment can be planned.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Do receptive anal sex result in uncomfortable lump at the anus opening?\n\nHello doctor, I see a lump at the opening of the anus. It is been there for over a week. It is not much painful but it is uncomfortable while sitting. I am a 25-year-old male. It never happened before and no current medications.",
    "doctor_response": "Hello,  Welcome to icliniq.com. I have seen the picture you have uploaded. (attachment removed to protect patient identity).  It appears to be thrombosed piles. It takes a few days for it to settle down well, but it is not anything sinister. A few things would help to give relief. Take Sitz bath (a large basin to be filled with warm water and a couple of spoons of common salt to be added and sit in it for 10 minutes) twice a day. Take analgesics Ibuprofen or Paracetamol twice a day for five days, laxatives Fybogel for three days, and Laxido before bedtime for a week. These would sort out the pain and discomfort. You have higher chances of developing hemorrhoids (piles) in the long term. Do exercise regularly,eat high fiber diet (no restrictions in having nonvegetarian) and reduce straining while opening bowels.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can ITP cause complications in marital life?\n\nHello I want to marry a girl who has suffered from ITP previously .She has done her treatment but as doctors say that there is no reason why ITP happens so there is no surety that this will not happen in future. I want to know is there any kind of complications in our marriage life because of  her ITP?",
    "doctor_response": "Hello and welcome to HCM,ITP stands for idiopathic thrombocytopenic purpura.In majority of cases, ITP is acquired and the cause is not known.Viral infection is the most probable cause of ITP.ITP can recur and it causes fall in platelet count. however, fall in platelet count will not affect your married life.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe and repetitive thigh pains?\n\nI had sudden severe thigh pains, late a night(sudden onset). The rt posterior thigh(lasted 4-6min.). 4 hours later, the left posterior thigh, same area as right. I have no diseases except ulcerative colitis. I haven t done any physical exertion and these cramps occurred while I was laying on my back in bed. The first caused so much pain and paralysis, I flipped to my rt side until it subsided. At 1am the second one occurred on the lt thigh and I was awakened from a deep sleep when this happenned. I flipped to my left side, same duration of time(4-6 min). Never felt or heard of anything like this.",
    "doctor_response": "Hi, It could be due to low calcium and vitamin D levels now so low levels of vitamin B12. Get the blood investigations done to check the level, can take proper supplements. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Jaideep Gaver, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "For how long should storfib 145 tab taken?\n\nhow long storfib 145 tab can be taken in case of tmt test is positive & blood pressure. no other symptoms occure.i got ct scan engeography also. only in one vein, got 30% blockage in age of 52 years(male).i am advised to take following three tablets od1. granry-150h2.Storfib 145Zevit caprequest send reply",
    "doctor_response": "HiAll patients who have a high risk of developing a future heart attack need to be taking a medicine like atorvastatin to prevent a heart attack. Besides this Atorvastatin will also reduce cholesterol. In some patients cholesterol is high inspite of taking atorvastatin maximum dose. In such patients drugs like storfib are given which contains another medicine called fenofibrate along with atorvastatin. Do you have high cholesterol? How is your LDL & HDL cholesterol? If your cholesterol is normal, then you can continue taking only atorvastatin. The period is usually indefinite once the age is above 50 years.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for liver cirrhosis\n\nalong with lung cancer I also have cirrhosis of the liver. My spec said the other day that after looking at my hands [palm side up] he mentioned that it mentioned my cirrhosis was starting to move . Just what did that mean? I am a 71yr, female never mind I did not know I had to pay. Should have been told at the beginning GREAT HELP",
    "doctor_response": "Hi thanks for asking question.Let me know you in cirrhosis hyperestrogen is there because of  defective metabolism.So because of estrogen palmar erythema present.So doctor just seeing that sign.Now you have to take care regarding healthy life style because if you don't care it will progress and encephalopathy can occur.So take good dietary habits like....Fruits more.Green leafy veg taken more.Avoid trans fat like pastry, cookies, meat etc.Avoid junk foodAvoid smoke and alcohol.Regular exercise.Oily food avoided.Cumin seed powder mix in butter milk and taken daily ... I hope your concern solved.Dr.Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it possible for a hypothyroid patient to develop diabetes?\n\nHello doctor, I am hypothyroid. Thyroid gland destroyed by Radioactive Iodine 14 years ago. My fasting blood sugar level is always in the range of 6.1 to 6.5. I have tried intermittent fasting even after 22 hours it does not drop below 6.0. Postprandial is in the range of 9.5-10.4. I do not have any sugar or rice or bread in my diet. Only carbohydrates is brown chapatis. Am I Type 2 diabetic? I take 200 mcg Levothyroxine everyday.",
    "doctor_response": "Hi. From your history it is evident that you are on replacement therapy for hypothyroidism post-radioactive iodine,and also known diabetic since 6 months. From your history, age and other parameters it is type 2 diabetes mellitus. It is not only carbohydrates which contributes to the same. Insulin resistance is the main culprit. From the details above it is clear your blood sugars are not under good control (hbA1C 8.8). I would recommend to monitor your blood sugars at different point of time to know at which time it is increasing. (That is monitoring before and 2 hours after breakfast, lunch and dinner using a glucometer) and want to adjust your diabetic medications accordingly. lifestyle modification Diabetic diet regular aerobic exercises for about 30min a day avoid simple sugars, juices, fruit with high glycemic index modify oral antihypoglycemic agents according to blood sugars",
    "dialogue_context": ""
  },
  {
    "patient_message": "Actiq paper using for dentures causing constant pain and losing teeth\n\nHow can you get help form a drug manufacturer for dentures? Medicare does not cover it. All patients who have posted on this site regarding actiq using over 3 years have lost all their teeth! Its not a main warning on the Actiq paper. I was very careful and still lost all my teeth! Im mad and feel so bad for the many people out their struggling. Being in constant pain is hard enough. Now you have no teeth as well!",
    "doctor_response": "Hi,Thanks for posting the query,   I would suggest you take take lukewarm saline nad antiseptic mouthwash gargles.Take multivitamin suplements.For pain relief, analgesic can be taken , a thorough clinical checkup is required.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Been trying to conceive over a year now\n\nMy husband and I have been trying to concieve for alittle over a year now. what else can i do? I taking prenatal vitamins and im eating healthy. I am small. I am 5'2 and weigh 82lbs. I have been trying for years to gain weight even tried diets to gain more weight. I drank protein shakes and everything. But what else can i do? I want to go to the doctor and try clomid but i am afraid it wont work. I have been trying for a long time and i dont want to wait to see if it works.",
    "doctor_response": "what is your problem why u are not conveiving is all decided by the doctor and based upon that he will decide which treatment option, how come you urself decide clomid treatment for yourself,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for leg pain?\n\nI was camping and stepped on something last weekend, I noticed pain all week but not to bad and I though it was bad athletes foot. But yester I looked and noticed what looked like a sliver but it ha calist over already. I tried taking it out today, but nothing was there, I dug out the area looking for it but now there s just a small whole and a red Line going up my foot. My foot is now tender on the top where the red line is going.",
    "doctor_response": "Looks kind your leg is inflamed and need some antibiotic with anti-inflammatory as well pain killer treatment.  If there is a wound then do proper dressing.  And yes do not move out much and keep your leg in elevated position at home to reduce swelling and take rest.  It should be fine in two or three days.  For medication and dressing do contact your near by physician also.  Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Crackling in ears on swallowing, swollen nostril, throat pain, swollen glands. Throat cancer?\n\nHi, I am a 22 year old male. I smoke close to a pack a day. For the last couple weeks my ear started crackling when I swallow . I started paying attention and noticed my left tonsil is swollen. Swollen for about a week now. No pain in the throat, but sinuses act up every other day, watery eyes and now both ears are clogged really bad causing pain. A swollen gland or something has formed over my right ear bout the size of a ellongated pea. Right in the rear of my temple. Could this be throat cancer or something very serious?",
    "doctor_response": "Hi, Welcome to HCM, I am Dr. Das From your history, symptoms are similar for having infection. Go to a general physician first. If required do a FNAC of that swollen gland which will confirm what you actually have.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for erection problems?\n\nI tried having sex 3 times but i was not able to do so. Reason is when ever i tried to put inside the vagina with the condom my penis erection would come down so i am really afraid that whether it happens with everyone during inital stages of sex or this problem is only with me. Please answer. Regards, Vikas.",
    "doctor_response": "This can be for many reason.  If you have blood pressure or diabetes, problem then it  needs to be kept under control.  Anxiety around sex can also cause the erection to be soft. Typically we can give an oral medicine that will help. Sildenafil is one type of medicine that can help and give you stronger erections.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dark complexion in children\n\nmy daughter is 9yrs old but her compexion is very dark . she never participate in any function in school.she has changed her section because of her complexion .what todo how can i help her. pl. suggest me some good creame or which soap should iuse for her jhonsons product doesnot suits her, so home or herbal products.thanks",
    "doctor_response": "hellodont be worriednot all will be fair.we must be happy with what we have.do talk to hermake her realise about this fact and that she should not be embaressed about it.try natural products like turmeric.you can visit a dermatologist also and give her what her skin deserves",
    "dialogue_context": ""
  },
  {
    "patient_message": "Teenager has on-again off-again habit of humming without realizing it popped again. Suggest?\n\nMy brother was nervous about football so his on-again off-again nervous habit of humming without realizing it popped up again. After about two and a half weeks of constantly reminding him that he is humming, he hasn't stopped. I don't know what to do, he gets so annoyed when anyone tells him. Teenagers, what are you gonna do with them, right? Anyway, please contact me and let me know what I have to do to help him.",
    "doctor_response": "Actively opposing to his idea will not work. You have to go along with him, take him into confidence, and then gradually tell the pros and cons of the same. Alternatively, contingent his study time with play time by making a behavioral contract. this works",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I often have heartburn. What can I do?\n\nHello doctor, I am suffering from heartburn, chest pain, nausea, and breathlessness. I got done 2D echo, ECG, vitamins D levels, endoscopy, and blood tests. All the reports\u00a0are normal.",
    "doctor_response": "Hello. There are several things you can do to prevent an episode of heartburn like: Hope this helps. For more information consult an internal medicine specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My dad has been advised temporary dialysis. Does he really require it?\n\nHi doctor,My 66 year old father suddenly got a\u00a0high fever and in few days we discovered he has a urinary tract infection. He is a diabetic and on insulin. He is a very disciplined person when it comes to his health. He checked his creatinine levels early this year and it was in the normal range. After admitting him to the hospital, his fever was gone and the doctor said he would go home in two days. His creatinine is increasing every day and has reached from 1 to 4 in three days. Same is the case with urea which is 125. The doctors are asking for a temporary dialysis to be started immediately, but we are not sure. Please help.",
    "doctor_response": "Hello. I am sorry to hear about your father. Hope this has helped alleviate your concerns. For further queries consult a nephrologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does \"free fungus in douglas's pouch\" suggest from ultrasound?\n\nI was diagnosed with Stage 1 breast cancer in March, 2010.  I had a mastectomy and finished four rounds of cmf chemo in September, 2010,  A pelvic ultrasound shws I have a trabeculated cyst in the left ovary measuring 32x30x20 mm (volue = 10.2 cm).  No vascularization was identified in the septum.  The only other comment is \"free fundus of Douglas's pouch.\"  What do these things mean?  I'm very frightened.  Thanks for your help.",
    "doctor_response": "Hi,Thanks for writing in.The pouch of Douglas is a space behind the uterus in females. It is a place where fluid gets collected. Free fluid in pouch of douglas suggests that there is some fluid in the abdominal cavity which is occupying the space behind the uterus at the time of scan.This fluid is in small quantity then is not a concern. If there is significant fluid then it might be due to any pelvic inflammatory disease or as a part of the fluid collected in the abdominal cavity. The Left ovary is slightly enlarged and is not a serious concern. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for panic attacks & stress?\n\nI am a 27 y.o. female in decent health. I have struggled with panic attacks and disorder for 12 years. I have only taken pills for it once, two years ago. My mother recently passed away and i have been having the ongoing symptoms of panic (shortness of breath, racing heart, heart feels like its going to flop out of my chest) for the past month. It comes and goes, and i have only had a couple of full blown attacks (hyperventalating, crying, basic melt down) twice. I have had these symptoms before and two years ago when i had them, i took myself to the emergency room again. Once again they said it was just stress and the panic disorder. I asked several times if they were sure my heart was ok and they said yes. So, my question...I am supposed to take my daughter to an amusement park tomorrow, and i suddenly am terrified about going on coasters, because of the way my heart has been latley. So, my hightened anxiety about riding the coasters makes me more nervous and then more paniced. Although i have been told before that there is nothing really wrong with my heart, do you think riding the roller coasters would be dangerous? Please note that i love roller coasters and have ridden them every summer for the past 8 years in spite of my anxiety. Do you think that my sensitivity regarding my mother and fear of my own mortality is making me feel worse, or should i really be concerned about my heart?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Panic attacks happen because of anxiety disorder. You are anxious about your health. That is hypochondriasis. You are anxious about something which may or may not happen in future. That is apprehension. You need treatment for these. Not for panic disorder. Once you treat these, panic disorder shall disappear eventually.Psychotherapy is enough to cure both of them Start with:Step 1 - Practice Deep and full breathing whenever possibleStep 2 - Drink plenty of water and fruit juices. Step 3 - A Tomato a day keeps anxiety at bayStep 4 - Exercise regularlyStart these and follow strictly. After 7 days 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can you let me know whether i need to consult some one ?\n\nCan you let me know if i need to consult some one? Also Liquefaction time here is 50 min. Do you think it would matter in the above test units? Volume: 2ml, Liquefaction Time: 50min, Ph: 8.0, Count: 28.6 Ml/ml, WBC/Pus Cell: 5-7/HPF, Mitility: Grade1: 10%, Grade 2: 15%, Grade 3: 15% Grade 4: 60%, Morphology: Normal: 60%, Agglutination: Absent, Impression: asthenozoospermia, Fructose: +ve",
    "doctor_response": "your sperm is having paralysis, it is not moving properly, please see an infertility doctor here. he can help you with some techniques or otherwise what is the guarantee cost of the baby, you know now -a-days there are guaranteed pregnancies too. is it not very interesting",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for kidney stones\n\nI AM SUFFERING FROM multiple kidney stones on my both kidneys. amazingly all are size of below 10 mm. pls suggest me what treatment i have to take. How i could control my diet i am using CYSTONE tablet 2 nos daily twice. pls advice..... thank you...",
    "doctor_response": "Does your urine show crystals? That will give us an idea of what diet to prescribe.Cystone is good.Also take lemon barley water twice a day.How old are you? What other medications are you taking?Please revert back--regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dull aches in kidneys and frequent urge to urinate?\n\nhi suffering with my kidneys the last week, i was getting dull aches on and off, sometime i feel the urinate but dont need to go. the pain has become more persistent and has been with me all day now i also feel quite fatigue. anyone have any advice. it would be much appreciated.",
    "doctor_response": "Thank you for choosing HCMI understand the pain you must be in. I think that you have a Urinary Tract infection or you have a kidney infection. I think that you need to see a Doctor to get to the cause. There are several causes for this. To diagnose a UTI, you will need to check your Urine for the levels of white blood cells in the body. This will help you get to the cause. On microscopy, you can discover bacteria and the white blood cells. If these are raised, you will be able to know that you have UTI. To treat the UTI, you will need to start on antibiotics. These antibiotics will help you recover from it. Follow up after 4 days. All the best.Hope this helps you.Dr Vignan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for stage 4 cancer?\n\nsir my all ready he have the cancer stage 4 as per dr pradhan tata bot i cant understand what i do he isnowat mumbai please help me . his cancer attack start by goal blader & liver.... he all ready touch with tata memorial canser hospital mumbai. plzzzzzzzzzzzzzzzz help me sir",
    "doctor_response": "HiThanks for your query.I am sorry to know about him. Stage 4 cancer may not be cured but some therapies are available to control the disease and make the patient feel better. Please consult any medical oncologist to discuss about these options.Hope this helps,Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I having yellow urine for last three months?\n\nHello doctor, I am suffering from yellowish urine from the last three months. I already got treatment for fatty liver and I personally take Liv-52 for my liver issue, but still, the problem has not gone properly. I have also done USG, total bilirubin, LFT, KFT, etc. There is no issue of jaundice but my bilirubin count is high. There is a digestion problem too.",
    "doctor_response": "Hi. This is mild unconjugated jaundice. The causes are hemolytic anemia, Gilbert syndrome. There is no harm of these disorders, the liver is fine, no need to take any medication. We just need to confirm the diagnosis. For that, we need to do investigations, a little bit costly but mandatory to be sure about the diagnosis. UGT1A1 mutation (TATA repeat) for Gilbert syndrome. Peripheral smear examination to look for the evidence of hemolytic anemia. Later on, we may need to do HB electrophoresis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for high temperature,sore throat and gastric\n\nMy 3 year old son has had a high temperature since yesterday afternoon along with a sore throat and a small amount of sickness. Today he has been runnig to his potty saying he needs a poo, when he sits down all that comes out is gas along with quite a bit of this clear bubbly liqiud. i am a little concerned. just for the record he has a hydrocyl on his testicle for which he will be having surgery in september. I look forward to hearing from you, many thanks Leigh-anne",
    "doctor_response": "Hi, your child has fever for 2 days and sore throat with complaint of passing stools since 1 day, this is suggestive of throat infection or stomach infection. In throat infection the child probably needs antibiotic like amoxyclav for 3 days and a cough syrup. I think that your child has throat infection due to which he must have taken less diet which resulted in difficulty in passing stools. In my opinion, you should start antibiotics, cough syrup and syrup for fever like paracetamol. I hope this will help you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to increase chances of conception?\n\ni am 34years old and my husband is also of same age.we  got married 2 years back.i have not conceived yet.i have endometrial polyp less than 1cm and posterior wall subserous fibroid.my height is 153cm and weight 60kg.regular period-24 to 27 days.2-3 days normal flow.Folicular study is ovulatory cycle without medicines.we have  seen allopathy drs.husband's tests are normal.doctors  said everything is fine.please sugest me some advice to get pregnant",
    "doctor_response": "Hi, I think you can try naturally for at least one year before undergoing any fertility treatment.  Be in contact with your husband every 2 to  3 days after your periods stop.  It will increase chances of your pregnancy.  If it doesn't work then you can go for some medicines for growth of your follicles and track your follicles growth by repeated ultrasound.  When follicles reach a size 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.  Hope I have answered your question. Regards Dr khushboo priya",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Misoprostol to be taken vaginally or orally?\n\nMy Girl Friend is pregment and she has taken mt ptost kit of cipla company. Doest this pills work and if yes are there any side affets. Also lets me that the company says the tablet misoprostol has to be taken vaginally is that so. or can it be taken orally. Reply soon",
    "doctor_response": "HiMisoprostol can be taken orally or vaginally.Vaginal route is slightly more effective than oral route.Kindly follow the instruction on the kit.Misoprostol can cause adverse effects like nausea,vomiting,abdominal cramps and diarrhoea.Hope I have answered your query. Let me know if I can assist you further. RegardsDr.Saranya Ramadoss, General and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stabbing pain in lower side of back, difficulty in walking. What could be this?\n\nI have a lower left side stabbing pain in lower left side of my lower back. What is this? I think after looking up things it may be kidney stones or hi uric acid.Do you know what this jabbing pain is. I've had it for 3 weeks now and its getting worse. Sometimes I can walk normal and other times the jabbing sharp pain stops me in my tracks. I don't have a gall bladder so I know its not gall stones. any ideas?",
    "doctor_response": "Hello, Thanks for writing to us. The pain at the bottom center of the rib cage on the left side could be due to a renal infection or a stone if the pain does not seem to be muscular in nature. This can be ruled out after getting an ultrasound scan done. If the pain is aggravated with deep breathing or coughing then a rib injury or a muscular sprain is likely. I suggest you to consult your docter for thorough examination and treatment according to that. Hope this helps you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Given paracetamol for constant abdominal pain in a child. Could it be an allergy?\n\nHi My 7 year old daughter frequently gets pain in her tummy and her school kept sending her home, but it never really developed into anything and she would just rest at home and go to school the next day. After it had happened a few times, I took her to the doctor, who prodded her tummy and said it felt fine and said that it was abdominal migraines, which were common in children and she should just have child paracetamol and rest and it would pass. I accepted this, but having kept an eye on it, it happens generally after eating and she often seems to have a lot of wind and sometimes very smelly at the same time as the tummyaches. She has a balanced diet and is otherwise healthy - but could it be an allergy or something other than abdominal migraines?",
    "doctor_response": "it can be food protein allergy as oner or more of major foods proteins start reacting with the body proteins to cause these problemsin my opinion if you get blood serum tests for specific antibodies for milk wheat potato chana and other food you take in consultation with allergy specialist and withdraw the foods your child will be benefitted in my opinion",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is C.difficile infection a contagious disease?\n\nIf i have just been diagnosed w c diff. My job is to teach nurses how to do an IV with my company's IV needle. I have no physical contact with nurses, I just show them on a vein board how to insert it. Then they practice the technique. Am I considered infecous to others in this setting?  IS it necessary for me to take off work?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Yes, it can be contagious disease.Clostridium difficile is a bacterium that can cause symptoms ranging from Diarrhea to life-threatening inflammation of the colon.It most commonly affects older adults in hospitals or in long-term care facilities and typically occurs after use of antibiotic medications.It can also be a contagious disease in the sense the bacteria can be spread from person-to-person by touch or by direct contact with contaminated objects and surfaces (for example, clothing, cell phones, door handles). Some individuals are carriers of this bacterium but have no symptoms of infection. However, these people are still infected with the bacteria can spread the infection to others.In general, the bacteria have to increase in numbers rapidly to cause disease, so the bacteria can be transferred to people, but not cause significant infection immediately.Disease occurs when conditions favor growth of these organisms such as weakened immune systems, the elderly, and especially individuals that are hospitalized, and are being treated with antibiotics that suppress the normal bowel flora.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mohammed Taher Ali",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I request for a second opinion of my CT scan. I suspect a possible brain hemorrhage.\n\nHello doctor, I am 29 years old. CT scan came up negative for problems associated with infection. I request for second opinion for possible hemorrhage/brain aneurysm or complications due to infection. I have attached the reports. Associated Problems: Tooth abscess. Symptoms: Light headedness, severe migraine, ice pick stabs on top of my head and a feeling of something running on top of my head. Note: \u00a0I went to emergency room and was denied treatment due to the diagnosis of 'routine headache' and then discharged.",
    "doctor_response": "Hi. I have read through your query in detail and have seen the reports. (attachment removed to protect patient identity) The following will confirm it as normal. Report Findings: Impression: It is possible that your headache is due to irritation of the trigeminal nerve that supplies the skin in the head and face region. Hope this answers your question. Revert back to a radiologist online for further follow up -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting of blood and pain near liver area?\n\nI am 21 years old, male, 240lbs. I have been binge drinking heavily for the last 2-3 weeks. This morning I threw up about 1-2 cups of dark red blood. The area where my liver is located still has a constant dull ache. What should I do? I would prefer to not go to the hospital, but I am unsure if this is serious or not.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Vomiting of blood is a serious problem. Uou may have esophageal variceal bleeding due to portal hypertension or yoy may have some other cause. You should go for upper GI endoscopy, ultrasound abdomen and liver function test. Search for the cause and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for upper left chest pain\n\nMy husband has had upper left chest pain for weeks. He s had a ct scan with contrast of lower pelvis nd abdomen and checked for kidney stones. They said he had lots of stool backed up. He has taken magnesium citrate twice and still has the pain. Any advice on what specialist to see next? YYYY@YYYY",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Constipation (stool backed up) can not be cause upper chest pain. Upper left chest pain is mostly due to heart and lung diseases. So consult internal medicine doctor and get done ecg and chest x ray. If both these are normal then no need to worry for heart and lung diseases. Hope I have solved your query. I will be happy to help you further. Wishing good health to your husband. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can partial dentures replace complete dentures when all the teeth have eroded?\n\nUmm, I am watching the Doctor's segment about the woman who had no teeth and I'm I the same situation. My bottom teeth have given themselves a root canal. By that I mean an infection has completely killed my teeth. it started by one tooth having a cavity and it never broke the enamel and ate downward along the root and went down along the jaw bone then up all the other teeth. I have no nerves and the teeth are just eroding away. Several have the gums grown over them. Several dentist said they are all infected, the calcium is completely depleted, many are just a facade or an empty shell. They want to pull all my teeth. I think I have 11 teeth left, 7 upper and 3 lower that I can still see and 3 under the gum.  I'm on Obama care so I can get my teeth pulled for free and have free full dentures but I watched my mom cry so many times after getting full dentures because of the pain she went through and I don't want to have to go through that. I'm praying for help to get  \"Full Denture Partials\". I think that consists of four posts (One on each quadrant) and the dentures snap in. Something like that but I'm so worried that I might not have any bone left to get them. Because it this problem I have developed breathing problems and headaches. I am experiencing heart trouble for which they want to put in a stint, they say I have a portion that is not getting any blood. I'm on housing, food stamps and have no job at this point because I am disabled and was wondering if I could get some help also. What do you think my chances are?",
    "doctor_response": "hi ..I understand your query..  There can be one treatment modality that is tooth supported overdenture. In that case, post will be given in your remaining teeth after root canal treatment and then denture will be fabricated on them. These overdentures reduce the instability of complete dentures and maintain alveolar bone.however you should have to take various precautions such as brushing the remaining teeth and go for regular follow up so any caries or periodontal disease can be treated and dentures can be relined.hope it helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back problem, L3 L4 prolapse, tried physio and hydro therapies, no help. Alternative medication ?\n\nHi Doctor,I have a problem with lower back,L3 L4 prolapse left hand side,done it 8 years ago.I have seen a Professor Gabreill here in Australia over 3 years ago,and nothing can be done for it he stated.I have had a back break down again three weeks ago and its still causing problems,I do physio and hydro threapy its seems to be easing the pain,is there any other medicatoins a availible that do not cause drowesyniess and help me cope with the consistant pain,am 56 years young and fit however I work full time and it seems to be getting wors",
    "doctor_response": "hi , over the period of 8 years, to know  the status of your l3-l4 disc , you need to repeat MRI study  consult orthopedic surgeon and get the MRI done . accordingly the management can be decided",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to determine paternity while pregnant?\n\ni cheated on my boyfriend on october 14th an we had sex 3 times that day i never seen him after that an i returned to my boyfriend the next an an had sex with him an we had sex all the time i found out i was pregaunt at the end of november an my due date is august 2nd who do you think the father of my child could be?",
    "doctor_response": "Hi, Dr Purushottam Neurgaonkar here. I welcome you to HCM VIRTUAL CLINIC. I have gone through your question, and I think I have understood your concern. I will suggest you the best possible treatment options. As such, day 10 to 20 of the cycle is the most fertile period of cycle in a woman with regular cycles. If all your sexual acts were in that period, then it will be difficult to know paternity of the baby .Otherwise, the person with whom you had sex during the  most fertile period, is most likely to be the father of the baby .Any way after the baby is born you have option to get DNA test to know paternity of the baby.I hope this answer helps you. Thanks Dr Purushottam Neurgaonkar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for continuous stomach pain\n\nHello. My son is 11 years old. He continuously have stomach ache. Recently I got a medicine from chemist of one which I could read the name : monorich - 150 and other's name I couldn't get but it's from zoic life sciences. He felt relieved. Please help with the kind of problem he is facing.",
    "doctor_response": "Hi.Thanks for your query. First of all getting a treatment directly from the pharmacy indicated you ae not serious about the problem of your child. The Medical field doesn't work like this. If you are serious about a child , who is your son too, I would advise the following with the history you have provided. * Clinical examination by a Surgeon / Pediatric Surgeon if you have in your city. This is important as a Doctor only can ask the proper questions. The proper history by you and your son can lead to a proper diagnosis. * X-ray of the chest and abdomen.* Ultrasonography of the whole abdomen- CT scan is done only if the Surgeon feels so. *The routine blood, urine and stool tests.The Treatment will all depend upon ::* The clinical findings, reports of the investigations and follow-up results after medical management. * A course of an antibiotic with Metronidazole, * Medicines for worms*Surgery if the cause is surgical such as appendicitis and so on.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have lower back pain. Used relief back patches and max freeze. What to do?\n\nI have a partner who has extreme back pain in the lower back- we have relief back patches one night, max-freeze two nights and the chiropratic doctor this morning-I have some medical knowledge but certainly don't know what to do at this point. Mysomewhat knowledge tells me-it's his kidneys.  thank you",
    "doctor_response": "Hi, thanks for writing to HCM.There are numerous causes for low back pain. The commonest causes are* any problems related to the lumbosacral spine like disc disease,lumbar strain, a nerve irritation, facet joint problem , spinal stenosis , inflammatory arthritis etc* Intra abdominal causes like Kidney related conditions, liver problems, pancreatic problems etc* Pelvic inflammatory conditions in female patients* Vascular causesSo, a detailed physical examination and appropriate investigations are necessary to establish the correct diagnosis.In the meantime, use some analgesics/ muscle relaxant preparations along with ice packing of the affected area once in 2 hours to alleviate the pain.Hope this information is helpful. Good day",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can chlamydia be treated?\n\nHello Dr. I need some urgent advice. Two weeks ago i went for blood tests which drs confirmed i had chlamydia..dr also said ut was in the acute phase so i was exposed to it in the last 6 months. I havent been with any other man except my fiance in 9 years. He went for tests (penile swab) and his tests were negative. I then went for a full cervical swab papsmear but havent received my results. I did however see on my mobile lancet that the chlamydia thrichomonas says not observed and the thricomatis says result pending. What does it mean not observed? Could i have the eye /pulmonary chlamydia? My fiance says he was not with another woman and i do know he is thruthful. How could i have gotten this? Please help",
    "doctor_response": "Hello, chlamidia is mainly transmitted through sexual route. Some times when people have chlamidia infection in  eye . it can be transmitted via contact with those secretions also. Males are usually symptomless or show minor symptoms but they infect others. Single dose of azithromycin or twice daily doxycyclin for 7-14days is helpful in curing the disease. Hope this helps Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for muscle twitching in the leg\n\nMy husband has been experiencing muscle twitches/spasm in legs and other random muscles. He complains of weakness in legs, has had some cramping in flank areas, and talks about a firing or iritation along the spinal cord. He has had several blood panels done and the only things our MD has pointed out include level of Creatine Kinase around 500 and low magnesium. He had a CT scan they said liver and spleen slightly enlarged and has a trace amount of blood in his urine.",
    "doctor_response": "Hi,Thanks  for  your query.It seems that you have muscle twitches or fasciculations. These are small, local, involuntary muscle contraction and relaxation visible under the skin arising from the spontaneous discharge of a bundle of skeletal muscle fibers. You might consult your doctor who can order 1. a few blood tests including thyroid function tests, 2. Serum electrolytes including Serum calcium and potassium levels. 3. Serum B12 levels In case the above tests are normal further testing can be done including - nerveconduction studies, Electromyography, etc. These tests might help to diagnose any underlying neurological issues. I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump of blood clot in the centre of roof of mouth?\n\ni ate something hot and crispy from the microwave and right after I went to wash out my mouth there was a lump of blood clot gathers in the center of the roof of my mouth. This scares me, the more i nasals at the spot of blood the bigger it got sliding towards back of my throat. I used my thumb and apply pressure on it . It then spew out blood. I did not hurt at the time, just a thin layer of skin funny feeling. That was 3 days ago. I'm now hurting at the back of my throat where the skin strips stopped. Hurts especially in the mornings, have difficulty speaking. Will this heal on its own with antibiotics?",
    "doctor_response": "Ya .. Its heat burn wound . it will take time to heal . and you have pain in morning is because whole night it was relaxed but in morning you start giving movement thus it cause pain .. Use den to gel over that wound it will help you in healing . start having vitm b complex tablet...thanksss",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are my teeth discolored due to cavities?\n\nHello doctor, Recently I have seen some discoloration on the side of my teeth, especially back towards my molars. However, I do not feel any pain, aches, or sensitivity. Is it a cavity? I am not sure what I should be looking for if I have a cavity.",
    "doctor_response": "Hi. I have gone through your question and I can understand your concern. Yes, if it is brown or black that means it is in the initial stage of the cavity. It takes a year or two to start symptoms like sensitivity or lodging of food in these cavities. You need to keep your teeth clean through brushing twice daily. If you can upload a picture here so that I can tell you that if there is any immediate treatment or filling needed. The proper way to address the problem is to get a dental filling done (restoration).",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stiffness in the legs while having influenza-b?\n\nMy 6 year old has had influenza b since Monday. He was 24 hours fever free, but now has a low grade temp and very stiff sore legs to the point he can hardly walk. I have increased his fluids and given him Tylenol and Motrin. He has been on Tamiflu since Tuesday.",
    "doctor_response": "Hi....by what you say this could be viral myositis or inflammation of the muscles due to viral illness. If the kid is otherwise getting better you need not worry. But if he's developing any weakness of limbs which is gradually progressing then, I suggest you take him to nearest emergency room.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to confirm pregnancy?\n\ni had my failed IVF in jan..after that within three days i got my periods..thats on jan 8th..but in feb till nw i didnt get my periods..jan 18th we did pregnency test at home..but it was negative..wht should i do? should i wait? is thr any chance of pregnency?vyga..muscat",
    "doctor_response": "HiGREETINGS There best way is to get an ultrasound scan to find out what could be the reason for not getting periods ..What was the indications for doing IVF? Hope my answer helps you. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do Benadryl and Lisinopril affect kidneys?\n\nage is 63 weight is 222pounds.  Ihave the starting of copd.  liver disease. and high blood pressure.Ijust had a blood test that says my gfr for kidneys is 55 and was 80 a few months back. all the other tests for the kidney was fine.  ws told to drink more fluids. was wondering if benadryl woud affect the kidneys and also lasinopril  thanks",
    "doctor_response": "Hi  & Welcome to HCM.I can understand your concern.Yes, these medications can affect the functioning of the kidneys.The normal for an elderly person aged 63 is over 90 ml/min/1.73m2.The given result is suggestive of acute kidney injury which seems to have been caused by the prescribed medications.Lisinopril (ACE inhibitor) may cause changes in afferent and efferent arteries in the kidneys due to its BP lower effect. Initially the kidneys compensate by stimulating the renin\u2013angiotensin\u2013aldosterone\u2013system & anti-diuretic hormone to maintain blood pressure. However, if a patient previously had hypoperfusion (decreased blood supply to the kidneys), this compensatory mechanism may fail resulting in a decreased glomerular filtration rate.Benadryl (Diphenhydramine) can cause post-renal obstruction (blockage of the urinary tract). Obstruction can occur from the urinary tubule to the urethra  resulting in urine accumulation and ultimately increasing upstream pressure and decreasing GFR.Such elderly patient should be carefully evaluated by a physician or nephrologist and a dosage reduction of Lisinopril or use an alternate medication would restore the normal GFR.Hope this will help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cough and weeping sound while breathing?\n\nHi have hade a  bad cough for 2 days know  and today i have only coughed like 6 times but there like 30 second coughs and they hurt realy bad i  have been taking 24 hour clariton for alergys and when i breath i have a weeping sound and my lungs feel like bubblesi, may I answer your health queries right now",
    "doctor_response": "You may have an infection of the airways (bronchitis or bronchiolitis) that is causing these symptoms. Also, asthma can cause cough and wheezing like this too.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for backache\n\nmy mother suffering from backache  from last 2 years after she slipped at home .after many treatments with orthopedics and others also no relief fopund till now. the latest MRI report says 1) postero -lateral disc protrusion noted at L4-L5 inter vertebral level indenting the thecal sac,narrowing it with bilateral nerve roots compression.2) Mild degenerative changes noted in form of disc dessication and marginal osteophytes formation at various corners of lumbar vertebra.kindly help for relief.",
    "doctor_response": "Hello, Thanks for your query.As per your mother MRI report, You have degenerative spondylosis & disc disease in lumbar spine. Generally the overlying muscles of the vertebral column reacts to any underlying irritation or inflammation in the form of spasm preventing any movement, termed as protective muscle spasm. Intermittant moist heat fomentation of the affected regions may be of great help in reducing the muscle stiffness.Muscle relaxant medications like Tizanidine, Cyclobenzaprine can be helpful. These are to be taken after consulting a doctor.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Anxiety, chest discomfort, stiff neck, fatigue, feeling of emptiness, intrusive thoughts. Minor depression diagnosed. Advise?\n\nI have been dealing with constant anxiety for almost 2 years now. First year, my anxiety level peaked and I was scared to do things like driving, meeting friends and even talking a walk outside home. Now i can do these with ease but i have constant chest discomfort and feeling of emptiness. I get intrusive thoughts that try to not live the life the fullest. I went to see a psychiatrist he said i have minor depression but definitelt should watch out for. What can be the reasons behind constant chest discomfort, stiff neck and fatigue?",
    "doctor_response": "hi there, that is true. In many cases anxiety and depression are combined. If your psychiatrist has been diagnosed you with minor depression, talk sessions can be helpful without taking medication. The reason for feeling fatigue and stiff neck that you mentioned could be sleep problem which could accompany depression as well. Talk therapy can improve that problem as well. Chest discomfort is a sign of your anxiety as you also mentioned. Practicing more about going to the social situations can definitely help. I wish you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rheumatoid arthritis\n\nI have rheumatoid arthritis for past 12 years after the delivery of my child. I am on western medicines pednisilone, mtx and was also on ayurved treatment. My ra factor is been on increase from 130 to 250. I have deformities on fingures and feet over the period. Can u suggest and advise. Regards chitra .",
    "doctor_response": "Hello, As the RA you have been having from long I assume you have the full knowledge of the condition. As in this condition, there is inflammation of the joints and due to pain, there will be deformity of the joints. Like the one, you have in fingers. I will advise continuing medicine. Try to take medicine only when you have the pain or maximum try to avoid the pain killers as this may over long run trouble the kidneys. Also, I will advise keeping the body warm as much as possible so the pain does not increase. Taking help from a Physiotherapist who can help you to regain the muscle property by which the joint inflammation can be reduced and also the normalcy of joints is achieved. For finger deformity, we need to assess the grade of deformation if we can make it correct with the help of exercise and splints we should do it at the earliest. With medication, and Physiotherapy you should be benefited. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had dizziness, headaches, tiredness and fluid in eyes after blacking out. What is the reason?\n\nI got in an accident on thursday i didnt black out or hit my head that i know of but felt dizzy after geting out the er didnt adress the dizzyness or the sudden tyredness i felt n i noticed over the last couple days theres clear fluid in my ears i use qtips to free it every few hrs . Do i need to go to the hospital or is it normal. Ive also had a slight headache on my right front side",
    "doctor_response": "Welcome to HCM!I can say from my clinical experience that you need to see a doctor and may also require MRI brain as- there is dizziness, tiredness, head ache post trauma, which is localised; then there is clear fluid discharge from eyes, which is not having any other apparent reason.It is ok that you didn't hit your head directly, but dizziness, head ache, watering from eye ( without redness Or any other eye complain) needs to be looked into.Getting it checked will not harm you in any way, even when everything comes out to be normal!Hope the reply is useful. Further managment can be advised only after examination and scan.Feel free to ask more queriesDr.Manisha Gopal.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excessive cheek biting in an infant?\n\nHi Dr. Keerthi, I am mother of 18 months old baby girl. Like 3 months ago, one night she wake me screaming and then she started crying but soon she slept. I was not thinking that there is something wrong as this was not the first time that happened. In the morning I found 2 blood drops on her pillow and I thought it was from teething. Just 4 weeks ago the same thing happened-scream, crying and blood on the pillow. The next day she was biting her inner cheeks till blood ( as her cheeks was little swollen from the one from the one during sleep) and then crying. I was reading in the net that this sleep biting can be from sleep seizure or sleep apnea. I never witnessed any seizure or something like this because I was also sleeping when that happened. Unfortunately there is no other explanation on the net for this sleep biting. Now I am really worried. Do you really think that she is having seizures or apneas or this biting is normal in her age. I\u2019ve asked all of my friends with babies and they said that their kids never had such an episodes ever. Please also note that she is also sometimes crying while sleeping, but I think Is normal, also from time to time screaming( just for second), but I also thing is normal to happened sometimes in babies due to teething. I will be really thankful if you advice me on what can this sleep cheek biting can be from. Please advise me if I have to see a specialist as our pediatrician said that he doesn\u2019t know that seizures can cause a biting during sleep. Thank you so much for your time. I hope your prompt respond. Silvia",
    "doctor_response": "helloi think there is nothing much to worry.to rule out seizures we can get an eeg done for her and a cect head too.",
    "dialogue_context": ""
  },
  {
    "patient_message": "PCOS. Pain in right hip, groin, back radiating to knee, calf. Told it was sciatica. Opinion?\n\nHi I am 35 years old, female and have PCOS . Since June, 2011, I have had pain in my right side - lower back, hip and groin . Sometimes the pain goes down my leg to my knee or calf , sometimes in the front and sometimes in the back. When I sit too long my groin hurts but if I stand or walk too long my lower right back and hip hurt. Heating pads sometimes help. I don t know if its sciatica , bulging disks (which run inmy family but no one ever has a problem this young) or maybe an ovarian cyst? I ve mentioned it to my GP and he told me it was sciatica but didn t even look at melt do any tests. I m going back next week but I just thought I d see what another doctor would say. Thanks!",
    "doctor_response": "hello nicole.. welcome to healthcare magic.. wel from your above depicted symptoms.. itz quite clear that the pains which you are having is not due to ovarian cyst because the pains from ovarian cyst may be radiated to back , hip and groin but not upto the calf area... it wil radiated only only above the knee... and as u said bulging discs and sciatica runs in your family its quite likely that u may be having the same too.. i suggest you to go soon to a nearby orthopaedician and get it examined, on examination it wil be clear and confirmed by proper radiological investigations... till then dont lift heavy objects esp while bading forward and take rest.. i hope i solved ur query.. i wish u get well soon..:) take care..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can TB reoccur?\n\nMy dad had undergone 6 months medication for tuberculosis 4 years ago and few weeks before he got severe cough and fever. I got worried so I send him to the hospital. He did chest x ray twice . The result says that there are fibrohazed densities in the right upper lobe and hazy densities in the right lower lobe. Impressions: minimal PTB right upper lobe and pneumonia right lower lobe. His doctor prescribed a medicine for 6 month medication same as what he prescribed before but what he said is it seems that the TB occurred again. To get a free medicines we went to a local health unit but when they test his saliva, he said that he was negative on TB? What was result means? Does his disease re occur?",
    "doctor_response": "Yes TB can reoccur.However both the doctor who prescribed tuberculosis treatment without doing a sputum test and the health unit who ended up doing test of saliva are wrong.What your dad needs to do is to give a proper sputum sample and not saliva for the test. If he is bringing out some amount of sputum, then a better test to do will be GENEXPERT/RIF test for tuberculosis.If he is not bringing any sputum then u need a HRCT to confirm the lesions seen on Xray chest are new or old",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am straining to pass my feces and gas. What should I do?\n\nHello doctor,I am a 20-year-old male with a suspected fecal impaction or bowel obstruction. It feels like there is a poop or something in my rectum. I can barely pass gas, I have slight abdominal pain, and have liquid stools and diarrhea. I have had a dingleberry that has been stuck to the hairs for a while. The doctor said to take a bath, but it still has not come out yet. I do not know if I have to pass it through stools or not. I am straining to pass my feces and pass gas and my stomach feels different. I went to the doctor last week and he gave me Metamucil and align probiotic for constipation. I am worried.",
    "doctor_response": "Hello. I have reviewed your health query and can understand how worried you are regarding constipation issues. Hope this helps. Please feel free to ask more if you have queries. Regards. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicine for anxiety attacks\n\ni have anxiety attacts, and hate hate hate being around crouds of people. I don t even remember the last time I was at Walmart. I have an appointment to see a counsiler at a mental health clinic Thurs. I never get much sleep, so that its self causes me to be very nervous. What, in your opinion , would be the best medication for me.",
    "doctor_response": "Brief answer: Consult psychiatrist Detail Answer:Hi dear,for anxiety attacks there are many medication but for proper medication which is good for you decide by taking detail history and mental status examination of your is necessary.medication like paroxetine, venlaflexine, desvenlaflexine, sertraline etc has good effects on long term but for immediate result you should take benzodiazepins.there are many newer molecule are available like tofisopam, opipramol, maxgaline ER etc..consult a psychiatrist and discuss.Psychotherapy also works best in anxiety.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am being ignored by people who are emotionally close to me. What should I do?\n\nHello doctor, Of late I am feeling like an orphan. My mother is always concerned about my sister who got married last year and has an infant. I feel my sister has no time for me and my mother has forgotten me. I give a lot in a relationship but I do not get even a quarter of it in return.",
    "doctor_response": "Hi. I understand you are going through a tough time emotionally. You are very close to your mother and sister emotionally and feel let down by them. You have mentioned that your sister has an infant and your mother is spending more time with her. Probably your mother feels at this point of time your sister needs her more as this being her first child. She may need all the physical and emotional support possible. A baby does take up a lot of effort. So probably your mother and sister do not realize that they are ignoring you and your needs even if they are doing so unintentionally. I would advise you to talk to them openly about it. You can begin by how happy your are about the new addition to the family and how you would love to be involved by the family in the process. Gradually tell them how you have been feeling ignored. You never realize how open communications can really help improve relationships. Every relationship has ups and downs. I am sure you will be able to resolve issues with your mother and sister.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in left side of back,goes severe sometimes,sleep deprive. Any treatment?\n\nIn the middle of my back on my left side I have a really uncomfortable pain stopping me from sleeping. This morning I attempted to push my pain area against the corner of a wall and massage it when a shooting pain shot through the area and dropped me to my knees for a few minutes. As I twist and turn certain positions ease the pain but then all of a sudden it quite painful. Please advise me what it could be and what I should do ?thank you. Adrian",
    "doctor_response": "Apply muscle relaxant/anti-inflammatory  cream  after  hot fomentation. avoid all  bending movements and lifting heavy objects. Lie in bed in  a  posture in  most  comfortable  posture  for  2-3  days  and  gradually  return  to  mild activity",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes anxiety and panic attacks?\n\nI turned 33 today, weigh 62 kgs (slender), 1,72 height, dont drink, smoke or eat unhealthy but have been diagnosed with anxiety...i dont get panic attacks anymore but when I get these skipped heart beats it sort of triggers me to be on edge. i have had skipped/flip flop sensations in my chest that have made me anxious for the past 3years....I could go without them for 2months but this last week it has been happening at least twice a day - could it be because I have gone back to exercising(aerobics)? Most information on websites says if they are frequesnt you need to see a doc but how many times is really frequent?? Is it when it happens every hour or every 30 min or is it when the episode lasts more than a minute?",
    "doctor_response": "HiThanks for using healthcare magicAnxiety attacks could be possible any time. Sometime during night or day, sometime while watching television or talking to some one. In your case, you can try some relaxation exercise or antidepressant to control further anxiety attacks. You can also try some benzodiazepine on sos basis when you get attacks. If you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for nausea and vomiting in a child\n\nMy 12 year old son has suddenly started vomiting every so often. Today was the second time in two months. What possible things could be the problem. Today we returned from theme park rides where he had some fish and chips. He is also autistic and when he was a baby I dropped him approximately three feet. I am worried that perhaps ultimately it is linked to the drop.",
    "doctor_response": "hi If he had vomiting only after taking food means may be due to gastritis due to eating out.NO need to worry if it happens once in a while.If it is frequent everyday ,we have to find whether vomit is forceful or associated with any abdominal pain to r/o GERD/ CNS CAUSE",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for swollen and painful toe?\n\nMy husband s second toe is swollen and extremely painfull down to the base there is also two hard bumps one on the side and one on the top of the toe which has a dark circle. He has not injured it, and we could seen no indication of an insect bite though we are not sure.",
    "doctor_response": "Here I want to know is he having diabetes? As well do he have any change in sensation for feet or hand? If yes then as per your explanation looks like the circulation to the toe is affected. And he need to do test on lower limb circulation ( dopler test ) . If he does not have diabetes as well no sensory change in feet level then it may be related to block due to vessels for lower limb due to deep vein thrombosis also. Again to conform he has to do dopler test. Here I also suggest to take a test on his complete blood count and cholesterol level also to rule out the blood related things like ESR , and HB, or  cholesterol problem and if there is problem here then he can take treatment as per that.Here it could be possible he does not have any thing above and then it means either there was a insect bite or he might have got hit some whrere but he does not remember. For this he need to check with doctor again and based on physical examination there will be antibiotics with anti inflammatory and pain killer medications will be needed.Here I have given general idea on possibilities since I have not doe any physical examination but I suggest once you check with your doctor with physical examination and few test they will be able to help you more.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Allergies/sinus problems, ear pain. Taken Augmentin and antibiotic. Ear pain persists. Consult ENT?\n\nHi. I have a family history of allergies/sinus problems as well as a tendency - the past few years - to clench my teeth while sleeping. This makes me a TMJ candidate. As a consequence, when I developed an on again, off again ear pain in early June, I did not rush to the ENT. I did not seek any medicine. Last week however, I saw the dentist about a tooth on the same side as the ear pain (my lymph node was also briefly swollen under that ear ), he advised me to see an ENT to cover all bases. I was then given Augmentin for any that infection may have not been visible on the dental x-ray near the tooth (it has a crown). My ear does not feel particularly bad since I started the antibiotic. The lymph node swelling went down a few days ago after that visit and as of now my external auditory meatus feels just a bit crusty but is not particularly painful. Is it imperative that I see an ENT to determine for certain whether I have been suffering from an off again on again ear infection since June or should I wait to see how I feel after I finish the antiobiotics?",
    "doctor_response": "Hello dear,First of all, the antibiotics prescribed by your doctor is correct.Please take them as advised.However, if the symptoms still persist, it will be better to consult an ENT specialist for further evaluation & management.Investigations like complete blood count, X ray of para-nasal sinuses will be helpful in clinching the diagnosis.Treatment usually involves:1. Analgesics like paracetamol2. Antibiotics depending upon culture & sensitivity reports to remove the causative organism.3. Antihistamine preparations can also be used to provide symptomatic relief.Meanwhile...avoid taking cold food & drinks, maintain adequate hydration & take soft, non-spicy foods.Wish you good health & a speedy recovery.Thanks & take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure epilepsy with sickle and Aids cells?\n\nHi I m a patient that s has sickle cells and Aids and I m epilepsy. For the last week in a half I been having night . Sweat and bad body pain and I can t keep anything down . I m going to the bathroom alot and its very loose . And I had two epilepsy episode today. I try taking my pain pills and other med its just comes back up",
    "doctor_response": "Hello!Thank you for asking on HCM!I understand your concern and would explain that your symptoms seem to be related to an infection (probably because of AIDS). You should know that epilepsy seizures can be triggered by these conditions (infections, anemia and hemolysis, etc.). The treatment of the underlying condition can help stop the seizures. For this reason, I would recommend going to the ER for a physical exam and some tests: - a chest X Ray study - complete blood count- kidney and liver function tests - a urine analysis. - a blood bacterial culture may be needed. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for fever with headache in children\n\nI have a son that for the past 2 days has been running a temp with a severe headache and the next min sweating. If he is on Tylenol or Ibuprofen he is up and playing but as soon as the med begins to wear off he obviously is without energy. No nausea/vomiting",
    "doctor_response": "Hello. I just read through your question. Fever Aline can often cause headache. Sometimes fever with headache can be a sign of a strep throat infection. If the symptoms persist for more than 48 hours, I recommend consulting with your doctor. Then the correct diagnosis can be made and the appropriate treatment plan implemented. Until then, fever control with tylenol and/or motrin, and plenty of fluids for hydration, is all that is necessary.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sperm report shows low levels of live count, motility, rapid linear progression. High non progressive sperms. Solution?\n\nHi, i need your help, please help me to get rid of this tension .. i have been married from last 8 years and still having infertile life, no pregnency yet... my semen analysis report is as follows :- [.....Quantity.....1.0 ml , colour...greyish white , transperency .....opaque , Viscosity......viscous , pH....7.5 , Total count.....20mil/ml , live count....04 mil/ml , sperm per ejaculate....20 mil/ml , Motility .....20% , rapid linear progression .....00 % , Slow/Non-linear progression......20% , Non-Progressive.....80% ] . Please tell what is the problem actually? and what should i do ....i m in great tension",
    "doctor_response": "Hello, welcome to HCM, I am dr das, Your semen analysis report indicates low sperm count, sperm count is lower than required. Motility is also lower than normal. So you have oligospermia with low mortility .so you have to take coenzyme Q and vitaminE containing drugs and take fresh vegetables daily.consult a infertility specialist. Hope this information suffices. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Took Familon, 321 pills after periods. Had unwanted 72 twice. When will periods start?\n\nI AM RONITA.I AM 30 YEARS OLD.LAST MONTH PERIDS DATE WAS 03-01-2013 .IT HAS FINISHED ON 7-01-13.I STARTED TO TAKE FEMILON PILLS FROM 8/1/13 .AND I TAKE 321 PILLS REGULARLY ALMOST SAME TIME.IT HAS FINISHED ON 28/1/13.IN BETWEEN I HAVE TAKEN UNWANTED 72 PILL ON 7/02/13 AND 10/2/13.I HAVENT START MY PERIODS THIS MONTH.BUT THERE IS BLOOD INSIDE OF MY VAGINA .I WANT TO KNOW EHEN MY PERIODS WILL START AGAIN THIS MONTH?",
    "doctor_response": "Hi,Thanks for writing in.Taking unwanted pills has caused your delayed periods. If you were on femilon, you should have continued taking it. Unwanted 72 is an emergency high hormone dose pill and causes delayed or early periods in most women and it can persist for the next two cycles. Unwanted 72 should be taken only in emergency and within 72 hours of unprotected sex. Taking it regularly can cause cysts in ovary and irregular periods.Hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for allergy\n\ni am a regular user of cetirizine , if i stop it allergy will recover again .Now i am going to study in banglore . At the time of allergy i have asthmatic problems,skin problems,eye and nose will runing given me a solution ? i am 18 years old women,weight 40 kg,with A+ve blood group .",
    "doctor_response": "HelloAs you mentioned that you are a patient of allergy and using ceterizine tablets for this purpose.Since diagnosis is established so avoid certain predisposing factors causing allergy , these are :Dust , mite , pollen ,hay , fodder , fine dusting powder, sudden fall and rise of temperature ( change in temperature ), mold ., pests ( cockroaches ) .If possible avoid these factors.When such type of patient visit my clinic I advise them to take Monteleukast+ fexofenadine combination according to need ( whenever require). Hot coffee and steam inhalation also provide relief . Hope this information will be helpful for you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in face/finger tips after treatment for NSCLC metastasis in head?\n\nI had radiation 17 months ago in my brain. It was a NSCLC metastasis to the head. after the treatment, my left face and left fingers tip were little bit numb. I have been taking Tarceva oral tablets for the same period. recently, my left face is more number and the left fingers number , stiff and weak. I feel the numb ascend to the left elbow. The oncologist prescripted the Duloxetine. But I dont want to use the antidepressant drug. I not sure the Mecobalamin and galantamine or Neostinmine can use for my case? The MRI for my head two weeks ago conclusiont was stable . But it report that the extensive bilateral deep white matter T2 hyperintensities demonstrate mild interval progression consistent with history of radiotherapy. Plese give some advices Thank you! Linda",
    "doctor_response": "Hi ,in your case this numbness is due to radiation necrosis in the region of face and hands . I advise you to do MRS brain and steroids for short term .Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain after laproscopic procedure to correct the cyst?\n\nA month after laparoscopy procedure, my wife is suffering from pains on her lower right abdomen side, right underneath her rib cage. She describes it as a pressure pain, that coincidentally, she claims before the surgery this very same pressure pain was located lower, almost to where her appendix would be. What could be causing this pains? To give you more info: The procedure was to correct a cyst, that was missed by her gynecologist, but spotted by her gastroenterologyst, due to the fact that it was located outside her uterus.",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.The typical pains in abdomen as pressure pains, could have been due to a problem with colon or so. This is so as the pain has persisted even after removal of the cyst.I would advise you the following. CT scan of the abdomen and colonoscopy.to get to the root of the problem. Enteroclysis if required.The final diagnosis for the pressure pains will lead to a proper treatment .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why did I see blood drop after masturbating ?\n\ni masturbated last night and in the morning i woke up with blood in my briefs. i had a drop of brown blood on my brief and a big spot of bright red. i also have hemroids and i did eat hot peppers but the blood was in the front of my briefs not the back part. so where is this blood coming from ?  and why?",
    "doctor_response": "Hi,You can neglect episodic single episode of blood in semen which is called hematospermia. If blood in semen persists than seminal vesicle inflammation or prostate infection could be possible. You need to investigate with trans rectal ultrasonography and semen culture for further work up. You can revert back with reports once done.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tailbone pain.\n\nHi,I get high tailbone pain with moderate sitting or two-wheeler driving.I started observing this couple of weeks ago and this intensity is getting higher with every passing day and activity.Kindly suggest good doctor to consult in Hyderabad, India.Thank you",
    "doctor_response": "Hello, I have studied your case. Due to microtauma there may be fibrosis formation on sacrum/tail bone.Do hot fomentation over sacrum. It will take weeks to months to subside.Use ring cushion and take sitz bath [sitting in lukewarm water for 10 min]Take analgesic like nucoxia 90 once daily along with tab methylcobalamine 1500 mcg once daily consulting your doctor.If not relieved with all these methods then local injection may be required. You can take this consulting your doctor.You can search doctor near locality on our website.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of hepatitis after touching infected water?\n\nI dropped something in a public toilet and hurriedly reached in to grab it. I had a small cut on one of my fingers that was about 3 days old. The water in the toilet appeared fresh and clean and I did wash my hands a couple times afterwards. Do I have any chance of catching hepatitis or some other form of harmful bacteria or virus?",
    "doctor_response": "Hi there,Thanks for posting in HCM.There are many types of hepatitis viruses... Hep A, B, C, EAmong these Hepatitis A and E spread by contaminated water.Since you washed you hands after touching the water, it is unlikely that you would acquire hepatitis infection.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing upper abdominal pain when all tests are normal?\n\ni have been suffering right upper abdominal pain for the last 6 years.CT SCAN, ENDOSCOPY, ULTRASONOGRAHY,VARIOUS BLOOD TEST, AND HEPATO BILLIARY TEST FOUND NOTHING.NOW I AM FINDING A LITTLE HARD LIKE A PIPE THING JUST BELOW RIGT RIB CAGE. PLEASE SUGGEST.",
    "doctor_response": "HI. This may be a very small hernia in the center which is missed by all. Another possibility is costo-chondritis wherein the edema fluid tracts into the muscles of upper abdomen , again missed easily .hard-like-pipe thing is suggestive of this.Needs the investigations on this ground and a good clinical examination one can find these, if the Doctor is aware of such rare things . Can you post further information as to :::Respiratory problems?Bowel problems ?Nausea and vomiting ?",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a blister on legs and knees indicate?\n\nMy child has a blister type rash (like diaper rash) that is now spreading up her legs to her knees, as well as bad breath, and a fever of 101+. One of the kids at daycare may have hand, foot, and mouth... could this be what she has, and if so, what can I do to help her?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. It could be any viral exanthematous illness. But as you quote them as itchy blisters - the possibilities are Hand Foot Mouth disease/ Chicken pox/ any other trivial viral exanthem. I suggest you use calamine lotion as its giving results along with oral antiallergic like Hydroxyziine or Cetrizine.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the suggested treatment for psoriasis?\n\nHi my name is felicia, I have psoriasis, I ve had it since I was about 8 yrs old and I am 41 now this winter has been the worst year that I have ever had as far as new winter patches and lots of different parts of my body I ve never had it before. Also, this year my elbows and hands are particulary bad and my arms hurt, I have had surface pain associated with rawness and itching before but this is intense real pain inside. My elbows hurt so bad it brings me to tears sometimes, its hard to describe sort of throbbing and seems to vibrate down my arms, on both sides. My fingers hurt to but not as intense. Both arms are also going numb from right above my elbows to my tips of fingers to where my fingers will turn white and i have to massage blood back in there. Are these things all related is it because of my psoriasis or is there something else going on? Thank You for your time Sincerely, Felicia Bredl",
    "doctor_response": "Hi, Consult a dermatologist and get evaluated. You can try analgesics like Tramadol or Gabapentin for symptomatic relief. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for recurrent fever in children\n\nQ)my son suffering with fever from yesterday morning.my local pediatrician give crocin syrup 4ml when ever temp 102&above. after given dosage temp dropped to normal.again temp raised after 6 hours 100-102. upto now i give dosage when temp raises.this will continue upto temperature normal .otherwise i go to doctor",
    "doctor_response": "fever is not the disease its a manifestation of disease. If your baby is not improving then you should again consult your pediatrician to look for cause of fever",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing bad abdominal pains along with nausea?\n\ni drink occassionally but recently went abroard and drank none stop on a lads holiday for 4 days. Since i have been back i cant stop drinking water and am having really bad abdominal pain associated with nausea. I am a clinical coder so come accross these symptoms regularly in my job and would just like some clarification",
    "doctor_response": "Hi.Your symptoms are more suggestive of a stomach ulcers. Take PPI, antacid gels, Domperidone and so on. Soft bland diet, small frequent feeds, will help a lot. If you do not get a relief , you can undergo ultrasonography and CT scan of the abdomen.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Lycored,Rebagen,and Kenkort effective for treatment of oral submucous fibrosis?\n\nDear Sir, I was diagnosed with osmf yesterday by an oral and maxillofacial surgeon yesterday in delhi. He advised to take Lycored (twice a day)and Rebagen(thrice a day) and kenkort ointment. Will these medicines make any improvement in future and what the risk of oral cancer in this situation. However I have stopped chewing tobacco bit I smoke and drink. Plz suggest.",
    "doctor_response": "Hello, Thanks for consulting HCM, Read your query , as you are diagnosed with Oral submucous fibrosis it is a precancerous condition.I will suggest you to quit your habit of smoking and chewing tobacco completly that will good for you, as you are asking for medication prescribed by your oral surgeon yes these are the medicine given in Osmf condition take these medication regularly and keep in contact with your oral surgeon for examination and evaluation .Hope it will help you. Wishing you good health.Regards , Dr. Priyanka tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of an indentation in the arm?\n\nI have an indetion on my on my upper arm right below my shoulder. I'm experincieng, no weakness or pain, I just noticed in the past month but never really thought anything of it. It hasnt changed size either. I feel like I have a pinched nerve something going up on the same side of my shoulder and around the area.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It could be muscle atrophy, that may indicate compression of the nerve that supplies that area of the arm. Get evaluated by your primary care Doctor as the first step to understand better your condition. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from anxiety and depression. Missed periods, feels pressure in head, light headed while standing. What's wrong?\n\nI do have anxiety and depression , but I ve been fine lately, and I have missed one period last month, but I have it now.. (I m just giving facts for you to get a better understanding) I m 20. But, for some reason, my head has been feeling like pressured on both sides in the middle, and my face , mainly my cheeks feel hot. I ve felt a little light headed when standing. What s wrong?",
    "doctor_response": "Dear Madam It is not clear whether you have been diagnosed to have mixed anxiety and depression. If not then symptoms you described may be due anxiety or tension headache if you have heaviness of head or headache. If it is so find out the source such as work related stress, over burden of any kind etc. and manage accordingly such as time management, resource management etc. Also try relaxation technique, deep breathing exercise etc. If you have a diagnosis you require active treatment from qualified psychiatrist in form of medication with or without psychotherapy. Hope you will be fine soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cysts on liver discovered after CT scan. Medication?\n\ni just completed a ct scan on my liver . the GP stated that during a CT scan checking my heart for blockages or anything irregular which they found nothing. they discovered three cysts or what appeared to be cysts on my liver. i thought they ran the scan across my total body from my chest to my groin area. is this normal? and is the cysts question easily answered once i receive the results?",
    "doctor_response": "Hello Liver cysts are usually asymptomatic, and most people having them are unaware about their condition. It is found that less than 5 percent of people with hepatic cysts develop noticeable symptoms. When the cysts grows larger to about 7 cm, or if there is bleeding inside the cysts, then only they cause symptoms. Bleeding into the cysts is characterized by sudden pain in the upper right abdomen. Since liver cysts don't disturb the normal functioning of the body, there are no significant treatment methods. In case, the cysts are big enough (for example more than 3 cm), it is advisable to go for a follow-up abdominal imaging to check the growth of cysts. People go for treatment of liver cysts only after they experience discomfort symptoms that disturb their normal routine. Treatment for the same is done by aspiration and/or surgical removal of the cysts.To To conclude, no specific treatment is needed for asymptomatic liver cysts. However, one should be aware about the complications of liver cysts, such as infection, jaundice (yellowing of the skin and sclera), bleeding into cyst (causing pain) and disturbance of the flow of bile juice. If anybody suspects that he/she has liver cysts, it is recommended to consult and seek advice from a physician so as to get proper medical attention. Except for the mild discomfort cases, hepatic cysts do not pose risks for liver cancer and liver failure. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does my spine MRI result indicate?\n\nI am 29 year old/ male, an occupational health nurse working in UAE on a construction site. I was recently married and  rejoined here 2 months ago.  Suddenly one day I was having sciatica pain on the left leg for 2 days and it shifted its location to right side after 2 days and it continued for another 5 more days. I underwent an MRI as per my orthopedic doctor's advice and the report shows that i am having degenerative disc disease on the lumbar region. This is the MRI report:- MRI OF LUMBAR SPINE Indication: Low backache radiating to bilateral lower limbs (R>L) Technique: MRI of Lumbar spine was done on 1.5 Tesla Scanner in multiple planes and using multisequence technique. Patient given Soft copy of MRI study Findings: Straightening of lumbar spine noted. Marginal osteophytes noted at L3-4 level. Transitional vertebra noted (sacralization of L5). The vertebral body heights are maintained with normal marrow signal intensity pattern. Disc desiccation with posterior diffuse disc bulge and annular tear at L3-4 level mildly indenting thecal sac and moderately narrowing bilateral neural foramina. Disc desiccation with posterior diffuse disc bulge at L4-5 level minimally indenting thecal sac and narrowing bilateral neural foramina. Rest of the intervertebral disc normal. Facetal joints normal. Pedicles, laminae and spinous processes are normal. Visualized spinal cord, conus medullaris and thecal sac are normal. Both psoas muscles are normal. Both sacro-iliac joints are normal. Pre and paravertebral soft tissues are normal. Opinion: Degenerative lumbar spine disease with Disc desiccation with posterior diffuse disc bulge and annular tear at L3-4 level mildly indenting thecal sac and moderately narrowing bilateral neural foramina. Disc desiccation with posterior diffuse disc bulge at L4-5 level minimally indenting thecal sac and narrowing bilateral neural foramina. I am not on any medication because the pain was lasted only for 7 days. Now i am absolutely pain free and i am able to do anything. I am over weight and it is 112 Kg with 6'0'' height. But I would like to know more about - 1) the problem what i have..??? 2) what will be managements ..?? 3) what are things i should take in consideration to avoid further damage..??? 4) Is there any cure for the disease..??? 5) What are the things i should keep in mind before intercourse...??? 6) Will sexual intercourse make further damage to the said problem...?? Please help....",
    "doctor_response": "I read your query carefully and I understand your concern.The report indicates diffuse degenerative changes of the lumbar spine and a herniated disc at the L3-L4 level which causes narrowing of the neural foramina thus compressing the nerve roots bilaterally, data which corresponds to your symptoms.The first step in treatment is physical therapy and pain killers like Ibuprofen. If symptoms don't subside local injections with corticosteroids and anesthetics are the next step. If still no success surgery could be considered, at times even earlier if there are new signs like motor weakness, saddle-like distribution sensory changes and micturition problems which could indicate cauda equina compression.You should also avoid heavy weight lifting if that is the case in your line of work.I hope to have been of help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause band around knee with swollen foot?\n\nMy left upper leg just above the knee feels like there is a band around it squeezing and is very painful. I have been taking 600mg of Ibuprofen once a day for the last 2 days with very little relief. My foot also began to swell last pm. I do exercise daily walking at a moderate pace (3.7-4.2mph) for 4-5 miles.",
    "doctor_response": "Hello, As this can be due to knee joint internal structures inflammation and an MRI is suggested. Once we get an MRI we should be able to understand the pathology of the soft tissues inside the knee joint. Using knee brace, hot water fermentation, keeping the leg over a pillow, ankle toe movements, static hamstring, static Quadriceps, straight leg raise should help improve the knee joint stability, reduce the swelling, and improve the functions of the knee joint. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in ribs post injury\n\nI fell and hurt landed on my rib cage under my breast 3 weeks ago and the pain seemed to go away a bit and now has come back on the front and back of my chest area and it hurts when I breath and sneeze. I haven t had any medical advice as I just though I d bruised them should I go to get them x/rayed? Thanks Laura",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have pain in ribs post injury . Well there can be many reasons for symptoms you mention in query like soft tissue injury , muscle spasm or fractured rib . I would suggest you to consult orthopedic surgeon for proper examination . Doctor may order x -ray or do physical examination . Doctor may recommend complete bed rest , physical therapy , prescribe muscle relaxant , anti inflammatory along with vitamin supplement for quick recovery . For now take ibuprofen or acetaminophen for pain and apply warm compresses . Avoid lifting heavy things . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i get pregnant with irregular periods?\n\nI am 47 and would like to have another baby i already have three children 11,17 and 18.  My periods are quite irregular now sometimes i dont have one for 3/4 months but i had two quite heavy periods in April and May.  Do you think it is possible for me to fall pregnant now as i feel this is my last chance now.",
    "doctor_response": "Hi, you can get pregnant with irregular periods also. Pregnancy can happen even within 1 year of menopause . you have 3 children I hope you don't want further child  .so you should use contraception.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest possible treatment for acute hairfall\n\ni m facing acute hairfall since last 1 year. tried everything but all went in vein. i had ayurvedic shirodhara, wellknown homeopathy dr's treatment. now i am trying some alopathy medicines one of which id follihair. does it show any positive signs or i am just wasting my money? I dont want to go bald.",
    "doctor_response": "Hi,Probably you may be having telogen effluvium.. It may be due to some cause. Most common cause is psychological upsets like anxiety,worries, tension or depression. Other causes may be thyroid dysfunction, vitamin and mineral deficiencies, anaemia, other internal diseases,drugs..etc. and you have thyroid dysfunction which might be responsible in your case.And remember that normal hair fall in adult may be 100 to 150 per day. So, please avoid anxiety related with hair fall.You consult dermatologist for firm diagnosis and treatment. Blood tests may be done to rule out internal diseases.There are so many preparations in market used for such problem. But, take treatment after visiting the dermatologist.He might prescribe biotin containing tablets for long time along with vitamin E cap. And mild steroid lotion like beclomethasone lotion may be suggested for application on scalp at night. Mild herbal shampoo to cleanse the scalp and almond oil as hair oil may be used. Have patience for the result. I hope you got my answer.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cold, cold sores and dizziness\n\nhi. My seven year son has had a cold for about two wekks now and he is just getting over the chicken pox also. This morning he was saying that his head is really sore and he feel dissy. He has also been vomiting today. I have tried to give him a bit of Benedryl to try to help. but that didn't work. Should I be bringing him to a hospital?",
    "doctor_response": "HiSuch symptoms in a 7 years old child must not be treated without doctor's advice. Bring your child to a hospital as child's physiology and diseases are different from adults. Only benadryl is not going to help. He might be need it in-hospital care. Do not panic but being him to hospital. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the erectile dysfunction symptoms in a diabetic?\n\nHi doctor, This is regarding a male, 27 years. He is suffering from type 1 diabetes from the age of 5 years. He is having an erection but is unable to sustain it during the intercourse. Firstly, he is not sure if he is suffering from ED or is it just anxiety. Are there any tests to be sure of ED? Secondly, if it is diagnosed to be ED (which most probably can be), can this be cured? How will his sexual life be? If it is curable, can it be cured with natural methods or medicine or surgery? If it cannot be cured, is there an alternative for him to have a happy sexual life?",
    "doctor_response": "Hi. I have gone through your symptoms and I would like to know a few more details to answer your query better. Is he able to achieve an erection sufficient for vaginal penetration during intercourse? Is the loss of erection due to early ejaculation or happens without ejaculation?  The mechanism of erection can be tested by a penile doppler study during which the response to medication can also be tested. If he is able to achieve an erection sufficient for vaginal penetration, then the cause is more likely to be either psychological or just early ejaculation. A detailed clinical examination is also required to make sure that there are no other abnormalities that can affect full erection. At this age, the cause is most likely anxiety, but given his history of diabetes, a full evaluation is necessary to rule or other causes. The treatment is based on his most predominant concerns, though it cannot be completely cured, it can definitely be managed to get a normal sexual life.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tab Nuzeu - Skin allergy antibiotic, please suggest\n\nI require to update me on Tab Nuzeu-c antibiotic provided by a Dr Shivaswamy ( Dermatologist )",
    "doctor_response": "Thanks for the query I tried searching for Tab Nezu C but could not find out the particulars. PLease turn over the leaflet and let me know what it contains so that i can help u out and pls tell me what symptoms u went to him with it Have a healthy life",
    "dialogue_context": ""
  },
  {
    "patient_message": "Episodes of breathlessness, dizziness, flashes, nausea, heart pain towards the end of the day. Cause and cure?\n\nhello my names ohlivia and i always feel mostly tworads the end of the day that i can t breath and i get dizzy, the room flashes in and out, i feel like i m going to puke , i get really light headed and my heart feels like it s being squeezed and it hurts. it s been getting stronger lately and i actually had to go to the nurses office and lay down and even then when i tried to slow my breathing and rest it pounded and i got hot like i always do during these attacks but worse i m scared that something worse will happen and this time and i won t wake up. i tried to tell my family but they just laughed. i told them it was because of stress and i tried to explain the pain and that i ve been going through it for years, actually like 3 years after my father left me. one time i had an attack in school and got my friends worried sick. please helpha me",
    "doctor_response": "Hello......... Thanks for your query. What you describe are suggestive of anxiety attacks. What i would suggest you is to undergo an ECG to rule out cardiac pathology. If normal, you would require a thorough psychiatric evaluation followed by anti-anxiety agents and psychotherapy. Yoga/meditation/breathing relaxation exercises are recommended. Hope you found the information useful. Regards Dr Sundar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could Benefiber cause pain & nausea in sternum ?\n\nFor the past week or so I have been experiencing gnawing pain in sternum with waves of nausea. I have been under some real stress latel and the only thing different in my diet is benefiber. 2 teaspoons twice a day. Could the benefiber be causing this. Any help would be greatly appreciatedAnnamaria",
    "doctor_response": "Hello Thank you for trusting HCM Dear benfiber won't cause your symptoms until unless you developed allergy to that product. Also possibility of your suffering from GERD gives same problems with nausea feeling. It may be costocondritis also. So just stop and see if your symptoms improved OK otherwise take tab. Pantaprazole before breakfast, avoid spicy food. If symptoms not improved consult your doctor immediately.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal and throat pain\n\nHi, I have been unwell for some time now and my primary symptoms are; constant phelgm needing to be cleared from back of throat which is worse after lying down for lying periods. I get abdominal pains after lying down for long periods such as at night. I get left leg pain from buttocks to knee when sitting down and have an alomost constant nausea feeling which again seems to worsen after lying down. Also from time to time get left chest pains. Regards.",
    "doctor_response": "Hi. Thanks for your query.Your history is full of unrelated symptoms.TO elucidate: you have pain in the throat, constant phlegm needing to be cleared, which is worst after lying down. This indicates that you may have sinusitis so that on lying down position the secretions of the sinuses travel down to the throat to cause the problems you have. Your abdominal pains too start on lying down as well as you have left leg pain from buttock to the knee increasing in lying down position. Both the things together suggest that there may be a problem with the intervertebral discs compressing on the cord. I would advise you the following.:MRI of the spine.Contrast enhanced CT scan of the abdomen, with angioigraphy if required. Diagnostic Laparoscopy if required.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes unusually persistent lower back pain that increases gradually?\n\nwhat could be the cause of lower back pain that seemed to come on gradually with no apparent cause and is now persistent; some days better than others and sometimes seems some supplements makes it worse (such as glucosamine which I have since quite taking and while it has helped the pain hasn t gone away).",
    "doctor_response": "Hello, What\u2019s your age? How long have been experiencing this pain? Did you have any injury? Please give me a detailed history so that I can help you out. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sarishkw, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the ways to cure pain in eye with mild pressure?\n\nHello doctor, I have eye pain in left side eye, minor or weird feel in the left side or have mild pressure on side of the eye. It is nearly there for the past four days. It is very awkward. Please help. Is it a sign of concern or anything else?",
    "doctor_response": "Hi. There are different causes of mild pain in the eye. It may be due to some foreign body or decrease to increased intraocular pressure in the eye. Some times people with sinusitis feel heaviness in the back of the eye. As your vision is same there is no emergency but if the pain is persistent or worsening you should consult an eye specialist for a complete eye exam to diagnose the exact cause of pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain with fatigue and dizziness?\n\nHi... Oct 24th 2013, I was admitted to hospital with a fish bone... which resulted in going to surgery to have it removed from the back of my throat ... I was home three hours after the operation but over the next few days suffered shortness of breath, and a cough.. resulting in having to sleep sitting up.  I attended my GP who sent me for a chest xray on 22nd Nov and this was compared to the one taken on Oct 24th..  Results on this was inconclusive so I've been sent for a CT scan... I continue to suffer from chest pains from front to back, shortness of breath and tiredness.  (I note that acid reflux has been mentioned as I find that I can't drink even a glass of wine or eat anything after 6pm without feeling unwell in the morning)... Today I got up at 8.30am  have been busy until 12.30 - have chest pains... extreme tiredness and am dizzy.  Would appreciate your thoughts on all written please?",
    "doctor_response": "What does the CT scan report say. Your could have had a aspiration/obstructive pneumonia following fish bone getting stuck in your airways. May be some residual abnormality is still persisting. You need a complete check up so consult your PCP.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need treatment for lump between the scrotum and anus.\n\nHello Drs. I have a lump between my scrotum and anus which i think is filled with fluid. Sometimes that fluid passes slightly through the nearby opening of the anus. There is no pain much normally, by if I touch / press I feel slight pain. And the fluid has some blood traces in it. And i feel the lump is brushes when i walk more and this irritates that I feel discomfort.Please help me in this situation.",
    "doctor_response": "Hi. If this is of a short duration , it is an abscess , get this operated by a surgeon with an antibiotic cover and you will be alright. But if this i long standing and recurrent - this is a fistula-in-ano... Needs an investigation to see if it is high or low- this decides the treatment module. Consult a Proctologist or gastro surgeon for a proper diagnosis and correct treatment. Please keep us posted the results of fistulogram/",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the sperm count in my semen analysis test indicate?\n\nhi Dr. I need your help to know that we are planning to have baby for last six months but did not get success.so Dr prescribed Semen analysis for me And the results are likeMacroscopy:   Quantity                    3.5 ml                       Viscosity                   Less viscous                        Colour                      Normal                        pH                            8.0                        Liquefaction time      30 minutesMicroscopy:     Sperm Count            4.5 millions/ml                        Motility   ;                                  Active             25%                                 sluggish          10%                                 Nonmotile        65%              Abnormal forms                  About 30%              Pus Cells                             2-4/HPF              Others                                 ----Please tell me about this report what does it mean",
    "doctor_response": "Hi,I have gone through your query.You semen analysis report is abnormal. Sperm count is very low along with less number of active sperms. This is the cause of infertility. You need to visit infertility expert for proper treatment.Hope i answered your query.You can contact me on my page  you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes knuckle puffiness with stinging?\n\nDominant hand center knuckle is puffy and stings. Is painful when touched. No open wound. Began a year ago. Have taken naproxin for a month with little change. Feels warm to the touch in the center. Any ideas of what to do next? Have been tested for gout and that was ruled out. Also, hand has been x-rayed and arthritis has been ruled out as well.",
    "doctor_response": "hiI think local infilteration with injection hydrocortisone or depomedrol may be tried.this may helpsubside non-specific inflammatory swelling of the knucklebest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain and diarrhea\n\nI am 27 weeks and 4 days pregnant today and have been constipated for about 4 days. Then tonight I had really bad tightening of the stomach and kept burping then pains in my stomach got really bad then I had terrible diarihia. I'm really worried whats happening please help",
    "doctor_response": "Hello dear,The symptoms as mentioned in your post is attributed to accumulation of gas in the stomach.The presence of constipation and the pregnant uterus pressing over the bowels has an additive effect over this.Under such circumstances, you need to regularize your bowel movements first.Symptomatic relief can be obtained with intake of Pantoprazole preparation (to be taken twice a day before meals) & antacid gel (to be taken after meals).They prevent formation of excess acid in the stomach & provide symptomatic relief.And it is also needed that you take certain precautions regarding your diet & lifestyle, such as:1. Take soft, plain, non-spicy foods.2. Drink lots of water to maintain adequate hydration.3. Avoid fast foods, carbonated drinks & gas producing food products like cabbage, etc.4. Avoid smoking & alcohol.5. Keep away stress, think positive.If symptoms still persist, kindly consult a Gastroenterologist for proper clinical examination.There is no need to worry, you will be fine.Wishing a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful lump on the hand\n\nOne yr ago a had a large cyst on the back of my left hand. It gradually got bigger with progressive pain. One day a had my husband smack the cyst with a large hardback book...the cyst went away. One yr later I am having moderate hand pain in both hands...more so in left hand.",
    "doctor_response": "Hi,Dear,Thanks for the query to HCM.I studied your problem in depth and I understood your concerns.Treatment for the painful lump on the hand-In my opinion you should not be concerned much as it would resolve on its own with the time , but should investigate it with your ER Ortho-Surgeon,who would treat it according to its cause.From your facts of the query-In my opinion-this lump seems to be due to the post-traumatic tissue damage of the Ganglion which arises from the joints of the back of the hand.Occurrence of the pain in other hand after a year -may be due to the systemic cause which your ER-Ortho-Surgeon would investigate and treat accordingly.So take treatment from your ER Ortho-Surgeon, who would treat it after due investigations and treat it  accordingly.This advise is based on the facts from the history you give and needs further clinical check.Hence I would advise you to check with ER Ortho- Surgeon.So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you.Hope this would relieve your problem.Welcome for any more query in this regard to HCM.Write good resume and Click thanks if you feel satisfied with my advise.Have a Good Day.Dr.Savaskar M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Growing molars, pain in gums. Abscess on hard palate. Infection?\n\nHi there,my two upper third molars have been growing and i felt pain on the whole stretch of gum and perhaps affecting my right lateral incisor.It has been 10 days since i ignored the tingling pain on my right lateral incisor and gum thinking it to be normal wisdom tooth growth.However,yesterday,there has been an abscess on my hard palate and on my own inspection there was slight cavity.Could it possibly be an infection needing root canal treatment? Is there any cure to soothe the abscess without extraction? Please advise.",
    "doctor_response": "Hello ; Thanx for asking  the question, Every infection can not be treated with root canal . in your case your wisdom teeth is erupted if it is tilted in any side then you go for the extraction of wisdom teeth .for the abscess you meet your dentist and derange it as soon as possible and take proper antibiotics .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a skin infection\n\nHello, Three days ago I woke up and found this single red welt on my right inner thigh close to my crotch. I didn t think it was dangerous so I shrugged it off. I wore a pair of shorts that day. The next day I found small little blisters on the welt now, a small line of blisters on the left side of the welt and a few medium sized blisters on the right side. It didn t hurt and I asked my grandmother what I should do, she suggested to put Vaseline on the welt and blisters becuase she believed it was just a rash, so I did. Today the welt was now painful to me, the welt was very tender and the blisters now hurt to even touch that had this stinging feeling. I tried Neosporin on it and covered it we a bandaid, thinking it would get better after that. I avoided wearing shorts that day. Hours later, the welt disappear where the area was not red, however the area was still tender. The blisters just stung even more and walking hurt too much because everytime I moved my right leg I would feel this stinging pain from the blisters. Also, if this bit information helps: I have a bit of a sore throat. I really want to know what is going on and I m worried it might be something really serious. I want to know if I should consult my doctor or dermotologist about the situation. If I do not have to go to a clinic or hospital, what kind of steps should I take to treat this? Please help.",
    "doctor_response": "Hi,You seem to suffer from pyoderma. It is skin infection caused by bacteria. You consult dermatologist immediately for perfect diagnosis and proper treatment. I would recommend you to take a course of antibiotics and antiinflammatory drugs. Apply antibiotic cream. Take bath in dettol mixed water. Improve hygiene and immunity. Sore throat may be infection in throat. ... may be due to poor immunity. Consult the physician and get investigated thoroughly to reach to the perfect diagnosis and then to get perfect treatment.Hope this helps.Thanks.Dr.Ilyas Patel,Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdomen to Testicle pain,ciprotab 500mg. Treatment?\n\nI have been having pains in my abdomen 2 my testicle n it now has a lump on one of the testicles after seeing a doctor n placed on ciprotab 500 for ten days.I'm still get pains in my abdomen always getting the urge to pee and lump on my testicle has not gone.please can I get help out of this thank you very much 4 your consideration",
    "doctor_response": "Welcome to HCMGreetings of the dayYou seem to be suffering from Epididymo-orchitis. Get Ultrasound of Testis and abdomen done which will tell about size and pathology of testis. Get Urine routine and culture done. Get back with the results.Take CareRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for a protruding bump on the knee\n\nA few weeks ago, after a busy night at work when I had to constantly get down on one knee to get beers out of the lowest part of the fridge (I bar tend for work) I noticed a protruding bump on my left knee that slightly hurt at the time but not much. A co-worker of mine who plays soccer alot said they thought it was a broken blood vessel and it happens to them all the time and would heal in a couple weeks... Its been about a month and still hasnt healed. Its now causing pain when I try to do exercises on my knees. What do you think it is and how can I heal it? would pressure help, like wrapping it? I'm 5'9\" 26yr old female, 170lb",
    "doctor_response": "Hi! thanks for considering us for your health problem!After going through your problem of a protruding almost painless lump on the knee, I would like to consider following possibilities first before going to the treatment part concerned:1. organised hematoma possibility 80%2. benign cystic conditions like bursa, ganglion cyst, synovitis, synovial herniation, patellar dislocation, synovial effusion etc , possibility 15%3. benign solid tumor or tumor-like conditions or organised abscess, possibility 5%Therefore, it is benign.It is inflammatory.It needs antibiotics and possibly surgical drainage!It should be treated by a general or orthopedic surgeon; and before that, you better confirm the diagnosis by ultrasonography and needle biopsy as advised by your doctor.Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain during ejaculation, discomfort. Any ideas?\n\nFor about 3 weeks I have like a dull pain during ejaculation that comes from lower right abdomen just go the left of my hip bone . It feels like a contraction of sorts that mirrors the ejaculation and stays dull and achy for about a day. Not unbearable, just kind of annoying. It seems like it contracts with me. Any ideas?",
    "doctor_response": "Hello,It may be a case of muscle spasm which is aggravated by sexual act.Rest and analgesic with help to releave the pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Irregular periods after taking plan b one step. Is it the side effects of medicine?\n\nMy question regards Plan B OneStep and irregular menstruation . My last period before taking Plan B OneStep began April 27. I took Plan B on May 14. I went through another seemingly normal period (all normal but for the early timing) which ended around May 24-25. I started bleeding again on June 7. This time the bleeding is much lighter and thinner, almost as if I didn t have enough lining to shed. Everything about this third period seems highly irregular; is this cause for concern or just a lingering effect of Plan B?",
    "doctor_response": "Hello mam, thanks for trusting health care magic.In my opinion do a urine pregnancy test which if negative get a pelvic ultrasonography done to see for ovarian volume and endometrial thickness.Most probably there is nothing to worry and this irregularity is just due to plan B which contains progesterone but still we should not take it lightly. Take care and wish you all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cortox of kidney hyper echoic, cortico medullory differentiation not well appreciated. Level of kidney damage?\n\nMy aunts Sonography report reads as follows : Cortex of both the kidneys Hyper echoic. Cortico Medullory Differentiation not well appreciated. Suggestive of a Medical Renal Disease. Serum Creatinine is 3.46 mgm%, Serum Urea is 69 mgm%, Hb is 11.8gms% and ESR 22 mm/hr. Other CBC parameters look normal as indicated in the report. What does the level of Kidney Damage does this suggest.",
    "doctor_response": "Increase in echo texture, raised renal parameters like creatinine 3.46 nd anaemic , it could be in early stage ofckd...definte staging can be done by the size nd gfr calculation...so it wud hav been better I f u ve provided other parameters like age nd weight and kidney size...thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What could this line going down my tooth be?\n\nHello doctor,I have a line going down my tooth that can only be seen under direct light. It looks a bit like a crack. I cannot feel it when I run my finger or tongue over it. Should I be worried?",
    "doctor_response": "Hello. The line which you have mentioned can be a fracture line which is sometimes very superficial. I would like to know about any pain or sensitivity associated with the tooth. If it is a deep fracture, it is generally painful and sensitive. On the other hand, if it is a fracture line, it can be caused by various hard foods. In case you have any associated symptoms, you can visit a dentist. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Flank pain after waking up, eases with body movements and urination, CT shows kidney stones. Possible diagnosis?\n\nHi. I m a 33 year old female w/ history of kidney stones , recurrent uti, and ovarian cysts . I am current on cipro, sprintec, naproxen and hydrocone. Symptoms that I have been having are flank pain( lt side radiating around to my abdomen, abdominal pain, HA, waking in severe pain after several hours of sleep w/ muscle ridgity, this pain will go away after movement of body and urination, extreme fatigue, body aches, decreased appetite, itching, depression and some anxiety. CBC, and u/a are normal , Abd ct shows only kidney stones. I feel better on the cipro but once it is stopped my symptoms continue. I know that something is wrong, either with my kidneys or possibly and adrenal gland issue... My main complain is the waking in severe pain with inability to move. I am scheduled to see an internist soon but I was hoping you could maybe shed some light on what may be going on or possible diagnoses I could have him check for.",
    "doctor_response": "You are having a persistant urinary tract infection which is not getting fully cured because of the stones and possible obstruction.You can get a urine culture and sensitivity done and will need a longer course of antibiotic like a single night time dose of ciprofloxacin 500 mg for 2-3 wks or a month.Also if the stones are causing any obstruction in the urinary tract, they may need to be removed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a person suffering from wheezing visit Kerala during the month of April ?\n\nDear Sir, My daughter has wheezing problem. She is 3 yrs old, and started use inhaler-Budecort. Is it safe for us to travel to Wayanad-Kerala district during the month of April. Kindly advice.",
    "doctor_response": "Yes u can surely travel. Just carry Inhaler Levosalbutamol and Babymask for emergency situations.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can panic attacks be treated?\n\nI just started a job hosting at a small ihop restaurant. when the store is busy and packed full of people i panic. all the people around me and having to hug corners to keep from runnin into someone freaks me out. when i panic everyone can see it on my face. if i dont get it together i may get fired. what should i do??",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. What I can opine is you are not actually panicking. You are just too apprehensive. Everyone do so. When they see an uphill task in front of them. So nothing to worry. In the wake of panic, you are not running away.. are you? Just enjoy and forget about panic.If you require more of my help in this aspect, Please post a direct question to me in this URL.  Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What caused heart palpitation making me sweat and shiver?\n\nHello Doctor my name is nagakumar i had some problem with my heart beat i.e., my heart suddenly starts beating fast and starts sweating from the body and it will reduces after some time and in that time my body will start shaking so can you please tell me why it happening like that",
    "doctor_response": "The so called heart palpitation with sweat and shiver is likely to be due to simply anxiety. It may be panic disorder also, correct diagnosis is essential to decide further treatment or no treatment. Also check for any fever. I hope this information is helpful to you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can implantation cause cramps?\n\nHello, I had my period starting on April 27th and had an IUI on my ovulation day May 6th with no medication since my husband is the one going through chemo. I had a polyp remove April 12 and my fallopian tubes were checked and okay d the week before IUI. I had cramps today for about an hour and half but period isn t due til the 27th. I ve been taking pregnancy tests everyday(since i m anxious) and they are all negative. Is there still a chance I m pregnant? Could the cramps today be implantation? This is my first time for this so I don t know what to think or do. Please help :(",
    "doctor_response": "Hi,I have understood your concern. I will suggest you the best possible treatment options. 1) First of all do not panic. 2) As per your history, you had IUI on 6th of May, if ovulation day was the same then I will suggest you to wait till 20th of May. Please do not perform urine pregnancy test at least till 24th of May.  It will be non conclusive before that date.3) Secondly, cramping pain within 48  hours after iui can be related to the procedure. Later on, it can be due to some kind of digestive system issue like indigestion or gaseous distension. Please seek prescription support from your treating doctor for getting anti emetics and anti spasmodic medicines. 4 ) I usually suggest to my patients to opt for a healthy diet and regular exercise regimen. Start with Folic acid, Vitamin B 12 and Omega 3 supplements at least 3 months before  planning to get pregnant. This helps to prevent many problems during pregnancy and delivery. Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Purushottam Neurgaonkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will taking I-pills affect future pregnancy?\n\ndear doctor , my wife used 4 times ipill tablet when she was in studying.now she completed study. that time she used i pill tab. sir my question is will ipll is affect in pregnancy. please tell me what is solution .. thank you.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As per your history,  no, it will affect your future preganacy. as I pill effect is temporary, so it will not any difficuity to conceive and pregnancy. You can use it as per your convinience, along with that you can use extra protection like condoms etc. Take care. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a swollen leg despite compression socks usage for a charley horse?\n\nA week and a half ago I had a really bad Charlie horse. My leg swelled and hurt so I went to the ER and I was checked for blood clots in my Left leg. There was no blood clot. The said it was a bakers cyst. My calf hurts going up and down steps it is still swollen. I have been wearing compression socks hoping it would help but when I take off the sock my leg swells and the pain set in. It burns in the lower calf. I don t know what to do any more. I tried stretching and icing Andy advill and Aleve. I have to limp to walk.",
    "doctor_response": "hiLeg wedges, specially designed cushions placed under the legs to elevate your feet while sleeping.Compression socks, hosiery, or calf sleeves, which provide graduated compression that helps reduce swelling. Graduated compression means that the hosiery is tightest around the areas of your worst swelling (usually your feet or lower leg). While comfortable to wear, the hosiery helps relieve discomfort from swelling.Low-impact exercise, which helps with circulation and can alleviate swelling. This may include walking, yoga, or light aerobics.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump in the stomach\n\nHi about two days ago I began to see a lump/bump on the bottom of my stomach like on the top of where my vaginal area starts. Now it is hard, extremely red, swollen, and I can't even touch it because it hurts so badly. I tried using a hot rag to reduce swelling but it just hurt. I also tried popping it but it hurts so much just too even poke it. I would like to know what this lump or bump is and what to do and how to get rid of it. Can you help me?",
    "doctor_response": "Welcome to Health care magic.1.The history suggest that it could be inguinal hernia - which is seen as a lump in the lower abdomen and pain on touch.2.Inguinal hernia with a strangulated bowel or omentu-fat will cause the above symptoms.3.This is an emergency - you need to get an emergency ultrasound - that will help to know the nature of the lump, its contents and source and where all its extending. 4.It will also confirm the presence of any strangulation. and blood supply. 5.Seek emergency help as soon as possible - it can complicate if you delay. Good luck.Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Medication for dizziness with pressure in the chest?\n\nHi, Im a healthy 40 yr old, non-smoker, runner. I take my BCP continual and had my period Dec 2013. early Jan 2014, had over 2 wks of very heavy bleeding & clumps. Along with this at times: light headed, dizzy, headaches and felt like someone was on my chest. Went to OBgyn, blood tests came back positive, ultrasound showed only fibroid but not big enough to create problems. Heavy bleeding stopped but have bleeding or slight bleeding every so often. head hurts at times, chest pressure continues, dizzy feeling. Last weekend had my BP checked and was high for me 148/90. im typically 110-120/60-70. i started having deep pressure focused in the left central part of my chest where it stopped me w what i was doing. I started getting tingling down my right arm to my finger. The pain in chest & tingling woke me up one night and next day much stronger. dizzy, feeling of out of it is more constant. Dr had me go to ER. BP 177/98, 148/86... chest xray clear. saw a cardiologist & he doesnt think any issues with heart. i have echo & stress test scheduled b/c i have bad family history with heart conditions. he mentioned gall bladder? Anythign else to consider?",
    "doctor_response": "Hello,As per my clinical experience, this narrates systemic manifestations from low hemoglobin due to a loss in the menses. Correction of the hemoglobin level with medicines and diet with high iron will support great. Additionally salt-restricted diet and meditations, yoga will keep blood pressure under desirable levels.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling bloated, tired and sad. Had taken morning after pill. Concerned\n\nHello, I'm hoping you can help clarify if what I'm experiencing us a side effect or something else-I finished my period around the 22nd march. I had taken the morning after pill in that month, around the 9th, abd then again on the 25th.  on the 28th-30th I had a long international flight and a very stressful experience. Not long after, on the 2nd April I got my period again and it is still here 9 days later. It is normal to experience this and if it doesn't stop how much longer should I wait before seeing a doctor? In general I am otherwise bloated, tired and a bit sad. I'm normally very positive and energetic. Thank you",
    "doctor_response": "Hellothanks for your query.The emergency contraceptive pill does tend to alter the pattern of your normal menstrual cycles.However, you should visit a gynecologist to rule out other conditions such as uterine fibroids, polyps, cysts etc.Have protected sex in future, and try to avoid emergency contraceptives.All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should Cefolac and Zinconia be continued?\n\nHi, My doctor has advised cefolac 100 for 5 days and zinconia for 14 day for my 11 months old as he had cold and diarrhea for last 2 days.. I have been giving this.. But is there any harm? Now wen I research o see it as antibiotics.. Before giving I had given tminic for 3 days..",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Cefolac can be given for 5 to 10 days as a complete course. Zinconia is given for 14 days for diarrhea. If given for prescribed period, they cause no harm. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high blood pressure in a child?\n\nMy 13 year old son went to get a physical today and was told his blood pressure 124/84 he weighs 101lbs ht 62inches pulse rate 66 and he is a very active person drinks lots of water doesn t drink much soda but alot of powerade and Gatorade and water what could be causing this and could it be just a onetime thing?",
    "doctor_response": "No one should reach a diagnosis of hypertension on a one-off measurement of the blood pressure. Please do not worry for now. Check his BP with the same physician using the same instrument after proper relaxation in the same position (sleeping/sitting/standing) on THREE separate occasions on THREE DIFFERENT DAYS at the same time of the day. If this reading is seen on all three occasions, you will need to consult a medical specialist for further guidance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to relieve chronic back pain\n\nI was wondering i was on Suboxone for 4 months before that I was taking 7.5 lortabs, I was wondering because I've done some research Suboxone isn't good or any help. I have cronic lower back pain and I was wondering if I could get my pain medication back? And why I went to a subonone clinc was because there was and accident in my family where my aunt got shot in the face. But I wasn't \" abusing \" loratabs I wanted to save myself. But I can't bare the pain no more! Help! Please thank you.",
    "doctor_response": "Hello,Thank you for writing to us,Back Pain should be depend on history of patient as its due to jerk or something similar.Here as you described i would like to suggest you for medical check up.Because back pain should relieve in maximum six months if not damaged internally parts and just because of jerk.for first you should have to do Rest -Leave all your work and just take rest, it may help to roots to begin to heal, which in turn will help relieve back pain.If not works you must have to concern doctor for the same without wait.Hope you'll find it out helpful.Thanks & Regards,Dr. Gaurav Prajapati",
    "dialogue_context": ""
  },
  {
    "patient_message": "Became unconscious after taking hot water bath, diagnosed Hot water epilepsy. Taking Levepil. Any problems if I stop taking the pill ?\n\nHi,I am 28 year old female. Became unconscious for 2 hours after taking hot water bath. Using Gas geyser with no proper ventilation. Doctor diagnosed as Hot water epilepsy and on medication of Levepil 500MG(Daily 2 times)MRI report normal. EEG report showed slight abnormalities.Consulted another doctor and advised as it could be because of Gas geyser emitting carbon-monoxide consumption also and asked to stop Levepil for a month by just avoiding geyser hot water bath.So far I have taken 2 500MG Levepil tablets.Is there any problem/complications if I stop taking Leviepil now? And wait for 1 month by avoiding hot water head bath.?Please advise.",
    "doctor_response": "hi Carbon monoxide (CO) poisoning is responsible for up to 40,000 emergency department visits and 5000 to 6000 deaths per year, making it one of the leading causes of poisoning death in the United States. Inadvertent CO poisoning likely causes around 500 deaths annually; the number of intentional CO poisonings is perhaps 10 times higher . The overall case-fatality rate for CO poisoning ranges from 0 to 31 percent . Unlike intentional poisoning, unintended poisoning demonstrates both seasonal and regional variation, and it is most common during the winter months in cold climates [5]. Morbidity, which is primarily related to late neurocognitive impairment, persists beyond initial stabilization in up to 40 percent of victims. Smoke inhalation is responsible for most inadvertent cases of CO poisoning. Other potential sources on, improperly vented fuel-burning devices (eg, kerosene heaters, charcoal grills, camping stoves [8], gasoline-powered electrical generators [9]), and motor vehicles operating in poorly ventilated areas (eg, ice rinks, warehouses, parking garages). CO poisonings following open air exposure to motorboat exhaust have also been reported [10]. In addition, underground electrical cable fires produce large amounts of CO, which can seep into adjacent buildings and homes [11]. An increase in carbon monoxide exposures has been reported to occur in the immediate aftermath of hurricanes [9,12,13]. advice plz shift your gas heater outside your washroom and there is no term like hot water epilepsy..carbonmonooxide does causes late neurological disturbance..but they ususally reside month or so...no use of taking levicitream.... take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain in right abdomen?\n\nOften when I exercise I get a sharp pain in my right abdomen, then my mouth starts watering like crazy and sometimes I vomit. I am 34 and somewhat healthy. I am taking Paxil and have had kidney stones and ovarian cysts in the past. Help, I am desperate to finish a run. Thank you.",
    "doctor_response": "Hi. Thanks for your query. After reading your history carefully I can suggest the following:Pain in right side of the abdomen on exercises is a definite symptom of an organic lesion in the right side of the abdomen. Twisting of the ovarian cyst can be the most probable reason as you have it. Kidney stones are not known to such pains.The watering of the mouth and vomiting is a reflex mechanism of pain in abdomen , whatever the reason may be. I would advise you to undergo review ultrasonography ./ CT scan and to get the surgical treatment undertaken if you need a permanent cure and finish the rum. Do not try medicines for a surgical problem, as may cause more complications .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and numbness on the hands and legs with asthma?\n\nHi,I have asthma and have been using symbicort twice a day, It works most of the time, but sometimes if i wait to take it or its a really muggy day I get dizzy, or my hands with go a bit numb. Rarely but occasionally ill get tingles in the side of my face like the feeling when your leg falls asleep. Is this normal? is it just a lack of oxygen?",
    "doctor_response": "Hi, thank you for posting!I have gone through your query and I understand your concerns.According to your symptoms, I think that they are cause by lack of oxygen in brain (cerebral hypoxia) and anxiety which accompanies this condition.You can treat your condition by taking anxielitical drugs and chiropractic procedure may also be effective.Consult your allergologist to discuss more about the treatment.Hope I helped.Take care,Dr. Behar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump on the thigh\n\nI have a golf ball sized lump where my leg meets my buttock, then a cluster of small ones on the other side. The smaller ones don t come out to the skin as much as the large. They have been there about a week, but don t hurt except the large one which is getting tender. Any idea what this is?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have enlarged inguinal lymphnode due to reactive hyperplasia, tuberculosis, lymphoma or metastatic carcinoma. Or you may have some soft tissue tumor. Uou should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Night splints, CTs syndrome. Can't sleep. What can help neck?\n\nHai! My name is Raul from Puerto Rico I was operated 3 years ago because my hand nerves were pinch. The main problem was with neck and shoulders so I got operated. Everything went well until now2012. I never had Cts syndrome , now I have to use night cock-up splints and it is a misery to go to sleep. I feel depress because I FEEL WORSE! I go to Quiropractic, psisiatra, and nothing works. I still have the same pain in the neck. Now I am using small amounts of percocet , Cataflam etc. Results negative. I don t like the way I am living! If you can help me in some advise I will apreciate your kindness. Thank you your friend Raul Rivera Ruiz PO BOX CIDRA PUERTO RICO 0000 Tel. 0000 8350 E-mail YYYY@YYYY ............",
    "doctor_response": "hi Raul..its understandable that CTS is painful condition..still you can consult with your orthopaedician for the next plan of management..these days pain clinics are available at hands where they try different things like nerve blocks and also certain medication..so don't give up..wishing you a speedy recovery",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain and high fever\n\nSir My daughter is 1 years & 7 months old and since the last 2 days she is having severe stomach ache/abdominal pain with High Fever irregular & constipated stool (No Vomiting & Diaorhea). Her atppetite has gone down considerably. Some other key changes observed are: 1#. Suddenly she has taken aversion to Water, be it to drink or to wash/sponge body;whereas earlier we had to try real hard to get her out of the Bathroom 2#. Give her anything that she normally likes/loves and she throws it down. 3#. Her Head is very hot compared to entire body. Please suggest",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query your daughter is suffering from  abdominal pain and high fever which seems to be due to viral infection and due to lack of fibres in diet leading to electrolyte imbalance in body. Need not to worry. I would suggest you to visit pediatrician once and get it examined. You should get blood tests done and start treatment after proper diagnosis. Take diet rich in fresh juices and fruits. You should give your daughter complete test. Drink plenty of water and fluids. You should take anti-allergic medication along with proper course of antiviral along with Ibuprofen. Do tepid sponging as well to lower down fever. Avoid intake of outside food and avoid sharp and spicy food substances.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Head injury, speech affected, stuttering, headaches, neck pain, off balance. Post concussive syndrome. On xanax. Suggestion\n\nI am being treated by work comp DR for head hit with ball at my school I work at. My speech was affected, not stuttering any more, but when the xanax they prescribed wears off,(.5 every 4 hours) I can tell my speech start to change. They they are not responsible for the speech. I have many other sumptoms, until; tehy found out it was from ball.Horrible headaches and neck pain, Short term memory loss, I walk funny, balance off, agitation from ANY emotion, can't cry, I can't stomach meat or wine like I used to, for get things when before I was sharp as a tack. Loma Linda diagnose Post concussive syndrome. I went to ER 3 days after hit with ball. Not hink ball, think stroke because of slurring and stuttering. Wouldn't that be a pysical symptom>> Dr tell me it is anxiety I felt from getting hit in the head with ball, but I say that's not true. My speech still affected since March 7th. I say it a physical symptom. What are your thoughts?",
    "doctor_response": "Hi,These symptoms can go with head injury you had earlier.Need to rule out seizure phenomenon in view of episodic, short term memory loss, headahes and neck pains, require EEG to rule out underlying seizure phenomenon.Repeat MRI brain with diffusion weight sequences to rule out fresh lesionsConsult neurologist/neurosurgeon for further plan of management",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could I get pregnant a few months after an abortion?\n\nHi! I think I'm pregnant since I'm 3 days late. However, my pregnancy test (I used Quick Stick) showed negative results. I took 2 tests before my first missed period day and 1 more test yesterday morning. All negative. I have a 8 month daughter. I had an abortion 3 months ago. My last period started on Jan.20.I'm not ready to have another baby right now.What should I do?Thanks,T",
    "doctor_response": "Hello, I would be happy to help you with your question.In the setting of a negative pregnancy test at the time of a missed period, the chance of pregnancy remains very small.  It is also possible that the test was just done too early based on some minor irregularity in terms of when you ovulated.  Here is what you should do:1.  Recheck the pregnancy test one week after the missed period2.  If the test remains negative, then talk to your doctor about progesterone to induce a period3.  Then get on a birth control I hope that this helps and good luck!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for breathlessness\n\nI am suffering from breathlessness whenever i am talking continuously. Recently (last week) i was diagnosed with GERD. I am taking Ganaton Total and Pantodac dsr but i am still getting a lot of bleching and gas problem. What could be the problem.",
    "doctor_response": "Hello! Welcome to HealthcareMagic! It could be H.Pylori infection or severe GERD. Kindly take H.Pylori kit or consult a gastrologist. Hope this clarifies your concerns. Thank you for the query. Take care varanasichestclinic.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the appearance of small lumps when the wrist is pressed?\n\nwhen i press down on the edge of my hand lots of small lumps come up on the inside of my wrist, also further up i have a permananet raised lump i had a ganglion on the outside of my wrist years ago and had it removed, i not sure if lumps are becasue of this?",
    "doctor_response": "Hi, The most likely these are ganglionic cysts in your wrist, however an MRI or FNAC will confirm the diagnosis. Thank you. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Jaideep Gaver, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe abdominal pains appendicitis or just infection?\n\ndear sir dear sir I got stomach pain last night and morning I went to doctor they taken all the test but report comes all nil .they advised as appendicitis but there is no symptoms in blood test .ecg .xray.scanning abdomen etc. so I went to another doctor he is specialist he advised there is no appendicitis it is infection so I confused wat is problem please help me how to find",
    "doctor_response": "HI.Appendix is a very small part of the intestinal system which when infected is usually removed to avoid complications of rupture , peritonitis and septicemia. Appendix is attached to the area where the small intestine enters the large intestine. This is the area which gets infected and is called typhlitis. The infection of this area mimics appendicitis. A course of an antibiotic, metronidazole, probiotic, rest will cure it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can ALS cause muscle twitching?\n\nHello doctor, My bicep muscle has been twitching and my leg and arms muscles twitch occasionally. I am super anxious about ALS. I am 36 and postpartum six weeks but I cannot stop obsessing about ALS. Please help.",
    "doctor_response": "Hello. I understand your concern and would explain that there are a lot of other benign causes that may lead to fasciculations like anxiety and insomnia, benign fasciculation syndrome, vitamin D and vitamin B12 deficiency, an electrolyte imbalance or thyroid gland dysfunction. For this reason, I would recommend performing some tests: Complete blood count, blood electrolytes, thyroid hormone levels, vitamin D and vitamin B12 plasma levels. Nerve conduction studies would help to definitely exclude ALS and put your mind to peace. You should discuss with your doctor on the above tests.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair leukoplakia\n\nabout 20 years ago I had a biopsy of the tongue.The results said that it had characteristics of hairy leukoplakia.The dentist that I see now sent me to an oral surgeon who wants to biopsy it. Is it  possible that it could be cancerous when I have had it so long? It just looks like a white area on either side. I have never smoked and with the exception of ulcerative colitis I am in pretty good health. I am 45 years old. Thankyou for your time.",
    "doctor_response": "HiWith your query, hairy leukoplakia is a precancerous lesion and usually associated with auto immune defieciency syndrome.In your scenario exact cause is not known. basically this is a viral infection caused by EBV i.e. epstein barr virus and the treatment is high doses of  anti viral drugs if it is associated with auto immune defieciency syndrome then antiretroviral drugs are used.Etiology in most of the cases is immunocomprised patients and have a healthy diet and get it thoroughly checked with biopsy investigations under a oral physician guidance.Hope this answers your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and semi-erection of penis after penile implant?\n\nMy husband had a 3 pc. penile implant on Monday of this week. He came home on Tuesday. He has had severe pain ever since the operation, so bad he can not get out of a chair without help. He was told to go to the emergency room Thursday and is still in the hospital receiving strong pain meds. Dr. says the amount of pain he has is above normal. He keeps getting semi-erection, the saline seems to be going into the penis by itself, as nothing is being done to make this happen. The Dr. has had to deflate the penis a few times. My husband has such pain when this happens that he can not stand it. Is this normal?",
    "doctor_response": "HelloThanks for query .Severe pain in penis after penile implant surgery is mostly due to either bleeding or infection .Please consult operating surgeon for clinical assessment .You may need to do ultrasound scanning of the penis to find out the cause of such a severe pain.In the meanwhile continue pain killers.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "<br>Blood blisters on gum, bleed when brushed, diagnosed as Haemangioma of the Mouth. Is low energy laser treatment safe?<br>\n\nI have what can only be described as a blood blister on my gum. It started a couple years ago as a small red dot at the tip of the gum between teeth which sometimes bleed when I blushed. My dentist had never seen anything like it and referred me to the School Of Dentistry NZ, and gave me some hygiene tips. The head of surgery at the dentistry school said he had never seen anything like it and it was extremely rare. They could only call it Haemangioma of the Mouth . They were hesitant in any laser treatment for fear of major disfigurement and or massive bleeding so referred me to a Dermatologist for a possible low energy laser treatment (first appointment in 2 weeks). I guess my questions are...Have any doctors out there heard/seen of this before? Am I on the right path by going to a dermatologist and do their low energy lasers stop blood-clots without damaging the top layer of skin(gum)? Any info on my condition would be appreciated. Thanks.",
    "doctor_response": "hello, thank u for posting ur query here.  based on ur explanation, ur case seems to be quite interesting. If the dentist u have visited has not seen such a problem before, then it could be a rare form of a Problem. Based on ur  complains i  would  not  call it straight away as  a  haemangioma. bleeding of gums is one of the common problems people complain off.  i would advise u to take an opinion from a nearest  Maxillofacial surgeon available at your place.  Its not  wrong for u to take a dermatologist's opinion regarding the same,  probable he/she would definately though some light on ur problem and guide u further. The explaination that iam giving u is  solely based on ur query alone and iam not addressing ur problem because i havnt assessed you. Thank U, regards. Dr. Manmeet",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for me not to conceive ?\n\nme & my husband s blood group is O Positive.is that reason for my conciving problem.my period cycle is 24 days long please tell me my ovulation period",
    "doctor_response": "hi, thanks for choosing healthcaremagic since your cycle is 24 your ovulatory days will be 10th day of your periods(usualy periods starts 14 days after ovulation).so if you are trying for pregnancy you have to contact from 8th to 14 th day of your periods.blood groups have no role in infertility",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to control high SGOT and SGPT by diet and exercise?\n\nI am 37 yr old lady. My sgot is 100 and my sgpt is 98.9 and GGt is 54. Plz help me how to control these 3 with diet and exercises?",
    "doctor_response": "YOUR LIVER FUNCTION TEST ARE ALTERED  MAY BE DUE TO HEAVY OILY FOOD , GHEE OR ALCOHOL DRINKING. SO AVOID IT AND BE HEALTHY",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does left axis deviation mean in ekg report?\n\nMy 9 year old son has been feeling chest pain, shortness of breath, random vomitting... we went to the doctors today, had an ekg that came back abnormal. The ekg said something about the left axis deviation. What does that mean??? He is not over weight, very active healthy little boy.",
    "doctor_response": "left axis deviation basically means increase in size or volume of left ventricle. it means there is some enlargement in left side of heart. however it can also be found if there is some problem in impulse conduction  in the heart",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for body ache\n\nHi, I m 23 years old and started feeling sick last night, woke up this morning achy body chest hurts, head hurts, Throat feels funny I don t have a fever, supera tired I don t even energy to move I m a mom of 3 what s wrong with me and what can and should I do???",
    "doctor_response": "Hello, I would explain that your symptoms could be related to a viral infection. For this reason, I recommend consulting with your attending physician for a physical exam and some blood lab tests (complete blood count, PCR, ESR, blood electrolytes). Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Nausea and diarrhea. Mild gastritis and small hernia detected. Severe depression. Is there any relation between them?\n\nHi Doctor, 2 months ago I was a very happy person , healthy and joyful. I was on holidays on a cruise and got sick on the last day of the cruise with possible food poisoning . My husband and son did not get sick. I had extreme nausea , diahhrea. Once I got home the nausea did not stop in fact it got worse and worse. This started in January 16th 2013... Then I got pain in tummy as well and ended up in hospital 3 times. I have lost 6 kilos and started getting anxiety as they said blood work was fine. I finally had an endoscopy and it showed mild gastritis and small hernia . I always vomit in morning and nothing comes out.lack of appetite. I feel sick and sore in tummy every day. What I also started noticing is that I am getting so tired it is hard to function and last couple of weeks I ve been crying all the time and feel like I have fallen into depression . I feel so exhausted , and emotionally empty even towards my family who I love so much I feel so empty with everything. I m on ppi and painkillers when needed but wanted to ask you why or how could I get depression all of a sudden and it all started from this gastritis 8 weeks ago as before then I was soooo happy. I m scared that I won t be the happy me again and feel joy again. It s very frightening . Lucky for me my husband supports me and tells me its not be but my body .. I still feel sick every day some days worse than others. I m getting more blood tests and stool tests done as well. Your help would be appreciated . Thankyou. I m 37 years old",
    "doctor_response": "Hi Carmen, Sorry to hear that you are very depressed and going through this phase , but , lucky for you, you have got a very supportive husband. Even though there is no clinical correlation between gastritis and depression, I have seen a couple of patients where the disease starts with gastritis and they end up feeling depressed despite being on proton pump inhibitors. You will feel better once you take active steps to come out of this situation. Continue your medications as per your doctor's advise and try to do the following: 1. Sign up for yoga classes , if you have a good instructor in your area. Yoga and relaxation techniques are of great benefit to cure anxiety and depression. 2. Regular exercise 30 minutes a day for 5 days a week. 3. Listen to music, Read good books... like Robin Sharma's \" who will cry when you die\" simple book but it will make you fall in love with your life. 4. Eat healthy food. Keep a food diary. Avoid foods that seem to worsen your symptoms. Avoid spicy and oily foods. Have you been tested for H. pylori infection? Wishing you a speedy recovery :) Regards, Dr. Divya Kuttikrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Red skin rash on back of legs, inner thighs. Spread to legs, arms. Itching. Reason?\n\nI m in Bali having returned 4 days ago from the island of Flores, Indonesia. Whilst there a mild red skin rash began on the back of my legs and inner thighs. This has now spread more broadly on the legs and onto the arms. Maybe a little bumpiness under the skin here and there on the torso. The rash has worsened with itching and raised ares exuding a clear fluid. Any treatment advice would be welcome. ,?!",
    "doctor_response": "hi...thanks for writing here...it seems that you are suffering from some sort of allergy, just take tab.allegra 180mg at day,tb.atarax at night,apply calamine lotion ,and antiboitic cream  over raised areas ,,hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for asthmatic bronchial condition and severe cough?\n\nMy husband is on a multiple myeloma trial of lenalidomide/dexamethasone/resprim forte treatment.  He has developed a severe asthmatic bronchial condition whereby he coughs extremely during the nighttime when he is lying on his side in a sleeping position.  He cannot remove the  \"bit of phlegm\" that seems to be stuck there causing his discomfort. He is 74 Y.O. and this has been going on for 3 months now.  He is on antibiotics and has had 4 cycles of these.  It is distressing him as he is having body pain from the amount of severe coughing he is doing to try and cough up the phlegm.",
    "doctor_response": "HelloYour husband is having multiple myeloma and also taking treatment for this including dexamethasone which is also a cough reliever . In spite of this your husband is not getting relief .In my opinion this is not an asthmatic cough ,but as I have noted in my so many patient s in such condition that something inhales into trachea or in airways , this produces severe bouts of cough . These inhaled particles or fluid produces wheezing or whistling type of sounds and this simulates  as an  asthmatic sound.But if asthma is there you may try monteleukast+ bambuterole tablet once or twice in day according to severity of disease or symptoms .In such cases I prescribe codeine + cholarpheniramine maleat syrup 2-4 T S F twice in day . But this is a habit forming drug so take a prescription from your treating physician . Steam inhalation also provide some relief with hot coffee.So consult your physician and get his opinion.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for hair loss?\n\nmy age is 24(male) n i am suffering from hair loss for last 2 yrs. everyday i loose 60-100 hairs.no one in my family is blad neither i have any infection on my scalp or dandruff. my doctor hv prescribed me for biotee plus tablets.but it doesnot seems working.please help.",
    "doctor_response": "Hi...It seems that you may be having a condition known as telogen effluvium. Normal hair fall in adult may be 100 to 150 hairs per day. You may be having hair fall more than normal.I would like to say few things about telogen effluvium. It is a condition in which the hairs fall in telogen stage of hair cycle. The causes may be many like. ...tension,anxiety, thyroid diseases, endocrinal diseases, hormonal diseases, diseases like typhoid, malaria,viral diseases,surgery,trauma,drugs like anticancer ..methotraxate ,internal diseases,anaemia,nutritional deficiencies..... etc might precipitate the disease. Excessive sun exposure may be resposible for the disease. Dandruff may be responsible..it should be ruled out. If it is there, ketoconazole shampoo may be done. You consult dermatologist for firm diagnosis and treatment.Investigations may be done to rule out thyroid disease and other internal diseases. If they are there,proper treatment may be taken.I generally treat my patients in following ways..-Nutritional and vitamins deficiencies may be treated.-Tab Biotin 10 mg daily may be taken for long time. -Vitamin E cap 400 mg daily may be taken.-Mild steroid lotion may be applied on the scalp daily at night.-Mild herbal shampoo may be done twice a week.-Oil like almond oil may be applied on hairs to improve hair shaft quality.Above treatment is not prescription, it is for your help in treatment,you consult dermatologist to have prescription.Be confident for the good result.. Have patience..as the good result takes time. Avoid tesion and worries. Be positive. You may feel better after few months treatment. I hope you got my answer.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for lumps on the back of the head?\n\nYesterday, i noticed I had 5 lumps in the lower part of the back of my head, they are hard, some more pointy, size varies a bit but they are small. Today it is giving me continuous headache and a sense of unwellness. I also have cold symptoms (throat, sneeze)",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have enlarged occipital lymphnode. It can be due reactive hyperplasia, tuberculosis or lymphoma. You should take a course of antibiotics. If it doesn't respond to treatment then biopsy diagnosis is advisable. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i take 'levonelle' morning after pill after missing a period?\n\nI have PCOS and never had a period last month. I had sex on wednesday and i am scared there could be a chance that i am pregnant as the condom kept slipping off, my question is am i safe to take Levonelle morning after pill even when i missed a month's period?",
    "doctor_response": "Hi,Since you have PCOS, you may be having irregular ovulation. I hope you were not sexually active last month. If you were, then there is a small possibility of that missed period being due to pregnancy.Levonelle is safe and you should take it even if you have missed last month's period. Levonelle although can be used within 72 hours of sex, it is more effective the earlier after sex you take this medicine.If you don't get your period in two weeks time,you should do the pregnancy test. (Levonelle is 95% effective in avoiding pregnancy. There is a small possibility of method failure).I hope I have answered to your satisfaction.",
    "dialogue_context": ""
  },
  {
    "patient_message": "treatment or vaccination for HBV, please suggest\n\nHi, I want to know that do I need any treatment or vaccination for HBV, however my PCR is not detected. Please Help",
    "doctor_response": "Hi.. Hepatitis vaccines are available.. It is of three doses vaccine..Vaccination is essential to all those who are at risk of getting the infection, like medical professionals, lab technicians, partners of HbsAg positive individuals and so on.. Inothers you need vaccine if you want to prevent the deadly infection.. Hence there is no harm in taking one... Contact your nearest hospital and you can avail this vaccination....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can certain yoga poses cause an electric sensation in the heel?\n\nHi, I just did a yoga session and noticed that while doing the downward facing dog I have a strange electric sensation in the bottom of my left heel. What can be causing this? Should I get this checked? I also sometimes have a similar sensation in my fingertip when I bend my neck.",
    "doctor_response": "Hello,This should be a warning that you should not be doing those poses. It may mean that you have some nerve impingement and it would be a good idea to see your doctor to get this checked.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does cruising help a person suffering with Laryngitis and Parkinson's disease?\n\nmy husband developed labrynthitis 18 months ago and has subsequently been diagnosed with parkinsons disease.He suffers a great deal with fatigue and is having  vestibular exercises to improve matters. To try and give him a stress free less tiring holiday would cruising be a good idea or adversely affect him",
    "doctor_response": "safe Cruising will be very good idea as most of the Parkinson's disease patient suffering from depression and mood swing because of significant disability. He 'll feel good in fresh air and open space and it 'll not help in parkinson symptoms as much. and be cautiousl about cold exposure and diet.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes allergy to gluten, corn and milk products?\n\nHi I m 31 years old and just realized last year I am allergic to gluten and very much allergic to corn. I think I may be allergic to milk as well. But both my parents are not allergic to anything. Neither is my family. How is this possible? Also when I eat corn I have lost my temper to an extreme amount that results in scary rages as well as shortness of breath. Gluten gives me shortness of breath and extreme insomnia, organ pain and spinal pain. When I drink milk I have breathing problems but am so limited on breakfast options that I need more than fruit. Have you heard of anything like this from someone?",
    "doctor_response": "Unlikely that rages or insomnia is due to your allergies. Yes shortness of breath is a symptom though. How was your allergies diagnosed?Ideally skin prick testing is the method of choice to diagnose allergies. Consult an allergist for the same.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe chest, shoulder and back pain\n\nHi, I had a mitral valve repair 3 years ago, having the chordae replaced. I also had a large Cardiac Tamponade, and ended up in ITU. For the past year I am having severe chest, shoulder and back pain, causing waves of pain spasms. There is an area at the top of the sternum, which when I put pressure on causes pain.This is also at the top of the chest incision.",
    "doctor_response": "this pain may be related with oprative scar.get repeat 2decho and MRI chest done to rule out any other problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does ear discharge with bleeding need ER admission?\n\nMy 3 year old had to have tubes put into his ears last year. Today he has came to us several times holding his right ear. This evening we noticed that same ear has a lot of discharge with light pink in it (blood, is my first thought). Is there problems with the tube? Should I take him into the ER or wait till in the morning and call his pediatrician? He is acting normally with no fever.",
    "doctor_response": "Hello. I just read through your question.This happens from time to time. it is generally not considered emergent as long as he is otherwise ok, which you've observed he is. So an ER visit is not necessary and it can wait until you are able to see your pediatrician in the morning.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life expectancy while having severe brain atrophy?\n\nWat is the life expectancy of someone with severe brain atrophy who has a long-term history of multi-organ damage due t0 Sjorgens and Lupus? I am 67 years old, 5 feet 3 inches tall amd weigh 123 lbs. In addition to the above, I have neuropathy throughout my body, rheumatoid arthritisl, avascular necrosis of bones, very advanced degenerative back and neck disease (can t walk due to spontaneous bone fractures thaat do not heal) and other problems. Thank you for your assistance. Donna Miller",
    "doctor_response": "I read your question carefully and I understand your concern.It is hard to give precise answers to a question about life expectancy since there are many conditions in play. I can tell you though that brain atrophy won't play any major role in your life expectancy as it is not threatening in itself, where the danger lies is with the damage to the other organs like heart, lungs and kidney due to Lupus, so your expectancy depends on the degree of damage in those organs.I hope to have been of help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the lifespan of the person who has cerebral atrophy without any symptoms ?\n\nIf CT scan shows cerebral atrophy but you're not experiencing any symptoms. What is the lifespan of that person? Lightheadedness , headache",
    "doctor_response": "Hello Nice to see you CT scan can suggest the presence of cerebral atrophy,but it can`t predict ones life span . Lightheadedness and headache varies from patient to patients  \u2018Hope I have answered your query, \u201cWish you Good Health and trouble free speedy recovery\u201d",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatments for Rubella in a child\n\nMY GRAND DAUGHTER HAS RUBELLA BECAUSE HER PARENTS WONT GET HER IMMUNIZED... HOW CAN WE HELP HER GET OVER IT? SHE WILL BREAK OUT THEN THE BUMPS WILL DISAPPEAR, SHE ITCHES, FEELS BAD, RUNNY NOSE, AND I HAD THE GERMAN MEASLES WHEN I WAS A YOUNG CHILD, CAN WE CONTRACT THEM OR SOMETHING ELSE FROM HER BOUT WITH THIS VIRUS?",
    "doctor_response": "Hi. I've gone through your query. I can understand your anxiety. As you failed to immunise your granddaughter for rubella, she might have contracted the infection now. Usually, she can be managed at home itself, unless you notice symptoms like stiff neck or ear ache or no drop in fever, where you need to consult a doctor near by. It will resolve within a week to 10days & symptomatic management is enough. It includes, 1. Bed rest at home ( not to spread virus at school) 2. Ibuprofen for body pain & fever 3. Plenty of fluid intake Hope I have answered your query. Let me know if I can assist you further. Take care. Regards, Dr. Yogapriya V, General and family physician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get stomach cramps with headache, loss of appetite, fever and diarrhea. Please suggest solution.\n\nHello doctor, I am a 27-year-old female. I have severe headaches for the past two days wiht loss appetite, nausea, fever, diarrhea, and stomach cramps. I am taking Paracetamol for my problems. Please help.",
    "doctor_response": "Hi. Let me tell you that the symptoms described by you suggest that you have acute gastroenteritis. I suggest antibiotic Metronidazole 400 mg three times a day for five days and continue Paracetamol for pain and fever management. Avoid taking non-steroidal anti-inflammatory medication like Ibuprofen, Aspirin and Diclofenac. Take plenty of oral rehydration solution with water. Make sure that you get plenty of rest. Stop eating solid foods to let your stomach settle. Avoid dairy products, caffeine, alcohol, and nicotine. Avoid sugary, fatty or highly seasoned foods. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause for severe back pain along with fatty liver?\n\nI Have Had Left Sided Back Pain For A Yr And A Half With A Loss Of appetite. I Have A Positive ANa 1:640 Homogenous Pattern And Now A Enlarged Spleen Measures17Cm. So Far My Cbc Is Normal. My Weight Has Been Steady But Lots Of Left Sided Back Pain And Never Hungry. I Am Just Lost What Could Cause This. I Have Also Been Told Possible Fatty Liver But Never Been A Drinker.",
    "doctor_response": "Hello, I have studied your case.Your ana titre suggest autoimmune disease.Back pain and joint pain are common symptoms of autoimmune diseaseAnd also check your vit B12 and vit D3 level.HLA B 27 blood test with RA test may rule out spondylitis.Medication like methylcobalamine and analgesic will reduce pain.You can do yoga exercises and focus on spine extension exercises.You may consult physiotherapist for guidance. He may start TENS, or ultrasound which is helpful in your case.Hope this helps. Wish you a speedy recovery.  Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a person with small uterus and a small period of pregnancy get pregnant in a healthy manner?\n\nHi, One of my friend wife have problem. A limited period of pregnancy ,baby can not alive due to small uterus and a small period of pregnancy 6month before baby wont alive. please advice me is there any possiblity to increase the uterus size(bachhadani) .thanks with regards,Manoj kumar Sharma",
    "doctor_response": "Dear Member,Thanks for posting your query.Various anomalies of the uterus like bicornuate uterus or a septum in the uterus will cause premature delivery or abortion. A specific diagnosis is must before any procedure is recommended. An ultrasound of the pelvis will tell whether there is really a small uterus or a anomaly which can be confirmed by MRI of pelvis . Some anomalies like septate uterus can be corrected surgically and give good results.sometimes a stich called cervical stitch is placed in the cervix to prevent abortion. please keep posted of any new investigations which are done.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to avoid being uncomfortable ?\n\nhi dear doctor m 20 yr boy m facing the problem is that whenever i face any woman i directly look on their chest rather looking at face and after it make me uncomfortable to talk also feel guilty and ashamed of myself and i skip from that place...... same happening with guys i directly look down and i feel uncomfortable due to this i m not able to talk with my friends freely the way i talk previously .....now i really ant to solve this problem...... kindly try to help me... hi dear doctor m 20 yr boy m facing the problem is that whenever i face any woman i directly look on their chest rather looking at face and after it make me uncomfortable to talk also feel guilty and ashamed of myself and i skip from that place...... same happening with guys i directly look down and i feel uncomfortable due to this i m not able to talk with my friends freely the way i talk previously .....now i really ant to solve this problem...... kindly try to help me...",
    "doctor_response": "Thanks for the query. I really dont know what to say, i guess you need counselling at this stage, there are no medications to solve your probem if that is what you are looking for,  Have a healthy living",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does absence of fluid in drain tube of liver indicate?\n\nI have a drain installed in my liver. recently, the drain tube began leaking under the dressing when I flushed it. now there is no fluid at all in the drain tube. I went to the VA ER on Friday, but no surgeon was available. they sent me home with extra dressings and instructions to apply a new dressing every time I flushed the drain. it was just Thursday when a fresh scan of my liver was conducted and determined the drain had more work to do. why would there be no fluid at all in the drain tube? No surgeons at the VA on weekends.",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein and I will try to help you as much as I can.There are few possible causes, drain may be closed with old hematoma or pus or kinked inside abdomen. If there is leaking behind drain then it means that there is intrabdominal collection that still persists. YOu need to do ultrasound and reposition of drain.I hope I have answered you query. If you have any further questions you can contact us.Kindly regards. Wish you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can happen if snapping hip syndrome is left untreated?\n\nMy little brother is 23 and mentally and physically disabled., he has had deformed hips his entire life, but they didn't start affecting him until he was about 16 years old. They continuously pop in and out of socket. First he quit walking at around 16 and then he quit crawling a few months ago. Now he doesn't want anyone to touch him. I think he needs a total hip replacement, but my mother doesnt want to put him through that. What should we do, and what happens if it goes untreated?",
    "doctor_response": "Hi, Surgical correction is rarely required and most of the cases respond well with conservative measures. You can consult an orthopedics and get evaluated. He can try stretching exercises and steroid injection. Most of the cases respond well and surgery seldom required. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with uterine fibroids. Could they turn into cancer?\n\nHi Dr. I was diagnosed with uterine fibroids couple years ago, could they turn into cancer? I was told they could shrink as I get older, but mine are very big do I need surgery or is there any medication that could help dissolve them, I m very worried. Sometimes my lower abdomen hurts. Thank you",
    "doctor_response": "Hi and wecome to HCM Thanks for the query. Fobroids are benign tumors and extremely rarely it can be cancerous so you dont have to be worried aout that. it can grow and cause symptoms such as pain and pressure in pelvic area and it can affect pregnancy and concieving. in these cases it is recommended to remove it surgically or do hysterectomy. if you are not in fertile age then i recommedn it to since it causes pain in your case.Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for recurrent lower back ache and lump above left buttock\n\nI am a 33 year old female and I have had lower back pain off and on a while but now noticed I have a grape sized lump on lower left side above buttocks.  Dr diagnosed as fatty cyst, sending me for X-Ray and have seen Chiropractor for releif, hasen't helped much.",
    "doctor_response": "Hi,Welcome to healthcare magic.After going through your query I think you are suffering from chronic backache.Treatment of back pain  is exercises and analgesics (diclofenac SR). Sometimes strong analgesic(such as ultracet three times a day after meals) is required.Consulting with treating doctor is advised.  Sometimes vitamin D deficiency is the cause so get your vitamin D checked .If it is low then vitamin D supplementation( weekly with milk) can be taken.Avoid  long continuous standing.Sit in a straight posture.Eat milk, fruits and green leafy vegetables daily.You need to done MRI TO RULE OUT other causes. Your fatty cyst require no treatment.I think your query answered",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible after rubbing penis on vagina and should pill be taken?\n\nHi me and my  girlfriend was messing about and i had a tiny bit of precum on end of my penis. I  was trying to insert it into her vagina but it didnt go in. The tip of my penis was just rubbing her vagina so could she be pregnant? And i have Mercilon so could i use it for morning after pill to stop the baby?",
    "doctor_response": "dear Sir, there is a tiny possibility that she gets pregnant so it is bettet to use the morning after pill to eliminate any chance of getting pregnant",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could it be if having pain in lower abdomen and hurts to urinate?\n\nHow soon can you tell If you are having an ectopic pregnancy?I am having pain in my lower right side & slight pain in my lower left side. It hurts when I pee, but not like a urinary tract infection... it almost feels as if I am pushing something? it hurts. I feel like I need to throw up, but never do. It feels like I  might have hemmorids as well.",
    "doctor_response": "Dear Friend.Welcome to healthcare magic.I am Dr Anshul Varshney. I understand your concern.Ectopic pregnancy is usually diagnosed when you miss your periods and have positive urine pregnancy test but on ultrasound you don't see any sign of pregnancy in uterus.The pain you are describing seems to be because of a stone in ureter or anywhere on urinary tract.I would advice you to get an ultrasound and a urine routine done to rule out stones and uti.If you have any further query you may write to us again.Stay Healthy",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hyper pigmented patch on the back of a 7 month old?\n\nhi doc, my doc prescribed flutivate for my daughter (7mths).she has, a hypopigmented patch on back and small reddish eruptions in circular pattern behind left ear lobe, now similar eruptions are seen in face on the sides of nose . sir what s this condition and is it safe to apply.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tingling and pins and needles sensation in arm. MRI done. Prescribed amitriptyline. Suggestions?\n\nI am a 66 yr old female and I have been having tingling and pins and needles down my left arm intermittently for the last 8 months. I have been to a chiropracter and an osteopath, have had neck and back x-rays (which just showed wear and tear), and been to a spinal specialist mainly to get an MRI scan which he did not think I needed. ( I also had sciatica last year which I still get in my left leg at night.) I can get rid of the tingling in my left arm by turning my head to the right or raising my left arm above my head. My GP has prescribed Amitriptyline to help me sleep and I have also had anti inflammatory tablets. Any suggestions or advice or exercises I can do to help would be greatly appreciated.",
    "doctor_response": "Hi. at your age it is common to have changes of wear and tear on X-rays. Some times these changes of aging bone can cause compression of the nerves which pass between neck vertebral bones. MRI scan may definitely help in pin pointing the location of compression. Neck collars to restrict movements at the neck and provide support may be useful. Use of hard bed with soft thin pillow may be helpful. Physical therapist can teach you some neck exercises. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing nerve pain in jaw after bone biopsy. Had tooth pulled. Will pain subside?\n\nHello, I m experiencing nerve pain in my jaw are after a bone biopsy was done over a year ago after I had a tooth pulled because of an abscess . Ever since then the are hasn t fully healed and it continues to hurt even more than a year after. I have been on pain meds ever since. Then in an attempt to relieve the pain, I had a nerve block procedure done where they inserted a needle in to my neck. Not sure exactly what was done, but something about blocking never ganglia. Furthermore I have HIV and have malaria in the past which I thought cause some sort of never damage. Should I just wait out the pain? Have a combinations of all of these things just caused that nerve never to be able to hear properly? Or I wonder if a never was actually cut accidentally. Any input is appreciated. Thanks.",
    "doctor_response": "Hello After reading your debtal history i would say that you shouldn't have done nerve blokage treatment done.we should find the cause that y there is pain even after extraction. I would advice you to get a dental x ray done of that area may be remnants of tooth is left pr may be there is spiny bony projection.if still the cause is not found then refer to neurologist.i would also advice you to mantain your oral hygiene rinse mouth with warm saline water twice daily.vitamin supplements like neurobian forte will help. Regards dr.sapna",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the movable, hard lump on arm pit and breast?\n\nI have found a hard lump in my arm pit..it is movable. I also have stomach pains the last 3 days. What could this be? There is a small pea side lump on my breast, the same side as my armpit lump. At doc today and sending me for an ultersound. Wanting your advice on this?",
    "doctor_response": "Hi.Please do not take otherwise.If you are known to have a lump in breast and armpit on the same side, good that you are going for an ultrasonography. But insist to go for USG guided FNAC- Fine needle aspiration cytology, as this may give a diagnosis , sonography can not tell whether this is cancer or not. If required / in doubt request them for excision biopsy; as this being a cancer or not has all the different implications on life and many patients out of fear or out of expectation make it late for diagnosis changing the stage in which they may be suffering.I am not trying to frighten you, want to make you aware to go for the tissue diagnosis at the earliest. to decide that nature of it. Stomach pain can have another reasons .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does lump inside center of back neck indicate?\n\nhello, I am 30 years old and I have an aprox. golf ball sized lump inside the center of back neck at hairline, it hurts when I move my neck looking up more than anything, I am also  an x-smoker just recently noticed the lump and stopped smoking since. MRI did not show anything and I have CT w/contrast done today would anyone know what it might be, thanks in advance",
    "doctor_response": "Hello!Thank you for the query.MRI or CT are usually not necessary to diagnose a lump in such location. Ultrasound is far enough to diagnose it. Such lump can be a sebaceus cyst, lipoma or enlarged lymph node. Cyst or lipoma are benign lesions which do not lead to a cancer and can be removed with small incision.Enlarged lymph node can be caused by some inflammation or a cancer (throat or larynx cancer is usually caused by smoking and can give such symptom).I suggest you to have an ultrasound of this area. In case of lymph node biopsy should be considered. You should also consult laryngologist and pulmunologist.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat severe tooth ache during 24 weeks pregnancy?\n\nIm 24 weeks pregnant and i have this horrible tooth ache that gets worse when i put anything cold in my mouth. It hits my head really bad and my whole right side of my face hurts and the back of my eye i don't know what to thibk could i have an exposed nerve ?",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,      I have gone through your query ,  as you have mentioned that you are Pregnant ,and you have pain and Senstivity in your tooth, dont worry it can be due to Pregnancy induced gingival problem , or may be due to your tooth is carious with exposed pulp , this time no treatment is possible as you are pregnant so , you take medicine one tablet Paracetamol when you feel pain ,    After  Delivery you consult Dentist and go for investigations if Carious then go for Root canal treatment and if periodontal problem or gingivitis then go for Oral prophylaxis done,    Hope this will help you.      Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for Neurofibromatosis\n\nHi. I recently discovered that my 12 year old adopted son has what I presume to be neurofibromatosis. We have a regular check up appt next week and I am wondering if I should put his diagnosis and follow thru in their hands or call a clinic myself to arrange diagnosis. Thank you.",
    "doctor_response": "you may easily wait for a week.It's not an emergency. If if the lumps are not Neuro-fibrosis you can wait.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough and cold in child\n\nHi, my son is 3 and a half years old. He has cough and cold problems every winter. Hence he was prescribed Montec LC kid and Foracort 100 pump by his pulmonologist last week. However since last 2-3 days he has running nose and cough(wet cough) inspite of being on medication. Can these drugs treat his current problem. If not, what do you suggest?",
    "doctor_response": "He is more than likely experiencing a cold right now.  Give it a few days and it should resolve on it's own.  If he develops fever or the symptoms worsen over the next week, have his doctor check him.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Unable to conceive. PCR test for menstrual blood done, mycobacterial detected. Infertility treatment?\n\nHi, I am 35 year old woman and recently gone through menstural blood pcr test and mycobacterial have been detected. My doctor said, I will not get pregnant because of this situation and suggested some medication for 3 months. and also said if I wont conceive in these 3 months, she needs to do some tube test. I am really scared that I will never get pregnant. I desperately want a baby. Can you share your thoughts on the above? Thanks",
    "doctor_response": "hello thereMenstrual blood PCR positive for mycobacterium suggests endometrial tuberculosis. In the woman, it cause tuberculous endomteritis ( infection of the uterus) and salpingitis ( infection of the tubes). This infection can often be silent, and may not cause any symptoms or signs.Once the histologic diagnosis of TB endometritis has been made(like in your case), then treatment with antitubercular medicine must be started to prevent further progression of the disease. However, usually with TB endometritis,  infection of the fallopian tubes also occurs and the damage caused to the tubes ( TB salpingitis) is irreversible. Infection of tubes might result in irreversible tubal infertility, and the only treatment option available then to conceive would be IVF. In the past some doctors would try to do surgery to repair the tubes, but this is futile surgery, because the tubes never work properly once they have been infected. Tubes which have been severely damaged may form a hydrosalpinx( dilated tubes with infected fluid), and may need to be removed surgically, prior to IVF, if they are very large.Although antitubercular chemotherapy is the mainstay of treatment, surgery may be indicated where medical therapy has failed to resolve symptoms and in presence of a persistent pelvic mass. So i suggest for now you continue with your antitubercular drugs which has to be taken minimum for 6 months. At present you should not undergo any tube test as in presence of a genital infection, any kind of tube test is contraindicated as it might flare up the infection. Since your diagnosis of TB has been made , theres no use getting a tube test now. ONLY after you complete your treatment and get repeat PCR menstrual blood negative for mycobacterial infection, then you can go for tube test if you dont conceive.After treatment for genital TB, the conception rate is low (19.2%) with a livebirth rate of 7.2%.There is also an increase in ectopic pregnancy and miscarriage rates (when endometrial scarring occurs after infection). In vitro fertilisation should therefore be offered to you if you fail to conceive spontaneously.So dont worry, there are options to conceive. Take your folic acid tab simultaneously which increases chances to conceive and improves pregnancy outcome.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Excessive acne scars on the face. Has excessive breakout that stopped with intake of Yasmin. How can I clear up scars?\n\nHi there, I m a 21 year old female, fair skinned brunette. I ve never had problems with my skin until about a year ago, when I started breaking out beside my mouth and on my cheeks. It spread as I experimented with cleansers and benezoyl peroxide , effectively covering my face, but my forehead remained clear. Three months ago I started Yasmin 21 and it stopped all new acne from forming, but I still have lots of post hyper pigmentation. What would be the best way to clear up the red marks left by hormonal acne?",
    "doctor_response": "Hello, Are you having only lots of hyperpigmentations or are you also having acne scars as well as complications of acne pimples? However, in order to answer your question about to get rid of acne hyperpigmentations, you need to undergo the following treatments carried out by an expert in the field of aesthetic medicine and laser aesthetic medicine: 1. Glycolic acid peels for hyperpigmentations and uniformizing the skin coloration. 2. Microdermabrasion: may help get rid of both acne scars and hyperpigmentations. 3. Laser removal of hyperpigmentations with the help of a Q-Switched Nd: YAG Laser. 4. Fractional CO2 laser treatment in case of acne scars in combination with hyperpigmentations. Use some very good hydrating/moisturizing serums/gels, skin nourishing/bio-activating and skin normalizing (turning fatty skin into normal skin) creams/products after any of the above-mentioned treatments. As a matter of precaution, after a treatment, also avoid direct sun exposure in order to prevent the appearance of post-inflammatory hyperpigmentations (PIH) after any of the above treatments done. Use a very good sun screen or sun block cream (SPF 50) in order to keep your skin away from any sun-induced hyperpigmentations.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stools with foamy discharge in a 3 year old?\n\nMy 3 1/2 years old will regularly have a foamy, frothy discharge with her stools yet she seems fine and isn t complaining about her bum. Just conscious that this shouldn t be presenting in her stools. Any suggestions as her diet would not have changed recently?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood clots and bleeding around teeth?\n\nhey..I am nur with 24 yrs of age.Its been a week whenever i wake up i find clots of blood around my teeth..and sometimes on day time i bleed from my mouth..i tried finding any lesion i cant see..and within two days there have been sores in my tongue..what do you i advice me??do i have any vit deficiency?",
    "doctor_response": "HiThanks for your query with healthcare magic, it would have been better if you had mentioned about your oral hygiene status any how do you have local deposits/tartar? if so it might be a periodontal disease with pocket formation.are you under stress? 'coz you have mentioned you have sores too. if no deposits and oral hygiene is good then it might be due to vit C deficiency. Whatever i would suggest you to visit your dentist for further treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a hard lump on the forehead cause headaches and dizziness?\n\ni have a hard lump on my forehead at the left hand side just on the bone above my eye it can be quite tender to touch the doctor has had a quick look and said possibly a cyst growing on the bone? I have since been having headaches and slightly dizzy could this be related?",
    "doctor_response": "Hi thanks for your question.The lump which you are having on your forehead,diagnosed by doctor to be a cyst growing on bone can cause headache and dizziness.Increased pressure inside the cyst or cyst compressing underlying bone can give rise to  symptoms you are havingHope this answers your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can bring relief to soreness and pain in back and spine?\n\nhi I am just recovering from the flu and I had a very sore back just at the bottom of the spine area. now the flu and back pain has gone but I have very sensitive skin around the lower back upper buttocks and central stomach area. would you have any ideas what this is? no rash or other symptoms.",
    "doctor_response": "Hello. Thanks for writing to us. The soreness and pain in the lower spine can best be relieved by an improvised posture, regular physiotherapy and back strengthening exercises, aerobics and swimming in addition to the medicines. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal ,drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for depression?\n\nI m a 28 year old lady suffering from depression, I took an overdose of sleeping pills & surely they ddnt work as I m still here. Then I again took an overdose of my anti-depressants & painkillers that didn t help either to take my life. Now I have blank episodes, always shaky, constant headaches, teary & want to sleep the whole time. I ve shut people out, please help",
    "doctor_response": "Hi dear,you take overdose of medication due to suicidal ideas or with faith of that taking too much medication relieve depression fast.if you have suicidal ideas than go and consult psychiatrist immediately. and if needed take electroconvulsive therapy and medication.Thankk you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What happens if one skips a tablet of positinor 2 in the row?\n\nhi im 22, had unprotected sex and took a tablet of postinor 2 the following morning...i forgot to take the next pill ten hours later but took it the next morning after the last one but it was still within 72hr..my period has delayed 2 days and my breast are getting bigger..can it be pregnacy",
    "doctor_response": "Hi,Thank for writing to us.Since you had taken within 72 hrs ,you need not worryPostinor 2(Levengestrel),it prevents 85-95% of expected pregnancy.Wait for 3 weeks.Changes in breast most likely due to Postinor.If you will not get periods after 3 weeks,you need to go for urine pregnancy test.No need to worry, in your case you have very less chances of getting pregnancy.If you have any queries I will be happy to help you.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat infertility problem?\n\nHello doctor, I am facing infertility problem for the last 1 year Last month i did hsg and in tat my doctor told me i have traces for tuberclosis in my uterus. But my blood test report is negetive. Even then my doctor asked me to take akt 3 for 3 months. Is there any chance for me to get pregnant? Shall I continue taking this tablet",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.As in HSG histosalpingography tuberculosis found then I would advise to take treatment of TB first, complete treatment of TB, and then plan for a baby.For TB treatment consult a pulmonologist also.Hope I answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have had severe back pain/coccyx for over a year. could it be cancer ?\n\nHiya, i am 42yr old women with 2 children (12 9) i have had severe back pain/ coccyx for over a year, problems with heavy periods and continual bleeding, a lump/ bulge in my lower right abdomen , frequent weeing and keep getting constipated and have lost over 4 stone. Had scan done 8 months ago which showed large fibroid and gallstones. Had endometrial ablation done 4 months ago which successfully stopped bleeding. Had incredible pain afterwards. and dr didnt find a large fibroid? Other symptoms still continuing and worsening. Had cortizone injection in coccyx recently, gave some temporary relief. Just had mri done, showed large ovarian cyst , is this the lump i can feel? Is it the cause of my symptoms? was the cyst originally misdiagnosed as a fibroid? What happens next? should i be concerned, could it be cancer ? or would that have shown on mri ? please help, still in lots of pain and scared too. Thankyou.",
    "doctor_response": "since you are 42 years and you have a family why dont you get the uterus and the problem ovary removed. mri will show only the mass and it has to be confirmed by the biopsy whether you have cancer or not",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for itchy lump in the arch of foot\n\non the arch of my foot it is very itchy and i can feel a lump. if i itch it it becomes very painful and swollen and the pain travels through my leg. by putting ice on it, it does die down but it is still there. i cant remember getting bitten or injured so i am worried as to what it is",
    "doctor_response": "Hi,thanks for the query to my HcM CLINIC.-In my opinion-You are suffering from- mostly ? plantar-psoriasis / or venous-eczema.-Consult your family doctor / and skin doctor and investigate to fix the cause of it.-Remedy-Would be for psoriatic-ithcy lump-Tb-Antihistaminic-Dipsalic oint--Urea cream application or-If venous eczema- with lump--Rest /Elevation,-Venous Stocking -and Correction of the Varicosity by ELA-endo-venous-laser-ablationcorrection of the incompetant varicose veins.-Consulting skin doctor would help you more.Hope this would resolve your itchy lump in arch of foot.Wishing your recover fast.Wellcome to my HCM Clinic again.Good night.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tightness, tenderness and fullness in upper abdomen that worsens with warmness over belly, taking Nexium. Suggestions?\n\nHi, My stomach/upper abdomen is very tight, tender and full, then suddenly gets worse when I get hot adrenaline from my belly button to my solar plexes. Like someone was injecting short bursts of hot liquid. It wasn t acidic or in my throat though... It immediately made my heart go very fast... I am on Nexium , had a helicobacter pylori test, adrenaline test.",
    "doctor_response": "Hi, Your problems are related to decreased gastric motility that can be increased after taking some drugs such as Motilium that can increase gastric motility. You will be fine after your gastric motility will be increase your belly will become soft and continue Nexum  as Antacid. You will be better soon I hope I am sucessful in solving your query If you have more you can ask me Take care Get well soon Regards, Dr. Azhar Sattar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Irregular periods, had ovary removed due to ovarian tumor. Trying to conceive for 3 years. Suggestion to get pregnant fast?\n\nHi I am trying to conceive for 3 half years now,have had my right ovary removed last year march for an ovarian tumor which has been tested and is Not cancerous,I have irregular periods which I take provera time to time to regulate and I have been on fertomid 50mg for 3 cycles and still no luck and I am insulin resistant,so what can I do to fall pregnant ASAP.",
    "doctor_response": "Hi,    Thanks for writing to us.    You should continue with your medication and If you are insulin resistant go for metformin.     Take folic acid tablet.     Sexual intercourse on most fertile days(detected by ovulation predictor kit.     Good luck.     Regards     Dr. Richa",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for Myoclonic jerks and partial siezures\n\nHello sir, my child is 06years06months old he born on 10-01-2005.normal delivery after birth of8 hours he get breath speed and we kept in nicu. after 3 days he get seizures R focal seizures he operated with subdural hematoma during his age at 3 months.up to 4 years of his age he get multiple seizures like uprolling of eye balls clonic movement of R UL and R LL some times clonic movement of left side,complex partial seizures and R focal seizures,after 4 yeaqrs of his age all seizures are stoped from january 2010 he get Myoclonic jerks after awalking from sleep from 17-02-2011 he get complex partial seizures, he is also operated with general cataract of left eye.In MRI he have (1)LEFT TEMPORAL LOBE PORENCEPHALIC CYST. (2)FEATURES SUGGESTIVE OF SEQUALAE TO PRETERM (MILD TO MODERATE)HIE.NOW he is on medicine (1) livitiraticim (TORLEVA-500 mg) 1-1/2-1 (2)clobazam 5mg-1-0-1 (3) clonozepam 1mg-0-0-1 Topiramate 25 -1-0-1 present problems :-(1) Myoclonic jerks (sudden jerk after awalking from sleep) apporx 10/day (2) complex partial seizures 2/week.give your valuable suggestion for my child for which i will be thankfull to you entire life.",
    "doctor_response": "acth and vigabatrin are very effective drugs whin use with steroids for management of myoclonic seizures. course of acth may b given to child. ketogenic diet is very effective in children which have recurrent seizures.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is itchy skin, dry scalp, hair loss and rashes on face after morning tea/coffee due to hormonal imbalance or allergy to caffeine?\n\ni have very itchy skin and dry scalp , had lot of hair loss too , i thought it was due to change of weather and due to a miscarriage last december , every morning if i have tea or coffee i get rashes on my face and neck , it itches too ....do i have hormonal imbalance or allergy to caffeine ?",
    "doctor_response": "allergy is due to milk protein not due to caffeine nor tannin content of coffee and tea. try drinking black tea and and coffee. get the allergen test done for  milk  protein",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in the center of chest\n\nHi There About a month ago I started to get a pain in the centre of my chest comes in a wave like feeling for a second and then goes again.  I have been getting it quite a lot since and presumed it was indigestion but I've never had indigestion for a month. sometimes it happens if I bend over any ideas? I am a 42 year old women, not overweight excercises frequently, I don't smoke, don't eat any meat purely vegetarian and I do drink wine? Any advice would be greatly appreciated. Wondered if it would be connected with going through the 'change' Many Thanks Tracey",
    "doctor_response": "hellothanks for posting here. your symptoms seem non specific for heart disease. chest pain originating from the heart comes and remains for a while.. it wont come for a second and go away. it can be relatrd to hyperacidity, indigestion. please take a course of antacids for two weeks. if still symptoms don't improve then go for a treadmill test which will help to rule out a probable heart disease. thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe memory loss. Why do I have sever absent mindedness? What can help?\n\nWell i am 32 and i am having severe memory loss since my school days and believe me i have passed my entire academics by copying which i used feel gr8 abt it those days but believe me i knew some day it will hit me very bad...i 4gt things very fast, like a routes,any article, subject related to my office work, moreoever i am so very absent minded and even now i am going to mba classes but ever i study very next moment i 4gt i really want to come out of it asap which i effecting my career and my personal life which lead to my divorce also...!! prakash/0000",
    "doctor_response": "Dear I am sorry for the health problem you are experiencing.I would advice you to do a brain CT scan so I can advice you and your memory improve.Wish you all the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high BP everyday after waking and reduces after 10 minutes?\n\nHi I am 26 years old  I wake up in the morning with high blood pressure 160/100 since over a year now ,doctors have prescribed different types of medications but this resulted in a major drops in blood pressure during the rest of the day with possible Vegas attack ,I did many investigations   And thet are all fine,I am currently on  a calcium channel Istin 2.5 mg  that I take at night around 7 p.m. It keepmy BP normal all day but only in the morning is high.Also I do snore a lot but don't have sleep apnea ,also I am a worrior and can take all my work and personal life anxiety with me when I fall asleep and I do get many busy dreams avery night,When I wake up  as I mentioned my BP is high but after  10 minutes it drops to normal 140 / 85 .I don't know the reason for that and please I need help and advice ,many thanks",
    "doctor_response": "Hi,It is a physiological response of organism, that ones blood pressure slightly increases after wake up. In your case you have tendency of high blood pressure, so it goes upper than normal. But you shouldn't worry, if it regulates in 10 minutes. It will cause no harm.Wishing you good healthIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce pain in tail bone?\n\nhi about a week and a half ago i started getting pain on what felt like my tail bone about 4 days ago it started getting extremely painful i cant lie on my back because the pain and when i lie on my left side i can feel a lump about 2 inches long but when lying on my right side its seems to go but is still painful",
    "doctor_response": "Hello, I have studied your case. Due to fall on hard surface sacrum may be injured. Due to microtauma there may be fibrosis formation.Do hot fomentation over sacrum. It will take weeks to months to subside.Use ring cushion and take sitz bath [sitting in lukewarm water for 10 min]Take analgesic like nucoxia 90 once daily along with tab methylcobalamine 1500 mcg once daily consulting your doctor.If not relieved with all these methods then local injection may be required. You can take this consulting your doctor.Clinically spinal origin of pain needs to be ruled out, if required MRI spine can be done. Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a small movable lump in mid jawline indicate?\n\nI have a small moveable lump mid jawline on the left side. It hurts very little when pushes, about 2-3/10. I'm worried about this although it hurts less today than it did yesterday, but I only noticed the lump today. I'm 12 and has my 12 year molars growing in just in case at has something to do with it.",
    "doctor_response": "Hi,Thanks for posting the query,       This lump could be due to infection,the infection in the tooth has spread to the surrounding peripaical tissue leading to formation of lump.I would suggest you to get a checkup done take an x-ray.Drainage of the abscess is required.A course of antibiotics and analgesics is required.At hometake lukewarm saline and antiseptic mouthwash rinses.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for constant headache, stomach pain and body ache\n\nMy son is having a constant headache, stomach pain, body ache, especially in his arms, bottom of his feet, legs, and neck, since last 10days. He has no fever, has good motion, no urination problem, and can eat everything. His doctor says he may be having stomach flu. She ordered all blood work, which was all normal and suggested hydrating him well. Over the counter pain medication, such as children;s Advil has not worked, nor has hot packs. I wanted to know how long it will last as it is not getting better since last 10 days and if there is something else we should be looking at, or should we just wait patiently for the flu to ride out it's own course? Thank you, Anuradha kamath",
    "doctor_response": "Thanks for contacting HCM.  Dear Anuradha Kamath as all your son's tests are normal you should ask your doctor to evaluate for Juvenile Rhematoid arthrits and if that is also ruled out then it is probably not a physical problem. Children some time react this way to some thing bothering them like a family squabble or most likely someone tormenting them for example a bully in school. It would be good idea to en-quire at school and meet his class teacher and classmates to get to the root of problem. Also shower him with love and affection and get him talking about his problems, he may trust you and tell you. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having lower back pain, wetness and sweaty buttocks on sexual arousal. Cure for symptoms?\n\ni have had lower back pain for around 6 months, GP tests showed nothing, so i assumed it was due to poor flexibility. within the last 2 months i have had anal leakage/sweaty bum cheeks. worst when needing to use the toilet or sexually aroused. i have to wipe and pat down my bottom after using the toilet as it gets so bad it soaks through my underwear.",
    "doctor_response": "Hello. Thanks for writing to us. The pain in the lower back and the symptoms you have mentioned can be due to a nerve root irritation at the level of the lumbosacral junction or at a lower level causing the excessive sweating. An MRI scan will help in detecting any such pathology. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes whitish discharge through the penis after oral sex?\n\nHello ~ I recently received unprotected oral sex with a guy 3 times in the past week, the most recent time being last saturday.  Since then I have noticed a little milky white discharge from my penis, accompanied by slight flu like symptoms -- it feels like I'm getting a cold.  I'm 45 years old, 5'11\", 185lbs with existing medical conditions.  My partner gets tested regularly and is clean.  Help",
    "doctor_response": "HelloThanks for query .Whitish discharge after Oral sex is mostly due to infection of urethral mucosa.Human oral cavity is full of plenty of bacterial flora hence one is more prone to get infection of urethra after oral sex . .Get swab test and culture of a discharge done to trace out the organisms causing this infection and antibiotics to which they are sensitive to .Take antibiotics like Doxicycline and anti inflammtory drug like Diclofenac twice daily for a week .Ensure to wash your genitals with warm water twice daily .Avoid sexual encounters till you get cured completely .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Wisdom teeth extracted. Dry socket pain packed with gauze. Painful lump inside cheek. What is it?\n\nI got 4 wisdom teeth extracted 17 days ago, I ve been back and forth to the oral surgeon 5 or 6 times due to dry socket like pain. I never got an answer on whether or not it was dry socket but the area was packed with gauze and clove oil and seemed to relieve the pain. At 14 days post op I had the last packings removed and told the Surgeon I was developing what seemed to be a painful lump inside my jaw/cheek area. The pain is back and worse then ever and the surgeon is calling in antibiotics for me but I can t see anyone til Monday! (It s Friday!) I have no fever or redness inside my mouth so what is painful lump inside my cheek/jaw area?? Thank you for your answer I m advance!",
    "doctor_response": "Hello and welcome, THE pain and swelling is usually associated post wisdom teeth extraction. The lump arised at the extraction socket area may be due to- traumatic extraction. tearing of gingival flap during extraction. dry socket. Alveolar bone which is fractured. I would suggest you to do frequent warm saline gargle. Maintain good oral hygiene. Please do not irritate the area using fingers/toothpicks. pLEse avoid frequent spitting. application of cold packs can be done. hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the recovery time after hernia operation?\n\nI just found out I have a hernia which their is a bulge on the left-side of my bladder ( the muscle ) it does not hurt, I am 58yrs old and am in a weight/cardio/stretching class here at the college I attend. I have no pain, can pee and have a bowel movement without a problem ( no blood or anything ) and have no pain walking no burning of the muscle, I don't feel sick and whenI lay flat thebulge goes down. The physision assistant told me I will need surgery andI have a Doctor's appointment june 26th. How long isthe recovery time I am a full-time student and my major classes startin the fall. after surgery can I do any light exercise without lifting weights.     bob",
    "doctor_response": "you should follow the guidelines provided by a general surgeon. don't do heavy exercise and follow light simple exercises and core strengthening. if you can take guidance from a physical therapist it will surely help you and if you perform simple exercise pre surgery then post surgery you will recover faster and stronger.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I go for surgery in case of club foot?\n\nI am going for a reconstruction ankle surgery June 14/12 very nervous, I have a club foot - was not born with and 1st surgery was 30 years ago 20 years were ok last 10 of and on pain. Should I go for the surgery and what are the chances of not having pain or success rate?",
    "doctor_response": "Hello, I think the decision depends on how your orthopedic specialist will evaluate the changes to your ankle after the first 2 surgeries. If he/she will judge as a must, yes, should go for another reconstruction surgery. Pain is part of our life, especially if there are such muscular-skeletal problems. So, we should do what's our best and wish for the best. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Albana Sejdini, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this brain MRI results indicate?\n\nMy wife, recently had a brain problem. Brain MRI shows impression as follows. No demonstarble abnormality seen in brain parenchyma. Evidence of thrombus seen involving right sigmoid and transverse sinus seen extending up to torcula and also seen in the ipsilateral proximal IJV.",
    "doctor_response": "This is saying there is a blood clot in the large veins in the head.This is a cerebral venous thrombosis, and often treated with blood thinners.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I found mucous and blood in my stools. Is this normal? What should I do?\n\nHello doctor, I am a 22 year old female. My height is 5 feet and 6 inches, and I weigh 60 kg. A few days back, after dinner, I passed stools and while flushing, I found the stool to have mucous and blood. When I attempted to clean the anal region after defecating, I found all three tips of my fingers covered with blood. I cleaned it and checked again, and at that time, there was no blood. A few years back, I had the same complaints, but then it subsided without any treatment. I usually pass stools immediately after eating. Is this normal? What should I do? Please help.",
    "doctor_response": "Hi. Following are the possibilities according to your complaints: You need to consult a doctor for physical examination. You will need proctoscopy (medical examination of the anal cavity with a thin tube). If the doctor finds any piles, we will have to treat them. If he feels that there are any chance of Inflammatory Bowel Disease, he will plan a colonoscopy (examination of the inside of the colon).",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get recurrent white patches at the back of the throat with swollen lymph nodes. Why?\n\nHello doctor, My symptoms are distinct white patches on the back of the throat, persistent swollen lymph node in the neck (for at least a week, possibly longer), slight soreness in throat near the node. No fever but have had headaches. Throat flared up in soreness about a week ago then subsided though lingered and lymph node has stayed swollen. Preceding this flare-up was a long period of post-nasal drip and feeling something thick in the back of the throat. Looking at photos of my throat from 2015, it looks like I had very similar white patches on the back of my throat then as well, so it is not clear if they are there permanently or chronically. I cannot find many images online that correspond to this particular shape and pattern of white blotches at the back of the throat. Please advise. I am a male of 39 years old. I take 100 mg Sumatriptan when needed.",
    "doctor_response": "Hello,  Welcome to icliniq.com. What you are seeing are enlarged lymphatic channels in the back of your throat. (attachment removed to protect patient identity).   This condition is called cobblestone throat. It is a term we use to describe irritated throat with visible bumps and lumps at the back. Remember that these bumps are due to enlarged lymphatic tissue in the tonsils and adenoids. These are small pockets of tissue in the back of your throat which when you get irritated due to allergies, postnasal drip or infection can become large and obvious. You do not have strep throat or fungal like picture. I would suggest trying anti-histamine and Tylenol for the next few weeks and see if it improves. If not consult an ENT. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause severe abdominal pain, dry heaves preceded by pain around navel and stomach discomfort?\n\nYes.  I had a very difficult night last night - extraordinary stomach/abdomen pain - all over - upper left side and extending into back, and lower right side; I had dry heaves. It was so painful, I couldn't sleep most of the night.  A heating pad was good.  Yesterday, before that attack, my stomach was feeling queasy and pains around the navel, a lot of healthy bowel movements.  What would your diagnosis and treatment be?  Today, the lower right side of my stomach feels tender.",
    "doctor_response": "hello thanks for using HCMYou are probably suffering fron appendicitis (inflammation of the appendix)This is an acute abdominal condition that neds urgent intervention.Classically, it begins with pain around the navel before being localised in the right lower abdomen. there may be associated nausea/vomiting, fever etc.please urgently see the closest medical doctor for proper assessment.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic otitis media\n\nMy 11 yr old daughter have been suffering from chronic otitis media since her 1.6 years. Eardrum of both ears, as said by an ENT Dr, have been eroded. He suggested for an instant operation, failing which, he opined, irreparable damage may cause to hearing nerve & CNS. Xray Mastoids says that Sclerosis of mastoid air cells on both sides of ear are detected. Kindly tell me about the treatment and the operation. Is it recoverable?",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, if the condition being treated for infection, and allergy and no satisfactory result found and it is the investigations suggestive of surgical condition then it is to be given try and it may not have any bad consequences, and if infection and allergy not being treated then these has to be given try first, in investigations MRI is the test can is advisable, it is also advisable to have second opinion, hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe pain in testicles and abdomen\n\nI've been to a urologist and we covered everything. Prostate exam, xrays, and ultra sound... diagnosis unsure, so doc gave me a month of antibiotics 3 months. I finished the meds but here I am again with the same pain in testicles and abdomen. Ouch! Pain maybe 7, testicles feel heavy... please help.",
    "doctor_response": "Hi.Thanks for your query.Noted your history and understood the concerns.You have already seen the urologist and undergone all the necessary tests, prostate, X-rays, ultrasound yet the diagnosis was unsure. So the Urologist gave you a long courses of antibiotics but the pain is here again 7 on a scale of 10.The pain in the testicles and abdomen with feeling of heaviness indicate that there may be either a local problem which can be diagnosed by MRI of the scrotum.If there is a doubt, there is always a chance to take a second opinion of another Urologist or a senior General Surgeon. Scrotal support to elevate off the weight is also needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does it take to cure paranoid schizophrenia?\n\nMy husband, a 66 year old Indian male diagnosed with paranoid schizophrenia and is on Nexito 5 mg 1-0-0, Pacitane 20mg 1-0-1, Sulpital 200 mg 0-0-1, larpose 1mg 0-0-1. He is also on Olmezest and Deplatt CV. He has gone thru had heart attack, by-pass surgery etc, in the past. Currently, he seems ok in the mornings but 3 pm onwards he becomes uncommunicative, staring, whispers, moves abnormally, cannot follow simple instructions etc. Why is this? When is he likely to get better?",
    "doctor_response": "If your diagnosis is right, I guess treatment is somewhat not proper. As in paranoid schizophrenia antipsychotic medicines are needed. You have sulpital(200)- amisulpride  but for paranoid schiz it is required more than 400 mg. Nexito is there to prevent depressive features. I think he should be evaluated for diagnosis gain for better outcome. You didn't mention when the illness begins , so difficult to judge about prognosis.If it is schizophrenia, likely possibility it can be controlled with medicines but you have to continue medicines for long as per treating doctor's advice. If it is depression it an be cured. So reevaluation needed for treatment and diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why chest feels tight after drinking soda and alcoholic drinks?\n\nI've never been able to drink soda's very fast becaue i get a tight feeling in my chest near my throat, it happens a lot more often when i drink alchoholic drinks.  I have a feeling it's trapped air of sorts because i hiccup a lot and feel like a good burp would make me feel better (which i've never been able to do on command)",
    "doctor_response": "Thanks for your question on HCM.I can understand your situation and problem.In my opinion you are having GERD (gastroesophageal reflux disease). It is due to laxity of gastroesophageal sphincter.Because of this, the acid of the stomach tends to come up in the esophagus and cause the burping sensation in the esophagus (throat).And alcohol actually deteriorate GERD.So better to avoid alcohol and start proton pump inhibitor.Avoid hot and spicy food. Avoid large meals, instead take frequent small meals.Avoid stress and anxiety.Don't worry, you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does restless work lead to a heart disease?\n\nDr.good after noon, My broter Tr. Balasubramanian got the treatment of angeio for his heart blockage and now he is allright on his normal work . He is a police officer of the rank of Inspector of police and it is his duty to do his work promptly then and there both law and order and crime aspect. It is my question is   will restless work lead the same problem again for a single day of his work without takeing any medicine or wirhout any diet controle though he is a diabatic patitient ?",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!I passed carefully through your question and would explain that it is important to maintain normal blood pressure values, coupled with normal glucose levels. If his blood pressure values and diabetes are well controlled, there is no need for restriction of physical activity.  I would also recommend avoiding straining physical activity and closely monitor his blood pressure values. It is also necessary taking anti-platelet agents coupled with anti-hypertensive drugs and anti-diabetic therapy regularly. Hope you will find this answer helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does the ocp causes weight gain?\n\nHi, I am 23 yr old married woman,I am on OCP from past two years. I want to know still how long is it safe to use OCP since me and my husband are not planning for child now, Also I have increased my weight from past 2yrs being on OCP. Is OCP the cause for my weight gain? Please advice.",
    "doctor_response": "Hi, It's rare, but some women do gain a little bit of weight when they start taking birth control pills. It's often a temporary side effect that's due to fluid retention, not extra fat. Studies have showed no evidence that birth control pills caused weight gain in most women. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ajeet Singh, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for blue/black painful swells in ankle\n\nI was hit with a baseball in the shin three weeks ago. My leg and ankle have been swollen since. At first my ankle turned black and blue but that has gone away. Now the spot that was hit is turning red and pain has moved below and above the bruise. The more active I am the more it swells and hurts",
    "doctor_response": "Hi, What I understand by the history is that there will be a direct impact of the hard ball over the shin. Now the shin of the leg doesn't contain more muscle in the bulky form like the thighs. but its more of the thinner muscles and consists more of the fascia. The fascia must have got inflamed and had a direct impact. It will be nice if you get an X-ray done. since if any hairline fracture stays it will heal slowly. Like there is principle for healing of bones. For upper limbs it is 3-4 weeks and for lower limbs it is 4-6 weeks. Sometimes 8 weeks. Depending upon the bone injury and the healing processes. Now since there is swelling which is common I think there is still weakness in the muscles of the shin and needs to be corrected as venous return is insufficient. You can try the balance board exercise which you can find online and rest assured your swelling will vanish. You might not need any medications in future for it. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I feeling kidney pain?\n\nLeft Kidney Shows Fullness of its pelvicalyceal system,for clinical correlation,otherwise both kidneyes are sonografically free.Right Kidney measures 10.2X4.2X1.5cm, left kidney measures 10.2X5.8X1.8cm. Kidly Explain it i am worried . I am still feeling little little pain",
    "doctor_response": "HelloYou findings suggests fullness of pelvi-calyceal system in left kidney.Generally it is a benign finding.It may be due to over distended urinary bladder,stage before emptying of urine into ureter.However,it may also be due to slight obstruction,reflux etc.This condition need clinical correlation and follow up ultrasound.Further  investigations like CT scan can be done if needed.You may also need routine investigations.Treatment depend upon findings.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring stomach pains?\n\nHI I'm a healthy 27 year old but everyday around the same time (between 1 and 3pm ) for the past 3 weeks I've had stomach pains. I go to the bathroom regularly, I exercise and eat right. What could cause this? I have bad stomach pains now as I am writing this.. Please Help...",
    "doctor_response": "hi welcome to hcm your pain could be related to GERD/GASTRIC ULCER.Take antacids like Tab.Pantoprazole 40mg once daily before breakfast and anti motility drugs like tab.lomotil twice daily for 5days.Avoid alchohol and spicy food,hot liquids.take fruits,buttermilk,water 3-4 litres per day.Get an upper GI Endoscopy by consulting your doctor if pain persists. Thankyou",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does wheezing and coughing indicate asthma which have remained uncured through allergy medication and inhaler ventolin?\n\nHI !   my name is Marlin and I am 51 years old.  I have condition that I have developed for the last 4 years that I believe is bronquios or Ashma. for the last 4 years I have this condition 1 or twice a year. star with wheezing or coughing really hard, I am using an inhaler Ventolin.  for two months I have this medicine plus a syrup Cheratussin AC100/10mg/5ml. The situation is that 4 days ago I started to have the coughing and several chest congestion, terrible wheezing and still like a thunderstorm. I went to a homeophatic store and bought to syrup 1 for day time, and 1 for nighttime. I didn't work, so I stop because I realize that contain suppressant. I can't  afford a doctor now, I don't have health Insurance, I have this problem that start the las week of November. I pay a clinic that was a Practitioner no a Doctor. and just got some prescription for Ventolin and cheratussin. treating myself with home remedies but right now I feel like only this terrible thunderston is in my chest .and supposed that the ventolin is for the wheezing . in the past I have taking PRO AIR AND SINGULAR. But I am taking the allergy medicine in the morning. I don't know why is this phlegm in my chest is spam there.",
    "doctor_response": "Hi and thank you so much for this query.I am so sorry to hear about what you have been experiencing. Wheezing in most cases suggest an obstruction of the airways of which the most common cause is asthma. Allergy  medications and ventoline are meant to control the symptoms and not cure asthma. The main stem of treatment is identifying the provoking factors and preventing exposure to. Some include oil, pollen, dust, cold, exercise. etc.depending on the severity of your symptoms, you may be required to take medications daily or only take drugs when you have crisis. Ask you doctor about educational material on this to help improve your understanding and participation in the management of this condition.I hope this addresses your query fully. Thank you so much for using our services and please feel free to ask for clarifications if need be. I wish you the best of health.Dr. Ditah, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest diet plans for weight loss\n\nhi !.i have a 12 year old daughter she is suffering a lot from she has cried lots weight problems she is about 14 stone and she comes to a gym with me for 30 minuetes she definetly needs a diet plan because she is saying oh no i wont eat this or that and when she sits down she will eat!!(chocolate etc) she is always hungry she is getting slagged and jeered a a lot!! so could you help me on a diet plan..???it would be very much apreciated she said she is willing to go on a diet but we need profesional help..???? thank you",
    "doctor_response": "Hi, Please put your child on high protein, low carbohydrate diet, foods rich in carbs like pasta, noodles, rice, roti, tortilla have to be avoided. She can have green leafy vegetables, grilled fish and boiled chicken. She can eat egg white. Please look up paleo diet and put her on the diet with moderate exercise. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Prasanna Lakshmi, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to deal a teenager who has extreme anger, lying and stealing habit, aggressive with frequent mood swings?\n\nI have a teenager with mental heath problems she has extreme anger issues she has always been strong willed since 2yrs old she will not tolerate adults not just me any adults she lies steals has total meltdowns very hyper then depressed mood swings from hour to hour aggressive to everyone in authority she is 16yrs old has a brother with autism she does not show all the signs of this but her social skills are poor and eye contact not goog unless when confrontational she will stare to intimidate you she has started smoking cannabis the last year also drinking she has no attention span unless she is intrested in something which is hanging around parks ect the list is endless I am very very concerd",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. From the given symptoms (I remind you that the symptoms you are providing could be biased and may not be properly observed) this behavioral problem seems to be borderline personality disorder.Borderline personality disorder (BPD) is a serious mental illness marked by unstable moods, behavior, and relationships. Most people who have BPD suffer from Problems with regulating emotions and thoughts, Impulsive and reckless behavior and Unstable relationships with other people.Best treatment includes psychiatric intervention and psychotherapy. Please consult a psychiatrist for further advice.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach infection in a child\n\nMy 18 month old son has been suffering from trapped wind/upset tummy for around 4 days. He has been off his off but is drinking fluids. This evening he woke and vomited twice, his stomach is gurgling a lot and seem uncomfortable. The past few days he has had yellow/cream stools which turned to diarrhoea. Today he has been passing a lot of wind accompanied by light diarrhoea. Around 5 weeks ago he suffered for gastroenteritis for around 10 days, since then he has been back to his normal self, eating and drinking normally. Temperature is fine although feels clammy to the touch during the night. Any advice would be much appreciated",
    "doctor_response": "HI..this seems like a viral diarrhea which is starting in your son. It will initially start with vomiting and then will gradually progress on to diarrhea. You need not worry unless he is extremely tired/ not passing urine/ there is blood in the motion/ abdominal distension/ listless.I suggest you give him plenty of oral fluids, avoid aerated drinks, avoid fruit juices and start on Zinc supplements. He will get better soon. If he develops any of the danger signs mentioned above, kindly consult your pediatrician.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Excessive pimples on face, using medicines, pimples still persisting. What can be done?\n\ni am 21 yrs old boy,,, i have lot of pimples on my face,,, i consult the doctor,,, i gave these medicines,,, Acnex soap , Acnegon cream , opelan cream and microdox- Dt tablets,, when im using these medicines pimples are little decresed,,, but there have,,,,,, im using these medicines almost 1 year,,, but still my problem is not solved,,, pls help.......",
    "doctor_response": "iadvise you to stop mik and diary products no ils mustard coconut walnut groundnut almonds soya apply olive cook in olive no milk and nut containg soap oils creams and ointments take oil free and greese free diet tab doxitab 100 mgm bd for 10 days apply clindac a gel morning and evening calamine in after noon do 2 months and ask for next step",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do soreness and swelling on the tongue indicate?\n\nIn the last couple of days my tongue has become sore and swollen and has now has swollen sections that are whitish yellow. The interior of my mouth is now becoming more sore and sensitive and I have been unable to eat and now drink.I need to know what this is and how to rid myself of it",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Sore swollen tongue with yellow white patches can be due to yeast infection or oral thrush. Consult an oral physician and get evaluated. A microscopy of scraping from tongue can help in confirmation of the diagnosis. If it is thrush then antifungal medicine like Nystatin mouthwash, Clotrimazole lozenges and oral medicine like Fluconzole can be advised for 15 days. Eat plenty of probiotics like yogurt and maintain a good oral hygiene.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe pain below the ribcage\n\nA 40 y/o male presents severe pain on his left side and back below the ribs. He describes the pain as spreading to the lower abdomen and groin and comes in waves that fluctuate in intensity. He has painful urination and brownish foul smelling urine. He reports a persistent urge to urinate and urinating more often than usual along with nausea and vomiting.what is he diagnosis with",
    "doctor_response": "Dear PatientYour symptoms indicate infection  in or around kidney on left side. The basic way to proceed is to get urine examination done along with USG o kub region. Kindly discuss your findings so that we can discuss on treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness in the upper chest and throat?\n\ni have been diagnosed as having impaired glucose tolerance. In the last one week I have been experiencing a tightness in my upper chest and throat.  I have had an Xray done and everything appears normal. My face appears bloated.  I am a 57 year-old woman",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern.I will try to explain you something and give you my opinion.You should know that typical heart pains have some characteristics.Usaly they are retro-sternal, uper chest pains like squizzing, tightness or heaviness.They migh irradiate to both arms , neck and jaw.They last from 5-20 minutes and usaly start during a physical activity.The fact that you have a impaired glucose tolerans  makes you at higer risc for cardiovascular disease.So, as you are experiencing chest pains my opinion is that you should do some examinations.I would recommend an electrocardiogram, a cardiac echo, cardiac enzymes and a strees test.After this you might be shure thats nothing to worry about or something else that should be resolved.Hope I was helpfull.Best regards, Dr.Ervina.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the sudden multiple bumps on face and ear?\n\nHi I have a multiple bumps that showed up over night they looked and felt like pimples when I woke up and saw on my face but they turned out to be like scabs with golden crust or something yellowish that we re coming off of it and some scabs showed up on my ear also I m not sure what it is but I scratch off the first layer, it starts to ooze then the gold layer comes",
    "doctor_response": "HI, thanks for using healthcare magicIt may be impetigo.This is common skin infection. It starts as redness or discomfort of the skin. This progresses to blisters or sores that then crust over.The crust would have a yellow appearance.It is treated with antibiotic therapy.It would be best to see your doctor for an assessment and treatment.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could muscle bruising with heaviness in back suggest?\n\nI have lower back pain which I have been told is muscle bruising, but the last week or so it's different, I now feel like there is a massive weight on me and I feel like I could collapse, I know I won't but it's as if I can feel everything beneath me moving. Any ideas?",
    "doctor_response": "Feeling  lower back pain and heaviness  as you described  is suggestive  of lumbar  muscle  spasm or strain . It's because of excessive  use of those muscle  or sudden  jerky  movements such as bending  twisting or turning . This will resolve slowly . You need to give your muscle rest.you can apply  topical painkiller  ointment. Do some extension  exercises . And avoid excessive  bending  and  jerking  etc. If pain persists  for longer duration  consult an orthopaedic  surgeon .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes redness in gum?\n\ni have hep c, about a year ago I noticed my gum turning red and a white film, my doctor told me I was alergic to whitening toothpaste which I had switched to, because of the hep c I have erthema nodosum and I am on minocycoline, my dentist said this med will help w/the gums, but its not, why",
    "doctor_response": "Thanks for your query. i have gone through your query. the redness in the gums could be because of gum infection secondary to deposits or it can be because of allergic stomatitis. consult a oral physician and rule out these two conditions. if it is because of gum infection then get the teeth cleaned. if it is allergic stomatitis change the tooth paste and apply topical steroids like triamcinolone acetonide(0.1%). i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Hypogammaglobulemia.\n\nHello,Since being diagnosed with Hypogammaglobulemia @ 53 yo , I'm trying to figure out the cause: Chronic pylonephritis resulting in nephrectomy 20yrs agoFocal segmental glomersclerosis in remaining kidneyAnkylosing Spondylitis + (spinal stenosis)FibromyalgiaOsteo-Arthritis (hands, feet, knees, etc...)Any ideas?",
    "doctor_response": "Hello and welcome to HCM,Gamma globulin is a protein produced by the liver.Hypogammaglobulinemia can be congenital or it can be acquired.Congenital hypogammaglobulinemia is due to congenital absence of production of gamma globulin and acquired can be due to liver disease.All the diseases mentioned by you- chronic pyelonephritis, glomersclerosis, ankylosing spondylitis, fibromyalgia and orthoarthritis are not directly responsible for hypogammaglobulinemia.Treatment consists of replacement with gammaglobulins.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp shooting pains in anus?\n\nHi, I keep getting sudden sharp shooting pains in my anus when standing. It s so bad that I can only describe it as a knife up there! When I sit down I get the same feeling but as though it s in my vagina. My tummy feels swollen & It comes and goes. What could it be?",
    "doctor_response": "Hello,As a physician, as you have sudden sharp shooting pain in the anus, my probable diagnosis is anal fissure or fistula or hemorrhoids or trauma.Can I come to know whether you have blood in stool or complaints of constipation?I will suggest you to consult with surgeon for per rectal examination. That will give a clear cut diagnosis. I will suggest you to apply Anovate ointment locally and tablet Dolo.I will also suggest you to review here with detailed history or consult with the surgeon.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can periodontal disease cause headaches associated with migraines?\n\nCan periodontal disease cause headaches associated with migraines. I noticed that I started having terrible headaches that make me dizzy and nauseus since I was told I had a gum infection. My gums are still sore and I feel pounding every now and then.",
    "doctor_response": "Hello,Periodontal disease can include infections that spread. Your system can react with these symptoms if the infection is severe. I do not know the extent of your periodontal disease or treatment provided. Are teeth loose and moving? Have you been placed on medications and have you ever had an allergic reaction to similar medications? Do you have habits such as grinding your teeth? Headaches and migranes can be associated with grinding or clenching your teeth. Often your bite needs adjustment with severe periodontal disease. I would suggest you discuss your symptoms with the dentist that diagnosed your periodontal disease.Toothpaste for sensitive teeth and fluoride rinses can help reduce soreness. You must keep up good dental hygiene. Warm salt water rinses may soothe healing tissue. Proper nutrition and hydration are important. Diet considerations may include a softer diet with reduced acidic, alcohol and spicy content. No smoking. Reduce irritants to your tissue. Pain and anti-inflammatory medications often help with discomfort and healing with periodontal treatments. Your dentist may prescribe a prescription rinse to assist healing and comfort.Thank you for your inquiry. I am available to answer additional questions if you provide additional details on your periodontal condition. I hope you find this helpful and will feel better soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause lower back pain on the right side?\n\nhello sir ,i have lower back pain on right side since last 2 years . i have used body building supplement (protin powder )after that i have got this pain . i have done many treatments like . kidney stone , urine infection . can u tell me what the matter is .",
    "doctor_response": "Dear patient Considering  your history chances of kidney stone is high since you have past history of infection  and kidney  stone. Single sided back pain is mostly due to renal stone. Also protein intake increases chances of stone. So I would advise radiograph  of  lumbosacral spine anteroposterior and lateral  which will show radio opaque stone clearly .Ultrasound  of  abdomen  is also advised to confirm position and size of stone.  Please consult expert urologist with report. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "My father have had Heart problem, please suggest him\n\nHi My father had a cardiac arrest about 8 years ago. His heart stopped beating for about 10 minutes. He was in a coma for 20 or 30 days and he got better slowly. Now he is physically fine, I mean that if you look at him you can not recognize he has any problem. But he can not control his piss and pee. He can feel everything, he can see and hear and even he can count and memorize something for a short time. He sometimes say poems but his learning is very weak. Can I do anything for him ? Sincerely yours - Omid Ghasemi",
    "doctor_response": "Hi... Brain damages are most often irreversible.. The chances of reversibility is only be therapies.. Though it has been too long to expect improvement, continue with the therapies if any.. Your care and love is very important in helping him improve.. So continue with it.. All the best...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for bruises in leg\n\nI fell from a chair a little I over 2 months ago. The chair fell over on my leg and it ended up bruising way down deep under the skin. The bruise was barely visible but was super tender to touch. Sense the fall a hard numb knot is on my leg that will not go away. It itches often and it sometimes hurts to walk.",
    "doctor_response": "when a chair fell over your leg the force of the chair wasn't enough to break your bones or injure your ligaments however it caused a localised contusion to your skin and tissues under the skin, this can be associated with some bleeding under the skin and a clot can form. It can take a while to go away but it will surely get better over time. simple pain tablets should help and the itching should get better. if you think that it is rather getting worse the best thing to do would be seeing a local doctor for examination since there is a possibility that what you are having now isn't related to the chair incident",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the effects of over masturbation ?\n\nis black spots occurs due to over masturbation? / size of penis is reduced due to over masturbation  i am in this act from the age of 15 year. my sperms is getting dilute. my dick is not straight at the time of raising it & size is 5\" only which is i think too small. Is the problem of STD can occurs due to above.Is this serious problem? can i get alright in future and get my sex power back",
    "doctor_response": "DearWe understand your concernsI went through your details. Masturbation is a natural process and is considered healthy if done within moderation. Black spots are not due to masturbation. Size or penis cannot decrease due to masturbation practice. Due to masturbation practice semen cannot be diluted. There are many other factors determining the thickness of semen. Your 5\" erect penis not at all small because even a 2 inch penis can satisfy any woman. STD cannot occur due to the above said problems.I suggest you to consult a psychologist / sexologist in order to gain the required amount of knowledge so as to clear your anxiety and doubts. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump in thigh with sharp pain in leg?\n\nHello. I have this lump on the side of my thigh. Its about the size of a tennis ball. (if you were to take the tennis ball in half, that would be the size of my lump) there s no discoloration on the bump, although my leg, ankle and foot appears to get pale at times. The lump on the lower side of my thigh is warm to touch, there s no pain when I push on it though. I ve noticed since I saw the bump, my leg, foot and ankle gets a sharp pain. The pain is kind of like a thumping pain. (pain is here one second, gone the next and then back again. Process continues over and over again, not sure the proper term for that, that s why I said thump) my leg also feels at times like it cramps up, and it only use to happen every now and then but it s happening more often now. My leg also feels heavy it times this just started happening though. I also noticed that my leg, ankle and foot gets swollen on a daily basis, whether im relaxing or actually walking. I first thought it was an internal bruise, but this is the third week with this, and symptoms seems to get worse instead of getting better. I need a doctors opinion before i go to my doctor and pay a bill for something that may be not that serious.",
    "doctor_response": "Hi, If I were your treating Doctor for this case of painful thigh lump, I would come up with two possibilities, these include: 1.\u00a0\u00a0\u00a0\u00a0\u00a0The first possibility is of benign and simple conditions like lipoma or neurofibroma; there is nothing to worry about these!3.\u00a0\u00a0\u00a0\u00a0\u00a0The last possibility is of sebaceous cyst or some other cysts like bursa or ganglion cysts! Nothing to worry about these also!I suggest you to go for an FNAC and ultrasound of the lumps for confirmation and to relieve your concerns!Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does cyst with stones mean cancer?\n\nHi I have a cyst with stones inside it. This was found on a ct scan 2 weeks ago, I am due to go for another CT Scan with injection of contrast into vein on the 18th March Yesterday I had my bloods taken for creation. I m worried that this is cancerous and I need to know",
    "doctor_response": "Hello,I can understand your concern. Cysts are fluid filled swellings that are benign/harmless. In most cases, they are left without treatment if they do not cause discomfort to the patient and are not infected. There are many cysts which are benign and may have stone-like calcified structures within it. Having stone in cyst does not mean it is cancerous. So do not worry about it just because they found calcified structures within cyst.The confirmation of presence of cancer in any area of the body is based on the biopsy of the area and lesion involved. You have failed to mention what part of your body is involved. However, if your surgeon decides to remove the cyst with the surgical procedure, histopathological analysis of the removed cyst in the laboratory will confirm if you have cancerous changes in your body.I hope this information helps you. Thank you for choosing HCM. Let me know if you have follow up questions.Best,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lump on right side of vagina, spotting with bloody discharge. History of atypical hyperplasia. Done intra vaginal scan. Cancer?\n\nI have had atypical hyperplasia 15 years ago and had a d andc...am now having same symptoms been to docs had a scan and a intravaginal one have got a lump on the right wall in my vagina and have been spotting for four weeks with a bloody discharge am waiting for results... Could this be either vaginal cancer or cervical or endometrium cancer..i am 49 and had atypical endometrium hyperplasia it was simple not complex",
    "doctor_response": "Hi, Atypical hyperplasia is not cancer. Lump in vagina may have some significance. Punch biopsy is necessary to clinch the diagnosis. Do not worry right now. Consult your gynaecologist . He/she can better guide you .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is red bumps and itching on tongue a reaction to acrylic retainer?\n\nMy daughter just got her braces off and received an acrylic retainer.  Since she started wearing the retainer, she has had mouth pain, severe itching and red bumps all over her tongue.  She has severe eczema and has extremely sensitive skin.  Could this be some kind of allergic reaction to the retainer?",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,     I have gone through your query, as you have small daughter having retainer yes problem of mouth pain , red bumps can be due to retainer if it has sharp edges or air bubbles causing irritation.  Dont worry on tongue and painful gums you can apply anaesthesic  ointment Mucopain or Dologel twice daily for 5 days Consult dentist and go for trimming of retainer if any problem is there   Do warm saline gargle two - three times a day. Hope this will help you. Wishing her good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Ativan and oleanz prescribed after having stress. Disturbed by negative thoughts. How to help?\n\nHello, 3 months ago my friend had a showdown at work and as a result of a lot of stress. I took him to a psychologist who recommended him Ativan and Oleanz Plus. He is 35, male and works in a industry requiring long hours. since that episode it has been 3 months and he has these flare ups. He stopped the meds within a week, and is trying to engage himself socially more. but negative thoughts seems to be hounding him again and he refuses to see a counsellor. His thoughts are random, like he is being spied on, or people are out there to get him, or he doesnt \"know what is gioing on\" and thinks others know more about him and not telling him that. How can i get him to confront this.",
    "doctor_response": "Hi,Thanks for using healthcare magic.I have gone through your available history.Your friend seems to have developed schizophreniform disorder or adjustment disorder with psychotic features.He require medication as well as counselling. If he does not agree to consult psychiatrist, you can give some medications like olanzapine or risperidone out of knowledge of the patient. You may have prescription from your local doctor for the same.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sinus infection, green discharge, pressure on head. Allergy medicine did not work. How to cure?\n\nHello Dr. Samuel, I moved to Great Lakes Illinois in November, and have developed a strange problem. Around the last week of December I developed a very strange sinus problem. It started out as a common sinus infection that lasted about two weeks. Then after the green discharge and blood stopped coming out of my nose , I kept on having nazil drainage. For the past two months I have been blowing my nose nonstop, and have head this uncomfortable pressure feeling in my sinus area that never goes away. I feel miserable all the time, and I have very little energy most of the time. I saw a doctor who thought I might have allergies. I have taken several different allergy medications , and none of them have helped at all. This is making everyday life much less enjoyable, and it also makes me feel very out of it. If you have any ideas on what could be wrong with me, I would love to hear them! Thanks, Jared",
    "doctor_response": "avoid any allergen. wear a mask covering ur nose and mouth from cold and other allergens. u can take tab levo-cetirizine sos. antibiotics and NSAIDs during infection. take tab septilin 2 tabs thrice daily for 4 months. ur sinusitis issues will disappear.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be Clavam dose for cough and cold in children?\n\nmy child, age 10 yrs and weight 26.5 kg, has taken clavam 625 - twice daily. This was prescribed by the doctor as child was suffering from cough/cold and fever. Is this a very high dose? Since the medicine is already taken, kindly advice if any further consultation to recover the side effects from high dose is required.",
    "doctor_response": "20 to 45 mg/kg/day in 2 to 3 divided doses.and ear infection(otitis media) is there you have to give as high as 80 mg /kg/ day in 2 divided doses",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have tonic clonic seizures before or after period. Could menses stimulate vagus nerve at this time and trigger a seizure?\n\nmy 18 year old daughter has tonic clonic seizures just before or after her period. In the past she had a problem with taking suppositories for constipation because of her vagus nerve (she would almost pass out). Could her menses stimulate her vegus nerve at this time and trigger a seizure?",
    "doctor_response": "Hi,Thank you for posting your query.It is common for certain types of seizures to get aggravated during the menstrual periods. This is referred to as catamenial epilepsy. This phenomena is related to hormonal influence rather than vagus nerve stimulation. Similar situation can occur in women with migraine, which can get worse during periods, referred to as catamenial or menstrual migraine.In your daughter's case, taking clobazam for a week during periods would help reduce the chances of seizure recurrence during that period.I hope my answer helps. Please get back if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Semen analysis done. Pus cells, epithelial cells, malformations in bloated heads. Explain\n\nHello Dr, what is the meaning of ; MICROSCOPY - 20% of sperm cells with normal forward progression, 50% Sluggish, 30% inactive or Dead, PUSS CELLS -12/HPF, EPITHELIAL CELLS - 3/HPF MORPHOLOGY - Some malformations in the form of bloated heads, short and coiled tails were common. Count - 27 Million/ml Please kindly help me, l received from semen analysis test",
    "doctor_response": "Hi friend, Welcome to Health Care Magic This means the quality of sperm is not up to the mark and there is infection. You need the help of Andrologist (Urologist) Take care Wishing speedy recovery God bless Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back injury, weakness in legs and spine, shooting pain, numbness. What can be done?\n\nWere do l start.hurt my back nearly 6 year ago at work not been able to get n with life l had 4 discs out told l had spine of a60 year old ''l am 37 was 31.had op about 2 year ago was worse leg pain especially any way this year felt I'll with my back in constant pain leg weakness .carry on wit life kids work etc any way my leg gave away when l got up my tail bone my hip right and these awful shooting pains down my right eLeg comes in waves like be ending in labour pain had this last 3 week my back pains there every min every day put l knew something don't feel right a lot of numb ness and yes when l nip the skin l still have no feeling feel like get no help/ been paidn clinic phsiyo you name it some things wrong soon as l stand the pain shooting up down my leg foot by the way on morpine help please",
    "doctor_response": "Hi and welcome to HCMI understand you have back pain . These symptoms are part of lumbar disc degeneration with PIVD where the nerves get compressed by the protruded disc.There are several treatment modalities with medicines, physiotherapy and with injections in the back called epidural injections and root/facet blocks.If you don\u2019t get better with these treatment ,I suggest you undergo surgery, by which the nerves are decompressed by removing the protruded disc (discectomy), which would significantly improve your symptomsI do hope that you have found something helpful and informative and I will be glad to answer any further query.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have tried various products to gain weight and spoiled my health. What to do now?\n\nHello doctor, I am trying to gain weight for the past six years. I have tried\u00a0many types of steroids like ayurveda tablets, allopathy\u00a0capsules, some of the mass gainers, weight gainers, etc., but they did not show any result. Once, I have gained 3 kg to 5 kg. But, when I left the supplements, I lost my weight. My efforts for gaining weight are still going on. I have tried many brands of mass gainer, protein power and capsules. My local doctor suggested medicines, but they never work properly. Also, the various products injured my metabolic system. Today, my condition is like, I never feel. My stomach sounds poorly all the time. I am very upset for my health. I had a lot of medicine and checkup. But, I am not healthy right now. What to do now?",
    "doctor_response": "Hello. I just read your query. Anxiety or excessive use of past medication or lifestyle. Revert after four weeks to an ayurveda specialist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever with stomach discomfort and sensitive skin?\n\nHi, my boyfriend is experiencing some tummy problems with it rumbling and feeling generally uncomfortable. He also has quite a high fever and his skin is pretty sensitive. He had breakfast and lunch but is feeling too weak to eat anything now. He tried to vomit, but to no avail. Is this just because his system is run down due to stress and exhaustion or is it something more serious? He rrecently started taking vitamin b supplements, but i'm not sure whether or not he is still taking them. Any suggestions?",
    "doctor_response": "Hello, You are talking about a weakness, upset stomach, discomfort, high fever and sensitive skin. Vitamin B supplements may not have anything to do with his present conditions. Because he has high fever, it should not be taken lightly. Therefore, my advice would be to consult a doctor earlier. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What tests should be done to know the latest heart condition?\n\nI have undergone angioplast twice in 1995 1999. I also have carted arterires left blockage 75%. I am asymptomatic .I am advised Stress echo test to know my latest heart condition as sometimes walking fast becomes not comfortable. What is this test? Are there any risks? In Mumbai where I can have the stress echo test",
    "doctor_response": "depending on your functional class and ecg you may be subjected to exercise or dobutamine stress echocardiography. both test are safer in specialist hand and centre.in exercise stress echo- you will get your baseline echo done followed by treadmill test up to a certain heart beat and then after echo to asess your heart function. if any of your arteries having significant blockage your heart function will decrease than expected.you can get it done from any cardiology centre.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are steroid injections safe for fetal growth?\n\nHello doctor, My first baby is healthy and my blood group is A positive and my wife's blood group is B negative. Now, my wife is again pregnant and has completed 26 weeks of pregnancy. She has developed antibodies and the latest ICT with titer test results show 1:64. Last week, we also did sonography and that did not have any impact on the baby. Now, the doctor suggests giving some steroids in this week which will help to develop the baby's lungs faster to prevent any complication. Is it safe? If my baby's blood group is also negative then are there any possibilities for antibodies to develop in my wife or does the baby's blood group does not matter at all? Should I go ahead with NIPT to find the baby's blood group?",
    "doctor_response": "Hello. Since your blood groups are negative, there is nothing to worry about. Yes, you can go ahead with injection for babies. They are safe. You need not go for a test to detect your baby's blood group as it is not an issue. However, if you have a doubt then get back to me. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for atrial fibrillation\n\nmy mother was diagnosed last may with afib. she was kept in ICU for a week to try to stabilize her heart beat. now she s been given a lot of medication (atorvastatin. metoprorol. candesartan. xarelto. verapamil. sulfameth.) I take her vital signs often but her heart beat has never stabilized. all she do is sleep and more sleep. she s getting worst and she never had an appointment with a cardiologist even at first. what should I do?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. After going through your medical details I understand your concern and I would like to tell you that in atrial fibrillation her heart rate will always be irregular as it\u2019s name indicating fibrillation. Kindly continue with the prescribed medication and blood thinners to avoid complications like stroke. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Done MRI. Have cold and numb arms, dizziness, tunnel vision in one eye\n\nI am just reading my MRI report again (without contrast) from a year ago that noted asymmetric T2 hyperintensity and punctuate focus hyperintensity. I have been having episodes. Last week I lost control of my legs for about a minute out of nowhere and fell. Arm goes cold and numb here and there. Bouts of dizziness . My right eye has kind of a tunnel vision here and there.",
    "doctor_response": "Hello, You need to see neurologist for this sooner.Your symptoms arise suspicion of transient ischemic attack or demyelinating disorder like multiple sclerosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp shooting pain in foot?\n\nstarted sunday evening, sharp sever nerve pain not muscle pain across top of right foot from 3rd and 4th toes to ankle to outside of lower leg to knee, so pain full unable to stand. would last 5 seconds stop and start again minutes later. stopped hurting after 3 hours and started again Monday after 7pm not as often 2-3 times an hour until about 10 pm, toay on and off again all day, now tonight constancely standing walking or setting. I am 35 year diabetic with nerve damage .",
    "doctor_response": "Hi,Given the history of nerve damage with diabetes these symptoms may be of nerve damage. Do take care of keeping your foot straight with pillows under knee to prevent any unwanted stretch at nerve. Drink lot of fluids, have green vegetables and have vitamin b12 supplements (vit b 12 is considered as nerve tonic). Do visit a neurologist. He may be able to help you with some nerve pain relieving medication. Do some active movements of toes and ankle it will keep the muscles toned up and prevent any swelling of ankles.Hope you find the answer useful. Let me know if I can assist you further.Regards,Dr. Harsh Swarup",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed pain on left side of rib cage & tightness in the esophagus\n\nI have been experiencing an intermittent pain under my left side rib cage for several years.  When it happens it seems to last for a few weeks then goes away for a while.  I have been bothered by this bout so much that I feel like I can't catch my breath (not because my lungs aren't clear but because it feels like my lung just can't expand completely).  I had blood tests yesterday and ruled out pancreatitis.  Still waiting for results on the bloodwork for ulcer.  I have had an ultrasound during one other bout and they couldn't see anything.  I get heartburn occassionally but not regularly.  Today, I not only feel the pain under my rib cage but a \"tightness\" in my esophagus and still feel like I can't catch my breath.  I am scheduled to see a gastroenterologist but I can't get in for over a month.  I am very frustrated because it seems like the symptoms I have don't fall into any obvious diagnosis.  Do you think seeing a gastroenterologist is the correct next step?  There is no food that I've noticed to aggrivate it.  In fact the only thing I notice that aggrivates it is abdominal exercises (like sit ups).",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. In my opinion you are having GERD (gastroesophageal reflux disease) and bronchitis. GERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause symptoms of Central chest pain, tightness, pressure etc. Reflux causes micro aspiration in the lungs. And this causes bronchitis. Bronchitis manifest as breathing difficulty. So control of GERD is must. And hence gastroenterologist consultation is needed. You should avoid hot and spicy food, stress and tension, junk food. Avoid large meals, instead take frequent small meals. Take proton pump inhibitors and prokinetic drugs. Don't worry, you will be alright. So consult pulmonologist and discuss all these. Hope I have solved your query. I will be happy to help you further. Please hit thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe ankle pain\n\nI have had a stabilization surgery on my ankle 4 years ago. I now have been experiencing Cramp Like symptoms that stem from where the surgery took place and shoot up the side of my leg. It is intense pain and lasts from 2-15 minutes. During this time the ankle often freezes or is unmovable. Sometimes the pain subsides for a minute and movement returns, but if I move it again it freezes and the pain returns again. This happens mainly early in the morning and wakes me from sleep. I find that moist heat can SOMETIMES relieve the pain. After one of these episodes the area of the ankle/leg are often sore. Should I consult a Dr about this and if so, what kind of doctor should I consult? a Pediatrist?",
    "doctor_response": "Hi,since your ankle was stabilized 4 years back, it means the implant would be still in your body, these symptoms could be either due to infection or implant irritation. since the implant has now solved its purpose, i would recommend you to get an X Ray done and get it removed. I hope this will solve your problem",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe leg pain\n\nI m trying to quite pain pills oxys I was in pain mgmt for couple yrs i and got hooked he dismissed me and didn t ween me off now I m going to different ppl seeking and its ruining my life I don t want on suboxan cause its addicting to what do i do I do have pain buldging disks with nerve pain down both legs with tear in spine I don t have money to pay you I m sorry please refund me",
    "doctor_response": "Dear Sir/MadamI have gone through your query and read your symptoms.do not care for money, if you have paid they will refund you, and this opinion is free.do not run here and there with disc problem, it will not only cost you more but will also make the things worst. so first RELAX, THERE IS ALWAYS A SECOND CHANCE.Look for a spine surgeon who operates in charity hospital, or government hospitals where you will have no cost of surgery, at least not high as the private players.GET PROPER TREATMENT AND PHYSIOTHERAPY GET OPERATED TO LESSEN THE MISERY EARLY.I hope that answers your query. If you want any more clarification, contact me back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for balow cancer?\n\nHi I m ciprian and my wife had balow cancer in 2011 at 29 years old, it was a t4 metastatic afterthat last year cancer appear to cervix area and this year to lungs....after 2 sesion of chimo and radio therapy unefectiv we decided this time when cacerapiar at lungs to go on raw diet and weath grass juce and vegetables juce and garlic every day...I don t know if it is the best think but definitely her buddy would not resist to any more chimo",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  She has stage 4 cancer.  Her cancer is spread in to cervix and lungs. So surgery will not help you.  Only treatment options are chemotherapy and radiotherapy. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes weakness in case of kidney failure?\n\nMy grand mother has stage 4 kidney failure and he has a uti and she has had many strokes on her brain steam is there any reason for her to be having weakness and drulling and she isn t asking like herself and she has altimers and my aunts are telling me she is fine but she doesn t know anyone or where she is and they said all of it is from the UTI but I don t think it causes all that but she doesn t have a fever and hasn t been complaining of any pain when she urinates can you please explain to me what this may be?",
    "doctor_response": "Hello and welcome to HCM.As an Urologist, i can understand your concern fully.I'm sure you can understand the health status of your grand mother,havingkidney failure with multiple strokes, UTI,with Alzheimers, due to which, she can't recognise anyone.  UTI should be diagnosed on urine culture only.The kidney failure leads to severe anemia,that causes low iron levels(Hb), weakness in bones as well.  Some patients'are also given an erythropoietin transfusion for that. If you can send me the reports in my name, i can advise treatment  as an expert.       Dr.Matthew  Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does pus cells-2-3 and protein-negative in urine test suggest?\n\nROUTINE URINE ANALYSI Straw Yelow /- Urine Automated -Reflctance photmetry Clear COLUR(URINE) PH (URINE) 7.0 - SPECIFC GRAVITY(URINE) 1.02 - GLUCOSE (URINE) NEGATIVE - PROTEIN (URINE) NEGATIVE - BILRUBIN (URINE) NEGATIVE - KETONE (URINE) NEGATIVE - UROBILNOGEN (URINE) 0.2 0.2-1.0 E.U /dl - Manual-microscopy SEDIMENT (URINE) PUS CELS 2-3 / HPF RBC NIL / HPF EPITHELIAL CELS 1-2 / HPF CAST NIL / HPF CRYSTALS NIL / HPF OTHERS (URINE) - - * End OfReport * Director-Central Laboratory Services Dr.Uma sekar M.D,CP Dr.Feb Renjitha Suman M.D ADITONAL PROFESOR Al investigations have their limtaions whic are imposed by the limts of senitvy and specifty of indvidual asy procedures as wel as the quality of the specimen recived by laboratory.Isolated laboratory investi this is my son 5 yrs old his report kindly inform that he s having any infection or not",
    "doctor_response": "Hello dear,welcome to HCM.Apart from 2-3 pus cells,the report is normal.But,whether this is significant or not,depends on the clinical condition of the child.If symptoms like fever, frequency,urgency,burning on urination etc are present,this needs to be treated with antibiotics.Your doctor will guide you.You may be asked for a urine culture test.Hope this answer might help.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have Rathke's cleft cyst on brain stem. How dangerous is this?\n\nHi. My name is Alexis, and I m 16 years old. In September of 2011 I was diagnosed with a Rathke s Cleft Cyst on the stem of my brain. I have been to many doctors and they all had me doing no physical activity, because I might hemorrage my cyst. But I recently changed doctors again, and this time I did hemorrage it, he doesn t really know much about this, and I was just wondering how dangerous it was, and what it could do to me?",
    "doctor_response": "Hi, Thank you for posting your query. Rathke's cleft cyst is a benign condition (it is not cancerous condition). So, by and large, it is a harmless condition. There is no medicine to cure this. The only treatment is surgery. Surgery is needed if the cyst is growing in size or if it is causing a pressure effect on vital parts of brain. Surgery can be safely done by trained neurosurgeon. Wishing you good helth, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is alternative birth control measure required while on antibiotics?\n\nI was recently on antibiotics and I m on norg-ee birth control. I started the antibiotics during the last half week of hormones in my pack and have since finished the antibiotics. I finished the antibiotic 2 days ago. I started my period on Monday and am finishing up my period now. My question is do I need to use alternative birth control measures since I have been on antibiotics or does it not matter due to where I am in my cycle (and have had my period). Thank you!",
    "doctor_response": "Hi, you don't need any other contraceptive measure as you have got your periods this time. Hope I have answered your question.Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to increase the size of the penis?\n\ndr. i am 28 yrs old male my problem is that my foreskin is tight and does not comes down and i feel pain if i touch my glance penis. i am getting married within 3 months and the given the fact that i have never penetrated causing severe mentall tensions. also my penis length is just 4inches which i feel quite short.........please advice",
    "doctor_response": "Hi,Like the shape of the nose, everyone's penis is different. Big nose doesn't mean it works well. Likewise a long, thick and straight penis is not needed for pleasuring women. The vagina accommodates any shape of penis. Since the length of the vagina is only 3.5 inches (8.9 cms) and 1 inch (2.54 cms) length of a penis is sufficient to fulfill its work. There are no proven ways to increase the length of the penis. The size of the penis is not equivalent to pleasure during sex or fertility.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent cold?\n\nHi My name is praveen 46 years old 1m68 75 kg. we have recently shifted to bangalore from delhi. (3 months). I have never had any breathing problem in my life and since 2 weeks i have lot of mucus and cough. and have trouble going for jogs. I have no symtopms of regular cold... what should i do? thank you. Praveen",
    "doctor_response": "HI, thanks for using healthcare magicIt is possible that your symptoms are related to allergic rhinosinusitis. This is inflammation of the nasal passages and sinuses.It would cause nasal congestion, post nasal drip and cough. Since it only started with your move, it is possible that it is related to change in your environment.You may want to consider the use of oral anti histamines along with topical steroid nasal sprays. The oral anti histamine may be available over the counter but you may need a prescription for the topical spray.Your pharmacist would be able to tell you which ones are available in your area.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high fever despite giving Paracetamol and Mefenamic acid?\n\nMy daughter is 22 months old. Last 2 days, she is having high fever 101, 102 like that.Yesterday, after giving paracetamol her fever still remained high. Nearby dr gave mefenamic acid and paracetamol. So that her fever was go down. Today also after giving paracetamol her fever is still 99. Should I give her paracetamol or mefenamic acid?",
    "doctor_response": "Hello, I understand your concern over the health condition of your baby. First of all, are there any other symptoms apart from fever? Like cough/ cold/ recent infection? If yes kindly mention the details. It's good that you consulted a doctor for this rather than waiting or just giving OTC drugs. In children, it's very important to give proper medical attention on time or else their condition gets bad over the time.      The paracetamol will help to bring the fever down but it's going to take time at least few days. Along with the paracetamol, the baby needs antibiotics treatment as well. Syrup Myclav would be a good option. For the proper dosage as per the baby's weight, I would suggest you consult a pediatrician soon.You have not given details regarding the baby's weight so it's better to let a pediatrician examine the baby in person and advise you proper dosage of the medicine I suggested. As children are very sensitive to anything, even the medicines they are given. So the best I can suggest you is visit a pediatrician. If there is need of any other medicines or advice as per the child's condition, that shall be taken care of better.    For now, as per the doctor's advice give the baby paracetamol for fever but do not wait longer for making an appointment with a pediatrician. Also keep the baby away from cold and things that are cold. Make sure environment around the baby is warm, clean. It will take few days to get the fever down completely so don't worry about it. Proper treatment will help the baby to recover quickly. Hope this helps. If you have any further queries feel free to contact. Stay healthy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the effects of pneumonia?\n\nHi, my husband had phnemiua and his oxygen level in the blood was 66% his right lung was full and it was going into his left lung he was hospitalized could you tell me all about the seriousness of it all the hospital doesn't explain it to me. thank you",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Normal oxygen saturation of body is more than 95%. So 66% saturation is considered as very low. Pneumonia is common cause for low oxygen saturation. Pneumonia if uncontrolled and extensive can cause collapse, consolidation and pleural effusion. All these causes non functioning of involved lung. So oxygenation (main function of lungs) is hampered. This is having poor prognosis. Body can not sustained for long time with this much low oxygen level. After sometimes kidney, heart and brain start loosing their functions due to low oxygen saturation. So his condition is extremely serious. Prognosis in such cases is very poor. So discuss with your doctor and start vigorous treatment to control pneumonia. Hope I have solved your query. Wishing good health to your husband. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness while having upper respiratory infection?\n\nHusband is having strange feelings. He says he is scared. Another time he says anxious. Monday he was diagnosed with an upper respiratory infection. He took the last dose of antibiotic today. He has answered every question I could think of with no ideas coming from them. He speaks clearly. His attitude is very stressed, grouchy, and irritable. He gets dizzy a bit, not really bad. For the last week, he has been having trouble sleeping and not eating even a 4th of his usual meals, about a 1/3 of what is on his plate.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. In my opinion, all his symptoms (irritable, stressful, dizziness) are due to lack of sleep (insomnia) since 1 week.So better to consult sleep specialist and get done prescription for clonazepam. Clonazepam will calm his mood and help in sleep. Once he gets normal sleep, he will be alright.Also tell him to avoid stress and tension.  Hope I have solved your query. I will be happy to help you further. Wishing good health to your husband. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower back and abdominal pain\n\nI ve been having lower back and abdominal pain and I ve been feel nausea I went to the er last week they said they could find out what was wrong with me I had unprotected sex with my boyfriend two weeks ago when I went to the er it was only a week that we did anything they said I was not pregnant but can you really know that early and a new symptom I have is cold sweaty feet can you tell me anything?",
    "doctor_response": "When they said you were not pregnant, cold sweating may be due to other reasons too due to hormonal changes. May get pregnancy test again.Have deep breathing exercises in fresh air.Hope it helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for aortic early calcified valve\n\nI am a retired  physician    My wife 643 yrs old  non hypertensive  non diabebetic   til now since  few yrs   she is allergic tuat times    getting   occasonal cough   recently treted  for  bronchitis   now  echo shows  AORTIC  EARLY CCALCIFIED  VALVE 60 percent  flow     SHE HAS NO ODEMA  EXERTIONAL DYSPNOEA  ONLY AFTER  CLIMBING  15 STEPS      she is not on any drugs    no free fluids in lungs  n abdomen  eats well  wt   160 lbs      is ther eany way she can  repeat  echo  n get   treatment    kindly suggest",
    "doctor_response": "Hello thereI understand your concernAs I understand she has mildly calcified aortic valve and she is mostly symptom free.  Therefore there is nothing to be done actively at this moment. A serialised echo can be performed every year to keep a check on the deterioration. but mostly it will depend upon the symptoms.Many able bodied people do also get breathless climbing 15 steps. Hope I have been able to answer your query wellStay healthy. spread your smile",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain post a shoulder surgery be managed?\n\nI 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.",
    "doctor_response": "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 painfree now whatever surgery is done. Do not take painkillers without prescription as they also have side effects. I would like to advise xray of the involved shoulder anteroposterior and axillary views to check for the reason of pain. please consult your operating surgeon with the xray as soon as possible. thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is increased weight loss and heavy menstruation sign of cancer?\n\nMY 20 YEAR OLD DAUGHTER HAS LOST ALLOT OF WEIGHT, UNEXPLAINED. HAS HER PERIOD SEVERAL TIMES PER MONTH. TOOK HER TO OUR FAMILY DR. DID BLOOD TESTS AND ULTRASOUND, THOUGHT UTERUS WAS ENLARGED AND HARD.  SAID LABS WERE NORMAL, BUT NOW SHE HAS BRUISING DOWN LEGS AND SIDES AND IS SO THIN ABOUT 30 POUNDS SINCE CHRISTMAS AND SHOWED ME LYMPH NODES IN GROIN ARE ENLARGED, HAS HAD NIGHT SWEATS AND IS ALWAYS TIRED. COULD SHE BE MISDIAGNOSED WITH SOME FORM OF CANCER",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your daughter's situation and problem. Possibility of cancer is unlikely in her case because she is of 20 years. And uterine cancers are common after the age of 60 years. So no need to worry for cancer in her case. She is mostly having PID (pelvic inflammatory disease). And the most common cause is bacterial infection. Her symptoms like night sweats, groin lymphnodes, menstrual abnormality, weight loss etc are suggestive of tuberculosis more. So better to consult gynecologist and get done clinical examination, microscopic examination of culture, endoscopic examination etc to rule out infective etiology. Hope I have solved your query. Wishing good health to your daughter. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does scarring of tympanum have any influence on hearing?\n\nHi doctor, I had a diagnosis of scarring of tympanum before 30 years. Recently, I was diagnosed with bilateral hearing loss and tinnitus. Could the residuals of this scarring have any influence on my hearing now?",
    "doctor_response": "Hi. Scarring of the tympanic membrane (myringosclerosis) rarely causes symptoms. Tympanosclerosis can extend to the middle ear and produce hearing loss. With your clinical history, it suggests presbycusis (an age-related degenerative disorder of inner ear). You need to visit an ENT specialist for proper examination and audiometry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had unprotected sex and took Ipill. Should I fear getting pregnant since I started bleeding?\n\nhi i had unprotected sex with my boyfriend last week (12th Oct) & my periods ended on the 9th. I took an ipill the next day around 25 hours after the act. I started bleeding on the 19th that is 7 days after and as I read about it, it may be a self induced period by the ipill. But I am having pregnancy scare. Please help?",
    "doctor_response": "Hello!The chance of being pregnant is very low because:    you have unprotected intercourse 3 days after periods  and ovulation happen in    the 10-13 day of menstrual cycle.    you took the pill within 72 hours     you started bleedingTo be safe you should take at least a pregnancy test at home.take care of your self",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for elevated LFT levels\n\nYour thoughts would be appreciated : 19yr White Female, Elevated LFT since April 09, recent test GGT355, ALP232, ALT107, AST55. All others within average incl Tot Bili at 11. R.B.C. 5.34. Liver biopsy not bad. PANCA Pos. APC Pos.  Enlarged bulky spleen 11.4x6x11.6cm, with no focal lesion.Fatty Liver. Contracted Gallbladder. MRI nothing outstanding, thin bile duct walls. Crohns in family history but endoscopy & colonoscopy clear. Took prednisalone which doubled LFT results. Non drinker and non drug user. Had knee surgery 2008.",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Possible vasculitis associated with bile duct injury.2. Liver function near normal. Mild obstruction seen at level of bile ducts. Immunosuppression necessary to avoid further damage.3. Complete hemogram essential to evaluate for hemolytic anemia. Need further clinical details and lab results for further opinion.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cramping, nausea and back pain due to allergy to diary\n\nlastnight I think I had a bad reaction to dairy, cramping, nausea, extreme back pain, and bad gas etc. I've had this before (I've only just linked this to Dairy yesterday) and it generally goes away after a 5-6hours. This time however, I was sick through the night and have flu like symptoms today. Upset stomach, body aching and skin sensitivity. Could this all be due to Dairy? and what should I take to feel better.. Ibuprofin for the aches, and ? for my stomach, zantac?",
    "doctor_response": "helloIf I would be your treating doctor i would suggest you to avoid heavy meals & outside food. TakeDashamoolarista 3tsp with 3tsp water twice a day.Tab triphala guggulu 1 tab twice a day.As this medicine is not given without prescription, consult to local doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sores in hair around genital area?\n\nMy husband had some little sores in the hair around his pubic area, and the doctor told him it was related to stress. Now I have them, too. I popped them and white pus came out followed by a lot of blood. No itching, pain, burning, etc. Nothing in my vagina. What could it be?",
    "doctor_response": "Hi, Since you have a similar issue, its less likely to be stress. Stress is not contagious in spreading abscesses. It can be bacterial infection can be STI. Make sure you get tested for STI, sending the PUS for culture sensitivity will help you diagnose the organism. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggestion for hemiparesis that has deteriorated to hemiplagia?\n\nHi Dr, I am sam seeking your suggestions about my grand father s brain attack. Patient is a 84 year old man. Admitted with hemiperasis in his right side and not responding to commands. Drs in a certain hospital have diagnosed his problem. It is acute cvd, mca territory infarct (bilateral infarct). Patient is administered anti-coagulant and anti -platlet (clexane inj and ecosprin tab) along with strocit inj. He is now being treated for aspirate pneumonia with meropenem 1gm inj every 8 hours four the next 10 days. It has been over a month now with him being stable but no improvement. Matter of fact hemiperasis has deteriorated to hemiplegia. He medical bill were taken care by the ex- army health care but they now refuse to fund him because they think he should have been in a better condition now. I need your suggestions about this issue.",
    "doctor_response": "Hi, I am so sorry to hear about your fathers hemiplegia. The treatment as far as medications seems to be going on as it should. But the most important part of long term recovery for a stroke patient is PHYSICAL THERAPY. He needs the services of a good physical therapist who will start with passive exercises and range of motion exercises and help your father regain his mobility. The physical therapist is not simply strengthening muscle here. What they are doing with these exercises is encouraging the brain to 'remap' the damaged nerve cells on to other undamaged ones. This process is slow and we normally see that the process stops on it's own after 6-8 months without PT. WITH PT we see that the remapping process can last up to 2 years and give many patients a great scope for recovery.So my advice is intensive, daily physical therapy for months and months. Passive and active, both.I hope this helps. If you would like a more detailed discussion of your Fathers issues with me or any of the other specialists, you can use our \"Ask a Specialist\" service. Thanks for coming to HealthCareMagic.comVinay",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why are doctors pushing to take linsopril and can I be normal?\n\nI started taking linsopril about a month ago and now having joint pain and tingling all over.  I  went back and have tested with positive with an ra factor of 23 and positve Esr.  why are Doctors pushing this poison?Can u advise if I can reverse this and be normal again?",
    "doctor_response": "Hello there I have read through your question and would like to tell you that lisnopril is an anti hypertensive and is given to keep the Blood pressure under control.The pain and tingling you are experiencing is because of your rheumatoid arthritis. You have to consult your physician regarding that as you may need to take an anti rheumatic drug like hydroxychloroquine or salfasalazine depending upon which suits you better and it's side effect profile. As these are prescription drugs you have to consult your physician before starting it. I hope that answers your question. If you have any further questions please feel free to write. Thank you for choosing healthcare magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have been advised endoscopy for Barrett's esophagus. I am scared of the sedation because I have varicose veins.\n\nHello doctor, I have been recently diagnosed with varicose veins in my left leg. I also have multiple heart problems which are right bundle branch block, bicuspid aortic valve, high blood pressure, and patent foramen ovale. I also have Barrett's esophagus and this week, I am going in for an endoscopy at a local hospital. I have had endoscopies before but, I recently saw in the news that someone passed away from a recent endoscopy. I am scared because the varicose veins are from my upper leg to my foot and are pretty gross looking. My vascular doctors' group have made me wear a compressed stocking, but I notice some new veins bulging or surfacing. I do not know if I should or should not wear the compressed stocking when I go for the endoscopy. I am concerned because even though these are superficial veins, they help pump the blood back to the heart, and I do not know what will happen when the sedative is injected intravenously. I guess I am just nervous because there is a new symptom to me. I have attached a photo of the side of my left leg where the vein is bulging in the front of my leg in front of my shin and across my ankle. It is very painful at times, however when I lay down the veins disappear. Please advise.",
    "doctor_response": "Hi. I have read through your query in detail. Please find my observations below. I can see that your leg has developed varicose veins (attachment removed to protect patient identity). This happens due to back flow of blood into the superficial venous system of the legs. Wearing a compression stocking will maintain the forward flow, but this is not a permanent solution. In patients with varicose veins, a venous doppler study of the affected lower limb is recommended, and this will tell the competency of the saphenofemoral junction (at the groin) and the saphenopopliteal junction (at the knee) which are the main valves that regulate the blood flow from the superficial to the deep venous system. Any collateral veins with incompetent perforators will also be known. Latest techniques involve laser ablation of the veins involved, and this prevents any complications of varicose veins. I guess your vascular doctor might have told you about varicose veins in detail. The endoscopy procedure can be done without any increased risk due to varicose veins. The sedative injection will not cause any problems due to varicose veins. So, you need not worry about that. Please be assured that the person who passed away during endoscopy might have had a different reason or underlying illness due to which the patient was unable to tolerate the procedure. Please stay calm and go for the procedure without hesitation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. The crown and screw came out of my root canal treated tooth 8 days back. When should I visit a dentist?\n\nHello doctor, I had a root canal done for a tooth, a couple of months ago. My crown came out 8 days back. I did not go back to the dentist, but now a screw came out my tooth. What does this mean? When should I visit a dentist?",
    "doctor_response": "Hi. First of all, I would like to explain the treatment that has been done to your tooth according to the details provided by you: You have to get the screw and crown fixed back in that tooth else it might breakdown more and more.\u00a0The screw was put in place after root canal treatment as your tooth was badly damaged and needed support to place the crown. Since it has broken, it needs to be done again to prevent further damage of the tooth. So, visit your dentist immediately to save your tooth. Revert back to a dentist online for further follow up -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of quick ejaculation during sex?\n\nHello, Im a 26 year old male with a lot of issue down in my left testicul, lower left abdomen and occasionally, inside of my left foot aches sometimes; when my left testical and abdomen aches. History; 18 (years of age); I caught syphillis it was my first STD. at 19 I caught it again in College and was treat. at 23 I caught gonnerhea twice within the same year. I did not wait the full sevens days both time before ejection, and back to sex. Lastly, at 24 i caught Tric.. and thats when things started to change, i didnt wait the 7 days again, and started back having sex with my girlfriend not knowing if we were giving it to each other back and forth. from 23-26 i have properly either masturbating or had sex, twice a day every single day, at one point i went 8 months straight ejectulating. Then one drunken night at 25, i took one of those sex pills u can get at a store, and smoked weed and drunk Hennessy (Cognac), that day. I didnt know what i was doing, and panic, because of performances reason. After that, the aches in the left side of my testicles, and left side of my Permia ( i think thats what its called), the muscle part of your penis that you can feel tighten, when u move ur penis, push urine out faster, and ejaculate. Extreme pain in that area and left testicules started a couple months later, I also started smoking cigarettes shortly during this period, and marijuana ( all which are bad, and may have caused worsen issues). in November 2012, i went to the hospital after walking down the street and had so much pain in my left testicul that i could not walk, and cab to the hospital..(They did an ultrasound, did see anything) They said it could be hydoceles and epdytimitis,.. took some anti-botics, muscle relaxer and told to see urologist,.. went to a urologist, he did an test for hydroceles, and said it wasnt that or epdytimitis, and told me to come back if pain consisted... I seen another doctor for test work. Everything came up negative... I seldom smoked cigarettes when im stressed, and thats when i can predict the pain in my left test,abdomen, and sometimes the inside of my left foot.... My testiculs,penis, and reproductive system just hasnt been the same. My testiculs rarely tighten up to my body like they use to, even during erection, they just hang and hang. My pain continue everything other day, i almost have to live with it, but dont want to.... My health insurance in over, Im waiting now on my",
    "doctor_response": "DearWe understand your concernsI went through your details. In most of the circumstances premature ejaculation is due to performance anxiety. With all those prior problems and stress you had, with lot of sexual information, for you, it is very easy to have performance anxiety.You need to understand sex. Sex is not essential for living. Sex is not just your pleasure. Daily sex is stress. You should address sex as just a meditation and stress relieving exercise. You should get a psychological sex counseling and should alter thinking about sex. You will be alright.If you require more of my help in this aspect, please use this URL.  sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a possibility for development of heart beat in fetus?\n\nI went in for a vaginal u/s being at 8 wk 1 day pregnant from my LMP and my Dr. said there was no heartbeat that baby measured at 6 wk 5 days 0.78 cm. Could it be that my calculation was off do to late implantation? Dr. said that I was going to miscarry and opted for D&C or pills to induce my labor. I told her I would like to wait another week and come back for another u/s hoping there would be some changes with the baby s heartbeat. Do I just having fallen hopes?",
    "doctor_response": "Hello,I have gone through your query and understood your concern. If the sonogram performed was through the trans-vaginal route and if your sonographer is an experienced person, it is likely that you may have miscarried, provided you have regular cycles and did not miscalculate. When this is not so, it is better to wait and see. In such a scenario, serial titres of serum beta-hCG are often done. Good progress of pregnancy is indicated by doubling of titres every 2-3 days. This should be coupled with follow up sonograms. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i give meftal for viral fever of a 3 year old?\n\nMy child is 3 hrs old his weight is 12.5 kgs .he is suffering viral fever .even after giving one dose of crocin and one dose of ibugesic after one hour of crocin the fever is still 101 degree .can I give meftal p?after how long of giving ibujesic plain?",
    "doctor_response": "Meftal P contains mefenamic acid which is more effective than ibugesic (ibuprofen) which is turn is more effective than crocin (paracetamol) in relieving fever. A child of 3 years (I hope it has accidentally mentioned as hrs) can be given Meftal P safely. Dose of Meftal P is unrelated to that of Ibugesic. Doses of Meftal P require a separation of about 6 hours from each other but not from that of other medicines like ibugesic or crocin.You can also give tepid sponging to bring down the temperature.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does naturotherapy help to treat back pain?\n\nHi doctors this is srikanth(23)... student... i am suffering with back pain from last 5 years.. i undergone treatment but there is no result..MRI scanning was also done but nothing is identified...if i perform any small work it is troubling me... now i want to go for naturo therapy..will there be any result with this..pls suggest me..",
    "doctor_response": "Yes, there are many types of alternative medical treatments that may help with your back pain. Naturopaths, acupuncturists and chiropractors are all very good at treating back pain. It is also important for you to maintain a good posture, use proper lifting techniques and do regular stretching exercises or yoga. I hope your back pain is resolved soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my period heavy with brown discharge?\n\nI started my period on march 22nd and it ended april 5th and it started again april 17th and it still has not ended, its dark red, sometimes brown and extremely heavy.. Im on Depo prevera, What could this mean? Should I get it checked out?",
    "doctor_response": "Hi.The Depo could be the cause for the irregular menstrual cycle and inter-menstrual bleeding, if you did not have such a haphazard cycle prior to the initiation then the depo could very well be the cause, so speak to your prescribing doctor about the same.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent fever with abdominal pains?\n\nHii doctor,Am a girl my age is 15. My height is 155cm and weight is 58 KG.  I have fever since 2 months and since past 2 days I have a stomach ache in the left abdominal(The pain was severe first day and now its mild) and I can't yawn or cough due to the pain. I have had no health issues till now but this is the first time. Am taking paracetamol doses for fever but fever doesn't seem to be reducing. I got fever after I traveled from uae to india. What could be causing this health issue?",
    "doctor_response": "Hello madam/sir, welcome to medical care magic.Did you got your blood and urine checked. if so you have not mentioned the diagnosis.If nothing has been done please got the blood and urine tests with chest xrays. 2 months fever is a serious issue. The cause should be cured. Please go  and visit physician with the reports. With this I hope I cleared your doubts. Any further doubts you are always welcome. Take care. Good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause for lump near the vagina?\n\nIn the crease above my inner thigh close to my vagina i have this lump that over the last year or 2 has filled with this puss and blood thick fluid when its popped or burts on its own after getting big enough.. Its painful, when i walk and my clothing rubbing on it and sore to the touch. It is a reacurring thing. What is it and do i need to go to docter asap? Thanku",
    "doctor_response": "Hi.The lump is there for more than a year and has symptoms.There is no need to rush, but the best way is to have it excised as it is near an important part of the body. This looks to be an infected sebaceous cyst.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy lumps with pus in the body?\n\nHi, im 20 years of age and ive recently been sick... Last week I went thru some very unlikely symptoms Im a very healthy girl..so all this is very rare... I went thru two night with chills in my sleep. Next morning on wensday I had diarreah & cramping. Thursday morning woke up with bumps all in different places in my body but mainly in my wrist, arms & upper back. Their very itchy. Went to my nearest clinical help...& the doctor only said its was a slight chance of it being chickenpox..but im very doubtful...well I had CP when I was young. The red bumps keep coming out..i scratch & liquid comes out.... What can this be... Food poisoning?",
    "doctor_response": "Hi.Thanks for your query.Read and understood your history. From the detailed history all your symptoms are fitting into the disease called chicken pox and this being a viral infection can cause other constitutional disturbances like that of gastroenteritis or gastroenteritis can co-exist due to reduced resistance power of the body. Take a proper treatment as advised by your Doctor and you will be fine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatments for peripheral neuropathy\n\nMy name is Ludvik Kouril and I have problem with peripheral neuropathy. My condition is getting worth within 2 tears. My neurologist prescribe Gabapentin 300, and I do not see any improvement. My blood sugar is normal, last blood test was done 6 month ago.",
    "doctor_response": "Hi Ludvik,first may I know the cause of your peripheral neuropathy, you say your blood sugar is normal, then are you alcoholic, the second most common cause of neuropathy,if not that, then what is the cause told by your neurologist. its important to know, as removing the cause is the first treatment to prevent further damage, the drugs you are taking have very little effect in the regeneration of neurons that have been irreversibly damaged.my recommendation to you is to continue medication and follow measures to preserve your hands and feet from too cold, warm, hot, friction, keep covered when sleeping.preservation will help you manage this easily, if secondary complications develop then its very tough to treat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get the feeling of emptying my bowel whenever I go out. Please help.\n\nHello doctor, I am 25 years old. My weight is 63 kg. I have masturbation habit for 6 years. My stomach gets bloated and there is gas formation. I also have tiredness and diarrhea. I have to apply pressure for passing urine and stools. I get the feeling of emptying my bowel whenever I got to go out for work. So, I have fear every time while going for work or going to meet someone. I do not get normal stools or my bladder does not get cleaned properly and I always have the fullness sensation. I have frequent urination problem. I have pain while I urinate and blood in stool like once in the last year. Report of gastroendoscopy says gastroduodenitis. I have checked for piles also but I do not have piles. Doctor's prescription and reports are attached. I had checked with the doctor about 4 months back. I have taken medicine also. But now I do not take any medicine.",
    "doctor_response": "Hi. I have gone through your reports (attachment removed to protect patient identity). It is a common problem, most of the individuals have bad bowel habits in some forms. This kind of problem is called IBS (Irritable Bowel Syndrome). This disorder leads to bloating and frequent bowel movements. The treatment is simple.Most of the patients respond to simple measures with dietary therapy and Isabgol. We do not need to do further investigation. 1. Take high fibre diet. 2. Take plenty of water. 3. Take Isabgol 3 spoons twice a day in 200 ml water/milk. 4. Avoid fatty foods and fat in meals. 5. Avoid spices in the meal. 6. Do regular exercise, at least for one hour in a day. 7. Take tablet Pantoprazole 40 mg once in a day for 15 days and then we will decrease it and can stop it later on.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be the cause of swollen glands in abdomen, legs, knees and arms?\n\nI have swollen glands in my abdomen, legs, knees, arms and several times a year inflammation between my tailbone and anus. I also think there is a gland at my clavicle sternal joint that gets inflamed. Is there cause to be concerned? I am a 50y/o/w/f who was diagnosed with a rare form of systemic solar urticaria a few years ago where photosensitivity spans into visible light where I am confined to home under a controlled environment.",
    "doctor_response": "Hi.Systemic solar urticaria is rare and indicates that you have an underlying dis-order. All the symptoms indicate towards an inflammatory origin. The Primary focus has to be found . The best way is to get an excision biopsy of any of the enlarged Lymph nodes. IT will get us best diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for ankle and feet swelling?\n\nhello siri would like to a one qus that my father has high blood suger, but now a few days he is suffering from high ankle & feet swelling please advise any gel or oil remove him swelling... please dr. help me................ my e-mail id  YYYY@YYYY",
    "doctor_response": "Hi i am Dr Ahmed Aly    thanks for using healthcaremagic site ,I had gone through your question and understand your concerns ..   In my opinion you should manage high blood sugar level it may not be the main cause of the swelling but it may exaggerate it. elevating his leg above 2 pillows , rest , avoid standing and sitting for a long tome , anti edematous drugs are helpful , topical NSAIDS like voltaren gel are of good value with hot massages . Please click THANK YOU and consider a 5 star rating with some positive feedback if the information was helpful. Hope the above information helps you,Any further clarifications feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am anxiety, What is the problem ?\n\nDear doctor i am in 28 year old lady my name as swetha . 4 months before one day i am feel my heart beated with speedly and i am suffering in other worries with my leg is very tired . So i am consult a doctor in near and said to me my bp is higher. I am consult a special doctor next day and take ECG but there is no problem in ECG. in some days later my bp is not get low. So the doctor said i am in tensioned women . so doctor give me tension tablet. take this tablet i am get very well . soon iam stop the tablet. One day i am suffered with worries that have nothing to say that. So doctor give me injection for balance ear problems. the next day morning i have no idea of my mind and i am walking with my mind. It is a experience of a lot of wories. i cannot sit and lay in bed totaly un balance mind . So i am consult a psychartist and give me its pills. In this time i am not get mences. So i am consult a doctor and get Norethisterone tablet. urenery infection is tortued me in many month. so the doctor suggest please check your kidney. doctor i am take the bp pills daily and tension pills also please tell me what is my problem",
    "doctor_response": "Hello Swetha, I agree with the title of your question - the problem does seem to be due to your anxiety, or 'tension' as another doctor put it. It is clear that you have been worrying a lot, and the rapid beating of the heart and increased BP could be related to anxiety itself. There are three points that are important here - 1. You felt better after the doctor gave you medicines for tension. What was the name of the medicine? Why did you stop taking it? 2. What exactly were the 'balance ear problems' for which the doctor gave you an injection? 3. Is it correct that your menses stopped after you began treatment from the psychiatrist? I find this a bit surprising because medicines used to treat anxiety do not affect menses, but some other medicines do. What medicines were you prescribed? In my opinion, you do not seem to have any serious problem. Please provide more details so I can try to help further. Regards, Saif",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to conceive?\n\naskingi have been married for 1 year and 4 months i have trying to get pregnant only for 6 monthes as before i was using condoms im asking shall i go to doctor shall my husband go and should i stay after sex in bed and altjougj staying sperms fall",
    "doctor_response": "Hallow Dear, How long you should wait giving the fair trial for natural conception depends upon the age of the couple, which you have not mentioned. Though you are married for 1 year and 4 months, you are sincerely trying for pregnancy for last 6 months only. If you are above 25 years of age, it is  the time now that you start investigating both of you. You may not carry all the investigations straight a way. Initially try to find evidence of your egg release. Though in the market home kits are available, I would advise you initially to get the evidence by ultrasonography. This will ensure whether you are ovulating or not; and if you are ovulating, it will inform you the day of your ovulation (egg release). Egg has a life of 24 hours while the sperms are active for 24 hours. Hence, a period of about one week around the day of ovulation is fertile window. Then get husband's semen examination done for the quality and quantity of the sperms. If both these investigation reports are within normal range, try to plan your intercourse at and around the day of ovulation. Lying on your back for about an hour after the intercourse is advisable. After intercourse, some amount of semen does flow out passively, it is hardly 10% to 20% of the total semen; so not an issue. To minimise this flow of semen, the penis should not be withdrawn while it is hard. Let it slip out of vagina passively when it is placid.  If you fail to conceive even after six months fair trial like this, get Hysterosalpingography and Laparoscopy done to find out the condition and patency of the tubes and uterus. However, if you are above 30 years of your age, get both of you investigated completely without delay. Report then to your Infertility consultant for further advice. You may ask me a Direct question on this forum with all these reports uploaded. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest fluttering with anxiety like symptoms?\n\nI m having fluttering in my chest cavity, no shortness of breath, no pain....but feels like anxiety or like the feeling one gets before speaking before a crowd. It started about 2 weeks ago, no life style changes, no real anxiety, but I am feeling it several hours a day. Not taking any meds, 50 yr old female, relatively good health, non-smoker. What could cause this? Any thing I should be concerned about?",
    "doctor_response": "Thanks for your question on HCM. In my opinion you are having palpitation.  It is feeling yourvown heart beat. So we have to first rule out cardiac cause.So better to get donECG and 2D ECHO to rule out cardiac cause.Another tool is Holter monitoring.  In this 24 hr recording of ECG is done. So that at the time of symptoms, we can look for  any ECG chenges occur or not. If all of the above are normal than no need to worry. Itis anxiety related only.So avoid stress and anxiety.  Be relax and keep calm.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are itchy raised black spots almost all over the body?\n\nsir, I have some raised black spots on my body like left ankle, left knee, left and right thighs, right pointing finger, right elbow. I am 30 years of age. I have a lot of itching sensation and when I scratch it a liquid is coming out. Initially this was on my left ankle but now it is distributed all over the body. When I use the tablets or ointments it is vanished but again it is appearing. when I consulted the doctor one says it is eczema and the other says it is psoriasis. please confirm me as what to do now",
    "doctor_response": "Hello,I can understand your concern for itchy raised black spots almost all over the body.There can be multiple possibilities of the condition and it requires a personal physical examination of the area by a dermatologist to see the area. I suggest you to either meet a dermatologist or can send  few good resolution pictures at:bit.ly/drsanjaykanodiaFor the interim of the help I suggest my patients to take an antihistamine like loratadine for 1-2 times daily.Do not scratch as it causes further aggravation of the condition.Hope it helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do I need to consult doctor for the back pain?\n\nI had a fall about a month ago, hurt my back. didn t go to a doctor, didn t seem necessary at the time. Some days I feel good, others...my back gives me pain. I had spinal surgery many years ago (1961-62)). I m wondering if that could be a problem? I am 85 yrs old now. Elaine",
    "doctor_response": "Hello, Thanks for your query.It seems you are suffering from degenerative disc disease & it occurs due to repetitive overload or stress to the disc & it increases the risk of disc herniation & spinal canal stenosis.The main treatment of such pain is bed rest along with pain killers and muscle relaxants. Muscle relaxants can help with your symptoms if used in appropriate dosage in combination with a potent analgesic.You can get the appropriate drugs prescribed from your Orthopedician after examination.Meanwhile you can follow these measures:- If the pain is severe, you need bed rest till the pain resolves. - Get some analgesics prescribed and apply analgesic spray or ointments.- While resting, keep a pillow under your knees if it doesn't bother you.- Avoid lifting heavy objects.- Back strengthening exercises and stretching exercises daily as advised by a Physiotherapist.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lump under the right nipple\n\nHi, I am a 20 year old male. About two weeks ago, i found a lump under my right nipple, its moving when i touch it and its painful. No nipple discharges. My left nipple is normal and my right nipple is puffy. Recently i was taking Isotretinoin for my acne treatment and the course is complete. After that i took Spironolactone for 1 week. I have problem with only my right nipple.",
    "doctor_response": "hi.it is best if you consult with a doctor, preferably a general surgeon, for medical and physical examination. a breast ultrasound may be requested for further evaluation of the said lesion. it could be any of benign breast lesions, but to be sure, medical consult is needed. management (medical or surgical) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Insomnia, memory loss, muscle twitches. MRI shows sinus blockage. Taken antibiotics. No periods\n\nI m a 20 year old female and 3 months ago after smoking a hookah for 3 nights in a row I developed insomnia , memory loss , muscle twitches, cognitive decline much like brain fog where I cant think straight or quickly, depression , anxiety and visual disturbances. Two weeks later I had an MRI done which came back normal except for total blockage in my sinuses, I was given steroids and antibiotics but my condition did not improve. I have had a an abdominal and pelvic CT scan and everything was normal. My blood work was normal except for elevated white blood count, elevated proteins , low vitamin D . This past summer I was diagnosed with gastroparesis , non alcoholic fatty liver disease and polycystic ovary disease, I have not had a period in 5 years. I recently had an EEG done by a neurologist and it was abnormal, he said I had diffused slowing and spikes in the background. He thinks I may have had an acute case of bacterial meningitis due to my severe sinusitis and these are the after effects. His final diagnosis was metabolic encephalopathy, he scheduled a follow up sleep deprived EEG to rule out a seizure disorder. I m afraid it something worse like Creutzefeld Jacob Disease. I have no family history of neurological illness. I still have the sinusitis and am taking estradiol and progesterone.",
    "doctor_response": "In addition to the advise by neurologist, in my opinion, you need to consult an endocrinologist who will estimate your hormonal profile like thyroid level, estrogen, progesterone FSH etcAlso, important to consult psychiatristContinue taking vit D till it comes to normal level or as advised by doctorCreutzefild jacob disease, to me seems less likely",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have throat pain. What do I do?\n\nHi, My age is 29 years. Yesterday I drank ice cold water in the afternoon. Since today morning I am feeling pain in the throat, body pain and laziness. Please suggest medicine for the same.",
    "doctor_response": "Hello. Start tablet Azithromycin 500mg once a day for three days after meals. Take tablet Paracetamol 500mg thrice daily for the pain relief. Drink plenty of water.Drink warm liquids. Gargle with warm salt water twice a day.Avoid cold, sour, junk, fried, oily, fatty foods and drinks like alcohol. If there is any chest congestion, blocked nose, fever, etc., consult a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to lower blood pressure without medication?\n\nI had taken Fruta Planta for 2 months. Lost 20 lbs. I stopped taking it for 2 weeks and going to gym regularly. I am eating fruits and vegetable and staying away from fried foods and fast food. Though my blood pressure is still high. What can I do to lower my blood pressure besides garlic pills, exercise, eating right. Don't want no medication.",
    "doctor_response": "Hello,Thanks for writing to Health Care Magic, I am Dr Asad Riaz, I have closely read your question and I understand your concerns, I will hereby guide you regarding your health related problem.High BP is majr risk factor for multiple major disease like IHD,stroke etc..most of teh time cause is not known called essential hypertension n for 5-10 percent pt haveing underlyng kidney disease,endocrine diseases,metabolic disorders.if patient have some other symptoms that sugestive of underlying disease thn workup is neded to fnd that cause n tx that will normalise bp but if no caue is found than accordng to BP control protocaols pt is put fisrt life tyle modification to dec BP in hic he/she is advised to dec fatty food take fruits ,de salt intake n do exercise for a period of 6 month n still having high bp then pt is put on medication to dec bp n then as to monitor bp chartng so that dose can be adjusted accordngly...I hope this answered your question, if you have more feel free to ask.Regards.Dr.Asad Riaz.General and Family Physician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why are my ankles always swollen after spraining it three weeks back?\n\nEvery member of my family, I think, has had diabetes -- onset, Type II. I am checked twice a year. My doctor was also my mother s, prior to her death. In the last two months, I have begun to urinate excessively. I do drink a lot, due to previous battles with blatter infections. However, this is new. I do not smoke. I have lost over 60 pounds in the last 1 1/2 years, but I still need to lose 25 pounds to be at an optimal weight for my height and age. I do water aerobics at least twice a week, an hour each time. I do not have any of the diseases my parents either were dead of, at my age, or were fighting at my age, including breast, lung, colon cancer. Both also had diabetes and heart issues (different kinds). I just returned from overseas -- healthy countries and I did not eat or drink while on land. I sprained my ankle, now three weeks ago. My ankles are swelling daily, to some extent. I walked miles overseas -- maybe not literally, but in my mind. The swelling of my ankles often occurs when I travel and I have been in the air almost as much as on the ground since March 1. I wrote that off to the travel. My bi-annual checkup is a couple of months off. Trying to decide if this is worth calling my doctor s nurse.",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The swelling of ankle after a sprain suggests a hematoma formation. Need to have an MRI scan to detect extent of damage. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicines for psoriasis along with liver problems\n\nHello, I am 57 year old female and have psoriasis (severe) since 1992 & Hep. B&C. In 2012 I took a year of my life and did the Ribavarin/Intefuron treatment and was Negative the entire time, however 2 weeks after completing treatment I RELAPSED. Anything I do for psoriasis effects my liver & vice versa. I have during this time been on every medicine available from creams, lotions, shampoos, injections etc., I am at a stand still right now plus I have arthritis in every joint. For the first time since 1992, the psoriasis seems to be in a Remission, not totally so I guess I cannot say Remission but it isn t covering my back at this time and I am so happy for this, I would like to know if you can inform me of any New Medications if available for my problem with my liver/psoriasis that I can TRY without it making the other out of control? Thanking you in advance Karen YYYY@YYYY",
    "doctor_response": "Hello,I can understand your concern for Psoriasis with liver problems.After analyzing your query I can make out that you have psoriasis since a long period of time. In general we prefer to give methotrexate in psoriatic patients but as you have liver problem so I would not suggest to take the same.In your kind of condition I generally start with Vitamin D3 tablet on daily or weekly basis. Additionally I prefer to give a steriod based cream such as clobetasol or mometasone.An antihistamine tablet like cetrizine is preferred to relieve the itching. I also suggest to do moisturization of the area.All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stones in kidney, ureter. Advised to take torate syrup, has side effects, surgery needed?\n\nHi I have few stones in kidney(both) and lower ureter . I have been taking Silofast for past 10 days but that didn t help much and just moved stones few inches further. Now I am taking Flotral 10 mg as advised by the doctor. He has also said that I can take Toterate syrup to dissolve kidney stones if I can bear side effects like uneasyness and vomiting . Please give your suggestions about the medicine and whether I should for surgery or not. Stones are of size 4mm to 6mm. 5 stones in total. 4 in both the kidneys and 1 in ureter.",
    "doctor_response": "Hi Welcome to HCM and thanks for your query. Kidney stones of this size requires plenty of oral fluids and reduction of red meat. The ureteric stone, if not passed in 2 to 3 weeks of the mentioned treatment- needs removal. You need to undergo scan every 6 months to check for the stone status. Get well soon. Regards DR GS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Unable to control temper, extreme elavated aggravation. Advice\n\nWhat would cause extreme elevated aggravation and a short temper? I have nothing going on that i know of that would cause me to be angry. And simple things will cause this anger to be triggered. It is rarely around people its usually when I am by myself with as something as bumping into a chair and it causing pain and ill get angry at the chair and my adrenaline will pump like crazy. I don't want to be angry at all but I cannot seem to help it. Sometimes ill punch things such as walls, etc. I am pretty sure i have multiple fractures in my hand, arm, elbow that have been hurt and then healed over the past 2 months. This started out of nowhere about 2 months ago. I need adivce",
    "doctor_response": "Hi, Thanks for using healthcare magic. I have gone through your available history. Anger and short temper can be symptoms of underlying stress or depression. so look for symptoms of depression like sadness of mood or decrease interest in activities. You should consult psychiatrist for detailed evaluation and treatment if required. You can also get benefit for anger management and stress management. You can also do yoga, meditation or breathing exercise for control of anger and stress. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low libido?\n\nHi, may I answer your health queries right now ?  Please type your query here...pls am a young guy of 22 yrs now and started masturbation when i was 13 now i have experience in my life that am getting weak and my sex activities is reducing i need your assitance please",
    "doctor_response": "Hello, Unlikely to be due to masturbation. You can get your hormones tested esply Thyroid and prolactin. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr B. Radhakrishnan. Nair, OBGYN",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning sensation in feet?\n\nHi, this is Satya from New Delhi India, I am 35 male, 75 KG, This is my problem :The bottom of my foot keeps getting burning hot and then it goes away. It's almost like if I've been running for awhile and the ball of your foot gets hot afterwards. It's annoying but I don't know why it keeps doing this.Thanks Satya",
    "doctor_response": "Hi, Welcome to HealthCareMagic.com I am Dr.J.Mariano Anto Bruno Mascarenhas. I have gone through your query with diligence and would like you to know that I am here to help you.This Burning Sensation is Neuropathy. You need to undergo NCS to find whether it is Axonopathy or involvement of the Myelin Alone or both Definitive treatment depends on the cause of neuropathyTill then you can use Drugs like Gabapentin, Pregabalin etc for temporary symptomatic reliefHope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in HealthCareMagic at  Wishes for Speedy Recovery Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headache with a lump on the head?\n\nYesterday my 61 yr old sister had itching on her scalp on the left side and later in the day a small bump appeared and in this morning she woke up with a terrible headache and there was a large lump on the side of her head. She went to the emergency room at Intermountain Medical Center in Salt lake City, Utah and was told she was having a migraine headache and was given Keflex and sent home with a prescription for more Keflex. The lump has gone down some and her headache is better. So what is the lump from I never heard of a migraine with a lump on the head. They told her it was on the outside of the skull.",
    "doctor_response": "Hi,Thanks for writing in.From the description of the lump on the head, it appears that it might be a scalp swelling, There are many kinds of swelling involving the head and scalp. Some of these remain inactive for a long time and then get infected and become enlarged in size with development of pain. These are commonly cysts like sebaceous cysts and can have a central opening when looked at closely. If doctors at ER have examined your sister then it is certainly not a tumor that is growing from within. As lump has gone down after taking keflex therefore there is an infection that is now under control. Migraine cannot be the result of a lump and cannot cause one. Migraine is a different medical entity and not related to the lump.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for perihilar opacification\n\nWhen my granddaughter was going to have her tonsils out, they took a chest x-ray and on the chest x-ray they found that she had right perihilar opacification which was concerning for early airspace disease. Should the parents do something about this. I do not believe the doctor said anything to them about this.",
    "doctor_response": "Thanks for your question on HCM.In children perihilar opacification is commonly seen and it is mostly from early lung infection. Hilar lymphnodes are draining lungs. So whenever there is infection in lung, lymphnodes are enlarged and these enlarged lymphnodes gives appearance of hilar opacification. So give him antibiotics and get done repeat chest x ray after 10 days. If opacities are same or worsening than get done CT THORAX for better evaluation of mediastinal nodes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dints on skull?\n\nI have recently discovered two dints in my skull ..they have only just appeared, never been there before. There is a lump which is solid between them and the whole thing resembles the shape and size of a slug, approx 5cms long and 1cm wide. It runs from my hair line at my forehead back to the middle of my head. These were noticed about 8wks ago and I have ignored them, but one a new indentation has appeared in my forehead, right underneath where the other two are...what could it be?",
    "doctor_response": "I think you should see a dermatologist, because several disease of the skin can start from the head skin and hairs.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are tingling sensation and pain in legs,arm and back signs of sciatica?\n\nHi,I woke in pain on sunday morning.  I have a pain in my buttocks and lower back and some tingling down my legs.  I have also had pain in my elbow joint but on sunday experienced tingling sensation and pain in the whole of my arm.  Could this be sciatica in both and what is the best action to take?  I'm better when I keep moving than when I tey to rest and sleep.",
    "doctor_response": "HiSciatica is a condition of lower back and lower limbs.Arm pain tingling is due to nerves of neck or in shoulder region,elbow or wrist.Anyway, both require to be treated simultaneously by anti inflammatory meds, and methycobalamin, lyrica etc .consult an orthopaedic or neurologist.X-rays or MRI of back and neck may be required, alsi physical examination to check for nerves, muscles implicated.Both conditions are treatable",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes flutters in chest and shortness of breath?\n\nI'm a 31 year old female...For about 3 weeks now i have been having flutters in my chest...and sometimes i can feel it in my throat. Its not painful just feels like a butterfly fluttering. It happens all through out the day and only last for a few seconds at a time. At times i feel short of breath like i've been running or exercising when i haven't. My medical history doesn't have anything to serious, pcos, and i am somewhat over weight...should i worry? What could be causing this?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, we should first rule out arrhythmia (rhythm disturbances in heart) because this can cause irregular heart beats which gives feeling of flutters in the chest. It also causes breathlessness. So better to consult doctor and get done ecg, 2d echo and Holter monitoring (24 hours continuous recording of ecg). If all these are normal then no need to worry for arrhythmia or other heart diseases. Sometimes, stress and anxiety can cause Fluttering feeling and breathlessness. So avoid stress and tension, be relax and calm. Don't worry, you will be alright. But first rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does growing lump around cervix indicate, apart from pregnancy?\n\ni have an appointment friday. a few weeks ago i found a pea size lump on the rim of my cervix, now it is less of a lump and more like half of my cervix rim is mushy (i am not pregnant, nor sexually active) and with in the last 2 days i believe i have the beginnings of a UTI. friday seems to far off to the questions i have today. can u tell me anything about this?",
    "doctor_response": "Hi,Dear,thanks for the query to HCM.I studied your query in depth.I am of the opinion that its just the co-incidence and the UTI you have needs routing -care-with-High intake of fluids and proper hygiene of the private parts.May be the cervical lump-with infectious discharge my lead to UTI.So dont get panicky.If pain is more-get sodabicarb-lemon juice 3 -4 times a day, would reduce the burining pain you have.If any more query plz feel free to ask.Hope this would resolve the query.Thnks.Wellcome.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain in morning, getting relief after bowel movements. Should i meet a doctor?\n\nHi doctor, I've been experiencing lower back pain in a morning when I get out of bed. I have always had back problems, I think due to the ligaments in the back of my leg tightening after exercise, and I stretch to relieve. However this seems different, relief seems to come after emptying my bowel of gas / bowel movement.  Do you think merits going to see my doctor? Thank you.  David (Age 40).",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum. Desire of defecation develops mild pain in intestine ( abdomen i.e. back) & this is a natural process. In my opinion this is not due to any disease so no consultation. If pain is more in back then you should consult an orthopaedician and get his opinion for lumbo-sacral region ( back). Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the MRI of brain and cervical spine mean?\n\nHi! I recently had a MRI of my brain. The findings state that there are small bilateral mastoid effusions. Mild ethmoid, right maxillary and frontal mucosal thickening, congestive or inflammatory. It also says a c4-c5 disc osteophyte complex partially effaces the ventral subarachnoid space. I also had a MRI of the cervical spine that states a mild reversal of the normal lordotic curve is seen either due to position and/or spasm. Can you please explain to me what this means and what symptoms would these cause. Thanks!",
    "doctor_response": "Hi,I am here with tried to give details in simple words-- Small bilateral mastoid effusions: It means there is mild fluid collection in mastoid air cells located within mastoid bone (prominent bone just behind ear) on both sides. It may be associated with infection.-  Mild ethmoid, right maxillary and frontal mucosal thickening, congestive or inflammatory : Mucosa (layer or lining) of sinuses is thickened which may be due to infection (inflammatory) or allergic (congestion).Above findings may indicate infection that may present with fever, cough,cold, throat pain. - c4-c5 disc means layer in between cervical spine (bone) no 4 & 5. - osteophyte means bony spikules.- ventral: anterior or to the front.- subarachnoid space: it is a fluid filled space surrounding the spinal cord.- c4-c5 disc osteophyte complex partially effaces the ventral subarachnoid space: It means bony spikules causes compression of subarachnoid space anteriorly.- mild reversal of the normal lordotic curve is seen either due to position and/or spasm: It means loss of normal curvature of cervical spine (convex anteriorly) ie. loss of curve and spine become straight which may be due to position (position of head and neck while doing MRI) or spasm (muscle spasm)Above findings may present with neck pain with stiffness, pain radiating from neck to shoulder or arms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can constipation elevate MS symptoms?\n\nI was diagnosed with MS x 18 yrs, have been on Avonex x 17 yrs. I have had 7 flares requiring Solumedrol over the past 18 yrs. I am experiencing some saddle seat and bilateral lower extremity numbness x 1 week. Present symptoms do not feel like MS, I have been constipated, do you think that constipation can be a contributing factor for my current symptoms??",
    "doctor_response": "I read your query carefully and I understand your concern.I wouldn't exclude MS as a cause of these symptoms as a spinal demielinating lesion could have these consequences. It is not typical though, urinary involvement is more common.I wouldn't see constipation as a cause, rather as another symptom along with lower extremity numbness and saddle sensory changes. I think the origin of the symptoms warrants MRI imaging of the spine not only for the MS lesions which I mentioned, but also for the possibility of disc disease or a tumor compressing the cauda equina (the bundle of nerves leaving the spinal cord at the lumbar region).I hope to have been of help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pain in the leg be due to allegra medicine?\n\nI started taking allegra about a month ago and I thnk about a month ago I started to have pain in my left leg. It is not a cramp or rls but a pulsating slightly burning uncomfortable pain that wakes me from sleep. As soon as I get un the pain goes away. I was wondering if there is any correlation between the two? Thank you",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. No, Allegra can not cause such pulsating leg pain. Allegra is having fexofenadine. It is antihistamine. It has nothing to do with such leg pain. So there is no correlation between your Allegra ingestion and this chest pain. In my opinion, you should get done left lower limb arterial and venous color doppler to rule out DVT (deep venous thrombosis) and varicose veins as both of these can cause similar kind of unilateral pulsating pain. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is conception difficult after being on contraception injections for 6 months?\n\nHi there I have been on the contraceptive injection since Feb and it is the end of the 2nd 13 week period mid august. My fiance and I want to try to conceive. After only 6 months of the injection, will I find it as hard to conceive or for my cycle to return to normal?",
    "doctor_response": "Hello,Thank You for trusting HealthcareMagicMost women are able to conceive 3-4 months after stopping contraceptive injections. Some women rarely require 9 months to a year to regain fertility.Hope I was able to answer your questionPlease address further questionsRegards,Dr.Lekshmi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should I do while recovering from dengue?\n\nhiii, i have been curing from dengue 15 days before, after recovery my platelet count becomes  above 2 lakhs  and returned to the normal life,but then i made a short trip and i could not mainten all this rules like taking fruit juices and taking rest etc.....for t",
    "doctor_response": "Hello, welcome to HCM,Dengue is a viral disease and it is a self limiting disease. Mainstay in the treatment is fluid maintenance and monitoring of platelet count.As your platelet count had returns to be normal after the treatment. You should taie care of your life style until all your symptoms comes  down.You need to boost up uour immunity by esting fruits and supplements like vit A and E should be added to your food.Take adequate rest and protect yourself from mosquito bite.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have pelvic pain with mild foul smelling watery discharge. Will this affect my fertility?\n\nHi doctor, Before two years, I got married. I have pelvic pain for around seven months. I also had back pain. But I neglected it, thinking that it might be some digestion issue. Now, I am getting a mild foul smelling watery discharge for the past one month. Will this affect my fertility? Last month, my periods were also delayed. I had a urinary infection before seven years.",
    "doctor_response": "Hi. You are suffering from pelvic inflammatory disease secondary to recurrent vaginal infections. Presently, foul-smelling watery discharge indicates a bacterial vaginosis infection which is a deterrent for the fertility indeed and needs to be treated first. Ideally, both partners should be tested and treated. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest a clinically confirmed pregnancy test\n\nso i have been trying to get pregnant, I am currently used pre-natal pills (PREG VIT).My things is that i have been experiencing cramps very now and then, mild nausea, my breast is slightly tender and is bigger than usual,body is very hot when i wake in the mornings and i throw up once, however i did a test but it was negative. I am very confused and stress out because we really want a baby. Can YOU advise on what i should be my next step.",
    "doctor_response": "Hi, I think you should go for evaluation first if you are trying for more than one year and if your periods are irregular.  Get a thyroid profile and prolactin levels and a ultrasound for your uterus and ovaries done.  Also track your ovulation by repeated ultrasound or ovulation detection kits.  If ovulation is happening, then you can try naturally.  Be in contact with your husband every 2 to 3 days after your periods stop.  It will increase chances of your pregnancy.  If it doesn't work, then you can go for ovulation induction with timed intercourse.  Talk to your doctor regarding this.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is tazocef injection, amikacin, kidped and monticope syrup right medication for bronchitis in an infant?\n\nGud evening doctor,My son 7 months old. Recently he suffered with running nose, we went to hospital for treatment. They recommed us to admit my son, they diagnosised as bronchiolitis. Treatment advised take for five days tazocef injection 400 mg and amikacin 60 mg. Syrup - kidped, monticope",
    "doctor_response": "Bronchiolitis and bronchitis are 2 different conditions. Bronchiolitis is more common in a 7 month old baby and generally does not require too many medicines or a lot of antibiotics. But admission is often necessary for giving oxygen, IV fluids and maybe nebulisation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fungal infection in the scrotum\n\nI have fungal infection in my scrotal area and in penis portions and i consulted a doctor and he prescribed the zolefung cream for 1 month and i used it.Then also it is not curing,what i have to do?Please give me suggestions? Is there a faster Oilment which can cure me?",
    "doctor_response": "Hi.I understand your concern. Fungal infection ccan be treated with medicine like anti fungal group. Medicines like fluconazole 150 mg once a week for 1 month and terbenafine ointment can be useful.But treatment depend upon type of fungal infection. It can decide only after proper examination. So consult dermatologist before taking any medicine and get help.Still if you have a query then feel free to ask. Happy to help you further. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible despite taking Postinor pills?\n\nhello, i had sex on tuesday, evening period and i used postinor first pill and waited for the next 12 hours to use the other... well i couldn t find and i waited till wednesday afternoon to get a new pack. i got a new pack Wednesday afternoon and i used the two pills at once. i had sex Wednesday night .. is there a chance that i might get pregnant and how effective are the pills i used.",
    "doctor_response": "Hello dearI understand your concernYou have used postinor 2 before the sexual intercourse.It will not protect against the sexual intercourse done after taking postinor pill.If you have sexual intercourse during the fertile phase of the cycle then there is chance of the pregnancy.But there is chance of the hormonal imbalance and cause delay in the period by 8-12 days.If your period will delay by more than 12 days then go for urine pregnancy test and or blood HCG to confirm the pregnancy.Meanwhile avoid stress, take healthy diet, drink plenty of water and do regular exerciseHope this may help youContact HCM for further health queryBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to determine if Hepatic artery stenosis surgery damaged the Celiac artery?\n\nHi, I am trying to come across sites that talk about hepatic artery stenosis, the causes of it and how it is surgically treated. I was diagnosed with MALS years ago and over time, due to misdiagnosis , surgery was pushed back. I just got my results from the abdominal utlrasound done Monday and it shows the hepatic, splenic and superior mesentaric arteries, significantly stenosed. I had a botched bariatric reversal/revision surgery back in 2008 and damage was done in surgery, which looks like from the Cath Lab procedure done on the arteries in 2010, that the surgery nicked the celiac artery and tried to patch it up in surgery. My aorta and celiac arteries look like they are improving while the other arteries are getting worse. If damage was done to the celiac artery in surgery, would that explain why the other 2 have improved and the other 3 have not? Melody. I am 29 years old. Thank you for your help. Need deperate answer",
    "doctor_response": "you need a vascular surgery consultation. you can benefit by a endo-vascular procedure with very good results as a stenting, but you will need to do a angiography or angio-CT. you can benefit also by a angioplasty. anyway is for the vascular surgeon to decide after the CT was made",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for fluctuating temperature in a baby\n\nim having alot of questions and i need an answer asap, i have 29 month baby and she recently had a fever for a week she was taking antibiotics and theirs still fever , she was takin amoxillin amoxicillin and clavulanic acid, and that produce diareah and also she had shots of Ceftriaxone and now she has low body temparature (35.6) and it goes up and down please in need a answer!",
    "doctor_response": "Hi, this is probably sepsis. Child needs admission in hospital. Blood culture needs to be done. CRP levels, CBC should be done. Examination is necessary here. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lower back pain\n\nHi, I'm a 26 year old male and I am experiencing lower back pain only on my lest side.  It started three weeks ago, out of nowhere, and has been off and on.  On a scale of ten I would rate the pain as a 7.  It is manageable, but it hurts when I try to touch my toes.  I think I should go to the doctor, but I don't know if I should see a specialist or what.  What do you think?",
    "doctor_response": "Thanks for contacting HCMI am sorry to hear that you have left sided back pain fro the past 3 weeks. It is substantial pain and this is a very common problem. I see this problem frequently and I usually start treatment with medication including Naprosyn and muscle relaxants. I also recommend seeing a massage or physical therapist to help reduce the muscle spasms. Hope this answers your question. Please contact us again with your concerns.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child had febrile convulsion post HIB vaccine. Is it safe to give the second shot?\n\nDear Sir, My daughter is 8 months old now.She has his first convulsion attack on 6 months after very next day of HIB vaccine .We ask her doc he said it is Ferbile seizure , his 2nd fit attacked her in after 1 n half months of first one,doc says it is coz of fever . and he changes the medicine from fardenal and eptoin(2 times daily) to epilex (2 times) nd Eptoin (1 time) also 1/2 frisum tablet daily for 15 days two times. In the 8th months she agan had HIB vaccine.Was it safe to give again HIB vaccine since she had first attack after this vaccine. Her M",
    "doctor_response": "Hi, welcome to H.C.M.Forum, it could be febrile convulsion if there is simultaneous high fever. always keep paracetamol syrup in hand and see that he never gets high fever. regarding HIB vaccine you better get it don by a pediatrician after explaining the situation. if it is febrile convulsion it will cease coming after the age of 5 years.thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated SGPT and SGOT levels?\n\nI am a diabetic of 38 years.  My blood work today showed the sgpt(42)and sgot (46) were slightly elevated.  Everything else was normal.  My cholesterol was 195, my triglyceride was 59, my hdl was 79, and ldl was 104.  Could it possibly be a diet issue.  I have been eating more fatty foods than normal, and have craved and eaten coconut lately.  I am 54, through menopause and everything seems to be topsy turvy.  My mom died 2 years ago with cirrosis of the liver and she never drank a drop in her life.  I am not a drinker of alcoholic beverages either.   Advise please!",
    "doctor_response": "Thank you for the query. As per history, you a 54yrs old lady (through menopause), a long term diabetic (around 38yrs) with slightly deranged Liver enzymes. Your lipid profile is within acceptable limits.Your profile is similar to a condition known as Non-Alcoholic fatty liver disease (NAFLD), which is common in diabetics (though the liver enzymes are more deranged in this condition). Consumption of fatty diet, may indeed be a cause. It is recommended to avoid refined carbohydrates, saturated fat and carbonated drinks. High fibre diet is advised. It is commendable that you do not consume alcohol.Cirrhosis, may not always be due to consumption of alcohol. A number of other conditions can cause Cirrhosis like - Chronic Hepatitis B/C infection, Autoimmune hepatitis, NAFLD, Wilson's disease etc. Without further information, it will be difficult to comment as to why she developed Cirrhosis.I would advise you to repeat your liver function test after a month, and if your enzymes are persistantly elevated or on the rising trend, please do visit your physician. Some investigations like USG upper abdomen and some blood tests may be needed.Hope this helps you out.Regards,Dr. Ayusmati Thakur",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe backache be treated?\n\nIhave a 53 yr old son-in-law. My daughter and him went to N.C. Up on Upon arrival him got out of the car he streched and heard a loud pop in his back area. they came back home he has been in unbelievable pain. The doctors have done C-scan, mris 16 b[ood tests. The only thing they have found is he has an inflamed disc a knot on his spine. No antibiotics have touched the infection. No pain killer works. he has lossed 50 lbs. The doctors have said MS Autoimmune and some other things but they can t seem to find it. they now say his pain is not connected to his back. Any ideas?",
    "doctor_response": "Dear patient Your symptoms indicate muscular origin of pain . Mri is very sensitive and specific for diagnosis of spine pathology. If it's normal most of  the spine pathology can be ruled out. Ct scan rules out bony pathology. Both tests are already done for you and they are normal. so You need not to worry. which pain killers you are taking? take proper rest with medications. Sometimes detailed clinical Examination is very helpful. I would advise to take second opinion from other doctor because you should be alright now.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure a lump in the left arm?\n\nMy daughter is a Hodgkins' Disease survivor--9 years since a successful transplant using her own cells.  She just delivered a baby 10 days ago, and baby has a lump in her left arm, exactly where my daughter had a tumorous cancer in her bones in her left arm and had surgery and radiation to remove the cancer.  Her baby has a lump in her arm exactly in the same spot that my daughter had her bone cancer in her left arm.  Is it possible that baby is having any cancer in her own left arm, since the lump is exactly where my daughter's cancer was in her own arm?",
    "doctor_response": "Hi,Thanks for writing in.It is unlikely that your grand child is having a cancer at exactly the same area where your daughter once had a tumor. However it is important to bring it to the notice of the pediatrician treating the baby and take a clinical opinion regarding the possibilities.Presently we have good imaging techniques and for a 10 day old child, doing an ultrasound scan will help us know should there be any concern regarding a lump in the left arm. If there is a strong suspicion then doing a X ray is also advised.It is more likely that the baby has some asymmetry of arms and this can be verified by clinical examination itself. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a hard swollen flat mass below the tail bone indicate?\n\nred, hard swollen flat mass below the tail bone with one big red blotch in the middle. i get a rash there often in summer because of wearing wet bathing suits but this time, it s not that. it appearred yesterday and is bigger and more awkward to sit down comfortably",
    "doctor_response": "Hello, As I find the history to be directing towards important thing is you have a gluteus muscle weakness due to which there is excessive pressure over the sacrum region. When the pressure is applied again and again there will be a beginning in the physiology of the skin tissue and the changes in the form of swelling, bruising, wound etc. Doing exercises for the gluteus muscle strengthening should be good and also using piles pillow to avoid excessive weight transferring over the sacrum. The icing is also a good thing to allow healing. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are letrozole tablets safe for conception ?\n\nI am 37 years old, trying to conceive for the second time, i was on ATT for the past 6 months, the doctor has prescribed letrozole tablets for conception, are they safe? pls advise",
    "doctor_response": "welcome to healthcaremagic letrozole is used as ovulatory drugs and used now by many besides taking your own treatment your husband's semen also should be normal and sexual activity must be there arond ovulation day treatment to be continued till there is result hope for the best and best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is small, blueish lump on right breast concerning?\n\nHi, i found a small lump on my right breast and it is small and its kind of blueish.. i went to check it with my doctor she said its a mole but its under my skin. I have never had a mole like that, it does not move.. Should i go for a mammography.. and iam 18 years old.",
    "doctor_response": "Welcome to Health care magic.1. At this age with the history suggest - possible cause could be some infective aetiology.2.If your doctor has examined and said normal - probably its superficial.3.In this case if you still doubtful then you can get a ultrasound scan done that will give you a clear picture - weather lesion / lump or not, source of the lump, its nature ( cyst, abscess, mass) and where all its extending will be clearly said.4.Mamogram in your age is not recommended - Not advised.5.If there is any lump / mass - an FNAC will be advised for cell nature to assess. ( fine needle aspiration cytology). Good luck.Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for vitiligo\n\nhello sir...i want to know how to stop vitiligo from spreading.is there any permanant cure for vitiligo so that i canget rid of this permanantly.l am taking an ayurvedic treatment for this since one year but the results are not satisfying. I am loosing hope. Please help.",
    "doctor_response": "Hello,Welcome to healthcare magic.Vitiligo is an autoimmune disorder in which our body attacks its own pigment forming cells.If you are having actively spreading vitiligo, we call it unstable disease. You will benefit from taking low dose steroids which are given only on weekends as pulses so as to minimize the side effects. Many people postpone treatment and resort to alternative herbal remedies because of the fear of side effects of steroids. However, this will lead to rapid spread of the disease and it will be too late to treat effectively. Low dose steroids given as pulses under supervision can stop the spread of disease and slowly cause repigmentation.There are other modalities like phototherapy,immunomodulator creams like tacrolimus and antioxidants which will also help.Please discuss with your dermatologist about these options. Do not neglect till it is too late. Earlier the treatment, better the results.Do not be frustrated as stress can worsen this disease.Be positive and motivated and I am sure you will be fine.Wishing you good health,Dr. Johny Chacko",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to recover from the sore,swollen and tender area below the knee?\n\nI hit the inside of myleg below my knee really hard on my desk drawer Wednesday. I notice last night an area on the indside of my leg below my and was really sore and I felt a lump the size of a pea. My knee leg was really sore this evening so I changed clothes and look at it. Now my leg has a hot red area about the size of a quarter that is swollen and tender.",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The lump is related to an injury. I suggest using anti inflammatory medications such as Acetaminophen to relieve the inflammation .I also suggest using cold compres for local application. The lump will gradually disappear. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness when diagnosed with haematoma at the back of the head?\n\nmy Aunt fell at the airport this am and had a big haematoma at the back of her head, I wasn t there so did not witness it but my cousins said that she was dizzy for a bit and was shaken up, took her to he first aid area, iced her head but she was able to make it to the flight 3 hours later. It is a long 14 hour flight, I am worried about stroke, can you pls tell me anything about the situation? thx",
    "doctor_response": "Hello!Welcome on Healthcaremagic!I would explain that dizziness is quite common after a head concussion, even in the absence of stroke. But, we can not exclude intracranial bleeding like a delayed subdural hemorhage. For this reason, I would recommend having some rest and avoiding physical activity. If the dizziness does not improve, or even worsens, or she experience symptoms like gait distubances, confusion or nausea, I would recommend bringing her to the ER for a brain CT scan, to exclude intracranial bleeding. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes soreness in lower abdomen after recovering from UTI?\n\nI recently was diagnosed with a UTI and they also cultured it. Prescribed Cipro and now 10 days later the urgency to urinate and the discomfort are gone, but I continue to feel sore in the lower abdomen. Went in 2 days ago and took another test which showed no infection but my abdomen still hurts and I just feel kinda crappy. D",
    "doctor_response": "Antibiotics are notorious to cause abdominal discomfort so it is advisable that u should have some probiotics and vitamins",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain on left and high heart rate?\n\nI am a nineteen year old female and i have an abnormaly high heart rate but i take medication for it and i have chest pains on the left side underneath my breast. I have been to the doctor and a hospital they tell me its anxiety. It has been going on for a month now and i am trying to find out what is making my chest still hurt.",
    "doctor_response": "Hello and thank you for asking in HCMI can understand your concern.According to the history you are under treatment for tachycardia.If i were your doctor and prior i would do some tests to exclude some problems other that anxiety as follows:Blood count for anemiaChest X RayTSH,FT4 for thyroid glandThyroid ultrasoundAbdominal ultrasoundChatecholamins blood test hormonesIf they come negative we can say is the stress situation.If any of them is positive than the relevant specialist will advise you further.Hope you are doing wellThank youDr.JolandaPulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in neck after getting PIC line inserted?\n\nI had a picc line inserted a week ago. Today I developed neck pain on the front left side of my neck (the side where the picc line was inserted). It is a dull pain (probably a 3-4 on a scale of 1-10). There is no discoloration and no swelling, but I ve heard neck pain can be a sine of a clot. I have no other pain in the arm or chest. Should I be worried?",
    "doctor_response": "Hello, No need to worry, this pain is normal, it will go away by its self in a couple of days, you may take analgesic to ease this pain. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Want to increase height.\n\nis there any proper medicine to increase height?",
    "doctor_response": "1. you haven't mentioned about your age,height. 2. practically speaking height of a person increases till the age of 18, there after the epiphyseal cartilage of bone closes and prevent further lengthening of bones. 3.  If the physique and height of parents are short, it is possible that the off spring will also be short  in stature. 4. make sure you get proper sleep, remain stress free,take nutritious and well balanced diet aand practice YOGIC exercises that stretch back and spine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause seizures after vomiting?\n\nMy son got seizures when he was around 2 years. When he was sleeping after his breakfast he got the seizures. He vomited also. Admitted in the hospital. EEG completed. it was normal.2) Again he got the seizures when he is 3 years. In the mid night during sleep. He vomited and his hand and legs are stiff with staring look. he got admitted to hospital. EEG and MRI done. both are normal. Blood test where also normal.Doctors also not sure about the problem. what we need to do now?",
    "doctor_response": "As a pediatrician I would like to know some details... For how much time seizure lasted?? Was it associated with fever?? After how much time of seizure MRI and eeg was done?? Prolonged seizure can cause brain damage and many a times it is not detected if MRI was done immediately... I would like to take detailed history and clinical examination... After that a ct brain, repeat MRI or mr angiography brain may be needed in this case...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should i do as my child is having cough and chest infection?\n\nWhat it is my son hes bout 8 months nealii 9 he has had a bad cough since he was born i have been in and out the doctors since he was born aswell, hes had 3 chest infections and was taking to hospital twice with a water infection but e he has come back from his dads today and i think hes lossing his voice when i was in the kitchen with the door shut because i was sorting his bottles out i could hear his breathing from in there so i was woundering what i should do?",
    "doctor_response": "HelloYour son is 8 months old and having severe cough . This is most probably due to asthmatic allergic bronchitis . The sound which you heard was actually due to bronchoconstriction and typically whistling ( wheezing ) sound develop .Since this is very common and the main cause is due to certain predisposing factors , these are , DUST , MITE , POLLEN, PESTS ( COCKROACHES ) , FUMES , SMOKING (  PASSIVE ) , SUDDEN INCREASE AND DECREASE of temperature , Fibers  and of course hereditary .Once you child will attain the age of 15- 16 years he will not get such allergy .So need not to worry .When such patient visit my clinic I prescribe montelukast+ bambuterol syrup ( 0.2 mg / kg body weight of both drugs ) .Steam inhalation , hot coffee also help.Whenever  , you notice any fever give him antibiotics , otherwise only this drug will be most suitable for your son.But this is a prescription drug , so consult your doctor and get his opinion.You can also use cough syrup .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nasal bleeding with bowel movements?\n\nMy son is having frequent nose bleeds. Some come randomly, some with the slightest bump, and last week every single time he had a bowel movement. We just moved from MI to ND. Should I find a PCP in ND or take him to the ER soon? Appetite, sleep, and color are good. No blood or dark color noted in stool and no straining.",
    "doctor_response": "Hi...this is an unusual coincidence and I suggest get his blood pressure checked and also a blood test to check his clotting efficiency of the blood and rule out bleeding disorders. Its not an emergency as he is active and of normal color, but definitely he needs further evaluation. You can be rest assured if everything is normal.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for intertrigo on scrotum\n\nHi, I have had what the derm believes to be intertrigo on my scrotum off and on in the past. This time around I have had it or something for about two months and was treating with shea butter for comfort, but it hasn t gone away, i plan to go get some nystatin and give that a try. Anyway, my main question is i started with about 3 pimples on my inner thighs, only they are not pimples, they are very sore, very swollen ,and some puss comes out but doesn t really relieve them. Now I have 1 on my for arm and about 4 more on thighs and knee. Could these two issues be related? Oh, and now my wife has about three of these pimple like things.",
    "doctor_response": "you must be having recurrent staphylococcal abscesses. I suggest you send pus for culture and start cloxacillin 500 mg thrice a day for 5 days. check for diabetes and anemia",
    "dialogue_context": ""
  },
  {
    "patient_message": "What precautions should be taken after the rupture of follicles?\n\nHello doctor,Im 28year female trying to conceive today is my 18 day from my periods date..I had taken injections name-humog 75IU..on 3rd.5th and 7th day...TVS ultrasound was done on day 9th which results in to 7mm follicle in Rt ovary and ET-4.6...second monitoring was done on 14th day results into 12.8mm andET-5.8....finally  done on 17th day...which shows no follicle in my rt ovary and ET increased to 8.6mm....just wanted to add same injection Humog was given to me on 9th,14th and im also taking Gluconorm SR 1500mg..since last two months...Pls suggest what happened to that follicle it got ruptured?..today is my 18th day",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.As per your follicular study your follicles could be ruptured on 17 th day and endometrium thickness is also very good. So has great chance to conceive if fertilization occurs. So do intercourse from day 17 on alternate day.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sharp abdominal cramps\n\nI am a 28-year old married woman. 5'8\" and 150 lbs. I noticed a sharp pain lower in the abdomen that menstrual cramps earlier today, and twice today, I have urinated with a dull pain at the end, but more importantly, there has been discharge with blood on the toilet paper, and my urine has a very strong odor. I am on the pill for 12 weeks at a time, and I do not have it now. I've had UTI's in the past, but this seems different. I plan on seeing my Ob/gyn on Monday if symptoms persist, but I was curious to see what sort of feedback I might get in the meantime...",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query.Apart from excluding a recurrent UTI by a urine routine, microscopic and culture sensitivity test, if I were your doctor, I would also go for a serum HCG, and an ultrasound abdomen of yours in addition to a general abdominal examination to rule out any chances of a pregnancy or a pelvic inflammatory disease. I would avoid giving you any active treatment excepting for a mild anti spasmodic drug till I rule out a pregnancy.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have hepatitis C. Pain in the liver after drinking coffee. Reason?\n\nI have Hep C and 1 1/2  years ado I had a liver biopsy. The doctors told me I have a liver of 16 year old, and I am 40. I have had hep C for 25 years. Just yesterday right after I drank a cup of coffee, my liver began having sharp pains when I would breathe in or slump to the side. I have changed my diet recently (more meats/paleo diet) and am taking more supplements (advocare). For the last three years, I was only taking Vit B and Milk Thistle. I ate a normal, fairly healthy diet. What is this sharp pain? It only lasted for 1/2 hour.",
    "doctor_response": "Hi and welcome to hcm. tHANK YOU FOR YOUR QUERY. It sounds to me more like gallblader issue and gallbladder attack caused by stones. Also gastritis can be cause of such pain too. So do ultrasounds first to rule out gallbladder and hepatic issue and if nothing is found you should do gastroscopy. Till that change dietary and lifestyle habbits. Do exercise, avoid alcohol,smoking, fats,fast food and carbonated drinks. Eat more fruit and vegetables, boiled meat and follow some of hepatoprotective diets. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of maroon colored streaks after bowel movement?\n\nHi just noticed past couple of days my son (age 3) has had some maroon colored streaks on the toilet paper after wiping him after bowel movement. He drinks a lot of milk and I think he did have a pretty hard bowel movement yesterday. Should I be concerned about this?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. I think your kid is having habitual constipation. I have certain questions and suggestions for you. The blood streaks you are seeing are because of the mucosal erosions due tot the hard stools. Suggestions:1. 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 Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in my lower back?\n\nI am having severe pain in my lower back, right at the tip of my tail bone. When I touch it it feels sore, and yet I did not fall down. What could have happened? The pain developed suddenly, starting small yesterday evening and now I am having to take Tyelenol muscle relaxant/inflamation reduction",
    "doctor_response": "That is coocydynia, sit on very soft surfaces with cushion. Try sleeping on sides so that pressure reduces on that part and slowly with medication inflammation would subside",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is chest pain related to intake of clindamycin and oxycodone?\n\nHi Dr. Bhatti, I was recently released from the hospital after a hand surgery and they provided me with Clindamycin 300mg and Oxycodone Acetaminophens. Ive taken this combination 3 times now and my chest feels really tight. Is there reason for me to worry?",
    "doctor_response": "Hello, The use of Clindamycin can cause stomach pain or a hyperacidity of the stomach. So, I recommend using a medication to lower the acidity production such as Omeprazole daily. I also suggest using Maalox three times a day and avoid food that can trigger the symptoms such as spicy food. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cirrhosis of the liver\n\nShe broke her humorous and it didn't heal over a years time. She finally decided to have surgery, this happened last Wednesday, February 3rd. She has Cirrhosis of the Liver and since she has been in her bilirubin has spiked from 2.1 to 9.7. Her INR score was at 1.2 up to 1.5 and now 1.4. Her Creatinine is at .53, BUN 19. She has had 4 units of platelets over the last 5 days - down to 50K and has had 4 units of hemoglobin down as low as 7.6. Her MELD score prior to surgery was 12, 13 on Friday and now with the spike in Bili it's at 19. She has had a catscan of her arm and stomach to ensure there is not internal bleeding, both negative.. as they are trying to figure out the bleeding problem. More lab results: albumin 2.3, protein 5.4, SGOT 59, Protime 14.1. What is your suggestion, there has not been a gastroenterologist seeing her in the hospital. Currently she has an attending that is an internist, a hematologist and a orthopedic doctor. I am scared they are going to send her home, she will continue to decline with platelets and hemoglobin and her liver function will worsen. Any suggestions on what we should do next?",
    "doctor_response": "For cirrhosis if you can take her to gastroenterolgist that would be much better. Make sure that she eat high protein diet ie white egg yolk and cheese.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes head discomfort and dizziness?\n\nFor a few months I\u2019ve been experiencing the feeling of something wriggling in my head/brain like a worm sometimes it hurts but since it started I\u2019ve had nothing but dizziness and waking up and feeling sick all day I wondered if you could help me figure out what it could be",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Several things would have to be known about your condition...your ORTHOSTATIC BLOOD PRESSURES, ELECTROLYTE LEVELS, HORMONES, LIVER and KIDNEY function tests, and CBC with differential.  You may have an infectious process, a condition known as BPPV, or there could be a spontaneous CSF leak (common in people who wake up with severe headaches with and without spinning sensations). Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can horseshoe kidneys be treated?\n\ndoctor of nephorology for online consultation Kidneys- there is evidence of horse-shoe kidneys with relatively small right moity. The isthmus is seen anteriorily lying in front of great vessels. The relatively large left kidney moity shows an approx. 38*32 mm sized cystic lesion in relation to pelvis.No evidence of any calculus or hydronephrosis is seen in both kidneys. The age of the patien is 20 years. Please  give your sugesstion. email : YYYY@YYYY",
    "doctor_response": "Hello,It appears, there are multiple developmental defects in the kidney. These defects do not need any treatment unless the patient is symptomatic.If the renal functions are normal and the patient is symptom free, then he may proceed with a normal life with no need for any additional precautions.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Karthik Rajan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Grade 1 - 2 fatty infiltration, sludge ball in gallbladder, moderate drinker. Will this turn to cirrhosis of liver?\n\nI have fatty liver & slightly enlarged liver, Grade I - II fatty infiltration seen. And I have 9 mm approax sludge ball in Galbladder. Just a month ago that was detected.I am a moderate drinker, doctor told not to drink beer.I drinks sometimes 80 ml max (scotch whysky ) & regular take medicine for my fatty liver & do excercise (walking more than a mile ). Can you tell me in this case can be turned to cirrhosis of liver? I am goign for Gallstone operation. My age 33yrs & weight 76 kgs, hight 5 10 Regards Sandipani",
    "doctor_response": "Dear Friend.Welcome to HCM.It seems you have been suffering from Chronic Hepatitis B. I would suggest you following:Yes this can turn into cirrhosis.I advise you following investigations:1. Viral markers2. Upper GI Endoscopy3. LFTReview with reportsYou require treatment for this.Stay Healthy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could a painful cut on the lip with jelly-like secretion be infected?\n\nMy husband threw my cell phone at me which busted my lip. There is a cut on the upper outside lip that has since dried up into a dark red dried up blood look. The swelling is going down on that however the other cut is directly underneath the outer cut. It is paining me to eat, talk for too long, smile etc. The inside cut is now purplish redish and white. I've put neosporin, gargled with warm salt water, taken ibuprofen, used canker relief and orajel but it still hurts and ever so often I have to wipe it because a jelly like substance comes out and sits there until I remove it. No fever or anything but still painful since. Besides the obvious going to have a doc look at it, in your professional opinion does it sound infected?",
    "doctor_response": "Hi,Looking to the history there is infection in your lip wound.Due to its place, healing is slow due to formation of saliva and lack of rest to the part due to constant movement due to speaking,eating.You might require one course of antibiotic for 3-5 days.Apply Gention violet lotion on the part.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen and heavy legs with pain\n\nI have suffered for as long as i can remember with very large heavy legs,now one seems to have swollen more than the other,although i can walk slowly without pain,very occasionally i feel a warm tingling in leg, it doesnt last long but worries me.My grand mother suffered with heavy swollen legs im told. Can you please advise. Thankyou.",
    "doctor_response": "There can be hormonal causes like Diabetes or thyroid or it can be due to nerve compression in the spine. Both can cause such pain and difficulty in walking. I would recommend you to get your spine MRI and blood investigation to see if there is any problem related to this.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump below shoulder blade\n\nHey.  My wife is 35, in great shape and fell on the stairs three weeks ago.   Last night I noticed she has a hand size lump on her back just below her shoulder blade on the right side where she fell.  Part of falling, she twisted her ankle but that is well enough for her to now run on.  The lump is smooth, colorless and not painful.  It is softer then muscle and harder then fat and does not appear to be part of her muscle.",
    "doctor_response": "Hi,Thanks for writing to HCM.That can be a hematoma, following the fall.That should resolve by itself in a few weeks. If it gets warm or painful, then it could mean its infected and needs drainage. So keep a watch on it.RegardsDr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for liver cirrhosis\n\nMy boyfriend has cirrohsis of the liver Not from alcohol. The other night while he was sleeping he starting coughing all of a sudden he gasps. Then his arms cameup tight against his chest and closed his hands tight His eyes rolled back in in head. I couldnt wake him up. Do u know what this was?",
    "doctor_response": "Hello! Thanks for putting your query in HCM.  I am Dr.Amit Jain (DM, Gastroenterologist). It appears to be an episode of seizure. I will suggest you to take him to ER for further evaluation and management.I hope I have answered your query. If you have any further query I will be happy to answer that too. Wish you a good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in cheeks and gums?\n\nSwollen cheek and gum. At the top of the gum meets the cheek. It's been swollen for three days and I have a dentist appointment tomorrow. Should I be worried about waiting so long or will one more night be okay. I have no pain really just a little discomfort due to the swelling of my cheek.",
    "doctor_response": "Thanks for your query, I have gone through your query.The swelling in the cheeks and gums can be because of the tooth or gum infection. The vestibular obliteration can be because of the collection of the pus. Nothing to be panic. Consult a oral physician and get it evaluated. If I am your treating doctor, I would have suggested you to take radiographs like RVG or IOPAR to rule out gum and teeth infection.If it is a gum or teeth infection i would have prescribed a course of antibiotics like amoxicillin 500mg and metronidazole 400mg tid for 5 days (if you are not allergic) till you consult the dentist. Then i would have suggested to go for scaling and root planing for gum infection. RCT or extraction if it is a tooth infection.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in right side. Kidney and gall bladder removed, have elevated liver count. Would this cause pain?\n\nI've been experiencing severe pain on my right side for the past week where the kidney would normally be. I've had my right kidney and gall bladder removed and have been diagnosed with elevated liver count. Would this account for the pain? I have an appt. with my urologist this week and should I seek his input or another type of specialist?",
    "doctor_response": "HIthanks for your question.Yes elevated liver count means there is problem in liver and it can account for pain, however other investigations like abdominal ultrasound, urine analysis would be use full.Urologist and liver specialist would be of help to you.Hope I answered your question, I will be happy to help you if you have other queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why the platelet count goes donw?\n\nI have naturally low plaelete count and just reciently it has been going down more...last blood test was at 69,000...no other abnormalities with blood, went to visit hemotologist he thinks itp, I weight train...pretty intensely, can I continue that without worry? or do I need to let up?",
    "doctor_response": "HiThanks for posting your query.        There are many causes for low platelet count. But since you have consulted hematologist and he thinks as ITP even i agree with that diagnosis.      Now coming to your query, low platelet poses risk of bleeding. In such a situation heavy exercise where the chances of external or internal injuries are high is not advisable. I advise you to do light aerobic exercise but not heavy exercise.     Any further clarification feel free to ask .    Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does abdominal pain, belching and blood in stool indicate stomach cancer?\n\nI am experiencing severe pain in my abdomen (upper right quadrant). Extreme bile and acid, belching, headache, blood loss stool, mimiced gall bladder pain (however no gall bladder). Last blood level from loss was 4.9. Transfusions were given. I practically live in hospitals and clinics and want to avoid going in. My concern is stomach cancer. What is your opinion? Also, although my condition is deemed idiopathic, do you have a possible cause for all of these organs to be shutting down resulting in removals? I have had a total pancreatectomy, islet cell transplant, total spleenectomy, gall bladder, sub-total colectomy (only rectum remains), kidney, stomach, small intestine as well. I have a portal vein thrombosis, experience several bowel obstructions weekly, blood transfusions, bi-monthly, blood transfusions (extreme blood loss rectally)are due to multiple varices, ulcers and lesions.",
    "doctor_response": "Hello,its not easy to say that you have cancer if we dont have exams resaults for this .Those signs are some of cancer symtomps,but we have to be sure for the diagnosis.The doctor will healps you for this.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. TSH is very high in a CMV IgG positive patient. Can she become pregnant?\n\nHello doctor, We are trying for pregnancy. My wife recently got some tests done namely a TORCH profile with the primary sample being serum through the ECLIA method. The toxoplasma IgG was 500.0 positive IU/mL and rubella IgM being\u00a00.20 with negative COI. With the\u00a0ELISA method, there is HSV I and II IgG antibody at 0.47 and negative AI and HSV I and II IgM antibody at 0.60 and negative AI. The instrument used was fully automated COBAS e411, Roche Germany. The second test was a fertility profile with a\u00a0primary sample being a serum. The FSH is 7.37 mIU/mL and the method is CLIA. The\u00a0LH is 5.73 mIU/mL and the method is CLIA. The instrument used was a fully Automated ADVIA Centaur XP, Siemens Germany. The third test was an anti-Mullerian hormone where the primary sample again was serum. The AMH was 2.64 ng/mL and the method was\u00a0ECLIA. The instrument was a fully automated COBAS e411, Roche Germany. The last test was a thyroid function test with serum as the primary sample. The\u00a0TSH Ultra was 18.048 H IU/mL and the method was CLIA. Instrument here was a fully automated ADVIA Centaur XP, Siemens Germany.\u00a0Her ovary releases multiple small sized eggs during ovulation.\u00a0We are worried about these results. She is tensed seeing high thyroid and rubella & CMV IgG positive.\u00a0What do these tests suggest?\u00a0What do we need to do to have a successful pregnancy?\u00a0Do we need to get any more tests done for a check on her health and take precautions about her health? I am looking forward to your response.",
    "doctor_response": "Hello. Your wife is immune to rubella and CMV (cytomegalovirus). If you just want to be sure about the recent infection get an avidity testing for CMV and rubella infection. Your TSH (thyroid-stimulating hormone) is very high. You need to see an endocrinologist or physician for your thyroid. I suggest you start at least 150 mcg of Thyronorm (Thyroxine) daily empty stomach every morning. Consult your specialist doctor, discuss with him or her and take the medicines with their consent. From a pregnancy point of view, your TSH should fall to around 2.4 mcg. Therefore, a repeat TSH after six weeks of treatment is needed. When your thyroid is under control then plan pregnancy as Thyroxine is required for baby's development. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How do I check my pulse rate?\n\nHello doctor, I notice whenever I am hooked up to a monitor, it reads a pulse on a pulsometer. My pulse is never steady. It bounces around each second and not gradually or one by one. It goes from 75, 82, 86, 92, 84, 101 and then back to 94 and then to 87. Is this normal? All my heart tests say I am healthy. It bounces within a 15 to 30 beat range. What should I do?",
    "doctor_response": "Hello. Pulse rate between 60 to 100 is called a normal range. Pulse rate remains on lower side during rest and sleep and on the upper side during activity, fear, fever etc. During exercise, it may go well beyond 100.  Monitors are machines, these are not error-free. For confirmation of your pulse rate, the best way is to count your pulse for one full minute. If it is within range of 60 to 100, it is perfectly normal. For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a red rash with small red dots on my penis. Can it be an STD?\n\nHello doctor, I have a red rash with small red dots on my penis. My previous partner cheated on me one year ago. Tonight, I made out with a girl. Both of us were dressed. There was a lot of rubbing. There is no itchiness or pain when I pee. Can it\u00a0be an STD from my ex a year ago which was my last unprotected sex or just irritation from sweat and rubbing?",
    "doctor_response": "Hello. I read your query and understand your concerns about the possibility of an STD (sexually transmitted disease). I hope this answers you. Feel free to write back to me if you have more questions. You may also approach me for online video consultations or counseling related to sexual disorders and sexual health. I will be glad to help you. For more information consult a sexologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in right thigh and groin\n\nHi . I am a 40 year old female. 2 days ago i began to have sore/tenderness to the inside of my right thigh. It moved down to my knee and onto my foot. It also traveled to right side of my genital area. Its now 2 days later and the genital area feels raw and painful to touch. I see no abrasion or cuts. What could be causing this discomfort?",
    "doctor_response": "hi,thank you for providing the brief history of you.As the pain is radiating in nature and there are no abrasions and cuts a thorough neuromuscular assessment and musculoskeletal assessment is advised.Post which we can conclude as the pain is due to which factor as well.Usually such radiating pain nature is possibly due to pinched nerve in the lumbar spine for which a clinical assessment can help along with the assistance of the MRI scan an exact soft tissue status is understood.Undergoing physical therapy like therapeutic ultrasound therapy and TENS therapy will help reduce the pain. followed by which performing exercises so strengthen the weaker muscles will help stabilize the joints and reduce the pain levels.In my clinical practice such cases respond well to physical therapy and near normal functionality is achieved soon.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any harm to do stretching exercises after gall bladder removal?\n\nsir, i am 20 years old, i had my gall bladder removed on 12 march-2012(nearly two months back). IS it advisable for me to do swimming and other rigourous and streching exercises like yoga and basketball.. pull ups.. hanging from a bar etc... etc at this time ???",
    "doctor_response": "hi.noted history of cholecystectomy several years back. to answer your question, yes, you may return to your exercise routine. it must be done gradually and as tolerated initially. even those have been operated on for years, occassionally experience pain/discomfort over the post-operative site, which is tolerable in intensity and resolving spontaneously. if symptoms are persistent/progressive, a follow-up consult with your surgeon is best for physical examination and clinical evaluation. low fat diet is also recommended.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can maxiflo inhaler be used by child who is less than 5years for asthma?\n\nHello Doctor, My Son is 4 years old and has Asthma. A Doctor suggested to use Maxiflo 125 Inhaler for 60 days. However, on CIPLA s website it is stated that Maxiflo 125 is not advisable for children under 5 years of age. Request you to let us know on how to proceed now.",
    "doctor_response": "Hello,Welcome to HCM,Maxiflo or other inhaler is not safe to continue for long time in children.Asthma is curable with homeopathic treatment. He is only 4 year old then don't make him habituated with allopathic medication when you have a better option in terms of homeopathy.Homeopathic treatment is based on total understanding of patient on physical and mental level. And that's why detail history of patient is needed for proper homeopathic treatment. Your problem can be cured permanently with homeopathy.So consult to good classical homeopath nearby you or contact us.Have a better health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Signoflam cause side effects like stomach upset?\n\nI have an insect bite on my forehead it swelled up and then the swelling was moving down over my eye and now to my cheek, it does not pain. I asked my doctor on phone and described by situation and he recommended signoflam for the swelling. I have taken two tablets and now my stomach is upset.",
    "doctor_response": "HiIndigestion,abdominal pain can occur with signoflam since it contains two pain killers namely Paracetamol and Aceclofenac.These side effects can be avoided by using H2 blockers or proton pump inhibitors half an hour before food.Hope I have answered your query. Let me know if I can assist you further. RegardsDr.Saranya Ramadoss, General and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could sore throat, nasal congestion and pain and bumps on tongue be sinus infection?\n\nHere are my symptoms over the past four days. Sore throat when swallowing, nasal congestion and sinus pain, eye muscle aches, headache, bad breathe with phlem in back of throat, bumps on back of tongue, stiff neck, all over body aches with concentrated backache and stiffness. Is this a sinus infection or something else. There has been no fever at all. Thank you",
    "doctor_response": "Hi,Thank you for your query. I can understand your concerns.It seems  that you have upper respiratory tract infection(URI) due to virus.Over 200 different viruses have been isolated in patients with URIs. The most common virus is called the rhinovirus. Other viruses include the coronavirus, parainfluenza virus, adenovirus, enterovirus, and respiratory syncytial virus.Sinusitis occurs as complications. One can have low grade fever which often gets unnoticed.Sinusitis  alone will not cause backache and stiffness and other symptoms as mentioned by you.Regards Dr. T.K. Biswas",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of getting rabies through a stray dog bite?\n\nHi,My husband's aunt was bitten by a stray dog yesterday on her hand. She has three puncture wounds on her hand (2 on the top and one near her thumb.  The top of her hand was very swollen shortly after the bite happened. She went to her doctor and they gave her antibiotics and told her to contact the health department.  They didn't even clean it.I am now concerned about the risk of rabies since the dog is a stray.  Do you have any advice I can pass along?",
    "doctor_response": "Hi thanks for asking question.Yes through dog bite rabies can surely transmitted.Even your husband aunt has not clean the wound.Whenever there is dog bite bite area wash throughly with soap and water.She has to take anti rabies vaccine because according to history chances of infection is high in your aunt case.I hope i have solved your query.thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can be done to cure mental trauma given by colleague?\n\nHello doctor, I am 41 years old. My office colleague is giving me mental trauma by gossiping about my childhood physical abuse. Sometimes suicidal thoughts come to my mind. How should I tackle it?",
    "doctor_response": "Hello. The first thing that you have to fix in your mind is you have done nothing wrong in that abuse episode, it is a matter of shame for that person who had done it and to those who are making fun of this. Be confident and set in your mind that you will never get disheartened, say to your own mind that you have fought very well with the circumstances and done your best to overcome that. Suicide can never be a solution to anything. Do people stop gossiping after you? They will keep talking, no matter or anyone else .one more thing, rule out other features of depression. If present consultant a psychiatrist. For the current situation try to talk with them and ask them if the same event had happened with someone to their relative or close one, will they keep talking like this? Do regular yoga and meditation. Take a healthy diet, proper sleep. Try to involve yourself in other activities and be happy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could intake of orange juice cause frequent watery motion in an infant?\n\nmy baby girl is 4 mnths 3 weeks old.since 2-3 days we have been giving her 1-2 ounces of orange juice daily one time.it seems like she puts motion more frequently than what she used to before ,also it looks watery.today i dint give her juice. is it loose motion or is it common wen we give juice, pls suggest",
    "doctor_response": "Hi, Bottled orange juice can contain a high concentration of sugar and hence cause loose motion. It's best avoided. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Cajetan, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe pain in wisdom tooth.  History of being suggested removal of wisdom tooth would cause paralysis.  Remedy?\n\nHi, My Dad still has his wisdom tooth. When he was younger and took an x-ray the dentist said that if he did a surgery and in the surgery they touch the nerve he could become paralyzed, because the nerve is very close to the tooth, My family lives in Japan right now and he does not have insurance so he can't do the surgery yet. But right now his wisdom tooth is hurting a lot. Will you please tell me all the ways to reduce the pain?",
    "doctor_response": "hello yes it is true that if they harm the nerve while doing surgical exraction of the third molar it can lead to paralysis.. but i would advice your father to go for one more x ray and take some oral surgeon's opinion about it... to relieve pain he can take amoxicillin 500mg plus clavunic acid 125mg 12 hourly and ketorolac 400 mg 12 hourly for five days.. also start warm saline rinses 3-4 times a day..  hope it is helpful",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have CKD, low GFR. Sonogram shows complex, septate cysts with hydronephrosis. Prudent?\n\nThank youI've been diagnosed with CKD. I am 68, 5'-7\", trim, very healthy (otherwise), take no meds, and exhibit no symptoms. My GFR is now 47. In the past (over 20 yrs ago) I also had some low GFR numbers, but did not receive a Dr's advice re the blood chemistry. I've recently altered my diet to eliminate animal protein, all sugars, breads, alcohol, and stick to just fruits and veggies (occasional small baked fish portion). I have relatively small kidneys (around 9 cm each) and 1 kidney has a large cyst (4.5cm x 3.4 cm x 3.6 cm) and the other has 2 much smaller ones. The sonogram listed the cysts as complex, septated cysts, with no hydronephrosis, no masses, or calculus. My BMI is in the low 20's. I am being told to have a nuclear medicine scan to assure that both kidneys are still working, preparatory to surgery to remove/reduce the cysts. Is this a prudent path?",
    "doctor_response": "Hi and thanks  for the query,I think the approach is very approach. the absence of hydronephrosis and other complications at this point in time warrant timely removal of these cysts to ensure they do not grow too big to cause other compression symptoms to nearby structures. It important to have adopted a healthy life style especially with your diet and you should continue with it. I strongly feel removing the cysts now is to your best interest in safeguarding the integrity of your kidneys. Proper follow up with your nephrologist is very important and being prudent with any drugs that could compromise kidney function is my advice.Thanks and hope this helps as I wish you the best of health.Kind regards,Bain LE, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can coumadin cause sensitive to sunshine and light?\n\nMy 96 year old father-in-law has been on coumadin for about 10 years.  He has developed osteoarthritis.  He refuses to go outside into the sunshine anymore.  Is there any reason he shouldn't while taking coumadin?  Does he even need to continue taking it at his age?",
    "doctor_response": "Unless one has some serious side effects,coumadin may be continued if prescribed for any reason by his doctor. There is no known bad effects of sunlight and it may be due to photophobia from other causes. so an opinion with eye specialist may be indicated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for difficulty in breathing and heart palpitations\n\nhello sirI am 24 years old. Height 5'4 and weight 55kg.I have constant breathing problem.Whenever i do any physical work like climbing stairs my heart starts beating very fast. i feel tired all the time. I have breathlessness and i always feel the heart's palpitation. Whenever i go to sleep i feel something is going on in my heart i dont know exactly but it feels as if i feel the blood flowing in my heart. I cannot breathe properly even while sitting it feels i am not getting full oxygen. I have been to a lung specialist and all the tests done they are all normal. I had a open heart surgery done for ASD closure in 2007. These symptoms i thought would go away after the surgery but there is not even 1% change in my condition. I feel the same before and after the surgery. Now i cant figure out which Doctor should i see. I have been to a cardiologist and pulmnologist and all tests are fine. Please suggest me which doctor should i see. Also i have lot of gas .....i keep burping all the time..Can these breathing problems are because of gas?? Should i see a gastrologist please advise??",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. First of all no need to worry for major heart and lung diseases because your all reports are normal. Sometimes undiagnosed stress and anxiety can cause similar symptoms like palpitations, breathlessness, gaseous bloating etc. So in my opinion, you should definitely consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic drugs too. Take pantoprazole and levosulperide combination on empty stomach twice daily for gaseous bloating. Avoid stress and tension, be relax and calm. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could brown discharge and abdominal pain post the birth control pills suggest?\n\ni have back pain, brown discharge, and sometimes abdominal pain come an go 4a few minutes, i am just after startin my birth control after a months break from it, i started on the  first day of my period,  witch started 12 days ago, i ahd my period an now am having brown discharge since it ended..what wrong with me?",
    "doctor_response": "HelloWelcome to HCMThis is a common side effect of this pills dont worry about it.You can take other birth control methods after consulting your doctor.For now you can have  tranexamic acid and mefenamic combination.Hope this is helpful..Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain and tiredness?\n\nhi!!!fis is abigail from philpines.i want to ask.last nov.my doktor advise to have a endoscopy.the result  acid septic disease and eroseive gastritis.i take my medicine nexium 40mgfor 2 weks.followed by omeprazole 4omg for almost 1 month.now im i always fel tired everyday and sometimes i fel pain in my stomach.im already 31 yrs.old,5'0 in height and 52kls.",
    "doctor_response": "Hithanks for writing HCM and your detailed history you already mentioned the diagnosis as acid peptic disease and on treatment my advise is take antacid like gelusil 2teaspoon thrice daily along with your current medications   to drink plenty of water,regularly timed food with every 3 hours but all in small quantity for eg 2-4 biscuits with adequate water and to avoid spicy and oily food,no alcohol,no coffee,no junk foods. I would be glad to provide answers to any further queries.Thanks for using HMC Have a good day!Regards, Dr. V.KUMARAGURU general surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful rash on the penis\n\nI had a rash on my penus that was very painful. I went to see the doctor three weeks ago and he gave me antibotics and a fungle cream. That did not clear it up, so I went back about a week and a half ago. He gave me an oral anti fungule. Slight improvement but rash still not gone, and there is a white /clear discharge from the head now. What is goin on??",
    "doctor_response": "Hello I share your concernLooking at your description this could be STI or infected ulcer I would like further informationto help you better Your age and relevant medical history like diabetes or other metabolic disease Any recent exposure to unprotected sex?You should ask your doctor for few investigations to confirm the diagnosis like Urine culture and sensitivity test as well as pus culture of the discharge from the rashApart from.this blood sugar fasting and post prandial and Blood for CBC and liver function test are also advisable.Maintain good hygieneWash and clean it with antiseptic solution or soapYou can apply mupirocin ointment externally.Use condom during sexHope this answers  your question please feel free to ask for more clarificationThanks and regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sharp pain in the abdomen followed by vomiting.Cause?\n\nHi. my daughter vommits a lot, followed by a sharp pain in ther abdomen.She first experienced this last year in August and doctors did all the tests and even some sonar scans, but nothing was wrong. Eventualy they decided on removing her apendix. It started again this month. I tried a different doctor. She got some nausea tablets. She is okay now, as long as she take the tabets. When she stops, it starts again. Is there a special diet that I should follow? She is twelve",
    "doctor_response": "helloAs you mentioned her scan was normal in august.I would suggest you to go for ultrasound abdomen to rule out the cause.-I would suggest her to take light food,avoid out side food,fried & bakery products.- Advise her to do exercise.-Chyavanpras 2 tsp with milk in morning improves her digestion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does fertyl 50 mg and folic acid to be started from 5th day of period help in conceiving?\n\ni m married since one and a half years, i just wanna ask what is tablet fertyl 50 mg, my doctor recommended to start from 5th day of my period and folic acid supplement in addition for 30 days, i m the fertyl tablets course and continuing with folic tablets too. will i become pregnant? thank you.",
    "doctor_response": "Dear member,Thanks for writing to healthcare magic.A pregnancy happens when a sperm fertilises a healthy ova. Women produce on an average one oven per menstrual period.fertyl increases the no of ova per cycle so that multiple ova are produced.thus chance of conceiving is more compared to other cycles,It can be started from day 5 for 5 days as recommended by your doctor.you have not mentioned whether your husband's sperm  has been tested .If not then its important that this be done foremost as without good quality sperm pregnancy chances are poor.Please write back if you have queries.Dr Bhagyashree.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest supplements for cancer patients with anemia\n\nHi, My mum is a cancer patient, she is on pemetrexed, a chemo given every 3 week. She is so anemic. Very pale and week. They did once give her two pints of blood. Can you suggest any other supplemens to help her? Apart from the health shop Iron and B vitimins and Vit etc?",
    "doctor_response": "Thanks for your question on HCM.In my opinion you can start anti oxidant tablets.Give her iron reach food like green leafy vegetables,  jaggery, sugar cane etc.Another alternative to blood transfusion is injection iron sucrose.You can also start it.Just check weather she is bleeding from anywhere. If yes than we need to stop it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "suggest treatment for swollen ankles\n\nMy daughter s ankle is slightly swollen & the skin has a red blotch about the size of a kiwi right over the outer ankle bone. It is not sore to the touch, but hurts a little after physical activity. She doesn t recall doing anything to cause any sprain or anything. She is recovering from a fibula fracture 2 months ago. Has been doing physical therapy and has received clearance to return to regular activity. Could this be a bite of some kind - we don t see any bite markings. Or could this be from her fracture/rehab?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. You haven't mentioned your daughter's age, is she is overweight?Swelling is often more apparent in the lower areas of the body because of gravity. As per your information, yes fibular fracture can be one of the cause, or any changes in the activity, standing or sitting for long periods,being overweight,few medications, any injury affecting the foot,leg,or ankle results in increased blood flow to the area presents as swelling.No need to worry much, I will suggest to elevate the legs while lying down. placing a pillow under the legs will make it more comfortable.Use an ice pack wrapped in a towel (don\u2019t use in direct contact with the skin) for up to 20 minutes, reapply if necessary after a 30 minute break.Stay active and focus on stretching and moving the legs, reduce salt intake.Avoid wearing garters and other types of restrictive clothing around your thighs.Maintain a healthy body weight.Wear support stockings or compression socks.Stand up or move around at least once every hour, especially if you\u2019re sitting or standing still for long periods of time.If you can't see any difference, contact to your primary doctor.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us and voting. I will be happy to answer your questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest best infant formula\n\nMy baby girl has completed 1 months but she is not taking breastfeeding because my wife is suffering from typhoid fever and she is taking medicine now. Is breastfeeding possible in this condition? If breastfeeding is not possible then What is the best infant formula for my baby? I was try lactogen but after feeding lactogen she starts vomiting. Please sir suggests me .",
    "doctor_response": "Please continue breast feeding even in such a condition. Please note that breast milk is the best alternative for a baby and there can be no substitutes for the same. No formula, no matter how costly it is, is good enough. Formula feeds are cow milk based which is difficult for a human child to digest and so she is vomiting. So I will strongly advocate against formula feeds. In case there is no other alternative, only then give formula feeds. NAN is a better alternative than Lactogen and manufactured by the same company Nestle.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My lower lip was extremely swollen and has some sort of yellow hard substance, please help\n\nI recently inhaled crystal meth for the first time yesterday and noticed this morning that my lower lip was extremely swollen and has some sort of yellow hard substance on it as well as what looks like water retention. I went to the doctor and she prescribed me antibiotics and antihistamines. Well this work ? I am really worried that it will remain permanent.",
    "doctor_response": "your DR has prescribed symptomatic treatment it gives temp.relief.you have to change the treatment.The present treatment may give irreversible side effects on prolonged usage",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to prevent hair loss\n\nHi, My name is salil khurana, 28yrs, M. I have a problem of hair loss. I used to have dandruff problem but now its over. My scalps center portion has heavy loss of hairs. Could you please suggest if it can be cured with some medicine or i should go for hair transplantation. Please advise a good clinic in delhi to consult specialised doctor for this problem. Regards, Salil khurana",
    "doctor_response": "loss of hairs over the crown area in adults without any illness points towards androgenic alopecia...its is a progressive condition and medical treatment would just slow down the process...yes hair transplantation is better option and also your age is appropriate for the same..there are many good hair transplant centers in delhi like eugenix, panacea global hair services etc.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the blood in my phlegm?\n\nI am 27, I have smoked pot regulary since I was 18...for about 4 to 5, years I have been coughing up brown phlegm (primarily in the morning) which I knew was from smoking...I sleep in a room that has VERY VERY dry air in the winter time, and I've had a bloody nose a month ago, and off and on since then I've had a couple specs of blood in my mucus in the morning (maybe once every week or so)...well two days ago I coughed up two pinhead specs of blood in the morning after the phlegm, and TODAY I coughed up a what I would call microscopic spec of red that I can only assume was blood...could this be related to the dry air in my room, or should I be worried about something life-threating here....I have already made the decision to stop smoking",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Yoi are having hemoptysis (blood in sputum). And it is common in smokers. Common causes are lung infection (pneumonia or tuberculosis), bronchitis and lung cancer. So better to quit smoking as soon as possible. Consult pulmonologist and get done clinical examination of respiratory system, chest x ray and PFT (Pulmonary Function Test). Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "marks on my face!\n\ni had pimples on my face and now they have left marks.what can i do to remove them?",
    "doctor_response": "Hi ..dear user -welcome to HCM..Marks after pimples are called 'Blemishes' in medical term..,this is called Post Pigmented Inflammation...it has very good treatment...1) Frequent washes of face by Triclosan and zinc oxide soap (Acnil,Acnelak)..2)  Topical treatment is..morning times Sunscreen lotion ( Suncote ,Sunkare,or Melaguard ) evening times....lightening creams i.e.Kojic acid with vit C or Combination of Hydroquinone,Tretinoin and Momentasome gives very good results..i.e 70% 3) Inexpensive procedure...RF-Demelanizing technique...Using RF (RadioFrequency) remove all black marks after using Lightning creams ..70to 80% results  4) Expensive treatment like LASER treatment...here giving  1064 nm of Q Switched nd:YAG Laser and Ideal Laser is Long and continuing mode with heavy and bulky Laser system i.e. Q Switched Ruby -carbon dioxide combination will delivers a flat topped beam utmost perfection ... now days commonly used Laser....hence choose the treatment.., do accordingly... ok... goodluck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes throbbing sensation in patella?\n\nHello, Doctor. For the past 4 months, I have had this throbbing sensation around my patella. It may last for 20-30 seconds at a time, and occur once every 2-4 hours. There is no pain. The sensation is similar to a heartbeat. Is this something I should be concerned about?",
    "doctor_response": "Hello,I think this is something that you do not need to be concerned about. I would be concerned if you had one of these signs: pain, swelling, limitation of motions, and redness of the skin. This might be a subjective sign that I would not worry.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Edvin Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in right shoulder blade?\n\nFor a few months now I have right shoulderblade spine pain off and on. I eat greasy or unhealthy foods or get full and have to immediately have a bowel movement. Cramping painful nausea sometimes vomiting. Then goes away leaving dull ache in lower left abdomen.",
    "doctor_response": "hi,Firstly you need to control your diet. eat a nutritious diet ... opt for roasted and grilled food and soups instead of fried items. take lots of fibrous rich foods like green leafy vegetables and citrous fruits.Avoid spicy foods.Kindly get an ultrasound abdomen and pelvis done. sometimes shoulder blade pain occurs due to inflammation of gall bladder or due to gastritis. Kindly take Esomeprazole(proton pump inhibitor) one tablet every morning atleast half an hour before breakfast for atleast 3 weeks.Regards,Dr.Riyanka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does myrbetriq cause increase in penis girth?\n\nHi, my boyfriend was prescribed Myrbetriq and has been taking it for a few days now and we had a concern as to why the medicine is causing an increase in girth of the penis and he becomes erect with no influence at all and is not able to ejaculate. It takes about an hour after sex to deflate or as long as 4 hours if no sex is involved. The internet has not provided more information about the effects of the medicine. It s getting frustrating.",
    "doctor_response": "Hi,Thanks for writing in.Myrbetriq (mirabegron) reduces muscle spasms of the bladder and urinary tract.Myrbetriq is used to treat overactive bladder with symptoms of frequent or urgent urination and urinary incontinence.Your boyfriend must be experiencing priapism which is a potential serious condition. It is to be discussed if this is  an effect of the medication that he is taking for an overactive urinary bladder or is an underlying condition in him. Please discuss with his doctor regarding sustained erection and if it is related to taking of the medication, this is termed priapism.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat fatty liver?\n\nsir my sgot-65,sgpt-82  hight -5'3 wt.86kgs & thyriode is very high livel I am taken thyriod medicene name is Thyronorm 100 mcg early morning last 5-6 year . sir my problem is Fatty liver , Consipition ,please advise / precribed me best medicene. regard's Anil Kumar",
    "doctor_response": "HiDont worry.your taking thyronorm.Fatty liver is due to so many causes.obesity , hypothyroidism both r contributing factors.Not only taking drugs , life style modification is important.reduce your body weight .Avoid high carbohydrate food , fats & alcohol .take green leafy  vegetables , fruits.exercise everyday.defenitly you wil improve.Thank uWith best regardsVasundhara nagireddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the recovery time from the back surgery with inserting rod from L1 through L-11 ?\n\nIt has been suggested that I have back surgery, inserting a rod from L-1 thru L-11,  At this point in my life, with the severe pain, inability to do much around the house or anything enjoyable outside of my home, I wonder if the is the route I should take and what kind of recovery time I might be looking at if I go ahead with the surgery?",
    "doctor_response": "Hello, I have studied your case.You may need to do MRI spine again to see for nerve compression It may take 3 months time for complete rehabilitation after surgery.It also depends on type of surgery and pattern of operation.You should consult with your operating surgeon before going for surgery.You can consult physiotherapist for help.Physiotherapy like ultrasound and TENS therapy will helpI will advise to check your vit B12 and vit D3 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hurting rashes all over the body?\n\nHi, My father is 72 and had a shingles vaccine 2-3 weeks ago...around that same time he found a tick on him which left a bulls eye rash on his arm. A few days later he broke out in a rash on his trunk , back and legs it will not go away. He has taken benadryl, we have bought laundry detergent for sensitive skin and changed to ivory soap. Nothing has helped . Yesterday the rash on his back around the belt line was worse and he said it hurt.",
    "doctor_response": "Hello, It looks like your father is having allergic reactions (hives) due to the vaccine or blistering rash due to shingles, these rashes cause itching, burning & pain that hurts. You can give him diphenhydramine or cetirizine for relieving. He can apply Capsaicin cream. For pain Acetaminophen (Tylenol), Naproxen. Take him to ER, let him get physically examined, he may need antivirals (Acyclovir), etc. Get evaluated & treated at the earliest. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nupur K, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the effects of left lateral ventricle dilation?\n\nim 26 weeks pregnant from my recent ultrasound, it came out that my left lateral ventricle is dilated...what possible effect with this unilateral dilation of left lateral ventricle to my ....baby? im 35y.o, 5 1 ht, 65kls. i am now having a skin asthma and im coughing.im taking seretide 250 for my cough medicine.",
    "doctor_response": "Hi.It can interfere with adequate blood circulation, and although this form of cardiomayopathy is a common complication in the last 5 months or so of pregnancy, I dont see it really causing any harm or impacting your babys health, so please do not worry and enjoy your pregnancy.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for spotting and brown discharge after mirena IUD\n\nI have had a mirena iud for one year now and recently within the last three months I have random spotting every couple of weeks with a lot of stringy looking discharge that is brownish in colour. I am extremely active, I work out at least five times per week and play volleyball competitively. Sometimes it almost seems to aggravate my body after physical exertion. My OBGYN told me that the string was cut too short to coil around my cervix during insertion.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As per your history, if you have bleeding and discharge , kindly consult wit gynaecologist and if it is because of IUDs, have to remove it. you can take tab. tranexamic acid after consultation. keep yourself hydrated. Kindly do ultrasound abdomen and pelvis to rule out other possibilities after consultation. Take care. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to treat the whitish mark on the inner cheek?\n\nHi doctor, I have a whitish mark on the inner cheek. I am also experiencing pain in the wisdom tooth. I used to eat betel nuts, but now I have stopped it. How to get this treated?",
    "doctor_response": "Hi. I can understand your concern regarding to dental health. X-ray of painful wisdom tooth. For further information consult a dentist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is raised Gamma GT in a teetotaller abnormal?\n\nHi.i applied for life cover.my gamma gt was 185.i don't drink alcohol or smoke .i exercise 6 days a week.resing pulse 62.did full liver function test .alt slightly elevated .did ultrasound on liver/gall bladder/kidneys.all clear.i am concerned as gamma gt was 195 a few years ago.i did a blood test a few months later gamma gt had dropped to 137.i did not test again as I thought it was trending down.i take omega 3 and red yeast rice supplement.also I tend to avoid sugar when possible.i am not diabetic.",
    "doctor_response": "Dear friend , greetings from HCM, ... Your alt and GGT levels elevat d indicated you have fatty liver .. Pls do take more of green leafy vegetable s and fruits , omega 3 and 6 supplements with choline tablets will help moreover, you need to exercise daily go for walk at least half an hour a day .. Don't take too much of fried and processed food and fiery products ... Definitely you will be alright .. Do contact us soon and take care ....",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long can a sperm survive in a cup?\n\nHi my name is Amanda. Me and my wife are looking into having a child and we were wondering about something. We have our own friend that is willing to be our sperm donor. We wanted to know how long after he ejaculates in a cup how long do we have to use his sperm?",
    "doctor_response": "Hi,Thanks for writing to HCM .I hope you must have got your semen analysis twice or thrice in different laboratory and confirmed that count is low.After ejaculation into container within 30 mins it should be given to laboratory for processing.  If delayed sperms start dying. And the fluid part dries off. It should be processed within 30 mins .Hope I have been helpful .RegardsDr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will stopping Adderall abruptly lead to withdrawal symptoms?\n\ni have been prescribed 30mg capsules of adderall because my doctor thinks i have ADD, i have take one each morning for the past 3 days and i dont like the way it makes me feel i also dont believe i have ADD  my doctor is not very smart and i am seeking a new one, im going to stop taking them as of tomorrow will i go through withdrawls",
    "doctor_response": "Hi there,Thanks for writing to us, Yes Adderall is a stimulant that is used in the treatment of attention deficit hyperactivity disorder. When used regularly for a long duration it causes dependence which causes withdrawal on stopping abruptly. It has to be stopped by tapering slowly,over a few weeks, under the supervision of a psychiatrist. It may increase your hyperactivity or cause concentration difficulties or even restlessness. Hope this helpsDr A Rao",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should infertility treatment last to cure PCOS?\n\ni am 30 yrs old female.i am 5 feet 1inch and 65kg. i am having pcos and was undergoing infertility treatment for so many years and not yet conceived.dr asked me to take obirax for weght loss .is there any side effects.in future any side effects by using this. and also undergone ivf but conceived after 2 months mis carriage and the reson dr told was no growth .is there any possibility.",
    "doctor_response": "Dont be upset take clomid and than go for ivf. During pregnancy take progestin tabs. It will help uou a lot. So dont worry.  Hope my suggestions helpful and thankful to you. Take care. I wish you will be mother soon. Dont forget to give ratings to me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause numb penis after rigiscan?\n\ni undergone rigiscan test.one of the loop got so tight at the base of penis due to malfunction and it was like that for 4 hrs it was very painful finally i removed the loop.from then my penis gone numb .it happened 48 hrs back it was still numb.is it curable.how much time it will take to recover .",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You may be got pudendal nerve compression may be lead to numbness. Don't worry it is reversible in 2-3 days if not please consult your doctor he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is vision problem of a 6 year old curable without wearing glasses?\n\nMy son is 6 yrs old. his eyes power is 1 in both eyes. whether it is necessary to wear glasses? whether it is cureable without glasses by means of healthy foods & eye exercises. If so, what kind of food he has to eat? what are the exercises he has to do",
    "doctor_response": "Hi....I understand your concern. But a power of 1, though you didn't mention whether it is myopia or hypermetropia is not to be neglected. This definitely needs correction with glasses. Regarding diet you can give him diet rich in vitamin A and these are carrots and other yellow to orange colored fruits.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Advil and Tylenol recommended for flu and fever?\n\nMy 4 year old daughter caught a cold/flu she gets a high fever 104 and I give her Advil or Tylenol to take it down,it will take one or two doses for it to go away, but it returns after a few hours . Then she gets better for a few days only to relapse, she gets sick ( throwing up) loss of appetite, but will drink fluids, Her doc said it sounds good, good urine etc... says it is a cold that is not rested... I keep her in to rest as much as possible...",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.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 15mg/kg/dose (maximum ceiling dose of 500mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Regards - Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling sleepy when reading, difficulty remembering. Need help\n\nGood day, am so glad to be here, av got a problem with my system in the sense that whenever am reading or having serious and important studies i begin to feel very sleepy and that usually cause a lot because i end up not also remembering all what av been thought. Please i really need your help on this, thank you so much.",
    "doctor_response": "Hi there ~ You feel sleepy when you start reading because it is something that you are not interested in.  To get your interest levels up you might need to start doing other things to help with concentration.  Yoga, pranayama, dhyana, and regular physical activity are known to boost concentration.  I would also recommend that you get evaluated by a psychiatrist to treat your condition if it needs medication.  I hope this helps. Take care and have a nice day !",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am confused to choose medical field, I need your help\n\nHi! I am a female and my age is 20. This year I have given Pre-medical exam but I am not very confident of getting an MBBS seat. So, I have to choose between the other medical fields. I am very confused which field to choose.... I have the following questions in which I need a help, * The foremost question- What is the difference between the BAMS course and MBBS course.. I need a little more detail than the basic difference of ayurveda and allopath . 1. What s the difference between ayurvedic medicine and allopathic medicine? (Except that the former has no side effects) I mean why would a patient prefer ayurvedic medicine over allopathic? 2. Can a BAMS doctor give allopathic medicine along with ayurvedic?? 3. Is BAMS doctor a full doctor?? Does he enjoy the same position as an MBBS/ BDS doctor enjoys? 4. Does BAMS course has a lot of sanskrit? 5. What should I choose BDS/ BAMS/ BHMS/ BUMS in terms of the jobs opportunities in India? 6. Does a BDS doctor get a better salary then BAMS in a govt. job or vice-versa?? 7. Does BAMS/BDS (done in India) have a good scope outside India also?? 8. what other couses can be done after BDS/ BAMS?? Sorry! I have a long list of questions but please help me get these answers. Thanks for reading!",
    "doctor_response": "Hi, Every bio student get confused after disqualification in MBBS. In other medical branch Bio technology, Nursing, Pharmacy, Lab technision, Hospital managment, Homoeopathy, Aryuvedic, Physio therapy etc. courses for bright future. In government job pay scale is same for MBBS, BAMS, BHMS etc. Choose according to your interest. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On Alesse oral contraceptives, get anxiety episodes. IS there a safe way to use pill to change schedule ?\n\nHi, I am on Alesse oral contraceptive and I get depressive/anxious episodes each month as part of my PMS. They last for about 3-4 days, and are tough for both me and my partner, but manageable. But in 11 months we are getting married, and our wedding date falls on a weekend when I will be experiencing PMS. Is there a safe way to use the timing of the Pill to slightly change my schedule over the next 11 months, so that my period comes a week earlier by next October?",
    "doctor_response": "IF YOU HAVE NO OTHER COMPLICATION YOU CAN USE THE PILLS CONTAING HARMONES LIKE PROMULOT N CONTINUE FOR 3 WEEK AND WHEN YOU LEAVE IT MENSES COMES AND YOU CAN TAKE ACCORDINLY FOR 3 WEEKS AND LEAVE ONE WEEK TOI SET YOUR CYCLES AS PER YOUR NEEDS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is shoulder pain a symptom of pregnancy?\n\nI have not taken a pregnancy test but believe I may be 6-8 weeks pregnant. I have had most symptoms indicating pregnancy and I have been reading that shoulder pain could indicate an ectopic pregnancy. Could the shoulder pain be a symptom even though it was 2 weeks ago? I am now bleeding yet I am not sure if this is my regular period or not. Thank you for any advice.",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the diagnosis of pregnancy is possible by urine pregnancy or blood pregnancy tests and ultrasound.So only the presence of symptoms of pregnancy like nausea,vomitings,increased urination,sore breasts might give suspicion of pregnancy but not confirm it.The confirmation is possible only by investigations .So I suggest you to consider doing a  urine pregnancy test done .Once the test is positive then the causes for bleeding during pregnancy like abnormal pregnancy like ectopic or miscarriage,thyroid abnormalities, progesterone insufficiency or any bleeding from cervix should be evaluated.The ectopic pregnancy presents with severe pain abdomen with or without spotting and weak positive urine pregnancy test.The transvaginal ultrasound confirms the ectopic pregnancy.When the ectopic pregnancy ruptures it will lead to severe bleeding in the abdominal cavity.This blood irritates the diaphragm and lead to shoulder pain.But there are many other causes for shoulder pain other than ectopic.I suggest you to check if it is really pregnancy or not to confirm the things but not just assume things and feel stressed.So relax.Avoid stress.Hope this helps.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can arachnoid cyst cause mood swings, depression or panic attacks?\n\nHello doctor, I want to know how bad or serious is type II (Galassi) arachnoid cyst located on the left temporal lobe? Can it be responsible for mood fluctuations, depression and/or panic attacks? There are no clear symptoms, but only mild depression (also had recent changes in life and my father died) and anxiety. No strong pain, only a minor one when my heart pounds fast. But I have to pay attention in order to feel it, it is very subtle. I am currently taking mild anti-stress natural medication and a quarter tablet of Betaloc-ZOK 50 mg in the evening to lower my pulse. I have done my MRI also.",
    "doctor_response": "Hi,  Welcome to icliniq.com.  There are no clear evidence in the literature favoring arachnoid cyst as a primary cause of any psychiatric disturbances. Having said that its size does affect the lobe functions if it is compressing it. So basically if you have symptoms that are not responding to the medical line of treatment then only you should opt for a surgical option.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is the antibiotic prescribed to my dad appropriate?\n\nHi doctor, My father is 76 years old. He has been in ICU for two days as he was\u00a0diagnosed with LRTI (CAP - community acquired pneumonia). Four years back he had TB. His vitals such as BP, temperature, renal and heart tests are fine. He is not responding to antibiotics and his condition is deteriorating. His saturation has dropped to 82% and put on oxygen. On the third day, he was given Amoxicillin 1000 IV and 5x nebulization and then switched to Piperacillin-tazobactam IV which I have read is for Pseudomonas. Pseudomonas\u00a0aeruginosa is a commonly acquired hospital bacterium. Doctors admit they have not identified the bacteria yet from the sputum culture and told it will take more than 5 days to identify the bacteria. Please help.",
    "doctor_response": "Hello. Your father is suffering from acute exacerbation of COPD (chronic obstructive pulmonary disease) with CAP (community acquired pneumonia) and sepsis. Currently he is on appropriate antibiotics. But, he needs systemic steroids to cope up the exacerbation along with inhaled steroids. Though his x-ray (attachment removed to protect patient identity) appears normal, CT thorax is suggestive of bilateral consolidation. Sputum culture should ideally tell us the exact bacteria and sensitive antibiotics for it. Supportive treatment like nutrition, supplemental oxygen or noninvasive ventilation must be given. There is no worry as other vital organs are functioning normally. But, definitely he will take time to recover from this exacerbation. He also had tubercular effusion 5 years back, but now it does not seem to be a relapse of TB (tuberculosis). So, no anti-TB medicines are required at present. Definitely it is CAP with COPD exacerbation. Even after he gets well, he should take consultation from pulmonologist for inhaler treatment. Sputum culture report should be sought for at earliest or if not available, fiberoptic bronchoscopy can be performed for taking endobronchial sampling for cultures. Steroids should be tapered in appropriate doses. Bacterial Infection. Sputum culture or bronchoscopic sampling for culture. CAP with sepsis. COPD exacerbation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes thymoma?\n\nMy mum has been diagnosed with a thymoma about 5,8 by 6,5 cm. Suffers fm severe left shoulder pain and is under high blood pressure medication. What is the best way to proceed with this thymoma, is it malignant and what is the survival rate of patients with thymoma. She is 62 years old. Lastly what causes this type of growth.",
    "doctor_response": "Thymoma originates from thymus gland in the compartment below your chest bone located in the center.Thymus gland functions in early life for immunity puposes. As age advances the gland shrinks .The cause is largely unkown, only 5 percent of thymomas are associated with syndromes.Benign or malignant thymomas are difficult to differentiate. Surgery is the treatment of choice .based on stage and completeness of surgery  the need for radiation is decided.Once surgery is done your oncologist can give a better clarity on the prognosis(survival)The prognosis is better than the cancers you hear about .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for nausea, diarrhoea and dizziness during pregnancy\n\nI have gained 45 pounds in about a year and a half and every time I eat, even if i just swallow something as small as sweet peas only, my stomach swells and makes me look as tho I m about 6+ months pregnant. I feel hungry sometimes but soon after eating I get full quickly, I get nausea frequently, sometimes dizzy, hot flashes, diarrhea, bloating, stomach pains in the center and right side of my stomach. I don t have regular bowel movements, usually just diarrhea when it actually wants to function have properly to pass the digested food. I m getting worse rather than better. I don t have insurance. What can I do? What could this be? How can I get relief? Relief is imperative, Thank you, Desperate Jennifer",
    "doctor_response": "dear Jennifercongratulations coming to your question to avoid the feelings you are getting take small meals.avoid fried foods, avoid peas, cauliflower , beans, radish, peanuts..take freshly cooked foodget your t3 , t4 and tsh doneremain activepractice relaxation technique  get your stool test doneDr. Mira Butani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness and pulsations in the back side of the head?\n\nWhat does it mean when the back side of my head is numb for 4 days now and when I move my head it get this pulse like fellj. Like you neck is jerking. Also the top of the front of my right side of my head is hurting . Is there any indictatio of a major problem?",
    "doctor_response": "Hello, The first thing to consider is high blood pressure. If no high blood pressure, then vascular malformations should be taken into consideration, and this is a serious problem, so get evaluated further even to exclude it.  See your Neurologist for these issues. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the reason for pain in chest and hands in this elderly woman?\n\nHello doctor, My grandmother had pain in her chest and hands. She is basically a heart patient. When she consulted a doctor, he gave her Retelex injection for immediate recovery and kept her under observation for one day. I would like to know what this treatment is and what the recovery status is. Ten years ago, she had a severe a heart stroke. Currently, she has done an ECG and a 2D echo. Please help.",
    "doctor_response": "Hello, Welcome back to icliniq.com. She has got a heart attack, an AWMI (anterior wall myocardial Infarction). This occurs due to a blood clot in the heart vessel and injection is given to dissolve those clots. Usually, the patients recover in three to four days if no complications occur. However, she should also undergo angiography and if needed angioplasty, which is the best possible treatment. All the medicines prescribed should be taken regularly and you need to have a healthy lifestyle. The doctor will prescribe all the necessary medicines and you need to have a healthy lifestyle like avoiding fatty, oily and a high-calorie diet. You need to have low salt diet and monitor blood pressure regularly. If the blood pressure is persistently more than 140/90 mmHg then you should be on medicines for it. Regular exercises like brisk walking, walking after recovery according to her capacity for at least 30 minutes a day and five days a week will help. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat severe bronchitis?\n\ni am taking prednisone 20 mg three times a day on decreasing scale.cefdinir 300 mg two times a day, atenonl 25 mg and proair hfa 90 mcg inhaler when needed. I just started all this yesterday for severe bronchitis, a sinus infection and severe ear infections. today, I took the inhaler and ten minutes later I became flush, my pulse went from a normal 79 to 96. and my hands began to shake slightly. I do have cardiac arethmeia and I wanted to know if I should stop taking or using the inhaler or is this caused from something else.",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. The most common cause for worsening of bronchitis is infection. And treatment of bronchospasm is inhaled bronchodilators and inhaled corticosteroid. You are taking correct treatment including antibiotics and inhaler. So continue same treatment and wait for at least 6-8 days. You should also start deep breathing exercise and chest physiotherapy to improve lung function and decrease symptoms. So don't stop this treatment, wait for few more days and start chest physiotherapy and deep breathing exercises. You will definitely improve.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lung pain\n\nWondering what is causing my lung pain. Background: Worsens both with activity/movement, and whilst lying down. Sitting still provides relief. Seems related to my menstrual cycle - over past year it is worst either during, or just before, menstruation. I ve been checked for heart issues - tests came up clear. Also had CT for chest to check for clots, came up clear. I have existing conditions: recurring stage 4 endometriosis in bowel and reproductive organs, PCOS and ongoing joint pain.",
    "doctor_response": "Thanks for your question on HCM.In my opinion you are having anxiety related chest symptoms mostly.Since your all cardiac and pulmonary tests are normal, no need to worry for major organic disease. It is anxiety mostly.You are also having endometriosis and PCOS (poly cystic ovarian disease). Both these diseases are associated with stress and anxiety.So I advice you to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life. And work out solution for the same.You may require anxiolytic drugs too.So avoid stress and tension. Be relax and calm.",
    "dialogue_context": ""
  },
  {
    "patient_message": "am i pregnant or not??\n\nHi i am 17 years old, it has been 35 days since the first day of my last menstral cycle. I am worried that i am pregnant so i took a home pregnancy test this morning at arround 3 am and it came up negative. Am i not pregnant or is the test wrong? why havent i started my menstral cycle again yet?",
    "doctor_response": "you should go to your doc.and have a blood test to find out if your preg.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What was the infection caused after miscarriage?\n\ni m smt megha i m newly mard women ...sir ,due to miscarriage for 2 months i m sufferng frm infection n doctor has suggested me to tke these tablets orni500,ferinum-xt and nervon..sir wether this infction wil be curd or not by takng this tablets plz tel me..",
    "doctor_response": "HIWell come to HCMAfter the miscarriage chances of infection may be there, but not always some time on precaution basis antibiotic being given, if this is infection then clinical symptoms is the only signs that could prove this, with antibiotic course this would come around within week, this is nothing to worry, take care and have a nice day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had fatty liver, raised bilirubin, cloudy urine, kidney stones. On HB medication. What is the solution?\n\nA number of years ago I was told I had a fatty liver.  I weighed less than I do now, probably 135ish, now 158ish (working at losing weight).  At least the last two years we have had HRA's at work.  My bilirubin has been listed as \"high\", 1.32.  I also have a problem with intermittent cloudy urine--never had kidney stones.  Could these  things be related?  I am a 60 year old female.  I have been on HB meds for about 12 years (10mg/day), family history.  Is there someone I should see regarding any of these conditions?",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum. Serum bilirubin level is high ( normal 1 mg ) 1.32 mg/dL .1 Cloudy urine is due to kidney disease . Diagnosis can be confirmed by ultrasound of both kidneys . Also get in urine examination complete . Also get in serum for creatinine level .2 As you are already having fatty liver so get ultrasound of liver to rule out any other disease in liver. So in this case ,in my opinion consult a physician and get his opinion for liver as well as kidney.Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain radiating to the upper abdomen\n\nu/s abd everything normal but: RIF:A long tubular structure visualized with thickened walls measuring 10.3mm size. No peristaltic movement is present and it is tender on comression. no free fluid is seen around it no freee fluid in the  leural cavities, in morrisons pouch or in pelvis. So the pain is going in upper abdomen and lower too at centre, the doctors are not sure whether its appendix or swelling in intestine.....the report marks as FOCAL ENTERITIS ? APPENDICITIS? I am feeling bit relieved from these medicenes: ofloaxin with orindazole 1X2 buscopan 1X3 pantoprazole with domiperidone 1X2 inj. getamycin 80mg 1X2 syp bestozyme 1X2 the tlc dlc has been done three times this week all showed a slight rise in neutrophils 79% - there is not even sensation of vomiting no fever no drinking just pain in upper abd at centre ..... a constant pain Pls do advise me if any further tests or any other scans or any other medicens to be taken with these ones. HELP",
    "doctor_response": "Hello Your findings is most likely suggestive of acute appendicitis.Described appearance of lesion like tubular appearance,non compressible,aperistaltic,tender indicate towards this.Acute appendicitis can also be very well evaluated by clinical examination.If there is doubt then contrast CT scan of abdomen can be done.It can clear the doubt.Proper treatment depend upon findings. You are getting right medicines,you should continue these medicines.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could pressure due to eruption of wisdom teeth, unbalanced walk and difficulty concentrating indicate encephalitis?\n\nMy son lives in key west florida,he has had a lot of trouble with his wisdom teeth coming in causeing a lot of pressure .2 weeks ago he had a sore come up in his mouth then it went away.today he called me and he said he is walking like a drunk person and has a hard time concentrating.could he have encephalitis? He is homeless but a vet He said he had a lot of pressure in his head.",
    "doctor_response": "First and foremost, dental pain is unlikely to cause encephalitis.there is only 1 condition where a dental problem can affect the brainThat usually happens when there is a dental extractionIt is called Cavernous Sinus Thrombosis'But Looking at the query, I dont think he has itNot till we can have an MRI brain done, and taken a good look at itThat way we can confirm itAny other symptom? Even normal flu can cause similar issues. So we need to know more before we can comment on a diagnosisBest of luckDr Mittal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vaginal bleeding during pregnancy?\n\nam pregnant with 9 weeks, but the problem that i have is that am bleeding,was attending the hospital and under go several ultra sound test and the doctoe said that the baby is fine and there is no any problem in the uterus,and he advice to take premolute depot once a week for five weeks,have alredy take 3,but for the last 4 days now i found that the bleeding is comes out with a bad smell,i went to the hospital again we do ultra sound and the doct said he didint find anything bad,the baby is verry active my i sould wash the vigina every time,am trying to do that but am still smell it,is going to be a problem please advice doctor",
    "doctor_response": "Hi dear, I have gone through your question and understand your concerns.Bleeding in early pregnancy can be due to threatened abortion, or subchorionic haemorrhage, or due to anylocal lesions in cervix and vagina.If the ultrasound is completely normal, then your doctor should do an internal examination to rule out any local lesions in cervix or vagina, which can cause foul smelling bloody discharge.Hope you found the answer helpful.Wishing you good health.Dr Deepti Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Prescribed Fertisure to increase sperm count. Any side effects?\n\nHallo Doctor, I am 33 years old and my wife is 32 years old. The doctor suggested to take Fertisure M tablet for 30 days due to increase my sperm count, whether this tablet has any side effects? Is there any food / diet needed for increase the sperm count. I won t smoke and drink. Also, I used to mastrubate in my young age, whether that has affected my sperm count, please advice in this regard. Thanks, James.",
    "doctor_response": "Hi, Welcome to HCM, Fertisure is a vitamin supplement given empirically. If there is no pregnancy, you both should be tested for having any problem for not having pregnancy. Afterwards line of treatment can be suggested. In your case first you go for semen examination and then question of treatment comes. There is no effect of masturbation on semen.so forget about and go for examination of both partners. Take high protein diet,pulses,dry fruits,green veggies etc for maintaining good quality of semen. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump near armpit?\n\nhi dr, my daughter 8moths got a lump near her left arm pit, bcg shot was given in the same arm. We had taken two drs opinions and two diff diagnosis. Genaeral surgeon says it is lymphadenitis and the other dr paedatric surgeon, not able to give a proper diagnosis. He says it is a cyst as per the CT scan with extensions or could be a tubercular lymphadenitis due to bcg or???. Anyway we have been adv no surgery and to take her for continous follow ups to a peadiatric surgeon. please adv as we are really confused.",
    "doctor_response": "Welcome to Health care magic.1. I would think in terms of lymph nodal enlargement after BCG, or any recent infection, fever or systemic causes.2.To clear the doubt regarding cyst or lymph node - get an ultrasound axillary region - it will give exact nature of lesion, its source and extensions.3.But personally i feel like lymph nodal enlargement - you need to monitor and a followup visit with the treating doctor.4.Follow the advise given by your doctor, he is right. Good luck.Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat CML confirmed through bone marrow and fluctuating WBC count?\n\ndear sir, my sister is suffering from CML confrimed through Bone marrow aspirationa d bcr acl test shows 90% blast. it was diagonised about 15 days back and undergoing treatment under a heamatology consultatnt and her WBC count keeps on fluctuatuing betwen 50,000 and 65,000. and she is having cold and aslo treated for that. kindly advice how to and with whom to continue the treatment. we are from chennai , can we go to ADAYAR  cancer research institute.",
    "doctor_response": "goodmorning. First of all dont get worried as CML is one of a good type of blood cancer and patients usually live very long 10 years or  sometimes upto 20 years or more. It takes 2 to 3 months for blood parameters to get normalised and very effective treatment in the form of oral tyrosine kinase inhibitors is available now days. Adayar is a good institute and you can take treatment from there.regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for heart blockage\n\nmy mother is 63 years old and she sufered an heart attack on 18-09-10 and she was admitted to the hospital and the doctors did a angio and told that there is 95% blockage and she should do by pass surgery imediately but my mother is very scared of surgery and i want to know about oxymed",
    "doctor_response": "Hello, Yes best treatment for blockages is angioplasty or bypass surgery. Is there a single block of 90 percent or many other blockages. Because, usually one or two blockages are treated with angioplasty only and bypass surgery can be avoided.    Medicine should be continued like Aspirin, clopidogrel, statin like atorvastatin, nitroglycerin, Metoprolol etc.Hope this helps you and get back with some more information or any doubts.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for abdominal cramps and pink discharge after removal of implanon?\n\nHi, I have just had my nexplanon put in in June, which prior I had the implanon for three years.I had protected sex on November 8th , but the condom broke, now on December 13 , I am having horrible cramps & pink spotting . I took two pregnancy tests on December 9 and both were negative.What could be the cause of these horrible cramps but no period?",
    "doctor_response": "HIThank for asking to HCMThis is not the pregnancy for sure this could be kind of smooth muscle pain without the specific reason and this will come around just wait for little if it does not go away then have Ibuprofen 400 mg tab. will come around with this have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Skin rashes. Painful, itchy. Having sore throat, sneezing. Treatment?\n\nhi .,. i have a problem .,. frome last night . having skin rashes . but these are not appeared at the skin only red round patches are seen . also having pain and itching .,. also have fever 101. sore thoart . sneezing .,., and i also suffering from . my elder sister also have this problem befor a week ., and reports sayes that is viral infection .,. i use augmentin and penadol .,.,but she use tercica, and cifixime , amoxiclave and penadol .,. i need treatment",
    "doctor_response": "Hello thanks for the query posted I would be pleased to answer your query . I would suggest that to get treatment you will need to book an appointment with the physician Dermatologist . Viral fever with rash ,  sore throat would be better off treated with Oral Vitamin C 1000mg per day , Oral Antibiotic like Azithromycin 500 m twice a day for 3 days and topical applications of Calamine lotion . Please do book an appointment with the Dermatologist to discuss the same . Thanks and Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Depression, shaking arms and hands, headache. Help\n\nHello I m 17 recently been diagnosed with depression so I m not sure if this has anything to do with my problem but recently I have shaking in my arms and hands I feel really weak I ve also had headache for the last 8/9 days? I don t have a lot of time to go to the doctors as I work and go college please help. Many thanks.",
    "doctor_response": "Hi,Thank you for posting your query.First of all, I would like to reassure you that your symptoms do not represent any serious neurological illness, and hence, there is no need to worry.The symptoms are related to depression, which can cause shaking in arms (due to anxiety) and headache.Please consult a psychiatrist, and you would benefit from using anti-depressants, such as escitalopram.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat left sided chest pain?\n\non 2007 i was having the pen on left side chest.i have gone to delhi escort hert hospital i meet with dr.sameer sreewatsav he is seanerr dr.of hert he told me to have ecosprine losacer metoler tonect-10 now after a long time now i m having same problem tell me what to do thanks sorry i m from india delhi my name muket lal gar g age 45",
    "doctor_response": "Hello!Welcome on HCM!Regarding your concern, I would explain that your symptoms could be related to coronary artery disease. Other possible causes to consider would be : -a lung disorder- a musculo-skeletal pain. - gastro-esophageal reflux. For this reason, I would recommend consulting with your attending physician and performing some tests to investigate for the possible underlying causes: - a resting ECG and a cardiac ultrasound- a cardiac stress tests to investigate for possible coronary artery disease- a lung X ray study- some blood lab tests (complete blood count, PCR, sedimentation rate, blood electrolytes). Are your symptoms relieved by antiacids or omeprazole? This would indicate possible gastro-esophageal reflux. You should discuss with your doctor on the above issues. Hope to have been helpful!Best wishes, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant stomach pain in a child?\n\nMy son is constantly complaining about a stomach ache. It can be morning, noon or night. I haven t found a common thread during these times like eating a specific food. He also worries himself so much about school work that I think that triggers it sometimes. Could there be an underlying cause? He s 10 years old.",
    "doctor_response": "Hi, I have just read through your question. Whatever you are describing is called Chronic Pain Abdomen in medical terms. The differential diagnosis of abdominal pain in children varies with age, gender, genetic predisposition, nutritional exposure and many environmental factors. The causes are many including - constipation / acid peptic disorders / inflammatory bowel disorders / irritable bowel syndrome / worm infestation etc. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of swollen gums and black teeth caused by accident?\n\nI have a broken tooth from a n accident a few years ago. since then the core has turned black recently with shots of pain and the gums become unaturally swolen im very sensitive to hot and cold foods as well. I dont have enough money to get it fixed since im taking care of my sister and my mother what can I do.",
    "doctor_response": "helloo....read through ur query ...i can say that the tooth is discoloured as it has become dead(necrosed).and swelling in the gum is due to infection in the root of the tooth as it has become dead...but nothing to worry...it can be treated by rootcanal treatment...and then placement of crown over it...since you said you dont have money u have to atleast do rootcanal treatment now..and can do crown after few months...(should not be later than that bcoz rootcanal treated tooth has chances of getting fractured if not put crown).now for infection u can take amoxicillin for 5 days and diclofenac when pain is present..hope u have got some benefit from my reply..be happy and have a healthy day!!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to relieve pain from back injury?\n\nHi, I am looking for a doctor in plymouth nh & need spine help should I try & find one that is orthopedic or neurologist.  Long time with back injury & no clue how to relieve pain without problems. I am on Medicare so...they often don't look at my history for some reason.  What primary care should I b looking for?",
    "doctor_response": "Hello, Thanks for your query.Rest your back for 24-48 hours, but do not stay completely immobile; limited, mild movement is better than bed rest.Apply ice packs for 15-20 minutes, 3-4 times a day for the first 48-72 hours.Apply moist heat after the first 48-72 hours if it makes you more comfortable.Aspirin, ibuprofen and naproxen may relieve pain and reduce inflammation.If you sleep on your side, place a pillow between your knees.If you sleep on your back, place a pillow under your knees.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pain in the upper arm a matter of concern?\n\nI woke this am with a pain in my left upper arm. It didn\u2019t seem to bother me a lot during the day but seems worse this evening and it is hard to lift my arm or move it around much. I had trouble taking off my blouse tonight. Can this be something serious?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The symptoms you have mentioned might be due to compression of nerves that have occurred during sleep. No need to worry as it will resolve in a week with supportive measures. You can take analgesics like Ibuprofen or Diclofenac for pain. If pain persist even after two days, consult a doctor and get evaluated. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can taking I-pill on 3 alternate days cause vomiting?\n\nHello doctor, My friend had an\u00a0intercourse\u00a0and after which she took an I-pill. After 10 days, she had her period.\u00a0It started yesterday and stopped. Now, again it started and she is vomiting whatever she eats.\u00a0She is feeling dizzy and weak. Please suggest some way to overcome this. Thank you.",
    "doctor_response": "Hello. You have not mentioned after how many hours of intercourse your friend has taken I-pill. And secondly, she had bleeding after 10 days of I-pill. To come to a conclusion we should know on what date of her cycle she had sex and when I-pill was taken. Revert back with the asked details to an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for kidney cancer\n\nHi, i am diagnosed with kidney cancer.  Doctors said I need to remove right kidney since the cancer is located right in the center of the right kidney. The problem is I do not have health insurance, and worried about the totla costs. Can you give me an estimated of the operation & all the costs? Thanks.",
    "doctor_response": "Hi and welcome to HCM.As an Urologist, i can understand your anxiety.Are you worried about the treatment of kidney cancer or operation cost.?The charges for the operation,vary from hospital to hospital.You should get it operated it as urgently as possible,if it hasn't spread much.There are two types of surgery,open or laporoscopy.It's done in 2 ways :1. Partial nephrectomy,removing the tumor and surrounding normal part.2. Radical nephrectomy. That's removing the kidney and surrounding part.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it possible for genital warts to appear 14 years later?\n\nHello doctor,My husband and I have been in a monogamous relationship (I believe) for 14 years. We had sexual partners before this. A few weeks into my first pregnancy, he and I have just broken out into HPV genital warts. Is it possible for warts to appear 14 years later? Is it more probable that my partner has been unfaithful?",
    "doctor_response": "Hello. I have noted your concern. Most HPV infection is self-limited. Most of the infected individuals are able to eradicate the virus within 20 to 24 months of infection. However, HPV infection can persist and it is possible to develop genital warts years after infection. Therefore it is hard to know when did one acquire the infection if he or she has had more than one sexual partner.  For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome immotality and abnormality from sperm analysis?\n\nmy name is sridhar...aged about 36years ,height 175cm,weight 72kg....in my sperm analysis report....sperm motality 10%fst....15%slow...60%immotile....and with head defects....60%..normal 10%....whak kind of treatment to overcome immotality and abnormality?",
    "doctor_response": "Hi thanks for contacting HCM...Here cause for immotility and abnormal sperm morphology has to be treated....First if you have habit of smoking and alcohol then avoid it....Heat exposure excessive  avoided.Hot shower limited...Tight undercloths not wear ...It should be somewhat loose...Stress can affect it...So avoid stress , for that psychiatric counselling session can be done....For semen analysis semen should collected with three days abstinence ...Otherwise false result can be there.Avoid too much frequent sex that can lead alter result.If you are taking hormonal supplement like anabolic steroid it can affect result.Heavy metal exposure can be harmful So for that if needed sea foods and organic food avoided.Rule out vitamin and mineral deficiency....Vitamin A,C , E and antioxidant useful.L carnitin tablet help in increasing motility...Even if with full investigation and treatment report abnormal then assisted reproductive technique need to be used for conception.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause the skin tag in my mouth?\n\nI have what looks Lila a skin tag on the right upper side of my mouth inside. I think several days ago I bit my gum but not sure if that is the cause. I noticed it about three days ago and it's just sore and unsightly. What is it and how long will it take to go away.",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. It can be because of the trauma only which was caused by bitting.  It is called as fibroma. You just wait and observe the lesion , if it starts creating problem then you have to visit a dentist to get it removed,  otherwise just apply a topical ointment named mucopain on it for symptomatic relief. Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Flecainide be taken for atrial fibrillation?\n\nI m a patient of 68, just found out have A Fib after an international trip of one month. I m otherwise a fairly health individual with regular excercise and watching the diet. I m wondering if Flecalinide will be used for current problem or it will be used for the rest of my life?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Yes, flecainide can be used for atrial fibrillation. But, if having for the first time, it has to be taken in hospital under medical supervision so as to assure it's safety in you. So you should not have it out of hospital for the first time. Otherwise, you may have rate control agents like Metoprolol if af is persistent and leading high heart rate. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful lump on the lower back\n\nI am 51 yrs old. I have an egg sized lump located in my lower back close to my spine. My doctor says it s a lipoma and nothing to worry about. Sometimes it hurts and cannot sit in a hard back chair as it puts pressure on it, otherwise it does not hurt. Should I be worried?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You may have soft tissue tumour like lipoma, neurofibroma, dermatofibroma or some other tumour. You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Surgical excision is the treatment of choice for most of the soft tissue tumour. Consult your doctor and take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain,fatigue and stress\n\nI had been on predisone for 10 years for asthma ,5 years ago they found out I had addrenial suppression. It took this long to get me to 6 1/2 milagrams . My doctor me I should not feel so fatigued . I have very bad back pain can this cause me stress and I get very weak legs and I feel light headed . I do drink 7 bottles of water a day.i have problems sleeping . I do get out of breath. Please help",
    "doctor_response": "Hello, I have studied your case.Most probable reason for your symptoms could be postural problem as you may be sitting for long time and working on computer/table for long time.When such patient comes to my hospital we usually take MRI to see for any nerve compression.Medication like methylcobalamine with muscle relaxant and analgesic will reduce pain; you can take them consulting your treating doctor.Some exercises which can be done after pain has reduced include- Spine extension exercises, Lying on your stomach flat lift leg 6 inches from ground, do it for other leg.Now lift both hand and leg simultaneously, 6 inch off the ground and stayPosition for around 10 breathes. Core stabilizing spine exercises will help.You may consult physiotherapist for further guidance. He may start TENS, or ultrasound which is helpful in your case.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you find this answer helpful do not hesitate to rate this answer at end of discussion.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can eye sight lost due to rocket blowing up in eye be cured?\n\nHi doctor, When I was younger, I had a bottle rocket blow up in my eye. It left a scar in front of my pupil, so I am no longer able to see out of the eye, and am considered legally blind. My pupil stays dilated all the time, and where it is not able to focus on anything, it wonders to the right. I was wondering if there is any new surgery, that could possibly help.",
    "doctor_response": "Hello. Thankfully only one eye was affected and I hope your other eye is intact and fully functional. Unfortunately, a dilated pupil that does not react to light in the affected eye means that it is no longer transmitting information to the brain and therefore is considered non functional. In most cases those changes are irreversible and the eye is no longer considered a functioning organ. But, hope dies last, and to cheer you up a bit, there are many ongoing clinical researches on the restoration of vision in blind eyes and mainly involve implanting a chip in the retina and connecting it to the brain and although the results are not what a patient would expect, nonetheless it helps the eye detect objects on a very primitive level. As I said earlier, thank God that only one eye was affected and you should take care of it by undergoing a yearly comprehensive eye exam. I wish you best of luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Hypotension caused by heat stroke\n\nI have low blood pressure due to heat stroke. Yesterday I got a shot in my knee consisting of a 24 hour pain block, anti-inflammatory and cartizone . Now my heart is racing and diastolic pressure has dropped into the 50 s, Could this shot have cause this? How long to wear off or should I call my doctor?",
    "doctor_response": "Hello There After going through your medical query I understand your concern and I would like to tell you that take plenty of fluids, coffee which can help you to increase in Blood pressure and if you dizzy and weak then you should visit an ER.Hopefully this information will guide you properly Kind Regards Dr Bhanu Partap",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am afraid about the vaginal fluid contact by hand inspite of using condom during sex. Am I safe?\n\nHello doctor, I had sex with a woman, but I do not know her HIV status. I used a condom, but I am afraid that the condom is not safe, and I might have into contact with some of her vaginal fluid by my hand.",
    "doctor_response": "Hello. A condom is much safer (about 80 %) compared to unprotected sex. So you are safer to that extent even if she would be HIV positive. But then, as you guessed right, condoms may not protect you from every infection or infestation. Therefore it is good to see an STD specialist and seek his counseling. You may require some tests based on symptoms, and other tests even if there are no symptoms. If the hand has no cuts or open wounds, ulcers, etc., transmission through the skin on the hands is rare for most infections (unless you did not bring the wet hand into contact with your penis or other sensitive areas).",
    "dialogue_context": ""
  },
  {
    "patient_message": "When should one take a pregnancy test?\n\nHi, I have been on cerazette for about 8/9 month now and haven t had a problem with it, i was on penicyllin antibiotics, i took my last set of antibiotics on wed 5th january and had intercourse early wednesday morning, I was worried i could be pregnant, so today I took a pregnancy test and it was negative, is there need to take another one at a later date or do you think i am worrying far too much.. Thank you :)",
    "doctor_response": "Dear Madam, Your narration could not clarify when did you have your menses, whether you missed it and on which day the cycle you had sexual intercourse. Also cannot figure out whether you are still on Cerazette, which is a birth control pill. In that case the chances of pregnancy are very remote. To guide you further on the urine pregnancy test: Usual urine pregnancy tests are more reliable 8-10 days after missing the period, before which they may give false negative results. However, beta hCG tests are more specific and sensitive and can give reliable results even within 2-3 days of missed period. You may try this test to clear the dilemma in your mind if you have missed your period. If you have not missed the period, please do not panic. Wait for your periods. If you miss the period, then only follow the guidelines about the pregnancy tests given above. I hope this helps you. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I not getting my period even after taking i-pill and Meprate?\n\nHi doctor, I had intercourse (he did not ejaculate) and took an i-pill the next day. I am suffering from PCOD and by doctor's prescription, I took Meprate for seven days twice daily. But still no sign of periods. What can be the causes? Also, after taking the i-pill there is no withdrawal bleeding. My last period was before two months and it is causing stress and I am overthinking. Please help.",
    "doctor_response": "Hi. Do not worry, you have nothing to worry about.  As you have PCOD (polycystic ovarian disease) your ovulation will not be on time. As you mentioned that he did not ejaculate and you took i-pill within 24 hours, chances of pregnancy are very low. Meprate is a hormone pill that increases the inner lining of the uterus and when you suddenly stop, it cause withdrawal bleeding. Usually, you can wait up to 10 days after stopping. Because you had I-pill and Meprate your period would have got postponed. So I would advise you to wait for periods till 10 days after the last day of Meprate. If still no periods, just for confirmation get urine pregnancy tested. I bet it will be negative. Then take any of the oral contraceptive pills like Novelone, or Ovrel G, or Dear 21 or Diane 35 or Intimacy plus 3 twice a day for 10 days, throw that extra last tab. You will surely get periods within the next 10 days. If you get periods in between just stop the pills. In PCOD the inner lining of the uterus may not be thick enough, so your periods will be light sometimes with pink discharge only, so no withdrawal bleeding with Meprate. These pills will increase the thickness. Next time onwards never have unprotected sex, to avoid these anxious moments. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the potential risk of getting hepatitis C?\n\nHi, I snorted cocaine for the first time last week- my nose didn't bleed but I shared a note to snort the cocaine. I didn't snort much cocaine but I am very paranoid about getting hepatitis C. I won't snort again, but am getting really paranoid. I can't sleep because of it and am really tired. I wanted to know the potential risk of getting hepatitis C.",
    "doctor_response": "hi.Thanks for posting query at HCMi understood you concern and the best advise i may give you is to have test for anti-HCV to rule out HepC infection.Also test for HBV and Liver function testwish you good and sound healthregardsDr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could suffering from flu be the cause of rapid heart rate?\n\nI have the flu and from yesterday even if i stand up or go get water my head starts to hurt and i get really light headed and have to hold on to the wall to walk and my heart races twice as fast when i walk 2. Is this something I should be woried about?",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern . You should not worry about .I will try to explain you something and give you my opinion. You should know that normal heart beats range between 50-100 beat for minute. If the heart beats over 100  for minute in a regular way than we talk about sinus tachycardia. Sinus tachycardia might happen for different reasons like simple emotional stress,  coffee and energy drinks consumption or pathologys like anemia, hyperthyroidism,  electrolyte imbalances , active infections. A flu or a bacterial infection might be responsible for sinus tachycardia becouse during infection our imunitare sistem is activated and the hole organism needs more supply so the heart goes on tachycardia. Other symtoms like headache, muscle aches and dizziness are normal, they soon will dissappear. So, dont worry, it will pass.Hope I was helpfull. Best regards, Dr.Ervina.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Shall i stop using vyvanse and adderall altogether? Should i be worried about the withdraw and relapse?\n\n40 year old male, executive level with high stress job,  prescribed vyvanse 70 mg and adderall booster for about 3 - 4 months. finding that i am using more than prescribed. have stopped a couple of times during the 4 months but find myself going back to the scripts. i think i should stop using the drugs alltogether but am concerned about withdraw and relapse. guess im looking for advice",
    "doctor_response": "Hello Please do not use any drug more than prescribed by your doctor .Please consult your doctor /Psychiatrist and discuss your drug issues and problems and follow the given advice .That you take care of your health Recover son Dr LalPsychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "On femodene to regulate periods, want to conceive. Should I stop it?\n\nHi,I m using femodene not for birth control or anything,I m using it to regulate my cycle.iv started using femodene last year Dec and I had my periods a week ago and now I m on my second box of femodene.My fiance and I are trying for a baby and I would like to know if I can stop immidiately or must I wait for the box to be finished.iv never took any form of contraception before and I would really love to get pregnant soon.",
    "doctor_response": "you can stop it if you are planning for pregnancy. this cycle it not sure when you bleed and when you ovulate. probably next cycle you can predict for ovulation .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am struggling with body image and want to become slimmer. What to do?\n\nHello doctor, I am a 19-year-old female dancer and my weight is 8.5 stone and my height is 5 feet 5 inches. I am currently struggling with issues of body image, being a dancer. I always feel I need to be slimmer than I am and it has got to a point where I feel that I should eat very little and occasionally have made me sick. I also have confidence issues which hold me back with dancing and this happens in everyday life too and I feel scared to talk to someone that I do not know.",
    "doctor_response": "Hi. I have read your query and I can understand what you are going through. I am sure you understand it is only your mind which is making you think you need to be thinner. Are you aware that there are many many dancers who are fat, really fat and they dance like a pro and are so flexible? Also, there are many dance forms which require you to have some body fat like the belly dancing. As you are aware that your body image issue is a big issue and needs attention, if you love yourself, I would request you to go to a psychologist or be very regular here to get the treatment you deserve and get better. If you decide to write back, please respond to the questions written below. Your answers will help me in understanding your situation better. Since when have you realized you have some issue? What have you done to take care of it? What form of dance do you do? Has anyone told you that your body is not nice? Revert with more information to a psychologist counselor online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the possibility of truth in speech made in psychosis state?\n\nMy boyfriend recently went to the hospital and has been in a psychosis state for about a week now. He is now at a hospital and they're slowly seeing improvement, which is good to hear. Before he went to the hospital he said some things that were very hurtful to me and his family. What is the likelihood of everything he said or \"confessed to\" being true?",
    "doctor_response": "Hi  thank you for using health care magic.Psychosis has one characteristic feature of loosing reality testing. Person in psychotic state is not in a position to differentiate real versus imagined thing. It is also possible that perception of psychotic person will be distorted. Whatever he had said under psychotic state is not be a true reflection of his belief about him or about his known one. Likelihood of everything he said of confessed to or being true can not be determine.  Making any belief about a person because  of his behavior in psychotic state is surely not the preferred way for judging him.Knowing more about psychotic state will surely help you to understand your boyfriend.Hope you will find this helpful.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest an alternative of Chlorhexidine for the treatment of gum infection\n\nHi -  i split the piece of gum between #20 and #21. i saw my prosthodontist yesterday, and he told me to use Chlorhexidine twice a day. He said not to rinse or brush afterwards (as he did in the past cause it can cause tooth discoloration. My concern is with the tooth discoloration.  Is there an alternative solution of any kind so i heal the area without using Chlorhexidine? I greatly appreciate your help and wish you a happy holiday season. Many Thanks,Priscilla",
    "doctor_response": "Hi..Thanks for the query..Well, you can use oral gel like Metronidazole that can be applied precisely over the injured area of the gum..You should keep spitting the saliva and do not swallow it..It will not cause any tooth discolouration and will help in preventing infection and heal the injured gum..Also do warm saline gargles and take soft diet..Avoid any hard and spicy foods..Use a soft toothbrush to brush your teeth to avoid injury to the gums..Hope this helps..Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be blood associated semen in a 29 years old male?\n\nSir I am 29 years old and till now I have maintain a healthy life and never have sex. Suddenly 2 days ago I found blood in my semen and again after 2 days I found this problem again. I am really tance because after a month Im going to be married. So is it caused any any problems in my married life? Can this prob is curable ?Please suggest me waiting for your reply.thanks in advance.",
    "doctor_response": "Hi,I have gone through your query.You had 2 episodes of bloody semen and you haven't mentioned if there is any other symptoms like fever or pain. It is difficult to comment on actual cause. As there can be infection (like prostatitis, epididymitis, urethritis), obstruction, tumor or systemic disease.I suggest you to wait for next time if again blood comes out with or without other symptoms, investigations like prostate examination, semen and urine test will be needed.Depending on the cause, it may or may not affect your married life and treatment will be done. Usually these problems are cured.Do consider a positive feedback as a credit to my work. Let me know if you have any further questions.You can contact me on my page",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for knuckle wound\n\nIt has been three weeks and my knuckle wound has not healed.  I have had it in a splint to keep me from bending it after the stitches were removed.  The edges are still not coming together and if I bend it, the wound will open.  Anything extra I should do?",
    "doctor_response": "HI, thanks for using healthcare magicThough it would be difficult, it would be best to avoid bending the hand in a way to cause the wound to open, this would delay healing.If there is any infection , this should be treated.Ensure a healthy diet, multivitamins to make sure that your immune system is working well.There are no other aspects of treatment that can be started to ensure healing at this point.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could lumps on vaginal suggest?\n\nI had a baby a year and half ago, i had a second degree tear..only Recently i discover a few lumps inside my vagina, only one side, about 5 different lumps diffrent sizes close together, they seem like soft growths bunched together. Could this be scar tissue? Or something to be worried about like cancer? I never noiticed this before so not sure if this is linked with the birth of my baby. Plz write back",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You may have some scar tissue after second degree tear. Chances of cancer is low. Still you should go for examination. If needed go for biopsy once. It will give you exact diagnosis. Then you should take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Weakness during period\n\nhi doc. during my periods i feel quite low i cant walk my legs feel tired i sweat a bit n i suffer with back pain .my colur becomes pale",
    "doctor_response": "Hello, This is all part of the menstrual cycle.Im afraid that few people like you suffer from this.Your hemoglobin should be checked.If low,start on hematinics.Start multivitamins too and do some sort of physical exercise.Drugs will help control the pain.I suggest seeing a doctor to rule out anemia.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for boils in tongue\n\nHi DR. Im 31 years; 74.5 KGS and 1.89 Metres tall. 1st: I had a boil undernetah my tongue that takes 3 to 4 weeks to fully develop and raptures by running iver my toungue. 1nd: I had a tooth ache; upper fornt ringht tooth. 3rd: I had a lyphnode on my neck; left side just behing the ear as well as left cheek just above the cheek bone. thanx",
    "doctor_response": "Hello,Your symptoms include signs associated with an infection. The upper tooth could be draining with a pathway to the lower arch and settle in the lymph node causing swelling. Antibiotics such as amoxicillin can help control an infection. You would need a prescription from your dentist after an evaluation. The upper tooth, if found to be the source, would need dental treatment such as a root canal or an extraction.Temporary pain relief and reduction of inflammation may be helped with anti-inflammatory medications such as acetaminophen and ibuprofen.Your symptoms may be unrelated and you need to address each condition separately. Do you have a condition such as a broken tooth or removable dental appliance that is causing irritation below the tongue? There is a salivary gland duct that could be clogged and causes a buildup of fluid. Your toothache can be due to large decay or inflamed gum and bone surrounding the tooth. Untreated decay will progress and cause an abscess if left untreated. Periodontal disease can result in infections and they will spread.You may have a wisdom tooth impacted under your gum and bone since you report discomfort near your ear. Your conditions are best evaluated by a dentist with a thorough exam and x-rays. Warm saltwater rinses may offer some additional assistance at this time.Your lymph node has the job of being the initial defense against infection. A dental abscess could very well cause inflamed lymph nodes. This could also indicate an underlying systemic disease which needs further evaluation by a physician. Blood tests may give you  valuable diagnostic information on your organ function and any nutrition deficiencies.Maintain a proper diet with balanced vitamins, keep well hydrated and follow good daily oral hygiene.Thank you for your inquiry. I hope my recommendations are helpful to you and that you are able to schedule a dental visit soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lips, hand and foot numbness with tingling?\n\nHi- Iam 77 yrs old and pretty healthy- bad knees abt it but have been very nervous the last few weeks due to a family problem- today I experenced a numbness and tingling in my lips and left hand and foot- it gets worse and then better but still there after 7hrs- can you tell me what this might be? thanks!",
    "doctor_response": "Hi, welcome to our site. I am Dr Saumya Mittal, MD.Read your query. That is a very significant question and i appreciate your problem. I will try my best to answer your queryThe symptoms are very much suggestive of a stroke. The stroke comes on suddenly with symptoms that are one sided- like in your case. Usually people expect to have loss of power. But there are variants of stroke where there are only sensory symptoms- like in you. Alternatively, these may just be the initial symptoms.I would suggest getting an MRI or CT scan done as soon as possible. If its an ischmic stroke, you will need antiplatelets and statins like ecosprin and atorvastatin and rosuvastatin. Eventually physiotherapy may be needed also.I hope this helps you. Inform the reports mentioned above/if any other so I can be of help further. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you. You can upload them on the site.You can upload them with the query, or if you have a problem, send them to attachments@healthcaremagic.com with Sub: ATTN 'Your Name'. Once we receive the photos or diagnostic reports, my team will send reports / pictures to me.Please do understand that some details could be extracted from a detailed history and examination.Please click on Thanks/Helpful if found useful.Please feel free to ask another query. I would be glad to help you. Looking forward to your return query with the details asked so that I can help you further. (If the answer has helped you, please indicate this by clicking on HELPFUL)Best of luck.Dr Mittal.MBBS, MD (Internal Medicine), CC (Diabetes Mellitus), DNB (Neurology)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes oily urine with ribs and shoulder blade pain?\n\nI have recently been diagnosed with Lupus which I have had since 1994. I started taking hydroxychloroquin and shortly after I developed an excessive amount of palpitations so I stopped the medication. It has been approximately two months since the meds and the palpitations have finally started to subside. Now I have oily urine and pain under both of my ribs but now more so on my right side shooting up my shoulder blade. I also have thyroid disease but approximately three months ago increased my medicine to .50 on the levothyroxine. What is this related to? Any ideas?",
    "doctor_response": "HIWell come to HCMThe history of Lupus and the medicine taken for this is nothing to do with the urine oily appearance, but this could be due to the infection and in my opinion this need to be ruled out and for that better to get done the urine examination, meanwhile you can try, \"Sodium hydrogen citrate solution\" 20 ml four times in day, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could a red spot on palate?\n\nhello Drs!! i just noticed 1 red spot on my top palate and next to it there is another one coming. I am really stressed atm due to exams but I would like some guidance! thank you very much! (4 days now i am on a pure protein diet-i dont know if this is important) thank you!",
    "doctor_response": "Thanks for your query, I have gone through your query.The red spot could be because of the ulcers like ahthous ulcer or herpetic ulcer. Consult a oral physician and get it ruled out.. The aphthous ulcer can come secondary to stress. so do not take tension.If it is aphthous ulcer  you can take topical anesthetic and analgesics like anabel gel. apply 3-4 times daily before food and topical steroid like triamcinolone acetonide 0.1% 4-5times daily after food.Do saline gargling. If the lesion does not heal in 5-7 days then consult a oral physician and get it examined.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red rash on 2 year old babies penis?\n\nMy 2 year old son gets horrible rashes. It s almost as if some 1/4 of his poops are acid. They literally leave burn like rashes. If you don t change it within minutes it will be horrific. As you can imagine, sometimes you don t smell them or whatever the case is, and it s just bad. But I got the ok from the pediatrician to use hydrocortisone in this case and it s literally the only thing that helps the rash go away faster. Tonight he had one of those poops except it was pretty explosive. But it didn t smell, so of course he sat in it for a little while. Well this time it burned not only his butt, but also his sack and what looks like the tip of his penis. The tip of the penis and penis hole were inflamed and bright red. Almost as if it were bleeding but it wasn t. It was the worst thing I have ever seen. And for it to happen so quickly is terrifying. Anyway, my question is am I allowed to use hydrocortisone on a penis? I would assume probably not but thought I d ask. I had him soak in a bathtub for awhile and then put neosporin on all the affected areas. This hasn t worked in the past but it s all I knew to do tonight until I can put a call in to the Ped tomorrow. Please assist! I have pictures if that helps. Thank you so much!",
    "doctor_response": "Hi,Thank you for asking question on health care magic.Your history indicates that your son is suffering from bacterial infection of the skin.Setroid ointment increases the bacterial infection,better avoid it as far as possible.application of neosporin ointment is OK.Oral antibiotic like erythromycin may cure the infection.Difficult diagnose skin disease without seeing it..Follow pediatricians advice.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for spine pain despite taking Dilaudid\n\nI have injected 8mg Dilaid x s like 4-6 a day for a lot of years (never having been prescribed them.) So 4 almost 5 weeks ago I sustained an injury and herniated my L5, S1 I believe. The doctor knows for sure, I had an MRI. I m being prescribed 4mg of Dilaid every 4-6 as needed. Problem is I have to take double that and my pain is still a 10 24/7!! What if anything gcan I do?",
    "doctor_response": "Hello, The pain is caused by nerve compression induced by prolapsed disc. As the common analgesics failed you can opt for a steroid injection to the spine which has got good results. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I often forget things with anxiety and behavioral change. How to deal with it?\n\nHello doctor, I forget things quite often and have anxiety problems that lead to a change in behavior. I have never experienced such problems and my head aches a lot and I am suffering from anxiety. Please help as my behavior is changed a lot which affects people living with me. I have not got any tests done.",
    "doctor_response": "Hello, Welcome to ciliniq.com. You seem to have a mixed anxiety-depressive disorder, This is very common and about 10-15 percent of people have this problem. It is also very easily treatable. You will need to visit a psychiatrist and he will prescribe you SSRI (selective serotonin reuptake inhibitors) type of medicines such as Escitalopram 10 mg, or Fluoxetine 20 mg, etc., which will help with your problem. It basically happens when some neurotransmitters such as serotonin reduce in your brain leading to a problem with handling the day to day stresses of life. Medicines are usually given for two to four months and then tapered off slowly and stopped. In addition to the medicines, you can also undergo a few sessions of cognitive behavioral therapy from a clinical psychologist. Also, do consider doing deep breathing exercises or progressive muscle relaxation daily. In case you are having problems with sleeping you can try some sleep hygiene methods like: 1. Maintain good temperature, no noise or light. 2. One hour prior to bed, wind down and try reading or music. 3. Do not use the laptop, TV or phone one hour prior. 4. Avoid caffeine, alcohol, or tobacco two hours prior to sleeping. 5. Avoid exercises three hours before sleeping and take warm milk at bedtime. 6. Go to bed only when sleepy and avoid other activities on bed. 7. Use bed only for sleeping or sex. 8. If you do not get sleep, do not toss and turn, get up go to another room, walk about for 10-15 minutes and come and lie down. See for 10 minutes, if not sleepy go out again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for itchy patches around neck and mouth\n\nafter using Pond s White Beauty cream, i have developed patches around my mouth and around my neck. They first were reddish but later became dried up and causing so much itching. I had cleansed off the cream after applying with warm water. Please advise what to do with the patches around my neck and mouth.",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern looking to the history given here I could say that because of the cosmetic product, this is a hypersensitivity reaction you have developed and now this could be treated with \"Diphenhydramine lotion\" and no need to worry about this, it would come around soon, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can high bp cause jitters in body?\n\nMy blood pressure is elevated the last two weeks. Approx 145/98 pn the average with pulse rate around 60 due to 3 meds I am on for this problem. I feel jittery inside. Could this be a side affect of the elevated numbers? I just lost 90 lbs over the last year and am very surprised with this sudden turn of events. I am also suffering from PVCs and have not had this condition in years. My gp is not concerned for they mostly occur at rest. Can all of this be related to an underlying condition? I would appreciate a second opinion",
    "doctor_response": "blood pressure reading you mentioned is certainly not too high to cause jitters, but your heart rate is certainly on lower side. these are one reading we don't know the trend of the events. My advice is you buy electronic bp apparatus and keep track of pulse rate and blood pressure. take frequent readings and make a chart. so if any of readings are two high or low then we can address the problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of improvement with Myelodysplastic syndrome?\n\nmy father is 75y/o.since 18 months ago he has been diagnosed by Myelodysblastic syndrome.he is pan cytopenic,he has hot recently whole blood transfussion  2 units,but still is anemic,thrombocytopenic and leukopenic. recently he has got bilateral leg swelling with bruises pointed in some areas on the legs.also always he suffers of itching generalised and scratching the areas and is taking oral antihistamines.do you have any specific oponion about improvement of my father general condition?thanx alot.",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Bilateral limb swelling is due to cardiac failure. Stagnation of blood due to edema is leading to blood perfusion into subcutaneous tissue and itching.2. Limb elevation and diuretics will reduce edema. Its very important for edema to disappear to improve itching symptoms.3. Avoid plasma and go for packed cells during next transfusion in view of cardiac problems. Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the hard and red lump in my pubic region?\n\nHello doc. I have a reddish bump in my pubic hair. About 1 inch away from base of shaft. I just noticed it today and am worried cause of the area. It s not an std I think cause I ve never participated in vaginal intercourse. It does not hurt unless pushed upon and when pushed upon I can feel a hardness to it. About the size of a pea. Just would like to know what s up. Thanks.",
    "doctor_response": "Hi,It seems that you might be having some ingrown hair follicle infection.If lump increases or pain develops, go for one antibiotic medicine course for 3days.Keep local hygiene clean and well shaved.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with kidney infection. Had mild back pain, lately is excruciating and is unbearable, is affecting abdominal area. What should be done?\n\nI was diagnosed with a kidney infection today while at the doctors. I have had a dull back pain (that my doctor said was because of this infection) that was a little bothersome, but bearable. Just about an hour ago, the pain became EXCRUCIATING. Like, an 9 on a scale of 1-10. It's now affecting my abdominal area as well. I am starting to feel nauseous. What should I do?",
    "doctor_response": "hi you have infected stones may be that broke and closed your urine duct and you have that much pain with nausea and or vomiting.coz the infected stones are the week ones and getting antibiotics make them weak and they broke........like to take slow breaths till you reach hospital dont drink anything coz you will vomit get an ultrsasound abdomen done ............Rush to ER take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What causes headache, dry mouth and tightness in neck?\n\nHello doctor, I am 20 years old boy. From the last 10 months I am suffering from physical symptoms like a tight band wrapped around my head every time, tightness and little pain in the neck, heavy head, head pressure a mild headache, ringing in the ears, dry mouth, dizziness, nausea, upset stomach, blurred vision, tense muscles, stress about having big diseases like a brain tumor, cancer, etc. I have also got MRI brain, CT scan.",
    "doctor_response": "Hi.. You seem to be suffering from chronic tension headache. I would recommend you to discuss with your doctor to start you on tablet Amitryptiline 10 mg once in the night and within three weeks, you would feel better. I would also recommend you to go for a morning walk, meditation and yoga.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for green stools during kidney infection\n\nMy 39 yr old daughter has a bad kidney infection and her stool is dark green and has been for a week.  The doctor put her on a strong antibiotic and gave her a shot 4 days ago.  She is not feeling much better and her stool is still green.  She has eliminated anything in her diet that might be a cause of this.  What should she do?",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, in disease condition such green colored stool is happening due to digestion function disturbances it may be due to bilirubin contains but this is nothing to worry it may not be direct indication of any disease,  hope this information helps, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Am I having bladder irritation or tightening because of Lisdexamfetamine?\n\nHello doctor,I am a 41-year-old female, 143 lbs. I currently take Lisdexamfetamine 50 mg for ADHD. I have been experiencing bladder discomfort off and on for three months now. It was quite intense for two weeks, then went away for several weeks, and now is present again although less intense. It just feels like I have a tight bladder all the time and need to use the toilet more often. There is no pain or difficulty when urinating. I have had two negative UTI tests and a normal ultrasound. I have had a completely normal cervical exam as well. I have been taking Dexamfetamine since last six months, and the symptoms arose two months later. I am wondering if the medication is causing bladder irritation, or tightening, or if the medication is turning my urine more acidic and that is the problem? It has been suggested that I use an alkalizing agent, but that seems to be contraindicated with the Lisdexamfetamine. I also have learned that Amphetamine products can liberate Histamine, and that might cause bladder irritation? Can you advise what might be the issue if the medication is contributing and how I might best address it? I do not have a better option for ADHD treatment and would like to deal with this symptom rather than change my medication.",
    "doctor_response": "Hi. If you are having increased frequency of urination, night-time frequency, the urgency of urination, it may be an overactive bladder. It can occur spontaneously or be precipitated by UTI episodes, stone disease, medications, etc. In your case, the medicine may not be responsible. But anyway, we cannot change the medicine. You need to restrict your fluid intake to about 2 to 2.5 liters per day, limit intake of carbonated beverages, coke, tea, coffee. You have to avoid constipation. You may also get a urine test done for sugar to rule out diabetes. If frequency persists, you may take an anticholinergic like Tolterodine or Darifenacin after consulting your doctor. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to treat my mother's compulsive superstitions?\n\nHi doctor, How to treat compulsive superstitions?\u00a0I need some help to treat my mother.\u00a0She is also a depression patient and for which she is taking medication.",
    "doctor_response": "Hi. Revert back with detailed history to a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the possible treatments for pneumonia?\n\nDaughter was told has pneumonia. She is on two antibiotics. She is supposed to go back tomorrow morning since she is having so much pain in chest. Tonight she is vomiting and her neck hurts. Should we consider a trip to ER or wait till morning. We are not sure what to look for. She can move her neck around. She has a lot of nausea. Very pale. Can t eat or drink without throwing up at this point.",
    "doctor_response": "U should go to ER. As unmeasured water loss from body is also increased during pneumonia & vomiting & inability to eat/drink can also lead to dehydration. &uncontrolled nausea/ vomiting also needs evaluation. Go to ER , get her oxygen level & few lab reports & blood pressure measured. & get the required treatment. According to lab reports & according to hospital admission criteria( CURB 65 &others) doctor will decide about hospital admission.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will taking L-Lysine everyday cause any side-effect?\n\nHi doctor, Please tell me whether L-Lysine is safe to take every day or not.",
    "doctor_response": "Hello. Yes, it is safe to take it daily upto 5 gm. It has shown positive effects in depression, wound healing and is good for skin and hair as well. Excess can cause gastric upset.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a painful lump above the navel indicate?\n\nMy husband has been having stomach issues, he just went to see his doctor on Tuesday and they are thinking he may have an ulcer. But this evening he was riding his horse and now has a lump above hi belly button, maybe a hernia? He says it painful, should we to urgent care?",
    "doctor_response": "Hello,The painful lump above navel may be sebaceous cyst, lipoma, hernia or else. Need clinical confirmation with ultrasound examination once the pain is controlled with analgesic medicines.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to concieve. Having PCOD. Prescribed Ovacare forte with APCOD. Having weightgain. Chances of concieving?\n\nHi. I am married and its almost two years now. I am trying to concieve. But i have the PCOD complication. When i consulted my doc she first gave me Dronis that was before marriage. After marriage she suggested me APCOD. But there was no improvement. Recently i consulted her and she has given me Ovacare forte with APCOD. I keep on putting weight though i go for walking (not ver regular) but have food control. Is there any chance of me concieving? Am worried",
    "doctor_response": "Hi, thanks for using healthcare magic It is possible to conceive with PCOS, it is just more difficult, but with the technology and procedures that exist today, conception is definitely possible. You are right in trying to lose weight , this would increase the chances of conception. It is easier to lose weight by modifying your diet because usually by altering a few things that are use calories can be reduced by 500 calories.It would take alot of exercise to achieve this same amount of calorie deficit. Exercise is important in general fitness and keeping weight off. To lose weight you would need to cut out all sodas and fruit drinks and use water instead. Use low carb fruits and vegetables as snacks. In terms of your other meals you can choose the low fat or low carb route.In the low carb route you would: Increase the amount of low carb fruits and/or vegetables that you use with your main meals and at the same time reduce the amount of carbohydrates to a minimum (pasta/rice/flour products/bread/biscuits/cereals/potatoes). There are lists of low carb foods available online. In the low fat route you would reduce fat used (fatty meats/frying/butter/certain oils/ high fat milk or cheeses or dressings/mayonaise), increase fruits and vegetables, use alot of water. Metformin has also been used in PCOS. This medication is used to reduce the insulin resistance associated with PCOS, help with weight loss and improve fertility.It is one of the most common drugs used in PCOS. You can consider speaking to your doctor about it. In addition, if with weight loss and metformin you still have difficulties, clomid can be used. This medication, again very widely available, helps with ovulation. If clomid  does not work then there are other medications that assist with ovulation. You may want to consider visiting a fertility specialist. Hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does small lump on lower abdomen near hip bone indicate?\n\nI just woke up and I felt a small lump in my lower abdomen near my left hip bone. I've never felt this before. what could it be? it doesn't hurt and I don't feel sick. I just started working out regularly doing the elliptical could I have pulled something?",
    "doctor_response": "HiWelcome to hcmThis can be hernia if it  is more towards groin and if it is more lateral it can be either lipoma or just blood /hematoma. You should see surgeon for confirmation.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible in case of hypothyroidism with bilateral polycystic ovaries?\n\nhi,im 31 years old and a mother of a 5 yrs old  girl.Im also suffering from hypothyroidism.Im having bilateral polycystic ovaries.My height is 5.1\" and weight is 68 kg.The size of ovaries are ROsize 3.2 x 2.5 x 2.2 cm(vol 9.7cc) and LO 3.3 x 2.6 x 2.0 cm (vol 9.2 cc).How it can be cured .Can I conceive again.",
    "doctor_response": "Hi.. Thanks for writing.. Hypothyroidism can be corrected by thyroid tablet..  There is no permanent solution for PCOS..  Good exercise and diet control jelps.. Ovulation induction with follicular study detects ovulation..  if there I'd ovulation there is good chance of pregnancy.. Hope I have answered your query. Good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any remedy for vein problem on right arm and chest pain ?\n\nits been for the past 1 year that my right arm is always aching, at times even in a sunny weather i have to wear warm cardigans as the pain makes me freeze. The veins through out my thighs and especially in my right arms have become visible and they appear in green color.When the pain comes it gives pressure on the vein through out my right breast and chest causing me so much pain in the chest also. What do you think is the remedy to this health problem, sir! ?",
    "doctor_response": "Hello you  need early investigation as vein dilation /prominence in the arm is due to some obstruction to  flow of blood ,in can be partial.Varicose veins are also common .so proper examination & treatment is indicated. \u2018Hope I have answered your query, I will be available to answer your follow up queries, \u201cWish you Good Health and trouble free speedy recovery\u201d",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Which antibiotic will be effective for typhoid fever?\n\nHi doctor, I am a 36 year old male patient. I have been\u00a0suffering from typhoid for the past one month. After getting my pathology report, the doctor advised me to take one week medication of tablet Cefuroxime 500 mg twice a day. Before this, I had Azithromycin 500 mg. Is the advice given by doctor correct? Which antibiotic will be effective for me? I have attached my pathology test report for your reference. I shall be grateful for your kind reply.",
    "doctor_response": "Hello. I had gone through all the details posted (attachment removed to protect patient identity). Kindly tell me some more details about your illness. For further information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is the spot of an injury still sensitive?\n\nI got hit by a baseball in the calf muscle 4 weeks ago. The bruising travelled down my leg and is still apparent but is slightly fading. My concern is that i have a bump where the ball hit and it is still very sensitive. Should I be getting this looked at?",
    "doctor_response": "Hello, As I see the history it appears there is a direct injury and there must be small knot happened in the muscle fiber to have the healing process to work on. Maybe you have tried the RICE after the injury. Also, for this, you can use hot water fermentation and a gentle kneading massage. Which should work on the symptoms. In case after 7 days you don't find any changes please get it examined once. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sore breasts, brownish discharge. Pregnant?\n\nHi, my name is Daisy.. Last menstrual period was April 23.. Had unprotected sex with my partner on May 3,4,5 and then again on the 8th.. Been having really sore breasts for over 1 wk now, feel very tired, and I just noticed some brown discharge today may 17.. Is it that my period is just around the corner or is there a chance I might be pregnant?",
    "doctor_response": "hello,You did unprotected sex around fertile days and there is quite chance of being pregnant. Brown discharge before period due date is mostly suggestive of implantation bleeding.Here, you need to undergo one blood test for beta hcg & TVS scan to rule out product of conception after one week or following missed period. Early test is less significant.You can consult with gynecologist after getting test reports for next line management. Wear tight breast support to get relief from breast discomfort.Practice safe sex in future. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I use Kojivit gel to get fair skin?\n\nHi doctor, I am a 22 year old female. I have a dusky skin that is brown skin. I want to become fair. Can I use Kojivit gel? Or any other dermoatology cream can I use? My hands are also brown in color and full of tan. Do you suggest any creams to get fair? I want to become fair as my marriage is going to get fixed by next year. Please suggest me some creams, so that it should not show any side effects. Also, how long I should use it? If I use anything, then will it have any effect in case of pregnancy, etc? Please help me. Thanks in advance.",
    "doctor_response": "Hi. One's skin color has 2 components. First one is genetic, which cannot be changed. Every skin color is beautiful in its own way and we should learn to love our skin color and augment it and not hide or lighten it. The second component is acquired, which is due to the influence of environment, sunlight, hormones, aging, etc. We can only target the acquired component of fair skin color while attempting lightening procedures. I suggest you antioxidant capsules like capsule Antoxid HC (Beta-carotene) and apply sunscreen lotion Lashield gel at 8 AM and 12 PM. Also, you can apply Glyaha koj lotion (Hydroquinone) at night time. Start with an alternate night application initialy as it may irritate your skin a bit and after a week or so, shift to daily night application. Consult your specialist doctor, discuss with him or her and take the treatment with consent. You can go for chemical peeling or microdermabrasion from your dermatologist which will help in exfoliating and give you a clearer skin tone. All these treatments are free of side effects. You may use them for three months. For further information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Paining and burning sensation on left side of tongue and gums, had root canal done. Taken amoxicillin. Could this be shingles?\n\nSix months ago I had dental work done on my back teeth on the left side. Since then the left side of my tongue and the gums at the back have been burning and painful.  I've had root canals on those teeth and last week I had one of them pulled because the pain and burning continues.  I've been on Amoxicillin twice.  The left side of my face almost feels like I've had a stroke.  I have no rash but could this be shingles.",
    "doctor_response": "Hello,Thanks for posting your query.Pain post root canal treatment is either due to re-infection or due to incomplete rct procedure undergone.Since the tooth has undergone extraction,the burning sensation as well as pain will subside gradually.Meanwhile take complete course of antibiotics prescribed.Swish with warm saline frequently.Maintain oral hygiene well.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause QRS contour abnormality in EKG?\n\nI had an ekg done and the reading was: QRS (T) contour abnormality consistent with anteroseptal infarct? My blood pressure was 120/80. I have never had high cholesterol. I have never smoke or drank but I am about 100 pounds overweight-no other symptons other than a stressful job.",
    "doctor_response": "Hello , Qrs showing  antero septal infarct means that you had a silent heart attack in the past , I say silent as you haven't mentioned any chest pain history or treatment in the past . However I would like you to understand that what you have mentioned is an automated machine interpretation which is a wrong many a times and should be viewed in a clinical context,  so I would request that you show the ecg to a cardiologist or you may upload on our forum so we can interpret it for you . Regards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does \"shadow on liver\" mean?\n\nMy Mother recently had Paget's breast cancer and after radiotherapy treatment was told that everything was fine.  After three months she had a routine scan to check that the cancer had not spread elsewhere.  She was told that she had a \"shadow\" on her liver, but there was no cause for concern.  What does this mean?",
    "doctor_response": "A darker area on the scan that may indicate a mass. The scan should be repeated in 3-6 months for comparison and to ensure that no growth has taken place.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lump in perineum and irregular bowel movement\n\nI have a growth in my perineum, the dr did a rectal exam and couldn t feel anything, gave me suppositories to dissolve any potential hemorrhoid, nothing changes and the obgyn doesn t see anything either in the Vagina, and suggested I go see a sex therapist as it could be muscle related. I know it is not, because I can feel the lump going to the bathroom and wiping. Bowel is irregular, please help",
    "doctor_response": "Hi,From history it seems that there might be having Cystocele or lax pelvic floor musculature giving this problem.Ultra sound will give some clue about your problem.Do regular pelvic floor exercises daily.Avoid constipation.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the withdrawal symptoms of Paxidep?\n\nI am taking Paxidep cr 25 from the past 2.5 months as I was suffering from Anxiety neurosis. Initially it was for 2 months and then after 1 tablet a day alternatively. On 2nd sept 2011 i finished with my 2 months regular schedule of taking the tablet after that I was taking it alternatively till today however I think I am developing withdrawal symptoms of this tablet. May I know what are the withdrawal symptoms of this medicine ?",
    "doctor_response": "HiThanks for using healthcare magicElimination half life of paroxetine is 21 to 26 hours and in that case, if you stop it immediately, it would take 4 to 5 days to come out of body. You have anxiety disorder and current symptoms, could be due to relapse rather than withdrawal. In that case, you should consult your psychiatrist and restarting it. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on the testicle\n\nHI, THANKS FOR BEING SO KIND. I HAVE SORT OF THICK FLESH OR LUMP SORT INSIDE MY LEFT TESTICLE. IT ONLY PAIN WHEN I SQUEEZE IT. ALSO THERE IS LONG VEING WHICH I FEEL LIKE A HARDEND THREAD WHAT CAN BE DONE. I DONT KNOW THE CAUSE. ITS THERE FOR THE PAST SAY 4 TO 5 YEARS PLUS",
    "doctor_response": "Welcome to health care magic. 1.The history suggest possible cause could be mass lesion on the first place.2.Followed by infections / inflammations - which can be treated by antibiotic treatment.3.If you are my patient i would have ask for a ultrasound scrotum to evaluate the lesion / mass.4.Ultrasound will help in assessing the nature of lesion, its source and extensions. At the same time the venous pathology what you feel also can be evaluate.5.Depending on finding treatment will be, if necessary FNAC - fine needle aspiration cytology to assess the cells involved. Good luck.Hope i have answered your query.Any thing to ask do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I have pain in jaws after a filling?\n\nHi doctor, I had a bad cavity, and I filled it. After doing it, I started to have pain on my jaws and the areas around the tooth. My dentist is not available for a few days. What can I do now?",
    "doctor_response": "Hi. I have gone through the query (attachment removed to protect patient identity). I can see high points. The uneven pressure on the tooth causes tenderness in your jaw. You have to reduce the high points present in the filling soon and make it as even. You can take Paracetamol 500 mg for the pain until you visit your dentist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for loss of concentration and sleeplessness\n\nsir i have been in a relation but  she dumped me for some reasons and it is affecting on my mind i cant sleep i cant focus on anything even not on my career. iam ok when iam with my friends or out form my home but when i come to my home i get depressed sometime in take relaxation pills for sleep and sir let me tell u about my personality iam not an emotionally stable person i get serious on tiny things plz tell me how can improve my self ang get out from this breakup condition...",
    "doctor_response": "Hi,u have symptom of depression. u have to consult some psychiatrist and u required counselling and medication both. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the side effect on skin post chemo therapy?\n\nI am an esthetician and have a potential client who is a breast cancer survivor. She is currently taking a medication similar to tamoxifen and has little blister looking pustuales on her face. I told her I would be more comfortable with a dermatology visit before I facial her to come up with a skincare plan. Is that a common side effect for skin post chemo?",
    "doctor_response": "Side effects on skin post chemotherapy can be redness, rashes, itching, peeling, dryness, or acne. Nails may become darkened, yellow, brittle, or cracked, and may also develop vertical lines or ridges.Sometimes, chemotherapy causes the skin along the vein to darken, especially in people who have very dark skin. After treatment ends, the darkened areas often fade in a few months.RegardsDR De",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could itchy scalp be symptom of high blood pressure?\n\nHello, I am 51 year old women. I have fought itchy scalp now for several years. It is not any thing like dandruff etc. I was recently told by my family Dr. when in for a visit that my blood pressure bottom number has been high last 3 times I have been there. This has been over a couple years. Could the itchy scalp be a symptom from high blood pressure?",
    "doctor_response": "Hello, Thank you for asking question on HealthCare Magic.As far as the relationship between scalp and high BP goes, there has been no clinical correlation defined so far. So you might want to pay a visit to dermatologist to come up with the cause of itchy hair. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can i do for severe pain in middle of my back?\n\nHi, I have a lot of pain in the middle of my back (lung area) and finding it very hard to breathe, this has occurred in the last 24 hours. I was lifting heavy equipment last night and the day previous got drenched by rain for about an hour. What is the best remedy for a cure?Thanks Joe",
    "doctor_response": "Hi,You will need to avoid heavy loads, lie flat on a flat hard surface and use pain killers. this done for 24 to 48 hours should provide enough relief. An C ray fo the spine should be done if pain persists regards. Kind regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is TB fully cured after taking complete medication?\n\nI am 25 y/o male was diagonised of Tb an year before,but i have taken medicine for 1 year, the lymph seems fine now and there is no sweeling all the test are showing normal,but the only concern is that i want to know can it recover ?? if yes then how much are the chances of reoccurence..and what are the things that is need to do as precautions in this...plzzz help!!.",
    "doctor_response": "Yes, you can recover from TB with the correct treatment. It sounds like you have had a cure. It is unlikely for this infection to reoccur, but you could get re-infected if you are again exposed to it. To avoid it, stay away from people that have it or are prone to have it, and from environments where it is common. Avoid using drugs, especially injecting drugs. This can lower you immunity and make it easier for you to get re-infected. Taking good care of yourself as far as diet, exercise, and sleep is also vital in maintaining a strong immune system. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on buttocks with tenderness and pain\n\nThere is like a limp bear my perineum on my lower butt cheeks. It feels tender and sore. If I touch it to hard it hurts reaally bad, if I wipe after the bathroom it hurts, when I sit it hurts, and if I stand a certain way. There s no white stuff and it doesn t look like a pimple or anything. It s not majorly big maybe a little over pea sized but like a area around it where pain is also. There is one on my left cheek and one on the right. It hurts really bad. Please someone help?",
    "doctor_response": "Hi,It seems that there might behaving folliculitis over the part giving this problem.This might be due to plenty of perspiration, friction and lack of proper hygiene due to poor approach due to odd site to go for proper cleaning.Go for one antibiotic medicine course for 3-5 days.Keep local hygiene proper.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can skin dryness with black nevi be treated?\n\nhello sir,           i am dr arvind kumar singh. my wife skin is dry and has black spots here and there mainly on back and arms mainly due to dryness. we have consulted many times but the treating doctors say that it is because your sweat pores are not fully open. please give advice for this problem. regards",
    "doctor_response": "thanksfor asking via HCM,, dryness with black spot - ichthyosisIchthyosis vulgaris is a skin condition that causes dry, dead skin cells to accumulate in patches on the surface of your skin. It\u2019s also known as \u201cfish scale disease\u201d because the dead skin accumulates in a similar pattern to a fish\u2019s scales.The first line of defense against scaly, dry skin is using thick moisturizers on the affected area on a regular basis. This may include applying thick creams and ointments several times a day. moisturizer should contain lactic acid , urea & aloe vera.regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for allergic rhinitis?\n\nDear Doctor, My daughter is 8 yrs old. She is having allergic rhinicitis. I consulted a paediatric pulmonologist in bangalore and she is under medication since 2 weeks (2 weeks back I had consulted him). As of now she has improved 50%. But still she coughs very hard...(we can hear the sound)...pls let me know whether giving the medicines (inhalers/syrup) would be good for a long time for the above ...thankx a lot",
    "doctor_response": "Thanks for asking in healthcaremagic forum   I appreciate your concern for your daughter. The best way to prevent allergic rhinitis is to prevent exposure to allergen after finding it. Otherwise medications like antihistaminics and mast cell stabilizers help a lot with least/no long term effects. So, you need not worry. You can promote her to go for yoga and respiratory exercises. All the best. For rest please consult your doctor only.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Adderall safe to be taken for absent-mindedness?\n\nHi, I am trying to figure out if there is a medicine that can help me out. I have been made fun of my whole life for being absent minded and I know I come off unintelligent sometimes but I don t believe I am dumb. I received good grades all through grade school but smoked way too much marijuana in my youth. I wonder if the pot I smoker did damage to my brain and that s why I come off slow all the time. Can you recommend anything? Could Adderall be a good choice?",
    "doctor_response": "Hello Thank you for trusting HCM Dear yes marjuna can cause blockage of memory formation can cause cognitive impairment in adulthood if use happens during adolescence. It can also quicken age-related brain cell loss, though marijuana has been shown to slow the progression of Alzheimer\u2019s disease.So please consult your neuro psychiatrist before you want to start any medication, it can cause many side effects. I think I answered to your question if you have more questions please feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having alcoholic cirrhosis and passing black stools. Does this imply liver failure?\n\nHello doctor, I am 59 years old. I was diagnosed with hepatitis C alcoholic cirrhosis, acute pancreatitis and that was almost two years. I am currently taking Levothyroxine 50 mg once daily, Labetalol Hydrochloride 100 mg once daily, Lisinopril 20 mg once daily. I was in the hospital at first to stabilize my condition. My hepatitis C cleared but still of course I cannot change the damage to my liver. I was told I would only be given five to ten years if I would quit drinking. I kind of fell off the wagon about six months ago, about three liters a day. I weigh about 120 kg. I went to my family physician, he ordered a liver profile and complete blood work. I am going to get it done tomorrow, but the only concern I have is this day I have been having not much but had some black stools. Does this mean that my liver is failing? I tried calling my specialist but they had already left their office. Should I go to the ER or just wait till I call my specialists? I quit drinking about a week ago. Can you help me with some advice?",
    "doctor_response": "Hello. Black stools are indicative of acute gastrointestinal hemorrhage. Melena or black stools can also turn into a medical emergency if a lot of blood is lost and hence my sincere advice to you would be to go see a doctor as soon as possible. This does not signify liver failure. However, with a history of drinking, the current status of the liver can only be assessed through a liver function test or an ultrasound. But melena does not mean that your liver is failing.  I will advise you on the following until you get to the doctor. Take Omeprazole 20 mg one tablet immediately, followed by one tablet every morning in the empty stomach. Sucralfate syrup two teaspoons immediately, followed by two teaspoons after every meal. This will help in coating the ulcer lining and help in healing. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes allergy to soy products?\n\nAbout 2 years ago I connected swelling of my tongue and throat with eating soy. I tried going to allergy experts, but I tested negative for a soy allergy. This past year I was perscribed utrogestan, a vaginal suppository derived from soy. It caused me extreme pain and a burning swelling feeling. I also get the same feeling most of the time when my husband ejaculates inside me. He was off soy for about a week and the burning went away. Is it possible that his sperm contains the soy proteins and there's something the allergists missed when testing me? (They suggested it might be an enzyme deficiency)",
    "doctor_response": "Any test is not showing 100% efficacy. It might happen that though you have soy sensitivity test might be negitive. it is called false negative.Your complaint suggest that you are sufferring from soy allergy. So, wihout going details in investigation, you should avoid soy containing food.Regarding the second part it might be possible that some proteins of soy will be there in semen. As semen consists of proteins and other elements like sucrose etc.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do you suggest for drug allergy with fever and cold when on microdox?\n\nHello Dr. I am suffering from fever and Cold. 6 months i had fever and went to Dr.He gave me microdox tablet. After i took them, I got black spots in my skin . I met Skin specialist.He told that this was drug allergy, due to intake of tablets. Day before yesterday i took half paracetomol , yesterday i found one more black area in my shoulder, What to do Sir?",
    "doctor_response": "Hello,Welcome to HCM,Before using any medicine inform your doctor if you are allergic to any medications.Some side effects of doxycycline may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Appearance of  rashes to this drug is very rare.If the rashes are increasing stop the medicine and inform your treating doctor regarding this. He will help you and tell whether it is allergic to drug or something else.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to get pregnant if I am having L5-S1 disc prolapse and protrusion ?\n\nam i eligible to deliver a baby with L5-S1 disc prolapse and protrusion? Hello sir, Am 31 yrs -female - had a c-section 3 years ago. I have L5-S1 disc prolapse(dont know how it came) with protrusion and also recently diagnised with more insulin - abt 42.8 units- taking metformin advised for 3 months - I would like to have a second baby - am I eligible? If yes - when can I proceed and what are all the cautions?",
    "doctor_response": "hi welcome, due to disc problem no need to worry only you should be in rest during the time. for increased  insulin any way you have to take medicines to reduce it otherwise consumption will not lead to child. any way never leave this disc problem as simple thing and also never go for the surgery also since it is not an over growth or waste thing to be removed,and also effective treatments are available in ayurveda along with panchakarma keep in  touch for further clarification christyjoseph1@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes purple spot on head of penis?\n\ni am 18 and have just found a purple spot on head of my penis, i noticed it straight after sexual intercourse,which was really only oral but did penetrate the vagina unprotected, a women also grabbed at my penis quite hard could this cause damage? i have read online an it seems it is not a sign of a std,but it does say it could be a burst blood vessel am not sure what to do..should i be worried?",
    "doctor_response": "Hello welcome to 'Ask A Doctor' service.I have reviewed your query and here is my advise.The purple spot is seems to be because of traumatic injury to penis head. Vigorous sex sometime can lead such problem.Ice application can be dobe and non steroid anti-inflammatory drug can be prescribed. You can post photo to comment further. In STD there is presence of ulcer like lesion.Hope I have answered your question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes occult blood in a 3 month old?\n\nhello. our 3 month old daughter has been getting a small amount of blood in her diaper. we took her to the ER a couple of weeks ago and she was admitted because she was also having vacant stares. they did a CT scan on her head which was normal, a 20 minute EEG which was normal and two lumbar punctures which were unfortunately unsuccessful but they tested it anyway and it was fine. They ended up diagnosing her with the rotavirus. she is still get periodic blood in her diaper though and wondered what might be other causes. she has been straining a bit the last few days but as she s breastfeeding isn t constipated. can you offer any advice please?",
    "doctor_response": "dear parent,  I understand your concerns but the color of blood should give a clue on the site of bleeding.  if bright red blood then the cause is in rectum if dark brown then the cause is in the intestines.  the most common cause is a tiny crack of the anus due to  straining and passing hard stools. this is treated by avoiding constipation. another common causes include 1) milk allergy 2) swallowing blood from cracked mother's nipple 3) lactose intolerance 4) infection",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with depression, taken deanxit, dizzy, tired, sleepy so stopped. Any suggestions?\n\nhi i was diagnosed with depression and took deanxit for a period of 6 months and after that i was relatively better. Now after a period of 10 years i always feel tired and need a nap midday i either feel dizzy or fatigued or nauseated . I sleep a lot but always feel tired . i have frequent headaches . what i do is take a deanxit tablet from time to time but it makes me feel very sleepy. so i stop the next day. Please tell me what to do.Thank you",
    "doctor_response": "dear user  as per u, you had deanxit  10 years back . u took for 6 month and u were well . now u are feeling everytime dizziness , are  current symptom similar to previous  which u experienced 10 year back .u should consult to your doctor . might be suffering from similar illness .get complete examination  .u may be anemic , go for CBC  complete  hectogram .go for thyroid profile to rule out hypothyroidism .hope this will help u .dr neha",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in leg after kidney transplant?\n\nI had a kidney transplant 50 days ago..they made an incision in the right part of the abdomen area ,however, I still feel my right leg ( the lump) numb. so is it normal ? will it recover by the time?...I will be so pleased if I get the answer...thank you.",
    "doctor_response": "Hello and welcome to HCM.As an Urologist and kidney transplant surgeon,i can understand your anxiety.What's the lump you're referring to ? Do you mean the kidney graft ? or leg.?That feeling of the graft will disappear soon.Numbness over the leg also disappears,as it may be due to the incision.Hope you're walking about, as it helps in faster recovery of the numbness.If you've any doubts,send all the reports to me,as a direct question.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to increase hemoglobin level?\n\nHi Doctor,Im a female aged 34 un-married with super skinny body. I have done my blood test after feeling dizziness and general weakness which showed HB @ 5.8 which is too low i think. After that i got my urine R.E which shows Puss Cells 8-10 HPF. Please guide me wot kind of treatment should i take to increase my HB level. I have problem of leucorrhoea for the last 15 years, treatment taken but no results. my diet is normal as i eat wot i think but mostly vegetarian. Please guide.",
    "doctor_response": "hi, your Hb level is too low. your urine shows pus cells are not much of concern its due to mild urinary infection. what you need to concern is your hb. first investigate the cause for your low hb. go for CBC and PS examination. it will give hints towards the cause.it may be iron deficiency, Vit B12 deficiency, Chronic bleeding or many more, so go to the consultant and take treatment according to your reports. you need immedieat treatment. because many serios complication can occurs with this low Hb. thanks for using health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause one to hear voices ?\n\nHi my question is my husband is hearing voices and  he tells me that its to the point that he is scared of them because its telling him that it wants to kill him  how can i deal with something like this? I am 33weeks pregent too.",
    "doctor_response": "Hi,I read your query and can understand what you might be going through. Your  husband seems to be having auditory hallucinations. This can occur in conditions like psychosis or even depression with psychotic symptoms. More details would be required to make  a definitive diagnosis.You must seek a psychiatric consultation for your husband. Proper evaluation will be required to establish a diagnosis and he might need treatment with anti-psychotics.Hope this information was helpful. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high PSA levels?\n\nHi i am 62 male builder by trade .for the last six months i have been so tired.so bad i can fall asleep standing up if i lean on something.i dont smoke. drink sometimes eat well 5foot 9 .weigh 92 kilos.i have been to my doctor no problems heart blood pressure.only thing has come to lite is my psa level is higher than he would like .any ideas please its driving me nuts .thanx Ray",
    "doctor_response": "Hello, Thnx to contact us. I understand your concern. If I am your doctor I suggest you that it is suggestive of malignancy of prostate. PSA is Prostate Specific Antigen it is produced by the cancer cells of the prostate. So if their level is increasing it is necessary to do Trans rectal ultrasonography of the prostate.I will be happy to answer more of your concerns, kindly know me,Wish you a very good health at health care magic. Dr. Arun Tank. Infectious Disease.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low blood pressure\n\n]I've been getting low blood pressure for the past 2 and a half months... it gets as low as 85/45 at night and a heart rate of 46. I've increased my salt, and added more caffiene this only helps for a very short time, an hour tops.. what can I do-now- to raise it?",
    "doctor_response": "Welcome to Healthcare Magic First please undergo complete lab test as HB, TLC, ESR, BLOOD UREA, SERUM CREATININE, SUGAR LEVEL, URINE test, most importantly thyroid test, serum sodium, serum potassium, and lastly abdominal ultrasound  You will get clue in these tests  If  everything comes out normal then you have to take tab Fludrocortosone till lab tests and ultrasound please take well nourished diet and any multivitamin antioxidant combination but take Fludrocortosone as the last resort. With Regards, Dr. Varinder Joshi",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a callus fatty type lump directly below my left elbow?\n\nI have a callus fatty type lump directly below my left elbow. Smaller one under the right elbow. I lean on my elbows all the time. When I squeeze the lump it kind of burns. However no pain at all. Over the years I have had one or more of the tendentious, arthuritus(spelling) and joint issues so wondering if this area is a tendon. Thanks for your feedback.",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein and I will try to help you as much as I can.I definitely recommend surgical removal especially if this lasts for so long. The procedure is short and simple and offers permanent solution.I hope I have answered you query. If you have any further questions you can contact us.Kindly regards. Wish you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for the stiffness in the sprained foot?\n\nI can put weight on my sprained foot after a week that it happened but still I feel stiffness on it when I walk. My Doctor never call me anymore after my X-ray for further examination maybe because the X-ray result is clear. But still I m worrying about my foot when I get it back to its normal condition. Help me please...Thanks!",
    "doctor_response": "Hello, Thanks for writing to us, I have studied your case with diligence.There can be deep muscle and ligament injury You can take vit C for early healing.If blood persist longer internally can lead to damage to tissue leading to cartilage damage.I will advise MRI if pain persist.If you see any signs of infection like raised local temperature, , increase in pain then you should consult your doctor..Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump in throat with anxiety and pain in chest?\n\nHello. I am eighteen years old and discovered a lump in my throat visible from the outside that appears to be connected to my adam s apple about two weeks ago. Last weekend I experienced some rather weird symptoms consisting of confusion, off set balance, and anxiety. Now, it feels as if there is something stuck in my throat making it hard for me to swallow and the middle of my chest hurts when I take a deep breath. Im afraid I have throat cancer. What are the other possibilities, or how should I persue this problem?",
    "doctor_response": "Hi,Dear,Welcome to HCM. Based on the facts of your query,You seem to suffer from-Globus pharyngeus-with GERD.Hurting chest confirms reflux acidity with GERD.Anxiety could be due to the toxic Goiter at the teening age.This tumour in the throat is not Cancerous / and the one felt by you with hurting chest is not related to the swelling on adams' apple of yours.You should check with Ent Surgeon and Physician to check out other possibilities,who would rule out the many possibilities and would fix the treatment according to the proved cause of your swallowing difficulty with swelling in the throat.USG/ FNAC Biospy and Thyroid CT with Second opinion from Ent Surgeon would fix the cause of this lump.Hope this reply would help you to plan further treatment with your doctors.Contact with a Followup Premium question to ME. Will appreciate your Hitting thanks and writing excellent review comments to help needy patients like you. suggestsGood Day!! Dr.Savaskar, Senior Surgical Specialist M.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chronic cough after sinus surgery?\n\nI have had sinus surgery about 2 months ago. Last month I developed a chronic cough that keeps me up half the night. It s not bad during the day. Now I have a taste of diesel exhaust/ kerosene in my mouth And sinus. Where is it coming from and how do I get rid of it?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Upper respiratory tract problems (sinusitis) can cause post infectious bronchitis and lower respiratory tract infection (LRTI). And both of these can cause persistent cough. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. PFT (Pulmonary Function Test) 3.  Chest x ray. PFT is needed for the diagnosis of bronchitis. Chest x ray is needed to rule out lung infection. You may need antibiotics, antihistamines, inhaled bronchodilators and inhaled corticosteroid (ICS). So better to 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is clear fluid from cheek bite a sign of cancer?\n\nHi thereI bit the inside of my cheek about 3 weeks ago but it's not healing. I noticed that it has clear liquid coming from it now and again. I feel the side of my neck hurts now and I'm getting very paranoid that it maybe Cancer. I've read all sorts online regarding mouth problems and I feel so depressed. Please can you give me any reassurance it'll be highly appreciated with my heart and soul. Please help! I'm 37 year old female.",
    "doctor_response": "Thank you for consulting Healthcare MagicI can assure you a mouth ulcer which developed following trauma which fails to heal is unlikely to be a cancerous growth. But I'd like to know whether you have any chewing habits.The difficulty in healing could be due to decreased oral hygiene or vitamin deficiencies.As a treating physician I'd advice my patients to maintain proper oral hygiene by brushing the teeth more frequently, even after each meals; till the ulcer heals. I'd also advice you to take some over the counter Multivitamin Tablets. Triamcinolone ointment can also be tried to make the healing faster.If still it fails to heal after a week consult a dental specialist and make sure no uneven teeth is repeatedly causing trauma.Thank you. Please revert with further details.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump underneath armpit\n\nHi, I am 26 years old and found a lump about the size of a pea underneath my armpit. It is not painful at all and doesn t really move if I move the skin around. It is not noticeable unless I pull tight on the skin. There is no redness at all, in fact you wouldn t even know it was there unless you felt it. I cant really pinch my skin without grabbing it but it also seems as thought its attached to something on the other side of the lump as well. I could do whatever to it and it doesn t bother me a bit. Any ideas... I have had a lot of allergy problems to foods and other things that I have found out in the last few months. So my body has had some changes it has gone through recently. I have minimized the amounts of allergic dermatitis rashes I have been getting...not sure if this would have anything to do with it?? Can anyone help? Thanks",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some enlarged axillary lymphnode.  It may be due to reactive hyperplasia, tuberculosis or lymphoma. It has nothing to do with your allergy.  You should take a course of antibiotics.  If lump doesn't respond to treatment then biopsy diagnosis is advised. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling and injury on face and eyes\n\nhey i fall off a bike quite hard on to concrete which grazed my upper check bone and eye area badly and caused the side of my face to swell so bad i cold hardly open my eye to start with. any tips on how i can get it to heal quickly? i have been keeping it dressed and putting dettol cream on it since it happened 2 days ago.",
    "doctor_response": "Hi, Most probably you have developed facial bone fracture and associated edema.Consult a physician and plan for a CT scan. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible with history of multiple ectopic pregnancies?\n\nHi, what are my chances of getting pregnant after 2 eptopic pregnancy s? Half of my left tub has been removed and the last ectopic was on the tip of my right ovary in may 2013. Ive been tested negative for all stds and told I don t have polysistic ovarys so I don t know why this has happened twice :-(.",
    "doctor_response": "Hi,\u00a0\u00a0\u00a0\u00a0\u00a0Thank you for choosing Healthcaremagic. Any previous ectopic pregnancy there is always risk of recurrent ectopic. It is an unfortunate fact. There is chances that you get normal pregnancy, kindly do not worry. But next time when you get pregnant make sure to get early scans to confirm the location of pregnancy.Please ask if you have more questions. If you are satisfied, please make sure that your ACCEPT my answer so that I receive credit. Good luck!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes leg cramps and lower back pain?\n\nhi last night i was having intense cramps in my upper legs very intence like electricity, with lower back pain, when streached was a bit better, but when i returned to bed same problem, this morning muscles are very sore in my leg,,are afraid to go to bed tonight as pain was intolarable",
    "doctor_response": "Hello, As a first line management you can take analgesics like paracetamol or aceclofenac for pain relief. Most probably it is due to spine related problem like nerve compression or disc prolapse. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility\n\nHi I am 31 years female, had three cycles of clofert 50 mg  from May to July'10, had two cycles of Letroz 2.5 mg  from Aug to Sept'10 and again had three cycles of Letroz 5 mg from April '11 to May'11, ifor being pregnant, all through inter-course but no result so far . Now my doctor wants to move to injectibles. In all the stimulated cycles I ovulated, but failed to ovulate in natural cycle in june'11. Pls advise",
    "doctor_response": "Hi, thanks for sharing your health concerns with HCM!           If I were your treating Doctor for this case of under therapy case of infertility, I would like to have some more information like:1.please mention your partner's semen analysis status also.2.is there any polycystic ovary? 3.any thyroid problem or diabetes or 4.hyper-prolactinemia?Therefore you have to rule out thyroid, pituitary, insulin and related problems along with evaluation on ovulation detection kit before I comment further!It might be possible to try it naturally then!Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health and early conceive!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What kind of test I should take to verify when i have diarrhea,swelling in ankle and asthma?\n\nHi, I have ashma,diabete and tb for several years.  Lately, I lost 8 pounds in a year and have diarrhea, swelling ankle and my blood test so that my eosinophil is high (1279 cells/ul).  Should I worry about it? what kind of test I should take further to verify my condition?  thanks",
    "doctor_response": "Hello,Thank you for asking at HCM.I would like to know more about you like age, duration of each of the diseases and all symptoms in great details.However, at present, I would like to make suggestions for you from your given history as follows:1. As your eosinophils are high and also you have asthma, I would suggest you skin prick testing for common allergens. This helps to identify your allergies.2. For confirmation of asthma, to rule out other lung disorders (as you had Tb also), I would suggest you spirometry with post-bronchodilator reversibility testing which measures your lung capacity as well as type of obstruction in lung airways.3. Usually diarrhea, weight loss and ankle swelling are not related to asthma. So please consult a physician who will examine you in detail, will review your medical history and medications in great detail and then decide the cause of such symptoms. Such symptoms can also be due to side-effects of some medications, poor nutrition, etc.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any side effect of using Turbafine and microgyon for nail infection?\n\nHello, good morning, I am currently taking Turbafine for fungal nail infection and am also on the pill microgynon 30.  Can turbafine interefer with the pill?  I ask this because I had my 7day pill break/my period 10 days ago, am now bak on the pill as normal but my period started again quite heavily this morning? do you know why this might be? I am 5\"9 and weight 180lb",
    "doctor_response": "Hi XXXX Thanks for your query at HCM! I am Dr. Sheetal Verma an Infectious Disease Specialist answering to your query! I went through your query and understand your concern. The terbinafine is an antifungal which works effectively in dermatophytosis. There are no interactions of the two drugs. No need to worry. Hope I have answered your question. If you would like some more information I will be happy to provide. It would be kind if you hit a thanks if found helpful. You can also write a review for me. Wish you good health Take care!  Wish you best of Health. Dr. Sheetal Verma Infectious Disease Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the semen analysis report indicate?\n\nPlease I want to know may be I can still impregnate my wife, we are marry for the past 3months, we do have sex on regular basis but up till know she has not conceive. I carried out a test, please find the result below: Count: 48million/ml Motility: 40% Progress: 25 Random: 10 Sluggish: 5 Dead: 60% Volume: 5ml Viscosity: Moderate Normal: 65 Abnormal: 35 (1) Double Head - Nil (2) Oblong Head - 30 (3) Giant Head - 5 Comments: Normosperm Kindly advise on my chances of impregnating my wife soonest. Thank you for your anticipated swift response.",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.I will suggest you Cap DOXY 100 mg 2 times a day for ten 10 days.60% non motile sperms need attention.Avoid alcohol, smoking if any.Indulge in healthy diet and exercise regimen.You stand good chance of becoming parent. Also get Tubal patency test- HSG  and USG of your spouse.Day 10 to 20 of the cycle are fertile days, so indulge in sex during this period.I hope my answer helps you.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rashes and hives in the arms?\n\nI got a rash over 2 weeks ago when I was in palm springs. I thought it was because I washed my bathing suit in a special soap. The rash is spreading and has bumps/welts at the end of the spreading rash. I went to the dermatologist and they gave me a prescription cream but I don t think it s working. Now I am getting what seem to be random hives on my arms.",
    "doctor_response": "Hi its more likely a reaction to something you ate. Please take Fexofenadine 120 mg anytime of the day, Benadryl 50 at night, and Omeprazole twice a day for 3-7 days. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the left knee?\n\nI've pain in my left knee which only hurts when i do squats or climb upstairs or downstairs in two steps.Otherwise I have no pain in walking or running.I had no injury or possible known physical damage that could lead me to this condition, what possibly is wrong with me ?",
    "doctor_response": "Hello,What I can infer from your complaints is you have got mild degeneration of the patellofemoral joint. It is a joint involving the knee cap. Activities like squatting and climbing up the stairs usually result in aggravation of pain. I would suggest you physiotherapy sessions with muscle strengthening exercises and stretching exercises. Also, it would be beneficial to avoid squatting and climbing stairs if possible. Hope I have answered your query. Let me know if I can assist you further.Regards,    Dr. Santosh S Jeevannavar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are a possible subtle fracture and sprain showing capsular thickening about the PIP joint of a finger serious concerns?\n\nIMPRESSION: 1. The insertion of the terminal tendon (distal extensor tendon) of the fourth finger (ring finger) at the dorsal aspect base of distal phalanx is not definitely visualized suggesting possible tear or avulsion. The central slip of the tendon is seen to insert at the dorsal aspect base of middle phalanx. Clinical correlation for extensor tendon injury is suggested. Flexor tendons are intact. 2. There is bone marrow edema involving the base and proximal shaft of the middle phalanx of the fourth finger. In the setting of trauma this is consistent with a bone bruise. Although a definite fracture line is not visualized, a subtle fracture line or avulsion fracture could be obscured by the bone marrow edema. Correlation with x-rays recommended to assess for a subtle fracture. 3. Capsular thickening about the PIP joint of the fourth finger suggesting a sprain. No definite tear of the collateral ligaments. No definite tear of the volar plate. There is surrounding soft tissue edema greater dorsally.",
    "doctor_response": "Hello, Consult an orthopaedician and get evaluated. An MRI scan is required for further assessment. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat stroke on the right of the body?\n\nhi question i had history of about five to seven concussions, in my teens to 30's  and was in a car crash months ago . that conussion was bad , two month of hellish  pain , still hellish migraines . l... still vomiting,tired and dizzy, speech problms  now use a cane to get around  , . I was told this week by doctors s that I also had a stroke on my right side the night of the car crash.. it will take a long time to  recover. I also  had  DVT as teen ager many many  years s ago. . I do  have history of family strokes  in their 30's from  drinking  and smoking i do not do those things hings  and I am post menopause in my 40s. I have  never heasrd of  people  having a stroke   the same time as a concussion thanks",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern and looking to the history given here I could say that you have not mentioned the clinical complain or the symptoms that you have but you simply said that doctor told you that this is the stroke and this may not be true unless you gave your symptom it would be difficult to say anything, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can hair thinning and falling be treated?\n\nHI, I am Salman, 22 years old male. I am noticing that the density of my hair on top is decreasing. I am a little worried about this early age hair loss problem. I used to have a lots of dandruff in my hair, about 4-5 years ago. So i have been using Selsun blue shampoo which significantly removed my dandruff but now my hair are starting to thin and fall. Please help.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You seem to have androgenetic alopecia. I suggest you to apply a topical minoxidil 5 %solution, 1ml, twice daily. In addition I suggest you to take an oral finasteride 1mg tab once a day for long. Both of these are approved remedies for androgenetic alopecia in males. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intermittent arm pain, twitching sensation in the thumb and body tremors?\n\nFor the past 3 wks I having been having bilateral arm pain and weakness, on and off. The first two wks I was having thumb twitching on and off with it. However, my muscles in my shoulders are very tight. When I rub them it seems like the pain is less the next day. Now I have been waking up shaking uncontrollably. I am not sure if it is anxiety?",
    "doctor_response": "Hi, I am not inclined to think of anxiety as a first cause. Your symptoms could be due to some problem in the brain. I suggest you get CT brain and consult a neurosurgeon. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for severe back pain?\n\nI am 23 years and my period started on April 17 and April 21 and came again in twelve days which it started on May 2 and ended on May 6 and it was very painful and i had very bad back pains in my lower back which has never happened before.It came again on June 3 and ended on June 7 and this pain was even worse and even had headaches the pain lasted three days i took paracetamol for the pain but when they wore off the pain was unbearable. I also felt a dull stick on my left side by my lower stomach by my ovaries and I have this stinging in my breasts and they hurt sometimes when i touch them. I also have a three year old who stopped breast feeding around the middle of last year so i was wondering if that happens when breast milk is drying up. It it possible that i am pregnant and if so could something be wrong with the baby.",
    "doctor_response": "For severe back pain you can take some pain killer like ultracet-plus or zerodol-sp only when the pain is worse enough or disturbing your daily routine work along with some calcium supplements like shalcal-d or toscal-gem once daily. Take some multivitamin like metilda-af or neurobian-plus once daily. Do some physiotherapy exercises after an expert opinion of physiotherapist. I will also advice you to sleep on a plain surface.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will scar reopening after surgery cause urinary problem in hypospadias patient?\n\nHello doctor, My son is 5 years old. He is born with hypospadias and had a stage 1 surgery to fix it back two years back. Everything went well so far. However, the following symptoms are now showing up. From the last week, he started to complain when passing urine saying it was stinging him. We went to GP and urine sample showed no infection. Since yesterday, drips of blood are there in his urine. We went to A and E and urine still showed no infection. However, the doctor advised seeing GP tomorrow to get a referral to a Urologist. The doctor is not sure what this could be due to mentioned that a scar could have reopened? Antibiotics prescribed to avoid potential infection? Could you please give us your feedback on these symptoms and let us know what kind of intervention is likely to happen if a complication was established? If it was a buildup of scar tissues or a urethral stricture for example, how would you treat it? We are deeply concerned as the first surgery was so painful and intense.",
    "doctor_response": "Hi. I have gone through your query. I would like to know a few more details. You mentioned stage 1 surgery was performed two years back. When was the second stage done? Did he complain of any urinary problems after surgery? The most likely cause is an infection given his history is surgery, now that infection has been ruled out, other factors like bleeding from the surgical site have to be checked out. It is also possible that this may be totally unrelated to surgery, young children do sometimes get blood in the urine due to unexplained causes or calcium in urine, but given the history of surgery, the factors related to that have to be ruled out first. Yes, it is possible to get a stricture after hypospadias repair, and that can also cause bleeding due to high pressure during urination, and it has to be checked out, even if there are no complaints. If it is established that it is a stricture, then the treatment will vary according to the location and severity. It can be endoscopic or repeat surgery or sometimes just dilatation would suffice. It is impossible to predict, without knowing the actual details about the previous surgery and without evaluation of the child now as to what treatment he will need.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chemical burn of infant s vagina and butt\n\nHi, My 7 month daughter got burn from 14 ml of dettol in approx 1 lit of water. It got burn in her vegina and ass. Previously i used Siloderm through which the upper surface partially got cured. But when i saw the inner surface was not cured. Pl. give me your suggestion.",
    "doctor_response": "HiInnerside of vagina usually heals well. Avoid harsh soaps for cleaning. If the area appears red and paining apply megaheal ointment.twice daily If the redness persists its better to consult ur doctor tio rule out any ibfection",
    "dialogue_context": ""
  },
  {
    "patient_message": "Kidney issues, blood in urine. Scheduled CT scan. Feeling tired, low BP. Whats the cause?\n\nMy fianc\u00e9e isn t feeling well. He s been complaining about his kidneys bothering him. He saw his Dr yesterday and was told he had blood in his urine . He has a scheduled CT Scan for next week tuesday. Now he is laying down not feeling too hot. Says he s feeling more tired then usual, his head is bothering him too and his blood pressure read 107/55. Not sure if all this is normal and if he can wait til Tuesday for the scan or if he should seek emergency help at the ER? Please help....",
    "doctor_response": "Hi, many thanks for the query!Diastolic BP of 55 as you said is not good, ask him to drink more water.If BP doesn't come up, see your doctor.Blood in urine can be due to several causes, more commonly it is due to Ca-oxalate stones causing mechanical trauma to mucosa of urinary tract as it has spikes on its surface.Also do- RFT, CBC.So, for time being, you may take anti-spasmodics, pain killers, diuretics withyour doctor's opinion.Wish you a good health. Take care. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Other than veneer, is there any solution to treat brown stains on teeth?\n\nHello doctor, I went to the dentist. I have dark brown stains on my teeth. He said it is from drinking fizzy drink and the only way to fix it is veneers. Is this true?",
    "doctor_response": "Hi. Yes, these are now internal stains that cannot be simply removed through scaling. One of the causes for these kinds of stains is fizzy drinks, others may include taking Iron supplements for long, or may be due to the use of extra fluoride in water during childhood like the use of salty water in some part of your age, use of alcohol, smoking or tobacco. All these may lead to these internal stains. Treatment options for these are composite veneers like economical or veneers of zirconia which are expensive but very good in aesthetics. No need for capping is there as staining is just around gums area (attachment removed to protect patient identity). Feel free to ask if you have any further questions regarding it. Stay happy and blessed. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "yeast,pus and epithelial cells in stool\n\nim 38yrs old,female,have been suffering from loose stools since the past ten days.just once a day in the mornings. had a rotine stool test done today which showed 'occasional' pus cells and epithelial cells. vegetable cells were present and yeast cells present.what does this indicate?there is no mucos or blood.",
    "doctor_response": "ONCE A DAY STOOL IS NOT LOOSE MOTIONS AND EPITHALIAL CELL AND OCCASIONAL PUS CELLS ARE NORMALLY PRESENT, WHT ABOUT YOUR WEIGHT AND HAEMOGLOBIN WISH YOU EALTH TC",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest an effective treatment for panic disorder\n\nSirI am facing a problem for last 6-7 month that is when i go sleep, in half sleep i feel blast sound in my both year and get awake with fear. I visit to ent they said everything is ok. i did my ct scan which is normal. i visit to physician they said u have panic disorder and prescribed Restyl .05. When i take i feel better. Everything was ok. But when i want quit the medicine. Problem reoccuring.. I am so upset what to do? I chew PAN (Tobacao) 2-3 per day. Please help me. Thanks a lot.",
    "doctor_response": "HiThanks for using healthcare magicIn that case, you need antidepressant like paroxetine. It would help to control the recurrent of anxiety attacks. You can also try some relaxation exercise like JPMR or deep breathing exercise. That would keep you calm and relax. Rest, you can discuss with your psychiatrist and in case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My sugar levels are high. What to do next?\n\nHello doctor, I am a 41 year old female. I had GDM 9 years back with twin pregnancy. Post-delivery for few months my blood sugars were normal. Later l was started on tablet Metformin 500 mg SR bd along with diet control. Last year l was started on tablet Atenolol 5 mg od. l feel fatigue even after slight exertion. So, l checked my sugar levels. There were fasting 190 and PP 227. Kindly advice what shall I do next.",
    "doctor_response": "Hi. Revert back after the investigations to an endocrinologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why the child is not talking,walking and communicating?\n\nI have a grandson who is very delayed. He is 5 years old and doesn t talk, walk or communicate, he also has very low muscle tone. I have a suspicion that he has cerebral palsy, but no official diagnosis. Over the past few months now he has been going through a stage where he is extremely tired, he just lays and sleeps , he will eat if fed. this will last for about a week, during this time he has no bowel movements. when he comes out of this period he has mega bowel movements and then goes into a hyper stage for a couple weeks where he doesnt sleep much and never sits still. Very weird. I know there are many more questions but have you heard of anything like this?",
    "doctor_response": "you need to get your grandson IQ, screen for metabolic disorders ,chromosomal abnormalities etc. delayed mile stones and decreased muscle tone can present in mental retardation also. in any brain damage patient be it cerebral palsy or mental retardation, there is high chances of having other psychiatric illness . his symptoms are suggestive of either bipolar disorder or ADHD. i would advise you to consult doctor get him thoroughly investigated and diagnosed and treated accordingly",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anemia and vitiligo\n\nHlw, I m 19(unmarried). Normally,I have this problem of likoria(no itch in the area) but for last three days ,I m observing thick white yellowish likoria.I have anemia ,taking medicine.l also have vitiligo slightly in my face ,I m taking medicines for that.I have a habit of drinking less water.do I have any infection / do I need to go to doctor for this problem(likoria)",
    "doctor_response": "Hi welcome to HCMI have gone thru your query regarding  anemia and vitiligo . Dear , all your problems are  outcome of  increase in the levels of toxins in the body and poor eating habits . In other words  , your low immunity  is the root cause of all your problems .  Anemia  occurs  because your body doesn't make enough red blood cells due to poor eating habits and faulty life style .Bleeding causes you to lose red blood cells more quickly than they can be replacedYour body destroys red blood cells causing you anemia and anemia causing  vitiligo , leuchorrhoea  and others .Vitiligo is a disease in which the pigment cells of the skin, melanocytes, are destroyed in certain areas.  Is also a life style desease .Leuchorrhoea  also known as vaginal discharge ,  is a very common condition that has been experienced by most women of all ages, at some time or the other. It is  thick white yellowish  color most of the time . is mainly experienced during puberty, when sexual organs are developing in a woman. It can be very irritating and damaging if left untreated This is because of the fact that the female genitals are highly prone to infections because they are moist and covered at most times. Moreover, women do tend to sweat a lot in that area, which increases the chances of infections and inflammation.  Some of the most common causes are  Anemia and Hormonal disturbances and  increase in the levels of toxins in the body and poor eating habits .Modification in your life style and food habits  -including regular  exercise ,yoga , pranayam and meditation for proper blood circulation  and  balanced  diet having essential nutrients  - fiber , Vitamins ,minerals antyoxidants  in natural form - lemon  juice , turmeric powder , honey , aloe vera juice , amla  regular intake will help  gain heallth in 6 months .All the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My upper incisor hurts only when I touch. Could it be due to sinus problem?\n\nHi doctor, My upper incisor hurts whenever I touch it. This morning when I woke up I was not feeling this pain but after I drank a cold juice I notice that it hurts. I went into the bathroom and check if I see any hole but there is none. I gargle with some warm salt water but it still does not stop. I brushed my teeth but I cannot go up to where the gum is because it hurts. When I eat food I do not have a problem with it but only when I touch it I feel pain. I do not know what is causing this and I am wondering if it is my sinus. But, I know that I have tooth decay because when I eat certain food my molar and premolar hurts. I have an appointment to see the dentist but it is not in the recent upcoming days.",
    "doctor_response": "Hi. I have read through your complaint and the relevant details. Pain on pressure is a clear sign of an infection deep in the roots of your upper incisors. It could be mostly because of a forgotten trauma or assault you had in your childhood. It is not necessarily because of tooth decay. The vital part of the tooth is suffering pressure and causing the infection. I advise you to visit the dentist on an emergency appointment immediately and you got to check with an x-ray to proceed with a root canal treatment in my opinion. Your appointment would be too late and you cannot be on Paracetamol for so long. There are a lot of chances for a bigger swelling or discoloration of the tooth. It is not related to sinusitis as you think and the pain you get in premolar and molar region is the referred pain that you feel because of the upper incisors. Meanwhile, try not to bite any hard object or food and gently brush with a soft-bristle toothbrush. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy?\n\nHi, I am 31 years ,married 6 months back Follicle Study report on 13th day was LO 1.87CM and RO 2.1CM Endometrium 1cm .Had HCG injection had sex that day and next .on 15 th day doctor said follical ruptured but could not have sex on that day but had next day .So what are the chances of pregnancy .Worried as i couldnot have on 15th day.",
    "doctor_response": "Hi, the sperms remain viable for 72 hours to fertilise the egg and after ovulation egg remains available for fertilisation for 24 hours.  After the injection rupture occurs in 34 to 36 hours. So even if you have contact on day of injection, sperms will be there to fertilise the egg.  So, don't worry about it.  Take progesterone for next 2 weeks.  Do a urine pregnancy test at home after that.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will surgery on nerve bring back sensation on fingers?\n\nI had surgery on my right wrist to remove a burning cyst, the Dr. said that because my thumb and fore finger were numb that removing it would not give me back my feeling in my thumb and fore finger. He said that my problem is c-6 in my neck, after he removed the burning lump it began to burn and he said that would go away. I WENT BACK TO THIS dR. ABOUT TO HAVE SURGERY ON MY LEFT meniscus THAT WAS LOCKED, I ask him about the burning from removal of cyst after surgery and he said it s your c-6 in your and I said that I had surgery on c-6 and got no relief. He said go to this highly rated Dr. and see what he rells you, so I did and he ordered an MRI AND SAIDLETS TRY CORTOSONE SHOTS AND REPORT BACK TO ME. I HAVE HAD 1 SHOT THAT DID NOT HELP AND I AM GETTING ANOTHER THIS MONDAY. The cyst is on top of my radial nerve and my neurologist said that he damaged the nerve when he removed the cyst. I don t know what I should do. PLEASE GIVE ME A DIRECTION THAT I SHOULD GO FOR, my new neck Dr. said he would do surgery from in front of my neck , the first one was behind my neck 2 years ago called a formical or he drilled a hole near the nerve c-6 to release pressure on the nerve. Is the surgery on my wrist that causes burning and swelling in my thumb and fore finger permanetly or would a 2nd surgery on my neck help. The pathologist that examined the burning lump from my wrist said it s consistant with Lipoma but he s never seen one like it. I don t know who to believe....!!",
    "doctor_response": "hi,as you mentioned your history in detail it was kind of you. I am wondered that why haven't you tried physical therapy. as physical therapist have something called the sensory integration techniques which adds on some improvements in patients with sensory dysfunction. also to mention, that sensory system is a complex system to under stand treat with. It is totally depending upon how the body's cellular mechanism is formed and moving. also, by undergoing the sensory integration techniques followed by physical therapist will possibly help you further. but the formation of the network between the sensory system and the brain is totally depending upon how the body is reacting to the sensory input.Also, you have a spinal disc degenerative changes, for which the strengthening the muscles of the cervical spine needs an alert. Also by doing simple neck exercises the compression from the nerve is released. Also to make use of breathing exercises helps for strengthening the accessory muscles of respiration, as these muscles also provide support to the neck to hold the head onto it.with the grace of God I wish you a speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated BP and chest pain?\n\nI am 50, non smoker, little high BP, but having chest pains but feels like I am drowning. Lots of liquids draining from head, nose into lungs. (maybe).. had a blood clot in lungs 2.5 yes ago this feels different. When I take deep breath I can\u2019t caught my breath",
    "doctor_response": "Hi, It could be related to a lung disorder or respiratory airways infection. For this reason, I would recommend consulting with your attending physician for a physical exam, a chest X-ray study and pulmonary function tests and some blood lab tests (complete blood count, arterial blood gas analysis, PCR, ESR for inflammation). A chest CT scan may be needed. You should discuss with your doctor on the above tests. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should the gall stones be removed having severe pain and chest burning?\n\nI ve got gull stones that I was diagnosed with dobtbknow if I should get gull bladder removed bc of the pain I ve been having from it but on top of that I ve got burning sensation UN chest and bad pains in middle of chest as well as Ichoke up white foam right when I first lay down what is going on",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  You may have cholecystitis with acidity.  You should go for ultrasound abdomen to know  exact size of gall bladder and confirm the diagnosis of cholecystitis.  If needed go for cholecystectomy.  You should also take Proton pump inhibitors like pentoprazol or rabeprazole.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes occasional pain in my chest?\n\nGood morning, I want to say that there is regular pain in my chest on left side. It comes & after some seconds it goes off automatically. This problem i am facing from last two months. Ans also when i use the stairs there is problem of breathing also.",
    "doctor_response": "An episode of chest discomfort with no apparent reason should be investigated. You will need to report prior smoking, diabetes, elevated cholesterol and family history of coronary artery disease. Brief, seconds of discomfort is reassuring but not a guarantee. You should contact your doctor and consider having a chest x ray and EKG.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What amount of semen is required to conceive and what position should one consider during intercourse for safe travel of semen ?\n\nHello Doc, we are planning for the baby now and its been 4 months we are trying and we havent took any precautions so would like to know the percentage of conceiving? Secondly, i would like to know that how much it takes for the fluid to travel inside the girl as after intercourse i have seen that every time the fluid comes out so would like to know how the sperms remain inside and what is the normal timeframe also is there any position that i need to stay sometime after the intercourse so that the sperms flows?",
    "doctor_response": "hiu can take up to one year to make urself conceive.fluid contain sperm which are important only .after intercourse they travel toward the fallopian tube and come in contact with female ovum.it is normal to spill fluid after sex .u can keep ur  pelvis in upward direction for few minute to divert fluid inside .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes memory and vision loss, tiredness with low iron counts?\n\nhi i am a 20 year old female.my concerns im constantly so tired, within the past few months ive slowy gradually had a harder time remembering things, in a minute i think of something and the next minute i just forget, loss of vision, slowly deteriorating, i remember about 2 years ago i was told i needed blood work because of low iron counts at school, havent done any testing ever, ? please advise",
    "doctor_response": "Hello and welcome to HCM,Low iron content in body can occur due to low iron intake, low iron absorption and increased iron loss.Iron deficiency leads to iron deficiency anemia.Iron deficiency anemia causes symptoms of lethargy, weakness, decreased concentration etc.Lack of attention and forgetfulness can also occur in cases of anemia.However, loss of vision is unlikely to be associated with iron deficiency.I suggest you t consult an eye specialist for clinical assessment and assessment of vision.Corrective action can be taken once examination is done.Thanks and take care Dr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen feet and ankles with numbness of toes?\n\nWhat causes swollen feet and ankles and numbness of toes. My feet kill me. I have been to doctors galore and have had every test done. I did however have 2 bands positive for lymes disease in the later stage. Now doc says neuropathy can come with lymes. I m still am not myself. Does neuropathy cause swelling in the feet and ankles and numbness of the toes? This is how it all started. I was tested for MS and sometimes I think that I have it with other unusal symtoms that I get like water dripping down my leg. However I was tested with MRI s of the brain and spine. Thanks",
    "doctor_response": "Hello, Thanks for writing to us, I have read your query,YES THIS CAN BE NEUROPATHY POST LYMES.          Change your diet and remove inflammatory foods such as citrus fruits, dairy products and wheat that may aggravate peripheral neuropathy. Simultaneously increase your intake of potassium and calcium-rich foods such as bananas and avocados and green leafy vegetable.Vitamin B12 is important in the maintenance of health and normal functioning of the nerve tissue and deficiency of it can lead to numbness. You can increase B12 level by taking meat and fish, or you can take Inj methylcobalamine.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are fatigue, dizziness, shortness of breath and nausea symptoms of withdrawal?\n\nYes, I have a sister who is experiencing extreme fatigue, dizziness, shortness of breath, and nausea.  At this point it only feels better when she lays on her stomach and closes her eyes.  She recently was taken off of 54mg Concerta, about a week now.  Might these be the symptoms of withdrawal.",
    "doctor_response": "Hello!Welcome on HCM!Her symptoms could be related to Concerta withdrawal syndrome. But I recommend you to monitor her blood pressure values for possible low blood pressure or orthostatic hypotension. I would also recommend performing some tests to investigate for other possible causes: - a complete blood count for anemia- blood electrolytes - thyroid hormone levels- a Head Up Tilt test for possible orthostatic hypotension. Hope you will find this answer helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does high level of IgE necessarily mean asthma ? Does inhaler raise some side effect or i can go for ayurvedic ?\n\nI ve got high level of IgE . I m 32, Male. 1. Does it necessarily mean ASTHMA? 2. If taking INHALER may raise some side effects, like dependency on INHALER etc. 3. I am having dry cough for long,almost over a yr. Is it going to be life long with me? 4. If any Ayurvadic treatment that can cure me.",
    "doctor_response": "Hi Welocme to Healthcare Magic As you are on inhalers and have chronic dry cough with the raised Ig E levels , it indicates that you are Asthmatic.To get rid of this chronic cough and inhalers you can start Homoeopathic treatment.Meanwhile you can take Syrup ASTHA AID 1 TSF IN 1/2 CUP OF LUKE WARM WATER THRICE DAILY. Thanks and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain with cramps\n\nIve been having really bad tightening and really bad back pains with cramping I went into the er last nighf and they said they were contraction s but nothinh to worrh about because my cervix was closed.....im 32 weeks pregnant measuring 35 baby has aloy of fluid and im getting nst every weeks and next week im going to see a ultrasound specialist to see if I should get induced because of the excessive amniotic fluid",
    "doctor_response": "I think that is just pregnancy induced and may be due to calcium deficiency and also because of pressing of aorta due to fetus.Carry out usg and consult gynecaologist and obst.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the risks if I proceed with IVF if the endometriosis is spreading to diaphragm and uterus ?\n\nHi. I recently had surgery to remove two large endometriomas in March. I suffer from endometriosis that has spread to my diaphragm and behind my uterus. I also had to have my appendix removed due to endometriosis that was covering it. It appears that I do have damage to my ouvaries and I will soon be beginning IVF treatments. I am worried that there may be damage to my eggs. I want to know what are my risks if I proceed with IVF? Will I be taking a chance on my health or the health of my unborn child? I am unsure as to whether or not I should proceed with the IVf or not take the chance? Thank you sandy",
    "doctor_response": "Hi,I read your query and I understand your concerns.Following is my reply:1) IVF is best done at the earliest.2) The delay will lead to decreased egg quality and failed IVF.3) There wont be problem to baby if conceived.Let me know if you have anymore questions.Regards,Dr. Mahesh Koregol",
    "dialogue_context": ""
  },
  {
    "patient_message": "Planning for second redo breast implant. Do you take the old silicone implants and put in new fuller?\n\nI would like to have a redo breast implant. Mine were done 30 years ago, everything has been just fine all this time, just that my body has changed some and I would like more lift and fuller upper breast area. How does this work? You take out the old silicone implants and then put in new fuller ones?",
    "doctor_response": "Hello,Thanks for the query,Yes it can be removed and new implant can be put.An additional implant can also be done depending upon the shape desired.Please meet a cosmetologist for exact diagnosis.Let me know if you have any other doubt.you can ask a direct question to me on this forum, following the below link. you a good health.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest suitable medication for palpitations\n\nI am 49 and about 60 lbs over weight. For the last year and half I keep having episods of Palpitations. They come from no where and can last half a day or a couple of hours. There has never been any pain at all but it makes me feel very lite headed and sometimes I get a a slight headache. I have been in the ER twice with this. The last time was by ambulance as my son is an EMT. They kept me and all the test were fine although each episode my bloodwork shows low potassium. The Cardiologist didn t feel worried and said that it may be something I get from time to time.???????? He put me on a low dose of blood pressure meds but was reluctent because it was fine. I now take Potassium, Maxide for edema, estrigen (Complete historectomy last nov.) low dose of BP meds. Plus asprin. This is wearing me out and frustrated.",
    "doctor_response": "Hi, Maxide (Triamterene) is a potassium-sparing diuretic and you are unlikely to get low potassium as you are taking potassium supplement as well. High carbohydrate meal at times precipitates hypokalemia. Hidden sympathomimetics, such as pseudoephedrine and ephedrine in cough syrup or dieting agents, may also cause unexpected hypokalemia. Finally, marked ingestion (dietary caffeine) may also cause hypokalemia. Hypokalemia is a major risk factor for both ventricular and atrial arrhythmias (palpitations). Blood pressure improves with the establishment of normokalemia. Aspirin is given as an antiplatelet drug in patients with high cardiovascular risk as primary or secondary prevention. Estrogens do not cause hypokalemia. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Tushar Kanti Biswas, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My left testis has become very small after an episode of pain and swelling. What to do?\n\nHi doctor, I am a 24 year old male. Two years back, all of a sudden, I felt a severe pain in my left scrotum, which became more and more severe.\u00a0Then my left testis was hard, and I also think it became a little bigger in size. The size of the left testis has become very small gradually over the past two years. What am\u00a0I supposed to do now?",
    "doctor_response": "Hello. It is good that you have sought advice at least now. For more information consult a urologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for pelvic pain?\n\nHello. I don't have a primary doctor so I have been seeing the emergency room doctors. Well I have horrible pelvic pain and they don't seem to be able to figure it out. It hurts to sit. Hurts with sex. Just plain hurt. Sometimes my lower back will just be unbearably sore. All I get from the doctors is basically I'm a healthy 25 year old and it's all in my head. If it helps any I have 2 children who were born vaginally",
    "doctor_response": "hi and thanks for the query,I think you will need to see a gynecologist to exclude a pelvic inflammatory disease or other causes. Screen for all sexually transmitted infections, do a pelvic ultrasound, CT scan and if possible an MRI. Your Gynecolgist i better placed here. Kind regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should i do for severe back pain?\n\nMy back hurts often. And daily activities become difficult because of my back pain. It especially hurts whenever I'm on my period. Sometimes to the point where it makes me cry. Today, I noticed I have a bruise on my skin on the middle area of my spine and I have no idea where the bruise came from.",
    "doctor_response": "hi,the solution shall depend on the intensity , type of pain and cause of the pain. A spinal x ray and MRI could be useful. Disc herniation and compression, arthritis and arthrosis, as well as tumors are general causes. I suggest you consult a doctor for appropriate diagnosis and treatment. Kind regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of persistent headaches and retrobulbar pain with numbness and loss of memory ?\n\ni hav been suffering from severe persistent headaches for last six months and retro-bulbar pain. my eye sight is negative 2.5....... there r no refractive errors........ i have felt some loss in my memory .......... my feelings and sensations all hav become dead...........i remain lost all the times...........",
    "doctor_response": "Hi,welcome to HCM, Consult Neuro physician and get your problem evaluated. You may require CTScan,fundoscopy and through neurological examination. After all reports go for treatment accordingly. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have small painless growths in the anus area. Please help.\n\nHello doctor, I have small growths in my anus area like small polyps (like berries). Is this life threatening? Or is this something to worry about? There is no pain and bleeding. I have small growths in my anus area like small polyps (like berries). Is this life threatening? Or is this something to worry about? There is no pain and bleeding.",
    "doctor_response": "Hi. I saw your pictures (attachment removed to protect patient identity). It is human papilloma viral infection, we call them as warts. Nothing serious and plan for cryotherapy as soon as possible by consulting a dermatologist near you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Extreme abdominal pains during urination, have to hold urine and cross legs to contain the pain, worsens after passing and persists for days, taking tylenol. What is the cause and remedy?\n\nI been having horrible stomach/lower abdominal pains only when I have to pee if i cant get to a bathroom within 1-2 mins and i have to try to hold my urine by tightening and crossing my legs so I wont pee my pants. Some urine does come out when i do this and i start getting sharp pains in my lower abdominal area up to my belly button area but I still hold until I can t hold it any longer and I uncontrollably pee my pants but i dont completly empty my bladder and so i have to get to a restroom and sit on the toilet and release the rest of the urine. But than the stomach pains continue to get worse to the point i am squatting hunched over, curled up on the ground or someother way to try to make it stop. The pain continues to grow and grow until I am not able to move around at all i cant think or even function. It takes 3 to 4 days for the pain to completly go away even when taking general pain pills ( tylenol etc).",
    "doctor_response": "Please consider if you have a urinary tract infection, Simple test would be a urine routine and microscopic examination to start with. Your GP/Physician would help you with this.take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could asthma attacks be due to getting influenza virus?\n\nI got infuenza virus almost 8 weeks ago. 7 days after getting the virus I started having asthma attacks daily and still do. At the beginning I needed 50 mg predinisone to regulate my breathing. Also on 3 different inhalers. I am a non-smoker with no other illnesses and never experienced asthma or any difficulty breathing before. I had 2 x-rays and 1 ct scan that was good. Therefore my doctor said I have allergies ? I have never been testing for allergies and personally think this influenza caused this . Your thoughts or recommendations would be appreciated",
    "doctor_response": "Hi, Welcome to Health care magic forum.                    As you describe, you had chest infection. If it viral infection, or an allergy it will have a bacterial infection and lead to pneumonia, if not treated promptly may lead to recurrent breathlessness.                      The infection of the tuberculosis also should be excluded.                     I advise you to consult a physician for diagnosis and treatment.                     I usually prescribe to my patient with such symptoms cifixime,D.E.C,theophylline,citrizine etc.                         Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be done for colon cancer that has spread into liver?\n\nmy son was just diagnosed with colon cancer which has spread into his liver he has 3 lesions in the liver one of which is 6 centementers large.  the mass in the color in causing a blockage only allowing liquids to pass.  He went to the local emergency room, was admitted to the icu, given 4 units of blood (his gamaglobin was 3.5) and they scheduledsurgery to do a colostomy  in 3 days which he refused since the bioupsy results weren't even back yet. now we don'tknow where he should go or what the next step should be.  Does he need immediate surgery or just an oncologist visit. He is home now and scared as we all are that the backup mighty rupture.",
    "doctor_response": "Hi, sorry to now the diagnosis. The biopsy results will be available soon as it takes a few days for this test. I wonder why the patient is at home. He must be in a hospital under constant supervision. Colostomy may be required to remove the blockage, cleansing of bowel and as a preliminary step for a major surgery if needed. Your Oncosurgeon will be in a better position to guide you and have a session of discussion as per the reports. #3 lesions in the liver may need CT Scan and/ or biopsy ( Fine needle Aspiration Cytology).",
    "dialogue_context": ""
  },
  {
    "patient_message": "How effective is pull out method in birth control\n\nI had unprotected sex last night but I have been on the gynera pill for the past 3 months now. I have only missed a pill the first cycle I took it and I always take it roughly at the same time, around 9, 9:30 every morning. We also used the pull out method. Is there a chance I might be pregnant?",
    "doctor_response": "HelloThere isn't much of a change you're pregnant with just missing a single pill.The withdrawal method, if one isn't on birth control, is about 90% effective in preventing conception",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the recommended daily intake of sugar?\n\nHi I have 5 teaspoons of sugars in my cup of tea, now I only have 4-5 cups a day and i don't eat any chocolate, crisps or sweets i also cant / don't drink juice or frizzy drinks . I am 4ft10 and weight 7stone5 so not anyway over weight but my mum says I'm going to get disabilities from having all that sugar in my tea. Is this correct? Do I need to cut down?",
    "doctor_response": "Hello and welcome to ask a doctor service. I reviewed your query and here is my answer.It looks like you are adding alot of sugar to your single cup of tea. If you are slim and not overweight and no history of family diabetes, then it may pose a little problem like having a risk of diabetes in future. So you need to lower intake of sugar in your diet and start eating other things more instead of sugar or take sugar less in amount. Else i have seen many patients who do take sugar even more than you with no problems, but one should be careful and cautious about health. So decreasing intake is in your own good.Hope i answered your question.  Feel free to ask if you need further assistance.  Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for cough\n\nHi, my sixteen year old daughter has just recovered from a viral fever,she developed a cough so gave her Benadryl thrice a day for five days but today at the end of fifth day she is coughing endlessly small dry coughs literally with every breadth..as a very young kid she ahd asthmatic cough also which went away...",
    "doctor_response": "Hi. I can understand your concern. Any viral infection can trigger asthma and allergy.So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of asthma. It will also tell you about severity of the disease and treatment is based on severity only. She may need inhaled bronchodilators and inhaled corticosteroid (ICS)Don't worry, she will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tremor and tiredness in left hand?\n\nI have a slight tremor with my left hand. it s been going on for months and some days it s better than others. I have noticed recently that my forearm seems a little tired also but not all the time. What are some possible causes? I am not on any medication",
    "doctor_response": "Hello, Your symptoms could be related to a pinched nerve. For this reason, I recommend consulting with a neurologist for a physical exam and performing nerve conduction studies. A brain and cervical spine MRI may be needed. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy with irregularity in taking birth control pills?\n\nHello, yesterday morning I had sex with my partner and he came inside of me. I am currently on the mini pill. I take it within 3 hours of the same time every night. However after yesterday morning I forgot to take my pill that same night. I just recently remembered but have not been able to take my missed pill or my pill for Saturday night. How will this effect me? Was I still protected? What are the chances of a pregnancy?",
    "doctor_response": "Hello and Welcome to 'Ask A Doctor' service. I have reviewed your query and here is my advice. As you took pills before and immediately after intercourse the possibility of pregnancy is less. But as you missed the pill next day, better to take within 24 hrs and also that day pill. If you missed a pill completely for one day, continue remaining pills and better to use barrier contraception for one week. And if you miss your expected date of periods better to go for urine pregnancy test once. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest ideal dosage of OxyContin 10 mg\n\nI had knee replacement surgery 2 weeks age. I was asked to take Oxycodone IR 5mg every 6 hours. which I did. I ran out of it & my GP gave OxyContin 10mg to be taken once daily. I am in pain, do I take the 2nd one only once, ? Are they bouh the same? Thank you. Rose Thakur",
    "doctor_response": "hithis should be reported to your doctor, usually  10mg can be taken twice a day, but in my opinion, tramadol is a good alternative and non addictive toothanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for child suffering from gastritis?\n\nMy 13 year old daughter has gastiritis.I think i have heard it also comes from stress.I think she is in stress mainly because i homeschooled her and she is missing alot people and friends.She never talks to anyone about this and tries to be happy.The only happiness for her is her cats.What can i do?",
    "doctor_response": "HelloGastritis can be due to so many causes,stress is one of them. If the condition persists endoscopy may be needed to rule out any ulcer.Although the main treatment is acid reducing agents like pantoprazole/rabeprazole/esomeprazole, but sometimes helicobactor pylori(HP) kit may be needed if there is an HP infection.For stress councelling and antidepressent/antianxiety medication may be needed.Change in diet is also needed like avoidens of spicy,oily foods with intake of plenty of water.I would suggest you to consult a physician for proper evaluation and management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to remove the lower wisdom tooth?\n\nHi, I got my lower left wisdom tooth removed yesterday. It is not hurting at all. ( may be due to an antibiotic and a 500mg painkiller prescribed . I have been asked to take both thrice a day). Is it safe to remove my other lower right wisdom tooth tomorrow ( 2 days after the first one was removed ) I am 24 yrs old and I really dont have any problems with my wisdom tooths. But I was advised to have it extracted as the impact on the neighbouring tooth was angler. ( I am also leaving out of country for 2 yrs )",
    "doctor_response": "Its good that you experience no post operative pain. You may get your other third molar also extracted but only after healing of this extraction socket otherwise you won't be able eat food from any side of your mouth. You can get it removed after 1 week.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Do my symptoms suggest celiac disease?\n\nHello doctor, I have always had weird symptoms and I think I have celiac disease. I also think that the combination of all my symptoms may mean something. I was tested once for thyroid problems and once for Lyme disease because I had a big, dangerous tick-bite rash. I am 19 years old and according to my growth curve (height of father and mother) my height should be 1.80 meters. I started puberty later than everyone else my age. I have always been too short, I am 1.68 meters now and I do not think that I will grow any longer. I am also feeling tired and sleepy all day long. I thought it was because of school and other stuffs and I just need some rest. But now during my holidays, though I have slept around 8-10 hours every day, I feel tired and sleepy. My black circles also did not disappear. My symptoms are as follows. I have signs of anemia, such as rapid heartbeat, headache, dizziness, pale skin through which veins can be seen and had little cracks at the corners of the mouth some years ago. I use to get sudden muscle spasms once per day or so. Since birth, I have been suffering from asthma and acid reflux. I have small individual red spots on torso, joint, bone and muscle pain for a few times a day and it does not hurt too badly. I have pop elbows for a year or so. I am getting pale sores in the mouth and bad teeth. I brush twice a day with an electric brush, but still many problems when I go to the dentist. I feel bloated and constipation. My stools are of bad smell and oily. I am also getting diarrhea a few times per week. I got hereditary hair loss and bald temples. I have a history of migraine including temporary blind spots in sight. Occasionally, I get strange things in eyesight, not only normal floaters, but sometimes also hundreds of very fast moving transparent balls. Sometimes, I suddenly see a very flashy thing in my eyesight for a few seconds. It takes long for me to fall in sleep after going to bed. I had intestinal problems all my life, but I just thought that they were normal. When I was very young, I did not really have so many issues like I have now. When I was around 14 years old, many of the problems started. I actually ended up in the hospital, because I had an unbearable pain under my ribs (right lower quadrant). They thought that I had a perforated cecum, but luckily that was not the case. They did not really know what it was, but I had high fever and I threw up 20 times or so. Around 17 ye",
    "doctor_response": "Hello. Thank you for sharing your detailed history with us. Revert back with the answers to the above questions to an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sever radiating pain on the left side of the body and severe headaches?\n\nDue to pain radiating from my kidneys, I was sent for an ultra sound back in January. After the technician sent results, they referred to what they found as a nodule . I was sent to the imaging center the next day to get a CT scan complete with dye through and IV. In conclusion they found that I have a benign cyst & that I was to drink plenty of water.... My question is: Should I be concerned that it is something more? I have severe pain radiating from my left side (I know for a fact it is not muscular) that is worse at night/ upon awakening. Sometimes it is dull/throbbing and others sharp and painful. I have also been having horrible headaches in the morning, which started about 2 weeks ago. My Grandmother died of Pancreatic cancer in her early 50s.",
    "doctor_response": "Hi,benign cyst of kidney is not so uncommon.They some time cause severe pain but they require no treatment.One can use oral NSAIDS or opeiods at the time of pain.In my practice i find them quite helpful to my patient.If the size of the cyst is large and they cause severe pain effecting your daily activity then they ma require surgery.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be the unmovable lump at the jawline?\n\nI have a lump on the side of my face right in front of my ear at the jawline.It's a hard unmovable lump that doesn't really cause pain but it occasionally feels like it's throbbing,plus it sticks out quite a bit on my jaw line.What can this be and what is the easiest way to remove this?",
    "doctor_response": "Hi! thanks for sharing your health problem with HCM!Well, it is very common to get an immovable painless throbbing jaw lump in any clinic especially in aged people and as per our record, I can mention the different possibilities in such cases according to the final biopsy reports as follows:1. chronic infection in the submandibular salivary gland could be due to dental or oral infections or stone in the gland: 30% cases2. benign tumor or tumor-like cystic conditions 15% cases3. benign enlargement of lymph nodes 30%4. tuberculosis 10% cases5. cancer or lymphoma 5% casesTherefore, ultrasound and needle biopsy evaluation is necessary to ascertain the cause and then surgery might be needed by an ENT specialist if medices are inappropriate!regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there side effects from giving Longifene DS for an infant?\n\nGd mrng sir. Iam kezia . iam in confusion abt my child of one year old. He use to additional have food along with my milk from 2 months.. but now he refused to take atleast little amount of it..so after that my doctor suggested to have Longifene-DS syrup for abt one month.. how come it will be good for my baby and what is the main purpose in using this? is therer any side effects? pls let me know clearly abt this.",
    "doctor_response": "Thank you for posting your question.Longifene DS is a drug containing buclizine which has recently been recognized with appetite stimulating effects. It has routinely not been prescribed for appetite stimulation in kids and it is just beginning to gain popularity.Though not harmful, if you are giving the drug then keep a watch for few side effects. These include nausea, vomiting, diarrhea, weight gain, headache, urine retention etc. I would also suggest that you try multivitamin and iron supplements. These may also play a role in increasing your child's appetite, apart from added supplementation.If you have any more doubts , do write back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluids in the knee?\n\nHello, my knee feels as if it is full of air, or flujid. my grandma said it felt like there was fluid (shes medically licensed) and im not sure whats going on. i noticed it doesnt really like to bend as muhch and i have to drag my leg when i walk after a bit of activity. it feels like pressure, like my knee cap is going to bust out of my leg. What is this?",
    "doctor_response": "Hello,The symptoms seem to be related to bursitis which is an inflammation of the bursa in the knee. I suggest using anti inflammatory medications such as Acetaminophen to relieve the inflammation. I also suggest using cold compresses for local application. If the symptoms continue, you should see an orthopedist.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get chest pain that goes up to throat. Should I be concerned?\n\nHello doctor, I get heavy chest pains and sometimes it is unbearable. It goes up to my throat, upper jaw and sometimes to my back. Should I be worried?",
    "doctor_response": "Hi. Revert back with the asked details to a general practitioner online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could a lump on breast be?\n\nmy 8 year old daughter had complained of on of her breasts being sore, upon examination i found a large lump ATLEAST AS BIG AS THE FIRST JOINT OF MY SECOND FINGER) it is directly under the nipple and is movable and can be seen if she puts her arm up in the air, what could this be, i called and have made an appt with her ped.",
    "doctor_response": "HI,Welcome with your query to HCM.Based on the facts of your query,after its review your daughter seems to have pubertal changes with developing breast,though it is bit earlier,but not uncommon in recent atmosphere of netizans.It could be start of Normal  pubertal changes and indicates early menses too in her case.If still if you feel  her development mile stones as abnormal for your family history,You can check with your doctor for Pre-caucious Puberty,which needs to be ruled out in your case if need be.So don't worry unless your GP doctor opines on it.Hope this reply resolves your worry with your queries.Will appreciate writing your feedback review comments,to help the needy patients like you at HCM.Good Day!!Dr.Savaskar,Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat painful lumps with soreness on the body?\n\ni been getting big red sore painful bumps been developing almost anywhere on my body mainly thighs and lower back about a week before my menstrual periods and been going on for about 6 years now please help i seen 3 different dermatoligist and none helped",
    "doctor_response": "Hi,Dear ,Good Evening.Thanks for you query to HCM.This is Dr.Savaskar from India helping you out of your health query. I studied your query in-depth and understood your health concerns.-In My opinion the Cause and Treatment --of the painless lump  with soreness anywhere on your body-is as follows-Cause -waning hormonal cycle-ie-Peri-Menopausal Syndrome(PMS),when hives /? CIU-Chronic Idiopathic Urticarias-Which are common -while the menstrual cycle goes of gradually.-These red painful lumps are part of the HOT flushes,which is part of the perimenopausal syndrome.Treatment-In my opinion a-is not with the Dermatologists-ONLY but along with -Gynaec specialist doctor also and with Physician.b-Supplementary ERT SOS when the symptoms become re-sistant and non-responding.c-Beside this de-worming / Di-ethyl Carbimazine / Cetrizine-loratadine treats would help whenever need be.d-Thus besides the above treats -Alzolam to care the anxiety aspect of this hormonal transitional phase of your life.e-Avoiding food articles / perfumes / body sprays/ cosmetics which would cause the chain reaction of skin rashes with anxiety and body disturbances.d-Bland carbo diets with /B12-Folic acid-vitamin suplemented liquids, with plenty of sleep hours would resolve your issue.Hope this would help you to plan treatments with your team of -Gynaec / Dermatologist/ Physician / nutritionist experts.Wellcome for further queries in this issue to HCM.Wishing a fast recovery for your baby.Have a Good day.RegradsDr.Savaskar M.N.M.S.Genl-CVTSSuper -Specialist in Non-Curable Chronic Diseases(NCCD)and Expert in therapy for-Cancer/Asthma/Psoriasis / Autoimmune disorders/Rejuvenation protocols etc.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my son passing out so many times?\n\nMy neighbor knocked on my door to inform me that my son had pass out...approx 3-4 times.  He was standing talking to him and he pass out approx 20-30 sec.  Came to....neighbor began to walk son home not far less than 20 ft and he did it again about 2-3 more times.  When I open door, son on ground looking up at me dazed.  He refuse to go to DR.  I took pressure 96 over 71 with heart rate of 109.  Giving fluids and feeding.  Also game potassium and asprin.  What else should I do...other than try to convince him to go to DR.  He says he's dehydrated.  Also 32 yr old male, 5'9, 165 lbs",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!I understand your concern and would explain that these episoded of fainting could be related to different causes. A low blood pressure could be the cause, as the blood pressure that you refer is low. Anyway a careful check up from his GP is needed to exclude other causes like a possible cardiac arrhythmia or epilepsy seizures. I would recommend performing some tests to exclude the above mentioned disorders: - resting ECG- chest x ray study (aorta)- head up tilt test (for orthostatic hypotension)- an EEG (for possible epilepsy)- some blood lab tests (complete blood count, fasting glucose, kidney and liver function tests, blood electrolytes, etc). Meanwhile, the best thing to do is to give him plenty of fluids and monitor his blood pressure. Hope to have been helpful!Best regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with asthma, diabetes from a long time, on medicines, recently have high BP with tingling and pain in foot. Suggestions?\n\nDear Doctor, I am 45 yrs Male in stressful Govt Service (administration and Mgt). I have Asthma for 15 years (Controlled by Seroflo 250 Rotacap BDS + Montair Plus OD) and also Diabetes ( 10 years, Volibo M 0.2 BDS, Pregeb MOD 75 OD, Modlib ASG 75 OD medication , HB1AC normally below 7 above 6, PP Blood Sugar 160-180). Now for last 2 months I am having higher BP average 130/95 and a tingling in my foot and lower leg and mild pain occasionally. What should I do? Should I start BP Medicines??",
    "doctor_response": "Hi, Welcome to HCM After going through history, Diabetes type II,Neuropathy,dyslipidemia,Asthma these are lifestyle diseases and need to be controlled lifelong. Certainly sress increases BP and makes sugar control difficult. Your BP is in pre hypertension range and can be monitered regularly along with life style modification, reduce Salt intake to Take up regular walking 3 to 4 km/day, do practice yoga and meditation,along with Pranayam which will also help Asthma. If overweight reduce weight also check your Lipid Profile and ECG. If BP is not controlled and rises further treatment with drug can be started. Your pain in lower limb and tinglig may be because of diabetic neuropathy. Discuss with treating Physician your treatment is OK. Take care Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Medicine for lower back pain despite Fentanyl and Dilaudid?\n\nI suffer from chronic pain due to lower back pain that has been diagnosed as piriformis syndrome or sciatica.  I have a .025 mcg fentanyl patch and 4 mg dilaudid up to 3 x daily for breakthrough.  My pain has begun to worsen at night to the point that it awakens me.  I've tried sleep medication to help me sleep through it but it does not help.  Once the pain starts, I wake up.  Is there something else that my doctor can do to help me just sleep through the night?  He doesn't want to give me any other narcotics but until I receive a proper diagnosis, what can I do?",
    "doctor_response": "I am not sure if you have checked your diagnosis  withMRI.  This is the best investigation to confirm  if you have sciatica.  After confirming your diagnosis we can focus on analgesics.  I would prefer gabapentin or amytryptalin  over drugs which you are taking.  If drugs are not effective physiotherapy and surgical solution  is also available.  I hope this answers your query.  Feel free to question  an  thing else. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does presence of cardiomyopathy along with ischemia affect the life expectancy?\n\nI have cardiomyopathy and sleep apnea. Four years ago, I was implanted with a bi-ventricular pacemaker with 3 leads to the heart. Recently, I have been diagnosed with ischemia. My beta blockers have been doubled to 25 mg. twice a day. What does that do to my life expectancy?",
    "doctor_response": "Thank you for choosing HCMHaving cardiomyopathy can significantly affect your life expectancy. The medication that you are on is correct and I do not think that you should worry. The best way to know the function and the effectiveness of the heart, you will need to get the heart checked up. You should see a Cardiologist to get a Echocardiogam and Technetium scan which will help find out if the heart is working properly.Please follow up after the results of the ECHO and the scan are back. All the best.Hope this helps you.Dr Vignan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are cramps in abdomen and spotting considered normal while on depo?\n\nHi i was on depo for two years. The say i got on depo my period completely stopped. I spotted a little each month but hardly. Got off of it for 5-7months and decided to get back on nov. 18. Mon. Dec.16 i started spotting wed i started having light cramps and still spotting but a lil heavier. The next two day my cramps are worse when i move they hurt to were i need to take some meds.and also im bleeding more as if im having a period. Sat. They arent so bad but they still hurt. Could it be my body reacting different from the depo? Are these just regular period signs? Ive never cramped this bad and i never bleed on the depo before?",
    "doctor_response": "HI,     You had taken a  gap of 5-7 months while taking depo preparaton for contraception & have started bleeding and cramps after one month- which is unusual.   Two things are possible-    - It's menstrual irregularity after restarting the dose after a gap.    - During the gap you had conceived,started depo preparation while pregnant & started bleeding ( thretened abortion)-    The position can be judged by a physical examination by a Gynecologist/ Pelvic sonography & managed there after.   Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of head lice?\n\nI'm 29M, I'm extremely disturbed of my head lice. I can't even concentrate on my work. Please help me out from the problem. Please advice me the best lotion for head lice which easily available in chennai and advice me how to take that treatment too. Thanks & Regards, Ramesh",
    "doctor_response": "WelcomeTreat with over-the-counter medicated shampoos called pediculicides (derived from chrysanthemums). The most common pediculicides are applied to dry hair, left on for 10 minutes, and then rinsed off.This  product is safe as long as they are used according to instructions.Or consult your family doctor , he would  prescribe - Permethrin lotion/cream -apply 60 ml of 1% lotion or cream to washed & towel dried hair  & allowed to remain for 10 minutes ,rinse with water .this may be repeated after 7- 10 days if lice or nits are detected.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a hard lump in the vagina?\n\nHi, I'm just worried because I just went to see my doctor (gyne) today and noticed a hard lump in my vagina where i got the stitch from birth since i gave birth 6 weeks ago. She said it's from the infection and so prescribed me a an antibiotic and advised to me do a hot sitz bath. I just wanna know if this lump will go away by itself after taking antibiotics? please let me know your idea. thank you.",
    "doctor_response": "Thank you for asking Healthcare majic. My name is Dr Ehsan Ullah & I have gone through your query.you have mentioned about Hard lump in Vagina which you mentioned that you had stitch at this region..if it's due to the infection then it will settle with antibiotic coverage andSitz bath as you Gynaecologist mentioned.you need not to worry and continue your medicine regularly along with regular Sitz bath.most of such infections in perineal and anal region respond very well to antibiotics with hygiene coverage and Sitz bath.Hope this may help you. Let me know if anything not clear. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to wean off Duloxetine?\n\nI ve tried many antidepressents and am now taking Duloxetine 60 MG. I want to try sam-e instead. How long must I be on 30 mg before cutting it out (I am taking 2 30 mg tablets per day) totally, and can I start Sam-e while I am only taking 30 mg. I am going to bed soon. Could you e-mail me your answer using the address below: YYYY@YYYY ? Thanks for helping! I wish all the antidepressants I have tried had worked, but they don t seem to do anything.",
    "doctor_response": "in  my  opinion  it  is  necessary   to   reduce  the  dose  once  in  2weeks  to  duloxetine   30  milligrams   and   then  reduce   it  to    half  a   tablet  also  cognitive    behavioral  therapy   moderate  exercise  ,  good  diet",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of taking calmpose ?\n\ncan anyone tell me what are the side effects of taking calmpose",
    "doctor_response": "Hello there, some of the side effects are sedation, light headedness,vertigo,confusional state, increased apetite and weight gain,alteration in sexual function,rashes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a lump in the arm?\n\nHi i shut my arm in a door at work and had instant swelling on my forearm double the size, I had an X-ray and found nothing. Now swelling has gone down I can feel a hard lump/ridge just before my wrist and my little finger and ring finger are nunb, tingly and purple.",
    "doctor_response": "Hello,Thank you for using healthcaremagic.I read your question and understood your concern.I think you have injured the ulnar nerve and/or ulnar arthery which caused hematoma (lump) in the forarm and changes in the color of 2 fingers.I suggest you see the vascular surgeon and neurologist for more examinations such as Doppler ultrasound and EMG.Dr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does clostridium difficile infection cause swelling in ankles?\n\nMy husband is recovering from C-Diff as a result of too many antibiotics due to complications from leg surgeries. He now had swollen ankles. Is this related to the C-Diff? He has taken Vancomycan and Dificid for the C-Diff plus multiple probiotics.",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.In my opinion ankle swelling had some different origin.C. difficile has nothing to do with ankle swelling. It is limited to the intestine only. It has never spread to ankle. Even its toxins won't spread to the ankle.I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can lower backache be treated?\n\ni have moderate to severe pain in my lower right back - just to the right of my spine at the top of my buttock. As the pain worsens, it radiates down the front of my right thigh. Ibuprofen isn't touching it. Diclofanac (150 mg twice a day) worked for a while, but has stopped being effective. Any suggestions?  THANK YOU!",
    "doctor_response": "Dear patient you may be having radicular pain due to nerve compression at the  lower lumbar spine. If diclofenac and ibuprofen  other are not working this needs to be investigated. First xray of the lumbo sacral spine anteroposterior and lateral views should be done. Mri of the lumbo sacral spine would also be required to confirm diagnosis. Meanwhile take strict bed rest. Start tab myoril 4 mg twice a day with tab pregalin x 75 mg one at bedtime. avoid forward bending and weight lifting. if not relieved you need to consult orthopaedic surgeon nearby your area with report.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is orthrodesis surgery essential for charcot marie tooth disease?\n\nMy 40 yr. old son has Charcot Marie tooth disease. His dr. recommended gastric recesssion triple orthrodesis surgery. I feel this is too intrusive. and I m afraid for him. I feel he needs another opinion. Can you suggest someone he could consult with?",
    "doctor_response": "hThanks for using Health Care Magic.Read your query.Yes,charcot Marie tooth disease is a hereditary condition which usually progresses slowly and is treated based on the symptoms developed as there is no complete cure for it till date.I would advice you to consult a good orthopedician and get it evaluated. Physiotherapy may be required based on what condition it.Surgery may or maybe not require based on the foot deformity.Have a good nutritious diet with ascorbic acid also .Have a healthy life .If systemic conditions of diabetes is present,start the treatment for it.Hope this was helpful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could difficulty in focussing refer to ADD or ADHD?\n\nI think that I have ADD or ADHD because I have a very difficult time focusing on what I'm reading and when I study for exams I have a difficult time remember what I've read the day before. I seem to have a very difficult time starting tasks that have many components to them or that seem like a lot of work. How do I know if I have ADD/ADHD?",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.Its a very common feeling among the exam goers that their memory is not adequate and that they have difficulty in remembering the things. For ADHD to  be present in the adulthood, its essential for that to be present since childhood. Your parents may agree to the finding of ADHD since adulthood, if at you were having an ADHD. The best way to get dignosed as ADHD is to visit a psychiatrist who will take a detailed history and mental status examination and get the diagnosis confirmed using the diagnostic and statistical manual of mental health disorder (5th ed). It has a specific criteria. Even Uttah has proposed a criteria for adult ADHD which can be used. 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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reddish dry patches on the hand. Due to cold weather? Numbness in the hands\n\nHi, I have these dry red patches on the back of my hands that basically look like a fingerless glove. What exactly is this? I m thinking it might be caused by the cold weather recently ( 40 F) because, thinking back, I would sometimes really feel numbness in my hands whenever I had to carry something outside. It doesn t hurt or itch , but just feels really dry and uncomfortable if I stretch the skin.",
    "doctor_response": "Hi Thanks for posting your query. Your problem looks like contact dermatitis due to detergents rather than due to clod weather as you have mentioned that is is dry. But your numbness points out to skin manifestation of cold weather too. This has to be confirmed by a dermatologist nearby as the treatment for these two conditions vary from each other. Good day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I do not have any symptoms, then why is my prolactin level high and testosterone level low?\n\nHello doctor, My doctor wants me to get an MRI after my blood work. I wanted to get a second opinion, and I have attached my\u00a0blood results. My prolactin is 20.4 (above normal), total testosterone is 269.3 (below normal), free testosterone is 8.9 (normal), FSH is 3.7 (normal), LH is 2.9 (normal). I have had a history of low testosterone, and it was 150 and 130 in the last two years. This recent test was done this month. I have no low libido or erection problems with my\u00a0wife. I do notice that I am not waking up with a morning erection. But if my wife arouses me in the morning, I immediately get an erection. I must admit that I was eating a lot and not exercising as much, but I started to change that. Do you think an MRI is needed? Should I see another local physician or urologist? Or should I just get medicines to lower my prolactin level?",
    "doctor_response": "Hi. Thanks for posting your query. Hope this information was useful to you.\u00a0 For further queries consult a\u00a0diabetologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring swelling in feet?\n\nI am curious why my feet get swollen every now and again, though i do regular exercise, am not overweight and it happens like 4 times a week. They are often okay when i wake up in the morning. I work from home and try to keep my feet elevated and move around regularly.",
    "doctor_response": "Hello, I think you should get the scanning for the kidney and also the heart done. Due to reduced venous return, the swelling can be there. There is even the possibility of the kidney malfunction leading to swelling. Until we check the physiological status of the heart and kidney we cannot give you an accurate cause for it. As with respect to swelling, there are multiple factors associated like heart conditions, kidney conditions, diabetes, etc. Until we have some clinical platform and lab reports it will not be fair on our part to make you panic. Get things examined by the laboratory so we can assist you better. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I had clinical depression and now normal on medication. How long should I take medication?\n\nHello doctor, I am a 24-year-old male. I am a dental student, and I suffered from clinical depression five years ago. I consulted a psychiatrist, and since then I was on antidepressant Sertraline, antipsychotic Aripiprazole, and Divalproex. Three years after the treatment when the symptoms subsided, the medication was reduced to only Divalproex, but due to some stress, Aripiprazole was started again. Then after some time again due to stress I lost my confidence and started feeling social phobia so Escitalopram was started. The reason I think behind this depression is my academic failure and bullying I suffered during my childhood. I feel normal on taking medications. But my query is that how long I have to take these medicines? Will it terminate and what can I do other than medications to overcome this situation?",
    "doctor_response": "Hello. It is good to know that you are able to function well at present and medication has been helpful. I note that you are currently on Escitalopram, Aripiprazole, and Divalproex. You have reported suffering from clinical depression, stress, and social phobia. Since you experienced some sort of relapse when Aripiprazole and Sertraline were stopped, it is advisable to continue the current regimen. Check with your psychiatrist about the exact diagnosis as in some types of affective disorder, mood stabilizer may need to be continued for a longer period (duration depends on individual circumstances, nature of depression, associated symptoms like mood instability, thought, and perceptual disturbances, etc.). Patients need to be on medication for at least some years to minimize chances of relapse. You can try CBT (cognitive behavioral therapy) or psychological therapy to help you manage your condition better and prevent relapse. Also, learn stress management techniques. You can try yoga, regular exercise, and develop good social relationships, etc. Have regular follow-ups with your psychiatrist. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is my BP normal?\n\nI am a 36 year old woman , I weigh about 215 pounds and I am 5'1\". I took my blood pressure this evening after cleaning the house and running up and down the stairs a few times to put my kids to bed. It was 117/84.  I guess What I want to know is if this is good and what is a good BP for me and what is a good resting heart rate.",
    "doctor_response": "Welcome to H.C.M. I am Dr Krishna Dubey.My dear friend, your blood pressure is normal. Normal blood pressure should be 120/80 mmhg and pulse rate should be 72 beat per minute(normal range 60 to 100 beat per minute). Your weight is more than normal person for your height and age.I suggest you to do regular exercise and decrease  fatty diets so you can reduce your weight.This will also help to control on your blood pressure.Thanx for query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will partners with the same blood type have babies with deficiency?\n\nhelo dc, I am about to begin a r/s with a girl. Basically, I am a chinese and both of us are having the same surname and same blood type. B+ . The question is, given the fact that both us are having the same surname; a POSSIBILITY that coming from a same ancestral, will it be a likelihood that our future baby will be having syndromes or disorder or abnormal? Please advice. Gary",
    "doctor_response": "Hello, Thnx to contact us. If I am your treating doctor I would like to advice you that when people marries to the person having a same blood origin, chances of autoimmune disease and some of the mutational disease are common. Having same surname dose not mean that you are from same blood origin. But what I think you are not from the same blood origin, and you can go ahead with the marriage. Also there are not a more chance for your baby being born with the syndrome. If you have anything else to ask please contact me. Thanx. Dr. Arun Tank",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infection at pierced site on ear in a child\n\nmy 6 year old daughter has had her ears pierced for 3 months ive just realised its infected a big lunp and looks pussy at the back? I am worried about it getting worse and her getting a more serious infection however I would prefer not to take them out if not needed. What is the best course of action.",
    "doctor_response": "HI...by what you quote I feel that it could be getting secondarily infected. It could be pyoderma of skin and soft tissue infection of the region. I suggest you consult your pediatrician regarding this as it might require either topical or oral antibiotics.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for persistent cough and headache\n\nHi I ve been unwell since last with sinusitis I still have it and don t seem to be getting any better I also have a cough and my back feels like it s been kicked in can you offer any advice I am taking regular paracetamol and non steroidal as I m having a lot of headaches etc",
    "doctor_response": "Just take steam inhalation along with a antibiotic for 5 days and a antihistamine tablet twice. You will improve nothing to worry",
    "dialogue_context": ""
  },
  {
    "patient_message": "I get light headed and my vision goes black sometimes but when I blow my nose it s all blood in the tissue\n\nWhat is this? Sometimes when i stand up too quickly I get light headed and my vision goes black Sometimes when i stand up too quickly I get light headed and my vision goes black but it comes back and I feel fine after a few seconds. I m tired all the time, my body aches and I ve been getting nose bleeds, but not the normal kind, It s not a heavy bleed, but when I blow my nose it s all blood in the tissue.",
    "doctor_response": "Hey Courtney, The light headedness is quite commonly seen in people due to a change in blood pressure that occurs from sitting to standing position. This is also called as postural hypotension / Orthostatic hypotension. The only way to control it is not to rush from sitting to standing position. As far as nose bleed is into the picture. It seems that the blood vessels of your nose have been damaged with regular blowing. I would advise lubricating your nose with some oil - olive, coconut. and reduce the frequency of blowing to allow the injury to heal. If still the above issue continue to bother you then you would need to visit an ENT. Hope it works, take care. Dr.Shirish Sachdeva Orthopaedic & Neurological Physical Therapy & Rehabilitation Lifestyle Medicine Counsellor",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is removing Harrington rods painful?\n\nremoving Harrington rods after 20 yrs,my daughter inlaw is having severe pain.What is the procedure, how difficult is it, are there any alternatives to complete removal of the rods, and what are the chances that her pain may not be abated by removal?",
    "doctor_response": "Hello,Harrington Rods will be removed under General anesthesia only.So, one need not to worry about Pain, but after you gain back the Consciousness there will be Pain but not that much severe and it will subside in few weeks.Tell her to take adequate Bed rest after the Procedure.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mohammed Abdullah",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes delay in menstruation other than pregnancy?\n\nhi. i had my last period 2 months ago. all urine home tests say negative. i have now been having stomach cramps over last few days and bad lower back pain. im 44 years old and i have had a blood test for menopause which came back normal. my doctor says it is not menopause. could i be pregnant? my son who is 19 years never should up on home tests",
    "doctor_response": "Hallow Dear,If you have been certified by your Gynaecologist after investigations that you are not having any menopausal changes as yet, you have to rule out the possibility of pregnancy first. Get your urine tested for Pregnancy. If you are not pregnant, you my take Tab. Deviry for 5 days and within 4-7 days after that you will get the menses. If you are pregnant, it can be easily terminated by medicines up to 9 weeks of gestation. These medicines have to be purchased by Obstetrician's prescription. Tab. Mifepristone and Tab. Misoprostol are very effective medicines which can terminate the pregnancy. Hope this helps you.Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there food restrictions post face injury?\n\nhey, this is about my sister. she recently fell off the stairs an have a deep cut on her face. our parents keep saying that she can t eat eggs, seafood, soy sauce, beef and eggs or else the stitched scar will be obvious. is this true? she have no medical history. she s 10 and she s around 5 feet. and she s around 30kg.",
    "doctor_response": "Hi....THERE ARE ABSOLUTELY NO FOOD RESTRICTIONS FOR ANY SORT OF INJURY ANYWHERE IN THE BODY. No scar will be more obvious because of the food intake of any food.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering form fever & cough\n\nMY 5 years old son suffered from fever with cough & cold since Wednesday. I hve change three doctors but no relief from fever. The fever always goes to 100 to 101. The Current advise to me Advent Syrup & Meftol Syrup.All Blood test has normal. Please suggest better medicine for my son. I am worried about for him",
    "doctor_response": "HiIn my opinion your child is suffering from an upper respiratory tract infection.Syp. Advent and meftal are good. Also use a decongestant and antihistamine drug such as Syp. Synarest. Room Humidifier and vapor rub also helps. Do not change your treatment very frequently as any response in this illness will be clear only after 2-3 days of proper medications.For further help, do contact us.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be wrong if suddenly felt lightheaded, extremely nauseous and numbness in tongue?\n\ni suddenly became very lightheaded then extremely nauseous. though i did not vomit, my tongue started to feel numb. what happened to me? i have recently been around people who had a Stomach bug that was going around, but none of them ever mentioned anything about their tongue feeling numb, also i feel fine now so i m not sure i caught what they had.",
    "doctor_response": "Hello, If this was just an episode, you should not be worried much more than necessary. A sudden change in blood pressure, for example, may cause such symptoms. If your symptoms persist, it is a possible infection of the gastrointestinal tract since there are other people affected. In such a case, you should see your Doctor. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is growth of a extra bone in the skull a tumor?\n\nI have a lump on the back of my skull. I had an xray today and it looks like its another bone growing out of the skull. Is this a bone tumor? Or is it possible that is a sebaceous cyst ( I had a couple of pimples that have turned to sebaceous cysts in the past)?",
    "doctor_response": "Hello,It could be an osteoma or other benign (non cancerous) lump. Cancerous tumor is unlikely. Consult a neurosurgeon and get evaluated. You might require a CT scan also.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump with pus in the genital area?\n\nI have a flesh colored lump/bump I guess but it not coming to a head and I can feel a bigger lump under my skin if I squeeze it I put hot compresses on it which made it smaller, does this sound like gential warts or anything else serious, it s not painful or filled wit pus",
    "doctor_response": "HI. Genital warts are above the skin.This can be a lipoma or a sebaceous cyst as the most probable diagnosis. Better to show this to the Surgeon and get it removed for 2 reasons.One : you get the disease out of the bodySecondly the removed lump is subjected to histology examination to know the exact diagnosis/",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can blood infections cause pain during urination with fever?\n\nmy dad is suffering from blood infection as doctors say, last year he had dengu and some blood was supplied to him... since then there was no problem but after 1 year he had a eruption on his nose which took two weeks to settle down during that he had high fevers also.. once the fever was over now he is again having little fever and he has lots of pain while passing urine and stool. his colour is also turning pale. what could be the reason. is it really the symptoms of blood infection???",
    "doctor_response": "Dear Friend.Welcome to HCM. I am Dr Anshul Varshney. I understand your concern.If he is having fever with burning in urine, he might be suffering from Urinary Tract Infection.I would advise you:1. Urine routine and microscopy2. Urine Culture and sensitivity3. Ultrasound KUB.Urine infection can cause infection in blood (Septicemia).This is my personal opinion for you based on available details. If you have any further query please ask me.Stay HealthyDr Anshul Varshney, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the urine culture report indicate?\n\nhello sir my kid age 2 years she was diagnosed as klesibella oxytoca for that they taken urine culture and blood cluture in blood cluture report sgot- 58.1, sgpt- 168, serum sodium- 150 crp serology- 41. is there any complication.she was underwent for medulla blastoma surgery 2 nd time 1 month back",
    "doctor_response": "Hi, welcome to healthcaremagic. The urine culture has grown klebsiella shows that there is a urinary tract infection which may present as fever and pain while passing urine. It is common in children who have undergone some surgery and were put on indwelling catheter for urine drainage. But, not only the culture report is required, we also require the colony counts and the mode of collection of urine to tell exactly whether it is significant or not as a cause of fever and sepsis. Crp is high so it is definite that sepsis is there. Investigating doctors might be trying to find the cause out of which urinary tract infection is one of them.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Suffering from nervousness, unknown fear, loss of concentration and sleep disturbance.\n\nDear doctor, My brother is suffering from nervousness, unknown fear, loss of concentration and no sleep during the whole night. He lost his wife four months ago due to sudden death. We have consulted a psychiatrist and he prescribed some medicines, but no relief yet. Give me suggestions.",
    "doctor_response": "Hi. Your brother is probably suffering from complicated grief reaction or depression. Generally, medicines take some time to have a proper effect. If he has started the medicine in the last one week, then it is better to wait for a few more days.If he has already taken the medicine for more than one week, then there is a possibility that the current medicine is not going to work for him within the current dose ranges. In such a case, we can either increase the dose of medication or change to another medicine which has better potential for your brother.I suggest you provide me the following details: With the above said details, either post a query or book a session for an online therapy for further consultation; so the needful can be done for him. Regarding loss of concentration, it is generally one of the symptoms of depression. So, I hope that with the treatment of depression, it will be corrected.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Liver enzymes found elavated during blood test. Scheduled ultrasound. Should i be concerned?\n\nAt my routine physical I had blood work done and I was asked to come back a second time because my liver enzymes were slightly elevated. They came back elevated again so my doctor scheduled an ultrasound. I didn't hear anything for about two weeks so I figured everything looked normal. I recently got a phone call from the receptionist that my doctor wanted me to come back a third time for more blood work. Should I be concerned?",
    "doctor_response": "hi,yes, you should be concerned, because of many deseases increase liver enzymes, i.e. may be any bacterial, viral, and helminthic infestations, and may be gall bladder manifestations.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy after taking Postinor-2?\n\nI had unprotected sex with my girlfriend around 10pm on  7 may 2016, at about 9am the following day I bought her postinor 2.... And she took the two tablets once...  Then at about 11pm I had unprotected sex with her again, do I need to buy contraceptive again????",
    "doctor_response": "Hello,Thanks for posting your query. When 2 tablets of Postinor are taken, the second one is to be taken exactly 12 hours after the first one. The protection offered varies depending on the time interval of pill intake after the intercourse. The pill effect is shown to remain for 5-7 days in the blood. You need not have to take a second course as there would be enough protection. Please remember that the pill use should be restricted to one or two occasions per year to avoid hormone imbalances. Regular contraception is the better alternative. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Vehicle accident, herniated cervical discs, tingling in arm when urinating. What is it?\n\nHad a vehicle accident which caused 2 herniated cervical discs, torn muscle in right shoulder . I am being treated with physical therapy . Since the accident, I have developed a strange sensation or pain down my left arm when I urinate. It feels like a tingling in the veins and involves my entire left arm. My doctor doesn t kniw what it is",
    "doctor_response": "HeloA latest MRI  scan of the full spine is required to know the extant of injury and current status of intervertebral disc;spacing ;compression on nerves etc. AS a psychatrist I analyse your symptoms as following It is sympathetic representation of right hand injury on to left hand Such a phenomenona is more commonly seen in eyes disease.The details of your accident is not avilable but it occurring during micturition stage may have to do some thing psychologically with your accident ; type of accident; posture in which you were at time of accideny etc.If MRI scan is normal and  Neurologist can not explain symptom on basis of MRI findings and neurological examination please get in touch with a counselor for helpGet well soonDr Lal Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain and bruising in knuckles be treated?\n\nMy right knuckle started hurting without hitting it and I looked down to see a bruise there all of a sudden and as time passed, not only this the bruise and pain spread, but the left knuckle started doing it. My right pinky is starting to tingle as well. Thoughts?",
    "doctor_response": "Hello, It might be due to minor trauma or abrasion that may have gone unnoticed. As of now, you can apply ice packs for symptomatic relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for having large amount of electricity in body?\n\nDr. I have a problem that has been going on for some time now, doctors aren't familiar with and civilians has never experience such at thing. I seem to have a large amount of electricity in my body, I suspect, don't really know...My symptoms are: my cell phone, gps, at times my computer with excessive use, gives me some type of electicity, magnetic, radiation type feeling through my fingers to hand and ear to head. I also make my tv scramble when I'm near..Less use of the items, less pain, more use it literally starts a burning/ going to sleep feeling of numbness..I've tried switching phones, same thing...any suggestions or maybe test that can be ran to determine what's going on with me.",
    "doctor_response": "Hi.Very true- only a few people have this problem , which in your case is more pronounced to the point of troublesome.Yes, some people are more conductive than others. It all depends upon the composition of your body of electrolytes and all.The currents you are feeling are due to the resistance- it is not getting grounded.The simple solution you can try - whenever possible is - try barefoot. This will allow the electric current to to get a ''grounding effect.Secondly discuss this with your Electric Engineer friend , who would understand and can tell you further solution. Let us also know any further solution you get.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and numbness in the face and hands?\n\nMy daughter is 25 weeks pregnant with her first baby and today she experienced tingling/ numbness in her face and hands and now she has a headache and is resting. She is a healthy 30 year old ,eats well and healthy,no red meat or pork . This pregnancy was invetro after a few missed attempts. Could you please inform me what she should do. She has texted her Dr. But has not heard back yet! Thank you, Deborah",
    "doctor_response": "Hi, It happens post delivery due to decreased hemoglobin. Ask her to start iron tablets and also a tab. Methylcobalamin. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Anuj Gupta, Spine Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medication for cold numb and painful fingers\n\neverynight i wake with cold numb painful fingers the tips of 2 fingers are numbish all day my middle finger nuckle is big i fold clothes for 75 boys for last 3 years before that i was a cleaner been and seen chiro i know dirty word but he is family so but to no releif dont have the best diet do drink a little say 3 vodkas 4 times a week do smoke cigarettes its really getting me depressed and tired can you give any help",
    "doctor_response": "HiThanks for using healthcare magicI think, you have underline depression and need low dose antidepressant. That would help to control underline anxiety and depressive symptoms. For pain in fingers, you can take pain killer on sos basis. Better to consult a psychiatrist for proper mental status consultation and further management.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is avocado good for cholesterol?\n\nHello doctor, I am 30 years old and my cholesterol report is showing as LDL 180 mg/dL. My friend says avocado helps in improving HDL and it does not increase LDL, as it has monounsaturated fat. I am confused. Is avocado good for cholesterol?",
    "doctor_response": "Hi, Welcome to icliniq. First, let me tell you some basics of cholesterol. HDL (high-density lipoprotein) is a good cholesterol. The higher the HDL, better the health. Whereas LDL  (low-density lipoprotein) is a bad cholesterol. The lower the LDL, better the health. Avocado, though a high-fat food, reduces LDL and raises HDL. So, it is good for health.  Since your LDL is very high, I would advise you to start medications after consulting a specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fatty liver\n\nI have been detected with Grade 1 Fatty Liver during my whole abdomen Ultra Sound test done two month back. My Lipid Profile is OK and my LFT has SGOT as 39 and SGPT as 97. This test was done one month back. I have been advised Nusam 400 mg twice a day by the doctor which I have been taking for last one month. I have on and off nagging pain on the lower right side of my abdomen under the ribs and it radiates backward sometime. I consulted another doctor who has advised me not to take Nusam 400 but rather take Evion 400 mg. For the last two months I have been doing regular exercise and diet control. I am still not feeling very comfortable. Please advice whether I should change Nusam 400 mg to Evion 400 mg and what can I do for the nagging pain?",
    "doctor_response": "Hello! Thanks for putting your query in HCM. I am a Gastroenterologist. Yes you should change to Cap Evion as it has some role in fatty liver. Also take Tab Udiliv 300mg tds. Continue with exercise and low fat diet. For pain take tablet ultracet sos.Also Fatty liver has many cause like Hepatitis B, C, Metabolic disorders, NAFLD, alcohol intake etc. So I will suggest you to visit a Hepatologist for evaluation who will advise tests and then manage accordinglyI hope I have answered your query and this will help you . Wish you a good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes head pain during a physical activity?\n\nOn Nov 12 2015 I was hit in the back by a car, the hospital said I was okay and I was at work the next day, I m now trying to prove nerve damage, spinal damage, dislocated,my ribs, shoulder blades, vertebrae aren t where they re supposed to, if I open a pickle jar, my spine twist and pain shoots into my head, I ve been referred to a neurologist but don t have health insurance, im afraid of the injury and what it s done to my skeleton, I m looking for a neurologist to prove nerve damage so I can move forward to seek diagnosis and treatment, please help",
    "doctor_response": "Hi, It may be well possible that there has been a spinal damage. However, if you need proof, I am afraid that simply contacting a neurologist, whether on this site or elsewhere is not enough, the diagnosis is confirmed through tests which can't be done online. So I understand your difficult situation regarding health insurance, but it is hard to prove anything without imaging tests like MRI. As for management it consists mainly of physical therapy and medication for neuropathic pain. After so much time it is doubtful that there would be any benefit from a surgical procedure (which again needs a MRI to determine whether there was any indication in the first place). Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for having cut in frenulum during intercourse\n\ni have small cut in frenulum during intercourse associated with very little pain. But due to this trauma, penis does not get stiff and i face erection problems from last 2 years. Even abstaining from sex for 2 months it gets healed but things recur during sex.I use vesceline during sex but due to fear of pain or rip it does not become stiff. Also i have weak tissue getting reddish during sex.I had heavy fixed drug reaction for about 3 months healing time in glans penis about 2 years earlier. Dermatologist says that cut in frenulum and weakness of penis tissue is not because of reaction and the cream he gives for applying does not help.plz propound some medication.VijayIndia",
    "doctor_response": "Hi, According to your complaints, it can be phimosis. If you had unprotected sex then we can think of STI. If you are not circumcised doing it will permanently solve your issue or else you can try local application of steroids. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does anti rabies injection effect stay in the body?\n\nhi, i was bitten by a dog 12hours ago, im wearing a jeans so didn't penetrate that much, i had a 2 scratches on my leg, few minutes it went swell and then hematoma of the 2 sites. i had my antirabies vaccine 10years ago due to exposure to a rabid patient. the dog was vaccinated against rabies. do i need to have a booster or a complete series of vaccination? thanks!",
    "doctor_response": "Hello,If the dog is vaccinated dont worry but since it has been just 12 hours since the bite., i suggest take antirabies post exposure vaccination- Rabipur or verorab.it should be taken on day 0, 3, 7,14, 30th day all in deltoid region.Rabies vaccination effect lasts for 2 - 5 years.Regards, Dr.Riyanka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to wean off cough syrup addiction\n\nHello sir/mam I have take at least 2 bottles drinking everyday cough syrup of corex since from 2yrs,lastly i had take 1 bottle at tomorrow 28th march in the evening .Day by days my life became like a hell.now i want to quit this cough syrup corex???just i need your help to get rid from drinking cough syrup.....I am always obliged your s for this.help me??",
    "doctor_response": "Dear friend,The active ingredients of COREX are chlorpheniramine maleate and codeine phosphate.Codeine is habit forming and has led to millions being addicted in India and Bangladesh, with many reported deaths.. Faced with large scale addiction to codeine containing cough syrups, Bangldesh banned this and brought in death penalty for possession of Corex above 2 litre. Smuggling from India through Tripura border is rampant with regular seizures by police, BSF.Corex has been banned in India from March 2016.Legally, Corex can only be obtained by a physician's prescription, but studies show that more than 90% of the product is sold without one. The majority of the sale of Corex are people of are addicted to it in India. Police in different states has been conducting regular raids, seizures and criminal cases against chemist stores, pharmacies and stockists who keep diverting Corex for sale to addicts.Corex is not generally a fatal drug substitute, unless taken in extremely high quantities. However, many side effects are common. It can cause short term memory loss, sleeplessness, tremors and spasms, muscular pains and dehydration.Long term abuse leads to serious kidney damage or constipation. Corex also has a high sugar content, and may be risky for acute diabetic patients.You must stop using it right away, as it is illegal and dangerous.  While the withdrawal symptoms alone are not typically life-threatening, there\u2019s always a chance that symptoms will get worse. For example, if not treated properly, dehydration can lead to dangerous and sometimes fatal health complications. It\u2019s best to err on the side of caution and find a medical detox program.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Difficulty in eating, drinking, reddish gums. Taking Warfarin. How to get relief?\n\nDear Doctor, Right Now im taking warfarin for the DVT which i have since 5 months. since last 2 months i cant eat and drink i feel sensitive pain and no problem in my teeth . but gums of the mouth all become reddish. could you please give me solution for that how can i get remedy for that and the same time i have to continue warfarin. Regards, KENNEDY",
    "doctor_response": "Hi, I read your problem. According to you problem, warfarin  is an anticoagulant an an has side effect also. Reddish gums, bleeding from gums due to warfarin. don't eat spicy food. use topical anaesthetics that contain benzocaine, lidocaine, tetracaine will help to relief.Use antiseptic mouthwash also. I  would advice you to visit your dentist to identify the problem and treat it accordingly. Have a nice time... take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes skipped heart beat and dizziness with history of anxiety?\n\nHello. I m a 26 year old male in good health. I ve been active for the majority of my life and have lead a relatively healthy life style (minus drinking on the weekends) for most of my life. About a year ago, I was sitting on the couch when all of the sudden I felt my heart skip a beat and I was dizzy for a second. Ever since then I get the same feeling at least once a day, sometime more. I ve also noticed that my pulse will feel stronger at times and I can see it in the center of my throat. I do have a history of anxiety and panic attacks, so I m assuming this is the reason. My biggest concern is that I ve never had these symptoms before. Now I m fixated on it and it seems to happen more and more, especially when I do physical activities and get my heart rate going. I m constantly worried about it. don t have a history of heart disease in my family. Im going to see a GP next week, but I wanted a 2nd opinion. Is this something that I should be worried about?",
    "doctor_response": "Hello, I would like to tell you that predominantly your symptoms are because of anxiety only but to exclude any heart abnormality and to rule out any heart arrhythmia kindly get a basic cardiac evaluation done which includes ecg, echocardiography and Holter (ambulatory ECG) and consult a physician with reports for further management. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid off from fungal infection in pubic area?\n\ni am suffering from fungal infections in my pubic area. i m 16, male. i had been suffering for more than 4 years. each time i visit a doctor, have some medicine and it gets over but after 1 month it comes back again. what should i do to get rid of it for ever? its horribly itching!",
    "doctor_response": "Hello,Welcome to HCM,As you are getting these jock itches frequently you need to practice some self care measures. The fungus are known to reside and develop in wet and moist area.The pubic area is one of the most common sit of fungal infection.As you are getting these infections regularly your doctor has prescribed some topical antifungal cream to apply locally. The antifungal cream like ketaconazole will helps to improve the condition.  In addition to aforementioned treatment I would suggest you to follow1.Keep the area dry and clean2.Oral antifungal drugs once a week for two months.3.Oral antihistamines.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure allergic rhinitis?\n\nI am sneezing continously atleast 8 or 10 times every time i take bath and come... it might also happen after i wakeup... or after facewash sometimes without any specific reason. how to stop it... doctor said it is allergetic rhinosis.. please suggest me precautions and cure for it. Thank you very much",
    "doctor_response": "Hello,Welcome to HCM,As your doctor as diagnosed that you are having Allergic rhinitis for reliving of symptoms you can take Montek LC on consultation with your doctor.This is a safer drug and can be taken for longer period of time.The permanent solution is you need to find out the allergen causing alllergic rhinitis by different test.Once we detect the allergen then it will be easy to manage the patient.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility in men\n\nHi, may I answer your health queries right now ?  Please type your query here... Dear, sir my age is 32 years. i am suffering from infertility problem.i am not able to pregnent my wife.it is about 14 months of our marriage.what shuld i do? thanks. Regards, Rajesh.",
    "doctor_response": "Hi,Welcome to HealthcareMagic . To know exactly what is the cause of your infertility you should get your semen analysis.  And also checkup of your wife. If you have got semen analysis done already you may give the details of it. If your counts are low you may go for IUI. It is intrauterine ingestion of sperms . Here sperms are washed and healthy sperms are placed in uterus . If there are no sperms in your semen then you need to take testicular biopsy . Hope I have answered your query . RegardsDr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for memory loss after an accident\n\nmy mom (age 40) having a minor accident in 25 nov'11 in which she got some memory lose  prblm, still now she is having prblm in recognising faces, and here doctors advised to do not give her food... wt should i do and wr should i go to a neurolgst nearby  jabalpur ...",
    "doctor_response": "Hi, welcome to our site. I am Dr Saumya Mittal, MD.Read your query. That is a very significant question and i appreciate your problem. I will try my best to answer your queryPlease enter a detailed query. The details given here are too short to make a valid suggestion. e.g.Did she have an MRI?What was the report of the MRI?Is she oriented?Is she willing to eat?When were her last electrolytes tested?What were the levels of the last electrolytes?Does she seem to be improving?Is she a diabetic?Is she hypertensive?As for meeting a neurologist, I think you can meet some good neurologists at Indore.I hope this helps you. Inform the reports mentioned above/if any other so I can be of help further. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you.Please do understand that some details could be extracted from a detailed history and examination.Please feel free to ask another query. I would be glad to help you. Looking forward to your return query with the details asked so that I can help you further. (If the answer has helped you, please indicate this)Best of luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is cyst in the mouth dangerous after root canal?\n\nHi. I'm very concerned about my boyfriend. Evidently he had a root canal done poorly over a decade ago when he was young, and now it's caused a cyst on the roof of his mouth. He's getting the root canal redone tomorrow as well as a biopsy, but the doctor says that there is significant bone degradation in the area. I'm scared. Could this be life-threatening?",
    "doctor_response": "Thanks for your query, I have gone through your query.The cyst is not life threatening but it has to be treated properly. Get the root canal treatment done followed by enucleation of the cyst. then send the biopsy to histopathological examination to rule out from other lesions like benign tumors.If there is severe bone loss we can try placing bone like material(graft) after enucleation of the cyst and support the tooth. if there is no possibility of placing the graft and if tooth is mobile then it has to be removed.Consult a good oral maxillofacial surgeon and get it doneI hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe itching on skin on an infant?\n\nI am a new mother my daughter is almost 4 months old and within the last couple months my skin has been itchy all over to the point where i want to scratch it off! My PCP didn t even look at my skin and said it is because of elevated estrogen levels could it be something else?",
    "doctor_response": "HI...it could any sort of allergy or as your PCP told it could be due to the hormones.But...Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for vomit,abdominal pain in a 12 years old child\n\nMy 12 year old daughter has been sick with vomiting and abdominal pain since the end of October. She has had 2 HYDA scans one came back with 0% ejection fraction and the other came back with 79%. She was in server pain during both. Does this mean there still may be issues with the Gallbladder? If so, is there another solution other than removing the gallbladder?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you daughter have symptoms of  vomit,abdominal pain. Well there can be many reasons for symptoms you mention in query like indigestion, IBS, appendicitis , ulcers or UTI. It could be due to underlying systemic condition. Need not to worry. I would suggest you to to eat light and take small and frequent meals , take non spicy food and take ibuprofen or acetaminophen or pain. Consult gastroenterologist for proper examination . Doctor may order ultrasound, endoscopy and stool test to confirm the diagnosis . Doctor may prescribe omeprazole , ornidazole , laxative or anaspas. Doctor may also refer you to urologist for UTI problem. Do not eat food products that can cause gas like dairy products and broccoli . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe pain in abdomen\n\nmy grand-son is 21 has gullstones and has been in and out of emergency , last night they gave morphine but he was in so much pain he cried so was given a stronger dose pain subsided and he was sent home.what can we do? please help hate seeing him in so much pain . I m sorry I don t have any money thank you anyway",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. At some point someone is going to have to treat the gallstones or he is (1) going to have more serious problems and (2) cost the medical institutions even more money. Luckily it is July. Any hospital with a medical school is looking to train their new surgeons in July and would welcome someone with gallstones to practice on. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Matt Wachsman",
    "dialogue_context": ""
  },
  {
    "patient_message": "Would heating pad be effective for stiffness in neck?\n\nI have a very stiff neck,it woke me up from my sleep last night and has persisted all day..I tried using a heating pad thinking maybe i sprained it somehow.But,it is truly painful. I can t lay flat down as the pain shoots thru my neck and right below my neck muscles..2 days ago, i had a terrible pain under my right shoulder blade,that went away after 1 day,but it seems to have weakened my right arm. I cant bend down without my head hurting and i m afraid 2 lay down as the pain in my neck gets more severe.I don t have a fever but, i do have chills on and off. I m afraid, i don t have a car or money for a cab so i would have 2 walk to the hospital which is about 10 blocks away. I feel weak and tired, i have developed some type of trembling in my hands. nothing severe..The neck pain is terrible tho ,it s like having a stiff neck only 100times worse..can u give me any advise?Oh,nevermind i see now that u have to pay for this.I m sorry..",
    "doctor_response": "Hello, I have studied your case. Due to compression of nerve root there is stiffness in your neck.In  cervical spine muscle spasm there may be loss of lordosis. For these symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.I will advise to check your vit B12 and vit D3 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen tonsils and red patches on palate\n\nI have one swollen tonsil that won t seem to reduce in size. It started out sore and it just recently stop feeling that way and yet it s still swollen and I have a red patch on the roof of my mouth towards the front right corner that just appeared after almost 2 weeks of this tonsil being swollen. I m worried it might be an sti, is there a reason why it s like that?",
    "doctor_response": "Hello,Thanks for consulting HCMRead your query , as you have swollen tonsils and rd patches on palate this can be due to throat infection or red patches on palate can be bacterial infection , Erythroleukoplakia , Burn , stomatitis Nicotina palate . I will suggest you to consult oral surgeon for visual examination of oral cavity , inmeanwhile you can do warm saline gargle two - three times a day.  You can take medicine like Azithromycin by consulting with your local doctor .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a red bump on the back of a child?\n\nmy grand daughter has a red bump (one not a rash and it looks like a large pimple) right on her spine near her butt.. the doctor said that is norma with newborns and it will go down and blend in .. It has been two and half weeks now and it looks like it is getting larger. she wil be 3 months next week.. please let me know is this normal like the doctor said?",
    "doctor_response": "Hi, By what you say I feel that it could be a capillary hemangioma and is self-limiting as your doctor said. Skin conditions are best diagnosed only after seeing directly. I suggest you upload photographs of the same on this website, so that I can guide you scientifically. Please revert back to me with images so that I can guide you better. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for AHAD\n\nGood Morning:Let me start off by saying that I have ADHD and I've been taking a combination of Adderall and Vyvanse for a few years now and it has done wonders with improving my focus and concentration at work and at home. I've had the same doctor for the length of time mentioned above; but I feel it's time to change physicians for a bunch of reasons. First off, it's a 2 hour transit time, there and back; so that in itself is a huge burden. Secondly, her office hours are during my work hours; so I always have to take time from work in order to see her. Lastly, she tends to forget things such as what scripts are due on which days: and required details on the scripts like the quantity and her signature. By doing this, I will have to return to her office to get a new script; which costs me time and money that I do not have.Furthermore, I get the feeling like I'm inconveniencing her when I have to contact her about these situations. It wasn't like this in the beginning; which is why I endured the transit times and her office hours. Prior to taking Adderall and Vyvanse, I did try other medications; but nothing worked. I don't want to go through a song and a dance when seeing a new doctor; so I guess my question would be how I should I approach the new doctor about taking Adderall and Vyvanse: and how I should go about screening doctors in my search.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Many researches and researchers confirm that medicines alone cannot cure mental disorders. Life style changes, change in thinking pattern, relaxation etc are as essential as medicines. Psychotherapy can help you changing your lifestyle and thinking patterns. Yoga and meditation help you to streamline your metabolism and neurological balance. Please consult a psychologist for further information. It is also important that you work closely with your psychiatrist. Do trust him fully. If you do not trust the current psychiatrist, find a psychiatrist whom you can trust wholly. That trust makes cure easier and fuller.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any chance of pregnancy?\n\nhi i am 27 years age  now i am planning for baby.yesterday is my 14'th day and my follicle size 18mm and the doctor advise yesterday i take hcg injection at 12 pm aftrernoon.and night i have abdomen pain.i think the egg is ruptured.doctor said 15'th day evening do IUI. is this possible for getting pregenant?",
    "doctor_response": "hello. if you are familiar with your ovulation pains and if you are sure you ovulated you have to undergo IUI within 24 hours. For best results within 24 hours is the best. If you could ask your doctor to change the time of IUI to 15th day morning or at least before 12 noon it is better. hope this helps. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to heal chronic pain?\n\nYES, i have been on 80mg of methadone for the past 10 years for chronic pain. it was used as a long lasting Rx for relife. in the past month my pain clinic has decided to take me off of it by weening me by reducing the daily dose 1/2 a 10mg pill aday for the last 2 months. the reason was i had a extra tic in my last ekg that the clinic does every year. they told me it could cause me problems in the furture, i have already had open heart surgury 2 years ago. has this drug, which i thought met my needs for long acting pain relife, already caused me problems with my heart?",
    "doctor_response": "Here in your explanation few things are not clear:1. For what you are taking pain killer. Which body part have the problem?2. What it means by ekg?Now here assuming ekg is basically you mean electrocardiogram, let me suggest you general way of healing chronic pain1. Do regular exercise with walking or cycling as well for warm up as well for cool down do different stretches.2. You can also joinnyoga therapy.3. Do pranayama regularly.4. Do relaxation therapy or meditation regularly.5. Give proper rest and sleep to body.6. Have healthy and balance food.7. Keep more of omega 3 consumption in diet or supplimnet to have anti inflammatory effect in body.Apart from this if you have issues do use hot and cold pack frequently to have some more pain relief.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest natural remedy to cure thyroid\n\nHello Dr.'s , I find that there's a strange lump on my throat and I think its a thyroid. I went to get check up and my dr. said that it's a thyroid, he said it could be a cyst. I did have my blood tested and will get an ultrasound soon. Is there a natural way to reduce my thyroid lump ?",
    "doctor_response": "Hai,I advise you to go for a ultrasound  and blood test for your neck to rule out any mass or abnormality in your  thyroid function.there is no natural remedy to cure thyroid lump.initially we have to rule out whats wrong going in thyroid gland and depending upon that we need to decide whether to treat it or not.thank youhope answered your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause pain in the armpits?\n\nWhat would cause pain in the armpits? Doesn t seem to be any swelling. I also often have pain high on the left side of my chest, not my heart, sometimes pain on the left side of my neck, again no swelling that I can tell. On days when the chest pain is worse I usually have a headache on the left side. Normal EKG in November, normal mammogram.",
    "doctor_response": "Hi,There are many causes for armpit pain. But if there is no swelling or no history of any injury along with pain at side of neck then it indicates towards a pulled pectoral muscle. You may have strained your pectorals while lifting some thing or doing any hing for extended period of time with out stretched arm. So I will suggest you to apply hot pack and use any pain relieving gel or spray, and do minimal activity. Do take special care while traveling, it may get aggravated. And do thing with close to your body don't over stretch yourself. Follow for 2 weeks as your pain gets relieved do get back to us for a graded exercise regime that will make your muscles strong. Do eat proteins, calcium and vitamin C rich diet and these will help in early healing.  Hope you find the answer useful. Let me know if I can assist you further.Regards,Dr. Harsh Swarup",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could +2 protein in urine cause kidney damage?\n\nMy 8 year old son has had protein in his urine for 6 weeks now. We have an appointment next week with paediatrician. He also has insomnia and is constantly eating but he is losing weight. The GP checked his urine and the protein was +2 and the specificgravity was 1.030. He suffered multiple recurrences of Henoch Schonlein Purpura 2 years ago. Could this be a sign of kidney damage??",
    "doctor_response": "i read your question and understand your concernaccording to your child history and reports there is possibility of kidney damage as there is a strong relation between HSP and kidney diseaseso i would suggest to take early appointment with your child doctor to get his proper checkup USG and other blood test and to get treatment accordinglyMay your son GET WELL SOONI hope my answer will satisfy yougood luck & tc",
    "dialogue_context": ""
  },
  {
    "patient_message": "What lead to lump formation under the bruise on calf?\n\nAbout a month ago, I developed a large bruise on my calf that had a hard lump underneath. It went away, but it am now developing a similar bruise/lump in the same spot. What might be causing this and should I see a doctor. The only medication I am currently on is birth control.",
    "doctor_response": "Hi, thanks for sharing your health concerns with HCM!   If I were your treating Doctor for this case of recurrent calf bruises / lumps, I would come up with two possibilities, these include: 1.\u00a0\u00a0\u00a0\u00a0\u00a0thrombosed veins with pressure hemorrhage in the overlying skin as birth control pills are known to cause this condition!2.\u00a0\u00a0\u00a0\u00a0\u00a0The second possibility is of varicose veins or colloid cyst or lymphatic cysts or a hematoma! I suggest you to go for a USG Doppler study of the region for confirmation and to urgently consult your physician or gynecologist!Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat extended penile outer skin?\n\nhi my penis outer skin covers completely and makes my penis to bend down. What could be reason. I can only pull the outer skin back when my penis is small (not errected) once errected the outer skin becomes tight and it pains a lot. Also it makes my penis bend down. Pls suggest.",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have what is called as Phimosis.The bending of the penis down on erection could be due to band of adhesion between glans penis and frenulum.This can be confirmed only on clinical examination by a qualified General Surgeon or Urologist .You need to get circumcised .This is a simple surgery done under local anaesthesia as a out patient procedure and offers permanent cure.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe back pain and stomach bloating\n\nI have a prolapsed bladder apparently affecting both bladder and bowel it is causing me a hard time to empty my bladder. My stomache swells and I get back pain. I know it is not an emergency but but what should I do to help with the soreness how long should I wait to be able to see a specialist",
    "doctor_response": "Dear friend,I am sorry to know that you are facing problem with urination and bowel movement because of prolapse of bladder.with the help of my clinical knowledge I am telling you as your normal lifestyle is getting hampered because of this,it is time to go for your surgeon for consultation.because to solve the prolapsed bladder problem you should undergo some clinical and radiological investigation .I sincerely hope under the guidance of your surgeon you will be screened throughly for the prolapsed  bowel condition .my best wishes for your health in coming days.thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Imbalance, sickness. Had laryngitis, bronchitis, asthma, What may be wrong?\n\nHello, I have noticed in this past year that I am unsteady on my feet when I turn my body, like being unbalanced. In November 2012, I had a laryngitis , then a bronchitis that triggered asthma which is still going on to this day, although not as bad. I will be having a pulmonary testing at the hospital on Wednesday. My symptoms of unsteadiness has intensified, I am feeling continuously nauseated. It feels as if my eyes are connected to my stomach. Turning my head, bending my head or getting up from sitting or lying down makes me feel sick. I have been doing the Dix-Hallpike maneuvre since this past Thursday and wore a soft collar for 48 hours. However, I still feel nauseated. Is there something else that needs to be looked at? Thank you in advance for your help. Linda G. YYYY@YYYY",
    "doctor_response": "Your history suggests that you are allergic to mostlikely wheat or alternately to milk get blood serum tested for milk and wheatspecific antibodies you will get answer all your symptomps are related to food alleregies",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is flying allowed with a low lying placental position in a pregnancy?\n\nHi,         I am 24 weeks pregnant. My placenta is posterior, lowlying, lower margin, 3.5 cm from internal os, grade 1 maturity. I want to go to bangalore and its 1 hour by flight. Can I take the journey and also how is the placental position. Is it ok.",
    "doctor_response": "Hello dear,I understand your concern. In my opinion  the placental position appears normal as per your information.The placenta is said to be low lying when it is present 2.5 cm from internal os.As it is 3.5 cm it cannot be considered as low lying.So relax.Yes you can travel by flight.And air journey is always better than rail or road ways.So you can go on.Take adequate fluids upto 3 litres per day to prevent urinary tract infection (UTI).Hope this helps.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does Clomid or Prolifen not help in conceiving ?\n\nhi  i m sadaf....i m trying to conceive from seven years...i got married in 2007 still waiting for baby.. dr said your all reports are clear....i have been used clomid for three months but not conceiving...then i leave all medicines from 1 year. now Dr suggest me prolifen. i m using prolifen from last three months. 1 capsule of prolifen 50mgin first month from 2nd day of period to 6th day. 2nd month 2 capsules of prolifen used & noe third month i m using 3 capsukles of prolifen, how many months i m using this medicine???",
    "doctor_response": "Hi,I read your query and I understand your concerns.Following is my reply:1) Using these tabets is not the only way to confirmed pregnancy.2) Please get semen analysis of your husband.3) Get follicular scan done regularlyLet me know if you have anymore questions.Regards,Dr. Mahesh Koregol",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do high GGT, AST, ALP, MCV readings mean for DVLA medical?\n\ni have to do a dvla medical to get my driving licence back i had liver test done by gp and all readdings ggt ast alp mcv were double or slitly more my gp said i had slight to moderate damage i have not had a drink since, nearly 2 mnths now will i pass med or how long should i stop for before taking test regards.",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. High GGT along with elevated ALP and AST indicates alcohol liver disease. 2. GGT is very specific to alcohol induced injury.3. High MCV indicates Vit B12 or folic acid deficiency, usually secondary to alcohol related malnutrition. Vit B-complex supplements is essential.4. For tests to get back to normal, it would take around 4-6 months. Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can any online doctor help me with the results of MRI?\n\nHi~ I am a school nurse and looking at MRI results for a student The results state that there are a few scattered punctate white matter hyperintensities in both cerebral hemispheres. Significance uncertain but consideration include gliosis, punctate foci of demyelination or punctate old ischemic change. Can this affect his learning?",
    "doctor_response": "Hi,Thank you for posting your query.I have noted the mRI abnormalities of your student.I would like to reassure you that these abnormalities are minor and would not adversely affect the student's learning.These findings are common in people with migraine and are not significant.The decision to use any medications would depend upon the patient's symptoms.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat for the pain in chest and spine caused by a hit?\n\nI was playing football Saturday and was hit in the ribs and upper body Sunday I played football without equipment on and a player hit me dead square and center in my chest now my chest and spine have been having pain and I can't sleep at night because it hurts so much",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. There is a possibility of rib fracture. You need to get examined by a doctor. X-ray of chest and thoracic spine is required. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can having injured neck and back hinder pregnancy?\n\nhi my name is Tosha i am 18 i had a very bad car wreck almost 2 years ago it broke my back in 2places and my neck.recently got married and i have ben trying to get pregant for almost 6months  and not haveng any luck.could this have something to do with my wreck",
    "doctor_response": "hello mrs tosha...i guess ur concern is whether tat accident is hindering u from becoming not pregnant....i got it..well dear my straight forward anzwer is -NO ...NOT AT ALL.....lets discuss pregnancy part n accident part one by one....pregnancy..well dear try to focus on term ' FERTILE PERIOD',it starts from 10th -16day of menses cycle..here ovulation occurs...so ovum meets sperm n women bcoms pregnant....so tatz y it  is called fertile period...so  having more episodes of sex during tis golden period chances of pregnancy will be doubled...but u havent shared info about ur menses.....whether its happening regularly or not????if not dont worry ....every problem has a sloution in tis 21st century...now accident thing...u told u got operated at 2 places of ur back n neck region...usually wen women becom pregnant baby grows in the womb of mother...wen baby starts growing slowly the belly of mother swells forward n to withstand the weight of baby mother's spine bends......its called lordosis......tis natures natural process.....but in ur case as u have been operated at back region...juz to have a safe pregnancy consult ur doctor who operated on u to know the pro n cos of become pregnant on spine and discuss about lordosis(juz to throw light on wat ur trying to convey to surgeon)well with tis small discussion try out my suggestions:-1.try to visit ur surgeon who operated on u....or u can also visit a nearby neurosurgeon to discuss tis n get green signal..2.try to do more episodes of sex in fertile period(scientific reazn told abv)for next 4-5 months..by tis hopefully u get results...3.visit nearby gynaecologist if u dont get results in 5 months or if have problems related to menses..i hope tis was informative enough,helpful n useful fr ur query..regards:dr.sudha rani panagar(recently got married,,trying to conceive..not succesfull...so tensionfull mind....u in past u had accident...so that has doubled ur tension...i can understand ur pshycology....i pray god u get blessed with baby as fast as possibel hopefully,TWINS!!!!!!)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chicken pox infection in a child\n\nHI, MY NAME IS JACKIE - I WASJUST INFORMED BY MY DAUGHTER-IN-LAW THAT HER 3 YEAR OLD (MY DRANDDAUGHTER) HAS THE CHICKEN POX. I REALLY DO NOT REMEMBER IF MY SON HAD IT. I DO NOT BELIEVE HE DID. IS THERE ANY KIND OF BLOOD TEST THAT WILL HELP TO KNOW IF HE HAD It? OR WHAT ARE YOUR GUGGESTIONS. LOVING MOM & GRANDMOTHER - JACKIE",
    "doctor_response": "Hi...you can test for chickenpox antibodies as once it comes the resistance power stays for life. The other option is to vaccinate all the people who come in to contact with the baby (Index case) with in 72 hours so that the spread may be curtailed.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could nerve pain be a result of taking nerve block after undergoing THR surgery?\n\nNerve block !I recently had THR surgery and am currently recovering.  Prior to my surgery I was given a nerve block to help my back condition and leg pain. It has now been a month since, and I am having horrible nerve pain. Could a bad nerve block have caused so much lower leg pain?",
    "doctor_response": "Hi,A nerve block would not be the cause of this nerve pain. I suggest you need thorough investigation for this new pain so prompt treatment may be started. It could be related to disc problems in your back or possibly related to your hip surgery. However, it would be impossible to offer a diagnosis without examination and scans.Regards,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rashes on  the body at night?\n\nHi Doc,Past week I had sudden rashes at thigh, buttocks, waistlines, back of elbow and sometimes shoulder; that comes out at night, especially after waking up from a sleep, but gone by day and coming at an alarming cycle. Sometimes itchy, mostly not until I touched it.",
    "doctor_response": "\"Hi!Welcome to Healthcaremagic. com.I have read your query in detail and do understand your concern. You seem to be suffering from urticaria. It appears in form of sudden wheals and then settles down without leaving a mark.If you find any causative factors- any dietary substance, dust, exertion, etc, try to avoid it. Usually  long term-low dose treatment is required required in form of antihistamines Apply\u00a0calamine\u00a0lotion over affected areas.Investigations in urticaria are more often than not, non contributory. It is very difficult to narrow down to one or more causative factors.Hope this helps!Good luck!\"",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can stem cell therapy cure knee pain post replacement?\n\nI ve already had my right knee replaced, am doing well now for that knee, but it took so long to recuperate. My left knee is really giving me much pain (bone on bone on inside of knee, but outside of knee looks good). I truly dread having another knee replacement! Can Stem Cell Therapy work for me, so I don t have to have a knee replacement. If Stem Cell Therapy works for me, will my knee be normal again, so I won t have to have surgery. Thank you, Margaret C. (I live in Charlotte, N. C.)",
    "doctor_response": "Hello, Stem cell therapy can help in repairing the damaged cartilage and can delay the need of knee replacement. It will not help after the knee replacement is done. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes palpitations every morning?\n\nI wake up with palpitations every morning, and they often occur when I've eaten.  My blood pressure is on the low side.  Could the two be related or have you suggestions to stop waking up like this please?  This has been going on for months.  I'm female, 42, and in good health otherwise.",
    "doctor_response": "Hello,Is there any anxiety, stress? If yes use some relaxation techniques like yoga and deep breathing exercises. Do you have any bloating, burping, upper abdominal pain, nausea, if yes this suggests acidity problem. You should get one hemoglobin and thyroid tested. You can get Tablet Ciplar LA prescribed from your local doctor. Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back pain after having neck surgery?\n\nI had neck surgery about 1 year ago, and soon after the surgery I began to experience lower back pain.  Ever since the surgery I am continuing to experience back pain and it seems to be getting worse. I am getting pain in my legs and it is starting to effect my duties at work.  Do yo have any advice that might help me?  Thank you.",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.After going through your query I came to know that you are suffering from chronic backache.It is unlikely to be related to your neck surgery. It may be due to vitamin and trace element deficiencies specially vitamin D and vitamin B 12.You can get vitamin D and vitamin B12 levels and if found low you can take its suppliments of vitamin B12 and D3.You need to done MRI to rule out other causes. Back exercises, neurotropics such as mecobalamine and analgesics such as Ibuprofen give relief. Avoid long continuous standing.You can discuss with your treating Doctor about it.Hope your query get answered.If you have any clarification then please don't hesitate to write to us. I will be happy to help you. Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does semen count 80 million opaque grey suggest?\n\nin my semen anlysis test  totl count 80 million color opaque grey rton  alkaline viscosity  abnormal liqufication time 2 hour progressive 50% nonprogressive 20%   non motile 30% morphology nml 80% morphology abnormal 20% this is my report any  problems",
    "doctor_response": "HelloYour findings suggests increased liquefaction time,it may be due toinfection.It is important to know about presence of pus cells etc in semen.You may need further assessment for increased liquefaction time.Rest of the findings are normal.Normally sperm count should be at least 20 millions/ml.Your finding suggests 80 millions/ml,so it is normal.Normally sperm motility should be at least 55 %.Your findings suggest overall 70 % motility,so it is also normal.Sperms with normal morphology is also normal.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest natural ways to control CKD\n\nI am a 50 yrs old male suffering from HTN/CKD. Taking B.P. drug for last 7 yrs. and diagnosed as CKD patient since two and a half years. currently my Hgb is 12.8 gm/dl. , Creatinine is 1.91 mg/dl. serum urea is 41 mg/dl. Albumin in urine is present at 10 mg/dl. and R.B.C. present stray.All the other parameters are normal. Previously doctor had advised to restricted diet only. Now should i consult the doctor for the albumin and R.B.C. abnormality or should i follow his advice of nutritive diet strictly and then only consult him? Please also tell me the natural ways of controlling this without drug.",
    "doctor_response": "Hello and thank you for your question. There are several things you can do to prevent the progression of the chronic kidney disease. The most important is to make sure that your blood pressure is always controlled. You should restrict salt and protein in your diet. It is very important to avoid anti-inflammatory medications and alcohol as they care worsen kidney disease. There are also medications such as ACE-inhibitors that can also protect the kidneys. Please see a doctor to make sure you get the best care possible to protect your kidney function.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the effects of having high cholesterol and triglyceride levels?\n\nHi Doctor, I am 35 years old, Male. I generally just got my LIPID profile done. The results are: Cholestrol : 209 Triglyceride: 246 HDL: 126 LDL: 56.8 VLDL: 26.2 Cholestrol /HDL ratio: 3.68 As per the report my Total Cholestrol and Triglyceride level looks high. Can you please help intrerpret the report for me and advise if there is any cause of worry for me? Thanks",
    "doctor_response": "Welcome and thank you for asking on HCM!I have gone through you question carefully. If the report values arecorrect .. you have a very high HDL ... that's really protective. In summary .. you need not worry . Continue to be physically active .. that would suffice .Hope you will find this answer helpful!Wishing all the best, Dr. D Sunil Reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes azoospermia?\n\nhi , my name is muller I live in Florida .My wife and I ve been trying to have a baby for long time . We ve been together for 6 years .I went to a specialist , he did a sperm test for me , when the result came out , he told me that there is no ( sels ) in my sperm . Can you tell me what can cause that , please .",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I think you may be having azoospermia. Testes are not working. Consult the surgeon. Proper investigations may be done to find out the cause. And accordingly the treatment may be given. Hope I have answered your query. Let me know if I can assist you further. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure pain in shoulder joints,elbow and right knee?\n\nHi.I am a 48-year old woman. For the past one year I have been having pain in my shoulder joints and elbow and right knee. X-ray of the knee showed mild degeneration of the disc but my shoulder x-rays showed nothing. Lately I am having pain in my right elbow too. I have taken numerous pain killers and medicines prescribed by doctors, tried homeopathy, yoga, etc without any improvement in the pain. I heard about Amway and would like to try this. Is this advisable? What do you recommend?",
    "doctor_response": "Hello, It may age-related arthritis lead to pain in the joints. It may be a muscular origin. Use physiotherapy and yoga may useful. use tablet.artilage twice a day for one week. If symptoms not improved please consult with your doctor he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Penchila Prasad Kandikattu",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back ache?\n\nI started having a pain back in January after climbing stairs while carrying a book bag.  The pain occurred upon sitting.  It was a weird pressure that begin at the base of the back of my head and then traveled down my spinal column and into my hips.  When it started it felt like pressure, but a minute or so later it had built into a strong severe pressing pain.  It occurs off and on (not every time I climb stairs, not always when lifting something) and it happened again this morning right after I sat down in the car.",
    "doctor_response": "Hello, Thanks for your query.It seems that your wrong body posture; inadequate exercise and reduced muscle tone is taking a toll on your back. For pain to go, it takes not only rest (on a comfortable bed) but also avoidance of particular positions (during work, rest or recreation).During the day don't sit in one position for more than an hour and take frequent stretch breaks. Do not bend forward to lift things up, bend the knees and hips for that. Also discontinue any strenuous activity or exercises for some time.I suggest you to try back strengthening exercises by extension of the back muscles which can be taught by your Physiotherapist. This will help to relieve the possible muscle spasm which causes the painI do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly guide me to find the reason for my allergy.\n\nHello doctor, I am an allergic patient from last few years, every alternate day I use to take Cetirizine pil, if I fail to take the same I feel breathing shortness, headache, itching, irritation, smooth, cold, swelling on face and head, and final up to fever. Once I reach to fever label, then Cetirizine does not work then I will have to approach a doctor for antibiotics. After taking Cetirizine pil, I feel sleepy and lazy, and even I measured low BP. I have consulted with many doctors, but everyone says to identify the reason (food) when you feel allergic. But I am failed to identify the same in the last few years. Tired with medicine and health to looking for permanent solutions. Need your guidance.",
    "doctor_response": "Hello. According to the information given by you, it looks like an allergic reaction to some item. What your doctor said was right you need to find the food item causing this reaction. Mostly foods like mustard, crab, seafood, can cause this. You can also consult an allergy specialist and undergo an allergy test. Fever is a sign that your body is fighting against something in your body in allergy antibiotic will not work. A routine blood test will also require to be done. There are many newer drugs for allergy other than Cetirizine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in legs when suffering from pulmonary hypertension?\n\nMy husband has pulmonary hypertension.  His legs and trunk of body are swollen every day.  His pulmonary pressure is 60 according to his cardiologist after a catheterization 3 weeks ago,  when he walks, he gets short of breath and has to stop.  What can be done for him.  He does take a diuretic and other medications for the hypertension.  However, the swelling and shortness of breadth to not go away.",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. If he still has edemas, the dose of diuretics should be increased. He should restrict the amount of fluids and salt intake. Other medications or procedures depends greatly on the cause of his pulmonary hypertension. Discuss it with your doctor if there is any other procedure that can be done to relieve his condition.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Lilit Baghdasaryan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated testosterone levels?\n\nI have very thick blood and have had three blood draws of a pint over the last 8 weeks. I take a testosterone supplement , the test that they do gives a reading of 18.5 which is high I have little understanding of the cause and the effects. Do you have any ideas about this.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As you are taking testosterone tablets, that itself might be the cause for it to be high. In the meantime, can I ask you why you are taking testosterone? Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Having endometriosis. Can I use Vitex with Duphaston to conceive ?\n\nHi doctor,I have endometriosis, so my doctor placed me on Duphaston 10 mg, once a day. But, I am not ovulating, and I am trying to conceive. Can I use Vitex 20 mg together with it?",
    "doctor_response": "Hi. How are you doing? May I start by telling you few basic facts of endometriosis. Every month, when a lady has periods, most of the blood goes out through the cervix, but a small fraction goes into the abdomen through the tubes. This blood settles on and around the ovaries and uterus. This blood gradually forms a lot of adhesions and causes the symptoms of pain during periods and sex, when the adhesions get pulled. This is a progressive condition, and every month this pain and adhesions keep increasing. Now you can imagine what is the solution, stop periods. For you the best method is pregnancy. You will have 10 months of no periods and later no periods till you stop breastfeeding. Tablet Duphaston is hormone Progesterone, which is the same hormone produced by the ovaries during the second half of periods. This will keep the inner lining of the uterus thin, and as it is taken continuously, it will stop the hormonal ups and downs needed for ovulation. That is the reason you are not ovulating. This is suitable when you are not waiting to get pregnant. I am not sure how helpful tablet Vitex would be. May I suggest that you stop Duphaston, and you will have periods of few days. Just go through the following investigations to find if any problems are there: In endometriosis, the tube can get blocked, and no matter how good the egg and sperm are, they may not meet at all. Once all tests are done, have ovulation induction under a doctor's supervision. Do not delay pregnancy using small methods. Your endometriosis will be progressing every month. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is shivering chest like inside tremors while having PVCs normal?\n\nThe palpitations I experience was diagnosed as PVC s & told it d nothing to worry about. That was a few months ago. My symptoms are at times very distracting & uncomfortable, it actually feels like my chest is shivering (not cold), like inside tremors. Is this normal?",
    "doctor_response": "Thanks for your question on HCM.In my opinion youneed to get done ECG again. As PVC (Premature Ventricular Contraction) can lead to arrhythmia sometimes. If ECG is normal than go for holter monitoring. Holter monitoring is 24 hour continuous recording of ECG. So we can easily picked the rhythm abnormality. If this is also normal than no need to worry about cardiac cause.You should get done CBC and TSH Level to rule out anemia and thyroid problems as they may also cause similar symptoms. If all these are normal than your symptoms are mostly due to anxiety. So better to consult psychiatrist and start treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for COPD?\n\nI am on bi-pap 18/14 with a ramp setting of 5 for 45 minutes, I have the humidifier at the lowest setting, over the past 6 weeks I have been on steroids and 3 different antibiotics. When I use the bi-pap after 2 hours start coughing, sort of a barking sound that won t stop until I turn off the bi-pap machine. I am concerned with compliance issues, I have contacted the hotline for bi-pap and my pulmonary doctor with no answers. I tried the machine again around 11 p.m. and to turn it off, I had not used the machine for the past 3 days and had no coughing attacks. I have COPD, I also use Flonase with no relief please any suggestions",
    "doctor_response": "Hello dear, thanks for your question on HCM. Since you are having barking type of coughing only with BiPAP use, in my opinion you are having problem in tubing of the BiPAP machine.After long time use, tubing s of BiPAP machine tend to develop Humidification,  serrations,  excoriations, colonisation of the bacteria etc.You are improved and not coughing,  since you have stopped BiPAP. So possibility of above mentioned things is high.So better to change the tubing and start using new tubings.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have gained weight and I have high cortisol level. Do I have Cushing's syndrome?\n\nHi doctor, I am suffering with hypothyroidism and polycystic ovaries. Over last three years, I have gained 15 kg of weight. I am taking T4 150 mg, Glucophage 850 mg and Yasmin. I think I have Cushing's syndrome. My cortisol level in blood is 34 in the morning but in 24 hour urine test it is in normal level. Also my ACTH is 63.4 whereas the upper limit is 64. I am eating healthy diet and I exercise every day. Over three years now, but I cannot find a solution for this problem. I visited an endocrinologist and also a dietitian but of no use. I also have acne. If I do not take birth control pills then I will not get my periods. I am very tired all day and I even feel very difficult to move. I have anxiety too. Please help.",
    "doctor_response": "Hi. There may be three possibilities. Either your polycystic ovarian syndrome and hypothyroidism are two separate disorders or it may be a pituitary or autoimmune disease which affects many organs. If any problem in the above tests then pituitary is affected and the treatment differs. Revert back with the test reports to an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My voice is like a girl. What is the remedy?\n\nHi doctor, I am a 21 year old male. My voice is like a girl. But hair growth pattern in my body is like a guy only. What is the remedy?",
    "doctor_response": "Hello. Beard, mustaches, pubic and axillary hair are named as the secondary sexual characters. If your secondary sexual characters are properly developed you need not have to worry. Your voice sounding like a girl can be corrected. This can be corrected throughspeech therapy and voice training. Consult a sexologist online for further help -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i continue folic acid tablets if trying to get pregnant?\n\nhi iam 23 yrs old. hi had miscarriage due to ecoptic pregancy and trying to conceive and my doctor suggest me to take metaformin hydrochloride and folic acid tablet .iam taking past three months but iam not conceive yet .did i want to continue the tablet or not please suggest me......",
    "doctor_response": "Hello, continue the medicine. Metformin is given for diabetes and it can also be used for reducing weight if you are overweight and thus helps in conceiving. Folic acid reduces chances of neural tube defects in the baby and is important for normal development o brain and spinal cord. So continue medication. If you are not conceiving you can join some weight reduction programmes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from Guttache psoriasis, using cream, no relief. Does taking protein shake is the cause?\n\nhi stephen i am wanting some advice on how to treat guttache psoriasis ,my 20 year old son has had it now for three months and is using prescribed creams that have failed to work and the condition is getting worse. he is into fitness and works out all the time taking protine shakes to build muscle could this cause his condition?",
    "doctor_response": "Hi, Protein shakes do not cause or exacerbate guttate psoriasis. If its guttate psoriasis, a course of oral antibiotic erythromycin along with application of steroid creams and emollients will help. If these do not help much, discuss with your dermatologist the option of starting your son on methotrexate for better control of disease. Hope that helps! Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How should a forehead cyst with scarring, irritation and bleeding be treated?\n\nI have what i think is a cyst on my forehead. I got into a fight and was hit in the head and since that happened there has been a bump of my head. Doctors have told me its a cyst but i have also heard its built up scar tissue... The bump goes from being soft back to being hard im guessing when its irraitated. Do you think this is a cyst? Ive tried poking it with a probe but all that comes out is blood.",
    "doctor_response": "Provisional Impression-Right Leg Cramps /Under InvestigationHi,Welcome with your query to HCM virtual Clinic.I reviewed all the details of your query,in context of the of the forehead lump and its progress.Based on the facts of your query,You seem to have resolved hematoma with fibroma at the forehead hit.If it was a cyst as told by your doctors,cystic fluid should have come after your poking,but as you confirm in you query that blood came out after poking with a probe.This reduces the possibility of this forehead lump being a Dermoid or Inclusion Cyst /or Sebaceous Cyst of the forehead.To resolve this ambiguity in its causes-USG of the lump and FNAC Biopsy with HPR report,would fix the nature of this forehead lump.CT study to find out any intra-cranical connection with any other lump or cyst there and Second Opinion from a Surgeon and if need be from your NeuroSurgeon would resolve the diagnostic worries for you.Treatment- Would depend on the cause confirmation by a team work of your doctors as explained above.Your Surgeon would be the right doctor to work out the cause as told above and would plan a best possible  treatment accordingly,after confirmation of the forehead lump.Excision Biopsy of the Lump with HPR study would resolve all the issues related with this forehead lump.Hope this reply would help you to plan treatment with your doctors and resolve your worries.Will appreciate writing excellent review comments to help the needy patient visitors like you at HCM.Welcome any further query and information in this regard.Good Day!!Dr.Savaskar M.N.M.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of candida?\n\nDear Doctor Please help.My age is 53 yrs. I have been suffering from Candida for the last 6-7 yrs. After infection l suffered with gas, bloating, loose motion, white coating and rash on my penis. Infection & itching on my nose joint and underarms. All still exist.l had also been taking Alcohol for 25 years which resulted in Fatty Liver. I was prescribed         Viboliv 500 mg, Heptral & Digestal. My last blood report of Liver Profile states everything to be normal but Ultrasound still shows fatty liver though reduced. Presently my condition is very bad because of Candida. I am suffering from constipation, loss of appetite,  chronic fatigue,  anxiety,  depression, insomnia , joint pain & my face has turned thin and sunken and looking very old and wrinkled. About 2 yrs back I was prescribed Fluconazol once a week for 4 months.  Later I have been prescribed Itrconazole which I have avoided because of my weak liver.Sir Please help in any way you can and guide me get rid of CANDIDA. M",
    "doctor_response": "Thanks for your query at HCM!I am Infectious Disease Specialist! I went through your query!Had you had unsafe intercourse in past. I suggest get an HIV test done.You can apply topical steroid+antifungal cream on lesion and oral anti-fungal.If you do not respond you can get culture/sensitivity at specialized centers for yeast infection. do treatment accordingly.What is blood sugar level?You also need to consult a psychiatrist.Happy to take more queries! You can also write a review for me. If you would like some more information, I will be happy to provide.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest opinion to conceive as i have bulky right ovary\n\nhi i just had transvaginal scan which shoved bulky right ovary with measurments 41x24x21 containig small immature follicles and a functional folicle /CL 25mm diameter .No free fluid ,cysts or adnexal masses were seen .Myself and my partner are trying to have a baby without success .My periods are irregular",
    "doctor_response": "Hi, I think you are having pcod. In this there are problems with ovulation.  So, periods are irregular.  You need to take some medicines like clomiphene 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.  Discuss with your doctor regarding this.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat hair loss?\n\nhi there,am dan and would like to know the best product to stop my hairloss and to regrow my lost hair.my family has a history of hair loss and i would like to stop mine.i have heard about products like minoxin, rogaine and loniten. i have also heard that some products will make my hair to fall first before they start working. which product is the best? how long should it be used and after how long does one start seeing results.",
    "doctor_response": "My DearWelcome to Healthcaremagic!I have noted your details and related concerns. My view is that: 1 You seem to be referring to Male Pattern Baldness which has a hereditary basis and that initially affects the frontal and crown areas before spreading to other scalp areas.2 had you not been suffering from hair loss already, I would have advised to wait since not all male members of a family actually face the problem.3 In a case like yours, Monoxidil 5% seems best option. It has to be applied twice a day in a dose of 1 ml or 15 drops each time to dry hairs of affected areas.4 This drug is effective as long as you continue with treatment,5 Minoxidil might show a lag period of up to 4 months or so before you notice any improvement6I would also advise you to refrain from using Finasteride at this stage especially if you are younger than 40 yrs or so.Most of my patients respond to this regime so well that I rarely have to resort to other treatments.Patience and regularity are the key to good results.Best wishes for your recovery!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for constipation\n\nmy baby is 5 weeks old. he has these spells where he acts like he needs to have a bowel movement - he stiffens up, works really hard, grunts, gets red in the face, and sometimes ends up crying. but most of the time nothing happens - he doesn t even have a bowel movement (when he does actually have a bowel movement, he doesn t even have to work like that... it just comes). he s obviously in some sort of discomfort when it happens, and those spells are quite frequent. what could it be?",
    "doctor_response": "Hi, Most probably what you described so well is the passage of gas through the intestines. Also called colic pain. It's quite normal to pass gas ten to twelve times a day, however, all children have a different pain threshold, and react accordingly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Cajetan, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can painful mouth ulcers be treated?\n\nI have had canker sores occasionally since I was a teenager, all of a sudden, I now have at least 6.  They are very painful.   I can't eat or even talk without excruciating pain.  I have a dr. Appointment on Tuesday.  Is there anything I can do to reduce the pain in the meantime?",
    "doctor_response": "Hi..Thanks for the query.From your explanation it seems that you are suffering from a severe case of Apthous ULcers or Canker Sores .It can occur due to a number of common causes like of iron and vitamin B12, stress, physical trauma to the tongue, allergies, acid reflux etc..If the pain is severe you cantake anti inflammatory painkiller like Ibuprofen.I would also suggest you to start gargling with warm saline solution.Gargle with a numbing mouthwash containing Lignocaine, specialised mouthwash like Magic Mouthwash is very useful if available in your area...Take a Vitamin B complex and lysine supplenet daily for atleast 15 days..Avoid spicy and hard foods..Take a soft and bland diet..You can also suck ice and do cool water rinses..In case of no improvement consult an Oral Physician and get evaluated..Hope this  helps..Regards.Dr.Honey  Arora.Dentist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high blood pressure\n\nHi Doctor, I am 27 Years working professional. About 1 year back i was digonsis with High BP - 142/92 and after blood routin examination it was found that my cholestole level (speacially - S. Trichlorides 250) gone up. since one year back i never underwent through any medicine. But since last 2 month when i didn t find any improvement in BP and it was going consistantly, i started lifestyle change such as daily exercise of 30 minutes calicum and potacium full diets such as carrots, apples and other supporting food such as two garlic cloves every morning empty stomach and get off fatty and salty foods. Now my blood pressure is little down 135/85. should i go through cholestrol test again or keep the lifestyle to achieve the desired level. Since starting regualer exercise i can sleep we and but i have little headache still, i also wore spaces of -1.25 power on both eyes as suggest by eye spe. i have also ringing in head (which is little less now these days)",
    "doctor_response": "Hi, Keep going on regular exercise and healthy food as you are doing, do not try to go for other lab tests, your life is getting better. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "what causes bump on the top of the head?\n\nMy daughter(2 yr old) has some sort of small bump on the top of her head. It s about the size of a pencil eraser, in diameter. She says it hurts when I clean it. It has liquid coming out of it, which dries onto her hair...making her hair stuck to the sore area. I m assuming this is some sort of bug bite since we were outdoors all day on Saturday. I ve been putting neosporain on it. Is there anything else I should do?",
    "doctor_response": "hi your daughter will require oral antibiotic for 5days and topical antibiotic like mupiromicin antibiotic. as it's size is large and pus is oozing out kindly show to your pediatrician as it may require drainage. hope this helps you, take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat lower back pain on disc 2?\n\nHii Good Afternoon Doctor im sakkld my problem is my lower back pain on 2 disc on right side of my back only, i did my MRi before , and i lost around 6 kg after that , before i have my calf pain and my thigh pain.my email address  YYYY@YYYY",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern and I would like to say that if this is spinal cord disease then the entire treatment and management is depends upon the pathophysiological process but the condition can be treated symptomatically till the final diagnosis being made, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "24 year old suffering from seizures, migraines and pain in the eye. Will pregnancy be a risk? Chances of brain aneurysm?\n\nHello, my girlfriend and I recently found out we are pregnant with our first child. She is 24 years old and about 4 weeks along. She had bought up to me the possibility of her having a brain aneyurism. She suffers from seizures, migraines, and pain behind her left eye. We were worried that she has a brain aneyurism and it could burst while she is in the middle of child birth and she could potentially suffer from brain damage or even worse. She does not have health insurance so we re going to planned parenthood next week to get information on being covered under WIC. I am scared to death that our baby and I are going to lose her.",
    "doctor_response": "See every aneurism is risk factor for rupture but it depends on size , pressure in it . But presuming the risk she can do elective CS for birth of baby once he is mature enough to survive outside. KINDLY convay this to your obstratrician it will help you lot.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which diet to be followed to get a healthy body for a person suffering from Gilbert syndrome?\n\nhello Dr. XXXXXX my self Ramandeep Singh. i am from india. i am suffring from gilbert syndrome from last 3 and half years. i m not gaining weight from a long time. my body i so slim and face is getting dull day by day. please suggest me dit to get healthy body. please help me i am in a problem.",
    "doctor_response": "Dear Friend.Hi , I am Dr Anshul Varshney , I have read your query in detail , I understand your concern.Gilbert syndrome as such doesn't require any treatment.There is no relation of slim body and Gilbert syndrome.However , i would still like to see you all investigations , to be sure that it is Gilbert Syndrome.I recommend you to share your reports with us and to take a good diet.This is my personal opinion based on details available here.  If you still have any query you may please ask me.Stay Healthy. Dr Anshul Varshney , MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for panic attacks due to fear\n\nHi, im suffering from many deep thoughts about dying this occurs only at night and the thoughts go into alot of detail, and is a very very very big fear of mine, all of this is bringing on panic attacks and i really hate it, i feel like im going crazy.",
    "doctor_response": "HiThanks for using healthcare magicI think, you have depression and in that case, you need to consult a psychiatrist for proper mental status evaluation. You need low dose antidepressant that would help to control these symptoms. You can also try some relaxation exercise like JPMR or deep breathing exercise. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Borderline Sjorgen's, have dry eye, mouth, nose and skin, excessive thirst, swollen ankles, knee edema, frequent urination. Kidney related?\n\nI was diagnosed borderline Sjogren s a few years ago, no major problems other than dry eye , mouth, nose and skin. In this recent heat I have developed swelling in ankles and now some edema in knee , and am thirsty. I also got a case of thrush from dry mouth and am treating with Rx lozenges. Not sure if I also have a UTI as I hav a little urgency, but no burning. I plan to see the MD but in the meantime, I am worried could this be kidney related? I have no other complaints.",
    "doctor_response": "Yeah it look like kidney relatedGet few investigation dobeRenal function testUltrasonography of whole abdomenLiver funtion test24hrs urine proteins.electrolyteTreatment-avoid nephrotoxin drugsTab-ciplox 1tab twice a dayTab-dytor 20mg once a day if blood pressure suitableTab.rablet 1 tab once a day before breakfastGet ur blood pressur regular checkedNephrologist opinion",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain below chest while breathing?\n\nHello doc. I would like to ask about what I suffered 2 days already. Everytime I breath Below my chest hurts. Probably it s the stomach. It s really painful everytime I breath in. But when I lay down the pain lessens. An answer from you would be helpful. Thank you so much..",
    "doctor_response": "Thanks for your question on HCM. In my opinion you are having muscular pain.  As bilateral chest pain is not seen in stomach problem. But we need to rule out cardiac cause first. So get done ECG. If this is normal than no need to worry for cardiac cause. Mostly you have muscular pain.  Try to follow these steps. 1. Avoid heavy weight lifting and strenuous exercise. 2. Avoid bad postures in sleep. 3. Take good painkiller and muscle relaxant. 4. Apply warm water pad on affected site.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pregnant. Foul taste from teeth after getting it cleaned. Solution?\n\nI am currently 5 months pregnant. I have my teeth cleaned yesterday and for the past week or so I have been experiencing a foul taste coming from between two of my back teeth. The dentist did not say anything about it yesterday. The taste is terrible and when I floss between those two teeth it smells awful. What do I do?",
    "doctor_response": "Hello and welcome, Usually the foul taste occurs due to the pus or abscess associated with any teeth. Deep dental caries,periodontitis,pericoronitis due to impacted wisdom teeth all these can cause pus accumulation and discharge. Since you are pregnant,your gums will be tender,soft causing gingivitis. So the abscess has to be diagnosed and curetted. Decayed teeth can be restored. If your wisdom teeth are erupting ,and pus drains from the site,you have to wait till your delivery as tooth extraction is contra-indicated at this time. Take warm saline betadine rinse for temporary relief. Taake care,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get off opiates or suboxone while being type 1 diabetic with on and off seizures?\n\nmy son is a type 1 diabetic now for 12 years and is 32. He had a car wreck and was given oxycotyn as pain was very bad and he became dependent on it and tried to get off by taking suboxone. He lost his job due to seizures and so had no insurance to continue getting off of the opiates or suboxone he wants to be off of everything but seems his seizures are getting worse and he cant get any help with insulin and no help with disability. Can a person totally get off of opiates or suboxone and does he need to be in a monitored facility due to seizures and out of control blood sugar (30 s to 400 s in a day)? HE/WE are desperate not sure where to turn since no insurance.",
    "doctor_response": "this is a complicated situation but notone that requires a hospital.  seizures are easily controlled with medicine so this should not be an issue and there are seizure medicines that work extremely well and costs less than five dollars a month.   if his blood sugars fluctuate that much a plan could be made with primary care doctors on how to keep him on a steady diet and insulin regimen.  sounds like main issue is access to treatment.  tapering off suboxone causes withdrawal symptoms but pain or addiction specialists can take care of this.  you should seek out an academic center that has Medicaid clinics.  these are usually associated with medical schools and residency programs",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be wrong if having backpain, clicking in shoulder after trying to pull a lever?\n\nHi ... i strained my body when i was awkwardly trying to both pull a lever on a rope down from toward the ceiling with one arm and lift from the floor up heavy garage door since the automatic opener was broken ... since then i have experienced pain in my back - between my spine and my right shoulder blade ... but also, when i move my right shoulder inward and forward into my body, something in there is clicking, like maybe something was dislocated ??? not sure ... but looking forward to hearing what you think the problem is",
    "doctor_response": "Hello, Thanks for your query.From the description given its likely that you have sustained muscle sprain.The pain is due to associated muscle spasm . So it is important to relieve it. I would suggest you the following which will definitely help1 Hot water Fomentation: Either by towel soaked in hot water or by hot water bag. Intermittent application of heat for 15 to 20 minutes each session 4 to 5 times a day will be helpful2. Muscle Relaxant: Oral taken muscle relaxant like Chlorzoxazone along with analgesic like Diclofenac Sodium will be helpful3. Local application of Diclofenac Sodium gel will be helpful. 4. Adequate rest and avoiding sudden movement. I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in hip and right rib cage?\n\nHi im 86 years old , I was fine in the morning and at 4pm I started feeling pain on my right hip and my right rib cage area and I have not been hungry today due to gases and when I stand up the pain gets stronger in my right hip and right rib cage. Please advise if this can be due to something?",
    "doctor_response": "hi,thank you for providing the brief history of you.As you are 86, and this pain can be either a referred pain due to systemic illness or may be a muscular one. due to degenerative changes happening in the human physiological process as ageing progress we need to have a thorough clinical examination and may be some blood routine to examine the cause.In my clinical practice I deal on regular basis with more of the geriatrics and found that this pains are muscular at most times. But without knowing your personal medical past history I will not be able to comment more.it could be even just happened due to the sleeping posture and may need rest and pain killer. but I will advice for a thorough examination and rule out the systemic illness which can help the medical management much easier to help further.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if do not want to get pregnant after unprotected sex?\n\nMy boyfriend and I had sex this morning unprotected. My birthcontrol patch was taken off this morning and i should be getting my period with in the next couple of days.  Im not sure if he ejaculated in me, im pretty sure he didnt, but is there anything i can do to make sure i do not become pregnant?",
    "doctor_response": "Yes you can take emergency contraception.. That is I pill.. But you have to take it with in seventy two hours",
    "dialogue_context": ""
  },
  {
    "patient_message": "Husband does not enjoy sex using condoms, asking for copper-t to be inserted. Side-effects and procedure?\n\nI am 28 years old woman. I have been married for 2 years.I have 1 baby who is 7 months old. My husband does not enjoy sex using condoms .He has been asking me to get copper-t inserted.I want to know the procedure of insertion, it s side effects and how painful it can be during insertion and after insertion.when is the best time to insert it?",
    "doctor_response": "Hi, Cooper =T is an intrauterine device inserted by OG inside your uterus. Usually, there is no pain during insertion. After insertion, some women have reported pain or cramps together with heavy periods. If you notice unusual symptoms can consult OG or physician immediately. Be careful when having sex not to remove the Cooper-t to avoid laceration of uterus. It can be inserted any time, but usually after the periods are over.All the best!Dr.Alba",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could small lump on groin with small itchy bumps inside legs and butt treated with jock itch cream suggest?\n\nI used to have a lump in my groin and it was about the size of a pea and now it is extremely small. I m not even sure if it is the same lump or even a lump at all. It is barely feel able probably only a few millimeters Big. Also a few weeks ago I had some mysterious small bumps appear on inside of my legs where my legs and crotch meet, underneath my hip, and on my butt. They were small but itchy and irratating. They went away after I applied some jock itch treatment. Do you know if these could be connected? And should I be concerned about either of them?",
    "doctor_response": "Thanks for asking in healthcaremagic forum fungal infection is very common in that area. If it is associated with itching probably it was fungal infection which went off after using anti fungal cream. Not to worry. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a painless lump on the forehead lead to hours of dizziness?\n\nHi I m visiting my mother who is 69 years old and outta no were a lump just appeared on the right side of her forehead which she says doesn t hurt also she says been dizzy for the last 3 or 4 hours she says she never hit her head what might this be thank you",
    "doctor_response": "Hi, what she has is an allergy to something she ate. The dizziness is also due to that. Give her an acid suppressant and she will be fine--regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pepto bismol recommended to a 5 year old for diarrhea?\n\nmy 5 year old has diarrea (which I m sure I m spelling wrong). He had a 24 hour like virus I believe, but is doubled over from diarrea. I have pepto bismol and would love to help this poor little guy feel better. Can I give him that? I know it says 12 and over...",
    "doctor_response": "Hello. Thanks for asking Healthcare Magic. It is not generally recommended in children recovering from a viral infection. I would suggest to go for a lactobacillus sachet 2-3 times a day. Zinc supplementation can also help. Give oral rehydrating solution in small sips throughout the day. Hope this helps. If you have any other queries/question please feel free to ask. Thanks and wish you a healthy life.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will a stretching in knuckle heal itself?\n\nI banged my knuckle yesterday and now when i move it it feels like something stretching in the knuckle. when i put my finger on the knuckle and move it i can feel a weird sensation like a rubber band being stretched too far. Should I get it checked out or will this heal by itself? Thank you for any advice you can give. appreciate it",
    "doctor_response": "In my opinion you should get it checked if you notice any blue or green color , Use antiinflamatory and wear a u wrist brace to keep your wrist extended Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for afib\n\nhello ,I have had afib for going on 4 yrs . I have been on many meds ,did a cardioversion that lasted 8 mo . I feel the same as I did when this all started and don t know how much longer I can take being this tired ... I bought a new camera a yr ago to start a new bus . but didn t even open it . why bother im to tired . ive been on metoprolol er 100 2x day now im on diltiazem er 240 2x day . nothing changes my pulse is in the 90s and my blood pressure is within normal range .my afib is fast but the meds don t realy help. im 61",
    "doctor_response": "Hi welcome to HCM.I understand your query and concern.Atrial fibrillaton is known to cause Rapid heart rate and fluctuations in blood pressure.I advise you to have a baseline 2 dimensional echocardiography,ECG and lipid profile to assess the basic cardiac reserve of your heart.Restrict the intake of salt to less than 6g/day.Regular physical exercise in the form of brisk walk for 20 min a daily is useful.Drugs like antihypertensives and antiarrhythmics will help.Reduce the intake of fatty and fried food.Electrophysiological study with or without Radiofrequency ablation is the procedure of choice in your case.You may also need Coronary angiogram to look for any co existent blocks in the heart. Consult a Cardiologist and discuss for further expert management.Post your further queries if any.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and stiffness in the cheek?\n\nhi, i recently have been experiencing pain and stiffness in my left cheek joint and or muscle as well as congestion in my left sinus, Also my lymph node appears to be swollen and discomfort travels down my neck into my upper chest which is tight and congested. Also i am a heavy smoker and it has been a bad allergy season, It has been creating a lot of discomfort and anxiety for me. I thought it could just be allergies but the pain in my cheek is odd and never had this before, Any thoughts?",
    "doctor_response": "Hello, As a first line management, you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist better to consult a physician and get evaluated. We have to rule out possible causes like TMJ dysfunction. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should activities involving increase in heart rate be avoided before stent implant?\n\nMy allergist recently had to have two stents implanted.   He is not overweight and very active.  He said there is some research that indicates \"spinning\" or any other activity that elevates heart activity may cause this.  Is that true? He said his doctor advised hin not to do any exercises that cause rapid heartbeats.",
    "doctor_response": "Hellowelcome to HCM. Activities that increase the heart rate increase the blood and oxygen requirement of the heart. So if the heart arteries already have blockages, then the sextra demand is not met and you may experience chest pain or discomfort. Do if you have established critical blockages in your heart, then activities increasing the heart ray should be avoided. These activities themselves do not lead to blockages in the heart. It may aggravate the symptoms due to increased demandduring exertion. Also on a stenting is done, the blockages are tackled and hence demand is met and the person can go back to his normal activities.I hope I have answered your query satisfactorily. Wishing you good healthRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does intake of folli hair tablet cause weight gain?\n\nIs folli hair tablet good or it has any side effects like weight gain ? folli hair tablet is good any side effects like weight gain or so? I have started taking follihair 15 days ago....i have found changes in my body weight. Does follihair increases weight?",
    "doctor_response": "Hi,Follihair contains folic acid and multivitamins useful as a nutritional supplement. Nausea, constipation or diarrhea may occur. Weight gain may occur with the drug.These effects are usually temporary and may disappear as your body adjusts to this medication. Adequately hydrate your body and increase physical activity.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Saranya Ramadoss, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for an infection in the genitals\n\nHello,im having foul smell discharge for than 2 months now,its not itchy but its always wait down there and smells fish.i tried canestin suppository,i tried flucozal,i even tried lactogyn but its still here.what should i do.i cant also ask and see a doctor,they might think im having a sexual relationship and its not allowed in the country i lived in.",
    "doctor_response": "Hi,Welcome to HCM.Foul smelling discharge from the genital area indicates infection which could be bacterial, fungal or parasitic. The most common cause of foul smelling discharge is candida or yeast infection. But you have tried antifungal therapy with no response.  Bacteria which cause this kind of foul smelling discharge are bacteroides, gardnerella and mobiluncus. Parasites like trichomonas cause similar disease.I suggest you take tab metronidazole 400 mg twice daily for 7 days. Also keep the area clean and dry as much as possible. The foul smelling discharge will reduce within a week. If it does not reduce you must see a nearby GP and get yourself examined.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to prevent psoriasis? Medication?\n\nhow can I prevent my psoriasis? I have it on my skin and scalp . I m a 24 year old male and I have this since I was about 13 years old. I m using an effective ointment, anti-inflammatory and it s very effective but it s too expensive. Is there any methods or medications that I can use so that I can prevent this skin problem? Thanks.",
    "doctor_response": "Hi, There is no permanent cure for psoriasis. But it can be checked nicely. Some small plaque psoriasis responds well & recurs rarely. Aggravation of psoriasis occur due to 1. Mental stress 2. Physical stress 3. Respiratory infection 4. Excess dryness Dandruff may be a part of it or it may be be a seborrhic one. So to reduce psoriasis you should 1. Reduce stress by yoga, meditation 2. In cough, cold consult doctor early 3. Apply moisturiser after bath when body is moist 4. Over scalp apply ketoconazole/coal tar/mild steroid shampoo Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat allergic reactions?\n\nI have a severe break out of red bumps in certain areas of my body. first and most are on my back shoulder blades. the brea out decreases as it still does break out down to and on my butt. little on my neck as well as my breast. very few have small white heads on them and a lot are sore. I do hve mild acne. its embarrasing and no over the counter medicines will work for an allergy reaction. I have been in the sun a little bit lately; exposed f0r 3-4 hours at a time in a bikini.",
    "doctor_response": "Hi, thanks for using healthcare magicWith a history of acne, it is possible that the lesions that you are seeing are due to acne.Acne is due to a combination of factors: (1) increase in sebum production( this is a waxy oily substance)(2)blockage of hair follicles(3)inflammation of the skin(4)presence of a particular bacteriaIt would be best to address all of these factors. You can consider a cleanser with benzoyl peroxide which would help with the inflammation and blockage.The use of a topical or oral antibiotic would also be helpful.Clindoxyl is a combination of antibiotic and benzoyl peroxide.If these are not enough to help you, you may need to consider the use of topical or oral retinoids.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for terminating pregnancy\n\nI got my last period which was on 21st January 2014, I missed my period this time... I checked with the home pregnancy test on 32nd day...and the result was negative but then again on 26th february 2014, I checked it... its showing positive... which means I m in my 5th week of pregnancy; but the issue is we both husband and wife dont want to keep this baby, as we have a 2 yr old boy and we are not at all prepared for another baby at this moment... please advice me the best way of abortion, Is there is any side effect of M T Pill or what else can be done without surgery and without side effects... If we plan a second baby after 6 months is it possible without any severe problem.... Seek your Advice ...",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the termination of pregnancy can be done by both medical and surgical methods.The medical termination of pregnancy is possible up to 7 weeks.And anything after 7 weeks surgical procedure like D&C is tried.But as you are 5 weeks pregnant the medical method can be tried.It might not cause any problem if taken properly under doctor supervision.So relax and consult your doctor.After the termination you can choose any contraception method to delay the pregnancy.Hope this helps.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any chance of long term illness due to sand flee bites?\n\nIs there any long term illness that can be a result of sand flee bites. Severe allergic reaction to sand flee bites 3 years ago required a visit to the ER while on vacation in Florida. Several months later full blown symtoms of RA developed and  severe joint and muscular pain is a daily occurance 3 years later.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Yes, allergic reaction and trypanosoniasis can occur with the sandfly bites.If allergic reaction is severe at first time it will be more severe on second time. So in my advice you should avoid the sand fly bites second time. It may be life threatening on second time.This both condition can cause joint pain, pancytopenia and other symptoms. You should examine yourself for the trypanosomia. Peripheral blood examination and bone marrow exanination can be helpful for diagnosis.Bone marrow examination can help diagnose the various morphological forms of the parasites.Once you treat the condition all the problem will be solved.Please use repellant, net and personal protective equipment for the prevention.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes strange rash on the body and face?\n\nHi my daughter is 8 years old. She is 42 pounds and 48 inches tall.For the last year she has had a strange reoccuring rash. The bumps start the size of 2 pinheads with a strange clear like center.  Some push out a seed like cyst looking object. Most just stay the same size for several weeks.Then out of the blue she will start itching them and they gain a red radius that seems to draw itself back in as the bumps then form heads.Once they are at this point, they look like pimples and hurt and itch her. I have taken here to Dr after Dr who give her creams that dont work. They seems to come in lines and on one side of the body at a time. The eruptions last for at least 4 weeks once they start to become pimple like. At first I noticed them on her legs, then arms and now her face. Her face has 11 spots (which is the most she has had at one time).Most of the 11 just erupted and then they shrink back down with a scab center. Those seem to be at the end of the cycle. Yet she has one on her leg that is just beginning. The ones that are new can stay dormant for weeks before they turn itchy and pimple like.Usually she will have 1-3 on her legs or arms.  This is the first time on her face. I have pictures, but no one can give me a clear answer.HELP!",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.As you say you have the pictures please upload them on this website.You can approach me at the following link. Please find the link below - www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain around an MMR vaccination site on the arm be treated?\n\nMy arm is kind swolleing, redness, painful in the site that I took MMR about a month ago. This side effects appear about a week ago and continue botter me because in kind painful and irritating. It is normal or ok. What should I do to make sure do not get worse. please can you help me.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Pain and swelling will be there after vaccination. So few patients may develop myalgia, fever, arthralgia, etc. Use cold and warm compression, use tablet Paracetamol thrice a day for five days. If you're symptoms not improving or aggravating every day means you have to consult your doctor he will examine and treat you accordingly. Take care. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy with 70% motility of sperms?\n\nHi Doc, I am 37 yrs old, conceived in the 1st month after marriage, had a miscarriage after 12 weeks, last Aug'10, trying to conceive since a year now.. I have been put on Letroz 2.5mg twice daily from CD1 & Duphaston from CD14. Husband's sperm count is 62 million/ ml with 70% motility.Please advice. Wish to conceive a boy soon.. Regards.. Sthirta.",
    "doctor_response": "Dear Ms, your husbands semen parameters are normal but you should know that chances of conception in a completely healthy and normal couple ranges from 15-20% each month.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to ascertain that my son has a heart disease?\n\nhi im just worried about my son, because the doctor said before my son had a heart murmur while he is in the hospital because of primary complex at the age of 1yr old and he is 10 yrs old he very active and energetic he looks very very fine, can u help pls. to get rid this feeling , tnx",
    "doctor_response": "Hello,After going through the medical details of your son, I understand your concern for his health, and I would like to tell you that listening to a heart murmur is common in fever but should be evaluated to exclude the underlying heart disease. Chances of having heart disease in your case are very less but kindly get an electrocardiogram (ECG) and echocardiography done for him to find out if he has any structural heart disease is present.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Bhanu Partap",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for glands in body due to neurofibroma\n\nRespected Sir, My name is vivek,I am 22 years old and suffering from neurofibroma since last 5 years.There are around 6 to 7 glands in my body mainly in left forearm and in my back.Sir if there is any cure then please tell me the appropiate medicines for it.",
    "doctor_response": "Hello, Unfortunately, you harbour a condition referred to as NEUROFIBROMATOSIS. I very much wish there were a definitive cure for your problem by using medication but there are none of the types you seek in order to reverse the presence of the neurofibromas in the left forearm and back. Sometimes if the neurofibromas become so large that they cause unrelenting or excruciating pain on a structure in its vicinity then, surgery can be done to remove the fibroma. The problem, however, is that they tend to come back after time and secondly. Sometimes the lesion is so enveloped around or within a nerve or group of the nerve that surgically removing is not easy or even recommended. Since the nerve itself would have to be sacrificed and this has other consequences compared to pain or other feelings of neuropathy. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is light orange color discharge from nipples normal during pregnancy?\n\nI am 23 weeks pregnant and am starting to experience some leakage from my nipples. Although I understand this is normal and it is mostly clear and white, from time to time the leakage is a light orange color. Is this norrnal? There is no other swelling or fever that would suggest an infection, but I am concerned.",
    "doctor_response": "Hi,It is usually known as colostrums, or pre-milk, which is a yellowish or clear liquid. In case of colostrums, at first, the discharge is usually yellow in color, but as the pregnancy approaches its due date, the discharge becomes pale and clear, but continues to remain sticky. This form of nipple discharge during pregnancy is not a cause for concern, as the breasts are only getting ready for the baby\u2019s arrival.All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes discomfort in the muscles post a wasp sting?\n\nI was stung by a wasp on my ring finger about 3 weeks ago. I didn t think to remove my ring since I had never had a bad reaction to a sting before. The next day I had to cut my ring off b/c my finger was so badly swollen. After about a week, the swelling disappeared after spreading to my other fingers and hand. Now I have a problem with the muscles in that hand. When I hold my fingers straight out and try to put them together, my pinkie sticks out by itself. I m also having some difficulty typing this with that hand. Should I be concerned or is this something that will take some time to clear up?",
    "doctor_response": "Hi,Wasp bites releases a toxin called apamin which causes nerve damage which is temporary and clears up after a while. Since its now 3 weeks and our finger still sticks out then this needs to be checked out for a compartment syndrome which means increased pressure in the compartments of the hand.See if you have numbness along the finger.This is done  by a hand surgeon. meanwhile continue anthistamines (benadryl) exercises squeezing a sponge in a bowls of warm and cold water.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking chemotherapy for ovarian cancer. Mal-nourished. Need diet advice\n\nMy daughter s oncologist told us there is/are recipes to make a high protein drink with Carnation Instant Breakfast, powdered milk, and 1% milk. I have tried a few searches but nothing comes up w/these 3 ingredients. Do you know of any such recipes? My daughter has stge 4 ovarian cancer and just started chemo . Doctor says she is mal-nourished since she hasn t been eating much for last 5-6 weeks.",
    "doctor_response": "I don't know any such reciepies. you can try kabiven powder. But one thing I can caution is that no nutrition supplement that will treat her mal nutrition. Only treatment of cancer will resolve her mal nutrition. There is controversy that feeding the patient with nutrition supplement is like feeding the tumor itself and only indication for supplement is when she is not able to take orally because of extensive oral ulcer caused by chemotherapy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can you get a hematoma from a bruise?\n\nHi, Fell off of step stool on the 16th around 8:30 PM ish Very bad fall and I fell on the R side of my face and I think torso and R leg fell on ladder. Saw MD on Saturday and my neck is OK. Still a lot of pain. BUT I AM NEEDING TO KNOW ABOUT a weird bruise. It is 5 X 6.5 and pretty much that wide throughout. And this particular spot on my R thigh, just above and to the R of that knee. Knee OK. Bruise is hard, swollen, very hot and still painful. It has lost a lot of it s color . The other bruises are all soft like usual. Just purple and other colors. This is the first one like this. I was putting ice on it the first day and then added an Rx lidocane patch on it c tape so it would stop jiggling when I walked. I skipped today but put on another this PM. It needs the support. What should I do with it? Heat or more ice, or just be patient? It is hard with defined edges. I m on baby ASA Is this a hematoma? I told the MD but he didn t want to see Thanks, Christine",
    "doctor_response": "Hi, The bruises and hematoma are simple collection of blood underneath the skin after a fall. Nothing much to worry as it will settle by itself without treatment. You can apply ice packs for faster recovery. If the bruises persist for long you can consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes milky discharge and soreness in wound on leg?\n\nI had a torn meniscus repaired two weeks ago. Just had stitches removed Thur and now I have oozing running down my leg constantly. It started with a clear, blood tinged color. My doctor put me on antibiotics for the weekend. Yesterday the discharge is milky colored and my knee sounds squishy. What is causing this?",
    "doctor_response": "Hi,It seems that there might be having bacterial infection at stitches site and now there might be having spreading to inside knee joint.Consult your treating doctor and get examined.You require proper treatment and dressing to prevent complications in your knee joint.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is surgery needed for sharp sciatic pain in the back?\n\nI was injured about 13 years ago at the L4, L5, and S1 levels in my back while laying on my right side, and immediately felt a sharp pain and have had continuing sciatica type of pain going down my left buttock and back of thigh area. In the past few years it now extends down into the left calf, ankle, and foot. An MRI revealed a fissure in the disc and a pinched nerve. Do I need surgery to stop the pain? I ve tried creams in the past and they help to a certain extent, but I always have the pain and it seems to be getting worse.",
    "doctor_response": "Hello, If the symptoms are severe, it is better to go for surgery.  Consult a neurosurgeon and he will direct you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat disturbed sleep?\n\nMy 1 year old wakes up between 2 and 4 every morning, screaming and crying, and does this for 30 minutes to 3 hours. She does not get a bottle at night, i ve given her a night light, toys, comforted her, let her sleep in my bed, let her cry it out (is what happens most nights) music and she also sleeps with a fan for white noise. We have ruled out night terrors. Nothing has worked, she still wakes up screaming. I have been trying to pinpoint what is triggering it. I have noticed that when she sleeps on her stomach (which is 99% of the time) she screams, the few times she has slept through the night (in 4 or more months) it has been when she has stayed on her back. I am out of answers...and ideas. I am starting to get worried that this isn t just a phase or stage and that there is something more serious going on...help?",
    "doctor_response": "Nothing is serious about thisAt this age this pattern at night seems quite common, there can be multiple factors for this like night terrors, hunger cry, thirst, parents anxiety etc. none is related to any illness. For this you can try one solid feed  following water before a sleep , and try to give water without awakening in between the sleep if accepts. Your problem can be solved. Also at this age during sleep (lying position) in some children acid regurgitate and comes in throat from stomach which is irritant can make child irritable this will resolve after an age. if it causes more problem can be treated with an tire fluxes medications.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach ache and discomfort while urinating?\n\nHello, I have a slight pain/discomfort while urinating.  This began last week right after I got back from a beach vacation where I was constantly in a bathing suit.  I have also had a stomach ache for the last couple of days (don't know if it's related).  What could this be?",
    "doctor_response": "Hi ! Good evening. i am Dr Shareef answering your query.If I were your doctor, I would go for a clinical examination of your abdomen, followed by a routine/microscopic/culture and sensitivity test of morning sample of your urine, a complete blood count, to rule out a urinary tract infection and treat it in case it comes out to be positive. Otherwise, I would also go for an ultrasound of your abdomen to rule out any intra abdominal pathology. Till then, I would advise you for an anti inflammatory, along with a proton pump inhibitor drug, with an advice to consume enough liquids in your routine.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shaking, breathlessness and dizziness?\n\nmy name is kevin an about 3 years ago i had was sleeping then it felt like i was shaking then i got up trying to fight every one and it felt like i couldnt breath and i thought i was dying after all of that 3 years later im still feeling like every time i get on a bridge or in front of a lot of pepole like in a store i get dizzy and it feel weird",
    "doctor_response": "Hello, Most probably it will be a panic attack. Other causes like cardiac and respiratory problems must be excluded. If symptoms persist better to consult a physician and get evaluated. An ECG is required to rule out cardiac problems even though it is unlikely. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest birth control options including IUD.  Not comfortable with condoms and pills.  No children as yet\n\nI am married for last 4 months. We have been using condoms till now, but dont find it very comfortable. It reduces pleasure and has burst during use. But I am also not keen on pills or anything to play havoc with my hormonal system. Can I use IUD? Is it advisable for women who did not have their first baby yet? I am not planning to have a baby for another 2-3 years",
    "doctor_response": "hello,thank you for using health care magic,for newly married couple O.C.pills are best contraceptive.. consult gynecologist to check weather you are fit for using pills or not.. if taken properly under supervision of gynecologist there are no hormonal havoc or any side effect...IUD is not indicated for female who doesnt have even single child.. it is advisable only after first child.. i will suggest you to not to go for IUD..If you are not ready to take pills go for norplant rod implantation .. in these they put small thing under skin of your forearm which prevents ovulation.. it need just minor surgical procedure under local anaesthesia its perfectly safe..hope this helps you..Regards,Dr.Nehal..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. From the reports, please tell me whether I am at risk of heart attack.\n\nHello doctor,I am 41 years old, single, non-smoker, and I do not have any illnesses or physical symptoms. Just I have chronic anxiety and I take permanent medications for 10 years for that under health care which are Zoloft 100 mg along with Buspar 30 mg daily. I have made a checkup and ECG and everything is normal and I have no abnormal symptoms. I have attached complete blood tests to take look at it since my query related to this results. My weight is 105 kg and the length is 173 cm note that the weight gain regarding side effects of constant medications especially Zoloft. The blood pressure is 140/82 and sometimes 150/90 and rarely became 159/110 as maximum reading. My questions now:I scare and worry always about heart attack and clots because of the following indices: my platelets are always 450, blood pressure borderline or mild high always, lipid profile borderline always and CRP high always. what do you think, please?To protect myself and encounter these risk early could I need regarding those values one of the following strategies. Note that I changed my lifestyle many times but no point because of the side effects of Zoloft and Buspar as weight gain.Taking cholesterol-lowering medication like Lipitor (Atorvastatin)?Taking blood pressure lowering medication like Cozaar (Losartan)?Taking baby Aspirin daily as 81 mg?Taking Metformin for encounter the weight gain resulting of Zoloft? And is it correct this medication can cause lactic acidosis poisonous by the time?Are the medications Zoloft and Buspar the reason of those abnormal values of lipid profile and elevated of blood pressure? Please let me know what is the correct and best options regarding your experiences or do you have any other options?",
    "doctor_response": "Hello. You have been taking Sertraline and Buspar drugs for chronic anxiety. These medications should be prescribed under the guidance of psychiatrist and for behavioral counseling you can consult a psychiatrist. Hereby I am giving you opinion for your questions: Take care. For more information consult a hematologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in sudden movements and watery eyes?\n\nany sudden movement like sitting, standing, turning is causing head ache.. it pains like hell at times.. it s not always but in 1 or 2 months i have it for about 15days continuously.. i think it may be coz of sufficient blood not reaching my brain.... And i yawn a lot while in lectures even when i am not bored..and my eyes water during yawning...",
    "doctor_response": "hi,thank-you for providing the brief history of you.A thorough clinical Neurological assessment is advised.As you get pain while any sudden moments like headache and watery of eyes you need a thorough clinical examination.If sudden movements cause headache this could be an area which needs an understanding. Many a times due lack of physical activity there will be such symptoms and needs a proper cardiac endurance training to improve the needs of each system.In my clinical practice sudden headache and all are related to neurological issue and post examination things can be workout with simplicity.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white patch on tongue?\n\nMy husband has a white patch on his tongue.  He has had it a few months now and it is getting bigger.  His dentist said he did not think it was anything to worry about it but said that he could do a biopsy if he wanted to.  It is also painful.  Should be go to the doctors and get it checked out.  He doesn't smoke.  Thanks",
    "doctor_response": "Dear User,Thanks for using health care magic.The presence of white patch in mouth known as leukoplakia which is a premalignant condition which mean they can turn to malignancy at time. I think your doctor is right in planning for his tongue biopsy. There is possibility that everything will be turn out normal after biopsy but the biopsy will tell you the exact nature of the lesion. You might be aware that early diagnosis saves life and easy to treat. There is not much pain associated with biopsy and it is just like opd procedure and dose not impair quality of life. It is quite safe and not associated with any major complication except hemorrhage. 'Hope I have answered your query. If you have any further questions I will be happy to help\".Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the dull pain in my chest after quitting smoking?\n\nhello i am a 14 year old male who recently after smoking them for a year just stopped smoking poppers (1 inch snip of cigarette topped with marijuana smoked out of a bong). B On my 3rd day of no smoking, I felt a dull pain in the center of my chest, since then i ve been experiencing this sharp pain regularly in my heart.",
    "doctor_response": "Thanks for your question on HCM.In my opinion it is nothing but withdrawal symptoms. And may be due to hyper acidity.Withdrawal of any habit can cause nervousness and anxiety.And these can trigger hyper acidity and symptoms.So better not to start the habit. Control yourself. Cope up with the situation. Drink plenty of fluids.Start proton pump inhibitors and avoid hot and spicy food.Spend time with family and friends.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with jaundice, USG abdomen showed hepatomegaly with fatty liver. Is fatty liver a serious issue?\n\nHi, My age is 41 and my height is 6.2 just 3 day back, I was detected for Jaundice . During USG abdomen study, the reports said that I am having a hepatomegaly with diffuse fatty changes Liver. and Right lobe span 16.5 cm .at that time, my weight was 84 kgs. I dont have smoking but sam tine drinking habit. and my job in construction company many time food diet out side of home . My questions : 1) Does Fatty Liver is a serious issue? 2) What are the Steps that I need to follow to bring back my liver to normal? 3) What kind of a Food diet that I need to follow? 4) I need to be take any medications? Please advise. I am very much worried about the Fatty Liver. Thank",
    "doctor_response": "Hi, Welcome to the forum. It is nice to know you are interested in getting well. Yes, fatty liver is a serious disease when left neglected, it may lead to jaundice, hepatitis, cirrhosis, liver failure/ liver cancer and finally death. If a person is aware, the situation can be made better. To bring back the liver to normal should be your goal. Liver is the largest and the most important organ of the body. You should get immunized with hepatitis A, B and C. This is a precautionary measure that can be taken to help the liver get better. You should consult your treating doctor about which vaccination will be the best for you. You should lose your weight, exercise regularly, take plenty of water ( pure and hygienic). You should quit smoking, alcohol or any other addiction. Cut on your carbohydrate and sugars, cut down on caffeine intake, avoid butter, red meat, myonaise, oily junk food. Take more fruits, juice and veggies. Prefer boiled and blanched food over spicy food. Eat papayas, take sugarcane juice ( these are good for the liver ). You can take white meat ( limited). Eat whole wheat grain products, eat low fat milk products. Yes, you should  keep in touch with your treating doctor and take medicines as prescribed. Some appetizers, antacids and liver tonic will be very helpful for you. Strictly follow the doses prescribed by the doctor. Adequate rest and good sleep are essential for a healthy liver. Have a good day. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatments for water in lungs and trouble in breathing\n\nhi doc, my mom has multiple problems 75 yr old, diabetes, high bp , and the last time she suffered multiple epiliptic fits. she is admitted for the the past 15 days. she has water in the lungs and is fed throu a tube. she gets really bad at times, cant breath and has a very bad cough. please advise",
    "doctor_response": "Hello dearWarm welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This is lung abscess or pneumonia .*  Needs intensive treatment in hospital in form of IV antibiotics , broncho    dilators  ,  oxygen  support with general  nursing care .Hope this will help you .Welcome for further guidance .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for getting pregnant\n\nI have pcos and i have been having issues getting pregnant. I have taken many doses of clomid and i have lost hope in that. My dr has prescibed me naltrexone(made at a compunded pharmacy) to treat my pcos. Do u think this will help in ability to get pregnant?",
    "doctor_response": "Hi, I think you should take some medicines like metformin and myoinositol to treat the pcod. Discuss with your doctor regarding this. You can take clomid for a maximum of 12 cycles. The chance to get pregnant in one cycle of clomid is 7 to 10 percent only.  So, don't get stressed too much.  Try to lose some weight and maintain a healthy lifestyle.  You can go for IUI if you have tried timed intercourse with clomid.  A semen analysis of your husband should be done.  HSG should be done to check tubal patency. Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for indent on spine, upper back and surrounding muscles?\n\nHi,  my girlfriend has an-indent on her spine on her upper back. And surrounding muscles. Became long lasting 24hrs ago. Note, often has to pop her back into place besides this. No movement issues, dent in from time to time and then out again. Makes crackling sound",
    "doctor_response": "Hello!Welcome on Healthcaremagic!Her symptoms could be related to a muscle spasm. But I recommend performing a spinal column X ray study to exclude a possible vertebral column disorder. A spinal cord CT scan may be needed. Hope you will find this answer helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are chances of mono recurring?\n\nI had mono about 4 or 5 months ago. The doctor said i got it sometime in april maybe and i came in around june because i wasn't feeling well. So technically the mono should be out of my system right? I know its something that will never go away but i shouldn't be feeling any of the symptons anymore. Around the beginning of August i was feeling better, but now I'm getting headaches again and i feel extremely tired, but that could be school related. I was just wondering if it's possible for me to have mono again.",
    "doctor_response": "thanks for posting your query to health care magic. Infectious mononucleosis is caused by EBV virus. once you recovered from disease virus can be shaded from your saliva for months and it is not possible for body to completely clear off it . so chances are there to repeat the attack of virus it depend upon your immune status ,whenever immunity goes down chances are incresed .thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red lump under the tongue in an infant?\n\nWhat causes a 5 month old baby to get blood clot looking like lump under tounge before that bleeding profusely out of mouth but now airwaves are blocked from swelling blood lump under tounge now is on ventilater a machine that breathes for you, for this to happen i feel some kind of trauma had to have happpend. Please help!!",
    "doctor_response": "Hi, welcome to HCM. Can understand your concerns. Kindly tell all history from beginning. And why the child is on ventilator.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes palpitations while suffering from depression and anxiety?\n\nHi, I\u2019m wondering if you could help me. My dad suffers with depression, bipolar, anxiety, agoraphobia and alcholism. He takes a combination of tablets including lithium and drinks 11 cans of Carling every night. He doesn\u2019t particularly eat until the evening and drinks water up until he starts his nightly routine of drinking. He previously had blood tests to check his liver every 3 months but due to changing doctors who won\u2019t do home visits because he\u2019s \u201cnot elderly\u201d despite the fact he\u2019s not left the house in 3 years means these have not been done regularly. He\u2019s had his first one in two years recently and his Gamma GT reading was 160. As it was a councillor who found this reading, she was unsure what it meant and he\u2019s getting a bit frantic about it. He has also recently had a change in tablets for his mental health problems and is also suffering with a bad chest and heart palpitations. Please could you shed a bit of light around the GGT reading and what it means? Thank you.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Gamma glutamyl transferase is an enzyme found in the body and is in high concentrations in the liver. Levels of GGT have to be corroborated with other investigations to give you an opinion. You have to focus on treatment of your father rather than on the levels. So try consulting a doctor who can provide the treatment. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medication is suggested for seizure like symptoms?\n\nMy son is seriously ill in hospital he has seizure like episodes, excessive sweating, tachycardia, high blood pressure, vomiting, shuffling walking style when he was able to walk, stops breathing in these episodes and they last for long periods of time. Please help I m scared I m going to lose my son it s been going on for 5 weeks now",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your son's symptoms.I agree with you that these could be suggestive of seizures.He needs to be investigated to exclude seizures. This can be done by doing an ambulatory electroencephalography (EEG), where EEG recording is done in ward or ICU setting.If an MRI brain has not been done, it should also be done to exclude brainstem disease. This is because his symptoms also suggest brainstem/autonomic dysfunction.In addition to using anti-seizure medications, a course of intravenous immunoglobulins should also be considered to treat his autonomic dysfunction.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with suspected endometriosis. Increases when being anxious. Will anxiety increase the pain?\n\nIt has been recently posited by my gynaecologist that I have suspected endometriosis. I have been reading a lot about this condition and I am panicking about the quality of life I will have to get used to due to the constant pain I am in. Sometimes I go through months where I am not in pain as much- which seems to correlate with not being as anxious. I find anxiety makes my pain worse. Is this possible that anxiety can make the pain worse?",
    "doctor_response": "Hi,The answer to your question is yes.Anxiety definitely increases pain symptoms.In fact they could be the cause of pain symptoms.You could try lifestyle measures to help you to relax ;yoga or meditation for instance.If you are comfortable with medications antidepressants would help. Dont worry too much about your illness.besides it is only suspected and not confirmed.hope you get relief soon.Dr B",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in the inner thighs?\n\nI have sever muscle cramping in the inner thye of both legs. will not be able to stand or walk, have fallen to the floor many times. seems to last from 5 to twenty min. at a time , goes away some times for weeks at a time. some times comes night after night. doctors have said they don t know what causes it . there must be a reason. can you help me or tell me what type of doctor I should see ? Thank you",
    "doctor_response": "Hi, I had gone through your question and understand your concernsHi, If I were your treating Doctor for this case of ,i would reassure you .This is mostly adductor muscle strain  which is the most common cause for inner thigh crampy pain .I prefer using strong muscle relaxant(systemic and topical), NSAID and finally warm fomentation will be helpful for you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is my risk for infections inspite of having protected sex on periods?\n\nI recently had sex while wearing a condom with a woman who was on her period. After the sex, I noticed blood on my condom and Hand from removing the condom, and blood on the base of my penis. I washed them off, and I had no breaks in the skin, What is my risk?",
    "doctor_response": "DearWe understand your concernsI went through your details. In the given description, there is nothing to be panic. If the information is correct, you are not at any risk of having any STDs of HIV. You used condom. There is no cut or scratch on your skin etc.  You must take care in the future, because, having sex with unknown girls can be dangerous on the health side. Avoid it. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can kidney problems, be related with back pain and fatigue?\n\nMy symptoms are: back pain (especially right side middle of back, possible muscle pull), fatigue, and at times chills.  I've had these now for over a week.  I figure a pulled muscle would be feeling better by now?  I'm worried it could be my kidney, since that's area of my back that hurts the most.  I'm urinating fine.  FYI...I've had LOTS of UTIs throughout my adulthood.  I'm a 37 year old female and the only medications I'm on right now are Lamisil (for toenail fungus) and Advil (which isn't helping my symptoms by the way).  Please help.",
    "doctor_response": "Hi,From history as you get chills, fatigue and back pain indicates that there might be  having urinary tract infection.Pulled muscle or strain does not cause chills or fatigue.Go for routine urine check up.After report go for treatment accordingly.Take plenty of water.Take Diclophenac, paracetamol combination for pain.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can fungal skin infection be treated?\n\nI have an ongoing rash. Dr says it a fungual infection & prescribed me Fluconazole 200 mg tabs to take 3 days & skip & repeat in 1 week. Have done this & has help somewhat, but not gone. What should I do. I have refill for the med, but understand it affects my liver",
    "doctor_response": "Hello,Do the rashes present all over your skin?Is it itching/bleeding?Is it shows white patchy scales?My suggestion is you can take Clotrimazole topical application cream for a week and consult a dermatologist.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Indhu Priyadharshini",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I have problems with my joints and back?\n\nI been having some problems with my joints and backs. I feel stiff and the time and when I crack my joint they continue to crack. Like if I keep extending my knee a certain way it keeps poping. I play football and wrestling if that has something to do with it. I m in constant discomfort .",
    "doctor_response": "Hello, As a first line management you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist, it is better to consult a physician and get evaluated. We have to rule out possible causes like arthritis. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and bruising on the leg and ankle?\n\nI am a barrel racer and recently during practice I took out a barrel at high speed twice in the same area right below my knee on my shin. Since then I have had severe bruising and swelling on my whole entire leg to the point it s almost doubled in size. My ankle is completely swollen and even my foot is swollen. There is bruising on my ankle and my foot keep falling asleep with the sensation going up to my mid calf. I m curious if I maybe broke something with this amount of swelling.",
    "doctor_response": "Hi Hope this message finds you in good health.I have gone through your complaints and understand your concern.I generally see many cases like this at my clinic.there may be a soft tissue injury or a ligament might be torn. there also are chances of a minor bone fracture.do get an xray or mri to find out the reason.You should eventually get back to normal in coming few days.Nothing to worry about.\u00a0\u00a0\u00a0\u00a0\u00a0I hope your question has been answered.If you have any follow-up queries,feel free to consult me anytime.Thanks,Take care,God bless.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for hair loss\n\nSir, I am Nandana, from hyderabad, my hair strength is very less. For this i even had biotin tablets and even I have tried many home remedies but no use and now i want to know how do i prevent hair loss? Kindly suggest a mild shampoo and a medicated and mild oil for my oily hair type.",
    "doctor_response": "Hi, I would recommend you to apply Anaboom antihair fall serum on the affected areas of the scalp twice daily and take hair supplements like tablet Follihair A once daily. Also use Triclenz shampoo twice weekly and apply x gain hair serum on the wet hair as a substitute for oil. These need to be continued for 4-5 months to see significant results. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are swelling in testicles, legs, feet after gallbladder removed, developing pancreatitis cause of concern?\n\nmy 39 year old son has his gallbladder removed and had developed pancretitus. He was give a lot of fluids and potassium drip. He was released from the hospital 2 days ago and continues to have swelling in his testicles and legs , feet and ankles. Is there any reason for concern?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern for your son the given history may be suggestive of low hemoglobin that could cause the swelling of leg and ankle and for the testicle pain this could be due to the poor posture during the sleep still the clinical examination is the rule in this case because here have a history of some medical condition take care and hope this information helps you, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pneumonia\n\nHi, I had pneumonia about five years ago. I got recovered after taking the antibiotic medicine. About a month ago, I had physical check up, the doctor found the scar in my lung he suggested further visits. I noticed myself too when I run, I feel out of breaths at the beginning but get better later on. Some days, I feel out of breaths not doing any exercises. My question is, could this symptom caused from the pneumonia that I had a while ago? Thanks.",
    "doctor_response": "Yes it may b related to ur old lung problem. ...better to visit some good pulmonologist...since old pneumonia could have damaged ur lung or this might be newer pathology. ....get xray done and also consider tuberculosis if u hav any family history",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anal itch in kids\n\nHi my son is nine and the last couple days he s said his butt itches,when I had him pull his pants so I could see what the problem was,like did he get any flea bites,his grandma has 4 cats.It s red and alittle welter from him itching so much.I put A&d ointment on it but it still itches.He s having problems sleeping.He said it doesn t hurt just itches.It s all on and around his anal region.What is it? I m keeping him home from school cause it s so uncomfortable for him and he can t itch his butt all the time in school.I ve also told him to try not to itch it with fingernails cause I know that had made it worse.",
    "doctor_response": "Dear parent,itching around the anal region and that too more in night disturbing his sleep might be because of worm infestation. some worms particularly come out during night causing itching.Its better to deworm the child and use an antihistaminic like cetrizine for 1week . please wash his under garments in hot water for 2 weeks.Cut his nails too . All the family members should take a deworming tablet too and cut your nails.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for headaches when having degenerative disc disease\n\nI have degenerative disc disease and am suffering with severe headaches..I have neck devise that i did get and use every day...some exercises but lately, like 1 in the a.m. this morning, I have been awakened wtih severe pain my my head, especially behind the left eye....",
    "doctor_response": "Hi,Thanks for writing in.It is possible that your symptoms of severe pain in the head and neck regions are due to irritation of nerve roots in the cervical spine. This is known as radiculopathy. It happens due to nerve root irritation due to slight movements including when you are asleep. This causes pressure on nerves roots and pinching of the nerves. This is followed by sudden shooting pain from the neck to the head and can also be experienced behind the eyes. Please avoid use of pillows when sleeping and sleep on a hard mattress. Avoid making sudden head and neck movements. If you feel severe pain at night then apply a little ointment containing pain reliever and muscle relaxant. Please discuss treatment available for degenerative cervical disc disease with your doctor and if surgery might help. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is paralyzed hands and legs curable at 75 year age?\n\nhi , my father is 75 yr old , he is paralysed on right hand and leg before 2 yrs in 2010 january , he is suffering from weekness and walks with help of others and stick . is it cured or not in this age . sushma Agrawal Bhilai",
    "doctor_response": "Hi, Paralysis is caused due to damage to brain tissue in which tissue may not regenerate, so function may be achieved progressively, but function and control of distal components like feet and palm, may remain in some residual problem like skill and balance, coordination in feet and palm. I will say the first 6 months is very critical, if you do exercises well then we would have regained strength and power after 9 years in 2019, it's already passed 9 years, function can be regained but JOINT control and skill will be a bit difficult, you need to continue physiotherapy treatment for years if you want to make him independent in his lifestyle. Hope I have answered your query. Let me know if I can assist you further. Regards, Hemang S Jani, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Norlevo cause irregular periods?\n\nHello, About a month and a half ago, I drank NORLEVO the morning after pill, and it worked beautifully. Month latter I got my period on time, and it finished a week ago. Today I got my period again. Is this because of the pill and what needs to be done? Thankyou!",
    "doctor_response": "Hello, Irregular menstrual bleeding, spotting or bleeding between the periods are some of the common side effects of the 'morning after pill' norlevo. These side effects appear to be due to hormonal imbalance caused by the pill. If period does not subside you should consult a an OBG doctor for further evaluation and to rule out other causes of irregular bleeding. Heavy menstrual bleedingSpotting or bleeding between periods Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bleeding followed by brown discharge and nausea after sex?\n\nOk so idk if it could be stress or somethig else but on Feb 9th my mom went to jail because she got into a big fight with my grandparents trying to defend me..Feb 10 I was really stressed out trying to pay the bond and trying to get my mom out, I was emotionally destroyed..Feb 11, after I had sex I wiped, had light pink blood. Feb 12, lots of brown blood, had to put on a pad, had lots of cramps. Feb 13, a lil bit of brown blood, rarely any cramps. Feb 14: I went on a one day cruise for valentines day, had very little brown blood, I threw up on the boat, I guess I was sea sick, now I m home and still feel naseous..is this normal? Stress? Pregnancy? P.S: i m not sopposed to get my period in another 2 weeks... i have been on birth control for almost a year now but me & my bf don t use condoms.. during the days that i was stressed i missed a pill or two..",
    "doctor_response": "Hi,Dear,Welcome to HCM. Based on the facts of your query,You seem to suffer from-yes,this nausea and brown discharge could be from hormonal imbalance with more stress hormones causing gastritis and the brown discharge after the sex could only be due to the withdrawn estrogen secretions due to severe stress you had lately.Possibility of pregnancy due to missed pills with unprotected sex, after recent sex,as a cause of this nausea and brown discharge-is very very less.Hope this reply would help you to plan further treatment with your doctors.Contact with a Followup Premium question to ME. Will appreciate your Hitting thanks and writing excellent review comments to help needy patients like you. suggestsGood Day!! Dr.Savaskar, Senior Surgical Specialist M.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itchy bumps on back of the hand. Worsens when scratched. Any recommendations?\n\nHi, I am getting small bumps under the skin that are extremely itchy. They have no color but they are on the back of my hands, the inside of my forearms and the area of the lower arm just above the elbow. the itch is almost unbearable. This has been going on for over a week. It bumps seem to get bigger and multiply if/when I scratch them. Thanks!...deb",
    "doctor_response": "Hi,From history it seems that you might be having some allergic rashes.As rashes are only on hand and upper arm, there is likely of having handling some chemicals or some stuff causing allergy.Take antihistamine like Cetrizine or Benadryl for 2-3 days.Apply some zinc-calamine lotion on the part.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain and pressure, breathing difficulties with arm numbness?\n\nmy 13 year old is very healthy but recently he has been complainnig of chest pain, pressure in his chest, hard time breathing, and numbness of the left arm and hand he had an ekg done and the results were abnormal we still have to see a cardiologist but what can this be or mean?",
    "doctor_response": "Hello!Thank you for asking on Healthcaremagic!I would like to directly review his ECG, if you can upload it for a more professional opinion. At his age, coronary artery disease would be really exceptional. Anyway, every ECG finding should be evaluated in correlation with the clinical symptoms and cardiac enzyme levels. I would also recommend performing a cardiac ultrasound and an exercise cardiac stress test, especially in case of abnormal cardiac enzymes. A chest X ray study coupled with pulmonary function tests is also necessary to exclude a possible lung disorder. Hope you will find this answer helpful!Wishing all the best, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from swollen breast, abdominal pain. Pregnancy negative.  History of ovarian cist with birth controls.\n\nI had overian cict in age of 15. Now I m 30. From that time I was on hormon medication with birth control till my 26th birthday. I had year with just two periods and then 2 years with perfect times +/- 2 days periods last 4-5 days, so normal. 3 months ago my boobs swollen and I had problems with sleeping due to so sensitive and paifull breasts. It last for 2 weeks aprox. My period didn t shown then and I had from that time just one period in now over 1,5 months ago. I have strong abdominal pains. Negative pragnancy tests. Nursea and sometimes sickness in mornings. Swallen ancle, tieredness. And really changening moods. 2 weeks ago I felt strong pain around my belly button. Above and below my belly buttom from time to time I feel like kicking. Lasting just few seconds and I feel them once or max twice a week. 3 weeks ago I had wierd feeling look like somebody move adult hand inside my belly. I m sceard.",
    "doctor_response": "Hello. Thanks for writing to us. The presence of ovarian cysts or the birth control pills can cause a breast pain like you are having. This usually subsides once you stop taking the pills.I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal ,drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe vomiting to a 5 year old?\n\nMy five year old son has been vomiting about once a week for over a month. He throws up until his stomach is empty and then he is fine again. The doctor thought maybe he had a dairy allergy so we took him off of all dairy, but he got sick and threw up again last night. It was only a small amount, not until his stomach was empty, but he has felt sick on and off all day today with no more vomiting.",
    "doctor_response": "Hi...once week vomiting need not be worried about if the kid is otherwise active and in-between episodes normal. This is definitely not diary allergy keeping in mind the age and frequency of symptoms.You need to worry about vomiting only if following symptoms are there ,- 1. Green or bilious vomiting.2. Severe headache.3. Double vision.4. Weakness or restriction of movement of any body part.5. Seizures.6. Altered behavior.7. High blood pressure.If these are there, it requires further evaluation. Otherwise be rest assured.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to avoid pregnancy after unprotected sex\n\nHi, I just had intercourse and I m a female. He did not put the condom on correctly, therefore it went out through the sides, but didn t get to the tip to be inserted in me. I am not ovulating, but what are the chances of me still being pregnant, and if it did just happen what can I do to prevent it. I went to the pharmacy to try to purchase the plan B pill but i m not of age, so any suggestions??",
    "doctor_response": "Hello,I have gone through the query and understood your concern. If you are in the safe period of your menstrual cycle, your chances of conceiving are very very less. Please remember, ejaculation is not needed to cause conception; even the pre-ejaculate contains sufficient sperm. In the current scenario, if you are not fit to receive emergency contraception, you may have to wait till your next natural period and if you become overdue by a week, take help from a specialist to plan further management. In future, please make sure to use regular contraception to avoid such difficulty. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "PCOS and other issues with trouble concieving\n\nI was diagnosed at 15 with PCOS and was told then that there was a chance I may never conceive however I did miscarry at the age of 21 with a nonviable pregnancy. I have had a megaovulation causing internal bruising, my cervix frozen, and with the PCOS was wondering what herbs would be good to take to improve my chances. I have moved and are looking for a new gyno to understand me but so far I know more then they do about my condition. After 8 yrs of trying to conceive, I am losing hope. Need some advice, please. Btw I am 27 and married and have the biggest case of baby fever ever.",
    "doctor_response": "Hi,Kandis, Thanks for query, Do not disappoint madam,there are many hope for conception,what is required is to have proper guidance and treatment. With all reports you consult good gynacologist and seek his advice. After evaluation of your case he will give proper guidance and treatment. Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for heart palpitations, breathlessness and vertigo\n\nwhat is abnormal repolarization possible nonspecific. I have just had an ECG (EKG) and been told I need to speak to my doctor. I have had hole in the heart surgery when I was 10 yrs old and repair on atrial fibrillation 10 yrs ago ( I am 37). Lately I have been experiencing palpitations, light headed and breathlessness. Not sure if it s physical or I am having anxiety attacks. Bloods all done and normal. Just worried about this ECG result. Can t find anything on net about it. Thank you in advance",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. In my opinion, we should first rule out heart diseases for your symptoms before considering anxiety attack. You are having significant past history of atrial fibrillation and heart surgery, so we should first rule out arrhythmia as a cause for your palpitations. So get done ecg, 2d echo and Holter monitoring (24 hour continuous monitoring of ecg). If all these are normal then we can say that your symptoms are due to anxiety attack. In that case, you need to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic drugs too. Don't worry, you will be alright. First rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had molar tooth extraction with two stitches. Prescribed painkillers. Afraid to take them due to side effects. Alternative remedies?\n\nHi, I ahd a molar tooth extraction last night, it required 2 stitches. After the loca anesthesia wore off it there was pin, I took one aleve and have eben pain free since. I was prescribed Clidamycin as a precaution. Now I am highly allergic to most antibitices, I have 3 difrent vertigo issus due to deafness (oscillopsia, Meniere s and PPV). I also have a snsitive stomach and digetive system. After reading he possibe side effects, I am too scared tot ake them. I also read that Clidamycinis only prescribed fo severe bacterial infections. I had several toothe xtractons inthe past and never had an nfection. I am vegan thus my immune system is very good. Is there anyay to keep mymouht extra cleana nd avoid taking the antibiotics? Thank you, Cheyenne",
    "doctor_response": "Hi, Welcome to HCM, Molar tooth extraction is surgical and im mouth anaerobic organisms are commonly present so your doctor has given good antibiotic please continue to take if you have any reaction always can report to doctor. There is usually swelling and reactionary muscle spasm along with pain hence you need to take analgesic ,anti inflammatory and if required muscle relaxants. You can do hexidine mouth wash afetr consulting dentist. Antibiotic are also required to prevent any infection going to heart and cause infective endocarditis. Please do not stop medicine by yourself, If acidity and stomach upset is proble take drugs after food and a H2 bloker or a PPI agent may help in tolerating medicines . Take care Good Luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Super Vir oil aid in increasing the length and girth of penis?\n\nHi, can super-vir oil work to increase length and girth to my penis? Or is there a any type of drug or anything that can work? I am 20 years old. My height is 5\"11 and I weigh 149 pounds. I have epilepsy and I take 400 mg of oxcarbomezapine every night.",
    "doctor_response": "Hi welcome to the health care magic If your penis is getting erected and if you don't have problem in election then Size of penis doesn't matter.... It's only 2 to 4 inch vaginal part that is sensitive and so help in reaching climax... So it's false belief that long and widther penis helps in more pleasure.. If you don't have erection problem,  then no need to worry Take care Hope your concern solved Consult physician for examination if needed",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the sudden appearance of black stain in an infant?\n\nHello, my name is Tania. I want to I m sorry for my english. I hope you can answer my question. My child was 6.5 months. Today, when I bathed the child I saw a dark stain on the back of the right circle, about 2 inch. What does this mean and where it came from so quickly?",
    "doctor_response": "Hi, Do not feel sorry for language or grammar problem. Anyway, I think the stain is on child's buttock. Usually there are some stains on body of infants. It may be some infection as ringworm or simple nappy rash. Take your child to nearest emergency or local doctor as he will observe and examine to make diagnosis. Do not worry. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Varinder Joshi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to have peritoneal dialysis after colostomy?\n\nI have weak veins in my arms and the surgeon is trying to connect an arteryto a very weak vein.  I have a colostomy.  Would it be possible for me tohave peritoneal dialysis?  My kidney doctor says he has never had a patientwith both.  The surgeon says it would work if necessary.",
    "doctor_response": "Hi. welcome to HCM.PD is possiblie even with colostomy and it is safe also.But, we should take great care in selecting site of PD catheter insertion.Don't get worried. You can meet your surgeon and discuss about the site of PD catheter insertion. There are number of modifications for that.I think this would be helpful to you.Best wishes. TC.Dr Jay Patel.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from depression\n\nHow do I get my husband to realize he needs to be on an anti-depressant ?When I went with him to a Drs. appt. our family physician refused to prescribe anything unless he asked for it. He is emotionally abusive to me,my children and Grandchildren. I am on the brink of leaving.",
    "doctor_response": "HiThanks for using healthcare magicI think, he has underline psychosis. In that case, he needs antipsychotic. You can not convince a patient with psychosis to take medicine. In his case, either you should think about admission in hospital or give him antipsychotic in form of injection. With that, you would able to improve in few days. Rest, you can discuss with his psychiatrist.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes throbbing, dull, achy abdominal pain?\n\nI am having pain in my abdomen that wraps around my side and onto my back. The pain is level with my belly button and is only on the left side. It came on suddenly and is a throbbing but dull achey pain. It goes back and forth between bareable and bad, I am on no medication, except birth control and I am a breast feeding mother. What should I do?",
    "doctor_response": "HelloThis type of pain in abdomen on the left side and radiating in the back may be due to these possibilities , these include.1 Left  renal calculus or stone in kidney as mostly pain in abdomen radiates to the back is a characteristic feature of renal calculus. Diagnosis can be confirmed by ultrasound abdomen .2 Urinary tract may be the cause of this pain , Diagnosis can be confirmed by urine culture.3  In female such type of pain may be due to salpingitis or Ovarian cyst . Diagnosis can be confirmed by ultrasound of ovary.In my opinion taking of pills is nothing to do with this pain.So consult a physician and get his opinion as mentioned above.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath?\n\nI have copd, presently I am on sprivia and advair. my shortness of breath seems to be getting worse since the advair was added. I also have had a number of times where I got what appears to me is a cold or flu, I get the chills, ackes and piaings etc, I",
    "doctor_response": "Thanks for posting you query to health care magic.Advair do not causes shortness of breath as it is a steroidal drug and usfull in releiving inflammtion of respiratory tract given to releive asthmatic attack.your shortness of breath may be due to some other causes .as you are presently suffering from flu like symptom so there may be possibility of some kind of infection and for which you need to contact to local physician for examination .you can take Paracetamol in 750mg adult dose  two times a day  to releieve pain and body ache .furhter treatment will be decided after examination by physician .Hope you would be satisfied with my answer .  Feel free to communicate if any query .regards,Dr.Manish PurohitInfectious disease specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have back pain, chest pain, neck pain. What is the problem?\n\nHello, I have a back pain since 4 days. Its in the middle and upper back area and in the neck . Now since yesterday I am having pain in chest area, left side. It feels like pain in heart . I am 34 years old male. What could be the problem? Could it be the heard? Are the pain in the back and neck related to the pain in chest?",
    "doctor_response": "Hello. Thanks for writing to us. The back and neck pain that you are having could be related to a cardiac cause or acute gastritis. Other causes could be a muscular pain or a ;lung disorder. A physical examination is necessary to find out the cause. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for recurrent fever in the evening and cold feet\n\n.my mom is 60+ she initially got swelling below right ribs with high fever we checked for typhoid h1n1 malaria dengu UTI all other cultures but every thing is negattive her fever has now changed to no fever in morning but as evening comes she gets cold feet with fever pls help",
    "doctor_response": "Hello,She may have tuberculosis or some pyrexia of unknown origin. She should go for a complete investigation like an ultrasound abdomen and chest x-ray. Find the foci of infection. Take the treatment accordingly.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Hardik Sanghvi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any unknown side effect for Sazo 1000?\n\nI am taking Sazo 1000 twice daily since last 3 months, and suffering from back pain since 12 years. Is there any side effect for taking such drugs since long. It is mention further that I am taking sazo 500 for last 8 months before taking sazo 1000. please advice regarding that matter.",
    "doctor_response": "Hello,I will ask you a few questions regarding your disease. You haven't mentioned why are you taking sazo. Usually the diseases for which sazo is needed also lead to backache (A part of disease). Regarding side effects, I think best part is that you have been tolerant to the drug for last few months.  You need to be vigilant for developing white blood deficiency, folic acid deficiency or some damage to your liver enzymes. (Very rare effects in very few patients). You need to take folic avoid along this drug, liver function testing after every 3 to 6 months and a blood complete picture once every 1 to 3 months. There are many other non serious side effects which are present in almost  all other drugs like a stomach acidity problem due to prolonged use.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammad Faisal Bacha, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for 15 year old suffering from lower abdominal pain?\n\nHI there my 15 year old daughter has had lower abdomen pain on her lower left side since weds (3 days ago) we saw out GP and he gave her a thorough check and suggested problem could be bowel or ovarie related and if no improvement we may need further investigations. She is mid- cycle but she said the pain is not like ovulating pain. She has not gotten any worse but is uncomfortable and the pain is moving around to the back area too.  There is no temperature.  She was given lactulose to have in the am for about a week or so to just rule out constipation issues.  I was going to take her to the doctors again in the morning, do you have any suggestions. Many thanks.",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern for your daughter in my opinion this could be bladder cystitis, from the history given here this can be said, if I would be her doctor then I would treat her with the following medicines 1) Tab Ofloxacin 400 mg twice in day 2) Tab Dicyclomine with Acetaminophen three times in day if she fails to respond to this treatment then further investigation would be needed like X-ray abdomen and USG, hope this information helps you have good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fibromyalgia\n\nI am over weight, very sore joints, I ve been told I have fibromyalgia, my muscles are weak, I have a bad back which restricts some types of exercise, I m female and 57. For the last year if I have any type of alcohol, I get an uncomfortable Head rush after the first couple steps and then it goes away. My skin is very dry. I sleep good and need 8-10 hours a night. I am a happy person but I want to feel better and lose weight",
    "doctor_response": "Hello,Fibromyalgia treatment involves multimodal strategy which includes physical therapy for the trigger points, medications like gabapentin with methyl cobalamin and vitamin D3. In addition to this, holistic approaches like yoga and meditation are of most help.I would suggest you to start with meditation and Physiotherapy. Get your Vitamin B12 and Vitamin D3 checked, and if low, get them corrected with medications.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Santosh S Jeevannavar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching inside the foot and numbness with a history of spinal decompression?\n\nHi everyone - I have SS and have so far had 3 spinal decompressions - I m 48 - Not sure if that s common for someone of my age. Anyway they were all successful (although recovering wasn t easy), but I still have the common itching inside the right foot. I would love to hear from anyone who has successfully managed to eliminate / ,minimise this tingling / numbness. I hope to hear from you guys. Thanks. Roger",
    "doctor_response": "Hi,Spinal stenosis and multiple surgeries is indeed a challenging problem to overcome. If all that is residual are the paresthesias and numbness of the right foot then, you should know that you are not being left with very much to deal with things could be much worse. I would not vote for more surgeries since each additional surgery confers a risk of complications that are not already there.  Have you been tried a TENS unit to be applied to the lower back where the surgery occurred (not the foot) since the PROBLEM is the nerve root that was decompressed, not the foot.  Have you tried medications such as Gabapentin, Pregabalin, or Oxcarbazepine?  Have been prescribed Aquatherapy and water jogging as part of a rehabilitative back program?  Have you had your Vitamin B12, D, and Thiamine (B1) levels checked since all of these nutritional deficiencies alone or in combination can contribute to the sensory neuropathy/radiculopathy you are experiencing.Hope I have answered your query. Let me know if I can assist you further by writing to me at: www.bit.ly/drdariushsaghafi with more questions or comments.Regards,Dr. Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe stomach pain with dizziness.\n\nHello, my name is Jocelyn and i am 17 years-old. I'm looking for a doctors advice because my mom won't listen to me no matter what i tell her. I haven't slept at all tonight because i've had this god awful stomach pains to the fact that i feel like crying. It started out with my lower back hurting for about 3 days and it still does hurt but not as bad and now i feel like i have to constantly poop and vomit. I also have really bad dizziness and I feel really weak. I recently went to the bathroom, and it still didn't help anything, and when i looked it after i wiped it looked like coffee grounds in diarrhea. Not to be gross but i'm actually starting to get a little nervous. Can you please help?",
    "doctor_response": "Hi. Thanks for an elucidate history. Yes, you have a problem- this is gastroenteritis. The dizziness is suggestive of an active infection with loss of electrolytes into the intestine ( the reverse process due to infection). You need to consult a Doctor for clinical examination , blood pressure and pulse rate. You may need IV antibiotics and supportive medicines as there is vomiting also.. Request your Mother to take you to ER",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the hip, back, ribs and the chest like gas. Worry? Ectopic pregnancy?\n\nI m having a pain that started last night which seems to be in my hip/back, but is starting to spread up towards my ribs/back and is also in the front like a gas pain or period cramp .... I m not sure at all. During my last pregnancy I passed a kidney stone , but have never had any previous history and now I m on Paraguard and am a little worried it might be an ectopic pregnancy .. however, i just ended my period.",
    "doctor_response": "It is unlikely to be ectopic pregnancy if you just had the periods.Regarding kidney stones you need to get an ultrasound and x-ray of kidney , ureter, bladder area. Also get your urine examined for any infection there.Till that time you can take an analgesic antispasmodic medicine like meftal spas and drink lot of liquids.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling,bruising and numbness at arch of foot?\n\nI broke my fibula bone all the way thru. It s been 5 months and I still have bruising and swelling going on. The worst part is the pain that shoots up my leg from the foot. It became unbearable. My general doc said to go to er and get checked for blood clots. None found. My heel went numb every night for awhile and part of the bottom of my foot. Told all of this to my ortho treating me and he did nothing but say, sounds like u have some nerve damage, should go away when swelling goes down. Swelling went down after 4 months but I can t even touch my foot to the ground without taking strong pain medication. I went to a neurologist and he kept hitting my leg with that reflex tool, it never moved at all. My arms and other leg responded and moved when hit. But the leg where I broke the ankle just hangs there like its dead. I hate having to take these pain pills and wish someone could find the problem and fix me. Do u know what could be wrong? I have swelling and bruising at arch of foot.",
    "doctor_response": "Thank you for asking Healthcare majic.  My name is Dr Ehsan Ullah & I have gone through your query.  it seems you have got common peroneal nerve injury due to fracture of fibula.as there is numbness kindly get EMG/NCS to get the status of nerve firing and then visit to neurosurgeon.  Meanwhile you can take gabapentin 150mg BD,pain killer SOS..i hope you will feel complete recovery as soon.kindly get visit to some neurosurgeon for further neurosurgical intervention.Hope this may help you. Let me know if anything not clear. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for persistent pain and numbness in arm\n\nHello, I had a medical Technician draw blood for a recent Dr. Appointment. Unfortunately, the Technician hit the Radial Nerve in my left arm. The pain and numbness still persist after 7-Days. What can I do to help with the pain and heal my Radial Nerve? Thank you for your help in advance!",
    "doctor_response": "I don't think any technician would hit a radial nerve whole drawing bloodif you feel pain and numbness I would suggest active and passive movements of elbow, wrist and finger movementsplus Tab meconerv plus once daily after Food",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain when taking a deep breath or stretching slightly?\n\nHi, I keep getting a sharp pain in the bottom half of my left side every time I breath deep or stretch slightly, this has been there since last night and I have woke up today and it is still the same. I have also noticed that i am going to the toilet a lot more than usual, could somebody tell me what this may be, my mum said the pain is around my kidney area",
    "doctor_response": "Hi ! Good morning. I am Dr Shareef answering your query.If I were youir doctor, I would advise you for a stool test and a urine test followed by a culture sensitivity of the urine to decide on the appropriate antibiotic for a possible urinary tract infection. Apart from this, an ultrasound abdomen could be a helping tool in ruling out any other urological or pelvic pathology. Your abdomen also needs a physical examination by the doctor. Therefore I would advise you to consult your family physician and go as per his advice.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reddish dry patch on the shoulder. Became worse on applying fungal medication. No itching\n\nAbout a month ago a red, dry patch appeared on my shoulder . I originally thought it was ringworm , but the anti fungal medication only made it worse. After applying the medicine, the patch grew from the side of a dime to the size of a quarter. It does not itch and is not painful. It is simply and red, scaly patch. What do you think it could be?",
    "doctor_response": "Hi, Thanks for writing in. The condition can be xerotic eczema,discoid eczema, ringworm etc. As it has worsen after antifungal application it is likely that it is eczema. You can apply a good moisturizer with shea butter twice daily along with mild steroid like hydrocortisone cream.Continue this for 2-3 weeks for visible effects. Hope this helps. Regards DrSudarshan MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pre ejaculation\n\nhello i am goin to marry next month but i am afraid of doing sex because when i am in sex pre ejaculation will come fast thats why i cannot satisfy my partner is there any medicine to control pre ejaculation or musli power will help to do long sex and many sex",
    "doctor_response": "HelloThanks for query .Based on the facts that you have posted you are facing problem f early ejaculation and unable to perform intercourse .This is very common at the beginning of sexual life and mostly due to what is called as performance anxiety .Following measure will help you to boost up your confidence and getting good erection and delay ejaculation. 1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning. 2) Take high protein diet rich in vegetables and fruits and Vitamin     A,C,D,E.and Zinc 3)Take anti oxidants like Almonds 5-6 everyday4) Avoid alcohol and smoking..Taking Sildenafil  (Viagra) or Cialis as on demand will help to get good hard sustainable erection and to have enjoyable sexDr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruised rib with severe pain and trouble in breathing?\n\nI think I have a cracked or bruised rib, although I don t remember doing anything to cause this. I have servere pain under my right boob and it is very tender to touch. It also catches my breath sometimes. But I have also noticed a small red spotty rash come up in the same area. I have exzema but it is not itchy and feels different.",
    "doctor_response": "Hello, The small red spotty rash may be due to inflammation. It looks from your details that present tender area may be due to an inflammation which can be due to a small trauma or due to a mild infection. You should do following to have relief in this:-Avoid heavy work-Take rest-You may have an anti inflammatory analgesic like diclofenac or aceclofenac on prescriptionIf any swelling in that area occurs or you feel feverish then you should consult to your doctor. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mukesh Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and tenderness in jawline after flossing teeth?\n\nA short while after flossing my teeth yesterday, I placed my hand on the side of my face and noticed that the area around my jaw line was tender and was slightly swollen. Should I see a dentist, the area feels warm to the touch. I've avoided chewing on that side of my mouth, although when I have it doesn't hurt.",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.The signs and symptoms mentioned makes it to be thought as a formation of an abscess in relation to any of tooth in that area( as you have not mentioned that is decay in any of your teeth).Please visit a dentist and get it evaluated and get the decayed tooth filled.If the swelling is due to the eruption of the wisdom tooth ,it will reduce once the tooth starts erupting and following the medication prescribed.Do not apply hot bag on the external surface.Do salt waster gargling.Hope this was useful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can body aches, sore throat, cough, headaches with nausea be treated?\n\nHi, i am 33 year old. i start body aches, sore throat and cough on thursday evening on 7th april went to doctor on monday. he told me i got bronchoitis and he gave me antibiotic and puffer. but my condition is getting worse. i have bad bad headache. my aches and all body hurts badly. i am feeling nauseous and even at my dughters game today i was feeling like i am going to faint. whats going on with me? what i should do? plz answer.",
    "doctor_response": "Hello I will try to explain something to you.I think this is a.viral situation that starts from the larynx and to the bronchi called Laryngotracheobronchitis in other wards the inflammation of the larynx, trachea and airways. Do you have high fever?  This bad headache might be related with the fever and the antibiotics should be add.For other symptoms you can safely take painkillers. If this situation become worse better to do a chest X Ray.Wish you best regards.Thank you Dr Jolanda Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment to get rid of embarrassment?\n\nHello Doc. I get nervous very soon and my ears become red when I am nervous. I am not able to speak properly. I think all these problems are due to onanism. Please let me know how to get rid of this embarrassment. Due to this shame I get very upset and feel dejected myself. Please reflect your views on this issue. Thanks",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  I hope you understand onanism means masturbation habit. Masturbation is no sin and in fact healthy. Masturbation cannot be the reason any sort of health problem unless you overdo it. Overdoing means doing it at least 14 times a week.  From the description, I cannot read much, and therefore diagnosis may not be possible. Please be more descriptive.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for feeling shoulder separation?\n\nI am a nurse. Twelve weeks ago, I was moving a 485 pound woman and after the episode I felt like my shoulder had separated. I had to strap the arm to my body with a belt because it felt so unstable. By the second day I could not lift it. Any subtle movement, I would feel it. MRI showed fluid in the capsule, no tear. MRI arthrogram didn t show a slap tear, although every time my ortho guy does the tests in his office, they come up positive. This is workers comp case, so they can t do surgery unless definitive objective evidence. Physical therapy has made things worse. I have not gotten any better. Today I am back to strapping my arm down because I am sick of the feeling of looseness . I m seeing the top shoulder guy in the area. Got any ideas? Is it still a slap tear just not showing up?",
    "doctor_response": "if it is painless then you should look for lumbs on your shoulder blade , if it is extremely painfull ,then MRI can possibly not show it try putting your arm in abduction for 24 hours , if its nothing problem should go away if you keep your arm rested in abduction Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Lexapro leads to lack of sex drive?\n\nHi, Im taking lexapro,concerta and I just started abilify.. I do not want to take lexapro anymore,because of the fact I have no sex drive. can I just take concerta and abilify? concerta hepls me the most with focus ,energy and mood, not sur about abilify yet. just started it. I want to give it time to work.",
    "doctor_response": "Hi  dear . I  had  gone  through  your  query .Lexpro is antidepressant  and it helps in mood features .Yes lexpro has some sexual indifference.Mostly erectile dysfunction  is common than decrease   in sex drive.Decrease  sex drive can be part of depression   and need to take proper consideration  between these two.There are some medicines  that improve sex drive if it is caused by lexpro or related medicines.Dose reduction   can also help.Better  to consult  with  your  doctor  and get advise  from  him .Detail evaluation  of psychological  stress and thought  process  will help for better  treatment .I hope  I  have  answered  your  concern .Happy  to  help  you  further .Thank  you .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can stopping acne medicine cause fluttering in chest?\n\nI am 16. My chest has been feeling fluttery whenever I am at rest for the past week or so. It s really starting to bother me. My mom said we would give it another week since my diet has been extremely messed up since Christmas Eve. But it s not like every once in a while like a heart murmur. It almost feels like a shortness of breath or something. I have accidentally stopped taking an acne medication that I have been on for many months just because my routine since Christmas has been weird. I don t know if my body is reacting to that? I have never even tasted alcohol, drugs, or cigarettes.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. No stopping of acne medicines can not cause fluttering sensation in chest. Fluttering sensation in chest is commonly seen in arrhythmia (rhythm disturbances in heart). So better to first rule out heart diseases in your case. So get done ecg, 2d echo and Holter monitoring (24 hour continuous monitoring of ecg). If all these are normal then no need to worry for arrhythmia. Sometimes stress and tension can also cause similar symptoms. So avoid stress and tension, be relax and calm. Don't worry, you will be alright. But first rule out arrhythmia. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fat globules in stool test?\n\nHi, may I answer your health queries right now ?  Please type your query here...i had my son stool examined last week and the result was MANY FAT GLOBULES.i have seen a mucus and a blood in his stool that time. now a week later his stool is back to normal.should i have to bring him to a doc for the fat globule result?",
    "doctor_response": "Hi.... if he had fat globules when he had intestinal infection or dysentery, you need not worry about the fat globules result in the stool test.If he is otherwise active and his weight gain is appropriate and he is otherwise healthy child you need not worry about this result at all.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "When can I get pregnant if I have bilateral tubal patency and peritubular adhesion problem with bleeding tubes ?\n\nhow long will it take to be cured and will be able to concieve? hello dr.i m 27 years old and got married may 2010.in sep i had appendix operation and than in oct 2010 i concieved but unfortunaely in dec 2010 it abort.since march 2011 i have been trying to concieve abt failed that in june i got HSG and its report is showing bilateral tubal patency and peritublar adhesion and tubes also showing bleeding in report kindly tell me whats the reason and problem like?as it be cured and i will be concieving?",
    "doctor_response": "Hello; welcome to HealthcareMagic Since the tubes are patent it is a good sign and you do have chances to get pregnant again.Please consult a Gynaecologist and get examined and treated.Also you have not mentioned whether you are having proper ovulation or no and to see that you will have to get done a follicular study.If the follicular study shows normal ovulation then you will conceive sooner or later.As for the peritubal adhesion they can be due to infection during abortion.So try for 3 more months and if you do not conceive the you can go for a laparoscopy to seperate peritubal adhesion. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruising and pain around the hip?\n\ni recently had some bruising around my right hip and right side pain more on the stomach side show up the last 4 days and having stomach cramps and more constipaction / change in my bowl movements for the last 2 months - I have always gone the same way and now its completely different with 1 little peddle every 3 days. I have not changed food habits or changed any other habits. I also have white gums and doctors have already ruled out UTI, NO Fungus or bacteria infection in my mouth and no HIV/STD. I am 32 years old female. My doctor has not done any other test yet he told me he thinks its malnutriention and told me to take vitmans for a month and if not better start doing stomach/intestine test. But I eat and still think its something more",
    "doctor_response": "Hello, I have studied your case. trochantric bursitis can lead to bruising and which is usually cystic [soft] and painful.It should have been visualized on MRI.FNAC [needle aspiration cytology] may help before going for biopsy procedure.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. You can send image directly on you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes change in mood after seizure in child?\n\nDear Sir, my 2 and half year old baby has got seizure when she was 3 months old after that day, day before yesterday she has got second time seizure, as per the prescription we are using Valparin syrub, but now doctor had prescribed EPTOIN syrub along with valparin, what will be the side effects since she is a preterm baby suffering from developmental delay. for the past two days after the seizure her mentality is totally changed, she s behaving adament like anything. kindly advice us. Veeramani. Chennai, South India",
    "doctor_response": "post seizures some may have some behavioural changes which usually lasts 24- 72 hrs. in any case u should go for a EEG",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Anger, severe irritation, abusive, mood swings. Taking medication for polio. Treatment options?\n\nI need to consult psychiatrist for my brother My brother is 34 yrs old. He gets angry and becomes irritated on small small issues. He is working in a call centre. He had polio but after the polio has been treated he is become more short tempered kind of a person. he abuses when he is driving when someone overtakes him. we need some suggestion for his sudden mood change prob. He is very noble hearted person but when he gets angry he himself dont know how is is behaving with his elders but when he calms down he aplogise for his behaviour. He do not drink or smoke . Please advise?",
    "doctor_response": "Hello ~ It seems like your brother has an anger management problem and impulsively becomes angry at little things.  However it also seems like these anger episodes are predictable, which makes it amenable to treatment.  I suggest that your brother take anger management classes or complete a do it yourself book for anger management.  It is helpful to consult a psychiatrist if you or your brother feels like this is not helping and medications may hold a key to the question of anger. I hope this helps.  Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back pain when diagnosed with kidney stones?\n\nhello, my lower left back has been hurting me for a while, i thought kidney stones since i suffer from that, i am always tired, and my stomach blows up all the time. i just dont feel good at all and unfortunately at the moment i have no insurance what could it be thanks Maria",
    "doctor_response": "Hello,As you are already diagnosed with kidney stones which causes pain in flank region of that side. But sometimes there will be referral pain in back region.Otherwise, there will be other causes of lower back pain are trauma, muscle spasm, sprain, spondylosis, referred pain of pancreatitis, neuropathy and many more.You can do ultrasound abdomen and pelvis or CT scan after consultation. Till now, you can take tablet Aceclofenac. I will suggest you to review here with detailed history or consult with the surgeon with reports.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Shyam B. Kale",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could lump under armpit be due to history of stopped breastfeeding?\n\nhello! pls am experiencing a lump uunder my armpit from three weeks ago. i use to brest feed my baby when 4months ago when he suddenly stop taking my brest milk. now he is going to be 9 month on the 23 of june. am also having my monthly period at present.. pls tell me wht could this be??",
    "doctor_response": "Hi.Thanks for your query and an elucidate history. Since your baby has breast feeding 4 months aga and you have a lump in the arm pit only for 3 wees, these are not related to each other, The probable causes can be :Enlarged breast-tail into armpit, can happen after a childbirthCan be lymph node Sebaceous cyst or a boil. Simple clinical examination by a Surgeon, ultrasonography and if required FNAC can give us the best possible diagnosis, go for this and get treated accordingly. May a times we just have to keep a watch on further development.Additional mammography and ultrasonography of the breast can help",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness in sternum?\n\njust like when you crack your knuckles or back or whatever.Been going on for a couple of days. Leaned back in a chair and felt a crack or pop in my sternum. It felt good and I ve felt the need to do it again whenever I feel a bit of tightness in my sternum. Now I can just do it by spreading arms and expanding the chest cavity. Is this normal? I lift weight 4 day a week. upper body on Mondays and Wednesdays",
    "doctor_response": "Hello,Welcome, and thanks for sharing your concern I went through your query, and I feel, this is probably coming from the muscles and not the bone, as stretching of the muscles cause, relief tightness sensation, so continue with this and see if you have any other associated problem. I hope my advice would have been useful, in decision making regarding your treatment, still if you have any clarifications or doubts feel free to contact back.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What type of diet is suitable to cure renal cortical cysts ?\n\nHi Doc, my mom is suffering from Renal Cortical Cyst and has high BP. She really wants to know what should be the foods habit she should follow. I would greatly appreciate your kind answer. Regards, jim",
    "doctor_response": "Hi, As far as high blood pressure is concerned she should take less salt diet,law fat and less carbohydrate. For renal cause she should avoid green vegetables which contains high phosphorous or sulfate Take plenty of water..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatments are suggested for sore lumps in labia?\n\nI have a small lump that is sore between my labia and the crease of my leg, slightly closer to the genitals but certainly in that crease area. The size of a pea. I thought it was an ingrown hair because I shaved recently and it kind of has the same type of soreness to it. I also had sex recently so I got scared.",
    "doctor_response": "Hello, The sore lumps can be due to an infection in the hair follicles. This can also be related to herpes. Proper tests are needed to find the cause. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why are my mouth and chin numb after taking flexeril for sickle cell pain?\n\nHello, i just recently today got out of the hospital after 5 days & i was given Flexeril due to my severe sickle cell pain in my back. Over the course of two days flexeril was given to me, one 5 tablet pill & also two 10Mg pills. The left side of my mouth & my chin has now been numb for two days. I m scared. Will this go away soon? What can i do? Thanks in advance",
    "doctor_response": "Hello,I can understand your concern. Flexeril is a muscle relaxant which is given to you for severe pain in your neck. However, it is a typical side effect of this medicine that it may cause numbness on the one side of the body. As you are having numbness only on the left side of the mouth, it can be because of the side effect only. To answer your questions, I do not expect it to go away until the medicines will stop or will be changed. So you can consult your treating and prescribing doctor regarding this issue and discuss if medicine can be stopped or changed. I hope this information guides you well. Thank you for choosing HealthcareMagic. Take care.Best,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat swelling of toe as got hit by a tree stump?\n\ndoc, i accidentally hit my toe on a tree stump while wearing tips...it happened that my toe got swollen and was running water for about 3 days then it stopped. then weeks after i tipped my toe again and when i decided to remove the tip. my entire toe nail came out but it wasn t painful @ all, i believe its because the toe has been damaged really bad wen the accident happen so my question to u is will it grow back? and if it does will it grow with a discolored look? because it has a brown look every now and then",
    "doctor_response": "Thanks for contacting Healthcare Magic. This is a common occurrence after trauma to the toenail. Your nail will probably grow back but it will take some time. The dark color may stay until the new growth nail grows completely out.Hope I have answered your query. If you have any further questions I will be happy to help",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stiff neck and upper back pain?\n\nI have been experiencing severe pain in my neck. I cannot move it from side to side or back to back with out resistance and sever pain. I also have pain down the center of my upper back which also affects my chest area. The pain pulsates with my heart beat, I guess spasms. Been in therapy with no success. The pains are also immediate onset with no prior warning and may last up to weeks. Sometimes it feels as if a bone is poking me from the inside.Thanks.",
    "doctor_response": "Hello,Although you have not mentioned your age and your occupation, the symptoms you have mentioned are possibly due to stiff neck which occurs due to cervical spasm secondary to disc prolapse.I would suggest you to undergo physiotherapy for pain relief and also to strengthen your cervical muscles. If the pain and stiffness still persists, then please consult a local orthopedician.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Santosh S Jeevannavar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest ways for pregnancy with abnormal periods\n\nhi, my name is keesha and im from Ghana. ive been married for 14 months now and my husband and i have been trying to get pregnant without success. my period stopped flowing for 4months and i took two scans and several tests which came out negative. last week i took a local herb medicine and my period came. i want to know what caused my missed period for that long and what i can do to boost my chances of getting pregnant....please help, thanks",
    "doctor_response": "Hello dear,I understand your concern.In my opinion there are different causes for irregular periods like:-1)Thyroid abnormalities.2)Polycystic ovarian disease (PCOD).3)Overweight or obesity.4)Stress.5)Anaemia.etc.So all the above causes should be evaluated by getting done physical examination and necessary investigations.Ultrasound helps to rule out PCOD,thyroid profile helps to rule out thyroid abnormalities and HB to rule out anaemia.If overweight or obesity weight reduction helps in regularisation of cycles.Avoid stress if any.Stress and anxiety cause hormonal imbalance and delay the fertility further.Nothing to worry.Once the cause is treated the cycles become regular.Also get the semen analysis done for your partner to rule out any abnormality.Relax.Hope this helps.Best regards.....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have been told to have bilateral extra renal pelvis. Having stabbing pain in the right side. How did I get that?\n\nI have been told I have bilateral extra renal pelvis recently however a year before it was only on the right and they said it could be a 2.3 cm cyst on the right or extra renal pelvis.  Now I am having all this flank pain/rt side pain extremely sharp at times, like a stabbing.  how can you acquire extra renal pelvis over a year I thought it was congenital?",
    "doctor_response": "Hi and thank you so much for this query.I am so sorry to hear about  this finding. Extra renal pelvis can only be gotten from embryogenesis. This has been there from the time the kidneys were formed. So it all happened when you were still in the womb. It all by itself presents no danger to health. That is most likely not the cause of your pain unless there is something like an infection, stone, obstruction, etc. This should not cause your doctors to stop thinking it is the cause of your symptoms. It is congenital and never acquired. Please, get a second opinion from another urologist/radiologist. The reading of your scans or ultrasounds must be problematic.I hope you find this helpful. Thank you so much for using our services and please do feel free to ask for clarifications if need be. I wish you the best of health.Dr. Ditah, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ECG variation\n\nI have dysautonomia. I often have abnormal ECG readings when I m feeling very bad. Today s reading is moderate right and mid precordial disturbance. Negative T in V3 V4 with small negative T in V2 V5. When I feel good ECG is normal. When I am symptomatic often my oxygen will show drastic dropping for 2-3 min as low as 67 then raises to mid to high 80 s as soon as I lay down. It s normal. 97/98 when I feel good. It s rare been trying to get in orphan disease clinic. Drs have trouble treating my symptoms. I am 46 I was 35 when I first got sick. My grandmother had same symptoms and passed at 49 of sudden cardiac death. I am under close care of Drs but the past 2 yrs have become more symptomatic. Array of autonomic dysfunction. POTS. Respitory a fib a flutter recently developed neurological raynauds and Printzmetals. I wonder if the Printzmetals causes the abnormal ECG. And oxygen flux. Oh when oxygen drop hr goes high. Usually 140-160 then drops as oxygen rises. Not sure if fast hr makes oxygen look low or low oxygen makes heart go up but I know something interferes with my berating because I can feel it drop and feels like an elephant on my chest before the reading shows it s dropping I can say it s fixing to drop without seeing reading and I know when it gets back up. If it stays in the 80 s I don t feel the change Sorry for info overload. I know my diagnosis. My question would be thoughts on the ECG? Thoughts on how dangerous is the oxygen flux is? And any treatment ideas? ranexa helps the Printzmetals but I can only tolerate it in 2 week intervals due to kidney pain. Take clonazepam .5 when my heart rate won t slow at bed time but can t take during day and drive so my hr runs around 120-140 most days and I manage to function when it gets higher I have to stay home and take clonazepam Can t take beta blockers because of POTS and my blood pressure already runs low causing me to pass out. I take saline to treat that at home. Again Sorry for info overload. I know my diagnosis. My question would be thoughts on the ECG? Thoughts on how dangerous is the oxygen flux is? And any treatment ideas?",
    "doctor_response": "hello,I have gone through your query.Thanks for using HCM. Indeed yours is very complicated case and I need to know entire detail ,every investigation to give you proper guidance.Regarding your query on ECG and heart rate,I can tell you that heart rate increases with drop of oxygen.T wave changes which you are describing may be due to coronary spasm of printzmetal angina.Once the spasm subsides they disappear.As regarding POTS ,it is small fiber autonomic neuropathy for which take plenty of  fluids and very low dose Beta blocker will help to control heart rate without affecting Blood pressure.Have you undergone investigations for Collagen disease?I would be glad to know and discuss with you regarding your case if I get feed back from youMy best wishesDr.Rajesh Teli,MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Teenaged, obese, veins in the entire body pop out and get dark, random neck and back pain. Cause?\n\nhi my name is savannah im 17, and wiegh about 170. my veins in my entire hand randomly pop oot and get very very dark. my wrists also hurts and my feet do the same thing. Ive had random neck and back pain but the pain in my wrist and arm are constant. over the years i have abused allergy medicine and was wondering if iam having any affects from it. Whats happening???",
    "doctor_response": "you are a case of food allergy as per my experiences many patients are allergic to wheat or milk as these causes harmonal imbalance mostly milk asit is animal protein and is not competible with human proteins get blood tests for specific antibodies for milk wheat and common foods you take daily start by wjthdrawing milk and diary from diet i think you may feel good in  wk",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had a heart attack, installed stent, taken plavix lisinopril. Under stress. Looks like?\n\nhi i had a heart attack 4 yrs ago widow maker they doc caught it in time installed stint no damage is there an average life span expectancy i take plavix lisinopril simcore and metropolol tish oil krill oil and asprin every day i know this can vary i do smoke about one pack of cigs a day i know i should quit i will soon to be 61 male i used to have a lot of stress at work and past relationships and i am 5 ft 8 inches a weigh about 195 dropped from 233 lbs thanks for you input dennis merrell",
    "doctor_response": "Hi, Welcome to HealthcareMagic Forum Excessive stress in your may be due to excessive work load or due to anxiety disorder. History of heart attack also increases chances of anxiety disorder. You can meet nearby psychiatrist to rule out anxiety and stress management in your case. Till that time do morning walk, meditation, take proper sleep and take balanced diet to reduce stress. I hope this information has been both informative and helpful for you. Wish you Good Health. Regards, Dr. Ashish Mittal www.99doctor.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to grow muscles in indentation caused by Gynecomastia surgery?\n\nHello doctor a few years ago i was very obese so i developed gynocomastia and i had surgery plus liposuction to get rid of it.2 years later now i lost much fat and want to become a fitness model so i started to workout..but on little growth of muscle i noticed there are indentations near my left nipple from the operation..and muscle is not building there..what are the solutions ?",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: Go for plastic surgeryExplanation: If you want to be a model, then you may consult plastic surgeon for muscle transposition. Otherwise there is no need to do any thing. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in lower pelvis?\n\nI ve been getting increasingly more painful feelings in my lower pelvis---now the pains are feeling ice cold but warm at the same time, and the location of these feelings seem to be right where my ovaries are. I m 27 years old, female, and an ultrasound scan showed nothing abnormal. thank you.",
    "doctor_response": "Hello,I read carefully your query and understand your concern. Based on the fact that the ultrasound is normal, some physiological conditions may cause the pain.One of them is during ovulation.In this case no treatment is required. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is accidental ingestion of Lisinopril by children a concern?\n\nI dropped one of my husband s 10mg lisinopril and i can not find it anywheres we think or 2 1/2 year old might have found it and swallowed it. I called the er they told me she should be ok to keep close eye on her and if she gets a fever or starts breathing fast to bring her in. This was an hour ago but i am lookinh for a 2nd opinion",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. If more than 4 hours have elapsed since he ingested the tablet (and we are not even sure that he did ingest it), I think the child should be safe. Contact us if there is anything else you would like to know.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause and treatment for pressure and pain in head?\n\ntension headachesHello -My name is Brittany. I've been experiencing pressure, starting in the back of my head, that makes it difficult for me to sometimes hold my head up. It feels like my ears are clogged and someone is squeezing my head. My primary care doc has said that it could have something to do with my scoliosis and prescribed me muscle relaxers. I worry about this because my mother suffered permanent injury from a TBI from which she had a congenital cyst on her brain. What could be causing these headaches and do you think I should get an MRI?",
    "doctor_response": "Hello Brittany!Thank you for asking on HCM!Regarding your concern, I would explain that your symptoms seem to be related to tension type headache, which is a benign type of headache caused by anxiety. Cervical spondylarthrosis and a wrong position of the head during the day, a bad billow during sleep, can trigger this type of headache. No one of the above mentioned causes is concerning. So, I would recommend you to perform a lot of physical activity, try to correct your posture and use an orthopedic pillow during the night. If headache does not improve from painkillers, I would recommend performing a brain CT scan or MRI to exclude other possible causes that may trigger these symptoms.  Hope to have been helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Frequent cough and cold, vomiting, weight loss, had severe infection. Any home remedies?\n\nHi Doctor,My daughter is 2 years old and is getting cough and cold very frequently. This monsoon, she caught sevre infections 3 times within 5 months. She usually vomits dureing this period and refuses to each much. It takes toll on her helath and results in weight loss. She goes to daycare for a year now. Kindly advise some home remedies to increase her immunity.",
    "doctor_response": "hi and thanks for the question,keeping her warm is very important. It might be important to know why she is having recurrent infections. This could be due to inadequate treatment, resistant organisms or a condition that predisposes to recurrent infections. Primary immuno deficiencies, child hood diabetes and any childhood malignancies must be checked for excluded. I suggest you consult a pediatrician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have West Nile virus. Has nerve damage in spine. It affected neuro and vision. How to improve by therapy?\n\nMy sister developed symtems due to the West Nile virus., she is no longer able to hold her weight due to she has nerve damage in one leg and weak in the other. This has effected her neuro system and vision and she now has nerve damage in her upper and lower spine and right leg. My question is, how long will she have these systems and when should we start seeing any improvement as this has been going on since June 20th? What steps can her family do to help her improve her therapy to learn to walk again?",
    "doctor_response": "Hi, it might be late to think of what to do. now only neurologists can do any thing after the examination of the nerves, and muscles.                          See that she may not develop anemia. give her juices of palatable vegetables, like tomato, carrot, and beetroot etc,                          I to my patient with such symptoms prescribe injections of vitamin B1,6, and 12 for 10 consecutive days.                          Give her green leafy vegetables, pulses, sprouts, and proteine rich foods, to facilitate the recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lost sensation on left side of the body after a stroke\n\nMy mum suffered a stroke on Sunday. She lives in a nursing home & they had trouble waking her at 7am on Sunday so suspected a stroke. She was taken to emergency where stroke was confirmed. Mum could open her eyes (once) yesterday & could understand direction however not able to talk however today she has only slept. Is this normal or do you think she may in the coming days open her eyes & start to make progress. Mum has no feeling on the left side of the body & this was caused by a clot which travelled to her brain. She is 83yo. Thanks.",
    "doctor_response": "Hi, your mother had CVA with left sided weakness and numbness.She is in altered sensorium now .With in coming days she will improve with time and start responding in abetter way .Her weakness will also improve. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high blood pressure and cholesterol\n\nHi, i am a 55 year old female and my current med s are high blood pressure & cholesterol medicines, which work just fine. I am on day 4 of these cold/flusymptoms.....headache, body aches, sore throat, deep, uncontrollable cough with mucous coming up. I went to the dr yesterday...she thought viral and no antibiotic at this time. Strep lab test came back today negative, and she said my lungs sounded clear. i probably gave a false impression of feeling better, as i was/am on x-strength tylenol and robitussin DM, and at the moment i saw her was feeling a bit better. Slept 12 hours last night...woke up still wiped out. Had to leave work at noon today.....really really feel lousy and just beat. I did have a flu shot this year. I have to watch my 6 month old granddaughter next week and do not want her to get sick.....should i request an antibiotic? she said if it didn t improve, i could call and ask for one. she never really said what she thinks i have....flu? bronchitis? just a cold? i never get sick, so this is new and i really feel lousy. any advice is most welcome. thank you",
    "doctor_response": "By all means you still may have viral infection,  in many cases the symptoms you describe may be persistent for 4-5 and,  and some soreness and tiredness  may remain for 2-3. week.  So still I would say no antibiotic Is indicated medically.  However with consideration that you are meeting your grand daughter,  you may take the antibiotic which may or may not cut short the duration of the illness.  Also I would like to point out that robitussin contains dextraminopen (codeine like drug) ,  which is known to cause  sedation and tirednessRegards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat MYCOBACTERIUM TB complex presence?\n\nhello doc,after performing TB PCR and MTB test by collecting menstural blood and endometrium dr said that MYCOBACTERIUM TB COMPLEX present,but not in blood.he suggested to takr AKT3 ,combuTnex,pyricontin.after 6 month a laporoscopy will be done.is it right and safe?after six months can i conceive?",
    "doctor_response": "Hi, yes ypu should take akt for 6 month. Mycobacterium tb is the most common agent causing infertility. and standard treatment guidelines are available given by WHO. Just take treatment and hope for the best.thanks for using health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Deep big hole in teeth, gums beneath tooth visible. Pain and bleeding when food stucks.Will operation hurt?\n\nI ve had this fairly large hole in the back side of one of my back teeth for over a year. It s gotten a little bigger over time and used to get sore once in a while, but I almost never feel any pain from it unless something gets deep inside it. It s large enough that some of my gums below the tooth are exposed. I only chew on my right side because sometimes food gets caught in the hole and I get it out asap. It only seems to bleed if it gets poked, and it s not a lot. It s really annoying and honestly very embarrasing, but I ve had some horrifying experiences at the dentist and I m so afraid to go. I know it is something that I need to do and will be a huge relief but I m not sure what to expect ,..is the operation gonna hurt much ??!! T_T",
    "doctor_response": "hello, the condition you had described seems to be deep proximal caries in your tooth with gingival polyp in the cavitated region..  its good that you are cleaning your infected tooth properly but you need to consult a dentist soon... as your chewing on one side will harm your jaw joints.. your past experiences might be bad but now a days with lots of advancement in technology the dental treatment has become very comfortable too.. the treatment options for your tooth involves- removal of carious lesion , gingival polyp and root canal treatment of the involved tooth .. you can take anti-anxiety medicines prior to dental appointment or can also opt for conscious sedation.. dont worry about pain.. your problem will stop as soon as your tooth gets treated.. IOPA radiograph is needed to check for any periapical pathology that requires special treatment like surgery.. Root canal treatment is simple procedure where infected pulp within canals is removed, tooth is cleaned from canals and is refilled till the tip of the root apex.. dont worry.. meanwhile use antiseptic mouthwashes and brush twice daily.. take care..",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can temporomandibular joint dysfunction be treated?\n\nwhat if I have been falling into flower bed when dead heading flowers & have fallen to my right side TMJ in jaw on right side,have seen 3 different doctors for this problem. Also getting worse feel shaky & jittery--thought I had diabetes. Canyou tell me what I have?",
    "doctor_response": "Hi..Thanks for the query..It looks like you have injured your jaw joint as you said that you have fallen on your right TMJ..It can cause jaw joint dislocation, damage to the soft cushion that is present between the two bony ends of the jaw joint, fractures etc..Feeling shaky or jittery can be due to anxiety or panic attacks however it can also be related to other causes for which you need to get thoroughly examined..For jaw joint related problem it would be better for you to consult an Oral Surgeon and get evaluated..A Panoromic x ray should be done for ruling out the exact cause..For now you can take painkillers lf there is pain and along with it take soft diet and avoid hard foods.Avoid excessive mouth opening like during yawning, laughing etc..Hope this helps..Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of head ache in back side?\n\ni have sevier head ache in back side...tell me the solution sir...",
    "doctor_response": "Hi,Head ache and migraine are so complicate, it could caused by nervous system disorders, injury your back, neck and head , food, any fragrances, sleep disorder, living environment, etc. i had migraine head ache for 30 years, 7 years ago i met a person and she told me about negative ion clothes, open mind and tried so far no pain anymore, i highly recommend to try it, it will surprise you. check here",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will a parasitic infection cause swelling of the stomach?\n\nHi I am 35 yr old 2 yr into my hemo dialysis I feel ill after eating in from a restaurant I stayed in the hospital for two weeks the first week my tummy started to swell they don t seem to know what is causing the swelling . I would like to know if parasite could cause my problem I have suffer with pin worms as a child .",
    "doctor_response": "Hello, Thank you for your contact to health care magic. I understand your concern. If I am your doctor I suggest you that pin worm or enterobius vermicularis infects the lower part of the anus and surrounding area. It never causes swelling in tummy. Secondly it never causes such a severe disease that requires your admission to hospital for week. There must be something else that require further investigation.I will be happy to answer your further concernYou can contact me. Dr Arun Tank. Infectious disease specialist. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if infection in tooth persists even after extraction and taking Clindamycin, Metronidzole?\n\nHi This is  Fayyaz I removed my lower 2nd left tooth 5 days ago.Before removing Dr took X Ray  there was infection but she removed. She gave me Clindamycin and Metronidzole but still infection is theirafter 5 days. Please advise me some good antibiotic.Thanks",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,   You have undergone extraction as u said that you have taken 5 days antibiotic course then how can you can that infection is still there, dont worry much about that , still if you feel that infection is there you can take  Capsule amoxicillin 250 mg twice daily and Tablet metronidazole twice daily and Capsule vitamin B complex once daily for three days only , then if you feels you, still have any problem then consult your dental surgeonHope this will help you..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated SGOT levels?\n\nMy sgot level is 52, but my sgpt level is normal, 30. I have had kidney disease (minimal change) in he past although I'm not currently having a relapse. Also, I am 7 weeks pregnant, although I was not pregnant at the time of the blood test. Is thia reason to be concerned?",
    "doctor_response": "Hello and thank you for asking HCM.I have read you reports,and i understand your concerns.Depending from the range of the laboratories,or the kits that they use, the  normal levels of the sgot (AST) are 5 to 55 units and for sgpt (ALT) 7 to 56.So your levels are normal. Or if by chance the laboratory where you did the blood analyse has the range for sgot (5-40) than your slightly elevated levels can be due to these reasons:-alcohol-excessive exercise -fatty liver-medications like ibuprofen,Tylenol (paracetamol) ect-your kidney disease might also rise the levels of sgot.If i was your caring doctor i would tell you to not worry. You need to do another test after 30-60 days to see if the levels of the sgot are the same,lower or higher.To help your fat to heal,use these advice:-have plenty of fresh fruits and vegetables (it helps with your pregnancy too)-avoid fatty foods. High-fat meats include bacon, sausage, bologna, salami and hot dogs-Eggs and cheese should be eaten in moderation-30 minutes of walking each dayIf you have any other question,feel free to ask me.Dr.Endri Katro",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pressure on the head after an injury behind the head normal?\n\ni slipped on a tile floor when i was 3 or 4, i hit the back of my head. dont remember if i went to the docs, i remember hearing my family wanting to take me to the chiropractor. now i am 33, that fall left a knot, i notice pressure around it and it is tender to touch",
    "doctor_response": "Hello!Welcome on Healthcaremagic!Your symptoms are not indicative of any serious medical disorder, considering such long time after the head trauma. The knot could be related to chronic changes in this region of the scull, probably due to inflammation at that time. But, there is nothing to worry about. I would not recommend any treatment. Hope you will find this answer helpful!Wishing all the best, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in lower abdomen?\n\nI m having severe pain in lower abdomen.. have had this on and off for more than a year. it s transient; lasts for about an hour every few days and then goes away. started in lower right and radiates to middle. I m 59 years old; female. Appendix, ovaries and uterus removed. Colonoscopy and ultrasound were negative. Happens whether i am seated or standing, full or fasting. One doctor thinks it may be a bowel twist... would that come and go like this?",
    "doctor_response": "welcome to Health care magic.1.Bowel twist can cause similar symptoms, But it need to be confirmed if it is so - by taking a erect abdomen x-ray ( To see air fluid levels and coffee bean sign)2.It feels like a IBS ( irritable bowel syndrome ) for me, It can be ruled out by taking a CT abdomen pelvis, to see the bowel wall thickness and presence of any diverticulosis.3.Try to change your food habit to a normal diet (fruits and salads) avoid junk and fast foods and alcohol (if you consume) for month and try.4.Generall they go off in any cases i have seen - if not then get CT done.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have pcos, hypothyroidism. Failed ivm. Suggested ivf. On letrozole, oosure. Suggestions?\n\nI am 32 and had a failed `ivm last month. Now Dr suggested me to wait before I begin the next IVF. Mean while I was asked to try conceiving with the help of letrozole for 5 days starting day 2 & oosure in place of glyciphage as I have PCOS. My BMI is 25 and I am also been treated for hypothyroidism, TSH level is 2. Is it a right suggestion?",
    "doctor_response": "Hello, Thanks for posting your query on health care magic. Your doctor is taking you in a right direction. Oosure contains myo Inositol whic helps in conception. Letrazole helps in follicular development. Since your thyroid profile is within normal limits, chances of conception are good. Continue taking folic acid tablets. Be stress free and hope for the best. Wish you good luck. regards, Dr Nilofer",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of mentoux?\n\nI am in medical line sat for pre employment medical checkup about a month ago.My mentoux test reading is positive with 15 mm reading. I went for futher chest X-ray done and did my sputum AFB for continously 3 days with NEGATIVE RESULT. But Iam wondering know coz my scar is slowly disappear but yet still I can see even it was not so clear, after a month having the test on my skin.I am scared if the 2nd mentoux test done again, it might shows same result even chest X-RAY and sputum was NEGATIVE. Somebody explain to me. I need this for my job.",
    "doctor_response": "Hi,Welcome to HCM.You do not have to worry about Montoux test being positive because it is not diagnostic of TB infection. This test is like a screening test which can indicate past infection also. TB has to be confirmed by Xray and AFB in sputum. If you are negative for both these results, there is no need to worry.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are the hives around the arms, neck and backside and swollen lumps allergic reaction to raspberry extract?\n\nI make fudge every year, normally orange creme. This year, I tested out a raspberry and creme fudge within 24 hours. About 2 hours after making it, I had small but multiple hives appear all over my arms, torso, neck, and backside. Today, not even 12 hours later, they are huge swollen lumps and I am shivering; cortizone cream is not helping much. Is this potentially an allergic reaction to raspberry extract?",
    "doctor_response": "Thanks for query on HCM.Your symptoms and history suggest allergic reaction due to local cream.Try to avoid present local cream or switch over to other cream.Only local treatment is not enough for this.Continue to apply cortizone cream.You have to take levocetrizine and short course of mild steroid.Be watchful for next time.Otherwise consult dermatologist for further guidance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tenderness in the knees and groin area?\n\nA patient complains of persistent tenderness in the right knee and groin area. The tenderness started a few weeks after he injured the big toe of his right foot , which became red, swollen, warm, and painful. He says the toe improved without medical attention. The knee and groin tenderness remain. What could the physician identify as the cause of the patient\u2019s knee and groin pain? What is a possible treatment? AND WHAT TYPE OF X-RAYS",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Can be related to an infection in the area or osteoarthritic changes. Direct examination can help. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can hepatitis B be treated?\n\nHello. Thank you. A new neighbor, very nice Vietnam vet. Looks like walking dead. Not one sign of meat or fat. Bones on face all protrude. Bones under butt checks are all there is. He informed me today he has hepatitis B. I don't know about B, but it's contagious! This man goes to V. A. Hospital. He goes also, EVERY OTHER DAY, to attempt to give blood for tests. They poke him over and over but get NO BLOOD. They DO NOT KNOW WHY HES DYING, HELP. Sincerely Erin",
    "doctor_response": "Hi;It looks like your neighbour has a serious malnutrion along with a uncontrolled chronic infection (hepatitis B) for a long time. He must be thoroughly evaluated for active hepatitis B infection and its long-term complications (liver damage, malignancies, concomittant hepatitis C or sexually transmitted diseases etc.). If patient is rapidly deteriorating, parenteral nutrition and examinations must be performed after hospitalization.You must also be cautious for physical contact with his body fluids while visiting him due to possible active hepatitis B infection (and other possible viral infections). If he is unable to take care of himself or he has no relatives, you must call and inform social services.Hope your neighbour recover soon.Hasan Mutlu, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swollen penis\n\nMy son is 2 years old, and he got bit by some ants, and i noticed that his uncircomsized penis was swollen and i cleaned it the best i could. well tonight when i cleaned it again it was still swollen and when i tryed to pull the foreskin away to clean the tip yellow discharge came out and i am now very scared.",
    "doctor_response": "Hi,It seems that there might be having some infection on glans due to not cleaning smegma leading to soreness and swelling.Clean local part with warm water and apply antibiotic cream.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is straightening of lumbar lordosis in MRI report a cause for worry? Suggest ointments for acne\n\nHello Doctor!:)Can U suggest an effective cream/oinment for Acne?I'm staying in India and have tried soo many creams and failed!Also,Iam suffering from PCODAnother question is that-My MRI report shows that My Lumbar Lordosis is staraightening!Is that something to worry?",
    "doctor_response": "Hi,Thank you for posting your query.There is no need to worry about straightening of lumbar spine or loss of lumbar lordosis on MRI. However, you need to start back extension exercises to make it better.Regarding  PCOD, please contact a gynaecologist and you would improve with medications.For acne, consult a dermatologist.I hope my answer helps. Please get back if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes thick bloody mucus in saliva, fatigue and back pain?\n\nI woke up from sleeping and had a mouth full of phlegm and when I spit it out in the sink there was blood in it. After rinsing my mouth out, I took a deep breath and coupled up thick mucus blood. Plus I am very fatigued and my back hurts towards the bottom of my lungs .",
    "doctor_response": "Hello,You are having hemoptysis (blood in sputum). And your other symptoms are suggestive of lung infection (pneumonia) more.So, it is better to consult pulmonologist and get done a clinical examination of the respiratory system and chest x-ray. If the chest x-ray is showing infiltration, then you will need antibiotics (Amoxicillin-Clavulanic acid or Levofloxacin).Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Kaushal Bhavsar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart palpitations after pneumothorax?\n\nI had a pneumothorax after a lung needle biopsy. I decided not to have the chest tube but go home from hospital to rest to heal on its own. The day after the pneumothorax I have heart palpitation, it is worse after eating. The only time I don t feel it is when I am sleeping or resting. The last check with my lung doctor after x-ray, I was told my lung is fully expanded, and the lung sounded ok. However, my heat palpitation is really bothering me. Was it caused by the pneumothorax, and will it ever get better?",
    "doctor_response": "Hello, I don't think that the pneumothorax is responsible for the palpitations since they are still present now that the lung is fully expanded. The primary lung problem (that you took the biopsy for) may have to do also, or a possible cardiac origin. I suggest you do a cardiac sonography and a 24h ECG Holter monitoring to get more information for the palpitations and to choose the right treatment if it is needed. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Anila Skenderi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am bleeding heavily with clots after using emergency contraceptive pills. Is it worrisome?\n\nHello doctor, I am a 23-year-old female who is currently struggling with the unknown of what is happening to my body. Since I first started menstruating, I have always been heavy and longer than average. My normal periods last for 8-10 days, and I use typically 1.5 complete boxes of tampons during a cycle. I am in a long term relationship and have only had this singular sexual partner since 2017. I am not on birth control of any means and in some cases, I have had to use emergency contraceptives post intercourse. In the past two months, I have used contraceptives twice, once in the end of March, and most recently about two weeks ago. Since then, and this is the first time experiencing this, I have had dark brown, clumpy discharge, the closest comparison would be like damp coffee grounds. Within the past week, I had also gotten a thing flesh-toned or white clot with blood on it, about 2.5 inches in length. I am started to feel concerned as the discharge has not stopped and I believe that is occurring rather than a menstrual cycle, at the time I am writing this I should have had my period cycle now, but instead, I have this dark brown discharge. At this time, I fear the idea of going to a doctor\u2019s office for the safety of myself during this pandemic but also do not want to prolong any critical issues I may be facing. I have taken photographed images of all of this in worry that the typed description does not come across correctly. Please help.",
    "doctor_response": "Hi. Do not be stressed, I am here to help. According to your history, you have not got periods this month and you are having some abnormal discharge. I saw the picture. (attachment removed to protect patient identity).  My first suggestion would be to do get a urine pregnancy test. I understand that you have used emergency contraceptive but sometimes it fails. We need to know whether you have a pregnancy in which cases sometime the discharge is of nature as you described. You may be in the process of a miscarriage. If this is negative, then the next step would be to get a pelvic ultrasound done because the discharge seems unusual. But let me assure you that there are more chances of you having a miscarriage due to the failure of emergency contraceptives. In case your urine pregnancy test is positive you need to take proper treatment like pregnancy termination kits or Misoprostol tablets depending on the condition of the conceptus (baby) at this time. In case your pregnancy test is negative you need a pap smear, ultrasound, and sos biopsy of the tissue you are discharging. Whatever it is, it can be managed properly if it is addressed on time. There is no need for panic. Please follow up with your pregnancy test results. I hope this helps. Failure of emergency contraception. Pregnancy test. Endometrial hyperplasia. According to the test results.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a bald spot on the scalp of a 5 year old?\n\nMy 5 year old son has had a blad spot on the left side of his head for about 2 months. Can someone let me know why its not growing back? I took him to our family doctor and he seems to be fine, my son had some type of allergic reaction, and he was prescribes some meds for 8 weeks. He has been taking the meds for 12 days now and his hair still has not grown back, I am really concerned this has never happened before. please advise thanks!",
    "doctor_response": "It may be alopecia aereata it may be due to genes unknown cause or tinea infection.Take your child to a dermatologist wgo will properly diagnose and treat your child ailmentHope you find this helpful",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Children s Motrin have a generic substitute in India?\n\nI used to give by 4 years daughter childrens mortin in fever. It was quite effective. It contents Ibuprofen 100mg and pseudoephedrine hcl 15mg/5ml in USA. Now i m using Crocin suspension in India. but it is not that much effective. Can you please name any alternative to Childrens Mortin in India?",
    "doctor_response": "Hi, i am Dr. Diana and would be happy to answer your question. Well, actually for fever plain paracetamol or ibugesic is enough. Pseudoephedrine is not required for fever. We do have syp. ibugesic which contains 100mg of ibuprofen in every 5ml. But for mild fevers, around 100deg F, paracetamol should be enough and for any fever beyond 102deg F, we generally recommend ibuprofen or mefenemic acid (which is syp. meftal P).",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for numbness in left side of jaw\n\nIve had a numbness in the left side of my jaw for 3days now and currently now have a sore throat that feels like my throat is closing up when i eat or drink anything the only thing i am able to drink is water, i am 20yrs old im 5'1 and weight is 314lbs",
    "doctor_response": "Dear Sir/ Mam, Numbness in left side of jaw might be because of eruption of your third molar or wisdom teeth.Since important nerves and blood vessels passes near the erupting wisdom teeth, you may feel the numbness and throat pain.If your wisdom teeth is already seen in the oral cavity, check for any decay or infection .Take a X-ray (OPG).Since the wisdom teeth is last one to erupt in the oral cavity there might not be enough space.If there is no sufficient space in the jaws or if the wisdom tooth is not in proper angulation it cannot comeout completely.If there is no problem with your wisdom teeth, then suspect jaw joint (TMJ) problem.Hope your query is answered.Please dont hesitate to contact me back for further doubts.Happy to answer you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of gallbladder issues?\n\nAfter having severe pain on my right side underneath rig cage, I went to the ER three times the last ER admitted, and found nothing. I continue with this pain, and cramps. Lots of test were done for gallbladder. My mother, and Grandmother experienced the same symptoms, it was there gallbladder, but wan.t know until after their gallbladder was removed, and discovered chronic inflammation. I am 24 year old male.",
    "doctor_response": "Hi,Thanks for posting your query.I am Dr.R.K and I am pleased to assist you.The symptoms of gallbladder issues include pain in the right upper abdomen which may radiate to the right shoulder or the shoulder blades. There may be fever, jaundice.However stones in the gallbladder most often remains without any symptoms.I hope that answers your question.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can swollen glands, fever and rashes symptoms for chicken pox?\n\nHave a 16yo exchange student staying with us from Spain.  For the last 48 hours she has been running a fever has had swollen glands and today developed a rash on palms and bottom of feet.  A few of the rash are more pronounced than other - like chicken pox look.",
    "doctor_response": "Hello,Welcome to healthcare magic.I understand your concern about your friend's health.From your description, it does not sound like chicken pox. Chicken pox presents with rash which starts usually on the trunk and then spreads to the arms and legs. It appears like clear fluid filled bubbles. From your description, I would consider the possibility of another viral infection called Hand- foot and mouth disease. You could google for images and check if they match. It presents with red rashes and fluid filled blisters on the palms, soles and the mouth, which could slowly become turbid pus filled blisters. It could spread to elbows and buttocks. Treatment is mainly symptomatic with Paracetamol to control fever and calamine lotion on the rashes. It will resolve in 7-10 days.Hope this helps you.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does hyperinflation of both lungs mean?\n\nthere is hyperinflation of both lungs.the heart is normal in size and shape.the trachea is at the midline.both hemidiaphragms are depressed. the osseous thoratic cage showed demineralization of the bones. conclusions  hyperaeration of both lungs and osteoporosis ..doc what do you mean this? please help my father.",
    "doctor_response": "thanks for your questionhyperinflation of lungs are seen in emphysema which is a part of copd a disease caused by smokingwhen the terminal parts of lungs which help in breathing get enlarged with air in them collectively this is called as emphysema this is a phenomenon that in turn causes lung destruction it can be diagnosed by a chest X-ray and a spirometry and accordingly can be stagedas per staging medications can be started to control symptomsmostly inhaled puffs are enough to control the symptomsthanksfeel free to ask more questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fits of anger and lack of patience?\n\nSo i get annoyed randomly... For example my brother will laugh -i get mad. When people dont act serious makes me mad. My mom will make jokes-i get mad. I love my family amd dont wanna make anyone sad but happens. My mom tries to explain something to me i dk t have patiance to listen u get mad and say whatever comes to my mind.. Ill be on my phone say watchingvideos-i get annoyed and just put it away and just dreathe deeply. Doin one activity for more thsn 20 minutes makes me kind of shakey... I dont know whats going on with me. This been happening for 2 months mostly. I have a boyfriend long distsnce... And isomeone tried to rape me 6 months ago and it was a person i cared about s lot. So i dont know whats going on with me... Im 20. And my blood pressure whenever i check its 160/100",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Anger always comes due to frustrations in life. Frustrations are normal with everyone. People learn to ignore frustrations when they get experienced. Do you get angry to circumstances outside your home as you get angry at your house? Your office, bus stand, railway station, neighbors etc. If yes, you might need to get evaluated for anger issues. If NO, just understand and compare the two situations and you can be better yourself.If you require more of my help in this aspect, Please post a direct question to me in this URL.  Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lip bruising with cyanosis and tiredness?\n\nHello My daughter is 8 years old and I just noticed strange bruising on her chin inner lip and purplish coloured lips. I asked her of she hurt herself and she said no. I asked her if she got hurt at school yesterday an she said no. She looks tired that s about it. She does however have medical issues incontinence of the bowel and bladder she has a mitroffanoff for the bladder since 2009 and currently for the c-tube to be inserted for the bowel. We just returned home this week from check ups at sick kids in Toronto ontario so could be viral that something she picked up. I m very concerned with no idea what to do. Everything I search says cancer and well I m not going to just jump the gun an panic. Could u please give me some advice before we rush to a hospital.... Please and thank you",
    "doctor_response": "Hi, Welcome to HCM. I have read your question in detail and I know that you are very concerned about your child. Bruising of chin with purple lips in a 8 year old child could be due to many reasons like idiopathic thrombocytopenic purpura, leukemia or platelet disorder. In my opinion, you should do complete blood count with peripheral smear to confirm the diagnosis. Review back with above report. I hope this will help you. Wishing your child good health. Take care. Regards Dr Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had elevated liver levels. Scan report showed multiple cysts in the liver and fatty infiltration. Suggestions?\n\nHello, Dr. Grief.. My husband had elevated liver levels on his last blood draw in late August this summer and was advised to have an abdomenal ultrasound (he had it last Thursday), which indicated \"multiple cysts in the liver (2 in the right and 1 in the left)\".  The largest is 7.7cm.  Also the words \"fatty infiltration\" and \"liver cellular disease\" were read to us by our primary care physician's nurse from the report when she called to say the doctor recommends having a CT scan.  Can you tell us how serious this may be?  He is 73 years old, is 6 feet tall and weighs about 225 lb. I know his BMI is under 33 but don't recall exactly what it is without pulling out his last blood work up (done the end of August this summer). He does not drink alcohol at all.  He has diabetes 2, high blood pressure, and high cholesterol.  He currently takes 1,000 mg. of Metformin twice per day, 50 mg. of Metoprolol in the morning, 50 mg. of Losartan Potassium at night, 20 mg. of Simvastatin at night, and 0.4 mg. of Tamsulosin at night.  He also takes Zyrtec for allergies at night.  Thank you, Sandy Nickora",
    "doctor_response": "Hi and welcome to HCM.Liver cysts are usually benign and no treatment is necessary if there is no symptom or rapid grow of cyst or sogn of malignancy.The most common liver disorders is fatty liver which can be found in healthy people, but usually is resulting from elevated blood lipids, overweight and elevated blood sugar. If ultrasounds didnt find anything and viral markers are negative then you have no reason to be concerned. YOu should treat it by changing dietary and lifestyle habits. Do exercise, avoid alcohol, smoking, fats, fast food and carbonated drinks. Eat more fruit and vegetables, boiled meat and follow some of hepatoprotective diets. Findings usually improves on such measures. If not, then some medicines can be prescribed, but I suggest to go step by step. If you dont have any symptoms then this is just slight and reversible liver damage.Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can ovarian cysts and PCOS be treated for a successful pregnancy?\n\nHello Dr  Im 34 and my GP told me from looking at a scan that i had some cysts around my ovaries. People have been telling me i have POS and will probably find it hard to conceive.   Im now trying for a baby and i have regular periods of around 30-34 days and i also have symptoms of ovulation during my 'fertile window' i.e cervical mucus and abdominal pains and i wanted to know whether my egg will be released ok ready for fertilisation.",
    "doctor_response": "Hi,   Thanks for the wuery I understand your concern.    A regular period with ovulation ofcourse can be fertilized.    You should go for ovulation study to confirm ovulation day &also development of ovum.  -  You can then plan for a baby with unprotected sex around ( 2 days before & 2days after)your ovulation day..   - In case some problem with ovulation is found... you need specifuc treatment to overcome it.    Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to deal with pain in chest in blue babies case?\n\nmy name is brendan im 21 and i have a pace maker ...have had one since 2008. i was born with heart defect .called Blue babies born with a defect called transposition of the great vessels/arteries, in which blood from the lungs flows back to the lungs and blood from the body flows back to the body. The two major arteries coming out of the heart, the aorta and the pulmonary artery are connected to the wrong chambers. Such babies look blue because insufficient oxygen is circulating in their bodies. . well i went to heart doctor for chest pains ..and they said i needed to get a pace maker ..well after having one and having my med s changed from 25mg to 50mg and on a new drug called Multaq its 400mg ....i m still having thes chest pain s and burning on my left side of my chest .my dr. doest know why i m having thes pains and burning ....and my heart is turn side way s ..i just wish i could have help knowing why i m still hurting if they can t find out why i am ...they so i shouldnt be ..and it even make s my left arm hurt and hands and arm s go numb at time s the pain does stay all the time it come s and goes ..it come s more when i m walking around or cleaning ....PLEASE help me figure out what i can do",
    "doctor_response": "Hi, The very first thing is to rule out cardiovascular problems. Do need to recheck your heart and pacemaker status (EKG, echocardiogram, Holter monitoring). Next, should rule out stomach hyperacidity problems (gastritis, acid reflux) as they are similar to symptoms you are currently experiencing. Upper endoscopy is also recommended. Another explanation is neuromuscular issues as you experience numbness after working around home. Can check it out by neurologist. EMG studies are also recommended. For the moment I can only suggest you to take magnesium supplement to ease the muscle spasms. Hope I have answered your query. Let me know if I can assist you further.  Regards, Dr. Albana Sejdini, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What medicines can help treat renal hypertension?\n\nHello doctor, I have renal hypertension. I am on Cilaheart 20 BD. My BP is 160/100. My creatinine is 4.18 and urea is 104. Please help.",
    "doctor_response": "Hello. I suggest you add up a diuretic like a tablet Torasemide 10 mg once daily along with tablet Arkamin (Clonidine and Hydrochlorothiazide) 0.1 mg thrice daily. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. These would be able to get your blood pressure well under control. For more information consult a nephrologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could blood in saliva with fever in infants suggest?\n\nI have noticed a small amount of blood in my 17 month old's drool. Is this a sign of something serious? I have looked in his mouth and haven't noticed any new teeth coming in, and this morning he woke up with a fever of 102. I know that some children can run small fevers when teething but my son never has.",
    "doctor_response": "How common blood coming out of mouth or gums? fever is not related to blood? just do a bleeding time and platelets as well coagulation profile to be on safer side and be away from fear.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to recover from thalassemia intermedia?\n\nHello doctor,My brother has thalassemia intermedia. His Hb is between 7.8 to 9. Please suggest how soon he can recover from this.",
    "doctor_response": "Hello, Welcome to the icliniq.com. Thalassemia intermedia is severe as compare to thalassemia minor. In this condition, episodic blood transfusion is needed, especially during childhood. Your brother can be prescribed iron tablets if there is no improvement then blood transfusion might be required. I hope I have answered your question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes left-sided abdominal pain while treating fibromyalgia?\n\nno energy, mid stomach pain on left side, bowls are very slow, need to be very loose to go. stress is causing problems with sugar levels and blood pressure. major flare up with fibromyalgia, lots of pain can hardly walk at the moment. Been this way for many months, saw a gastronolagist wanted a c-scan of my left side, insurance wont approve request and been at a stand still for month and a half. I wrote a appeal letter have not heard anything. I cannot get my energy back or go back into remission with the fibro or maintain my blood sugars as long as I continue to be stressed by my digestive system",
    "doctor_response": "Hi, The left sided abdominal pain can itself be a symptom of fibromyalgia or can be related to renal colic, intestinal infection or a pelvic problem. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have astigmatism. Can I opt for a regular contact lens and will it cause any damage?\n\nHello doctor, I have a very blurred vision due to high eye grade and astigmatism. My left eye is 225, and the right eye is 675. I am planning to get a pair of contact lenses, but the special lenses are a bit pricey. Will it damage my eyesight if I am going to choose regular contact lenses?",
    "doctor_response": "Hello. In general, contact lenses are only meant for occasional use and cannot be used every day. In case you meant the special lenses have higher oxygen permeability and help your cornea stay healthy, please go ahead with those. The best option to remain permanently free from glasses is refractive surgery. If your power has been stable for around a year, I will recommend that you see your ophthalmologist for SMILE (small incision lenticule extraction) or PRK (photorefractive keratectomy) than using contact lenses for a long term. In case you need further information, please let me know.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having problem with bleeding gums\n\nHi my name is Sai. I have noticed on occasions that I am spitting red saliva. This has happened on three occasions and I am not sure if it is to do with bleeding gums or another cause. I have brushed my teeth regularly however don't seem to see any blood. Can you give me some advise on what it may be?",
    "doctor_response": "Hi! Welcome to Healthcaremagic.I read your query. Do you have any known illness? Or some throat infection? Most probably it could be bleeding from gums, which can be due to gum disease as well as some systemic disease.Do you notice plaque or calculus on your teeth? Get oral prophylaxis done. Dental check can confirm if you have gum bleeding or not. Brush twice daily. Use mouthwash with tannic acid. Take healthy diet, multivitamins and minerals.If bleeding persists, see a physician and get blood test done for clotting factors, Hb, chest xray, etc.At times throat irritation may cause blood on spitting.Hope the answer helps you. Thank you!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for open wound on buttock crack\n\nI have an 82 year old female that suffered a stroke 5 years ago. She recently (yesterday) developed an open would at on her bottom. what could I use to treat it? It is located in the top of her butt crack. (sorry don t know a better way to describe its location)",
    "doctor_response": "HI, thanks for using healthcare magicIt is possible that it is a bed sore especially if her movements are restricted due to her stroke.If this is the case then one of the main aspects of treatment would be to limit the amount of time she spends in particular positions. She should be turned at least every 2 hours while in bed. She should sit out of bed regularly.The bedding may have to be changed to those that exert less pressure.Dressings such as hydrocolloid and alginate dressing are helpful in bedsores.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat childhood operation mediated deformed penis?\n\nHello,My friend had an operation on his penis when he was a child and it deformed his penis. His penis head is split in 3 parts and he is a virgin. He will get married soon but is scared to have sex with his wife and doesn't know how to handle the situation, please give some advice. Thank you",
    "doctor_response": "Hi,Actually it is better to be examined visually by surgeon and then he will have some idea about his problem.After examination he will decide weather any reconstructive surgery is required or not to correct this position.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feel anxiety when having sex with boyfriend. Treatment?\n\nHello, would you please tell me what kind of treatment i need for BDD, apart for teraphy, councelling and CBT . I get very anxious when i have sex with my boyfriend and cannot watch him on the face, i alawys need to be dark in the room, and all the time feel shame when we make sex. He kind of get use with me but for me its very unconfortable,. I think my behaviour relate to my teeneger years when i have been very aubused by a man, mentally and physicaly. After that, now 10 years since happen, i have alawys been ashamed in relationship and wonder if i have to tell my boyfriend what make me happy in the bed or still keep shut, as i am concern about rejection or any other stress about my own body. Thank you very much for reading this and very apreciate if you can help me. Angela",
    "doctor_response": "Hello and welcome to Healthcare Magic. Thanks for your query. I'm not sure what you are referring to by the term \"BDD\". You have probably mispelt it; so please clarify. You have also mentioned that you are having a problem of feeling anxious and unconfortable while having sex. Like you have mentioned, it could be related to your past history of abuse or past negative sexual experiences. I would advise you to consult a psychiatrist for a detailed evaluation, so that further management of your problem can be planned. Wish you all the best. Regards, Dr. Jonas Sundarakumar Consultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can cause less dense beard?\n\nHi doctor, I am a 23 year old male. My height is 5'8\" and weight is 63 kg. I am currently not using any kind of medicine. My beard is not growing completely and I notice less growth on my mustache. Please help me.",
    "doctor_response": "Hi. Revert back with the reports to a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for abdominal pain\n\nDear sir.  I have been suffering from upper abdominal pain from last 4 years I have tried every possible ways but could not find relief.  I have got done endoscopy colonoscopy ct ultrasound lft and other blood test also. All were normal. It my request to please advice me what should I do. I am really very concern about this.  I used to imagine that i have big disease . I will wait for your reply.",
    "doctor_response": "Hello, thank you for your query.As far as I can see there is nothing to worry if all your reports were normal. You seem to be having acid peptic disorder (And dont worry its not a big disease).You should take a fibre rich diet (salads and fruits),whole grains, yougurt along with plenty of water/oral fluids. Avoid these 4 S:SpiceSmokeSpirit (alcohol)StressTake small frequent meals instead of 3 big ones. Avoid having constipation. If constipated,a mild laxative might help.Take a course of pentaprazole and domperidone (empty stomach)   twice a day ( for initial few days.Hope this was helpful. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it serious to have pain in the kidney area, pain by the side of the spine, tingling in lower legs after falling from a height?\n\nHello on December 19th due to the ice we got i was walking in house and fall from top of stairs about 4 feet and land on bottom, i landed on my back more on the left.side ,since then i have pain in my left kidney area ,i also get sharp pain in back along the side of spine with movement, bending over just a little i will get tingling in lower legs both and in both.feet, also happens when sitting certain ways,on toliet, certain chairs ,if i lay down a certain way.too, i also get tingling in fingers, what could i have done, is this something i should be worried about,seen for,it seems to be getting worse.  Thank you for help",
    "doctor_response": "Hi, thanks for writing to HCM.Based on the description of your symptoms, it is highly suggestive that you have suffered a Lumbar disc prolapse (due to fall) that is causing pressure over the adjacent nerve roots resulting in radicular pain (sharp & tingling pain) down the legs.An MRI scan of the Lumbar spine which help in diagnosing the severity of the problem.The initial management for this condition is by conservative measures as follows - Usually 1-2 days of bed rest will calm severe back pain. Do not stay off your feet for longer, though.- Change your daily activities so that you avoid movements that can cause further pain, especially bending forward and lifting  as it will worsen the disc protrusion. if you want to bend forwards, do it with your hips and knees flexed.- Avoid lifting heavy weights as it imparts more strain on your back- Use a lumbosacral back support to stabilize your spinal muscles- Use analgesics like advil or aleve and muscle relaxants to relieve pain and muscle spasm, as needed. Vitamin B12 supplements & Pregabalin may be helpful in controlling the neuropathic pain.- After the initial pain has subsided, remedial exercises to strengthen the spine are very important to restore normal spinal movements and muscle strength. The main aim of exercise is to encourage mobility, reduce muscle spasm, prevent further deterioration in the muscles and speed recovery.If your fail to improve with the above measures, an Epidural steroid injection may provide good symptom relief for a few months. There is good evidence that epidural injections can be successful in 60-70% of patients who have not been helped by 6 weeks or more of conservative management ( nonsurgical care).Hope this information is helpful. Good day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for shrinking kidneys\n\nthe blood pressure had increased leadind to paralysis attack . luckily the clot in the brain got diluted by medicines. person is now normal as to ble to walk on his own but both the kidneys have shrunk. bp is now normal. what is the remedy for the kidneys ?",
    "doctor_response": "Hello, there are several reasons for the kidney to shrink in size. Usually in chronic kidney disease, the size of kidneys shrink.Does he have any other complaints? Like decrease in urine output? Or swelling over feet or face?Sometime even with age the kidney size can shrink a little bit.I would suggest if there are no other complaints associated, no need to worry about the size of kidney. Just a regular follow up with USG  abdomen to look for size changes will suffice.But if there are other related symptoms, it would be better to get urine examination and renal function test to get it diagnosed and treated accordingly.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to test if delay in periods is caused due to pregnancy?\n\ndear doc, me & my(28years) wife had sex on December 24, 25, 26(protected).she had her period on January 16-22, a heavy one like regular(no sex in between as we work in different countries) . now in February, she is 13 days late. should we worry about her being pregnant or other health issues? we re not trying for a baby so early in our career.thanks in advance.",
    "doctor_response": "Hello,Thanks for letting us know your health concern. If you did not have any further intercourse after your wife had her natural period, there is no need to worry about pregnancy. This delay in menstrual cycle could be due to a transient hormone imbalance often caused by sudden weight changes, stress, infections etc. Please ask her to see her health care provider to detect the cause and plan further management. If the sonogram of the pelvis shows normal study, hormones can be given to induce the period. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes ill health and loss of appetite post dialysis?\n\nhi, my mother-in-law is on dialysis for about one year at the start of dialysis she was in good health but she is getting down and down very low energy level, loss of appetite and extreme weakness that all the time she is on the bed. she has a dialysis twice a week.i am so much worried about her can u please help me out in this regard?",
    "doctor_response": "hi i have understood your concernprobabilities of her problems are1.insufficient dialysis , may be she needs weekly thrice dialysis2.anemia secondary to chronic kidney disease3.vitamin deficiencies , during dialysis water soluble vitamins lost.4.electrolyte imbalances like hyperphosphatemia, hypo and hypercalcemia.i can suggest you to check1. serum sodium,potassium,phosphate and calcium2.hemoglobin levelstreatment1.if hemoglobin is less than 8 gms she needs transfusion.2.supplement her with becosules3.depending upon serum electrolytes she needs correction4.depending upon her volume status  , acid levels  and creatinine she may need weekly 3 times dialysis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in jaw?\n\nI am having severe jaw pain along with extreme sensitivity to the upper teeth. Earlier this week the bottom teeth also hurt.  Hot or cold shot severe pain thru my mouth.  I do know that I have TMJ, and problems with my shoulders and neck.  Can any of these be the reason for the pain?  Or is there something else that can cause it.  My sinuses bother me a lot but I haven't been checked for allergies, just the diagnosis of TMJ.",
    "doctor_response": "Thanks for your query, I have gone through your query.The sensitivity and pain in the teeth can be because of the decay resulting in teeth infection. The jaw pain is because of the temporomandibular joint disc displacement resulting in radiating pain to the jaws. Nothing to be panic, consult a oral physician and get it evaluated. You have to take radiographs like OPG and TMJ views to confirm the diagnosis. Mean while you can take anti inflammatory analgesics like piroxicam for the joint disorder. Antibiotics like amoxicillin for the tooth infection. Do not eat hard things, do not open your jaw too wide.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recurring swollen and itchy rashes in extremities of body, bright red gradually turning brownish. Possible causes ?\n\nHi, I wanted to know what kind of condition(s) could I possibly have. I randomly have a recurring condition where an area of my body develop some kind of rash. It is raised and itchy and swollen. Sometimes it s large, and sometimes it s small patch of the affected skin. The rash doesn t go away quickly, rather it stays bright red after a few weeks. It gradually became flat and not swollen anymore and then the rash gradually turn brownish and it is difficult to fade or disappear. The rashes only appear on my extremities, arms and legs, so far.",
    "doctor_response": "Welcome to HealthcareMagicForum Hi..flo.. there are many conditions for the development of the rashes, some are wearing new cloths leads to allergy, food allergy, insect bites.., you need to be clinically examined , evaluated, and treated..consult the dermatologist.. Take care..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Esophagitis and  gastritis, Blood and mucus in bowels. Colon cancer?\n\nI have acid reflux and was diagnosed with esophagitis and gastritis through upper endoscopy. Am constipated on and off and have recently noticed a (very)  small amount of blood and mucous after a bowel movement. I am 48 and my last colonoscopy was 13 yrs ago- normal. Fecal occult blood test last month- negative. I am feeling really worried about colon cancer?  Could it be something less serious?",
    "doctor_response": "Hello,There can be various causes for blood in stools along with mucus.These causes can be ..HemorrhoidsInflammatory bowel diseases like ulcerative colitis and crohn's disease.Colon and rectal cancer.You should not take it lightly and get a colonoscopy along with a possible biopsy,if required.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nervousness, light headedness and high BP?\n\nAll week I have felt intensely nervous and light headed at times and at times my verbiage when I m speaking is not in order, my systolic is 142 diastolic is 91 pulse is 91 and these numbers are the average over the last 4 days. Should I be alarmed? I am 35 years old, 6 1, 195 pds, i do smoke approx a half a pack each day of cigarettes, however i do not drink nor use any illegal substances. I am epileptic and take anticonvulsant meds 3 times daily. Should I be concerned?",
    "doctor_response": "Hello, Your symptoms could be related to mild arterial hypertension, probably caused by a stressful situation. For this reason, I would recommend having some rest and avoid smoking or caffeine intake. It is also important checking your thyroid hormone levels for possible thyroid gland dysfunction. Only if high blood pressure values persist, further tests may be needed (complete blood count, PCR, ESR, kidney and liver function tests, blood electrolytes, a resting ECG) and also consider starting anti-hypertensive therapy. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is my missed period due to stress?\n\nHello doctor, I am a 35 year old female who weighs 139 kg. I am concerned about my periods. I had my last period two months ago, but have not had one since then. I feel that I ovulated on time after my last period, and have basically had PMS ever since. I have very tender breasts, lower left sided abdominal pains from time to time, lower back ache to a lesser extent, and am feeling very emotional, just like my period is about to arrive. But, there is no sign of it. I have had four negative pregnancy tests over the last couple of weeks including two home tests, one urine\u00a0test, and one blood test. My GP had carried out full blood work and everything came back normal. I know I am very overweight. However, I had never had a period problem before. I have been under some stress this year. So, I wonder if that is the cause. But, I am very concerned in any case. I am due to attend the hospital for a transvaginal ultrasound scan soon, to find out the cause of the lower left abdominal pain\u00a0but, wondered if you had any further ideas as to why my period may have stopped, even though I feel that it is about to arrive.",
    "doctor_response": "Hello. The problem was bound to start sooner, if not later. For more information, consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a sting on the arm\n\nHi there I ve been stung/bitten on my arm It was either last night or early this morning. I ve taken antihistamine but it s got worse through out the day. My whole are has swollen up, it s very painful, it s making me feel sick and my arm feels like it s starting to go numb. Is this normal? Thanks Brioney",
    "doctor_response": "dear, donot worry. sometimes bite injuries take time to get ok.. so, you should take an antiinflammatory & an anti histaminic. it will get alright in 1-2days",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to wean off Paroxetine and Clonazepam?\n\ni am 47 year old men i am suffering from general anxiety disorder .i am feeling thartharahat sweating blurd vision ,stomuch fullness , i diagnosed fatty lever grad 1 in 2017. i am taking paroxetin cr 12.5 since 2012 with chlonazipam 0.5 od now i want to tapper medicine(pexep cr 12.5) but after 5 days to stop the medicine i feel a vibration in haead and body. sir i am wraping tobaco paste gudakhu from 20 years now i want to stop medicine and tobaco paste kindly help me.",
    "doctor_response": "hiyou have probably - ssri with benzodiapine with nicotine use diaorderthere are 2 modes of therapy1. substitutionhere we substitute tobacco with a nicotine lozenges 4mg twice or thrice a day and add bupropion extended release 150mg to act on both craving and anxiety2. de addiction with admissionan indoor therapy where we stop all the substances and get de addiction done with iv fluid and other medicinal supportthank u",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have burning sensation in chest with throat irritation and no fever. Please help.\n\nHello doctor, I am a 27-year-old male. I have had a mild burning sensation in the middle of the chest for the past few days and along with slight irritation in my throat. I also sometimes feel bloated and have slightly more than normal amount of burps. I have no cough or fever (checking temperature on a daily basis and highest is 98.6\u00baC).",
    "doctor_response": "Hello. Based on your history and symptoms you may be having gastroesophageal reflux disease (GERD). If the acid goes up to the throat area, it might cause thick mucus. In this case, this is classified as laryngopharyngeal reflux disease (LPR). You would need to take a different medication. I recommend you take Omeprazole 40 mg one tablet 30 minutes before breakfast for two to three weeks. I would also recommend you avoid oily, fatty, spicy, and dairy food. Avoid alcoholic, carbonated, and caffeinated drinks. Avoid smoking and avoid lying down within one hour after eating. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for back pain\n\nI haven't been working for a while now because I'm a full time student.  Last week I work for 3 consecutive days stading, moving and walking around for 7-8 straight hours.  Then I slowly realize that my lower back hurts so bad, and now I'm in school it still hurts but not too much as it used to.  So why does my lower back hurts?",
    "doctor_response": "any kind of stress in the body can lead to injury , I think there must be lot of pressure in back muscle , this is normal of of excertion , you can take muscle relaxant and things will be back to normal, even if you work for long hours, try to do some body stretch outs, it helps to relax the muscle .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest a remedy for tonsillitis in a 4 year old\n\nhi my 4 year old daughter has tonsillitis she can t eat or swallow her own saliva it is pouring out of her mouth.she is taking a 10 day course of penicillin started on tuesday after refusing to take erithrymicin given on saturday.she hasn t eaten solids since last friday has lost a lot of weight she will only drink orange juice",
    "doctor_response": "Drooling of saliva in tonsillitis is due to pain associated with swallowing. This also causes loss of appetite.Ask your doctor to add ibuprofen and paracetamol. These medications will reduce pain associated with swallowing and your child might start eating and drinking.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dull ache in left testicle?\n\nHi, may I answer your health queries right now ?  Please type your query here...I have been having some pain in my left testicle.It is just an dull aching pain but nothing is sore to the touch.I have noticed that it seems to ache more after i stretch.should i be concerned",
    "doctor_response": "Hello, It is likely to be muscle stretch. However other possible causes are infection, stone, varicocele and rarely tumour. Try using tight undergarment. If still the problem persists, do ultrasound scrotum. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Sujoy Dasgupta",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in lower back,hips and knee\n\nwhich doctor should i see if i have pain in my lower back (deterating disk with artirtis ) and artirtis in my neck and now the pain is going into my hips that it is hard to walk because of the pain and now also i have pain in my left knee. I am also 2 shorter on my right side than my left but i have lifts in my shoes.",
    "doctor_response": "hi,thank you for providing the brief history of you.As you have degenerative disc disease and arthirits you need to have a thorough neuromuscular assessment and an MRI as well. By which the level of this injury and soft tissue status can be understood.Undergoing physical therapy like therapeutic ultrasound therapy and TENS therapy should help you reduce the inflammation and pain.In my clinical practice most cases with degenerative disc disease responds well to physcial therapy.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in the right hand?\n\nHi, my almost six year old daughter has said 2x today that her right hand felt numb and prickley. Once in the morning and once in the evening. She has done nothing out of the ordinary today or yesterday. She is otherwise healthy. Is this a sign of a serious medical problem and can a six year old get MS?",
    "doctor_response": "DearWelcome to HCMWe understand your concernsI went through your details. Numbness and prickly feeling of right hand should be investigated. But nothing to worry about. Check the child's writing position and hand position while sleeping. these are tow basic causes for numbness.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had inflammation of lungs. Noticed flu virus during washing. Taken fostair steroid and ventolin inhalers and doxycline. Guide\n\nHi there, I have gone downhill since before  2008. The consultant advised me it was the bird feathers on my elderly parakeet that caused scarring of the lungs. (re-occurrent chest infections) New consultant, 2012, does not agree with allergy and thinks it is something else. I have just recovered from pneumonia (hospitalised) and tamiflu, they found this in one of my lungs, after bronchoscopy to find cause of inflammation in the lungs. I was too ill for them to do biopsy, but they performed washings...that is how they came across the flu virus. Have taken the emergency meds for that now and hopefully on the road to recovery. I have fostair steroid inhaler and ventolin inhalers and doxycline for a month. I have a consultant appointment in early May. I do trust my consultant and he wants the answer to what is attacking my lungs as much as me. I hate inhalers though, especially the steroid one, as have osteroporosis...on a natural diet and exercise programme for this.   Any advice you can give me?",
    "doctor_response": "Hello,Welcome to Healthcare Magic.I am not certain what the diagnosis is at this stage: posibilities (1) central bronchectasis, with asthma and aspergillus sensitivity (not certain if this test was done) is ABPA (Allergic Bronchopulmonary Aspergillosis); (2) or depending on the nature of your work, or the number of avian species at home it is hypersensitivity pneumontis.You need the following tests:1. HRCT Chest2. Precipitins3. or Aspergillus IgG4. Total IgE levels5. Skin prick test to aspergillus species6. Pulmonary function testsYou must get these tests done when you are well from this recent infection.A combination of steroids and antifungals could be tried if it is hypersensitivity pneumonitis.Best Wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Meningocele repair in an infant risky?\n\nMy 3 month old granddaughter is scheduled to have Meningocele Repair in the morning about 10 hours from now, I m concerned that her parents have not been made fully aware of the risks to her immediate and future health. She has a 12mm round cyst on her lower spine which is covered with a thin membrane, it is sometimes more or less flat (raised around the edge) and sometimes raised to about 13mm. Since birth she is a normal happy interactive baby with normal strength in her legs and normal bowel & urinary function, she responds to touch on her legs & feet. The Specialist has said the spinal cord is in its NORMAL LOCATION inside the spine, there is NO nerve tissue inside the cyst and so the risk is insignificant, any functional or sensory disruption would be only short term. From various internet sources it seems even with no nerve tissue present in the cyst / meningocele there is still significant risk of permanent motor / sensory / urinary / bowel function LOSS. What is the truth ?.",
    "doctor_response": "Hello, Meningocele repair always carry the risk of permanent weakness due to close proximity of the nerves. In your case the odds for complications are low. However, proper consent must be taken and risk must be explained. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring cold and cough in a child?\n\nHello, my daughter is 2yrs. She weighs 9.5kg. For the past 1month she is suffering from cold n cough. Later she was fine for 2weeks n again the same is repeating n the doctor prescribed for montair LCD kid. I also have a doubt that for what she might be allergic to. I bit worried abt her.",
    "doctor_response": "Most of the cough in children of this age is caused by certain viruses and such infections often recurr. It generally has an allergic component. It is not that she is allergic to certain things and hence montair LC (monteleukast + levocetirizine) is being given. It is simply to reduce the allergic reaction of cough. Your doctor has done the right thing. Also give the child steam inhalation. The water in form of vapour will reach deep into the lungs and help in diluting the cough and give your child relief.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pulled out teeth, foamy liquid draining from teeth. Is it some bacteria under my teeth?\n\nI have had two 3- teeth bridges slide off recently; two back teeth that needed to be pulled; and a root canal . All of this happened within 2 months. Something is draining from what looks like under my teeth - usually it s slick and today it s foamy. It has a horrible putrid-sweet-sour taste and I haven t even eaten anything. Could it be some sort of bacteria under my teeth?",
    "doctor_response": "HI ROCKYY, Thanks for posting your query. The foamy liquid is due to the abscess formed at the periapical area of involved tooth. The pus usually contains bacteria. I would suggest you get the tooth either root canal treated or extracted depending on the condition of tooth. Take complte course of antibiotics too. The sour taste will disappear once the pus drains out completely. Maintain good oral hygiene. Please get the treatment soon as it can lead into sinus infection if left untreated. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for bruise on the chest region?\n\nHello - in an attempt to pick me up and throw me over his shoulder like a jokester barbarian, my husband accidentally put too much pressure directly in the center of my chest and it now is very tender. I don t have any bruising or swelling, but I can t lie down flat, cough or do certain movements, like push down the trunk of my car, without pain. I ve looked up common symptoms for bruised/broken ribs/sternum but everything says I would have swelling and/or bruising, but I don t. It s extremely sensitive in the center of my chest and outward to the left. I can breathe deeply with some sensitivity, but not unbearable, but it does hurt when I put my shoulders back to sit up straight. Any thoughts?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. You are having blunt chest trauma. And because of this, you are facing musculoskeletal injury. No need to worry much for this as it will gradually improve over the time of 1-2 weeks. Follow these steps for better symptomatic relief in musculoskeletal pain. 1. Avoid movements causing pain. 2. Avoid bad postures in sleep. 3. Avoid heavyweight lifting and strenuous exercise. 4. Apply warm water pad on affected areas. 5. Take painkiller and anti inflammatory drugs. Don't worry, you will be fine with all these. If not improving after 1-2 weeks then consult doctor and get done chest x ray to rule out internal lung injury.  Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly explain whether my cytology report shows metastatic breast cancer cells.\n\nHi doctor, I had my cytology report from pelvic wash before hysterectomy. I need some clarifications on the pathology report. The report showed\u00a0atypical cells - reactive mesothelial cells, enlarged and crowded nuclei, positive for calretinin and negative for Ber-EP4. Could these be metastatic breast cancer cells? I have a previous history of TNBC.",
    "doctor_response": "Hi. You have not mentioned the reason for which hysterectomy was done. Before giving a comment, the location of mass should be known. Usually, calretinin stain applied to differentiate between mesothelioma and other metastatic carcinoma or adenocarcinomas. Calretinin can be positive in breast malignancy. Certain ovarian tumor, adrenal cortical tumor, olfactory neuroblastoma, etc., also give positive calretinin reaction. So, mention where the tumor or mass located and accordingly further comment can be given. And histopathology examination is advised for reaching the final diagnosis. Take care. for further information consult a pathologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the prognosis of ALS with total paralysis?\n\nYes, I m looking for a staight anwer. Thanks for your time. I take care of a very dear friend that has als. I feel she is nearing the end . She is totally paralyzed and can hardly talk or swallow anymore. She has refused any prolonging assistance. Could you possibly give me some kind of time line . Her first symptoms started in 2007, but wasn t officially diagnosed till yearly 2009. Can you give me any info. Thank You, Carma P. Amery, Wi.",
    "doctor_response": "Hello, As of you already know, no one knows the exact time for this particular patient. However, other patients similar to him who develop bulbar symptoms (speaking or swallowing issues) usually survive for about two years. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sudhir Kumar, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can painful chest be a result of hypertension or possible angina?\n\nHello i recently started running like 3 months ago,  I am now running 3 miles like 3 times a week. I have started getting pain only in my chest not in my arms or jaw that goes away in like 1 hour. I am on 32mg of atacand for hypertension could it be heartburn or possibly angina I am going to see my doctor tomorrow and I am really nervous could the running have caused angina My cholesterol is normal and my blood work is checked every year by my doctor. My blood pressure I check it everyday it is between 110/65 and my resting heart rate since I am running is 75bpm. I am scared to run now.",
    "doctor_response": "hi as most of your parameter are normal  its goodbut as chest pain is  there while running(exertion) cardiac involvement cannot be ruled outyou have not mentioned your smoking and drinking habiitssmoking if present is a sole risk factor for all cardiac diseases i would suggest you a easy way next time if during running you feel chest pain, take a tablet of sorbitrate  sublingually ,if pain relieves in  10 minutes ...it is very likely to be anginaget an echo cardiography done and a tmt dobne as tmt will reflect any loss of blood supply toheart during exercise ,,,as in you case tx",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment and precautions to be followed for the fits?\n\nhi i am balaji, 25 years old and 172 cms height and 54kg weight. i fell down first time in december 2010 due to fits, and then i was prescribed with medicine eptoin 100 mg for 3 months, one per day at morning. after using 2 months again fell down even i taken it. but i drunk day before that day. then i prescribed with epsilon 300mg. i used 2 months, then again i used 100mg for 3 months and i stopped. 9 months later recently i fell down and doctor now given me zeptol 300 for testing of 10 days. can u pl tell me is it match to me? if yes pl explain the things what i should not.",
    "doctor_response": "Hello, The most important thing is never ever skip the drugs. Avoid high-risk activities like driving, swimming or handling heavy objects. An MRI scan may be taken to rule out any possible focal lesion in brain. Consult a neurologist and he will direct you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can sperm count decrease or Fallopian tubes get blocked suddenly ?\n\nHii.. I was pregnant on April 2010.But in June 2010 I have to undergo abortion because heart beat of the featus has stopped.After that we took a break of six months as per Doc advice. Now we are trying for a baby from Jan 2011,but I am still not pregnant. Doc has monitoried by ovulation by giving Fertyl tab in March and Letrozole in April.I am ovulating properly.We have not done sperm test yet. Can you please guide us what wsa tha possible cause of not getting pregnant? First time I got pregnant naturally.Is it possible that after that sperm coun may have decreased ot may fallopian tube may have blocked please guide.",
    "doctor_response": "Hello ; welcome to HealthcareMagic Since you had one pregnancy naturally then you should get pregnant as there should be no major problem.But since ironically you had to get aborted.If you have regular periods;ovulation is proper;semen analysis of husband is normal and fallopian tubes are patent then you will get pregnant as these are the main criteria to get pregnant.So get examined by a Gynaecologist and if required investigated to see the patency of tubes and go ahead and you should get pregnant sooner or later. All the best. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes these symptoms?\n\nI had h pylori in which was treated via antibiotic. I take probiotics on occasion to aid in digestion. Currently, I have lower stomach cramps,pain,bloating,fatigue,lighthediness,nausea,lowerback pain,,random dizziiness,more frequent urination..I was retesed for hpylori and it went away..what can this be?",
    "doctor_response": "You have not mentioned the duration of your symptoms. However, the symptoms do not suggest an exacerbation of a Helicobacter pylori infection. It is more suggestive of an enteric bacterial or viral infection that must have caused an infection. You should give your urine and feces for culture and sensitivity to know what this is. Please meet your physician with these results, and he should help you in taking this further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with PCOD, rashes, blisters, itching. Recommended Lactacyd. Suggest medication\n\nhi,im 25 yrs old. recently married..i have been diagnosed with PCOD a year back.few months back i started to have slight itchiness in the vaginal area and one medico friend of mine suggested me LACTACYD. i used it for few days and everything was alright. now itchiness,rash and small blisters around vagina on exterior side developed.LACTACYD is not working for this.so pls suggest a proper medication for this",
    "doctor_response": "Hello,Welcome to Healthcaremagic.Thanks for your query.I have gone through your query and understand your concern.I suspect you may have Genital herpes.The features you are having like blisters, rashes and itching are typically genital herpes symptoms.It is one of the sexually transmitted disease. It does not necessarily mean to transfer by sex. It may be transmitted by use of infected individuals soap and scents etc..There is no permanent cure for genital herpes.But the symptoms can be lessened and prevented with treatment. Treatment can also reduce the risk of passing the virus on to someone else.Usual treatment for Genital herpes is Antivirals like Acyclovir.Your Primary care physician may know about the dosage and drugs.My advise is to get proper physical examination by dermatologist.If possible , consider about swab test for further diagnosis.Hope this helps.Please reply for further queries.Wishing you good health.Regards,Dr.Manjeth kumar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Gynera pills. Am I safe if I have unprotected sex?\n\nit s my first time to use gynera pills..i started my menstruation last sept.26,2012..i drink the tablet on my 7th day..am i safe if ever i ll have unprotected sex? When is really the best day or time to take the pill in my period? I usually have my menstruation more than 1 week,that s why i tried the pill..so that next time i ll have my period,maybe it ll be a normal flow. Please advise,thanks.",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern, I actually do not believe in hormone tablet if taken without any clinical cause if your are taking this medicine for contraceptive purpose then let me tell you that no contraceptive method ate 100 % promising and safe, taking such medicine for no good or valid reason would be harmful, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the gap between molar tooth and gum?\n\nHi!I had a temporary filling done 6 months ago, and last week a piece from my molar tooth just broke, so I went to the dentist who just removed the old temp filling and did a new one(the dentist said that he used a new filling method that is done with gel). The problem is that after the filling I noticed a gap between my molar tooth and gum. Isn't that a sign of periodontitis and shouldn't my dentist have diagnosed that? How should it be treated?",
    "doctor_response": "Hello,  Thanks for consulting HCM, Read your query , as you have gap between molar tooth and gum this can be due to periodontal problem may be due to recession or due to bone loss there is gap between teeth is there , there is nothing to be worried I will suggest you to consult oral surgeon (Periodontist ) and go for examination of gums and tooth if needed, go for IOPA xray of tooth to evaluate the bone loss in between tooth and go for its treatment.  In meantime maintain proper oral hygiene , do warm saline rinses, brush your teeth twice daily. Hope it will help you.  Wishing you good health.Regards , Dr. Priyanka tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to confirm pregnancy after missing a period?\n\nHello Madam, I just want to know that my wife does not got periods on her expected date (27Oct'10) and we intimated on 6th Nov and she also not got her periods again, as she is now pregnant, Mam can u please let me know that is she 2 months pregnant or 1 month..",
    "doctor_response": "Hi dear, I have gone through your question and understand your concerns.Delayed periods can be due to pregnancy, or hormonal disturbances like hypothyroidism, hyperprolactemia.Iwill suggest her to get a urine pregnancy test done to confirm the pregnancy, if positive then a ultrasound should be done to assess the duration of pregnancy.Hope you found the answer helpful.Wishing you good health.Dr Deepti Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for varicocele?\n\nhii dr.. i am 33 yrs old ,i got married since one yr .i resently found varicocele in my lt side..i am working in dubai.its mild degree.dr told me to take tablet for 3 months. i will go vaccation on october.shall i try to get pregnent to my wife on october and post pond my surgery may b next yr..it might b on april...bc my wife also working abord..kindly reply to me sir thank u..",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn Short: Usually surgery is not advised if varicocoele is mild.Explanation: Varicocoele usually occurs on the left side. You need not worry about this if it is mild and your semen analysis is normal. So, there is no hurry  to have a child, you can take your own time and it is ok to have child after your surgery also.                   Its your personal decision so, you may proceed with your own idea without postponement.                   Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My report says there is blood in urine, but my doctor says I am fine. What should I do?\n\nHi doctor, Recently, I had undergone chest X-ray, ECG, creatinine, fasting glucose, postprandial blood sugar, urea, uric acid, lipid profile, liver function test, thyroid stimulating hormone, TSH, urine complete analysis, complete blood count with ESR and ultrasound of abdomen and pelvis. All the reports came back normal except my urine report. My chemical examination of urine says there is blood in the urine and the microscopic examination says pus cells and RBCs are present. I contacted my\u00a0doctor immediately and he suggested to go for urine culture and sensitivity. The report came after three days and it looks normal as well. It says, no growth noticed at the end of 48 hours of incubation and microscopic examination says occasional pus cells and no microorganisms were seen. The doctor said not to worry and that everything is alright. He suggested taking more water. He also mentioned that the ultrasound report is also normal. I searched on the internet about RBCs in the blood and saw some very strange articles which scared me a lot. I request you to kindly help me out and suggest what I should\u00a0do.",
    "doctor_response": "Hello. According to your reports, it seems to be a urinary tract infection secondary to a kidney stone. Some kidney stones are not visible on the ultrasound. So, I suggest you do a CT scan of the abdomen and repeat urinalysis. If the same report persists, then we can think of nephrolithiasis. Such reports can be seen in acute kidney injury secondary to a urinary tract infection which usually subsides on its own. Do not worry. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itchy rash, scaly, spreading in nature. Applying ointment. Should i take oral medication?\n\nHi I have a skin problem and its spreading all over my body head to toe. I have been waiting for the dermatolgist to phone with an appountment it been over 1 yr since I have been referred. anyways the rash is itichy scaley I'm using a oniment with steriod in it stops the itching but its not going away. should I be taking an oral medication?",
    "doctor_response": "Hi, thanks for your query. As per your information you are suffering from itchy and scaly rash since one year and you are not relieved of the problem by steroid ointment.You seem to have a fungal infection for which you may require oral anti fungal medications and local anti fungal creams. I advise to get it examined by a dermatologist for exact diagnosis and treatment rather than self medication. Hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach tumor\n\nlast 5 days before my father got paralize.he went to neurologist he did head ct scan he observe through scan some problem in stomach like tumer. he send for ultra sound and MRI we did ultra sound some problem in ultra sound report still waiting for MRI report i am away from my father. it is realy relation with paralize with any type of stomach cancer",
    "doctor_response": "Hi! Good evening. I am Dr Shareef, a general surgeon answering your query.Stomach tumour per se won't result in a paralysis, but some tumours spread by the blood stream and then cells of the tumour might travel in the blood to any part of the body, brain being one. These transferred cells would then start multiplying in the brain resulting in pressure symptoms, and paralysis could result by this pressure. This is also known as pressure on the brain due to a SOL(space occupying lesion) due to the growth of the cells.I hope I answered your question. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does honey, cinnamon powder and hot water help the arthritic pain?\n\nI read that 2 Tbs of honey, 1 tsp cinnamon powder, and 8 oz of hot water mixed together will help arthritis pain.  But how many times a day would I need to take this?  Do you think this will help?  I have stomach problems, am on B/P meds and not able to take arthritis meds.",
    "doctor_response": "Hello,,You can take these home remedies 2 or 3 times in a day.Arthritis is treatable with homeopathic treatment and it is not contradictory in stomach problem and hypertension but also help you in all your problem.Homeopathic medicine have no side effect and it may gradually control your BP and you can be free from BP medicine too.Have a better health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling sensation and numbness on the right hand?\n\nWhen I was out for a walk 3-blocks one-way, and on the way back, about 3:30 pm, my fingers on my right hand started to tingle and begin to feel a little numb. I look at my right hand, and all the fingers (except thumb) from the mid-knuckle/joint to the finger tips were white. below the mid-knuckle/joint toward the wrist, were the usual light pink color. Once back into the residence, the fingers slowly became normal pink, with the index and middle finger being last to recover. A similar event, on the same right hand occurred last month in my temporary residence when it was very cold indoors. The same four fingers were practically white with a slight grayish color at the joint closest to the finger nail. Historically, I had a injury to my neck when doing sit-ups, and had my hands behind my head, and jerk my head forward to do the situp. During the next few days, a slight, moderate, then extreme pain occurred. This was documented with a test and recently a scan of my neck. Occasionally, would get skin tingling on my left arm and upper left leg, in addition to a slight burning sensation in the upper left leg. Any ideas for the right hand fingers? Thanks, L LUM I just noticed this service requires a payment, which I was not aware of. My primary physician is aware of my concern, and should be in contact with me tomorrow, Friday February 10, 2017. If I had to be seen, my medical insurance would apply. A complimentary second opinion is welcomed.",
    "doctor_response": "Hello, Consult an orthopaedician and plan for an MRI scan. We have to rule out possibilities like nerve injury. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for numbness in the arm and fingers\n\nmy left arm has been going numb. my pinky and my thumb I try using my left arm and I can't really grip anything. I try unlocking my house door with my keys and don't have the strength. it like my pinky and thumb won't work right. I am 43 years old. As I'm typing my pinky and thumb are numb feel like needles on them. it happening more and more were my left arm and some of my fingers go numb.",
    "doctor_response": "Hello there I have read through your question and would like to tell you that pain and numbness in the finger s with pins and  needles sensation is a sign of nerve compression. I would advise you to get an MRI cervical spine done. Meanwhile try doing some stretching exercises. I hope that answers your question. If you have any further questions please feel free to write. Thank you for choosing healthcare magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can balanitis be treated?\n\nHi . My penis forehead skin suddenly so tight to pull back .it is so ruf and red ..I contact one mbbs doctor, he told me that it is balanitis . Doctor prescribed me to use two cream mix fucidin and onabet and than apply on penis forehead and forskin Sir I just want to know fucidin cream is safe to apply on penis glance ( penis forehead) ...sir please clear my tention . Due to this fear I didn t use it on penis glance ( penis forehead)",
    "doctor_response": "Hello,Yes, you should apply it and take medicines. It does not cause any harm, and you will recover soon.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhadresh Lakhani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having spotting and then full periods. Taking morning after pill. Gained weight. Pregnant?\n\nLike last month a week before I took the morning after pill I had my period and then I took the pill and  a week later I had a full period which I thought was just spotting at first but wasn't and on the box it says that your period may be a few days early but mine was like almost 3 weeks early and originally it should of been now. So if Ii don't know 'm pregnant or my period come in 2 more weeks because the pill messed everything up and I just gained weight.",
    "doctor_response": "hi,thanx for query.u had delayed periods.ispite of that u can be pregnant.plz get doctors advice and get b hcg test done to confirm pregnancy.a full pelvic scan by agynaecologist and blood work up is required.it might be case of ectopic pregnancy too.plz get help byee.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes seizures with muscle twitching, legs heaviness and tiredness, dizziness?\n\nI had 7 unexplained seizures last week were I was then tested in neurology while staying in the hospital with no conclusion. Tonight, I got very hot and dizzy followed by an upset stomach. When I was lying down, I had lots of random muscle twitching. After that stopped, my legs were very heavy and tired. Is this likely a small seizure or events leading up to a seizure",
    "doctor_response": "Hello!Thank you for the question on HCM! I understand your concern. The random muscle twitching are part of generalized myoclonic seizure. It is not a small seizure, but a generalized one , meaning that the brain cell dysfunction is spread all over your brain during this seizure. The hot and dizzy feeling which the upset stomach are part of an Aura ( symptoms preceding the seizure, part of the seizure)I would recommend a prolonged EEG and a brain MRI to find out the possible cause of these frequent seizures, besides full blood work , electrolytes and other tests. You need to start an anti epileptic drug as soon as possible , based on the consult with the neurologist and the results of the above tests. Hope to have been helpful!Greetings! Dr. Abaz Quka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swollen vein after injury, tenderness, low blood pressure. CBC shows high red cells and hemoglobin. Ideas?\n\nI stepped down hard on a rock two days ago. A vein below my left calf instantly swelled, turned the area around it red as well. Pain was level 10. Yesterday the redness was gone. Swollen and tender to the touch. Today I have an 5\"diameter bruise around the whole area. Still tender to touch. I have very low blood pressure but a recent cbc had high red cells & hemaglobin. Ideas? Should I call my Dr.?",
    "doctor_response": "Hi and thanks for the query,Raised hemoglobin and blood cells are raised under two main circumstances. First , this is usually due to errors in the measurement of these parameters and the machine used might need to be checked or the test done elsewhere. Secondly, in case the values are actually raised, there is a condition called polycythemia rubra vera of Vaquez disease that causes this. This is usually accompanied by redness in the palms, headaches and body itches.I suggest you consult a hematologist for a complete clinical review. Thanks and kind regards,Bain LE, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with psoriasis, dandruff in hair and other body parts. Permanent remedy?\n\nMy e-mail is YYYY@YYYY . i am suffering from soriyasis last 4 months. I am very upset, as I can t tell this to anybody.Please tell me the remedy for permanent solution. Due to my personal family problems I am very nervous.Please tell me the medicines. There is much dandruff in my hair & some part of the body too.What to eat /not to eat please let me know.",
    "doctor_response": "Hi, There is no permanent cure for psoriasis. But it can be checked nicely. Some small plaque psoriasis responds well & recurs rarely. Aggravation of psoriasis occur due to 1. Mental stress 2. Physical stress 3. Respiratory infection 4. Excess dryness Dandruff may be a part of it or it may be be a seborrhic one. So to reduce psoriasis you should 1. Reduce stress by yoga, meditation 2. In cough, cold consult doctor early 3. Apply moisturiser after bath when body is moist 4. Over scalp apply ketoconazole/coal tar/mild steroid shampoo Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to go for swimming after treatment for abscess on the gums ?\n\nHello, In January, I had root canal treatment on a premolar (number 25?). When I went back to have the crown fitted, my dentist decided she needed to do a root canal treatment on the adjacent molar (number 26), which had caused the problem in the first place (cavity spreading from that molar to the premolar). As I live abroad, and could only go back to have the crown fitted at the beginning of March, she put a heavy-duty temporary dressing on. Unfortunately, I was unable to go back in March. At the end of March, the dressing was beginning thinner, and one evening, the cap sealing the tooth moved: I had to yank it back on. Over the course of the next days, the gum above that tooth became tender and I eventually developed an abscess , the size of a molar. The lymph node under the same side of the jaw was also swollen and tender. I managed to see a dentist where I am (hard work!). She removed what was left of the dressing, cleaned the inside of the tooth, put a new dressing on, and, after some hesitation, lanced the abscess (not very easy as you had to press very hard to get something to come out, and then it was more blood than pus, yuk!). She gave me a prescription of amoxicillin 250mg, 3 times a day for 5 days, and told me to do mouthwashs with salt water, and to keep pressing the abscess to try and evacuate the pus if I could. I did as told, except for the abscess pressing which did not seem to work very well. The antibiotic worked like magic and the abscess had completely disappeared by the end of the 3rd day. It s now been 5 days since the end of the treatment, and I m wondering whether I could start going to the swimming pool again, before I see my dentist in 2 weeks time. When I had my wisdom teeth extracted, I was banned from swimming for 2 weeks when all went well, and a whole month when the wound for one of them didn t heal and became infected. I feel well now, the molar is no longer wobbly and the gum has healed where the dentist lanced it. Thanks in advance. Regards.",
    "doctor_response": "Hi, I am very happy to see your long and elaborated dental history. Swelling and mobility in the tooth appeared due to the acute exacerbation of chronic infection in the tooth. once dentist puncture the abscess and put you on antibiotic thats why you got the relief. About swimming there is no contraindication but the precaution you have to take is get your treatment finished as soon as possible. so that such periapical infection will not occur again. Thanks, Dr. Vishal jain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a pinching sensation near the ribs?\n\nHi, so for the last about...6 years. Theres time when I sit down and when I do, unless i lean the the left as much as i can, my skin on my right side feels like it s being pinched in between my ribs. and lately ive noticed that if i push my ribs on my right side, one will..fall out of place and will do it for the rest of the day when i try to breathe",
    "doctor_response": "I would suggest you seek help and have Thoracic CT performed, you may have rib lesion or mass that is affecting your intercostal nerve. Greetings",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe abdominal pain\n\ni am a female,age38,mother of two children,younger one is 8 years,from last 2 years i am facing gastric problem ,and after a plenty of exercise i was well again but from last night i have got a saveir pain in lower abdomen and need your suggestion as to what should i do to get a rid of the pain?",
    "doctor_response": "Hi welcome to hcmYour problem could be acute gastritis.use proton pump inhibitors like tab.pantop40mg before breakfast.get ultrasound abdomen and rapid urease test to rule out h pylori infection.if RUT is positive for H.pylori you should start H.pylori kit of antibiotics for 21 days.consult your gastro enterologist for expert managementThankyou.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedy for ear ache.\n\nMy ear just started hurting today. The pain has been getting worse throughout the day. It hurts when I burp, swallow, and somewhat when touching it. I used to get ear infections all the time when I was a lot younger and had tubes put in my ears once. Not sure what would cause an ear infection if I have one, I haven t went swimming and I don t have any other symptoms. What could this be and can I treat it at home?",
    "doctor_response": "Hi1.Fresh, pressed garlic, olive oil, tea tree oil, and aloe vera (all mixed & warmed up) and a few drops in my ear enclosed w/ a cotton ball 2.Take a cup of Mustard oil (available in Indian grocery stores) heat it and add 3 tablespoon of Ajwain seeds (carrom seeds) (only available in Indian grocery stores)bring it to a boil, let it cool. seive it and remove the seeds. Add 3-4 drops of oil in the affected ear, 3 times a day. You could feel some relief till you consult your ENT specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low grade fever and vomiting in a 8 year old child\n\nMy daughter is 8 1/2. She has been complaining of being achy, has a low fever. She vomited a little bit ago and now her legs are shaking uncontrollably. She does complain of stuffy nose. And combined of a bad headache off and on today. She said it was the worst she has ever had. It comes and goes. My son and I had an achy illness a couple weeks ago. Only lasted 24 hours and followed by a cold. Wondering if she could have the same thing or something more serious.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.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 15mg/kg/dose (maximum ceiling dose of 500mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I having pain in belly followed by passage of stools?\n\nHello doctor, From the last 15 days I have a problem that I feel pain in my belly and then after that, I have to go to the toilet to pass stool. This happened 4 to 5 times a day. Because of this I also have a problem of rashes on my anus. Kindly suggest.",
    "doctor_response": "Hello. You can have acute gastroenteritis like infective pathology. It is advisable to take an antacid like Rabeprazole for a week. Empirically broad spectrum antibiotic like Ofloxacin plus Ornidazole combination can be started. Take bland diet more. Avoid excess spicy foods. I suggest you investigate with ultrasonography of abdomen, stool routine micro examination and occult blood test for further work up. For more information consult a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could the persistent severe back pain be due to?\n\nI have had severe back pain everyday for the last 3 years. Ive been to doctors, chiropractors, and had massages.They have done xrays, and an mri, and tell me nothing is wrong. I use hot and cold packs and nothing has helped. I recently had an epidural and that hasn't worked either. Im 26, and im tired of living in pain everyday. What else could this be?",
    "doctor_response": "Hello,I had gone through the case and found that if all reports are normal then very difficult to diagnose the case . I will suggest you to go for vitamin D3 test.After that take calcium once a day and Vitamin D3 once a week for 3 months.Avoid to lift heavy weight and stand for long time.Take rest and avoid exercise might be pain does not subside due to inflammed tissue.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause fluid coming out of pores of body with retained fluid in body?\n\nmy dad is 63 has a lot of health problems. hw just got released from the hospital 1 day ago. He was in there because his body retains fuild and they were trying to get the fuild off his chest and lungs. But they were taking it off so fast that it was interfering with his kidneys and bladder. SO they stopped, and sent him home. Now he is having fuild coming out of the pores of his body (feet, legs, arms, everywhere) What is causing this",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, it must be tapping done on your father to get the fluid out, if it is in lungs then this could be pleural effusion, because of this kidney and bladder may not be affected, more over as you stated that it is fluid coming out from every where so this is not possible  , if the lesions are there on the skin then and then it may ooze, hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching under scrotum and suggest treatment?\n\ni have been experiencing itchiness right under my scrotum. i am just wondering because i have a good practice when it comes to hygiene. i take a bath twice daily using only safeguard. i tried using a certain cream - terbinafine. the brand name is lamisil.however, no signs of improvement was observed.the itchiness is persistent.",
    "doctor_response": "HiWelcomeBased on the information it might be fungal infection or might have caused as result of excessive perspiration.Dusting powder like Clocip might be helpfulGet it checked by local doctor for examination and confirming.Hope this helps.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Nephrotic syndrome, pulmonary phlogistic, elevated liver enzymes, fever. Taken prednisolone. Does that cause side effect?\n\nMy father has a serious condition. He got nephrotic syndrome 3 years ago and he has been using Frednisolon since then. That medicine has caused some side effects, his body resistance has been going down and down. Then he got pulmonary phlogistic. He used Streptomycine and Turbezid for treatment. But as I know Frednisolon is against Streptomycine, and one of serious side effect caused by Streptomycine is elevated liver enzymes. He gets fever daily. He is now in a complicated status. The doctor just forcuses on his liver. After the liver gets better, they will treat for his lung. My point is to find another medicine which can replace Streptomycine, can treat for pulmonary phlogistic but not against Frednisolon. Could you give me some advice for this sistuation please? Thank you initially",
    "doctor_response": "Hi and thanks for the query,Prescription of drugs, especially under such circumstances need special considerations. Your doctor certainly measures all these before prescription. I do understand that Streptomycine could have side effects at the level of the kidneys and the ears, and might not be the best option in this case.I would recommend third generation cephalosporines, which cover a broad spectrum of possible infections and have minimal side effects. you might have to discuss options with your doctor before switching treatment. Thanks and kind regards.Bain LE, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are bloating, cramps, nausea and tiredness side effects of depo shot?\n\nhi do you know much about the side affects of the depo shot.  I have been on the depo for two years.  This is the first time i have gotten sick.  I feel bloated, cramps, achy, tired, and nausious. I hear sometimes its a side affect but in the two years on the depo i have never had any problems and i feel so sick.",
    "doctor_response": "Hello user,side effects of depo shot are headache,breast tenderness,acne,depression,dizziness,irregular periods,break through bleeding  etc..yes,your symptoms are due to depo shots..thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the possible level of liver damage in an alcoholic, had stroke, being on level 2 diet?\n\nMy life partner of 14 years who is an alcoholic, had a stroke on November 25th. He is 50 years old. He has been hospitalized since that date. Today, he walked with the aid of a walker, passed a scope swallow test and they aer starting him on level 2 diet. I felt elated, then the attending told me that I might want to consider Hospice. I was floored. No gastro MD has seen him to determine the liver damage level. Am I missing something? After the discussion, the MD admitted that he had not reviewed my partners records in a couple of days.",
    "doctor_response": "Hello,Thanks for posting on HCM,It is actually not easy to exactly provide the level of liver damage but all I can say is that given his risk factors i.e age, alcohol and current medical history, I can say that it is possible for him to have a liver problem which obviously might not be serious given he is not presenting with any obvious symptoms. I am pretty sure while on admission, they have run some essential tests including liver function (which often is considered as routine test) but in case it has not been done, I am sure your partner's doctors are better placed to know why it has been excluded. So saying, your partner might have liver injury but that could only be determining by running the necessary tests.Hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain, bloating and gas, diarrhea. Abdominal ultrasound, endoscopy, blood test normal. Help?\n\nI am a 41 hear old female.  I have been experiencing mild stomach pain accompanied by bloating and gas, on and off for the past few months.  It mostly occurs after meals.  Tonight I woke up sweating and have stomach pain and diarrhea.  I took my temp and it is below 96.  I have had 2 or 3 episodes where I became nauseas and vomited within hours of eating a heavy meal.  I happened to have a heavy meal earlier tonight.  I am starting to feel better now.  I have had an abdominal ultrasound and upper endoscopy within the last few months and both came back fine.  Blood tests came back normal as well.  But I continue to have the same stomach issues.  Any ideas on what could be the problem?",
    "doctor_response": "hello your symptoms suggests of gastric upset..i would advise a patient like you norfloxacin 400 mg mg plus tinidazole 400mg 12 hourly,  & omeprazole 20 mg plus domperidone 30 mg half an hour before meals , also you can take any anti spasmodic like spasmindon every 8 hourly..take plenty of fluids.. avoid spicy and fatty foods. follow this prescription for 5 days and if then also you find no relief visit your general physician.. hope it helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore stomach,chest and phlegmy cough?\n\nMy daughter had her tonsils and adenoids out 4 days ago now complaining of sore stomach, chest and has a phelmy cough but not producing anything with the cough. Do I need to take her to Emergency or can it wait till the morning and see the family dr or just let it ride out? She is taking pain medication, drinking fluids but not eating much. She is 6 years old.",
    "doctor_response": "Dr. Hanif warmly welcomes you!Thanks for consulting at my virtual clinic. I have carefully worked through your case, and can realize your health worries. Being your physician, I want to assure, I will take care all of your medical concerns.give her plenty of fluids. Arrange for a morning visit to her family physician. Its not like an emergency. Give her any over the counter cough syrup. It looks like she has got respiratory tract infection and may she be in need of an antibiotic treatment. It will be decided by the examining physician after complete physical examination and evaluation.Hope I answered all of your questions. In future, if you need further, detailed and quick assistance on any health issue, feel free to click on 'Ask me a question' directly from my profile. Have a wonderful time ahead. Regards!DR. MUHAMMAD M. HANIFUSA",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are implant supported bridges good?\n\nHello doctor, Are implant supported bridges good? Will they cause bad breath in the long term? I have dental bridges in my four front teeth for about eight years, but now it is causing bad odor.",
    "doctor_response": "Hi. Implant supported bridge is an extremely good option for replacement of missing teeth. Implant is the best treatment option in dentistry and it is a lifelong treatment option. It stays for ur whole life without causing any problem. Once osseointegration has taken place successfully it acts extremely perfect. But you have to maintain your oral hygiene nicely. You have to use electric brushes for maintaining your implant and you have to visit the dentist every year for follow up for scaling and polishing, just for maintaining your oral hygiene. Go for It. It is the best treatment option if you are healthy systemically. Patients suffering from high blood pressure or diabetes might have some problems. So your dentist will decide what is best in those conditions after all the blood tests, OPG, and CBCT (will decide your bone condition) diagnosis. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fatty liver and advised to take Udiliv and Heptral. Fainting tendency and frequent urination. Reason?\n\ni have fatty liver 1 disease with no alcohal and doctor suggested me to take udiliv 300 mg for three times a day  and heptral 400 mg twice a day. however, im feeling fainting tendency with frequent urination. please suggest me the disease may be reduced by taking that medicines and what is the reason for fainting tendency and frequent urination.",
    "doctor_response": "Hi and welcome to HCM,thanks for the query.These medicines will improve your liver function definitely and it will reduce fatty liver. But it should be combined with dietary changes and exercise.frequent urination can be caused by urinary infection or enlarged prostate and i dont think this is related to your liver condition. You should do urologic work up to rule out these 2. till that,try to drink rasberry tea, drink plenty of fluids and check your basic blood test.Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any chances of getting pregnant with unprotected sex?\n\nHi, 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",
    "doctor_response": "Hello dearI understand your concernYou are on primolut N to delayed period since last week.If you did sex when you are on primout N then it itself act as contraception and prevent pregnancy.But if you did sex before starting primout N and during fertile phase of period then there is chance of pregnancy.If period will not occur 7 days after stopping primout N then go for urine pregnancy test and or blood HCG test to confirm pregnancy.Avoid stress, take health diet, drink plenty of water, do regular exerciseHope this may help youContact further if follow up neededBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can one cure intracranial aneurysm?\n\nDiagnosed with intracranial aneurysm at age 72, 4mm, asymmetrical, in vicinity of left ophthalmic artery. Neurologist feels I ve had it very long time and could have been born with it. Decision was to discontinue coiling procedure as I would have lost vision in that eye and it will be monitored. I m concerned and would like to know what future years may bring because of this issue. I am otherwise healthy, active, looking forward to many years of good fortune.",
    "doctor_response": "Hi, Your risk for a rupture is extremely small and if it's been present as a congenital entity then, you've gotten to 72 years of age without a problem I don't see the need to try and manipulate this aneurysm especially if the risk of causing a rupture or other major damage is higher than the annual prevalence rate of 2-3% in the general population. In 1 study called the International Study of Unruptured Aneurysms, lesions of  I believe there is very little chance (so long as you continue to remain healthy, don't smoke, eat well, and exercise) that this aneurysm will complicate in the near future. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Been masturbating excessively, weakness, depression, suicidal, sleeplessness, loss of memory. Suggest?\n\ni am suffering from excessive masturbation.iIhave doing it from last 10 years and i am 24 years old now .I have serious problems like low eye sight,loss of memory power,unsleepiness, weakness depression ,suicidal thought .It has become difficult for me enjoy my life.People call me insane when they look in my eyes and look my facial expression. How can i recover my life back with those happiness drop this habit",
    "doctor_response": "Hello Welcome to health care magic I can understand your situation. I appreciate your effort to seek online support. You have probably \"Compulsive masturbation\" which comes under \"Obsessive Compulsive Spectrum disorders\". The other features described by you are due to associated depression. Don't worry and relax. Consult a psychiatrist for detailed evaluation and management. Following treatment strategies would be helpful- 1) Antidepressants like SSRIs (escitalopram, sertarline, paroxetine etc) 2) Antianxiety agents like clonazepam, lorazepam, alprazolam etc 3) Psychotherapy/ Counselling sessions 4) Relaxation techniques like yoga, meditation, deep breathing etc Hope it helps Good luck Regards Dr. Gourav Monga Consultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low BP without any symptoms?\n\ni went to the doctor on Friday and my blood pressure is 98/66, the nurse double checked it because it surprised her so much. I feel like my blood pressure has always been low in the past. Is that healthy? I am 20 years old, never get dizzy or light headed and I usually workout 4-6 times per week.",
    "doctor_response": "Hello,No need to worry about it. Its probably a normal bp for you as you don't have any symptoms. Your body needs this much amount of bp to maintain its function normal. Hope this helps you and get back if you have any doubts.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I feel light headed when I stand up quickly ?\n\nWhen I stand up quickly sometime I need to hold on to something because I get light headed and once feel down I m only 49 years young and had all kinds of test includeing CT scans of the chest to head Ct scan of the chest to pelvis all kinds of blood work, went and saw a head and eye specalist and nobody can seem to find out why I get so light headed to a point of fainting. Help!!",
    "doctor_response": "Hello,Orthostatic (postural) hypotension is a condition to consider in your case. It is necessary to measure your blood pressure in different body positions (lying, sitting and standing). Tilt table tests also may be necessary. Discuss with your Doctor for these issues.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes skin rashes?\n\nI have a rash that I am not sure of what it is.....large circle-positive it is NOT a ringworm, itchy, tiny bumps, warm bumps. I have been exposed to poison ivy and have an identifiable rash from that. Does another poison plant, sumac, oak have these symptoms? Keep getting the run around when I try to google rash photos",
    "doctor_response": "Hi, Your symptoms seem to be related to contact dermatitis. Some advises that I can give to you are: -use Calmine lotion for local relief -use daily antihistamines If you don't get better take prescribed corticosteroids. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bad taste and pain in mouth after wisdom tooth removal?\n\nHello, I had my wisdom teeth removed on December 21st. Everything was going well and a week after I had them taken out I went back to the surgeon and he removed the stitches and said I was good and I had felt okay at that time. But ever since they took the stitches out I have had this nasty taste in my mouth. I didn't really think anything of it until I got really bad pain today from my mouth, and my whole head. I am just wondering if this is normal or if I should go back to my surgeon.",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain bad taste in mouth along with severe pain can be due to causes like infection in the area of extraction while can also be due to development of dry socket that is an unhealed socket..There is also a possibility that there is any left out root piece or foreign body impaction in that area and it is leading to flaring up of inflammation and infection and causing severe pain..I would suggest you to consult an Oral Surgeon and get evaluated and he can do a thorough clinical evaluation and advise you x ray of socket..In case if there is root piece or foreign body removal of same can help..In case of dry socket packing the socket with a sedative dressing like Zinc oxide eugenol can help..As of now you can take higher painkiller like Tramadol or Ketorolac to relieve pain..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment and diet plan for joints pain\n\nHi I have severe pain over my joints since the last few days and it s hurting me every morning.. I met the doctor and he advised me certain blood test. . And was found that I have a slight increase in Esr. My level was 25 while the normal was 15-20 what can I do to reduce this and please help me with the diet plan for it also.",
    "doctor_response": "Hi Dear, Understanding your concern.ESR, or erythrocyte sedimentation rate, is a medical test that measures how much inflammation occurs throughout your body.It is worth bearing in mind that ESR does tend to rise with age, regardless of the presence of inflammation, and that it is beneficial to do a repeat test after about a month and see if the level has changed.Eating a diet too high in acidic foods (starches and meats) and not enough alkaline foods (fruits and vegetables) leads to blood acidity and this makes the body function poorly and not heal well. Eating a good balanced diet with fresh foods helps with your brain and keeps you feeling good. Gamma linoleic acid (GLA) is an essential fatty acid derivative which has been shown to work particularly well. The best sources of GLA are plant oils, such as evening primrose oil, blackcurrant seed oil, and borage oil (also known as starflower oil).Eliminate inflammatory foods from her diet \u2014 which means avoiding processed foods, fried foods, red meat, carbonated beverages, processed sugars, and in some cases where there is a specific intolerance to grains or dairy, these should also be ruled out.Fruit and vegetables and pure water should be consumed in abundance. At least 30 minutes of brisk cardio exercise a day is recommended.I m hoping that your concern has been resolved now. Get back to me if any further queries.Regards,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I make my lateral incisors look normal ?\n\nI am 17 and when my baby lateral incisors came out, i never received my adult lateral incisors. I have had a brace and my teeth are straight however as the teeth 3rd from the middle have been moved into where my lateral incisors should be i wanted to know what there is i can do to make them look like normal lateral incisors rather than fangs. It is a real problem for me (mentally) as it lowers my confidence significantly. I am 17 and when my baby lateral incisors came out, i never received my adult lateral incisors. I have had a brace and my teeth are straight however as the teeth 3rd from the middle have been moved into where my lateral incisors should be i wanted to know what there is i can do to make them look like normal lateral incisors rather than fangs. It is a real problem for me (mentally) as it lowers my confidence significantly.",
    "doctor_response": "hi, the best solution would be to get your canines grinded (flattened) and reshaped using a composite filling, thats all you need this will improve your smile. First try out this treatment rather than going in straight for more invasive procedures. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Redish colour Inflammation and like boil on left breast near/under the nipple\n\nRedish colour Inflammation and boil like on left breast near/under the nipple Inflammation and boil like on left breast near/under the nipple I have problem of redish colour patchy skin - inflammation and boil like - on my left breast near/under the nipple - feeling pain,hard,and hot in that area since five days. Seeking your kind help for remedy please ( Iam a female 56 years old, periods stopped already) - Mohana,coimbatore",
    "doctor_response": "You should get a breast examination done. If it is an inflammation then it can be treated with certain medicines. Certain cases shall also require surgical excision. But for confirmation of what type of swelling is inflammatory/benign/carcinogenic, it should be examined.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on thighs?\n\nHello , I have an after bruise lump that has formed under the tissue of my thigh from a terrible fall down the stars , I am glad that the result was only a terrible bruise ( that most of has faded away) and a lump (I know formed by blood pooled in the fatty tissue of my leg) . I was just wondering if there was or is anyway to speed up the process of getting rid of this lump . I am fourteen and it s just something I don t think any teen girl would like to see on her leg everyday :) I would really appreciate some method ideas thanks :) Joanna",
    "doctor_response": "Hi,It seems that there might be having formation of hematoma following injury.It will take some time to disappear due to good amount of blood collection.Go for ice pack application 2-3 times a day for few days.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are Glucophage and Duphaston the right medication for PCOS?\n\nHello Doctor, I m 26 years old and having pcos for almost 4 years... From last month I m trying to get pregnant. I undergo all the test and I have little cyst now. Doctor checked my ovulation this month and told no egg growth. She gave glucophage for one month and duphaston for 10 days. And she told will go with injection after next period. I m confused. Is it ok to go with injection for egg growth?",
    "doctor_response": "welcome to hcm ..mam ..metformin has very hopd results for pcod ..just go ahead with advise of your gynaecologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can flu cause elevation in the liver enzymes?\n\nI  recently had a liver enzyme test and the numbers were elevated. I had  what I thought was the flu; vomiting etc. and close to 2 weeks when I wasnt better I went to see a physician and they ordered blood work finding the elevated enzymes. I RARELY drink alcohol and hadnt had any for at least a month or more before I was ill. They followed up with Hepatitis test, all were normal and negative for A-C.  I did have the test re-ordered a week later and my levels are now within normal limits. Can the flu cause elevated liver enzymes? What would cause these numbers to fluctuate? I have Scleroderma (systemic sclerosis) and Im wondering if I should contact my rheumatologist about the one time elevated enzymes?",
    "doctor_response": "Hello, Any systemic infection in the body sometimes can cause liver enzymes to rise, what exactly did u suffer with? Any major infection? And what kind of treatment are you on for Scleroderma? Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My daughter has got two blister of chickenpox. Does it imply enough antibodies against chickenpox?\n\nHello doctor, My twin daughters, age is 17years. One of them got the first blister of chicken pox and totally she got 30-40 blisters a few on back, hands, scalp, chest and 4-5 blisters on forehead. Now since yesterday, they have formed a scab. Second twin got the first blister on the chest five days later, and the second blister after that, a total of two blisters and till now no scab is formed. They both got vaccination when they were small. My question is whether the second twin who got only two blisters, has she got enough antibodies of chicken pox so that she is safe not to get it again in the near future?",
    "doctor_response": "Hello. You need to understand that chicken pox (varicella) vaccine does not guarantee that one would never get chicken pox. It tries to give control over it and if it fails, chicken pox occurs. Most of the times the severity is low, as the person already has pre-formed antibodies against it. As far as scab formation is concerned, they would surely appear if it is chicken pox. This is because any chicken pox infection heals by scab formation. The formation of scab may vary form person to person and in many people, they may appear late. Now, as far as your particular query is concerned, the scab formation or lesions are not markers of developing antibodies or immunity. It is usually seen that a person who develops chicken pox once does not get it again. But we have seen people and it is now well accepted, that a person who has got chicken pox once may get it again in the life time. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can cough and cold be treated during a pregnancy?\n\nLast week i took pregnancy test it came positive and my last periods   started  at 25 of September and i have cough and cold i went to physician  he did not gave me any medicine what should i do iam not able to sleep and cough is horrible does it will stop me to become pregnant",
    "doctor_response": "deartake the steam inhalation , two to three times a day.drink lukewarm water.avoid cold water , cold drinks, preserved food.do salt water gargle.for blocked nose you can use saline dropstake care of your dietDr.Mira Butani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurrent dizziness and pain in the right thigh and knee?\n\nI m experiencing very regular lightheadness. Dizzy. Like I m going to faint but I don t. Generally I m really fit and active but my body feels heavy lately and my muscles tight. I keep getting pains in my right hip thigh and knee ( I rub on magnesium and this seems to help). I feel I m urinating quite a lot, maybe twice an hour, but I do try to drink a lot of water. I m also experiencing pains similar to period pains but there not during my cycle. Been quite a heavy drinker for many years but upon feeling this way I have given up and not had a drink for 2 months. This seems to have made the lightheadness more frequent. Also feeling regular fatigue when I m normally full of energy. Craving more sugar foods when I generally eat a very very healthy diet with a super low salt and sugar intake. I m a smoker aged 40. Female",
    "doctor_response": "Hello,What I can advise after going through your complaints is to get your blood pressure and sugar level checked. There are a lot of causes for dizziness and generalized weakness and fatigue. Sometimes it can also be due to alcohol withdrawal. I would suggest you visit your general practitioner and get your blood pressure and sugar level checked.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Santosh S Jeevannavar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in right underside of the breast and breathing problem?\n\nI am a 25 year old woman, I started having a pain on the right side of my chest (under my breast) and ride side of my back by my shoulder blade, At times it feels as though i am not taking a deep enough breath or getting enough oxygen. Im just curious as to what it could be.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.By your history and description, possibility of musculoskeletal pain is more likely.So follow these steps for better symptomatic relief in musculoskeletal pain. 1. Avoid movements causing pain.2. Avoid heavyweight lifting and strenuous exercise.3. Apply warm water pad on affected areas.4. Take simple painkiller like paracetamol or ibuprofen.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to control seminal loss by natural supplements?\n\nSIR, AGE 48 YERS WEIGHT 79 KGS. HIGHT 5'8\" DEPRESSION AND GASTIC DISORDER AND USING PENTOP DSR,NEXITO 10MG., TRAZALON 25MG., ZOLCENT 10MG. I AM SUFFERING FROM SEMINAL LOSS WHEN STRAINING AT STOOL AND AFTER URINATION SINCE 30 YEARS AND NOW I AM 48 YEARS OLD.PL. GIVE ME SUGESSITION TO CONTROL IT BY WAY OF NATURAL SUPPLEMENNTS AND FOOD.",
    "doctor_response": "HiSeminal loss while urinate or stool passing is myth and it is called DHAT syndrome.Read more about DHAT syndrome.It is thinking about loss but actual it is normal and common.Constant thinking of it lead to guilt and then depression.Medicines like nexito can be useful.But psychotherapy and counseling will give proper evaluation. and understanding about it.Need to educate yourself.Consult your psychiatrist and get help.I hope i have answered your query.Feel free to ask.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can ADHD be treated?\n\nHow can I get an edge on my ADHD/my being overwhelmed about my clutter/ and my being fatigued a lot when it comes to overcoming my being a disorganized person? I formerly used to be an ORGANIZED person. My medicines I take don t seem to coincide with each other, I bet. I don t have the finances to pay a fee nor create another future debt. Thanks, anyway. I ll keep taking my medicine and have my loving Saviour help me.",
    "doctor_response": "in  my  opinion  it  is  necessary  to  be  on    stimulant  drugs  like  methylphenidate   .attention  enhancing  techniques  certain  video  gamesorganization  of  activities   breaking  down  activities   into  smaller  activities",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for depression after the death of a loved one\n\nI have been treated for depression - eating disorders n the past with Effexor It s been 4 years since I was last treated and have been fine. However my father passed away in November and I am feeling down again. I have never had suicidal thoughts. I just do not have insurance and am a single mom. How can I get treated and back on medication to help get through this grieving time?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I understand your problem and let me say you that it is important that you ask for help. I will suggest to take an appointment with your psychiatrist doctor, to get a professional help and a regular follow up. Taking medication without seeing a doctor is not safe. Hope the best for you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Paralysis, memory issues, BP and pulse rate fine, no fever,  has swelling and clots, suffered DVT. Done biopsy. What is wrong?\n\nHi  Drs.My Mother had paralysis had suffer of fever on 1987 (One-month in komma and 1-year spent in the Holy Family Hospital and after that she was not hospitalised but now she has suffer DVT in left-leg and she is admitted in Fortis Escort hospita since 18-September and put IVC filter on her on 20- September. She was problem in left arm swell and fever in the month of June and admitted in the Holy family hospital but some clots are moving in lungs then their doctors refer to Fortis Escorts hospital to  precaution to clotts not go inside the heart. After 15-days she was release to home but she has again problem swelling on left-leg. She has a big bed sore behind of slightly upper waste. Now, she has multi-types of problems like TLC has been increase day by day (On 13-October TLC is 28,000,  14-October TLC is 30,000 and now today TLC 31,000) and infection has been increase day by day. She is not talking properly and loss the previous few hours memory. her treatment is running for the DVT on left-leg but  now see her leg has swalling and clotts on two finger and fingers look like Red-black. She has no fever, Blood pressure and pulse rate is fine. On duration of treatment she has the infected by Cancer of neck by testing  of  biopsy. Drs. said that her body not responding the anibiotics which they given by diagnose and they said she have a few days to live. Please Aadvise  me any scope for her to save life",
    "doctor_response": "Hi,Thank you for posting your query.Based on the description, it appears that your mother is really sick with severe infection, possibly she is in sepsis, as evidenced by raised blood counts (TLC). The source of infection could be bed sores. In addition, she has deep vein thrombosis and cancer.As she is not re spending to the usual treatment, it is likely that she may not survive long. However, it is difficult to give a definite opinion regarding treatment and prognosis, until we have all the reports and doctor's notes.So, I request you to send all the reports and prescriptions including the discharge summaries.I hope it helps.Best wishes,Dr Sudhir Kumar MD DM (Neurology)Senior Consultant neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Foot pain due to nerve injury, do not want to take medication. Can you help?\n\nI had a nerve injury to my foot done by accident by a surgeon in dec of 2009. Since then, I have been on Norco, Percocet , and Valium as well as something to sleep. I have had nerve graft surgery which was my 6th surgery on the foot and heading into the 7th surgery for the toes because they have retreated backwards. I think I take too much Norco (about 5-6/day 10/325) and Percocet (about 3/day 10/325); the Percocets have been for the last several months and the Norco for 2 years. I have decided to get off of all of it and I need to know how on my own without rehab . I still have pain in the foot, but I hate the meds and how they alter my personality, my energy level and just knowing that I take meds. Can you help me?",
    "doctor_response": "Dear user, very sorry to hear about your injury. You have to keep in mind that chronic neuropathic pain is very hard to control, something i think you know by now. its very important that you keep on working with your rehab, getting off your medication by your own completely might have negative consequences on your situation, talk it through with your doctor to lower the doses or change to milder form until you feel better without them. legs messages might help but without proper pain medications and rehab your injury might not get better as fast as you wish. i hope this advice helped you and please get better soon. best regards, Dr. Nazzal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "IHC report showed CD117 positive,  CD 34 focal positive,  ki-67 positive 1%. Diagnosed GIST.  History of removal of tumor from small intestine.     Right diagnose?\n\nHi, I am 58 years old male. Recently i removed tumor from small intestine with a size of 6x5x4 cm. My IHC report was, CD117 positive and CD34 with focal positive, while SMA is negative and ki-67 is positive with 1%. Based on these data our physician diagnos as it was GIST and start imatinib. My query is that is it sufficient data to diagnos for GIST and as per the data how long I have to take imatinib.",
    "doctor_response": "Hi and welcome to HCM. Thank you for your query.It is never 100%,but it is enough for right diagnosis. Also GIST can be easily recognized by morphological characteristic which can be seen during the surgery and by clear borders and non-infiltration of surrounding tissue. If imatinib is used just for prevention of recidive then it should be used only short time. If there is still evidence of tumor then it has to be taken for 6m-1 year. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to diagnose the presence of Schizophrenia?\n\nHello, For the last few weeks, I feel like I ve gone insane. Several weeks back, I thought I heard my friend say my name at swim practice. He didn t. Since then, my mental health has seemingly gone downhill fast, and it has worried me so incredibly much. Every time I hear a noise that I don t know the source of, I have gotten really scared. But, I figured I was just being paranoid about it. But, recently, particularly in the last few days, I ve had random thoughts just pop into my head. I don t know how to explain it, but they re soft, and they re not mine, at all. For instance, I was reading a article a few hours ago, and the word communists just popped into my head. Just the word, nothing else, and it seems as if I didnt think of it. It s like having auditory hallucinations, but you don t hear them, you think them. In the last few weeks, I occasionally would have one of those random thoughts once or twice a day. But today, I ve had countless. At the same time, I ve had ringing ears. I ll turn my head, and the ringing will stop. It scares me, and I think I m going crazy. Today, I also heard beeping in my ears, and what sounded like construction. And, whenever I think or reflect on the ringing in my ears, it comes back again. So, am I developing schizophrenia, have I gone completely insane?",
    "doctor_response": "Hi dear,for diagnosis of schizophrenia there are certain criteria must be fulfilled and for diagnosis detail history and mental status examination patient is very important.form your history you might have schizophrenia but some other illness you have to exclude like any substance addiction , medical illness, any chronic medication etc.for diagnosis best to consult psychiatrist.not to worry much about your symptoms even if you have schizophrenia it is treatable.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe redness on the penis?\n\nHi Doctor, for last six years I have been having redness on my penis on and off. I once showed it to a dermatologist and he asked me to apply Clobenate GM tube on the affected area. I would apply the cream every time I had redness on my Penis. However, it didn t cure the disease permanently. Moreover, the cream doesn t even provide temporary solution at all now. It s been 6 years now and I still have this problem. Should I go to a Dermatologist or Sexologist for the treatment?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Redness on the penis may be due to Infection like herpes or syphilis etc. It may be due to eczema or balanitis in diabetes patients. Please consult your dermatologist he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life expectancy with kidney failure and spinal tumor?\n\nHi, my friend has klippel feil syndrome with a lot of complications including ongoing acute kidney failure, heart abnormalities, spinal tumor, and water retention issues.  Im afraid her life will be cut short if the doctors cant do something, she is only 40.  Please help",
    "doctor_response": "Hi,Thanks for writing in.1. The ongoing kidney failure requires to be analyzed from the stage of failure she is in. If it is stage 1 or 2 then she can maintain kidney functions for few years. Since she is 40 years old, a renal transplant might be thought of but this needs to be discussion with her other health conditions.2. Heart abnormalities are important to be corrected. There can be heart abnormalities due to valve defects or electrical rhythm disturbances. Some of these might be treated with medicines and when there is severe disease then surgical treatment might be suggested depending on the cause of heart failure.3. Spinal tumor must be investigated in detail to know if that is a benign or malignant tumor and its location. Tumors localized to a particular area and causing pressure symptoms need to be surgically operated for treatment of associated discomfort. Water retention might be due to kidney or heart disorder requiring treatment. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for feeling of air bubbles trapped in chest and throat\n\nI feel like I have air bubbles trapped in my chest and throat. I think it is indigetion. What can i do to treat it? It is causing pain in my back, chest, and between my shoulder blades up the back of my neck and i feel miserable. it is not a constant pain but it comes and goes in waves. I have already taken prilosec otc. I was diagnosed with gerd about three years ago after an upper gi.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Your current symptoms are mostly due to GERD (gastroesophageal reflux disease) you are having. GERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause symptoms of bloating (bubble feeling), gaseous distention, burping, belching etc. You are taking prilosec (pantoprazole). Along with this, you need to follow these lifestyle modifications for better symptomatic relief. 1. Avoid stress and tension. 2. Avoid hot and spicy food. 3. Avoid large meals, instead take frequent small meals. 4. Quit alcohol and smoking if you have these habits. 5. Keep 2-3 pillows under head in bed to prevent reflux. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes green yellow mucus in nose of a child?\n\nmy 1 yr old wakes up with green-yellow expectorant in his nose and eyes almost every morning and obstructed breathing wakes him a few times a week. he was on antibiotics which help when he is on them but a few days later the symptoms return. does he need an adenoidectomy or could it be simple allergies?",
    "doctor_response": "Hi.... Please do not even think about adenoidectomy at this age. By what you say I feel that it is only a simple allergy or common viral cold. He will get better soon and in due course the frequency also reduces. Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could i be pregnant as i have a lot of menstrual discharge?\n\nI thought I was pregnant because my menstruation came late but now its on and I have orange colored blood but I noticed mucus mingled with it but prior to my menstruation coming on I have been discharging a lot but it has no odor and its clear could I be pregnant with my menstrual cycle on because that's really the only time I discharge alot",
    "doctor_response": "Hallow Dear,Probably you are suspecting bleeding due to abortion. It is likely. Heavy bleeding after delayed menses may be due to process of abortion - it may be threatened abortion or incomplete abortion. Please get your ultrasonography done. If there are any products of conception visualized in the uterine cavity, you are in process  of abortion. If the cervical opening is closed and complete baby is seen in the uterine cavity, you are having threatened abortion. If there is no pain in abdomen, it can be managed by bed rest and some Progestational preparation like Susten. If the products are partly seen and/or the cervical opening is open, you are either having inevitable abortion or incomplete abortion. Then the uterine cavity will have to be evacuated. If you are not pregnant at all, the bleeding could be due to hormonal imbalance. Blood examination for FSH, LH, Oestrogen, Progesterone, T3, T4 and TSH will throw some light on the cause of such bleeding. Please report to your Gynaecologist.Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest tests to confirm impotenecy\n\nHello, i have 18 years and i started to have impotency problems before 8 months, i visited a doctor and he told me that it is nothing its in my head. I know that this is not correct because he didnt make any test on me or smthing like that, before that i was thinking about sex more often and my erections were more often, but know, there are no erections almost at all, even when i am with my girlfriend. What could it be the reason of my problem? ( pls dont say its in your head, cause it makes me problems almost one year)",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Well you are suffering from erectile dysfunction (ED) and psychological erectile dysfunction is one of the cause but it is not the only cause there are many other reasons behind erectile dysfunction. If you would have come to me then i would have ordered certain tests to rule out the cause of erectile dysfunction and if everything came out to be fine then i would label it as psychogenic ED because psychogenic ED is always diagnosis of exclusion. I would have ordered serum uric acid levels, fasting lipid profile, HbA1c levels and scrotal Doppler ultrasound as these problems often contributes towards ED. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could raised levels of ESR be the cause of severe cough?\n\nhi, for a month or so now iv had severe cough and have been getting ear and throat infections over and over. Iv had a blood test which showed raised ESR levels which they want to repeat in two weeks. Over the last two weeks now iv felt like iv got a lump at the back of my mouth/top of my throat which is getting more and more painful eachday and i am finding that i can barley swollow, iv tried having soup and hot drinks but im lucky if i can swollow it. Im also getting sick alot. Im very concerned as im only 17 but have been smoking for six years, (have not smoked in three months though) and used to go through 40 a day.",
    "doctor_response": "Hello,Since you were a heavy smoker and recently left smoking, we should definitely rule out lung diseases for your persistent cough. High ESR with a persistent cough is commonly seen in lung infection like pneumonia, tuberculosis or bronchitis. So better to consult pulmonologist and get done a clinical examination of the respiratory system, chest x-ray and PFT (Pulmonary Function Test). Chest x-ray is must for the diagnosis of lung infection. PFT is needed for the diagnosis of bronchitis. You may need antibiotics and inhaled treatment based on the diagnosis. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Kaushal Bhavsar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bumps on each knee at different locations that swell sometimes and are sensitive\n\nI used to play volleyball & soccer when I was younger and now am a runner. I used to have tendinitis on my right knee but now am having problems with both knees. There s a new bump on each knee in different locations on each, they sometimes swell & are sensitive to the touch, also my knees will sometimes go to sleep or feel numb. Should I be concerned?",
    "doctor_response": "Hello,For how long has this been happening? How old are you? Do you have full motion of the knees, 100% extension and flexion? When these signs starts for how long do they last? What makes it worse or better? I think you need to visit a doctor in order to do a physical examination too. Wish you good health.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Emilda Belortaja",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to get pregnant. Everything normal. On and off all birth control pills. Suggest\n\nHey doctor.. I have been trying to get pregnant by my husband for five years now an nothing has happen.. Every time i go to my ob/gyn she says everything is fine.. Im only 24 an have been sexually active from the age of 18 yet nothing has happen... Ive been on an off of all the birth control you can think of but for the past 3 years i haven't used any birth control at all",
    "doctor_response": "Hi,Thanks for the query.Better to go for the semen analysis of your husband.If that comes normal, in this cycle you consult your gynecologist and take tablets for ovulation induction.Then track the ovulation either by ovulation kit or by follicular study and plan unprotected intercourse around that period.This will increase the possibility of pregnancy.If the attempt fails once go for hysterosalpingography.For more details you can ask me through:  care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for hair loss\n\nHi doctor,I am pradeep 27 yrs,i a few dermatology problems please help me find an solution1)hair is lost i am becoming bald,and hair has become white almost 50%.now berd is becoming white almost 25% even in private places hair is becoming white.please tell me how can i get rid of premature ageing and grow hair.Thankyou in advance",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Unfortunately there isn't much treatment for grey hairs. But to prevent further greying you could improve your dietary intake with foods rich in vitamin B9, B12, and copper. These are green leafy vegetables, lentils, potatoes, mushrooms, dried fruits like prunes, eggs, pumpkin seeds to name a few. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Smruti Pevekar",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to wean off Xanax?\n\nI have been on Xanax 1mg twice a day since March of last year and I am wanting to get off it and get on something more effective with less side effects and no withdrawal syndrome when I stop taking it. Several years ago when my father passed away I was put on Xanax and was up to 5mg a day for almost 5 years. Lost my health insurance and the health dept wouldn t prescribe me Xanax even to be gradually taken off of it, this led to me getting cut off cold turkey and I went through the worst withdrawals that I didn t know existed until afterwards when I looked up Benzodiazepine Withdrawal Syndrome and found out that them making me stop cold turkey could have killed me (and trust me, it felt like I was literally dying by day 3). Against my better judgement last year I started taking them again, this time 1mg twice a day. Then I ran out of my script before a holiday weekend and ended up in the hospital because by day two I already felt the withdrawal symptoms coming on and didn t want to go through that again. After that weekend I went back to the doctor and got my script. I ve been thinking about this long and hard and I don t want to be on Benzodiazepines at all anymore, they are way to dangerous in my opinion. So here s my question (2 actually)....1) what kind of taper off Xanax plan works the best without any of the withdrawal symptoms and 2) what medications could I be taking alternatively to help with my moderate anxiety, maybe one that can even address my mild to severe depression episodes (which I ve been dealing with both anxiety and depression since puberty). Thank you in advance for any help you may be able to provide before I make an appointment with my doctor to proceed with benzodiazepine taper and getting on something else less dangerous as far as addiction and withdrawals are concerned.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Weaning off from Xanax is not a tough thing and the withdrawal symptoms are minimal with twice daily. You can talk to your psychiatrist regarding this and he can help you. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluttering in the stomach after using the depo shot?\n\nI am a 26 year old woman with 2 children. I've been on the depo shot for almost 2 years. For the past week or so, I've been feeling a strange fluttering feeling on the left side of my stomach. I had a pregnancy test which turned out negative. I would just like to know what could be causing this. Thanks in advance for any info you can offer.",
    "doctor_response": "Hi.Thanks for your query.The fluttering in the left power abdomen may not be related to the Depo shot as you are having the Depo shot for the last 2 years. The possible causes in absence of a positive pregnancy test can be:Colitis of the sigmoid colon.Urinary tract infection, with or without stone. Mild intestinal infection. I would advise you to see a General Surgeon and get actual physical examination, investigations like ultrasonography and other relevant tests of blood, urine and stool. Further treatment will be according to the Physical findings and the reports of the tests. '",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of Gemer P intake for sugar?\n\nMy boold sugar level in average( Fasting) remains 115 to 125. I am taking Gemer P 2, Pl advise the side effects as I am taking this medicine from the last four to five years. Some times there is funges on my tongue. Pl inform is the same is due to this medicine. Regards BM Ghai",
    "doctor_response": "HiHypoglycemia,nausea,abdominal pain, diarrhoea, weight gain and headache are some of the common side effects of the drug.Fungal infection of the tongue has occurred due to diabetes.Diabetes is an immunity reducing disease and hence it is easier for fungal infections to occur that has to be treated with antifungal drugs.Hope I have answered your query. Let me know if I can assist you further. RegardsDr.Saranya Ramadoss, General and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest tightness and pain?\n\nHi, my name is Faith. I have a tight chest with pains and a feeling of a swollen throat and I feel like I dont get enough breath. When this happens, I normally even feel like my eyes are extra ordinarily bigger or wide opened than usual. What could be this?",
    "doctor_response": "If you have noticed it to be associated with intake of certain food, medication or exposure to particular agent, then it is probably an allergic reaction for which you need to consult an allergist at the earliest.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with rhinites. History of sinus, allergies. Prescribed kenacort, penidore injections with medications. Is taking injections needed?\n\nHello DoctorI have been diagnosed with Rhinites , i have sinus for past 15 years and got operated in year 2001. I had allergy in past with Pollens etc. Doctor has written me Injection (Kenacort 40 mg+ Penidore 24) plus T Febrex plus and spray Avamys. Medicines are ok but I am not able to understand shall i take this injection as i read on net that its effect is not long lasting and is very painful as well. Hence confused shall i take medicines only? I am having watery eyes also for past 20 days.",
    "doctor_response": "Apparently you are having severe allergic rhinitis.The Penidure 24 is a long acting penicillin which is effective for upto 3 weeks,the Kenacort will also be effective for about 4-5 days.The penidure injection is painful,your doctor may be trying to treat a bacterial  infection like strep,a single doe of this injection will be effective in such cases.the addition of Monteleukast,a leukotriene inhibitor will help deal with your allergy.The decision of whether to take the injection or not lies with you and your doctor,it would be unfair for me to comment on this issue without examining you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have diarrhea, headache, lightheadedness, dizziness, tired when standing in sun. Allergic to sun exposure?\n\ni show horses, so i am in the sun a lot for horse shows... i have noticed that i get diarrhea a lot when i am outside in the sun doing things.. i also get head aches all the time from the humidity, and after the diarrhea spells i am very light headed and dizzy when i stand, also very tired whenever i am out in the sun! my question is if the diarrhea would be caused by the sun? and is it possible i am allergic to sun exposure?",
    "doctor_response": "no chances of sun exposure allergiesyour allergies trigers by hot you must have sinusitis which is triggered in hot and discharge of mucus in back of throat and abdomn causes thisget xray pns and tret sinuses your problems will decrease by doing allergy treatments",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Ibugesic Plus be given to an infant for pain after a vaccination shot?\n\ni have got my 7weeks old son vaccinated and applied thrombotas ointment on it and as soon as i applied it on his leg that area became red so is there anything to worry about and can i give ibugesic plus for pain relief",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It's better not use combination with Paracetamol. Paracetamol can be given, if fever is more than 100 F. I suggest not using combination of medicines for fever, especially with Paracetamol. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Use Advair for asthma, have to gasp for air, get huge migraines, sudden vision blurring. What is going on ?\n\nHi, I need help. I'm having a lot of issued right now, I don't know what's going on. I have asthma, and I use my Advair inhaler everyday. But, a few nights ago I was perfectly fine one second, and then next second I couldn't breathe. I had to gasp for air, I thought I was having an anxiety attack, but nothing bad was happening; and that's never happened before. It lasted about five minutes, and then went away. But even now I have to take a lot more deeper breaths than usual. Also, earlier today I was using the bathroom, and sometimes when I get huge migraines, I feel like I'm in a complete dimension. I had no headache when I went into the bathroom, I was completely fine, but as I was in use, for about five seconds I felt out of place. My whole body went cold, I was shaking, and my vision blurred and I saw two of everything. After about five seconds, I returned back to normal and nothing happened. It's really stressing me out, what is going on?",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum. Since , how many days , you are taking ADVAIR inhaler as the ingredients are beta agonist+corticosteroids.  Now your main complaint is same breathlessness and cessation of breath. In my opinion consult a physician and get in complete examination of heart and blood for anemia and calcium ( if corticosteroids uses for long time may cause calcium depletion and this causes such type of symptoms). Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does it mean to experience sharp stabbing pain in lower abdomen with headaches and nausea?\n\nI have the mirena iud and for about a week now, I have had sharp, stabbing pain in my lower belly, right side. I have also have really light spotting, really dark brown in color. My lower back hurts, I have a headache, and I am light headed. I have also had nausea and been throwing up after almost every meal. I tried to call my ob today, and she can t get me in for at least two weeks. Should I go to the er?",
    "doctor_response": "Hi there,I had gone through your query and understand your concern.Yes,Please visit the ER as Mirena IUD can cause side effects like headache with nausea ,persisting lower abdominal pain or pain int the sides of the abdomen at the earliest.Nothing to worry.Mirena IUD in about 1 % can cause theses effects like Tubal pregnancy ,Gastritis,severe headaches/Migraines which needs to be reported.Please consult the ER if OBG consultant is not available immediately.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility\n\nI have been married for 12 years now and am failing to conceive. i had tried several fertility treatments locally. i stay in Malawi in Africa. Last year in march , i tried a fertility clinic in india and they gave me medication and in june i got pregnant. unfortunately i miscarried in september. am diabetic. please advise me wat should i do now. will i fall pregnant again naturally or i still need to go to india but it was so expensive to me i dont think i can afford anymore. PLEASE HELP ME. AM 34 years old but before we got married i had two abortion the same man am married to now impregnanted me. HSG was done, the tubes were not blocked. after we got married, we stayed for 3 years taking contraceptive pills and when we tried to get pregnant, i failed. PLEASE HELP ME. WHAT SHOULD I DO NOW? THANK YOU",
    "doctor_response": "please don't worry these can be due to many hormonal problems ,so get your prolactin thyroid tested also last option is to go for a test tube baby",
    "dialogue_context": ""
  },
  {
    "patient_message": "Nerves damaged in both legs,thinning of the kidneys,fibromyalgia,copd, osteoarthritis.Treatment?\n\nI currently have nerve damage on both my right and left sides of my legs. I also have thinning in both kidneys, fibromyalgia, copd, osteoarthritis. I have constant itching in the middle of my back which also stays numb. What can the cause possibly be?",
    "doctor_response": "Hi, Detailed evaluation is required, you can consult a nephrologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can nystatin and triamcinolone acetonide cream be used for yeast infection?\n\nHi was just wondering if nystatin and triamcinolone acetonide cream is ok for my 4yr old daughter. Ive had the cream around my house from her yeast infections a year ago and couldnt remember if this was the cream that I used last time. Just want to give her the right treatment bc her drs wont be open til tuesday! Please help!!!",
    "doctor_response": "Nystatin is for yeast infections and is safe for a 4 year old. I would not use the triamcinolone. It is a steroid cream will not help a yeast infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headache and anxiety after an accident?\n\nMy daughter was in a serious car accident 5 years ago. To this day, she has almost daily headaches...some very minor, and occasionally more severe. She was pronounced cured from her concussion caused by the car accident, and an MRI showed a normal brain. We do not know what to do or who to talk to about her current daily migraines. Do you have any thoughts or suggestions. The headaches may or may not be related to the accident. She also suffers occasionally with anxiety attacks. PTSD? How long might that last, and are headaches typically associated with PTSD? Thank you.",
    "doctor_response": "Hello,Headaches are not frequently associated but certainly may be in some cases. The best treatment for PTSD is long-term therapy with a well trained counselor or therapist. For the headaches, there are many medications that may prevent daily headaches and may also give some relief to the PTSD symptoms. She needs to see a neurologist for a discussion of these medications.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can you suggest a good kidney doctor in India ?\n\nMy cousin has a problem with 1 kidney which is negligibly functional and the other one appears to be shrinked as per the report, please suggest the best doctor/surgeon/hospital in India in a medium cost of budget. And whether it is serious and is curable.",
    "doctor_response": "hi u need to admit him in kidney hospital. there is no 1 kidney hospital in civil campus of ahmedabad. it is trust hospital so it is economy with high standard treatment. its Institute of Kidney Diseases and Research Center, Gate No 3, Civil Hospital Campus, Asarwa, Ahmedabad, 2685600/01",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for testicle pain\n\nDear Doctor. Last year in july i had Filaria and i got Banoside, then it was ok, but it didn't heal my right testical pain..still it continous with back pain when i worked hard, but when i sleep No pain is there.. according to the Ultra Sound scan it was Normal....... why is that Doctor ?",
    "doctor_response": "Hello, As a first line management you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persists better to consult a general surgeon and plan for an ultrasound scan. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain on exhaling, no pain on inhaling. Taking flexeril for neck pain. Causes for symptoms?\n\nHello, I keep getting a sharp crushing pain in my back ONLY when I exhale completely. It doesnt hurt when inhaling or breathing shallow. I am 28 years old. I went to doctor a week ago because I was having neck pain , (Dr. thought it was pulled muscle) and I was prescibed Flexeril and an anti inflammatory. Could this be a side effect or something completely different?",
    "doctor_response": "Hello, pain cannot be a side effect of anti inflammatory or flexeril. Your crushing pain in the back could also be due to pulled muscle. Rest for couple of days, do not strain, continue flexeril for total duration of 5 days, and you can apply a analgesic gel to your back but no massage. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for headache and vomiting with hydrocephalus\n\nMy daughter was born with hydrocephalus (2 months prem), She gets severe headaches although when scanned there seems to be no problem with the shunt. She is a very able child, but because of occasional vomiting and the headaches i have to take her to A&E alot. We also travel to bristol occasionally to see her neurosurgeon. I find myself awake alot at night with her because of the headaches. Could she possibly qualify for DLA because of the travel expenses and washing of bedding?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Some neurosurgeons recommend intracranial pressure monitoring for severe, persistent headaches where the CT scan shows no enlargement of the ventricles. This procedure is done in the hospital where the pressure inside the brain is continually monitored. The pressure is correlated with the patient's symptoms; the shunt pressure valve can then be revised as needed. There is an organization named the Hydrocephalus Association.  It has much good information for parents.  It is in Bethesda, MD, USA. Hope I have answered your query. Let me know if I can assist you further. Regards, Arnold Zedd",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of potential pregnancy?\n\nI got my period on Nov. 13th and it lasted 6 days, ending the 19th. My fiance and I had unprotected sex on the 20th and he finished inside of me. Since the 20th until now, we have had unprotected sex but have used the pull out method. The last 4 days I have been ovulating or what I think is ovulating. I m curious of when in your cycle your supposed to get implantation bleeding , if I were to get it. And If I were to be pregnant, would I be ovulating at all if the unprotected sex was shortly before my ovulation was supposed to occur? Oh and if I were to be pregnant, what is the earliest I could take a home pregnancy test and get it be positive?",
    "doctor_response": "I would advice you that don't worry ,a urine pregnancy test get positive by 8 to 10 days of pregnancy but always a confirmation is needed by a ultrasound",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Shocking feeling from collarbone to neck with intense arm, neck and shoulder pain. History of seizure. What could this be?\n\nWhat could possibly cause a shocking feeling the goes from the collarbone to the neck on the on the left side?I have had these infrequently for all of my adult life but just had the worse one i have ever had.I went to look to the left and the shock pain traveled in bothdirections down into my shoulder/ chest and up my neck into my head as it usually does and i was unable to for a split second see anything except a bright blue/white light.It only lasted seconds but this time my arm aches horribly as well as my neck & the back of my shoulder.Does this sound like anything you have heard of before & should I be worried?Will these become stronger in intensity.As a teen i injured myself when i fell off the uneven bars in gymnastics, my spotter was distracted & i landed on on the top of my head causing me to have the last childhood seizure i ever had.I have wondered before if that has had anything to do with having these.",
    "doctor_response": "Hello, One possibility i would consider is that intermittently the nerves or blood vessels or both may be getting compressed in the cervical spine in a particular head position. This can cause the transient symptoms of the type that you described. History of fall and injury in the past that you had favours this. Another possibility, which is less likely is that these are minor seizures. You chould definitely get evaluated by a neurologist and treatment may be planned after finding the cause. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a swollen and painful lump on the armpit\n\nDear Dr, I have a problem in my armpit.A swelling is occuring frequently like a cyst a hard stone like structure inside.After few weeks the pain got worse and i was even unable to lift my arm.And after few days it got opened and puss is coming out from a hole.I have used clotrimazole powder.It cured and hole was closed.And next day again the pain started and hole again opened and puss coming out even worse with bad odour.Please suggest me some remedies .",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some enlarged lymphnode vwith abscess formation.  It can be due to reactive hyperplasia or tuberculosis.  Or you may have sebaceous cyst or other benign cyst with infection.  You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest an effective medicine for pain\n\nHi am Bhagya my sister is 25 years old unable to walk she s sitting from more then 10 years by sitting f long period she got bed sores n cysts in her lower back also she has a chronic tail bone pain n fever we took her to orthopedic doctor n they hv prescribed bandages f wounds n ring pillow f tail bone pain n 2 tablets zerodol p and taxim o by which she s nt getting any relief from d pain so can u pls help with this n suggest her any good medicine to get rid of d pains am very much worried f her so am requesting u to pls help with this.",
    "doctor_response": "Dear patient First of all I want to know why your sister is not walking for last 10 years?is she suffering from neurological disorder or myopathy? is she having bed sores? as per your history she seems to have neurological disorder with decreased sensations and so due to prolonged sitting she had got bed sores and coccydynia. Initial treatment is to take off pressure on sore area by using air inflated tyre tube. Daily dressing  and antibiotics like cefixime. sleeping in lateral decubitus position also helps. If there is no improvement opinion from plastic surgeon for skin grafting should be taken. For pain relied she should take tab diclofenac sodium 50 mg twice a day and tab ultracet once at night.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for depression and lack of libido\n\nHi Doctor , 2 yrs back i had depression and was treated with Serotinin reuptake inibitors and dopamine affecting oral medication.After Few month i realized that my pleasure for sex or orgasm has vanished although erection has been there. I have feeling towards any sex act. Now its just an exercise for self being.",
    "doctor_response": "Hello thanks for asking from HCMYou have depression and were given SSRIs. The medicines resulted in sexual side effects like poor orgasm and lack of pleasure in sex. Now you have lack of libido and you have discontinued the medicines.Sexual dysfunction caused by SSRIs is reversible and it can't persist for long periods of time. So most likely the symptoms you are having are due to depression itself. In sexual dysfunction of depression medicines like Mirtazapine, Bupropion can prove useful. These medicines act as antidepressants and help in improving sexual dysfunction also.For poor libido medicines like Sildenafil, Tadalafil can be utilised. They help to improve symptoms of poor libido and erection. Herbal medicines like Tantex Forte, Yohimbin supplements also have good role in improving libido in sexual dysfunction of depression. Visit a psychiatrist for prescription of medicines.Thanks, hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anxiety and anger disorder\n\nDear Doctor, This is Savitha from India. From past few months my mind is not in my control.. Last June I came to know that my Husband was talked with a Lady on a daily basis(only one time after 11.30 pm and his duty over at that time). Once i saw her number i asked him that who is this and he told me that it is a sales man.. After few months again i saw that number and called and came to know that that was a lady. Then I asked to my husband about her and he told me that she is a Cancer Patient and she dont have anyone so she asked to my Hubby to call her daily. After that I called her and she told me that she is a cancer patient and she dont have one Kidney too and she loved my husband and my husband also loved her but my husband never express his love to her.. My husband thrown his old sim card and told me that he never loved anybody except me and he dont want to talk anybody without my permission. After few days I became a mental patient and treated by a Doctor. Unfortunately we couldnt complete my treatment and the Doctor suggested me Opripol, Zosert and Anxozap Tablets. 2014 August 25 i tried to commit to suicide with Anxozap tablets.. I have two beautiful kids and I always thinking about my husband and that lady, Doctor. Still I cant sleep well, eat well and I often crying in the night. I know that my husband will not cheat me but i couldnt control myself. I still asking him about that lady . Sometimes I am thinking that I want to kill her and you know doctor she is not a patient and she is a fraud and she want to talk with my husband so she lied him that she is a cancer patient. I know all these things but i cant forget her words. I want to die doctor.Please help me please",
    "doctor_response": "Dear SavithaWe understand your concernsI went through your details. Let me be very clear in my approach. Nobody can help you die except god. You suspected your husband with such a venom and because of that you had to be diagnosed mental patient. why would you like to do so? You have never saw your husband with that girl. You just suspect and suspect. I don't see any reason or proof of the relationship between your husband and that girl. He lied to you, I can understand. There are so many occasions in a family relationship, where lies are common. Can you say for sure that you never lied to your husband? Your husband clearly told you he do not have any relationship with that girl and he promised to love you and you only. You did not believe him and instead believed circumstances. In family relationship, you should learn to believe your husband rather than circumstances. Then family life becomes peaceful. The best option you have now is to consult a psychologist for several counseling sessions. Take care.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the connection between Clopidogrel and bleeding of gums?\n\nI have been taking clopidogrel for a number of years. After two weeks of weariness and fever, my doctor recently diagnosed Infective Endocarditis by blood cultures. An echocardiogram indicated a bicuspid aortic valve, and listening to the chest using a stethoscope the doctor could also detect a slight murmur. His doctor had asked me if I had had any dental treatment recently. i admitted that I had not seen a dentist for a number of years and a cursory investigation revealed dental caries and inflammation of the gums. I avoid the dentist because of bleeding in my mouth following visits. Also. What is the connection between Clopidogrel and bleeding gums AND when should prophalytic antibiotics should be prescribed prior to oral treatments.?",
    "doctor_response": "For what reason , clopidogrel is prescribed? Secondly at times mucosal bleed may occur, but rare. As you already have dental caries, the reason of bleeding is same. As you have dental infection, antibiotic treatment is must and if you are having infective endocarditis, you should complete the course as per doctor. Pre procedure antibiotic prophylaxis is must in valvular problems.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is Mometasone dangerous to use on Face to clear my acne pimples?\n\nHello doctor, I am seriously facing acne pimples problem. Sometimes they occur on my face when I masturbate. If I use Mometasone, it gives a good result. Is it okay to continue this?",
    "doctor_response": "Hello. Acne is a universal issue in the age group of 15 to 25 years due to hormonal changes in adolescents. However, there are multiple effective treatment options depending on the grade and severity of the problem. Mometasone is a topical steroid and is to be avoided strictly on the face and for acne as it can harm your skin in the long run. Acne is dependent on hormones hence excess masturbation may sometimes lead to an increase in the problem. I would advise you to stop Mometasone immediately and kindly upload appropriate images to help us assess your current grade of acne and treat you better. Regards. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in scrotum\n\nHi, I recently had a pain in my scrotum. Whenever i sit, my balls used to ache. When i visited a urologist, he said that i have Varicocele. Now i am taking medication for Varicocele. I normally sleep in Foetus position. Is it safe if i continue my sleep in Foetus position or as my one friend suggested sleep in Starfish position with a pillow placed under my back as a support to my balls. My another friend suggested to dip my balls in Cold Ice water. Is it safe to dip balls in ice cold water to improve the pain. Please suggest",
    "doctor_response": "Thanks for asking in healthcaremagic forum  Please do not listen to your freinds. You may use scrotal support if its aching while you stand for long time/walk. You can sleep as you want. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring fever?\n\nsir i have low grade fever always around at 6pm to 7pm i have tested for TB but all reports are negative except montoux test i am taking anti depressent medicine also from the last 2 months and i have also excrete some infection from my urine please suggest me what to do i am very much in confusion mind",
    "doctor_response": "Dear Friend.Welcome to HCM. I am Dr Anshul Varshney. I have read your query in detail. I understand your concern.I suppose you should get a proper evaluation done.It is not like that every chronic fever is due to tuberculosis only.Give me detailed history and get following investigations:1. Hemogram with ESR2. LFT / KFT3. Chest Xray4. Urine R/M and C/S5. Sputum for AFB.Montoux test has no significance even if it is positive.If you have all these investigations, give me detailed history and attach the reports.This is my best advise for you based on available details. If you have any further query please ask me.Stay Healthy.Dr Anshul Varshney, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bumps in groin area?\n\nIv been with my girlfriend for over a year now and have only had intercourse with her. Sunday-Tuesday we had intercourse and i think she started her period because after i noticced a little blood on my pubic region. The same week on thursday i started to notice little red bumps start to form and are scattered around. I dont shave but 1 felt like an ingrown hair and i have a bad habit at picking at it. The 1 i was picking at felt like a bump or lump under the skin. What could this be or is it an STD?",
    "doctor_response": "Hi,Welcome to HCM. I understand your concern.The lump you have got under the skin should not be a sign of STD. As you are describing, the lumps you are feeling with the ingrown hairs are most probaly due to the friction on the area as ell as can be due to the prolonged wetting also with the direct contact. It is kind of an allergic reaction of your skin against the discharge from vagina.There's no need to worry. You should keep the area clean and dry. And don't expose the are to friction as well. If you see the bumps growing, it can be sign of a pustule formation. In that case, you can take help of your physician who can incise and drain it if need be and cover up with antibiotics.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the condition of severe learning disabilities?\n\nI am the teacher of a 9 year old girl with severe learning disabilities.  She wets the bed nightly and has frequent, sudden urinary accidents at school.  There are times when she stares into space, refuses to respond to verbal directions, can't follow along when someone else is reading and is very slow to process information.  I am concerned that she may be having undiagnosed petit mal seizures.  Can these be causing her urinary problems?",
    "doctor_response": "Any seizure can be asssociated with passing urine. Lapse of attention for few seconds can be an absence seizure.Learning disability has to assessed in details. At times they are associated with adjustment problems at school, emotional difficulties in child, anxiety and depression, parenting issues and all. In such conditions improvement is possible. But if learning disability is a result of a developmental anomaly then its less likely to improveRegards,Dr Arun",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for memory loss\n\nHi I am a \u00c7A student I am not able to remember things I have kept for the past few years. I have consulted u for depression few years back. Now a days every one is blaming me for not remembering.They say I am not matured but I know I am. I lost my ATM card, bracelet... I feel so sad because of all these things. I am so care less . Sometimes I used to wake up at night and simply cry . Every one says to me accept the reality. Everyone is so supportive and caring.and I think they all love me .But I know I am making them all sad.i don t know why? Please prescribe me medicine for memory gain.",
    "doctor_response": "Hello!Welcome on Healthcaremagic!Your memory troubles could be related to difficulty in concentration and depression. The fact that you cry during the night is another argument in favor of this disorder. At your age, dementia would be really an exceptional diagnosis. But, you should know that the management of depression would improve your concentration and memory problems. There is no need to take any memory pills. I would just recommend consulting with a psychotherapist and performing a lot of physical activity (Yoga, aerobics, running, etc.). If this does not help, an antidepressant may be necessary. But you should discuss with a psychiatrist before taking any medication. Hope you will find this answer helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Liver function tests reveals a fatty liver. Took Statin but had little improvement. How to cure this?\n\nHi. I  am 28 years old male. I am a healthy person but recently had my liver function tests. All other enzymes were normal except ALT. It came out to be 135. The doctor asked me about my diet and he told me that I have a fatty liver. I donot drink alcohol. I have changed my diet I only eat organic fruits and vegetables now. Recently some one told me to take statin to lower down my cholesterol. I took it for ten days and when I went for tests my ALT was again 110 only a little less. I need to drop it down within a week what should I do? As I have to go for tests again next week.",
    "doctor_response": "Hi, If your doctor did not prescribe statin, I suggest not to take it anymore without prescription. Harms you will get at this young age will be more than benefits. Next, please be patient. It will take up to 3 months after you apply changes in your lifestyle and diet to see improvement. So, I advise to wait for other 3 months before taking the tests again, then, you will see the difference. Always consult your doctor!All the best!Dr.Alba",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Metoprolol advisable instead of Labetalol for high BP?\n\nI was previously taking Labetalol 100 mg twice a day and has just changed to metoprolol succinate ER today. It seemed like the Labetalol worked better at controlling my bp but I do have a lot of side effects with it. How long does it take for metoprolol to work? Should it take several days to get into my system and work better at lowering my bp?",
    "doctor_response": "Hello,If you are hypertensive patient then it is ruled that you need to stick to the single molecule if it suits to you, it can not be changed by itself (By patient) but physician taking the decision, if you have some symptoms that might not be due to the anti-hypertensive drug but you have to inform your doctor, You have not given any information no age no gender, you have talked about the side effects but did not mention it, as long as the anti-hypertensive drugs are concern it start working very fast, you have not even given the blood pressure reading, with such little information difficult to say or comment or advise in proper way, I could only say that you discuss it with your physician.Hope I have answered your query. Let me know if I can assist you further.Regards,    Dr. Husain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in arms after getting an IV?\n\nMy Mom was released from ICU yesterday morning. Today she woke up with her arm weeping. She said it feels like a water ballon. She was in for enema but they did not find the source. they gave here plenty of fluids in IV's. Could this be serious and should she go back to the Dr.?",
    "doctor_response": "Hi,This may be due to water clogging under her soft tissues due to either reduced urine output and excess input of iv fluids comparatively.Other reason may be vein puncture during iv infusionConsult a physician.Lasix or other diuretics may help drain out the excess fluid from the body.However,diuretics need to be taken under medical supervision.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can smoking hamper h.pylori treatment, if yes, should i restart the treatment?\n\nHi, I'm 25 years old and I am in treatment for h.pylori.  I've been smoking during the treatment.  I thought it was ok but I'm reading that smoking weed during the treatment of h.pylori is bad.  I've been on the treatment for a week and I'm supposed to be in the treatment for two weeks.  Should I stop smoking and start my treatment again as if it was day zero.",
    "doctor_response": "Hello, Welcome to HCM, Your on treatment for H Pylori, because infection with this organism can lead to acid peptyic disease. As you continue to smoke the effectivness of the drugs used in the kit will come down. Now as you are aware of this, stop smoking and continue the treatment , there is no need for restarting the treatment. Complete the treatment regimen as per your doctors advise and undergo follow up examination. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can shape of the face be corrected by using braces or cheek implants?\n\nHi, i had braces at my age of 25 for 8 months and retainer for next 8 months. Before wearing braces my face shape was square but now it has become oval. I had braces for correcting the upper jaw side wise teeth extended ( upper bite problem).can i correct this using braces or cheek implantation ?",
    "doctor_response": "Thanks for your query, I have gone through your query.The altered facial profile can be corrected by the orthodontic treatment. Consult a good orthodontist and get it corrected. No need to go for cheek implants.Before going for any treatment get a radiograph done to rule out any defect in the jaw bone. Later we can decide whether only orthodontic treatment is enough or it needs surgery along with braces.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can redness on cheeks be due to something serious?\n\nHello doctor, I have redness on my cheeks that is not acne. I have used Sodium Sulfacetamide as a wash and Benzoyl Peroxide gel which just seem to worsen the condition. I have struggled with this issue and cannot seem to find a solution.",
    "doctor_response": "Hello. From the photo, it seems like rosacea (attachment removed to protect patient identity). It is a common skin disease characterized by a tendency to blush or flush more easily than other people. Treatment consists of preventing the aggravation of symptoms. This is possible through finding and avoiding triggering factors like foods, weather temperatures, or any cosmetic. Do put always sunscreen with SPF 30 or higher. Avoid rubbing your face skin, avoid skin irritants. To ease the redness, you should apply Azelaic acid cream locally twice daily. Plus, should apply Aloe vera gel throughout the day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever and throat pain in a child?\n\nMy 5 month old grandaughter is staying the weekend with me and started running a fever of 100. She started late yesterday afternoon not wanting to take her bottle - or seemed to have a hard time with it and will only eat a few bites of food with a spoon. She is little fussy but is still smiling and playing. she did take an unusual amount of naps yesterday and today but never slept more than 30 min. how do i know if she is teething or her throat is hurting?",
    "doctor_response": "Sore throat in a child occurs either due to certain viruses like epstein barr virus or due to certain bacteria like streptococcus. For breast fed babies, such problems generally do not occur. But for formula fed babies such things may occur. You need not assume the cause of fever to be sore throat however but some sort of viral infection is likely to be the cause. If the child is playful and otherwise ok, you need not get concerned but if you feel that the child is not feeding well or is lethargic, you will have to take the child to a doctor and get her blood counts and C-reactive protein checked. Give paracetamol to contol fever. Teething is not associated with fever. Throat hurting is also quite unlikely. Your doctor can examine and say more.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is hernai ?\n\nWhat are the symptoms and how much it will take to cure approximately",
    "doctor_response": "Hi.. Hernia is medically defined as abnormal protrussion of contents through a cavity in which it is normally contained.. Most often the protrussion occurs throught the abdominal wall which results in a swelling.. Other internal hernia is also known to occurs such as hiatus hernia, where there is protrussion of the stomach through the diaphram.. These hernia usually cause asymptomatic hernia and diagnosed incidentally by examination. The symptoms, if occurs depends on the contents of the hernia.. The next common symptom is pain.. Finally the rest of the symptoms such as\u00a0 vomiting, fever, constipation and so on will occur if there are complications.. The cost of the treatment varies in different institutes and depending on the type of hernia.. The rough estimate would be a few thousand Indian rupees..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bleeding from the mouth, blood vomiting. History of head injury, brain stem injury. Treatment?\n\ni recieved a head injury 28 years ago,i suffer from extreme pain and swelling i nthe back of my head, i was told injury to the brain stem ,i have knots that swell up tremendously and i have siesures i take dilantin ,question i have been bleeding for several weeks the tummy specialist sats its comung from swelling and pressure from head,could this be so?i wake up with huge amount of blood in my mouth and i puke up blood some times brown but usually bright red and lots of it ?",
    "doctor_response": "Dear Friend, This cud be cause of gum hypertrophy due to Dilantin but you must see ENT specialist Regards Dr. Vineet Saggar (MCh)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for valve leakage and hardening of heart muscle\n\nI have slight valve leakage and slight hardening of the heart muscle. Currently I take 10mg of ramril and 5 mg amlipodine and 10mg statin. Is there anything that can reverse the hardening of the heart muscle. Blood pressure has been a little uncontrolled over the last 6 months?",
    "doctor_response": "Unfortunately there is no treatment for this Harding of your heart muscles...all we can do is to control your blood pressure as you can, and keep on taking your drugs",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the lump be a symptom of strain from kayaking?\n\nI just noticed what seems like a pulled muscle in the top left of my right breast.  It is about an inch long and half inch wide.  I have been doing a lot of strenuous kayaking and did pull muscle in my right arm.  Could the lump be a symptom of the strain from my arm and the kayaking?",
    "doctor_response": "Hi.Certainly yeas.You have rightly noticed this.The muscles here are in the form of a belly and one such belly is pulled / strained in this particular area. Simple test is to  cross the arms in front ofs the chest in opposite direction and see if this is increasing the selling and pain. If this is so , this is a strained muscle. And is due to kayaking",
    "dialogue_context": ""
  },
  {
    "patient_message": "When should i start taking cerazette pills?\n\nHi there, I have been taking Cilest birth control pills for the past 10 years but ue to migraines have been prescribed cerazette in place. I have had my pill free week and would have continued with the cilest on Tuesday had the cerazette not been prescribed. I was wondering when the best time to start taking this new mini pill? Should I use extra precautions for a while? Thank you",
    "doctor_response": "cerazette pills u can take from first day of cycle or as late as 5th day of cycle...in both d cases u dont need any additional mode of contraceptin...but if u start from middle of cycle...u need to take contraception fr first 2 days...dese r mini pills...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain and shortness of breath while working out?\n\nHello, I have been consistently working out for two years now 5 days a week. All five I do cardio and three days a week I life weights. So far I have been able to run without stopping and without being exhausted or overly tired for three miles. Sometimes however I develop a kind of bad cheat pain on my left side about 1.5 miles in. I have no other symptoms of tiredness and sometimes if I breath extremely deeply the rest of the time it will go away. Is this cause for serious concern? I also do very hard elliptical workouts which always by the end I am more tired than when running but the chest symptom never occurs and I do the elliptical nearly every day.",
    "doctor_response": "Hi welcome to HCM....You are doing cardiorespiratory exercise regularly ....So chance of coronary artery disease or any heart problem is less....But still to be on safe side I would like you to suggest following investigation and consult pulmonologist....1.Blood pressure measurement2.ECG 3.Tread mill testing 4.Auscultation along with pulse palpation If needed then echo done ...If no significant cause present then pain could be from musculoskeletal pain....For that simple analgesic taken....Don't perform all heavy weight lifting exercise once a day for every muscle...Rather you do individual muscle work out daily...Hot pads application useful for pain relief.Sleep posture should be proper....Hope I have solved your concern...Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes coughing and spiking fever?\n\nMy son, 9 yr old,  has had a spiking fever for the last 48 hours. He has no other symptoms when we get the fever down but when it spikes up to 103-104 he gets a cough... what could that be? Should I take him to the doctor, I mean I have no symptoms but a spiking fever. It takes 1 advil and one tylenol to get it to come down every time.",
    "doctor_response": "hi dear. lower respiratory infection presents with fever and cough . my advice to you will be .Get a chest X-ray done in Ap and lateral position to rule put pneumonia or any consolidation , if there are changes Consult a physician .check his CBC, and blood culture .He should be started on antibiotics if his fever persists and congestion .you can continue giving paracetamol for fever .hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes indentations on arm?\n\nHi my wife has had some pain in the back of her legs the last few days, it resided but just popped up in her right arm and there are small indentations as if she had leaned on something for too long but has not done so. she is on birth control but that is it.",
    "doctor_response": "Hello, Consult an orthopaedician and get evaluated. An MRI scan is required for further assessment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain, bulging of veins and swelling in left hand?\n\nSwollen fingers, bulging dark colored veins on wrist towards Palm, tingling sensation felt throughout my hand at times and pain felt throughout my wrist makes veins bulge more. Have not had any injuries that I m aware of what could it be? This is on my left hand Right hand looks Normal",
    "doctor_response": "Welcome at HCM    I have gone through your query and being your physician I completely understand your health  concerns.   It is not possible to provide you accurate diagnosis. You need to be examined clinically. Meet your attending physician for proper assessmennt.             Meanwhile stay calm and use acetaminophen to relieve pain   Get well soon Hope your query is adequately addressed if you still have any feel free to ask   RegardsDr Saad Sultan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes unusual movement in the left rib cage?\n\nHello Doctor,I recently discovered that if I apply pressure to a certain spot on my left ribcage, something moves; it does not happen to my right. Even if I look in a mirror my left ribcage sticks out more than my right. I asked a phychiatrist and he said a swollen organ may be pressing against my ribcage. Should I be worried?",
    "doctor_response": "Hi and welcome.Thanks for asking here at the website.@ The unusual movement in rib cage indicates possible inflammatory of rib or intercostal muscle , which requires to be evaluated with x-ray chest with or    without MRI as per clinical concern.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tinnitus,headaches and stiffness in legs\n\nHi i am a 29 yr old female with I.H. I m hearing a whooshing sound in my ears headache on left side of face and moving towards the upper right neck pain and stiffness my muscles are weak especially my legs and arms my left side towards my back is killing me I have been put on 500mg or diamox 4x daily but having a problem urinating can u please help I don t what to do",
    "doctor_response": "hi,thank you for giving a brief history of you. kindly see that for your titinus you can do gargling with water continuous for about 60 seconds. this will help the facial and throat muscles to get some strength. along with it you can do hot water fermentation for your neck region. post that do some small neck strengthening exercises like static neck strengthening exercises. also try doing some core strengthening exercise like Pilates. Suppose in case the pain doesn't come down then you can meet up an ortho for which he might guide you for an MRI of spine which will help come closer to diagnosis. for the exercises you can meet up a physical therapist who can help you to learn proper exercises and also assess you. taking a help from an expert is always on a benefit side.with the grace of God I wish you a speedy recovery",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is my vaginal opening is too loose without any sex?\n\nHello doctor, My vaginal opening is too loose without any sex. I do not know what is the reason? Can you please tell me what is the reason?",
    "doctor_response": "Hi, Welcome to ilciniq.com. How are you? Hope you are fine. I have read your problem carefully. There is some lack of information. Your age, profession, height, previous sexual history, etc. You should remember that a loose vagina is a myth. It is a misconception. The vagina is elastic. With your age, it may lose their elasticity. So opening may lose their elasticity. Vaginal opening may be loose. If the looseness is fixed and not progressive you can wait. If loosening is progressive you should consult with a medical specialist or gynecologist-obstetrician. There is some exercise of pelvic muscle which may help such as Kegel exercise, pelvic tilt exercise. Do not be panic. Lead your normal life and observe.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be done after a dog bite?\n\nI was bitten by a dog when I was 5 or 6, now I'm 14. I was bitten in my right leg. I was bought to a traditional healer, instead of a medical doctor. The dog that bit me wasn't vaccinated before it bit me, it was alive for 3 months, and then it was sold. I am okay now, but what I'm worrying about is it wasn't washed with water and soap when I had the wound. This is my question, is it okay if it wasn't washed? will I be alright?",
    "doctor_response": "Hello,Welcome to HCM,Rabies is a 100 fatal but it is 100% preventable with proper and adequate treatment. As you were bit by a unvaccinated dog when you were 5-6 years old and know your are 14 year old.For any dog bite the wound should be thoroughly washed with soap and water for 15 mins under the running water, which will wash off the virus if any at the bite site.As you have not washed the wound when it had bit you 8 years, it is not a good practice. As 8 years has elapsed following your episode of dog bit and as you have not developed any symptoms of rabies till now nothing to worry. But it is not a good practice. 99 5 of the treatment lies in proper wound toileting.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bruise from hip to knee\n\nI fell off a scooter and got a chromosomal on my left hip. It s through the bruise stage now but yesterday d aye it s yt? Rated to look bigger. To daily there is a black wide bruise running from my hip to my knee area and I have numbness in both hands since it s happened. I m 47 @almost 48,have a husband and two small children. I ve been to a hospital yt? All twice where I was retooled I m governed x rated. I have been on abstention. 600 mg 3xs a day, methadone 3days@ day, clonazepam 1 mg 3 xxx a day and 5 mg of a blood pressured lysinoptril in the past 6 ?not h s and amitriptyline 10 mg at bed. They added torpedo for antoi inflammatory properties sin c e the f all and everything else I ve been on and off for years since a f all when 4 out a 3 story window, spinal issues, bursitis, degenerative v e disc disease, and problems in both lower and upper spine and k legs. Is the numbness something to b e concerned about? It s new and v Dr scary. :(",
    "doctor_response": "Hi Hope this message finds you in good health.I have gone through your complaints and understand your concern.You seem to have injured your thigh muscles which generally take around 3-4 weeks time to heel,if given adequate rest.The treatment you are taking is absolutely right,but i guess you are not taking sufficient rest.But still,it will eventually heal.Tingling sensations are caused by sort of hormonal,calcium or vitamin deficiency. Another possibility is neuropathy,that can be cured by pregabalin tablets.You can get an Xray and Nerve Conduction studies to find out whats wrong.Take analgesics,anti-inflammatory tablets,crepe bandage,rest.Nothing to worry about.I hope your question has been answered.If you have any follow-up queries,feel free to consult me anytime.Thanks,Take care,God bless.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of asthma ?\n\nI am 18 years old and I weigh 118 pounds. I have asthma and that's just about the only health problem I have. But I recently noticed that one of my scars. from 12 years ago, has turned black and blue ish... It's from being bitten by a dog. I don't know why it looks like this because it has never been this way before.",
    "doctor_response": "HelloThank You for contacting HCM.I would suggest to visit a dermatologist for proper evaluation & treatment as skin leision require visual confirmation for treatment or any opinion.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stage 5 renal patient, catheter removal done, have strong urge to urinate. When will I feel normal?\n\nThe sensation to pee is strong, but can't--saw a urologists today and she says ttha my bladder is empty.  She had a cathether placed and removed because there was no need to keep it in--when does the sensation ends?  I am also stage 5 renal patient expecting to stop, so no surprises, but the sensation/urge--how long til I feel normal?",
    "doctor_response": "hi as you are stage 5 CKD patient, the urine output is going to be low and will cease as the disease progresses. The sensation of urge to pass urine when you have no urine in the bladder could be due to bladder spasms. the bladder spasms could be due to cystitis or due to neurological problem with the bladder. First to rule out bladder infection (cystitis) by doing urine routine test and treat with antibiotics. If no infection contact your Doc , to prescribe some anti spasmodics for bladder spasms. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a chance of pregnancy without an ejaculation?\n\nHello, my gf and I were messing around the other day and I was beside her touching my penis to get an erection but I didn t ejaculate (it s possible I could ve precummed) and I proceeded to finger her right after that. She s on the pill and I didn t think much of it until later. Any chance she could get pregnant from this?",
    "doctor_response": "Hello dearI understand your concernChance of the pregnancy is nil because1. You have not did penetrative sexual intercourse2. Your partner is already on the pillTo become pregnant penetrative sexual intercourse in the unsafe period of the cycle is required.Fingering to vagina does not cause pregnancySo you are completely safe and no need to worry.Avoid stress, take healthy diet, drink plenty of water and do regular exercise.Hope this may help youContact HCM for further health queryBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes erectile dysfunction and delayed ejaculation and how to rectify it?\n\nam 35 year man and my wife is 30 yrs old got married just 6 months back .whenever I have sex with my wife my penis erect but it was not enough to penetrate and it took lot of time to ejaculate that too after rubbing it with my hand and also I don\u2019t feel much excited when having sex .did I have some nutrition deficiency or imbalance in my harmon level.One more think we only have sex in dark only at night and that without any light because my wife is shy of doing it in light is the problem of not penetrating due to it .Please suggest any suitable medicine or I need to see a doctor .",
    "doctor_response": "alcohol ,smoking, stress, lack of sleep,diabetes can cause erectile dysfunction.sildenafil(viagra) is commonly prescribed for this problem.kindly consult your sexologist before taking viagra.taking viagra is not indicated in some persons.heart patients,those take drugs for hypertension,those who has  eye problems are contraindicated to take viagra.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lower lumbar pain\n\nsever lower lumbar painIve had epidorals done radiofrecwenies to burn the nevers off severl times I take oxicodone 7.5 gabapeten diclofenac and tizanidine all for my back. I get something pinched  in it alot but today i was going to stand upright from leaning over and did something to the point im in extrem pain. I called 911 and before transport was given two doses of \"phentatolin\" a pain med to reduce the pain befor transport it did nothing. I was taken to the er where an x-ray was done and it showed nothin that way. while there i was given three doses of some pain med that starts with a \"D\" the Dr. said was the strongest pain med they had and it did absolutely nothing and they sent me out the door. Im still in the same condition I was in when i called 911. I need to know what could be wrong with my back,what might i have done?",
    "doctor_response": "hellowelcome to hcmyour symptoms are most probably due to development of PIVD i.e PROLAPSE INTER VERTEBRAL DISC in which a protective cushion called as intervertebral disc,bulges out from between the two vertebral bones which leads to compression of the spinal nerves and can also cause spasm of the surrounding muscles of the back region which in turn causes pain and stiffness in that region of back....to diagnose how many discs are involved you need to get a investigation called as MRI....if i were your treating doctor i would suggest the following - whenever the pain is very severe you can INJECTION THIOCOLCHICOSIDE INTRAMUSCULARLY two times a day for 3 daysthe most important modality to have long term relief from pain is STRENGTHENING YOUR BACK MUSCLES BY PHYSIOTHERAPY....any good physiotherapist can teach you the specific back/spinal exercises which you can then do at home regularly and include those exercises in your daily routine...remember,in the beginning you might feel lazy to do exercises but remember medicines can only provide short term relief and permanent relief can only be obtained by strengthening your back by exercising regularlytake care Dr Rahul Rathee",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal and urethra pain along with dark circles?\n\nSir i m suffering from abdominal pain and uretra pain,can,t carry heavy,light fever at morning and black under eyes.i check my urine but all is ok.is my kideny getting weak.",
    "doctor_response": "Hi.Thanks for your query. Read the history and understood the problems. Your symptoms of pain in abdomen, pain in urethra, unable to carry heavy loads, fever in the morning and black circles under the eyes are indicative of the following probable causes:Chronic urinary tract infection.Anemia causing dark circles under the eyes. I would advise you the following:-Get an opinion of a Nephrologist or Urologist for clinical evaluation and actual physical examination as this gives a lot of information and guides us towards which investigations are to be done.-Investigations:Urine :: culture and sensitivity, routine and microscopy; 24 hour urine proteins.Blood: Kidney functions, CBC ESR and PCVUltrasonography and intravenous Pyelography if urea and creatinine are normal. Further treatment as per the reports.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for blood clot in lung\n\nI am a 59 year old male. In 2005 I had a major blood clot enter my left lung. I have problems breathing and need to lose a lot of weight. I have been a type 2 diabetic for the past 14 years. How is the best way to lose weight. YYYY@YYYY",
    "doctor_response": "Are you talking about clot in the airways or in blood vessels of left lung. For clot in blood vessels u should consult a pulmonologist and also a cardiothoracic surgeon for need of any surgical intervention if required. Avoid severe exertion.To lose weight have high protein , low carbohydrate diet and do a regular brisk walking for atleast 30 mins 5 times a week.Have your diabetes under control with regular glucose monitoring",
    "dialogue_context": ""
  },
  {
    "patient_message": "Total sperm count 65 million/mL,30% abnormal morphology. Is this normal?\n\nhello iam 33yrs my semen analysis report below,kindly let me know wthr it is normal Appearence greyish white volume 1.3ml liquefaction time 30mins visosity viscous Reaction Alkaline Fructose Positive Total sperm count 65.0millions/ml MOTILTY ACTIVE 35% SLUGGISH 20% NON-MOTILE 45% MORPHOLOGY 30% ABNORMAL PUS CELLS 6-8/HPF",
    "doctor_response": "Hi, Your semen analysis report seems to be normal except for pus cells of 6 to 8. This should also go away on its own. If not, you may need a course of antibiotics. Drink plenty of water. Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for scar on nose after a fall in child\n\nYesterday, my 14-month granddaughter fell on her sidewalk and got a bad sidewalk burn on her nose and a small on her forehead.Her nose is swollen some.Her Mom is putting children s neosporin on it and I told her to be sure and 100% sunblock to keep from tanning.Are these correct and what would you recommend to speed healing and to prevent scarring?My son and wife are so worried about scarring.It s really burned badly on her nose.Thanks, Janet Steele",
    "doctor_response": "Hi....USUALLY THE BLOOD SUPPLY TO THE FACIAL REGION IS VERY RICH AND THE HEALING WITHOUT MUCH SCARRING CAN BE EXPECTED.But....Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take Ganaton Total and Darolac for stomach problems?\n\nHi i m suffering from stomach diseses for last 2-3 years. I have all stomach diseses. I recently saw a gastronomologist. She advised me following medicines : Ganaton Total and Darolac.I m suppose ti take these medicines for atleast 2 months. Please advise if it is safe to take these medicines.",
    "doctor_response": "Hi,Yes, the prescribed medications are well tolerated and are considered safe. Ganaton is a combination of a proton pump inhibitor with a prokinetic commonly prescribed to treat gastroesophageal reflux disease, and stomach ulcers.Darolac is a probiotic (good bacteria) useful in the treatment of acute diarrhea, bowel irregularities, indigestion, and inflammatory bowel diseases. Continue taking them as prescribed. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for bruises in leg\n\nI was in an accident two weeks ago yesterday and my legs were badly bruised by the car air bag. A few days ago one particular spot was itchy and I scratched it a bit. Now that area is redder than before and also hot to the touch. Is this cause for concern?",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.Hotness indicated there is some inflammation. It can be reduced by antibiotics, analgesic such as ibuprofen for pain relief.Sometimes it requires draining the pus by incision and drainage.You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for injury on middle of brow bone\n\nDented or broken eyebrow bone?!So I bent down quickly and forcefully to pick something up. I hit the middle of my brow bone on the corner of a booth at a restaurant. It s very tender and sore, but nothing visible like bruises or redness. It seems dented and hurts a lot. Will it heal on it s own or should I see a doctor and get an x ray? Are there any treatments? Please help, and I am a 16 year old female by the way",
    "doctor_response": "Hi..Injury to the eye brow without any ocular ( eye) abnormality or to the head is not a major concern accept for cosmetic purpose.Eye brow injury can cause fracture of the supraorbital ridge ( eye brow bone) which heals by itself. unless for a cosmetic purpose which if required should be addressed later not immediately.things to do:1)i would suggest to leave the injury alone for 4-5 weeks, if there is a fracture let it heal and later see for any visible cosmetic deformities (indent/bump)  , if present and bothering your appearance then visit a plastic surgeon with x-rays and CT scan.As of now2) take pain killer ( diclofenac 50mg twice a day if ur non asthmatic, if ur asthmatic take paracetamol 500mg twice/thrice a day)3) take serriopeptidase twice a day to reduce the swelling.4) the eye might swell up in short time due to edema and blood collection do not worry it will subside in course of time.5) watch for any head injury signs like loss of consciousness, amnesia, vomiting , seizures, blurring of vision , giddiness etc and also for loss of vision if occurs report immediately to the hospital.6) good rest, hydration and nutrition can assist in faster healing.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cellulitis on legs and thigh\n\nI was told that I have cellulitis by my doctor just a couple of days ago and I ve been prescribed Keflex but now the infection has spread from just the lower part of my leg to my knee on my other leg and my thigh. Should I go to a hospital, be tested, etc.?",
    "doctor_response": "This should be promptly evaluated, as the bacteria causing your infection may not be sensitive to the Keflex. You might need a different antibiotic. Contact your doctor and let him/her know what is going on, and get seen at emergency or urgent care. If you are having fevers, this is especially important. It is very concerning that infection has spread to your other leg. You might have resistant bacteria such as MRSA that require aggressive treatment. Cellulitis can get into the bloodstream and cause serious disease. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for painful  molar teeth\n\nMy wife's back left molar has a huge cavity and is scheduled to be removed on the 13th. She is in so much pain that she hasn't been able to eat for the last three days. she's tryed useing orajel, Vikeden, and over the counter pain killers with no relief is there anything she might be able to do to help her with this?",
    "doctor_response": "Thanks for using health Caremagic.Read your query.Yes,tooth pain can be too bothersome .Pain could be due to the tooth getting invoilved deeply in the pulp,leading to abcess formation.I would advice you to prepone the date of visiting the dentist ,so that he can put her on antibiotics like Amoxicillin along with the pain killer.This will provide relief to her .Extraction can be followed after that.Do salt water gargling.Do not apply hot bag externally.Hope this was helpful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had wisdom teeth removed, had dry sockets removed, advised to do it myself. Any home remedy ?\n\ni had my wisdom teeth removed almost 2 weeks ago, and on friday i went into the office to get my dry sockets packed. He did it in the office and told me to do it my self that night and that following evening. He gave me 4 syringes, 2 with and i quote my dentist , some brown shit , and another 2 with some clear sealant in it. now i ran out of both things and i was wondering if i can pack it with something thats over the counter or maybe a home remedy?",
    "doctor_response": "dear friend. thanks for sharing your concern. Dry socket is a painful condition post extraction I can recommend you the treatment modalities followed for dry socket but are you comfortable applying it on your own in the socket? i mean post extraction evaluation is a part of treatment,which is carried out by the same dentist. therefore i would suggest you to revisit your dentist if possible. anyways, for your dressing i can say this. you can slowly and carefully debride the socket  with warm normal saline,do this twice. After that, take a small gauze piece on which you can put iodoform paste OR zinc eugenol paste and slowly place it in the extracted socket. Place it loosely and not very tightly in the socket.as it will get hardened and difficult to remove later. Dressing is given first 24 hours,then every alternate day,then every 3 to 4 day ,then on weekly basis it is done.along with this take analgesics also for first three days if required. hope it helps. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to remove wax from ears?\n\nHi , I just came back form doctor office where my 5 year old daughter got the was remoal from her rightside ear. Despite attempts and several time using the ear wash device and 5 days of ear drop , the wax did not came out. The doctor used a something like what ladies us eto shape their eyebrow (metal tool) and that caused my daughter's ear to bleed at the time of suing the tool my daughter was feeling severe pain. The doctor said the bleeding is normal. I just wante dto make sure this has not caused damage to her ear . Thanks, Simin",
    "doctor_response": "In most cases, ear wax gradually comes out on its own and we never even notice it. At times, when earwax gets impacted, it may become hard and adherent to the skin. A forceful attempt to remove it may cause pain and even some amount of bleeding. In order to avert such things from happening, drops like ceruklear or other wax softeners are used before such procedure is attempted. By saying damage to the ear, what you actually mean is damage to the eardrum. Ear wax generally gets collected on the periphery of the ear canal and not on the eardrum, so no harm is expected in this regard. Moreover, an ENT doctor is supposed to be aware and hence you need not fear if you have gone to a doctor for wax removal.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes loss of hair from body parts other than head?\n\nSir,I am a 21 year old male.Ihave been experiencing hair loss from my legs,arms and torso for the past five months.I do not have hair loss from my head and I sometimes notice a small patch on my beard where there is no hair but after a few weeks it returns back to normal.What could this be? Your response is highly awaited.Thank You",
    "doctor_response": "Hi and welcome to HCMFrom your history you seem to be suffering from a condition called alopecia areata where hair is lost in patches usually on scalp, beard. You seem to be progressing towards alopecia totalis, which involves the body hair as well.Is is what we call autoimmune disease where your own body reacts against itself, here against the hair.It may continue to spread or grow back on its own at intervals depending on the immune reaction of your body. I would advise you to consult a dermatologist to assess the exact type of hair loss. Also you may be tested for other such conditions like thyroid disorder. Does anyone else in the family have similar complaints. Did you have any illness before the symptoms started?You can start on minoxidil solution application on the beard and head every night, along with hair supplements like keraglo men capsules. But further treatment options are required, so do consult a dermatologist who may prescribe steroids, steroid injections and other immune regulating meds.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the left hand and back of the chest?\n\ni recently did the blood test. The results are Total Colesterol is 183mg/dl, LDL 126mg/dl, HDL 33mg/dl and VKDL 25mg/dl and Triglycerides 122mg/dl. Doctor told that all normal and no medication. But I feel very often pain in the left hand and back as also chest. Could you please advise what should be my next step. Do i need to take medicines. Thanks.",
    "doctor_response": "Hello, As a first line management you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I having abdominal burning, throat pain, and diarrhea after alcohol drinking?\n\nHello doctor,I saw a doctor for abdominal burning and pain in the throat after one night of drinking alcohol. She said I had gastritis but I did not say I had diarrhea as well. What shall I do? Currently, I am taking Lansoprazole.",
    "doctor_response": "Hi. The current medicine will help in improving diarrhea as well, if associated with gastritis. Take the medicine for at least a week. Try to be on a bland soft diet for the next few days. For more information consult a medical gastroenterologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which treatment can be given for swelling in ankles and feet?\n\nMy daughter age 6 has hives as diagnosed by the nurse this morning at my surgery but has come home from school today unable to walk with completely swollen ankles and feet. We are givin her piriton and calpol but is there anything else we should be doing as this seems quite severe.",
    "doctor_response": "Also, you she should put her foot on cold bath and applying compressing band on foot and ankle with rest at first. Lab investigations such as serum uric acid must be done to exclude gout arthritis. Applying topical and oral syrp non steroidal antiinflammatory drugs for 2weeks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in the chest with mucus and blood from nose\n\nhi one day i was walking and my heart started to speed up with every moment i made on  the right side of my body around my middle lope i feel like a dent between my rib cage and i also feel like a lump right in the middle of my chest im having shortness of breath and when i blow my nose out comes mucus and blood and very dark bugors what can this be plus from time to time i feel a sharpness of pain shoots from the spot of my middle lope to my brain what symtoms are these lung cancer probably ive been to the hospital got a x-ray but they said theres nothing wrong",
    "doctor_response": "Blood from chest raises suspicion. You need to get a Chest CT done and get properly investigated for the source of blood. Consult a specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic endplate irregularities, spinal fracture and severe back pain\n\nI have been diagnosed with chronic endplate irregularities, acute spinal fracture, multilevel degenerative disc disease, L5-S1 paracentral protrusion coupled with extreme back pain standing more than 5 minutes, right calf pain and random incontinence.",
    "doctor_response": "Hello, As you have this disc protrusion the symptoms of the radiating pain are expected to trouble. Using a hot water fermentation and lumbar spinal brace will.be good to reduce pain and stabilizing the joints. Post which once the fracture is healed then Physiotherapy management follows like the therapeutic ultrasound therapy and TENS therapy for pain relief and reduction in Inflammation as well. Exercise will be followed in the later stages and it will focus on core stability, back strengthening and lower limb as a whole for the flexors and extensor groups. Most cases do well with physiotherapy but need to continue longer to learn and then at home based exercise prescription is followed. In my clinical practice of over 12 years, most cases respond well with conservative management. In a few cases where it is displaced fracture and compromising neurological functions then surgery is advised. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will drinking alcohol affect the Plavix?\n\nMy husband is going in for an angioplasty with possible stent placement. I know he will have to be on a blood thinner for at least a year or longer. He has at least two stiff alcoholic drinks every night, how will this affect the Plavix or aspirin?",
    "doctor_response": "Hello,I will suggest you make your husband realize that aspirin taken with alcohol leads to more chances of bleeding from gastrointestinal tract. Less than 65 years should have less than 2 drinks per day if they are taking aspirin alone. But as he will require aspirin and plavix both in beginning  he should definitely stop alcohol intake for at least an year during which these 2 drugs are taken as a must post procedure.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammad Faisal Bacha, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for  chest infection and mild asthma\n\nMy 16 year old daugher was diagnosed with pulmonary hypertension 3 months ago after a really bad chest infection that was eventually diagnosed as pneumonia.  They also found her sinuses were all inflamed and put her on a nose inhaler and tablets that are taking for mild asthma.  She was also put on seretide to inhale and open up her lungs as the doctor said her lungs were not processing enough oxygen leading to the right side of her heart swelling.  She has a new symptom now which is nose bleeds.  After some activity she will nosebleed.  Before the nosebleed happens she says she is dizzy and next thing that happens is the nose bleeds.  She also has fainting episodes.  Please help me understand what is happening.  Thank you.",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query for  your  daughter in details  .*  The nose bleed seems in relation with side effect  of  steroid  possibly ,    which has to be discussed with your doctor .*  Treatment  part  consists  of  antibiotics  of  proper  group , molecules    for  keeping  bronchi open  along with  life  style  modifications  as    -  Maintaining hydration with plenty of liquids .    -  Balanced  nutritious  diet .    -  Walking in fresh air , deep breathing  exercises , YOGA are  corner       stone  of  the  recovery .    -  Avoid  exposure  to  environment  with dust , pollens  ;  if  necessary       use  triple  layer  face  mask .Hope this  will help  to clear your doubt   .Wishing  her  fine  recovery .Always welcome for any further assistance anytime .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat fluid cysts on the mid finger and knuckles?\n\nI have a cyst on my middle finger right above the top knuckle and also 2 fluid sacks below the knuckle. A Dr. pricked a hole in with a needle and pushed the fluid out but it was back the next day. I am trying to determine if a HAND SURGEON is who I need to see rather than just a Orthopedic surgeon",
    "doctor_response": "dear sir/ madamthose cystic swellings are because of the overuse and probably arising from tendon sheath /synovial sheath.if those cystic swellings are not causing any pain or discomfort it can be left alone,complete cyst excision is to be done for them.but even after complete cyst excision there is always possibility of recurrence because primary problem is overuse,so considering all these treatment is to be planned,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Unprotected sex, vomiting, nausea feeling, headache, test negative, got late period, pregnant?\n\nMy periods are always quite regular , last month got the periods three days earlier that is on 4th Feb ,and later on march first had unprotected sex...took a pregnancy tests has periods were delayed , once or twice vomited , also had nausea feeling , headaches ,tests twice were negative but 20th march got my periods ..still feel the same ....is there are any chances i am pregnant ..or is it any other health issue..since i have never had periods delay so long ....",
    "doctor_response": "Hello,Here, you need to undergo one blood test for beta-hcg to rule out product of conception or miscarriage. TVS scan gives some additional information.Other reasons of irregular period are stress/ anxiety, hormonal imbalance, pelvic infection, over wt, irregular diet pattern, uterine pathology etc.Consult with your gynecologist for proper examination & relevant investigations. Take suggestive measures accordingly.Practice safe sex in future. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "After c sec delivery I am having back pain constantly\n\nhello Dr. I m 25 . I had a c sec delivery. after that I am having back pain . its feeing like current is going towards my legs. I went for some treatment like hot patch,current treatment. I am doing some back exersice sometimes. but its is not going. what would work ?",
    "doctor_response": "hi; From what you say it looks to e a nerve pain .If you are not on any medicine right now you can take a painkiller twice a day along with tab-Neurokind  once at night for 10 days & see. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurrent chest infections and fatigue?\n\nI keep getting chest infections and fatigue, I had other related systoms such as neusea, dizzyness and a neck rash. I've had various different antibiotics which help but it keeps coming back. I also recently found a lump in my testical which i had checked, the ultrasound didn't find the lump. I.E as if it didn't exsist, but both me and urologist can feel it. I seemto feeling really i'll again with nausea, dizzyness, fatigue, stomach pain  and a cough. I'm just worried there related and i don't seem to be getting better. First i'll signs Oct 2010 Really i'll - could walk around house early Dec 2010. Cancer check Jan/feb 2010 Second urology appointment due 24th Feb 2010 regards",
    "doctor_response": "Hello dear , hiWelcome to Healthcaremagic.comI have evaluated your query thoroughly .*  There are different  reasons  possible  as    -  bronchitis  from  various  issues  -  underlying  systemic  medical  or       autoimmune  disorder  -  decreased  lung  immunity  -  low   hemoglobin  or  vitamins levels  -  others . *  Needs  detailed  evaluations  with  basic  lab  tests , x-ray  chest , CT    scan  chest  for  further  diagnosis  and  management  guidelines .Hope this clears your query .Wishing you fine  recovery .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lumps in nipple\n\nI am a 27 year old male. I noticed two days ago that I had a slightly painful lump about half the size of a penny to the right of my right nipple. This morning I wake up and squeezed it and some dark green/ yellow liquid came out of the areola. Is this something that will go away on its own? When should I see a physician?",
    "doctor_response": "Hello! Welcome to HCM.Painful lump with discharge indicates presence of infection.You haven't mentioned about fever.This usually needs to be treated with antibiotics & drainage of pus if any.This won't resolve on its own.FNAC - fine needle aspiration cytology is advisable for diagnosis.Hope this helps.Wish you speedy recovery.Thanks.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the petchiae rash on my ankles?\n\nI have a like a petchiae rash on my ankles and starting to go up my legs now for almost a month. At first thought it was from the antibotics I was on but that has been a month ago. My left leg keeps swelling and I have were my feet get really cold or vice versus my hand get cold. What could this be and should I be seen immediately?",
    "doctor_response": "drug induced petechie rash will disappear with the discontinuation of drug. with rash there is edema too only on left leg, then get the venous doppler of the leg done with blood investigations including platelet count, retic count, LDH and ANA to rule out vasculitis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rash and spots inside the cheeks, pain. Any suggestion?\n\nhi,i have small spot inside my cheek that have to turn purplish colour and i have a rash on my back side of that spots. And i have some white and some red colour spots inside my mouth and cheek side. some times it is paining and some times not. mostly when i am eating spicy items i have pain in that area. could u plz suggest what is the problem and what is the solution for that?",
    "doctor_response": "Hello,Thanks for sharing your problem with us.As per your description it seems that you have ulcers in your mouth.There are many conditions which causes the ulcers in mouth.It depends upon Age,Sex,occupation,viral infection etc...Information provided by you is insufficient,so here I am giving common tips to get the relief:1) Avoid spicy food2) take food which is rich in vitamin B. Like meat or you can take capsules of vitamin B12 under the prescription of your physician.3) Avoid stress,overnight working5) regularity in food intake and avoid constipation.6) you can have coconut milk or wet coconut7) To get relief from pain you can apply topical anesthetic like Lidoocain gel to ulcers,your dentist would prescribe for you.In case you are not getting relief please send us your details about age,sex,occupation,medical history;so that I would help you to avoid the condition.Hope you are satisfied,please give us feedback.Take care.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have 10 spots on penis for a long duration with no harm. Is it STD?\n\nHello doctor, I am 24 years old. I have always been very anxious about health, especially my sexual health. But when I was about 9 or 10 a spot came up on my penis where the glans and shaft meet. It was flesh colored, painless, and round. There was no dimple in it. I was never sexually abused or sexually active at this age. I did not even masturbate the first time until I was 12 or 13. My mom took me to the doctor and they said like just come back if it gets bigger. She had likened it to a wart, but it was not very hard or dry. Anyway, it stayed for a couple of years after that it shrinks down. It no longer appears as if it is above the skin but appears as a small pin-sized bump underneath a skin bridge. I am curious if it cannot be an STD and I have never found anything similar online. So what could it be? I would not think a wart would stick around that long. And it really does not look like that at all. That was there over 12 years so I would not think it is anything fatal. To be even more specific, it is on the top side to the right. As I said, it looks like a skin bridge with a little bump underneath. But it really has no sort of texture. And the only problem it really causes is some skin rubbing when that extra skin rubs my underwear.",
    "doctor_response": "Hello. This was likely a wart only. Warts can have very varied morphology and most plausible explanation is for wart only. Because, considering it was a single lesion, was not painful or itchy, flesh colored and it persisted for a long time and resolved on its own. So all these factors favor it. Morphology can be variable. The negative factor was not sexually active. Although most common causes are sexual contacts, but significant number of individuals may have it with non-sexual contacts as well, it can be transmitted vertically during childbirth and remain dormant for a long time activating later in life. It can be transmitted with usual contacts and can be transmitted through clothing like underwear (if came in direct or indirect contact with infected individual clothing), sharing toilets, etc., can also transmit it. So being not sexually active is not a strong factor against it. Rest all causes like skin tags which would persist without treatment or fall off suddenly, PPP (pearly penile papules) would be numerous papules, other infectious causes would be short-lived and multiple lesions and symptomatic like painful tender or red. Malignancies are unlikely at this age and would progress. So the probability is high for wart only. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child with itchy rashes. Taking antihistamines. Cure?\n\nI get randon small itchy rashes and they just come and go at anytime. I have been to a doctor and have had allergy test. I am not allergic to anything and I have been instructed to take antihistamine. I take 180 mg 4 to 6 times a day and I am certain this is not good. Lately the rashes are still apearing even after the antihistamine. The itch is so bad that I end up scratching till I bleed . Please help!",
    "doctor_response": "Greetings thanks for the question on healthcare magic the small itchy rashes appearing on the skin is due the changes happening in the internal body organs. In homeopathy we do refer it as external manifestation of the symptoms due to psychological problems,internal organs not working to competent levels  .I would suggest you to have entire body check up of the liver function test and would also recommend you to give entire history to a good homeopath. As just with one symptoms giving medications or suggesting the line treatment would be difficult so please do show to a good homeopath and would be able to cure you completely its just a our reciprocal of any body organs might not be reciprocating to the optimum level to capture that a  good case history with a homeopath and would suggest you the remedial action for the same thank you you can also give me your complete history on dratulpawar@hotmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure lack of concentration?\n\nhi i come from nepal from a middle class family and i am 19 years old.i am currently studyigengineering but i am hated ny all. my educaion grades haven't been sogod and i have been lazy sinde i know avoiding snhool and staying on tv as much as i know..i was also yoted miss silent and miss latecomer and people say i am characterless and purpose less i finish reading 2 paragraph per day and i am yery naive my parents planed me in the best schoolnut i did turn out being nothing i have flunked all subjest this sem but i do nothing else study help??",
    "doctor_response": "HIThanks for using healthcare magicAll these symptoms could be part of depression. Better to consult a psychiatrist and get yourself properly evaluated. I think, you need antidepressant and that would help you to come out of this phase. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does fever reducer takes to reduce fever in a child?\n\nI have 2 year daughter who has been with a fever 100 for two days, I took her to her doctor, he told she had throat infection; well the doctor said she does have a throat infection and prescribed antibiotic and fever reducer.My question is from last two days her fever seems not reduced with the fever reducer. (Still her fever is 99.5 to 100)She is just so hot to the touch. How many days will take for better result?",
    "doctor_response": "Hi,It depends on the organism causing the infection. She has been prescribed an antibiotic and in case she is suffering from a bacterial infection, it should reduce in 3-4 days. However, in case she is suffering from a viral infection, the antibiotic will have no effect on it and fever will itself decrease in 6-7 days. I'd suggest you to do tepid sponging whenever her temperature starts to increase. Take a cloth , completely soak it in water and apply the wet cloth to her whole body. This will be very effective in reducing the temperature for the time being.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and soreness in the testis?\n\nJust Yesterday being 8/11/2011, I took a stroll after which i discover a bit pain @ my Testis. I tried all possible best to resist such pains after taking pain relief tabs and some antibiotic but the pain is quite unbearable and getting even worse even as the Testis increase in his swollen. Pls help me doctor.",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query.  I understand your concerns and I will try to help you as much as I can.All these symptoms are suggestive of epididimitis which is inflammation of part of testicle and this not uncommon in males especially in young age. This is usually treated with 10 days of antibiotics, usually ciprofloxacin and there are no permanent consequances. MAsturbation and intercourse should be avoided till pain persist, if possible since I may prolong inflammation course. Some more serious conditions such as tumors or torsion are rare but in doubtful cases you should do Doppler ultrasound or scintigraphy. In this particular case, I don\u2019t think this is required,unless redness, increased pain and syncope with nausea and vomit occurs. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of dark circles on my face?\n\nHello sir,!! i have a problem with my skin ago ....... i have black circle on my face like (.cheeks) . i use melalite-xl cream for his but this not showing any effecting now .. please help me with this............. and how many times use this , one time in a day or night .how will i use the medicine.",
    "doctor_response": "Hello and welcome to healthcaremagicI have gone through your concern and i have understood it.Dark circles can be quite difficult to treat. Melalite -XL cream should never be used for dark circles because it is not meant for dark circles and moreover it can cause irritation and further thinning of the already thin skin around the eye.Hereditary seems to play a significant role. In allergy prone individuals, a condition or state of 'atopy' exists & these atopic individuals more often than not manifest with 'dark circles' under the eyes.It also depends a lot on your lifestyle pattern- diet, sleep, computer / TV use and stress. Stressors/ Strain due to working for long hours on computers & lack of sleep play a major role too.Dark circles due to thin under eye skin, the thin skin makes the blood vessels under the skin very prominent and hence this appears dark. You could benefit from using a cream containing Vitamin K and Retinol( EGA cream). Use it once a day for at least 3 months to notice a difference.Another important cause of undereye dark circles is Iron deficiency Anemia.As can be judged from some of the reasons cited, good hydration, regular 6-8 hours of sleep, addressing stressors and a multivitamin and Iron supplement  by themselves will go a long way in correcting this issue.Skin lightening cream containing glycolic acid, kojic acid, Vit C can be helpful in reducing the appearance of dark circles. Glycolic acid and Arginine peels are the two commonly used peels by dermatologists for undereye dark circles. You can try a few peeling sessions (6-8 sessions).regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can I make the wound due to omphalectomy heal faster?\n\nHi doctor, I have undergone omphalectomy six months back as I was having endometriosis. The stitch was removed four days later. But I have a raw wound which according to the doctor will heal gradually. I am cleaning the wound using Savlon and dressing the wound and applying T-Bact ointment. But the wound is still there though better than before. Can you kindly suggest if there is any other way to heal up the wound faster?",
    "doctor_response": "Hello. As you said the wound is there since last 20 days, it has reached a chronic stage. If it is healing it is well and good, but most of the wound at this stage will either: Savlon, we do not prefer as a cleansing agent, as it irritates the granulation more. Better use plain saline. If there is a biofilm layer, then silver based cream are preferred over the T-Bact ointment (Mupirocin). If healthy granulation tissue, then ask your doctor about grafting the wound. In any case, if possible you can send me a snap of the wound to understand it better and guide you, regarding which treatment will benefit the wound more. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any possibility of pregnancy after vasectomy?\n\nI am having some pregnancy symptoms now for a week and my period is not due for another 9 to 12 days; I've had 3 other pregnancies with similar symptoms but the question here is that my husband had a vasectomy 5 years ago and that is the last thing on my mind; so I am not sure if it possible to get pregnant??",
    "doctor_response": "Hello and welcome,It is sometimes possible for recanalization to occur after vasectomy and pregnancy may be possible. But it occurs during the initial months after vasectomy and rarely occurs so late. Also you are still in the ovulation phase, so pregnancy takes at least 5-6 weeks to give rise to symptoms.The best way to know this is to get a semen analysis done for presence of sperms. If they are present then it indicates a failure. So most likely these symptoms are due to gastric trouble and stomach upset. Try eating yogurt and clear soups and take B complex vitamins. If the symptoms do not improve with this, you may need to see a doctor. Hope this satisfies your query. Thanks for using HCM.\u00a0\u00a0\u00a0\u00a0\u00a0Feel free to ask any more questions that you may have. Dr Madhuri BagdeConsultant Obstetrician and Gynecologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I experiencing pain in the right side of my lower stomach ?\n\nmy lower stomach hurt in the right side and i dont know why can you explain please?",
    "doctor_response": "HI ! If you are thinking of UTI,check for its signs and go for urine test: The urge to urinate frequently, which may recur immediately after the bladder is emptied. A painful burning sensation when urinating. Discomfort or pressure in the lower abdomen. The abdomen can feel bloated. Pain in the pelvic area or back. Occasionally, fever develops. OR it could be due to other reasons also like appendicitis OR Infection in the Kidney (Pyelonephritis). So,consult your Doctor for the diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain?\n\nI am 17 and in good health I eat healthy although I practically only drink Mountain Dew and have for the past four to five years. I ve noticed however that occasionally my chest hurts around my heart and I describe it as my heart feels like it s pumping grease or just that my blood feels really thick. I think the two may be related but wanted another opinion",
    "doctor_response": "Hello! Thank you for asking on HCM!I understand your concern and would like to explain that your complains seems to be mostly related to increased stress and anxiety, as it looks like a kind of palpitations, and nonspecific chest discomfort. There are several factors, why you experience such feelings, and the heart reacts that way. Smoking, several stimulants like excessive alcoholic drinks, caffeinated drinks, general anxiety, etc may be accused many times to be the cause of those complains.My advice is to perform a general routine check up to your GP, wit ha careful physical exam, and some additional lab tests, to rule out any possible body system disorders, and avoid all the above mentioned triggering factors, including Mountain Drew (it has a caffeinated version as well).Hope to have been helpful to you. Greetings! Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cough and interrupted respiration\n\nMy daughter is seven months old. She is not having cold, but cough a little. Her repiration is sometimes interrupted as if she has something to swallow, and cannot lie on her back even while sleeping. It seems that she cannot swallow her saliva. Pleae help",
    "doctor_response": "Brief answer :Nasal block or wheezing episodes Detailed answer :Hi, welcome to HCM. Your child is having only mild cough but has intermittent respiration, this could be due to nasal block or a wheezing episode. In nasal block, sometimes the respiration becomes intermittent as child tries to clear the nose. In wheezing episodes there is difficulty in breathing which causes intermittent breathing. In my opinion, you should start saline nasal drops 1 drop in each nostril three times a day and get the chest examined by a Pediatrician. I hope this will help you. Take care. Regards - Dr Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hard and long nipples after gynecomastia surgery\n\nI am 36yrs old and had Gynecomastia surgery over 12 years ago. This really worked in changing the shape and look of my chest (male breast). But the actual nipples are still very long and typically hard. I don't like to take my shirt off, even though I work out regularly. I refrain from wearing just a t-shirt, especially a white shirt without a tight fitting tank top. I have to wear dark shirts to hide my nipples from sticking out like a sore thumb when dressing. If insurance won't cover nipple reduction surgery, it seems as if I could just cut the nipple part off....I know this is drastic but if done in a clean environment with sterile equipment, couldn't I save myself the money for a plastic surgeon.",
    "doctor_response": "Hello,No, its not wise to remove a part of it at home as it may get complicated with excessive bleeding and post removal infection. Its always wise to let doctors handle such circumstances themselves since performing surgery demands skill and perfection as well.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Sameen Bin Naeem, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for advanced squamous cell carcinoma\n\nDiagnosis: Loco regionally advanced squamous cell carcinoma of lower alveolus Treatment undergone 1. Composite resection (including mandibulectomy, plate insertion ) with PMMC flap reconstruction in september 2008 2. Concurrent adjuvant Chemo radiation from 13/10/2008 to 21/11/08, 36 radiation, sixplaton chemo 3. Removal of the inserted plate surgery- 11/07/09 4. Regular follow up 5. Last biopsy is positive(24/04/2010) further surgery not advised by the doctor next options? and chance of success",
    "doctor_response": "Hello dear. You  can undergo another round of radiation and chemotherapy. After that only option left is chemotherapy. Hope you u understand.regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to heal from surgery ?\n\ni am a 25 year old guy.i was recently circumcissed n almost two weeks n more are over after the operation i feel a burning sensation on ma glans because of which i cannot wear ma ususl clothing.its paining a lot.does it have any remedy.i m a working guy.n really in troble as i cant go to office..i dont pain whre stiched but on the exposed glans a burning sensation prevailing..",
    "doctor_response": "Hello, Circumcision surgery is a minor one and a wound created by this minor surgery takes around a week to cure. But it depends on the surgical procedure. Therefore I suggest you to talk to your surgeon. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Sameen Bin Naeem, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could missed heart beats be caused by Prolomet x125?\n\nI am taking prolomet xl25 since past 4 months. This has been prescribed by cardiologist for HT. I face missing beats especially when (a) I have had a very tiring day and (b) I move from one position lying down to up right position and (c) When I am stressed. It is not a regular occurance but sometimes. Please let me know how serious is this and is it the sideeffect of the drug.Thanks.",
    "doctor_response": "Hello, To me, you should monitor your blood pressure (bp), record the results for reference. The missing heartbeats are indicating that your heart is not working properly. You need to get it monitored through Holter monitoring. Blood electrolytes should also get checked, and treated adequately. Discuss this further with your cardiologist. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Albana Sejdini, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can stress and restlessness delay periods?\n\nHello doctor, I had PCOD and took homeopathy medicine, after which my periods started getting regular. I got engaged about two months back and I got married last month. I took pills during my engagement and marriage time\u00a0to advance my periods. I got my period on 14th each month after taking the pills. This month, I did not use any pill but had unprotected sex twice after the 21st day. I have slight cramps, but no sign of periods. Should I be worried about getting pregnant or is it stress and restlessness that is delaying them? I am very tensed. Please answer.",
    "doctor_response": "Hi. Revert back with the reports to an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the pain in my lower back?\n\nI am having pain in my lower left side of my back.  It comes and goes over and over, kinda like contractions.  It will last a few hours to a day or so.  I can take pain meds and it helps.  It will go away for a few days then come back again. Can this be a kidney stone?",
    "doctor_response": "First get ultrasound to check if any stone is present. If report is not showing any stone than  it can be muscle strain. I would suggest you to start Muscle relaxant like Myoril or Myospaz. Also you should take warm water shower. You should also learn back muscle strengthening exercises from physiotherapist . It will give power to your muscles so you would not have such pain in future. till than you avoid pizza delivary by bike.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Am i taking the proper treatment for infertility problem with thyroid ?\n\nHi, m Neha, 28yrs, 5.1 , 62 kgs, n my query is about my pregnancy . M married now for 2yrs, n m trying to conceive for last 1 yr, after my follicle report my doctor said its POD form of ovary , so she suggested me to take Letroz 2.5mg* 2 (3rd-9th day of period, daily), n then for the follicle test, after this my report was normal, after rupturation i took Duphouston 10mg, but then also i coundt conceive,(this was repeated for 5 cycles), then my husband had the test( sperm analysis) n v found tat it was not normal, so doc suggested for Maxoza 5gms*2 times daily, n he continued it for 3 months, it worked in between but now the results r not at all good. Now the doc has changed the medicine to Siphene 25mg*1 daily for 3 weeks n take 1 week gap n again repeat the same. So is it safe to take it? N if yes is there any side effects of it? For how many days should it be consumed? Now m taking Ovanac 600mg*3times (daily) n B-long f*1daily, m also thyroid patient for last 2 1/2yrs,now my thyroid is 11, taking Thyrox 100mg, for 1 month, otherwise 25mg daily. Is our procedure going correct?",
    "doctor_response": "hi Neha, welcome to HCM. read your prob, you have been suffering from PCOD n hypothyroidism, both diease inhibit ovulation , n most common cause of primary infertility,  so you can continue the advised treatment , it has no major side effect, but there is drug interaction between that drugs which you taken so you should adjust dose as per advise your doc.  as you mention your hubby s report is not normal so get his testosteron leval n start proper treatment. Dr aseem 9982583020 aseemadhuri@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the solution for tight frenulum in the penis?\n\nHi I have a tight frenulum where the head of me penis bends backwards when I pull skin down shaft. I was thinking of tying off frenulum but not sure how close to shaft I should pierce triangle as it has minor veins incorporated within it, should these veins be in the knot?",
    "doctor_response": "HelloThanks for query.Your penis bends backward on erection and when you atetempt to retract foreskin over glans penis .This is due to a band of adhesion between glans and frenulum .You need to excise this band (Frenuloplasty)by a qualified general surgeon .Do not attempt to cut it your self as there is risk of profuse bleeding .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever and brown vaginal discharge during pregnancy?\n\nHi, I think I am 5 weeks. I have been running a low grade fever for 5 days and everytime I urinate, there is light brown discharge with like very small grey and brown flakes of tissue in it. I called my doc but he said it would be too early to see anything now and to just go to the ER if I started bleeding bright red and cramping. Is this normal?",
    "doctor_response": "HI,    I can understand your concern.   * In 5 weeks pregnancy it's possible to conform by urine pregnancy test/ USG abdomen.    Some times bleeding is possible with fever i early pregnancy -this is due to hormonal deficiency caused by stress   *To avoid probable pregnancy loss-   Get you pregnancy confirmed/ excluded with help of investigations & a gynecologist's consultation. If pregnancy is +ve, you would need hormonal supplement (for the bleeding you have)along with fever medicines..     Take bed rest/ light nutritious diet.      Visit ER if there is bleeding in spite of the care taken.   Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cracking and popping upper spine while breathing?\n\nHI. For the past three months my upper spine cracks and pops when I breathe deep, move my back slightly, or straighten my back. It s only slightly painful because it feels like a sharp pain is jabbing between my right shoulder blade and my spine. Tonight I noticed that that area was numb but it eventually subsided. Do you have any idea what this could be?",
    "doctor_response": "hi,thank-you for providing the brief history of you.A thorough neuromuscular assessment is advised.As by your history I understand the pain is bothering alot. Since the symptoms are pain, numbness, etc. After a thorough neuromuscular assessment you may need an MRI of the cervical spine.Based on the finding the treatment will be guided with simple medication and physical therapy.As the area is the neck and upper back with shoulder blade having sharp shooting pain, a physical therapist can help you with therapeutic ultrasound therapy and TENS therapy for pain management.Also , on later stages you need to strengthen this area by exercises which the therapist will teach you and you can perfrom them later at home.Usually patients recover in 2-3 weeks of time as per my clinical experience.regardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. No medicines seem to work for my anxiety. Can you suggest any solution?\n\nHello doctor, I am 24 years old.I have anxiety and I am taking medications for that - Effexor XR two times a day Olanzapine 5 mg one at night. It has been now four years that I am struggling with this illness and now none of the medicine work for me. Please advice me what should I do.",
    "doctor_response": "Hello. If you are suffering from anxiety disorder only, why do you need to take Olanzapine? Olanzapine is an antipsychotic and it has no role in anxiety. Effexor (Venlafaxine) is a good medication. You can try a simple and good medication with a low side effect like tablet Sertraline or tablet Escitalopram. Olanzapine causes weight gain - hypercholesterolemia and diabetes (metabolic syndrome) after two or three years of use. Effexor is also known for its cardiovascular side effect like hypertension. I would advise you to switch over to other medications if you have only anxiety problem and no other medications have been used in the past. Do daily exercise. Take good care of health. Avoid junk food. Have a good quality of proper sleep. Learn to do relaxation. Thank you. For more information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is masturbation good for health?\n\nHi Dr. My name is Kishor and I m 24 year old, I m doing masturbation from last 6 to 7 years daily.I want to know that masturbation is good for the health..??It will effect my further life.....??I m doing masturbation from last 6 to 7 years daily.",
    "doctor_response": "HelloThanks for query .It is natural and normal for a man to get indulged in masturbation at the age of adolescence .It is the safest way to get sexual satisfaction without a female partner .There is myth in a mind of common man that excessive masturbation is the reason many  problems But I would like to state that it has been discussed in scientific forums all over the world and proved scientifically that masturbation does not have any negative effect on any organ or system in the body .However excessive and frequent masturbation may lead to sexual problems like Erectile Dysfunction or Premature ejaculation in future.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it fine to give Meftal-P for fever in 10 months old baby?\n\nHi doctor, My 10 months old son got a fever since last night. It has been 24 hours and his fever is between 100 and 102 degrees Fahrenheit. He has no other symptom till now. We are giving him Paracetamol drops. What can we do for him? The doctor suggested Meftal-P. Is it fine to give for 10 months old baby?",
    "doctor_response": "Hi. Paracetamol drops are fine. Meftal-P (Mefenamic acid) is a group of drug NSAID which is not first class drug given to babies under 1-year-old. First priority is Paracetamol or Acetaminophen. The reason is NSAID causes closure of the vessel in hearing in the fetal phase. So until the baby grows up, NSAID is not preferred. As fever is high grade, sponge him with a wet towel. This would decrease temperature and then blood circulation will be normal and Paracetamol will reach tissues and work. Watch for other signs like a cough, flu, crying (abdominal pain), and diarrhea. Follow up after three days. Adequate fluid and breastfeed if given. 1.Viral. 2.Bacterial. 1.Complete blood count. 1.Acute gastroenteritis. 2.Respiratory tract infection. 1.Viral fever. 1.Paracetamol drops. 2.Adequate fluid, and food. 3.Wet sponging. 1.Avoid unhygienic measures. 2.No outside food. For more information consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I become a father as per my semen analysis report?\n\nFirst Name: sanjay Last Name: kumar I am a: Patient, Family member or Friend Email Address:  YYYY@YYYY Subject: sperm analysis Comments: result of my semen analysis. SANJAY KUMAR 28 YEARS MALE 30JUN2011. SEMEN ANALYSIS Time of collection :2.05 pm Time of examination :2.35pm PHYSICAL EXAMINATION Volume :1 ml Colour :Grey opalescene Appearence :Clear Consistency :Hypo Viscous pH :7.5 FRUCTOSE Present MICROSCOPIC EXAMINATION Microscopic examination reveals morphologically normal spermatoza along with pus cells (1-2/hpf) and epithelial cells. Forms with excessively long tails are also noted. Sperm Count :8 Million/ml of fluid motality 05% shows rapid linear progressive motility. 15% shows sluggish linear progressive motility. 20% shows non-progressive motility. 60% are non-motile. SIR, what is my report? could i made a father? plz send me details.",
    "doctor_response": "Hi thanks for writing to health care magic.I have gone through your report.Your semen analysis shows less than normal sperm count 8 million is below normal, 20 million atleast. Decreased motility.You should investigate for this. Ultrasound of scrotum to rule out varicocele.Varicocele is commonest cause for male infertility.But u can become father with this report also.There are so many techniques in this era. Like semen wash out and many more.Consult a urologist and he will advise you further.Have a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment should I take to control acne ?\n\nIve had a problem with acne and now it has gotten to my chest area i am a female and it is uneasy to keep that are hidden, what can i possibly do?",
    "doctor_response": "Hi..user  welcome to HCM ..........as per your complaint of the lesion ,which is on chest area .., it could be  either Acne or  steroid cream........(steriod acne)..hence U do one thing ...1) Removal of lesions by using RF cautery ..or  2)  topically use 5% Benzol peroxide (persol 5.% ) 3) orally take ..tab Doxicycline 100 mg daily after lunch for 10 days...4) Frequent washing of Triclosan zinc oxide soap   o.k bye...best of luck..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for indentation with pain on leg after an injury\n\nMy 17 yr old daughter was hit on the left leg as she was between a car an a golf cart. The golf cart was moving and hit her. She now has about a 5 inch indention with pain on the side of her thigh. She can walk but it does hurt. Just wondering if there is any need to take he to the doc or will it heal itself in time",
    "doctor_response": "Hello, This will be just a muscle injury and will heal on its own. For now, stabilize the thigh in the thigh brace. Do hot water fermentation. Simple exercises for the thigh like static quadriceps and static hamstring. She should do well. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for pain around the area of the PICC line site?\n\nI had a PICC line put in2days later it was found that there was a clot along the vein. I was put on fragmin And then told could not take out line for fear of moving clot into lungs. I have pain around the area of the PICC line site. It feels like an elastic band around my arm. What is this ? is it normal?",
    "doctor_response": "The pain around the area of the PICC line could be due to 1. Infection 2. The Normal pain due to the procedure 3. ThrombosisIf there is redness and tenderness near the site of insertion then its better to check up with your surgeon/ radiologist and start on antibiotics and anti-inflammatory drugs.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it unsafe to have unprotected sex or pregnancy after a C-section?\n\nHI, we had unprotected sex on the 11th day after my Cesarian . 5minutes after that i bled a little . Is this symptom risky . And will I fall pregnant again . And is there any risk factor to be worried about because i had sex too early after my cesarian.",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the intercourse after the caesarian might not cause any problem.There is no chance for pregnancy to occur for 3 months after delivery if you are breast feeding adequately.The bleeding might be normal.Nothing to worry.If the bleeding becomes heavier then consult doctor.If you are not breast feeding then there is protection upto 3 weeks.So don't worry about pregnancy.There is no chance for pregnancy this early.Avoid physical strain till 3 months after surgery.Best regards...Dr Srilatha",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is blood pressure of 168/93 normal?\n\nis my blood pressure high, my reading is 168/93I am 68 years old, my weight is 12 st 8pound.I am 5feet 3 inches tall. Have underactive thyroid.Take the following medication:Amolpodine 5mg,Bendroflumethiazide 2.5 mg,Ramipril 2.5mg,Levothroxine125mg.",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice.This BP for your age is high. We keep a target bp of 150/90mm Hg for age more than 60 years. You can continue taking  Amlodipine and should increase Ramipril dosage. Follow a lot salt diet and do regular exercise.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sameer Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lumps in the nipples and how can they be treated ? Could it indicate cancer ?\n\nI m a 13 year old boy and I ve had a hard lump that hurts when I squeeze it in both my nipples for a few months. it s been getting larger since when I got them and I m scared it s breast cancer . what is this?",
    "doctor_response": "Hi, Thanks for query, It seems that you might have Gynacomastia. Due to hormonal changes if female hormone is predominant this can occur. Consult endocrinologist and get evaluated, Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the possibility of getting throat cancer from smoking?\n\nhi , i am 17 years old and i was wondering what's the possibility a teenager like me can get throat cancer . i  have smoked only like about 7 ciggaretts my whole life time and i dont have any symptoms of it but sometimes i feel theres someting in my throat ? i dont know if its my adams apple moving or im just being paraniod ? and its not all the time i feel its only sometimes.",
    "doctor_response": "Hello.welcome to Health care magic.1.Its just your feeling, not to worry.2.Smoking is one of the cause for sure, but for regular smokers. In your case you have mentioned that, you have smoked only 7. Don't worry it will not effect.3.Try not to make smoking habit, if you do so- then you have to worry about many things.4.Not keep any thing in your mind, unless its evident symptoms.Hope helped. Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have severe itching on my legs,foot,back for more than 2 months continuously\n\ni am 38 years old,i\u00a0 have been having sever itching on my legs,foot,back for more than 2 months continously,i have taking fusin tablet all to no avail.what can i do to stop the itching.my body is full of scars due to d itching",
    "doctor_response": "hello..\u2018Welcome to HealthcareMagic Forum\u2019. the itching of the skin can be due to many factors .. its important to know the cause for the recovery and medications.. the itching can be due to some allerigic reaction your body is allergic to, like ceratian food substances... urticaria..seasonal changes or change in the cliamatic conditons.. or diabetes.. or due to dryness of the skin.. check  your blood sugar levels to.. consult your doctor for the right diagnosis.. for the itching you can opt for homeopathy it is of great help in such cases wishing you good health..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mild posterior central disc protrusion at l5 s1 ?\n\nhii my sister suffered hand injury 1 week back. She ran on treadmill the following day, the next morning when she woke her balance was not proper..like drop foot.she is admitted n MRI report says mild posterocentral disc protrusion at L5 S1 causing effacement of epidural fat . now she couldn t walk a single step..your suggestion please!",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern. She is having acute disc prolapse. Treatment of it is rest in lateral position with flexion of both hips and knees.  Analgesic such as ibuprofen is helpful in pain relief. Mecobalamine is helpful in reducing numbness. If not relieved by this treatment then she can think of operative treatment. But I think you should try rest and analgesic as first treatment .You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any side effects of taking Finasteride?\n\nMy father is taking 5 MG of finasteride a day-with 50 mg Janvria, 20 mG Lisinopril, 40 mg simvastatin. He was doing very well for his age, he is 83 and he was able to do everything for himself until they added the finasteride to his drug list. He is urinating at night every 15-20 minutes, his legs cannot hold him up anymore, he seems incoherent at times, his fingers have shooting pains. He has fallen mulitple times trying to get to the bathroom. This downgrade has happened almost overnight. I think he is resigned to dying, but none of this makes any sense. 6 months ago, his family doctor said he would live to 100 and he is getting progressively worse EVERY DAY! Could some of this stem from the new medicine?",
    "doctor_response": "Hello, Side effects of Finasteride include impotence,decreased libido) loss of interest in sex,trouble having an orgasm,abnormal ejaculation,erectle dysfunction,swelling in your hands or feet,swelling or tenderness in your breasts,dizziness and weakness. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. AJEET SINGH",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the after effects of influenza?\n\nhello,I had the flue a month ago.i wanted to ask you is it normal for me to have no taste bud for a month already. I also dont have appetite. I notice that also my cheeks inside are like black and blue. It comes and goes. and I had a ear ache for a week",
    "doctor_response": "Hello, thank you for your contact to health care magic. If I am your doctor I suggest that you should antibiotics like cefixime for this condition. I suspect it is secondary infection which is very common after the flu. Also in some cases buds working late, there is nothing wrong. You will be alright after a week. If you have anything else to ask you can contact me. Dr. Arun Tank. Infectious disease specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever and cough after getting bronchoscopy?\n\nHi My mother recently went through broncho-scopy to get her lungs checked. Doctors suspected TB. Did a CT Scan too but they were not sure since she has had TB before ..around 2 times atleast. Since bronchoscopy, she is getting high fever all the time and coughing badly.. sometimes feels nausea... what should we do now? Please respond urgently.. Thanks",
    "doctor_response": "HelloUsually cough is a normal lung reaction due to bronchoscopy.Regarding the fever it has nothing to do with however her doctor knows better her conditions.RegardsDr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for high BP and a lump on the head?\n\nI had high blood pressure yesterday, it was 170/110, and I noticed a lump behind my head.  Today the lump was gone and the back of my head feels like a big bruise.  Should I see a neurologist or have other concerns other than the blood pressure? or was this due to the high blood pressure?",
    "doctor_response": "Hi thereHigh blood pressure and lump can't be core lated.  kindly furnish us with your age sex and other medical conditions if any. and for high blood pressure you need to see a doctor to run few basic tests. Good luck \u263a",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have pain in right thumb due to excess of squeezing lemon. Please help.\n\nHi doctor, I would like to ask for your advice about the pain at the base of my right thumb. I suspect this is the result of what I did back before two months, I always squeeze a lemon fruit using my hands. This pain started last month and still continues to this day. I feel pain when I stretch open my palm. The thumb is in pain when I use it. I do not feel so good because I cannot play table tennis and the piano because of this. Can you help? Your advice is greatly appreciated.",
    "doctor_response": "Hi. I totally understand that you are suffering from first metacarpophalangeal joint arthritis. This condition occurs when you involve in repeated twisting motion of the thumb. This is partly confirmed by the vague bulge at the joint region. I would suggest you to get an x-ray of the hand once to confirm the same. Meanwhile, I would suggest you with treatment protocol. Repeated usage of the joint. X-ray hand AP, lateral. Rheumatoid nodule. Arthritis of first MCP joint. Tablet Lornaxicam and Paracetomol BD after food for one week. Tablet Rabeprazole 20 mg OD before breakfast for one week, tablet Tendofit forte BD after food for one week, Diclofenac sodium gel twice a day for local application, hot fomentation twice a day. Do not use the same thumb at least for two weeks. Review with reports.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for high fever in a child?\n\nmy son has had a fever around 100-102 for the last week, and only at night, i have given him Tylenol which has helped bring the fever down, but he still tells me that he is sick but cant explain what is wrong, he has only one kidney, could this be anything to do with what is going on? What is wrong????",
    "doctor_response": "Hello,Probably your child was suffering from some sort of viral fever as you have not mentioned any other complaints. Kids usually have post viral weakness, lethargy, and poor appetite which resolve with time, mostly in a week.Single kidney does not cause any problem in usual seasonal illnesses.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sachin Kumar Agarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with VDRL positive, took pencilin with same results. Should I take a higher dosage?\n\nsir, during blood test i was diagonised VDRL positive 1:16 later i have taken Pencilin4L for ten days and after that i have taken pencilin 12L now after 10 days when i have undergone same blood test the result is same as 1:16 on the same day after blood test i have taken one more 12L pencilin , wheather i need to take medicne agiain ? can u plz guide me i am confused",
    "doctor_response": "Hi and thanks for the query, VDRL measures antibodies and they do not get cleared out of the system immediately with reception of anti biotics. These antibiotics take time to be cleared and its but normal that the test result should be almost the same. Its advisable for you to repeat the test in 3 months, together with the TPHA test. Thanks and hope this helps, Best regards, Luchuo, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medicines can a teenager take for acne and dark circles ?\n\nI am 15 year old girl and i have acne on my face also i have an oily and sensitive skin I also have dark circles I want to have an absolute clear skin please help acne",
    "doctor_response": "Hi there,your problem is very common in your age group due to change of hormones,you need to stay calm wash ur face every day thrice and use a good face wash to remove the bacterias, an keep your skin clean,you can also start taking b complex tablets and vit c tabs which dont have anyside effects but will keep your skin healthy,and you must sleep well,i would not advise you to start on any antibiotics as it will setle in a sumtime.take care and live healthy,you can get in touch with me if you have any doubts,9611678998.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do pain and tenderness behind the neck indicate?\n\nIA few days ago I had a tender little painful to touch area on neck area behind left lower ear lobe, it has been spreading and now is bothersome without touching, but when I lightly touch it hurts and feels in one spot worse and like it is a bulging vessel? Is this something that could be serious",
    "doctor_response": "Hi, You may be having lymph node inflammation. We call it lymphadenitis. This happens when you have sore throat or mouth ulcer. Lymph nodes are organs which protects spread of infection. So when you have sore throat drainage of fluid to lymph nodes leads to inflammation and swelling. treatment is to treat the cause and lymph node swelling will reduce. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can wine cause pressure on the lower back?\n\nIt seems like everytime I drink a glass of red wine or take the Reversatrol with wine Extract, I have alot of pressure on my lower back a few days later. I drank 3 glasses of wine on Sat. night, by Monday I had alot of pressure, and had to leave work, it seemed like I was having muscle spasms, by lunch time I couldn t even walk, it hurt to sit down and even walk. I took Ibuprofen 800mg and finally whatever was inflammed was better by 5:30 the next day. I don t think I pulled a muscle, because I ve had that before, it takes longer to heal.",
    "doctor_response": "Dear patient drinking wine as such cannot lead to pressure on your lower back.  also it doesn't lead to back pain. But drinking can lead to increased acids in muscles and may lead to lactic acidosis which leads to muscle pain after heavy drinking.  some persons are more prone to this lactic acidosis and you may be one of them. it's not serious condition and if you are getting repeated same symptoms you should avoid drinking wine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can viral fever and body tremors in a child be treated when RBC and WBC counts are high?\n\nHi doctor, My kid is 6 year old 20kg weight. Crp blood test is positive with 50 value. As per doctor, it is Viral. Hemigram also has high WBC and RBC. Doctor prescribed antibiotic. I have question as his temperature is not returning to normal. 103 degree ferannite is temp. It is not getting reduced. I gave maftal p 3.5ml Now he is shivering and we are waiting for temp to return normal. In this condition can I do sponging at Home though he is shivering or shall I rush my kid for admission. Pls advise",
    "doctor_response": "dearthanks for writing to HCMI understand your concern.High fever in kids mandates sponging, so it should be started immediately.Shivering will be followed by a increase in temperature  again.Do sponging with normal tap water and be calm.Fever will  decrease,however we need a hospitalisation if prolonged and repeated bouts of fever are there.hope this helps most welcome for further queries",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from ED and PE. Please advise proper medicines.\n\nHi doctor, I have no sugar and BP. I am living a healthy lifestyle. I am suffering severely from ED and PE since last 10 to 12 years (it lasts for two to three minutes only). Please advise proper medicine which is not harmful to my health.",
    "doctor_response": "Hi. There are many reasons for this condition, so you need to be evaluated and physical examination is required. For managing ED (erectile dysfunction), a drug like Sildenafil or Tadalafil are the first-line treatment. Sildenafil can be started from 50 mg for almost half an hour before the sexual activity. Similarly, Tadalafil 10 mg can be used. The effects of Sildenafil last for one day while Tadalafil lasts for three days. For managing Premature ejaculation, a drug from SSRI (selective serotonin reuptake inhibitor) group such as Fluoxetine or Sertraline or Dapoxetine is used. Fluoxetine 20 mg daily or Sertraline 50 mg daily or Dapoxetine 30 mg can be taken one hour before the sexual activity. There is a combination of Dapoxetine and Sildenafil available in the market that can be used one hour before the sexual activity. Maintain a healthy lifestyle, take healthy food, avoid substance abuse and do regular exercise. For more information consult a sexologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Brown spot on the knee. Diagnosed as Benign. Prescribed to get a Biopsy. Serious?\n\nHi, about two weeks ago I had a health checkup where I noticed a brown spot on my knee that had suddenly appeared next to a black mole that appeared a few years ago. I had the old mole checked up before and was told it was benign. Anyway it concerned me so I asked the doctor to take a look. He didn t make much comments on it but wrote me a referral to a specialist and suggest I get a biopsy there. I ve tried scratching at the brown spot and scrubbing at it. It s definitely not dirt or anything as it did not budge at all but I just looked at it and it has disappeared leaving a slight bump. Should I be concerned about this? I have not seen the specialist yet but would like not to if it isn t anything serious.",
    "doctor_response": "Hello! Thank you for the query. No doctor is able to tell if the mole is benign or malignant without removing it and sending for histopathology. Dermatologist are able to establish if the mole is in high risk of melanoma malignum. It can be done with dermatoscope. But the final diagnose can be set only when you do remove it and check for cancer cells under the microscope. If the mole changes its size, color, gets painful, redness appears around, gets more prominent, the verges are uneven, the mole is suspicious and should be removed. Otherwise, it should be left alone. Hope this will help. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can back and leg pain with a bone spur be treated?\n\nI have low back pain with severe pain going down my right leg. Nothing shows on my MRI It affects my sleeping and showing signs of weakness in the leg also. The MRI did show a spur, but should not effect my leg. I am so miserable that I actually cried when they told me my Mri showed nothing",
    "doctor_response": "Hi, welcome. After going through your query my opinion is that It is not necessary that mri shows disease in all cases.  Please follow following advise in this circumstances  take rest and avoid forward bending,lifting weight, take analgesics and Muscle relaxants,and vit b 12. Went to physiotherapist for flexor regime. Start physiotherapy when your pain get resolved. Mean while let your ESr,crp,CBC peripheral blood film get done.Hope ur query get solved. Welcome for further queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest natural ways of keeping cholesterol under control\n\nI am a 55 yr old yoga teacher. I eat VERY healthy, weigh 115 at 5' 2\". I am HEALTHY...but just got my cholesterol checked. The total is 242 with my HDL only 43 and my LDL 155. Help! I don't want to take medication. I would like to fix this naturally. I believe my body, for some reason, is producing this cholesterol. Is there a way to tell my body to stop?",
    "doctor_response": "Hi,Actually you can't tell your body to stop producing bad cholesterol. But you can reduce it with some products such as fish oil. And I would like to mention that if you don't have high blood pressure, diabetes mellitus, and heredity of heart attacks in your family, there is nothing to worry. Just keep following healthy lifestyle and your cholesterol level will not affect you.Hope I could help youWishing you good healthIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "When should I see the doctor during pregnancy?\n\nhello my name is markeela gray im 8 months pregnant and this is my 4th baby and i havent seen a doctor every since ive bein pregnant so is there a possible that something can go wrong with my baby and i dont know what im havin and im not on medicaid so thats why i havent bein to the doctor",
    "doctor_response": "Hello,I have gone through your query. I am not aware of the free medical services provided in your country, hence please see your health care provider for further information. As per your physical condition, you should see a specialist as soon as possible to assess the pregnancy status, fetal well-being, provide general supplements and assess your general condition and monitor vital data. You need to be vaccinated, if not done already and if the due date has not passed. A sonogram is needed along with routine blood tests and urinalysis. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for seizures in a 13 year old\n\nMy wrd age of 13 has seizer problem from the age of 9.6 month.last 5 year not to come fit with jerk of body only within short jerked to be continued many times in a day ..in exit ment or taking pressure at mind. with homeopathy treatment continue from 2012 to15 .but badly last 3 months 3time for a gap of 20 to 30 day convaltion again occurred like previous stage.",
    "doctor_response": "Hi, welcome to HCM. Can understand your concerns. Seizure is a serious issue in child. You should immediately get the child examined by a doctor. MRI brain also needs to be done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for viral fever in a 3.5 years child\n\nDear Doctor how long does viral fever last and what are the symptoms of viral fever ,my son is suffering from fever since last 10 days i have been advised to give meftal p and calpol altrnatively,and also cefective 100mg .i am worried please advise he is 3.5yrs old",
    "doctor_response": "Hi, welcome to HCM. Viral fever usually lasts for 3 to 4 days. Since, your child has fever for 10 days, a possibility of typhoid fever is very much likely. In my opinion, you should do some blood tests like CBC, typhidot Igm for diagnosis of typhoid. If I was your treating doctor, i would have given cefixime with azithromycin for 5 days. However, since this is a prescription medicine, i advice you to meet the local doctor to confirm the diagnosis. I hope this has helped you. Take care. Regards - Dr Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes narrowing of bile duct inspite of ERCP?\n\nhave a bile duct stucture a result of gall blader surgery.  I have had 10 ERCP done to strech the bile duct, it continues to narrows. what is the min. size it could be. I'm trierd of getting these ERCP's done and i have had some complaction with there procedurs",
    "doctor_response": "Hi and welcome.There are benign and malignant possible causes. Benign stricture is seen in some cases and may be caused by inflammation or stone while malignant are caused by tumors. if there is jaundice then you should do surgical procedure and have stent put in. If not, then it can be observed for longer period. WIsh you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pigmentation during pregnancy. Had treatments, used creams and facial products with no success. Any suggestion?\n\nHi , I have been struggling with hyperpigmentation which developed during my pregnancy three years ago.  I have been on chemical peel treatments once a month for almost  2 1/2 years now but the marks wont go away. I have waisted a lot of money on creams and facial products with no success. Yesterday I saw Demelan at Phamarcy and read a little bit about it and it sounds promising but I would just like to know what are the chances that it will work because I cant handle another disappointment and I am really frustrated with my face. Any other treatment or product that you can suggest?RegardsVirginia",
    "doctor_response": "hi You have a condition called Melasma/Chloasma. Its difficult to cure it completely and sometimes it can come back again after clearing. Its a frustrating condition bot for the patient and doctor equally. Anyways their are mutiple modalities available: Ideally you should use a broadspectrum sunscreen with all forms of treatment, which protects you both from UVB and UVA rays and apply it every 3-4 hours.A treatment plan which combines exfoliation of already existing pigment with that which reduces synthesis of new melanin works better than undergoing just exfoliation of existing pigment(like you are undergoing glycolic peels)Demelan contains glycolic acid, which is exfoliating and will help reduce existing pigment and it contains kojic acid and arbutin, both of them help reduce synthesis of new pigment. So its a logical combination.always usea broadspectrum sunscreen with any form of treatment",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stiffness in the back\n\nhi, im 16 years old and training to be a hairdresser which means i spend 8 hours a day on my feet.. is there anything i can do to not feel so stiff? (upper back - half way down is the worse) .. and is there anything i can take for fluid in my needs?.. iv suffuered in the past but nothing worked.. meaning everything my doctor gave me was just temporary  and the problem came back (not as bad but sometimes i get really tired because of my job.. any suggestions?",
    "doctor_response": "since you stand for a long period of time the whole body weight comes on your back. few things you have to be marked:wear good shoes-your shoes should be comfortable and have cushion effect on heel area this will helps you to distribute your body weight equally(sports shoes of good quality works better): while doing hair-dressing make sure you are not bending too much forward the angle of chair should be at your shoulder level so that no forward bending happens.:take breaks interval in your working hrs continous standing can hamper your spine:apply hot packs for 10-15 mins where you find stiffness:do whole body stretching exercises daily and walk also:apply a good ointment if there is spasm or swelling: use firm mattress while sleeping: take side turn while getting up from bed : get lil ultrasonic therapy on that area you will feel bettertake care of your health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I smoke a packet of cigarette every day. Can it cause nail clubbing?\n\nHello doctor, I am a 23 year old male, who weighs 195 lbs and I am 5.10 feet tall. All of my fingers are clubbed. My nails have become wide and thick giving them an abnormal round appearance. The skin above my cuticles is slightly raised and red. My nails do not extend straight out, but they curve down. I am almost certain that my nails are clubbed, and I am extremely concerned because there is no denying there is something is wrong with me. My nails used to be straight with a normal skin around it. Now my nails are abnormally round and extremely wide. I have all the physical symptoms of clubbing. I smoke a pack\u00a0of cigarette a day for approximately eight years. I do not experience shortness of breath, except at times when doing physical activities. I am in great shape and work out six days a week. I have read articles on clubbing, and the possible causes are very alarming. Is it too late to reverse the clubbing? Is it possible that it is from smoking, and if not what can it be? I am attaching a photo of my fingers.",
    "doctor_response": "Hello. Hope this helps you and get back if you have any doubts. Revert with more information to an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for premature ejaculation?\n\nI am 33 and married, my wife is away and i started masterbating a lot while watching porn, and now as soon as i get aroused i leak pre=cum, even before an erection, i also always had a problem with pre mature ejaculation, if i stop materbating for a week or so, will this problem of pre-cum go away?",
    "doctor_response": "Hello, Pre cum is a normal phenomenon and you should not try to stop it. By the way, you should try reduce the masturbation frequency to thrice a week. Therefore I suggest consulting a psychologist for counseling. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. K. V. Anand",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Do I need to see a doctor if I have small sunburn blisters?\n\nHi doctor, Do I need to visit a doctor for small sunburn blisters?",
    "doctor_response": "Hi. To help you better, I need to know a few more details. If you could send a photo, it will be helpful. Revert back with the answers to a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tongue and chest pain with radiation to arm nerves?\n\nQuestion on something that is some kind of attack, starts with dull tight pain under the tongue gonig into the front center of the chest and with the last one extended to the nerve in the arm that ends in the thumbs. I have experianced three of these in the last two days. Any ideas?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. In my opinion, we should first rule out heart diseases for your symptoms.So get done ecg, 2d echo and stress test (trade mill test).If all these are normal then no need to worry for heart diseases. Sometimes, stress and anxiety can also cause similar kind of pain. So avoid stress and tension, be relax and calm. Don't worry, you will be alright but first rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach pain with stiffness in limbs and fever\n\nHi, may I answer your health queries right now ? Please type your query here... I hav an 8yr old girl who hasnt been well for over5weeks now she has had two courses of anitboitics she seems to be suffering from tummy pains stiffness of limbs tempure and a genril low feeling any ideals",
    "doctor_response": "Hi,From what you said, she is suffering for fever, body stiffness and abdominal pain, for over one month. She had already received two courses of antibiotics. Although the details given are not sufficient for a firm conclusion, if I were your treating doctor, after a thorough physical examination to look for pallor, lymph node enlargement, enlarged liver/spleen and abdominal tenderness, I would have ordered few tests like blood count with ESR, urine routine, serum Widal and a peripheral smear and proceed further accordingly. Your doctor will guide you.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam TK, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I have trouble pronouncing words and restricted voice due to mucus in throat?\n\nHi doctor,I have been having trouble pronouncing words correctly and feel that my voice is restricted due to mucus in my throat. There are certain times, especially when I am eating when I have a runny nose, and this is when I find that it is much easier to speak freely and maintain a consistent voice. If I take medications to thin the mucus in my throat, it makes it even more difficult to speak. But, when I suck on hard candy, it is easier to speak. I can still talk but it is very uncomfortable because I cannot speak with the inflections that I want or the tone of voice that I want because I cannot control my voice. An ENT did a laryngoscopy and did not find anything.",
    "doctor_response": "Hello. As you have mentioned, your primary complaint is excessive mucus in the throat leading to you having trouble pronouncing words. Your voice gets better when you are eating, or have a runny nose, or on sucking a hard candy. All these things have one thing in common that they dilute the mucus ( eating, sucking a candy cause increased salivation, thereby diluting the mucus). That means you have a thick, sticky mucus interfering with your speech, which may be due to sinusitis, chronic pharyngitis, gastro-esophageal reflux disease or environmental factors like cigarette smoke or dust. If you have a tendency to frequently clear your throat, that may be a sign of chronic sinusitis. You may need to get a nasal endoscopy done. A clinical examination of the posterior wall of the pharynx may reveal mucosal changes, suggesting a diagnosis of chronic pharyngitis (due to any cause).  The treatment will depend upon the cause. For example, chronic rhinosinusitis is treated with antibiotics, antihistaminics (like Cetirizine), nasal sprays, etc. Chronic pharyngitis is treated with (sometimes) antibiotics, throat gargles, antihistaminics, etc. A course of PPI (proton pump inhibitors) like pantoprazole is required to treat gastroesophageal reflux disease. Whatever may be the cause, important is to stay hydrated by drinking lots of water and avoiding dust or cigarette smoke, etc. For more information consult an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a rare sperm count indicate?\n\nhi my husband just had a vasectomy reversal 4 months ago.  He took a sample of his sperm to the doctor. The doctor told him that he had a rare sperm count.  What does this means for me??? Would he be able to get me pregnant? Can he do anything to increase his sperm count???",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.Your husband underwent reversal of vasectomy 4 months back and now has rare sperm count is matter of concern. You can go sperm drilling method , semen washout and intrauterine insemination IUI.To increase sperm count there are many medicines / hormones but i would not advise because you had reversal of vasectomy.Hope i have answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "When does a person with urine infection resume eating food?\n\nMy mother is 104 she ate well walk with walker with help ate three meals every day, but Friday morning when I went to give her breakfast her eyes were shut, she could not speak and I took her to emergency, test done such as a scan showed no strokes her system such as blood, pressure and all her body were almost normal. All they found was an urine infection, she was hospitalized and three days later started talking somewhat and her eyes were slightly open. She is in IV and four days today without food. The therapist on swallowing said she may start tomorrow if everything looks a bit better than today, how long dies it take to be in her condition without food....",
    "doctor_response": "HI, thanks for using healthcare magicIt is understandable to be concerned.Food is obviously important for survival but if she is receiving enough fluids via iv to prevent dehydration then , in the absence of any other issues, she should be ok.The response to infection can be more severe with aging and whereas a UTI would not cause significant harm in a younger person, it can be harmful for an older person especially at your mother's age.If she responds to the antibiotics , does not develop any complications and is kept well hydrated , she should be recover to her pre infection status.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sharp pain in waist usually when walking. Liver or kidney issue?\n\nI've been having a sharp pain on my left side, waist level, above hip bone. The most pain happens when I take a step, shifting my weight when walking. I can push hard into my side and feel where it is, right above hip bone, on the side not the front like a period pain. I can totally deal with a pulled muscle issue but I wanted to make sure it isn't where you would feel pain if you had a liver or a kidney issue?",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum. You mentioned that pain is on the left side, at waist level above hip bone. This pain is in the abdomen deep seated. However there are so many reasons of this pain. From how many days, you are feeling this  pain ? Is there urine problem ?Loss of appetite ?One of the most important point  is that LIVER is on the right side so don't concern about that. Now you query  is that this pain may be due to kidney trouble? I would say not , because in kidney pain usually there are burning micturition , blood in urine may be or  may not be.If stone in the   urinary tract system than it may be . So for this you  have an X ray  K  U B ( involves kidney ureter, bladder). Consult a physician and get in his opinion and deal accordingly. However urine examination may reveals some diseases, if any. Don't forget about intestine pain, as this  is most common on this side. So before any diagnosis assessment is necessary by an expert through physical examination. Hope I have answered your question. If further any question I will help. Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child have wheezing. Had a sip of soda earlier. What to do now?\n\nMy seven years old son had a problem this evening. A sip of soda went down wrong way. He was coughing for about ten minutes, and than stopped. He has an asthma, but did not have the asthma attack, so I did not give him medicine. We were not at home at that time. He fell asleep after we got home, at his regular bedtime. I went to check him and I can hear wheezing. Should I wake him up and give him medicine or let him to sleep? Do we have to go to emergency?  Thank you for your answer.",
    "doctor_response": "your soda intake worsoned the conditioni think if you start with short course of steroids you can skip energencytake betnesol 10 mg tdstab montelucast 5 mg tdssyp asthalin 1 tsf tdssyp tossex 1 taf nightdo for 5 days and that control this episode then you can consult your allergydoctor to treat then otherwuise you wont be able to know which food increses the allergies",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have bladder infection. Have severe abdominal pain. Reports showed fatty liver gallbladder. Taking antibiotics. Suggest\n\nI'm currently in hospital with bladder infection blood reselts showed a count of 88. Went for sonar as I had severe pain in abdominal and in my right side. Resilts show a fatty liver my gallbladder was removed 3 years ago. What can I do as the pain is stil present eventhough I'm sill getting antibiotics for the infection hrough the drip",
    "doctor_response": "Hi, You are in hospital with bladder infection, got pain in right side of of abdomen. you got gall bladder removed 3 years ago. sonar shows fatty liver. Pain there though antibiotics are given by drip.                                 I advise you to avoid spices, junk foods, and oily foods. I to my patients give a combination of omeprazole and domperidone , and antacid gel for temporary pain relief. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a hard movable lump on the lower back\n\nI have a hard moveable on the right side of my lower back where the dimple is, I have had this for about four years and it is getting worse it hurts to bend over or sit or stand to long. It sends sharp shooting pain up my back and down my legs. I have no insurance and I m 23 you have any idea what this might be",
    "doctor_response": "Hi,Welcome to HCM. You need to confirm its cause and nature.In my opinion it seems to be Pilonidal Cyst with infection?abscess, lately,as it is with shooting pains lately and with 4 yrs past silent history.Second Opinion from surgeon would rule out other causes from Boil with abscess/Sebaceous Cyst with abscess.Remedy-Cold fomentationsTab Motrin Tab oflox with Metrogyl.I & D if no regression after antibioticsIf Pilonidal Cyst with abscess, drainage and elective coccyx excision.Hope this would help you to resolve your query.Else Contact with a Followup Premium question to ME.Will appreciate your Hitting thanks and writing excellent review comments to help needy patients like you. Welcome with any other further query in this regard.Good Day!!Dr.Savaskar,Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for non-Hodgkin lymphoma stage 4\n\nHi I have a question. Let me tell you my history. This past August I was diagnosed with stage 4 nhl all positive. At that time I needed a bag to drain the guild around my heart. I began chemo and was release without the bag when I start to get batter mid August. I finished chemo in December and declared cancer free. 2 days ago my chest started hurting, I think I pulled a muscle because it feels the same as when I was released back in August after they removed the bag. It hurts when I hold my breath and move but if I sit still it fine. Does it sound like a pulled muscle?",
    "doctor_response": "Hi,Thanks for writing in.If you have taken recommended chemotherapy for non hodgkin lymphoma and were confirmed disease free then it is likely that your recent pain in chest is due to non cancer cause. If you feel that there might be a pulled muscle in the chest then it is suggested to take rest and apply ointment containing muscle relaxant over the painful region.The pain due to muscle pull will improve in 3 to 5 days and you should be feeling better after that. If the pain persists or increases then it requires clinical examination and probably investigations like X ray and echocardiography to know if there is any fluid collection in the heart or lungs. Treatment depends on the cause. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for the severe back pain?\n\nI had ED suddenly in November 2013 (writing this in June 2014). Since then morning erections have also gradually gone down to almost none or very weak. The size of the penis has also shrunk. I ve recently read about Peyronie s disease. Though there s no curve, and no hourglass shape when erect. When flaccid, very rarely the hourglass shape is slightly visible. I had an excruciating lower back pain which led to sciatica like pain in the buttocks and down, and it troubled me for quite some time -- at the moment it s relieved because i have been taking some homeopathic medicine since last 3 months. We have no history of diabetes, heart trouble in the family on both maternal and paternal sides. I m 35 right now, 5 8 , and weigh about 73kg. I was once married and had a daughter but now divorced since 6 years. Will really appreciate any help. Thanks",
    "doctor_response": "When I have any patient with symptoms what you have given I will check whether the patient have complain of radiating pain from back to legs along with numbness or tingling sensation or not. If yes then it shows me there is a problem at lumbar spine level. This could be lumbar disc issue with loss of normal lumbar curve. However the conformation will be done only by MRI scan. When there is no radiating pain to legs and no symptoms like numbness or tingling then the problem could be only as back muscle weakness or very mild issue at spinal level.Here the conservative treatment will be with few of  pain relieving medication along with muscle relaxants as suggested by your orthopedic doctor and also take physiotherapy treatment along with do spinal exercise to strengthen the spinal muscles.For major damage showing report in MRI spine, orthopedic surgeon will suggest for surgical option. You can discuss details with him.I am sure you will be fine if you follow step by step process as given above. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excruciating back spasms?\n\nHello. My husband is having back spasms so excruciating that he cannot move. This started Thursday, May 25. I am contemplating taking him to ER (if i can get him in a car). My question is what can the ER do for him that we are not already doing? We have been doing ice, heat and he has muscle relaxers and pain med from former back spasm issue. He has never had one this painful.",
    "doctor_response": "Hello,Taking muscle relaxants like Thiocolchicoside and NSAIDs like Aceclofenac for short term followed by physiotherapy will be helpful.You can go for infrared therapy and TENS. Back muscle strengthening exercises also will be helpful.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Nishad BN",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat hearing problem in toddler?\n\nmy grandson is 2 year old, he cries and screams at least once or twice a day, the length of times varies. he hasn t started talking yet and there are times that he seems not to hear you when you talk to him, almost like he is ignoring you. he doesn t seem to sleep well at night and is sometimes restless.",
    "doctor_response": "Get a test called BERA urgently. If not Okay consult ENT surgeon.If Okay visit Pediatrician.This could be hearing impairment or developmental problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Headaches due to injury to the cerebellum. Neck pain, black and white lines in vision. Any advice?\n\nI have been having a headache everyday since feb I went to my dr and he referred me to a neurologist. MRI of my brain showed fine except my cerebellum poked down but the dr said it was an accidental finding and doesn't think it's poked down enough to cause the headaches.  I'm now having neck pain. Also seein black and white lines in my vision  and bright lights have a big flow around. I wear contacts",
    "doctor_response": "Hi, Thank you for posting your query. Your MRI findings could mean a herniation of cerebellar tonsils. If you can upload your report, it would be helpful in confirming that. If it is mild, then there is no need to worry. However, if it is significant, then it may press on the lower part of brain (medulla) and upper spinal cord, leading to headache and neck pain. Please get back if you require any additional information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is 5.7 level in sugar test normal for a 2 year old?\n\niv had diabetes since i was ten im now 52,my two year old grandaughter had a wee test done today and there was sugar in it had a finger prick blood test done and it was 5.7 is this ok for her as dr. seemed to think she was o.k but why would she have sugar in her wee? she does drink alot but she doesnt have any other symptoms and is very active. thanks.",
    "doctor_response": "HI5.7 is OK--it's not an indication of diabetesThe sugar in her urine is likely hereditary from you and not from er being diabetic",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing constant pain in lower back?\n\nOur son is 16 and has pain in his low back on the right side to the right of the tail bone.  It started hurting on and off a few weeks ago.  During the last few days it hurts continually.  During his basketball game the pain became so bad that our son asked to be removed from the game.  The pain feels like it is on a bone.  What could it be?",
    "doctor_response": "Hello.For the symptoms that you refer, an radiography of the lower back is needed.For now, in my opinion, Diclofenac 50 mg thrice a day can be taken for treating pain.Please, go to your doctor to request radiography and for prescription.I wish you good health.(If the answer has helped you, please indicate this)",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat white dry layer on the penis?\n\nDear Doctor I am 28 year old male married.. I am seeing a white dry layer on my penis head lately.. i tried to clean it with warm water but couldn t rub off.. Penis head is very dry n red during intercourse it pains a lot to me and also to my wife.. please suggest a cure",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have infection of the glans penis ( Ballanitis).You need to take broad spectrum antibiotic like Cefexine along with anti inflammatory drug like Diclofenac twice daily.along with topical antibiotic ointment like Neosporin twice daily.Ensure to wash your genitals with warm water twice dailyEnsure to avoid sexual encounters till it heals up completely.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment of calcified granuloma in right parafalcine region\n\nHello sir, my mother(age 50,weight 60) had been suffering pain in the left knee joint for the past 4 months..the doctor which she had consulted told her to have CT Scan of her brain..The scan report showed Calcified granuloma in right parafalcine region..sir i would like to know what is a calcified granuloma and is it the main cause of her knee pain..the doctor treating her had given medicines of Calcium reformation thinking that it might be a case of arthritis .she is also a diabetic for the past 12 years..plzz help me out sir..",
    "doctor_response": "Welcome to Healthcare Magic Good Day Since your Mum is in her 50s the Calcium-Vitamin D supplement given is to prevent Osteoporosis and to treat Vitamin D deficiency induced bone and joint pain. The granuloma can be due to many reasons commonly TB, Syphilis, Sarcoidosis. Since she has joint pain, do get her checked up for Sarcoidosis as this can also cause arthritis, eye pain, cough, shortness of breath, skin pain, kidney stones as well. Review her with the Orthopaedician to discuss this possibility and get adequately treated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring itchy skin rashes on back, chest and arms?\n\nMy son has a rash that looks similar to bed bug bites but we have check very well and its not bed bugs and it comes and goes....its on his back chest and arms and sides..we have had it looked at twice and got no answers...it starts out real red and itchy then fades away but comes back within a week or two",
    "doctor_response": "Hello,Thank you for posting on HCM.The condition you have referred to is called Urticaria or hives. Its an allergic manifestation of skin, where an allergen leads to release of certain substances from your blood, leading to itchy skin rash and swelling over soft tissues. Its proper management requires thorough history, clinical and laboratory work-up.You may have to go for specific tests like patch test, food prick test, IgE antibody levels etc. As for treatment part, best would be the avoidance of allergen as far as possible. Try to eliminate possible triggering foods from diet. I would also advise you various anti-histaminics for long duration( atleast 3 months) with or without oral corticosteroids. For non- responding cases there are many other drugs like dapsone, cyclosporine, montelukast, omalizumab etc which can be used in certain selected cases. Hope this will help you in resolving your query.Thank you Dr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Ultrasound showing mild hydrocephalus. Should I be concerned?\n\nHi doctor, My present ultrasound is showing mild hydrocephalus with breech presentation (36 weeks) dilated 13 mm ventricle. No genetic disorder reported earlier done in second trimester. All the previous ultrasound showed normal and sound growth of fetus. Reports attached for your reference. Thank you.",
    "doctor_response": "Hello. Antenatal infection. 1. MRI brain and spine. 2. Ultrasound abdomen and 2D echo (echocardiogram) of the heart. 3. Karyotype. Surgery if required. Revert back after MRI to a paediatric surgeon online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the pain in the abdomen be due to umbilical hernia?\n\nMy name is David Langston.  I am 28 years old, 5' 11\", 172 lbs.  I had a vasectomy in April, but no other surgeries.  I do not smoke, do drugs, or drink on a regular basis.  I do not have a history of high blood pressure or cholesterol.  Five days ago I was doing some heavy yard work, and I felt a sharp pain in my abdomen.  The nest morning, I noticed a small lump about the diameter of a dime under the skin just below my naval, though not visable.  I contacted my doctor who was not sure what it was, but he suggested I may have an umbilical hernia.  I have had minor gas pains and I need to use the restroom three times a day - more often than normal.  I am not in pain, though I do feel pressure when sitting upright, and when I massage the area, it feels as though I am massaging my intestines.  Does this sound like an umbilical hernia, or are there other reasons for my discomfort?",
    "doctor_response": "hithanks for askingi would like to answer as follow as you have given a very lucid history.it looks like an an umbilical hernia...you can do a simple test by your own...look at the ceiling, do a strong cough and notice the swelling,if it moves outside then it is an para umbilical hernia....you can also do an ultrasound abdomen to confirm it.....i do not think that your abdominal discomfort is due to other reasons....",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes weakness and twitching in arms and legs?\n\nHi I have been having the feeling of weakness in my left hand. I also been experiencing fasciculation in my arms, legs, hands, feet, eye lids, and lips. My joints crack a lot and I am nineteen. I have a history of anxiety so I am fearing that I have ALS. Is there anyway you could put my mind at ease? -Mack",
    "doctor_response": "Hi. The symptoms you are having could stem from anxiety also.But before that we should try vit supplements and see if that works.Get bit B12 level done.along with it get your serum calcium and vit D 3 levels.Hope that helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why are my legs are so swollen and getting worse?\n\n65 yr old male stroke alzhimers wary stage .THE STROKE EFFECTED MY RIGHT SIDE BADLY WHERE WALKING UNAIDED IS IMPOSSIBLE .i sit all day an watch Tv .MY LEGS ARE SWOLLEN AN I NEED TO WEAR STOCKINGS TO THE KNEE ON BOTH LEGS AN I NEED TO KEEP MY LEGS UP .I DONT HAVE ANY SENSATION WITH MY BLADDER .MY QUESTION IS WHY ARE MY LEGS SO SWOLLEN AN GETTING WORSE ?",
    "doctor_response": "they could be due to venous stasis because of  (lack of movement and muscle tone)..or kidney function disorder...get a kidney function test..and if clear then you should try being a bit active and move as you can walk even with assisting device or person...elevate your legs and try buerger's exercise 1, Elevate feet on padded chair or board for 1/2 to 3 minutes.2, Sit in relaxed position while each foot is flexed and extended then pronated and supinated for 3 minutes. The feet should become entirely pink. If the feet are blue or painful, elevate them and relax as necessary.3, Lie quietly for 5 minutes, keeping legs warm with a blanket.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain at the bottom of thumb and wrist?\n\nAbout 4 or 5 weeks ago my buddy and I were sparring and I threw a bad punch and now every time I bend my right wrist when extending my thumb it hurts. The same the pain occurs when pressure is applied to thumb, for example pushing of edge of chair, also when the base of my wrist is squeezed my inner wrist and the bottom of my thumb hurt.",
    "doctor_response": "HelloI have read your query. There is possibility of ligament injury to thumb.I will advise you splint and rest. Physiotherapy like ultrasound and Tens may give you relief. Another possibility of hair line fracture. x ray will help to confirm diagnosis. I hope I have answered your questions. If you have further questions please feel free to contact us. I will be happy to answer. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes salty taste in mouth?\n\nHello doctor, for the past two weeks i have been having this salty taste coming from the right side of my mouth. It is also slightyly numb as well and i really dont know what it is. This taste still remains no matter what i eat and how many times i brush my teeth including the side of my mouth. When i use my mouthwash it buen in that place and also when i gargle with salt water. can you pls help me.",
    "doctor_response": "Thanks for your query, I have gone through your query.The salty taste in the oral cavity could be because of the tooth or  gum infection resulting in abscess formation leading to pus discharge. When there is a pus discharge the metallic taste will be there. Consult a oral physician and get it ruled out. If it is gum or tooth infection get it treated. You can take a course of antibiotics like amoxicillin 500mg and metronidazole 400mg tid for 5 days(if you are not allergic).  After taking antibiotics you can get the tooth treated with RCT(if bone support is fine) for tooth infection.if it is gum infection then get your teeth cleaned once and maintain the oral hygiene.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Asthma, allergies, fainting on urination. Is this a kidney issue?\n\nMy sons has asthma & allergies & has been on a lot of medications since infancy. In the past couple of years he s started fainting & collapsing when he has to go pee. Not every time, but usually if he s drank a lot or getting sick. What causes this & could it be a potentially life threatening kidney issue? I m afraid all of the medications over time can affect his kidneys.",
    "doctor_response": "these types of allergies are due to one of these food products wheat milk egg fish potato chana rice get bloodserum tested forspecific antibodiesfor these foods you will get results after that ask for slit treatment and that will cure the problem and other medicines will be taken of",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking birth control. Have late periods, weight gain, uterus feels popped out, feels lump in center of pelvis\n\nI am currently taking birth control I have been taking it for two months straight now. I am two months late on my period and the white pills are supposed to make you start your period. I took a pregnancy test but it came out negative. I have most pregnancy symptoms I'm gaining weight. My uterus feels popped out. I feel kind of like a lump in the center where my pelvis is located. Could I be pregnant ?",
    "doctor_response": "Hi, Thanks for the query. If you have regularly been taking birth control pills then pregnancy is unlikely. It seems from your query that you are taking pills for 28 days of these 21 are active and 7 inactive pills. Periods usually start after 3-4 days of beginning of the inactive pills. I suggest that you check your pack of pills to see if they are 21 or 28. If it is a 21 days pack you need to stop pills for 7 days. You must repeat the pregnancy test after 7 -10 days. If it is negative and you use a 28 days pack, I suggest that you continue your pack for this month and see if the periods come during the inactive pills, if they do not come other causes of need to be ruled out. Check to see if you have been experiencing too much stress or have lost or gained weight. Also check to see if you have any discharge from the nipples as all these can cause absence of periods. There are certain other causes that need to be evaluated like thyroid problems or ovarian lumps. For this you will need to see a gynecologist. The weight gain may be due to the pills. The belly lump needs to be checked if it is due to fat deposition or due to an enlarged ovary. Your doctor will help you with this. Once again I think that the chances of pregnancy are low but if you continue to have absent periods, get yourself examined. Hope you find this useful, Thanks for using health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the success rate for bypass surgery?\n\nRespected Sir / Madam , Kindly find attached the PP of angiogram of my brother who is 43 yrs old. The doctors have diagnosed as Moya  Moya disease. My brother had hemorrhage on 10 December 2010, \"CT showed right thalamic bleed with extension into all ventricles. Mild hydrocephalus. Old right frontal infarct.\" He was discharged from hospital on 18.12.10 and was advised to take the following medicines. -Tab Paracetemol 650 mg thrice a day. -Tab Rablet D twice a day. -Tab Divolprox Sodium 500 mg twice a day -Adequate water intake He had recovered a lot besides complaining a headache after  5 days. Doctors are advising for bypass surgery. Kindly advice for -Shall we go for surgery? if yes , after how much time ? -What is the successful rate of surgery? -Any draw backs of surgery? -Can it be done in India? if yes , where? -Cost of Surgery? With Best Regards",
    "doctor_response": "Hi,Welcome.This is Dr Sameer.Bypass surgery has good success rate & is considered betrer than angioplasty. So their is absolutely nothing to worry. I did not find any attachment with your message. So please try again. So i can not tell you within how much time it should be done.Bypass is done very commonly in India in all major hospitals with cardiology setup. Discharge takes around 4-7 days depending on patients progress.In India it costs between 2 to 3 lakhs.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of supraumbilical hernia?\n\nI have just been advised that i have a supraumbilical hernia just wanted to know what the symptoms for that is i have been feeling very hungry but then go to eat something and feel so full and about to explode i feel that i have a baby's head bulging from my stomach could this be due to the hernia",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query. The symptoms of a supra umbilical hernia might vary according to the size of the hernia. If it the size of the head baby bulging out of your abdomen, then yes, it is possible that you could get these kind of symptoms. I would advise you to get in touch with a general surgeon who after a clinical assessement would go for some routine investigations and advise you for some kind of hernioplasty ( a surgery for the hernia) either by open method, or by the more frequent laparoscopic hernioplasty for a faster recovery.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for mood swings and panic attacks?\n\nHello my name is Robert. I have was diagnosed with major depression and anxiety back in 2008 and have been struggling with medications since then. I recently got off of 300mgs of Venlafaxine. The side effects were horrible to the point of forcing me off them cold turkey. -major motion sickness/unable to walk -sickness -brain shivers -CRAZY mood swings and random crying spirts I am currently without any medication due to being afraid to try any more of this pills(been on about 10 different types). In the united states medical cannabis is quite popular and i have friends who have suggested this route. I have done my research on this but i am not sure of how to bring this up to a doctor... Most doctors do not accept this as a valid medication and i am desperate to get help as my panic attacks and mood swings are getting to be too much for me to handle.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Non conventional methods are always dangerous and that is the reason why your doctors are objecting. Mood swings and panic attacks are not diseases, but disorders. They need medications in the beginning, then not. Because those medications are habit forming and are addictive.After initial 15 day dose, it is expected that the affected person undergoes some life style changes and relaxes. Doctors do advice in that way. but these advices are not taken and medicines are taken continuously.Time and again, it has been proven that medicines alone cannot cure depression, anxiety and panic attacks. Relaxation, psychotherapy can surely cure along with psychotropic medications. When the relief starts, the medicines needs to be tapered off.You can post a direct question to me in this website. Include every detail as much as you can. I shall prescribe some psychotherapy techniques to control your condition. I am sure that the techniques should be a success.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing severe lower back pain along with abnormal sleepy?\n\nHi my fiance has lower back pain and is abnormally sleepy laterly to the point he passes out. He worried because he feels odd but doesn't wanna have to go to the hospital. Any ideas? His pain in his back from a so extreme he can only loft our one year old a few times before almost falling over in pain",
    "doctor_response": "I would recommend her to get her thyroid check up done. As symptoms which you are suggesting can be due to low thyroid hormone level in body . Also it can cause back pain. ]Till that time she should take muscle relaxant and diclofenec gel for her back. Once we will get blood report i can suggest you further management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Asthamatic. What is the treatment for swollen throat, chest and back pain?\n\nHello! I was diagnosed with very severe sleep apnea and I have asthma (severe) I have been having pain both in the middle of my chest and the middle of my back and at times I feel like my throat is swollen and it is quite difficult for me to breathe and sleep. How do I seek help and find a doctor that will help me?",
    "doctor_response": "Was your sleep apnea diagnosed on polysomnography if so what is our AHI index.Have you been prescribed home CPAP ventilation.Get your ENT check up for any problem in your tonsils or adenoids or any other obstruction  like polyps.You have also not specified the treatment you are taking for asthama.Once your sleep apnea gets proper treatment then your other symptoms would get releived.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having nausea, cramping and irritability. Using pill. Side effects of pill?\n\ni started the pill my last period which was at the end of april took it until next period, has bleeding inbetween that lasted for a few days, then got what i think is my next period a few days earlier then it should be..., really confused, i have been having symptoms like nausea, cramping, irritability....what could this mean? is this from the pill or something else",
    "doctor_response": "Hi.Thanks for asking in Healthcare Magic.All  OCPs contain hormones and  will result in hormonal imbalance by interfering with the existing hormonal status of the body. So depending upon the individuals, it will take some time, usually 3 to 6 months, for establishment of  the regular cyclical pattern of menstruation.One of the main side effects of the pills is irregular bleeding and bleeding between periods. Your nausea, cramping and irritability are due to the action of progesterone in the pill. You should complete all the pills in the pack and should not stop if the bleeding starts. Mistaking the bleeding/spotting before the completion of the pack and stopping the pills will interfere with the next cycle and will also abolish the contraceptive effect of the pills. OCPs are available in different combinations with various strengths. If you still have these side effects after few cycles, then you can consult with your treating Dr. for a different type of pill. Usually progesterone alone pill or mini pill causes these problems but you have not mentioned the type of pill you are taking. Either go in for a combination pill or if you are already taking one, then go for pill with higher estrogen dose. Your treating Dr will know about these preparations.I hope this is useful to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever, nausea and reddish rash on the right knee?\n\nMy son has what seems to be either an ingrown hair or insect bite on his inside right knee. It has a small head, very redish around the area. He has a 100F fever, has a little nausea as weep as has been feeling tired all day. The area somewhat resembles a staph infection.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. If there is Erythema with fever and rash with previous skin damage than likely to be infection for which water antibiotics systemic and Mupirocin local application. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes worm like particles in feces?\n\nHi, may I answer your health queries right now ? Please type your query here... My 15 month old has clear particles shaped like a grain of rice(slightly larger) worm like appearance in his feces. They do not move. Appear to be jelly substance. What is this?",
    "doctor_response": "Dear Parent,The jelly like substance in your child's stool seems to be mucus which keeps our intestines moist and lubricated. Small amounts of mucus in stools is normal. However you will need to consult a pediatrician if the amount of mucus in stools increases or is associated with blood and abdomen pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high lipase levels?\n\nMy Lipase levels are high at 158. The amylase level is at 82, which is normal. What could be the cause of this. My present doctor as well as my last primary care doctor do not seem concerned. This has been the case for at least 11 years. I have a sensitivity to gluten and wheat.Could there be a correlation? I do not have abdominal pain just sensitivity to wheat, gluten and some dairy. Thanks so much! Carol Ann Trifiletti",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  You lipase level is high with normal amylase level.  But it is like that for last 11 years with no any abdominal pain or other symptoms.  So nothing to worry about enzymes level.  Avoid wheat, rye,  barley and other dairy products against which you have allergy.  No other treatment is required right now. Just be relaxed. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes large painful swelling below the hip after a body sprain?\n\nMy father twisted suddenly, felt a sharp pain in his hip....it swelled just below his waist to the size of a softball. He iced it and has been resting for 6 days. It s still sore and has become very black and blue from the top of his thigh to just above his knee. What could have caused this? He is almost 94 and still walks 3 miles a day and is anxious to get back to walking. I have told him to discontinue his 81 mg of aspirin that he takes everyday. Is that ok?",
    "doctor_response": "thank you for the information you have furnished here.. if we see the picture we can come to the diagnosis... it may be hematoma.. even... it will be subsided shortly.... with in a 10days or so.. mean while better consult doctor to rule out any fractures or moralle lawelli lesion . if it is contusion he can go for walking no issues in that.. better do some hot water mopping over the lesion it will help you.. dont bother.. he will become normal with in a week or two",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rapid heart beats, dizziness, weakness, on chemo for ovarian cancer. Should I consult?\n\nI often have rapoid heartbeat It is allways over 110 and now it is 135 I do feel dizzy and weak often but I also have ovarian cancer I had 3 chemo . surgery and just finished last Friday my last chemo and am waiting to see if I am in remission All thru this journey that started last june docs and nurses have questions my heartbeat Should I consult or not worry Thank you",
    "doctor_response": "Hi, You have got tachycardia. your pulse rate , rhythm , volume, character to be examined .  Your ECG report may guide to an diagnosis. Anyway chemotherapy for ovarian cancer at first line generally include platin and taxane, your symptoms not match with toxicity profile of these two drugs. Consult with an cardiologist. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever, coughing and nausea?\n\nmy child is4.5 year old premature born in 7th month and weight was around8oo gr.now he is still under weight 12kg.since nov he got fever,coughing and nosia.doctor gave him amoxil,adol and vintoline 10 days but nothing helps then they starts augmentin for 5days.after completing dose 4or 5 days later he start coughing and low fever",
    "doctor_response": "Hi, By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze. I have a few questions for you -Questions: 1. How many days per month does your kid cough or feel breathless? 2. How many nights per month does your kid's sleep gets disturbed due to the above symptoms? 3. Does your kid feel breathless when running around or playing with other kids? 4. Are the symptoms when there are seasonal changes? 5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.? 6. Is the cough always associated with fever? Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is increase in weight be the reason for non parenthood?\n\nhi docits been married 1 and half years and my wife havent yet conceived, last month i had my semen analysis done, which showed 14 million/ml, after that i have changed my life style of using laptop on my laps, and also iam 20kgs more than my normal weight, will this be a cause for not becoming a father. please advise?",
    "doctor_response": "Hi,Thanks for writing to HCM.Yes over weight may cause infertility. Due to over weight the production of healthy sperms may be hampered and also the motility of sperms may be less.Due to over weight there will be more fat in body so more production of oestrogen which is female sex hormone. This decreases sperms production by reducing testosterone(male sex hormone) levels. Also tend to produce abnormal sperms.Do some some life style modifications like --\u00a0\u00a0\u00a0\u00a0\u00a0Reduce weight, do exercise.-\u00a0\u00a0\u00a0\u00a0\u00a0Stop smoking and alcohol. -\u00a0\u00a0\u00a0\u00a0\u00a0Avoid caffeine.-\u00a0\u00a0\u00a0\u00a0\u00a0Ware loose under garments.-\u00a0\u00a0\u00a0\u00a0\u00a0Healthy diet with multivitamin and zinc.-\u00a0\u00a0\u00a0\u00a0\u00a0Avoid trauma to testis.Hope I have been helpful.Regards\u00a0\u00a0\u00a0\u00a0\u00a0Dr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful urination after circumcision?\n\nmy grandbaby was circumsised 2 days ago. The gauze like tape has not fallen off,yet. It did not hurt to pee at first, but now it seems to be painful. He trys to hold it until he can no longer hold it,and then he cry, profusely. Is that last piece of guaze restricting him, or is something else going on?",
    "doctor_response": "Hi,Thanks and welcome to healthcare magicYour history suggests that it may be a stitch infection leading pain and consequent holding of urine.Better consult your doctor.He will suggest antibiotics and remove the stitch that has not absorbed or come out.Hope this answer serves your purpose .Please feel free to ask further queries if any.Dr.M.V.Subrahmanyam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe upper abdominal pain. EGD shows hernia, gave medication for constipation. Relief from pain?\n\nMy family suffers from severe upper abdominal pain.. It s never been diagnosed .. I ve had this problem over four years . The pain feel exactly like gallstones.ive had 4 EGD s they show only a hernia the GI doctor put me on a medicine thats for constipation & said its going to work I ve been in the hospital 9 times since September because the pain is SO bad I ve been checked for diabetes, h-pylori , diverticulitis & had my pancreas PLEASE HELP",
    "doctor_response": "Hi If you are suspecting gall stones,you should go for an Ultrasound abdomen. If they have diagnosed Hiatus hernia,it may also cause pain. Please take Rabeprazole with Domperidone and antispasmodic Dicyclomine. Get an Ultrasound abdomen and come back. I will clarify further Wish you good health Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for complex partial seizures in a child\n\nmy son aged 5 1/2 yrs has been on tegretol and encorate to help him with his complex partial seizures. Tegretol, 10ml, 3 times a day and encorate 7.5ml twice a day. We had reason to believe that encorate was not such an effective drug and are in the process of tapering it down. We have reached 6ml twice a day. His attacks tho have suddenly increased, frequency and intensity. Does this mean that we have to go back to 7.5ml. We came down to 6ml, only .5ml at a time. Which means that we were on 7ml for 15 days, then 6.5ml for 15 days. Only when we reached 6ml is when his frequency has increased. Should we then go back to 6.5 or 7ml?",
    "doctor_response": "Hi,Both Valproate / encroate and tegretal (carbamazepine) are a good choices in complex partial seizure. I am not aware about the reason for interchange. Anyhow, if the seizure was well controlled on 7.5ml encroate, I would recommend to revert back to the same dose (tegretal to be continued as such) and review with your doctor for further decision making.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam T. K., Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for back pain with gastric problems?\n\nSir; 1) I use to get constantly back bone pain due to fell down from the tree ,2 ) Gastri problem...in my left stomach,also I have done my heart surgery almost 10 year ago..P.O AVR st Jude...so ple let meh know how to get free from gastric problem n back bone pain...sir ple help to get free offcourse.",
    "doctor_response": "hithanks for writting to HCMfor your back pain my advice would be- 1.postre correction that is to say -sit,walk,stand like a soldier  2.regular excercises like surya namaskarand diet rich in calcium and vitamin D like milk and milk products.     if pain occurs take powergesic MR on sos basis.Regarding oyour stomach pain,please clarify what problem do you have.But still my advice is divide your 3 meals into 6 meal that is to say eat in small amount and eat more frequently.take care and wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "How is strep infection treated during pregnancy?\n\nHi there i have been told i have group b strep and i am 19 weeks pregnant. they have given me penicillin to take but i read online that it doesnt work and that if i have it nearer the time of birth they give u iv antibiotics when ur in labour to prevent baby from getting it is this all true?",
    "doctor_response": "Hi, Thanks for posting in HCM. I understand your concern. Group B streptococcus (GBS) is a type of bacterial infection that can be found in a pregnant woman\u2019s vagina or rectum. This bacteria is normally found in the vagina and/or rectum in about 25% of all healthy adult women. However, women who test positive for GBS are said to be colonized. There is a risk that mother can pass GBS to her baby during delivery. Not every baby who is born to a mother who tests positive for GBS is known to become ill. Expectant mothers who are tested positive for needs to be treated with antibiotics when they go into labour or if their membranes rupture early. In case the mother is not tested but is thought to be at high risk for passing the bacteria on to her baby during the birth process, she will also be treated with antibiotics to kill the bacteria during her labour. To help protect their babies from infection, pregnant women who test positive for group B strep in the current pregnancy should receive antibiotics through the vein (IV) during labor.Penicillin is the most common antibiotic that is given since it is very safe and effective in preventing group B strep disease in newborns. For women who are allergic to penicillin, there are other antibiotics that can be given. This problem can be tackled and hence you need not worry. Kindly keep your antenatal check-ups up to date and consult Gynecologist for appropriate management when necessary. Hope the information provided would be helpful. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headache and shortness of breath?\n\nHello I have been sick for about a week and I am just returning to work today. My resting pulse is at 107 and I am having SOB and I have a really bad headache. Is this normal since I have been for the most part on bed rest this last week?",
    "doctor_response": "Dr. Muhammad M. Hanif warmly Welcomes you!Thanks for consulting me at virtual clinic. I have carefully worked through your case, and can realize your health worries. Being your physician, I want to assure, I will take care all of your medical concerns.It isn't due to being on bedrest. It looks like you have some underlying disease, like anemia or some lung problem. It may also be due to your recent illness that you feel weak and short of breath.Hope I answered all of your questions. In future, If you need further, detailed and quick assistance related to any health issues, feel free to 'ask me a question' directly from my profile. You can also attach Lab reports and pictures directly from the question window, or by emailing it to attachments@healthcaremagic.com with the Subject as, Attention: Dr. Muhammad Hanif, and the lab reports and images will directly reach my inbox for review.May you get very well soon and have a wonderful time ahead. Please don't forget to give your valuable positive feedback and five star rating, to help me assist you in a better way in future too. Please, write a review about your experience with me, after you close this discussion.Regards!DR. MUHAMMAD HANIFPHILADELPHIA-PA, USA",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the treatment for cough and cold in a 4-year-old?\n\nHello doctor, My 4-year-old boy is suffering from cold and cough. His symptoms are, 1) Choked nose (not running). 2) Time to time heavy coughing, 3) No temperature. Suffering from last three days. Started with light cold, but today heavy voice and frequent coughing.",
    "doctor_response": "Hello. It is a common cold due to viral infection, but as you have said that cough is increased now so it may be normal or it may be complications. The common complications are viral pneumonia (self-limiting), and another one is croup. The second one is having problems and characterized by a sick looking child and barking cough. If your child is not sick looking and breathing is normal and no fever, you need to apply nasaoclear drops in the nose every two hourly along with cough syrup (one teaspoon three times a day). It will subside by the time. If he is sick looking and fever is increased breathing, then you need to visit your nearest physician. Then we need to give antibiotics. You can ask specifically if needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have pelvic, lower abdomen, vaginal pain, numb bottom, urinating urge, vaginal bleeding. Cervix removed after cervical cancer\n\nPain in hips and pelvic area, it goes into my lower back and causes numbness in my bottom and backs of legs. Fullness in my abdomen all the time, constantly need to pee, heaviness in vagina and back passage with constant bleeding from vagina, pressure and pain in this area when I sit, constant pain in lower abdomen area, vagina and back passage when I walk, had cervical cancer, cervix was removed still waiting on all clear from this, CIN3 in womb",
    "doctor_response": "Hi and welcome to HCM. Thank you foryour querry. This is definitely something that should be evaluated especially considering your previous surgery and cancer. After surgical procedure in pelvis usually adhesions develops which can cause bowel compression,bloating and cramps. I think that ultrasound it at least what should be done to rule out cancer relapse and other serious diagnosis. But I would do CT scan too in your case. You shouldnt ignore these signs. ALso, do basic lab ant urine analysis to exclude anaemia and uroinfection. WIsh you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain\n\nHi, my husband is having central chest pain, worse when lying or sitting. Also worse when breathing in. He says his throat muscles feel sore in the back of throat, feels as though he has a toothache (lower teeth, left side) and it radiates to the ear as well (intermittently). This has been going on since early morning (around 4 a.m.), so about 14 hours or more. There has been no reprieve. He ate pancakes and sandwiches yesterday, grits today. Should I take him to the ER, or see how he feels tomorrow? Maybe he's just stressed out and doesn't realize it? Thank you for your help!!",
    "doctor_response": "Hello welcome to HCM...Noted your husband have sore throat...So here he might have respiratory viral infection and this infection can lead chest pain as constitutional symptoms...Rest done...symptomatic management needed.Drink more water.Use distilled or hot water for drinking.Salt water gargle taken...Decongestent taken like oxymetazoline.Chlorpheniremine given for relieve inflammation.Avoid excess spicy food and smoking...Fried food taken less for few days.If still condition increasing antibiotic given.Auscultation done....If need chest x ray done to do further work up.Hope you get well soon.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What causes unexplained bruising?\n\nHi doctor, I have been experiencing some unexplained bruising for a few weeks. Also, last week I had a few pin point red dots on the side of my back which went away in about two days. This past week I discovered some more of the cluster of red dots on the back of my thigh, which turned into a big bruise the following day. Also, today I woke up with the red dots on the back of my other thigh. I had a CBC done today, but is this something I should be concerned about? I am not having any other symptoms. Would I be more symptomatic if I had a blood cancer?",
    "doctor_response": "Hello. Your symptoms are not suggestive of any blood cancer or other form of cancer. For repeated bruise and attached photo of lesion (attachment removed to protect patient identity) you have to investigate as follows: Liver profile reports to check liver pathology. CBC to rule out low platelet count, if present. PT, APTT to rule out coagulation problem if present. BT bleeding time testing to rule out vessel problem if present. After checking all these reports further work up can be planned. Meanwhile you can be prescribed oral Vitamin C tablet 500 mg BD for seven days. Topical Vitamin K cream application also can be helpful. You can consult nearby physician for detailed evaluation and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough and viral fever in a child\n\nMy 2 1/2 year old has had a bad hoarse cough, runny nose and watery eyes, I have taken him twice to see the doctor and all they tell me is it s a virus and I have to let it run it s course but he has been like this since Jan. 14th, he can t sleep or carry a conversation without coughing. He can t even breath at night when he sleeps. I have done it all, humidifier, lemon/honey, Nasonex and he takes his allergy medicine everyday. I need HELP!!!!!!!!!!",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Greetings from Chennai.By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze. I have a few questions for you -Questions:1. How many days per month does she cough or feel breathless?2. How many nights per month does her sleep get disturbed due to above symptoms?3. Does she feel breathless when she runs around or plays with other kids?4. Are the symptoms when there are seasonal changes?5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?6. Is the cough always associated with fever?Get back to me with answers to above questions.You can approach me at the following link. Please find the link below.www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does \"nodules in upper lobe and middle lobe\" suggest on chest x-ray?\n\nCentri nobular nodules noted in anterior segment of right upper lobe and middle lobe segment. This slightly reprsent the areas of active infrective process. Mediastinal lymph adenopathy. Multiple enlarge mediastinal lymph node noted at sub cranial, pretracheal and right para tracheal region and in aorto pulmonary window. What is the diasease and its treatment?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. I have gone through the report you have mentioned. Yes, you are about infective etiology. Most common cause for centrilobular nodules is infection. Amongst infection, tuberculosis is the likely infection. You are also having mediastinal Lymphadenopathy. This also favours tuberculosis more. So get done sputum microscopic examination for AFB (acid fast bacilli - bacteria causing tuberculosis). You will need anti tubercular drugs for at least 6-8 months. So consult pulmonologist and discuss all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach ache and dizzy spells after gall bladder removal?\n\nI get bad stomach aches if i don't eat every two to three hours. They hurt thru to my back. I also get these weird dizzy spells sometimes too. I don't know if they are related. It started after I had my gallbladder removed. I'm 43 and I exercise but want to know if it could it be diabetes?",
    "doctor_response": "hi.noted history of stomach ache and dizziness after cholecystectomy. it is best if you do a follow-up consult with your surgeon for complete physical examination and clinical evaluation. it may or may not be related to your surgery, hence, personal consultation is important. diagnostics and management will be directed accoridngly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "PCOS, hair on face and neck, scan shows polycystic ovaries. Not conceiving despite regular periods\n\nhello doctor... i am 25yrs old.. am married from 1 yr.. i have pcos n lot of hair on my face n neck .. i am trying to become pregnant.. i dont even know if i am ovulating.. in my scan result is multiple small perpherally located follicles with central echogenic stroma- suggestive of polycystic ovaries. i am over weight n doin all kind of exercises n diet to reduce weight but none of it is workin.. am takin tab metformin1000mg from 1n half yr. i even started takin contraceptive pills 4 months before my weddin for 8 moonths n stopped usin it 4 months back.. am takin folsafe n meta-x from 6 months.. ovacare forte A+B from 2 months. my doc prescribed tab obicure for 1 month for weight loss . i used it wid regular exercise n diet but dint reduce even 1 kg.. i have regular periods but am not concievin.. am worried.. plz help me doctor...",
    "doctor_response": "Hi, Thanks for your query. I have read your query & I understand your concerns. First of all you need to confirm if you are ovulating. Hence I suggest you visit an infertility specialist and get follicular growth scan done. It will help you to predict acurate ovulation time and days to have intercourse. I hope I answered your query. I will be available for any followup queries you have. Regards, Dr.Mahesh Koregol IVF & Infertility Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the preventive measures for clostridium difficile virus?\n\nI am 78 and have survived a long and severe clostridiumdeficile.After 32 days in hospital I am so weak that i am literally learning to walk again.Can you suggest ways to build up my strength again quickly and preventative measures.i am truly terrified of having this virus again.",
    "doctor_response": "For prevention take healthy diet, containing green vegetables, fruits, pulses, plenty of water.drink boiled water daily. Take multi vitamins and supplement too",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I have sharp pain in chest everytime I swallow food?\n\nIm 16 5ft 10 weight 242 lbs and the last 3 days i have been having a sharp pain in my chest everytime i swallow food or drink and the pain stops in the middle of my stomach it started after i had eaten something. It feels like something is in my stomach everytime i swallow",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, possibility of GERD (gastroesophageal reflux disease) is more. GERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause symptoms of chest pain especially after food. So follow these steps for better symptomatic relief in GERD. 1. Avoid hot and spicy food. Avoid junk food. 2. Avoid stress and tension, be relax and calm. 3. Avoid large meals, instead take frequent small meals. 4. Take pantoprazole tablet on empty stomach. 5. Keep 2-3 pillows under head in the bed to prevent reflux. 6. Quit smoking and Alcohol if you have these habits. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances to get pregnant while using Loestrin and Cephalexin together?\n\nIm on Loestrin 24 fe for 2 years now. I always take it the same time everyday but also have unprotected sex with my partner. He doesnt ejaculate inside me and i havnt gotten pregnate. I was just put on Cephalexin for an infection on my fingers, can i get pregnate from using both these pills?",
    "doctor_response": "Hello, You can get pregnant if you stopped using loestrin tablets and have unprotected sex coarse, as for cephalexin, it does not affect pregnancy occurrence in any way. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for severe hair loss?\n\nHi l am suffering from hair loss for last 5 years .The frontal part has become very thin .My doctor prescribed manexil gel 2%.Before useing it I want to know about the medicine.My doctor wrote only the composition name may I know any brand name with same composition?",
    "doctor_response": "Hi, You have not mentioned age and gender. I think you may be a male. And so, most probably it may be androgenetic alopecia. You may take tab Finesteride daily for a few months to a few years. And apply Minoxidil solution twice a day on the scalp. Take Biotin tablet daily till one get a good response. Avoid stress and anxiety. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr.Ilyas Patel MD Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What medicine can lower blood pressure during pregnancy?\n\nHello doctor,I am a 30-year-old female with a height of 5 feet 3 inches and a weight of 65 pounds. This is my first pregnancy. All test reports are normal until now but my BP is 140/90. Is it very high? I am too much tensed. Please help me.",
    "doctor_response": "Hello. Fourteen weeks pregnancy and blood pressure is 140/90. You need to monitor your blood pressure every six hours with your gynaecologist who will judge whether it is really raised or just a chance of finding. Accordingly, he will prescribe you medicines. You may start with tablet Aspirin 75 mg to maintain your blood pressure and fetal growth parameters. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. You need to have diet changes such as low salt diet, no pickles and spicy food. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness and heaviness on upper arm?\n\ni am trying to lay down to sleep. I am tired but the inside of my upper arms feels tight and my arms feel heavy. I almost feel like climbing out of myself inside. I am calm. I have no anger and am not upset about anything. Just finished having a great day with my family. I am male and almost 48 years old. My circulation in my arms feels restricted.",
    "doctor_response": "Hello, Consult a pain physician and get evaluated. An ECG is required to rule out cardiac causes like angina even though it is unlikely. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I took tablet Metronidazole 5 hours after I had taken 20 ml of red wine. What can I do now?\n\nHello Doctor, I took tablet Metronidazole 5 hours after\u00a0I had taken 20 ml of red wine. What can I do now?",
    "doctor_response": "Hi, Metronidazole and alcohol interaction causes disulfiram-like reaction. This leads to nausea, vomiting, tachycardia (increased heartbeat), shortness of breath, etc. If you had consumed red wine 5 hours before the drug intake, then it is all right. There is nothing much to fear. You may have nausea and vomiting, but that would be minimal and temporary. 5 hours is ample time for the wine to be metabolized in the body. For further follow up, consult a family physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for pain and numbness in the thigh and legs?\n\nHi if i had a ACL, a MCL ( torn-snapped in half ) repaired also tears in the meniscus & tears posterior horns, grafts from left leg to help right, in a brace for 4 months before op, had severe pain straight from operation etc when standing whole foot throbbed, swelled & could bare to be standing, aching day night no sleep, numbness from thigh down ( in both legs ) then manipulation 2 weeks after that & 48hrs manipulation machine, pain blocks in back 3 months later, couldn t stand or sit or laying for long periods & always the bad leg with pain.. 4 yrs on still pain both legs are numb thigh down ( including graf leg L ) burning pain down front leg into toes, crunching in knee cap, no full flexation or straight.... but have no nerve damage so i really would like to know where the numbness in both legs are from & what would the rest problems be from.. thank you",
    "doctor_response": "numbness above knee level is coming from lumber vertebra propably due to the 4 month in brace and long term inactivity your knee flextion limitation is expected if numbness apears only in the morning then it should go away on its own once you are active againotherwise you should do lumber CT scan to be safe Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for blue lump on the shoulder and dizziness\n\nHi, i m almost 18 and have a hard blue bump on my shoulder, at first i thought it was just a bruise but now it has turned into a lump/bump. it doesn t hurt so much ( only if i push it ) it feels like a bone, but in circle version. I also have little sores or rashes on my knees a long with flu, and a litlle dizzyness please help??",
    "doctor_response": "Hi I am Dr Fahim and I will help you with your queryI have through your question. Need more information to reach a diagnosis_ any history trauma on that side?_ can skin moves over the swelling?_ Far how long it was there and how you first noticed it?_ How is progressed over a period of time?Anyhow from the available information it appears to be bruise + hematoma formation. Local treatment like icing, steroid ointment application along with tab paracetmol 2 tab 8 hourly will help. It will resolve completely in few weeks. Do come back with answers of the above questions for better understanding of the problem.I hope my answer will help. Do rate it, if you like it.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having noticed spotting after the removal of copper T\n\nI have removed my copper t four months ago andafter thati had no periods for amonth and the next two months i have had spottings only for two days. I am foty six and my pregnancy test is negative what could be the reason my email is  YYYY@YYYY",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. After removal of Cu T bleeding may occur. But you noticed spotting after a month. Well, it can be due to drop of progeterone level. Watch out spotting or bleeding may occur for 5 days & in some cases for a month. No worries, if your pregnancy test is negative. But, if you have any discomfort & do not get regular periods, visit your gynae to have CBC done for anaemia & investigations to rule out pelvic inflammatory diseases, endometrial biopy, etc. Eat healthy, do regular exercises,  avoid addictions. Take care. Regards, Dr Nupur K",
    "dialogue_context": ""
  },
  {
    "patient_message": "My mum has hydrocephalus, kindly advice me\n\nmy mum has hydrocephalus an she doesn't seem to be getting any better after so many shunt operations. she has gone into a deep sleep. an the doctors are saying it is because of the medication they are giving her. can morphine cause her to go into a deep sleep?",
    "doctor_response": "Hi well come to HCM. Yes morphine can relieve the pain and as well pt can go in to deep sleep. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the bulge appearing by the belly button?\n\nI have a two year old little boy. Lately i have been noticing sometimes that he will move the right way or something that i will see a bulge by his belly button. I ended up calling his family doctor and they had me make an appointment for him to be seen. Well in the meanwhile I touch the area and it went away so when I got him to the doctors there was nothing there. So they told me to watch the area and if it did it again to call.",
    "doctor_response": "Hello!Thank you for the query.What you have noticed is umbilical hernia. It is quite common in infants. Usually it goes away at the age of 1. However if it still will be present at the age of 4, should be repaired with small surgical procedure (usually two stitches are enough to close it).I suggest you to consult a surgeon with this issue. As long as you can easily push into abdominal cavity, nothing serious is happening. You should be aware of symptoms like pain and hardness in umbilical area along with nausea, vomiting and fever. In such case, ER visit is necessary.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for hair loss and pigmentation on face\n\ni am 55 years female with hair loss , have tried several treatments, and have been to the dermatologist but have not been successful. hair loss started at the age of 38.condition is bad on the sides of my head and top. i feel ugly as i also have pigmentation on my face and people are alarmed when they see me and always comment. i am a bread winner and a clerk by profession and cannot afford to continuously spend money on these treatments.treatment that was given to me by dermatologist for hair was vichy shampoo, vichy aminex womem sp94 ,richelet hair strength selenium caps.For face kligmans formula 4%, scinderm herbal mulberry cream, vichy bi-even wash, luca critical wavelength spf30. after this treatment i was back to square one. DOES ONE HAVE TO CONTINUE THESE TREATMENTS FOR THE REST OF THEIR LIVES ?",
    "doctor_response": "Hello, I think you should check your thyroid hormone levels because Hypothyroidism can cause hair loss and also skin pigmentation. Also you may need to do a total blood count to check for iron deficiency anemia. Taking iron supplement may be advisable. Also if you have Hypothyroidism you may need to take levothyroxine. Using minoxidil can help you improve hair quantity. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Olgeta Xhufka, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Was a responsible child. Now acting weirdly. Took a treatment of Larium. Is it Catatonic symptoms? Treatment?\n\nWe have a son who has shown unusual signs for some time....this past four years.   He has studied at university, is very talented musicically , and is very athletic and physically fit,  but has shown some extremes .He is 28 yrs and had been working  with GNS Science in field of Geo Physics. He seemed at times disorientated in the latter 6mths out of his working for 2yrs there.  We were very concerned and made inquiries  after concerns where our son was doing bizarre things like running  for hours late at night  or deciding to experiment with physics problems etc to excessive hours etc or seemed apprehensive . Also  lacking insight in some situations where things are appropiate or inappropriate.    In the past he had always been very courteous, responsible, sensitive to needs and people's situations. So this was quite out of character and most unlike him, and made us realize something wasn't right with him. After making iquiries at his workplace we also  realized he had had treatment Larium  ( Malaria innoculation ) by his GNS Science Co as part of a prerequisite in case of posting in Indonesia.  We wondered if this could have triggered some of the behaviours now evident which point to possible Schizoprenia  especially Catatonic symtoms ( stationary in one position for lengthy periods) social withdrawal at times,explosive reactions, fear of cellphones , Internet, and not wanting to communicate or enter into any decisionmaking.  We have observed a deterioration and isolation, intolerance to light , curtains always drawn, repetitiveness and routine etc,   Because of the Privacy Act  we are not informed by his Dr or Psychologist and so we asked for a referral to privately have an assessment of his Mental state.   He is receiving some help from Psychological counsellors but we would like to see someone who could advise us on how to help our son recognize his need for specialist medical help as we also want to minimize areas of inaccurate diagnosis. We are his  parents and have been supporting him and caring for him but feel very shut out in helping for his recovery plan. It seems that the System is happy to allow his condition to continue for years  while we know that the longer this situation is left untreated the greater the damage can be to our son's health.  Please can you advise  what we should do . and possible harmful side effects",
    "doctor_response": "DearWe understand your concernsFirst of all let me assure you that there is nothing wrong if a man who is wholeheartedly doing his studies and is so concentrating that he is mistaken as catatonic. Visit any professional colleges and you will find at least 10% students like your son and they would be toppers. It is also common that parents don;t like these. They want their child to be active, social, lovable etc. Second. Have you talked to your son about this? If not talk now. If yes,what is the outcome. Let me know.I consider this as normal now. Mind you, You cannot judge your son as schizophrenic or catatonic because you are not trained in that area. Now a days people sit and play video games hours together without interruptions. Will you call them out of world?Please take your time to assess the situation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest good treatment for joint pains\n\nHI PLS I HAVE HAD PAIN IN MY LEFT LEG FOR 11 YEARS. I FEEL THE PAIN IN THE JOINTS OF THE LEG AND IT FEELS NUMB ESPECIALLY AROUND THE BACK OF MY THIGH. IT MAKES ME UNABLE TO STAND, SIT OR WALK FOR A LONG TIME. ALL I GET WHEN I GO TO HOSPITAL IS PAINKILLERS AND BALMS.PLEASE WHAT COULD BE WRONG?",
    "doctor_response": "Hello, Your symptoms seem to be related to rheumatoid arthritis. I suggest using anti-inflammatory medications such as Acetaminophen to relieve the symptoms. I also suggest using Voltaren cream for local application I suggest using ice compresses for relieve. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need tooth removal, suspect extreme natural of peridontal disease. Any help ?\n\nYes I need help in Dental area I m Indigent ---Take carte of Brother who is Impaired but if I don t get teeth out i m subject to dying due to extreme natural of peridontal disease----I don t have money I m filed for disability ---Have notes from emergency rm. that I m in need of this I almost Died in 2010 due to teeth they are dragging me down alom ng with other health problems",
    "doctor_response": "Hello, Periodontal diseases arise due to- Poor oral hygiene maintenance weak bone supporting teeth systemic diseases associated like diabetes,epilepsy,hypertension. Please do get an ultrasound scaling done. Brush your teeth twice daily in back-forth and up-down motion. Avoid vigorous brushing and always use soft-bristled toothbrush. Rinse your mouth after every meals. Hope this helps. regards DR.BINDIYA BHASKAR",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Laxido be taken for anenima?\n\nMy mother had to have an anenima two weeks ago due to constipation the district nurses said to give her laxido every day and try to find the right dosage to keep her going example half a sachet a day. Mum is 91 and suffers quite a lot with constipation. Up until now mum has only taken it when needed which is quite often. Is it o.k for mum to take axido in small does every day. from Sue",
    "doctor_response": "HelloThank You for contacting HCM.Welcome to Health Care Magic.My name is Dr Muhammad Ahmad & i will look into your problem.I have gone through your query and would try to help you in the best possible way.It's Ok for her to take laxido for her constipation she can take what dose suits her and she has to adjust the dose herself               Like if full pack make her stools very watery make it a half or a quarter for that matter,                   Give her more fibrous food like porridge oat meal or wheat porridge,replace simple milk bread with bran bread,  Anemia in this age is not a rare finding.                 Discuss your doctor about supplementation if anemia can be controlled by it.                  Constipation has many complications so its better that she doesn't have it for long.                  Yes !! it's ok for her yo take it in small doses every day. in this age a person loses appetite so keep her at goo hydration and don't expect her to eat a big meal like you 4-5 spoons of porridge an hour should do :)Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. Wishing her good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain, not pregnant. Done partial hysterectomy. Have diverticulitis. Pain after meals. Help\n\nI am having severe abdominal pain. Not pregnant; had partial hysterectomy. I have diverticulosis/itis, and every time I eat anything, I have an attack, as of this week. They are getting worse and worse and feel like labor pains!! I also have PCOS, degenerative disc disease, hbp, diabetes, and possibly IBS, colitis and fibromyalgia. I can't take much more of this pain! Because of all of my health issues, it's difficult to pinpoint anything. Help!!!",
    "doctor_response": "Hi, Thanks for posting your query. Do you have acidic belching/ abdominal discomfort/ gargling sound in abdomen/ abdominal bloating after taking meals? Does he have retrosternal burning pain causing difficulty in swallowing? Do you have fever/ spasmodic abdominal pain? Pain after eating is very characteristic in cholecystitis, pancreatitis and peptic ulcer disease. You should consult with internal medicine specialist/ gastroenterologist and should go for thorough check up. You should also go for complete blood count, Ultrasound imaging abdomen, thyroid profile, blood sugar, x ray abdomen and serum electrolytes. Meanwhile, you should take proton pump inhibitors along with prokinetics for relief of your symptoms. You should also take tramadol for relief of your symptoms. You should also take plenty of water and perform increased physical activity. Avoid oily and spicy food, tomatoes, citrus fruits, excessive tea & coffee, chocolates. Take soft diet along with yogurt. Take care, Dr. Mayank Bhargava",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can high fever in a teenager need immediate medical attention?\n\nMy 16 year old son has fever (39.8 degree celsius) this afternoon around 5:45 PM so 1 tab Paracetamol 500 mg was given to him per orem. Fever was monitored and went down to 38.2. By 8pm, his fever went up to 39.4 so another tablet of Paracetamol was given. It's 9:30 PM  but his fever has not subsided. Should I bring him to the ER already?",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Yes, if the facility of immediate treatment is available than you can go for the treatment immediately.You can do the laboratory testing of blood for the malaria, typhoid, dengue. Also get tested for urine microscopic examination.This will give you catch about the possible pathogen.Till that time I advice you to take the paracetamol to cover the fever. Please drink plenty of water.Please check for any serious sign like high fever, unconscious ness and hemorrhage. If this happens than you can immediately transfer to the hospital.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for increase penis size\n\nHi, may I answer your health queries right now ?  Please type your query here... hi doctor this is chetan sharma from dausa my sex organ has decrease in size so my married life is destroing i can't satishfy my wife kindly consult me to increase my sex organ and power.",
    "doctor_response": "Hello, I have reviewed your query and here is my advice. Increasing the size of the penis after the age of 20 is almost not possible other than the reconstructive surgical way. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for persistent vertigo and excessive sweating\n\nHello, I am a 50 year old woman , in very good shape and health. About once every couple of months I suddenly get very weak and feel very faint that I have to lie down! 5 to 10 minutes later when I start feeling better I break out into a sweat from head to toe. This has been going on for about 5 years!! I look forward to an answer! Thank you!",
    "doctor_response": "Hello!My name is Dr. Aida and I am glad to attend you on Healthcaremagic!Your symptoms are suggestive or orthostatic hypotension or hypoglycemia. Dehydration can lead to this clinical situation too. Coming to this point, I would recommend consulting with your doctor for a physical exam and some tests: -a  Head Up Tilt test for orthostatic hypotension- complete blood count for anemia- fasting glucose and glucose tolerance test- a resting ECG. Meanwhile, I recommend you to monitor your blood pressure frequently. Hope you will find this answer helpful!Kind regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat painful lump on the arm ?\n\nHello, I have a painful lump that appeared on my arm a few weeks ago. I thought I at first had been bitten by something but now I m really not sure. I have put neosporine on it but that just makes it look worse. The pain is only present when I accidently hit it on something. I have been unemployed since 2008 and have no health insurance...don t know what to do.",
    "doctor_response": "Hi,Dear,Thanks for your query to HCM.Studied your query in full depth of its details.Reviewed it in context of your health concerns.Based On the facts,You seem to suffer from-painful lump on your forearm caused from bruise,with infected skin around it.It seems to be caused from wound infection with abscess developing in it/ or could be from infected hematoma ,which got resolved with infection cellulitis,causing pain on hiting only.So it appears to be resolved hematoma or chronic resolving abscess.USG would confirm the extent of its spread and its volume depth.Treat-Antibiotics- x 7 days timeTab NSAIDS-x 7 days timeBlood Tests for-DiabetesSurgeons opinion with USG evaluation of the painful lump.IF need be-Surgical Drainage and Evacuation of the infected resolved hematoma / or chronic abscess with debridement of abscess wall ,with pressure dressing for 2-7 days time.Hope this reply would satisfy you and would help you to plan further treatment with your doctor there.Welcome any further query in this regard,which would be replied in next session..Good Day!!Dr.Savaskar M.N.Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intense collar bone pain after an injury?\n\nOn June 20, 2017 it will have been 3 weeks since I broke my collarbone in 3 places along with 2 ribs after a fall. The pain seem to be getting worse. The Orthopedic Dr. says it will feel better in another 2 weeks but the pain seems to be worse as time goes on. I spent a week in the hospital on morphine. I came home and saw Orthopedic Dr., he prescribed Oxycodone and I plan on calling him tomorrow as I don t see any improvement. I m not scheduled to see him for another 2 weeks. Am I doing the right thing?",
    "doctor_response": "i clearly understood what you are facing.. look there is multiple fracture in your collar bone so it will took time to unite, until it start unite you will feel pain..i suggest to my patients apply collar brace ( figure of 8 ) with a sling on affected site with some analgesic and calcium medications.once it start healing your pain will start subside..you go to your doctor and be punctual and take an x ray to confirm healing..hope i solved your problem..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can multiple myeloma be related to chest infection?\n\nMy father is 82 years old and a multiple myeloma patient for the last one year. He has been maintaining very good creatinine and urea levels. On 17th Jan his creatinine level was 0.6. However on 25 he developed a chest infection and went into dizziness. He was treated for chest infection with antibiotics which did not improve his condition much. when on one particular day he did not pass the urine he was hospitalised. Doctors after treating him for the electrolytes imbalances and waiting for 2 days declared him to be suffering from ARF. He has undergone two dialysis. Doctors say that revival of kidneys is possible. My question is how long and after how many dialysis it would be decided whether he suffers from permanent damage of kidneys or not. Please reply.",
    "doctor_response": "This is a very difficult thing to predict because it depends on the severity of his kidney injury and the signs of improvement he has shown. The best sign is urine output; if this improves, the prognosis is good. It may take several weeks for the kidneys to recover after a serious infection however.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will chest congestion pills cause vomiting and diarrhea in infants?\n\nMy 13 month 10kg son has chest congestion last week and our doc recommended antibiotic and xpecy ls ans macfasr for fever....post he was better now he started to vomit and has loose stools doc prescibed ondem can u pls help he has been vomiting and loose stools since 2 days",
    "doctor_response": "hiin one world the answer is -yes.vomiting  and and diarrhea is the common side effect of many drugs especially antibiotic groups.drug induced vomiting and diarrhea will be resolved upon withdrawal of the culprit drug.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is right time to conceive after treating ovarian cyst with medicines?\n\nI've(23yrs age) an 4cm ovarian cyst.My Doc prescribe OCP(Doluton-L) fr taking cont 12wks.Now the time is remained 2 wks to over.will it really dissolve?I've not any health problem during medicatication.can i try for pregnancy now?Plz help me what to do now?",
    "doctor_response": "Hi, I think if the cysts is simple, it will dissolve. You can try for pregnancy after stopping the tablet.  Be in contact with your husband every 2 to 3 days after your periods stop.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I have pain in right side across my belly button?\n\nI ve been having a pain in right side straight across from my belly button, just below my ribs. Reminds of a stitch in my side you get after running. I ve been on AdvoCare products since November 30th using MNSMAX supplements, drinking Spark and Meal replacement shakes. Sometimes I get a build up of gas (belching, farting). I have been previously diagnosed with GERD but do not and have not taken medication for it in a long time. The pain in my side is constant and sometimes gets worse when I have a bowel movement. Sometimes after eating, I feel like I could vomit but I have not.",
    "doctor_response": "Hi ! Good evening. I am Dr Shareef answering your query.If I were your doctor, I would advise you for a routine complete blood count, liver function tests, and  an ultrasound abdomen to rule out gall stones. If the ultrasound comes out to be positive for gall stone, or any other surgical/gynaecological problem, I would refer you to a general surgeon/gynaecologist. I would also advise you for a stool test to rule out amebiasis, and any worm infestation, which has to be ruled out especially if you are from such endemic areas and the treatment would relieve you of your problem.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anemia\n\nI went to my local blood bank to give blood today and I couldn't because they said i was anemic, I have never been told that I was anemic before. My level was below 10.5 and they said it should be at least 12 or higher. I have noticed that I have been very tired lately and also have been eatiing a lot if ice. What would you suggest I do ?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You have mild anemia. You should go for complete blood count with rbc indicies, peripheral smear examination and anemia profile. Find out the cause of anemia. It may be due to iron, vitamin B12 or folic acid deficiency or it may be due to some other cause. Take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Flucoxacillin advisable for re-occurrence of an abscess after a root canal treatment?\n\nI had stage one of a root canal on am upper premolar on Wednesday, and it's still a little painful - my dentist hasn't quite finished drilling the roots out. That's scheduled for next week. Question is, my cheek seems to be a little swollen now, even tough the pain has subsided compare to yesterday... I'm worried that there might be a slight infection there.I have some Flucloxacillin tablets - 500mg. Will taking them minimise the risk of another abscess forming?",
    "doctor_response": "Hello and welcome    As I had gone through your question I can understand your concern.    As you said pain has been releaved this this because of the pulp exterpation (removal of pulp) and the pus is draining easily through the opening.   The swelling is because of infection and you need to take antibiotics like Amoxycilin or flucloxicillin  and anti inflammatory drugs for that Ibuprofen for pain management.  Yes you can take 500mg 4times daily if you are more then 18 years and your weight is more then 60kg.  Hope my answer will help you, in case of any further questions we will love to help you.. Regards Dr Muzaffar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shoulder and neck pain with heavy head and eyes?\n\nhi my name is david. ive been experincing neck and shoulder pain mainly on left side of body!! i have been getting headaches mainly at the back of the head and eyes feel heavy. ive been sleeping ok, im a decorater and i think i hurt my neck doing a ceiling a month ago. the other symptoms im getting are my left ear canal and glands seem swollen. im not in alot of pain but getting abit tired of it!! some days are better than others but it just grinds me down, its just the balance and wobbly feeling i dont like the most!! im on beta blockers for HB. and have had problems with glue ear where i had a t tube fitted in my left ear drum but came out last month after four years, can you give me any insight ? thankyou",
    "doctor_response": "Hello, Cannot say in your particular case, but generally, the location and movement of pain give clues as to what is going on. and pinched nerves at the top of the neck go to the back of the head. Of course, ear infection also can cause headache and is a more acute problem needing fairly immediate attention. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach ache and oily stools in children?\n\nHi I have a 3 year old son he was complaining about his tummy hurting tonight...well the he tells me he has to poop...so I took him to the bathroom he used it the poop looked fine but the water looked like it had oil in it...what could this be? It s also the first time this happened",
    "doctor_response": "Thank you for the query.By your description of the problem, at this juncture its advisable to wait and watch.Quite possibly this time it was simple cleaning of bowels.But it is advisable to consult a doctor if he develops lose motions, fever or pain in tummy continues or worsens.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for moobs\n\nhello sir greetings for the day!!sir i think i have problem of moobs though im not sure about it as i have never consulted any doctor. i have been goin to gym for the past two months but dnt see any change in my body structure especially the chest area kindly suggest,",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Male chest some times may deposit fat appear like breast called Gynecomastia seen in 1.Alcohol consumption. 2.Metabolic syndrome. 3.Drugs intake like Digitoxin, Spirenolactone, Ketoconazole and Cimetidine. 4. Abnormal sensitivity of chest tissue in teenage. 5. Hormonal imbalance etc. Until examination is done it is difficult to say what it is. Please consult your endocrinologist he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for red ring around areola while having breast cancer\n\nA friend of mine called to tell me she has a red ring around the areola and it's very painful.  She went to a surgen and was told it a rare form of Breast Cancer and they want to remove her breast in 2 weeks - I've been on line and cannot find out anything about this - it's seems very drastic.  please advise",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Red areola with painful tumour is seen in inflammatory carcinoma of breast. However it can be something elese.  You should go for mammography and biopsy of that lump.  It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause tender, moist skin in crotch area between testicles and thighs and treatment?\n\nI have a very tender, moist skin in my crotch area, between my testicles and thighs. It frequently itches. I also develop a long narrow crack of the outer skin (very superficial but painful) on the same area as if the skin is torn due to forceful excessive stretch. What could be the reason and treatment?",
    "doctor_response": "Hello welcome to Health Care magic.1. You can get rid of itchy ness by local hygiene and avoiding tight wears for some time.2.Do not pull abruptly the over lying skin, do it gradually of you have narrow opening, it will stretch over time.3.For the present crack whack you feel, give some time gap.Like to ask ? Do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy a possibility while experiencing nausea and headache?\n\nHi, I have taken divery tablets in June for two days and got my periods. In July as well my periods were on time without the tablets. However, I have this pukish feeling, headache, etc since my July month s period is over. Is there a chance of me being pregnant?",
    "doctor_response": "Hello dear. After end of 5 days bleeding during every period, a week later, from 12 to 15th day of menstrual cycle (average 14th day), ovulation occurs. During this time if fertilization occurs then there will be pregnancy. Now to know whether you are pregnant or not, you need to get a urine pregnancy test done.with regards- Dr Sanjay Kini",
    "dialogue_context": ""
  },
  {
    "patient_message": "Concerned about growth in ovary. History of ovarian cancer and celiac disease\n\nI have had many medical issues in my 37 years of life. Celiac disease , a mixed germ cell ovarian cancer 15 years ago then a giant cell tendon sheath tumor removed twice from my thumb. Just today I found out I again have a 5incj growth on my only ovary?!?! Can this all be tied together some how!! Do I have a auto immune disorder?!?",
    "doctor_response": "Hi, Growth of ovary should be carefully assessed. Abdominal imaging should be done and in case of any suspicion proper surgical intervention to be done to get the correct diagnosis. All the symptoms you have mentioned probably not interrelated.  Autoimmune disorder often associated with other symptoms. That can be suspected on proper history taking and clinical examination.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of swelling in abdomen?\n\nmy daughter is three and has some swelling on her right side just beneath her ribs acompanied with minor bruising and mild pain. she says its stops hurting when we put a cold compress on it. she also has been complaining of a belly acke the past 2 days. could this be something serious? thankyou samantha",
    "doctor_response": "Hi...This looks like a viral illness with costochondritis. But associated bruising is something which needs immediate medical attention. I suggest you get her evaluated by her pediatrician.regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "The ultrasound reveals peritoneal free fluid collection on the left inguinal region on the left upper portion of the testes. What does this indicate?\n\nDear doctor My son had a check up and was ultrasound and find out that he has a peritoneal free fluid collection on the left inguinal region on his left upper portion of his testes.may I know doc if what it is.does this condition is safe and does it have some medicine.tnx doc",
    "doctor_response": "Hi, As per your description, it seems like a condition called hydrocele (probably a small one). You can wait for a few weeks as most of them resolve spontaneously. If the collection persists you can consult a paediatric surgeon and get it drained. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of bump after nose piercing?\n\nDaughter got a nose piercing and now has a bump at the piercing site. She has tried the sea salt, & aspirin paste. She is reading online that Tea Tree Oil may help and some are even suggesting Dettrol. Is the Dettrol safe to use and could Tea Tree Oil actually work. She suffers from persistent Acne and is worried about using any oil on her face. Comments on these recommendations or Any other ideas on how to get rid of this bump is greatly appreciated.",
    "doctor_response": "HelloThank You for contacting HCM.The site has become infected. I would suggest you following things:> First & most important is to keep the area clean.> Don't touch it with dirty hands.> Clean it with detol or spirit> Then apply polyfax plus ointment over it(on outer aspect) in small quantity.> Take acetaminophen for pain (if occurs)> Wash hands before & after applying medicine.Report to hospital if:> Condition remain same after 3-4 days> Any unusual symptom appears> Condition deteriorates.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. Wishing her good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have venous thrombosis on leg after typhoid treatment. Does anticoagulant injection works in thrombosis?\n\nhello sir i have venous thrombosis on my left leg in ankle region and its is visible i can feel it is hard i got this after treatment of typhoid .and doctors detected thrombosis in two regions at thigh and at ankle due to thigh region i had pain but after feeling normal out of pain i discontinued medicine without doctor advice so thrombosis on my ankle still persist and that region become dark due to blockage of blood . During treatment he recommended me anticoagulant injection grefac and antibacterial medicine. Does an anticogulant can work alone in thrombosis age 22 male",
    "doctor_response": "Hi !Hi there, Thank you for posting your question. I will do my best to help youI have tried to understand your query to my best.Venous Thrombosis is not condition to be neglected.If diagnosed as in your case as mentioned ,do take complete treatment as advised by the treating Consultant.Venous Thrombosis is a condition in which a blood clot (thrombus) forms in one or more of the deep veins in your body, usually in your legs.The blood clot that has formed in your vein can break loose, travel through your bloodstream and lodge in your lungs, blocking blood flow (pulmonary embolism).Hence ,to prevent this complication which is serious , you will need to take a medicine called an anticoagulant which was prescribed to you as per Information provided (Injection Grefac) under medical supervision .Role of ANTICOAGULANT :-Anticoagulant medicines prevent a blood clot from getting bigger- help to stop part of the blood clot from breaking off and becoming lodged in another part of your bloodstream (prevents embolism)-Two different types of anticoagulants are used - (1) Heparin \u2013Available in two forms \u2013Standard (unfractioned)Heparin and Low molecular weight Heparin (LMWH) (2) Warfarin-Heparin is usually prescribed first, because it works immediately to prevent further clotting-After this initial treatment you may also need to take warfarin to prevent another blood clot forming ( as per Medical consultant advise if required)) -Standard (unfractioned) heparin can be given as an  intravenous injection -(this must be done in hospital under supervision)-LMWH is usually given as a subcutaneous injection-Warfarin is taken as a tablet. You may need to take it after an initial heparin treatment to prevent further blood clots occurringDiscontinuing treatment for the diagnosed illness -Venous thrombosis is not advised .My sincere advise to you is to consult the Treating Physician immediately or at earliest without neglecting .Prevention is better than cure.Thanks for trusting Healthcaremagic and posting your query. I hope that I have answered your questions fully and been of some help.If you have anymore questions please contact me again anytimeRegards,Dr.Sushma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is doctor consultation advisable for lack of motivation and tiredness in an adolescent?\n\nHello, I am 17 years old and I\u2019m trying to diagnose myself for depression. Recently my parents have divorced and our family has been falling apart with lots of internal problems. I can barely wake up in the morning and find the motivation to get dressed. I\u2019ve worn sweatpants and a sweatshirt 3/5 days at school. I can\u2019t motivate myself to do homework or anything really. This is unsual as I am a good student and athlete however, I just can\u2019t find the drive and motivation in me. I\u2019m tired 24/7 and I\u2019ve gained 45 pounds (used to be around 165 now 205). I still like to talk with friends and videogames help me escape from everything. Now a days I feel dismal sitting in my room in front of a computer trying to find something to do. Is this normal or should I consider going to the doctor?",
    "doctor_response": "Hello, From the description, it seems that you are depressed due to the events that transpired in your family. You can self motivate yourself to an extent. But help from a therapist should do wonders. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chronic ear infection due to use of allergy towards fake earrings. Is there any cure?\n\nHi Doctor, can i ask you something please? My ear is infected for a long time , i m 17 right now, I think it s because i only can wear gold/white gold/silver but ,when i was like 4 i could were those fake-earrings all the time? will my allergy ever end ?or do i always have to wear golden earrings? Thanks for your help!",
    "doctor_response": "Hello, People who have allergy to a particular metal would continue exhibiting allergy to it when it is used subsequently. You can abstain from wearing ear rings for a few weeks and then try again wearing those ear rings to which you have allergy to see if it has resolved, otherwise you would need to wear those golden ear rings all the time. Gold is one of the metals which is least allergic so is titanium therefore these are your options.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for psoriasis\n\nHi...sir my mom is suffering from psoriasis and take many treatment.When she take medicines then for a while r say for a period of time it gets cured and again come back.So plz suggest a treatment r good docs name and nos in chandigarh.     With best regard Vaneet Sial.",
    "doctor_response": "Hi,As you said your mother suffers from psoriasis...I would like to say few things about psoriasis... . Psoriasis is a chronic relapsing and autoimmune disease. You may be having scaly plaques on various parts of the body,scaly lesions on the scalp. Exact cause is not known. Genetic tendency, autoimmunitity,stress,dry wheather...etc may be responsible for precipitation and exacerbation of psoriasis. You consult dermatologist for firm diagnosis and treatment.I usually recommend cap acitretin 10 mg twice a day along with methotraxate 15 mg weekly in three devided doses 12 hourly...for psoriasis.This may be taken for long time till good response. Blood tests may be done to monitor the treatment. For itching, you may take antihistamnics like levocetirizin...Avoid steroid ,as there may be severe flare up after stopping it.She may apply mild steroid cream or calcipotriol oint on the lesions on the psoriatic lesions. She may apply moisturiser to improve the skin texture. She should avoid soap bath for few weeks..And she should be free of stress and worries as that might worsen psoriasis. She might get good result.I hope you got my answer.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump under teeth?\n\nI have a saw lump on my lower bottom bum at the bottom under my teeth. It is hard and veary painfull, my face feels swollen and alittle num and the tooth on top of it is veary sore and fells like its coming lose. Im 22 y fem and im scared i may have mouth cancer ?",
    "doctor_response": "Hi ! Good evening. I am Dr Shareef answering your query.Any gum swelling could be a benign or a malignant lesion and the differentiation could be made only on a clinical examination and related radiological and histological investigations which might not be possible over net. Therefore, I would suggest you to get appointment with a general surgeon/maxillo-facial surgeon for a clinical assessment and further management.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can one conceive with hormonal imbalance?\n\nHi,this is Pauline,i am 23 now and i have been married for about 1year. My husband and I were trying to have a baby,but we failed because I have hormonal imbalance. I want to have baby this year. What shall we do? please advice me what to do. Thanks and more power. God bless",
    "doctor_response": "Hi, I think you can take some medicines like clomiphene for the growth of your follicles and track your follicles growth by repeated ultrasound.  When follicles reach a size 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.  Just do a thyroid profile and prolactin levels for yourself and a semen analysis of your husband.  You can also do a tubal patency test.  Discuss with your doctor regarding this.  If it is normal, you can go for IUI also. Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is bruise in legs with tender lump a symptom of protein s deficiency?\n\nHi, I am 25 years old and have protein s deficiency. Recently I have been bruising very easily, particularly on my lower legs. Whenever I have a bruise I have a hard, tender lump underneath the bruise and my legs feel tired and ache. Is this normal and could it be related to the protein S deficiency? Thanks.",
    "doctor_response": "Hello, It could be an abscess or hematoma. It is unlikely to be related to protein deficiency. If there is any diagnostic confusion an ultrasound scan can be tried. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is redness on the inside of the throat a concern?\n\nMy child just finished amoxicillin for an ear infection, last dose today, i was looking at my throat due to drainage and my 2.5 year old son wanted me to look at his, so i did and he has a lot of red veins on his tonsils/throat, his throat doesn\u2019t hurt and no white spots. Is this normal??",
    "doctor_response": "Hello,Any throat congestion in children is a concern. However, I assume he does not have any symptom of throat infection like fever or throat pain, and you also mentioned that he is on his last day of antibiotic.I would recommend you to wait and watch for any symptom of infection, no further intervention required as of now.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Ravi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling and pain in mouth after root canal treatment\n\nHi, I had two root canals done yesterday(about 31hours ago). I am taking T#3 and my two teeth are still hurting. There is some swelling and My gums over the two teeth are purple, there is also some bleeding. I am grugling salt and icing my face. I am not sure if I should do anything about this or if it is normal. My mouth hurts. Please Help! Jody",
    "doctor_response": "Hellois your root canal complete or the doctor has called for next sittings?are you taking any antibiotics also?it may take 2-3 days for pain to subside.but if the pain is severe then you should  consult your treating doctor.generally the pain subsides soon after the completion of root canal therapy.Hope this answer helps.RegardsDr. Shesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My father has severe headaches and nausea. I want a second opinion on his MRI of brain.\n\nHi doctor, My father is 70 years old, and he had severe headaches and nausea a few weeks ago, so the doctor ordered an MRI brain. \u00a0Based on the results, he is taking some medications and is doing well. I want a second opinion, just to be sure that there are no other issues. I am attaching his brain scan results. He had an open heart surgery 11 years ago, to remove some blocks.",
    "doctor_response": "Hi. I have gone through your query and the reports (attachment removed to protect patient identity) with diligence and would like you to know, that I am here to help you. Let me know if I can assist you further. Revert with more information to a neuro surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sleeplessness and tiredness while treating visual hallucinations?\n\nMy father is 78 years old and was admitted into the hospital for hallucinations. They have given him meds to help him sleep, but it\u2019s not working. When he gets sleep, he seems to be more himself, but for some reason he can\u2019t sleep and he is so tired. What do we do? He\u2019s talking out of his head, sometimes he doesn\u2019t know who we are. The hospital done several tests including UTI and for infection. He has a bad heart. Please help!",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I have read your query, many times inadequate sleep results in hallucinations. These symptoms will get resolved if adequate sleep is obtained. You need to consult a Clinical Psychologist or a Psychiatrist 'cause your father needs medications else symptoms may complicate to paranoia. In the meantime keep him well hydrated with ORS & nutritious food to maintain the electrolyte balance. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for lump on clavicle extending upto neck?\n\nI went to an ear, nose and throat doctor last week.   He just told me to get a CT scan and contact a bone specialist.  My problem is in my neck.   On my clavicle there is a lump getting bigger by the day,  it is mass extending over and up to my neck.   This Dr. Doesch said he did know what it is.  He is supposed to be specialist in this field.  I got on line and found what looks and sounds like my lumps, Laryngocles.   Can you tell me who to go to in the Cincinnati or Dayton Area?    I live in Lebanon Ohio  45036.  I have asthma and I cough so much especially at night going to bed, I have to sleep with my mouth open so I can breathe.   Please tell me what to doLinda Leak     age 66",
    "doctor_response": "HI.Laryngocele is compressible, can be pressed and may be with a sound.Get a CT of neck (and chest also)done and is this is mass do not waste time , get FNAC done. Tell CT people about your asthma.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump near area where hip and abdomen meet?\n\nHi, yesterday I discovered a lump where my hip meets my lower abdominal area on my right side. It's not very big, and it's not hard, but it is slightly painful. I've had multiple ovarian cysts on my right side, but this is higher up than where my ovaries are. Should I be worried?",
    "doctor_response": "Hi,This may be a hernia but would need examining to confirm this. I suggest you see your doctor for assessment. Regards,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "I feel numbness through out my body when angry. Is it physical or psychological ?\n\nHello, I am one of thoes people that rarely get mad even though I have good reasons to be mad, but when I do get mad I tend breathe heavily and get a strong tingly numbness feeling throught my whole body. Is that a problem? If so is it a physicaly problem or physcological?",
    "doctor_response": "Thanks for your query to HealthcareMagic.Based on your description, it appears that when you tend to get angry, you hyperventilate (increase in the number of breaths per minute with your breaths becoming short and quick) . Your feeling of strong tingly numbness throughout the body could possibly be due to hyperventilation. Some of the other common symptoms which people usually report with this are- dryness of mouth, tremors of hand, sweating in the palm and/forehead, palpitation,and giddiness.If you come to an understanding that you do tend to hyperventilate when angry, do the following-- Relaxation and breathing exercises. If you are into Yoga, Sawashana and Anulom-Vilom can be handy.- Anger management can be done through meditation. It appears that you might be into meditation as you seem to suppress your anger more than other people. Hope this information will be of some help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a chance of cancer being cured for a person having heart problem, sugar patient?\n\nmy friend is suffering from cancer.  doctor says it is in 4th stage.  He was having heart problem and also sugar patient.  he was very weak. he was not in a position to walk. doctors says he will live only 6 months.  in this condition is it possible to cure cancer ?",
    "doctor_response": "Most stage 4 cancers confer about the same survival as mentioned by your doctor,Heart and sugar problems rarely restrict treatments in cancer, Any treatment received will palliate his symptoms and prolong his survival further by months.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long would it take for me to find out if I m pregnant?\n\nI ve been off of the depo povera shot for about a month. I ve had some irregular spotting and some abdominal pain. It s been about two weeks after intercourse. My breast have been a bit tender and a off whitish/clear substance came from my breast. I took an at home pregnancy test and it came back negative. I wanted to know how long would it take for me to find out if I m pregnant?",
    "doctor_response": "Hallow Dear,Breast secretions during pregnancy start usually 2 weeks after the missed period. I would advise you to wait till you miss your period. If you miss it, then also carry out urine pregnancy test after 8-10 days, that too on overnight first morning urine sample. Done earlier, these tests may give false negative results. Alternatively, you may go for Beta hCG test which gives reliable results even few days before missing period. The possibility of post Depo Provera irregularity and spotting should be kept in mind, however should not be presumed. If your pregnancy tests are negative, you are not pregnant. Then you have got two opions: 1. Wait for the periods to appear naturally. or2. Take Tab. Deveri for 5 days.  4-7 days after discontinuing them, you will get withdrawal bleeding. The choice is up to you. I hope this helps you.Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for heart ailments\n\nHi, yesterday l had a shooting pain in my chest that went up my neck and up into my sinus and someone passed by that l knew at that time and asked if l was ok coz l looked really tired. Was wondering if it might be an early heart attack warning? Female non smoker about 7lbs overweight on 10mg baclofen daily",
    "doctor_response": "Hello Thanks for posting at HCM.Your symptoms do not look typical for early heart attacks. It seems to be more like hyperacidity and burping sensation coming from your esophagus (food pipe) causing shooting pain in the chest and going upwards into the neck and coming out through the nose. Please take a course of antacids for 14 days. If still you continue to have the symptoms, please do a treadmill test in which you are made to walk on a treadmill while your ECG is continuously being monitored. This will help us evaluate if there is any cardiac involvement also.Wishing you good healthRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain and pressure in my chest\n\nIve been smoking crystal meth on and off for about 7 months now. When I smoke now I sometimes feel pressure and pain to the left side of my chest, especially around my heart. What does this mean? Its only been a few months Ive been smoking, but I do have alot of gas when I smoke due to my binge alcohol drinking.",
    "doctor_response": "Hi thanks for contacting HCM...You are mentioning gas problem...So if you have chronic constipation then yes chest pain can occur....So for it more water intake ....with fruits more.Fiber food like whole grain , wheat bran taken....Fiber supplement useful...Avoid gas forming food like cabbage , cauliflower , onion etc....Second if you have cough also with chest pain then bronchitis also has to be ruled out...Chest x ray useful for it....If needed for detail respi examination then spirometry done....Finally to rule out cardiac cause ECG or echo done....With keeping this in mind consult physician for your detail examination and accordingly investigation...Hope your concern solved...Take care....Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Done abortion. Done follicular study. Taken HMG injection, duphaston, susten. Any chance of pregnancy?\n\nI got aborted on 5thj November 2012 and got LMP on 1st Jan, 2013 N i was going through the Follicular Study & Injected by HMG 75IU thrice and the injected for Rapture the eggs on 16th day the size was 18mm now egg got raptured on 22nd day with 30mm size. Please confirm me still there any chance to get pregnant. I m also taking Duphaston & Susten 300.",
    "doctor_response": "Hello, Thanks for the query, Ideal size of the follicle at the time of ovulation for it to fertilize is 18-24mm. Since the size of your follicle was 30mm at the time of rupture, there are less chances of conception or pregnancy. Duphaston and susten are given to sustain pregnancy and to reduce the chances of abortion in high risk pregnant women. Hope this helps, regards, Dr Nilofer",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the persistent lower back pain I am experiencing be related to spinal injury?\n\nHi, I had a spinal injury 2 years ago. It was an anvulsion fracture in the lumbar spine. That\u2019s what I was told when I went to the ER. But when I went to a specialist he said I was completely fine no injury whatsoever and shoed me out. Now it\u2019s two years later, my lower back has not stopped hurting since. I can not bend over properly, my legs go numb, I get frequent headaches, and shooting pain in both legs when sitting. I got the injury from a horseback riding accident. I can\u2019t even function properly at this point. There is not point in time when my lower back does not hurt really badly. I am at a loss. I went back to the er they said I have the same injury, asked why I didn\u2019t go to the specialist, then sent me back to him again. And this time he didn\u2019t even see me. He came out to the waiting room and told me I\u2019m fine and go home. Now I don\u2019t know what to do.",
    "doctor_response": "Hi, Your symptoms are suggestive of nerve compression in lower back, which could have resulted due to your back injury. You should undergo an MRI of lumbar spine to determine the exact nature and cause of nerve compression. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sudhir Kumar, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "41 year old pregnant got the ultrasound report saying gestational sac and yolk sac, no pole sac found. What does it mean?\n\nHello, My name is Lisa. I am 41 years old and pregnant for the first time. Last Wednesday I had my first ultrasound at 6 weeks and 3 days pregnant and it only showed the gestational sac and yolk sac. No pole sac was detected. What does this mean? My doctor is going to repeat the sonogram again this week, but I am nervous and just looking for some input. Best regards",
    "doctor_response": "hello,You are elderly primi gravida and carrying pregnancy of 6 wk plus as on USG.Early scan may not reveal detail of FPP and need to wait at least 2 wk for repeat scan to get details with fetal heart beat and pole. May undergo TVS (Trans Vaginal Sonography) to get early details than TAS (Trans abdominal sonography). On TVS, you get details of fetal pole/cardiac activity around 6 wk gestational age. So consult with your doctor for suggestive measure.Continue folic acid supplements,protein rich diet,avoid long journey/heavy work,maintain personal hygiene,take adequate rest.Be well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does PANDAS cause urinary incontinence?\n\nMy 9 year old son was diagnosed with P.A.N.D.A.S 3 weeks ago (he is currently on penicillin). He has never had trouble with restroom issues but has urinated and soiled his pants on seperate occasions since his last dr s visit. He is going to see the dr in 2 weeks but should I be worried about this new possible symptom?",
    "doctor_response": "HiWelcome to the HCMI understand your concerns. PANDA syndrome is associated with acute behavioural and neuropsychiatric changes. Bed wetting and incontinence is a part of the spectrum of this syndrome. So, you should definitely discuss them along with the other details on next visit to your doctor. Don't worry as many cases do improve completely with proper cognitive behavioural therapy and medications such as SSRI. Hopefully this will help you. I would be happy to help you in any further questions.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for strained calf muscle\n\nI believe I strained my calf after running in hot weather while not well hydrated. I have been taking it easy and giving myself a lot of rest, but when I try to run, it feels like I am straining it again after about a mile, every time I try to get back out.",
    "doctor_response": "Hi, As per the history I see , I should be related to the post cramp induced pain. which is a common symptoms while running in hot weather. I would advice you to slow down your running/jogging. Also along with your regular workout routine you can add a pinch of salt and sugar to the lemon juice so you don't lose more sodium from the tissue and avoid cramps. Keep yourself more hydrated. You can use hot water fermentation to relax the muscle and ease the pain/swelling. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes redness around anus?\n\nHi my 15 month old daughter s anus area has been red for over 2 months. It started out when I gave her antibiotic for ear infection and with that she got yeast infection in the diaper area. The yeast infection went away with anti fungal cream but the redness is not going away. It looks really bad. Now using topical antibiotic ointment but what if the redness doesn t go away?????? Help",
    "doctor_response": "Hi Dearwelcome to the HCM,Deworm the kid with single dose of albendazole.Some probiotic to be given orally.antifungal cream with mild steroid application at the anal verge will relieve the symptom.Hope the query is answered.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in elbow\n\nHi I have had a terrible pain in my right arm at the front of my elbow where my arm bends, it comes and goes very randomly but when I do have the pain every time I bend it fully or straighten it fully the pain is unbearable but sometime with abit of fiddling about with my hands the pain goes into I bent it again Any ideas would be wonderful",
    "doctor_response": "Hi, The location and movement of a pain gives clues as to what is going on. going from an area in a line implies nerve and the funny bone is actually the ulnar nerve which runs over the outside of the elbow in a groove there. Rest and anti-inflammatories often help, but sometimes very slight surgery to relieve pressure is needed.cannot say in your particular case, but generally, this would be true. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can chlamydia be reinfected after 48 hours?\n\nBoth me and my partner were treated for chylamdia on the same day. The doctor at planned parenthood prescribed us two, 500 mg azithromycin pills and told us no sex until 48 hours. We waited about 57 hours, is there a chance we reinfected each other???",
    "doctor_response": "Hello, thank you for your contact to health care magic. If I am your doctor I suggesting you no reinfection won't happens in 57 hours. So do not worry you can start your sexual activity now onwards. If there is still itching the reason behind it may be something else. You can visit nearby doctor to diagnose the condition. If you have to ask me anything you can contact me. Dr Arun Tank. Infectious disease specialist. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "When can I get pregnant again after the right fallopian tube was removed previously ?\n\nI had an ectopic pregnancy at May09,2011 which my right fallopian tube was removed. When is the right time for me to get pregnant again and how can I avoid the risk of ectopic pregnancy again?",
    "doctor_response": "Hi! Thanks for choosing healthcaremagic.com.Post A Ectopic gestation,the outlook for future pregnancies depends on several factors, especially whether the other Fallopian tube is patent and also that side ovary is normally ovulating. As a general guide, after one ectopic pregnancy, 20 per cent of women will experience another ectopic pregnancy, 30 per cent will not become pregnant again and 50 per cent will have a successful pregnancy inside the womb. Best to start conceive is wait for a cycle or two for Hcg levels to drop completely till zero.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am unable to move the left side of my face properly since yesterday. Please help.\n\nHello doctor, I have not been able to move the left side of my face properly since yesterday morning. I went to the doctor yesterday, and he said if it did not improve to come back, but I can not get back into the doctor. I have pain under my jaw and now feeling in my tongue on that side of my face either.",
    "doctor_response": "Hello. I have read your question carefully, and I understand your concern. 1. Do you have difficulties also in closing your left eye or raising your left eyebrow 2. Did your taste change? 3. Did your doctor prescribe any medication? 4. What was your doctor's opinion yesterday, since he surely did a physical exam? Did he also check your ears? 5. Do you have other symptoms or is just the face involved? In general, if the answer for the first two questions is yes (not smiling properly, difficulty closing the left eye and raising the left eyebrow, if you chew food on the left side, you notice the taste is changed) and the symptoms are confined just to your left side of the face, I suspect a peripheral facial nerve palsy. The management plan that you should discuss face to face with your doctor, 1. Corticosteroid treatment within 72 hours of symptoms onset. After 72 hours, I do not recommend (like Prednisolon 50 mg per day for five days, then reducing the dose gradually over five days in total 10 days of corticosteroid therapy). 2. Artificial tears during the day and eye protection during the night. 3. Nerve conduction studies after 10-14 days. 4. Physical therapy (your doctor might give you a leaflet with appropriate exercises, or you could search on youtube for Bell's palsy exercises. I hope my answer was helpful. Feel free to contact me again if you have further questions or concerns.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to reduce uric acid level\n\nmy gender is female and age 63, height  168cm weight 73 kgs. during recent blood analysis the uric acid level was foun to be 6.5 and ortho doctor asked to bring below that level. I have knee joint pain dus to wear and tear and having pain while walking. But when I cycle there is no pain. Pl advice how to reduce uric acid.Fathima.",
    "doctor_response": "Hi,Thanks for asking.Based on your clinical history and query, my opinion is as follows:1. The Uric acid of 6.5 is within normal limits.  Normal levels are 3.6 - 8.5 mg/dl. If you still want to reduce, you can follow the next few thing.2. Increase fluid intake and avoid alcohol3. Check for medications like beta blockers, etc. They can also contribute to raised levels of uric acid.4. Avoid caffeine containing beverages, mushrooms, legumes, and organ meats.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tight penis foreskin after unprotected sex?\n\nI recently had unprotected sex with my girlfriend and I had no worries with my foreskin pulling back , but the next day my foreskin became verry tight , and felt different it had a leathery feel and now it's verry pain ful to pull my foreskin half way across the head of my penis , what is this and what should I do?",
    "doctor_response": "Hello and welcomethanks for your query. I shall make an effort to provide you with good professional recommendations specific to your questions.Based on the information provided by you it appears to be a case of STI (sexually transmitted infection)or  some allergy  to some substance  that you might have come in contact with or inflammation due to injury during sex.You can soothe irritated skin with a cool soak. Water can wash away any remaining allergens and help inflamed tissues to shrink back to their normal size. Wearing breathable fabrics like cotton might also be helpful, as the inflamed skin might need to breathe in order to heal. You can apply any over the counter penis health cream.Itching over other areas can be addressed by keeping the areas dry and either using over the counter antihistamine cream or taking oral antihistamine medication.If it persists after few days or it intensifies, I advice you to see doctor for examination and further treatment.Yet again, I duly appreciate your query to me, I do hope that have found something useful to help you and I shall be glad to answer any further apprehensions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes black stool despite taking Gutspore by a child?\n\nHi my son is 3yr old. Initially my son was having semisolid stool with black and some time greenish color. Doctor given bacilli 5ml once daily and an antibiotic. After 5 days there was not significant improvement. Then I went to other doc he has given gutspore 5ml thrice a day, taxim , satrogyl o,....Now stool is fully solid...But some time it is blackish. This all happening since 10 days...Doc told me not to give milk, wheat and sugar to my son.... But since day before yesterday fever is coming ...I m having pink berry syrup that I m giving 5ml thrice a day...But no significant improvement....What to do plz suggest.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. If the kid is active otherwise and feeding and voiding well, the color of the stools need not be worried about. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting. You need not worry. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatments for trouble in conceiving\n\nHi, I want to know some information. My sister got married around 4 yrs back. but till now no kids. How this hospital can help us? Please let me know some famous doctor who can check this. I will come and visit your hospital. Thanks, Dileep, 0000.",
    "doctor_response": "Hi I am aware of your concern and happy to guide you through this. Your sister can go to a gynaecologist where both she and her hubby could get tested. Initially her husband should get tested regarding his sperm count etc. If it is normal then only your sister would be examined regarding her problem",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the swollen lymph nodes in the cervix be due to cancer?\n\nHi, I am a 16 year old male of Indian descent and i have had a swollen cervical lymph node for the past 6 months or so. Since then, i have felt some other swollen nodes in the area as well as two in the left supraclavicular area. I havent yet had teh chance to go to a doctor for tests, but i am wondering whether it is necessary as i feel ocmpletely healthy with no night sweats,, fatigue or fever. I am scared i have cancer. What should i do?",
    "doctor_response": "most common causes rInfectionsViruses Infectious mononucleosis (mono)    Chickenpox    Measles    HIV    Herpes Common cold viruses    Adenovirus    Many other virusesBacteria    Streptococcus    Staphylococcus    Cat scratch disease    Syphilis    Tuberculosis    Chlamydia    Other sexually transmitted diseasesParasites    Toxoplasmosis    LeishmaniasisFungal    Coccidiomycosis    HistoplasmosisInflammation",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from critical upper abdomen hernia. What i need to do ?\n\nDear Doctor, I am Rani from India. My mother is about 64 years old and having critical upper abdomen hernia and severe pain. We would like to go for surgery for complete cure. I heard that is upper abdomen surgery is very critical because other organs like lungs, heart are very close and it is very critical. Could please clarify me how far it is critical and how much do we need to careful. Please help me with your expert answers. Thanks in advance, Rani.",
    "doctor_response": "Hi welcome to Healthcaremagic Hi... the patient is needed to be clinically evaluated and examined only then we can comment on the severity of the disease and risk of the surgery... The surgery done will be Mayos hernioplasty.. in which they will use Mesh to support the abdominal wall... which will get fibrosed and join with the muscle and Aponuerosis... Hope I have answered your question.. Takecare...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I go to cardiologist soon?\n\nHi, I went for Physical check up this morning. They did the EKG and told me that my heart rate is 52. So I was referred to Cardiologist. I had fever yesterday and took ibrufen tablets. Will it affect my heart rate? How soon should I go to Cadiologist?",
    "doctor_response": "Hi,Ibuprofen usually doesn't affect heart rate. Fever can affect heart rate only in very severe cases.Sometimes people have slow heart rates, which is normal for them, especially athletes.If you don't have any complaints, dizziness, weakness, episodes of loss of consciousness, there is nothing to worry, just refer to cardiologist for a regular check up.Wishing you good healthRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does safe sex on the 5th day of periods lead to pregnancy ?\n\nMy name is vivian and am 21yrs,5feet tall and weighs 54kg.i had on protected sex for the first tym on the fifth day my period end and since den ave bin feelin strange avin a yellowish and sumtym smellin discharge a wk later started feeelin pain im lower abdomen .so am so scared bcos i tink am pregant.pls hlp me are all did nomal or its part of ovulation .",
    "doctor_response": "Hi! Welcome to healthcaremagic.com.Discharge like that must be investigated ,must be some vaginal infection it is not normal.Please see a gynaecologist and get thoroughly examined to rule out STD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does using Phenobarbitone affect a pregnancy adversely?\n\ni had a threatened abortion, my pregnancy is only 6 weeks, i was admitted for two days, after my discharge, the doctor gave me phenobarbital, when i checked on line , i realize how dangerous the drug can be for the pregnancy. Please i am now more scared, i hope my pregnancy is not under any risk. Please what is the adverse effect of phenorbarbitone? please i need a quick response",
    "doctor_response": "Hallow Dear,Your doubt is valid. Phenobarbital has been assigned to pregnancy category D by the FDA. An increased risk of congenital malformations has been associated with use of phenobarbital during pregnancy. I would not advise you to take this medicine during pregnancy. Phenobarbital should only be given during pregnancy when there are no alternatives and benefit outweighs risk.In fact, Phenobarbitone might have been prescribed to you so that you take good bed rest. I feel you should drop these tablets and take bed rest without any sedatives. This is not a must medicine for the treatment of threatened abortion. Instead, you may start taking Tab. Sustain which is a Progestational medicine and will help stabilizing your pregnancy. I hope you got the message.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. l got a sore hard lump after the removal of wisdom tooth. Is it normal?\n\nHello doctor,I just got one side of my wisdom teeth removed both upper and lower six days ago, and I have another one scheduled after two days for the left side. The upper is 100 % fine, which they pulled. The lower they pulled the tooth without removing the root because it was too close to the nerve. I do have some stitching in this area currently on the lower cheek. Noticed a hard lump about 1 inch between my lower jawline and cheek area. Is this normal because of swelling or something else. Currently taking Amoxicillin 500 mg and Ibuprofen 600 mg. Please let me know what this hard lump is, also generally on the lower side where this lump is, remains sore.",
    "doctor_response": "Hello. The lump is mostly a hard swelling which forms postsurgical removal of the wisdom tooth or maybe even by swollen lymph nodes due to infection. It takes a week or two for the swelling to subside. Sometimes, if the root is still inside, the infection may be remaining there causing swelling. Get an X-ray done to find out the exact problem and stronger antibiotics like Augmentin (Amoxicillin and Clavulanic acid) along with a painkiller for a week. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can after MRSA pneumonia cause blood in the phlegm?\n\nwhat are the signs of MRSA pneumonia?  My 17yr old has a cough with phlegm and she says sometimes there is a small dot of red blood in her phlegm.  She is otherwise healthy, and functioning normally, except with this chronic wet cough.  Coincidently, my 19yr old is being treated for MRSA, diagnosed last week, characterized with facial boils.  Could my 17yr old have caught it but it manifested itself in her lungs instead of skin?",
    "doctor_response": "Hi, Thanks for using HCM.The signs of MRSA pneumonia are more or less like other bacterial pneumonia; only symptoms can be severe as it does not respond to common antibiotics. The common symptoms are fever, cough, sputum production, tiredness, body pain, headache, loss of appetite; sometimes chest pain and blood in sputum. Staphylococcus aureus is a common bacteria found in nose, mouth and skin; which sometimes cause upper respiratory infections, pneumonia or skin infections. it s called MRSA when this bacteria is resitant to Methicillin; and hence resistant to most of the common antibiotics.You should take your daughter to your GP and she needs to do some tests including Chest Xray, blood tests and sputum culture and sensitivity. Hope I have cleared your doubts",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing pain in both arms\n\nwhy do both of my arms hurt after a coughing fit and continue to hurt? i have been to the ER twice for this no diagnosis but going to prescribe antibiotics first time then second time extra strength tylenol. i told extra strength tylenol doesn t work.",
    "doctor_response": "Hello, As a first line management, you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist better to consult a neurologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I give soya yogurt and tofu for 10 month kid with milk allergy?\n\nMy 10 month old daughter has a milk allergy. I am still breastfeeding her twice a day but would like to stop now. She refuses formula (soya and Aptimal pepti 2). Can I simply top her up with Soya yogurt and tofu in the day for calcium or does she have to still have liquid feeds?",
    "doctor_response": "Hello. Welcome to HCM. Yes you can give her soy yogurt or tofu if she accept its. She can take all the liquids she need for water or other fruit juices don't worry. If she doesn't accept either of this you can take some calcium supplements for her.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What would non-itchy pink spots on the back of head be?\n\nMy 6 month old daughter had two pink spots on the back of her head yesterday. They are not raised. One looked like it may be a little swollen, but not sure. This morning They were darker. With kind of a greenish/brownish tint in the middle. Now they are just all red. Don t seem to be bothering her or itchy. Any idea what it could be?",
    "doctor_response": "HiWelcome to the HCMIt seems to be due to folliculitis. Most commonly it is caused by staphylococcus infection and need proper oral antibiotics such as penicillin or amoxicillin. An oral antibiotic course of 5 days with local fusidic acid application should help in complete resolution.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I have itching in my body after taking irovite?\n\nhi..i am 27 years old women.now i wish to get pregnant.after my last menses i started to take cap.IROVITE.but now i have very itiching in my body parts.i am not sure because of its side effects.now[ for 2 days ]i am stopping this tablet.can you please suggest another good iron tablet for pre pregnancy period",
    "doctor_response": "Hi,I don't think you need any iron tablets pre-pregnancy.  You can stop taking this tablet. Just folic acid tablet will be sufficient. For the itching, It may be because of some infection.  So please consult a doctor for that. May be you will need some antibiotics.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Khushboo Priya",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the exact dose of Meftal-P for a 22 months old?\n\nHi doctor, My daughter got fever since last night. It has been 24 hours and her fever is between 102 and 103.5 degree Fahrenheit.\u00a0She has no other symptom till now.\u00a0She is 22 months old.\u00a0We are giving her Fevago drops.\u00a0What can we do for her?",
    "doctor_response": "Hello. This could be a viral fever, so continue giving Paracetamol that is Fevago every 4 to 5 hours irrespective of fever. If fever is above 101 degree Fahrenheit, then start tepid sponging and give Meftal-P syrup (Mefenamic acid) instead of Paracetamol. If the fever goes beyond three days, then we can evaluate or investigate for causes of fever other than viral by means of a blood test and urine test. Generally, viral fever may last for three to five days and no need of antibiotic at this moment. For further information consult a paediatrician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest ways to alleviate lower back pain\n\nHi, i have been experiencing lower back pain by the tail bone on the right side for a couple years now but it has been getting worse. I cant exactly locate the pain i just know the area in which it is. It seems to hurt/swell when im on my feet all day or doing physical activity. Sometimes the pain is so bad that my legs shake and i cant move. I have tried ice, heating pads, muscle relaxers, hot tub, stretching, freeze it. But nothing seems to help.",
    "doctor_response": "Hi thank you for trusting usI read your query and understand your concern I am sorry for the symptoms you are suffering In my opinion you are suffering from lumbar discopathy, it provoke pain but you shouldn't worry too much as it isn't dangerous It can be confirmed by scheduling a lumbar CT scanMeantime you should wear a lumbar fortress and continue pain killers Hope I have been of helpWish you good healthRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and numbness in the hands while suffering from a pinched nerve?\n\nHi I have had a pinched nerve in my left arm since 2011. and have since had constant tingling and some numbness in my hand and wrist.. but as of late I have some like swelling or mass around my thumb and my hand now does not lay straight its going to the left. gave me great pain today not in my joint of hand but in the center. I also have arthritis but I really don t know what is causing this to happen now.",
    "doctor_response": "Hi, In my opinion, you are suffering from carpal tunnel syndrome (it causes pinching of nerve at the wrist). This position of hand going to the left is mainly because of arthritis in the hand. I suggest you get surgery for the carpal tunnel syndrome ASAP and then think in terms of getting a cure for arthritis. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffered from lower back pain, report shows Spondyloisthesis, causing severe degenerative change in facet and symphsis pubis. Cause for pain?\n\ni have suffered lowe back pain since i was 22,23. I have had many scans over the years to see what was wrong but always came back normal. In 2010 i had been said in a report that i had spondylolisthesis being caused by severe degenerative change in the facet joints bilaterally. There is uncovering of the intervertebral disc without herniation. Prominent calcification of the free margin of the disc at the right lateral aspect. There is mild central canal stenosis. Lateral recess is adequate. Nominal mild foraminal stenosis bilaterally in L5/s1. degenerative changes in the symphysis pubis. In the last 2 years i can not walk without getting bad pain where i had to get crutches and cant sit for long or stand for long. The more things i try to do the worse it gets. My doctor told me that this scan is fine and it is normal, but i dont understand what all this means.I wake up through the night with pains in both hips and bad bottom pains and tingling in my left leg",
    "doctor_response": "Hello. Thanks for writing to us. The findings of your MRI scan are suggestive of degenerative changes of the spine. These are causing the nerve root irritation causing the symptoms that you are having. Taking muscle relaxants and regular physiotherapy exercises can help in retarding the further deterioration. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have fever and headache after mosquito bite. Please advise.\n\nHi doctor, I was playing football and I had got bitten by a black and white mosquito. After some time, I got shaking and had a fever, head pain, and a back muscle pain.",
    "doctor_response": "Hi. According to the history, you have to rule out dengue fever, chikungunya or malaria fever. So take Paracetamol 500 mg two tablets for six hours until the blood tests are done. Avoid mosquito breeding places like stagnant water near home, wear full sleeve clothes. Take an adequate amount of fluids. The probable cause could be due to Aedes mosquito. You can get a complete blood count, IgM test for dengue, IgG for malaria, microscopy, blood smear test done. For more information consult a general practitioner online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is there a way to quit Zoloft without getting withdrawal symptoms?\n\nHi doctor, I am using 75 mg Zoloft for the past seven months for anxiety disorder. I have started with 25 mg and my doctor increased the dosage slowly for my panic attacks. But for the past two months, I do not have any strong panic attacks and when I have the small ones, I am capable of handling it. I want to stop to taking medication. Could you please advise me how to do it in order to avoid withdrawal syndromes of Zoloft. How should I quit? How much I should reduce the dosage and how long should I continue?",
    "doctor_response": "Hello. Zoloft (Sertraline) is a good medication for anxiety disorder. You are on a low moderate dose of 75 mg once daily (dose range is 50 mg to 200 mg once daily). It is good that you are feeling better for the past two months. It is recommended to continue Sertraline for at least six months after you are feeling better. So it is advisable to continue for at least another four months. During this period also develop psychological strategies to manage anxiety (talking therapy or CBT will help you to achieve this). If stable after four months, discuss with your prescribing doctor about gradually tapering down the dosage gradually. You can try cutting down to 50 mg once daily and see whether you continue to be stable. After a month, you can consider cutting down further to 25 mg once daily. Continue for another month then stop completely. Remember, if symptoms reappear at any time during tapering down, you have to go back on the higher dose. To sum up, continue Zoloft at least for another four months. Get CBT if not done already. Then if stable after four months, taper down gradually under medical supervision.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My son has eaten half a tablet of Metrogyl, does he need medical attention?\n\ni think my son has taken one of my husband metrogyl 400mg tablets, he was trowing up and then i found the tablets opened on the floor in my room with one tablet half chewed up and spat out on the floor. my son threw up a desent amount and then went a little clammy, he seems fine now and is sleeping but i have been keeping an eye on him. i was just wondering should i be taking him to the hospital or just keep an eye on him?",
    "doctor_response": "Hi, I do not think you need to worry about this. But for another two or three days he might not eat properly because of metallic taste in the mouth. Just keep him well hydrated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can be the reason for raised liver enzymes during fever?\n\nHi doctor, The issue is from 39 years ago. When I was 13 years old, I was considered for the possibility of poisoning. I was admitted to hospital for 8 days and the diagnoses were cervical adenitis and viral syndrome. I had a fever of 103 degrees for several days before going to hospital. My throat culture grew Strep. On admission to hospital, CBC showed WBC 12,900 (normal range), Hb 13.2, Hct 38.7, 36 lymphocytes, 9 monocytes, 7 eosinophils and the platelets were adequate. The almond size lymph node on the left cervical chain and the right side lymph was golf ball size. The neck was supple, no rigidity and some restriction of movement. There is no mass or thyroid palpable. The rest of the physical examination is within normal limits. Total bilirubin 0.4, ALT or SGPT was 714 initially and on discharge it was 215. SGOT or AST was 426 initially and 202 on discharge. LDH was 297 and then 217 on the day of discharge and albumin 3.8. \u00a0I am trying to figure out why my liver enzymes were so high initially and 8 days later they came down. I was treated with Keflex IV antibiotic, which cured the infection. Mono spot was negative. Urine and blood cultures are negative. From what I read, the liver cause could be toxic. But, at the of 13, I neither drink, nor had hepatitis.",
    "doctor_response": "Hello. Revert back with the answer to the above questions to an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does taking Deviry during pregnancy cause any complications?\n\nI use to have my periods on 21 every month. ON march 22 i got periods and upto now i didnt get again. I tested using prega news but result in negative. i consulted doctor and she suggested to take deviry 10 mg. My friends and parents are telling for some people pregnancy result might get late. As i am using this Deviry 10 mg is that going to effect if i am pregnant?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. If I were your treating doctor, then I would rule out other causes of irregular menstruation. In my opinion, first pregnancy should be ruled out with investigation e.g. USG. There after your line of treatment should be defined. For that you must consult your gynecologist. And yes, Deviry can adversely affect your growing child, if you are pregnant. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. There is heaviness in the body with dizziness and gastrointestinal reflux. Please help.\n\nHi doctor, There is heaviness in the body always. I feel like bursting whenever I lay down. I am grinding teeth, have dizziness, and gastrointestinal reflux.",
    "doctor_response": "Hello. The bursting and acid reflux problem can be connected to each other. But dizziness might not be due to acid reflux. For acid reflux, you need to take Pantoprazole like antacid for a week. Avoid the intake of excess spicy foods. Head should be elevated by putting a pillow when going to sleep. It is advisable to go to bed two hours after taking the meal. For dizziness, your blood pressure and sugar level should be checked first. You need to get checked your detailed otological evaluation for primary workup. Beta Histidine can be taken for dizziness. The anemia also can be causative sometimes, so rule out it by CBC.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for sternum pain when sitting, laying, breathing, coughing and sneezing?\n\nHi my friend cracked my back last night and pushed on my chest really hard at the same time. And right after my sternum stared to hurt very badly, and it still hurts today. It hurts when I sit up from laying down (sit up motion,) and when I take deep breaths or cough or sneeze. Is this serious?",
    "doctor_response": "Hi, As mentioned in history, I feel it will be a small hairline fracture over the chest. You can take the X-ray to cross it. The symptoms are indicative of the same. Doing deep breathing exercises while keeping the hand over the painful area should help the movement of rib cage to stay optimum and avoid any chest complications. Use hot water fermentation over the painful region for soothing effect. Also kindly avoid applying more pressure to the chest. avoid lifting heavy objects for time being. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for spider bite on the elbow\n\nI seem to have been bitten by spider near my elbow last evening that appeared as two welts...now I have about 11 and they are appearing to travel towards my hand. okay never mind. I don t have paypaly or credit card. thanks anyway. have a good day.",
    "doctor_response": "Hello, Thank you for your contact to health care magic. I understand your concern. If I am your doctor I suggest you that start antibiotic powder like neosporin. Take antibiotic like cefixime, aveclofenac, pantoprazole, Cetrizine tablet. It will be cured in a week or two.I will be happy to answer your further concernYou can contact me. Dr Arun Tank. Infectious disease specialist. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for small projection on the tongue\n\nhello ,,, my baby girl is 3 yrs old n she had a history of fall down n had teeth bite on her tongue..( when she was 1 n half) as she grown up we found a small projection appearing from dorsal aspect of tongue.. now it is cometically looking bad n also hampering her normal life ...kindly give me some resolution ...",
    "doctor_response": "Hello,I can understand your concern. The dorsum aspect of the tongue has rough texture. This texture is due to the presence of different papillae on the surface that contain taste buds. In case of your daughter, it is possible that some of the papillae are overgrown and giving projection like look. I would advise you to visit an oral and maxillofacial surgeon for the clinical examination of the tongue and further investigations. Treatment may include excision of the projection with minor surgical procedure.I hope this information helps you. Thank you for choosing HealthcareMagic. Take care.Best,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to become pregnant while having history of miscarriages\n\nhello Dr. I Wanna to know that I get married on 25th feb 2011 nd got pregnant bt whn it took 20 days miscarriage.and after that I again got pregnant bt whn 3 months spend my Dr. tell me that the hearbeat of ur baby has stopped since 1 month and i had to abort my baby.bt now I wanna to get pregnant bt I cant get pregnant.what i do mam?????? plz help me.",
    "doctor_response": "HI,i completely understand your concern because of previous history of two miscarriages.you must get certain blood investigations done like cbc,abo rh grouping,tsh,torch test,apla,ana,fbs,ppbs done to find out the cause of abortions.in the meanwhile you can start taking tab folic acid.you can also get a hsg(hysterosalpingogram)to see whether your tubes are open or blocked and if all reports are normal you can an ultrasound done to see whether you are ovulating or not.stop taking stress as stress  itself reduces chances of pregnancy.all the best and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly tell me if there is any alternative to bronchoscopy to get tissue for testing cancer.\n\nHello doctor, I have a family friend that recently was admitted to hospital for shortness of breath. She was advised that after several examinations that she has a form of cancer. The information that we were provided with was that they were unable to ascertain where or how severe the cancer was. Some confusion over whether it was thyroid or lung cancer and also its placement. The advice given was for her to undertake a bronchoscopy in order to do a biopsy of the lung. She had complications as a result of the bronchoscopy and was put in ICU for observation. That was last week, we have now been told that she will not recover and is too weak to breathe for herself and fight cancer. They have given her 48 hours. I really would like a second opinion because I feel we have not been told the full story. Would you recommend this procedure despite knowing that a patient was under stress with her breathing? Was there another way they could have gone about retrieving what they needed through a different procedure? I just want to quiet the nagging thoughts I have because I feel like this should have been a simple day proceedure.",
    "doctor_response": "Hi. Confirmation of any form of cancer is by biopsy only when the malignant cells are visualized under a microscope and reported to be positive. Rest of the radiological test like HRCT and MRI are highly sensitive but not specific. I am assuming that the cancer was either diagnosed by cytology or radiology in her case and they did a bronchoscopy to get the tissue they suspected of being malignant. Usually, broncoscopy is done under anesthesia and does not cause any complication. Probably the cancer had been more advanced in this case or the patient's physical condition was poor but anyhow there is no other way than broncocopic tissue examination to confirm the diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce swelling of the eyebrow?\n\nI was hit in very hard accidentally on my eyebrow 13 days ago. It swelled up and I had a black eye for over a week. The black eye went away, but my eyebrow is still tender and a little swollen. Should I see someone about it? If so, what kind of doctor should I go to? Thanks for your advice.",
    "doctor_response": "Hi iam dr.nallammaiWelcome to hcmDue to ur trauma,U hv developed  inflammation of eyebrows, u need nt worry abou it..it ll settle by taking the foll. Medications and ice fomentation..C.phexin500 mg 1-0-1 fr 5 daysT.serratiopeptidase1-1-1 fr 3 daysT.combiflam1-0-1 fr 3 daysT.rantac 150mg 1-0-1 fr 3 daysLast 2 tabs if u hv severe painT.bact ointment fr local applnU ll get well soon",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can B-Cell Lymphoma be treated ?\n\nI have B-cell Lymphoma and will be getting a transplant in the next few days.I went through clemo for a few months and their is still a few spots left on my chest . I was at stage two when I first started clemo. How long can I expect to live with this ? and will I need to see doctors the rest of my life?",
    "doctor_response": "well there are only three modalities of treatment Chemoterapy,Radiation and monoclonal antibody therapy. Now after receiving a transplant you definitely need to be visiting your docter as the compliance has  to be checked.so trust the treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My semen is reddish brown in color. Should I be concerned?\n\nHi doctor, I am a 35 year old male. Two weeks ago, I noticed that my semen was brownish. Again yesterday and today, it is the same reddish-brown, and I think it is more watery than usual. I do not have any other symptoms. I do have a varicocele, but I do not think this condition is related to varicocele. Should I be concerned?",
    "doctor_response": "Hi. The reddish-brown color of the semen indicates a condition called hematospermia. The most common cause for this condition is idiopathic inflammation of the prostate or seminal vesicles. Do you have any feeling of dysuria (difficulty in urination or painful urination) or incomplete voiding? So, a workup for this condition is digital rectal examination to feel your prostate and seminal vesicles and also PSA (Prostate-Specific Antigen) level. We usually treat idiopathic hematospermia with a Quinolone antibiotic for four weeks (to take care of any prostatic infection). We also give a two-month course of Alfuzosin and Dutasteride combination.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to lower sgpt and sgot levels?\n\nhello doctor i am having itching for the past one month. i went to the doctor last week. now taking rupanex tablet on alternate days. itching has reduced. but i am worried about my blood test as my sgpt and sgot levels are 142u/l and 44u/l, lympho-55%, eosino-4%",
    "doctor_response": "Hi thanks for contacting HCM...Noted you have high liver enzymes...Along with lymphocytosis present....So more chance of viral hepatitis....In liver affection itching can occur....Here USG or liver scan done to rule out if gall stone , fatty liver or cholangitis preset....Viral marker study by ELISA can be done for hepatitis virus B, C , A or E.....Meanwhile low fat diet taken with more fruits....Green leafy veg more...Avoid alcohol...Junk foods and non veg avoided....Regular follow up done....If hepatitis b diagnosed then repeat test for it done after 6 month to exclude Carrier....Take care....",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant vertigo, nausea and dizziness on right side?\n\nHi I had decompression of my Arnold chiari, in Dec 2013. Post op mri showed a pseudomenigocele. In March this year I started having the headaches again and numbness in hands and at times when headaches are bad I get pupillary changes, my right pupil is a size or 2 above the left. I had another mi which showed no change and my N S said if the symptoms are un manageable he would do a shunt as last resort.For the last 5 weeks I ve had vertigo and nausea, the dizziness occurs and goes quickly but is only over the right side. Nausea is constant heightened by turning my neck sideways. I m in constant pain and its worse of a night. It s at the site of my scar and is very deep seated. Also I feel foggy and forgetful and my concentration is awful. Friends and family although their kind their running out of sympathy.",
    "doctor_response": "Hello user..First of all u need to know that Arnold Chiari is a malformation for which permanent solution is still to be obtained..Firstly,although posterior decompression is the most favoured therapy it is not helpful in all the patients..m sure ur doctor has given u the right treatment because i cannot comment without seeing the patient and the images.Secondly pseudomeningocele is one of the complications of such a surgery.One more complication is cerebellar slump,which is due to cerebellar herniation through the defect and compressing on the right side of brainstem causing right cranial nerve palsies.All your right side symptoms could be attributed to them.Again its just one of the possible reasons.In my opinion u need a re exploration surgery with duroplasty.Hope I have answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can stopping of intake of Ecosprin 75 mg increase platelet count?\n\nI was given zivast 5 mg and ecosprin 75 mg fours back when my colastrol was 250 and platelets count were 250000 since then my colastrol remains 175 but platelets count has come down to 165000 so can I stop taking ecosprin 75 mg so that my platelets count can go up? Please advise.",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Ecosprin does not reduce platelet count, same way, stopping ecosprin would not increase platelet count.2. Ecosprin only helps in reducing platelet clot formation.3. 165000 is good platelet count. Only if the platelet count is below 100000, then only need to worry. Platelet count is not affected by ecosprin.4. Nutritional diet along with moderate exercises should help in improving bone marrow response, which elevated platelet count. At present, platelet count within normal range, not to worry.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from severe constipation with loss of appetite. Also have right abdominal pain from last 2 years\n\ni m male,27yrs. im problem having right side abdominal pain since last 2 years..before 5-6 month i have been getting another problem that is hard and dark stool but there is no pain in anus. my ultrasound , occult blod _ve, upper indoscopy and sigmoindoscopy is normal.. doctor other symtom is only loss of appitite. urine pass normally. no swelling in the neck..every day i drink water atleast 2 ltrs...doctor every morning stool not easily goes i must pus. its verry hard..doctor wht kind of problem is this...",
    "doctor_response": "Welcome to Healthcare Magic Good Day This could be due to sedentary lifestyle. Fast walking everyday for atleast 40 minutes to 1 hour. Eat more palak, spinach, broccoli in the diet everyday. Eat fresh fruits like banana, mango everyday. Drink 6-8 glasses of water everyday. Don't take tension. Do Yoga or meditation, deep breathing exercises to help relax. Be cool. You will be fine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for itchy rashes on the ankle\n\nI have a rash on my left leg at the ankle -it has hard small raised surfaces and is bright red shading off to pink. It is on my leg where the leg and ankle meet -it has not gotten any larger or better and itches at times. What shall I put on it to ease the tightness and mild itch? My leg is also awollen around the knee and should I keep elevatating that leg and if so how high. I am in a wheelchair much of the time.",
    "doctor_response": "Hi, It seems that probably you may be having contact allergic dermatitis at ankle area. Consult the dermatologist for the perfect diagnosis and proper treatment. I would suggest you to find out the contactant which triggers the disease and avoid that. It may be material of shoes,socks,the part of wheel chair,soap or other. Take tab. Cetirizine daily and apply mild steroid cream on affected area. Swelling of knee may be due to arthritis of the knee. Consult the rheumatologist or orthopaedic surgeon. Take rest with elevated leg about two pillows. Hot compresses might improve. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Ilyas Patel, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have Wegener s granulomatosis. Want information about treatment facility\n\nMy son, Md. Shawkat Ali is suffering from\"Rheumatology : WEGENER'S GRANULOMATOSIS since about quite few years. I am interested to know if you kindly suggest me about any treatment facility with name of Doctor and expenses to be incurred , possibly in Bangladesh or India, specially  Kolkata or New Delhi......... Thank you very much.My name is Jalal Uddin Ahmed, email : YYYY@YYYY , Mobile +88-0000 385 299",
    "doctor_response": "hello welcome to health care magic wegeners granulomatosis is disorder characterised by inflamation of blood vessels,,it may affect kidney lungs..reason for this is auto antibodies targeted to our own cells... treatment facility is there for this disorder,,it contains coricosteriod and an immunosuppresive drug to supress the immune status for a period of 18-24 months..and to maintain remission new drug is approved that is RITUXIMAB... regular maintenance is required after the treatment.. consult your local physician,he/she will guide you where to go..dont do late for this disorder.. hope you will understand my suggestion. thank you Dr siddartha",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for headaches and urethral irritation\n\nHi, Doc.am a young male who had a xposure with a girl who claims to be negativ about 6 months ago.i went down with a headache,chill but temp ws always below 37\u00a4c and some urethral iritation which have persisted to date.my girlfriend also went down with a flu like en the doctor we were seeing then diagnosed us with a UTI as urinalysis showed RBC ana LEUKOCYTES.my girlfriend recoverd well but i havent up to date.stil have these tension headaches,and periodic chills.i took a rapid test at 6,8,20 weeks all fine",
    "doctor_response": "Hello,It is not necessary to have sexually transmitted infections and you need to check your urine routine examination as well along with cultures. Headaches could be due to sinusitis as you are having flu like symptoms as well. I suggest you to visit your local doctor to get checked properly and tested accordingly.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sameen Bin Naeem, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stuck condom in vagina during protected sex,  suspected little leak.   On Lutera bc.   Taking morning after pill suggested?\n\nHello. This morning around 3am I had intercourse with my boyffriend and I'm currently on Lutera bc and he used a condom. After the third round, we noticed that the sex felt a lil bit different and when he pulled out, the condom got stuck in me and its possible a lil bit was inside of me. I always take my pills between 8am-12pm each day and we never had unprotected sex before. I read online that Lutera can be used as a backup morning after pill if you take 5 the first day and five the second day. Should I use the Lutera as backup or get a morning after pill?",
    "doctor_response": "Hi,Since you are regular with your contraception, there is not much to worry about. You may use it as an emergency contraceptive but the efficacy is not known. If you wish, you may use an emergency pill after contacting your consultant. Please remember, any type of excess hormone use is going to disrupt your hormonal balance and may cause cycle disturbances for a while. Hope your query is answered. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for severe spasms?\n\nI had a lower back injury in 1997. The pain is so severe & not only in that area, but all over. I had a ruptured disc & I was too overweight to have surg. Over a yr. later, I had a gastric bypass & lost 160 lbs. My left leg became totally numb, back side of lower part was always on fire, couldn t stand sheets touching me. Left foot numb & severe spasms. I was told - I have neuropathy of my foot. I had been told that once they got that piece off of my nerve, I would get my feeling back. I never did, they apologized, but said we waited too long & nerve damage was permanent. I have some bulging discs & ruptured disc, spinal stenosis, arthritis throughout spine & pelvic area, & my bottom hurts really bad too, left leg stays numb anytime I stand or walk. It has for about a yr. now become like concrete. Burning, tingling also. I was told I have muscle spasticity? I can t bear to get out of bed, I force myself. At night, my leg & toes twist, all different directions & behind my left knee. (My knee pain has been very painful since I had 2 surg. The 2nd one I had a total knee replacement. A ligament? sticks out real far behind my left knee & I can t straighten my leg or bend it when I m in bed. I can t turn over or get up. It feels like it s breaking, ever since knee surg. I scream out & fight tears. Makes me out of breath, pain so bad. The surgeon told me there was nothing wrong with my knee. x-rays didn t show anything. The other surg. told me the same thing. But, the Dr. that sent me to this surgeon showed x-rays that showed bone on bone. He couldn t believe first surg. said everything was fine. Now after 2nd surg. it s still severe & it constantly pops. I had 2 surg on right knee in 2005 & 2006. I didn t even have therapy - I did the exercises on my own. I don t have pain in that knee. I never had the problems I m having now. The Dr. said it s because I m older now. (58) when I had surg. last in May. One pain management Dr.( had many injections, tens unit, meds, PT, Pain Patches) nothing works. He wanted to put a stimulator in my spine & all the way up to cervical area. (lower back L5-S1) is all that workers comp would cover. But, they refused & Dr. said he couldn t do anything more. My upper spine would have to be covered by Medicare. I have severe head aches, can t turn my head & bone spurs on cervical spine. I am on perm. disability. I went to another Dr. (Orthopedic surgeon) & he had injection put into L5 nerve. If it ",
    "doctor_response": "In my opinion best remedy for sever spasm is a hot bath for 40 minalso try standing on your heels with ankle dorsi flextion , extended knees while leaning forwards for 30 secounds , this should give you immediate relief Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest ayurvedic or homeopathic medicines for liver cirrhosis\n\nNamaskar,      My father is suffering form cirrohsis (Hepatitis C). Is liver biopsy is required.  And please give me details whether it can be treated by Ayurveda or Homeopath since Allopathic treatment have so many side effects and I think at the age of 71 it is very difficult to sustain such therepy.",
    "doctor_response": "There are many good medicines for Yakrit rogas or liver disorders.Pls give more details about the symptoms and the current status of the liver function. An USG and a complete liver function test would be good enough. After seeing through the results a detailed medicine  can be prescribed. For the initial support for the liver, i would suggest to give him the following medicines1. Sudharshan choorn tablet 2-2-2 BF 2. Herbitars tablet 1-1-1 AF 3. Drakshadi kwatha 10ml twice a day Before food.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy with pre cum?\n\nI was having sex with my girlfriend and the condom broke. I did not ejaculate and we stopped immediately. She washed herself with soap and water, and the next day she took Plan-B one step( a 1.5mg tablet of levonorgestrel); an Emergency Contraceptive. After purchasing better lubricated condoms from the health clinic we had sex again the next day, and three of the condoms broke. Once again I did not ejaculate, but we did continue having intercourse. Since she was ovulating during this time I am concerned that she may become pregnant from the pre-cum. Does pre-ejaculatory fluid contain active sperm, would the EC delay the egg enough to prevent fertilization, and what are the chances that she is pregnant?",
    "doctor_response": "Hello dear,I uqnderstand your concern.In my opinion the chances of pregnancy are very very rare with precum.As the emergency contraception was taken nothing to worry.Though it works for only time there is no need to worry regarding the condom breakage for 2 nd time.So relax.The pill might affect the timing and bleeding of period.So dont worry if period is delayed.Avoid stress.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are light headedness and numbness of head symptoms of intracranial hemorrhage?\n\nHello doctor, I have been lightheaded or unsteady for the last month. My entire head has been going numb a few times and sometimes the sides of my head. I had a cat scan to rule out bleeding, and it was negative, but I feel like I should get an MRI to check. Do you think I could have an intracranial hemorrhage?",
    "doctor_response": "Hello. You seem to have the paroxysmal symptom of vertigo possibly secondary to labyrinthine dysfunction. Did you have symptoms of upper respiratory illness recently? There is no need to panic as it is not related to bleed inside your brain. If symptoms persist, you can start Stugeron tablet 25 mg (Cinnarizine) twice a day for one to two months. You can start doing some vestibular exercises. These simple techniques will strengthen your vestibular system, but you have to be regular in it. I hope you will be better soon. Secondary to post viral labyrinthitis. Dix hall pike test to determine site. Central vertigo. Chronic labyrinthitis. 1. Stugeron (Cinnarizine) 25 mg bid for one to two months. 2. Vestibular exercise. Avoid walking alone on undulating surfaces.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dull stomach pains, burning yellow stool after having gallon of orange juice, energy drinks. Due to juice acid?\n\nI finished off a gallon of orange juice a day ago that I had only opened the day before that, meaning I drank the whole thing in two days alone, I also had about six V8 energy drinks. Now I'm having some dull, stomach pains not really focused on any particular area (just generally around my stomach) and I'm also having burning, yellow stool. Is this from the high amount of acids in the Orange Juice?",
    "doctor_response": "stomach infection use short course of metronidazoleuse antacid gel  thrice a dayuse antispasmodic tab soslot of warm water high fiber low protein diet for few days will help you more",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can medicine for allergy cause side effects while on antibiotics after miscarriage?\n\nHi, Good day, after my miscarriage a weeks ago, my Dr. gave antibiotics for 7 days of my medication unfortunately, i encountered skin allergy.,My Question is the medicine for the allergy has no side effects in relation w/ my miscarriage? I need your good advise.Thanks.",
    "doctor_response": "Hi,Anti-allergic medicines have no side effects in relation to miscarriage. These medicines are given to prevent histamine-induced skin manifestations of allergy like urticarial rash or itching. They do have any negative effects with regard to miscarriage.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician and Fetal Medicine",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can carpel tunnel cause pronounced veins in the hands?\n\nHi, About 5 days ago I noticed that the veins on the backs of my hands are much more pronounced, it is hot where I am and thought that was possibly just due to the heat . Veins swell when hands are down but contract when raised- fairly normal for many people. Between that time and now I have developed major carpel tunnel symptoms in both hands. I am almost positive that it is indeed carpel tunnel but what concerns me is the pronounced hand veins...is this a normal symptom in conjunction with carpel tunnel.",
    "doctor_response": "Hi.Congested veins at the back of hand have nothing to do with your carpal tunnel.they are normal and needs no treatment unless they cause any problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Prescribed Lupride. Have endometriotic cyst and adenmyosis in uterus. How to improve follicle size?\n\nHi, I am sufffering from endometriotic cycst and adinomiocis in my uterus ,to reduce the uterus size Dr. had given me lupride depo 11mg injection and due to that 4 months i didnot had my charms and then again they gave a pills to regular my periods and from that cycle i plan for pregnancy ,Dr. gave injection to increase my follicles but my bad luck after taking 2 injection also my follicles are not increasing.so i need ur suggestion how to improve my follicles,in my case Dr. are advicing to go for IVF ,as IVF is costly so i kept that as last option so planning to go for IUI please suggest which will be good IVF or IUI and also suggest some good hospital in bangalore for IVF and IUI. can u suggest any medicine or home remidies to increase the follicles.looking forward to hear from you.",
    "doctor_response": "Hi, Thanks for your query. I have read your query & I understand your concerns. Leupride will help you in down regulating hormones. not to increase follicular size. You can still go for IUI if your age is young. We can try by changing powerful injections. If you are in Bangalore you can come to my clinic after taking appointment calling 9886744700. I shall discuss in detail about possible options. I hope I answered your query. I will be available for any followup queries you have. Regards, Dr.Mahesh Koregol IVF & Infertility Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes raised body temperature during pregnancy?\n\nHi, I am 20 weeks pregnant and having raised temperature (37 degrees celsius = 98.6 fahrenheit) while my normal temperature (before pregnancy, in the period before the ovulation was around 36.2-36.4 celsius (97.16 - 97.52 fahrenheit). I know that in the 1st trimester teh raised temperature is a good sign of hormones doing their job.... but how long the elevated temperature should stay? Is that temperature normal in week 20? or is it a sign of some infection? Thank you for your answer.",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the raise of body temperature of about 0.1 or 0.2 degrees might not be significant.The normal body temperature is 38.4 degree C or 98.6 degree F .The body temperature is dependant on the basal metabolic rate(BMR).So considering the above values your temperature raise is insignificant.Anything more than 99 degree with any associated symptoms might be significant.So relax.There will be increased basal metabolic rate in pregnancy so it might also cause the raise of body temperature.Take healthy nutritional diet and adequate fluids upto 3 litres per day.Urinary tract infections(UTI) are common in pregnancy so taking adequate fluids will prevent them.Nothing to worry.Hope this helps.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tight calf muscles with shortness of breath?\n\nHello, I have recently noticed that my legs tighten up in the calves and my lower back hurts with shortness of breath until I sit down. Breathing returns to normal after a few seconds.. Legs feel tight and like I need to pop them, especially my left leg....Any clues as to what may cause this?",
    "doctor_response": "Hi, You have not mentioned your age. Are you diabetic or having any cardiac issue? Tight compartment of leg and breathlessness can be due to thrombo-embolism. Get your colour Doppler of calf muscles done. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Jaideep Gaver, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if there is pain in kidney, lower back and bad anxiety following a car accident?\n\nhello my name is Dustin i was in a very bad car crash and my lower back and kidney hurts almost all the time. The car fliped 5 times and i was throwed out the car we was going 65 miles a hour. Ialso have very bad anxiety now and did in the past. What can i take or do to help this?",
    "doctor_response": "Well...pain in the lower back and kidney region...That sounds alarming ...this pain could me from kidneys..the back bone or muscleBetter to go a doctor so that he could examine you... he will advise you some tests like blood test,xray lower back,ultrasound abdomen and ueine tests.Get well soon...bye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. While on birth control pill, what can cause vaginal spotting?\n\nHi doctor, I have been taking the birth control pill, Tri-Sprintec for almost five years now. I started my new pack of pills on 19 of last month. I had intercourse twice on 20th and once on the 21st of last month. I used to take my pill between 7 and 8 AM. One day I had pill at 6:30 AM as I woke up early and I hope that did not cause a problem. I started to notice a little pain on my right side in the pelvic area. I had intercourse again on 26th. I started my second week of the pack that day. During intercourse I felt pain, which never happened before. On 30th, when I was showering, I saw a rusty brown color discharge from my vagina and panicked immediately. When I continued to wipe my vagina a light brown, tan tinge appeared on the paper. Again on 31st, I saw a brown tinge on the toilet paper. Today, my urine color was brown initially and then became lighter. My period is not due now. I do not want to get pregnant. Please help.",
    "doctor_response": "Hi. The brown rusty vaginal discharge appears to be one of the side effects of Tri-Sprintec (combination of Norgestimate and Ethinyl estradiol). Irregular periods, unscheduled bleeding and vaginal spotting are side effects during the first few months of starting Tri-Sprintec. Another theory may also explain this unscheduled spotting. 26th of last month was close to your ovulation date on which you had intercourse and 30th coincides closely to the implantation date on which you may have vaginal spotting while implantation of the embryo occurs. But again the above theory is highly unlikely as you have been on oral contraceptive pills for a long time and they cause anovulatory cycles that is no egg will be formed or released. So for now hope for the best and wait for your periods. Stay optimistic. If you do not get your periods, then get a UPT (urine pregnancy test) done. For further information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to terminate pregnancy?\n\nHi doctor, I am pregnent for month.but I want to miscarriage it because I have 10 month old baby.i am staying in uae.here have doing abortion is banned.so pls tell me the other wat to miscarriage my embrio.pls tell me any solution for this.may I have aborting pills.have any side effect for having it.is it effect my baby by feeding him",
    "doctor_response": "Hallow Dear,Pregnancy can be terminated safely, simply and effectively by medicines up to 9 weeks duration. Tab. Mifepristone and Tab. Misoprostol are the medicines which terminate the pregnancy. However, before going for these medicines please understand that if these medicines fail, do not revert the decision to continue the pregnancy as these medicines can cause abnormalities in the baby. In that case, it is advisable that you get the pregnancy terminated by surgical evacuation. Let me assure you that, these medicines have got very good success rate. However, they are not 'over the counter' medicines. They should be taken by an Obstetrician's advice and prescription only. It is advisable to make a follow up visit to the Obstetrician on day 7 after the medicines. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and fatigue while having low platelet and hemoglobin count?\n\nhi I recently went to the hospital less than a month ago and they drew some blood was experiencing watery diarrhea did a colonoscopy and they found ileitis. When they drew my blood they found low hemoglobin count and low platelet count but did not suggest leukemia yet I am worried about the possibility of it, because I often suffer dizziness and extreme fatigue. This is a good hospital would they have found or at least thought of something this serious or could it have been overlooked.thank you I am extremely concerned",
    "doctor_response": "Hello,         I would suggest you to completely relax and not worry about it. Feeling dizzy and early fatigue on walking is a common symptom with anaemia(low hemoglobin count). Low hemoglobin count in blood decreases your capacity of red blood cells in your blood to carry oxygen, so your brain, muscles and other parts of the body has decreased oxygen supply, which manifests as dizziness and fatigue        Low platelet count causes bleeding ( only if it is too low i.e. below 50,000) and hence anemia and fatigue. It doesn't cause dizziness and fatique directly.         As you said the doctor has already done your blood tests and they havent suggested it, which makes it very unlikely for you to have leukemia. For your information the cells count in blood increases in leukemia but they are immature.       If you were my patient, i would have asked more about- for how much time you were experiencing these symptoms.- was it associated with nausea, vomiting(bloody or nonbloody)- for how much time you have the diarrhea and what is the frequency- have you notices any swollen nodes- have you got any bone aches?- have you noticed blood in stools and color of stools- CBC    Hope i have answered your question. If you still have any doubt, I am happy to help you with that. Meanwhile if you do not have clarifications you can close the discussion and rate the answer.    WISH YOU BEST OF HEALTH!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pressure pulsating chest pain during eating and drinking?\n\nHi, so I have been having this pressure pulsating chest pain since yesterday. Its very discomforting seems that it happends more when I move around a lot and when I lay down. It also hurts when I eat or drink anythnig as well, I am 24 years old and I am not over weight.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can I can understand your. Possibility of GERD (gastroesophageal reflux disease) is more. Your chest pain and pressure worsen with eating and on lying down, so possibility of GERD is more. GERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause symptoms of chest pressure, pain etc. So do following things for better symptomatic relief. 1. Avoid hot and spicy food. 2. Avoid stress and tension. 3. Avoid large meals, instead take frequent small meals. 4. Take proton pump inhibitor like pantoprazole. 5. Keep 2-3 pillows under head in bed to prevent reflux. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a natural product to take to replace pristiq?\n\nHi is there a natural product to take to replace Pristiq. I have taken in for 5 days to treat minor depression, but I don't like taking prescription drugs. I will admit I feel much better but like I said I would prefer to take something naturalthank you",
    "doctor_response": "HiI can not suggest any substitute but Cognitive Behaviour Therapy is one method by which depression can be treated with out drug This is done by behaviour therapistTake careDr Lal Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any non surgical treatment of normal pressure hydrocephalus including herbal treatments? My mother is 75 years old and was diagnosed by MRI  about 2 weeks ago. She does not want surgery. Also could you tell me the prognosis without surgical treatment? Thanks for your reply. my email address is  YYYY@YYYY",
    "doctor_response": "Hi,Thank you for posting your query.The diagnosis of normal pressure hydrocephalus (NPH) can not be confirmed on the basis of MRI alone. We need to drain the cerebrospinal fluid by doing a lumbar puncture, and see whether her walking improves. NPH presents with a triad of symptoms- difficulty in walking, urinary incontinence and dementia. After surgery, the first two improves but dementia does not improve.There are no herbal treatments for NPH.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hand tremors after having ablation for congestive heart failure?\n\nMy husband is 61 years old, diagnosed with congestive heart failure, had ablation a year ago. ever since then has episodes of hand tremors, shakiness. sometimes it goes away when he starts to move around, other times not. he wonders why this happens. Thank you",
    "doctor_response": "Hello, Rhythm control may be achieved in Atrial arrhythmias, especially atrial fibrillation with heart failure by Catheter ablation and pulmonary vein isolation. It seems he has developed Parkinsonism (tremors, shakiness-disappears on movement/less severe during voluntary activity) which is unrelated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Tushar Kanti Biswas, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What makes the heart work harder?\n\ni have to have a stress test and an echocardiagram - had an ekg that showed an \"extra heartbeat\" - doc said my heart is working harder than it should. Also said to be prepared for a catheterization....how who they know that before i've had the other tests done first? age: 49, aprox: 125 lbs.",
    "doctor_response": "Hello don't fall on any conclusion suddenly ...only for few extra heart beats not require catheterization...few more finding will be there on stress test ...only after seeing then can give some conclusion .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hot toe redness?\n\nHi.Lately my feet get red around the toes and outside edges, it lasts for awhile then goes away, then comes back again, it happened this past winter then went away, now it s back, doesn t hurt or itch, just feels hot...I am a female 71 yrs. Thanks,Crol",
    "doctor_response": "HiThank you for asking HCMI have gone through your query. Your problem can be most likely due to getting Gout attacks. High uric acid level in blood is the reason for this. By checking uric acid level in blood you can rule out this. Taking uricosuric drugs like Allopurinol or Probenecid is helpful not get further attacks by reducing uric acid levels in blood. During acute attack you can take NSAIDs like Naproxen or Ibuprofen. Avoid high purine content foods like organ meat , big fishes , Red meat , shrimp , lobsters etc.Hope this may help you. Let me know if anything not clear.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes irritating lump on hip?\n\nSudden lump on hip, closer to left groin area. Comes and goes for the last 3 months or so but always is colored like a bruise going away, greenish. Slight irritation when I press on it. In the last month I ve noticed same area numb or tingly. Don t want to get laughed at in the dr office so any suggestion you could provide would be great!",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have inguinal lymphnode enlargement. It may be due to reactive hyperplasia due to some infection or it may be dur to some other cause like tuberculosis. You should go for examination.  If needed go for fine needle aspiration cytology of lump and search the exact cause.  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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the right lower leg?\n\nRight lower leg pain. This is the second time it is happening in a 7 day period - pain starts about 7-10\u201d above my foot and I ended up not being able to walk for about 45 minutes. It \u2018took over\u2019 my entire leg and I had to crawl around to get the kids ready for school. Then it just went away. It is now coming back and it does not feel good.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Where is your pain in the leg? Is it whole limb? associated with tingling or numbness? Possible causes are sciatica or lumbar spondylosis with compressive neuropathy or osteoarthritis etc. Until examination is done it is difficult to say what it is. Dear until examination is done it is difficult to say what it is. Avoid lifting weights from ground, please consult your orthopedics he will examine and do x ray and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dizziness,night sweats with headache and cold\n\nI am having dizziness, and night sweats with headache and a persistent cough which won't go away. 2 weeks ago, I was ill for a week (headache, fever and cough with night sweats) then I got better only to relapse a week later for a day and then a week after that, another relapse.  I am beginning to worry what it could be.",
    "doctor_response": "Hi, Welcome to healthcare Magic! It seems like you are having some chronic infection like tuberculosis or malaria or any of other visceral infections. You should be evaluated with clinical physical examination to start with. You should also get some initial work up like ultrasound of whole abdomen, complete blood counts, renal function test, chest X Ray and blood tests for malaria to provide more clues to the diagnosis. I hope the advise would be informative and useful for you. Take Care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the sperm count normal?\n\nhello sir, i m 35 male and having sperm anlaysies is volume 2.0ml, Reaction- Alkaline, morphology- only 0-4 dead or non motile sperms seen.However actively motile sperm seen. my wife is ok and we have a daughter 8yrs and my wife get miscarage before 4 yrs.Till that time we are trying. i m taking PATERNIA PLUS TAB and FERTISURE-M tab.from 2 days. is it ok for me and what i should eat. i don t drink and smoke.",
    "doctor_response": "Hai,Hai,Both the prescribed drugs  can be taken.As you don't drink and smoke is appreciated.follow the below mentioned foods to be taken;take plenty of water.add protein foods like almond,pista,peanut,soybean,pumpkin seed in your daily food intake.take dates,pomegranate,fig and  watermelon.add more diary product.take wheat,jaggery,dal with ghee prepared food. all the above food will facilitate to increase  your healthy sperm count.Avoid stress,junk food,fried items and caffeinated drinks.thank youhope i answered your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes watery stool in infant?\n\nDear Sir I have a 13 days old baby girl whenever her mother breast feeds her she immediately pass on the watery stool what could be the reason my wife had Cesarean and she still under medication is the medicine she is taking could be the possible reason",
    "doctor_response": "HiWelcome to the HCM I understand your concerns but don't worry. Newborns are prone to variations in frequency, consistency and colour of stools. This occurs due to immature bowel, gastro colic reflux and growing gut flora. So, don't worry. Just feed her regularly with exclusive breast milk without any water or other pacifiers. If the stools are not red, black or clay coloured and baby is active, alert, feeding well with urination atleast 6-8 hours daily, then there is nothing to worry about.Hopefully this will be helpful. I would be happy to help you in any further questions.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause for the severe pain above the knee?\n\nI have been having excruciating pain above my right knee for two days, today is the second day, and the pain has been worse. I can t fold my right knee, I can t even climb the stairs I have to rely on my left leg. I rely don t know what s wrong with my knee or what to do,",
    "doctor_response": "Dear sir, There are several things that could explain your pain.1. Suprapatelar bursitis.2. Quadriceps muscle tear3. Direct trauma4. Tumors5. You have contanct your physicion and from the examination he will tell  whta you should do",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What causes intermittent and heavy flowing periods?\n\nHello doctor, My menstrual period has changed a lot for the past two months. I noticed that it has become intermittent and may last for two weeks with super heavy flows with blood clots. Last month, it started suddenly with heavy flow with big blood clot, and I thought it was my first day. However, it stopped and went back again during the first week of this month. Until now, I still have my period and I am starting to get very worried because I am still on heavy flow. I am almost 40 years of age. Thanks.",
    "doctor_response": "Hello. Menstrual irregularities are very common at your age group and it could be due to endometrial hyperplasia (one of the reasons). I would advise you to get a pelvic scan done to see the endometrial thickness to see how it is. If it is normal, then you might need hormonal pills to regulate your cycle. Mirena is the best option to avail for regularity and reducing heaviness. But I would advise to seek medical help in person and get yourself assessed in detail first and then get treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a blood disorder be treated?\n\nGr and-daughter has serious blood condition that is not lupus, but has the word lupus in the definition of her disorder. Stsrted with clot by her kidney.treated with weekly injections. Two wks.later a stroke.Ho do we know if the treament she gets is what she needs. thnk you.",
    "doctor_response": "Hello,She is having thromboembolic event. Thrombosis occlude the artery Hence blood supply to the organ is affected. So, stroke and kidney clot occurred.For that, initially low molecular weight heparin can be given as injectable course. And then, oral medications prescribed like warfarin or rivaroxaban like drugs.Clotting disorder panel can be investigated to search cause for thrombosis. Please, provide your reports to us for giving more comment.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat my wife's mental problem?\n\nMy wife age 35 years old.She have mental problem. 24X7 she have only one question do are involved some other girls. She is harassing me regular even my office also.every time she call in my office and cross check me i am in office or not.in late evening after sleep around 2-3 am she say's  \"getup why your phone busy in morning..  Sir actually her younger brother is totally mental retard. I am suffering this problem last 6 years now my son is 5 years and i am very upset with my house environment very bad with my wife nature... she is not interested to devoted my son education life just start... please help me",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. I sincerely opine, if your wife's condition is that bad as you eplain, that  please consult a psychiatrist for psychiatric treatment. She is obsessed with you. Rather her obsession has been developed into paranoid personality disorder. PPD is completely curable if proper treatment is taken.If you still need my help, please describe the whole problem in detail and post a direct question to me. I shall definitely help you with psychotherapy techniques to over come your problems.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does bilateral adrenal neoplasia shown on kidney USG mean?\n\nmy mother is a cancer patient. today she had done usg, the report state that a hypoechoic sol measuring 3.0x 5.5 is noted at upper pole of right kidney and another hypoechoic sol measuring 8.9 x9.4 is notted at upper pole of left kidney- bilateral adrenal neoplasia. can i know what does it mean?",
    "doctor_response": "hai,adrenal gland which is situated above the both  kidney and neoplasia refers to abnormal growth.as your mother is a cancer patient her ultrasound investigation reveals abnormal growth in the adrenal gland seems to a malgnancy(cancer).thank you hope i answered your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life expectancy for pancreatic cancer?\n\nmy husbands ex wife is a five year survivor from stage 4 pancreatic cancer. Oct 11th this year she went for her tumor marker test to find it elevated to 45...test was repeated on Nov 15 and came in as 186....CT scans along with needle biobsy, and PET scan shows that the cancer is back and as of Dec 21 her marker level has jumped to 257....the cancer has metastisized to the liver and there is a 2 mm and growing tumor on the tip...so far no other spots have been found....the only symptoms she has is the fact that she is tired and her hips hurt really bad...Drs have said no surgery but are beginning chemo in quadrouple drugs on jan 3rd...followed by a pump to be repeated for 2 months...then they want to scan again and look for more spots...they have said this is an aggresive tumor...I believe they are just trying to pacifiy her by saying that they would not be optimistic under normal conditions but they are because she was in remission for so long...what is usually the life expectancy under... my husbands ex wife is a five year survivor from stage 4 pancreatic cancer. Oct 11th this year she went for her tumor marker test to find it elevated to 45...test was repeated on Nov 15 and came in as 186....CT scans along with needle biobsy, and PET scan shows that the cancer is back and as of Dec 21 her marker level has jumped to 257....the cancer has metastisized to the liver and there is a 2 mm and growing tumor on the tip...so far no other spots have been found....the only symptoms she has is the fact that she is tired and her hips hurt really bad...Drs have said no surgery but are beginning chemo in quadrouple drugs on jan 3rd...followed by a pump to be repeated for 2 months...then they want to scan again and look for more spots...they have said this is an aggresive tumor...I believe they are just trying to pacifiy her by saying that they would not be optimistic under normal conditions but they are because she was in remission for so long...what is usually the life expectancy under a situation like this and is it possible that it could be in her bones by the pain she is showing in her hips...although an ex wife we do get along quite well and I am interested in what the kids may need to be prepared for in the future",
    "doctor_response": "hello dear. I have read your question. The usual survival in a metastatic cancer pf pancreas is 8 to 11 months with treatment. However in this case it appears a little low as her performance status (fitness) is also poor. Hope you understand. regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes on and off fever and cough with periods like bleeding?\n\nHi i ve been having fever for about 6days on and off and having severe cough which causes my chest to ache and feel numb. Also i ve released some blood this morning which is kinda like menstruation then it s gone. Is it because of my cough and fever? I have been diagnose last yr with UTI so im afraid that it will come back, isn t fever a sign of infection in the body?",
    "doctor_response": "HI, thanks for using healthcare magicFever is part of the body's inflammatory response which means that it can occur with infection, allergies or trauma though infection is the most common cause.Viral, bacterial, fungal or parasitic infections can cause fever.Cough and colds are usually due to viral infections though in some cases, the symptoms can be due to bacterial infection requiring antibiotics.It is quite possible that the fever is due to your cough/cold.Infections can affect the menstrual cycle so this may be the reason for the irregular bleeding that you noticed. At this stage, it can be monitored.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment to get pregnant?\n\nHello doctor, I am 6 months consieve . During Last month scan doctor told Placenta is Low lying and most probably it will move up by the 8th month. I am working as software engineer .can I know what precautions is necessary and it will definetly move or remains same.",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the low lying placenta in early pregnancy might not be considered as serious problem.Because spontaneous movement occurs in 90% of cases by 7-8 months.So nothing to worry.But proper care need to be taken till it moves up like avoid physical strain,prolonged standing,intercourse.Take good rest.It needs to be followed by serial ultrasounds.Best regards....",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pleural effusion and calcified foci in chest?\n\nHi,my dad under went a bypass surgery 3 months back.He had pleural efffusion in both his lungs of which 250 cc was tapped from his right lung post surgery and it remain clear till date.But the pleural effusion in his left lung had increased from 80cc post surgery to 250cc, after which he was started with Diator 10 mg (diuretic) and his pleural effusion was down to 40 cc a month back. His dosage of Diator was reduced to only twice a week, but the recent report still shows 40cc of pleural effusion in his left lung. His total fluid intake in 1500ml/day. Further more the Chest X ray shows a few calcified foci. What is the cause for both this problem and what should be the treatment. Thanks, Hemal Lodaya",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. His pleural effusion is mostly due to underlying heart disease. So you can give him Dytor tablet daily. Calcified foci on lung are mostly due to old, healed lung infections like tuberculosis or pneumonia. Nothing should be done for this Calcified foci as these are inactive and noninfectious lesions. Hope I have solved your query. I will be happy to help you further. Wishing good health to your father. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes higher liver functioning test during pregnancy?\n\nI had a stillborn at 33 weeks with my first baby due to HELLP Syndrom. I am now 35 weeks pregnant with my seconde child and my liver funtion test has come back higher than normal. Could this result to anthing bad happerning to the baby or me?",
    "doctor_response": "Hi there,Liver function tests could be abnormal due to a lot of reasons. It is usually a variation of the normal, and need not cause you to worry. This is because pregnancy itself causes the normal limits of the liver function to change (and this is usually not reported with reference to pregnancy but in reference to adult female). This could lead to the values being read as abnormal.If you do not have high BP, HELLP, or abnormal itching or any other symptoms indicating liver diseases, then you need not worry yourself.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for tachycardia?\n\nI am 50 years old have tachycardia, but lately all I want to do is sleep. I injured my back in 2000. Get headaches alot, can go 2 to 3 days not eating. Get dizzy standing up. am on Cymbalta 60mg once a day,Metoprolol ER 100mg once a day,Lisinopril 10mg once a day, Morphine 30mg 1 every 8 hours, Methadone 10mg eight times a day. Also am 5 6 and weigh 232. I know over the winter I got lazy. Sometimes walking just wears me out and my heart beats out of my chest, yesterday my pulse was very high and I was just sitting.",
    "doctor_response": "Hello,You may be having some condition here, a tachycardia while sitting and getting effortless may be signs of heart failure. You need to get checked by a cardiologist to do EKG, echocardiography, and some labs. Some thyroid dysfunction may be a differential here. So, I suggest to do a thyroid profile. Also, check your blood pressure regularly as it may be lowered too much with you medications.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mahmmad Gamal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have spherecytosis. CT scan shows enlarged spleen and liver. High bilirubin level, abdominal pain. What is going on?\n\nMy son has spherecytosis - he has recently found through CT to have an enlarged spleen and liver and his bilirubin is climbing - he appears well and sometimes has pain in the left side of his abdo where is spleen is. Unsure what is going on, we are due to have more bloods and another uss on Monday but just a little confused as to what could be happening",
    "doctor_response": "Hi bsw1972, This is a condition called hereditary spherocytosis which occurs due to membrane defect in red blood cells due to which it is easily destroyed while passing through the blood vessels particularly in spleen. In addition to the test results you have mentioned osmotic fragility test helps in confirming the diagnosis. Raising bilirubin level may be due to increased destruction of red cells or due pigment stones formed in the biliary tract. Usually spleen has to be removed surgically to increase the lifespan of red blood cells and if there is any gall stones that also needs to removed during surgery.. With regards, Dr.Parthipan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does loose green stools in an infant while on Nan pro 1 mean lactose intolerance?\n\nMy 4.5 month old baby starts passing loose green stools when formula fed with Nan pro 1. When switched to Isonomil (soya formula), his stools are normal yellow colour. Is this sign of lactose intolerance? He was doing fine with Nan 1 pro for 1.5 months.",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.Babies fed with lactose based formulas are more likely to have frequent motions than on lactose free formulas but it does not mean baby has lactose intolerance , if baby is having watery stools with presence of reducing substances in stool , chances of lactose intolerance are more . Colour other than presence of blood is not significant.Hope this answers your question. If you have additional questions then please do not hesitate in writing to us.Take care.\u2022\u00a0\u00a0\u00a0\u00a0\u00a0DISCLAIMER: - All the information provided here is for information purpose only   , it is not a substitute for the advice of a physician after physical examination , it is not intended to replace your relationship with your doctor. This information in no way establishes a doctor-patient relationship. Before acting anything based on this information do consult your doctor. I  recommend that online users seek the advice of a physician who can perform an in-person physical examination",
    "dialogue_context": ""
  },
  {
    "patient_message": "Filling of caries tooth, What is filling ?\n\nFrom child hood I like sweets a lot. I used to take lot of chocolates. Now iam having lot of caries tooth. I frequently get tooth pain. I used to take pain killers for this. I saw a Dentist he said my teeth needs filling. Other wise it will cause lot of problems. What is filling ?",
    "doctor_response": "Hello, Thanks for posting your query. A filling is a way to restore a tooth damaged by decay back to its normal function and shape. Dentist first removes the decayed tooth material, cleans the affected area, and then fills the cleaned out cavity with a filling material. There are different filling materials :- Gold filling Amalgam filling Composite filling Porcelain filling No,one type of filling is best for everyone. What's right for you will be determined by the extent of the repair, whether you have allergies to certain materials, where in your mouth the filling is needed, and the cost. Hope I have answered your query. Wishing you good health. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Rigevidon pill. Unprotected sex. Chances of pregnancy? What is the difference between the periods and withdrawal bleeding?\n\nHi, I m 18 and on the newer version of the pill , Rigevidon. I m on my 7day break (without having missed a pill) as required but also had unprotected sex with my boyfriend a couple of nights ago. I was wondering what the chances are of becoming pregnant and the difference between the actual period and a withdrawl bleed . I am also aware that as the pill gives the body the perception of being pregnant a pregnancy test would come up positive.",
    "doctor_response": "Hello. Thanks for writing to us. Since you are taking the pill regularly you are protected against pregnancy even during the 7 day pill free period. Withdrawal bleeding is usually milder than period.I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal ,drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pains and dizziness?\n\nI have pain under my left rib cage.  The best way to describe it is like a quarter moving around.  I have some chest pains from time to time.  I also have alot of gas and have been dizzy lately.  Can you tell me what this might be.  The pain is left not right.  Thank you.",
    "doctor_response": "Hi ThereAfter going through your query I understand your concern.I would like to tell you that Chest pain can be because of many factors like, heart disease, lung problems, of gastric reflux. Heart and lung  disease depends on your age, family history or any structural abnormality. Your symptoms are due to Gastric Reflux. Its recommended for you to take over the counter antacids and stop eating spicy and junk food .Kind Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for severe pain in feet\n\nBoth of my feet hurt. When I get up in the morning I can bearly stand up and walk, the pain does get bearable after I walk around the house. I am taking ibeprofrin every 4 to 6 hours. The pain is in my heels and the arch of my foot is VERY VERY painful.",
    "doctor_response": "hi,thank-you for providing the brief history of you.a thorough musculoskeletal assessment is advised.As you have pain in feet this can be due to one of the possible reasons and needs a thorough assessment.1. increased uric acid levels2. Calcaneal spur3. plantar fasciitis4. disc degenerative changes.After a thorough assessment we can come closer to the cause and the treatment will be guided according.With simple medication and physical therapy most cases recover and get maximum functional ability.In my clinical experience we get patients with such feet pain and post thorough assessment treatment is planned and majority responds well to physical therapy.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recurred pain in lower abdomen, dizziness after being on antibiotics for kidney infection.  Is this serious?\n\nI was hospitalized for a kidney infection on December 23 and was just moniterd with iv antibiotics, due to the infection and the fact i was only born with one kidney.  I was sent home the following day and took all of my antibiotics(cipro) and pain med oxcyodne like prescribed.  Well my lower stomach (bladder) began with pain again yesterday, and I woke up this morning nauseated and dizzy with the pain intensified.  I dont have the pain in my back only in my lower stomach and it hurts when I breathe.  I began to take Uristat and drinking alot of water.  Should I follow up with a Doctor on Monday?",
    "doctor_response": "Hi, I have read you query & according to me before you should take any medicine  you get your blood urea ,serum creatinine and ultrasound abdomen.     Follow up me after report.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red spots on the legs and ankles after a surgery on the neck?\n\nhi ...my husband had surgery on his neck c6/c7 area of his neck where they put in titanium disc fuse thing....after surgery he had a small rash on his chest which seemed to go away after awhile but now(surgery was may 2) he has pinpoint pink to red spots on his lower legs ankles inside forearms some on chest and back and they itch thruout the day he started vitamins 2weeks prior to surgery ....also since march 10 he has had steroid meds pain killers an injection in neck and then the surgery. the rash appeared on chest after surgery but did fade but now what seems to be spreading has been going on since maybe a few day to a week after surgery just spreading more now! should he be seen for this ? what would it be?",
    "doctor_response": "hi,thank-you for providing the brief history of your husbandA thorough neuromuscular assessment is advised.As he had the surgery in the spine, there will be some sensory protective mechanism happening by the bodynl itself to control and balance the new implant. This this of spots will stay for a while and as time passes by it will go away. If any thing is due to drug reaction than needs a thorough pharmacological assessment of the drugs induced.Also, by keeping the cervical spine stable and doing little physical therapy should help for the strength.This red spots will go slowly as it is more of the sensory issues. The nerves carry two major functions - motor & sensory.Since after the operation there needs to be a balance Certain times such reaction occurs but fades off with time.Regards.Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pelvic area swelling above the penis and scrotum?\n\nmy son had a small omphaloce repaired after birth (born sep 7th of this year). he s also a possible beckwith-wiedemann case (had a tongue resection 2 weeks after birth). today i noticed swelling in his pelvic area - no redness perse, but definite swelling around and above his penis and scrotum. i m concerned in general due to the potential bowel obstruction issues, etc. that could be a result of his abdominal wall defect, etc. Any thoughts?",
    "doctor_response": "Hi, It could be inguinal hernia. Please check whether swelling is increasing with cough or any other straining exercise. If so, consult a pediatrician for examination and proper medical assistance and ultrasound. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Prasanna Lakshmi, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain and swelling in the jaws?\n\nMy mother (91 yrs old) has bone loss, and her doctor recommended she receive Reclast. Since then, shehas been having sharp pains in her jaws, and some swelling. I took her to the emergency room, and thedoctor, as well as her doctor, assures me that this has nothing to do with the drug. I don't believe that istrue. Does the pain and swelling mean that the drug is damaging her jaw bones? If so, is there a remedy?",
    "doctor_response": "Hi..Thanks for the query..Well, sharp pain and swelling in jaws can be due to Reclast infusion as it is a bisphosphonate and in case if there is any dental infection present it can get severely aggravated leading to Osteonecrosis of the jaw..At times jaw pain can be a side effect of Reclast.So my suggestion is to immediately consult an Oral Surgeon and get her evaluated and a thorough clinical examination, palpation of her jaws and necessary x rays like Panoromic x ray will help in ruling out the cause and treatment can be done accordingly..As of now do cool compresses over the jaws and take a soft diet..Take any painkiller only after consulting her physician..Hope this helps..Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with PCOS. On Meprate, Siphene and Pause MF. Medication affects pregnancy?\n\nHi.. I have PCOS  because of which I do not get my periods regularly. We are planning for a kid and consulting a doctor who gave me Meprate to get my periods on time and once I get my periods he has told me to take SIPHENE 50 mg. I am heavly bleeding because of that.. now my doctor has given me PAUSE MF. Please tell Is this safe to take Pause MF because I am planning for a kid.",
    "doctor_response": "Hello Thanks for your query. It is safe to take Pause MF. It does not affect conception in any way. You are not having heavy bleeding due to siphene, but because patients with PCOS, have irregular and delayed cycles, but when they do bleed, bleeding is generally heavy as the thickened endometrium is shed off. You need to consult an infertility specialist, as PCOS is associated with irregular ovulation and sometimes no ovulation. If siphene fails to give you positve results, you would need injections such as gonadotropins etc. You also need to be evaluated for diabetes, hypothyroidism, adrenal hormone status, lipid profile levels and vitamin D deficiency. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "History of cancer, painful liver cyst. Something more serious?\n\nI am a 60 yr old woman and recent diagnosis of enlarged mediastinal and ap window nodes. I have a 2cm cyst in right lobe of liver that is very painfull. 20 years ago I had a melanoma tumor on abdomen over liver area that was stage 2. It was big and required an 8 inch wide incision. The ct says the lesion of liver is a cyst, but I am concerned about the pain. I see a cardiac-thorasic surgeon in 2 weeks for the lymph node removal. Can the liver cyst be something more serious? I also had a melonoma on my forehead, cervical cancer and squamas cell carcinoma of vagina and vulva. With so much cancer history, I am very worried because of the pain and enlarged nodes.",
    "doctor_response": "Dear  ! I have gone through your mail in detaill and could gather the facts. The liver cyst you ''ve mentioned seems to be a simple cyst. It is very unlikely to be the cause of pain. Rarely a cystic liver secondary can look like this. Your treating surgeon can sort this out. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stress and depression\n\nHello DOctor 1.IF a person is suspicious on his wife with out any proof 2. IF he doesn't feel to hasve sex with wife daily telling one Reason and when comes to have sex he things like a neighbour. 3. what things if i do to him he is not satidsfied in any work 4. He takes opinion from others and he listen to talks 5. He wont mingle with anybody, He will only on his work dialy Morning he lives @7.30 &Return Back @10:30",
    "doctor_response": "Hi dear,Thank you for your query.What ever you describe about problem suggest he might have depression with psychotic symptoms or negative schizophrenia.between two difficult to diagnose without history and mental status examination.But he needs psychiatric treatment.For his case best possible treatment is antidepressant medication and if not improved then only add anti psychotic medication.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why child is having mottled and purplish red arms and leg with fever?\n\nMy 2 year old was seen in the ER last night for high fever lasting 3+ days. Fever free today but temp going back up. When he was getting in the tub I noticed his skin , especially arms and legs are mottled looking and purplish red. Should I call the dr. Again?",
    "doctor_response": "Hi....this sort biphasic fever you are describing can occur in viral hemorrhagic fevers like dengue. The discoloration on palms also signifies the same. Sometimes it can lead to drop in blood pressure or bleeding manifestations. I suggest you get back toythe doctor immediately.Regards - Dr. Sumanthhe",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for arthritis\n\nHi, my father-in-law has arthritis. As he is currently with us in Sweden, I can see that in mornings, when he wakes up it took him an hour to get on feet. But in day time he walks with a little pain. Please advice me what can I do??? He is currently on Homoeopathic medicine.",
    "doctor_response": "Hello, Homeopathy may not act fast in chronic arthritis. Consult a rheumatologist and get your. Newer drugs like immunomodulators will be very effective. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fatty liver with prostatomegaly?\n\ngood morning doctor my father is a type 1 diabetic.....he was being diagnosed with liver abscess in 2003 which was later aspirated...now the probmle is ,hwe was complaining about abdominal pain...on USG it revealed that he is having fatty liver with prostatomegaly.....kindly advise",
    "doctor_response": "Hi thanks for asking question.With advancing age benign prostatic hyperplasia is common condition.It is due to effect of testosterone on prostate that lead to epithelial and smoth muscle proliferation.So clinical follow up needed in BPH with tamsulosin or other suitable drug.Secondly fatty liver can be by many causes like ....Excess alcohol.Hypoxia...Protein energy malnutritionHyper cholesterolChemical injury etc....For fatty liver take care regarding taking low fat diet.Green leafy veg more.Exercise regularly....Both this condition treatable and clinical regular follow up needed.I hope my answer will helpful to you...Take care....",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long can FET delay periods ?\n\nHi. for how long can FET medication delay the period.. (i.e) how long (how many months) it takes to regulate the patient period again I had fet back on Dec.. (failed) .. the next 2 period were fine and didn t delay a bit.. but this is my 3ed one after the failed FET.. and now I am late for more than a week.. first time on my life.. after miss my peroid of 3 days .. I had negative home test result.. any suggestion please",
    "doctor_response": "If you have had normal periods the previous 2 times,then this current delay is not due the medication.If your pregnancy test is negative,then wait for your periods.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause and treatment for fever in an infant?\n\nMy 8 month old has been sick for two weeks. It started with an out of nowhere fever with no other sx s other than being feverish and not wanting to really eat for about 24 hours. His temp went up to 102. Then he started feeling better and a week later his head was really congested and eyes puffy with dark circles. Finally on sunday night his nose started to drain a sort of yellow/green color mucous. We have done saline spray with aspirator, humidifier, hot shower and his sx s are still not relieved. I must add that prior to his fever we were on the road for two days driving to colorado, which is part of the reason we didn t go to doc. Motrin seemed to break the fever. In addition he had gray poop on saturday and today. The other times it was normal.",
    "doctor_response": "Hi...by what you quote your kid initially seemed to have a viral illness and now I think he is getting a secondary bacterial infection. I suggest you consult a paediatrician and your son might require some blood tests and antibiotic.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a sudden inability to breathe?\n\nHello. I have this issue where all of a sudden I will feel like I can t breathe (almost like an anxiety attack), so I make this noise from the back of my throat and open my mouth to open my airway. These periods can last anywhere from a few minutes to a few hours. It really bothers and stresses me and I would like to know what s wrong. Could you help me? Thank you!",
    "doctor_response": "You should get pulmonary function test ( a breathing test) to fing if there is constriction of airways which is causing this problem..I would opine you to visit a chest physician regarding the same..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is cartigen effective for backache?\n\nI am suffering from backace due to disc difuse bulge in L4-L5, L5-SI . The Doctor has advised me Cartigen/Duo, Calcium Tab and Ubi Car Tablet once each in a day. Since I am also suffering from Ulcer , only Ultracet tab was recommended for severe pain. Pl advise. Preveen Raheja",
    "doctor_response": "Hi, Welcome to healthcare magic.your doctor has prescribed correct treatment.You can add vitD3 if your level of vitD3 is low (by blood test).I think your query got answered",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent pain in lower left abdomen?\n\nsir , my brother was feeling pain on left side lower of stomach since 3 month. But one month back one docter started curing him by antibiotic medicine. but nothing happened. after 10 days later he tried muscle contraction dosage. Eventually , Pain started with more intensity and on right side new pain at same time on right side of lower stomach. Other hod gastro, got the full colonoscopy . Surprisingly , reports shows that he has lymphoid hyperplasia non specific chronic in his terminal ileum. he has advised for mesacol od 1.2 g x 3 times a day. Is it right to take mesacol ? . I am very much confused why is pain on left side . Now he is feeling pain on both side and no relief . He has taking medicine for last 10 days. From Brijesh",
    "doctor_response": "HiI appreciate your concern looking at history this could be inflammatory bowel disease In my opinion he should continue with the mesacolIf he is experiencing diarrhoea give home plenty of fluids with ORS to counter dehydrationplenty of dietary fiber and fresh fruitsHope I have answered your question you can ask for more assistancethanks for your querygood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated D-dimer?\n\nI am a 35 y/o female with a 4 month history of CP with SOA.  I have had a Nuclear Stress test and an Echo, all which were normal.  However, they did find that I have a Left Bundle Branch Block.  I wore a 30 day halter monitor which revealed PVC's/PAC's, but not much else.  I had the same chest pain last night above my left breast, with shortness of breath, and left arm numbness.  After an hour I went to the ER.  The normal tests were ordered, but the ER doctor also ordered a D-Dimer, and mine was elevated to 0.65.  All other lab tests were WNL. She ordered a CT Angio of my chest which came back normal.  She didn't explain what could cause the elevated D-Dimer, nor whether or not I should be concerned, or what I should do about it.  I am on Metoprolol and Lisinopril for my heart.",
    "doctor_response": "Brief Answer:The most serious health problems that may increase D-Dimer levels are excluded and the increase is not significant.Check the D- Dimer level after 1 week.Detailed Answer:Hello,Thank you for using HCM. I read your question carefully and I think you don't have to be worried because in your case, the most serious health problems that may increase D-Dimer levels are excluded. As your cardiac enzymes and your ECG did not show any new modifications this means that you were not suffering a myocardium infarction. Angio CT of the chest is the gold standard for diagnosing pulmonary thromboembolism, which in your case came out to be normal. Also the rise of the D-Dimer level is not so significant to indicate serious diseases.A venous thromboembolism (VTE) is also a cause of high D-Dimer levels , but it can be excluded by the lack of symptoms suggestive for it and low increase of D- Dimer level. (Usually is significant for levels above 1)A more possible cause in your case may be a systemic disease  such as reumatological disease or infection.Eventhough , what to do next ?   If I were your doctor , I should advice you to check D-Dimer level in blood  after 1 week.Hope this is helpful.Let me know if you need more clarifications. Otherwise please close and rate the answer.Kind Regards, Dr. Juarda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain, above navel, irritated, heaviness. Done abdominal ultrasound. Suggestion?\n\nHello Doctor, My mother is suffering from dull pain in stomach just above navel.It is not continuous and somewhat dull but this kind of pain is irritating to her since it is continuing from last 2 months. also when she eats small amount also ,she has afeelibg of heaviness but feels fatigue and weak too . Her abdomen ultrasound is pretty fine just liver being little fatty which local doctors says it is normal onyl.Can you suggest what to do ?",
    "doctor_response": "IT CAN BE DUE TO SOME MEDICINES IF SHE IS TAKING FOR OTHER PROBLEMS LIKE BP PAIN KILLERS ANTIBIOTICS VTAMINS CALCIUM OR DIETRY SUPPLIMENTS OR SHE MIGHT HAVE DEVELOPED SOME ALLERGY TO P[ARTICULAR FOOD LIKE MILK O WHEAT A PERSON CAN GET ALLERGY FROM ANY FOOD AOR MATERIAL AT ANY TIME AT ANY AGE YOU YOU CAN THINK POSSIBILITIES ACCORDING TO ABOVE GUIDENCE IF YOU ARE TAKING MEDICINES YOU CAN CHANGE SALTS IN CONSULYTATION WITH YOUR DOCTOR OR GET ALLERGY TESTS TO FIND OUT THE CULPRIT FOOD BY TESTING BLOOD SERUM AFTER ELIMINATION YOU WILL BE FINE",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fatty liver, heavy drinker, Hepatitis C negative, elevated GGT levels. Advice?\n\nHello Doctor, can I speak to you now with regard to my elevated GGT levels? I am a heavy drinker (only beer) but in good quantity every day. When I checked my LFTs, it shows GGT as 130, SGPT 79, SGOT 47. I have big pain at the side of the liver. I have not stopped the drinks for 3 days and it is for ever. Sixe months back, when I had an ultrasound, there was slight fatty liver too. I have hepatitis c antibody in my blood, but when I did polymerised RNA test (to count the virus) it was negative and I did it two times in two years and it is still negative. Can you advise as to what can be done now. If it is due to alcoholism, can it be reversed since I stopped it. Please help me. Thanks a lot.. Reji",
    "doctor_response": "Undergo complete liver tests like liver function tests and ultrasound abdomen ,stop alcohol intake,start on liver vitamins like liv 52 along with hepamerz twice a day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Been on birth control, have brown discharge, bad anxiety, stressed. Should I worry?\n\nHello im a 18 year old female, I have been on birth control for about a little over a year now, My boyfriend of three years have intercourse, only about twice a month, last month my period did not come, I figured it was because I messed up my birth control a few days but not that serious but I had the symptoms, cramping and such, My periods are usually only two days long on the pill , usually if my cycle was normally I would be starting my period today, but after I was finished going to the bathroom I saw a brown discharge on the toilet paper but never got my period, Ive been having my normal cramps and stuff, I have gone a month without my period before when I first started birth control, Is this normal? Could I be pregnant? Should I worry? I do have really bad anxiety and get stressed alot if that helps",
    "doctor_response": "Hi there ~ It is not uncommon to have these symptoms while you are on birth control pills.  You are also advised to take a urine pregnancy test to rule out pregnancy.  It may be worthwhile discussing the results with your boyfriend.  If the pregnancy test is negative you may need to have a pelvic ultra sonogram.  However you need to consult a qualified gynecologist to have things sorted out and relieve your anxiety. I hope this helped.  Take care and have a nice day !",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Cartigen effective in treatment of joint pain?\n\ni am 54 years work in office for 8 hours. I have osteoarthiritis. i am taking cartigen since recently. i also took nuflam two a day for nearly 3 months but did not feel any difference in joint swelling in evenings and stiff joint when getting up after being seated. Now i started taking CARTIGEN . will this work for my still joints and pain by evening after being seated at work. otherwise have i also to take chrondotrin together with CARTIGEN. will i then have side effects? shall be grateful to have your advice Dr. Tks & Rgds! shivanthi",
    "doctor_response": "Collagen Peptides are good for non surgical treatment in early osteoarthritis. They have to be taken regularly for minimum six months and can be taken for indefinite period of time. The effect starts after few weeks only",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the prognosis of a patient suffering from kidney cancer metastasized to spine and hip?\n\nMy husband was diagnosed with kidney cancer in sept 2013, with bone mets in spine & hip. 3 months into taking Sutent, has had kidney removed, 2 ops on back for stabilization, seeing oncologist next thurs once CT scan completed tues...Sutent seems to be working well for him with not too many side effects, but dodgy stomach, not great colour & mobility slowing down, just want to know what to expect & what the future holds or what i should be preparing for on thursday",
    "doctor_response": "Once the affected kidney is removed the survival is much better compared to a kidney cancer which cannot be operated upon. If  patient responds to sutent i.e., if the metastasis is stable or reduces and if no new sites of disease pop up , he can be continued on the drug untill the response is lost. In this event  second line drugs similar to sutent are available.Other side effects you have to watch for are rashes . blisters in mouth . discoloration of feet and hands. Blisters in feet and hand.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on middle joint of ring finger\n\nI am 32 and have a soft lump/swelling on the middle joint  of my ring finger. It gets bigger when my hand is downward or when my hands swell. If I put my hand up in the air the lump gets smaller. It does not hurt (it is not a ganglion cyst). Waiting on specialist appointment. Have had it for about 3 months.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have hemangioma or other soft tissue tumor or some cyst.  You should go for examination and if needed go for biopsy.It 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intermittent but increasing rectal pain?\n\nMy 5 yr old son has been having infrequent, though increasing, intermittent rectal pains for over a year now. Tonight was another episode. Looking at his rectum, it appears mildly beefy red/inflamed and has a single satellite mildly red bump measuring approx 3mm about 1 cm to the right of his rectum. It is very sore to him as this has awakened him from sleep. Putting even routine hydrocortisone on it hurts (per his words). He doesn t have any fever/chills, abdominal pain, nausea, vomiting, or diarrhea. Maybe some mild constipation though. I ve been trying to figure this out on my own. I ve come up with either UC/Up (proctitis) or anal fissure (though cannot actually see it). He has h/o mild intermittent asthma taking flovent seasonally which controls it well. Your thoughts???? Thank you.",
    "doctor_response": "Hi, by what you quote, it seems that your child probably has anal figure, anal tag or proctitis. Proctitis seems little unlikely as in proctitis inflammation is more, pain is more and sometimes fever and loose stools are also present. In my opinion, proctoscopy should be done to confirm the diagnosis. Sitz bath should be given and local anesthetic cream like lignocaine might help. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause pigmentation on dental implantation site?\n\nhi.. mom  aged abt 70  had dental implant ... she is fine on the day and in the next day she had rinsed her mouth with mouthwash.. and after 1hr seen the complete chin area ( implanted place) turned to dark color.. is it bllod clot or some chemical reaction ... she is comfortable and noticed no pain... only dark color in chin area..",
    "doctor_response": "THANKS FOR YOUR QUERY, i have gone through your query, the dark color over the chin area could be because of the hemorrhage secondary to implant placement. nothing to worry, you can apply cold things(ice cube) over the site. consult your implantologist and get the prescription for the blood clot to dissolve(like thromboplebh ointment. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can my back pain be cured or not please suggest me\n\nHello sir i am bhadrashetti, 38 year, from Davangere karnataka,INDIA 5 year back when i wash my pace. I got an MRI 5 back year back, doctor told me Disc bulge at L4 - L5 level they said I have a Mild Disc Bulge at L4-L5 level that MS (Ortho) said it is not that serious take bed rest. i got 3 months bed rest. afterwards every day left legs pain pain some time i am not get up bed because back is very tite, i am cosult lot of doctor no use My pain starts from left side only can i go surgery please advise me one more thing after intercourse pain rise I cannot do all the things well, I dont know whether this pain can be cured or not Please suggest me methods of reducing the pain.. I sincerely thank you all..",
    "doctor_response": "1.Mild disc buldging is manageable by medicines & physiotherapy. 2.Surgery is indicated if the condition is severe &/ symptoms are severe. 3.You can try homoeopathy , it is safe for pain management . 4.Stiffness of the back is worse is cold/damp weather (for most people), so meanwhile you can try Hot fomentation (hot water bottle) at the site of pain, also massage with warm oil, at night. These will help you for a while in pain & stiffness. TakeCare",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain and cramps in the hip and thigh\n\nmy husband just had back surgery, several fusions and a cyst removed from his spinal cord. He is home from the hospital, but the nerves are waking up and he is experiencing really bad pain and cramps in his hip and thigh. What is the best way to alleviate this pain?",
    "doctor_response": "Hello, I have studied your case.Medication like methylcobalamine with Pregabalin and analgesic will reduce pain; you can take them consulting your treating doctor.You may consult physiotherapist for further guidance. He may start TENS, or IFT which is helpful in your case. If you have started it continue it for few more days.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you find this answer helpful do not hesitate to rate this answer at end of discussion.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of infections like extra deposition of collagen?\n\nSir i m myself a medical student. I showed may dermat but al r giving various xplanation.i m havin recurrent infection and palpable not at al painful mass such as deposition of collagen like a scar tissue near mandible.it is sm mass.please help me it affects cosmetic status of mine",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.In some patient collagen deposition is extra abnormally.I suspect same in you. The only problem to your problem is apply steroid cream over the wound area.Whenever you have even slight injury you should start applying the steroid cream under your doctors guidance.The extra collagen you have can only be treated is surgical excision. I advice you to visit nearby surgeon which will guide you regarding excision procedure.I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does an incipient varicocele on left testicle affect fertility?\n\nHello Doctor, we have been trying to conceive for the last 3 years and still looking for the solution to our problem, my wife is consulting a specialist, and on my side I run some spermogram studies to see what the numbers where, so this is what I got so far, Volume: 4.5 ml; Count: 124.500.000 per ml; Motility: 15% (Fast Linear Progression), 25% (Slow Linear Progression), 30% (without linear motion), 30% (dead); Morphology: 70% (Ref: 30%).I am 37 my wife 36. Besides an ultrasound says that I have an incipient varicocele on my left testicle. What's your opinion of this, is it ok ?",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, even if the amount of ejaculated semen is little less but the sperm count is okay, and this this is nothing to worry, there are enough chance of conception even with the history of varicocele, hope this information helps, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be the reason for the pain in the child's neck?\n\nMy three-year-old daughter has a very bad pain in her neck behind her right ear.  There is a bulge there and she cannot turn her head to the right.  She is in a lot of pain.  We have heat on it but she is flat on her back.  What could it be and what else can I do for her?",
    "doctor_response": "Hello,Now, the size of swelling is important here, whether it is lymph nodes swelling or any pus collection under skin.Give him any pain killer and start syrup Cefim twice a day for 5 days with syrup Arinac 1 teaspoonful (tsf) twice a day. Check for results, if not subsiding, then you must visit surgeon.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Hina Javed",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back pain with fatigue?\n\nFor the past several days I ve been experiencing pains in my lower.back sides also pain when I ur my fatigue has been very very weak I ve been having cold chills there out my entire body and waivwke up dripping sweat also have sum nausea on and off please help me understand what a the matter with me? Ian",
    "doctor_response": "Its symptoms of general weakness , u need to take antioxidants ...and also  to take heavy breakfast with milk ...u have to being exercise under physiotherapist ...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for back pain?\n\nMy mother who is 64 yrs now has an issues. Her L4 and/or L5 has issues.They are dehydrated and a bit herniated as a result it is pressing some nerves leading to a lot of pain and change in posture. What should we do?She is hypertensive, diabetic and hypothyroidic.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.From the information that you give looks like your mother has a herniated disc that is compressing the nerve.Usually, the initial treatment should be nonoperative with nonsteroidal anti-inflammatory medicine and pain killers and physiotherapy once the pain is decreased.Then the next step is Cortisone and Lidocaine injections in the spine to calm down the inflammation and shrink the hernia down. If after all these means of treatment you are still the same or worse than surgical treatment is indicated after the neurology has evaluated your reflexes motor and sensor status. Now a days the surgery for hernia is minimal invasive with small incision and you walk on the same day of surgery.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Edvin Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is having brown-tinged urine while having candidiasis normal?\n\nI was diagnosed with candidias and i have been takin medicens and I suspect that I suffer from it because I went on a birth control pill. my first question : Is urinating Brown Urine normal while having candidias? Question 2: Me and partner Had Sex now his penis Burns and has reddish rash on it, Is that serious, Should we use a med.?",
    "doctor_response": "Hi, I have gone through your question and understand your concern. Urinating brown urine means you are taking less water. In candidiasis there is a white discharge from vagina so white fragments may come in urine. Burning and rash on penis may be due to other infection for that you must take proper antibiotics like azithal and for candidiasis take fluconazole or apply candid cream locally. Maintain good hygiene and avoid sex.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does semen analysis report mean?\n\ni am maried from last 6 month. my semen report is: last coitus 7 days, method of production masturbation, liquefaction time 15 minutes, appearance dirty whitish,  volume 05ml, consistency thick,   ph 8.0    count/concentration :170 million/ml,  motility grades are: dead 75  semi siuggish 05 siuggish 10, fully motile10   pus cells 2-3/hfp, red cells nil, epith cells, a few            STAINED FLIM EXAMINATION: Acrosomal cap  Present 70%  Abnormal Heads: seen 15%, Mid Pieces : Present 75%,  Tails Present 85%                                   Please told me what i have disease, can i get the baby ,  if i am not well, how much time to take in my recover or i can't recover",
    "doctor_response": "HelloYour semen analysis findings may indicate infection with low sperm motility and excess abnormal morphology sperms.You may need clinical correlation and few investigations like routine hemogram,random blood sugar,semen culture and sensitivity,ultrasound of scrotum.Infection is indicated due to presence of pus cells in semen.You may need to take antibiotics based on culture and sensitivity report.Motility is low.Normally it should be at least 55 %.Your findings suggests over all 75% immotile sperms,so it is low.Sperm count is normal.Normally it should be at least 20 millions/ml.Normal morphology sperms are also low.At least 16 % sperms should have normal morphology sperms for natural fertilization.Fertility is expected to improve with control of infection.You should take healthy and nutritious food.Avoid smoking and alcohol if you take it.Take antioxidants and go for regular exercise.Avoid wearing tight undergarments.If infertility persists then you may need assisted fertilization technique.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Have PCOS, white discharge, itching and burning sensation. Taking ovulation treatment and folic acid. Help\n\nhii dr am hvg mild pcod from past 1 yr .am taking ovulation treatnment for getting pregnancy  frm 2 months am nt taking treatment am jst taking folic acid contained tablet n glycipage tablet and i missed my period last month it should be on 3rd may bt i didnt got period am i pregnant and am hvg water milky white discharge without itching burning n it is odourless plz kindly guide me",
    "doctor_response": "Hello, You said you have PCOD and on ovulation induction. Since You have not got the periods, Do urine pregnancy test with early morning sample. For white discharge and with out itching or burning is normal, so nothing to worry about it.See your obstetrician in case your Urine pregnancy test is positive.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to see small worms come out of your head? My sister has shaved her head and wears a stocking on her head before she wears her wig. She says she can see and hear them Bakersfield California think she is crazy and keeps giving her pills for illusions",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. It is possible to see small worms coming out of a persons head even though actually it is not the case. This type of behavior originates from psychoses. Illusions and hallucinations are normally their companion. Because of numerous such illusions, they settle to one illusion which they think they can overcome with their own trick. And they live with it. Treatment with the help of psychotropic drugs by a psychiatrist is the remedy. The treatment can also be augmented with psychotherapy techniques like Cognitive Behavioral Therapy (CBT).For more psychotherapy techniques, You can post a direct question to me in this website. Include every detail as much as you can. I shall prescribe some psychotherapy techniques to control your condition. I am sure that the techniques should be a success.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Liver problem. Leg and stomach swelling. Advise on health status and medication?\n\nDear Team, I am Ayush Kataruka residing at Purulia, West Bengal. My father, Anup Kataruka aged 52 years is facing liver problem. He is also facing swelling of his legs and stomach. I have shown him in Apollo Hospital, Ranchi on June 25, 2012. I have also carried various Blood test , CT Scan and Echo test of my father (all reports attached). The doctors prescription are also attached. Please advise on the status of my father s health, medicines prescribed and further course of treatment.",
    "doctor_response": "hi Thank you asking HCM. I am a gastroenterologist  and hepatologist with regards to  your attached medical reports I can't see them.I can say that  liver problems like  cirrhosis is often associated with swelling legs and other problems.we can talk together asking a direct query to me I would  be glad to assist you further Dr.KLerida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sperm analysis done. Sperm motility less. How can I improve sluggish motile sperms?\n\nhi,Doctor I have done  my sperm analysis test in which Detail Given Below Volume - 3.0 Ml Liquifection - 30 Mts Appearance - Thick And Viscous Sperm Count - 60 mill/ml Sperm Motility: 35% Actively Motile 50% Sluggishly Motile 15% Non Motile Abnormal Sperm  Please suggest that how can i improve my Sluggishly motile sperms",
    "doctor_response": "Hello,Thanks for the query,Zinc and vitamin A is necessary for sperm development.Please take these supplements daily.You will get good relief with this.Get sperm analysis done again after a month.Please meet an infertility specialist if problem persists.Let me know if you have any other doubt.you can ask a direct question to me on this forum, following the below link. you  good health,Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen ankle and sickness after injury\n\nHello I feel really sick I have recently just fallen on my ankle. My ankle turned inward with my foot facing outward. Just above the ankle it appears to be swollen. Why do I feel sick? How can is top feeling sic? What possibly could I have don t to my ankle?",
    "doctor_response": "Hello,I have studied your case. I think you might be having soft tissue injury in ankle. There is also chances of hair line fracture. I would recommend you to get x ray of the ankle joint to confirm the diagnosis. If there is fracture or ligament injury then you will need splinting of the ankle.   I would also suggest you to apply ice over the ankle and volini ointment local application. Do not keep in hanging or dependent.    I hope this answer will be useful for you. Let me know if there is any other followup questions.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am also hypo thyroid but normal count & nerve disorder\n\nI some times feel numbness in head ,ticklinn in my spine and down.Mild shakynes in head,followed by panick attacks and blurr image .Now at present i am 100 % well.But as climate changes or heavy climatic condition it occurs.Pls suggest .I am also hypo thyroid but normal count.",
    "doctor_response": "Hi Welcome to Healthcaremagic It is important to know your age and any other disease aprt from hypothyroidism, like hypertension and diabetes. But as it is seasonal, it does not look like an organic cause for which you should be worried. Anxiolytics may help you. Consult physician. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does sprayed bleach cause snoring and trouble breathing?\n\nI spayed bleach on the floor while my daughter was in the room and she started making gagging noises as though about to puke. She didn t puke, but now she seems to be breathing harder and snoring when asleep. Are the 2 related? She doesn t normally snore. Should I be concerned? She s 2 years old.",
    "doctor_response": "Hello.  I just read through your question. It is possible that your daughter is reacting to the smell of the bleach. I recommend consulting with your doctor so that she may be examined to make sure her lungs are clear.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause of infertility\n\ngood evening, my previous follicular study report shows bilateral ovaries adherent to each other .it cause problem of infertility ?",
    "doctor_response": "Kissing ovaries may some time cause infertility,adherent ovaries are some times clearly seen on ultrasound,cause may differ . Disclaimer",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in kidney, blood and white particles in urine?\n\nI am 27 yrs old with kidney pain. I have had blood in my urine and kidney infections for 3 months now. I have been on two different antiobotics and I drink 64 ounces of water a day. No caffine. I also have a history of reflux, and kidney stones. I had an IVP and CT done and it shows a stone in my left kidney. I also notice white particles in urine and 2 days ago and today I noticed tiney black specs a little larger than the size of a grain of sand. Been to 2 drs and they want to run more and more tests. My next appt isnt until a month away and I have pain in my kidneys and back.",
    "doctor_response": "Good Day and thank you for being with Healthcare Magic!I believe you may be passing out some kidney stones (small fragment) thereby causing pain on the flank area and sometimes in the abdomen at the lower quadrants. You may need to do a urinalysis to check for blood and to rule out UTI. A ct STONOGRAM would be the best imaging choice for you since it can detect 90% of stones in the urinary tract. If the stones are small then you may be able to pass it out spontaneously with just fluid hydration (2Liters of water a day).  I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at:   I would gladly help you.  Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sore in my mouth causing lip and tooth numbness\n\nAbout a week ago I developed an ulcer inside my lower lip btw the gum and fleshy part holding my lip to my gum. About 4 days ago I noticed that my tooth was going numb and now my lip on the right side is also feeling numb. I have noticed I am clenching my teeth together at times during the day...I am afraid of cancer! I don t and have not smoked or dipped and no family history of oral cancer . What is this? My dentist saw it ystrday and was concerned bt is waiting to see what happens over the next 2 wks.",
    "doctor_response": "you feel numbness because your dentist give u danzocaine content gel this is slightly topical local anesthesia............don't worry your dentist will treat this.......",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Sinarest plus syrup the right medicine for fever , dry cough and cold in a child?\n\nMy daughter was having fever, cold and a bit of dry cough. Her ped advised Calpol for 3 days, now her fever is reduced but it comes back in 6 hrs so the ped changed her medicines and advised Sinarest plus.Is it safe to give his sryup to my 4.4 yr old daughter?",
    "doctor_response": "Hi, yes its safe to give sinarest plus syrup to child. It mainly acts against cold, cough and mild fever. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat eosinophilia?\n\nMy nephew aged 3 years is suffering from Eosinophilia and the doctors are unable to understand the reason why it happens and no proper cure is done since 2 to 3 months it is also effecting his brain and the doctors are suggesting his brain condition as Acute disseminated encephalomyelitis. Kindly advice what to do?",
    "doctor_response": "HelloThe patient is 3 years old having eiosinophilia . The normal count of eiosinophils in body is 2-5 % while more than 8 % is suggestive of eiosinophilia and the drug of choice is \"diethylcarbamazine\" 1mg / kg body weight in divide doses. Increase up to 6 mg / kg body weight . You can also add steroid , if not treated with above medicine .As far as concerned about ACUTE DISSEMINATED ENCEPHALOMYELITIS , I recommend you consult a \"NEUROLOGIST \" and get his opinion because this is a disease covered by  a SUPER SPECIALIST or Neurologist .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pregnancy happen after having intercourse during a period?\n\nHow likely is it to become pregnant when having unprotected sexual intercourse on the first day of a menstrual cycle ? Is it a sign when the menstrual cycle (unlike being the usual 3-4 days time period) to only last one day and the bleeding stops completely the next day after intercourse and have no cramps ?",
    "doctor_response": "Hi,    Thanks for asking. I understand your concern.      Conception is impossible without ovulation.&ovulation can not take place during menstruation (it is 14 days prior to expected date of next period) -so ni chance of pregnancy with unprotected sex on 1st day of menses.     But you had scanty bleeding in following day of sex....in case you don't get normal bleeding in comming few days... please remember.. conception due to previous sex in last month  is possible &it would be followed by scanty bleeding due to implantation bleeding.      Pregnancy test should follow scanty bleeding...Aafter a week to exclude pregnancy.   Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes locked fingers?\n\nHi Dr. For several years when i have cleaned with bleach or ammonia my fingers or hands lock up. It used to only happen a few times a year at best. However, now my fingers lock up more often and my hands just ache...it is painful at times too...It doesn t seem to even need the bleach or ammonia these days to cause it....i am worried that it could be arthritic, or even RA. i also read that it could be related to an underactive thyroid, which i am convinced i have even though i have not been diagnosed with it...or possibly carpal tunnel although i don t think it is that, the pain is different from what i recall my one CTS episode was like (i felt it more in the thumb area that one time where this is the joints)...can you please help me?",
    "doctor_response": "Hi, Locking of one or two fingers occurs with depuytrens contracture phenomenon called as triggering of fingers. It is a gradually progressive condition characterised by roughening and pitting of palmar skin along with burning sensation, most commonly involved is the ring finger followed in order by little and middle fingers. Arthritis causes deformities in fingers but frank locking is not present. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Rohan Shanker Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can ringworm spread to others after starting treatment?\n\nI ve been diagnosed with Ringworm by my doctor, it is currently on both sides of my thighs and hands. It looks more like a rash on my hands and is very itchy. On my thighs is does look typically like ring worm and some of the lesions are quite large and join together. I have been on itraconzal tablets for 4 days now and have only seen an improvement in my right hand. My thighs are not getting better and new lesions keep appearing. I live in a house of 10 people with my family and there are a few children and babies - are they at risk of catching it even though I have started medication? It s getting me so depressed I keep crying everyday I m only 22 so I don t know why i ve got this. When will the medication start to work? Or do I need something else? Please help I don t know what to do.",
    "doctor_response": "Hello, Thank you for your contact to health care magic. I understand your concern. If I am your doctor I suggest you that ring worm or tenia infection are contagious they can spread by the micro spore and macro spore which arises from it. Once this spore establishes them self on the upper layer of skin of the other family member it start the diseases. You can use clotrimazole or Itraconazole cream for local application. Cetrizine helps to prevent itching. If the tenia is much wide spread and severe oral treatment with fluconazole is necessary.I will be happy to answer your further concernYou can contact me. Dr Arun Tank. Infectious disease specialist. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive after miscarriage. Can take folic acid? Not producing cervical mucous. How to boost it?\n\n(1) It's three months after my miscarriage now and really trying to conceive again. I have done all necessary check ups. Is it okay to take only folic acid 5mg per day.(2) Also, I observed 'm not producing cervical mucous during ovulation since after my miscarriage. Please what can I do to boost the production of fertile cervical mucous during ovulation.",
    "doctor_response": "Hello,Yes, folic acid can be taken on a daily basis as a prenatal vitamin. If ovulation status has been achieved on a regular basis and the hormonal profile is normal, there is no need of additional hormonal supplementation. If needed, your doctor may prescribe progesterone supplements to be used during the latter half of the cycle. Checking of tubal patency also is necessary if you do not see any result after at least six months of trying. Hope you find this information useful. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Done ovulation sonography after taking Fertyl. Chances of growth and conception?\n\nhi dr. i have undergone ovulation sonography after taking fertyl 50 mg,from d 3rd day of my periods i e 5th feb to 9th feb. on d 10th day of sonography, the follicle grew to 15x16 with endometrium 3 mm and today on 12th day d follicle size is 18x20 but endometrim is only 5mm my gynac has asked me to take progynova 1 mg 2tabs 3 times today and 2 tabs 1 time tomorrow and undergo sonography again .What r d chances of the growth and most importantly chances of concieving?",
    "doctor_response": "Hi there ~ There is a high chance of you conceiving.  Please follow the instructions of your gynecologist.  I wish you all the very best. I hope this helped.  Take care and have a lovely day !",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason of right apex fibrosis seen on x-ray?\n\nHi recently i have taken the medical report for going abroad in that they have taken a x-ray report that they was telling i have right apex fibrosis. but i didn t got any chest pain, cough, fever and kind of diseases. then why the doctor has tell like that can instruct for me",
    "doctor_response": "Rt upper lobe fibrosis can be due to subclinical or asymptomatic tuberculosis and can be completely unknown to you. Get a HRCT chest to rule out any active disease and also to confirm that it is a past sequelae",
    "dialogue_context": ""
  },
  {
    "patient_message": "Vertigo, dizziness, shoulder pain, arm pain when moved\n\nA week ago I had a sudden attack of vertigo , (so violent that it almost caused me to fall), which lasted only a minute but left me weak and dizzy for an entire day. The next day I felt better but still prone to dizziness . Now, a week later, I m mostly fine but yesterday I experienced a momentary dizziness while having lunch outdoors. This morning, I awoke with a sharp pain in my right upper shoulder . The pain does not seem to be traveling down my arm but I m having difficulty moving my arm without pain.",
    "doctor_response": "Dear sir ,vertigo and the pain in your right upper shoulder are two different things that don't have any relation with each other. I would recomand you b-histine 16mg twice daily for a period of two weeks. For your shoulder pain you should consult a rheumatologist probably it is a bursitis, that means a infamation of the shoulder articulation that is not a concern problem. wish all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could BP being 142/91 and pulse approx 60 after being on Nebicard for high BP indicate?\n\nHi! I am 36 year old Male, my BP was always on the higher side - 155+ /95 +. Post advise by a doctor, I started with Nebicard 5 mg OD. I feel lighter and better but my BP is 142/ 91 kinds and pulse is 60 approx, still not well controlled. Wat do you suggest? Regards, Rahul",
    "doctor_response": "Thank you for the query.As per your clinically history, you are a middle aged gentleman suffering from Hypertension (duration not specified).You have been started on Nebicard 5 mg (Nebivolol) by your physician. Presently, your BP recording is around 142/90 mm of Hg and Pulse rate is 60/min. Nebivolol is a cardioselective \u03b2 blocker (\u03b21 receptor blocker) with some vasodilatory property. The intake of this drug may explain your Heart rate of 60/min. At this stage I would advise you to strictly monitor the intake of salt in your diet (salt restricted diet is preferred), avoid smoking and opt for physical exercise. If you are overweight, then gradual weight reduction is advised.In case your BP is still not controlled, I would advise you to consult your physician/cardiologist, regarding addition of a second drug in the regimen like Calcium channel blockers (eg Cilnidipine) or ACEI/ARB. I dont think the dose of Nebicard can be increased further since your HR is 60/min.(As per the new JNC 8 guidelines it is preferable to maintain a BP <140/90 in a subject <60 yrs of age)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. A spot appeared on my hand recently. Does it look like a melanoma?\n\nHello doctor,I have a history of melanoma. This spot appeared on my hand this month. I am worried it could be acral lentiginous melanoma. Does it look like it needs to be biopsied? I had a wide excision of melanoma on the other hand on the middle left knuckle.",
    "doctor_response": "Hello. I have gone through the image (attachment removed to protect patient identity). It is a very small papular lesion at present. It does not need biopsy at present. But, if there is: then consider a skin biopsy. At present, a test like dermoscopy would help to see the morphology of the lesion. Knowing your past history keep check on the lesions. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be concerned about the poking of cat's injection needle?\n\nI was giving my cat her insulin injection through her scruff on the back of the neck. While I was injecting her, the needle went through her skin and poked my finger. I'm not sure if I injected myself but it is possible. She takes a very small dose of Lantus insulin. Should I be concerned or is it no big deal?",
    "doctor_response": "Hi, Thanks for posting in HCM. I have read your description and understand your concern. Since it a small dose of insulin and you had an accidental prick, you need not worry as insulin is absorbed well by subcutaneous route. In any case, kindly take care of the prick site by washing with soap and water along with rinsing the area with antiseptic solution, so that it would not get infected. Hope the information provided would be helpful. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will sleeping on his back cause a flat spot on my baby s head?\n\nMy infant 2 mo. has a dent in the back of his head from sleeping on his back and looking left. I have tried to turn his head, thus waking him. I have also tried rolling a blanket on his right side so he looks left. This seems to work until he scoots up when he wakes. My question is will this dent go away? And is it too late now that he is two months of age to reverse the dent?",
    "doctor_response": "Hi Thanks for writing to Healthcare magic.This is seen in many babies with flattening of one side if scalp. Its due to continuously sleeping on that side. Try out to keep his head in one position. Its difficult I know. Anyways, even if he has a dent do not worry, it will be only cosmetic , and can be camouflage with hair style later. And once dent is formed it cannot be revered",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for body pain and memory loss\n\nmy father is 71 yrs old and he is a diabetic patient for near 20 yrs. He is suffering from severe body pain and memory loss. He is unable to walk properly also. Diabetologists have suggested to consult with neuro specialists. And i am looking forward to clear suggestions in this regard to cure this illness.",
    "doctor_response": "Hello!My name is Dr. Aida and I am glad to attend you on Healthcaremagic!His symptoms (body pain) could be suggestive of peripheral neuropathy (considering the fact that he suffers from diabetes. The troubles with memory could be related to dementia or small vessel disease. For this reason, I would recommend consulting with his doctor and performing some tests: - a nerve conduction study for neuropathy- cognitive tests and a brain MRI study for dementia- complete blood count, PCR, sedimentation rate for inflammation- vitamin D and vitamin B12 plasma levels for deficiency- kidney and liver function tests. Hope you will find this answer helpful!Best wishes!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest tips to improve focus and concentration in studies and sports\n\nHi, My sister has 7 year old twins. One boy & 1 girl. Both of them are doing well. The girl is very smart and finishes all her work on time, but the boy is unable to focus on anything. He is also smart - but does not want to sit and do anything. He doesn t want to read or write. Even in sports lessons he doesn t show interest. What kind of evaluation will help him. Should we see a child psychiatrist ? What kind of tests are available in Chennai ?",
    "doctor_response": "HiI would recommend you to visit a child psychiatrist to rule out ADHD ( attention deficiency hyperactivity disorder) or learning difficulty in the child. A proper evaluation will be helpful. It can be easily done in Chennai.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is blood viscosity reversible by simply cutting down nicotine?\n\nHello doctor, It has been seven days since I have smoked a cigarette (quit cold turkey). How long will it take after quitting smoking, for the blood to be free from nicotine? Is blood viscosity reversible by simply cutting down nicotine?",
    "doctor_response": "Hi. Looking at the query, my opinion is as follows: The effect of nicotine is dependent upon the amount and years of cigarettes smoked and can vary from two days to two months. On an average, usually within a month of withdrawal of nicotine, the blood viscosity starts reducing. Yes, it is reversible as nicotine affects the platelets, red blood cells, the endothelium, and the clotting factors to increase blood viscosity. Once withdrawn, red blood cells will take a longer time, while the other usually recover as early as a month. During withdrawal, due to a reduction in blood viscosity, you might have dizziness periods as the blood pressure will also reduce. Give at leastthree more weeks to notice the improvement in blood viscosity. Nicotine patches havea low dosage of nicotine. You can use it to avoid cigarette in the initial periods, if necessary. Consult a hematologist online for further follow up -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Irregular period, experienced cramping, loss of appetite. Could I be pregnant?\n\nHi. Im 19. I ve always had irregular periods. I will sometimes skip a month but I have never skipped a month and experienced cramping before until now. My last period was Dec. 12 .2012. I have also had a loss of appetite . I get these cramps on and off and at first they were very severe but they have now calmed down a little bit. Could I be pregnant?",
    "doctor_response": "Hello,First of all, you have to rule out pregnancy ( as your period is late by 3 weeks from expected due date) by blood test for beta HCG or ultrasound scan.In exclusion of pregnancy, causes of irregular period are hormonal imbalance, stress/anxiety, ovarian cyst/PCOD, thyroid problem, wt gain/extreme loss, irregular eating habits, psychological factor etc.Need to investigate properly to rule out underlying pathology by USG lower abdomen,Thyroid profile, LH/FSH, blood sugar, blood estrogen & progesterone level etc. So consult with your doctor and take suggestive measures.Avoid stress, take healthy diet with iron supplements, control body wt ,maintain genital hygiene and need proper sleep.For direct consultation with me, you may visit my profile on  well & take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Medicines I took for ear fullness are causing tinnitus since a month. Please help me.\n\nHello doctor, I was having a severe headache and ear disturbances (fullness). After consultation with an ENT doctor,\u00a0Augmentin antibiotic and Actifed cold were prescribed for me. In the process of taking the drugs, I started having tinnitus (ringing and buzzing in the ear), which has refused to stop for about a month and two weeks now. It is very disturbing, even more than the previous ear fullness. I find it difficult to concentrate. Since then, happiness has eluded me. I need a medical advice. So, please help me.",
    "doctor_response": "Hello. Please let me know the following: Please revert with these answers, so that I can help you better. Please attach your prescription as well. Revert with more information to an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pains in my lower abdomen near my ovaries on the LHS?\n\nI am having pains in my lower abdomen near to my ovaries on the left hand side. These come and go over time, but tonight they are very painful. The pain is a sharp pain that doesnt go away. Sometimes it is in my ribs as well. I am also frequently urinating.",
    "doctor_response": "hello madam, thanks for writing to us,  as per your above mentioned symptoms the pain site can be a cause of concern. the reason for pain in that area could be either for some pathology in the ovary or in the kidney of left side. but this can only be confirmed after an USG of abdomen done,therefore i would request you to go for the above mentioned investigation along with other regular investigations.  thank you and wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the remedies for enlarged head in infants?\n\nMy son is only two months old. His head is slightly enlarged, arteries of his scalp are visible, although; he has a fair skin texture which allow such a visibility. I am sorry for his head size since i learned about hydrocephalus in infants! Pls help me out. My email:  YYYY@YYYY",
    "doctor_response": "Hi Dear Welcome to the HCM,It requires a local examination by your pediatrician to satisfy your suspicion.CT scan Head will rule out the diagnosis.Hope the query is answered.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will a cancerous mole have spread in 7 months?\n\nmy mom caught a mole today that she has had for seven months. it turns out it is cancerous and she is going to the doctor tomorrow to discuss surgery to see if the cancer has spread. if she caught the mole within 7 months, what are the chances she caught it in time?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your mother's situation and problem. Yes, a mole can develop into cancer in seven moths time. Skin cancers like malignant melanoma, squamous cell carcinoma etc can present as cancerous mole on skin. Usually prognosis is excellent if early detection and surgical removal of mole is done. So better to get done staging of this cancer. And if it is localised cancer than surgical removal with negative margins is curative. Seven months duration is sufficient for spread of tumour. If she undergone biopsy earlier than early detection was possible. So first get done staging of her cancer and than decide treatment strategy. Hope I have solved your query. Wishing good health to your mother. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for falling tendency in parkinsons disease\n\nRESPECTED DR NAMASTE.I AM A PARKINSON PATIENT SUFFERING FROM DISEASE SINCE 15 YEAR (SINCE1995) I AM TAKING FOLLOWING MEDICINE AS PRESCRIBED BY AIIMS SINCE YEAR 2005. MY ID IS MD NO.584/05.AGE 55 YEAR. MY MEDICINE:- (1) SYNDOPA PLUS 125 MG-1X7 TIMES ( 6 TO 8 TABLETS AS PER MOVEMENT REQUIRED i.e. 750 TO 1000 MG,)THIS DOSE IS CONSTANT FROM LAST 6 YEARS-WHEN I STARTED AIIMS TREATMENT IN YEAR 2005. (2) AMANTREL-1X3 TIMES (3) PACITANE-1/2 X3 TIMES (4) LONAZEP 0.5MG-DAILY NIGHT (5) SERTA-100MG-1 DAILY FOR B P:-------- (a) ATEN50-1 DAILY (b) AMLONG 10MG-1 DAILY (c) TOZAAR-1 DAILY ABOUT ALL MEDICINES HAVE BEEN TRIED.ABOVE IS THE BEST COMBINATION OF MEDICINE,FOR WHICH, I AM VERY GRATEFUL TO AIIMS. I HAVE CHECKED MY BLOOD SUGAR WHICH IS NORMAL(139 MG %) WITH ABOVE MEDICINES , I WALK ABOUT 200 M NORMAL BUT FUTHER ABNORMAL IS THERE ANY ANY HOPE TO AVOID FALLING TEDENCY? IMPROVEMENT IN WALKING AND WRITING AND TALKING?? . MEDICINE REACTED:--- 1--ECRIPT 2.5MG 4--PROCTINAL 2--TRIVASTAL L.A 3--ADCAPONE/ SYNCAPRONE 5--SINAMET ROPARK---NO EFFECT",
    "doctor_response": "Hi, It is good to note that you are doing fairly well even after having Parkinson's disease (PD) for so many years. However, it is well known that medicines for PD become less effective over time and may lead to side effects such as sleep disturbance, hallucinations, nausea, etc. In late stages of PD, you should explore the option of DBS- deep brain stimulation surgery. DBS is very useful for patients with tremors and drug-induced dyskinesia. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Sudhir Kumar, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat an infected crowned tooth and gum?\n\nI have had a problem with aa crowned tooth which became infected about a year ago, I went to the dentist had an xray which shoed some bone loss and was put on antibiotics then referred to a hygenist. I have since had trouble again and went back to the same dentist, he said wanted me to go back to the hygenist, I went to a different hygenist who said I had to change way way I brished to get rid of the bacteria. I tried his way but still have a problem, it has also been quite sensitive at times. I isn't as red although not pink like the rest of my gums and I notice a small red spot above the tooth, just want it to come right",
    "doctor_response": "Thanks for your query, I have gone through your query.The infected tooth which has a crown can be treated with root canal treatment and root planing with bone grafting. The red spot over the gums can be a pus discharging sinus tract. Consult a oral physician and get a radiograph done to confirm the diagnosis. Get the root canal treatment done by endodontist, followed by root planing and grafting by periodontist.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pressure in the head and dizziness?\n\nHi, For as long as I can remember I have funny spells of feeling very sick, going very dizzy (not being able to stand) and feeling like the room is spinning, I also feel a lot of pressure in my head. This usually happens when I get out of bed or if I stand up too quickly. 90% of these spells happen at night. I m only 20 so have never been too worried but it is happen a lot more frequently the last few weeks. What could this be? My GP seems to brush me off when I mention it!",
    "doctor_response": "Hi there. It could be Vertigo due to inner ear disorders, brain disorders, fluctuating blood pressure etc. Get a Neurologist checkup.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath while suffering from stomach flu?\n\nI went to the hospital day before yesterday for dehydration due to stomach flu. I am able to keep down water and gatorade and crackers and toast. 3 days ago I was sick from both ends(sorry for graphics) no more vomiting but diarrhea in the am today. I am continuing to have shortness of breath...is this normal? What should I do??",
    "doctor_response": "Respected user , HiThanks for using Healthcaremagic.comI have evaluated your query thoroughly .*  This is in relation with reflux of stomach acid due to stomach flu ,  electrolyte imbalance giving  rise  to short breath .*  Recommendations  for better recovery -  Deep  breathing  exercises  , YOGA-  Remain ambulatory with walking in fresh air .-  Avoid oily , spicy stuffs .-  No smoking .Hope this will help you .Welcome for further doubts .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constipation in an infant?\n\nsir my baby is in 22 days in starting time he was very well in deliver motion but last week he went two days late and three days late so please say the reason and problem and how to cure this problem and this problem only for this time or else in future please say",
    "doctor_response": "Hi, can very well understand your concern. Infants passing motion once in three days to 7-8 times a day is considered to be a normal. If baby is accepting feeds well, no vomiting, no excessive crying then not to worry about motion. Feed the baby every two to three hourly. Burp the baby well by holding the baby in upright position. Baby's having mixed feeding like breastfeeding and top feeding may have digestion issue. Feeding mother should drink plenty of water. Hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for skin allergy\n\nHi,My name is Mrs. Firoza Bhandari. I have been having skin allergy since one year. it started from my leg and has reached till chest. I have already consulted so many doctors and have performed all the test. but its not getting any better. Pls advice",
    "doctor_response": "Hi firoza,You have mentioned about skin allergy from leg to chest but you didn't mentioned what kind of allergic symptoms were they? What was the appearance of skin?See,skin allergy is a very broad term,doctor will not be able to understand to have a clear diagnosis.The best way to cure allergy is to avoid contact with the allergen rather than taking treatment.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes memory loss while on Xanax?\n\nI am a 71-y-o white female with IBS. A Houston neurogastroenterologist put me on Xanax (+ other meds) 10+ years ago and I was later put on gabapentin by a Houston neurologist for an undiagnosed (not epilepsy or Parkinson s) heavy, significant intermittent tremor sometimes associated with stress. Could either of these long-term drugs cause memory loss re. vocabulary (words & names)? It s is very frustrating and seems slowly increasing.",
    "doctor_response": "long term use of xanax , alprazolam causes decreased concentration , decreased memory but not severe memory loss. gabapentin may cause excess sedation , decreased concentration. but no severe memory loss by either drug. at 70 yr age most common cause of memory loss is alzeimer disease. it is slowly progressive degenerative disese cause memory loss in old age",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blisters on foreskin and red spots on penis?\n\nWhat s the explanation for the sudden blisters on my foreskin and the red spots on my penis? Blisters heal for a day or two and then when I peel to wash, the skin gets cracked again. Some information for you: My wife has frequent yeast infections. I am not circumcised. I am using a new scented soap to wash the glans. I am also on antibiotics for a bacterial infection.",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: May be herpes/ balanoposthitisExplanation: Herpes infection can cause these type of blisters. Creacking of forskin is due to dryness and repeated infection and scarring of prepuce. So, as you are already under medication, please continue that and go for a followup with your doctor for complete cure. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood discharge from the mouth and weight loss?\n\nmy sister s weight is just dropping likeanything and recently she has been waking with a mouthfull of blood for the last few days...... we have been to the hospital and they can t seemed to diagnose her yet but hey seemed t be contnuing drawing blood out of her spine for some reason ... and she is in agony when they do it because they did it like 8times yesterday and when she wantsto go to the toilet afterward as sson as she stood up blood just shoot out from the whole on her back wher they have been drawing blood from.... the doctor still hasn t come up with anything yet and we are really concern about this situation ... please help...",
    "doctor_response": "Hi, As per my clinical experience, there can be various possible issues as - blood dyscrasias as coagulopathy or else - tuberculosis of spine or else - malignancy or other grave pathology. However, if you can provide the available reports as scanned copy in follow up conversation, I can guide still further precisely. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to heal gas problem in infants?\n\nMy 3 week old infant has been traightening his legs and crying and looks in discomfort.He has only just started doing this in the past couple of days and seems to wake up after an hour after settling him down to sleep or 2 hours after his feed. he has been passing wind and burping extremely loudly. Is this a case of trapped wind? If so what do you recommend? thank you.",
    "doctor_response": "children usually tighten their limbs and get uncomfortable due to colic which is a very common problem at this age.if the child is breast feeding try to feed the child while sittingkeep the child upright on your shoulder and burp him for 10 to 15 minutes you can try making the baby sleep on his left side or on his tummy dont make the baby lie down immidiately after feed if the problem persists you can try anti flatulence drops like simethicone (colicaid) 0.5ml when the child is having colic.can be given for 2 to 3 times a day",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a bruise on the toe after a big sting?\n\nI got stung by a honey bee on the bottom of my second to yesterday, not allergic thankfully. I removed the stinger right away and cleaned with alcohol, a little swelling but it felt like I dropped something very heavy on the top of my toe. The bottom is fine and the swelling is gone, but now there is a bruise on the top of my toe. I m wondering, is that normal?",
    "doctor_response": "dear user......sting usually followed by allergic or immune reaction that cause swelling or inflammation or bruise of the affected area ...........but from your words you did amistake when you apply alcohol to affected toe.............we recommend only ice packs...it will make improvement............alcohol generally is very irritant and not recommended in case of sting injury............alcohol cause more reaction of the tissue and cause bruise so it was good that you have no swelling when injured but mostly alcohol cause that bruise............wish you ahealthy life...take care of your self",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the signs of infertility?\n\nmy wife took the birth contole tri-spentec for almost a year and stoped taking it nearly 3 months ago and we have been trying to concieve for 2 months now our first child concieved on the first try is this a sign of infertility or is it normal after coming off berth controle",
    "doctor_response": "Hi,Thanks for writing to HCM.After stopping of birth control pills it takes average 6 months for body to adjust and become normal. Some may take more and some less. Because whole one year body is getting signal not to become pregnant.Its not a sign of infertility.I suggest you to try for 6 months if didn't conceive then consult gynac .If your wife  cycles are not regular then you may consult doctor now itself. But even cycles take time to become regular.Hope I have been helpful.RegardsDr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest diet for a patient with renal failure\n\nmy mother is 48,she is has gone through two operation of gole stone and uterus in same day after that,doctor said she has a acute renal failure now she is in dialysis thrice in a week.and recommended to take potassium less diet. please allow me the diet chart.",
    "doctor_response": "Hi and welcome to HCM.  As an Urologist and kidney transplant surgeon, i can understand your anxiety.Diet is very important in renal failure patients.1. salt restricted to 5gm/ day. No added salt while eating food.2. 40gm protein/ day. Avoid red meat totally.3. 2000 calories / day in an adult,but adjusted according to body weight.4. No fresh fruits or coconut water,as they're potassium rich.!!5. Fluid intake should be strictly,urine output plus 400 ml/day.If you've any other doubts,send a direct question,in my name.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for having low platelet count for a person having history of HCV?\n\nHello, My mother is 54. She has a history of HCV which has been treated and is on SVR, She has T2DM and on Insulin, plus she has celiac disease. The problem is, she often has low platelet counts such as 70 thousand a week ago. What could be the reason.",
    "doctor_response": "Hi, Low platelet counts are commonly seen in hep C infected patients. The reason is weak bone marrow which cannot synthesize platelets and large spleen which eats some of the platelets. Autoimmune destruction of platelets has also been proposed. however, you need not worry as long as platelet count is over 30000 as clinical bleeding is uncommon above that level. you need to take precautions to see that she keeps away from injuries to prevent bleeding.All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can medicines improve kidney conditions?\n\nhi my brother is kidney patient n now he is on dialysis heart enlarged hepatomegaly vommiting n urea creatinine raised n very less urine n his bp is 160/100 after taking medicine twice a day i want to know can he cure frm any treatment can his kidneys improved frm frm medicine his age is 27 plz reply me as soon as possible thank you",
    "doctor_response": "Hello and welcome to HCM.As an Urologist and transplant surgeon,i can understand your anxiety.Your brother has kidney failure,enlargement of heart and liver,with H.T.For kidney failure,he's on dialysis. A kidney biopsy is needed to know,cause of kidney failure. B.P.will be controlled with medication. The cause for vomitting,may be due to any of his medical problems.He'll need to do blood routine,creatinine,LFT,electrolytes,RBS,and U/S-KUB.Once his medical condition improves,he should have kidney transplant.If you've any doubts,send the reports to me,as a direct question.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white penile discharge and pain in leg?\n\nhi doctor, for the last 4 months iv had a white penile discharge. Ive been tesded for STD, urology, swab urine test, all Negative result, and had a prostate exam im only 24years old. Ive been in antibiotics like doxcillin for 4 weeks and andither strong one for two weeks, yet i still have have this condition! I also feel like a pain above my left leg and usually after ejaculation when i walk on my left lower side a discomfort. Could i have leaking semen? What can it be? Thanks",
    "doctor_response": "Hi, It can be retrograde ejaculation (leaking semen), urinary tract infection and chlamydia. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stone in gall blader. What is the treatment for this ?\n\nMy father has stone in his gall bladder. what is the right treatment for this",
    "doctor_response": "You have not mentioned his age.Size of the stone,number of sones in the gall bladder,other medical condition like diabetes,high cholesterol level are all factors to be considered when we plan the treatment.in general ,patients with multiple stones,single large stone ,  diabetes  and those who had complications due to stone are candidates for removal of gall bladder.medical treatment can be done in selected patients but not for large stones.Removal of the gall bladder is done without making large opening in abdomen.The procedure of choice is Laparoscopic cholecystectomy which has become the gold standard and it is a common procedure",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in ribs while breathing?\n\ni have realli bad pain n my ribs when i breath that i have to stop the breath im taking and take very smaller breathes.. n i wake up with random brusing all over my body.. what could it be? my hair is even falling out more then ussual.. i kan run my hand thru it and literally get a hand full o fhair",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Your chest pain is mostly due to musculoskeletal cause.So avoid movements causing pain. Avoid heavyweight lifting and strenuous exercise. Apply warm water pad on affected areas of chest. Take simple painkiller like paracetamol or ibuprofen. Your hair fall should be evaluated for hyperthyroidism. So get done thyroid function test.If this is normal then no need to worry for hyperthyroidism.Sometimes stress can also cause hair fall. So avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be concerned for lump below skull?\n\nafter a visit to dentist yesterday and concern I have an infeciton somewhere, I noticed a small hard lump while shampooing my hair this morning. It is just below my skull about 1-1.5 in. to the left of spine. It is tender but no significant pain. Should i be more concerned or is this a gland or something?",
    "doctor_response": "Hi,It seems that this might be due to enlarged lymph node due to some infection in the mouth like teeth or on scalp.consult your doctor and get examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat swollen glands accompanied with pshoriasas, Rosea?\n\nI got swollen glands above my penis to the left and right,almost at the same time I got pshoriasas on the soles of my feet and the palm of my hands with severe Rosea..have tried everything to no avail otherwise Iam quite healthy,I did loose a lot of weight as I lost appitide maybe 2 stone,but have regained some of the weight",
    "doctor_response": "Hi,.The swollen glands are not related to your palmo-plantar psoriasis. Palmo-plantar psoriasis can be well controlled by applying moisturizing creams and keratolytic ointments as topical application after softening the affected part with warm water. Vitamin A and Omega 3 fatty acid supplements will also help for faster relief.Regarding the glands, investigations to rule out possible causes including STD,Tuberculosis, Filariasis etc. have to be carried out. If necessary a Fine needle aspiration biopsy from the gland will help to fix the diagnosis and for further treatment. Get Well soon. Dr S.Murugan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes throbbing pain between lower back and hip?\n\nwhy do i have a throbbing pain between my lower back and hip. seems like it is on the right side most of the time. It is not there all of the time. I first notice it early in the morning while trying to sleep. It eventually goes away a couple hours after I get up and eat breakfast.",
    "doctor_response": "Dear Sir/ Madam,Thank you for your posting your query at www.healthcaremagic.com.Morning pain in back sheds the light on sleeping pattern and the mattress. If the mattress is too soft than one can get back pain. Also try to use body pillow if you turn one side and sleep and if you sleep on your back then keep a pillow under the knees. Use of hot water fermentation will help in releiving painTry doing warm up and cool down exercises in your exercises regime.It the pain is terrible and radiating down the legs, than please consult the orthopedic who will advice you to take an x-ray and/or MRI.It would have been easy for me to advice you more precisely if I would have known the age, sex(post pregnancy), weight,  for how long the pain is?, type of work, any previous history of injury.Please write to me if you require any further information.Thank you!With best wishes,Tehzib saiyed (PT)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard black stool and cough after giving Motrin?\n\ni think my infant had a childrens motrin allergy/ Ibuprofren allergy.im curious to know if the reaction stays in the system until treated/addressed or does it cure itself? my pediatrician said my son has excema and disregarded my concern I want to say he started slight skin rashing aound 6mo - around same time he got HFMD and was given infants motrin in the last year the rash comes n goes, his poops are like rocks/ clay like or black 75% of the time, and has had repeated coughs n congestion- I recently gave him the childrens motrin and he broke out in a burning hive rash aka excema don t think soo",
    "doctor_response": "Hello.  Welcome to 'Ask A Doctor'.  I have read your query and here is my advice.  A side effect of Motrin(ibuprofen) is to cause stomach inflammation which can make the stomach's inside lining bleed. The blood is carried along with intestinal contents through the entire intestinal tract.  By the time it reaches the end it is black and makes stool black.  Blueberries, Pepto-Bismol, and iron supplements also make stool black.  A hive rash is an allergic rash and could be due to Motrin, especially if the hives appeared very soon after you gave him the dose.  Tylenol does not irritate the stomach and is safer.   Hard stool is usually due to not enough liquid intake.  You may want to try giving apple and pear juices.  If that doesn't help, prune juice, 1-2ounces one-two times per day might be beneficial.  Frequent colds and coughing could be from being in close contact with other young children who are infected with various viruses.  How old is your child?  Does he attend daycare?  Also, cold and cough syrups are NOT recommended to give to children five years or under because their is no evidence that they are effective for colds and they have side effects.  Saline nose drops(such as Nasal) one drop into each nostril before feeding and naptime will moisturize his nasal mucus and help him to sneeze and blow mucus to front of nose where you can easily suction it out.  Humidifier so that mist gets to his nose might also help.   Hope I have answered your query.  If you have any further questions, I will be happy to help.  Arnold Zedd, MD, FAAP",
    "dialogue_context": ""
  },
  {
    "patient_message": "Irregular periods, taking medrigest. When can i do intercourse to get pregnant?\n\nHi, I have taken  tablet prescribed by my  doctor last month for irregular periods and I got periods on Aug. 13 ask me to put medrigest on 10th day after periods  for 5 days.now on 2nd September I got periods and running on, again if I put medrigest on 10th day it will not affect my pregnancy? when can I do intercourse to get pregnant this month?",
    "doctor_response": "Hello,Medrigest contains Medroxyprogesterone and it can be used on 10th day as per your doctor's recommendation. It will not affect your pregnancy if you conceive successfully.In irregular cycle, you have to track down your ovulation time. You have to use ovulation prediction kit after period over if you have short cycle. Do unprotected sex close to ovulation day (14 days prior to next period) or fertile days to maximize the chance of pregnancy. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "PCOS, irregular periods, had miscarriage, 3 IUI unsuccessful. Suggested IVF. How to know fertility days ?\n\nhellow doctor,i have pcos diagnosed in 2009.my marriage was 24-10-2008.after marriage my periods are irregular.I have a misscarriage in 2010. (6 week Pregnency).Me and my hus going for treatment.2011 i have laproscopic surgery. after than 3 iui done. At that time no ovulation happend. Next our doctor suggested ivf . Now i got period.today is 4th day.it 36 day cycle. Now i wnt to know my fertility days.now we are trying naturally.My hus count was good. But lower motility.",
    "doctor_response": "Hi, Whenever PCOS is there, it is difficult to determine the period of ovulation naturally. Since you have tried 3 cycles of IUI already, I would suggest you to check the patency of your tube also. The best method to check for ovulation is Scan-  follicular study.Since your husband's semen motility is low, there are certain medicines (anti oxidants) which improves the motility. Since you had one pregnancy earlier, you have high chance of getting pregnant. All the Best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat neck swelling and pneumonia?\n\nI have stage 4 oral cancer, and just have another biopsy done a week ago. Since the surgery I have noticed that my lymph node on the right side of my neck has been swollen and trender. Can't really swallow wether I'm drinking fluids or trying to drink soup broth. FYI my biopsy results came back neg. it's just a bit of pneumonia in my chest and lung so praise the Lord that it wasn't more cancer. Please help with answers having trouble putting weight back up from just ensures alone.",
    "doctor_response": "HIWell come to HCMBecause of the Bacterial infection such lymph node is common signs, in my the biopsy is unremarkable then with the treatment of underlying cause everything would be fine, proper antibiotic is the matter, hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightening in the chest?\n\nI am a 23  year old female.  Today I woke up and when I breathe in deeply I feel tightening on my chest , close to my collar bone.  My throat is also bothering me along with my left ear.  Im not sure if the chest pain is because I am developing a cold or it has to deal with my heart.",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, tightening here in your case could be due to muscular spasm and it may not be due to any cardiac disease, in this young age and in female chest pain due to heart disease is not likely unless have some congenital disease, what the symptoms you mentioned it here could be muscular spasm and would be temporary if ever happening due to deep breathing spell  and hope this information may helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for nausea and dizziness along with dry heaving\n\nI am a 49 y/o male..I work the night shift and get mixed /broken sleep...Here in the last 4-6 weeks.. I have encountered bouts of dizziness and extreme nausea..The nausea hits hardest in the early morning hours around 5 am to the point of dry heaves.. Moving my head sometimes exacerbates the dizziness and nausea.... Have recently been to Dr and put on BP medication and told I am hypertensive and also have an inguinal hernia which I already,,knew.. The above mentioned symptoms have hit me squarely within the last 4 weeks however..... Would like some further advice... Thanks",
    "doctor_response": "HiThanks for using healthcare magicI think, you have panic attack. In that case, you need antidepressant with low dose benzodiazepine. That would help to control underline anxiety and keep you calm. You can also try some relaxation exercise like JPMR or deep breathing exercise. Better to consult a psychiatrist for proper diagnosis and treatment. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the heart and back of a child?\n\nMy 6 yr old complains of shooting pains in his heart , back pain, and other various pains. His ped said his lungs are clear and heart sounds normal. He mostly complains1st thing in the morn or before bed and not during physical activity. He seems in good health otherwise. What could it be?",
    "doctor_response": "Hi,Thanks and welcome to HCM. your history suggests that he may be suffering from acid refluxLanzol junior syrup will relieve his symptoms.Avoid spices,chillies and oily foods in the diet for short time.Hope this reply is OK for you.Please feel free to ask further queries if any.Dr.M.V.Subrahmanyam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the right age to give Omega 3 for kids?\n\nat what age can i begin to give my 4 month old baby omega 3 or is it just got naturally through food? hes on formula not breast milk.i breastfed for two weeks and i took omega 3 the whole way throughout my pregnancy. also how do i boost his immune system?",
    "doctor_response": "Hi,No need for such fancy things. Top feed contain all of these. You just start try to breast feed again and this will increase your immune system automatically.  Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Hina Javed",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes black spot and lump at the bottom of the foot?\n\nHi Doc, since about a month now I have two black spot at the bottom of my foot, first I thought something was in like a piece of wood or something, but I know for sure that there is nothing in, it feels like a little lump and sometimes hurts when I put it directly on something. What do you think it is and how can I get rid of it. I just moved to Egypt and could not find any skin doctors, so is there anything I can do at home.Thanks in advance",
    "doctor_response": "HI,Dear,Thanks for the query to HCM.1-I have studied your query in depth.2-DEar,IN my opinion, these 2 black spots on the foot for a month duration,which hurts when handled or hit,are due to the -recovering hits causing black-blue spots,which are not resolving-this could mean a recurring hit on low leg-varicose vein,causing these 2 black spots not going over a  months time.3-The pain points at the traumatic origin and the non-resolving spots-points to the Varicose-perforators being repeatedly hit ,leading to the non-resolution over a month.4-Other causes ,could be a melanoma ,which needs Surgeons consultation 5-Surgeon would fix the diagnosis of the black spot and would treat accordingly.I would advise you to consult ER surgeon URGTLY-as the  pain could be damaging to your foot.6-Hope this would solve your query to your satisfaction.7-Wellcome for more queries to me On HCM.8-Thnks once again for your inquisitive query.Have a Good Day..!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Decayed teeth, had abscessed tooth, swelling in gum. Should I get dentures?\n\nI have really bad decayed teeth from poor hygiene And the disorder I was born with I had absessed tooth almost a year ago and went To the er Had to to go the dentist Went to the u of m school of denistry They said my best opinion was to get dentures on top And partial on bottom.they pulled 3 teeth in the period of going There 8.months . It s hard because i don t have insurance So I had to pay everytime out of pocket I m scared to do it Right now my tooth on the bottom which is the tooth I had the absess is swollen The gum is swollen I brushed it as best I could because it hurts Just a little . I took Advil about an hour ago",
    "doctor_response": "Hello, As you have mentioned your tooth seems to have undergone decay . Decayed teeth spread infection to the deep tissues and infects the nerve pf the tooth leading to pain and sensitivity , this is called PULPITIS , that is inflammation of the tooth nerve. Infection from the tooth spreads to the underlying periodontal tissues leading to formation of abscess. i suggest you to visit a dentist and get a root canal treatment done for your tooth which will remove the infected nerve and seals the root apex. Gum abscess is drained and heals as the tooth is devitalized. the root canal procedure  devitalises the tooth completely and subsides pain permanently. After root canal treatment ,the tooth is covered with a crown coverage and the adjacent missing teeth can also be replaced by a prosthesis. i hope this helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will susten 200 affect subsequent ovulation?\n\nmy wife was given susten 200 for 10 days after ovulation through an injection. After 14 days of ovulation, period happened but period was very light and short (2 days), usually it use to be for 3 days. Now, it is 18th day and I doubt that ovulation has happened. Will susten 200 affect subsequent ovulation.",
    "doctor_response": "Hi,Thanks for writing to HCM .Ovulation has happened or not you can tell either by monitoring daily basal temperature or using ovulation kits or ultrasound scan. Some symptoms of ovulation are abdominal and pelvic pain, white discharge. Susten is progesterone ,natural sex hormone which helps in maintaining early pregnancy and avoid abortion. So it is given after ovulation so that if conception occur it should be managed.  Susten doesn't effect subsequent ovulation.But after taking so many hormones you may get little variation in period length or ovulation timing .   Hope I have been helpful ..Regards Dr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should the antibiotic for bronchitis be taken to complete the course?\n\nHi, may I answer your health queries right now ?  Please type your query here... I had bronchitis. And now I am better, and have a slight and occasional cough. should i still take the antibotic given to me, and completete the course? even if im better?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Yes, you should definitely finish the entire course of antibiotics given to you. It is good that you are better now. But you don't finish the antibiotics, infection might relapse and cause recurrent bronchitis. There is always chance of drug (antibiotic) resistance if you don't finish complete antibiotics.So better to finish whole antibiotic course given to you despite of improvement. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pericarditis associated with pain in chest and armpit?\n\nhello. I have a sharp, stabbing pain in the center of my chest that come and goes. I also feel a dull pain in the center of my shoulder blades in my back, I have a resting heartrate of 104. im a 38 year old black female weighing 179 a 5 1 . I have also been have weakness and a pain I cannot really describe in my left arm from arpit to thumb, iwas thinking pericarditis and planned to go so my dr but I didn t get to call in bwfore they closed. can you enlighten me as to what may possibly be going on? I live 45 min away from nearest hospital.",
    "doctor_response": "Thanks for your question on HCM. I can understand your concern. By your history and description, possibility of ischemic heart disease(coronary artery disease-CAD) is more.Paricarditis is unlikely cause for chest pain. But you should consult emergency room android get done ecg and 2d echo. These will rule out both pericarditis and CAD. If both are normal then no need to worry much. Your symptoms are mostly due to stress and anxiety.  So avoid stress and tension. Be relax and calm. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure severe back pain?\n\ni am on tramal hydrochloride 100 mg 2ml injections. I have server back pain. I was on oxicotin 60 mi for 3 years. My problem is nothing is working anymore. I was told by a friend to inject the tramal strait into my vein and I would get better releaf is that true.",
    "doctor_response": "Hi, thanks for writing to HCM.Simply, increasing the dose of an analgesic medication or changing the mode of administration (by I.V.route) will only masks or suppresses the pain but that is not going to solve your problem as the root cause for your back pain is not being addressed.So, unless proper diagnosis for your back pain is made and the root cause is treated, your symptoms will stay with you.I suggest you to consult a spine surgeon for a detailed clinical examination and further workup (xrays & MRI scans).Hope this information is helpful. Good day",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat anxiety and depression with history of  brain aneurysm?\n\nI had a brain aneurysm in 1997,  and now I am dealing with anxiety and depression. I have been to mental health services and seen psychiatry. That keeps me more disturb saying things that I am making up things and that I am hyper and I monopolies about my past. I am suffering now and need suggestions to control of head again. I look normal on the outside but inside my head I fell very sick.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Your mental health services people could be right. Let me explain. they said that because they could not find any organic relationship between your current problem and brain aneurysm in 1997. So possible reason is hypochondriasis.  Hypochondriasis or hypochondria (sometimes referred to as health phobia or health anxiety) refers to excessive preoccupancy or worry about having a serious illness. This debilitating condition is the result of an inaccurate perception of the condition of body or mind despite the absence of an actual medical condition.In your case, you probably are worried about the previous illness and that causes you the discomfort. Such a discomfort and state is possible. The best possible treatment include psychotherapy and relaxation techniques.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.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Duphaston effective in the treatment of infertility?\n\nHi ,I am 30 yrs old.am try to getting conceive last 6month.my gyne advised to take duphaston 10 mg to regularise the period.i am pcos patient.i took duphaston 11 to 19 days.still no get period.in between time we had fun .nipple soreness last 2days.Am I got pregnant?",
    "doctor_response": "Hello,It is a little tricky because breast tenderness is seen in both situations of pregnancy and premenstrual period (normal cycles).As you have PCOS (Polycystic ovary syndrome), you might be having irregular periods, and anovulatory cycles where progesterone hormone is not released so might not have experienced these symptoms of progesterone-like soreness of breast or bloated sensation.Now that your Gynae doctor started you on progesterone in the luteal phase, you might be experiencing this.Anyway, you can wait for one week after finishing the dose and test for pregnancy either by Bhcg in blood or urine pregnancy test.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Avanti Sathineedi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it possible to experience urine leakage due to anxiety?\n\nHello doctor, I am a 36-year-old male. I have been having a problem with urine leakage for the past few months. After I urinate, several drops of urine oftentimes leak out. It has left a small spot on my jeans a couple of times. It happens even if I wait a minute and try to force all of the excess urine out. I have also noticed a drop in the tip of my penis occasionally when I am lying in bed. I am wondering if this could be caused from anxiety. I have had an extreme amount of stress over the past year, which I believe has caused me to have some muscle twitching. But I am also wondering if all of this could be caused by a pinched nerve. Also, because of the stress, I gained approximately 20 pounds a few months ago. At 5\u2019-11\u201d I am 182 lbs, which is just barely overweight. Could this cause this problem? Could this be caused by either stress, a pinched nerve, or weight gain? Also, do I need to be concerned about prostate cancer?",
    "doctor_response": "Hello. First thing first. You do not need to be concerned about prostate cancer at all. It does not occur at this age. Secondly, have you done any investigations yet like uroflowmetry or ultrasound abdomen with PVRU? Do you have any urinary complaints like frequency, urgency, poor stream, nocturia, dribbling, burning micturation? Are you diabetic or hypertensive or on any medications for this? Do you have taken any medication for your urinary problem (urine leakage)? Do you have urine leakage only after you go to pee or sometimes before going to pee you are not able to control and it leaks? And when you cough or sneeze do urine leakage occur? Married? Children? Any history of constipation?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can auto immune problems cause swelling in joints?\n\nam suffering from auto immune related problem....for that am taking medicine wysolone 5, pan 40, zy-q, sazo 1000, oncotrex from last two months..but still my has not reduced...earlier only right knee was swelling and paining.but now my left hand joint and back bone also paining hell lot....may i know wats the reason for this and medicine???",
    "doctor_response": "Hi, There are lot of autoimmune diseases which causes joint pain like rheumatoid arthritis and psoriatic arthritis and many more, for the correct diagnosis and treatment get your blood test done respectively. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Jaideep Gaver, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for vomiting?\n\nMy three year old son was prescribed Ondansetron yesterday after a stomach virus lasting several days landed him in the ER. It has been very effective at stopping the vomiting. Now his twin brother has begun to vomit as well and I m tempted to give him a dose of the Ondansetron to help him get through the night. Talk me out of it....",
    "doctor_response": "hi, yes you can give ondansetron to the child to prevent vomiting but an examination by doctor should be done as early as possible. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do my muscles in the lower back pain post operation?\n\nAm post op recovery - since early January find that when I sit too long my muscles in lower back just below my tailbone the muscles hurt.  My hyster was april 10 2013... maybe weight gain... have to always sit on cushion to be comfortable this last while - am a hyster sister member.",
    "doctor_response": "it is a common thing to have pain after hysterectomy or Caesarian section. This is because abdominal muscles are not providing support to back. I would like to suggest back muscle strengthening exercise. Also you should wear lumbosacral belt , so that abdominal muscles able to support your back. Also I would like to advice you muscle relaxant like Myoril or Myospaz. Apart from this apply Diclofenec gel . Hot water fomentation and back strengthening exercises is also helpful you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness after a dental extraction?\n\nHi,My wife had three teeth pulled on Wednesday(preparation for a bridge). She started feeling dizzy on Thursday afternoon and is still feeling dizzy and tired on Saturday. She has been eating and getting fluids. i was wondering if these are normal symptoms",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,   I have gone through your query , yes this dizzeness can be due to , malnutrition or deficiency of vitamin B , Anemia .  You should advised her to take healthy nutritious diet .  Fluid intake should be maintained like fruit juice , glucose .  One Capsule vitamin B 6, 12 supplement   Proper sleep of 8 hours  There is nothing to worry much if it happens for more then one week then consult physician.   Hope this will help you  Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dizziness with jaw pain and numbness\n\nblood pressure standing 126/79 and sitting 137/78, jaw numbness coming and going, more when sitting, slight fatigue, feeling low last week was diagnosed WPW after going to ED from work regarding dizziness and jaw pain and numbness. No heart problems after 1 night of observations. No jaw or head symptoms out side of work environment.",
    "doctor_response": "Hello, Your symptoms could be related to cervical spine chronic degenerations. For this reason, I recommend performing a cervical spine X-ray study. The changes in your blood pressure could be suggestive of orthostatic hypotension. For this reason, I recommend performing a Head-up Tilt Test in order to investigate this possible disorder. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden dizziness and weakness on right arm and leg?\n\nHi, my wife has been experiencing sudden weakness on her right arm and right leg. This had happened 4 times during the last two years. Every time she would just all of a sudden feel dizzy and just faint. She would then wake up about half an hour or so later. What s wrong with her?",
    "doctor_response": "Hello, As in females, it's become off late common to faint and lead to tension in the home. But this is totally related to lower hemoglobin and low iron levels. Having a blood routine to check the HB will be good as an oral supplement of iron and calcium medicines or through diet can be helpful. Indulging into physical activity will be on a positive note. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What was the pain in my lower palm area?\n\nLast night, I got a mysterious pain in my hands, both in the lower palm area. Also, I ve lately noticed strange feelings in my back beneath the skin, and itching at the surface.The last part seems irrelevant to me, but they might be connected. I dunno.",
    "doctor_response": "Hello,Thank you for contacting me at \"Ask a Doctor\". I will try to answer your question to the best of my ability.Your symptoms are very nonspecific and it is very difficult to give you a true clinical impression of your problems.  From the sounds of it this is probably something very minor and will resolve spontaneously.  If your symptoms worsen or you develops any new symptoms I would suggest that you see your primary care physician as soon as possible.I hope this information is useful for you. Please do not hesitate to message us back if you have any further questions.Best wishes,Adrian Rawlinson MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are diarrhea and joints pain signs of vitamin C allergy?\n\nIs there such a thing as allergy to vitamin C. Two females I know are telling me they are. One has diarrhea, the other has diarrhea and bone and joint pain. Both have had complete physicals, recently. Other than age related aches and pains (both in there late 60s) they both are healthy. I didn t think it possible to have this kind of reaction to vitamin C.",
    "doctor_response": "Hello, Yes, it might be an allergy reaction. You should know that everything might cause an allergic reaction to the organism. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Jnikolla, Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard painful lump on right side of neck in child?\n\nMy 5 year old daughter has a hard lump (maybe an inch in diameter) on the right side of her neck that she says is a little painful.  It doesn't seem to move at all when touched.  I am so scared.  Calling Doctor's office as soon as they open, but want to try to figure out what it might be.  Thanks.",
    "doctor_response": "Hi, thanks for sharing your daughter's health concerns with HCM!    If I were your treating Doctor for this case of hard painful lump on right side of neck in child, I would come up with three possibilities, these include: 1.\u00a0\u00a0\u00a0\u00a0\u00a0a lymph node might be tuberculosis, viral infection or just reaction to any infection2.\u00a0\u00a0\u00a0\u00a0\u00a0The second possibility is of a benign cyst \u00a0\u00a0\u00a0\u00a0\u00a0like branchial cyst, thyroid cyst or lymphatic cyst! 3.\u00a0\u00a0\u00a0\u00a0\u00a0The last possibility is of an abscess, dermatofibroma or could be some skin tag also getting inflamed! \u00a0\u00a0\u00a0\u00a0\u00a0Overall, it needs a physical examination and possibly FNAC test for confirmation!Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing your daughter good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump near the ear lobe?\n\nHi Doctor, I have a small bump in front of my right ear, about 3 mm away from the ear, next to the ear lobe. It s not visible, however, I can feel it when I press on my face near it. I am a little worried about it. I suffer from a mild hipochondria, and I can find myslelf searching all the time for other lymph nodes. I read a lot about lymphoma and I constantly make myself believe that I have it. Additionally, I had an ear ache about three weeks ago. I am also diagnosed with a chronic adenoids infection. About a month ago I felt a small lymph node on the left side of my neck. I had an ultrasound done on this lymph node and the doctor said it is nothing serious and I should not worry about it. Now I can feel two lymph nodes: the one on my neck and one next to my ear ( I suppose this one is also a lymph node). Do I have any reasons to worry ? Should I do an ultrasound of the ear lymph node as well?",
    "doctor_response": "Hi, this is a small solitary lymph node and not to worry about this as this is a common thing and causes are dandruff, ear, nose or throat infections but could also be tuberculosis!please go for an FNAC test and revert back to us!all the best........",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the pain in knees?\n\nFor the past few months I can t sit indian style - crossing my legs, nor can I get on my knees for any period of time. When I get up to walk it takes awhile for my leg to fully extend, and is very painful. I have had a desk job for 12 yrs. Prior to that, I stood on my feet most of the day for 15 yrs. No sports injuries. 54 yr old female.",
    "doctor_response": "Hello, The symptoms that you have are suggestive of age-related osteoarthritis of the knee joints. This happens due to decrease in joint lubricants. Pain killers, proper supplements and regular physiotherapy can help. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a pea sized lump in between shoulder and neck?\n\nI have a pea-sized lump in between my shoulder and neck. (left side) I asked my doctor about it months ago, and she said that it's nothing to worry about it will go away over time. It's been almost a year since I've had it. It looks like its filled with puss...there is no pain though. I've tried putting a face cloth dipped in hot water on it to try and drain it. But it doesn't do anything. Should I be worried?",
    "doctor_response": "HiAs per your description, it looks like Lipoma. It is accumulation of fat. It doesn't look like Infection as it will not present for 1 year without causing pain.Please consult your Surgeon, get examined clinically. Get the swelling removed and send it for histopathological examination ( Biopsy ). Exact diagnosis will be confirmed. Nothing to worry. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Prescribed Fertigyn, done follicle scan. Had intercourse. Any chance of pregnancy? Stomach pain and back ache\n\nI am trying to concieve..Have PCOD ...this month had 4 follicle scans and right follicle was 19mm by 18mm...no change in left..dr gave me Fertigyn 5000 and then one more scan...I had had intercourse after injection and before scan...last scan showed some follicle rupture ....and had intercourse 2 times after that day... now its 7 days after I had the injection...Are there chances of me being pregnant??? I have cramps in my stomache for 4-5 days and backache too...",
    "doctor_response": "Hi, Thanks for your query. I read your query and understand your concerns. Following is my reply: Stomach ache and backache now does not signify anything. You wait for another 7 days and get serum beta hCG test done which confirms if there is pregnacy. You have chances of pregnancy as you have taken correct treatment. Wait and watch... I hope I answered your query. I will be available for any follow up queries you have. Regards, Dr.Mahesh Koregol IVF & Infertility Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diabetic with tears around anus and swollen, painful penis' foreskin after acupuncture. What does it indicate?\n\nDear Dr.I am a a diabetic. recently I took to single needle acupuncture treatment. Initially results were good with weight loss of over 10 kilos but continuing to be active. But for the last few months I notice my lips corners tearing my  sides of penis tearing and mouth of anus also. Then a new problem has started. Severe itching on the front head if the penis from inside and white discharge after itching coming out. The worsr part is the foreskin not rolling back and swollen and painful. I tried rolling back and washing with the help of xylocaine but once sedation effect is over it pains a lot. The foreskin has become even enlarged. Can I do without circumcision? How much does it cost for circumcision? Kindly advise.Thanks Kumar",
    "doctor_response": "Hi,From your history it seems that you got infection ,most probably fungal or bacterial. Being diabetic and using the needles increases it chance. A complete blood count (full blood count) may be indicated, including assessment of the levels of iron, ferritin, vitamin B12 (and possibly other B vitamins), and folate and a proper clinical examination need to be done.You should consult your local doctor for necessary investigation. Treatment will be based on cause of disease may be antifungal or antibiotics.Circumcision will not be advised during infection. More probably medicines will help you out. Cost of circumcision surgery varies as per cities and hospitals.Do consider a positive feedback as a credit to my work Let me know if you have any further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does shadow above gall bladder in ultrasound indicate?\n\nWent in for a number of accident related xrays and have been scheduled for another chest x-ray as there was some thicking- not to mention a ultrasound as a result of seeing a shadow above my gall bladder.  Could these be related to the accident or should I be concerned of something more serious?",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. Shadow usually inidcates some lesion which may be benign or malignant and in this case I suggest to do Ct scan to clear this out since ultrasound is not specific enough for it and i cant discriminate what exactly this is. All in all, this is most probably nothing and wont reuired further steps but as I saind, this should be ruled out.I hope I have answered you query.Kindly regards. Wish you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the right forearm after lifting a keyboard?\n\nI was lifting some keyboards in my school to set up for a concert yesterday, and today I woke up with pain in my right forearm. It is on the inside/bottom of my for arm and it is similar to that of a pulled muscle. It hurts when I clench my writ, or when I bend my hand downwards. It also hurts when I grab thing and do everyday activities.",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Weight-related forearm pain can occur if you overuse the arm muscles -- especially if you push yourself too hard or weight-train daily. It can develop if you fracture a bone, sprain a muscle or strain a tendon in the forearm when using weights. In addition, you can also develop tendinitis. This condition occurs suddenly or from continuously repeating a particular movement, such as lifting weights over a long period. Take rest, use pain killer medication and cold compression. If symptoms not improved please consult your doctor he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it ok if the baby lies upside down for a long time ?\n\nmy baby likes a lot to spend some time upside down. I mean When he is starting to foss. I lay him on his back and let his head hanging off the side of the bead. Is it ok? For how long? He is three months old and he likes it a lot.. Thank you very much",
    "doctor_response": "Did you mean upside down or prone? If he prefers to be prone, and you make sure that his nose isn't getting pinched by the bedsheets and pillows, then there is no problem ... except that you should be near him when he is lying on his stomach. There will be no issues with his digestion or anything else. Best wishes,Dr. Taher",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is sore mouth normal after root canal treatment?\n\nMy mouth is really sore.  Had root canal last week on top left but pain is in the front bottom along the bottom.  Dr. thought prob sinusitis and gave me shot of Rocephin and Augmentin but so far it hasn't helped.  Don't know if I should see my dentist tomorrow or give it a little more time.  Looks like pooled blood in spots along the base of the bottom gum",
    "doctor_response": "Thanks for your query, I have gone through your query.The soreness in the mouth particularly in the bottom teeth could be because of the gum infection secondary to deposits. It is not related to sinus infection.Consult a oral physician and get it diagnosed and treated by getting your teeth cleaned. You can take a course of antibiotics like amoxicillin 500mg and metronidazole 400mg tid for 5 days (if you are not allergic). Do saline gargling. I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Ultrasound report normal, blood test normal. Will fertomid 50 helps to get pregnant in old age?\n\nWould you like to suggest me to try Fertomid 50 - if my age is over 40 (47) and in my past 2 years ago I get pregnant naturally, but accidentally I have had a miscarriage ... After we tried with my partner (30yo) many times, but without any success. We have been checked and everything seems to be OK... I am still ovulating and I was checked by specialist in Gynecology- ultrasound for my ovarian ...may I get some blockage or cyst ... But the results was all ok... I was for blood test for ovulation as well and there was everything Ok as well... I know my age is highly up, but it will be not possible to try with some help as Fertomid? In my past 30y ago I was married and I delivered 3 healthy babies, today adult. With my partner we would like soon marry and get a new family, but my age make us troubles in this case many thanks for your answer. ingrid",
    "doctor_response": "Hello. Thanks for writing to us. At your age, if you are ovulating normally, then your chances of getting pregnant are present. You can take the help of ovulation inducing drugs like clomiphene under the guidance of your gynecologist for an early conception. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat chiari 1 malformation in a 13 years old child?\n\nMy son 13 year old son has been diagnosed with a chiari 1 malformation. His symptoms are, severe lethargy, head aches, blurred vision, dizziness, ringing in his ears, and chest pains. The doctors we have seen are still running lots of tests as they do not think the chiari is responsible for all of his symptoms. From research I have done, all his symptoms are consistent with a chiari malformation. I am feeling very frustrated as it breaks my heart to see my son in pain and not living a normal teenage life. I would appreciate your opinion",
    "doctor_response": "Hi, If I were your treating Doctor for this case, I would come up with three surgical possibilities for relief pressure on the brain and spinal cord, these include:1.Posterior fossa decompression surgery. This involves the removal of a small portion of the bottom of the skull and sometimes part of the spinal column to correct the irregular bony structure. The surgeon also may open and widen the dura matter(hard membrane of brain). That's the firm covering of the brain and spinal cord tissues. This creates additional space for the cerebrospinal fluid to circulate.2.Electrocautery. This uses high-frequency electrical currents to shrink the lower part of the cerebellum.3.Spinal laminectomy. This is the removal of part of the arched, bony roof of the spinal canal. This increases the canal's size and reduces pressure on the spinal cord and nerve roots.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing your son good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "History of pelvic pain, postcoital spotting, high risk HPV positive, severe dysplasia. Done pap test. What do I expect?\n\nIm a 30 y/o with a recent 6 month history of pelvic pain and postcoital spotting. i followed up with my current OB/GYN in March, pap revealed ASCUS with high risk HPV positive, colpo later the next week showing moderate dysplasia; CIN 2, LEEP procedure preformed May 6th; of the 4 specs removed, all revealed severe dysplasia CIN 3 with dysplasia present in all 4 margins incuding endocervical margins. My Dr is recommending repeat pap in 6 months. I have diagnosed polycyctic ovaries, which have also become a bother again, 2 beautiful children (plans for no more-thus my husband's vasectomy 4 yrs ago) and a maternal grandmother who's deceased post Stage 4 cervical cancer. Is this a reasonable wait or should I seek a second opinion? Thank You!!!",
    "doctor_response": "Hi,  I can understand your concern. Nothing to worry right now.  CIN does not mean invasive carcinoma. There is a dilemma regarding management at this stage of disease. Preferred mode is follow up after 6 months with repeat pap smear. More radical approach like hysterectomy may be required but no universal consensus. So you may better opt for 6 monthly follow up approach . This is an accepted way to follow up.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe dry cough with headache\n\nHello My wife have severe dry cough and already my family doctor advice me take blood and urine and chest x-rays all are normal be advice my wife to take cough tonic and tables but still my wife has severe cough due to this she got light headake and throught and body pain .Sir - what should my wife do to stop severe dry cough and ?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. No need to worry for lung infection because her chest x ray is normal. Sometimes bronchitis can cause uncontrolled dry cough and headache. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. PFT (pulmonary function test). PFT will not only diagnose bronchitis but it will also tell you about severity of the disease. And treatment of bronchitis is based on severity only. She may need inhaled bronchodilator and inhaled corticosteroids (ICS). Don't worry, with proper treatment, she will be alright. Hope I have solved your query. I will be happy to help you further. Wishing good health to your wife. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chronic vomiting during 8 weeks of pregnancy?\n\nhi i am 8 weeks pregnant & feeling vomiting all the time...even not able to eat anything. My doct suggest me to take 1 emestat Od with folvite in the morning after breakfast & 2 dominate with folvite at night after having dinner so is it safe for having all these medicines? & also don t want to have roti & sabzi so is there any other option available for this?",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the vomitings in pregnancy are routinely seen and they usually persist till 12-20 weeks.But they can be controlled by medicines.The medicines  like doxinate,emestat are such medicines and they are safe to be used in pregnancy.So relax and continue taking them.Take fluids upto 2-3 litres,coconut water,fruit juices daily.Take food in small quantities frequently every 2 hours.Dont worry.Avoid spicy and oily diet.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are tests to be carried out to diagnose charcots marie disease?\n\nHi my name is samantha i actually have quite a few question considering my health has went down hill pretty fast in the last 5 yrs but ill start with this one. My dad has charcots maries desiese along with a few others on his inermediete side but they are all deciesed i was told i couldnt be tested with out documentation in which i cannot retrieve. I have checked into this an quite frankly im worried because i favor alot of symptoms so how do i get tested for this thanks",
    "doctor_response": "Hi thereCharcot Marie Tooth(CMT) is also called Hereditary Motor and sensory Neuropathy. there are 2 types. type I is the most common and the best way of testing for this disease is to do a nerve biopsy. we usually take a segment of one of the expendable nerves(one you can live without) commonly the sural nerve( taken from your leg)and sent to the laboratory to check for CMT. However this test is only conducted for patients with symptoms suggestive of CMT. If no symptoms this test can't be used for screening purpose.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should Vitex be taken with Mirena birth control to balance the hormones?\n\nI'm on the Mirena birth control, and someone suggested taking Vitex to balance my hormones while using this birth control method. I tried to look up the drug interactions between the two but can't seem to find much information. Will Vitex decrease the effectiveness of the Mirena? Thank you!Hannah",
    "doctor_response": "Hi,Welcome to Health Care Magic.I am Dr Ramadevi Wani. I will be answering your concerns.Mirena releases about 12 micrograms  progesterone in the uterine cavity which mainly acts locally causing thinning of endometrium. A very small amount is absorbed in the blood stream. Mirena  does not cause imbalance in your body hormones. So there is no need to use Vitex. There is no evidence of interaction between vitex and Mirena. There is no evidence that Vitex decreases the effect of MIrena. Since Mirena acts locally, I do not see any possibility of Vitex decreasing its effect.I hope this is helpful.If you have any further concerns do contact me through Healthcare Magic.Best wishes,Dr Rama",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high fever in kid\n\nMy child of age 4.5 years has been suffering from high fefer (some time rises up to 104-105 deg)from past 12 days.Initiaaly after 6 days widal test conducted found negative but now after 12 days widal test conducted found positive for typhoid fever. Doctor prescribed cexime 100mg oral suspension and azithromycin 200mg oral suspension",
    "doctor_response": "Hi,It is confirmed that your child is suffering from typhoid fever.Continue with antibiotic medicine prescribed your doctor.It take few days to start its effect to reduce fever down.Give liquid diet and plenty of water.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat twisted arms in baby?\n\nmy granddaughter is six months old and it seems like her arms are twisted outward from her shoulders down. when arm is relaxed it hangs with hand pointed out with palms facing up. Her doctor has never mentioned anything was wrong but seems every odd to me.",
    "doctor_response": "Thanks for using Healthcaremagic.I have gone through your query and I can understand your concerns.Your description suggest a possibility of dislocated  shoulder.Ask the parents for any history of fall,If not it could be a congenital dislocation.I suggest you to consult an orthopaedician at earliest and get evaluated.We have to do an X-ray to make a diagnosis.Most of the cases can be reduced manually with out any surgery .Rarely surgery may be needed to correct the deformity.Both cases require immobilization in a cast for few weeks .Hope I have answered your query.Regards.Dr.Shinas",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can i get pregnant while suffering from hypothyroidism?\n\nSir, I am a 26yr old married women, (Weight 76Kg, Height 5.4\")Having Subclinical Hypothyroidism for the last 3Yrs.I had done my Blood test  in every  6 Months, &  in previous two test result My TSH level Shows 3.7 & 3.52 Respectively. Bt I hav done my test 2days before shows TSH is 8.5 . So Plz tell me hw to reduce my TSH Level(T3 is 1.09,&T4 is  6.51) .Nw I am having thyronorm 25MG daily, and I am Trying to reduce weight and conceive. Plz Tell , what i want to do nw??",
    "doctor_response": "Hi I think your thyroid dose needs to be increased. Consult your doctor. Also do a prolactin level and a ultrasound to see your follicles. also do a semen analysis of your husband. If everything is fine you can try for 3 to 6 months. If pregnancy doesn't happen then you can try medicines for growth of your eggs. Hope I have answered your question. If you have any other query I will be happy to help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I having Swelling & Redness below my knee?\n\nI have swelling and redness below the knee for more than 2 weeks. I have had an ultrasound to look for a blood clot but it came back negative. I am now on antibiotics, but 4 days in and no improvement. I am resting it and elevating it and icing it but i m wondering what it could be?",
    "doctor_response": "your description about the symptoms is highly inappropriate to provide a proffer answer. diagnosis highly depend on weather it is back of the knee or front of the knee. as well how below it from knee joint. if it is back of the knee [deep vein thrombosis. baker's cyst] must be excluded. cellulitis[infection of soft tissue] and bursitis can happen anywhere around knee joint. treatments are highly depends on cause for swelling. antibiotics will helps if it is a cellulitis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness while turning head?\n\nthe moment I put my head on the pillow and turn it to the left side I feel dizzy for a while . nothing happens turning to the right side while lying on bed. what might be the cause. I had pheco operation in my right eye and now I have cataract in my left eye.",
    "doctor_response": "Hi, It is a case of BPPV- benign paroxysmal positional vertigo. Consult an ENT/neuro/Vertigo specialist and you can be cured by a simple bedside maneuver. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sudhir Kumar, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of chest pain?\n\nSir, My name is D.Rama Rao, 63 year old. Last year i.e Feb.2010 I am suffering with chest pain. Immediately. I went to hospital and Cath Diagnosis CAD SINGLE VESSEL DISEASE NORMAL LV FUNCTION (BY ECHO) I used the following medicines Deplatt-A 150, Cardivas 3.125 mg. Storvas 20 mg. Olmezest-40mg and Glyzid 80mg.         Today My Blood Sugar Fasting 152mg/dl         Fasting Urine Sugar Trace, Post Break Fast Blood Sugar 140mg/dl. Total Cholesterol 125 mg./dl    HDL Cholestrol 50mg/dl, LDL Cholostrol 59 mg., VLDL Cholestrol 16 mg/dl, Chol/HDL - Ratio 2.5 and Tryglycerides 80 mg/dl. Kindly advise me thea bove medicines how long continue and is there any side effects for long time using. Thanking you sir,",
    "doctor_response": "Hey there,According to your reports your blood values are under control.I would suggest continue same treatment.Of course you are supposed to take treatment for longer time.Only prescribing doctor would advice you to discontinue treatment or not.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having stroke like symptoms. Numbness on the left side, slurred speech. No stroke. What is causing this?\n\ni started having stroke like symptoms back in 2007 my left side would go numb and i would fall to the floor cause my leg and arm would be useless. at the same time i felt it coming it started in my head and face slurred speech and all but the docs ran tests and said no stroke but the events kept happening every so often. i haven t had an episode in a few months but i still don t have normal feeling on my left side anywhere feels like my left side is sedated by an epidural",
    "doctor_response": "helloAs you have said you have multiple episodes of weakness in left side (arm,legs), with slurred speech and face weakness and your ct /mri brain came normal meaning TIA(transient ischemic attacks)TIA occurs when vessel of brain is occluded for some time and then the vessel reopens , giving you the symptoms , with no changes on ct/mri. Tia improves with in daysOR you have partial occlusion in neck vessels (carotids), that causes or throws clots in brain causing transient symptoms,.....get doppler carotidsOR  your upper part of heart due to wrong rhtym throws clots known as paroxysmal atrial fibrillation.....get hotler/EP studiesResidual symptoms like numbness, pain , weakness in that part exists, treatment includes.....vit b12, pregabalin and so onHope this helpsTake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does white tissue at a tooth extraction site indicate?\n\nMy 6 yr child just had his tooth pulled. It came off after the 2nd pull easily but there seems to be a little bit of white tissue left behind in the socket. His adult teeth has already emerged from behind. I was worried that it might be roots left behind the baby teeth? I thought it might be a little piece of the tooth but it s appears to be soft. Should I attempt to remove or just left it be? Thanks!",
    "doctor_response": "Hello,The white tissue that is left at the extraction site and is soft can be due to the healing tissue that is responsible for healing of the extraction site. Please click pictures and upload it to me so that I can have a look and let you known more precisely.For now, you should follow the post extraction instructions and give him soft meals. Also, if there is any doubt you can also get an x ray done for confirmation.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes congestion in bronchial area?\n\nI have an NTM MAC infection, primarily in the right lung. we initially tried Rifampin, Ethanbutol and Azithromycin but the Rifampin gave me fevers. Same with Rifabitin. Tried Amikacin tabs but the pharmacist wasn t happy with that because of my heart issues. I m now on the nebulizer version of the Amikacin along with the Azithromycin and Ethanbutol. In the past 2 weeks my bronchial area is becoming increasingly congested. I wheeze at times, but have not coughed anything up since early November. Any ideas, thoughts or feedback?",
    "doctor_response": "thanks for asking your queryi completly understand you problemin mac or non tubercular mycobacterial disease of lungs there is a bacterial infection and that infection causes increase in mucous secretion or increased edema in the infected tissue leads to leakage of exudates in the lungs that causes congestionyou shoukd continue with the drugs which are prescribed to youdo consult a pulmonologist thatvwould be more appropriate and a pulmonologist can guide you and ll adjust the drugs as per latest recommendations by american thoracic society  guidelines for ntmdont panicthanks feel free to ask more questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. A cat has scratched my child's toe. Should I get her a vaccination?\n\nHi doctor, My baby is 22 months old. Yesterday, a cat scratched his toe. But my child does not have a wound or blood there. Do I have to give vaccination to my baby?",
    "doctor_response": "Hi. A cat has scratched your child, and it has not caused any barrier disruption or wound or bleeding. But still, it is advisable to clean the area with running water and soap. Apply some antiseptic in the area. Rabies is generally transmitted by animal saliva when it comes in contact with disrupted skin barrier and wound formed by the bite. In your case, you are safe from rabies, and rabies vaccine is not required. The scratch caused by a cat generally causes cat scratch disease. It causes scratching of the skin barrier and makes a wound. This causes infection with some bacteria like streptococci. You should wash the area properly and apply antiseptic. If there is a wound, you must give antibiotics. A tetanus vaccine is required when your child is not adequately immunized till date.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe pain in the cheek after being bitten accidentally. Do I need to go to the doctor?\n\nI accidentally bit into my cheek while chewing gum about a week ago. Now there is flap of skin where I bit. It s not swollen, hot/warm, or a cold sore (from what I can tell). It didn t start hurting until 4 days ago and the pain is similar to the stingy pain of a cut cheek from wearing braces. I need to know if I need to go to the dentist to get it checked out because the flap has not gone down at all and only increases in pain.",
    "doctor_response": "hello probably your cheek is ulcerated because of biting. generally it should heal within 2-3 days. since it has not healed even after 4days, you should consult dentist. may be the ulcer is too big to heal on its own or there might be some sharp tooth surface which is not letting ulcer to heal. dentist will round off sharp tooth surface and will prescribe some gel so that ulcer heals faster. take care Dr.Avinash",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am being nervous with simple things like water from nos is killing me & wet eyes\n\nCan`t stop water dripping from my nose , I saw different doctors but nothing changed, I did also allergy test but I have no allergy. Blocked nose every day breathing from mouth, when I lie on spine side it goes down my throat, when I lie on my side position, that position is being blocked and I have to breath with mouth. It is killing me, difficulty on breathing , wet eyes and I am being nervous with simple things. This is happening more than 1 year. Does anyone have idea what to do ?",
    "doctor_response": "Hi.. I am able to understand the problem you are facing as i too had similar problems but not on regular basis...\u00a0 Later learnt that some of the nasal drops have been contributing to the problem. So if you are on some nasal drops i would advise you to stop these... Natural means such as steam inhalation and vitamin rich foods helped...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I get bumps on the private parts after shaving ?\n\nhi.am 21 year old girl and i weigh 72kg.i notice bumps on private parts after shaving ,i ve tried several methods all to no avail.pls what do i do",
    "doctor_response": "Hi...dear user., Thanks for chosing HCM., Little bumps after shaving..., could be IRRITANT DERMATITIS.., it is due to shaving , cutting of hair buds produce..., minor abrasions in turn produce bumps...., 1) Don't shave hairs around genitals..., only trim with trimmer., 2) Salt water washing is allowable...don't use any chemicals there.., 3) Apply Fusidin cream till get good result.., 4) Tab Doxicycline 100 mg daily for 7 days.., 5) If itching presnt go for Cetrizine tablets...ok..good luck.,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is sperm discharge at the beginning of urination good sign?\n\nsperm come out sometimes beginning of urination,is its a good sine.I am a 25yr old boy.sometime i have masturbated.in time of masturbation the amount and the density of sperm is very poor.please tell me what is my position  now,an how could i improve it.",
    "doctor_response": "HelloSemen leakage before urination may be due to over excited state,excessive fantasy or straining.You should avoid provocative literature and videos.You should try to be calm and try to engage yourself in your job.It is also important to evaluate for constipation etc.Consistency of semen depend upon many things like frequency of ejaculation,race etc.You should take healthy and nutritious diet.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump at the top of metal bar implant?\n\nI have a metal bar in my forearm for when I broke it back in march of '09. A couple days ago I noticed my arm is starting to develope a lump right at the top of the bar area.  its about 4 stitches in length. It hurts when i twist my forearm and when do things.  The pain level is about a 7 to an 8. Any suggestions?",
    "doctor_response": "Hi.The metal bar is getting extruded out by the body as it is a foreign body. I would advise you to get an X-ray , Orthopedic Surgeon's opinion and surgery to get the bar out of the body before it causes more complications as it can one day pierce through the skin . Till then put that particular limb in  sling to give it a rest.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurrent abdominal tenderness and cramps with diarrhea?\n\nI am having widespread abdominal tenderness, cramps and or aches that occur infrequently from just below my rib cage down below my belly button. I also have very loose stool. Symptoms are not everyday and I cannot associate with dietary changes. The abdominal tenderness withh pressure is pretty consistent. I went to my doctors office (saw a nurse practitioner who ran several tests and did not find infection or anything else she could associate with my symptoms. I did an online medical symptom checker and I am pretty concerned. Please advise. Email is YYYY@YYYY . My name is Tim",
    "doctor_response": "hello, It is possible to have persistent cough after respiratory tract infection in an  asthmatic, atopic , and a person with dyspeptic symptoms. But if the infection is settled, cough should get lesser by time.    Persistent cough would cause continuous forceful contraction of chest and abdominal muscles . This would lead to muscle pulling and you would have pain, stiffness, and tenderness of muscles. If you are not a Wheezer you can have ibuprofen or other NSAID together with local diclogenac sodium gel.  But you have to stop the cough which cause the muscle pain.   If you are a topic or person with wheezing it is better to have small dose of prednisolon for 3,4 days, deriphillin, and a mucolytic like bisolvin for another week. If it is still not settling, need to do your blood investigations full blood count, CRP, ESR and chest xray. Because certain atypical pneumonias has less symptoms except for dry bout of persistent cough but blood and xray would consists changes. If there are changes there are oral antibiotics for those pneumonias.  Hpoe this helps. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for spina bifida?\n\nhi, My name is surekha. I am a resident of Bangalore.I have spina bifida. In Nov 2011 I underwent a surger for the excision of the 5th metatarsal. I need a footwear that will keep my leg protected from repeated ulcers. Can you please suggest where can i have it done",
    "doctor_response": "Hello, It's a very individualized situation. About 10% of people used to have some spina bifida but in the vast majority, it was just a boney abnormality that did NOT do anything and did not expose much of the spine. It can be so bad as to cause congenital paraplegia. This is rare. You'd have to see how much of the spine is affected both in extent and depth. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high blood pressure\n\n33 yoa, 5'3\" 170lbs have a history of high cholesterol with hdl being low, ldl being high and some prehypertension evem during pregnancy. am not on medicines. i was red in the face so i checked my bloodpressure 146/88 with a pulse of 97. i had been walking slowly in the store. i was having some neck pain also.",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern. First of all when we speak for high blood pressure we have to make a fine diagnose of its type.You should know that in medicine we divide hypertension in two types. What we call essential hypertension seen in older ages and secondary hypertension seen in younger ages.In fact, according to your young  age the fundamental thing is to exclude the secondary causes of hypertension.This secondary causes might be: problems with adrenal gland,problems of the artery supplying the kidneys,cardiovascular anomalies that manifest with high blood pressure values in younger ages. We talk about high pressure if we have mean values above 140/80. These can be the cause  of your head or neck pain.So, if I was your treating doctor first of all Id like to be sure that we do have hypertension. So I will recommend you to monitor it or to have a blood pressure holter monitoring for 24 h to have a good graphic of your values during all day. A simple value its not enought. After that of course i will recommend an electrocardiogram, a cardiac echo-graphy and a full blood test analyses to check for problems of adrenal gland. According to the results than we can decide for further examinations for renal arteries.In my opinion, as you are very young its essential to exclude the secondary causes of hypertension. If we find the cause than we can treat it and avoid hypertension. Reducing your cholesterol and your weight might improve your blood pressure values.Knowing the cause can help us to know how to treat the hypertension.Hope I was helpful. Wish you good health.Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does novelon and cobatea increase weight?\n\nhello m a 16 yrs old gal....i have been gettin irregular periods n mostly i miss my periods ...last tym i missed for 5 months....so i went to consult d doc.....he prescribed me to take novelon n cobatea......also i have gained weight already...i wonder these medication will put more weight to me...pls.. want ur suggestion...help me",
    "doctor_response": "HiYes Novelon is a hormonal pill which can cause weight gain. Cobatea is a multivitamin drug which can also contribute to weight gain.Regular exercise,healthy diet,Adequate hydration and weekly monitoring of weight can reduce the rate of weight gain.Hope I have answered your query. Let me know if I can assist you further. RegardsDr.Saranya Ramadoss, General and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Totally health loss in ulcerative colitis\n\nhi docter i m 23 yrs old girl n dignosed wid ulcerative colitise.i have problem of loos motions daily 7-10 since i was 13 yr old but my docter could nt find the particular reason but before two year my doc told me that i have ibs then aftr one doc find that i have have ulcerative colitis as my bloody stool is.n mucus also n lower left side pain in my abdomen but now my docter say that they have givven me all medicines,but i have no relief by my pain i m on treatmnt.n i cant eat any thing except daal n roti,pllzz suggest me what shud i do?i m really tierd n i m anemic too",
    "doctor_response": "thanks for choosing health care magic.Ulceration colitis is problem of intestine in which there are ulcers in your intestine.This leads to pain and other problems that you have.But this disease usually have remissions in between means the disease will be active for some time and then the symptoms will be resolved for some time and appear again.Usually medicines are effective along with diet control so do not get dishearten.Take medicines and  diet as advised.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause recurring white powder like product on penis?\n\nDear sir, I have some kind of white powder kind of product in my penis very frequently. Suppose if I clean it today next day I will have it again  at the edge of my penis.. it irritates .Is this any disease?. I want to know that which kind of doctor i need consultant.. Do you know any medicine?? etc please suggest.",
    "doctor_response": "Good Day and thank you for being with Healthcare Magic! You may have a skin infection that is due to an infected sweat gland. This is termed abscess or carbuncle. I suggest to see a local physician to get a prescription for an antibiotic. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at:   I would gladly help you.  Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can ovulation be confirmed?\n\nI have pcos and have been prescribed duromine have been on metformin to help with high insulin resistance gone off as couldn t find insulin resistance anyhow old gyn said I had very high number of insulin resistance another doctor tested insulin levels and took me off metformin and put me on clomid to try to achieve pregnancy didn t get monitored and had cysts form how can I tell if I ovulated? How does doc know how sensitive I am to clomid? Can I get clomid through a gp as gyn won t help me have a baby",
    "doctor_response": "Check you urine (morning sample) regularly using ovulation kit (LH kit) regularly from day 12th until it is positive (usually by 14-16th day and if negative by 16th, no need to retest). If positive, note the day of positivity and repeat in next cycle in that day. Once it's positive, have frequent intercourse for 2-3 days following it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent chest pains?\n\ni've been having chest pains for two weeks now, been to two hospitals but all my ekg, x-ray and urine test are normal. the first time i had it i went to the hospital, had the test and was back to normal in three days. Yesterday again i had the pain, i feel week. I don't understand whats happening with my body",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.No need to worry for heart diseases as your repeated ecg s are normal.Sometimes simple musculoskeletal pain can also cause similar kind of chest pain.So avoid movements causing pain. Avoid heavyweight lifting and strenuous exercise.Take simple painkiller like paracetamol or ibuprofen. Apply warm water pad on affected areas of chest.Don't worry, you will be alright with all these.Avoid stress and tension, be relax and calm because stress can also cause chest pain.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for lymphangitis in the penis?\n\nI have a lymph channel infection under the right side of the head of my penis on the foreskin. While erect I can barely feel it but while flaccid it feels like a small vein like cord structure under the skin what type of medicine do I need to make this go away",
    "doctor_response": "Thanks for asking in healthcaremagic forumIN short: Who diagnosed your lymphangitis?Explanation: In lymphangitis red streak like lines are visible with severe pain over there. Do you really have this? I dont think so. So, please do not diagnose yourself instead visit a doctor for opinion.                   Antibiotics may help for lymphangitis, but its better to visit a doctor for opinion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bump on head and blockage in eye\n\nMy mother had been diabetic for more than a decade and she is 74 yrs of age & live in Philippines. She saw an ENT today & was been told that her small bump on the head that grow bigger if her sugar is high and ooze some watery fluid might be a cancer...also, she was complaining about her eyes and when the doctor give her an eye drop, the doctor says that her eyes had a big problem for there was some blockage....I got this info from my brother thru phone but was cut off....pls help and educate me..thank you ...",
    "doctor_response": "The bump on the head, i assume is bony hard maybe a spread of cancer to the skull bone. Since you ve got the information from your brother over phone, it is minimal.  I would like to suggest that she be further evaluated to find where the cancer originally comes from ( the primary site). Mostly it will include biopsy of the lump and screening of various body systems with CT imaging.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am on Levothyroxine but still have hair loss, and weight gain. Please help.\n\nHello doctor,I was diagnosed with Hashimoto's 10 years ago. I have been on Levothyroxine, and current dose is 125 mcg. During that time I have been hospitalized four times because of heart palpitations. Even though I am on medicine I still have coarse hair, hair loss, weight gain, puffy face, hoarse voice, and constipation. I was wondering if I should switch to a different thyroid medicine? The other medicines that I take are Welbutrin 150 mg, Cymbalta 90 mg, Probiotic, stool softener, and Vitamin B12.",
    "doctor_response": "Hello. I just read your query and from what you have mentioned it appears that you are having very good thyroid function test results. I would not recommend that you change the form of Thyroxine at any cost. Regarding your hair, face and constipation I understand it is hard having these side effects from Thyroxine which will still be there in spite of switching to an alternative form but the risk is more in switching the drug. For more information consult an endocrinologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for bronchial asthma\n\nI am 30 yrs. old. For the last 17 months I was in Texas,U.S.A and I had very little Breathing problem though from childhood I have history of Bronchial Asthma. I came to Kolkata on 15 th. December to meet my parents and since then I am suffering from running nose, sneezing and spasm. i have taken Antibiotic and l montus and Doxofylline prescribed by a Doctor. Still I am not getting complete relief. Please advice me because I will have to go back to USA within a week.",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your history and would like to make suggestions for you as follows:1. If L-Montus cannot give relief for running nose and sneezing, in such case, I usually prescribe intranasal corticosteroid (Mometasone or Fluticasone) sprays to my patients for 1 week or so.2. Were I treating you, I would prescribe you salbutamol or levosalbutamol as inhaler for treating spasm. Please continue Doxofylline as suggested by your physician.3. As you have had problems since childhood, I would suggest you regular breathing exercises including Yoga & Pranayama which will increase your lung capacity over time.4. I would also suggest you allergy testing which will help you identify the substances you may be allergic to and also to know the measures to avoid their exposure.Based on the report, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which works on immune system to gradually improve allergy symptoms.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health and a rapid recovery.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could keeping the foot elevated cure infected cut on it?\n\nI'm an insulin dependent diabetic and have an infected cut on my foot. The initial antibiotic wasn't working so I went back to the doctor. He added another antibiotic and told me to keep my foot elevated. How does keeping the foot elevated help? It isn't swollen.",
    "doctor_response": "Hi,Elevating the leg only gives you relief from a pain and decreases induration and edema.As you are diabetic take care of this cut in foot and rule out any possibility of having diabetic foot. Go for proper dressing and proper antibiotic medicine to cure in time.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain post surgery with headaches and numbness in arm\n\nhad disc rem. & fusion 12/12/12. I was told 12/13 that a spacer had shifted and surgery needs redone. I have been debating...have been in pain since surgery & now have headaches and some numbness in my arm. For the last two weeks my blood pressure has been 150 s to 170 s and ears are ringing like crazy.",
    "doctor_response": "Hi, Pain can increase blood pressure. taking the pressure at multiple times including having a 24 hr monitoring of it would tell how much blood pressure there is. Without an exam, I can only give general information, and there is increased risk of stroke, heart attack and kidney failure above 150 certainly. Sometimes it can cause ringing in the ears. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes upper abdominal pain?\n\nI have been having pain in upper left portion of abdomen for about 8 or nine months now. Right under my rib cage on the left side. It started out just every now and then, but lately it has been a constant ache. I do have problems with constipation. It has also started hurting in my back on the same side. Do I need to see a Dr. for this problem?",
    "doctor_response": "Hi.Thanks for your query. Your pain in abdomen is for 9 months now - under rib cage on left side - now it is constant, along with constipation and now also started to hurt in the back on the same left side. Read the history and understood your problem. your problem looks to be due to Costochondritis or colonic problem like inflammation or cancer, or pancreatitis, I would advise you the following:Clinical evaluation and actual physical examination by a General surgeon.CT scan of the whole abdomen.Test of blood, urine and stool. Colonoscopy and upper GI Endoscopy.This will give a proper diagnosis and a plan for the treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Unable to find needle, anesthesia for upper molar treatment. Pain, numbness followed. Possible reason?\n\ni think the doctor left the needle in my jaw after he gave me anesthesia to work on an upper right molar. He pulled out the plastic part and said , hey where is the needle? When i became frightened he said it probably fell on the floor near the cabinet. I have been in pain and feeling numb every time I eat or talk. Help!!!",
    "doctor_response": "reason for pain at the injection site is because of deep penetration of injection needle to the bundle of veins called pterygoid plexus of veins. to get rid of pain you can use tab.mobizox a muscle relaxant twice a day for 3 to 5 days 12th hourly and for the post numbness in the injection site use tab neurobion for a month.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Sometimes my heart flutters and I feel dizzy and short of breath. Why?\n\nHello doctor, I am a 25-year-old woman and 21 weeks pregnant. I have always noticed some irregular things with my heart but none have ever been detected on a monitor. However, it is much worse since becoming pregnant. I have noticed after eating any food, drinking caffeine, or feeling anxious my heart flutters and I feel dizzy and short of breath. Sometimes, I get a sudden wave of extreme fatigue. I am concerned I have atrial fibrillation or some other heart rhythm problem that my doctors are not finding. This triggers my anxiety and makes the symptoms worse. How would I know if it is just anxiety that seems to come at certain times, or if it is a problem with my heart? I have had a few EKGs and one 24 hour Holter monitor but did not experience symptoms during the tests.",
    "doctor_response": "Hello. All these symptoms may just indicate anxiety. However, we should make some attempt to rule out arrhythmias. Now, your symptoms which occurs including fluttering and dizziness can occur with anxiety or caffeine. Caffeine itself can produce palpitations and various symptoms. So overall, I would keep anxiety as the first possibility. But, whenever you get symptoms, you should try to feel pulse for pulse rate in one minute if possible for you. Or else if you have electronic BP apparatus then it may show your pulse rate. So it may indicate the possibility of atrial fibrillation. Next, ectopics are quite a common arrhythmia in the young patient, and it can be there in you. May get aggravated by pregnancy. It can give you the feeling of a skipped beat. Now, we should confirm it objectively. So the best way other than Holter is, you order Alivecor Kardia monitor, which is a mobile-based system, which is portable and you can attach yourself at home and it will record your rhythm and can be analyzed. Alternatively, various watches are available which can record your pulse rate throughout the day and we can at least analyze the heart to consider the possibility of atrial fibrillation. Overall, it does not appear anything serious to me at the moment. I guess you must have had an echo done, right?",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in breathing after quitting smoking?\n\nI quit smoking 6 weeks ago and since have had trouble breathing (mostly at night), then I can't back to sleep because I panic about not being able to breathe.  I went to ER a couple of nights ago and my blood pressure was 184/101, they did an EKG, heart was fine, my lungs sounded fine . . . doctor says it's anxiety and put me on Xanax.  I have a blood pressure cuff & keep checking and it has lowered, but not by a whole lot.  Guess I'm still worried.",
    "doctor_response": "HelloNo according to the history this is related to quitting smoking and the stress caused by it.Do not worry it will pass with the passing time.RegardsDr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain above elbow radiating to wrist and shoulder\n\nI have been experiencing a vise like pain just above my left elbow radiating down to my wrist and hand or up to my shoulder and once into my neck. This started like a pinched nerve Tues evening waking me. It comes and goes in its severity, I seem to be experiencing no other symtoms.",
    "doctor_response": "Hello, It seems like a pinched nerve is causing your issues.  Ulnar nerve compression at the elbow may result in spreading of the symptoms above and below the compression site. Getting evaluated medically and by tests (nerve conduction study in your case) are necessary for a correct diagnosis. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is playing rugby safe after a heart attack?\n\nI'm 30yrs old and 6 weeks ago i had a m.i. heart attack. I have had one stent fitted.   Before the heart attack i was considering joining a rugby team... I was wondering if, after a year and i felt alright, would i be able to start rugby or will i have to give the idea up permanently?",
    "doctor_response": "hi dear post myocardial infarction the heart takes almost 12 weeks to settle downrepeat a 2d echo after 12weeks and a treadmill test if every thing is fine in these tests then you can do whatever a normal person can do you can play rugby but remember one thi g do  ot over strain yourself ,donot over strain your heart ,just increase your capacity graduallybefore starting to play rugby do brisk waking fir 45minutes a day fir atleast 15days !!thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain, difficulty in sitting. Fell from horse. Should i see a doctor?\n\nhello, i was thrown from a horse on Tuesday and my lower back is still painful. its aove my waist line, more of the center but the pain can come all the way across. i cant sit down comfortably and have to sit at a funny angle so it doesn't hurt. should i go see a doctor or will it pass? there is no bruising or marks just a sharp pain can sometimes feel like burning",
    "doctor_response": "Hi, thanks for writing to HCM.Based on the description of the symptoms, I suspect that you could have suffered a soft tissue contusion involving the paravertebral muscles.An xray is mandatory to rule out any bony injuries to the vertebral elements.You can try the following measures before visiting a doctor -* Adequate rest to the injured area and avoid activities that produces pain* Ice packing of the affected area once in 2-3 hours* Local painkiller gel application with mild massage* Moist heat fomentation over the injured area to relax the taut muscles* Analgesic & muscle relaxant medications as neededHope this information is helpful. Good day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will drinking alcohol be responsible for high blood sugar?\n\nHello doctor, I am 50 years old. I have done my sugar test last week which showed\u00a0high blood sugar value and high cholesterol. My doctor advised me to test because I had irritation while urinating. My doctor prescribed me to take Cumet-SR tablets. My weight is 85 kg and height 5.8 feet. I have few questions regarding this. Is this sugar value bad? Is drinking alcohol responsible for high blood sugar? Which fruits and meals can I take to control my blood sugar? Should I reduce my weight? My cholesterol level is little bit high. Can you suggest a diet for that? Is oats good for controlling blood sugar? I have attached my blood reports for your reference. Please help.",
    "doctor_response": "Hi. I have gone through your complaint and seen your reports (attachment removed to protect patient identity). Yes, drinking alcohol raises blood sugar. You should take 5-6 portions of fruit or vegetables each day. You can eat citrus fruits like orange, sweet lemon or other fruits like 1 cup pieces of papaya, pineapple, water melon and apple daily. You should avoid mango, grape, date and sugarcane. Take adequate amount of salad containing tomatoes, cucumber and green leafy vegetables daily. Use green leafy vegetables in soup or salad. Take adequate intake of beans and nuts. You can use artificial sweeteners up to certain extent. You must restrict your carbohydrate intake. Avoid rice, processed flour, potato and sweet potato. Avoid alcohol, smoking, sweets and cold drinks. Try to incorporate whole wheat in diet. Oats are good in controlling sugar. You must carry out moderate exercise 20 minutes per day for five days a week. 1. Obesity. 2. Alcohol. 1. HbA1c. 2. Blood sugar. Diabetes Mellitus. For further information consult an internal medicine physician online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sticky discharge from ear with awful smell?\n\nI noticed when I kissed my son on the cheek that something smelled awful. Later I noticed his ear was full of a sticky discharge that was a very dark brown. I cleaned out the part that I could see around the outside of the ear canal and it was definately the source of the smell. It smells bad and was very goopy. Could it be an infection?",
    "doctor_response": "Hello. Yes, it certainly seems like he has an infection in his ear. i would advise you to see a pediatrician/ENT specialist and do a culture of the sticky discharge to see what organism grows. They could also look into his ear with an otoscope and see if there is a hole in his ear drum. Usually bacterial infections are accompanied by pain in the ear, fever and yellowish pus.If he had just a mild amount of brown discharge that was not so smelly, we could have attributed that to ear wax, but lets not take chances in this case.Hope this answers your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning sensation in the mouth and throat?\n\ni have thick saliva dry mouth burning mouth and throat for three years and none of the speaciaists can figure it out, ive gone for mri's and neck scans which showed up  and a salivary gland test all normal.  my denist just recently noticed that my right lymph node is swollen and the location is close to my salivary gland..... I plan to go back to my ENT, however I am fearful no one will figure this out",
    "doctor_response": "Hi..Thanks for the query..Well, thick saliva and dry burning mouth are all clearly pointing towards a condition known as Xerostomia or Dry Mouth..If the Lymph node is swollen the cause needs to be ruled out..Also the adjacent salivary gland should be re-scanned..For now you can take supportive treatment to reduce the symptoms like chew sugar free chewing gum.Use mouth lubricant like oral gel..You can suck ice pops to reduce inflammation and burning..You can do Lidocaine mouth gargles..Hope this helps..Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does one need complete reconstruction of the stomach muscles?\n\nLast January My husband had prostate surgery.   His wound opened.  After that he had to wear a wound vac for about 6 weeks.   Now his incision scar caves in at the middle and he has a hernia.  He is going to have to have complete reconstruction of the stomach muscles.   Should this have happened in the first place?",
    "doctor_response": "Hi there ! Good evening. I am Dr Shareef answering your query. Your husband must have had an open prostate surgery (not a transurethral one) which could result in a hernia in the incision site. This could result due to very many factors, like a week musculature, or a post operative infection, due to chronic cough/constipation resulting in increased intra abdominal pressure or due to dehiscence of the suture line due to inability of the suture to hold both side of the incision in place. This would need an elective surgery which would close the defect and strengthen the musculature with a synthetic mesh. This could also be done by a laparoscopic method in competent hands and results are usually good. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the lump between breast and the belly button?\n\nwhat is my lump? Hi my names Melissa im 15 years old around 5'4 and i weigh about 124 pounds. A year ago i was at the waterpark with my friend and felt my stomach and there was this lump under my skin. Its not 3D but you can definitely feel it. Its still there. Its in between my belly button and boobs. I tried looking it up and i think it might be a hernia or something. I can push it in and it feels weird. What could it be?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have umbilical or paraumbilical hernia. Or ypu have some soft tissue tumor.  You should go for examination first and if needed go for ultrasound. It will give you exact diagnosis.  If you have hernia then you should go for surgery.  Hernia repair by meshplasty is the treatment of choice. Consult your doctor and take treatment according to diagnosis. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can rashes on back,chest and abdominal area be chicken pox?\n\nhi i'm jovy 23 yrs old, 44kgs,5'2\" in height. i had rashes at my back,chest and abdominal area. the rashes were somewhat elevated but no blister,reddish,very itchy. when i went for check up the dr. said it was chicken pox..its already for 5 days today yet no blister formation and no eruption occurred on the rashes. is this consider chicken pox?",
    "doctor_response": "Hello. Thanks for writing to us at healthcaremagicIt is unlikely that the rash is chicken Pox because as you rightly pointed it out there are no fluid filled lesions since the rash appeared.Chicken pox classically presents as fluid filled lesions distributed mainly over the trunk and face and extending on to the extremities. The lesions are initially red but usually turn into blisters within 24 hours. Scalp and oral mucosa may also be involved.These is usually no itching in chicken pox except when the lesions have dried up to form scabs.I will suggest that you visit a specialist in your region. Your specialist will be able to have a look at it and advice accordingly.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "TSH is low. Overweight. Going through premenopause. Have kidney stones. Had Thyroidectomy and Lithotrispy. Suggestions?\n\nI am having a host of issues I think are all pointing back to my thyroid.  I am having trouble getting into my GP and I really want some answers.  I had a thyroidectomy in 2000 removing the left lobe and center of my thyroid.  My most recent test was 4/2/13.  My levels are TSH-0.11, T3-30, T4-7.3, Free T4-2.2.  I am not sure why the TSH is so low and the others are within the normal ranges.  I am 30 pounds overweight and I can not seem to lose it with diet and exercise.  Secondly, I'm apparently going through perimenapause because I have been having raging hot flashes and I have not had a regular cycle since January.  Lastly, I had several kidney stones (all small except one) and had lithotripsy two weeks ago.  Needless to say... I feel like poop and I'm not really sure where to start and where to go from here.",
    "doctor_response": "helloas you have said you are a patient of thyroidectomy , and your fresh thyroid status shows subclinical hyperthyroidism with low tsh and normal t3, t4, in perimenopusal status, with kidney stonesin perimenopausal period women have increased calcium absorption from bones and hence more stoneshot flushes are common in perimenopausal period and best treatment is vitamin e with venlafaxinesubclinical hyperthyroidism again causing more calcium absorption and hence more stonesyour residual thyroid has become over active or about to become overactive .....treatment is complete thyroidectomy or neomercazoleyou need to go to endocrinologist for thyroid problemsgynaecologist for hot flushesnothing to worry about , follow my advice and your problems will be solved in a weektake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for shortness of breath and wheezing\n\nI am taking now metoprolol er 50mg. I am an active and play soccer. Sometime just to warm up, I do jogging for 3 miles and it has become difficult. I get short breath and whizzing. Why is that? Is there any remedies? is there any one who can help me? I am don't have money?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, you should consult pulmonologist because possibility of either asthma or bronchitis is more. Both of these can cause wheezing and breathlessness. So consult pulmonologist and get done 1. Clinical examination of respiratory system 2. PFT (pulmonary function test). PFT will not only diagnose them but it will also tell you about severity of the disease and treatment is based on severity only. You will need inhaled bronchodilator (formoterol or salmeterol) and inhaled corticosteroids (ICS) (budesonide or fluticasone).. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itching, rash spreading in body and warm feeling. What could this be?\n\nMy son returned from camping this morning.  He complained of itching and I noticed a rash on his upper inner thigh.  The rash seemed to spread to his stomach and he also developed welps in the armpit area.  He feels warm and is complaining that he is \"freezing\".",
    "doctor_response": "Hello, Thank you for posting. The conditon you described is very difficult to diagnose untill proper physical examination. For now it can be two things. Firstly he might have got an acute attack of hives or urticaria which is a common allergy causing rash and itching all over body. It ususally subsides on its own but may require a short course of corticosteroids and antihistamincs which your GP or dermatologist can easily prescribe for you. Secondly he might have contracted scabies which is common in people who frequently go for camping. For scabies,  you might want to launder all his clothes, bedding inwarm water to remove tiny mites which cause scabies. Apart from this, he needs oral (ivermectin)and topical antiscabetic cream(permethrin 5%) to get rid of mites from his body.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent abdominal pain?\n\nHello, I m a 20 year old pretty healthy female, I m having right abdominal pain. My urine is foggy but it isn t painful. It s been hurting all day, as if I haven t used the bathroom in hours but I have. My period was two weeks ago, so I don t think that s it.",
    "doctor_response": "Hello! Thanks for putting your query in HCM. I am a Gastroenterologist (DM). Abdominal pain on right side may be due to many causes related to liver, gallbladder, billiary tract, stomach or intestine so I will suggest you to visit a Gastroenterologist for evaluation and management.I hope I have answered your query and this will help you. If you have any further query  I will be happy to answer that too. Remain in touch and get-well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my mother unable to walk?\n\nmy mom is 59 years old she has been having mild signs of altzeihmers like repeating herself and forgetting newly given information .....yesterday i took her to the hospital because she couldn't walk and her legs kept giving out on her they gave her and ekg and said she seemed fine which she did because she began to walk again... however the same thing happened again this morning any suggestions on what is causing this problem",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.Alzheimers cannot lead to this kind of symptom although presence of alzheimers as an independent diagnosis cannot be negated as she has significant forgetfullness. Her forgetfullness needs to be evaluated in detail. Regarding her inability to walk, there could be a problem in the brain which could be leading to such a problem of having inability to walk. She should go ahead with an MRI of the brain. 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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is popping ribs with painful bruise, pain while coughing and sneezing serious?\n\nI was sleeping high on a pillow on my left side this morning when I heard a pop and felt pain in my ribs. Now there is a bruise forming over the back side of my left rib cage. It is painful.. (but tolerable)especially when I sneeze or cough. Is this serious?",
    "doctor_response": "Hello!The poping sound let me think that X-ray investigation is needed to confirm fracture.Anaesthetic gel can relieve pain (Ibuprofen based)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes astasia with high fever?\n\nmy friend is male, 36 years old, and has been confined in the hospital for 17 days so far. her initial tests ecg, chest xray, blood tests turned out normal. he will undergo colonoscopy and other tests. he was rushed to the hospital because his legs grew weak and he could barely walk. he has maintained a high fever - 38-39 degrees and has chills whenever the i.v. pushed paracetamol would lose its effect. he has been a heavy smoker and drinker for years. what could be wrong with him please? thank you",
    "doctor_response": "Hi, As per his history, it appears to be a case of typhoid. All you need to do is to get a blood culture done. In the meantime, keep him on conservative management. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Rohan Shanker Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathlessness with stuffy nose and red dots on chest?\n\nHi. My granddaughter is 4 1/2 mos old. She has a very stuffy nose and when she starts to fall asleep she cannot breath. She sounds like she is gasping. After sitting up for a while she seems a little better. We just noticed small tiny red dots on her chest, abdomen, arms and legs. Not too many.",
    "doctor_response": "Hi, By what you say I feel that she might be having a lower respiratory tract infection which could be either viral or bacterial. At this age, it could be acute bronchiolitis and she will require medical attention or oxygen therapy also. I suggest you take her to the nearest Emergency Room as soon as possible. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for deep vein thrombosis\n\nHi my father is suffering from ivdp from 1 year, he is in allopathy treatment for about a month along with the physiotherapy. In the meanwhile DVT problem has started. Now he has stopped treatment for ivdp n started treatment for DVT. But pain is not reducing. I am totally confuse",
    "doctor_response": "Hi Welcome to HCMI have gone thru your  query regarding DVT problem of your fatherI can understand your concern . Once you receive treatment for deep vein thrombosis you need to watch your diet and ife style which affects your  immune system Gulping on only medicines will not help cure unless you mind your life style .   Include essential nutrients -  fiber , vitamins ,minerals ,  in natural form  fruit ,green   leafy veges  , almonds , Fenu greek  powder a spoon with water   ginger , garlic  coconut water,  & lot of water  and look for signs of excessive bleeding, as well as take steps to help prevent another  DVT .   Add  supplements full of antioxidants   as lemon jiuice  with  Water  ,Aloe vera juice + amla juice 2 spoons  ,  Turmeric powder a level spoon + almond oil  with a cup of hot milk at bed time   ,  Unless the muscle retains its flexibility which keeps the inter-vertebral spaces apart preventing compression of the disc, the problem will recur. Thus to regain or improve the flexibility the best tool is Yoga. After the period of active pain/bed rest, pavana muktasana without raising head and tiger stretch (Marjari asana) with dead slow up and bending (curving) of lumbar part shall be two postures that can help. It is the mechanical way of treating the condition.  is mother of all Later, a routine practice of merudandasana, setubandasana, bhujangasana, salabasana and vakrasana , Kapal bhati pranayam , deep breathing  , back bending exercises  will not only improve in due course of time the flexibility but will also increase the bone strength and immune system  and helps resistance from diseases  and pave way for . Constipation is mother of all ills ,so avoid and also fast , fried foods, Tea ,alcohol smoking , over exertion .Meditation  and rest and Medication for two to three months while orally taking traditional Ayurvedic / herbal medicine - Giloy , Shilajeet  , Tulsi  ,Almonds , Ashvgandha  strengthens the Nervous System and specifically the Para-Vertebral muscles of the BACK. By this, it reduces the compression on the Inter-Vertebral Disc and gives relief to all the related symptoms and resistanc from diseases for life ahead , by strengthening  immunity . Hope this helps solve your query . Take care Wish him  early recovery  & good health . Don't  hesitate to come back for further query .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes flank pain and vomiting?\n\nhi sir i have some questions plz help me ....i had kidney stones and i fill burning when urining  and i passed 1 stones....thn i feel good next day but after 2 days i went to on my friend birthday party and i drunk whiskey and i hangover thn vomiting and now i got pain my left side inside the kidney and i dont feel any burning when urining and i dont see any blood in my urine  and urine color is light yellow and smelt is better then before when i had a stones... and i dont have any fever and anything just pain in my left side....so is it any muscle problem or gas or any kidney disease ????? plz help me sir thankxxx",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. you had passed one kidney stone recently and in my opinion the cause is still the  other kidney stone which is stuck in the kidney, i would recommend you to get your ultrasound kidney,ureter and bladder done along with complete urine examination.in the meanwhile you can take painkiller to control the pain, if your urine report shows infection the appropriate antibiotic course will treat it and if ultrasound shows renal stone then the tretement would depend upon the size and site of renal stone. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of small bump on my scrotum sack?\n\nhi dr. i have small bumps on my scrotum sack. i am having that since 10 yrs. now i find it is growing and two more are emerging now. whatz the remedy?",
    "doctor_response": "Hello, It can be due to acne or skin tag, sharing a picture will help for better diagnose. If no pain or irritation no need to worry. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can Parkinson disease be cured by acupuncture ?\n\nhow can parkinsons disease be cured by accupuncture",
    "doctor_response": "Welcome to healthcare magic forum,acupuncture could never be a cure for perkinsons.it is a degenerative brain disease with lack of dopeminergic neuro transtmitter.acupuncture does not help this.mode of action of acupuncture is to find some trigger pionts and modulate endogenous pain pathway by activating opoids receptors.it has some role in chronic pain management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes black streaks during head cold?\n\n16 year old Daughter has chronic congestion and can't smell very much. has gotten a recent head cold without fever and is now blowing out greenish mucus and also black streaks. THought it might be old blood, but it definitely doesn't look like globs of old blood at all. Looks more like strings of black. What type of bacteria or fungus causes black streaks?",
    "doctor_response": "Hi. I can understand your concern. It would be advisable for you to get a chest x ray , blood tests and phlegm tested for culture done. It could mostly be old blood only. Which should not be neglected. Don't worry, she will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe leg pain after excessive masturbation?\n\nHello, I have been masturbathing since i was 16. Now I am 22 years old. Initially I used to masturbathe for around 2-3 times a day. But later on when i came into 11th and 12th i reduced it down to twice a week. Then now i am doing my engineering. Now also on an average i masturbathe once or twice a week. From paast one year I have been suffering from a back ache. I consulted many doctors everything was normal. They gave me some medicines. But nothing worked out. Recently from past 1 month I am suffering from severe leg pain. I am not able to do my daily acrivities properly. Even i am nt able to turn around and sleep on bed . I have to struggle to do it. Eveytime I masturbathe i feel very guilty of doing this. I thought masturbathing wouldn t be a problem. I always used to masturbathe sitting in a indian style commode and I always used my left hand. I barely used my right hand. So is this the reason of my back and leg pain. Its really troubling me a lot. Help me to get a solution for this. I need to get back to normal as soon as possible.",
    "doctor_response": "well masturbating is not the cause of your back pain it is the indian sitting style any way check your back for disc lesions avoid sitting for long or sit with legs extended on another chairtill you see a physical therapistu should be fixed in no time",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for recurring chills , fever and body pain\n\nMy husband has been experience a recurring chills and body aches following a three day fever and flu he had while we were on vacation in France last week. Many members of the group on board the ship experience the same flu. We have a doctor s appointment for Monday and he is currently taking a generic tylonal product. Is there anything else we should be doing?",
    "doctor_response": "HelloFever with chills may be due to many  possibilities but in your husband case may be due to upper respiratory infection due to any type of the virus including flu.Fever ( en mass i.e. most of members in troop ) with chills and generalized body ache is a common fever.Usually the course of this type of fever is 5-10 days and tylenol is the best medicine beside rest . So wait for next 3-5 days . Still no relief then consult a physician and get his opinion.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes loss of speaking ability in a child?\n\nHi, it is about 16 months that my son who is five and half years old has lost his ability to speak, he does not have a good appetite, he eats very little food, and cries a lot during the day and night. I would like to seek your assistance in this regard, though I have taken to doctors many time but no improvement is observed.",
    "doctor_response": "Hi....I understand your concern.I have few questions and suggestions for you -1. What is his birth weight and current weight?2. When did he start walking?3. Did he cry immediately after birth or did he require any special assistance to take the first breath?4. How long does he see television or tablet or cartoons per day?5. Did any one of the parents' had a speech delay as children?6. How many word s does he speak as of now- I mean his vocabulary consists of how many words?Suggestions:1. I suggest you are doing great by singing rhymes to him.2. Do not use tablet or computer or TV or laptop for doing that.3. Do not force him too much comparing him with others.4. He might get benefited by speech therapy, but before that kindly get back with the answers to my above questions.If you need any future medical consultation and suggestions, I will be glad to help. You can approach me at the following link. Please find the link below.www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does my wife able to conceive after an abortion of one month child ?\n\ndoes my wife able to conceive after an abortion of one month child Dear Doctor hai actually i was responsible for my wife abortion. I didnt want that child and she had to abort him/her as i wanted. Since then ourlife has become hell. She has irregulars periods, gain lots of weight,etc. I even thought of suicide. I dont know but when god given me i did not accept it. The doctor advised forthe test tube baby. Even my semen counts were shown low this time. I am very confused and intense. Her one tests shown our desire of becoming of Parents down. Her Fsh test shown 32%. I dont know what to do doctor. At last we have started to take homeopathy medicines.",
    "doctor_response": "Homeopathy may not help as good as the allopathic medications. Get her hormones under control and eat a well balanced diet, avoid smoking and alcohol to increase your sperm counts.. Once everything is fine, go ahead with the test tube baby thing..Abortion is known to cause infertility problems..educate other couples not to abort the first pregnancy to avoid later complications such that you are facing.. Babies are God's gift, if you refuse it, and kill it, God will not find you worthy to get blessed again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am 42 years old and weighs 65 kg weight. Is it mandatory to have Nutrigain?\n\nHello doctor,I am a 42-year-old male, having normal physic, weight 65 kg. Do you recommend Nutrigain to build my muscle? How should I use the granules and capsules together?",
    "doctor_response": "Hello. Based on your age, this is the normal weight. Increasing weight after this age is not advisable. Because of the risk of developing diabetes, blood pressure, and cholesterol complications. If you feel that you are not able to do your work efficiently or you think you are weak, then you can start using these products to build your weight. You have not mentioned what capsule and granules you are using. So, I am giving general instruction.  You can add granules (5 gm or one spoon) in boiled cow milk and stir with a spoon. It can be consumed morning and night before food. During your routine tea time itself, granules can be taken. The capsule can be consumed after food in the morning and night. Usually, Ayurvedic herbal pills are one to two can be consumed at a time. Read the instruction on the capsules or show nearby Ayurvedic physician to get to know. Please avoid vigorous exercises at this age. Daily walking is the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Symptoms of pseudotumor are reverting after stoppage of drugs. Will it lead to immediate blindness?\n\nHello doctor,I have pseudotumor diagnosed before four years. I was taking Diamox and had a spinal tap. I stopped taking Diamox because I was pregnant before two years, and my symptoms went away along with the swelling. Last year my symptoms came back. I am not able to see an ophthalmologist until four more days. I am worried that I will go blind before I get to see my ophthalmologist. Will blindness happen all of a sudden?",
    "doctor_response": "Hello. Diamox is to control your eye pressure. It does not treat the actual disease it is to manage your ocular pressure that might have increased due to pseudotumor. Since it is a diagnosis of exclusion, you might have undergone a lot of investigations to exclude all other possibilities, including sarcoidosis and wegners. Treatment for pseudotumor or non-specific orbital inflammation is steroids. Some people need a short course of maintainable in the long term to control it without which it recurs. Some get resolved after some time it all depends on the type of pseudotumor you are having did you had an orbital biopsy (a piece of your lesion taken through an operation). Usually, we do a one if not it is orbital apex or sclerotic. For your record sclerosing variety is resistant to treatment. Unfortunately, I cannot say whether you can go blind or not suddenly because not impossible. Due to high pressure, vascular occlusion, optic nerve compressing or reduced blood supply to it and many other things can cause blindness. What I can say is if it is predotumer and if it is a recurrence (not something new) you need steroids and other treatment accordingly. Most importantly, you need close monitoring of your vision to exclude optic nerve damage, which is detrimental and require urgent action.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling sick, stomach pain, tasteless mouth after taking unwanted 72 pill. What should be done?\n\nI had an unprotective sex with my bf on 18sept than I took unwanted 72 on the very next day (19sept). Late Night we had sex again & I took one another Unwanted 72 next day (20sept). After consuming it I felt short period of sickness, but from yesterday I'm having stomach aches, tasteless mouth & mouth watering. Suggest me what to do & what not?",
    "doctor_response": "Hi, unwanted 72 is a harmone preparation, so there will be gastric irritation, and more over you have used two packs in 72 hours. So you had gastric irritation, and cramps.                          I to my patient with such symptoms prescribe omeprazole, domperidone, and antacid gel for relief. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. On application of Selsun blue shampoo, my cheek turned white. Please help.\n\nHi doctor, I am a 37 year old male. From my childhood, I had white patches (skin discoloration) that come and go and I was informed that was due to dandruff. I always use moisturizer.\u00a0I read an online post and I applied Selsun blue shampoo on one side of the cheek where there were light wheatish patch. From the next day, the part started turning white. It has been six months and slowly the white turning into wheatish. But, still it did not entirely match the skin tone. Can you please help me? Is there any cream that I can apply to match my color tone?",
    "doctor_response": "Hi. Revert back with the answers to the above questions to a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is IUI safe and successful in achieving a pregnancy?\n\nHi Sir My name is Harish, iam married for 2.7yrs now and we are planned for a baby and thats not successful we are undergoing a lot of treatment i dont have any issues but its seems my wife has now we have finally come to a decision of undergoing IUI procedure. IF you could let me know how safe and how successful is this and if you could also let me know the cost of it. I have got one of my friend who is successful with this after 2yrs of no kid, I have also chcked internet that shows 80% a good procedure. We are not ready for any further treatment we have to go for IUI procedure as its high time. Please help us with this.",
    "doctor_response": "Hello, usual cost is around 1-1.5 lacs but changes with city and centre.IUI is very safe and enhancesw the chances of conception many foldIn case you have any questions in future you can contact me directly on",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could purple spots on gums suggest?\n\nI just found a purple-ish spot on my gums on the bottom row of my teeth in the front. The biggest spot is off to the left side at the top of the gum between two teeth and the other is between the two front lower teeth. They aren t big spots but I haven t noticed them until today. I am pretty good at brushing my teeth everyday but sometimes I miss a day. I am scared that it is something bad.",
    "doctor_response": "Hello and welcome to HCM,Purple spots on gums suggest petechial hemorrhages on the gums.Petechial hemorrhages on the gums are due to disorders of platelets like reduced platelets or dysfunction of platelets.Trauma to the gums can precipitate the formation of petechiae.I suggest you to get a complete blood counts to assess the platelet number and platelet parameters.If platelet number and other parameters are within normal limits, disorders of coagulation factors can be the cause.I suggest you to consult your dentist for clinical assessment and prescription of investigations.If platelet disorder is detected, you need to consult a hematologist.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for hair loss\n\nHi. I am a woman with 29 years Hi. I am a woman with 29 years old and 60 kg and 160 height. I have a very intense hair loss,about 200 in a day. in 2010 in the same time my hair loss begins and I used rigendiet tablets and vitality shampoo and tablet.after stopping to use these tablets (because they made me fat) my hair loss...",
    "doctor_response": "Hello,Thanks for the query.You need nutritional supplements and essential proteins for good hair.Biotin causes hair growth.It is one of the component of hair building unit.It also promotes utilization of proteins by hair.Use minoxidil along with biotin.Its a good treatment.Apart from this you can also use tab androanagen.Regarding food you can take any diet rich in protein.Also you can wash hair daily.Washing wont cause hair fall.Let me know if you have any other doubt.you can ask a direct question to me on this forum, following the below link. you a good health.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to detect the true labor contractions?\n\n1. I just read that \"Braxton Hicks Contractions\" are not painful, but in My first pregnancy..I had contractions without pain(it might be rare case), another problem is I don't even know how the contractions will be, although I am having second pregnancy. In my last pregnancy, one day suddenly my stomach got too Tighten over belly and I went to the hospital then I found I am in labor. when doctor found cervix dilation, she induced labor to feel the contractions more, then cervix dilation has happened more but still I didn't feel the pain of any contractions or any sign of labor or no water break. Then Doctor broke my water and baby started move at that time then I felt pain and baby came out (it took hardly 10 mins). In this case I really didn't feel actual labor signs so I really don't know what is going to happen this time. from 3-4 days, I observed that my stomach is too tighten and baby movements got less (may be it is too early to feel this) but I am not sure. so I am worried how to find the true labor contractions? ( Now I am 30 weeks pregnant)",
    "doctor_response": "Hi, Dr Purushottam Neurgaonkar here. I welcome you to HCM VIRTUAL CLINIC. I have gone through your question, and I think I have understood your concern. I will suggest you the best possible treatment options. As you said, the labour pains and contractions were nit felt by you in the last pregnancy.  Please keep watch on abdominal tightness , which is stronger than Braxton.s tightness. Also as mouth of the womb starts opening you may Get white or red sticky discharge, low back pain and tightness of abdomen will progressively increase. Once you notice any of these , it.s onset of labour process .I hope this answer helps you. Thanks Dr Purushottam Neurgaonkar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for severe abdominal pain?\n\ni have had really bad stomach pains all week and hurts when i urinate and im over a week late on my period .. i didnt use a condom not this saturday jus gone but the one before but my boyfriend claims he didnt cum inside me? we are pretty confused? and im only 14 and not on the pill yet",
    "doctor_response": "Hi.Thanks for your query.Read and understood your problems: Severe Abdominal pain all over week and hurts on urination - over a week late on periods - You had sex and did not use condom this Saturday- if within this week means you might have been in a safe period and your boy friend says he did not cum in . I would advise you the following:Consult your parents as you are minor and this answer is out of humanity of a Doctor for social responsibility. Get pregnancy test. If it is negative , nothing to worry about.Otherwise follow whatever your parents say so. The possibility of Severe urinary tract infection has to be borne in mind. Get the following tests:Blood CBC for infectionUrine : Culture and sensitivity, routine and microscopyUltrasonography of the abdomen.A course of an antibiotic and supportive medicines till you are cured.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes inflammation on bellybutton of an infant?\n\nHello, My 11 months old son s bellybutton is bright red. I ve used a q-tip to see if there is any infection or pus but it was all dry. It doesn t have any odor. it is just red.He is not crying up in pain or grabbing it at all. His behavior is normal for an 11 months old. What do you think?",
    "doctor_response": "HiThe condition is most likely due to umbilical granuloma. Small umbilical granulomas usually respond to silver nitrate application. Large umbilical granulomas or those that persist after silver nitrate treatment require surgical excision.Hopefully it will be of help.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high sgpt and sgot when taking baraclude for hepatitis B?\n\nHi.. My father is diagnosed with Hepatitis B.. He is now taking Baraclude medicine.. Recently his LFT showed that he has high SGPT & SGOT (72 & 83 respectively).. But his bilirubin is normal... Does this mean that medicine (Baraclude) for HBV is not working?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Your father has hepatitis B. His SGOT and SGPT is slightly raised only.  In hepatitis theses enzymes level increased very high.  If your previous SGOT and SGPT level ars very high then its comes normal level now and nothing to worry.  Continue your drug treatment accordingly. Avoid fatty food and alcohol. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have head itching for about 8 months\n\nsir i have head itching for morethan 8 months and prescribed lot of antibiotics and creams.Till date no cure. please advice me for a good food and a permanent solution to be free from my head allergies& itchings",
    "doctor_response": "Hello shajahan; welcome to HealthcareMagic Itching in head can be due to dandruff;lice;infection of bacteria or fungi;and even allergic.So to start with you can use a antidandruff and antifungal shampoo like Danclean or Nizral 2% which will help to reduce the dandruff and even treat the fungal infection.If the itching does not settle please consult a Skin specialist for examination and treatment. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest better nutritious food for my kid\n\nHello doctor, My daughter is 7months old and she is taking Farex formula 1 milk of 120ml daily of 4times approx. Morning and evening she will take 3spns of Rice Farex. My worry is tht she is not taking rice at all in her menu and she eats banana and mango and sapota occcasionally. I request you wht nutritious food need to give to my daughter to her healthy growth. She never touches the rice with ghee and tried so many times and now i stopped to give the same. Please give and advice...",
    "doctor_response": "For a 7 maths old baby introduction of complementary feeds after 6 months is absolutely essential. The formula feed in your case can continue although breast feed is more desirable. The introduction of semisolid food is gradual , hypoallergenic , and without any extra sugar or salt. These us the time when long term preferences for food is established. You may start with mashed fruits and mashed vegetables. for 1-2 weeks and gradually start cereals ( rice) , pulses , wheat and dairy products. Non vegetarians can start poultry and flesh rich in iron. The gap to be covered is for iron , energy , proteins ,  Vit A in that order. The protein should be restricted to less than 20% of the total Calories to avoid obesity. Food should be 3-4 times a day by one year. Continue formula feeds til. 1 year but you can use dairy milk for preparing foods like sooji kheer or porridge etc.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are Cifran CT, Sporlac and Zofer advisable for intestinal infection?\n\nHey doctor, I was diagnosed online by doctor with what he believes is an intestinal infection and he recommend I taking cifran ct twice a day, sporolac twice a day and 4mg zofer twice a daily until the infection subsides. Are these medications OTC or do I need a prescription?",
    "doctor_response": "Hi, You can safely continue Cifran and Zofer. Nothing much to worry and your treatment is in the right track. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility problems\n\nhi, I saw this add I thought I might try it out. Me and my husband have been trying to conceive for about two years now. I have had a regular menstration, but last month after I had my period (exactly) a week later I bled in the morning, (light pink when wiping) After an hour it was gone, Ive been feeling tired and always hungry, it might just be me thinking im pregnant when im not..but why would this happen. Im suppose to start in 8 days. Can you please help me? Thank You Natasha",
    "doctor_response": "HelloYou are feeling tiredness , having hunger ( in excess ) and also bleeding spot , why?You are having a very regular menstruation ( regular date ) . This time exactly after 7 days of regular period , you had bleeding just like a spot .According to you this spotting was on the 8th day of period .Now note down this thing .The size of dominant ( which carries ovum ) follicle should be 19 to 20 mm on the day 14 -15  at least to rupture and endometrium thickness must be around 11 mm to conceive.It means ovulation occurs on day 14-15 after 1st day of period ( bleeding day ) and in your case bleeding spot was on day 8th , in my opinion no chance of any pregnancy . However felling of tiredness, hungriness may be due to anxiety , tension ,because you are so eager for conception , these symptoms may be fake symptoms .So in my opinion consult an INFERTILITY specialist and get his opinion regarding pregnancy.Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are pain inside throat and vomiting sensation upon first smoke due to cancer?\n\nHi, I worry about my boyfriend who will be 38. He smokes a lot , and he recently complains that his throat hurts inside , and the pain doesn t go away. He has also strong acid reflux, and feels like vomiting every morning, when smoking his first cigarette. His Dad almost died of colon cancer, and his Granpa died of colon cancer. I am afraid he has advanced throat cancer that has low chance of survival.",
    "doctor_response": "Thanks for your question on HCM. In my opinion you should first consult pulmonologist and get done chest x ray and Broncho scopy to rule out any pathology of throat.The pain mostly from GERD only. And smoking has deteriorated effect on GERD. It actually worsens GERD. So if chest x ray and Bronchoscopy is normal than no need to worry about throat cancer. His symptoms are mostly due to GERD. So cessation of smoking is needed in his case. Along with these do following things for better control of GERD.1. Avoid oily and spicy food. 2. Avoid heavy meals, instead take small meals.3. Avoid stress and tension.4. Start proton pump inhibitor. 5. Go for walk after meals.6. Keep 2-3 pillows under head in bed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes too much sleep and back ache?\n\nSir, I had unsafe sex with My Girl friend and another day she had the unwanted pregnancy pill, and it s been like one week ago, and she misses her period this month and she is suffering back ache too much even she sleeps too much now. Please tell me what is this?",
    "doctor_response": "Dear caring boyfriend first of all avoid unsafe sex altogether. Your partner's back pain  might be due to pelvic infection. She also missed her periods which may be due to pregnancy which is unwanted and she might be getting depressed, which might be the reason for excessive sleep. Take her for visit to expert gynecologist and get her checked for pregnancy test. I would also advice starting antibiotics once pregnancy ruled out. And above all counsel her and avoid unset sex in future.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for abdominal pain and frequent sleep on child?\n\nMy 11 yo daughter has been complaining of stomach pain at and to the right of her belly button. She has no fever, vomiting, or diarrhea. She has had this for the last 4 days,and has been sleeping almost immediately after school and then all night. Any ideas?",
    "doctor_response": "Hi,Thanks and welcome to healthcare magic.Pain abdomen in a 11 year old child may be due to Amobic colitis, urinary tract infection ,worm infestation  and digestive disturbance .Albendazole at bed time to eradicate worm infestation and metronidazole for Amoebiasis can be tried.Get the urine examined microscopically to rule out urinary tract infection .Consult pediatrician if there is no outcome .Hope this reply is OK for you.Please feel free to ask further queries if any.Dr.M.V.Subrahmanyam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of Nuvaring IUD?\n\nHello. I am currently on nuvaring birth control and mistakenly took it out a week early the. My regular schedule.Once I realized I was early in removing the ring I put it back in with in a 24 hr period but beyond the 3 hour limit.  I did have unprotected sex during the time of when the Nuvaring was removed. Do I need to take emergency contraception pill or let the nuvaring release the hormones during 7 days to regulate my hormones again?",
    "doctor_response": "Hello,Thanks for trusting us with your health concern. I have gone through the query and understood your concern. In the current scenario, you need to use other back up method of contraception until the ring is inside continuously for seven days subsequent to the reinsertion to allow the hormones to work. If you cannot leave the nuvaring inside for seven days , you have to use emergency contraception. Reinsertion should always be done after washing the ring with lukewarm water. Hope you find this information useful. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe depression?\n\nMy nephew (33 yrs old) has suffered with depression for the past 15 years. He has not had significant relief through a regime of drugs. His psychiatrist is suggesting ect. I know without knowing you nephew you can t make a diagnosis; however, what is your opinion of ect? Thanks, Bernadette Maher",
    "doctor_response": "HelloDear, if no drug regime is working for him, ECT is the best treatment option. The treatment is safe and has no major side effects. It would be better to go for it than to keep experimenting with drugs.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have smooth rash like covering on groin and upper thigh area, looks like faded blood dots. Underlying cause\n\nHello.  About 2 weeks ago, my daughter noticed a smooth rash like skin condition that was covering her  groin and upper thigh area.  Aslo behind one knee.  It doesn't itch or bother her in any way.  She said she wouldn't know it was there if she couldn't see it.  Her skin is very sensitive and she has a severe case of karatosis polaris, so I figured she was just having a reaction to something.  However, it has not gone away.  It has lightened some and looks sort of like light brown bruising...like could be caused by gripping the skin too tightly.  The skin looks like it has tiny, faded blood dots..like it's been pinched.  Can you please tell me if this sounds at all familiar.  Thank you!!",
    "doctor_response": "Hi, Welcome to Health care magic forum.                         It appears to be the ring worm, or eczema, she may need to use antifungals, and steroid combination creams.                        So i advise you to consult a dermatologist for diagnosis and treatment.                        I usually prescribe to my patient with such symptoms grisofulvin 500 mg , and betamethasone, miconazole, and neo mycin. for local application.                         Wishing for a quick and complete recovery.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have back pain for a long time which reoccurs very frequently. All test done but normal results. What could be wrong?\n\nHi, I have been having right side lower back pain on and off for some months now and have been going to the chiropractor for it thinking it from my job as I am a can. The adjustments were helping the pain go away for awhile then pain started coming on more frequently and now seems to not go away and my chiropractor says my back looks good. Also when I do have this pain I get real nauseated and throw up and can't keep nothing down, I also get chills with pain. It seems I can't do anything without pain coming back and just feel nauseated more now. chiropractor is doing treatment but don't seem to be working. What could be wrong with me? Is it something besides my muscle strain?",
    "doctor_response": "HiI think you should do x ray as well as sonography to rule out kidny stone or other pelivic pathology. If everything normal in that you can consult your physiotherapist for low back short wave diathermy , lumbar traction and lower back exercise.Get well soon.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes reduced sperm motility and count?\n\nhi doctor,i done a sperm analysis test and found that my sperm count is 20million and the sperm motality is 15%.and the doctor told me that a varicosele is found in my testis...is the varicosele  the factor for my sperm motality and sperm count?if i have do a surgery for removing varicosele,then there is any chance to improve my fertility?",
    "doctor_response": "Hi, The varicocele can affect sperm count and motility. So it's better to get operated for varicocele. It will help in regaining fertility. Meanwhile Hormonal profile can be checked and Hey Forte like tablet can be prescribed. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden stabbing pain in the collar bone area?\n\nlast night out of nowhere I got a sharp stabbing like pain on my left side near my collar bone, i woke up due to the pain and it is still going on almost 24 hours later. When i am sitting it doesnt hurt unless i take a deep breath, cough or sniffle. i have noticed that today the pain is now also radiating to the lower part of my neck and my shoulder blade. any ideas?",
    "doctor_response": "Hi..Welcome to healthcare magic. As you mentioned you have problem of pain at left side of collar bone and radiate towards shoulder that may be because of heart problem or other reasons..Consult a physician for further diagnosis. Detail history and physical examination give exact idea about problems. I hope this will help. Get well soon.. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the suggested medication for jaundice?\n\nsir my son aged 14 years is suffering from jaundice from 3 weeks level of bilirubin is22 and indirct billirubin is 15.6 S.G.P.T IS 61 HE IS SUFFERING SEVERE ITCHINGFROM LAST 04 DAYS SGPT IS LOWERING BUT BILLIRBIN IS SLOWLY INCREASING WHAT TO DO he is ok no vomiting/no much weakness",
    "doctor_response": "hi.noted history of jaundice associated with pruritus (generalized itchiness). it is possible that your son has an obstruction (from a stone or a lesion) somewhere along his hepaticopancreaticobiliary tree causing his jaundice. deposit of bile salts causes his pruritus. it is best if you bring him to a doctor, preferably a general surgeon or a gastroenterologist, for physical examination and clinical evaluation. diagnostics (such as ultrasound, ct-scan, MRCP/ERCP, liver function tests, etc.) and management (medical and/or surgical if indications are found) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hematoma in buttock and shortness of breath\n\n11/3/11, fell down 1/2 flight of steps on right buttock. I was in shock and had pain up to my right chest area around ribs. Taken by ambulance to hospital. CT Scans/xrays showed to breaks or cracks. Developed grapefruit size hematoma in right buttock. Two months later still have shortness of breath and life-stopping pain in right chest.",
    "doctor_response": "Hello,A chest X-ray study is necessary, coupled with a thoracic spine X-ray study, in order to exclude a possible bulging disc in this level, caused by the trauma. You should discuss with your doctor on the above tests.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vertigo with headaches?\n\nHi, I am Sabhyata from Karnal Haryana India, My age is 29, Weight-54, hight-5\u2019-5\u201d. I married on Nov-2009, currently don\u2019t have any kids. From last 3 years I am suffering from Vertigo (Chakkar aana), earlier that problem reoccur within 2-3 Months, but from last 3 months I am facing this problem frequently (in every 2 or 3 days), During this problem I feel that my surround is rotating, I am not able to stand or Sit, Even I am not able to move my head. I feel my head very heavy and I have to lie down for some time than I feel ok, after vertigo feel headache and body ache. My senses like hearing and eye-sight is also fine. Please suggest me any solution as I am always scared to go out or travel, don\u2019t know when this problem suddenly hit me.",
    "doctor_response": "Hi, Your symptoms are suggestive of migraine-associated vertigo. In view of frequent episodes, you would require prophylactic therapy. The best drugs for this are flunarizine and topiramate. These need to be prescribed by a doctor, so, please consult a doctor online or in person. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Sudhir Kumar, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring, painful lump in armpit?\n\nHi, ive experience a lump in my arm pit 4 times in under a year. It hurts a lot, usually when stretching my arm or putting deodorant on. I usually stays for about a week then goes away. What can cause it? my doctor says its a swollen lymph node last time I had it around easter. But now its back again.",
    "doctor_response": "Hi ! Good evening. I am Dr Shareef answering your query.From your history, it looks like a sebaceous cyst in your arm pit which gets infected secondarily with bacteria to give rise to signs of inflammation like pain, redness, etc. If I were your doctor, after confirming my diagnosis by a personal local clinical examination, I would refer you to a general surgeon for a possible excision biopsy for a confirmation of the diagnosis and a cure. Till then, you could go for a over the counter anti inflammatory drug along with a proton pump inhibitor for a symptomatic relief only.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lethargy,nausea and bloating?\n\nI feel so tired, always hungry and nauseaous at the same time. I m also moody, easily irritated, and sometimes when I eat I feel dizzy and shaky. I also get hot like I flare up or get hot flashes. Also once I a take sip of water, juice or soda I burp right away. This also happens when i take a bite of food. Oh and I also get bloated. Also every morning i feel my bladder is going to explode so I have to get up and run to the bathroom to pee. This has been going on for months, what could be wrong with me?",
    "doctor_response": "Thanks for your question on HCM. In my opinion you should get done some blood investigation to find out cause.1. CBC ( Complete Blood Count ) to rule out anemia. 2. Thyroid function test to rule out thyroid diseases. 3. Urine examination to rule out urine infection. Your bloating, nauseous feeling etc can be due to GERD ( Gastro Esophageal Reflux Disease ).  So avoid hot and spicy food. Take proton pump inhibitor. If all the above tests are normal than mostly you are having anxiety. So avoid stress and tension. Be relax and calm.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the leg, reddish spots on the calf and knee. Pain radiating to the thigh. Recovering from an ulcer on the ankle. Have thrombocythemia\n\nI have pain in my left leg, red spots on my calf and around knee , pain and swelling around knee area and below, pain radiates up and behind my upper thigh, the skin is burning. Knee hurts when \\i bend it. I am also healing from an ulcer in my left ankle. I do not have diaabetes. I am also taking a new medication called Myleran for essential trombocythemia.",
    "doctor_response": "Hello,Thrombocythemia has high chance of bleeding and bruising.Trivial injuries also cause you to bleed and bruise.You need to rule out any bleeding into the knee joint.Check you Platelet count, bleeding and clotting time.Consult your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Got red lump in the left side of head while playing, headache. Should i worry about something?\n\nHi, this morning my son hit his head with another kid from school and has a little red lump in the left side on the temple. He didnt went to the school nurse. When he got out of school he mentioned me it and that he has a little bit of head ache. I made him the pupils eye exam with a flashlight- ok, the balance exam- a little out of balance, he seems a little bit drowsy. He ate food after school, he is looking the tv and playing computer games. Should i worry about something? Should i bring him to the doctor or the hospital? Thanks for your help",
    "doctor_response": "Hi As per your query,he is active after accident. The red lump is Haematoma,collection of blood.It comes down spontaneously in course of time. If he loses his consciousness,develops vomiting,bleeding from ear,nose and throat;then it is matter of concern and should be taken to doctor. At present,nothing to worry. Give him anti inflammatory drug. Wish him speedy recovery Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Delayed periods after third IUI, HPT negative, frequent urination, vaginal wetness. Am I pregnant ?\n\nDear Dr My periods are very regular. I am on tyroxin 150mg. TTC for 3 yesra and after my third IUI my period is delayed by one week. I did a HPT two days back it came negative. I have frequent urination , viginal wetness,a pain in my leg and hips ( intermittant ). Feel hungry lot and have gained weight Am i preganat? Please help Thanks",
    "doctor_response": "Hello, Well madam, there are chances that you are pregnant. Many a times urine test for pregnancy can be negative in very early weeks of gestation. So be patient and continue the treatment as advised by your doctor . Repeat the test after 1 week if you don't resume menses. thanks.take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for stickiness in chest even while on medication for GERD\n\nhello doctor, i am a patient diagnosed with GERD.  after an endoscopy procedure and antibiotic therapy for H pylori, i have been advised to take a course of pantocid and lesuride.  the problem is that i still feel some kind of stickiness in the chest.  what should i do.  pls suggest",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Along with drugs, GERD needs following lifestyle modifications for complete symptomatic relief. So start these lifestyle modifications. 1. Avoid hot and spicy food. 2. Avoid junk food. Avoid stress and tension. 3. Avoid large meals, instead take frequent small meals. 4. Go for walk after meals. 5. Keep 2-3 pillows under head in the bed to prevent reflux. 6. Avoid smoking and alcohol if you have these habits. 7. Loose weight if you are obese. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can allergic cough be treated?\n\na high eosinophil count......doesn t link with a chronic cough,according to all the cause and effect literature l ve read on a high count of these white blood cells.....my wife for a long time has a high count of Eosinophil and for many years has tried every process/procedure,medication to try and eradicate the debilitating cough she has been plagued with without success.......she had a stressed induced heart-attack after a severe bout of coughing .........there is little or no phlegm during these coughing spells.....anything spring to the fore ?......thanks for your time",
    "doctor_response": "I am sorry for the troubles that she is experiencing.  I don't want to just recommend an allergist, but a high eosinophil count is usually indicative of some uncontrolled allergy which can often be something in the home environment.  Fortunately today there are a number of treatments that can be directed towards the eosinophilia itself.  If you haven't done so already, I would also recommend getting anti-allergen pillow and mattress covers as well as a high efficiency air filter for the bedroom and living room.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes wet dream when stopped masturbation?\n\nhi i am now 23 yrs . i was started hand practice when i was 12 yrs becouse of wrong friend circle and then doing it regular (2-3 times in a week). Now weight is 62 kg and 5.6 ft height. The problem is that now in a week if i am not do hand practice than it will couse a wet dream in a week. Another major think is that i a Company secretary and doing CA( chartered accountant course) many times i am not able to recognize my work and concepts. every time my body is tired. i also suffered with accidity many times pls help me ASAP",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Doing masturbation to avoid wet dreams is not justified as wet dreams is body's natural process to remove old sperms to make room for new sperms. Being weak and having acidity has nothing to do with the habit of masturbation. I would recommend you to take some multivitamin supplements for the weakness and antacids for the stomach acidity. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain\n\nI had really bad pain in my stomach, kind of in the middle in between where the rib cage starts.  It woke me up at 4am, i couldn't stand straight.  On our way to the ER, as my wife was backing up i felt something, can't really explain it, maybe when something unglues itself, and it went away.  The day went by and it was pretty painless, but now if i press on it it's pretty sore, not sure if it's still there or it's just sore from whatever it was.I'll be glad to provide any other needed info,Thanks in advance",
    "doctor_response": "Hi.Thanks for your query.Noted your history of bad pain in the stomach, in between the rib cage, which woke you up at 4 am, and went away suddenly. There is still soreness on pressure.I would advise you the following in such a case:X-ray in the standing position. Barium meal for stomach in head low position. This is so as there is a possibility of gastric volvulus or intestinal obstruction or internal herniation and so on. You really need a proper clinical evaluation, examination and investigations to get a correct diagnosis as there is always a chance of recurrence.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of gall stones?\n\nI have gallstones which have just started causing me pain but my problem is that i feel numbness in my left abdoman under my left rib. It also goes around to my back area. There is no rash. Is this related to the gallstones or something else. What could be causing this numbness that comes and goes?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have history of gall stone. Your pain and numbness may be due to that.  You should go for ultrasound abdomen to know the exact size and site as well as thickness of gall bladder wall.  Treatment depends on size of stone and whether you have cholecystitis or not. For abdominal pain you can take buscofan or dicyclomine.  If you have large stone then surgery is required. Consult your doctor and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does presence of bacteria and hpf in urine during pregnancy indicate?\n\nHi Doctor, I am 31 weeks pregnant now and had my urine test last week. Every other things seems normal apart from one thing which says bacteria FEW / HPF. I want to know whats the meaning of it. I am visiting my doc today but before that need more views from other doctors also. Thanks in advance...",
    "doctor_response": "Hi,Urinary tract infection is a common finding in pregnancy, especially in the last few months. Do you have any fever, burning sensation when passing urine or urgency.You need to know which type of bacteria and what antibiotic it is sensitive to.For this you will need to do urine - culture and sensitivity.Depending on this you could take the antibiotic course , which is safe in pregnancy. This will treat the it.You need to get it checked as urinary tract infection if untreated may lead to preterm labour in some women.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high BP\n\nHi, I am 47, 4 11, 208lbs. I have high blood pressure and medicine has been changed thrice(side affects). Lisinopril after three years, ziac after about a year and now losartan. I am a african american female and I have pretty large breasts. My gallbladder was removed about a year ago Ive had very bad pain since. Some time ago my sleep was disrupted by hearing my pulse in my right ear. Along with this I started waking feeling like I wasn t breathing properly, and now I am waking up over in the late night or early morning with a rapid heart beat that I can feel and hear in my right ear. I also feel some paused or delayed heart beats but these are not just at night. Oh yeah, I have reflux/digestion problems. Seems like I m just falling apart. With no medical insurance it seems next to impossible to get answers.",
    "doctor_response": "hi i have gone through your question in african american vasodilators and diuretics are best you may take hydoclorthiazide 25mg in morning with amlodipine 5mg at evening also if your heart beat is fast than it worth to take beta blockers for instance metaprolol 25 mg in morning with drugs check your bp daily and titrate the dose accordingly reduce your weight take less salt daily intake less than 1.5g and do exercise decreases systollic bp by 20-30 mmhg thanks hope answer your question",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent bowel movements ,sore throat, chest pain and breathing difficulty?\n\nhi i think i have cancer and am too scared to put me mum through the pain beacause her dad just died of it no i am always needing toilet, blocked nose, sore throat, and pains in my chest and sumtimes feel like i cnt breath sum times, am getting dead upset cos am only 20 i dnt want to leave my mum an dad already",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. No need to worry for cancer as cancer is extremely unlikely at the age of 20 years. Your symptoms are more suggestive of viral infection. So better to consult doctor and start appropriate treatment. Sometimes stress and anxiety can also cause similar symptoms. So avoid stress and tension, be relax and calm. Don't worry, you will be alright. And don't worry about cancer. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bad smell\n\nsince one month bad smell in comming from gas, motion is normal only",
    "doctor_response": "Thanks for the query There is no specific treatment for this. I suggest u frink lots of water, take tab neutrlin B twice daily for 7 days, this will replace all the bad bacteria with good ones in the colon Have a healthy living",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are nausea, fever and bloating signs of hernia?\n\nI have been experiencing a lot of nausea and fullness when I just start to eat. When I lay down at night some times vomit comes up. Other times I just feel sick until I get up and walk around then I burp and pass gas constantly. Needless to say I haven t been getting much sleep. I have also been running a fever between 99.5 and 100.4. I have a history of acid reflux, ulcers and a hiatal hernia? The acid reflux and ulcers were under control. I watch what I eat, elevate my head when I sleep and I don t eat before bed. I take pantaprozole twice a day. I am obese and have diabetes. My question is could this be a sign that the hernia has gotten worse and should I see my gastro doctor?",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query.Yes, these symptoms could be due to your diagnosed hiatal hernia. However, chances of an amebiasis would have to be ruled out specially if you were used to eat from outside. If I were your doctor, I would advise you for the following:1) A routine stool test for ova and cyst and treat it if positive which would relieve your symptoms.2) Elevate the head end of the bed with two blocks on each side, so that the regurgitation does not occur while lying down, and the contents of esophagus and stomach flow down with gravity.3) Some modification in your diet like more of roughage, enough liquids, avoidance of oily, fried, and fast food along with avoiding any kind of alcoholic beverages and smoking if you do.4) Regular routine exercises like morning walk depending on your medical fitness.5) Prescription for a prokinetic agent and a proton pump inhibitor  for symptomatic relief and to have a control on the acid production and facilitate movement of gastric contents downwards6) Your fever could be due to any kind of intestinal infections specially if you eat from outside, or might be an independent entity itself which would have to be investigated.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing numbness of fingers due to issue with ulnar nerve\n\nHad ulnar nerve release about 7 years ago. Dislocated shoulder and broke top of humerous (greater tuberosity) 9 months ago. Shoulder froze and had surgery end of January. Fingers numb. Emg test couple days ago. Technician said issue with ulna nerve. Will this get worse if I don t have surgery",
    "doctor_response": "Hi I have read your description . your EMG report say that your ulnar nerve is involved. How exactly is it involved? Probably re compression of decompressed ulnar nerve. If there is pressure on the ulnar nerve then it should be released , else the compression may become worse and numbness may increase.And it probably has nothing to do with shoulder dislocation or fracture greater tuberosity.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in upper chest and back with crystals around the heart\n\nI have upper chest and back pain. I went to emergency and they checked my lungs and heart and everything is fine, some crystals around my heart and I will follow up with doctor but they said this awful pain is probably just a strain. What can I do to get rid of this paid? It gets worse and worse the more I move. What else can this be. I made an appointment with my regular doctor but can t get in until next Friday. Any suggestions?",
    "doctor_response": "Dear Sir/ MadamThanks for your query.1. It is not clear that what your doctor meant by crystals around heart.2. A pain which worsens by moving is not likely to be due to angina or heart attack.3. Pain which worsens on movement can be due to muscle, bone or joint related problems. Pain arising from inflammation of coverings of heart and lungs causes such pains which changes with posture and respiration.4. Re-consult your ER doctor and at least get a prescription of pain killers if it seems a local cause to them. It is not possible to make an exact diagnosis without an examination.SincerelySukhvinder",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I feel my bottom part of the belly is inflated. Kindly help.\n\nHello doctor, I feel that the bottom part of my belly is always inflated, and especially at nights when I eat something, I feel like it does not get digest. But during the day I do not have this problem. Also, I have done the gammagraphy test for my intestinal transit rate, and it was the three times higher the range but at night.",
    "doctor_response": "Hello. I read your query, and from what you have mentioned, it appears that you have idiopathic gastroparesis. You might benefit from a highly specialized gastroenterologist consultation for consideration of gastric pacemaker or gastric electrical stimulation. Gastric electrical stimulation (GES) uses a small, battery-powered device to send mild electrical pulses to the nerves and muscles in the lower stomach.  A surgeon puts the device under the skin in your lower abdomen and attaches wires from the device to the muscles in the wall of your stomach. GES can help decrease long-term nausea and vomiting. GES is used to treat people with gastroparesis due to diabetes or unknown causes only, and only in people whose symptoms cannot be controlled with medicines. Check with your gastroenterologist for further details. I hope you find my advice beneficial.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will the pain while peeing be due to kidney stone or UTI?\n\nI have a history with kidney stones and normally when i have one i get pain toward the end of urination in my clitorus. i Just got off of an antibiotic for a sinus infection and got a yeast infection and treated it with the 3 day monastat stuff. and now im feeling that pain again in my clit when i pee. is it just a kidney store or is it a UTI, also have some pain during intercorse",
    "doctor_response": "HelloThanks for query .Pain at the urination is mostly due to infection of Bladder (Cystitis) however since you are known to have history of kidney stone possibility of urinary stone needs to be ruled out .Please consult qualified Urologist for clinical  examination and get following basic tests done to confirm the diagnosis.1) Urine routine and culture.2) Ultrasound scanning of abdomen and pelvisTake broad spectrum antibiotics like Cefixime   along with urinary antiseptic like Nitrofurantoin twice daily and urine alkalizer thrice daily .Later on switch on to appropriate antibiotics as per culture report.Get the prescription of medicines from your family Physician.Ensure to drink more water .To keep your urine dilute This will help to control dysuria.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Penis shrinked after masturbation. Why does erection not last long? Why is groin swollen?\n\nHey, thank you for the help. Around 6 days ago, well masterbaiting ( im male.) Something happened, im not sure what. By sense then my penis has become very small and only kind of responds to touch. I can get an erection if i force it, but it doesn t last long. Nothing has hurt at all untill today, my whole groan area seems to be swollen feeling.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry. Nothing happened. That is it. Everything is imagination, is in your mind. You are thinking about your genetal area too much. Forget it. You must concentrate in your studies or career as of now. Erection is possible when you are sexually aroused. Why you want to force erection? Forcing erection will do no good. Masturbate only twice or thrice in a week. Never more than that. Because if you cross this limit, you may have sex performance anxiety. You can contact me for sexology related queries.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause a dent on the left side of the back?\n\nHi, I have a dent on my left side of my back I would say almost at the base of my rib, there is a very noticeable dent,, or should I say dimple or where the skin has puckered. . . has me nervous for several reasons. Not sure if you need brief medical history.",
    "doctor_response": "If Dent causing any difficulty or pain then go for treatment otherwise do some back extensor muscle strengthening exercises .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain?\n\nhi,i had bad cough from last 1 n half month ,with cough i have back head pan and fore head pain,even some time chest pain.and now from 2-3 days pain or pressure around nose cheek and forehead ,even i have cold now,cough is so bad at night,not able to sleep,please advise,reason to which doctor should i meet",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.By your history and description, possibility of sinusitis and bronchitis is more likely.So drink plenty of fluids orally. Do steam inhalation and warm water gargles 5-6 times a day. Take broad spectrum antibiotic like levofloxacin or azithromycin once a day for 5 days.Also take levocetrizine and paracetamol combination twice daily. Don't worry, you will be alright with all these. If not improving in 1 week, consult doctor.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing sever lower back pain with headache?\n\nI m having fairly sever lower back pain, pain in front thighs and bad headaches. I had the depo shot approx 2 weeks ago. Wondering if this might be the cause and when/if I should go to the hospital. I m taking robaxacet, one dose so far, which has given me a bit of relief.",
    "doctor_response": "Hello, Thanks for your query.Low backache looks like a positional anomaly. The low back ache is a result of muscle spasm which in itself is a protective mechanism body develops so that the back avoids abnormal posture. For pain to go, it takes not only rest (on a comfortable bed) but also avoidance of particular positions (during work, rest or recreation).Avoid sleeping on sides and stomach in case you do. While on work don't sit in one position for more than an hour and take frequent stretch breaks. Do not bend forward to lift things up, bend the knees and hips for that. Also discontinue any strenuous activity or exercises for some time.Headache not seems to related with it. Get it evaluated by your doctor for proper management.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes precum immediately after erection?\n\nHow come whenever I get an erection from watching porn precum flows out. I can t watch it for five minutes without it coming out. Is there something wrong with me. Is it because I have the ability to produce more and needs to come out or there is something wrong with me. Also is losing too much precum bad.",
    "doctor_response": "Hi Thank you for asking HCM. I have gone through your query. It is usual have precum when you get stimulated. Some will get that more and some less. It is normal . You don't need to worry about that. If it simply flowing without any stimulation then you should get checked by an urologist. It is also not harmful if you loose it . Hope this may help you. Let me know if you have any further queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is resting rate of 85-91 normal?\n\nMy resting rate is around 85 - 91 bpm without any exertion.  My blood pressure is normal.  Is this normal or should I be concerned.  I do drink alot of caffeine during the day and I'm about 20 pounds over my target weight.  I'm 47 years old. I take .112 mg synthroid.  I'm 5'8 weigh 180 lbs. Thanks!",
    "doctor_response": "Hello,It's in normal range per se, although on a higher side. No need to worry. Try to cut down your caffeine intake which increases heart rate and also get your tsh test. If TSH is low then needs to decrease thyroxine dose, which also cause increased heart rate. Also get your hemoglobin tested.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bumps on arms, shoulders, red rashes on legs, thigh. Sore throat, nausea, shingles, skin dry and peels. Solution?\n\nThe other day out of no where in my right inner elbow I found these two separate little circles of raised non itchy bumps, a little while later I started noticing these little bumps traveling up my arm,and then anotherNon itchy group appeared then there's a line of three red bumps on my shoulder. On my chest there is a group of more bumps that are close together but do not gotten a circle like the other spots. On my legs I have like this red rash that is not bumpy or raised traveling from my ankle all the way up to my thigh. I woke up Monday with a sore throat, then I developed a horrible cough and terrible naseousnes. I have had shingles, I have also have tinea versicolor I think Is what it's called my skin is always really dry and my skin just peels of taking my pigment with it... I am very concerned because in 2008 I had necrotizing fasciitis...",
    "doctor_response": "Hi i understood ur query and concern Circular  bumps u explained can be tinea corporis .yes sometimes it is associted with tinea versicolor..both are fungal infections .they should be treated with oral flucanazole 150mg weekly once for 4-6weeks and application of nizral ointment over the both the lesions can treat the condition.regarding shingles use antiviral treatment.as these are coming together rule out immunocomprimised disease like hbsag or hiv",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for pain beside the kidneys and at the back,frequent urination,heart burn,excessive sweating,abdominal pain and gas symptoms ?\n\ni have a problem i feel pain by my two side of kidney at d back.i feel like vomitin most times.i can sleep for more than 3 hours.wen i urinate i feel like somebody is cudin me.but i urinate frequently wen i drink water.pains on my ribs.but my legs doesnt swelow. heart burn.i sweat alot.abdormen pain.nd excretion of gaseous.my stomach swalow most evenin.pls wat could dat be",
    "doctor_response": "Dear Magna,thanks for query.There are couple of common possibilities.The first one could be renal stone or infection in urinary tract.Another could be infection in gastrointestinal tract.But in any case you need to go to doctor and get your self examined.take light diet and more of liquids.bye and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in limbs of a newborn twin?\n\ndoctor sir, 2 weeks before my sister blessed with twins.one male (2000 grams) and female baby(1500 grams). at the time of birth female baby foots and wrist are fully swollen. but still it is not reduced , i don t know the reason , please give your suggestion.",
    "doctor_response": "Hi,Only foot and hand swelling without any other body part swelling is less likely. If I would be your doctor, I would suggest you to relax and watch.Now here, I can't judge about swelling without watching it. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Hina Javed",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for wisdom teeth pain\n\nMy wisdom tooth is ripping my cheek leaving a bit of a dimple-like mark in my cheek. The tooth has not fully erupted out of the gum yet but it is extremely sharp and it seems like its only growing from one side and not the other (as if its growing sideways).",
    "doctor_response": "The position you describe will constantly lead to trauma and probably may lead to severe infection at a latter date. Transient relief canbe gained by antibiotic and analgesic therapy. But on along run you need to get an xray done and probably consider removal of the wisdom tooth.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from ITP and recently underwent spleenoctmy. On wysolene. Any side effect of this steriod?\n\nHi doctor, My wife is suffering from ITP and recently underwent Spleenoctmy.Though her platelet count has increased,she is still on steroids(30 mg of wysolene).Once she takes the tab she starts to shiver and would be out very low till the effect comes down.This may be for 4-5 hrs. Is this a a sympton of Wysolene? Also she feels heaviness in her body,Also are there any food intake that would reduce the tablet effects?Thanks in advance",
    "doctor_response": "Hello Sukumar, ITP is an autoimmune disorder. And Wysolone (which belongs to the class of corticosteroids) is given to suppress the immune system. However, once the platelet count improves, the dose of corticosteroid is gradually reduced and the possibility of relapse is monitored. Long-term steroids usage is associated with certain side-effects like: 1. Increased susceptibility to infections 2. Abnormal fat distribution 3. Osteoporosis 4. Diabetes 5. Hypertension 6. Cataract, etc Symptoms aggravate if medication is stopped abruptly. Make sure while discontinuing the medication, its dose should be tapered gradually instead of stopping it abruptly. Food products which strengthen the immune system should be taken like fresh fruits & vegetables, milk, etc. Wishing a good health. Let me know if I need to clarify further. Thanks & take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medication is suggested for fabry disease?\n\nmy husband has fabry disease. he has had at least 3 episodes of blood clots- 2 as teenager, one 12 yrs ago, and now he is exhibiting signs again. an ultrasound 2 wks ago was negative. He is complaining of heaviness, aching, in both legs, but has discoloration on the inside of one ankle, and now has developed area of bruising about the size of a dollar on the inside of his thigh/groin. Our family dr is not very concerned/aggressive, saying IF he has one, it can be treated at home? so- I can't even get my husband to an ER now that this bruise UP HIGH has developed. Is this an emergency situation?",
    "doctor_response": "Hi,Thanks for writing to HCM.Fabry's disease is a storage disorder where in fatty substances keep accumalating in the body due to the genetic deficiency of the enzyme Alpha galactosidase A.Hence this makes Enzyme replacement therapy is the only FDA approved treatment for this disease . Kindly regularly take the enzyme shots on Out patient basis. Since your husband is having these complaints of discolouration , he may need to be put on analgesics (relieve pain) and blood thinners.Hence kindly take him to the ER before its becomes a more serious condition.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please check the report and reveal the reason for my dry mouth along with left-sided jaw and arm pain.\n\nHello doctor,I had a bad pain in my left arm and jaws. Lightheaded and dry mouth, and hence got the test done.",
    "doctor_response": "Hello. I have gone through your reports, and they are normal. This is unlikely to be related to the heart. A similar kind of pain may occur in reflux disease. Do you get any bloating, burping, soar water feeling in mouth or chest burning intermittently? If yes, then it likely indicates reflux-related pain, and even otherwise it may be related to reflux or esophageal spasms. So, I do not think there is anything to worry about it.  You should be on antacids like Pantoprazole, Domperidone combination for a week or two. Also, avoid oily fatty, spicy food, and avoid smoking alcohol if any. Have regular exercise and avoiding resting immediately after the meal instead have some walk. I hope this helps you and get back if you have any doubts.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for strep pneumoniae lung abscess\n\nMy brother went through ER with left lung strep pneumonia and went into septic shock and was given a blood restrictive drug due to low blood pressure to reduce blood flow to limbs and direct to vital organs. Less than 18 hours after this drug was administered, I noticed that his feet were cold and white and insisted that the ICU nurse warm them, later his wife also commented on his cold feet and they put socks on him. Is there anything that can be done if the blood flow to his feet has been stopped to reestablish blood flow when pointed out this early.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your brother's situation and problem. Septic shock causes hypotension and decrease in tissue perfusion. So first and foremost treatment of Septic shock is control of infection through effective antibiotic. Cardiac inotropic drugs are also needed to elevate the blood pressure. Warmers and compression stocking are also advisable to increase blood flow to lower limbs. High Flow oxygen is also beneficial to improve tissue perfusion and hence blood flow in lower limbs. So discuss all these with his doctor ND start appropriate treatment. First and most important thing is to control sepsis (infection). Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is colonoscopy required every year in case of adenamatous polyps?\n\nweirdest online site  i ever come across but here is my question are all adenamatous polys precancerous bad? does one need colonscopy every year i dont even know what specialist is gonna answer my question boz to a gynac answering this makes no sense",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have multiple adenomatous polyp. All polup are not bad or precancerous but it is pre cancerous condition and it can turn into adenocarcinoma of colon.  To detect that at very early stage you should go for regular colonoscopy. Consult your doctor and plan accordingly. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for double Pneumonia with plural effusion\n\nhi, my father is suffering from Double Pnemonia with plural effusion. He was hospitalized from 10-12 days. Now he's recover from pnemonia and when he's hospitalized Approx 250 ML Fluid remove from his lungs. Now again he's suffering from Plural effusion. Please suggest what to do now?",
    "doctor_response": "Hi thanks for contacting health care magic....Because of pneumonia you had exudative pleural effusion...250 ml fluid is very much high amount...Now again you have pleural effusion....For that first sputum is send for microscopic examination...Sputum culture also need to be done....ADA estimation also done along with sputum for Tuberculosis detection..If TB present AKT need to be given...If TB not present again pneumonia has to be treated according to culture report....If therapeutic pleural effusion fluid removed then send it for cytological examination....Consult pulmonologist or physician for your condition...Take care.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can skin infection around the penis be treated?\n\nHello I had sex a few days ago and I had blantius before so I know the symptoms but this time I woke up 2 days after I had sex and notices my forskin to be irritated and my tip of my penis to have little red bumps so I said ok I have blantius again maby due to moisture in my groin area and or soap I was using but then a day later it hurt very bad to pull my forskin back I wasn t able to pull past a centimeter or 2 then I saw white things on my foreskin and it looked like white dead skin or something and it became puffy any home remedy s I can use? The doctor that I usually go to closed there facility so I have no option but he s home treatment I m on day 2 of the infection and it seems to be not as bad as last time also has a fowl smell",
    "doctor_response": "Hello, You can apply topical antibiotics like Mupirocin after cleaning with soap and water. If symptoms persist you can consult a physician and get evaluated, Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bump on upper arm?\n\ni have what looks like a freckle, but now its like a small slightly raised bump on my upper arm. It is a bit red right now and looks like it has a small hole in the middle. Do you know what this could be? I can't remember if it was a freckle before or if its just a new mark.",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.This may be a small boil and nothing serious. BY virtue of the position- this may have ribbed against the clothes or body and altered the classical appearance. A small course of antibiotic and anti-inflammatory medicine can help solve your problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a painful lump on the vulva?\n\nQuestion, only just the other day when I was using the restroom and i was cleaning up, i noticed a sharp pain. Upon further investigation I discovered a very firm bump at the back of my vulva that was very tender to the touch (irritated from presumably wiping after the toilet). The placement is to the very far back left side, close to my anus, on the inside of the lip. It is very tender and I m worried it is being aggravated when I use the rest room. Additionally my body has experienced sever pain near my lower abdominal, night sweats, warm skin to the touch (not quite a fever) headaches and chills. When I investigated with a mirror the bump looks like it s a white ish color but there is only one, and it is the size of a pea. Havent had sex in over 3 months, this only started 48 hours ago. I m an avid gym goer and periodically have to run erronds after working out in my gym clothes. Have to wait until morning to call for an appointment but any ideas what it could be?",
    "doctor_response": "Respected user , HiThanks for using Healthcaremagic.comI have evaluated your query thoroughly .*  This seems most likely bartholin cyst , vulva abscess or perineal abscess *  Require sound clinical examination to confirm the diagnosis and further     line of management .Hope this clears your query .Welcome for further assistance .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for abdominal stretch marks\n\nHello..i am 19 years old.i have stretch marks on my abdominal region as well as on my back. i am a fat girl,but now i am doing gym and losing wait also.But is there is any way to get rid of these stretch marks,and how much it would cost for....PLEASE tell me...!!",
    "doctor_response": "Hi.Stretch marks are due to loss of the collagen in these area and not curable. They are treatable. Continue your weight loss management and do not worry about the stretch marks. Loosing weight is most important. Take Vitamin A and D in proper dosage and continue with antioxidants. The body takes care of stretch marks.,You can apply a mixture of honey and Vaseline lightly massaged in which helps a lot.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can stent change in bile duct not be performed if suffering from high fever?\n\nHi there!,I was hospitalized last week for a stent change in the bile duct(ERCP) and had to be returned to hospital after 48hrs due to high fever, now I am home again still feeling low, is this normal? I am in Leicestershire, England with health services from NHS",
    "doctor_response": "Hi thanks for asking question.Noted you have put stent in bile duct...After surgery you have fever....Mostly after surgery inflammatory mediators released that can lead fever....You can take simple paracetamol for it....Get your CRP done....If still fever day by day increasing then with advise from your doctor antibiotic need to be given as to treat secondary infection ...Take care...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pain in leg after hip surgery?\n\nwhere can i go in orange county  for my pain it is in my leg after hip surgery, its been 9 months my doctor that did the surgery had no answer, its like a lot of bees stings in front of my leg , maybe nerve ends growing. he has no answer, need help i cannot handle this anymore.  i have reach out to other doctors they say they want a referral from dr.",
    "doctor_response": "I understand your symptom. These symptoms are of nerve compression. This may be of hip joint disorder or of lumber disc disprders. This may need long time to be relieved and this is why your doctor had no answer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can anyone go through angiography with kidney infection ?\n\nGud evening doctor my father age is 51 years . He is having glucose 120.1mg, Urea nitrogen 42.2mg, Creatinine 3.5mg, Sodium 130.6 mg, Chloride 89.8mg, Calcium 8.3mg, and Uric acid 9.0mg. According to the doctors he cant go through angiography due to kidney infection as they r saying, because of which they are in doubts that he might be having blokeage also in heart . He is right now taking medicine prescribed by the doctors of Jaslok hospital, Mumbai. I m not satisfied with them so, could you please let me know the dieses with which he is suffering and wht further step should i take further...",
    "doctor_response": "Hi well come to HCM His reports suggests only renal impairment and his uric acidis on higher side and sodium on lower side cangive hint about abnormal kidney functions.But there are many causes like HBP,DM.Chronic pylo-nephritis,ObstRuctive diseases of kidney etc. By this reports no body can stamp the DIAGNOSIS. tHANKS",
    "dialogue_context": ""
  },
  {
    "patient_message": "How serious an issue are herniated disks in lower back shown in MRI?\n\ni recently had a mri and it showed that i had 3 herniated or bulging disks in my lower back and my left leg suddenly drags behind my right leg which in turn causes my left leg to give way and i fall to the floor.  what can be done about this serious problem and i am 75  years old",
    "doctor_response": "As you have 3 herniated discs and disk bulging it needs to be properly managed by your orthopedic surgeon and you also need to follow some precaution like:1. Avoid lifting heavy weight2.Avoid bending forward or backward3.Avoid any jerky movement that can further damage your spinal cord.4.Use firm mattress or bed and avoid soft bedding.Besides this please consult a physiotherapist for some conservative managementwith best wishesDr Chowhan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pain on the right side of the abdomen from the ovulation day a symptom of pregnancy ?\n\nHello doctor ,I am 25yrs married woman.Actually, my periods is irregular from the very beginning.I took several medicines but no use.Now we are planning for a baby.Today is my 29th day.I used Clearblue Digital Ovulation Test Kit and Saliva Microscope Test to identify my most fertile days.We had intercourse(all most continuous) from 8th day of my periods and 17th and 18th day is my most fertile days.I am having pain on the right side from the ovulation day.What does it mean? Can I become pregnant? Is it a symptom of pregnant? Please answer me doctor.",
    "doctor_response": "You coiuld have got pregnant and no it is not a symptom of pregnancy. Please get yourself a urine pregnancy test kit. You could also go to a doctor and confirm it by an ultra sound abdomen and pelvis. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain and dry heaving for an 8 years old?\n\nHi, my son is a relativly healthy 8 year old. He did not eat a lot yesterday stating he wasnt hungry and didnt eat his lunch or dinner. He woke this morning at 4 and began dry heaving. My boyfriend keeps saying hes making himsrlf do it, because he was in trouble last night and now wants attention. Im not so convinced though. He tried to eat breakfast, but kept stopping saying his stomach still hurt and then threw up what he ate. He has no fever, but states he cant eat because of the hurt in his stomach. What can i do? We dont have $ for an appointment.",
    "doctor_response": "Hello,Probably he is suffering from gastritis. You may use medications like syrup Ondansetron and syrup Ranitidine. Offer him ORS solution, fruit juices so that he doesn't gets dehydrated. If no improvement or complaints worsening, you will have to consult your doctor.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Khan Shoeb Mohammad Sher Mohammad",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause severe pain in ribcage with movements and breathing?\n\nGood morning, Yesterday afternoon I started feeling pain on my ribcage with certain movements I made but today the pain has gottn worse, when I make certain movements example turn my upper body side to side seem the pay is almost paralizing for a moment and also when I breath deeply it hurts seems pain is mostly on my right side also when I open my chest to breath. what could this be?",
    "doctor_response": "As you are feeling pain even on deep breathing it can be a sign of inflammation of pleura (covering of lungs)..I will opine to get an Xray chest done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does BP reading of 160/85 indicate?\n\nI'm 57 years old, male. My BP reading now is 160/85. Is the reading alaming? For your info I am not in any medications because the doctor said not neccesary yet. But she asked to monitor the BP within 2 weeks and come back to hear for anaysis. Thanks Bakhtiar Baharuddin email:  YYYY@YYYY",
    "doctor_response": "Hello Thanks for posting at HCM. You're BP reading is definitely higher. But since it is just a single reading, it cannot be diagnosed as hypertension. For a diagnosis of hypertension three readings one per week for three weeks is adviced. If all three readings are high then you should be started on both medications. As of now I agree with your doctor and feel that you must not take any medications. Your doctor has called you after two weeks for the same reason. Wishing you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can puffy eyes with spreading rashes and congestion be treated?\n\nHi my 4 yo son started having puffy eyes and some congestion. He has a rash around his eyes that I thought came from rubbing but now the rash has spread to his chin, his torso and now his extremities. He was in our pollen filled yard in freshly cut grass. I have kept him inside and given him zyrtec but the syptoms has gotten worse. He doesn't have a fever and is still very active any clues?",
    "doctor_response": "seems to be allergic for which you already given zyrtec. if no improvement tell me the type of rash itchy or not and time since zyrtec is given",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on penis after having unprotected sex?\n\nHey i had unprotected sex 6 days ago, and recently i felt a little lump on my penis and when i pulled my foreskin back, i found a little red dot, sometimes it feels like it burns then it goes away then comes back, then goes away, do you have any idea what this is? i pulled out from having sex within about a minute, could it be a std?",
    "doctor_response": "HelloThanks for query .Based on history of unprotected sex the symptoms , lump and red dot over glans penis that you have developed strongly suggest infection of the genitals The possibility of STD can not be ruled out .Get following tests doen to establish diagnosis 1) Urine routine and culture 2) Swab test and culture of secretions  from the lesion3) Blood tests for STD and basic screening test for HIV.In the mean while start taking Althrocin twice daily with topical antibiotic ointment for local application Ensure to wash your genitals with warm water twice daily.Ensure to avoid sexual encounters till it heals up completely.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can the yeast infection become systemic?\n\nI am male and have an active yeast infection (jock itch). I decided it would help if I shaved my pubic hairs. As I was shaving, I nicked myself in 2 places. The nicks bleed, but not bad or for very long. I applied nystatin cream on the area, including nicks, when I got out of the shower. I am also taking oral medication (terbinafine). Should I be concerned with the infection become systemic?",
    "doctor_response": "Hello, If you have a systemic fungal infection then fever might be present. You will mostly have a topical fungal infection. For that, you can apply topical clotrimazole cream over that. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the painful lump on my gooch?\n\nhi i have a rectangle shaped lump on my gooch it hurts if it is touched, i noticed it a couple of days ago but it was alot smaller then. Also a couple of weeks ago i had a similar lump on my neck but it looked like a GIANT pimple and now that my neck lump has healed there is no hair growing in that spot. Could this gooch lump be the same as my neck lump and is it harmful?",
    "doctor_response": "Hi,Good Morning,Thanks for your query to My-HCM Clinic.I studied your query in depth.I understood your concerns.My opinion on the gooch lump- is -mostly a -furunculitis with boil.-It appears to be the same as that on the neck.-Coincidence of 2 boils /furuncles -suspects diabetes and needs to be ruled out ASAP.-I would advise-FBS,PPS and consult a physician and surgeon.-Treat with antibiotics and NSAIDs, if does not reduce the lump , then a surgeons help to drain it is needed. -Hope this would help you  to recover from worry-some query.Wish you a Fast Recovey.Wellcome to HCM again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Non alcoholic fatty liver, high SGOT, SGPT, bilirubin levels, high with hepatomegaly. What therapy should be included?\n\nHI i am 36 year old, in a routine mri i was found non alcohalic  fatty liver with following liver test with sgot 139, sgpt 86, ggtp 97, bilrubin is normal , with mri i am found fatty liver with  mild hepatomegaly. my all hepatitis test is normal, wilson test is also normal. after taking medicine like usyles & NE 400 for six weeks and loosing 6 kg with very rigorous exercises my liver function test came back to border line like sgot came down to 36 and all other are also under normal. now my querry is  what is the current position of my liver whether have i got scarring in my liver due to 139 sgot and sgpt 86, ggtp 97 or i am still safe or i have reversed fatty liver or their cannot be scarring so early, what does it actually indicate, if scarring has happened what are the physical symptoms of scarring, how to reverse it completely , what are the therapy and medicine to heal scarring completely and how long it takes to develop chirrosis and how can i avoid chirrosis.how can i make my liver very strong. what nutritious food i should take and what should i avoid. i am doing lots of stomach crunches for weight loss in belly is there any risk.  pls help",
    "doctor_response": "Hi and welcome to HCM.this is not some serious liver damage and this is just the beginning of liver fibrosis. The most common liver disorders is fatty liver which can be found in healthy people, but usually is resulting from elevated blood lipids, overweight and elevated blood sugar. If ultrasounds didnt find anything and viral markers are negative then you have no reason to be concerned. YOu should treat it by changing dietary and lifestyle habits. Do exercise, avoid alcohol, smoking, fats, fast food and carbonated drinks. Eat more fruit and vegetables, boiled meat and follow some of hepatoprotective diets. Findings usually improves on such measures. If not, then some medicines can be prescribed, but I suggest to go step by step. sacrring is manifested by fatigue,jaundice, hepatomegaly abdominal pain and many other nonspecific symptoms. but you just need frequent follow up and you ll prevent serious liver damage.Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Medicine for thyroid without side effects\n\nFor thyroid related problem which type of medicine is best to avoid the side effects.since am having irregular periods because of that.having so many tablets...many of my friends suggested to go for alternatives medicines like ayurveda ,homeopathy.....am confused which one to proceed for??",
    "doctor_response": "hello dear homoeopathy is the holistic way of curing he disease from the root without any side effects. your periods as well thyroid problem will be recovered with the help of homeopathic medicine. consult nearby homeopath . rgds, dr mishty.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause chest and neck pain?\n\nI have been having left chest and neck pains for months. I've been to the ER a few times now. Last time I noticed the monitor said \"irregular HR\" but the doctor never mentioned it. sometimes it feels like my heart is fluttering in my chest. What should I do?",
    "doctor_response": "Hello,  If you are very sure that it's irregular and your doctor missed it than to confirm if symptoms are occurring everyday,  get a 24 hour holter monitoring done.  Many a times the monitor may over diagnose and your doctor wouldn't have mentioned because he would know it's a mistaken  interpretation by the machine .  Lastly don't get anxious,  as anxiety itself will increase the probability  of you having racing of heart as it will push in adrenaline in the blood stream which may increase the palipation or in may precipitate an event.  Hoping I could help.  Regards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does taking green tea effect the IVF treatment?\n\nHi Doctor, Im worried, I had my Embryo Transfer 4 days ago, and this morning I had mug of green tea (for ignorance I guess), i was researching and found out that it cointains caffeine (I normally dont drink coffe or any strong tea). can this cup of tea change my results??im so fustrated right now, please help",
    "doctor_response": "As far as green tea is concerned it doesn't affect the result of IVF result.Green tea is very good for health, as it contains natural anti oxidants.So no need to worry regarding Green tea as ivf rsult is concerned.Ivf result concerned with procedure, both eggs status, culture of media and many more.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lumbar incisional hernia\n\nHave have been diagnosed through ct of a lumbar incional hernia following 360 spine fusion 1 1/2 years ago. It has only recently started to bother me - ct scan measures it 3 cm diameter (though it looks and feels much bigger to me). I have h/o lung cancer (completely recovered) and aside from this am in good health, work, and am physically active. Is this something that should be surgically fixed even though I am only uncomfortable, not in real pain?",
    "doctor_response": "hi,as you mentioned your history i don't think you should worry much as there are no symptoms. You can perform regular exercises of spine strengthening and core stability which will help improve the metabolism of the body and reduce the hernia formation. Since body is a self healer at most times. Also performing regular breathing exercises will keep the functions of the lung to optimum. also, if there are symptoms which are like pain or anything else then a neurologist is contacted. but most cases with incisional hernia improve gradually with simple exercises. Provide gradual slow kneading massage to the incisional hernia as it will improve the scar mobility and reduce the tightness of the skin.with the grace of god I wish you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe pain in lower back. MR findings enclosed. Suggestion\n\nMy mom is having severe pain in lower back .I am sending you the MR findings Disc degenerative disease with grade anteriolisthesis of L5 over S1vertrebra with,Diffuse disc bulge with minimal postero disc protrusion at L3-L4 level effacing the ventralepidural fat plane and mild impression over the ventral nerve roots,Diffuse posterior and foraminal disc bulge at L4-L5 level and along listheseis and facetopathy is causing canal and foraminal stenosis compressing thethecal sac and bilateral exiting and traversing nerve roots.Canal diameter at L4-L5 is 8mm atL5-S1 is 9mm.",
    "doctor_response": "HI This report is suggestive of degeneration of disc, means the normal consistency thickness broadness of bone disc are not there and not in normal position, in such case Surgery is the only remedy one can try. Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What medicine can relieve me of pain and loose motions?\n\nHello doctor, I am suffering from pain and loose motions since morning but at present, the frequency of loose motion has increased. Please advise us medicines for instant relief.",
    "doctor_response": "Hello. You are most likely suffering from a case of gastroenteritis. Probable cause of loose motion may be food poisoning. You need to take ORS (oral rehydration salt) saline to stay hydrated and to keep your electrolytes in check. Please take it as per the instruction on the sachet. Also, since the frequency of loose motion is increasing, I suggest you take tablet Loperamide just once which will stop the motion almost right away but this is a prescription medication so you need to talk to your pharmacist whether or not you can take it. Any existing heart disease or irregular pulse is a total contraindication for taking this drug. You may also need prescription antibiotics if symptoms do not improve. Consult your specialist doctor, discuss with him or her and with their consent take the above medicines. For more information consult a general practitioner online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the bump on my helix?\n\nHi, I have a bump on the top of my helix where usually a piercing would be, but i never had a piercing before, just informing you where this bump is. It looks like a blister, but it doesn t hurt. I don t know how long it s been there. If you could please tell me what it might be that would be great! Thank You.",
    "doctor_response": "Hi,Dear,Welcome with your query to HCM.Studied your query in full depth of its details.Reviewed it in context of your health concerns.Based On the facts,Dear, you need to consult Surgeon for checking other causes of such a lump.But I would alert you to rule out TB with Erythema Nodosum which may be missed as a cause of such a lump on the helix.Fibro-chondroma from trauma could be the cause of it / or by trauma-fibrosed hematoma.This reply would help you to plan further treatment soon with your treating doctors.Best of Luck and early recovery.Welcome any further query in this regard,which would be replied in next session.Good Day!!Dr.Savaskar M.N.Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is mild generalized atrophy?\n\nHello I just had a baby with full trissomy 18 and she was submited to a Transfontanellar ultrasound (is that the word in english?) that showed a mild generalized atrophy in the brain. What does that mean? Can she have an independent life? I imagine she ll have cognitive and motor problems becouse the syndrome that she has doenst have a good prognosis but with estimulation will she be able to do things by herself? Talk? walk? the douctor said, to her surprise, that she\u00b4ve seen worst... and kinda let us belive that that was really possible in her case. Thank you so much...",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Regarding your concern, I would explain that mild generalized brain atrophy, means that there is a mild shrinking of the brain. This is usually related to low development or aging in older patients. But her development does not really depend on this finding. I would encourage you to try to talk and search for professional help , which can help improve her development (there are many professional institutions who deal with patients like her). Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for allergy to non veg and sun allergy\n\nHi, doctor.I am from Salem,TN.I have allergic problem due to Non -veg. And also i have sun allergy.I took medicines before 1.5years. after no sun allergy affected. But now daily i  am getting itching problem.it will make so rashes in my body.so i often apply coconut oil.is it good?. When i get panic or get tension ,my body get very hot, and irritation.Severe irritation forms.I apply water.What to do this doctors?What are the foods have to avoid?pls tell me Doctor by the way Very Thanks",
    "doctor_response": "Hello Salem.Thank you for asking at HCM.I went through your history. I think you have food allergy related to non-veg diet and what we call \"solar urticaria\".Talking about food allergy, it is very important to know your symptoms related to consumption of food. Usually they are immediate itching, rash, swelling after consumption of food. If it is so, I would suggest you to avoid the food you are allergic to for at least 6 months. Afterwards you can try to eat in small quantity to see whether you react. If you are not sure exactly to which non-veg food you are allergic to, I would suggest you to observe closely your diet and symptoms. Most common non-veg foods causing allergy are fish, shell fish, eggs, etc.Regarding sun allergy (solar urticaria), I would suggest you to take daily levocetirizine and montelukast for a month & use a good sunscreen lotion. Please protect your skin from direct exposure to sunlight. Vitamin A rich food like carrots, mango, green leafy vegetables will also help.Stress/tension can aggravate allergies, so I would recommend you daily relaxation and meditation. This will help you in a long run.Hope this will be useful to you.Wish you the best of the health.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Loose false tooth, advised removal of adjacent tooth, fitting a dental bridge for missing teeth. Is it advisable?\n\nFIRST OF ALL IM 41 YEAR OLD FEMALE ..I HAD A TOOTH TAKEN OUT 2 YEARS AGO I HAD A FALSE TOOTH PUT THERE ,IT CAME OUT I WENT TO THE DENTIST WHOM TOLD ME THAT A NEED ANOTHER TOOTH OUT AND TO HAVE A DENTAL BRIDGE FITTED FOR 2 MISSING TEETH ,THIS HAS BEEN PLAYING ON MY MIND ,THE TOOTH THAT NEEDS TO COME OUT IS MORE THAN BROKEN OFF AT THE GUMLINE ..I AM TERRIFED OF THE DENTIST ..ITS THE THOUGHT OF MT TOOTH BEING TAKEN OUT AND WAITING FOR MY BRIDGE TO BE FIITED PLEASE HELP THANKS",
    "doctor_response": "Hello and thank you for your question. Yes I trust the treatment plan that your dentist is providing based on the information given to me by you.  The tooth that is broken off at the gum line is serving no purpose and would be better removed than retained.  You are at an increased risk of infection and abscess formation leaving the broken tooth in.  when you get a bridge you need to have strong abutment teeth to hold the bridge in place.  If the teeth are mobile then they are not good candidates for bridge support. Best wishes and good health Dr. Ward",
    "dialogue_context": ""
  },
  {
    "patient_message": "Iron deficiency, anemia. CBC smear test shows positive Anisopoikilocytosis, Microcyte. Serious condition?\n\nmy CBC smaer examination reads RBC Morphology: Anisopoikilocytosis++, Microcyte++, hypochromia++, Elliptocytes, tear drop cells & polychromasia seen. W.B.C: within normal limits. Platelets: Adequate on smear. Parasites on smear: not seen Impression: S/O Iron deficiency Anemia what does it mean and is it a serious condition. I am 31 tears old.",
    "doctor_response": "dear friend, welcome to HCM. iron deficiency anaemia is an extremely common condition and not that serious unless neglected and anaemia results in heart failure etc. it is due to nutritional deficiency of iron or blood loss. do you have excess menstrual bleed or other bleeds? black stools? have they ruled out occult GI bleed by stool occult blood test? do you have swollen feet? breathless? pl. get detailed evaluation done and take appropriate treatment under medical supervision. it is easily treatable usually. take care and keep me posted.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is blood transfusion a solution for low hemoglobin?\n\nI (male) have been diagnoised with low hemoglobin (9.0) due to a recent loss of blood (ulcer). I am feeling really tired and was told by my family Doctor that it would be a slow process to regaining my normal degree (12.0 -14.0) Can I request a blood tranfusion?",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern.  But till possible you should avoid blood transfusion. Hb level 9 is low but not an indication for blood transfusion.  You should take oral or injectable iron. Because there are many risks of blood transfusion. So consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of corn in left foot?\n\nI have a corn below my left foot on back side, i have started using a corn cap/plaster for 4 days, i could see it healed and started developing again. Currently I`m using corn plaster again, could you please suggest me with earliest recovery method. Thank you. Prakash K",
    "doctor_response": "Greetings K Prakash.Felt glad that i am able to guide you overcome your discomfort.Well my opinion after reading your query is that since Corn in left foot reappear even after applying plaster, best advise, not only for your betterment but also to avoid further complication is that, SURGICAL REMOVAL OF CORN LEFT FOOT completely along with antibiotic treatment & regular dressing of wound.Visit your Family doctor/Surgeon who help you getting rid of CORN from your foot forever.Don't worry. It's the earliest recovery method.Meanwhile maintain hygiene of your foot.Avoid pressure to that foot. Wear shoes while going out. Get treated at the earliest.Hope i guided you right & it helped.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mild diastolic dysfunction?\n\nToday I was diagnosed as having very mild diastolic dysfunction. I'm 48 years old, obese, no high blood pressure, normally it run 118 to 124 over 68 to 82. Last Saturday it was a bit high (first time) at 138/92. I am not diabetic (just tested with a hemoglobin A1C). Recent CBC, Lipids were normal, thyroid is normal. I have used a lot of 800mg ibuprofen since 7/2010 because of pain with my siatic nerve, I've been taking 2 to 3 of these a day everyday since then, but quit taking them 6 days ago. I'm premenopausal and went to the cardiologist because of heart palpatations that would come for a couple weeks each month with my cycle since Jan of 2010. They would last for 10 to 12 hours then quit and come back the following day. They went away in July of 2010, and didn't return again until Feb., one day in March, and then nothing since then. I don't know how I developed this, although the ibuprofen has been mentioned as a possible cause. I'm scared now. Can I live a long life with this condition? I'm only 48, I'd like to see 70 :) I should mention that I have a life long history of chronic broncitis too. Thank you for any advice you can offer.",
    "doctor_response": "First thing diastolic dysfunction in not a big concern.About Palpitations,you can get them post menopausal also,for that HRT is recommended.Don't worry about your BP,as per your age it's normal value less than 140.Don't stress your self so much,even anxiety can trigger your Palpitations.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for SPD and shooting pains in both legs\n\nHi I m 39+3 weeks pregnant and suffer with realy bad spd can hardly move in the night also I keep getting shooting pains down my legs when I stand up feels like my legs gunna explode going seeing a consultant tomorrow about inducing me you got any suggestions",
    "doctor_response": "Hello,I read carefully your query and understand your concern. Some common\u00a0pregnancy aches\u00a0include swollen and\u00a0painful\u00a0feet and\u00a0legs, and calf\u00a0cramps.I suggest using Tylenol for the pain which is safe to use during pregnancy. Warm shower can also help in pain relieve. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dark discoloration on the foot?\n\nMy spouse is a diabetic and she got up this morning and the top of her left foot is black, she says it does not hurt and she is not in pain. What can cause this? Yesterday it was not like this at all, her foot was normal, she says she has not twisted her foot nor hit it on anything or dropped anything on her foot.",
    "doctor_response": "welcome to hcm ...as she is diabetic ..she is at risk of blood clots ..please go to emergency to get colour doppler of foot as soon as possible ..donot delay ..if there is no pain pr history of injury donot delay doppler study of her blood vessels of foot ..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain , vomiting and diarrhea\n\nMy mother in law, age 87, has complained with chest pain. She has a stent, but the pain lasted only one day. After that she experienced, vomiting, and diarrhea. She doesn t want to eat. Also, she says her stools are yellow. We are having a hard time getting her to see the doctor. What could these symptoms be an indication of?",
    "doctor_response": "Hi thanks for asking question.Here are few possibilities.First it can be because of generalised viral infection.symptomatic management done.Drink more water and fruit juice.For vomiting domperidone like drug helpful.Maintain hydration of her.Second you can do her electrocardiogram to see if any changes of ischemic heart dz or angina.Third if no specific cause found it could be muscular pain because of improper posture.I hope my suggestion will help you.If still problem deteriorating then further work up needed.Wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling sensation in the face with a history of stoke?\n\nI had a mini stroke last year cat scan came out normal sonogram of my charotic vein on my neck normal EKG normal my pressure has been a little bit high but normal but today my face on my left side got tingly for about 5 min then it stop I took an aspirin I walk fine no vomiting no blurt vision I m walking fine could it be a side effect from a medicine",
    "doctor_response": "tingling and paresthesia may occur following minor stroke esp thalamic region.....if it's troublesome then u can try tab Amitriptyline.control risk factors of stroke eg BP , Sugar if any...regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does long term nephrology treatment result in yellowing of tooth?\n\nAS my son 6 yrs old ,he getting treatment in nephology  ,he used to take omnacotil according Dr.dosage,any side effect while he take this medicine ,bc's now my son permanent front tooth got yellow colour,if i check with dental Dr. there is calcium defenency effect ,pls advice ,this treatment start from 2 yrs old.",
    "doctor_response": "hello thanks for consulting at hcm..plz consult ur dentist for acheck up and review with ur nephrologist,,since corticosteroid does cause calcium deficiencies,,u have treatment for this like veneers,,hope it helps,,tc",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My mom gets hyper for no reason. What could be the cause?\n\nHello doctor,My mother gets hyper for no reason. She keeps repeating things over and over again. She gets too upset easily. She has a high blood pressure, thyroid problems, as well as migraine. But, she takes medicines only for her thyroid issues. Can you tell me what she should do?",
    "doctor_response": "Hello. Symptoms you described could be part of a depressive disorder. It is difficult to confirm with out knowing more details. Kindly read the questions I have asked and reply. for more information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause of painful lump near upper thigh?\n\nFirst I am diabetic type 2 for more then 10 years now. I have been having pain in my upper left thigh right below the crease. on the front of the thigh. I got exrays showed nothing. When I lay on my left side it hurts in my upper thigh.. if I sit indian style it hurts if I walk to much it throbs and hurts.. although I have been dealing with that as I need to exersize. My doctor tells me its cause I am fat.. I hate her. Now I find a oblong smaller then a grape size lump where the pain radiates from. I just dont know what it could be .. it makes the whole top of my thigh ache to the top of my knee, I have good circulation no numbness no pins and needles feelings.",
    "doctor_response": "As you had pain first followed by a swelling, it could be cellulitis now progressed to lymphadenitis. However other swellings such as lipoma or neurofibroma can not be ruled out without examining you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does my thumb hurt with stiffness?\n\nMy thumb hurts to move like a 5-10 most of the time some motions are a 7-10 and its a little stiff it hurts to even hold a glass of water and the pain is on the outside of the thumb where the finger connects to the hand its not entirely on the joint its right above it twoards the tip of my thumb. I feel like it could be a hairline fracture it hurts but i can still move it much like if you broke a toe",
    "doctor_response": "Go for icepack and having taping on it. Meet with orthopaedics and have xray,  if xray doesn't show anything then go to physiotherapists amd he will do a special test for DQ. Just let us know that ur most of work is from tumb like a dentist or IT engg. Having always work on PC.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to remove allergic scars from body?\n\nHai, I would like to know how to remove my allergic scars from my body. i got skin allergy since 17 years . I have tried all types of medicine only for my rashes now its high time to look after my skin even though now i don t have rashes my whole body is covered with black scars . i am born fair but now i have turned dark . can you please help me to remove this scars from my body . thank you",
    "doctor_response": "Hi Thanks for your query Its really very hard to remove those dark spots. You can apply locally tretinoic acid on those areas only but it will take time and result cannot be full assured. Recently there is a cosmetic surgery known as derma abrasion. You may consult a dermatologist and take his opinion about derma abrasion. But if its extensive then several sittings may be required. Consult this issue with your dermatologist. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am 13 weeks pregnant and got a double marker test. Is there any complication?\n\nHi doctor, I am 13 weeks pregnant. I got a double marker test:hCG free beta-62.50ng/mL.PAPP-A - 7.17mlU/mLTrisomy 21-1:250Trisomy 18/13 -1:100NT-1.00 mmNT MoM's -0.63MoMCRL -61.8mm Is there any complication?",
    "doctor_response": "Hello. I have gone through your attached dual screen report and it shows low risk for all the chromosomal abnormality which is absolutely normal. It should be kept in mind that this is a screening test which calculates the risk of carrying a baby with chromosomal abnormalities like trisomy 21 which causes the Down's syndrome and trisomy 13 and 18. In your case, all are at low risk. So, stay calm and enjoy your pregnancy. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from back pain. Facing gastric issues and having cracks on thumb. What to do?\n\nHello, Im Puja 28 year old, single, Hight 5 4 weight 70 Kg, suffering from back pain . Im working in bank where its a sitting job. Im facing back pain from past some time but now its quite painful and paining from upper back to till toe . Presently im facing gastric issues as well. and having cracks on thumb and surrounded are of thumb in feet palm.",
    "doctor_response": "hi, the possible contributing factors for your back ache are, - sometimes we will sit with out support for long time, which during work we may not notice that, -the ideal weight for your height is 60kgs that may be contributing for your problem, what you can do is try to change your position and try to walk for some time at least after one hour of sitting, always sit with support, try to reduce weight by some physical exercise, with advice of your doctor use calcium tablets, for the cracks of your thumb etc, try to keep dry all these parts, if using saxes try to avoid for some days, you can use some soothing creams with your doctor's advice. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes infection in the mouth?\n\nI have dental problems all my life but lately i've had infection after infection i'm awaiting my first appointment with an oral surgery to get the rest of my top teeth removed but i cant keep the infection down its been a week i've been off antibiotics and my face is swollen again why is the meds not working and why do they reoccure as soon as i stop the antibiotic",
    "doctor_response": "Hello!Thank you for posting here.You already have infected teeth in your jaws.You did not mention why you postponed the treatment so long.Antibiotics will just subside the infection.The source of infection is the tooth.Infection can be eliminated after removal  of the tooth or cleaning it with a root canal treatment.Your dentist suggested removal of the infected teeth.Use warm saline gargle thrice daily.Get your appointment early as it is not advised to take too much of antibiotics.Take metrogyl400mg and Amoxicillin 500mg for a week course.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is not finding the cervix with presence of shadow in ultrasound concerning?\n\nHello, My daughter in law had her first pregnancy ultrasound today. She is 11 weeks and baby looked good. However they couldn t find her cervix at first and kept talking about a shadow.Finally another tech came in had my daughter in law empty her bladder then they saw it measured it and told her to call her Dr What could this be?.",
    "doctor_response": "HiI have gone through your complaints.Dont worry by hearing discussions of sonographers while scanning.Urine bag should be full to see cervix clearly.if it is partial bowel wil form a shadow obscuring its visualisation.cervix is seen to assess is there any chance of midterm miscarriage.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had appendectomy, cleaned ruptured cyst. Is it normal to have vaginal discharge after it?\n\nHi I am 33 yrs old 5 2 and had an appendectomy 1 1/2 wk ago. I was wondering if it s normal to have vaginal discharge? I was on my 3rd day of my cycle when I had the surgery. Didn t bleed anymore after my surgery, only had discharge. When they opened me to do the appendectomy the surgeon noticed I had a ruptured cyst . The surgeon just cleaned the blood from the ruptured cyst and went ahead with the appendectomy. So is this normal?",
    "doctor_response": "Hi Vaginal discharge is not related to Appendicectomy surgery or surgery for Ovarian cyst. Vaginal discharge may be due to many conditions.It may be physiological or due to infection. Please consult your gynaecologist and proceed accordingly. Wish you good health Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair fall\n\nHii m a boy 21yrs old from d mumbai experiencing hairfall since 3yrs after i shiftd from lucknowi tried many thnings including treatment from dr. Batrawhen i shave off my head my hairfall stops for about 6mnths and then again it starts and the problem is heriditary in my familycan anything be done",
    "doctor_response": "First thing to consider is if you have a family history of hair loss, if there is male baldness in the family. In this case you will be more prone to similar problems. It may not recover very well with medicines.Also change or residence, environment, water, diet is common cause for hair fall and changes in growth cycle.Other causes to consider are hormonal(thyroid etc),  stress, any history of recent illness like typhoid, any chemical procedures, etc.These causes need to be considered and treated as they affect hair growth.If you are currently not an any treatment, you may apply Minoxidil solution to scalp with hair supplements daily like Keraglo Men. This needs to be continued at least for 2-3 months. Do consult a dermatologist as well, to assess your type of hair loss and to give you treatment based on the results. they may also suggest some routine blood tests if required.Since medical methods do not work well for you,certain new surgical procedures can be considered such as PRP,hair transplant or other procedures etc, as will be advised by your consulting doctor after observation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can non penetrative sex cause pregnancy?\n\nHi, may I answer your healthhello mam i am 19 years old and my partner is also 19.we had normal sex i.e he just kissed me near neck and stomach and thats all we did.during that he use to wear jeans and mine legins(in full cloths).we kiss daily ( smooch kiss).after that 2-3 days i lost my periods.i am having doubt that is it sign of pregnancy. i am suffering from leucoderma and weakness.so mam just tel me whether i would be pregnant or not.i am in tension.my exams are nearby.i already started taking mala-D contraceptive pills.the day we had above normal sex was before 20 days and from 21st day i started taking pill.so it will work na. please i am losing my control. queries right now ?  Please type you",
    "doctor_response": "Hi,Welcome to healthcare magic. I am Dr Ramadevi Wani. I will be answering your concerns. You have not had any intercourse.  He has not ejaculated also. So there isnoquestion of pregnancy happening. Relax. Occasionally a period can be delayed and it is normal. There are several reasons for the delay in periods. Even stress ( physical or mental) can delay your periods. In your case you are not getting the period because you are taking the contraceptive pills. Once you stop the pill you will start your period within a week's time. I hope this is helpful. If you have further concerns, do contact me through Healthcare Magic. Best wishes,Dr Rama",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure pus filled cyst in the groin while suffering from SLE?\n\nHi, I am a SLE patient, I m taking the following pills daily: vyslone 2.5mg, shelcal HD, HCQS 300 mg. Now, I am getting cyst with puss repeatedly in my right and left side of the groin and also in armpits. I consulted with a dermo and he suggested T-Bact cream. Now, everything is fine except my right side groin. There repeatedly cyst swells with puss and pain. My dermo requests me to go for surgery as that right side gland is getting infected repeatedly. As of now I am given the following antibiotics for this infection: Doxy 100mg and Becelac for a week. I am so worried about surgery. Please advice.",
    "doctor_response": "Hello dear patient. Welcome to HCM.I am Dr Jigar(ID specialist). I definitely understand your problem as it is tough to deal with a chronic disease like sle.As SLE patients already have disturbed immune system, addition of therapeutic agents like corticosteroid, which you are also taking, acts as double edged sword.They suppress immune system and as a side effect you are at higher risk of getting infection and difficult to treat.My advice is before going for surgical approach go for culture and sensitivity report of pus from infected area and take antibiotic according to report. Also take expert advice whether he can taper the dose of steroids during these period which may help in clearing infection.If this doesn't help then you can proceed for surgical treatment.I hope this will be helpful for you..Please give feedback for this and feel free if you need help in future management.RegardsDr Jigar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatments for swollen and painful ankles\n\nmy ankles are swollen and get worse as I work or set. And they are very painful and electricity comes from the ankle and really hurts if one foot touches the other one. I have what is called Colophony Allergy and it is very serious. My legs are finally healing from that. Also I just got my veins lasered both legs. I also have neuropathy in feet;; What can I do to heal my body. I am 76 years old been ill for 30 years with no able to help to tell what was wrong with my body until 5 months ago. I am doing the best I can with not much help from dr.s. They do not know what to do hear in this area. thanks",
    "doctor_response": "Hi,Your problems in the ankle and feet are due to affection of the nerves of the feet and poor blood flow from the varicose veins and possibly from arteriosclerosis ( hardening of the blood vessels).If you have diabetes then this situation explains itself.Firstly avoid swelling by using elastic socks , elevation of the legs while sleeping and sitting down.if diabetic then this should be well controlled.Medications like Neurontin, a course of B1B6 B12 vitamin injections, and medication to improve blood flow in the feet can be used.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have two small gall bladder polyps (4-5 mm), will it create any problem in pregnancy ?\n\nI am 32 yr old male & have been detected with two small Gb polyps, 4-5 mm in size, during a routine health check. I have no other problem or symptom as per my complete health check report. A doctor has advised me to get my gall bladder removed, but I am not convinced. Pls suggest what should I do.",
    "doctor_response": "Hi Shailender,Welcome to HCM.I presume the GB polyps were detected during routine ultrasound examination. I suggest you consult a gastroenterologist and most probably it will have to be doubly confirmed and if it is proved beyond doubt that you have polyp in the Gall Bladder, then yes it is advisable to have your GB removed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does crease on ear lobe indicate possibility of heart disease?\n\nI have a diagonal crease on my right ear lobe and have had for at least 20 years (if not more). I am a 44 year old woman and take statins for cholesterol (purely preventative measure). My father (who was a GP) died at 61 years old with a sudden stroke and my GP said my cholesterol was at the high side of normal and that statins would be a good measure. I do not have blood pressure. Is this crease a definite indicator of heart disease? Many thanks. RJ",
    "doctor_response": "Hello, I would explain that there are many studies which indicate that ear crease is an independent cardio-vascular risk factor. Anyway, dyslipidemia, family history are other independent risk factors. For this reason, I would agree with your doctor on the description of statins for dyslipidemia. It is also recommendable to closely monitor your blood pressure values and follow a healthy lifestyle (regular physical activity, avoid smoking and alcohol and follow the Mediterranean diet). Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a white spot inside the nostrils?\n\nI am a 58 year old woman who just visited the dentist. In his office he is using a CT scan to get 3D pictures of the jaw, neck, face, etc. On mine, he noticed a white spot just to the side of my right nostril. What could this possibly be? He said I needed a more specific scan to that area to get a better picture. would a deviated septum show up like that?",
    "doctor_response": "Hello,  Read your query, as you have white spot inside nostril it can be due to folliculitis , nasal polyp, sinusitis, or deviated nasal septum for this I will suggest you to consult ENT specialist and go for investigations like PNS view for deviated septum and its treatment.  Hope it will help you.  Wishing you good health.Regards,  Dr. Priyanka tiwari.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful lump on the back of the head\n\nMy fiance has a lump on the back left side of his head. Size of a quarter, soft, and sensitive. It is painful. He is complaining of feeling like his eyes are popping out and his head hurts. Just showed up this morning. And I m starting to get worried.",
    "doctor_response": "Hi,It seems that he might be having folliculitis giving this problem.there might be having some local infection on scalp like fungal infection, dandruff or ingrown hair follicle infection.Go for one antibiotic, anti-inflammatory medicine course for 3-5 days.Take regular head bath and keep local part clean.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could a lump behind the ear with fever and chills indicate?\n\nMy husband has been having low grade fever, chills, cold feet and hands, coughing, feeling tired aching neck and bsck and the skin on his back is sensitive to the touch and found a lump behind his ear, can you try and help ,e figure out what might this be",
    "doctor_response": "Hello!Thank you for the query.His symptoms indicate an infection in the head/neck area. It might be tonsils infection (pain while swallowing), ear infection (ear pain), tooth infection or other infection in the close neighborhood to the lump which seems to be a lymph node.I suggest your husband to do not wait with it as complication of infection in this area can be life threatening. He should consult laryngologist. Antibiotic seems necessary.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having a constant deep pain?\n\nGood morning, I have constant deep pain that seems to range from the front of my left side about 8 inches towards my back. It is hard to lay on my back, and movement causes pain. This has been going on for a couple of years. My mom had kidney cancer and survived it. What questions might I ask my doctor?",
    "doctor_response": "Hello,There are multiple reasons for the pain on your left side of your back.Some of the common causes areRadiating pain from- portruded discbone disease of the lumbar vertebraeKidney stones/cancerrib cage injuriessplenomegalypancreatitisinflammation of intestinesstomach ulcersTo get a proper diagnosis you need to tell your doctor any other prevailing symptoms likePain on urinationhyperacidity before or after eatingchanges in stool colourbreathing difficultydigestion difficultyvomiting, headache,fever,cough,cold,pain on any other areaswelling in legs or any other areadepending upon the diagnosis the doctor will suggest appropriate blood test and other investigations like ultrasound,MRI or X-rayHope you found your answerthank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bump on collarbone and neck. Is it cancerous? What can I do?\n\nI have recently noticed a bump looks like half of an egg size mainly on my left side but it is also on my right. It is located in the space of where the collarbone and neck meet. It is more defined if I shrug my shoulders up like when brushing teeth . It is not painful, rather soft, but getting larger. I recently was told I have a tumur on my thyroid right size golf ball size which is getting removed in a week or so. I just really concerned about these new bumps now, last year I had a nerve shealth tumor removed of spine that I was told was non cancerous. The FNA I had on the thyroid tumor also suggested non cancerous. I have an ultrasound scheduled for new bumps but I m getting sick to my stomach stressing about it. Can you give me any insight as to what you may believe it is? Thank you, 42 yr old Marine",
    "doctor_response": "hi, welcome to HCM I am Dr. Das So, you have cervical and probably left supraclavicular lymphadenopathy. Now, to be frank, on left side both cancerous and non cancerous cause. Which include ifectious conditions alongwith some carcinomas. You did not mentioned what type of thyroid lesion you have. Now,first you have to do FNAC from those lymph nodes . It is must. If it becimes noncontributary then surgical biopsy needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold and chest congestion\n\nI have been suffering from a cold for the last 6 days, stuffy nose, congestion and cough. I started feeling better on Saturday. But now I am having ear pain, sore throat when swallowing and a sore tender spot on my scalp sinus pain pressure under by eyes and even by top teeth are sore and gums are a little swollen.. This is all on my left side,",
    "doctor_response": "You have acute rhinitis and acute sinusitis most probably. You may also have an ear infection. You will need a prescription for antibiotics and decongestants from your doctor. Meanwhile as home remedies, do steam inhalation 3 times a day, warm saline gargle 3 times a day. You can also use nasal decongestant drops to releive the congestion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent fever with cough and vomiting?\n\nHi, my baby is 10 months old, 7days before he had a fever dueto infection in his throat, he was advised with antibiotic. And fever was gone after 2days of medication. But after finishing the medicine. He again got a low grade fever with cough,occational vhomiting and lose motion",
    "doctor_response": "Hi,Welcome to Hcm,There is a possibility of viral infection in your child. Best thing you doing is that you already started treatment for throat infection. However recurrence of fever with other symptoms are suggestive of a viral illness similar to dengue. Pls continue same treatment but pay increased attention on his fluid intake. He should take as much fluid as he can. If symptoms doesn't subside in next 24 hrs, you need to get his blood tested and test for dengue also. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for seizures post head injury\n\nI am trying to find a DO or MD that works in neurology. I was in a car accident 35 years ago and have recently started having seizures from the head injury. I want to find someone who will work with me to get me off meds as much as possible thru more naturalistic approaches.",
    "doctor_response": "It is quite unlikely to develop seizures 35 years after head injury. You may be having some other lesion in the brain, which needs to be ruled out first, before trying naturopathy. You need a detailed evaluation and an MRI brain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness in the chest across the breast area?\n\ni have chest tightnes,  mainly across left breast area and under arm. i had breast cancer left sid with four lymph nodes removed under left arm six years ago. i have hada ct scan which was negative, the tightnes is getting worse as it is there all the time now rather than just on exertion. could it be caused by anxiety or scar tissue",
    "doctor_response": "Hi. I can understand your concern. Scar tissue can cause such pain , you can consult a dermatologist for the same. Also get a  chest x ray done to look for any other cause.Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes narcoleptic syndrome?\n\nI was just informed that my 81 year old father has some sort of narcoleptic syndrome triggered by medications which he has been taking for dementia (seroquel). Is this really a possible explanation for the fact that one month ago he was perfectly mobile, talking and functioning normally with sporadic memory loss and is bedridden and unable to speak or move for the past 5 days??",
    "doctor_response": "Hello, The neuroleptic malignant syndrome is a reaction of the body after the block of dopamine receptors. It has a genetic basis, so some people are more liable to have this syndrome, while others are not. The use of antipsychotics in the elderly is commonly associated with the neuroleptic malignant syndrome, so we give Carbamazepine to an elderly patient instead of antipsychotic,the dose should start from 100mg and increase gradually every 6 days to reach 600 mg per day in three divided doses. But,we could give antipsychotic to the elderly patient in a small dose then every 6 days we could increase the dose gradually until the case responds or the side effects occur. The treatment of neuroleptic malignant syndrome should be in a well-equipped hospital and a full investigations should be done to ensure that he has not any serious consequences. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dr/Mustafa, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on lower lip and pulsating upper lip\n\nI had a lump appear on my lower lip. Its a little smaller than marble size. Its in the lower right side. The doc is trying to rule out infection, so he prescribed Clinamyacin, now my upper lip is pulsating, which its never done before. And, the lump is still here and its day 3 of meds. Whats going on?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  You may have some infection, cyst or benign tumour like hemangioma. You should go for examination and take a complete course of antibiotics. If it doesn't respond to treatment then biopsy diagnosis is advisable. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can intake of zerodol,ra-quin 400mg cause your body to increase in weight ?\n\nmy sister takes zerodol,ra-quin 400mg and mylonerv tablets for her cronic leg pain.she lives in India.she has been taking the pills for past year or so and has gained a lot of weight.just wanted to know which one of these tablts could be contributing factor!please advice..thanks",
    "doctor_response": "Hello, Yes, one of the ingredients can cause sodium retention and fluid retention causing weight gain by fluid retention. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Kathy Robinson, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low  hemoglobin count?\n\nhi Robert my mom has low hemoglobin count its 5.49 but just 2 days back we have provided her 2 bottles of blood externally,Now its reach to 7.59 So is this expected result ? or still having an problem ,why its not reach to 10 or above, I need to suggestion please",
    "doctor_response": "Thanks for contacting HCM. This is the expected result. Your mom's hemoglobin was very low(5.49) and could have led to cardiac failure so blood transfusion was given and reached 7.59 as can be expected after infusion of two bottles. Now with the help of your doctor find out the reason as to why she had low hemoglobin at the first place because if the cause is not treated she will again develop low hemoglobin. Also, to further raise her hemoglobin give her iron supplements which should provide atleast 100mg of elemental iron 2-3 times a day. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can liver enlargement be due to an excessive protein diet?\n\nhi my husband who is 30 years old, few days ago he ate 2 boiled eggs from shop and found they were black in colour,, he asked the shop keeper why its black then the shop keeper answered due to over boiled its black... he ate but after some times he felt very un easy,,, then he ate hazmola... but now he is not well,,, why? is it because he ate  2 black boiled eggs or for some thing else... he went to the doctor,, did his ultra sound and doctor told him that because of over diet of protein his LIVER is enlarge,, plz help me....",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.Usually liver enlargement may indicate some types of hepatitis or fatty liver diseases and in most cases it doesnt require any specific treatment.  If this is caused by diet, obesity and diabetes then dietary and lifestyle changes will be beneficial in every case. Alcohol and viral hepatitis are most common causes and in this case medical evaluation is required. Also if there is infectious disease or biliary duct disorders then you need to do some tests to rule out more serious issues which require specific medical treatment. You need to check your viral markers and do liver biopsy if necessary.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes weight increase after dialysis?\n\nsir, my uncle suffer from kidney problem. urine going very well. but by report doctor told filteration process little affected lik that., he going for heomo dialysis twice a week.now he is very normal.at early stage of dialysis the weight increased by two kgs while going to do dialysis. he doing dialysis for the past eight months.now a days, the weight increases 200gms oly while going to dialysis. If it means is there any improvement in kidney function?? please help me sir..",
    "doctor_response": "Reduction of weight between dialysis is not very common. probably your uncle is not taking appropriate fluids or urine output is normal. As long as his urinary output per day is equal to his fluid intake ,weight gain problem won't occur. Regarding improvement of kidney status.. recovery unusual after 8 months of dialysis.. However he should be evaluated by expert nephrologist for any chances of recovery which is possible in1-2% cases. All the best. If you have any questions feel free to contact me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat swelling and dark discoloration of the knee caused due to an injury?\n\nHi, I am a 63 yr old female. I tripped and fell a week ago, slamming my knee on the concert. It turned black and blue just below my knee and is still numb to the touch. I have been icing it and staying off of it as much as possible. Yesterday, I noticed that my ankle is now swollen and black and blue. There appears to be a yellowish streak down my shin also. I also felt the sensation of blood running down my leg, but there was none. There is no open wound. I can walk on it without to much trouble. I am just not sure how to proceed from this point. Do I need to go to the doctor, or is what I am doing okay. I know it will take probably 6 to 8 weeks to heal. I did not go to the doctor when this happen, so I am not sure if I fractured my leg or not. But, if I did, what could/would they do?",
    "doctor_response": "Hello Thank you for using healthcaremagic I read your question and understood your concern I do not think that you had a fracture since you can walkI think you had an hematoma in the knee that after some days went down from gravity in the ankle region.Keep the leg up above the heart level for few days and some kind of elastic bandage in the ankle region.Dr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lumps in neck\n\nmy 17 yr old daughter has two lumps on each side of her neck, the left side is more noticeable.  currently under Doctors care, they think it can be mono in the worse scenario cancer.  waiting is the worse part. what do you think.  She complaints it hurts when she moves her neck and is constantly tired, never the less she's a high school student and wakes up at 5am Monday through Friday and works right after school, therefore that part of being tire I can understand but still worried.  Thank you",
    "doctor_response": "Hello and welcome to HCM,Multiple lumps in neck could be due to infection, inflammation or neoplasm.A history of tiredness can be seen in chronic inflammation like tuberculosis and neoplasms.A history of pain suggests an infectious pathology.You need to get some investigations done.An aspiration cytology of these multiple lymph nodes is required.In this investigation, cells are aspirated from the lymph nodes, spread on glass slide, stained with appropriate stain.These cells are examined microscopically  know the origin and nature of the lesion.Along with aspiration of the lymph nodes or swellings, peripheral blood smear also needs to be done.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes increase in size of knuckle of finger?\n\nWhile having a manicure my fingers were gently pulled and massaged, one of my knuckles immediate got bigger but no pain. This was 2 years ago . I haven t been able to wear my wedding band since. What could have happened? No pain and full range of motion",
    "doctor_response": "Hello, May be there had been injury before.is there any pain on movements.  So better take xray to see anything there",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a small lump under a birth mark in the elbow of a new born?\n\nmy son was just born on March 9th, so he is almost 7 weeks old. He seemed to have a birth mark on his elbow. Today, my wife was putting a short sleeved shirt on him and noticed that under the mark there felt like what is a small lump. There is not a lump present on the other arm, under the other elbow. It does not seem to cause him discomfort. What could this be and what should the next course of action be?",
    "doctor_response": "Thank you for posting your question.Birth marks in children usually evolve over time and are all not necessarily present at birth. The mark under the elbow that you mentioned might have evolved to become thicker and hence palpable.However it is important to know what kind of birth mark ( hyper pigmented/depigmented/hairy etc.) that you are talking about, which could help us rule out any other cause.By and large it seems to be a benign occurance and the only thing that needs to be done is keeping a watch for similar lumps on other parts of body or an increase in size of the existing lump. If so, a medical consultation would be advisable.Also rule out some trivial local injury that may have caused a temporary swelling under the elbow.If you need any more advice regarding this, do write back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can you conceive with Pcod ?\n\nmy husband is a sthenospermia and i am pcod apart from the treatment is it possible to get pregnancy my hus age is 33 and mine is 27 kindly answer",
    "doctor_response": "Hi, Thanks for posting query. PCOD causes anovulation in woman and that causes fertility problem. Those who wish to get pregnant are treated with ovulation induction drugs such as clomifene,  tamoxifen and gonadotropins etc. and if it doesn\u2019t work then think for insulin sensitizer or laparoscopic surgery. Consult your gynecologist for further opinion. Best Wishes, Dr Sourav Ganguly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can dengue or typhoid cause prolonged abdominal pain and shivering?\n\nHi Sir/ Madam,.. I have been afffected by thypoid before a year. Now i was been infected with dengue. I have been admitted in hospital and treated for the fever. Tested for Dengue, its positive and the doctor says it has been infected you before and now its been an antibiotic.My blood platelets drops due to this. Now its normal. But for past one year i had abdominal pain and shivering. I would like to know whether it is because of the thypoid fever or of dengue fever. Till now i have shivering . I have abdominal pain after i masturbate, pain in the joints. Liver, Kidney function is normal. please give me some suggestion, what could be the reason for this and if any other test should be done or it comes normal after dengue is cured fully..",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Typhoid infection can cause intestinal ulcer. Though typhoid got treated it can remain in its place causing a pain while you are on stress.Superadded dengue further causes injury in this ulcer. In some cases dengue can cause perforation and case even got worse.I advice you to take the USG abdomen this will guide you for any ulcer if present.Please do not eat heavily, you can eat small and frequent diet this will help you in your pain.You can take the lactobacilli and serratopeptidase which can help in healing.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yellow thick secretions from nose?\n\nWhat if the child (3 Yrs) has a runny nose with yellow thick secretions in the morning which becomes white and thin during the day. It has been for a few days like this. there is nasal twang in the voice. No fever. This has been recurrent and making the child uncomfortable.",
    "doctor_response": "Many thanks.children are very much prone to different infections.this could be due to recent viral flu like infection and now may be healing stage.He is also having sinuses infection which needs antibiotic for 7 to 10 days .if problems is recurrent then refer to ENT specialist for further diagnosis .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from abdominal pain. Trying to conceive. Diagnosed with swollen endometrium. What is the cause and cure?\n\nI have been experiencing abdominal pain and tried to conceive for several years after I lost two pregnancies all at around 3 months. I went for sonar yesterday, my doctor discovered that I have a swollen endometrium . My progesterone level is always at around 7.7 even on day 21, and my periods are ever heavy and sometimes late. what is the cause of that, and what medication can help?",
    "doctor_response": "Hello. Thanks for writing to us. From your description, it seems that you are having a hormonal imbalance which is causing an early pregnmancy loss. Adequate progesterone supplementation after day 16 of the cycle will help in overcoming this problem. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What else besides daktarin can be used to cure redness caused by thrush infection in mouth?\n\nI have a red area around the side of my mouth and I have been to the doctor down the road. He said I have a thrush infection. I have constantly used the prescribed cream yet the red area remains. It stings alot and I am very conscious of it; it s embarrassing... The cream I have is called Daktarin , it cleared the area for a short while (a couple of days), I kept using it but the inflammated circle came back! Hope you can provide a cure! :-)",
    "doctor_response": "Hello,Actually this red area can be because of fungal infection or because of habit of smoking or areca nut chewing.-If you have a habit of smoking or areca nut or tobacco you have to drop it and consult your dentist for the medications.-If you are having a fungal infection also then also you have to consult a good dentist , as he will prescribe you both topical anti-fungal and oral anti-fungal with some multivitaminsThese can help you to improve your condition.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can LFT be normal as I have hepatitis b?\n\nI am diagnoised with Hepatitis B since 2003( If I can remember) but a year back i did blood test and did LFT(Liver function test) but the result came out normal for LFT. So I am a bit confused as there should be some problem with my liver since I got Hepatitis B so how can LFt result be normal? Please help.",
    "doctor_response": "HI thank you asking HCM If  your LFT are normal we can  say that you are a healthy carrier of virus B. Virus B is not damaging your liver. wishing you all the best Dr.Klerida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of fatal familial insomnia?\n\nHi my name is Anna Maria and I have a mother who is 81 years old. A little over a year ago she fell (at home) and hit the back of her head and was bleeding a lot because she takes blood thinners. She required 6 stitches. This was in October of 2009. My mother also suffers from severe osteo arthritis. BUT ever since that fall, her health has gotten worse. For the last 6 months or more she has been experiencing terrible night sweats, to the point where she has to keep changing the top of her pyjamas because they are soaked; at least that is what she tells me. As a result she does not sleep much either. Could she has something called Fatal Familial Insomnia? How do I get her tested? Sincerely, Anna Maria",
    "doctor_response": "HelloThanks for askingShe is 81 years old and have symptoms of terrible night sweats. She has history of fall few years back and also osteoarthritis. The symptoms aggravated after fall. Familial Fatal Insomnia is a prion disorder. It runs in families and it present with a number of symptoms and detailed pathological workup is needed to make proper diagnosis. As per my opinion she is not having this disorder. This disorder is very very rare in populations.Most likely the cause of her symptoms is severe anxiety. Anxiety is causing symptoms like night sweats. Consult a Psychiatrist for help. Some times low dose anti-depressants like Sertraline helps in such situation. The drug will help in achieving good sleep also. Consult a psychiatrist for treatment.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from redness and red spots on my face inspite of using ointments. What is the treatment?\n\nHello doctor,I have strange redness and red spots on my face. I have photos to attach. It came up one day six months ago for no particular reason. Since then, it has been on and off in terms of severity but never completely disappeared. At first, I thought it was dry skin and tried some moisturizer and reduced the use of hot water on my face, but no change.It seems to be getting worse and get better for absolutely no reason. I am unable to pinpoint any cause for it. I have never had this before ever in my life, and as I said, it came up one day for no reason. I had not changed anything. I have used Proactiv for my whole life. But not that high on my face, so it is unrelated to that. Past history of the same issue. Never until six months ago out of the blue.",
    "doctor_response": "Hello. It looks like an eczematous rash only (attachment removed to protect patient identity). It could be due to dryness, or excess seborrhoea which is getting exacerbated by sunlight exposure. Use the following medicines they should help, 1. Fluticasone propionate 0.05% cream once a day at night. 2. Cetaphil gentle cleansing lotion twice a day for washing the face. 3. Cetaphil moisturizer twice a day. 4. A good sunscreen of SPF 30 at least at 9 am 12 pm, 3 pm, 15 to 20 mins before going out in the sun. 5. Tablet Levocetirizine 5 mg, if there is irritation or itching. Follow-up in two weeks to see whether this needs to be continued as such or if any changes are required.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dark color urine, foul smell and rashes on neck and back\n\nMy 2 yr old daughter had dark colord urine and its very foul smelling alsi she also had a rash in her belly neck and back of her neck and then she had 2 very red eyes that had discharge and the swelled a little abd she had some pain with it YYYY@YYYY",
    "doctor_response": "Hi....by what you quote I feel that it could be a vasculitis causing this red urine or hematuria and also rash over her torso. Vasculitis can sometimes be very rapidly progressive. I suggest you take her to the nearest emergency room and get her evaluated including a blood pressure check....as red colored urine signifies a glomerular or kidney disease.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Shall I go with compression wrap for wrist sprain?\n\nHello doctor, I had a mild sprain while using a punching bag. But, it does not hurt at all in my two days off work. Now I am back to work, on day three since my injury, and it hurts really bad. I am locked in for the next several hours and I can tough it out. Obviously I am going to be doing some hot treatment. Is it too late in the game for a compression wrap? Will that help with the irritation from small movements? Please guide.",
    "doctor_response": "Hi. Better late than never. Go for compression wrap (active type or elastic wrist splint). Rest your wrist. If pain does not go down or increase in spite of all the measures and medication in two to four weeks then go for MRI wrist. Do specify your complaints more elaborately as mentioned below: Sports injury. MRI wrist. 1. Tendinitis. 2. Tenosynovitis (inflammation as well as swelling of a tendon). 3. Bursitis. 4. Hair line fractures. 5. Arthritis. Ligament sprain. 1. Rest. 2. Cryotherapy or ice packs. 3. Compression wraps. 4. Elastic bandage. 5. Pain therapy with tablet Paracetamol 650 mg thrice a day if not relieved local colonial spray and systemic medication with tablet Aceclofenac taken twice daily. 4. Joint immobilization. Avoid physical exertion and all activities that exacerbate pain for two weeks. Revert back with the asked details and the MRI wrist to an general medicine physician online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pressure in ears while on Apo-Ramipril for high BP?\n\nI am suffering with the sensation of pressure in my ears and also pain especially in the right ear. I ve seen an ear specialist and after examination of the ear he concluded the ears were good. The only thing he noted was the ear canals were very small and he wants to follow up with an ear test. I have high blood pressure and in the last few months my pills were changed. They removed the fluid component of the blood pressure pills. I take apo rampril and I was wondering if there is any connection to the problems I am having with the ears? I also smell smoke when there is no smoke around me.",
    "doctor_response": "Hello, I would explain that your symptoms could be related to ramipril adverse effects (the pressure in your ear). For this reason, I would recommend switching to another anti-hypertensive drug. If this situation does not change after stopping Ramipril, I would recommend consulting with a neurologist and performing a brain MRI. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the hard, painful lump under scalp?\n\nI am 42, 5'5\" and I weigh around 145. I have Fibromyalgia, severe scoliosis, osteoporosis, and degenerative arthritis (please forgive my misspellings) I went to the urgent care yesterday and was diagnosed with shingles on my scalp and face, but there is also a hard but movable pea-sized lump under the scalp that hurts. It's not filled with liquid, and it's not opening like the other blisters. What is it?",
    "doctor_response": "Hi,Good Morning,Thanks for your query to My-HCM Clinic.I studied your query in depth.I understood your concerns.My opinion -You have-Furucle in early stage-with sore-indurated cellulitic stage.Its the boil of the scalp and is caused by the scratching of the scalp or trauma by combing.-Hope this would help you  to recover from worry-some query.Wish you a Fast Recovey.Wellcome to HCM again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling of chest wall with bladder spasms\n\nAge 63 height 5 6 weight 360. Have swelling in the left side of chest wall that is palpable have rs CHF have been having severe bladder spasms taking macrobid 2 x s day for 4 days now spasms not getting any better. Take many water pills for CHF but body is accumulating fluid in abd legs upper arms and have cath in place as bedridden. Not sure what to do cause everytime i go to er they send me home on levaquin for cellulitis. I have no oozing areas only severe redness in abd on both sides that go around to my back like paniculitis and had 23 blood transfusions last year alone not knowing why my HG was staying below 8.0",
    "doctor_response": "Respected user, hi I evaluated your query thoroughly.* Chest wall swelling if not painful , can be kept conservative wait & watch   management.* Bladder spasms require stronger analgesics like Tramadol(37.5)mg mor &    eve after meals .Hope this helps you.Thanks for using Health care magic & keeping trust in our medical services.Wishing him better condition ahead.Regards dear take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes restlessness in child with DiGeorge syndrome?\n\nI have a 5 month old child that has been diagnosed with DiGeorge syndrome and has been very restless and not eating as well as he should. He is on medication for low calcium issues. I d like to know about the restlessness though could medication cause that or is that another symptom of the syndrome or is it a breathing problem???",
    "doctor_response": "HelloAs the baby of DiGeorge syndrome are deficient in immunity. The respiratory infection is a common problem.If he is restless and has poor oral acceptance with some breathing problem,consult your pediatrician to rule out any respiratory infection.These baby have increased chance of congenital heart defect. An echocardiography should also be done to rule out any heart disease if there are clinical signs.  Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be done for excessive weight gain despite eating very less when diagnosed with anxiety and depression?\n\nHello I m 34 female and been fighting anxiety since about 5yrs.old it turned to depression & anxiety after that . I didn t say anything till about 16 when I had an abortion so I was proscribed Zoloft and it wasn t for me it made me not wanting a hung from anyone even sex with my boyfriend even though I was aloud to have him stay the night while in high school mom bought condoms and spermicide lubricant. I ve always been insecure about my looks my whole life wondering how great it would be wonderful to be her ( any beautiful / well off financially women ) that I people watched, not like that though lol people in my presence. I m sooooo depressed and leg myself go. I was very good looking then but still wasn t happy. My looks changed during the years and I gained 100 pounds out of no where I was even eating less never a weight issue in my life always athletic till my back surgery. I didn t stuff myself I ate a lot less but continued to gain with no alcohol and maybe 600 calories a day pears or oranges mostly. I went to the endocrinologist and got on lasix nothing happened next visit diet pill and nothing my thyroid checked its fine . so my prolaction levels fine good diet not a lot of carbs or junk I ve been in a gym and took ballet tap pointe lyrical gymnastics hip hop and jazz since ages 11-23 then taught for a living all genre s. I even had my so 3weeeks early ( 37week) chechup then I gained 15pounds from the week before visit! I had my son that day due to preclampcia and in 9months went from 200pounds (really 187pds. Before preclamspcia) to 114pounds and I walked every day and took hydroxycut to help was it bad to do that? I stopped and stayed smaller heaviest was 125 I m 5 2 I had c4,c5 replaced due to car accident . Then 2 dequeryvains release surgeries on left wrist with carpel tunnel surgery on the hand for the 2nd dequeryvains release . I then had L4-5 replaced with a cage put around it. I had no connective tissue when my surgerion operated he said now he believes the pain I was in . I was also diagnosed with fibromyalgia when I was 20 and I m still in a lot of pain and carry and retain sooo much fluild and nothing is helping either not even starving myself only seating flood with fiber or super foods none of. Y meds had any weight gain for side effects even cymbalta a side effect has weight loss as one ? Help I don t like me I m nervous ",
    "doctor_response": "hi, i think u r conscious regarding your body. which leads to severe anxiety in u. i will suggest u start cap.flunil(20) 1-0-0 along with tab.oxmazetol(300) 1-0-1 with tab.lonazap(0.5) 1/2-1/2-1 for 15 days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive for months. Normal test reports. Suggestions to get pregnant soon?\n\nhii am 25 years old.i got married in the month of feb,2012. still i am trying to conceive. Myself and my husband have gone to a lady doctor for treatment. my doctor told me to reduce my weight. Actually i was 68 kg(height 5.2) before 3 months. now i have reduced 6 kgs. Now she suggested to take ovaashield, metformin 500mg hcl tablet and ebexid tablets.there is no any problem in both of our reports. pls give me your suggestions to get pregnancy soon",
    "doctor_response": "Hi,    Thanks for writing to us.    In my opinion you should continue with all these drugs and do not take any tension If your reports are normal then you should take proper diet so your weight getting reduced.     You should use your most fertile days for sexual intercourse for early concievement.      Good luck.      Regards      Dr. Richa",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is my 6 days old baby having loose motion?\n\nHi doctor, My baby is 6 days old and he is suffering from loose motion since today.",
    "doctor_response": "Hi. Basically, if it is watery loose motion, either it is viral induced or milk intolerance. In a 6-day-old baby, if mother's milk is exclusively given, not to worry about it as it can simulate like a loose motion in breastmilk-fed infants. Only you have to worry when the baby becomes weak, dehydrated and starts vomiting.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes foot pain radiating towards the leg and thigh?\n\npain left foot- over 5 days traveled up leg - calf to thigh -lower left rib cage- point of major pain migrates up staying moderate to severe were it stops - leaves behind lesser pain and cramping and weakness - now my right calf is cramping and weakness- however major pain point still in lower left rib cage- kidney surgery infected stone basket removal on 12/21/17 - nephrostomy tube removed after 2weeks VA ER initially labeled this sciatica - prior to migration up to rib cage- deep vein ONLY - ultrasound no DVT- completed 2 days after ER- NO scan of the pain areas done- each day brings new area of affects,,,",
    "doctor_response": "Hello, Consult an orthopaedician and get evaluated. You have to rule out conditions like plantar fasciitis. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dog bite\n\nHello, I was bitten by a pit bull on Monday afternoon while playing with a 3 year old. I was bit on my left calf muscle, the dogs Caine tooth sliced a spot in my leg open and around it is bruised really bad, it's a mixture between red,blue,green, and yellow. Around my cut its very red and extremely tender. I cannot wear pants due to them rubbing the puncture, is it normal for me not to be able to walk very good after being bitten?",
    "doctor_response": "This sounds like you have an infection associated with the dog bite. I recommend that you see your medical provider and start an oral antibiotic. In the mean time clean the wound well with soap and water. Dress the wound with a good cover bandage.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain and angry disorder\n\nHi I m taking methylprednisolone for 6 days it s 4mg 6 pills for first 5 for second and so on. I m experiencing chest pain I can t tell if it s heart burn or not though, and I have notice that I m geting very angrey quickly I m only on my second day 2nd pill.",
    "doctor_response": "Thanks for your question on HCM.Methylprednisolone is oral steroid and can cause severe gastritis.So your heart burn is explained by this.And in very few cases this drug can cause acute psychiatric illness too. So may be your anger is due to this drug only.So better to consult your doctor and discuss about this drug and if possible try to substitute it.Take proton pump inhibitors for your heart burn.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hard lump on collarbone, occasional night sweats, tingling around mouth, thyroid imbalance, sjoren's suspected. Previous breast cancer. Recommendations?\n\nHelloI am a breast cancer survivor, right side 7 years ago.  Have noticed a hard lump on my collarbone, feels like hard bone and is the size of a large marble.  I have some night sweats but have had these for years. Also slight tingling around my mouth.  I also have a slight thyroid imbalance that is currently untreated, and suspected sjogrens.What are the causes of a lump on the collarbone.Had a mammogram about three months ago, and nothing showed.",
    "doctor_response": "HelloWelcome to healthcaremagic.Swelling in collarbone can be due to various reasons. It can be a bony swelling or enlarged lymph node. If it is bony swelling it is usually due to some benign bone disease and you need not worry much for that. However since you are breast cancer survivor - chances of that swelling being a malignant lymph node are also high.Supraclavicular lymph nodes are located in that area and thay can get involved in breast cancer.These lymph nodes are not seen in mammogram.You should consult your breast surgeon and undergo clinical examination. Ultrosonogram may be needed and biopsy will give you the final diagnosis.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dizziness while trying to get pregnant\n\nI dont have any abnormalities except lh hormone. I took krimson for three months. I did hsg test. While taking follicular study my ovum did not get ruptured. I was given gonodotrophin injection to rupture ovary. I am also given naturogest 300 mg. I felt very dizzy and i feel nauseated. Then i m given naturogest 100 mg to be taken in morning and night. I still feel dizzy. What. Should i do",
    "doctor_response": "take plenty of liquids ...rest and if dizziness not subsiding take vertin 4mg....don't skip meals...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for mitral regurgitation?\n\nI just had a yearly echocardiogram.   I have mild mitral regurgitation.   On this latest echo the doctor said they say a shadow on my aorta.  He said he was 99% sure it was nothing but he had to look at the results himself.   What could the shadow be?",
    "doctor_response": "hello, I have gone through your query.Thanks for using HCM. Mild mitral regurgitation is not cause of concern.I need to see echo report or perform Echo myself to cpmment on the shadow behind aorta, My best wishes Dr.Rajesh Teli,MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever and runny noses in a 4 year old?\n\nHi, my 4 yr old son has experienced fever, tiredness,runny nose and watery eyes for the past 1-2 days. Earlier today he looked to have dark circles around his eyes however the skin has now become quite red. I have been giving him panadol and neurofen intimitantly. I am right to think he is experiencing cold or flu symptoms? He is generally a healthy, active boy with a weight of approx 18kg.",
    "doctor_response": "Hi,It seems that he might be having viral infection giving all these symptoms.It requires symptomatic treatment to get relief.Within 2-3 days he will be alright.Along with pain and fever reducing medicine give some decongestant syrup like Wikoryl for running nose and watery eyes.Give him complete rest.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How risky is lung and heart bypass when suffering from ASD and ITP?\n\nI was told I have an ASD, I have ITP and Factor V Liaden, I have had a DVT in my right leg a heart attack six years ago with no real cause, I have suffered migraines since I was nines years old and I was told that I have had several TIA's, they want to do open heart surgery and use my own tissue to close the whole, with all my issues and having to go on heart and lung bypass how risky is all of this. I am 52 years old.",
    "doctor_response": "Respected user , hi I evaluated your query thoroughly .* Any minor / major surgery is having risk to some more or less extent for   any person .* As the surgery type is major and associated co morbid conditions present   are more , in your case you have more risk than other person for the    same  surgery .    - Outcome in terms of success and complications are to be evaluated      combinely by  expert Anesthetic doctor & operating Surgeon .   - Ultimately it is the evaluation of need of surgery depending upon the      symptoms & severity assessment by parameters versus possible risks      involved in & after  the procedure .* My personal recommendations for you    If much symptomatic & bothering issue for you , take all risks and go for   surgery ; if not much problematic in day to day life don`t take risk as    doctors are pressurizing .Hope this helps you .Welcome for any further assistance .Thanks for using Healthcaremagic.com & giving me an opportunity to assistWishing you fine health ahead.Regards dear take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes neck pain in a child?\n\nMy four year old daughter is complaining of her neck hurting. It is on her right side and there is tightness is a little area(hard). She turns her upper body when you want her to look at something on her right side. She does not have fever and seems to be feeling good. Could this be a crick?",
    "doctor_response": "Hello. I just read through your question.Sounds like she developed a bit of muscle tightness on the right side. Most likely reason for this is perhaps she spent a long time turned in that position (maybe while sleeping). It is very common and nothing to worry about. Warm compresses will slowly loosen the muscle, will decrease her pain, and will help her regain her range of motion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Pentom 40 and Baycip tabs causing abdominal pain?\n\nHi I was having mild intermittent stomach pain and consulted a local doctor.He suspected gastroenteritis and recommended medicines like Spasmonrindon and Baycip TZ.During follow up, I told him about problems I am experiencing due to gas. And he gave me Pentom 40 (Pantaprazole) and Baycip tabs. After taking first dose of these meds, I am experiencing stomach pain.Could you please tell me what could be the reason and should i stop using these medicines?",
    "doctor_response": "Hi.Thanks for your query.Intermittent mild stomach pains was suspected by your Doctor as Gastroenteritis and you took Spasmonrindon and Baycip TZ, Pentom 40 started later, Shifted  to Plain Baycip. Since you need antibiotics, you need to be changed to another antibiotic like Cefixime which is stomach-friendly, as you have got pain in abdomen which can be due to not responding to Baycip or due to gastritis .Continue rest of the medicines. It may take a few more days to get settled.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Body twitching, heat rush, occasionally painful. Concerned\n\nI am 40 years old and went through a traumatic relationship 2 years ago. Within about 6 months I started having anxiety attacks and all I wanted to do was sleep, sleep, sleep. Then I would periodically break out in crying. it did not matter where I was. Then I started experiencing like a rush of heat and like a fluid draining in my left feet down to my toes, then came burning and twitching in the area. Now the twitching are all over my body. To the point where literally it wakes me up whenever i go to sleep. I have done several blood tests that have given good results, but I am concerned as it sometimes give me pain. What do you suggest?",
    "doctor_response": "Hi, welcome to HCM you are suffering from POST TRAUMATIC STRESS DISORDER. No use of any blodd investigations or imaging tests. You have to consult psychitrist and need proper treatment with councelling. All your complaints are just part of your stress, talk with your other family members so that you will feel little better. Thanking you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is sweating and weakness normal during treatment for acute pericarditis?\n\nI am recovering from acute P.E. - 3 weeks ago. Now on 8mg coumadin/day. About once/twice a day i feel weak, sweaty (after I have been on my feet for a while) and have to sit down for a while. Is this an aspect of my healing, or the medicine, or low BP, or what? Mary(54).",
    "doctor_response": "Hello Mary!Welcome on HCM!Regarding your concern, I would like to explain that your current symptomatology (weakness and sweating) is nonspecific and may be related to several health disorders, including an ongoing inflammation/infection, a chronic disorders (cardiac, pulmonary, hormonal, metabolic, anemia, etc).Considering your recent health disorder, most likely causes could be the compromised overall pulmonary function, or right heart failure (not rarely found in important PE).Coming to this point, I recommend consulting with your attending physician on the opportunity of performing a careful physical exam and additional tests, including:- chest X ray study,- arterial blood gas analysis,- cardiac ultrasound,- anticoagulation level (INR),- complete blood count,- thyroid hormone levels,- liver and renal function tests- fasting blood glucose levelAt the end, you need to frequently monitor your BP and heart rate values and refer them when meeting your doctor in order to properly optimize your ongoing therapy.Hope you will find this answer helpful.Kind regards,Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain\n\nhello sir/madam,i am adeel ahmad from INDIA.since last two year i am suffering chest pain.ihave consulted so many doctors but didnt get relief.before two  days back i havecontacted one chest specialist he told me you have chest deformity thats a maincause of paining.but now i am really fed up of doctors and medicines.what should i do pleasegive me some valuable advice. hope you understand my problem.i am eagerly waiting for you reply.thanks & regardsadeel ahmad",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Chest deformity can cause chronic chest pain. These kind of pains are life long. They are mostly due to musculoskeletal malalignment. So follow these steps for better symptomatic relief. 1. Apply warm water pad on affected areas of chest. 2. Avoid movements causing pain. Avoid heavyweight lifting and strenuous exercise. 3. Avoid sudden jerky movements of chest.4. Take simple painkiller like paracetamol or ibuprofen if required.5. Start calcium and vitamin d 3 supplements for faster recovery.Don't worry, you will be alright with all these. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is CTA or a standard angiogram recommended given the test readings?\n\nHi, Help! My wife had a stress test recently because her family doctor just purchased stress test equipment(note: she has had no symptoms of heart problems but has diabetes). She was the 4th person to have the test on this equipment. According to the results stress images reveal a large sized perfusion abnormality of moderate to severe intensity in the lateral and anterolateral walls . Stress images also showed a medium sized perfusion abnormality of mild to moderate intensity in the interoseptal and inferiolateral walls. Grade V stage. Gated SPECT revealed abnormal left ventricular function with an ejection fraction of 36%. There was severe hypokinesis in the inferior, lateral, anterolateral, and inferolateral walls of the left ventricle. There is diminished systolic wall thickening in these regions as well. Images would appear to show that heart is not functioning while under stress. Family doctor and specialist are recommending Standard Angiogram. Wife and I have doubts about the validity of the test because she was the 4th patient to have it(at least 1 other patient had an abnormal reading). Also there is a percentage of false positives in females. When we suggested a CTA doctors balked saying that she would still need a Standard Angiogram. Are we wrong in wanting the CTA first(we would pay entire cost of test) then if indicated have the Standard Angiogram. Thank you for reading and hopefully replying.",
    "doctor_response": "Hellothanks for posting here.  I have gone through the findings of the stress imaging. It is a very sensitive test for diagnosing coronary artery disease. By the reports of her stress imaging it appears she has multiple areas of blood supply insufficiency. It is a quite sensitive test and there is no reason to suspect report or images may not be accurate because it is new. Also a faulty machine would not show so many deficiencies. So she definitely has significant coronary artery disease which is indicated by multiple areas of perdusion abnormality with decrease in contractile function to 36% and akinesia/hypokinesia. Do she should undergo a conventional angiogram and not a CTA. CTA has more of a role in patients in whom diagnostic tests are negative, but the patient has heart related complaints. So basically it is to rule out coronary artery disease in patients who are less likely to have coronary artery disease. In her case, since there is a steong suspicion of coronary artery disease, conventional angio must be done. Also CTA is not very good in quantifying the severity of a block. Also even if she undergoes a CTA, and some blocks are diagnosed (which will come up in her case), the next step would be a conventional angiogram. So the ideal way to proceed from here is a conventional angiogram and definitely not a CTA. wishing her good health.regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat penile red rash with pimple in pubic hair?\n\nI recently had sex with new partner condom popped. I went to std clinic immediately and they said it was normal but this isn t new for me. I had a red rash for about a wk or two. Now it s ashy underneath my penis where the rash is and I have a pimple in my pubic hairs",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have infection of the glans penis (Ballanitis)due to unprotected sex and boil over pubic region.You need to take broad spectrum antibiotic like Cefexine along with anti inflammatory drug like Diclofenac twice daily.along with topical antibiotic ointment like Neosporin twice daily.Ensure to wash your genitals with warm water twice dailyEnsure to avoid sexual encounters till it heals up completely.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy rash on the body after taking hcg drops for weight loss?\n\n.  I read all thdear doctor,  I am 71 years old and began hcg drops after observing two people lose weight with out major proplems. My weight was 204 lbs.  I followed the instructions to force eat the first two days gaining to 212 lbs.  I have been on the drops and diet for two weeks.  i began to have itching and then broke in a painful rash. i did lose the weight I gained on the two day feed and 14 lbs altogether.  I take medications that I could not stop for blood pressure and thyroid.  I read the research and there was no indication that these symptoms would occur.  My doctor says it is an allergy.  I did not tell him I was using hcg.  Will these drops show up in my blood work?",
    "doctor_response": "Hcg  drops can  cause  allergic  skin reactions that  is itchy  rash on  body. It  has side  effect  like  that. Yes  hcg  can  be tested in blood  after tking drops. Hcg  diets  are  sold as  homeopathic  medicines. Dont go asyray  consult  your  family  doctor. The  best  way  to  reduce weight  is  diet  planning  and  excercise. We advice  excercise  not  only for  rducing  weight  but  also  for  strenthening  the  body  and  vital  organs.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and cough\n\nHi Doctor , 20 days before i had temperature , cough and it takes 15 to 20 days , and here local doctor gave me anti bio tics i eat them and now i well , no temperature but still have cough , it seems like some times the dry one and some times not, with all this my complex i mean color of my face and body becomes pale and brown , all people says to me what happen to your face , today i look in mirror i saw black, grey spot on my tongue also.What you suggest and recommend.",
    "doctor_response": "HIThanks for posting your query.  Fever with cough indicates infection, though you were treated with Antibiotic , your cough has still persisted . It means the Antibiotic given to you has not worked properly and you need to get another course of antibiotic.    But this time before getting an antibiotic started I would recommend a test called Throat swab culture sensitivity test. This test will tell which is the right Antibiotic for you and if you use that Antibiotic your cough will subside.     Also do salt water gargling , drink hot water, avoid non veg food and avoid citrus fruits. Hope this information was useful to you. Any clarifications feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain, backache and fatigue?\n\ni missed my period for 2 months and negative HCG test. But then i could feel acute pain in th left side of my abdomen. then sever backache and gradually lower abdomen pain. My tummy is bloated and i m feeling very lazy, hot and fatigue. Can u tell me that am i pregnant?",
    "doctor_response": "Hello!I read carefully your query.If you did only one  home pregnancy test and it result was negative ,I can't exclude the possibility that it was a falls negative (mean that the test show negative but you are pregnant).The symptoms you describe might due to ectopic pregnancy but many other conditions can cause such symptoms. If I were you treating doctor I would try to exclude this possibility before consider other possible causes for this acute pain you felt.I suggest to consult a physician and get an blood HCG test and an abdominal ultrasound to exclude a possible pregnancy.Once excluded this possibility the doctor can evaluate you in order to sort out the right cause.Hope my answer has helped.Take care.Dr.Rovena",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a lump and constipation?\n\nMy one and half year old daughter have a lump between vagina and anus and suffering from constipation. We are using glycerin depositories daily,she cries whenever passing stool as it hurts.the lump is skin colour and  is growing in size and we are very much worried,please help",
    "doctor_response": "Hi  Dear welcome to the HCM,Surgical opinion is required for the lump.Constipation to be relieved with high fiber diet, fruits etc.laxatives like picosulphate to be given regularly  for the constipation.hope the query is answered.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How unhealthy is following masturbation?\n\nHello doctor. I hope u would answer me.. Thank you in advance. My age is 19. Usually I do masturbation once in 2days. I got frightend. My marriage is after 4 years. My question is, Am going in correct wat, is masturbate good for me and does it affect my man power ? Pls say you suggestion. Ill be thank full to you",
    "doctor_response": ",First of all no need to worrymasturbation is a normal thing, that is very much common in people of your age group and also in almost all ages. masturbation doesn't affect any man power and doing it regularly will not affect your health. any other queries please feel free to askthan you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for cervical cancer?\n\nMy 69 year-old mother was treated for cervical cancer about 7 years ago.  She has not had any vaginal bleeding since going through the menopause at the age of 54. Last week, however, she lost a small clot and some very dark blood from her vagina. She is now convinced that the cancer has returned. Is this likely to be the case?",
    "doctor_response": "Hello dear.  I have gone though the details. So in a post menopausal female with a prior history of cervical cancer, a repeat bleeding is to be taken as relapse of cancer until proven otherwise. Please get her investigated. Thanks regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain after gall bladder removal, tiredness, diarrhea. What could this be?\n\nHi I had my gall bladder removed 5 weeks ago & I am still suffering pain ... I am awaiting a camera test as the doctors now think I may have another condition ... I am still suffering attacks of severe pain especially after I eat, I have extreme tiredness & also have severe diahorrea quite often ... This had been ongoing for 3 years now & I am struggling to cope ... Do you know what this could be, sorry I forgot to mention I have also lost quite a bit of weight.",
    "doctor_response": "Hello! Thank you for the query. It is very common that gall bladder is getting removed as a reason of pains and it turns that it was not the reason. What are you suffering from is probably peptic ulcer (it causes pain after 1-2 hour of meal, loss of weight, but does not cause diarrhea). However some other conditions should be checked. As you are after gall bladder removal, sometimes it happen that some small stone gets into the bile ducts and gives a lot of pain. Upper GI endoscopy is a good idea as it will rule peptic ulcer and stomach cancer out. But before it is advisable to have fool blood work with liver tests (AST,ALT and GGTP), pancreas tests(amylase), urine analysis and abdominal ultrasound. After this tests upper GI endoscopy should be performed and if GGTP elevated, during this test ERCP should be done as well. If you find all this tests negative, stool tests and colonoscopy should be performed as well. Such symptoms may be also present when partial intestines obstruction appears due to colon cancer. Hope this will help. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are recommended medications for alopecia effective?\n\nRecommended medications for alopecia. Are they effective? Do they have any side effect? 0 answers, 5 views Posted in: Hair Loss Edited 3 minutes ago Intense pain after routine colonoscopy, CT shows Mesentary Panniculitis. Is surgery necessary to improve ?",
    "doctor_response": "Hello, Yes, partially. There is currently no cure for alopecia areata, although there are some forms of treatment that can be suggested by doctors to help hair re-grow more quickly. Other medications that can be prescribed that either promote hair growth or affect the immune system include Minoxidil, Anthralin, SADBE, and DPCP. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr AJEET SINGH, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suspected aneurysm on pituitary. Tortuosity of vessels noted in the CTA. What is it?\n\nHi, I had a CTA because on the MRI , they thought there was something on my Pituitarry, The MRA showed something more suspecting of an aneurysm so they did a CTA. On the results they rulled out the aneurysm but said there vessels in the let P1 which were torturisity and most likely resembled the aneurysm. Can you explain the torturisity. I have heard this can cause stroke if not repaired.",
    "doctor_response": "Hi, Thank you for posting your query. Tortuousity of the blood vessel refers to mild abnormal dilatation of the blood vessel, however, it is not similar to an aneurysm. An aneurysm is an abnormal out-pouching of the artery (a ballon like dilatation). An aneurysm has a higher risk of rupture and causing brain haemorrhage (bleeding in the brain). Tortuous vessel may predispose to a stroke, as blood flow may be sluggish through a tortuous vessel leading to thrombosis (clot formation). However, this risk is very small. Wishing you good health, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the tightness and cording under my arm?\n\nI have a cording which is possibly a lymph gland issue under my rt arm. It was slightly uncomfortable but is only slightly tight now. I m extremely concerned. I ve not had any infections, I have no palpable lumps in my breast. I m having a mamo next week. Should I be concerned because I AM.",
    "doctor_response": "Hi.The commonest cause of the feeling you are getting like a lymph node in the axilla (armpit) must be diagnosed by FNAC - fine needle aspiration  cytology or a formal biopsy for the perfect and the fastest diagnosis. Mammography and all other tests will be helpful but will be losing your precious time. Request your Surgeon for the definitive diagnostic procedures.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could itchy rashes on thigh indicate?\n\nMy son went to the er with a rash that began on his inner thighs and elbows. It was in the shape of horsehoes allover. It spread to his hands, back, stomach, and feet. It was slightly itchy, but not bothersome. No fever or anything exceot his hands were swollen and his arms were numb. They have no clue what it is and I can t find anything like it online....",
    "doctor_response": "Hi, It may be ringworm infection most probably. It is also called dermatophytosis or Tinea corporis, Tinea cruris, Tinea manus according to the site involved. It is highly infectious or contagious skin disease. Consult the dermatologist for the perfect diagnosis and proper treatment. Antifungal like cap itraconazole with antihistaminics like cetirizine. Apply Antifungal cream like sertaconazole or luliconazole cream on affected areas. Avoid soap bath. Dettol liquid may be used for bath. Wash the clothes in hot water to prevent the further spread. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilyas Patel, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to increase penis size?\n\nHi. I am 18 and I think I have hypogonadism. My penis is very small when soft and sometimes it will retract inside itself so it looks like I am uncircumcised even though I am circumsized. My penis is probably smaller than a childs and I would like to see a doctor but i don t know who to see.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Size of the penis is never a determinant factor in sexual life. Very few ladies like huge penis. After marriage, huge penis becomes a burden. Secondly, even a 2 inch penis (erect condition) can satisfy a woman. Woman vagina sensory cells are available only up to 2 inches from the vaginal opening. Medical science have never seen erect penis less than 2 inches in size. Therefore, I am sure that your problem is just because of your negative thinking. Please concentrate on your studies and career enhancement.You can post a direct question to me in this website. Include every detail as much as you can. I shall prescribe some sexology related psychotherapy techniques to control your condition. I am sure that the techniques should be a success.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it normal to have upset stomach with semi-solid stool and frequent urination?\n\nHello doctor, Just two days back I suddenly experienced an upset stomach with just a semi-solid consistency of stool. However a day later, I found that I had the urge to pee more often than usual immediately after emptying my bladder. I am 40 years old and my last period was a month back. I am 5'3\" and weigh 70 kg. I have no pain at all while urinating. However, this sudden new symptom has caused me to be very anxious. I also have some PMS symptoms like muscle ache and so on. Could you please advise doctor?",
    "doctor_response": "Hi. Sometimes urine symptoms can happen whenever there is altered stool pattern. If there is any problem in stool passage, it may reflect as a burning sensation or frequency of urine as the nerve supply to both areas is same. In case there is no fever, and stomach is still upset, you can start with a probiotic like Econorm sachet twice a day for three days. If symptoms persist beyond 2 to 3 days, then get urine routine test and an ultrasound KUB and revert. A short course of antibiotic like Nitrofurantoin 100 mg twice a day for three days and Solifenacin 5 mg once a day for five days can be started after consultation with your GP.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomitting after stress test?\n\nI recently had an abnormal stress test and another test that showed damaged to the two bottom chambers of my heart.  I have noticed that I have been throwing up frequently and feeling very sick lately. What could be the issue?  I am now seeing a cardiologist for the heart proboem.",
    "doctor_response": "hia stress test is highly sensitive for cardiac ailmentsif it is abnormal you need a thorough investigation of your heart damaged bottom chambers can mean that there is some motion abnormalitities in that chambera detailed analysis of your printed report is very essential before making any commentbut throwing up  and feeling maliase  can be because of cardiac conditions like coronary artery disease and congestive cardiac failurea detailed report is to be analysed as it is a matter of high concernthank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the ileocecal valve?\n\nYes, I have severe pain in the illeocecal valve area; ER several times say I have good health; drinking mag citrate relieved it = however a few crackers immediately started the pain - up all night; could the gluten prevent the illececal valve from opening? Thank You",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The most common\u00a0causes\u00a0of\u00a0Ileocecal Valve Disorder\u00a0are diet, allergies, food sensitivities, and stress.So, I suggest to avoid gluten for a while and evaluate if you will have again the symptoms. If gluten is the cause of your symptoms,you can consult a dietologist for a specific diet.Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "I read an article that using hydrogen peroxide helps irradiating bad breath. Can i use this two times a day ?\n\ni have bad breath i read an article that using hydrogen peroxide helps irradicating bad breath can i use this two times a day on a daily basis i have bad breath i read an article that using hydrogen peroxide helps irradicating bad breath can i use this two times a day on a daily basis",
    "doctor_response": "Hello. Welcome to HealthcareMagic forum. Using hydrogen peroxide once daily is sufficient enough. But the solution should be very dilute as a concentrated solution will damage your taste buds and can even result in burning sensation in your mouth. Use it very carefully. Dr. Rakhi Tayal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of spotting?\n\nI am 7th day post IUI. I am currently taking tablet Duphaston 10 mg at nights. My Gyneic has prescribed them to be taken for 10 days and i have pain lower abdomen and backache also lots of cervical mucus spotting pls give me answer that is good sign or bad sign.",
    "doctor_response": "Hi , These symptoms can be of the baby entering the uterus lining, but also seen in impending periods. The excessive discharge is due to the progestrone hormone in Duphastone , but if pregnant , body is producing the same hormone in excess to support the baby.No test can confirm the condition so early. Only the urine test as per your Doctor's advise or Serum Beta HCG at that time can confirm pregnancyAll the bestDr.Balakrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for burning sensation after insect bite\n\nMy friend was bitten by a spider. He is experiencing a burning sensation in his hands, breaking out in a rash on his arms, feels his air way swelling and it is becoming hard to breath. We gave him a benedryl to help with the allergic syptoms he was having. All of his sypmtoms have ceased but, should we seek further medical help?",
    "doctor_response": "Hi,Some time some poisonous bite gives rise severe allergic reaction producing severe edema in throat leading to medical emergency.Now as all allergic symptoms ceased, nothing to worry.Continue Benadryl or Cetrizine for 2-3 days more.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment for pain between hip bone and belly button\n\nI have a very sharp intense pain on my left side in between my hip bone and belly button. When I cough or sneeze the pain is intense. If I lie down it doesn t seem to be as bad until I hop up. it is sore if I push on it. The pain makes me feel a little breathless as well",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have pain between hip bone and belly button. Well there can be many reasons for symptoms you mention in query like UTI , appendicitis , pancreatitis or IBS . I would suggest you to consult gastroenterologist for proper examination . Doctor may order endoscopy along with ultrasound , stool test or take history . Doctor may recommend surgery in case of appendicitis or prescribe ornidazole , anti inflammatory or omeprazole . For now ear light and non spicy , also take ibuprofen or acetaminophen for pain . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Disc bulge, have intense back pain, recurring sprains. Which exercises for strengthening the back can be done at home?<br>\n\ni have a disc bulge l4 l5 and s1 .i have sprained my back a few times .and underwent prolotehrpay physiotherapy .i statred dance exercises now and im in pain.its been more than 1 year since i have been in pain.its on and off.wat would be a great method to do at home.some exercises for strengthening hurt my back.please help me. thank you so much YYYY@YYYY",
    "doctor_response": "Hi, You should start doing some back strengthening exercises like lying on tour stomach, pull up your upper body with support of your arms and hold for 10 seconds. Repeat it 8-10 times. Second stand on your toes and stretch like trying to reach up to the ceiling, third sit in a kneeling posture bend over and stretch. These should be good to start with.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is diarrhea  with bleeding symptoms of cancer?\n\nI have had diarrea for 5wks. It then improved but began to bleed.My doctor has taken blood and there are no nasty bugs and I am waiting to see if there are cancer markers.There is cancer in all of my mothers sided of the family.If the diarrea has eased could it still be cancer?",
    "doctor_response": "Severe inflamation in intestines can also cause bleeding while passing stools.Any bleeding while passing stools shoul be evaluated as it is a sign of cancer.Since you have a family history i strongly suggest you toGet a colonoscopy to ruleout cancer. Meet a gastroenterologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does face swelling in a heart patient indicate?\n\nMy father had 2 massive heart attacks in one year! The second one caused him to pass away and he was brought back after 45 minutes of recessitation. He has 15% capacity left in his heart as well as having diabetes! He smokes 2 packs of cigarettes.a day and doesn't eat properly! He is constantly sick and sleeps the days away! He has shut himself off from everyone but recently I ran into him and his face was puffy almost swollen looking. I remember his face looking similar after the second heart attack! Could this be a sign of arising issues?",
    "doctor_response": "Hello I have gone through your question and appreciate Your concern. Ur father may be suffering from heart failure. Which is causing Accumulation of fluid in body.Is there any swelling over abdomen and legs.It is Better to get examined by cardiologist And echo done. His dose of diuretics may need to be increased.Don't ignore it and get consultation done as early As possible. Thanks.U can write me back for any query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I get white teeth ?\n\nhello,Im 24yrs old lady.i brush daily two times but still my teeth are yellow colour. Please suggest a solution.",
    "doctor_response": "hi.....yellow color can be changed into white by 2 ways..... go for bleaching or if few teeth if u feel are more yellowish,then go for ceramic crown... and my advice l be,if its not much yellow,then leave it as it is.....undergo scaling.that l b enough.....tk care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold symptoms due to allergy\n\nHello,my 4 years old has been having allergy like symptoms for several month.His pediatrition handles it as common cold...He also says his heart is hurting several times after he  cought so hard, and mentioned that his left handside under his heard ia hurting too..I dont want to overeactbut I dont want to be careless either...Thank so much",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your son's history. From your history, both allergic and non-allergic causes are possible.I would like to make following suggestions to you:1. Were I treating him, I would prescribe a combination of montelukast and levocetirizine for at least 2-4 weeks (depending upon response).2. I would like to ask his symptoms in detail. e.g., Has he ever had wheezing? does he have cough? During what time of the day he has maximum symptoms? Does anyone of his family members have allergy? What are the medications he is taking? etc etc.3. I would also like to prescribe him a course of vitamin C for at least 4 weeks. It helps in reducing common cold episodes.4. I would suggest you to consult an Allergist-Immunologist who will advise him allergy testing so that you can know whether he is allergic or non-allergic as well as if allergic, what are the substances he is allergic to.5. I would suggest not to smoke at home if anyone in your family smokes. Also, please try to avoid exposure to dusts, smokes and air pollution to your son as much as possible.6. A nutritive diet rich in vitamins and minerals (e.g., adequate green leafy vegetables, fruits, sprouted beans, etc) will be helpful in long run.7. Some medications used in cough syrups can cause heart running fast. So I would like to review his medications.8. Pain in chest at 4 years of age is usually not due to heart-related cause. Personally I would consider muscular pain or gastritis first. In that case, paracetamol for muscular pain and antacids for gastritis will be enough. So please do not worry about heart condition at present. 9. Of course, if by listening to his heart sounds via stethoscope one thinks there is a possibility of heart disease or if he has any of the following symptoms, I would suggest Echocardiography to diagnose/rule out cardiac cause: breathlessness after walking/running, bluish discoloration of lips/nails, swelling of the feet, etc.Hope above answer will be helpful to you.Wish your son the best of the health.Should you have any query, please feel free to ask at HCM.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Red mottled rash on upper body front and back, pricky with fever. Is it allergy ?\n\nMy grandson had a red motteled rash on his upper body front and back. It is prickely but is flat so it does not look like a heat rash or anything that raises to a bump. H did run a slight fever but is fine now except the rash as not gone away. Could it be a form of heat rash or is it more likely a allergic reaction to something. He is six. Thank you I will check with his family and get back to you I may just take his to his peditrition tomorrow.",
    "doctor_response": "Dear Concerned ., Thanks for writing to us. In all probability , the history of prickly sensation is suggestive of subcutaneous denaturation of protiens in the lower stratum of skin and subsequent allergic reaction that ensues against denatured protein  underneath producing prickly heat rashes on the exposed parts of the body. Kindly apply soothening creams/lotions  such as Lotio calamine over the affected area generously and do not allow exposure to Sun for a three to four days. The lesions will subside.If there is fever pls take him to local doctor as it indicates infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does bilateral prominent renal pelvis mean?\n\nHi, I just had a renal tract ultrasound and my right kidney is 117mm with a 9mm cortex and a 6mm renal pelvis. left kidney is with a 9mm cortex, renal pelvis of 17x8x6mm. What does bilateral promient renal pelves mean and is further assessment with CT KUB necessary?  What is 'normal'?",
    "doctor_response": "Hi,A prominent pelvis in the the kidney on ultrasound simply means a pelvis larger in size which in a majority of cases a normal variant.However, it is always prudent to have a follow up ultrasound 3-4 weeks later to see the progress.CT KUB is not indicated as of now.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure burning and pain due to coughing and sneezing?\n\n2 WEEKS AGO i COUGHED AND SNEEZED AT THE SAME TIME.  i FELT A BURN AND RIPPING PAIN.  fOR 1 WEEK IF i COUGHED OR SNEEZED IT BROUGHT ME TO MY KNEES.  iT WENT AWAY FOR A LITTLE BUT IS SORE AGAIN TODAY.  iS THIS REALLY JUST A PULLED MUSCLE OR SHOULD i BE CONCERNED",
    "doctor_response": "Hi thanks for contacting HCM...Here coughing and sneezing suggesting viral respiratory infection ...It can lead muscle pain like constitutional symptoms...Symptomatic management done ..For cold decongestent like antihistaminic drug given ..Steam inhalation with added eucalyptus oil useful for congestion relief ...If nasal blockage felt than oxymetazoline nasal drop used for it ....For pain analgesic taken ...Meanwhile investigate with ....1.CBC 2.CRP (For determining whether viral , bacterial or allergic infection )If needed throat swab taken for culture and aso titer also done ....Consult physician for this ...Take care ....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment for food allergy that causes skin deterioration?\n\nOkay. My daughter suffers from a food allergy that leads to her skin deteriorating on her trunk, hands, neck and arms . It occurs within 30 seconds of eating high concentrations (not amounts) of protein.",
    "doctor_response": "Hello,Thank you for posting on HCM.The condition you have referred to is called urticaria or hives. Its an allergic manifestation of skin, where an allergen leads to release of certain substances from your blood, leading to itchy skin rash and swelling over soft tissues.Its proper management requires thorough history, clinical and laboratory work-up. As, you have specifically mentioned proteins you go for specific tests like patch test, food prick test etc. As for treatment part, best would be the avoidance of allergen as far as possible. Try to eliminate possible triggering foods from diet. I would also advise you various anti-histaminics for long duration( atleast 3 months) with or without oral corticosteorids. For non- responding cases there are many other drugs like dapsoe, cyclosporine, montelukast, omalizumab etc which can be used un certain selected cases. Hope this will help you in resolving your query.Thank you Dr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain persisting after gall bladder removal. Stone in the bile duct. Will the pain subside?\n\nI had my gallbladder removed 12/11 I had just had a baby 10/11 I had been sick for 2 years before the procedure. I was still in pain after the surgery for several months; the pain stopped and returned in 10/12 I went for an ercp 2 days ago and a golf ball size stone was found in my bile duct . I am still in a lot of pain that is shooting up my chest and my neck I was told I can return to work the next day and I would be fine. Im not taking anything for pain but was wondering should I go back to the hospital or will the pain eventually subside",
    "doctor_response": "Hi and welcome to Healthcare magic.Thank you for the query.It should subsde if there is no stone anymore and if there wasntoermanent bile duct damage. So just be patient for several weks and see will there be improvement. If not, you will ned repeat ERCP to verify the exact diagnosis.Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication after heart stenting\n\nI'm 60 years old and have 4 stents does this qualify me for disability? I'm 5'1'' 127lbs heart dease runs in my family,my brother had a heart attack before the age of 50, grandmother passed with a heart attack,aunt had blockage of the leg arteries,had heart attack and passed, mother had same leg bolckage ended uphaving a stroke. I was seeing my doctor every 6 months until last year when he said I could see him in a year,took me off all my meds except for toporal once a day. I was going to make an appointment for my yearly check-up but  before I couls do that I had lost my job,so no insurance.I have about 3 days left of my medicine then I don't know what to do. I 'll be taking low dose asprin i guess",
    "doctor_response": "After cardiac Stenting Aspirin is continued lifelong and also other medicine like Atorvastatin 40 mg.  Also if you had heart attack then metoprolol is also given. Also heart is little weak, working less than 40 %, then tab ramipril and spironolactone is also given. These medications should not be stopped. you should discuss all these issues with your physician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for pain in clitoris after sex\n\nHi. Can you rupture/tear your clitoris? It really hurts when I go to the toilet. But not only when I go to the toilet. There\u00b4s no bleeding. It hurts like infection but I think my clitoris looks different then it looked before (looks like its torn). I had sex but the pain only started 4 days after. Thank you for your hepl.",
    "doctor_response": "Hello,Thanks for posting on HCM,Infection is the most likely cause for pain found on your clitoris. Clitoral pain is a specific subset of vulvodynia produced by neuralgia of the anterior division of the pudendal nerve. It is manifested by pain localized to the clitoris with or without associated pain such as vulvar vestibulitis and pelvic floor myalgia. The symptoms may be constant or variable and may improve or worsen with movement or sexual activity. The cause may be metabolic (rarely), traumatic (likely), or idiopathic (i.e., unknown).  Trauma from violent stimulation (which should occur shortly after sex and not only a couple of days after), tight clothing, or straddle injuries may produce these neuropathic changes.  In other cases, clitoris pain may come from an infection that may develop slowly and persist or worsen over time. What to do now? I suggest you see medical attention as soon as possible. Usually, it is rarely a problem, but if persisting you will have to receive treatment. Hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it effective and safe to take benicar and metropollo for high BP?\n\nMy husband is taking benicar and metropollo for his blood pressure but he can't seem to regulate his bp. It is normal range early morning then drops to 104/48. Then he will drink a little Gatorade to make it come up. Then in the evening it will go extremely high like 180/63 to 235/100 + he will take  colodine to drop it. He is staying stressed and frustrated which I know doesn't help! What can we do?",
    "doctor_response": "Hi. Thank you for your question. Normal ranges of blood pressure are: systolic, 100-139 mmHg and diastolic, 60-89 mmHg. It is safe, as well as efective, to combine a beta-blocker (metoprolol) with a angiotensin receptor blocker (benicar - olmesartan). My opinion is that Gatorade, as well as high intake of caffeine and a diet rich in salt, should be avoided. I hope I was helpful. Greetings.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does BP 117/64 & pulse 58 suggest?\n\nI am a 61 yo F and have high blood pressure & GERD and take diltiazem 360 and spironolactone 25mg as well as Zegrid (2xday). My pulse usually runs in the 60 s. I ate lunch about 45 mins ago (tuna salad) and am feeling lightheaded with a funny sensation in my chest....not pain....more like a bubble . I took my blood pressure it s 117/64 and my pulse is 58....slower than usual. These sensations have been going for about 15 mins. Shoud I be concerned?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. No need to worry for heart related diseases for blood pressure of 117/64 and pulse of 58. These readings are normal. Since you are also having GERD, your chest discomfort is mostly due to GERD. So take antacid (pantoprazole) and anti Emetic (domperidone) combination on empty stomach before meals. Avoid hot and spicy food. Avoid stress and tension, be relax and calm. Avoid large meals, instead take frequent small meals. Don't worry, you will be alright with all these. No need to worry at present. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in forearms while holding the grip?\n\nThere is a pain in my left forearm for about a week now, and my other forearm is starting to hurt now too. There is no bruising or swelling at all. I do removals for a funeral home so sometimes I do have to do heavy lifting. Any idea what is going on? I use some sort of gel, that are used on cattle, and rub it on the forearm and it relieves the pain. It only hurts right after I release my grip from an object and the pain doesn t last after that.",
    "doctor_response": "hiThere may be overstraining of muscles, ligaments or tendons in wrist,forearm.Do hot  fomentation and apply voltaren gel or any over the counter anti -inflammatory gel.Take tylenoltabs as well and give rest to arms by avoiding heavy object lifting for 5 daysthanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes body aches, chills and headache?\n\nI have body aches, cills, and a headache. I also taste a sick taste when I clear my throat. I had Hip surgery in March and I am still taking pain meds here and there so I took two 10mg oxycodone this morning because I was in a lot of pain. I am also taking phentermine 37.5mg. I have never had to take two pain pills with my diet pill so I am wondering if I am sick or is it these meds I took?",
    "doctor_response": "Your symptoms like body aches chills is basically related to fever but this fever will be related to either infection in body or the pain at your hip level. You have informed you have undergone for hip replacement surgery in march, usually hip replacement surgery takes 1-2 month time to recover with the help of physiotherapy rehabilitation program and post one month it is not supposed to be a painful condition. For you it's already 1 month over and still you are in too much of pain so I suggest take one xray of your operated hip joint and check with your orthopadic doctor for infection or healing issues. If everything is fine then you can use cold pack frequently at home to reduce inflammation and pain. We can also use alternately hot pack to increase blood circulation as well heailling process. If you have not followed physiotherapy rehabilitation after hip replacement I suggest to start following now and do regular exercises as well as the treatment as suggested by physiotherapist. Suppose if there is a problem in your hip x-ray like infection or healing issues you need to take enough of antibiotics along with calcium and vitamin d tablets for this your orthopadic doctor will guide you in detail.I am sure this will be helpful for you if you follow my suggestion properly. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to control high BP\n\nMy age 32. I have high blood pressure. Last 3 year, my doctor give me amdolopin 5gm per day for High BP & it is in control. But some day ago My BP is again high So, my doctor change my medicine. After taking the new medicine, now my BP in control but my penis is not hard for any time. Sometime it hard but not long time. I have share it with my wife. Pls give me a solution.",
    "doctor_response": "Hello,There are some drugs which have erectile dysfunction as a side effect as beta-blockers are one such class. So avoid drugs as metoprolol atenolol or carvedilol. You can take tablet telmisartan once a day. Decrease fast fried foods go for morning or evening walk at a moderate pace keep your sugar and lipid profile you should take multivitamin antioxidant combination once a day. Hope I have answered your query. Let me know if I can assist you further.Regards,\u00a0\u00a0 Dr. Varinder Joshi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes creaky sound from lungs while sleeping?\n\ni was treated last week for pneumonia (1/5 of left lung was full), am still on levoquin and feeling better but my now my lungs/lower throat make creaky,squeaky sounds when i'm trying to sleep. if i cough hard, sometimes phlegm comes up and sound quiets..sometimes not. i REALLY need to sleep, these noises and the stomach pain + insomnia from Prednisone prescribed for same issue are keeping me from getting much rest. Is this sound ok, will it stop eventually, and what do you advise for now?",
    "doctor_response": "Respected user , HiThanks for using Healthcaremagic.comI have evaluated your query thoroughly .*  These sound are due to wheezing from irritation of pleura via lung     inflammation .*  Will come  around  with  the  recovery  of  the  lung  pathology .    Some suggestions for better recovery -  Continue medicines at present given from the doctor .-  Gargles with salted lukewarm water and added peppermint oil 3 times a    day .-  Inhalation of vapors of boiled  water  with  added  tincture  benzoin with   blanket  over  the  head  for  5 minutes each 3 times  a day .-  Avoid exposure to excess cold .-  Deep breathing exercises , YOGA , fresh air walking must .-  Avoid smoking ( active or passive )-  Avoid exposure to atmosphere with pollens , if necessary use face mask .-  Sleep in semi reclining position with back support always till full recovery -  Avoid chilled beverages , oily , spicy , excess sugar , alcohol .-  Avoid air conditioner , air cooler .Hope this clears your query .Welcome for further doubts .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest tests to detect cancer other than biopsy\n\nMy mother is 78 years old and had 2 heart attacks in 2002 and during that period stenting was done. Now one month ago she had a paralitic stroke. There is no effect on any part. She can walk and eat herself. Recently she had pain in her cheeks. Dr said it is a cheek bite. But when we went to a dentist he suggested for biopsy. Now the problem is she is having acitome and ecosprin and we are try to maintain the result of pt inr between 2 to 3. Is there any other option to detect whether it is a cancer or not apart from biopsy?",
    "doctor_response": "if we are looking for detecting cancer in the throat, cheeks, oral cavity bx is the mainstay of diagnosing cancer. Unfortunately we dont have any tumor markers or radiaologic tests to exactly say it is cancer. Biopsy is the go.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to prevent pinworms of intestine?\n\nHello, Im 13 and 2 months to 14, 33.5kg This is about human intestine worms, more spesifically pinworms, 1. Can they be as small as 1mm? 2. If you see a doctor and got the medicine for it, how to you keep any more unhatched eggs around the house or on your clothes from infecting you again? 3. Is it a bad thing to have worms inside you? 4. Is there a way to kill these worms by eating something not a medicine(somehting like orange or lettece)? 5. how do you keep other people from getting infected in your family when you have them?",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Pin worm or enterobius vermicularis is the very tiny worm which lives in the area around anal canal. They won't reside in the intestine it self.Yes they are highly infectious it can infect the other members if the one member is infected. It can also spread through respiratory tract.Yes it is a bad thing to have worms inside you, it may cause severe itching around the analcanal.Clothing should be washed separately of infected person. Bed sheet should be changed daily until the infected person cured.Albendazole can be given to the infected person. If the infected person is more in numbers than all the members requires a treatment simultaneously.There are no other treatment methods other than drugs.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause phlegm containing dark red spots ?\n\nI was wondering if there was any complication associated with phlegm containing stringy dark spots and other symptoms such as headache, myalgia, anxiety, and stomach problems. I have been to a physician who treated me with antibiotics for sinusitis to no avail and am worrying that it might be a fungal infection.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. You are having hemoptysis (blood in sputum). And yes, it can be seen in fungal infection. Hemoptysis is common in following diseases. 1. Bronchitis 2. Lung infection like tuberculosis, fungal infection, bacterial pneumonia etc. 3. Lung cancer. So better to consult pulmonologist and get done clinical examination of respiratory system, chest x ray, PFT and sputum culture and sensitivity report. PFT is must for the diagnosis of bronchitis. Chest x ray is needed to rule out lung infection and lung cancer. Sputum culture and sensitivity report is needed to rule type of infection whether tubercular or fungal or bacterial. So consult pulmonologist and discuss all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for congestion and breathing trouble\n\nHi, I am 18 years old. I ve been experiencing congestion and difficulty breathing. My throat tightens up everytime I eat or drink and then it loosens up after a while. The pain is gone, all that is left is the tightness and slight itchiness. Its pretty scary, what sickness do I have?",
    "doctor_response": "Thanks for your question on HCM.It looks like upper respiratory tract infection (URTI). But we need to rule out lung infection. So get done chest x ray first.And if it is normal than mostly you are having URTI.Try to follow these.1. Avoid hot, oily and spicy food.2. Drink plenty of fluids.3. Warm water gargles 5-6 times a day.4. Start macrolide antibiotic. 5. Start antihistamines and anti inflammatory drugs.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Punched his jaw. Had surgery, put plates. Is it normal to have pains?\n\nHi, my son who is 27 years old, got punched in the jaw last April. He had surgery performed by an oral surgeon and put plates. After seven months he is still in pain. The surgeon told him today that if using the mouth guard does not help after a month or so, he would need another surgery. What is your opinion. Is it normal to have still pain after 7 months? thank you!",
    "doctor_response": "Hello,Thanks for posting your query in healthcaremagic.If the fractured jaws has not completely fused even after bone plating,it can cause pain.AN OPG radiograph as well  as clinical evaluation like palpation will help to rule out the cause of pain.Meanwhile,i would suggest you to take augmentin along with analgesics.If necessary,another  surgery has to be performed.Avoid mouth opening too widely.Jaws has to be immobilised for a while.Physiotherapy may be helpful.I wish your son speedy recovery.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a jolt like feeling on the right hand?\n\nIn my right hand occasionally when I grasp things, I get this jolt/shock that reminds me of being electrocuted or zapped from touching an outlet that had a loose wire or something. About halfway through the intense shock, my hand starts to feel damp and cool, like the feeling you get just after you wash your hands, the whole things only lasts about a minute, but it scares the crap outta me",
    "doctor_response": "Hello,The symptoms can be related to a pinched nerve in the hand. I suggest to maintain a splint to avoid further damage of the nerve. I also suggest using anti inflammatory medications such as Ibuprofen 400 mg three times a day to relieve the symptoms. If the symptoms continue, you should see a neurologist.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for episodes of tachycardia\n\n29 year old girl, history of pre syncope and PVCs since childhood,but professional athlete, affected carditis in 19 years of age , with no structural sequel, but increased episodes of arrhythmia mainly very frequent PVCs and episodes of SVT. EF around 50%. pericarditis in 22 years of age followed by severe decrease in functional class despite good EF and increased presyncope and syncope during exercise...now suffering with episodes of tachycardia which only increases to 150bmp but severe dyspnea, intolerant of exhaustion , least exhaustion brings on sinus tachycardia lasting for hours, despite good hyderation. also increased need to beta blocker, (Metohexal), increased resting rate despite medication and recently getting acrocyanosis post exercise. thank you",
    "doctor_response": "hi, so permanent solution for this problem is electrophysiological studies and ablation which will cure your svt with 90% probability and need for any drugs further. You already being on metoprolol and get acrocyanosis I would advise to Star tab diltiazem, it will take care of both svt and acrocyanosis. so I would advise to disciss this with your physician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for welts on cheek and temple caused by fall\n\nMy two year old boy fell (short distance) from the toilet to the floor. He hit his temple and side of his cheek on the side of our sink cabinet. Cried, hugged and looked at his boo boos and then he was fine. Two small welts one on his temple other on his cheek. Should I be concerned?? He s sleeping now, woke up after an hour crying... Took a couple minutes but he s back to sleep. Please help with advice!!",
    "doctor_response": "Thanks for your query, I have gone through your query.The welts on the cheek and temple region can be secondary to the injury or it can be secondary to fractured bone. Nothing to be panic, consult a pediatric dental surgeon and get it evaluated. You might have to take a radiograph to confirm the diagnosis. Mean while you can give tablet or syrup paracetamol.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for asthma in a child?\n\nHi my name is stormy im 22. The day my friend had her son i was in the room and i got really weak and turned pale white i had asthma as a child. Lately ive been feeling weak and tired and bad headaches and back pain. Plus in my lower very lower belly it feels like im being scratched.",
    "doctor_response": "thank you for using healthcare magic.hi stormy. Asthma usually presents with chronic coughing or difficulty in breathing which are not present from the symptoms you described. Although asthma may attack even after several years from your last attack, it is best to have yourself checked by your doctor to confirm that this really is an asthma attack. As for treatment, SABA (short acting beta2 agonist) like Salbutamol is the drug of choice for exacerbations of asthma. Sincerely,Mark Rosario MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from chronic kidney disease. Any treatment?\n\nI have been diagnosed with CKD Stage 3a.  I am having difficulty with being authorized to see a nephrologist.  My doctor Verna Liss, MD has known I have CKD, yet failed to let me know this for the past three years.  I am very concerned about the lack of treatment and information I am being given, and need help.  Also, the lab tests ordered by Dr. Liss are not being paid by my carrier, Anthem Blue Cross.  I cannot afford to pay for having my question answered.Linda Florey09/04/1949",
    "doctor_response": "HIThanks for your query.The general measures which help control the progression of CKD include:1) Control of blood pressure (BP2) LDL cholestrol3) Strict control of blood sugars ( if you are a diabetic)4) Quit smoking5) Use of a class of medications known as ARBs under the supervision of a doctor6) Appropriate diet ( need to know more reports)Specific measures can be takebn once we know the cause of CKDHope this helpsGood luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am on low dose of Seroquel. Will it affect my normal thyroid function?\n\nHello doctor, I am on a low dose of Seroquel, which suppressed my thyroid FT4 and, subsequently, my FT3 during these three years of recovery from Hashimoto\u2019s disease. I have stopped Seroquel, and my exogenous administration of testosterone is reduced to half from 700 to 387. Do Seroquel increases the prolactin levels? My sugar levels drop quickly after meals, and I have low genetic TBG. If I increase my exogenous testosterone back to the previous level, will my TT3 level get lowered? I am on Propranolol and my last Seroquel dose of 25 mg. It was affecting my eye sight, so I stopped it, and my FT4 was always low after Hashimoto\u2019s recovery.",
    "doctor_response": "Hello. I understood your question, and the answer is: An increase in testosterone dosage will not suppress T3 (triiodothyronine) levels. It will take some time to recover from the consequences due to the long term administration of Seroquel (Quetiapine). Propranolol can cause low testosterone levels, so no point in artificially increasing the testosterone.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does masturbation cause difficulty to do sex for more than 2 mins?\n\nI Do Masturbation twice in day before my love affair, and i am started to do when i am in 11 thi think due to this i am not able to sex more then 2 mints with my girl friend.what i do ?it much get effected on my body.and my hair color is got change to white.and my eyes Spekkies no is increasingis this effect of heavy Masturbation",
    "doctor_response": "Hi,Nothing to worry, masturbation has no any bad effect in your body.Having quick ejaculation might be due to over sexual excitement.Take high protein nourishing diet.go for regular exercise daily.Avoid sedentary life and remain busy all the time.Avoid over masturbation.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain due to stomach cramps, intense near ribs and lower abdomen along scar line post c-section. What could be the cause?\n\nI had a cesearian section and sterilisation 1 year ago this week, and have recently been using a vibroplate plate machine. In the past couple of weeks I have also been in quite a bit of pain with stomached cramps . High near my ribs and also lower abdomen pain along my scar line. I had twins and my stomach was massive as I am only of small build. I imagine my stomach muscles received a lot of trauma during this time. Is it just muscles repairing them selves or is it causing problems with my internal healing of surgery?",
    "doctor_response": "Hello,There is alway a chance of muscle weakness post surgery.Pain at the scar site is mostly due to muscle spasm.Rest during pain is advised.Regularly do abdominal muscle strengthening exercise.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is sexual intercourse safe with skin cut on frenulum?\n\nHello I was having intercourse with my girlfriend and I appears I have a small cut on my frenulum. It was bleeding for a little bit but after the next day the bleeding stops and looks like it s healing it s hard to tell it there s a little pain every now and then. Can I still have intercourse with a condom or should I wait a couple weeks? I m a little concerned this is never happened I am not circumcised I haven t had this problem before",
    "doctor_response": "HIWell come HCMChances of developing phimosis or paraphimosis is likely and care need to be taken for this, in my opinion such case needs clinical examination for right diagnosis and advise so better to see the urologist, some time this may need circumcision, hope this information helps, have a nice day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Infected swollen pimple on the face. Applied polysporin and aloe. Medication?\n\nI picked a pimple on my face. It became a scab, which I put aloe on to keep moist then after a shower i peeled it off... So bad.... Then continued with aloe and vitamin e ... Left that on before bed and now woke up to my whole cheek and under eye being swollen and inflamed.... Put polysporin on went back to bed woke up to no change... It looks really infected and swollen and bad",
    "doctor_response": "you take tab doxitab 100 mgm bd tab allegra120 mgm od keep face dry no oils no ointments and no grresy application on face apply clindac a gel morning and evening apply histocalamine afternoon wah wth niko soap warm water 3 glasses in morning and night before sleep after 3 week stop all apply retinoic acid .25 mgm at nigh for next 1-2 months if there is dryness due to ointment you can mix little mometasone with retinoic acid",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment for polyps and sludge in gallbladder?\n\nHello I am a 47 year old woman. I was recently taken to the er by ambulance because I was having what they thought were symptoms of a heart attack. Pain in my chest pain in my right side so painful I couldn t take a breath without severe pain.I threw up twice I had pain in my back like someone is stabbing me. After many test they said I have polyps and sludge in my gallbladder. I need to follow up with a surgeon next week since this incident I really haven t been able to eat anything without pain I also noticed that my stool is almost white. I m trying to wait for my appt but this is getting hard to tolerate much longer. Do you think I should go back to the ER or just tough it out until I see the surgeon I don t know how much more I can take and is this something that will require surgery? Sorry to ramble I m just really scared I m a pretty healthy person and this is really scary please help",
    "doctor_response": "Hi there,Thanks for posting in HCM.You look like having obstruction of bile flow probably due to gallstones in the bile duct. A MRCP may be done to confirm it.If confirmed, ERCP may be done to relieve obstruction followed by laparascopic removal of the gallbladder.If you are having feve with chill, go to ER. If no fever, you can visit your surgeon as per the appointment given.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with seizures, taling levipill since a long term. Will it cause any side effects?\n\nMy father is 81 years and haven diagnosed for seizures.. He has. Been taking levipill 500 since feb 2011 . Morning 2 tab and night 2 tabs..will he have any side effects. He has reduced tab as morning two tab and evening one and half since three months.again he had seizures.is is because of reduction in medicine.now he is on IV with levipill. How will he stabilise?",
    "doctor_response": "Hi, Thank you for posting your query. Levipil (levetiracetam) is a safe medicine for treating epilepsy. His current dose of 500 mg two tablets- 1000 mg twice daily is safe. There is no need to reduce the dose, as dose reduction may cause seizures to recur. Epilepsy is a chronic disease, and needs long-term medications. There is no need to worry about his current clondition, as he would recover soon. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red bumps on cheeks?\n\ni am a 36 year old female. two weeks ago I noticed that I had a rash of small red bumps on my cheeks. I thought it was a new hair product I was using that possibly had gotten on my pillows. I've washed all my sheets and it seems to go away then i feel tingling and itching and they are back.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern.As per your query you have symptoms of red bumps on cheeks which is mainly by mild irritation or allergic reaction by cosmetic products mainly. As you have used new hair product, you noticed the red bumps after using a new hair product such as soap or conditioner, discontinue use and see if the bumps go away.I would suggest you not to worry about anything. Visit dermatologist once and start with use of antibiotics such as Azithromycin , topical medications such as topical steroids and glycolic peels or you can go with combination of these as well. Antihistamines can also be started if its because of allergic reaction.Wash your face with plain water at least after every 2-3 hrs. Take multivitamin supplement. Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it advisable to go for driving lessons in case of heart ailments?\n\nHi i am a driving instructor. Yesterday a pupil of mine nearly fainted behind the wheel it was only then that she told me she had a blocked artery in her heart valve and had been to hospital twice over the weekend to have some injections to slow her heart down and had also been on the heart machine I would like a doctors opinion regarding taking her out on further lessons. Should i make sure she is medically fit to drive. I not sure what to do if i could have some advice would be helpfull. Thanks",
    "doctor_response": "Hi,This is Dr Sameer, cardiologist.Ability of a heart patient to drive depends on the current status of a patient. If she had surgery done recently or heart rate has increased recently than their are chances of increasing again after exertion. So it is advisable for such patients to not travel alone. Its better for such patients to avoid driving.If the patient is stable for a long time than he/she can drive safely.Hope you find this helpfulRegardsDr Sameer Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking antibiotics for pussy sores on arms, legs and chest but hasn t helped. What can it be?\n\nMy daughter has pussy sores that just appear on her arms, legs and now moving to her chest and back. She has been on antibiotics for 10 days (2 pills twice a day), and it hasn t helped. She is afraid it might be MRSA, but could it be something else, like shingles, impetigo?",
    "doctor_response": "definitely, it is viral related,,,,and not the staphylococcus infection,,,it will get subsided by itself....meanwhile youcan start with Avil 10mg, it helps her...regards Dr Shyamalaplease rate this if you are satisfied...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Prescribed ovofar, ebexid, sicriptine, duphaston. Will I be able to conceive if I try on fertile days?\n\nHello Doctor, I was prescribed with: 1)OVOFAR (50) from D3 - D7 , 1 tab twice a day for 1st 2 cycles then 1 tab thrice a day for next 2 cycles and 2 tab twice a day next 2 cycles. 2)EBEXID - 2 tab daily for 3 months. 3)SICRIPTINE - 1 tab daily for 6 months. 4)HYPONIDD - 1 tab daily for 3 months. 5) DUPHASTON : 1 tab daily of D16 - D25 for 6 cycles. My LMP was on 27th april 2012. I want to know whether i will be able to conceive now, if we try on the fertile days ? If the conception occurs is it safe to continue the above prescribed medicines ? Kindly help me with the answers. Regards",
    "doctor_response": "Hello Kan, Welcome here on hcm. In my view you will be able to conceive certainly. Once you are declared pregnant than your treating doctor will change the medicines. So dont worry. I will suggest you to go along with your treating doctor. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pimples a side effect of atenol 50 intake?\n\nHi, I have hypertension. I was on atenol 50 mg and amlodipine 5 mg. About 2 months ago, my doc changed the medication to nebicard 2.5 mg and cilacar 10 mg. Of late, I am getting pimples over my forehead, cheeks and neck. Is this a side effect of cilacar?",
    "doctor_response": "Hi, Atenolol is unlikely to be the cause of pimples. Cilacar is a calcium channel blocker commonly prescribed to treat high blood pressure. Its common side effects include increased heart beats, flushing, palpitations, constipation and swelling of the feet and ankles. It is not known to cause pimples. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mohammed Taher Ali",
    "dialogue_context": ""
  },
  {
    "patient_message": "Acne, forming blisters, bleeding. Remedies?\n\nMy 13 year old daughter has bad acne and has been using Pro Active and the new version of Pro Active called XOut. She had a pimple on her cheek a few weeks ago that later started bleeding and turned into a big blood blister . It gets large and stays perfectly round and filled with blood. If it breaks open it bleeds a lot and then reforms the blood blister. What should we do? Thanks",
    "doctor_response": "Hi kharanshu, Thanks for writing in. Acne is caused by hormonal imbalance. Blockage of sebaceous glands causes papules and pustule and cystic acne. Hormonal work up is essential for proper treatment. Acne is treatable now.With correct treatment all your pimples , scars and dark spots can be treated. You have to stop using proactive. May be your skin is allergic to it. Cryotherapy and chemical peeling can give you fast and long lasting results.They are available at dermatology clinics. Discuss the option of Isotretinoin with your dermatologist.It will have rapid effect. Hope this helps. Regards. dr Sudarshan. MD dermatology.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the red spots with yellow heads?\n\nHi when my daughter woke up this morning she had a few small red spots with small yellow heads in them. Since returning from school she has about a dozen. She is 5 doesn't feel unwell and they don't seem to be bothering her. She has never had chicken pox. What do you think it could be?",
    "doctor_response": "Yes she has been suffering from chicken pox or contact dermatitis. Follow up for developed fever, itching.if chicken pox, take rest and give acyclovir,antihistamine,paracetamol. In case of contact dermatitis, take antihistamine and local steroid ointment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in the upper part of the rib cage?\n\nI have been having pain in my upper ribs on the right side which often moves to the back under my shoulder. I ve had a chest x-ray and mammography. Both showed nothing. Also had bloodwork done. I work out everyday. Could this possibly be muscle strain?",
    "doctor_response": "Hello, I have studied your case. I will like to give few differential diagnoses for your symptoms.There can be thoracic nerve compression in spinal canal leading to right sided pain from rib and shoulder.Due to compression of this nerve root there is pain in your rib.I will advise you to do MRI spine for this.Another possibility of abdominal mass leading to pain on right side.CT scan abdomen with pelvis will help to get further details.Till time for these symptoms analgesic and neurotropic medication can be started.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can explain dizziness and convulsive attacks?\n\nhi , male 28 age i am rizwan from saudi arabia .i have a some serious condition about my brain . i am suffering before one year dizziness . but dizziness duration is very small but too much heavy. my doctor take my MRI test and EEG test. mri test report is normal but in eeg test he write ........................................... chief complaint : Convulsion Attack medication : none Sedation : none summary of findings: background activity : Alpha rhythm. 8-10h synchronous,recurrent sharp waves ,slow waves activity,seen on right occipto -centroparietal areas. photic stimulation and hyperventilation do not induce other amnormalities conclusion: right side epileptiform discharges . so doctor i am taking madicine before 4 month contiue .may tablet name LOXOL LAMOTRIGINE and doctor say to me contiue it for two years . but before tow days i am feeling some problems in sleeping time suddenly i awake up and i feel like that now i will die because at that time i dont know what is going and also my brain is totally blank and my mouth inside is dry i am so upset please tell me some treatment and some suggestions . i am also feeling that my around places are moving but not fastly . and some sound come from my brain which disturbed me too much . i want to tell you that i suffered some problems in my past about my personal life . it means before 2 yaers some problems covered me and also i cried for my problems too much .i take my problems deeply but now i am so upset what can i do i dont know .",
    "doctor_response": "I read your query and I am sorry about the issues you are experiencing.What you are currently describing seems more likely to be related to anxiety and not to seizures. There are several options to alleviate your symptoms which include psychotherapy or pharmacological therapy. You should also try to lead a regular lifestyle, regular sleeping hours avoid sleeping during the day, avoid drinks containing caffeine or other stimulants, especially before bedtime. Regarding pharmacological treatment it depends. Since you say you've had these problems only for the couple of days and that episode 2 years ago then I think a drug of the benzodiazepine class should be used, but only for short term treatment 4 weeks at most because they create dependance and tolerance. They constitute no problem for your seizure issue, at times they are used to treat seizures actually. If on the other hand psychotherapy doesn't work and the problems seems to have become a persistent one then other more suitable antianxiety alternatives like antidepressants should be considered.These are drugs which must be prescribed only after doctor evaluation (neurologist or psychiatrist) though, especially in your case as some antidepressants are not suited in patients suffering epilepsy.Hope these episodes are temporary and you won't need prolonged treatment. Feel free to ask further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for numbness in the lips?\n\nI have had a root canal on a tooth - lower left side..... before I had it, I had the swelling and numbness..... was put on an antibiotic, then had the root canal a week ago...... the left side of my lip is still numb from before.  Is this normal and what is the cause?",
    "doctor_response": "hellooo....read your query...in my opinion numbness could be due to infection that was present there....now ur root canal treatment is over so infection will subside in few weeks time....take amox and metronidazole...for 5 days....hope u got reply....kp smiling and be happy..have a nice day!!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Abilify advisable for a 10 year old child?\n\nI am a school psychologist and have seen a significant increase in children being prescribed Abilify in the past 2 months. Diagnosis range in age 5-13 with either ADHD, bipolar, or anxiety and often by a family nurse practioner. Is this common? Are there studies supporting this drug in children under age 10?Thank you for your time",
    "doctor_response": "hi sir /madam,welcome to health care magic ,I can certainly understand your concern about abilify prescription in children,as some studies say that it is effectively prescribed in bipolar disorder and schizophrenia in children, as it is also FDA Approved in them. Definitely it has some Side Effects like tardive dyskinesia but this is the tricky situation that the psychiatrist has to be dealt with. Apart from  side effects, it has some specific  advantages like long half life, once daily dosing is enough significant sedating effects , prolactin sparing when compared to other atypical antipsychotics made it superior in specific situations I can explain you that this tricky situation can be dealt with slow and gradual titration of the dosage that is starting with the initial dose of 2 mg and gradually tapering to the target dose so if these guidelines are followed safely  it can be prescribed in children of this age group, and its usuage also depends on risk benefit ratio in this age groupplease post your further questions if any, i will always be available to answer themThank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen legs and blood blisters while suffering from diabetes?\n\nMy mother is 92, has Type II Diabetes (managed with diet and a pill).  She has developed an odd assortment of symptoms in her right leg which may or may not be related.  For about a week or so she had what she described as a pain in the muscle of her right thigh.  We put heat on it and she massaged it herself.  That pain went away and then she woke up with a swollen right knee with what looked like blood blisters and heavy bruising under the skin.  We iced that for several days.  Now the knee is improving but the lower leg is swollen and the skin is very tight and shiny in appearance and dark brownish red in color.  From the first symptom to the current about 4 weeks have elapsed. Ideas?",
    "doctor_response": "Hi, After going through your mother's case record  there is a development of right Diabetic Foot. Her symptoms started with pain in right thigh after applying heat and massaging the symptoms aggravated. (Applications of heat and massaging should be avoided in Diabetes patients.) Subsequently there is decreasing knee swelling but development of swollen leg with overlying tight, brown, shiny skin. Skin changes denote possibility of cellulitis (infection) with compartment syndrome (swelling of leg muscles and other tissues underneath overlying skin leads to increase in pressure which hampers blood supply to leg.) Diabetic patients are more prone to develop foot problems because - 1) loss of protective sensation of foot (diabetic neuropathy) which make patient more prone for injuries to feet. 2) Impaired blood supply due diabetic vasculopathy, which impaires nutrition of leg. 3)Diabetes patients are more prone for infections and poor, delayed wound healing. I will advise you to consult your doctor immediately. She requires detailed foot Examination. Blood investigation. Intravenous antibiotics. Strict blood sugar level monitoring and control. Arterial and venous doppler of right leg to assess blood supply of leg. Depending upon her clinical condition and test results she may require surgical intervention. I think this much information is enough for you to make further decision. You are free to contact me for further queries. Dr Abhay Mali.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can accurate blood pressure readings be taken?\n\nI went to the doctor recently and the nurse took it and got 170/80, later the doctor took it and got 150/80, but whenever I do it anywhere else I never get a reading that high, usually it ranges from 124/80 to 135/80 how do i know which reading is right? The same day that next day after I left the doctors office I stopped at a supermarket to use one of thier bp machines and the reading came out to 132/80 and two days later I passed by again it was 124/80...this has me very confused.",
    "doctor_response": "Hi,Difference in BP at home and at hospitals are a very common finding. It occurs because of the anxiety that follows when you go to a health care facility. Still, correct BP measurement is considered when a person is calm and relaxed.It has to be taken in sitting position with level of machine at heart level (means that the BP machine should be at the level of your chest). If the home BP & BP in relaxed state is fine, we generally consider it to be the true reading.Hope I have answered your query. Let me know if I can assist you further. Thanks,Dr Sameer Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for heel pain in an elderly patient\n\nI ve had pain in my heel for several months now . I have bought in soles and do stretching quite often but the pain continues. what is the next step? I m a youthful 69 years old and my calf mucsles dont seem to flex like they use to. any ideas for my self treatment?",
    "doctor_response": "Hi, The condition which is bothering you is a calcaneal spur. It is one of the common problems that occur during elderly ages and can be easily diagnosed by an X-Ray. In the mean time I suggest to use footwear with soft and thick soles. For treating the condition I suggest you take following Ayurvedic medicines with a due discussion with your Ayurvedic Physician. 1. Kaishora Guggulu. 2. Rasnasaptaka Kwatha. 3. Karpuradi Taila is to be applied over the region and given a mild massage. Later this is followed by dipping the foot in hot (Bearable limit) saline water for 10 to 15 minutes. Start with this regimen and get back to me after 15 days. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mahesh T.S., Ayurveda Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it possible to cure type 2 ligament tear without operation?\n\nHi doctor, I got an accident before a month. I got a right knee ACL ligament type 2 tear. Is it possible for the type 2 ligament to get cured by itself without operation and if so, how many days does it take to heal?",
    "doctor_response": "Hi. ACL (anterior cruciate ligament) tears will not heal on its own as they are inside the joint. To bring the ends together, you need surgery, but even that too is not successful. It is the reason for doing ACL reconstruction. It is not recommended for everyone. Only if your knee is giving way or if it is unstable or when you are unable to lead an athletic life, then you need an ACL reconstruction.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could i be pregnant from unprotected sex after periods?\n\nHi Doctor. I have irregular period cycle. On May 16 2015 I started noticing pinkish color when I wipe only. That went on and off throughtout the whole week. On Saturday 23 May 2015 I started heavy bleeding. I assumed it was my period. My period finished on Saturday 6 June 2015. this is the first time I had my period since July 2014. so last night I had unprotected sex. And today, I went to the toilet and notice light pink when I wipe only. Anyways, my question is, could I be pregnant? Is it possible? Please help!",
    "doctor_response": "as you cycles r quite irregular. ..better u do upt n check out whether it is positive or negative...u can start ocp pills frm 5th day to make your cycles regular",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Meprate intake cause any side effects?\n\nHi, My age is 25yrs. I have missed my periods it is 3 months now . I tested with HPT it shows negative. I have been prescribed with meprate 5mg for 5 days and asked me to wait for a week. is their any side effect of meprate as iam taking it for the first time????",
    "doctor_response": "HiOn starting the pill,nausea,vomiting,abdominal cramps,headache, spotting or irregular bleeding ,acne can occur as side effects.Not all the adverse effects occur in all women.The adverse effects will reduce in most women with continued use since the body will adjust to the hormone levels.Hope I have answered your query. Let me know if I can assist you further. RegardsDr.Saranya Ramadoss, General and Family Physician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can platelets be read via a meter?\n\nIs there a meter to read the platelets? My husband(31 year- old, 70 kg) has polycitemia vera and we were wandering if there is something like this. He is now on Anagrelide, is it ok? Already chemotherapy? He had a stomach bleeding because he took aspirin.",
    "doctor_response": "Hello,Thank you for your contact to healthcare magic.I understand your health concern, if I am your doctor I suggest you that there is no machine available that can read the platelets. But you can read it at laboratory. So do non worry whenever you are required to do platelet count visit the nearby laboratory your husbands current drug is fine and just continue with it.I will be happy to answer all your future concern. Thank you,Dr Arun TankInfectious disease specialist.Wish you a best health at health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does typical urothelial cell means?\n\nMy father has blood in his urine so he went for an ultrasound and they found a mass on the lower left pole of his kidney. i dont recall the size of the mass but it was fairly large. He also had a urinalysis done and the Cytology Daignosis came back with Atypical urothelial cells present and RBC's present. Is is possible that this is a large kidney stone cuasing the issue rather than cancer?",
    "doctor_response": "Hello and welcome to HCM. As an Urologist,i can understand your anxiety.You should've written his age.A stone is very easy to diagnose on any scan and will be reported also.A mass or tumor,needs a CT-IVU,for further evaluation,and's very accurate.Typically,the person has blood in urine,which's sent for a cytology test.Atypical cells further increase the chance, of the tumor being a cancer.A CT guided needle biopsy,is done in most centers,to confirm the diagnosis.You may send the reports to me,as a direct question,to clear all your doubt.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for liver tumor\n\nHello Dr ! My mom is 78 yrs old,having Hepatitis B + . Virus Count around 1 lakh.Problem she has now is in ultrasound report there is Tumer in her liver.Report shows, Liver shows well defined hypoechoic SOL with well defined margin of size 32 x 30mm in right lobe of liver. Please advice.",
    "doctor_response": "hi.noted history of hepatitits B infection and liver tumor on ultrasound report. it is best if you consult with a doctor, preferably a general surgeon or a gastroenterologist, for physical examination and clinical evaluation. benign vs malignant tumor lesions of the liver must be ruled-out. one important thing that must be considered is hepatocellular carcinoma, which has a high risk of occurrence if you have a history of hepatitis B. other diagnostics (such as ct-scan, liver function tests, tumor markers, etc.) and management (medical and/or surgical if indications are found) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is tinnitus a side effect of AZO?\n\nHello doctor, I began exhibiting symptoms that I would describe as tinnitus from a week. I get a loud noise or ringing in my left ear, although it also happens in\u00a0the right ear. One fine day the tinnitus actually went to the other ear (my right ear), my tinnitus since then has not been focused in a single ear, but seems to alternate.\u00a0I had to leave work three days back, as I had a sudden nauseous feeling. Since then, I have experienced random rushes of sensation that go throughout my body, which\u00a0most of the time are accompanied by temporary nausea. This feeling I can only describe as a \u2018wave\u2019 passing throughout my body. In my past, I have taken MDMA (ecstasy)\u00a0and would experience the same sensation then. I have heard people, remark about how this could be vertigo, but after reading descriptions I do not think it is. I do not feel like I lose control and balance, at least not significantly. I went to an urgent care physician to discuss my symptoms. The doctor listened to my ideas on what it was, but did not seem very knowledgeable on ototoxicity and assessed the situation saying I may now have tinnitus and this is something I will learn to deal with. He did remove severely impacted ear wax from my left ear\u00a0and was unable to finally remove all from the right ear. Upon removing the left ear wax I did feel a relief in the volume of the ringing. Since then, I have noticed that the tinnitus feeling seems to feel more internal than external.\u00a0My doctor prescribed me Acetic acid drops for my left ear\u00a0since there was slight bleeding during micro-suction. He also prescribed me Meclizine for vertigo\u00a0and Ondansetron for nausea that could accompany that. I went to a dermatologist and had a mole removal with local anesthesia. During this time I was also taking AZO, which is over-the-counter bladder calmer. Throughout the past four years or so, I have taken AZO over periods of time. I had issues with urinary incontinence and I took this\u00a0without input from a physician. There were periods where I took it for five days of the week, for maybe three months total. I originally took two pills at once, and then later took a pill at a time. It has been some time since I have taken AZO\u00a0before I took it again. I was completely unaware that AZO (Pyridium) can be ototoxic as it was near impossible to find this listed as a potential ototoxic medication. I never before exhibited any symptoms like this, and although while I began getting tinnitus tha",
    "doctor_response": "Hello. While you have elaborated on your symptoms very meticulously, I still require some more details. It is true that MDMA (3,4-methylenedioxy-methamphetamine) can cause tinnitus and worsen noise-induced hearing loss. However, it will be related to an episode of taking the drug. It is possible that regular use of the drug could have made the inner hair cells more susceptible to noise-induced trauma and would have manifested on someday when you subjected yourself to some noise (acoustic trauma). AZO (Phenazopyridine hydrochloride) is not a proven ototoxic drug. But since you are saying you have been using it, I suggest you stop that and consult a physician for the urinary symptoms. I suspect Meniere's disease, which is an inner ear problem and also ototoxicity. So, get the following tests done. In your next query, please attach the reports of the above. The above tests are necessary to find the cause of the problem and also arrive at the right diagnosis. Only after that, we can give a definitive treatment for you. Ear wax can cause tinnitus and aural fullness manifesting as imbalance, but the same will not be as severe as described by you. If the abrasion inside the ear has healed, you use some wax dissolvent to remove the wax. It will make it more soluble, and an ENT can remove it easier. Also, continue the medicine Meclizine, till we get the diagnosis right. I suggest you refrain from party drugs, alcohol, smoke, and dope. Revert with more information to an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medicines should I take for quick relief from filaria ?\n\nThere is inflammation in hands & legs with throbing pains, swelling. the eosinophila is 13%. Suspected Falerial treatment is going on with Hydrocotyle-Q, F.P & Cal Flr of 200x. Belladone did not work. Please prescribe for quick relief. Thanks,",
    "doctor_response": "hi welcome to health care magic.this all medication prescribed by any homoeopath or you started on your own?if prescribed by any homoeopath do regular follow up or if you take its from your own risk pleas don't do this consult any homoeopath for further guide line.you also contact me on my id. thanks Dr.dhara dhara.shah84@yahoo.in",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sensitivity to sound,light and smell?\n\nHi, I was diagnosed with Graves disease 5 years ago. When I started taking carbimazole to treat it, I experienced tiredness and sore muscles/joints. The specialist said these were normal side-effects, but after stopping the treatment after 1.5 years, these symptoms did not go away. And I developed numbness and tingling in my left foot, which gradually spread up my left leg, and down my left arm, into my left hand. I ve seen various specialists, including a neurologist to rule out MS, and had 2 MRI scans over the past 4 years, and had a lumbar puncture done approx 3 years ago. All tests came back negative. I ve now been discharged from all specialists, and since my carbimazole treatment, I ve been in remission for Graves . The neurologist did say that it s possible (though unlikely) that I might develop MS at some stage, and to go back if my symptoms develop. I ve since been diagnosed with fibromyalgia, chronic fatigue syndrome, and have tried all treatments but to no avail. I m currently medication-free. The last few weeks, I ve been much more sensitive to sound, light and smell. Please advise. Thanks.",
    "doctor_response": "Hello!Thank you for asking on HCM!I carefully read your question and would explain that your symptoms don't seem to be related to MS. Your repeated MRI can confirm this. But, Graves is an autoimmune disease and it is commonly associated to some autoimmune neurological disorders like MS or Myastenia gravis. Neuropathy from thyroid dysfunction can not be excluded either. So, I would recommend performing some other tests: - a nerve conduction study, including repetitive nerve stimulation to investigate for neuropathy or myastenic syndrome- thyroid hormone levels for possible dysfunction which can contribute to this symptomatology. - vitamin D plasma levels for possible deficiency- vitamin B 12 plasma levels for possible deficiency. If all the above tests result normal, you should consider chronic fatigue syndrome as the main cause of these symptoms. Duloxetine would be helpful to treat this disorder (considering also fibromyalgia). Hope you will find this answer helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does dexolac in infants cause side effects like foamy mucus stools?\n\nHi, My baby is 4 months and 19 days old.We are giving the Dexolac-1 for my baby for the past 3 months.For the past few days(approximately 4 to 5 days) ,after taking the dexolac,baby immediately passing the foamy mucus stool..This is happening immediately after,the baby takes the dexolac.Is there any other reason for this? can we provide any other food for our baby.Can you please suggest your ideas on this to prevent this.",
    "doctor_response": "Hai im Dr.SubramanianWelcome to HCMFormula feeds like dexolac sometimes can cause such problems.Breast milk is the best milk for the babyExclusive breast feeding is required for 6 months.All these side effects will not cause  any problem to your baby, it will settle in few days once your baby adapts it.No treatment is required.If it persists switch over to Nan 1.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does fatty liver take to get cured?\n\nHello Dr I have mild pain in lower left abdomen and After that I had an ultrasound. Now the report says its Fatty liver (Grade-1) I have taken food precautions like having less carbohydrates like Rice and white flour and trying to have more fruit juice and chappati Please advice me how soon will I be able to reverse my fatty liver and what other precautions should I take. Thank you !!",
    "doctor_response": "Hi, There are two main types of fatty liver disease so treatment depends on this: Alcoholic liver disease and Nonalcoholic fatty liver disease. You can get alcoholic liver disease from drinking lots of alcohol. It can even show up after a short period of heavy drinking, other causes are obesity and hepatitis B and C. If you have alcoholic liver disease and you are a heavy drinker, quitting is the most important thing you can do. Talk to your doctor about how to get help. If you don't stop you could get complications like alcoholic hepatitis or cirrhosis. Even if you have nonalcoholic fatty liver disease, it can help to avoid drinking. If you are overweight or obese, do what you can to gradually lose weight -- no more than 1 or 2 pounds a week. Eat a balanced and healthy diet and get regular exercise. Limit high-carb foods such as bread, grits, rice, potatoes, and corn. And cut down on drinks with lots of sugar like sports drinks and juice. This should lead to improvement. You should repeat your liver markers in 3-4 weeks. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ivan R. Rommstein, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can constipation with pain and unusual stools be treated?\n\nMy 3 yr old son is constantly constipated and for 3 days he has been having very minor stools come out in his underwear which are a tree green colour. When he tries to pass more he just cries in pain. I have tried parachoc before with his constipation which has worked but it says not to use it too often. Previously he didn t have the green stools. Any known cause?",
    "doctor_response": "Hi...what you are quoting is exactly called encopresis. This occurs when the kid has hard stools, almost similar to constipation. But what happens here is the liquid stools will seep out on the sides of the hard stools and leak out. But, the main treatment of this is relieving of constipation.Suggestions:1. 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 Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Regards - Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does spine injury cause memory loss?\n\nMy mother is 74 years old and was very healthy until she was recently diagnosed with a herniated disc caused by a fall. Since then she is extremely fragile, she can t do regular activities such as getting up off a chair or getting out of the car without help. During the last week, we have noticed her memory is also affected. Forgetting to turn off the oven, not knowing where an item came from, and even thanking my father for running the vacuum (which he had not). She has an appointment with a neurosurgeon at the end of August. Just wondering if this memory loss could be caused by her spine issue. Thanks",
    "doctor_response": "hello; thanks for the query. Simple answer NO. Spine injuries will not cause memory issues. But given her age 70+ years; these may easily be senility related memory issues or onset of a process known as dementia. You might have suddenly started noticing it as she has recently suffered a fall & hence you are taking her health issues more seriously than before; whereas there is a possibility that there might be very subtle signs of memory difficulties over last 6 months to 1 year which might have gone unnoticed. Your description of her problems seems more likely to be due to dementia (probably Alzeihmer's dementia). Hence get her evaluated by a Psychiatrist/Neurologist & start appropriate treatment. Hope this helps. Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pneumonia cause itching in upper torso?\n\nMy daughter is 11 years old she has has pneumonia she has been sick since January 3rd symptoms keep changing. she is up at night itching all over her upper torso, head, and ears. She has major headache and abdominal pain.. she is very upset and crying because this is going on way to long and she has seen many doctors with no relief any suggestions. Tried most itching products what could be causing the head pain and stomach pain. they check her today for appendicitis",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. According to the history it might be a viral situation or an allergy.  Don't worry so much she is under medical control. Regards Dr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the upper back while on blood pressure medication?\n\nI have High Blood Pressure been taking medications. I have upper back Pain and right side of my rib only feel when I take real deep breaths or bend over. I am a lil over weight but I have just kicked salt to the curb and eating right. But still back is tight when i walk for a while or stop to bend down. I am 46 years old.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.Hi with this clinical picture there are two possibilities.1. Cervical disc pain 2. Fibro fasciitis. I suggest you start pain killers and neck muscle strengthening exercises.Physiotherapy would also help. Also please get an X Ray neck to see the condition of cervical spine.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes slight numbness and tingling on the right side of head in the temporal lobe vicinity?\n\nI have noticed in the past two days I have slight numbness and tingling on the right side of my head in the temporal lobe vacinity! This is including my ear and some of the right side of my face. I dont know what this is and how it would have come about?? Can you tell me what it might be??",
    "doctor_response": "Hi, Numbness and tingling suggest involvement of trigeminal nerve. You need a detailed neurological examination followed by MRI of brain to identify the cause. In the meanwhile, you can use pregabalin capsules for symptomatic relief. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sudhir Kumar, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could redness in gums and sores on lips be due to stomach infection?\n\nhi my daughter is 17 mos and ben to the doctors 4 times they keep giving me different things that are wrong with her shes ben sick for 3 weeks now she had fever stuff up nose and cough now shes getting over those but now i see in her mouth that her gums are red and sores on her lips the doc thinks that its a stomach infection but what can i do?",
    "doctor_response": "there are various reasons for redness in gums and soreness,,, e.g. tooth bite while chewing, vit. B complex/ vit. C  deficiency, local infection etc. initially u should maintain oral hygine regularly and take vitamine B complex/ vit. C tablets for 5 to 6 days,,,,,, if still problem persist u should consult ENT surgon for that,,,,,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is that i got small circular in my tongue at tip and bottom?\n\ni have this small circular in my togue at the tip and bottom,it doesnt hurt but made me sick of thinking what it is,the first i saw its just 3 circular red like the tip of a match but not that big now they become more,and noticed that i had it also on the other side of my togue,pls give me an advise",
    "doctor_response": "thanks for your query, i have gone through your query. the the small circular area could be a depapillated tongue or benign migratory glossitis or an ulcer. consult your oral physician to rule out these two. if i am your treating doctor i would have suggested symptomatic treatment like topical anesthetics and analgesics with multivitamins. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need treatment for dizziness with loss of appetite\n\nI am getting dizzy when I lay down and get up it all started yesterday I got up on a chair to change a lightbulb looked up and had to get down because I got dizzy the room was spinning this has never happened to me and now I made supper to and really don t have much of an appetite I ate but wasn t really hungry",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern, the history that you gave here is suggestive of some uneven movement and that might have compressed the cervical nerve which is maintaining the balance and irritation of this never greatly cause the dizziness just lie down for few hours this would get corrected soon, hope this information helps you, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for headaches, nausea and floaters\n\nI am worried about my daughters blood pressure. I took it with my home blood pressure monitor and the readings were as follows over two days. 165/100, 143/106, 150/106, 164/108, 186/107, 163/109, 162/110. She tells me that she has also had these symptoms over the last two weeks. Headache, nausea, vision changes (floaters), shortness of breath and chest pain. Please advise a very worried father.",
    "doctor_response": "Hello. I just read through your question. Based on the numbers you report, your daughter has hypertension. The accompanying symptoms are very concerning. It is important that she be seen by her doctor as soon as possible so that her hypertension can be treated and the remaining symptoms resolved.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest alternate treatment for tooth abscess\n\ni have a tooth abscess and have been taking pennicilian 500mg 4 times a day for a week now and the abscess is not much better, I have taken alot of pennicilian and amoxicillian in my life and they just dont work well anymore.  i had a nose bleed last night and feel pressure in my head when i lay down. the tooth is an upper tooth. i can not get to the dentist until august 9 will i be ok or should i go to the hospital?",
    "doctor_response": "Hello, Thank you for consulting with HCM.When there is an abscess in the tooth, you have to go for root canal treatment of the tooth, as the pain will not be relieved till abscess is drained.Antibiotics and analgesics are not the proper treatment and even you have continued for antibiotics more than a week, then it will be better to visit a good dentist before 9th of august.Till then you just start with a dispersible paracetamol.Hope it will  help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Histroy of hepatitis B cured. Moderate beer drinking safe?\n\nhello Doctor,weight: 75kgs. Height: 5.8. Had jaundice (Hepatitis B) one and half years back. After treatment doctor said that I was completely cured. Now, in the recent 3 months I have attended 3 parties in which i took beers (2 at each party). But regularly I am taking fresh juices without ice and less sugar and drinking lots of water. No oily stuffs too. Regular gym guy too. My question is, I have one more important party ahead and can I have 2 beers for that? After that I will quit boozing completely. I am serious. Please answer Doctor.",
    "doctor_response": "Hi and welcome to HCM, This is not something serious and this is almost negligible amount of alcohol. This shouldnt cause any problems. YOu can take those 2 beers of course but not more. ALso, you can have 1-2 beers per week . I suggest to do liver enymes frequently every 6months to evaluate is there liver damage. If your findings are normal you can drink reasonably. WIsh you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Regular masturbation. Penis muscles have lost erection. Can I heal this?\n\nHi, am 24 yrs i have usually doing Masturbation since 8 yrs ago and now i feel like my penis muscles are lost erection and i cant help it or stop it though i have a girlfriend but still i cant stop doing it, so concerning my erection is there ways to bring it normal quality like i used to be because am so worry right now",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have been indulged in masturbation since 8 years  and now facing problems related to sexual activities.First of all there is myth in a mind of common man that excessive masturbation is the reason of all sexual problems But I would like to state that it has been discussed in scientific forums all over the world and proved scientifically that masturbation does not have any negative effect on any organ or system in the body.All the problems that you are facing now are mind related and due to anxiety.Following measure will help you to boost up your confidence and getting good erection.and delay ejaculation.1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning.2) Take high protein diet rich in vegetables and fruits and Vitamin A,C,D,E.and Zinc3)Take anti oxidants like Almonds 5-6 everyday..4) Avoid alcohol and smoking.Try to reduce the frequency of masturbation.Dr.Patil..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the meaning of INFECTIOUS DISEASE SPECIALIST ?\n\nWhat is the meaning of INFECTIOUS DISEASE SPECIALIST? where we can find this specialist?",
    "doctor_response": "hi infectious disease specialist means doctor who is expert in infectious disease which are spread from one person to other. after MD doctor has done specialization in it. they can find only in big city. contact ur family doctor ,he will guide u",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe back pain?\n\ngynecologistHi, doctor I am 29 years old female weighing around 70+ kgs with height of 5.3 inch. i have 2 children both from operations. elder one is 4 years n younger one 3.6 months old. from the past few days I m suffering from excessive white discharge which has resulted into excessive back pain. Since the delivery, swelling from the body still remains on the parts like face, legs, hands etc.  After the delivery of my second child, it was the first time i had my periods which were this week only. Since the birth of my first child I am getting obese also as i m putting my weight on day by day. My periods have also become irregular.Kindly suggest me as the problem is getting worse due to which I am not able to do my regular household job",
    "doctor_response": "Hi,From history it seems that you might be having some infection in your genital tract.From other symptoms there is some doubt about thyroid problem as well.Go for thyroid function tests and blood sugar as well.Consult your Gynaec and get examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Malignant nodes in carotid sheaths from metastatic cancer. Have Horner's syndrome. Burning in the eyes. Damaged vagus nerve?\n\nI still have malignant nodes in carodit sheaths from mestatic thy roid cancer . Last surgery was radical neck disectomy resulting in horner s syndrome to right eye 9 months ago. Now my eyes are both burning so much I can hardly keep them open more than 6 hours a day, worse on right eye. I ve been afraid to mention this burning symptom for fear my doc will stop refilling my Butrans pain patch refill and not procede with planned steroid pain injections in neck. I am in a loooottt of pain and don t want docs to think my symptoms are from pain meds. Would it more likely be that this burning is from further damage to vegus nerve and active malignancy?",
    "doctor_response": "Hi, We should think about other ophthalmologic cause first. There is a chance of keratitis or acute conjunctivitis also. you should visit an ophthalmologist's office. Anyway other medication has no relation to your eye condition. There doses will not be reduced for the present problem, so feel free to ask your doctor about your condition.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes anxiety attacks having high blood pressure?\n\ni m 33yr. male. having blood presure. I feel very tense always last 2 month. i hv a fear that i hv heart disease. i fear to go doctor. i also fear to check my blood presure. when i go to doctor my BP grow high. plesase give me advise and a diet chart. i live in bangladesh",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  High blood pressure is always associated with anxiety and stress. Anxiety disorder should be treated by professional psychologist / psychotherapist. Also you are talking about the BP obsession. That is also normal. Don;t worry about it. Understand the BP and remove the misconceptions about it. Go to doctor when you are supposed to check your BP. Do not try to escape. If you just do it the right way, within a short span of time, your obsession will be cleared. Never run away. To treat your anxiety, you should consult a psychologist.  Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for ditz syndrome?\n\ni'm female 23 years ...i have  chest pain besid sternum whith upper back pain.and arm pain ...the doctor told me it's ditz syndrom without invistigation he gave me steriod  and ms relaxent pells five dayz ago...but the pain still exsistant and i feel that the heart it's lump .....what should i do .????Please help me",
    "doctor_response": "without investigation it is difficult to stamp dietz syndorme. I would not agree to continue treatment for undiagnosed problem. better you get first investigated. get EKG, chest X ray done, if required go for mammography too to rule out any lump in breast. once diagnosed you start treatment as per the doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it true that viral infections during early pregnancy causes autism?\n\nHi doctor, My wife is seven weeks pregnant (about three weeks from fertilization, we think, because she has long cycles) and came down with shingles almost 2 weeks ago (and a cold about a week ago). She has been taking Acyclovir and the pain has reduced but is still present. We are worried about the effect on the baby, particularly because we have read viral infections in early pregnancy can lead to Autism. Do you have any advice about how serious the risks are?",
    "doctor_response": "Hi. Shingles is herpes zoster, which is the reactivation of the chicken-pox virus in the body due to an immunocompromised status like pregnancy. But thankfully, the effects are not disastrous for the unborn baby as your wife already has antibodies against the virus in her body to combat transmission. If she had disseminated widespread shingles, there could be theoretical chances of viremia and fetus being affected. She is already taking Acyclovir, so viremia is not possible anymore. Do not worry, be happy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diabetic on insulin, has back pain, MRI showed diffuse posterior disc osteophyte complex. Is fusion surgery necessary?\n\nMy dad has been suffering from back pain since last 1 year. we went in for an MRI scan before 6 mths and result shows Diffuse posterior disc osteophyte complex at C4-C5,C5-C6 & C6-C7 levels with ligamentum flavum hypertrophy causing narrowing of spinal canal without significant nerve root/cord compression. Ligamentum flavum thickening ia seen at D10-D11 & D11-D12 levels without significant cord copression. Now he is suffering from severe unbareble pain. He can not walk without walker. He is 72 years old with diabetes (at the age of 40) controlled with insulin ( last15 years). My question is does he need fusion surgeory ? or there is other alternative treatment? He is taking pain killers and went for physiotherapy also. what is the risk factor for this surgeory?",
    "doctor_response": "Thanks for the query. Back pain may be due to disc degeneration. Where is the location? Also its important to know the level of the painful disc. You can not go on fusing the spine without knowing the exact pain source. Also he is long standing diabetic and it can cause this pain. Initially try to control pain  with medicine  (Antiinflammatory, muscle relaxants and if required pregabalin) and physiotherapy modalities such as IFT, manual therapy. I doubt about the need for the fusion surgery. I would suggest to get him examined by a spine specialist. Also sometimes if we can pinpoint the pain generator then we can give him local injection blocks. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does lump in the liver in CT scan indicate?\n\nWas at the gastroenterologist yesterday and by chance a CT scan showed a lump in my liver. I was not expecting this, as that was not what I was being treated for. It is 1/2 AND HE SAID TO WAIT 3 MONTHS AND WE WOULD DO ANOTHER SCAN to see if it grows. Should I be worried and see another doctor?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Accidental lump in the liver is common. You may some benign cyst or hemangioma. Wait for a month. GO for ultrasound and if size is increasing then you should go for ultrasound guided liver biopsy to search the cause of lump. Then you should take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of asthma?\n\nHi, I am mildly athsmatic, I have been waking up multiple times in the night coughing up fluid and having to clear my sinuses. Last night the average was about three times an hour every hour for the first six hours of sleep. I usually eat late due to my job and have thought the problem to be reflux, but it is primarily clear fluid I bring up. Sometimes it is jellied in texture. I fear that it could be a sysmtom of Congestive Heart Failure. I have not been disgnosed with this, I have only been looking online for possible causes, and CHF keeps popping up. I'll call my Doc Monday, but as for now I'm scared. Any thoughts on any other conditions it could be. I have had pneumonia in the past. I do have hypertention. I am considerably overweight. I drive for a living, 12-16hr days. Have had swelling in my calves. Have been battling fatiuge for years.   Thanks, Matt",
    "doctor_response": "HI, thanks for using healthcare magicCCF is a possible cause of coughing but not one of the more common causes. In addition, to progress to coughing at night (which means fluid is building up in the lungs), it is likely that you would have other indicators of heart failure.There would also be a history of risk factors that put you are risk of developing heart failure.The most common causes of persistent coughing: (1) post nasal drip (2) asthma (3) refluxWith the discharge you are seeing , post nasal drip is possible and more likely than heart failure unless you have risk factors.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful baltod?\n\nI am frequently suffering from baltod since after marriage. Once I recovered from the first one the second one occur. It has been more than 12 Baltod within 3 month. Its really paininful. Although I am using Antibiotic and Pain Killing medicine advise by doctor. But my query why this is constantly happening.",
    "doctor_response": "HelloAs far as known to in this area \"BALTOD \" is known as frunculosis or ingrown hairs infection, causes may be :1 Diabetes ( not necessary in young persons ), in spite of this get in blood sugar examination for confirmation.2 Streptococcal infection i.e. resistant infection.3 Unhygienic care ,some times I have noted that due to improper skin care there develop infection the hairs root .So take bath with anti bacterial soap .Get in blood examination for culture and drug sensitivity test for proper antibiotics.Also get in stool examination  as sometimes worm infection also produces recurrent baltod.So consult a dermatologist and get his opinion.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sugar level increased, sleep disorders, depression, degenerative arthritis. On pain medication, metformin. Side effects?\n\nI was on insulin for over 5 years until the end of Jan. I ran out, doctor had no samples. so i didnt take any sugar medicine.  my sugar meter apears to run 50 to 60 points low according to my A1c last week.  they say my reading was 7.2 and told me to start on glyburid-metformin 1.25-250 mg. i really hate going on the medicine. i have fibromalgia. rls. sleep disorder depression. dengenertive arthuristics and cant spell worth a flip. i even stopped taking pain medicine regular for the arthuristic and fibro.  lots of meds are bad. side effects are usally worst than the health issue. we r on a limited bugdet and I no longer am able to hold down a job. doctors say what i should eat. but i cant aford the food. what is daily average on sugar if A1c  is 7.2.  thank you very much",
    "doctor_response": "Hi there ~ I understand your concerns and diabetes can be a chronic debilitating disease.  However, I would take your doctor's advice and give it serious thought.  Please take the doctor's suggestions.  Your HbA1C should be less than 7.0 and the lesser it is the better you have had your glucose under control.  It is a long term indicator of diabetes control.  If you have worsening of any of your psychiatric conditions either, fibromyalgia or depression, please see a psychiatrist and get a second opinion on medications.  Also RLS and sleep disorder need attention from a qualified sleep disorder specialist although a psychiatrist can help with these conditions as well.  I hope this helps. Take care and have a lovely day!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for numbness on one side of the body,slurred speech and problems in moving the arms and walking?\n\nI am a 31 year old female. For the past 2 years, I have experienced stroke like symptoms, numbness on one side of my body from my arm down to my leg, slurred speech, difficulty talking, thinking, and understanding words. I had problems moving my arms and walking. I literally had to think and figure out how to do simple tasks such as chewing and moving my limbs. I went to the ER and MRI and CT scans were normal. I did not have a stroke or TIA. Another time I went to the ER they admitted me and did a MRI with contrast and that showed normal as well. I went to a neuro and they prescribed Vitamin D. I went to a cardio and heart looks normal. I also have frequent migraines and have high blood pressure. I just experienced another episode (my 6th one) a few weeks ago. What could this be?",
    "doctor_response": "Hello, Since the MRIs resulted to be normal, a number of serious condition that may cause  your symptoms are excluded. Migraine variants may be an explanation. Multiple sclerosis also should be kept in mind and if your Neurologist doesn't think that your symptoms are linked to migraine, further evaluation (spinal tap for example) is necessary. Hope you found the answer helpful. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high blood pressure after a massive heart attack\n\nhi i had a massive heart attack at 40.and had three stents put in since then.im on heart meds that was nine years ago.my blood as never been up  in that nine years the top number i just check it and its 154 over 84.like i said thats the first time yet .its been like this of and on for three weeks",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Yes, you should definitely control your systolic blood pressure below 140mmHg. For this strict salt restriction in diet is needed. You are taking your cardiac drugs since 8 years. So you may need high dose of some antihypertensive drug or you may need additional antihypertensive drug too. Make sure that you are taking newer beta blocker (metoprolol) because it is having excellent effect in post angioplasty patient. It reduces heart damage and also control blood pressure. So discuss all these with your heart doctor and start treatment accordingly. Avoid stress and tension, if you are having stressful life. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest alternate remedy for relieving tension\n\nHi, I am taking pyroglare and telma 20 for diabetes and hypertension, but i was advised to take stalopam 10mg for reliving me tension, but instead it has worsened and i am getting negative thoughts. Pl advise what to do.My diabetese is 130 to170 and BP is 90 by 130.",
    "doctor_response": "Stalopam (Escitaplopram) takes time to act in your body and give relief to you. Initially it may worsen your thoughts, but after some time you will be back to normal. This may take around 3 weeks. If the negative thoughts are too troublesome, I would suggest Flouxetine as an alternative. You can discuss the above option with your care giver. Hope this helps you. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and light headed due to mosquito bite?\n\nhi i have just come back from a holiday in italy and venice.  I have had quite a few mosquito bites in the last 7 days, and twice i have felt dizzy and light-headed (not sickness) that has lasted for approx 4-6 hours (from waking up til mid-afternoon).  could this be caused by the bites and what should i do? age 38, male, 5ft 10in, weight 14stone, take medication for high blood pressure. many thanks",
    "doctor_response": "HIThanks for posting your query to Healthcaremagic.     I don't think it is due to mosquito bite unless you have fever ( which can be due to mosquito bite ).    There are many causes for Dizziness, from simple and easily treatable causes to serious causes . Simple causes are :1. Abnormalities in BP: Both high and low BP can cause dizziness. 2. Abnormalities in Blood sugars: Both high and low Blood sugars can cause dizziness.3. Abnormalities in blood sodium levels. 4. Low Hemoglobin ( Anemia )5. Inner Ear problems . Some serious problems are :1. Heart Problems2: Brain problem My advise to you is to get your Blood pressure , Eyes and Ear examination done and if they are normal kindly get the following tests and revert back to me .   Hemogobin , Fasting and Postprandial Blood Sugars , Serum Sodium levels, Serum TSH , Serum Vitamin B12 levels checked and an ECG.   Hope you find this information useful . Any clarification feel free to ask",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should i do as my baby is suffering from breathing problem?\n\nHi Doctor,I have a 3mths old baby. Our family doctor gave Muolite Drops for him as he has cold. I gave this 4 drops 3 times a day with Noscoclear (3times a day). but still my baby is suffering from breathing problem. He is not having milk. pls suggest.",
    "doctor_response": "hi Breathing problem with decreased intake of feeds in a small baby may be due to Respiratory tract infection involving lower part(Bronchiolitis) which needs close observation and treatment with Nebulisation+ oxygen.Please take him to a near by child specialist for immediate treatment",
    "dialogue_context": ""
  },
  {
    "patient_message": "On pill. Trying for a baby. Have vaginal leaking after sex. Doctors couldn't find cervix. Why?\n\nI HAVE BEEN OFF THE PILL FOR NEARLY 6 MONTHS AS I AM TRYING FOR A BABY WITH MY BF. WE HAVE SEX ONCE A WEEK AS HE LIVES AN HOUR AWAY. I FIND IT REALLY HARD TO CLIMAX BUT DO EVENTUALLY. I HAVE A LOT OF VAGINAL LEAKING AFTER SEX FOR A COUPLE OF HOURS AND WONDERED IF THIS IS STOPPING ME GETTING PREGNANT. I HAVE BEEN TO THE DOCTOR AND WHEN HE EXAMINED ME HE FOUND IT HARD TO FIND MY CERVIX SO I AM EXTREMELY WORRIED. IS THERE ANYTHING ELSE I CAN DO AS I AM SO DESPERATE.",
    "doctor_response": "hi, white discharge increases during intercourse and some amount of semen can come out of vagina after the act sometimes possibly that you have interpreted as excessive vaginal leak, cervix sometimes may not be visualized in examination due to difficulty in putting speculum or because of position of uterus etc, so if it is anatomically normal no need to worry. you plan intercourse during period of ovulation which will increase the chances of pregnancy. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest possible medication to improve kidney conditions\n\nis there anythind that can be done to improve kidney function?I was taking 5mg glipizide one time a day but now 2.5mg twice a day depending what my blodd glucose reading is.I tend to run between 60 to 110.If the reading is below 110 then I do not take glipizide in the morning and my a1c is 6.3.",
    "doctor_response": "Hi,Thanks for writing in.A HbA1C level of 6.3 is at upper limit of pre diabetes. It shows that your diabetes is under satisfactory control and you are taking medications oral hypoglycemeic agents properly. Kidneys always get affected after some years in diabetes. This cannot be totally avoided but you can delay it by having balanced diet and taking medications regularly. A normal level of blood glucose will help in maintaining the balance. Please get your eyes and kidneys checked regularly. Kidney must be assessed by doing serum creatinine test and urinary proteins. This will guide you through future treatment. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for memory loss\n\nHello doctor, I am very upset just because i forget things fast and cant concentrate, I tries a lot to remember the roads but i forgets the name of the road and the route, I cant remember the words what my boss or my father says. please give me a solution for this i want to get rid of this. Thanks Ankush.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Simple forgetfulness due to busy schedule and ignorance are common with so many people. You should not get alarmed of these. You are unable to remember things because you are not actually involving yourself. So many people forget the name of roads and places. There is nothing to worry.If you want further confirmation, consult a psychologist who shall test you psycho metrically for your remembrance and recollection ability.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can damage to leg due to polio and accident be reversed?\n\nHello dr I have a polio in my right leg from my birth and the length is shorter than my other leg about 1 -1/2 inches , I cannot walk straight , I met with an accident twice on same polio leg n operated with rods inside n remains still in since 22 years. Is there any miracle done from which I can walk straight n my leg become strong.",
    "doctor_response": "central nervous system cells do not heal , so unfortunatly there is no reversing the damage really sorry , Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mood swings, short temper, anxiety, stress, sleeplessness, able to see and hear things not seen and heard by others.  Symptoms of bipolar.  Help\n\nhi  my name I lisa and I would like to tell you some of my problems just for an opion if thats ok I get mood swings one minute im fine the next im  I hear and see things that no one eles does I lose my temper easy  I have really bad nreves I have anxiety im under a lot of stress I cant sleep at night at all I worry a lot. I have every sytptom of bipolar I hear see taste and smell things that others don't so what do u think just by what I said",
    "doctor_response": "Dear Lisa,hearing and seeing things that no other person does when they are with you may be hallucinations and there are number of illness which may lead to such symptoms ranging from psychiatric illness like schizophrenia , depression, drug abuse to organic illness like epilepsy. associated mood swings, anxiety , sleep disturbances may be due to hallucinations or may be associated with an entirely different illness. what you need is a evaluation from Psychiatrist and neuroimaging (MRI brain). if this symptoms are disturbing your daily routine and impairing your social and occupational life you definitely need to take medications.All the bestDr Sanghanayak Meshram",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dust allergy\n\nMy son is allergic to dust. Always hv mucuous secretion. He has to yake anti allergic medicine evernight. Bt still cough replase everytime with minute changes in weather or may be dust or allergens. What should we do? Do eggs creates cough? Pls let us knw.",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your son's history and I think he is having respiratory allergic disorder.I would like to know the age of your son. However, I assume he is pediatric age group.Personally I would suggest him to continue a drug like montelukast regularly. If he has nose symptoms like obstruction, running nose, etc, I would suggest to take levocetirizine and montellukast.If in spite of being on these medications, he has intermittent cough, I would suggest you to consult a Pediatrician at time of his symptoms. A Pediatrician will examine his chest and decide what is the cause of coughing.For identification of allergy causing substance, allergy testing will be useful. Common allergy causing substances are those in our daily environment like house dust mite, molds, pollens, etc.Eggs do not create cough unless he is allergic to them. Hope this will be useful to you.Wish your son the best of the health.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for psoriasis and infertility\n\nhi me and my husband have been trying for a baby for 3 yrs now and cant conceve we did 1s and had a misscarige but nothing since my husband has a skin condishion witch is geting worst do to stress its called phserises and is being put on meds that cut your sperm acount down to low realy low the doc said and we r so up set we cant conceve and realy want r own familey what can we do ?",
    "doctor_response": "Hi,For infertility you must check for testosterone and thyroid imbalance, based on the cause only the treatment can be given. For psoriasis you can use salicylic acid with steroids.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. S. R. Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. 2. 5 year old suffering from stomach ache. Which medicine has to be given?\n\nHi doctor, My son is 2.5 years old. For a week, he is complaining of stomach pain. After farting he is fine. Our family doctor recommended one antibiotic for five days and a medicine to avoid vomiting. He had small vomits twice, but later it was fine. Now, after completing the course of medicine he again complaints the same. His diet is almost nothing and he is not ready to take any food. He just has few mL of milk. He does not have fever. His stool was watery, but it is normal now. Can you provide any recommendation on diet and medicine? Please give me a solution to the problem. Thank you.",
    "doctor_response": "Hi. I can understand your concerns. Complain of abdomen pain with vomiting suggests that your child probably has acute gastroenteritis or food poisoning. Since, antibiotic is already given and now there are no loose stools or vomiting, there is no need to give antibiotic again. For abdomen pain, you can give syrup Cyclopam (Dicyclomine hydrochloride and Paracetamol) 5 mL on SOS basis (as and when required) that is when abdomen pain occurs. Whenever a child becomes sick, there is decrease in his appetite which improves as child recovers. Now, you should give him all the foods that you were giving him earlier. If he is not eating then you can start Glucon-D in water thrice a day for one or two days. Start a multivitamin like syrup Bevon 5 mL once a day for 15 days. Keep patience. Child will eat properly now as he has recovered from illness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Prominent veins in hands, stopped drinking coffee. Never smoked. Reason?\n\nwhat does it mean when veins stick out on my hands? I do have various veins in my left leg and have had an operation in 1993 and they have come back. I a very slim, skinny and petite. I don t drink much water as I don t enjoy drinking water. I have lots of tea. I had stopped drinking coffer for over 5 years. I drink a glass of red with dinner but not every night. I have never smoked. Do any of these things help you answer my question?",
    "doctor_response": "Hello,Prominent veins can be from a High Blood pressure, or a Venous Obstruction in the large veins of the arm / shoulder.You need a Doppler Ultrasound to look for this possible obstruction.Regards,Dr.Saurabh Joshi,MD, FNVIRVascular Interventional Radiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes occasional heart palpitation?\n\nSo for a few years now I've been occasionally experiencing what I found out recently to be heart palputations. I've had an echo done and everything was fine they said. My doctor also said it was due to PMSing, but I experience it all month long, and it worsens with PMSing. Every time I have an \"episode,\" it leaves me exhausted for days, which is terrible because it happens every few days. Basically, I'm tired all the time and I feel my heartbeat, which is irregular, all throughout my body. Nothing I do seems to help slow my heart down, and it gets worse when I try to sleep. I lost some weight when I was 16, and it became rare that I'd have this problem and I wouldn't get tired back then. I recently turned 18 and the episodes have been a lot more frequent and extreme in the past few months. Any ideas?",
    "doctor_response": "Hello,  This can be a cardiac arrhythmia like psvt or atrial fibrillation, in which heart rate suddenly goes up and also suddenly decreases. Blood pressure falls during these episodes and one has dizziness, fainting, blackouts, sometimes syncope. Usually ecg is normal as it is usually done in between the episodes. ECG done during episodes will show abnormality. You will need 24 hour holter monitoring. So visit nearby cardiologist for these investigation.Also, hemoglobin and thyroid test should be done. ln order to abort such episodes you should try to cough hard.Is there any stress or anxiety associated. Till the time your evaluation is complete, you can ask your local doctor for tab ciplar LA 20 mg once a day. If none of the above is successful then last option is of electrophysiological studies which is invasive test which can diagnose and treat the arrhythmia permanently in most of the cases.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Got wisdom teeth, infection. Gave antibiotics. Lump along jaw, swollen cheeks. Are the teeth infected?\n\nso in october I got all four of my wisdom teeth removed and I got an infection from where I hadnt gotten the stitches out soon on the left side of my jaw where a lump formed. My surgeon told me to get a warm wash cloth and push everything out and gave me antibiotics . Well after everything I still had a lump along my jaw. Sn july I was feeling the bump and now.its gotten bigger and hurts for everythinh when before it would just hurt to light pressure. My cheek is a little swollen now and you can see the outline of it. I dont know whether its infected or just swollen . It feels heavy.especially when I wake up from sleeping",
    "doctor_response": "Hello & welcome, As you have undergone extensive procedure of wisdom teeth removal , swelling and infection are the conditions commonly associated with it after the procedure. If there is lump present, that clearly indicates the presence of associated infection & sometimes it might become quiet painful. Visit your dentist who removed your wisdom teeth, get clinical examination thoroughly done to diagnose any remaining suture material in the wound or presence of any type of secondary infection. Antibiotics & Anti-inflammatory drugs are very vital in such condition to arrest the infection from spreading in surrounding tissue. Even, if your dentist finds that the infection is severe, then Antibiotics might be needed to be administered by intra-venous rout for faster results. Don't take these drugs without consulting your dentist as random use of the drugs may worsen the situation. Keep your oral cavity clean as much as possible with proper use of brushing done regularly & with antiseptic mouthwash. Avoid hot fomentation or eating hot food or drinking hot drinks like tea & coffee as heat may aggravate the swelling. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can novasure ablation cause cramps and dizziness?\n\nI had a Novasure ablation two weeks ago and have been feeling awful since.    I have experienced lots of painful cramps and extreme tiredness and dizziness.    I am also suffering from constipation, which is something I do not suffer with and am extremely uncomfortable.",
    "doctor_response": "Hello,It is sometimes possible to have some side effects of CO2 which is filled in the uterus as part of the procedure before integrity is tested. If you have completed shedding of the ablated endometrium, as evidenced by a follow up trans-vaginal sonogram, you should look for any hints of pelvic infection. The tiredness and dizziness are likely to be part of the general weakness caused by the general malnutrition. Yet, it is imperative that you should have a physician visit to look for other possible sources. Constipation can be relieved by increasing the intake of fiber in the diet added by lactulose to facilitate easy passage. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent loose motion\n\nMy grandson is suffering from toothing and has loose motion one doctor has suggested ofm suspension n there is different opinion that it is not to be given my grand is 1year7 month old loose motion is not in control kindly pls advice that the above medicine can be given to him",
    "doctor_response": "Hi...loose motions form toothing come because the kids of this age keep everything in the mouth and this is cause for viral diarrhea.  Stop OFM - it is an antibiotic.It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics like OFM unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can enlarged uterus cause abdominal pain?\n\nHi I have had a scan done about 2 weeks ago.  The findings showed that the Uterus ils enlarged, bulky and heterogeneous.  Within the myometrium, there are a number of areas of altered echogenicity, consistent wth fibroids.  Two in the anterior myometrium measure 2.4 x 2 cm and the other 2 x 1.8cm. They are adjacent tot he endometrium but not extending into the cavity.  There are a number of smaller fibroids also present. I am waiting to see a gyno.  In the meantime I am experiencing a lot of pain in my lower abdomen.  I cannot seem to tolerate long drives as this seems to agravate this pain even more.",
    "doctor_response": "Hi.The multiple fibroids in the uterus as described on a CT scan definitely can cause the pain in abdomen. The other caused coulf have been diagnosed on it. The most proper treatment for such fibroids is hysterectomy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is exercising advisable after suffering a contusion in the hip and sternum?\n\nI am 62 yrs old. I jumped off a 30ft cliff into the ocean in Hawaii. The dr I saw said I had. Contusion on my left hip and also sternum. I am wondering if I shudder be doing exercises for the sternum while it s healing. I am taking ibprophren 3 times a day and muscle relaxer at night only. The trauma happened a week ago today. Going home tonight to Denver on an airplane",
    "doctor_response": "hello....contusions take time to heal...if you continue to exercise ,healing time will prolong..i would suggest you to have some rest for few days and once you get relief then only start exercises..thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring vaginal yeast infection upon having intercourse?\n\nI have a had a recurrent yeast infection lately each time I have been intimate with my husband. I have never had a yeast infection within my 47 years of life so I am very concerned about what is going on. Although we are separated I know that I have not been with anyone else and he says that he has not and I am believing him. So if multiple partners are not the case what else could it be?",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, yeast infection may not be due to coitus it is not the disease of STD but it can be likely with poor hygiene, and with other sources, if the it is being suspected due to intercourse then both the partner have to take the shot of the dose to eradicates the infection, although it is very common in females, hygiene have to be taken great care  hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it advisable to exercise with musculoskeletal pain?\n\nI have musculoskeletal pain in the chest and back brought on by excessive use of caffeine for years. I had gotten better but I had a deep tissue massage which brought by pain I have nt had in months. i want to work out again, is it okay to do so now that the pain iis lessoning?",
    "doctor_response": "It IS ok to start training but make sure to be hydrated and use muscle relaxant and take warm shower after each exercise. Always make sure you have your vitamins.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why has the shape and texture of areola changed and itches from inside?\n\ni found a lump in my left breat a year ago,I had a scan and they said it was just compressed fat cells,and not malignant.I recently noticed that the same breast that it itches inside, under the skin, and the shape and texture of the aureole has changed, and the skin has darkened.Should I be worried?Is this cancer? My sister was diagnosed with breats canbcer when she wa 26, she had 2 lumpectomy s and was on kimo, and has survived.She is 41 now, but i am always worried. Can you advise?",
    "doctor_response": "hi.based from your description, it could possibly be a cyst, a fibroma (fibrous tissue formation) or fibrocystic changes of the breast, which are all benign breast lesions. it is best if you consult with a doctor, preferably a general surgeon, for clinical evaluation. diagnostics such as breast ultrasound and mammography may be recommended. management (medical and/or surgical) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain and swelling in the foot\n\nHi , now I know you cant tell me if its broken but I dropped something in my foot yesterday. Its not swollen and does NOT tingle anymore. Its just tender to touch and my foot will hurt if I walk on it to much Should I go get it looked at right away or just keep putting ice on it for now?",
    "doctor_response": "Dear patient it seems possibility of minor fracture in your foot should be ruled out by xray of involved foot anteroposterior and oblique views. Please get it done from radiology centre nearby you. Start tab zerodol sp twice a day for pain relief. Keep foot elevated. Do ice application. If Xray is abnormal you need to consult expert orthopaedic surgeon nearby you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe toothache with sensitive gum. Feeling pain in the face. Why?\n\nHi. My tooth hurts me really bad on the right side of my face. Its extremely sensitive when I touch it, so do my gums all around the area of that tooth. As well, another tooth seem to be paining me every now and then as well. Im even starting to have my right side of my face in pain and it goes up to my head. I feel like its pretty serious. Only lasted past 2 days. Can you please tell me what it could possibly be? Thank you.",
    "doctor_response": "Hello,Thanks for writing to us.Cause of toothache has to be evaluated clinically.If tooth is decayed,it has to be root canal treated or extracted depending on severity of lesion.Take complete course of antibiotics-analgesics.Get your teeth cleaned.Maintain oral hygiene well.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of injection decaduraboline?\n\ni used 6 injection of decaduraboline in previous year it gives me lot of bad reaction,like,many body parts loose pations and my body dont accept now any power medicine,i cant eat any food which give me strentgh,if i eat it give me bad result,and it going from previous year when i take decaduraboline pls help me",
    "doctor_response": "HiKindly avoid the medication since it has a lot of side effects.It is an anabolic drug which is reserved for use in catobolic states which causes extreme weight loss such as cancer,severe anemia due to renal failure to build muscle.Reduced sperm count,gastro intestinal problems,acne, liver dysfunction,depression,blood clots can occur with the drug.Hence it should not be used without proper indication.Hope I have answered your query. Let me know if I can assist you further. RegardsDr.Saranya Ramadoss, General and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Discomfort and pain, CT scan showed benign cyst in liver. What diet is recommended?\n\nI m 59 years old and had CT Scan recently,and found out that I have a benign cyst of my liver .Had gone for Cholecystectomy 2 yrs. ago. Most of the time I have a discomfort bec. of the pain but they told me that there is no treatment with this problem. I want to know what are the foods I can take? Thanks a lot.",
    "doctor_response": "any kind of food u can take,but not to spicy.benign cyst in the liver is not harmful but they need to be evaluated in a proper way,kindly tell cyst size,if associated with fever or not",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take Acetaminaphen for temperature above 100 degrees?\n\nMy 68 year old husband has a history of kidney stones.  He had a lithotripsy 4 days ago for a kidney stone after having a stent placed for a week prior.  The stone was intially lodged in the ureter but was too high to have a basket retrieval so it was pushed back into the kidney for the later lithotripsy.  He was taken off Plavix and ASA he takes for 2 prior heart attacks. He was taking Hydrocodone every 4 hours for pain.  He also has a hx of prostate cancer successfully treated by proton therapy.  The stent was removed yesterday.  He developed low abdominal discomfort, lethargy, loss of appetite and a low grade temp.  He is voiding without difficulty.  IVP was done today along with a urinalysis, CBC and chem profile but all is normal.  Waiting on urine culture results.  IM Rosefin and PO Ceclor was started today.  He  continues with the low grade temp, now no higher than 100.8 but has no appetite (is drinkining) and falls asleep at the drop of a hat.  He is currently taking Acetaminaphen for the temp above 100, Ceclor 3x/day and Protonix.  MD does not think problem could be a fungal infection.  Just waiting now for urine culture results but my husband is miserable in the meantime.  Any thoughts?",
    "doctor_response": "Hi, It is safe to take acetaminophen if you have a high temperature. It is good that the IVP was already done which basically rules out an obstruction in the kidneys. He may have urinary tract infection in which he is already on antibiotics. I think you just need time for the antibiotics  to work. He needs to drink adequate fluids and rest so that his body can recover. Once the culture is out then we can see what organism is causing the infection and what antibiotics are needed to treat him properly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Manuel C See IV, Urologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain while deep breathing\n\nin september i had pneumothorax it happened while i was sleeping in bed never thought it was serious a few days later i went hospital cause pain would not in away and thought it was my heart cause it was on the left side and it turned out my lung had collapsed and had a chest drain and kept in the next day it was taken out and i was sent home went back 4 weeks later and had a x ray and my lung was up and fine but told if ever get them pains again to come straight back so not last thursday the thursday before i had the same pains i had when my lung first collapsed but not as painfull so went back to a&e and had an x ray and was told everything was fine and my lung was still up even though i still did not feel right the doctor said i was fine so went home and told to take pain killers so i did then saturday just gone got a urgent letter from hospital to attend a&e asap for another x ray so i did and was told that my lung had collapsed again a week earlier and the doctor on duty never seen it so had another x ray and it was still collapsed but not as much as it was a week earlier but was still down so as you can guess i was not happy but they said that it will come up on its own and have been given codine and other pain killers and sent home again cause they said there is nothing they can do and come back in a week i am not happy and still foot feel well at all like i have the flu coming on and still hurts when take deep breaths and can not lie on my side but dont know how bad the pain really is cause had that many pain killers i just want to know if you think its best i go to another hospital for a second opinion i just dont know what to do ?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. * As per my clinical experience, once expanded lung will not give these much intense trouble unless there is infection or other issues. * I recommend to consult in follow up chat with all reports as an   attachment for best possible evaluation. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Took Tylenol for cold and passed out. EKG was done with no specific results. Consult Neurologist?\n\nMy sister was feeling the cold symptoms and took a Tylenol and Nyquil before going to bed. The next morning took another Tylenol, she passed out and the witness reported LOC for about 30 sec\u2019s, twice and sounded like choking while unconscious. She does not remember passing out. She was taken to the ER; an EKG was done and sent home b/c nothing was found. Next morning she started c/o headaches, went to her PCP and dx with Migraines HA, ibuprofen given (she is allergic to aspirin) with some steroid (??)  medication in case she gets a reaction. She is not getting better and I am afraid she could get a bad reaction to the ibuprofen. It looks to me that she had some kind of seizure. This is the second time it happened after having her baby. What should I tell her to do? My feelings tell me she needs to be seen by a neurologist, any recommendations, please.",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum. In my opinion tylenol is not responsible for her fits ( passed out). Two reasons may be ,1 due to anemia , if any . 2 Epileptic seizures , so for this you will have to consult a neurologist and get E E G  and take his opinion & treatment. One more reason may  be due to cold as I have seen so many patient develops drowsiness due to cold . Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with PTSD. Taking lexapro and diazepam. How can I stop medication?\n\nI have diagnosed PTSD, my meds were changed 2 weeks ago to Lexapro and diazapam when needed,I haven t been able to get back to the doc to check in as I know I was supposed too because of floods in my neck of the woods. Along with the med change I m being \u00ebncouraged to start seeing the psychologist again as I haven t been to see him for nearly 3 years. I didn t want to start taking meds again or seeing the psych doc, now the meds are making me feel all over the place. I feel that all the good work I did a few years back to get on top of the PTSD has been for nothing, I m back where I started from...is that normal with PTSD? Seems like one step forward and a whole heap back.",
    "doctor_response": "Hi there ~ I am sorry that you are feeling this way.  I understand that you have been having problems with depression along with post traumatic stress and the floods in the neck of your woods are not helping any.  I am sure you are having a tough time at this time of the year.  I would highly suggest that you go back on the lexapro and the diazepam if you still have enough supply.  I think that this is going to help you out a lot and make life easier for you as it had been for a long time.  You should start feeling better instantaneously.  I hope this helps and you start seeing a psychiatrist as soon as you can. Take care and have a lovely day !",
    "dialogue_context": ""
  },
  {
    "patient_message": "Not having regular sex, no discharge, dont feels like having baby. Is this anxiety problem or weakness?\n\nHi I am a girl age 22 , I am married from 1 year my husband s age is 33 , since we got married my husband is doing sex with a gap of 1 week or 2 sometimes 1 month, I want to ask why my husband is behaving like this? is there any psychological problem with him or what? while performing sex when he going to get discharge he suddenly pull out, i does not get satisfaction, is he weak or anxiety problem?  He also dnt want baby right now, I am really depressed, plz guide me",
    "doctor_response": "Hello,Normally couples married for one year have intercourse 2-3 times a week. But having less frequency does not point out towards any specific disorder especially when it is not associated with any problem with sexual performance (Erectile Dysfunction/ Premature Ejaculation) or other depressive/anxiety features (decreased interest in pleasurable activities/sadness of mood, hopelessness, death wishes).Its a possibility that he may be stressed out and not yet ready for kids therefore not going for intercourse. You need to talk to him and be open about your desires of sexual gratification so as you two can sort this out to resume your healthy sexual life. You may have to let him see the woman in you so as he should be attracted to you sexually more frequently.The reason for his lack of sexual desire if persists despite that may be depression, low testosterone (male sex hormone) levels, or other medical conditions such as diabetes or thyroid problem which decreases the libido.Since the reason for your depression is lack of sexual gratification by your husband, that is the treatment for you. If your depression persists, see a psychiatrist and get couple counseling.Hope the answer is helpful. Take care and feel free to ask queries.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How many times should we have intercourse to conceive ?\n\nDear Doctor , I want to ask that how much we should do sex with our partner in a week and how to do effective sex to get my partner pregnant? Thanks in advance.",
    "doctor_response": "If you are trying to concieve then the optimum time would be between day 11-16 of the menstrual cycle.Provided that your partner has normal,regular menses.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment should I go for fatty liver?\n\nI was just told by the nurse that my ct scan shows a fatty liver. I can't get appt for 4 more weeks. I look 8 monthes prego in pain.  Chest tight. Calfs hurt so bad. I am so tired I can't keep eyes open. Feel like I want to throw up 24 / 7What should I do?",
    "doctor_response": "for fatty liver , avoid foods high in fat. If you have too much fat in your liver, it can definitely affects its function. the way you're feeling now may be related to your pregnancy but if it persists, please go to nearest ER",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is there any medical risk from using a secondhand car seat?\n\nHello doctor,My daughter who is 15 months old now had a used car seat up to age 1. My sister gave me the car seat and it was used by her 6 year old daughter when she was a baby. When I went to buy a car seat recently, I realized that the newer models of the car seat I had used were much softer and more padded than the one I had used which was a bit worn from use and quite hard. I am worried that the hard car seat could have caused harm to my baby either now or in the future. Could it have harmed her cells? Is this medically possible? I have postnatal anxiety and my main worry is the hard car seat and regret that I did not buy a new one.",
    "doctor_response": "Hello. In my opinion, it may not have caused any harm, as far as your daughter is walking well, no gait issue, and no complains of pain over hip joints. Kids cells have higher regeneration power compared to adults. Theoretically, one can take a biopsy of a particular site and see under the microscope for any change, but in my opinion, it will be useless, and practically does not add value to the outcome. I will suggest, focus on involving her in a safe sports activity where hip mobility can be ensured. Do not blame yourself. You and your sister did it in good faith. The baby will be alright. I would be happy to hear after six months on how she is doing. I wish her great health. For more information consult a paediatrician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have shortness of breath for about a week with no relief on herbal syrup. Is this Covid-19?\n\nHello doctor, I am a 23-year-old female. I am 70 kg, 5'3\" feet. I am currently experiencing shortness of breath, it started a week ago and never went away even though I am taking lagundi or herbal cough medicine 500 mg three times a day after meal. I also feel like I have a lot of phlegm that I cannot release. It just feels heavy on my right chest that passes through my back. I am having paranoia on having COVID-19, but I am afraid to get checked because I might actually get it from the hospital. Please help.",
    "doctor_response": "Hello. I understand your concern. I do not think it is Covid-19 as you do not have a fever. But you need an antibiotic I believe, it may just be pneumonia. Are you taking any antipyretic drug because you need to know if you have a fever. For Covid-19 you should have a fever, cough, and difficulty in breathing.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Intermittent high fever, chills, headaches after appendicitis surgery. Worrisome?\n\nrecently did an appendicitis surgery, about 5 days after surgery started having on an off fevers and headaches(coming an going) this kept on for 3days, on third night the fever was really high to a point when i was having chills an started shaking a lil...............is this a major problem and if it is how soon do i have to check it out",
    "doctor_response": "Hello! After any abdominal surgery there is a risk of intra abdomen abscess. Also your wound is not healed after so recent surgery. That is why an ultrasound of abdomen and of a front abdomen wall is necessary. Some blood test should be performed as well. Hope this will help",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is Curam prescribed while treating tooth decay?\n\nWhat is curam 1g?I want to take a medicine for pain last day march 3 I go to hospital to see my teeth we have some tooth decay and i decide pick one of my teeth..after finish we dont have give any medicine what i take..4 days I've got pain ..what is the best medicine take..?",
    "doctor_response": "Hi..Thanks for the queryCuram 1 GM is an antibiotic combination containing Amoxicillin 875mg and Clavulanate Potassium 125 mg..It is given post extraction of teeth to prevent Infection or to reduce Infection in dental Infections and other conditions..It is not a pain reliever..If you have pain after extraction that has increased gradually can be due to Infection or Dry Socket formation, so first of all a clinical examination is a must to rule out the cause of pain..For temporary relief you can take painkillers like Ibuprofen or Naproxen and if pain is severe Ketorolac can be taken but as painkillers are prescription medications so first of all consult an Emergency room for prescription..Hope this helps .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Urge to urinate, distended abdomen. Had surgery to remove kidney stones. Taking stool softeners. Normal?\n\nI just had surgery to remove stones from both of my kidneys and also had stents placed in both of them. I am urinating but I feel like I am not going as much as I should. My abdomen is also extremely distended. I have been taking stool softeners 3x daily. Is this normal and is there anything I can do to relieve the swelling?",
    "doctor_response": "you may be having urinary tract infection which is common with ureteric stents in place.get a urine culture and sensitivity done and take a course of appropriate antibiotic as suggested by culture report.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am i not getting erection daily?\n\ni have hpertension 150/90 , obeysity and  ed  problem  and  i  am using asprinim,prazopress,atorvastatin,esam2.5 enance d  an viagra 50mg.  my probelm is i am not getting  erection in morning and day time without using viagra last 15 years and   i am 47 years old and my weight 140kg.  what shall i do to get  erection daily.",
    "doctor_response": "HiGreetings Main reason is obesity.You can consult a bariatric surgeon and discuss about weight reduction surgery.That will help you in controlling hypertension and improving sex power.Hope my answer helps you. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Worried for lower back pain, abdominal discomfort and heaviness in legs\n\nHi I recently start to have lower back pain accompanied with the feeling of heavy legs and discomfort in lower abdomin, should I be worried? I am 42, female, 5'6, 125 pounds and no metical history but my office job dictates that I sit down for long time when at work.",
    "doctor_response": "Welcome to HCM,I had gone through the case and found that it might be the symptoms of sedentary life style.So do the exercise ,walk and take proper healthy diet.Also go for Vitamin D3 test and take Calcium daily for a month.If D3 deficient then take vitamin d3 once a week with milk.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will rabies vaccination have effect if delayed?\n\nI am due to have my third rabies vacination today but the surgury has just phoned to cancel the appointment saying the will phone on monday.  today is 21 days after the first injection i am worried the vacination will not work if given late. I am 27 and 5 foot 10",
    "doctor_response": "Helloi appreciate your concernyou need to take your scheduled vaccine please don't delay itonce it delayed it will affect the antibody titeryou can postpone surgery if it's not indicated immediatelyPlease upload me a complete.medical history to guide you betterwaiting for your responseregards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes warm forehead and fever in a baby during teething?\n\nhello sir,i have 10 months baby. she had upper respiratory tract. she took medicine for 10 days. now she is alright. but her forehead is always being worm. body temperature up down all the time. it is 100 f. when we told this to our doctor. he prescribed to cbc test for her. we think this is her teething period also. what should i do?",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..As per your complain mild fever can occur during teething that is generally due to the tendency of the toddler to take anything in mouth to bite on as they have itchy and sore gums and needs to gratify themselves..It leads to infections and can cause mild fever..But in case if the fever is persistent then it is not due to teething bit some other causes and as your baby already had upper respiratory tract infection, it is indicating towards viral infection and not just teething..Getting a CBC done will help in ruling out the exact cause of fever and can be treated accordingly..As of now you can give her Acetaminophen in syrup form to reduce fever..Also get him clean and sterilised teething rings if she urges to bite on and  do not let her put anything else in her mouth not even her fingers.. Hope this helps..Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had an abortion. Tried IUI. Tubes normal. ICSI procedure?\n\nhi doctor.. am shwetha.. am married since 5yrs.. i had an abortion 3yrs back in 5 month of my pregnancy, due to placenta low.. and now am suffering from pcod problem.. i had tried IUI 2 times but it was not successful.. and my both tubes are normal.. am ovulating every month with matured egg.. mu husband sperm count is also normal.. my gynac tods us everything is normal.. but still its not working.. gynac has prescribed oosure tablet and next month she wants to do another IUI.. before that i want to know your suggestion and guidance.. or we can directly go for icsi procedure.. am confused.. and can u please let me know what are the chances of pregnancy..",
    "doctor_response": "hello thank you for writing to HCM I understand your anxiety after you have had a miscarriage In about 25% of the cases everything will be normal Please try a couple of more IUI, as you have got pregnant earlier If not successful then you can go ahead with higher treatment modalities All the best Dr Nandita Thakkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have some sort of sac protruding from my anus. It looks purple and it has bimps on it.\n\nHi, i am seventeen and i have some sort of sac protruding from my anus it developed about a week ago and it itches and is sensitive to touch. It looks purple and it has bimps on it.",
    "doctor_response": "iam 26 yrs i\u00a0 used masturbain since 10 yrs righ\u00a0 now i can not\u00a0 ejacuakte\u00a0 and my penn is soft\u00a0\u00a0 even has no movment\u00a0 iam in difficult time what to do is there some thing broken",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. 2. 5 year old suffering from stomach ache. Which medicine has to be given?\n\nHi doctor, My son is 2.5 years old. For a week, he is complaining of stomach pain. After farting he is fine. Our family doctor recommended one antibiotic for five days and a medicine to avoid vomiting. He had small vomits twice, but later it was fine. Now, after completing the course of medicine he again complaints the same. His diet is almost nothing and he is not ready to take any food. He just has few mL of milk. He does not have fever. His stool was watery, but it is normal now. Can you provide any recommendation on diet and medicine? Please give me a solution to the problem. Thank you.",
    "doctor_response": "Hi. I can understand your concerns. Complain of abdomen pain with vomiting suggests that your child probably has acute gastroenteritis or food poisoning. Since, antibiotic is already given and now there are no loose stools or vomiting, there is no need to give antibiotic again. For abdomen pain, you can give syrup Cyclopam (Dicyclomine hydrochloride and Paracetamol) 5 mL on SOS basis (as and when required) that is when abdomen pain occurs. Whenever a child becomes sick, there is decrease in his appetite which improves as child recovers. Now, you should give him all the foods that you were giving him earlier. If he is not eating then you can start Glucon-D in water thrice a day for one or two days. Start a multivitamin like syrup Bevon 5 mL once a day for 15 days. Keep patience. Child will eat properly now as he has recovered from illness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I consume marijuana and I am 22 weeks preganent. How long will it stay in my system?\n\nHello doctor,I am 22 weeks pregnant. Due date is after three months. I smoked marijuana for the first few months to help with severe morning sickness. I stopped smoking probably last month. I went to a gynecologist this month, and they took a urine sample in which they tested for drugs and marijuana was the only one I tested positive for.After two weeks of my appointment, I smoked once to help with a bout of morning sickness and have not since then. And I have planned not to do ever again during my pregnancy. My next appointment is after one week. Will I be threatened with CPS because of my positive urine from last time? And will they test my urine at my next visit? I am only 18, and I am very nervous. I am concerned because before I got pregnant, I smoked marijuana every day since I was 15. How long will it stay in my system? How can I safely detox it from my body?",
    "doctor_response": "Hello. My advice to you that please stop taking marijuana, if you love your baby, then please stop it right now, because it affects your baby growth. And why you want your baby to suffer because of you, so please stop it and the other thing there is no safe antidote of marijuana. So better is to stop it, and yes, marijuana remains in your body system for up to three weeks. Please take medicine regularly and do USG (ultrasound) regularly and please for your child please stop to take marijuana.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe lower back pain radiating towards the legs?\n\nSuddenly this morning I got really excruciating lower right back pain. I was standing in the kitchen and it came on suddenly. It s the lower right side. It does not go down in the my legs it s just isolated to my back. I have no nausea or no blood in my urine. Any idea on what it could be?",
    "doctor_response": "Hello! Welcome to HealthcareMagic! Lower back pain may cause by right lumber disc prolapse which compresses the nerve. but exact other causes are diagnosed by physical examination or by MRI. Common causes of lower backache and leg pain is a lumbar ruptured disc or herniated disc. Symptoms of a herniated disc may include dull or sharp pain, muscle spasm or cramping, sciatica, and leg weakness or loss of leg function. Sneezing, coughing, or bending usually intensify the pain.Rarely bowel or bladder control is lost, and if this occurs, seek medical attention at once.Sciatica is a symptom frequently associated with a lumbar herniated disc. Pressure on one or several nerves that contribute to the sciatic nerve can cause pain, burning, tingling, and numbness that extends from the buttock into the leg and sometimes into the foot. Usually one side (left or right) is affected. Take care Regards, Dr. Akhilesh Kumar, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for 6 mm stone in the right kidney\n\nhello sir my wife having 6mm stone on the right side. she already got operated in few months back, should this stone remove through medicine or again we need to go for surgery. at present my wife not having pain on regularly basis. in a week or two week she suffered some minor pain. pls advice what should i do ? Thanks Parveen Chandra",
    "doctor_response": "HelloYour wife's findings suggests small calculus in right kidney.Treatment of renal calculus depend upon many things like composition,position,size of calculus etc.Small calculus may pass spontaneously with adequate hydration.Drink lot of water and initially she may need syrup like sodium and potassium citrate.She may also need routine hemogram,random blood sugar,urine RE/ME.Since size of calculus is small in your wife's case,it is likely to be flushed out with hydration and sodium,potassium citrate syrup.She may need need further treatment like lithotripsy etc if findings and symptoms persists.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a cure for Asperger syndrome?\n\nOur grandson has passengers and now thinks he is a girl in a boy's body is there any cure?",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.It seems that along with the aspergers disorder your grandson is also having gender identity disorder. Both these illnesses are not treatable with drugs. They need intensive psychotherapy and the treatment duration is also very long.You need to have patience and show your grandson to a psychologist who is trained in psychotherapies. 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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a pull in back result in stiffness of hips and legs?\n\nRecently I pulled my back, now when I walk my hips and back of my legs start to tighten, and the bottom of my feet start to tingle. I cant walk very much without this occurring, and once I sit for a little while it all seems to go away. what is going on?",
    "doctor_response": "Hello dearThanks for your query at hcm.Pain that is running from back to legs with tingling sensation might be because of the compression on sciatic nerve producing pain called sciatica .My recommendation would be get physically examined by orthopedic surgeon for further investigation and  management .MRI scan would help you to come to diagnosis.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of recovery from induced coma?\n\nA 70ish year old female friend had a heart attack; she was put in an induced coma at the hospital and was cooled down. Since they have re-warmed her, three days ago, she is catatonic...no talking, no movement, but eyes open. What are her chances for recovery?",
    "doctor_response": "Chances of recovery depends on cause of brain insult and extent of insult.  At present patient is in akinetic mutism and will progress to vegetative state. However we should not give up hope as miracles does happen. Continue supportive care. And if possible share detail records and imaging findings to comment better.Hope my advice will help you.  Take care. Don't forget to rate me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Delayed speech and movement after passing out. Is this serious neurological problem?\n\nhello im looking to find a nero doctor for my dad who is currently in rehab. He passed out on Nov.5 and was found the next day problem is he has been delayed ever since need to know what to do next because the doctors says he didn t have a stroke but he seems delayed with his speech and movements",
    "doctor_response": "Hi,Thank you for posting your query.It is unfortunate that your father has a neurological problem, without clear cut diagnosis and he is not getting better. An MRI scan of brain would confirm whether or not he had a stroke.Other possibilities to be considered are lack of oxygen supply to brain, effect of electrolyte imbalance, or drugs or toxins on the brain.I would be pleased to help you further in terms of diagnosis and treatment.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a throbbing pain on the right side of the hip\n\nsince march of this year I have had a pain / discomfort on my right hip. throbbing even during resting or sleeping. cant sit indian style hurts bad when I do. if I am sitting for too long I fee it the worst. the pain is only on the right hip and it has been more worst on some days than others.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have throbbing pain on the right side of the hip  . Well there can be many reasons for symptoms you mention in query like rheumatoid arthritis , bursitis , hip labral tear , inguinal hernia , sprains and strains , tendinitis or herniated disk . I would suggest you to avoid Indian style , apply warm compresses to side of hip , take ibuprofen or acetaminophen for pain and do gentle massage on side of the hip . Consult orthopedic surgeon for proper examination . Doctor will examine physically by checking the hip movement , order CT scan . Doctor may prescribe muscle relaxant , anti inflammatory along with vitamin supplement for quick healing . In seever cases doctor may recommend hip replacement surgery . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it serious if having chest tightness, sudden chills, pain in left shoulder, heart racing?\n\nI feel a quick tightening in the middle of my chest and now I got a \"chilly\" feeling through my body, My chest stings, it does not \"hurt\" just stings, my left shoulder aches. I feel cold from head to toe. Now my heart beats quicker for like 2-3 beats and returns to normal. I have a history of anxiety, depression, I am type 2 diabetes. My total cholesterol is 102. I am 5 ft 6 inches tall 324 pounds, and I smoke approx 8-10 cigarettes a day. I am on Metformin, gemfibrizol, and rantadine, along with a birth control pill because I have disfunctional uterine bleeding. Should I visit the er?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Yes, you should definitely visit emergency room and rule out heart diseases. You have following risk factors for heart diseases. 1.  Smoking 2. Diabetes 3. Obesity 4. Birth control pills. And your symptoms are more in favour of heart diseases like hypertension, arrhythmia, coronary artery disease. So immediately consult emergency department and get done blood pressure monitoring, ecg, 2d echo and coronary angiography if required. Strict control of diabetes and weight reduction are needed. And quit smoking as soon as possible. Don't wait at home, rule out heart diseases because without treatment these can be life threatening. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in upper abdomen when moving or breathing deeply?\n\nI am having significant pain in my upper abdominal area, just below my left rib cage when I move or breath deeply. It started about twenty hours ago. Could it be a kidney stone. I have had two other stones within the last five years. The pain is at a level 8 out of 10. Where can I go on line to get info for free.",
    "doctor_response": "Hi.Here is the chance for you to take an opinion. The classical pain you have described may be due to a lung or a pleura problem.This is because you are having pain on moving and taking deep breaths and is on a higher scale,.I would advise- X-ray of the chest and ultrasonography of the abdomen. The pain is not likely to be due to kidney stones unless the kidney is infected also.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in abdomen\n\nHave a gradual pain in center of abdomin for fours weeks. Pain in back and now three days ago testicular pain. Stool sample normal but told that all blood work points to gallstones. Pain in abdomin is a level 8 this evening. I am 38 years old 220 lbs and 5 11. What could this be and what can I ask of my PCP to get some answers and relief?",
    "doctor_response": "Hi.Thanks for your query and an elucidate history. The reason of the pain in the center of the abdomen and the back can be related to the Gastric Ulcer / Cancer or pancreatitis.Pain in the testicle may be unrelated to the pain in abdomen and may be due to orchitis or so. No blood tests are suggestive of gall stones. Ask PCP the following:Get an ultrasonography.Upper GI Endoscopy and Colonoscopy,Blood: Liver function tests, amylase, lipase, CT scan to confirm the diagnosis. The treatment will depend upon the diagnosis, hence getting a right diagnosis is of utmost importance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes knee problems to a gymnast?\n\nHi I am a full time gymnast! I train 14 hours a week for the past few weeks my knee has been bothering me. Not as much while doing activity more of after any type of running of pounding for example I had practice yesterday morning and I can now barley walk. What could be the problem",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. Its possible that you could be undergoing knee fatigue and your rest periods between activities are long enough so your body is not recovering in time. Usually during activity, blood flow to active muscles and adrenaline happens, but during rest all that goes away and since your muscles and joints never recovered it exhibits signs of fatigue. I would recommend taking full day of rest and resuming to see if that helps. Also proper nutrition goes a long way. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Samuel Parmar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cough during asthma\n\nI have mild asthma. Have had a irritated barky cough since July. Got started on atrovent, dulera, singular, , and atrovent for emergencies. After two rounds of abx for sinus infection which exacerbated my symptoms I am still coughing!!! I have a small amount of secretions when I cough which taste yucky and metallic. My bronchi are so irritated I am short of breath and the only thing which slows down my cough is Thessalonians perles and cough drops. What else should I do?",
    "doctor_response": "Hi and thanks for the query,t might be difficult to dissociate the management of cough during an asthmatic crises from the management of asthma itself. It might be important to note that the cough only arises as a reflex due to the underlying mechanisms involved in asthma. Proper management of asthma will lead to decrease and fading out of the cough. It might be important however to exclude complications like infections to take care of them appropriately. Kind regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take volume pills?\n\nHi I recently married but I am still masterbates 3-4 times everyday, becuase of this may be I cannot make my wife pregnent? by the I am not with my wife now I will go home after 2 months only. she want to have a baby. so i taking some volume pills I don't know wether is safe or not ? but now I am having back pain",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. If you would have come to me then i would have advised you to reduce the frequency of your masturbation rather the using volume pill. Your body keeps on producing sperms on daily basis but we have only limited space to store the sperms and if you masturbate 3 or 4 times a day a time will come when you will be having dry ejaculate since all the sperms are released and then it will take at least 20-4 hours to replete the deposits. I would recommend you to reduce the frequency of masturbation to get your wife pregnant. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stiffness in neck and respiratory infection?\n\nI have had a stiff neck for about 2 weeks now. Just neck. No shoulders. Recently been fighting a respiratory infection and sinus issues about 1 month No other real symptoms. No fever, headache, eye pain. No change in pillows or mattress. Primarily pain when I attempt to look left or right. Minimal pain when head moved downward. No pain when head moved back",
    "doctor_response": "thanks for asking your questionI completely understand your issue it seems like you have spasm in neck muscles . you need to take some muscle relaxants and pain killer like etoricoxib after consulting your physician.for cough and sinusitis u need to take some antibiotics like cefexime and some antihistaminics like monteleukast and fexofenadine after consulting a pulmonologist .he can give you the prescription for the above mentioned medicinesthanks / regardsfeel free to ask more questions may god bless you with good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dark spots all over the body\n\nHi my name is Priyanka I am 24 years old..I had skin disease when i was 15 years old. It left me with dark spots all over my body..it also left with me discoloration and, pigmentations on my neck, chest,and arms.I have been to many dermatologists and used multiple creams such as: Betnovate,Melalite and Vitamin C capsule.However, the spots remain pretty much the same.Can any one help me please?",
    "doctor_response": "Hello,Thank you for posting on HCMThe condition you have described is called Pityriasis versicolor, a superficial skin infection caused by a fungus.I would recommend you take short course of oral antifungal drug like fluconazole as advised by your dermatologist.Apply ketoconazole cream twice a day over the white patches regularly.Use shampoo containing ketoconazole and selenium sulfite for rinsing daily.Maintain hygiene.Hope you will get fine soonThank youDr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is continuous intake of soya food healthy for children?\n\ni have given Nusobee soya powder to my child from one year onwards, (she is now 2 years old) based on the advice given by Pediatrician and avoiding cow milk totally. i heard that continuous intake of soya will not be good for children especially girl baby because some problem may arise related to fertility. whether it is good for health in fertiity point of view also in future. i want to know about in detail regarding the intake of soya powder.",
    "doctor_response": "Soya milk is not really milk. It is cereal. At this age you need not depend on soya milk, rather put her on Normal family diet. you may substitute milk with Curd & see the response. Soya does have components that increase Estrogens, ie female hormones in body.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful loose tooth in a child?\n\nHi, My 9 year old daughter has a very loose tooth. When we went to take it out, she states it s very painful. It looks like a piece of the gum is inside the tooth. Is this normal? Her teeth normally come out very easily but this one has been giving her a hard time and I m worried.",
    "doctor_response": "Hi.... this is not normal I suggest that you take her to a dental surgeon.Please do not attempt to take it out by yourself.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this semen analysis report indicate?\n\nQuery- Hi doctor, I am 25 yrs old, my weight is 65 kg and height is 5 feet 6 inches. I recently got married. My semen analysis report is following: sperm count- 64 million/cumm, motile-40%, sluggish-20%, non motile-40%, volume-1.5 ml, reaction- alkaline, colour- M. White, RBC-NIL, normal-70%, abnormal-30% Is this report normal? ASSIST me soon.",
    "doctor_response": "Hi, Your report is almost normal except for motility. You can repeat the test after 2 months again. Meanwhile, get a direct check up with urologist to rule out any infection or varicocele. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. B. Radhakrishnan. Nair, OBGYN",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can ovarian cyst spread to kidneys?\n\ncan a ovarian cyst spread to the kidneys Female 30, 5'9\" 110 lbs. I just had my left side ovary and tubes taken out due to cysts so there is nothing on left side anymore. But I am still having pain on that side. Could he cyst before being removed cause cysts on other organs such as my kidneys?",
    "doctor_response": "Hello,Cysts in the ovary are generally isolated and they donor spread to other organs like kidneys. It is however possible for a cyst to recur after removal in the ovary itself if it was preserved.However, as your ovary has been removed and assuming that the biopsy report was benign the chances of recurrence are very minimal.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Karthik Rajan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes HCG present after second dose of hepatitis B?\n\nI got the second dose of Hepatitis B and the same time a pregnancy test.  The pregnancy test showed HCG present. Am very doubtful that the results are correct.  Could there be any relationship in the two that could make one get HCG detected? 34 years old, 85 Kgs no family history of illness",
    "doctor_response": "Hello! Thanks for putting your query in HCM. I am a Gastroenterologist. No there is no relation at all between HCV levels and Hepatitis B vaccineI hope I have answered your query and this will help you . Wish you a good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness in the middle of the chest?\n\nim a 16 years old girl and i am 5 ft. tall and i weigh 115 pounds. the middle of my chest has been hurting for about 2 weeks. whenever i sneeze or breath or stretch or anything random, it feels really tight or sharp? i dont really know how to explain it.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Since your chest pain is associated with specific movement (sneezing) and position (stretching), possibility of musculoskeletal pain is more. So follow these steps for better symptomatic relief in musculoskeletal pain. 1. Avoid movements causing pain. 2. Avoid bad postures in sleep. 3. Apply warm water pad on affected areas. 4. Take painkiller like ibuprofen. 5. Apply warm water pad on affected areas. Don't worry, you will be alright with all these in 1 week. If not improving after 1 week then consult doctor. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bruise on shin\n\nHi, I got hit with a softball in the shin about a week and a half ago and the area is still very bruised and hurts to walk and touch. Do you think this is something I should get checked out? It started to feel better but then the pain came back and is numb in the area",
    "doctor_response": "Thanks for contacting HCM with your medical questions.I am sorry to hear that you have a bruise on your shin. These bruises can be alarming as they cause pain and large deformity on the leg. These bruises though are completely harmless. The bruise will take several days to be absorbed but will resolve within 2 weeks. I can reassure you that you have nothing to be concerned about and this will go away.I hope this answers your question. Please contact HCM again with any of your health care concerns",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tongue to swell at night?\n\nOver the last few months my husbands tongue swells up during the night and is huge in the morning. It can take all day to go back to normal. I am sure it's not an allergic reaction to any thing as he has eaten nothing different. He has always snored. I am concerned as he had a cancer spot taken off his face just under the eye about 3 years ago and was wondering if he has more cancer. Can you help please? I'm sorry. I have no money to pay you.",
    "doctor_response": "although its unlikely to be cancer, but i would like you to get a pet scan done to be fully assured.wish u a good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling sensation in the chest?\n\nHi , for a few years now I constantly now and then have a weird tightning sensation which seems to be feeling like its on my heart as if someone was squeezing and tighning it , It does feel like it's more to the left side of my chest and I understand the heart is directly in the middle of your chest , but I can honestly say it feels as if it is the heart , I am getting worried as it seems to be getting worse , I try to go to my gp but all I ever get told is it cannot be my heart etc ..... What do you think this sensation could be ?",
    "doctor_response": "thanks for asking your queryI completely understand your problemthis tightening sensation can be due to a variety of cause in which gastritis/peptic ulcer is common cause in young age and that can be dealt by taking some proton pum inhibitors like pantoprazole ,if u are worrying too much u can have a echo cardiography (ecg) done and consult a cardiologist which would be the best option and that will end your worries.thanks may god bless you with good healthif you have more questions feel free to ask",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes increase in blood pressure when taking cardace?\n\nI am a patient having blood presure .My Dr prescribed me to take cardace 7.5 mg perday. I have been taking this since 2005 October starting 2.5mg and gardually it raise until 7.5 now.I want to know is it side effect cause of this drug. kindly reply me",
    "doctor_response": "Hi, Thanks for your question. I want to know --  Your age and gender. -  Any associated conditions like diabetes, heart disease. -  Current Blood pressure levels. Tab Candace contains ramipril. It not only used for high blood pressure but it also has beneficial effects on heart and Kidney. - It prevent or slows the process of cardiac remodeling (Effect of blood pressure on heart structure). - It prevent or slows the process of nephropathy. (effect of blood pressure and diabetes on kidney). Side effects of ramipril - - Usually ramipril is well tolerated. - As you are taking it for almost 10 years without any side effects, there are less chance of developing side effects now. - It is recommended to monitor Serum potassium level when on ramipril. So it will be better to discuss regarding increase in dose with your treating physician whether it is because uncontrolled  blood pressure or for protection of heart and Kidney. Hope this helps you, if so do vote.",
    "dialogue_context": ""
  },
  {
    "patient_message": "In stressful situations, what is the average heart rate?\n\nIn stressful situations, what is the average heart rate.  I had to do an activity where I put myself in a stressful situation (rush hour traffic) and my heart rate fluctuated a lot, is this normal?  It began at 92, peaked at 141 after 27 minutes, and then reached 116 at 51 minutues.",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!I understand your concern, and would like to explain that your heart rate seems to be perfectly normal for physical exercise. You should know that during physical exercise the levels of catecholamines (adrenaline and noradrenaline) raise in your blood, leading to tachycardia and even ectopic heart beats. These levels fluctuate during physical exercise (the balance between the production and metabolisation) , leading to modifications of the heart rate. But in your it seems to be everything within the normal limits. So there is nothing to worry about. Hope to have been helpful!Best wishes, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in buttocks and leg\n\nI have had an MRI of my back and have an L5 disc bulge that is causing alot of nerve pain in my buttocks and leg.  I coach basketball, and it even hurts when I shoot or blow the whistle too hard.  I've had a steroid shot and it didn't help much.  What other options do I have?",
    "doctor_response": "Hi, you can go ahead with transforaminal block, decompression discectomy, nucleolysis, piriformis block, per cutaneius laser discectomy. All these options are available with the pain specialists. So consult one in your region.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for itching and burning in genital and thigh area\n\nI have been experiencing itching burning crawling sensation on my genitals and thighs mainly. Slight itchiness continues underneath towards the anus. There is no recognizable rash no blisters or sores. The bottom of the scrotum is slightly red and at one point felt raw and looked slightly scaly. I have been tested for std 3 weeks after last encounter all showed negative. I have been using a jock itch cream for a few days which seems to be slightly decreasing the discomfort. The open air also seems to help with the itching/burning. Any idea what this could be?",
    "doctor_response": "HIThanks for posting your query to Healthcaremagic.      Most likely you are having a fungal Infection and because of scratching an addition bacterial infection over the fungal infection might have happened.    Most of the Jock Itch cream contains Anti-fungal medications , so kindly let me know the name of it . Otherwise ask your doctor to prescribe you a combination of Antifungal medication+ Antibiotic cream and a steroid cream . Use this for around 2 weeks and everything will get cleared .    Also keep that area as dry as possible . Hope you find this information useful.Any clarifications or Queries feel free to ask. Happy to help you. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to improve sperm count and motility\n\ndear doctor,my husband 33 took a semen analysis test and has 3 million total sperm count and 100% immortile sperm. i'm not sure if the sperm cells are dead or just can swim. is there any treatment to increas sperm count and mortility? if not, is IVF possible with such results.",
    "doctor_response": "Hi, Based on the cause only, the treatment can be given. test for varicocele, thyroid imbalance and testosterone levels. regular exercise, balanced diet and yoga can help you.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood pressure to increase during sleep?\n\nI have a friend 80yrs of age, about 5' 10, 146 lbs.  He has torus palatinus and believes that it causes elevated blood pressure during sleep.  He can get no definitive answers from his gp or an ent.  Any  help on this would be appreciated.  He awakes to find his blood pressure 190/105.  He takes medication.",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!Regarding your concern, I would explain that sometimes high blood pressure values during the night may indicate uncontrolled high blood pressure. An optimization of antihypertensive therapy is needed in such cases. But, I would also recommend excluding some other disorders (like sleeping apnea), which can lead to this symptomatology. So, I would recommend performing some tests: - a chest X ray study and respiratory function tests- a blood gas analysis- a multiple sleep latency test or polysomnography to investigate for sleep apnea. You should discuss with him on the above issues. Hope you will find this answer helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a stinging pain in the inside of foot?\n\nI was standing in line today and I moved and a stinging pain hit the inside side of my right foot. At first I was convinced that there was something stuck in my flipflop or I had been stung by a bee. There is no mark and no swelling or external sign that anything happened. It s been a few hours and I can still feel it slightly, but noticeably more when I step on it. Any ideas?",
    "doctor_response": "Hello, As a first line management you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist better to consult an orthopedician and get evaluated. In severe cases steroid injection to the sole might be required. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for chronic pain after shingles?\n\nI have postherpetic neuralgia--I had shingles for about 2 weeks in August 2013...and since then have been suffering unbelievable pain 24/7 with no let up...pain clinics are nt pain clinics, they ask questions and don't know what the hell they are doing....have you dealt with this post shingles chronic pain...I am 84 years old....",
    "doctor_response": "Hello dear,Welcome to healthcaremagic.I have read your query and understood your concern.Postherpetic neuralgia is really a bothersome condition usually found in old aged people.Various drugs are available for the pain relief and treatment of this condition like combination of methylcobalamin with gabapentin/ pregabalin, amitriptyline etc.Topical medications like lignocaine , capsacin also provide relief to some extent.You may discuss it with your doctor. I hope he/she will agree with my opinion.If you have further query, you may ask me.Stay healthy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest diet chart for an infant of 7 months\n\nmy baby is 7 months old.he eats 3 scoops of cerelac thrice a day & three times bottle feeding.I would like to know how much quantity of furit or veg should be mixed in 3 scoops of cerelac & can i give him four scoops of cerelac.What more solid food can be given to a 7 month baby.",
    "doctor_response": "Hello, At this age you can start giving Cerelac stage one rice or Nestum rice stage 1 etc. All are same in calories and energy. Only thing is palatability which is subjective for each kid. Other home-made food options will be - 1. Daal and rice well cooked and made into a porridge along with ghee2. Boiled apple or banana and mashed into a paste.3. Any made cereal porridge preparation with additional ghee added.Remember certain principles like -1. Add one food material / cereal or fruit per week. This will be useful because if he develops vomiting or diarrhoea, we will know what to avoid.2. Add vegetables and fruits made into a paste surely to avoid constipation.3. Do not add too much sugar as it may cause diarrhea. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this semen analysis report indicate?\n\nHi, I and my wife looking for a baby and I would like to ask you about my semen result . Is it good to have a pregnancy? Appearance : normal Volume : 1.5 pH : 8 Viscosity : normal Sperm count/ml : 234,000,000 Total sperm count/ejaculate : 351,000,000 Motility: 50% Progressive : 35% Non progressive : 15% Immotile : 50% Spermatogenic cells : 4-6 RBCS : 1-3 Agglutination: ( ++) Normal forms : 25% Abnormal heads : 50% Abnormal midpieces : 20% Abnormal pieces : 5%",
    "doctor_response": "hiwell i have gone through your case and i will be happy to help you outover all the semen analysis report is good you can proceed for pregnancythanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for red/black patch removal on teeth in pan masala chewers\n\nI am a pan masala (read Rajnigandha but not Gutkha) chewer . My teeth(s) have got red patches from back though not in front and have formed a sort of layer at the back side. There is as such no problem like pain etc but i am getting worried now on how to clear the back of teeth and getting rid of those red patches. Brushes normally cant clear out those areas. Can you suggest me some techniques or any equipment which can help me clean out those patches? or visit to a doctor needed?",
    "doctor_response": "HiWith your query, they are nothing but stains caused by pan masala you can get it treated by thorough scaling and follow the instructions given by the dentist with proper brushing technique.I SINCERELY RECOMMEND PAN CHEWING IS INJURIOUS TO HEALTH WHICH MAY RESULT IN CAUSING CANCER AND OTHER DANGEROUS ORAL DISEASES.Hope thus clarifies your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes growling of stomach in a child?\n\nMy 4 year old has been experiencing a lot of bubbling in her stomach for a few days now. I can hear it and her stools are normally bubbly, liquidy. I ve seen the color change from yellow to green. However her appetite has picked up and she is sleeping normally again. Should I be concern?",
    "doctor_response": "Hello,I think you do not have to worry about it. Sometimes the increased fiber intake or diet change does this.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Olgeta Xhufka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for large bruise on left shin\n\nHi, I had my 2nd skiing lesson on Sunday evening. I fell over a few times and when I had finished and got in the car to drive home my left shin was very sore, I looked at it and there was a reddish lump which has now developed into a large bruise. I am tending to bruise easily at the moment and they ache. I had varicose vein removal surgery last year. Should I worry about this?",
    "doctor_response": "Hello, Bruises or contusion aren't that uncommon. This type of usually minor injury happens when tiny blood vessels called capillaries are broken due to the fall. I suggest using cold compresses for local applications. I also suggest using anti-inflammatory medications such as Acetaminophen to relieve the pain. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hearing loss\n\nhi my son aged about 9 1/2 years has got hearing loss in his right ear for the past few years.Doctors have conducted an audiometry test and put at moderately severe mixed Hg loss(rt side) and Mild conductive Hg.loss at Lt.side. please inform which doctor I have to consult",
    "doctor_response": "Hello, I have gone through your question and I understand your concerns but please send his reports to be able to help your further. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of the lump on the forehead after a headache?\n\nI have had a headache for the past couple days , not severe. Today I noticed a small raised lump to the left of my forehead measuring about 1.5cm in diameter. I feel fine right now just wondering us this something I should be concerned about. The lump is not tender, no warmth to it.",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query. The lump on your head might not be related to the head ache. If I were your doctor, after a clinical examination of yours, I might advise you for a fine needle aspiration cytology to have a diagnosis. Further management would depend on the report.I would also measure your blood pressure to rule this out as a reason for your headache.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I feel excessive gas formation and numbness of head. Is it a psychiatric issue?\n\nHello doctor, I have been hospitalized for excessive gas and the doctor ran a liver profile which came out normal. So, the doctor diagnosed that my excessive gas formation was due to anxiety and they prescribed Xet CR, Etizola, Clonafit, and Rabekind. I have used Etizolam for three weeks and stopped. I used Xet CR for the last six to eight weeks and Clonafit for the last two weeks. However, I still have episodes where I feel my head going numb in the back of the head. I got an X-ray and it said I have mild spondylosis. Because of the pain, I have developed a repulsion to sleeping as well and now I am completely tired during work. My doctor asked me to consult a psychiatrist. So, looking for help here.",
    "doctor_response": "Hello. A lot of individuals with anxiety present with symptoms of epigastric discomfort. This could present as symptoms of excessive gas formation. It is usually accompanied with symptoms like rapid heart rate, sweating, trembling of hands or body, sense of fear, feeling as if the throat is choking, etc. The cervical X-ray (attachment removed to protect patient identity) is almost normal. Mild spondylosis is seen in a lot of individuals and this usually causes slight pain in the neck. This is not the cause of the symptoms you are having. Feeling of heaviness in the neck and numbness in head is most likely part of anxiety. If there is any associated stress, then that further confirms anxiety. You have been given Paroxetine (Xet), Clonazepam and Etizolam. These are anti-anxiety drugs and help control the anxiety. If even with Xet CR your symptoms are persisting, then you can talk with your doctor to increase the dose. If you are on 12.5 mg dose then the dose can be increased to 25 mg per day. For reducing the heaviness in head, drugs like Propranolol can be used. Propranolol 10 to 20 mg in morning can help to control the symptoms and will reduce the numbness of head as well as anxiety. For more information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain, spasms, fatty liver, posterior cyst. Done CT scan . What treatment is recommended?\n\nI am a 59 year old female. I started having sudden pain all across my abdomen last Wednesday the pain was worse on my right side that felt like spams, went to my Dr . on Friday he ordered blood work and a abdominal ultrasound on Monday. The results from ultrasound showed I have fatty liver infiltration and a Anechoic posterior cyst measuring 3.8x2.9x5 cm all other organs and ducts showed normal. My Doctor is having me follow up with a CT scan to confirm findings. My question is this........is this considered a very large cyst and also there is no involvement with the ducts why am I having the pain and what will be the most likely treatment? Thank you so much for your information and time.   Marian B",
    "doctor_response": "Hi Mariam,Thanks for writing in.I am particularly unable to comprehend the anechoic posterior cyst mentioned by you. By anechoic, it is taken as a fluid filled cyst. By measurements, 3.8x2.9x5 cm is not a big cyst but not small enough and may be the cause of your pain.A CT scan would be of much more help to characterise the cyst and offer you accurate treatment options.The fatty liver is not a serious finding and needs to be correlated with liver function tests.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red face, abdominal pain and headache in a child?\n\nA few hours ago I noticed my 13 yr old daughter had a very red face- the only parts of her face not affected was an area around the eyes, mouth, and under her nose. Some of the redness has faded, but she complains of feeling hot, abdominal pain, and headache. She does not have a fever. What could be wrong with her?",
    "doctor_response": "Hello, The symptoms seem to be related to a viral infection. I suggest giving her Tylenol for the pain. I also suggest giving liquids and rest. I suggest using Calamine lotion for local application in the red area. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in the chest and upper part of the stomach\n\nHi there, I am having an issue with my stomach.. I often feel pain on left side of my chest, upper side of stomach or sometime in my left arm.. Sometime Pain comes out when I breath out or sometime when I breath in, and some time I it parish when I lay down on bed on my left side. Some times it continues irritating me and I fall in different type of thoughts, and got depressed. This normaly happens after taking meal Or sometimes when I have empty stomach. I also have some medical tests like Hpyilory, LFT, Euric Acid and chest X-ray.. Test shows every thing is good. ECG is also good, then where is there problem ? Please give me suggestion and guide me, thanx",
    "doctor_response": "Thanks for your question on HCM. I can understand your problem and situation. By your history and description, possibility of GERD (gastroesophageal reflux disease) is more. It is due to laxity of gastroesophageal sphincter. Because of this, the acid of the stomach tends to come up in the esophagus and cause the symptoms like central chest pain, upper stomach pain etc. So avoid stress and tension. Avoid hot and spicy food. Avoid large meals, instead take frequent small meals. Start Proton pump inhibitors. Go for walk after meals. Avoid alcohol and smoking if you have this habits. You will be improve by these lifestyle modifications. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to remove an earring that has a crooked back screw?\n\nMy 7 month old daughter's earring backs are crooked. How do I remove the earring or twist the backings so they are no longer crooked? She is not in pain but eventually they need to be removed. She is current on all her immunizations and had her ears pierced professionally 4 months ago in the mall.",
    "doctor_response": "Hi,It seems that earring is got stacked or covering ear patch by the skin behind.Consult your doctor, he will remove ear ring with forcep and will do dressing.Do not try to remove by yourself as it might damage ear lobe or develop infection.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest natural medicines to avoid hairloss\n\nHello Doctor, I am 28 years old suffering from hairloss please let me know the natural way ( food intake) to promote hair loss. currently i am taking dr.batras treatment. Pls let me know the foods i need to consume. currently i am eating 2 teaspoons of fenugreek seeds daily.",
    "doctor_response": "Hello,I understand your concern as hair loss can directly effect our looks.1. Hair loss can be genetic or due to other reasons like dietary deficiency, stress, etc.2. At home u can do a few things to help prevent hair loss n have better hair.A. As in diet make sure u eat good protein diet like egg, fish, chicken. If vegetarian u can have various lentils / days.B. Include flax seed in your diet . 1 tsp daily. Can b had as it is or mixed with food after powdering it or roasting it.      U can also mix the powdered flax seed with water n drink it, preferably empty stomach.C. U can have amla/ gooseberry daily in any form like raw / preserved with salt, turmeric n water/ amla juice.D. Try substituting brown rice instead of white polished rice. It might b little difficult but slowly try adapting the taste.    The husk of rice is removed when polished which contains lot if vitamin b, which improves hair density.E. Have a cup of green tea daily. It has antioxidants , which helps to stay young n in turn makes hair healthy. 3. Other than that u can apply few things on hair which promotes hair growth. A. Methi seeds soaked n crushed to paste.B. Amla n shikakai pasteC. Burnt shell of coconut powdered in mixed with oil n applyD. Hibiscus flower pastethese pastes should b applied n left on hair for an hour or more. Then washed properly with mild sulfate free shampoo preferably. Hope this helps.Please feel free to ask any queries.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Continuous periods after coming off depo injection.   Trying to conceive.  Any chances of pregnancy?\n\nI came off the depo injection at the end of November 2013, ever since I've had constant periods all over the place, like most weeks, for 5-7days. I was wondering if there's actually any chance I could get pregnant ? As I really want a baby an that's the reson for coming off the depo injection, me and my partner have been trying every weekend as he works away and so far it's been no good :/ please someone help me find out?",
    "doctor_response": "Hi,   Thanks for writing to us.   The fertility obtained immediately after stopping depot injection.    The bleeding may be a side effect of withdrawal symptoms of depot injection.    You can consult a gynaecologist for your problem.    Good luck.    Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of potential hernia?\n\nMy sister baby male is 2 months and a few weeks old. belly button is pushing out like an outie. Poop is a little watery. the family is sick. Yellow color. she is no longer breast feeding for 2 weeks now. baby is on Enfamil newborn. She can not take the baby till Monday to the doctor to see if this is a hernia. Any thoughts?",
    "doctor_response": "Thanks for the query.You have not given cause for not feeding.It is although preferable to completely breast feed the child till six months of age.Hernia of belly button is a very common condition and usually does not cause any problem.It gets resolved on its own by two years of age. As abdominal muscles grow.For lose motions check if utensils used for feeding are clean and sterile, which is a source of intestinal infection.If child is taking feeds, sleeping properly, passing urine and motion well then you need not worry.If lose motions are too watery and frequent then it is advisable to visit doctor ASAP.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need Information of treatments for cancer\n\nHi. What is the process of detoxification of the body in a cancer patient after Chemo / Radiology?",
    "doctor_response": "Meet:  Ty Bollinger at  His advice in his book on the above website helped me overcome colon cancer grade  3. Cancer is a world which has not been fully reseached yet. Cancer affects the body the mind and spirit, all three need attention when dealing with cancer. From the date of me being told I had grade 3 colon cancer (during an operation to remove my painful appendix) to the date of the latest MRI, six months later, my doctor read the MRI report to me. YOU ARE CLEAN, so sign of metastases in your body, from head to toe!  I refused Chemo having read Ty's book.  Order the book, should you so wish, email Ty, he helped me in my darkest hour.  Suffering cancer entails deep emotions and getting through one's darkest hour is not easy. The problem with most cases is that the first sign of being afflicted with cancer takes place too late when tumours have already formed with damage. Early detection is a key element and keeping ones immunse system strong by a healthy vegetarian diet, lots of fruit and veggies, etc. and reducing stress, goes a long way to retaining one's health. Egon Kramer email:  koisan12@aol.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can tightness in ribs occur due to hcg diet?\n\ni have been on the hcg diet for 5 days and i am experiencing tightness in my upper rib cage to where it is uncomfortable to take deep breaths, do you think it can be related to the diet? it almost feels like an air bubble but i tool alka seltzer with no relief.",
    "doctor_response": "Hello,Since you are on a hCG diet and are now experiencing discomfort, it can be due to it. Side effects include restlessness, fatigue, depression, irritability, etc. Stop hCG diet for a while and switch on to normal diet. But keep your treating doctor informed.Other causes of chest tightness can be angina, acid reflux, asthma, etc. You are suggested to get clinically examined by a GP. You will have to get blood and imaging tests done. Take PPI's for relief. You can take acetaminophen, one SOS when pain. Your treatment will depend on the pathology detected and the clinical condition.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Nupur K., General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with amyloidosis involving renal, consistent swelling in legs. Will Cat's claw be helpful in curing it?\n\nHi, My father is suffering from Amyloidosis with renal involvement. His legs will be swollen everytime. Have consulted with few doctors but its not yet identified if its Primary or Secondary type. Which test will make that clear ? He has already gone through Bone Marrow and Kidney biopsy. Some where on internet it was suggested that Cat s Claw help in reducing the Amyloid, how true is that ? Can he take it in his day to day routine. Should I keep consulting a Hematologist or should I approach a Nephrologist as kidney s function is getting affected day by day. Please help me with these question. Please let me know if you need any information.",
    "doctor_response": "Hi there,Using cats claw isn't going to help him at all.  I've never heard of such a treatment and I'd be wary of using this. You should definitely consult a nephrologist if his kidney function is worsening. He may end up needing dialysis, but he can at least treat his swelling in the meantime with some medications such as diuretics.  I hope I have answered your questions. Please feel free to contact me if you have any further questions or if you feel I haven't addressed your question adequately.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Renal scan showing perfusion in kidney, mild cortical thinning. Waiting to get cystogram done. Suffering from pain, short of breath and elevated blood pressure. Treatment?\n\nI had a Renal Scan done which said that on my right kidney I have 35% Perfusion and 44% perfusion. mild Cortical thinning or scaring in the mid lateral kidney. Now I am just waiting to get another test done, a cystogram. I have been having pain for some time now. I also have stones that are hight up in my kidneys. But I know Im not passing them. I have passed stones before and this pain is different. This pain makes me feel week, it is more dull but at the same time it sometimes takes my breathe away. I have been a little short on breathe and my blood pressure use to be 115/77, last few months it has been 130 to 150 over 79 to 90, my heart rate has been from 110-143. I dont know if these symptoms are related to one problem. and how serious is the condition with my kidneys, what kind of treatment",
    "doctor_response": "You have not mentioned if you have an obstruction due to the stones.Most likely you are having it along with infection.What are the findings of urine routine and culture tests.The cortical thinning and scarring you mentioned is due to Chronic Pyelonephritis which is a result of persistant or recurrent infection of urinary tract and results in gradual damage to kidneys function.Along with the cystogram get a urine culture done and decide further treatment accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taken ipill after sex. Cramping, nausea, back pain. Side effects of ipill last long?\n\nHi.. Post sex I took an ipill but i took it after 72 hours. Ive been habing cramping, nausea bachache since about a week. Do side effects of ipill last so long or could this mean early pregnancy symptoms?? Just for your information i had sex on 7th or 8th sept and my next period is due on 28th sept ( last one was 28th aug). Im waiting in anticipation as its too early to take a pregnancy test . Pls suggest. Thanks surbhi",
    "doctor_response": "Hi, you had unprotected sex on 8th of aug. previous period is on 28th aug. So ovulation is expected to be be around 14th aug. So there is is no possibility of pregnancy, These symptoms may be due to the pill, or some thing else. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "High SGPT and uric acid level,recurring numbness in the abdomen,heartburn\n\nI have a high SGPT and Uric Acid levels. I found this out after the doctor asked me to undergo laboratory tests. Prior to my consultation I have complaints of numbness in the left side of my abdomen and also I have a history of hurt burn. It just seems to be frequently felt these days. Is liver diseases a congenital one? My grandmother and an uncle died with it.",
    "doctor_response": "Hello. Thanks for writing to us. Liver disease with mildly raised SGPT and uric acid levels is not likely to be congenital in nature. Proper biochemical analysis of enzymes can guide you regarding the nature of the disease. Usually minor abnormalities are curable after proper treatment by a gastroenterologist. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the lump on the penis with clear fluid draining?\n\nI am 15 and around six days ago a red lump appeared on my penis which is about the same size as a spot on someone s face and when I tried to pop it clear liquid came out of it. From what I have read online it suggests I have penile lymphocele but I need someone s best diagnosis.",
    "doctor_response": "Thanks for asking in healthcaremagic forum  Do not daignose yourself and take self medication. Please provide details regarding fever,itching,pain, any discharge over there for further suggestion. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for foot and mouth disease\n\nHi! My 18 month old had hand, foot and mouth disease last week and passed it along to my husband. Little blisters began to form on his hands, feet and mouth on Friday but is still not feeling any better. He has a cough (he s had over two weeks), low fever, mild headache and feels light headed. My impression of the diseases was that he should be feeling better after the blisters appeared but that does not seem to be the case. He feels worse now than he did Friday. Should he see a doctor tomorrow?",
    "doctor_response": "Hello,Welcome to HCM,Hand, foot, and mouth disease is caused by a group of viruses known as enteroviruses. This is a condition which can lead to fever, blisters on the hands and feet, mouth sores, sore throat and a poor appetite.It can spread from one person to another through direct contact with discharge from the nose and throat, saliva, infected stools, or fluid from a blister.There is no specific treatment for HFMD. Medication may be given for relief of symptoms such as fever and aches.I would suggest yo to follow1.Good personal hygiene2.Oral NSAIDs3.Topical anesthetics to minimize the pain caused by the blisters.4.Wash your hands frequently.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is swimming safe in people with acute pharyngitis and respiratory infections?\n\nI am a 32 year old female- I have acute pharyngitis and upper respiratory infection. My family is going swimming tomorrow at a local pool, should I get in the water or not? I started Amoxicillan this evening- so it will not be even 24 hours on the meds. I don't feel like swimming, but I don't know if it might help or might hurt.",
    "doctor_response": "Hi welcome to the health care magic In congestive upper respiratory tract infection swimming is not advisable For you it is better not to do swimming until congestive symptoms relieved Take benadryl like decongestant drug and complete course of antibiotics Even if still you want to do swimming and your condition good with no fever than you can swim with ear plug wear Take care Consult physician for examination Hope your concern solved",
    "dialogue_context": ""
  },
  {
    "patient_message": "Panic attacks. Done EKG. Family history of heart attack and diabetes. Odds of panic attack?\n\nI am a 28 year old female over weight but otherwise healthy. I suffer from panic attacks I currently became a vegan. My paternal grandfather died if a heart attack from diAbetes. I had an EKG a few years on and blood pressure and chilesterol doctor says are on but I feel I am going to have a heart attack what are the odds I will??",
    "doctor_response": "Hello,A positive family history of early heart disease and diabetes puts you at increased risk for heart disease and diabetes ,even if you don't have other risk factors such as high cholesterol, high blood pressure, diabetes, and obesity.Since you are overweight,your chances increases still further.Do's for you....Avoid fatty foods and sweetsReduce your calorie intakeReduce your weight and be in your required range of your BMIDo regular aerobic exercises for 45 minutes a day.Keep a check on your BP,blood sugar levels and cholesterol levels.De stress yourself by doing regular yoga.If you develop good dietary habits along with exercises and shedding of weight,even a positive family history won't cause any damage to you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Used Triphasil and Trigestrel. Should I take the red pill now?\n\nHi doctor, i was using Triphasil and went for a refill and got Trigestrel now i don t know how to use it. on triphasil i would be on my red pill in the red area, now on Trigestrel there is no red pill for my day (monday) on the red area? should i take the red pill anyway? and will i have to use extra precautions (mechanical) and will my body start having withdrawl bleeding again?",
    "doctor_response": "Hello. Thanks for writing to us. If you are having a bleeding now then you can take the red pills and then start with the next pack after finishing red pills. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal ,drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could chronic lymphocytic leukemia be the reason for high wbc?\n\nmy husband was just released from emergency room from a fall. during his exam blood was taken and his wbc was off the charts. They said he most likely had chronic lymphocytic leukemia. However, he is taking prednison 20m three times aday for gout for 7 days this is day 6. could that have caused the high wbc?",
    "doctor_response": "usually steroid doesn't cause leukemia. actually , it will decrease the blood counts. so, don't worry steroids are not the cause of present diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I relieve severe cough and acid reflux?\n\nHave had a cough for about 10 weeks., Had three lots of antibiotics, steroids, inhaler, tablets for acid reflux, but it s still there. Had a ched t x Ray which was normal. Can t sleep for coughing and have a lit of white phlegm.also a lot of funny noises in chest when lying down",
    "doctor_response": "HelloAs you explain the situation this might be a pneumonia.You should see your doctor and he or she will recommend you to do a chest x ray and a hemogram and pcr blood tests and after will be the correct treatment.RegardsDr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rash on butt cheek?\n\nhi, i suddenly have this rash looking mark on the bottom of my left butt cheek. i had it for about 3 days now and it feels like a brush burn and when i finally was able to look at it cause it in a weird spot my skin was peeling and it look raw almost!! i have tried to clean it in the shower and put cocoa butter on it (that s what i do to all my sore or scratches) but it burned then started to itch. just to keep in mind i haven t had sex in about three weeks. when i did have sex we used a condom and i have never had anal sex in my life.. what do you suppose it came from??",
    "doctor_response": "HiThank you for asking HCMI have gone through your query.Your problem is most likely a fungal infection, tenia corporis. For such cases i advise to apply ointments of clotrimazole or terbinafine. I also advise to take tab fluconazole weekly once for 1 month to stop recurrance. Hope this may help you.Let me know if you have any further query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing abdominal shrinkage of my fetus?\n\nGood Morning I am 33 weeks pregnant today. I am currently having scans every 2 weeks due to complication with my first child (early onset pre eclampsia with HELLP at 24wks). I had a scan yesterday, all measurements are fine apart from baby abdomen measured smaller yesterday than 2 weeks ago. I have been booked into the day unit at my local hospital tomorrow and monday for monitoring and again on wed with another scan. What could be the problem as i was not really told anything? I am also measuring 30weeks with the midwife? Thank you in advance Helen",
    "doctor_response": "Hi Helen, I have read through your query and feel that, the smaller abdominal circumference and smaller baby size indicate that the baby is having intra uterine growth restriction. The babies special sonography called Doppler studies needs to be done to know the type of blood flow into the placenta. This could be due to your previous history of Pre-eclampsia and HELLP , women with these are known to have more likelyhood of smaller babies in future pregnancies. Along with regular Doppler and fetal heart rate tracing of the baby, your BP and urine albumin need to be measured as it is likely that you can get pre-eclampsia again.If the Doppler studies indicate abnormal blood flow and ultrasound show that the baby is not growing as expected and the fluid around the baby is getting less, early delivery may have to be considered.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes redness and swelling of one breast?\n\nMy friend told me that one of her breast is red and swollen also one breast is larger than the other. She had breast cancer about 12 years ago. She has an appt. at the end of June. Don t you think she should get an appt. asap. Please answer. Cora. I did not know that I have to pay for an answer.",
    "doctor_response": "In a patient of breast cancer if one of the breasts is red and swollen then it is definitely a cause for concern and your friend should immediately consult her oncologist. It could possibly mean the return of her cancer. However it may be nothing but a localised infection. This issue can only be settled by seeing an oncologist and this needs to be done asap.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain while breathing after waking up?\n\nHello, I am a male 29 years old. Almost every morning I wake up and take my first breath I get pain internally. After, I take that initial breath the pain stops. One other thing that I have been noticing is when I brush my tongue sometimes I gag and I spit out blood. First it started with just a small amount of blood but as the days go by I notice more. And it is only in the mornings. During the day I am perfectly fine. Any thoughts? I will be doing a doctors visit soon.",
    "doctor_response": "Thanks for your question on HCM. Coughing out blood during brushing teeth can be seen in1. Dental problems. 2. Pulmonary Disease. So first consult dental surgeon to rule out  dental causes like caries or decaying tooth.If this is normal than get done chest x ray to rule out pulmonary cause.Since you are having chest pain on breathing with blood in cough, you may have pneumonia. So chest x ray is must.If this is also normal then no need to worry much. You may have muscular cause for your chest pain.So take good painkiller and muscle relaxant.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why are my liver enzymes raised?\n\nHello doctor, Today I took blood test and found out that triglycerides, aspartate transaminase and alanine aminotransferase are high. One week back, I had taken Liv.52 DS, triphala and bael. Shall I continue them? Or should take any other medicine? I have attached my medical reports. Kindly check them. Thank you.",
    "doctor_response": "Hello. According to your reports (attachments removed to protect patient identity), your triglyceride levels are absolutely normal. Revert back after the investigations to an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Piriton syrup be given to a child for nasal congestion?\n\nHi my almost 1 year old (He s 1 in 2 weeks time) has had a severely congested nose, running constantly with bright yellow/green mucus for almost 6 weeks now. Had him to doctor about 5 weeks ago who prescribed antibiotics for upper respiratory infection (didn t really make much difference if I m honest), took him back to doctor yesterday who said he had double ear infection and prescribed more antibiotics for this. However, he said that he thought his nose congestion/mucus was most likely due to an allergy. I didn t think at the time but I m now wondering if I could try piriton syrup to see if it helps his nose if it is an allergy? I noticed it said not suitable for under 1 but since he s almost one and large for his age (29lb) I wondered if I could try him with some?",
    "doctor_response": "Hi,Don't give medicine that is not recommended for kids under 1 year. I agree with the doctor said it seems to be respiratory allergy. Any parents or brother have? If yes it is a one more point to be that. Besides that kind of drug will not help him. Try an Otolaryngologist doctor he could make more tests and help your child.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sharp pain in the leg\n\nI keep getting pins and needles in my right leg at least 20 times a day and most off the time my leg just feels dead and have really strong painful shooting pains it normally comes and goes but tonight I ve had it for 2 hours and it s really painful ive had paracetamol but it s still hurts I m really worried because my mum sufferd from dvt and has now had a stroke can this be signs off dvt in my leg? Or what can this be? And why? Thanks",
    "doctor_response": "Hi. Your pain seems to stem from spine. First do not panic,  you need an MRI done of your spine after that you may need surgery or just therapy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause for pain in the left lower abdomen?\n\nHiI've been experiencing a dragging pain / ache in my lower left abdomen for a couple of weeks which seems to be increasing in severity. It is aggravated by walking and relieved slightly when crouched down. I am now experiencing pain during intercourse. Can you advise what it might be? Thanks",
    "doctor_response": "Hi. This may be due to pelvic inflammatory disease, wherein one gets inflammation in the pelvic area. Your symptoms are quite classical or it may be a problem with a ovarian cyst. I would advise such a patient to undergo a clinical examination by Gynecologist and abdominal ultrasonography to assist in proper diagnosis. This scan lead us to a proper course of treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Percocet effective for low back pain?\n\nI am having terrible chronic low back pain from an injury (house work) approx 3-4 months ago.I have tolerated Percocet 10/325 previously fro this injury. I was hoping to do an online interview for a prescription of Percocet. I  need help please. State TN.",
    "doctor_response": "Dear patient Percocet  is combination of oxycodone  and acetaminophen or paracetamol.  Oxycodone is opioid drug which is centrally acting pain reliever and habit forming if taken for long time. It is very effective  for back pain. It has side effects of respiratory  depression,addiction  and constipation.  Paracetamol is nsaids  group drug and increases effects of oxycodone. It has side effects of  liver damage if taken in excess. Rare skin reaction is also noted. So combination  has synergistic  effect in pain relief. Dosage is one tablet twice a day initially and then as and when required.  Avoid taking drug if you have asthma , cirrhosis or  allergy. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does MPV(mean platelet volume) FL 8.8 suggest?\n\nJust had some recent yearly blood testing done.  My MPV (Mean Platlet volume (FL) was 8.8 with the range being 9.4-12.3.  Not sure whether this is something to be concerned about and what does it really mean.  What can I do to increase my number of 8.8?  Thanks.",
    "doctor_response": "Dear,Unless you have any problem low platelet volume of this nature has not much significance. To make their volume normal you have to check iron, folic acid and B12 level. If any of these are deficient they need to be corrected.Truly,Dr. J. Ticku",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is mycrogynon pill safer than depo shots?\n\nI am currently using the pill injection as contraceptive, used for 3 months but do not like it. I have 3 months worth of mycrogynon pills which I would like to use again, have used this for 10 years and i have 2 children within his time so it works for me. My depo is due Monday 23rd jan, when should I start taking the mycrogynon again? Thanks",
    "doctor_response": "Hi,Yes, you can start your hormonal contraceptive on the day that you are due for a Depo shot. Because Depo-Provera remains in your body for up to 15 weeks after your last shot, you can start your first birth control pill at any time. For the first seven days of using the pill, I would suggest you to use an additional method of contraception such as condoms since the pills can take 7 days to become fully effective.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Saranya Ramadoss, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for mental health problem\n\nI am partial complex epileptic and I am 70 and I had a sezure during the day at a restaurant I frequent. I have amnesia regarding that incident and over past twenty years I have had several in bed and one other one while I was at adenny s restaurant,with a business friend,in the morning. I lost short term memory and one other thing I always pee in my pants. in total 4-5 seizures over 7-8 yrs. does that make me an epileptic and will I be cured by taking better care of myself. my neurologist say I have slight abnormal eletrcal brain activity in one of my lobs. is this really true?",
    "doctor_response": "hi dear,you have epilepsy and for that you must take treatment.as with every episode it affects your memory some what.it is the hyperactivity in your brain which leads to seizure episode.for epilepsy you must take medication for seizure free three years continuous  .there is no other treatment for epilepsy.consult neurologist for further detail and treatment.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I give Seroflo for my 7 year old son for his dry cough and breathlessness ?\n\nmy son is of7trs on and off he starts dry coughing followed bye breathelessness what should be done doctor suggests to give seroflo 250 for 3 months but i hesitate to give it what should be done",
    "doctor_response": "Hi Harsh, All this thing is due to allergy and low immune system. As doctor prescribed plz start medicine, if problem is too much for temporary relief. As doctor use to say there is no treatment of allergy in Allopath, only it can be controlled using inhaler but it can\u2019t be cured. The solution is very simple, We can improve our immune (resistance) to fight with any disease and can get permanent cure. I had Eosinophil Count Problem (~1150). I use to take EOFIL FORTE\u00ae - Diethylcarbamazine (DEC) for continuous one which helped me to maintain for Eosinophil Count for next two months. But it has never given me permanent cure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can an online doctor suggest a treatment for my abnormal seminal report ?\n\nhi this is juher pathan looking for answer the treatment duration for my abnormal seminal report ,Questions related to - seminal report Dear Doctor my age 28 yearsheight 6 fitweight 58 kg i Q : Dear Doctor my age 28 yearsheight 6 fitweight 58 kg i have TB in my past Presently iam healthy seminal report is quantity 20mlcolour milky whiteconsistency thick liquidreaction alkalnePH 70 total cout of sperms 10 million Dear Doctor my age 28 years,height-6 fit,weight 58 kg, i have TB in my past Presently iam healthy seminal report is quantity 2.0ml,colour-milky white,consistency-thick liquid,reaction-alkalne,P.H-7.0, total cout of sperms 10 million/ml of semen Motality after 1/2 hours total motile-10% active motile-10%,moderatelymotile-10%,sluggeshly motile-20% ,non motile-60% after 1hour total motile-8% active motile-5%,moderatelymotile-10%,sluggeshly motile-25% ,non motile-60% after 4hour total motile-2% active motile-00%,moderatelymotile-5%,sluggeshly motile-15% ,non motile-80% micro scopic morphology-10 to15% immature forms 08 to 10% tail less-02 to 04 %,pin head 01 to02%,W.B.C-4-6/hpf,R.B.C-no found, epithelial cell-not found,trichmonous-not found so pls tell sir i can be a fatheror not if not treatments are avilable for me.and duration of treatment.",
    "doctor_response": "Hello juher ; welcome to HealthcareMagic Sorry to say but your semen analysis report is not good.The motility is bad and morphology is also not good.It will improve with treatment but it will take time so you have to be patient and take medicines regularly as advised.You should consult a Urologist for detailed explanation and treatment.Please consult as early as possible so that you can be treated accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rapid breathing?\n\nhi, my 3 year old daughter s breathing seems rather quick -- 60 breathes per minute. She is sick right now (complains of a tummy ache and is on antibiotics for MRSA staph). She had RSV one year ago, and it seems that since then, whenever she gets sick, she breathes rapidly. Should this be a concern?",
    "doctor_response": "Hi, welcome to HCM. Can understand your concerns. - Rapid breathing rate of around 60 per minute is very high at 3 year of age. It suggests that child has pneumonia and she is not responding to antibiotics which you are already giving for MRSA staph infection.- Child needs to be hospitalised and blood culture and CRP levels should be repeated. - Further treatment will depend on above reports. I hope this will help you. Wishing your child good health. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for constant depression and forgetfulness\n\nI dont know what wronge with me i cry and hurt and forget things this has gone on for years but i cry and sometime think im turning into my mother that was depressed n had mental problems.Im afraid to leave my house and talk or do anything at times i push myself.I get so sick in my stomach.",
    "doctor_response": "Hello, You require antidepressants for you problem. I would advice you to start with tablet escitalopram 10mg.Additionally, take green vegetables in diet. These also increase serotonin levels in the body.Hope your health improves quickly.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low dopamine levels and body tremors\n\nI was diagnosed withGAD with agoraphobiaI shake &jerk all the time.Lab tests have shown my catecholamines are high except the dopamine.I take ativan but it doesn t help much.Anything I do physically causes me to shake uncontrollably.My dopamine levels are very low.Too many tests,no answers!!",
    "doctor_response": "in  my  opinion  it  is  useful  to  go  for  a  complete  blood  profile  that  is  thyroid  test  also  antidepressants   like   see tramline  is  usefulin tial  few  weeks  it  is  also  necessary   to   be  on  low  dose  benzodiazepinescognitive  behavioral  therapy  is  useful",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain under breast with dizziness?\n\nhi, how can I know if I have a air bubble in my heart or lung? I just felt a sharp and fast pain under my left breast. It felt like  a bubble was going through. I got a bit sick from a stomach and felt like fainting but I don't know if it was caused by the pain or me getting scared. what could it be? Thanks for any advice...",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Possibility of gaseous distention of stomach and related air bubble is more likely. But better to get done ecg and chest x ray first. If both these are normal then no need to worry for heart or lung related diseases. Take pantoprazole and levosulperide combination on empty stomach twice daily. Avoid hot and spicy food. Avoid junk food. Avoid stress and tension, be relax and calm. 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",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the bilateral median neuropathy mean?\n\nHi I had in Dec.2010 my first neck fusion of c-5,6,7 because of a buldge disk of c5,6 which was incroching in To my spinal cord. It had started time fail in April 2011 with some broken screws that the Dr. PA told me but nothing was done after 18 month I took things into my own hands had so nerve conductions done and then saw my hand Dr. they both agreed that there was a underlined problem and was told to see a Nerospinesurgen. So I did he Han me do a CT Mylagram which showed a compleat failed hardwere and needed another surgery. So after living for 18 months with this failur with not even any bone growth the Surgen said it was a mess and he had to take c4 now. So my fusion is cc4c5c6c7 and I have problems with my arms left is worst the the right. The Niro conduction says.( bilateral median nerves neuropathy,sensory, L R, demyelinating. bilateral median neuropathy, motor, L R ( left side axonal and demyelinating ,and right side axonal) Could anyone let me know in a way I can understand. I know how I feel and the constant pain and numbing I m going threw I just want to know why.",
    "doctor_response": "Hi, I am Dr.Bruno.  I have read your question with care and understand your concerns. Let me try to help you Median nerve is the nerve that supplies most of the muscles in your fore arm and some important muscles in your hand In your case, this nerve is affected on both sidesSoyou may have difficulty in using your wrist and thumbyou may also have difficulty in griping objects in addition you may have numbness or tingling sensation in area supplied by median nerve the treatment has to start woth medicines that improve the nerve regeneration. Hope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of getting pregnant if had unprotected sex and ovaries are upside down?\n\nI slept with a friend a few days ago and we didnt use a condom since her ovaries or how ever you spell it idk :-P are upside down so I was wondering what are the chances of her getting pregnant.I trust her that she has the illness but just to be shure :-D",
    "doctor_response": "Hello,Welcome to HCMThere is nothing called upside down of the ovaries,but there is a condition called tilted or retroverted uterus.Ovaries are essential only for the release of ovum or egg.Fertilization of egg takes place in fallopian tube.Hence,position of ovaries wont affect pregnancy.So,there may be chances of your friend becoming pregnant if you had unprotected sex.I would suggest your friend to confirm it by doing urine pregnancy test once she misses her next periods.Hope you are happy with the answer.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I having ulcers that come and go in different sites inside mouth?\n\nHello doctor, I have something in my mouth on my tongue. Sometimes it is inside my cheeks as well. It comes and goes in different spots.",
    "doctor_response": "Hello. Mostly these things are fungal ulcers. Repeated attacks means low immunity which appears after emotional and psychological stress. Are these ulcers painful or tender for foods and drinks? Do you have reflux? Do you have psychological stress? Anyway until answering my questions you can use Nystatin oral drops with oral antifungal gel.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest tips to improve concentration\n\nit is more than a year that i feel bored! i have used lots of medicine like:fluoxetine 20,prapranolol 10, serteraline 50, but it again exists. and these days i feel more sleepy, lazy, and got bad headache that dose not allow me to concentrate even for the simplest things! i am 21,70kg,164cm and i am studding power engineering so that whit headache and whit out concentration i would be able to do nothing!",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. The medicines you are taking are generally used for depressive or anxiety disorders. Means you have some mental disorders. These medicines do induce lethargy and laziness. You should overcome it. Talk to your psychiatrist regarding the problem and the psychiatrist may, if possible, reduce the dose so as to encourage you to concentrate. Work with your psychiatrist for a good solution.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the prognosis for having positive bilirubin test result?\n\nHi doctors good day!i have a question.what are the indications of bilirubin positive in the test of 5 years old and what are the further more tests does she needs? She had been taking tb drugs for 1year and some antibiotics and currently,/she had allergies. Thanks",
    "doctor_response": "Hi...it all depends on how high is the bilirubin. If it is high then we need to do GGT and liver enzyme estimation also done. As she is on anti TB drugs, this carries even more significance. I suggest you approach your pediatrician regarding this.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is uncontrolled anger suggestive of bipolar or borderline personality disorder?\n\nHi doctor, I always get angered at my mom and I always yell at her. I have also found some symptoms which indicate that I have either bipolar or borderline personality disorder and I cannot control my anger usually. No matter how much I try to stop, I always end up yelling and screaming like a maniac. Please help me.",
    "doctor_response": "Hello. I understand your problem. But I want to clarify what else apart from the anger you find in line with borderline personality or bipolar disorder. Mere getting angry cannot be a 100 percent indication of these disorders. Some people especially young ones have short temper, particularly during this hormonal surge phase. So learn anger management techniques first. If it does not work, consult a psychiatrist. Thyroid function test. Counseling, anger management techniques.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does fever persist after recovering from a kidney infection along with fatigue and nausea?\n\nI have had a kidney infection for about a week with a mild fever pain in back right side that goes into my side and right side of stomach. Fatigue some nausea and throwing up and stabbing pain on the right side of my head. its been a week and the fever wont go down past 99.9 when I take meds and when they wear off it goes up to 100.9",
    "doctor_response": "Hi, Persistent fever due to Kidney infection (Pyelonephritis) despite treatment may be due to antibiotic resistance or TB or fungal infection. Re-investigation for fever along with fresh clinical examination to find any fresh symptoms or sign are needed. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Tushar Kanti Biswas, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes feet pain and itching with redness?\n\nMy feet a few times a week turn brigh red from standing or at times sitting. And hurt. They get worse when I m standing in a shower and hurt very much n itch. When it take a hot bath and get out the pain is a 10. Wearing cute flat sandals in the heat set it off also. I have no health Insurance and don t meet the qualifications. I m 44 and have started having this problem about, I ll say almost two years ago. It s getting worse. I was diagnosed with Fibromyalgia and have have had depression for well over 13 years and have bypolar depression, which I take meds for through Tri County.. I have had major back surgery twice twice over seven years ago for herniated disk when I had insurance. At times I take Norco n muscle relaxers if needed for the pain and flair up. Just trying to give you info on my background. My feet are really starting to worry me. Till then...",
    "doctor_response": "Hi,Thanks  for  your query. According to your description , pain over your feet seems to be inflammatory in nature. It could be an acute attack of gout.I advice you to give you rest to the part affected, take anti-inflammatory drug like motrin 1tablet with food as and when required (upto 4 tablets daily) to reduce pain and inflammation and consult your doctor for thorough examination and rule out any infective cause.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for promoting calcification in a broken bone\n\nI m 40 years old. I broke my ankle 2 months ago. It was a clean break that didn t require surgery. I went to the doctor today and he said he wanted to see more calcification in the broken bone. I drink a ton of milk and eat cheese. What more can I do?",
    "doctor_response": "Hello, No definite drugs are required. Bone healing is a natural process and you can promote it by a good diet. Serial weight-bearing and physiotherapy also be useful. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can non itching arm lumps with redness be treated?\n\nhi, i have had non itchy bumps on my arm for a couple years now, they are non itchy, just look bad, and get red and more visible after workout, but its not as visible when i wake up in the morning, i have tried amlactin and exfoliating, exfoliating seem to aggravate it more.",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein and I will try to help you as much as I can. These are possible lipomas or ateromas and local ointemnts or local dermatologic therapy wont be succesful in this case. I suggest to have it surgically removed under local anashesia. This the best and the easies way. I hope I have answered you query. If you have any further questions you can contact us. Kindly regards. Wish you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have weakness and pain in the arm. Should I anticipate surgery?\n\nHi doctor,I recently had an MRI\u00a0on my neck. I have a 75 % weakness and pain on the left arm (tricep). Should I anticipate surgery?",
    "doctor_response": "Hello. I am sorry to hear this. I have gone through your reports (attachment removed to protect patient identity). Wishing you a speedy recovery. Best wishes. For more information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any alternative medicine for otrivin?\n\nSir,I need ayurvedic/ herbal/ unani, nasal decongestant which can replace otrivin .Otrivin is a very good medicine but it has rebound effect ,so i want to replace it with something less harmfull. Saline solution doesnt work for a long time,moisturising my nose helps but only till the nose is moisturized.I need nasal decongestant especially at night for a restful sleep.",
    "doctor_response": "Hi and thanks for your query, Otrivine is a local anti histamine, and offcourse with prolonged use could have rebound effects. However, I am glad to inform you that, if i your case you find yourself almost depending on otirvine, there are other many drug options that could actually replace otrivine, with long lasting effects and efficacy. It certainly implies you should be having allergic rhinitis. A chronic sinusitis too needs to be excluded for other systemic drugs or local acting long effect drugs like local steroids to be prescribed. These drugs when taking appropriately reduce symptoms and actually increase and improve quality of life in patients with allergic rhinitis. I suggest you take an appointment with an ENT surgeon. He might be of real help, first by examining you to exclude other pathologies, like polyps and sinusitis, and secondly, prescribing appropriate effective drugs, in case , its exclusively allergic rhinitis. Thanks for the question and hope this helps, Luchuo, MD>",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pimple like bump, breast cancer survivor, testicles seem smaller. Is it ingrown hair infection?\n\nI am a 23 year old male PT grad student, sorta poor diet, 5'11 160lbs. I recently discovered a pimple-like ordeal bump under i my gooch area. I had popped it and then as days passed by it has just gotten bigger. It is now the size of a walnut. My father died of cancer and my mother is a breast cancer survivor. For the past few years one of my testicles( smaller than the other, but not by much) has become noticeably more sensitive as well. I have seen a doctor about the testicle pain but he had told me previously that it is nothing to worry about. However this pimple like infection is new (4 days) and has just gotten bigger and i have noticed not only more swelling but another one is coming up. I do not shave so I do not believe that it is an ingrown hair infection.",
    "doctor_response": "Hi and welcome to HCM. Thank you for your query.It doesnt need to be ingrown hair but it can be bacterial skin infection with no obvious cause. If you are afraid of cancerous you shouldnt be ,it doesnt manifest on this way. YOu should just not to rouch it scratch it and apply some antibacterial cream. If this grows you might need antibiotic treatmetn so consult your GP about it. WIsh you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Hep c in liver damage patients\n\nhiii....gud afternoon...my father has hepatitis c ...firstly he had both hepp B and C ...now he is taking treatment from fortis mohali...his hepatitis b is cured....but doctor is saying he cant treat for hep C because its very risky to give him treatment bcz of bad condition of lever...can u tell me please wat to do in this situation??",
    "doctor_response": "Hi,How are you? I am really sorry to hear about your Dad's diagnosis but it is indeed good news that he has cleared hepatitis B. What is his age?Unlike hepatitis C, in hepatitis B, there is usually no need to take treatment if your liver function is normal and if your viral load is low. He will need additional tests to look for other markers of infection and to see if you are infective to others (Hepatitis B PCR, Anti-Hbs ab, Anti Hbc ab, Anti Hbe Ab,). Based on this we can categorise your dad as a carrier or as someone who has cleared the virus. Most people will clear the virus by themselves without any treatment. Only a minority become chronic carriers and only a minority in them will develop cirrhosis at a later stage.Hepatitis B only needs treatment if the viral load is very high or if the liver is being damaged as evident from blood tests.Hepatitis C on the other hand is more aggressive disease and most people do develop some form of liver damage over the years. This is the reason why most doctors will treat this disease aggressively in order to obtain a cure. But treatment will depend on the viral load (hep C viral PCR) and the genotype of the virus (1,2,3,4) as different genotypes need different treatment and they respond differently to treatment as well. But the hepatitis C treatment is toxic to the body (damages liver and bone marrow) and so can be given only to those who can tolerate it. If the liver has already been damaged i,e has become cirrhotic, then I think you should start thinking in terms of getting a liver transplant done for your dad. Hope this helped and hope your dad feels better. Please do not hesitate to contact me for further details, esp regarding places in INdia which treats Hepatitis C and which offer Liver transplant - rxsuresh@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for CA count being 1300\n\nHI My mother aged 60 years, has been diagonised overian cancer 3C stage she had undergone surjery 8 months, uterus has been removed and 6 cycles of chemotherapy has been given , At the end of 6th cycle , The CA 125 count was showing 16 rescently got checked and CA 125 count has increased to 1300 Kindly suggest next treatement ??",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern.  CA 125 is the marker of ovarian cancer.  If it is raised up to 1300 it means you have recurrent ovarian cancer or some metastatic lesion from ovarian cancer.  You should go for ct scan abdomen to know the spread of cancer 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can sharp pains in chest be a sign of something serious?\n\nMy son fell while trying to do a somersault. His chin hit the middle of his chest and now he is having sharp pains in the middle of his chest and finding it slightly difficult to breath. Is this from getting the air knocked out of him or something more serious?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your son's situation and problem. He is having blunt chest trauma. Musculoskeletal injury is common after such trauma. But since he is having slight difficulty in breathing and sharp chest pain, better to get done chest x ray to rule out internal lung injury like pneumothorax, Pulmonary contusions, fracture etc. If chest x ray is normal than no need to worry much for this. He is having simple musculoskeletal pain. Ask him to avoid heavyweight lifting and strenuous exercise. Avoid movements causing pain. Take painkiller and muscle relaxant drugs. Application of warm water pad on affected areas is also helpful. Don't worry, he will be alright but first get done chest x ray. Hope I have solved your query. Wishing good health to your son. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure blister like spots filled with pus on inner sole of foot?\n\nblister type spots filled with white pus on inner sole of foot and pressure points. Spots develop from red itchy skin and gradually come to a head over a week or so, painful to touch and only disappearing once they have popped or i pierce them to relieve pressure. I am 44, 5 foot 4 and 10 stone in weight.",
    "doctor_response": "Thanks for posting you query to health care magic.As i understand pus filled blister are due to infection .you should not pierce them as it increases infection .If it is a large blister you should contect to surgeon for proper surgical drainage and dressing .If it is small you can take antibiotic to eradicate infection , further you should investigate for your pus to culture and sensitivity .presently you can take1. antibiotic Amoxicillin 500 mg with clavulanic acid 125 mg 3 tmis a day for 5 days .2. Diclophenac sodium 50 mg with serratiopeptidase 10 mg 2 times a day.for pain releief.hope you would be  satisfied with my answer .  feel free to communicate if any query .regards,Dr.Manish PurohitInfectious disease specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the causes and treatment for rashes on the inner thigh?\n\nHi, There is a small (around the size of a quarter or a little bit bigger) red rash on my inner thigh, that every once in a while (at least twice a day) itches. It hasn't spread, but it won't go away. It also has an odd smell to it. There arent any bumps on the rash or anything either. Do you know what this could be or how to treat it?",
    "doctor_response": "Hello. Thank you for writing to us at healthcaremagicI will keep a possibility of fungal infection/tinea cruris. The location and the fact that it itches goes in favor of a fungal infection.Groin folds is a common site for fungal infections because of the anatomy. The closely apposed body folds favor moist, warm conditions in the groin folds which allows the fungus to proliferate and form itchy patches.A KOH wet preparation made from a small amount of scale scraped from the rash to look for fungal elements will help confirm the diagnosis.I suggest you to try an OTC topical antifungal e.g clotrimazole 1% cream, twice daily at the itchy patches.An Oral antifungal e.g fluconazole Or terbinafine may also be required if the patches are extensive.An OTC oral antihistamine e.g cetrizine 10 mg once daily will provide you symptomatic relief from itching.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurrent sinus infections?\n\nI have recurrent sinus infections. I ve had 2 in the last 5 weeks and my doctor prescribed antibiotics and sterioids. I have had 6 -8 sinus infections the last 2 years with 5 bouts of pneumonia. Why do I keep getting sinus infections and pneumonia? I ve had my tonsils out.",
    "doctor_response": "HI, thanks for using healthcare magicIf you have allergic sinusitis then this may be predisposing you to infections of the sinuses.Treatment of sinusitis involves avoiding any known allergen, use of oral antihistamines and topical steroid nasal sprays.Allergy testing can help to specify the allergen.Imaging of the sinuses may also be needed to see if there is any structural change that would cause sinusitis.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the possible causes of left side abdominal pain?\n\nHi kkmkie is my name?  last night my side of my Tummy was in Pain, it was the left hand side, My partner said it maybe my kidneys, But when i got home , i made my self comfortable and started to massage my tummy, took Panadole. He said i take too much Panadole,to be honest he doesn't like me taking Drugs. I had tight jeans which didn't help. But he told me to go and check it out anyway.Could you help?/",
    "doctor_response": "Hi. Your writing about additional symptoms would have helped me to give you a clinical diagnosis= Do you have associated symptoms like fever, nausea, vomiting, loose motions , burning urination or anything ? The left sided pain can be commonly due to colitis/ left sided ureteric colic , kidney infection and so on. Take antispasmodic tablets like dicyclomin. If the problem persists it is wise to consult your Doctor and get a clinical examination and investigation if needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest diet to avoid constipation\n\ni hav a 11 yrs old daughter who got  disabled at the time of birth due to cord rounded around her neck. her survival was not complete and now she is a special child. she is completely bed ridden and dependent on liquid or mashed diet. she is bed ridden can not hold her neck and also feels fits. she passes stool after 6-7 days. she is on medicines like revotril drops, tab topamax.kindly suggest balanced diet for her particularly to keep her fresh and avoid constipation",
    "doctor_response": "Hello dear!I can understand your concern as i am a mother too. It feels heartbroken to see your child in misery.I would advise you to make a diet chart based on her caloric requirement according to her current weight and considering the ideal weight at this age. Suppose at this age,she should have a weightof atleast 35 kg,which i am sureshe wontbe.so you should start with ATLEAST 60% of the required calories of this weight that is 1800 calories (60% would be around 1000 calories)i am making a sample of diet chart which you can give to her and gradually increasing calories.starting from 8 am in the morning give her whole egg in the form of a puree made with poring egg in about 5 ounces of boiled  milk and gradually stirring with a whisk.it will be like a custard.add in 2 teaspoons of sugar and a drop of vanilla essence for flavorit will provide around 220 calories.at 10 am you can give chicken stock made with about a 100 gm of chicken in water with selected spices like black pepper or paprika and salt,whichever she likes.it will provide around 150 caloriessave the meat of chicken and blend it with a cup of wheat cereal with a little stock if remaining)it will provide around 250 calories.At 12 noon you can give about a cup of rice pudding made with 4-5 ounces of boiled rice and 8-10 ounces of milk with added sugar if she likes and a cardamom to enhance the flavor.It will provide around 200-250 calories.at 2 pm you can give her mashed veggies like a mashed potato medium sized..you can also grill with butter and sprinkle some salt and then mesh it with chicken stock or milk or anything you like.It will provide around 150 calories and with added butter and stock around 250-300 calories.At 4 pm repeat the wheat and chicken stock (wheat cereal/porridge is high in fiber to avoid constipation).At 6 pm give her banana shake..2 bananas in 5-6 ounces of milk, it will provide around 200 calories.At 8 pm give her lentil soup (about a 100 grams) with selected spices. it will provide around 250 calories in almost a cup of 5-6 ounces.At 10 pm repeat rice puddingAt 12 midnight give her warm milk about 5-6 ounces with a tablespoon of olive oil. It will enhance the calories and relieve constipation.Hope it will help.You can always make variations in the diet with the choice of ingredients.Wishing your child good health :-)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Gallbladder removed, serious headache with bitter taste, tummy irritable. Bile leakage? Cure?\n\nI had my gallbladder removed a month ago. A week ago I presented symptoms of a flu but later faded away today at night I woke up with a serious headache with a bitter taste as if something is coming up my throat could it be that my bile is leaking cause my tummy has also started being irritatable? If not what could be wrong with me? I'm 25 year old female",
    "doctor_response": "Hi and welcome to HCM. Bile leak would manifest on other way. It can be related to your operation, because sometimes postcholecystectomy syndrome or gastritis may occur after such sugeries. You should wait 1-2 months more till your digestion become balanced. Till that you can take some antiacid and spasmolitic medicines and follow hepatic diet. MAny people experiennce such symptoms but it teally pass in short time. WIsh you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI shows grossly unremarkable study of brain. Indications?\n\nI m 24 y/o and I d like to understand my MRI report of my brain as it below technique = Axial T1, T2,Flair = Coronal T2 = Sagittal t1 findings - Normal ventricular system shape and configuration with well maintained basal CSF cisterns -well maintained normal grey / white interface, with no MRI abnormal white matter signal. -no MRI evidence of focal ischaemic insult or heamorrhagic vascular accidents. -no sizable intra or extracranial masses or collections. -normal posterior fossa structures. -clear scanned paranasal sinuses . Opinion -grossly unremarkable MRI study of the brain.",
    "doctor_response": "Hi, welcome to HCM T1, T2 and flair are sequences taken in MRI, it is technical language. Your MRI scan is absolutely normal. It will quite difficult to understand all the minor details in brain MRI, as one has to study all the anatomy. Report has explained the all structures in brain like ventricle, neurons are normal. Dont worry about details. Thanking you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a positive test for ANA mean?\n\nQuestion about test positive for lupus Las February in my check examinations test in all the exams I got 2 thinks that let me think about, I got a ANAs positive a exam for Antibody antinuclears and I got my creatine in the upper limit of my levels in urine, this week I will get my 6 months exams, if it will positive for ANAs again I will got lupus? if I will what should I do? thanks",
    "doctor_response": "hiwhat do you mean by positive? what are the levels? do you have features of lupus, why were you investigated for lupus?lupus low titre can be present in normal individuals, without any meaning.see a rheumatologist to confirm it",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes growing lump at base of penis?\n\nI found a firm lump on the inside of the penis near the base . Very little discomfort but annoying during erection. Over the last several months it hasn t gone away, but has gotten longer and is about half an inch wide. Still no big discomfort, however now when I have an erection the penis curves upward and doesn t achieve full length due to the lump. Very annoying during sex. At first, from reading on the internet I thought it might be lymphangiosclerosis. However this has lasted quite some time without going away or getting smaller. I am worried it might be something more. What should I do?",
    "doctor_response": "It might be due filariasis or any malignant conditions of the penis.you have to consult surgeon for the same or post some photographs of the lump with penis and age of yours.both of these diseases are serious and take medical attention as soon as possible.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing swollen lymph nodes on my body?\n\nI had a swollen lymph node in my neck 2 weeks ago; I asked my doctor about it and she told me to take Cefuroxime for 7 days then it disappeared, but after that I felt something in my groin, there was a swollen lymph node too, I went back to my doctor and he told me to take Co-Amoxiclav. Today is my last day of taking the medicine, but the enlargement of the node just decrease in size but it still there. Then yesterday, I felt a swollen knots in my outer thighs and inner legs, what might that be? Help me please. Now I have a painful node in the clavicular area. What might my sickness is?",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Lymphnode enlargement suggests infection. Multiple lymphnode enlargement needs to looked at carefully.2. As it is recurring, site of primary infection needs to be identified. Also a lymphnode biopsy and culture would be helpful.3. Improve your diet with protein and Vit A, B-complex, Vit C and Zinc. Improved immunity reduces risk of infection. Maintain hygiene. Get an FNAC done to rule out other causes of lymphnode enlargement.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is tab tetralysal dangerous if planning to conceive?\n\nI have been taking Tetralysal for 8 weeks and my last tablet was on friday (2 days ago). Is it dangerous to conceive at this moment as that s what has happened this morning??? I am very worried and contemplating wether I should take the morning afetr pill.",
    "doctor_response": "Hi,Tetralysal is a tetracycline derivative antibiotic. Its effect remains in blood for 24-32 hours from the time of taking the last pill. You had finished the course 2 days before unprotected sex and even if you conceive at the time, there would be hardly any traces of antibiotic in your body. If the medicine is taken during pregnancy the colour of babies teeth may get affected so avoid taking it during pregnancy. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Vasudha Jayant Athavale, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to get pregnant with RH negative?\n\nShould I get pregnant agin? The fetus has not been vialble since week 7 and I started spotting two weeks ago. I would now be 12 weeks pregnant. The doctor that I saw that time called me 10 days ago to tell me that I was RH-negative and to wait till my next period before I get labs done and get my RHOgam shot. I didn't even know prior to this that I was RH negetive or what it ment. Reading up on the RH factor everything I read said 72 hours after. I went for a second opinion and he recomended to get it now, almost two weeks after I started spotting. I still will follow up with my lab work, to find out if I have the antibodies capable of attacking an RH-positive fetus, and if I do How dangerous is getting pregnant again?",
    "doctor_response": "Hi,So you have had a missed abortion and are spotting from 9 weeks.You do not need to take Anti D (RHOGAM) and do not need to worry about RH factor as yet. The reasons are..Anti D (Rhogam ) is not given in abortion less than 12 weeks .Anti D is most effective 72 hours after sensitizing event(Abortion,fetal death,delivery ,trauma to abdomen), but can be given upto 10 days.Also, before you worry so much, I would like to know your partners blood group, if he is also Rh negative you need not worry at all.Even if he is Rh postive but heterozygous to Rh there is a 50% chance that your baby will Rh negative and you will not need Anti D.It is not at all dangerous for you to get pregnant. You can consider getting pregnant as soon as you are mentally and physically ready.You could inform the obstetrician in next pregnancy and she could check fetal Rh by a technology called Cell-free fetal DNA. If this confirms that your baby is Rh negative, then you don't need extra monitoring. If this shows the baby is Rh positive, she could monitor you and inform the neonatalogist when baby is born. Also take Anti D then after delivery if baby is Rh positive.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I continue entacaver till hbsag becomes negative?\n\nI am a hbsag positive and hbeag negative but DNA 282722 copies/ml, my age 46 then i took entcaver, and was terminated from the job as nursing. my DNA became negative, so my quesition is can i still continue the medication till hbsag negative, and can i go back to work or not.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  If your hbe and dna copies doesn't show infection then you can stop the drug.  Hbsag will remain positive.  Don't worry about that. You can go for work. Consult your doctor and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does reduced level of hemoglobin cause shivers and shortness of breath?\n\nI am feeling a bit shakey and have been having trouble off and on with shortness of breath since last night. Last year I was anemic and had a hemoglobin level of 5 and to have a blood transfusion. Im not sure if my levels had dropped again and shuold I seek medical attention.",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.In my opinion it must be again drop in the haemoglobin, that causes you weak feeling.Haemoglobin is essential to o transport oxygen to different organs of the body. If you have anemia haemoglobin stops transferring to various organs of the body.HB in the range of five is the likely cause of such a reaction.I think you should check your haemoglobin level in the blood again. If again haemoglobin has gone down then you must require compulsory blood transfusion.I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having lump sensation in throat after eating, no pain. Is this cancer or some form of indigestion?\n\nI have had a lump sensation in my throat for a few months now. The sensation comes and goes and there is no pain associated with it. The lump sensation is comes mostly after I eat and is accompanied by a lot of burping. It is especially irritating around my menstrual cycle. What could this be, is this cancer or some form of indigestion?",
    "doctor_response": "Hi, Relax, your problem does not fit in a description of cancer. It seems most likely to be GERD and please take proton pump inhibitors with prokinetics for few days. Use mucain gel before meals and avoid spicy and oily foods. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for rash after intake of metrogyl 400 ?\n\nI am having acute dysentry with diarrhea . I am taking metrogyl 400 feeling some relief but now having some rash , seems to be a reaction. What to do now? Any other effective drug for dysentry?",
    "doctor_response": "Hello; Thanks for your query. Metrogyl is used in cases of amoebic dysentery and as a side effect in some cases a rash and itching can be seen. As you have developed rash you should consult a doctor close by abd he will give you some antiallergic and the rash shall subside. Also if the dysentery has not subsided then the doctor will give you antibiotics to treat the infection. Take care. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for diarrhea and heartburn\n\nI have had a touch of flu for several weeks now and got a stomach bug a week ago. I have had mild diarrhea and heartburn for a week. I have been extremely dizzy and weak for a week now and can't even get out of bed. I have lost 5 lbs and am now 87 lbs. Should I go to the er or can I treat this at home? What should I do to treat it at home?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have symptoms of diarrhea and heartburn which seems to be due to acute gastroenteritis and electrolyte imbalance in body. It is due to gastroesophageal reflux disease as well which leads to excessive acid production in body. It could be due to poor immunity and increased susceptibility of getting infected. Need not to owrry. Avoid hot, sharp and spicy food. You should take banana on daily basis and light food. Drink plenty of fluids to rehydrate body. I would suggest you not to panic at all. You should start treatment with combination of fluoroquinolones and ornidazole. Visit gastroenterologist once and get it examined and start treatment after prescription. You should get intravenous fluid administration as well. .Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of potential hernia?\n\nHi, may I answer your health queries right now ?  Please type your query here...hello my 2 year old niece has pooping problems and locks up everytime she has to go its very painful to her the doc say she has a hernia but want do anything else please tell us what we can do to help her",
    "doctor_response": "nothing but a painless swelling when the intra-abdominal pressure is increasedthe contents of the abdomen try to get out through the muscular defect in the wallthat's it!sometimes it may be painful if the neck of the sac gets constricted!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does it mean to have high AST level on liver test during pregnancy?\n\nhello I am 35 weeks pregnant and did a liver panel and my AST level came back and is 62. Everything else is normal. I ll be seeing a doctor next week, but I m wondering if I should be concerned or if there s anything to know before I speak to the Dr.",
    "doctor_response": "hello. there is no concern. the elevation of the livery enzymes can be normal but you need close follow up and regular blood tests",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get longer erection?\n\nIam a male.While Iam in 12 years old from being Iam doing masterbution.Now I want to get for  marrige.but having fear.during 40 seconds sex out.How can I control my wife.pls give me suggestion.whats the way I can removed my bad habit & increase the duration.where is my query answer.pls reply to me?",
    "doctor_response": "Hi, You can practice more yoga and meditation for your excess masturbation problem. I suggest you watch less porn videos if applicable for you. The premature ejaculation problem is commonly due to performance anxiety for the initial few sexual acts. If after few sexual intercourses it persist then you can apply topical Lignocaine jelly over penis after erection to delay ejaculation. If you have excess anxiety history than fluoxetine can be prescribed for you. You need to learn when to slow down sexual stimulus during sex. You can take help of psychiatrist or sexologist if needed. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicine to relieve limb pain following chemo treatment\n\nMy sister was diagnosed with stage 4 adenocarcinoma of the lung and has had several chemo treatments. Prior to beginning chemo. she experienced severe pain in her feet, then lower legs and now knees. She is taking a low dose of Prednisone which the doctor was hesitant to give her due to side effects but she finds a slight relief from it. She does not communicate well with her oncologist and her husband of 40 years appears to be in shock. She is suffering a great deal and her oncologist has prescribed Dilaudid which she takes at night but it does not address any real issue. Do you have any ideas which might offer her some relief?",
    "doctor_response": "Hello, I will suggest you to increase the dose of dilaudid. If still problem persists she can be offered nerve block for lower limb. Other than that you should work upon the exact cause of pain in her lower limb like you can do venous and arterial Doppler of lower limb and CPK levels. Once these tests and Doppler studies are done we can draw future course of action.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Muhammad Faisal Bacha, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes brown and grey colored stools with blood in a 2 year old?\n\nhello,my 2 and a half year old has been having tiny amount of blood at the end of the stool...my pediatrician ordered an ex ray and said she was constipated evan though she poops quite regularly.He said most likely the blood comes from a scratch at the end of the bowel that continually gets irrataded and then today the stool turned gray! half of it came out brown then gray and two hours later more grey poop what could this mean?",
    "doctor_response": "Dear Parent,The gray color stool of your child can be due to different causes. Commonest one if your child is on a milk only diet. Other serious cause is blocked liver ducts ( however in this condition your child will gave yellow of eyes, skin). I suggest that you see a pediatrician if the gray stools occurs 2 or more times,  lasts more than 24 hrs and lasts more than 48 hours after changing from a milk only diet, and you notice yellow discoloration of eyes, skin.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ECG report sinus brady cardia\n\nHI doctor  ,  im 23 years old i have breathing problem with left chest pain, after consult a doctor my ECG report states SINUS BRADY CARDIA and my left cxhest is slightly bulge in bone and had problem in breathing , now im mouth breathing in night . what problem for me and what can i do for it ?",
    "doctor_response": "hello,I have gone though your query.Thanks for using HCM.Your sinus bradycardia may not be serious at all,At young age with atheletic exercise it may be normal finding.Your symptoms may be due to allergic respiratory condition and may need treatment.I suggest you to get your X ray chest PA view,Blood for hemogram done.Having obtained this report we may consider further course of action,My best wishesDr.Rajesh Teli,MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for toothache\n\nHello, I have a tooache. I think it is caused by a decaying tooth in the final position of upper row. I have taken Advil for 3 days (today is the third day). But the pain comes back every 5 hours. I cant see a dentist today since it is holiday in Canada now. What else can I do to relieve the pain at least until I see a dentist tomorrow? Is it ok when I take advil for 3 days, which means that I took 4 tablets totally? When the pain is still here, can the decaying tooth be removed? I also wash my mouth by water with salt (salt is used for cooking). Is it dangerous for the pain? Thanks.",
    "doctor_response": "Thanks for your query, I have gone through your query.The pain is because of the root tip infection in the the tooth(acute apical periodontitis).You need to get a radiograph to rule out the tooth infection. If the tooth has sufficient structure left(>60%), then it can be restored with RCT and crown. If I am your treating doctor, I would have prescribed a course of antibiotics like amoxicillin 500mg and metronidazole 400mg tid for 5 days (if you are not allergic). You can continue taking advil three times daily till you consult the oral physician. You can do saline gargling.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dizziness the moment I stand\n\nI have been to several doctors for dizziness, have been in Omniax chair 2 times, one helped the other time didn t. My vertigo is different than others, as I am not dizzy while sitting or laying, but the minute I stand I start swaying, I have to use a cane or walker, or will fall.",
    "doctor_response": "Hello!Thank you for asking on HCM!Regarding your concern, I would recommend performing a brain MRI, to exclude other possible causes of vertigo. It seems to be a peripheral vertigo, related to an inner ear disorder, although the Omniax chair was not very effective in the second time. Anyway, I would recommend starting Dimenhydrinate to help you will your symptoms. Hope you will find this answer helpful! Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for priapism\n\nI had to go to the ER this weekend because of an erection that lasted 22 hours. They had to put a bunch of needles in me to remove the blood that had built up. I returned to the ER yesterday because my shaft and head have turned black. The med on duty said this was normal due to the emergency treatment performed. Is this normal and what else should i expect in regards to symptoms after treatment for Priapism?",
    "doctor_response": "Hello and .As an Urologist, let me assure you that, the color changes you're seeing, are quite normal after treatment of priapism.You could've reported to ER much earlier.  The discoloration is due to the congestion and blood clots, that had collected inside.One complication that may occur after treatment,  is erectile dysfunction.I'm sure the ER doctor may have told you that. The black color you describe, is difficult to make out. You should see an Urologist for that.You can send a photo of the penis to me, for an expert opinion.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for violent seizures\n\nHello Doctor,My Dad has been on 500mg X 2 dosage for the past 3 years. He has however been changing his dosage intermittently on his own only to be corrected by the family members with the help of doctors. The drug was started by his doctor after looking at his Color Doppler and CT following a very violent seizure. There was a tiny clot found. Since then he has had only one violent seizure, but often gets smaller episodes of forgetfullness of duration 2-3 minutes when he loses complete context of his surroundings and looks puzzled. The help that I require is:1. on the side effects that may be caused2. how to subside/overcome those side effects.3. Natural diet that can help him to build resistance to side effects.4. Is there a way of doing away with medication with the help of a one-time treatment?I would always remain indebted to you for this help.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Unfortunately, it looks like you've provided a good deal of other information to someone else in this forum and were expecting the same doctor to continue with your particular question. However, I have no information on what medication you're talking about or the actual condition being treated. Medications that come in 500 mg and are given twice daily are many but perhaps you're talking about Keppra? And maybe you're referring to a seizure disorder diagnosed in your father? Side effects of what we call AED's (antiepileptic drugs) range from mild to severe and definitely can involve cognition (that is memory, thought processing, etc.). There would be no known dietary regimen to prevent side effects of the medication that is specific to the drug at hand due to its chemical properties and how your father's metabolism chooses to react to it. No amount of dietary supplementation or improvement will alter those effects (at least none that have ever been studied or published. Interesting thought though to be sure).Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Dariush Saghafi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could continued numbness in arms and fingers be just pinched nerve or silent cardiac symptoms?\n\nI m a 42yo white female, not obese, great health, but my left arm has been numb down to my 1st 3 fingers for about 4 days. I think it s probably a pitched nerve, but don t want to miss any cardiac symptoms either. What are other silent cardiac symptoms in women?",
    "doctor_response": "hi In my opinion you have pinched nerves probably at the level of your cervical spine or at wrist ( carpal Tunnel syndrome). This kind of pain is usually not seen in cardiac pain. I suggest you get NCV both upper limbs and if this does not detect pressure on the nerves then go for MRI Neck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes scratching of head, neck and back with scabs?\n\nMy baby, whom is 20 months old, has been scratching her head, behind her ears, neck and back causing red scratches and scabs thru out. I have not changed any of her soaps/ shampoos and she has not eaten any new foods. She does have a tooth coming in but she continues to wake thru out the night for the past week and it has not gone away. Thanks!",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the lump in my soleus?\n\nI've had a pinball size lump on my soleus for the past few weeks. It doesn't hurt, not bruised and there has been no injury to the area. Had an ultrasound today and the impression was \"no mass identified in the region of the palpable lump\". Does this mean it's nothing?",
    "doctor_response": "Hello there,Yes it may not be anything of concern, need not to worry, or if it is it may be a cyst of any kind.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest thightness\n\nHi, I have tightness in my upper chest sometimes, and it s sometimes hard to breath it s like I have to sit up grasp for air, when I work out it doesn t bother me most times it s when I m not as active or mainly inside. I ve never had a EKG or a CAT scan or a PET scan all I know is that those are my symptoms and that my heart also tends to race a little. I am 16yrs old good/great physical condition and 140 5 4",
    "doctor_response": "Thanks for your question on HCM. In young age group chest tightness is mostly due to anxiety and stress. But we need to rule out cardiac and pulmonary causes first.So get done ECG to rule out cardiac cause.Get done chest x ray and PFT (Pulmonary Function Test) to rule out pulmonary cause.If all of the above are normal than we need to rule out anemia and thyroid problem.So get done CBC and S.TSH to rule out these.If all are normal than it must be related to stress and anxiety. Better to consult psychiatrist and get done counselling sessions. Avoid stress and anxiety. You may need anxiolytics.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes food to get stuck in teeth causing pain?\n\nHello, Whenever I eat food particles go between the gaps of my molars and cause pain. Hot or Cold food does not matter but food like chicken get easily stuck and cause pain.  My tooth is fine no sensitivity at all. But the when food goes into them it pains a lot. I floss twice daily and use mouthwash once a day but still no relief.",
    "doctor_response": "Hi,   Thank you for posting your query. I had gone through your problem. Normally there should not be any gaps between teeth. But because of gum diseases in some individuals gaps will be formed between the teeth. Some times infection is seen beneath the gums. when ever food is accumulated in these areas wage to moderate pain is felt. Pain will be severe if chicken like substances are accumulated in these areas because of putrefaction by the micro organisms. It is not possible to remove that infection by using floss or by using mouth wash. profession treatment is necessary to get rid of the problem. So i would like to suggest you to meet the gum specialist i.e., periodontist. Hope my explanation would satisfy your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible after HPT being negative?\n\nHi, may I answer your health queries rightHello, I have missed 2 periods and have several pregnancy symptoms, but my preg test was neg a few days after 1st missed period. I was told I couldn't get preg but have regular periods. Could I still be preg after a neg test",
    "doctor_response": "No I think you are not pregnant otherwise your upt would be positive.  There are other causes for delayed periods.  Consult your gynaecologist  and go for investigations to rule out other causes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be the reason for reduction in platelets count?\n\nI am 74yrs female, 5'5\", 180lbs. Have low platelets 74,000 they have been dropping for the last 11 yrs, i am under the care of drs. i have no other medical problems. I play a lot of golf, go to gym sometimes and walk and lift weights, but not on a regular basis. MY mother died with leukemia. So of course i have some worries. How would know if you have myelodysplastic? I do not really have a diagnoise.",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern.  There are many cause of low platelet count.  Even simple viral infection can leads to low platelet count. Many times its idiopathic and no any causes are found. If you have persistent lowpplatelet then you should go for bone marrow examination once. It will rule out most of the major causes. Myelodysplasolia also can be ruled out by bone marrow.  So consult haematologist and plan for that accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath and chest pain?\n\nMy husband is 53 and has been having shortness of breath and some chest pain and pounding heart beat with little exertion. He has had an echo stress test, ekg and a VP scan of his lungs, all were normal and was told he had a low probability of a PE. What else should he have checked out?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your husband's situation and problem. Since his extensive cardiac work up is normal, no need to worry for cardiac diseases. His VP (ventilation perfusion) scan is also normal, so Pulmonary embolism is less likely. In my opinion, we should rule out bronchitis in his case. Bronchitis can cause breathlessness and chest pain. So better to consult pulmonologist and get done PFT (Pulmonary Function Test). PFT is needed for the diagnosis of bronchitis. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. He may need inhaled bronchodilators and inhaled corticosteroid (ICS). So get done PFT. Hope I have solved your  query. Wishing good health to your husband. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Numbing nerve pain in hands and fingers, pain between the shoulder blades. Spinal X-ray showing minimal scoliosis. Treatment?\n\nI get numbing nerve pain in hands and fingers:  thumb, index and middle fingers on either side.  Pain seems to be triggered when performing any activity using upper shoulders and arms (riding bycylce, typing on a keyboard, lying on my side) where tingling numb sensation will start and end up with severe burning pain.  Also have some thoraic pain between shoulder blades.  Jan 2012 had  cervical spine x-ray:  minimal scoliosis MAR and thoraic x-ray: mild to moderate degenerative changes MAR.  Also have some artheritis in lower bank.  Age 59, female and have been on HRT (estrogen) since age 30 due to complete hysterectomy (endometriosis).  Age 40 became hypo-throid and currently have adequate treatment with T3 & T4 replacement hormones (synthroid & cytomel)",
    "doctor_response": "Hi, Thank you for posting your query. Based on your symptoms, we need to exclude a diagnosis of carpal tunnel syndrome (CTS). where the median nerve (of hand) is compressed at the level of wrist. The diagnosis can be confirmed by nerve conduction studies. Treatment would consist of gabapentin capsules. In some cases, a minor surgery may be required. Please get back if you require any additional information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Difficulty in moving body while sleeping, choking. Could this be small seizures?\n\nMy son is 18 years of age an when he is sleeping he feels he can t move his body also is choking. He has had a lot of these episodes that he can t breathe. I was wondering if maybe he has a small seizures during sleep because it takes one of us to hear him whisper sometimes when he says can t breathe. Making a gasping noise an for air.",
    "doctor_response": "Hi,Thank you for posting your query.The most important condition to rule out in your son's case would be obstructive sleep apnea (OSA), where there is obstruction in the airway while sleeping, resulting in small periods of choking and inability to breathe. A sleep study (polysomnography) would help in this. EEG recording is also included in this study, which would also help in diagnosing any seizures.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My email: drsudhirkumar@yahoo.comMy blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and rash around neck in a child\n\nMy 2 yr old is having vomiting, reflux, distended hard stomach that starts out in the AM flat and normal and by night is big and hard and sometimes is distended all day and night. No food allergies. Is on reflux meds and stool softener. just started stool softener. been on reflux meds since birth. Sometimes a high fever and rash around neck",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.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 15mg/kg/dose (maximum ceiling dose of 500mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with ParacetamoI.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What causes radiating lower back pain during sleep?\n\nHi doctor, I am 54 years old. My weight is 145 lbs and height is 5'7\". Almost every night I am getting severe pain in my right hip and groin. The pain is sharp and burning. It radiates down to my right leg. However, it completely dissipates after about 15 minutes of walking around. Always the pain occurs in the same side. I have zero pain during the day. This has been going on for almost six months now. What could this be? What questions should I ask my primary care physician? Earlier I was diagnosed with osteoporosis and low protein C and S. My medications are Forteo since one year, Estrogen patch over 5 years and B12 injection.",
    "doctor_response": "Hi. I have read your query completely. I do not think this pain is due to appendicitis or ureteric stone. They will cause severe pain and does not relieve by walking. You are taking Forte for osteoporosis which does not cause you this problem. It may be due to cramps, which is common in osteoporosis due to altered calcium and other mineral metabolisms.The pain may be due to lumbar disc prolapse which is lumbar discitis. In which case the pain starts from the lower back and spreads to one of the legs. It can also be due to faulty sleeping position. Many people have sleepy legs due to faulty sleeping position. It is commonly relieved by altering the position. Sometimes we sleep by keeping one leg over a pillow or edge of the cot. It may cause nerve compression and temporary burning pain over the legs. You should ask the following questions to your primary care physician: After visiting your doctor please do update me for any doubts you have. My wishes for quick recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Done surgery for lower back pain. Can you recommend pain management doctors in West Tennessee?\n\nHey Doc. I have low back problems and have for the past 8 years. 1 neurosurgeon said total fusion of my 5 lower vertebrae. I opted to do pain management instead. I stopped all pain medications in February of this year. Couldn t live with pain. Had surgery at Laser Spine Institute in July. Need 2 more surgeries due to problems at 3 levels. I live with chronic pain. I am an assistant principal at a high school in tennessee. I want to make it until for retirement. Can you reccomend Pain Management doctors in west tennessee? Little druggies have made it impossible for me to get help. They treat me like some street addict. I have a lovely wife and 3 kids and want to enjoy life. PAIN has taken my life from me.",
    "doctor_response": "Hi, Welcome to Health care magic forum.                            You got medical treatment for back ache since 8 years. Had surgery at laser institute in july yet 2 surgeries are to be done, and feeling chronic pain.                            The information of the doctors , is difficult to fetch, but you can have some suggetions  to go through.                             I to my patient with such symptoms prescribe neurotropic injections for 10 consecutive days, and then one injection every week, fortnight and then monthly for ever.                             Avoid taking potato, other tubers, tomato,egg, chicken, and sea foods. These will bring down the dosages of the pain medication slowly.                             Besides you can have your surgeries , pain medication, and rest every thing as usual.                                Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a hard knot on elbow after an injury?\n\nHello, I knocked my elbow into the corner of a wall 3 weeks ago -- very painful.  A huge bruise resulted -- and then faded normally.  However, I am left with a hard knot under the skin by my elbow.  It is freaking me out a bit. Can you please help me?",
    "doctor_response": "Hello!Your story let me think about bursitis and its cured now.The hard knot is residues of liquid collection. Physical procedures like magnetic wave therapy can help.You can massage the knot till get to physical therapy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tremors in thumb and severe nerve pain\n\nI started having tremors in my right thumb and finger several years ago. Then 3 years ago I started having severe nerve pain. My legs don t want to move freely. I have been checked for m.s. and was told it is all in my head. Tremor is now spreading and my legs still dont work with ease. I am now having tremors or constant movement on the right side of my body. Drs make me feel like im crazy. One other thing is that I can identify with all symptoms. I get a numb feeling in my mouth right side feels like I have been given novacaine. Please help",
    "doctor_response": "Your doctors might be reasonable on the basis of allopathic science.In Ayurveda, it is called vitiation of 'Vata' humour esp a kind of Vata is Vyan VAYU which manifests itself in the whole body nerves.It, most probably, is 'kamp Vata' and can be corrected if select medicine on the basis of more info is given for some time. Medicines are harmless and natural.If you agree, meet any Ayurveda doctor near you or write me direct question giving some more history.Hope its helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hit my forhead and it feels tight, Is that normal?\n\nI hit my forehead,and now it is really sore, and it feels tight, Is that normal?",
    "doctor_response": "WELCOME TO HEALTHCAREMAGIC IF YOU ARE HAVING COMPLAINS AFTER HITTING YOUR FORE HEAD YOU SHOULD TAKE IT SERIOUSLY BETTER YOU CONSULT SURGEON/ NEUROSURGEON  AND GET CHECKED UP YO RULE OUT ANY INTERNAL INJURY HOPE YOU BE ALRIGHT SOON",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lumps in between anal opening and vagina\n\nI have this weird lumpy thing, that literally just turned up, between my anus and vagina and its starting to spread out. I don't know what I did to annoy it because I'm really big on hygiene and I'm freaked out by germs. I got up this morning and it's got bigger and now it seems to have popped or something. I mean it's bleeding and it smells a lot like fish...It's disgusting and painful when I walk, sit, lie down etc. What is it and how do I make go away?",
    "doctor_response": "Hi,Dear,Good evening.Thanks for your query to my virtual HCM Clinic.I studied your query in-depth.In My opinion-you are suffering from-perianal-Ano-rectla abscess with fistula formation after bursting of abscess.Treatment-a-Seitz bath with luke-warm dettol,b-Antibiotics with Tb-tinidazonle-for the  control of-anaerobic foul smelling discharge and infection, c-If the wound doesnt heal, then debridement of the fistulous tract with above treatment-under ER Surgeons-care, would treat the discharging lumps in between-peri-anal and peri-vaginal area.Hope this would resolve your worrying query.Wellcome for more query from you.Good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bruise and swelling in chest after hitting\n\n2 days ago I was hit in the chest by a hook that was pulled from the ceiling by a resistance band pulled at full resistance.  Similar to a hit from a sling shot.  There was no penetration but the area and surrounding began to bruise and swell immediately.  Could I have done damage that requires doctors attention?",
    "doctor_response": "Respected user , HiThanks for using Healthcaremagic.comI have gone through your query in depth .*  Suggestions for better recovery-  Ice  pack  application 3 - 4 times a day .-  Ibuprofen  tablet  3  times  a  day  after meals .-  Consult later doctor if required .Hope this clears your doubt .Welcome for further guidance .Regards dear take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is one tablet of Ovral I enough to prevent pregnancy?\n\nHello doctor, I had protected sex with my partner six days before. I consumed one tablet of Ovral l within 24 hours of the intercourse as a safety measure and because that was the only tablet available immediately. We have a doubt that the condom may have broken and do not want to risk being pregnant. Is that one tablet of Ovral l enough to avoid it? (Similar to I-pill or unwanted 72). Also, because I got scared I consumed two tablets of Ovral l today morning. I need help with the right information and further guidance to avoid pregnancy and any side effects caused by these pills.",
    "doctor_response": "Hi. The dose of Levonorgestrel is quite low in Ovral L compared to Unwanted 72. So the effectiveness for prevention of pregnancy, the two tablets of Ovral L may be sufficient. Now onward, please use regular protection and do not depend much on Unwanted 72. If the 72 hours have not passed, then you can take Unwanted 72 else or equal amount of Levonorgestrel, if it is already more than 72 hours then wait and watch for your scheduled time of the menses and if you miss your period then consult a gynecologist immediately.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for the palpitations, chest tightness and diarrhea?\n\nHi . Since June I have experienced many changes throughout my body , I went to a and e with tight chest pain ,feeling breathless and being woken up in the night all tests were normal . But for the last 3 weeks I have been experiencing a tingling sensation in my left arm , chest tightness , breathlessness and hot and cold feelings . Also suffering with diarrhoea on and off . I now am having palpitations so worried I have a heart problem please help",
    "doctor_response": "hello,I have gone through your query.Thanks for using HCM.You symptoms are likely due to Anxiety.As you mentioned that you have already undergone check up and all your reports are normal.You may use Tab.Clonazepam 0.5 mg mouth dissolving tablet when you are feeling these distressing symptoms.I also suggest you to get your Thyroid functions Test done to rule out hyperthyroidism.My best wishesDr.Rajesh Teli,MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Respond plus for psychic behaviour, keeps talking to herself. Why is Espazine prescribed for?\n\nMy wife is a psychiatrist person since many years. she is taking Respond plus tablet at night. Now recently she gets up at 3.00 a.m. early morning and remembering her old incidents in life and keeps talking to herself. Why is Espazine prescribed for? How many days can she take Espazine? Waiting for your advise. A. S. Bhasker Raj Bangalore India",
    "doctor_response": "Hello  It is very common in Psychotic Disorder to have muttering or self talking behavior. She is having restlessness and disturbance in sleeping and due to this she is remembering past incidents. I will advise you to please visit her psychiatrist for proper medicine for sleep. Resperidone is a good drug for psychotic symptoms and it causes sedation also. But as she is having improper sleep please visit psychiatrist. Espazine is also an antipsychotic drug. It belongs to first generation antipsychotic drugs. It contain Trifluparazine. If she has been prescribed espazine also then it will cover problem of sleep also. For change in medicines if required please visit her psychiatrist. Give her warm and supportive care, she needs your help. thanks Dr. Seikhoo Bishnoi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are my chances of pregnancy?\n\nHi, may I answer your health queries right now ?  Please type your query here...i am 28 years old.my doctor told me to start Ovral*l on the 5th day of my period.i had sex with my husband on the first day of taking this pill.is there any chance to get pregnant?",
    "doctor_response": "Hi,Thanks for submitting your question here.As you have a sex on the fifth day of your cycle, the chance of pregnancy is almost nil.I suggest you to continue ovral but not from the fifth day; just keep a gap of seven days and restart a new pack irrespective of the days of your cycle. Ovral should be taken in this format just 21 days on and 7 days off.SincerelyDr Bhattacharyya",
    "dialogue_context": ""
  },
  {
    "patient_message": "Irregular periods.  On krimson 35 for PCOd.  Is protection from condoms needed during sexual intercourse while being on krimson?\n\nHai,I am 23 years old I am suffering from irregular periods.. Scan and Harmon test every thing is ok... But I had pcdo so doc preferred to use krimson35... My question is while using these tablets we have to use preqution during intercourse or it's not necessary...if I am not using condoms then I will get pregnancy?  Plz answer my question thanku..",
    "doctor_response": "Hello ma'am and welcome.It is best to use contraceptive methods like the use of condoms despite of the condition and treatment you are receiving. We cannot say for sure whether or not you will conceive without the use of condoms, and it is best not to experiment either. So please go ahead and use condoms.Hope this helps.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump under my chin on the upper most part?\n\nHey I have a lump under my chin on the upper most part. When ever I gently rub it it s numb and the bump is hard. My glands have swollen but i saw a doctor and they gave me medication for the swollen glands. I m most concerned about my lump under my chin",
    "doctor_response": "Hi,Dear,Good afternoon.Thanks for the query to my HCM online- clinic .I studied your query  in-depth.I  can understand your concerns for  your chin lump.-In my opinion the hard lump under your chin is -hardened pimple -first possibility / and or hardened with died out- infected -sebaceous cyst.-The fact  that your doctor advised medicines goes in favour of infective pathology of the chin lump and the swollen neck glands with it.-.I would advise --Alert-A review with ER-Surgeon for the steps to be taken with his advise is a must and urgently advisable in your case.-Hope this would resolve your worry-some query.Wellcome again to HCM .Have a good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly advise treatment for acne and oily skin.\n\nHi doctor,I am 18 years old and I have somewhat mild acne and often oily skin. I have had acne for about two years but this year it got worse. Some topical medications I have used in the past are Trimethoprim, Sulfamethoxazole-F, Adapalene gel, Differin. I have tried almost every drugstore prosecutors out there and nothing seems to work. Products I use at this moment are Cetaphil gentle foaming facial cleanser, Witch hazel, and aloe vera plant on my face every night. I have been doing this for only three days, do not see much of a difference yet. I wrote this because I want a final solution to at least control my acne. As it messes with my self-esteem.",
    "doctor_response": "Hi. I have gone through your case. Well, first of all, be patient. You need to understand acne is common in your age and it is an ongoing process and you may experience frequent exacerbation due to stress and hormonal. It occurs due to hormonal activity at puberty. So you may not get final medicine or final decision. And the problem may last until your twenties. Moreover, you have taken too much of medicine which may be another reason for resistant acne. Just stick to one. Apply Clindamycin gel two times a day on the pimple. Use Cetaphil cleaner. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a ball shaped circle under the right jaw line?\n\nHello. This mourning I noticed that when I put my chin to my chest there was a ball shaped circle basically under my right my jaw line when I left my head up it then goes back down into my neck. When I roll my neck out move it or touch it, there is some tenderness. Other than that it doesn't seem to tender. On my left side there is nothing there.",
    "doctor_response": "Hello!Welcome to HCM.The round thing you are feeling is a sub-mandibular lymph node.They are normally palpable with head bent down.Lymph nodes are tender for many reasons.You must be suffering a infection in your teeth or sinuses.Do not bother it too much.Do not keep palpating it.See your physician if tenderness persists.Do warm saline gargling twice daily.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant pain in the abdomen?\n\nI am having pain in my left side of my abdomen sometimes radiating to the center the pain is dull and constant. It hurts mostly when I move but I can feel it when I press on it. region for the last 4 days. I had a low grade fever of 100 degrees It started off a week ago with a severe headache and a sore throat then I was extremely tired. Then I had a bout of diarhea then This pain started.",
    "doctor_response": "Hi ! Good morning. I am Dr Shareef answering your query.If I were your doctor, I would advise you for a routine/microscopic/culture sensitivity test of urine and stool test for ova and cyst. Till the results of the investigations were available, I would advise you with a broad spectrum antibiotic, an anti spasmodic, a proton pump inhibitor drug, and a probiotic. This could change depending on the investigation reports.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on neck that is sore to touch\n\n18 yr old female. I have a lump on the back of my neck that is sore to the touch and makes it uncomfortable to move my head. I think it is a swollen lymph node. Is there any way I can get rid of it. I am on holiday at the moment so there is no way I can get to a doctor for the next week or so.",
    "doctor_response": "Hi,If it is an inflamed node then you need to take a course of antibiotics and anti inflammatory medicines. I usually advice my patients Tab Augmentin thrice a day and Tab Combiflam thrice a day both full stomach for 5 days and then the swelling and inflammation would come down. You can also apply warm compresses over the node.But, please your Doctor once you get back and get examined.Take care,Dr Rishi, New Delhi, India.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in liver area while passing urine?\n\nI noticed when I drink alot of alcohol or let my bladder get over full, as I urine I feel a slight relieving pain as I perform. This feeling is located in my LLQ, left lower quadrant, i believe anaomitcally its my liver region. Any insights would be appriciated.",
    "doctor_response": "Hello and thank you for asking HCM.I have read your symptoms and i will answer at your questions.Your symptoms : relieving pain in your left lower quadrant,after you have a lot of alcohol might correlate with a kidney stone,an infection of your urinary tract, or even a cyst in the left ovary (if you are a female)If i was your caring doctor,i would advice to do an ultrasound of your abdomen,to check your abdomen (especially your urinary tract)-an urine test to see if there is an infection,and if so,treat it with antibioticsAccording to your symptoms,you have nothing to worry about your liver,since the liver is located in the upper right quadrant of your abdomen and you feel pain in your lower left quadrant. If you have any other question,feel free to ask me.Dr.Endri Katro",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is alcohol recommendable while on roaccutane?\n\nim on a 20mg/day dose of roaccutane, and have been on this for 3 weeks now, am seeing good improvement already, i am planning to go and and drink quite abit of alcohol, i was wondering if this is ok, as i have cut back from drinking and going out altogether since I ve started my course.",
    "doctor_response": "Hi,It is not advisable to consume alcohol while on roaccutane. Consuming alcohol while on roaccutane may cause unpleasant side effects such as fast heartbeats, palpitations, flushing, headache, tingling sensation, nausea, and vomiting. So, avoid drinking alcohol while you are taking roaccutane.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can having nodule in lung cause cancer?\n\nI am 30 years old and the doctors have found a 1.8 module in my left lower lung. I have done test to check for valley fever and TB both came back negative. Now I have to do a PET scan. I have had cancer before from an HPV and they did a hysterectomy. Should I be worried this is cancer?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Since you are a uterine cancer survivor, this nodule in lung can be due to metastasis. Uterine malignancy is known to metastasize to lungs. And in initial stages, metastatic lesion looks like nodule only. So your current nodule can be due to cancer. But it is too early to say this. You need to get done CT scan every three monthly and if nodule is increasing in size then biopsy is needed to confirm malignancy. But if nodule is static or decreasing in size then no need to worry for malignancy. It might be due to benign cyst or fibrosis.So better to consult pulmonologist and discuss all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Burning sensation while urinating first time in the morning. History of urinary tract TB. Treatment?\n\nHello,I am a 31 year old male, living in bangalore. SInce couple of days, i get burning sensation only when i micturate first time in the morning. I drink 3-4 litre of water a day. past histroy...I have been treated for Urinary tract TB for a year (Monto 4 for 2 months and Monto 2 for 10 months)treatment duration July 2011 - June 2012.",
    "doctor_response": "Hello, thanks for  the query to H. .C. M.  Forum Renal tuberculosis  is known as extra pulmonary tuberculosis. As  you had taken complete treatment of this disease  already. Now please note down one thing that resistance to drugs is very common in tuberculosis. Recurrence is also very common in tuberculosis. Now please get in blood examination for C B C  and E S R. If  E S R is  mote than 70 mm  than consult a doctor and rethink about the disease. 2 nd reason of burning urination may be due to  U T I. So please get in urine analysis complete as well culture. Think about renal stone also. Regards   Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i give gripe water for stomachache to 39 days old?\n\nhi .. i have 39 days old baby and i am giving him breast milk and lactogen1 from birth.. and one bottle tufpro (half in the morning and half in evening ) and azyme 2 times ... till now everything was alright.. but suddenly he started crying very high in the night from past 2 days... and he is showing some stomach ache... what should i do... can i go for gripe water if yes so which gripe water is best ??",
    "doctor_response": "You can take gripe water of any company ,it will helpful. I t is just herbal medicine with ginger,fennel,chamomile for colics.Hope it helps.Wish your baby good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes uncomfortable vomiting sensation?\n\nHi my husband went on a roller coaster ride and immediately started sweating profusely and also felt uncomfortable and vomiting sensation also this happened about 4pm later we had our dinner around 9.30 in the night but still complains of vomiting now he is asleep she we consult dr. Or can he take an ecosprin 75 mg which he usually takes in the morning",
    "doctor_response": "Hello, I'm sorry there are two possibilities. Gastric upset - where you should not take ecosprin and need antiemetic and anti gastric drugs. If it's cardiac related due to sudden stress from roller coaster needs immediate ECG and start Ecosprin. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for H.pylori\n\nHello Doctor I am taking treatment for H . pylori bacteria ; doctor prescribed Mox 500 ( two tab in morning & two In night ) for 5 days after that ask me to take 1 tab of TINIBA500 & 1 TAB OF CLARINOVA 500 ( ONE EACH IN MORING & ONE EACH IN NIGHT ) just want to know this treatment will help me",
    "doctor_response": "Hi & Welcome to HCM.I appreciate your concern for the effectiveness of the prescribed treatment for H. pylori.The prescribed treatment may not help in the eradication of the H.pylori.1. The prescribed regimen by your treating doctor is INCOMPLETE as it contains only the  \"sequentially used\" antibiotics (Mox, Tiniba & Clarinova).Notable missing drug here is a proton pump inhibitor like Omeprazole or Pantoprazole which should have also be taken simultaneously.2. Proton pump inhibitor should be continued for another 4-6 weeks for total eradication of the H.pylori and the healing of the stomach ulcer.Had you been my patient I would have advised the following \"Triple Therapy\" which is found to be more efficacious:1. Two antibiotics (Mox to be taken twice and Tiniba to be taken twice) along with a PPI like Pantoprazole  for 14 days, this is followed by2. A PPI like Pantoprazole alone for a period of at least 4-6 weeks.Hope to have answered your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a painful lump in the leg?\n\nI have a small lump on my left leg which an ultrasound indicates is a hypoechoic lump. It can be very painful at times, sometimes when I get out of bed and also if I am just standing/sitting. If I touch it it can be extremely painful but the area immediately around is not.should I have it removed?",
    "doctor_response": "Hello, Any lump in the body must be investigated. this lump/swelling/space occupying lesion must be removed surgically and examined histologically. Further treatment will depend on the histology report. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Nirmal Chander Gupta, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for numbness in hand\n\nWhen I have my first cigarette in the morning , my left hand becomes numb . And for about 15 minutes or so, then goes away Is this something I should be concerned about . I do have hypertension but it is being managed by doctor Also taking Zoloff for menopause , but basically healthy other than these.",
    "doctor_response": "Hithis may mean some coronary spasm may be there which relaxes in 15minutes,ideally you may have  an TMT test for heart evaluation for any warning signs, consult an cardiologist, to rule out any coronary causes.it is better to avoid cigarretes.Do some deep relaxing breath exercises early morning instead of the smoke,it may helpbest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain, breathlessness, pain, head and chest pain. Family history of kidney disease. Any idea?\n\n35 female, 260 pounds, healthy. severe pain mid back, more on the right side, now radiating around to the front right ribs, takes my breath away. i seen my dr and said iw as sitting wrong in my work chair! pain has become consistantly worse the last 2 weeks, since i have a head and chest cold . today it is almost unbearable. i was gonna go to er, but figured the dr would tell me to take ibuprofen and relax. any idea. family history, kidney disease, galbladder and pancrease issues, heart disease, alzheimers and breast cancer , ia lso forgot to say i am on medication for high triglycerides, and syntroid for my thyroid .",
    "doctor_response": "Hi, Welcome to HCM You have most likely developed back muscles spasm may be due to wrong posture and possibly precipitated by cold. A simple analgesic and local hot fomentation will help you to reduce pain.as if  muscle relaxant drugs may be required which you will get only on prescription. If condition is severe enough then visit to ER is advisable. As you are over weight and a spine disc problem may be there so a x ray spine to see condition of spine if required a MRI may give valuable information. Please continue to take medication for thyroid and triglycerides. Take care Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to bring control over mind while being unstable?\n\nA man is saying that his mind is not stable ,he is thinking too much.he is also saying that his tmy is burning like a fle, and he have been bomate two times.. Please help me what should I do in this situation because there is no doctor in here. And the man is in serious condition.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Your friend is not stable, according to your description. His tummy is burning and he vomited twice. I think you wanted to tell us this information.If he is complaining about his stomach pain and is vomiting, then there could be something wrong. If you are sure that he is thinking and making the symptoms worse, you should be able to calm you with your understanding of him. Otherwise, the problem should be related to food poison. You should give him a lot of water to drink. Then as soon as possible please take him to a doctor.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for liver ailments\n\nHi, sir good evening, 3 days back US Abdomen Whole reports came, In reports all are normal but Liver: 16 CM-Enlarged in size echogenecity NO IHBD/SOL, Report end given Impression: Hepatomegaly with fatty changes, what about the liver position healthy or not? please give me answer.",
    "doctor_response": "HelloYour findings suggests mildly enlarged liver with fatty changes.It may be due to many reasons like hepatitis,alcohol intake,obesity,altered lipid profile,medicines,auto immune causes etc.Fatty liver is reversible condition.Obesity and sedentary life style are its common causes,so these factors should be ruled out.You may need to change your diet and life style.You should a go for brisk walk regularly and avoid fatty food.You may need investigations like routine hemogram,random blood sugar,liver function test,lipid profile.Treatment depend upon findings.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for seasonal asthma\n\nWell I'm male, 15 years old, approximately 137.6 pounds. I have been diagnosed with seasonal asthma. But lung  trouble is not why I'm here. I was in bed, and I decided to get up, I took about 4 steps when all the sudden I had an extreme sharp pain and burning sensation in the middle of my chest, I percieved it as the heart. But the pain lasted 1 minute then dulled and has continued to hurt for the past 10 minutes.",
    "doctor_response": "Sharp pain and burning sensation in the middle of the chest suggest gastroesophageal reflux. This means acid produced in your stomach is getting regurgitated in esophagus. Take Cap Omeprazole once daily under guidance of your physician to curb acidity.Drinks lots of water, do not take stress, sleep adequately, do not eat upto full stomach, do not drink water immediately after having meal, avoid spicy and fried foods.Dont worry and be happy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest congestion and rashes\n\nHi my 10 yr old has had a cough (chesty, phlegm, etc) for a little over a week. This morning presented with an itchy rash from his knees downwards, and back of legs and hands very hot and red.  Took to Dr who diagnosed viral condition and to see. Tonight still coughing periodically and when does so it is continuous for a while, but is now presenting with hives all over his body - am presuming this is part of a \"virus\" - Dr checked over and said that his chest, etc was clear but had glands up all over his neck.",
    "doctor_response": "I think ur child has developed urticarial rashes. Urticaria may be associated with wheezing.. So take care for respiratory distress. Give tab/syp atarax. For skin lesion apply calamine lotion. If condition worst then require steroid supplementation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Nodule in axilla, sensitive, not raised. No history of breast cancer. What do you think?\n\nI found a nodule in my left axilla this morning while showering, it is sensitive, but not an abscess or raised area. It is probably about a quarter of an inch deep and round, does not roll or move.  No history of breast cancer in my family, I have not been sick at all except general tiredness which I attribute to working too many hours.  I called a surgeon and they cant see me until the 12 of the month, what do you think?",
    "doctor_response": "Hi there, kindly tel exact how old are you.. It matters alot to know your exact age to say whether it is  benign or malignant breast lump.. and if you a feeding mother there might be chances of abscess, or its a lymph node enlargement.. there many conditions to rule out regarding your query!! So the only way i can suggest you is to visit a pathologist and get your FNAC done for confirmation..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dry patches of skin all over the body?\n\nI have very dry patches appearing suddenly on my body.  My knees, foot, ankle.  They don't itch or hurt and are not red.  Just very very dry rough patches.  Should I be concerned?  I live in Florida but haven't been out in the sun much this summer.  Thank you!",
    "doctor_response": "Hello,Thanks for the query,Probably you have developed psoriasis.Your description matches with that.Psoriasis cannot be totally cured.It can be only controlled.You can use steroid creams to control this.Please meet a dermatologist for exact diagnosis.And get the medication prescribed.Let me know if you have any other doubt.you can ask a direct question to me on this forum, following the below link. you  good health,Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for constipation in an infant\n\nHello. I am a desperate mommy! My 11week old has silent reflux. He was on novalac ha and did very well with the milk. No gas. His tummy went daily. Then i put him on nexiam which made him constipated. My paed said to stop with the nexium and use novalac ar,now he is gassy and fussy and even more constipated. He is suffering. And i am going back to work next week. Need sleep. Will nestragel help?! Can l put it in the novalac ar? I heard that it also helps to soften stools. Please help",
    "doctor_response": "VERY GOOD QUESTION,FIRST OF ALL I WANT TO KNOW HIS FEEDING SCHEDULE AND WHAT YOU ARE GIVING ,IF YOUR BABY IS FORMULA FEED THEN CONSTIPATION IS LIKELY PROBLEM OFTEN WITH FORMULA FEED,BUT IF BABIES ARE ON MOTHERS MILK THEN THEY MAY HAVE MOTION FREQUENTLY,OR THEY MAY PASS MOTION BY 2-3 DAYS BUT MOTIONS ARE SOFT IF YOU FEEL NOVALAC IS HELPFUL ADJUST PROPER DOSE PROBLEM WILL BE SOLVED",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will candid ointment cure fungal infection?\n\nI have a bad itching(fungal infection) in my groin & scrotum areas and after scratching the skin becomes red around these areas and also bulges. I am using Candid ointment with candid powder and also planning to take Avil 25...Does it help me?? I need an immediate relief..ThanksAge: 24, Height: 174 cm, Weight:75 kg,Sex: Male",
    "doctor_response": "Hi,From history it seems that there might be having super-added bacterial infection producing redness and bulging.Go for one antibiotic medicine course for 3-5 days.Go for one oral anti-fungal medicine course as well.Continue with Candid cream.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure Dementia?\n\nMy husband is 80 years old and has dementia. His problem now is that is right knee is swollen and giving him a lot of pain. I think he should see an orthopedic doctor but I don t know if it should be a doctor or a surgeon. Could recommend what I can do? What doctor I should take him to?",
    "doctor_response": "Hello! I read your question and I understand your concern.In my opinion the swollen knee is not related to any neurological problem. I think the main cause of his problems is arthritis from degeneration of the bones and ligaments of this joint.I would like to know if he has had any trauma or fall. I would recommend you to consult with a rheumatologist first and have a full blood work, inflammation tests and a xray of the knee. If a traumatic injuryor fracture suspected in the xray I recommend you to consult with an orthopedist. A MRI of the knee would examine better the problem. Hope to have been helpful!Best wishes Dr. Abaz Quka",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this ECG report indicate?\n\nHello I am a female 39 yesrs old. I went to the cardiologist because i had a screening called a valvescan done at my ob dr. the results suggested i had a valve obstruction (i had the screening redone and it came out normal the second time.) I had already gone to the cardiologist before the second screening. My ecg said nonspecific abnormality present. I dont know what to think of that. what does thst mean?? the dr. said it was all normal. he did reccomend a stress test and an ultrasound. had high cholesterol a couple of years ago because i was overweight. i have not had high cholesterol in the last 2 years. and i am not overweight anymore. so in other words my question is what can a nonspecific abnormality mean? thabk you",
    "doctor_response": "Sometimes the ECG machine interprets falsely. so better not to trust machine and believe your doctor what he says. most of the times the ECG pattern is all normal then also machine interpretation is vague one. So all you have to do is have faith in the doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Low back pain, dark line down the whole spine after a bat hit the mouth. Any ideas ?\n\nHi, my name is AAAA  and i am 14 years old. Ever since a bat hit my mouth with it s mouth leaving saliva on my mouth. I have lower backpain and this dark line going down my spine . What could it be? And if this helps, i did a back tuck on my trampoline yesterday and i landed on my neck . Now the line is darker and goes along my whole spine, and my whole back aches.",
    "doctor_response": "In my opinion your salivery gland is traumatised and that is only causing salivation. Along with this your cervical spine is traumatised. And following twisting exercise local heamatoma may be tingle down what caused dark line. Please wear cervical collar and a course of antibiotic . Advise you to get MRI scan of cervical spine  and consult neurosergeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for abdominal cramps & loss of appetite\n\nMy 16-year old daughter has been ill for 8 days now.  Symptoms are vomiting (in the first week), loss of appetite, excrutiating abdominal cramps, sore throat, slight fever, lethargy.  A doctor administered two antibiotic injections three days ago...she is still ill as before.  What could be the problem.  I am becoming extremely concerned",
    "doctor_response": "Hi.The commonest cause of pain in abdomen, vomiting, fever , sore-throat and all in a girl of 16 years can be due to infection. Only 2 shots of antibiotic may not work at all. I think she needs to continue a course of an antibiotic and symptomatic treatment. Till then get her blood, urine, stool and ultrasonography done. Widal for typhoid to be done.Take a second opinion of another Doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pains with breathing difficulties?\n\nhi im 43yrs old ,ihave been having chest pains for couple of months and am always short of breath ,another thing is that if i go for walks ido get short of breath and with it my right side gets very sore the pain is like a needle poking through so i have to stand or sit for a while till the pain subsides then i start walking ,iwent to my familyphysician and he sent me for a echocardiogram and the result said i have mild tricuspid regurgitation ,so now he sent me to see a cardiologist aug 10th,my husband says i makefunny sound when iam sleeping i am 5feet one and seems like i have gained some weight ,120lbs iwant to know the symptoms i have are because of this tricuspid regurgitation  thanks . regina edmonton",
    "doctor_response": "hi mild tricuspid regurgitation is a very normal finding and is not responsible for your symptomsyour symptoms are rather suggestive of stable anginapain in walking is referred to as angina on exertion grade 2-and breathlessness is called dyspnoe on exertion grade 2both are classical features of stable anginai would suggest you to go for tread mill test as this test will indicate if there is sny compromise in blood supply to heart during strenous exercise thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestions for burning feet/ hands in a person with kidney transplant and on prednisolone , tacrolimus and myfordic?\n\nI have burning feet and hands, especially at night, so painfull it keeps me awake. I have had this for quite a few years, thinking it was associated with my polyscytic kidney disease. I had a transplant a year ago but the burning remains. I am taking prednisolone , tacrolimus and myfordic. Any suggestions? Michele",
    "doctor_response": "Hi Michele,Thanks for your query.Burning feet/hands is usually due to Vitamin B12 deficiency. Take 1500 micrograms of B12 daily, which will gradually relieve the burning sensation.Consult your doctor and apprise him of my opinion. I am certain that he will agree with me, and prescribe the advised supplement in appropriate dose.If you find my response helpful and informative, do not forget an \u201cexcellent\u201d (5-star rating)  to my answer, to ENCOURAGE ALL doctors- engaged in social service- to render sound advice to the FREE queries. Take careDr. Rakesh Karanwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stoppage in menstruation?\n\nMr Girlfriend had period on 4th December we had sex on 14 December then taken i-pill in 2 hrs... She didnt hd periods till 4th January and took MT-PILL on 7th January without testing... still no periods.. done pregnanccy test on 11th Januar which was negative...?",
    "doctor_response": "Hi dear, I have gone through your question and understand your concerns.I pill has the side effect of delaying the next expected periods by2-3 weeks.If the urine pregnancy test is negative, then the pregnancy is ruled out.I will suggest her to not to worry and wait for the periods to come.Hope you found the answer helpful.Wishing you good health.Dr Deepti Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Wisdom teeth removal surgery, pain, soreness in jaw. Infection?\n\nI had 4 wisdom teeth taken out 5 years ago, 3 were impacted. The following day of surgery It was infected horribly. my entire face was swollen to the point i couldt open my lips . EVER since, But not prior to, I have had constant pain and sorenes on both sides of my neck just behind jaw bone close to ear, and under my chin on both sides. After the surgery once infected the dentist gave me antibiotics, following a year later my doctor said maybe there was some infection lingering or something with my nodes. could the infection have damaged my muscle or lymphnoids?",
    "doctor_response": "hi as there is pain and soreness on both sides of your neck behind jaw bone and under the chin area, it points toward excessive trauma while your extratcion which could have lead to excessive damage to bone and surrounding muscles and nerves. so the pain and soreness can be due to the the bone and muscle damage at that time. as for under the chin area, your nerve to the concerned area may have been damaged. thats why pain is still there. infection dont last so long and you have already taken antibiotics for a long time. but to be sure, get yourself clinicaly examined and also a opg xray done and post it here. in the meanwhile go for painkiller- orthodex three times a day. wishing you speedy recovery With best regards Dr Ankit Aggarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can small hernia style tear on pelvic area cause squeezing pain in testicle?\n\nAsking this question for my husband. He was told he has a small hernia style tear lower pelvic area. No symptoms then. He is experiencing a squeezing pain in his left testicle. No pain urinating. Has a history of Kidney stones. Is any of this related to this pain or if not what else may be causing it. No recent accidents.",
    "doctor_response": "Hi,From history it seems that he might be having indirect hernia entering in scrotal sac giving this squeezing pain in scrotal sac.Consult surgeon and get physically examined.This will give clear idea of having this problem.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had wisdom teeth removed. What is the bump in lower gum? Why does it hurt?\n\nabout a month ago i had my 4 wisdom teeth taken out. im 19. they mostly have healed, but in my left lower gum, i can feel a bump, it is hard like bone. i can feel it at the angle of my jaw where my back teeth are. it hurts when i touch it, i dont know what it is. this is preventing my lower gum from healing . any idea what it is?",
    "doctor_response": "hi there were chances that when the wisdom teeth pulled out it may broken by its root & one of the piece of root remains.check it with your your dentist as it may delay healing process Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bumps on calves and arm?\n\nMy 6 yr old has small bumps on her calves that are itchy. They are not in any particular shape,however almost on same portion of calf and inner calf, on both legs. They are raised,hard and swollen. A few,on her thigh  are red w swollen rings around them. A few more are now on upper arms;much more tinier,",
    "doctor_response": "Hi,It may be lichen urticatus. Consult the dermatologist for the perfect diagnosis and proper treatment. I would recommend to apply calamine lotion and to give antihistaminics like Hydroxyzine HCL syrup to reduce itching. Protect him from insects.Hope this helps.Dr. Ilyas Patel,Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does rise in blood pressure during tooth extraction affect brain?\n\nI'm going through post concussion syndrome and I'm worried about a tooth extraction I'm due for soon. I don't need to get put under anesthesia, just numbing the mouth, but I'm worried my rise in blood pressure during the extraction will cause issues with my brain.Is it safe?",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain in case if you are suffering from post concussion syndrome that occurs due to mild injury to the brain caused post trauma and the symptoms of post concussion lasts for about 3 months and then resolves gradually..As far as rise in blood pressure during dental extraction is concerned, the extraction will be carried out only after proper evaluation of your vital signs like monitoring of your blood pressure, heart rate and other general signs..To avoid blood pressure complications the local anaesthesia that will be given to you will be free from Adrenaline that can cause rise in blood pressure..Secondly in case if not an emergency, extraction can be delayed for time being and can be proceeded once your post concussion symptoms ceases..Consult an Oral Surgeon and get evaluated and a thorough clinical evaluation and investigations will be done to decide the further course of treatment and its effect over the brain..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason behind extremely itchy rashes all over the body with leg cramps,sore throat,congestion and heartburn?\n\nI have had a rash for about 3 to 4 weeks now it is on the back and side of my neck, in my armpits, inside of my elbows, forearms, under my breasts, lower abdomen, groin, and back of knees.  It is extremely itchy and seems to bother me worse at night.  I have also been experiencing foot and leg cramps on a daily basis, sore throat, congestion, and heartburn.  I went to see my doctor and she said it was most likely from my detergent so I bought dye free allergy free detergent and have not used or eaten anything different and the rash isnt getting any better.",
    "doctor_response": "HIThank for asking to HCMI can really appreciate your concern, this could be urticarial rash, If I would be your doctor then I would treat you with the second generation long acting antihistamine and the best drug would be \"Levocetrizine  10 mg three times in day, if this fails to respond then the next drug would be \"Hydroxyzine\" 10 mg three times in day, you would get alright with this treatment, have nice time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent numbness in hands while sleeping, driving, holding above heart?\n\nMy hands get numb often, It Happens while I m sleeping. I sleep with hands above my heart sometimes under my head. It also happens while I m driving with hands on steering wheel. They will get numb just by holding above my heart. I m really concerned. What is probable cause and remedy for this?",
    "doctor_response": "In my opinion you need to perform a cervical CT scan as i suspect cervical spondylosis which explain increased pain while sleeping Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes flank pain and white tissues in urine?\n\nAbout 4 months ago, I noticed white tissue like particles in my urine.  It is very visible and is in my urine EVERYDAY, it's not always present everytime I use the bathroom.  I went to have my urine tested and that moment there were no particles present at the time of that urinalysis.  I was given a strainer to catch the particles to be analyzed.  I was told by the doctor the lab results showed that as protein.  They sent me to a urologist and again they did a pee test and there were no particles present, so they want me to do a 24hr test.  What can be causing this? I didn't have any pain associated with it. Although, about 2 weeks ago I have started having flank pain on both sides.  I am a 28yr old female, with high blood pressure(on medicine and under control right now), I take Yaz, and I am on Synthroid.  Both Kidney disease and heart disease run in my family.",
    "doctor_response": "Hi,White urine or particles in urine generally suggestive of either UTI(pus) in urine or protein in urine. As your one report suggestive of proteinurea. But according to your description, it's transient. Generally transient or intermittent proteinurea is a common condition called orthostatic proteinurea means protein loss with postural variation. This is normal physiological condition and not to be worry about it. But you also mentioned pain in bilateral flank region also and you are hypertensive along with taking of steroids. These all are high risk conditions for protein loss. So you should be evaluated thoroughly wather this is physiological protein loss or pathological. You get Urine protein creatinine ratio and 24 hours urine test to decide the severity of protein loss. This will also help to find out the cause of protein loss. If both reports come inconclusive then better go for USG abdomen for kidney size and other pathology. And after then go for kidney biopsy to find out the exact pathology. Meanwhile you control your blood pressure and gradually tapper the dose of steroid along with diet modification with high proteins.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can kissing and getting touched by vaginal fluid on face cause HIV?\n\nHi doctor, Two days ago, I met a sex worker and we were just kissing each other and my underwear was on. Then she started playing with herself and there were vaginal fluids on her hand. She put her hand on my face and close to my nose and wanted me to smell her vaginal fluid. After about 10 minutes, I felt like this thing might be dangerous, so I went and washed my face. I do not know if she had HIV or not but I am very scared.",
    "doctor_response": "Hello. When there is no sex intervention and vaginal fluid was touched by her on the face, so it is clearly no penetration as the skin acts as a strong barrier. Kissing has the least chance or nil for HIV but yes, HSV (herpes simplex virus) is common. If any symptoms other than seasonal like a sore throat, common cold, then consult a general physician MD or an ENT specialist. The night sweat, rash all are common, so do not panic. Yet, if you have fear or anxiety, you can go for the test. Once the test results are negative, you are risk-free.  Take healthy food, fruit juice, milk products. The test to be taken are ELISA (enzyme-linked immunosorbent assay) kit within 7 to 10 days, RNA PCR on the 15th day, fourth generation CMIA kit test on the 28th day. You can take any of these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does gallbladder dysfunction cause fever, body ache and stomach cramps?\n\nI need my gallbladder removed. It\u2019s sluggish. I\u2019ve been having a fever, body aches, stomach cramping a lot. I\u2019ve had 2 pelvic exams and everything is fine. Could my gallbladder be causing me to have these symptoms?",
    "doctor_response": "Hi, The mentioned symptoms can occur in gall bladder infection. But additionally, pain in the right upper abdomen is also present. For gall bladder infection confirmation, ultrasonography investigation needs to be done. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to confirm if pin worm medicines are working?\n\nHow do you know if the pin worm medicine is working? Do the come out of the anus when they die? I about ready to take my second dose to treat them but it feels like my anus is always unclean and smells horrible and they're are sometimes little white things that come oit around anus that I'm told are the eggs?",
    "doctor_response": "Hi,Live or dead worms might come out after taking anti worm medicine.Eggs also might come out.Nothing to worry, medicine will work against this infection.If require repeat this dose after one week.Local part might be sore or some irritation might be there.After cure of infection it will be alright.You may apply antibiotic cream on affected part.Keep local hygiene clean and dry.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does my semen analysis regarding sperm count indicate?\n\nPlease what does my test analysis say? Colour- straw Volume 6.4ml Consistency - moderately viscouse Liquefaction - within 30mins Ph 8.0 Protein (++) Normal 70% Abnormal 30% Active 60% Sluggish 20% Non motile 20% Pus cell (1-2)/hpf Epithelial (+)/hpf Total sperm count. 87x10(6) cell/ml",
    "doctor_response": "HelloThanks for query.All the parameters like sperm count,motility and morphology of the sperms are normal as per WHO standards except presence of 1-2 pus cells which suggests mild infection of either Seminal Vesicle or Prostate which can be cured by taking antibiotic for 3-4 weeks.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have tension and do not feel like talking to anyone. Suggestions?\n\nHi,This is Sheela, i'm gonna complete my MBA in a weeks time. i'm really stressed out about my future. I don't have my mom and i was a boarding student for the past 15 years. for a couple of weeks i'm really tensed and i don't feel like talking to anyone : friends and family........ i feel like i don't belong here. i am feeling as if no one cares for me.......",
    "doctor_response": "Hello, Thanks for using health care magic for posting your query. I have gone through your given history in detail. It appears that you are really stressed by your life and thinking. Although you will accept that there is nothing specific to be upset about. Among all the things you have stated there is no reason for you to get upset. If you are anxious about the future you should visit a psychiatrist who can help you with some talk therapy sessions. Do exercise regularly and eat a good diet. 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/dr-srikanth-reddy Wish you good health, Dr. Srikanth Reddy M.D.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a lump on head be callus type tissue damage?\n\nSeveral years ago my son, 2 1/2 yrs old, was at the park w/ grandpa and fell and hit his forehead (glabella area) on a step. There was a small indent that quickly swelled and no signs of brain injury but 3 years later there is STILL a squishy lump at the impact site that s very noticeable when he makes certain facial expressions (raising eyebrows) Ped doesn t seem concerned. Says it s likely a callus type tissue damage. Should I be concerned and can expect it to ever go away..?",
    "doctor_response": "Hi.Thanks for your query and an elucidate history. Well, this is not a calosity for sure. This can be a organized hematoma, post-traumatic. And seen only on frowning as it must be attached to the muscles called frontalis, which works when we gaze-up.Get this checked by a Pediatric Surgeon, investigated and see if this can be removed now as it has been there for one and half years and not expected to go way.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tension and stomach discomfort?\n\nHello sir,I am rahul from india. I am pursuing an engineering degree in elec. The thing is, Currently I am in the bad phase of my life.Previously I admire the best and successful people in my life and I wanted to become like them. I read all about them on internet and wanted to become like that. I was far away from reality and the current position of mine.Now I know where I stand right now and what can I do. But those dreams of mine which I saw previously are being heavy on me. I cannot get rid of them. Its not a bad thing but kind of too high and big to achieve instantaneously. Since last 4 months, I got problems in my stomach and mind. There is always a discomfort their. I feel contraction in my abdomen and also lack of appetite. My mind also get tensed. I felt horribly exhausted In my mind.I did all the checkups I.e. ECG, blood tests, xrays, and even endoscopy. All tests are perfectly normal. Sometime I found my simptomes similar to irritable bowel sindrom.Please sir tell me what s wrong and what should I do.. if you need any additional information then I would appreciatiate that",
    "doctor_response": "Hi. first of all, do not pressure yourself to be someone else, someone youre not. what you are doing is a great field and you should just maximize your potential and stretch your limits till a point you feel is okay. do not over indulge. start a new dream which has no relation from the ones of your past. make sure you think about positive things and ideas. as for your physical health, take care of your diet and have alot of water. always be hydrated and visit your doctor about the abdomenal pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Large masses on cervix, lymph nodes were big. Freeze test is negative. Family history of uterine cancer.\n\nHello, i just had a total hysterectomy done. My Dr was surprised to find that my uterus was 4xs the normal size. There wer large masses on my cervix, and in his words \"they looked funky\" he had the pathalogist flash freeze test them, those were negative. He also found that all  the lymph nodes were big on both sides, so he also removed them and sent those in for testing. I am 41 yrs old and have a family history of uterine cancer, including sarcoma, which my 33yr old sister past away from just last year in January. I just don't know if i should be concerned",
    "doctor_response": "Hi, Thanks for using HCM.some of Uterine malignancies run in families. As your Hysterectomy is done, Wait for histopathology report, Depending on that further action needs to be taken.Family history of uterine cancer is a risk factor And also get your breast examined for any lumps or change in consistency. Hope this helps you Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is low rapid progressive motility a problem to impregnate?\n\nMy husband's SFA says his rapidly progressive sperm motility is (a)  2.4 % and slow  progressive sperm motility is 45.1 % (b)volume 2.3 mlsperm concentration 54.3 millions/ml total sperm number 124.9 millions progressively motile sperm concentration 1.3 millions/mlWe have been ttc for 4. years, is  low rapid progressive motility, a problem according to this reportThank you in advanceSanje",
    "doctor_response": "HelloThanks for query.According to WHO standards  accepted range of active grade one motile sperms should be minimum 15% of total normal sperms  for effective fertilization of female egg to result in to conception.Since your progressive motile sperm count is just 2.4% there are no chances of normal pregnancy..Please consult qualified Infertility specialist to explore the possibility of pregnancy with the help of newly assisted reproductive techniques like IVF or ICSI,Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low confidence,fear and self defeat\n\nMy Son persuing Engg course is 22 years now was suffering a few years back from low confidence, fear,  self defeat, thinks all are talking about him had recovered, now is back in same mental frame, has confusion, indecision, weird feelings like his pennis is small, shrinking & may severe off, please help",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Low self confidence, low self esteem, confusion, indecision, weird feelings etc are by products of misunderstanding life. He need to see a psychological counselor who shall be able impart self confidence to your son and make him aware of what he is and what he is capable of. Please consult a psychological counselor.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should Nordette be taken as an ECP after having unprotected sex?\n\ni've taken nordette last jan. 21 as ecp..and got my withdrawal bleeding after 7 days...last night feb. 7 i had an unprotected sex and im on the 12th day of my cycle..should i take nordette again as an ecp?..i'm also taking pills for two months now but i usually miss some of it but i make sure i get to take the missed pills",
    "doctor_response": "HelloTHanks for writing to us with your health concern.It is not recommended to take ECP so frequently.When taken so often, the lose efficacy, and the side effects just add up.You have taken the pills well enough ( as you said you used to cover up for the missed pills. )If you feel you have been highly irregular with the pills, take a repeat ECP.However, be prepared for side effects.your normal periods will get messed up.Day 12 is high risk in terms of the possibility of ovulation.SO just for once, you can take the ECP.In future, make sure you have protected sex, or are on birth control.All the best.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hydrocephalus in a child\n\nI take care of a 2 year old who was never expected to live more than a few days but her Mother had different ideas and she is now almost three. She has mild Hydrocephalus and she is missing midbrain.se both sides of her brain . I am trying to find ways to get her to recognize and use her limbs together Can you give me ideas",
    "doctor_response": "Play is the best way to achieve your goal, is she walking and what are the functional problems? can you make it little clear? so that i can try my best suggestions to you.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for heart ailments\n\nI am 27 years old. the NP in my drs office told me a couple of years ago that I had a heart murmur. nothing was done about it. My dr. never noticed even tho I wore a holter monitor one night until the np said something about it. He gave me adipex last thurs. the past couple of days ive been really tired, kind of lightheaded, and a little bit of pain in my chest. when i just walk say to the kitchen at a normal pace my legs hurt kind of like ive been walking on them all day nonstop...I guess they just feel tired. I have been walking a mile a day since last friday..I didnt walk today tho cause I have felt so bad. Could it be from the adipex?",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. These can be due to adipex but are you obese. It is prescribed for obesity. You also mentioned you had heart murmur and this drug should be avoided in patients with heart murmur. Better option to have low calorie and low fat diet and regular exercises rather than using a drug.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for wheezing in a child\n\nMy daughter age 7 yrs suffering veezing problem, in night he get continues caugh and in night breathing problem. Docotor advised not to eat chockaltet, ice greet and citric acid items and give the medicine for 30 days. Plesae help me to clarify it is recoverable problem and can i approach Sidha medicine.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Night time wheezing, coughing in child is mostly due to asthma. Best treatment of asthma is inhaled treatment. So better to consult pulmonologist and start inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).Avoid dust, smoke, pollens, chemical fumes etc. Usually childhood asthma resolve after the age of 14-15 years.Better not to give Sidha medicine. Hope I have solved your query. I will be happy to help you further. Wishing good health to your child. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for positive HBSaG\n\nGoodnightSIR I am avinash myHBSaG POSITV my DNA TES(HBSAG QUNTITATIV) report is fllowing 1st.64iu/ml 2nd 20iu/ml 3rd 225iu/ml 4th 22 iu/ml 5v 20 iu/ml 6x 11 iu/ml can i beat hepetitic i am regular use Rivabrin(lupin) 12reliferon(ROCHE) 20 refron(RILANCE)",
    "doctor_response": "hi.thanks for posting query at HCM.HBsAg can not be completely eradicated in a patient suffering from HepB.however, complications maybe prevented if proper medication is taken and proper diet plan is followed. even if HBV DNA count in PCR are not high, Liver enzymes should be monitored regularly while HepB markers maybe checked every 6 to 12 months.hope to answer your concern.wish you good n sound health.regardsDr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for weakness post a benign tumor removal surgery\n\nI had a benine tumer surgery in April, since then I have been very week and recently I have fallen a number of times, the nurses at both the hospital and the rehab center called me a fall risk. My Pharmicist recomended Glucosamine Sulfate I don t know anything about this drug or any of its side effects what do you think and what are its side effects.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You didn't mention the site of the tumor and how it was removed. What anesthesia was used (local, spinal or general). As a rule removal of a benign tumor doesn't cause these systemic effects. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for very sore abdomen on right side which resulted in fainting?\n\nI have a really sore abdominal on the right side. It was worse yesterday and I ended up fainting. I don't know if it was because i was so scared it was my appendix. The paramedics didn't know what it was and didnt take me to the hospital. What could it be?? anya",
    "doctor_response": "Hi and Welcome to HCM, What is your pulse rate?  Do you have extreme tenderness (when you palpate your abdomen do you get pain), whether you have pain in right iliac region.  If its in right upper abdomen it may be liver or gall bladder problem, middle portion it may be due to renal colic, lower portion may be due to appendicitis or amoebic colitis. Do you have fever.  Whether stool normal?.  Do you have constipation.  My recommendation is do x-ray of abdomen erect view, ultrasound.  Wish you speedy recoveryThank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have dark vertical stripes on my nails. What are they?\n\nHello doctor,I have a few concerns, got a few lines appearing on my nail, which is dark vertical stripes. Especially the one on my right thumb is in the middle, and it has been here for the last two weeks now.",
    "doctor_response": "Hello. Any symptoms or any other systemic complaints like diabetes or hypertension? And on any medication?",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does my son's renal scan with diminished tracer uptake in kidney's mean?\n\nGood morning.  My 11 year old son was found to have renal ultrasound findings of mild pelvocalyceal fullness in both kidneys.  Per DMSA renal scan, the interpretation was:  \"Diminished tracer uptake in superior portion of both kidneys probably due to previous pyelonephritis.  What does it mean?  Thank you.  From a Worrying Mother",
    "doctor_response": "Good day and thank you for being with health Care magic!It means that because of previous infection the upper part of your sons kidney is not functioning very well. I suggest to repeat the same scan 3 months after and if infection is still present , it should be managed properly. I hope I have answered your question satisfactorily and please consider a 5 Star rating for my answer. thank you very much.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cough with mucus\n\nHi, I am a 44 yr old male 180 cm height and 84 kg weight with previous hay fever in this time of years 9from 35 years ago. today I saw a ellipsoidal mucus like thing resembling an egg or larvae (like a round shaped mucus) after a cough. It didn't move but when I pushed, it was ruptured and a mucus came out from it. Would you pls tell me what is it?",
    "doctor_response": "Hello and thank you for your question.It sounds like you had a tonsil stone. Sometimes people have crypts in their tonsils and food can get packed in there and form a little ball of inflammation. Sometimes when you cough or clear your throat the tonsil stones will come out. They can be different shapes but are usually rounded and white to yellow in color.Hope this is helpful",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having solar plexus pain causing extreme weakness and taking antacid but no relief. Suggest a possible cause and course of action ?\n\nMy mother aged about 56 use to have severe pain and heaviness at solar plexus region. Any exertion or walking brings the pain and the solar plexus region (2 inches below the sternum) gets stiff. Whenever this pain starts, there comes symptoms like high BP, heat flushes alternating with chills, faintness, sudden loss of strength, extreme weakness etc. USG of abdomen revealed atrophy of the uterus. She is taking medicines for high BP and heart . The doctor prescribed antacid for solar plexus region, but it is not providing any relief. Could you please suggest the possible cause for this pain and probable course of action?",
    "doctor_response": "Hi, Thanks for query, Your mother might have some cardiac problem. Consult cardiologist and get investigated. Second possibility is she might have manopausal syndrome and I think she is having this problem.Due to hormonal imbalance this type of symptoms are common. Consult gynaec and go for treatment. She can attend manopausal clinic and take guidence. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain?\n\nDear Doctor : I had a bout of 15 motions within two days a month ago at which time Ciplox TZ and enuff were prescribed to me for 3 days and I felt better. I don t eat outside food. After that again since last week I m having 4/5 motions but the consistency is not like before. They are just motions but I do not feel ok as I feel uneasy all the time in the stomach and feel as if i have to go to the toilet. I get pain on the left side of the stomach. Also I don t like to eat food and the taste in the mouth is also different. Previously I had a lot of gas problems which stopped after i took homoeopathy medicine. Do u think this is the cause of the pain. Gas problems ? I have abdominal hernia measuring 1.5 in diameter after my bypass operation in 2008. I also have hiatus hernia since 2008. my doctor has today prescribed Stelbid for 3 days. Would like yr opinion please. Thank you.",
    "doctor_response": "HI.It looks to be badly treated case of gastroenteritis, you took Homeopathy too and now your Doctor if thinking about IBS - Irritable Bowel Disease; that is why you have been prescribed Stelabid. Since you already have Co-morbidities like the hernia, bypass surgery of heart you have to be really careful and get properly examined and investigated.Get the blood -CBC , sugar, thyroid, liver and kidney functions.Urine testsStool tests detailed including occult blood Ultrasonography, CT scan of the abdomen Endoscopies. All these will help you get a proper diagnosis to get a proper treatment .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest care to be taken after infant gets hit on head\n\nmy 15 month old son fell on a rock and hit his forhead at 5pm . Immediatly a bump started forming and he was crying. He only cryed for about 5-10 minutes though. I got him to a friend s house near by and applied ice. He only let me put the ice on his head about 10 seconds at a time. The bump is a small golf ball size -it looks aweful! He acted as normal as ever...played, ate dinner etc..We put him to bed at 8pm. DO you think I should wake him every 2 hours to keep checking on him? Did we leave enough time between the fall and his bed time?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. I understand your concern. First be reassured that your kid is normal. I will suggest you danger signs of head injury -1. Vomiting continuously2. Seizures3. Watery of bloody discharge from ears and nose4. Unconsciousness5. Altered sensorium or behaviour.If none of them are present, I don't think you should worry about his trivial head injury. For pain you can give oral Paracetamol in the dose of 15mg/kg/dose(max ceiling dose 500mg) every 4-6th hourly. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for body pain and chills caused by a viral infection\n\nI was told by a gp that i have a viral infection, after returning from mexico 6 days ago. I still have aches and shivers feel sick and have today woke this morning with a blotchy rash and feel itchy, the gp said if i was not better in 2 to 3 days then i should go to a and e, do u reccomend this at this stage, many thanks",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have body pain and chills caused by virus infection and due to poor immunity of body. Need not to worry. II would suggest you to take few preventive measures and along with that you should take antiallergic medication such as Levocetrizine and proper course of antiviral medication for 5 days to supress infection. Avoid intake of cold beverages and spicy, sharp and oily food. Visit ENT specialist once and get it examined. You should go for throat swab test as well and start treatment after proper diagnosis. You should take muscle relaxant as well. Drink plenty of fluids.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain with nausea?\n\nHi, I get upper abdominal pain occasionally (maybe every couple of months?) and it lasts for 2-4 days at a time. It is right at the bottom of my ribcage, pretty much in the center. It only bothers me when I m standing or walking, to the point that I start feeling miserable or even nauseous. However, as soon as I sit down it pretty much goes away instantly. I also seem to feel like I need to belch more when this happens. I have tried everything, antacids, gas-x, pepto, pain relievers, nothing helps, it just has to go away on it s own after a couple days. I have gone to my local clinic after symptoms stopped and was seen by the RN, but nothing was done since the pain had stopped. What could this be??",
    "doctor_response": "HIWell come to HCMChances of hyperacidity would be more, may associated with some infection, on tentative basis this can be managed with the following drugs, if symptoms does not improved then this need to brought to investigations, that may includes plain x-ray abdomen, CT Abdomen, till then this can be treated with following medicines 1) Tab Omeprazole 40 mg once on day at evening time for six weeks 2) Tab Domperidone 30 mg once in day for six weeks 3) Tab Clinidium with ChlordiazepoxideHope this information helps, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rash on buttock?\n\nHi there. I m just curious about a rash I have. Its iin my groin towards my buttock. There wasn t any bumps,pustules,or anything but it seems like It get irritated causing maceration and clea fluid secretions. Gets itchy when I sweat and burns with water. Just would like to know is it funal or more less like diaper rash maybe?",
    "doctor_response": "hi,as per your history, you have intertrigo cause by repeated friction of skin.my treatment advise would be:1. maintain hygiene.2. wear loose cotton clothes.3. you may apply miconazole cream twice a day over groin and macrerated area.4. you may take tab levocetrizine twice a day for itching.5. also, you may nned oral antifungals like tab fluconazole, but that has to be taken only after consulting a dermatologist.wishing you good health.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for constant bleeding from little finger due to injury\n\nHi, my mother shut her little finger in her car door by mistake yesterday and since then it has not stopped bleeding. The nail has split near the bottom of her finger and she said it came right off when the accident happened but she has pushed it back down.  Yesterday I made her hold her hand above her heart on a load of pillows and a pack of frozen peas for a couple of hours before bed time which helped the blood start thicken but it has never stopped bleeding yet.",
    "doctor_response": "Take it serious normally blood should clot with in 10 min, u r saying it not clotted for long time, do investigation , ct , pt , aptt, bt, platelet count..dont neglect...there is some abnormal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for seizure after sex\n\nMy girlfriend and I just had sex, and afterwards she complained about not feeling well. She said her ears were ringing and it felt like she was going to throw up. I told her to lay down and take a couple deep breaths. This seemed to calm her down, but then she started to shake heavily with her legs, and her eyes seemed to roll away a little. It took her a couple seconds to respond to me telling her to wake up and calm down. Afterwards she said it just felt like she woke up, and doesn't remember the shaking. I gave her some water and now she says she feels good. Could this have been a seizure and should we go to the hospital? She said this never happened before.",
    "doctor_response": "Some ladies usually develops a period of unconsioisness immediately after the intercourse or at the peak of that. This is not a disease. But there is drugs to prevent it. You should consult a doctor before using them.Wish you happy life.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do I need to know about neuropathy in feet and blockages in legs?\n\nI have servere polyneuropathy since 2004. I am still walking and doing pool therapy but have fallen and have not had therapy in 3 months. Yesterday they just did a Doppler on my legs and feet and have found multiple blockages in both legs and severe blockages in both feet. I have 11 stents in my heart and additional blockages in my heart and just had a chemical stress test on my heart. The did a Doppler on my carotid artery and found 90% blockage there. I have tri are 400-900 and my clo. are 300-400. All are inherited. Don t know result of Ultersound on legs and feet yet or heart test. Wondering how this all will effect my neuropathy. Also had mini strokes next to the ganglia. What do I need to know about my neuropathy legs and feet esp. feet?",
    "doctor_response": "HIThank for asking to HCMYou really do have big health issues, it is now nothing to know more for you because you already knew it every thing now the crucial part of life is how to cope up with these conditions, you have more than enough problems which mostly may not be come around with the medicines and the natural course of disease is also uncertain your will power would be the best weapon against all of these, wish you good luck for fast recovery, and take care of your self.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes grinding sound in my lower back?\n\nI was told a few yrs back that I had a herniated disc in my lower back and in my neck. well, for about a year now I have had an audible and palpable grinding in my lower back. Used to be just with certain movements, but now, with almost all movement. No pain with the sound though. And back in November, Thanksgiving to be exact, started with heaklth issues...unable to void, had to cath self, bowel problems, perineu, numb. Had numerous tests done on bladder and nothing found. resloved after a few weeks. And also, my hands and arms go numb if I put above my head.",
    "doctor_response": "Hello. Thanks for writing to us. The grinding sound in the lower back is likely to be due to decreased joint lubricants or rough surface of the discs. This is early spondylottic change of spine. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal . For future query, you can directly approach me through my profile URL  drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have acne. Can I use Pantoprazole with Cutein?\n\nHello doctor, I have acne for around five years. Now I am using Cutein tablets. I suddenly got a burning sensation in my stomach. So, now I am using Pantoprazole tablets along with Cutein. Is that effective or injurious?",
    "doctor_response": "Hi. Cutein tablet contains Iron as one of the ingredients, along with some other vitamins. The iron tablets can give increased acid in the stomach and indigestion. But, if you take both Cutein and Pantoprazole tablets together, the iron will not get absorbed. Therefore, first take Cutein tablet on empty stomach in the morning, and then 30 minutes later take Pantoprazole.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and light headedness?\n\nYesterday, when I got home from church, I laid down on my bed for a minute. I felt fine, just wanted to lay down. When I got up I felt extremely dizzy and light-headed. It has been almost 24 hours and I still feel dizzy and light-headed!",
    "doctor_response": "Hello, Your symptoms could be related to low blood pressure or orthostatic hypotension. For this reason, I recommend taking plenty of water, increase salt intake and closely monitor your blood pressure values. Some rest would help. If your situation does not improve, I recommend consulting with your attending physician for a physical exam and some blood lab tests (complete blood count, blood electrolytes). Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a hard lump in the buttocks?\n\nhi. i have a hard lump in between my bum cheeks, above my tail bone. its gives me unbearable pain and iv been to the doctors but he just asked me questions, pressed on it with pants over top and said it was my muscles straining or something. but last night the boil started oozing out with puss and blood that really smells and now it wont stop. what is it? and what do i do",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern.  You may have some abscess formation.  You should go for incision and drainage of that abscess.  Then take a course of antibiotics. Consult your doctor and take treatment accordingly.Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for right patches on cheek\n\nHello Dr, I ve female child of 3yrs old, she has got white patches on right cheek since 2 months, went to skin specialist, he consluted to use mixture of emoderm and ketoconazole creams in equal amounts, but still the patches didn t disappear. Please help out with a good treatment.",
    "doctor_response": "Dear Sir/ Madam,Thank you for posting your query at healthcaremagic.comThis is common thing in a growing child of that age. Generally, it goes off as the child grows. There is no question of defeincy or infection. Ideally keep the area moist with emoderm. One hour before bath you can apply paraffin liqud, after bath expose the child to sunbath.If you have any further question, kindly revert back, will be happy to assist you.If you find my answer informative, thank you note will be appreciated!with best wishes,Dr. Vishwanath Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the heart rate normal to my age?\n\nI am a 68 year old male. I am 6''4\" and weigh 83kgs. I walk about 50kms a week (6kms each day and longer on the weekend. My resting heart rate is 53 bpm and when pushed on steep hills this gets to around 90bpm. I think my blood pressure is 125 / 65. I am planning to walk 250kms over 3 weeks in the UK in Sept.  How does my fitness rate against men of my own age.  How typical am I?",
    "doctor_response": "Hi,53 is not normal, it's low, you should get one thyroid test and renal function test done.Do you have chest pain or so? are you on any drugs? do u have any symptoms like giddiness, shortness of breath, blackouts etc.you will probably need one holter monitoring test which will monitor your and other details of heart rate and tell the future risk of heart block.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for obsessive disorder\n\nI have learnt that I have an obsessive disorder. I used to play the computer all the time when i got into situations of stress. I went to a behavioural therapist and worked out I had this behaviour and have further worked out with her help that foods containing excessive amounts of salt or sugar magnify these feelings. I have since found that I have no need to go to the computer and seem to remain calm, but do often cry when faced with these situations. My son has been through trauma, and last night he went downstairs with a knife to stab anyone who was making noise in his unit. I am going out there today to pick him up and bring him back to a quiter environment, and he is going to a therapist today for a session. Do I tell the therapist of his behaviour last night. What do I do?",
    "doctor_response": "Hello and welcome to Healthcare Magic. Thanks for your query.You have mentioned that you have been diagnosed to have an obsessive disorder and that your symptoms are better after seeing a behavioural therapist. Stress is ofen a factor which can worsen psychological symptoms. So, in response to your question, I think it is better to tell your therapist about the recent stressful incident involving your son. You can also ask your therapist about stree management techniques and coping skills as these will also help you handle your stressors better.Wish you all the best.Regards,Dr. Jonas SundarakumarConsultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should frizum and epilex chrono be taken life long for seizure disorder?\n\nMY HUSBAND AGE IS 31.HE IS HAVING SEISURE DISORDER IT WAS STARTED AT 27 YRS.6MONTH INTERVAL PERIOD ONLY FITS CAME . HE IS TAKING TAB.FRIZUM 10 MG AND TAB. EPILEX CHRONO MY QESTION. LIFE LONG CONTINU FOR THIS TAB! .WHAT CAN I DO FOR STOP THE FITS PROBLEM!",
    "doctor_response": "Hello, I cannot answer your question because I don't have sufficient information about his specific epileptic disorder. You must speak to the doctor about the REASON he is having such problems. Sometimes it is possible to retire the medications if he has been seizure-free for a period of at least 2-3 years. It doesn't sound like this is happening.  Stopping the fits means your doctor should be able to tell you EITHER the underlying cause to his episodes OR the doctor needs to find another combination or another DOSING regimen of medications that can control his episodes. Also, you can help your husband by making sure he is well HYDRATED at all times, DOESN'T skip meals, TAKES his medications as ordered by the doctor every time and ON TIME. You should also make sure with the pharmacist that your husband is not taking any other medications or EATING certain foods or beverages that can NEGATE the effects of his medications to control the seizures. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a skin rash in a 1 year old be treated?\n\nMy 1 year old nephew has a rash from his stomach to the top of his head. No fever. His skin does turn white when I press on a red spot. He had his chicken pox and MMR vaccines 8 days ago. Should I take him to the er? Also, I gave him zyrtec for the first time this morning",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Please note that some children develop rash after chickenpox or mmr or mr vaccine . As there is no fever or cough or cold , you need not worry .Just give zyrtec to child. If child develops fever or cough or cold then you should  take child to emergency. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for hair fall and dandruff\n\nHi doctor, I am suffering from much hairfall and dandraff i consult the doctor and he said use salisia kt shampoo and vitamins capsaule i used this 2 week but my hair fall was not control and also i used many homemade products bt nt control i dont knw now what i do i am very upset if i wash my hair that day 300 To 400 Hair are lossed i am really very upset doctor plz help me.",
    "doctor_response": "Welcome to HCM, the best Online clinic. I can well understand your concerns. But don't worry we can work with it to benefit you in the best possible way.(The worst part of the case history is that I don't even know your Gender. But no problem I am still here to help you in the best possible way)In male hairfall has a strong genetic association. Females have their own different reasons of the issue. Dandruff is the most serious a reason of this problem and is common in both genders.Take a bath daily. But don't use hot water for it. Normal water helps improve this condition by reducing dryness and dandruff. Keep your hair properly trimmed. When young patients come to me I usually prescribe them to take Capsule Perfectil. It will catch up the deficiencies and your hair nails and skin will glow and grow optimally. Take plenty of fluids and fruits. Exercises on regular basis will help you a lot. Minoxidil 5% spray is also beneficial. But if it causes dandruff or allergy stop using Minoxidil.{Males get benefit and a noticeable improvement by taking tablet Genesis (finasteride). Not to be used by females.} Its time taking to kick in properly and show results. Male baldness is mostly due to peripheral Testosterone effects that destroy specific hair follicles on top and front of the scalp.This management will help you a lot. Have a nice time ahead. Don't forget to give your best positive feedback. If you need further assistance, feel free to contact me back anytime.Regards! DR. HANIF USA",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning pain near the pelvis?\n\nI am a 34 year old woman who was woken up at 2:00 a.m. with an extreme burning pain near my pelvis. My leg is weak, my pain is still intolerable. My stomache hurts, I m nauseous and I do not feel like eating. Could this be a cyst and if so what should I do? I have taken ibuprofen & pepto bismol and nothing is helping.",
    "doctor_response": "hi,as you mentioned about the burning sensation and pain. First to rule out the abdominal and pelvic floor pathology by ultrasonography. Also doing a laboratory test may help to find out if any urinary tract infection is there. based on the signs and symptoms recovered , the medical management will start. so until anything confirms do not think much.with the grace of God I wish you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the person with ALS only paralyzed in arms?\n\nI have a son 54 years of age diagnosed with ALS...since there is no real diagnosis for this disease and it has been 3 years.........the doctors say he is doing very well compared to most..his arms are paralyzed, but rest of his body is sound and good....makes us wonder if it could be something else...any thoughts on this would be so very appreciated..but I know this is a difficult one",
    "doctor_response": "Sorry to hear about your son condition. ALS is progressive loss of anterior horn cells. The involvement of bilateral arms without other limb involvement occurs in man in barrel syndrome like variant. Other possibilities may be cervical cord lesion probably syrinx or some rare limb girdle muscular dystrophy or bilateral brachial plexopathy. But if some neurologist had evaluated and made such diagnosis then other possibilities are rarity.  You should be in touch with neurologist and physiotherapist for your son. May God bless your son.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long do I need to rest after ACDF on C5/C6?\n\nI have been told i need an ACDF on c5/c6. I am an industrial electrician which involves pulling large wire and running heavy conduit and also working on ladders with arms over my head looking up. How long will I not be able to go back to doing my job?",
    "doctor_response": "Hi,Thank you for posting your query.I have noted that you are going to undergo a spine surgery, ACDF on C5-C6.If the surgery goes on well, and there are no complications, then, you would be discharged from the hospital in about a week.After that you would require rest for 7-10 days, and then, you would be able to start light job. Heavy job such as yours may be resumed after about a month of surgery.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can autoimmune disease causing severe hair loss be reversed and made better?\n\nIS THERE ANYTHING THAT CAN BE DONE TO REVERSE THE AUTOIMMUNE DISEASE THAT CREATES MAJOR HAIR LOSS IN WOMEN? AT ONE POINT I THOUGHT THE PROGRESSIVE HAIR LOSS WAS DUE TO STRESS AND WAS PERHAPS AGE RELATED. MY FRIEND HAS LOST ALL OF THE HAIR ON HER HEAD AND HER EYEBROWS. I AM CONCERNED THAT I HAVE AN INFLAMMATORY CONDITION THAT CAUSES BALDNESS. I ONCE HAD HAIR. NOW MY REMAINING HAIR IS SO THIN I LOSE HAIR EVERYDAY.",
    "doctor_response": "Hello,Hair loss can be due to stress, vitamin deficiency, autoimmune, inflammatory, cancerous, et cetera, there are many etiologies for that. You can rule out one by one with remedies.First, take care of your stress, do meditation and yoga exercises to calm your mind. If it is due to vitamin deficiency, better take some multivitamin tablets or milk powders with vitamins and minerals. Eat nuts, fruits, vegetables a lot.If it is due to autoimmune disorder, you need to be investigated. It is male or female type of baldness central or peripheral variety and necessary investigation can distinguish it from other causes of hair loss.I will suggest you to follow up with detailed history or consult with physician for detailed examination.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Archana",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I was exposed to herpes zoster virus in the first month of pregnancy. Do I have to terminate?\n\nHi doctor,I am being advised to terminate a desired pregnancy because of the medication I have been prescribed to tackle a virus that I got just after becoming pregnant. I am looking for a second medical opinion on whether termination is necessary. I would like to understand the risks to the fetus of being exposed to the herpes zoster virus in the\u00a0first month of pregnancy, and the risks of the medication (including steroids) that I am on at this stage in pregnancy. Here are the details of the timings and medications.I had my last period on the 26th two months back, and I ovulated on the 13th of last month.\u00a020th of last month, I had Ramsay Hunt Syndrome (inner ear pain and right side facial paralysis), and on 21st, I was diagnosed with Bell's palsy, for which I was prescribed Prednisolone. I took 30 mg, 25 mg, and 20 mg Prednisolone respectively on 22nd, 23rd, and 24th. The symptoms got worse, including outer ear pain and rash, and I was diagnosed with herpes zoster virus, and I was given Vitamin B12 injection. From 24th to 31st, I took Famciclovir (6x250 mg) tablets per day. From 25th to 27th, I took Dexamethasone injections 10 mg (2 ml) per day for three days.From\u00a028th to 31st, I took Prednisolone 30 mg per day. On 29th of last month, pregnancy was confirmed. On the\u00a0First to fourth of this month, I had Prednisolone 20 mg per day, and 10 mg for the next four days. From 26th of last month, I took daily injections of vitamin B1 and B12, and I used Acyclovir 3 % topical cream on the ear.",
    "doctor_response": "Hello. The increased exposure to corticosteroid can cross the placental barrier and cause adrenal suppression in the fetus. This can lead to salt wasting, electrolyte imbalances, and even poor development of the fetus. The organs can also have improper developed and anomalies can be possible. It can also lead to sexual organ development disorders in case of a male fetus. It would be safer to go in for a termination, as it is still in the early months of pregnancy. Also, exposure to herpes zoster can cause scarring of the face, limb, and organ deformities in the fetus. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathlessness?\n\nHi, I am 12weeks and I work at a hospital. I transport patient through out the hospital via;wheelchair,inpatient beds and litters.Should I be doing this? I feel shortwinded sometimes and I have to use my stomach muscles a lot on the beds and litters.I was just a little concerned.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have breathlessness. Well there can be many reasons for symptoms you mention in query like asthma attack , pneumonia , heart attack , atrial fibrillation , pulmonary embolism or anaemia . I would suggest you to consult chest specialist for proper examination . Doctor may order chest x-ray along with sample from lung for lab testing . Doctor may prescribe antibiotics along with anti inflammatory and decongestants . Doctor may also refer you to cardiologist for heart problem . For now take proper rest and take steam twice a day . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I have mild pain in testicle?\n\nHi doctor, I am 27 years old. I have mild pain in right testicle for a week. The nerves connecting to the right testicle are always in strain mainly in the area of epididymis and vas deference. It pains when I walk, jump, rub or masturbate. I get random swelling, irritation and pain in my right testicle. Sometime, the pain also accompanied by fever. When there is pain, the scrotum becomes swollen and turn red. I also have pain with ejaculation. My ultrasound was perfect, nothing came abnormal. I am having this problem since eight years. I am taking Dolo 650, Levomac- 500 and EIDO multivitamin capsule. Please suggest me some medication or tests to get them cured. Thank you.",
    "doctor_response": "Hi. From your symptoms, I believe you are having one of the following: Very rarely ureteric stones for repeated testicular torsion can cause testicular pain. A per-rectal examination, ultrasound of KUB (kidneys, ureters and bladders) and prostate, urine routine tests and urine culture (after per-rectal prostatic massage) will help. Ask your family doctor to get these done or refer you to a urologist for further physical evaluation and you can get back with the reports. If you have redness, swelling of scrotum along with pain attacks and especially if there is vomiting, better get ultrasound scrotum with Doppler study to rule out recurrent torsion. From the above details: Revert back with the investigations to a urologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for increase in penis size?\n\nSir mere ling ka size 4.5 h aur sex karte waqt mera virya jaldi nikal jata h aur fir me sex nahi kar pata hu .sir me japani oil and tablets lene k bare me soch rahahu kya ye sahi h and iska kuch side effect to nahi hota h and me japani ling vardak yantra(instrument) se ling ki size badane ka soch raha hu kya ye possible h plz answer my query 0000",
    "doctor_response": "Thanks for asking in healthcaremagic forum   It is not possible to increase the size and girth of penis by any oil/medications like you think. Please do not go to quacks who tell that they can increase your penis length. Search for kegel exercise on net which can help you for your problem of premature ejaculation. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for severe abdominal pain\n\nHi. I ve been having severe abdominal pain for over 5 hours starting after I ate lunch. It is in the top center of my abdomen and is a sharp cramping feeling. It is not muscular and I am extremely bloated. I vomited a small amount about an hour after it started. The pain comes in waves of varying degrees. I took a couple antacid tablets that did not seem to have an effect. Do you have any advice on what I should do or any medication I can take to relieve the pain?",
    "doctor_response": "Hi.The type of pain you are describing gives me an insight about the possibility of a perforated gastric ulcer. You need to get admitted.Get an X-ray of the abdomen in standing position to see for gas under diaphragm. Intravenous fluids and antibiotics.Nil orally. Do not take anything orally till ordered by a Doctor. Ultrasonography and other blood and urine tests.IF this is a perforation you need urgent surgery. If not the treatment already you will be under will be sufficient, and we will have to find for another causes like Pancreatitis, severe gastroenteritis and so on.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes night sweats, loss of energy and weight loss?\n\nI am a diabetic and I had a knee replacement Aug 12. I am normally on medication. I have been taking a 325 aspirin twice a day. My blood pressure yesterday was 127/79 pulse 81 then 106/62 pulse 86 in the evening. Today a.m. 121/74 and p.m.114/70 pulse 84 a.m. And 77 p.m. I have had weight loss and low energy. Sweats at night for the past 2 nights. Should i be going to the Dr.?",
    "doctor_response": "Hi there. I think it's a very high dose of Aspirin you are currently taking and i dint find any information as to why you are such a high dose . Also yours symptoms can be explained by overactive Thyroid gland and i suggest you start from there although your blood pressure and pulse seem to be normal. First get a blood thyroid hormone levels checked. That includes Free T3 T4 and TSH.  If it is abnormal you need to take therapy for that.Also you need to speak to your Physician as to cutting down Aspirin dosage and if you need it at all as you run a high risk of Stomach ulcer with that.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in the left testicle?\n\nMy partner has great pain comming from his left testicle going up his groin adnomen. He sufferes erectile difficulties and his ejaculation is much less. His left testicle had shrunk dramatically, almost half the size of the right. there is no blood in his urine but does have difficulty in uriniating at times.",
    "doctor_response": "hai,As from  your complaint it seems to be an  abnormality in testis and other related organ(epdidymis,prostate etc)pain radiating from testis to groin and difficulty in urinating  indicates some problem in the urethral path.left testis got shrunk in size possibly  it got atrophied. in condition like viral infection,injury to the groin area,blood flow interruption to the testis can cause atrophy. I advise  to do ultrasound and kindly consult an urologist for further management.thank youhope i answered your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do cysts in kidneys, liver and spleen cause hip and flank pain?\n\nhaving pain in right hip and flank just had ct scan no stone but do have cyst on both kidneys liver and spleen cant seem to get clear answer from any of doc mean time pain is getting bad have history of lch langers always have blood in kidneys but no infection and blood pressure is up feet are purple colored some of and on numbness in right leg",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Renal cysts can cause dull aching pain in the flanks. If the size of the cyst is too large surgical correction may be needed. Consult a urologist and get evaluated. Wishing you good health. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had unprotected sex. Now feeling cramps, trouble sleeping, light periods. Pregnancy test negative. Still pregnant?\n\nI'm an 18 year old female. Last months period started on May 13, on the 24th i had unprotected sex.I've had trouble sleeping at night, but could come home at the end of the day and take a two hour nap, then be feeling tired again by 10 instead of being able to stay awake until 12 like usual. And i would also get slight crampy pains, and sometimes around lunch time i would get a slight tingly light feeling throughout my body.I wasn't expecting my next period until the 10th of June, but it came on the 7th, and it doesn't feel as heavy as my normal periods but still enough to wear a pad. I took a pregnancy test on the 8th but it came out negative.Could i have tested to early? Should i still be concerned about possibly being pregnant?",
    "doctor_response": "Hello,First of all, you did unprotected sex close to your fertile days. So, chance of being pregnant is still there.Early pregnancy test is less significant and you need to repeat home pregnancy test after 7 days. Blood test for beta-HCG is quite reliable.Following test reports, you need to consult with gynecologist for suggestive measures. Practice safe sex in future and use proper contraceptive method.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does neoprene rubber in a waist trimmer belt cause cancer ?\n\nDoes neoprene rubber in a waist trimmer belt cause cancer?  I have read that neoprene found in the rubber of the waistbelt has been found to cause cancer in California.  I am a healthy adult female trying to use this belt to trim my waist line.  Thank you",
    "doctor_response": "Hi Terry, Welcome to Healthcare Magic forum. I believe you must have see this message on the belt. WARNING! This product contains a chemical known to the State of California to cause birth defects or other reproductive harm. So, yes it does pose a health risk. If you are planning to use this belt to reduce/trim your waist line. My opinion is that it will not do the job. Because you must understand that there no such thing as spot fat reduction methods. Unless and until you specially cut the fat out of those areas which is done by liposuction only. Even liposuction is not a permanent. Fat will get deposited again those areas at the shortest possible time. You must understand that fat is distributed all throughout the body. In order to reduce the fat at the waist line you have to reduce your total body fat, which can be done only through strict diet and exercise regimen. If you still insists on trying to reduce your waist line with waist trimmer belt, I suggest you buy a waist trimmer belt which is made of different material. Hope I have answered your questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a right a cyst in kidney?\n\nI have been told that my right kidney has a large complex cyst over 7cm arising from my superior pole with thin internal septations and low level internal echoes with no color flow within. Unfortunately my only healthcare is through the VA so my appointment with the urologist isn t for another month. Is this something to be concerned about as far as cancer ?",
    "doctor_response": "Hello and welcome to HCM.As an Urologist, i can understand your concern.Basically,you should know,there're two types of cyst, simple and complex.Simple cysts are filled with clear fluid and are well-defined on a CT scan.A complex cyst is irregular,inhomogenous,has septations or calcified, etc.A simple cyst needs only observation, unless symptomatic. A complex cyst,needs surgery and biopsy,after surgery.If you've severe pain, blood in urine,fever,breathlessness,etc,report to ER. You may send your reports to me as a direct question,for an expert opinion.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from bouts of abdominal pain with vomiting. Suffered from food poisoning from pack of sushi. What could be the reason, Is it diet related?\n\nI am suffering from bouts of abdominal pain with some vomiting . I m pretty sure about 3 months ago i suffered food poisoning from a pack of sushi from a supermarket, and since then every 3-4 weeks i get the same stomoach pains and vomiting, it lasts a few hours rarely more, but given what i had eaten yesterday with the last bout, I fail to see its diet related. I had eaten 2 wraps of ham and salad, with new ham and wholemeal wraps. no diarrohea. although I can suffer seperate instances of this which I think may be related to lactose intolerance at the very least",
    "doctor_response": "Hi thus seems to be a case of chronic gastroenteritis, amoebiasis. It woukd be advised that u keep a check of your dietary habits, particularly a check on food hygeine. It would be good to take a course of metronidazole 400mg thrice a day for 5 days. Take a good folic acid supplement once a day for one month. You will be absolutely fine. Get well soon. Dr anchal dranchalgupta@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe tachycardia and anxiety\n\nMy son had a horrible tachycardia episode a year ago. He had smoked marijuana just before this. He ended up in the ED and had to have cardioversion with drugs. He is now suffering from anxiety so severely it is effecting every part of his life. What kind of help can I get him, he thinks he is having heart failure and afraid he will die.",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!Regarding your concern, I would explain that marijuana can cause these adverse effects. But, as he is feeling anxious (considering also possible withdrawal syndrome from marijuana), I would recommend consulting with a specialist of this field (psychotherapist or psychiatrist) to help him manage anxiety. Periodically scheduled follow up by the cardiologist, including a cardiac ultrasound and a resting ECG every 6-12 months, would also help reassure him that nothing bad is going on. Hope you will find this answer helpful!Wishing good health, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the urge of stretching I am having?\n\nhi, whenever i sit for studying especially in the evenings , there is a kind of sensations in my body for streching .Therefore i study nowadays while standing. Even then there is urge to contract my hips and buttock muscles or back. Earlier i used this to discard as more energy.But what is it?",
    "doctor_response": "Hello, When you sleep, your muscles lose tone and fluid tends to pool along with your back. Stretching helps to massage fluid gently back into the normal position. Also, your muscles protect themselves from over-extension by inhibiting the nerve impulses as they approach their limit. Causes are lack of physical movement lead to the urge to stretch, dehydration and chemical response in the brain may lead to an urge to stretch. Until examination is done it is difficult to say what it is. Drink plenty of liquids and tender coconut water, eat green leafy vegetables. Get it done Ra factor, serum electrolytes and haemoglobin status then consult your doctor he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Penchila Prasad Kandikattu , Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for nose bleed in a child?\n\nHi my daughter is 4 and was playin today and hit something but her nose was bleedin on and off she was ok for a min but when she started playin again her nose started bleedin again it not a lot but I don t kno what 2 do should I take her to get a x_ray or some thing?I just checked her nose while she was sleep and it was ok but what about when she go 2 school",
    "doctor_response": "Hello,No need to get an x-ray, this is very common after a hit to the nose. If it bleeds again, place an ice pack on the bridge of her nose, this will stop bleeding quickly.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Eric Goldstein",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long after c-section delivery can the second child be planned?\n\nhi i am 30 year old.height 5 ft 7 inches, weight 83 kgs and no history of diabetes or blood pressure. and have 1 and 8 month old son by c-section , c-section done because my blood pressure was 80/142. now when should i plan for second child so that i can have normal delivery?",
    "doctor_response": "Hi, thanks for writing..Minimum of 2 year gap is advised after c section.. If BP goes up at the time of delivery, then again C section would be opted.. It would be advisable to take antihypertensives as soon as high BP is detected in pregnancy.. Hope I have answered your query.. good day..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can uni knee surgery causes pain in the tibia and walking?\n\nHad a uni knee surgery that changed my alignment 6 degrees. Had to walk slow. The first time I walked a little fast I had severe pain in the center of my tibia. It s been 9 weeks and it still hurts if I walk fast or turn my foot. Should I have an x-Ray? Could it be fractured or bruised?",
    "doctor_response": "I understood your problem. you have to consult orthopedic doctor.he will suggest for x ray.it may be ligament /miniscus injury over the knee joint.for treatment you can go for physiotherapy .some exercises and modalities can give you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Depression, anxiety, disturbed sleep, fatigue, appetite change, unable to concentrate. Will medicine resolve the problem?\n\nSir My wife suffering some problem depression and symptoms of depressive illness , including anxiety, loss of interest in usual activities, disturbed sleep, change in appetite, fatigue , feelings of worthlessness or guilt, difficulty thinking or concentrating, and recurrent thoughts of suicide . A doctor recomended below medicine, is this medicines can resolve her problems ? Nexito Plus Tablet , LAMITOR OD 100,MODALERT 100,PETRIL BETA 10",
    "doctor_response": "Hello....... Thanks for your query. I understand your concern with your wife's depressive symtoms. The medications suggested : nexito is escitaopram, an antidepressant of SSRI class; Lamitor is lamotrigine, an anti-depressant mood stabiliser; modalert is modafinil, a psychostimulant and petril is clonazepam, a sedative. These are standard drugs prescribed for depression. You need to ensure she is compliant to these drugs. Wish her speedy recovery ! Regards Dr Sundar Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from lupus. What does CT scan after panic attack suggest?\n\nHi my name is Ronnie and I m 39 years old I have lupus. I recently went ion the hospital for a panic attack and they did a ct scan. The result did not show any blockage but it s stated that their where several subcentimeter para tracheal lymph nodes. I don t understand what they mean by that. Please help me understand.",
    "doctor_response": "Dear Madam,You need to tell Ct scan of which all portions was done because you are mentioning findings of ct chest which are not otherwise indicated in panic attack generally . Kindly elaborate.Dr. Shruti",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed E coli infection. Low oxygen levels, high body temperature. On dialysis. Have hallucination. Reason?\n\nMy aunt is going to be 70 in 2 weeks. She was diagnosed with E coli on the 18th of March when she was found non-responsive on her bathroom floor. She spent 3 days in ICU and showed great improvement. Then on the 28th she took a dive. today her oxygen is in the 80's her body temp is 92, she is hallucinating and non functioning. She is still on dialysis for 3 hours every other day. 6 days ago she could talk, feed herself and play cards, today she doesn't know who or where she is and doesn't recognize anyone. She can't hold on to a tissue. Do you have any idea what could cause all of this? Is it possible that it is some kind of poisoning?",
    "doctor_response": "Hello.His aunt  suffers Confusional Syndrome (hallucinations and delusions). The confusional syndrome is a psychic pathology that appears in 25-30% of hospitalized older than 65 years.The psychic pathology  is the result of physical pathology(complicated infection in this case).Although the situation of her aunt is very serious,if it resolves the physical pathology, will resolve the psychic pathology.I wish you good health.(In case the answer would have been useful please indicate this)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cracking of neck everytime on turning the head, urge to crack it frequently resulting in soreness and discomfort. Had taken treatment for back pain. What could be causing this?\n\nI injured my back about 10 months ago and is was always tight and cracked allot. I began seeing a chiropractor and a P.T. Somewhere during this process my back started to get better but now my neck cracks every time I turn my head to the left or tilt it to the right. I have an uncontrollable desire to crack it all the time (multiple times a minute). This leaves my neck very sore by the end of the day and I am in continual discomfort. Then neck pain/cracking has been going on for about 3 1/2 weeks. Do you have any idea what might be causing this?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern looking to the history here I could say that this is the maniac disorders that you are going to develop and you really need to forget this otherwise you would face the bad consequences of this later on, hope this information helps you, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluctuating WBC count?\n\nShould I be concerned, or what should I do about my fluctuating WBC? I had chemo that ended April 2017. In August my WBC were 2.7, then went up to 3.4 in Dec. In early March it went down to 2.5 and last week back up to 3.4. I had no symptoms or problems at anypoint along this timeline.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Slight variations in WBC count is common. Specially after chemotherapy it is low and slight fluctuation is common after chemotherapy. If you don't have any symptoms then nothing to worry about that. Just be relax. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I would like to have the best treatment for constant running nose.\n\nHi doctor, I have problems with my nose for over 10 years. My nose runs all time every day. I got a surgery on the nasal valve and it got worse. The surgeon told me that it is normal and prescribed me Xozal.\u00a0I am using it for past three months but no improvement with it. I wish to get something prescribed through which I will be able to live like a normal person, not having tissue all day.",
    "doctor_response": "Hi. You seem to be suffering from allergic rhinitis which is a form of hypersensitivity and it causes running nose. However this has an offending agent and when the allergen is avoided, the allergy subsides. To confirm whether it is allergy we can do two tests which includes absolute eosinophil count and serum IgE. The positive signal shows that you suffer from allergy. A negative in the above tests need not always rule out allergy. For allergic rhinitis, the accompanying symptoms are itching of eyes or nose, occasional nose block and sneezing multiple times. Next, constant running nose can be due to nasal polyps, chronic sinusitis, inverted papilloma, nasal malignancy, deviated nasal septum, etc. Please give me details regarding the following too: What is the color and consistency of nasal discharge? Is there any foul smell from the discharge? How you perceive smell? Kindly attach your previous investigations, reports and medical records pertaining to this matter so that we can arrive at a decisive diagnosis and institute the correct medications for you. Allergic rhinitis Ethmoidal polyposis Chronic hypertrophic rhinitis Chronic rhinosinusitis Inverted papilloma Nasal malignancy Revert back with the reports to an ENT otolaryngologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lump in leg\n\nI found a lump where my left leg meets my groin in the crease. It s about level with pubic bone but where I close my leg. I can t see it but I can feel it. It s below the skin by the bone. I am having vagina discharge making feel that I m having an infection some where. It s tender but not painful. I m kind of scared what is it?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have enlarged inguinal lymphnode.  It can be due to reactive hyperplasia most likely.  Rare cause are tuberculosis or lymphoma.  You should go for fine needle aspiration cytology of lump.  It will give you exact diagnosis. Then you should take treatment accordingly. Fir your vaginal discharge you should go for examination.  It can be candida infection or bacterial vaginosis. Drugs like clotrimazole and metronidazole are helpful.  These all are prescription based medicine so consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please suggest homeopathy medicine for urticaria.\n\nHi doctor, I am a 30 year old male. Recently, I have been diagnosed with having urticaria (burning, itching sensations throughout the body from head to toe). It started out in an acute way but is turning out to be chronic. It has been more than two and a half months and I am still suffering from it. FYI, my blood test is very clean and good. PFA. In the past two months, I have been using Bepozic tablet twice or thrice a day on a dermatologist's advice, but all I observed is that medicine is just soothing me a bit from having any itches but is not fighting with the root cause of it. For that reason, I keep getting this burning itching sensation again and again if I stop taking the medicines and on the other hand, I do not want to run myself on medication for months and years. I researched a bit online and surprisingly, found out that allopathy has no perfect cure for it but homeopathy does. That is the reason I wanted to try homeopathy treatment this time. Here are my following questions: I read that homeopathy treatment takes a while to cure. So, can I use these Bepozic (antihistamine) tablets twice a day, so that I do not have to worry about itching? Is it safe to use homeopathy medicines with other generic medicines like Paracetamol, Cetirizine, Benadryl, etc.? I just want to be sure if I can take them along with homeopathy medicines, just in case I encounter any of those in the near future? How long does this treatment take to cure, from your past experiences or consultations?",
    "doctor_response": "Hello. I have seen your reports (attachment removed to protect patient identity), your thyroid profile is normal, and serum triglycerides level is a little bit high. For urticaria, in homeopathy, we have best remedies. So, you need not worry about your problem. Your blood reports are not related to your problem. While using homeopathy, you need not use antihistamine medicines. Homeopathy can solve your problem. Homeopathy is the best and no side effects. And along with allopathic medicines you can use homeopathic medicines. Due to urticaria, the eruptions like hives occur. The range of size from a few millimeters to several inches in diameter. It is caused by allergic reaction. You may have acute urticaria. Before getting this problem, have you used any medicines for other problem? Some foods also cause urticaria. Some bacteria like streptococcus and Helicobacter pylori also cause urticaria. Symptoms of urticaria are intense itching, burning, and sense of heat. According to your symptoms, the homeopathic drug ARS ALB 200 is the best remedy. I suggest 10 pills once for three days only. For more information consult a homeopathic physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be done for pain in neck and eyes?\n\nHi, i have left upper back pain which is worst ol left side on neck and in my left eye. The pain is dull and severe, I tried every kind of madications and none of them helped. When I have this pain my left side of neck is swollen and stiff,as well as my left eye is swollen and the eyelid drops.",
    "doctor_response": "It looks like that you are having weak cervical muscles. Are you sit for long hours in front of laptop or drive bike or play any sport. Because these things can make your neck muscles fatigue. I would recommend you to start neck muscle physiotherapy, take muscle relaxant like myoril and apply diclofenec ointment at your neck. avoid using very high pillow.For dropping eye lid I woould advice you to eye specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen gums and burning sensation on tongue?\n\nHello ,Im sure two days ago i developedMy gums were painful two days ago when I wake up and swollen . Since then I've been rinsing with hydrogen peroxide and crest pro health. The spot I was concerned about looked a bit better his morning and my gums are still slightly inflamed . Last night I used the crest pro health (I've been using it like every two hours ) and it burned the tip of my tounge .This morning I mixed water with the by the hydrogen peroxide and rinsed . It burned my whole mouth and the living where your gums and lips meet and made the bottom of my tounge white and it stayed for like two hours. I'll get to the dentist when I can for sure . The actual painful area of the whole mouth actually feels less painful than two days ago and isn't nearly as swollen .!is the burning tounge and the burning on my mouth because I'm doing overkill with the hydrogen peroxide and crest pro health ? I've seen pictures of gingivitis and the pictures I've seen are NOTHING like I've seen. Is the burning because I'm overdoing it ? I'm just hoping it will keep my mouth sterile enough to undo the gingivitis which it seems it may have started actually doing .Thanks oh and will biaxin help?",
    "doctor_response": "Hello,I suggest you stop using hydrogen peroxide and switch to warm salt water rinses since using multiple times a day. You must be careful of the percentage of peroxide used. You can continue the Pro Health one or two times a day. Try to take some anti-inflammatory medication such as tylenol or Advil. Practice proper daily hygiene including gently brushing your tongue. Proper nutrition with balanced vitamins especially vitamin B12 is suggested. Keep well hydrated.Dry mouth can cause these symptoms especially after waking up if you have congestion or snore. Fungal infections such as oral thrush can cause the symptoms especially with your discomfort associated with the tongue. A prescription for an anti-fungal medication such as Nystatin would be prescribed by your dentist with this diagnosis. Changes in your health or medications taken can cause an imbalance in your oral environment. Your medical and dental history are important to determine possible causes. Are you up to date on your routine dental exam?Please follow my suggestions and relax. Do not continue to try various medications without an actual diagnosis. Schedule a dental visit. Your dentist will evaluate your dental health and provide treatment recommendations based on a clinical diagnosis.I hope you will feel better soon. Thank you for your inquiry",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent cough with swelling and numbness in the arm?\n\nI cannot stop coughing. I ve been given antibiotic and mucinex dm that are not working completely (well, the mucinex) though there has been some relief. I have had a few isolated incidences of asthma in the past and this feels a bit like that. Also, the clinic I visited let me go with a blood pressure of 120 something over 90. I have never been over 90. the most 78. my left hand is swollen and there is some numbness in my left arm and hand. I am exhausted with coughing. Some relief comes with boiling water on the stove. I also have rheumatoid arthritis.",
    "doctor_response": "I think what you are doing is overreacting.Try  & chill down a bit.swelling in your hands may be due to acute inflammation on Rheumatoid arthritis-you should take hydroquinolone 200 mg  twice a day for that & for cough i think  you can take alerfix-M tablet for 10 days.And about your bp ,Normal BP is 120/80 and its okay to have diastolic BP till or less than 90.also there are machine's errors many times along with some personal errors while measuring like cough too loose etc So dont worry about bp & get it checked once more it will definitely come below 90.Thanks to contact hcm.Happy to answer your queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it fine to take half losartan potassium tablet?\n\nI have received a prescription for losartan potassium (generic) 50mg for hypertension.  I had an allergic reaction to lisinopryl and had extreme fatigue on beta blockers, HCTZ, and calcium channel blockers. I am concerned in taking the full dose at one time and would like to split the pill in half at least on the first dose to see how I react.  I had a horrible reaction to the lisinopryl on 2.5 mg. Is it okay to cut the losartan potassium pill in half?",
    "doctor_response": "Hi,For the first dose you can divide the tablet unless your blood pressure is too high.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cubitus valgus\n\nsir i have been declared unfit due to cubitus valgus by armed forces medical board for commission in navy because my carrying angle of elbow is more than 20 degree.what can i do? what problem occurs due to more carrying angle in the training of armed forces? plz guide me",
    "doctor_response": "Hello, The history indicates that there is a deviation in the elbow joint. When there is a deviation in the elbow joint beyond the normal values the chances of landing into fracture are more often. This could be one of the reasons the armed forces rejected your physical test application. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen cheeks in a child after getting teeth filled?\n\nMy 4 year old had to have 2 small fillings placed in his his upper and lower back teeth.  His cheek is so swollen now, in side and out that it looks like someone hit him.  Could this be from biting his cheek whil it was numb, I really don't see bite marks.",
    "doctor_response": "hellooo....read thru ur query i can say that it can be due to cheek biting can have injured some minor salivary gland causing swollen cheek.marks wont be there properly...but dont worry..it will heal fast..if he is having pain apply dologel just before food..thats all needed..it will heal by itself..if after few days still swelling u can meet oral surgeon and see the problem..in my view it will heal very fast in few days....hope i have replied to your query....have a healthy day!!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen fluttering stomach?\n\nhi, i have a swollen stomach and can feel constant little fluttering or pulse like sensation in my  lower stomach. i am not pregnant, my age is 46. i feel bloated and uncomfortable as if you are when you are pregnant. i have been very stressed lately due to a family member passing away. any ideas what could be wrong? my bowel movements are regular",
    "doctor_response": "Hi.Thanks for your query.Noted all the history. This can be due to a mild form of enteritis or a mild form of IBS - irritable bowel syndrome. Do not worry much, observe for a few more days, may settle with time. As there are no other symptoms like pain, bowel movements are normal, just wait and watch.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it advisable to use trio heat ice and ibuprofen for back condition?\n\nHello! I am a 29 year old female with a history of back and neck injures due to a few car accidents. Yesterday I did some heavy lifting (I know I m not supposed to, but the work needed finished and I am not someone who lets things ride.). This morning I got out of the shower and noticed a strange sensation in my left back, left leg and left foot. No pain like usual, but instead the left side of my body felt warmer than the right. I think it might be some numbness? This has been constant throughout the day and now My left foot is tingling but still no pain. I ve been on my feet all day as I am a 4th grade teacher. Is this something I should be concerned with? Or will it sort itself out with the usual trio heat ice and ibuprofen ?",
    "doctor_response": "Dear patient Considering  your  case you might be having disc prolapse with nerve root compression.  This might be due to weight lifting.  I would advise Xray of lumbosacral spine anteroposterior and lateral views to rule out bony abnormalities.  MRI  of lumbosacral  spine with screening of whole spine is required to assess level of disc prolapse  and severity  of prolapse.  Visit radiology center nearby you and get it done.  Avoid forward bending and heavy weight lifting.  Start taking tab diclofenac plus thiocolchicoside combination twice a day for 5 days. Take tab pregabalin plus methylcobalamin one at bedtime for 10 days. This will relieve you of tingling and numbness. If mri report is abnormal  need to consult expert spine surgeon with report.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes relapse of chronic bacterial prostatitis?\n\nHi, may I answer your health queries right now ?  Please type your query here...i am suffering from chronic bacterial prostate since two years now and tried all the antibiotic like sepro and tarivid , tavanic but the problems appear again after finish the course",
    "doctor_response": "Hello, You can go for a prostate biopsy to look for any other causes. In severe cases IV antibiotics may be needed. Consult a urologist and he will direct you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can chemotherapy be done on patient weighing 40 KG?\n\nHALLO DR.I AM SANDEEP JOSHI,FROM BHUSAWAL MAHATRASHTRA. MY MOM HAS DETECTED ENDOMETRIUM CARCINOMA LAST THREE MONTHS AGO WE OPERATE HER FOR ENDOMETRIUM BUT BIOSPY CAME POSITIVE AFTER OPERATION .WE WENT TO TATA BUT DR FROM TATA REFUSE FOR CHEMOTHERPHY AS HER WEIGHT IS ONLY 40 KG AND SHE CAN NOT WALK BECAUSE OF WICKNESS",
    "doctor_response": "Hi,Thanks for writing in.Chemotherapy is given to a patient if they can tolerate the stress during treatment. If her weight is 40 kg then her general health condition is such that chemotherapy might cause more complication. Chemotherapy is done by giving strong medicine which will cause certain reactions in the body that might not be acceptable to your mother.Other than weight it will help to know if your mother has normal blood report and liver function tests. Please give her protein diet and that might help to increase her weight and make her suitable for chemotherapy. You might also discuss the case with her doctor and if radiation therapy is possible to be given in place of chemotherapy. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for leg pain\n\nI woke up this morning with a sharp aching pain in my inner thigh I have never experienced before. I took some ibuprofen and went back to sleep. When I woke up the pain now starts left to my groin and shoots down to the bottom of my foot. It s almost unbearable. What can I do?",
    "doctor_response": "Hi there. Welcome to Healthcare Magic. I have read your query. Do you have any back pain ? What is your age ? It appears you could be having muscle spasm as a result of nerve pinching due to possible disc prolapse Bebside the pain is radiating to your foot from the thigh. There are various causes for the same but if you are having back pain as well, it is imperative to get evaluated for disc problems in your spine and any problems in the hip like arthritis. Kindly avoid lighting heavy weights or bending forward.Eat healthy. Stay stress free. Consult your Orthopaedic surgeon in this regard for a thorough examination and evaluation of your problem. I hope I have answered your query. Thanking you. Regards, Dr. Aashish Raghu",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lump in armpit\n\nI have a lump in armpit since last ten years and i am not sure what it is not sure which doctor to go to? From internet i got to know that it can be cancerous or due to infection or extension of breast tissue. Not sure what is it but want to get rid of it safely",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have lump in axilla.  It can be lipoma, benign cyst or some enlarged lymphnode due to reactive hyperplasia, tuberculosis or lymphoma. You should consult general surgeon for that.  If needed go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can dementia and aggressive behaviour be managed?\n\nMy mother has dementia. We are trying to place her into long term care. She lives at home and my siblings and I take turns taking care of and being with her. today she is very belligerent and confrontational and were wondering if taking her to the hospital to get help calming her down.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I hope your mother is under treatment for dementia. You must have known that dementia is a combination of many health and mind related behavior problems which includes loss of memory most of the time. In your mother's case, your doctor must have advised you on this behalf. I suggest you to consult him for further advise. Dementia and aggressive behavior of a dementia patient can be managed with the help of drugs and careful empathy. You needs to be patient with a dementia patient. Hope I have answered your query. Let me know if I can assist you further. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in the knee joints\n\nHello I am 17.5 years old..... Whenever I wake up at morning i feel pain in my neck and sometimes back also..... Pain lessers after 2-3 hours but today pain is not leaving...... First time i suffered from this pain 2 years ago.. I also have pain in my knee joints...... Even at such small age i feel that i have lost my health....... I cannot put my bag on my shoulders for more than half an hour because it stats paining........... I am very depressed due to this.. Plz tell me any solution.....",
    "doctor_response": "Hello,Thanks for the query.Most probably the causes will be ligament or cartilage related problems.As a first line management you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist better to consult an orthopaedic and get evaluated, An MRI knee joint is needed.Wishing all the best.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes inconsistencies in periods?\n\nHi doctor! i have a question for my wife to get the pregnancy 12th july & 14th august is the menses time, 16th september we had a intercourse then menses did not came and after 3 weeks she got vomitting feeling and other symtomps but 16th october she got menses. what was the problem doctor?",
    "doctor_response": "Hello dear,I understand your concern.In my opinion if there is delayed period in case of regular cycles the pregnancy should be ruled out by doing a urine pregnancy test.If the test is positive the bleeding can be considered as miscarriage.If the test is negative the delayed period can be due to hormonal imbalance due to stress regarding pregnancy or anything.So dont worry.Avoid stress.Practice regular intercourse to increase the chances of conception.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Koch's disease cause high temeperature and abdominal pain?\n\nmy son was diagnosed with primary koch\"s infection few days ago. Now he's having a high fever and complaining of abdominal pain. So i decided to have his urine testeda nd the result shows 0-4 WBC (Pus cells) and 0-2 RBC ,  bacteria-occasional , epithilial cells-occasional, mucus threads-few. amorphous urates-moderate.   What does this mean , and does the abdominal pain is due to the pus cells in the urine? is he having UTI? or does the lung infection has something to do with the abdominal pain ang the high fever?  his pedia schedule is still tomorrow , do i need to rush him to ER if the fever does not subside? please advise..thank you...",
    "doctor_response": "hello..kochs diagnosed few days ago generally doesn't cause abdomen pain..it is mild urine infection..pain exact location..?did you get a any blood investigation done..?does he have tenderness?fever with chills?i would advise to get checkup as early as possible..because there can be some causes which need immediate attention..i would advise a blood test and USG of abdomen..followed by a course of antibiotics and other medications..if pain is severe and looks dehydrated take him to the ER..if you have any problem you can message me..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the echo-cardiogram with mild impaired left ventricular relaxation indicate?\n\nHi. I am a 52 year old woman. Two months After being hospitalized last year with ulcerative colitis, I had dvt/pe. I have been on coumadin since August. When I was discharged from hospital I was on 1 mg coumadin. I have regular pt/inr tests and am currently on 7mg coumadin daily. I have congential lymphedema & have always had ankle & leg swelling, however since pe have much more swelling. Recently had echocardiogram that showed pulomary hypertension, mild impaired left ventricular relaxation, trace mitral regurgitation, mild tricuspid regurgitation w/right ventricular systolic pressure estimated at 55 mmHG indicating moderate pulmonary hypertension.What does all of this mean? Am I at risk for another pe?",
    "doctor_response": "Hello ma'am After going through your medical details I would try to explain things to you in a rather simple way. Your echocardiogram reports tells us that you have leakage in two valve one is of mild type and other a bit more. Pulmonary hypertension in your case is due the Pulmonary embolosm u had which happened due to DVT. Impaired relaxation of left ventricle means your ventricle is not able to relax fully during the stage of blood filling in it which is a common age related change that happens in Heart after 45 to 50 years of age. Chances of having a pulmonary embolism in DVT patients are more than other people so you need to take good care of yourself in terms of proper medication, checking your INR periodically and keeping yourself mobile and active.Wish you Good Health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes finger lumps with itching, redness, soreness and pus?\n\nI have one finger that has gotten these itchy small bumps that have clear fluid in them.  I have tried allergy cream, now the area is red and sore.  I'm not sure what to make of it as it came out of no where. If I use no bandage it gets dry and more itchy.",
    "doctor_response": "Welcome to health care magic. 1.The most possible cause in this case is ganglions in the joint from the joint spaces. Next possible cause could be infective aetiology with collection of pus within. If you are male - the other possible cause could be hair follicle infection.2.The remedy in this case - do not squeeze, compress, scratch the lumps as you will be complicating in that way,and delay healing process.3.Treatment in this case includes a course of antibiotics, maintain local hygiene.4.If lumps are big and not responding to treatment - an incision and drainage followed by a course of antibiotics.5.In case of ganglions, generally monitored - if symptomatic needs excision and drainage. Good luck.Hope i have answered your query,any thing to ask do not hesitate to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am having problem in passing urine, please suggest me the remedy for it\n\nI am having problem in passing urine. I am takaing Urimax 04 mg in the morning and was taking Roliflo in the evening. Now that Roliflo is not available, I was prescribed Trofame XR cappsuslels but these capsules perhaps do not suit me as it seems to block urine free flow. Which medicine I should use in its place Thanks",
    "doctor_response": "Oh are you having Prostate issue. If you are not gettin help frm medicines, then you will need to undergo surgery as the ultimate treatment. But with timely medicines, they say that surgery can be prevented.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for erectile dysfunction\n\nHaving been circumcised at birth I now find loss of sensitivity in the tip of my penis, causing erectile dysfunction.   Is there cream that can soften the tip (for increased sensitivity) or some sort of protection that will allow my penis to become more sensitive with time.   I am now 56yrs old.",
    "doctor_response": "Hello, As per your history, it may be due to performance anxiety For that you can take tablet sildenafil one hour before sexual act. Foreplay will also help Along with that avoid stress. Take balanced diet and proper rest. Discuss issues with your partner Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have lymphoma. Consuming cannabis. Increase melatonin levels?\n\nthey say cannabis increases melatonin levels in the body. I have lymphoma and have read that increased melatonin is bad because it benefits the immune system, and as a result benefiting the lymphoma. Is there any truth to this logic? i can understand how smoking it would be harmful to ones health but what about consuming cannabis?",
    "doctor_response": "Hi, Cannabis increases level of melatonin. The relation of melatonin with immune boost up has been studied. There are some results supporting its immune enhancing property but definite proof is lacking. Anyway relation  of lymphoma and melatonin level are difficult to say. No comments on the harmful effects are possible.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes delay in periods?\n\nOn 23rd jan my period started which lasted 27th jan. On 29th jan I had an unprotected sex and next morning I took unwanted 72.  On 4th feb I got again periods for next 4 days.  Now yet I have not got my periods.  When will it come. Pls reply soon.Thanks.",
    "doctor_response": "hiiii,.You did sex on 29th Jan, just 2 days after your last period and it is very much safe sex. You also took Unwanted 72 pill within 24hr and it will give extra protection against unwanted pregnancy. Here, chance of pregnancy is almost nil.Your got period on 4th Feb due to withdrawal effect of emergency pill. I suggest you to await for next coming period up to 4th March.Late period may be due to psychological upset, mental stress, altered eating habit, wt loss or gain, hormonal imbalance, thyroid disorder, ovarian cyst, high prolactin etc.I suggest to consult with your doctor and need to carry out some basic investigations (pelvic ultrasound scan and hormone profile) to evaluate underlying pathology if you don't get your period on expected date.Avoid stress by regular deep breathing, take healthy diet and proper sleep.Practice safe sex and good luck. Be well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does conceiving after being treated for hepatitis C result in deformed child?\n\nhi , i contracted hep c over a year ago from a tattoo and had a full years treatment of interfierion and also ribviron , i cleared it after 12 weeks inclusiding anti bodys but still had full treatment ive been off it for over a month , thing is it stopped my period and now i had it back last month for full week normal and am due it it now , basicaly me and my bfirend had sex he didnt fully .. just pre come i think its called basicaly this happened three times, he didnt tell me about the pree come so thought i was ok , i am religious so dont belive in abortion , (hypoctit sex beofore marridge but we are going to be) any way i left it to late and now need to know if iam (chances are small but g-d wil prob punish me for sinning lol) then will the baby be deformed and what should i do please help as i feel very upset by this thank u M",
    "doctor_response": "HI,    I understand your concern. Hepatitis C when left untreated. is known to cause cirrhosis liver after many years of infection & such untreated hepatitis can affect fetal development..    But fortunately you were sufficiently treated to take the infection out of your system. I don't think you need to be stressed about fetal abnormality. Still routine pregnancy check ups/ special tests for excluding fetal anomaly are needful First thing is to tell your treating doctor about your infection.. so taht he would be careful while treating you.   Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does one become pregnant ?\n\nis it always possible to become pregnant the first time you have sex?",
    "doctor_response": "not necessarily. pregnancy depends upon on female's ovulation & male's sperm union. After female's ovulation the female egg remains fertile for 72 hours. After ejaculation male's sperm live alive & active for 24 to 48 hours for fertilisation. If male's sperm & female's egg unite & fertilise during that period, then & then pregnancy takes place.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is some treatment needed for Nausea and dizziness when I stand for long?\n\nI hit my head 4 days ago. I am experiencing flue like symptoms. Nausea and dizziness when I stand for too long. I also had a rash breakout over my entire upper torso. The area of the trauma is now itchy on my scalp. My vision has improved. I had double vision less than 24 hours after the injury. This has improved. My face is puffy. I hit the back of my head on the left side. I do not have insurance and am wondering if I need to go to the ER. I seem to be very emotional. I only feel well when I am lying down. Could the rash have something to do with the head trauma, or could I have a virus separate from the head injury? What should be my coarse of action? I do feel better than I did a couple of days ago.",
    "doctor_response": "Hello, As you had symptoms like double vision, it is better to go for a CT scan to rule out head injury. The rashes are not related to the head trauma. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason of having strange moving sensations inside chest?\n\nHi i basically have a feeling in my chest area that i can feel somethin movin inside me. Sometimes it feels like a tiny pebble moving up and down from my throat to my belly and other times its feels like something is just moving around in me. I sometime change position that im sittin or laying in to fell this sensation less. Its not painful or anything it just feels weird",
    "doctor_response": "Hello,Maybe, you have some neurological disorder or psychiatric disorder. This feeling is called a hallucination.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Chandra Shekhar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could it be if had elevated creatinine levels, pressure in head, abdominal pain, diarrhoea, tachycardia?\n\nCortisol 763, ACTH 11.5, creatinine +3X normal, pressure in head, abdominal pain RUQ, diarrhea severe, tachycardia, hypertensive, MRI head, CT abdomen, CXR all done-no abnormalities, Colonoscopy normal. What could this be? Numerous blood and urine tests done. Have not done DST, should this be considered?",
    "doctor_response": "hello hello I am your physician I have read your query and came to conclusion that you are having kidney dysfunction with your adrenal glands which is causing all the problems. headache is due to hypertension which is cause by the Kidneys tachycardia is also you can say a side effect as in hepatorenal syndrome. diarrhoea is due to electrolyte imbalance which is also function regulated by Kidneys so this can be also a side effect. I suggest you to consult nephrologist for opinion",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can norethisterone be taken during menstruation?\n\ni have started taking norethisterone, however i did not take it 3 days before my period was meant to commence. I have already taken 3 tablets, yet my period has begun. Should i continue to use these tablets, or will it have no effect on my period? thanks.",
    "doctor_response": "Hi,Continuing norethisterone after the commencement of period may not be effective in controlling bleeding. Hence always start the drug 3 days prior to expected date of periods.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Saranya Ramadoss, General & Family Ph",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe joints pain in the hands?\n\nThe joints in my hands started aching about two weeks ago. Both thumbs first and now both my hands. I d never had this issue before. I can t think of anything I ve changed as far as eating or physical. I go to my Dr. next week, but If I could ID what is happening, the pain would go away sooner.",
    "doctor_response": "Hello, As the history sounds to be a compression over the flexor retinaculum. I will advise you to do hot water fermentation and compression. Once the pain level falls to 4-5 in visual analog pain scale of 0-10 then do simple hand exercises in the hot water. This should help you ease it. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chest discomfort, bronchial oedema and heaviness on suprasternal notch area. Reason?\n\n20y male with h/o smoking for past 2 years an average of roughly about 6 a day, started experiencing chest discomfort mainly seemed like bronchial oedema and heaviness around the suprasternal notch area, went to a chest medicine doctor and had my spirometery and FeNO done which was roughly about 44ppb and spirometery showed the mef25-75 i.e the small vessels were effected..which showed improvement on asthalin inhalation .. doctor has prescribed formoterol+ budesonide rotacaps medication, also had an allergen sensitivity skin prick test done which showed im sensitive to spider web dust, dust mite and cockroach i have the following queries 1. what is the most probably diagnosis? (asthma/bronchitis/other inflamatory condition) 2. can the medication be taken SOS and does it have an dependancy or rebound phenomenon esp down regulation of the b2 receptor in my bronchi? 3. now if it is asthma or setting of COPD changes, there is remodelling of the bronchial system, will this drug retard the the process and restore it back to normal? 4. how long am i supposed to stay on medication? also due to rotacap medication is it likely that thepowder may irritate the air passage and cause a bronchoconstriction instead of dilatation? 5. could u suggest some exercises or processes to improve my lung function? and also to reduce the bronchial oedema over a longer duration? thank you for your time :)",
    "doctor_response": "at your age the smoking cannot harm in 2 years it is some other allergy exagerated by smoking these allergies are comon for milk,wheat,egg ,potato,chana,rice you get blood serum test specific antibodies for these foods in the meantime take singular 10 mgm bd tab allegra 120 mgm bd syp ventrolin 1/2 tsf bd syo tossex 1/2 tsf night applu neospotin h eye onitment in nose sea water 2 drops at night in eacxh nose 3 week post after tests",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard bump on inner thigh?\n\nI woke up and on the inside of my left inner thigh where the crease meets the pelvic area I found a huge hard sorta oblong feeling and it feels hard as a rock but hurts little when you push in it. what the heck could it be. its not a lump outwards its a lump like if you were to do a breast check.",
    "doctor_response": "Hi, thanks for using healthcare magicThe 'bump' may be a lymph node that is inflamed or infected or abscess which is a collection of pus. An abscess is initially hard/firm then softens as pus is formed.Lumps can also form if there is trauma to an area.Your doctor can determine which is present based on the exact location.Antibiotics may be needed if an infection is present.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does prolonged use of amphetamine cause damage to the kidneys ?\n\nhi my nane is martin i have been useing amphetamine for ten years daily althow i have redused my consumpsun down to half a gram daily, i have some worries that i have caused damage to my kidneys as i get a lot of pain in that area and i get pain in my testicals mainly my right one iam in good health in general but i get worried afrter so many years on this drug and what it has done to my body iam 43 years old thank you for any advice you can give me martin",
    "doctor_response": "hi, welcome to HCM read your prob, first you mention why are you taking this drug for a long time. this drug stimolate brain n brain become more active. it has less effect n more side effect, like neurotoxicity, cardiotoxicity, develop any psyciatric prob.  it has not nephrotoxic effect. you feel pain at that area may be this is due to neurotxicity. so try to taper this drug , consult your neeurologist n psychiatrist. Dr aseem aseemadhuri@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rash on neck, chest that appears as small brown spots?\n\nI have a rash on my neck and chest that appears as small brown spots. It is also accompanied by a small breakout to the side of my nose and bumps on the back of my neck. I first experienced this a few weeks ago when I got sick with a severely painful throat but the rash began to go away. Suddenly, it has reappered but also on my neck and with much greater intensity. The only other thing that has recently changed that  may somehow be the cause is my diet. Do you have any idea what could be causing this?",
    "doctor_response": "Hello, It could be either pityriasis versicolor or pityriasis rosea. I would recommend you to upload the pictures of the affected areas under the premium section of the site so that I can have a clearer picture of the condition and can guide you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dark red colored pimples caused by masturbation\n\nhi dr..i m 21 yrs old..and because of menstruation i am getting lot of pimples with dark red colour and they pain a lot..my doctor consulted azifast 250mg...is it a right treatment..i too have many dark spots which are left after pimples go..pls reply",
    "doctor_response": "Hi thanks for contacting HCM...According to your complain you can have superficial bacterial infection ....For which antibiotic needed especially which is effective against gram positive organism.....Here amoxycillin or azithromycin drug can be used.You are given azithromycin drug which is effective ...complete its course....Topical application of cream containing neomycin also effective ...Maintain hygiene if pubic area...Keep it clean....Tight underwear avoided....Drink lots of water...Rule out diabetics .....If still no benefit consult physician for examination..Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lumps in arm pit and in breast?\n\nI HAD BREAST CANCER 5 YEARS AGO IN MY EFT BREAST LUMPECTOMY LATLEY I BEEN TELLING HER I GET PAIN SOMETIMES SHE SAID IT WAS SCAR TISSUE AND LEFT IT AT THAT BUT IT CONTINUED A FEW WEEKS AGO I FELT AT EAST 5 LUMPS UNDER MY ARM PIT AND SOME IN MY RIGHT WHAT CAN IT BE THANK YOU VERY MUCH",
    "doctor_response": "Hi, dearI have gone through your question.I can understand your concern.You have history of breast cancer. You there is high chance that you have some metastatic breast cancer in your axillary lymphnode. You should go for examination. If needed go for biopsy of axillary lymphnodes. Then take treatment accordingly. Hope I have answered your question. If you have any doubts then feel free to ask me. Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "For how long can the recommended dose of Tylenol be given?\n\nSo my daughter who is almost 7 months old has been teething for quite a while. I was giving her half the recommended dose of Tylenol X3 a day. I just realized that we have been giving it to her for longer than the recommended amount of days! Will she be okay? Is she going to have lasting damage because of my neglect to read the information? Please help, I just want my daughter to be okay :(",
    "doctor_response": "dear user, thanks for your query. Tylenol is used  for fever and as a pain reliever. long term or excessive use may cause side effects. it may damage liver. i suggest you to not to use more then recommended dose and schedule.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. We did MRCP test as my mother's bile duct is dilated. Can you please interpret the report?\n\nHello dear doctor. my mother had a issue about her abdomen.it has been 1 or maybe nearly 2 month she is felling an unusual pain in the abdomen Which is accompanied by bloating and severe intestinal gas. we saw an expert doctors.one of them said The gallbladder is oily after After seeing the result of the ultrasound and another doctor said The bile duct is dilated and due that he recommend us to take MRCP image and we did that and recieve images but due to corona virus outbrteak and especially my mother age which is 54 years old we afraid to go to hospital and show that to the doctors which recommend us to do MRCP and we cant make online contact with him. maybe to be helpful and For more information, my mother has been using opium for 25 years.i will realy appericiate if you help us. Thank you for your attention. Best Regard",
    "doctor_response": "Dear, Great to meet you, welcome. I reviewed the history and MRCP report of your mother. Oily liver or gall bladder is not an issue.Her Biliary ducts are dilated but ther e is no obvious cause of dilatation.There is no stone or tumor in it.It may be secondary to chronic use of opium but It will needs further evaluation by endoscopic procedure called ERCP but in my opinion that is not an emergency. Meanwhile start using following treatment and it will help out in her symptoms. Opium/ Periampullary lesion ERCP LFTs CBC Periampullary lesion Opioid induced Opioid Induced SOD Dysfunction Tab.Levosulphride 25mg three times before meals.  Tab.Rifixamine 550mg two times after meals  PEG Sachet 1 at night time. Use these medication till you follow your consultant. Meanwhile do the advised laboratory tests and let me know, I will guide you about ERCP needs",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest diet plans for jaundice wit bilirubin level 2\n\nhi m 21 years old...i was suffering from jaundice from 1month...actually my bilirubin level is 2 and i got epigastric trouble too..my sgpt lvls r high...i took medicine and thse lvls r coming down..now i need sme info regarding my diet..can i eat potato,dal etc..pls suggest me sme food items tht i should take",
    "doctor_response": "Hi,Thanks for posting your query.I am Dr.R.K and I am pleased to assist you.You are probably recovering from acute viral hepatitis.Yes you can take potato and dal.You need to avoid alcohol, oily food.You should eat lots of vegetables and fruits and cut down on fats and sugars.I hope that answers your question.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain on the calf and thighs with history of back surgery\n\nSurgery on jul 15 this year to repair 3 compressed disc in lower back causing pain in right calf. Everything seemed to go fine and about 3 weeks after surgery began having intense pain down back of right leg - butt, thigh and calf. Pain is far worse than before surgery. A second opinion from another neurosurgeon indicates there is a tear in the decal sac and he believes it is causing the pain. He says I have to go back to original surgeon which I have NO desire to do. Any suggestions? How is thecal sac repaired?",
    "doctor_response": "There are many causes of pain after surgery. We call it FAILED BACK SURGERY SYNDROME. It could be arachnoiditis, Sacroiliac joint pain, wrong initial diagnosis and surgery, facet arthropathy etc etc. i think you go to a pain physician for making a correct diagnosis and treatment. Thecal sac gets repaired on its own do not worry.Dr Anurag Aggarwal9958830005",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any chance to conceive after blockage of left Fallopian tube?\n\nHi my wife has got ESh report like below --Uterine endometrial of non visualisation of left fallopian tube ---?Tubal block Uterine endometrial cavity is noramal in size and shape --No filling defects are seen --No congenital anomalies of uteries are noted --Peritoneal spill is noted on right side Will she get pregency ????",
    "doctor_response": "Dear sir, if the right Fallopian tube is parent and intact then your wife can get pregnant. if both tubes are blocked then the chance of pregnancy is only through IVF treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had bipolar, took lithium which was changed to Residone and Depakote with Celexa. Now has dementia. Advise?\n\nMy mom, 70 yrs old was diagnosed as bipolar 40 yrs ago.  She took Lithium for years.   Last time she was hospitalized with this condition the physician knew the Lithium was not for older patients and because she had taken it so long the onset of some Kidney Issues were apparent.  (Nothing life threatening)     So her meds were changed to Respidone and Depakote along with Celexa for depression.   She seem to function fairly well for a year.   However, within the last 3 weeks she has shown more signs of Dementia.  So being back in the hospital she now is on Namenda and Exlexon for memory.   Seems her memory or confusion has diminished... Now her Manic or Mania seems to have busted lose.   We are told she will need care 24/7 when she is released.    From being able to take care of herself to total care...seems so very EXTREME.....    Although I sound like someone in denial, I truly just want reassurance.    How would we go about getting a second opinion or having our reservations of this very QUICK downturn verified?thanks in advance for your prompt response to this matter.  We are at our wits end...  Wanting to do the right thing.Yvonnie",
    "doctor_response": "Hi, your mother is now at 70, and at the end of her journey. At this time though not due to the drug she may be failing her organs .                         What i think is is it will be better to start the previous drug lithium, again, leaving the recent drugs, and watch the improve ment, with the advise of her doctor. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant throbbing leg pain radiating to knees?\n\nPast two weeks constant foot, ankle, lower leg aches. Dull to severe aches, no sharp pain. I ve purchased new tennis shoes and no relief. At times it seems to throb even. It s both feet and travels up my legs sometimes reaching my knees. No swelling",
    "doctor_response": "Hello, It could be peripheral neuropathy. We have to rule out other causes like POVD also. As of now, you can take drugs like gabapentin for symptomatic relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Right side of neck is sore. Have hard lump in SCM muscle. Cancer?\n\nThe right side of my neck has been sore for over 4 months and I have a hard lump deep in the scm muscleIt was discovered by a neurologist who did trigger point injection along my right side close to the location of the lump. My pcg ordered a ct with contrast which I had on Friday I'm afraid it's cancer. I'm a healthy 49 yr old do not smoke or drink I exercise and eat healthy",
    "doctor_response": "Hello friend,There is a general trend in the society to suspect any tumour as cancer. you are no exception. That is why you also do the investigations to rule out cancer. The very sight of the lump started frightening you. Now you are in a panicky stage till you get a negative report after the CT scan. Cancer is associated with in curability and death and that is why you are scared.If you can remember the date on which you started noticing the lump in the SCM muscle, then take it from me, there should have had a shocking and unexpected conflict in your life just before that. That must have been in your mind level . In certain part of the brain which corresponds to the particular organ and side of the neck, there was certain changes which ultimately produced the tumour. This tumour is not to kill you but to save you. If the lump is continuing to remain there as a sore that means,the conflict is not yet resolved. I am a Homoeopath and this I am giving from my experience. Homoeopathy can identify how you reacted to the above mentioned conflict and can select a corrective constitutional remedy to assist you to get back to original condition. Please do not get frightened even if the investigations tell you that you have cancer because Homoeopathy can cure cancer . Your fear can reduce the chance of  recovery but once you are aware of the condition and reveal everything to an expert Homoeopath, he can help you. With best wishes for a speedy recovery through Homoeopathy,Dr. C. J. VargheseHomoeopathdrcjvarghese@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be done if my child is not talking to any one?\n\ngrief of my child on issue of  name change due to teasing of college friends and lecturers & we tried to change the name through court formalities but we came to know that as per Govt G.O name change will be done only alternation , they should not change the full name  my  daughter from two months she is not talking to any one neither family members nor  out side please suggest me Jayasree",
    "doctor_response": "DearWe understand your concerns.I went through your details. We all know \"what is there in  name?\". Such thought itself is childish. Also your child is being childish now. That is normal. Instead of pacifying her and convince her, you did wrong by trying to change name. No problem. Taking her to a psychological counselor shall surely help. Only that shall help, because you already tried whatever you can. Now an approach psychologically can only change her. Please do not ignore.Hope this answers your query. Available for further clarifications. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can be done for midgut malrotation in a newborn?\n\nHello doctor, My 24 days newborn son is suffering from midgut malrotation. Is this a problem?",
    "doctor_response": "Hi. Abnormal relationship of the vessels can cause intestinal obstruction or volvulus. It may be asymptomatic as well. If it is symptomatic in the form of pain that is related to malrotation, then this baby may need corrective surgery. You should show to a pediatric surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is ingestion of 'ibuprofen' by a baby harmful to his health?\n\nmy 22 month old son has just found in my bag an ibuprofen tablet a pink sugar coated one i found just over half on the floor but all the pink coat had been licked off and i am asuming he ate th other half, he seems fina and still playing, can half be harmful to him?",
    "doctor_response": "Thanks for your query. I have gone through your query.Nothing to be panic, keep an eye on your child for any changes like rashes or vomiting or any discomfort. If you find any of these symptoms then immediately consult a pediatrician and get it evaluated. If you dont find any symptoms then nothing to worry. Be careful from now on wards with your kid regarding drug exposure.I hope i have answered your query. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest tests to confirm pregnancy\n\nMe and my boyfrnd were having sometime togthr sexually. he did not enter me fully. but we just tried putting the penis tip into my vagina. he came after taking it out. (we are sure about that. ). there was some cum above my pubic region but not anywer near to my vagina. and also it was a dry process. i was not having any lubrication at all. is der ny chance of getting pregnant? we also came to knw abt the precum and its chances to make pregnant. we r little worried. kindly give an answer as soon as possible.",
    "doctor_response": "Hello dear,I understand your concern.In my opinion there are rare chances of pregnancy.Usualy there is scope for pregnancy when semen is ejaculated inside the vagina during the fertile period.There is very rare chance when then semen outside the vagona resulting in pregnancy.Byt anyway confirmation is done by a urine pregnancy test.The test needs to be done a week after missed period if at all the period is missed.The first sign of pregnancy is missed period.Other signs of pregnancy like nausea,vomitings,increased urination,sore breasts start 2 weeks after missed period Incase of pregnancyAnyway overall the chance of pregnancy is very rare.So avoid stress and wait and check for the period.Hope this helps.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Vomiting a day after wisdom tooth extraction, eased with injection, persisting nausea, tightness in chest. Worrisome?\n\nI had my lower right wisdom tooth extracted Tuesday at 10am. Early Wednesday morning at 4 am I woke up vomiting and did not stop until I received an injection at my family doc s office at 1030 am. I still feel extremely nauseous in waves. Also there s a consistent tightness in my chest. Should I be worried or is this a side effect of the mild constipation I m experiencing due to the codeine?",
    "doctor_response": "HELLO AND WELCOME, codeine is an opium alkaloid, its degree of analgesia is comparable to aspirin.it can relieve only mild to moderate pain. constipation is the prominent side effct of this drug when used as an analgesic. it is also used as an antitussive drug and also to control diarrhoea. the nausea ,vomitting and dizziness are the other side effects. so the symptoms you experience are the side effects of the drug used. if the symptoms persist ,visit your dentist and ask him for anti-emetic drug like domperidone and a purgative drug. regards DR.BINDIYA",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes popping of sternum during deep breath?\n\n40 yr old male. Sometimes my hip seems to nearly lock up, and I have to lean to that side and put stress on it to make it 'pop'. Hurts a little, but I get my range of motion back. In addition, after sitting for maybe a short as an hour, deep inside my pelvic region on both sides will 'pop' as I flex/tighten my muscles to sit up prior to standing. I fear that I may have a fractured hip tho I guess it could be mis aligned. But it's the deep pelvic 'poping' that has me concerned. I can only find references similar to what I feel as things a woman feels during pregnancy. And I assure you, I am not pregnant ':-). All of my joints are becomeing easier to crack, as if I live a stress free life ( which I doubt ) and my muscles around my joints seems to have relaxed inadvertently to the point that a slight movement on my part causes them to 'pop'. Most disturbing of all is that I can 'pop' my sternum by taking a deep breath stretching my shoulders back. Is this some kind of arthritis disease? Could my body be releasing 'relaxin' uncontrollably for no reason? Some joints are painful like my knees and shoulders and hip, and others are not, like my ankles,wrists, elbows, lower and middle back and my sternum is pain free. thanks",
    "doctor_response": "Hi thanks for contacting HCM...Noted you have mainly pain at hip joint.Yes if you are overweight then arthritis might lead pain....With advancing age and if calcium defeciency then osteoporosis like change might lead such presentation...For these condition to rule out x ray of hip joint done.....If multiple joint paining as you have mentioned in last also involvement of knee and wrist joint then rheumatoid arthritis might ruled out by RA factor if suspected.X ray will also rule out about any fracture or inflammatory arthropathy....Take calcium tablet if hypocalcemia.Vitamin d deficiency also corrected.Take care.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with anxiety. History of being allergic to bee stings, saved after taking epinephrine shot. Does the anxiety cause the body to produce epinephrine?\n\nHello I am allergic to bee stings and have been my whole life. When I was younger I had such a severe reaction that I had to get my epinephrine shot within ten minutes or I would die. I also have been diagnosed with general anxiety and have heard that anxiety causes the body to produce epinephrine. Is that true? I was stung today, but didn't have my epi-pen with me so I was not able to give myself a shot. I did not have any reaction to the bee sting. Could the epinephrine produced from my anxiety, if thats true, be enough to save me even though I was not feeling anxious about being stung. Thank you, Matt",
    "doctor_response": "Hi, the allergic states may vary from time to time. Once you are allergic now you may not. So don't worry about bee stings.It appears that now you are not allergic now. or the bee might be without poison, or it may be different bee.  Anxiety may produce epinephrine , but in minimal quantities. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can masturbation cause erectile dysfunction?\n\nHi doctor, I am facing issues of erectile dysfunction. But, I have a bad habit of masturbation since childhood. I am unable to keep my organ hard for a long time. It is big, very flaccid and not very hard. My testis has got shrunked day by day due to masturbation. Please suggest as I am getting married very soon.",
    "doctor_response": "Hi. I would like to mention that masturbation does not cause any weakness or sexual dysfunction. It is associated with guilt and anxiety that causes the problems. Do not get worried. Treatment is possible. Consult a psychiatrist or a sexologist in person for evaluation and treatment. For more information consult a sexologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sciatica nerve endings, stiffness, painful while sleeping, cervical pain. Done physio therapy. Will acupuncture help?\n\nI HAVE GOT THE SCIATIC NERVE ENDING STIFFNESS AND PAIN IN THE NIGHT WHILE SLEEPING AND I HAVE TO WAKE UP WITH THE SEVERE PAIN BUT WHEN I WALK INSTANTLY IT IS RELIEVED. THIS HAPPENS ONCE IN 2-3 MONTHS IN A YEAR (FOR THE LAST 4-5 YEARS)....CURRENTLY I AM CARRYING THE CERVICAL PAIN IN SHOULDERS AND NECK WITH STIFFNESS FOR THE LAST ONE YEAR. TOOK THE PHYSIOTHERAPY AND ORTHO TREATMENT BUT NOT HELPED MUSH TO ME. NOW I AM ON THE ACCUPRESSURE FOR THE LAST MONTH",
    "doctor_response": "Hi, Can try, in some patients has shown effective as long as no harm has been done. As you have noticed, once you walk, the pain and stiffness is done; so it is better not to stop exercising (walking, or other light exercise) to relieve pain and stiffness. NSAD taken orally or locally can also help. Talk to neurologist if any intervention can be done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tremors and delirium post treatment for pancreatitis?\n\nmy father is 76 he was just in the hospital 3 weeks for pancreatitis he was home 3 days and was back in er with shaking and delirium. All his tests are good. What is going on. He talks all the time even in his sleep. He seems great one day and the next he is confused.",
    "doctor_response": "Hello,Unfortunately delirium may be caused by many things and it will require a physical exam and blood tests to begin to sort this out. Just having a minor infection may cause delirium in some patients. Other causes are medications, toxins and metabolic disturbances.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause burning pain/ sensation in the urethra at the time of urination?\n\nI am 16 years old, have been sexually active with the same partener for almost 2 years and never had troubles till tonight when i went to pee and had bad pain and burning sensations throughout my urethra, it has never happened before and did not just slowly come on, it was sudden. Please help me, it hurts and i cant stop peeing but it is just a tiny bit everytime, about every 5 minutes and the urine is clear. Please help me, it is very very uncomfortablr and hurts",
    "doctor_response": "Hi there.Thanks for writing in.You might be having a urinary tract infection... as evident by your symptoms like burning urination and increased frequency of urination.Any other suggestive symptoms like fever, nausea, vomiting,backache, or lower abdominal pain.For confirmation of the diagnosis as well as the choice of antibiotics, you will have to get a urine routine and culture and sensitivity done...So please visit your doctor regarding that.In the meantime, drink plenty of water to flush out the toxins.Periodic regular emptying of bladder is a must...even when you get better.. do pee every 3-4 hours, to ensure clean bladder.Avoid intercourse for 1 or 2 weeks.A glass or 2 of cranberry juice might help.You most probably do need to take a course of antibiotics ...do consult your physician.Take care.Regards,Dr. Divya Kuttikrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to avoid skin rashes due to allergic reaction to antibiotics?\n\nHi I took doxycycline a while back for an infection and had a terrible reaction with stomach pains felt like glass in my stomach and went to the ER and was told to take mylanta, probiotics etc to help ease the pains away over a fews days which turned into a severe rash all over my body im not sure if it was from the doxycycline or the probiotics (since it was about 7 days after finishing doxy . Now I have another infection and told the doctor my reaction to doxycycline and he put me on a a one day 1000mg (4x250mg) of azithromycin.  I have a very busy weekend coming up and I do not want to have the same reaction with this but my infection is pretty bad.  Its a do the pros weigh out the cons scenario because I do not want to have those same reactions. Thanks very much",
    "doctor_response": "HI, thanks for using healthcare magicYou may not have the same reaction with the azithromycin though most antibiotics can have gastrointestinal effects.To reduce the chance of this occurring, you can consider starting a course of probiotics at the same time. Probiotics reduce the symptoms that can occur with antibiotic therapy.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can hypercapnia be prevented in a TB patient under oxygenation?\n\nHello doctor,I have TB disease, type1 respiratory failure. Oxygen was given, oxygenation improves but falls to LVL on presentation. What support should be given before the onset of hypercapnia? I have dry cough for two weeks, blood in sputum, fever, sweating and weight loss.",
    "doctor_response": "Hello. As you said, the patient has TB, hypoxia is more common which leads to type 1 respiratory failure. So only supplemental oxygen is not enough. We should start noninvasive ventilation as early as possible before hypercarbia sets in. So the possible options for NIV are CPAP or BIPAP depending on availability. The IPAP and EPAP pressures can be set up according to blood oxygen levels and oxygen saturation to be aimed to keep above 95 %. Minimal sedation will keep the patient calm and also help to reduce further hemoptysis.  Supportive measures like good nutrition and good nursing care should help to recover faster. Frequently keep a watch on blood gases. If NIV is not helping to keep oxygen above 95 % or hypercarbia sets in, mechanical ventilation may be needed. Ultimately we have to titrate depending on the blood oxygen levels. Antitubercular treatment must be continued simultaneously. Antibiotics according to infection markers.  TB. Arterial blood gas. Pneumonia. NIV and anti TB treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have abdominal pain, cramps, nausea and vomiting\n\nI was in a car accident 8 days ago. The last few days I have had abdominal pain. This morning I had severe cramps and went to the restroom. I had a small BM but then was extremely nauseated and vomited. I have had these symptoms several times today and the last BM I noticed bright red blood mixed in with my stool. Should I be worried?",
    "doctor_response": "HIThank for asking to HCMI can understand your problem and this could be intestinal infection and most probably Protozoa infection is likely, if I would be your doctor then I would treat you with the following medicine.1) Tab Metronidazole 400 mg twice in day for 7 days2) Tab. Dicyclomine with Acetaminophen three time in day (once pain stops no need to take this )I hope you wold feel much better with this, take care and have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any side effects for lcz mont tab?\n\ni am taking lcz mont tab for the last three year. Is there any side effrct of this medicine? .recently there is a lose of sodium salt in my body resulting genral beakness in my body despite taking extra salt for the last many days pl.conform is it the side efect of this medicine?",
    "doctor_response": "Hello,How do you know that decreased sodium in your blood? Usually levocetirizine with monterleukast may not cause hyponatremia. It may be excessive sweat loss or decreased intake or through renal loss or due to drugs like diuretics. Get well hydrated, avoid hot climate roaming. Use ORS sachets for rehydration. Please consult with your physician he will examine and treat you accordingly.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause of severe leg pain and inability to move?\n\nMy 79 year old mother suddenly could not move her legs. She was unable to walk with severe pain at the top of her legs. It lasted about 30 minutes before she could move and pain continued throughout the night. Still tender today but not near as painful.  Any ideas what may have caused her seizing up like that?",
    "doctor_response": "Hello againLeg Muscle cramps are very common in females my advise for youTake plenty of water, fluid intake will dilute toxins.Physiotherapy with ultrasound and Tens will help you,Yes you can do exercises like swimming, riding stationary bicycle, but do not overexert yourself.Take potassium rich diet.Hot and cold fomentation to leg. You need to continue you medication for couple of month to see effects.Add tab methylcobal 1500 once day.Nerve compression can be seen on  MRI which may lead to leg pain.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take careHope I have answered your query. I will be available to answer followup queries. If you are satisfied with the answer, please give your review at the end of the discussion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy lump above the Adams apple?\n\nHi doctor, Recently I have been I'll and was throwing up regularly and have now discovered a large knot or hard lump on my neck just above my Adams apple and below my jaw line. I have no idea what it is. Maybe I pulled a muscle and it knotted up. I have tried massaging it to get blood flowing back through the muscles but no sign of change. Plus now two days later it's beginning to itch. Is this a sign of heeling? Please help. Kind regards.",
    "doctor_response": "HiWelcome to HCMYou have not mentioned the size of lump. This can be thyroid cyst or thyroglossal cyst. Both needs surgery. If it is some simple pimple it will go with time. But if persistant or increasing in size see your surgeon.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can wheezing and cough be treated while suffering from pneumonia?\n\nI have walking pneumonia and am on antibiotic for ten days. Told to get plenty rest and drink plenty. Seems worse late day and night with wheezing and cough but no coughing in morning once I\u2019m up and about. Help me understand what I need to do to know I\u2019m getting better",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.You may need to see your doctor again. Most likely you will need a prescription for an inhaler to help with the coughing and sneezing.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Kathy Robinson",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bladder infection\n\nI had surgery 8 days ago to have two stents put in my double collecting kidney , there was a stone in the urethra and I also had a bladder infection. On fluids and antibiotics and discharged from the hospital last monday. The bleeding had stopped a few days ago. Last night the stents became more painful now lots of blood again. Is this normal?",
    "doctor_response": "Brief Answer:You should see an urologist.You should have an abdominal ultrasound.Detailed Answer:Hello,Thank you for using HCM.Usually the stents does not cause pain, when they are in the right position and they are functioning well. They may cause a bothering sensation, or a heaviness sensation into the flanks. As your pain is growing up in intensity, and the urine contains blood within it, you should make an abdominal ultrasound. It helps to differentiate if the stents have moved from the their position, or there are small stones passing throw them that cause pain and blood in urine.If you do not have difficulties in urination, you should keep drinking plenty of liquids.If you experience fever, nausea, difficulties in urination, then you should do a urine analysis and a full blood count. You should discuss the results of the above mentioned exams, with an urologist.Hope this is helpful.Let me know if you need more clarifications. Otherwise please close and rate the answer.Kind Regards, Dr. Juarda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. 10 year old on Methotrexate and Enbrel for psoriasis polyarthritis. Will any other steroids help?\n\nHello doctor,",
    "doctor_response": "Hello. I have gone through your history. Well, it seems like you developed a reaction to Enbrel which is quite common as it does flare psoriasis in some patients. Pertaining to your queries: Since you have mentioned only one ankle is swollen, it is not justified taking such a high dose of steroids. Considering the patient is 10-year-old, it will hamper the growth and height of the patient. Firstly, one needs to see, if there is an effusion left or there is synovial thickening due to prolonged inflammation. The thickening will not respond to the injections or the steroids. Also, if only ankle is the problem then, consult an orthopedic and you may want some synovectomy done to relieve the inflammation if the other methods have failed. If 20 mg is not working, it is very less likely higher doses will work. My suggestion is to get orthopedic advice. It is hard to say but normally one year of the swelling can damage the joint. If the disease is too aggressive, may be two months are enough. Always a tough thing to call for. US (ultrasound) of the ankle. Orthopedic intervention.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in heart and numbness on legs and face\n\nhi,for the past week i have been having slight pain in my heart and numbness on my legs and face.i had been to the doctor before and they told me i hyprviolated.i didnt get anything to treat it,and now a while later i have felt the same thing.i when to the doctor again and they gave me anxiety pills.i drank one and i went away but the next day i felt the same.",
    "doctor_response": "Hello,I passed carefully through your question and would explain that anxiety can trigger this entire clinical situation, by leading to hyperventilation.Anyway, I would also recommend performing some further tests to investigate for other possible causes that may lead to this clinical scenario:- Complete Blood Count for anemia- PCR, ESR for inflammation- A chest x-ray study and pulmonary function tests to exclude a lung disorder- A resting ECG- Blood electrolytes for any possible imbalanceYou should discuss with your physician on the above mentioned tests.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Ilir Sharka",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness in the foreskin with scarring on the outer skin?\n\nhi,a few years ago i had to take lots of antibiotics beacause i kept getting tonsilitis,i then kept getting thrush,i went g,u,m clinic and they told to just was with salt water,i did this quite a few times and ever since then my foreskin has been quite tight and when i now ave sex it can be uncomfortable because the skin wont go any further than the gland and there is slight scarring on the outer skin,,,what should i do",
    "doctor_response": "thank you for query.it is due to balanoposthitis now it is causing you phimosis by the description given.Please consult surgeon immediately for examination and confirmation.It may require simple procedure like slitting or circumcision.Clean the area with warm water twice daily.it may trouble you during intercourse as it progresses.You can get back to me for any clarifications with the photos.Dr Bharatesh D Basti Dermatologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to manage lower back pain radiating down to the ankles?\n\nI am experiencing pain in my lower back, in my left outside hip, down side of the leg , and in both knees and ankles. The pain gets worse after sitting for a time. I can hardly get up and walk, then it eases off the more I move. When I get into bed at night my legs hurt terribly, mostly the left leg from the hip down. It keeps me awake until I take some Motrin . Also, on both feet the two toes next to the baby toe feel like they are gone.",
    "doctor_response": "HiThis appears to be coming from lower spine and or hip,which must be evaluated by orthopedist with X-rays and MRI, clinical physical examination.You may take Advil 2 to 3 times after meals and also Dolo- neurobion tabs twice daily.avoid lifting objects by bending and do low back muscles strengthening exercises after hot packs.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sickness and ear/neck pain after completing medication for sinus infection?\n\ni'm sick. i've been sick for weeks. two weeks ago, i went to the doctor and they said i had a sinus infection. they perscribed amoxcillin and i took it until my perscription was done. but now, i've been continually sick... right now, my left side of my neck hurts bad and my hearing is funny in my left ear. plus, ill get occassionall really bad pains in my head, like a severe headache",
    "doctor_response": "Hi welcome to HCM..Here you might have persistent sinus infection....First para nasal sinus x ray done for rule out sinusitis.....Nasal examination by rhinoscopy done for rule out nasal polyp....Here for congestive symptom antihistaminic drug taken....Steam inhalation taken with eucalyptus added in water...If cause not clear MRI or CT scan of sinus need for detail investigation...If you are immunocompromised then aspergillosis or mucormycosis might ruled out ....this investigation helpful for it...If needed endoscopic drainage might done with biopsy ....Peppermint oil inhalation help in relieving headache by increase blood flow and improve ventilation....Avoid exposure  with allergen less like dust , pollen etc....Your rhinoscopy and detail respi examination needed by treating doctor and accordingly treated or investigated....Take care....Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath?\n\nSir,I was suffering from jaundice last year. Then I recovered completely by taking medicines. But lately I have started feeling so weak that I cool in my legs in winter and I have Shortness of breath after some hard work,please tell me solution.ThanksNaresh Jain",
    "doctor_response": "Hi thanks for asking question.Noted you have breathlessness after exertion.So here first possibility could be early cardiac failure if edema and hypertension like condition present.ECG can be useful.If cardiac failure beginning with hypertension diuretic started.Here asthma or bronchitis like respiratory condition also ruled out.pulmonary functionTest helpful in differentiating between restrictive and obstructive pulmonary condition.Check your hemoglobin level also.Anemia can also lead to dyspnea on exertion.if present treated with iron tablet or by vitamin b12 .I hope my suggestion will be helpful to you.Take care....Dr.Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the lower right side of my abdomen?\n\nI had stomach pain in the lower right side of my abdomen that felt like contractions.  I have had a complete hysterectomy so it is not pregnancy-related.  The pain has subsided but my right side feels very tight and like I could have another cramp/contraction at any time.",
    "doctor_response": "The most common cause of right side lower abdominal pain is acute appendicitis.I would advise you to get ultrasound abdomen to rule out appendicitis.  For cramps you can take any antispasmodic like Tab Meftalspas.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does fever persist during TB with fluid accumulation?\n\nHi, this is bharathi who had diagnosed with TB with fluid accumulation observerd in  x-ray. got admitted and pleural tapping was done. and i am on mediction. Please tell me usually how long the fever persists. the tratment was started from 3weeks before. Please advise.",
    "doctor_response": "HiUsually the fever after starting the treatment lasts for up to one month but it depends on the case. Take care Dr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the back & in the knee?\n\nmy husband has back problem, developed leg and knee pain. knee and back pain better since rehab. Now pain in calf. negative venous doppler study. Xray of knee showed osteoarthritis with effusion. Back of knee black from bruise , heel also bruised ? what's going  on??",
    "doctor_response": "HiThis are age related changes.Your husband needs to do exercise daily for knee and spine along with hot and cold dipping of leg for heel pain. Besides this should take morning Sundays and calcium diet. If too much pain in knee in future may need knee replacement.Get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause intense pain from heel to toe?\n\nThere s intense pain on my feet from the heel to the toe. I am 43 years old and run about 30-40 kms/week. There s no pain when I am running, but pain gets intense early in the mornings and when I get up after sitting for a while. I am icing it and doing the basic stretches. After taking a break of 2 weeks from running, can I continue my usual running routine or will that cause any permanent damage?",
    "doctor_response": "Hello,I read carefully your query and understand your concern. Your symptoms seem to be related to plantar fasciitis. That's an irritation or inflammation of the band of tough tissue connecting the\u00a0heel\u00a0bone to the\u00a0toes. Usually, it hurts the worst in the morning when you're getting out of bed. Wear shoes with good arch support and a cushioned sole.I also suggest using anti inflammatory medications such as Acetaminophen to relieve the pain. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes discomfort while sitting ?\n\nMy bum cheeks and coccyx area have been bothering me since last year. I find it difficult to sit for long periods without discomfort and constant shifting. I just feel very tender and sore there. Plus, it hurts when I have sex in the doggy position. I had an x-ray done of my coccyx and lower lumbar area - results were normal. I don t recall having fallen really hard on my bum but I do have a very sedentary lifestyle - I m a student and sit for long periods. Any advice?",
    "doctor_response": "Hello,The symptoms seem to be related to piriformis syndrome. Piriformis syndrome\u00a0is a condition in which the\u00a0piriformis\u00a0muscle, located in the buttock region, spasms and causes buttock pain. It doesn't usually require treatment. Physical therapy is more often recommended to relieve the symptoms.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to harden penis\n\nMy age is 24, height is 5ft 3inch,weight is 88.Sir my name is salman, i am very weak my penis is not getting hard,my penis is always been small i always been involved in masterbuiting, and my feets paining every time, my full body is week, no power in my muscles. sir kindlly help me please",
    "doctor_response": "HelloThanks for writing to HCMTrue erectile dysfunction is unlikely in your age.Your problem may be due to stress or psychological causes.You should avoid stressful situation.Don't take alcohol or cigarettes if you take these things and try to lose your weight.Masturbation is normally practiced by many persons but its obsession is bad.You should concentrate in your activities.You should avoid provocative literature and videos and try to keep busy yourself in your job.You can also try yoga and meditation,this will help a lot.Hope i have answered your query.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain in my chest?\n\nI have chest pain in the area of my sternum (radiating out just a bit), some extra saliva. 37yr old overweight female who does suffer depression & panic attacks. I took my sertraline & Prilosec about an hour ago. Should I be freaking out? (Which causes sharper pain)",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. By your history and description, possibility of GERD (gastroesophageal reflux disease) is more. GERD is common in depression and panic disorder. Both of these cause laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms of Central chest pain. So proper treatment of depression and panic disorder is needed. So consult psychiatrist and get done counseling sessions. Try to identify stressor in your life and start working on its solution. Start proton pump inhibitors. Avoid stress and tension. Avoid hot and spicy food. Avoid junk food. Drink plenty of fluids orally. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dull and sharp pains in left abdominal area?\n\nYes, thank you. As of yesterday, I started having dull & sharp pains in my left pelvic/abdominal area. I have been experiencing for a month or more now, some dizziness/headaches and continue to. I'm going to have labs done this Friday. I'm wondering if i should make an appointment with my gyno.",
    "doctor_response": "Hello! Welcome to HCM.This can be due to either infection & inflammation of bowel or a stone in urinary tract.Do you have fever? Any urinary complaints?In my clinic, to such patients, I advise ultrasound abdomen & pelvis, X-ray KUB, renal function tests, urine & stool routine, CBC & BSL.Treatment is done accordingly.If all these tests are normal, it can be musculoskeletal pain, in which case you should consult your Orthopaedic surgeon.Hope this helps.Wish you speedy recovery.Thanks.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain on the left side of the breast\n\ntripped & fell onto a chainsaw case didn t think much of it til the next day from the pain on my left side around the breast area. had xrays done & they said my lungs were good and its probadly a broke or cracked rib. given Percocet to take every 4 hrs, tyneol#3& naproxen. The pain is high can I take Tylenol 3 with codein e if I had 3 Percocet today?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have pain on the left side of the breast. Well there can be many reasons for symptoms you mention in query like lymph node swelling , breast cancer , localize infection, broken rib or angina . I would suggest you to consult doctor , who may order mammogram , blood test or chest x-ray . Doctor may prescribe antibiotics at least for 5 days , along with anti inflammatory . Doctor may recommend radiotherapy . Doctor may refer you to orthopedic surgeon for proper examination for broken rib . For now take rest and apply warm compresses to pain site . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on upper thigh, burning and numbness in right knee?\n\nI have a small lump on my upper right thigh, it seems in increase in size a fair bit, however I get a burning, numbness and pulling into my right knee, it recently started pulling around my outer knee. I also have lower back pain and on my feet all day. What is this?",
    "doctor_response": "Not to worry much about this this is nothing but a neurofibroma or a bursa like inflammatory condition.Please go for an FNAC test to relieve your tension.All the best and regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to fix glute imbalance?\n\nHi I ve been having problems with my glutes for months now (well, since September ish) both sides of my butt feel different when I walk, it wasn t a huge deal at first, then I started thinking about it more and felt like my butt might be uneven looking when it probably isn t. The creases under my butt cheeks are slightly different but that s probably the only real difference I can tell in their appearance. Anyways, I used to like doing squats and riding my bike but now I can t stand doing either as the frustration with my butt drives me to tears (it sounds really stupid, I know). Like you know how your butt feels when you do a fire dude any exercise? That s kind of hous it feels on my right side when I squat or ride my bike (which is how it used to feel on both sides prior to this issue) and on my left it just doesn t feel the same at all. This is really bothering me and I know it is probably a stupid issue but I really appreciate any help I can get.",
    "doctor_response": "Hello, Consult an orthopaedician and get evaluated.  An MRI scan is required for further assessment. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly explain the management for low calcium in a thyroid patient?\n\nHello doctor, What can be done for low calcium in a thyroid patient?",
    "doctor_response": "Hello.  Is it possible you can do histopathology of thyroid gland to rule out? You have many metabolic disorders that you need correction (attachment removed to protect patient identity). Relative hypocalcemia Thyoid Disorder Histopatholgy of thyroid and parathyroid Gland MRI Thyroid Gland Collor Dopller Thyroid Gland Relative Hypocalcemia Thyroid Carcinomatous change Thyroiditis Tab Zecal MAX 1 Tab po od 1 month  Salt added food  Syp Potklor 10 ml Po bd with glass of juice Steroid Chemotherapy With report",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having PCOD. Please advise.\n\nHello doctor, I am having PCOD. Please advise.",
    "doctor_response": "Hello. PCOD (Polycystic Ovarian Disease) is a very common condition nowadays. It is a treatable condition and will not affect your life much if the cysts are small in size. A lot depends on your lifestyle. Stress is a major factor. Eating healthy home cooked food and doing regular exercise will make a big positive difference to your condition. If you are overweight, reducing your excess weight will work wonders for you. So do not worry. As your question does not have details, I would like to ask you a few questions that would help me answer better: 1. How old are you? 2. Are you married? If yes, do you have kids? 3. Are your periods regular? 4. Is your weight in the normal range? 5. Do you have excess hair on your body or face? 6. Are you on any medication for PCOD or any other condition? 7. Can you explain your food habits? (veg/nonveg, what times of the day you eat, and in what quantity) 8. Do you indulge in any kind of physical exercise daily? 9. How is your sleep pattern? 10. If you have a scan report, what is the size of the cyst? (please do attach the report)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Spinal Canal Stenosis cause numbing / throbbing of toes on sitting?\n\nI have mild spinal canal stenosis at L4-5 due to posterior annular bulging, accented be ligament hypertrophy. I also have left foraminal encroachment at L5-S1 due to fibrosis and disc protrusion. The doctor said he could fix the stenosis problem and it should take care of my pain. I have read that when a person sits, the pain gets better and even goes away. When I sit, I get more pressure, numbing toes, throbbing etc.",
    "doctor_response": "Hi, I am Dr.Bruno.  I have read your question with care and understand your concerns. Let me try to help you Question : Can Spinal Canal Stenosis cause numbing / throbbing of toes on sitting?Answer : Yes It Can Depending on which root is compressed and depending on whether it is compressed from front or back, the symptoms will vary Please don't worry Hope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can depression and panic attacks be treated?\n\nI m having a large amount of panic attacks and depression I m currently unemployed and no insurance before I was on medication and seeing a therapist for 6 years can I use niacin for help until I can get some insurance I read that it s a vitamin that can possibly help with the chemicals in my brain",
    "doctor_response": "Dear userWe understand your concernsI went through your details. PANIC ATTACK a sudden overwhelming feeling of acute and disabling anxiety. Panic disorder is different from the normal fear and anxiety reactions to stressful events. Panic disorder is a serious condition that strikes without reason or warning. Symptoms of panic disorder include sudden attacks of fear and nervousness, as well as physical symptoms such as sweating and a racing heart. Panic attack always happens due to an underlying anxiety disorder. So you need to treat anxiety disorder. Anxiety disorder is treated with the help of counseling and psychotherapy. You should consult a psychologist. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had unprotected sex during the ovulation time. Chances of pregnancy as I am bleeding?\n\nFor the past few months my boyfriend and I have been pulling out (I know, not good birth control but we are 26 and fully aware of the risk). A couple weeks ago, he and I had sex at my peak ovulation time. Recently now I ve been extremely tired, started getting nauseous and having sore breasts a few days ago and now (4 days before my expected period) I m having a very watery period which is unusual for me since normally my periods are thick with clots. Could I still possibly be pregnant even though I m bleeding?",
    "doctor_response": "Hello,Unprotected sex with pull out method has failure rate near about 15-28%. Here, chance of being pregnant is quite high.Watery period 4 days before due date may indicate early sign of miscarriage. Here, you need to undergo one blood test for beta hcg & TVS scan to rule out conception product.Following test report, you need to consult with gynecologist for next line management. Practice safe sex in future.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could diarrhea and mild headaches be related to my blood sugar?\n\nI have been taking metformin 500 mg 2xday since April after being dianosed with type 2 diabetes. Just this week I have had severe diarrhea for 3 days but not in a row, I have had a little nausea and some acid reflux for which i take omeprazole as needed. Also my appetite has been up and down. Also mild headaches off and on this week and just a general feeling of blah. Just wondering if this could be related to my blood sugar or maybe something else going on. I am due to go get my bllod tests done but not until first of July. Any info is appreciated. Thank you",
    "doctor_response": "Hi      your diarrhea and diabetes may not be directly related however if ur diabetes not controlled then treatment of diarrhea may get delayed. high sugar levels will be media for the pathogens to grow.  suggest u do ur fasting sugar and if it is abnormal then control by exercise and diet and modify medication in consultation with your diabetologist.  for ur diarrhea u can take sporlac powder with water two times daily. avoid milky items.  consume fresh fruit juices  and if you do not get relief  get a stool culture done   wish you good health    regards Dr Sridhar K",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with cerebral atrophy, have difficulty in walking, balance. Is this curable?\n\nhello doctor Actually I am suffering from cerebral atrophy from past 4 years.I got the tests done including MRI .Doctors are saying that it is a genetic problem n it can t be cured. I have problem in balancing,walking,climbing stairs, excessive weakness and loss of confidence. I just want to know that if this can t be cured is there any way to reduce the effect of its symptoms?Or you can suggest any cure? I will be very gratefyl to you.",
    "doctor_response": "It is a neurodegenerative disease and do not have any cure however lot of research has taken place in stem cell therapy for atrophy of brain and good results have been seen. This therapy is avaliable in form of experimental treatment,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bump like swelling in knee\n\nHi, I m a 31 female and I fell hard on my right knee a week ago. My knee immediately swelled all over, but especially on the right side--there was a bump a little larger than a golf ball. I could walk on it, though it was sore, and I immediately went home and iced it and elevated it. The next day was more painful, but, again, I could still walk. The swelling went down, and now, a week later, it s terribly bruised and still painful--especially when I touch it, try to kneel, and sometimes even bend it). My main concern is that there s a solid hard painful bump that s the size of maybe a large marble (?) right were the major swelling occurred. Do you think I just need to keep icing it, or should I see a doctor for an x-ray?",
    "doctor_response": "Hi, Ideally X Ray should be done of the affected knee joint just to be sure that the bones are ok, because sometimes even a small undisplaced crack manifests with pain and difficulty in ambulation only. As far as swelling is concerned, it could just be a organized haematoma but my concern is that if there is a significant haematoma over the joint, it usually suggests a significant soft tissue injury inside the knee joint which can be meniscus or a Ligament injury, so ideally 3 weeks of Rest and Ice packs and even after that your symptoms are still there kindly visit your Orthopaedic specialist and get necessary investigations done. Till that time as i have mentioned. - Ice Packs 3-4 times a day - Compression bandage - Anti inflammatory medication along with medicine to reduce swelling. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Akshay Kumar Saxena",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in right lower abdomen worsened while standing, feeling of tight pants without weight gain.  No visible hernia or swelling.  Thoughts?\n\nI have has pain on the right side of my lower abdomen for about 10 days . It is worse when standing, but does not completely disappear when reclining. It seems to be located at hip level down to the groin area on the right. I don't have any obvious hernia or swelling tho I do feel as if my pants have become tighter without any weight gain. I have not noticed any bowel symptoms up to this point.",
    "doctor_response": "Hi,  It may be due to various reason as mentioned below.1) Appendicitis2) Crohn's disease3) Diverticulitis4) Injury5) Intestinal obstruction6) Irritable bowel syndrome I would advice you to visit near by medical center and have it checked. Since for diagnosis, physical examination as well as diagnostic tests may be needed.Thanks, hope above answer proves helpful.Dr.JAY PATEL.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore and swollen ulcers in the genital area?\n\nHello I was recently diagnosed for genital herpes, and was given aciclovir and emla cream to sooth the sores, the sores are beginning to go after 2 days of treatment but I have now developed 3 ulcers in my genital area and it s really painful and swollen. I need to know what can heal this as fast as it is painful and embarrassing and I don t feel clean down there. HELP! !!",
    "doctor_response": "HelloI appreciate your concernthis could be STI like gonorrhoea or herpesplease make a visit to your doctor for examination and swab culture test to know to strain of infectionhave plenty of fluidsmaintain good hygienepractice safe sex use condomhope this adresses your question please feel free to ask me a direct question for further clarificationgood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should i do to increase hair growth on my body and face?\n\nI AM 24 yo  and i have facial hair and body hair  ,but some places have a light hair and others  have thick hair  in my face and my chest and body    what  should i do to increase my facial and chest hair and body hair  and  to be all thicker and have a normal View ....?",
    "doctor_response": "DearWe understand your concernsI went through your details. Facial and body hair thickness depends on the amount of male hormone in the body. You can see majority of people with scarce body hair. Majority will not have thick facial hair even at their middle age. I mean to say that you should not worry about such silly matters. Thickness of body hair is never a determinant of your personality or behavior. There are no tried and tested medicines which can improve body and face hair growth. Please understand. If you still need my assistance in this regard, please use this link.  Please remember to describe the whole problem with full detail.Hope this answers your query. Please feel free to post follow up queries. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is brown mucus discharge normal?\n\nI have been on depo for about a year now and was suppose to get one two weeks ago but didn t for personal reasons and insurance(missed one n got it about two months later). ...... but before that I had an iud after the birth of my now 5 yr old..... so I haven t had a period for about 5 yrs now..... since I didn t get my shot I had brown discharge and now like a mucus discharge and I m wondering if it is normal for this to happen",
    "doctor_response": "Thank you for the question.What you are describing is normal and probably related to a small amount of bleeding from the lining of the uterus.  When there is bleeding in small amounts it frequently makes its way out as a brownish discharge.  Other causes include:1.  Early pregnancy - check a pregnancy test2.  Vaginal or cervical infections - an exam and testing recommended3.  Bleeding related to intercourse - could be described the same wayI hope that this helps.Dr. Raichle",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of cyst in the stomach area?\n\nI have a lump on the right side of my body.  It is under my rib cage and slightly above my waist. I noticed it just recently and thought it might be a muscle knot but now I'm worried. That it could be more.  Are there any muscles in that area?  Could it be a cyst?  You can feel it - about 4\" across x 2\" tall.  Not sure how deep.  Nothing on surface of skin.",
    "doctor_response": "Hello!I read carefully your query and understand your concern.It is hard to tell exactly what it is without seeing or feeling it.You really need to see a physician to have the lump physically examined. Factors such as associated pain, discoloration, rate of growth of the lump, will help your physician decide if the lump is of concern.It might be a lipoma (benign fatty lump that usually causes no symptoms ).In this case it is a soft, squishy lump, well circumscribed, mobile.It also might be something serious (it the lump is hard,immobile and not well circumscribed)  and to exclude this you should get examined and probably run some tests and investigation including Abdominal ultrasound.I strongly suggest to consult a physician and get examined.Hope my answer has helped.Take care.Dr.Rovena",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower back pain after accident\n\nI was involved in a car accident, as a result my lower back area lumbar l-5 was e-ray . the findings was an equivocal L-5 s spondylolysis without spondylolisthesis. there are minimal generalized spondylosis and facet arthropathy without fractures or destructive boney lesions. I had no problems with back before the care accident. I m in pain all the time. It is very painful. question. Do you think the car accident attributed to this. I did have any pain before",
    "doctor_response": "Hello, I have studied your case and reports with diligence.As per your x ray report there is severe degenerative changes in whole lumbar spine with disc space reduction.At old there can be degenerative wear of bones, muscles, ligament and facet joint arthritis, due to deficiency of calcium, vitamin D, VIT B12.so supplements of these nutrients can relieve pain.Check your bone strength with DEXA SCAN and you can start medication according to level of osteoporosis,And also check your vit B12 and vit D3 level.I will advise you to do regular physiotherapy and exercises as my patients find much relief by these therapies.You may consult physiotherapist for guidance. He may start TENS, or ultrasound which is helpful in your case you need to take diet rich in calcium and vitamin D.You may need MRI spine.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you find this answer helpful do not hesitate to rate this answer at end of discussion. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the meaning of 'no focal area of altered echogenicity is noted and intrahepatic tubular structures are normal'?\n\nHi, my cousin sister in 42years old and ultrasonography revealed a liver span of 186mm. She weighs 84 kg and height is 5 ft. It is mentioned in the report that no focal area of altered echogenicity is noted and intrahepatic tubular structures are normal. Her LFT blood report is fully normal. Does this show any kind of problem?",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.This means that there are no suspicious leisons such as tumors so this is good report and you dont need to be worriedI 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.DR. Ivan Rommstein",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes upper abdomen pain at night?\n\nI have pain around mid to upper abdomen on the right, it mild when sitting or lying down but it gets worst when I stand. The pain is not consistent, it comes and goes. I don\u2019t have any change in bowel movements or vomitus not have my eating habits changed.",
    "doctor_response": "Hi there.Thanks for writing in.The symptoms you are experiencing might be due to acidity/gas trouble. You could try taking a course of proton pump inhibitors (to reduce the acidity ) like pantoprazole after consulting with your physician.If it doesn't get better, get a complete blood picture,and an abdominal ultrasound done, visit a gastroenterologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes skin rashes on the face, neck, hands and stomach?\n\nHi. I am consuming 3 tablets of eptoin daily , and 2 tablets of Levipill 500 daily.. Due to which I am suffering from skin problems like rashes on my face neck hands stomach.. Can you please tell me why all this is happening to me.. And I am consuming same from last to last month 30th..",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.In my opinion, you are having Drug hypersenstivity reaction to Eptoin. Please do consult your Dermatologist immediately and explain about your problem and give proper drug history. You might also need to consult neurologist later for prescribing alternate drug for epilepsy.Please do not delay consultation as drug reaction may lead to serious adverse effects.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cost of kidney transplant and hospitals in India\n\nmy brother is suffered from kidney disese when he was 2 years old . Now i wish for his kidney transplantation. He is now 31 years old and getting pain and ineffeciency and i m married n live in moscow. So the cost of transplantation, timing and for donar i hv query",
    "doctor_response": "Hello Thanks for nice query. Facility of kidney transplant is available in many hospitals in metro city of India like  Delhi ,Mumbai,Bangalore,Kolkata  and many more  cost varies from hospital to hospitals  from 5 -15 lacs INR. \u2018Hope I have answered your query, I will be available to answer your follow up queries, \u201cWish you Good Health and trouble free speedy recovery\u201d",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hemiparesis post injury, feel a bit heavy with persisting neurological problems, progressing day by day but slowly. When will I recover fully?\n\nhi i have suffered an injury through my brain in the right piece of it wich resulted in hemiparesis in my left side. 3 months passed the injury, i am getting better but not like before . i still find my self a little bit heavier and still have neurological problems but what u need to know is that everyday is passing by i feel a little bit better than before but i am progressing so slowly. may i know when i will be 100 % back normal ?? thank you",
    "doctor_response": "Hi there. Thanks for the query. Since after the injury you are not getting worse but progressively better, it is a good sign of only temporary neuron loss. This means recovery will take place. Regarding 100% recovery, it is highly difficult t comment because this depends very much on your original disability stats. If the grade of disability is lesser the chance of full recovery is excellent. It is best to stay positive and do daily exercise to increase the strength of your muscles very gradually and not forcefully. Wishing speedy recovery. Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for stress?\n\nHi my name is Mandilakhe, i have been suffering from stress for more than a year now, I have talked with psychologist and i have also seen a psychiatrist. I am presently using antidepressants but i still suffer from stress sometime my moods change and i would feel down, sometimes i just feel happy and sometimes angry or bored i need help",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. First of all, i would like to suggest you that simple stress related disorders do not need medicines. Awareness and life style changes should be a cure. You need to find your stress source. Once you found your stressors, try to understand them. Why, How, What and When?After you get the answer to these questions, change your life style according to the answers. In the beginning, it may feel like this is not possible. I assure you, once started, it is as easy as peeling banana. Trust me. If you require more of my help in this aspect, Please post a direct question to me in this URL.  Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes growth of bumps on the back of the shaft?\n\nHello, excuse any typos but i am 20 years of age and i noticed a group of small lightly red bumps at the back of my shaft were my pubic hair grow. It is only a few, between 5 and 8, one is fairly larger than the rest, but overall small. Now I have eczema and I do shave often But i have had eczema for years and when it came on my penis it cleared away really quickly, i know that these are not shaving bumps they simply do not look like it. I was thinking a pimple because i have really bad acne but that is only on my face. I have noticed in my sex life, if i do not use a condom, after sex if i did not take a bath my penis would itch. it never got server and bumped up badly. but when it did i treated it with hydrocortisone 2.5%..i had sex a little of 2 months ago with out a condom and i noticed that my penis itches after. It was not anything new. but i did have a lot of sex for two days straight with out a condom. the itch did not increase. it really came and went away. until i took a shower. but i did notice some bumps and since they did not itch i left them alone. but now months later there are not as many bumps. there never were that many. but i just want them gone. and i am scared i might have an std. i treated it with hydrocortisone 1% i have no 2.5% and the 1% was over the counter. any advice?",
    "doctor_response": "HelloThanks for query .Based on your description you seem to have multiple sebaceous cysts over shaft of the penis .The penile  skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin. Normally they fade away without treatment however they need to be treated if increase in size or get infected. Consult qualified General Surgeon for clinical evaluation and further treatment. If needed the  bigger one may need to get excised in Toto (Completely along with the sac).Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the effects of switching from Ursocol to Essentiale forte?\n\nWhat is effective of Ursodeoxycholic Acid (URSOCOL 450) in Fatty Liver versus use of Polyene Phosphatidylcholine (Essentiale Forte N) I was taking Ursocol when i was in India and Recently moved to China and doctor asked me to switch to Essentiale Forte N. What are Pro and Cons",
    "doctor_response": "Hi there is not any role of medication in fatty liver disease. Ursocol is used to treat flatulence associated with bile system. In your case you can continue essentiale.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does AHA cream help to treat pearly penile papules?\n\nHi ,i am 15 years old and i have pearly penile papules, i went to the doctor and they said its perfectly normal and there is no cure. i researched on the internet and the main cure in getting CO2 laser surgery. i really dont want a laser on my penis and i doubht my parents will want me to either. I also heard many succeses with AHA cream which contain alpha hyroxy . Do you think this will work?",
    "doctor_response": "Hi, PPP is harmless. It will not help in PPP. You can try the co2 laser. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr B. Radhakrishnan. Nair, OBGYN",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for anxiety , dizziness and sweating?\n\nMy doctor precribed me effexor for my anxiety and it was causing my heart to flutter and I was in the hospital for it. I stopped cold turkey taking it and now I am having constant dizziness feeling, sweating, and other things. Is this withdrawal and how long will it last?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. If the problem detected was anxiety and the diagnosis was correct, then the given medication should be suitable. You must also understand that Many researches and researchers confirm that medicines alone cannot cure mental disorders. Life style changes, change in thinking pattern, relaxation etc are as essential as medicines. Psychotherapy can help you changing your lifestyle and thinking patterns. Yoga and meditation help you to streamline your metabolism and neurological balance. Please consult a psychologist for further information.If you require more of my help in this aspect, Please post a direct question to me in this URL.  Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mom had utern cancer 3rd stage renal failure copd chf she had blood clots in lungs. Hand swollen. Finger black. Treatment?\n\nmy mom has utern cancer 3rd stage renal failure copd chf she had blood clots in both lungs she has been on lovenox for a few months now she woke up the other day and her left hand was swollen and across her finger were bblack and bthe top of her hand was sore to touch we put ice and heat on it  It seems to be cahngeing everyday now the swelling has moved to the side of her wrist and some of fingers look like their going to pop what should we do",
    "doctor_response": "Hi, your mother has uterus cancer, 3rd stage, renal failure, copd, clots in the lungs, so any thing is possible, but as the swelling of the fingers is changing from place to place, it could be the allergy to the tablets she is using or to the changes in the tissues.                          As she must be under the treatment i advise you to consult your doctor. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a GFR of 57 normal?\n\nI have a very healthy 28 yrs old daughter that had bloodwork done and had a GFR of 69 two months ago and recently was checked again and it was 57. She questioned her doctor and they said that this was normal. From what I understand it should not be below 90. She has been tired for over a year, has acne that she takes medication for. She is extremely athletic, has a resting pulse of 57 and no physical issues. Her grandmother has been having kidney issues but I don t know the details. I guess my question is, that GFR of 57 is a real concern, is this something that sounds normal. Thank You",
    "doctor_response": "Hello and welcome to  HCM.Your concern is understandable.A normal GFR ranges between 90-120ml/min/1.73m2.GFR is an indicator of kidney function. It decreases with age,  slightly.If your daughters' case, she needs to carry out certain other tests, like urine microalbumin, 24 hours urine protein, blood kidney function tests like creatinine, urea,sugar and an ultrasound scan of the abdomen. See another doctor with the reports. GFR of less than 20ml/min. needs urgent medical consult.As an Urologist,you're welcome to contact me by name, with reports.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pus formation in the gums of a child?\n\nMy 8 month old baby has a small amount of white pus on his bottom, left gums (where the canine tooth would be expected to erupt). The lower left canine tooth has not erupted, though he is teething (he has both top canines). What is this white matter/pus? Thank you",
    "doctor_response": "Hi dear, I understand your concern. It is not pus,it is possible during teething, it is connective tissue,because gingiva has rupture s during teething.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Discomfort in stomach, bloated, painful, pressure sensation, white discharge. What is the cause?\n\nHello, I started having an uncomfortable feeling in the middle portion of my stomach mostly around my belly button. It feels tight almost like bloating. Only slightly painful to pressure. Has become more noticeable in the past few hours. Inside of belly button is red with some clear/whitish discharge, not painful but a little sore feeling. I'm 29, medium build. I did have full tummy tuck with no complications 5 years ago. What could be causing this?",
    "doctor_response": "this is a congenital disorder when u was born like belly urachus a connection between bladder and button",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for not getting early morning erections when having sickle cell?\n\nGood! I am a sickle cell patient and sometimes i have priapsim (painful erection of the penis not necessarily caused by sexual urge). But in Novemeber 2009, i had a serious one and had to go for operation cos it lasted for one weekafter the surgery in which i gave my consent, i discovered there are no more early morning erections and that is it. its been like that since that novemrbre till now",
    "doctor_response": "Hi, It might be due to nerve involvement after the surgery. If symptoms persist you can consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Am I having side effects from Alphamox?\n\nHi I have been taking Alphamox for the last 4days my dentist prescribed me to take it for 5 days. I have been getting really bad headaches and my jaw has been really sore. as well as feeling a little nausious. can I stop the ALphamox before completing the 5th day . thanks susy .",
    "doctor_response": "Hello, Alphamox is an antibiotic and stopping it without completing 5th day dose is not a good idea. I would suggest you complete all the Alphamox tablets prescribed by your dentist. Stopping it would put you vulnerable to infections which could quickly spread. It might also lead to future resistant infection which might warrant more strong antibiotic to clear your infection. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Jasmine Jagan, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How safe is taking Folitrax, Indocap and Folic acid for PSA?\n\nHI, My brother has been diagnosed with PsA, he has psoriasis from past 4 yrs but it showed only on the middle fingure on one hand. He was detected with chicken gunya 6 months back and ever since then he was in severe pain in all joints and swelling as well, could not walk also. Just a month back rheumatologist  diagnosed him . He is on Folitrax 15mg/week, Indocap sr 75 daily once, and Folic acid.. Is this right treatment and can he take folitrax for life as said by the doctor.??? Pls do reply",
    "doctor_response": "Hi, Yes, you can take anti-rheumatic medication too. Yes, this is the same medication fallowed in most of the rheumatologists unless there is severity/complication. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cyst in buttocks\n\ni have a marble size cyst on my upper left size of buttocks causing  pain in  left leg from my sciatic nerve , cyst was caused from injection of steroid in wrong area,and i'm sure this cyst has crystalized near or on nerve, i've literraly tried everything short of surgery \"Help pain is getting unbearable",
    "doctor_response": "Hi, Welcome to HCM.As you already have tried everthing apart from surgery, i would suggest that you can try to get the cyst aspirated out by a needle under guidence of ultrasond for localization.If that also doesn't helps then yoh will have to get it removed by open surgery only.Regards,Dr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes diarrhea after dengue fever?\n\nMy cousin's child had been identified with dengue fever last week and admitted in hospital with platelet count around 1lakh. She got discharged 3 days back and started having loose motion green in color from that night itself. dr gave medicine for diarrhea; the color has changed but still she is passing stools very frequently and they are  very loose. What could be the reason?",
    "doctor_response": "HelloThe acute episode of uncomplicated dengue fever usually last for a week.This diarrhea is not related to dengue illness.The loose stool may persist for 5-7 days.The main aim of management in diarrhea is to prevent dehydration by giving adequate amount of fluid(ORS).Give her Zinc syrup with some probiotic for early recovery.If there is decreased urinary frequency or decreased oral accepatance consult your doctor immediately.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can swelling and discomfort in the ankle due to edema be treated?\n\nRecently every night I have some foot and ankle edema and pain and burning. I know I have diabetic neuropathy but never had the sudden onset of edema before. Not sure what to do to relieve swelling and discomfort. I elevate my legs and feet and take ibuprofen for pain. No effectiveness at all.",
    "doctor_response": "Hi, Apply ice packs and apply compression bandages. If symptoms persist better to get an MRI scan for further assessment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "On and off dull pain in abdomen with intake of food, belching. High alkaline phosphatase in liver. Suggest\n\ni have a high level of alkaline phosphate in my liver i have to see a doctor in two weeks although i have been waiting to see him since March i have a dull pain on my upper right side of my abdomin which is sometimes worse than others also when i eat i sometimes get pain in the top middle of my stomach this can last anything from 5 mins to 1 hour and i cannot stop belching its like mu food is stuck. I am really worried.",
    "doctor_response": "DEAR SIR,IT SEEMS YOU ARE SUFFERING FROM HEPATO-BILIARY DISEASE.FIRST OF ALL GET YOUR -LIVER FUNCTION TEST,ULTRA SONOGRAPHY DONE.THEN PROCEED ACCORDINGLY.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to stop masturbating?\n\ni masterbate o lot in my childhood 3 times a day i started at age of 13 and now i am 24 i feel weak and restless how can i cure it by diet i not want to go doctor because i am shy type of person so tell me about diet and now i discharge while thinking about wrong things",
    "doctor_response": "HiGREETINGS masterbation is a healthy way of satisfying your sexual disires and doesn't have any side effects.You can do daily or alternate days.You will be enjoying better if you do on alternate days rather than daily.Semen is produced daily in our body and masterbation will not affect your health or fertility.One precaution is never hurry to discharge, delay ejaculation always by atleast 5 to 10 min.There are so many myths about masterbation in internet.Hope my answer helps you Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Got IUD inserted previously. Experiencing pelvic pain radiating to back. Body rejecting IUD?\n\nHy I had an iud inserted 5 month ago. 1st three month I had my period regular a bit more Heavy . Then it disappeared. Now I m experiencing loads of pelvic pain n cramps reaching Out till my back. No painkiller is helping. I went for ultrasound my uterus ovaries r fine N my copper T is in place. Is my body rejecting now the iud? Thnx",
    "doctor_response": "Hi good day. If ultrasonogram is normal then no need to worry much about IUD. Get ine gynaecologist opinion to rule out other causes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the causes of body pain?\n\nI m having problem with my body hurting all the time even during the night my legs cramp up and sometime they feel numb. I cant sleep on my right side because my right hip harts real bad. after I get off work it hurts to set down and get up I just b-don t understand what s going on with me.",
    "doctor_response": "how old are you? have u got any other diseases like diabetes or thyroid disease. are you stressed out",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for abrupt speaking after a brain stroke\n\nHello Dr.! My mother had brain stroke 4 years ago on the left side. She has been bed ridden since then. She has recoverd a bit in last 4 years in terms of eating and undertanding things. But she speaks abroptly a lot specially when sun rises. She speaks whole day but as sun sets she calms down in the evening and later we give her sleeping medicine and she sleeps. I was wondering if there is any medicine to control her abrupt speaking.",
    "doctor_response": "Hello,Anti-psychotic drugs (like risperidone) can help calm her down and reduce her impulsivity. You should discuss with her doctor on the above treatment option.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can masturbation cause nerve exhaustion?\n\nhi i am experiencing numbness in legs and hands . i have been masturbating on a daily basis for past 3 years..i dont drink or smoke..is masturbation sole reason for my nerve exhaustion.. can i take renerve plus to get rid of this nervous exhaustion...any medicine for this..",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. No masturbation daily will not result in \"nerve\" exhaustion.  I'm not quite certain what you're referring to as \"nervous exhaustion\", however, I'm assuming it has something to do with generalized anxiety and nervousness. Depending on the cause of your symptoms there are very effective treatments or better yet. Addressing the underlying causes, not just take something to cover the symptoms. However, I repeat, MASTURBATION should have nothing to do with your symptoms. With your son's diagnosis of oligodendrolioma already being known in the left occipital lobe. What I can tell you is that I can virtually guarantee that your son's left hand symptom is NOT from that tumor. However, if your son were in my care I would immediately obtain an MRI with gadolinium contrast looking for something (possibly related to this oligo as a 2nd lesion) in the left fronto-parietal region. I would also have him undergo a PET scan. I hope I have answered you query. If you have any further questions you can contact us in every time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath?\n\nGood day, I 'm 27 years old and i've been having a shortness of breath, specially when i'm outside, i feel like i'm gonna faint,i drink plenty of water all day long and rtoday i'm feeling so tired when i slept ok last night.and i haven't done anything.",
    "doctor_response": "Hey,Breathlessness on exertion at this age can have a lot of causes1) Low Haemoglobin2) Cardiac Disease3) Respiratory DiseaseSo first of all check your Hb than get a xray and echo done to know the cause of breathlessness and easy tiredness. Wishing you good healthDr Sameer Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for aphasia post head injury\n\nHello sir, Good Morning, My father was treated under your observations in yashodhara Hospital. , due to internal head injury.. we came here for follow up. But we are unable to meet you today. As recovery is good but still patient is still not able to speak normally. .. sir please guide us.. please share your own hospital or contact details so we can approach.",
    "doctor_response": "Hi, Consult a neurologist and get evaluated. An MRI scan is required to look for a possible intracranial cause. Sometimes there is tissue damage to speech areas in the brain following the trauma and result in aphasia. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause and treatment for discomfort under the penis?\n\nThe skin on the underside of my penis, the area where it is wrinkled when flaccid, has been irritated off and on for the last 6 months or so. It may have started during sex due to some friction one time, or maybe when running and rubbing against my underpants. either way, it's clearly a SKIN issue, and i've already had it checked out by my doctor, and he said essentially it's just a skin issue that \"should heal,\" NOT an STD, so i'm not looking for that alternative diagnosis.It basically is just a little red line that is like a small break in the skin. This is very small. Sometimes there is just one, sometimes up to three. THey never really heal 100%. I've tried simply abstaining from sex for a while, but it hasn't helped really. It might be a litlte better one day or worse the next, but it seems to be unrelated to sexual activity. Maybe it's because simply getting an erection, which stretches out the skin, might be preventing it from healing completely, and it's kinda hard to prevent that...I've tried, at the direction of my doctor:-1% hydrocortizone-vitamin A cream-bacitracin oinment-zinc oxide ointmentNothing really worked wonders at all (obviously since it's 7 months later). I'm unsure what to do next. even abstaining from sex doesnt' seem to help...and my doctor didn't really know of other creams.",
    "doctor_response": "HelloThanks for query .You have not mentioned your age in your query .Based on the facts that you have posted the cuts in foreskin that you have since last 7 months are mostly due to infection of foreskin (Posthatitis) .This is common presentation in a individuals with Diabetes .Hence You need to get your sugar levels on empty stomach and 2 hours after lunch done to rule out diabetes .You need to take broad spectrum antibiotic like Cefotaxime and anti inflammatory drug like Diclofenac twice daily along with topical antibiotic ointment like Neosporin twice daily.Ensure to wash your genitals with warm water twice daily.Ensure to avoid sexual encounters till it heals up completely.If these measure fail to get the issue resolved you may need to get circumcised .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "When should a kidney dialysis be started after an infection ?\n\nMy father is a diabetic patient since 15 years . Now his kidney also affected . Creatinine Ievel is 5.1 and urea is 90. Kidney size reduced to 88& 89 cm. The doctor said the kidney almost 75% not working . Kindly advice , do we need to start dialysis ? If yes when? Is it risky procedure? And how long the life expectancy except?",
    "doctor_response": "Hi, Thanks for query, Your father is now to under go for dialysis. You consult Nephrologist for information and investigations. It is not risky procedure. With frequent dialysis expectancy of life is good. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain?\n\ni am 33 years old male.i have pain in chest.my ecg,eko,and mri of chest is clear.my dorsal spine have problem in d7,d8,d11,d12.i have no signs of angina .my  doctor gave me beta blockers.but i jogging 35 minutes and walk for 25 minutes.plz tell me whats going on with me .i am in tension.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. Since your extensive cardiac work up is normal, no need to worry for heart related diseases for your chest pain. You have been prescribed beta blocker for anxiety and stress. Since you are in tension, possibility of stress and anxiety related chest pain is more in your case. Along with drugs (beta blocker), counseling is also important. So better to consult psychiatrist and get done counseling sessions. Try to identify stressor in your life and start working on its solution. Don't worry, you will be alright. Avoid stress and tension, be relax and calm.. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can SUcrol O be given as SOS for acute lower stomach pain after undergoing cholelithesis?\n\nmy mother, 65 yrs, undergone cholelithesis on 16th of this month, recovering smoothly at home after getting dischaged from Hospital, suddenly developed acute lower stomach pain yesterday, the doctor had given Sucrol O, Pantocid L and in Anafortan Inj as SOS, pl suggest if SUcrol O is also to be given as SOS",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I understand from your question that removal of gall bladder is done & lower abdominal pain is unrelated to this. I will suggest an ultrasound examination of the abdomen and pelvis to be done. Will like to get back to you with the ultrasound report. Sucrol O is antacid, can be taken if symptom is getting relieved. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the resting pulse rate of 105 suggest?\n\ni have a resting pulse rate of 105 is that ok?and my doctor took my blood pressure three times today to get a average it was 141 over 93and he said i have a tachycaridio i was that much in a panic i didnt understand what this ment, could you help and explain to me please. am i ok or do i have  a heart condition",
    "doctor_response": "Hi there , welcome to HCMWell the very first thing that I'd like you to do is calm down , just relax for a bit.Yes resting HR of 105/min is definitely tachycardia but that doesn't mean you need to be so panicky. Also average BP of 141/93MMHG can be just normal for some individuals. These are just clinical findings which needs to be thoroughly evaluated thoroughly before coming down to some conclusion. First of all just get a 12Lead ECG done (preferably with long lead II), also please attach it here so that I can comment further Please don't panic and try to understand that Tachycardia can be there even in a otherwise healthy individual, doesn't necessarily mean that you're having a heart condition.But my advice in this case would be to get a proper metabolic work-up done(CBC, Serum Electrolytes , Thyroid Function Test, ESR along with 12Lead ECG off course ) before coming down to any conclusionThanks a lot for contacting HCM , let me update further in your next follow-up",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is disc desiccation with moderate loss of disc height and a circumferential disc bulge dangerous?\n\nwhat does grade 1 anterolisthesis of L3 on L4 measuring 4 mm. There is disc desiccation with moderate loss of disc height and a circumferential disc bulge. There is server bilateral facet hypertrophy and ligament flavum thickening. There is server dural compression with newar complete effacement of the CSF. There is mild bilateral neuroforaminal stenosis.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. There is a slipped disk of the spinal cord causing your symptoms. You may need neurosurgeon opinion on its management. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Achira Dilanka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I took one Yaz pill after unprotected sex. Will it be effective?\n\nHi doctor, I had unprotected sex before two days. The next day, I took one Yaz pill. Do I need to take more pills? Will it be effective?",
    "doctor_response": "Hi. I have gone through your history, and I can understand your concern. There is a chance of pregnancy in your case as you have taken only one dose of Yasmin pill (Drospirenone with Ethinylestradiol). Delayed menses can occur due to hormonal imbalance caused by sex. Do a home urine test if you miss your period by seven days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the recurring severe pain in the back of neck?\n\nI have sharp pulsating pain in the left back of my neck. it started over a week ago after a visit to the chiropractor. it comes and goes but when it comes it gets so severe I literally cry from the pain. what could this possibly be and should I go see my doctor?",
    "doctor_response": "Hello, As a first line management you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persists better to consult an orthopedician and plan for an MRI scan. We have to rule out possible causes like cervical spondylitis. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recommend treatment for breathing issues\n\nI am worried about some issues I've been having.  For one, I feel like I don't get enough air at times. I am only 38 years old and have been extremely healthy all of my life, but lately I have had this breathing problem. Now sometimes when I speak I can't seem to say some words or finish my sentences when I talk. People are always saying that they didn't hear what I said or they ask me to repeat what I just said. I hate feeling this way.  What could it be?",
    "doctor_response": "Hello dearThanks for using Healthcaremagic.comI have evaluated your query thoroughly .*  This seems in relation with issue regarding respiratory drive .*  Must see a physician , get proper work up with x-ray chest and if     necessary  pulmonary function test .*  Suggestions for better recovery  -  Maintain hydration with plenty of liquids .-  Deep breathing  exercises , walking in fresh air , YOGA help great .-  Avoid smoking of any type passive or active .-  Should protect yourself from dusty weather , pollens ; if required use     face mask .-  Avoid stress , anxiety .-  Have regular sound sleep of 8 hours .Hope this will help you for sure .Welcome for further guidance .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes disrupted sleep,horrible dreams,suicidal thoughts,drowsiness and headaches?\n\nthelocal doctor had prescribed Mecobal Od once a day and Gabapentin tablets two times.After taking the prescribed dose two days ago I had terrible night.My sleep was disrupted,I had horrible dreams.Some fear was there and some suicidal thoughts also and in the morning I had drowsiness,headache,dullardness.Since then I am not using anymore please confirm what was wrong?Sarin",
    "doctor_response": "Gabapentin may be cause these symptoms in some patients.There is no way to predict which patients will get these side effects. Therefore, you should inform your local doctor about them. You have not mentioned the condition for which you were prescribed Gabapentin. The doctor will be able to evaluate whether there is something else that is causing the symptoms.Since you have discontinued the medicine you should not worry, but do see your doctor or some other specialist.I hope this answers your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring episodes of fainting?\n\nMy Bhabhi age 37 years, became unconscious after every 2-3 months, when she wake up, she forgot all about her family & herself. She suffered from this disease from last 5-6 years. She is being treated at Bikaner, but not getting well, Please help me. Jitendra Bhati Mail Id:- YYYY@YYYY",
    "doctor_response": "Hello, Seizures may cause such problems. It is a necessary evaluation by the Neurologist, EEG, and brain MRI in order to have a correct diagnosis and treatment. Discuss with the Neurologist for these issues.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of hydro cortisone?\n\nAfter my plastic surgery, I noticed between my breast developed a rash, so I put hydrocortisone bc I thought it was a rash. Now the rash has healed and in the middle of my breast is white while the border in the middle is dark. What is this caused by? And how do I treat it",
    "doctor_response": "Hi,If you had conceived in 7 days gap in oral pill. Yes, the Depo (provera) and the regular pills in addition to it. It is known to cause fetal abnormality and you need to get it aborted. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Vasudha Jayant Athavale, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are mood swings, tiredness and irritation stress related?\n\nI am a 32 yr old female, experiencing a bit of stress. I am mostly concern about feeling extremely tired even tho' I sleep at least 8 hrs per day I still feel tired throughout the day, also I've been getting mood swings and I become easily irritated or sad. Wondering if it's all just stress related?",
    "doctor_response": "hithanks for using healthcare magicI think u r in depression. Easy fatiguability, irritability, low mood, excessive sleep, etc all are symptoms of depression. U need some antidepressant that would help u. Consult a psychiatrist and discuss ur issue with psychiatrist. According to ur severity of disorder, u can get treatment. U can also do some relaxation exercise, that would help u to stay calm.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are vitamin A and D supplements safe to take with fatty liver?\n\nHi doctor, I have low vitamin A and D levels. Are vitamin A and D supplements safe to take with liver disease? What are the highest doses that are safe to take? I have fatty liver but I do not know if it is a simple fatty liver or has progressed to NASH and fibrosis. I am a 33-year-old female. I smoke and have a history of acid reflux, low heart rates, fat indigestion, and fatty liver. Lab tests showed vitamin A 0.9 umol/L and vitamin D 37 nmol/L. Previously, I had an abdominal ultrasound and it showed liver 14.6 cm in length which gives rise to a moderately coarse dense echo pattern consistent with fatty infiltration. ALT level was 58 U/L. I am currently on N-acetyl cysteine (NAC). Thank you.",
    "doctor_response": "Hello. Your vitamin A level is marginal rather than low. Less than 0.7 or 0.5 is considered low and up to 1.05 is considered marginal. So, you will probably need supplements at a very low dose. Total intake of up to 10,000 units daily is unlikely to cause any harmful effects. So, supplements of 7500 units or even 10,000 units per day for a month or two would be enough for you. I guess you do not have any symptoms of vitamin D deficiency like xerophthalmia or visual difficulties where one would need higher doses. Also, for vitamin D, supplements like Calcirol sachet are recommended in dosing of 60,000 units once a week for eight weeks with milk, and following which you may have it once a month for the next six months. Both these are unlikely to interfere with liver issues considering fatty liver and high ALT level. You are unlikely to have progressed to the severe liver disease within such a short period and without symptoms. Hope this helps you and get back if you have any doubts.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain & headache\n\nhello for the last few days i have had really bad headache to the point i want to cry. i have been feeling sick and had stumach pains. i went to the doctors 2 weeks ago with headaches and dizziness and had bloodtests but nothing was wrong. i am now worried this could be something worse.",
    "doctor_response": "Hi,Thanks for asking HCM.In my opinion you need go for further special  investigation for head ache and dizziness, like CT scan, in consultation with your treating doctor.For pain abdomen you can start with Proton pump inhibitor empty  stomach.Bland small frequent diet with plenty of oral fluids should help.If constipation, mild laxative might be helpful,in head ache as well to some extent.Proper sleep is also necessary for both the conditions.Your doctor is in better position to advice you with all investigations and after physical examination.After all the investigations you can also put your query to HCM.Have a good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Orange colored urine. Elevated liver enzymes. What is the reason?\n\nMy urine is orange only when I am not drinking alcohol for the last couple if days. I do drink a lot though. When I drink its much more clear. However I have gone to the doctor in the last couple of months and had mildly elevated liver enzymes but when back after not drinking or taking any meds and it was more regular. I am worried because when I pee during day at work after drinking no alcohol it is orange. What is going on? An I ok?",
    "doctor_response": "Hi and welcome to HCM. You are ok,but it seems to me like you are trying to find a reason to drink alcohol:) When you drink alcohol your urine is more diluted and there is higher amount of water in it so this is the reason why it seems like you dont have orange urine when after drinking. Orange urine can be caused by blood in urine and it should be checked up. YOu could have urinary infection or kidney stones. Also you could have had trauma of kidneys and penis. YOu should do urine analysis to verify all this. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for redness and heat sensation on foreskin\n\nHi, For several months I have redness on foreskin and tip and heat in scrotum and anus, also some numbness along shaft of penis. Ejaculation can be painful in my anus as well. Tried various fungal creams and lotrimin made the redness worse. Doc says prostate is ok and got the all clear at the GU clinic. Have a constant crawly feeling in uretha under scrotum and into anus. Have not been given any antibiotics as yet.",
    "doctor_response": "HelloThanks for query ,Based on the symptoms that you have I think you have infection of the prostate (Prostatitis)Consult qualified Urologist for clinical and digital rectal examination and get following basic tests done to help to establish diagnosis.1)Urine routine and urine culture 2) Ultrasound Scanning of abdomen and pelvis 3)Semen examination and semen culture .Further treatment will be decided by him and will depend upon results of these test and final diagnosis.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to heal severe tooth pain?\n\n2 weeks ago I had a few cavities filled.  I wasn't in pain right after the dental work but the last 5 days have been miserable.  I have been taking ibprofin or tylonol every four hours to help with the tooth and pounding migrane.  I just started to feel really light headed.  Not sure what do do...",
    "doctor_response": "thanks for query, the pain could be because of the tooth infection in the restored tooth, consult a oral  physician and take a radiograph and confirm the diagnosis get a prescription of antibiotic along with the pain killers nly pain killers wont work. i hope my answer will help you. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure allergic cough, cold and itching in ears and eyes?\n\nHello Sir...I m a female, age 28,weight 50 kg,height 5, living in Mumbai India..I am suffering from allergies from last 2 years..It causes me cough, cold, itching in nose, eyes, ears, sneezing continuously, nose blocking whenever i sleep, coughing (dry) continuously hole night when sleep. I never suffer this king of illness previously but when I shifted to Mumbai 2 years back then I started suffering  this kind of problems. Please advice me what are the cures to get rid from these problems...Thank you",
    "doctor_response": "HI,I recommend following medicines for you...syrup Tus Q dx 5ml twice a day after food for allergic coughDuonase nasal spray One spray/nostril twice daily 1 month...am sure you will feel alright",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe shoulder pain\n\nI shocked my twice at work and there is pain in my shoulder and where i bend my arm and my hand is tingles is it okay? the first time i shocked it it was my 4th finger and i felt the shock go up my arm and the second time i shocked it, it was my middle finger and the shock went up my arm again",
    "doctor_response": "there is some kind of shooting pain in your upper limb suggesting nerve compression at neck or shoulder or elbow or wrist so kindly get an nerve conduction studies done if only shoulder is paining due to shock just hot water fomentation will work but tingling is also present so to rule out spine involvement kindly get done mri spine alsoso that we can come to a conclusion",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for neck pain from an injury\n\nI just hit the top of my head pretty hard, my friend was lifting me up and we didn t realize how low the ceiling was and my head hit the ceiling pretty hard right on the top. I don t have any pain on my head but my neck hurts really bad, especially on the left side right at the top of my neck and towards the bottom of my head, and it hurts worse when I look to the right... This literally just happened so I don t know if I should be concerned.. I ve had concussions and I don t think I am concussed I m just worried about the neck pain... What should I do???",
    "doctor_response": "Here you should use cold pack and hot pack frequently and check if you get any relief.  Here I must suggest if your pain is intense and high in intensity then do visit doctor and do mri of cervical spine  and brain to check there is no internal damage as well disc problem. Later you must take visit with orthopedic as well as with Physiotherapist for further treatment management.  Specially if it's only soft tissue pain then physiotherapy will help you lot for soft tissue relaxation and pain relief.  As well you can also take some stretching and strengthening exercise program from physio therapist as per your problem which will help you again to have some more pain relief. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are dangers of continuing having heart palpitations?\n\nI HAVE HEART PALPITATIONS MY HEART GETS OUT OF RHYTHM AND IT BEATS FAST-I AM ON MEDS-BUT I WAS GIVEN THE OPTION IF IT IS ANNOYING TO ME I COULD GET  A CHEST PLATE AND MONITOR FOR A MONTH AND THIS WOULD DECIDE FURTHER TREATMENT-I HAVE HAD THIS SEVERAL YRS AND IT IS GETTING A LOT MORE FREQUENT -I GUESS MY QUESTION IS WHAT IS THE DANGER IF I CONTINUE LIKE I AM-WILL IT DAMAGE MY HEART OR CAUSE A HEART ATTACK. I WORK AND DON'T HAVE TIME TO GO IN THE HOSPITAL OVER NITE FOR MEDS OR A PROCEDURE-MY ECHO,EKG WERE OK THIS THE 3RD OR 4TH IN LAST 4 YRS.I HAVE HAD THE GROIN TEST NO BLOCKAGES- I AM NOT A SMOKER. IT JUST SCARES ME WHEN MY HEART GETS OUT OF WHACK AND I FEEL SO WEAK AND CAN HARDLY FUNCTION FOR 24 HRS-THEN THE NEXT DAY I A M OK",
    "doctor_response": "first I want to your age because if it is AF then its treatment depends upon age too. second what was your holter or loop recorder report.does it have AF.third it can give u brain attack rather than heart attack (but mau occur) please mention  all reports resultsfinally if it is not Arrhythmia then no worry it is just anxiety .you can prevent your palpitations by taking beta blocker and anti anxiety drugs",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking birth control pill. Have abnormal bleeding, constant cold, mood swings. Want insight\n\nHi Doctor, I m having a few issues with my health at the moment and I can t tell if it s extreme coincidence they re all happening at the same time or whether something more serious is happening. My first issue (and what I think is the most important) is that I ve been taking the pill for almost a year and a half now and I m getting some abnormal bleeding . I missed a couple (not in a row) over Christmas and I got my period early and it s still here nearly two weeks later. I skipped the sugar pills and just continued active pills as the pack and doctors suggest. It s mostly concerning as I m getting an IUD inserted in a weeks time, so I want to know if I have to cancel my appointment. My second issue is that I ve had a cold for near two months. This is not that abnormal for myself, I work in an environment where I often have colds all year round, but this one is getting on my nerves. I ve been healthy recently and have started exercising and eating better and thought I was getting better (I went without a cold for a while, which was strange to me) but now it s back and I just can t kick it. My final issue is my mood. I m aware PMS etc can change your mood, but this is serious mood swings unlike I ve ever had. I have lost all my motivation for my studies and don t want to be anywhere near people at all. I am overtired (which could be the cold) and thoughts are keeping me up most of the night, making me extremely fatigued. I m hoping you can give me some insight as to what is going on, and hopefully some tips to make myself better. I m normally a very cheery, energetic person.",
    "doctor_response": "Hello thanks for writing in. Missing a pill, and even otherwise, on birth control pills, it is not rare to have irregular/abnormal bleeding or spotting. Do not cancel your appointment, as even with mild spotting, IUD can be inserted, but do not do it pre menstrually, as IUD is best inserted after a period is over. Regarding your mood swings, frequent colds, tiredness etc., please take vitamin C and vitamin D supplements. Also get your thyroid profile checked. Do away with any stress/ anxiety /emotional upheaval. You can try yoga / relaxation breathing/ meditation. Also, eat healthy, eat right and exercise in moderation Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of liquid discharge from penis?\n\nage-32 years,Height-5.8 inchesDear sir,Around 15 years ago, I inserted a thick long needle in my penis, After a certain point it stops, when I try to insert it more, suddenly blood is flowing of my penis continuously. when I hold penis tight for 15 minutes then it stops flowing. There is no problem for 2 years. After two yearswhenever I walk liquid come out from my penis. due to this I can't run. 24 hours I feel that ants are moving at the joining point of two legs below the penis.",
    "doctor_response": "DearWe understand your concernsI went through your details. Whatever the injury must have cause two years earlier, must have cured at that time itself. Now whatever you are feeling could be psychological issues. Regarding the liquid flow, you should consult an urologist, if you thing it is really that way. Urinary incontinence needs to be treated.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for an infection around the anus\n\nhey, i have really embarrsing problem, i have booked an appointment to see the doctor but i am just wondering what it could be in the mean time as it is really irritating, around my anus it is white like eczema seems dry and very itchy when i itch skin peels off and looks hard/white dead skin sometimes i bleed from itching it not much blood though",
    "doctor_response": "Hi,Welcome to HCMBased on the symptoms you have mentioned, I am suspecting fungal infection which is common in those areas due to increased moisture. I suggest you get a fungal culture done of skin scrapings taken from that area. Try to keep that area clean and dry as much as possible. Get a dermatologist opinion for antifungal treatment. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of partial uvula removal?\n\nHi, I have a small growth on my uvula and I am due to have surgery to have it removed, the DR said it is very common and it is some sort of a skin tag? Should I ask for it to be tested after removal or should I just trust him? Also what side effects does partial uvula removal entail?",
    "doctor_response": "Thanks for posting your query to HCM.After going through your question, I would recommend you to take a second opinion if you are not able to trust your doctor. You can also ask him to send the specimen for excisional biopsy to keep you clear off all the doubts.As you are saying its an overgrowth on uvula, so you wont face any side effects as you are only removing extra tissue.Hope my answer will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can viral infection be treated with cefixime?\n\nHi I am a female, 24 years old and 55 kg weight, I have been suffering from viral infection for almost a week now. I just had my blood & urine tests done. My blood report is normal meanwhile my urine tests show that I have 105.6 SGPT level and 10-12/ hpf in WBCs. The Doctor has prescribed me PCM and antibiotic - Cefixime. I have a doubt if antibiotic like cefixime will in viral infection as it has no anti viral property. Do help me....... Thank you",
    "doctor_response": "Hello,It may be due viral infection. Antibiotics tablet cefixime will not help to cure viral infection. For fever you can take tablet acetaminophen. Continue Saline or Betadine gargles twice a day. Keep your self hydrated and take balanced diet Hope I have answered your query and let me know if I can assist you further. Regards, Dr Shyam Kale Family and general physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for COPD\n\nMy mother has severe COPD. I suffer from it as well, but have been stable for many years due to following recommendations... ie: avoiding public places, public transportation, limiting grandchildren especially when sick, masking when in the store and using hand sanitizer. My mother, newly diagnosed (we have known for awhile but she would not go to doctor) we are trying to advise her about Casino visits, letting dirty snotty nosed grandchildren in the house, groups of church people in and out of home... sharing her phone with out cleaning, bathroom issue with so many in the house.... all these being triggers to her exacerbating her illness. 1) Is this true, or are we misinformed. 2) Any way we can get printed material about this and other precautions for severe stage with 24 hour oxygen?",
    "doctor_response": "Thanks for your question on HCM.COPD treatment needs following things to be done simultaneously. 1. Quit smoking if habit is there.2. Inhaled bronchodilators having long acting beta 2 agonist and corticosteroids. 3. Pulmonary rehabilitation and chest physiotherapy with deep breathing exercise.4. Adult vaccination with pneumococcal and h.influenza to prevent infection.And once you vacconate her, no need to avoid things you have mentioned.COPD patients can live normal life once disease is controlled.And in end stage disease home oxygen therapy is needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lost sensitivity in foot, lower back pain, cold feeling. What is wrong?\n\nHi I m a 41 year old woman who lives in Sweden. For some month ago I lost feeling on the outside of my right foot . When I touch the side of the foot I can t feel it. Then I started to have lower backpain on the right side of the spine . Sometimes it felt like cold water were running outside my right leg below the knee . Now it started to feels like someone is poring cold water on the outside of my LEFT foot. I m getting scared! What is wrong with me?",
    "doctor_response": "Hello, Abnormal sensations or loss of sensations in a particular area of the lower limb which is associated with low back ache, suggests pathology of the sciatic nerve or its branches. Usually the pathology originates in the spine most likely disc disease or some other cause which is putting pressure on the nerve and causing the abnormal sensations on that particular area of nerve distribution. the area involved in your case is S1 dermatome. Some times loss of sensation in perenial area can occur. Better consult a orthopedic doctor and get a MRI of the lumbo-sacral spine. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can lower platelets count cause low energy levels?\n\nHi  I am a 65 year old male . My platelets are consistently 15 points lower than normal. My doc says so long as they are  at a consistent level It is ok. I am consistently tired and have low energy levels. Is this ok? If the platelets were higher would I be less tired. I am fairly active?",
    "doctor_response": "Low platelets generally are not the direct cause of fatigue.  It is usually only when low platelets lead to low red blood cell count that platelets play a role in fatigue. Make sure your other blood counts are within normal limits & follow up with your doctor regarding the severity of platelet counts.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could red penis head with spots in children suggest?\n\nHi, may I answer your health queries right now ?  Please type your query here... My 14 month old son foreskin can finally be pulled down now... As I was cleaning it, I saw that the top of his penis was red and had a small red circular spot. Can u help me??",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically. Please revert back to me with images so that I can guide you better.You can approach me at the following link.Once the page opens there will be an option below my image as \u2013 ASK ME A QUESTION \u2013 click on it.Please find the link below -www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rashes on the penis?\n\nHi , my boyfriend has had this scratch like wounds on his penis that he thought was because of allergic to the lubricant he uses.this was about 3 or 4 months ago.now the scratches are gone but the skin of those parts are a bit swolen and red .the area of the redness is more than the area of the scratches.may it be a desease that may need a cure?do i need to see a doctor, too?",
    "doctor_response": "Hello. I have reviewed your query and here is my advice. From the given symptoms it seems that the penis skin has some infection. It will be better to consult a skin specialist or urologist.Hope I have answered your query. You can contact me for treatment options. Let me know if I can assist you further. Regards, Dr. K. V. Anand",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump at an injection site indicate?\n\nhi..um.. okay so i am a dumb person and to start off I want to say I have no intentions of killing or harming myself or being a drug addict but um.. I watch greys anatomy and I wanted to practice poking a needle so I did it on myself and I accidentally injected lidocaine hci 2% into the top of my hand not very much but im scared because there\u2019s a small  thick lump and it\u2019s more pale then the rest of my hand please help..",
    "doctor_response": "Hello,It is possible due to\u00a0-\u00a0The anesthetic\u00a0effect of the\u00a0lidocaine\u00a0- developing\u00a0cellulitis\u00a0or abscess.\u00a0-Doppler\u00a0ultrasound\u00a0recommended for further management guidelines.\u00a0Hope I have answered your query. Let me know if I can assist you further.Regards,\u00a0Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take foracort for allergic bronchitis?\n\nI have allergic bronchitis . I am on Foracort 400 for the past one year. Im keeping absolutely fine except for a little sneezing and sinus occasionally. Is it alright to take Foracort for extended periods. My peak flow meter is 300 without foracort and 340 after foracortMalini",
    "doctor_response": "Hi Dear !! Thanks for your query to HCM .Read and reviewed your query and health concerns. You seems to suffer from -resistance to Foracort effect with Allergic Bronchitis.Tab motnelucast/or Fexofenadine(allegra)orally need to be supplemented with-Plenty of fluids for good hydration.Tab Hetrazan-for Tropical Pulmonary Eosinophilia(TPE) and if need be Sporonox-(itraconazole)for aspergillosis, need to be considered with good care for sinusitis, with Loratidine.Second opinion with Chest / allergy specialist is a MUST.Hope this would help you to plan further care of this complex illness of yours.If need be, update any health issue 24 x 7 by a direct question to ME, at following HCM link-Dear, if satisfied,Don't forget to close this query with YOUR pleasing feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at HCM services.If you want to update more details and ask more update queries ,You are most Welcome herewith !!Good Day!!Wishing Good Healthy Life in time to come!!Dr.Savaskar M.N.Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Seroflo safe for a child suffering from wheezing?\n\nHello Dr,My nine year old daughter was suffering from wheezing from last 2 months and was on oral medication but the relief was temporary, now the dr. Has advised for sorflo 125 two puffs day n night .Is it safe to have this? Her grandfather is severe asthmatic patient,Does it hereditary symptom ?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.Inhalation therapy including inhalation steroids (serflo) is standard treatment and prophylaxis for wheezing considered to be allergic . These drugs are reasonably safe to use on long term basis. ( risk /benefit analysis is in favor of their use ) . In case of  history of asthma/allergy  in family is chances of this wheezing due to asthma are more  .Hope this answers your question. If you have additional questions then please do not hesitate in writing to us.Take care.\u2022\u00a0\u00a0\u00a0\u00a0\u00a0DISCLAIMER: - All the information provided here is for information purpose only   , it is not a substitute for the advice of a physician after physical examination , it is not intended to replace your relationship with your doctor. This information in no way establishes a doctor-patient relationship. Before acting anything based on this information do consult your doctor. I  recommend that online users seek the advice of a physician who can perform an in-person physical examination",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does popping sound from joints in a child mean?\n\nhi i am too much worried for my baby. but actually i really don t know is this the reason for worriedness. my baby is 1 1/2 yr old n i hear his all joints sound i donno weathr it calls popping or whatever. bt these sounds i hear from since he is one yr old. plz suggest me should i go to a doctor for complete check up or what?? why these sounds come. plz reply!!!",
    "doctor_response": "Hi, If the baby's growth and development is normal and she is able to help a normal range of moments in all the joints with normal power around the muscles surrounding each joint then the popping sound need not be worried about and it could be a sign of hypermobility which is physiological in some individuals. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What medicines to take for chest pain while urinating?\n\nHello doctor, My father aged 78 years is suffering from heart artery blockage with COPD. He underwent an angiogram, ECG, and related blood tests. Currently, he is taking the following medications for the last six months as per the doctor's advise.  Nitrocontin 6.4 mg two times. Concor Cor 2.5 mg once. Nikoran 5 mg two times. Ranozex 500 mg three strips two times. Aerocort Rotacap three times. Amaryl 1 mg once early morning. Deplatt a 75 once at bedtime. Roseday 10 mg once at bedtime.  Of late, my father is experiencing chest pain during urination, bathing, bedtime and took Sorbitrate 5 mg half. Please suggest if any further medication or increased dosage is to be given to avoid surgery. If a cardiac arrest happens what medicine should I give before taking to the hospital?",
    "doctor_response": "Hello. Medication wise, your father is on the maximum dosage. You could also try adding Flavedon MR (Trimetazidine) 35 twice a day. Consult your specialist doctor, discuss with him or her and start taking the medicine with their consent. But, I strongly feel after going through the angiogram report (attachment removed to protect patient identity) that he needs early CABG (coronary artery bypass grafting)/ staged PTCA (percutaneous transluminal coronary angioplasty) as recommended by the treating cardiologist. The only treatment for sudden cardiac arrest would be immediate cardiopulmonary resuscitation and rushing him to a nearby hospital. Intravenous drugs should only be administered in that setting. Regards. For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the drug clomipine safe for me ?\n\n29yrs,pcod,irregular periods, taken three month course for pcod after that two months past doctor take USG but not found any major follicle in this. now she recommened another three month course. what would you suggest? another doctor recommend ovulation induction drug i.e some clomipine type.?IS this safe for me i am confused .which doctor i had to follow? i want preg soon. if i choose induction drug method Is it solve my problem .otherwise one more month would be wasted.and then i have to follow three month course.",
    "doctor_response": "Hi Welcome to HCM Read your prob, if your follicals are small in size that means they are not mature. so there is no chance of ovulation so ovarial stimulant like clomifen or Hcg are not recommonded. if your follicals will be near or equal to normal size then clomifen or other drug can works n induse ovulation. so first you should get course of another three month, get follicular study every month , when you find your follicals are normal then take one shot of beta Hcg.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back pain and abdominal cramps during pregnancy?\n\nhi im 35 weeks pregant and have been having really bad lower back pain and stomach pain. My ribs hurt alot aswell to breathe. Been having alot of trouble sleeping i cant lie on either of my sides or back without it hurting. Also get really bad leg cramps.",
    "doctor_response": "Hi,This type of pain,backache, discomfort and leg cramps are likely due to change of posture and having pressure nerves and blood supply at this stage of pregnancy.Change the position frequently while lying down position.Go for normal walking exercises daily.Avoid sedentary life style.Go for deep breathing exercises.Just relax and avoid stress.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain post dengue?\n\nI was hospitalized because of dengue. Few days after I discharged from the hospital I felt completely recovered and regained my strength. However, one week later, I've felt slight pain in my stomach again (feeling of being full), slightly shaking and tired. Do i need to go back to my doctor? What i'm doing right now is to drink lots of water and eat nutritious food. What is this that I am feeling? Do i need to take some medication for this? Please advice. Thank you. --from the Philippines.",
    "doctor_response": "Hi.Thanks for your query and an elucidate history. Once you have recovered from dengue, if there is pain in abdomen , feeling of being full, shaking and tired, you are advised to visit the Doctor urgently. I would advise you the following:Urgent Examination by a Doctor , Investigations of the blood , urine and stool as per the clinical findings; Appropriate treatment- symptomatic, supportive and specific according to the reports.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for red spots on penis\n\ni got spots awhile ago on my penis. red little spots and made its hard to touch my penis. i couldnt masturbate for like 2 weeks and the spots would always come and go but there wasnt pain anymore however i cant masturbate as often anymore. only 3 time tops a week. wtf is wrong with me?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Spots on the Penis are usually not as serious as they appear. They may be regular modifications of the underlying skin structures. They are of concern only if you have had a unprotected sexual intercourse in the last couple of weeks to months. If they are nodular, you must see a doctor, they can be genital warts and will need treatment. But you can relax, because it is quite treatable.Otherwise, if you do not have history of such a sexual encounter, you must not worry at all.Take care,Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does my wife feel that she might have dust allergy and so is always cleaning the house ?\n\nmy wife always want to wash hands, face and leg if you touch anything, always swiping on floor, if some body comes from outside complete floor to be washed, if you ask her , she is saying that dust is alergy for her by mentally not phscicaly , please suggest which spaecialist to consult",
    "doctor_response": "Dear Ekambaram , It seems that she may have obsessive compusive disorder. Psychiatrist will be the best person who can help you for her diagnosis and managment of condition.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does chest pain with fluttering and cough need cardiac evaluation?\n\nHad one episode of a fib brought on by dvt in leg and pulmonary embolism. Stopped heart twice before it regained normal rhythm. Had extensive testing done by cardiologist, including stress test with persantine and thalium. Result: small leak in one of my valves, but nothing to worry about. On pradaxa since March and have been having chest pain under breast bone annoying but not unbearable, accompanied by a flutter feeling, not intense like the 205 bpm I had with a fib and also .. I have a cough too. BP has been normal (take med) and heart rate around 60. Should I seek cardiac evaluation again?",
    "doctor_response": "HelloThanks for posting at HCM.I have gone through your history. Since you have been completely evaluated for the heart including a thallium and persantine scan, there is no need to seek a cardiac evaluation now. Since you had DVT with pulmonary embolism, it may be possible that some amount of lung tissue was affected by the embolism and infarcted. This may be the reason of cough and the chest pain. Another reason for cough can be lung congestion brought on due to atrial fibrillation. But you have mentioned that you had only one episode of AF so i suppose, you have reverted to sinus rhythm.In your case, I suspect there is a lung issue more than a heart involvement. I recommend a chest X ray initially and if it shows any abnormalities, a HRCT chest to look for lung issues.Cardiac wise you need no evaluation except an ECG.Wishing you good healthRegards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to avoid pregnancy\n\ni didn t use my nuvaring for the required dosage. I took it out, fridged it and 1 week later put it back in. 1 week after that I had unprotected sex. 2 days after that, took it out again for 1 week. im scared to death that I have gotten myself pregnant. what should I do??",
    "doctor_response": "Hello,Thanks for sharing your health concern with us. In the current scenario, your cycle is no longer protected. I would ask you to go for a home pregnancy test a week after your expected period if you miss it. Since you have used the contraceptive irregularly, you can expect abnormal menstrual pattern. If you wish to have an earlier detection, please go for the estimation of the serum beta-hCG titres ten days after the intercourse since ovulation, if at all has occurred, cannot be predicted here. See a specialist for further help. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the natural remedy for the boil behind the ear?\n\nI have a boil behind my ear. It is small and keeps filling with puss and clear fluid.  When I pop it the puss and clear fluid smell.  Is there any natural remedy I can to get this to dry up.  I had already seen a dermatologist about it.  They gave me 6 weeks of antibiotic and it still did not go away.",
    "doctor_response": "**1. if there is presence of boil behind the ear thus best doctor to visit is ENT specialist for examination [mastoid process for tenderness] and evaluation 2. stop popping it otherwise,it might cause some secondary/serious infection3. since boil are mixture of bacteria their by-products as well as degraded tissue from infection] thus reason of being smelly.4. Some need antibiotics and some need surgical drainage. [might be the reason not going with antibiotic therapy] 5. prefer warm compresses initially, if it starts draining wash the boil with antibacterial soap/warm water, apply an antibacterial cream or ointment  and cover with gauze dressing and thereafter see your doctor to ascertain if it needs to be drained.6. In order to prevent boils from further infecting you:. do not share towels, clothes or bedding with anyone who has a boil. Although boils themselves are not contagious, the bacteria which causes them is.. Practice good hygiene.PS. you may try tea tree oil, diaper rash cream [since contains aloe vera in it will help in reducing redness",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to improve chances of conceiving along with taking folic acid?\n\nHello. im 34 female. healthy, perfect weight. Have a 10 year old daughter now panicking over my biological clock and want to have another baby. Been trying around 4 months now with no sucess. Getting desperate. Taking folic acid every day and having sex on my fertile days...any advice please? Thank you",
    "doctor_response": "Hi , How are you doing ?If you have a previous pregnancy , you still have a good chance of second pregnancy. Folic acid will help improve the health of the baby , but will not help in getting pregnant. As you said your age is ticking so need to clear any hindrances to get pregnant. Kindly see if the following checklist of investigations is doneHusband- Semen analysis at least 2-  done 4 weeks apart preferably in an infertility center ( examination done by andrologist), Blood sugarsWife - Blood Sugars, Thyroid profile Ultrasound scans to evaluate Uterus , Ovaries & adnexa          Confirm tubal patency- most important- Tube is the connection           between uterus & ovaries( the bridge where sperm meets the egg &           forms a baby) this is size of hair follicle & cannot be seen on scans.           So check with HSG( Xray with dye), or SSG ( Scan with dye) or             LaparoscopyIf all this done & found normal , nothing can stop a pregnancy with God's willHope I have cleared your queryAll the bestDr.Balakrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tapping feeling in rib/lung/muscle?\n\nAround near my spine, I m getting a weird feeling in my rib/lung/muscle .. It s like a flicking feeling or a tapping feeling. It doesn t cause me pain but it feels weird. It s been happening for 2 days now and I m scared( I don t know why though) maybe I m just overreacting. It s hard to describe but I feel the sudden urge to cough after I feel it cause I feel a slight shortness of breath or something. Maybe it s not related to that as I ve had the flu recently but it s a weird flicking or beating feeling.",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. But you need to relax first.Since you have flu recently,  possibility of lower respiratory tract infection ( LRTI ) is high. And symptoms like pain on coughing and breathlessness are seen in LRTI.So get done chest x ray to rule out LRTI. If this is normal than no need to worry much. Your symptoms may be due to muscular cause only. So try to follow these steps for better symptomatic relief in muscular pain. 1. Avoid heavy weight lifting and strenuous exercise. 2. Avoid bad postures in sleep. 3. Take good painkiller and muscle relaxant. 4. Apply warm water pad on affected site.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are minimal caliectasis in left kidney and encysted fluid encasing the left ovary a serious concern?\n\nMy wife Ultrasound report says she has Minimal caliectasis is seen in Left Kidney of 3.5 mm in it middle calyx. and also there is encysted fluid containing area of dimension 5.92x3.03x5.56 cm is seen encasing the left ovary. She has sever pain in left kidney side and pelvic area.",
    "doctor_response": "consult urologist. drink more water  take alcasol three times daily. if possible the calculi is to be removed surgically. can be broken and removed by ultrasound guididance.is also called lithotrypsy.by focusing high intensity ultrasound beam breaking the stone to small granules it come down toureter and bladder. can be further removed by buscating.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat cheekbone bruising caused by trauma?\n\nHi this morning, i fell and bumped the bottom of my cheekbone, the area instantly swelled up but felt numb, as the day has gone on the swelling has gone down however it is starting to become painful. No bruising has come up where I actually hit my face however at the end of the cheekbone next to my nose a bruise has come up. What would you reccomend? I am female & 21 years of age",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms seem to be related to the injury on the cheekbone.I suggest using anti inflammatory medications such as Acetaminophen to relieve the pain .I also suggest using cold compresses for local application and rest.Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the angiography show?\n\nage 50,weight 73 kg,ht.(cm):164 blood pressur normal, glucose (random):144 anjio graphy result: LEFT MAIN CA:normal LAD:  Mid Lad with 70%-80%tubular stensis. CIRCUMFLEX: first obtuse marginal with 705discret ostial stenosis. RIGHT CA proximal right cornary artery with 90%discrete stenosis. What u sugest about this result?",
    "doctor_response": "Hi,The patient has 3 vessel coronary artery disease, which means that there are narrowing in three arteries which supply blood to heart. In this case there are two options; surgery vs invasive treatment (coronary stenting). The decision depends on the anatomy of the narrowing and patient's condition.Take careCome back if you have any further questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath and dizziness?\n\nI have shortness of breath, headache, swelling in hands and feet, fatigue, muscle and joint pain, low on vitamin D, some light headedness, memory and concerns/ confusion. Recently the headache seemed to be like a migraine... I saw black flashes in front of me, tremendous pain, couldn\u2019t look at light, and became very fatigued.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As you explain the history this might be a migraine headache. This needs painkillers such as Ibuprofen however it would be better for you to be examined by your doctor. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Nausea, tiredness, pain in liver after taking Cepadem. History of Hepatitis, jaundice. Should I be concerned ?\n\nHI I HAD HIPATITIS AT LEAST 12 YEARS AGO AND I HAD IT REALLY REALLY BAD, GOT IT FROM MY KIDS WHO HAD YELLOW YAUNDICE, THEY WERE NOT EFFECTED SO BAD AND GOT OVER IT QUICKLY, I HOWEVER GOT SO SICK I THOUGHT I WAS DYING, COULDNT KEEP ANYTHING DOWN, ITCHY SKIN.  ABOUT A YEAR AGO I WAS PUT ONTO AVALON ANTIBIOTIC FOR BRONCHITIS AND IT EFFECTED MY LIVER AND I WAS IN SEVERE PAIN AGAIN. I STOPPED THE ANTIBIOTIC AND IT CLEARED UP AFTER ABOUT A 2 WEEKS.  A WEEK AGO MY GP PUT ME ONTO ANTIBIOTICS AGAIN,  CEPADEM AND AFTER THE 2ND DAY I HAD TO STOP AS IT WAS EFFECTING MY LIVER ONCE AGAIN, ITS BEEN A WEEK NOW AND IM STILL EXPERIENCING NAUSEA, TIREDNESS AND PAIN IN MY LIVER AREA, I CAN FEEL ITS STILL SWOLLEN. I HAVE HAD A DISCHARGE OF BLOOD BUT NOT FRESH BLOOD AND ITS CONTINUING.  SHOULD I BE CONCERNED OR IS IT JUST PART OF THE HEALING PROCESSES MY LIVER NEEDS TO GO THRU?",
    "doctor_response": "Hi and welcome to Healthcare magic.Thank you for the query.This is not common side effect of antibiotic,but is possible. This shouldnt cause some serious liver damage and 3-4 weeks may be necessary till  LFT recover. You shuld just stop this or any similar drug. Avid hepatotoxic substances and check your LFT frequently.Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Hydrochlorothiazide be the cause of a false POSITIVE home pregnancy test?\n\nI'm sure these are silly questions, but I'm grasping at straws here.  Can hydrochlorothiazide 12.5 mg be the cause of a false POSITIVE home pregnancy test?  I took a Clearblue pregnancy test this morning and it seemed to be missing that all important word...\"not\".  Uh oh.  I am 46 years old.  I am not menopausal.  Could my age also influence a false positive?  Thank you",
    "doctor_response": "Hi,Welcome to Healthcaremagic,After going through your history,This medication would not affect a pregnancy test.If you have tested at least two weeks after a missed period, and you had unprotected sex during this period, then visit Gynecologist and confirm it with blood test Beta HCG level which is 99.9% accurate and a ultrasonography may be done to confirm.If you do not want to continue pregnancy medical and surgical options to terminate are available.your Gynecologist would guide you for what is best for you.First we need to exclude pregnancy than other causes of amenorrhoea can be analysed and investigated if required.Hope this helps you.Take care.Good Luck.Dr.Akhilesh Dubey M.D.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the treatment and symptoms of the yeast infection?\n\nAbout the 2nd week of May I got what seemed to be a yeast infection, I did not go to the Gyno nor take any medication I just waited for it to pass which it did after about a week and half. After the symptoms went away I had sexual intercourse and it was extremely painful. So I took another break for about 2 weeks or so and had sexual intercourse last night and it was fine once he was in, but when he got out and tried to get back in it was extremely painful. The only way I know how to describe it is it felt like skin burn from the rubbing.  Any suggestions?",
    "doctor_response": "Thanks for posting you query to health care magic.As you said you are having yeast infection but yeast are not always pathogenic as they can be present as commansal vaginal flora.So you should be investigated to find out other infection.genital infection are usually due to sexually transmitted infection (STD) and acquire by contact with infected partner. There are a group of organism causes STD. So I suggest you to fist you should confirm your diagnosis .you should be investigated for :1. Microscopic examination of Vaginal discharge .If discharge is not present Vaginal Swab can be used it will sugget you causative organism and about your microbial flora.However syndromic management can be started after opinion from Gynecologist .But always remember treatment should be always given to your sexual partner also and keep sexual abstinence or use condom until you get cured.Hope you would be satisfied with my answer .  Feel free to communicate if any query .regards,Dr.Manish PurohitInfectious disease specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is vaccination advisable to prevent infection?\n\nHello... Recently while outside one of the local foxes came by to check out what we were doing.  I work outside most days and today the temperature was -10 and we were all bundled up.  This particular fox which is one of the normal ones we see on almost a weekly basis found my glasses which I had dropped out of my pocket and took them in his mouth and walked a few yards before dropping them after we yelled at him.  I went over to pick up my glasses with a gloved hand to bring them inside to wash them.  I washed the glasses without a gloved hand and sanitized afterwards.  Under the advice of my coworker I threw the glasses out.  Fox exhibited no signs of infection other then its usual curiosity  Is there a risk for rabies here?  If I need a vaccine I could not get it for 3 - 4 days without an emergency flight home due to my location.  Could this be determental to my health.  Thanks!",
    "doctor_response": "Hi, Welcome to HCM. I understand your concern regarding necessity for vaccination. Based on the details mentioned in your query, you do not require vaccination for this episode as there was no direct exposure to the animal. However, as you mention that there is a chance of getting exposed to wild animals due to your location, pre exposure prophylaxis can be recommended. You have to take three doses of the rabies vaccine on 0,3,7 days with 0 being the first dose, followed by vaccination on 3 rd day and then the seventh day. Avoid direct confrontations with wild animals for your own safety.I hope I have answered your query satisfactorily. Please get back if any more queries.thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nausea and dizziness with compression fracture?\n\nMy wife has a T 8 compression fracture. We were told that radiation treatment that she received to treat lower lung cancer contributed to the compression fracture. Along with pain she is experiencing nausea and dizziness. Is this related to the compression fracture.",
    "doctor_response": "Hi, I am Dr.Bruno.  I have read your question and understand your concerns. Let me try to help you Question : What causes nausea and dizziness with compression fracture?Answer : Compression Fracture is probably due to a secondary tumour from Lung Cancer. Nausea and dizziness can be due to either the tumour or the radiation Question : Is this related to the compression fracture.Answer : Not likelyHope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes greenish discharge from my baby s eyes?\n\nhello, my 8 old month baby has a problem with her eyes. whenhello, my 8 old month baby has a problem with her eyes. when she crys something green comes out of her two eyes. but when she wakes up one of her eyelashes from the top and buttom gets srucked. i clean her both eyes with apple tea. if you can please help me or what should i clean her eyes with?",
    "doctor_response": "Hi, Please do not self medicate especially regarding the eye and skin conditions. I suggest either you consult her pediatrician or upload an image here so that we can guide you better. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had ruptured cerebral aneurysm. Had spinal tap done. Having lower back pain. Suggestions?\n\nHi I recently had a ruptured cerebral aneurysm and had a coiling proceedure done. They did a spinal tap to be able to find traces of blood in my fluid. Since the spinal tap I have had lower back pain everyday and in a couple of cases my legs have almost given out on me. The spinal tap was done about 3 weeks ago now. Should I be worried about this. I have researched the internet and have found that other people have experienced this as well.",
    "doctor_response": "Hello. Thanks for writing to us. The spinal tap is sometimes associated with a persistent pain in the legs due to the irritation of the nerve roots at the level of spinal cord. This is a self limiting symptom and is likely to improve in next 2-3 weeks. Taking methylcobalamin supplements will help. I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL  Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Consumed isotrion for skin treatment. Developed into acidity, swelling in liver. Why is breathing difficult?\n\nhi doctor i am 25 yr old girl unmarried 6 months ago i consume a tablet isotrion for my skin treatment bt soon after using it acidity start developing i stop dat n restart using it with ocid tablet.... bt my prb got worsen day by day i complete stop dat tablet 6 mnths ago bt still acidity occuring in moderation. but sir from d last 4 months i got diagnosed wid swelling liver my stomach is bcome like a pregnent women one n having difficulty while breathing . doctor plz advice me sumthing how can i get rid of it m completely shatterd with bcoz did disease is not ending in anyform",
    "doctor_response": "Hi  I have read your history and I am sorry for experiencing such sad situation.Isotrion has a lot of side effects sush as :- severe pain in your upper stomach ( gastritis, ulcers or esophagitis ), nausea and vomiting.- hipertrigliceridemia- bronchospasms ( difficulty while breathing) during the treatmen. you have done the right thing takeing ocid ( omeprazole) and you should continue it. With regards to the difficulty while breathing, it is possibly realted  with:1. swelling liver if it is severe because it pushes up the diafragma and you feel difficulty while breathing2. hiper acidity may  couse GERD ( gastroesophageal reflux disease) and  difficulty while breathing.I recommend you to do an upper endoscopy  so we wll know exactly your diagnose, and the GI doctor will decide if your concerns are from hyperacidity.  and than  you should perform chest X-ray and  consult a pneumologyst if you have lung any lung problem. all the best Dr.kleridap.s. if you have further concern, please write me back!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes skin break out, pimples, throat swelling when having lymph node infection?\n\nDear Dr Prasad. I had frequent break outs on my skin. A lot of pimples suddenly. As an aside, I also had severe throat swelling and ear pain, unlike the symptoms of tonsilitis. My GP told me it was because of a lymph node infection. Can pimples break out because of this? And what is the treatment?",
    "doctor_response": "ALWAYS MENTION YOUR AGE & GENDER.LYMPH NODES OCCURS  DUE TO INFECTION. NOT DUE TO PIMPLES. FOR PIMPLES .KEEP THE FACE CLEAN WITH FACE WASH TWICE A DAY.AVOID OIL FOR HAIR & FACE.USE OIL FREE MOISTURIZERS .WASH YOUR HAIR. WITH  SHAMPOO TWICE A WEEK.AVOID HOT & HUMID.FOR THROAT SWELLING USE HOT SALINE GARGLES TWICE A DAY.YOU CAN TAKE PARACETAMOL/IBUPROFEN FOR PAIN.USE BEZYLE BENZOATE CREAM FOR PIMPLES.DO NOT PINCH OR SQEEZE PIMPLES ,IT LEAVES SCAR.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for loss of appetite and runny nose in infants\n\n13M month old has been kind of cranky since coming home from daycare. Loss of appetite, cranky, then just woke up 10 min. ago with 101.3 fever. In between this he ran into the side of the dresser that left a big bruise. No coughing or sneezing, a little runmy nose w/thick micus. What to do?",
    "doctor_response": "HiWelcome to the HCMIn my opinion, your child is probably suffering from a viral illness. Its usually associated with fever, running nose, poor appetite and lethargy.You can give him Syrup Acetaminophen for fever at 15-20mg/kg dose for fever. Also do sponging to bring down the fever.Start an antihistaminic for running nose such as Syrup Maxtra or Syp. T-minic 2.5 ml thrice daily.In case the child does not show any improvement even after 2 days of treatment, consult a pediatrician for physical examination and further management.For further questions, do contact us.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for phimosis\n\nHello doctor, i didnt had sex till now but i had noticed my penis outer skin its joint and its not going back as well as the hole opening is too small, i tried pulling back but the upper skin is joint and it doesnt come back. Please advice if i need any surgery or treatment ans whether i have a risk of losing my manhood after surgery.....",
    "doctor_response": "Thanks for asking in healthcaremagic forum   If you are not able to retract the foreskin till the coronal sulcus exposing the glans, then please visit an urologist who can advise you surgery/other remedies for relief. Do not worry surgery for this cannot cause any damage to your manhood. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for costochondritis\n\nhello sir, i have been suffering from costochondritis for 8 months. doctor said that no need to worry, it will cure automatically. i don't believe that he is telling right. till now i have pain. so sir, please suggest me what to do, what to eat to cure it fully?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Costochondritis is inflammation of of cartilagious joints of rib cage. This condition heals by its own slowly, but you need to follow these steps strictly. 1. Avoid movements causing pain. 2. Avoid heavyweight lifting and strenuous exercise. 3. Avoid bad postures in sleep. 4. Start painkiller and anti inflammatory drugs. 5. Apply warm water pad on affected areas. 6. Wear rib belt to prevent mobilisation of painful areas. No specific diet is needed for this. You need proper rest and above mentioned treatment for recovery. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is my brother having fever due to accident?\n\nmy brother have a car accident today he went to the ER they done the initial investigations and they said he is well and need to be under observation but now he got fever of 38.5 c with no symptoms suggestive of infection is it releated to the accident? it is an alarm of something dangerous? please answer me quickly!",
    "doctor_response": "Hi, thanks for using HCM.Ruse in temperature could be due to body's response to accident. Any change in consciousness or vomiting needs to be addressed early.Anti inflammatory medication helps to control temperature.Not to worry.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest natural remedies for kidney stones\n\ngood afternoon doc.may ask a question regarding to my condition,i have a kidney stone both left and right measuring 0.5x0.4 while the other one is 0.5x0.5 wthe best remedy for my health problem i cant afford to have a long time medication even operation can you give me tips on how to cure my illness without taking medicine?thank you so much !",
    "doctor_response": "Macrotyloma uniflorum is a legume and is widely used across Indian sub continent. It's popularly called Kulth or horse gram.If you boil it with or without rice in semi liquid form and eat, it helps to dissolve renal stones. It's decoction can also be drunk frequently.You can also mix Pomegranates seeds crush and holy basil leaves extract or crush Tribulus ( Gokhru) powder in this decoction for better results.A lot of water to be drunk. Ready made syrups viz Cystone and Neeri have also the same effect.Hope it helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can ankle swelling be caused by gout on the feet?\n\nI am 81 years young.....however my left ankles is swollen....I take medications for hpb and cholesteI have been to see a Dr. about 5 years ago and was sent =by my excellent intern....they examined my ankles and everything was okay....In the past 3 yearsI have developed gout which is in both my feet...Is that the problem?",
    "doctor_response": "Hello I have studied your case, gout can be treated with medication and diet restriction.I will advise to do blood inv like complete blood count ,uric acid levelFor gout you may need medicine like zyloric, allopurinol and newer febuxostat you can start then according to blood uric acid level consulting his treating doctor. Food to be avoided in diet includes \u2013meat and poultry. The most abundant source of purines are the full range of meats: beef, pork, poultry, fish and other seafood. Organ meats are especially high in purines and should be avoided completely on a gout diet. When reducing meat, get protein from other sources including low-fat dairy, eggs and plant-based sources such as beans, legumes, soybeans and whole grains.AlcoholAlcohol reduces the ability of your body to excrete uric acid via the kidneys and urine. If your gout is severe or you are having an attack, avoid alcohol completely. Increase your daily intake of water. As the water is turned into urine, it carries uric acid out of your body. Institute of Medicine recommends that adult men drink 3 litres of water daily; women should drink 2 litres.Processed CarbohydratesProcessed carbohydrates and sugars take the place of healthy carbohydrates, such as fruits and vegetables, in your diet. Although no direct link has been established between sugar intake and gout severity, high sugar intake can contribute to obesity, a risk factor for gout. The fibre in fruits, vegetables and whole grains may also help carry excess uric acid out of your body.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain and faster heart beat?\n\nmy 18 year old son was companing that his heart was hurting. he randomly will complain about this. I felt his chest and counted 130 beats per minute. it felt like it was pounding outside his chest. I gave him some water and it slowed down a bit. he's on no meds or cafeine. should i tke him in to a doctor",
    "doctor_response": "Hello!Welcome on HCM!I understand your concern and would explain that his symptoms could be related to anxiety or musculo-skeletal pain. It is very unlikely (considering his age) that these symptoms are related to any cardiac disorders.  Besides, the increased heart rate could be related to anxiety and also muscular pain (normal autonomic reaction). But, if this problem repeats, I would recommend consulting with his attending physician for a careful physical exam and some tests: - a resting ECG- a chest X ray study- complete blood count for anemia- inflammation tests (PCR, sedimentation rate)- thyroid hormone levels for possible thyroid dysfunction. If all the above tests result normal, you should consider anxiety as the main cause of all this clinical scenario. Hope to have been helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for enlargement of prostate\n\nsticky substance comes out after urine in the morning i notice,making me weak and thin ...i need a solution that can cure this...i am very tensed ....i hv also shown urologist,blood test, urinalysis is all ok,RGA ,x-ray done ..doctor says everythin is normal only a llitle bit enlargement of prostate...prescribed med named zanocin 400mg,urispus, tamflo,rabifast-20 for 7,7,30,14 days resp. but condition still prevail....what to do???? plz help i hv to do lot of things for the society...",
    "doctor_response": "Thanks for asking in heathcaremagic forumIn short: Enlarged prostate after certain age is normal.Explanation: You have not mentioned your age here. Prostate enlarges in every individual after certain age (usually starts at around 50). So, prostate enlargement is seen in almost all elderly males.                    So, you need not worry take medications as prescribed by your doctor and if your urinary symptoms increase then your doctor only will advise you for surgery(TURP). So till then be happy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there pain in hands and feet with fever?\n\nHi doctor, My 4 years son had a cough for two days. Now his cough is fine but now he has a high fever on the head side but his hands are ice cold. He is telling pain sometimes in hands and some times in feet. What is the cause? Please explain.",
    "doctor_response": "Hi. From the description, it seems your son is having an upper respiratory infection. If he is playful and active in between fever it may be a simple infection which will subside by its own. You can give Paracetamol during the fever spikes. If his fever is lasting for more than three days, then you have to do a blood test including complete blood counts and may go for antibiotics after consulting a doctor in person. Pain can be part of the infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have hypertension. Please suggest me some natural ways to treat this.\n\nHi doctor, I have hypertension. Please suggest some natural ways to treat it.",
    "doctor_response": "Hello. I understand that you are not interested in taking medications for hypertension for a long time. So I am suggesting you a natural way of dealing with hypertension. Take raisins. Soak it in rose water overnight. Chew and eat it in the morning. You have to follow this for 21 days with 1 raisin on the first day, 2 raisins on the second day, 3 raisins on the third day and so on till you have 21 raisins on the 21 st day. Then stop this and after a gap of 2 weeks, repeat this. Follow 4 to 5 cycles like this. Meanwhile, keep taking your allopathic medication during this period. Afterward, you can taper off the medication. Keep checking your blood pressure after every 21 days. This might work for you depending on your body condition. Also, try to do meditation and yoga.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tibia contusion\n\nI was diagnosed with a tibia contusion, and have a hemotoma in the area of the injury. I applied ice, the hematoma swelling is down. Yet when I rise o walk it is extremely painful for about 5 min. Then moderately painful. I am not sure what is going on .......",
    "doctor_response": "Dear sir /madam If I were your treating doctor since you history of injury. I  would examine your leg for local bony tenderness, and then take the radiograph of the part to look for fracture. For contusion it is recommended to rest the part, ice fomentation and some analgesics, And assess again after 1 week",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the prognosis for pleural effusion with an elevated diaphragm?\n\nmy father is 60. he developed a pleural effusion about a week ago which got slightly complicated. the fluid became pus (acute bacterial empyema). a substantial volume of the fluid has been drained through a tube, and he seems fine. latest x ray shows an elevated diaphragm. what is a possible prognosis for that, and what should be done next? thank you",
    "doctor_response": "HelloThis is a complicated situation and exept the dranaige of the pus the insertion of the antibiotics in site should be done further.RegardsDr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for holes on teeth between the gums\n\nI have a hole on one of my upper teeth where it meets my gums. It is starting to really hurt and I have always had a great smile but I am scared to now bc food literally gets stuck in it and I have to get it out with an instrument. How did this happen and how can I fix it? Didn't think I had to pay. Silly silly me of course you would!",
    "doctor_response": "Hi,Thanks for posting the query,            According to your clinical symptoms i suppose thta you might have developed with gingival recession, i would suggest you to consult a Dentist and get a checkup done get a complete mouth scaling and polishing done, if required a periodontal surgery can be done, for this you require to get an OPG radiograph done, at home take lukewarm saline and antiseptic mouthwash rinses, take multivitamin suplements, maintain a good oral hygiene.Hope you find this as helpful,Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Consistent severe cough, occasional vomiting, itchy throat, have air blowing inside the room due to faulty ac. Could that be a cause?\n\nI have a cough that is consistent and at time cough so hard I throw up. My throat is itchy as well. Went to the Doctor about 2 weeks ago and whopping cough test was negative. Was given an inhaler and antibiotics and it stopped. It has now started again. I found that my portable ac unit had water inside and has probably been there since I used it last which was a year ago. Plus I did not have it hooked up correctly so the air was blowing inside the room. Could this be the cause?",
    "doctor_response": "You could be suffering from cough variant asthma and trigger could be as you have said the stale water in your portable ac. There must be moulds and spores of these moulds may have triggered the attack. You should take inhalers like asthalin, seroflo. montair tablet and if required, a short course of oral steroids. Frequently change your bed linen and sun your matress and pillow frequently.Your room should also have fresh air ventilation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lumps on the tibia bone below the knee?\n\nthanks for your concern. my daughter is two years old.she is having two peanut  sized bulgings over tibia bone below the knee.i think they are painless because she is very active and never complained about it .iam very much worried . can any one tell me what it could be.",
    "doctor_response": "Hi.... by what you quote I feel that it could be small lipoma or a dermoid cyst or fibrous cyst which are appearing like small nodules below the knee joint. As this is not causing any discomfort you need not worry. Nevertheless I suggest that you consult your pediatrician regarding this.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does calf muscle pain take to heal after an injury?\n\nI was hit in the knee with a softball 10 days ago. The calfl muscle is still very sore to the touch and I still can t walk correctly or run at all. I am 64 years old, in good physical condition and play softball 2 times a week.I have been icing the leg and taking motron.How long should it take for my calf muscle to stop hurting and loosen up?",
    "doctor_response": "Hello,Well the first thing to do is stop the icing and use heat. A heating pad or soaks in a bathtub 2-4 times a day. Ice can actually delay the healing. It really depends upon what sort of injury you had. If you had a tendon tear it can take months to heal. If it is a joint injury and is just sore from the swelling then it should clear up in 4-6 weeks.If you think it is not healing properly then see your doctor.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring welts on the shins?\n\nI have reoccurring welts on my shins and they will temporarily calm down and rise up again, so they nevery really go away. I have been told it is from dry skin and I have taken shots and have steroid creams. They simply keep reoccurring could it be food or environment.",
    "doctor_response": "HIWell come to HCMThe reoccurring of this lesion is possible if this is not being treated properly without the consultation of doctor, food and environment are nothing to take with this, in my opinion better to have a opinion from the skin specialist, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment for swollen cervical lymph node\n\nI have cervical lymph node swelling just on the left side, I have begun snoring incredibly loud at night- so loud that I wake myself as well as my spouse, and I have a constant ache in my left upper arm and left shoulder. I went to my PCP today, and she ordered TSH level and a CT of the neck and chest. Anything else I ought to ask my MD to check? I am 40 yrs old with a negative health hx, no tobacco hx, and min. ETOH use. Since my time for taking care of myself is limited due to other commitments, I just want to make sure that I can be as efficient as possible when I do go see my MD.",
    "doctor_response": "Hello, I have studied your case. if your neck lymphnode is enlarged then you should get needle tests. If there is any pus or any cell then it can be checked under microscope.  Most probably it will be infection and you will required Antibiotics. For your snoring you need to see an  ent  specialist. I hope this answer will be useful for you. let me know if there is any other followup questions. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can mucus in the throat, chest congestion and cough be treated?\n\n3 weeks ago, had lots of mucus in my head which got into my lungs and caused me to cough a lot. It has mostly gotten better but still have some mucus coming down in my throat. I have a feeling of a cold in my upper chest and if I try to breath out a real deep breath, there is a wheezing sound and I have to cough. I lost my appetite which is coming back a little bit and also am very tired.",
    "doctor_response": "Hi, As you explain the situation you can take mucolitics drugs to liquid the secretions and to relieve from them. Hope I have answered your query. Let me know if I can assist you further.  Regards, Dr. Jnikolla, Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will there be any effect on pregnancy by having horseshoe kidneys ?\n\ni am writing to ask a question about my kidneys condition. After a dignosis i had two days ago, i discovered that i have hourseshoe kidneys which was a strange thing for me. My question is : do this shape and position of my kidneys have an effect on pregnancy?? and does this conditin have side effects??? thanks",
    "doctor_response": "If your kidney functions are normal and no urine infections, there is nothing to worry. Horseshoe kidneys themselves do not have any affect on pregnancy. However some persons with horseshoe kidney have abnormalities in the drainage system. During pregnancy there is a tendency for urine to flow backwards from the bladder to the kidney. This can increase the chances of UTI. No specific measures are required. Check your Blood Urea, Creatinine and Urine routine. Take adequate fluids.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from fever even after taking Ibuprofen, what to do?\n\nMy son started with a low grade temp last night of 100.8, gave tylenol , He woke up this morning with a temp again , gave him Ibprohen at 5:30pm, he was at daycare a slepted for 4 hours got him home and his temp was 103.5. so I gave him some Ibprophen....it seemed to help but now about 54 hrs into the ibprohen his temp is back over 103 so I gave him some tylenol..... Was just wondering when or if I should bring him in to see someone..He isn't eating but I can get him to drink ..",
    "doctor_response": "Hello,Welcome to HCM,As your son is having high temperature with swing of temperature is not good ont he health of your son.If the temp is going above 103 it may leads to febrile convulsions, be careful regarding this. Even after giving tab Ibuprofen if the temp is not coming down you have to give cold tepid sponging.You can give Meftal P, whenever the temp is above 100. As he is having fever for more than 4 days, he may require lab investigation.I would suggest you to take your son to your paediatrician for complete evaluation.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a lump on the forearm be treated?\n\nI just fell from tree trimming. About 5-6 feet. Thought I just had a few scrapes. Don't feel any pain. But after sitting down for a bit I noticed a large lump on my forearm. I am not in any pain. Put ice on it. Going down. Is there any reason I need to get it checked out?",
    "doctor_response": "Respected user , hiThanks for using Healthcaremagic.comI have evaluated your query thoroughly .* This is due to post traumatic hematoma formation .* Continue ice application 3 - 4 times a day , with elevation of the arm till    possible .   In case it is large size , I would strongly recommend to consult your PCP   to  get medications in form of antibiotics and anti inflammatory agents    which will -- prevent secondary infection                   -- help early resolution of current lump                  -- take care of pain component Hope this clears your query .Always feel welcome to ask further questions .Wishing fine recovery from the same .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Delayed periods, pregnancy tests negative. Chances of pregnancy?\n\nHi so I had my period on august 27th and then again on september 13th which is not normal since my cycles are usually about 28 days. So I figured my next period would be due the 11th this month but still haven t gotten it. I ve taken a few pregnancy tests and they are all negative. Could I still be pregnant and should I go to my doctor for bloodwork? Just kind of freaking out and want answers, sick of waiting.",
    "doctor_response": "Hello Periods can be early or delayed sometimes. If so, it is difficult to determine when the next one will be. Do get a pregnancy test done to alleviate your concern. You can just do a home pregnancy test, which is also quite accurate, if you do not want to go to the doctor. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of pulsations in the temple?\n\ni can feel a vein pulsate on the left side of my temple...it hurts..it hurts even more when i stand up..or look at my computer..i also wear glasses..but not all the time..only when i play video games because their to fragile to wear anywhere else..what does that mean? i did not know which specialty to choose.",
    "doctor_response": "Hi,Regarding your concern, you should know that your symptoms could be related to compression of the temporal artery from your glasses. Anyway, I would recommend performing inflammation tests (complete blood count, PCR, sedimentation rate) to exclude temporal arteritis which could mimic some of your symptoms. But if the above tests result normal, you should try to wear another pair of glasses, maybe more large, to avoid pressure on the temporal region. Hope to have been helpful. Let me know if I can assist you further. Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes basophilia and leucocytopenia?\n\nI have Grade III piles. Today i had my blood checkup and found that my plate counts is somewhere 87.1 and suffering from basophilia and leucotopenia. What does that indicate? I often bleed once or twice a week. It is due to piles or something else?? plz answer. Am very much worried",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Your basophilia and leucocytopenia has no relation with your piles.Leucocytopenia and thromocytopenia is common in viral infection or malarial infection. If you have any symptoms of fever then take treatment of that. Ohterwise no need to worry. Just go for repeat blood count.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which antibiotics helps with low fever in children?\n\ndear doctor, my son is 18 months old.he had runny nose since 2 days.today he started having low grade fever 99.5 degree farenht with lot of runny nose & throat irritation.shall i give him any antibiotics.by the way,a week ago my 6 yr old daughter had viral fever  &she is recoverng from that.pls suggest.",
    "doctor_response": "Hi.... by what you Quote I feel that your kid is having a viral fever. This does not require antibiotics. Usually when viral fever starts it will be there for 4 or 5 days. Unless the kid i's having fast breathing or fits or seizures or bleeding manifestations or Rash over the body you need not worry about fever. What is more important is the activity of the kid when the fever comes down. If the kid is active and playing around when there is no fever it is Viral illness. You need not use antibiotics for this.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore throat when diagnosed with mononucleosis?\n\nmy daughter has been diagnosised with mono.  She started with a very sore throat which lead to the discovery.  She has missed over a week of school currently.  She went yesterday and is now home again with congestion, sneezing, coughing and the sore throat again.  Do I take her back to be seen???",
    "doctor_response": "Hello!I have been through your question. Related your concern I think that your daughter recently could have a viral situation( flu) not related with EBV.I suggest to meet a doctor if your daughter has these symptoms more than 3-4 days and high fever in order to control for complications. During this time your daughter can use hot tea, a lot of water, antiflu combination drugs and antitussive.I hope my answer helps you.I wish your daughter a quick recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is P2X(PPX) treatment safe during pregnancy?\n\nhi, I am 1 month pregnant and have been taking P2X (PPX) treatment for face (1 session near the day suspected to be pregnant). Is there any effect to baby? Can I continue using skin care products which include hydraulic acid, citric acid. Is bird nest good for pregnancy as it s rich of amino acid.? Tks very much",
    "doctor_response": "HI,   I understand your query.   Bioskin facial treatment by PPx is just a local treatment of skin by pressure application. It's a painless procedure, without any local or oral chemicals. So it is asfe in pregnancy. BUT.. Pregnancy hormones tend to increase crops of acne  .. so your treatment might be without effect.You can ask the treatment giver person about this, & the continue with your sittings.   Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. l got a sore hard lump after the removal of wisdom tooth. Is it normal?\n\nHello doctor,I just got one side of my wisdom teeth removed both upper and lower six days ago, and I have another one scheduled after two days for the left side. The upper is 100 % fine, which they pulled. The lower they pulled the tooth without removing the root because it was too close to the nerve. I do have some stitching in this area currently on the lower cheek. Noticed a hard lump about 1 inch between my lower jawline and cheek area. Is this normal because of swelling or something else. Currently taking Amoxicillin 500 mg and Ibuprofen 600 mg. Please let me know what this hard lump is, also generally on the lower side where this lump is, remains sore.",
    "doctor_response": "Hello. The lump is mostly a hard swelling which forms postsurgical removal of the wisdom tooth or maybe even by swollen lymph nodes due to infection. It takes a week or two for the swelling to subside. Sometimes, if the root is still inside, the infection may be remaining there causing swelling. Get an X-ray done to find out the exact problem and stronger antibiotics like Augmentin (Amoxicillin and Clavulanic acid) along with a painkiller for a week. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain with TB symptoms\n\nmy father suffring from lower back pain some tb symptoms in lower back bone dr. says will doing surrgery",
    "doctor_response": "hello milind. back pain can be of different causes.. before saying anything i need ur MRI report if u have and the nature of work and the pain profile... all the back pain does nt need surgery.. mail me detail sidharthphysio15@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms and treatment for mycobacterium kansasii infection?\n\nHi there, my husband has been diagnosed with severe COPD at least 18 years ago.  He saw his Respiratologist today for a sputum result and was informed that he has a mycobacterium kansasii infection.   The specialist is referring him to a TB clinic.  I would like to find out more about this infection as the specialist said that it was very serious.   Can you provide me with information? Many thanks",
    "doctor_response": "Hi,    I have read your query and understand your concern. Mycobacterium kansasii infection is quite similar to TB or tuberculosis caused by mycobacterium tuberculosis. Their symptoms are also quite similar. Patient infected with Mycobacterium kansasii develops symptoms like cough and coughing up sputum. Some people develop blood tinged sputum. Few people have weight loss and find it difficult to breath.Some other symptoms are fever and sweating at night.        It tends to infect people with previous damaged lungs due to other conditions like COPD, TB, bronchiectasis, etc. It can also infect people with weak immune system like in HIV/AIDS. Your doctor might have told its dangerous as it can spread to brain causing meningitis as well.        But you need not worry so much. Mycobacterium kansasii can respond well to combined drug treatment of rifampicin, ethambutol and isoniazid. If its resistant to rifampicin, then other drugs are used.         As your doctor has referred your husband to TB clinic, they will take care of all his tests and drug treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the natural remedy for gastric problem?\n\nDear Sir, My name is Panakj Shah. My age is 61years. As such i am enjoying good health. I am walking daily  for 4o minutes (brisk waliking). Morning I do yoga and meditation.  I have storng gasrtric problem. After eating I start geting gas in my stomch and some times i get pain in chest. My main problem is I am geting trmor in my right hand thumb and  first finger. I do not know how to slove this. Kindly help me. I would prefer if possible natural products and excerise. Regards P.V.Shah",
    "doctor_response": "Dear pankaj,i conclude you got digestion problem.take food in regular interval,don't take heavy food in night.go to bed after  2 hrs time of dinner.I will advise you take steamed food and leafy vegetables and fruits.avoid fast food,junk ,fried items and caffeinated drinks.Medication:Tablet- Abana- 2 tablet- thrice  a day.You already doing yoga.no need for exercise.regarding your tremor in right thumb and index finger:tremor it can be physiological or degenerative cause to the localized nerve.may associated with Brian component defect or any systemic involvement.associated symptoms  to be ruled out.consult a neurologist and get aopinion.Hope I answered your query.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high blood pressure and dizziness\n\nmy wife is age 54 today she had a episode of passing out at work she felt a rwinge in her right shoulder area and her arms became heavy eyes rolled back in her head they checked her blood pressure it was extremely high she don y remember how high they sent her to the dr. they are sending her on fri 02/19 for stress test echo test ho her monitor mri but i just took her blood pressure and it was 150/100 should i take her to a hospital now or do you think she can wait safely ?",
    "doctor_response": "Hello, I would explain that her symptoms could be related to an epilepsy seizure. For this reason, I would recommend going to the ER For a physical exam, a brain CT scan and an EEG. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Delayed periods.  History of being off birth control, had protected sex.  Possible pregnancy?\n\nHello yes i have had protected sex with my boyfriend which he never ejaculated the whole time we just had sex and that was on september 9th i normally have my periods on the 21st to 22nd of each month and it is now October 1st and still no period should i be worried? I am 24 and have had messed up periods before but i was on birth control and fixed it but i got off birthcontrol four years ago but i still made him use a condom so should i be worried?",
    "doctor_response": "Hello,Thanks for posting,There is actually no need to get worried as you practiced protected sex and he did not even ejaculate. I do not see how you can get pregnant (if your description is correct). Stress alone and change lifestyle can cause missed period. Your period will definitely be back before you know it and if it persist (i.e you not seeing your period) after 1-2 weeks from now, it is best you see a gynobs for further investigation. Pregnancy will always be ruled out in any sexually active reproductive woman with a missed period and you are an idle candidate (as one never knows). Just stay calm and continue your daily activities. If pregnancy is not the cause as I suspect, you will be fine.Hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tremors and numbness in legs?\n\nWhen I get up too fast and start walking I get leg tremors and feint feeling. I am diabetic type 2, had bypass 3 surgery 13 years ago. I am on meds for feet pain at night (amytriptyline). I have not discussed with my doctor yet but will soon on my next appointment. When I have these episodes, I stop and take deep breaths and in a short time I am o.k.",
    "doctor_response": "Hello. I have been through your question and understand your concern.Your symptoms seem to be related to orthostatic hypotension, which is a benign condition, caused by venous insufficiency. Uncontrolled diabetes can cause this by affecting vasa vasorum which are the vessels which supply the big vessels. Arteries and veins beside carrying blood, are also structures which need to be supplied by blood in order to stay healthy, which are carried out by this tiny vessels called vasa vasorum. Diabetes affects this tiny vessels causing sometimes orthostatic hypotension.So I recommend a endocrinological consult to check your glucose blood level and   the glycated hemoglobine level.Hope this helps, please feel free using MHC for further questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure shortness of breath while doing heavy duty work?\n\nWhen lifting heavy items or climbing stairs, I get short of breath. I am a 37 year old female. This started a year ago. At the onset of this problem, I had test ran on my heart and everything came back fine. The allergy doctor tested my lung function and everything was fine. What could be the problem?",
    "doctor_response": "Hello.Thank you for asking at HCM.Feeling short of breath with lifting heavy weight or climbing stairs may be due to many reasons.As your cardiac evaluation and lung function are normal, I would suggest you to get blood hemoglobin done. If it is low, you could take iron tablets along with folic acid & vitamin B12 tablets for a few months. Also if you are not accustomed to lifting heavy weights or climbing stairs since long and if you have started these activities recently, that may also be the cause. Even obesity/overweight may be the cause. In these cases, I would suggest you to consult a good physio trainer who will advice you regarding diet and exercise.Hope this will be helpful to you.Wish you best of the health.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump under the skin of pelvic area?\n\nI am a 32 year old male that has a gold ball size lump, or swelling under the skin on the right side of my pelvic area just above my penis.  It does not hurt or even get irratated.  I have had it now for at least 7 or 8 months.  Not quit sure what this would be?",
    "doctor_response": "Hi. Great noting.If the is fixed to the skin , it can be a Sebaceous Cyst. If it is free it can be a lipoma.. Both are benign swellings and to worry about. Somehow I have a feeling that whatever is no of the body should be removed and subjected to the histology. This helps in two ways. You disease goes away and you are sure about what is was.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat hair fall and dandruff?\n\nHello doctor I am suffering hairfall and dandruff 12 yr i had taken many tipe treatment like homiopathick and medicine but my hairfall and dandruf is nt stoping.resently i was taking tretment for one doctor bt no result.please advise me i am using shampoo daily (8x shampoo) can i use daily this ahampoo .",
    "doctor_response": "Hi,You seem to have seborrheic dermatitis on scalp...also called dandruff. There may be whitish flakes on the scalp. Itching may be there. Hair fall may be increased.Anxiety,stress and tension might exacerbate the disease. Pityrosporon ovale may be resposible for the disease.You consult dermatologist for firm diagnosis and treatment.Mild steroid lotion with salicylic acid may be applied at night. And cleanse the scalp with ketoconazole containing shampoo. You dilute the shampoo in water and then rinse the scalp. You may do daily at bath.Orally,you may take antifungal like ketoconazole daily in morning for few weeks. Steroid may be taken in tappering dose. If there is itching,take antihistaminics.Control of dandruff might reduce hair fall. Biotin 10 mg tab may be taken daily for long time to have good hair growth. I hope you got my answer.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever\n\nHI DOC, From the past few weeks i have been facing fever like symptoms. Something more like dry lips,feels hot sensation inside my mouth,sometimes i feels burning up sensation on my neck and forehead part,even increase in the saliva on the tongue. so my question what could be the reason of this?",
    "doctor_response": "dear, all these symptoms are due to dehydration & weakness. For the betterment you should keep yourself hydrated & take proper rest. You will get alright soon. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Famnynor be taken as an emergency contraceptive pill?\n\nGood evening trust you doing well . I would like to ask , my friend went to the clinic to get the morning after pill however they gave her 4 tablets to take , 2 immediately and then 2 after 12 hours .The name of the tablets is called Famnynor and marked as emergency contaceptives , however after googling it we saw that  it was a oral contraceptive so we a bit confused as to why they would give her that ? Please help !",
    "doctor_response": "Hi, famnynor can be taken as a emergency pill also. It is generally a oral contraceptive but in high doses, it can be used as emergency contraceptive also. Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am losing sexual efficiency as I am aging. Please help.\n\nHi doctor, I am 65 years old. I am having an active sex life. Nowadays, I am slowly losing efficiency. I am requesting you to advise some medicine to prolong my sexual act. Thank you.",
    "doctor_response": "Hi. I read your query and understood your concerns.\u00a0Before we can make any conclusions, I request you to provide the following details. So, an impression can be made about the cause and solutions of the problem. Revert back with the answers to the above questions to a sexologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does ALT level 42 suggest?\n\nIs an alt test of 42 bad?  I was on prescription medicine that affects the liver and was instructed to go off of it now.  Is that enough to bring it down to below 40? I am 28 years old.  I am 5'4\", 160 lbs.  I do drink once or twice a week as well.  I have never really had any health concerns.  I recently have changed my diet (joined weight watchers) and have started exercising.",
    "doctor_response": "thank you posting query at HCM.history of drug induced liver injury.ALT 42 is very mild hepatitis. Nothing to worry.usually takes 6to8 weeks or more to return to normal if strictly followed advice.is hep A, B C viral serology Negative??do a lipid profile test and and an \"abdominal ultrasound\".if all above results negative thenadvice:abstinence from \"Alcohol and drugs\" - LOW fat diet should be followed- NO red meat- vegetables should be ingested daily- Moreover, less activity should be carried out (no sports). - use lemon juice (lemonade) once in a day- walk 30 to 40 minutes everyday.- or swimming is alternative to walking- NO sports and NO jogging-\"recheck liver enzymes after 6 to 8 weeks\".wish you good health.further queries are welcomed.Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health.regards,Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does taking Rifampin reduces the effect of I-pill?\n\ndear Sir / ma am, I had sex sometime on 25 august and it was not unprotected. My partner used a condom. I took an ipill the next day.....but the cause of worry is that I am on tuberculosis medication for the past 7 months and I read earlier that the drug rifampin reduces the effect of the ipill. I even read that the dosage needs to be doubled so I took another ipill the next day. I am quite anxious? Is there a cause for worry....would there be a minute chance that I could be pregant? Kindly do get back to me as soon as possible. Thanks and regards",
    "doctor_response": "Hello,I have gone through your query and understood  the concern. It is true that Rifampicin reduces the contraceptive effect of hormonal contraceptives. If you had the intercourse during your safe period or non-ovulation period, you are naturally protected. Please note that ovulation occurs two weeks prior to the onset of the next period and this is the fertile period of the cycle. You have also had double protection and hence need not worry about failure. The excess hormone content in the pills can induce withdrawal bleeding and delay the next natural cycle by a week or two. Please see the specialist if you become overdue by ten days. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bleeding from wound with swelling?\n\ni stepped on a tooth pick 2 weeks ago and went to E.R and there they cut my foot open ...only a small part and checked and found nothing was there but after a few days it hurt again and again i was cut open and nothing was found. This happened once more and yesterday the nurse told me the wound was dry and removed the dressing but later that night a bit of blood came out of the wound so i cleaned it and but some antibiotic cream ...some swelling is there .....what should i do?",
    "doctor_response": "Hello,Welcome to healthcaremagic.The problem you are facing is most probably due to infected wound which needs oral antibiotic as well as  antiseptic cream to fully cure the wound. Otherwise it will keep bleeding and after a while pus discharge might even start from the site.With medication it is also important that you keep the foot clean and dry and avoid closed shoes for a few days so that your foot is well ventilated. Clean the wound daily with iodine solution and have a clean fresh dressing one to 2 times daily. And once the wound has become dry then you can skip dressing the wound . Then just wash multiple times during the day.Hopefully the wound will recover. I hope the answer was helpful. In case of further assistance feel free to contact us in writing .Regards.Dr Talal Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes freqent urination?\n\nI have a seven week old son who seems to be urinating very frequently, 1-2x per hour. It seems to have just started being this frequent over the last week. What is normal for this age? He is eating about 4 oz. every 3 hours. He also cries immediately upon urinating, even waking from sleep during naps. Should I be concerned about urinary tract infection. Thought this was rare in boys. We did have some complications with the circumcision - excessive bleeding that had to be cauterized.",
    "doctor_response": "Looks like Tract injury during cautery.Visit a doctor if there is flow seems irregular or stream appears thin.UTI remains a possibility, get tested for same.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for blood clots in brain\n\nSir,My father has blood clot in brain he is about 61 years old . he is suffering  with paining with hand and leg and when he is speaking some what different than before. please suggest us , i cant spend more money, Please give your suggestion to survive him.Even though last doctor  can cure with medicine. How much correct i dont know.Iam very serious particular about that",
    "doctor_response": "Hi,Thank you for posting your query.Based on description, it seems to be a brain stroke. We need to continue physiotherapy to improve his chances of recovery.Medications are needed to prevent stroke, such as aspirin and statins.For pain relief, we may use pregabalin capsules.Best wishes,Dr Sudhir Kumar MD DM (Neurology)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes on and off fever, headache and pale skin?\n\nmy 4 year old has been running a fever for 2 weeks now off and on about 102 degrees. A couple days he complained of headache. He seems a little pale to me, more than usual. But he is still acting like himeself. No ear or throat pain. His ears get bright red and he lays around when the fever hits. Thought it was a virus mabey running it s course, but getting worried thinking i should take him to pediatrian. What are your thoughts?",
    "doctor_response": "HiViral fevers are usually self limiting and subside within a week or two. Since it's fever of more than 2 weeks duration along with headache and pallor, I would recommend you to visit a pediatrician for complete clinical examination and laboratory investigations.Investigations such as complete blood counts with differential, peripheral smear for malarial parasite, WIDAL, Dengue test, urine examination, chest x ray and abdominal ultrasound may help for investigation if there are no specific localising signs. Treatment will depend upon the clinical examination and lab reports.Hopefully this will help you. I would be happy to help you in any further questions.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can high dose of Ashwagandha cause problem in super sensitive individuals?\n\nHello doctor, I have been interested in the herb Ashwagandha for a long time. I am a 42-year-old woman, slightly overweight, moderately active and have anxiety, depression, and fatigue. I took Ashwagandha for a month when I was off Prozac and it seemed to help with my anxiety. When I upped my dose, I started getting bad stomach pain, got worried, and stopped. I have heard that those taking SSRIs and Benzodiazepines, like I am, should not take Ashwagandha. That it can cause serotonin syndrome and/or make a Benzodiazepine user sleepy. I have also heard it can ramp up the body's immune response. That worries me a bit too as I am super sensitive. The more I am taking anything, whether it be vitamins, fish oil, etc, the worse I feel. I went to a naturopathic doctor who prescribed me a lot of supplements and I think my body tried to detox too fast or something because it caused me to get sick and shaky. She did not understand why. I just know that too much of anything can overwhelm my system. Your advice is much appreciated. I did a saliva test a few years ago that showed high cortisol in the evening and night.",
    "doctor_response": "Hi. As you mentioned, Ashwagandha has health benefits, especially in anxiety. If the herb root is available in raw powder form, then it could be 1 g or 1.5 g. If it is in the extract form, then the therapeutic dose must be 200 to 300 mg. More than that, it is going to cause gastric irritation, that leads to stomach pain in your case. So, the powder or extract in the therapeutic dosage could be consumed along with a cup of milk or honey and warm water to reduce gastric irritation. Honey is safer in gastritis than milk. The herb has been proven to interact with many other drugs, the interaction with SSRI (selective serotonin reuptake inhibitor) or Benzodiazepines are not proven scientifically. The news available in this regard in social media are not authentic. So, the herb can be combined with SSRI or Benzodiazepines. It is true that the herb boosts the immunity. But, no scientific research has proven it as a threaten herb in super sensitive patients. Much preclinical basic research has proven that this herb boosts the essential T- immunity cells and will not affect the sensitized immune cells. This is called as an immunomodulatory effect. This herb is popular for having immunomodulatory effect. In your case, this herb will not aggravate the immune sensitivity. So, you can continue to take Ashwagandha herb with honey and warm water or milk. For more information consult a naturopathy specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest measures to control chest pain\n\nI ma suffering from chest pains. I am a golfer and this sucks for my summer of mini events. I cracked my sternum as a kid and I'm 24 now. I'm gooing to the md tomorrow.  Everything I've read has k III MD's pointed in one direction. The pain is severe in one location, when touched.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. You are having chest pain with tenderness (pain on touching). This is characteristic feature of musculoskeletal pain. Being a golfer, you need to stretch your ribs and intercostal muscles for shots. This might have injured your ribs or pulled your muscle. So better to follow these steps for better symptomatic relief. 1. Avoid heavyweight lifting and strenuous exercise. If possible avoid playing long shorts for 1-2 weeks. 2. Avoid movements causing pain. 3. Avoid bad postures in sleep. 4. Start painkiller and muscle relaxant drugs. 5. Apply warm water pad on affected areas. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for multiple matted erythema\n\nhello sir, best regards. im a medical student in bangladesh of final year. my brother had a prblem right now. he has multiple matted erythema specially on chest with sever pruritus. i prefered him  Fexofenadine, but improvement is not significant. should i use Imidazoles & topical steroids. pls , help me, sir. i can't able my seniors right now. thank u, sir",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Multiple matted arrhythmia with pruritus can be due to urticaria (skin allergy). And in my opinion, it is better to give combination of anti allergic (montelukast) and anti histamine (fexofenadine) instead of plain fexofenadine. You can also apply steroid cream (mometasone). In severe cases, oral steroids (prednisone) is also advisable. If he still feels itching then consult dermatologist and get done clinical examination and skin Biopsy for confirmation. Hope I have solved your query. I will be happy to help you further. Wishing good health to your brother. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pelvic area pain, foul odor in urine, faded yellow colour. What could the cause be?\n\nI have had pain in my pelvic area starting on the left side and going across the front of my body to my right side.I have not had this kind of pain before.  I do know around this time I also had urine with a foul odor and my urine looks like a faded or dull yellow colour.  I also have pain on my right side above my leg in my abdominal area.What can this be?",
    "doctor_response": "Hi, Pelvic pain can be caused by pelvic organs including the intestines,urinary tract and in females the uterus and the ovaries.In your case since the pain is associated with urinary problems also ,the chances of involvement of the urinary tract is high.Pathologically it can be a stone ,infection or both.In your case it seems to be both considering the nature of the pain and the foul odour of the urine.Further investigations are required including blood counts,urine for RBC s and pus cells,Urine culture and sensitivity and USG abdomen.In the meanwhile you can take plenty of oral fluids along with antispasmodics and broad spectrum antibiotics.Wish you a speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathlessness and lump on uvula?\n\nMy girlfriend's been suffering from random breathing difficulties recently over the last week or so. She can be sitting comfortably watching TV when all of a sudden she feels like there's no air and her throat is closing up. I had a look into her throat to see if there is anything unusual and noticed a small lump on the side of the uvula. Is that anything to worry about at all?",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query.As the clinical situation in your case needs to be examined physically by an ENT specialist, I would advise you for consulting an ENT specialist for a definitive diagnosis and appropriate management. Thanks for contacting Heatlh care magic for clearing  the doubts on health. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest pain revilers post knee replacement\n\nHad full knee replacement 4 weeks ago. Cant sleep night through, getting up 3 to 4 times with burning stinging pain. On arising in a.m., leh is stiff as a board. Going to phys therapy 3 times a week. Still icing alot. Anything to alleviate burning stinging pain beside pain pills, which take every 12 hours with 1 tylenol. Pain pill is dilaudid, take 2 with the tylenol.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The location and movement of a pain gives clues as to what is going on, also the type. There could be inflammation. this could be from infection and that would be bad, but nearly always it seems infected if this occurs with fever, chills, shakes, sweats, and the area is HOT. Or it can be inflammation in which case naproxen is generally good. The burning can also be due to a nerve inflammation in which case, nerve pills such as anti=epileptics can be helpful. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for snoring,bad breath and shortness of breath\n\nDear Doctor, I am the mother of a two year old girl with multiple food allergies, causing severe skin rashes and itching. We were doing ok with the management of this but recently she has been very disrupted in the night, every hour or so. She snores heavily, her nose appears either blocked or runny, she breathes through her mouth, her breath smells fishy and more morrying, we watched her last night and every now and again she seems to stop breathing. Any advice would be greatly appreciated, she has been through so much, she is also being seen for GI issues. She is of normal development and otherwise thriving. Thank you very much for your assistance. Anna",
    "doctor_response": "Hello, Sleep problems with snores and apnea are suggesting her airways are blocked constantly. Immediate consultation with lung pediatrician is highly recommended plus ENT doctor to check for nasal polyps. She needs steroid nasal spray to open airways.Apply vapour rub on her chest and upper back at bedtime.Apply nasal decongestant.Give allergy syrup containing thyme. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Albana Sejdini, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can intrusive thoughts be controlled?\n\nI am trying avoid some intrusive thoughts. those thoughts come to my mind every day every moment. at first i even cant ignore those thoughts. but after a couple of months I can ignore those thoughts(i saw in some page, i think most likely it is an ocd issue). now a days i m worrying about how will i confess those thoughts to the others. this is my recent issue that come to my mind every time. and therefore i cant concentrate in my life. i have thousands of those dirty thoughts.And the more i think about them the more they comes to my mind. what should i do ??? i will be very thankful if you help me in this regard.",
    "doctor_response": "you need to relax yourself by doing relaxation therapy along with this do exposure and prevention response...also take capsule fluoxetine 20mgs after lunch for 6bdays and then increase to 40mgs",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a painful lump under the armpit indicate?\n\nI have recently discovered a little lump under my armpit and it hurts to the touch, its not hard on the surface its more like a pimple but when i press it it gets hard it hurts when i move my arm I dont know what is it Im gonna get it checked tomorrow I am so worried though",
    "doctor_response": "Respected user , HiWelcome to Healthcaremagic.comI have gone through your concern in depth .*  This seems inflammatory condition involving subcutaneous space may be    sebaceous cyst , boil or else .*  Need  clinical confirmation with examination or evaluation with high    resolution photo pic as an attachment .Hope this will help you for sure .Wishing you fine recovery from the same .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for child having bruise in corners of eyes\n\nHi my 16 month old boy fell into our coffee table and bruised between his eyes. It swelled very fast and very big it has been 4 hours ago and it is still very swollen. Now the bruise is going into the corners of his eyes. I have applied ice in a rag to it but the swelling will not go down. What should i do? Do you think he broke his nose or something?",
    "doctor_response": "Hi.... by what you say it looks like a hematoma which is spreading. But as it is spreading very fast I suggest you take him to the nearest Emergency Room and get him evaluated. If it had stopped spreading I would not have suggested this, but I insist that you take him to physician's evaluation.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can betnesol be given to a child suffering from prolonged cough?\n\nhello dr. good morning......my baby is 5.5 months old and he is having prolonged cough.....my paedriatic has given hom anti biotics but it doesn;t give the results...now my dr. has advised me to go for t3-t4 test and blood test...is that essential.....betnesol is also given..can we give this corticosteroid at this age???will it not harm my baby???thanx a tonn for ur opinoin...",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query your child have symptoms of prolonged cough which is due to upper respiratory tract infection leading to bronchitis/ granular pharyngitis. Need not to worry. I would suggest you to do warm saline gargles and take steam twice a day. You can give betnesol to your child. Avoid use of sharp and spicy food substances. Avoid cold carbonated beverages. Your symptoms will resolve in 1 week. if symptoms keeps on persisting you should consult pediatrician once and take proper treatment. You should get X-ray chest done along with pulmonary function tests. Doctor may prescribe antibiotics ( amoxicillin or penicillin ) at least for 5 days along with decongestant.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My HbA1c level was 7. 5 last month. Should I continue Gemer 1 tablet?\n\nHi doctor, Last month, my HbA1C was 7.5. I was advised to take Gemer 1 tablet before breakfast for 30 days. My LDL cholesterol is 119 mg/dL, HDL is 40mg/dL and triglycerides 161 mg/dL. My age is 49. Should I continue Gemer 1 along with other medicines? Kindly suggest.",
    "doctor_response": "Hi. C-peptide, renal function test, liver function test, serum electrolyte and complete blood picture. Diabetes mellitus. Hypoglycemic drugs with euglycemic drugs (to maintain normal blood sugar). Diet and exercise. Revert back for further information to an internal medicine physician online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdomen pain, stomach bloated, kidney infection. What should be done?\n\nHI I have pain (dull) in the lower right side of my abdomen and lower right side of back. Stomach is bloated also and I have slight discomfort when I pass urine . I have had kidney infections in the past so know it is not this. These pains have been coming and going for quite some time now. Sometimes I also feel discomfort under my right ribs - as if there something there. Any ideas?",
    "doctor_response": "HelloThanks for writing to HCMYou need proper evaluation for abdominal pain.It includes proper history taking, clinical examination and investigations like routine hemogram, Urine RE/ME.Ultrasound of abdomen should also be done. It can detect many pathologies.For bloated abdomen you can take pantoprazole right now.Take plenty of liquids.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My sister got her periods in 15 days. Could it be due to her thyroiditis?\n\nHello doctor, This question is regarding my sister. She is 33 years old. She is a mother of 6 year old twins. Two months ago, she was diagnosed with thyroiditis. From\u00a0the last month, she gets her periods, once every 15 days. Kindly tell me the probable reason and the course of action to be taken.",
    "doctor_response": "Hello. Revert with more information to an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause chest pain and dizziness?\n\nHi i am a 37 year old female and have had some chest pain that goes into my back and little waves of dizziness....i do workout 5 days a week and was doing some things with chest muscles yesterday...could that be why my chest was hurting?  I feel better today.",
    "doctor_response": "Hello. Welcome to HCM and thank you for your question. I understand your concern. Pain in the chest can have different origins, which include also the locomotion system, i.e. muscles, joints and ribs. Now, every time we work out, even if we do not include the between rib (intercostal) muscles, suffices that we have heavy breathing and this can cause intercostal muscle soreness, which is mostly reflected as pain. If you try to cough, and you get the pain, then it is probably this diagnosis. As all other episodes with muscle soreness, no special treatment is required, as it goes away in few days. According to your age, my opinion is that cardiac and pulmonary origin of this pain is less likely. However, just to be secure and \"in the safe\", I would recommend you to do an EKG, as there sometimes are inflammations of cardiac lining (pericardium) which do not have an age predilection and can happen in all ages, especially after an episode with flu or other forms of infection. Just to be clear, my suspicion that this is the case is very low, but I recommended the EKG to securely exclude this as an origin of your pain. As about the waves of dizziness, I would be more comfortable answering this question if I had more details, because dizziness is a symptoms that may have various origins. It probably is, in this case, from over loading of physical activity and, in this case, no further examination is required. I would recommend you to take two to three days off from working out, and see if these bouts of dizziness happen again. I hope this helps. Take care. Best regards, Dr. Meriton",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for abdominal pain\n\nMy girlfriend has been having a pain in her upper abdomen for about 5 hours now, and it's a pain that keeps coming, and when it comes it hurts to the point where she's crying, and then it leaves and lightly hurts. I'm not sure what to do, or what it is. PLEASE HELP",
    "doctor_response": "Hi,It seems that she might be having abdominal colic giving this problem.Give her antispasmodic medicine like Colimax or meftal spas.Avoid constipation if she has.Ask her to take plenty of water.Give her light diet.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes green color loose motions?\n\nMy baby is 7months old n abt to be 8th in 3days. Since 3days he is suffeding from cough n cold. Since last two days he has loose stool n sice yesterday he is passing green color stool. What is d reason of green stool. And he has started teething process. Can this cause loose stool.",
    "doctor_response": "These are all symptoms of a viral infection with involvement of the nose and throat on the one hand, and the intestines on the other. No antibiotics should be used. Teething can cause a day or two of greenish loose stools without any foul smell, mucus or blood. Dr. Taher",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should I do for frequent attacks of cold and cough which will remain until two weeks?\n\nAs soon as I am caught by cold I also start coughing. And the cough remains for 2 weeks untill I start taking some cough syrup.  Is it normal? I can not take cold drinks or ice cream as I am afraid of cough. A little amount of cold drink leads to cold and then cough.Please suggest what should I do.",
    "doctor_response": "Hi...you seem to have allergic rhinitis... allergic to sudden change in temperature... avoid all the things that trigger it...take combination of levocetrizine and montelukast initially morning and before goingvto bed thn slowly you can make it once daily after two or three weeks depending upon the response...Dr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "My 10 yrs son was in the hosp for ADHD and depression issues\n\n.My 10 yo son was in the hosp for ADHD and depression issues while there they did a short neurological work up on him and the Dr herself called me with the results being she was concerned she wants a full workup done on an outpatient basis. She said he has some hypotonia (sp?),he is unable to identify palm sensations with his eyes closed, clumsiness and his eyes were tracking the wrong way when like up and down rather than left or right. what kind of possibilities am I looking at? where as his cognitive abilites are not an issue",
    "doctor_response": "what exactly it is it will be apparent only after full neurological work up. in ADHD there will be some amount of cognitive impairment, given he has depression also.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On and off lower abdominal pain and painful gas. Recommend\n\nI am a 28 yr old female.i have been suffering with lower abdominal pain on and off for a long time.it also causes pain through my bum.it is sometimes hard to sit up straight due to pain.and bowel movement gives a sharp pain from abdomen through my bum.intercourse usually triggers it off.but sometimes it starts from nothing.i also get painfull gas that usually lasts for 3 days at a time and is very uncomfortable",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for calling H.C.M.Forum. You are 28 years, female, been suffering from lower abdominal pain, pain through the bum, it is hard to sit straight, bowel movement and intercourse triggers the pain. It appears to be the urinary tract infection, or stone in the urinary bladder, or may be pelvic inflammatory disease. i advise you to consult an urologist for diagnosis and treatment. You may need to have M.R.I.besides other routine tests for confirmation. Wishing for a quick and complete recovery. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for itchy lump near my nipple\n\nhello iam martin and iam worried for the last month on my right male breats on the right side of my nipple i got a lump wich comes and goes and it itches also the skin peels of and wen my nipple gos hard because of coldness the lump comes out to wot is it and wot should i do ?",
    "doctor_response": "HI,Dear,Thanks for the query regarding your daughter.I studied your query and understood your health concerns.Remedy-You seem to have acne/pimple of the Montgomery glands on right nipple.Treatment would be antibiotics / anti-inflammatory drugs for 5 days time.This would reduce completely with this treatment.Else show it to Surgeon who would treat it accordingly.So Don't worry and act fast as suggested.Welcome for any query to HCM and me in this regard.Have a Good Day.Dr.Savaskar M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "63 years, has fatigue, back pain and cough. X-ray shows pneumonia. Low hemoglobin. Suggestions?\n\n63 year old patient complaining of fatigue and shortness of breath, upper back pain and cough that has become productive the last 2 days. a chest Xray revealed pneumonia . rbc count is decrease, hemoglobin: decrease, wbc: normal, ESR: increased. Serum IgG is increased and both IgM and IgA are decreased. what is likely the diagnosis?",
    "doctor_response": "Hi and thanks for the question, The symptoms are very compatible with pneumonia. Shortness of breath, raised ESR and chest X ray findings. Hope an appropriate antibiotherapy has been prescribed. How ever, the low Hemoglobin levels have to be investigated. Low hemoglobin levels could be caused by the infection, but if very low, other causes should be considered. Other tests could be quite helpful in doing this assessment. Serum IgG is an indication that the infection is chronic, But IgG measurements are however very non specific and we cannot be conclusive. Knowing exactly for how long she has been coughing is too important. A chronic cough might warrant sputum exams and a tuberculin skin test to be be done to exclude pulmonary tuberculosis. The back pain might require a spinal x ray, ESR, alkaline phosphatse levels, Complete blood count, serum electrolytes to exclude any bone malignancy. I suggest visiting an internist with these ideas in mind could help min a proper reevaluation and management of your patient. Thanks and hope this helps, Luchuo, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful lump in upper back?\n\nHi, I currently have a series of health problems, which includes high and low blood pressure, spastic esophogus, fever, constipation, fibromalgia, raynauds phenomena, depression, anxiety. I have aslo noticed huge lumps in my upper back which hurts a lot.  Can you tell me anything about the lumps?",
    "doctor_response": "hi dear thanks for the query on HCMyou need to get the swelling examined by a surgeon who will suggest a fnac of the swelling following a ultrasound of the swelling.based on the result will suggest a treatmentswelling could be lipoma, epidermoid cyst, abscess, neurofibroma.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i conceive as i have hypothyroidism and bulky uterus?\n\nHello, I am a 34 yr old women with 2 children, 5 and 3. I was diagnosed with PCOS 6 years ago when trying for 2 yrs to fall pregnent with my 5yr old. Fortunately i was able to fall pregnent with no medical assistance. and again after about 8 months of trying with my 3 yrs old. i have been trying for  the past 12 months to fall pregnant again with no luck. I have Hypothyroidism and taking 10o micrograms daily since i was about 12yrs old. i have been taking my temp and checking the position of my cervix as i find it very difficult to know when im ovulating. i have very painful cramps around when i think im ovulating, but often not backed up with egg white mucous. my periods have been regular 28 day cycles since my 3 year old was born, up until the past 3 months, which have started to be out by a 4-7 days late. this month i didnt get my period for 48 days. i had had intercouse a week before i got period on day 41 and had severe pain to the point i was going to go to the hospital. it did subside the next day after taking some pain killers. i saw my GP who sent me for an ultrasound. the results were: uterus is in anteverted position with bulky appearance, measuring 95cc. Myometrium is heterogeneous. Endometrium appears unremarkable, measuring 12mm. Right ovary, there is a 1.8 x 1.7cm thick walled hypoechoic structure with internal echoes. no abnormal vascularity demonstrated. left ovary appears in remarkable, measuring 7cc, right ovary measures 12cc. I have had all the usual blood test, hcg, prolactin, progesterone, testosterone, thyroid, shg. all have come back within normal range. I am unsure what this all means. Will this make it harder for me to fall pregnant? should i even try? would this cause complications if i was to fall pregnant? Regards Lisa",
    "doctor_response": "Hi there, I have understood your concern . I will suggest you the best possible treatment options. First of all do not panic. Please consider that you have already been able to get pregnant twice.  Please keep taking your thyroid treatment meticulously, monitor TSH levels every 3 months. For your PCOS, I will suggest you to opt for a healthy diet and regular exercise regimen. Try to have optimum weight,  with vody mass index od 23. Avoid deep fried foods, bakery products and refined sugars. Avoid substance abuse if any. Start on Folic acid, Vitamin B 12 and Omega 3 supplements at least 3 months before you plan to get pregnant. This helps to prevent many problems during pregnancy and delivery. As your remaining reports are normal , you need not worry about getting pregnant. You can simply get USG done for follicle study, to know the day of ovulation. accordingly you can have unprotected sex act, or IUI on the day of ovulation. I hope this answer helps you. Thanks. Dr. Purushottam Neurgaonkar .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why have I missed my period ene though my pregnancy test shows negative ?\n\nhi i had a period on december 26th 2010 and its now febuary 2nd 2011, i had no period since, i have stomach cramps headache feel mega sick and tired i had loweback pain and weird cravings for foods,i done a test to day and its negative as usual. i dont use any birth control and i had problems in the past with irreglar periods but for last 6 months my periods been normal 5 days, but has been light browny colour for a long time",
    "doctor_response": "i adivce you to visit a doctor.. they a can guide you on a regular dose of medicines. there are also many ayurvedic medicines available in the market as well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can we manage constipation and anal fissure?\n\nHi doctor, My mother is 48 years old. She is suffering from constipation with an anterior anal fissure for the past 10 years. Her TSH value is 7.01 mIU/L. She is taking two tablets of Bisacodyl BP 5 mg during night time every day. Now, I would like to know any suggestion from your side.",
    "doctor_response": "Hi. The anal fissure can be painful, and it can lead to constipation. The USG (ultrasonography) abdomen scan should be done to rule out any organic cause if present. A stool softener like Cremaffin syrup (Liquid paraffin with Magnesium hydroxide) can be prescribed. As the fissure is present for a long time, she needs surgical management. For proctoscopy examination and operative management, you have to consult a surgeon. For more information consult a general practitioner online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in the shoulder and knee\n\nFor a couple months now I have had pain in my shoulders, knees, ankles, and a little bit in my hips. The worst is in my shoulders. Some days its hard to lift my arms above my head. When I m really tired, I get this weird almost a tickle like sensations that go from my shoulder to my hands. Its not a good tickle tho. I am 44 years old.",
    "doctor_response": "Hi, I value your concern regarding the symptoms. I have gone through your symptoms, and in my opinion pain in multiple joints need evaluation in term of stiffness of these joints in morning, duration of symptoms, and some blood tests CBC, ESR, CRP. the involvement seems most likely to be inflammatory arthritisHope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.Special note-  Any medication prescribed needs to be taken after consultation with your personal doctor only.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in the leg of a 3 year old?\n\nMy 3 year old son has been complaining off leg pain at night specific to his right leg on and off for the last few months. We brought him to the hospital and he has been referred to an endocrinologist and an orthopaedic dept although we were told in A&E they coudln t identify any specific problem at the time. The appointments are not for a couple of months and in the past week he has started to have nose bleeds, Should I be concerned and if so why?",
    "doctor_response": "Hi, I don't think that nose bleed has any relation to leg pain. Nose bleed can occur occasionally in children. Advice child to stop nose picking. It will help. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I twisted my knee and in pain with swelling. How to manage this?\n\nHi doctor,Two days ago I twisted my knee. It has been paining ever since. I can bend it all the way back, but when I try to put pressure on it or fully extend it, I am in so much pain. There is a swelling. It looks like my right knee cap is out more than the left one.",
    "doctor_response": "Hello. You have a history of knee injury two days back, but you have been able to ambulate after the injury, even though it is painful to you. Initial management is to give rest to the affected joint and try to limit pain and hemarthrosis. In my opinion, since it is a twisting injury, if at all, there may be some soft tissue injury, and usually no immediate intervention is required. You can do the following things : 1. Intensive ice packs for local application over the injured joint to keep pain and swelling to a bare minimum. 2. Knee Brace can be used to hold the knee in extension and restrict movements initially. 3. You can start with anti-inflammatory medication according to your body's suitability. 4. Local analgesic spray can also be used after ice therapy. We will wait for next two weeks till acute pain and swelling have subsided, after that a thorough examination of your knee joint is required to understand what exact injury is there and maybe a MRI scan will be required.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes body chills and sweating after taking Minocycline?\n\nI have a large blister around the side & bottom of my thumbnail bed. I went to the Doc & he drained it & sent a sample of the fluid off to be tested. He put me on Minocycline 100MG. I am now having chills & sweating. Should I go to ER? Email address YYYY@YYYY .",
    "doctor_response": "Hello,The symptoms seem to be related to the infection. I suggest to continue the medication as prescribed by your doctor. I also suggest to use anti-inflammatory medications such as Tylenol to treat the chills. If you have breathing difficulties you should see your doctor for further evaluation.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will Glycomet and Ovral-L help in getting pregnant?\n\nHello, am 26yr old female, 5ft5in tall, 83kgs. I have had 2 miscarriages in the past.I have been diagnosed with PCOD and my TSH is slightly higher than normal range. My doctor has started me on Glycomet 850mg twice a day, thyrox-25, OVRAL-L, folvite and mumfer-f. am I on the correct combination of medications that will help me carry the baby full term? Also, i have been experiencing headache, dizziness and nausea since I have started on these mediactions. Are these common side effects? Also, i would like to know what kind of diet and exercise plan to follow when am on these medications?",
    "doctor_response": "Hi, Ovral L is a contraceptive and is given to treat pco. But you can't conceive while using this medicine. So, you can take ovral for 3 months and then stop it if you want pregnancy. The problem in pcod is ovulation, so you can track your follicles growth by repeated ultrasound and see if rupture of follicles is occurring or not. If your follicles are not growing or not rupturing, then you have to take medicines like clomiphene for that. Discuss with your doctor regarding this.  The headache , dizziness and nausea are side effects of ovral.  So don't worry about it.  Have a healthy diet.  You can do any type of weight reducing exercises, brisk walking can be one of them. Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting in a baby while suffering from cough?\n\nHi my 11 months old baby vomits whenever he has cough. Excactly two weeks ago he had a cold and was prescribed penicline. He has been vomiting eversince at least once a day, his cough is not so bad right now so why is he still vomiting? should I take him to the GP? thanks",
    "doctor_response": "Hello, A severe cough might induce spasm and lead to vomiting. Generally, it will settle once the cough improves. If symptoms persist better to consult a pediatrician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can breathing difficulties in the lungs be treated?\n\nmy brother is having problem in lungs, according to doctors the lungs are not working properly with full strength. He used to take additional oxygen whenever he needed, for better treatment we want to consult a expert doctor, kindly advise We are in muzaffar nagar (UP)",
    "doctor_response": "Hello dear , HiWarm welcome to  Healthcaremagic.comI have evaluated your query thoroughly .*  There are many reasons for the lung function problems , and the     management  depends upon the root  cause .*  You  need  expert opinion  of  Pulmonologist  for  which  you have to go    Doctors  in  India  -  Pulmonologist  -  prefer  area  nearby you .    or  can  have  assistance  with  our  expert  customer  care  dedicated     team  crews .Hope this will help you for sure .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have PCOS. Is my blood test report too worrying?\n\nHello doctor, I am a female and single. I have received a report of my blood test and am worried to consult my family doctor as my parents are worried about my PCOS and I want to be sure that it has no bad news. My query is that in the report it is showing decreased level section that oral contraceptive, ovarian failure what does that mean? Please help me understand what does that mean I am worried.",
    "doctor_response": "Hello. First, calm down. I have seen your reports (attachment removed to protect patient identity). Your antimullerian hormone level is showing high, and that means you have a polycystic ovary. A polycystic ovary is a gynecological hormonal disturbance that can irregularize cycles with other symptoms like abnormal hair growth, weight gain or insulin irregularities. You should have some healthy long-term precautions. It is better to have daily walks, exercise or yoga for having normal BMI (body mass index) and weight. Have a healthy diet with less salt, sugar, oil, and spices to reduce the chance of diabetes as in PCOS, it is there. Have a check on other symmptoms like irregular periods or abnormal hair growth. I suggest you have combined oral contraceptive pills for regulation of cycles for three months cyclically. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is scalp biopsy ordered while undergoing treatment for hair loss?\n\nI am going through a treatment for hair loss. Derma roler, accupunture, laser comb. Now they have advised for Scalp biopsy, Hemoglobin, S.Ferritin. Free T3, Free T4, TSH, and S Prolactin test. Please let me knw the reason they r suggesting me these tests now? (why not bfore starting the treatment ). N wht could be the approx cost fpr these test?",
    "doctor_response": "scalp biopsy is done in cases of scarring alopecia while in non scarring alopecia the blood investigations are done to find out cause",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for abdominal pain, thigh pain, nausea after medical abortion?\n\ni recently had an abortion an i have been having pain in my lower abdomen , is painful to hold or press my lower abdomen mainly on the left hand side. it has also affected my left thigh  it is painful too .i still feel nauseated and i didn't get any bleeding after the medical abortion.. laying on my tummy or on my left side is so uncomfortable and am scared of anything happening to my uterus and legs.it feels like I have sores in my uterus . advice me on what to do.",
    "doctor_response": "HelloThanks for the query to H.C.M. Forum.You didn't mention the way of medical abortion as it was with the help of pills or D  & C .Still feeling of the pain may be due to .1 Retained part of some placenta or piece of it . Diagnosis can be confirmed by ultrasound of uterus or physical examination by a gynecologist . As you mentioned that pain is mainly on the left side & also in thigh , so chances of retained portion may be there.2 The next possibility may be some injury on the left side . As you are complaining that pain is on the left side , so may be some injury to uterus or other parts on the left side . Diagnosis can be confirmed by ultrasound and physical examination.3 As you mentioned that pain is so  severe  that it develop nausea i.e . so some sort of infection may be ( septicaemia).In my opinion consult a gynecologist  and get his opinion.Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on the outer knee?\n\nHi, I have a lump that has developed in the outer front of my right knee. It feels a little spongy and is not painful unless kneeling. It is about half the size of golf ball and does not float. What could this be? Recommended treatment? It has been a few weeks with no change and ice does not make it go away.",
    "doctor_response": "Hello... Well its look like a benign lump... may be due to trauma or spontaneous in course...It may be a collection of blood...or fat (lipoma) or something other...Primarily sonographic examination of joint will give us good guide of nature of lump anx further management. ..So get done usg of that local part and proceed further",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this X-ray test report for right-sided shoulder pain indicate?\n\n! Hello! I am a quite healthy and active 76 year old woman who has never given birth. Was in a car accident about 6 years ago and wrenched my R shoulder fom the back seat to the front. AAbout a year ago someone rear ended me & I jumped out of the car and reinjured that same shoulder. Have had physical therapy, get massages monthly and am now seeing a chiropractor and it doesnot seem to lbe improving much. An Xray revealed 2 bone spurs on that shoulder. What would U advise me to do. I m continuing exercizes assigned me but not when they hurt or a jabbing pain erupts usually down the center of the shoulder and stops about 4 in. above my elbow ... What to do??? Also,I eat well, lots of fruits and veggies, chicken & fish, do not eat many packaged foods and wonder how much calcium citrate does this healthy body need to take as a supplement??? Thanks....Thanks for your response, Mary",
    "doctor_response": "Hi, there!X-rays show bone condition only and spurs were found. It says, that biceps tendon and rotator cuff are affected too.Ultrasonography or MRI scan can reveal tendon and bone cartilage condition.You are on the right way doing exercises and physiotherapy.You can make Ultrasound wave therapy with Diclophenac gel or Cortison shot in shoulder joint, if tendinits confirms after scans. The last step is shoulder arthroscopy, but seems that Your shoulder condition isnt so bad.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause for swelling and pain in the abdomen?\n\nMy upper abdomen is starting to look like i'm 4 months pregnant and my entire stomach is swelling. I have lower back pain. Feels like I'm pregnant but have had a hysterectomy - one ovary left. I've been having mild headaches, intermittent dizziness, easily fatigued and feel miserable. I've had liposuction done about 15 years ago so my stomach has been flat. Any ideas?",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.This may be subclinical for of gastroenteritis, showing only distension in the beginning. This may resolve on its own if the body takes care of this as a natural healing process. You will need antibiotic cover if you get other symptoms like nausea, vomiting, loose motions , fever etc. Take plenty of water / fluids if there is no nausea or vomiting.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat for pain due to inter coastal strain?\n\nhi i got dumped surfing in some big surf on thursday causing a twisting strain i think it is a intercostal strain i have been to hospital taking endone and anti imflam naproxen 500 iam 55 years old have to sleep sitting up have alot of pain tablets help how long does this last",
    "doctor_response": "hi,thank-you for providing the brief history.As you have intercostal muscle spasm this will last for about a week or two. As there will be inflammation of the muscles and may be costochindritis this pain will last a maximum of 2 weeks.I will advice you to undergo some simple breathing exercises like -1. Deep breathing exercises 2. Diaphragmatic breathing exercises 3. costal breathing exercises 4. pursed lip breathing exercises 5. abdominal breathing exercises.As doing this breathing exercises will help improve the strength of the muscles of respiration and improve the lung capacities as well.Kindly note that when performing this exercises you Need place the hand on the injured area so the pain will be avoided.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is burning sensation during urination a symptom of kidney infection?\n\nI have. Aburning sensation when i pee and sometimes when i hold my pee not even for 5 minutes my lower back starts hurting and about a month ago i was throwing up nausea and had chills like a flu but i think is because i have a kidney infection at least thats what soembody told me now i dont know if thats true",
    "doctor_response": "Hello,A kidney infection may cause problems with urination and also nausea and chills but generally, these happen at the same time and I would not expect a kidney infection to last for so long.The best way to make sure if you have a urinary infection or not would be to have a urinalysis and possibly a urine culture.After the results of these tests, the doctor will know for sure if you have an infection and which antibiotic is needed in this case.I hope this answers your query. Let me know if I can assist you further. Regards, Dr. Antoneta Zotaj, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to regain motivation and concentration?\n\nI am 55 years old , have five children . I had lost my savings in the stock market . I don't have a desire to pursue any kind of business or employment.Always think about what happened and can't forget it . I have a lot of responsibility toward the family.I am scared to take drugs . How can i get my self esteem,motivation and concentration back.",
    "doctor_response": "Hi, Thank you for using health care magic.I feel sorry for your loss and understand your concerns.You seems to be suffering from depression.You described you are scared about taking drugs , if this is due to side effect than nowadays good medicines with lesser side effect is available for the condition you are in. But still if you decided to remain far from drug then psychotherapy is a good option. Cognitive and behavioral therapy practiced in psychiatry is  proven treatment for depression and has excellent results when done by professionals along with use of antidepressant.Consult a psychiatrist and discuss your concern , you will surely be out of this condition in near future.I hope this will help you.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How do I get rid of depression?\n\nhi... please how can i be free from all my depression, like specially my study, i actually want to go for my farther study but due to lack of finances i may not able to approach, i really want to go for the course of counseling course, so this make me lot of tension and depress. i cannot able to study properly this time, actually i am doing my Theology course. but i could not do my study....",
    "doctor_response": "Hi friend,Welcome to Health Care MagicThe ideal option is to go for Psychiatric assessment and assistane...Family and social support are very helpful.It is reactive to the situation and hence, che prognosis is likely to be excellent...Take care\u00a0\u00a0\u00a0\u00a0\u00a0Wishing speedy recoveryGod blessGood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly tell me the best medicine to cure prostate enlargement.\n\nHello doctor, I have the condition of enlargement of the prostate for the last over five years. I am 53 years old. I am taking capsule Urimax 40 mg once in a day and I am able to manage the condition. However, it seems that of late, my libido is negative and the sex life is absolutely zero. Though sex at this age is not important but sometimes for the sake of feeling that you are not 70 years male one desires to feel with a certain enthusiasm. So could you please let me know that whether the prostate enlargement and the Urimax is having a fallout on my libido and poor sex life? Is there any mild medicine for the treatment of this condition which is not having any side effect and is not habit forming and has no withdrawal symptoms if the medicine is discontinued after use?",
    "doctor_response": "Hi. I have gone through your query. The symptoms of BPH (benign prostatic hyperplasia), if severe can have a negative impact on the sexual drive of the person. The medication that you are currently taking, does not have any effect on libido but itself. That said the most likely reason in your case must be reduced testosterone levels, which can be checked. If reduced, you can be given supplemental testosterone. Also, if your symptoms of BPH are not very severe, there are medications that improve erectile function which are effective for early BPH as well. You can consult with your treating urologist for changing your medication and see if there is an improvement.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatments fro my SGOT being 34\n\nPlease  be  informed  that my age 49.4 a man and  i   did general tests in Lab. and  found  that  my  SGOT 34 ( NORMAL UP TO  40 )AND SGPT (47 ) (NORAML UP TO 45 )  .  CHOLESTROL 222 , LDL 146 , HDL 41, TRIG 176 ...last year i did  abdomin ultrasound every thing was  ok  except Dr.said you  have  little fat on liver and you have  to do  exercises and  reduce  wieght . i was 83 kg  and still same  wieght ..170  cm , BMI =OVER WIEGHT  >>> please  advise me  as  i  dont  feel any  pain",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.These are normal liver markers findings and it may indicate just ild fatty liver. If you have alcoholic fatty liver disease and you are a heavy drinker, quitting is the most important thing you can do. Talk to your doctor about how to get help. If you don't stop you could get complications like alcoholic hepatitis or cirrhosis. Even if you have nonalcoholic fatty liver disease, it can help to avoid drinking. If you are overweight or obese, do what you can to gradually lose weight -- no more than 1 or 2 pounds a week.Eat a balanced and healthy diet and get regular exercise. Limit high-carb foods such as bread, grits, rice, potatoes, and corn. And cut down on drinks with lots of sugar like sports drinks and juice.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is sebamed baby cream safe for a child?\n\nHi, My sister daughter was dark in color so someone told that seba baby cream is good to use to get glow.My question is this product really works if yes means till which age baby can use this cream and can u please guide the cream name specifically (has confusion in cream name), kindly advice.",
    "doctor_response": "Hi thank you for choosing healthcare magic.Kindly note that there is not much we can do for skin colour as it is determined by their genes. You can use sebamed baby cream as it is mild and doesn't cause any reactions and has a lasting moisturising effect. You can try bodywash also, but both of them donot cause any skin lightening effects.Hope this has helped you. Your vote of thanks is appreciated,Good luck,   Dr J Sravanthi, Peadiatrician and Neonatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to handle appetite problems in diabetics?\n\nHi I'm 33 years old and I have type 2 diabetes I had it for 3 years I always had a problem with my appetite now that I have diabetes my doctor took me off and now I stay sick alot I lost weight I stop taking my medicine so that I won't be sick so much what should I do",
    "doctor_response": "Hi     if ur sugar levels are normal  consume diet as advised by ur doctor  u can have fruits like apple grape fruit avacoda pomegrane   u can have plenty of cabbage  cauliflower cucumber   tomota  leafy vegetables tomoto soup lime juice without sugar  wish u good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a hurting head after a major hit?\n\nI fell over today while ice skating and hit my head hard falling backwards onto the ice, I felt weird once I was hit my head and wen I got up but then after sitting for 5 minutes I was ok , but after about 2 hours I ve started to get a headache and fell asleep this afternoon as was hurting .",
    "doctor_response": "Hello,Thanks for posting,You need to get a bed rest after taking some analgesics such as acetaminophen or ibuprofen or aspirin. Ice pack will also be useful in relief.If headache persist, just book an appointment to see a doctor who can examine you and request for CT scan or MRI just to be sure that it is nothing severe.I am sure you are having just a mild concussion that will subside subsequently.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pregnancy occur if only one egg remains?\n\nHi I am reena.i  am diagnosed wth pocs by my gyne.i want to get pregnant now and this is second month of trying.she has prescribed me actos, metformin, euthyrox last month .thn on my second day of periods she gave me clomid for 5days and on 7th day she gave me ovitrelle shot. Also she prescribed me progyluton for 10 days. Now when go on 14 day after my periods finished. She said one ovary has released egg whc is not fertile but 2nd is still is showng a egg.she wants me to come on 10th day of my next period to see further. I am confused if ths line of treatment is right. Can I still try to get pregnent if I hav 1 egg in me.pz advice I am getting depressed. Thanks a lot.",
    "doctor_response": "Hi,Your line of management is correct. your doctor is giving medicines to produce a fertile ovum. In women's one cycle usually one ovum is produced at a time. It is sufficient for pregnancy the normal way. There is no need to worry. Just continue with your treatment the way your doctor advised. If there is no outcome then there is another way to conceive. Do consider a positive feedback as a credit to my work. Let me know if you have any further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Bactrim the right antibiotic for infection post skin cancer treatment?\n\nI am a nurse.  I just had some mild skin cancer removed from my back, and the left over hole required 12 stitches.  Because I work at a hospital, my doctor prescribed Bactrim as an antibiotic prophylactically because sometimes occasionally we have a MRSA pt at the hospital.  Are antibiotics  normally prescribed for stitches?  And if so, is Bactrim appropriate for that just because I am a nurse?",
    "doctor_response": "HelloSince you are a para medic ,hence you are prone to infection and this is very common.Normally antibiotics are also advised for 4-5 days for prophylaxis purposes after surgery . Since this is most effective and the one of the best antibiotics combination  so for prophylactic purposes your doctor prescribed .Take care as this drug has minimum side effects.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have low back pain, cramping and bloating, on birth control pill. Not due for periods. Why is this happening ?\n\nI have been on the 3 month birth control pill for over 2 years and for the past 2-3 days I've been feeling like my period is coming: low back pain, cramping and bloating. I haven't missed any pills lately and my period isn't due for 4 weeks. Why is this happening? It's never happened before atleast not when I'm not on my period.",
    "doctor_response": "Hello ma'am.It looks as though your symptoms are a sid effect of the contraception you are on.I would recommend you visit your doctor for further management by either changing the contraception or help releive you of your symptoms. Do not worry ma'am, these are common side effects with contraception use.Hope this helps.Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen lymph nodes in neck with severe itching\n\nI have swollen lymph node in my neck for about a month,missed my last 4 periods,  have terrible body itching,  abdominal pains.  Went to see the Dr he asked for blood tests. ca242 was 43. 0 (which he said is high (NSE was 18. 66 ( which he said is high)Everything else was normal. He has prescribed 2 ampules of lutonefolone.  After reading the leaflet it seems its an abortion medicine..  why would he prescribe this when I am not pregnant.  Ultra sound showed no cysts.",
    "doctor_response": "the drugs were prescribed to induce withdrawal bleeding after you take medication.also get a complete blood count",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the sternum?\n\nI m 52 and weigh 250. I m having pain in my sternum mostly and a little in my right shoulder. I suspect that it is related to indigestion which I have had lately due to the fact that I ve eaten foods which tend to give me indigestion. The problem started while I was sleeping at night.",
    "doctor_response": "It can be do to food and indigestion but you should visit your doctor for excluding cause such as heart related.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the pinched nerve be the cause of numbness in legs and hands?\n\nI have numbness on my hands and sometimes my leg usually when I m asleep but i m not sleeping on them. My left leg seems to be numb when I m not sleeping. I have had a pinched nerve in my neck that I haven t gone to the doctor for yet. Could that be the cause of this problem?",
    "doctor_response": "Hello dear,In your post, you have mentioned regarding pinched nerve in neck.Under such circumstances, the symptoms can be attributed to entrapment of nerve fibers at the spinal region.Other causes can be:1. Para-spinal muscle spasm due to improper sleeping posture.2. Inadequate hydration & Electrolyte imbalance of the body.3. Dietary deficiencies of certain nutrients like Iron, Calcium, Vitamin D, Vitamin B12, Folic acid, etc. which help in blood formation & nerve conduction.4. Peripheral neuropathy caused due to any fluctuation in blood pressure or blood sugar level.Symptomatic relief can be obtained by intake of nervigenic agents (like Vitamin B6, Vitamin B12, Folic acid) as well as multivitamin & multimineral supplements including iron, calcium & Vitamin D needs to be added in your diet.Physiotherapy & postural exercise will also be helpful.If symptoms still persist, kindly consult a Neurologist & get a complete Neurological examination done.Certain investigations like complete blood count, serum electrolyte estimation, fresh estimation of blood pressure & blood sugar levels & nerve conduction studies will be helpful to rule out any pathological cause for the symptoms.X ray & MRI of whole spine can also be carried out to detect any nerve entrapment.Wishing you a Good Health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes premature ejaculation?\n\nMale married having one kid.pressure sugaar and cholestrol(TGL-387) normal weight 57kg.while doning sex lot of lubricating fluid secreting.In one minute 1 drop.It is secreting from the feel of sex.Scanning result is normal.so i have to take too much care on to my erection otherwise I will loose. please suggest",
    "doctor_response": "Hi,Thanks for writing in.You might be having sexual performance anxiety leading to pre mature ejaculation. This is because your penis scan is normal and there is no organic or physical cause for your problem. Constant worry over your appearance or ability in bed can make sex stressful leading to pre mature ejaculation. It is all in the mind and you need to relax your mind and be more emotionally close to your partner.There are certain brain chemicals which regulate ejaculation in males. In fact, deficient amounts of GABA and serotonin are responsible for norandrenergic sympathetic nerve function overpowering the parasympathetic nerve control of an ejaculation. The end result can cause premature ejaculations for men, producing embarrassing, often debilitating side effects such as creating more fear and nervousness toward intimacy.To overcome premature ejaculation please have sex with a free mind probably at the end of the day or early in the morning. Also spend a good amount of time having foreplay with your partner. You may also practice the start stop technique where when you feel that your penis is becoming erect then take rest and then again try to get arousal after some time. The subsequent erection will be stronger and help you delay ejaculation. You can also practice yoga to get stress free.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be the prognosis for hypoxic brain injury?\n\nhi I am Anil My maasi(Aunt) is 42 years old and she is having hypoxic brain Injury due to acute respiratory failure and she is on a ventilatory support. She was on support initially for 15days and was off venti for 07days but then the tube was blocked and she had effortful breathing since yesterday so she was put on venti back yesterday I want to know the prognosis as she is not etting her consciousness since last 25days..Please help rest all her parametres are fine",
    "doctor_response": "Prognosis in such patients is guarded and considering ventilator dependence in this case seems to be poor. Some patients do recover esp those with minimal hypoxic brain damage. And those don't improve by 3 months, land into vegetative state. Mail me imaging findings.Hope my answer will help you. Take care.dont forget to rate me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes right abdominal squeezing pain with pressure, light urination and bruising?\n\nI have acute sqeezing very painful contracting type pain on my right side that starts slowly like a sqeezing and as the sqeezing increases the pain increases until it is so intense I cannot function and must take pain medication to manage. The pain is worse than childbirth. The sqeezing intensifies and lasts until I can go to sleep on pain medication. I feel like I have to urinate but can only get dribbles. When I wake up in the morning, the intense sqeezing pain is gone but my side feels like I have been kicked and am bruised. It comes on out of the blue.",
    "doctor_response": "Hi.The squeezing type of pain as you have described, which increases gradually , gets a relief only on medication followed by a feeling of being kicked and bruised in the right side can be due to the following :-Intestinal obstruction, particularly where the small intestine opens into the large intestine. This is called ileo-caecal region. There are few diseases which affects this area. These are Tuberculosis, Crohn's, recurrent intususception. This can be well diagnosed by :-Colonoscopy and biopsy.-CT scan of the abdomen.The treatment will be as per the reports and clinical suspicion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does bleeding during pregnancy due to low lying placenta requires serious attention\n\nAt 16 weeks I started to bleed and was told that I had low lying placenta. The bleeding slowed down until I was about 18 weeks where it started up again, this was a week ago, the bleeding continues but now worried because I have started getting cramps. Is it possible to be miscarry so far into the pregnancy? Should I be worried. I have another check up in a weeks time but worried that I would be leaving it too late.",
    "doctor_response": "Welcome to the HealthCareMagic.com and thanks for sonsulting us!I feel sorry for the health issues you have and can understand your frustration on the issue that is all genuinly natural. Yes, this is a matter of worry and instead of waiting for a week time, you should go straight to your OBGYN for consultation and evaluation. Yes, it may lwad to miscarriage and can be associated even with more complications like uncontrolled heavy bleeding. So you need a workup as advised by your OBGYN and also to keep an eye on the issue.I hope you get an eventless pregnancy and safely deliver the child.Healthiest Regards!Dr. Sumaira Kousar MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for nocturnal emission and erectile dysfunction\n\nSir I have one problem that my penis now doesn t have than much power and also the erection is small.Sir the matter is that I used to masturbate a lot for the last 5 years now my age is 19.sometimes I masturbate more than two times in a day .So sir now I am facing problem. Also sometimes in the night now in my sleep I sometimes wet my bed due to this. so sir please help me.Also my ejaculations are earlier.",
    "doctor_response": "HelloThanks for query .Problem of Erectile Dysfunction(ED) that you are facing is mostly due to frequent habitual masturbation since long time .The only long lasting solution to resolve your problem of ED  is to avoid masturbation.This requires self determination .Please try to avoid  masturbation by keeping yourself busy in activities like sports ,reading ,social work etc so that you will not get free time to masturbate.As regards your problem of night emission ,it is normal and natural to get night emission at the age of adolescence .It gets resolved without any treaatment over a period of time .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat polyps in gall bladder?\n\nMy husband is experiencing uper abdominal pressure, that radiates to the left around to his back. He had an abdominal ultrasound that found gallbladder polyps, with the sizes not noted in the report, per the physician. I am finding that it is uncommon for the polyps to be the source of the pain, especially radiating to the left. The first few days he started experiencing the pressure, he also had an episode of left arm numbness/tingling. He was checked out in the ER and had a full cardiac work-up and was eventually admitted and released, with a 'virus.' He is now scheduled to have his GB removed, in a few days. Interestingly enough, he has a history of melanoma and an acoustic neuroma. My question is 1. should we be concerned that the polyps are cancerous? 2. should we be concerned we are not only dealing with a bad gallbladder? Thank you",
    "doctor_response": "Hi,Polyps are very rarely cancerous but it is recommended to do chlecystectomy if polyps are found to prevent cancer development in future. If cancer is found now after removal, it is in most cases curative surgery and then you can be happy that it was detected in such early phase. it cant be missed that this poylps is inside the galbladder, don't need to worry about this. I hope I have answered you query. If you have any further questions you can contact us in every time.Kindly regards,Dr. Ivan R. Rommstein",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to prevent dizziness in the case of Parkinson s disease?\n\nI have Parkinson\u2019s and I female and am age 65. I am extremely dizzy taking Simenet medication and I get up alowly and it is not related to blood pressure. How can I prevent being so dizzy. Any advice you can give me is much appreciated. Thanks, Beth",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Your physician is going to be the resource for advice since I am not privy to the details of your clinical history, the dose of medication you're taking, other medications you may be taking, or any laboratory or other data about you to know exactly the reason for your dizziness and how best to fix the problem.  However, this is a common problem with Sinemet.  Often, it IS question of BP, except not as you perceive it. Simply taking the blood pressure doesn't tell the whole story. As a side effect sinemet can cause something called ORTHOSTATIC HYPOTENSION to occur.  This will cause blood pressure to drastically drop whenever standing from either a lying or seated position.  There could be also be a DRUG TO DRUG interaction going on causing this problem (though less likely since you're only reporting something wrong upon standing).  Again, I emphasize the utility in speaking with your doctor to say what they say first before making any changes to your regimen or deciding on not taking the medication. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Upper abdominal pain. Ultrasound shows gallstones. MCRP showed dilated pancreatic duct. Still having gallbladder problem?\n\nI ve had US of abdomen for right upper abdomal pain under rib cage with a lot of pressure for over 8 weeks, they see gallstones, sludge , had Hida scan with pain in right upper quadrant during but was told HIDA scan was normal. Had EGD, noraml, all blood work normal. On MRCP saw a dilated pancreatic duct at head of pancreas? Could I still have a gallbladder problem?",
    "doctor_response": "Hi, Symptomatic gallstones necessitate cholecystectomy. The MRCP plates need to be studied to look for any obstruction to the pancreatic duct. If there is'nt then removal of the gall bladder is the treatment. regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excruciating pain in knee when mobile?\n\nI am a 21 year old female, 5 4, 135lbs. Recently, i have been experiencing some pain in my left knee. Every time I extend it, i feel a popping sensation on the outside of my knee cap. It does not hurt to put weight on it, for i experience pain only when i am mobile. This has been going on for the past couple of days, but it seems to be getting progressively worse. Its beginning to hurt to walk up stairs. I have not been doing any strenuous work lately to cause such a painful injury, but I have hyperextended my knee before, several years ago. Please help, as this pain is beginning to become excruciating. Thank you.",
    "doctor_response": "Hello,You may have a soft tissue injury to your left knee. As you have previous complaints related to the same knee, it may be a ligament or muscle strain. Apply pain relieving balm or gel locally and give hot fomentation for 2 days and see how it goes. I would recommend you to get a MRI scan done to know if there is any ligament strain.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Santosh S Jeevannavar, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in ribs,cough and runny nose\n\nhi am Patrick. i have been having a dry cough, runny noses, sneezing that have persisted for more than 5yrs. i have visited so many hospitals and have not been helped. i have tested for tb and it was negative. during the night, i experience alot of pain in my ribs or and chest. please help",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. Possibility of viral infection is more in your case. Running nose, cough, chest pain etc are suggestive of rhinitis and bronchitis. Both are commonly seen in viral infection. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x ray 3. PFT (Pulmonary Function Test). Chest x ray is needed to rule other lung disease. PFT is must for the diagnosis of bronchitis. You need antihistamine, inhaled bronchodilators and inhaled corticosteroid (ICS). Drink plenty of fluids orally. Take steam inhalation 5-6 times a day. Don't worry, you will be alright with all these.Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy back pain\n\nI hurt my back at work in 99 i have 3 herniated disks 2 buldging sciatica in the 2nd of the 4th stage osteoarthritis was getting si injections had a bad reaction which ate through the muscle and cartiledge so now im bone on bone with bone spurs and extensive nerve damage. The only thing that helps anymore is soma but I keep getting referred to more and more specialist and the pain is un-explainable but i have medicaid so im limited. Do you have any suggestions the orthopedic surgeon i saw said sorry about your luck but i had a scheduled fusion surgery 5 years ago then got divorced and lost my ins. The pain goes down right leg and sometimes cant use it but now my right arm. They had me on gabapentin which made me lose my appetite so 76 pds now and 37 2 kids. Will I get better before as they say I wake up paralyzed or my organs shut down from the pain?",
    "doctor_response": "Hello,Thank you for contact us,As you described it might because of more driving.But Now a days its mostly the common problems in humans.Mainly its due to inactivity of muscles it.Today every one having totally sitting life as no work at all that could be count as a body exercise due to that problem occurs.For lower back Pain you should follow instructions described below -Best medicine for Lower back pain is Rest.Resting for some days will heal the muscles which could be damage because of jerk. Muscles need some time to heal so give them time for the same.Another way is to take massage with hot or cold water, Some people take cold water and some take hot for massage.If pain is because of any accident or something big issue than you have to concern good doctor for the same.Other exercise should be done as doctors suggest after checking you physically.Hope it will work for your back pain.Good luck, Take care.Thanks & regards,Dr. Gaurav Prajapati",
    "dialogue_context": ""
  },
  {
    "patient_message": "CT scan of abdomen done, shows mass projecting from right kidney, necrosis, calcification, mitotic etiology. Related to kidney stones operation?\n\nTHE ABDOMEN CT REPORT REPORT CT FINDINGS REVEAL A LARGE WELL DEFINED,HETEROGENEOUS DENSITY MASS SEEN PROJECTING EXOPHYTICALLY FROM THE UPPER LOBE OF RIGHT KIDNEY WITH CENTRAL AREAS OF NON-ENHANCEMENT/ NECROSIS & CALCIFICATION .THE MORPHOLOGY,EXTENT & DIMENSIONS OF THE MASS ARE DESCRIBED ABOVE IMAGING FEATURES ARE SUGGESTIVE OF LIKELY MITOTIC ETIOLOGY. HOW DO WE CORRELATE IT TO?COULD IT BE DUE TO KIDNEY OPERATION DONE TO REMOVE STONES MANY MANY YEARS EARLIER.",
    "doctor_response": "Hello Your CT report means that there is a tumor of the right kidney. It does not arise due to any surgery, and is a separate condition. Get the treatment done as advised by your specialist. Take care..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with acne, pus filled white heads on nose, prescribed persol gel, isinin, dexodil tablets. Are they safe?\n\nHi i am anmol suffering from acne my doctor prescribed me persol gel (Night)and capsule of isinin 20(For morning) and a tablet of dexodil which should be consumed Day and Night. But i am little scared with this treatment because my acne or pimples whatever they are from very long, i have gone through different treatments like ayurveda , homeo, allopathy too... I dont know what comes the result. I have white heads on my nose which when pressed gives white textured substance. Few red pimples on the back, face with marks as i used to press them a lot. My diet is perfect. No one diabetic in family, father as good cholestrol problm including grand father, not me (recent checkup). Plz help me my id id YYYY@YYYY Thanks..",
    "doctor_response": "hi Anmol, Mostly Acne @ young age are due to hormonal changes occuring in body, again there are various causes behind this problem like pollution, dust, inadequete sleep, mental stress, dandruff in hair, some wrong eating habbits etc.. So it requires to avoid the cause, take suppliment of protien, vit. E, Vit.C. Hope this ans your query.than",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it advisable to buy Clomid online and have ovulation?\n\nHi, may I answer your health queries My doctor already told me im going to have to probably need Clomid but she will prescribe it to me in 3months. My insurance im paying for is $200 dollars a month. I thinking about purchasing some online off brand. So I can get started now due to have been taking ovoluation test that tell me im not ovualting. I'm married and have been trying for 2 years. Do you think it is ok to purchase online? I'm so ready to get pregnant.right now ?  Please type your query here...",
    "doctor_response": "Clomid is the drug for ovulation, you can buy it online. But before buying consult your gynecologist for the brand that which brand/company is good...Clomid contains clomiphene. 50 mg. Should be taken from 3rd day for 5,days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on the armpit?\n\nhi my baby boy 8 month old has a lomp in his left armpit , its painless ..not tender, about1.5 cm in size , it's attached to the deeper tissue and the skin above it is mobile, there is no discoloration of skin above it, the baby's health is generally well and i noticet this lump only yesterday",
    "doctor_response": "HI,Welcome with your query to HCM.Based on the facts of your query,your 8 mths old baby has a painless lump mostly from Reactive adenitis to the Vaccine shots,which he might have had lately,or it could be post-viral infection of the throat/chest.I would suggest Second Opinion after Xray Chest/blood tests,from Surgeon,who would after proper diagnosis could  treat  according to its cause.Hope you got the answer for your query.Hope this would help you.Welcome for any further query in this regardWill appreciate writing your feedback review comments,to help the needy patients like you at HCM.Good Day!!Dr.Savaskar,Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Gevrabon be taken to regain severe energy loss associated with lupus?\n\nIs it wise to take Gevrabon to help regain my severe energy loss associated with Lupus. I use to take it when I was younger and raising a family while working 2 jobs. Now besides having Lupus and Parkinsons , I am also the sole caregiver for my 96 yr. Old mother who now lives with me, but havebthe added chore to vacate and sale her home. I m in dire need of more energy!",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Of course you can use gevrabon to improve your energy, but make sure first to control lupus disease activity, to be sure that lupus is under control, and you don\u2019t have fatigue because of that. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilektra Xhafa(Kacareli)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am 16 years old and having 3 degree scoliosis. Will it stop progressing when I grow further?\n\nHi doctor, I am 16 years old. I just recently discovered that I have scoliosis. I do not know much about it but I will tell you what I know. My scoliosis currently has only a 3-degree curve and I am pretty confident it is a C shaped curve, although I am not sure. What do you think are the chances that my scoliosis will develop into adulthood? Do you think it will stop progressing once I am fully grown?",
    "doctor_response": "Hello. Before going into the progress of scoliosis, I would like to make you some clarity about the facts on it. 1) The Cobb angle is a measure of the curvature of the spine in degrees. This helps to determine what type of treatment is necessary. A Cobb angle of 10 degrees is regarded as a minimum angulation to define scoliosis. 2) A scoliosis curve of 10 to 15 degrees normally does not require any treatment except for regular check-ups. 3) If the scoliosis curve is 20 to 40 degrees, the orthopedic doctor will prescribe a back brace help to keep the spine from developing more of a curve. 4) More than 45 degrees need correction surgery keeping many pedicle screw and osteotomy to correct the curve. I hope you go for x ray done of your spine and it will be easy to measure properly about the curvature.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in upper abdomen after liver biopsy, lower back pain. Having hypothyroid, lupus. Should i call hospital where biopsy was done?\n\nI am 58 yr old female with diagnosis of Hypothyroid, MS, Lupus, Arthritis, Sj\u00f6gren's syndrome, I have had elevated liver enzymes since 9/2012 ... meds have been ruled out ... ultrasound showed nothing ... liver biopsy on 7/9/2013 and waiting on results ... immediately after the biopsy I felt some pain/pressure in my upper abdomen just under my rib cage ... having a dull constant pain in the area of my left kidney and also some low back pain ... could any of this be a result of the liver biopsy or something else that has to do with my elevated liver enzymes ... should I call the doctor or hospital where the biopsy was done? sick of being sick!",
    "doctor_response": "Hi and welcome to Healthcare magic.Thank you for the query.yes,you should. There are few serious compications of liver biopsy including bleeding. So you need to do ultrasounds to rule this out. But it can also be pain frombiopsy because liver capsule is roken and this is commonly very painful in some people. YOu need to take strong painkillers and patient for several more days. Also,you should rest laying on your stomach.Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Alcoholic liver disease. Swollen stomach, bleeding in mouth. Is it curable, can I try hospice care?\n\nMy friend has alcoholic liver disease, her stomach is very swollen, her eyes and skin are yellow and it seems like her tongue keeps leaking blood, the hospital have said they cannot do anything else for her, do you think her life is coming to an end and shall I try and get some hospice care for her now as she wants to be at home? Thank you",
    "doctor_response": "Hello,     thanks for  asking this \"Q\".                                                                                                              Alcoholic liver disease, they had told you.                                                                                                        Before taking any decision we have to consider many things.                                                                                    Stomach is very swollen ( you mean abdomen) as far as concerned about yellow color of eyes and skin I would like to says that due to severe anemia patients seems in whitish yellow color in outlook.If  haemoglobin of patient is normal and color  yellow in eyes( sclera) and skin than we have to consider that patient might have Jaundice.                                                                                                  If Jaundice than please confirm her bilirubin level through blood test, if it is more than 2mg % than think about treatment of jaundice.                                                                                                                                Tongue keeps leaking blood . it look like that because of anemia and liver disease as these cherry color type condition is common during above mentioned diseases.                                                                    Still there is big hope for your friend, don't be panic consult another hospital and good  doctors they will advice you some thing new and good.                                                                                            Good luck and wishes for your's friend.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Loneliness, torturing myself, confused, partner diagnosed with bipolar, highly qualified.  Help\n\nHi! I'm a MD too. Brazilian, surgeon, professor and researcher, 45 years old, married. My husband is a vascular surgeon and bipolar diagnosed 5 years ago. I've been struggling to understand, help and \"save\" my married despite so many crazy things that I've been living the last years. Recently I've noticed that I'm alone, not working... torturing myself... I can't see how to recover my own life",
    "doctor_response": "Have you ever looked into  therapy for codependency? A good therapist can help you to reclaim your life by using therapies that include CBT, empowerment. Reading books from Melodie Beatty such as Codependent No More, etc. may shed some light into your situation. The Bipolar partner can breach any boundaries you set up for yourself to be healthy and sane, learning coping mechanisms for that can help you set parameters as to what you may be able to accept or not for your own well being.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is SMZ/TMP recommendable for the treatment of greater than 100,000 CFU/mL of Escherichia Coli infection?\n\nThank you, I just received a path report from urgent care. Its states I have Greater than 100,000 CFU/mL of Escherichia Coli. Do I need to get on an antibiotic? The Dr gave me SMZ/TMP if I wasn t feeling better. Would this be the correct antibiotic to treat this infection? Malinda",
    "doctor_response": "Dear Friend.Welcome to HCM. I am Dr Anshul Varshney. I have read your query in detail. I understand your concern.You can take this antibiotic, but before you start on it, get Urine antibiotic sensitivity done.I suppose, since have got a report of E.Coli growth in urine then there must be associated report of Antibiotic sensitivity.Your doctor must have checked that and given you this antibiotic.This is my best opinion for you based on available details. If you have any further query please ask me.Stay Healthy.Dr Anshul Varshney, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having persistent asthma, allergies. Bottom of left lung collapsed. Pain in chest, lungs. Suggestions?\n\nhello im asking this help for my sister. around the age of 1 she had phenomia, asthma and allergy s. from the outcome from phenioma, the bottom of her left lung collapsed. she is now 24 still has asthma, and now the area where her lung collapsed is hurting and she feels alot of pain in her chest and lungs. she is a non smoker is not around any areas to alert her allergy s.what could be the problem /",
    "doctor_response": "Hello, Please correct me if i am wrong - your sister had a bad episode of pneumonia at the age of 1 year, and not since! She however has developed allergic asthma and gets pains in the chest where the pneumonia had occurred. It is unusual for the pain to be related to the previous pneumonia episode, unless she has had further lung problems and has left lung scarring, in medical terms this is known as fibrosis. Lung fibrosis can lead to several complications, and if there is evidence of bronchiectasis on HRCT scans, pain in that area can happen as sputum production continues and the constant cough leaves one with pain. My suggestion would be to get proper investigations done, such as HRCT Chest, lung function studies with DLCO (that shows the current lung function with regard to oxygen diffusion) and get these reviewed by a Chest Physician. Rib pain can also be a possibility if there has been a recent fall, and the CT will pick this up as well. Please ensure that the asthma is also optimally controlled. You can ask her to do the ACT (Asthma Control Test) online to see the level of control. Hope this helps. Best Wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for idiopathic hypertrophic subaortic stenosis\n\ni m supposed to get echocardiograms every 2 years b/c of a heart condition that runs in my family (IHSS). It s been 3 years since my last one (those results were normal) and I made an appt. for one in 2 weeks. I ve been having some chest pains and I m generally worried about my heart and don t want to wait 2 weeks for the test. Can I go to an emergency room or urgent care to have one done right away?",
    "doctor_response": "Hi,Welcome, this is Dr Sameer, cardiologist.IHSS do follow a hereditary pattern and we advice such patients to be in regular follow up & do some tests. If your earlier tests have been fine, than it does not rule out possibility of having a heart issue in future.If you are having chest pain, I'll recommend you to go to the Emergency & at least do a ECG to see if anything is wrong.For your knowledge, cardiac pain is non localized (i.e. it is diffused) & increase on exertion (with exercise like walking, running or stress) & it is generally not relieved by traditional pain killers.So yes, get yourself evaluated soon.In future, despite of having a simple echocardiogram, I'll advice you for a stress echo, which helps better in predicting chances of future cardiac events.ThanksTake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for frequent vomiting\n\nHi, My daughter woke up vomiting this morning. she feels better after each episode. but she is vomiting every 3-4 hours (it was never any closer than that)...trying to sip Sprite but it doesn t really stay down. No fever. Should I be over concerned or is it likely a virus?",
    "doctor_response": "Hi Dear,Understanding your concern. As per your query your daughter have symptoms of frequent vomiting which seems to be due to electrolyte imbalance in body and could be due to viral infection leading to acute gastroenteritis. Need not to worry. Avoid hot, sharp and spicy food.You can take banana on daily basis and light food. I would suggest you to start treatment with combination of fluoroquinolones and ornidazole.You should get intravenous fluid administration as well. Drink plenty of fluids to rehydrate yourself. Visit gastroenterologist once and get it examined and start treatment after prescription. You should get barium meal study done if symptoms exaggerating. You should avoid taking dairy products in excess. Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach pain and red eyes in a child\n\nI just took 12 Tylenols and 2 flu pills . I had already taken 4 other Tylenols today. I m 14 , and weight 140 I m 5 2. Oh earlier I also took some allergy pill, and cramps pill . I kinda feel a stabbing pain in my upper stomach every once is a while my eyes are really red but I feel fine other than that.",
    "doctor_response": "Hi.... I suggest that you immediately go to the nearest Emergency Room. I think that you have Over drugged yourself. Please do not repeat such things here after.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is available for Gerd?\n\nAs per the child specialist my grand daughter of 2 months is suffering from G.E.R.D. Inspite of giving her Omeprazole, Reglan and a host of other allopathic drugs, her health is not improving. I am looking forward for some other alterative medicines, like Unani/Ayurvedic or others, as her pain is unbearable.",
    "doctor_response": "****1. Since the case is diagnosed esophageal motility disorder [G.E.R.D] thus following preventive aspect can be tried & since age is 2 months I won't recommend any single drug or medicine: [without first inspecting and examining the child]. bland and soft diet, more of milk [thickened feedings]. avoid hot drinks and spicy food. give small, non-bulky meals more frequently [since GERD causes hiccups/ irritability]. head high position at night. [since GERD causes regurgitation/choking]2. Management of GERD in both adults and children is based on disease severity, the degree of symptoms, and presence or absence of complications of GERD determined by the diagnostic evaluation [so be under regular supervision of Pediatrician].. since her health is not improving it might be one effect of GERD and one has to keep a watch on other complications arising due to G.E.R.D such as: respiratory and feeding problems",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the swelling in parodist gland be due to viral infection?\n\ni have problem before 12 day ago with swelling left Parodist      gland  first 8 day pain full now no pain , swelling bit of but am have swelling wen am eating after 4 min   eating   again swelling going of bit my blood test look like viral infection   am on antibiotic thanks and sorry for my pore English",
    "doctor_response": "Hi.Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain swelling of the Parotid Gland especially when you eat is not due to infection of the parotid gland but it is due to clogging of the duct of the salivary gland which can be due to obstruction of the duct orifice by some foreign body or it can be due to formation of crystalline stones in the gland or the duct from the minerals present in saliva and can lead to clogged duct and when the saliva cannot flow to mouth from the gland due to obstruction it flows back into the gland and there is swelling in the gland and due to expansion and stretching of the gland there can be pain..During eating there is increase in the flow of saliva and due to it the swelling also increases during meals..I would suggest you to consult an Oral Physician and get evaluated and in case if salivary stones is diagnosed the doctor can advise you an Endoscopy [SIALOSCOPY] to rule out the location of the stones..In case of superficial stones the physician can palpate over the stones and remove them manually by pushing towards the ducts..In case of deeper stones surgical removal has to be done..As of now you can take more of sour candies, lemon drops or sugar free chewing gums as they will stimulate saliva flow and at times the stones gets flushed out with the saliva..Hope this information helps..If you find the answer helpful please give me a Five Star Review and click on found the answer helpful as a token of appreciation..Thanks and regards..Dr.Honey Nandwani Arora..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to remove gall bladder during the second trimester of pregnancy?\n\nWhy are some surgeons willing to remove gall bladder during second trimester and others are not willing? I don t eat greasy, high-fat or spicy foods. Stay away from foods that are an irritant and still suffer severe pains that reduce me to tears in the middle of the night. Heart attack type pain at 8 weeks pregnancy caused trip to ER and discovered sludge in gall bladder. I meet with a surgeon on nov. 2 and want to know how to best advocate for myself and my baby. I have lost 18 lbs, now drink ensure plus frequently and throw up pretty much all solids, broth, water, etc.",
    "doctor_response": "Hi and welcome to HCm. yes it is safe, and risk of complications is the same as for those who are not pregnant. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does pain during urination need immediate consultation with urologist?\n\nmy 3 1/2 yr. old son has painful urination- they said it s from strep he had in his throat and it went to his urethra. He has been on amoxicillan, had ointments for his penis and pain relieving dye pills. They said if he s not better in two days, I need a scan and then maybe a urologist. Should I just take him to a urologist now?",
    "doctor_response": "Pain during urination can be caused by infection in the urinary system, irritation or injury of the genital area, or stones (small masses of minerals) in the urinary tract. Urinary tract infections (UTIs) are the most common cause of painful urination.Treatment:Give antibiotics for UTIEncourage drinking lots of water and juices.Give acetaminophen or ibuprofen as needed for discomfort.If no relief:Consult your doctor and ask for investigations like USG, Urine analysis etc.For further queries regarding this disease or its medications you can consult me at Healthcare Magic.Dr. Khan Shoeb",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bed wetting and foul smelling urine\n\nMy son is nine and still having problems with bed wetting at night. However in the mornings his urine smells like sewage. He drinks approximately six glasses of water daily with no other symptoms of cloudy urine or pain when urinating. One thing I have noticed is that when he is up doing normal things, the second he feels the urge to go, he has to go running immediately. Is this something I should be concerned about?",
    "doctor_response": "DearWelcome to HCMWe understand your concernsI went through your details. If you are sure that you never noticed anything wrong with the urine color or other symptoms like burning sensations, itching etc, there may not be anything wrong. Children always know that they want to urinate at the brink of urge. Then they run. There is nothing abnormal about it.Regarding bed wetting (enuresis) you should be able to train him for toilet practice. Set alarm for every two hours at night. On alarm you get up and wake him up and compel to urinate. Repeat every alarm. within a week your child should learn toilet practice. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for cramps and abdominal pain?\n\nI had a really bad stomach ache last night with a lot of cramping. I went to the bathroom and just sat there but couldn t go. I started to sweat profusely and when I got up from the toilet I started to feel very dizzy. This has happened before and I usually try to get to a low position incase I faint. Anyway, I was leaning on my ironing board, feeling sweaty, dizzy and started the chills. The next thing I knew I was lying flat on the floor, on my back. My floor is some type of a hard granite so I think I might have given myself a concussion. The back of my head has a huge lump, I have a very bad headache and just feeling very tired. Never mind!! I didn t see that you guys charge for this. I should have realized that.",
    "doctor_response": "Hi.You have two major issues.1. related to the abdominal pain and sweating, fainting ans so.2. Head injury The cause for severe cramps that lead you to the bathroom, profuse sweating, dizziness and falling down must have been die to severe intestinal infection causing the third space loss of body fluids into the intestine with electrolyte imbalances and severe toxemia due to intestinal infection. The head injury due to fall on a granite floor can cause concussion, internal bleeding and so on. The hematoma at the back of the head will resolve soon.I would advise you to report to the ER urgently to get yourself examined for vital of pulse, blood pressure and other signs, and get a CT / MRI scan to prove or disprove the internal brain injury. You will also get intravenous fluids and antibiotics and supportive medicines. Also gets observation for head-injury.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of gastro-oesophageal reflux disease?\n\nI am suffering from stomach problem. Whenever my stomach is empty I start getting belching with slight burning sensation in the oesophagus. I am taking tablet Happi twice a day before breakfast and dinner and tablet Ganaton thrice a day before breakfast, lunch and dinner. I am taking only bland food. Though there seems to be some improvement, still I feel uneasy at times especially in the morning when the stomach is empty.",
    "doctor_response": "Your symptoms are typical of Gastroesophageal Reflux Disease (GERD). In this problem, there is laxity of the junction between our food pipe and the stomach, that leads to acid refluxing up in to the food pipe from the stomach. The diagnosis is usually made from clinical symptom and an endoscopy.  Most patients get good relief in symptoms from medications: acid suppressants and prokinetic agents. There are several of them available in the market and your doctor can prescribe you the same. In addition, there is a big role of life style changes which I strongly advocate. Some of these include:  *avoiding hot, spicy and fatty meals  *Instead of large meals at one go, take small frequent meals  *Do not lie down within an hour of your last meal  *Elevate head end of your bed by a brick  *Avoid cola beverages, nuts, chocolates  *No smoking and alcohol  *Weight reduction for those who are overweight  I am sure that with above measures coupled with medications, you can get good relief in your symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for nerve pain in leg and hand\n\nDear Dr Sir I am 35 years male in gender.I have very much nervs pain in my leg and hand in right side.I visited Dr. R.k. Somani (Neurologist at Kolkata) and taken Tribantin-300.But whil taking this medicine i fill Gas too much. Also there is no any improvement in my nerves pain.",
    "doctor_response": "Hi, You need detailed evaluation to ascertain the cause of right sided pain. Clinical examination followed by MRI scan can confirm the diagnosis. After that, appropriate medicines can be advised. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sudhir Kumar, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it normal to get decreased taste sensation following sinusitis?\n\nHi doctor, I am a 40 year old female, non smoker.\u00a0I had a sinus infection as a result of cold nearly two months ago. I was put on Doxycycline for two weeks and then a steroid nasal spray when the inflammation in my nose had not resided. I can smell things quite clearly up close to my nose but cannot taste whatsoever. I am now on a course of Amoxicillin and Prednisone to try and get rid of the inflammation once and for all. I had a CT scan which did not show any blockages just some mucous and inflammation. If I burp, I can taste my food. Does this mean I will get my taste back when everything clears up? How long should this take? I still feel some tightness in the bridge of my nose and one nostril still feels more blocked than the other. I am just so scared that my taste will not go back to normal and I have a constant nauseous feeling. I wonder if this is because I am so stressed about losing my taste forever. Thanks for your help.",
    "doctor_response": "Hi. We will help you alleviate the problem. I understand that you are a 40 year old otherwise healthy lady suffering from sinus infection. You perceive smells close up your nose but have decreased taste sensation. You are worried about when the taste sensation will return and what can be done to accelerate the return. Next, I understand that you have taken a complete course of Doxycycline and now you are on a course of Amoxicillin. Also to relieve the inflammation the doctor initially gave you a locally acting steroid nasal spray. Currently, you are taking steroids (Prednisolone) orally. I would suggest the following measures as well which if you follow will help you in a great way. I reiterate that this loss of taste sensation is temporary and it will be restored as and when your sino-nasal infection resolves. For the same, I have suggested you various measures. Nasal congestion. 1. Diagnostic naso-endoscopy. The endoscopic viewing helps us to see the pathology and ascertain if the inflammation is indeed what we think or has some other pathology. It helps us to take samples for culture sensitivity and histopathology as well. 2. CT para-nasal air sinuses. Please attach the report as I see that you have already done the scan. Ideally, I would require the CT scan film that they would have given as a soft copy as well. 3. Serum IgE. 4. Absolute eosinophil count (investigations AEC and Serum IgE help us understand if you suffer from allergy). 5. Hemoglobin level, to check for anemia and rule out Plummer-Vinson syndrome also called as Patterson-Brown-Kelly Syndrome. 6. Total leukocyte count and differentiated leukocyte count. 7. Erythrocyte sedimentation rate. 1. Chronic rhino-sinusitis. 2. Fungal sinusitis. 3. Occupational rhinitis. 4. Allergic fungal rhino-sinusitis. Chronic rhino-sinusitis. Revert back with the answers for the above questions and CT reports to an ENT otolaryngologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for abdominal pain in a child\n\nMy 6 yr old son has been complaining off & on for a couple weeks that his belly hurts. He now has a couple rash looking spots on his belly & also on his cheeks. No fever or any other symptoms. Wondering what it could be & if we should take him to see our dr or let it run it s course",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query your son is having symptoms of abdominal pain. Well the symptoms you mention in query can occur due to many reasons like food poisoning , food allergy , infection of digestive system, acid reflex , stomach flu or colic. Need not to worry much. I would suggest you to have quietly sips of water or other clear fluids. You should give child oral rehydrating solution as well. If condition doesn't get better then consult pediatrician for proper examination. Doctor may prescribe antiemetic drug , antibiotics ,analgesic and antacid. Avoid solid foods for a few hours try small amounts of mild foods such as rice, applesauce, or crackers and do not give your child foods or drinks caffeine, carbonated beverages, citrus and dairy products.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Finished last pill, had cramping with brown spotting, sore breasts, HPT negative. Could be pregnant?\n\nHi I finished my last pill on the 27th of January and was due on Thursday 31st of January but I got a little cramping feeling along with brown spotting lasting only 3days, feel a bit bloated in my belly and breast feel a little sore I ve done 4 pregnancy test but have all came up negative but the 2nd one had a very very faint line but the rest have said negative. Could I be pregnant?",
    "doctor_response": "dear user. welcome to healthcare magic.the blood test is much more sensitive than the home urine test. So the first thing to do in your case is to have a quantitative hcg test in you blood.if the test is negative consider this as an abnormal event that happened due to any reason (stress for an example), and wait for the next cycle. if the test is positive, you should visit your doctor as soon as possible to identify the cause of bleeding and to exclude ectopic pregnancy.Although pregnancy is a remote possibility but it should be excluded.I hope these words were useful to you.good luck.dr. Ahmed Bahaa.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red spots on face of a 18 month baby?\n\nMy 18 month old has been getting a couple of spots on his face when he wakes in the morning, they are normally gone by the next day. They are red, with little whiteheads on them. He doesn t have any anywhere else, is eating normally and running around as normal. Any ideas? Thank you.",
    "doctor_response": "HiWelcome to the HCMI have gone through your question. As per your description, it seems that your child has miliaria crystalline which occurs due to blocked sweat glands. It occurs more often by oils when applied during hot weather. No compelling reason to treat miliaria crystallina exists because this condition is asymptomatic and self-limited.The prevention and treatment of miliaria primarily consists of controlling heat and humidity so that sweating is not stimulated. Measures may involve treating a febrile illness; removing occlusive clothing; limiting activity; providing air conditioning; or, as a last resort, having the patient move to a cooler climate.Topical treatments that have been advocated involve lotions containing calamine, boric acid, or menthol; cool wet-to-dry compresses; frequent showering with soap.Hopefully this will help you. I will be happy to help you in any further child health related questions.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for abdominal pain, nausea, gastritis, inflammation and weight loss\n\nHello, i am a 56 year old woman with digestive issues. I ve had C-D twice and in April 2013 I had left-sided ischemic colitis. I ve bowel problems for many years, mainly loose bowels, dark stools, mucos. Since last april i ve had more bad days then good; abdominal pain, right and left side and across the middle, nausea, gastritis, inflamation, weight loss apprx 30 lbs. I ve had colonoscopies (inflamation of the large intestine), endoscopy (acute gastritious and stomach inflamtion), capsule endoscopy (normal small intestine)",
    "doctor_response": "Hi.Thanks for your query and an elucidate history..Since you are already well investigated, the treatment has to be well planned. This is because you have a complicated combination of colitis and gastritis.It is good that the small intestine is normal. I would suggest you the following and I hope you are already taking some treatment under the care of the Gastroenterologist. Soft bland diet to be equally distributed in 4 parts and spaced nicely to cover at 5 to 6 hourly duration.Ranitidine /PPI Antacid gel at 3 hourly interval.For colitis:The 5 day course of an antibiotic and metronidazole, probiotic. Avoid all the foods and beverages which you must have noticed by this time that increase your problem. Review endoscopies after one and half months. And to reschedule treatment as per the new findings.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling on frenulum and upper lip?\n\nMy son (almost 5) has been sick for the past week. We saw a dr. Who did blood work and saw that he had an ear infection and very swollen lymph nodes. While most of his symptoms have improved, his frenulum and his upper lip is quite swollen and painful. Any suggestion to ease discomfort? Should I be concerned?",
    "doctor_response": "Hi...looks like angioedema, a sort of allergy or localized cellulitis or skin and soft tissue infection.The area you are mentioning is called dangerous area of face. If the infection spreads it may be dangerous. I suggest you get back to your doctor.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a sore finger cuticle be treated using a home remedy?\n\nok... my finger is cuticle has been sore, but now it's gotten very bad. Feels tight, is very red and getting more and more painful and getting bigger and bigger!It's hot and shiny and swelling... What can I do here at home (I've been soaking it in warm water and peroxide but has since getting worse!",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Based on your description, you may have paronychia which is a fungal or bacterial infection that affects the sides of the nail bed. Though soaking the finger may be helpful, the other aspects of treatment include the use of an oral antibiotic. In addition, if there is a collection of pus (an abscess), this needs to be professionally drained. Hope I have answered your query. Let me know if I can assist you further.Regards, \u00a0\u00a0\u00a0\u00a0\u00a0Dr. Michelle Gibson James",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does massaging the Restylane injection site avoid nerve damage?\n\ni had restylane injected under my eyes and after the first day my upper right lip became numb and tingling. I also have lumps that are tender to the touch after 5 datys. I returned to the doctor on day 3 and he said i need to message the filler and it probably got into the nerve area below my eye. My question is how long should i let this go on before I become concerned about permanent nerve damage? Will messaging relieve this or should i have it dissolved? Is this a common problem?",
    "doctor_response": "Hi, Cannot say in your particular case AND if the body of the nerve is not killed but only the outgrowths, then repair usually occurs but may take months. The repair might not be complete and could give odd or painful sensations. Massaging is not generally helpful. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest natural remedies to reduce dandruff and hair fall\n\nDear Sir...I'm 26/working in Saudi Arabia for last almost one year...but i found there are severe dandruf on my head which causing enormous hairfal.I did clean saved my head...but still on the hairless head..there are very small scale like dandruf...please suggest any natural therapy may be slow but resulting.",
    "doctor_response": "HiI had gone through your query and understand your concern. Its not a problem much to worry about. Thousands of patients have used and are continuously using this medication in the following manner to lead a dandruff free life. 80 - 90 % dandruff will go away in 1 week application.. Apply 10 - 15 ml of 'SHIVTATTVADI MISHRAN' in your scalp overnight continuously for 1 WEEK and wash with any shampoo in the morning. The medicine should remain in your head for at least 10 hrs before washing.. Now apply the same process ONCE in a week to prevent the recurrence.Hope I have answered your query. If you have any further question I will be happy to help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be done to conceive at 43 years while on clomipure  100 foil 123 oosure  cerifert  m2- tone  naturogen & also hgc 1000 injection with no result?\n\niam 43 & husband is 46 years we married two years before he as kids & he is diverse  person now we planing to have a baby my dr took follicle test & gave  clomipure  100 foil 123 oosure  cerifert  m2- tone  naturogen & also hgc 1000 injection we tryed three times but we have no result  what to do  shall i try agine",
    "doctor_response": "Hello!Thanks for your query.Three cycles with clomipure are enough for you in this age.You should take in consideration IVF because with increasing age : fertility decreases(longer to conceive,decrease ovarian reserve)    high risk pregnancies  increases    chromosomal abnormalities increasesTake care of your self",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in knee after having Xarelto?\n\nI had Xarelto day 2 and day 3 after total knee replacement. Severe swelling began and Doctor stopped pills. After being home a few days swelling and redness became worse and I was put back in hospital to suction out blood amount size of football. Two days later Doctor drained off about 3-4 ounces of blood so I could go home. CPM machine was stopped also. I still have a lot of swelling and redness. Therapy is difficult. I had a very successful knee replacement 11 years ago on opposite knee",
    "doctor_response": "Hi thereXarelto is a blood thinner, prescribed to you after knee replacement to prevent you from making blood clots in your legs which could ultimately travel up to your lungs and kill. complications of Xarelto or any other blood thinner is bleeding. swelling in the knee was caused by new bleeding in the knee, hence your doctor had to drain it out and Stop Xarelto. This incident increases your risk of knee infection. If you are still worried that swelling is worse then I suggest you see your surgeon again as soon as you can since this time it could be an infection setting in.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Inflamed liver. High glucose, potassium high. What is going on?\n\nI have given blood to my doctor three times since Feb. 2012 for inflammed liver . The 2nd blood test 6 weeks from the first in Feb., my test results came back with glucose high. So I gave blood 6 weeks from the second test stating salts, sugar, liver, proteins , kidneys normal. Potassium is high, so I went Monday 7-23-2012 and gave blood again awaiting for results. What is going on? I have had no alcohol since 7-10-12, stopped taking omega Q, Tylanol of any kind, stopped smoking 8-8-08!",
    "doctor_response": "Hello sir/madam,You results are suggestive of probable diabetes.Hyperkalemia needs evaluation .  Kindly meet a physician with FBS, PPBS, ABG, Urine spot potassium ,repeat LFT, S creatinine. You are most welcome to get back to me in case of further queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from viral hepatitis. Elevated bilirubin levels and stable SGPT levels. Why?\n\nMy daughter is suffering from viral hepatitis . As of today her Bilirubin level was 2.8 the same level as on 30 July. While SGPT as of today is 92 compared to 201 as of 30 July. My querry is as to why the S.B. level has not come dowm as compared to SGPT? My daughter s liver function test of 30.07.2012 reads as: Serum Bilirubin (DMSO Method) Total- 2.8; Direct- 2; Indirect - 0.8 SGPT- 206.8 IN THE REVIEW TEST DONE TODAY (05.08.2012) The report reads: Serum Bilirubin: Total - 2.8; Direct- 1.5; Indirect - 1.3 SGPT- 92.5 My worry is when SGPT level has come down why Bilirubin has not come down proportionately.",
    "doctor_response": "Hello Thanks for the query Raised bilirubin signifies liver cell dysfunction. It will take 4-6 weeks in some cases to show little improvement in bilirubin. It might take longer in cases of Hepatitis B and Hepatitis C. Please approach a gastro enterologist for further management. Avoid the following things 1. High fat and protein diet 2. Heavy exercise Let her drink lots of water and let her take adequate bed rest. I wish her a speedy recovery Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain, pressure in legs. Have periods with clear discharge\n\nHi I started getting lower back pain, which was very painful for two days then I started getting mild contraction pain feeling pressure in both  my legs. The contraction pain and lower back  pain are still on going and  I have took a pregnancy test on the day my period was due.The next following day my period started but the mild contractions are still there. I could  feel the twinging in my legs and pressure in all my body. My period has spots of blood and is colour red and clear type of discharge in it.",
    "doctor_response": "hello,as you took the HPT too early you have to check once again after waiting for 1week if it is still negative and you still have the same symptoms you can contact your doctor.In early pregnancy you can find spotting some times so first its better to rule out pregnancy and then go for other investigations.THANK YOU.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I use Kojivit gel to get fair skin?\n\nHi doctor, I am a 22 year old female. I have a dusky skin that is brown skin. I want to become fair. Can I use Kojivit gel? Or any other dermoatology cream can I use? My hands are also brown in color and full of tan. Do you suggest any creams to get fair? I want to become fair as my marriage is going to get fixed by next year. Please suggest me some creams, so that it should not show any side effects. Also, how long I should use it? If I use anything, then will it have any effect in case of pregnancy, etc? Please help me. Thanks in advance.",
    "doctor_response": "Hi. One's skin color has 2 components. First one is genetic, which cannot be changed. Every skin color is beautiful in its own way and we should learn to love our skin color and augment it and not hide or lighten it. The second component is acquired, which is due to the influence of environment, sunlight, hormones, aging, etc. We can only target the acquired component of fair skin color while attempting lightening procedures. I suggest you antioxidant capsules like capsule Antoxid HC (Beta-carotene) and apply sunscreen lotion Lashield gel at 8 AM and 12 PM. Also, you can apply Glyaha koj lotion (Hydroquinone) at night time. Start with an alternate night application initialy as it may irritate your skin a bit and after a week or so, shift to daily night application. Consult your specialist doctor, discuss with him or her and take the treatment with consent. You can go for chemical peeling or microdermabrasion from your dermatologist which will help in exfoliating and give you a clearer skin tone. All these treatments are free of side effects. You may use them for three months. For further information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high rate of BPM?\n\nHi my name is kevin, 3 months ago i started to have what my first doctor called an anxiety attack, they told me to take lorazepam when it happend and i would feel better, i was having 1 every 2 days. finally i was doing better and having 1 every 6 days. I couldnt work or anything and havnt since, after 1 month i got a bad cold and started having 3 a day. After my cold stopped i continued having alot so i went to another doctor which told me to take blood tests and take this xanex 3 times a day at.25mg then i went back to another doctor and he said the other doctor was wrong i took more blood tests and had .5mg xanex for a month. Thats when i really had troubles breathing through out the day and so i went to see a chyropractor/kinsiologist and he told me that i would be fine its just i had too much acidity in my body so i should eat right. Soon after i went back to my doctor who perscribed me .5mg xanex and told him i wanted off , then he told me after 3 months its weird that your heart is still going fast , i thought it was cause u took too much redbull but now u need to go see a cardioligist (heart doctor) and strap a machine on u for 24 hours to see ur heart . he lowered my xanex to .25mg and said in two weeks to go lower and then off , he also told me to take more blood tests. My heartbeat stays at about 100bpm sometimes its 80 bpm and somtimes 120 bpm , he told me if it goes over 140bpm i should go to the Emergency room, but since the last 6 days it hasnt gone over 120 that i know of. Can someone just please help me its been 3 months i havnt worked and i feel like sh*t. i went to go see a cardiologist but they said i have to wait till march 2012 ....... What am i suppose to do. Can i even do exercize if my heart cant go over 140? my doctor seems weird. My chyropractor/kinsiologist seemed more aware of the situation, the other doctor i see for 2 minutes and he gets me out right away.",
    "doctor_response": "Kevin, a normal heart rate is 60-100 beats/minute. It is less if you exercise and more if you don\u2019t. Your heart rate variation may be anxiety related. If so, I agree that xanax is a poor long-term treatment option. You should try to wean from it if possible. The monitor is a good idea. I will usually ask for long-term (3-7days) monitoring to judge. It is good to keep of diary of symptoms with heart rate along with blood pressure. Sometimes abnormal control of blood pressure and heart rate go together to make you feel tired.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Explain why TCA is prescribed?\n\nI was recently ,well 5 months ago rushed to hospital and admitted to ICU for drug overdose. , from Barbituates,Meethedone,TCA .I can assure you I take none of these drugs .I am very interested in finding out what TCA stands for ? I will say I take serequel,at the time was taking lyrica ,I felt very depressed right after taking that medication. I am inremission frim stage 3 non-hodgekins lymphoma also have cryroglobulin vasculitis hep.c an neuropathy .Ialso found out that serequel can interact with other med. to look like TCA please help me",
    "doctor_response": "Hello and welcome to Healthcare Magic. Thanks for your query.I understand that you are going through a difficult time due to your problems. Now, I'm not sure in what context the abbreviation TCA was used, but with regards to psychiatric medication, 'TCA' stands for Tricyclic Antidepressant. Tricyclic Antidepressants are a class of anti-depressant medication used in the treatment of depression. You have also mentioned that you are taking Seroquel (Quetiapine) - which is an anti-psychotic medication and Lyrica (Pregabalin) - which is an anti-anxiety medication. Since you have mentioned different calsses of medication and since you have provided very little information about your symptoms, it is not possible to arrive at a definitive diagnosis for your problems. So, please discuss with your prescribing doctor regarding your diagnosis and the indication for your medication.Wish you all the best.Regards,Dr. Jonas SundarakumarConsultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can surgery treat the severe pain from narrowing and bulging discs, as steroids offered no relief?\n\nHello Doctor I have severe and mild narrowing Disc space of the L5-S1 and i have like 5 bulging disc any where from 1.5mm to 4mm. I have done PT and had 3 stearoid shots. I am still in a lot of pain should I get surgery? My neck curves the wrong way also.",
    "doctor_response": "Dear madam,surgery certainly relieves your pain but complications of surgery may incapacitate you so consult orthopedic surgeon to evaluate positive and negative results if undergoing surgery",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat generalized anxiety disorder?\n\nI\u2019m pretty sure that I have \u201cgeneralized anxiety disorder\u201d I\u2019ve had lots of stressful things constantly going on since March of 2015. Thank you for your willingness to help. All my symptoms just seem to fit. I\u2019ve had a recent physical and I\u2019m in very good health except for being about 8lbs over weight.",
    "doctor_response": "in  my  opinion  it   is  important   to  do  testing  of  thyroid  function  and  hemoglobin  levels  use  of  antidepressants   like  see tramline   25  my  once  daily  later  on  increased  to  50  my  once  daily  and  use  benzodiazepines  for  short duration  along  with  cognitive   behavioral  therapy  with  a  therapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take allergex at 7.5 months of pregnancy?\n\nHello there. I have flu and im 7.5 months pregnant. My doctor prescribed Allergex (elixir) to me. I asked if if was OK with baby and he said fine. The one chemist at the pharmacy were I bought it was not too sure...but asked the other one who said it was fine. Ques 1) is if fine to take it when im 7.5 months pregnant / Ques 2) Isnt it for Allergies...not flu?",
    "doctor_response": "anti allergics are used for flue alsoas if cold or flue the anti allergics can helpin reducingit s safe to take medicines in 7 months pregnancythis salt is okay and you can take it without any fear",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this MRI report of spine indicate?\n\nHi- Have had progressive pain in lower back, R buttock & R hip. Unable to sleep well thru night or difficulty with any activity. MRI- multilevel degenerative changes most pronounced at L3-L4 where there is mild to moderate central spinal canal stenosis. Mild foraminal compression of the right L3 and left L4 nerve roots. This is 3rd MRI that has progressively worsened past 3 years. I ve seen chiropracters, physical therapy, steroid injections and massage.",
    "doctor_response": "Hello,Since these conservative treatment modalities did not improve your condition, in my opinion, surgery (decompression) should be considered. This also because the MRI findings show stenosis and worsening. Discuss with a Neurosurgeon for these issues.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could sciatic problems cause loss of balance and weakness in legs?\n\nI started to get out of my car and I could not move my legs. I had no balance, if I had been next to my car and had my hands on the door I would have fallen. I was able to use my arms and get my rear back in the seat. I set for a while and was able to drive home. I was ok after that. I have sciatic problems was that my problem?",
    "doctor_response": "Hi, Of you have been diagnosed with the sciatica problems in the past that the symptoms of loss of balance and weakness of legs is possible that it is due to sciatic issue. You need to get involved in the core stability exercise, spinal muscle strengthening exercises, hip muscle strengthening exercises, static hamstring, static Quadriceps, straight leg raise exercises. As this will help you to have good strength of the muscles and stability of the spinal column. Also an MRI will be suggested because if there is any progression of the condition in the spine we can see in the MRI and guide you accordingly. Hope I have answered your query. Let me know if I can assist you further.  Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for eye discharge and nasal congestion in a child\n\nMy 10 month old daughter woke up with deep circles under her eyes and eye discharge so thick she had trouble opening her eyes.  Her eyes are swollen but the whites of her eyes are not pink.  She also has dark colored mucus draining out of her nose.  If I go to the urgent care, will they give me Rx for her or send me home and say it's just a cold?",
    "doctor_response": "Hello,Yes, it is just cold with secondary bacterial infections with purulent eye discharge suggestive of conjunctivitis.Start antibiotic drops, anti-cold syrup, antibiotic eye drops, and eye cleaning. It will respond well to treatment.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sachin Kumar Agarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe asthma and shortness of breath\n\nMy grand mother had severe asthma. I am a 28 years old unmarried female and I never had asthma symptoms before. My father passed away 4 months ago and since then I am  under a lot of mental pressure/ stress. I work long hours and ours is a very polluted city. For the last 2/ 3 weeks I have been suffering from severe cough..both dry cough and productive cough, but no temperature or severe shortness of breathe. I had taken cough suppressants, but they didn't work. What might be the diagnosis?",
    "doctor_response": "Hello dear,The symptoms as mentioned in your post can be attributed to Allergic rhino-tracheo-bronchitis.Presented with similar complaints, I usually treat my patients with:1. Tablet Allegra 60 mg twice a day or Tablet Levocetrizine 10 mg in the evening.2. Tablet Montelukast 10 mg in the evening.3. Anti tussive preparations like Grillinctus 10 ml three times a day.4. Asthalin inhaler (if there is associated breathing difficulty).5. Voice rest- avoid talking in loud voice & for a long time.6. Stay protected from exposure to cold, dust & other allergens.7. Steam inhalation & deep breathing exercise.8. Avoid smoking, cold food & drinks, maintain adequate hydration & take soft, non-spicy foods.There is no need to worry, you will be fine.Wishing you a Good Health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat pernicious anaemia/megaloblastic anaemia?\n\nI am a 42 year old female who was diagnosed 15 months ago with pernicious anaemia/megaloblastic anaemia. I was having horrendous heart palpitations and breathlessness. An ECG showed i have RBBB. Does the PA exacerbate the heart condition, or could there be an underlying heart disease quite separate to the anaemia?",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You have pernicious/ megaloblastic anemia.  For that you should take imjectable vitamin B12 therapy. Your heart disease is totally separate conditions for that consult your physician and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health. I",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of BP medication?\n\nI have side effects from 2 medicines that I am taking. They are for high blood pressure and congestive heart failure. I have taken them for about a year and 3 months. I believe I am toxic to these medicines at this point and I am worried about taking them. What is the best way to taper the medicines? This happened once before and I ended up in the intensive care for 7 days due to the medicines. I also had elevated potassium and was in critical condition for a short time. The heart problem was not present any longer and I had been taking the medicines for several years. No one knew why the heart was not a problem any longer. Some doctors thought that I had a virus that attacked the heart. The echo was 35 and I had heart failure diagnosed 2 different times now. But, the first time, it went away after taking medications for several years and maybe the same thing has happened this time. I have a cardiologist but he wanted to operate. He can not tell what is wrong with my heart so I have not agreed to have surgery at this point. What would you recommend? I think I am in more danger from the medications at this point than from the heart",
    "doctor_response": "Hello,I have gone through your question.I can understand your concern.first of all I need to know exactly which BP medicines you are getting.without knowing it I can't give you any information about side effects.but as you mentioned about pottasium ,I presume that it must either ramipril or similar kind of medicine which in fact is very good medicine for BP and heart failure .in view if side effect it should be changed.Actually no medicine is without side effect ,real art of a doctor is to use it smartly getting desired effect and avoiding side effects depending upon patient's constitution.You must continue medicines for BP and heart failure life long.In your case what is cause of your heart failure ?you have not given any detail about investigations .I can't opine on surgery .you have not mentioned which surgery and for what indication ?I am quite willing to guide you further if you provide me all details .My best wishesDr.Teli,MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "PCOD, fertility test done, follicle size not dominant. Is PCOD curable?\n\nI have PCOD problem just few months back i came to know this. Last year I had fertility test done and everything looked fine - PCOD was not detected that time. Please let me know if this PCOD problem is curable. Also I weigh more trying to reduce that through proper diet and exercise. Because of this problem my Follicle size is not Dominant ..today took a scan test (Day 11) and the size was around 7.2mm and 9.5mm. Please let me know if there are any chance of getting pregnant?",
    "doctor_response": "Hello mam plz dont get depressed pcod is found in number of femail and there are bright chances of your to get pregnent. Just be with your gyn and do your follicular cycle well follow the medicine thing will work better. Its good that you are trying to controll your weight just follow diet and brisk walk for an hour you will suerly loss your weight. Bye and think positive.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Ejaculated in condom but rubbed the penis on vagina and it is sore. Will I get pregnant?\n\nhi my fella had a condom on he ejaculated it was all in condom and he slid his penis rubbed on my vagina then slid out then up rubbed again contents was all in condom but vagina is sore im dew my period and scared i wont come on how do i know i had sex",
    "doctor_response": "Hello and welcome to health care magic. Your description is a bit unclear. What I understand is that your partner took his penis from r condom after ejaculation and rubbed it on your vagina. If so there is high chance of you getting pregnant. That's because even 1 ml of semen contains millions of sperms and they can swim upwards through the vagina to your uterus. My advice is to go and visit your OBGYN doctor at the earliest. She can prescribe a post coital contraceptive pill if the sex happened within 48 hours. Hope this discussion will be helpful to you. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could it be if there is an unexplained spot on the hip and experiencing joint pains?\n\ni went to the dr today. im having a lot of problem with my joints hurting and fills like they are going to pop out of socket. the dr took a xray of my hips today. right above my left hip was a spot. the dr said she had never seen anything like that before. what could it be. thanks",
    "doctor_response": "Hello, Consult an orthopedician and get evaluated. A detailed evaluation is required to find out the exact cause. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my baby's breathing shallow and fast?\n\nMy baby is 5 months and 3 weeks old.  She usually gets these raid breathing spells that last for about 5 seconds.  her breathing is very shallow and fast and she makes noises sometimes.  she is not sick, as in fever, vomiting or coughing. Should i be worried.",
    "doctor_response": "HiAfter going through the history of your child it doesn't seem to be problematic. Usually baby has a irregular breathing ie for some seconds it will breath fast and for some it will be slower. This is usually a normal pattern in a new born child.If your baby is feeding well and having proper weight gain also achieving developmental milestones with age then no need to worry.Faster breathing needs special attention when associated with1] High grade fever.2] cough3] Feeding difficulties.4] Increased respiratory muscle activity.If any of above are present then please consult a pediatrician.Hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be the reason for burning and blood in urine with left lower quadrant pain ?\n\ni am having left lower quadrant pain along with buring when i urinate and some blood . never had this before. i do have pancretic cancer . can this part of the problem?",
    "doctor_response": "welcome to healthcaremagic your presentation may be due to some stone in left ureter .blood in urine and pain are typical features as you suffer from pancreatic ca you should go for tests to rule out spread once urinary stone/infection is ruled out",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the ways to treat rashes on arms and legs caused by agapanthus plants' sap?\n\nHave been working in the garden today cutting back and dividing agapanthus plants.  Have just realised the sap they produce is poisonous and have now a red rash on my arms and legs where I came in contact with the sap.  What can I use to sooth the rash.",
    "doctor_response": "Hi ,  There is hypersensitivity reaction in your body due to allergen (sap) . so don't waste time and immediately  take pheniramine maleate  tab ( avil )stat along with anti histaminic twice a day with rantidine for 3 days .   If the symptom aggravates like generalized rashes , etching , breathing difficulty , sweating , palpitation , chest discomfort etc then don't waste time and rush to emergency dept for injectable steroid , avil , beta 2 agonist if required  and other supportive management .  Thanks n regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dry patch on the inner part of lip, feeling of roughness on the site on running the tongue, apparent on eating, no discoloration or pain. Treatment required?\n\nHi, I m a 33 year old healthy woman. I have a strange dryish feeling patch on my upper inner lip. The two sides of my upper lip don t feel symmetrical - when I run my tongue over the left side (where the dry patch is), it feels almost a little rough, like very fine-grade sandpaper. the right side feels normal and slick. Also, when I purse my lips , the right side still feels smooth and plump on the inside, but the left side, where the patch is, creases into sharp wrinkles . I notice it especially when I m eating - especially drier foods like cereals - which feel like they catch there. And the lip sometimes feels like it catches on my teeth on that side if they re dry. I first notices this about 3 weeks ago. I can t see any discoloration, and it s totally painless, just odd. Should I see a dentist? Or a dermatologist? Thanks!",
    "doctor_response": "hi as per the information provided by you i would recommend you to see a dentist to rule out any dental structure(natural or prosthetic) responsible for this patch. sometimes chronic local irritation from sharp edge tooth or dental prostheses lead to such patch appearance.am sure that a dental doctor can fully take care of this particular problem. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI shows multilevel degenerative disc disease, moderate right neural foraminal narrowing due to uncovertebral hypertrophy. Indications?\n\nI recentley had an MRI for my neck pain down my shoulder blade and arms can you explain what al this means? NEURALGIA/NEURITIS NOS-LT C8 RADICULOPATHY- provided. Neck pain. COMPARISON: None TECHNIQUE/PROTOCOL: Standard noncontrast cervical spine HNP protocol MR performed. No immediate patient complications or events noted. FINDINGS: Postsurgical changes of C5-7 ACDF. Slightly focal lordosis at the C4-5 level just above the fusion. Minimal retrolisthesis of C4 on C5, unchanged. Cord caliber and cord signal are normal. Normal bone marrow and craniocervical junction. Visualized paraspinal and neck soft tissues unremarkable. C1-C2: Unremarkable. C2-C3: No disc bulge, canal stenosis or neural foraminal narrowing. C3-C4: Broad-based disc bulge causes mild narrowing of the ventral CSF space. No canal stenosis or neural foraminal narrowing. C4-C5: Broad-based disc bulge narrows the ventral CSF space. No significant canal stenosis or neural foraminal narrowing. C5-C6: Fused disc space with no significant canal stenosis. Right-sided uncovertebral hypertrophy causes moderate Right neural foraminal narrowing. C6-C7: Fused disc space without canal stenosis or neural foraminal narrowing. C7-T1: Right paracentral disc osteophyte narrows the ventral CSF space without significant canal or neural foraminal narrowing. T1-2: Sagittal images only. No disc bulge or canal stenosis. T2-3: Sagittal images only. No disc bulge or canal stenosis. IMPRESSION: 1. Postsurgical changes of C5-7 ACDF with multilevel degenerative disc disease causing no significant canal stenosis. 2. Moderate right neural foraminal narrowing at C5-6 due to uncovertebral hypertrophy. David Barber YYYY@YYYY",
    "doctor_response": "Hi Mr David, Thank you for posting your query. I have gone through the report of your MRI of cervical spine. I would like to first reassure you that there are no serious problems noted in the MRI. The reports suggest degenerative and post-operative changes. There is no significant compression of any of the cervical nerves. Based on the reports, you require only conservative management such as medications (pregabalin, etc) for nerve pain; and physiotherapy. Wishing you good health, Dr Sudhir Kumar MD DM (Neurology)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have PCOD. Taking Siphene, HCG injection, Duphaston. Correct treatment?\n\nHello Doctor, I have been diagnosed with PCOD . Married for 2+ years now. Since 1 year, we have been undergoing treatment. From 3rd day, my doctor has suggested to take Siphene for 5 days. Then based on the follicle size, HCG injection is given. From then, we will be making love alternative days for 10days with Duphaston tablet. This was the process that we were following. Then we had done IUI for 8 times (Siphene on initial days and Duphaston from ovulation day). All the times, it s negative. Now underwent Laparoscopic Surgery , Ovarian drilling and D&C. Till now no luck. Can you please tell me if I am going in correct way? Thanks a lot. Preetha",
    "doctor_response": "Hello, Welcome to HCM, I am Dr. Das Look, you were treated in absolutely right way. But, the way did not lead to any result. It is a matter of chance. Either you have to wait or you have to think something else. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for giddiness and high blood pressure\n\ni feel giddiness after having salty food, I am under little bit depression also and often get stressed my b.p. normally ranges 86-90/110-140. I am very much upset due to giddiness . pl. help Iam also having frequent cough and acidity problem . My age is 40 years",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. After going through your medical details I understand your\u200bconcern and I would like to tell you that your blood pressure is almost under control which requires general monitoring. Cause for your giddiness can be related to postural hypotension which requires proper evaluation for better management. It recommended for you to consult a physician for proper physical and diagnostic evaluation. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Mebeverine Hydrochloride intake safe when trying to conceive?\n\nhi there im thinking of having a baby but i suffer from severe ibs. i take mebeverine hydrochloride 200mg twice a day to keep it at bay daily. will this harm the baby through pregnancy?? if i stop taking it i get very poorly with the ibs so i am worried that i will not be able to get pregnant without being ill.....",
    "doctor_response": "Hello, Its safety during pregnancy has not been fully established and for this reason it is not usually recommended for women who are pregnant or going to be pregnant. A baby\u2019s body and most internal organs are formed during the first 12 weeks of pregnancy. It is mainly during this time that some medicines are known to cause birth defects. No studies have been done to establish its safety for the growing baby. However, if your symptoms cannot be controlled in any other way, the use of an antispasmodic in pregnancy might be considered. When deciding whether or not to take an antispasmodic during pregnancy it is important to weigh up the benefits of use against the known or possible risks, some of which will depend on how many weeks pregnant you are. You must consult your doctor to see what is right for you and your baby considering your symptoms of IBS. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hoarse voice and constant cough?\n\nMy dr just told me I have a growth on my thyroid but my labs for my thyroid are fine, im 31. And already had an ultrasound with no answers yet what could this mean? Could I have cancer? My voice is hoarse and I have a cough constantly at night, I'm terrified.",
    "doctor_response": "Hi,From history it seems that there might be having some irritation producing cough reflex.As there is history of hoarseness of voice there might be having some swelling or nodule on the vocal cord.This nodule or swelliing can give rise to cough reflex and hoarseness of voice.You might require indirect laryngoscopy for nodule on vocal cord.Consult ENT surgeon and get examined.Quit smoking or chewing Gutkha if you are having habit of it.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red lumps on the legs and high fever?\n\nMy wife, 59, has had a fever between 99-101.8 for a week. She has red wells on both legs, all over them...probably 20 or more. There is no itching. Her legs feel like they are on fire from just clothes touching them, and bumping into something is very painful. She went to an urgent care center and the doctor put her on amoxycillin for a suspected sinus infection (she recently had a cold, but there is no outward sign of this infection), but she threw up after taking one, and did not replace with another antibiotic. The hives/welps problem started before she took the antibiotic.She has another doctor appt,. on Wednesday.",
    "doctor_response": "Hello,This is dermatitis due to variety of pathogens ranging from bacteria to viruses/fungi. Suggestions till meet the doctor: \u2022 Keep parts clean with antiseptic liquids and dry\u2022 Local application of dusting powder Clotrimazole (1%) \u2022 Tylenol (500) mg with Benadryl helpsHope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is testosterone therapy safe for CIDP?\n\nI have had CIDP for 10+ hrs.  Have just one kidney and neurologists think ivig therapy poses too much risk of damage to single kidney.  Have read that testosterone therapy may be of benefit in treating CIDP symptoms. Mpy testosterone level is 401i and neuros will not give me testosterone.  Could it be helpful, and if so, where can i get it?",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your symptoms and diagnosis.Testosterone therapy is not effective for treating CIDP (chronic inflammatory demyelinating polyradiculoneuropathy) and moreover, it may cause side effects. Therefore, I would not recommend you to start testosterone therapy.The best option for you is to start corticosteroids. Initially, you may take intravenous injections of steroids, followed by steroid tablets.IVIG (immunoglobulins) are also safe in people with single kidney. So, if needed, you may also take IVIG injections.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for acid reflux in infants\n\nHi Docs,My daughter 36 weeks birth, ~ 2.2 Kgs now and one month now is having grade 1 acid reflux. Every couple of hours she generally clenches her fists and her eyes are stuck on one side with the legs straightened. She is on Lanzol (once a day) and Domstal (1Ml three times a day). She is having gas all the time, any thing I can do lessen her pain... Thanks in advance.",
    "doctor_response": "Preterm babies often have laxity of muscles including that of the lower end of the food pipe which may cause the stomach acids to reflux. The acid is otherwise essential for the digestion of the food. The solution is not in giving Lanzol although Domstal may be given. The main solution is proper burping of the baby. Hold the child erect on your lap for around 20 mins after each feed. It should take care of the problem. If you put down the baby on the bed soon after the feed, reflux is not unusual.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest whether to do dialysis or to control high BP\n\nMy father is suffering with High Blood pressure for the last so many years , Due to which his both Kidney got affeted, last month Dr advised for Dialysis . We did dialysis . This month we met with another Dr in Lucknow who suggest that Dialysis would not be require now but we have to take care of High blood pressure & focus should be to control the High BP. I am confused to what should we do now.",
    "doctor_response": "HelloThanks for query .Your father who is known to have hypertension since many years developed renal failure for which he has to be treated with dialysis .It is known for patent with long standing hypertension to develop renal failure.Please consult qualified Nephrologist  for clinical assessment and get following basic tests done to confirm the diagnosis.1) Urine routine and culture with total quantity of protein excreted in 24 hours sample of urine 2)Ultrasound scanning of abdomen and pelvis3) Renal function tests Further treatment as regards need for Dialysis will depend upon result of these tests and final diagnosis.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tingling in arms, numbness in face and mouth, chills, anxiety, clenching jaw, tight head, bad memory.  Possible MS?\n\nAbout three weeks ago I felt tingling on outside of my arms, numbness spreading around my face and mouth, chills and deep anxiety. A few days later I felt a tight band around my head and my top jaw felt as if it were clenching. My memory is noticeably bad. Sometimes I cant find a word I know or miss-call a name. When I exercise my muscles don't seem to ache as they used to.My doctor thinks its anxiety but I now fear M.S. My blood results were all fine. What do you think?",
    "doctor_response": "Hi,Thank you for posting your query.The symptoms you have had are non specific and could occur in MS as well as other neurological problems. To qualify as an attack of MS, the symptoms should last for at least 24 hours duration. Also, the new symptoms should occur after a gap of 30 days or more, to be classified as another episode of MS.In any case, if in doubt, doing an MRI of brain and spine would exclude MS.Best wishes,Dr Sudhir Kumar MD DM (Neurology)Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i take prochlorper along with rejection medicine?\n\ni have had a kidney transplant 17 years ago, recently diagnosed with breast cancer and have started radiation treatments, my oncologist prescribed  prochlorper for the nasaue and vomiting yesterday. wha ti need to know is it alright to take with the rejection medicine",
    "doctor_response": "Hello and welcome to HCM.As an Urologist, i can advise you, that Prochlorper is a safe medicine for treating nausea and vomitting.If you can be more specific about your immuno-suppressive or anti-rejection treatment,  being taken for the transplanted kidney, i can give you an expert advice.You can send the medicines being taken to me, as a direct question.Wish you well.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Intense low back pain. Cant sit, stand straight & walk, pain & numbness on feet. Slip disc?\n\nHello earlier today I had sudden intense pain across my lower back, it was that bad i fell to my knees, since then i can not sit up straight, or walk properly (im using crutchs) Iwhen trying to walk i cant stand straight the pain in my lower back is too bad, Ive been experiencing pins and needles in my feet and numbness with the odd pins and needles in the centre of my lower back, what could this be? is it a slipped disc? should I go to A&E~?",
    "doctor_response": "Hello and Welcome to HCM, Thanks for writing to us. These symptoms are part of lumbar disc degeneration with PIVD where the nerves get compressed by the protruded disc.. There are several treatment modalities with medicines, physiotherapy and with injections in the back called epidural injections and root/facet blocks. If you dont get better with these treatment ,another option is surgery, by which the nerves are decompressed by removing the protruded disc (discectomy), which would significantly improve your symptoms Hope this helps you. Wishing you good health... Regards. Dr Saurabh Gupta. Orthopaedic Surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain in the neck?\n\nI m constantly have this sharp pain on the right side of my neck. It pulsates at times, comes and goes every month or so. When I touch it I feel like its right around the area where the artery is in my neck. The pain shoots into my jaw as well. I am a right side sleeper, which I ve read can cause issues with acid reflux. Any ideas?",
    "doctor_response": "hi,thank-you for providing the brief history.As the symptoms suggest me it is more of a muscular pain and with thorough clinical examination and if required an MRI of cervical spine should help us understand the causative factor.Also, the pain in the neck can be due to some factors like - trapezitis, cerical muscle spasm or degenerative disc pathology.Post the clinical examination and MRI the treatment will be initiated with drug therapy to reduce pain and muscle spasm. Also physical therapy for improving the muscle strength to make the neck muscles stronger.This pain radiating to the jaw can be due to muscle spasm in the neck as a part of a refered pain.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sore with yellowish discharge on the tongue, dry mouth and excessive thirst. Reason?\n\nOn the 6th Dec. 2012 i had sore on my tongue and was given all manner of antibiotics, since then i can not have spicy food which i normally like,also i have being having yellowish kind of wax on my tongue every morning, sometime i feel dry dry mouth, i have being drinking so much water and urinating as well.Right i have this pep perish kind of feeling.",
    "doctor_response": "Hello,Symptoms are associated with occurrence of aphthous ulcers .I would advice you to maintain oral hygiene well. Take plenty of fluids and nutritious diet.Intake of spicy foods has to be limited.Avoid anxiety and stress.Get your teeth cleaned.Vitamin c,and folic acid supplemnts has to be administered.If symptoms persists,please do visit a dentist.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Rash on the penis for second time. I am scared of penile cancer.\n\nHi doctor, For the second time I have suffered a rash on the glans of my penis in this year.\u00a0This time the rash was more intense in color. There has never been any itching or pain associated with this rash. But, just a scary looking color.\u00a0I was tested for all STD and STI infections before a month and it was negative for HIV, chlamydia, gonorrhea, syphilis, HPV, etc. This was completed by full blood test and urine sample.\u00a0I am 36 years old and married. My sexual partner has been the same for the last 10 years.\u00a0I do have a tight foreskin, which cannot be retracted the whole way over the head of my penis, but can come back about 75% of the way. Over the past three weeks, the rash has subsided and the redness is slowly going away. I have used Hydrocortisone 1% for two days and Canesten cream for two days. I also have Trimovate cream, which was prescribed to me for the first occurrence of this rash earlier this year.My main concern is penile cancer, although rare from what I have read, it worries me that this could be a tumor of some sort. Or is this a case of balanitis?\u00a0The other concern I have is the white markings on my penis, which have developed over the past one month. My personal hygiene is excellent. I do not use soaps on my penis glans and just warm water twice a day.\u00a0I have attached some images of the rash. I would appreciate any advice.",
    "doctor_response": "Hi. Fasting blood sugar, postprandial blood sugar and HbA1c levels in blood. Revert back with the reports to an andrologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Scratched scrotum area. Now pink and has abrasions. Will it heal quickly? Will treatment cost much?\n\nhello doctor, i am a 17 year old boy and i have scratched my groin region and the scrotum bag pretty badly. now the area has become pinkish in color and i also have to walk a lot daily, so the abrasions also cause me much pain. i just want it to heal quickly. it has persisted from quite some time. is there any sort of medicine that i can take to quickly heal the area,if yes then what is it and how much will it cost? please help",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.Normally the abrasions from itching heal quickly in 2-4 days. However if the same has persisted beyond that time then it is likely that you are having a add on bacterial or fungal infection. You should start yourself on some antibiotics like cefexime for 3-5 days and keep the area dry and clean. In India the antibiotic will cost you Rs 100. 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, or want to further details about your query, you can use the below mentioned link:bit.ly/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can sinus allergy cause wet feeling on head and dizziness?\n\ni am getting a wet feeling on my head with some dizziness, i can also feel fluid in ears with stuffed nose, get some twitching in legs and arms occasionally, it happens in evenings. my primary care doctor says it might be because of allergy/sinus, what could cause this?",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your history and would like to make following suggestions for you:1. Wet feeling on head, heaviness of head/face as well as fluid in ears, stuffed nose can be caused by sinusitis, especially if it is long standing. Dizziness can also be caused by sinusitis due to disturbance in pressures in middle ear cavity.2. In my opinion, usually twitching in legs and arms may not be due to sinusitis or allergies but they may be due to medicines as side effects or due to any other cause.3. From your symptoms, were I treating you, I would suggest you a prolonged treatment for sinusitis (at least 2-4 weeks). I would suggest you intranasal corticosteroids, montelukast, levocetirizine and daily regular steam inhalation. I would also suggest you antibiotics if you have fever.4. In general, I would suggest you to avoid exposure to dusts, smokes and air pollution as much as possible.5. I would also suggest you to take plenty of warm fluids during day as well as a healthy diet rich in vitamins & minerals (adequate amounts of green leafy vegetables, fruits, sprouts, etc).Hope above suggestions will be helpful to you.Should you have any other query, please feel free to ask at HCM.Wish you the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for breathing problems\n\nI have fibromyalgia and neuropathy. Here lately mainly in morning when I move (walk, pick up something,etc.) myheart starts beating really fast and hard. I feel like its going to jump out my chest and it makes it hard to breath. Could it be a cause of my fibro or neuropathy? I also take cymbalta and gabapenten.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. No, these symptoms are not due to fibromyalgia or neuropathy. Possibility of stress and anxiety related symptoms is more. But better to first get done ecg to rule out cardiac diseases. If ecg is normal than no need to worry for heart diseases. Stress and anxiety cause tachycardia, palpitation, chest pressure and heaviness. So better to consult psychiatrist and get done counseling sessions. Try to identify stressor in your life and start working on its solution. Avoid stress and tension. Be relax and calm. You may need anxiolytic drugs too. Don't worry, you will be alright. But first rule out cardiac cause. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be causing fatigue, forgetfulness, blurry vision, hairloss after pituitary tumor removal?\n\nI m 28 year old female 5 3 110lbs. I was diagnosed with a 5mm pituitary tumor about 4 1/2yrs ago. Had it rescanned in 2009 and they said that the tumor was gone. Well since November I have been experiencing fatigue, and within the last few weeks the fatigue has increased to a level that I have never experienced, along wiith feeling very foggy and forgetful. I noticed yesterday that I feel like my vision is kinda blurry when I look from a distance, I almost feel kind of drunk, if that makes sence. Also my hair is breaking off all over in very large sections.. I am a hairstylist and know from my knowledge that nothing I m doing in my daily hair care routine should be breaking my hair like this. I have not colored my hair in a few months either. I am going to have my thyroid checked in a few days, but is there any chance that my past history with pitutary tumor could have anything to do with this? I had an open MRI on my last scan, if that makes a difference.",
    "doctor_response": "Hi, It would be useful to repeat the MRI scan, as pituitary tumor can recur. You should also get vitamin B12 testing done. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Sudhir Kumar, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Soreness in stomach, discomfort, air bubble near rib cage. On buscopan and salpraz. What is it?\n\nHi, My stomach over the past 3 days has been very sore as in i feel like there is a huge \"air bubble\" in there, just below my rib cage. it is very painful, i find it extremley hard to sleep due to the discomfort, and throughout the day i just cant seem to get rid of the feeling of the \"air bubble\". i have never had anything like this before nor have a changed my diet or done anything out of the ordaniary. I went to the doctor and he has given me Buscopan and salpraz. So far i have taken 2 tablets of buscopan and i have been told to take 2 tablets 4 times a day which i will and 1 salpraz tablet after my last meal as thats when the pain is at its worse, when i go to sleep, but i wanted to know if any of this will actually help or was there anything else i can do to stop this anoying painful \"air bubble\". Jessica cook",
    "doctor_response": "Hello!Thank you for the query.This medicines (especially Buscopan) are only to ease the symptoms. So you may feel a relief, but only temporarily.Upper middle abdominal pain, discomfort are most likely caused by stomach issues including stomach inflammation, peptic ulcer, Helicobacter Pylori infection. The pain is dull, usually appears after a meal. Nausea and vomiting can be present.If the pain is more on the left abdomen, and radiates to the back, gallstones can be the reason.I suggest you to find out the reason first, than choose correct treatment. Otherwise, medicines can delay the diagnose. You should have abdominal ultrasound and gastroscopy done. Stomach cancer should be always ruled out with such symptoms (gastroscopy will do it).In a meanwhile please avoid fatty foods, spicy foods, fried foods, coffee.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for red blister on lip\n\nhi i have a red blister on uper inside lip.its red bump with fluwed and looks like a black dot in the middle.ive never had this before.i pop it with a needle and put proxide on it but it keeps coming back.its deffernt than a white sore in mouth.them you put proxide and there gone in a few days..",
    "doctor_response": "Do not try to pop with a needle, it could lead to serious complications. Get yourself examined and you might well be prescribed with topical antiviral ointment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure severe itchiness of the perineum?\n\nHi, I am a male 37 years old with good hygiene, but have been experiencing somewhat severe itchiness of the perineum for some time now.  It comes and goes, but when it \"acts up\" scratching it leads to a very intense feeling of relief. Do you have any thoughts what this could be?",
    "doctor_response": "Yes I have thoughts on conveying that some herbal combos having antiallergenic and antiseptic effect, without interaction and side effects is a safe bet for sustained relief.If interested pl ask direct question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat head spinning?\n\nThis morning while driving I had a sudden spell of some sort. Everything was fine then suddenly everything was spinning so bad I couldn t see where the road was. I knew I would wreck if I didn t get stopped, so I stepped on the brakes and steered toward the shoulder. By the time I got stopped the spinning had stopped. What could have caused this?",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, it was the typical symptoms of travelling sickness although it is very less likely when some one is driving and suddenly experience the vertigo, if this is so then near cause of this is needs to be known like cardio vascular disorders, vestibular dysfunction, hypoglycemia, condition demands little care,  hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Missed taking the Femilon tablet, had sex. Missed tablet on the 11th day of my cycle. Will I get pregnant? How to avoid it?\n\nHi,I am taking femilon tablet for the past 2 months to avoid pregnancy..But for the third month i missed taking the tablet for one day . Me and my husband had sex that night and i am really worried about the pregnancy now?can you let me know the status my condition ? is there any way to avoid it now ?Please Note : Missed taking my tablet on the 11th day of my cycle.Please advise.Maks",
    "doctor_response": "hello,thank you for using health care magic,well if it is less than 24 hours since when you involved in unprotected sex take emergency contracertive pill asap.. take its another dose after 12 hours of first dose..if it is already more than 24 hours consult gynecologist and go for IUD insertion.. if you get IUD  inserted with in 5 days of unprotected sex than there are rare chaces of pregnancy...in future if you forget to take pill take it as soon as you remember and continue it in rest of cycle normally..plus for that particular cycle use additional   method of contraception like condom..hope this helps you,..Regards,Dr.Nehal..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Frequent kidney infections. What measures can I take to avoid it?\n\nI have been suffering with kidney infections since I was around 16. I am now 47 and they are getting more frequent and more server. I just got out of hospital on Monday wth my last one but there never seems to be any kind of follow up? Once the infection has been treated I m sent home. I do live in in UK and this is the NHS that deals with it...",
    "doctor_response": "recurrent kidney/urinary infections is not uncommon. it signifies the failure of the normal defence mechanisms of the body. these could include presence of immunosupressive state like diabettes, HCV, HBV or other viral infections, use of certain medictions. Disturbence of the normal flow of urine like in cases of hydronephrosis, reflux disease, obstructive uropathy, renal stones. prolonged duration of antibiotics, profylactic antibiotics, evaluation for underlying predisposing condition with help in decresing the frequency of episodes. inspite of this patients can have repeated infections. i think your doctor must be trying his best! hope you get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruise-like red spots on breasts?\n\ni m worried. I m still develouping and think i ll have my period soon. I m 13.But i woke up with these red spots above my breasts and it kinda looks like a sunburn but I don t think it is. It doesnt FEEL like a sunburn either. it feels hard and feels like a light bruise almost. I haven t had any sexual contact with males or anything. Please help!",
    "doctor_response": "HiDon't worry. Such rash can be due to allergic rash or insect bites. You may use lactocalamine lotion for relief along with oral antihistamines such as fexofenadine. If the lesion doesn't improve then upload the image for our reference.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dent on the head with less hair on it?\n\nMy husband accidentally hit our daughter s head with his elbow while greeting some visitors when she was 5months old and 7 months now, she still has a dent on the right side of her head and the hair around the dented part has become very thin, please advise.",
    "doctor_response": "Hi, an elbow trauma doesn't cause dent. MRI brain should be done to look for cause. If anterior fontanalle is open, then ultrasound head can also help. Review with report. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pinkish,raised, waxy, lump, resembles like crater on chest. Should be concerned?\n\nHello. I am a 26 year old female. I have red hair and very fair skin. I found a strange mark/lump over a month ago. It is pinkish, raised and waxy. I took a picture of it earlier and noticed that up close it resembles a crater. I found this on my chest, about 2 inches below my left collar bone. It is mildly unsettling to look at, but the pictures make me worry more. Should I be concerned?",
    "doctor_response": "Hi. The explanation looks like sebacious cyst or folliculitis. You can apply topical antibiotic ointment like fusidic acid and don't  squeze it.this should help you. If it does not heal in couple of days then consult your doctor for examination and further management.Hope this helps you.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cardiac stress analysis: Positive for inducible myocardial ischaemia\n\nHi, Please let me know about my Tread Mill Stress Test report result as follows: \" CARDIAC STRESS ANALYSIS POSITIVE FOR  INDUCIBLE  MYOCARDIAL  ISCHAEMIA AT GOOD WORK LOAD 88 % OF MAXIMUM HEART RATE RESPONSE. \" What shall I do now? Please give me your openion on this.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Your stress test is positive for inducible ischemia. This means that your heart is not getting enough blood when you are exerting. Most common cause for this is coronary artery obstruction. So you should definitely consult cardiologist and get done Coronary angiography to rule out coronary artery blockade. If blockage is there then you will need angioplasty with stenting to open the blocked artery and restoration of blood supply. So next step in your case is cardiologist consultation and angiography to rule out coronary artery blockade. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hypertension\n\nI HAVE HIGH BLOOD PRESSURE AND TAKING MEDICINE LAST TEN YEARS. RECENTLY I TESTED MY BLOOD IN LAB AND FOUND THAT MY CREATININE LEVEL IN BLOOD IS 1.1. DO I HAVE ANY PROBLEM IN KIDNEY IN NEAR FUTURE?T HAVE ALSO ASTHMATIC PROBLEM FOR MAY YEARS. RECENT CHECKING BLOOD PRESSURE IS 13/85 AFTER TAKING MEDICINE. I AM AMLE AND 40 YEARS OLD.",
    "doctor_response": "Hello, thanks for posting a question on our site.A normal creatinine level for men is 0.7 - 1.3 mg/dL. So your creatinine level is normal likewise your blood pressure at 130/85 mmHg. I advise that you keep taking your blood pressure medications as prescribed, and all will be fine hopefully. Warm regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in upper left side of abdomen under ribcage?\n\nI am 54 yrs old have never had any bowel problems over the yrs, never constipated, eat a good healthy diet and do not smoke or drink. My question is that I am having moderate to severe pain in the upper left side of my abdomen, directly under my rib cage.  I have had the pain for 2 and half weeks.......I am getting a coloscopy next week.  I have had blood wrk just the standard CBC which is normal and no injuries to my abdomen, why am I in so much pain?",
    "doctor_response": "Hi,Thanks for writing to HCM and  for your detailed history. but i need further information regarding any recent history of trauma . have you lifted any heavy weight recently ,what are the factors aggravating your pain,any history of hypertension/diabetes  if i were your treating doctor i would first take ECG considering your age ,and ultrasound abdomen and pelvis most probably it is just muscle spasm as your CBC is within normal limits infectious cause can be ruled out,   and no history of altered bowel habits(so intestinal disease unlikely),my advise is to take T.ZERODOL SP 1-0-1(after food) and T.PAN 40 mg 0-0-1 (before food)for 3 days .before that i advise to consult physician with ecg  and ultrasound abdomen if both are within normal limits and symptoms not relieved with above mentioned analgesics ,consult neurologist to rule out spine pathologyHope I have been helpful .RegardsDr.kumaraguru",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does masturbating cause trouble in conceiving?\n\nHi doctors!! Im 32 yrs old now i begun masturbating when im at the age of 10 till now, i do masturbate a lot now that im married and planning to have babies u think i can still have the chance to get pregnant pls help as im so guilty and really want to have a childrens!! Thank u",
    "doctor_response": "Hi There is no reason to feel guilty. Masturbation is something that most normal women do.Masturbation does not cause inferlity.You have not given me some details like how long have you been married, your BMI, whether your cycles are regular etc.Since you are 32 years of age, if you have been trying for pregnancy since 6 months then see a gynecologist and do hormone test and tubal patency test for you and semen analysis for your husband. The results of these tests will guide in further management.I hope I have answered your questions.If you have any further concerns do contact me through Healthcare Magic",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to treat skin itching and scratching problem in a diabetic individual?\n\nHi doctor, My mother has itching and scratching for the past three months. She is 85 years old with a controlled diabetic. For now, she is applying Polysporin ointment and Benadryl 25 mg. She gets better for a while, and she gets it again. I am attaching the picture. Please suggest.",
    "doctor_response": "Hi. I have gone through the attachment (attachment removed to protect patient identity). It looks like prurigo simplex. Apply Mometasone cream. Mix it with coconut oil in equal ratio and apply over the affected area twice daily for two weeks. Take tablet Levocetirizine 5 mg twice daily. Please say whether your mother had any skin lesion in the fingers, abdomen, thighs, and private parts. Please mention whether the itching got increased at night. Please say whether any family member had similar complaints. If these are present, then the treatment varies or else go ahead with the above treatment for two weeks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause for discomfort in the joints?\n\nHi, I have a mallet fx in the first joint of my pinky finger, I had a pin in for 4 weeks and a splint part time for 2 weeks and it does not seem to be improving. what next? It is still very red and sore at the joint. should i be moving it more or splinting it more?",
    "doctor_response": "Hello,Welcome to HealthcareMagic.Thank you for providing the brief history.Any surgery of upper limb will ask the immobilization for upto 3-4 weeks. Post which based on the healing you may be asked to take Physical therapy sessions so the movement is regained.Also, nothing much to worry. you can start slow and gradual physical therapy which will help you regain full function of the finger.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for palpitations and irregular heart beats\n\nHi Doc,I'm 43yr old female, 5'4 and 146 pounds.Since '2009 I've been in and out of the emergency room for palpitations and feelings of irregular heart beats. I've had EKG'S, ECOCARDIO and blood-work. Dr's said all test checked out fine. I'm waiting for the county hospital to schedule me for a stress test and holter monitor in a couple of months. I've been a healthy person with no family history of heart problems. I don't understand why I'm going through this.I've also had strange headaches which feels like Cluster headaches, Dr's did a scan and found nothing so they said I didn't need an MRI.Thanks,Need insight",
    "doctor_response": "Hi,Irregular heart rate could be abnormal beat from a normal part of heart (VPC - Ventricular Premature Contraction) or could be sinus arrhythmia (irregular heart beat due to breathing, which is a normal phenomenon) or could be serious Atrial Fibrillation. To know the exact diagnosis you need a ECG at the time of this irregular heart beat. If ECG is normal, than we put a 24hr ECG monitoring called Holter Monitor which will tell the diagnosis & than the treatment plan accordingly. Stress test is done to rule out coronary disease as a probable cause of this irregular heart rate.So wait for the Holter report.ThanksTake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Non-smoker, has asthma, reduced lung capacity, normal X-ray, CT scan of chest, ige panel 25, allergy and aspergillius tests suggested. Advice?\n\n66yr old male diagnosed 2 yrs ago with asthma . my pulmonologist said in the last 2 yrs i lost 18 pct of lung capacity when i had breathing tests chest x ray is normal. he wants to send for ct scan of chest and ige panel 25 hydroxy vit. d alpha anthtrpsin test ne allergy panel and aspergillius precipitins test i am a non smoker . what other scenarios due you think he might be looking for",
    "doctor_response": "thanks for ur enquiry yes if ur diagnosis of asthma is right its very unusual to be diagnosed of having asthma at 64 years of age, if it really happened then it is adult onset asthma the prognosis of which is worse than the childhood onset variety. above all u have lost 18 pct of lung capacity. in this regards we have to search something in asssociation...may be an underlying diffuse parenchymal lung diseases..in this regard an HRCT scan thorax should have to be done. ur physician also suspected of allergic bronchopulmonary aspergillosis that's why he is asking for those tests. it is a good approach. let the test be done and consult with ur doctors after reports are getting available..need not to worry",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for uncontrolled diabetes\n\nHello Doctor, Hope you are keeping well, I am based in Dar es Salaam , Tanzania. I have a brother of age 24 years, who is suffering from Diabetes, for the past 16 years and he is under mixtard Insulin, He is injecting himself 2 times a day, morning 24 units and evening 18 units, he has been injecting as mentioned above for the past 16 years. He has gone into comma 3 times, and has recovered successfully. Recently 3 months back he has been suffering from neuropathy infection and his kidneys have started producing protein, we have consultated 4-5 doctors here in Dar es Salaam, but it has not worked out. He has pain in his left leg and the leg is getting thinner and thinner, he is unable to walk as well. He has been controlling his sugar as well but doesnt seem to work out as well. We are now planning to visit India, for his further treatment, we got your contact through the website, Can you assist us in this and give us ur estimated cost. Looking forward for your kind assistance regarding this matter. Incase you need any further information please do not hesitate to contace me on this number +0000. Thanking you in advance.",
    "doctor_response": "Dear friend, greetings from HCM.. I understand your concern .. The whole problem is that .. The sugar levels are poorly controlled .. Hence due to high glucose levels he is all end organ impact at the early age itself .. You also told that he was admitted because of coma .. That too three times .. That is really not good sign of diabetic management... You need to evaluate him thoroughly first.. Get his fasting glucose, HbA1c, lipid profile , 24 hour urinary proteins and thyroid profile .,.that gives an idea what could be the problem .. And what should be done .. Kindly take care of his diet and exercise.. Ask him to take more of green leafy vegetables, oats, milets, and whole grains .. Divide the meals into 3/4 small parts when ever he is hungry ... He can take little of fish .. Avoid carbohydrates.. He need to have some physical activities.. Even at home no problem .. Take care and do contact us with the report ....",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can serum urea and creatinine be controlled?\n\ni am 36 years old , since 10 years ago i was sick. according to my blood report  HG 11.9,wbc 7000 Neutrophil 46, Lymphocyte 44, Eosinophill 06 monocyte 04. BCT blood glucose (R) 114, Serum urea 111, serum creatinine 5.0, sodium 137, potassium 4.2, serum uric acid 6.7, serum calcium 10.1, phosphorus 4.2. Report on urine examination- colour - light yellow, transparency- clear, reaction- acid, albumine - trace, sugar- nill, pus cell- 2-4, others - nill. according to this report doctor says \" it is serious case , you have to prepare to transplant your kidney.\" and the doctor says\" now it is the correct  time to transplant .\" but sir i have no any swelling no fever.sir please tell me how can i recover from this situation ? what i can do sir? how to control my body's urea and creatinine ?",
    "doctor_response": "Dear Patient, I agree, there is a severe renal failure. However, there are not dialytic urgencies because electrolytes are normal. Please perform a blood gas analysis and provide a renal ultrasound just to understand if your kidney are chronically I'll or are still good for a renal biopsy.Let me know.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes knot and pain in and around IV area?\n\ni recently had an IV. They put it in the bend of my elbow. It very hard for me to extend my arm without pain. The vein is very hard below & above the IV site along with a knot at the site itself. It s not painful unless I touch it or try to extend my arm.",
    "doctor_response": "Hello!I really appreciate your concern. Your symptoms are due to inflammation and thrombosis around the vein (thrombophlebitis). It would be tender on touch for many days. You can apply thrombophob ointment specially for reliving such pain, tenderness and hardness. You can alternatively apply ice to the site.Hope my answer has solved your query. Take Care.Thank you. Best Regards.Dr. Manan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes presence of nitrates with mild burning having diagnosed with hypospadias?\n\nI have a hypospadias penis I am 38 years old and ever time I have unprotected sex I get a UTI this time I have some mild burning, have to pee ever 10 minutes, and positive nitrates on the urine dip stick is this a UTI, my Dr give me 10 days of Cirpo is this correct",
    "doctor_response": "HelloThanks for query .Based on the facts that you have Hypospadias and has developed UTI after  sex .Please note that having hypospadias has no relation to get UTI it is entirely due to unprotected sex most probably due to  your female partner having vaginal infection .Get your routine urine test and urine culture done to find out the organisms causing this infection and antibiotics to which they are sensitive to.Please take broad spectrum antibiotics like Ciprofloxacin along with urinary antiseptic   like Nitrofurantoin twice daily and urine alkalizer thrice daily .Later on switch on to appropriate antibiotics as per culture report.Get the prescription of medicines from your family Physician.Ensure to drink more  water .To keep your urine dilute This will help to control dysuria.Get your female partner /Wife examined by qualified Gynecologist for vaginal infection and ask her to take treatment if required .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child have a itchy rash on butt. Used  hydrocortisone cream. When it spread given trimathcone. Now have chills, fever. Suggestions?\n\n2days ago my daughter broke out with a itchy rash on her butt i applied hydrocortisone cream and the second day it spread into the crack of her butt so i took her to the dr and they prescribed a cream trimathcone im sure thats not spelled right but im sure u know what im talkn about....well today she woke up with chills and fever i gave her 2 motrin but tonite the fever is back....can u tell me what to do",
    "doctor_response": "Hi and thank you so much for this query.I am sorry to hear about this rash and the eventual fever that your daughter has developed.From the description of these symptoms, the break in her skin on the butt has created an opening for germs to gain access into the body and cause and infection. The fact that she has now developed fevers warrants and immediate consultation for proper investigation and management. You may continue to use the fever to control the fever  but getting her evaluated by a pediatrician is the best next step.All the creams you have applied are able to deal with the itches bu not the cause of these itches except they are allergies. If this is a child, the most common cause is usually a fungal infection that needs antifungal creams and not steroids. However, without examining the patient it would be difficult to make a definitive call and that's why getting consulted is of prime importance.I hope this helps and guides you. Thanks for using our services and feel free to request for more information if need be. I wish your daughter well.Thanks.Dr. Ditah, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with PCOS. Suggested primolut. Should I expect period?\n\nhi i m 30yrs old woman .recently i have been diagonesd with pcos and two months delay in my periods .....after my gynec suggusted primolut n three times a day for 5 day.....s i took it for 3 days and i m not able to get the primolut n any where in pharmacies ....so i stopped taking it from 4th day ...my question is do i get my periods? after 3 days of medication?",
    "doctor_response": "HelloThanks for your query.Patients with PCOS often have delayed cycles and scanty bleeding.Normally, Primolut - N should be taken for 5 days, as proper progesterone effect is established only after taking it for 5 days.Many doctors prescribe it for 3 days also.After stopping the drug, you normally experience hormonal withdrawal effect.this means that after stopping medication, you normally experience withdrawal bleeding within 2 - 3 days, but definitely maximum within one week.So wait for that time period, and then consult your doctor if you do not have periods by then.take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for itching bumps in buttocks\n\nFor the past couple months I've noticed that in my buttocks creases only I have tiny bumps...they do not itch and are not painful, but haven't gone away...I have really oily skin and have dealt with ingrown hairs in the pubic area as a person of african descent but my butt in pretty hairless...I've even looked at it in the mirror and they don't have big heads/look like genital warts look in pictures but I don't know what's wrong..can you please give me some considerations?",
    "doctor_response": "HI. Thanks for an elucidate history. These look just small boils and may be due to pressure sores. If there is no problem , nothing to worry. Take Vitamin a 6 capsules and Vit D sachet. Many times this improves such skin conditions a lot.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does asthma effect the unborn child?\n\nhello doctor i had a confution .. so i believe that u clear my confution.. i had 1 child ( 5yrs) now i am planning for 2nd..but i am a asthama patient so i take montek lc daily night.( half). If i became pregnent there is any problem to child pls answer me....",
    "doctor_response": "Hi dear,At the outset, please take a note that asthma might have affect  on unborn child ,but chances are minimal.You may be put on bronchodilators or inhalers like Foracort during your pregnancy ,because pregnancy will bring physiological changes in body like you may have difficulty in breathing .So.only Tab .montek-lc will not be effective in pregnancy .I would be glad to know if my advice any helped you.B/RDr.Harpreet kaury",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have developed blisters and sugar lowered after taking Metformim. What dosage to continue with damaged liver?\n\nI have been taking  Metformim for two weeks doctor has me taken 1 pill at night for 1 to 2 weeks. Since I started this I have small blisters on my hands. My blood sugar has decreased from 240 down to 140 or 130 in the mornings and lowers during the day tonight it was 114. I'm afraid to take 2 pills at night as she instructed as I already have liver damage and am afraid my sugar will go to low. Should I take the two pills? Will the blisters go away?",
    "doctor_response": "Hi there,Thanks for your query.Firstly, Metformin has brought down your blood sugar to within desirable range, though the morning (empty stomach) blood sugar is still high. There is thus, a need of increasing the dose of metformin; or, addition of another drug.Metformin is detoxified and thrown out of the body predominantly by the kidneys. Hence, mild liver damage in not a contraindication of stopping metformin.Lastly, it is probably a coincidence that you developed blisters on the hand after you started metformin. These blisters are probably viral and need a course of anti-viral agents.Consult your doctor and apprise him of my opinion. I am certain that he will agree with me, order required tests, and- based on the reports-  will prescribe suitable/modified treatment as advised.In case of any further queries, revert back to me THROUGH DIRECT PREMIUM QUERY (Paid), addressed to me personally. You will receive- almost immediately- my response in great details.If you find my response helpful and informative, do not forget an \u201cexcellent\u201d (5-star rating)  to my answer, to ENCOURAGE all doctors- engaged in social service- to render sound advice to the FREE queries. Fond regards and have a nice dayDr. Rakesh Karanwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "what is the difference between a TENS machine and an SCS implant?\n\nCan you please tell me what the difference is between a TENS machine and a SCS implant? I have had chronic lower back pain after a injury 8 years ago. I am on Morphine 100mg x 2 daily, and am looking for something to help with the pain besides increasing the dose of meds. Thank you, Lisa",
    "doctor_response": "hi,the TENS therapy is a Transcutaneous electrical nerve stimulation, so it is superficial electrical stimulation via the skinThe SCS implant is the spinal cord stimulation implant which is placed in the spine under the skin surface.Both helps in stimulation of the nerves and reduce Pain via the pain gate theory.For TENS you do not need a surgery but for SCS you need oneThank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Am I still likely to get pregnant after urinating and washing off sperms post-intercourse?\n\nPls I had sex yesterday and after my partner didnt knw he released in me but after I felt the sperm all over my virgina after I washed it and urinated immediately is there a possiblity that I can get pregnant cos ill menstrate this weekend and also wat.medicine.can I take to flash it",
    "doctor_response": "Hi, thanks for using HCM.With history of unprotected intercourse pregnancy can't be ruled out.  You can wait till your due date, any delay in periods need to get your urine pregnancy test to rule out or confirm pregnancy.The i pill(emergency contraceptive pill) can be taken within 72 hours of intercourse and it will give protection. But failure rate is seen in 1% of women using these pill. 1 or 2 i pill in a cycle are effective in providing contraception, Regular use of this pill is not recommended.Hope this helps you.regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful lump above the anal opening\n\ni have a lump inbetween my bum cheeks like right in the middle quite a bit above my bum hole or whatever you want to call it but yeah its not like on top of the skin its like in it and it hurts to touch but not really to sit down because its like deep inbetween my bum cheeks but yeah its about half the size of a golf ball but i dont think its a boil or anything its like quite under yeah what is it thank you :)",
    "doctor_response": "HiWelcome to hcmYou are having pilonidal sinus/cystmost likely as per your discription. This needs surgical removal of the cyst. It can be abscess also. In any case it requires surgery. So you have to show it to your surgeon. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can shingles be treated?\n\nActually, this is a suggestion. I have shingles. I ve found that maintaining steady pressure on the rash and blisters greatly reduces pain and itching. To do that, I am using a compression shirt and a large elastic bandage wrapped around my torso. I suggest making that suggestion on your website. Others may find it helpful.",
    "doctor_response": "Hello,Welcome and thanks for your suggestion.The reason why you feel less pain and itching is due to the counter pressure/ irritation which suppresses the sensation from the lesions. Even though it may have some relief to symptoms, it is no substitute for the well accepted medical treatments for shingles ( Herpes Zoster) and without proper medications there is a chance for spreading of the lesion and causing harm due to the same.Do get back to me if you have further queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My father had polychondritis. I am now suffering from knee joint pain, pain in my middle back when I raise my arm blurred vision and and blocked ears. Could polychondritis be hereditary? I also was diagnosed with prostate cancer and received Radiation therapy one year ago.",
    "doctor_response": "Hi, Polychondritis is an autoimmune disorder affecting mainly the joints, nose, ears and respiratory tubules though exact genetic predisposition is not found but it runs in families. As you also have history of prostate carcinoma which is known to metastasize to bones, especially the vertebraes, so you need to rule out other causes of joint pain apart from polychondritis. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Rohan Shanker Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pregnancy happen after having penetrative sex?\n\nME and my girlfriend had sex twice last night. The first time we used a condom and i ejaculated in to the condom. Then i put my boxers back on but did not properly clean up. About an hour later i pentrated her again but this time without a condom. I did not ejaculate this time but she did and i was just wondering could she get pregnent because i ejaculated early that night and then pentrated her again an hour later but did not ejaculate this time?",
    "doctor_response": "Hello, Thank you for your query Yes it is possible, but chances are slim. There may still be live sperm within the urethra which could lead to pregnancy. If her period is delayed, please ask her to take a home pregnancy test. I suggest that you use contraception everything you have intercourse to prevent unwanted pregnancy and complications.. Hope this helps. Please let me know if there is anything else I can help you with. Wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can be done to improve the appetite of 22 months old baby?\n\nHello doctor, My 22 months old baby girl had a fever on Wednesday and was on Babygesic and Sinarest-AF drops for cold and fever. Until now she did not have fever but now she has raised temperature. She has not eaten solids from Wednesday. I am very worried. Please help. She is such a poor eater and is currently on Dee drops, Aptivate for hunger on a daily basis. Vitamin D test was performed last year.",
    "doctor_response": "Hello. First of all your baby is quite underweight. She has to be above 13 kg by 22 months (attachment removed to protect patient identity). Coming to the fever part, she requires an antibiotic for the fever to subside. Please give her syrup Azee (Azithromycin) 200 - 2.5ml once a day for three days. Now, her not eating solid food issue. Do not force her in any way or else she will develop an aversion to food and will become fussier. It is okay if she does not want to, do not come under pressure from the people surrounding you. They do not know your baby as you do. Please add the Pediasure powder to her milk and give it compulsorily twice a day. Her weight will improve in two weeks. I cannot stress this enough. Do not force food on her. For more information consult a paediatrician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is nausea and tingling sensation in foot normal after ankle sprain?\n\nI sprained my ankle last week it swelled slightly the first couple days I did RICE and stayed off of it.  It is now a week later and it is a little more swollen and purple along outside bottom and in between middle of toes.  I have been walking on it and I have been feeling tingly on my foot and nauseous in my stomach. Is this normal",
    "doctor_response": "HiAn x-ray or MRI of ankle should be done for evaluation of joint bones,ligaments.history suggests some disruptive sprain or even some hai line crack possibly.show an orthopaedic doctor.A cast or ankle brace for 2 weeks may be worn for 2 weeks for immobilisation and healing,defer walking.Antiinflammatories meds like advil maybe taken thrice a day for 5 days after meals",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure pain in the spleen?\n\nMy daughter has pain in her spleen. She went to the ER today. Her spleen is enlarged. Her liver enzymes are elevated. She has been tested for mono and it has come back negative. This is the second time she has been in the ER. They are confussed as we are. what could it be?",
    "doctor_response": "HIWell come to HCMYou are under the wrong impression in fact the pain could be at let mid quadrant of abdomen, and this may be nonspecific if I would be her doctor then I would treat this case with Tab clinidium with Chlordiazepoxide three times in day, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are Hashimoto\u2019s, and ankylosing spondylitis the reason for severe hair loss?\n\nHello doctor, I have had a lot of hair loss in the past year. Mostly on top of my head. Lost half my hair. My regular doctor did not find anything wrong with my blood test and said hair loss affects a lot of women and accept it. My new Naturopath thought my numbers seemed low and suggested iron and thyroid supplements. I need another opinion. I have tested positive for Hashimoto\u2019s, and I have ankylosing spondylitis. The dermatologist did scalp bio negative for inflammation. My TSH is 3.71, T4 is 99, T3 is 110, and FSH is 8.1. The values of zinc is 82, ferritin 36, Iron 93 and TIBC 315. Please help me know what I should do?",
    "doctor_response": "Hello. Hair loss in females can be due to many causes, most common being 1. Telogen effluvium stress-induced, due to illness, a diet with low protein intake, surgery, post-pregnancy, and mental stress. 2. Female pattern alopecia is genetic and hormone-mediated, runs in the family. 3. Diffuse alopecia areata is autoimmune condition usually associated with other autoimmune disorders like diabetes, thyroid disorders, and ulcerative colitis. 4. Drugs such as Isotretinoin, and Chemotherapy drugs induce hair fall. 5. Lupus, scarring alopecia. With your description, it seems like diffuse hair loss, but I cannot confirm unless I see the pictures. In your situation, I feel it is autoimmune condition most probably diffuse alopecia areata, because you have been diagnosed with Hashimoto's and ankylosing spondylitis. I do not know if you have taken an injection of corticosteroids (Triamcinolone) for the scalp. This is very helpful in an autoimmune condition. I am considering the most probable cause, and it could even be female pattern alopecia. Do you have a family history of baldness, history of surgery, illness, stressful events before you noticed hair loss? Please send the pictures of the scalp.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for strained muscle in left side\n\nI have been doing a yoga teacher training course for the last three months & in the last week experienced what I thought was a strained muscle in my lower left side. It has now spread to the right & is around the old hysterectomy scar that I had done over 10 years ago. At first it hurt on movement but now I am aware of it burning a lot of the time. Should I be concerned or is it just likely that it is old scar tissue that has become aggravated? I have also moved several times during the course & been lifting moderately heavy suitcases.",
    "doctor_response": "you are a yoga performer. so may be the more activity you will perform is stretching. you might have either damaged the muscle or may have got a sprain or may have got a pinched nerve. apparently first line of action is to take rest, then slowly working out for the strength in core muscles. and later go into a proper fitness training. you will be ease of pain and again perform better yoga.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it necessary to take out gall stone?\n\nI have a 4 cm gallstone. Should it be taken out if I don't have many of the usual symptoms. I am 65 and my dr. says that I have probably had it a long time. I don't hurt when I eat a fatty meal or a big meal. Right now I keep having a pain just about the area of my right bottom rib cage. It has been there for about 4 months. I weigh 150 pounds and am female.",
    "doctor_response": "Hello,You have a large gallstone. The symptoms of right upper abdominal pain could be due to the gall stone. If this is the case the it would be advisable to get the surgery done to remove the gall bladder.Hope this helpsRegardsDr Samir patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a knee injury?\n\nI gashed my knee last night ice skating and rammed into the side of the rink with my knee. It was bleeding so I put ice and then hydrogen peroxide on it, a large bandaid and went to bed. The weird thing is that it was numb to the touch, and more of a gash than a cut, the side don't come together.  Is this a problem?",
    "doctor_response": "Hello,Thank you for using Healthcaremagic.I read your question and understood your concern.I think you need to see the doctor as this may have complications if you do not treat properly.Dr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for flat head syndrome in baby\n\nHI MY BABY SON HAS JUST TURNED 7 MONTHS , HE HAS FLAT HEAD SYNDROME AND HAS AN APPOINTMENT TO SEE A PAEDIATRICIAN SOON, HIS SOFT SPOT HAS ALSO CLOSED ON THE FRONT OF HIS HEAD IM WORRIED ABOUT THIS CAN YOU PLEASE TELL ME IF THIS WILL HARM HIS DEVELOPMENT IN ANY WAY.",
    "doctor_response": "Hello. I just read through your question.The closing of the soft spot at this age typically does not cause any problems. As for the other issue, I recommend bringing this up at your doctor appointment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe numbness in the forearm\n\nWas bit by large dog on forearm 10 punctures total, has been 2 days no sign of infection, moderate swelling but having numbness on the top of my forearm to my two middle fingers... Currently taking antibiotics & anti inflammatory. Does the numbness subside typically after the wounds heal or could it be a sign of nerve damage?",
    "doctor_response": "Yes this is a sign of nerve damage.  It may resolve spontaneously or may persist depanding grade of injury, which can be measured by NCV. Just start methycobal also which helps to repair the nerve damage.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the MRI with mildly dehydrated disc spaces indicate?\n\nHi I am 43 years old and suffering from back pain.I went for MRI scan and may report says:The disc spaces are mildly dehydrated in lower lumbar spine.A small left posterolateral disc protrusionL4-L5 is seen mildly stretching the left exiting nerve root.there is also subtle disc bulge L5-S1.What have you suggest me.Thanks",
    "doctor_response": "Hello MRI findings suggests mild degenerative disc disease of lumbar spine.There is mild dehydration(loss of water) of inter vertebral disc in lower lumbar vertebra.At L4-5 level,there is small left posterolateral disc herniation which is mildly stretching left exiting nerve roots.There is also subtle disc bulge L5-S1 level.Majority of the cases of degenerative spine disease are benefited by physiotherapy and analgesics.Since you have mild findings,so you should try physiotherapy first.Surgery should be the last option.Treatment can be planned after consultation with neurologist.Get well soon. Take Care Dr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are tremors and anxiety a sign of parkinson s prior to a surgery?\n\nmy grandmother died at 26 of RA I feel i might be at risk ..at 46 i have DDD in Lumbar n Neck serve waiting on surgery but they wont till i stop shacking w anxiety n get it under control buy i think they r missing something??? I can hardly type i feel like like i have parkinsons????",
    "doctor_response": "Hello!Welcome on Healthcaremagic!You should know that tremor is not the main typical sign of Parkinson disease. A thyroid dysfunction or anxiety could be the cause of tremor. Anyway, I recommend consulting with a neurologist for a careful physical exam and performing some tests  (complete blood count for anemia, thyroid hormone levels for thyroid dysfunction, blood electrolytes for possible imbalance) to exclude other possible causes. A DAT scan would definitely help exclude Parkinson disease. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of lower back pain and discomfort?\n\nI fell on my butt at work a month ago and I ve noticed that my lower back hurts when I lay for too long, or standing for a while. It s not a sharp sharp pain but it s really uncomfortable it hurts, I don t know what to do to relieve it I can t swallow pills for pain.",
    "doctor_response": "HiThank you for asking HCMI have gone through your query.Your problem can be a muscle strain or intervetebral disc injury or sacroiliac joint dysfunction.A thorough physical examination by an orthopedician will give clue for that and an X ray followed by MRI might be needed to confirm it.For such cases i advise a short course of NSAIDs like Aceclofenac Muscle relaxants like thiocolchicoside and neurotropic drugs.I also recommend physiotherapy along with this.Usually it will take at least 1 month to recover.For some it may prolong till 6 months.If no improvement with conservative therapy surgical treatment can be considered.Hope this may help you.Let me know if you have any further query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dilated ducts and diverticulitis after the removal of gall bladder?\n\nHi I had my Gallbladder removed 1 yr ago.  Now 1 yr later I have had my white blood cell count come back 3 times out of the norm.  Blood in urine and dilated bile ducts which leads to Diverticulitis.  This has happened 3 times in the last 5 months.  Why are my Ducts dilated where I had my gallbladder surgery done.  Can this be fixed so this infection can stop speading through my stomach.  They have me on Leviquin and flagel antibotics.  They also said my pattasium was low and my liver enzyemes were elevated.  Can there be a tear somewhere since my most irritated spot is where my gallbladder was taking out.  Any advice would be helpful? They did Cat scan and ulra sound of abdomen and found diveriticultis and dilated ducted where gall blatter was removed - What is causing this?",
    "doctor_response": "Hello,Diverticulitis is not related to gall bladder surgery but dilated ducts are not good if this is significant. You might have some stone or stricture. Consult some surgeon.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. B.dinesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mild chest pain\n\nI am a 28 yr old female with no known health problems. I started working out this past week doing a lot of upper body stuff. Today I was doing wall ball squats where you throw a 10 lb medicine ball at the wall, catch it, and do a squat & repeat. After awhile I started getting a pain in the center of my chest about 3 inches down from my collarbone. I told my coach and she said to keep going. I did but was slowing way down because everytime I would catch it, it would hurt/stab (and not like I was sore from working out). Finally after awhile I started to become short of breathe and had to stop altogether because I couldn't breathe. This isn't the first time it has happened in the last few years & I have seen a doctor who was of no help. For added information I am a hair stylist and have my arms up most of the day. I also have silicone gel implants that I got about 3 years ago. I have no idea if there is a connection. Also once in awhile I take a prescription  called provigil for Narcolepsy. I don't take it often though because it is a pretty mild case.  Please help!",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Possibility of musculoskeletal pain is more likely because your pain is associated with exercise. So follow these steps for better symptomatic relief in musculoskeletal pain. 1. Avoid movements causing pain. Avoid sudden jerky movements of chest.2. Avoid heavyweight lifting and strenuous exercise for 1-2 weeks.3. Take painkiller and muscle relaxant drugs like ibuprofen and thiocolchicoside.4. Apply warm water pad on affected areas.Don't worry, you will be alright with all these in 1-2 weeks.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedyfor bruises in buttocks\n\nWORRIED!! I fell down the stairs a week ago. Hurt my upper buttocks area pretty bad. It bruised reall bad after a few days on the spot where I landed. The bruising eventually went down my buttocks further. NOW...I have a large fatty-feeling swollen bump (like the third of a softball) on the upper area where I landed. It feels very strange and is still very sensitive if I sit on it wrong (against back of chair). It, however is not bruised but worries me. I have no insurance or I would have had it checked out. -Poor Rad Tech Student",
    "doctor_response": "Hello, I think you have a haematoma there which needs to be addressed, if it is not getting resolved automatically over time. Apply some hot fomentation or Seritz bath if possible. It should settle down. Make sure you're not having fever that it should not get infected it will need a surgical treatment. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Rajesh Hingwe",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does clogged arteries while being on stents lead to bypass surgery?\n\nI had 2 stent put in my main heart artery in January.  I am scared to death it may not last. I can find nothing on the internet to give me any hope.  1 artery is fully clogged and the other 2 are badly clogged.I am 73 years old and wonder if a complete by pass is and able to be in my future?",
    "doctor_response": "Hello and thank you for using HCM. I carefully read your question and i totally understand your concern.It  is very difficult to give an opinion just by this short story. But I will try to explain you something.It is quite known in cardiology that stent ri-stenosis might happen. This risk is higher during the first 6 month and than decreases. But there are  other possibilities after a stent re-stenosis like angioplasty whith balloon , stent-intra stent implantation that mean that you might implant a stent into the obstructed stent, always depending on the type of your first stent and the characteristic of the stenosis. And the last option when the other are not possible is by-pass surgery that you all ready know. So, yes...if your three arteries have problems and your stents get stenosis you might end to bypass surgery. If this is technically possible or not depends on the characteristics of your coronary arteries and the positions of  stenosis.The risk of bypass surgery depends on your age, your heart function and other organs functions.But you should not worry. You do have possibilities to go quite well. There are a lot of possibilities today with a good chronic medical treatment, angioplasty and by pas surgery. Wish I was helpful. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain after undergoing IUI?\n\nhi i have done iui on 1/7/2011 and today is my 14th day, i m feeling lots of abdominal pain like felt in periods...wat does that mean?? i m not more with any medicines ritenow.. i took the duphaston for 10days after iui and laa ef for 3days..kindly suggest me",
    "doctor_response": "Hi there, I have understood your concern. I will suggest you the best possible treatment options. Please do not worry. As you might be aware that  menstrual bleeding starts 14 days after the ovulation if you are not pregnant. Please wait patiently for 3 to 5 days.  I'd you happen to cross your expected date of the cycle then please get morning's first sample of urine tested for pregnancy. As for now please seek prescription support from your treating doctor for getting anti spasmodic medicines like Dicyclomine. Think positive.  I am sure that you must be taking Folic acid, Vitamin B 12 supplements. May God bless you with a bundle of joy. I hope this answer helps you. Thanks. Dr. Purushottam Neurgaonkar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in back and abs?\n\nrespected sir,                   I fill a pain from last 4 day                   I go to the doctor                    1st day he pus me  Nuporto & Asspos tfter that I releaf from that pain                    Last night there was pain again                   what can i do?                    it is my left side of back & lower abs                                            plz help me",
    "doctor_response": "HelloBack ache may be due to many reasons like musculoskeletal reasons,renal calculus,pelvis pathology etc.You need proper evaluation and investigations.Investigations include routine hemogram,random blood sugar,liver function test,urine RE/ME,ultrasound of abdomen.I also suggest X-ray L/S spine (AP/Lateral view).Ultrasound of abdomen can exclude many possibilities.Treatment depend upon findings.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with intermittent anxiety, heaviness in chest, eases with lorazopam. Tips to gradually withdraw the medicine?\n\ni am 70 years old.had been suffering from intermittent anxiety/sress.had been taking for last 25-30 yrs one or other benevery night like diazapam,lorazopam,alprozam etc.Since early october have been suffering from moderate anxiety,gloom,melancholy with a heaviness in chest region.lorazopam 1 mg morning and in the evening gi8ves substantial relief i feel good & cheerful.i am also started homeopathic treament who wish me to continue allopathic medicines i.e lorazapam till i begin to feel better.i wish to how long one can continue taking lorazopam & how to leave it gradually at a a later stage thanks pbhalla",
    "doctor_response": "Hello and welcome to Healthcare Magic. Thanks for your query. Medication such as Lorazepam, Diazepam, Alprazolam, etc. belong to a category of medication called benzodiazepines. Now, this group of medication is used to treat anxiety as well as sleep disorders. When used for the treatment of these problems, these medication should be used only for short periods, because prolonged use can lead to medication dependence or 'addiction'. So, if you are continuing to take these medication on your own, then I would advise you to consult a doctor, preferably a psychiatrist for further advise regarding continuing these medication or gradually tapering and stopping them. There are also other non-addictive anxiety medication, which can be taken safely for long duration. There are also many psychological therapies which can help you effectively deal with your anxiety / stress. I would also suggest that you try relaxation techniques like deeep breathing, yoga, etc. for managing your stress and anxiety. Best wishes, Dr. Sheeba Stephen",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pins and needles in left arm/leg?\n\nhi there for the past few months i have been gettting pins and needles in my left arm every now and again but now for the past 2 days ihave had it all day long also i have some pins and needles in my left leg, i had malignant melanoma 3 years ago thank you regards anne",
    "doctor_response": "Hello, It could be neuropathic pain. As first-line management, you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist better to consult a neurologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take Napoxin for severe back pain?\n\nHi I have hd severe back pain for years. I am 26 with two kids and overweight at 5 7 and 265 pounds. I also have polycystic ovaries.. I am taking adipex and had xrays along with blood tests for thyroid work done. Results have not come back. For my pain my doctor perscribed tramadol which made me sick so instead she perscribed napoxin for pain, but I have read numerous bad reports of this medication. Is it safe? I need something to cover the pain until we see xray results. What should I do?",
    "doctor_response": "Dear- thanks for using our service and will try to help you with my medical advise. First of all, Naproxen should be taken with some food to avoid more damage to the walls of the stomach. It is a safe drug, just need to be careful if you have history of gastritis or ulcers.If that is the case, then avoid it. You can take Acetaminophen to avoid the side effects of Naproxen or just alternate with both for the chronic pain. It depends of the xray results, you might be a candidate for physical therapy or epidural block.Weight loss will help the back problem too.Dr.Garcia",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pulmonary hypertension in an elderly person\n\nMY MOTHER IS 73 AND HAS PULMONARY HYPERTENSION - THIS IS BEING MANAGED WITH LASIX AND OXYGEN AT HOME WITH FAMILY AND VISITING NURSES BUT SHE HAS RECENTLY DEVELOPED A BLACK FINGER TIP THAT IS VERY PAINFUL - IT GOT BLACKER AND BLACKER AND IS NOW SHRIVELING UP - WE HAVE GONE TO THE DOCTORS AND THEY DONT KNOW WHAT TO DO SHE RECEIVED A SPINAL NERVE BLOCK, AFTER MANY OTHER TESTS AND NOW SHE IS GETTING IT IN HER OTHER HAND - BOTH ARE HER RING FINGERS PLEASE HELP US!",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.Black fingers in Pulmonary hypertension (PH) patients suggest worsening of PH and gangrene formation (due to hypoxia-low oxygen).So along with oxygen and Lasix, she should start specific drugs for reducing PH.Specific drugs like tadalafil, bosentan, ambrisentan etc.She should also start blood thinners (aspirin or clopidogrel).So consult pulmonologist and discuss all these.Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason of loud thumping noise heard from chest,and a sensation of something bursting out of chest?\n\nHi, okay so, last night I was sitting down, relaxing watching tv and out of nowhere i started hearing this loud thumping noise that was really loud, I look down and I see my chest moving like something was about to burst through my chest and my jugular was going crazy. What happened? It's never happened before and it scared the hell out of me.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. The sound you are saying is mostly due to gaseous distention of stomach and release of gas from it. But better to get done ecg and 2d echo to rule out cardiac cause for your symptoms. If both are normal than no need to worry much for cardiac or jugular vein disease. You are mostly having gaseous release from stomach. So better to avoid hot and spicy food. Drink plenty of fluids orally. Start proton pump inhibitors and prokinetic drugs. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lumbar spondylosis, disc bulging, tear at L4-L5, narrowing of neural foramina. MRI done. What does this mean?\n\nMy mom MRI result shows this , so I want to have some advice on treatment. Lumber spondylosis mild bulge of the disc with left posterior lateral annular tear at l4-l5 causing effacement of tsecal sac and narrowing of neural foramina L/ R focal posterior central annular tear at L5-S1 hypertrophied ligamentum slvum seen at L4-5, L5-S1 Thanks",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern this could be degenerative disease of spine and treatment is depend upon the neurological symptoms this can be managed medically if the symptoms are not severe or else surgical intervention would be necessary, hope this information helps you, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have osteopinia. Taking fozamax, actonel. Both having side effects. Density not improving constantly. Other medication?\n\nI have osteopinia. I have had it now for 4 years. I am 58 years old and I have been either on fozamax or actonel. Both with side effects after taking each for 4 months or longer. ( fatique ,aches and lethargic) Actonel has been more tolerable. Does it benefit me to take medication when it is not constantly improving density to do so? After the first two years my density improved somewhat, but now after my last test it seems to be about the same. I am very active. I run, do body fitness with weight bearing regularly and yoga . I watch my calcium intake and vitamin D which I have been tested for which showed I was not deficient.",
    "doctor_response": "Hiwelcome to HCMostteopenia is the precursor of osteoporosis. There are 3 major cause of lowering bone mineral density- 1) deficiency of Vit D and calcium 2) inactive of vit D receptors by certain inflammatory cytokines result from the presence of few microbs 3) low level of estrogen in case of menopause.As your vit D and calcium level is normal so you have the others causative factors like Vit D receptor inactivation and low estrogen level. if you will  go for a proper homeopathic treatment that things can be solved. It is needed a some detail physical symptoms to suggest some homeopathy remedies like i) how is about your sweats? more sweats than other?, ii) do you have any burning sensation of hands or palms or legs. iii)are you susceptible for catching cold easily iii) do you have any hot flushing of face and any part of body. iv) do you prefer egg mostly in your diet.etc. So if you want to consult me can contact here. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness & dull pain in testicles with erection problems?\n\nhelo Dr Chandan,i am a 34 year old male,taking med for hypothyroid for 8 years now.125 thyronorm for now.my doc just added deanxit for 15 days last week.it makes me sleep on time,but i am not able to maintain n erection,what could be the reasons.i have never been a smoker or drinker.but there is a dull pain in my right tecticle,which i cant explain,i have got an ultrasound done and the doc says its fine,though the numbness and the dull pain remains.",
    "doctor_response": "HiI understand your concern.If ultrasound came normal then only anxiety can affect your erection problem.There is no other local pathology which can produce erectile dysfunction.Do you have morning erection? if yes then all things are normal just do certain modification like.Relationshipfree communicative and mutual understanding will helpsex is mutual act\u00a0\u00a0\u00a0\u00a0\u00a0so try to do mutually and tell your problem to partnerthis will reduce your anxiety and able to erect easilyLife stylestress and busy life style make u fatigue and secondary to this it makes less desire in sex and erectile problems.Psychological mildness is must.Do stress free work.proper sleep.Daily scheduling work.Exercise and meditation.All of this is reduce your stress.Condition can be treated withmedicines like sildenafil,, tadanafil, tetrafol plus etc,do take advise from doctorsGet well soon thank youTake care.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sickness, sneezing and watery eyes\n\nI have been sick for about 2 days.. Although symptoms appeared 2 weeks ago. I am EXTREMELY congested and constantly sneezing. Body aches have occured and my eyes water. I have also had nausea. I went to the doctor today and he said it was sinus but I have been taking sinus meds for about 2 weeks now.",
    "doctor_response": "Hi,it can be due to sinusitis, flu,sore throat or just common cold,may be upper respiratory infectionBut what I have seen in my clinical practice is that only symptomatic treatment doesnt  help,antibiotics works excellently despite if its viral infectionSo go to your ENT specialist and get prescribed according",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the quality of life after undergoing angioplasty?\n\nHi, may I answer your health queries right now ?  Please type your query here...I just had a stent placed in the big artery going to my heart.  TWo years ago I had coratedectomy on my right side.  I have RA.  I am 63.  What kind of life span can I realistically look at?  I am wondering if I should quit my job or keep going.  I do not want to die on the job without having gone to the coast.",
    "doctor_response": "HelloJust have a little positive attitude, with the advised precautions by your doctor and by taking regular medicines and going for regular follow ups with your treating doctor you will have a normal life as any other individual.There is no need to quit your job as joblessness do kill people psychologically.Kind RegardsDr Bhanu Partap",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump on the waist indicate?\n\nHello.I have a near golf ball size lump on my waist line on the left size. It's been there for two months now but was previously the size of a pea and has suddenly gotten bigger. It's slightly red now and only moderately painful. I'm a 31 year old male with Crohn's and on humira. I saw an emergency room doctor while it was still small and he thought it was maybe a lipoma but wasn't sure. The fact that it's now getting much bigger has me concerned.Thanks for any help!",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .*  This seem sebaceous cyst or some boil more likely *  Kindly get an ultrasound of the swelling and consult with report .Wishing you fine recovery .Feel free to ask any further  queries .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "How safe is taking Hydrocodone for sciatic pain?\n\ni was prescribed a dosage of 10/325 hydrocodone for sciatic pain and have been using it at a dosage of 3 tablets per day. I am going to try another treatment and another doctor . How long is this med going to stay in my system and what would be the best way to discontinue it",
    "doctor_response": "I wish you meet a spine specialist and discuss about the Physiotherapy sessions. as physiotherapist can help with a non invasive techniques which will help you get strength in your muscles and help you avoid pains and progression of this sciatica symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How should acute hair fall be treated?\n\nI am suffering from hair fall for the past 2 years but since last 2 months it has increased. I have started going to the gym, hence my diet plan has changed and also i live away from my family so have to eat outside because of my long office timings. Can you suggest any remedy for this. I also had a haircut recently. People say that you will have hairfall if you cut your hair. I don't know what to do. I want to know good shampoos, also whether Sodium Laureth Sulfate is good for the hair. Anything that can give me a relief from hairfall would be fine.",
    "doctor_response": "you have chronic telogen effluvium with acute episode superimposed since 2 monh due to crash dieting and irregular dietary intake. I would advise you to take regular nutritious diet with proteins and micronutrients wit lots of fruit and vegetables. Also do take iron and calcium supplements. You canuse sodium laureth sulfate shampoo with conditioner for gentle cleansing andwashyour hair every other day. Donot use harsh treatments likehot combing and straigtening. You can also use Minoxidil 2% lotion lotion locally at bed time.Haircut has no impact on hair fall hich needsto be treated",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be done after a child swallows NP thyroid?\n\nMy 2-year old may have swallowed my thyroid medicine (NP Thyroid TAB 90mg; sub for Amour Thyro Tab 90mg). I don't know for sure that he took the pill, and I know for certain that 1-2 is the most amount of pills that could have even been in the bottle. What should I do?",
    "doctor_response": "Hi, I am sorry for the accident happened to your boy. I advise to do the following if:- you know that he has swallowed the pills within the last 2 hours. In this case, give him plenty of warm water to drink. In this way, he will vomit the pill together with stomach content. - if  you do not know the time when he swallowed the pills, then, observe if unusual changes will happen to him. You should send to ER for further evaluations. Hope it was of help!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bouts of sneezing and itching?\n\nI am having bouts of sneezing and itching eysin the early morning and several times in the day, speciaaly more if I walk in the high grass. Doctor prescribed Motek LC for next 30 days. After firs tab there is instant relief. If I discontinue, It will recurr or it is healed........",
    "doctor_response": "Hi,Montek LC contains Levocetrizine and Monteleukast. These molecules are given for runny nose, itchy eyes, sneezing etcetera due to allergic reactions. They do not have any severe side effects except some patients may experience gastrointestinal symptoms and drowsiness. There are cases where this medication has been given for 6 months to patients as per physician's instructions. However, as you are feeling good with one or two doses only, you may feel to avoid taking it for next 30 days. I can understand your concern. In that case, you can take this medication for 5 days and then discontinue. However, I would like to caution you to keep extra doses with you so that you can start them if the symptoms appear again. If the symptoms do appear again, I would recommend taking the dose for full month as per advised by your consulting physician. If you feel you get these symptoms more while walking on grass, you can try some days not walking on grass and see if symptoms happen. This can help you to decide if you are allergic to grass or not.To be absolutely sure what you are allergic to, you can get your blood tested in laboratory for Allergy Test. However, you can go for this if the symptoms keep relapsing and you are not sure what is causing them. Otherwise, there is no need for this test for occasional symptoms that can be controlled by medicines. I hope this information helps. Thank you for choosing HealthCareMagic.Best,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for topical burn on my abdomen after an injury with bleeding while urinating?\n\nI am 2 weeks post-op from TVAH.  I have had some hypotension (probably related to pain meds).  I also have an topical burn on my abdomen due to an ice pack opening up and the chemicals pouring onto my abdomen.  I began having a small amount of bright red bleeding (usually when urinating but not always) today.  Is this concerning?  I have been having brown discharge up until this point.",
    "doctor_response": "Good day! post surgical wound complications and such presentation as yours are never enough to be adviced from a thousand mile typing advice. Needs work up and examination and then some thing can be said what to do what not to do. SO hope you seek it in a right perspective. Involve your Ob Gyn or general surgeons in it and let them decide what these issues anticipatetake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fluctuating lumps on head, ears, neck and scalp that are occasionally painful, abdominal pain. Related to spleen?\n\nHello. I have flucuating lumps on my head,ears and neck and scalp . At times they are oainfl but not in general. Sometumes they are small with a moving ball inside and a couple are very hard. In addition I have abdominal pain on my lwft side above the rib cage and under the left breast bone. I m thinking this is my spleen . At times I can feel it. I know the spleen may be a lymhnode too. Do you have any duggestions?",
    "doctor_response": "these are allergies and due to that there is off and on sinusitis causing problems of head neck and ears the same allergy causes stomach and spleen problems like ibs and spleen is the reactive part of disease it might be linked with foods we take dailyif you can get blood serum tests for specific antibodies of foods we take daily like milk wheat egg potato chana rice nuts egg and others you can elimnate them from diet and after few wk your disease will start reversing till then treat according to symptomps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have lower back pain, numbness in thigh, leg pain. MRI shows facet arthrosis. Meaning?\n\nI have been previously diagnosed with DJD, IVDS, Sciatica in left lower extremity. I have chronic lower back pain, numbness on my front left thigh, sharp shooting pains in my left leg to my foot, sharp shooting pain in my left buttock. I have more recently been having the same type shooting pains in my right leg, although not as intense as in the left, and more severe pain in my lower back. I had a recent MRI that showed... Finding:Alignment of lumbar spine, height, an signal intensity of vertebral bodies is maintained. Disk space narrowing with hypointense T2 signal is present at L5-S1 level. Conus medullaris ends at L1-L2 level. No mass or abnormal signal intensity within conus medullaris is seen.-- At L3-L4 level no bulging disk, foraminal or central spinal stenosis.-- At L4-L5 level an asymetric bulging disk, to the right, is noted. There is an abutment upon the root of the right L4 nerve. Mild arthrosis is noted.-- At L5-S1 level focal central broad-based disk protrusion is seen with slight compression upon the anterior thecal sac. There is an abutment upon the roots of right S1 nerve. There is also close proximity/an abutment upon the roots of L5 nerve. There are short pedicles with lateral orientation. Mild hypertrophy of the facet joints is seen.Impression:1. Focal central disk protrusion at L5-S1 level with compression upon the roots of S1 nerve and abutment of roots of L5 nerve.2. Short pedicles indicative of congenital spinal stenosis.3. Multilevel facet arthrosis.Can someone help explain in lay terms the MRI results? Do the findings line up with my previous diagnoses and do they explain the more recent pains in my right leg? Thanks for your input.",
    "doctor_response": "Hello. Thanks for writing to us. The findings of your MRI are consistent with a degenerative disc disease with the nerve root compression at the level of lower spine., The symptoms that you have described are related to these findings. I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL  Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe scalp pain\n\nI have been having scalp pain for about 2 weeks now. It is a stabbing pain that hurts most with the movement of my hair. It is isolated to one area on the top of my head. There are no obvious lesions noted on my scalp nor any palpable mass. Occasionally I feel a popping sensation at the location of the pain. I have Hashimoto s thyroiditis but am otherwise a healthy 38 year old white female.",
    "doctor_response": "Hi, Consult a physician and get evaluated. Detailed evaluation is required to find out what exactly causing this symptoms. Wishing you good health. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat zit on my left leg?\n\n3 months ago i had a zit on my left leg. I tried to pop it before it was ready and it became infected. Took antiobiotics and knocked it out. A month kater, same thing on my right leg. I was stupid and did the same thing got infected again, antiobiotics again. Now i have another one, havent touched it, it formed a white head, but its pretty big. I'm 44 yrs old, have had leg zits for a long time, but now they seem to be getting worse. Why?",
    "doctor_response": "HelloWithin a period of three months , you had three  ZITS and pop it every time , got infection and took antibiotics . The possibilities of such zits may be due to :1 Some bacterial infection like staphylococcus or streptococcus or any any other bacteria . Diagnosis can be confirmed by blood culture or biopsy of affected parts.2 The next reason of such zits may be due to dermatitis or eczematous dermatitis . Diagnosis can be confirmed by physical examination by a dermatologist .3 At the age of 44 years sometimes due to lowering of immunity skin got infection.So please consult a dermatologist and get his opinion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for kid showing odd behaviour\n\nI have a 5 almost 6y/o grandson who is exihibiting behaviors such as throwing chairs/desks in school, rocks at kids in playground. He once put a kid in a hammerlock. Rarely sits still especially at home. Will sit & draw. He is mouthy. You can tell him something like not to run in the house& seconds later is doing it again. Time outs don t help. He sees a counciler at school but I see no Improvement,nHelp!",
    "doctor_response": "Hi,Thank you for asking question on health care magic.Hyperactive behavior is seen in most of the children of that age.Usually they grow over it within few years.Better ignore and do not pay any heed to it.If you feel it requires immediate redressal, better consult Psychiatrist.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can you conceive with progesterone level of 0.51 ?\n\nis iit possible to get pregnant with a progesterone level as 051ng I am 22 year old female,got married ,planning to get pregnant.Before and after marriage my period cycle is regular.But for last 2 month it got delayed,but pregnancy test was negative. So underwent treatment, they asked to take blood test such as haemoglobin,thyroid,prolactin,insulin, all are good enough, after that took progesterone test on 21st day(9.2.2011) the value is 0.51 ng/ml,it lies in follicular phase,actually i need to get periods on 20.2.2011,but i did not get it till now(3.3.2011). Is it possible to get pregnant? please suggest me.",
    "doctor_response": "hi welcome to health care magic.see normally during period from 1 to 14 day progesterone level more then 1 -1.5 ng/dl from 15-28 days                   2 -2.8ng/dl. your progesterone level slightly lower side thats why you have irregular period you have to concern your gynec for that and make your period regular then go for plan a child. thanks dr.dhara dhara.shah84@yahoo.in",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cough after smoking menthol cigarettes?\n\nI started smoking menthol cigarettes about 6 months ago from a regular light cigarette and am wondering if that is why I am having perisitant coughing that I did not have prior?  We are not sure if it's allergies,  but xray has shown my chest is fine, cultures are not coming up with anything so I am trying to delete things to figure out why this is happening.",
    "doctor_response": "Hi,Welcome to HCM,Your cough may be due to allergy/hyper reactivity to menthol cigarettes which at time cn cause bad cough.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can reduced growth rate in one of the twins cause health complications?\n\nAm pregnant (6months) have got twin babies when checked in ultra sound scan it was found that growth of one of the baby is less, doctor has asked me to scan again on 2nd March to check the growth of the baby. you said if there is twin babies then it is a complication case. Is there any issues for the baby in the womb until it comes out? Or what can be done for my baby to be healthy and safe until it comes out?",
    "doctor_response": "HI.If one baby suffers from growth retardation then it is not an indication for corticosteroids, but only your doctor can be the best judge for this. Growth retardation can be dealt with in a few ways, but to be honest it is possible for the twin experiencing some growth retardation to have some health related issues (possible not very serious) once born.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a tender bump on the bruised spot?\n\nI fell about 3 weeks ago... I am 35 year old woman. After the fall I had an immediate bruise about the size of a dollar...It was more linear than round. It was sore to walk on for a few days but hey I am 35 and fell on concrete bashing my shin on a concrete step. I have not gone to the doctor just rest, ice, elevate and Motrin. Last night I noticed a hard dime sized lump. It is not able to be moved and is solid not fluid filled. Should I have it looked at or just wait. It is tender to touch and I am not able to kneel on it at all! It is raised more than my knee so when I kneel my weight is on this lump and hurts. Thank you in advance for your time.",
    "doctor_response": "HI,Welcome  to HCM.Based on the facts of your query,you  seems to suffer from-Leg Shin Cellulitis with  Resolving Hematoma.Seems you started your activity early as compared to the trauma/hit you had from the Concrete Step.Tenderness indicates Cellulitis there still.As its 3 weeks now,You should take your doctor's opinion to assess the cause of the delayed regression of the tender bruised lump on the shin,ONLY if you find after 1 week that it has not regressed or it is increasing.Possibility of the bony injury needs to be ruled out by Xray and Usg of the lump and by Surgeon's Second Opinion.Hope this reply would help youWelcome for any further query in this regardWill appreciate writing your feedback review comments,to help the needy patients like you at HCM.Good Day!!\u00a0\u00a0\u00a0\u00a0\u00a0Dr.Savaskar,Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pain reliever advisable for the ligament tear in the foot?\n\nMy son 38 years, 5 feet 2 in has been prescribed EEZSFLAM for pain relief since he has a LIGAMENT tear in his foot. He is also on Cortizone and harmone replacement therapy since last 17 years after an opeartaion for Cranyophranjiama ( non malignant). Is it OK for him to take EEZSFLAM? YYYY@YYYY",
    "doctor_response": "Yes he can take eezflam for the ligament tear.But before he does make sure that he does not have a history of1 ) Asthma2) Venous disorders3 Currently on blood thinners4) Hemorrhage5) Allergy to painkillersIf not then he is free to take the medicine as its main component is a non steroidal antiinflammatory drug by the name diclofenac",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the treatments required after analyzing the sonography result?\n\nHI. my father has been diagnosed cyst in liver after sonography , below is the remark Grade one fatty infiltration of liver ;few scattered small cystics areas in both lobes;? degenrativ crowded bowesl in lower abdomen , could yu please suggest what is this and treatment",
    "doctor_response": "hiread your queryyou have absolutely left out why the usg was done in the first placethe report has to be read according to the symptomsa usg is not an absoluteyour dad has fatty liver, liver cysts both of these could be insignificant chance findingsand both of they could point to illnesses like alcohol intake and cld, tb, amebiasisthese can be ruled out after a complete historysimilarlycrowded bowels could mean he has had some past disease or surgerycould be nothingcould be a current infection like tboverall i would suggest you meet your gastroenterologistbest of luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Low grade fever, rashes, blisters on chest, on arms and vagina, sun burn. How long will it take to clear up?\n\nI run a low grade fever not over 99 degrees temp at night, a rash with tiny blisters that started on my chest (collar area) then it spread to first my arms and external vaginal area, then my legs and now it is getting on my face - it burns, feels like a sun burn and looks like I have been scalded; I am retaining fluid where the rash is. This has happened in the past. This started in August, seemed to be about to clear up, and then this past weekend it seemed to start over but worse.",
    "doctor_response": "Hi i think it is not a sunburn as unexposed areas are also involved.rule out immunobullous disorders.herpes infection.immunobullous disorders can be ruled out by biopsy and immunoflouroscence.whereas herpes can be ruled out by tzanck smear where u will find multinucleated cells.treat the condition with atarax 25 mg at night.antibiotic twice daily and use of wysolone 30mg tapered off to 10mg within one fortnight and application of gentisn violet for unruptured blisters and fucibet ointment for ruptured blisters",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest an effective alternative for Diclofenac Sodium\n\nMy mother had an allergic reaction to Diclofenac Sodium , used it for knee arthritis pain, her throat glands swelled and respiratory difficulty ensued. Medication worked very well for relieving pain, is there any other similar medication to Diclofenac that would not have that allergic reaction.",
    "doctor_response": "Hello, You can consider analgesics like tramadol which is safe and effective especially for long-term use. It does not usually produce an allergic reaction also. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swelling in the abdomen\n\nI had a lap. appendectomy on Friday, February 14. During this procedure and trying to get around I have pulled an abdominal muscle. The pulled muscle is a swollen knot low in my abdomen. I am still very swollen where that muscle is and in my lower stomach. I literally cannot suck in my stomach without pain. How long does it take to lose all of the swelling and for that abdominis rectus to heal?",
    "doctor_response": "The swelling that you are talking about, seems to be a ganglion which occurs when some fibres of the muscles get torn by accident or due to some other cause. These torn muscle fibres curl up together and form such a structure. If that is the case, although the pain would gradually subside, the swelling might still be there. What it actually is, can be commented upon only after proper examination. I would strongly insist that you visit a doctor and get yourself examined.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hypogonadism\n\ndear doctor, please what is the way forward for a 23 year old boy that has been diagonised of hypogonadism?. fsh low(6) lh high(23) testotesterone low(2.3) and prolactin level high(25). i have not noticed a significant change in my sex organ since i was small. i have being placed on parlodel since more than a year now but i havee not noticed difference. i am gaining fats all over my body always weak~, weak muscles; changes in body complexion. please i need your help. thanks for your concern",
    "doctor_response": "Hi, Parlodel is for a prolactic secreting growth in the brain. The prolactic would gnerally be very high. Mostly someone is going to need testosterone if the testosterone and the testosterone stimulating hormones are low. Surgery fixes prolactin-secreting growths but a head scan would be needed to see it. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have itchy scalp, neck, arm, upper back. Have rashes, bumps. Is is burning also. Had used iodine supplement. Treatment?\n\nHi, this morning, I started itching my scalp and then my neck, I then started itching my upper arm, my upper back, I have rashes and a lots of bumps and ridge looking bumps that just popped up about an hour ago, the itching hasn't stopped but getting more and now burning, I haven't changed soap or lotion or used new medication, I only started using iodine supplement 3 days ago, can you please help",
    "doctor_response": "Hello,Taking Iodine can worse rash caused by Dermatitis Herpetiformis.Other than that Iodine is safe and doesn't cause any problem.You may take antihistamines to control the itching and rash.Consult a Dermatologist for further management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should metrolgyl 2.5 ml be continued for loose motion?\n\nHi my daughter is 3month old and she having loose motion 5 times in day from last 2 days yest i have given nor metrolgyl 2.5 ml twice a day..now she is felling well shall i continue or stop.she don;t have vomit or not feeling dull also..her taking milk thing is also going well",
    "doctor_response": "Brief answer :No need to give metrogyl. Detailed answer :A 3 month baby can pass 5 to 6 stools per day and can pass stool only once in 3 to 4 days, both these things are normal and there is no need to give antibiotics in that. In my opinion, you should stop metrogyl as it has no role in diarrhea in 3 month old baby. In my opinion, you should give enterogermina ampule once a day for 3 days. Enterogermina is a prebiotic which is used to increase gut immunity in child. I hope this has helped you. Take care. Regards - Dr Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could jelly-like substance in semen indicate?\n\nHi , I am 18 years old , sometimes after masturbating and ejaculate if find that small pieces of sperm are jelly like as if they are rubber like in touch. What are the probable causes and is it dangerous or what ?? Hope you got my querry . Thanks A lot !.",
    "doctor_response": "Hello dearUnderstand your concernIt is normal phenomena , do not get worry. It is just seminal viscosity.  After ejaculation seminal fluid get undergo coagulation and get coagulated.So jelly formation is due to coagulum. Generally seen after abstinence of masturbation for long time. Still if you have worry you can go for seminal testingHope this may help youBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Levipill 500 proper dosage for 10 year old child?\n\nHi, My son having 10 year old having problem in epilipsy problems after sleeping for 5 to 10 sec onlyand happnened once or twice in a year; Neuroogist done EEG test and sugget Levipill-500- 1/2 tab morning & 1 Tab at night, i want to know Levipill 500 is quite high dose for 10 year child or not?",
    "doctor_response": "Thank you for asking query.First i like to know weight of the baby. so we can calculate dosage.Levipil cna be given in the dosage range of 10-60mg/kg/day so no need to worry.Hope this is helpful to you.Rate the answer if you like it.Regards,Dr rushikesh kute",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe backache be treated?\n\nHello, I have severe back pain from several surgeries, including bone graft, fusions at L2-L5, titanium cages, rods, and brackets. I have been give, oxi-codin, percocet, morphine, and a variety of other poppy seed drugs. I hate them! I am interested in knowing your opinion on Marinol. Please respond",
    "doctor_response": "With multiple surgery, and intractable problems, I may think to have fentanyl skin patch and epidural injection of local anesthetic mixed with cortisone. Most of implants may be removed if healed.Physical therapy combined with local application of Ayurveda gels,oils,massage, some homeopathic pain meds.like rus  tox under guidance of Ayurveda n. Homeopathic specialists often give satisfactory respite.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How virus are transmitted?\n\nHow long does the virus which causes hand.foot.mouth disease live on inanimate objects? I realize it is mostly transmitted by saliva, contact with infected kids, etc, but wondered if we should be cleaning our church nursery toys again, since the breakout of HFMD, which are used one day per week. Thanks! Holly",
    "doctor_response": "Hello,Welcome to HCM,Hand, foot and mouth disease (HFMD) is a disease caused by intestinal viruses like Coxsackievirus and Enterovirus.HFMD is a common and highly contagious viral infection that typically causes a mild febrile illness followed by a maculopapular rash that may involve the skin of the hands, feet, and oral cavity.This is not transmitted by the animals.As this is a viral disease which gets better on its own and there is no specific curative treatment for hand, foot and mouth disease.Pain from the sores can be reduced with the use of analgesic medications and this can lasts for 1 week.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for increased blood pressure\n\nmy husbands doctor told him four days ago that he is concerned about his blood pressure.  It was 142 over 90.  He sent him for blood work (not back yet) and to monitor his blood pressure every day at the same time.  Each day it has increased.  Today being 147 over 101.  He wants to know if he should be concerned right this minute",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. In my opinion, your husband should start anti hypertensive drug. His blood pressure reading is not stable, it is increasing. So he is mostly having hypertension. Better to first start low dose antihypertensive drug like amodipine (5mg) or telmisartan (40mg). Along with drugs, strict salt restriction in diet and exercise are also needed to control blood pressure. If he is having stressful life then stress management is also important. So he should immediately start anti hypertensive drug. Get done repeat blood pressure monitoring after 10 days.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible for someone to come out of coma depasse?\n\nMy cousin had an accident 5 days ago. Doctors say that he is in Coma Depasse which means that his brain is not working, can he wake up one day? We are desperately waiting for your answer, doctors here say his body lives but his head doesn t. We don t want to believe that we keep hoping that something might change since we see his heartbeats.",
    "doctor_response": "Hi, I am so sorry about your cousin. The \"Coma DePasse\" state is a very deep state of brain injury. What the doctors are basically saying is that the basic parts of his brain that control basic body functions are pretty badly damaged. I hate to do this to you but the chances of recovery from this kind of injury are very rare.    It would be a good idea to try and get a bit more testing done. See about checking what the blood flow is like in the damaged regions of the brain (they have Brain angiograms that can do that) and see if there is any organized electrical activity in the Brain( from EEG's).  I have unfortunately seen brain injury first hand from both sides of the doctor patient relationship and there are no 100% perfect answers. And there is no solace for those who have the responsibility for making the tough calls. Work with your doctors, talk to them, try and understand what the whole team is thinking.  I wish you all the luck in the world and if you want to discuss things in a more detailed discussion, you can always come back.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach pain in a child\n\nHi, My kid is not having proper diet for one week. He is now 2.5yr old. Had once vomiting a week back after that he stopped taking the food. He is feeling vomiting sensation just after having 2-3 feeds and start crying if we force him to eat. He is now slightly having cold and mild cough. Some times he cries in mid-night saying leg pain or stomach pain. Please suggest. Thanks.",
    "doctor_response": "Hello, By what you say I feel that this stomach pain may be induced by severe coughing because of the stretching and contraction of abdominal muscles. The other possibility is that it could be because of worm infestation which you can treat with over-the-counter available tablet Albendazole 400mg 1 today and another dose after 10 days. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have epigastic pain, constant nausea, constipation and fatty liver. Suffer from chronic depression, migraines and fibromayalgia\n\nHi there, I have been unwell, for over two yrs now on n off. With one 5 day hospital stay, with zero answered outcome.My symptoms since April of this yr and pretty much throughout are deep seeded upper epigastic pain, contanst nausea, constipation/ diarrhea , diagnosed severe fatty liver , inflamed gallbladder , have not eaten a proper meal since July , am obese I weigh 216lbs. have lost 12 hard fought and lost lbs as I simply cannot lose weight therefore I am not taken seriously as a pt malnourished . I have no energy suffer from chronic depression and fibromyalgia and chronic migraines . Thank you",
    "doctor_response": "Hi. Your history of unwell goes back to 2 years, and severity increased for the last 9 Months. With the similar symptoms of any other patient , I would like to go for your upper GI Endoscopy, Ultrasonography and preferably Contrast enhanced CT scan of whole abdomen after preparation with laxatives and antiflatulent tablets. Obesity itself is a disorder, a root cause of many of your problems you are suffering. Wight reduction and a diet as per Dietitian is recommended. Inflamed gall bladder may need a removal. I am sure you would be benefited with treatment of obesity. I hope my answer has helped you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from lower back pain near the waist region\n\nI have a pain in my lower back about 3 days now. Lower right side of spine. Gets worse when sitting still. Hurts to lay back. Now....it just traveled up higher to lower back right waist area. If I go to the bathroom it was helping but today, I have to stay on here.",
    "doctor_response": "Hi thanks for using HCMIn my opinion you should stop worrying. For immediate relief have some pain killer along with a muscle relaxant  and do some back strengthening exercises. Do not lie down on soft mattress use hard one instead, do not sit for longer durations and do not travel long distance for 2 weeks . Take complete bed rest and you will be fine . If the pain increases do some hot fermentation locally",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for back pain & tiredness\n\nI've been feeling really tired the past 8 months. I was under a lot of stress and just assumed it to be that. As time's gone on I've noticed some other symptoms. my ankles get a little swollen at work (I'm not extremely over wieght or anything). My lower back started hurting. I've also noticed over the past three months that I go to the bathroom a lot more and my urins been really clear. More recently I've been feeling light-headed and unable to focus. I keep trying to tell myself it's just stress and for the most part I've ingnored it, I'm just a little concerned because none of the symptoms have gone away.",
    "doctor_response": "Dear patient Considering your case possibility  can be 1. Anxiety  2.  Diabetes Mellitus . I would like to advise blood testing for fasting and postprandial blood sugar levels. Get it done from reputed laboratory.  If reports are normal diagnosis  is anxiety disorder. If reports are showing high sugar levels  it's diabetes Mellitus. For DM  YOU NEED TO consult diabetiologist.  If you are having excessive stress and anxiety in life try meditation  and yoga which are very helpful. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long shingles take to go after chemotherapy of Lymphoma patient?\n\nMy mother has contracted shingles whilst on chemo for Lymphoma. Chemo has now been stopped, but the shingles are still active into the 5th week. Her weight has dropped to 6 stone 12, and most of the time can't get up. How long does this last with this type of patient, she is 78?",
    "doctor_response": "Hi,Thanks for writing in.Singles infection is caused by the chicken pox virus reactivation at the dorsal ganglion of spinal nerves. This condition is usually seen in immunologically weak and in elderly. As your mother is taking chemotherapy and is also elderly, this reactivation of the chicken pox virus has taken place with a higher magnitude.Patients with suspected shingles have to be given a course of antiviral medicine like acyclovir or valacyclovir within 72 hours of first appearance of rashes. If not given then the rashes take a longer time and the patient is in more pain and discomfort.If the rashes are not responding to acyclovir or valacyclovir then it might be resistant to treatment and this has to be followed up with other medicines.Though the rashes usually fall off in a week in most patients, it is difficult to predict the course of this illness in a patient having lymphoma and in elderly age group. Some patients also require treatment with IV medications and this can reduce the flaring of symptoms.Shingles pain and discomfort might persist for up to 6 months and there is herpes neuralgia in which the patient might have burning symptoms for a long time. This is treated with powerful pain relievers.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes spasms and pain in the back?\n\nI m a 32 yr old female born with Erbs Palsy in my left shoulder and neck. My left was paralyzed for 6mon at birth. Then my nerves grew back on their own and I m able to use the arm. However I have restrictive use turning my wrist completely over and I can t reach above my head. For the past few months I ve been having spasms throughout my back, pain in the side of my neck and shoulder, my shoulder blade feels like it s pulling away from my spine and I m getting these electric shocks in my chest, back and neck that shoot up into my head. My doctor continues to tell me a lot of this comes from anxiety. I take anxiety meds and pains meds which numb everything, but as soon as they wear off I feel pain again. What should do? I think I need an MRI ASAP but who knows what my dr will recommend.",
    "doctor_response": "HiI would suggest a help from a physical therapist for ultrasonic massage, diathermy fomentation and exercises.Application of over the counter muscle relaxant gel application and  carisoma compound if your doctor agrees for muscle spasm relief.MRI may not be needed for now",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes small bumps on the penis after masturbation?\n\nAfter masturbating i develop small bumps on my penis it doesn t hurt or itch an it scabed over but i managed to ripped it off when i fell doing gymnastic. Its in the middle of the shaft. An i have burned skin off before but this one is different. The bumps if i pop them release a clear liquid. There spaced out an not in cluster but im freaking the hell out.",
    "doctor_response": "DearWe understand your concernsI went through your details. Having bumps after rough masturbation is normal and possible. You said the blisters leak clear liquid. In that case, definitely dermatologist consultation is necessary. Instead of having your own thoughts and instead of getting worried. You should consult a dermatologist. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes purple spot/swelling inside the gum?\n\nMy son is  a year old and I noticed that he has a purple spot inside the gum  and the color is getting more purple, and is swollen. It looks like his tooth is underneath. He has not had any any falls and wondered what that could be?  What would you recommend other than taking him to a dentist or oral specialist. Thanks",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM I have gone through your query,  as you have small one year child , dont worry this swelling can be Eruption cyst this forms when tooth about to erupts in oral cavity . This is normal dont worry this swelling subsides when tooth erupts in oral cavity . If your child has pain in swelling then consult dentist for oral examination .Hope this will help you. Wishing him good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for elevated liver enzymes?\n\nLiver enzymes were over 600 two weeks ago after being on sulfasalazine for two weeks for RA.  Now my alt is down to 147 but my ast is going up and is 80.  I feel fine with the usual joint pain and fatigue - but nothing new.  Should I be concerned?",
    "doctor_response": "Dear FriendWelcome to HCM.Methrotexate used for RA is the most common culprit causing liver dysfunctionGet following:1. Ultrasound abdomen2. Liver Function Test- Complete3. Viral Markers.Review with these reports and the prescription paper.Stay HealthyDr Charu Bansal, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can cognitive impairment be treated?\n\nYesterday I found myself with impaired memory while conducting a weekend meeting. The night before it started and could not function mentally to prepare for meeting. I took a short nap hoping it would help. It did some. This morning and last night I felt like yesterday where I had little recollection of memory information I was trying to recall?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Please do not panic. There may not be anything serious at all. Often stress and related work pressure can take its toll on your memory. Therefore take rest for two or three days. You should be normal.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump on the right thigh indicate?\n\nMy 15 year old son developed a hard, painless lump on the top of his right thigh. It is more prominent when he flexes his leg. It came out of nowhere over the weekend. He is in track at the moment and has been practicing, but states he did not injure it at anytime. What could this be?",
    "doctor_response": "Hello,The lump on thigh becoming more prominent with flexion indicates soft tissue lesion as lipoma or others. I recommend taking an ultrasound of the local part to diagnose it precisely.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Am on birth control patches, have brown discharge after sex, HPV positive. What could this be from?\n\nI am 27 years old and am on birth control patches . I was having sex with my boyfriend and have had postcoital brownish tinged discharge . I have had this before and I spoke with a nurse and she said it is normal. I have tested positive for HPV and have had several colposcopies in the past. I will not have my mensus until next Monday, August 20th. What could this be from?",
    "doctor_response": "HIWell come to HCMIf you do not have any symptoms then this nothing to worry, because some time this could be pseudo positive without clinical symptoms this would not be matter of concern, menses could be due to hormone imbalance, hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does single intrauterine gestational sac with single embryo is seen mean?\n\nHello Doctar. I am two and half months pregnant. Actually i am having sevear pain in my left abdomen from first month and my doctor advised me pain killer. last month i gone through sonography and my reports are...... single intrauterine gestational sac with single embryo is seen- another approx 0.47 size suspicious echogenic area is seen in dependeny portion of gestational sac.....please tell me what problem i m going through..",
    "doctor_response": "Hi,Single intrauterine gestational sac with single embryo means that you have a normally situated pregnancy with one baby in it .This is a good sign.As when a patient has one side abdominal pain in pregnancy we want to confirm if the pregnancy is in the womb or in tubes. For you it is in the womb so you can be reassured.Also regarding the small echogenic area, it could a be a small collection of blood behind the placenta which gets absorbed on its own as the pregnancy advances.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes right-sided chest pain while having pneumonia?\n\nI am recovering from pnuemonia. I was thinking that that I tore a muscle coughing but now I am beginning to wonder. On the right side of my chest, under my breast it hurts when I cough. It hurts when I press on it, but when I pinchthe muscles with my fingers I have no tenderness. It hurts as i go to touch my toes. Could I be having a problem with an organ under my ribs ? I have no pain on my left side.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Pneumonia can cause pleurisy (inflammation of pleura) and this can cause similar kind of pain. So in my opinion, you should first get the chest X-ray done. If the chest X-ray is worsening, then your pain is due to pneumonia and you will need higher antibiotics. But if the chest X-ray is improving, then possibility of musculoskeletal pain is more likely. So apply warm water pad on the affected areas. Avoid movements causing pain. Avoid sudden jerky movements of the chest. Take simple painkillers and muscle relaxant drugs like Ibuprofen and Thiocolchicoside. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sleep discomfort with buttock and back pain?\n\nMy toddler has had trouble sleeping since he was an infant. Squirms and kicks like something is making him uncomfortable. He has lately been saying that it hurts inside his butt. I think this is something that he has had for a long time. He also says that his back hurts.",
    "doctor_response": "Hello,Your case needs a lot of history taking all CNS system would be assessed then any conclusion can be made.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Hina Javed",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy vulva and anus?\n\nI have a very very itchy vulva and anus.  I cannot stop scratching!  the crack above my anus is peeling and burning.  my vulva is swollen and tender.  there is also a pea size bump near the hair line about level with my vigina.  I have not had intercoarse in over 2 years.",
    "doctor_response": "Hello, Welcome to HCM,The history and symptoms are favouring fungal infection. These area are known for fungal infection as yeast are the normal commensal of the genitals. Whenever there is change in environment these fungus will activate and produces these symptoms. I would suggest you to follow1. Keep the area clean and dry.2. Topical antifungal cream will help to reduce the symptoms. 3. Single dose of oral Diflucan, 150 mg.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes irregular heart beats?\n\nI recently started skipping heart beats.  this happened several years ago and I was on meds for several years but my current dr. told me to try going off the meds several months a go and I was fine.  I am 75 teach exercise four hours a week and am generally in good health.  I had a complete heart work up before going on the meds and they found nothing wrong",
    "doctor_response": "Hi. Thank you for asking on HCM. I carefully read your query and I understand your concern. The \"skipping heart beat\" is a situation that is called premature heartbeat or extrasystole. It represents an activation of the electrical system prematurely, usually from an another excited site within the heart muscle (ectopic beat). When atrial in origin, or single ventricular, they usually are harmless and nothing to worry about. Let this aside, I would recommend you to have an EKG and a 24-hour Holter rhythm monitor or an episode monitor. After having these examinations in hand, we can further discuss about the severity of this condition, and whether we should start or withhold treatment. I hope I was helpful. Feel free to contact me again. Good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for enlarged inguinal lymph nodes & bruises on spine\n\nMy daughter has many health problems including repaired ToF, repaired imperforate anus, urinary reflux, agenesis of corpus callosum, and repaired bilateral cleft lip and palate and multiple vertabrae fusions they are worried about problems developing in the future. She loses weight a lot she is almost 3 and 20lbs, she has what seems to be enlarged inguinal lymph nodes, and she gets dark bruises along her spine for no reason. I just want to know what are possible causes for the lymph nodes and bruising... should i be worried or am i just being paranoid from past history??",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern.  She may have reactive lymphnode enlargement or may have tuberculosis or malignancy.  You should go for fine needle aspiration cytology to search the exact cause.  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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for headaches and lightheadedness\n\nI have a friend. And he has been having horrible symptoms for about a month. His first problem was in his school, his heart was racing really fast, felt light-headed, and said he just felt weak. He went to the doctor and they calmed him down. But then, he went to school the next day and it happened again. It kept happening over and over again the week, so he decided to stop going to school. So, he stayed home...but then he started getting headaches. The headaches were migraines actually. With the headaches, also came along with his heart racing still. He went to the doctor and the doctor prescribed him with a medicine(I m not sure of the medicine). Then the next week, he still had the headaches but he started to get feeling of not I can t tell where I am I can t remember everything and u get the same feeling except its 24 every day...My mind skips I blank out and come back and I feel like I can t come back anymore. He mentions how he doesn t feel like he s himself anymore. Also, lately he s been having these twitches in his shoulder and seizures. And he is having droopiness in his face...And it s just getting worse and worse...I really want to know wants wrong with him...can you PLEASE help me...just give me an idea of what it may possibly be...he was suppose to go to a neurologist, but I don t know what the hold up is....but please give me some answers...I care about this boy so much... And the boy is 17 years old, 5 11 or 6 , 135-145 Ib",
    "doctor_response": "Hi, Most likely he is having anxiety and panic attacks with dissociative symptoms of depersonalization and conversion. He needs an evaluation from a neurological point of view. But after excluding neurological conditions, he needs treatment for psychiatric symptoms. Not very difficult to treat. Just relax and take him to the hospital (psychiatrist). Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Waleed Ahmad, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest infection\n\nim 21 weeks pregnant and have had a virus that ended in a nastey chest infection, i have had horrendous pain in my left rib and whilst coughing last week i felt a pop in my ribs, i now have a pop sensation when ever i breath and am in pain when i wake in the mornings if led on left hand side. lifting my left arm high causes discomfort what have i done",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. Since you are pregnant,  chest x ray to confirm lung infection,  is contraindicated in your case.Treatment of chest infection is based on isolation of causative organism.So get done sputum culture and sensitivity. Culture is needed to isolate the causative organism and sensitivity will be helpful in guiding appropriate antibiotic treatment. By this, we can avoid haphazard antibiotic use.Antibiotics in pregnancy should be used cautiously as they can damage fetus.So better to get done sputum culture and sensitivity to guide appropriate antibiotic treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from hypomania, insomnia, and conflicting opinions. Why?\n\nHello doctor, 1. I have periods of a hypomanic switch into periods of depression fast, but depression does not go to the point of suicidal thoughts. 2. Insomnia, extreme active periods and periods of no motivation to do anything. 3. Conflicting opinions, but also strong opinions. 4. Two opposite sides, a bright, playful and innocent side, and a violent, dark, crazy, psycho side, either can switch in an instant. Both of these sides are myself, and I often have trouble finding out which personality is the real me. One day I can feel like one, and the next day, I will feel like the other side, like a completely different person. 5. These two sides are entirely opposites meaning my values, behavior, hobbies, feelings towards others, etc. all are getting changed.",
    "doctor_response": "Hello. Most people with psychiatric conditions like psychosis, schizophrenia, bipolar disorders, etc. do not realize they are ill. That is called a lack of insight. The fact that you are concerned about yourself enough to ask for help here means that you have an idea. You are at that growing up the stage when you are figuring out your personality, and the hormonal surges can also make you go through an emotional rollercoaster so you might be experiencing normal physiological and psychological changes with your age but overthinking it. I would suggest listening to music, running, doing meditation, and other things to divert your mind for a month and see how you feel. If things do not change, let me know. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for soreness and severe pain in the back\n\nHi. I m a 19 year old male, and last night I jumped out of a 2 story window and messed up my back. I landed on grass, but the ground was slippery and I slipped. I didn t hit my head. But when I fell, I felt a pop in the middle of my back, and moderate pain as I was walking off. This morning I woke up and I was extremely sore. All in my back & neck. I can t really move my head without moving my whole body. I have received a massage, and I ve been taking ibuprofen, eating protein, and using ice & also taking warm baths to help. But is there anything else I can do? It s very uncomfortable. It doesn t hurt much when I m lying down, but if I m up walking around it s painful and hard to move my neck and back. Please help, thank you.",
    "doctor_response": "Dead patient You have got significant  trauma to your back and neck and this needs to be investigated to rule out possibility  of fracture.  I would advise Xray of 1. Cervical spine anteroposterior and lateral views 2. Dorsolumbar spine anteroposterior and lateral views to rule out fracture.  Visit radiology center nearby you and get it done.  If Xray report is normal you need not to worry. Take rest for 3 days and start tab diclofenac plus thiocolchicoside combination twice a day for 7 days. Apply ice packs and  diclofenac gel locally  at the site of pain. If  Xray is abnormal  you need to consult expert spine surgeon with report. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause continued flu like symptoms?\n\nHi, my husband has been sick for the past 6 weeks with different flu-like symptoms, like a sore throat, fatigue, tight chest, etc. He took antibiotics and finished the course about a week ago. Recently, his chest has become cold to the touch and he feels cold but he also wakes up drenched in sweat. I am concerned. He is seeing his doctor tomorrow but I can't find anything online to explain what a cold chest/stomach could signify.He is 34, 6'2, 185 lbs and in good health otherwise. Eats well and exercises, although he tends to overwork.",
    "doctor_response": "working atmosphere of the patient must be checked. some times metal fumes, metal dusts, dust (allergen also) cause constant irritation and flue like condition. if the atmosphere is well then see for folic acid or vitamin B-12 deficiency, because deficiency of this nutrients can cause sore throat repeatedly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for nail clubbing since birth\n\nI have only nail clubbing since of the birth. I didn t test chest X ECG or Eco test . No lung or heart related problems were identified. I didn t feel any breathing problem till now can i shot this problem. Specially I haven t these the symptoms and signs of concerning are : Breathing difficulty, Blood in the sputum, Prolonged fever, Cough, Chest pain, Shortness of breath, Altered bowel habits, Abdominal pain or distention, Loss of weight, Jaundice, Loss of appetite, Bleeding per rectum, Bluish discoloration of lips and fingers and I have not any difficulty and I am fine now. I am healthy situation in now. but, I read about nail clubbing it got me worried. 21 years old, male.",
    "doctor_response": "Hello,Thanks for contacting us at \"Ask a Doctor\". I will try to answer your question to the best of my ability. It is true that finger clubbing can be associated with underlying disease - mainly of the heart and lungs. However, if you have no symptoms and are healthy then you most likely have idiopathic clubbing. This is nothing to worry about and I would simply ignore it at this time.I hope this helps. Please message me back if you have any further questions.Best wishes,Adrian Rawlinson MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does the intake of Tramadol result in a heart attack?\n\nI recently lost my father and wish to know that according to  WWW.WWWW.WW an injection of tramadol should not be given to patients who are on anti depressants and sleeping tablets, but my father passed away 6 hours after recieving a tramadol injection. They said he passed due to heart failure, could this have been caused by the Tramadol",
    "doctor_response": "Hi Welcome.Tremadol is relatively safe drug for cardiac patients & does not cause any problem. So tremadol was not the cause of heart attack or heart failure. It must be the underlying heart disease which has caused this.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is painful blood clot in groin cause any problem during pregnancy?\n\nMy daughter in law has just been diagnosed with blood clot in her gorin and she is 5 months pregnant. It is 3 days now since she started her injections to disperse it but in still in a lot of pain. Is this normal and should the pain not begin to easy by now?",
    "doctor_response": "Hello, and I hope I can help you today.The complication of getting blood clots in the legs, called a DVT, or groin is uncommon but not rare during pregnancy. Normally, the clock will gradually disappear with the aid of blood thinners. It actually takes somewhere between one even more than three months for the clock to actually dissolve and be reabsorbed by the bloodstream. Therefore, the symptoms of pain, and swelling in the leg where the blockage occurred are not unusual while this is taking place.The most dangerous complication of a blood clot in the legs for pregnant woman is if a piece of the clot actually breaks off it can travel through the bloodstream towards the lungs and cause serious complications for breathing and sometimes even death.So symptoms your daughter-in-law should watch out for our shortness of breath, chest pain, or feeling very anxious with a rapid heartbeat.In terms of pain control for right now, applying a hot water bottle (comfortably hot) to the groin or soaking in a warm bath can help to relieve the pain symptoms at this time.Your daughter-in-law should discuss the further management of her blood clot with her doctor but in the meantime it is much too early to see improvement in the pain.I hope I was able to adequately answer your question today, and that this information was helpful.Best wishes to your daughter-in-law for the rest of her pregnancy,Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes muscle and tendon cramps and lock up in legs and toes?\n\nI many times work around the house and outdoors, and consistently push my physical capabilities too much. I drink plenty of fluids but to no avail I get muscle and tendon cramps so severe they lock up my legs, toes, rib area, etc., you name it. What am I lacking concerning intake? Thank you so much if you have the answer, sincerely, Craig",
    "doctor_response": "here you have mention, you do lots of indore as well as outdoor activity and consume enough of fluid but then still you have issues with muscle cramp let me explain you different reason for having muscle cramp some of them are deficiency of vitamin b, less water intake, as well many times deficiency of magnesium mineral in our body.you can try to improve this by having vitamin b supplement tablet and having foods which contain board of magnesium as a mineral also along with this you should be doing different stretching and strengthening exercises for sure upper limb and lower limb muscles this will help to prevent the locking of your soft tissues.still if this does not help i suggest to take complete health checkup and do visit orthopaedic doctor for further guidelines and medication support.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cancer of food pipe\n\nGood morning Doctor, I live in Melbourne, Australia.  I have a query for my uncle who has Cancer of the food pipe and is very serious. He is being treated by Dr Rai in Chennai and is in his hospital.  I am afraid from what I hear that he is not getting the required attention. I am thinking of moving him to the Adyar Cancer institute.  I am concerned that my uncle is suffering far too much.  Can you please suggest what I do in this situation.  Thank you for your time Doctor.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Your uncle has esophageal cancer. Treatment of esophageal cancer depends on type of cancer, stage of cancer and spread of cancer. In early stage surgery can be done to remove that part. In later stage chemotherapy and radiotherapy are the treatment options. Please send me his all reports so that i can help you further Or consult your oncologist and plan accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI of brain, lacunar ischemia arteriosclerotic changes with admixed virchow-robin perivascular spaces. Meaning?\n\nmri of my brother s head shows multiple punctuate and ovoid foci of signal alteration scattered in bilateral gangliocapsular complexes and periventricular subcortical and deep white matter in the centrum semi ovale and fronto parietal lobes appearing iso hyper intense with sans any restricted diffusion on diffision images suggestive of non specific white matter hyperintensities- LACUNAR ISCHEMIA ARTERIOSCLEROTIC CHANGES WITH ADMIXED VIRCHOW-ROBIN PERIVASCULAR SPACES. what does that mean ?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern from the given report of MRI I could say that this report suggestive of some ischemic changes of certain area of brain this could be possibly happens in the hypertensive patient, here the clinical symptoms and the age are not given and without this can not say any thing for sure because such report need to be correlate with clinical condition and history, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for prostate cancer iv stage\n\nDear Sir     Good morningMy father have Prostate Cancer iv Stage, he have operated Hormone therapy ,currently we have tested PSA  25  right now 1) He is not able to walk and talk2) not able to take food 3) not able to identity the person alsoPlease suggest , what can i do for my  my father",
    "doctor_response": "Standard treatment options for stage IV prostate cancer include the following:1.Hormonal manipulations.2.Bisphosphonates.3.External-beam radiation therapy (EBRT) with or without hormonal therapy.4.Palliative radiation therapy.5.Palliative surgery with transurethral resection of the prostate (TURP).6.Watchful waiting or active surveillance.RegardsDR De",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for soreness & pain on back\n\nhelo i have a sore and painful backside i cam feel a boil/spot but i think it under the skin because it is not visible, i am on ibreufin/ antibiotics and a capsule i frgotten the name, but the pain is nbearable iv been on the medication for two days, the doctor said if it is still painful i will have it drained, is that. an operation.?",
    "doctor_response": "Hello,I had gone through the case and found that draining is not operation, it is just peircing of neddle on boil and drain the pus and done under local anaesthesia.So it is not so painful.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. If problem is in hip joint then why do I have pain in the knee?\n\nHi doctor, I am 24 years old. I have stiffness and pain in thighs and knees\u00a0for more than a year. I cannot sit properly and stand up instantly. I am having problem in each and every activity involving legs. I have reduced mobility and flexibility of legs. My report shows AVN stage 3 of hip joint, for which I have been suggested hip replacement surgery.\u00a0My question is that, if problem is in hip joint then why I have so many problems with knees? When I stand up, my knee gets blocked and I cannot stand instantly. There is cracking sound in knees when I sit or stand up. I am worried whether I have some other problem in knees also.",
    "doctor_response": "Hi. Hip avascular necrosis (AVN) and hip arthritis causes pain in the affected hip and also sometimes in the knees as the same nerve which supplies the hip also supplies the knee joint. It is called as obturator nerve. This nerve supplies both the joints. So if there is hip joint pain, many patients also get pain in the knee joint. But, also to be sure if nothing is wrong with the knee joint, you should take x-rays and document it. Get x-ray of the knee joint both in anteroposterior view (AP) and lateral view and then get a follow up done to confirm your problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a 32 yr old with PCOs ovulate without using drugs and who has no dominant follicle and uterus is low?\n\nI went for scan on CD16 and had no dominant follicle, my uterus was still low...i have PCOS but Im not overweight, eat healthy, no stress, dont smoke, dont drink alcohol or coffee, I use acupuncture... How can I ovulate without using drugs? Please help im 32y",
    "doctor_response": "Dear member,Thanks for using healthcare magic.If overweight then reducing weight will help the chance of regular menstrual cycles.But as you are already 32 and not obese you may require drugs to induce eggs.ThanksDr Bhagyashree",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing thinning of hair?\n\nI ama 60 year old female who has been under alot of stress for 5 years due to multiple deaths in my family all at once. Getting better. My hair has been thinning for a year or so. I noticed a year ago wads came out in the shoer one or two times. I had been low on Vit D, take 2000 in suppliments a day. I also now take a multi vitamin daily as well. THought perhaps it was due to vitamin deficiency. What are your thoughts. I always had VERY think hair until now.....",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As per your case history you are having female pattern baldness. My treatment advice is - 1. Use a good herbal hair oil and shampoo for routine use. 2. Take good nutritious diet full of green leafy vegetables and milk. 3. Take an iron supplement and vitamin B12 supplement. If problem persists then consult a dermatologist. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hepatitis and jaundice\n\nplease doctor i need your help my friend was diagnosed as having hepatitis before 2 days his complain is slight fever / headache / anorexia / jaundice / slight tender right hypochondrium his test is HBS anigen + / HBS antibody - / HBC IGM antibody + / HBE antigen and antibody - his liver function test showes high bilirubin ,alkaline phosphatase, and transaminases also high what can i do for him please i need your help i mean i need a prescription for him please write aprescription for him and i am very grateful to you (patient age 26/ male gender)",
    "doctor_response": "Before having any prescription, the viral load of virus should be done. Hospitalize your friend and get the treatment done thete.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe depression and paranoia be treated?\n\nOur daughter is experiencing depression and some symptoms of paranoid. she is easy to cry and suspicious of people She believes and we may be recording her telephone conversations to replay to someone She has has taken some serious falls recently and had two operations for bunions on her toe. We think that having the falls checked out organic brain problems? Entering a course of appointments with a counselor Being evaluated to see if a trial course of antidepressants. What say you?",
    "doctor_response": "thanks for using HCM.your daughter need  evaluation that why is she Having such problems.  It is quite possible that because of fall she might have suffered head injury causing these symptoms. So a brain scan is must before starting any psychiatric drugs.Second antidepressants are not useful in such situations.Antipsychotic are helpful in such situations.But an evaluation by psychiatrist is must before such drugs.thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes complete numbness in the arm,headache and weakness?\n\nI was diagnosed with SVT in may 2010 after I had my 2nd child. I have since had tests done and they say the heart is ok. Recently I have had chest tightness, headaches, tingling numbing in the arm, hand, leg & feet. I had a MRI o brain and blood work and everything is commin out normal. I was released from hospital yesterday with a diagnosis of Mirgraine aura. Today i wake up my arm is completly numb and i have a very bad headace, weak and not hungary. What could this be?",
    "doctor_response": "Hi, First of all, you should know the oral contraceptive pills have some effects such as: thrombosis and hypertension. So, you should stop them and ask a gynecologist for help. Second you should do more investigations on your heart such as:an ECG with effort and an ECHO on your heart to assess your heart condition. Third,you should change your lifestyle choice, for example, you should stop eating fat-rich diet, decrease salt intake and avoid drinking and smoking. If you were overweight, you should decrease your weight by going on diet. Finally, you should take Aspirin 160 mg twice per day after meals to avoid thrombosis, Vitamin B complex once per day after lunch and Benfotiamine 40 mg twice per day after meals. Sometimes, the symptoms of migraine could be mistaken with the symptoms of Transient Ischemic Attack. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mustafa, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a growth on gum adjacent to an infected tooth?\n\nI have had a tooth infection for about 2 years now caused a chipped tooth which I know now that the inside has decayed and died, hence the reason I have had no pain for about a year. I have not gone to the dentist since when the pain stopped a year ago. He took an X-Ray, told me what I knew, and said it had to be extracted. however he also added that another tooth that was leaning on this one (located on bottom right jaw but not the wisdom tooth) had to also be removed. He refused to remove just the infected one so I left it untreated because I am a student and do not have health insurance. I have had two abscesses that I have treated with antibiotics and that got rid of them. Now, my current problem is this: I now have another growth on the outside of my gum, adjacent to the infected tooth. This one is not puss filled and is hard and if I push on it, it causes minor discomfort to the tooth. It is growing under the gun, not on it. I have now been prompted to go see another dentist because I have found no answers online. I am just curious as to what this could be.",
    "doctor_response": "Thanks for using Health Care magic.Read your query.The signs and symptoms you have mentioned in the query suggests an abscess in relation to the infected tooth,though they may differ in variation from the previous time.Once left without treated , it may lead to pain and spread of infection to the adjacent tissues.I would advice you to visit the dentist at the earliest and get a radiograph redone .If extraction is advised,go ahead with it.Antibiotics amoxicillin 500mg and metrolag on prescription may be needed.Do salt water gargling.Hope this was useful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for the severe back pain?\n\nsir i have a back pain from almost 1year..it started during journey( and also was in depression from 2 months before it) when i wa sleeping, i thought it was normal one and would reduce after some time so  i went to gym and did some exercises normally like every day..but it didnt reduce from then till now...i am 23 years..i went to so many doctors and all of them said its normal seeing my x ray...plz tell me wat is my problem...i want my life to be normal again",
    "doctor_response": "Hello, I have studied your case.Most probable reason for your symptoms could be postural problem as you may be sitting for long time and working on computer/table for long time.When such patient comes to my hospital we usually take  if required MRI to see for any nerve compression.Medication like methylcobalamine with muscle relaxant and analgesic will reduce pain; you can take them consulting your treating doctor.Some exercises which can be done after pain has reduced include- Spine extension exercises, Lying on your stomach flat lift leg 6 inches from ground, do it for other leg.Now lift both hand and leg simultaneously, 6 inch off the ground and stayPosition for around 10 breathes. Core stabilizing spine exercises will help.You may consult physiotherapist for further guidance. He may start TENS, or ultrasound which is helpful in your case.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you find this answer helpful do not hesitate to rate this answer at end of discussion.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest complication with rectal cancer\n\nmy brother in law has rectal cancer.  had surgery to remove tumor.  he was not abl to get chemo due to low tolerance.  radiation produced scar tissue and a second surgery is too risky.  pet scan lit up in bladder tailbone and lymph nodes away from orig tumor site.  doctors are saying it is too complicated for them to treat.  referred them to mayo clinic for second opinion.  he is going down fast.  how long if no treatment?",
    "doctor_response": "Hi,Thanks for writing in.I understand that your brother in law is having a cancer with local spread. Post surgery the primary cancer has been removed but the disease process has continued to involve other areas; the sacrum and pelvic lymph nodes.In such situations, he can get high intensity focused radiation treatment if possible as decided by his oncologist to slow down the disease progress as he is not healthy enough to with stand chemotherapy.This way his disease progress can be slowed down but not stopped. The survival in such cases is usually 12 months to 15 months without treatment. I hope the second opinion at mayo clinic helps in improving his over all survival.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mouth ulcers and itchy blisters on skin in a child\n\nboth my daughters age 1 year old and 4 year old have a inflammation in throat with ulcers inside the mouth and on tongue.they have also had fever for over 2 days with itchy blisters on palm of hands, arms, ankles and aoles of feet. The younger daughter also has it in her nappy area. Please advise?",
    "doctor_response": "Hi...I feel by what you quote he should be having a - Hand Foot Mouth disease. This is one viral illness among all other exanthemas which can cause fever followed by rash over palms and soles. It is a self-limiting disorder and itching can be really worrisome. I suggest you use any over the counter antihistamine if you have one with you now. You can use Hydroxyzine at 1-2mg/kg/dose (Maximum 10mg) every 6th to 8th hourly for 7 days. This can even cause some peeling of skin in the next 4-6 weeks and do not worry about it.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "When should a swine flu shot be taken?\n\nHi there, my Husband works an opposite shift from another employee who has been hospitalized with swine flu. He does not work with him, but has used the same shower to clean up after his shift. If my Husband has been exposed , will getting a flu shot now do any good? This guy has been in the hospital all week and just now got diagnosed.Thank you",
    "doctor_response": "Brief:Low chances of infection but better get vaccinated.Detailed:Hi it's Dr.Muhammad Ahmad i have carefully read you question and will try to answer in detail.In thin changes of your husband catching the flu are rare but i will help you understand how it spreads...it spreads between humans when infected people cough or sneeze,other people breathe in the virus or touch something with the virus on it and then touch their own face.(so a towel or a tap used by that infected man can be a source in your husband's case) he should Avoid touching his eyes, nose or mouth after shower . Germs spread this way.\"He should wash his hand thoroughly back at home after reaching back from work.This flue doesn't spread through food or pork in food.The swine flu in humans is most contagious during the first five days of the illness,(so if that other person has been treated already then chances of infecting others further drop) although some people, most commonly children, can remain contagious for up to ten days.Conclusion: Get Him vaccinated                   Take precautions as i told you like frequent washing of hands with soap and water or with alcohol-based hand sanitizers, especially after being at a place where the patient worked. Chance of transmission is also reduced by disinfecting workplace surfaces, which can be done effectively with a diluted chlorine bleach solution.(this can be suggested to owners)It can spread in coughs or sneezes, but an increasing body of evidence shows small droplets containing the virus can linger on tabletops, telephones and other surfaces and be transferred via the fingers to the eyes, nose or mouth.Social distancing, another tactic, is staying away from other people who might be infected.Hope that Answered your Query . Wish you and your husband lasting health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anal fissure\n\nI am suffering from anal fissure like which is very old at least more than 15 years. Only twice there was sever problem once heavy  bleeding & another time less bleeding. In each case it was treated by homeopathic treatment and got relief. After getting relieve I use Coconut Oil in anal. Last few yaers there is some irruption at one side of anal outer surface. some it swelling some time normal. Last about a month the problem is continuous swelling with irruption. There is a pain when it is swell. I am in treatment of Homeopath with using initially Proctocedal oinment and now with Deltigesic. Whether it is in malignancy or fissure. I don't agree to go with surgery as adviced by a Allopathic Doctor. Please advice.",
    "doctor_response": "Hi,Looking to the history it seems that you might be having fistula in ano rather having fissure.When there is pus collection in sinus of fistula you get swelling and eruption.If fistula is there, no medicine from homeopath, ayurvedic or alopathy can work.Surgery is only the option.Consult surgeon and get it diagnosed.Avoid constipation.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I pale, weak and exhausted after recovering from anaemia?\n\nI  nearly collapsed in town 2 months ago and the Doctor said it was due to low blood (Anemia) I spent near 2 weeks in bed and often found it hard to get up and on to my feet. I was very weak, pale and dizzy at times and I looked terrible. It has been 2 months now and my Blood Level has come up so I am not anemic anymore. I am really starting to worry as I am thinking the reason why I collapsed 2 months ago was NOT due to the Anemia (I thought this in the first place) so- 2 months later and I am pale, weak and extremely physically and mentally exhausted every day. I go out every day but I feel like I can't live like this anymore. Can anyone tell me what they think is wrong as my anemia has gone now? Many thanks",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Will require hemoglobin levels to comment on anemia and weakness.2. However, if its improved, will require thyroid hormone levels evaluation.3. Meet your doctor for the tests and correlation. Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i have alcohol while i am having piles\n\nI have first stage of piles but m weekly drinker which brand of alcohol i should use if at all you allow me to take in limited quantity.MEANING WHITE LIQUER/RED--GIN/RUM/ VODKA OR BEER?",
    "doctor_response": "Piles or Hemorrhoids have \"Straining while Defecation\" as the main cause, which in turn is caused by hard stools, Alcohol in any form causes hard stool hence aggravate Hemorrhoids, it should avoided, if you take it, then double the amount of water intake. The color type or make of Alcoholic drinks makes no difference.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes small dark brown spots and redness in eyes in a 13 months old?\n\nhi my 13 month old son has a bad cough and runny nose and will not settle at all at night. He doesnt want to be comforted as this seems to upset him - not sure if he is a bit achy. HE also has small dark brown/red spots on his tongue and a little bit of redness in his eye next to his iris",
    "doctor_response": "Hi, I feel that he is going through a viral upper respiratory tract infection. But at the same time as you say there is small bleeding in the subconjunctival region, it would be but Pertussis also. A child at this age when he is not liking to be comforted means he is agitated, he will require medical attention. Please take him to the nearest Emergency Room. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the severe pain in chest and throat while breathing?\n\nAround dinner time I breathed in and my throat and chest hurt a little and then I layed on the couch and I can t even yawn now because of the pain it s like a deep pain in my throat and chest when I lay flat it throbs so bad and every time I breathe in or out",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. In my opinion you are having pleurisy ( inflammation of pleura ). Chest pain or throbbing type associated with cough and deep breathing is characteristic of pleurisy. Causes for pleurisy are1. Pneumonia2. Pleural effusion. 3. TB4.  Pneumothorax5. Pulmonary contusions etcSo grt done chest x ray to rule out all these. If chest x ray is normal than no need to worry much. It is just musculoskeletal pain. Take good painkiller and muscle relaxant.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain after doing cardio exercises?\n\nI have this pain in my lower abdominal but mostly right side and i get them on my left side too when I do anything that has to so with cardio excerise espically runnin i can only last for 3minutes max....and if i stop i dont feel the pain anymore even if i press on it, i feel nothing i wanted to know why that happens ..... And another thing when i sleep at night and i sometimes get lazy to go to the bathroom and pee so i hold and then late rmaybe after and hour or so whn i breath i get this back pain and i instantly would have to go to the bathroom i would eb grateful if i get a reply thanks alot",
    "doctor_response": "Hi.Thanks for your query.The causes of getting pain in lower abdomen on both sides after cardio exercises are :Colitis, appendicitis, ovarian cyst problems or some inflammatory condition of the internal pelvic structures'You can get the proper diagnosis by the following :Ultrasonography of the abdomen and CT scan to confirm. Get operated if there is a definite cause. If there is hernia, get operated. Your another problem is back pain at night if you hold back the urine and have to rush. This is indicative of bladder infection .Get investigated and treated according to the reports .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the permanent treatment for post inflammatory hyper pigmentation after tinea cruris ?\n\ni have post inflammatory hyperpigmentation after tinea cruris infection.is there laser treatment or any effective depigmentation creams apart from topical steroids which helps.",
    "doctor_response": "Hi , the first question to ask here is if one has got rid of the Tinea infection entirely. It is  worth having a prolonged application of a suitable cream for Tinea which your doctor will easily suggest. Try this prior to other treatments for hyperpigmentation. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low grade fever\n\nMy husband said he isn t feeling well. While he was lying down, I put my hand on his forehead. He felt cool and clammy. I have taken his temperature 4 times and he has a temp of 96.5; 96.9;96.1 and 96.3 on 4 different thermometers. I have a very warm bath ready, but not sure if this is the thing to do. Please help if you can. Does he need to go to the ER??? It is 12:30 am where I am. Thank you so much.",
    "doctor_response": "I'd recommend tepid sponging instead of warm bathHe can take acetaminophen /paracetamol 500mg tablet once now and once in morning if fever persists.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have facial flushing, increased food allergies, urticaria, dizziness. Oral glucose tolerance test done. Do I have insulinoma?\n\nDuring an oral glucose tolerance test that was supposed to last 5 hours, the nurse stopped it shortly after 4 hours asking me if I felt ok.  I told her I felt fine.  She said I had \"bottomed out\" and that my blood glucose was 30mg.  At the same time as I was experiencing 30 mg of glucose, I had elevated insulin of 110 uIU.  The hour before that reading, my blood glucose was 55 mg while my insulin was 58 uIU (I want to mention that so you can see that my insulin was definitely increasing even after I had reached a low blood glucose level).  My doctor informed me that I could possibly have an insulinoma.  For many years I have had periodic facial flushing, increased food allergies, and urticaria.  I also experience dizziness almost every time I stand up.  Is this likely to be an insulinoma?  If it is, what steps should be taken and when should they be taken?  Any help you can give would be greatly appreciated!",
    "doctor_response": "Hi, To confirm your diagnosis, further radiological evaluation is needed including CT-scan, MRI, endoscopic ultrasound, etc.Depending on the findings, the doctors (including surgeons) would decide if to go for an operation or not and what type of operation is needed. Usually, insulinomas are benign in the majority of cases, so, once they are surgically removed, everything gets back to normality again. Hope this is your case too!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe abdominal pain, gastritis, lost appetite, history of bowel cancer. Ruled out appendix. Mesenteric lymphadenitis test needed?\n\nmy 4yo was taken to hospital with severe stomach pains after ruling out appendix and passing some smelly wind symptoms subsided and we left. Since then he has had stomach pains re-occur and now at every meal. He has lost his very good appetite and has lost a lot of weight. his stools are very pale and loose and has had a few problems with urgency and loss of bowel control. He has a history on his fathers side with stomach and bowel cancer.  I am wondering if I should have him tested for mesenteric lymphadentitis and if this may be due to viral infection like hepatitis. his immune system seems to be rather poor showing not much resistance to infections.",
    "doctor_response": "Hello and welcome to HCM,The presence of abdominal pain, loss of appetite, loss of weight, pale stools suggest disease process pertaining to liver.You need to get liver function tests done.These symptoms could be due to hepatitis, however, the diagnosis can be made after investigations only.Urgency occurs in infection of the urinary tract.Get a urine examination done - routine and microscopy to look for any evidence of infection.If infection is present, appropriate antibiotics need to be taken.Loss of bowel control could be due to loose stools and dBefore getting any investigations done, you need to consult a pediatrician for clinical examination.Thanks an take careDr Shailja p Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI of brain done, high resolution flair, diffusion, calcified granuloma, normal sulci and fissures. What does this indicate?\n\nsir one of my relative aged 30 years got fit few days back and on the recommendation of doctor got MRI Brain (E.P.) Report is as follows:MR imaging of the brain was performed and high resolution FLAIR, Diffusion. T1 and T2 weighted sections were obtained in the sagittal, coronal and axial planes.The study reveals a hypointense focus on all sequences in right temporal region suggestive of calcified granuloma.  No perilesional edema is seen.Rest of the creberal parenchymal appear normal.  The lateral, third and fourth ventricles are normal is size, shape and position.  The cerebellum, brainstem & pituitary gland are normalBasal cistems, sulci and fissures are normal.  7th & 8th nerve complexes is seen.No abnormal vascular loop is seen around the brainstemADVISED: Further evaluation...........Please correlate clinically.........Recommended Treatment:Levesam (500mg) twice a day atleast for three yearsPlease let me know:Can he drive two wheeler or four wheeler as he is a marketing managercan he take drink or eat non-veg, although doctor advised to avoid itcan he play games/sports like swimming, cricket etc..what diet should be taken can he enjoy married life as he is married and having a daughter",
    "doctor_response": "Hi,Your relative had seizure (fits) secondary to R) temporal calcified granulomaHe need to continue the same medicine as plannedHe should avoid driving for next 1 month after the onset of fits because 5o% recur within one month while on medicinesHe can have normal diet (mixed).he should not drink as it precipitates seizureHe can play games and other sports except swimming for next 1months, during swimming for subsequent months some one should monitor himYes he can enjoy married life.Precautions to be taken are avoid fasting , sleep deprivation and drinking alcoholHope this will help youRegards Dr Sandhya ManorenjNeurologistHi tech city Hyderabad",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is stomach problems due to gvhd?\n\nMy husband is a cancer patient. In 2009, he had a stem cell transplant. He is doing fine but sometimes has stomach problems. He says it feels like someone punched him in the stomach. When this happens, he will usually end up with a fever and I have to take him to the BMT clinica where they do testing which always come back negative. He gets a an iv with saline and usually 7 days of antibiotics. He then gets better. Could this be part of GVHD?",
    "doctor_response": "Just stomach pain is not manifestation of GVHD. GVHD manifests with skin rash, diarrhoea and liver function abnormalities which manifests as fatigue, loss of appetite or jaundice. You need get an upper GI endoscopy and ultrasound or CT abdomen to know exactly what is happening. Since pain is associated with fever, infection is a strong possibility. Sometimes tiny abscesses are missed on ultrasound and CT is required.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tingling sensation, discomfort in back. History of back injury. Can discomfort be resolved by exercises?\n\nHello I am Bhavesh Bhimani from India. A 26 year old male from India. My height is 6 feet four inches. In 2008 I had underwent a surgery on my lower back for what the doctor told me as Lumbar Spondylisis .The reason were many as had injured my back twice before this. I haven t had any major side effect ever since except for occasional discomfort in my right leg. Over the years I was completely fine and ran and sat very comfortably, but I ignored the excerecises that I was advised to take from my doctor. Now, from the last one month or so I am having discomfort in my right leg again. The thing is, I recently got a job where I am supposed to sit on a chair all day long. Initially the chair that was given to me was very small and caused me discomfort. I went along with it for about two weeks but after which the discomfort increased. By the time the chair was changed the discomfort has remained ever since. I do not feel acute pain , and even the discomfort comes and goes. It starts with some tingling sensation, some discomfort and no real pain as such. I still walk easily and travel easily. But while sleeping sometimes the discomfort crops up. I am avoiding sleeping on pillows and have started exercising again. I am walking slowly too. Do you think this discomfort can be resolved by the exercises and by showing some physiotherapist . I am scared to go for a surgery again. I repeat I am not having any severe pain as such. But just want the discomfort to go away.",
    "doctor_response": "As the surgery done in 2008, it is advised to repeat MRI scan of l s spine  . Mean while you are advised to continue back exercises with the help of physiotherapist.  Please continue to wear l s belt during your work . It is advised to take interval every hour for 5 - 10 mins if you r sitting continuously.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are tiny echogenic foci in both lobes of the prostate a serious concern?\n\nprostate: normal in size measuring about (3.4 *3.2*3.0) cm, volume being 16.9 cc and the wight is 16.9 gm. few tiny echogenic foci of about 0.5-0.6 cm are seen in both lobes of prostate. impression; few tiny echogenic foci in prostate (D/D: 1. foci of calcification 2. corpora amylacea",
    "doctor_response": "sometimes prostate can calcify (mostly after recovering from infections). these calcifications appear as echogenic foci on ultrasound. since the size of your prostate gland is normal, and the calcifications are in lobes of prostate i think you dont need to worry about it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore roof, tender mouth with sensitive jaw lining?\n\nthe inside of my mouth is tender and sore roof of bleed when brushed tongue sensitive lining of jaws inside and out is painful along down beside and under ears and chin pain affects my throat and adbominal area.  All tooth paste dont care how mind aggravate the burning and painful feeliing also the tooth paste with salvia poarch my lip leaving them burning and swollan.  Its like this 7 days a week 24 hours a day the pain either mild, medium or severe.",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.Your symptoms including bleeding and tenderness suggests gingivitis and periodontitis (inflammation of the gums and associated regions).I would advice you to visit a periodontist and get it thoroughly checked.Get your teeth cleaned by the dentist and this will reduce the bleeding.You can follow up by using mouth wash for a while,then brush regularly and maintain your oral health well.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How should I manage gas in the colon when diagnosed with prostate cancer?\n\nHello, my husband is being treated for prostate cancer via radiation. At the time of treatment is needs to have approx. 20oz. of water in his bladder and an empty colon. The colon part seems to be the problem. He has gas - now taking GasX, eats Greek Yogurt and drinks chicken broth. Any other recommendations?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Radiation and chemotherapy can cause gastritis and related problems. You can try antacids like Pantoprazole or Omeprazole which bare quite effective for radiation induced gastritis. Also try Sucralfate syrup which act as a barrier and provide symptomatic relief. Also avoid hot and spicy food stuff. Wishing all the best. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling in wrist due to barbs\n\nMy son grabbed a tree branch and a black fuzzy catipillar with barbs or something like that squished near his wrist - now he has these barbs about 7 of them in his hand/wrist. The wrist and had are swolen and the barbs are deep in the skin. I gave him benadryl and put a paste of baking soda and water on his wrist. Any ideas?",
    "doctor_response": "HI, thanks for using healthcare magicThe barbs in his hand need to be removed because the reaction will continue to occur once these foreign bodies are present.They may also result in an infection in this area.It would be best to take him to a doctor for assessment and treatment as soon as possible.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mouth opening during sleep in a child?\n\nIs it normal for a 11 month old to sleep with mouth open? She has been sleeping with mouth open since birth. At birth she aspirated meconium and was in respiratory distress.... Also had a collapsed lung and open heart surgery.... Please help!!!!! Thanks. ..",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.Sleeping with mouth open is not a problem if this is not due to nasal blockade or problem of adenoids. If there any snoring  during sleep , what is breathing pattern when she is awake. If  there are no upper airway obstruction , then sleeping with open mouth is not a cause of concern .Hope this answers your question. If you have additional questions then please do not hesitate in writing to us.Take care.\u2022 DISCLAIMER: - All the information provided here is for information purpose only , it is not a substitute for the advice of a physician after physical examination , it is not intended to replace your relationship with your doctor. This information in no way establishes a doctor-patient relationship. Before acting anything based on this information do consult your doctor. I recommend that online users seek the advice of a physician who can perform an in-person physical examination",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling on leg\n\nIm 35 weeks pregnant and I m afraid I have cellutise in my leg. I see my doctor tomorrow, but I m afraid it will hurt the baby. My leg and foot is very swollen with a red color that has not gone away in two weeks. I saw my doctor two weeks ago and he did not seem worried. I don t have high blood pressure and the babys heartbeat was strong and I still feel him kicking often.",
    "doctor_response": "Is the swelling in one leg or both legs? Cellulitis generally involves only one leg- it will cause  fever and pain along with swelling. Since you are consulting your doc, just wait for his/ her advice",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heaviness feeling in stomach?\n\nHi I recenlty saw my attending doctor about a gall bladder problem. I recently went out with friends on a trips to Cleveland and drank. Little too much, I also have Gerd. My stomach does not have pain it just feels like there s a rock sitting in it, what should I do",
    "doctor_response": "hi.noted history of gallbladder problem? is it due to stones? usual pain or discomfort caused by a gallbladder pathology, is colicky in character, associated with bloatedness, nausea, vomiting, fever or jaundice. if it is secondary to a gallstone disease, definitive treatment is cholecystectomy or surgical removal of the gallbladder. it could be done laparoscopically (goldstandard) or thru open technique. low fat diet is also advised.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "advice for Jandies & lever infection\n\nMy brother mr. venkatesh has suffering from jandies since 6 months water found around the lever. every 2-3 days he is suffering from fever and need bed rest, after 2-3 days he is feeling good. what is the actual problem advise me further treatment to cure jandies Lever infection' Kindly advise me sir",
    "doctor_response": "What is the cause for his liver damage? first look into that and let the treatment continue..you can also take second opinion from renowned gastroenterologists on whats the best way to deal with it..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My problem of bad breath persists even after teeth cleaning. What to do?\n\nHello doctor,I tried teeth cleaning, I avoided non-veg foods and beverage drinks, which produce gas, and I am eating a balanced diet. My bad breath problem is since for the past five years till now, so in this period I realize that I have a white layer on my tongue and when I smell my tongue then I feel very bad breath. Also, I have a hole on my throat back of the tongue, and something comes through that way like thick water and when I smell it so bad.Another is when I eat something, then that smell lasts for a long time. What to do? I have been spent more money to avoid bad breath, so give me a suggestion to get rid of it. Bad breath is the main reason for my unsuccessfulness. Sometimes thinking about this problem, I become depreciate. I needed your help.",
    "doctor_response": "Hello. The white coating on your tongue is mostly due to bacteria and debris. And, it seems that you might have a dry mouth. All this must be causing bad breath. Clean or scrape your tongue regularly, maintain proper oral hygiene, drink a lot of water and even empty stomach will cause bad breath, so have food regularly on time. Do mouth rinse with lukewarm water and salt or lukewarm water and a bit of mouthwash diluted in the water. But, better to avoid continuous use of mouthwash as this itself can cause dry mouth sometimes, and discoloration of teeth. Get a consultation from a dentist regarding dry mouth, to rule it out. If you have dry mouth, a Sialogogue (to increase salivary flow) will be prescribed by the dentist. Do not worry. You will be fine. If possible, send me a picture of your tongue and teeth.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is overdose of Naproxen for painful lower back nerve trauma harmful?\n\nI ve been taking Naproxen 375mg for many years.(Chronic back pain... nerve trauma in my lower back) I have a great respect for my body and the drug so I always take it with food and only take it when I feel I can t control my pain (Usually when I m out and can t modify what I m doing) I m only suppose to take it twice a day but some days I take it every 6 to 8 hours. How much harm am I doing?",
    "doctor_response": "HelloChronic ingestion of an NSAID like Naproxen can cause gastritis, peptic ulcer, and it can do damage to both your liver and your kidneys so you need upper endoscopy and blood work to check for all that.Neurontin, Lyrica, and, if necessary, opiates like oxycodone may be more appropriate medications for your pain so you need to ask your doctor about that.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hepatitis B\n\nHello Doctor,I am suffering from hepatitis B .. since 1991 but it was in inactive state.. but since last almost 3 months it is in active state... and causing lots of problem since then.. please guide me through for the proper treatment and if possible please give me the details of the specialist doctor in mumbai",
    "doctor_response": "Hi,Thanks for writing in.You need to undergo a few tests. If the tests reveal active replication then a course of antiviral treatment is indicated. You need to consult a medical gastroenterologist for the treatment.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a bump on the hard palate after removing primary incisors?\n\nI had an injury to my teeth and my primary incisors was removed. A bridge was built on the upper jaw (R2 and L1) and I have been using a ceramic bridge since past 20 years. I have been having minor tooth aches on the canine and incisors on the left. Recently a week ago a bump was formed on my hard palate, I have taken an x ray which shows a cyst on the incisor and canine on the left upper jaw. Is the bump caused by the cyst or could there be other reasons for the bump.",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concern...As per your complain a lump on the palate can be due to  residual cyst while it can also be an abscess that can be related to any infected tooth leading to dental abscess formation..I would suggest you to consult an Oral Physician and get evaluated and a thorough clinical evaluation done..In case if it is a cyst or an abscess you can get it removed by root canal treatment..At times the cyst can be removed by enucleation procedure..Hope this information helps..Thanks and regards..Dr.Honey Nandwani Arora..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden shock feeling in the chest?\n\nMay I know what happen to me, when I was going home, I walk like at least a kilometer or so, when I drink some refreshment, then I walk again, when suddenly, A \"shock\" happen in my chest, I though it was a heart attack, but after that I feel stronger.",
    "doctor_response": "Hello!Welcome and thank your for asking on HCM!I read your question and understand your concern. Your symptoms may be related to a musculo-skeletal pain or an esophageal spasm. The fresh drink after physical exercise could trigger the above disorders. Did you have any other symptoms like chest pain, difficulty breathing, dizziness, etc. These symptoms could raise the suspicion of a cardiac cause.It is not typical of any cardiac disorder shock pain that lasts for seconds, without leaving any symptoms after.  I would like to know your age and your past medical history. If these symptoms repeat, I recommend consulting with the GP for a careful physical examination, a resting ECG, a chest x ray and some lab tests (a complete blood count, inflammation tests, fasting glucose, kidney and liver function tests, blood electrolytes), to exclude other possible causes related to this clinical scenario. Hope to have been helpful!Best wishes, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump in the rectum with abdominal cramping?\n\nI have a small lump inside/maybe edge of my anus that i noticed about 2 weeks ago after getting back from the beach, its somewhat soft and seems as though its under skin and can be kind of pushed up and there hasnt been any pain but ive been worried about what it is. I drank 10oz of Magnesium Citrate 2 nights ago after being afraid of straining to hard while trying to empty my bowels thinking it could be a possible prolapse, as i said there has been no pain and no bleeding so im not sure what it is and today my stomach has been cramping and ive had quite abit of gas. I am 28, M.",
    "doctor_response": "Hii...the lump u described may be a hemorrhoid... which on enlargement comes out... constipation and straining at stool are aggravating factor it...get it confirmed by ur physician....Simple diet modifications and local treatment are useful in early cases of it",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is meant by soft tissue injury?\n\nHi Doc, what s a soft tissue injury? My six month old daughter took a fall 5 days ago, we noticed a bulge on her forehead the next day, despite applying cold compress, antibiotics and vitamin c (recommended by our GP) the swelling is yet to subside, should we be worried? I m considering having an xray done...",
    "doctor_response": "Thank you for consulting in Health care Magic .Your daughter may be have haematoma, which happened after injury of soft tissue-skin, muscles. Bones are normal, if you want to check -better MRA,because less radiation. If you will apply heparine ointment 2-3 times small amount and rubber this place with massage, then it will disappear, you should wait 10-14 days,if bulge(haematoma) will not disappear then you go to neurosurgeon, he will do punction and removing blood from there.Best regardsDr.Svetlana",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible while on contraceptive pills?\n\nAm 29years old i took three contraceptive pills ten hours before having sex,could i be pregnant?i was on pill but when the pack finished i stopped and i was not  having sex but when i thought of having sex its when i took three of them but it was before sex.could i be pregnant?",
    "doctor_response": "HelloThanks for writing to us with your health concern.That is not the way to use pills for birth control.You have to be on the regular pill pack to have the contraceptive benefits.For emergency contraception, distinct set of pills with other distinct formulations are available.So yes there is a risk of pregnancy, particularly if you were mid cycle, around your peri ovulatory days.Please use regular contraception in future.Do take a pregnancy test if you skip your periods.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can recurrent yeast infection be prevented?\n\nI have reoccurring yeast infections and recently got rid of one. But I've noticed today my urine is a orange yellow colour, and it itches alot down there. As well as a little red and sore. I've been checked for STIs and it all came back clear. What can it be and how can I stop it",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.The symptoms seem to be related to a yeast infection.Some advice that I can give to you are:-take antifungal medication such as fluconasole-wash and dry frequently the area-use cotton underwearHope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sharp severe pain in stomach just below bottom of rib cage\n\nsharp severe pain in stomach just below bottom of rib cage, center. pain does Not radiate oR move.have had two kids, i KNOW its not gas,or integestion or heartburn or acid reflux , had it all , this is so different its off the reservation! lasts for hours of tossing and turning and rocking and crying and ends in vomiting. starts suddenly in the middle of the night. happened a couple times this week so far now. gut wrenching pain, cant even stand up straight! my mother and older sister have had theyre glablatters removed, quite recently too. bit scared that this pain is telling me its my turn.",
    "doctor_response": "Hello Thanks for query Get the ultrasound done to find the cause &get proper treatment.Possibility of gallbladder stone can`t be ruled out without USG Hope I have answered your question well to your satisfaction. Wish you speedy complete recovery at the earliest.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a numb knot in lower back after a shot\n\ni had 3 blocks in 4 months the last one seemed to work better , i still have pain and since the last block i have had a knot in my lower back right where the shot was , will this go away it feels like a dead knot and it bothers me more than the pain does , it had a dead numb feeling ,",
    "doctor_response": "Hello, Most of the time injection site irritation and symptoms are similar to what you've described and do tend to get better with time. The problem is getting reinjected in the same area and this could reactivate you after effects. I recommend you speak to your doctor about the lack of effect for your pain that these injections have given in the hopes of coming up with an alternative. I do not advocate my patients that they continue using medications or undergo procedures which no longer seem to be efficacious.  At that point, we look for alternatives. Hope I have answered your query. Let me know if I can assist you further. Take care. Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a dark spot on kidney?\n\nI was told I had a dark spot on my kidney. What could this be? I was told it could be a cyst on an MRI then was tod I needed a ultra sound to further test it and now I was was called back and need a ct scan because I was told it was a dark spot on my kidney...The y told me might might be nothing but what do you think this might be just to give me and idea of whats going on?",
    "doctor_response": "Hello and welcome to HCM.As an Urologist,i can understand your anxiety. You should write your age.MRI scan has the best resolution and far better, than CT or ultrasound scan.Anyway,don't worry about a black spot on kidney,seen on MRI scan.Most probably,they may be meaning a cyst,which is a fluid filled swelling.Such cysts are normally seen in many people and of no significance.You can safely wait for 6 months and repeat an ultrasound scan then.If you've any doubts,you may send them to me,as a direct question.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does depression aggravate despite using Lithium and Wellbutrin?\n\nMy 26 yr old son was depressed at the beginning of th year and was prescribed prozac. This precipitated manic episode from mar-jun, during which he was taken off prozac, put on lithium (450) mg, then fell into a severe depression. He was then put on wellbutrin (past 4 weeks) but depression seems to be worsening. altho he has a psychiatrist and a therapist, he is low-functioning and desperate. I am bipolar II myself and have been trying to help him through this but he seems stuck. My question is what else can we do to help him? We are both afraid. Carrie YYYY@YYYY",
    "doctor_response": "HelloBipolar depression is a difficult to treat condition. If he is still in depression, I would advice a dose increment of lithium. The max dose of lithium is 1200mg. It should be increased. Discuss this with your doctor.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic obstructive pulmonary disease\n\nmy husband has a hart problem and he was a soker before and he has copd from that but ina catscan they see a spot my question to you is whether he should go to rdiation ad battle the side effect becouse thay can not do a byopsy do the hy risdk he is so they think it may be cancer or an infection becouse it has grown to 10 mm. in 2 years he is going to be 84 acording to the pulmary DR. he can refuse but i am thinking that if the side effect is not so bad maybe this will shrink the infection",
    "doctor_response": "Thanks for your question on HCM. I can understand your husband's situation and problem. One should not start radiotherapy only on the basis of CT scan report. You need to have diagnosis of malignancy before starting radiotherapy. Since he is smoker, possibility of malignancy is high for this nodule. But we need to have tissue diagnosis first. Biopsy is not the only tool to detect malignancy. Rather for detection of early malignant lung nodule, go for bronchoscopy and BAL (bronchoalveolar lavage) analysis to detect malignant cells. You can go for PET scan also. So first diagnose malignancy and then start radiotherapy. Ask him to quit smoking as soon as possible.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intermittent appearance of a bruise with knot on left forearm?\n\nI noticed a nickel sized bruise on my left forearm about 3 weeks ago. It was only slightly discolored when I noticed it and there also seems to be a small knot under the skin. It hasn t gone away completely and the coloring seems to change. A few days after I noticed it the blue/green tint was gone but it still felt like a normal bruise. The next week the blue/green tint was back and then a few days later it was gone but felt the same. Now the color is bac again. I plan on making an appointment to have it checked, but wanted to make sure I didn t need to do something immediately. Thanks!",
    "doctor_response": "Hi,Thanks  for  your query.Unexplained bruising once in while is understandable but if occurs frequently should be investigated thoroughly since it can indicate an underlying medical condition or ailment.It has been observed that bruises are often observed more on women than men. Women often complain of bruising on legs, thighs, buttocks and upper arms. Thinner people are more prone to bruising as they lack the fat cushion that helps prevent injury. It may also be due to deficiency of vitamin C, vitamin B12, folic acid and vitamin K.Many times taking medications like aspirin, ibuprofen, non steroidal anti-inflammatory drugs, and even birth control pills increases chances of sudden bruising. Topical and systemic corticosteroids cause skin thinning, making one prone to bruises. Many a time bruising can be caused due to liver ailments, kidney diseases and blood disorder. I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting and tummy ache followed by fever and flu?\n\nHi, my 6 years old daughter just recovered from a fever, flu. She was alright in the morning and having her porridge as per normal. But after a milk feed in the night, she suddenly vomit 7-8 times until yellowish liquid is vomited out. Recently, she has been complaining of tummyache and soon after it will be followed by a fever. I am worried what can be the cause of these.",
    "doctor_response": "The symptoms you had mentioned are mostly due to some sort of viral infection. For treatment you can give your daughter some antibiotic like syrup zifi-cv or syrup oflox-oz after an expert advice along with syrup cyclopam or nimol-plus for fever, lethargy and stomach ache. You can give her syrup vomikind or syrup onset for nausea and vomiting with zincovit syrup or drops for loss of appetite. Do cold sponging to reduce the temperature of her body.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching of arms, back and legs?\n\nfor the past few months my 2 year old has complained of itching on her arms and legs and around her back. there is no rash just lots of scratch marks where she has drawn blood. when she starts scratching an area hives might appear for a short time but then they go away. is this an allergy? she has had eczema in the past but this looks nothing like excema. there is no redness, blistering, raised area - nothing to associate with eczema.",
    "doctor_response": "Brief answer:Acute urticaria. Detailed answer:Hi, welcome to HCM. Your child has itching and he scratches it so hard that marks are left behind and it appears all over the body. This appears to be acute urticaria. Acute urticaria is an allergic condition where redness and itching occurs over whole body and it subsides on taking antiallergic medicines. Also, you need to identify the allergens which might be causing this problem. Most common allergens are dust and some foods like egg. I hope this has helped you. Wishing your child good health. Take care. Regards:Dr Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe mid-lower back despite taking Celebrex?\n\nI ve had an unusual pain in my right mid-lower back region that I attributed to a disc problem. The pain is more prevalent when I go to bed. I have much pain turning over in bed. The pain has not relented for the last 2 days, despite taking a celebrex and a muscle relaxer. Some occur to me today this may not be a disc problem but a kidney problem.",
    "doctor_response": "back pain is a common symptom in middle and older age population. there are various pain producing structures in the lower back. although i do not know  know your age , the fact that the pain is more while turning in bed indicates a spinal instability pain pattern. Although pain in lower back can occur  due to pathology in other organs called referred  pain, its usually in a small percentage of patients. i would suggest you to consult a specialist for evaluation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Disc herniation with central canal and foraminal stenosis. Treatment?\n\nI have a 7-8mm disc herniation at L5 S1 with severe central canal and foraminal stenosis . Any suggestions for treatment? I ve done oral steroid, anti inflamitory for 2 months,3 cortisone injections, physical therapy , chiropractor, scheduled for epidural . All to no relief. Suffering for 3 1/2 months. I m 95% bedridden. Can t stand or sit for more than 3 min at a time. I m 37 yr old female",
    "doctor_response": "Hi, Thank you for posting your query. I can understand your discomfort on account of your pain. Lumbar disc prolapse causing nerve compression and pain is a common problem. In about 90% of patients, improvement occurs with the treatments you have had. However, 10 % of people do not improve with these measures. Here, I feel, surgical decompression to release the compressed nerve is a good option. Please consult a neurosurgeon or spine surgeon for the same. Wishing you good health, Dr Sudhir Kumar MD DM (Neurology) drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning sensation and difficulty in passing urine in a 5 year old?\n\nhello doctor, my 5 year old daughter is facing problem in passing urine. since yesterday evening she feels like going to washroom evry 10 mins. she also had burning sensation yesterday which today is not there. can i give her citralka syrup? if yes, what dosage?",
    "doctor_response": "Hi...it could as well be a urinary tract infection too. As there is no fever, the other possibility is that it could be a voiding dysfunction where in the urinary bladder wall will be thickened. I do not suggest using Citralka without evaluation. I suggest you do a urine routine analysis and get back to me or your paediatrician.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful ejaculation\n\nhi I am a 27 yo male. I am highly sexually active . In 2009 I was diagnosed with UTI after having multiple sex partners the same time. I had some white pus come out of penis & had burning on urinating . My left prostate got slightly enlarged. I was given a dose of antobiotics which I took regularly & the symptoms subsided. Some things stayed the same such as 1. feeling of testes being a little tight 2. slower urination 3. Semen is yellowish or pale in color. ( I do intake onions regularly but even when I dont & then ejaculate the color is yellow or pale) 4. Pain slight heavy feeling in testes while sitting its been few yrs now and the above 3 still exist. I have met many urologists .. all acknowledge but say it is fine . 3 days back I ejaculated in bed ( wet dream) but I found it was somewat painful. Yesterday I had oral sex and again I found ejaculation a bit painful. Please advise if there is anything serious ? Also pls advise if there is a test I could do to check testosterone level.",
    "doctor_response": "Hello Thanks for query .The symptoms that you have strongly suggest to be due to Chronic Prostatitis .Please consult qualified Urologist for clinical and digital rectal examination and get following basic tests done to confirm the diagnosis.1) Urine routine and culture.2) Ultrasound scanning of abdomen and pelvis3) Semen examination and semen culture .In the mean while start taking antibiotics like Doxicycline along with anti inflammatory medicine Diclofenac twice daily .Further treatment will depend upon result of these tests and final diagnosis.Please note that Prostatitis takes long time to get cured hence one has to take appropriate antibiotics for a period of 6-8 weeks .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for vomiting in a child\n\nhi, my six year old daughter used to drink milk normally but since last three weeks , she vomits a little milk in the morning...while drinking....and then finishes the whole glass..And she doesnt vomit after that. She is normal whole day and eats n drinks normally and is perfectly healthy. She has always been a fussy eater and takes time to eat and drink .Hence i usually reserve 30 -40 minutes in morning for her to drink milk and then she carries breakfast to school which she eats without an issue. But dmaking her drink milk in the morning has become a problem coz of this.I cannot skip milk coz she eats bf from school only at 9 and she refuses to eat early morning since she was never used to it.She has been drinking milk early morning ever since she was 3.",
    "doctor_response": "HI...by what you quote I feel that the infant is having severe form of GER (gastroesophageal reflux).  Your daughter will need - 1. Antireflux therapy - Proton pump inhibitors + antiemetics2. Always make her lie down in a propped up position - as in the care seat. She should not be sleeping completely flatly.3. Avoid heavy feeding and feeding more times and in small aliquots.4. This type of GER is the root cause for the constipation she is having.She needs expert gastroenterology consultation.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What lead to sudden urinary incontinence and stomach ache?\n\nhi my daughter is 3 years old and has been potty trained for well over 6 months day and night with few to no accidents. For the last week she has lost all bladder control and is urinating more frequently, she is also complaining of tummy ache up to 3 times a day. She has been checked for a water infection and the results have come back negative.",
    "doctor_response": "You need to check also for constipation signs..Her psychological status can affect her and causes urinary incontinence.How long did she succeed to control her urinary bowel?Try to encourage her and restart the botty training bit by bit",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the causes for white spots and rashes on my penis?\n\nI have small white spots on the outer gland of my penis and sorta like a rash on half of the head of my penis . I have bin sextually active but I don t think it has anything to do with my problom, I m kinda freaked out. I hope you can give me an answer that can fix or help me out on this problom of mine.",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern looking to the history given here I could say that the spot that you have noticed on your penis may be nonspecific and this is nothing to do with the active sex life, no need to worry about this and just take it easy, hope this information helps you, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why ants are attracted to sperm wiped tissues?\n\nAfter masturbate in my room i cleaned my sperm using tissue and put it on the floor. Then I feel asleep for 2 hours. After I woke up, I saw LOTS of ants attracted to the tissue and it freaked me out. I dont think such thing happen before. Is it normal? Or it it due to my diet? Thank you",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. That's a normal phenomenon, the semen contains fructose which is a form of sugar which is released by seminal vesicle. Which is added into the semen to provide nourishment to the sperms. If ants are attracted towards the semen stained tissue, it is due to the presence of fructose in the semen which is a normal and natural constituent of semen. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have acute nonhemorrhagic infarct in the temporo parietal region. Possibility of paralysis?\n\nhi i am ravindra my mother age of 45 yrs have 1)acute nonhemorrhagic infarct in the temporo parietal region involving posterior part of the perislyvian region 2)old nonhemorghagic in the fronto -temoro parietal region 3)old infart with gliosis in the left frontal region 4)mild microvascular chronic white matter ischemic chnages in the bilateral frontoparietal region due to this she have slurred speech plz advice is it can be cured 100% by medicine or it needs surgery and is thier any possibility of paralysis in fututre? plz advice",
    "doctor_response": "Dear the problem seems to be not be excluded with surgery.My advice is to undertake your mother to blood test to exclude diabetes.Does your mother suffers from heart problem, atrial fibrillation?I think cause of those brain damage is a cardiac problem or vasculitis.Take contact with a neurologist and he will explain you.Be sure that your mother is taking aspirin 100-300mg once a day.Wish my advice will help you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have backache and chest discomfort following RF ablation. How to confirm it is non-cardiac?\n\nHello doctor, I am living with idiopathic RVOT NSVT for over ten years now. I had my RF ablation done a 20 days ago and my ectopic, NSVT episodes have come down by 90% and I am feeling healthy generally. I had my echo, ECG, Holter, cardiac MRI. Echo, cardiac MRI are normal. Cardiac MRI was done post RF ablation and also has come out to be normal. MRI was ordered to rule out any structural abnormalities and to rule to ARVD, and cardiomyopathy. I am feeling back ache, shoulder ache, and mild chest discomfort now continuously for a few days. It looks very much like muscle and back pain that I have always and is not related to exertion as some times I feel it even while sleeping. I have not been doing any physical exercise for a couple of months and have put on some weight too. With normal MRI, echo, ECG except for ectopic beats, can I conclude the pain is not cardiac related? Attaching here with my reports. Does the MRI report also talk about ischemic factors or should I under go any further cardiac tests to rule out cardiac factors? If not cardiac, which specialist should I consult now for my back pain?",
    "doctor_response": "Hello. I had gone through your all reports. (attachment removed to protect patient identity).  Your Holter monitoring suggestive of premature ventricular beats some time occasionally, sometime in bigeminy, other time in couplet or NSVT (nonsustained ventricular tachycardia) this could contribute to irregular pulse or palpitation. MRI (magnetic resonance imaging) not suggesting any ischemic areas, and your RVOT (right ventricular outflow tract) also not unduly dilated. There is a very mild defect in the mitral valve but that is not contributing to regurgitation or any symptom so nothing to worry and yes, you can exclude cardiac factor but only after some investigation like x-ray whole spine (cervical, thoracic and lumbosacral region). For your shoulder and back pain, I want to ask a few things. Since how long you are suffering from this? Is this pain radiate to arms also? Back pain is confined to which area? Lower back or upper back? Did you have an episode of palpitation along with chest discomfort? Until then, I will advise you to use the hard bed without a pillow, do some physical exercises. Take Neurobion once daily for seven days. Reduce wait. Avoid oily foods.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lethargy, lightheadedness, blackouts and dizziness?\n\nLately when I ve been feeling really lethargic and light headed, when I ve been sitting down for a while then stand up I go really light headed and dizzy and feel like I m going to pass out, also I get like blind spots in my vision when this happens it was going on for around a month. I ve started drinking more water, eating healthier and working out, it has helped however if I have a lazy day it comes back. I told a friend and they suggested it may be my blood pressure.",
    "doctor_response": "Hello, Dehydration and less than optimal nutrition are 2 of the most common causes of these types of symptoms. Another could be LOW blood pressure, however, you are theoretically correcting the problem with drinking more fluids. However, there's nothing wrong with having your BP checked on the times you do feel faint, etc. and see if at that time you do have low pressure running. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for dizziness , burning sensation in the neck and anxiety?\n\nhi have problems with my lower back and recently have a burning sensation in my neck, the last couple of weeks l have felt dizzy more a foggy feeling in my head and dizzy. l allso suffer from anxiety and when i get this dizziness it doesnt help the anxiety at all. what could be causing the burning feeling in the back of my neck i have allso been told i have athrities,l shouldnt feel this way im only 40 and its restricting my life in so many ways hope you can give me some answers had a mri on lower back some thinkg wrong with my lumbar always pains in my hips and this has been going on for about 19 months my doctor said it will get better with time will it,hope you can help thanks",
    "doctor_response": "HiThanks for using healthcare magicIn that case, you should try some relaxation exercise and antidepressant with benzodiazepine. That would help to control these symptoms. Better to consult a psychiatrist for proper treatment. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sudden giddiness, uneasiness and fainting. Suggestions and remedies?\n\nMy wife aged 36 had giddiness yesterday. We just started our shopping and she was standing in a shop. suddenly she felt uneasiness. We made het sit on a chair. After a few seconds she became unconsious. We sprinkled water on her face and after a few seconds she opened her eyes. Then she took rest for 10-15 minutes in the shop and then we moved out. That time she felt like gas coming out of mouth from stomach . She was feeling uneasiness and giddiness feeling for another 1 hour or so. There after she was normal. Some months back also she had similar uneasiness but she did not become unconcious. Please give some suggestions/remedies",
    "doctor_response": "Hi,Thank you for posting your query.Your wife needs to be evaluated to find out the reason for her unconsciousness. The causes could range from simple exhaustion to lack of blood flow to brain and heart problems.Initially, please consult a physician, and get her haemoglobin, blood sugar and cholesterol checked up.Later on, she may need neurology and cardiology evaluation, if no causes are found.In addition, she has to ensure adequate sleep, regular meal timings, and avoid stress.I hope it helps. Please get back if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of conception on having skipped a dose of Norifam, instead took contraceptive pills?\n\nhi im using norifam for 2 years the last december i didnt take it on my regular schedule my sched was every 30 but last december it was moved to 10,but i had my period on the 30th. so this january i should take it 10 also of the month but i didnt get the dose instead i took a contraceptive pills this 11, then we had intercourse its my 2nd day of taking pills am i safe?",
    "doctor_response": "Hi, Thanks for the query.I understand that you shifted to a new pill from norifam. Since you had a period on 30, you should have started the new pack of pills from day 3 of the periods. You started it a little late. So it was advisable to use a backup contraceptive method like condoms during the first 7 days. Day 12 of the cycle cannot be considered a safe day so chance of pregnancy are not very high but not zero. Also since you have been using norifam, the return to fertility after the drug is also delayed in some cases and protect against pregnancy. But there is no way to be absolutely sure. If it is less than 72 hours since intercourse, you can try plan B and continue your pills. This will reduce the chances of pregnancy significantly and you need not worry then.Hope this was helpful. Thanks for using HCM.Dr Madhuri BagdeConsultant Obstetrician and Gynecologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are there any chances for regrowth of my breasts?\n\nHello doctor, I am undergoing the fifth cycle of chemotherapy for my left breast. For the past five months, I am undergoing this treatment. Prior to chemotherapy, I was taking ayurvedic medicine for the same problem. I took the medicine for about eight months, but it did not have any benefit. At\u00a0that time, I was not aware of the exact problem. I was advised to remove the breast completely, but by the god's grace, I was referred to a doctor in oncology. The surgery has not been performed. They started with chemotherapy. Till now, I have completed five cycles. Still, how many cycles are needed for me? Will rest be given to me after the cycles? I am unable to eat, swallow or drink. I have lost my appetite. I have vomiting. Motions are happening from when I start eating my regular diet. I am feeling very depressed and demotivated. I have lost hope from the past\u00a0five months.\u00a0My left breast is healing and dressing is done over it. The skin is removed over a part. My breast looks flat as if it is removed. There is itching over the breast.\u00a0Are there any chances for the regrowth of my breast? If yes, how many months will it take? If it does not regrow, what is the alternative for that?",
    "doctor_response": "Hi. From your description, I fear that you have metastatic breast cancer. Usually, the surgery is done after four cycles of chemotherapy for locally advanced breast cancer. As you have undergone five cycles, you must be on palliative chemotherapy to control the disease. Usually, it is reassessed at every three cycles to know the response and treatment is based on it, which may include a change in the type of chemotherapy, hormonal therapy, etc. You may require toilet mastectomy at some stage for your ulceration of the breast or it may be controlled with radiotherapy. These decisions are made by your oncologist and kindly ask him or her in detail. I am answering this based on your description. I can better answer if all reports are presented. Revert back with the reports to a surgical oncologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could a mass behind the heart be?\n\nmy mom has a history of heart disease. She has had a triple bypass and has also had surgery on the caratoid artery. she just had a stress test and they found a mass behind the heart, a small finding behind the right atrium. what could this be and what would treatment be?",
    "doctor_response": "Hello, It could be an atrial myxoma. It is kind of a tumour. Consult a cardiac surgeon and evaluated. Surgical removal is the treatment of choice. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful lump on the braest\n\nHi. A lump suddenly appeared under my left breast. It was the size of a pea but it grew overnight and is quite sore and itchy. I also have felt very sleepy recently and have had a hard time getting over an illness. I have an appointment tomorrow but do malignant tumor typically hurt and itch?",
    "doctor_response": "Hi,Dear thanks for the query to HCM virtual clinic.I studied your query in all the details you gave.Treatment-Malignant Tumour dont pain and itch and hence don't worry.Cause of the lump under the left breast seems to be boil/bug bite.Don't be anxious.I would advise you to consult with ER primary doctor who would give anti-inflammatory and antibiotics drugs,which you take for 5 days time and it would reduce.If not relieved, consult a ER Surgeon, who would investigate and treat it according to its cause.Welcome for any more query to HCM in this regard.Write Excellent review and hit thanks if this reply Helps you out.Have a Good Day.Dr.Savasakr M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for elevated cholesterol/bp with family history of ischaemic heart disease\n\ni'm a 35 year old male with a family history of ischaemic heart disease. i'd high blood pressure for the last year, 3 months ago my cholestrol level elevated with a serum TG of 1275 found on regular checkup. i'd no other complain. please advise me what to do.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Due to strong family history of ischemic heart disease (IHD), high blood pressure and high cholesterol, you are at high risk of development of IHD or other heart diseases in future. So better to follow these steps. 1. Strict control of blood pressure is needed. So take your antihypertensive drugs timely. Get done regular (monthly) blood pressure monitoring with doctor. 2. Strict salt restrictions in diet is needed. 3. Avoid oily and fatty food. 4. Do regular aerobic exercise like running, cycling, swimming etc. 5. Avoid stress and tension if you are having stressful life. 6. Get done regular lipid profile,ecg, 2d echo and stress test once a year. 7. Start lipid lowering agents like atorvastatin or rosuvastatin. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I take Vitamin B12 with Seroxat?\n\nHi doctor, Can I take vitamin B12 with Seroxat?",
    "doctor_response": "Hello. Seroxat is Paroxetine and is an SSRI drug. You can take Vitamin B12 with this drug without any worries. Cyanocobalamine or Methylcobalamine either of the form you can take. This will not cause any drug interdictions. Take care.  For more information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should a hard lump on the leg be massaged or given heat treatment?\n\nAfter a fall three weeks ago my leg was black and blue and somewhat swollen.  The ecchymosis and general swelling have faded but there is a hard tender lump in one area which I assume is a solidified hematoma.  Should I be applying heat or massaging it?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. No, you dont need to do that since it wont help and you should just let some time pass and it will reduce in size and hematoma will be resorbed into blood circulation Small traumatic fibroma may persist but it will not cause any problems in future. If there is estetic concern it can be treated surgically but only after 6 weeks when healing process is over. Heat and massage will not be efficient in these cases. I hope I have answered your query. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high fever despite taking Tylenol\n\nMy niece is eleven years old. She is in UK hospital. Her symptoms are continuous high fever, even with Tylenol and Motrin. Swelling of the eyes, face ,neck, hands and feet. It started with a sore throat. She also has stiff neck, joint soreness, a rash on her stomach, neck, face and ears. Her heart rate is very high, blood pressure very low, oxygen low, inflamed lungs and heart, with fluid in her lungs and now entering her stomach. All obvious illnesses have been ruled out, even things like Lyme s desease and mono. What do you think it is? The doctors are saying she is a mystery!",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I am limited in my ability to help you as I am unable to examine your niece.  Also, I do not know how her physicians are evaluating her. But, because of her fever, rash, musculoskeletal symptoms, and swelling possibilities that come to mind are: -Rheumatic fever. -Lupus -Juvenile idiopathic arthritis. -Allergic reaction. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to heal post-trauma scratch mark faster? Met with an accident and got scratches on face and forehead.\n\nDear Doctor, I met with an accident recently and got few scratches on my face and the forehead. Kindly give me suggestions to cure faster. Age-20 years/ male.",
    "doctor_response": "Hi. I am sorry to hear about your accident. I hope you just sustained some scratches and have been otherwise well! Now coming to your skin query. Well, ideally, the best would be to let me have a look at your scratches by posting well-focused pictures of your scratched or abraded areas, or come for a video-chat. Otherwise, I would suggest simple remedies as of now which would definitely expedite the healing of any post-trauma scratch mark: 1) Apply a cream containing an antibiotic, preferably containing a healing substance. There is a tube called ENZOMAC (containing antibiotic mupirocin and healing agent bromelain) or you may use SOFINOX cream (containing antibiotic fusidic acid and healing agents). Apply any one of them twice a day for 7-10 days. 2) If the above mentioned tubes are not available, then you may use separate antibiotic cream twice a day and a healing cream twice a day, example: T-BACT (containing antibiotic mupirocin) cream/ointment or NADIBACT (containing antibiotic nadifloxacin) cream/gel twice a day as the antibiotic and for healing - PLACENTREX gel can be applied one hour after applying either of the above mentioned antibiotic creams. 3) Avoid using a medicated soap or face wash and also avoid a scrub. Wash the scratched area with a mild moisturising soap or baby soap. 4) Keep that area completely protected from sun exposure. Preferably apply a sunscreen lotion with SPF of at least 30, two times a day on the entire face and other affected areas. First coat of sunscreen should be applied half hour before anticipated exposure and second coat after 4-5 hours. 5) Just in case if your scratches are deep, you should take oral vitamin C 500mg twice a day for 10 days (CELIN 500 or LIMCEE 500) and a zinc containing multivitamin capsule once a day (ZINCOVIT or BECOSULE-Z) I hope this helps you. Though I would still prefer to look at the skin condition through posting picture or video conference. Consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden syncope with disorientation, bruising and tiredness?\n\nMy mom 91 faints suddenly and is falling down without warning, when she wakes back she does not know what happen. Two days ago she bruised herself and today she was unresponsive and we could not find her pulse, but after we put her down she woke up tired but coherent . She started to fall down about 2 years ago and first we were thinking that she does not pay attention how she walks but she has no warning .",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, this could be due to TIA (Transient Ischemic Attack) and to rule out this she may need CT of brain some time this could be  due to geriatric condition, rule out the hypertension too, condition and symptom need to be taken seriously, hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Throbbing sensation behind the neck which the doctors are unable to diagnose. What could this be?\n\nI have had a plusing or throbbing sensation in the back of the neck area for about 6 years. It it at its worst when I wake up in the morning, have seen heart- nero- and other types of doctors, all kinds of test- heart, blood vessels, brain, and all other type of x-ray and such. so far no Doctor has been able to find out what is wrong with me. Can you help?",
    "doctor_response": "HIThank for asking to HCMOne thing you should bear in your mind and that is any pathology if does not treated in time then consequences would be graved, you have this problem since last six years and nothing bad happened up till now this means it may not be pathological but could be functional problem and that must be treated accordingly, if I would be your doctor then  would suggest you suggest you to control your self it is much better to go in hand of psychiatrist, be free from anxiety obsession delusion everything will be fine soon have nice day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Getting severe stomach pain. Have tried ENO and butter milk. Treatment?\n\nHi Doctor, I am Sushma,22 years old.I am getting severe stomach pain after eating breakfast in the morning.Even,I am having very simple and light food with out masala.I have tried Eno thinking it is reason of gastric trouble but there is no pain relief.Pain is getting reduced if I have any butter milk.Is it because of gastric trouble?Please help me with a solution for this problem and kindly suggest the diet to be followed. Thanks, Sushma.",
    "doctor_response": "Hello, vwmulasaisushma, I am glad to see that you have limited the intake of spices. If you are regularly experiencing stomach distress after eating, we definitely have to look into causes. You are a very young female, and I am sure you are under a lot of stress. Duodenal ulcer is common among young population. If you have a family history of stomach problems, more likely that you have this. Eno or alkaseltzer can give very minor relief but they don't control acid very well. If any, they can cause more acid rebound. There are very effective medications available over the counter, such as H-2 blockers,Proton Pump Inhibitors for acid control. H-2 blockers include Cimetadine, Ranitidine etc. PPIs include Omeprazole,Lansoprazole,Rabeprazole, Esomeprazole etc. These are highly effective. You can start taking these twice a day about one hour before breakfast and before the evning meal. You need to take this for 4-6 weeks. If you get complete relief, you probably don't need x-rays or endoscopy. If the symptoms continue, see a specialist. I also want to tell you that most of the duodenal ulcers are associated with a bacteria called H.Pylori. You need to be tested for that and if positive, needs treatment. Avoid excess caffeine, alcohol,tomato and citrus products. I wish you the very best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for skin rash\n\nHi, I seem to be getting a reoccurring skin rash on my legs, lower stomach and sometimes on my upper arms but it's only in the fall and winter.  It looks as if it is around the hair follicle and is usually very itchy.  They are just small bumps.  I moisturize frequently and have been to the dermo a few times.  Sometimes they tell me it's folliculitis and other times they say it's another type of infection.  Regardless, I never seem to pinpoint it and it keeps coming back (for the last 3 years).  First off, is there any chance it is an HIV rash?  If not, do you have any idea what it might be?",
    "doctor_response": "Hi,It may be chronic superficial folliculitis which occurs off and on. Consult the dermatologist for the perfect diagnosis and proper treatment. A course of antibiotic like doxycycline may be taken for few months to control the recurrence of folliculitis lesions.Hope this helps.Dr.Ilyas Patel, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can the rashes on the shoulder and breast be due to miscarriage?\n\nive had miscarriage with out knowing it. I stop menstruating for 3 months I thought its just because of stress and exercise, I usually jog and bike at morning. two months later I started having rashes in the shoulders, and breast. Is it because of missed miscarriage? Thus the dead fetus in my womb infect my immune system that started having rashes?",
    "doctor_response": "Hi, Miscarriage is usually not associated with rash. But any bleeding abnormality can cause rash. As you have not mentioned about the characteristics of the rash, it would be difficult for me to arrive at a provisional diagnosis. So, I request you to consult your Dermatologist for arriving at a proper diagnosis and for initiating the treatment. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have discharge from gums. Had wisdom teeth removed. What is the fluid discharge?\n\nhi i got all four of my wisdom teeth cut out on april 19th and the holes seem to be healing fine, however my top hole on the left side of my mouth leaks a white creamy discharge whenever i blow my nose or sneeze. it's really thick and taste like blood but when i open my mouth to look at what it is, its always thick, white, and creamy. what is this?",
    "doctor_response": "Hi autmnallen, Thanks for choosing health care magic forum, From the details provided,its clear that your wisdom tooth extracted socket has not healed and developed dry socket as well as abscess. I would advice you to gargle frequently using warm saline and betadine. Maintain oral hygiene well. Take complete course of antibiotics. The socket has to be curetted well by your dentist. Dressing the socket using povidine iodine may enhance wound healing. Avoid food lodgement in the socket. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to relieve itching between legs below testicles\n\nI have a serious problem in between my legs bellow my testical that it is very itchi and I can t stop scratching it and I believe it s called jock itch and I think it was cause by sweat I don t know but I want to know what could be the cure for this please!!!!",
    "doctor_response": "HiI had gone through your query.If itching is only due to sweating then following will helpful.1.Washing with warm water.2. Apply talc powder.3. Medicines like cetrizine will useful.But persistent of itching will indicate fungal infection.Examination of that part is necessary to diagnose it proper way.Anti fungal lotion or cream like terbanafin or candid cream will useful but only given after proper diagnosis.so consult dermatologist for further assistance.Still have a query then feel free to ask.Get well soon.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruises on penis after sex?\n\nI had genital warts at age 32 since then now age 36 I haven't had an out break.  I always use a condom but now my new boy friend says that he has bruises on his penis.  no hurt at all but it looks like it went through a meat grinder (his words).  Please help do we need to lubricate more?",
    "doctor_response": "Yes. Lubrication is more important to prevent bruises. Also dont shave the pubic hair. Trim it. This will prevent bruises. Also tell your boyfriend to do more foreplay which will make you to lubricate more. Sex is all about understanding. His words will make you to lose your libido, so educate him",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any cure for left bundle branch block?\n\nI have been diagnosed with LBBB (Left bundle branch block) , 2D echo shows LV ejection fraction 61% , septal motion abnormality consistent with LBBB rest nomal , my weight is 88 kgs  5'6\"  I am vegeterian , drink rarely , non smoker Is there any treatment/surgery/medicine to cure the same ? Please assist",
    "doctor_response": "In many left bundle branch block which would have occurred because of degenerative process of the heart condition system at your age . So if there are no symptoms I would suggest no further evaluation at this point of time and heart ejection fraction is on the nomral side . If at all you have any giddiness , black out like sensation a 24 hour holter to rule out any pauses is suggested . Wishing you good health.  Regards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could back pain while on HCG diet indicate?\n\nHi, may I answer your health queries right now ? Please type your query here...I ve been on the hcg diet and have horrible back pain acoss the shoulders and lower neck, friend is having the same pain she is on phase III of the diet with a lose of 33 pds, I ve been on it for 25 days with an 11lb lose. Why??",
    "doctor_response": "Hi there.You should be on a balanced diet of adequate proteins, fats and carbohydrates. Also important to keep well hydrated during hCG therapy. If you are intolerant to this diet, you may need to caese it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Throat cancer. Unable to eat or sleep. What medicine for painless death can be given?\n\nHi, One of my relatives aged 85 years, she is suffering from throat cancer at 3 stage because of this reason who is not able to eat any thing and sleep,they do not have any financial support also to meet the doctor, because of her total family started suffering among which small kids are there, they fied up with them so they decided to give any best medicine for giving her in smooth die, but they do not have any idea which drug or medicine to give her, please do not feel bad and let me know if is there any drug or table for giving her for smooth die. Thanks",
    "doctor_response": "Unfortunately there is no medicine to meet your need. Suggestion is you consult a Palliative Care specialist. Also there are dedicated hospice centers in many major cities like Mumbai, Pune, bangalore. They will ensure a peaceful, comfortable last days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome feelings of guilt?\n\nA recent thought has been driving me absolutely insane with guilt/shame as I battle to understand something I did as a child. As a 12-year-old, I babysat my neighbor s kids all the time. They were like family to me. I m a 28 y/o female now. For some reason, a memory was triggered recently. I remember being 12 and while changing the 2-year-old boy s diaper, I touched his penis to see what it felt like for a second. I remember immediately being grossed out. I can only assume that at that age, I was just curious but at the same time, I cannot believe I would think that was an okay decision to make. What on earth? As a side, I ve worked with kids all my life and never recalled this, thought twice about anything or had any weird thoughts like that. Remembering this event is making me feel like a terrible person, as if I m all of a sudden labeling myself and changing my own sense of self. I ve been struggling with this for two weeks now and I m starting to have a difficult time just making it through the day. I m starting to think that this has simply become rumination. Can I really feel guilty for something like that as a 12-year old child?",
    "doctor_response": "HIThanks for using healthcare magicWhatever you have done, that is past now and no one could change your past. If you feel guilt on that incidence, this could lead to either depression or psychosis. Being a child, what ever you did, was not wrong. Sometime in curiosity, you do such things and same you did in childhood. Better to stay relax and enjoy your life. In case you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cough with mucus?\n\nhi, i have been sick and have had bronchitus.. i got antibiotics for this, and had to use the repeats.. however i still caugh (even though i told my doctor to give me stronger antibiotics since the normal once never help!) and my coughing attacks usually comes at night.. however my mucus is no longer green/yellow-ish and just today i threw up quite a lot of clear mucus in one go (thought i threw up food but it turned out to be mucus! which has never happened to me before..) do u know why this is? should i be worried?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. You are not receiving appropriate treatment for bronchitis. Inhaled treatment in best for bronchitis.Since you are not receiving inhaled treatment you are not improving completely.So consult pulmonologist and start inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).Don't worry, you will be alright with all these in 2 weeks.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes memory loss while on medication for heart attack?\n\nhello dr. well my uncle got heart attack on saturday ,we took him to hospital he was admitted there 3 days on 3rd day he got his angiography report and discharged by the hospital's authority,they said they he had mild disease which will be cured by using medicine, we bring him tgo home after one day when we started giving medicine.after one hour when we gave medicine he said that i m feeling weired and he can't say any one's name ,mean he can recognoised but he can't articulate the words and names of reletives who are infront of him.please give me some suggestion, his age is 50 years and wait will be 70-75 kg",
    "doctor_response": "Hi ! Thank you for using HCM According to what you describe to me , he should go as soon as you can to the hospital .This is a mental  confusion : temporarily memmory  problem  and articulation ptoblem, may be caused by a very low blood in the brain area .The low blood pressure may be from the heart or the medication you   gave  in certain dosage can be a risk factor of causing this .It's neccesary  to go and to do the  examination of the heart and other examination Wish your uncle good health .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the risks of pregnancy while on IUD and how does it affect ovulation?\n\nI have a merida IUD. I have not had a period in 2 1/2 years but recently started spotting. I have taken benedryl to sleep for the last five years and recently decided to wean myself off and switch to melatonin. What are the risks of pregnancy while on the IUD and how does it affect ovulation. Thank you",
    "doctor_response": "Thank you for the question and I am happy to help.The Mirena IUD secretes progesterone in the inside of the uterus and prevents the uterine lining from responding to the normal cycle of hormones produced by your ovaries.  The Mirena IUD does not affect ovulation - you are still ovulating while it is in place.  The main way that this IUD works is by thickening cervical mucous and creating a barrier for sperm to get to the fallopian tube.  When the IUD has been in place for a long time, it might cause thinning of the uterine lining which can lead to breakthrough bleeding.  This can be prevented by putting you on a short course of progesterone or birth control pills.  The risks of pregnancy while on the Mirena IUD are extremely small.  They are not zero, however, and you should take a pregnancy test.I hope that this helps and good luck to you!Dr. Tim",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is blood in urine a sign of liver disease?\n\nHi, my friend is a chronic alcoholic and ha s been for years. He will have times when he will give it up and go to meetings but always ends up back drinking as much as he can. He just told me there was blood in his urine and I m very concerned as he has just gone back on it after being clean 3 months. Could this be a sign of liver disease. Thank you for taking the time to read this and I will look forward to hearing back from you. Debbie",
    "doctor_response": "hi.welcome to healthcare magic.i understand your problem.my opinion is that,blood in urine may be due to,1.kidney stones.2.any infections in prostate.3.urinary tract infection.4.hemoglobin excertion in urine.kindly do ultrasound of the abdomen and pelvis to rule out the cause for blood in urine.thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are there any harmful effects in practicing rhythmic breathing?\n\nHi doctor, I have recently started practicing rhythmic breathing for peace of mind. The practice includes proper cycles of fast and slow breathing.\u00a0I have heard that such process might lead to hyperventilation and asthma problems. Further while doing the process I feel some tingling and vibration in my fist and forehead. I also feel mild headache at times after the process.\u00a0However, overall the process gives peace of mind. Should I discontinue the process? Are there any harmful effects of the same?",
    "doctor_response": "Hi. First of all, I congratulate you for adapting breathing exercise. It is scientifically proven exercise to control ventilation and calm down the mind. It is also helpful for the people with breathing problems and asthma. In no way it is harmful to the body. It is not at all causing asthma or any other problems. As you said, because of overventilation, you can experience some tingling, numbness, headache or lightheadedness. But, these effects are temporary and in long run it is very helpful for the control of breathing and meditation. So, I encourage you to continue this and be happy in life by learning the art of living. Till date it is the scientifically proven way of meditation without any side effects.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic allergy\n\nHi, I have chronic allergy issues, I have been to serveral specialists who are unable to help me. I use nasal sprays regularly... but when I go to certain places it just sets me off - specifically my sinus. After about three days (and continual use of nasal sprays) I lose my voice. Any ideas as to what I can do to prevent this?",
    "doctor_response": "Now a days chronic allergy is common issue many people suffer from it. And the problem is managable with certain precausion.keep track on your activity and identify those culprit( you can also go for allergen test to identify allergen) which creats problem then avoid that activity or perticular thing which is reaponcible for allergy.this will help you a lot. Other thing that you should do is yoga( like anulombvilom and kapalbhati) which help to improve body immunity and hence will benifit you.there are certain regime which block the allergen by using specific antibody and are very effective. You said that you use regular nasal spray but forgot to specify type of nasal spray but i would suggest not to use it on daily basis cause there are many side effects like rhinitis medicamentosa and it also worsen the condition once you discontinue the spray which again leads you use it agai (cycling process). So avoid apray as much as possible. Your history also suggest that you might suffering drom chronic sinusitis . For that you should go for x ray, ct scan or mri head to confirm it . If it is chronic sinuaitis then it can be treated by medicatin like antibiotics , anti histamonics and NSAIDs if it ao sever that it does not reapond to above treatment then surgery can be done sucssesfully..i hope this information will help to proper treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore stomach and throat in a 4 year old?\n\nHi I have a 4 year old girl complaining of a sore tummy she has been in tears and really crying and clutching her tummy.. she also says she has a sore throat and she is a little hot to touch than normal.. should I just go to the pharmacy to get something or take her to see a doctor?",
    "doctor_response": "Dear parent, for fever you can give acetaminophen or ibuprofen syrup every 6-8 hours. for sore tommy you can give an antispasmodic as visceralgine . for sore throat offer her warm fluids and throat lozenge together with an antihistaminic as citrizine once before going to bed",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain after injury\n\nhi there.  i fell down some stairs about 4 days ago.  the main areas hurt (with hot to touch bruises), are my right elbow, and very top of my right buttock.  about a week prior to this, i was bending under a table, and when i moved to get upright again, i smashed my tailbone into the corner of the table.  the buise for that has just about disappeared. i've started getting an odd pain in my abdomen (right side).  it's not a contstant pain.  it comes and goes every minute or so.  it's fairly sharp - but not a terrible stabbing pain right now. i feel healthy otherwise.  i'm taking a couple of asprin a day to avoid any clotting. what's the abdomen pain about do yoyu",
    "doctor_response": "Hi.Thanks for your query .Fall from stairs certainly cause such injuries that can become obvious only after some days. Yours are at the right elbow, top of your right buttock.As I told just now that some injuries can becomes obvious only after some days and hence tries to neglect the proper examination by a Doctor and the investigations. Since you have a pain in the abdomen, again on the right side. This is not constant, comes and goes, and is fairly sharp. I would advise you the following ::First of all stop Aspirin as it can enhance your problem by causing or increasing internal bleeding by virtue of its anti-platelet activity.Secondly, get a clinical / Physical examination by a Surgeon for proper clinical diagnosis.Thirdly, go for CT scan of the abdomen to get the details whether there is any internal injury to the colon , right kidney, liver or so.If found get admitted for ''under-observation and review of the condition as you may need surgery any time. IF normal , nothing to worry as this can then be just a bruised abdominal wall muscles.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What diet should be given for a 3 year old diagnosed with Frazier s syndrome?\n\nHello, my name is Lisa. I just found out that my 3 yr old son has Fraziers Syndrome. He is also developmental delay, Autistic and has cardiac mumours. My question is all the research that I have done tonight shows me that it all boils down to the kidneys. what diet should I have him on to maintain them in Great health and can he play in sports without stressing out the body.",
    "doctor_response": "Thanks Lisa for putting up your query at HealthCareMagic. I am sorry that your 3 year old son is suffering from Frasier syndrome. It is a rare disease with improper development (dysplasia), underdevelopment (hypoplasia), or absence of one or both kidneys (unilateral or bilateral renal agenesis) caused due to a genetic defect. There are certain other associated abnormalities and I am not going into the details. Unless I can come to know the exact nature of kidney defect your child has, it is difficult to comment on the diet. An ultrasonography would make things clearer. That would also indicate whether the livers are affected as well. That too would play a role in determining the diet. It would also vary with the presence or absence of protein in urine which would indicate a defect at microscopic level. Please get back to me with the details and I would try to help you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am 22 year old female. Looking for sun protected cream which not cause damage to skin\n\nhi..i d like to ask about sun block creams.and what s the better one which not cause damage to skin?? female 22years...about sun block creams is it dangerous?i mean using it on long run..as i use it daily twice and i fear if there is any problem...thanks..",
    "doctor_response": "Hi, Do not worry most of the sunscreen do not harm..but you have sensitive skin..I would suggest Spectraban Sensitive 30 plus SPF..it good..apply 7:30Am and reapply at 12 Noon.If problem persist can consult nearest Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How is a pregnancy s paternity and date calculated?\n\nBased off my due date, which is December 11, 2010 that would mean the day I concieved was on March 20, 2010. So does this mean that that was the time frame that I was ovulating and got pregnant from precum? Also if I had sex with someone else on the 25th, would that due date add up, to make that person the baby s father?",
    "doctor_response": "Expected date of pregnancy calculated by adding 9 month and 7 day in the first date of your last menstruation cycle.  If you want to calculate date of ovulation than add 14 days to first day of your menstruation cycle. According to your your last menstruation was 11 December, according to this your ovulation was on 25 December.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce abdominal cramps caused after eating?\n\nHi, I recently came back from an overseas trip and ever since my return 2 weeks ago, I have been experiencing abdominal cramps after I eat .  It's like airbubbles in my ribs and I have a lot of bloating a discomfort.  Any advice would be appreciated.    Jacki",
    "doctor_response": "Hi. This is called a gastro-intestinal reflex. This indicates you contracted an intestinal infection particularly at a junction of small intestine with the large intestine and appendix. You may please go for the blood tests routine and particularly of the typhoid. Another possibility of appendicitis has to be excluded by an ultrasound examination of whole abdomen. Start antibiotic treatment along with metronidazole under the directives of the Doctor. Continue for minimum of 5 days, see the results ; if typhoid is positive , insist for 21 days therapy.If appendicitis- ask if surgery is required now or after a gap with medical management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can the kidney aneurysm eruption be avoided?\n\nMy Mum has been diagnosed with an anurism on her kidneys...4.1.  She has to wait for a scan until December 2011.  Is there danger of this anurism erupting at any time.  What can she do to avoid an eruption?  She is still having occasional cigarettes and is worrying herself sick.  She is 77 years old and had a bowel/colon op 6 months ago which successfully got the cancerous tumour.",
    "doctor_response": "Hi and welcome to HCM.As an Urologist, i can understand your anxiety.A renal aneurysm can potentially have a rupture.This can be prevented by several techniques.She should stop smoking at once.As she had surgery for cancer colon,she needs to be examined by an Urologist and then do the following tests :Blood routine,creatinine,RBS,LFT,platelets,CT-IVU or a MRU.An abdominal CT scan and angiography is needed,with a chest X-ray.The aneurysm can be blocked by interventional techniques,using coils.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are upcoming risks with Stachybotrys exposure?\n\nI am a toxic mold victim and through out the years i have became more ill and now i have tumors and a lot more life threaten health problems for life time.I was exposed to Stachybotrys a very deadly and a Toxic Black Mold.What kind of help do i need and treatment???",
    "doctor_response": "hello and thnx for your queryas Stachybotrys is known as a toxic mold because it produces toxins called mycotoxins.The solution is to remove the toxic black mold from your environment or remove yourself from the environment. Once you are away from toxic black mold your body will start to recover and most of your symptoms should go away over time. However some of the damage from toxic black mold can be permanent.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a swollen scrotum after undergoing hernia operation?\n\nMy name is Eddy Somerville. I had a grapefruit size hernia that was operated on Dec.6th. The operation went well, but my scrotum was swollen and it still is. I was told a doctor to elevate the scrotum, but I don t know how. Can you pleaser give some suggestions? Mt email is below. I m on google.",
    "doctor_response": "Good Day and thank you for being with Healthcare Magic!To elevate the scrotum you need to wear tight fitting  underwear to support it. When lying down and sleeping, put a rolled towel under the scrotum so it will be raised. We do this to prevent edema and fluid from accumulating in the scrotum.  I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at:   I would gladly help you.  Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have pain in chick after root canal treatment. Took antibiotics but it is of no use. What is the remedy for this?\n\nits been two monthsroot canal treatment was done  I am often feel very heaviness in the whole my left chick and pain running to head, ear and neck on my left side.   Visted several doctors including endodontist suggested antibiotic but after completing my medicine course I am still having pain.your valuable suggetion will help me a lot.thanks and regards",
    "doctor_response": "Hi, Thanks for asking the query, After a sucessful root canal treatment the canals are removed and the tooth is completely devitalised so there are no chances of pain. There are chances of pain radiating from the infected tooth to the cheek, ear and neck ,i would suggest you to get an x-ray done of the affected tooth. Also look wisdom tooth on the same side if crooked, impacted or crowded can lead to pan in the cheeks. Another cause is allergic reactions, inflammation of the lymph nodes, any blunt trauma to the face, inflammation of parotid gland, growth such as tumors cyst can also cause such type of symptoms. I would suggest you to get a complete clinical evaluation by the Dentist to confirm the cause and plan appropraiate treatment, if the tooth is reinfected you habe to go for re-RCT of the tooth. You continue with the course of antibiotics ans analgesics and maintain a good oral hygiene. Hope this helps out. Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Sarcoidosis\n\nI was diagnosedwith sarcoidosis 4 years ago. I did not stay in physician care but returned this year. T he doctor now treats melike itis not a serious illness and my symptoms are in my head. This doctor gave me 5 years to live 4 years ago. I finally stopped work because I do feel extremely weak. I do have a hard time getting enough air. Yet my breathing test states Im at 80% this was with medication. So she wont help me get disability. I am always in pain. I spasm badly when trying to sweep a floor yet she says Im fine. I did do sleep study that said I sleep 17 minutes an hour. I have a bi-pap machine. Not helping. Just cannot get usede toit. My question is why was it serious 4 years ago and now when I feel I cant go no more doctor acts like its all in my mind. I know what I am feeling, why wont anything show up. Ct scan reveals I still have it but they claim not as bad. I dont understand.",
    "doctor_response": "thanks for your question I completely understand your question sarcoid is a autoimmune disease and treatment involves giving drugs to suppress the immune system.drugs which are now a days used are steroids and cyclophosphamidesarcoid in lung has 4 stages depending on the lung lesions and hilar lymphaticsfirst you should visit / consult a pulmonologist who can accurately diagnose and stage the disease and then he can prescribe you drugs to slow the progression of the disease sometimes giving treatment sarcoidosis can be controlled on low dose of steroids and a continous low dose is neededsarcoid is a self limiting disease also it can reverse itself by its own in some casesso you should now visit a pulmonologist and disscuss the above treatment modalities and wat next to do thanksfeel free to ask more questions may god bless you with good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could exercising increase the risk of heart failure while having LBBB and tricuspid regurgitation?\n\nHad an abnormal EKG with a LBBB (QRS - 142) diagnosis. It was confirmed on an echo with the following echo interpretation summary of: Borderline left ventricular systolic function, ejection fraction 50% Normal right ventricular systolic function Tricuspid regurgitation - mild Elevated pulmonary artery systolic pressure - borderline I am scheduled for a stress echo next week but not sure if I should continue exercising. Am I at any higher risk of heart failure if I continue exercising?",
    "doctor_response": "welcome to hcm ..you can continue with mild to moderate exercise plan especially if you are already exercise doing but please avoid heavy stressful exertion and maintain bp ..sugar and Hb...avoid infection if you have any further query then you can come back to hcm i will definitely help you and guide you appropriately with regards dr varinder joshi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am i getting yellowish stuff from private part?\n\nhi i pulled out a hair (i don't wanna say where yet) but it had this hard yellowish stuff all around it it from the tip to the root. it really creeped me out. could you tell me what that could be? I mean is it just a allergic reaction to soap or something?",
    "doctor_response": "Hello,Welcome to HCM,The history and symptoms suggest me that you are having the fungal infection of the genitals, which are the normal comensals of the genitals which will be kept under control by the helpful organisms whenever there is a imbalance in the environment it will lead to multiplication and growth of the fungus.I would suggest you to follow1.Keep the area clean and dry2.Topical antifungal cream3.Oral antihistaminesThese measures will help you to control the symptoms and improve the condition.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the after effects of birth control drugs?\n\nhi..i am a 18 year old girl.who has been on the deprovera injection for over five years.i finally got my periods a year later when i cam off the injection.after two months i went back onto the two month injection throughout these two years i have been on and off the injection and have being having my periods randomly..sometimes missing two months and then gettng them.i last got my period end of october 2010 and had unprotected sexual intercourse. From then and now..i have not had my period..as well as the secons time i had intercourse i had taking taken the morning after pill. i have taken two pregnancy tests and they stat negative.its being almost three months and im still not sure if im pregnant..or could it be somethings else. As my father is diabetic and i and a bit overweight as i like alot of sugar.",
    "doctor_response": "injectable contraceptive can delay periods as well as can delay ovulation  so your delayed periods are the side effects of your injectables. Take precaution everytime as you never know when will you have ovulation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does my kidney report mean?\n\nMy elder brother of age 40 did usg of lower abdomen . Kidney report is as follow: Right kidney: Measuring 14.1cm in long axis(including SOL) with a heterogeneous, mainly hypoechoic SOL (9.6cm x 8.5cm) involving its lower half, this SOL shows vascularity. No calculus/ hydronephrosis seen. Please tell me what does this mean and what should we need to do....",
    "doctor_response": "berberis Vulgaris Q 10 drops with half cup of water will solve ur bro problems!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could painful lumps on jawline indicate?\n\nHi I have noticed two matching (on either side of my face) small lumps about the size of a pea. They are in front of my ear, at the top of my jaw. They are quite tender to touch. But they are not getting any bigger. They have been there about 4 days now. Any ideas?",
    "doctor_response": "Hello Thanks for consulting hcm Read your query as you have pea sized lump on jawline this can be enlarged lymp node . There is nothing to be worried so much if it is not getting enlarged . Lymph nodes enlarges when thereis infection . For this I will suggest you to consult oral surgeon for examination of lymph nodes . Hope this will help you .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore tongue and mouth in a type 2 diabetic person?\n\nMy tongue and mouth are uncomfortably sore for 1-2 weeks---I m thinking it may be oral thrush but there are no white spots; I m not a smoker. I am a generally healthy Type 2 diabetic, well controlled w/ medication. Is there something I can take to relieve the discomfort.",
    "doctor_response": "Dear Sir, greetings from HCM ... I understand your problems ... You told that your blood glucose is well in control ... That's great .. Any way to be on the safer side get your HbA1c done ...along with lipid profile and fasting glucose levels ... The sore tongue could be due to vitamin deficiency .. Please take good nutritious food and for a month better take any vitamin and mineral supplements .. Riboflavin / even zinc deficiency could also lead to this kind of problems ... U will be alright in a week after starting supplements but regularly take green leafy vegetables and fruits which will give these supplements naturally .. Take care and all the best .. Do contact us for more queries..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Got molar extracted due to infection. Taking antibiotics. Swelling and pain in cheek. Cure?\n\nHi , I had infection in one of my molars, which was treated by RC method twice in the last 8-9 years. Because of this infection, I have developed swelling and pain in my lower cheek, jaw line and a part of chin. I gave up, and got this tooth extracted. However, inspite of 3 days of antibiotic dosage, the swelling and pain in cheeks area is not going away.. Do I need some kind of procedure to drain the pus which probably has accumulated in this area and causing pain and swelling?",
    "doctor_response": "Hi, Thanks for asking the query, There can be chance of some broken root piece left in the socket due to which you are experiencing pain and swelling. I would suggest you to visit the concerned Dentist and get the checkup done, take an x-ray to see any left over tooth particle, if present it can be surgically removed. Take complete course of antibiotics and analgesics. Take lukewarm saline gargles and antiseptic mouthwash gargles. Apply ice packs externally over the area. Maintain a good oral hygiene. Hope this helps out. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Enlarged papillae and white spots on tongue. Reasons?\n\nHi, I am 21 years old and recently (for the last 2 months or so) I have had 2 enlarged circumvallate papilli on the back of my tongue and white spots at the back of my tongue as well. It is all clustered to the back and is not on any other surface in my mouth. I saw a doctor but they did not seem to think these symptoms were alarming, but they never went away. What are common reasons for this and what should I do? Should I see an ear nose and throat specialist?",
    "doctor_response": "Hello Welcome to HCM I would like to tell you that papilla enlargement can be seen in cases like:- -Iron & vitamin deficiency -Poor Oral hygiene -Smoking -Trauma First you need to rule out the cause & then get it treated accordingly. Consult your dentist for further query. Take Care Regards Dr.Neha",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with adenocarcinoma. Currently having jaundice symptoms due to liver tumor. How to sustain this condition ?\n\nHi, my husband has been diagnosed with adenocarcinoma but currently has jaundice symptoms due to the liver having a tumour in it. They thought that he would have passed on by now due to the stent not working while in hospital but it appears to be working sometimes and his overall health seems to be improving. Is there any advice you can give to sustain his current condition and how long do you think this will last?",
    "doctor_response": "Hi Avylyle,Welcome to healthcare magic!You are really having very troubled times.Adenocarcinoma in liver is a lethal tumor, due to obstructive features and jaundice these patient become drowsy and develop hepatic encephalopathy and lastly coma.They are also vulnerable to DIC, Altered coagulation and hemorrhagic complications,Due to drowsiness may develop aspiration pneumonia, respiratory failure etc.I hope this advise would be helpful for you.I wish him a better health!",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get pregnant while suffering from PCOS?\n\nhi Im 27 and myself and partner has been trying to concieve for over 3 years i have pcos and under active throid i have been taking metforim for 6 months and have lost 59 pounds i have researching pcos, and clomid is one of the treatments i keep coming across, i am contacting you really for more infomation and what you think my next step would be thank you",
    "doctor_response": "Hello,Do serum TSH, free T3 and T4, and serum prolactin. Then do serial follicular study after taking Clomiphene with gonadotropins under the guidance of a gynecologist till follicle size increase to 18 mm and then ruptures, then IUI for early results.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sheetal Agarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause and treatment for severe abdominal pain?\n\nabout a week ago i had severe abdominal pain, i went to the doctors they werent sure if this was appendicitis or an infection. the doctor told me if these pills dont help you come back on monday, anyway the abdominal pain had stopped about three days ago and now im experincing nausea everyday what could this be?",
    "doctor_response": "HI.Even appendicitis is also an infection of intestine. Anyway the good part is your pain has subsided. The nausea may be due to medicines/ recovering from infection. If there is no fever, vomiting, loose motions or any other abdominal symptoms, this is a good sign and you may please go for an ultrasonography or CT scan of abdomen to see any organic problem. In case of appendicitis you have an option to go for surgery after 6  weeks of treatment. Continue the treatment for a full course.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does hydrosalpinx recur after a bilateral tube disconnection?\n\nHello doctor, I am 36 years old. I had a bilateral hydrosalpinx (HSG) mainly due to endometriosis. I do not have any pain symptoms, and I had a bilateral tubal disconnection to maintain the blood supply to the ovaries. After this, I had IVF but failed. I had HSG again, and I do not know if there was spilling on the right side but no hydrosalpinx. Some doctors suggest left tube corneal end cauterization, but I was afraid. I had the hysteroscopy and was free, and I am now on the second trial with the frozen ones but experienced now some watery vaginal discharge, and I am worried if there is hydrosalpinx and the second HSG after disconnection what do you think and what you suggest?",
    "doctor_response": "Hello. I find lots of misunderstandings in the history. From the report you have sent, I can say that your uterus is normal and thereby there will be no problems in undergoing IVF. Once the tubes have been disconnected, how can you still have HSG showing spill in either tube? The inner diameter of the tube is 1 mm and is so sensitive. Once the tube has been disconnected by a knot or clip or cautery or any other method, then there can be the reversal of patency only by surgery, if the prognosis is bad. I do not see any fluid collection inside the tubal area. As you see there is no such connection between uterine cavity and tubes. So the watery discharge cannot be from tubes. Fluid could be from erosion on the cervix, or a vaginal infection, which can be treated locally. So in total, I feel the uterus is normal and can confidently go ahead with IVF, no need to have any further interventions on tubes. They are not visible and have no connections with the uterine cavity. So neither can fluid enter uterus from tubes nor can embryo enter tubes from the uterus. To further substantiate my advice, your hysteroscopy was also normal. So just do not worry about it. Hope I have clarified your query, do write back if any more queries and give me your feedback. For more information consult an infertility specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard lump on the right side of the rib cage?\n\nI have a somewhat small immovable hard lump on the right side of my rib cage. It had swelled up and became painful and the Dr told me it was probably a lipoma and that it should be removed. It's been about a week now and it has shrank down and isn't as painful. Is this normal for a lipoma and should I still get it removed?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some soft tissue tumor like lipoma, neurofibroma or dermatofibroma.  Excision is the treatment of choice for all.  You should go for excision biopsy and histopathological examination of the lump.  Consult your doctor and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I do not have occlusion in one side of my crown with eating difficulty. How to manage?\n\nHello doctor, I am 71 years old and I am in the process of getting major work done throughout my mouth. At the moment, I have only three grinding teeth on my upper. Two on the left and one on the right (numbers 4, 12 and 13). 11 days ago, the dentist reinstalled the crown on number four, but when I left his office there was no contact in number 4. There was only contact (occlusion) on 12 and 13. Of course, it was very difficult eating with only two teeth that had full contact. After a few days, I started to get a lot of pain in my neck and behind my ear and up almost to the top of my head on the side of number 4 (right side) and there was numbness in the area of my jaw joint (in front of my ear). I saw the dentist again four days ago and he added some type of material on top of number 4 to achieve occlusion there. I still have the pain constantly and it is pretty unbearable. 800 mg of Ibuprofen and Aspercreme on the area help me somewhat. I called the dentist and he said that the pain was related to some nerve problems inside the number 4 tooth. I have been thinking maybe there was some damage in my jaw or something because of my jaw having had overwork trying to make on the right side while eating. What do you think?",
    "doctor_response": "Hi  I have read through your complaint and the relevant details. Firstly, I would like to ask you for what reason was the crown was placed for tooth 4. And usually, when there is no occlusion on one side, you will get pain and soreness on the opposite side. If the occlusion is high i.e. too high crown, the pain and soreness will be on the same side. Repairing the crown with extra material would not be ideal. If the occlusion is not there, the dentist must have given you a new crown in place.  Were there any x-rays taken for the same tooth? In that case, any nerve problem can be easily identified. Please do not worry that you got a jaw problem. It is with the construction of the occlusion which helps you to do normal function.  Ibuprofen 400 mg thrice daily should work well for this kind of pain. Heavy doses are not advisable. I reckon you check with the x-ray for that tooth if you have not had any before and forward it to me. I also request you to send the picture of the teeth so that I could arrive at a better diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in hand, black marks on nails, painful knees, leg cramps. Diagnosed with lupus. Suggest?\n\nHello.  I am a 45 year old female.  I was previously diagnosed with Lupus, but it was later changed to undifferentiated connective tissue disease.  I am presently experiencing the following symptoms: 1) Pain in my right hand (mostly index and middle fingers) 2) Black marks under my fingernails 3) Burning on fingertips, right hand 4) Wart on index finger of right hand 5) Itching on right hand and  extremities 6) Pain in the knees 7) Leg cramps (every so often) 8) Hot flashes.  What is going on? I am currently taking co-diovan (HBP) and extra strength panadol and arcoxia for the pain.",
    "doctor_response": "for undifferentiated connective tissue disease you should probably be on hydroxychloroquine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat blocked nose in a 4 year old?\n\nHi! My 4 yr ols son seem 2 have a blocked nose. Especially when he s sleeping, seems like he has difficulty breathing resulting in him snoring and trying 2 breathe through the mouth... and then as he sleeps facing up, a foam-like saliva come out. I think its becuase he breathes through the mouth. Please help, what do you think could be theproblem?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.There is a possibility that your son has obstructive sleep apnea (OSA). In addition to snoring, other signs of OSA include restless sleeping (tossing and turning in bed), being fatigued when he wakes up in the morning as well as during the day, and enlarged tonsils and adenoids. Obesity and elevated blood pressure are also associated with OSA.It is best to have him evaluated by a paediatrician (if possible), ENT specialist sooner rather than later. We want him wide awake and ready to learn when he starts school.I hope this has been helpful. Please return should you have further concerns.I hope I have answered your query. Let me know if you have any further questions. Regards,Dr.Arnold Zedd",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is my urine result normal ?\n\nsir,iam 37 y female.i have recurrent uti.atpresent i take cefxime-5days.my urine result as follow.reaction-alkaline,albumin-faint trace,sugar nil,bilesalt,pigment-negative,puscells-2-3,redcells0-1,epithial cells4-6,bacterial rods nil,mucus threads nil,.is this normal or not sir.iam worried.",
    "doctor_response": "Hello banu ; welcome to HealthcareMagic The report you have posted is normal but it is also important to see that you have no symptoms like before :-frequent urination;fever;burning during urine or any other symptom you had.If there is no symptom and you are feeling better and since the report is also normal you should continue the medicine for the period as recommended by your doctor and you will be fine. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for heart ailments\n\nHi,My dad suffers from Diabetes, and has his heart muscle enlarged. Heart works 22%-25% at the moment. All doctors recommend a pacemaker, but scared of the surgery as hes diabetic and An infection might take up. Its like 3-4 years now that My dad hasn't faced any problems. Is this the right time to get the pacemaker installed? And Yes, My Dad's age is 55 right now.Thanx a lot!",
    "doctor_response": "Hello,Is there any history of chest pain or heart attack? Has angiography been done anytime in the past? First angiography should be done if there are blockages they should be opened. If not and working capacity is this much only, then special type of pacemaker called as AICD is indicated and should be put. Surgery is not a big surgery and although infection risk is bit higher if sugar is well controlled and with antibiotics risk of infection is less. This will protect him from sudden cardiac death. so my advice is angiography followed by AICD. Also lifestyle modification like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly once  or twice a week. Regular exercises like brisk walking, jogging according your capacity at 30 min a day and 5 days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn't abdominal fat deposition or obesity.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause recurrent anal fissure along with pain in the stomach and hips?\n\nmy now 4 year old had a anal fissure at 2 that took a very long time to heal. She was on Resoralax up until 3 months ago, and it seems it has came back or never fully healed. Even when she was off the laxative, she always had diarrah like poos( never even close to hard) and will refuse to poo sitting down, only standing because she said it would hurt. Currently she is experiencing spasms that last anywhere from 1-15 minutes, and feels pain in her hips, stomach, tailbone and legs. She has to either stand or lay down( can't sit until after she passes a bowel movement.) the entire area is painful to any touch and even water sometimes. I'm worried there may be a greater problem cause the fissure to reoccurs or never actually heal",
    "doctor_response": "Hi, But this problem is very unusual in a four years old child except if she is suffering from severe constipation which is not the case. Please make sure she is not sexually abused which can cause such severe complications. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it advisable to give appetizers for a 4 year old?\n\nHi, may I answer your health queries right now ? Please type your query here... I have a 4 1/2 yr old son who is 15.5 kg in wt and 103cm in height.He is a very fussy eater and does not like to eat any type of food can you please let me know if his wt. ht ratio is fine and if we could give any appetizers",
    "doctor_response": "Hi,The weight is ok, and Height is in limit but it is ok. But if you use BMI formula you will see that he is more weight than height, so he probably are eating more carbohydrate foods like milk, pasta, and other caloric, so you can give appetizer in my opinion, No.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat mosquito bite allergy with itching?\n\nim suffering from mosquito bite allergy for about 5 years.. i even tried homeopathy medicnie.. daily im applyin mosquito repellent cream and caladryl lotion n aloe vera gel on hand n legs.. too many creams like EMODERM etc.. i even tried eatin many tablets for tat.. but i couldnt get rid of tat.. there are too many marks on my legs n hands and its itchin so much.. pls find a solution for me.. im 17 years old..",
    "doctor_response": "HelloThank You for contacting HCM.> levocetirizine one at night for 5 days.> Montelukast one daily for one month. Research has shown that it decreases the allergic symptoms considerably.I would also suggest you to under go allergy testing at allergy clinic as you have chronic allergy problem. It will tell that you are allergic to what specific thing. The results will help an allergist to prescribe you immunotherapy to that specific allergen and it will improve the problem.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Tylenol Extra Strength be taken for stomach pain in cancer patient?\n\nMy Mother is going through Chemotherapy treatment and is currently taking Taxol, so because she has stomach pain, she would like to know if she can take Tylenol Extra Strenght which contains Acetaminophen . Can she take this medication right now? Please advise. It would be highly appreciated. Thank you, Sincere regards, Jaime",
    "doctor_response": "Acetaminophen has no contraindication in patients receiving Taxol. Yes she can take extra strength tablets also as long as her liver function is good. If her liver function tests are normal she has no contraindications for any strength of analgecis",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be done for back pain alleviation ?\n\nPain What to do for back pain alleviation?",
    "doctor_response": "Hi, Welcome to Healthcare magic forum, Lower back pain radiating to lower limbs suggests inter vertebral lumbar disc prolapse or bulge. The best way to diagnose is to get MRI LS spine. Precaution to take: Avoid riding two wheeler. Dont lift heavy weight. Sleep on hard mattress and on ur back and side, dont sleep in ur abdomen since the muscles will get more strained. Avoid sudden bending and turning. Take hot fomentation daily twice. Sit in a proper potion, dont hunch back when u sit. U can wear LS belt while travelling. Consult ortho specialist for further treatment. Hope I have answered ur question, Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly explain my NT scan and double marker blood test reports in detail.\n\nHi doctor, I am 12 weeks 5 days pregnant. I got my NT scan and double marker blood test results. NT value 1.1 mm, free b-hCG 1.52 MOM, PAPP-A 0.37 MOM, trisomy 21+NT risk 1:1132, trisomy 21 1:169, trisomy 13/18+NT. In urine culture, there is no significant growth observed after 48 hours. I am currently, All 9D in the morning, Ecosprin and Endogest SR 200 in the night.",
    "doctor_response": "Hello. I have seen the report completely (attachment removed to protect patient identity). Your report is normal and there is no need to worry. If you want a detailed explanation about the report, then here you go. There are some genetic syndromes, which are happening worldwide in which baby can be seriously handicapped physically, body function wise or mentally. Now you cannot diagnose any genetic disease directly without baby cell as it contains DNA. But, the procedure (amniocentesis) for obtaining baby cell itself is very risky and can even lead to abortion and also more costly. So, we are doing a screening test to diagnose the high risk pregnancies that have a high risk of getting that genetically abnormal baby. For that we combine different parameters and compare it with a standardized data to come to a ratio for chance of current pregnancy having that genetic abnormality. The test is negative and positive; according to either it is below the cutoff value or above. 1:250 meaning, 250 pregnancies like you having a chance of only 1 positive for that genetic abnormal baby. So, as your report is good in which it is negative for Down's syndrome (trisomy 21) and also for 18 and 13 (Patau and Edward syndrome). So, your pregnancy is normal and no need to worry. You have to do only one thing and that is to follow normal medicines and precautions. One more thing I have seen in your report is that the cervical length is 3.0 cm. It is somewhat borderline at 12 weeks of pregnancy. For that you need to take proper rest. Just increase the duration of your rest time and continue Progesterone (Endogest 200) two or three times a day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bumps between teeth and under the gum?\n\nI have small bumps in between some of my teeth but not at the very end and a few larger bumps under the gum above both eye teeth.  They don't hurt and don't bleed and really don't seem to be bothering me, however, when I finish brushing or eating my gums turn red.  I have never had these bumps or redness before.  I was to the dentist a few weeks ago for a periodontal cleaning and scraping and they didn't make to much of them, but it is not going away.  Any ideas?",
    "doctor_response": "Hello, Thank you for consulting with HCM.This bump which you are mentioning can be just a normal swelling of gums, as if it was a infection of gums, it might have gone by cleaning of tooth.If it is not causing any problem or not painful than you should leave it like this. But if in future it creates any problem then you should go for an x-ray of the areas as it will show the cause of infection.Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe back and shoulder pain?\n\nI recently fell down a couple of stairs while carrying my 37 lb baby on my left side. I didn t think much of it at the time except that I knew my knees would be sore. But my upper back around my shoulder blade up into my neck and down into my arm and the front of my shoulder. I have a appointment with my MD next week but was wondering what could be causing me such excruciating pain. I have a pretty high pain tolerance but this pain brings me to tears. Thanks",
    "doctor_response": "Hi,There may be soft tissue injury or hairline fracture over vertebrae, which can only be diagnosed on xray of cervicodorsal spine in AP and Lateral view.So get it done and send me the report.Thanks,Dr.CHANDER MOHAN SINGH.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have alopecia in my beard. Will hair grow back in the patchy areas?\n\nHello doctor, I have noticed some alopecia on my beard. It has been there for the past few months. I have never had any issues like this before and worried that the hair will not grow back. Is there anything I can do? I am currently taking Hydrocortisone for dermatitis in private area.",
    "doctor_response": "Hello. I can understand your concern. According to your statement, you have alopecia on beard. It has been there for the last few months and you are on medication like Hydrocortisone for dermatitis. You may be suffered from alopecia areata which is a peculiar form of hair loss that usually affects the scalp but can occur on any hair-bearing skin like your beard. For most patients the condition resolves without treatment within a year but the hair loss is sometimes permanent. The cause of alopecia areata is probably an autoimmune reaction. This means the body's immune system incorrectly attacks the body's own cells. In case of alopecia areata, the cells under attack are in the hair follicles (structure that grow hair), especially follicles within hair-bearing skin. Alopecia Areata can be resulted from autoimmune disorders such as atopy, allergy, thyroiditis, vitiligo, etc. Even some studies show that stress, family history of alopecia, vitamin deficiency like Biotin, Vitamin A, C, D, E, etc., nutritional deficiency like iron, zinc, protein, etc., can also cause alopecia areata. For the treatment of alopecia areata, you can use Intralesional corticosteroid injections, topical Minoxidil, Anthralin cream or ointment, and topical corticosteroids. By using any of the above-mentioned medication and taking vitamin and nutrition that are mentioned above, you can get rid of alopecia areata within some months.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for recurring fever\n\nhi doctor my mother is 33years ago had a problem of fever for last 4 or 5 days she is getting fever only in night and body pain also. i want to ask which tablet is good for my mother and which tablet shall i give to my mother.",
    "doctor_response": "Hi,It seems that she might be having viral infection giving this problem.Give her paracetamol or ibuprofen as needed for fever.Give her plenty of water.Give her light food.If fever persisted then she might require some investigations like,complete blood testing, TC, DC, platelet count etc.Routine urine check up.After report your doctor will go for appropriate treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my left leg harder to lift than my right leg?\n\njust curious, I have a hard time getting down on the floor and then having to get up is difficult. Also, my left leg is harder to lift than my right leg. It almost seems really heavy at times. I don t have pain in the hip or anything. Do you think it could be arthritis related?",
    "doctor_response": "Hello,The symptoms can be related to arthritis. I suggest to do some examinations to help through the diagnosis. I recommend a complete blood count, rheumatoid factor level and ERS level. Meanwhile, I suggest to use anti inflammatory medication such as Ibuprofen 400 gm to relieve the symptoms.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a PSA of 14 indicate?\n\nWhat could be the cause of a PSA of 14 with no enlargement of the Prostate with the only symptom is occasional blood in the urine? Is there any other diagnosis than cancer. He is a man in his late 50 s. He has an appointment tomorrow with a urologist.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. There are other causes of raised PSA levels aswell but PSA levels of this much indicates prostatic biopsy to rule out cancer. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy if took Postinor-2 after sex but missed periods?\n\nHi... i had my last period on Nov 9th.. then i did succesfull sexual intercourse on Nov 24th.. then i took Postinor-2 2 tablet in a time.. after that we did it using condom.. but about 3-4 days later, we did it again without condom and 1 day after i took postinor-2 again, 2 tablet in a time... But until now (December 19th) i don't have my period yet.. My period is usually unregular..It comes every month, but not in exactly same period...The cycle can be 30,32,36,36,38 or even 40 days... I worried because today is 40 days already since my last period.. Now i feel little bit nausea...i checked Presumptive Pregnancy test (Test Pack) last week.. Blurred line...I repeated 1 day after, it showed the same result..Not positive,but also not sure negative.. I'm scared to check it again now... Is it possible that i'm pregnant since i take 2 packet (4 tablet of Postinor-2) in a month? thanks alot..",
    "doctor_response": "Hi, Welcome to Healthcare magic. I am Dr Ramadevi Wani. I will be answering your concerns today.Postinor 2 if taken within 24 hours of unprotected sex is 95% effective in preventing pregnancy. You did delay in taking Postinor 2 the second time. So there is a possibility of pregnancy.The pregnancy line blurred or sharp, does indicate pregnancy. I hope you are doing the test properly. I suggest you repeat the test either with early morning urine sample or do a blood pregnancy test which is more reliable.I hope this is helpful.Best wishes,Dr Rama",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fungal infection with severe itching on the genitals?\n\ni have skin disease on my groin area and its on both thighs and testicles and most of the penis . and keep on spreading it's not itchy it's like some kind of fungus on my skin if i put little water and rub it it will disappear . it s  color is tan/ash/white ... my skin is dark so first appearance is  white when i rub it the white dust so called fungus rip of the skin what is this it's really embarrassing.. before this skin disease I had itchy rash I think it's tinea curis (jockey rash)  and i used betamethasone cream and it was cured",
    "doctor_response": "Thanks for contacting HCM with your healt concerns and questions.I am sorry to hear that you continue to have itching a rash in the groin area. You say the rash is light color and makes the skin peel when rubbed. This could be tinea cruris again but from another form of fungus. there are several fungus that can cause tinea. In my practice I have my patients use Tinactin or Lamisil to cure the infection. I avoid using betamethasone as this may actually cause the fungal infection to worsen and it is also a powerful steroid that can cause serious skin changes in the groin area. So I recommend that you stop betamethasone and try Lamisil or Tinactin. If these measures don't help then seek medical attention for more powerful anti fungal treatments.Hope this answers your question. Please contact us again with your medical concerns and questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can medication help in producing twin or triplet babies?\n\ni am 33years old,single, of average height of about 5.5m,i weigh 75kg,i am fertile but would not want to go through the process of having kids in different years i would like to have them if possible once and for all .by BP last 3 weeks was 150/100 but i have tried to stabilize it by staying stress free.is it possible to have oral medication that can help in producing twin babies or triplets without having to go through ivf",
    "doctor_response": "Hi,  Welcome tO HCM.I have read your query &understood your concern. Yes there are medicines which can cause multiple ova to mature &can result in multiple fetuses in a single pregnancy.... which ofcourse depends on luck.. no one can predict number of fetuses  formed during fertilization.    Again one can find the efforts needed to nourish 3 babies during pregnancy &also look after the same after birth practically more stressful than having three separate pregnancies &give birth to 3 babies.     Apart from this maternal  problems like raised blood pressure/anemia/digestive problems &possiblity of Premature &underweight babies in Triplets is also common.     Considering all these things... if you still want to have multiple fetuses out of one pregnancy... consult &be under care of a fertulity specialist.   Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful lump on the rib cage\n\nHi, I am a 28 year old male. I have discovered a round lump one of my ribs on the right hand side. it feels roughly 2cm wide. I am unable to move it around if I push it, etc. It is quite tender to touch but not particularly painful when I am not touching it. Im pretty sure it just happened overnight. Any idea what this might be?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have lump on rib.  It can be bone tumour, soft tissue tumor or cyst.  You should go for x ray first.  If it shows any bony lesion thebn you should go for biopsy.  If x ray is normal then it may be soft tissue tumor like lipoma or neurofibroma or some cyst.  Then you should take treatment accordingly. Consult your doctor and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lumps in lower stomach?\n\nhi im 26 yearsold, i keep getting bloated a lot , im a skiny person and decided to lie down and feel my stomach. on the inside of my left hip don t towards lower stomach i have a couple of lumps and thought it may be my bowels, but i had bowels open and still can feel it, what could it possibly be, kidney stones, cyst or something serious.",
    "doctor_response": "Hi,From history it seems  that there might behaving few enlarged inguinal lymph node giving this picture.Or if lumps are still above can be few hard fecoliths giving feeling of lumps.Consult your doctor and get examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cure for the small lump at the back of the head causing sensitivity and pain?\n\nLast night, on a section in the back of my head, I felt some sensitivity and pain. There was a small lump I hadn't noticed before as well. I felt a little \"off\" all day, lightheaded and almost weightless. A few times things like patterns felt like the were moving, and moving my head too quickly made me dizzy. The pain is still there today, just not as severe as it felt last night. I did get hit snowboarding by someone coming down the mountain in that exact spot on my head, by I was wearing my helmet and it was a week ago. Wouldn't I have felt all this before if it was from that? What else could it be?",
    "doctor_response": "Hello!Thank you for the query.As this lump is associated with recent injury, most probable reason of your symptoms is a blood accumulation (hematoma) which has gotten infected and turned into an abscess. If so, the area should be painful, swollen. You may also have fever and weakness due to infection.I suggest you to consult a surgeon. In case  of any doubts, ultrasound should be done. Abscess should be incised and drained.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for barrel chest\n\na smoker, comes to see his doctor because he has a persistent cough and becomes short of breath after very little exertion. Physical examination shows that Omar has a barrel chest and a red face. Omar explains that it is difficult for him to exhale but not to inhale.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By his symptoms, history and barrel shaped chest, possibility of COPD (chronic obstructive pulmonary disease) is more in his case. It is progressive disease of lungs. Cigarette smoking is the biggest risk factor for this. So he should definitely quit smoking as soon as possible. Other treatment options are as follows. 1. Enroll him in pulmonary rehabilitation center where chest physiotherapy any deep breathing exercises are done. 2. Consult pulmonologist and get done PFT (pulmonary function test) to rule know the severity of the disease. Treatment is based on severity only. He will need inhaled bronchodilator (formoterol order salmeterol) and inhaled corticosteroids (ICS) (budesonide or fluticasone). 3. Give him adult respiratory vaccines like influenza and pneumococcal to prevent recurrent respiratory tract infection. So consult pulmonologist and discuss all these. Hope I have solved your query. I will be happy to help you further. Wishing him good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain below the ribs and nausea?\n\nDo gallbladder problems run in families? I have been have sharp pains right under my breast rib area and nausea with some slight chest pain. My grandma and uncle on my Mom's side have had gallstones and had there removed and my cousin on my Dad's side had the same issue.",
    "doctor_response": "hithank you for posting query.Gall bladder disease due to Gall stones do not necessary run in families.need further evaluation.advice:- get an ultrasound (abdomen) to rule out any stones- also get a complete blood cell count(CBC) test- avoid eating stomach full and mouth full- avoid spicy food wish you good health.further queries are welcomed.regards,Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the lack of response in a pneumonia patient be due to slipping into coma?\n\nMy husband has been in the hospital for 8 weeks and has had three surgeries, he also has pnh and diabetes. he is 54, the last few days he developed sepsis and pneumonia, today he was not responding to anything. it takes a very long time to wake him. can he be slipping into a coma?",
    "doctor_response": "HelloI am sorry for your husband and his situation.He suffers from DM,pneumonia ,three surgeries and today he is not responding.How was the sugar blood level?Did he previously smoked a lot?Because in persons with comorbidities and smokers too, the pneumonia (which is the inflammation  of the lung tissue) is more aggravated in a smokers lung. He is recover in ICU ward with these problems.In my opinion the coma might be from DM or sepsis due to pneumonia too.I wish a fast recovery for your husband.Thank youDr.JolandaPulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly tell me the ayurvedic medicine to cure hemorrhoids and constipation.\n\nHi doctor, Kindly tell me the ayurvedic medicines for hemorrhoids third grade and constipation. Which is safe and what dietary control should be taken for this till it gets healed without any allopathic processes.",
    "doctor_response": "Hi. Mostly piles generate after changing food habits and lifestyles. Frequently constipated bowel, sedentary lifestyle, smoking, and drinking may cause piles. Third-grade piles need Ksharasutra ligation treatment along with ayurvedic medications. Now it can be managed naturally through ayurvedic medicines. Constipation, irregular food habits, reduced physical activities, frequently smoking and drinking. Fissure in ano, fistula in ano, sentinel tags. Take the following medicines regularly for one month. Rx, 1. Panchasakar Churna 3 gm with Arshoghni Vati two tablets and Arogyavardhini Vati one tablet twice a day with warm water after meals. 2. Abhayaristam 15 ml twice a day with an equal amount of water after meals. Avoid spicy and fried junk foods. Drink plenty of lukewarm water. Quit smoking and drinking if you have these habits. Do regular kapalbhati, mandukasana, and ardhamatsyendrasana regularly as well as pranayamas like anuloma vilom, nadi sodhan, and bhramari.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does plaque formation in my widow maker artery indicate?\n\nmy doctor said that i had some plaque build up in my widow maker artery. they put me through arigorus series of tests including a stress test that included some form of dye or radium injected while the test was done. the cardiologist said i did not have a blocage and said everything was flowing fine. how con cerned should i be. thanks bii troy",
    "doctor_response": "hello,i have gone through your question,Thanks for using HCM.well if your stress imaging was normal then you should not be worried about the widow making artery...As such I need exact reports of your ECG,stress test and radionuclide test to give you proper guidance.But i presume that you may have some atypical symptoms and borderline ECG findings that might have led to suspicion of blocks,but since you have undergone more definitive test which has ruled out possibility of major block.so dont worry and follow healthy life styleMy best wishesDr.teli,MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of darkening of child s bottom lip?\n\nI have noticed that my 2 year old s bottom lip has darkened. The appearance is as if he has eaten a purple popsicle. No other visible changes. Appetite is consistent (well, as consistent as you can expect a two year old to be ). What may be the cause?",
    "doctor_response": "Hi...Darkening only of the lower lip can be either a normal phenomenon or a pigment related disorder of the skin. The other possibility could be Peutz Zegher Syndrome. I suggest you consult your pediatrician regarding this or upload images here on this website so that we will be in a better position to help you.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for nausea and upper abdominal pain\n\nNauseated, but have not thrown up, some heaving, no diarrhea, no constipation, no temperature, chills at times tho and lots of discomfort in upper abdomen mostly on right side - had same symptoms last Thursday but with throwing up off and on from1:00 am to 10/11:00 am and then stopped until early evening then threw up one last time. Felt poorly till Sunday then ok until this morning around 11:00. Bug? Appendicitis?",
    "doctor_response": "Hi. All the symptoms of nausea and others are suggestive of  either gastritis or a gall bladder problems. I would advise you the following :Ultrasound of the abdomen. Upper GI endoscopy. Blood for WBC, liver function tests, amylase and lopase. These will give us an early diagnosis and a plan for future treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does throat infection leads to throat cancer?\n\nHi, I am 5'6, weighs 155, 34 yrs. of age, just had a baby 2months ago and breastfeeding right now. As far as I know I am a healthy person, the only thing is, I am always getting throat infection, yearly infact. I was tested by it last few weeks ago but it was negative but  my throat is sore right now, my right cheek is a bit swollen, my lower back tooth on my right is hurting and my ear is plugged. Could this be a throat cancer? Told my doctor that I want to see an ENT but she won't refer me.",
    "doctor_response": "Hi,Thanks for writing in.Having throat infection once a year is acceptable. Please take precautions and do warm water gargle twice daily for a week and you will start feeling better. You can get a throat swab done if it worsens in 3 days time. It is not cancer and you should not think of it.Since you just had a baby therefore it is important to protect your baby from infection. Please avoid exposure to dust pollution and stay away from extreme temperatures. Taking medicines should be after asking your doctors since you are breastfeeding your baby. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure painful knots on the tricep and inner arm?\n\nI was flipped onto the asphalt by an ambulance crew, and my left arm impacted the ground from 5 feet into the air. I was xrayed, no broken bones, but a month later, I have large knots in on the tricep and inner arm. They appear to be fluid related, disappearing with ultrasound and reappearing a few hours later. They are not at the point of impact but farther down the arm. The arm is VERY painful and any resistance causes more of these lumps to appear. What do you think has happened?",
    "doctor_response": "Hello, The large knots are due to presence of fluid draining from healed soft tissues.There was probably also some collection of blood at upper arm from which there is small sepage of serum after complete healing of soft tissues.Most probably there is nothing to worry.This all will go away gradually. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mukesh Tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is constant pain in lower left stomach due to being on birth control?\n\nHi, I have no idea if this is real. But I just need results of my issues.First off my name is Nicole, I have pain in my lower left stomach. and its the only stop that really hurts. Im on birth control, and have been for yrs. for health reasons. and I know its not from that. But I have had the pain for a week now. its off and on, everyday, every hour, every min. :(",
    "doctor_response": "Dear Madam,I dont think it is due to birth control pills . You will need to see a gastroenterologist for this .Dr. Shruti",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying for baby. Semen test and hematology test fine. Taking medication. Recommendations?\n\nI am female, i consulted a female doctor for getting pregnant. I am having smooth sex with my husband. Doctor advised my husband to do semen test. The report was normal (i.e. total count is 72, molality in first hour is 75%, in second hour is 70%, in third hour is 65% and morphology is 80%). Doctor advised me to do hematology test (includes Neutrophilis 69%, Lymphocytes 29%, Monocytes 1%, Eosinophils 1% and Basophils 00%), ESR (is 30 mm/Hr), LH & FSH (is Average), Prolactin (is Average), Thyroid (T3 is 120.7, T4 is 7.4 and TSH is 5.5), Tubercular Serology (is 0.52), Mantoux Test ( Erythema is 4 mm & Induration is 2 mm with result as negative), Abdominal Ultrasonography (Result as no diagnostic Abnormality Detected), HSG (Result as no diagnostic Abnormality Detected & multiple antral folicles is seen). Here i want to ask that why i am not getting pregnant, since from last 10 months i am using Medicines prescribed by my doctor. Also please advice name of medicines to take. waiting for reply. thanks",
    "doctor_response": "Hello thank you for your query. Firstly, you have been trying for only 10 months to conceive, so I wonder why you are getting so anxious. Please relax, because stress is the major reason for not conceiving as I see in your case. Moreover, what medications have you already taken. At present, I would advise you to take regular folic acid supplements and naturally try for a couple of months more. You should be aware of the fertile days ( around ovulation ) during which intercourse should be essential. Maintain a healthy BMI and a positive outlook. An HSG cannot comment on multiple follicles, so something is wrong with the reports you have typed, some error in typing probably. If you fail to conceive within three months more, consult a proper Infertility specialist. get your laparoscopy done to assess tubal function and have a follicular study to detect ovulation. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach issues with normal endoscopy despite having OCD?\n\nI have been having issues with stomach for past 15 years. Endoscopy was done twice to check if there was any issue. I have consulted 5 different gastro enterologists in past several years..including ones in National institute of Gastro enterology. Things went on well till one physician told that it could be because of depression I may be having all these issues. on this GP s advise, I have consulted a very famous psychriatist and was told that it is OCD. I was under his treatment for 2 years & was put on all anti depressants. I have had panic attacks, my immune system went down & I under went apendicitis surgeny in nov 2012. In November 2013 I have realised that the Psychriatist had put me on several medicines which may not be required. I have quit all medicines including 2 mg dosage of tablets to reduce anxiety, 3 anti depressants, one antiacid but have been struggling to live nomal life from then but invein. I have left the job & was not working for 6 months hoping that health would be normal but after takingup new job I am unable to perform. I was always a topper and was sent on deputation to Manilla, received several rewards & recognitions in all MNCs I have worked. I would also give you list of all medicines & how long they have been in use for further analysis. I beg you ....plead you to get me nomal. I was not what I am today. Can someone kindly help.",
    "doctor_response": "Hello,I think your problem was not OCD. It would have been a somatoform disorder at the most. I think you should take advice of your nearest psychologist. Or if you can post the details of your treatment, it would be easier for me to guide you further.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump near the eyebrow?\n\nI got hit above the eye earlier today by a throw that bounced off my glove. Its a big bump right near the eyebrow. I have a very slight headache now which is like 3-5 hours later. I did not expierence any syptoms of a concussion during the game cause I was checked by a trainer. Is it just a bruise?",
    "doctor_response": "hi.it's probably just an inflammatory reaction secondary to the impact of the ball. just observe for now. it will eventually subside in a few days time. a follow-up on your school/health clinic would also be good for you.hope this helps.good day!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "With reference to the creatinine level am I suffering from kidney disease?\n\nI have no diabetes or no high blood pressure and do a lot of walking. My microalbumin urine is 381mg/l but my creatinine is 4.2mmol/l. Do I have kidney disease? i am very active normally and but have been using simvastatin to control my cholesterol over last 2 years( around 5.2mmol/l). Thank you",
    "doctor_response": "Hello! Yes, your concern is very true.Raised creatinine level indicates either obstructive uropathy or Medico-renal disease i.e. obstruction to urine outflow or dysfunction of parenchyma (functional tissue) of kidneys.Obstruction can be due to many causes like stones/strictures/growths or pressure on urinary tubes (ureters/urethra) from outside i.e. growths from surrounding structures like rectum/uterus/colon etc.In my clinic, I advise X-ray KUB, ultrasound abdomen & pelvis, urine routine, renal function tests, serum uric acid.Treatment is accordingly.Hope this information is useful to you.Wish you healthy life.Thanks. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high blood pressure?\n\nIm 20 years old female weigh 225. I normally have low blood pressure 110/72 range.but the past 2 days my mom has toldme to track my bp because she noticed my face was getting severely flushed and red as a stop sign. I just took my bp and it was 122/119 is that bad? This is the highest it has been",
    "doctor_response": "Hello,It's an entirely normal bp. Not need to worry about it. Get your thyroid and hemoglobin tested once. Hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cough and fever?\n\nmy daughter who 4 has a really bad cough like wheezy for the past couple of days she is clammy has a slight fever her face is red and is more clingy than usual She complains she is hot. She is on a prescription for zyrtec that she takes daily she has been taking that. Is it just allergies or something else",
    "doctor_response": "Thanks for posting your query at HealthCareMagic. Most of the cough and fever that occur, are due to viral causes. There is a condition called bronchiolitis which usually affects children under the age of 2, with a peak age of 3 to 6 months. It is a common, and sometimes severe illness. Respiratory syncytial virus (RSV) is the most common cause. More than half of all infants are exposed to this virus by their first birthday. Other viruses that can cause bronchiolitis include: Adenovirus, Influenza and Parainfluenza.The virus is spread to infants by coming into direct contact with nose and throat fluids of someone who has the illness. Usually such a viral infection also has an allergic component. Zyrtec (cetirizine) is an antiallergic used to treat such conditions.I hope that helps. Feel free to contact back in case of further queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Azithral 250mg effective for dust allergy?\n\nmy doctor has prescribed the following for allergy of dust & morning chillness. I get sneezing & mucus secretion daily morning immediately after i wake up. my father is also suffering the same duration 1 year Azithral 250mg & zincovit during mornings hetrazan 100mg & Okacet during nights is it correct diagnosis",
    "doctor_response": "Hi, I have gone through your query and understand your concern.Brief answer: I presume that your physician made his best possible diagnosis and prescribed accordingly. No, Azithral has no direct effect for dust allergy.Detailed answer: If I were the treating physician, I would look for few queries:\u2022\u00a0\u00a0\u00a0\u00a0\u00a0Do you have nasal blockage, nasal irritation?\u2022\u00a0\u00a0\u00a0\u00a0\u00a0Do you have known allergy other than dust?\u2022\u00a0\u00a0\u00a0\u00a0\u00a0Do you have breathlessness, wheeze or chest tightness?Then I would perform some physical examination specially nose and chest.So that I could establish the diagnosis of allergic rhinitis and to exclude asthma. If I thought of rhinitis, I would advice:\u2022\u00a0\u00a0\u00a0\u00a0\u00a0Avoid triggers ,example: dust\u2022\u00a0\u00a0\u00a0\u00a0\u00a0Wash nasal cavity with normal saline or water\u2022\u00a0\u00a0\u00a0\u00a0\u00a0Oral antihistamine\u2022\u00a0\u00a0\u00a0\u00a0\u00a0Steroid nasal spray Since this is a prescription medicine, I would suggest you to meet the local Doctor to confirm the diagnosis.Hope this helps you. If you have further questions or follow up queries, please feel easy to ask us.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My sister behavior has become very aggressive after separated, kindly help me\n\nMy sister in law is separated from her husband with one girl child. She has had a marriage with lots of problems in which she also tried to commit suicide once by consuming tablets. Since the last few years her behavior has become very aggressive. Her anger has reached unreasonable levels resulting in strained relations with friends, neighbours and relatives. Also, she does not worry about creating a scene in presence of other people. Besides that she has become obsessive about cleanliness which has also reached alarming proportions. Please help.",
    "doctor_response": "hi i think she require proper psychiatric treatment as early as possible,seperation frm husband,agitation,obssesive cleaniness,suicidal attempt and recent history of relationship problem,all this factor suggest her to take regular and longterm treatment ,first of all diagnostic evaluation is require to rule out personality disorder and other illness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yellowish discharge from penis?\n\nI ve used cytotec 14 days ago I believe the miscarriage is complete and I m no longer bleeding. I had sex with my boyfriend yesterday and late this afternoon and now he s having some yellowish discharge coming out from his penis and he said its a little bit painful what could this be?",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: Its infection of Urinary tractExplanation: Any discharge from Urinary tract except semen is infection. So, if he is having painalso, then please visit a doctor immediately for investigation and treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How often can one masturbate?\n\nI have read on many websites that masturbation can change the sensitivity of a mans penis. I also read that stopping masturbation for awhile can bring back sensitivity making it easier for a man to ejaculate during intercourse is this true? If so can i still masturbate? Which would probably be healthy every other day,once a week,,maybe three times a month?",
    "doctor_response": "Welcome to healthcaremagic.com and myself Dr. Atishay  Bukharia would be answering your questions.. various studies have suggested that twice weekly is ideal frequency for masturbation. masturbation has nothing to do with increase or decrease sensitivity. Hope it helpsIf you have any other question please do not hesitate to contact usRegards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in lower back with chills and dizziness?\n\nI woke up this morning with some pretty terrible back pain. It s in the middle/kind of lower part of my back but more on the sides. I m currently experiencing some chills but no fever and very strange body aches. I have the dizzy/fatigue feel of a fever but don t have a fever.",
    "doctor_response": "Hi,From history it seems that there might be having viral infection producing generalized body ache, malaise and fatigue producing this problem.You may get fever afterwards.Take rest and light diet.Take ibuprofen, paracetamol combination medicine as needed.Take plenty of water and liquids.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause soreness, bruise after recieving hydrocortisone shot for hives?\n\nI received a shot in the upper arm for hives about a year ago. I believe it was hydrocordizone. It was red and had a good size lump. For many months after it would flare up the become sore, hot and swollen again. It still is sore and has a bruise still after a year. What could cause this?",
    "doctor_response": "Hi, Without an exam, I can only give general information. There are a lot of possibilities. if the stinger was retained, then there are a lot of reactions to it that are possible. And, re-exposure to something someone has had a reaction to can produce a reaction in the area of the previous exposure. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain, headache and diarrhoea?\n\nWhat do you think can be wrong, my girlfriend is 18 years old 130ilbs and about 5\u20193.  A couple days ago she was sick. She felt weak she was vomiting, stomach pains diarrhea, head ache, and was experiencing hot cold flashes. What can be some causes",
    "doctor_response": "HI. Vomiting , pain in abdomen, diarrhea, headache and hot-cold flashes are suggestive of a Gastroenteritis , a waterborne infection. You need to take your friend to the ER, get intravenous fluids and antibiotics and may have to stay till getting alright. Do not force oral fluids if vomiting. Dehydration and septicemia are the complications you have to worry about.Once the vomiting stops , oral fluids, curds, banana, activated charcoal and probiotics can be started .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please suggest a meal plan for my mother based on her recent reports.\n\nHello doctor, My 59 year old mother is under treatment for hypothyroidism, hypertension, and osteoarthritis of knee joints along with a mild iron deficiency anemia. With the help of medications, TSH (3.15), BP (120/72) and FBS (89) are currently stable, although she used to get symptoms like reeling of the head a few times (once after breakfast another after lunch), which as per our family doctor, is due to low BP. She also faces gastritis and some amount of constipation from time to time, although a physical examination does not indicate anything worrisome. She had lost weight, nearly 5 kg in the past eight months, which is not explained by any of the clinical findings. I request your help to identify if she follows the right schedule in terms of daily food habits and also if she should include any particular type of food to fight against the current medical conditions. Below mentioned is her daily routine and food habit summary, which I request you to kindly review and share your feedback, as required.She wakes up at 5.30 AM and takes Eltroxin 50 mcg on an empty stomach. She takes regular tea with biscuits at 7.30 AM while doing the regular exercise for knee joints, and then does her household work such as cooking, etc. She then takes her BP medicine (Olmezest 20 mg) at 9.30 AM. Her household work gets completed around 11 AM, after which she takes breakfast. This mostly consists of brown bread (four pieces) or sooji or noodles or fruits (mostly apple, guava and sweet orange). Every alternate day, she takes four pieces of dates as well. After breakfast, she takes Gemcal D3. She takes lunch at 3 PM, which mostly consists of white rice, dal or vegetable and fish. She had stopped curd for colitis since the past six months as advised by her doctor. After lunch, she takes the multivitamin Cobadex CZS. In the evening, she takes normal tea with a biscuit around 7.30 PM and then does her regular exercise for knee joints. She then takes dinner at 11 PM, which mostly consists of whole wheat roti (three pieces), vegetable or paneer and mostly no fish at night. There is no other medication after dinner.",
    "doctor_response": "Hello. I saw her reports (attachment removed to protect patient identity). All her numbers are alright, except few which are in the borderline. But, no need to worry about it. Her diet should be perfectly balanced according to the climate. Also, exercise and yoga play a significant role in treating her. Feel free to contact in case of further queries. For more information consult a dietician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for painful boil in buttock cheek\n\nIm 32 yrs, female, non smoker. 4 days ago i felt what i believed was a boil on my buttcheek.  It is very painful.  It is about the size of a quarter, very swollen, it feels like a boil but i used black sab on it for 2 1/2 days and it hasnt done anything as of yet.  I tried to burst it althought its in the worse place so i can only reach 1 hand to touch it, nothing has come out but a little blood, i tried it again a day later and a tiny bit of pus came out but just on the tiny scab that is covering this thing.  Alls i can say is that it is day 4 and this thing is very painful.  I started to use bacitracin ointment last night, i havent felt a difference.  Right now i am trying to figure out if this is a spider bite or a cyst..i may have to make a trip to the emergency room. What would your advice be.  Thanks! Theresa.",
    "doctor_response": "HI, thanks for using healthcare magicBoils (an abscess) can be associated with significant pain.The definitive treatment of an abscess is incisive and drainage of the discharge.This should be done at your doctor's office.In addition, a course of antibiotics may also be needed.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How do I use Mifegest kit to abort 8 weeks pregnancy?\n\nHi doctor, I am 8 weeks pregnant. I got Mifegest kit as I want to discontinue the pregnancy. After taking the first pill today afternoon I would be taking next two pills after 48 hours orally. So, when should I take another two pills? Should I take it orally or vaginally? As bleeding is expected after taking two pills, how should I take the next two pills vaginally? Would it be less effective if I take the third dose orally and not vaginally?",
    "doctor_response": "Hi. Using oral medications after seven weeks of pregnancy may lead to heavy bleeding. Please ensure that you can attend a hospital with blood bank facility in your easy reach if any mishap of such kind happens. The Misoprostol tablets 200 mcg into four tablets should be inserted high inside the vagina after 48 hours of tablet Mifepristone intake. In case, you already start bleeding after Mifepristone (occurs in 30% of cases) ingestion, take two tablets on the third day morning (ie, around 36 hours) and two tablets in the evening. Please take pill Zofer (Ondansetron) before taking the Misoprostol tablets orally, as it may induce vomiting and waste the medicine. The bleeding may stay for 10-14 days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in the left hand while suffering from low BP?\n\nMy doctor today got low blood pressure rating in my left arm (80/40) but normal readings in my right arm. He scheduled me for a cat scan and a sonogram for my left arm. My left hand is partially numb and it feels cold. What are the possible diagnosis ?",
    "doctor_response": "Hello, The symptoms are consistent with neuropathic causes. Consult a neurologist and get evaluated. Detailed evaluation including nerve conduction study is required for further assessment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be the cause of abdominal pain, night sweats and headaches?\n\nI have upper right side abdominal pain (below the ribs), night sweats, low level headache .  This pain started two weeks ago.  Had CT scan.  No indication of what causing this pain. Digestive tract is fine.  I am 67 years old and in great Heath. Male. Thanks HUGH PARSONS",
    "doctor_response": "Hello!Thank you for the query.Upper right abdominal pain is usually caused by gallstones. Gallstones are in most cases invisible in CT. That is why, abdominal ultrasound is better in stones diagnostics. Gallstones usually give the pain which radiates to the back. Nausea and vomiting can be present.So if your pain seems to be similar to that, please visit your doctor and have abdominal ultrasound.Night sweats and headaches can indicate an inflammation.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stoppage in periods?\n\ni always get my period the last week of every month, i was supposed to get it jan 24th and i havent gotten it since its been a month now and if i dont get it this month it will be 2 months, i took pregnancy tests twice and they both say NOT PREGNANT!!!",
    "doctor_response": "Hi there,,Sometimes the periods could be delayed due to stress, anxiety , hormonal imbalances in thyroid, prolactin, estrogen, progesterone or any other medical illness like anemia too.If this has happened only once you need to be too concerned.Pregnancy is ruled out as you have already done the tests twice. You need not worry so much and if you want to get he period right away, you should take progesterone tablets for three days and stop. After which you will get periods due to progesterone withdrawal.If this happens again you need to be evaluated with ultrasound pelvis and hormonal studies  Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is stomach pain, nausea, chills and headache flu symptoms? Unable to have clonazapam and citalopram\n\nI just lost my insurance and so I am not able to get my clonazapam and citalopram. Would I get sick from not being able to take it? Or do I have the flu (even with having the flu shot)? My symptoms are pain in stomach, nasea, chills one min and warm the next, headache, shaking, and more. Please help me!!",
    "doctor_response": "Hello!Thank you for the query.Sudden quit from taking this medicines can cause such symptoms indeed. Clonazepam when taking it for a long time causes addiction. Citalopram can not be suddenly stopped as very often causes symptoms just like yours. The symptoms usually start after few days from quitting. So please try to get this medicines. You should also consult a doctor if the symptoms wont go away.Stomach flu would rather cause diarrhea and vomiting.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cancer patient passing black stool, Is this serious ?\n\nhello my grandfather, aged 86, was diagnosed with adeno carcinoma of stomach - grade III, 2 months back.He is undergoing oral chemotherapy. Recently he passed black stool. Is this serious? If so what does this mean?",
    "doctor_response": "Hi,thanks for query.Black stool means he has bleeding some where in his G.I. tract.This can happen because of ulcers or the cancer it self.Please inform your doctor about this.bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a sensitive rash on the arms and face related to subcutaneous lupus?\n\nI have recently had a skin punch biopsy for a light sensitive rash on my arms and face. I saw an allergist first who tested me and said the rash was not associated with any allergies. He sent me to a dermatologist who does research at NIH who immediately said he thought I had lupus. The skin biopsy revealed vacuolar interface dermatitis with rare dyskeratotic keratinocytes with an early lesion of erythema multiforme. Blood work revealed Sjorgren s Anti-SS-A of 8.0 and Sjogren s Anti-SS-B of 1.5...The ANA Direct was positive. Isaw a highly recommended rheumatologist in the DC/MD area where I live. Because I also have dry mouth from medications that I take, she diagnosed me with only Sjogren s disease and subscribed Plaquenil. She says I do not have lupus. A friend who is a resident and rheumatology resident at Emory University says she thinks it is subacute cutaneous Lupus. In the last few months, I have developed fatigue, muscle and joint pain and have difficulty remembering names and words. My doctor also did not do an immunefluorescence test..she said I did not need it. My doctor friend could not understand why she would not do it and the dermatologist who reviewed my test results with me told me he thought it was absolutely Lupus and that I would probably be sent back to him for that test. I have an upcoming appt. with the rheumatologist on Feb. 2, but my family thinks I need to change doctor s after the conflicting information. Help, do I have subacute cutaneous Lupus Plus Sjorgen s or maybe starting to develop SLE by itself. I am very confused and do not want to be misdiagnosed.",
    "doctor_response": "Hello,When you have Sj\u00f6gren's syndrome, it can be a part of lupus and so is the skin rash, as you have systemic symptoms: fever, arthritis, etcetera. It will help to get the Antinuclear Antibody Panel ( ANA ) and ANA panel and start you on prednisone and other medications for systemic lupus, which works for skin and Sj\u00f6gren's syndrome: Imuran or Cellcept.  Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Priya Sadanandan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Implanon have any effect on the fetus?\n\nHi I had a Jandell implant out in 2014 Got it removed about appox 2 or so months ago but only 1 rod was removed, I m on the wwaiting list to get the last rod removed because they were unable to get to it,I have found out I m pregnant,would that 1 rod in my upper arm effect the pregnancy or baby ?",
    "doctor_response": "Hello,Implanon have not found to affect the fetus. You do not have to worry. Follow up with your doctor to get the last rod removed.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Lekshmi Rita Venugopal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes presence of enterococcus faecalis in urine?\n\nis an enterococcus faecalis count of 10,000 in the urine with a normal dipstick and trace leukocytes urinalysis and normal otherwise urine counts mean a UTI. can a husband with phimosis transmit infection to wife and can swimming in a lake give you this.",
    "doctor_response": "Hi,I have gone through your query and I can understand your concerns.Enterococcus is a bacteria present in the digestive tract.The most common cause of transmission is poor hygiene.Unhealthy sexual practice can cause infection.So I suggest you to correct phimosis.Swimming in a lake generally do not cause infection.Enterococcus infection may become severe because of its resistance to usual antibiotics.You have to consult a physician as soon as possible,early treatment have better outcome.Hope this helps.Regards.Dr.Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Electric current sensation in arms, cramping in feet. History of renal transplant\n\nmy wife is a renal transplantee for 8 years and is on immuno suppressants and bp controls. Lately she has developed recurrent sensations of electric current lasting from 1 minute to 5 minutes throughout her body. Usually from arms then down the side of the body sometimes with flushes and numbness or cramping in the feet . She is a lacto vegetarian for 35 years but has never had such symptoms before. She feared it may be an early precursor to MS or a reaction to her drugs. He blood picture is good.",
    "doctor_response": "Hi, Thank you for posting your query. It is very unlikely for a patient on immunosuppressants to develop multiple sclerosis (MS). This is because MS is an auto-immune disease, where immunosuppressants are used for treating it. However, her symptoms need attention and further evaluation is necessary. Common reasons are lack of serum vitamin B12 and ischemia (lack of blood flow) of brain. Please consult a neurologist for evaluation. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes wheezing with terrible cough?\n\nI Went to the doctor three weeks ago with what I thought what is bronchitis when I went my doctor gave me a chest x-ray and a breathing test because of my symptoms everything must have been okay because they never called me back with any negative results however he did say I had pharyngitis and put me on the Z pack within a couple days I got worse ended up having to go to a med Point Because the cough was so severe I couldn t take the pain in my ribs and back from coughing was so severe my ribs and back hurt terribly. I also had bad wheezing which I had never had before. Sounded like snoring. The doc. At med point gave me a breathing treatment which helped a lot and because it helped he diagnosed me with bronchitis. He put me on an inhaler and pain meds for cough and pain. I also had green mucous. I ve been off zpak for about 2 weeks and still have a feeling to cough with occasional green mucous and a burning feeling in my chest mainly to right side. Do I need more antibiotics? I am a smoker who is cutting down and trying to quit. Could it be something else? No fever , oh and during my coughing attacks my nodes in my neck were very swollen too.",
    "doctor_response": "Thanks for your question on HCM.I can understand your situation and problem.I advice you , not to take further antibiotics.In my opinion you are having early COPD (chronic obstructive pulmonary disease) because of cigarette smoking.So consult pulmonologist and get done repeat PFT (pulmonary function test) to rule out early COPD. In early COPD markers of small airway are affected. So look for decrease in FEF 25-75% for the diagnosis of early COPD. If early COPD is present than you may need inhaled Bronchodilators.And quit smoking as early as possible. It will only harm you. So better to avoid smoking and start treatment.You can join rehabilitation for quitting smoking.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause the palms to stay hot?\n\nThe last couple of days both the palms of my hands have been hot. I have been holding cold drinks in both hands to get relief. At night my right hand starts to tingle slightly and rhe tip of my finger has a numb like feeling. Just wondering what could be cauding this?",
    "doctor_response": "Hello, Consult a neurologist and get evaluated. We have to rule out possible neurological causes. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for cramps in the feet?\n\nHi my daughter (11) has been having cramps in her feet and what she is describing as a stitch - upper right abdominal. She is also complaining of headache and excessive thirst. DUe to the thirst she is drinking plenty, so I am not thinking dehydration. What could it be?",
    "doctor_response": "Hello, The cramps can happen due to decreased fluid intake, electrolyte imbalance or low levels of thyroid hormone. Taking plenty of electrolyte-rich fluids will help. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diverticulitis, ultrasound showed cyst grown deep into the vaginal wall, history of Bartholin's cyst. Cancer?\n\nI was diagnosed with a bartholin cyst 10 years ago and the DR said to just ignore it and it would go away on its own I still have it only its now much larger and recently I was hospitalized and told I diverticulitis and thru an ulrtasound they saw that the cyst has grown deep into my vaginal wall and I need to follow up with my obgyn should I be concerned with this now being cancer as I am 50 this year?",
    "doctor_response": "Hi Bartholin cyst if it is very large and symptomatic must be removed surgically. You have not mentioned where you have diverticulitis? small bowel / large bowel / bladder ? Any how your cyst has to be removed and sent for Pahological study. This will rule out cancer. Long standing bartholin cyst does not predispose to cancer. Mohammed Ibrahim mdibrahimdr@yahoo.co.in Surgical Oncologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dandruff and hair fall\n\nhelo doc P V S Prasad,im 33yrs old female n i have got 2kids by c-sec,elder is 5yrs n younger is about to b 5mnths old,i started to have severe hairfall when my younger kid was almost 3 months old,i also have dandruff,premature graying of hair,i breastfeed my younger kid,please advise solution to my problem",
    "doctor_response": "Hello, welcomeslets discuss one by one.dandruff has two reason mainly1. fungal2. scalp flaky skin, drynessSalicia KT(salicylic+ketoconazole) shampoo use it twice in wee. Put it over scalp for 10 minutes then wash it. Also take oral antifungal too. Tab fluconazole 150 mg twice in day . take one month course. this will surely solve your dandruff problem.graying of hair is most of the time not related to any disease. It is some what related to mental stress, physical stress, nutrition , life style, familial and some time just natural.1. 1st check your blood haemoglobin if it is less then take iron and folic acid tablet once in day.2. Tab follihair it contain all multivitamins required for hair. Take it once in a day.3. ALTRIS GEL use it once in night . Just apply it over white hair .All treatment should continue for 1 monthMost of patients give good response with this.for hair fall1. 100-150 hair fall every day is very normal. So should be consider hair fall if number of hair more than this.2. Generalized hair fall in female is mostly due to stress, poor sleep, poor nutrition and excessive blood loss due to menstruation3. Stress alopecia is also common in which female keeps their hair very tight in certain manner which creates tension in root and cause hair fall.4. Straightening and other procedure also cause weakness of root5. Other condition like fever, ptyphoid, maleria, thyroid, etc also cause hair fall( less common)Treatment1. Have good sleep. food., green vegetables , fruits2. Take iron and multivitamines like follihair atleast 3 month.3. Check you blood hemoglobine if it is less iron and folic acid supplements should start.4. Check thyroid and diabetes to rule out other cause.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the pea size lump in my testis related to cancer?\n\nI m sixteen years old and I m worried I have testicular cancer. I found something pea shaped to the side of my right testie. It seems to be attached my something. But not directly, they are close though. It doesn t hurt when squeezed, and I didn t know if something was inside of me at first so I shun a light underneath my scrotum onto it and light passed through. I read somewhere that it could just be a swelling of sperm or water. I m just worried though. I masterbate on average, daily if that has anything to do with it. Please get back to me as soon as you can. This is causing me a lot of stress.",
    "doctor_response": "HelloPea size lump may be due to many causes like spermatocele(cystic structure),epididymal swelling etc.This need proper clinical evaluation and investigations.Ultrasound of scrotum is most important.Ultrasound can differentiate between mass,cyst etc.I don't think it is serious issue.You should go for investigations.Treatment depend upon findings.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes primary complex and lymph nodes on lungs with high fever?\n\nHello my 1 year old son has primary complex and lymph nodes on lungs, that was the result of x-ray. He also experience high fever and also rashes showing in his skin. What does that mean? I mean what is primary complex and lymph nodes on lungs and why does he experience high fever? Thank you",
    "doctor_response": "HelloPrimary complex term is related to pulmonary koch's(tuberculosis).Primary complex with enlarged lymph node may indicate primary pulmonary tuberculosis.Primary complex of tuberculosis consists of local reaction in the parenchyma of lung where organisms lodge and inflammatory reaction of the associated lymph nodes.Your son's clinical findings may also indicate about koch's infection.He may need few more tests like mantoux test,T.B gold test or PCR test for confirmation.He may need anitubercular medicines.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat rhiniits,subsequent bronchospasm in a 11 years child?\n\nmy son aged 11 years has been advised budamate 200 inhaler twice a day for one year,for his asthmatic treatment,he is very prone to allergic reactions,resulting in rhiniits and subsequent bronchospasm.Is this the right treastmnet.Will it have any side effects on his height gain/",
    "doctor_response": "This is just the right treatment. Asthma is due to his allergic tendency. Budamate inhalation will help curb the allergic tendency and it needs to be continued periods, as advised. This is a 'preventer' medicine which will prevent frquent attacks. In the dose prescribed no effect on growth/ height is expected.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dark circles\n\nHello doctor I am a 28 year old female. Would like to know an effective remedy for dark circles. I am anaemic but for the past six months, i've been taking iron pills (Ferric Ascorbate with folic acid) as advised by the doctor. Most of the other symptoms of iron-deficiency have gone except the dark circles. I do sit on the computer for most part of the day due to work, so can't really escape that. I am having dark circles since the age of 17-18. Please tell me how can i get rid of dark circles? I was thinking of trying melalite cream at night and doctor reddy's niltan during the day time. Is that ok? Would also, like to add that i've been trying various home remedies as well but they hardly show any difference. Thanks,.",
    "doctor_response": "Hello dear,Welcome to HCm.i have read your query and understood your concern.Dark circles is relatively a refractory condition. It takes really a long time before it shows good response to treatment.It may be due to familial causes, inadequate sleep, anaemia, strain on eyes etc.In your cases, multiple factors are implicated.I will advise you to use safer depigmenting creams around eyes like those containing kojic acid, arbutin, liquorice etc (like radant i /wunder eye cream)I hope it helps.You may discuss this with your doctor.Stay healthy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can an infected surgical wound be treated?\n\nOn Sept 29 2017 I had left hand carpal tunnel surgery and left hand ring finger surgery for trigger finger. Stitches at 6 days were removed yet the incisions were still to open. The Dr assistant using a wrong instrument,digging deep into both incisions removed the stitches. Pain was extreme. Hand became swollen and infected. A thick,white solid cyst or tumor appeared at the ring finger incision. Dr has pushed a large needle through and into the cyst to obtain fluid. None appeared. What do you suggest to be done next. Thank you for your help Marge from NJ PS \u2014 I just saw there is a charge not able to do at this time. Thank you",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Have you taken a course of antibiotic treatment yet. It could be that you have a hematoma at the site that is getting infected.You could undergo an ultrasound at the local site and a fluid examination from the site.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Pranav Balakrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does low blood platelet count indicate dengue fever?\n\nMy son is suffering from a fever for almost 4 days now, we had his blood test and he has a low platelet count. according to the test, the normal platelet count is 170,000...and his platelet count is 150,000... the doctor said he has a dengue? but he has no symptoms of dengue! does his lowering of platelts already a diagnose of dengue fever?",
    "doctor_response": "Hello sir/madamNormal platelet count is 150,000-400,000 per cubib mm , so ur son's platelet count is within norman rangeLow platelet count is \"suggestive\" of dengue in dengue endemic areas but is NOT \"diagnostic\" of dengue fever.Antibody titer for dengue virus types , is commonly used for diagnosis of dengue feverRegardsDr.Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is severe abdominal pain a sign of pregnancy?\n\nI'm having all the pregnant symptoms my period was a day late it came on the 29th April for three days I took a home test and it read negative like all my other test before that don't work with me but me belly is rising and I'm getting a lot of abdominal pain what should I do if I'm pregnant what's the best and faster way to aboard it",
    "doctor_response": "Hello,If your urine pregnancy test is negative unlikely you are pregnant, so don't worry. You can take Meprate then stop for withdrawal bleeding.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for tightness in the upper wisdom tooth\n\nWhen I open my mouth wide, on the right side, the part of the palate the appears to connect to the upper wisdom tooth is extremely tight compared to the left.  It almost feels as thought it is stretching and going to rip.  My tongue also is not level.  Instead the left side is slightly elevated versus the right side.  What could be causing this?",
    "doctor_response": "Hello and welcome to HCM,Tightness in the region of right upper wisdom tooth could be due to infection or inflammation in the region of the wisdom tooth.Is there associated pain in that region?In case there is associated pain, then there is possibility of infection and inflammation.I suggest you to consult your dental surgeon for clinical assessment and relevant investigation- X-ray of jaw.The exact diagnosis can be made after clinical assessment and investigations.Treatment can be planned thereafter.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling imbalanced, pressure on left side of neck. Difficultty while driving. What can be the reason?\n\nHello, I like to request your professional advise and help: my dad has a situation of feeling imbalance or disequilibrium for many years and sometimes it can get better and sometimes not. There is also constant pressure on left side neck area associated it. Most uncomfortable is the imbalance, especially trying to lay down and getting back up. Also, riding in a vehicle causes more discomfort. Seem few neurologist but we have not figured out an answer yet. Please advise. Thank you.",
    "doctor_response": "your dad will be definetely of elderly age i think.He has problems with balancing n associated discomfort on the left side of the neck riding a vehicle increases the problem.This probably suggests he has severe cervical spondylosis with compression over the cervical cord.Does he have any radiating pain to the hands?Does he have any episodes of sudden fall/transient visual obsurations.Kindly consult a good neurosurgeon and not a neurologist.IN the mean time ask ur dad to wear a hard cervical collar when he is sitting or standing n remove it only when he lies down on bed.If he has severe pain ask him to take tab dolo 650 mg when he has severe pain n consult a neurosurgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the purpose of prescribing Gestofit 300 SR?\n\nHello Doctor, I have missed my period by 15 days (last date of period was March 15, 2014), I have consulted a doctor and she prescribed me gestofit 300 sr . She also did a pregnancy test, which showed a single faint line, so she was doubtful about pregnancy. but as per my belief I have not undergone any sexual intercourse during the concerned period. Please let me know the use of gestofit 300 sr . Will it help me to get my period back as I had regular periods earlier. Also, I would like to inform you that it has been 1 month I have come to a new place with my husband and also have gained 2 kg weight recently. Please help....",
    "doctor_response": "Hanks for writing.. Gestofit is progesterone tablete.  It helps to get periods once it is stopped and secondly if you are pregnant It supports pregnancy.. So there is no problem in taking taking gestofit.. Hope I have answered your query. Good day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed H pylori positive. History of having unprotected sex. Pregnancy tests negative at 6 weeks. Possible positive test at 12 weeks?\n\nHi Dr. i had unprotected sex(vaginal) after almost 3weeks i developed all ars symptoms: fatigue, abnominal pain,soar throat, mouth ulcer(only 2 days and disappeared), pimples at lower back then later on bach shoulders, chest, dark knuckles, high BP, dizziness. i was diagonized and found h pylori postive and put under medication- healed. But i was overwhelmed by anxiety and the symptoms continued. at 19 days took p24 ag test-neg. at 24 days elisa test-neg, at 6 weeks 6days took pcr dna and elisa test both came negative. Could there be a possibility of turning positve at 12weeks?",
    "doctor_response": "HIThank for asking to HCMThe best way to confirm the pregnancy is imaging study ( Ultra sonography) this can detects the gestational sac of very early days, for your other problems it seems functional problems acid level could increase in state of stress and this can aggravate the symptoms of reflexes so keep your stress level low, no need to worry it will be okay be safe and take care of yourself bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pulmonary fibrosis\n\nmy mother is suffering from pulmonary fibrosis since two years, every time she is given gupison and tapered gradually, after a period of time from stopping gupison she gets the symptoms again , (SOB, wheezes, and hypoxia) she is on lasix continuously . This time she has been doing great on gupison 20 mg since 3 months. I am thinking to keep her on the same dose to avoid her suffering again, she is already on wheelchair and taking calcium and vitamin D tablets , she is 73 years old . Am I making a mistake?",
    "doctor_response": "Thanks for your question on HCM.Pulmonary fibrosis is end stage pulmonary disease with no effective drugs available. No proven treatment is available.  Gimison is steroid and should be given in low doses if you want to give it for long time.Continue calcium and D3.I advice few more things which helps your mother more.1. Tab perfinodone is newer antifibrotic drug.2. N acetyl cystine is also used in fibrosis as it is antioxidant and antiinflammatory.3. Home oxygen therapy.4. Pukmonary vacconation with pbeumococcal and h.influenza to prevent future infection.5. Chest pysiotherapy.So better to consult pulmonologist and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this LFT result with history of having fatty liver indicate?\n\nJust got a blood test done and my liver enzymes were AST/SGOT56 and ALT/SGPT57 I do drink almost everyday I have had an MRI on my liver about 6 months ago and results were a fatty liver 2 months ago I had a blood test and everything was normal do you think I need to worry I m trying to cut down on my drinking but I may have a problem with that",
    "doctor_response": "Hi, Thanks for posting in HCM. I understand your concern. Liver enzymes with AST 56 U/L and ALT 57 U/L is showing a two fold increase above normal. Drinking alcohol everyday with history of fatty liver is not good for health, as the liver damage has already been started. Even though enzyme levels do not indicate gross increase, that does not mean that the underlying pathology in liver for the progress of the disease is not taking place. You need to quit alcohol intake completely. Otherwise, you may land up in complications like cirrhosis of liver or acute liver failure. Hope the information provided would be helpful. All the best. Regards, Dr.Ashakiran.S., MBBS., MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the cancer treatment options other than TACE?\n\nI got the news that my dad had a cancer by the end of April. He had been done twice transcatheter arterial chemoembolization\uff08TACE\uff09surgery in on Apirl and June, but the tumor still grows bigger from 34mm*38mm to 102mm*82mm. Are there any better treatment you can recommend for us?",
    "doctor_response": "Since you said TACE, your dad must be suffering from hepatocellular carcinoma. Treatment of HCC depends on many factors. If localised there are many options like resection, intralesional injections, radiofrequency ablation. Transplant is an option is suitable candidates. If nothing is feasible, chemotherapy is the last option",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment for hyper tension?\n\ni m 43 yr, @ 17 yrs,lebled as HTN, in 2010, with DMSA & TDPA, diagnosed as ch. phylonopritis , imaging , reveal as CORTICAL SCARRING, Crt clr @85ml, s,crt always remain inbetween 0.9 ~1. electrolyte bal OK, Urine, Ok(only for last 01 yrs, 02 time reported as PROTEINE TRACE) getting antihypertensive treatment. What treatment best for me? how i can recover from this desease?",
    "doctor_response": "Hi thank you for querry.As you mentioned you have a patient of Hypertention along with chronic pyelonephritis and ocassional protienurea.Hypertention and protienurea are due to chronic pyelinephritis.hypertention with suchage factor and protienurea the strongly recommended drug is ACEI like Enalapril or Ramipril it controll hypertention along with protienurea.Dosage is titrated according to BP reading started from 5 mg PO Once a day.prompt antibiotic therap required such as amoxicilline,cephalexin,septran or nitrofurantion.So consult your nephrologist for proper treatment.Hope the answer will help you in understanding the disease process and decision making for consultation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful lump on ankle caused by an injury\n\nA heavy chair fell on my inside ankle bone and hurt very badly. I applied ice on and off for the next hour and a half and it was fine to walk on without pain. I did not feel it or notice it for the next month but found there is a lump in the area and when I press on it, I feel a bruise-like pain. It is not discolored nor does it hurt unless pressed on. I had a previous knee bone injury that seemed to take a long while to heal as well. I would appreciate your suggestion as to follow up if any for now.",
    "doctor_response": "Hello,Skin lumps caused by injury usually fade on their own as the swelling goes down. Applying an ice pack and elevating the area can reduce inflammation and ease pain. Using anti inflammatory medications such as Acetaminophen can also help in relieving the symptoms. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i go to ER if my BP is 170/108 with slight shortness of breath?\n\nHi. I am 24 years old. I have taken 6 BP readings over the last 30 min, and they average around 165/105. My heart rate is normal at 65, but it feels like it is beating much harder/heavier than normal. I m also experiencing slight shortness of breath which feels a lot better when I take a deep and deliberate inhalation. One of my readings was 170/108 which is close to Hypertensive crisis. Note: I have a history (3-4) years of fluctuating high blood pressure. Family GP has ran tests, nothing abnormal, but my BP ranges a lot from 130/85 to 155/high90s. Should I go to the ER?",
    "doctor_response": "Hello, I had gone through the case and found that you are hypertensive at your young age.It might be due to family history of hrart problem or due to bad life style like drink, smoking, late night sleep or anything else.So I will advise you to take antihypertensive medicine Tab Atenol once a day alongwith that go for treadmill test to know the exact condition of heart.Last do yoga and breathing exercise and avoid salt.and preserved food.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "High prolactin level. Regular period. On cabegolin, folic acid, multivitamin, oradexon. Get pregnant?\n\nI have high prolactin level its 1219 whereas the highest range is 619 and i have pcos.Though my period is regular, i have little flow.I am 32, my weight is 5'1\".my weight is 63 kg.I have coarse hair problem in my chin. I want to get pregnant. My medication now going on is cabegolin,folic acid, multivitamin,and oradexon(Dexamethasone Micronised BP .5mg) from 1st day of period for 13 days.Is my treatment ok?",
    "doctor_response": "Hello Thank you for your query. You are receiving Cabergolin for high prolactin levels. You can discontinue the treatment after 6 weeks if the levels are normal. FOlic acid and multivitamins are absolutely alright. I fail to understand why you are being given dexamethasone. You are definitely suffering from pcos, which explains the hirsutism and the irregular cycles. You should be investigated completely and treated for the same. Please consult an infertility specialist if you wish to conceive. Also take regular folic acid supplements, and maintain a healthy BMI, as that is the mainstay of treatment for PCOS. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why was my son's penis tip swollen and now has urinary incontinence?\n\nmy son is 7 and i had to take him to the er because his penis was red and the tip was like a balloon they gave him different type of meds and it cleared up within 2 days..now he have a problem urinating in his underwear maybe 4-5 times a day not knowing that he's doing it what could this be?",
    "doctor_response": "Hi,it seems that due to infection and irritation at tip of penis might have giving this urinary incontinence type of feeling.I think he might be on antibiotic medicine and if so continue with antibiotic.After local infection subsides, he will feel better.Give him plenty of water.ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for the compressed vein in the brain that causes me to faint frequently ?\n\nhi, one of my freind s child has fallen during his childhood and got minor injury on his head . On oral medication, he was all right, and doing normal. Now, from Past 1 year he has developed some complications, he suddenly get unconsious & faint. While going through CT scan , it is found that, one veins in his head has been supressed, and so the complication. He is 14 years old. Pls. let me know, whether it can cured by oral medication or surgery is the only way out?",
    "doctor_response": "Dear thanks for choosing health care magic.First of all it is important to know that whether there is connection between the present complaints and past incidence.Because it might  be a co incidence.As you are saying it must be block in the vessel,if the block is major he may need surgery,in case of minor block medicines may work,ok buy take care and wish him all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medicine for back injury\n\nI need to get an AME doctors name in Chico, Ca . I hurt my back and workers comp did not give me an ame doctors name nor did they send me one. i am having to go to a deposotopn on may 20th and i was told that i should have seen an ame docotrto give me per cent frm my injury on my back",
    "doctor_response": "Hello I have gone through your question and appreciate Your concern. For your back pain u should try analgesics like ibuprofen. Local Analgesic gel application will also be useful. Lie on flat hard bed. Avoid bending forward and lifting heavy Weights. Hot fomentation thrice a day. Muscle relaxants and analgesics will help you. Thanks U can write me back for any query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for restlessness in a child\n\nShould I seek medical help for my son. He is physically healthy however I am concerned about him cognitively. My son is always fidgeting, he will get up while he is eating, he never finishes a task unless I sit with him, and even then he stands up than sits back down, he is always interrupting me or other people. I do not think he is depressed or scared or anything but I m concerned that he is struggling with his relationships. He also gets very impatient and does not like to wait his turn when we play games.",
    "doctor_response": "as per symptoms u mention you should see pediatric  psychiatrist, as there symptoms may of ADHD (attention deficient hyperactivity syndrome) , with medicine it will improve.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can my pimples be cured ?\n\ntell me solutions for pimples because i lost studies please tell me solution i am 17 years old masturbating from 3 years i want glow on my face what to eat what exercise to do",
    "doctor_response": "Dear Shubham, Welcome to Healthcaremagic! You can use topically Adapalene 0.1% gel [at night only], & use a good soap on face 1-2 times a day. Improvement will start in 2-3 weeks. This will also lead to improved glow on face. Masturbation will not cause any problem to your general or sexual health. Stop thinking about it & take good diet. Wishing you best of health. Dr NAVEEN KANSAL, MD [PGI, Chd] Skin Clinic, SCO 298, Sect. 20, Panchkula. kansalnaveen@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain in chest and heartburn be treated?\n\nstarting an eliptical excersise training session and now I have a sharp pain in the middle of my chest only when i move my arms....happen only 3 times the last 4 days...plus I have a lot of gas and mild mild heartburn....both go away with a glass of wine...thinking it could be stress plus injury from over doing the elipitical sessions...no other symptoms.",
    "doctor_response": "HelloEmpirically you can take proton pump inhibitors like tablet pantoprazole 40 mg twice daily half hour before food for one week then one tablet can be taken for one month.You should avoid wine completely because it will aggravate your problem.It is also important to exclude any cardiopulmonary problem.You may need routine hemogram,random blood sugar,liver and renal function test,lipid profile,ECG,ECHO.You may also need upper GI endoscopy after evaluation.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What could be the cause of ventricular fibrillation?\n\nHello doctor, My 29 year\u00a0old\u00a0brother had a pacemaker placed three years ago after survival from a sudden cardiac arrest. Doctors found the cause of the cardiac arrest to be a ventricular fibrillation. Last week was the first time he received a shock from his pacemaker, that is, exactly three years after his first episode. My question is, whether we can find the root cause of his ventricular fibrillation. What is the best treatment for his case?",
    "doctor_response": "Hello. Ventricular fibrillation, the commonest cause is coronary artery disease. The other causes are dilated cardiomyopathy or low heart function. What is his ejection fraction? Low ejection fraction due to any reason like coronary artery disease or others can lead to ventricular tachycardia and fibrillation. He should undergo angiography, and echocardiogram, if he has not already. His electrolyte levels should also be checked as it is a very important precipitator for ventricular fibrillation. In treatment, he should receive Cordarone (Amiodarone), and multiple other medicines depending upon the echocardiogram and angiography reports. Usually, patients get antiplatelets like Aspirin, Clopidogrel, ACE inhibitor like ramipril, and Spironolactone along with other medications. You can upload his reports if any so that I can opine on the cause. Hope this helps you and get back if you have any doubts. For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does erectile dysfunction need medical intervention?\n\nhi sir am irfan am 25 years old,i cant able to control doin hand job sir,may be weekly 6 times i doing it,and nowadays am feeling like erectic disfunction,i searched tablet for this problem in a website,tablet name is 4T plus,is the tablet ll help me to solve my prblm or i need to consult a doctor...",
    "doctor_response": "Hi,Thanks for writing in.The typical symptoms of over masturbation includes chronic fatigue, weak erection, thinning hair, and depression.4T plus tablet is an ayurvedic preparation and can reverse symptoms due to over masturbation. First you must stop doing masturbation more than 2 to 3 times a week and not more than once daily.This can cause low sperm concentration and that is why there is erectile dysfunction and your semen is not coming out as before. Masturbating so many times can cause depletion of sperm concentration.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe groin pain after having catheter ablation?\n\nI had a cathater ablation middle of July had bad pain in groin area it has gotten worse and I have to hold on to things when I walk because all of the sudden I get this sharp pain in my groin that can cause me to fall. What has happened and who do I see about it, I called the cardio office nurse two days ago and she hasn t called back YYYY@YYYY",
    "doctor_response": "hello , if the groin pain is in the same area where the puncture for the procedure was taken , you should consult your cardiologist as though small there is a definative possibility of hematoma (blood clot ) , which may compress the nerve to leg  and based on clinical examination and sos sonography with doppler should guide furthur management , which is mostly conservative with some mediation . Regards Dr Priyank Mody , Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of pressure in the left side of the skull?\n\nhelp. i hit the top of my head about 3 hrs ago near my coronal suture area(in the middle where it dips in), while jumping under my doorway not realizing how short it was or tall i was. i feel just a very smaaaall amount of pressure near the front and left side of my skull. what should i do?",
    "doctor_response": "Hi dear ,i can understand your problem .I will suggest you to put ice packs where you hurt yourself and take a NSAID like ibugesic for relief of your pain .Don't worry about pressure feeling ,it will go by itself within few hrs .best wishes for good health .regardsDr.Harpreet Kaur",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does costochondritis cause pain and burning sensation under the armpit?\n\nSo ive had a common cold for the past 5 days and yesterday and the night before i had this sore tight aching feeling in my left outter chest kind of under my armpit but a bit up more then today it felt fine with a little burning feeling but in the same place could possibly tell me what i have I think it is cosoconditis is how i think you spell it",
    "doctor_response": "Hi, Costochondritis can cause similar symptoms. As of now you can take analgesics like Paracetamol or Ibuprofen. If symptoms persist better to consult a physician and get evaluated. Nothing much to worry as it will settle by itself. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe chest pain\n\nMy son age 24 went to emergency room with chest (upper abdomen) pain. After an EGG and some blood work, they said the EKG was abnormal and something about muscle on the heart. He has an apt to see a cardiologist on Friday. WHat does muscle on the heart mean?",
    "doctor_response": "as our body has muscles ,heart also has muscles which helps in the pumping action of the heart, these are involuntary striated muscles.so as ekg is abnormal and something is wrong with the heart muscles means there can be hypertrophy ,that means increased size of muscles that leads to increase size of the heart and that leads to ineffective pumping.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dizziness on taking strong smells, get racing heart, nasal and throat burning, coarse voice. How can I fix this?\n\nWell I have this issue with anything that has a scent. Mainly with detergent laundy, dish soap, cleanning supplies. With detergent and cleaning supplies I feel like a I dizzy and then zone out! As friend put it. I feel like body shut down with this I get the heart racing, burning in nose and throat and harsh voice. I have been tested pumlonary. I do not have ashma. So wandering what it is and what I can do for this to get better. I have removed all scented products from home.",
    "doctor_response": "THERE ARE SOME HIDEN ALLERGIES WHICH GETS WORST AFTER EXPOSSURE TO SMELLS DUSTS AND SCENTS THE P[ROBLEM IS NOT WITH THESE PRODUCTS BUT ANY OTHER ALLERGIES GET EXXAGERATED EXPOSED TO THESE PRODUCTS YOU CONSULT ALLERGY SPECIALIST GET BLOOD SERUM TESTED FOR SPECIFIC ANTIBODIES FOR SPECIFIC FOODS GET IT TREATED YOU WONT BE TROUBLED BY THESE PRODUCTS AGAIN",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes continuous weight gain in a child?\n\nyes, pleaseI have a grandson aged about 10 years. Inspite of all efforts, he is gaining weight.I would like to get a doctor's diagnosis and required related tests to find an answer and cure to the probemCould you please suggest a proper physician to meet and discuss the matterthanks.",
    "doctor_response": "Hi you need to consult pediatrician and endocrinologist to find out cause of weight gain.I also would like to weight and height of your baby.thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sore breasts in male\n\nI am a 48 year old man,I weigh 223 pounds and am 5ft 11 inches. Recently mt breast or surrounding my nipples are 'extremly sore'. My wife went to lay her head on my chest and it was like a sharp knife had stuck me.It is both sides but the left side seems to be more painful. This has been going on for roughly a month and my Dr. does not seem concerned.I had a mild heart attack in 2004 and had a stint put in. I also have high blood pressure.",
    "doctor_response": "Hello, It can be due to abscess - doing a mammogram will help you. benign or malignant lesion - doing a mammogram will help you. Hormonal imbalance  - can check for increased prolactin level, thyroid. Get a review from a surgeon, the local examination will give you more details Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sweating when nervous?\n\ni am 56 yrs old, i sweat when i get nervous or when i try to speak to an audiance. but recently my buttocks sweat all the time. sometimes when i walk my underclothes and pants get wet from my sweating. i recently had a complete physical to include colonoscopy, thiroid, pancreas, kidney and liver check all is well.",
    "doctor_response": "HiThanks for using healthcare magicI think, you have anxiety disorder like performance anxiety. In that case, you need antidepressant like paroxetine with low dose benzodiazepine. You can also try some relaxation exercise like JPMR or relaxation exercise. Better to consult a psychiatrist and psychologist for proper therapy. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for less sperm count in men\n\nMy husband has weak sperm count. I ve done IVF 6 times and miscarried after 2 months each time because my body rejects the hormones I get injected with. I ve been told by countless doctors that I have no issues and my husbands sperm is the problem. I don t want to do IVF anymore. I want my husbands sperm to be made well and for him to get treatment. What are the treatment options for men?",
    "doctor_response": "Well, whether you need IVF or not, depends on exact condition of your husband's semen at present. To increase sperm count, we need proper diagnosis of low sperm count- by physical examination and some tests like blood test and ultrasound. And then we have to correct the cause of low count. Please read-",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling on the wrist\n\nI had an IV in my arm from June 19-24 and went to the MD on July 1st because top of my wrist has a swollen bump area and it hurt. She said it is not a blood clot. However it is worse today so I called to see if i can get an ultrasound. The nurse have not called back since 10am should I go to the ER to rule out a blood clot. Thanks.",
    "doctor_response": "Hi,Welcome to HealthcareMagic.Yes you need to go to emergency room to rule out blood clot. Because it is worsening and increasing in size.After diagnosing it may be aspirated if needed.Hope I have answered your query.RegardsDr Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is convulsions and high fever related to gallbladder stones?\n\nMy father suffers from convulsions and high fever. the fever comes swiftly followed by fainting, excess perspiration, convulsions, low BP. it lasts for about 3-4 minutes approximately. He has stones in his gall bladder and portal hypertension and portal vein thrombosis. The root cause has not been diagnosed as yet. Please help.",
    "doctor_response": "Hello and welcome to ask a doctor service.  I read your query and here is my answer. It look s he is suffering from some sort of infection most likely CNS infection.  Gall stones has nothing to do with these. He may need certain tests like blood test, csf test and ct scan may be. You need to take him to the hospital as it may be dangerous for his health.Hope i answered your question.  Feel free to ask more if you need further assistance.  Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain be managed in leg, neck, etc.?\n\nI have been taking tramadol 50mg once a day as and when my back and neck pain due to bulging disc became unbearable . Now the muscles in both upper forearms and muscles in both front thighs are going into spasms is this due to pressure on nerves from bulging discs 1 in c6-7 vertebrae and also LS 1 &osteo in 456 or due to side effect of tramadol which is increashed to 2 mornings as pain is worse. I am awaiting electric impulse tests soon as no reflexes found in upper arms also have severe pain in both legs and feet and amround both ankles . Thank you",
    "doctor_response": "Hi, Well, tramadol is a 3 times a day drug. spasm and other nerve signs are treated better with nerve medicines like lidocaine, anti-epileptics, even cold packs and electric impulse generators (TENS). Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cramping in the toes & abdominal region?\n\nHi, Question regarding cramping. im 37 yr old male, avid weightlifter/amateur bodybuilder. I experience cramps in my toes and abdominal region fairly often. The toe cramps arent painful and go away within 30 seconds. The lower ab and oblique cramps feel like a golfball sized compact tightening of the muscles and can be brought on by simple act such as twisting and turning during normal daily activities. They can last up to a minute or two and leave me writhing around trying to get it to unclentch. I try to drink at least a gallon of water a day due to the vitamins and legal supplements I take. Aside from water and bananas and not overtraining my stomach muscles, what can I do to mitigate these cramps. Thanks for your help",
    "doctor_response": "Hi.Thanks for your query and an elucidate history. The cramps and particularly the history of ''golfball sized compact tightening in fact can be a real mass or a cyst or a lipoma inside the muscle mass or a small hernia. I would advise you to get a physical examination done by a General Surgeon and evaluation by a high resolution ultrasonography. IF indicated get operated and you will be dine. The cramps at the toe may be just incidental, do not worry if there ae no other associated symptoms of lower limb weakening or so.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for suffering from recurring viral fever?\n\nMy son is 30 years old and keeps having a reoccurring high fever periodically.  It usually last 3-4 days and occurs around August each year.  He has been to the doctor and  they do blood test that indicate that it is a virus.  This has been happening for about 6-7 years.  What does he need to do?",
    "doctor_response": "Thanks for poting your query to health care magic .I will releive your worry about your son .As I understand he is suffering from some kind of intermittent fever . I just want to know some more information that is what test your doctor have done to diagnosed Viral cause of fever and which Virus they detect and further nature of fever  weather it is a continuous fever of there is a symptom free period of fever during each episode ,is there chills or rigor before episode of fever  .Because as I understand it is a seasonal fever every repeated   yearly and meantime he remain symptom free. So there could be  possibility of allergic  or parasitic fever also .so you require some more investigation to detect cause of fever .I would like to suggest you one more investigation :Complete blood Count .Untilll and unless I get the correct diagnosis I could not suggest you the medicine  however you can do following :Avoid expouser of environmental polluent .Take good regular diteAvoid fasting between meals.Take mutivitamin medication containg B-complex, Vit C, Zinc ,Lycopodium,Iron  two times a day for 1 month etc. review me after investigation done . feel free to contact me any time /regards,Dr.Manish Purohit",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I having severe abdominal pain and heart burn?\n\nI woke up at 2am with severe abdominal pain, centered just below my rib cage.I made myself throw up because that helps when I get really bad heartburn, and now the pain has dulled but is still there.  My vomit was heavy and dark and gritty.  Should I be concerned?  I still can't fall asleep from the pain.",
    "doctor_response": "Hi. This can be a serious problem unless proved otherwise by a X-ray -Abdomen in a standing position to rule out perforation, Urgent ultrasonography  to rule out pancreatitis, liver abscess, gall bladder inflammation, blood tests relevant to what I noticed.In short this is a serious problem. Stop taking anything orally, rush to ER / Hospital",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is my semen analysis test normal ?\n\nDear Sir/Madam, Today I have done my semen analysis test and herebelow is the description:- Volume:- 2.5 ml Colour: Whitish Reaction: Alkaline Total Sperm count: 79 mill/cc Rapid Progressive Motility: 60 mill/cc Sluggish Progressive motility: 18 mill/cc Non Progressive motility: 02 mill/cc Immotile: 20 Mill/cc Abnormal Forms: OCC Double Head & Tails Pus Cells: 1-2 /HPF RBC: 0-1 /HPF Gram Stain: No organism seen In veiw of above, pls tell me whether the above report is normal !!! With regards, manoj",
    "doctor_response": "Hi Manoj Welcome to HealthcareMagic Above report appears to be normal. You have not mentioned morphology clearly. According to WHO criteria its normal if morphologically normal sperms are above 30%. Rest all parameters are normal. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Am I feeling dizzy due to abnormal vitamin D count?\n\nHi i just had a bunch of blood work done because i get dizzy if i eat breakfast no other meal just breakfast. Everything came back normal except for my vitamin D count. Could that be making me feel dizzy after i eat breakfast. I am going to see a heart DR. next monday to rule that out. Just seems weird that it only happens when i eat breakfast so i stopped eating breakfast then i don't get dizzy.",
    "doctor_response": "HIThank for asking to HCMThis is kind of mental condition you have developed and that is not at all related with any of the pathology neither indicates the sign of any physical disease this is what memorised in your mind and it is working, you have to delete this memory, vitamin D has nothing to do with this, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lower back injury\n\nwhite male, age 32, lower back injury in January with pain radiating down the LEFT leg. did physical therapy, and chiropractics with no relief. Dr practioner prescribed oral steroid and pain patch on Thursday of last week. Have not actually seen an MD. Also a history of Crohn s disease. Now am experiencing numbness and uncoordination of the RIGHT leg, no shooting pain down right leg. Also have not had a bowel movement for three days. MRI is supposed to be scheduled within the next seven days. I think this is getting extremely serious now and am worried about more serious problems. Medical advice would be appreciated on what to do next. Do I need to go to ER or wait to talk to someone in doctors office on Monday.",
    "doctor_response": "Hi I did review your concernI would advice you to get an MRI done as soon as possible. with a history of crohns disease, your condition could be due to associated arthritis of the back. It can sometimes impinge nerve roots and cause the neurological numbness you are experiencing. Shooting pain can be present or can not be present.The MRI will help to determine cause of pain. Also a neurological assessement by a doctor will help in determining further management. severe nerve compression may also need a surgery.I hope this helpsWish you all the best.Thank you for using healthcare magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tachycardia and palpitations\n\nRecently ( two days ago), I am having tachycardia (100 to 130 pulse rate) with palpitations. I was prescribed concor cor 2.5 mg. I am wondering what is the underlying cause of this condition. I am diabetic (recently diagnosed- 2 months). Also had a disc hernia on January 10th and still trying conservative approach, suffering from pain and sleep deprivation. Consumed a mix of drugs during the last 3 weeks. But now off drugs.",
    "doctor_response": "Hello. Thank you for your question and welcome to HCM. I understand your concern. Heart rate, standardized as normal for the worldwide population, is 60 to 100. There are many changes that happen in the human body during a day that can change this parameter, such as physical activity, hormonal changes and psychological factors. Now, even insomnia or sleep deprivation can cause heart rate to speed up, mainly because of the changes to hormonal peak and nadir levels. There are also caffeine-containing beverages, that can increase the heart rate. Anyway, I am assuming that bisoprolol was prescribed for the blood pressure and to reduce the heart workload, as a measure of prevention. While a safe and effective drug, it does not have marked affect on the heart rate. My recommendation is that you should discuss with your cardiologist for an alternative drug, which also affects the heart rate, by slowing it down. I am referring to other beta-blockers, such as atenolol or metoprolol (although with caution, since you are a diabetic patient) or a drug from the class of calcium channel blockers (e.g. verapamil or diltiazem). I hope I was helpful. Kind regards, Dr. Meriton",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure red swollen nose of a baby?\n\nMy 2 1/2 yr old little girl has seemed slightly warm to me over the past two weeks but not with a big difference in body temp per se via a thermometer. I also have just noticed that her nasal passages are very swollen, red and scabbed over (she is not a picker) and she freaks out and cries when i try to look at them. We have had the air conditioning on for 3 weeks straight due to the high temps outside and i am wondering if she could have started with a mild nasal irritation due to dry air thay progress to this tissue becoming distressed and consequently infected thetefore producing a low grade fever? I would appreciateany answers or advice.",
    "doctor_response": "Hi...by what you quote I feel that you kid might be going through a season allergy. Fever can be due to viral illness also. If the fever or the redness in the nose is not bothering her you need not worry. Cough and cold are viral 95% of the times in children. For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15mg/kg/dose (max ceiling dose 500mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat sciatica and joint pain?\n\nI am 67 and I am an RN. I have a very health diet, but am experiencing some sciatica and joint pain. Do you believe an anti-inflammatory diet works. I also have developed some osteoporosis. I take helath supplements but I do not feel it is helping. I am active and exercise.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Basically your concern is sciatica and joint pains right? sciatica will have classic numbness in the course of nerves and can be healed by vitamin B12 tablets like neurobione forte tablets for one month after food can be taken. For joint pains I better recommend X-ray of the part which will tell us the underlying pathology. Even osteoporosis can be detected so kindly get investigated for that and come back to us. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the causes of fatty kidney and high cholesterol?\n\nHi, I was feeling bubble in right side of lower stomach.So,I went for complete checkup(CBP,lipid profile,thryoide,Kidely test,urine test and full stomach abdoman. reports says- fatty kidney grade-2,high coloestrol(Border line), hab1c = 8.5 %, fast blood suger - 119,post lunch was 240. when I have consulted physiscan,they have given - one tablet related to kidney boostup for 1 month,gluconorm Sr for 1 month and STORFIB 145 for 3 month.they ask me to change lifestyle(diet and excersie) After 3 month, again i went checkup for boold sugar test and lipid profile.There was no much change in lipid profile result .So,they again ask me to contimue STOFIB 145 for 3 month.Now, again I went for FBS/PLBS,lipid profile,this time, colostrol level is OK,HAB1C - 5.75 %,still,they ask me to contiue storfib 145 for next 3 month. I am 35 years old,wight was initally 70 kg and now it is 67 kg.hieght is 5 5 . I am not sure,if i am daibetic or not,or pre diabetic or why colestrol is to high..I am feeling no other issue,in general.I am doing 3-4 day gym(running and cycling) for 30-45 minute per week. I am wondering if I did mistake for taking Gluconorm SR for one month? Please adbvise....",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Bubble in right lower part is it increasing in size on coughing? It could be hernia. Did you get it checked? You are not diabetic. Fasting sugar 119 HBA1C 5.7. You are not diabetic. Continue doing exercise, running, etc cholesterol. You didn't give the values just said they are borderline. Why worry about those. A good exercise and diet control is the best medicine for controlling cholesterol levels. Its ok if you took gluconorm for one month. Forget it. It does no harm. Is your blood pressure normal? And urine tests? If they are fine you need not worry about those fatty kidney reports. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does water accumulate in the back causing back pain?\n\nHello, My Uncle is 56 yrs old, from last one month, he has lost his weight drastically, now he is hospitalised and doctor says, water is getting accumalated in his stumoch and back. Doctor has darined around 3 lit water in last 3 days but the water is still getting accumalated. he is also suffering from intense back pain. Can you please suggest me, what should be the best treatment in this case?",
    "doctor_response": "Hi,From history it seems that he might be having Cirrhosis of liver causing collection of fluid in abdomen.Consult Gastroenterologist and get examined and investigations like Liver function tests and ultra sound abdomen.After proper diagnosis plan of treatment can be decided.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Frequent sneezing causing watery eyes and headache, rise in temperature. No relief with treatment. Remedy?\n\nHi, I have a really a big issue regarding my sneezing .I over sneeze 20 times a day non stop.This leads watery eyes and headaches .I currently live in uk and I never sneeze when I travel outside uk.I have noticed my sneeze start whwhen my body temperature rise,I get less sleep and as soon as I come out of shower.I don t seem to sneeze in cold weather and when I say cold weather I mean when I m walking/travelling outside. I have tried all medicines and nothing seems to help.",
    "doctor_response": "hi, you clearly are allergic to something, and it looks like you are allergic to dust, may be even pollen. you need to make a note if you sneeze when you go to garden or near plants . also do you get sneezing while cleaning your house or dusting pillows bed sheet mattress etc. if this s troubling you a lot then you go to immunologist or allergy specialist . he will do skin prick test on you, by this you will surely know what your allergic to. once this is done you have to take immunotherapy ,this is the best modality of treatment available and it is very effective. but before you try immunotherapy , you try nasal steroid spray this also is very effective,consult immunologist or ent specialist for nasal sprays. thank you dr.mukesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "IUI in India for single women\n\nCan you please tell me if India allows IUI  for foreign single women",
    "doctor_response": "It is not a crime and one can get it done I believe. There should not be any hindrances for that.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling on feet?\n\nMy age is 25. and recently i got tested my blood and got high ESR level og 55. I am worried about it. since last month my feet is swelling and sometime paining also. if i take rest its less swelled but not fully normal like other feet but when i walk more or go gym again swell more.what is the proper solution for this disease .Just because of ESR i am facing swell problem in my feet or something other reason is there? if yes, how can i solve it and how can i reduce my ESR level?",
    "doctor_response": "Hello, Your symptoms seem to be related to rheumatoid arthritis. I suggest checking the rheumatoid factor level to help through the diagnosis. Meanwhile, I suggest using anti-inflammatory medications such as Acetaminophen to relieve the inflammation. I also suggest maintaining the feet elevated to prevent the swelling. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistently soft stools?\n\nhello, my 8mos & 28 days daughter just had her fecalysis and the result is fat globules- rare. Bacteria- few. Rbc-1-3/hpf. Pus cells- 2-4/hpf. shes having soft stools,but not watery, for almost 2mks. not a sign of dehydration. i already changed her milk to lactose free for 3 days now . can you tell me why shes still having soft stool. by the way she moves bowel 2-3 times. but not consecutively for that almost 2 weeks.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query your daughter have symptoms of persistently soft stools. Well there can be many reasons for symptoms you mention in query like inherited intolerance for gluten, a protein found in wheat, barley and rye, including IBS, parasitic infections and gall bladder disease. It seems you have increased susceptibility of getting infected. Need not to worry. Give child plenty of fluids. I would suggest you to consult gastroenterologist for proper examination. Doctor may order ultrasound , stool test or take history to confirm the diagnosis . Doctor may prescribe anti allergic , omeprazole , laxative or recommend removal of gallbladder or recommend you to take gluten free diet .Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Acyclovir cause tingling sensation in the leg?\n\nHello, My doctor put me on a medication called Acyclovir 800mg. I do not have any kind of rash or sores anywhere, The only symptom he is going by is a tingling in the inside of my left left (about 8-10 inches) I developed this pain on June 10, 2018 after a fall and being diag with bulged disc and sciatica down my leg. My question is...the medication that he put me on is causing MORE tingling and burning sensation in that area. I m not sure if this is a side effect from the RX? I am questioning my Dr s diagonosis. Can you please advise? Thank you",
    "doctor_response": "Hi, Acyclovir if mentioned correctly in history, then this drug is for anti viral infection. if the physician have prescribed the drug he may have found some viral infection while your complaint. Since you have the past history of radiating pain I think you should start the exercises for stabilizing the core, strengthening the muscles of the spine and lower limbs. I think the tingling is due to the disc injury and needs exercises to be done to have control to the symptoms. once the symptoms starts reducing you can cross check with he Physician to continue or discontinue the medicine given. In my clinical practice of over 12 years most cases with sciatica respond well to exercise. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Ofloxacin advisable for infant?\n\nIs it advisable to give Ofloxacin Suspension 50mg/5ml to 4 month old infant ? What should be dose and how many times a day. Also inform if Metronidazole Suspension 200mg/5ml can also be given simultaneously . If yes what should be the dose. He is passing stool 6-7 times a day.",
    "doctor_response": "Hi,Ofloxacin can damage the growing cartilage (arthropathy) and tendinitis if given to young children, hence it is not advisable for a 4 month old infant. Metronidazole suspension can be given in the dose of 5 mg/kg orally 3 times a day for 5 to 7 days for the treatment of infective diarrhea caused by protozoa like ameba.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does sperm motility:actively motile 70% feebly motile10% mean?\n\nthanks for your response. i want know that as bellow : now result 11/06/14 1. volume : 3.0 ml 2. Liquefaction: completely liquefied 3. sperm Count : 120Million/ml 4. sperm motility: actively motile 70% feebly motile10% non motile 20% (motility within one our of ejaculation). 5. Morphology: 10% Sperm abnormal: (abnormality of head/body/tail) 6.other Cell: a. leukocytes : 2-3 b. epithetial cells : 0-2 /HPF C. RBC/Germ Cells: absent 7. sperm Clumping: absent 8. Fructose: Present comments: Normozoospermia",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.This is absolute normal report of the semen analysis.Every parameter you have mentioned is normal in your report. With this report you can become father very easily if the spem meets the ovum directly.In the comment it is mentioned normozoospermia which means it is normal semen reports.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is serum creatinine and why do we measure it?\n\nHello Doctor, What is serum creatinine and why do we measure it?",
    "doctor_response": "Hello. We normally measure serum creatinine values in a few medical conditions. Serum creatinine is a very important determinant, since it is a waste product. Its elevation in the serum points some kidney disorder such as glomerulonephritis, pyelonephritis, UTI (Urinary Tract Infection), acute renal failure, dehydration, shock or acidosis. Normally the range is between 0.7-1.3 mg/dL. Even a minimal increase is considered to be significant. There are few treatment options available to lower the creatinine values such as Diet modifications, Through Medications, Dialysis and Hemodialysis. For more details consult a urologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Clear runny nose, sneezing, viral fever mostly at mornings. Possible kidney issue or sinus infection?\n\nHi Doctor, I have clear runny nose and sneezing , particullarly while wake up in the morning. Allegara and cetrizen tablets wont helped for this.Both the tablets , just stopped the runny nose for 1 day. Same for Nasonac spary - Just stopped for one day. When I wake up in the next morning - again sneezing & running nose started. Met doctor and took CT scan . There is no sinus infection . Met doctor to check my lungs. They make a test by checking my air pressure and told no problem. I noticed that I have high sneezing and running nose - when I took a water. Based on water quantiy - the symptom is increasing or decreasing. In the past - I have sneezing only after path. It is just 5 minutes. I got severe viral fever last year. My Platelet count got reduced to below 1.5. When I am ok - the running nose started and continuing till date. I have polups in my left nose and my nose bone is not in a stright position. Is there any chance for fluid leak ? Is there any chance for lung infection ? Is there any chance for Kidney problem? I feel like my nerves are lakcing the strength/weaken day by day.. My fingers are making typing after sneezing. Can anyone cure this problem.",
    "doctor_response": "mosstly in viral fever when you use antibiotics paracetamol and viamins your viral change to allergies now you are having allergies you should consult allergeologust for treting allergies some tips i give you take plenty of warm water take antiallergic ebastine 10 mg night daily for 4 week apply neomycin h eye ointment in nose bd put sea water  drops each nostril night avoid milk and diary no ue of heavy oils like mustard coconut walnut groundnut soya use olive for cooking and application",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diabetic, hypertensive and IHD with stent done, may have gallbladder cancer. Is it chronic inflammation?\n\nMy father who is diabetic hypertensive and IHD with stent placement done in MAy 2012. now doctor while taking ultrasound is suspecting Gall bladder cancer , so MRI was taken. Doctor told its stage IV with liver and periportal lymph nodes ivolvement . Doctor suggested palliative open colecystectomy? Father is right now very fine doing his normal duties, no symptoms. I went to take second opinion from another doctor. He ask for CT scan saying MRI is little doubtfu. it might be chronic inflammmation too. Now is a CT scan actually required? Other people are telling not to subject him to surgery as it will only torture him. Please advice????",
    "doctor_response": "Hi, Contrast enhanced CT scan can confidently comment regarding liver metastasis and enlarged periportal lymph nodes. If on CT scan these findings are found out then probably stage IV disease can be diagnosed. Then a FNAC can confirm the tissue diagnosis. If the disease has already spread to that extent it will be better to put the patient on chemotherapy, surgery will not be very helpful. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Light headed, anxiety, depression, breast tenderness, frequent urination, pregnancy or stress symptoms?\n\nHello, I am 21 years old, and last had my period starting on March 20th, and ending on March 26th. I have been feeling light headed, anxious, depressed, sore, breast tenderness, constant bathroom trips; urine and poop; as well as I have taken a home pregnancy test that came up negative a few days ago. I am trying to figure out whether I am pregnant or this is all stress related. Can someone help me depict whether or not this is just stress related or if I am pregnant?",
    "doctor_response": ". Your next cycle should be on around 20th april,if it missed and with your described symptoms there is a chances of pregnancy.Sometime urine pregnancy test gives late result.Do it again. Better go for USG and consult your gynecologist for confirm diagnosis and better further management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Getting unwanted thoughts, taking Riswlplus. Chest pain, running nose, producing more saliva. Curable?\n\nmyson is 22yr old he gets lot of unwanted thoughts like as if he has extradinary power even if the train hitts him the train will get damaged but he will not.he assume him self as if he lived with a girl of his classmate and got a child.Their parents wont allow him to go out his native after his studies completes.some body keep on tells some thing not study becuse they including himself to devil family.some times he saya to their parents they are not his parents. this conditions persits for the last two years.after consulting the doctor takes RISWLPLUS two tap per day. now he seems to be improved.but the side effect of kiddyness chestpain,running nose,over salaiva from the mouth producing is going on.once stop the medicne he feels comfort. Buthe get old un wanted memmories  and smile himself now and then when he is alone. My question is IS IT CURABLE.What is the best medicine to be followed?AND how long the treatment to be continued?",
    "doctor_response": "HelloThe symptoms you have mentioned like thoughts of having power, belief that he has been married to a girl and has a child also or simple delusion, suspiciousness etc commonly occur in Psychotic Disorders. As he is just 22 so most likely either he is in prodrome or he is having full blown Schizophrenia. I need some more details of symptoms to clearly delineate the exact diagnosis. The drug resperidone is very effective in controlling the psychotic symptoms but the side effects like sedation, movements in body, tremors and in his case excessive salivation are really bothersome. I would advise you to consult his psychiatrist regarding the side effects especially salivation. Medicines like THP can effectively control the symptoms. The disease can be controlled easily with proper drug therapy and family support.Hope this helps you, thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high ALT and AST?\n\nI have a history of high ALT and AST (currently and recently tested they are: ALT 129 and AST 73). Doctors have done many tests and even a liver biopsy. I do not have Hep A, B or C; my liver biopsy didn t even show fatty liver. My gall bladder was removed about 10 years ago, but well before that even I tested high ALT and AST. One doctor tested for autoimmune hep and my markers came by positive but low. I was just placed on generic Lipitor and Losartan for blood pressure. Any thoughts?",
    "doctor_response": "HelloIncreased ALT may indicate liver injury.It may be due to many reasons like hepatitis,alcohol intake,altered lipid profile, medicines,auto immune causes etc.It may be related to autoimmune heaptitis in your case.You have been prescribed right medicines.Lipitor is advised for altered lipid profile.I also suggest tablet ursodeoxycholic acid 300 mg twice daily for three months to my patients.It helps in regeneration of liver cells.AST in non specific and it increases in many conditions.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nausea and headache while moving head?\n\n10 yr old boy nausea and head aches when he moves his head\u2026fatigue\u2026.has been going on for weeks, treated with antibotics presuming a sinus infection. This is a nephew who lives in Arizona. I am thinking could be a number of other things like menigitis (sp?) He has not gotten better with antibotic treatment\u2026they just changed the antibotic.",
    "doctor_response": "Hi...I feel that this could be a vertigo as it is associated with positional change of the head. This is not meningitis as it cannot go on like this in a 10year old boy like this with out manifesting any other symptoms like seizures or altered sensorium.  I suggest you get him evaluated by an ENT surgeon and then proceed as advised by him/her.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I substitute levolin to inhaler or can I take for life long?\n\nHi, I am 20 years old and im asthamatic. I have undergone treatment and have been better for about two years after which it has started again. My doctor had prescribed me levolin as an emergency medication ,budate as my regular medication along with a tablet of montair lc every night(tablets for two weeks). The montair lc make me feel much better and keep me covered the whole day and i do not even need to take my inhalers. But the problem is whenever i try to skip these my symptoms come back i.e wheazing and coughing(particularly during the night). I have noticed that during this bout if i take one tablet of these,the symptoms subside in about half an hour like magic. I have been taking this drug for the past 2 months now continuosly. I am afraid that i might be dependent on them. I also do not want to take my inhalers since i am overweight and it just makes me bloated. Can i substitute the anti allergics for my inhalers. And can it be used as a long term medication. If used what could be the possible side effects to these drugs. Thank you.",
    "doctor_response": "hello,thanks for your query, your montair -lc ia a prophylactic drug used in allergic rhinitis and asthma. if ur comfortable with montailr-lc , continue one tab at bed time,use inhalers during acute episodes. it can be used for 4-6 months ,then it should be withdrawan by tapering.as such sedation,constipation it causes ,no other harmful side effects.hope i have answered your query,all the best. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes knot in forehead of a 2 year old?\n\nAbout a month ago my two yr old daughter had a knot that came up on the fore head,the same nite it went down then the next day it came back out. This morning it came back up,she layed down for a nap and it went down.Later tonite it came back out.She says it does not hurt or itch.",
    "doctor_response": "Hi, welcome to HCM. Knot at forehead in a 2 year old child could be due to insect bite. In insect bite, there is redness and swelling at the site of insect bite which usually itches. In my opinion, you should give hydroxizine syrup 5 ml PO three times a day for 3 days. Review after 2 days. I hope this will help you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could headache and arm bruising after wakeboarding injury be serious?\n\nMy boyfriend was wakeboarding and fell in the water and he blacked out for like two seconds then couldn't move his body. He's moving around now and claims he has a really bad headache. His arm also turned purple but its turning back to its normal color now. Is he okay? What should we do?he's 18, 6'3\", and has no medical history, 170 lbs",
    "doctor_response": "Severity of the injury needs to be really assessed.Transient loss of consciousness and severe headache are very bad signs.And are an indications for ct brain study.So to really know how bad us the hurt please consult at emergency.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the sperm count normal?\n\nMy test report result. SEMEN ANALYSIS Amount 3ML Liquified (within 30mins.) Liquified My test report result. Motile (after 30 mins.) Motile 50% Sluggish 25% Non Motile 25% Abnormal % WBC 3-5/Hpf RBC /Hpf Count 40 Million/Cc Pllease explain this report",
    "doctor_response": "Hi, Welcome to HealthcareMagic . According to your report your sperm count is normal. Also the motility is good. Other parameters are also fine. So with this you should not get any problem in getting your wife pregnant unless she has any fertility problem. You may try for natural conception.  Hope I have answered your query. RegardsDr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the methods to heal a disc prolapse?\n\nmy  mother in law is suffering from  disc prolapse what  are the methods to heal it when we have done the mri scan docter adviced to take injection  in the disc is ther any sideeffects for this and success rate of this procedure and cost of the procedure......... can u explain sir",
    "doctor_response": "Hello Thank you for trusting HCM Dear probably your doctor advised epidural steroid injection (esi), many patients feel some pain relief after injection. If pain relief not more require 2more injections 1 to 4week intervals. Side effects less. Common side effects infection, allergic reaction, bleeding and nerve damage etc.. Other methods like physical exercise, heat and cold therapy, cheerio practice,and stretching. If symptoms not improved need surgery. Please consult your doctor he will examine and treat you accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could dry, flaky and itchy pimples on skin refer to?\n\nDry, flaky, super itchy skin with small pimple like things on my back, hips, chest , upper shoulder and thighs, itching is so bad at times I draw blood, but I can't control the itchy feeling, scratching makes me feel like heaven at times specially when I come back home from studies. I have been treated for acshene, bacterial infectiousness many other diagnosis this problem I have from last 5 years and I have consulted many doctors.",
    "doctor_response": "Hello,Thank you for posting on HCM.It\u2019s very difficult to approach conclusive diagnosis unless for proper physical examination, anyways from your description it seems you are suffering from scabies.Scabies is a contagious disease caused due to mite and it spreads among people who are in close physical contact and by use of common household articles.Treatment is pretty straight foreword. Firstly, i would suggest treatment of your secondary infection (if any) with oral and topical antibiotics.The key to successful treatment of scabies lies in treating everyone simultaneously in the family and others who are in close physical contact. Your doctor would prescribe oral drugs like ivermectin which will kill the parasite. You might also be advised application of permethrin 5% cream and a corticosteroid with fusidic acid cream. Apply the medicated creams exactly as advised by your doctor. Take antihistaminics as advised to relieve itching and irritation. Avoid sharing of clothing and toiletries and launder all you bedding and clothes in warm water.Hope this will take care of your issue.Wish you best of health.Thank youDr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for low back pain ?\n\nI have had lower back pain which may have been caused by heavy lifting for over 2 months now. It is getting more and more severe. It hurts to sit and to bend over. I also think it has caused constipation. I was prescribed Naproxen for the pain and cycloprine as a muscle relaxant. They only moderately help the pain and I wasn't satisfied with the doctors check-up. It seems to be getting worse still. It is making it very difficult for me to work let alone get in and out of the car. I am 20 years old, 6ft, 180lbs and I am very active and healthy otherwise. Any ideas would be greatly appreciated so that I could take some knowledge with me to the doctor next time.",
    "doctor_response": "In all probability we would suspect you to be having Spinal problem. It could be Muscular spasm or pull of muscles around the spine, Disc Prolapse, Discitis, Spondylosis. To confirm the same the doctors run few tests like X-ray or MRI of your spine. Most of the back pains fully recover with complete bed rest and later with appropriate physical therapy. Most of the patients doesn?t recognize the importance of Complete Bed rest ( ambulation only for nature calls)  so we want to inform you  that you may have to be prepared to take off from work for some days completely as recommended by your doctor.  Any back pain not responding to usual treatment  and rest needs to be intervened promptly. Moreover not able to sit in the car, Constipation are not good signs to wait.  We would suggest you to consult an Orthopedician immediately for further evaluation and management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes weakness in the leg and hand despite a normal CT scan?\n\nI woke up Saturday and could barely walk. Right leg tried to buckle and I felt like a deer on ice. Sunday I woke up and my right hand was not working properly. I can t sign my name. I had a CT scan done and they said they couldn t see anything. I was taking zocor 40mg for 4 days. I stopped taking it immediately.",
    "doctor_response": "Hi, If the simvastatin was the culprit, symptoms should regress after stopping it.If the symptoms persist, I suggest you to consider cervical spine problems ( stenosis, herniation, etc.) as a possible condition.MRI is a more specific radiological examination in such cases. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for red, long, infected abdominal scar\n\nI have an old, long, abdominal scar that has recently become red and infected in part of it. When I realized it was infected I began to apply peroxide and neosporin twice daily keeping it covered. The infection has improved but is still there, it is still red, the wound is still open and after six weeks is now not improving. Any suggestions?",
    "doctor_response": "Hi,Welcome to HCM!Sorry to hear about your problem.Since your scar is infected, merely applying the lotion/powder on it won't suffice. You will have to take an oral antibiotic course. The wound may require closure again and hence, I'd suggest you to visit your treating doctor and get it sutured again. Also, it will need proper dressing.Also, I'd like you to get your blood sugar investigation done. A common cause of non-healing wounds and recurrent infection is Diabetes. Hence, it's bettr to rule it out.Hope this information helps. Feel free to ask if you have any doubt.Wishing you a speedy recovery.Warm regards,Dr. Sridhar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause of eye swelling post eating peanut butter in one with severe anxiety ?\n\nI have never had allergies before, up until this year (some sinus issues on and off, but nothing major). About 4 months ago I had a few episodes were my eyes got very itchy and dry on and off and a few times I had some eye symptoms...minor swelling of the right upper eyelid , twice had a bubble which looked like a mosquito bite form under the eye (one time each eye) and another time I woke up with small to medium size bag under my left eye. Each time I felt fine other than the small amount of swelling and each time it was only in one eye, never both. In fact, most times I didn t realize until I went and looked in the mirror and then got scared after seeing the small amount of swelling. I also saw an eye doctor last fall after the first issue with it and the covering of my left eyeball was slightly fluid filled, which he said was due to an irritant and nothing to worry about. We had also found some black mold in our basement at that time that a plumber opened up the ceiling (so conceivably, some of these mold spores may have come out into the air...I had had no issues before this). I am now about 120 pounds (was 140 before I lost the weight) and female and 45 years old. I am a very nervous person and had been under severe stress for several months. It was during this time I started getting the eye symptoms. So stress, the mold issue and most likely the start of peri- menopause may all be contributing. Two of times I got the eye symptoms I had eaten peanut butter....but many hours beforehand. One time it was probably between 4-6 hours earlier and the second time, it was about 10-12 hours earlier. I had also had peanut butter in between with no symptoms. Each time I felt fine other than later on getting some eye symptoms. I had also, due to the stress, had lost 20 pounds during those months and once became dehydrated. Both times I had gotten the little bump under my eye (like a mosquito bite), I had been under acute stress both those days. Those are the only 2 times that ever happened. My general physician feels it s all stress-related and also seasonal allergies (I seem to have a little bit of hayfever). He said my symptoms are not consistent with food allergy or peanut butter allergy. Since not having any peanut products, I ve had no eye swelling, bags or bumps, but my stress level is also a LOT lower now. Should I get a blood allergy test for peanuts or is it mo",
    "doctor_response": "Hi, Thanks for writing in. I think you should get yourself tested for an allergy to peanuts. Its unlikely that stress or hormonal issues are contributing to these allergies. I would suggest that you steer clear of peanuts for the time being as allergic reactions can be very severe  at times ( fatal reactions have also been reported) Try and reduce your anxiety levels with deep breathing and yoga. This should benefit you a great deal. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is smoking marijuana be the cause for blood clotting disorder?\n\nI have a DVT in left leg and am curious is smoking marijuana compared to cigarettes puts me at risk or if marijuana will affect me as ive also got a blood clotting disorder and am a geno 4 type MTHFR. I also am taking injections of lovinox 90ml 2x daily, along with warafin 5mg 4x daily and 7.5mg 2x daily will marijuana hurt me",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern.  You should stop smoking marijuana.  It will definitely hurt you with your deep vein thrombosis. If you get any withdrawal symptoms then consult your doctor and take treatment accordingly. You can also go for rehabilitation. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for loose stools?\n\nHi, I just came to China. I've been here for about 2 weeks. Since I arrived I have made a strong effort with the help of my girlfriend that lives here to eat as well as I can knowing the unreliability of the food they produce here. I'm not sure if this is the issue but since I arrived my stool has become more and more of a liquid. Previously it was nothing serious, it seemed more remnant of something like eating too much spicy food back home but recently as in just this day all my poos have been pure liquid and very frequent. I don't really feel nausea or stomach pains. I just seem to have to poo a lot and every time its all very watery. What is it and what can i do? Are there any natural way of dealing with this without going to a hospital?",
    "doctor_response": "Hi WelcomtoHCM As you are caught in  the rigmrol of atmospheric change from upset problem is not to be ruled out .But you shold take care of  the intake  of lots of fluids   and refill the defeciency of electrolytes you suffer by frequent  poos include weak tea with a little sugar, sports drinks such as Gatorade, flat soda pop (decaffeinated flavors such as ginger ale are best), and fruit juices .Drink plenty of fluids. Consume two quarts (eight cups) of fluids a day, three quarts (12 cups) if you're running a fever. Plain water lacks electrolytesyoghurt can help produce lactic acid in your intestines, which can kill off the nasty bacteria and get you feeling better, faster. Start semi liquid porridge when you recover . you can take banana  and curd , curd and thinly cooked rice for 2-3 days Thats all you have to do.And if required dont shirk from going to doc for guidance hope this helps solve your  query . Take care all the bestDon't hesitate to come back if have any further query",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat swollen lever and TB?\n\nSir I am From Raipur. My mother is around 70 years old. She is suffering from Stomach pain since last 2-3 months. As per doctors instruction we have done certain test and I found that my mothers liver has swollen and on the basis of tests symptons of TB is also noticed . what shall i do whether we have to give treatment for swollen liver first before starting medicines for TB",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. She has tuberculosis and liver inflammation.  She should go for complete liver function test including baseline SGPT level and ultrasound study before starting anti tuberculous treatment.  Because mostbof drugs in anti tuberculous treatment are hepatototoxic and damage the liver.  So she should plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed swollen taste buds v shape, red swollen bumps back of tongue, taking mono. Normal?\n\nI have had mono since two months ago & recently got tested again for anything else. Everything was negative. But I looked at my tounge one day & my taste buds was swollen in a v shape in the back of my tounge. & I looked further back and there is a ton of red swollen bumps is this normal? What is it? & there is kind of white a round the v shape.",
    "doctor_response": "Hello , Thanks for writing in. The swelling of taste buds may be due to ulceration/inflammation of tastebuds. Avoid anxiety and stressful works. vITAMIN rich fruits and plenty of fluids can be taken. Avoid  intake of hot/spicy/salty food items. mAINtain good oral hygiene. Take vitamin becosules,iron,folic acid supplements. Please do get clinical check up by a dentist. hope this suffices.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can fnac liver biopsy cause fever and body aches?\n\ni had undergone fnac liver biopsy test three days back. i m having pain in my shoulders, headache,possibly on right side . i m having tooth ache and joint pain and fever. joints in my wrest,knee and ankle is paining more.i m taking 250 mg paracetamol for fever. after the test they didnt made me to remain in observation and they didnt check my BP . few days before they took blood test to know my blood clotting time etc. after the biopsy i came home and now i m suffering from fever and full body pain. is this because of the side effects of the biopsy or something else? please answer my question and make me to comfort to come out of my fear like anything. i will give my handfull of thanks to u if i get an answer.",
    "doctor_response": "HIIt's possible that you've developed an infection in your liver after the biopsy so you need to see a doctor right away for an ultrasound of the liver and a course of antibiotics",
    "dialogue_context": ""
  },
  {
    "patient_message": "My father is suffering from multiple system atorphy\n\nmy father age is 54. he is suffering from MSA (Multiple system atorphy). I went to a nerologist and he told this. As per him there is no diagnostic for this disease. could some body please help me i have read in internet that this disease can not be cured and sysmtoms will worse with time. Please suggest me any medication. please..",
    "doctor_response": "Hi, welcome to health care magic forum, Yes Multiple organ atrophy is a rare condition. In Homeopathy the medicines are not prescribed on the basis of disease you are suffering, but they are prescribed on the basis of symptoms, that is the reason why in Homeopathy you can treat number of complicated and incurable diseases, like multiple organ atropy. So you i think you should start Homeopathic treatment for your father, for more info mail us at info@drkackerhomeopathy.com or visit us at www.drkackerhomeopathy.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Ultrasound shows myomas, bulky uterus, follicular ovarian cyst. Treatment?\n\nI am 42 years old. trying to conceive for my second child. but my ultra sonogram report says that bulky non-homogeneous uterus with uterine soft tissue masses (myomas). Follicular cyst in left ovary . I feel that there is something is stuck with my belly button and having pain and bleeding. advice me how can i conceive.",
    "doctor_response": "Hello. Thanks for writing to us. The ultrasound findings are suggestive of a myoma which might be causing a difficulty in implantation. Follicular cyst is a physiological finding and does not affect the fertility. You can consult an infertility specialist for proper guidance. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for narcolepsy\n\nMy Dr has suggested that I have narcolepsy and is suggesting medication. I am 68 years old and had a heart attack when I was 57. My blood pressure and colestrol are being controlled by medication. Is it safe for my heart to take medication for narcolepsy?",
    "doctor_response": "If you truly have narcolepsy then, a sleep study which includes what is called a MSLT will give you the answer and would be a much better thing to do in order to verify the diagnosis rather than blindly taking medication that can affect the heart and also has other side effects that I'm sure you'd rather NOT have.If you would like a more comprehensive consultation please write me at: www.bit.ly/drdariushsaghafiPlease rate with HIGH STARS if so inclined and click THANK YOU.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have started bleeding heavily in my postpartum. What to do?\n\nHi doctor, I am currently (almost) 6 weeks postpartum. I had sex at 4 weeks of postpartum and I got the Nexplanon inserted a couple of days before that. My doctor checked to see whether my uterus was still up high and it was not. Also, I did not have any tearing during birth. My bleeding stopped at 2 weeks of postpartum. But, after I had sex, I started bleeding heavy with bright red blood. I am still bleeding. I am breastfeeding, so I was not expecting a period for a while. Yesterday, I started getting terrible cramps and my stomach looks the same as it did at 20 weeks pregnant. I feel bloated and the left side is really hard. I am having terrible cramps on the left side. Everything that I have been eating in the last two days, have made me so terribly nauseous. Also, I am having pulsating pains in my rectum and my vagina.",
    "doctor_response": "Hi. Revert back with the reports to an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can infertility be treated?\n\nI am married since past 7 months me and my husband are trying since then to have baby. I was fortunately found pregnant in the month of July. But i do not what happened after 5 days i started bleeding as a normal period. The after 10 day i started bleeding heavily with full pain in my abdoman for 15 days. I consulted to Gynaecologist then in UAE (Dubai) she said it was just chemical pregnancy. Nothing worry. Since then i have irregularity in my cycle. My haemoglobin count is also decreasing. Now its more than week i didnt get periods, yesterday i went to doctor for B HCG test it showed negative. I am really stressed for my pregnancy. Please help me out with good suggestions so that I can conceive as soon as in a month. Thanks hoping for your best solution in this case",
    "doctor_response": "Hi there,I have understood your concern and I will suggest you the best possible treatment options.I will suggest you to get USG done to know if there is PCOS- polycystic ovarian syndrome as a cause for your irregular cycles.If so opt for a healthy diet and regular exercise regime. Include more portions of fruits, vegetables and salads in daily diet. Avoid refined sugars , deep fried foods and bakery products. Start on Folic acid and Vitamin B 12 supplements.Please get postmenstrual HSG - Hysterosalpingography done to know about the patency of Fallopian tubes.Please seek assistance from your treating doctor for ovulation induction medicine like Clomiphene, and get follicle study done to know the day of ovulation.You can opt for natural intercourse on and around the day of ovulation or opt for IUI- intrauterine insemination on the day of ovulation.Think positive.Meditate regularly.May God bless you with a bundle of Joy.I hope this answer helps you.Thanks Dr. Purushottam Neurgaonkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to control blood pressure\n\nI am 68 +6 02 -228lbs......don t smoke and don t drink alcohol....I exercise daily and my heart rate resting is normally 62-65....however my BP is 145/86 when I first taking it...but will lower after resting 10 mins to 130/78 or so.....is this acceptable?????",
    "doctor_response": "Hi welcome to HCM.I understand your query and concern.Blood pressure needs adequate control in your case.Maintain Blood pressure below 130/80 mm of hg in your case.Your blood pressure is slightly on a higher note.I advise you to have a baseline 2 dimensional echocardiography,ECG and lipid profile to assess the basic cardiac reserve of your heart.Restrict the intake of salt to less than 6g/day.Regular physical exercise in the form of brisk walk for 20 min a day for 5 days a week is pretty useful.Drugs like antihypertensives ex metoprolol once or twice a day will help will help.Reduce the intake of fatty and fried food.One pomegranate a day will help to keep your heart at good pace without clot formation. Weight reduction will help to control the blood pressure an well Consult a Cardiologist for further expert management.Post your further queries if any.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can ibuprofen be taken for back pain while taking atenolol for high BP ?\n\ncan ibuprofen be taken for back pain while taking atenolol for high blood > pressure?   can ibuprofen be taken for back pain while taking atenolol for high blood > pressure?",
    "doctor_response": "In MOST cases, but check with the prescriber of both drugs before you mix them.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My wife's benign thyroid nodule shows some changes in scan. Please give your opinion.\n\nHello doctor, My wife got scanned her thyroid by a novice user just for training purposes. She has been scanned in the hospital before, as part of an assessment of an autoinflammatory disease. At this time, they found a thyroid nodule (~12 mm) but no further investigation, as it seemed benign. Now, at the training scan, we observed the nodule had changed in shape, size, and it looks like there are some microcalcifications. But we are not the experts. We noticed it has changed. Could you give your second opinion on the attached images?",
    "doctor_response": "Hello. According to the american college of radiology thyroid imaging reporting and data systems (TIRADS), the nodule falls under category TR4, which defines it as moderately suspicious. However, as you mentioned, there is a change in morphology with the development of microcalcifications. Microcalcifications are the feature of papillary carcinoma of the thyroid, and therefore, it is essential to rule out that for which a fine needle aspiration cytology and biopsy (FNAC-FNAB) is recommended. Further, I would like to know if any necrotic neck nodes were detected. Let me know the results. I hope and pray that the nodule turns out to be benign and not malignant. FNAC-FNAB  Ultrasound guided fine needle aspiration cytology and biopsy. Papillary carcinoma of thyroid and benign colloid nodule.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching all over the body?\n\nRecently i have an itchy and pinching feeling all over my body that lasts for a few minutes and dissipates. It appears to be an allergic reaction since when i take Benadryl it ceases for a day or 2... My PCP refeered me to an allergist which i m seeing later this week. I was diagnosed with celiac 2 years ago so thought i read that could cause itching as well ... Any thoughts?",
    "doctor_response": "hi sir/madam,Thanks for your question on Healthcare Magic.these allergic reactions can be easily treated in Ayurveda.Allergy is a hyperactive response of the immune system to particular substances called allergens. These allergens may be food, pollen, dust, drugs, molds, air-borne, dog, cat, mushroom, soy, gluten, etc. Sometimes, it may be for short times or continue for longer periods.before going for treatment we should focus on to prevention of this problem.The main causes of allergy are:-1. Infectious diseases at childhood2 .Pollution3 .Food allergies to peanuts, pecans, pistachios, pine nuts, and walnuts etc.4. Latex sensitivity5. Hereditary6 .Hives7. Eczema8. Redness9. Swelling 10 Abdominal crampsYou can go for these test for your allergies:-1. Upper endoscopy.2. Skin Test for allergy.3. Blood test for allergies-RAST and ELISA.4. Food allergy testing.Doing yoga will also help you in this issue,the yoga's like:-1.Matsyasana:- It is a good aasana for those people who suffer from asthma, bronchitis and other lungs ailment thereby relieves congestion.2. Sarvangasana:- It  helps in clearing of exchange of gases through the nasal passage.3. Tadasana:- It improves concentration of mind and develop sense of balance.4. Padhastasana:- It improves concentration and helps to decongest the nose.5. Trikonasana:- It systematically revitalizes the entire body.6. Padmasana:- It induces mental calmness and helps to bring about physical health and mental equilibrium on permanent basis.7. Bhujangasana:- It expands the chest more than usual, helping to improve one\u2019s breathing.8. Paschitmoasana:- It  tones all the abdominal organs, including the liver, pancreas, spleen, kidney and adrenal glands thus helps to mental calmness.9. Pavan Muktasana:- It relieves from abdominal ailments associated with malfunctioning of inefficient organs.You can see these yoga aasan in the internet for better understandings.Simple home remedies for allergy which you can do yourself at home itself:-1. Warm water gargling with salt helps to treat it.2. For inflamed eyes, use the mixture of lime+ mallow + chamomile tea.3. Quince + Honey + Lemon show a good impact on the throat.4. Eye irritation may be reduced washing it through cold water.5.Keep yourself away from allergens.6. Hot shower is effective to ward off allergen and may be used as skin.7. Use sunglasses to protect your eyes from pollen, mites, dust etc.8. Dust mites favour humid place that may spur the condition.9. Hay, straw and grass b",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for erection problems due to frequent masturbation\n\nDear sir iam suresh from chennai . my age is 29 married iam having past 7 years masterbason . iam not satissfy my wife and my pines 2.5 inch in normal time.sombody told dont consult dr. any medision take after few month same problam came . but I WANT ANS UR SIDE SIR REFER MEDISION",
    "doctor_response": "Hi thanks for contacting HCM...You are doing masturbation since seven year ...Now after marriage you cannot satisfy your wife ...Here mostly it seems to be performance anxiety mainly .....While doing sex fore play done more ....Do sex in comfortable position and be relax....If you are overweight lose wright ...Regular exercise done ...Avoid smoking and alcohol....Take healthy and balanced diet....If still problem there investigate with.....-RBS for diabetis -Serum cholesterol -blood pressure measurement -rule out cardiac history -serum testosterone and prolactin If you are using certain drug like thiazide diuretic then also problem can occur ...These is all I explained you us for your good education and help in resolving your problem...Sidenafil like drug useful that can be taken 30 minute before ejaculation....Consult psychiatrist for that .Dr.parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Developed stinging pain below shoulder. Having physio for a chronic back problem. Have sciatica and prolapsed disc. Guide\n\nI have recently developed a sharp stinging pain immediately below my right shoulder blade, when I make certain movements.  However, sometimes I can move without the pain.  It's like a hot needle.  Recently, I had a simiilar pain in my right 'breast' (I am male) but this seems to have sorted itself out.  I'm 54 y.o., 6'1\", 14 st 10 lbs (on Weightwatchers - down from 18 stone) and have recently been having physio for a cronic back problem (scatica since 2004 and prolapsed disc(s) in 2009).  Over to you, doc.  What's up?",
    "doctor_response": "Hi,Thank you for posting your query.It is possible that you have a pinched nerve in the neck/upper back, due to bulging of disc at that level.At this moment, in addition to physiotherapy, you could take pregabalin or gabapentin capsules. In case your pain persists, you could get your MRI cervical spine done.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump in the left side of the chest?\n\nHi my husband  has a medium sized hard lump on the left side of his chest about an inch above the nipple.  It has a yellowish bruise on the skin for about a week now....the bruise is about the size of a small childs fist....making an appointment for him today but I am worried",
    "doctor_response": "HI,Dear,Thanks for the query to HCM.1-I have studied your query in depth.2-IN my opinion, this medium hard lump on left chest above nipple with yellow bruise for a week , appears to be -hematoma -if any recent trauma is there, which you havent clarified -as the bruise could be after some trauma only.3-The yellow hallow around the lump -is the recovering induration and should not worry you much.4-On Hardness of the lump -I would advise-a-NSAID ,b-Surgeons conultation , c,-not to worry, as it would resolve in 2 wks time with proper care as told above.5-I would advise you to consult ER surgeon URGTLY-as the severe pain could be damaging to your testes.5-Hope this would solve your query to your satisfaction.6-Wellcome for more queries to me On HCM.7-Thnks once again for your inquisitive query.Have a Good Day..!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cheek pain after having tooth extracted. Taken Amox and Lortab. Worried\n\nExcruciating pain in cheek (or my son calls it a sore on the inside of his upper cheek close to the gums) 4th tooth from the front (upper) extracted yesterday and he is having sharp pain in the area.  Tooth seems fine, no pain there.  Saw dentist today who took another xray and said there was no root left, so pain should be ok.  Was given amox as a precaution and lortab for pain management.  Just worried because the pain seems so severe and its not evenin the tooth or gum area.  What are your thoughts?",
    "doctor_response": "Hi,Thanks for asking the query,Pain and swelling are common complications after tooth extraction.As you mentioned that there is no root piece left so there is no need to worry. Just follow the post extraction instructions given by the Dentist properly.Take the complete course of antibiotics and analgesics prescribed to you.You dont worry about the symptoms it can be because of trauma at the time of extraction which will subside after sometimes on its own.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have potential borderline personality disorder, possible depression.  What can I do?\n\nHi, I have become concerned recently with my state of mental health, I am usually just about able to cope with day to day life but I feel that potential boderline personality disorder and possible dpression are holding me back from a lot of things and I can't really go anywhere in life at the moment. I want to visit my GP to possibly get reffered to a mental health professional but I am not sure of the steps involved.",
    "doctor_response": "Hi, Thanks for using healthcare magic. You should consult psychiatrist for detailed evaluation and treatment if required.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the stomach with spots?\n\nHi, my daughter has got red spots with a yellow head on her stomach and the top of her legs. She has complained of headache and stomach pain, feeling sick but nothing serious. No temperature. She has had chicken pox before, I think these are different.",
    "doctor_response": "hello,better do get them examined by a dermatologist for the exact diagnosisas they cannot be easily diagnosed without seeing them,,,follow their instructions..things will improve",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of mycobacterium tuberculosis infection?\n\ni m detected with mycobacterial dna pcr with species mycobacterium tuberculosis complex, what it is actually, and what can be the consequences?i am given medication RHE FD Tablets, zoncovit, liv-52. doc suggested to undergo a surgery after 3 months....",
    "doctor_response": "Hello. Thank you for your question.From your results , I understand that you have been diagnosed with Tuberculosis.Let me try and explain it.Tuberculosis is a bacterial infection.It is called Pulmonary Tuberculosis when it affects the lungs, although it can affect other parts of the body such as gastrointestinal tract, central nervous system etc.The treatment is a combination of drugs known as antituberculous drugs.The duration of treatment is usually 6 months although it can be longer for different parts of the body affected.Hence it would be useful if you mention the site of infection.Your physician will do some blood tests before you begin treatment, such as your liver function tests.This is done in order to detect any drug side effects during the course of your therapy.Even though the duration of treatment is long and there are potential side effects for the drugs used, in majority of cases , the Anti TB regimen has been found to be highly effective in clearing the infection.Hope you have found this information useful.Thanks Dr. Alex",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of non union after big toe fusion?\n\nHi had big toe fusion 7 weeks ago due to arthertic joint. Got infection in scar and orthopedic doctor says ive got mobility in joint still. I had non union on other big toe last year and hope it doesnt happen again...he used titanium plate and 6 screws so surely it shudnt move at all any info would be good thanks",
    "doctor_response": "hi,thank you for providing the brief history of you.A thorough musculoskeletal assessment is advised.As, the toe is a small bone and any surgery performed will be totally dependable on the metabolism of the individual. Also, due to infection the healing is delayed and the non union is possible. As you are having arthritic joint, there is a possibility of less calcium in the bone and the bone is small to have proper calcium deposition.For the non union, there needs to be the use of the bone graft to advance healing and the union can be expected.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for rashes on breast spreading to stomach?\n\nrashI have a rash on both breasts which is spreading to my stomach, these bumps are slightly raised and peeling in the centre, as they get bigger the middle turns a yellow/brown with a big ring border, only itches if im hot? what could this be? thanks",
    "doctor_response": "Hello,Thank you for posting on HCM.It seems you are suffering from Tinea corporis, a kind of fungal infection.I would suggest you to consult your dermatologist for proper management of the condition.I usually recommend proper course of oral anti-fungal drugs like Fluconazole or Itraconazole along with anti-fungal cream like luliconazole for local application at bedtime. You can additionally use antifungal dusting powder containing sertaconazole during day time and a soap containing ketoconazole for rinsing of affected areas. Take oral antihistaminics for itching as required.Maintain hygiene over those areas and avoid wearing tight undergarments.Hope your queries are resolved and wish you best of health.Kindly spare some time to rate my answer and drop your valuable review at the following link:  you require any further assistance in future, you can reach me directly through the above mentioned link.Thank youDr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pregnancy be delayed for two years after recovering from TB?\n\nI am a 25 year old female and I have been undergoing treatment for TB (uterus) which would last for 6 months. I have already completed 3.5 months, I was told I can start trying to conceive after 4 months into the treatment. I want to know if Ii can wait for another 2 years before getting pregnant or should I get pregnant immediately to reduce infertility. Please help",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Better to plan for pregnancy as early as possible after completion of treatment for tuberculosis. If  you wait for few more years there maybe unforeseen complications which can lead to infertility as you are suspecting. But if the postponement of pregnancy is must to you,  you can follow with regular check ups, checking with ultrasound, monitoring AMH levels, hysterosalpingography etc. If everything is normal,  you can wait for few more months and can plan pregnancy.  But better to take advice with your treating gynecologist who will be more aware of extent of your problem. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had miscarriage, want to concieve again. When will be the ovulation date?\n\nhello doctor, i want to conceive again, lost my baby in January. had my periods on October 8, my last periods was on 26 of June and i had bleeding till 26 of july. then my next periods was on October 8 and over within a week. can i know when will be my ovulation date? and also some do s and dont s after ovulation, because i want to conceive for sure this time. please do help me out doctor.",
    "doctor_response": "Hi, As per your history, you seem to be having irregular cycles recently. If you were having regular cycles previously, the cause of this irregularity should be found out first. For this, you need to see a gynecologist and get examined and investigated. You may need hormonal profile and pelvic sonogram. If you are not ovulating naturally now, you may need induction. The period for conception will be around the day of ovulation as the ovum remains viable for one day after ovulation. So, in a 28-35 day cycle, the period for conception will range from 11-20 days. Please get further advice from your doctor. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Lexapro or Risperdal cause hallucinations and depression in the elderly?\n\nHello. My mother has been taking Xanax for a few years now and had an episode of depression due to being taken out of her home environment. She will be 89 this month and has terrible vision and is almost blind, which adds anxiety and depression when she is removed from her home. Just recently, she was prescribed with Lexipro and Risperdal along with her Xanax. She is having problems with hallucinations and bad depression mood swings. Her doctor said she could stop taking the Lexipro but is still taking Risperdal. I think her problem is with the Risperdal and I want her to stop taking it. She has only been on this medication for less than a month. Her doctor wants her to stay on it so she can be examined. Is it dangerous to take her off this medication when it is apparently the reason for her latest episodes?",
    "doctor_response": "HelloAt this age, overdose of any drug can cause hallucinations. If she is still having issues, you can stop her risperdal. It does not causes withdrawal symptoms. Keep your doctor informed about this.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard bulge above belly button after splenectomy?\n\nI had a spleenectomy and a piece of my diaphram removed due to cancer.. been 5 months since, now I am seeing this hard bulge just above my belly button.  I've been told I have a hiatal hernia, but isn't that too low for it?  I'll make an appointment to see my doctor, but which doctor my surgeon or internest?",
    "doctor_response": "Hi,Dear,Good Morning and Thanks for your query to my virtual Clinic At HCM.I studied your query in depth and understood your concerns .Causes for hard bulge above belly button are as follows-Mostly they are ?Secondary tumour post- cancer removal.Check with ER Surgeon to resolve the worry for hiatus hernia-post cancer Surgery.Don't worry of them,as they could be relieved with proper treatment.Hope above reply would help you to relieve of the issue you have.Welcome for any further query to ME and HCM.Wishing you a Fast Recovery.Write Good review for the benefit of my new patients.Click thanks ASAP after this.Have A Good Day.With RegardsDr.Savaskar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment for cirrosis?\n\nA friend of mine 48 yr.old male 5 7 180 lbs. was diagnosed with hep c in 2000, after he went into a coma from a thyroid problem. (He takes thyroid meds everyday) .He s in prison , where the medical care is awful , he wrote me this week saying he keeps getting nose bleeds. They told him 7 yrs ago he has cirrosis, but he refused a biopsy , due to the fact it s prison care . In 2000 he was totally yellow , from head to toe . They keep turning down his request to see a real Dr, instead of a nurse or Dr. assisant . stating that a nosebleed is not serious . I do NOT agree , from what I have learned on late stage Hep C , should he take these nose bleeds seriously ? and demand to be seen by a specialist ??? Thank You ....",
    "doctor_response": "Hi dear thanks for asking question...Take symptoms seriously dear....Your friend have liver cirrhosis as you have mentioned...In cirrhosis because of less functioning liver coagulation factors not produced properly.So clotting system affected and yes nose bleeding can occur....So he should consult doctor....If needed for portal hypertension TIPSS like surgery or beta blocker started...Ultimate final treatment is liver transplantation....Meanwhile if variceal bleed occur immediate consult doc for banding....Dr.Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of taking expired Fluzet syrup?\n\nMy 3 year old son,was given 5 ml,of fluzet syrup which was expired frm last 6 months..,soon an,anti infection dose was given to him but he got ulcers in,his mouth... M a bit worried... Wanna ask wat r d side effects of taking expired fluzet syrup..,its manufactured by cipla.",
    "doctor_response": "Hi dear,It is not experied for so long time that cause trush in the mouth. It can easily treated with soda water and Pantosal ointment. I suggest also to apply Vitamin A for healing .Hope it is answer to your question. If your have more queries,then don't hesitate to write to us .I will happy to help you.Wish your baby speedy recovery recovery and good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in left-to-middle of chest, erratic pulsing movement all around?\n\nHello, a few days ago while I was resting I suddenly felt violent pain in the left-to-middle side of my chest and slumped to the left: It felt like rapid and erratic lightening storm-like strikes; and jerky erratic pulsing movement all around; and a jelllo-like quivering sensation all at the same time.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. In my opinion, you should definitely consult cardiologist and get done blood pressure monitoring, ecg, 2d echo and stress test (trade mill test) to rule out heart diseases.If all these are normal then no need to worry much. But better to immediately get done all the reports because your symptoms are more suggestive of heart disease (coronary artery disease - CAD).Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do I have a fatty liver disease as the ultrasound shows liver is echo texture and normal ?\n\nHi I am 39 yrs and have aweight of around 73Kgs. Now the US scan report shows that  my liver is echo texture fatty and size normal. No focal lesions. Hepatic billiary radicles normal. Portal vein normal. Does I have Fatty liver disease or no?  I am not using alcohol regularly,but I take beer occasionally,(once in a month).What precations I have to take?",
    "doctor_response": "HelloYour ultrasound report suggests fatty liver,however size of liver is normal.Fatty liver is due to deposition of fat within liver cells.Fatty liver may be due to many causes like obesity,sedentary life,hepatitis,altered lipid profile,metabolic disorder etc.You may need few more investigations like routine hemogram,random blood sugar,liver function test,lipid profile,urine RE/ME.Try to reduce your weight if BMI is high.Avoid beer completely.Go for brisk walk regularly and take lot of fibers in your food.Avoid saturated fat and fried food.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Snake bites. spots became very painfully and lickage some liquied water\n\nme female 48 years from india,after 14 years a snake bitten me and every year red spots & itch appear on my left leg under knee in the month august-september now these spots became very painfully and lickage some liquied water type anything from these spots.plz. suggest me any allopathic medicine. thanking u in anticipation",
    "doctor_response": "1. any cracking of skin,pus or any other secretion apart from water? 2. getting around a particular month...could be eczema with fungal infection? 3. cortisone and oral anti-histamine will help with itching and other symptoms. 4. consult with a dermatologist for further necessary medical care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any chance of getting pregnant while using Krimson-35 tablets?\n\nHello sir....i am suffering from pco problem in ovaries..so doctor advised me to take krimson-35 with metformin, after using this tablet there is a side effects of vomiting sensation, slight giddyness,back pain...is thr any chance of getting pregnant while using this tablets? i am very eager to have baby due to this problem i am suffering with depression....is thr any solution?",
    "doctor_response": "Hi there,Welcome to HCM,Krimson 35 should not be used by you because it is not suiting you and you are having side effects due to it. Also because you are eager to conceive and since it's a contraceptive pill it will prevent you from conceiving.It is very unlikely that you are pregnant while on krimson, less than 1% chance of it.Moreover in women with pcos who would like to conceive other options such as clomiphene, inositol should be considered. Krimson would not be the ideal drug for them.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does RBC in semen analysis indicate?\n\nHi I underwent a semen anaysis and I am 26 years old.I contracted mumps last year. Volume:4.0, viscosity- decreased,pus cells-2-4,rbc-2-4, actively motile-37%,sluggishly motile_ 18%, morphology normal -97%.sperm count-18.6M. Is rbc in semen indicates something?Is my RBC result normal?thank you.Can i still father a child?",
    "doctor_response": "Hi, More than 2 to 4 RBC in semen or urine indicate infection, pus calls more than 1 to 2 and RBC in semen indicate infection. Since you can both increase. We need to rule out infection. Doing urine complete and urine culture sensitivity will help you diagnose. Yes, you can father a child, its a minor issue. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat itchy brownish/reddish bumps on penis and scrotum?\n\nHi, ive got brownish/reddish bumbs, they are all together its not like i got one in my penis and another one in my sack its like a spot with bumbs, on my ball sack and it itches when i touch it im a virgin so i dont think its herpes. ps, ive got it since i was born.",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have Sebaceous Cysts over scrotum and shaft of the penis.The scrotal skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin.Normally they fade away without treatment however they need to be treated if increase in size or get infected.Please consult qualified General Surgeon for clinical evaluation and further treatment.If needed some of them which are bigger may need to get excised in Toto (Completely along with the sac)Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pigmentation loss on penis be a result of excessive masturbation?\n\ni have pigmentation loss on my penis head and tip of the foreskin.  It started around 2 years ago and is very very slowly increasingI believe it is due to over masturbation as i'm not sexually active so no chance of any STDIs there any remedy for this ? please let me know",
    "doctor_response": "HiSee loss of pigment from the penile region can lead up to two basics causes.One it can be due to vitiligo. Second it can be due to a comparatively rarer skin disease which is Bxo.Now see since the loss of pigment is continuously increasing,  I am sure it is a cause of concern and needs proper evaluation and treatment by a dermatologist.Both of these are essentially treatable skin conditions if treatment is started on time and is not delayed too much.So you should see a nearby dermatologist soon and start adequate treatment.Dr Geetika Paul",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause for the lump at the top of the rib?\n\nBeen there since I can remember doesn t bother me so never bothered looking into it but when I stretch there s a possibility that a lump pops out about an inch away from my diaphragm, comes out on top of my ribs and can cause a lot of pain if I leave it and starts twitching/pulsing, I have to physically push the lump off the front of my ribs and just seems to dissappear till next time. Any ideas what it could be?",
    "doctor_response": "Hi,Welcome with your query to HCM Virtual Clinic.Reviewed your query details.You seems to have Epigastric Ventral Hernia,as it comes when you stretch and pops out with pulsations in it.This is due to defect in the linea alba of the recturs sheath and through which the contents of abdomen herniate through it.This reply would help you to plan treatment with your doctor.Contact after  1 weeks time with a Followup Premium question to ME.Will appreciate your Hitting thanks . Will appreciate review with your excellent review write up comments. Welcome with any other further query in this regard,if need be.Good Day!!Dr.Savaskar,Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bleeding from wound on thumb joint?\n\nRecently I knocked the top of my thumb between the thumbnail and the first joint and it bleed yellow with some light red blood. I called my GP s office and ask why and was told that they had never heard of such a thing. then day before yesterday I was scraping a small what I was a bump and when I did the blood was light red and dried to be the color of orange. What could cause this and should I be concerned?",
    "doctor_response": "Hello,I have studied your case, Due to blunt injury there can be hematoma collection .The bleeding that occurs result in hematoma collection. Over a period of time, as hematoma resolves it cause local skin symptoms around the hematoma. Continue ice application, and thrombhophobe ointment may help and take rest.If required you may need to do blood investigation for prognosis and recovery.Take precaution to avoid infection around hematoma.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain due to spinal TB\n\nHi Doc, My dad is infected of Spain TB and he is having sever pain in his back, it is almost 12 day he has not got relief from the pain . Please recommend if any medicine or medication required. He is 47 years old and don t have any other disease also please let us know how he can slip to reduce the pain.",
    "doctor_response": "Hello, Spinal tuberculosis is definitely very painful but is curable. I am sure he must be on anti-tubercular medications that will take care of the infection. Meanwhile, to reduce the pain, please use over the counter pain relievers. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Haleema Yezdani, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shortness of breath\n\nhi, i have been experiencing shortness of breath, increased pulse rate, sore throat, headaches, mouth sores recently. My tests were negative: ECG, 2D echo, chest xray, cbc (HDL/LDL are ok). Only minor findings are: borderline uric acid, borderline ASO-titer (streptococcus bacteria) and mild skip beats. My cardiologist and pulmonologist says i am healthy. However, i have been tortured by this feeling for the past 7 weeks now. I was initially given antibiotics by my cardiologist, for me to take for 3 months. However, after consulting an Otolaryngology (EENT) and another cardio, they advised me to stop the antibiotics.  I have observed that while i was taking the antibiotics (4 weeks), my shortness of breath decreased, mouthsore gone,  but still my pulse rate is high. Then when i stopped the antibiotics, all these went back.. with greater intensity. What is wrong with me?",
    "doctor_response": "if ecg and cxr are normal and still there is increaded pulse rate and other symptoms ._1-get ur thyroid function test done to rule out hyperthyroidism2-routine blood test to rule out chronic anemia .i would prescribe u -1-3 times gargling with warm salt water ,it will definetely improve throat symptoms2-tab cobadex czs -1 tab at night after meal.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How could the gap between the front two teeth be reduced?\n\nhi doctor i am a 21 yr old girl from kerala . the problem is that  i'm having small gaps between my upper front teeth and i need to cure it as fast as possible about 6-8 months or less. can u help me to choose the best treatment for me and the cost for that treatment",
    "doctor_response": "There ara many treatment option.- Fixed barackets .duration.10 -18 Months. -composit resin filling (tooth coloured filling) immediate cure- Veneers .duration.5-6 Days - Lumineers .latest treatment method..cost is little high duration 5-10 Days*all treatment cost.duration and result deppends on clinical evaluation",
    "dialogue_context": ""
  },
  {
    "patient_message": "Facial area puffy, abdomen sore, tender. Are symptoms related. Possible cause?\n\nTwo days ago my husband woke up and noticed his entire facial area was puffy.  Although it is less puffy today, it is still noticeable today, it seems to be better.  To add to this, today he has felt some soreness in his upper left abdomen just under the rib cage.  If he applies pressure to the area it is somewhat tender to the touch.  Do the two have anything to do with each other and what may be causing this?",
    "doctor_response": "Hello,Welcome to Healthcaremagic.Both Puffiness of face and left upper quadrant abdominal pain may or may not be relates.because puffiness of face may be seen in allergies and kidney diseases.Left upper abdominal may be either from heart cause like Heart attack, angina etc.Some other causes are Splenic causes ie. ruptured spleen, splenic abscess.Kidney causes are renal infection, stones or chronic or acute renal failure etc.Even gastric problem can be a cause.Since the facial puffiness decreases in one or two days most probably allergy or kidney problem could be the cause.Please do an ECG and X ray chest to ruleout Heart and lung disease.We have to do Ultrasound abdomen, blood urea , creatinine, and urinalysis to rule out kidney disease.As tenderness is in left upper quadrant, apleen may be involved. Check for  hemoglobin and other RBC parameters and Peripheral smear for RBC details.Hope this helps.Take care.Regards,Dr.Manjeth.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood clots in the kidneys?\n\nHi ! My name is cindy and I just turned 59. The first of Feb. I started out with what I thought was bladder infection. I seen my doctor and had the urine test done and it came back with I had blood in my kidneys, shortly after that I started to have very bad pain in my back and in my ovaries, also my legs. I started to pass what I thought was kidney stones. one looked like a dark maroon oval stone, the next two looked like 2 cucumber seeds and the next time there was about 6 long and skinny oval stones. They looked like the were off white. My doctor said kidney stones do not look like that and he didn t know what it could be. I went to my Gyno. and did a pap smear. I was looking up polyps on the web and a lot of the symptoms are like what I am going through. Can polyps drop in the toilet like that? Thank-you. I am just trying to figure out what my body is doing!",
    "doctor_response": "Dear Patient,those stones should be analyzed. Stones may appear with shapes in every kind. It is unlikely to find polyps on urine, extremely rare since they goes to maceration before being urinated (they are ischaemic while ready to detach).",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicines for scoliosis and SI joint dysfunction\n\nCan you write legal prescriptions?  I have scoliosis, SI joint dysfunction (suspected) and a vertebrae that is pushed forward and to the side.  Am waiting on an MRI, but have to wait until the first of the year.  HATE the thought of asking my doctor for pain medication, so much so that he asked and I said no.  He gave me a Medrol dose pack which helped initially, but now pain is back with a vengeance.  Christmas shopping to do, two young children.  I feel crippled.",
    "doctor_response": "Hi i am Dr Ahmed Aly    thanks for using healthcaremagic site ,I had gone through your question and understand your concerns ..  For my patients i suggest painkillers like advil tab twice daily after meals , hot massaging with topical gels , avoid vigorous movements and heavy lifting , muscle relaxants like tizanidine 4 mg once daily , B12 multivitamins , physiotherapy and even yoga will be effective for now till you get your results for proper evaluation and management .Please click THANK YOU and consider a 5 star rating with some positive feedback if the information was helpful. Hope the above information helps you,Any further clarifications feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain, numbness and weakness in legs?\n\nI have pain in the center of my back which radiates around both sides, I also have severe pain in my lower back causing numbness, pain, and weakness in my legs. My doctor says I need to quit smoking and strengthen my core muscles and all my pain will go away",
    "doctor_response": "Hello,Your symptoms seem to be related to sciatica pain. Sciatica, which is caused by a pinched nerve in the lower\u00a0back, is\u00a0pain\u00a0that radiates along the sciatic nerve. I suggest to do an X-ray for further evaluation. Meanwhile, I agree with your doctor that you should do regular exercise, especially gentle stretching exercises.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it necessary to get blood pressure checked before dental filling?\n\nHi doctor, I get really bad anxiety when I have to get my blood pressure taken. I am not really sure why, but it has caused me to stop going to the dentists ever since they started taking blood pressure readings. I have a cavity that I have put off getting filled for a long time because of it. Is there any way I can get around having my blood pressure taken and get this cavity filled? My anxiety brings me to tears. I do not know what to do anymore. Any help would be greatly appreciated.",
    "doctor_response": "Hi. I have gone through your question and I can understand your concern. There is no need of BP reading if you do not have hypertension. Blood pressure reading is nothing but a simple instrument as is your watch. So there is nothing to worry. At the age of 34, you cannot be a hypertension patient. So enjoy the reading. In case you are further apprehensive, tell the dentist you do not want it. There is no need of BP reading in simple procedures like filling.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach ache, fatty liver, piles problem.  Bilirubin .4, sgpt and sgot 156 and  112.  On liv 52 and other medicines.  Suggest diet plan\n\ni had 1.5 bilirubin 2 weeks back and 108 sgot and 125 sgpt, now bilirubin is .4 but sgpt and sgot are 156 and 112 respectively. i get stomach aches. i have fatty lever from one year. having Liv 52 and other medications.i have piles problem too. please help me the precautions i should take and diet i should follow. I am already avoiding oily food and i dnt drink.",
    "doctor_response": "Hello,thanks for your query,you are having consistantly high serum bilirubin level and high sgot and sgpt.,you also mentioned of stomach aches for all this you need to do some tests like sonogragphy of abdomen and consult a general surgeon asap.for time being billary secretogauge like ursodiol can help and for piles laxative like lactifibre along with lots of oral fluid and avoiding spicy/oily food will help.                     hope this will answer your query.                                                     dr.akhilesh chamediya",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does urination increase pain experienced in abdomen and lead to severe bleeding?\n\nHello I am 22,54 137lbs and have always been healthy. My question Is I was feeling pressure such as sharp pain in my uterus so I went to go pee then along with what I felt pain scale 1-10 it would be 9 I am thankfully Not bleeding I am on my ovulation week and me and my partner have been trying to conceive a baby first I want to know what you think it might be any addition I can help you to help me please let me know thank you. NOTE: and I have felt this before last time I felt this and experience this before it did have peeing blood lots also it lead me to the hospital knowing it was a by-pass kidney stone",
    "doctor_response": "In my opinion this sharp pain episode was again due to passing stone which might be a small oneI advice my patients in this type of situation to go for urine examination and ultra sonogram of kidneys ureters and bladder to rule out any other stones.Plenty of fluids and juices relieve them from pain and recurrence of stones.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can chest pain after inhaling diatomaceous earth be treated?\n\nI bought diatomamaceous earth, food grade for my cat s fleas. she shook herself and I breathed it in. I began to have pain in my chest and hands. drinking cold milk and cold water may be helping. should I call anyone? it is nearly 10 p.m. YYYY@YYYY",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. * The chest pain after inhaling diatomaceous earth is sensitivity of   bronchi to the particular ailment. * I recommend to consume plenty of liquids, deep breathing exercises, preference for semi reclining position in rest at present ; consult your    doctor tomorrow if problem remains. Wish you fine recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for breathlessness\n\nMy son was working on a farm, for a period of about 3 months. He was exposed to chemicals. He has started having breathing problems. His lung performance has dropped from 640 to about 320. He's very concerned but the doctors have so far only prescribed inhalers and more recently are suggesting he goes for an Xray. His symptoms have now been ongoing for about 3 to 4 months. My son is an athlete but can now only walk on a tread mill before getting out of breath.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Your son was fit and healthy before this work. After 3 months of work, he is deteriorating which is proved on breathometer readings.So possibility of occupational lung disease (OLD) is more likely in his case.So consult pulmonologist and get done clinical examination of respiratory system, PFT (Pulmonary Function Test) and CT thorax.All these will help to determine severity of lung disease. Based on severity, decision about continuation or discontinuation of job is decided.So consult pulmonologist and discuss all these. Hope I have solved your query. I will be happy to help you further. Wishing good health to your son. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful leg after removed gallbladder?\n\niam suresh my age 44. my son name sai charan.2 months back galbladder removed to himnow he suffering with pains. After MR scan Dr. told its a BONE TB. NOW TREATMENT GOING ON.BUT 2 DAYS ONWARDS HE FEELING HEAVY PAINS AT RIGHT LEG SIDE. HE NOT ABLE TO WALK / SITCAN I KNOW THE REASON OR ADVISE",
    "doctor_response": "Hi, I am Dr Gopal Goel Orthopedic Surgeon. In my opinion ,it could be Tuberculosis of the spine. Please get an X Ray of Spine and if possible MRI spine to see it tuberculosis has spread to bones . In this case The pressure of pus from TB can cause leg symptoms .The treatment would depend on the extent of disease.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could lumps on armpit suggest?\n\nHi, may I answer your health queries right now ?  Please type your query here...I have had a lump under my armpit for the passed couple weeks that looks like a pimple before it gets its head.  It is not exactly bothersome but it hurts slightly when I touch it.",
    "doctor_response": "welcome to Health care magic.1.Its infective cause - likely bacterial infection of hair follicle.2.Avoid shaving the axillary region to avoid infections, and accelerate the healing process.3.Maintain local hygiene, keep dry.4.a course of antibiotic in small size, larger one needs incision and drainage.5.Get an appointment with your doctor and get the needful treatment done.Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have issue with breathing. Why is it difficult to swallow? Is it anxiety? Why always dizzy?\n\nI am 35 year old female. I have this issue with breathing . It seems like my chest rattles when I am laying down, only at night/early morning. If the weather is muggy I can also feel it. My doctor has given me an inhaler , but it only seems to make it harder for me to breathe. I am also noticing it to be more difficult to swallow . What is going on? I started with a variety of symptoms in November of 2011, about 2 months postpartum. My first episode was in the end of November. While with my two young children at Walmart I started to see very fuzzy, then felt very faint. I asked a passerby to take my baby and I sat on the ground. They helped me make my way to the front and I called my husband to come and get me. In looking back I hadn t really eaten or drank that well and given the fact that I was nursing I thought maybe I was hungry or dehydrated. About a week later, the same sort of scenario, it was early morning and I was in the kitchen and suddenly felt like I was going to pass out. My mother was here with me at the time and she got me some orang juice and I got something to eat as it was near breakfast time, my dad rushed over to my home and took my blood sugar( which was fine) I was very shakey. This time I went to the ER. Ultimately they ran labs and checked me over and everything seemed ok, they even did an xray of my heart to make sure it was not swollen from after the baby, that was fine. They went ahead and sent me home with a heart monitor, which came back borderline abnormal. You should also know that just after this my PCP put me on 50mg of Zoloft which caused incredible side effects,from shaking to hot flashes to severe panic. They decreased my dose, but the side effects were just too much to handle.I was then put on Paxil which seemed to aggrivate my SVT, though keep in mind at this time the PCP did not know I was struggling with SVT they called it anxiety .In February 2012 I was finally given a stress test which showed SVT, but that the structure of my heart seemed fine. In that same month of February I had noticed the breathing issue begin, it would seem that it would rattle when I would be laying down only, or upon waking. I went in my PCP and he did a chest xray which indicated the possible beginning of pneumonia, which he hesistated to treat stating that it may just be breast tissue . He treated it with Zpack anyway. Along the way I have also no",
    "doctor_response": "ei thing you mustttttttttttgo for xray pns waters view and other investiations hb,haemogram total ige level in blood total ttg levels of blood tatal eosinophil count' thee will be anwer sitting on these investigations post after this homework",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I have a strange feeling in my heart?\n\nHello doctor, My oxygen level is 93, my pulse is 95, and my heart feels different like maybe it is skipping beats or something. Should I go to the ER? This has been going on for about four to five days.",
    "doctor_response": "Hello. It is better to go to the emergency room and to get an ECG (electrocardiogram) to confirm the diagnosis. Do you have any history of diabetes or hypertension? These risk factors for atrial fibrillation are quite common for people your age. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause sharp pains on the right side between stomach and back?\n\nHi i started getting sharp pains on the right side of my stomach between my belly and my back last Friday a week ago but they went away and then on Wednesday nearly a week later I was on the lounge laying on my left side and suddenly got this really painful sharp pain in the same area as before this time it hasn t gone away it hurts to walk to drive I cant sleep on my left side I cant really sleep at all it hurts to touch that area I went to the hospital Thursday they did urine test and blood test and sent me home with antibiotics and said they think its a kidney infection since then the pain is getting worst I felt really dizzy this morning and then I started bleeding and been getting hot flashes and not feeling well all day",
    "doctor_response": "Yes my friend,  it is probably because of renal stone passing down through ureter.....Take adequate hydration and contact ur doc for oral analgesic",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest permanent remedy for androgenic alopecia\n\nhi, I m infected with androgenic alopecia and have started losing hairs. I m 25 years old and want to know a permanent remedy over this. Already using minoxidil 5 and finasteride tablets which when stopped consuming causes reoccurrence of the syptoms and hair loss.",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, actually alopecia is not the infection but this is genetic condition and this can be given try with \"Minoxidil 5% for local application and \"Tab Finasteride 1 mg once in day for three months, (If your are male person)  hope this information helps, treatment may not give promising result, but worth trying, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "PTSD, get hand tremors, body jerks, walking seizure, prescribed Clonazepam. Can I take valium?\n\nI have ptsd, and tremors of my hands and sometime my body will jerk all over like a walking seizure, in 1996 a doctor wrote me 100, 10mg valium and said they must last a month, i live in southwest VA, and can not find a doctor to write me anything excdept Clonazepam and i am a big guy not obese type just wide and big. i wear a 38 pant size if that tells you im not fat i need a doctor to see me on line or help finding one that will write me the valium, i have been given xanax and it is not for my tremor problem it helped the ptsd but i type on finger because of the shakes. please help",
    "doctor_response": "Hi,Thank you for posting your query.It seems to me that you may have valium (diazepam) dependence, which may be aggravating the tremors. In any case, valium is not a good drug to suppress tremors.Best options for reducing tremors would include beta blockers and clonazepam. At the same time, please meet a psychiatrist who would get you off valium.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My email: drsudhirkumar@yahoo.comMy blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pernicious anemia\n\nI have severe dizziness, sinus pressure, ear pressure, a recent diagnosis of Intracranial Hypertension, and am on Prednisone for inflamation of my optic nerves. I also have been having severe pain in my neck, arm pits, and groin. The only thing I can think of is lymph nodes? Could this be causing my Intracranial Hypertension? I also have a long list of autoimmune diseases that include, viteligo, hoshimotto s, pernicious anemia, autoimmune atrophic gastritis, as well as a history of gastric carcinoid tumors. I am in distress over all of this. The intracranial hypertension has caused swelling of my brain, the lymph nodes have been like this for months and are painful. What can I do & how can I get doctors to expidite my care? No one seems to be in a big hurry to help me and my health is going down hill quickly.",
    "doctor_response": "Hi, Pernicious anemia is due to a lack of vitamin B12. It has to be injected to get in. Monthly injections will fix pernicious anemia. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly explain a few materials that are toxic to humans.\n\nHi doctor, Please list a few things that are toxic to humans. Please explain.",
    "doctor_response": "Hi. Detergents contain hazardous chemicals. It can irritate our skin and cause eczema. Some people may even get contact dermatitis. When they are ingested, it damages our mucosal lining of the gastrointestinal tract. Perfumes and body sprays contain chemicals. When they are inhaled, they irritate the mucosal surface of the respiratory tract leading to asthma and allergic rhinitis. Processed food like sausages are harmful to the digestive system and may predispose to colon cancer if ingested regularly over a long time. Canned food also contain chemicals that are carcinogenic. Air fresheners contain chemicals that are harmful to the kidneys and lungs. Some may affect reproductive functions also.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excessive fatigue and loss of appetite during kidney dialysis?\n\nMy mother, 79, is undergoing kidney dialysis, has other issues (primarily diabetes-related issues), has recently become moodier, more lethargic, has no appetite at all, and is showing signs of Alzheimer s. Her meds change often. Would there be any benefit in getting her to a Gerontologist? Thank you.",
    "doctor_response": "Hello, I work in a hemodialysis center. Based on these symptoms, first I would check for anemia (Hemoglobin level, hematocrit and iron studies) and second for dialysis adequacy (blood urea nitrogen pre and post dialysis). If the results are acceptable, then your mother should consult a Gerontologist. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Elton Halili, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a large bump on the head of a child?\n\nI have a child that has formed a large bump on his head and it has been draining and pussing and scabs over yellow. Within the last few days he has developed red bumps on his face and upper body and look to be turning into sores? 3 doctors have yet to diagnose him and I am scared this is a serious condition",
    "doctor_response": "Hello, Does your child have a fever? How active is he? Does he have these rashes elsewhere on the body? Does anyone have similar symptoms in the family? He needs to be investigated the pus and wound needs to be evaluated microbiologically before coming to a diagnosis. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr ASHWIN BALIGA, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching and bruising on the hands and foot?\n\nMy hands are very itchy and also the bottom of one foot. But when I itch my hands they feel very tender and bruised. Certain parts of my hands do look a little discolored but the discoloration comes and goes. What are some possible reasons for this?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.As per your clinical history is concerned your problem is due to an allergy. So, do a blood differential count and do a clinical examination by your local dermatologist and take medication as per the report.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Uday Nath Sahoo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent fever despite medication?\n\nHai i am Alwin John from INDIA BANGALORE my daughter aged 1.3 years old, her ESR Count is 90mm/hour. last one year she is getting fever once a month and it continues for 10 days. Doctors preferred crocin drops and novomox 125 mg. but still she gets fever. ESR is checked very recently. Baby is under weight and small. kindly advise me how to get though this problem.",
    "doctor_response": "Hi....your daughter seems to be having a recurrent viral infection. Rather than using antibiotics without knowing what it is I suggest you do an immunodeficiency work up for your kid after consulting with your pediatrician. I am telling this because every month she gets fever of 10 days, which is very unusual and she is underweight too.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can alcohol cause damage to my liver if I have an ALT of 206 and an AST of 126 on my LFT ?\n\nI have mono and am taking clindamycin for an infection in my tonsils. My LFT included an ALT of 206 and an AST of 126. Is it okay if I drink alcohol.",
    "doctor_response": "Dear friend No blood investigation suggests okay to drink alcohol. the levels of ALT AND AST u have mentioned is normal. try to stop taking alcohol or natleast try to reduce the amount. Dr. M R Puhan Mob: 9437873112 drpuhan123@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest Ayurveda treatment for jaundice\n\nMy relative is affected by jaundice. He is alchoholic. He is also suffering from psoriasis. I want to get the jaundice cured immly before embarking upon the equally serious problem of psoriasis.  As unani/ayurvedic/homeopathy is said to be a better option for jaundice treatment, please let me know the dependable and successful doctors/clinics in those disciplines,in Chennai. tnks.  Jaanaa",
    "doctor_response": "Hello welcome to 'Ask A Doctor' service. I have reviewed your query and here is my advise. For jaundice Symptomatic management done mainly and proper rest is needed. Ursodeoxycholic acid daily can be prescribed for dissolving cholesterol in bile. Fatty foods and alcohol should be restricted in jaundice. Sugar cane juice and apple juice can be taken more. Ayurvedic treatment can be taken but it has to be taken for long time to see significance improvement. As a allopathy doctor I suggest you to consult gastroenterologist for examination and dermatologist for management of jaundice and psoriasis. Hope I have solved your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatments for recurrent OCD\n\nI am an old woman, aged 68. Suffering from ocd. In 2001, I was advised to take citalopram and was fully cured and rid of all symptoms. But again in 2009, I had a relapse. under the advice of my psychiatrist , I am presently having fluvaxamine 100 mg twice daily plus citalopram 10 mg twice daily.  Is of no sustained benefit. Can I switch over to some other drug?",
    "doctor_response": "HiI understand your concern. OCD has episode of relapse and need to treat as such.Fluoxamine and citalopram both are SSRI and has good review in treatment of OCD.Clomipramine is also useful drug for OCD. .. But change in medicines or change in doses only require if you do not have benefit from old regimen. There are lots of augmentation strategy for OCD for that you have to take medicines Regularly and do take follow up regularly. Take yyour doctors advise who knows your detail history. I hope I have answered your question. Still if you have a query then feel free to ask. Thank you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high appetite, low energy levels and drowsiness in children\n\nMy son eats constantly but never seems to get full. He has several BM a day that are very pungent. He has lost a lot of weight very rapidly. He has gone from over 200lbs to about 150lbs maybe. He sleeps most of the day and does not have the energy to due anything. He is a diabetic and his sugar level have been very high. He does not have PCM.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Is he taking any medicines for diabetes? Is he being followed by an endocrinologist or any other physician who is expert in the treatment of diabetic patients? He must have treatment immediately or else he could fall into a diabetic coma. Take him to the nearest hospital ER.After the acute condition is properly treated, I strongly advise you to find a physician who is an expert in diabetes care for your son. If you live in the USA, contact the nearest center of the American Diabetes Association who will provide you with the names of doctors who can help your son.If you reside in another country, contact a large hospital and ask if they have doctors who care for diabetic patients. Please, start acting as soon as you can for your son's sake. Come back to us after his diabetes is fully treated. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Arnold Zedd",
    "dialogue_context": ""
  },
  {
    "patient_message": "Where do they inject for stent removal between the kidney and bladder?\n\nHELP! If it is local, where do they stick the needle??? How long does it take and how will I feel afterwards? I intend having nothing to eat and drink from the evening before because pain makes me sick. I had the stent placed last week after removal of a kidney stone -the stent is between my kidney and bladder. I was offered to have it removed under general but there is a waiting list and the stent is painful and uncomfortable. I just hope this procedure is quick",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Double j stents are placed between kidney and urinary bladder in the ureter. They can be removed easily in local anesthesia the most common way is to just insert lignocain gel in the urethra and wait for 5 to 10 mins then they will pass cystoscope through your urethra and localize the lower end of the stent and pull it out of your urethra it is just a 15 min procedure and you will not be feeling any sort of pain after local anesthesia. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can anxiety be cured with the help of acupuncture?\n\nHi, may I answer your health queries right now ?  Please type your query here...- I have anxiety? can it be cured by acupuncture?I love traveling but now i always go with somebody from the family coz I'm afraid it will occur again. I'm 30 yrs. old and this illness started when I was 24. Sometimes I catch my breathe but I know it's only in the  mind but I can't really help it sometimes",
    "doctor_response": "Hi Welcome to HCMI have gone through your query regarding cure of anxiety through accupucture . Anxiety is one of the most common mental illnesses worldwide. Many people suffer some form of anxiety occasionally but others cannot manage this natural response to a stressful situation. When a person experiences a highly stressful or threatening scenario, the mind can be overloaded and fail to develop ways of coping. Acupuncture is an ancient form of traditional Chinese medicine. It works on the principle of stimulating points in the body to correct imbalances in the flow of energy through channels known as meridians. This belief is based on the interaction of the five elements (wood, fire, earth, metal and water) and having profound effects on internal organs, which are either yin or yang.Traditional Chinese medicine also recognizes the mind and body interacting as one, meaning that emotions have a physiological effect on the body.Western medical practitioners traditionally have questioned the validity of traditional Chinese medicines such as acupuncture. More recently, acupuncture has been recognized as a legitimate treatment for some conditions and is growing in popularity.<>Traditional Chinese medicine relates anxiety to an imbalance of the heart and kidney. Fire represents the heart and joy according to the five elements. The diagnosis is that too much heat in the heart will imbalance the interaction with the kidney (represented as water and fear). This will result in the water organ failing to contain the fire organ rising up to the mind, leading to anxiety. Acupuncture on points around the heart, kidney, spleen and ear are used to treat anxiety. Pro and con of everything are there  t least it has no side effects . So you should not worry about it . Can get cured  through Accupuncture  Hope this gives you reply to your query , All the best  Take careDont hesitate to get back if have any further query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could neck strain be a convulsion symptom?\n\nNeuro issue- my wife got an brain hypoxia along with heart attack in September 22 , 2013. she was in coma for a month and recovered slowly. She was on encorate and now the dosage was reduced to levipil.As per the dr advice we have reduce the dosage to 1/2 tablet of levipil and slowly stopped. today after stopping the medicine for past two she got a her neck strainghted is it convulsion symptom? please guide",
    "doctor_response": "I do not think this could be the reason. provide little neck massage and I hope it should be fine. still if it persists you can visit the neurologist and take guidance which will be surely of help",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the feeling of something being stuck in heart?\n\na few weeks ago I WAS AWAKENED DURING THE NIGHT TO FLUTTERS IN BACK OF MY LEFT LEG. i have experienced it once in right leg. Last night in shower it felt like a rock w/pins in it was stuck in my heart. I had to take 12 deep breathes and it passed only after my heart did like a huge pump then it went back to normal. What could it be?",
    "doctor_response": "the commonest cause could be gastritis or acid peptic disease but before that you need to exclude any likely cardiac condition",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is the rash on my genitals not getting cured even after taking Fluconazole?\n\nHi doctor,I have a rash on my genitals from a month. So, I went to a venereologist, who told me to take Fluconazole, one tablet for two weeks. As you can see by the photos attached, the rash is still the same even after a month. Please help me diagnose and treat my rashes.",
    "doctor_response": "Hi. I have seen the rash\u00a0pictures\u00a0(attachment removed to protect patient identity). For further queries consult a venereologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause leg ache along with swelling in the ankles and headache?\n\nI am not feeling well. Both my legs are hurting. Right one i have sciatic arthritis. Left one mu ankle is swollen and i have fallen a few times. Have headache and sinus drainage and.swollen lymph node onthe right side if my neck. Headache in my forehead. And heart sometimes flutter. I was given 2 tranfusions about 2 months ago for anemia. What is wrong with me?",
    "doctor_response": "Hi, It is possible that swelling in the legs due to anemia or hypo proteinemia. Headache may be due to sinusitis with pharyngitis. Lymphadenopathy due to upper respiratory tract infection. Anemia lead to palpitations due to hyperfunctioning condition. Please elevate the limbs, use tablet Orofer XT. Avoid cool drinks and freeze water avoid smoking and caffeine drinks. Use water vapor inhalation and salt water gargling thrice a day for five days. If symptoms not improved please consult your physician/ENT specialist he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Using cortisone shots for lower back pain and blood clot in the right lung\n\nHi.  I have a blood clot in my right lung post surgery in August 2013.  I am now having severe lower back pain and my physician is suggesting that I get cortisone shots.  She stated this should be safe for my blood clot because they will not fully anesthetize me during the procedure.  I am nervous about getting the shots because of the blood clot.  In your opinion is this a safe procedure in my situation.",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. Yes, it is safe  to take cortisone shot while having pulmonary embolism (blood clots in lung).But following things should be noted.1. You must follow your blood thinner medicines.  Regular PT,  INR report should be done to titrate blood thinner medicine. 2. Make sure your doctor is giving cortisone in the joint and not in the vessels. Intra articular steroid injection is treatment of chronic joint pain. So it is safe, just make sure that it is intra articular and not intravascular. And continue your blood thinner drugs fir pulmonary embolism.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is passing out followed by sleepiness after urination concerning?\n\ni always pee and pass out since 3 yrs ago.more than 15 times i pee and 5 times i pass out a day. however i feel well but always want to sleep.i active in sport.of course i drink a lot.i had seen a doctor 3 times but these problem still. i think this unusual eventhough i feel well",
    "doctor_response": "yes you should see a neurologist.  it is not normal to lose consciousness even once a day let alone multiple times a day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Nausea, pelvic pain, prescribed Vicodin, had Mirena removed, vomiting. What should I do next?\n\nI have been extremely sick for 2 almost 3 months now. I had nausea for 3 weeks daily with minor pelvic pain . After 3 weeks I could not keep anything down and started having pelvic pain so I went to my pcp where she ordered blood work, urine tests, & an utrasound. All tests came back normal. When doing the ultrasound and checking my left ovary that felt like where all my pain was coming from it was bigger than my right but my doctor said that it was normal. I was told to wait and see. I went back into my pcp 7 days later my pain was beginning to be unbareable. I was told to wait and see. I went to the emergency room one night after spending 4 days in bed crying in pain and had a contrast ct that again was normal. The Vicodin prescribed did not even come close to helping with my pain. I then thought maybe my mirena iud was the cause (it had been in almost 5 years exactly) and so I went to planned parenthood and had it removed. I waited and 10 days later I felt much worse than before though my dizziness had stopped my pelvic area hurt all over and not just the left side and more areas around my lower stomach. My lower and middle back started hurting. I called my pcp and demanded a referral to an Obgyn . My Obgyn informed me that my insurance will not cover explorative surgery and prescribed me metronidazole and doxycycline hyclate. I am on day 5 and I have been vomiting constantly for months and I still feel worse each day. It s been 29 days since my mirena removal and I have not bled the tiniest bit. The er doctor said it could be endometriosis and after asking my mom I was informed that she and my grandmother both had hysterectomies for endometriosis. I am a divorced single mother with two young children that I am having difficulty taking care of at the moment and I have missed work for over a month now. I need to get better and I don t know what to do now. My Obgyn suggested I go back to my pcp. Is there a good chance that it is endometriosis, i will happily pay out of pocket and go into debt if this could make me okay again... If not what could it be or what should I do next?",
    "doctor_response": "hi there, thanks for posing you querry.there is the possibility thet you are truely suffering from endometriosis owing to the pelvic pain and family history. endometriosis is the proliferation and functioning of endometrial tissue outside the uterine cavity, the frequent sites being the ovary, broad ligamen, douglas etc.however, i thick you should still go for STI screening (chlamydia, mycoplasma, ureaplasma etc) and proper treatment if need be.am always at your service... goodluck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sharp chest pain after panic attack\n\nHi , I had went to a haunted house last night and I had what seemed to be a panic attack. I had chest pajns afterwards and this morning they werent very bad but they keep occur occuring and some of them are very sharp pains. Do I need to go get checked out?",
    "doctor_response": "Hellowelcome to hcmwell the chest pain you had was most probably due to ACUTE ANXIETY AND PANIC ATTACK...but to be on the safer side kindly get done an ECG and XRAY OF CHEST and then send me a scanned copy of your reports so that i can make a precise diagnosis and guidd you furthertake caredr rahul",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Cushing s syndrome\n\nI have a pituitary tumor. Have a hump in back of neck, gained fifty pounds (although I don t eat and differently and work out everyday),moon face, fatty pads on collar bone, extended abdomen, muscle pain, memory loss, and stretch marks.Blood test show high dhea levels. I believe I have Cushing s.",
    "doctor_response": "Dear User, Anti-gluco-corticoid and anti-hypertensive medications, along with steroid inhibitors, can be used as adjunctive treatments. lowering cortisol can be at least helped by switching to a whole foods, anti-inflammatory foods diet, reducing stress levels, and changing the level of exercise and physical activity.Best to take Foods rich in vitamin B, Potassium, Magnesium and calcium.intake of high protein food helps burst stress naturally and keeps active.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pus filled bumps all over the body?\n\nFOR ABOUT A MONTH NOW I HAVE BUMPS, ALMOST LIKE SMALL PIMPLES, SOMETIMES WITH A TEENY TINY AMOUNT OF PUSS IN THEM AND SOMETIMES JUST RED. I AM SOMEONE WHO IF I GET IN THE SUN MY CHEST WILL BREAK OUT TERRIBLY SO I AM ASSUMING I GET SUN POSION HOWEVER I HAVE NOT BEEN IN THE SUN NOR A TANNING BED AND FOR ALMOST 1 FULL MONTH NOW I HAVE THESE SPOTS. I HAVE NOT CHANGED ANYTHING..NO NEW DETERGENT, SOAPS, FOODS ETC. SOMETIMES THEY LOOK WORSE THAN OTHERS. I WOKE UP YESTERDAY MORNING WITH NEW ONES GOING UP MY NECK AND ON THE SIDES. I CURRENTLY HAVE THEM ON MY CHEST, UPPER ARMS, BACK AND NOW MY NECK. THEY DONT ITCH BUT RATHER EMABARRASING. HELP!!!",
    "doctor_response": "Hello,Welcome to HCM.I understand your concern.From the details you have given, I assume that you are suffering from folliculities. The red pus filled pimple you are having on your body are most likely infected follicles(hair roots).There may be many reasons for the same like a previous exposure to sun, excessive sweating, friction due to tight clothing, etc.You need not worry in this matter because most of the time it is benign self limiting condition. You should apply some antibiotic ointment (like povidone) or antibiotic powder (neosporin powder) along with skin soothing lotion like calamine. I advise you to keep the area clean by washing it with warm water and mild soap. You should not wear tight cloths and should not let the follicles excessively compressed or stretched. Avoid scratching or bursting the pus filled follicles.Consult a doctor if they don't go away in 10 days.Please rate this answer helpful if it was helpful to you.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is treatment necessary for a throbbing dog bite?\n\nMy dog bit me on the finger about 3 1/2 hours ago. I washed it and put on antibacterial wash and a bandage. It is still throbbing and oozing slowly through the bandage. It s not bleeding a lot, just not completely stopping. My dog has all his vaccinations and had his rabies shot updated a few months ago. Should I just blow it off or go to the doctor? Thanks!",
    "doctor_response": "Hello,Welcome to HCM,Dogs are known reservoir of rabies virus and can transmit to human beings by biting. Rabies is 100% fatal but it is 100% preventable by proper and adequate treatment.As there was a bleeding from the bite site, according WHO categorization it is categorized into Cat III. So cat III bite should receive following treatment.1.Wash the wound thoroughly with soap and water.2.Active immunization with anti rabies vaccine on days 0,3,7,14 and 28.3.Passive immunization with anti rabies serum around the wound.4.Inj TT, 0.5 ml, IM5.A course of Antibiotics like Tab Augmentin, twice daily for 5 days.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What medicines can I take for throat irritation post LASIK surgery?\n\nHi doctor, I am 32 years now. Last Monday got LASIK\u00a0for my eyes and in recovery phase this week. I had cold before that which has increased and continuing till now. I have throat irritation and slight nose block for which I took Otrivin at night for 2 days but still not much improvement. What tablets shall I take? I also have some mouth ulcer for past 2 days. What tablets shall I take for that?\u00a0LASIK doctor had told no restriction in food or medical practices. After your suggestion will also check with him once if you recommend so. Thank you.",
    "doctor_response": "Hi. I have read through your query in detail.\u00a0Please find my observations below. For further information consult a general practitioner online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a arm IV vein with hardness and puffing be treated?\n\nMy  daughter had Gallbladder surgery about 3 weeks ago. Of course she had an IV and now the vein in the crease of her right arm seems puffy and slightly hard. Just a small size, about the size of a pea.Is this normal and will it just take care on it's own?",
    "doctor_response": "Hi and welcome to HCM. Thank you for your query.In most cases this is self limiting and this is called thrombophlebitis. It can be treated by elastic cimpresses and icing and ibuprofenum 400mg daily. It should improve within few days. If not, you should do Doppler ultrasound to rule out deep vein thrombosis.Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can I keep my hair healthy?\n\nHello doctor, I am 21 years old, and I have been struggling all my life with how to manage my hair and maintain a healthy hair texture. My hair used to be curly when I was younger but then became wavy over time and for the most part, it is wavy (I feel like it would be slightly more curled if it was healthy). I used to have a lot of insecurities with my hair growing up. To the point where I cry about it sometimes even now. It is always very dry and tangly and I used to straighten my hair a lot to be able to manage it. But I stopped straightening my hair over two years ago due to damage. I feel like hair products I use (like leave-in conditioners and sprays) only help my hair for a few weeks to a month, it almost seems like my hair gets used to it and adapts to fight me back. I have used hair masks like olive oil and coconut oil but not consistently. Lately, I only wash my hair once a week (it takes a lot for my hair to get oily, and I only wash it more than that if I am outside where there is a lot of dust or dirt). My diet is a lot of protein and carbohydrates (I workout 5 to 6 days a week) but very little greens (I am trying to work on eating that more). When I wash my hair once a week, I also lose a lot of hair, like 2 to 3 clumps, I do not have bald spots or anything, but I do get worried about my hair. I feel overall my hair is very fine, dry, and flat. It sits flat on top of my head with no body and it bothers me very much. I hate when other girls complain about their hair saying it is dead and they need a haircut, when their hair is way better than mine. I am going to have my hair for the rest of my life, I just want to know how to take good care of it and keep it healthy and put the right products so that I can feel happy, healthy, and confident.",
    "doctor_response": "Hi. I think your problem is very common and you should not feel so let down. Please get your blood tests for thyroid and iron profile. I hope your cycles are normal. If not then please get yourself checked from a gynecologist and follow a healthy diet like drinking lots of water. Eat lots of vegetables like broccoli and fruits like avocado. Please apply fresh aloe vera gel on the damaged root tips once or twice a week. Make a paste consisting of yogurt, almond oil, and vitamin E capsule and apply once or twice a week. Do not use any sulfate-based shampoo and use good serum oils on your root tips. Keep doing this and you will get results soon. Apart from that, wash your hair twice a week a least.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is trigaine solution effective for hair loss?\n\nhello doctor. Iam a ectodermal Dysplasia patient.I am 26 now.I have been experiencing severe hair loss and i have gone bald. My doctor prescribed me Manexil gel 5% along with Finpecia and trichoton tablets. Initially i had good results but now my hair loss has got aggrevated. so when i consulted him he has given me trigaine solution along with same set of tablets.I would like to have your considered opinion in this regard",
    "doctor_response": "HIWell come to HCMIf you are a male patient then this could be Male Patron Baldness, and there is no cure for this, you need to continue the medicine that you are using right now, may not give promising result, hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for pneumonia and kidney infection?\n\nmy dad was rushed to hospital a week ago.He was unresponsive at first with severe dehydration.They dicovered he had pnemonia & a chest&kidney infection,he's stiil unsteady on his feet but our main concern is he can remember eveything up to a few days before ill &is now forgetting even simple things such as what he had for lunch. Could it be as his body has beeen through so much&he seeems very tired?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Your father has pneumonia and kidney infection. He needs higher antibiotics to control the infection first. Taxim, gentamycin and metronidazole or other broad spectrum antibiotics should be used. For intravenous antibiotics and fluid treatment he needs hospitalization. regular complete blood count and creatinine level should be measured. So go for hospitalization and take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest therapy for a neural problem\n\nGood Evening, my fiance is a TBI patient. His has full use of many of all his abilities. His processes are often a little slower than others but he does well. He has impulse issues. Lately, he has had several behavior control issues and it has caused a great deal of difficulty getting him to relate and understand his actions and/or behaviors. He will say he didn t do this or that when in fact he did. He feel asleep while I was talking to him via skype. In combination of all these recent changes, the relationship is strained. How do I help?",
    "doctor_response": "Hi there, thanks for writing. TBI patients are a very complex population with many individual needs. Based on your concerns, it seems like your fiance's problems are less physical in nature but more related to cognitive/behavioral issues since his injury. I would recommend you reach out to his primary care doctor to help coordinate cognitive rehabilitation for him. Some rehab centers even have TBI clinics where they can specifically tailor the treatment to your fiance's specific needs. I wish you the best of luck and hope my answer was helpful to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hard lump on roof of mouth, had cavity filled. Serious?\n\nI have a small lump, it s flesh colored and hard, on the roof of my mouth. I had a crown removed and cavity filled last week. It might be where the Novocain was injected but I m not sure if that was the spot it was. I m going to the dentist in 2 weeks to get my crown put on. Is that too long to wait?? Could this be serious??",
    "doctor_response": "Hello and thank you for your question. You may have a torus palantinus.  This is an outgrown of bone found in the hard palate along the midline and a common benign finding.  You may have had this for a while but did not take notice until after the procedure.  If it is near the gum line, and you had a rubber dam placed, this could be a spot of trauma from the dental clamp and is part of the healing process. Keep an eye on the spot.  If it is non-ulcerated and flesh colored it can wait two weeks.  This is most likely benign and you can rest easily.  Please bring this up with your dentist to evaluate so he may bury any more anxiety or fears you may have. Best wishes and good health. Dr. Ward",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fibromyalgia\n\nA few years ago, I was beginning a diagnostic treatment for what I thought was fibromyalgia. My doctor began me on a series of antidepressants to rule out depression as a cause of the pains I was feeling. I stopped taking antidepressants because I don t like the way they make me feel, and I wasn t depressed. My common ailments include random nerve pain throughout my body, like the feeling someone is taking a nerve from both ends and pulling it slightly, headaches, a foggy feeling trying to remember facts and details, increased tiredness. The nerve pains bother me more than anything, I could be doing something simple such as driving down the road when a nerve pain will begin flashing in a random area of my body for a couple minutes, usually close to major joints (Wrists, ankles, knees, neck).This sounds like typical fibromyalgia from my research but I can t be sure.",
    "doctor_response": "Antidepressants are the second most effective medicine for fibromyalgia and the findings in fibromyalgia and depression with body symptoms are identical in every way. The mood changes are generally NOT noticed by the person as much as those around her.The most effective is exercise. It works in multiple ways.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could numb, tingly hnads with racing heart along with diagnosed lupus indicate SLE?\n\nTested positive for lupus anticoagulant and my Dr has a suspicion that I have sle.  Waiting  to see a rheumatologist. Right now I'm lying down and my hands keep going numb/tingly and that happens right after my heart races then slows down and pressure is in my chest cavity.  It feels like a cycle. Not sure what this is and it's worrying me.",
    "doctor_response": "HIThank for asking to HCMI really understand your problem, the symptoms that you have described here are not the symptoms of SLE, if you have history of tingling, and tingling then cervical spine problem could be there, you can use cervical collar, and this will give nice result but I would advise you to get it confirm and for that either you have to get done the x-ray of cervical spine, hope this information helps you, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause low blood platelet count and elevated ANA levels?\n\nI have a question regarding immune thrombocytopenia. I went to the doctor for some heart palpitations and my doctor ordered a few blood tests and my platelet count was 50,000. I had never had a CBC done before, so I was really surprised. All follow up counts were low, so I went to a hematologist who ordered more tests, including an ANA which came back 1:1280 and speckled. I was sent to a rheumatologist, and all further lupus/autoimmune tests were negative. So my question is, what\u2019s going on? Is my ANA high bc of the ITP? I have zero symptoms of lupus and the only other thing that was found in my labs was that I\u2019m B12 deficient, slightly anemic, and my red cells are shaped/sized weirdly (ovalocytes and RDW 17%) Any idea what my deal is? I feel fine, and the plan so far is for me to just get a CBC every month to keep an eye on my platelet count- is there anything else that should be tested or ruled out?",
    "doctor_response": "Hi, Please, do not worry. When ANA test positive doctors do another specific test called anti-dsDNA test. This test is specific for systemic lupus erythematosus. It is likely you do not have lupus if anti-dsDNA test came back negative. ANA test can be positive in healthy people as well or after using certain medicines or in infections. Besides other autoimmune conditions;  scleroderma, polymyositis and rheumatoid arthritis may also have positive ANA. Your low red blood cells and platelet is likely caused by low B12 level. You should consult with your doctor to find out the cause of the B12 deficiency. Dietary B12 deficiency is very rare. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment for lung cancer?\n\nmy dad was diagnosed with lung cancer which has now spread to his bones, he was given 6 mths, he is now on a nebuliser and his speech is slurred etc and he repeats himself saying he is dying and he is goin soon, is this a sign he is come towards the end now.",
    "doctor_response": "Hi welcome to the health care magic Sorry to heard that your father having lung cancer It has been spread to bones,  hence i am sorry but lung cancer has been metastasized to outside lung and so prognosis is poor here.... In lung tumour surgical resection done but here tumour spread to bone Hence if needed chemotherapy or radiotherapy can be given according to need... Prognosis according to history seems poor here Chemotherapy choice depend on type of lung cancer whether it is small cell or non small cell carcinoma Hope your concern solved Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for upper abdominal pain ?\n\ni dont have money but i need ur help please answer me..i have pain my upper abdomen ..when i ate foods has an acids my upper abdomen is very painfull",
    "doctor_response": "HELLO WELCOME TO HCM DEAR PATIENT DONT WORRY YOUR PROBLEM WILL BE SOLVED SOON ADVISE EAT FREQUENT FOOD DONT BE EMPTY STOMACH FOR LONG TIME TAKE REGULAR INTERVAL FOOD MEDICATIONS YOU CAN TAKE TABLET PANTAPRAZOLE TWO TIMES DAILY HALF AN HOUR BEFORE GOOD MORNING AND EVENING. IT WILL SURELY SOLVE YOUR THIS PROBLEM TAKE CARE REGARDS DR VIKAS PODDAR",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal for shingles to become black blisters after medicine?\n\nMy aunt is visiting and we took her to the er 2 days ago for a rash. Dr. said it was shingles.  2 days later it is worse and these red blisters are now black and have spread very quickly.  Is this the normal progression- black blisters after starting antiviral meds?",
    "doctor_response": "Hi,Thanks for writing to us.The change in color of the blister suggests wither it has become blood filled or has scabbed.In herpes, clear vesicles can later on fill with pus or blood.Usually once the antivirals like acyclovir (800 mg five times in a day) or valaciclovir( 1g thrice in a day) are started in appropriate dose, progression of disease stops.If you are having and doubt either consult the doctor again or use ask a specialist feature of this website to upload pics and have an elaborate discussion.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes depression despite taking Escitalopram?\n\nI have had a tramatic brain injury for 12 years I was suppost to go to Columbia and retrain my brain 12 years ago but I thought cause I remembered my family and my past I was fine but the past 5 to 10 years I know I m never going to be who I was and I need the right medication s to live a real life I m on escitalopram and conazapam I feel its been 3 months I have been taking escitalopram I m still moody and depressed its not the conazapam I need help figuring out wat I need",
    "doctor_response": "in  my  opinion  if  u  r  feeling  depressed  in spite  of    escitalopram    one  can  go  for  change  in antidepressants   and  attend  cognitive  behavioral  therapy  with experienced  therapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal that I feel tired by mid- afternoon and ready to sleep?\n\nHi I have been taken bisoprolol 2.5 mg for four months now to regulate an ectopic heart beat, I work in construction which is quite physically demanding. Is it normal that by 2 pm I m feel shattered and ready to sleep?, I now find myself going to bed a nine most evenings.",
    "doctor_response": "Hi,Welcome to Health Care Magic, Thanks for writing to us,I am Dr.Ahmad Bilal, I have read your question, I understand your concern and will try to help you in the best possible way.There are many causes of getting new onset fatigue I will mention them in my answer.First I would like to address your concern about Bisoprolol, If you are concerned that your heart rate control medicine is causing this fatigue , then I would like to mention here that fatigue is definitely a side effect of bisoprolol ,But to see if it is actually caused by your medicine, we will have to consider, when you did start your medicine and when did the symptoms start to appear.If symptoms started after starting this med (usually happens after 2 weeks of med) then  you can contact your doctor and change to some other heart rate controlling drug either in beta blocker or any other category.In my clinic i would suggest such patients to get Sustained release Calcium channel blockers like diltiazem , these do not have such side effects,Other than meds ,Hypothyroidism,Excess work without much rest can cause such symptoms.Mental stress can cause it.Insufficient energy intake can cause this.I would suggest you to discuss all the possibilities with your doctor and hopefully things will end up great for you.....I Hope this answers your question, if your have more queries feel free to ask,I will be pleased to alleviate your concerns.Wish you the best of health.Regards,Dr.Ahmad Bilal.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How serious is minimal cardiomegaly and scoliosis?\n\nMy others Xray report Showed: Mild Aortic Unfolding, Minimal Cardiomegaly & Mild Scoliosis. Is this very Serious. If we take the medicines will this be cured completely. Will she be able to work & do things very actively. She is 53 years old. PLS HELP me. I want to know that is she is fine...",
    "doctor_response": "Hello, Regarding your concern, I would explain that a chest X-ray study is not the best tool to examine the heart. For this reason, I would recommend performing a cardiac ultrasound and a resting ECG in order to examine her heart function and structure. I would be glad to review her test reports as soon as you will be able to upload them for a second opinion! Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to control fits permanently in child and does it affects brain?\n\nDear Sir, My son(15months old) is suffering from fever from yesterday and suddenly during night he got fits and we have taken him to hospital and doctor prescribed to use Encorate daily. Can you pls tell me how we can control this disease permanently? Is there any other medicine to be taken?Is it effects his brain in future? This is second time he got in last 4months.",
    "doctor_response": "Hello dear,As per your narration, seizure in fever in age group 6 months to 6 years without any focal onset or focal deficit fall under the category of febrile seizures. Generally febrile seizures doesn't require any treatment or investigations. Only treatment required is management of fever. In cases with repeated episodes per rectal diazepam as home remedy may be advised. In your case antiepileptics have been started. You need to consult a pediatrician or neurologist for proper advice and treatment guidance.Also it resolves in nearly all children crossing the age of six with only few developing risk of future epilepsy. So be assurred.Hope you find the answer helpful.wishing good health to your child.Dr Neeraj kumarNeurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does delayed menstruation indicate pregnancy?\n\nHi dr... usually i get mensus between my 28th day to 32nd day.usually i get some cramp in my lower stomach before 10days from my period.this time also i got that cramp.but nw my period exceeds 4days..now 34th day.but now too am getting that cramping occasionally. some white discharge also there. light pain in my nipple. but am not having any other syptoms.am i pregnant?.. i havent take any test.",
    "doctor_response": "Get urine pregnancy test done. These cramps do not necessarily mean that you are pregnant. So, don't worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does using lacto calamine aloe lotion for skin affect pregnancy ?\n\nHi, I am a married lady planning to start a family soon. I am using lacto calamine aloe lotion for my skin as it has acne . Will this lotion affect my conception? pls reply . My age is 31.",
    "doctor_response": "hi welcome to health care magic.no my dear this lotion is not affect your conception.its just colling lotion,so you plan without any tention best luck for that. thanks dr.dhara dhara.shah84@yahoo.in",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bad breath. Need a remedy\n\nhi pleas help me, i have bad breath for many years,if i eat chicken i will have bad breath,If i drink anything else that is not water my breath gets worse,i brush my teeth and tongue 3 times a day,this time i am ready to stop bad breath,pleas give me some advice,i will be grateful to you,just let me talk to someone too close,for peace",
    "doctor_response": "Hello, Thanks for writing to us. Remedy for bad breath:- \u2022Brush your teeth and rinse your mouth thoroughly after every meal to remove food particle from the mouth. \u2022Quit smoking. \u2022Have regular check-ups with your dentist to rule out gum disease and to correct any faulty restorations, overhanging fillings or leaking crowns, all of which can trap food in the mouth. \u2022Chew sugarless gum or suck on sugarless lozenges to increase the flow of saliva. . Use mouthwash. Hope this helps you. Wishing you good health... Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes short term memory loss having sinus infection and taking treatment fit CVID?\n\nI have CVID and get treatments every month by IVig. I am always getting sinus infections they just never seems to go away and broncitius every year along with some other medical issues such Central Apnea that is being treated and managed effectively. My question in the last six months my short term memory as gotten a lot worse. I forget just common words when speaking in conversation or can not remember what I did hour ago. It s something I have not brought to my Dr attention or my family I just don t want to feel like I am going nuts. I am 43 year old male.",
    "doctor_response": "Hi, I believe that for your condition and the chronic treatments you are receiving of IVIg it would be perfectly reasonable to request a neurological screening for cognitive issues you've noticed occurring in the past several months.  I see no harm and certainly a potential benefit to doing at least a bedside screening test such as a Montreal Cognitive Assessment or something even a less complex such as an ST. Louis University Mental Assessement. Also, I would definitely send you for blood assays for B12, FT4, TSH, and Testosterone levels known to all affect general cognitive competencies when getting chronic infusions or suffering from something such as central apnes. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for wheezing in a child\n\nHI, My baby is 2 months and 2 weeks old. he has a slight wheezing sound while he breathes, esp when sleeping. And since 2 days he has dry cough. His Paediatrician prescribed Ceff syrup,Meftal - P syrup and Alerid Syrup. Baby doesnt have fever, so if Meftal necessary? Please let me know. He also gave me Dex Tablets and asked me to powder and mix in milk and give. My baby is breast fed.. wonder, if the tablets is necessary. I do not want to give him any other milk .. unless its absolutely necessary - even if its just a spoonful. Thannks",
    "doctor_response": "HiThanks for writing to us.1.Meftal is not necessary. Plain paracetamol is sufficient for fever.2. Dex tablets can be given if your doctor has prescribed, you can express your milk and powder it and give if you dont want to give other milkRegardsDR ARUN",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I have heart palpitations with shivers?\n\nI have felt like I've had a few heart palpitations...feeling shaky inside.. little or no appetite ...and a tiny bit of diarrhea. I am currently on a generic Keppra from where I had one seizure months ago....and on lisinopril 10 mg for blood pressure....I do not have actual chest pain. I'm trying to cipher if anxiety or something else",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!I understand your concern and would explain that your symptoms seem to be related to a viral infection. What is the dose of levetiracetam that you are taking? What is your body temperature? Do you have fevers?I recommend consulting with your GP for a careful physical examination, a resting ECG, an abdominal ultrasound, a stool analysis and some blood lab tests: -complete blood count-PCR, sedimentation rate-blood electrolytes-kidney and liver function tests-blood bacterial culture. You should discuss with your doctor on the above mentioned issues. Hope to have been helpful!Best wishes!Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to stop high blood pressure medication?\n\nHi, im currently taking meds for high blood pressure, Lisinopril, i notice that with a daily regimen of exercise, my blood pressure has been fine, well within the normal range, i stopped taking the meds and even then, blood pressure fine. Question is, should i have eased off the meds 1st? or am i fine?",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!I understand your concern and would explain that if your blood pressure is blood pressure is too low taking lisinopril, it indicates that you should stop this treatment, or reduce the dose. It is true that  lifestyle modifications in a stage I arterial hypertension, can decrease blood pressure in the normal ranges. In such case it is ok to stop antihypertensive therapy. Hope to have been helpful!Best regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cracking sound in neck leading to neck and shoulder pain?\n\nI have a lot of neck- shoulder pain for almost a month now. One night I herd a crack sound on my neck during sleep and I couldn t move my head , my neck was hurting really bad and the pain goes down to the right shoulder. From that night I cannot sleep well and often I had bad pain in shoulder neck and I even cannot turn my head to the right!! What s your suggestion? Are those symptom s of AS ?",
    "doctor_response": "Possibly there been some intervertebral disc prolapse which got aggravated by bad neck posture and may be compressing any exiting nerve root. I advise you to use a soft cervical collar to restrict the neck movements and get MRI cervical spine done.In AS (Ankylosing spondylitis) there can be involvement of cervical spine, but its a gradually progressive disease, for which you not told any previous neck/back symptoms like morning stiffness etc. So AS is less likely possibility.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent dizziness?\n\nSo I have been feeling extremely dizzy for the past 4 days, mostly if I sit or lie down. I feel light headed when I m awake. I went to the doc and had my ears checked. Nothing looked wrong... there is a rare blood disease that is dominant on my mother s side called spherocytosis. Dizziness is a symptom and I also had to have my gallbladder removed when I was 16. I have been tested before when i was younger and the test came back negative. Could I possibly have this disease now?",
    "doctor_response": "Hello dear,Considering the fact that you have a family history of Spherocytosis, the symptom of dizziness as mentioned in your post can be attributed to anemia (most probably haemolytic anemia due to destruction of red blood cells).Investigations like complete blood count and peripheral blood smear will be helpful in clinching the diagnosis.Other causes can be:1. Pathology in the Vestibular Apparatus in inner ear (it is associated with maintenance of body posture & balance) most probably Labyrinthitis or Benign Paroxysmal Positional Vertigo2. Electrolyte imbalance in the body3. Fluctuation in blood pressure or blood sugar levels, etc.So, kindly consult your Physician/ ENT Specialist & get a complete clinical examination done.Investigations like estimation of serum electrolytes, blood sugar level & vestibular function tests will be required to rule out any pathological cause for the symptoms.There is no need to worry, you will be fine.Till then, maintain adequate hydration & proper nutrition status and avoid stress.Also take precautions like getting up from bed slowly & avoid sudden head movements.Wishing you a Good Health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child with severe abdominal pain. No fever. Chances of food poisoning or stomach flu?\n\nMy 10 year old daughter started having abdominal pain and cannot walk standing straight up. She is walking very hunched over and says it takes her forever to get where she needs to go because her body feels unsteady. She is in bed with me now and it took her 10 min to roll to the other side. She is sleeping right now. It doesn t seem to be the stomach flu or food poisoning . She isn t running to the bathroom like crazy. I m pretty sure she wouldn t be able run if she needed to. Also she does not have a fever , not even a slight one.",
    "doctor_response": "Hi! If She Complaining Of Abdominal Pain The reason Could Be Many.Inlarge Liver, Stomach Ulcer, Give Her Antispasm Tab For Stomach Pain And Wait. If Problem Remain Same Do Consult A Doctor For Further Checkups. Takecare.  Bye !",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for penile infection\n\nHello , My Semon Is Normal But It have Like Part's Come Out With It and If i didn't have sex for like 10 day's it become a little bit yellow and doe's part's are what make me afriad they are like little worm's but there just from semon and i cum fast having sex so plz help ?",
    "doctor_response": "Hi,Coming early doing sex is known as premature ejaculation which can be managed with behavioural therapy and certain medicine so you need not to worry, your problem is very much treatable.Worm doesn't appear in semen,this could be semen threads.I would advise you for a battery of investigation like CBC, Liver function test, blood sugar, urine culture and you may require a course of antibiotics under medical supervision if urine culture comes positive.In my opinion you should follow these guidelines Say No to smoking and drinking Alley your stress and anxiety by relaxation exercises and yoga or meditation. Spend more time in foreplay and withdraw your penis when you feel like ejaculation. Paroxetine or depoxetine group of can be advisable for premature ejaculation under medical supervision.Hope this answers your question please feel free to ask for follow up question I will be happy to help you.Best wishes,Dr. B R Hudda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a concern regarding my Maryland bridge. Please guide me.\n\nHello\u00a0doctor, I am 19 years old. Can a Maryland bridge or any bridge move up, down, right or left?",
    "doctor_response": "Hello. Hope this answered your query. In case you need more clarification, you can reframe your question and get back. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Painful bruise with a lump on the hand without injury. Could it be due to a spider bite? Have cold, sore throat and sneezing\n\nI have a bruise on my hand , that started bluish green and is turning purplish and redl. Except there is a firm, white bump in the middle, that is the only part that hurts, not the bruise part.I do not remember hitting my hand that hard, so I worry it is a spider bite . I also got a cold around the same time it appeared. Regular symptoms; sneezing , chills, sore throat and sinuses draining. That was last weekend, so exactly a week ago. The bump is firmer and more visible, the cold is almost gone, so what do you think this is?",
    "doctor_response": "the sneezing and other symptomps are of allergy and when allergy is not controlled that goes to skin allergy if you treat sinus will go to skin and if skin is treatec it will go to sinus if you get allergy tests done you can find allergies and go for slit therapy in the mean time take singular 10 mgm bd allegra 120 mgm bd and apply mometasone ointment in skin portion go on taking off and on till you get tests and treatment for nasal allergies",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will elevated ferritin 185ug/L cause loss of weight\n\nYes I would love u to answer a question. I have had weight loss in the last 8 months of 4-5kg without trying. I have had ct scans (normal) and blood tests. Only thing on blood test is slightly elevated ferritin 185ug/L. I can not seem to gain weight I am female 50 years full mamagram 2yrs ago not breast changes. I have had servere stress that is now subsiding but don t think that is the reason. I have thought I may be taking too much thyroxine 100mg per day for 51kgs and is taking my body a while to recover from that. Thankyou",
    "doctor_response": "HiThanks for using healthcare magicIn your case, weight loss may be due to thyroid hormone. Thyroid helps to  maintain metabolism and if it level is towards higher side, it could lead to weight loss. Better to get your thyroid profile done and if it is towards higher side, then decrease the dose of thyroxine.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in lower back on left side. MRI done, suspects TB in lower spine\n\nHi doctor. I have been having pain in the lower back and only on the left side for almost 2 months. I got mri done and my doctor suspects that is have a tb in the spine. The tests cannit be done in the country in which i am living in because i wil be deproted as soon as they suspect tb..so i planned on goin back to my country to check it. What are your suggestion",
    "doctor_response": "Hi, thanks for writing to HCM.The diagnosis of TB spine has to be confirmed by all means (radiological, biochemical, biopsy, microbiological methods, CT/MRI scans ).Once it is confirmed, that you have Tuberculosis of spine and if there is no neurological involvement, the treatment would be with Anti-tuberculous drugs for a period of 6months to 12 months, which should result in disease free state and you will be back to normal.So, a detailed evaluation and appropriate investigations are needed to establish the correct diagnosis of your problem.Hope this information is helpful. Good day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Took Unwanted72 after having sex. Missed periods, having breast pain. Chances of pregnancy?\n\nmy friend finished with her normal periods on 22nd of may, she had sex with her husband on 26th of may and taken unwanted 72 on 27th of may one more pill she has taken on 29th of may without any intercourse.... after 7 days of taking pill (4th june) she started bleeding that was only for one and a half day now its 8th july and she did not get her periods yet.......but she started feeling some breast pain which always she feels before her periods gets start...........i want to ask is there any chance of pregnancy in her case......why her periods are not coming.......or she should wait for few more days............",
    "doctor_response": "Hi, Thanks for using HCM.Since she had sex at safe period that is 8th day and took unwanted 72 with in a day no chances of pregnancy and because of pills her periods has postponed. If you suspect pregnancy to be the reason of delayed periods with the light periods being decidual bleeding, then get a thorough evaluation by your gynecologist with ultrasound scan and blood tests to confirm/rule out pregnancyNo need to worry now but get one UPT done.Consult your doctor for examination and management.Hope I answered your question. Feel free to ask me if you have any further queries. Wish you good health. Take care.RegardsDr. Lohit",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for heart disease\n\ncomplicated circumstance. 52 year old quadriplegic. already has MVP with regurgitation, has to have cardiac clearance for non-cardiac surgery; stress test came back small inferolateral and lateral wall reversible defect noted, not fixed defect noted, normal LV function, the probability of flow limiting coronary artery disease is intermediate. (LV ejection 59 at rest, 56 with Lexiscan. Now what??",
    "doctor_response": "Hello, After going through your medical query I understand your concern and I would like to tell you that now before going for non-cardiac surgery you have to go for cardiac catheterisation for CAD evaluation and risk stratification. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the preventive measures for the convulsions?\n\njust three days ago my youngest son was having a high fever and by few minutes he was in convuisive , what is the prevention if in case it will happen again. and will he be living normal life in the future ? by the way my son is five years old and he is kinder 2, will it affects his studies?",
    "doctor_response": "Hi,Thank you for posting your query.I have noted the details. Based on the description, it seems to be a case of febrile seizures. Febrile seizures can occur in children upto the age of six, when they have high fever.They need not be started on anti-epileptic medications, as the risk of seizures coming in the future is less.However, if the child develops any fever in future, it should be brought down rapidly with paracetamol and cold sponging.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to confirm pregnancy?\n\nWe are trying to concieve last ovulation was 3 weeks ago i had a very light period that only lasted at day/day and half.  I usually have tender breasts about a week before my period but they are still tender now, last week i suffered from quite a few headaches and for the last 2 days i have been feeling nauseaus on and off all the time.  Is it too early to do a pregnancy test?",
    "doctor_response": "Hello dear, I understand your concern.In my opinion as the period is lighter than usual and you have symptoms like tender breasts, nausea the pregnancy is to be ruled out.I suggest you to consider doing a urine pregnancy test to check for the pregnancy.Usually a urine pregnancy test gives accurate results a week after missed period.As the test confirms the presence or absence of pregnancy kindly do a urine pregnancy test.Avoid stress.Hope this helps.Best regards.....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Infected tooth extracted, have swollen mass under jaw, on antibiotics. What to do?\n\ni had an infected tooth extracted. i have a swollen mass under my jaw. it does not seem to be muscular hypertrophy has there are no muscle in that region. i fear it may be a cyst, however have been on antibiotics for 2 days and it has not changed much. also 2 days post oral surgery",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. It can be possible that you where having an abscess or cyst in relation to that infected tooth. After the extraction definitely the infection has relived, but swelling will be there.You should complete your antibiotic course and follow all the instructions given by the dentist it will take 5 to 7 days for swelling to reduce.If it does not reduces after that also then you should visit your dentist for the follow up. Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can snorting of the energy pills cause any side effects?\n\nHi. My friend bought these new energy pills, OxyElitePro. They contain 100mg of caffeine along with Proprietary Blend Bauhinia Purpurea L (leaf and Pod) (Standarized for Bauhiniastatins 1-4), Bacopa Monniera Leaf), 1,3-Dimethylamylamine (Geranium [stem], Cirsium Oligophyllum (Whole Plant Extract), Rauwolscine (Rauvolfia Canescens L [leaf and Root]. Recently he s started cutting open the capsules and snorting them. When i asked why he said the effects would onset faster and he just liked the feeling. Other then the obvious destruction snorting anything does to your nose, what are the other negative side effects, if any.",
    "doctor_response": "Hi, Yes, it may cause some serious side effects. Oxyelite-Pro is a dietary supplement promoted for weight loss. However its safety and efficacy has not been established on any scientific studies. Apart from causing necrosis of the nasal mucosa if snorted, its use is also linked to liver injury resulting in hepatitis. It also contains fluoxetine which is an antidepressant which may cause sleep disturbances, sexual dysfunction and seizures. In view of the above the Food and Drug Administration (FDA) has already advised its consumers not use this supplement. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mohammed Taher Ali",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be worried about the GSR score being 80 in the blood test?\n\nI had blood work done 2-28-14. The doctor talked to me about several things but never about the GFR score. It was 80. The printout says that is stage 2 and indicates kidney damage. The GFR score on this printout is rather hard to notice; I never noticed it until today. Do you think my doctor may have overlooked it and I should ask her about it or should I ignore it.",
    "doctor_response": "Hi, welcome to HCMKidney damage defines according to GFR. But, without implication on health of patient or if it is not associated with other abnormality suggestive of kidney disease, if GFR is> 60 then it is not considered as kidney damage.Check basic urine report, BP, S.potassium and sonography.With these reports, we can rule out kidney damage.You can then consult your doctor or you can get back to me also with reports.I think this would be helpful to you.Best wishes. TC.Dr Jay Patel.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in left side of the collar bone\n\nMy left side of my collor bone in the front when I turn a certain way or swallow it feels weird and it feels like its broken I have a redspot prob from holding it cause of the pain the lump it feels sometimes like it pushes against my lung. the pain feels like its throbbing and it abit swallow.",
    "doctor_response": "Hello, As you feel like a lump in the throat region I will advise for the ENT examination and an MRI of the throat. As usually swallowing disorders aren't something which leads to pain in the lungs or bony regions like the collar bone. For now, until you get this examined by the ENT and take an MRI I will advise for hot water fermentation and simple gentle stroking massage. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need treatment for dizziness\n\nMy wife has been getting dizzy when getting up from sitting or laying down she also has been very fatigued and no energy she also has has a bad taste in her mouth that she describes as like stale smoke or cigarettes. She is not a smoker for at least the past 15 years.",
    "doctor_response": "Hi, I am Dr.Bruno and Let me answer your query.I am sorry to hear about your wife's problems1. getting dizzy when getting up from sitting or laying down 2. very fatigued and 3. no energy 4. bad taste in her mouth that she describes as like stale smoke or cigarettes.All these point out to Anemia or Iron Deficiency Anemia I would suggest you to consult your family doctor and do the following tests 1. Hb %2. PCV 3. RBC Count 4. Peripheral Smear Anemia is easily treatable and is a curable condition If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intense knee pain?\n\nI am having knee pain that is more intense after being in a sitting position for even as little as 5 minutes. I have a brace I am using again and have been told I have fluid under my knee cap. I m wondering if this fluid could have built up over that course of the last year to cause so much discomfort?",
    "doctor_response": "Hi thanks for contacting health care magic.Noted you have fluid accumulation in knee joint...Do you have history of trauma???Here you can have severe osteoarthritis like condition....In which as tear of synovial membrane fluid can get accumulated.You should consult orthopedic surgeon for detail investigation.MRI is also useful for rule out ligament or menisci injury....If need surgical intervention done with use of disease modifying drugs...The accumulated fluid if not resolving then needs removal and send for pathological examination...Take care.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes inflamed left chest?\n\nI woke up this morning with an inflamed left chest. I am a male 37yrs old healthy. The only thing i think it could be is, i did a chin-up without correct form? Could i have sprained my chest. The only pain i have is like  after a workout doing bench press?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. In my opinion, you are mostly having musculoskeletal pain due to exercise. So follow these steps for better symptomatic relief. 1. Avoid heavyweight lifting and strenuous exercise. 2. Avoid bad postures in sleep. 3. Avoid movements causing pain. 4. Take painkiller and muscle relaxant drugs. 5. Apply warm water pad on affected areas. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Copper IUD fell off. Spotting and cramps after period. How soon to see doctor?\n\nHi, my copper iud just fell off , I ve had it for 6 months , my periods were regular and not heavy, at the end of my period yesterday i started spotting red bloud all over again and today i felt something poking it was the tip of the iud so i pulled it out, I have light red spotting and mild cramps , how soon should i see my doctor?",
    "doctor_response": "Hi,kindly immediately consult a gynaecologist to avoid any reminants of the IUD in the uterus that can cause infections and severe pain and bleeding.An ultrasonography may be required depending on clinical examination.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes discomfort in the chest during an erection?\n\n12 months back I had a tearing feeling in my upper chest once the previous night I had masturbated with squizeeing my base of the penis sine then whenever I am in upright position I get a feeling as if my nerve is been pulled in the upper chest I also a tingling feeling in my left ear and left shoulder arch and as soon as I lie down the pressure gets realeased",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. In my opinion you are having mostly muscular pain.But since you had lefy sided chest pain with left arm pain, we should rule out cardiac cause first. So get done ecg and 2d echo to rule out cardiac cause. If both are normal, then no need to worry much for cardiac cause.Your pain is mostly musculoskeletal in nature.So avoid strenuous exercise. Avoid heavyweight lifting.Avoid bad postures in sleep. Avoid movements causing pain. Start painkiller and muscle relaxant. Apply warm water pad on affected site.Don't worry, you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can UTI and trichomonas vaginalis infection in pregnant lady lead to cervical cancer?\n\nHello good morning , i'm 18 weeks pregnant ,  i went to my ob gyne yesterday and she test my urine , they see that i have UTI that causes my bleeding , and she said i have trichomonas vaginalis ,, is it going to become a cervical cancer ?? Doctor gave me a hexetidine vagi-hex and utrogestan 200g . Is it safe for my baby ? Next march 13 my ob said i will have pap smear is it safe ??",
    "doctor_response": "Hi and thank you so much for this query.These infections cannot lead to cervical cancer. It may be just a routine pap smear and not that these infectious are responsible for cancer. The germ most implicated in cervical cancer is HPV. Both drugs are safe during pregnancy and safe to your pregnancy. There is no reason to get worried over this.I wish a safe pregnancy and delivery. welcome to the little one.Dr. Ditah, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for cough and vomiting in a child?\n\nMy son has had cold symptons for several days. This morning both of his eyes were matted shut and his eyes have ran with green gunk all day. He has a terrible cough that results in the vomiting of phlegm. He has no fever, but does have a nasty nose. Should we ride it out or is it time to see a doctor?",
    "doctor_response": "dear parent,  for his eyes you should use an antibiotic eye drops as topradex. for cough you should give a cough suppressent as dexomethorphan,  together with an expectorant as mucinex.  for the running nose you should give an antihistaminic as citrizine once daily before going to bed",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can swollen purple discolouration on the foot be treated after a bone fracture?\n\nBroke the three middle bones in my foot 12 weeks ago. Still dealing with swelling and my foot turning purple especially around my big toe. Not sure if this is normal or something to be concerned with. A compression sock helps with both symptoms however if not wearing the pain comes back. Thank you.",
    "doctor_response": "Hello These symptoms could be due to vascular occlusion around your ankle.Colour Doppler may help in diagnosis.This can lead to purple toe.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Metrogyl given to treat bacteria?\n\nMy husband and I are leaving on a 2 month holiday in Africa, Europe, Jordan, Dubai and Bali.  We have had our innoculations and I asked my Dr for a general antibiotic and also mentioned my husband once had Giardia after a holiday in Thailand.  I filled out the prescriptions and there is one called Metrogyl 400. Can it be used as a general antibiotic? Is it more for treating amoebic bacteria. Instructions just say \"as directed by your Dr\", but unfortunately he didn't give me any.  Thank you for any advice. Regards Helen",
    "doctor_response": "Hi,Metrogyl is not an antibiotic but an anti-protozoal medicine and given for Giardiasis or for mixed infection.It can be taken if there is food contamination during traveling.One can take one tablet 2-3 times a day if infection is there.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the lumps on her wrists?\n\nLast Wednesday I picked my 6 year old daughter up from her afterschool program and she showed me a hard lump on the lateral side of her right wrist, she didn t have the lump that morning, and she said she noticed during class, the lump doesn t bother her mostly, but is bothersome/painful when she bumps it, or it s touched. My sister is a pediatric LPN and she looked at the lump Saturday night, and she said it looked as though it could be a cyst, and should be looked at, but could wait unitl Monday. Then yesterday morning when she woke up, she had another lump, and it is on the lateral side of her left wrist, the lump on the right wrist was still there as well. I took her to the urgent care, the doc said to give her motrin, he wanted an xray, and if nothing shows up on the xray, and the lump are still there in 4 days then we d have to go to the next phase of testing, but their xray machine was broken, won t be up and running until tomorrow, and he said he isn t too concerned and it could wait until Tuesday. Well, the lump on the right wrist has already been there for 4 days, and I am just trying to get some idea of what might be going on, or causing these lumps. Also, she has not fallen, or anything like that, so injury isn t a factor, if anyone has any clue, please let me know. Kim",
    "doctor_response": "Hi,These lumps on the wrists seem to be insect bites as it pains on handling them.The second on the left wrist came overnight and hence seems to be due to bedbug bite or insect bite.Don't worry and it would go in next weeks time.Apply anti-inflammatory gel like Voltaren and your daughter would be alright.Hope this would resolve your query.Welcome for any further query in this regard to HCM.Write good review and hit thanks if this reply is helpful to you.Have a Good Day.Dr.Savaskar M.N.Senior Surgical Consultant.M.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for seizures in a child\n\nYes my niece is 7months old, she's having seizures that have been treated, she has been to the emergency room a lot, she has an appointment with her neurologist tomorrow. However the seizures last for about 1min to 2min and after wards she cries for 30 min. my question is, is there pain that she's feeling, what can I do besides giving her meds to help ease her when she has an episode? is their anything that i should be doing to not cause them?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.During an episode of seizure , keep baby in lateral position to avoid risk of aspiration of secretions , do not give anything including medicines by mouth , usually seizures abort in 2-3 minutes ,in case of prolonged seizures you need to learn use of  rectal or intranasal drugs or rush to emergency to get seizures aborted. Cause of excess cry is post seizure irritability due to  effect on brain .Preventing seizures from occurring needs proper evaluation of cause and regular medicines  to control seizure.Hope this answers your question. If you have additional questions then please do not hesitate in writing to us.Take care.\u2022 DISCLAIMER: - All the information provided here is for information purpose only , it is not a substitute for the advice of a physician after physical examination , it is not intended to replace your relationship with your doctor. This information in no way establishes a doctor-patient relationship. Before acting anything based on this information do consult your doctor. I recommend that online users seek the advice of a physician who can perform an in-person physical examination.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can elevated liver enzymes and bilirubin levels along with vomiting and diarrhea be managed?\n\nMy sister has elevated Liver Enzymes and Elevated Bilirubin levels with Stomach pain, Vomiting and diarrhea for the last two weeks. Normal abdominal ultrasound. Only medications she is taking currently are Gabapentin and Zofran which is supposed to stop the vomiting , but isnt. What comes to mind?",
    "doctor_response": "Hello, She should rule out viral hepatitis by viral marker investigation like anti HAV estimation, Hbsag estimation, Anti HCV estimation, Anti HB E antibody estimation etc. You can revert back with reports once done. Meanwhile, take care not to eat high fatty foods and sugar cane juice should be taken more. Apple juice also beneficial. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore,swelling and a pointy knot beside the elbow bone after an injury?\n\nMy fourteen year old daughter hit her elbow on footboard of her bed. It is very sore, has a small pointy knot right beside the elbow bone, she cant straighten her arm all the way out she gets a burning feeling and feels like its going to pop. There is some swelling to the area as well.",
    "doctor_response": "Hello, It could be a contusion probably. As of now, you can use analgesics/anti-inflammatory combination like aceclofenac/serratiopeptidase for symptomatic relief. Apply icepacks for faster recovery. If symptoms persist better to consult an orthopedic and plan for an X-ray. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My symptoms are suggestive of bipolar. Please help.\n\nHello doctor, I am a student. For some months, I have noticed that my mind is playing tricks on me. It is more like every day I have a down phase which lasts for two to four hours when I feel all negative emotions are coming to my mind. I think of anxiety and fear. I feel like I have a beast inside my mind to which I have to fight to make myself in a normal state. First, I thought it was depression, but it is not lasting for whole days, not it continuing for months, but more like two to three hours of down phase. I have seen people with severe depression, where it is difficult to get out of bed also a difficult task. This is not for me. At least I can talk to people, and I go to work every day. For me to feel better, I have to sleep or distract myself with songs. I thought it might be bipolar, but I am not sure. I want to know can it be symptoms of mild to moderate depression, or is it bipolar or any other mental disorder or it is due to stress?",
    "doctor_response": "Hello. I can certainly understand your condition. I have worked through your attached query in detail. As per your symptoms, you possibly seem to have subsyndromal depression otherwise called as dysthymia. If it is not treated on time, it may convert into depression. (Please note mild, moderate and severe are grades of depression but not dysthymia). In individuals with all the above symptoms, it is advisable to screen yourself for thyroid issues if not checked earlier. This is certainly not a case of bipolar disorder. It is advisable to consider certain medications to improve your symptoms. Treatment may last for six to nine months. In case if you are looking for a prescription, please let me know, I shall offer medications. Stress Complete Thyroid profile (T3, T4, TSH). Depression, bipolar disorder Dysthymia. SSRIs (selective serotonin reuptake inhibitors). Stress management. Good sleep and appetite. Avoid smoking and alcohol intake.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for folliculitis\n\nHi, i went to the doctor today because i am in a lot of pain. He diagnosed me with Folliculitis but took blood to make sure it s not herpes. I have an open sore/ blister and it is SO painful, to the point where i am crying trying to urinate. I just sat in a tub for twenty minutes and still cannot because of the pain. The pharmacy is already closed and i don t know what to do. It is unbearable. What do i do?",
    "doctor_response": "HI, thanks for using healthcare magicIf you have petroleum or a zinc based cream you can use these as barrier protection on the lesion. This would reduce any irritation that you feel as the urine passes over the area.The zinc based creams can be found in many baby diaper barrier creams.If neither of these an option at this time of the day then you can try using a gauze or clean tissue over the area to reduce contact during urination.Oral anti inflammatory pain killers such as ibuprofen, naproxen, cataflam can be used to help relieve the pain.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause frequent loss of memory?\n\nHello My sister been having this situation. While asleep, she starts foaming from the mouth, biting her lips and she s unable to wake up. After a few minutes, she wakes up and doesn t remember anything. This is the second time this happens. The first time, about a year ago, she just couldn t wake up after trying for 15 minutes. Do you have any idea why this may happen?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern what the history given for your sister here this could be suggestive of Petit mal syndrome in my opinion this need to be ruled out and for that you need to see the neurophysician, hope this information helps you, have nice a day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to get root canal treatment done after heart attack?\n\nI had a heart attack (mid wall variant takotsubo syndrome) on 15th April and am booked in for a root canal treatment on 3rd may, is it safe to go ahead and have this done.  I am 62 years of age, am on one aspirin daily and half a 50mg metoprolol tablet twice a day.  I was on medication for hypertension before this happened.",
    "doctor_response": "hello...read thru ur query...n i must say that if i was ur doctor i would have waited for 3 months more to do root canal treatment if u dont have pain now..but its fine if v do it now also..my treatment is to wait for 6months aftr heartattack..different doc hav different treatment modalties...its fine if u do it now.and regarding ur aspirin and metaprolol its better to consult ur cardiologist b4 doin root canal bcoz some cases u have to stop these drugs for few days ....it all depends on ur body and ur cardiologist will b knowing it.....hope u got some help from my reply..have a nice healthy day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for choking and wheezing due to contact with bleach\n\nYes, I was cleaning the shop where I work at and I took my 8 month old infant with me and I started scrubing the floors with bleach and fabuloso of course I had the door open cause of my baby and the fume. But when I got home this evening my son started to go to sleep and he started gaging like he was choking on something and he sounds like he s weezing a little, what should I do I m scared I mean he s asleep but he sounds like his got a sore throat?? What should I do I m worried!!",
    "doctor_response": "It seems patient has got allergy or some kind of respiratory tract infection... Consult a pediatrician child may need nebulization and antibiotics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having pinched nerves in the neck, how to treat pain radiating up to fingers?\n\nI know I have pinched nerves in my neck Never had two fingers on my left hand go numb. Thumb and pointer finger Very uncomfortable When I stretch I get a shock radiating from my shoulder down to my hand Is this very serious and what can I do Thanks sabjkhndy",
    "doctor_response": "this type of problem occurs in case of cervical spondylitis. for this you might have to use a cervical collar, adept for your neck size and do cervical exercise for toning up your neck muscles. If there substantial pressure on the nerves, which can be seen by an MRI, you might have to undrgo neurosrgery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I want some name of good doctor for Ulcer\n\nHi Sir, Can you suggest best specialist doctor for ulcer disease in varanasi?",
    "doctor_response": "Hi.. You may have to consult a gastroenterologist.. Few tests including an endoscopy might\u00a0 be needed.. If you are planning to get all these test, you may visit a multispeciality hospital where you have all the facilities available (including a gastroenterologist and endoscopic procedures are performed.. Alternatively you may consult a gastroenterologist of your choice. You can use find a doctor option available in this website.. All the best..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes joint pain?\n\nChild suffering from knee joint pain, blood test shows ASO positive. Given Penidure6 la. Right treatment?My son 8 years old suffering from knee joint pain.but it is appearing once in a while.It is only restricted to only knee joint not any other joints. Blood report shows ASO +ve.Doctors saying ? to rhenumatic ...",
    "doctor_response": "Hi...you are right...if its only single joint it is highly unlikely to be a Rheumatic fever. More so we should have to consider the possibility of - 1. Reactive arthritis2. Septic arthritis3. Pauci articular rheumatoid arthritis (this is different form rheumatic fever).I suggest you seek your paediatrician's help with these tips.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Upper back pain, chest tightness, underarm pain, gastritis. All tests normal. Any ideas?\n\nI have upper back pain on both sides, chest tightness both sides and underarm pain. I had full heart work up and it was cleared. I had an upper endoscopy, lower abdominal ct scan, and gall bladder ultrasound. All were fine. I have some gastritis everyday. I am wondering if I should have my lungs or spine checked. I don't have any trouble breathing or pain when breathing, but have read early lung cancer can cause this pain. Any ideas what could cause this?",
    "doctor_response": "Hello Thanks for posting your query. Upper back pain and chest tightness seems to be due to muscle spasm. As your heart workup,lower abd ct,  ultrasound are fine, do not worry. Also it is not sign of early lung cancer.Back streching exercises will be helpful to relieve the spasm. Doing hot fomatation and applying muscle relaxant gel will be also helpful. Hope this will help youRegards. Dr Saurabh gupta.Orthopaedic Surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the CECT report taken after six cycles of chemotherapy.\n\nHi doctor, My father is 62 years old. I have attached his CECT of thorax, abdomen, and pelvis. It is taken after six cycles of chemotherapy with Gemcitabine and Cisplatin. He is diagnosed with carcinoma of unknown primary with left lung metastasis.",
    "doctor_response": "Hi. I have gone through the attachment (attachment removed to protect patient identity). The scans look quite reassuring. There is nodular enhancement involving the left diaphragmatic pleura with minimal pleural effusion. Background fibrotic changes are seen in the bilateral upper lobes. The head, body, and tail of pancreas appear healthy with no focal solid-cystic lesion or area of calcification. The gallbladder seems normal. There is no intrahepatic biliary radicle dilatation seen. There is no focal lesion seen in the liver or spleen. A small cystic lesion is noted in the mid pole of the right kidney, and it is like a simple cyst. The urinary bladder is partially distended and grossly normal. There is no ascites or lymphadenopathy seen. Bowel loops are non dilated. There is no focal area of thickening seen. The prostate is enlarged, and it needs further evaluation with ultrasound (transrectal ultrasonography) and blood PSA (prostate-specific antigen) levels.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness and with hematoma on ankle?\n\nJust unsure how concerned to be about numbness with a hematoma - I was hit in the shin, just above the anklebone by a field hockey ball shot by my daughter about a week ago. Had significant swelling initially, which has become a diffuse bruise measuring about six inches in diameter, wrapping around my ankle. The numbness in the center is also white, and the tissue is thicker than the rest. Being that it s late on a Thursday, and I have to go into work at 4:45 AM tomorrow and work all day an hour from my medical facility (and then it s the weekend). Trying to figure out if I should cut the day short and come back and be seen. There isn t significant pain at this time, other than when pressure is placed on the bruising, or I rotate the ankle. My toes are fine.",
    "doctor_response": "Hi Hope this message finds you in good health.I have gone through your complaints and understand your concern.u seem to have injured some sort of soft tissues in that area causing the bruise.ice pack,crepe,analgesic,anti inflammatory tablets should help.Nothing to worry about.\u00a0\u00a0\u00a0\u00a0\u00a0I hope your question has been answered.If you have any follow-up queries,feel free to consult me anytime.Thanks,Take care,God bless.",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI shows sac above kidney, infected. Bag put to drain, taken antibiotics. How long should this bag be worn?\n\nMy friend had severe pain. At emergency, with MRI & Cat Scan..they found a 'sack' formed above his kidney..which we is infected.. A 'bag' was put on..to drain it.  Hes had this for 4 weeks now.. (not in hospital)..the drainage is getting less.... At first he was on antibotics..is not now.   What is the prognosis of his future..will he have to wear this bag a long time.. the drs. had said perhaps 4-6 mths........ What comes next??",
    "doctor_response": "Hi,  I don't understand the term bag above kidney. I guess probably his kidneys are dilated because of some obstruction. And the kidney has become bag like and it was infected. I suppose that's why they have kept a tube drain. Further course will be to asses kidney function by doing a scan called DTPA renogram and further treatment according to scan report.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting of white, thick stuff to a 1 year old?\n\nMy 1 year old granddaughter just threw up very thick white stuff that smelled horrible and she s running a 103 degree temp. I ve never seen such thick vomit or smelled vomit that stunk so bad. She just started drinking whole milk a few days ago, so I m wondering if it s possible it has anything to do with that. Your thoughts?",
    "doctor_response": "Hi, your child has got stomach infection. It has nothing to do with milk. In my opinion, antibiotic like syrup oflox 3 ml three times a day for 3 days. However, since this is a prescription medicine, i advice you to meet the local doctor to confirm the diagnosis. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain, dehydration, blood test normal, taking Bentyl for pain. Treatment?\n\nMy daughter is 12, and has been having severe abdominal pain , unable to eat, and has been hospitalized twice due to dehydration . They have run all blood test, including liver pancreas A1C, all came back normal. She also had an MRCP which ruled out pancreas and gall bladder issues. She had an upper and lower endoscopy and all looked fine. She was sent home this time from the hospital after 3 days with Bentyl for pain, and told that if she does not increase her diet and drink more she will require and feeding tube. I am so frusterated and don t know what else to do...My little girl is getting smaller and smaller and is still in pain 90% of the time. We have had behavioral health come in and have ruled out anxiety and other disorders. Please any thoughts would help so much...Which hospital is the best for childhood GI issues?",
    "doctor_response": "dear sir i have gone through the history provided by you. after all these tests symptoms and signs are not co-relating. your child may not be having any major illness, hence you need not to worry. its better if you can consult CHILD PSYCHIATRIST. because this is the age at which most of the children suffer the illness which your child is suffering. kindly behave friendly with your child. encourage  her to overcome her problem but never show too much mercy. hope my answer is helpful to you regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is the pain recurring even after disc herniation surgery?\n\nHi doctor, Five months ago, my wife had a disc herniation surgery. She was fine for the next two to three months, but again she is getting the pain. Her doctor advised us to go for repeated MRI. We are yet to meet her doctor, But, I am looking forward to know what is going on. I have attached the reports for your reference. Please help.",
    "doctor_response": "Hi. I have read through your query in detail.\u00a0Please find my observations below. Revert back with the first MRI scan to a radiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i do physical exercise after having stent on LAD?\n\nIm only 33 years old man , I have stent on my LAD. Doctor gave me Plavix and Aspirin 300 for one year . Is Aspirins 300 too much or should be lowered after 3 month. my other question , can I do physical exercise such running or playing football and climbing mountain",
    "doctor_response": "hello,I have gone through your query.Thanks for using HCM.yes you can and you should reduce the dose of aspirin to 75 mg per day.If you did not have significant damage to heart and your LVEF is normal you can surely do sport activity of your choice,My best wishesDr.Rajesh Teli,MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a white smelly hole on the gum?\n\nHi, may I answer your health queries right now ?  Please type your query here... Hey I have a White smelly whole forming on the gum were the teeth meets it right at the back the White stuff after I brushed away has left a whole but still more White stuff in there what is it and what can I do",
    "doctor_response": "Hi, can you please tell me the region of your teeth?? And in upper or lower arch???By knowing this i can better answer your query. -Dr.Bhuwanesh Sharma BDS,MIDA (Oral & Dental Surgeon)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i give omnacortil forte for cough in my child?\n\nmy baby 3yrs old having severe cough having a history of bronchial asthma .... but this time there is no wheezing and asthama , but this time he is having only serious dry cough frm 2 days,,,,, medcines zerotuss, levolin inhaler and budecort200 ug ... no progress yet ...shall i give omnacortil forte",
    "doctor_response": "Hi,Thank you for asking question on health care magic.You are already giving steroids by inhaler.There is no need for giving Omnacortril specially when there is no wheezing asthma.Omnacortril forte (15 mg/5 ml) is too high a dose for 3 year old baby.I personally do not recommend Omnacortril forte for this case.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling of people hearing and seeing my thoughts after being overdosed by neozep forte medicine.  Is there any cure?\n\nHi. I'm Kristine Lucanas from Philippines. You see, I got overdosed by a medecine - neozep forte. I think it had brain effects on me; that i got some sort of telepathic ability. Whatever I think, people can hear and see it also. Help me cure this disease please. Thank you.",
    "doctor_response": "HiYour symptoms suggest a disease called schizophrenia That would have been my diagnosis if the patients with so small history was brought to me Please get in touch with psychiatrist for detailed evaluation and treatments. Good tratment and drugs are avilable and disease can be scceccesfully treatedDr Lal Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes small painless blisters on penis post intercourse?\n\nHi, After sex I have been getting a small, painless, clear blister looking swell on the underside head of my penis, either side of the end of my frenulum. It always disappears without a trace pretty quickly, usually within an hour, and causes no real discomfort other than a temporarily poory fitting foreskin! My questions are simple ones: is this normal and why does it happen? Thanks in advance for any advice, JB.",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: May be small cutsExplanation: No infection disappears this fast. So,may be a small cut. Visit a doctor next time when you have the lesion. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can medication for fever be taken after the tooth extraction?\n\nMy son had 4 wisdom teeth extracted and was given percocet for pain. He now has a fever and wants to know if he can take anything for that or should he go to the ER? Teeth were removed 2 days ago, med dose is 325mg every 4 hrs, uncomfortable but not excruciating pain. Thank you.",
    "doctor_response": "Thanks for your query, I have gone through your query.The fever following extraction of the tooth can be of inflammatory origin. Nothing to be panic. You can continue the same medicines that is percocet and take a course of antibiotics along with percocet like amoxicillin and metronidazole.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have pus oozing lesion in my underarm. What can it be?\n\nHi doctor, I am a 41 year old female.\u00a0I am obese. My weight is\u00a089 kg and height is 5 feet 7 inches. Currently, I am taking Thyronorm 75 mcg and Storfib 145.\u00a0Previously, I used to get lymph node enlargement in underarms and groin area, but they never become lesions.\u00a0I have been having a pus oozing lesion in my underarm for the past 1.5 years. When I take antibiotic, it heals. But once I stop the medicine, it recurs. Earlier, I showed this lesion to a lady physician who suggested an ultrasound scan. Scan revealed a pocket of pus, but no changes in surrounding tissue. This lesion started, when I changed my deodorant once. My 14 year old son also has the same issue. He gets lesions in his underarms, sometimes heals and at other times pus leaks. I do not feel any thickness in my breasts in self-examination. I feel it is more dermatological. Please share your valuable opinion. Thank you.",
    "doctor_response": "Hello. Revert back with the photographs to a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes drop in heart rate with chest pain?\n\nMy son is 21 years old. WHEN HE WAS 10 he had to have surgery to repair a hole in his heart. His heart rate was high so he took meds for awhile. He s been off meds for 11 years now. Lately his heart rate has been dropping suddenly and having chest pain. Only last a minute or two. He had 3 spells like that this morning. It seems if he gets mad or upset it brings one on.",
    "doctor_response": "The pains are in your son right now are not related to surgery in the heart he had before. They are mostly related to the psychological problems that he may have and emotional. If the pain is severe all the stress is also to severe it may cause a higher parasympathetic tone resulting in slow heart rate it is not dangerous but  you should teach him to do biofeedback.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes unusual tiredness and bed wetting?\n\nhi. Im a 28 yr old student. Over the last month I have been tired all the time, I forget regular bits of information like the date, and have had several incidents of bed wetting in the last 2 weeks. Could this be due to the stress of my up coming exams?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Feeling tired, forgetting details and incidents of bed wetting could be associated with stress and anxiety. Still you need to confirm from a doctor in person. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes peripheral edema and chest discomfort?\n\nI have peripheral edema and am waiting for a echo cardiogram.I have been having this pain all over my body for a very long time and have notcied that i also have this huge pocket of fluid starting from my under the rib cage to just below my hip all around the back.Could this be heart valve failure..this chest discomfort started 5 days ago and aches contant .I was at hosp 2 days ago and they said im fine according to ecg.",
    "doctor_response": "hihope this msg finds u in good health oedema has many reasons..one of it is heart problem in which oedema is first found in legs..get a detailed blood profile done n let me know thanks Take care god bless",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for muscle pain and twitching while treating restless leg syndrome\n\nHello, I have suffered from restless leg syndrome in both legs for years +15. I experience twitching and pain in the lower leg that is relieved when I move my legs. Because of this problem I have poor sleep quality. Is there any new research that explains the cause and therefore the treatment of the underlying condition? I look forward to your response. Evelyn",
    "doctor_response": "i Dear,Welcome to HCM.Understanding your concern. As per your query you have muscle pain and twitching while treating restless leg syndrome. Well there can be many reasons for symptoms you mention in query like nerve compression , neuropathy , DVT , muscle spasm or multiple Sclerosis , but in your case the symptoms is due to restless leg syndrome which is a neurological disorder. If condition doesn't get well then consult orthopedic surgeon as well as psychiatrist for proper examination. Doctor may prescribe methotrexate , anti inflammatory , gabapentin long with nerve supplement and recommend physical therapy . Along with that doctor may also prescribe antiepileptic drug and anti depressants .I would suggest you to do light stretching exercises along with gentle massage , apply warm compresses on entire leg and take muscle relaxants like orthodox MR . Do not sit or stand for long time in one position , do yoga , meditation , avoid alcohol and caffeinated products and keep your legs in hot water tub with Epsom salt for 15 minutes. It can also occur due to side effects of some meditation , so if your re taking any medicine the do consider it and consult doctor about it . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat limping of leg after a knee revision surgery?\n\nPlease try to help. I had knee revision surgery and am limping quite a bit. From specialist to specialist I can find no reason, and to a number of specialists from knee to hip, to back etc, etc. to another MD.There seems to be no one with an answer. Thank you.",
    "doctor_response": "Hello,I have studied your case and I think that limping after knee surgery can be due to many causes. it is very difficult to comment about your causes without having your x rays.It will be best if you can send me your current x rays. I would suggest you following.1.Please check if there is any difference in length of both legs. Some time there can be difference of one to two cm. It can be corrected by foot wear change.2.Check if there is any pain in knee joint. It can be due to weak muscles. Physiotherapy can help in this condition.3.Yoiu can used walking aid also.i hope these steps will be helpful for you.Let me know if there is any other followup questions.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for excess sweating with cough\n\nHi, sorry to bother you. I was wondering if you could advise me on my i'llness. Im getting hot and cold flushes and could not sleep last night. I was sweating very badly but still feeling cold. I also have a very painfull cough and it feels like i want to cough somthing up but it just feels dry.",
    "doctor_response": "Dear Customer , This is Dr. S. Tomar from healthcaremagic.com's medical team and I ll be your medical advisor for this question. First of all thank you for sharing your concern with us and showing trust on us.Such manifestations are indicative that you are having respiratory infection . A chest x ray and CBC should be done to know the exact cause  . If you had any upper respiratory infection in last 2 weeks and these manifestations are continuing from that infection then it could be a bacterial infection and antibiotics will be needed . Gargle with salt water multiple times a day .  If you get fever also then contact your PCP straight away as there might be need of antibiotic course as well .This is my initial response and discussion is open until you have any query or need further clarification.I wish you good health .Thank you for your question and feel free to contact further for any question .sincerely,Dr. Shardendu Tomar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any side effects to high single dosage of vitamin D3?\n\nI accidentally gave my 4 and a half year old 10,000IUs of vitamin D3. I was given the wrong bottle at the health food store...I had asked for 1000IUs. He weighs 45lbs. I put it in his yogurt and he only are half when I looked at the bottle and discovered it. Will he be ok from this single dosage?",
    "doctor_response": "HiWelcome to the HCMI have gone through your question and understand your concerns. But don't worry. Vitamin D3 may lead to toxicity only when given high doses for many days. It's usually rare at the dose you gave to your child.The main consequence of vitamin D toxicity is a buildup of calcium in your blood (hypercalcemia), which can cause poor appetite, nausea and vomiting. Weakness, frequent urination and kidney problems also may occur.At present, just hold on the vitamin D3 drops for next 10 days and restart it there after.Everything will be fine. For any further questions, you may contact me.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does sharp shoulder pain indicate parasitic infection in the intestine?\n\nIsn 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",
    "doctor_response": "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. Regards, Dr. Jayesh Vaza, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Ciproxen recommended for long term use in typhoid?\n\nmy name is Tahir and i m working in saudi arabia my typiod fever history is very old first typiod fever in 2008 and every singal year typiod fever come now my wedal test result date 28/06/2014 is salmonella typhi ( TO) ---Tittre 1/640 salmonella typhi (TH) ----Tittre 1/80 salmonella paratyphi (A) ---no agglutination salmonella Paratyphi ( B) ----Tittre 1/160 so plz give me answer doctor give me tablets ciproxen 500 mg for two weeks but these tablets i take for last five or six years when typiod coming .",
    "doctor_response": "Hello, thank you for your contact to health care magic. If I am your doctor I suggesting you that salmonella is very notorious for causing relapsr. Yes for now you can start with ciprofloxacin to get cured from salmonella. In long relapse cases some doctor suggest elective cholecystectomy. Gall bladder is the reservoir of the salmonella, so once it is removed it will be cured forever. If you have to ask me anything you can contact me. Dr Arun Tank. Infectious disease specialist. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it advisable to have Misoprost pills at this time?\n\nHi Doctor My Wife is 29yrs old , Its been one week over her periods date .We did prgency test which was positive. My doc friend advised to have 2 Mtpills followed by Misoprost 2 pills after 48 hours. Its been more then 30 hours now she had Mt pills bleeding is no started .Is it advisable for still to have Misoprost pills ? How long it normally takes to start with bleeding ?Should we go for some other medicine ? Please advice Thanks",
    "doctor_response": "HI,    Thanks for the query. I understand your concern.       THE MT pill kit can be used to terminate 37 to 63 days of pregnancy.     You had taken Mifepristone pills on day one    It kills the fetus .It may not start bleeding.     On day 3 ( after 48 hours ) you have to take two pills of MIsoprostol..( orally/ vaginally )., This pill now causes uterine contractions to expel the dead fetus out. Bleeding starts after taking MIsoprostol. If there is no bleeding in 12 hours 2 more pills of Misoprostol are used..Abortion is complete in a couple of days.   Check up by a gynecologist/ USG is essential to confirm complete abortion.   * You may need doctor's help in case there is profuse bleeding or incomplete abortion. SO it is better taken under expert guidance of a gynecologist.    Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for a yeast infection\n\nI started dating a guy 9 months ago and our sex life was awesome but since Oct. I have gotten yeast infections off and on. I have been trying to figure out what is causing them, I only get them after we have intercourse and it's within 20 minutes. After much trail and error I think it could either be from his Celex ( he started that in Oct) or him eating pickles. Is it possible?",
    "doctor_response": "Hi, Thanks for posting in HCM. I understand your concern. Symptoms what you are experiencing could be due to recurrence of yeast infection. This may be due to poor hygiene or due to transmission by asymptomatic partner during sex. Kindly do the following to overcome the problem what you are facing: 1. Wash the area with warm water and mild antiseptic twice daily until the symptoms subsides. 2. Abstain from sexual activity till your symptoms subside completely. 3. After using the toilet, wipe from front to back to avoid spreading yeast or bacteria from your anus to the vagina or urinary tract. 4. Wear undergarments that helps keep your genital area dry and doesn't hold in warmth and moisture. 5. Change pads or tampons often during periods. 6. Use vaginal anti-fungal medicines which are available for 1-day, 3-day, and longer courses, depending on the strength of the medicine. 7. Along with it, you can use vaginal boric acid capsules, which are available over-the-counter. Do not use this medication if you are pregnant. If the infection recurs again and again, the following things needs to be done: 1. Maintenance therapy like a regimen of oral fluconazole tablets once a week for six months or clotrimazole as a vaginal suppository used once a week for six months can be used. 2. Treating your partner if your partner has symptoms of a genital yeast infection (balanitis). Hope the information provided would be helpful. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for muscle weakness, sleeplessness and imbalance issues\n\nI have a impinchment at C 2 thru 6. It is causing severe terriblemuscle weakness pain,unable to sleep, unbalance. Have seen a neorologists, going to a orth.-neck surgeon in three days, what can I expect.they say surgery, alto very dangerous, is absolutely necesssary. cord impingment/compression on 10-2-14. quadripresis",
    "doctor_response": "Hi,Most of the symptoms are due to the nerve compression or cord compression if any. You should explore the option of surgery at the earliest as the prognosis will be better than when you are delaying the surgery. Also with good and regular physical therapy you will be able to retain some of the former strength depending upon a few parameters of how compressed the nerves were prior to surgery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy and diet for fatty liver\n\nHello Doctor, In a recent diagnostics it has been observed that I am a fatty liver patient. One doctor told me that right condition will leads to cihrrosis in 6 months. What are the precautions i should take care. I am 32 year male working as an IT professional. I am non Alcoholic. Please let me know a perfect diet for me to reduce my wait as well as fat. My waste size is 40. weight in 95Kg height is 175cm",
    "doctor_response": "Hello Fatty liver is a reversible stage.It is important to know your grading of fatty liver.Elastography of liver can be done to assess its propensity to convert into fatty liver.Most commonly it is due to obesity and sedentary life.You need few investigations like routine hemogram,Random blood sugar(RBS),Liver function test(LFT),Lipid profile,Renal function test(RFT).Fatty liver can be reversed by diet and life style changes.You may need some medicines after full investigations.It may take 3-4 months to reverse the findings.You should be active in your daily life. You should avoid red meat and high fat milk products.Cook food in olive or canola oil.You should take limited salt in your diet.You should also avoid fried and junk food.Take lot of fruits and vegetables.You should also increase your physical activity in the form of walking and exercise.Get well soon.Hope I have answered your question.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Would surgery for hole in the heart during childhood have an impact on married life?\n\nI am a female age 25. Was diagnosed with hole in heart at birth which was surgically cured successfully at age 7. I have had a normal health since then and have undertaken all sorts of physical endurance and sports and activities like dance etc. Am getting married now and would like to know if this surgery would have any bearing on married life, safe pregnancy etc.",
    "doctor_response": "No, the condition which you had since it has already been treated at an early age should not have bearing on your married life nor on your pregnancies.The best approach would be to undergo a yearly evaluation with an Echocardiography and prior to delivery to ensure things are alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause difficulty in breathing?\n\nhi there i am 29 yerar old male and i have been taking ibuprofen 400 and co-codamol 8/500 for dental problems and i have noticed i am finding it hard to catch a breath it feels like my lungs are not filling up with air properly could this be sown to the meds",
    "doctor_response": "Hello dear , hiWarm welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This seems in relation with synergistic effects of ibuprofen with codeine    giving  difficulty in breathing .Hope this will help you for sure .Wishing you fine  recovery .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child 5 years - has fever from morning - gave two doeses of Calpol Syrup from morning, 2nd dose approx 3 hours back. Since We could not give another dose of Calpol right away, called doctor. he has suggested Meftal P 6 ml now and 6 ml tomorrow morning. Is Meftal P safe for the kid?",
    "doctor_response": "Hello, Please don't get panic. Yes, meftal-p is safe if given in prescribed Doses & duration as advised by Dr. It's basically NSAID group of medicine. To control Fever I would suggest you to give Paracetamol 6 hourly in Doses as per the weight of the kid. And if Fever is on the higher side (>100\u00b0F)  then cold sponging shall be helpful to bring down the body temperature. 4 hourly temperature charting shall be helpful to decide further course of treatment & need for investigations to be planned. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ajaygupta009, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will xanax helping in reducing heart rate and BP?\n\ni take lisinopril for high bp, 10mg.. and digoxin .25mg for my heart rate.. as of now and most of the day my heart rate has mee up to 120 and my bp so far hit as high as 170 can i take the lisinorril again? and does xanax work for bringing down the heart rate and bp?",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern. I will try to explain you and give my opinion. You should know that when we treat hypertension  our goal is to keep mean blood pressure values below 140 / 90 mmHgA person might have high frequency and blood pressure value during emotional and physical strees so its mandatory to judge on mean values. So, if you have mean value that exceeds 140 / 90 mmHg than it is posible to rise the dosage of lisinopril up to 20 mg.xanax is an antidepressant drug.It might help to lower your frequency or blood pressure if you are an emotional type,meaning that your values are strongly related to emotions, stress. In this cases xanax might help.If not, you can add to your therapy another medication that lower your frequency but you have to discuss this with your doctor according to your heart function.Hope I was helpfull. Best regards,Dr.Ervina.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause of pain after knee injury due to fall?\n\nI slipped in a puddle of water on kitchen floor on 12/20 and fell on my right knee.   Thereafter the knee was sore and a little puffy.  I have been icing my knee cap, which I feel has helped.  However, I am unable to climb stairs now due to extreme pain.  What can be causing the pain and should I seek medical care?",
    "doctor_response": "Hi,Yes it would be good if you see an orthopedic. There is a swelling which can be a fracture or an internal soft tissue injury. Good you applied ice, continue with that and also applying compression bandage or wearing a knee cap will help for the time being. Avoid taking weight on your knee as it will deteriorate the condition, a rest is advisable. If you need to walk you can do with the help of some support like crutches. Medicines like Ibuprofen or Diclofenac will help you in pain relief.Hope this has helped you. Let me know if I can assist you further. Regards,Dr. Jenis Bhalavat",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this scan report during pregnancy indicate?\n\nAge: 27 years I had my 20 weeks scan done last week (28 May 2010) and the report showed a TCD of 18 mm. I was then advised for a second opinion scan which was done on 4 June 2010 and the TCD shows 19mm. THe report says that the cerebellar growth is on the 5th centile. Fetal growth and amniotic fluid are normal. There are no obvious structural defects or markers for chromosomal abnormalities in particular the rest of the intracranial structures appear normal. Fetal cardiac scan showed a normallly connected heart with no obvious defects and normal flow patterns. The urinary artery doppler and cervical length are normal. This cerebullar growth on the 5th centile appears to be an isolated defect and in the absence of any defects the possibility of syndromic associations appears to be low. Is this a cause for worry? My Gynaec has asked me to do a rescan after 2 weeks. Is there a chance of the growth spurting back to normal levels in 2 weeks? Please advise",
    "doctor_response": "Hi there,A low value of cerebellar diameter should be always seen with other parameters which could give an overall view. If it's an isolated defect it should not cause you to worry so much. After all ultrasound findings are only there to identify problems when there is a defect, if no other defect is seen this should be taken very positively by you.The cerebellar values are usually only checked in the 2nd trimester, a repeat scan will confirm that there are no co-existent anomalies. This scan must have been recommended by your gynae to confirm the same.So do not be over concerned about it.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is vitamin b complex capsules good for health?\n\nHi :) I am a 23 old girl. My height is 5 feet 3 inches. I weigh 50 kg. My query is that can i have vitamin b complex capsules. My mother says it is good for general good health. Also my grandmum supports this. I just want to know why to take risks and spoil the health that I have. Thankyou :)",
    "doctor_response": "HiMultivitamin tablets are one of the safest drugs available.You can take one capsule a day for general well being.More important is the consumption of healthy food and adequate hydration which will go a long way in maintaining your overall health.Mild physical exercise should also be done to improve your physical health,prevent stress.Monitor your weight regularly every 20 days.Hope I have answered your query. Let me know if I can assist you further. RegardsDr.Saranya Ramadoss, General and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for stomach ache tingling in legs and arms?\n\nwhat could cause tingling in legs and arms and a stomach ache and feeling badly for months, I don t know if the two problems are related or not. I have drank kind of excessive in the past but drink moderately now just a couple of beers in the evening. I would much appreciate and respect your opinion. Thank you Randy",
    "doctor_response": "Hi, Stomach ache and tingling may not be related to each other. You can consult a general surgeon and get an ultrasound scan to look for any possible cause for abdominal pain. Tingling may be due to neurological causes like nephropathy secondary to uncontrolled diabetes. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to cure head tremors\n\nHello There, I am Nishant and have been smoking from last 6 years. But from past ten days I am getting this problem of shaking my head. There is no fixed time for that , it will happen any time and will last from 30 seconds to 2 mins. It will mostly happen when I am about to have my meal. I am really getting tensed by this. By any chance is it an effect of smoking . What should I do in order to eradicate the unusual shaking of my head?? Moreover I have reduced my smoking to 6 ciggrates from 20 a day!!  But from past 3 days I havn't encountered this problem. Looking for a favorable response! Thanks",
    "doctor_response": "Hi Nishant, I am a neurologist. I am sure that your problem directly or indirectly related to your smoking habit. but as a superspecialist I can give you a treatment and your tremor 'll go away but before giving drug I 'll ask for MRI Brain to look for any infarct or hemorralhage inside brain as you have acute onset of your head tremor. If MRI Brain is normal then you can take Tab clonazepam 0.5 mg and tab tetrabenzine your tremor 'll go away.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain\n\nMy brother in law feel very pain at chest firstly there was a superficial blockad nerve or we donot know what we consult a vascular surjury expert dr rajeev parekh he examined via whole body test but not suceed and his pain incresing so pl. advise what we do or to whom we consult",
    "doctor_response": "HelloFirst you should consult a pulmonologist and then a cardiologist (if needed)RegardsDr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Baby having loose stools when given formula. Could it be milk allergy?\n\nMy 11 month old has had whst looks like pepper flakes in some of her recent stools. She's healthy.  Breatfeeds 3x a day & gets one cup of grrber toddler formula a day. She's having 3-4 stools a day, and sometimes one is runnier than the others. On the weekends when she isny at daycare she doesn't get the formula usually & doesn't seem to havr as many stools. Could she have a milk allergy?",
    "doctor_response": "Hello dear,The symptom of passing loose stools only on days fed with the formula indicates the presence of allergy to the formula feeds.The allergy can either be due to milk or any of the constituent present in the formula feed.If it is due to milk allergy(known as Lactose intolerance), then investigations like Stool acidity test & Stool glucose chromatography will be helpful in clinching the diagnosis.And your child need to avoid diet containing milk & milk products.However, it will be better to consult a Pediatrician to rule out other cause of loose stool.You can ask me any further query on this website using the below link:  your child a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling on forehead with tingling sensation?\n\nI have an excruciating pain only when I raise my left eyebrow. Started maybe 6 days ago and has progressively gotten worse. My left forehead feels swollen and I have slight tingling feeling coming down beside my eye and it feels that the pain has slowly grown towards my temple. Any help in diagnosis is appreciated. Thanks",
    "doctor_response": "Hello!I understand your concern.Your symptoms are more likely to be caused by a disorder called Trigeminal neuralgia affecting the ophthalmic branch of the trigeminal nerve. This is the main nerve responsible for our head sensitivity. It is an inflammation of this nerve causing sharp pain like electric shock.The fact that it happens when you raise you eyebrow is typical, because the pain is often triggered by face movements.I would recommend you a head MRI to find out the cause of this disorder. There are different causes like tumors, vascular problems, cysts, infections, etc. The treatment would be antiepilepsy drugs like Carbamazepine, Gabapentine, etc.If a lesion is diagnosed in MRI surgery may be needed.Hope to have been helpful!Thank you for using HCM!Best wishes Dr. Abaz",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for abnormal bilirubin levels despite recovery from jaundice?\n\nDoc i was diagnosed with jaundice on 17th feb and the got LFT done in which serum bilirubin was 4.51, conjugated bilirubin 3.57, unconjugated bilirubin 0.94, SGOT 3939.3 and SGPT 3240.2. Last i got test done on 7thMarch and my serum bilirubin was 2.38. Plz tell if everything is ok because its going to be one month soon and i also feel little uneasy on my right ribs.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You have very high bilirubin level with extremely high level of SGOT and SGPT. It suggest hepatitis. It can be due to viral hepatitis or due to other cause like toxins. You should go for complete hepatitis test to search the cause. Then you should take treatment accordingly. Your bilirubin level is decreasing but it is still high and your liver has inflammation so right side abdominal discomfort is obvious. You should take fat free diet with high protein diet. Tab Liv 52 and ursocol tablets are useful. Consult your doctor and take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest diet plans for a person with bowel cancer\n\nHello In 2007 I had a complete colectomy with illio rectal anistomosis due to bowel cancer from genetic mismatch repair gene (Muir Torre) . In 2009 I needed a whipple procedure as cancer had mastisized in my duodenum. I am well most days but suffer setbacks and diet is still an issue. Do you have a recommended diet for someone in my position, that will cause the least amount of reaction. I know sugar is not good and most dairy and grains are also a problem. I just want to be fit. I am active but get stopped by sudden urges to go to the toilet at any time. Little warning and not a lot of storage space. I do take immodium when needed but I would rather control this with diet. I am on acimax each morning as advised when I left the hospital. Can you recommend foods which would be helpful to me. I also take psyllium each morning and rujevenix. I use psyllium through the day as well. If you know of a diet that will work for me I would appreciate your help. Thank you so much. R.",
    "doctor_response": "What is your weight , BMI and  activity level? I think you are doing fine. Imodium and Fiber adds bulk to your stool but if you eat lot of salad and fresh fruit , then it will also benefit you. Whole grains like oats , and less milk products except curd.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I having numbness in hands and legs?\n\nI HAVE HAD SURGERY ON MY BACK {L4-5}AND THE ANOTHER TO PUT A PLATE AND TWO SCREWS ON THE SAME NOW TO FIND OUT THAT MY C2-3 MY CAUSE ME TO NOT BE ABLE TO WALK IF NOT ATTENDED TO SOON IT IS CAUSING PROBLEM IN MY HANDS {DROPPING THINGS NUMBNESS FROM MY KNEES TO MY FEET STUMBLING} WHAT IS YOUR SUGGESTION.",
    "doctor_response": "Hi If c2,3 levels are implicated,an MRI may show extent of pathology.use a cervical collar, and do isometric cervical exercises under a physiotherapist.consult orthopedic doctor if traction is needed for relieving any nerve impingement in neck to account for hand symp3.Take lyrica 75mg twice a day and myoril twice a day after meals.your surgeon may decide future course of action after evaluationBest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for short breath\n\ncatscans show biapical fibrosis as well as a calcified 3mm granuloma inthe rught upper lobe. fibrotic seen in the form of confluentbands withmild air brochograms. Primary docs says no problem. It doesn't sound normal and I have been experiencing shortness of breath for some itme. What is this?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. You are having fibrosis in lung. And this can cause chronic bronchitis. This is the most common cause for shortness of breath in these patients. So better to get done PFT (Pulmonary Function Test) for the diagnosis of bronchitis. It will also tell you about severity of the disease. And treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid (ICS). Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What caused severe pain and bleeding from my penis after an injury?\n\nI was masturbating a few moments ago and when I rolled over I managed to jab the center of my penis on the pin on my belt buckle (that goes into the holes). Though it didn t pierce the skin (blunt trauma) it certainly hurt like hell, blood started coming out of my penis. The bleeding and pain has stopped, but I m really freaked out. What exactly happened down there?",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn Short: You might have injured your frenulum(fold of skin which holds foreskin when retracted.Explanation: Frenulum tear might have caused this as you injured yourself with belt's part. If bleeding, pain has stopped, no wound and if you are able to retract foreskin normally during sex then no need to do any thing.                 If not visit a doctor for further treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling tired after L5-S1 spinal fusion\n\nI had L5-S1 spinal fusion about 3 weeks ago, now I feel really tired and I sweat super heavy at night and in the day. I dont have a fever but I'm really lethargic, I feel sick, and I sweat like crazy. Is this normal or something I should be worried about?",
    "doctor_response": "Dear patient L5s1  fusion is major surgery and blood loss may be significant at the time of surgery. This leads to anemia in which patient feels tired and wants rest all the time. He gets fatigue on walking few steps and gets breathless. I would like to advise complete blood count with peripheral smear examination to confirm diagnosis. You need to consult your operating surgeon with report.  Meanwhile start tab ferrous sulphate twice a day . thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bloated stomach, irregular period, breathing difficulty, vomiting, loss of appetite. What is going on?\n\nHi i'm having bloated stomach and dont feel hungry, but i have a feeling of vomiting and breathing difficulty my menses is irregular since i give birth to my 3rd child.. after i give birth 3month without menses and not breast feeding.. than after that 4 month come menses and 5 month did not have menses..may i know what is the reason? Once i take a deep breath i feel giddy..",
    "doctor_response": "DUE TO MEDICINES VITAMINS CALCIUM IRON DIETRY SUPPLIMENTS WE GIVE IN PRENANCY IN ROUTINE CAUSES THESE TYES AS THE VTAMINS AD DIET SUPPLIMENTS ARE ANIMAL PROTEINS MOSTLY THERE IS HARMONAL DISTURBANCES LEADING LIKE THISTHRE ARE ACID REFLUXES DGESTIVE PROBLEMS AND OTHER PROBLEMS AS WRITEN BY YOUSOP ALL MEDICINESTAKE LOT OF WATERWITHDRAW ANIMAL PROTEINS IF ANYTAKE SYMPATOMATIC TREATMENT IF YOU NEED LIKE ANTACIDS FOR GASTRIC SYMPTOMPS LIKE NO HUNGE BLOATING IN STOMACH AND HARMONES FOR MILK AND MENSES AND RELATE ACCORDING TO SIGNSANDSYMPTOMPS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes runny nose while suffering from flu?\n\nMy 5 year old Grandaughter was just diagnosed with the flu. She has NONE ( fever, aches, cough, nausea, etc.) of the symptoms associated with the flu. The only thing She has is a lot of is mucus associated with a runny nose. She has allergies. Thank you in advance for your help.",
    "doctor_response": "Welcome to ' Ask a doctor ' service .I have reviewed your query and here is my answer .Please note that flu has the prominent feature of nasal secretions as runny nose .It may be present without other flu symptoms as cough or fever or body pains .Give plenty of fluids to child , physical rest and decongestant nasal drops .She will get symptom free in a week .I hope I have solved your query .Let me know if I can assist you further in this query .With Regards , Dr Varinder Joshi .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could dehydration and anxiety be due to chemo treatments?\n\nMy husband has been under chemo treatments for 6 months now after colon cancer was found after obstruction and removal of colon and in the last 2 weeks he has not ate well been having trouble with dehydration and anxiety. The last 3 days are of him non-stop talking, from things he wants to do to god knows what. Not a person can get a word in and if you try he will walk away and get sick.... I told him it was like dealing with a spoiled rude baby... he just kept on talking about the sewer system. Is this a sign the cancer has spread to his brain - He said he will not go back to the Dr. cause the chemo is the problem.",
    "doctor_response": "Hi,Thanks for writing in.Cancer is a difficult condition to treat and depends on the individual case. Your husband had a surgery followed by chemotherapy that has been on for last 6 months. It is possible that due to side effects of chemotherapy he is unable to have a good meal because of lack of appetite. Along with inability to eat there is also decreased liquid and water intake in many people on treatment with chemotherapy. In this situation you must see that he has an adequate fluid intake of 2.5 liters every day to keep his hydration normal. Since a colon cancer can cause liver spread in half of the patients therefore complete follow up is required and ultrasound scans and CT scan might help.Regarding his talking irrelevantly, it is important to know if his serum electrolytes are normal as you have said about his possibility of dehydration. Please get his sodium, chloride, calcium and potassium levels checked. He also has little amount of anxiety that is present due to continuous treatment and not being able to lead a normal life. A spread to brain is less likely if you think about the way he is behaving. If he continues to behave this way and his electrolytes are normal then consult a neurologist. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back pain and blood in stool?\n\nHi, I was experiencing lower back pain on the right side this morning. I had a BM at 11:30am and there was blood in my stool, maroon in color, and thick. I am currently feeling pain in the lower right side of my back again. Is this something that I should be concerned with?",
    "doctor_response": "Hello,I had gone through the case and found that it might be internal hemorrhage or colitis.So immediate go for ultrasound of abdomen and blood test. After that take proper treatment .Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any alternate medicine for novocain?\n\nI have to have a angiogram done and a stent put in., My question is How will the doctors do this when I have blood pooling when given Novocain which is used at the local insertion sight, and Aspirin causes me extreme stomach pain, nausea, and diarrhea. My Dr. says if the stent goes in I will half to be on aspirin forever. Oh and I flat lined from a sulfite reaction. Sulfite is the preservative in Novocain and other types of these pain meds. Are the any alternative drugs/meds they can use?",
    "doctor_response": "Hello. Thank you for your question and welcome to HCM. I understand your concern. Let us treat the problems one by one. Now, in medicine, every decision is carried out by a doctor who carefully weighs the benefit/risk balance. If a coronary artery narrowing or blockage is left untreated with a stent placement, then that artery will surely totally close and give you a heart attack. This is the primary problem in these cases. In your particular case, you said that you have problems with your stomach. Indeed, aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) irritate the stomach inner lining by blocking an important factor which inhibits the acid production in the stomach (prostaglandins). From now to the end, I will share my and our clinic's experience in these cases. First, I would order an upper gastrointestinal (GI) endoscopy, to see if there is an actual problem in your stomach, such as gastro-oesophageal reflux disease (GERD), chronic gastritis or ulcer. If there is a present inflammation there, I would withhold the procedure, until this inflammation is healed. If there is not, then you can take aspirin and clopidogrel, accompanied, of course, with a stomach mucosa protector (anti-H2 hystamine receptor drugs or protein pump inhibitor (PPI) drugs). As for the novocain, yes, it contains sulfite derivatives, which can cause allergic reactions, ranging from mild to true, life-threatening, anaphylactic shock. Lidocaine is used in our clinic, which also contains sodium metabisulfite. However, the need for stent placement is critical. So, you would be safe if an anti-allergic reaction protocol is used, which consists on: - prednisolone 2 x 25 mg (amp), given 13, 7 and 1 hour before the procedure, and - telfast 1 x 180 mg (tb), given 13 and 1 hour before the procedure. I hope I was clear, helpful and thorough with my answer. Good luck with the procedure. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if having fatty liver and exercise, diet and weightloss do not help?\n\ni am diabetic and all my liver tests are fine. but i was diagnosed with a fatty liver, grade 3, three months ago. i was already on a diet due to diabetes, but now am on a more stricter diet due to fatty liver. i took another sonograpy of my liver a week ago with no improvement shown. i was 71 kgs three months ago, now with exercise and diet, i have lost 6 kgs. please guide. thanks",
    "doctor_response": "HelloWelcome to Healthcare MagicYou have diabetes and fatty liver so you have to take care yourself more. You may avoid serious complications if follow simple advices of weight loss, diet, exercise, and medicines.You should do vigorous exercise like swimming, cycling etc every day for almost an hour. Around 10% decrease weight will helpful in reducing fatty liver. Please follow this strictly. This will also help in diabetes too. Do yoga and some relaxation therapy also. Take deep breathes when you are free. Take small meals throughout a day. Go for walking after meal mainly after dinner.In diet, take very little fat. Use coffee it will help. Avoid alcohol and heavy diet. Use vitamin D diet due to decreased level in fatty liver. In medications, consult your physician for medicines which increase the level of insulin in your body. Use vitamin E for reducing inflammation. Also use lipid lowering drugs in your medication after consultation.for reducing weight and diabetes, bariatric surgeries are also available. Hope you are satisfied by these.Have a healthy life ahead...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bad breath from mouth\n\niam getting bad breath all over the day.  how to avoid , even though iam brushing two times a day and using mouthwash in the morning hour after brushing.  after taking food the original smell of the food is coming from the mouth from lungs by air and iam getting irritated .  please let me know what to do to cure this",
    "doctor_response": "thanks for your query, i have gone through your query. the bad breath could be because of the deposits over the teeth resulting in gum infection and pus discharge. it can also be because of respiratory tract infection. nothing to worry consult your oral physician and get it evaluated and get a cleaning done. and maintain oral hygiene after that. rinse your mouth with saline or water or mouth wash. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a blood disorder similar to hep C?\n\nHello I am under going treatment for hep c I am 5 weeks in and seem to be tolerating the treatment well! My original viral load was 222886+ well i went and had my 4week viral load done it returned a -45.My question is,is there any other blood disorders that act like hep c? I never felt like i had it, never sick or jaundice// I am worried it could be something worse!  TY sandra in Mesa!",
    "doctor_response": "You should think about if you have any history of unprotected sex , or any blood transfusion in past. Continue with the medication,  and go for regular check of liver function tests, anti-HCV antibodies, liver biopsy if you are HCV-PCR positive to assess liver damage..tc care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for peeling and flaking of hands\n\nHello. My hand suddenly started peeling and flaking by itself a week ago. Its on the underside of my palm, both of it. Been like that for about a week. I tried using hand cream but it didn't work and my hand is not any better.  It doesnt itch or hurts but its just there, like some bubbles. May i know what i can do?",
    "doctor_response": "Hello,I can understand your concern for the peeling of skin of palms.After reading your query I can make out that you have keratolysis of the skin.This is a common condition affecting the skin of palm sand soles during change of weather and due to bit change on temperature too.In my patients I suggest them to apply a moisturizing cream with bland humectants cream for multiple times a day. If the skin still shows peeling with redness then I suggest to apply a mild steroid based cream such as hydrocortisone for few days only.For any type of itching I suggest my patients to take an antihistamine tablet such as loratadine for once or twice daily.I suggest you to meet a dermatologist and get most appropriate therapy according to the grade of peeling of skin.All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in testis sometimes left and sometimes right?\n\ni continously mastrubate past 3-4 years. now i were engaged and my marriage is on febraury 2016.so, i stopped mastrubate for the past one month for my future. now when i get tempered, i control myself. but i've  pain in my testis sometime in left and sometime in right. is there any problem in my sexual organs. give a way to stop the pain. and i want to recover my power and energy. is there any medicine to recover my energy. because i want to get a strong relationship with my gf for more years without any problem",
    "doctor_response": "Hi and thank you so much for trusting us with your health query.I am so sorry to hear about this testicular pain. There are a number of different reasons why you may have this pain which include infections, varicoceles, mechanical pain, etc. However, the information you have provided is not enough to pinpoint the cause. I will suggest that you get examined to pick up more clues to direct investigations on the exact cause of this. Depending on findings, you shall be provided with measures and treatment options to help overcome this.I hope you find this helpful. Thank you so much for using our services and please feel free to for more information or clarifications if need be. I wish you the best of health.Dr. Ditah, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the lower right jaw in the wisdom tooth area?\n\ni had a drug induced seizure from an Accidental ultram overdose. since this event i have had the worst pain in my lower right jaw back where my wisdom teeth should be. i am 21 5'11 over all healthy male, could i have done some serious damage to myself during this seizure???",
    "doctor_response": "Hello thanks for consulting at hcm.the accidental seizure could have resulted in tongue bite--ulcer.since you are having jaw pain it could also be due to impacted teeth..due to wisdom tooth..get an iopa radiograph-to check for type of impaction..plz consult a oral physician to check for any ulceration secindary to biting during seizure... Hope it helps take care...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bruise in shoulder and numbness in fingers after surgery.\n\n4-5 weeks ago I slipped, caught myself with my left hand/arm/shoulder. I had a big bruise on my shoulder. It partially went away. But now there is still have a funky bruise left ... and sometimes, in certain positions, my left left thumb and index finger go numb - fall asleep .",
    "doctor_response": "Hello, The bruise in the shoulder suggests a local injury and some internal bleeding. The numbness can be due to mild swelling around the nerve roots. A direct examination is needed for proper diagnosis. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tender rash that started on buttocks near thigh spreading onto legs. How to treat it ?\n\nI have a rash that started on my buttocks near my thigh and has spread in 2 other places on my leg. It doesn t really itch as much as it is tender feeling. Like a bruise , but it is not purple in color. It looks pink and the spot on my buttocks is one large bump with a bunch of little ones around it. The ones on my leg are a little group of maybe 3-5 bumps. Not feeling ill or fevered. It s just irritating. I ve been putting neosporin on it since I realized it was there, which was yesterday. Doesn t seem to be helping at this point. Any idea what it could be and how I should treat it?",
    "doctor_response": "Hello,Thanks for the query,You might be suffering from a fungal infection,In this area it is called as Tinea cruris.It usually as itchy rash but soon gets infected and develops pain.Only neosporin wont help.Treatment with anti fungals might be requiredPlease meet a dermatologist for final diagnosis and treatmentLet me know if you have any other doubt.you can ask a direct question to me on this forum, following the below link.  you a good health.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stabbing pain on lower right abdomen?\n\nI have a sharp, stabbing pain in my lower right abdomen. I also have the mirena IUD. Could the mirena be causing the pain? I've had it for a year and a half... I have no issuses with bowel movements; just an insane amount of pain that sometimes radiates down to my leg.",
    "doctor_response": "Hello...yes your pain is due to that intrauterine device,get a urgent ultrasound n send me your reports....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sneezing,blocked nose and itchy eyes\n\nHi, I am Ramesh, I live in bangalore. I am having sneezing daily morning. sometimes more and sometimes less. Also blocked nose and itchy eyes. I consulted doctor who prescribed medicine. However it is temporary relief. Is there a permanent solution. Please advice.",
    "doctor_response": "HI, thanks for using healthcare magicBlocked nose, itchy eyes, sneezing are all symptoms of allergies. The only way of completely eliminating this response would be to identify the allergen and eliminate it.There are allergy tests that can be done to determine the source of the allergies.The use of oral anti histamines , which are available over the counter and also topical steroid nasal sprays would help to reduce your symptoms.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever and loose motion in a child?\n\nHello sir, My son 2 years 3 months old get high fever 10 days back and watert loose motions with head warm .I give him medicines under paedistrician guidance , but now he get cold ,cough,sneezing and loose motions .So suggest me are , all these are symptoms of teething",
    "doctor_response": "Hi..teething will not cause these symptoms. But the teeth are erupting the kids tend to keep anything they find in the mouth to sooth the sensation and the dirt and microbes on the surfaces will cause diarrhoea.Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron (as prescribed by your paediatrician).Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in right leg?\n\nHello. I m just curious if I should be concerned or more active..until now. Long story short, I have always been active. very involved with yoga and the gym. I recently haven t been going to the gym since I got my new job. Which is a behind the desk job, resulting in me sitting down for 8 constant hours a day, getting up to make a copy, get coffee, take a restroom break, etc. For about 3 weeks now my right leg has been starting to go to sleep more frequently then usually. So I get up, make a lap and try to walk it off. It has caused me to lose motivation for the gym, therefor my muscles aren t being worked hardly at all compared to a 5 days a week gym goer. My leg is constantly numb.. Is this because I haven t been as active and my muscles are tighting up or do I have a pinched nerve? I have mild to no pain right now. I m worried about it getting worse in time if I don t get it figured out",
    "doctor_response": "helloYou need to take frequent walks in between desk work say for 5 minutes  every 2 hours of sitting work to ease the leg muscles and nerve s.Do exercises, jogging 10 minutes morning and evenings. Take neurobion forte tabs and massge legs daily twice a day for 15 minutes with olemessa oil. you shall be okay. see a doctor if necessarythanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nocturnal emissions?\n\nHello sir! am from india ....(age 22).......for the last 3 months regularly, at nights while sleeping sperms is coming involuntarily.......I m very lean&tall GUY!Now i just warn to avoid this situation.I ALSO warns to know y this happens?Because every morning feel very tired & bodypain . I m mentally depressed......please tell me some remedies or suggest me some medicines if it is available... I also heard that coz of this lots of energy & weights will loss.......... Actually I WANA gain some weight ,for that what s the best way?",
    "doctor_response": "hi,Involuntary ejaculation of sperms is pretty normal and you need not worry about it. It NEVER causes loss of energy or weight loss. this is a misconception. The option to avoid wet nights is to avoid things that sexually provoke you. For example watching a song that causes sexual attraction, thinking about someone/something that makes you feel sexually pleasurable etc. It might seem more difficult to control these thoughts when comparing to just ignoring your involuntary ejaculation. Since you are not involved in any sexual activity that lets out your sperms, your body is naturally finding a way to get rid of the excess sperms stored. this is the reason for nocturnal emissions. True it causes body pain and tiredness in morning. This will get sorted out if you during plenty of water during those times",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can one continue taking pegasys in the peri-op period?\n\nthis is for a Hepatologisti have a patient on pegasys for Hep C who has been having recurrent attacks of galls tone colics and needs a lap cholecystectomy. the patient has a Child A cirrhosis with portal hypertension. can I have the patient continue taking pegasys in the peri-op period?aabha",
    "doctor_response": "Hello! Thanks for putting your query in HCM. I am a Gastroenterologist. yes you can continue with pegasys in the periop or post op also. But three things you have to keep in mind:1. He is having Cirrhosis, Child'S A, so avoid hepatotoxic drugs and tell the patient about the risk of surgery2. Now oral medications (DAA-Directly acting antivirals) are available for treatment of Hepatitis c. You can switch him to that depending on the Genotype. 3. Universal precautionsI hope I have answered your query and this will help you . Wish you a good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Done blood test. Feeling tired. Blood in stool. History of angioplasty and TIA\n\nHi, My dad had a recent blood test and they told us his blood count is 97 - down from the previous 107 and he is feeling tired and drained. He had a blood transfusion a month or so ago and an iron transfusion less than a month ago. The doctor said there is some bleeding in the stool and he is going for a colonoscopy . What should a normal blood count be for a man aged 83 years old with past angioplasty and TIA s??? Thank you for your help!",
    "doctor_response": "Hello sir, i thionk you mean the platelet count.. the normal should be more than 150. But spontaneous bleeding sets in once it goes below 20. The blood in stools is mostly due to some structural pathology in the gut. Tiredness is secondary to anemia from blood loss",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be done for the growth of the moustache ?\n\nHello, Mu cousin have very less moustache . He his 26 now. Is there is any problem. Plz help",
    "doctor_response": "At the age of 26; if there are no other issues to address; it's unlikely that your cousin will benefit by hormonal medication or tests. Hormonal medication can only be started only if benefits outweigh the risks. Hair transplant for moustache are is a relatively simple solution in such scenarios with very good outcome. You can mail his pictures to know the exact number of hair needed and expected outcome.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mild fever and cough\n\nMy 2 1/2 year old boy has been sneezing, coughing (wet cough) and has a runny nose. When he is breathing there is a bubbling noise in his lungs. Yeterday he coughed all night to the point he was unable to get any sleep and he vomited once. He has in the past suffred from mild ashma and was prescribed with Salbutamol Sulphate reliever. We are currently in Ethiopia which is a very hot country and the pollen count is low. I never had to use his inhaler previously in this country. My question is I m not entirely sure if his current condition is caused by an allargy, pollen etc. His cousin who has been staying with us was recovering from a bad cold with simlar sympoms mentioned above. She recovered fully in just a few days. The runny nosie she had was clear in the begning but trurned yellowsih after a few days which indicates that her conditon was caused by cold? I think he might have caught cold from her? Today he had a mild fever 37.4 and I give calpol for this. The coughing, runny nose and sneezing persisted throughout the day. I m not too sure how to treat my son shall I give him the Salbutamol reliver? Is this an infection or common cold, allergy or a combination of all three? please advise. Many thanks",
    "doctor_response": "Hello dear.As per your symptoms,its chest infection that he caught through his cousin.Also he is prone to allergies aa he caught asthma last year.I would like to ask if there is any exposure to dust,mites,carpets or stuff toys on which there is furr???If yes then plz avoid such stuff.I would recommend antipyretics like paracetamol 120 mg/5ml (5 ml 4-6 hourly for fever) and amoxil syrup 125mg/5ml 5 ml three times a day for 1 week along with some bronchodilator syrup like terbutaline 0.3mg/ml (5 ml thrice a day for 1 week) and anti histamines like benadryl for the acute phase.you should also try some home remedies like 1 teaspoon of honey in luke warm water daily along with avoidance of cold drinks,cold and sour foods,candies,ketchup etc.Also i would recommend monteleukast sachet 4mg daily at night for about 2 months to prevent further attacks.Hope it will help.Stay blessed :-)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red painful bumps all over the body and swollen ankles/knees?\n\nI have hard red painful marks ALL OVER my legs. like probably today 20 to 25 on each leg yesterday probably 15 to 20.... they probably started 2 weeks ago with only 3 on my lower left leg. but in the last 5 days they have spead up both legs and they are VERY VERY PAIN-FULL . but before the red bumps started on my right leg only my rt knee was painful, solid red and even had fever. now this evening more painful red dot/ bumps{they are like hard under the skin???} on my legs and both knees are now swollen red and have fever. and my ankles are 3 times their size!!!",
    "doctor_response": "In my opinion you have a viral infection , HIV or Lyme I recommend you see a doctor immediately  , the earlier the treatment the betterGood Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe pain in lower back.  History of severe chronic bladder infection with inflammation in left kidney.  Diabetic.  Concerning?\n\nI am a type 1 Diabetic and I have had severe cronic bladder infections with inflamation of my left kidney. My kidney was so inflamed at one point I could not button my pants. I was hospitolized recently and told the day I was discharged that I was near kidney failure when I got there. Now when I start hurting in my lower back ; I can't even mesage or touch the area because it hurt's to touch it. Should I be more concerned with this or is there anything I can do to helpmyself? Ican't afford to see a doctor right now!",
    "doctor_response": "hi ,as per your symptoms it looks like you have severe kidney infection, you cant do anything by yourself, as it needs vigorous treatment. meet your doctor as soon as possible.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can liver damage be cured ?\n\nMy mother-in-law has cirhossis of liver . She has naver consumed alcohol in her life. The doctor says 70% of her liver is damaged. Is there any treatment for the disease. How long can she live with this condition? Sex : F Age : 65 No alcohol consumption, no hepatitis",
    "doctor_response": "hi welcome, in some cases withou the history of alcoholism also cirrhosis will occur her liver 70%is damaged now if she is undergoing proper treatment according to doctor she will be saved. if much damage go for replacement which will be expensive. she will survive if  start treatment now itself thankingyou",
    "dialogue_context": ""
  },
  {
    "patient_message": "Ultrasound showed enlarged spleen with sludge in gallbladder for symptoms of stomach pain, nausea, diarrhea. Any thoughts?\n\nMy boyfriend has been having stomach pains for three months. He gets very tired, nauseated, indigestion, and some diarrhea. He has had blood work done, physical exam, and stool test, which all came back normal. He had a ultrasound today that showed an enlarged spleen and sludge in the gallbladder. What do you think is wrong?",
    "doctor_response": "Hi, Welcome to Health care magic forum.  Gallbladder sludge is a mixture of bile, mucous,and cholesterol, and calcium based particles.                       It strucks in the bile duct and cause pain.May lead to gallbladder infection, infection of pancreas,or gall stones.                        Mostly resolves by its own, or else gall bladder is to be operated.                        Your condition appears to be due to the pancriatitis.                        I advise you to consult a gastro enterologist for diagnosis and treatment.                        Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in left upper quadrant after fall\n\nI fell two years ago and had a lot of pain in left upper quadrant. when I lift some thing heavy the pain comes back stays for days. It hurts really bad when I sit or take a deep breath. I also pass a lot of gas and then seem to feel a little better. phyllis",
    "doctor_response": "Several features of pain can be helpful in clarifying what is going on and the next steps for diagnosis and treatment. Type of pain. Burning mostly means a nerve is having problems. This can be either a sick nerve or a nerve that has had an injury. Electrical, shooting would be others implying nerve source for pain. Ache and pain with movement implies muscle and pain with gas implies bowel.Location of pain. There is a lot to this. First, if something goes in the pathway of a nerve, then that is the nerve involved. Nerves are long and the pain is in a belt-like long pathway. Smaller areas are smaller nerves. This also tends to say what might  be going on. Obviously if there was an injury to the area and then there was pain outward from it \"hit a nerve\" would be a possibility. Sick nerves are MULTIPLE areas and tends to be the TIPS of the nerve not the whole nerveWhat hurts. Moving a particular way that triggers the pain tells what is hurting. Specifically it can distinguish outward structures like skin, muscles, tendons, joints from deep structures like organs and nerves.``\u00a0\u00a0\u00a0\u00a0\u00a0Having a diagnosis leads to choice of medicine for the pain. Inflamed outer structures respond to treating inflammation. Inner structures need diagnostic tests because something internal is broken. MRI's.And, structures that cannot be fixed need adaptations. Physical therapy, pillows, supportive structures internal and external. And graded increasing activity to get the area used to moving and getting used to the pain. BUTthis can be hazardous in some situations.For example, personally I have a break in the abdominal wall muscles. Gut can pop out of it. Straining will make it worse and make it required to get it fixed with surgery. Yeah, it fits with muscle and abdomen. I think it's the only thing that does. So, surgery would be the answer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is painful chest after being kicked on chest followed by stopped breathing for a minute concerning?\n\nhello im a teenage girl i was kicked at his hardest in a chest by a male wearing office shoes. the heel hit into my chest and caused me to fall to the floor and stop breathing for 1 to 2 minutes. my chest has been painful and very achey. however there is no bruising. should i be worried?",
    "doctor_response": "Thanks for your query. A blunt trauma to the chest may result in fracture of ribs, contusion of lungs, leakage of air from the breached lung. You must get a chest xray done. If everything is normal a course of analgesic will help you. Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood clots in periods?\n\nroughly 2 weeks ago passed a blood clot , wasnt big at all .... slight bleeding after but nothing really , since then , ive been feelin more tired than normal , nausea comes and goes within the last week or so ... just within the last few days my breasts have gotten really sore and heavy like . my period is due within the next 2 days , and i havent had my normal cramping or bloating .... nothing , not even my horrible mood swings i get from PMS ... im not sure what to do , i dont have a doc , and can barely afford a home pregnancy test ... what would you suggest i do ?",
    "doctor_response": "Hello dear,I understand your concern.In my opinion it appears from your history that there is irregular bleeding.If your actual period is delayed I suggest you to do a   urine pregnancy test.Usually a urine pregnancy test gives accurate results a week after missed period.But if the irregular bleeding is continued I suggest you to consult doctor.But if it is first time the irregularity can be attributed to stress.So nothing to worry.Relax.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Developed severe Asthma and sharp pain in the lungs. Cause for this symptoms?\n\nHello I am a 31yr old women who has in the last 7 monthe developed severe asthma . I have had pnuemonia 3 times last yr, and I spent 5 days on life support. I have a pulmonary dr, family dr, asthmatic specialist, gastronoligist, vocal cord specialist... I have hd a severe sharp pain in my right lung . I have been treated for pluerasy, and the pain is only getting worse. The pain has actually moved from my back, to my side and is now at the present time in the front of mt chest right under right breast bone....Should I just go to the hospital? I have phoned all my dr and they have missed diagnosed me so many times, Pnuemonia, celiac disease , asthma, copd ,emphasyma.... its always changing and the pain is only getting worse... I am scared...I almost died on life support and now with everything that has happend and now this pain for 8 weeks...Im really scared and dont know what to do. Im tired of being passed from one doctor to the next",
    "doctor_response": "It is wheat allergy not celiac If a person start getting allergies and thse stmptomps they aare allergic to wheat If you stop wheat your all diseases will go get blood serum tested for wheat specific antibodies add other food like milk potato rice nuts egg to see their interference",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for sleep apnea seizures\n\nwhat can be done to prevent or help lennox gestaut sleep apnea in a 4 year old child. he has been suffering from this condition for 2 years. he is a complicated individual but lately he has been experiencing an increase in this particulare type of sleep apnea seizure?",
    "doctor_response": "HiLennox gestaut syndrome is prone to various types of seizures. The treatment options are Valproic acid, Clonazepam, clobazam and many more antiepileptics. The choice will depend on the current treatment and dose of medication of your child. You may post the details, so that we may help you out in the best possible way.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes erratic behaviour and extreme mood swings?\n\nWanda (age 19) works nights at the local diner. Work isn\u2019t going very well for Wanda. Her boss finds her moods to be erratic. She seems confused. She lives with her mother and stepfather. Her stepfather married her mother when Wanda was seven years old. Wanda, who previously had not wet her bed, began to wet her bed after her stepfather moved in with her mother. Since that time, Wanda has displayed different personalities when having to deal with stressful situations. At times Wanda can\u2019t remember how she has spent her day. When going to work, Wanda wears different types of clothing depending on how she is feeling that day. Sometimes the clothing is rather provocative, other times it is demure and rather cute. Her boss and her mother often complain that they don\u2019t know which Wanda they will see that day.",
    "doctor_response": "Hello there, I see that your friend Wanda has been so from her childhood itself. A step father coming into the family brings about huge stress in children, depression at the age of 7 can cause symptoms like bed wetting along with other complains as well. Her mood being different everyday does not seem to significantly affect her work. Different sorts of behaviors with stressful situations may be normal at times, if you could give a details of her behavior in a certain stressful situation, I will be in a position to help you better. Not remembering how the day went on could be purely because of lack of concentration. If her mood is appropriate to the given situation, then there is nothing much to worry about. I can surely help you more if you can give me more details of her behavior, including the content of her speech in a given situation, biological functioning, commonly sleep and appetite. My advise is to consult a psychiatrist at the earliest, as she might require psychotherapy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long will it take for circumcision to heal?\n\nHi i am age of 31 male i am planing for circumcision including removal of frenulum  i mean fully removal of foreskin .how long it will take to heal completely heal and when i can have intercourse?how long it will take the surgery?thank you for your kind advice",
    "doctor_response": "Hello and .As an Urologist, i can understand your anxiety.  After circumcision,it usually takes about a week to heal completely.By 3-4 weeks after surgery, you should be able to have intercourse.Duration of surgery is about 10 minutes.It's a routine surgery and you don't have to worry at all.Hope all your doubts are cleared.If you've any doubts,you may send it as a direct question, to me.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment  for premature ejaculation\n\nHi I m 25 yrs old, n i want to increase the duration of intercourse, I guess I m suffering from premature ejaculation, I get over within a minute.so wat shud I do to increase the duration and to make penis more erect.plzz suggest me the appropriate medicines.",
    "doctor_response": "Dear Patient,   Thank you very much for your question. I donot think you do not need any medications for premature ejaculation. Instead of taking medications to treat premature ejaculation, you can practice \"masters and Johnson\" pause-squeeze technique to prolong your time of ejaculation.      In  Pause and squeeze technique, you may ask your partner to stimulate your penis untill you feel the urge of ejaculation. Once you have the urge to ejaculate, ask your partner to squeeze area where glans penis connect to shaft untill the urge disappears. Practising this method you can delay your ejaculation. However, anxiety or stress can be the underlying cause for your problem. In you have anxiety, it can affect both your erection and ejaculatory mechanism.  Therefore, my advice is to see your family physician if pause and squeeze technique finds less effective. Low testosterone level also  causes poor erection and maintaing a good erection during sexual intercourse. If you consult your family doctor, he or she can check your blood for testosterone, do physical examination to find any biological causes for premature ejaculation and treat anxiety if it is the cause for your problems.  Even some drugs like Fluoxetine which is used to treat anxiety, can be used to treat premature ejaculation too.                Therefore, see your family physician if you do not have help from pause-squeeze technique. If you have more questions, please let me know. Good luck!Dr. Dinesh Nuwan Weerasinghe. MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if still have pain in the foot even after having stump neuroma surgery?\n\nI had foot neuroma surgery last April and still have pain in the ball of my foot. The DPM told me that its a stump neuroma. I dont know what to do and how to have this cured. My foot doctor does not have the answer, except maybe more surgery down the line, which I definitely do not want. I long longer have faith in this doctor who has been my foot doctor for many many years.",
    "doctor_response": "Hello,I suggest that you see an orthopedic surgeon. Foot doctors are great in many circumstances but for a persistent problem like this an orthopedic surgeon that specializes in foot and ankle problems may be more helpful.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excessive heated feeling ?\n\nIn recent months, I am very easily overheated.  The littlest exertion (I'm fit, healthy, not overweight) will cause me to break a sweat - making the bed, climbing the stairs, putting the dishes away.  I'm dressing for summer under winter coats, walking 1.5 miles to work, and then sweating copiously for an hour after the walk (30 degree snowy weather, or colder.)  43, pre-menopausal, definitely not hot-flashes.",
    "doctor_response": "HIWell come to HCMBecause of the hormone disturbances such symptoms are just likely and this is happening in menopause but this is nothing to worry do not pay attention, and every thing would be fine, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can nicotine patch be used when suffering from thoracic aortic aneurysm?\n\nI have been diagnosed with a thoracic aortic aneurysm.  I have been on the nicotine patch for the last two weeks.  Should I be using the patch or can it affect the aneurysm.  I have had an MRI last week but have not found out the results, but from a CT scan, it looks like it is 4 centimeters.",
    "doctor_response": "Yes you can keep using the nicotine patch.  nicotine patch is help you stop smoking. Aortic Aneurysm is not affected by this patch.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for fever & foul smell in the mouth\n\nMy son (7 yrs old) just started with a fever earlier today about 11 hours ago. It broke once with motrin. And i have just given him a second dose. This time the fever is taking longer to break and he is also complaining that his mouth taste like bones (I m guessing he means chalky. What could cause this and is it anything to be worried about? Thank you",
    "doctor_response": "Hi Dear welcome to the HCM,Viral  fever are quite common in this rainy season.Requires paracetamol 4 to 6 hourly with doses  of about 15 mg/kg .Plenty of fluids to be given.Take care of the nutrition.tepid water sponging  repeatedly will help in reducing the high grade fever.Metallic taste could be because of the fever. Hope it should respond 3 to 4 days.If fever do not responds in this 3 to 4 days then please consult the pediatrician for further evaluation.Hope the query is answered.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will numbness in shin go away by applying neosporin?\n\nI scraped my shin to the bone (about a 1 1/2 inch scrape) and the area around my shin is numb. I disinfected it and applied some neosporin to it but I was wondering if there is anything else I should do? I was also wondering if I should go see a doctor or can I just let this heal on its own?",
    "doctor_response": "Hello, What I can infer from your complaints is that you are having a graze in your shin. This will heal by a scan formation in about a week. You just need to keep it clean and dry Neosporin is ok to apply. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Santosh S Jeevannavar, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stress due to personal life\n\nmy dad was in the hospital back in oct. he passd  in nov and i noticed patches of hair on my face going away and then my hair on my head started falling out. my dads passing and changes at work and dealing with my mom being depressed has put alot of stress on me is this stressed related ?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Hair and related problems do not have much relations with stress. But premature greying of hair does. But you are worried about stress. You are having stress and you feel it. Then the stress is real. You feel it. That is why you are worrying about the stress in your life. We all come across such stress in our life. Some overcome it sooner and some later.  you shall come out of the stress for sure. For the time being, it shall be better if you unwind yourself. Take a weeks leave and go away for holiday. Make sure your office people are not disturbing you. A week's full throttle enjoyment should unwind you. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain in kids?\n\nhi my 5yo child has complained about stomache pains (for about two weeks) around her navel after eating and now won t eat because she is worried of them coming back!!!!!! she is really quite skinny and is losing more weight . she has been to the doctors twice they just send me away saying it could be viral. can you help",
    "doctor_response": "Hello,Your description is indicative of worm infestation, please, get her checked for the same. If she has an evening rise of temperature along with the loss of the weight, then check for tuberculosis and other possibilities.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Ratna Mulay",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nausea, dehydration and dizziness after hitting the stomach?\n\nhi, yesterday i was hit extremely hard in the stomach to the point i could feel everything inside shake and ache. I fell down the stairs on concrete  floor today and right after i got up i had severe nauseous, dehydration, and dizziness. i have no broken bones just a bruised back and jamed fingers, im curious to know if this could be something severe or just something that will go away over time?",
    "doctor_response": "Hi.The blunt trauma over the abdomen can have many consequences.You have already developed a few symptoms suggestive of some internal problems. This can be a contusion to any internal organ, perforation of the bowel and so on.The best way to get a proper diagnosis is to have a clinical / physical examination by a Surgeon to see the abdomen and vitals like temperature, pulse , BP etc. You have to go for the tests of the blood, urine and stool as well as ultrasonography and X-ray of the abdomen in a standing position.CT scan to confirm any positive findings. I would advise such a patient to get admitted to the hospital for observation and management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for itchy scars in legs\n\nhello doctor!!!!! im a 17 yrs old girl i have lots of itching scars on my legs. what can i do for it???",
    "doctor_response": "Hi Dear,Understanding your concern. As per your query you have symptoms of itchy scars in legs which is mainly due to post inflammatory hyperpigmentation.Need not to worry. Apply aloe vera gel at night . You should apply meladerm cream and it is purely safe to use as this is combination of hydroquinone + Tretinoin + steroid and apply it at night time. Drink plenty of water. If condition doesn't get well in a week then consult dermatologist for proper examination and treatment . Doctor may prescribe antibiotics like minocycline, steroid ointment and may recommend chemical peeling for marks. Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower abdominal pain and sharp pain across right side of the body. What does its indicate?\n\ni have been getting lower abdominal pains for 3 days now none stop..they havnt got anybetter.but seem to be getting slowly worse. i was awake most of the night as i started to get the odd sharp pain rip through the right side of my body. and now my lower back.  i have taken pregnancy tests but what else could it be? i hope you can help me thank you",
    "doctor_response": "Hi,the type of pain you are giving as history is usually of kidney or ureteric stone. And you have mention that there is chance of pregnancy, i'll suggest you to go for USG whole abdomen. It will show if you have stone or any ectopic pregnancy( pregnancy outside uterus like in fallopian tube).Its better to consult your local doctor for full evaluation.regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for very high blood pressure\n\nhey my aunt fell last week no one knows how. took her to the er and they just gave her pain meds. she do not have use of her rightside of her body. It looks like she has had a stroke. took her back to the er yesterday and her bp was 218/151. they got it down to 181/105  and let her go home. What should I do?",
    "doctor_response": "Hello, Thanks for posting your query on Healthcare Magic...* Brief Answer: she should be on regular medications for hypertension. short information about progress of weakness.*Explanation: My opinion is that high blood pressure on many occasions is an indication for control .That happens on many levels. First, be sure that high blood pressure is not secondary to any other diseases as Cushing or renal failure.Then ,Diet with low salt and less fat content is crucial. Exercise and other healthy activities are also a mean to control blood pressure. If all that dose not help, medications are a must .That is usually decided by your doctor according to your condition and comorbidities .Some drugs that are perfect for patients are not necessary good for others.Regular blood pressure monitoring is as important as starting treatment so that we could assess efficacy of the medication we started. weakness or neurological deficit in a hypertensive patient is a dangerous sign and need to be managed as soon as possible to avoid brain hemorrhageI suggest my patients the following : lower blood pressure to a reasonable level, follow up conscious level and weakness.The information provided by you is not sufficient to provide a good opinion. If someone comes to me with this condition I would ask them about other comorbidities like diabetes, hyperlipidemia etc , also you didn't mention the fate of weakness or investigations done.*Conclusion: I suggest you consult  your physician about your aunt antihypertensive medications .   If you have any further questions I will be happy to help, If not, you can close the discussion and rate the answer. Wish your aunt good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes skin rashes all over the body after taking vaccination?\n\nMy 12 month year old son was diagnosed with HFMD on 6/7/11, which started 6/4/11 by 6/9/11 he was getting back to normal and received his one year old vaccinations. He has been running a mild fever ever since but yesterday he started to develop a rash which is quickly spreading over his entire body today. He has no energy and has been sleeping most of the day. His fluid intake has been cut in half. Is this just a reaction to the vaccinations? Male, 12 months, 20 pounds - no prior medical problems, up to date on vaccinations",
    "doctor_response": "Hi...I do not think this is due to vaccination. this seems more like a viral exanthem which is spreading.Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering form seasonal allergies. Taking liquid potassium. Are these related?\n\nI have seasonal allergies - usually running nose - sneezing etc.  The allergies have never caused pain, dry mouth  or burning sensation in mouth before. (but I am experiencing this condition presently/  I have been taking liquid potassium and wonder if this could be causing the problem or if it could be related to allergies.",
    "doctor_response": "the mucus contains saltsand using of potassium may cause dryness of the mucus causing the problemtreat allergies by consultin allergy specialist for one time to get it cure instread of getting drug interactions",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can ascites secondary to liver disease be treated?\n\nhello doc,i just want to know how to deal a person with secondary to chronic liver disease? and what should i could help with that person with can kind of sicknes.thanks hope you can help me.age is coming 63 year old,weight somewhere around 69 kilos and height is 180cm. this is the doctor diagnosis ascitis probably secondary to chronic liver diseases",
    "doctor_response": "Hello, Thanks for using Healthcaremagic. I had gone through the data you have posted. Ascites forms in patients with liver disease due to low albumin and increased portal pressure. we need to restrict salt intake and start on dieuretics like furosemide + spironolactone to optimise the fluidstatus.if serum sodium is low then we need to restrict salt and water intake.we need to start Betablocker to reduce portal pressure. by doing this we can tackle ascites part of chronic liver disease...Hope this helps..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Still paining in the same spot after gall bladder removal 3 wks back with pain while breathing deep?\n\nHi, I jaded my gallbladder removed 3 weeks ago, I had stones and it was also quite infected. However, I'm still having a lot of pain in the exact same spot and can't even breathe properly because it hurts too much when I take deep breaths. The pain goes into my right shoulder blade and is quite sharp. I have A Vascular Necrosis in my left hip so because of that I take 50mg of methadone and 20mg of statex when needed, and that isn't even helping with the pain! Plz help .....",
    "doctor_response": "Hello and welcome to HCM,Gall stones cause inflammation of the gall bladder.Inflammation of the gall bladder is called cholecystitis.The inflamed gall bladder with stones has been surgically removed in your case.Pain which increases with deep breathing is usually associated with pleural involvement.The pain radiating to the right shoulder blade is seen in cases of acute cholecystitis.However, your gall bladder has already been removed surgically so this pain could not be due to acute cholecystitis.You need to consult your doctor for clinical examination of the chest and imaging study to look for evidence of any pleural involvement.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure chronic pain and spasms on hand?\n\nI have had 4 cervical operations over the past 5 years my 1st cervical fusion didn t take and the 2nd one I was opened in the front neck and back the last one at duke due to chronic pain from muscles being cut so much they took the hardware out thinking it would help it didn t needless to say , I ve also had 4 wrist (right) operations last one being a complete wrist replacement I m only to lift 1 to 3 lbs. with right hand and have 20 percent range of motion . I developed a few months ago spasms in my hand same fingers each time which appear to look as if my hand is deformed lasting 45 seconds to over a minute it has since progressed to same toes at times and now the left side also always the same fingers or toes , I am very concerned due to all the surgeries on both cervical spine and wrist . I have seen the dr who operated on my wrist replacement and he said I need to see a neurologist that it wasn t stemming from my wrist ? Can you give your opinion what you think it might be ???? I m really concerned !!!!",
    "doctor_response": "hi,thank-you for providing the brief history of you. secondly I a. sorry to hear you have to go through all this pains.let's come to the point now. as you mentioned you have undergone two spinal and one TWR I would have been happy if more about the functional status of you was mentioned.As to this getting spasm, I feel it should be muscular initially. as the muscles of the wrist post replacement needed more attention. Also, taking up an x-ray would have been better to understand more of the joint positioning. Also, how long did you undergo physcial therapy rehabilitation plan? as per my view you should go for longer than expected.Also, indeed you got operated for spine twice, but how much time you performed the physical therapy post surgery?physical therapy is a scientific and secure way to rehabilitate the muscle and movements.also, I will say too look for a physical therapy now as to which he will assist you to further. Meantime you can surely take an appointment with a neurologist, as every experts advice will play a role. May be the use of diagnaotics will come into role as technology has helped alot to rule out human body illness to a greater extent. but hardly we understand the best use of technology used in assessing the human body.okay, your muscle spasm is of what kind? that is important. First you need to reduce the muscle spasm by hot water fermentation and whirlpool therapy. you may have to spend a little time in this process as The muscle relaxation will take some time.I will say that you visit a physical therapist so by which your treatment starts. with the grace of God I wish you a speedy recovery",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is sopra & astadol effective for ribs fracture?\n\nsir my mother right side 2 ribs are fractured... and doctor advice rest and the medicine which is given below :sopra (lansoprazole) 30mg astadol (tramadol hcl+ paracetamol)comapan (naproxen sodium) 550mgsir kindly tell me, are this medicine satisfatory ?? my mother took 2 doses but no relief from pain now",
    "doctor_response": "Dear  patient Your mother is given medications for pain relief ( astradol , naproxen ) and antacid (soprano ). This are effective partially. Movement at fracture site has to be prevented for total pain relief. This can be done by wearing chest belt tight at the level of fracture ribs. This serves two purpose 1. Reducing pain 2. Early union of fracture  by preventing  movement.  You need to buy appropriate  size from the market and use it for one month and she will be fine. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to rule out concussion in a child after an injury?\n\nHi there, My 10 months old fell off the couch hitting a hard floor. He cried really hard for about 25min and fell asleep after that. He hit the back of his head, all I saw is a reddened area but no bump. My husband said, let s watch him before thinking the worst. But I m afraid and I would like to know what could happen now or what if he had an internal bleeding? What are the sign to look for?",
    "doctor_response": "signs of concussions like vomiting,drowsiness or altered sensorium ,some times even convulsions due to any internal bleed can be the symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Blood report showing high platelet count. Is it dangerous? Is there a way to reduce it?\n\nhello, good evening.. i am just going to ask about the high platelet count.. recently i got complete blood count and i found out that i have 512,000 of platelets and a doctor told that the normal range is 150,000-400,000.. is there anything that i can take to reduce my high platelet count or any foods to avoid.. and what vitamins i can that will not cause anything to make my platelet count high again? thank you very much",
    "doctor_response": "Hi thanks for your question. There are 2 types of causes for increased platlet. No 1;Primary where bone marrow produce more platlet and cause is not known called as primary thrombocytosis.This type is congenitally inherited that is pass from parents to childeren. No 2;Secondary .In this platlet increase in response to many diseases in body.There is long list of diseases but most common are; Cancer of gut, breast, lung ,ovary and lymphoma Iron, deficiency anaemia and hemolytic anaemia, After spleen surgery, Inflammatory bowel diseases and some infective diseases. There is no vitamen or drug which can decrease platlet.It has to be investigated and treated. I would suggest yout consult a haematolgist who may be able to evaluate you for your increased platlet and may treat accordingly. Hope this answers your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does my tooth feel loose at the bottom?\n\nMy tooth feels loose at the bottom. I got up this morning and brushed my teeth and when I ran my toungue on the bottom row, one of them felt sharp on the bottom. I've noticed it before, and just recently went to the dentist and forgot to mention it, but he didn't notice it either. it feels worse today. Is it going to fall out. I have pretty straight teeth its jst the four bottom that aren't.",
    "doctor_response": "Hello,I assume you are concerned with the tongue side of your lower front near the gum tissue? You may have some recession and root exposure. This area can accumulate tartar quickly. This can be sharp or break off, leaving a rough edge. If your entire tooth feels loose or mobile, then I suspect bone loss. You should consider X-rays of this area and a periodontal evaluation. If you just had a routine exam and cleaning, you should contact your dentist and inquire about your periodontal health.if your teeth are sharp and chipping at the biting edge, then you may grind your teeth at night. This stress can damage enamel and the ligament holding the teeth in bone. Teeth can move with pressure. A night guard to protect your teeth is a suggestion. Have you had recent changes in the position of your lower teeth? Both grinding teeth and bone loss can cause this to occur.More details and a clinical exam would be helpful to further evaluate your dental condition. I am glad to answer additional questions. Thank you for your inquiry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of heel pain after walking on the treadmill?\n\nI walk on the treadmill for 45 minutes daily except Sundays  but when I am finished my heel hurts on the left foot. I am diabetic but I do not eat before exercising so what is causing the pain? It does not last all day but the pain remains on the left foot only. The right foot has no problems.",
    "doctor_response": "HIThank for asking to HCMI really appreciate your problem, the hill pain while walking on treadmill could be due to the uneven gate while walking you have to take maintain the good gate while walking, have rest for few days this will be alright, hope this information helps you have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to apply antibiotics syrup for the boils seen in a baby?\n\nMy baby is now five months old, but having boils has been his major ailment.. a month ago, our doctor examined him and gave him some drugs which include Antibiotics,two months ago, same thing with antibiotics syrup. Again, he has boils, I ve refused to apply antibiotics syrup.",
    "doctor_response": "HiWelcome to HCMIf your child has recurrent boils, they may need to have a course of antibiotics to deal with the infection. If the boils do not respond to the antibiotics, they may need to be drained and removed.It can be hard to completely remove S. aureus from the body. The following treatment can help, but to make sure it works as well as possible, all members of the family should have this treatment at the same time.Naseptin \u2013 a medication taken four times a day for a period of 10 daysChlorhexidine shower or bath and hairwash every day for a period of 14 days.Keep a separate towel for each member of the family, change for a clean towel every two days and wash the dirty towels on a hot wash cycle.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is dental mouth guard available to use before and during grand mal seizures?\n\nHi, may I answer your health queries right now ?  Please type your query here... I have grand mal seizures for 15 years now.  Everytime i have one i bite my tongue badly and have been having dental problems. I recently bit down so hard that i knocked my bottom teeth lose and realigned them.  I was informed that you are not supposed to put anything in your mouth before or when you have one. I would like to know if there is a dental mouth guard i can put in prior to  my seizure so my teeth aren't affected anymore??",
    "doctor_response": "Thanks for using Health care Magic.Read your query.During an attack (grand mal) the seizures can last for 2-5 min and there will be lot of motor activity in the mouth. This can lead to unexpected results such as dislodgement of the mouth piece ?mouth guard if worn which would put you at risk of choking. Even if it stays in place it could result in serious injury to your teeth.So it is not advisable for any mouth guard in a person with seizures.Hope this was helpful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause and treatment for severe itching in scrotum?\n\nThank u doctor for your consideration.... Nearly 30 years...I have been living with severe itching in my scrotum. Many tests, and various medications have been taken in these very long period. But the result is in vain. Doctors can only conclude u have nothing except you must have to be an allergic to something which you dont know, their common respons is. I married 20 years before and having 5 children , with no problems in having normal sex, as same never heared complain from my wife. Now still I feel the iching and live having it ...I tried as medicine to use mixiture of oil and garlic.....I do not know what to do...I am 59 years old.....Please help me? I thank you T. Abraham...02 June, 2011 ...Height 1.65 cm...weight 70kg NB.Sexually very active at this age",
    "doctor_response": "Hi, You have been bothered by testicular itching on and off for years. This itching and possible redness of the scrotum or inguinal area is likely due to a fungal infection. A fungus is an opportunistic infection that grows in places that are dark, warm and moist which describes the scrotal area very well. Your doctor decided to use the clobetasol to control the itching from the fungal infection. I would recommend that in addition to using the clobetasol for the itching that you also add tinactin or Lamisil powder to reduce the fungus. In summary1. clobetasol to reduce itching only2. Add tinactin or Lamisil for possible fungal infection. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ivan R. Rommstein, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. The 25th week pregnancy scan showed oligohydramnios and IUGR. What to do?\n\nHi doctor, I am 31 weeks and two days pregnant. I had an ultrasound at 20 weeks, and everything was normal. However, with time, I noticed there was little or no movement, and the baby's movement was more like a ball rolling in a difficult position. So, my doctor sent me for an ultrasound at the thirtieth week. The scan showed severe oligohydramnios and intrauterine growth restriction. My due date was brought forward by a month. On the twenty-fifth\u00a0week, the baby's weight was 603 g. I have tried rehydration and bed rest. Can you offer more help?",
    "doctor_response": "Hi. Let me put forth few facts about pregnancy and baby growth. The growth of the baby is progressive, but if it stops at some stage, that amount of growth cannot be regained. Some reason has been missed by the doctor during the pregnancy monitoring. There could be many causes like uncontrolled diabetes, severe thyrotoxicosis, inadequate food intake or severe vomiting, or a condition called APLA (antiphospholipid antibodies) syndrome (here the baby is rejected by mother's body gradually, as it is a foreign body). So blood flow gradually reduces, as the blood flow to baby's kidney reduces, baby's urine output reduces and thus oligohydramnios becomes severe. In the same way, the baby has to be monitored with scans every week or more often depending on the scan report, fluid level, and doppler scan changes. We cannot take the baby out very early because it will die of immaturity. We can give the mother Steroid prophylaxis at around 28 weeks, to improve baby's lung maturity and to prevent hemorrhage in the baby. Once any of the findings are abnormal, the baby has to be immediately delivered. All we can do is wait and monitor. At least in the next pregnancy, such problems should be anticipated. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for pain in my abdomen after a heavy lift?\n\nI am a healthy 62 year old woman.  I lifted a box 2 days ago which was too heavy and felt like I tore something in my abdomen...it burned a little and has been achy since.  I have also felt unusually tired since this happened.  It is possible that I am bleeding in that area?",
    "doctor_response": "Hi. Yes, this is definitely a muscle strain with minimal bleeding, which continues with pain. Another possibility is starting a hernia, which a Surgeon would be in a position to to diagnose better- have you got a bulge at the spot of pain ?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could tonsillitis be caused by mold?\n\ni have had chronic tonsilitis since february, when i am on antibiotic my symptoms are gone but after a few days off the antibiotic they return. I take allegra d every day and omnaris nasal spray. Could my tonsilitis be caused by mold. I live in a basement and I do know there is mold present.",
    "doctor_response": "RECURRENT TONSILITIS ARE DUE TO.ALLERGY.POLLUTIONSMOKING.BAD ORAL HEIGYN.AVOID SMOKING,PAAN,TOBACCO.BRUSH TWICE A DAY.HOT SALINE GARGLES TWICE A DAYBEFORE TAKING ANTIBIOTIC GET BLOOD TEST  FOR CULTURE .CONSULT DENTIST.FEEDBACK TO HCM",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headache, feeling pressure in neck and chest?\n\nhere are the symptoms i don't know what to make sense of: sudden severe headache (history of migraines), sharp pain and feeling of pressure in neck and chest (this part only lasts a few mintues), numbness down one arm and into hand, and dizziness. any thoughts?",
    "doctor_response": "Thanks for your question dear first from hoew much time do you have this are you have Hypertention or diabetes etc  if not then ok if yes then  go to consult with cardiologist for your chest pain and for headache and numbess if still continue and causes weakness of arms and legs or any where  have ct brain plain ok",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need treatment for hip pain.\n\nHello I have hip pain in my right side after sitting down for a while then when I get up I limp a few steps to the pain goes but not fully, when I am in bed and I lay on the right side its like I have been laying on that side for a long time but I could only been laying there for a few minutes my other hip is fine I am 47 cheers michelle.",
    "doctor_response": "HIIf I would be your treating physician then I would advise you to maintain the good posture because such symptoms likely to happens due to poor posture I would treat this case with Tab Diclofenac 50 mg once in day, better to get done the spine imaging study to rule out the spine degenerative disease, hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will taking mega 3 capsule help in reducing the cholesterol level and any side effects?\n\nMy Recent Lab Reports are as follows: CHOLESTEROL, TOTAL=  239mg/dL LDL CHOL, CALCULATED= 145mg/dL HDL CHOLESTEROL=34mg/dL CHOLESTEROL/HDL RATIO= 7.0 TRIGLYCERIDES=301mg/dL GLUCOSE, FASTING (PLASMA)=103 mg/dL Somebody suggested me to take Dr. Reddy's Mega-3 capsules per day to reduce triglycerides. Will it help me to reduce above counts? Is there any side effects. For how long I can take the Capsules.",
    "doctor_response": "Hi I can understand your concern....Your cholesterol level high....Particularly triglyceride very high.The drug you are telling is docosahexonoic acid which is omega 3 Fatty acid rich.It is used as nutritional supplement .But for lower down cholesterol you can better use atorvastatin like good drug that will be beneficial...You have to change life style habit for lower cholesterol.Take less fried and fatty food....Fruits more.Green leafy veg more.Regular one hour active flooring exercise done.Jogging , running will be good.Avoid smoking.Although you have not asked I would suggest you to do following investigation .......-tread mill -blood pressure measurement -usg abdomen for fatty liver and gall stoneTake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fatigue, pinching pain in the chest, itchy palms with dry skin and reddish spots. Have thyroid problem. Could this be due to asthma?\n\nFor bout 6 months I have felt like crap. It started with just feeling exhausted all the time. Im a usually active person and other than smoking ... Which is bad... Pretty healthy. Now the fatigue is so bad I just cnt get enough sleep n I get shortness of breath whrnever I exert.myself. I doubt asthma becuz I had it as a child n this is not asthma... I have no cough I dnt weeze I just feel like I ran A MILE. I have a pinching pain in my chest tht radiates out to my armpitz n my stomach is constantly queezy. Ive lost 60 pounds since june n im not even on a diet. I went to my doc n my blood work is flagged for mpv of 6.9 im 6ft 2 in n weigh 205 i also have itchy palms with no visible dry skin n red dotts tht look weird on my feet i just want an opinion cuz i trust my doc but dnt feel like she has a clue another prof. Opinion would help in easing my mind n my thyroid is 1.055 which is the lowest its ever been",
    "doctor_response": "Hello, Welcome to Healthcare Magic. To clarify, MPV 6.9 is not significant but the other values such as Hb, MCV, MCH, TC DC, platelet count are more important but I presume they were normal. I do not understand what the thyroid 1.055 is ; if this is TSH value then it is pretty low and am surprised that you are not on treatment for this. Please get a repeat TSH fT4 value and if the TSH is low or undetectable with raised fT4 then the diagnosis is thyrotoxicosis and that is why you are getting the chest pains, stomach cramps, skin problems. An ECG with a thyroid scan is also important. Carbimazole with propranolol (beta blockers) to reduce the pulse rate and close monitoring of bloods is the management. I hope this helps. Get these done as soon as possible. Best Wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for the pain in back\n\nHi, thank you kindly Dr.Rynne. I would like to but am not too sure how to describe it promptly. It is conserning my daughter, she is age 25 and hassome back problems. Maybe If she can reach you tomorrow here this can be much better? Thank you again. Tanya",
    "doctor_response": "Dear: thanks for using our service and will try to help you with an advise for your daughter. She needs an X-ray of her back to evaluate for scoliosis.or stenosis . If the X-ray is negative, they MRI of the back to check pinch nerve.I hope that my advise has been helpfulDrSara",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause pain in the feet and joints of the toe in a 45-year-old?\n\nHello, I am 45 year old male. I have been having pain in my right foot. First it was my big toe joint on the inside of my foot. Very tender to the touch or if I bumped it. Would send frequent pain bursts into big toe. Now it also includes my littl toe. If I put pressure on my foot to pivot, my little toe will send shooting pain into my foot. I still have the big toe issue as well. Any ideas?",
    "doctor_response": "Hello, This sounds to be an increasing level of uric acid. Kindly get this checked. As due to increase in the uric acid levels there might be symptoms of the foot pain, toe pain etc. Monitoring the uric acid levels with the help of medicine should provide some relief. Consume more water and pass more urine to reduce the uric acid levels in the body. Also, I will advise doing simple exercises at home to improve the strength in the muscles of the legs. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain, burning sensation, blood in stool. Had hysterectomy. Suggestions?\n\nI had a total abdominal hysterectomy 8 weeks ago. But have been back to work at 7 weeks. My job is standing all day and lifting I have started having extreme pain in my abdominal area started from the right side and is burning also. I have blood in my stool also. I am feeling totally worn out.  I work in a meat department.",
    "doctor_response": "may be some infection left and wound weekdue to preesure of standing this may happenconsult the doctor who can judge better by physical exam rather thoughtsbut you need restmetrogyl 400 mg tds to cover infection if leftlot of warm waterantacids to prevent constipationsand meftal spas sos till you consukt doctor who did your surgery",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can liver cirrhosis and an enlarged spleen and veins be treated?\n\nhi my name is tammy.  I have multiple gallstones, hep c chorrosis of liver, enlarged spleen, enlarged veins.  no one here where i live wants to touch me they want to send me to a bigger town better drs....also want me on a liver doner list, which is very hared to get isn't it?",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.This is serious disease and quitting alcohol is the most important thing that should be done. Also, medications which are hematotoxic should be avoided. This is necessary to prevent disease progression  which is lethal in most cases. At early stages it can be treated with these measures but but in case of progression, only liver transplantation may help. Diet should be balanced and healthy and get regular exercise. Limit high-carb foods such as bread, grits, rice, potatoes, and corn. And cut down on drinks with lots of sugar like sports drinks and juice. If there is viral hepatitis as udnelying cause then antiviral medications are required.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for erection problems\n\nMy husband has problems with being able to get or keep an erection. He says its always been this way but has never been to a dr. for it. We have only been together for 4 years and he is 52 years old. I am 43 and have a very high sex drive and have had for my whole life so this is causing some problems for us. We just want to know what type of Dr. do we need to see to help us. He does not just want to take pills but wants to know what the true problem is and what is the cure",
    "doctor_response": "Dear service user,Thank you for contacting Healthcaremagic. I have gone through your question and understand your concerns.Let me know whether he can achieve and maintain a good quality of erection during sleep, in the early morning, during masturbation but not at the time of coitus? If he is able to achieve and maintain erection in any one of the above mentioned situations than his problem is more likely psychological rather than physical.Sex is largely what happens between two ears and not that happens between two legs. An occasional episode of erectile failure due to functional or situational reasons like fatigue, tension or own ''pressure to 'perform' rather to enjoy'' is very common. This diminishes arousal level and hence erection too.This 'failure' of erection makes one feel 'I should perform best' and he 'tries to erect\u2019. This in turn further leads to lack of erection.Some common causes of erectile dysfunction are:- 1. Diabetes 2. Some medicines like anti depressants and anti psychotics3. Hypertension3. Performance anxiety (the most common reason)4. Alcohol use5. SmokingWhen similar patients come to my clinic I prescribe them Sildenafil 50 to 100 mg to be taken 1 hour before anticipated sexual activity. But it should be taken only under medical supervision as it can be harmful if taken in extra dose than needed. This helps together with behavior therapy.I suggest consulting a psychiatrist for the same. The problem can be overcome with successful treatment.Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My wife has peculiar headache near left ear. What is it?\n\nHi doctor, My wife is 35 years old. She is 5 feet and weighs 50 kg. She is having a peculiar pain for the past six to eight months. The pain is located just above the left ear and 2 cm beside the left eye. Earlier, the pain use to occur once in one to two months. Usual timing for this pain is bedtime during nights around 10 to 11 PM. The pain will last for just 5 to 10 minutes. She kept ignoring it by assuming as a normal headache. Slowly the frequency of this pain increased to once in every 15 to 20 days. This went on to reach once in every two to three days during last month. We were to go on an urgent trip to hometown; therefore we thought to postpone the checkup till the return from the trip. During the hometown trip, we discussed with a known neuro doctor, who got her head CT done. CT report is absolutely normal and he suggested that my wife should not take much tension. For past one week, the frequency of the pain increased to two to three times in a day. At times she had some kind of pain with her left ear in the past. But that is not affecting her now. Currently, the timing of the pain is not fixed and the same happens at any point of time. Usually it lasts for approximately 15-20 minutes. Since the CT scan report of the head is absolutely normal, we are not able to figure out the real reason for this pain. What could be the possible reason for this pain? Can I get the detailed response? She is also having very minor increase in thyroid level. However, as per experts the current level does not require any medication. I am attaching the CT report as well as the recent thyroid report. Apart from this, she does not have any other significant symptom. I am looking forward to your response.",
    "doctor_response": "Hi. Revert back with the answers for the above questions to a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause a blood in shorts while farting and minor bleeding in nose?\n\nI am a  70 year old man.  I have capillary fragility- same as my father did.  Get red spots on my forearm taht gradully fade and then new ones randomly appear.I noticed recently if I emit a powerful fart I find bright red blood in my shorts.  Is this likely due to the capillary fragility.  I also have some minor bleeding in my nose.",
    "doctor_response": "Yes, It is because of capillary fragility. When you perform powerful act like farting and nose blowing. Small capillary near the area are pressurised as you have the capillary fragillity, capillary under pressure will burst. Thnx",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the recovery time for swollen lymph node in a child?\n\nhi!my baby girl she s 18 months now got a lump on her right side on her lymph node,it s been 4 months now.I take her to the doctor they said it snormal and it will fade away but i just just noticed she s got bad breath.she s fine and eating well but i am worried will it fade away..first time mum and she s my only daughter...please help",
    "doctor_response": "Hi,From history it seems that this enlrged lymph node might be due to some chronic infection in surrounding parts.As she is fine and good appetite nothing to worry.If problem  persisted then problem of having primary complex should be ruled out with some investigations like,Montoux test,X-ray chest andComplete blood checking.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mottling behind thighs, shooting pain in legs. MRI of spine shows disc bulging. Suggestions?\n\nI recently have noticed what appears to be a mottling appearance behind both thighs. I am not cold by nature. A MMRI of my spine reveals multiple disc bulging & I have been having pain running up & down my legs....a bulge is pressing a nerve. I am to begin PT next week to strengthen my core, but this mottling now has me concerned. Any idea what thus could be? Thank you!",
    "doctor_response": "Hi, Thank you for posting your query. Mottling behind the thighs are not related to lumbar disc bulges and nerve compression. Mottling could be due to minor bleeding underneath the skin. Are you taking medicines like aspirin? If not, you may need to check your platelet count. Please consult your GP for further evaluation. Best wishes, Dr Sudhir Kumar MD DM (Neurology)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i get pregnant after undergoing medical abortion?\n\nokay so i am freaking out... I had a medical abortion on Feb 5 2011. I went to my follow up visit 2 weeks after and had an ultrasound and was told I was not longer pregnant. Meanwhile I was stupidly having unprotected sex with my boyfriend just a week after the abortion. I took a pregnancy test yesterday and today and they are coming back positive. Could I be pregnant again?",
    "doctor_response": "Hi,I understand your concerns.Following is my reply:1)\u00a0\u00a0\u00a0\u00a0\u00a0You are unlikely to be pregnant.2) This test is positive from previous abortion pregnancy.You can contact me anytime directly to ask question by pasting following link in your browser:XXXX",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes repeated head pain?\n\nMy 2 year old grandson has complained of instant head pain that is very intense and it only last for a minuet.  He has these episodes at least three times a week.  He started having them about six months ago and the doctors can not find anything wrong with him.  Do you have any answers?",
    "doctor_response": "I hope the primary tests needed for investigation of such problems e.g. vision test, intraocular pressure in eye, scan of head etc have been done. If everything is in order and still headaches, Ayurveda has the answer for 'Shirshool' - the headaches. Many kinds of SHIRSHOOL are mentioned in Ayurveda. If you agree to go for Ayurveda's safe herbals, pl inform little more. Any other symptoms - vomiting, fever or not, hyperactivity, indigestion etc whatever you notice.Till then pl give him Tinospora cordifolia capsules (Guduchi capsules). Capsule may be cut and contents pored into a bowel. Mix little honey and give to the child. Do it twice daily for next two weeks. Else if you are in India, you can get Guduchi satv or Giloy satv powder too whichay be given approximately 125 mg twice a day. Amritarishta liquid 5 ml + water may also be given twice a day. Generally such SHIRSHOOLAS are vitiation of Pitta humour as per Ayurveda.When we get more info, we ll add more, if needed.Pl keep in mind that these are harmless, safe prepations and no interaction with other drugs, no side effects. On the other hand moder toxic drugs with side effects should only be given in acute emergency to such small children where question of life needs quickest relief.If you agree, pl inform further. In case of any query, pl communicate through direct question.Hope it is helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for chest and nasal congestion?\n\nmy son 15 months is often suffers from chest congestion and nasal congestion and we r taking treatment continuously we have given him cheston , levolin, macpod for first time and again 2nd cycle vetrolin , sinnarest af and macpod but temporary cure pls tell me wat to do for permanent cure",
    "doctor_response": "Hi. I can understand your concern. He might be having asthma . Asthma is most common allergic disease causing these symptoms. Consult a pulmonologist for the same. He may benefit from nebulizations.Don't worry, he will be alright. Hope I have solved your query. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fungal infection in the groin area\n\nI ve got fungal infection in the groin area. The dermatologist has suggested the following medicines : 1. Cefadroxil capsules : twice daily for 10 days 2. Itraconazole capsules : twice daily for 10 days 3. Levocetrizine tablet : once after dinner for 10 days 4. Onabet lotion : twice daily application for 10 days 5. Washing/bathing with Kz soap There s a burning sensation after using onabet lotion for the first 10 minutes. Is it ok? Or shall I use coconut oil instead of onabet? How much time does it generally take to get absolutely free from the problem? Please revert",
    "doctor_response": "Hello, Thanks for writing in HCM.Well, after going through your post, what has been prescribed by Dermatologist for fungal infection is absolutely right. Since fungal infections takes a little longer to heal, you need to be patient and con not expect quick results. You cannot replace Onabet lotion with coconut oil. In case the lotion is causing burning sensation, you can replace it with Onabet powder. Kindly continue the same and it would take about 2 weeks for complete recovery. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. 10 year old is suffering from diarrhea. What medicine can I give?\n\nHi doctor, My daughter is 10 years old. She has been having diarrhea since today morning. What medicine or drops can I administer?",
    "doctor_response": "Hi Welcome to icliniq.com. A 10-year-old child's average weight is 30 kg. Hence, I suggest the following medicine. Consult your doctor, discuss with him/her and take medication with concern. Give him half tablet Norflox TZ (Norfloxacin, Tinidazole and Lactobacillus) and twice a day for three days, Syp Zn 20 (5 ml /20 mg - zinc) 5 ml once a day for 14 days, Sporlac sachet one sachet bd for five days and ORS 200 ml per loose stool (oral rehydration solution). In diet give coconut water, curd, and banana.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatments for filarial fever with abdominal pain\n\nhi my name is chandra prakash from delhi and i am surfing from filariya fever and pain in my abdomen. i have taken banocide fort tablet 3 month continually according the doctor suggestion but after 15 days i feel pain in my abdomen & fiver again. please suggest my about my treatment.",
    "doctor_response": "Hi.Thanks for your query.First of all I would like to ask a simple question: Is the diagnosis filariasis is confirmed by blood tests ?Continue tablet Banocide forte - at least for 3 weeks. If you are not relieved of the symptoms , I would advise you to go for tests to rule out or confirm the diagnosis of pain in abdomen and fever. - blood tests = routine, for blood sugar, kidney function and liver functions.-Ultrasonography of abdomen. - It is possible to get another diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What happens when the TB course is discontinued ?\n\nHi all, My fiancy is continuing her TB madicine course. During the course she had some other problem. So doctor asked to stop the TB medicine 4 a week. Even the course was over almost one month, he prescribed fresh neglecting the last month course. When she approached to another doctor, he included the last one month also and suggested the medicine. So we are confused whom to believe. Can any one suggest what happens when the course is dicsontinued.",
    "doctor_response": "Dear friend, firstly, do not take the disease lightly, secondly never to stop the anti TB medicines , once started . if the patient had some drug reaction, or drug induced jaundice, then de sensitization to anti TB drugs followed by full course of Rx for 6 to 9 months is necessary. stopping and restarting for no significant reason leads to multiple drug resistance, which is difficult to treat TB and the patient also spreads\u00a0 the MDR TB to other innocent people. better have a follow up check with X-rays and sputum examinations if\u00a0 the patient has lung TB. remember, in TB only thing that cures it is regular medicines.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for ankle sprain and calf lump?\n\nLast week ankle felt weak. No big deal sprain them every year. so I babied it bit so I wouldn t sprain it and be no crutches. Yesterday {Feb 2nd} woke up put my foot on the floor and thought i would go through the roof.My left foot , started on the bottom of foot. Now ankle, calf and calf has a lump on it as of this morning. it feels a little better once i can stand or put pressure on it. This stinks because its the first time in more then 25 years I have no benefits. Left foot a little swollen,hot inside not really to touch.A little red. I am over weight 47 years old. Have had a few weird sinking moments in the past 6-7 mo. One minute fine next on the floor but the last one was before thanksgiving..Blood pressure is always low. Never had anything else wrong. Haven t been as active as usual either. Just tired all the time.",
    "doctor_response": "Hello I have studied your case.As per your history and symptoms possibility of cellulitis can be considered.Consulting your doctor infection /cellulitis can be confirmed, antibiotic can be started according to examination.If required you may need to do blood investigation for prognosis and recovery.Take precaution to avoid spread of infection. Vitamin B12 is important in the maintenance of health and normal functioning of the nerve tissue. You can increase B12 level by taking meat and fish, or you can take Inj methylcobalamine.You need weight reduction and blood sugar checking.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness in the chest and dizziness?\n\nWell a few times in the last two months and just about an hour ago I had a tightening in my chest that alarmed me but it was hard to tell what came first. I was with a client at work but was rushing to bring my wife to a doctor apt at the hospital but I almost drove around to the er myself. Still have some tightness. I get lightheaded sometimes and I feel like my hear flutters yet I completed a vigorous workout at noon....??",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As you have chest tightness plus fluttering of heart, I will suggest that you should undergo urgent ECG and blood pressure monitoring. Also go for lipid profile and blood sugar level. Reduce smoking and coffee consumption. If your routine ECG comes normal, I suggest to undergo holter monitoring. Please do not ignore. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this urine culture test result during pregnancy indicate?\n\nHello Dr I am 25 yrs old 32 weeks pregnant fot 1st time My urine pus cells was 8- 10 counts during 2 trimester After cbc hiv n urine test my urine pus is 40 % on 3 trimester I got my urine culture test done waiting fr reports I dont hv any burning sensations Little pain at lower abdomenal n slight discharge when i over walk or work Pls help",
    "doctor_response": "hello user,you should consult your gynecologist and take a course of antibiotics,take lot of fluids,healthy diet.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe chest pains\n\nI have had HORRIBLE chest pains but more so near my left breast it takes my breath away and is very painful when i move a certain way or even talk a certain way. Im also 6wks pregnant. I was sent to get an EKG done today the lady said it came back normal but the doctor still had to go over the readings so does that mean there still could be something wrong",
    "doctor_response": "Hello,Chest pain in pregnancy. Give me some more details about the patients and tests I need to examine the patient before giving any treatment.Hope I have answered your query. Let me know if I can assist you further.Regards,      Dr. RS Gulati",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough and throat pain\n\nMy 4 year old has been coughing for about 3 weeks but said he feels fine, so i didnt worry much about it. Now he has said his throat hurts a little, and will hardly eat. but still no fever and says overall he feels ok, just tired and nothing tastes good. Should i wait it out or take him to the dr.?",
    "doctor_response": "Hi, As per your query you have symptoms of cough and throat pain which seems to be due to viral infection, which usually goes away by its own after completing the course. Need not to worry. For now do warm saline gargles, take over the counter cough syrup and take ibuprofen or acetaminophen for pain and swelling. I would suggest you consult ENT specialist gain for proper examination. The doctor may order a test like a throat swab test, viral culture test and blood test to confirm the diagnosis. The doctor may prescribe an antiviral drug like acyclovir and with an anti-inflammatory. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Harry Maheshwari, Dentist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any remedy to reduce FSH levels in a male and to concieve?\n\nHai..Dis is Victoria...Im having a query for my husband..He is 28 years old,recently we came to know that the FSH level is very high..Doctors are suggesting to go ICSI..But we dont know what decision to take...Is there any way to reduce the FSH level? Do we have any chance to concieve? Plz reply...",
    "doctor_response": "Higreetings. Your husband's  FSH is high means his testis may not be functioning properly.To know that we will need LH,TOTAL TESTOSTERONE Prolactin values.He may be having hypergonadotrophic   hopogonadism meaning in spite of stimulation by the pituitary gland testis is not functioning.After analysing and confirming we should find out the cause for testicular problem and if correctable should be treated. what about his semen analysis.? If the count is low and testicular problem cannot be treated then IVF _ICSI  can be considered.Hope my answer helps you. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "When should the chemical stress test be scheduled after a chemotherapy?\n\nMy dad is undergoing chemotherapy for small cell carcinoma of the lung.  He is on procrit for low RBC and is diabetic, but controlled.  He is 74, 6 ft tall and 196 lbs (lost 30 lbs since Feb 2011).  He is scheduled for a chemical stress test tomorrow and I am wondering if he should wait and reschedule.  Thank you.",
    "doctor_response": "Hi,Thanks for writing in.Chemical stress test might be done if his general health condition is satisfactory. His doctors will confirm his tolerance level and check his vital parameters before doing the chemical stress test. This will make sure that the test will not compromise his health and the fact that he is under chemotherapy for small cell cancer lung.Please follow instructions before the test and in case of any discomfort or weakness he can inform the doctors performing the test and then if he is not keeping fit then he can reschedule the test. Many people get the test done without any risks to their health. There will be emergency medicines at the time of doing the test in case he feels uncomfortable at any time during the test process and he should promptly inform. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated liver enzymes?\n\nHi. My ast is 314...alt 631 and another enzyme is 300 something as well. Ive been tested for hepatitis..neg. ultrasound...neg. dont drink or smoke..triclycerides 90...ima big guy but dont have high bp go to gym regularly...ive had pancreatis before...thought i had attack other day amilase was 744 but yesterday was normal but these other numbers...had a camera down my throat a year ago looking at pancreas...no cancer..on that test..but im really confused as to whats up any thoughts",
    "doctor_response": "Hi, SGOT and SGPT  are sensitive indicators of liver damage or injury from different types of diseases or conditions, and collectively they are termed liver tests or liver blood tests. So the next step is to look for certain liver damage and most common casue is fatty liver disease. It should be confirmed by ultrasound. Other causes are viral hepatitis,cirrhosis, medications, alcohol intake or autoimmune diseases. To verify the exact cause, US, bilirubin levels and tumor markers should be additionally done Then appropriate treatment can be started. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ivan R. Rommstein, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high heart rate and strain with chest infection?\n\nSaw doctor Wednesday diagnosed with chest infection, blood test showed crp 27.7 is this normal for a infection?Had 4 days of antibiotics so far, feel heaps better but things are stillA bit more of a strain and heart rate elevates more than normal, is this just my body recovering from infection?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. It could have been a infection which you are getting over. Drink lots of fluids.Build your immunity by eating lots of fresh fruits and vegetables. Consume high protein diet to get over your illness.Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent dizziness?\n\nRecently I have been feeling faint, stood up once this weekend and almost fell over. I had to hold onto a door, just not to fall over and knelt back down to recoup. I have also had slight pangs on both my left and right side towards my back. I don t know if my blood pressure being low( culprit) for the faint feeling?",
    "doctor_response": "Hello!I read your question and understand your concern. There are many causes of dizziness and fainting. The most simple thing would be a low blood pressure or an orthostatic hypotension. I would recommend you to measure your blood pressure regularly and in two positions, sitting and standing up. A decrease more than 30mm Hg from sitting to standing position would be indicative of orthostatic hypotension.Another cause would be a vertebral artery insufficiency or from cervical spondylarthrosis causing compression of the vertebral artery. It would also explain the back pain. A cardiac arrhythmia can cause similar symptoms too. I would recommend you to consult with your GP , have a full blood work to rule out anemia. A doppler ultrasound of the cervical vessels and a cervical column xray would also be needed. Other tests for the heart like an 24h ECG monitoring , and a Heat up tilt test for orthostatic hypotension may be necessary. Hope to have been of help! Best wishes, Dr. Abaz Quka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedy for psoriasis like skin infections\n\nhello  i am 21 year old female have been suffering from a kind of diseases since 9 years  which i exactly dont aware of. it is in form of white flakes of bigger sizes and smaller sizes even.according to consulted doctors,it is a kind of psoriasis as one says  and  other says excess secretion of oil from hair oil gland.due to this i lose huge amount of hair..sir i am very nervous and desperately wants its treatment because i think may be due to this problem there are certain side effect like continuous cold.presently i am on medication of isotretinoin capsules usp 5mg (acutret 5) past 3 weeks and doctor has prescribed for 1 month. i am even late to my periodic cycle by 2 week .i am very scared..plzz doctor recommend me what to do and whether to stay upon with this medicine .is there any remedy from ayurveda or home made techniques.",
    "doctor_response": "Hallo. Psoriasis is a autoimmune disorder. Diet may play a role in managing psoriasis.Eliminating red meat and fatty foods have been effective for skin infections.     Apply Neem Oil two times daily on the affected part and wash with Turmeric powder with  lukewarm water.      God bless you..!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes discomfort at the back of the neck?\n\nI had an aneurysm Sept. 28, 1983 and had a daughter a year later, Oct. 19, 1984 because they took me off the pill and I had just been married 9 1/2 months when I had my aneurysm and the birth control they gave me after that was just too inconvenient. Anyway, lately the back of my neck has been feeling like it did when I had my aneurysm. I had an arterialgram (sp.?) and they said I no longer had an aneurysm. What else could it be and why does it feel just like the aneurysm?",
    "doctor_response": "Hi, Most aneurysms are small, about 1/8 inch to nearly one inch, and an estimated 50 to 80 per cent of all aneurysms do not rupture during the course of a person\u2019s lifetime. Aneurysms larger than one inch are referred to as \u201cgiant\u201d aneurysms and can pose a particularly high risk and can be difficult to treat. But complete recovery from aneurysms without embolization or coiling is very rare. So earlier one is an artefact or infract etc. Please consult your neurosurgeon, he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe cough and pain under the breast\n\nI m a 49 yr old white female, I recovered from bronchitis two weeks ago with pretazone perscription. Yesterday i shoveled snow for five min in seven degree weather and now i am coughing again and I have a sharp pain in my right lung under my breast every time I cough.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.The intense pain and cough after exposure to cold weather indicate underlying bronchitis. Guidelines at present for a better outcome are :- Deep breathing exercises.- Inhalation of vapors of boiled water added tincture benzoin.- Cough formula, antibiotic and bronchodilator medicines as per the physician concern.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could the problem be if I am having irregular periods and not conceiving after having unprotected sex ?\n\nmy periods are irregular and i am spotting or bleeding heavly my periods are irregular and i am spotting or bleeding heavly for about 2 and ahalf weeks at a time my husband and i are trying to get pregnet and we have had no luck we have a 8 year old all ready and no birth control in over 4 years what could this be",
    "doctor_response": "Welcome to Healthcare Magic You probably have hormonal disturbance. Have you got your thyroid hormones checked recently. Hypothyroidism can cause heavy bleeding and possible infertility as well. Even PCOD can cause similar disturbance. Also do get a thorough checkup by your Gynaecologist to rule out other problems like excess uterine thickness which can cause heavy bleeding which may require D&C procedure to confirm as well. Not to worry. There is a possible solution in every case. Have faith in God and your Doctor and do not hesitate to get a thorough examination by your Doctor in order for proper solution.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for hair loss?\n\nGood Morning Dr.. I am Sathish From Tamilnadu, i had a treatment of hair loss & get growth hair on scalp. my Dr Suggest the following Medicins. 1. Seren Shampoo 2. Mintop 10 3. Foligain Lotion 4. Finax 1mg TAB 5. Adgain Cap 6. Bots Folica Lotion this are all stop hair loss & get hair growth on scap? Please give a idea for this one Thank You -Sathish",
    "doctor_response": "Hi,I read history and also got knowledge about medicines you are taking. After that I conclude that most probably you may be having androgenetic alopecia. I can understand your concern for hairloss.You may continue some drugs...and may add some new one...- continue finax- continue minoxidil application - take biotin 10 mg daily- Chang shampoo.. Use ketoconazole containing shampoo daily- have patience- take treatment for more than 2 years or good resultI hope this would help you..Thanks..Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does one lower blood sugar level before seeking medical assistance?\n\nMy bloodsugar registered 599 so I re-checked it and now the meter will read is \"HI\". Should I seek medical assistance at this time or is there some way to lower my sugar until I can see my physician Monday. I have not been diagnosed with diabetes. And I am taking blood pressure and synthyroid meds.",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Blood sugar is too high. Yes, you should seek medical assistance at this time.2. Do not try to take any medications with out an exact diagnosis.3. At the hospital, do get an HbA1C done for diagnosis of diabetes. Will require estimate of ketone bodies too. It could be complicated diabetes mellitus.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low hemoglobin?\n\nI have had clotting during my jens trail cycle I am 48 yrs old. Had bcc hgb 3.56 hot 7.8 . Are there other blood tests that should be done to evaluate this ? Does the excessive bleeding play a factor and can a small fibroid and a sense of sexual relations for several years effect it?",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You have low hemoglobin. Bleeding is the most common cause of low hemoglobin.  It ultimately leads to iron deficiency anemia. You should go for peripherals smear examination once. Consult your gynecologist and take treatment of fibroid.  Also take iron rich food like jeggary, dates, green leafy vegetables, dry fruits etc. You can also take oral or injectable iron supplements.  O ce your bleeding will stoped. Your hb will come back to normal. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Am I getting pain in arm, hip and knee due to low vitamin D level?\n\nHi doctor, I have just found out that I am very low in vitamin D. I have just had lots of different blood tests, bone profile, 12 folates complete blood count, vitamin D and a couple of others, all came back normal apart from vitamin D. I have been getting an aching pain in my upper arm and elbow, hip and knee but mostly my upper arm. Can it be the low vitamin D that is causing it?",
    "doctor_response": "Hi. I cannot say it with utmost certainty, but yes it could be due to low vitamin D3 levels. The majority of patients with moderate to mild vitamin D deficiency (serum vitamin D between 15 and 20. The majority of patients with moderate to mild vitamin D deficiency (serum 25[OH]D between 15 and 20 ng/mL [37.5 to 50 nmol/L]) are asymptomatic. Serum calcium, phosphorus, and alkaline phosphatase are typically normal. Serum parathyroid hormone (PTH) levels are elevated in about 40 and 50 percent of patients with serum vitamin D levels less than 20 and 10 ng/mL, respectively. Patients with low vitamin D and increased PTH (secondary increase) are at increased risk of having rapid bone loss, seen as low bone mineral density (BMD) in dual-energy X-ray absorptiometry [DEXA scans]), fragility fractures. With chronically low vitamin D levels one can develop secondary hyperparathyroidism, which can affect serum calcium and phosphorus levels. The patient usually develops symptoms at this stage with features of osteomalacia (bony pain, etc.). I do not know your vitamin D levels, but there is usually no harm in taking vitamin D supplements orally weekly or daily.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a 12 year old to feel voices in the head?\n\nHi. About a year ago, my 12 year old son told us that he was hearing voices in his head. He described the voices as a lot of people talking but he could not understand what they were saying. We contributed it to a song that he heard on wrestling and did not follow-up with his peditrician. However, his has been displaying signs of attentiveness at home and school. His inability to pay attention and to stay on task at school has caused his grades to decline drastically. In addition, he has become unorganized and forgrtful. Is it possible that the voices are still in his head and he is focusing on those and not at the task at hand? What are some options that we as parents can do to help him without placing him on medication? We would like for the medication to be the last option.",
    "doctor_response": "your son is showing symptoms of attention deficit and hyperactivity disorder  ( ADHD ) but the type is inattentive type , because unlike the name ADHD there is one type of hyperactivity and the other type is inattentive type .careful history taking and physical exam will confirm the diagnosis a lot of behavioural disorders can be Delt with without medications through psychotherapy, but the first step is to take him to the pediatrician and assess his case .I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Numbness in knee after C-section. Taking Clexane, wearing TEd stockings\n\nI had a c section 8 weeks ago due to placenta praevia and very risky complications. This was done by spinal epidural and i was kept awake. A week later i noticed a numbness in my right knee which didn t hurt but felt very strange. This past week the numbness has changed into feeling very tight and it is painful to walk on it particularly going up and down stairs. I do have a history of knee pin but it has always been put down to hypermobility . This tighness is like someone has wrapped a bandage around it far too tightly and it doesn t go away when sitting or standing. I was on clexane for 6 weeks following surgery and wore the TEd stockings for 2 weeks. Thanks for your helps",
    "doctor_response": "Hi,This is unlikely to be related to your surgery or spinal/epidural as the symptoms came on a week after the procedure. The tightness may indicate you have an effusion which is fluid around the knee joint. I suggest you see an orthopedic specialist and you may need an MRI to assist diagnosis.Regards,Dr K A Pottinger,MBChB  FRCA",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling sensations in the foot?\n\nHi I fell down 2 steps and rolled my ankle. It swelled up but in a few minutes was able to walk on it. The next day I could not put any weight on it and it swelled up with slight bruising under it. Never went to the doctor but each day since (6 m) it has gotten a little better. I can put all my weight on it by turning my ankle inwards is still painful. Now I am experiencing tingling in my foot and the area around the outside of my ankle is really tender to the touch- is this normal for a sprained ankle (which I have just assumed I have)?",
    "doctor_response": "Hello, Thanks for writing to us, I have studied your case with diligence.As per your history  pattern there can be persistent tear in ankle ligament leading  capsular tightness.I will advise to do MRI ankle for soft tissue involvement.Till time you can continue physiotherapy exercises and also use supportive splint or brace.Physiotherapy like ultrasound and TENS will help in early healing.If there is complete ligament tear then arthroscopic ankle ligament repair can be done or if capsular tightness is severe then release can be done.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for diarrhea and lack of appetite in infant\n\nhi doctor, good morning my 8 month old baby green watery diarrhea since 2 weeks. initially it was with high grade fever & i took her to doctor. he examined & said pharyngitis & given cephalosporin. 5 days of course completed but still diarrhea persisting. she refuse to take any food except breast milk. what should i do",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry.There is no need to use antibiotics (LIKE CEPHALOSPORINS) unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Long term lower and mid back pain issues. Using a special chair, tried all medications. What to do ?\n\nI have had long term lower & mid back issues. The usual stuff.. bad posture is certainly a regular thing. I had a special chair put in at work with all the bells and whistles..this un-firtunately suffered a weld failure a week or so ago. I was in in at the time (I am 13 stone 5lbs). The pain is breathtaking and has been for about ten days now.... Targenact, co-codamol 50/500 and even Versatis 5% medicated plasters are doing little.... I really need to get back to work asap and would like some advice on what to do.",
    "doctor_response": "Hello, I think you should get a MRI of lower back done to see if there is disc bulge causing pinched nerve. Generally in long term backache cases this is the underlying cause. After MRI more appropriate treatment can be planned. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will sustane 200 postpone my periods as I had IUI?\n\nHi, I had IUI on 11th December 2013 and my doctor suggested me to have Sustane 200- 2 times a day. My last period date was 26th November 2013 and it's a 25 to 26 day cycle for me. Doctor suggested to take sustene 200 for 15 days. My home pregnancy test was negative. My doubts are Will sustane 200 postpone my periods? Do i have to wait for a week to get my Periods after stopping sustene 200?",
    "doctor_response": "Hi susten tablet delays the periods.  It actually support pregnancy also. So it is given after ovulation. You will get your periods in 1 to 2 weeks after stopping it if you are not pregnant.  if you don't get your periods after 1 week.She you can repeat the pregnancy test. Hope I have answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heartburn and tingling in arm?\n\nI woke up in the night (sleeping on my right side) with my left arm tingling (fell asleep feeling) and heartburn. I've been having lots of heartburn lately and I've noticed lately being more out of breath walking up a short flight of stairs. I'm 58 and my Dad died at 49 after having thinking he had heartburn all day. Should I be concerned?",
    "doctor_response": "Hello,Thanks for writing to Health Care Magic, I am Dr Asad Riaz, I have closely read your question and I understand your concerns, I will hereby guide you regarding your health related problem.heart burn can be due to GERD or heart diseases..tingling is an neurological feature that can be either due to some nerve daamage 2ndry to either infection or trauma or systemic diseae kike DM etc....or it can be due to cardiac issue..if u were my pateint i woud like to do detai histri n exam n then will do some relevant test like cxr to see infection or pulmnmnry congetion...ecg n echo to rule heart heart disease n endoscopy to see isnt GIT issue n then will treat u accordngly...yes u should concern abt these symptoms n should be treated properly...I hope this answered your question, if you have more feel free to ask.Regards.Dr.Asad Riaz.General and Family Physician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes knee pain and psoriasis in legs when suffering from OCD?\n\nHi, I was suffering from Obsessive Compulsive Disorder (OCD) since 2006 and I was under medication for 3 years (anti depressent and sleeping dosage). During this period, I have gained weight from 50 Kgs to 75 Kgs. Currently I am 70 Kg. Over the past 2 years, I got severe knee pain as well as in the heel (both legs) Also, I am getting tired sooner and pain persist in my hands as well. Doctor advised me to take RA test and it was well within the limits. I have tried different medication but no use so far. Recently my doctor advised me to take Vitamin D and Vitamin B12 test and the results as below: Vitamin B12 - 246 pg/ml 25-OH Vitamin D - 21.49 ng/ml Doctor advised me to take DV 60 K (one dose per week for 8 weeks) and Renerve plus (1 tablet per day for 8 weeks). I am 33 and pure vegetarian. I got mild psoriasis in my legs and fingers.. (not even visible for others) OCD since I was 7 but got diagonised only when I was 25. No physical activity (walking, cycling) in the past few years especially after taking the medication for OCD.",
    "doctor_response": "HiThank you for asking HCM.I have gone through your query. For OCD you should get a proper counselling by psychologist. Medications are added if counselling alone not helping. A proper follow up should be taken also. Low vitamin D can give skin problems like psoriasis. Get sunlight exposure when intensity of sunlight is low, like in the evening time. You can also take D3 supplements with the advise of your doctor. Decreasing of physical activity is not a good thing. It can decrease your strength. Have a regular exercise. Jogging or brisk walking is good. Absence of physical activity can also weaken and cause quadriceps atrophy and can results in knee pain. Quadriceps strengthening exercise will be helpful in such case also.Hope this may help you. Let me know if anything not clear.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach pain in a child\n\nMy daughter has frequent stomach belly hurts aches. They always either occur at night after eating or first thing in the morning when she wakes up. She does not vomit from them. Even when in the midst of one of her episodes she will still want to eat. She seems to constantly be hungry. Tonight after dinner she was complaining of her belly hurting but was still hungry. This is a constant...she is always hungry and her belly aches do not stop her from eating.",
    "doctor_response": "from your history I can say your daughter is suffering from some sort of abdominal infection and digestive problems. You have not mentioned the age of your daughter so it is very difficult to say about dosage of the drugs. Anyways you have to give her syrup oflox-oz 5 ml twice daily with syrup cyclopam 5 ml twice daily for stomach pain with some digestive enzymes like syrup unizyme 5 ml twice daily. Along with give syrup bandy-plus 10 ml stat at night and 10 ml stat again at night after 7 days. You can also give syrup gelusil-mps plus 2 tsf four times daily empty stomach.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How serious is diffuse cerebral and cerebellar volume loss?\n\nI was informed that: 1. Mild to moderate diffuse cerebral and cerebellar volume loss, somewhat greater than expected for the patient s age. 2. Small incidental curvilinear posterior pericallosal lipoma (benign tumor of fatty tissue) 3. Otherwise normal MRI of the brain. How serious is all this? I m very concerned.",
    "doctor_response": "I read your question carefully and I understand your concern.Everyone of us after our twenties starts to lose brain cells, hence brain volume, it's part of aging. With the passing of the years as the loss adds up it will start to become visible on MRI. So how abnormal that finding is depends on your age which unfortunately you do not mention.Judging by the report it would seem it is more than the average for someone your age. It says somewhat so it's not allarmingly more and it is a somewhat subjective estimation anyway.I don't know why you had the MRI, but that finding shouldn't be causing any symptoms. At worst it may indicate that your brain is aging quickly, might have a greater predisposition for cognitive decline in the future, but that isn't necessarily so, there isn't an exact correlation between brain mass and cognitive performance.I hope to have been of help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for sore throat, cough & exhaustion\n\nHello, I have been sick for 2 weeks.  It began with a sore throat, coughing, and exhaustion.  I was coughing up green phlegm.  By day 4 of feeling like this I took a z-pak (my mom had an extra prescription that she let me use).  I felt improved after the antibiotic (sore throat disappeared, was only coughing up yellow phlegm for a few days).  Unfortunately,  the sore throat and exhaustion are back.  Should I be concerned?  I am avoiding going to the doctor because I am broke and have no health insurance.  Thank you.",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .*  Guidelines for better  outcome-  Gargles with salted lukewarm water  added  peppermint  oil  3 times a     day .-  Consume plenty of liquids .-  Prefer  soft , light  diet .-  Tessalon pearls  3  times  a  day .-  Avoid exposure to weather with dust , pollens ; if  necessary  use  triple    layer  face mask  wisely .-  Avoid smoking or tobacco in any form if using .*  Consult later your doctor  if  symptoms  are  persistent .Hope this will clear your query .Wishing you fine recovery .Feel free to ask any further  queries .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hives around the anal area in a child?\n\nhi Dr. My 5 years old son is having hives around his anal area intermittently..it pains as well..after applying rashfree creams it goes off and again comes back at a interval of 15-20 days. he doesnot have fever but he is complaining for stomach ache also..it comes just for 2 mins and goes.",
    "doctor_response": "Hi... I feel the possibilities could be -1. Worm infestation2. Acute Pancreatitis3. Inflammatory bowel disease.i suggest you seek your pediatrician's consultation regarding this and get him evaluated.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I get pregnant on Duphaston for 10 days ?\n\nI took Duphaston for 10 days, starting on my ovulation date. I have missed my period for 9 days now and my breasts are very sensitive than usual. Could I be pregnant? I don t want to check to avoid disappointment.",
    "doctor_response": "Hi, Thanks for query, It seems that you are having pregnancy, Wait for few days more if you do not want pregnancy test. Do not worry signs are definitely of pregnancy. Keep it up,I wish you good luck. Ok and bye,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the blood pressure tests with 145/93 indicate?\n\nI have had 3 blood pressure readings over 3 months the first was 158/91 then 153/93 the last one yesterday was 145/91.  I am 46 Years of age and weigh 75kg I have recently stopped smoking and do not drink alcohol to excess.  My doctor has not given me any indication as to whether this is dropping or the risks to my health with my blood pressure being in this range.  I exercise regularly but also I am HRT.   I would like to know what risks my blood pressure range is and should my doctor be doing anything more.",
    "doctor_response": "Hello thereYour blood pressure readings indicate that you need a medication .. however simple your life style is you still need to modify it.. Your doctor should be counselling you and advising you medicines to be timely takenHope that helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Was in induced coma. Developed multi organ failure. Having lack of concentration, depression. Allergic to anesthesia?\n\nHi I had a asthma attack in 2009 which lead me being put into a induced coma from that I developed multi organ failure hypertension septieemia mrsa meningitis and was only given a hour to live the special ist doctor was called in and my lugs was given a adrenaline bath as as last result and it started to work 3 months hospital staff and myself battled for my life and I m here to tell the tail but I ve had on going problems 1st pres was dignosed on going severe head catches left side weakness severe lower back pin forgetfulness lack of concentration hip pain shoulder pain bad eye sight depression stress anxiety tiered all the time and arthritis plus more recently I had a operation on my right knee and they had problems bringing out of the anesthetic due to having a asthma attack while I was on the operating table do you think that I might be allergic to the anesthetic",
    "doctor_response": "THESIA CAN BE E CANT TELL EXACTLY WHAT COULD CAUSE YOU THIS BECAUSE YOU HAVE MULTIORGAN PROBLEMS AND ANYTHING CAN CONTRIBUTE TO THAT YOUR MEDICINES ANTIBIOTICS AND VITAMINS PARACETAMOL DEITRY SUPPLIMENTS ALL CAN BE RESPONSIBLE FOR IT OR THE MEDICINES OF ANAESTHESIA MAY BE SO WE CANT SINGLE OUT ONE THING HERE YOU CAN GET TESTS DONE FOR MEDICINES GROUP YOU ARE ALLERGIC TO SO THAT YOU MAY BE ON SAFE MEDICINES TO WHICH DO NOT REACT",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dry mouth and excessive thirst while on Norvasc?\n\nI have been taking Norvas for about 3 years but about a year ago I started expirecency Extreme Dry mouth , Constant Thirst, Problems Swallowing food , vision changes , Extreme Tiredness , Alot of Sinus infection's , body aches and my Migraines have increased can this be due to the Norvasc I take or the Topomaz for pre Migraines? Tell people you are going to Charge Them before they tell you there Problem!! Waste of Time !!!!",
    "doctor_response": "Hello,As per your query you have symptoms of dry mouth and excessive thirst while on Norvasc which is very common after medication intake as it leads to fluid imbalance and stomach disturbances.Need not to worry. I would suggest you to:- Drink plenty of fluids.- Gargle with specialized mouthwashes that are formulated for dry mouth such as containing Biotene.- Use artificial saliva drops containing methyl-cellulose and limit intake of coffee, tea, tobacco.- Chew sugar free chewing gums and also suck tart candies.If the condition does not get well, then consult an oral physician once. The doctor may prescribe an alternative course of medication and can start treatment accordingly.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dark penis with fishy odor?\n\nHi! I\u2019m currently experiencing a real embarrassing stage of my life. I\u2019m std free as tested but my penis turned dark and I\u2019m not sure what might be the main cause. I\u2019ve also been experiencing urinal flow issues. After having sex I fell asleep and having a fishy smell in this area",
    "doctor_response": "Thanks for asking in healthcaremagic forum   Genital area is dark compared to rest of the body due to more pigment cells and loose skin over there and falling asleep after intercourse/ejaculation is a natural phenomenon.   Usually semen has a peculiar odour which you might have confused as foul smelling. So, please visit a doctor for examination as you have urinary issue , to rule our infection as the cause of fishy odour.   Also provide details regarding your age and associated urinary symptoms for further suggestions.   All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from lower backpain. Hurts to bend. What could it be?\n\nhi im a 21 year old female and im having lower back pain on the left side. Im also on my menstrual cycle it has been irregular for a couple of months as well and im urinateting normal but it really hurts even to bend! It just came on all of a sudden so i would really like to know if anyone could hlep me please. thank you",
    "doctor_response": "Hi,It could be that you've pulled a muscle, did you do any exercises or lift anything heavy recently?Try putting some ice on it or some heat using a hot pad. A hot shower can also help.If your pain persists for more than 2-3 days, go to a doctor, they can run some tests on you.I hope this answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Metformin and Ovigyn for PCOD. Chances of pregnancy?\n\ndear doctor i am 33 yr old i have been diagnosed with pcod i am taking treatment since 8 yrs my follicle growth is also not good i had 2 miscarriages. currently iam taking metformin twice daily and ovigyn d tablet 3 times a day from past 4 months.I want to get pregnant please help what r the chances of me getting pregnant.",
    "doctor_response": "Hi, Thanks for your query. I have read your query & I understand your concerns. Your chances of getting pregnant are good. Please undergo regular folliculr monitoring and ovulation induction if necessary. Metformin and ovigyn -D would definitely help you. Please see an infertility specialist for the same. I hope I answered your query. I will be available for any followup queries you have. Regards, Dr.Mahesh Koregol IVF & Infertility Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get cough almost every month. I cannot breathe properly. How can I overcome these problems?\n\nHello doctor, I am an electrical engineering student. My age is 21 years. I have been facing some problems in the last five years. I get cough almost every month. When I get cough, I feel uneasy. If I do not take any medicine, water comes out of my nose and irritates me. I consulted many doctors. They advised cough syrups. One doctor advised to take a syrup which contains Ambroxol. Another doctor advised to take a syrup which contains Guaifenesin + Pseudoephedrine + Triprolidine HCl. Now when I get cold, I take Guaifenesin + Pseudoephedrine + Triprolidine HCl. I want to know why do I have cough periodically. When I take bath in cold water, I cannot breathe properly. So, I always use hot water to bathe. I consulted a local doctor to solve this problem. But, he advised to take bath in cold water and also said that it is not a problem at all. This also worsened my cough. How do I reduce it? I cannot travel by regular bus. When the bus window is opened and when the outside air circulates and if the air flows through my mouth, my mouth becomes dry and I cannot breathe. So, I always travel by air-conditioned buses in which the windows stay closed. How can I overcome these problems? Please help.",
    "doctor_response": "Hello. It is clear from your case history and symptoms that you are suffering from two disorders namely: Kindly get the following tests done from a good lab so that I can evaluate your reports and prescribe you the appropriate treatment. Do not worry. Your condition is treatable. Hope this helps. Revert back to a pulmonologist online for further follow up -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching in groin?\n\nI am male, 25yrs. Doctor I am facing consistent itching in the groin. I consulted a doctor some 6 months back he prescribed Onabet B cream. After applying the cream itching get reduced. Now even though I am applying the cream the itching continues. There is no red dots or rashes as in Fungal infection. Groin appears to be normal.Please guide me the medicine. Thanks in advance.",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: Keep area clean and dry(you may trim/shave)Explanation: Moisture can cause fungal infection frequently over there. So keep that area clean and dry to prevent such infection and itch.                   Visit a doctor if it doesnot subside.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for blood in urine and blood clots as well\n\nHello, A few days ago, I experienced blood in my urine and have seen blood clots less than 25 or so. I haven t had sex, although I have been taking HGH maximize plus, to enhance penis size, along with HGF max, I normally take vitamins A-Z daily, I started HGH for about a month, now seeing blood in my urine and have stopped all HGH products. I underwent High Dose Radiation Jan 2009, I normally see my Urologist once a year, I am on the other side of the globe, I haven t had a sex life since the HDR, using the HGH allows me to at least masterbate and get an erection, now I have neither, since I have stopped using HGH products.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.No, nine of the drugs cause bleeding and clotted blood in the urine.Also sex and masturbation never causes bleeding and clotting in the urine.Such things are common after the radiation so do not worry. And continue your therapy.Drink as much water as you can. It will help flush the blood and it's clot.It is radiation that is causing a blood in the urine. Radiation usually taken for the cancer therapy. So thisnvsn cause dead tissue destroyed followed by its excretion.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What should I opt for a nervous person a nerve block or general anesthesia?\n\nHello doctor,I want to know what procedure is better for a nervous person? Twilight with nerve block or general anesthesia?",
    "doctor_response": "Hello. Fibula is lower leg bone for that usually they will give anesthesia called spinal anesthesia in which injection is given to your spine at your lower back, that is simple, and pain free surgery can be done and only your two legs will have anesthesia another full body will have senses you can see, feel, talk and everything will be normal after four to five hours your legs will lose anesthesia, and you can start feeling them. If you are terrified and having the anxiety of operation, you can ask for spinal anesthesia and sedation so that you can happily sleep. General anesthesia for this surgery is not a good option because they will anesthetize full body and you will be connected to an artificial ventilator, and it will support your breathing. My choice is to go for spinal or block.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent back pain for weeks?\n\nMy 15 year old son has has persistent back pain for over 2 weeks now and it's not improving, he says the pain feels like it's in his spine, the docs just said muscle strain but there's no improvement after 3 days of rest, he said the pain is changing from a dull ache to a sharp pain...please help!!",
    "doctor_response": "Hello,I had gone through the case and it might be slip disc or herniation of disc.So go for MRI of spine and then go for physiotherapy and treatment.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluctuation in blood pressure?\n\nI am a woman and have just turned 70. I have been taking 5 mg Ramipril for  many years for high blood pressure; this has, more or less, kept it at a normal level. Because of side-effects, I asked my doctor to prescribe a lower dose, i.e., 2.5 mg, a week ago.  I find that my BP readings fluctuate.  For instance, half an hour after getting up this morning, it was 132/78; 3 hours later, I began to feel light-headed and BP was 102/73, then 109/73.  Can you tell me why this is.",
    "doctor_response": "Hello, madame! Welcome to HCM. I understand your concern. Blood pressure is a variant component of examination. It varies in great figures throughout a day. I understand that this can come as a concern and a worrisome event to non-medical community, but there are a myriad of reasons that cause the blood pressure to fluctuate from day to day, even from hour to hour. These blood pressure-fluctuating factors can be physical activity, psychological stress, extreme temperatures (when it is hot outside, arteries dilate, hence low blood pressure), physiological diurnal and nocturnal changes in hormone levels etc. Blood pressure is not a credible component if it is measured separately, after some activity, after caffeine-containing beverages, and in the doctor's office (white coat syndrome). Also, blood pressure can be considered low when under 100/60 mmHg.Ramipril is a safe and effective drug in high blood pressure control. It has rare side effects, predominantly with dry cough, and is counterindicated when there is damage to the kidney function. Dosage of 2.5 mg/day is a good dosage, if it controls the high blood pressure. I hope I was of help. Take care. Regards, Dr. Meriton",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could hard lumps on vagina suggest?\n\nHi, may I answer your health queries right now ?  Please type your query here...I have a large lump under the skin on the side of my vagina. It is unbelievably painful, and very red. It is hard and has gotten bigger since yesterday. I had a colposcopy about a month ago, what should I do, and should I worry?",
    "doctor_response": "Hi & Welcome to HCMI appreciate your concern for the hard and painful lump inside the vagina.After having gone through the history given in your query, I am of the opinion that you have developed infected Bartholin's cyst with an abscess.Consult a gynecologist for as it may have to be surgically drained under anesthesia. Meanwhile take Sitz bath 3-4 times a day.Hope to have answered your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Vicks NyQuil cold and flu advisable for a 8 year old?\n\nCan I give my 8 year old niece Vicks NyQuil cold and flu nighttime relief? On the label it says consult a dr for ages 4-12. She's had a cough now all weekend, but her throat doesn't hurt. I have a 2 year old and a one year old and we use Hylands cold n cough and a humidifier for them. So that's the only other thing I have girl her to take.",
    "doctor_response": "NyQuil can safely be given to a child of 8 years. However, I do not recommend the use of such a medicine as it contains Dextromethorphan which is a cough suppressant. Instead I would prefer some expectorant. Steam or humidifier acts as a good expectorant. The water vapour will help in diluting the steam and will provide relief. That should be sufficient. However, you may add some antiallergic syrup like Relent (cetirizine) one teaspoonful twice a day for a few days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for xanthochromia and paralysis\n\nI had a lumbar puncture n five hrs after could not move my toes on one foot n progressed till was in both legs up to n incl ankles. It s permanent paralysis. I had mild stenosis n previous back surgery. My CSF fluid results showed xanthochromia high protein n fresh erthocytes on that day n I was vomiting profusely n headache. Have u heard of cases of distal bilateral paralysis within hours of LP.",
    "doctor_response": "Hello. I have been through your question and understand your concern.The only cause that LP can lead to paraplegia is lumbar epidural hematoma which is caused by the LP. Yoi should immediayely have a lumbar MRI to rule out this eventuality.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in chest and arms during weather change?\n\nHi, I usually feel sick when clouds start gathering before rain (sometimes there is no signs of rain the day before and the sky is clear and I start feeling sick, then clouds start gathering afterwards), I can't tell if its allergy or what (I don't suffer from those allergies usually only skin/milk allergies) what I feel is a a terrible pain in my chest and arms,and I feel very down, I can't also talk or do any activities properly.Thank you in advance",
    "doctor_response": "This may be a symptom of coronary artery disease(ischemic heart disease).Risk factor assessment to be done.Pls provide age/sex/smoking history/History of hypertension/diabetes any regular medicine/family history of heart diseases.Some basic test (like fasting blood sugar/lipid profile/ECG )may require if indicated.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough with an eosinophilia count 9?\n\nHi, I am 26 years old suffering from cough with white sputum in small quantity, itching, sneezing, shortness of breath (sometimes severe) and unable to hear properly since 3weeks. I got a full blood count done that revealed eosinophillia(9%). Prescribe some good medicine. Thanks",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your history and would like to know more about you like - Since what age you are having these problems? Is there any particular season that is worst for you? Do you have might time symptoms more than day? Do you smoke? Does any of your family members have allergy/asthma?From your given history, I would like to make suggestions to you as follows:1. Were I treating you, I would suggest you daily montelukast and levocetirizine/cetirizine for t lest 2-4 weeks.2. I would also prescribe you a salbutamol/levosalbutaol inhaler which is to be used when you have shortness of breath on as-and-when-needed basis.3. Regular breathing exercises and a healthy diet rich in vitamins & minerals (adequate amounts of green leafy vegetables, fruits, sprouts, etc) and plenty of warm fluids during the day will also help.4. Please avoid exposure to dusts, smokes and air pollution as much as possible.5. I would also suggest you allergy testing for air-borne allergens like house dust mites, common molds in your area, common pollens in your area, cockroach and animal proteins (if you have pets) etc. This will help you identifying the substances that are causing trouble to you and also to know measured how to avoid them.Hope above suggestions will be helpful to you.Should you have any other query, please feel free to ask at HCM.Wish you the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to get burning sensation in the brain due to stress and depression?\n\nin the last 2 weeks i a have been feeling dizzy and unwell, and then yesterday i experienced a burning sensation in the left side of my brain for 30 seconds. I have been quite stressed lately. I went to a doctor but he sent me away saying it was my stress and depression. Is this common?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Such things do happen and the experience may sound weird. Stress do wonders with human. Coupled with apprehension / anxiety they play havoc. Weird body symptoms due to stress or apprehension are called somatoform symptoms. If the symptoms prolong due to the anxiety and negative thinking of the patient, the patient feels as if the symptoms are actually there. No amount of medical intervention or tests or clinical advices fail to convince him. Then they become mental disorders and called somatoform disorder / hypochondriasis. You should forget the episode and never bring it back in your brain.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does severe cold also cause diarrhea and nausea?\n\nHi, I have been sick with a cold for 4 days. It started with a sore throat, then coughing, then a runny blocked nose. I am concerned though because I have started feeling nauseous (last 2 days)  have a loss of appetite am having diahrreah particularly at night when I am really blocked up. I'm wondering if it's to do with the mucas (clear).",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have severe cold, cough, runny blocked nose which seems to be due to upper respiratory tract infection is caused by virus known as common cold infection. Need not to worry about it. Nauseating feel and diarrhea occurs mainly as a co-infection due to impaired immunity of body and it could be side effect of medications if any you taken. I would suggest you to take few preventive measures such as avoid fried and spicy food. Apply mist humidifiers in room. Take multivitamins to booster your immunity. Visit ENT specialist once if symptoms keeps on persisting and get it examined and start treatment accordingly. You should take antihistamine drugs along with antibiotic combination. You should use decongestant nasal sprays like Otrivin along with antibiotic such as Amoxiclav.  Use throat lozenges. You should do saltwater gargle as well.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which is better Effexo or Cybalta for fibromyalgia ?\n\nHi, I have had fibromyalgia for 15+ years and it is getting progressively worse. I am on Nabilone .10mg per day and Lyrica 200mg. I am having severe mood swings and am thinking of asking my doc to put me back on effexor . Effexor worked very well for me at one time and then stopped being effective. I ve been on Cybalta which was not good for me at all. No pain relief whatsoever. What are your thoughts. Linda",
    "doctor_response": "hithank-you for providing the brief history of you.A thorough neuromuscular assessment is advised.As first thing to know is what is fibromyalgia ? Now it's not that difficult to understand, as by understanding what is the problem you can surely deal better. Fibro-myal-gia - pain in the fibres of muscles. So the medicine provided will help for symptomatic relief and for further more assistance you need a thorough workout. Like doing breathing exercises will improve the oxygen carrying in the blood tissues and by which the metabolism is improved and the faigue is delayed, so does the pain. Meditation - this will help further to control your mind and avoid mood swings, as due to pain it is possible to have a lot of mood swings. Also, by performing regular physical therapy you will have strength and balance in the metabolism of the muscles and improve the drug absorption.In my clinical practice I have been dealing with cases of fibromyalgia. A combination of all of the above give you relief.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump near my testicles?\n\ni have looked at photos of STD s and im still not sure if i have one. on iner part of my leg kinda close to my testicals i have a bumb under the skin, it feels like there is small egg shapped rock under the skin. im really worried about this and i have no money to go see a doctor nor do i have any health insurece, can you please help??",
    "doctor_response": "The swelling in question seems to be lymph node enlargement generally due to some infective focus or injury sustained on the leg. Have some antibiotics like Amoxyclav 625 mg. B D for a week after meals.  It is likely to subside Other possibilities are lipoma, femoral hernia.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pregnancy happen if condom breaks during intercourse?\n\nYes, Hi i am very nervous and afraid i had sex may 29th  protected but found out after intercourse the condom broke...i came on my period June 5th and i havent come on yet by my calculations if they are right i am 3 days late my question is would i be pregnant from the incident on the 29th even tho i came on my period or would this be a pregnancy occurring after June12 which is when i came off.. keep in mind i was having sex during my period during this week :-/",
    "doctor_response": "Hello,Yes you can get pregnant if condom breaks during intercourse. But in your case, it's not around ovulation so you will not get pregnant. In a 28 days cycle if you keep relationship between 11 to 18 days, which is around ovulation then only you get pregnant.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sheetal Agarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do masturbation affect the sex life?\n\nSir i am a boy of 17 year. I started masturbation when i was 11 year. Now when i masturbate i ejaculate within 10 second. But when i start it first it was 20 minute. Now my question is it affect in my next sex life?How can i recover with natural treatment?",
    "doctor_response": "Dear user,Thank you for writing to us.I can understand your concern about early ejaculations over time with masturbation.It has been believed by several experts that some masturbation practices cause one to 'learn' ejaculate soon. Masturbation is done in privacy and one often have concern 'to finish it fast' for fear of breach in privacy. So one's mind learns to ejaculate soon unconsciously.I suggest reducing the frequency of masturbation.You can practice start-stop technique to learn to identify the point of ejaculatory inevitability. This will help you to control ejaculation.Also practice kegel excercise.Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does 5th metacarpal breaking cause swelling on the palm?\n\nHi, today I punched a wall and obviously after the adrenaline wore off it became very painful. I had different frozen foods on it throughout the day and now I have had ice off it for about 2 hours. I just put my hand on a flat surface and it felt like there was a ball in my palm under the pinky area, it is heavily swollen around this area. I wanted to know if the reason I feel this ball is because of the swelling or my 5th metacarpal breaking?",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein and I will try to help you as much as I can.Yes, this is probable cause of such swelling since hematoma spreads around fracture site and it may affect other areas of hand so this is nothing to be concerned. I hope I have answered you query. If you have any further questions you can contact us.Kindly regards. Wish you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I miss my best friend and feel depressed. What to do?\n\nHi doctor, I am an 18 year old boy. Last year, I made a very best friend. He was like my second half. He used to share each and everything with me. A few months back, I saw him with his ex-girlfriend, and they were in a relationship now. He never told me that. She lives near my home, and my friend always drops her to her home, but whenever I asked him to come to my place he used to tell that it is too far away. Then we had a major fight without any violence, and we both stopped talking. Then I started realizing that I like him so much. I miss him as he used to hold my hand in public places always. I started remaining sad the whole day. I was depressed, and I tried to commit suicide. After that, it is like at sometimes during the night I express all my warm feelings with anyone on chat, and after a few minutes, I regret it. I feel like there are two persons inside me. First I thought that it is split personality, but I do not have memory loss. Please help me. What should I do? I hate his girlfriend. But, I am not sure whether I love my friend or not. Sometimes, I feel like I love him and after a few minutes, it is like just friendship. Am I gay? But, but I have a crush on girls also. I think I am attracted to both boys and girls. I am totally confused. Please help me.",
    "doctor_response": "Hi. I can understand your problem. This is completely normal at the age of 18 years. You like your friend as a friend and not as a partner. He was very close to you, but it does not mean you are gay. This is a very common feeling at your age. At this age, we can get attracted towards both the sexes, but this feeling is temporary. As your friend is in a relationship with a girl, it is evident that he will less interact with you. So do not get hurt. You should respect your friendship and his decision. Presently you are irritable because of depression, and you miss your relationship. You have suicidal ideation. To avoid this situation get involved yourself in some outdoor games and other hobbies. Make new friends, interact socially and stop negative thinking. If this thought sustains, then you can visit a local psychiatrist for treatment with medicines. But, do not worry. You will be fine. For further information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to detect what causes hives?\n\ni have been having hives since march of 2010 i have seen 7 doctors 2 allergist 1 dermetologist a sinus doctor my gynecologist my primary doctor they have ran several test and can not figure out where my hives are coming from i have hives with angiodema i dont know who else to see they say maybe im 1% of the people they never find out where it comes from but i think there over looking something the only thing i have been told was that my iron was low and vitamin d but i think the vitamin d was low cause they had me taking steriods for a while This has really been hard to deal with i am a single parent with children and sometimes i cant work .",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your history and can understand your concern.I would like to make following suggestions for you:1. I would like to know more details about you like - a. What is the frequency of your episodes? b. How long each episode lasts? c. Do you have any other symptoms? d. Do you have any other allergies? e. What are the medications you are currently taking? f. Does stress contributes you to your symptoms? g. What are your reports?2. Above details would help me guide you better. At present I would like to give following information to you:Common causes of hives & angioedema are - allergies to some foods, insects, air borne substances or drugs; some physical factors like exercise, cold/warmth, pressure, vibration, water; preservatives/colors in outside/packed  foods, stress, some autoimmune disorders, etc. Sometimes the cause may not be found despite investigations (it's actually not 1%, it's more than 25-30%)3. Were I treating you, I would suggest you daily montelukast and antihistamines like cetirizine or hydroxyzine. However, knowing above mentioned information is important for me to guide you better.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cough diagnosed as paralyzed vocal cord. Taken Zyrtec for allergies. What could this be?\n\nI have had a cough on and off most every day for approximately 3 yrs now that I have been unable to get rid off. the 1st ENT I went to took a test & told me I have a paralyzed vocal cord & sinus problems. The 2nd doctor (an Otolaryngologist) I went took the test & said that I also had allergies & to take Zyrtec. That doesn't help. I have gone to another doctor that prescribed Nexium for stomach acid which I took for 90 days a couple of yrs ago that didn't work either. I seem to have issues with coughing when I eat to. What could this be? I've just kind of learned to live with it but it's frustrating & embarrasing when I start coughing and...not normal!",
    "doctor_response": "Hello,This is to be Hyperreactive airway and Gastroesophageal reflux disease.(GERD)You may need 1. X ray of the chest(To rule out bronchitis)2. Endoscopy of the Upper GI tract(To rule out GERD).In the meantime you need to be on1. Bronchodilators and antihistamines.2. Proton pump inhibitors.Consult a Pulmonologist and Gastroenterologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a bump at the back that release white discharge on pressing?\n\nI have a bump on my back that has a thick white discharge when pressed.  I a have another that I cannot reach.They do not hurt but I would like to get rid of them.  If I discharge them they will fill again over a short time.  Is there a topical product that would help.",
    "doctor_response": "HelloThis type of bump which secrets whitish substance don't hurt ( painless ) even after pressing is actually a bump of sebaceous gland present in plenty of number in the upper part of back .The sebaceous glands secret a fatty substance which is rich in cholesterol , called sebum.It helps to keep the skin greasy and prevents drying.However this is natural and depend on the type of skin having an individuals .Only option is keep skin dry and don't use oil .Further if you are feeling trouble form these bumps , consult a DERMATOLOGIST & get his opinion and lotion.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I get pregnant after unprotected sex with lutera?\n\nI was recently put on Lutera as a \"quick start\" so I was told to start whenever I wanted.  I've taken 7 consecutive pills at 7PM each day.  The eighth day I took it promptly at 7PM but had unprotected sex after.  Should I be worried that I could be pregnant?  I'm 19 years old, 5'1\", 98 pounds.  It was my first time having unprotected sex.  I'm not allergic to any types of medication and only taking multivitamins right now.",
    "doctor_response": "Hi, thanks for posting in the HCM. From the information provided, my understanding is that you are on combined oral contraceptive pills containing LNG and ethinyl estradiol. Hence, I would say these COCPs are very good contraceptives and very less failure rate. But, in case there is a failure, the chance of ectopic pregnancy is higher. So, if you miss your usual periods or have spotting or pain abdomen, immediately get one urine pregnancy test and ultrasound scan of lower abdomen done.Another thing I should tell you that that these pills are not protective against sexually transmitted diseases. So, please be careful and ask your partner to use condom everytime during intercourse.Please also avoid multiple sexual partners (if applicable) and unprotected oral or anal intercourse (if applicable).If you or your partner develops any genitourinary symptom, both of you should visit the nearest STI clinic for further evaluation and treatment.Hope you are satisfied with my answer. If you have any further query related to this, please write back.In case you have any new query in future, you can directly ask me questions @  I will try my level best to help you.Regards,Dr. Kaushik",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having loss of strength in my left hand especially my thumb?\n\nI have had two surgeries in my neck (plate in the front, rods in the back )and 10 spine surgeries with 4 rods and 50 or so pins from the base of my spine to the top of my shoulder. Real recently, my left hand, especially my thumb have lost a lot of strength. What could be causing this?",
    "doctor_response": "Hi i am Dr Ahmed Aly    thanks for using healthcaremagic site ,I had gone through your question and understand your concerns ..   In my opinion that may be due to cervical disc herniation or compression on your nerve roots that causes loss of strength  or any inflammation of the neurovascular bundles of your thumb which is supplied by the radial nerve .  For my patients i recommend rest , avoid heavy lifting and vigorous movements , advil tab when needed , B12 multivitamins supplementation , hot massages with topical gels will be effective  . Please consider a 5 star rating with some positive feedback if the information was helpful. Wish you good health,Any further clarifications feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high fever with head and neck pulled to back for a child?\n\nMy granddaughter is ill with a temperature of 105 degrees, head and neck pulled to her back, left leg and left arm are curled to her back and she has an embolism in the occipital lobe of the brain. Her doctors are in a quandary as to the exact cause of this illness. Can you help us, please?",
    "doctor_response": "Hi,  according to me it is a seizure disorder with abnormality in the brain. It could be because of the emboli in the occipital region. Since I don't have any other details I am unable to diagnose further. Please wait till your doctor explains the situation to you......",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does a cirrhosis patient require medicines to increase platelet count and Hb?\n\nHello doctor, I am a liver cirrhosis patient. My platelet count is 72,000 and hemoglobin is 10. Everything else including protein and albumin are normal. The doctor is giving Ricovir 300, Pantosec 40, Udliv 150, Vitamin A to Z daily and Lasilactone 50 mg on alternate days. But, he is not giving any medicine to increase platelet count and for reduced hemoglobin. Is it alright or is that required?",
    "doctor_response": "Hello. In liver cirrhosis, chronic fibrosis occurs and such fibrotic tissue obstructs portal blood flow and so, because of portal hypertension splenomegaly can occur. An enlarged spleen traps platelet count and so your platelet count is low. With an improvement of cirrhosis by medication and avoidance of alcohol and through a healthy lifestyle, your platelet count can increase with time. But if cirrhosis worsens, then the condition might reverse. You have been prescribed antiviral medication as well. So, hepatitis B or C might be associated. In hepatitis, bone marrow can be suppressed and there can be pancytopenia in which hemoglobin, WBC count, and platelet all three get reduced. So, check your WBC count as well. For low platelet, you need only monitoring and a healthy lifestyle. For low hemoglobin, check your serum ferritin and TIBC (total iron-binding capacity) level and peripheral smear examination to give more comment on that. If any unusual bleeding starts, then platelet needs to be transfused. For more information consult a family physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why my big toe has become numb?\n\nMy big toe has recently become numb. Not the entire toe but the right side on my left toe. I had a infection where the end of the toe nail meets skin which I drained the puss from myself and clipped the nail to prevent it happening again. It has been numb for about a week or so, I have also had lightheaded ness and am becoming worried. Any advice?:(",
    "doctor_response": "consult your family doctor for physical examination,to rule out,1-diabetic neuropathy,2-radiculopathy,3-peripheral vascular disease,get blood & urine test for sugar,are you taking any other medicines for other disease,wait ,you would be alright,feedback.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is esophagitis and lump in the throat sign of esophageal cancer?\n\nI'm very concerned about having esophageal cancer. In 2009 I didn't have trouble swallowing or food getting stuck that i can remember, but I did have that constant lump in my throat feeling for about a whole month. After an endoscopy I was diagnosed with grade B esophagitis, normal biopsy, and put on nexium 40mg once a day. Any time I try to go off of it now, that lump feeling comes back, I lose my appetite mainly because I feel like heaving, and can't really burp, or it's foam..",
    "doctor_response": "Hi,Thanks for writing in.Esophagitis is a condition where there is an inflammation of the lining and there is development of an ulcer like condition. Rarely a person having esophagitis can develop a cancer and the risk for this is around two to five percent. As biopsy is normal for you therefore there is no need to worry.Please take nexium as prescribed by your doctor and avoid taking spicy and oily foods that might increase your esophagitis. The lump in throat might be due to the esophagitis or can also be a psychological thought that persists in your mind. Please be reassured that if the biopsy is normal then the chances of transformation in to a cancer is remote.You need to take a bland diet and also eat small meals every 4 hours in the daytime and avoid fasting. Avoid lying down after having a heavy meal and also try to raise the head end of your bed by 6 inches to reduce symptoms and dependence on medicine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain and vomit feeling?\n\nHi I am 21, 5'1, 61kg . My SGPT is 37.8 u/l and SGOT is 33.1 u/l as indicated in my blood test to be elevated while my LDL cholesterol is low. Do they have anything in common? and am i suppose to worry ? i lately have been experience stomach pains which i was connecting to my irregular period and sudden feeling of wanting to vomit. May you please inform me if i need to go to a doctor.",
    "doctor_response": "Hi.Thanks for your query.You need to go to a Doctor for a physical / clinical examination to correlate the laboratory findings with your symptoms and the signs that the Doctor finds. The SGOT and SGPT are normal/ just elevated (as you have not mentioned the normal range that particular laboratory has).The is no relation between the liver enzymes and the LDL Cholesterol.Now that you have stomach pains, late periods and sudden feeling of vomiting, I would advise you the following ::Get an opinion and examination done by a Gynecologist.Ultrasonography and urine pregnancy test to see whether there is intra-uterine or tubal pregnancy.If it is so , you may need an urgent surgery;if not so to find out other reasons and get treated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does cyst in the ovaries inhibit pregnancy?\n\nHi, my boyfriend and I are trying to have a baby we have been together over 3 years and have been trying for about a year now and no luck. I would like to go in and see a doctor and get some tests run but I unfortunately do not have the money so I was wondering if I could get some advice on here. I know I have cystic ovaries and I was wondering if this could be a cause of me not conceiving or might be something else. I ve been told to get checked to see if I have PCOD and I have read up on it and some of the symptoms I have. Is there anything I could possibly do to help me conceive?",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.1] Firstly do not panic. PCOS -multiple cysts in ovaries -inhibit regular egg formation, but with proper treatment you can get a baby.2] PCOS can be confirmed simply by USG.3] I will suggest to start on FOLIC ACID, B12, Multivitamins.4] Have healthy diet plan and regular exercise regime.5] Avoid deep fried foods, bakery items and refined sugars.6] You need to take egg forming Medicines -FERTYL for 5 days from day 2 of the cycle.Do follicle study USg and have sex activity during the days of ovulation.7] Please do not worry, PCOS patients have high chances for pregnancy with proper treatment.I hope my answer helps you.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is laying out in sun without putting sunscreen for 40 min cause melanoma?\n\nmelanoma should you wear sunscreen? my mom seems to think its OK to spend 40 min. outside laying out without sunscreen and her skin is starting to look like leather and she says its healthy because she is getting vitamin d what do u think by the way she is 46? I am afraid she is going to get melanoma.",
    "doctor_response": "hi..your mom should apply sunscreens with proper SPF,,.UV rays present in sunlight are known to cause skin cancers..by causing damage to skin cells leading to mutations,,ultimately causing carcinomas..So it is advised to apply sunscreens 30 mins before sunexposure,,and reapply after 4 to5 hours for optimum effects..Moreover,sunlight around 12p.m to 3p.m must b avoided,,as this contain more intensity of harmful uvlight.Take care.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a positive TB skin test mean?\n\nHi Dr Grief,i am from Philippines and i got my Tb skin test check two days ago and its showed that its positive, what is that mean?i dont have any symtoms of having Tb..i have a medical exam in philippines before i came here in usa and everything is good..i also have an chest xray  3 years ago.and some vaccine",
    "doctor_response": "Hey dear as you are not having any symptoms you need not to worry about.The positive skin TB test does not always means a disease.The positive TB test indicates that you might have had infection with TB bacilli which does not mean you have suffered the disease from it.Having TB infection & having TB disease are two different entities.Furthermore occasionally few people who has been vaccinated with BCG vaccination might show positive re-activity to the test.The results of the positive TT test should always be correlated with the symptoms. ( persistent non responsive cough with expectoration more than 3 weeks duration, weight loss, fever, difficulty in breathing Etc ) So considering your case you need not to worry about.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated GGT levels?\n\nHello, I am 30 years old, live in Brazil and more than 10 years living with rates of high GGT and ALT, and they come and go frequently. The GGT reaches 700 and 500 the ALT. Actually I was already in various medical and match any of them can tell what it is! What do you think about it?",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.GGT i sliver enzymes usually increased in liver damage, especially alcoholoc liver damage. If other findings bilirubin and AST and ALT are fine then alcohol is most common cause. So the next step is to look for certain liver damage and most common cause is fatty liver disease beside alcohol. It should be confirmed by ultrasound. Other causes are viral hepatitis,cirrhosis, medications, alcohol intake or autoimmune diseases. To verify exact cause, US, bilirubin levels and tumor markers should be additionaly done Then appropriate treatment can be started.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intermittent abdomen pain with soreness?\n\nI have been having a dull intermittent pain in my lower abdomen above my pelvic bone a little to the right.  It seems a little low to be my appendix, but has lasted since last Friday.  Today, the pain is less and just seems sore. Could this be a bladder infection? I haven't had any other symptoms accompanying the random pain",
    "doctor_response": "Hi.Thanks for your query.Noted the history of pain and now soreness only above the pubic bone just to the right. This can be due to cystitis as you have suggested or can be due to appendicitis or inflammation of the pelvis organs like intestines and female pelvis organs like ovary, tubes or so if you are a female patient. I would advise you the following:Get the blood, urine and stool tested.Ultrasonography of the abdomenPhysical examination by a general Surgeon to ascertain the cause, advise you investigations and give you the most appropriated treatment .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause cramping in my lower abdomen?\n\nhi dr. i am 26 years old, clean health history, weight:150lbs. last night i all of a sudden started cramping in my lower abdomen. it felt like really bad period cramps, but my period isn't due until next week. it was so bad i almost passed out and was also really nauseous. i eventually did have a bowel movement and it was slightly green.",
    "doctor_response": "Hi.The green stool with an attack of severe pain with a feeling of passing -out all indicate an intestinal infection and would strongly recommend  you to be clinical examined by a Doctor and to get the prescription based medicines ASAP.Do not wait till further complications.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated SGPT/SGOT/bilirubin while on tuberculosis treatment?\n\nHi, I am on undergoing tb treatment for past 2 weeks. My doctor advised sgpt,sgot and billirubin test after 15 days. The results of the tests are sgpt-58,sgot-70 and billirubin-0.9. Is it normal to have high levels of these while on tb treatment? What is the meaning of this please help?",
    "doctor_response": "Hi there,Thanks for using HCM.During the initial phase of treatment for tuberculosis medications like INH, Rifampicin, Pyrazinamide and ethionamide are used. Of these four drugs, the first three can affect the liver and cause the liver enzymes to raise.When it raises more than 2-3 times the upper limit of normal it is significant. When it is raised multiple folds, the medications are usually stopped.In your case it is not significantly raised.Moreover you have not mentioned about the baseline levels which is what the liver enzyme levels were before starting the treatment.I would advise you to get a ultrasound scan of the abdomen done.If you have the habit of drinking alcohol, you need to stop it.Is this answer helpful?",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a soft lump in scrotum?\n\nHi I have a lump on the side of my scrotum right where it begins to transition into the space between the scrotum and the thighs. I squeezed it and puss came out but the lump is still there. It is tender to the touch and it s hard. Should I go see a doctor?",
    "doctor_response": "HelloPus discharging lump may indicate infection.You may need clinical correlation and antibiotics.You may also need ultrasound of involved area to exclude other possibilities.It is expected to respond to antibiotics.Surgical drainage may be needed in non responding cases.You may also need routine investigations like routine hemogram,random blood sugar.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any other methods to get cure from herniated disc and sciatica?\n\nHi doctor, I'm suffering from herniated disc and sciatica, I've followed the treatment so it relieves me. but when I stop this treatment, the pain come back. so I'd like to ask if is there any solution without drugs, example  walking or swimming ...I don't know.thanks.",
    "doctor_response": "Hi ,  As diagnosed with PIVD with radiculopathy it should be mananaged  conservatively with regular physiotherapy (spinal extention exercises), avoiding sternous work/exercise bending forward , warm compression with vitamins , analgesic , muscle relaxant (if pain ) n PPI under guidance of orthopaedition . If symptoms aggravates, bladder bowel involve , neurological involvement ...... then may require decompression .   So in my opinion be in regular follow up and treatment accordingly including  physiotherapy .hope it ll help Thanks n regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any treatment to avoid getting periods in 9 year old?\n\nmy daughter is 9 years old.stud in 4th standard.she is having little bit breast now,near her nose small pimples,i am afaird ,she will get peroid soon,i am mother i want advice from a doctor.their is any treatment to avoid it.please help me.height 4ft weight 30",
    "doctor_response": "Hi,Welcome to Hcm,Menstruation is a phase of development in a child. 9yr is too early age to start menstrual cycle. In different phases of sexual development breast development happens first and last is menstruation. So do not worry, she will develop menstruation much later and I would never suggest you to start any medicine for preventing it. Its a nature made process. Any attempt to alter it might lead to unwanted problems and we dont want that. Your daughter is going to do great . take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure foot and leg injury fast?\n\nHey, yesterday I kicked a wall with the bottom of my foot, like right where the knuckle type things are (but not on the top, but the bottom). In addition, I punched the wall with both fists, however I only hurt the middle knuckle on both hands. And as of now it hurts to walk on my one foot and it hurts to touch the knuckle or clench on both of my hands. How can I help the healing process of my hand and foot and whats the quickest way? Thanks.",
    "doctor_response": "Hi, As what I understand that you have a direct impact over the bone this should be a bone pain. If the pain don't subside more than 3 days and swelling is takes the place than I will consider it to be hairline fracture.  An X-ray might be needed if the pain and swelling don't come down. For a good advice , I will tell you to soak the feet and hand in Luke warm water and use some tight socks and tight gloves to have a good compression which can allow the pain to reduce and avoid any swelling. Also this can make you functional as well up to 70%. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is my shoulder pain a disc problem or nerve pain?\n\nHello doctor, I am working as a design engineer. I work more than ten hours per day in front of the computer. Last two months ago I have pain in my right leg while walking and irritating buds while sitting on the right side. So I went to doctor. He took MRI and says I have disc bulge L4 L5 and it presses the nerve root. The doctor prescribed some anti-inflammation tablet and take physiotherapy for ten days and take rest some days. I finished my physiotherapy and I do exercise twice a day suggest by the physiotherapist. I take rest in bed for one month, but my pain not reduced. I consulted some ortho specialist they said bulge is very small only no need to worry. Now I have some shoulder pain and nerve pain in my right hand. While sleeping I feel numbness in my baby finger and ring finger from the wrist on both hands. I am confused now is it the only disc problem or something nerve problem? I have taken medication for erectile dysfunction for two months ago. The doctor prescribed one month medicine but I took two weeks only later I scared of my leg pain and I stopped medicine.",
    "doctor_response": "Hello. The numbness in your small finger is related to a pinched nerve in the elbow, probably related to a wrong position during sleeping. It is not related to the bulging disc in the lumbar vertebral column. I would just recommend performing a nerve conduction study if the numbness persists. In the meantime, I would recommend avoiding pressure on the elbow during sleeping or on the desk. For more information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should I do dor sore lump inside bum cheek?\n\nThis is quite embarrassing, I have a hard lump on the inside of my bum cheek, which is quite sore. I noticed it about 4 weeks ago when it was really sore to sit own but after a few days the pain went away, even though the lump was still there. It is starting to get sore again. What could this be",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some piles.  Or you may have fissures or fistula.  You should take high fiber diet, drink plenty of water,  avoid constipation.  Local anesthetic gel can be useful.  Permanent treatment is surgery.  Consult your doctor and go for 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility\n\nHello Dr,I am trying to conceive for past 6 months. This time we had regularly. My periods also came and was not like the usual one (flow is less) on the third i got  blleding with heavy clots for 5mins continuously and AF stopped. When i had sex on 5th day i started to bleed (which is not normal because, i have done this before and i did not get bleeding)..",
    "doctor_response": "Hi I think if your periods are regular, you can try for 6 months more. Be in contact with your husband every 2 to 3 days after your periods stop.  It will increase chance of pregnancy. If you want to het yourself evaluated, get a thyroid profile and prolactin level and a ultrasound done to see uterus and ovaries. Also get a semen analysis done for your husband. If anything is abnormal, it can be treated. Hope it helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sharp abdominal pains especially while using bathroom\n\nI starting getting sharp pains that felt like gas pains about a day and a half ago and then when I use the bathroom and try to somewhat push while peeing or defacating it sends a sharp pain up my abdomen . I do have Crohn s disease but nothing like this has ever happened. What do you think it could be?",
    "doctor_response": "thanks for choosing health care magic.This could be due some infection in your stomach or urinary tract.Try to avoid heavy foods,take light diet,more of semi solids and liquids.Avoid straining at stool.Take anti spasmodic for pain.and see your doctor if you do not get comfortable with this.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be concerned for painless lump on forearm?\n\nHi, I am 34 yr old male in good health. I just recently noticed a lump in my forearm (underside) halfway between the elbow and wrist. It is not on the skin but below. It is a firm lump that does not move, is not painful though slightly tender at times. Seems to have gotten a bit larger over the past day (about the size of a pinto bean). Should I watch it over the next few days or should it be looked at sooner?",
    "doctor_response": "HI,Good Evening.Thanks for your query.I studied the query in-depth.I understand your concerns.I need to have more info-which I can get after clinical examn only.With whatever facts told in your query,I would try to give most probable causes to help you to reduce your worry.I would advise Excision Biopsy which would fix the diagnosis.-By your description,its mostly of subcutaneous lump and you should relax on that positive ground.-Mostly in my opinion that  lump is -Lipoma/ fibromyoma-as lump is painless.-Excision Biopsy-would fix the differrentiation of the causes of the forearm lump and would treat them as well.-You need not worry of the outcome as both these tumours are benign.Littlle variation in size should not worry you,unless its painful and with regional node enlargment.-Hope this would help to regain the lost-health fast.-Wishing you early recovery and good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the chest after a hard hit?\n\nMy daughter 13 years old, was hit in the chest very hard with a kicked soccer ball tonight. She is having much pain when she coughs and laughs. Also, when she straightens back and leans slightly backward. What could be the problem? YYYY@YYYY",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. It would be advisable for you to get a chest x ray done. Possibilities include rib fracture or lung contusion. If x ray is normal nothing to worry about , give some cold compressions and anti inflammatory tablets.Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cough with temperature and headaches?\n\nmy son had a mantoux test done early last week. on friday results were negative but on the weekend he came down with very high temp 39.9 which only lowered to 39 after panadol. On sunday we went to clinic presenting with temp, headache and cough. they said it was influenza and gave ibuprofen along with the panadol. Temp is regular most of the time but still has headache and cough. He is getting his wisdom teeth pulled today as surgeon said it would be ok. Is it just influenza or could it be from the mantoux test?",
    "doctor_response": "Hello,It cannot be due to the Mantoux test. It could a viral illness or influenza. The teeth pulling could also cause some pain and fever. You can continue the medications for pain and fever relief, which you are currently using.Hope I have answered your query. Let me know if I can assist you further.Regards,     Dr. Sumanth Amperayani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best pain medication for having pain all over body, after taking chemo for hodgkins lymphoma?\n\nWhat is the best pain medication for a 75 year old female who has finished chemo for non Hodgkin's lymphoma and now has pain all over her body. She does not tolerate codeine well and extra strength Tylenol is simply not enough? We are going to our doctor and would like to have some ideas beforehand. Thanks for your help.",
    "doctor_response": "HIThank for asking to HCMPost radiotherapy pain is very common and disturbing, most of the pain killer fails to respond particularly common NSAID, and I think opioid is the best choice for this, different brands are available on counter you can have nay one of it or better to have words with her oncologist, one thing I would like to mention here and that is such pain does not cause any harm to the patient accept disturbances but if it is being tolerated by patient then it wont be troublesome, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in jaw and left side of head after dental crown replacement?\n\nI broke a crown on the left bottom molar. Had a replacement crown placed 2 weeks ago. Now cont pain in jaw ,cheek, and left side of my head with sore gland under my jaw. Only relief with Motrin . High spots have all been filed down. Had no pain with this tooth eve after I broke it. What could be the problem?",
    "doctor_response": "Hi Dear ,As per your query you have pain in the jaw and left side of the head after getting crown . Well the symptoms you mention in query can occur due to three reasons :-- Firstly there can be still a high point ion crown ,  which is responsible for misalignment of jaw  .- Secondly the infection has spread under the tooth and crown , which is causing pressure and pain . - Thirdly there can be cracked tooth under the crown , which get broken during tooth cutting for crown . I would suggest you to visite dentist again for proper diagnosis . Doctor may order X-ray , bite test or examine it with probe . Doctor my remove the crown and considered root canal give splint or extract in case of crack , relieve the high point further . Doctor may also prescribe antibiotics along with anti inflammatory . For now do warm saline rinses and take ibuprofen or acetaminophen for pain . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Interferential therapy therapy be recommended for low back pain?\n\nhello doctor i am physiotherapist, one of my patient having low back ache ,severe piles and fistula history previously, he had stent 5 yrs before , can interfential therapy is recommended, currently he is wearing lumbosacral belt, and spinal exs, help me sir",
    "doctor_response": "If fistula and piles is still severe then you should not give IFT. But if it already treated and piles is under control then you can give IFT.Most important thing is you need to assess the patient thoroughly for the source of pain only then you can treat him well. Use all the special test for back pain. Take care of red flags. If piles and fistula still worse then first you should send the patient to concerning Surgeon for appropriate treatment. Because I some cases fistula can also be source of back pain.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest alternate medication for Zinofil Forte\n\nhi sir; my doctor had suggested me a medicine named ZINOFIL FORTE,med manor org pvt limited, that consists carbamazine citrate and cetirizine. i want to know about its substitute medicine. since i am not able to get the same medicine,here in kolkata, india.kindly suggest me.azmat ali YYYY@YYYY",
    "doctor_response": "**1. Zinofil forte [cetrizine [10mg] and diethyl carbamazine (300 mg)], is WHO approved drug for TPE [tropical pulmonary eosinophilia], Eosinophilia and frequent wheezing and cold, mainly given for parasitic infection.2. If the said Brand is not available in kolkata, you may ask for:. Carlev/carlev forte from Aamorb pharma, . Decet-BD & DECET-OD from RND Lab, . BOCET-BD from Bioman pharma3.  Ayurvedic treatment is aimed at controlling the infection and treating the symptoms of this disease, where Guggulu and Kachnaar, are considered to be the main stay of treatment for this disease.. Sukshma-Triphala, Gandhak-Rasayan, Mahamanjishthadi-Qadha, Chandraprabha-Vati and Trivang-Bhasma are used to treat the basic parasitic infection responsible for this disease.4.  Apart from taking the said medicine, also practice safe hygienic measures to prevent contacting the infection:. Use mosquito nets while sleeping and/or use mosquito repellent cream on exposed areas.. Do not keep stagnant water in the surroundings as these pools of water are their breeding grounds.. People living in endemic areas [even if healthy] must take the tablets as they may have the eggs (microfilariae) in their blood even though they are without symptoms.. Do not expose arms and legs while in affected places, wear clothes with long sleeves, full length pants and socks for adequate protection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why the child is humping things?\n\nI have a friend whose daughter has been humping things since she was 9 months old. She is now almost four and is still doing this. I am very close to this family so I know for sure the child has not been molested in any way whatsoever. I need to know why they do it and is it normal or do they need to take her to see someone. She has been to a regular doctor and checked out and the advice they gave is that she would eventually out grow it. I am beginning to wonder. Any advice would be welcome.",
    "doctor_response": "Brief answer :Seems to be normal. Detailed answer :Hi, welcome to HCM. Child age is only 4 years, a 4 year child doesn't have that much mind to understand whether humping has bad impression. I think she is just playing and it's a habitual thing. This will improve as child grows. In my opinion, you need not worry about this. I hope this has helped you. Take care. Regards - Dr Deepak Patel MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant spotting after insertion of Nexplanon?\n\nI had nexplanon put in July 9 and had constant red and brown spotting so I had it removed on September 23 but the spotting still hasn t stopped and I ve went through a month of birth control pills since! Why is this happening to me and how can I stop it?",
    "doctor_response": "Hi Hope this message finds u in good health.I have gone through ur msg and understand your concern.it may be due to some sort of hormonal imbalances or variations in the body,though there may be other reasons as wellNothing to worry about, You should eventually get back to normal.Take multi vitamin and calcium supplements Do consult a gynecologist if symptoms worsenGet back to me for any  FOLLOW UP QUERIES anytime.Regards,Dr Mahaveer Patil...(MBBS,MS,Mch)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on back of throat behind uvula?\n\nI have a lump on the back of my throat almost directly behind the uvula. Noticeable when swallowing. Additionally, it feels hard like a bone. Also I have been experiencing occasional sharp stabbing pains in my left ear for two weeks. About two weeks ago I had the most horrible headache I have every had in my life... I have occasional migraines. My cousin had a tumor in her ear and lost her hearing. What do you think it could be?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern.Thanks for your query. The symptoms your mention are pointing towards a condition known as granular phryngitis , which is a infection of pharynx behind the uvula . Its a which looking pus filled lump and appear to you like a bone .Some times infection from pharynx or lump itself interfere with the functioning of eustachian tune which cause hearing problem and give feeling of clogged ear .I would suggest you to to:- - Do warm saline gargles and betadine gargles alternately 2-3 times a day .- For pain and swelling take ibuprofen (if not allergic) or acetaminophen .- Give warm compresses to ear .Consult ENT specialist (ear,nose,throat) for proper diagnosis and to rule out other causes . Doctor will examine physically or may order swan test or blood test to confirm the diagnosis .Doctor may prescribe antibiotics (penicillin or amoxicillin) at least for a week mucolytic agent like ambroxol or decongestants  . Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for auditory hallucinations with sleep apnea\n\nthis is the first time I have posted here. I just joined a few minutes ago. I don t know if I have Bipolar disorder, I had a brief psychotic episode 3 years ago. I had never had any symptoms before. I was 48. I had been on extremely high doses of opioids for rheumatoid arthritis for years. I began sleeping 18 hours a day. then after a year of that, I began to see people in my room that weren t there. and having auditory hallucinations. I was put into psychiatric hospitals for 4 and a half months. on and off, about a third of that time. I was placed on Seroquel that I have been on ever since. I am wondering, should I try to wean off. I still feel like the heavy doses of narcotics, including morphine 120 mgs a day, oxycodone, 120 mgs a day and lyrica, Neurontin, vistaril, lunesta, had a major cause of this, since I know I was having a lot of sleep apnea etc. I had lost 80 lbs and had stopped eating. I was near death, literally. So I feel like, I would like to see if I should try to wean off of this, but what is the best way, so as not to have rebound hallucinations, in the process. thank you.",
    "doctor_response": "HiThanks for using healthcare magicBest way to stop antipsychotic and pain killers is taper them gradually. Better to take help of a psychiatrist in that case. That would help you to control withdrawal symptoms. If you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ankle sprain\n\nI sprained my right ankle about 4 months ago...it's not a break.  I went to the Rothman Institute in Philla and was given a shot of cortisone in my ankle.  In the joint between the fibula and tibia where the front of my foot meets my leg and where the ankle bends.  I have had rounds of PT and that didn't help.  I had a cortisone shot yesterday and so far there is great improvement.  I cannot fine the correct PI on here.  I am an RN, but want to know when it peaks and the half life.  I know I can have only 3 of these a year.  Although it feels better today, the Doc. said I may only need just this one shot.....if the peak is only 8 hours, how can that be true?  The half-life seems to be short too.  I cannot find a PI on here.  I have drug books and may resort to them, but really I was in such pain before the shot!  It's ruined my golf game!  Should I be using it full force or relax it?  Anyway the shot was not IM, it was in the joint, and that name escapes me.  Can I find the PI on line??  I should be able to, or I'll just look into my nursing drug books.",
    "doctor_response": "Hello, Thanks for writing to us, I have studied your case with diligence.As per your history and injury pattern there can be persistent tear of ankle ligament leading to pain and swelling.Instability may increase due to laxity of ligament.I will advise to do MRI ankle for soft tissue involvement.Till time you can continue use supportive splint or brace.Physiotherapy like ultrasound and TENS will help in early healing.Persistent pain after ankle injury is common and may take 6 months to heal.If there is complete ligament tear on lateral aspect then arthroscopic ankle ligament repair can be done.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest infection\n\nI have had a chest infection sinced the end of december iam an asthmatic and also had TB 7 years ago.  I have had two courses od antibiotics and a course of steroids.  I am just as bad today as 2 months ago.  I come good not better then I get sick again.  I know I should rest but I have an olympic distance triathlon in 3 weeks.  What would you suggest?",
    "doctor_response": "Respected user , hiThanks for using Healthcaremagic.comI have evaluated your query thoroughly .* This relates to underlying Bronchitis .* Strongly recommended to get expert physician consultation , undergo   basic laboratory tests , x-ray chest , pulmonary function test  as per    clinician  concern .   As you have less time  for your Olympic , kindly act promptly without    delay .Hope to clarify the query .Welcome for further assistance . Thanks for using Healthcaremagic.com & giving opportunity to assistWishing fine recovery & Best wishes for your Triathlon .Regards dear take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What cause color change of toe in a diabetic patient?\n\nHello doctor, My father has diabetes, and recently we noticed that his toes turn to purple at night, espcially when he is not walking or standing. It goes back to normal when he walks for a little bit. We run some tests, and I would like a specialist to look at them. We consulted a cardio doctor but I am not sure they know what is wrong. So, I have the lab results and I need a doctor to give me more information on what they mean and what possible directions we could take. I also want to share the list of drugs they gave him so far.",
    "doctor_response": "Hi. Gone through the reports you provided (attachment removed to protect patient identity). He is having diabetes. Reports suggest that he is having blockages in leg arteries and also in heart arteries. Doctors have started on anti-platelet drugs and cholesterol lowering drugs. Prescription looks okay. Further I will suggest be on all these medications. If his toes does not improve within 2 to 4 weeks he may need a procedure to open the limb artery blockages. As he is not having any heart related symptoms like chest pain, breathing difficulty can wait and watch for heart issue with continuation of prescribed medications.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the report of my liver function test states?\n\nGood Afternoon sir,My father is 74 yr old we tested LFT and done ultrasound of pelvis and abdominal after advice from doctor. In LFT the serum bilirubin(total) was 1.60mg/dl and ultrasound report was mild fatty lever and mild prostatic enlargement,after 10 days we tested LFT again the serum bilirubin(total) was1.80mg/dl, hemoglobin was 11.1.Is anything serious please advice.",
    "doctor_response": "Hello, The low hemoglobin and elevated bilirubin suggestive towards any hemolytic anemia condition like Sickle cell, thalassemia, G6PD, spherocytosis, AIHA etc. So you need to investigate further with serum LDH estimation, reticulocyte count, peripheral smear examination report and hb electrophoresis for further work up. You can revert back with reports once done. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can swollen nodes cause pinched  nerve?\n\nI have chronic (>5yrs) generalised lymph node swelling in the groin on both sides however the left nodes are quite hard and not in lumps but one long swollen mass about a finger length (~5cm long and 1 cm in width). There is a worrying pain from the left side, not very painful but sometimes sharp. The pain is dull and always there but sometimes shoots up as if a nerve is compressed or something. Could the swollen nodes have pinched a nerve?",
    "doctor_response": "Hello,I can understand your concern. As lymph nodes are surrounded by nerves and blood vessels everywhere around them, increase in their size due to swelling can surely compress the nerve and/or blood vessels causing pain and other neurological symptoms.I think this is the time you should see your treating doctor or neurologist and discuss the situation as if the swelling is increasing, it can cause further complications.I hope this information helps. Thank you for choosing HealthcareMagic. Take care.Best,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes foul odor in urine?\n\nmy urine is cloudy and have a foul odor. i have no other symptoms but did a unrine analysis and was told there are \"clue cells\".  I still dont undersstand what the diagnosis is.  Yhis has been going on for over a year.  Please give me a name for my condition",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have clue cell in urine. Clue cells are the typical vaginal epithelial cells covered by bacteria. It is seen in bacterial vaginosis. It is caused by gardnella vaginitis. You should take antibiotic treatment. Metronidazole is the drug of choice. It is prescription based medicine so consult your doctor and take treatment accordingly. Consult your doctor and take treatment accordingly.Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a swallowed nail be removed safely?\n\nhi i was eating some porridge n i put it down n my little boy put his hands in it. i didnt notice anythin in his hands but when i took another spoonful i swallowed a nail' it is about 1 inch long cos he had the other one in his hand. it felt sharp goin down but thats all; it was about 5 hours ago now what should i do",
    "doctor_response": "HelloThank You for contacting HCM.Main problem occurs during swallowing. It may get obstruct all the way to stomach or cause erosion. As nothing such occurred so you should not worry. It will itself be excreted via feces but if you feel severe pain in abdomen or feel any unusual symptom then do report to hospitalHope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to look young?\n\nHi. I have random cell damage which is causig me to age rapidly. I am 35 years old and look much older. I have loss elasticity in my skin and am beginning to have fragile bones. what should I do and what type of tests should I get. Is there a cure for this?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern and let me tell you that physical look is not that much matter but one should be mentally young and the over all thinking must be like ever green, and for the general health I would ask to have all the anti oxidant diet fresh fruit is the best option, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes delay in periods?\n\ni am a virgin i dint actually have sex with boyfriend but i have noticed that my period comes very late and the right side of my stomach aches  a lot these days i recently saw blood coming out of my vagina but its not as thick as the blood from my period am not sure if  am pregnant i do vomit sometimes and i have diarrhea too please help",
    "doctor_response": "Hi dear, I have gone through your question and understand your concerns.Scanty and delayed periods can be due to hormonal disturbances like hypothyroidism, hyperprolactemia or polycystic ovarian disease.I will suggest you to consult an OBGYN specialist to get properly examined, investigated including ultrasound and hormonal profile and treated accordingly.Hope you found the answer helpful.Wishing you good health.Dr Deepti Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to reduce hair fall soon?\n\nHi doctor, I am 22 years old. I have a problem of hair fall. My hairs fall so quickly, and there is no regrowth of hairs. Please help.",
    "doctor_response": "Hi. Nowadays, hair fall is very common due to change in lifestyle and food habits. Excessive use of different kinds of shampoos, conditioners and washing hairs using hard water result in hair fall. Reduced blood supply to the hair roots makes the hair weak, and it leads to hair fall. You should follow some precautions to prevent hair fall. Apply Bhringaraja oil to the hair at night. Massage the hair for five to ten minutes and wash them with water the next morning. Shampoo your hair weekly twice or thrice using protein shampoo. Do these things and provide your valuable feedback.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is swelling feet and ankle a symptom of Lymphedema or leaky varicose?\n\nI am having swelling in my feet and ankle saw a doc he says I have lymphedema I have had no cancer or surgery. then saw a surgeon he said it was Leaky varicose vein and need surgery. I have not had a physical done yet to see if my kidney, liver and heart is ok. what do u suggest me to do.",
    "doctor_response": "Lymphedema and varicose veins have similar symptoms such as lower extremity swelling. Varicose veins will cause dermatitis and usually manifest on inside of your ankle joint. If your in pain and the swelling is out of control I would agree with your vascular doctor but if your not in pain and the swelling is mild I would recommend over the count compression stockings as long as you don't have any heart or liver problems. Regarding getting a physical exam once every year is not a bad idea so if you havent had a physical exam yet, that would not be a bad place to start.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heat and pressure on the feet?\n\nfeet over heat when sitting or laying down makes concentration impossible sleep comes best early in morning I feel blood pools in my feet creating pressure and generating heat mentioned earlier ice water help briefly symptoms are getting worse Michael",
    "doctor_response": "Kindly tell me your ag & sex?This is burning feet syndrome, often associated with diabetes or other metabolic disorders.Multivitamn tabs.1 OD along with other neurotropic medicines ( gabapantin)  will help you.You may contact me  again if needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat severe lower back pain caused due to sleeping posture?\n\nI am in the process of trying out a foam medium firmness. I was sleeping on a spring coil for many years. I have 120 days to make up my mind. I did look at one of their beds that is very soft and comfortable. It will cost $1500. more. I have severe low back pain and want the mattress that is best for me.",
    "doctor_response": "Hi  In my opinion patients with back pain are most comfortable when they sleep on firm mattresses which compensate for body shape by getting contoured accordingly AND the contour changes with the posture .  Any firm mattress will be good. Special mattresses are nothing more than marketing practices. Get the treatment of your back pain under orthopedic surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for liver enlargement and rib cage pain?\n\ni had my liver enlarge as seen twice already thru ultrasound,the result say hepatomegally,i had that before my gallbladder remove last 2008.i am a type 2 diabetic,hypertension had taken for meds for maintenance.i been experiencing pain on my left in rib cage for the 3 weels it was on and off but now its contstant and i feel also pain on my chest and numb n pain of my left arm.",
    "doctor_response": "hi.thanks for posting query.insufficient history.further evaluation needed.have following blood tests1. Blood routine test 2. liver function test3. HepB and HepC serology4. HbA1cdiabetes may also cause neuropathy which is causing numbness and pain.your advised to strictly control blood glucose.Pure edible olive oil ingestion once daily ( 2tsp) before breakfast early in morning may help.wish you good and sound healthregardsDR Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of high blood pressure?\n\nThis am my bld preasure was 149 73  66 Some time I awake with high bld preasure  other time 129 55  72,,, I change to normal & high & lows that scare me    I had a 98.45. 72 awhile back    why should there be  such radical changes?  I'm 87  yrs old exercise walking a dog ..sometimes walk at a good clip & slow down wt 125   5'2\"  Diabetic controled  5.7 tp 6.4 AC1   What is normal? My cardiologist  thinks it's OK BUT THE READINGS SCARE ME",
    "doctor_response": "If you have long standing diabetic even if well controlled and also age related ,  what happens is your nerves get weak over time what we call autonomic dysfunction,  where there would be fluctuations in the BP.  Till you don't have symptoms don't worry about the fluctuations.  However I would personally prefer your BP on the higher range like between 135-150 and lower 80-90,  secondly don't suddenly change position and things  should be all fine.  Regards Dr Priyank Mody,  Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for anemia disorder?\n\nI successfully completed the HCG diet 6 weeks ago and have followed the maintenance program and have been rigorously working out.  However, I have anemia disorder that comes and goes and is back with a vengeance.  I have been weak and faint for 3 days now.  Although replenishing my body with iron enriched foods I am still feeling not myself.  Could the HCG have affected me that bad? How do I quickly build up my hemoglobin?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You may have iron deficiency anemia. You should take oral or injectable iron therapy. You should take iron rich food like dates, dryfruits, jeggary, green leafy vegetables etc. Consult your doctor and start treament accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the prognosis after left kidney is functioning 17% and having pyelonephritis?\n\nMy kidney function currently is 17% left kidney 83% right kidney. I m 48 yr old female, had a pyeloplasty at the age of 7 years of age. I ve had another bout of pyelonephritis, currently week 3, ongoing pain in my kidney. What are my options long term?",
    "doctor_response": "Good Day and thank you for being with Healthcare Magic! is your pyelonephritis in the left kidney? If you have recurrent UTIs from the left kidney then options in the future would be prophylactic antibiotic daily or if still with breakthrough infection despite the antibiotic then you might need to have your kidney removed laparoscopically. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at:   I would gladly help you.  Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can kidney stones, grossly unremarkable bladder in ultrasound and blood in urine indicate bladder cancer?\n\ni have blood in my urine...no pain....blood test showed I MAY have an infection.  Was given strong antibiotic and blood disappeared (visually) within 3 hours.  Had an ultrasound....showed kidney stones (9mm) in one kidney and that the bladder was grossly unremarkable.  2 days later blood seen in urine again for a short period (2 hours)...now I am scheduled for an cystoscopy and wonder what my odds of bladder cancer are?",
    "doctor_response": "Hi, thank you for asking Healthcare Magic.I have gone through your query and understood your concerns.Blood in urine can be from anywhere along the urinary tract.Blood at the beginning of urination is most likely to be from urethra, blood towards the end of urination is likely to be from bladder while blood in urine from the beginning to the end is either from the kidney or a severely bleeding lesion in the bladder. This can give you an idea concerning the origin of blood in your urine. With the history of a kidney stone, I think it is most probable that the source of blood would be kidney and not bladder. Even within the bladder, there are other possible causes of blood in urine apart from cancer.I hope that answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. We will be delighted to answer more questions from you.I wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain around upper thigh while standing?\n\nWhen I stand or walk there is pain in the area where the upper thigh and torso meet, in the bending area, towards the outside more than towards the center of the body. It s intense enough to cause a significant limp. Started when I got out of the car this morning after driving to work. Is this a hip joint situation or nerve?",
    "doctor_response": "Hi, It could be due to musculoskeletal pain. As the first line of management, you can take analgesics like Tramadol for pain relief. If symptoms persist you can consult an orthopedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat testicular pain?\n\nhi, it has been 4 weeks that i have slight pain in left testicle that is radiating to the left leg. it is getting worse after ejaculation. my Dr gave me Doxycycline 100mg for 3 weeks ( 1 tablet per day). but the pain is still there after 12 days of taking the antibiotics.",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern if you have given the Doxycycline, this is the antibiotic medicine and this wont work in relieving the pain, if this is inflammatory condition of epididymis then you need to tale the anti-inflammatory drugs and the best choice is Tab Ibuprofen 400 mg three time in day, hope this information helps you, take care and have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could over-dosage of anti-anxiety and pain killer pills lead to death?\n\nMy 24 year old son was found dead in his living room floor, he had an addiction to pain killers and was on anti-aniexty pills, he had also been drinking those energy drinks. When he was found he had foam coming out of his mouth what could be the cause?",
    "doctor_response": "Hello,Over dosage of anti anxiety meds or sedatives might cause central nervous system suppression and cardiac cause. Excessive use of pain killers also dangerous,Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a large lump under the armpit?\n\nI have noticed that I have a large bump on my armpit. I would say it is almost the size of a golf ball. There is not really any pain, but I have just noticed it 2 days ago. I recently found out that i have hyperthyroidism, and a month ago took the radioactive iodine pill treatment. Could that be a reason why?",
    "doctor_response": "welcome to Health care magic.1.In this case pain less lump in the armpit ( axillary region) are lymph nodal enlargement.2.Lymph nodal enlarge net could be infection / inflammatory reactions in the body.3.It could be one of the reason for sure, as any systemic disease can cause enlargement.4.See your doctor and ask for alternative medication and see.5.If still not resolving - you need to get an biopsy get done to find out the cause.hope it helps you.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes unusual heart beats when lying down?\n\nAt night when I lay down on a certain side my heart beat alot harder. It forces me to switch sides. It also happens when i am just laying down but not as often. Is this a problem? I have had my heart checked out before and they said it beats slowly but it is nor al because I am physically active(exercise, workout etc.)",
    "doctor_response": "Hello, Regarding your concern, I would explain that your symptoms could be related to your body constitution. You should know that this is quite normal in tall and thin persons. Anyway, I would recommend performing a cardiac ultrasound in order to examine your heart function and structure. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can kidney problem cause the urine to smell bad?\n\nMy husband s urine smells like vomit (he flushes, but I can smell it when I enter the bathroom minutes later) and when I mentioned it, he says it is also really frothy. He thinks this is funny, but is there something wrong with his kidneys? Diabetes runs in his family.",
    "doctor_response": "Hello, thanks for posting on HCM.It is good you took this into consideration. Smelly and frothy urine means that he might be losing proteins in urine. Smelly urine could be because of ketones in urine.As diabetes history is present in family it will be very much important to find out his diabetic status.I would like to advise you to get a urine routine examination done and also get a morning fasting blood sugar levels. Urine examination will comment on presence of proteins, ketones, any sort of infection present in urine or not. Fasting blood sugar will tell you whether he is entering in diabetic range of blood sugars or not. If you have a family doctor you can consult him with the reports or you can revert back with me. I will be glad to report it and advice accordingly.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes grains of brown rice in stool of a child?\n\nMy 2 year old has had diarrhea for several days with no other symptoms. What has concerned me is in his stools have been what almost looks like small grains of brown rice. They are hard like rice and a little smaller than a grain of rice. Almost like a seed maybe. But he hasn t had anything with seeds. Especially not THAT many seeds. its been there in each pamper I have changed. He has been eating and drinking like normal. What could this be?",
    "doctor_response": "some times children can have whats is called toddlers diarrhoea. any child who is gaining weight normally and is eating well with no other symtoms and has loose stools which may have a different cosistency and frequency is said to hve this this. you need to decrease fruit juices and incerase fibre in his diet. rest assure need not worrry about it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling low, stressed out, irritated, do not get proper sleep, disinterested. How can get over these?\n\nI m a working woman, mother of two teenagers, husband works in a city far away and possible to meet each other every six months. I ve been feeling very low, irritated, stressed-out, as if i need a break from everything. Cant sleep properly, wake-up startled sometimes, dont feel like doing anything atall, annoyed at myself, sad, lost my smile, etc........pls guide me on these.",
    "doctor_response": "These are seemingly symptoms of depression. Management of such state: 1. Consulting a psychiatrist for thorough assessment 2. Improving your situation (finding some alternative that you and husband can stay together, sharing the responsibility of office work and house hold work etc.) 3. Sharing your distress with someone 4. Taking break from your monotonos work off and on",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shoulder pain while lifting up the arm?\n\nhi i have had pain in my shoulder for about 3 months now, the pain started when i was doing some push-ups, so i stopped doing them about 3 months ago but the pain is still there when i lift my arm up to the side, or when i pick up a mildy heavy object. jennie",
    "doctor_response": "Hi, This condition is called - in layman's terms a Frozen shoulder. The possibility of Muscle/tendon rupture during push-ups remains high. Diagnosis is by MRI. Treatment is pain killers and physiotherapy and depends on MRI report. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pulsing and bubble like feeling in stomach?\n\nHi I've been having this crazy pulsing feeling in my abdomen and now Ive recently started to feel little bubbles could I be pregnant? No missed period and two negative test, but it common for the women in my family to still gave  their period during pregnancy",
    "doctor_response": "Hello and welcome to HCM,A negative pregnancy rules out pregnancy for all practical purposes.The pulsing and bubble like feeling could be due to some other cause but it is not due to pregnancy as suspected by you.Menstrual cycles do not occur during pregnancy.Bleeding during pregnancy should be taken seriously as it can be due to threatened abortion or missed abortion.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to treat vestibular papillomatosis?\n\nHello doctor, Would you please take a look at the attached pictures and diagnose as the felt symptoms are rare itchiness. Is this HPV or vestibular papillomatosis?",
    "doctor_response": "Hi. I have seen the pictures. (attachment removed to protect patient identity).  It is vestibular papillomatosis. But tell me the answers to some questions. Since when it is present? Painful or not? Is it also present in areas other than mentioned in the photo? If it is since childhood, not painful, and not present anywhere else then, it is vestibular papillomatosis. There are many thoughts on the condition and some also believe that it can be caused by HPV (human papillomavirus). It is a debatable issue. So if you are confused with two or three opinions then you can go for biopsy for confirmatory diagnosis. But as I said it is vestibular papillomatosis on the first look, with symmetrical spread only on labia.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is my baby having hearing loss after a cold?\n\nHello doctor, My 5-year-old son is suffering from bilateral hearing loss. He was born as a normal child. Suddenly, he got such problem due to cold.",
    "doctor_response": "Hello. Your son is suffering from bilateral hearing loss following a cold. This is most likely due to obstruction of the tube connecting between the ear and the nose (ETD: eustachian tube dysfunction). You can start the following medicine syrup T-Minic (Chlorpheniramine maleate and phenylephrine) 5 ml two times for two weeks. If not improving, then you need examination by local ENT surgeon and hearing test (audiogram).",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with Bilateral disc protrusion & spondolysis\n\nMy husband is in the moderate stages of Alzheimers , and is having pain, numbness in his c-spine. An MRI revealed bilateral disc protrusion and spondolysis along with some other things. My questions is, should he have surgery to repair it and risk more confusion from the drugs or endure the pain?",
    "doctor_response": "hi,thanks for providing the brief history of your husband. since you mentioned that he has cervical disc prolapse he must be in pain which I can understand as I have seen end number of cases. Also you mentioned he is into the moderate stages of Alzheimer's as well.I hope the physician must have mentioned certain medicine which will help. also you can discuss with your physician about the physical therapy as it works well in cases without a need for surgery.since your husband is having Alzheimer's issue I will recommend to avoid surgery. physical therapy is a non invasive way to help relief of pain. also you should follow the guidelines given by you physion of DOS and donts.with the grace of God your husband will receive a good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to party with a 15 month old child?\n\nMy boyfriend and I have a 15 month old and my boyfriend finally got a job at a hookah bar which opens tomorrow. Tonight is the friends and family night and we are both invited. Well my question is, will it be safe for our son to be there with us? If not, what is the risk?",
    "doctor_response": "Brief answer:It is not safe to go for party with 15 months child. Detailed answer:Hi, welcome to HCM. A 15 months child is totally dependent on the caretaker for everything. If you take the child along with you at the party, then you have to take care of the child at every moment. Children at 15 months of age have a habit of putting everything in the mouth, so you should be more cautious till the party ends. In my opinion, its not safe to take the child to the party. I hope this has helped you. Wishing your child good health. If you have any more questions, i will be very happy to help. Take care. Regards:Dr Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Kidney cancer,removal of left kidney,fluid in lungs,radiation therapy,loss of speech\n\nmy father is diagnosed with kidney cancer in july last yr, he got his left kidneyremoved and was given target therapy starting from nexavar .after 6 months PAT scan showed slight increase in disease and was put onsecond med which further detiorated the condition .....causing utter weakness as a result med was discontinuedfor a week which further worsened the condition .....again fluid in lungs and now speech is also not clear ....brain CT was done n some cells were found.....as a result radiation therapy was given for 10 days ....it gave positive results along with med VOTRIENT....everything remained fine for a month but today he had a fit type condition and lost his speech for sometime so Doc pls guide what next PAT SCAN is due in june first week.",
    "doctor_response": "Dear Mr. sarnakur, I am sory to convey you that your father has entered in a very advanced stage of the disease. He is resistant to all forms of therapy now and is also intolerant to  other active treatment.. Please  give him only palliative management to comfort him. No active treatment is advocated. Please consult your primary physician who will guide you for this form of terminal care and comfort. Truly, Dr. Jawahar Ticku",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to strengthen a weak heart?\n\nWhat can I do to improve my weak heart? My ejection fraction ratio is around 28 % and I am under a heart doctors care and taken my precribed medications as ordered. However, is there anything else that I can do to help my heart come up to the desire 50/55 ratio for my age?",
    "doctor_response": "Hi, As a matter of fact, it is not possible to increase EF from 28 to 55. Some drugs cause some increase as digoxin. Please consult your heart doctor as he will guide you whether you are fit to take digoxin or not. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Varinder Joshi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated BP, tachycardia with discomfort in chest?\n\nHi, I have elevated blood pressure, tachycardia when standing, squeezing sensation in my chest around left shoulder and neck and a chronic cough that increases with activity. I have also noticed some bright colored blood in my sputum. I have a clean chest X-ray, clean echocardiogram, normal ECG and a recent CAT-scan of my aorta is also non-alarming. The chest discomfort intensifies at rest and is not constant. Additional symptoms: Headache, enlarged blood vessels in my eyes, intermittent kidney discomfort, bluish fingernails, intermittent tingling of left hand fingers and feet.",
    "doctor_response": "Hypertension is alifestyle disease which needs a lifestyle solution.Please rule out secondary causes of hypertension especially Pheo chromo cytomapleaase doa TMT to rule out IHD.You have not mentioned about your work stress and home stress Your occupation ,whether you are a smokerwas Vitamin D , Magnesium and HS CRP  TEST DONE and their results .A more detailed hsitory required to give more specific advice",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does \"minimal cp angle blunting due to plueral thickening\" mean?\n\nMy chest x-ray radiologist report says, minimal cp angle blunting due to plueral thickening, whereas my doctor after seeing x-ray has said nothing to worry and all other things are normal. Do i need to worry about minimal cp angle blunting. My age is 36",
    "doctor_response": "HiNo don't worry this is a passed situation and now nothing to doYou might have pain sometimes due to ot.Regards Dr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high sgpt and high blood pressure?\n\nDear Dr s, I am aged 36 years, recently i went for a medical check up In which My sgpt is 66 & blood pressure upper 170 and lower 110. All the check ups i.e. ultrasound, x-ray shown nothing. Pls examine on the basis of above and suggest me. Thanking you",
    "doctor_response": "hello,  Most probable reason for sgpt elevation is obesity and fatty liver. As fat accumulates in the abdomen, it also accumulates in liver leading to liver damage and elevation of enzymes. Also, you should reconfirm the elevation.  Do you drink alcohol if yes it could be a reason. Also, you should get one viral marker test done like HBsAg, Anti HCV, in order to rule viral hepatitis. To confirm the diagnosis, we need ultrasound of liver.Treatment for this is dietary changes like low fat, oily and sugar diet and regular exercise and weight loss.    For bp, it can be age related change occurring early or secondary to some disease. You being an young hypertensive you ll first evaluation for cause of blood pressure. You should undergo test like kidney function test, renal artery Doppler, Sr cortisol and 24 hr Urinary metanephrines.    You should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. If bp is persistently more than 140/90 mmhg, then you should be on medicines for it like telmisartan or amlodipine. Regular exercises like brisk walking, jogging according your capacity atleast 30 min a day and 5 days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn't abdominal fat deposition or obesity. Get your lipid profile and sugars tested once..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Red swollen gums, pain swallowing, cant open jaw\n\nRed swollen guns around my wisdom teeth , pain when swallowing , jaw is hard to open and close. I have been using salt water for 3 days. It s very painful and It s gotten so bad that I can t sleep.",
    "doctor_response": "Hi, Thanks for asking the query, I would like to tell you that wisdom tooth is the last tooth to errupt in the oral in the oral cavity which is usually malaligned and impacted in the jaw bone, the area is difficult to clean and causes bacterial accumulation leading to inflammation and swelling of the overlying gums known as PERICORONITIS. I would suggest you to visit the Dentist and get thorough checkup done take an OPG radiograph. The tooth can either be extracted or the pericoronal flap can be surgically removed to guide the erruption of the tooth in the oral cavity. Take complete course of antibiotics and analgesics. Take lukewarm saline rinses and antiseptic mouthwash gargles twice daily. Hope this helps out. Regards....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Celiac symptoms but negative blood test\n\nHi I have had stomach problems my whole life, starting with heartburn and progressing to bloating, abdominal pain, sometimes diarrhea sometimes constipation. Now , for years i've been chronically constipated. I have Hashimoto's thyroid disease and lots of allergies. My doctor tested me for celiac, but only did the IA-2 antibody and folate. Had fine folate and IA 2 came back negative. Should I get an endoscopy to double check, since i've been taking multivitamins before i was tested? Also, I have a recurring rash on the top of my foot that doesn't seem to be related to anything i do, and i have geographic tongue for no apparent reason. Can i have those and not have celiac?",
    "doctor_response": "Hi ashley, By seeing your history it appears that yoy are suffering from Malabsorption syndrome which may be celiac/topical sprue, pernecious anaemia, glutein enteropathy or irritable bowel syndrome, so you need to be evaluated in detail to rule out the above causes just doing investigation for celiac sprue may not able to diagnose actual condition, you may also require endoscopic biopsy at different sites, consult gasteroenterologist for further evaluation and suggest my advises also. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does exercising and walking on treadmill cause infection around toe nail?\n\ni have an infection around my left toe nail. I exercise everyday at the gym with 45 minutes of walking on treadmill and the eliptical.  could this be the cause?  right now it's fairly painful to fast walk but not unbareable.  What can I do at home that will help?",
    "doctor_response": "Hi,Welcome to HCM!No, exercising and walking on treadmill does not cause nail infection. However, keep your foot unhygienic by not washing after sweating might cause fungal infection. Also, try and remember if you had trauma/injury to your toe as it might be a cause of infection.Nevertheless, apply antibacterial and antifungal cream to the affected area and keep it dry till infection goes.Hope this information helps.With warm regards,Dr. Sridhar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness after falling down?\n\nI slipped today and fell pretty hard. I think I landed on my elbow, but I am feeling a little dizzy. I was nauseous early. I have good mobility in my arm, and the dizziness/lightheadedness didn t come in for a bit. Is there any way I got a concussion without hitting my head?",
    "doctor_response": "Thank you for asking Healthcare majic. My name is Dr Ehsan Ullah & I have gone through your query.Dear when there is counter-coup injury to skull then concussion occurs leading to memory disturbances.And the above mentioned symptoms of your shows that its natural response of body after falling down which get subsided within one or two days...       just get tab.stemetil twice a day                    tab.omeprazole 20mg twice a day for a week.Hope this may help you. Let me know if anything not clear. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can anemia also cause voice hoarseness?\n\nI have been sick and have had no or little voice for 10 days now.  Took the zpack and finished it 3 days ago.  Also anemic and currently going through Venofer infusions - could the two be realted?  My white count and Neut% are also high.  When should I become concerned?",
    "doctor_response": "hi, anemai have no any relation with your horseness of voice. you should consult your doctor. no need to wait. because some dangerous condition may leads to horseness of voice like some mass lesion affect the reccurrent lkaryngeal nerve then it will lead to horseness of voice. so consult your doctor and take treatment accordingly. it has no realation with anemia.thanks for using health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes allergy and vomiting to beef consumption?\n\nHello, I am a 50 year old female with diabetes, high blood pressure which is under control with medication and a partial hysterectomy. About a month ago beef started making me feel nauseous after eating it and sometimes before from the smell. I ve also vomited or been queasy all day after eating beef. It doesn t matter if I cooked it myself or purchased at a restaurant.",
    "doctor_response": "HI, thanks for using healthcare magicYou are intolerant to beef.The main treatment of food intolerance is to avoid contact with the source of the problem.This means that you should avoid using beef in the future to prevent further problems.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having abdominal swelling and loss of appetite?\n\ni am a nursing student in Bhutan, i have patient whose complain is swelling of abdomen, fever,and  loss of appetite. now i am a trouble to form a nursing diagnosis, would help in forming it. patient is 12 years of age and diagnosed as abdominal tuberculosis.",
    "doctor_response": "Hi,Thanks for posting your query.I am Dr.R.K and I am pleased to assist you.You have given the diagnosis - abdominal tuberculosis.The distension could be due to ascites (fluid in the abdomen). Individuals  with tuberculosis will have fever, loss of appetite and loss of weight.You can get an ultrasound done to confirm the presence of ascites. If it is confirmed, the ascitic fluid analysis may be done to confirm the diagnosis of tuberculosis.I hope that answers your question.Regards,Dr.R.K",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ameloblastoma\n\nI am diagnosed with ameloblastoma mainly cystic nature with some component of solid in my mandilbe jaw. will have resection surgery and will use NVBG with the length of about 7cm. will have about 1 tooth right side and 3 tooth left side. Will use tray and particle of both of my hip bones will be place on the tray with some RHBMT use. little bit nervous on the operation and after the operation for the recovery, will be nice to have some sort of input on it. thank you",
    "doctor_response": "You can opt for Homoeopathic mode of management.As Homoeopathy is side effectless and very mild to act in oncological cases where immunity gets very heavily deranged.Homoeopathy treatment needs a thorough Case taking to select proper Medicine which needs thorough detailed Case history and reports.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for hard stool ?\n\nim male,27yrs. im problem having right side abdominal pain since last 2 years..before 5-6 month i have been getting another problem that is hard and daek stool but there is no pain in anus. my ultrasound , occult blod, upper indoscopy and sigmoindoscopy is normal..so doctor what should i do?",
    "doctor_response": "Ayurvedic treatment- as per your info according to me your digestion has become sluggish and intake of water is low,so see that your water intake should be between meals which will help for ruling out constipation,besides that Ayurvedic drugs- ampachak Vati- 4 tab for chewing,sookhsarak choorna 1 tsp with warm water at night",
    "dialogue_context": ""
  },
  {
    "patient_message": "Disfigured bump on lips looking like cleft palate after stitching up due to accident. Interferes with eating. Guide for rectifying.\n\nI was in a horrible car accident on my bicycle, was hit at 30+ miles an hour, flown from the bike and my face scraped the concrete. When I regained consciousness, my lip was cut in half! My lip is the major problem, after having it operated on twice, both doctors did a horrible stitching job (they're not beauticians).  My lip was left with a bump on it and is visible when I smile. It looks like I have a cleft lip! I feel disfigured, and am extremely self conscious about it. Sometimes it interferes with eating, and my teeth scrape it.  What can I do? Can I go to the emergency room to fix it? Cut off the excess flesh? I could bite it perhaps? These are the insane ideas I've had to live with and contemplate. Could I also be suffering from head trauma? Or accident related trauma? I've been in six car accidents in my life, three on bikes and I am deathly afraid of careless drivers.",
    "doctor_response": "Hello,The problem you are complaining of arises from an improper repair of the muscle inside your lip which is known as orbicularis oris. Revisional surgery entails a complete disruption of the repair, stitching the lip in 3 layers with resection of any mucosa that might occur in your case and with particular attention to repair of the orbicularis. Please visit a plastic surgeon for more details, there is no need to be depressed.Dr. Adhikari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the suggested treatment for dissolving kidney stones?\n\nFollowing excruciating paIn and vomiting, I have undertaken an ultra sound and CT scan defining kidney stones. I do not drink fizzy drinks, alcohol, only one cup of coffee a day, all other liquids being app. 1 ltr. or more of fresh tank water, eat very little meat, drink very small quantity of skim milk (only in cup of coffee) and other dairy, however, have app 2 tablespoons of natural yoghurt daily. My diet intake consists of homegrown fruit and vegetables, maybe one to two slices of toasted whole-meal/whole-grain or rye bread, perhaps an egg or two, no fast-food, no takeaway, no cakes, biscuits, sweets. Moderate intake of spinach and tomatoes. What would you suggest to dissolve the stones and prevent reoccurrence? Thank you",
    "doctor_response": "Hellofirst of all get this test done....SERUM CALCIUM/PHOSPHATE LEVELS ...take tablet urimax twice daily and tablet cystone 2 tablets 3 times a day for two weeks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could loss of weight and hair be due to masturbation?\n\nHello, i need ur help.. My name is Nagraj,  my problem is mastrubation! How long i dnt no may be frm the age of 8yrs nw my age is 20. In my home one girl stayd for PG she used me for sex wen m 8yrs, she stayd 6 years she used me up to that & with that i mastrubated also n after she left away i continue with mastrubating til now. I lost my energy i lost my child hood i lost my life, m luking very ugly very thin holowd eys straight face, i lost my hairs if i compare to my brother 2yrs smaler from me he looks very young nd energetic glowing face attrction face i want be lyk him.. Can i recovr my helth?can my reprodctiv hormons r re-grows? Which herbal medicns wil giv me good reselts soon?? Some medicns wil not wrks but they need money so they want to improv ther busines but u Plz sugest me one gud medicin n help me plz plz & i vl nevr forgot u in my life time. Thank you..",
    "doctor_response": "Hi,Sorry to heard about your health. But let me know usually masturbation for 2 to 3 times in week cannot cause loosening of weight and hair.I suggest you get checked your CBC report, serum TSH estimation, random blood sugar estimation for primary work up. You can rule out all STD and HIV also because of history with suspicious girl. Your weight loss might be due to excess stress as well. I suggest you take more protein diet and becosule like multivitamin tablet. You can revert back with reports once done. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please view my wife's transthoracic echo doppler report and tell us what is wrong.\n\nHello doctor, My wife's transthoracic echo doppler report interpretations are as follows. 1. No regional wall motion abnormality (LVEF 60 %). 2. Normal cardiac chamber dimensions. 3. a.Trace MR. b. Trace TR, normal PASP. 4. IVC is normal in diameter. 5. No LV Clot, vegetation, pericardial effusion. Are these findings fine, or is there anything to worry?",
    "doctor_response": "Hello. This echo is normal, however considering her diabetes status and dyslipidemia, it is better to subject her to further testing like treadmill test or CT coronary angiography to know the status of cardiac vessels. Patients with such risk factors frequently have blockages in the arteries, so should undergo further evaluation. I hope this helps you and get back if you have any doubts.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can continuous use of 2.5 ml of Cremaffin a day for a 2-month-old baby cause any side effects?\n\nMy 2month old baby have seviour problem of gas becose of which she use to cry continuesly. Dr advise cremaffine after several medicines. After giving cremaffin my baby has become happy baby. But then dr advise to stop cremaffin. And very next day of stopping medicine. Baby become again cry and crancky baby. Can i continue cremaffine??? I am givin 2.5ml a day and dose it has any side effect. Pls suggest.....",
    "doctor_response": "Hi, I suggest you not to use Cremaffin as it is common for babies of this age to pass gas like this. This is called evening colic and gets better by itself. Cremaffin has got side effect of diarrhea and is not recommended at this age group please. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My uncle has been diagnosed with cancer. Please give suggestion on palliative care.\n\nHello doctor, My uncle has been diagnosed with cancer. I am looking for treatment options and advice from an oncologist. The current doctor who has been treating him has suggested we stop all treatment as he may not have much time left. I am looking for other options or opinions this is what one of the doctors said on seeing the biopsy. \"It appears like rectal malignancy but a PSA value and PSA stain of the biopsy tissue would rule out prostate cancer. It is not a good prognosis if it is rectal cancer given the stage but I think a PCN will only help to improve him temporarily with improvement in creatinine and possibly avoid dialysis. I guess you need an oncology opinion to give palliative care to keep him comfortable ie.. free of pain, eating and breath easy.\" I can provide you with some status, but since I am not sure how to distinguish between prostate cancer and rectum cancer. I would need help from a professional to differentiate. Additionally, he has two bags attached to his body now, one for stool another for urine. He got operated for rectal dysfunction about 18 years ago and has had been using a stool bag since. Due to his recent kidney stone issue, a urine bag has been added as well. Please help. He is really suffering, and I do not know how to help.",
    "doctor_response": "Hello. I have seen the reports. (attachment removed to protect patient identity). It is quite sad that your uncle has advanced stage of cancer. As you asked me how to differentiate between prostate and rectal cancer. There are three possible ways.  1. Serum PSA (noninvasive). 2. PSMA PET scan (noninvasive). 3. TRUS guided biopsy (invasive).  Doing a PCN (percutaneous nephrostomy) is a very good option as a tumor of such kind usually obstructs the ureter. And depending upon whether it is a prostate or rectal primary. Palliative radiotherapy along with metronomic chemotherapy is a good choice at this stage. But this will improve his condition on a temporary basis only. And if it is a prostate cancer then he can be started on hormonal therapy. Serum PSA (prostrate specific antigen) levels, PSMA PET (prostrate-specific membrane antigen) scan, or TRUS (transrectal ultrasound guided) biopsy. Ca rectum. Ca prostate. Based on histology or PSA (prostate-specific antigen) level but with palliative intent only.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why are my menses 4 weeks late?\n\ni had my period on the 16th of december but have not had one since.my periods are irregualer but i have never been more than 2weeks late.i am nearly 4weeks late now.i have done lots of pregnancy tests and some have come back with a faint line but others have not.i have been to the doctors and told them this and they said to go and do another test and make another apoinment if it comes back possitve.one did and one didnt.im so confused.am i pregnant.",
    "doctor_response": "Hallow Dear,Missing period for 4 weeks is suggestive of pregnancy. You have to rule out the pregnancy first before you think of any other diagnosis. Some of your pregnancy tests are faint positive. It so happens when:1.The baby in no more viable 2.When the pregnancy is located somewhere outside the uterine cavity (ectopic pregnancy). Ectopic pregnancy is a very serious condition. It usually ruptures and then the bleeding is life threatening. So my advice is to go for ultrasonography. If the uterus is empty in spite of faint positive pregnancy test result, it should be investigated further for ectopic pregnancy, may be by laparoscopy. Ectopic pregnancy will need immediate intervention. If it is unruptured at the time of laparoscopy, it can be tackled laparoscopically also. If it is ruptured, it may required opening of the abdomen and lot of blood transfusion. If the uterine cavity shows baby, it is intrauterine pregnancy. If the baby's heart beats are seen, then the pregnancy is normal; if they are absent, then it is missed abortion  and needs termination of pregnancy ASAP. Delay in terminating missed abortion may lead to serious complications like severe bleeding due to clotting disorders (DIC), infection, kidney failure, etc. So without delay, please get your ultrasonography done to decide about the further line of action. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swollen cheeks, pain in tongue and throat, bad taste in mouth, cracked tooth. Due to crab in tooth?\n\nMy face cheeks have been swollen for a month. Also my tongue is huge and thorat hurts. Have a awful taste in my mouth? Also I cracked my tooth on a crab leg. I am allergic to seafood. Don t have money for dental work either. Could it be that I have a piece of the crab in my tooth still, that s causing my face to swell?",
    "doctor_response": "Hello & welcome, First of all, you are putting yourself on high risk by eating sea food even after having the knowledge of carrying its allergy. Never ever do this again as allergic reactions go on increasing in the severity with each episode & you may put yourself in life threatening situation. Now, your face & cheeks are swelled along with tongue & throat that's hurting that means you are in advanced stage of infection because of fractured tooth which is acting as main focus of infection. Only piece of crab remaining in oral cavity can not present with such swelling unless it's an allergic reaction itself. So, as you are in advanced stage of infection, intake of Antibiotics & painkiller on your own is not at all advisable here. Visit your dentist as quick as possible & get evaluated. This is because, if there is abscess formation it might need to be drained by incision which can be done by dentist only. Severe infection may require administration of Antibiotics intravenously to lower the risk of developing septicemia. Again I would advise you to visit your dentist as quick as possible because, if such infections if not treated on time may land you in life threatening condition requiring hospitalization. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes throbbing hand pain?\n\nI have a throbbing pain on my right hand side. It began off and on a couple of months back. Now it is effecting my sleep, and daily activities. It has begun to be constant in the last few days. It is directly on my side around the middle; above my hip area.",
    "doctor_response": "Thank you for question. 1) Thoracic Outlet syndrome: This is a condition where the subclavian artery may be blocked leading to throbbing pain. The reason could be a) Cervical rib: Get an xray of the neckb)Scalene muscle spasm: Try a muscle relaxant Flexon mr 500mg and see if it relieves pain.c) Others: Discuss with your orthopedic surgeon2)Nerve impingement:a) Cervical spondylosis: Get an xray cervical spineb) Osteoarthritis of medial epicondyle: elbow xray and examinationc)Ulnar nerve traction: Get a nerve conduction test. d) Saturday night palsy: Did u fall asleep on a chair with your arm hanging on the side?Hopefully you dont have a previous fracture around your elbow or it could be a complication of that.Get well soon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the kidney, blood in urine, difficulty in passing urine. What to do?\n\nhello Dr. in 2009 i had a trouble and pain in my kidney , when i pee it was totally red. after that when i went towards doctor and took my test so they found a stone in my urine pipe. Doctor prescribe me medicines and after a shorter period it came out from my urine pipe. now i am living in Sweden, for the last six month i am facing problem in urine in the sense that when i pee i discharge half of it but after that i have to wait at least 30 minutes or some times 1 hour. today i felt pain in my right side of kidney. i am very worry, what should i have to do.",
    "doctor_response": "Hi,Thanks for query.You need to go for ultrasound to have proper diagnosis.There are chances of some blockages in the urine pipe or some problem with your urinary bladder which is not emptying properly.You need to consult urologist for this and get your self treated,please do not ignore this.Wishing you good health.Dr.Pragnesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the ribcage?\n\nMY 13YR OLD IS HAVING PAIN ON HER RIGHT SIDE DIRECTLY UNDER HER RIB CAGE. IT IS VERY SORE AND WHEN SHE TAKES DEEP BREATHES IT HURTS AS WELL AS TOUCHING AND NOT TOUCHING. SHE SAYS IT HURTS AS WELL TO COUGH, YAWN, AND GIGGLE. SHE HAS A OKAY EATING HABITS NO VOMITING OR NAUSEA. WHAT COULD THIS BE AND HOW CAN I HELP AND COMFORT HER? PLEASE HELP",
    "doctor_response": "Hi, It could be costochondritis or it could be intercostal neuralgia.I suggest you discuss these possibilities with your pediatrician. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chronic kidney stones, cystitis, endometriosis. On oxycodone. Trying to wean off. Safest way?\n\nHi I am dependent on prescription pain medication and very badly would like to quit. I started using pain meds due to chronic kidney stones, interstatil cystitis and endometriosis. I have had to increase my dosage because of tolerance. I use up to 180 mg. Of oxycodone daily. Those are the heavy days. I have been using for about two years now. I would like to get a dr. To prescribe me medication to wean me off these meds at home. I have a psychiatrist i have mentioned this to but he said i needed to go to rehab. I cannot afford rehab and do not have insurance. I have a masters degree in counseling and have learned all the mental health aspects of addiction and what i need to do to stay clean after detoxing. Im just scared to death of withdrawal symptoms as i have felt the onset of them before. Any help would be greatly appreciated. I am a 28 year old female who weighs about 108 lbs and is 5 foot tall.",
    "doctor_response": "Hi,Your psychiatrist perhaps advised you to go to rehab because quitting this high dose of oxycodone abruptly can be expected to result in strong withdrawal symptoms which would be easier to manage if you are under constant medical supervision. If going to rehab is not an option, then rather than quitting this abruptly, try reducing the dose of oxycodone gradually before quitting. Go very slow, not more than 5 mg per week, and even slower if you wish. Keep yourself hydrated. Use over the counter medicines if there are mild withdrawal symptoms. And above all, remember that one may easily die from opioid overdose but not from opioid withdrawal.Hope this helps you. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain during medication for typhoid?\n\nHELLO My son has been diagnosed with Microcytic hychromic Aneamia & typhoid fever. the Doctor administered the ff darolac, oflox200mg 2xb/d, cepodem200mg 2xb/d, iron & blood supl & boosters, folic acid. my concern is he started complaining of abdominal pain into the 3rd day of the medication. My fear is i dont know what is causing the pain, is it the drug reaction or the typhoid pls help",
    "doctor_response": "HI.The abdominal pain in cases of Typhoid on day 3 is usually die to the complication like inflamed part of the terminal ilieum due to Payer's patches , leaking out of this area or perforation of this part due to typhoid ulcer.  This is not a drug reaction.I would advise you to rush to ER to get X-ray of the abdomen in standing position to see for the sign of air under the diaphragm as a sign of perforation of the small intestine, ultrasonograph, clinical evaluation and further management .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are all mental illnesses some forms of sleep disorders?\n\nI have a theory that many if not all mental illnesses may indeed really be forms of sleep disorders and thus may be amenable to sleep meds of one sort or another. I have attempted to study brain scans of schizophrenics, etc, from sites on the internet but have not found any clear correlations. Perhaps because the brain activity may be different than previously thought and unique and new. For instance, I think that anxiety or panic attacks may be a form of microsleeps where a person goes to sleep instantly, is not aware of this, and then suddenly awakens seconds or microseconds later and is seized by panic attacks or the fear of losing control, as you do when u go into the REM state. Also sleep paralysis is common upon suddenly awakening from the dream state, thus the fear of not having control.Perhaps also related to narcolepsy. As for schizophrenia, I believe it MAY be caused by someone who never completely awakens and stays in what is known as the hypnopompic dream state. During this real scientific state of REM dreaming, a person often hears voices, imagines things that are not real and sees strange people and things. (It has been put forth as a reason why alien abductions almost always occur at night- this what seems like a long period of abduction may really only last minutes in the distorted dream state before awakening. Also a time of sleep paralysis, the feeling that you cannot move. Anyway, I believe that some if not all forms of schizophrenia may be traced to a person who NEVER quite awakens from the dream state, thus the illusions and voices, etc. While in a schizophrenic break, they may actually be sleeping and dreaming at the same time. Impossible, well then explain sleepwalking and talking and doing things like driving your car under influence of certain sleep meds, such as Ambien. Anyway, just food for thought!",
    "doctor_response": "HaiChange in sleep pattern is one of the commonest finding for any psychiatric disorder.As of now we cannot conclude that every psychiatric disorder is due to sleep pattern change.But any contribution is welcome in field of Psychiatry... if you could get a guidance from a Psychiatrist and try a systematic research in this areathank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headaches in a child while suffering from congenital scoliosis?\n\nMy daughter is 7 years old and has been complaining of headaches for the past week. They seem to be getting worse. My initial thought was to get her eyes checked. However, she claims that is primarily on the right temple and ocassionally shoots down to her right leg. I should also mention that she has congenital scoliosis which we have measured every year and has not had a significant change in the degree of the curve. But, I am wondering if it could be pinching a nerve?",
    "doctor_response": "Hi DearWelcome to the HCM,Possibility of spinal cord  or any nerve irritation are there . MRI OF THE SPINE MAY EXPLAIN THE PROBLEM BETTER.Hope the query is answered.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the side effects of Gorochanadi Gulika?\n\nHi doctor, My daughter is 2 years and 5 months old. She was on tablet Gorochanadi\u00a0Gulika when she was 1 and a half year\u00a0old. She took it for a month to balance her vata-pitta dosha, and she was all right. This year also the same medicine was advised as she was not very active, and I am giving her the tablet. I want to know the side effects\u00a0of the drug. And how to diagnose them?",
    "doctor_response": "Hi. I just read your query. I hope you are satisfied with my answer. For more queries, you can consult me. Thank you. For further queries consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can hydrocodone cause sudden atrial fibrillation?\n\nHello,I m a 52 year old male in reasonably good health . I had an episode last Monday where my heart went into Afib for no apparent underlying causes. I have been on Hydrocodone 10/650 since 2011 for pain management of spinsl fusion I had. Could the medication be aggravating my heart?",
    "doctor_response": "Hello and thanks for writing.I can understand your concern and would try to help you in the best possible way. There have been some studies that have shown that opiates like hydrocodone increase the risk of atrial fibrillation but conclusive medical evidence is lacking. In any case you should consult a cardiologist who would evaluate you for AF and begin a management plan. He would also asses you for risk of developing clot and take a call on necessity of anti coagulation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Boils on skin due to dettol allergy ,problem is persisting after consulting, please give your suggestion\n\nHad a cut and bruised knee after a fall durign a game of cricket. Cleaned it wth dettol antiseptic and put betadine ointment on the same for a few days. Now the skin surrounding the cut has developed boils (like from burns) and the boils have watery fluid, which comes out when they break. and this is leading to its spread in the skin. Consulted a skin specialist, but the problem is persisting. plz guide. Regards Leya",
    "doctor_response": "u seem to have an allergic contact dermatitis becoz of either dettol or betadiene..does it itch / burn...what else have u been applying? did u experience such symptoms earlier with application of either betadiene or dettol? it wil be worthwhile if u cud send ur pics on dr.resham@gmail.com for a precise diagnosis. till then t allegra 180 mg once a day for itching and fucibet cream for local application twice a day wud help",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sciatic pain. Taken prednisone. Advice?\n\nbeen having sciatic pain since beginning of april....went on 2 regimens of steroids (prednisone - 10 mg tabs) 3 pills  for 3 days, then 2 pills for 3 days then 1 pill for 3 days, experienced relief then pain returned, so doctor put me on 3 pills for 7, then 2 pills for 7 (last does this past monday) - woke up today with lower back discomfort and then made a wrong turn and pain is back --- full blown - feels like spasms in left leg -  have taken 5 ibuprofen and 1 hydrocodone and still feels like spasms (worst pain yet)  - have scheduled appt on mon - will attempting to stretch (haven't yet due to pain) exacerbate the prob?  have already done ice a bit as well.  whatta pain!",
    "doctor_response": "hi iam dr usmandefinetly your symptoms are due to sciatica when there is nerve impringement by prolapsed discs. steriods help some times in reducing the inflammation but i will suggest if even after 01 week of steriod therapy symptoms are there infact worsened you need to get an mri done as soon as possible to evaluate your spine and then get a neurosurgical consultation thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling dizzy & spinning of head towards one direction\n\nmy wife, who is around 40 year old, is having problem in her head for the past two days. she is getting spinning like feel in her head whenever she is trying to sleep sideways and lowering her head to do some work like trying to pick some thing from the floor. anirudh.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. From your description conditions that are related to the inner ear dysfunction (benign positional paroxysmal vertigo for example) should be considered. It is necessary an evaluation by an ENT Doctor in order to confirm the diagnosis. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have vaginal pain while urinating along with stomach and back pain. Is it fine?\n\nHello doctor, I have pain in the inside of my vagina when I pee and lower back and stomach pain that comes and goes. Is this normal?",
    "doctor_response": "Hi. It could be sexually transmitted infection or pelvic infection. Have high vaginal swab urinalysis, urine culture. Strict hygiene. Soft comfortable undergarments. Use condoms to avoid sexually transmitted infection. Avoid cosmetics locally, just use a soft razor for hair removal. Lots of water and Cranberry juice to avoid UTI. After collection of the swab, have medications, tablet Doxycycline 100 mg twice daily and tablet Metronidazole 400 mg eight hourly for 14 days. Collect reports and discuss here.  STI or PID. Urinalysis, urine culture, HVS (high vaginal swab). UTI or PID. STI or PID. Oral antibiotics.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for problem in hip area\n\nmy mother is 82, she keeps having spells where her leg in the hip area makes a quick jerk and she almost falls, if she did not have hold of he walker she would go down. She says that there is no pain, She has seen her family doctor and a Neurologist because she said it was like a lightning bolt when it happens I assumed it might have some thing to do with nerves not muscle weakness. Neither doctor can figure out what the issue is. I need to know what type of Dr. to take her too, this has been going on for over a year?",
    "doctor_response": "I recommend you to visit a physical therapist who will help her perfrom some static and free ROM exercises for the lower limbs. try doing bridging exercises and straight leg raise. it will help your mom to avoid falls. since ageing is a factor the improvement is purely dependent upon the seriousness she applies during exercise.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure lymphedema in hand which is painful?\n\nMy mother had breast cancer 10 years back. After surgery she got lymphedema in hand. Yesterday she felt unbearable pain in her hand and her hand became red and now she is suffering from fever. Probably this is due to infection. What should we do right now?",
    "doctor_response": "Hello,She may be either having cellulitis or deep vein thrombosis of her hand. I shall advise to not to wait and consult to your doctor.He may need some blood examination like CBC, ESR, CRP and Doppler test. She need a prescription of a broad spectrum antibiotic. Meanwhile, you may give her an anti-inflammatory analgesic like tylenol or aspirin for relief.  Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mukesh Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are abdominal and back pain normal after failed IUI?\n\nHi:I had a IUI that failed.  It is now the 6th day of my cycle and I am having horrible lower abdominal and back pain.  I used ovradil to help stimulate ovulation and progesterone suppositories up until my negative pregnancy test.  This the pain normal and how long will it last ?",
    "doctor_response": "certain degree of pain can be seen after it but it is usally self limiting so if there is persistant or progessive pain,you should see doctor for it and do further tests. wish you good health. reagrds",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is treatment required for erections that are curved downwards?\n\nI 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.",
    "doctor_response": "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 confido tablet for ED. It will help you. Its a herbal product and has no side effect. I hope this is helpful to you.RegardsDr. Tripat Mehta",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy flat bump on upper lip and itchiness in back of throat?\n\nI am 24 years old, 5'2\", 106 lbs. I have an itchy flat bump on my upper lip of my mouth. The back of my throat is also itchy as well. There are no strange spots or growth in my mouth. I was taking allergy medicine for a while and had attributed the itchiness to that. In the past year, I have been getting more frequent cold sores than usual. I had been diagnosed with HPV in the past - after a colposcopy and frequent visits to the gynecologist, it has cleared. Concerned about oral hpv.",
    "doctor_response": "Dr. Hanif warmly welcomes you!Thanks for consulting at my virtual clinic. I have carefully worked through your case, and can realize your health worries. Being your physician, I want to assure, I will take care all of your medical concerns.It needs proper physical examination and to see if there is associated gingivostomatitis due to HPV. You should visit your physician for that.Uptil that time apply somogel on the sores and leave for 5 minutes. After that rinse with plain water to soothe your mouth. Warm saline gargles will help. Keep good hydration with plenty of fluids. fruits and a balanced diet will help.Hope I answered all of your questions. In future, if you need further, detailed and quick assistance on any health issue, feel free to click on 'Ask me a question' directly from my profile. Have a wonderful time ahead. Regards!DR. MUHAMMAD M. HANIFUSA",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the benefits of undergoing circumcision?\n\nhi, im a 13 year old boy. I was curious about circumcision. My penis is 3 inches when flaccid but has the foreskin covering it. I read about the benefits of it and was interested, I can pull back the foreskin but not all the way. i heard that you can contract diseases from not having an uncircumcised penis and need advice.",
    "doctor_response": "Hi, I understand your concerns.Clinical trials have shown that circumcision benefits are notable. It reduces HIV infection risk for about 50-60%. About 30 % risk of contacting HPV and herpes are reduced, notorious causes of penile carcinoma. The benefits of preventing urinary tract infections and sexually transmitted diseases  after vaginal sex are now documented.You should consult your local surgeon for better advice.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can be done for frequent urge to urinate?\n\nHello doctor, I am 22 years old, 5.4 feet and 75 kg man suffering from a repeated urge to urinate in every one hour. This problem is occurring from childhood and is the same till date. No changes in this time interval.",
    "doctor_response": "Hello. You are having repeated urination problem. For that, you need to investigate as follows. Serum random blood sugar estimation to rule out diabetes, urine routine microscopic examination to rule out any infection, if present, ultrasonography pelvis to look interior of bladder and kidney, if no cause identified then urodynamic flow study can be done. You can consult a urologist for examination and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart murmur, sleep apnea and strech marks on shoulder?\n\nMy daughter has pectus moderate a heart murmur sleep apnea and streach marks in her shoulder and lower back but she tends to scratch at those. Also she had a strawberry birth Mark ss s baby on her spine vrry wide eyes and unusual svsbs on her legs at birth",
    "doctor_response": "Hi,This is Dr Sameer.Heart murmur in a child with strawberry patch & pectus should be pathological. I'll advice you for a 2D Echo, which will decide further management plan.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Untreated Hashimoto's disease, had developed elevated liver enzymes while on medicine. Could Hashimoto's be causing this?\n\nI have untreated Hashimotos disease. Have been on medication on and off. While off the medication, I developed elevated liver enzymes . I have had a liver biopsy and do not have liver disease yet my liver enzymes are still higher than normal. The liver specialist thinks it is from supplements or prescription medication. I know that is possible and he said I would have to be off the offender for several months to determine what is the cause. He does not want me to take any new medications or supplements. I am wondering if it could be the untreated Hashimotos that is causing the problem. My liver enzymes have been elevated from Sept 2009.",
    "doctor_response": "Hi there,Thanks for your query.Hashimoto's is an autoimmune disease, whereby which the immune system recognizes thyroid tissue as foreign and destroys it gradually.Hashimoto's is commonly associated with other autoimmune disorders, such as, diabetes and celiac disease (allergy to wheat, rye, barley and their products). It is therefore possible that you may autoimmune hepatitis. This may account for persistently raised liver enzymes.Thyroid hormone replacement therapy for hashimoto's does not ordinarily raise liver enzymes. You should therefore continue to take Thyroid hormone replacement therapy.Consult your doctor and apprise him of my opinion. I am certain that he will agree with me, order required tests, and- based on the reports-  will prescribe suitable/modified treatment as advised.In case of any further queries, revert back to me THROUGH DIRECT PREMIUM QUERY (Paid), addressed to me personally. You will receive- almost immediately- my response in great details.If you find my response helpful and informative, do not forget an \u201cexcellent\u201d (5-star rating)  to my answer, to ENCOURAGE ALL doctors- engaged in social service- to render sound advice to the FREE queries. Fond regards and have a nice dayDr. Rakesh Karanwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment for endocarditis\n\nendocarditis my father )age 64 )affected endocarditis , currently treatment is ampicillian & sulbactam (salbum 1.5 ) injection given every 6 hours, 2days over in treatment-but still fever comes daily,pls give any other tratment?",
    "doctor_response": "Hi well come to HCM. Drugs selected are ok. To treat endocarditis at times pretty long time course of antibiotic is needed. Duration of two days is not sufficient to judge efficacy of any antibiotic. Any antibiotic ones selected should be given fair trial unless condition becomes critical in between. If at all it happens Doctor will add some thing to this for additional help in terms of antibiotic of his choice. Trust your doctor they will do their best. Good luck. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a rapidly spreading fungal infection?\n\nMy 10 year-old daughter has a fungal infection behind her ears and in the earring hole. We have treated it with tea tree oil, which really helped. We let it go, without treating it, and it has spread and and has become worse. What can we do to heal this?",
    "doctor_response": "Hi,To cure fungal infection home remedy with tea tree oil is not enough.She might require course of oral anti-fungal medicine and local application of anti-fungal cream.Keep local hygiene clean and dry.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high TSH level\n\nHi Had my thyroid removed 1 1/2 years ago. Tsh levels keep going up even while on meds. Tried different types, brands, etc...now they want to do an absorption test. Last tsh level was 163 Recent med I d Tirosint 200 mcg daily I m 42, female, 5 8 and 210 pds Fyi can t control weight gain... My question? How bad is having a tsh level at 163 while on meds? What is an absorption study? How is it done?",
    "doctor_response": "Hello and welcome to HCM,Removal of thyroid gland has led to fall in levels of thyroid hormones.Fall in levels of thyroid hormones lead to increase in levels of TSH.TSH increases as a result of fall in thyroid hormones.Thus, a replacement therapy is required to suppress the elevated levels of TSH.Weight gain that you have mentioned is due to hypothyroidism or low thyroid hormones.Absorption study refers to introduction of radioactive iodine in body, the radio-active iodine gets concentrated in the thyroid gland and thus functional status of the thyroid gland can be determined.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is BP level of 139/90 a cause for concern?\n\n29 year old male, normal day to day activities, 5'9 175 lbs..no family known family history with hypertension, medical background is normal for age, surgery on broken foot. blood pressure is reading 136/90 at pharmacy...this is staying consistent. Normal diet. Is this something we should worry about?",
    "doctor_response": "136/90 is not a reading that should make you worry. Instead you should be cautious and start taking precautions. I would have advised my patient to bring the blood pressure down to around 120/80. The measures include regular physical activity with cut down on sedentary activities, a well balanced diet with reduced intake of salt and activities that reduces stress in life like meditation and others. I would follow up my patient for 6 months after lifestyle modifications. If the blood pressure remains the same despite intensive lifestyle modifications, I would suggest medications at that stage. Hope I have answered your concerns. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having pain under rib cage.\n\nI am hurting under my rib cage and I am having problems with diarrehia and dizziness severe pain, what is this?",
    "doctor_response": "Rib cage pain could be an injury or strain related or even a gastric one. Diarrhea and dizziness are related and this shall go more in favor of Stomach problem say an infection like which needs to be treated with a course of antibiotics.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for red bumps after eyebrow electrolysis?\n\nHi, I had my eyebrows electrolysis treatment done by an electrologist. after treatment, the treated area had red bumps and was hurting a lot so I applied a little bit of the trimelasin cream on the effected area before going to bed. The next day, when I got up my eyes were swollen and the vein under one of my eyes was  also swollen. Swelling  went away within 3 or 4 days but now the skin below my eyebrows is loose and kind of sagging. I had very wide and awake eyes before but now I am very concerned about the loose skin on my eyelids. I also would like to mention that she poked one of my eyelid with the needle during the treatment and the poked skin is more saggy. I wonder, this loose skin is because of the electrolysis or because of the tri melasin cream. How can I treat it. I had my treatment 6 days ago. Thanks.",
    "doctor_response": "Hi,You seem to have post inflammatory swelling and oedema/sagging developed after electrolysis of hairs. Consult the dermatologist for the perfect diagnosis and proper treatment. I would recommend you to take rest for few weeks. You may take a course of antibiotics and anti-inflammatory drugs...okHope this helps.Dr.Ilyas Patel, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is anti rabies injection needed for children after a dog bite?\n\nHello my daughter is 7 yrs old she has been bittne by a 4 yr old dog that has a history of roaming loose in the neightborhood all hours of the night. animal control confirmed with me yesterday that the dog has no current rabbies vacine, my daughter has about 15 small puncture marks and three large claw scrathes all of which bleed some have gotten swollen and red. its now going into day three of injury. the local er says no need to have anti rabbies but I dont agree with them what are your thoughts. She ran a fever in the first 24 hours and then has vomited from the augmentain she cant keep it down??",
    "doctor_response": "HelloIn my opinion Your daughter should get anti rabies vaccine as early as possible .Post exposure prophylaxis of RABIES.Human rabies immune globulin ( HRIG).Administer 20 IU/kg body weight . If anatomically feasible , the full dose should be infiltrated around and into the wounds ( as she is having 15 small and 3 large wounds , so this is feasible ) .Vaccine=== Human diploid cell vaccine ( HDCV) or purified chick embryo cell vaccine ( PCECV) 1.0 mL intramuscular (I M ) ( deltoid area),one each on days 0, 3 , 7 and 14 .In my opinion anti rabies vaccine in most important for your daughter.Get it as soon as possible.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting while on medication for strep throat?\n\nHello, (10/16/14) My 5 year old daughter was diagnosed with strep throat this past week. I was surprised that the culture came back positive as she has had no fever, her throat is not hurting, and no other symptoms except coughing (mainly at night) and a belly ache. She has been on an antibiotic since Tuesday but it has been 8 nights in a row where she vomits about 20 min after falling asleep. We are going back to the doctor tomorrow but thought I would see if this sounds familiar to anyone else? Thanks, Nicole",
    "doctor_response": "Hi..in this scenario there will be intense cough reflex and it in-turn causes vomiting and it is usual. Unless the kid's having low urine output or very dull or excessively sleepy or green bilious vomiting...you need not worry. Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for the cut on head with heavy bleeding.\n\ni cut my head yesterday on the corner of my glass bathroom cabinet, it bled for a couple of hours. its a straight cut and is about 5cm long. i couldn t sleep on that side of my head at all last night and it really aches this morning, will it be ok to leave it or should i go to a walk in centre?",
    "doctor_response": "Hello, As the wound is quite long. It is better to go for wound suturing for proper healing and prevent bleeding. Consult a general surgeon and get evaluated. Nothing much to worry and it can be done under local anaesthesia. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in finger after getting a cut on it?\n\nAbout a week ago, cut my left index finger on sheet metal while working on a farm. It was a medium-depth cut (perhaps quarter of an inch), and about 2 inches long, going from just above pointer finger fingerprint diagnolly along the outside (right, with palm facing downards), and ending about an inch back from the right side of nail. It bled a lot during the initial cut, but hasn t since. I ve been using antibacterial salve and gause/tape to keep it wrapped up. At the moment, the cut itself is completely closed... But from where the cut is, upwards towards the top middle of finger is swollen a little, as well as numb. I can feel pressure, but there is no sensation at all. Is this normal, and is feeling/sensation likely to return, or did something bad happen and I m likely to not get sensation any longer?",
    "doctor_response": "Hi there. Thanks for the query. Due to the wound and swelling on the finger the nerve endings may be injured. It can also happen due to the injury. I advise you to get the wound dressed and apply ice and avoid lifting weights.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for rash bumps and itching on ankles and legs?\n\nYes. I am allergic to sulfa drugs. I have swelling of ankles and legs and rash bumps with terrible itching. Saw my dr on Friday and he thought it was from my connective tissue disease. Well today is sat and swelling is down but itch is still bad and nothing I try stops the itch. The only thing different I m taking is mucinex and I m allergic to sulfa. I have takin before and no problems but got the dm max this time. Ugh. Help",
    "doctor_response": "Hi, The rash could be a diabetes induced erythema of foot or could be due to arthritis (inflammation of joint). As I could not be able to make a final diagnosis without proper clinical examination. I request you to consult your doctor to arrive at a diagnosis and to provide proper treatment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Siva Subramanian, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in lungs?\n\nMy boyfriend hugged me earlier and when he did, he squeezed me so tight I couldn t breathe. But here I am, about 5 hours later, and my chest feels like someone is crushing my lungs from the top, down. It hurts so bad. Please help, I m not sick, but I have mild asthma when I run. I haven t been running.",
    "doctor_response": "Thanks for your question on HCM. In my opinion you are having muscular injury due to tight hugging and squeezing by your boyfriend.  Do try to follow these steps for better symptomatic relief in muscular pain. 1. Avoid heavy weight lifting and strenuous exercise. 2. Avoid bad postures in sleep. 3. Take good painkiller and muscle relaxant. 4. Apply warm water pad on affected site. If not improving in 2-3 days than consult pulmonologist to rule out asthma worsening as you have asthma.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to prevent hurting other people with behavior\n\nI think I am going mad. I can't control my actions, I am scared of hurting people around me, I have tried to get nhs help I have been on a waiting list for a long time, I can't afford to go private but I need help, what can I do? I can't live my life this way for any longer",
    "doctor_response": "ok dear. take olanzapine 5 mg bd for a month. and yes do follow up with me. take  single tablet of clonzepam 1 mg at night before going sleep.  so don't worry. hope my answer is helpful and thankful to you. take care. plz foolow up to know me the effect of the drugs.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for inhaling fungal matter, sickness, asthma, wheezing, high BP, joint pain in hip, water retention?\n\nI am almost sure that I inhale some sort of fungal matter. I have been very sick, asthma, wheezing, blood pressure is always high. I know have severe joint pain in my hip.just above my ankle and also water retention. I explain this to the doctor but he did not believe me, now I am waiting to die.",
    "doctor_response": "Hi and welcome to HCM,   You should take Lasix 1 BD which will reduce water retention and BP.  Take Deriphyllin with Asthalein inhaler.  Antifungal oral treatment can be done.  Take x-ray to rule out any fungus ball in the x-ray.  Detailed examination required to asses further.  Wish you speedy recoveryThanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness, pins and needle sensation in hands and feet?\n\nHi I have the same problem of feeling like slipping. no problem on grass or carpet.also pins and needles in hands and feet at times. I slipped on a tile floor 3 years ago.suffered a small brain injury however don t feel like I have completely recovered. memory loss ,able to do things that are every day stuff however have no confidence to try new challenges. feel like the side of my head that was effected is abit dull in responding( left side) it s my right foot that has slipping sensation.",
    "doctor_response": "Your narration about your head injury is not complete. I am assuming that you have unilateral complaints of pins and needle sensation along with slipping on right side. Then it can be related to head injury on left side of brain around motor and sensory cortex. However if you have pins and needle sensation in all limbs then you have to be evaluated for causes of peripheral neuropathy like diabetes, renal function, nerve conduction study, immune profile.  Hope you recover early.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can painful finger tip swelling with spotting be treated?\n\nI have a red swollen area on mp pointer finger with a white spot in the middle that has a blackness under the white spot. I can t recall being bitten by anything and my whole finger is in pain. I have tried to bring the swelling to a head so that it might bust and release some inflamation and pressure but no luck. It s been 4 days and it is extremely painful. Any ideas of what this might be or what i can do?",
    "doctor_response": "Hi,you are having infection in your finger, and this could be tenosynovitis, where the tendon sheath gets infected and filled with pus, it has a poor prognosis, so I would advise you to see a hand surgeon fast and get it explored and drained out, then you will need rigorous therapy to heal faster and preserve movement in the finger",
    "dialogue_context": ""
  },
  {
    "patient_message": "How serious is a corpus callosum lipoma?\n\nHi, am 23 years old and i am diagnosed with corpus callosum lipoma. i suffer often from headaches, (thou i do wear glasses and maybe this is the reason) but besides this there arent any other symptomes .. as much as i know. So can you please tell me how severe this is, and if any other side effects appear in future. Thank you very much",
    "doctor_response": "Hi, corpus callosum lipoma is benign tumor in the centre of brain.Mostly it is asymptomatic or presents with seizures.Generally surgery is not required .It is not severe and side effects dont appear.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of lupus?\n\nhello i have been diagonosed with lupus but the doctors i have seen wont give me anything for pain. i also have a rash that feels like a bee sting along with the other symptoms of lupus. could my doctor have over looked somethingi am tired of living on steroids.",
    "doctor_response": "Hi and thanks for the query.I am Dr. Alok and very pleased to be assisting you with your health questions today.Lupus can affect any part of body, but classic presentation is triad of fever, joint pain, and rash in a woman of childbearing age.  Patients may present with any of the following manifestations-- fatigue, weight changes, skin rashes, oral ulcer, hair fall, shortness of breath, urinary problems etc.I think you should see a rheumatologist as soon as possible, because there are many good medicines available other than steroidsHope this helps and provides answers to your question.I wish you good health.Dr. Alok",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood and pus in urine after undergoing lithotripsy?\n\nI am 32 year old female that had a lithrotripsy done three weeks ago on a 5mm stone and now I have blood and pus in urine and another stone doctor is going to explore it in the morning to see if it is lodged in uretha what can be causing all of this now",
    "doctor_response": "Hi,Thanks for writing in.Most persons pass blood in their urine after the lithotripsy procedure. This is normal and should clear after several days to a week. Blood and pus can be due to injury of ureter by dislodged smaller fragment and subsequent infection. Lots of fluids should be taken to encourage the flushing of any gravel remaining in the urinary system. Treated persons should follow up with a urologist in about two weeks to make sure that everything is progressing as planned. You may need to take a course of antibiotics to control infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does tooth decay affect my body?\n\nHi!I have been feeling sick for quite some time, fatigued, lethargic, and dizzy.  I switched dentists and went to my annual check up during this evaluation the dentist recommended to have one of my amalgam fillings removed, to which I agreed.  When the dentist removed the filling, she found pieces of cotton and metal in the tooth that had been left there, decomposing for more than ten years.  The dentist prescribed antibiotics for a possible infection.  I wonder if my body has been fighting a tooth infection for some time and how that has affected my health.  Also, I would like to know how to boost my immune system.",
    "doctor_response": "Hi..Welcome to HCM..As per your complain in case if you have a deep decay in tooth that has become chronic due to not treating it, it can cause septicemia and bacteremia that is due to advancement of bacteria from the site of tooth infection to the body via blood and can cause infection with symptoms like fever, lethargy etc..But in your case it does not seems to be the cause and the problem of fatigue, dizziness and lethargy does not seems to be due to tooth infection caused by cotton placed in the tooth as you did not have pain in tooth that means the infection did not progress deeply..So my suggestion is to consult a General Physician and get evaluated and a thorough clinical evaluation and investigations like complete blood picture and also checking up your ear and MRI scan can help in diagnosis and treatment can be done as per cause..As far as tooth is concerned, it does not seems causing these symptoms, however you should get a proper tooth coloured filling done for saving the tooth..Hope this helps..Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump in breast with family history of lung cancer?\n\nhi i have a lump in my left breast but the pins and needles are in my nipple and all over the breast im scared cos my mum died of lung cancer can you please tell me its fine.i am 37years old.i have been going throw the change of life from i was 28 years old can u help",
    "doctor_response": "welcome to Health care magic.1.The lump in the breast need to be evaluated - you can't ignore.2.Letus not think of needle and pins instead get an Ultrasound breast done and find out the nature of the lump ( ductal dilatation/cyst/solid/mixes/calcifications)3.Once the nature of lump is found, one can act accordingly.4.There are familial cause for cancers - but its not definitely a cancer so do not worry - first let evaluate.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had a miscarriage. Have minor spotting, cramps constantly. Done CAT scan. Is it a cyst or a fibroid?\n\nHi-I live in Dubai but am back in the US visiting family.  While in Dubai, I'm sure I got pregnant and had a miscarriage.  I couldn't see a doctor about it, it's illegal to have a child if unmarried in Dubai.SO here I am in the states.  It's bee three weeks since the miscarriage took place.  I've had minor spotting since then, and the cramps weren't as bad as those first few days.  I noticed a pain that wasn't going away.  When I looked online, it was exactly where my fallopian tubes/cervix are.  It's a constant pain that has been growing since yesterday and got so painful that I went to the hospital.  The doctor seemed more worried about the fact that I could have appendicitis than the whole pregnancy/miscarriage itself.  She decided to do a cat scan.  Four hours later, I was released from the hospital with a sheet that said \"lower abdominal pain, follow up with a doctor in three days\".  I asked the doctor at the hospital...is there a cyst, maybe a fibroid, maybe infection, maybe I'm not healing up properly.  SHe looked at me as if I was crazy every time I talked about the miscarriage.  She said she would have to do an ultrasound to find those but that the cat scan didn't show anything, and the blood work said no inflammation or pregnancy. SHe mentioned that it could be irritable bowel syndrome, since I also mentioned that I had hemmorhoids that started yesterday.  I have had that before and I remember it being much higher up than my vaginal area.  I'm not looking to be sick.  I'm aware of my body and I know this isn't normal.  Are cat-scans as accurate as ultra sounds when it comes to miscarriages?  COuld she have missed something or am I going crazy?  Many thanks--Jillian",
    "doctor_response": "Hi, I think you are getting worried day by day. The best information you could get about your miscarriage is through Ultrasound.some spotting is common after miscarriage but make sure there are no products left in your uterus. You may also develop a pelvic infection foll.a miscarriage which needs a course of antibiotics.You can take a gastro consult for your cramps and haemorrhoids. I think mostly your scan should also be normal, dont worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Weight gain after mirena, distended stomach, episode of dry patches on face, body pain, continuous cramping. Reason?\n\nI had the mirena placed on Thursday of last week (6th) since then I have gained 6.5 pounds, I look like I am 9 months pregnant and grossly distended, then this morning I woke up and could hardly open my eyes due to hives on my eye lids, and I also have dry patches all over my face. My entire body hurts and I am horribly tired dispite sleeping most of the weekend. I had it placed not to prevent pregnancy but to stop periods as I am having an iron absorbtion problem which is making me extremely anemic. I am beginning to think that it is the Mirena causing these new issues as I don t know what else it would be. I also have not stoped having cramps since it was inserted.",
    "doctor_response": "Hello!Weight gainmenstrual irregularitiessleeprashdistended stomachare the side effects of mirena.You should consult to your doctor to see another method  to stop your bleeding.Take care of your self",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does fractured skull take time to heal?\n\nmy partner had a fractued skull on the 11th june and we are ment to be going on holiday on the 07th seotember he is ment to have a check up scan before we go but they are now advising this might not be possible is it still ok to go we need to fly for 4 hours?",
    "doctor_response": "Hi and welcome to HCM. Thanks for the query. It takes up to 6 weeks till skull fracture heals and it would be advisable to do follow up ct scan before trip. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain and vomiting?\n\nHi! My question is about my 10 year old grandson. He has had pain in his upper middle just below where the middle of the chest is. He has had this since Thursday. He is not running a fever, if he walks around for a short time he throws up. He has not ate much at all and he does not feel like eating. If he eats the pain gets worse. My question is could this be something serious and my daughter should take him to the ER.",
    "doctor_response": "it may be heartburn/dyspepsia due to peptic ulcer.should avoid caffeinated drinks and should take proton pump inhibitors as advised by physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, clear discharge. What is going on?\n\nHi, I m trying to conceive! I was suppose to ovulate November 1-5 & I ve been producing Cervical mucus Oct.26 and OCT.29 I had wet/milky mucus, I had intercourse that day. Yesterday October 30 I had strechy cervical mucus and had intercourse aswell. Now this morning October 31 , I woke up to pee and I rushed to the restroom because I felt I was going to start my period early but when I sat on the toilet clear disharge came out. I don t know if I started ovulation early and that was a sign of the last day of ovulation or just disharge cleaning out. I want to know what s going on or would I have a chance in becoming pregnant??? PLEASE HELP!",
    "doctor_response": "Hi, As you had intercourse around time of ovulation you have good chance of pregnancy (25-35%) if other factors(semen analysis, patent tubes) are fine. Wish you good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes decreased CBC levels while suffering from fibroid?\n\nHi there. Ive been having significant drops in my H&H. I dont have my print out with me, but I am reticing. My Iron saturation is 4. Im going to assume I have fibriods? Each month my CBC values have been declining. My question is : Will I need a transfusion if I postpone getting my fibriods removed?",
    "doctor_response": "HiBased on your query my opinion is1. Yes, fibroids can cause a fall in hemoglobin values and parameters related to RBC.2. This is explained by the effect of sub mucosal fibroids which can cause increased bleeding, so blood loss results in decrease RBC counts and Hemoglobin.3. You need to get it removed if it is a large fibroid and sub mucosal in location.4. Transfusion requirements depend on how much your Hemoglobin is. If its less than 7, you will require transfusion, if not it can be corrected by parenteral iron therapy.Hope this helpsRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are some home remedies for the treatment of cystic acne on the face?\n\nHi I have moderate to severe modular and cystic acne. I need some relief ASAP. My face looks like it has burns all over it. My face wash does not seem to help (Affinia Facial Care System by Melaleuca) and my lotion (Pond\u2019s Clarant B3 Dark Spot Correcting Cream) only seems to clog the cyst/nodule more. What is some home treatments I can do to help my face? Can I use Triamcinolone Acetonide 0.1% Cream on my face for those types of acne? Is African Black Soap better for this type of acne?",
    "doctor_response": "Hello, Treatment of acne depends on severity. The creams that you are using are not used to treat acne. Mild to moderate acne we may use antibiotics oral like Doxycycline or topical like Clindamycin cream. Isotretinoin cream can also be also used. However for severe or cystic acne the only treatment that works excellent is oral retinoids. the work magic to help severe acne.These are only advised by specialist and strictly Contraindicated in pregnancy. Pregnancy should be avoided for an year after its use. So if you acne is severe you can see a dermatologist. This may work very well for you. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mahboob Ur Rahman , General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My wife has calf pain that aggravates in the night. Why?\n\nHello doctor, My wife, who is 30 years old, having pain in both legs\u00a0in the calf area. She is having pain throughout the day, but seems to be aggravated during night. It started two to three weeks back, but it has become severe now. She is also having pain in both heels.\u00a0Please help.",
    "doctor_response": "Hi. I have gone through your query and can understand your health concern. For further clarifications consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for edema in the lower legs and ankles\n\nHello Doctor; I m suffering from Edema ( lower legs and ankles). Have had all the test and have turned up nothing. Been to two (2) other doctors, so far no-one has any answers. My last visit with an M.D. said the vales in the ankles and feet is NOT opening and closing properly. Any suggestions would be greatly appreciated. (Short of using a meat cleaver to remove the same). Thanks, Jim.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Bilateral lower limb edema has variety of cause but mostly when a patient presents to me with the lower limb edema my first preference is to rule out heart,liver and kidney pathology for which i tell my patients to get ECHOCARDIOGRAPHY for heart, renal and liver function test and if still nothing comes out to be positive then i would suggest them to get doppler ultrasound of both limbs to see for vascular pathology and even if that is inconclusive then i would label it as dependent edema and would tell my patients to avoid sitting with legs hanged and sleep with a pillow below both legs to elevate them above heart level. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for obstructive pulmonary disease?\n\nhi i receantly quite a job that was making me sick had blood in my pool and recently got back my chest exray and i have obstructive pulmonary disease and am going for a castonoghfy when i was working i constantly complained about the gas fumes could this be the cause of my illnesses and how can i test for it doctors keep telling me there are no test",
    "doctor_response": "Thanks for your question on HCM.Yes, you are right. Chronic inhalation of chemical fumes can lead to chronic obstructive pulmonary disease (COPD).And if you are smoker chances of COPD are more.So gas fumes can cause COPD.The cornerstone of COPD diagnosis is PFT (Pulmonary Function Test). It will not only diagnose COPD, But also tells you about severity of the disease. And treatment of COPD is according to the severity of the disease.So better to consult pulmonologist first and discuss all these, get done PFT and start treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does tendinitis take to heal?\n\nI have tendinitis in my left hand and its in a splint and I have to have to take it easy on that hand and right hand because I have tendinitis in the left and the Drs are concerned about the right hand as well, I have no splint on right also I\u2019ve been diagnosed with Osteo Arthritis, They said I will have splint on till 6 weeks, I have to do limited activities on my right hand I do not have a splint on right hand.. I am 56 years of age how long does it take to heal tendons?",
    "doctor_response": "Hi, Tendinitis, if it is not getting well with medicines and support. Should be treated with local injection of steroids or PRP, PRP is a better choice. If there is no improvement with injections then surgery may be required.T here is no use keeping it in a splint for a long time. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What would cause a high AST level of about 108 from the blood test?\n\nMy blood test results show high level of AST. During 1 year from 86 to 108. I don t drink alcohol and my diet is pretty balanced. I also have unpleasant feeling under my right ribs and fatigue. What could be the cause and what shall I do to lower AST down? Thank you in advance",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.An AST or SGOT level of 108 is not very alarming.A right upper abdomen discomfort can be due to many reasons like- gall stone disease- hepatitis- pancreatitis- a liver abscess (fever would be present)to name a fewIt would have been great had I examined you on my own.I would suggest you to get an abdominal ultrasound done. This will help in the diagnosis.Do not worry.Visit a gastro-enterologist. He/she can examine you and correlate clinically.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes soft and foul smelling stools in a child?\n\ni have a girl 2 years old her stool is soft and pus cells are 6-7 protozoa are nill and direct examination few fecal leucocytes . culture negative for salonellla,shigella and staphyllococcus aureus . the stool smell very bad and she stoll immediately after she have food. please advice the reason and how to treat her",
    "doctor_response": "Hi, What your kid is having is not diarrhea and is only gastro-colic reflux. It is quite common for babies of this age group to pass a small amount of diarrhea or loose stools soon after feeds. This need not be treated as diarrhea and especially antibiotics are not indicated. When the kid takes food, the stomach expands - then when it is contracting it sets off a waveform which moves down the intestines and when that wave reaches the lower down rectum, a small quantity of the stool is evacuated out. This is the basis for gastro-colic reflex. Do not worry. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. The other possibility when it related is passing motion immediately after food is that it could have been worm infestation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stabbing pain across abdomen in woman on arthritis and cholesterol medication?\n\nI am a female 57, Hispanic and I have had several episode where a stabbing pain that runs across my abdomen. It also comes around to the back.  It only last a couple of seconds. It's happened a few times. My stomach on the left side is a little puffy, and I burp alot. I have had a hysterectomy about 5 years ago. I have prediabetes and take lodine for arthritis.  I also have hypothyroidism and have blood pressure and choleterol medications. Can you tell me what might this stabbing be. Thanks. oh i also have lipomas around my back and possibly under my rib cage.",
    "doctor_response": "Hi ! Good morning. I am Dr Shareef answering your query. If I were your doctor, I would go for a liver function tests, and an ultrasound of abdomen to rule out any pathology in the liver due to the anti cholesterol medications. Apart from that, I would also like to examine you clinically to rule out any pathology in the abdomen. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy while on birth control pills?\n\nI am on birth control and take it usually at 10 on every night. Last Friday I had unprotected sex with my boyfriend withdrawing and didn t take my pill that night, but instead at 9 am the next morning, and took my Saturday pill at the normal time. (This was on my third week of pills) I am now on my placebo pills and am late for my pill, is there a chance of pregnancy?",
    "doctor_response": ". It is my pleasure to assist you today.There are less chances of pregnancy when on birth control pills. As far as the missed/late dose is concerned it is ok as after unprotected sexual intercourse you have 72 hours to take the contraceptive pill. And you did in that window period.If you are still worried or in doubt, better option is to go for an OBGYN visit who will confirm for you the chances of pregnancy after going for an Ultrasound abdomen and pelvis.I think it is all you needed an answer for today. If you have more health related issues you have the option to contact us anytime.  We , the HCM team will be more than happy to address your issues with care.Healthiest Regards!Dr. Sumaira Kousar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Scar on nose, using hydroquinone, tretinon, fluocinolone acetonide, kojic acid and vitamin c, reappears when exposed.\n\nI m a 17 years boy and i lack my self confidence and suffer due to a scar at left side of nose from last 10 years. The scar usually covers upto whole left nose area.  I was advised by a doctor to use hydroquinone,tretinon and fluocinolone acetonide cream @ December 2011  I continuously used and some difference appeared on it.Then after when the scar seemed to be gone (not fully but somewhat lightened), it reappeared with some darkening whenever i used to go outside(even usin suncreen >50 spf).  Now the problem is that i was advised by healthcare magic's doctor to use kojic acid and vitamin c cream but it also had a slight affect .. and the main problem is the redness of scar. Also my scar has somewhat dotted appearence.....  please do something doctor because i cant even focus on anything else and have tried lot of creams ... and my grades are decreasing due to this scar bt my parents never understand. PLEASE TELL ME SOMETHING USEFUL TI RELEIVE FROM MY PAIN ..!!!!!!!!!   i want to be anonymous dats y i m not giving my name(Hope u understand)",
    "doctor_response": "Hi scar on the nose should be differentiated from black mark.actualy scar cannot be removed by medical treatment.black marks can be removed by kojic acid but it should not be used alone in sensitive individuals it should be mixed with moisteriser to get it cured..use if sunscreen is the must in the morning.if no response go for chemical peels like azalic acid or mandelic acid",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Paroxetine cause social inhibition and fatigue?\n\nI m 52 and taking a 30 mg Paroxetine each day...I have always woken up at 4:30 am since I was a small girl...I find lately that by the time I m done with work at 3 or 4 each day...I freeze up and can t go out the door to socialize... It s so hard...I want to have a social life, but I m physically just tired....when I wake up at 4:30, I am wide awake so I read and do some personal enrichment things....spiritually and cognitively....many times I go back to sleep...and feel so awesome when I wake up....just wondering if this is a normal thing for someone my age and if it will pass.... YYYY@YYYY",
    "doctor_response": "in  my  opinion   plz  make  sure  thyroid  ,  kidney  function   are  okayand  hemoglobin  levels  parole tines  can  cause  fatiguebut  not  social  inhibitionplz  get  involved  in  social  activities   slowly  inhibition  will  go  away",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for Moles in face?\n\nhi.. my name is ansar im 50yr old.. i had moles on my face which usualy developd after menupause.. nw 4 weeks ago i had Laser treatment for the moles ..its been 4 weeks since treatment and my skin is not coming bak to normal as there are brown coloured spots left on the  treated areas... now what shud i do? is there any medicine or cream for this?",
    "doctor_response": "Hello. Thanks for your query.You seem to have developed Post-inflammatory Hyperpiegmentation , which is common after a Laser procedure, specially if sun protection was not strictly adhered to.If I was the treating doctor I would suggest that you use a broad spectrum sunscreen, throughout the day. Your sunscreen should cover both UV A as well as UV B part of the spectrum. You may find a sunscreen OTC from a drug store or you may ask for a prescription for it from your dermatologist.For the spots, I would have normally recommended you a skin lightening cream containing one or more of the following ingredients e.g Kojic acid, Glycolic acid, Arbutin, Hydroquinone etc. These ingredients are available in various combination in a cream formulation. These creams are prescription products and you may visit your dermatologist for the same.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can poor weight gain in a toddler be managed?\n\nHi doctor i m from Bangladesh... My daughter age is (3 years).. she do not eat any food (like khichuri, egg,rice) sometimes she eat some meal... but she only eat milk... when she was hungry only taking milk... my friend suggest me e practin syrup.... what i can do? plze help me.... (her weight &height also perfect but she does not take her meal properly)...",
    "doctor_response": "Hello, Let me begin by saying that all tonics and medicines are unnecessary.  All attempts at forcing her to eat must be stopped.  There must be no persuasion on your part, no coaxing, no bribing, no threatening, and no punishment. All tricks to make her eat must be absolutely stopped.  No walking about the room. She should sit up at the table and eat the food or leave it.  Mother, you avoid anxious looks at the plate and no need for praise when she eats her dinner. No negative attitude if she does not eat and no suggestion that she is being naughty.  Your daughter should not be prevented from doing what she wants to do because she has not eaten her dinner.  If she does not want the meal, it should be taken from her. There should be nothing between meals. This includes milk.  She must wait until the next regular mealtime.  If it happens again at next meal, she should still be left without food.  She will soon eat when she gets hungry and no one makes a fuss about what she eats.  You may allow her to eat some of the meat course, then dessert, and return to the meat. Her mother, you, should make it plain that the food in front of her is all there is and that if she does not like it, she can leave, but that is all there is. Make her food attractive, with bright colors.  Put a small amount on her plate and let her ask for more.  There should be variety so she does not get tired of one food.  With her poor appetite,  give her no more than a pint of milk per day.  She should be allowed to help prepare the meal, helping with potatoes, fruit, and pastry.  Allow to have meals with her parents or other children. If she is playing with her food when the rest of the table has been cleared and washing up has been done, her food should be removed.  If she cries, make no fuss, just allow a reasonable amount of time for her to eat, and then without any threats or argument, remove the food. See that she gets as much outdoor exercise as possible and avoid over-fatigue. A healthy three-year old needs 11-12 hours of sleep over a 24 hour period. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest infection with back pain and shortness of breath\n\nhi. i am 2 weeks post total laporoscopy hysterectomy. i have been treated for a chest infection which is now worse and i have pain in lower back,grion area both sides and to the sides of my back with some stabbing pains and shortness of breath under left ribcage. any idea's ?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Since you had pneumonia, we should rule out 1. Worsening of Pneumonia 2. Post infectious bronchitis. Both of fluids them can cause symptoms like cough, expectoration, chest pain, shortness of breath etc. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Repeat chest x ray to rule out worsening of Pneumonia. 3. PFT (pulmonary function test) for the diagnosis of bronchitis. You may need higher antibiotics, inhaled bronchodilator and inhaled corticosteroids on the basis of above reports. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a decline in the RBC & WBC count?\n\nI had a complete blood picture along with some other blood tests due to chest pain symptoms. All tests were fine but the RBC and WBC showed slightly low levels. The cardiologist I saw said this was likely due to a previous virus (although I have had no complaints) I am also experiencing a lot of headaches and fatigue should I go any further with investigations or just put it down to low immunity right now. Its written Normochromic anaemia and WBC shows leucopenia?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have anemia and leukopenia. It is very common in viral infection. You may have viral infection in past and it goes unnoticed. No need to worry about that. Just go for repeat blood test after a month. It will back to the normal. Just put it down to low immunity right now.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can betadine and albothyl inserted at one time ?\n\ni am 27 yrs old and married my doctor told that i am having cervical erosion in severe condition and she suggested me betadine and albothyl along with some oral priscription should i insert the both betadine and albothyl together",
    "doctor_response": "Hi, Thanks for query, Along with Albothyl suppossitories,other local application is not recommanded but as betadine is prescribed along with by you gynaec so after his advice you can start. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fuzzy feeling in head?\n\nI have been having a fuzzy/dizzy feeling in my head. I also hear a sand noise when i turn my neck. I took blood test and they were ok, I had a cat scan and it was fine. I normally try to stay away feom the Dr because when I told them they dont believe me.They think I am making it up. However Ive never missed a day of work nor had anything more than sinus problems.",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern, your symptoms could be due to the less blood supply to the tympanic membrane this is the near possibility can be granted, and for that I would suggest you to take the following drug,1) Tab Betahistine three times in dayI hope this information helps you take care and have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is breathlessness associated with heart disease?\n\nI am a 67 yr. old female with RA. I am having some lung breathing problems, shortness of breath, the last digit of my fingers on both hands filled with blood where they felt like they would burst open. I put them in a pale of very warm water. It has helped considerably. Is this a problem with my heart or what else could ite? Ms. wallace",
    "doctor_response": "Hellothanks for posting here. rheumatoid arthritis is a disease of the joints leading to sever pain, swelling  and deformity of the joints, mostly affrcting the small joints of the hands and legs ( wrist, fingers and toes). Rheumatoid arthritis also causes a disease affecting the lungs called ILD which i suppose is the cause of your breathing issues. your swollen finger joints are most probably due to rheumatoid arthritis and the associated lung disease. The symptoms of heart disease are chest pain, breathlessness on exertion initially later progressing to breathlessness at rest, fatigue, left arm pain and decreased effort tolerance. since your symptoms are already explained by RA  and lung disease i dont think there is an element of heart disease.wishing you good healthRegards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for gas pedal position causing leg/thigh/calf/butt pain?\n\nGas Pedal Leg Pain after about 45Min to an Hour in the Car. As soon as I get out and walk it is gone. No other Walking or Sitting Position does this happen, only when in the Car after an Hour or so. Sometimes in the Right Butt, others the Thigh and/or Calf. Always on the underside ??",
    "doctor_response": "Hello, As mentioned in history, I feel you are getting nerve entrapment while driving the car. This could be due to the weakness of the muscles of the lower back and hip. That is where the nerve is getting trapped and the pain is felt in the hip, thigh, leg and foot. Having examined by an orthopedist should provide insight into the symptoms along with an MRI scan of the lumbar spine. Usually, in certain positions, there is pressure over the nerve roots and this may lead to the symptoms you having. In my practice of 12 years, I have seen many CSR drivers complaining about the same symptoms. They all responded well to physical therapy. I will recommend you also the same, do some physical exercise for strengthening the muscles of the core, back, hip, thigh and legs. This should help you. For time being I will advise you to take frequent breaks while driving the car. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hoe to get rid of a tumor that keeps growing back?\n\nmy aunt has brain tumour stage four she did her third surgery about two months ago when she went back for a check up they did a cat scan an said the tumour grew back an there is nothing they can do about it so i would like to know how long she has to live",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  Life expectancy and prognosis depends on type, stage and behaviour of your brain tumour.  It is stage 4 cancer so irrespective of type prognosis remains poor. No surgery is possible in this case.  Palliative radiotherapy is the only option.  And life expectancy is very low despite of treatment. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes throbbing neck pain and twitching of eyes?\n\nThrobbing pain base of skull and back of head ,feel some relief with moving head and neck. Also pressure and twitching of eyes. mostly right eye . pain is about 8 or 9 on scale of 10. But responds to aspirin. Also have had some strange sensations near left ear.",
    "doctor_response": "Hello!Welcome on Healthcaremagic!Your symptoms could be related to different possible causes: migraine, hypertension or an inflammatory disorder. The fact that the pain is relieved by head and neck movements could indicate a tension type headache. Anyway, I would first recommend measuring your blood pressure values. If your blood pressure values are normal, I would recommend consulting with your GP for a physical check up and some tests: -a cervical spine X ray study-complete blood count, sedimentation rate and PCR for inflammation. If these tests result normal, you should consider tension type headache as the main cause of your complaints. In such case, painkillers and physical activity (Yoga, recreational sports) would help improve your situation. Hope you will find this answer helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and lump in abdominal area?\n\nHave had a pain and soft lump with constant vibration and sounds about 3 inches left of my belly button for 8 to 9 months. Cannot sleep and recently it seems to have moved lower to the left groin area and is causing spasms in my left lower leg. Had an ultrasound of the abdomen and a mild hepatomegaly was noted also a slight thickening of the gallbladder wall. The doctor listened to the first area with her stethoscope and said she never heard anything like it and put on brown rice water diet, charcoal tabs and a mild diet which did nothing. Barely have appetite and am taking probiotics, green juice and eat a small meal. I am a 51 year old male, 185 lb , 5 10 .",
    "doctor_response": "Hi.Thanks for your query. With the history you have provided about the pain and soft lump in the area you mentioned and the shifting and other associated things you need to go for the following investigations:Enteroclysis - to see for intestinal obstruction. CT scan of the abdomen for the mass / cancer/ internal hernia and so on.These will get you the proper diagnosis and the clear idea for the future treatment. This looks to be a Surgical case and consult a Surgical Gastroenterologist for physical examination, investigations and management",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for persisting knot after hitting\n\nHi. I tripped and hit my forehead on the curb. I had a huge knot on my eyebrow with a scrape on it and a black eye appeared the next day. I immediately iced the lump after I fell. My question is: 4 days later should there still be a knot and what can I do about it?",
    "doctor_response": "Hi,It seems that there might be having hematoma formation following injury.Now blood from hematoma gravitated down in the eye giving black eye.Now there might be having small blood collection in hematoma forming lump or knot.nothing to worry this will be absorbed gradually.Apply ice pack for few days.Apply thrombophob cream locally.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Developed rashes, redness and blotchiness, no itching, cough. Tried benadryl. Is it an allergic reaction?\n\nMy son has been developing a rash that is red and blotchy, but not raised.  He says it does not hurt or itch and it goes away using children's benydryl.  He also has had congestion and a mild cough lately.  The rash is only on areas not covered by clothing.  It is also on his ears.  It seems aggravated by headphones, is it possible that a brand new pair of headphones is causing an allergic reaction?",
    "doctor_response": "Hi yes there is a possibility of brand new earphones causing the rash but usually allergic rash is itchy.it think in ur case it can be due to sun allergy or milaria due to excessive sweating .even then rule out other viral rashes where itching is minimal.use of benadryl tablet along with vitamin c chewable tablet can cure the condition.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes knees pain, anxiety and lack of taste in food?\n\nMy husband is 52, 6 1, weighs close to 400 lbs. His knees are causing him severe pain. He has actually lost abou 50 lbs in 6 months by trying to eat more natural food (Daniel Plan). He also has familial tremors which also csuse anxiety, he took himself off the medication about 2 years ago. He is experiencing anxiety, feeling bad, fear of having a heart attack, hot to cold flashes, lack of taste in food. Is he experiencing high blood pressure, tremor symptoms or what?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. From the given symptoms, you husband could be suffering from Health anxiety disorder, popularly known as hypochondriasis. But the knee pain must be driving him anxious and all other symptoms related to anxiety being triggered. please work with the doctor whom your husband consults. The doctor will be able to help your husband as he knows your husband's condition better.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does sinus arrhythmia, right percordial repolarization disturbance found in EKG mean?\n\nHi, I just got an EKG done, and it came back saying this: Sinus arrhythmia, Minimal right-precordial repolarization disturbance. I went to my GP today and got this EKG done today. I have been having problems since I could remember. I'm an 18 year old female. My problem is with my heart rate. My resting heart rate, or overall heart rate is ALWAYS elevated. Between 99- over 100, even when I first wake up in the morning. I've had this since I was little, and it always affected me when I played basketball. I would get light headed, see \"tunnel vision\" where everything starts to go black, and I see stars. I would immediately have to sit down because I was afraid I was going to pass out. I walk up a flight of stairs, and my pulse starts to race, and I get all of the symptoms again, tunnel vision, stars, light headed. It's caused me to be afraid to work out because my symptoms ALWAYS occur 24/7. I also have chest pain, especially when my pulse gets really fast. It feels like 2 metal weights are crushing my heart on both sides. Last year I ended up in the ER, and they did a CT with dye, and I was diagnosed with an Aberrant Right Subclavian Artery. I have not been to a cardiologist or anything. This Thursday I am getting a stress test done, with cardo-lite, and ecocardiograhm, and halter monitor. Can anybody please help me out. I've been struggling all these years and I just want answers.",
    "doctor_response": "Hello and thank you for using HCM. I carefully read your question and i totally understand your concern. I will try to explain you something and give you my opinion.You should not worry for your electrocardiogram report. First of all, you should not read what the paper says, because it is just a computer explanation. The electrocardiogram should allways be interpret by the doctor, not the machine. If it is the doctor that gave this interpretation, again you should not worry. Sinus arrhythmia might be normal at your age. Re polarization disturbance is just an electrical term that means nothing at your age.What we should worry are your symtoms during this years. As you explain we are dealing with a rhythm issue.Someone might experience fast heart beats for very different reasons and pathologies. It might be simple  sinus tachycardia to other arhythmias like supra-ventricular tachycardia, atrial fibrillation ect.This are caused from different problems from simple emotional stress to other pathologies like anemia, hyperthiroidism or electrical conduction system anomalies. The aberrant subclavian artery does not cause this symptoms but might rise a suspicion of any anatomic  variation on your electrical conduction system of your heart.So my opinion is that now its time to meet the cardiologist and do all the thinks that you have planed to do. The most important the holter monitoring, preferably for 48 h. This will help to see what are this fast heart beats.In mean time avoid caffeine products because they rise your heart frequency.Hope I was helpful. Best regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat internal psoriasis when liver and kidneys are not functioning properly?\n\nmy colleague is suffering from internal soriasis and as such his liver is not functioning due to which the kidneys arealso not funtioning properly he is in banglaore hospital and is no dialysis his bp is under control but no sugar age is 35 what is his positiion",
    "doctor_response": "Hello, Since your colleague is suffering from multiple organ failure he needs to treat specifically with limited medications. Please let me know his Kidney function tests like Sr.creatinine, BUN and Liver function test like SGPT, SGOT. Different types of newer medications called biologic s are can be very effective such as Secukinumab (Cosentyx), which is an injection approved to treat Internal psoriasis.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Pramod Kokare, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "When can i conceive again?\n\nI went through normal delivery after five months of pregnancy on 23 nov 2013 as according to doctors my trisomy 21 was at high risk and fish test also came positive, can you please tell me when I can conceive next and I have started clingen tablets today what are the side effects and tell me about the discharge.",
    "doctor_response": "Hi,I read your query and I understand your concerns.Following is my reply:1)  You can try to conceive again after 3 months of termination of pregnancy.Let me know if you have anymore questions.Regards,Dr. Mahesh Koregol",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is surgery advisable for medial meniscus injury of right knee?\n\nI am Babul, My age is 38,Weight 70kg,height 5 -6 .I am suffering from medial meniscus injury of right knee since last two years ago. I was more or less good but from last two month pain of knee is increased then as per suggestion of Dr. I did MRI and report is ACI with medial meniscus injury then i went another surgeon.He suggested for physiotherapy and exercise i e knee banding exercise ,SWD. I exercise started accordingly and feel better than before and In this circumstances what can do about this. I want to know further if surgery, is it safe?Please answer. thanks",
    "doctor_response": "hi,i appreciate your cocern.since u have been better and symptom free for last 2 years,there seems to be some new trigger which is causing problemnow.you are advised to do blood tests to rule out crystal arthropathy at this age.apart fromexercises,and swd,intra articular inj of hyluronic acid and some cartilage improving medicines are also available with promising results in my institution.removal of cartilege is not very exiting choice nowadays,rather it needs to be protected by all means first. thanks.i will be happy to answer future quaries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medication for soreness in back & bottom right side of the body\n\nI have a really sore back, bottomr right hand side and its giving me difficulty sleeping at noght, walking and even when I laugh. I ve also been really light headed, lostt my balance yesterday and fell into a wall, today I ve woke up and the pain has stayed at my back but also travelled to my neck. My friends have said my eyes look funny and black, and I have been experiencing numbness in my thumb. Also I have lost my appetite and do not feel like eating, when I do my very mouth hurts. Help please!",
    "doctor_response": "hello welcome to Health Care Magic I am your physician Dr Prakash I think you did not hit your head but if you did it your head or your spine then I should suggest you should have MRI of head and spine as I think you should be suffering from neurological problem and should consult a Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have mild irritation around the navel. What medicines to take?\n\nHello doctor, I have a mild irritation type around the navel area. What medicines to take? Please suggest medicine.",
    "doctor_response": "Hello. The irritation around the navel area is most likely due to fungal infection, especially if associated with itchiness and redness. So, please provide me with a clear photo and tell me if there is itchiness or redness. A local antifungal cream will be suitable after confirming the diagnosis. The other (less likely) diagnosis is scabies. Is there any irritation in other places of the body? Any other family members with same problem? For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Jaundice.   LFT,  abdominal and pelvic scanning results normal.  Prescribed Ursocol.   Reason for medication?\n\nI am suffering from jaundice. initially three months back my bilirubing was 3.6  after one month reduced to 2.47 and within a week again 3.8. now i have taken LFT and abdominal + pelvis scaning .  results showing normal. doctor prescribed ursocol 300 mg twice a day for 20 days and asked me to come after course. what could be the reason. please help me in this regard.REgardsKSK",
    "doctor_response": "Thank you for your query. Ursocol is a drug which increases conjugated bilirubin and helps in excretion of bile and cholesterol from our body thus decreasing the jaundice.It decreases the raised liver enzyme levels back to normal. It is probably describe because you have fatty liver or sign of fibrosis and cirrhosis. YOu should continue taking it till your bilirubin levels stabilize. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for temporomandibular disorders\n\nI have been experiencing a buzzing/humming sound in my left ear for the last 6 days. I saw an ENT and he felt it was due to middle ear pressure and recommended saline nasal spray and Allegra. My hearing test and ear pressure were normal and except for a small amount of wax in the ear it was otherwise normal. I have not noticed any improvement since starting the recommended medications. Just as a note I was earlier diagnosed with TMJ by my dentist and begun using a fabricated mouth guard. I also has soreness in the muscles be.ow the left side of my jaw. What do believe I need to do at this point? I thank you in advance for your response.",
    "doctor_response": "Thanks for your query. I have gone through your query.The sound near the ear can be because of the disc displacement in the temporomandibular joint. Nothing to be panic, consult a oral physician and get it evaluated. You need to get an MRI done to confirm the diagnosis. You can continue to use the splints. For the soreness over the muscles, you can take an analgesic like ibuprofen with a muscle relaxant like chlorzoxazone(if you are not allergic). For the disc displacement of TMJ, you can take piroxicam. You can also give hot fomentation over the joints. Take soft diet. I hope i have answered your query. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluttering feel in hands?\n\nI have a strange fluttering that i can feel with my hand and see in the mirror about 2 inches below my belly button. It has been happening for weeks now but especially when my legs are drawn up. It is not painful at all just very annoying. I am def not pregnant and have one child who is 9. Should I be concerned or it his just air or a muscle jumping?",
    "doctor_response": "you should not be concerned unless you have any changes in period you can also check you magnesium and zink levels in blood Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this ECG report indicate?\n\nI had an echocardiogram after my doc heard a murmur. My internal med doc said the results were fine however some septum hypertrophy. He advised my to get another echo within 12 months . I m 53, Caucasian male, athletic, no known history of family heart issues. Note: the tech who completed the echo said i would have to have annual echo s. I m concerned even though my family doc doesn t seem to be. Now background: since my divorce in 2010 I ve been drinking too much and I ve been using smokeless tobacco.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I think you may suffering from hypertrophic cardiomyopathy in which people may prone for sudden cardiac death. So that's why they advised annual echo. If it is severe septal hypertrophy may prone to develop ischemia, arrhythmia and Syncope. Few cases sudden cardiac death. Please consult your cardiologist with annual screening then he may advice appropriate treatment for you. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pilonidal cyst\n\nI have pilonidal cyst, for the third time in a year and half! I just had the second surgery last August and they did and excision. I would like to know what there is to do to get rid of this for good. And I would like to know if it could become cancerous",
    "doctor_response": "Thanks for asking at Healthcare Magic. I read your question and I understand your concern. Pilonidal cyst recurrence after surgery occurs due to four reasons. 1. lack of proper surgical procedure 2. prolonged sitting 3 Not shaving the area near tail bone if in natal cleft4. lack of proper hygiene I Would like to advise you to have sitz bath, use to shave the affected area if hairy, proper hygieneand if problem persist then ask your surgeon to have Marsupilzation procedure for its removal. There is minimal risk of squamous cell carcinoma. Hope it helps best. Don't forget to rate this answer and close the discussion at Healthcare Magic. Take your best care. Regards Dr Ejaz",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with vasovagal syncope. Often having faint spell. Happening after inserting pacemaker for bradycardia. Suggestions?\n\ni have been dx with vasovagal syncope . i have within the last 7 months fainted as many as 6-9 times in a day. i have been dealing with this for years but 7 mo ago it went from an occasional faint spell to quite often. i had a pacemaker put in 3 yrs ago for bradycardia but my cardiologist says there is nothing wrong with my pacer and that its not heart related. can u possibly tell me what i need to do to have a normal life again. i cant work, drive, be by myself and i think im going into alzheimers because my memory is bad just x 7 mo",
    "doctor_response": "Hi, Thank you for posting your query. Vaso vagal syncope is a common illness. Cardiac arrhythmia can be responsible for this. I noted that you had a pacemaker implanted for a possible bradycardia. This makes you quite safe and you should be able to resume all normal activities. Regarding memory impairment, please get a check up done. It could be related to anxiety, vitamin B 12 deficiency, etc. A brain scan would also help in diagnosing any underlying brain disease such as ischemia (less blood flow). Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I noticed peeling skin with itchy white dots on my glans penis. Kindly advise.\n\nHello doctor, I have skin peeling on my glans penis and also some white dots near the skin joint on glans. It is a bit itchy too and there is no white discharge. What would you advise? More details about the presenting complaint: Started 2 to 3 days back. I did have intercourse.",
    "doctor_response": "Hi. I have gone through your case. Keep your skin well moisturized by frequent application of liquid Paraffin. Mix Hydrocortisone and Clotrimazole cream in equal amount and apply two times a day for 14 days. Maintain good hygiene. Avoid friction.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does these MRI scan of spine indicate?\n\nhi,My MRI results shows below. Please suggest me to recover from it.Mild disc bulge at L4-L5 with partial extension into both neural foramina causing mild impingement on bilateral existing nerve roots.Mild right foramina disc bulge at L3-L4 with minimal impingement on right side existing nerve roots.",
    "doctor_response": "this mri indicates that you have mild discsno need for surgical intervention if you dont have severe symptoms",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do I need continue the antibiotic if my throat infection reduces?\n\nI am recovering from non type A strep throat. My doctor prescribed me a 10 day dosage of amoxicilin, but told me that unlike a normal course of antibiotics it was not, in this case, essential that I continue to take them for the entire 10 days. She said that if, for example, I felt 100% by day 7, it was ok for me to stop, since strands of strep other than type A are less dangerous and do not actually require the use of antibiotics except to relieve symptoms and speed recovery.I have now finished day 4 of my antibiotics, am feeling well, but am suffering from nausea, headaches, and indigestion from the medicine. I'm taking probiotics to counteract the negative effects but they do not seem to be helping. Is it safe for me to discontinue use of the antibiotics now?",
    "doctor_response": "hello,plz continue the antibiotics for 10 days as described earlier. take esomeprazole for indigestion and dyspepsia. probiotics don't reduce side effects you just described. take them after the antibiotics are over. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment for hair loss?\n\nits mukesh here..!! I qm frm udaipur Sir I am having heavy hairfall from last 1year earlier I used to have very dense hair but now I am loosing hairs at vey high rate My hairs are getting very thin also I have tried homeopathy treatment that stoped my hair fall but after some time its again shreeding.... help me",
    "doctor_response": "Hello, You seem to have androgenetic alopecia.  I suggest you use Minoxidil 5% solution, 1ml, twice daily.  In addition, I suggest you take Finasteride 1mg tablet once a day for 6-12 months. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Kakkar S., Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is hydromorphone safe for bile duct cancer?\n\nMy mom was prescribed 2mg hydromorphone for moderate back pain due to her terminal cancer, her diagnosis is looking like the cancer is bile duct cancer, she just had a stent put in her bile duct because of obstructive jaundice and her kidney and liver function is obviously not good. I did some reading about this drug and it said it s not a good drug to give to anyone with liver, kidney or bile duct issues... I was told that Tylenol and Ibuprofen is not an appropriate pain reliever because they are hard on these organs. So my question is ...is hydromorphone okay for her then??",
    "doctor_response": "Hi and welcome to HCM thanks for the query.if this is terminal disease then yes, it is appropriate but morphine derivates can cause bile duct sphincter to contract so it could worsen her jaundice if stents don't work. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is mucusy bowel movement of a 10 week baby cause for concern?\n\nHi...my 10weeks old baby girl is having mucusy poop in small quantity. This morning she pooped twice which was like a normal ones but then she passed a small quantity of mucus tinged poop. Till now it has happened just once. Is this of some concern? thanks in advance",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.What your kid is having is not a diarrhea and is only a gastro-colic reflux. It is quite common for babies of this age group t pass small amount of diarrhea or loose stools soon after feeds. This need not be treated as diarrhea and especially antibiotics are not indicated.When the baby takes milk , the stomach expands - then when it is contracting it sets off a wave form which moves down the intestines and when that wave reaches the lower down rectum, a small quantity of the stool is evacuated out. This is the basis for gastro-colic reflex. Do not worry. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for BPD\n\nHi I'm a 20 year old (21 in November) male, 6'1\", 170 lb.My concern is more psychological than physical. I've always thought I had some sort of mental illness for a few years now but I always dismissed it cause I don't fit all the symptoms of any disorders I researched online (although I do fit quite a few). But especially beginning last year my suspicions have grown and I seem to have less control over my symptoms. I was miserable most of the year and I did very poorly academicaly (I usually am a scholar). But since the symptoms vary in intensity from day to day, I still tend to dismiss my suspicions on a relatively good day. I really don't like to make a big deal out of nothing but I also feel miserable sometimes so I really would love to have a proper diagnosis. I've suspected many different disorders but recently I've come to believe I have BPD. Could you chat with me so as to make a non-final diagnosis? It would releive me greatly. Thank you.",
    "doctor_response": "HIThanks for using healthcare magicI think, you have borderline personality disorder. It usually happens with patients of personality disorder. They do not fit in one diagnosis. Better to consult a psychologist and get your personality test done. That would help to make proper diagnosis. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for back pain?\n\nHi im vincent im 14 and i started to notice a pain in my back about 3 monthes ago in the dimple of my back and it will hurt when i move my back quickly and move my leg. when it got as bad as it does i cant move at all and the next morning i would feel nothing than about a month later it will hurt again",
    "doctor_response": "Hi, welcome to our site. I am Dr Saumya Mittal, MD.Read your query. That is a very significant question and i appreciate your problem. I will try my best to answer your queryI think that there is some pathology developing in the back. This may be mild at the moment and may be gradually building up. So I would seriously suggest that you move for an imaging modality like MRI/X ray (the former being the preferred modality).The physiotherapy is usually a good option for people who have backache. So look for a qualified physiotherapist around you who may help you with the pain and also the fomentation techniques.Pain killers may be taken once in a while but I would suggest you avoid them as far as possible due to the possibilities of long term problems like gastritis and kidney damageI hope this helps you. Inform the reports mentioned above/if any other so I can be of help further. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you.Please do understand that some details could be extracted from a detailed history and examination.Please feel free to ask another query. I would be glad to help you. Looking forward to your return query with the details asked so that I can help you further. (If the answer has helped you, please indicate this)Best of luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain and shortness breath\n\nDull left mid back ache and unsatisfying breathe. Been 5 days. Noticed after heavy drinking. Stopped drinking. Ache not as bad. Just dull. I feel full at times. But I take a deep breath and it just doesn t seem right. I noticed this several times in past while starting atenolol. I stopped that drug and seemed fine in past. I tried atenolol on 3 occasions and same result each time. Dull back ache and unsatisfying breathe. But I m not short of breathe. No chest pain. No other symptoms.",
    "doctor_response": "hi,thank you for providing the brief history of you.a thorough clinical examination is advised.as one of the side effect of atenolol is the shortness of breath and stopping that should help but for doing such you need to have a word with your physician.Also, back aches are due to similar factors of atenolol as most of the times the role of the drug is to lower the heart rate and also the neural activity of the brain leading to fatigue and dull ache in the backin my clinical practice most of the patients on atenolol has similar isues we advice physical therapy as by balancing the drug prescribed with the exercises a combination works well and the drug pharmacokinetics is improved leading to adaption of the drug with no side effects.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a pimple on my foreskin. Please help\n\nHello doctor, I had a pimple on my foreskin around 15 days ago. I squeezed it and applied an antibacterial cream, but there was very little improvement .\u00a0From the same day, I am having some stomach problem and anxiety. So, I visited my physician today, and he prescribed Vapal\u00a0150 and Cufix\u00a0200, and asked me to follow up after five days. I have attached a picture for your consideration.",
    "doctor_response": "Hello. I read your query and understand your concerns. I hope this helps you. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can fibroids cause problems in conceiving for a patient who has undergone cystectomy ?\n\n.Had a cystectomy 3 years ago removed cyst big as a soda can to and a lot of small ones one the other side. The left side is completely closed off from scar tissue the rt side is open and have eggs. And still haven t conceived. I have tried the ovulation kits that tel me when I ovulate, and I do ovulate still no pregnacy.... Is there anything I can do without going thru IVF? Also just found out I have a small fibroid. Is this preventing me from getting pregnant?",
    "doctor_response": "Hello. Thanks for choosing HealthcareMagic forum. If you are ovulating normally then you can get pregnant without IVF.As one of your ovaries is normal and tube on one side is patent then there should not be any problem in conceiving Just try having intercourse more frequently at least twice daily around the time of ovulation. Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy bump in anus?\n\nHello, I had a itch today so whaited till I got into shower to scratch. Felt like it was wright on my but hole, tried to itch and found out it was a bit inside. Put the tip of my finger in to try to see if I could solve the itch, and found a bump. Not shure if I should be worried. FYI. No anal sex, nore any thing for pleasure goes in their.",
    "doctor_response": "This one is some kind of infection or in worse case it could be some fistula also!Take some antiseptic / antibiotic lotion or cream for temporary relief and if not working then go for a stool examination and see your surgeon.All the best and regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruise on the leg?\n\nMajor bruise on my left leg that seems to be moving down, I m tired, I didn t fall or hit my leg on anything, I don t do drugs or drink and I just don t feel right it s hard to get up and start moving my leg, feels weak but after awhile standing it seems okay -I m sorry but I have no $$",
    "doctor_response": "contusions  due to poor vascularity can cause your symptoms also it could happen without any direct hit as burst of blood capillaries is common i wish u could provide age and sex so i can confirm my diagnosisalso for the part where you imptove with movement it indicates arthritis could be in lower back  causing weakness of your leg muscle i hope my answer helps Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic cough and breathlessness\n\nHard to swallow liquids,coughing,sound of fluid in the lungs breathing heavy with little movement. 70 years old, my husband. Smokes for 60+ years, mod. Drinking of beer everyday. Vietnam vet. Please help, he won t go to doctor and when he did he was told he had a cold. This has been present for 1 year + and sx s are getting worse. He was given at that time Doxy, cough syrup with codeine .",
    "doctor_response": "Hello and welcomethanks for posting your questionLooking at his history this could be a case of lung cancer or a lung abscesshis symptoms and history of smoking is very much suggestive of a long cancerin my opinion you should visit a pulmonologist for the examination and investigations like X ray or CT scan chest as well as sputum culture and microscopymeanwhile you can advise him to do steam inhalation and a cough syrup like BromhexineHope this addresses your questionwishing you bot a very good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen lymph nodes,severe diarrhea,high fever\n\nI have been sick for over 5 days now.  Swollen lymph nodes on both sided of throat.  Sever diarrhea, high fever 101.9, chills, aches and pains.  Thought it was just the flu but now not so sure. Age is 39 female, non smoker, weight is 160lbs.  Now I probably lost 10 from the diarrhea.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have symptoms of swollen lymph nodes,severe diarrhea,high fever which seems to be due to strep throat which is a bacterial infection. Need not to panic about it. I would suggest you to 1) Sip on lukewarm water and take throat lozenges. 2) Antibiotics are first line of treatment option in this case. In case of mild fever you can take Calpol or paracetamol for relief as well as it will relieve throat pain too.3) Avoid spicy and rough food. Take diet rich in soft food. 4) Hot milk with a pinch of turmeric boiled with it at bed time for 2-3 days as it has antimicrobial action. 5) Take anti inflammatory drugs such as Levocetirizine.If symptoms keeps on persisting visit pediatrician once and get it examined. Maintain oral hygiene. Take proper course of antibiotics. Get blood tests done if required.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to interpret semen analysis?\n\nhi,Would you please comment and advise on my semen analysis:PH: 8.0Volume: 3.0mlpus cells: 1-3RBC; NILEpith cells: 0-1Colour: cream whiteViscosity: MucoidConcentration: 0.1 x 106mlIdeal forms: 03%Big head defects: 37%mid piece defects: 30%Pin head defects: 30%Viable: 20%Dead: 80%Active: 02%sluggish: 18%Non motile: 80%",
    "doctor_response": "HIThank for asking to HCMI really appreciate the concern the report given here of semen is not said to be a normal this could a case of Oligospermia means the low volume abnormal other parameters the chances of conception with such semen is minimal but nor totally impossible because just single sperm required for conception, hope this information helps you, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Born with one kidney. Water infection. How do we know its functioning properly?\n\nHi my son is 11 years old he was born with 1 kidney we were not aware of this until he was 18 months old because he was taking into hospital with a water infection he has a test were they put dye into your kidney to make sure it was working properly and hasn't been seen since is this ok or does he. Need further check ups",
    "doctor_response": "HiThanks for the query.A single healthy kidney is often capable of doing the work of 2 kidneys and the patient is often able to lead a healthy life.However we need to do the following tests to be sure that the kidney function is OK: Blood urea and creatinine levels, Urine R&M and USG of the abdomen.We also have to take the following precautions to preserve the kidney function:1) Treat all infections aggressively2) Avoid medications like brufen which are harmful to the kidneys (see your doctor for a complete list)3) Check blood pressure once a yearHope this helpsGood luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden drop in the BP level while on Insulin?\n\nHi, I have been hypertensive for about 30 years and in the last week or so my pressure has dropped significantly. I normally run about 160 over 90 and now it has dropped to around 70/40. I have extensive heart disease with a history of 4 ami s and open heart surgery about 7 years ago. Also I am diabetic and insulin dependent. Just though I would ask if you have any suggestions. I have called my Dr. and waited about 5 days and I get a nurse to call back but no real answer. Thanks in advance for your reply. T om K.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Your query being appreciated, sudden hypotension can not be it self, if you do not have any  symptoms that indicates the hypotension (Low blood pressure ) then it is nothing to worry, because hypotension can not be it self, and if the blood pressure reading that is being here is so then you need to see the ER, one more think always try to see the physician if you have any doubt about your blood pressure and let the physician read the blood pressure, if you are going to read it on your own it may show some error, in absence of symptom it is nothing to worry  hope this information helps. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Pradaxa safe to take in Lupus Anticoagulant?\n\nI have Lupus Anticoagulant and have quit taking cumadin and taking Pradaxa.  Now I have a new doctor who is not sure this is the correct medicine for Lupus Anticoagulant.  I have an appt with a hemotologist tomorrow to check it out.  Do you know if Pradaxa is a safe choice for me?",
    "doctor_response": "Hi,Welcome and thanks for asking.Pradaxa has similar function yo warfarin and can be safely used in recommended doses.However,  do not exceed recommended dosage as anticoagulant action cannot be reversed. Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am six weeks pregnant with sacroiliitis. How will my pregnancy affect sacroiliitis?\n\nHello doctor, I have been diagnosed with Sacroiliitis caused by AS and hypermobility, which I manage without tablets, and by doing exercises, stretching and seeing an osteopath once a month to prevent flare-ups. I have also been refered to a rheumatologist with suspected fibromyalgia and I am still waiting for the first appointment. I have now found out that I am six weeks pregnant and have a few questions. Can I still see the rheumatologist regarding fibromyalgia and treatment for sacroiliitis? How will pregnancy affect my sacroiliitis? Will I get more pain? Are there risks in giving birth? How could I be affected after giving birth?",
    "doctor_response": "Hello,  Welcome to icliniq.com. To answer your questions in turn, yes, that will be fine to see a rheumatologist, they should be able to help you. It is hard to say how pregnancy will affect sacroiliitis. Some people improve during pregnancy and some people worsen but there are things that can be done even whilst you are pregnant. The rheumatologist can help you with this. There are not any actual extra risks giving birth, your joints are inflamed but not damaged. After birth your symptoms may worsen or improve, it is difficult to know at this stage, but again there is plenty that can be done to help. So it would be good to see your rheumatologist shortly after birth. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lumps in armpit\n\nI have a hard kind of a lump the size of a pea deep inside my armpit.its not showing from above but if I poke my finger deep into my armpit I can feel it..I am 27 yrs old female..what can it be..it was not there 6 months before but once after I waxed my armpit last yr November I had boils in my armpit.then the boils went away and I cud feel this pea like lump..sometimes I have a burning sensation in my armpit..I m tensed is it cancer?",
    "doctor_response": "Hi,It seems that there might be having non specific axillary lymphadenitis giving this problem.There might be having some infection in armpit in the past producing enlarged lymph node.Nothing to worry.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes restricted movement in hand along with lightheadedness?\n\nmy husband is experiencing spells in which he is unable to move his right hand. He has a lightheaded sensation prior to these eposides and they last between 15 seconds - 10 minutes. He is on Dilantin and we are wondering if it is not working? He was at an ER yesterday and his MRI and dilantin levels were confirmed as fine?",
    "doctor_response": "Hi,Thanks for writing in.It can indicate that your husband might be having a type of partial seizures. Since MRI brain is normal therefore a serious condition in the brain is ruled out. Dilantin can take some time to work and the response might take few days to show improvement. It is required that he consults a neurologist or an epilepsy clinic for a complete assessment and further investigations like electroencephalogram and a detailed medical history. Should he be taking any medications then these must be discussed in details to know if he his symptoms are related to other medical conditions and medications. Anti epileptics usually take 15 days for any visible improvements in most patients. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do not get freshening deep sleep after masturbating and any time and penis erection not normal. What is the reason and solution?\n\nsir,my age 30 mostly weekly 2time I doing self masturbation.mostly doing night 7  to 11pm in between when I doing after that I go to bed I can't sleep well around 2 or 3pm only I fall in sleep.next day night also some time affect.day time also very fresh never come sleep.what's the problem what the solution. because never deep sleep my penins never erect normaly..pls sir give me good solution..any medicine need to take.. last 2years I got this problem",
    "doctor_response": "Although masturbation does not included in disorder but masturbation may harm in term of injury over skin and penis by friction.It is myth that masturbation may lead to a deep sleep.please consider a method of sleep hygiene instead of masturbation for deep sleep.If you think u are suffering from erectile dysfunction then please visit near by psychiatrist who would assess the fact and give you a realistic advise.best of luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pressure in chest and cough?\n\nI have been having a weird feeling in my throat, like pressure it can be at the top below my jaw or at the bottom going to my chest. I also have a slight cough. Sometime I find myself to feel very shakey and weak I am always exhausted. Every once in a while it feels like my heart is trying harder then it really has too. I am a little concerned I have been feeling like this for a little less then a month",
    "doctor_response": "Hello dearWelcome to Healthcaremagic.comI have gone through your concern in depth .*  This is in relation with psychosomatic manifestation of underlying stress     or  anxiety disorder .*  Suggestions for better recovery     -  Need proper relaxation , deep breathing exercises , regular walking in        fresh air , YOGA .    -  Avoid stress , anxiety .    -  Regular sound sleep of 8 hrs .    -  Balanced nutritious diet .    -  Avoid smoking or alcohol in any form .    -  After all of the above , if problem consult your doctor .Hope this will help you for sure .Welcome for further guidance .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal cramps while on naturogest?\n\nim 25 years old.i had a very early miscarrige for 2 times.i took follicular scan to know wen im ovulating.it was on 15th day..i was prescribed naturogest after my ovulation for 2 weeks.now its 25th day and im having cramps similar 2 menstrual cramps.will i get my periods?im very much worried.",
    "doctor_response": "Hi, I think at this stage it can bring premenstrual cramp as well as a sign of implantation also. So, better to wait for your periods.  Do a pregnancy test after completing naturogest tablet.  If positive consult your doctor.  If negative wait for your periods.  It may take 1 to 2 weeks for the periods to come after stopping the tablet.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen lymph nodes\n\nI ve been getting swollen lymph nodes for over 5 months. It first started in my neck. I had extreme fatigue and my neck felt stiff and hurt so bad. I went to a doctor and got a ct scan and put on antibiotics. Then swollen lymph nodes did not go away. They have now gotten bigger and moved to the side and above my collarbone. I still have extreme fatigue. I also have no insurance but I need to do something. I have never felt like this",
    "doctor_response": "Hello, Thank you for your contact to health caremagic. I understand your concern. If I am your doctor I suggest you to go for swollen lymph node FNAC, also do ZN staining from the aspirate to rule out TB. In most of the cases untreated swollen lymph node will be consider as TB, and treated accordingly.I will be happy to answer your further concernYou can contact me. Dr Arun Tank. Infectious disease specialist. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes neck pain radiating towards shoulder after bending the head?\n\nYea. I bent my head now and my neck started hurting and i felt heavyness start in my sholder and travel down my left arm to my bysept and continue to travel into my forearm. i stayed in that possition for a second to see what else would happen then it started traveling from the back of my neck into the back of my head then i started feeling dizzy like i was gona pass out to i lifted up my head from that posission and took a breath and it started going away? and my left arm still feels a bit heavy? what do you think this is?",
    "doctor_response": "Hi i am Dr Ahmed Aly    thanks for using healthcaremagic site ,I had gone through your question and understand your concerns ..   In my opinion i think you have cervical radiating pain due to nerve compression , i suggest you do an MRI to exclude disc herniation .  For now you may use painkillers like advil tabs when needed , hot massages with topical gels , B12 vitamin supplements , muscle relaxants  will be fine for most of cases .  If pain persists i recommend you visit your physician for proper evaluation and management . Please click and consider a 5 star rating with some positive feedback if the information was helpful. Wish you good health,Any further clarifications feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling and pain in upper arm\n\nMy right bicep/upper arm area is red and swollen. It started out as 2 red circular shaped spots that were painful. Next, one of the spots developed several small blisters. Now, my entire upper arm/bicep area is warm, swollen & red. It has a red line extending upwards on my arm & one extending downwards. It is painful and very sensitive to the touch.",
    "doctor_response": "Probably u r suffering from cellulitis.immediately go to the hospital.otherwise u may suffer from sepsis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of getting pregnant without penetration?\n\nHi Doctor. I am a virgin and 24 years old. Today, boyfriend and I were messing around, so we decided to dry hump. He had on thick boxers and I had my underwear on. We noticed two spots on his boxers, and we believe is pre-cum. He did not come, or came near me with his private part. Is there any chance I can be pregnant?",
    "doctor_response": "Hi,   Thanks for the query under health care magic platform.   I understand your concern.   Conception is not possible unless semen is ejaculated in  vagina,   so that  sperms reach mature ovum. You did not have any  direct physical contact .. so you do no have any6 chamce of pregnancy.    thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for varicose vains\n\nmy self aged 56 yrs suffering from varicose vain lot of pain, my legs and hands changed color and became thick skin with irritation. is it advisable to me to take ecosprin AV. if yes, 75 or 150. please help me. C.jayalakshmi, house wife, goutham nagar, malkajgiri, hyd. 0000",
    "doctor_response": "Hello .as per your sasaying.. It seems it's severe  varicose vein. If it is not Severus do take that medicine. Do start from ok m 75 my. And put on stockings. But of its severe  surgery will be a good option.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I opt for non allopathic treatment for paralysis?\n\nMy father age 71 experience paralyse attack 2 months ago. Left leg and left arm is not working. Alopathic treatment is going on but not desired result yet. Sugest that I should seek local treatment( desi ilaz) or not. And how my father will get well soon?..............................shiv nath Himachal pradesh.",
    "doctor_response": "**1. since the case is diagnosed and he is in recovery stage, [nervous system takes time to heal] and probably bed ridden, thus prior to initiate/suggest alternate medicines, please keep following things in  mind:i. if there is history of diabetes, high blood pressure, raised cholesterol: these issues should be managed simultaneously.ii. avoid alcohol, smoking and start general supportive measures as follows. change the position every 1-2 hours to avoid bed sores.. feeding should be done preferably in sitting position.. give protein supplements, avoid foods that may cause diarrhea.. give enema on alternate days to evacuate the bowels.. sponge the patient everyday with a wet towel followed by dry towel, followed by talcum powder.. Physiotherapy is advised to prevent joint contracture and edema of the limb, and to promote recovery of strength.PS. Passive movements of the limb also prevents venous stasis and pulmonary embolism. check every 2-3 days for bed sores over sacrum,back,greater trochanter and ankles. If bed sores is developed, dressing & padding.. avoid soakage of urine or stools, as bedsores develop very quickly in such cases.. Chest physiotherapy should be started to promote coughing and prevent pneumonia.. Rehabilitation: speech and occupational therapy should be tried.PS. average families cannot afford Nursing homes for prolonged periods & the more convenient & loving way is to take care at home under supervision and help of family doctor.iii. mis 100 gm of covered kidney bean powder [urad dal] and dried ginger in 2 cup milk and give it to drink daily for 1 month.. you may ask for prescription medicines like:- mahanarayan oil/prasarini oil for massage.- ekangvir ras,vishtinduk vati,vaat kulantak ras,guggul preparations,dashmool/ bala arishta, tab Rheumalya, R-compound for oral consumptionPS. You may seek local treatment, but always take care of bladder, bowel, base of the lungs, and boost the morale, you may contact me [9418308949], as my clinic is in Himachal Pradesh [Shimla] for further Dietary Regime and lifestyle management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI shows facetal arthropathy in lumbar spine with diiccation in L2 3 and L3 4 disc, mild diffuse posterior bulge of L4 5 indenting thecal sac, nerve root.  Curable?\n\nHello Dr. Herrick, I am Trupti from India. I am 30 yrs old femail. Today I got my MRI report. The highlighted points are as below: 1. Facetal arthropathy is seen in lumbar spine with disc desiccation in L2-3 and L3-4 discs. 2. Mild diffuse posterior bulge of L4-5 disc indenting thecal sac and traversing nerve roots. 3. Mild diffuse posterior bulge of L5-S1 disc indent traversing nerve roots. 4. Mild diffuse posterior bulge of L3-4 disc indenting thecal sac.  I want to know answers to below my questions: 1. Is this 100% curable? If \"yes\", please suggest what is the period required for the same?",
    "doctor_response": "Hi Truti,Thank you for posting your query.I have gone through your MRI reports. I would like to point out that this disease is fully treatable. However, we need to know your symptoms, and examination findings, before suggesting the best treatment option for you.Usual treatments for disc prolapse include physiotherapy, medications such as pregabalin, epidural injections, and in some cases, surgery.Please get back if you require any more information.Best wishes,Dr Sudhir Kumar MD DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does reduced lung capacity affect the energy level of a person?\n\nPartially imaged right lung shows apparent pronounced volume losswith right hemidiaphragmatic elevation. This is part of the result of my MRI if Pectoralis Major muscle tear, which is torn. Will the reduced lung capacity affect energy level, because I get tired quickly and my thyroid levels are all showing in the mid range of being normal?",
    "doctor_response": "Hello, * Per se reduced lung capacity will not affect energy level unless there is systemic involvement of multiple systems apart from lung. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest discomfort and heaviness in the jaw in sleeping position?\n\nI was awakened by my heart this morning, when laying on my right side. It felt similar to shaking uncontrollably when cold, same uncontrolled feeling in my chest. Lasted 10 min. During the time my pulse was thredy, with pauses and runs of tach. When I turned on to my back my chest was heavy and both side of my jaw felt pressure ..... Any thoughts?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. After going through your medical details I understand your concern and I would like to tell you that all these symptoms can be because of underlying cardiac disease which is highly recommended to go for basic cardiac evaluation. Kindly get an ECG, echocardiography and cardiac biomarkers done and consult a Cardiologist for further management. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes muscle spasms in the back?\n\nI m a young, relatively healthy female with a pulsing painless feeling, kind of like a painless muscle spasm, under my left shoulderblade. It s been like this for about a month now and it s starting to drive me crazy. The feeling resembles the feeling of your heart beating, but in my case it s irregular and in my back. What could this be?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Can EB related to disc problem, bad posture, back muscle strain or poor electrolyte levels. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the pain in lower back bone?\n\ni was three months pregnant and the other day i just felt a  moving of my lower backborn moving with a sound ka this led to me hvng a  miscarriage ,what was it ,since then i have a problem wth tht lower bck born of mine wen i bent down i expirience a divastating pain for  me to stand upright",
    "doctor_response": "Hellou have disc prolapse..get an MRI OF LUMBOSACRAL SPINE and also get an urgent ultrasound to see the fetal wellbeing",
    "dialogue_context": ""
  },
  {
    "patient_message": "Eyes swollen due to seasonal allergies. Concerned about taking diphenhydramine. Safe to take Benedryl?\n\nMy father is having blood drawn tomorrow to check his PSA levels which have been rising over the past year. His eyes are almost swollen shut, presumably from seasonal allergies. He is concerned that taking 25-50 mg diphenhydramine (Benedryl) will affect his PSA levels and give the physician an inaccurate reading from tomorrow s bloodwork. Can he take the Benedryl today without acutely affecting his PSA?",
    "doctor_response": "Hi, Thanks for using HCM.Diphenhydramine: Is anti histamine drug belongs to 1st generation for allergy. Due to its anticholinergic effects it has urine retention property and it is not recommended for elderly unless prescribed by doctor. You can give him 2nd generation drugs. But diphenhydramine wont affect level of PSA. You should also concerned about swollen eyes. This can be due to allergy or even due to problem in kidney. Get done urine routine, renal function test and also per rectal examination along with PSA level for management. Consult your doctor for examination and management and adhere to his treatment. Hope I answered your question. Wish you and your father good health. Feel free to ask me if you have any further queries. Take care.RegardsDr. Lohit",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest any natural treatment to improve skin complexion\n\nmy daughter is 9yrs old but her compexion is very dark . she never participate in any function in school.she has changed her section because of her complexion .what todo how can i help her. pl. suggest me some good creame or which soap should iuse for her jhonsons product doesnot suits her, so home or herbal products.thanks",
    "doctor_response": "Welcome to heath care magic,I am sorry to say , Dark complexion is genetically decided. No any cream or remedy can really make a change. They just remove upper layer dead skin maximum and give you some lighter shed temporarily.U can use pealoff or shrubs available in the market , but nothing can really make a change.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for gouty arthritis\n\nI am a healthy 44 y/o white male..very active and fit. I experience gout attacks about twice per year. Currently..about a half hour ago..I have a patch of white on my index finger pad. It looks like paint & will not wash off..(soap, nail polish remover..etc..) I have not come in contact with any white surface.. ????",
    "doctor_response": "Hello I have studied your case,I will advise to do blood inv like complete blood count ,uric acid levelFor gout you may need medicine like zyloric, allopurinol and newer febuxostat you can start then according to blood uric acid level consulting his treating doctor. Food to be avoided in diet includes \u2013meat and poultry. Alcohol.Processed CarbohydratesProcessed carbohydrates and sugars take the place of healthy carbohydrates, such as fruits and vegetables, in your diet. Although no direct link has been established between sugar intake and gout severity, high sugar intake can contribute to obesity, a risk factor for gout. The fibre in fruits, vegetables and whole grains may also help carry excess uric acid out of your body.If required you may need crystal deposit excision.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of potential pregnancy?\n\nMy boyfriend and i were messing around, and he wasnt wearing a condom. He went inside of me for maybe 5-10 seconds, twice. butit old him no, since i am not on birth conrol and he wasnt wearing anything. when he was about to cum, we stopped and i finished him off in a different way so he wasnt near my vagina. my last period was on the 12 and ended on the 18th. is there a possiblitly that i could get pregnant? he didnt cum inside of me, but other than being in me briefly, he was just moving in and out between my legs. HElp, is thee a small chance?",
    "doctor_response": "Hallow Dear,You should be informed that some secretions are ejected from the male penis before ejaculation. This is called as pre-ejaculatory secretions or 'Precum'. Precum is expelled out unknowingly and the male is completely unaware of ejaculation of precum. Since he withdrew his penis just before he ejaculated his semen, it is most likely that he has deposited precum inside your vagina. Precum does contain some sperms. These sperms are capable of fertilizing an egg and cause pregnancy. You have mentioned the dates of your menses; however have not mentioned the date of your sexual exposure. It would have helped me to assess the risk of pregnancy. Now, I will give you the information by which you can assess the possibility of pregnancy yourself. Egg is released 14 days prior to the next menses. Egg is having 24 hours life while the sperms are active for 72 hours. Hence, a period of 8 days around the day of egg release is fertile window. If you had this venture during this period, you stand the risk for pregnancy. If you have not crossed 72 hours after the intercourse, it is best to take emergency contraceptive pill. If you miss your period, you may get pregnancy test done on the urine 8-10 days after missed period. Done earlier, these tests may give false negative results. Another very reliable option for you, though costly, is to get Beta hCG test performed. This test is very specific and hence highly sensitive and may give reliable results even few days prior to the missed period. If you are pregnant, you have option of Medical Termination of Pregnancy available. I am sure, this helps you. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the hard knot at my anal opening?\n\nmale 32. slightly inside anus towards front when washing several months ago i felt a hard knot seemed to be under the skin slightly. its not painful or sore unless i have very hard stool bowel movements which is very rare i usually have very loose stool. but this \"knot\" area hasnt seemed to moved or grown any since i first felt it but its probably about an inch inside the anus on the front wall area",
    "doctor_response": "Hi can you please tell moe more about this as it could be pilonidal sinus if i am thinking right. I have the right treatment for it but I need to know more about it and if you can ask me a premium question I can solve it better.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does injecting Deca Durabolin in the buttocks cause pain in the hips?\n\nI have severe muscle pain in my right left at the hip join (site of surgery from 2 years ago). Yesterday, I self injected Deca in my right buttocks. The usual swelling and pain continued for a day. 24 hours later, the pain is now so severe I cannot walk without assistance. I have a mild fever. I suspect the injection may have caused an infection that might be traveling down my leg. I m visiting from Brazil. I do not have health insurance and my limited funding maxs at $500. I m not sure what to do. I have been taking ibuprofun for 12 hours. It helps a little. while there is no apparent swelling or redness in the area on my hip where the pain is, there is a rash that I ave developed before. I used a clean needle to inject 1 ml of testosterone phynolproprianate. I cannot say if the injection and pain is directly related. But, it hurts enough for a 30 year old man to cry.",
    "doctor_response": "Hi, The injection is painful and can cause a pain in the soft tissue for a few days which gradually subsides on its own. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for low hemoglobin levels due to noncancerous tumors\n\ndear doctor my uncle( 58 yrs) has multiple noncancerous tumours in his intestinal lining.they bleed often and his haemoglobin level always remains very low and needs to take blood often.doctors have suggested that because of the position of tumours surgery is not possible.is there any cure possible for this disease?will he need to take blood like this thoroughout life?",
    "doctor_response": "Hello and welcome to HCM,Chronic blood loss from body will cause low hemoglobin and thus anemia.I understand from your description that non-cancerous tumors are polyps which are bleeding.It is possible to remove the polyps surgically because if they continue to bleed continuously, low hemoglobin will remain a constant problem.Iron supplements can help but getting rid of the source of constant bleeding is the definitive cure.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the ways to change winter skin-care routine to spring?\n\nHello doctor, How to do transition of your winter skin-care routine to spring?",
    "doctor_response": "Hello. As compared to winter, in spring season skincare is changed as follows. 1. In winters, an individual's requirement of water becomes less, whereas in spring one should increase the intake of water as insensible loss of water increases from our skin. 2. In winters, skin becomes very dry so we need to moisturize it frequently whereas in spring the moisturizing requirement becomes less. 3. Protection from sunlight is important in both winters and spring but more important in the spring season. 4. Protection from allergic plants becomes more important in the spring season with the eruption of new plants and its different species.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can gluteus maximus pain on normal movements be treated?\n\nI have continuous pain in my right gluteuos maximus. It is hard sitting, getting up, stooping, etc. Have been going to gym but easy on the right side exercises which are painful on right buttocks. Strange. Dr. says it may be pinched nerve, may have injured during exercise. I am active person, 74 years of age. What can I do to help the healing of muscle? Thank you for your opinion. Heidi Gillen",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.You are likely to be having muscular pain. Treatment of it is analgesic such as ibuprofen for pain relief. Muscular relaxant such as thiocholcoside is of help. vitamin B and C is helpful in recovery. Rest is important in recovery.You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can open pores on the spine be related to severe back pain?\n\nI have back issues. Chronic pain. Lower back as well as my neck. I have an open pore, aggravated at the base(bottom of my spine) as well as at the base of my neck. Are they somehow related? The open pores(pimple) are extremely painful and occasionally has puss. They both have been there a long time, over a few years.",
    "doctor_response": "Hi i am Dr Ahmed Aly    thanks for using healthcaremagic site ,I had gone through your question and understand your concerns ..  Actually i think the have exaggerated the underlying cause of pain which i think it could be cervical radiating pain due to nerve compression or mild disc bulging or herniation .  The presence of pus proves the presence of infection and thus causing more inflammation or swelling and pressing on your cervical spinal nerve roots and cause such pain .  Maintain a healthy clean wound by adding topical antibiotics with clean dry dressings and NSAIDs like Advil tab to decrease that infection .  If pain persists i recommend you visit your physician for proper evaluation and management of your case to prevent further complications . Please click and consider a 5 star rating with some positive feedback if the information was helpful. Wish you good health,Any further clarifications feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the possibility of getting pregnant from unprotected sex?\n\nI m 34 years old, have two young children & have very irregular periods. My recent periods: 29th Nov 2014 (29days) (4weeks+1) 28th Dec 2014 (62days) (8weeks+6) 28th Feb 2015 (29days) (4weeks+1) 29th March 2015 (41days) (5weeks+6) 9th May 2015 (31days) (4weeks+3) 9th June 2015 (57 days.... I had unprotected sex on July 30th 2015. Is there any possibility I might be pregnant? I still have yet to start my period. Thank you.",
    "doctor_response": "with periods that irregular its very difficult to sort out ovulation day and hence pregnancy. Talk to your ObGyn and let them have a look.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have watery diarrhea from three days. Please help.\n\nHi doctor, I am a 25 year old girl suffering from really watery diarrhea from three days. I vomited two times but I cannot even keep water down as it passes as diarrhea. Sudden stomach cramps make me cry. Imodium does not work.",
    "doctor_response": "Hello. You are having acute gastroenteritis infective condition. Kindly answer the following questions: I suggest you take Ciprofloxacin plus Metronidazole like broad-spectrum antibiotic for seven days. Cooked oatmeal helps in soothing the stomach. Include curd in your milk. For two to three days, take semisolid diet more like khichdi, fruits juices, mashed potato, etc. For vomiting Ondansteron MD mouth dissolving tablet can be prescribed. Take Vital Z powder with water to maintain hydration and electrolyte balance. Investigate with stool routine micro examination also. For more information consult a family physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes delays in menstruation?\n\nHi, I took postinor 2 about 7days after my period. a few days later I bled lightly for about 4 days and then stopped. I took the emergency pill again 2 weeks later. I still have not got my period it is late. what could the problem be? could I be pregnant?",
    "doctor_response": "Dear Madam,It is this emergency contraceptive pill which is delaying your menses. This pill contains Levonorgestrel. It is a Progesterone preparation. Thus the Progesterone levels in the blood increase preventing the menstruation. Moreover, you have repeated the pills again. Thus the periods are further delayed. Wait for 10 days and you will get the withdrawal bleeding. Do not worry, the possibility of pregnancy is very very low.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for metastasis in thyroid gland\n\nDear Dr.I was diagnosed Clear cell adenosquamous carcinoma of Cervix stage IBI on November, 2009. The preventive treatment was radicalhysteroctomy and chemoradiation, after which I should had been cured. In November, 2010, recurrence metastasis was found in the paraortic retroperitoneum (node of 8.5 x 4.5 cm.) and several other little tumors in the pelvis and belly. This was treated by Taxol + Cisplatin chemotheapy. In the first CT after 3 treatment, a detention of the illness was observed and the treatment, continued, but after other three treatments we see that the treatment is ineffective: the tumors have grown and there's an additional metastasis in the thyroid gland. How would you continue the treatment? Thank you in advanced. Marilyz",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have cervical cancer and treatment by radical surgery followed by chemotherapy and radiotherapy.  Now you have multiple metastatic lesion.  So it becomes stage 4 disease now. Surgery will not helpful now.  Only treatment options available is chemotherapy. It is not effective. So you can change the chemotherapy.  But any treatment will not cure the disease.  Prognosis remains poor despite of all treatment. Life expectancy is not good.  And chemotherapy had its own side effects. So no treatment should be given according to my opinion.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Xanax and Pristiq for anxiety and depression. Can I take Xanax after consuming beer?\n\nHi. I m a 21 year old female, 5 , 125lbs. I m prescribed 0.5mg of Xanax to take as needed for anxiety. I m also prescribed a daily 50mg of Pristiq for depression and anxiety. My psychiatrist told me that the general rule of thumb was to allow about 6 hours before or after taking Xanax if I want to consume any alcohol at all. I had 1.5 beers about two hours ago and was wondering if it would be wise for me to take a Xanax right now. (I wasn t anticipating needing to take Xanax tonight but had an unexpectedly stressful even arise.) Thanks",
    "doctor_response": "Greetings !Well you see alcohol and Xanax both act at the same receptors and tend to lead to severe CNS ( Central Nervous System ) depression thereby resulting in excessive drowsiness , at times  stupor to the extent of extreme seriousness. So ideally taking these two together is discouraged not even 6 hours apart however some doctors may allow the two to be taken 6-8 hours apart but in your case it is too soon to take Xanax since not enough time has elapsed since you took alcoholic beverage so keeping in mind the perils of this cocktail kindly refrain yourself from taking it now after 2 hours. Instead try to distract yourself by indulging in some task or errand or try to meditate to calm your nerves.I hope this helps.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mouth sore\n\nTaking Lisinopril ~ & have developed a mouth sore on my rt. upper, inner gum!  It hurts, and will not go away, have had it for 4 wks. now.  I have never been proned to mouth sores or canker's and the few I have had in the past usually go away in 3-5 days with baking soda treatment.",
    "doctor_response": "Hello!Read your query.ACE inhibitors can be causative for mouth ulcers.The best thing to do is warm salt water gargling thrice daily.Apply a lignocaine based gel like GUMTONE before food.Maintain a proper oral hygiene.If it persists more than 1 week or new ulcers develop, you must consult with your physician for a change in the prescription.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can fungal infection on the toe nail be treated?\n\nHello,My big toe nail turns black and about every year or so it seems to rot and falls off. Always grows back and soon starts to turn black again and falls off.What can I out on it to prevent it from turning black again? No pain but something not right,Thanks very much,DAN YYYY@YYYY",
    "doctor_response": "Treatment for a fungal nail infection includes using medicines and possibly removing the affected nail.A combination of oral antifungal medication such as Griseofulvin and antifungal nail lacquer. These treatments are brushed onto the nail in the same way that you would apply nail polish.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have pus in the gums of decayed wisdom tooth. Will antibiotic help in clearing infection?\n\nHello doctor, My wisdom teeth came a few years ago. The top ones are straight but too close to the molars next to them, so they broke the molars. Those top molars next to the wisdom teeth, as well as those top wisdom teeth are broken, decayed, and sometimes painful. My bottom wisdom teeth have not damaged the molars next to them, but they are not fully erupted out of the gums. One is impacted but does not cause trouble. The other is straight, but in pain, it is also infected. There is green pus that comes out from between the gum and that tooth as well as from the tooth in front of it. There is also a cracked second molar which the gum is partially detached from and it also has some pus coming from it. Now here is the dilemma, I have been taking Amoxicillin 250 mg three times a day for a month now, and just yesterday I switched to 500 mg three times a day to try to clear up that infection. Yesterday there is no pus, but today there is. I do not have an appointment with the oral surgeon until a few weeks. I am afraid that this infection will not clear up with the 500 mg Amoxicillin. And the big problem is that I am on Medicaid and they only give us 1000 dollars a year which resets every July. I only have about half of that left which means I cannot go to any more appointments until after this oral surgeon. I can only have three to four of the six bad teeth out. So do I have to extract the bottom infected wisdom and cracked tooth or the semi painful broken decayed top teeth? And to make it even better, I have high blood pressure and severe anxiety and happen to be on Propranolol for the blood pressure and heart rate. I know that Propranolol interacts with local anesthetics that have vasoconstrictor in it, but local anesthetics without vasoconstrictor do not last as long and I am severely afraid of death from dental work (or from infection). So I do not know which teeth to do, what to do about the anesthetic, and I am afraid of the infection spreading. Please help.",
    "doctor_response": "Hello. Put your mind at ease. There is a high chance of food getting stuck between the wisdom tooth and the molar because of the position of the molar. This gets unnoticed during brushing and over time gives rise to the decayed tooth. Plain Amoxicillin will not help in decreasing the infection. You need Amoxicillin and Clavulanic acid combination (675 mg) two times a day for three days. This with Metronidazole 400 mg three times a day for three days. Before having these, it is mandatory that your blood pressure is within the normal range. Local anesthesia with vasoconstrictor can be used for hypertensive patients with proper guidelines being followed. Do not worry. Please visit the dentist first, take the revised set of medicines, bring your BP under control as well. Let the infection subside and then remove the infected tooth.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing constant numbness in legs along with swelling?\n\nFor the past week I have been suffering from constant numbness...at first i only noticed it in both of my legs and now its from the waist down and i noticed last night that i have swelling in both my feet. What could be yhe cause for this?? Its starting to concern me.",
    "doctor_response": "Hi I would advise you get an x-ray/MRI of thoraco lumbar spine done.And also check your B-12, Calcium and magnesium levels.Meanwhile take a good multivitamin/ multimineral preparation --regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest solution for gallstone.\n\nmy mom had a pain on her right side she took xray. the xray showed gallstone . she has very bad pain. the doctor talked about a blockage, the doctor want her to wait until september  1. she is on vacation in another country. i told her  to come back what do you think ?",
    "doctor_response": "Hi thanks for contacting HCM....Here your mother having gall stone....USG done for gall stone for proper evaluation...If needed CT scan might needed...Because of obstruction if mucocele like condition there then surgical management needed....If stone multiple and symptomatic with frequent pain then cholecystectomy needed....Udiliv tablet taken that is made up of ursodeoxycholic acid ....It dissolve cholesterol in bile....It affect cholesterol absorption in intestine ...so useful in gall stone...Meanwhile low fat diet taken....Green leafy vegetables like spinach , bitter gourd , mustard green taken more....If fever occurs and cholangitis there then antibiotic needed.....Take care...Avoid alcohol....Consult gastroentetologist for proper examination and accordingly treatment Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sneezing and gurgling sound in chest?\n\nMy 2 year old is currently getting over a cold. He is still sneezing and coughing occasionally but ...I am worried because he has this gurgling sound in his chest when he breaths (it sounds like he has a cough that needs to get out) after he coughs..the sound stops. Is this something I should be concerned about? DO you think it is more than a cold? Thanks!",
    "doctor_response": "Hello dear, welcome to HCM forum.This may indicate a lower respiratory tract infection beyond simple cold, and may need antibiotic treatment. Kindly see your doctor for a chest examination, especially if he is having fever or breathing difficulty.Hope this answer will help.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can bruxism be treated and prevented?\n\nDear Sir,i am age of 56 Yr.i have problem of teething grinding in sleep.sleep of my wife is being disturb when she wake up in night.please advise me what actions have to take and any exercise i have to do to prevent from above.Thanking  you,Pinakin",
    "doctor_response": "Hi, Grinding teeth in sleep or nocturnal bruxism can be due to a number of causes like stress and anxiety, alcohol abuse, smoking, snoring, sleep apnea, excessive intake of caffeinated drinks, etc. So if any of these are responsible in your case you should try and eliminate the same. Secondly start doing meditation and deep breathing exercises. Avoid alcohol intake if you do. Consult a dentist and get examined. A night guard can be made for you to wear at night. At times low doses of anto anxiety medicine can be advised. Jaw alignment exercise can be demonstrated and can help in improvement. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Honey Arora, Dentist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can pneumonia cause prolonged QT waves?\n\nHi doctor, I went to the emergency room with fast heartbeats. The doctor did an EKG and chest x-ray, and he said I had pneumonia. But, my QT was slightly prolonged. He repeated the EKG after a week later\u00a0and said it was fine. Should I be concerned about the prolonged QT? Can pneumonia have caused it?",
    "doctor_response": "Hello. Hope this helps you and get back if you have any doubts. For further queries consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could the odd sensation in adam s apple, after taking a deep breath mean?\n\nHello there, and thank you for taking my question. I am 20 years old, 6 feet tall, and 180 pounds. I can take a deep breath and feel an odd sensation to the right side of my adams apple... Oddly enough... When I push it out of curiosity, it makes a clicking noise as if I have pressed a button! Please help",
    "doctor_response": "Hello,It may be because of an infection or a sore throat, and you have to take antibiotics and anti-allergic and also saline water gargle. If not cured, then an ENT specialist opinion is needed.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Chandra Shekhar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain, Fistula, Suggested surgical treatment. Any recommendations?\n\nI have fistula for 2 years and doctor x ray my fistula , he suggest you can do surgical treatment and cut off all fistula portion ,or leave it doing nothing and I don't feel much pain only when I touch feel little and sometime for month pus don't come and little pain also vanish but if I go for long drive and sit long time for 12,13 hours up and down to my village than the little pain come and feel little pimple size fistula and I know if I rest for 3,4 week  than little pain vanish and fistula but if I sit for long time than again come up ...what to do help me doctor",
    "doctor_response": "Hello,Basically there is no treatment for peri anal fistula except surgery.There is no medical treatment for this condition.Untreated peri anal fistulas may result in deep peri anal abscesses,cause deep fistulas going above external sphincter and making the surgery difficult and in rare cases may turn malignant.Get the surgery done as early as possible as this is not going to be all right without surgery.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to have Aspirin to reduce inflammation and thin blood?\n\nHi. I have the MTHFR gene, and am having a hard time treating it. I got on an Optimal Prenatal with methylated vitamins ( I am not pregnant ) Should I also be taking baby aspirin to thin blood and reduce inflammation? I feel like I bruise easy already. I ve changed my diet, and am taking some good supplements but still struggle with inflammation.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Aspirin is very useful in reducing inflammation.  It is also useful as blood thinner. However thete is slight risk of bleeding.  You should keep that thing in mind.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for neck and shoulder pain after lumbar discectomy\n\nI have had a lumber discecterme two weeks ago, I started to reduce my tablets as adviced and found my shoulders and neck ache an I can barely lift my head up, is this to be expected after surgory or should i be concernd and I cant afford to pay for an answer!!!!! so i sit in dought",
    "doctor_response": "Hello, Some pain is quite normal after surgery. Anyway, I would recommend holding a lumbar brace and performing physiotherapy. If the gait difficulty persists or even worsens, I would recommend going to the ER for a lumbar spine CT scan. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe pain in hip joint\n\nhip hello so i have really bad pain in my right hip joint. both hips are in my sockets wied and it makes me walk with my feet pointing out but my right is driving me nut with pain yesterday i played softball and messed it up worse i can walk but it hurts and im wondering what could be wrong with it",
    "doctor_response": "Hello, As this pain must be related to the muscle spasms. Doing hot water fermentation will help reduce the pains. Also, simple Strengthening and stretching exercises will help further reduction in the pain and avoid the abnormalities happening due to it. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes small piece of skin dangling from uvula?\n\nI have a small peice of skin dangling from my uvula, I saw a few months ago but forgot all about it until I was in the shower and sneezed with my mouth closed and then spit out a little blood. So I looked in my mouth with a light, didn't see any blood but I saw the skin tag on my uvula that I forgot about. Is there any concerns with it?",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,    I have gone through your query , blood from mouth can be due to periodontal problem , you should consult dentist and go for Scaling and root planning properly .  For uvla skin tag you should consult dentist and go for Oral examination .  Do warm saline gargle two - three times a day.   Do brushing twice daily and chlorhexidine mouthwash twice daily. Hope this will help you. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with Heptatis B. Can any online doctor help me?\n\nI am diagnosed with Heptatis B in last two years. Although, my viral load is high (used to be over a million but in past few months measured at 350,000), I am not on any kind of medication and so far my liver enzymes are normal (every three months I do blood test for LE). My Hepatologist has retired and now I am looking for another one. My question from you is this, based on this brief information I have given, what would you recommend? Thank you kindly,",
    "doctor_response": "Hi, you are a hepatitis B positive since 2 years, and you are not using any medicine with your doctors advise or individual reasoning. I am asking because the virus is a virulent and wait for an opertunity to attack the patient.                           During any convalacence it may flare. I prefer to give to my patients the supportive therapy to the liver, so that the patient may not be at risk.                            If it is your hepatologists openion he will be the better judge.                            Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could heavy bleeding and brown discharge during pregnancy indicate miscarriage?\n\nAbout 3 weeks ago i found out i was pregnant, the day after i had very severe cramping and heavy bleeding with clotting, since then ive experienced brown discharge which hasnt stopped, i took a test today and it still says im pregnant. Could i have miscarriaged?",
    "doctor_response": "i have read and understood your queryI hope this will be helpfulThe amount of blood and clots you have mentioned is pointing towards the miscarriage.The pregnancy test come positive because the substance B Hcg which is detected in urine for pregnancy test keep on secreting in urine for weeks even after miscarriage .I Would highly recommend you to get yourself checked by ob/gynae doctor for an abdominal scan and management accordingly.the brown discharge can be due to infection or remnants of fetus in uterusI will be very glad to know if you find it usefulThankyouRegards Dr Faeza Sherdil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any side effect for Benadryl, amoxicillin and tylenol in 2 year old?\n\nis it safe for 2 yr old to take Benadryl and amoxicillin at the same time? and also Tylenol if fevered? she has a bad cough, tight chest and runny nose.I just gave her Tylenol and Benadryl which her doc said it was fine but have to start her on her amoxicillin tonight just need to know if its ok or should I wait a bit?..",
    "doctor_response": "Thanks for putting your query up at HealthCareMagic. I understand the cause of concern. Let me mention that the tolerated but common side effect of anti-allergics like Benadryl is sleepiness. Amoxycillin is an antibiotic and while killing the bad bugs it also eliminates the good bacteria that reside in our bowels. As a result sometimes mild diarrhoea or signs of vitamin B deficiency may occur. It can be overcome by giving curd/yogurt which contain lactobacilli. Prebiotics and probiotics (available in brand names like Vizylac, enterogermina) can also be give. Tylenol is a very safe drug. Let me tell you that these are very frequently used and safe drugs and you need not worry about serious side effects when giving these drugs. I hope that helps. Feel free to revert back with further queries if any.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the impotency be the cause for the man to be away from sex since one year?\n\nHi, my boyfriend has been separated for a year from his wife. We have been dating for three months and recently began having sex. I would say that he is impotent, but don t know if in time this will correct itself because it s been a year since he last had sex or not. He said that things were fine the last time he had sex with her. What do you suggest",
    "doctor_response": "Thanks for asking in healthcaremagic forum   May be/may not be. Please do not judge yourself, ask him politely about his problem for not having sex with you. You can visit a psychologist/psychiatrist for counselling together. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can you please go through my electrophoresis report and tell me if I have thalassemia minor?\n\nHi doctor, Could you please go through my reports and tell me if I have\u00a0thalassemia minor? I have attached my\u00a0electrophoresis test reports.\u00a0Some of the values in the report are\u00a0Hb F - 0.8 %,\u00a0Hb adult - 66.0 %,\u00a0Hb A2 - 30.8 % and other\u00a0non-specific - 2.4 %.",
    "doctor_response": "Hi. Revert with more information to a hematologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pimple like bumps on legs\n\nMy 22 month old I noticed recently developed pimple like bumps on areas of his body, including on his legs, on the area in which he has eczema. I noticed today that there are a few of the same pimple like bumps around his buttocks, close to the rectal area and I just discovered 2 small bumps on the underside of his bottom lip. They don t seem to be be bothersome as he is not complaining nor is he scratching, except the area in which his eczema is located. Any suggestions as to possible cause",
    "doctor_response": "Hi please describe the the bumps a little more whether any redness is there sorounding them/ whether they are increasing in size/coming and going off,associated with itching or not; which will help us in differentiating between a allergic tendency or infection. If not associated with pain/fever, simply USE a local application of emolient/moisturiser over the area and if persists need to add a antiallergic drops/syrup .Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Please tell me about my C/s Urin test report\n\nOne of my friend s c/s urin tesst repport is below: Direct microscopy (Uncenrifuged sample) shows no pus cell NO BACTERIURIA Notes:Method-Aerobic Culture at37degrees C. Pls give me details about it.",
    "doctor_response": "Hi Welcome to healthcaremagic This report is indicative of no infection in urie. No worries .Take care Bye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will there be a need of VDRL test to check the presence of syphilis?\n\nhello doctors, i just want to ask, i take an gram stain test and its negative from any std i also take an HIV test and its non reactive, but im still worrying, do i still need to take VDRL test to check for presence of syphilis even im already negative in gram stain and HIV test?",
    "doctor_response": "Hi..welcome to HCM.I am Dr jigar, ID specialist & laboratory medicine expert. I am glad to answer your concern.You must be aware that syphillis is a sexually transmitted disease & risk of getting HIV infection is much more when someone is sufferring from STDs.Now coming to your question, yes to rule out syphillis you need to go for VDRL test. Gram test is not helpful to detect trepanoma spp. which causes syphillis & hiv negative status does not rule out syphillis.Also want to firmly suggest that safer sex is the best way to stay away from STDs. Hope my words were able to guide you for further steps.Dr Jigar GusaniID specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe learning disability, seizures, hair fall. Taking epilim chronoshere. Treatment?\n\nmy 15 year old daughter has severe learning problems and has peti mals she is taking 600mg of epilim chronoshere twice a day and has been taking this for about three months, she was on epilim liquid before that.her seizures have stopped but she is losing her hair,is this a temporary thing or permanent what can i do to help her is there any shapoo that will stop it.",
    "doctor_response": "Hello, Hair loss is known rare side effect of the medication that your daughter is taking. The hair loss is usually transient and hair growth reappears. There are no shampoo to prevent it. Multivitamin containing zinc may be tried to improve it, however benefit is not certain. Since seizures are well control  i would advice to stick to the medication and hope for the best. good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for positive crp\n\nmy name is rahul agarwal. my crp is positive. three days back i struck with fever and then i was told by my doctor that my crp is positive.plese give me some suggesions about how can i fight with this disease and how much time it will take to be cured.what are the medicines that i should prefer.",
    "doctor_response": "C rp is C reactive protein and it is the marker of inflammation. So you had fever and its slso due to some inflammation. take antibiotics and anti inflammatory drugs. Once your inflammation is subsided your crp level will automatically come back to normal range",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. l got a sore hard lump after the removal of wisdom tooth. Is it normal?\n\nHello doctor,I just got one side of my wisdom teeth removed both upper and lower six days ago, and I have another one scheduled after two days for the left side. The upper is 100 % fine, which they pulled. The lower they pulled the tooth without removing the root because it was too close to the nerve. I do have some stitching in this area currently on the lower cheek. Noticed a hard lump about 1 inch between my lower jawline and cheek area. Is this normal because of swelling or something else. Currently taking Amoxicillin 500 mg and Ibuprofen 600 mg. Please let me know what this hard lump is, also generally on the lower side where this lump is, remains sore.",
    "doctor_response": "Hello. The lump is mostly a hard swelling which forms postsurgical removal of the wisdom tooth or maybe even by swollen lymph nodes due to infection. It takes a week or two for the swelling to subside. Sometimes, if the root is still inside, the infection may be remaining there causing swelling. Get an X-ray done to find out the exact problem and stronger antibiotics like Augmentin (Amoxicillin and Clavulanic acid) along with a painkiller for a week. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy and diet food, for loose motion in infants\n\nhello sir my baby is one year and 5 months old but she prefers only milk and she has loose motion for the past two days as we travel long, please give me some tips to make her eat other food and some remedies to solve her loose motion thanks in advance sudha",
    "doctor_response": "Hello, A child of this age generally needs to eat three large meals and three small snacks with adequate emphasis on fruits and vegetables. Generally, milk consumption without solid food reduces the child's appetite and may cause loose stools. In the case of diarrhoea while travelling it could be because of altered diet pattern or the milk itself. I would suggest you give adequate fluids, may be oral re-hydration fluids to replenish the ongoing fluid losses. The rule is one glass of Oral Rehydration solution of  200ml for every loose stool. Then observe her appetite, urine output. There is no medicine to improve appetite. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr ASHWIN BALIGA, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in the left arm and nose with puffiness in face?\n\nI have a friend that ate far too many desserts over thanksgiving and this morning he has numbness in his left arm, numbness on his nose and his eyes and face seem to be puffy.  He has had this problem before after eating too much candy.   Do you have any idea what's wrong?",
    "doctor_response": "Hello,Thank you for using Healthcaremagic.I read your question and understood your concern.I think your friend may be allergic from a food , maybe candy ingredients , so he needs to see a allergic disease doctorDr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hot rash on cheeks?\n\nMy just turned 9 year old daughter woke up with a red rash of sorts on her cheeks, they arehot to the touch, but her forehead isn t warm as for a fever. She is eating well, going to the bathroom, and this seems like something....just not sure what to do for her.",
    "doctor_response": "HI...this is called slapped cheek appearance. It could happen during lying done on the same side in sleep and also in some viral illnesses or some type of skin allergies. If she is her usual self and playing around you need not worry. But she develops fever, you need to consult your doctor.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stabbing pain in the arm\n\nMy upper right arm feels like it has been punched. No lumps in arms that I can feel. Movement is limited also. Stabbing pain when I use right arm to reach across to touch left shoulder. Nightly Charlie horse in area. Also feel stabs when lifting anything more than the remote. This has been going n for 3 months. I right handed so possible re injure?",
    "doctor_response": "hi, I dont know how old you are or your past medical history which would have a bearing on the answer. Most pain in this location is referred from the shoulder joint. A careful examination of your shoulder would identify the cause of the pain which could then be treated. Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with sub acute lupus. Having flare ups in fingers, toes, thigh, back, chest. Reason?\n\nI am 51 and I have a diagnosis of sub acute lupus for years associated with sun. The last flare up was 10 years ago when I was pregnant in the 1st trimester only. I am awaiting dermatological review. Have a severe flare up at the moment and not sure what may be causing this at the moment. I commenced a weight loss programme 6weeks ago and 2 weeks into this process I started to flare. I cannot be sure it s lupus as its on fingers toes and thigh as well as my back an chest which are 2areas I had before? I have not gone through menopause yet.",
    "doctor_response": "it may be possible that the weight loss program is causing the flare. you may need to start on hydroxychloroquine and also some mild topical ointment for the lesions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Would kidney stones with UTI with history of removal of one kidney possibly damage the existing kidney?\n\nI had to go to the emergency room last night because of abdominal pain and bleeding. They said I had a bad urinary tract infection and a kidney stone about two centimeters. I only have  one kidney. I had to have the right kidney removed in April of 2013. They found a mass on it. I just wanted to know if the kidney stone will damage the kidney I do have because they told me I needed to go back to my kidney doctor within the next day or to. I was wandering why.",
    "doctor_response": "Hello,Untreated kidney infection and a kidney stone would keep on damaging your kidney unless and until stone is removed and infection treated.This becomes all the more important since you are having only one kidney.You must learn from your kidney doctor,how to keep your remaining kidney healthy.Consult the doctor as early as possible.Once this remaing kidney gets damaged,you have no other option except to go for kidney transplant.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to avoid transmission of infection after accidental needle prick?\n\nHi Doctor,My wife got an accidental prick after administering insulin to her mother who is currently down with liver failure due to water filling her stomach every few days.       I am also listing below her 63 year old (frail, weak and weighing 39Kgs/80lbs) mom's medical histroy below for your ref:1.  Suffering from Asthama for over 30 years...........  2. Diagnosed with Breast Cancer 5 years ago ....  treated with laser and has been sort of been contained fortunately two years back and not currently spreading.3.  Diagnosed with Hepatitis 'C' 4 years ago... and under treatement. About 4 months back her belly started to fill with water and had to be removed every 1 month twice and later every 15days and now every 7-10days.....Doctors are advising to have a TIPS procedure done to let the water out continously.4. Diagnosed 4 months back with high sugar levels and advised to administer insulin regularly.Please advise, what should my wife do immediately to ensure she is not getting any infection from her mom's used insulin needle? Thanx",
    "doctor_response": "Good day and thanks for your question.  From your story the only transmissible infection your wife can contract from her mother is Hepatitis C. Asthma, breast cancer and high sugar levels cannot be transmitted through needle prick. However the risk of contracting hepatitis C via needle prick (insulin needle) is extremely low. No need to panic my dear brother. However you can take her to the hospital, she will do a baseline test on Hepatitis C (anti-HCV and liver function test especially alanine amino transferase) and the test is repeated 4-6 weeks after. Hope it helps. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is a small lump in my armpit?\n\nI have a small lump in my right armpit.  It has been there since mid December and has not gone away.  It has not changed in size, and it is not from shaving.  I thought maybe it maybe a cyst, so I did have not gone to see my doctor. Since it is still there, should I be concerned?  What could it be?",
    "doctor_response": "Hi.A small persistent swelling in the armpit for such a long duration can be a lymph node / lipoma/ sebaceous cyst.The concern is about the diagnosis , so you should once consult a Surgeon to get a diagnosis.If this is a lipoma , you may not get it removed urgently. If this is a lymph node , we have to get a diagnosis by FNAC or excision. If sebaceous cyst, better to remove as early as possible to avoid getting an infection and its complications.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking flovent tablet for years. Is it safe to use flovent inhaler?\n\nI am 56 years old and have been prescribed Flovent for about 15 years. Even though I have insurance , the cost of Flovent is very expensive. My question is I just bought the inhaler Flohale which is suppose to be the ingredient equivalent to Flovent except a lot cheaper. I haven't used it yet. Can I trust it to be safe to use? Thank you. Ken. Email  YYYY@YYYY .",
    "doctor_response": "HiYou can use flovent inhaler.Inhaler is the better option than tablet.tablet will have systemic effects as well.If you have only respiratory discomfort you can use inhaler.Hope this may help you.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Used chemical peel on face. Having dark pigmentation under the lips. Solution?\n\nI am 45 years old and I am an African American female. Like most people of my ethnic background I came into this world a much lighter skin tone than I am right now. By black people standards when I was born I was light skinned. I was not not high yellow but I was on the light side. In my childhood I received several dark hyper-pigmentation scars on my arms and legs. On my face I did a mild home chemical peel when I was around 20 years old, and it left a very dark hyper-pigmentation scar under my entire lower lip . I am very self conscious about these scars. Putting make-up on the scarring sometimes just makes it more obvious. Which then makes me even more embarrassed about the situation. What advise can you give me.",
    "doctor_response": "Hi,To treat your pigmentation issue try these recommendations-Use a sunscreen with SPF more than50Take oral vitamin c supplements and antioxidantsApply a mild Glycolic acid based or Kojic acid based skin lightening cream every day.Chemical peels should always be done by a doctor as it can have post inflammatory hyperpigmentation as its side effect. Nevertheless a doctor supervised peel can again be taken to reduce PIH.Hope that answers your query. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Routine test showed high SGPT levels. Suggestions for medicine and diet?\n\nHi doctor, I go through medical fitness for recruitment , so in that they found my all other test are normal but only my SGPT levet is high , its around 120. So what is the reason behind only elevated SGPT. How can i bring down it to normal level in 3 to 4 days,because i have only this 3 to 4 days with me... please suggest some medicine and diet",
    "doctor_response": "hi thank for your query Liver function tests such as SGPT, SGOT, serum alkaline phosphatase,  globulin and albumin are few of the markers of the liver function and its ailments. SGPT and SGOT are the most important enzymes of the liver parenchymal cells. They are in large numbers in the liver. These enzymes are released in the blood when the liver cells get damaged. You will have to get further investigation done such as test for hepatitis C, B, and E.  Also get a  sonography of the abdomen done",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat pain in neck,hands and knuckle swelling?\n\nMy husband has a history of juvenile RA and is diabetic. He is currently taking the generic for relafin.. Has been experiencing right UE pain from his neck into his hands /fingers. Swelling in his knuckles on occasion. Have tried a wrist splint for carpal tunnel with no relief, some relief with tennis elbow strap. Ibuprofen helps the most. Drives truck for a living and has difficulty lifting his arm up overhead and grasping things. Yet putting his arm up on the passenger seat next to him can provide some relief. Any ideas?",
    "doctor_response": "Hi,For neck pain, applying hot pack twice a day along with gentle neck movements after every half an hour along with neck isometric exercises will help and for hand pain and knuckle swelling do hot and cold therapy (do take a bowl  of luke warm water and another of cold water, dip hand and knuckles in hot water for three mins then dip in cold water for one mins, do it 7-10 times) along with it doing some hand exercises and finger stretching exercises will help.Hope you will find the answer useful. Let me know if I can assist you further.Regards,Dr. Harsh Swarup",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for having anhedonia?\n\nIts not about me, but it's about my partner. He's BiPolar which ive known about for years, but recently he's told me he thinks he's got anhedonia. We hardly ever have sex now because of it and i want to know if theres anything i can do to help him or for him to help himself!",
    "doctor_response": "Hi, Thanks for writing to us, In a person with bipolar disorder if there is recent onset anhedonia and low mood or loss of interest, a depressive episode should be ruled out. If he is taking his regular medications the chances of an episode is less but if there is any stressor in his life, an episode can get precipitated even with medications. Please consult his psychiatrist for an evaluation. Hope this helpsDr A Rao",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can SGPT level be brought down with diet and exercise?\n\nDear Doctor my SGPT is 52, I'm not smoker neither I drink alcohol however my diet most of the time is meat, chicket etc. Moreover I am 6 feet tall and my weight is 96, I will appreciate if you kindly let me know how to drag SGBT down to a normal level with in few days through diet and excercise. Kind regards,",
    "doctor_response": "Hello, You need to be investigated for other causes of raised SGPT levels.You need to be tested for hepatitis B and hepatitis C along with an ultrasound of the abdomen. If these tests are negative then i would suggest regular exercise/ walk or jogging/ aerobics 3- 5 times a week. Cut down on Red meat , sweets, and fried food and increase fibre in your diet. I might take upto three months  for the levels to fall.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could back pain radiating down to leg be due to kidney problem?\n\nI have been diagnosed with a UTI and am having back pain, hot flashes and sweating.  I am taking anti biotics and getting a CT scan in a couple days. Now I seem to be having the back pain radiate from my side down my leg.  Could this be kidney related?",
    "doctor_response": "Noo its back pain with radiculopathy. I suggest you to start physiotherapy n take short wave diathermy with diclofenac ointment applications locally",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest management for ROCD\n\nHello.myself kanchan chourasia.I am 23 year old,I live in Indore and i am doing BDS .I am in Final year. In the year 2007 i came to know that i have OCD.that time i used to check my books regularly as i was scarred if any of them got misplaced then what will i do. then i had thoughts that if my mom or dad will die then what will happen.i took treatment and councelling also.gradually i was fine.2 years back i met a boy,he was very supporting and motivating to me,i fell in love with him.but he is not gudluking.In these 2 years i was living happily with him.i told my mom also about him.she also likes him very much because of his nature.but in sometimes i used to think about his looks,but that was not much disturbing to me.but now since last 1 month continuosly this thought is creating anxiety to me that he is not goodluking,what my relatives and others will say on our marriage.also he is from Varanasi.this also disturbs me that varanasi is backward city,how will i live there.also i keep thinking that i really love him or not then i try to confirm by asking questions to myself or him to get sure about this. this really creating anxiety within me. i tried to breakup with him but i am unable to do that.i don't want to think all this about him.i searched on internet ,ifound that it is something related to ROCD.is it true?If yes ,then am i also have the same?plz help",
    "doctor_response": "HiThanks for using healthcare magicI think, you need help of a psychologist. You may have adjustment disorder or relationship issues. In that case, psychologist would have you. You need cognitive behavioral therapy. A relationship never depends upon external beauty, it depends upon internal beauty. Beauty is just for few years, but nature for life long. Better to discuss your issue with a psychologist. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dark bruises and swelling in the legs while having Baker s cyst?\n\nMy boyfriend has congestive heart failure and in the past he has delivered baker cysts behind his knees which make his lower kegs and ankles swell. In the past 24 hours it has become painful for him to walk he is swollen a new the skin is hot to touch . Here is the new symptom there is a dark bruise behind his right knee both legs are swollen but the bruise is only behind the right knee is this a sign of a blood clot",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Yes, kindly go for color doppler study. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the ways to concentrate in studies after marriage?\n\nHi doctor, I am 28 years old, married. My problem is that I am unable to concentrate on studies as I want to appear for exams in the coming year. Every month is getting wasted. Please help me out. I will be very thankful to you as it is a do or die situation for me.",
    "doctor_response": "Hi. Thanks for your query. I understand that focusing on high-level studies is often difficult. Since you are married, you did not mention your routine activities. Because in order to suggest something it is important to manage your time.Time management is difficult to understand, for you, it is important to prioritize things. 1. By highlighting daily activities. 2. How much time you can give to your studies easily (two hours or more). 3. Try to find time for your studies when you have minimum distractions such as cooking, attending to someone, etc. 4. The best time can be when you are alone or can be alone. 5. Also, you need to learn some reading and learning strategies, that depends upon your subject and content which can be suggested later on if you need. 6. You also need to manage anxiety related to the exam. 7. Making a timeline of subjects would be also helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dull pain on left carotid artery?\n\nToday, I m experiencing a dull pain on left carotid artery. Once in awhile I feel the same dull pain..at the same location when I m running. Just as a heads up..I m a healthy marathon runner. What are your thoughts?. Oh, and have an history of hypertension an Acid reflux.",
    "doctor_response": "Hi There I've read your question and understanding your concern.I want to tell you Blockage in arteries can give you dull and shooting Pain. Pain at a particular place can also be because of muscular or bony pain. If the Pain don't increase or decrease during running then it can not be because of Carotid Artery. It is advisable to get a Carotid Artery colur Doppler done to confirm if any blood circulation is impaired. And if it comes normal then personally see a orthopeditian .Hopefully I answered all your QuariesGood Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying for pregnancy. Irregular periods. What is the meaning of this ovulation test report?\n\nhi, i got period twice this month.I was trying for baby,we got ovulotion smile and that time we had sex.but after ovulotion 8 days later i had again first 2/3 days spotting and after light bleeding is going on but it is not just like my period.my bbt also just like that after ovulotion 36.4,36.7,36.6,36.6,36.7,36.7,37,36.6,36.7,36.7,36.7,36.6,36.7.what does mean?",
    "doctor_response": "hi, both your ovulation kit and basal body temperature are suggesting that ovulation has occurred, so as you had intercourse during that period there is chance for pregnancy and your bleeding might be implantation bleeding, so if you miss your periods you once go for blood test for pregnancy which will rule out the possibility. if pregnancy test comes negative you can consult gynecologist and get investigated for causes for spotting. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in left arm and heart pain?\n\nhi, i got shocked yesterday by an outlet, loss of feeling n left arm except buzzing dull pain and i couldnt speak, and heart/chest pain. very tight feeling i went to hosptial ekg normal but still having heart pain what can i do to stop the heart pain? and does is sound like i had a heart attack?",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern.I will try to explain you something and give you my opinion.You should know that typical heart pains have some characteristics.They usaly are retro-sternal pains likesquizzing,tightness or heaviness. They may irradiate to both arms ,neck and jaw. They last from 5 to 20 minutes.A heart attack is usaly more dramatic, whith sever  long chest pain associated with nausea,vomiting ect.Heart pains are not related whith outside factors,meaning that you cannot have a heart attack if you just hurt your chest.If your electrocardiogram is normal,this is a very good think.You dont mention your age but if I was your treating doctor to exclude any heart problem I would recommend some examination like a cardiac echo,a full blood analyze,cardiac enzymes and a strees test if it is posible.Aftet this you can be quite shure if it is something to worry about or is just a muscular or sceletic problem. Knowing the reason helps to understand how to treat it.Hope I was helpfull.Best regards,Dr.Ervina.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which specialist to consult for tiredness, dizziness and pain in temple area?\n\nHI, For the last one month, I have been experiencing tiredness, sleepyness, dizzy and pain in the temple area. Got my tests done and my doc says that this is due to the rise in insulin and has advised me to avoid sugar or sugary food at all. Before the test he had given me some multivitamins but in vain, post test diagnosis, he has given me some medicine to control the insulin level I believe. However, its been a week now and I dont see improvement. I am worried. Please help and suggest which doc (specialist) i should consult for this issue. Regards Rajesh",
    "doctor_response": "Hi,Thanks for writing in.It is possible that you have higher than insulin levels circulating in your blood. This is causing the blood glucose levels to go below normal and that can cause problems like tiredness or dizziness. This if confirmed might be the opposite of diabetes where the insulin does not act on receptors. You should consult a doctor who deals with conditions of pancreas. They can be gastroenterologists or endocrinologists. They have to do certain tests to know the source of high insulin and few tests like insulin levels in blood and ultrasound and CT scan might be asked for. There are small tumors called insulinomas in the pancreas which secrete excess insulin and a search for such tumors is indicated. Insulinoma is a benign tumor of the pancreas in 90 percent of patients and removal of the tumor cures the patient of the symptoms. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have pimple scars, no pimples. Treatment?\n\nsir, i had pimples on my face for a long time. Now there are no pimples but there are a few red acne spots left. How can i treat them, pls suggest me a cream or lotion.",
    "doctor_response": "Hi...dear aashi.., Thanks for choosing HCM.., Red acne spots.....indiactes just appearing..., lesions again...so go for.., 1) Frequent washes with Triclosan soap.., 2) 1% clindamycin (ZYCLINE-cadila) apply on face., 2 times daily.., 3) Tab Isotretinoin 10 mg daily for 1 monh.., and after 2 months again start (Pulse therapy)., 4) Take plenty of veegetables and fruits..ok..thanQ",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruise near shoulder and difficulty in moment after injury?\n\ndislocated shoulder from lifting weights, i go to a family doctor yesterday take xray they said im negative to fracture or dislocation but i think its not negative now my shoulder near armpit have bruise (front part) and cant move it properly and loss of power i need advice what to do thanks.",
    "doctor_response": "Hello, It could be a contusion or sprain. As first-line management, you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist better to consult an orthopedician and plan for an MRI to look for ligament or tendon injury. Hope I have answered your query. Let me know if I can assist you further. Reagrds, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cyst in the groin area\n\nI have  something on my groin. every so often it pops out like a mountain of red tissue. then it goes back in. the skin becomes flat and the whole area around it is purple. I went to a dermatologist 2 weeks ago. he took a culture of it and said its nothing/cyst. gave me some pills to make sure it doesn't get infected. while i was on the pills it seemed to have closed up until about 2 days ago. please help.",
    "doctor_response": "Thanks for asking in healthcaremagic forum    Boils/cysts are common in groin area. Boils are infected hair follicles which are painful. Cysts are harmless unless you meddle with it.    So, please send me details regarding any pain/itching/discharge from the lesion for further suggestions.    All the best & will be waiting for your details.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness and tingling across head?\n\ni have suffered from migraines for years and have had some numbness/tingling in a band across the top of my head with the feeling of pressure behind it during the attacks. Recently, I have been having these symptoms without the migraine with it or continuing after the migrain is gone. Any idea what the cause could be. I am not on any medications.",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your symptoms. It is common for sensory symptoms to occur after an episode of migraine.In migraine, there may be fluctuation of blood flow to certain parts of brain, which can lead to band-like sensations after the headache.However, if these are occurring at an increased frequency, then, it may be better to consult a neurologist and get brain MRI scan done.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have a swollen node in groin area?\n\ni have a swollen node in my groin are where the edge of a bathingsuit bottom would fit in the crease. i also have one a little further away. is it normal? i do have 2 relatively larg cuts on the same leg that were a little infected. they dont \"hurt\" but are a little tender to the touch :'( im worried.",
    "doctor_response": "Hi,Given the history of the cuts in the leg it is absolutely normal to have inflamed tender nodes in the same groin as the infection control process leads to nodal inflammation.Do not worry, take antibiotics for the wound and take proper wound care by keeping it clean and applying an antibiotic dressing if it is a bigger wound.It should get relieved in 6 to 7 days.Take care,Dr Rishi, New Delhi, India.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the lumpy feeling in the abdomen due to an enlarged ovary?\n\nhello, I've recently had IVF treatment that resulted in pg and OHSS. I had 2-3l of fluid in my abdomen as per US and have enlarged ovaries (right one 115mm x 60mm, left 93mmx74mm. There were still some follicles present when i had the US (1/6). I am feeling OK now, just noticed a lumpy feeling in my right side of the lower abdomen. I am worried about this. Can this be the enlarged ovary that I feel? its just under the bellybutton on the right side",
    "doctor_response": "Hi welcomr to healthcaremagic.I have gone through your question.You have lumpy feeling due to very large ovaries due to enlarged follicles and this much fluid may be due to rupture of follicles as a consequence of ohss over stimulation.So i would advise you that stop treatment for 1/2 cycle and consult gynecologist for further treatment.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden weakness in the arms, knees and severe headache?\n\nThis morning I had an episode of a weak arm, it fell slowly while pouring pancake mix on a griddle. I also felt weak in the knees. It all happened for just 1 minute but seemed in slow motion. I also had a real bad headache yesterday. Should I call my doctor tomorrow?",
    "doctor_response": "Hello,Thank you for using healthcare magic.I read your question and understood your concern.I think the complaints that you are having might have the origin from the head maybe blood pressure change or stroke so I urgently advise you to go and seek doctor's help to check your health condition.Dr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain and shortness of breath\n\nhi my boyfriend gets pain in his chest sometimes short of breath a pain in his left upper back,sometimes he getrs hot,hes contently tierd even after a good nights sleep.hes been in hospital twice and had a heart scan they told him his vessels were the wrong way round what dose this mean.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. His symptoms could be related to a congenital heart malformation. Anyway, I would like to directly review his cardiac ultrasound report for a more professional opinion. Hope you will find this answer helpful!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes problem in bowel movement?\n\nhi my baby is four month and she has anul hole problem doctor said hole is very lower portion and for the correct place use sugerian my baby is very crying in doing potty. so what i do i am very disturbed and doctor advised milk of magnesia for loose potty.so tell me any way to without any surgery",
    "doctor_response": "There is no other way of treatment. You should continue the treatment as prescribed by doctor and go for surgery for permanent cure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should i expect on MRI done for neck pain?\n\nHello, I'm about to get me cervical spine MRI results with a neurologist, and would like to know what to expect. The scan was done because of continued episodes of neck pain over the last 6 years - wry neck, and so on. The last such event occured in May of this year, and isn't quite normal yet.",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your symptoms.The most common cause of neck pain is cervical disc disease. In this condition, the discs located between the vertebral bodies in the spine bulges (slips) out, causing compression of the nerves at that level. MRI is the best technique to evaluate the disc disease. It is a safe method of scanning without any radiation hazard.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the sperm count on semenogram indicate?\n\nhiii Doc..I am Ali from India.. I get married 10 months ago..but could not impregnent my wife.. I tried Semenogram test. Results are as follows:Colour: Whitish, Volume: 1.3ml, Reaction: Alkaline, Viscosity: ThinTotal count:18mil/cum, Active:35%, Dead:60%, Slagish:05%Pus Cells:7-10/hpf, RBCs:5-7/hpf, Morphology:normalWhat does the resuls declare? can i become Father? My doctor prescribed me Fertyl-M for 3 months. Is it enough?Please advise.",
    "doctor_response": "HelloThanks for your query,based on the  report of semen analysis that you have posted it appears that your semen report revealed low sperm count (Oligospermia) as per WHO standards and  presence of 7-10 pus cells which suggest infection  either Seminal Vesicle or Prostate.You need to take broad spectrum antibiotics like Doxicycline  for 6-8 weeks along with medicines prescribed by your family physician.Repeat semen analysis after two months.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does blood clots take to heal?\n\nHi sir my father diagnos blood clot .he discharge and doctor says 6 month tretment .now he having bleeding .now bleeding was stopped.doctor said stop the acitrom for two days we do pt inr .after that we start acitrom .sir how much time it s take to cure this problem.",
    "doctor_response": "Hello and welcome to HCM,Formation of blood clots occurs due to abnormal activation of clotting factors and/or deficiency of anti-coagulants in the body.The disorder is managed by drugs that inhibit clotting.However, excess of this drug can cause bleeding.INR is an investigation which is performed to keep a check on bleeding.Thus, get INR done and consult your treating doctor.Bleeding can be avoided by keeping INR under check.Bleeding will get controlled within few hours of taking the drug and controlling INR.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for sharp pain in arm while stretching\n\nOn Monday, I felt fine all day until about 2 hours before bed. I noticed when I d reach for things with my right arm, there was a sharp pain in my mid-forearm (underneath - on palm side). It wasn t too intense and I figured it would go away overnight. The next day it felt same. It only hurts when extended, so I forgot after shower and bent to put socks on. When I extended my arm, there was a strong sharp horrible pain in the mid arm. Since then, i feel the sharp pain anytime my arm is stretched out. If it is folded up (like now while typing) I don t feel anything. There is small pain radiating from my wrist (below my thumb down to the spot where the sharp pain came from).",
    "doctor_response": "Yeah, I've got this. It is a sprain of the biceps tendon. Sometimes it needs surgery to put it back. Mostly, it is a sprain. Rest for about a week and graded increases in weight bearing (very low weight barbells). At the point I am at (3 to 4 months out) flexibility of the area is the main issue and the barbells still help but some non-weight bearing very slow range of motion exercises with moist heat also is needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in neck and upper back, tinnitus after cervical disectomy. Solution?\n\nIn 2004 I went through a cervical disectomy using a titanium implant. Shortly afterwards I begin experiencing ringing in my ears. Within four years, I totally lost my hearing in the left ear and still have severe tinnitus . I have pain in my spine due to deterioration below and above the implants causing pressure on the nerves and have also developed arthritis of the spine. I experience mild to severe pain in my neck and upper back. What can I do to alleviate this problem?",
    "doctor_response": "these all cannot be cured but contreolled you can have rehabilitation physiotherapy exercises and tinnitus relexation exercises to gety control with other medicines",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am trying to conceive but I am spotting in my last two cycles. Why?\n\nHello doctor, I have been having spotting during my past two cycles on an off for days on end. I am not sure if I should be concerned. I have stopped birth control for over one year, and I am trying to conceive from the past two months. I have had a couple of urinary tract infections during these cycles. I am worried that my hormones are out of balance.",
    "doctor_response": "Hello. The presence of pinkish-brown spotting in the proliferative phase of your cycle does indicate that you are having inadequate endometrialization possibly due to decreased serum estradiol levels during the phase. Also if the spotting turns darkish brown in the second phase of the cycle, then the level of progesterone is also inadequate which can cause early spotting premises as well. It is suggested that you should get your hormonal profile for day-2 of cycle done and also take to sequential ultrasonographic follicular and endometrial thickness monitoring which would indicate the state of endometrialization due to estrogens and also the correct time of ovulation. This can be corrected by starting estradiol pills in the first half of the cycle followed by progesterone-only pills post ovulation, which shall prevent these bleeding episodes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for darkening of skin on face\n\nHello Doctor,I am a 21 year old male of Indian origin. I have been shaving for almost four years now. But since a year back my cheeks and chin where i shave started turning black. Now a days i am not able to get a clean shave also. Though my skin has tanned a little over the past, these ares are relatively much darker. I have been using prescribed Hydroquinone and glycolic acid based prescribed creams with no effect. Over the past few months started using spf 50 sunscreen also. Also i do have a good balanced diet. Any suggestions welcome. Thank you doctor.",
    "doctor_response": "Hello. Thanks for your query.Pigmentation could very well be due to irritant dermatitis to the shaving products/aftershave that you may be using.I would suggest you to apply a moderately potent topical steroid e.g fluticasone propionate cream, twice daily for a few days.An oral Vitamin C supplement once daily would also help.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "SGTP high with no liver damage. Drink and smoke. Vomit daily. Had heart problem. How to control?\n\nhello.i am a 24 years old boy with SGTP 70.i had done sonography and there is no sign of liver damage .i smoke but i drink alcohol rarely.i take some drugs such az floxetin and clonazepam under doctors priscription.and they add gabapantin and domperidon recently,i vomit every morning.and i had a heart problem for somyears ago.plz help me,what should i do now?",
    "doctor_response": "Hello, Welcome to HCM, I have reviewed your query, your liver enzymes are high though there is no sign of liver damage seen under ultrasound, but you need to be careful as the medications you mentioned are metabolised by the liver and your daily vomit could be associated with early onset of damage to your gastro-hepatic system, hence will advice you to consult your physician or hepatologists with all your reports to review all the medications and advice accordingly. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does ball under neck indicate after recovering from respiratory tract infection?\n\nMy daughter has a small round ball under her neck,las week he had taken antibiotic because of upper respiratory track infection,but right now its three days after he had done her med,her upper respiaratory track infection was healead already,her xray is clear,shes eight years old very active,im just worried.but compare last week its getting smaller already.thank.jho",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. This ball is nothing but an enlarged neck lymphnode. Lymphnodes are commonly enlarge in infection. Neck nodes are enlarged in upper respiratory tract infection (URTI).  So her URTI is causing this ball like swelling in neck. No need to worry for this as you are saying that the size of lymphnode is decreasing and she is improved in URTI. So this swelling will also subside by its own in 1 week. Don't worry, she will be alright. Hope I have solved your query. I will be happy to help you further. Wishing good health to your daughter. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to determine whether my 6 month s old s fontanelle is pushed?\n\nI m worried that last night, while taking my 6 month old s shirt off, my thumb accidentally pushed on the fontanelle slightly. The baby isn t showing any signs of swelling or fever but has been cranky since last night. I m just worried I may have done some damage, even though I didn t push hard. Help...?",
    "doctor_response": "there is no reason to worry, damage to fontanelles need a serious trauma.. observe the area of his head only, if you find a swelling or redness then go to a doctor",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can taking Hydrochlorazide 25 mg be safe for high BP?\n\nI went to the dr for bp going through menapause i spike at times with anxiety. It was 150/90 she prescribed hydrochlorazide 25mg when I came home it was 136/86 should i take the pill i am 60 females and on no meds she also suggested  valerian root.Thanks, Kathy",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. If BP is persistently more than 140/90 mmhg, then you should be on hydrochlorothiazide as prescribed.  Regular exercises like brisk walking, jogging according your capacity at least 30 min a day and 5 days a week. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do as I have dark bruises on the top and underneath of the scrotum?\n\nI was in a car wreck three days ago. had seatbelt on so there are marks were the impact pulled on my lower stomach and i just noticed last night that i have dark bruising on the top and underneath my scrotum, is sensitive and sore at touch. should i be concerned and what are some risks of this?",
    "doctor_response": "Hello, Mostly you have bruise over the scrotum area due to car accident trauma. For that, I suggest you take an anti inflammatory drug like brufen for 5 days. However, it's advisable to investigate with ultrasound testis to check whether orchitis that is testis inflammation present or not. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does thick white vaginal discharge indicate that I am nearing ovulation date ?\n\ni got my periods on july 24th 2011, today is 30th july,mine is a 28 dayz cycle but now doctor says make it 30days.....now i am getting thick white discharge from morning little frequent. am i nearing ovulation??",
    "doctor_response": "Hi,Shehnaz, Thanks for query, Ovulation time is not possible as it is too early. You might have some infection in genital tract. Go for vaginal swab examination and after report go fo treatment accordingly. Take plenty of water. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for decrease in size of both the kidneys\n\nDear sir, my both kidney sizes reduced, i think due to high blood pressure sizes of kidneys are 7.5 and 8.1. i contact to specialist he gave me some medicines and advice for proper walk. He also advice me for food. In this regard any good suggestion is appreciated.",
    "doctor_response": "Hello, yes due to high blood pressure kidneys can take some damage and as you have, they can shrink in size and their functioning also decreases. I suppose your doctor must have put you on antihypertensive medications. For your condition not to worsen, few things are very important. First is taking medications regularly. You should not skip any medication given for high BP or delay the timings.Second thing is taking proper diet, low salt diet, less oily food, low cholesterol food will keep your blood pressure and blood cholesterol in control which is essential.Third and important thing is exercise. With regular medications and proper diet, regular exercise is also equally important as it keeps your heart functioning well and keeps your blood pressure under check. All this things will help you in long run and also keep other vital organs like kidney, heart healthy.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i combine clomid and clexane injections to get pregnant?\n\nHi I m currently have clexane injections daily and was trying to fall pregnant too. I am taking clomid to fall pregnant and was wondering if the clexane can effect it in anyway? I am currently 3 days late for my period and I did a home pregnancy test and it was negative. How accurate are these?",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. Clomid cause increase in ovulation in 80% case and increase the 50% chance of pregnancy. USG and ovarian follicle study should advisable after taking it. If ovarian follicle size will be between 18 to 21 mm then high chance of pregnancy. So you can take it under the advise of gynecologist. Clexane contain low molecular weight heparin. It is usually recommended in women who are having risk of miscarriage or stillbirth due to coagulation abnormalities. It should started as soon as the cardiac activity appears. I would suggest to go for  APLA screening, PT, APTT and ICT  Beta-2 microglobulin antibodies, thrombophilia profile to rule out any coagulation defect. So it should be taken under evaluation to maintain pregnancy in history of repeated miscarriage due to coagulation defect. So you can ask doctor about coagulation defect. If above test will come normal then no need to take it.So you can become pregnant as you used clomid. But pregnancy test will give positive result 8 to 10 days after delayed period. There may be chance of false negative as you did early. You can also go for accurate blood HCG test. Avoid stress, take healthy diet, drink plenty of water and do regular exercise.Hope I have answered your query. Let me know if I can assist you further.Best regards,Dr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning pain on the soles of feet?\n\nI have burning pain on the bottom of my feet. My legs swelling and won\u2019t go down, they are hot to the touch. I have pain and swelling in joints. I am a 350 lb women age 48. Just had lapband surgery to help with control of my eating habits and weight. that went ok. However they want to do surgery again because they say they wanted to correct something but won\u2019t tell me what. I have had prior to surgery and still do now have the same pain in my right side.",
    "doctor_response": "burning feet could be sign of neuropathy due to diabetes, or this may be due to infection, the other cause could be lack of vit in your diet and deficency in your body. So what you need is to get a thorough workup of and ascertain the cause of your symptoms.I hope this answers your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of the flat moles on my scrotum?\n\ntwo brown/black totally flat moles on my scortum when testicle skin is tight moles looks normal size & average with perfect border ..but when testicle skin looses mole look bigger too & border also dnt look 100% perfect u can say just 90% is that normal ? i am suffering frm jock itch ... no pain ..no burning in those moles.. just itch sometimes that bcoz of jock itch",
    "doctor_response": "Hello,You can get it removed by consulting a general surgeon. It will be a minor procedure, and you can permanently get rid of it.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. B. Radhakrishnan Nair",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life expectancy when suffering from heart disease?\n\nMy father, 81 had bypass about 9 years ago. He is now having regular angina. He had dye injected and the main bypass still looked good but some of the smaller ones have blockage. His cardiologist didn t recommend any surgery at this point - just changed his meds. Advised is a candidact for heart attack but that where blockage is would be too risky to operate. Dad has pains several times weekly and also has several times had to use three nitro pills to resolve. He has an EF of about 40 and possibly may do a pacemaker at some point. Seems we are at wait and see. Still leads a busy life style. Working and getting around Ok but having a lot of pain fairly often. What type of life expectancy could he have if nothing changes. Non-smoker, reasonable diet, 160 lbs but limited energy at this point.",
    "doctor_response": "Hipacemaker is required for critically lowered ejection fraction less then 30% , your father is 40% which is not that bad.If your cardiac surgeon is saying that  cabg can cause more harm then benifit , then you can ask him to keep your father on  chronic antianginals, they are highly efficient in reducing stable anginaApart  from nitratres he can take tablet ranolazine, trimetazidine  and nikorandin in theraputic doses . in fact trimetazidines apart from being a chronic antianginal will also improve his cardiac functions",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed soreness of jaw and swollen area beneath the jaw\n\nI have had a sore jaw for two days with difficulty chewing and now have a swollen area just beneath my jaw that is very tender and feels hot to the touch.  It feels like a swollen gland but I have no cold or flu or problems with my teeth at present.  What if any glands lay just beneath one's jaw?",
    "doctor_response": "HelloWelcome to HCMI read your query, the  pain and soreness in jaw must be due to swollen and infected salivary gland. You should get your OPG xray done and visit your  dentist meanwhile you can start with antibiotics and painkiller dose coverage for 5 days.Amoxyclav 1BD, flexon AA 1 OD along with becasule Z 1 OD FOR 5 days.Thanknyou",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be done if only sac is identified but not the fetus from the scan?\n\nhi my names sarah and im at early stages of pregnancy around 5 to 6 weeks  ive had a scan done and thay have found my sac  but thay cant find the baby im so scaired my hcg is normal and my cervix is shut tight and my sac is still growing . does this mean im loseing my baby please help me understan",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the gestational sac is seen around 6 weeks in abdominal ultrasound and fetal pole and yolk sac are seen around 7 weeks.The cardiac activity is seen around 8 weeks.All these changes are seen 1 week earlier in transvaginal ultrasound.So dont worry.I suggest you to repeat the ultrasound after 2 weeks to see the progress.Finding of gestational sac at 5-6 weeks might be a normal finding.So relax.Avoid stress.Take healthy nutritional diet and prenatals.Avoid physical strain and intercourse.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the ways to manage hemoglobin and sugar level in a diabetic patient?\n\nHello doctor, I am opening up a new subscription under you, so that I can chat more easily. I request you to follow our discussions from previous records. To remind again, this query is for my mother. Age-47, she is on her regular medicines for above mentioned conditions. However, recently her hemoglobin levels fell to 7.8. After consulting a doctor in my local area, she is taking iron pills. The problem is with her fluctuations in Diabetes readings and haemoglobin levels. I am attaching the recent conducted reports below- 1.\tBlood sugar level + Hb 2.\tCbc + Lipid profile 3.\tUrine culture 4.\tThyroid panel My query is to what can be done to improve her diabetes readings and hemoglobin levels. It will be highly helpful if you elaborate the necessary steps to be taken including types of medicines that are to be taken.",
    "doctor_response": "Hello. I have seen the medicine list being taken by her (attachment removed to protect patient identity). Of those drugs ROXCEF is an antibiotic to be given for a very limited period may be 5 days or so. BIO D 3 strong is also not needed on continuous basis, unless she has any specific neuropathy problems or any such complaints. Is there a to speak to you so that I can clarify a few things in one go. For her diabetes I feel Glycomet G2 once a day (instead of Voglibose containing tablet) once a day with DYNAGLIPT-M is enough. Rest of the medicines are to be continued.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swollen muscle and pain in the lower back\n\nhi.. i am feeling pain between my buttock on the muscle near the rectum. if we follow the spinal cord right to the bottom where it ends, after that the muscle part between the tip of the bone and the rectum. I feel no pain on the bone when i press it but the muscle below it seems a little swollen and it hurts. there is a constant pain there for last four days.",
    "doctor_response": "HiWelcome to healthcaremagicAfter going through your query I came to know that you are suffering from muscular pain.Treatment of it is rest and analgesics (diclofenac three times a day after meals).Muscle relaxant such as thiocolchicoside can be added Vitamin B-complex and Vitamin C supplementation can used to promote healing. It may take a week time to relief. However you can get x ray of sacral spine to exclude bony pain. You can discuss with your treating Doctor about it.Hope I have answered your query.If you have any further questions then don't hesitate to writing to us . I will be happy to help you.Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back ache on the left side?\n\nHello...my mother is aged about 48 years at now, she has a problem in the left side of her body..since long she is suffering from back pain which starts from left side and thereafter spread in whole back including waist, she has been treated by several doctors but nothing satisfactory came out...neither the reason of the problem nor the solution, only one doctor said that she has some problem in her spinal code.....now i can t understand how can i find out her actual problem...by full body check up or by something else and the solution....can you suggest me anything??",
    "doctor_response": "Hello,Thank you for using healthcaremagic.I read your question and understood your concern.I think your mother need to do a back Magnetic Resonance examination wich will exclude or confirm the spinal cord problem that is giving this pain. It may be a discal hernia or tumor or inflamation or infection. Wish your mother quick recovery.Dr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest test during pregnancy to confirm if fetus is mentally challenged\n\nHi! M a famale 29 years old. My question is ... In my family there is a history of menatlly challenged male birth,so now I am married n m worried that will my child will also be the same.. are there any test which can tell me that my child will not be mentally challenged.",
    "doctor_response": "Hi,   Thanks for the query. I understand your concern.   Mendle's law of inheritance says if one parent has family history of any disease ( & is confirmed by chromosomal analysis to be carrier)  & other parent does not have it their child has 50% chances of getting the disease. In case you are not a carrier still new gewneration would have 25 % chances of getting the disease.    According to the law, provided your husband does not have any family history of mental illness..your would be children would run  at least 25 % risk of getting the disease.     This possibility can be excluded / confirmed by chromosomal analysis of the fetus by amniocentesis during the pregnancy.So every time you are pregnant, you should exclude the possibility by chromosomal analysis & then continue with the pregnancy.   Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any side effects for taking protection against Diphtheria, Tetanus and Polio?\n\nHello, I have recently recived a letter saying that I have to go to my local doctors surgery to recive protection protection against Diph, Tet, Polio Reinforcing . I was wondering if I absaloutly have to attend to this, the reason why I dont want to go if that I assume a needle will be used and I am very nervous about it. If I attend this is there another way I can recive protection other than a needle and if I have to use a nedle that you can give me anyway of helping my nerves on it? Also is there any side affects on this treatment? Be much appreciated if you can anser my question. George.",
    "doctor_response": "Hello,DT (diphtheria, tetanus)  and polio vaccines are generally given routine in children and then every certain number of years in adults to provide protection against these infections.Polio can be taken orally, 2 oral drops. This is a live vaccine and poses higher risk for side effects compared to the injectable form. Some countries do not even have oral polio due to its side effects.DT, unfortunately, is only in the injection form. So, if you need protection against these infections, the injection is the only way to have it.I hope this answers your query.I remain at your disposal for further medical assistance.Regards,Dr. Antoneta ZotajGeneral and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have to take up the birth control shot. Advised to be accompanied by another person. Is it really required?\n\nHello, My name is BrianneI have an appointment tomorrow to receive my second birth control shot. My mom has to work so I was going to take myself but, they said that my parent or an adult who can sign for me had to be there. I'm 17 so I was wondering can't I go by myself without a parent because under consent and confidentiality laws I didn't even have to tell my mother. So can you help me figure this out.",
    "doctor_response": "Hi Brianne,Thanks for the query.Usually in some countries a person can give consent for contraceptive purposes only after 18 years.Possibly because of that your doctor or hospital people might have told like that.So better to take your mother along with you as per the rules.Ans also it will be good if some body accompanies you because sometimes side effects can occur to shots.If your mother is busy you can take help of some other family member. For more details you can ask me through:  care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "22 years old, feelings of laziness, anger, irritation, excessive sleepiness. Drinking coffee, sleeping late. Treatment for symptoms?\n\nhi, i am a 22 years, male, my problem is somewhat psychological -i guess-the thing is since I ve been a fresh grad( a few months ago) i can t determine my goals, i find it really hard to study for my masters actually am not studying at all (instead of being a top student), which is really frustrating me. also i tend to be extremely lazy, could reach high anger levels if irritated (i am supposed to be a very calm and quite person) and sleepy. what should i do to get over this and get back to my life that I ve really enjoyed note: i drink about two cups of coffee a day max and i tend to sleep at 4:00 am every day if not after that.",
    "doctor_response": "Hi, Welcome to Healthcaremagic. There is apparently no organic problem in you.It is just that you need a strong motivation to start reading.No psychiatrist will be able to help you here. You have to get into a group which is preparing for the exams and be a part of the competition ,only then you will be able to read well. Wish you the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are fungal infections, related with itchy and dry red lips?\n\nI've had red lips for a while now, they are itchy and dry. Topical cortisone cream is not helping. I don't believe that the redness is due to licking them too much. Another doctor prescribed an anti-fungal cream thinking that its a fungal infection. Does anyone confirm this diagnosis? Asking for a second opinion.",
    "doctor_response": "Welcome to Health Care Magic Team.Understanding your concern. As per your query you have itchy and dry red lips which is due to excessive licking of lips. Excessive licking along with dry climatic condition removes the natural moist layer from the lips and that is the reason cracks starts appearing on the lips which further become prone to fungal infection. I would suggest you to use petroleum jelly , drink lots of water ,avoid to stay in dry environment for longer period. You should use lip balm which can be directly applied rather than if you use finger it will cause spreading of infection again and again whenever you will apply with finger. Avoid using creams containing high steroid content ,wash your face with mild soap twice a day and avoid licking your lips. Use cream rich in SPF factor to prevent sun exposure as well. Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr.Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recurring itchy reddish swollen hair follicles in the shin. Need a permanent cure\n\nI have red swollen hair follicles on my right shin for about 3 months. It all started when I wore these new pair of pants that made me itch. I scratched my right shin and my nails were obviously sharp at the time and broke skin. The follicles around that area became red and swollen. It would start to heal then the itch would reoccur and the follicles would bled and the process would start all over again. I've also noticed that the itch occurs whenever the skin on my legs dry out. Should I get that checked? It's been 3 months now and the follicles are still red and swollen. It's healing, I think, but whenever it itches again, the scabs that were on the healing follicles would be scratched off.",
    "doctor_response": "Hi, thanks for your query As per the details mentioned by you , it seems that the problem started with contact dermatitis due to the new fabric of pants which worsened to infection due to scratching of the skin. Once you itch , you feel a sense of relief but soon you have a sensation of increased intensity of itching every time to the extent that bleeding occurs. This is SCRATCH ITCH CYCLE which is most challenging part of the treatment. You are right ,dry skin aggravates itching. For this you may do as follows: -Avoid scratching the lesion instead apply ice or cold compresses which decrease itching -Take oral antihistaminic  for itching like cetrizine in the morning and fexofenadine at night for a few days to break the scratch itch cycle after prescription -Oral antibiotic for 5-7days Keep your skin well hydrated with moisturisers Use mild cleansing agent or syndet based soaps Wear loose fitting cotton cloths Get your blood sugar checked You may approach a dermatologist for examination or upload your pictures on our site . Hope this solves your query Wish you a speedy recovery",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is frequent urination normal after a spinal fusion surgery?\n\nHello. About a week ago my husband had anterior/posterior lumbar surgery with spinal fusion. He was under anesthesia for about 4 hours. Since he s been home he s had to urinate frequently. Is this normal? He did have a build up of fluid in his body. His feet and legs were swollen but this seems to have subsided. Thank you.",
    "doctor_response": "Thank you for asking Healthcare majic. My name is Dr Ehsan Ullah & I have gone through your query.well if the surgery is performed safely without involving nerve roots then its normal for 1-2 months.i will also like to know the age of your husband and co-morbid conditions like diabetes and hypertension status..Also restrict your husband not to lift heavy weights,stairs climbing and bike riding..give him proper rest...he will be fine with in 15 days.Hope this may help you. Let me know if anything not clear. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to relieve stomach pain with nausea sensation?\n\nFor the last couple of weeks my stomach has been hurting more then normal. it mostly occurs later in the evening or at night. I use the bathroom regularly. It feels as if im going to vomit, almost to the point I want to go makeself do it so it goes away",
    "doctor_response": "Such problem occurs due to severe acidity.Treatment needs to be done.1. Antacids with prokinetic combination - esmeprazole/pantaprozole+ domperidone2. Avoid heavy meals at one time, easp. Night.3 . decrease coffee n tea, n also smoking or alcohol in case you take.4. Chew ginger, of the size of a pea, empty stomach early morning.Hope these help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and pain in the ball of the foot?\n\nCompletely unexpectedly, with no prior history, or obvious injury, I went to get out of my car and felt like my left ball of my foot had something stuck between foot and sandal. When I looked it was VERY swollen and somewhat painful, though more uncomfortable due to swelling. After a couple of hours it subsided enough that as a coach of runners I went ahead and shuffled carefully around for 30 min. It felt better and swelling went down , now it is VERY purple in color. This same foot has been experiencing some Achilles and heel pain but this ball of foot has never been a problem",
    "doctor_response": "Dear patient thank you for your question.It seems to me that you have a hematoma collection in the ball of your foot.While this is nothing to be worried about and will resolve within a week max I must suggest that you do get your coagulation profile done to make sure that your platelet count etc are in order. I hope this helped",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sweating with numbness on the body and mouth?\n\nI have experienced twice this week tingling all over like every nerve was on edge. The first episode included sweating. My mouth felt numb. I felt the need to eat something with sugar in it & the symptoms went away. The second episode included the feeling that I needed sugar & my tongue was numb. I felt some dizziness both times but today I felt the sensations if a pre-migraine. Thoughts?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have sweating with numbness on the body and mouth. Well there can be many reasons for symptoms you mention in query like peripheral neuropathy , vitamin B12 deficiency , anxiety disorder , medication reaction or side-effect , panic attack , hyperhidrosis , diabetic neuropathy or stroke. I would suggest you to consult general practitioner for proper examination . Doctor may order certain test like blood test , ECG and check vitals to confirm the diagnosis . Doctor may refer you to cardiologist in case of heart problem . Doctor may prescribe vitamin supplement . For now kee yourself relax , take proper rest and do mind relaxing exercises like meditation . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to control Serum T.Cholesterol -229mgs/dl in blood?\n\nI HAVE GONE THROUGH LAB TEST ,THE RESULT SERUM T.CHOLESTEROL IS 229mgs/dl AND SERUM TRIGLYCERIDES IS 304gms/dl what kind of treatment shall i follow to control the cholesterol in my body what are the steps to be followed, pl mail me sir.                                                ThanksK.Ganeshmurthy",
    "doctor_response": "Hi Mr Ganeshmurthy KAfter going through your reports, my opinion is as follows1. Your cholesterol is borderline high and your triglycerides are high.2.  High lipids can affect the blood pressure, so needs to be controlled.3. You can discuss with your consulting doctor regarding stations and other lipid lowering agents, their dosage to control lipids.4. Exercise on a regular basis to control weight as well as to stay fit.5. Cut down on oil rich foods, junk food. Have diet rich in fibers, proteins and lots of fruits and vegetables. 6. Make necessary lifestyle modifications like avoiding stress, practicing yoga/ meditation. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bumps on penis?\n\nI have some wierd bumps on my penis on one side. They are not red and do not hurt and are not hard. I think I may have psyched myslef out with all the pictures online I thought somehow it may be Herpes but i haven t had sexual ckntact with anyone except my wife. Only thing out of the ordinary is I recieved a massage in TX for shoulder pain but the place looked a little shady and i was offered sexual favors.",
    "doctor_response": "thanks for writing to HCM;No; there is nothing to worry about this and this is not Herpes...Hi, If I were your treating Doctor for this case of BUMPS ON PENIS, I would come up with three possibilities, these include: 1. benign and simple conditions like skin tag/papilloma, para-urethral cyst,  lipoma or neurofibroma or dermatofibroma; there is nothing to worry about these!\u00a0\u00a0\u00a0\u00a0\u00a02. some sebaceous cyst or some other cysts3. resolved old infection,  chronic folliculitis or some benign stromal nodule!I suggest you to go for clinical assessment and if necessary FNAC test for confirmation and to relieve your concerns!Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sudden and acute dizzy spells, nausea. Had an ECG. Possible anteroseptal infarct. What is going on?\n\nHello, I'm a 31y/o Latin woman who recently went to the doctor because I've had very sudden, acute dizzy spells for over 1 week and, while there, had an ECG done (Actually 2) in which I was informed of a Possible Anteroseptal Infarct. I'm still having the dizzy spells and they are strong enough to cause SOB and nausea. What does this mean?",
    "doctor_response": "Hi there ~I understand your concerns and if you have had an anteroseptal infarct and have had dizzy spells for over one week then it might be best to go visit your cardiologist for the necessary recommendations.  I also would advise you to take all your reports from before so as to help in the process.  I hope this works for you.  Take care and have a lovely day!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does Fatty liver mean?\n\nI am 33 years old and have drank for about 15 years alot i went to the doctor 2 weeks ago for a bllod test and had already been drinking my ast was 98 and alt was 155 so they had me quit drinking and retest i havnt had a beer in 7 days and retested today now my ast is 85 and my alt is 198 going to see my gi doctor wendsday but im done drinking will this clear up as long as i dont drink and what could it mean i was diagnosed with fatty liver 3 years ago thanks alot for your help.....",
    "doctor_response": "Good day! Drinking alcohol puts a burden on liver and it converts it into fats. When production exceeds demand then it gets deposited in liver and it is called fatty liver. Needs clinical correlation and a consult to gastroenterologistgood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause lump and pain in the under arm?\n\nhi my name is bahisht rahim. i am female 20 years of age. i am having pain in my right side underarm. it like a feel inside there is something round round. ouside there is no red or anything. i am very scared is it something related to breast cancer? i am very scared. please guide me.",
    "doctor_response": "Hi Bahisht ! Good evening. I am Dr Shareef, a general surgeon answering your query. Being concerned about one's own health is good, but getting obsessed with cancer with anything and everything is not advisable. So, not to worry for cancer at the present moment. The pain itself points to the inflammatory nature of the lumps in your under arm, and the common cause coud be due to a boil or due to inflammatory swelling of the lymphnodes due to any infected wound in the right hand or right breast. If I were your doctor, I would clinically examine both your breasts for any abnormality there, and after being  certain about the inflammatory cause, would advise you a course of broad spectrum antiobiotic and an anti inflammatory drug along with a proton pump inhibitor for symptomatic relief, which could also be a cure for the condition. In case of no relief, I would advise you to visit a general surgeon who might advise you for a FNAC of the lesion for a cytological diagnosis and further management would depend on this. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain after an accident\n\nI was rear-ended in a car accident, the car was going 70 klm and I was in a stopped position on impact. The accident was June 19, 2014. This was over two months ago I have been receiving physio treatments since July and recently had a massage which may have aggrevated my condition. The pain in my hip radiates down my right hip whenever I walk, I also have lower back pain on the right side. I am in so much pain that my whole body hurts it feels like a burning sensation all over. I find myself gritting my teeth to get through the day.",
    "doctor_response": "well symptoms seems to be of nerve compression because of disc prolapse/canal stenosis Xray LS spine to be done and to review with orthopaedician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from nasal congestion even after having drugs. Please suggest treatment.\n\nHello doctor, I am a 43-year-old male with height 167 cm and weight 79 kg. I am having nasal congestion for 10 days now and have taken Niacin and Kaasahara syrup for the past four days, but there is no improvement before that I tried Allopathy. Please suggest if the medication what I am taking is fine and should continue, or else suggest alternate medicine.",
    "doctor_response": "Hello. The medicines you are taking are mostly for cough, and not for nasal congestion. I suggest, 1. Haridra khanda one teaspoon mixed with one teaspoon honey, taken a day after food thrice. 2. Anu thailam 2 drops in each nostril, twice a day. When you put this nasal drop, it may come to your throat in which case spit it out. If you swallow it mistakenly, it is fine as it is harmless. 3. Mahalaxmi vilas ras (plain) 1 tablet taken a day after food thrice. These medicines are available in Ayurvedic stores.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Got itchy and dry rashes on face. Looking for permanent solution\n\nI m 25 years old.Married.I have got a rash type of Acne in my face since last week.I ve had it before two weeks back, then I was asked to get Microdox dt for 6 days(Doctor s Opinion) with Acne Aid Soap, immediately my rash was healed. But now it has appeared again.My face is itching also.It has become dry and reddish(infected Area). Kindly let me know what I can do for this.earlier I had a clear and good skin.",
    "doctor_response": "Hello.You shouldn't be stoppin antibiotics till your doctor tells you to do so, usually for 3 to 6 months.You will also require anti acne creams and emmolients.Stop Acne aid bar if it is causing dryness and irritation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a facial lump with discoloration be treated?\n\nI have a lump on my face, on the bridge of my nose and it seems to be getting bigger, I thought it was a spot but it hasn't turned into a spot, i've had it for a while now and it's starting to make me concerned and I would like to get rid of it but I don't know what it is. It turns white if I frown and it is quite large.",
    "doctor_response": "Hi,Dear Thanks for the query to HCM virtual Clinic.I studied your query with available details given in your query.I understood your health concerns.Treatment and Cause for  the painful multiple lumps in arm vein-For the right treatment right diagnosis of the cause of the lump on the nose bridge is to be done.Cause of lump -It very difficult to comment on the cause of the lump on the bridge as the data is insufficient. Following possibilities could be ruled out with help from your doctor-DERMOID CYST/ACNE/Boil/Epidermoid Cyst/Syringoma/Sebaceous Cyst.From the size told by you, possibility of it being Dermoid Cyst / or Sebaceous Cyst-is moreSo Don't worry.Its not cancerous .Still if worried I would advise you to get the USG guided  FNAC biospy, to rule out it being cancerous.This would help you to plan treatment with your doctor, whom you should plan your visit urgently , before it complicates any more.Don't Self-treat or medicate in your case as the case may go in to further complications.Hope this reply would resolve your query and would help you to plan treatment with your doctor.Hope this would relieve of your health concerns.Welcome for any further query in this regard before final suggestions are given in your query.Wishing you fast recovery..Have a good day.Dr.Savaskar M.N.Senior Surgical Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated levels of estradiol?\n\nMy test report shows that i have elevated levels of estradiol 72 (Normal upto 42).I did exercise to reduce fat level and also i made dieting.Because of poor dieting,i was not getting sleep at fullnight before 3months.then i changed to my normal eating habits and doing exercise.Still estradiol level is high.I am afraid that i have some prostate issues>kindly suggest me",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Your estradiol level is slightly high. There are many causes of high estradiol level. Hepatic cirrhosis, hyperthyroidism, estrogen secreting tumour are the common cause. You should check your thyroid level and go for ultrasound abdomen. It will give some idea about cause. Then you should take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can hemopericardium detected through tests?\n\nmy husband died last week of a haemopericardium, he was sixty two years old. Cycled and swam daily, fittest nut. He had been suffering heart burn, chewing too many Tums. If he had seen the doctor would they know what tests to run, could they have saved his life?",
    "doctor_response": "Hello , before I start I would wish to tell you this that thinking in this direction will never bring closure , and so you must consider it ad gods will . Hemopericardium means blood around the heart . It's not it which would have caused demise of your husband , rather the cause of it . As you said he has heart burn s , it probably would be because of a heart attack like senerio,  which weakest the heart muscle who h may give way and cause spillage of blood outside the heart I  the covering causing death.  Alone hemopericardium can prevent any effective circulation of blood causing an event . If clinically suspected the doctor can do an echo cardiography which helps confirming such a problem . May his soul rest in peace . Again it's very common to mis interpret heart events as heart burn related to stomach and no where he or you were at any fault Regards Dr. Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does stress cause dizziness and chest pain?\n\nHello, I'm 30 yr male, Ht 5'6'', wt 55Kg I'm feeling bit dizzyness at the chest and the pain would be for say 10 - 15 mins and comes back after a while....I never had any other health issues...but off late feeling bit pain in the chest and also I'm mentally stressed due to my personal problems...Is this anything to do with the pain ??",
    "doctor_response": "Dizziness could be because of dehydration if you live in a sunny place , unhealthy eating habits or lack of sleep. You should consult a general physician if your chest pain is too severe. Stress directly effects our heart , which in turn makes our chest pain. Don't ignore this problem and kindly don't keep on deviating the problem by taking pills for it. Consult a doctor as soon as possible.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes semen discharge during urination?\n\nI am 31 year guy getting marriage after 2 months .I have a problem when i am using toilet. i have sperm loss with urine. also sometimes when i have some sex feeling i loss my sperms in drops i want to know the problem please suggest me with solution. May it make a bad effect in married life?",
    "doctor_response": "Hello, As per your history, it may be due sexually transmitted infection. For that you may require complete hemogram, urine analysis, ultrasound abdomen and pelvis after consultation. Take balanced diet and keep your self hydrated Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment for liver cirrhosis?\n\nHi, may I answer your health queries right now ?  My father is suffering from lever cirrosis i like to know about its best treatment. What cost for same. Tell me it is dangeries for life and how long person leave if both lever failed by alcohol which having from 45 years. My father's is 64 years old , height is 5'10\".weight is 90kgs.",
    "doctor_response": "Hi welcome to HCM...Cirrhosis is irreversible condition because of more fibrosis......So ultimate final treatment is liver transplantation....It is costly procedure.....In cirrhosis if spleenomegaly and ascites present then it is portal hypertension case....For which low salt diet taken....Diuretic if needed given...Beta blocker help in reducing portal pressure......If portal hypertension very much high and transplantation not possible then TIPSS like shunt placement can be done for high portal blood pressure .....Take daily early in morning grined spinach and carrot juice .....Take care.Follow up regularly done....Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Has ovarian cyst, swollen abdomen, been bleeding. Taking apple cidar vinegar. What is going on?\n\nHello, I just came across your website My aunt found out that she has a 4.6cm ovarian cyst in her left ovary since January 19th, it was a lot big before but she s been taking medicines now so it has shrunk to 4cm. She has been taking a drink made of molasses and apple cidar vinegar, heard that it s effective. But she s seeing no changes so far, her abdomen has swelled up and she s been bleeding for 2 months now. How much time does it require for an ovarian cyst to dissolve completely? Also, could you tell me the treatments for it? Any effective home rememdies you know? Thanks a lot, she s really worried right now. I hope you write back soon, thank you.",
    "doctor_response": "hello,welcome to HCM, as per the details u have given, there is no relation ship with the ovarian cyst and the type of food that you will eat/drink to reduce its size.. more over , it is strongly advised to get through a ULTRSONOGRAM to confirm the type of ovarian cyst , if it is a simple follicular or haemorrhagic cyst , they are benign and gradually disappear ....but problem comes with the malignant ovarian cysts... so i advise you to dont wait for cyst to disappear by giving some drinks or foods..go get the pelvic sonogram immediatley... hope this will help u lot..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Headache, high temperature, dizziness, feeling thirsty. History of irregular and continuous bleeding after using contraceptive implant. Opinion?\n\nHello. I am a 22 year old female. 10 months ago I started using the contraceptive implant. It is great only bleeding is irregular. Currently the bleeding has lasted for a whole month. In the last 3 days I have been feeling unwell. On the first day I woke up in the morning with a headache. As the day went on I developed a high temperature (not sure of exact temp as I had no thermometer but I know it was high). Took paracetamol and rested and this just about got rid of the headache and lowered the temp. Day 2 I had a mild headache and felt a bit dizzy at times. I am feeling the same today as I was yesterday. I seem to be quite thirsty as well and at certain intervals during the day I will lose my appetite I can sometimes feel nauseous, though this only last for a short while during the day. Overall I have a good appetite and eat enough every day. Have you any idea what might be causing this? Appreciate any answers thanks",
    "doctor_response": "Hi Dear,you are suffering from two unrelated problems.Firstly, excessive bleeding due to implant which should be taken care of. In absence of any treatment you will become anemic and develop weakness. Consult your gynae as it can be managed with medicines. However, if no improvement, the implant has to be removed and you can go for other birth control measure.Secondly, the fever which you are having may be seasonal and has to be investigated properly. Consult a physician and get investigated for all possible causes of fever including dengue, malaria and typhoid",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to cure pancreatic cancer ?\n\nis pancreatic cancer curable",
    "doctor_response": "Hi dear Welcome to HealthcareMagic.Pancreatic cancer can be treatable based on the type of cancer and on the choice of treatment.Ultimate treatment is surgical approach and chemotherapy..Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can weight cause difficulty in conception?\n\nme and my hubby have been trying for a baby in the last year we cant seem to get pregnant he thinks that because he doesnt get aroused very easily and when he does he finishes really fast. and for my self i think it's because of my weight i cant concevie",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.Early arousal and early ejaculation doesn't cause infertility.Overweight also doesn't cause infertility if penetration occurs properly.For your infertility consult your gynecologist to rule out any pathological cause.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for redness and welts on hands and feet\n\nhello, My son started about a year ago getting this redness on the backs of his hands and the tops of his feet with some welts. I have sone all the questions like what he touched ate drank if it was after a shower etc. Nothing It just appears and spreads and will be there for about a hour or so and will go away He is 15 and has autism. this has been going on for a couple of years One time it was all over his back and stomach I took pictures It seems kind of pointless to take him to the doctor when I walk in with a kid with no rash can you advise",
    "doctor_response": "Hi...By what you quote it should be an urticarial or a simple skin allergy.  Most important thing to be remembered is that it has a propensity to recur (called as second crop) within 10-14 days. If this happens, you can start using the same medicine but I suggest you get the kid evaluated with your pediatrician.A simple suggestion is to carry an image of the welts in  your cell phone when you go to your doctor next time. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest an alternative of Tramadol for the treatment of backache\n\nHi I take Tramadol 10 mg 3 to 4 times a day. it is not helping I have a Degenerative back pain its pretty sever. What other Med can I take in place of It? surgery is out of question. I don twant anythingto effect Mind Im 81 yrs Thanks Joy H",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Tramadol is opioid type of analgesics which acts centrally. Other type of painkillers are acting at peripheral level like NSAIDs.Both type of medicines relieve symptoms and do not affect basic pathology. So, these medicines should not be taken regularly.You can take tablet Diclofenac sodium twice a day for 5 days. It helps in pain relief. But considering your age, it may affect your kidney. Less harmful medicines are Etodolac and Piroxicam.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Jayesh Vaza",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I stop addiction of pentazocine injection?\n\nHi, Dr. I am addicted to taking pentazocine injection for my pain and it works well but lately I discovered that I am addicted to this drugs. How can I stop this adduction please I really need your help on alternatives and how I can stop this.RegardsFunsho",
    "doctor_response": "Hello Funsho, it would be better if you made some more things clear to us..regarding..*What is the reason for taking pentazocine injection?* Are u addicted to take it without prescription?* Since how many days or years are you taking it?*Your age and Are you combining it with other drugs?Its really a grave situation if you are really addicted to it and it may require residential treatment center to completely treat it.Hope it helps..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is angioplasty painful?\n\ndear doctor , please let me know angioplasty , does it hurt while doing , as I have scheduled for same on the 14 December 2011, also explain what is the meaning of \"high suspicion of de novo angina\" specially the word 'de novo' Thanks Channa",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern. You should not worry. I'll try to explain you something and give you my opinion. You should know that angiography its not painfull.It is made through local anesthesia in the plase of punctuation. The point of punctuation might be in your inguinal aera or in your wrist. So you will feel just the a small pain like when you take a blood analyze.Then the plase in under anesthesia and you don't feel anything.If you have problems with your coronary arteries it might happen to experience chest pains but they will be resolved through the procedure. Angor de novo its a medical term to explain a typical heart pain that appears for the first time. The term de nove means new pain,in a period between 30 days.This means that this complains should be verified through angiography. Hope I was helpfull. Wish you good luck. Best regards, Dr.Ervina.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat pain and swelling of the testicle after being hit?\n\nMy son has only one testicle (the other was undesended and had to be removed when he was 6, he is now 11). This morning he woke with acute pain in his testicle. I took him to the nearby emergency room (not the children's hospital in our city) and they performed an ultra sound and ruled out testicular torsion. He was given morphine while there. We went home, but he is still in considerable pain. I am very concerned that he may have been misdiagnosed and torsion might still be an issue. Further, he was hit in the testicle 6 days ago (his friend accidently hit him with his hand pretty hard and there was extended pain and swelling). He was PAIN FREE for 5 days prior to pain begining this morning. Should I take him to the children's hospital? should I still be worried?",
    "doctor_response": "Hi, You should get a checkup with urologist including an ultrasound scan to rule out torsion or any haematoma. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. B. Radhakrishnan. Nair, OBGYN",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a child be given Antinal for Egypt Tummy?\n\nHi there - very quick question. I'm going to Egypt and no doubt we (family) will get the infamous 'Egypt tummy'. Antinal (aka nifuroxazide) is apparently the thing said to be effective to cure. I have a 2yr old. Is it ok for him to have? If so, how much can I give? Is is 1 capsule twice a day? I think a capule is 200mg.... Any ideas?",
    "doctor_response": "Antinal (nifuroxazide) can be used to treat 'Egypt tummy' in children. Nifuroxazide 100 mg capsule (available) 1 such thrice daily for 5 days should be ideal for a child of 2 years of age. It can be given to a child of such an age without worrying.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for thalamic bleed\n\nI'm 50 years of age, 5'5\" , 174 lbs. and my medical history was acute thalamic bleed. left, hypertensive cardiovascular disease. As of now, i'm stay at house for my recovery (mild stroke was happend last June 27, 2011). Please kindly answer my query to avoid second attack. Teddy S. Libre Nortern Catadman, Ozamis City Philippines",
    "doctor_response": "Because  you are hypertensive keep it under control. Get regular BP check up .Stick to DASH diet details of which is available online.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Cefpodoxime recommended for loose motion in infants?\n\nHello Dr My daughter vaccinated 2days before at 2.5month..after she had fever and I give her paracetamol tablet 1/6 part..then her stool coming as loose motion .like watery ..(I had viral fever before 2 days..is that affected her?).Dr gopal advised me to give her Cefpodoxime ,zinc syrup,and Nutrolin B syrup(lactic acid bacillus with vitamin b6) Can it cure my child problems?",
    "doctor_response": "HiWelcome to the HCMFever episodes after immunisation are expected for 2-3 days due to immune response of the body. It's especially common after DPT vaccine given at the age of your child. So don't worry.Infants show great variations in colour, consistency and frequency of stools. Also, most infections of gut in this age are due to self limiting viral infections. So, is your baby is feeding well, active, alert and passing atleast 6-8 times urine per day. Then there is no need for any further medications. Just ensure regular feeds to keep him well hydrated. Antibiotics such as Cefpodoxime may be used in case the child looks sick with blood in stools. It needs to be given after paediatric clinical examination.Hopefully this will help you. I would be happy to help you in any further questions.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I put Asthmanefrin liquid medicine on tongue?\n\nThe Asthmanefrin medicine cup become clotted, even though it was properly cleaned after each use. My question is, what would happen if I put the liquid Asthmanefrin medicine on my tongue while waiting for the company to forward me another medicine cap/cup?",
    "doctor_response": "See, asthmanefrin was considered safe previously as it was readily available OTC but cases have been reported to US FDA of tachycardia, hypertension or chest pain as far as what I have heard, so it should not be used as an OTC Strict medical monitoring is required.Kindly contact your physician for further advise",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does gastroenteritis have similar symptoms as hepatitis ?\n\nCan gastroenteritis be confused with hepatitis (symptom-wise)? The reason I ask is because I had my liver function tested on Wednesday and on Monday (5 days later), I felt really tired and woke up hours later to extreme diarrhea , chills and some vomiting . I felt so bad that I went to the ER and was given an IV and some anti-acid and anti-diarrhea meds. By Wednesday I felt better and started eating regular food after only having water, Gatorade and Lipton noodle soup the previous day. On Wednesday, one week after the liver test was done, my doctor called to inform me that my liver enzymes were elevated (at 88 when norm is up to 50). He s re-testing me and also running other liver tests. Could I have been experiencing hepatitis and not gastroenteritis? It is now Saturday, 5 days since I first felt ill and my feces is solid but yellow.",
    "doctor_response": "Dear Mister, symptoms that you have described are specific for gastroenteritis and it should be the first problem to think about. If you feel better now and dont have these symptom it means that your therapy was successful. Symptoms of hepatitis are nonspecific. It depends are you talking about acute or chronic hepatitis? A,B or C? Which liver enzymes are elevated? If AST and ALT than it can be liver lesion, if GGT it can be alcoholic liver disease and ALP means that you probably have billiary system obstruction. Symptoms of acute hepatitisa are pain in upper right quadrant, jaundice, anorexia and fatigue but it can asymptomatic as well.So what should you do?1. Lab tests: bilirubin, red blood count2. Viral DNA/RNA analysis to rule out viral hepatitis3. Liver ultrasoundWhen you do this everything should be clear..Wish you good health, Dr. Ivan Romich (Rominho)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling, numbness, swelling and occasional pain in feet?\n\nI am having tingling, numbness and occasional pain in my toes. They also get very cold. My feet hurt so badly most of the time. My lower legs and feet swell. I take Lasix 40mg/day for that. I had bilateral knee replacements 3 years ago. What would cause my feet to hurt so much?",
    "doctor_response": "Hi,Thanks  for  your query.Most likely cause for numbness in feet  is peripheral neuropathy. I would recommend you to get vitamin B 12 levels done.There are chances of Raynaud's phenomenon. In this condition, people will experience numbness in feet with similar cold feeling. Cold stimulation test confirms it.We should also rule out hypothyroidism where few patient experience similar symptoms. Get T3, T4, and TSH done.Sometimes vascular occlusion of lower limb vessels also causes similar symptoms. To diagnose it we need to do Duplex ultrasound of lower limb vessels.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest dosage of cartigen for osteoarthritis\n\nHi! My father is known diabetic and hypertensive. His blood sugars are well maintained on normoglycemics only. He has recently developed knee nd shoulder pain findings suggestive of OA. What dose of cartigen plus should he take alongwith what other medication specific to OA he takes tramol on and off",
    "doctor_response": "dear friendcartigen plus has many ingredients the main ones being glucosamine and chondroitin sulfate. both of them have shown no effect on glycemic control on patients with diabetes.he can safely take the medication",
    "dialogue_context": ""
  },
  {
    "patient_message": "What course of treatment should be given for bipolar and paranoid schizophrenia?\n\nMy wife was diagnosed with bi polar b- into paranoid schizophrenic just over 9 years ago or so. At that time she was receptive to the fact that something in her mind just wasn t right. She began medication and once a few months had past I began seeing real changes, it brought me so much hope and is what made me decide to go ahead and marry her because I thought we found the answer and all was solved. I was wrong, she became pregnant and due to the pregnancy she could not take her medication, I had no problem with that as she agreed once she had the child she would return to taking her medication. She became pregnant again before starting her medication back up and therefore could not, then after that pregnancy she said she wasn t going to be getting back on the medication because it just made her sleepy at night. I was devastated and afraid what would happen. 5 years after no medication, she had a really bad episode that I was unable to manage or cope with myself and I ended up in jail for her lying and making things up that didn t happen. Before she was diagnosed, she begged me to kill her for hours on end, I obviously refused and when I told her, not even if you wrote an authorized letter to do so would I even be able to think about doing such a thing. She then did just that, as if doing what I said wouldn t matter would change my mind? I am now sitting at my father s house because she wants a divorce because she is having an episode of extreme negative thoughts and is being very hostile just for starters. I have 4 kids I do not want to lose, how do I take control of the situation and not lose my wife and kids and everything I ve worked for?",
    "doctor_response": "Hello, In case she lost her judgement about her illness leading to consequences (impending divorce) there is option for forced treatment as per the provisions of mental health acts prevailing in your country. You can approach the law enforcement agencies for rescuing her and treating her as per the need of hour. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ashok Kumar, Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes food pipe to block after jaw cancer surgeries?\n\nage 50 year wt 56kg heamoglobin 10.4 wbc 17800 operated thrice for jaw cancer lastly operaqted 2011 food pipe got blocked 2 days back today water can pass what is your opinion weather cancer got spread to food pipe.swelling at left jaw since last 3 months ulcers are there at swelling part pus also coming out .",
    "doctor_response": "Hi and welcome to HCM thanks for the query. yes, unfortunately tis can be sign of cancer swelling but also some benign diseases could cause this such as esophagus inflammation,stricgure or oedema so you need to seegastroenterolgosit for further plansWish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is liv 52 recommended for my SGOT, SGPT and urea levels?\n\nhi my name is sahil and i am 27 year young guy last day i gone through with a test of liver function and as per my report SGOT is 84 and my SGPT is 113 . Blood Urea is 34 . can u suggest me liv.52 will be a good medican for the problem .. kindly suggest me what should i do to control it.",
    "doctor_response": "sgot/sgpt can be elevated due to many reasons like alcohol, non-alcoholic fatty liver disease, any viral infections. You should undergo detailed evaluation with liver function test, viral screen and ultrasonogram of abdomen. Liv 52 is not recommended.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent sneezing, pain and blood clots after tooth extraction?\n\nI had a rear upper molar extracted three days ago, during the procedure the dentist told me my root to my tooth was embedded into my sinuses, they put some type of patch in as a fill after they removed my root. Since then I have had several sneezing incidents and on top of the pain I have had lots of drainage and some blood clots . I have a follow up in 3 days but is there anything else I can be doing in the meantime?",
    "doctor_response": "thanks for your query, i have gone through your question, the complication during extraction that is formation of communication between oral cavity and maxillary sinus could have resulted in some inflammation of the sinus results in sneezing which in turn creates negative pressure and induces bleeding...nothing to worry it will heal in one week...consult your dentist for suture removal and review...continue antibiotics...take soft diet..avoid vigorous gargling...i hope my answer will help you..take care...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is red blotchy area on cheeks due to side effects of Tdap vaccination?\n\nI had a Tdap vaccination around 1030 am today and was out doing yardwork and know my face has red blotchy areas on cheeks...am i having an allergic reaction or is this normal side effect from the shot? I am only allergic to septra/bactrim type drugs....",
    "doctor_response": "Hello,Your symptoms seem to be related to an allergic reaction. I suggest using antihistamines such as Cetirizine 10 mg daily. I also suggest using steroid cream such as betametasone cream for local application.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can I get a good sleep at night?\n\nHi doctor, I cannot sleep at night. Although my head is hurting throughout the day and I know that it is because of not sleeping I still cannot sleep, overthinking all night, and because of this, I have really bad acne now. I do not know how to put my mind at ease and sleep. Can you please help me?",
    "doctor_response": "Hi. Close your eyes and concentrate on breathing and relax your whole body. Make comfortable ambient for your sleep means dark rooms, no noise, no mobile or TV at least half an hour before sleep. Drink warm milk for sleep induction. Wear comfortable and loose clothes, wash hands and legs before sleep. If still there is no sleep, then you can try any antihistamine like Cetirizine, that can help you to sleep.  For daily or routine life, fix your schedule and time to go to bed and wake up time. Do the daily exercise for 30 to 45 minutes, do meditation for 15 minutes, eat healthy good home cooked food, avoid junk food, eat light food at dinner.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower abdominal pain?\n\nhi, i have lower right abdominal pain. Its the second time its happening. The first time it lasted for a week long, and that was last month,now this month its happening again. It does not hurt when i lie down but when i move or sneeze its worse ,but the pain is mild and then later worse again. Can you maby give me advise on what it can be?",
    "doctor_response": "Hi,from history it seems that you might be having chronic apppendicitis giving this type of pain and often recurrence.Consult your doctor and get examined.Physical examination while having pain will give more precise clue about your problem.Meanwhile take some antispasmodic or anti-inflammatory medicine to get temporary relief.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in hands?\n\nI have very swollen hands on the top. To the oint my kin is tearing and draining. On the palm and wrist is my blistering eczema. What mwy be causing the swelling, What can i do to help it ? I am using my steroid cream as ordered. I have iced my hands and wrapped them with no results.",
    "doctor_response": "Hi i am Dr Ahmed Alyprednisone tablets and ointments are usually effective but sometimes eczema extends to 2 weeks in rare cases years   its main cause is allergy you may use clean dressings with frequent cleaning without soap and drying it well before putting the ointment then avoid its moisture and avoid humidity as possible, then ask for some antiedematous drugs and try elevating hands  and avoid dropping them down to decrease the swolleness .Be patient iam sure it will go away and will return better than before just follow your dermatologist for required dosing of the steroids as they may have some undesirable effects on long term",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does a systemic clostridium infection show up with a symptom of acute acne?\n\nHi.  I'm a research scientist, and I'm doing a query to find out if a systemic Clostridium infection could show up with a symptom of acute acne?  I'm not thinking C. tetani or perfringens, but maybe a commensal organism that isn't usually associated with serious illness?",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.In my opinion you should go ahead in such pathway. There are evidence of anaerobic bacteria causing acne.As clostridium species are anaerobic one, it may involve in acne. If you do some research you can found some evidence and which can be helpful for man kind.  I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dizziness, weakness, tingling arm and feet, chest tightness, trouble breathing. What can be done?\n\nhello docter i keep coming over all dizzy and weak and i have been having tingling feelins in my right arm and bottom of right foot alsohaving tight chest trouble breathing it comes and goes i went to the docters ans they checked me over and reckon there nothing he can do for me why when im feeling like this ? whats a matter with me ? i have ashma and high blood pressure and got a small leaky vavle in my right heart vavle but to small to do anything bout i found that out few months ageo there must be something that can be done ?",
    "doctor_response": "Hi,based on the details right sided TIA (minor stroke) versus seizure phenomenon has to be considered.You should consult neurologist for neurological examination and requires confirmation by imaging brain ( CT scan brain/Mri brain )Treatment is based on examiantion and reportsHope this will help youBest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can radioactive chemical substance in the blood be contracted through intercourse?\n\nPlease type your query here. Since this query is directed to our panel of specialists and super-specialists, please mention your problem in as much detail as possible. Do not forget to highlight your Age, Gender, Medical History and Treatment History of the problem you are facing.dear dr  i have a very close friend,he was a giornalist in war countries....recently a brain tumor was removed,but dr found a chemical substance in the blood possibly radioactive from bombing etc.we are in love and he's planning to move to my country so we finally be together..i love him very much,but i'm worried..my question is :is this contagious,do i get something with sexual intercourse?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You should not worry about contracting radioactive substance.  No need to worry about that. Intercourse has no relation with chemical or radioactive substance spreading. So don't worry about that.  Just be relaxed. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could swelling in hands every morning indicate elevation of BP overnight?\n\nI've been diagnosed with hypertension. I was on a diuretic for about 6 months, then I was taken off- doctors orders. Fast forward almost 4 years and I wake up EVERY morning with swollen hands. Throughout the day, the swelling goes down. Is this a sign that my BP elevates overnight every night?",
    "doctor_response": "Hi,It is not a sign of elevated blood pressure at night, you should check your kidney function, if it is normal, then you shouldn't worry.And is you suspect that you have high blood pressure at night, you can have 24 hour ambulatory  blood pressure monitoring done and find out what is your blood pressure at night.Hope I could help youWishing you good healthIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruises and muscle pain?\n\nI m writing on behalf of a friend who after working out got a few mysterious bruises on his legs and ankle. Then they turned into a rash. He also has lots of muscle pain. After 2 urgent cares and 2 antibiotics it s not better? What could this possibly be? Thank u, ,",
    "doctor_response": "Hello, What I see with history is there might be some blood routine to be get done. Pain can be due to DOMS if he is not a regular exercise person. Also, what is your friend's age? This gives more insight into why there are bruises and rashes. Antibiotics should be administered only if any blood routine is done and infection found. Kindly take the blood routine first and please provide his age. If aged then have to assess other things too & if young then only blood routine. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do ureteral stents cause bleeding?\n\nI had a ureteral stent to my right kidney put in 3 weeks ago after a hysterectomy (there was a kink in the ureteral) - I will sometimes have blood in my urine if I have been on my feet too long or perhaps not drank enough fluids - but in the last couple days - I have been experiencing some sharp back pain after emptying my bladder - it is only for that moment - but worries me since it is the same pain I experienced in determining the kink. Should I be concerned that something is not right with the stent - or could it be contributed to activity / fluids?",
    "doctor_response": "HelloThanks for query.The blood in urine after putting stent is common and is due to foreign body reaction of Ureteral mucosa (Ureteritis) to stent and it gets resolved by drinking more water .The pain in flank while urinating is due to fact that while urinating when bladder contracts to pump out the urine through urethra some amount of urine goes back upwards through the lumen of the stent  in to kidney giving rise to increase in renal pelvis pressure and there by pain in flanksThere is nothing to be worried about it It will get resolved once the stent is removed.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are Glynase and Glycomet appropriate for increasing blood sugar levels?\n\nHi doctor My mother is diabetic for last 3year initially she advised glynase 10mg day after 6months increased to 20 mg day after that her blood sugar become 120-135 fasting and 180-200 pp but recently her blood sugar level increased 140-160 fasting and190-270pp her endocrinologist suggest to 20mg glynase with 10 mg glycomet a day. Is this ok",
    "doctor_response": "yes it's wise to start with 2 drugs if one drug remained fail to control sugar. follow prescription strictly and also strict dietary control repeat her blood sugar levels after at least 6 weeks to further see the control . get her renal functions fasting lipid profile done to see effect on tht. also get her reviews by eye splt to see diabetic retinopathy. strict dietary control is necessary",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swollen and nasty sour, had teeth extracted. Any ideas?\n\nHi, I had all 4 wisdom teeth extracted 7 days ago. My lower left is slightly swollen and there is a nasty sour taste coming from it. I called my oral surgeon and he said it was fine, just continue with salt water rinses. I am wondering if I can use a piece of gauze over it to get rid of the taste or will that be a bad idea? Thanks!",
    "doctor_response": "Hi ,Thanks for posting your query.It's just the taste coming from the healing orifices where your wisdom teeth used to be. It's a natural part of the process, the taste will go away eventually. Definitely keep up with the salt water rinses and the antiseptic mouthwashes. Do FLOSSING. Floss well in the backs of those molars next to where your wisdom teeth used to be. You'd be surprised at the amount of plaque that can build there, and bacteria from your healing mouth can gather there and hold that bad taste. Hope this will helps you. Warm regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathing difficulty?\n\nHi. Am 42 years old. Six years ago I was diagnosed with mild scoliosis. Lately I have experienced worsening breathing difficulties and notice a small hump in my upper spine just where my neck starts. I also feel a lump in my throat. I also notice my chest points left of center when standing.I was told by my spine doc six years ago that adult mild scoliosis doesn t worsen. He also did not give me a brace for my back, or a lift for my shoe or check me for vitamin d deficiency which I recently found I am deficient in.Is it possible for my scoliosis to worsen? What can I do to slow it down or stop it? I am very active with sports and exercise. Is it true that post surgery for scoliosis means no more sports? Thank you",
    "doctor_response": "HiIt depends on the severity of the scoliosis.Given the fact that surgery is recommended for you means that yes after it you should be careful with the effort.Dr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes weight gain when on treatment for MS and diabetes?\n\nI have just had a multiple Sclerosis relapse. Rather than gfoing into hpospitsal for 5 dayb and having the IV Hyrdocortisone, I was give oral  Methylpredinisolone  500mg for 5 days, 200mg for 5 days, 100mg for 3 day. I am now charted a weaning course of prednisone 100mg for 2 days, 80 for 2 days, 60 for 2 days, 40 mg  for 2, 20 for 2 days, 10 for 2, 5mg for 2. I have 2 questions. I gave gained 5 kilos since starting this course. I'm an RN so I know that weight comes with the territory but as I wean off, will much of this weight come off as I return rto my normal activities. Also I'm a Type 1 Diabetic so my blood sugars have been elevated so have been managing my insulin accordingly. I am starting to see some leveling out but I still have approximately 12 days too go, Can I still expect to see gradual reduction. I'm on Glargine BD and I was initially told to double this when on the high doses Medrol. Now this is too much but I guess I need ideas about a decreasing sliding scale. I am talking with my doctors and nurses but just wondering if you could give me some ideas.",
    "doctor_response": "Hi,Thank you for posting your query.It is unusual to start oral steroids for treating a relapse of multiple sclerosis (MS). The usual and standard treatment for an MS relapse is to give a five day course of IV methylprednisolone. A tapering schedule of steroids over the next 2-3 weeks is not deemed necessary.I agree with you that the weight gain and elevated sugars are related to the steroid use, and once you stop the steroids, both would normalize.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could constant sore neck, out of line lower jaw after tooth extraction and cracking the neck mean damaged nerves?\n\nHello. I allowed somebody, untrained to crack my neck a year ago. Since then. I cannot seem to keep my head straight and my neck is always sore. I am wondering if my nerves have been permanently damaged. Also, I had impacted wisdom teeth removed from my lower jaw, and since then my jaw has been out of line, I am needing to have the top two removed, will this balance out my face again?",
    "doctor_response": "Hi i am Dr Ahmed Aly    thanks for using healthcaremagic site ,I had gone through your question and understand your concerns ..  In my opinion such injuries to spine or to the nerves coming out of it to supply your neck may take a long time to resolve completely as any other nerve injury that requires time to resolve in addition to your tooth extraction that may have exagerrated your pain a little i think the removal of other jaw may improve your facial expression but i suggest CT , MRI to exclude any cervical disc herniation and for proper management of your neck problem completely . Please click THANK YOU and consider a 5 star rating with some positive feedback if the information was helpful. Hope the above information helps you,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high BP?\n\nTried meth a couple of times. Dumb I know... Anyway I have a history of high blood pressure and have gotten it under control as of lately. I am prescribed Xanax as well. I get numbness in my fingers and lower legs by my feet. I typed in the symptoms online and it told me about about a condition called Parasthesia. Looking at the symptoms and everything, I really only noticed 2 things. 1, I have a history of benzo use and though I don t use daily or necessarily weekly, I do use it and according to what I read, one of the causes of Parasthesia is benzo withdrawl. I have no other symptoms though so I m kinda of skeptical and think it has to do with the meth elevating my blood pressure and everything CNS related. Anyway I was hoping you could provide some insight perhaps? Let me know if I could paint a clearer picture.",
    "doctor_response": "Hello, This parasthesia have to do nothing with your hypertension, although it may due to the effect of benzo you have to take, see a neurologist as you need further investigations. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for rib cage pain?\n\nHello, the past couple of months I have noticed that when I drink fluids, it tends to go down the wrong hole a lot of the time and makes me choke. I ve also been coughing a lot, constantly feeling like I have phlegm. Having strange pains under my ribs and I am now experiencing rumbling on my right sight under my ribs.",
    "doctor_response": "Hello,I have studied your case and It can be due to chest and pharynx infection. This infection can cause formation of thick wall in throat making you feel like chocking. I would suggest you to get an examination by throat specialist. If there is any infection than you need to take antibiotics accordingly. Some time severe bout of cough can cause fracture in the ribs leading to severe pain.A chest x ray is best method to confirm the diagnosis. treatment is hot water fomentation and volini gel local application along with bed rest and avoiding jerky activity.I hope this answer will be useful for you. Let me know if there is any other followup questions.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What precautions should be taken for planning for a child through donor?\n\nGood Morning, I was wondering if you could help point me in the direction i need. My partner and i are planning to have a baby, We have found a doner since we are a gay couple. We know the Doner on a personal level but we want to do this very cautiously. Do you know where I can find any informantion on this. We have spoke with our GYN and PCP I would like to make sure we take all percautions so i want information like what tests we should have our doner take and what not. Think you can help?",
    "doctor_response": "Hi,Donors needs to be screened for multiple infections such as HIV ,HBsAg,HCV,VDRLOther tests depends upon examination of donor to rule out any systemic illnesses such as Diabetes,thyroid problems.If i would have been your treating Doctor. Would like to do all basic tests of Donor to rule out sexualy transmitted diseases ,basic routine tests such as TSH , complete blood count,Liver and Kidney function test,Clinical examination to rule out heart problem,respiratory problem ,blood pressure measurement.Other part is do sonogram to check ovarian volume and antral follicles.It is preferable to get AMH anti mullerian hormone test donedone",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting and low fever?\n\nMy 7 year old sister has been on and off sick for the past couple of weeks, her symptoms are vomiting, low grade fever, and lethrgy. she has seen her doctor and has urine tests and blood test done, they all came back normal except for a UTI. One day she will be fine and the next she is throwing up. what could it possible be?",
    "doctor_response": "Hi...UTI can as well cause chronic vomiting if it gets complicated into a reflux disease. I suggest you to get your kid evaluated for the same - If I were your pediatrician I would have done - 1. Urine routine and culture2. Ultrasound abdomen and if this is abnormal - go ahead with MCU and DMSA scans.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does Pelvic fullness kidney and massive multioculated Ascites in a 3 year old mean?\n\nGood afternoon Doc I would like to ask this query regarding my grandson result of his ultrasound,pelvicalyceal fullness right kidney & massive multioculated and multiseptated ascites with intraluminal debris.My grandson is 3 years old,male.His abdomen is elevated.Thanks Doc",
    "doctor_response": "Hi, report suggests that your child has fluid collection in his abdominal cavity.Along with this, he also has dilataion of the exit point of right kidney.This could be due to any obstruction to the flow of urine through the right kdney and ureter or it could be physiological. Fluid in the abdominal cavity will require some investigations in form of urine routine microscopy, KFT, LFT and hemogram. Get a chest Xray and a Mountoux test done for your child. Consult a doctor as he might require admission and further work up and management on the lines of reports.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Would post carpel tunnel surgery cause dizziness ?\n\nHi I had a corner of a car boot accidently dropped on head it caused a nasty cut to my head and had stitches and concussion x I also have had surgery for carpal tunnel syndrome on my hands I have had mri scan which show c5 c6 disc damage can u tell le weather the hit to ly head has caused this or it it likely to b wear and tear sthank you",
    "doctor_response": "carpel tunnel syndrome surgery will never cause dizziness. However blunt trauma to head can cause it. However there are other common causes for dizziness....much more common than trauma....like Vertigo due to BPPV...anaemia....vestibulopathy....Better to consult a neurologist  and get examined.regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen tonsils, dizziness and muscle stiffness\n\nI am a 22-year-old female and I do smoke, but this morning I noticed a slight burning on my tongue, when I looked in the mirror I noticed a sore and slight yellow blotches also noticed when I put a light on it yellow tint on the roof of my mouth and my throat. tonsil swollen on the left side,nausea, dizziness with a headache only on the right side of my head as well as muscle stiffness. With lower back pain.",
    "doctor_response": "HIWell come to HCMNonspecific lesion of mouth is very likely, tonsil sometime look little bigger but that may not be due to any infection, chances of stomatitis may be very likely, this could be allergic or due to infection, if I would be your treating doctor then I would treat this case with the following medicines, 1) Tab Amoxicillin 500 mg three time in day 2) Tab Folic acid three times in day3) Tab Domperidone 30 mg three times in daythis is nothing to worry, everything would be fine soon, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the soft lump with hard core on my shoulder?\n\nI noticed a lump about the size of a quarter soft like the ear lobe but a smaller nodule inside that feels a little more firm it is stationed in between my shoulder and collar bone. Any idea what it could actually be? Just noticed it today and so far has not been painful",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some supraclavicular or infraclavicular lymphnode enlargement or may have some tumor pathology.  You should go for fine needle aspiration cytology. 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes RUQ pain and nausea?\n\nRUQ pain two months. HIDA scan reproduced all sxs of RUQ pain radiating into shoulder and neck but fraction was 63%. Upper and colonoscopy normal only showing some gastritis. Awaiting biopsy. Also have nausea and some bloat or reflux. Most sxs are during the night but have gotten sxs during the day too. 47 yr female normal weight eat no fried foods dairy low fat low sugar diet. Also pain and nausea with exercise. What could this be",
    "doctor_response": "Hi ! Good evening. I am Dr Shareef answering your query. If  I were your doctor, I would also advise you for an ultrasound of the abdomen in addition to the tests already done to rule out gall stone disease. Further a serum amylase and lipasae would be worthwhile to rule out chances of any pancreatitis. Till then, I would advise you with some anti spasmodic along with a proton pump ihnibitor drug for symptomatic relilef only.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will antifungal treatment cure dandruff and hair loss?\n\nHello doctor, I have attached a test report for fungal overgrowth. Can you please look at the report and let me know if you suggest an antifungal treatment? I also have a lot of dandruff in my head and hair loss.",
    "doctor_response": "Hi. I have seen your report and have found a fungal growth. Before going to suggest you the treatment, I would like to know some more things. Send me the following details. Your occupation, what specimen you submitted, what is your clinical complaint, how long you are suffering from the present complaint, treatment history, any additional complaint.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do the blood test results indicate regarding liver conditions?\n\ntwo years ago i was diagnosed with deranged liver caused by drnking i had a bloodtest  last week after not drinking beer for two weeks which gave the following results. SGOT/AST H 47...........SGPT/ALT.H 78 do these figures suggest significant liver damage?",
    "doctor_response": "Thank you for posting query at HCM.further evaluation needed.whats your age? height? weight?are you take any sort of medication?viral serology>?ultrasound abdomen.anyhow, increase in the level of liver enzymes reflect an INJURY to the Liver. medically, the condition is know as \"Hepatitis\". its maybe due to viral infection, excess fat, gall stones, excess alcohol, excess iron, and so on. virus and alcohol are most common.slightly elevated should NOT be concerning but a level more than 2 times the upper limit should be evaluated.did you get HepB and C viral serology?and get a \"Lipid Profile\" test.liver enzymes take one to  two months to return to normal.- abstinence from \"Alcohol and drugs\" - very LOW or fat free diet should be followed for couple to few weeks- Moreover, less activity should be carried out (no sports). - use lemon juice (lemonade) once in a day-recheck liver enzymes after 4 weeks.- reduce weight if overweightwish you good health.further queries are welcomed.Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health.regards,Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair loss\n\nI m suffering from hair loss since past 7-8 years I am a female aged 31 years ,my hair strands are have become very thin and weak they come out easily when I comb please can you suggest me definite remedy,I will be very thankful                      Thanks                                     Dr.laxmi.s",
    "doctor_response": "Hi,You seem to suffer from telegenic effluvium. There are many causes. One has to find out the particular cause and that is to be treated. Kindly consult the dermatologist for the perfect diagnosis and proper treatment.  I would suggest ....- apply mild steroid lotion on the scalp daily- take biotin 10 mg daily- take treatment of underlying disease- herbal oil and shampoo may usedI hope this would help you.Thanks. Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Meftal-P be given to a child having fever?\n\nmy daughter trisha is 2.5 yrs of age and wt is 12.4 kg, she is having cough and fever, she also puke in night coz of cough, i have should paedi. he has put here on augmentin duo 5 ml * bd, meftal-p 5ml *bd, and viscodyne - t 5 ml bd, here temp. is 103 degree, i live in chembur mumbai, pls suggest is this medicine correct? i am worrier about temp?",
    "doctor_response": "Meftal-P is used in case of uncontrollable high fever.It is recommended that children under 12 years of age should be given MEFTAL-P (Mefenamic Acid)inn the usual dose of 25 mg / kg of bodyweight daily, in divided doses.Weight of your child is 12.4 kg. So the dose comes out to be approximately 300mg/day which is divided three times as 100mg.Meftal-P syrup contains 100mg/5ml.So the dose is 5ml three times per day.Your doctor has prescribed 5ml two times per day which is lower and hence fever is not getting relieved.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for slipped disc and numbness in the knee?\n\nI am 26 year old male. 2 months back I found out I have L3L4 slip disc, through MRI, after I noticed numbness below the waistline upto the knees throughout. I am under physiotherapy and slowly recovering from the numbness but the pain is still there. one more problem is that my groin is still numb and I can hardly feel my penis, perineum, anal area, buttocks and scrotum or I should say the sensation has gone down to 50% from normal. Also the erections have become weak. Kindly suggest a line of treatment as I am very much worried about this because I have read L3L4 slip disc causes impotence or ED due to nerve compression. Please help such that I can have a normal sex life.",
    "doctor_response": "Hello, I have gone through your questiin and understand your concern. This is very serious. I think your slipped disc causes compression on the dural sac and the nerves in it causing a caudal syndrome, which is a neurosurgical emergency. You should repeat the MRI (remember: a herniated disc may appear smaller on MRI because the exam is done in a clinostatic position) and should have a decompression procedure, at least a micro herniectomy.Wishing you good health, please feel free to ask further questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest better medications for muscle pain\n\nI am 64 and did something about 7-8 days ago, by lifting something too heavy, and strained my back, or pulled a muscle, or worse, at first didn't feel anything.  Kept thinking it would get better, but has gotten worse last 3 days, can hardly get up from chair, or walk without much, lots of pain.  Just went to urgent care, and there was a 3 hour waiting there, as there was so many people.  Will go again Fri or Sat.  Is it possible to get a 2-3 day prescription of Vicodin, or some other strong pain medicine?  1-10, pain is a solid 10.  my doctors office is closed today and tomorrow,  thanks, Ron",
    "doctor_response": "Dear user,I really understand your concern.For your severe pain (10-points as you said means that is the worst pain ever you felt) I would prescribe just two shots of Sol. Diclofenac (intramusculary)  in first 8 hrs, followed by Advil 400 mg when needed in the first day, and three times daily for 1 to 2 days. Applying ice, rest and physiotherapy will help to rehabilitate.Hope my answer was helpful for you.Wish you good health!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal swelling after an abortion?\n\ni m 23 yr s old. I got an Abortion of 1month jst 1 month back. I saw my tummy get increased due to that maybe but when recently i start drinking banana shake from 5 days i feel my tummy really see more bigger. so that my question is that it is due to abortion process my tummy increasing or it is normal and how can i get my tummy in normal as it is before my abortion?",
    "doctor_response": "Hello,Welcome to the HCM.Normaly it takes 6 months in involution of uterus to its normal size.you may also avoid things which cause increase weight  for example banana shake, fried things, sweets etc.if you get fever or some pain then you should further discuss with your gynaecologist.Regards,Dr.Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the ribs?\n\nI have severe pain under my ribs on right side almost daily. It feels as though there is a lump moving around. I feel nauseated and have difficulty eating. My gums are also bleeding and tender. I have diabetes and have had MRSA in my bone and bone marrow. Any idea what could be wrong???",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms seem to be related to costochondritis. Most cases of costochondritis are treated with over-the-counter\u00a0medications. If your pain is mild to moderate, you may take nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen.I also recommend to rest.Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Augmentin, Wysolone and Nebulization help to treat asthma during pregnancy?\n\nHi I am 22 weeks pregnant and i have little wheezing and shortness of breath while sleeping.there is also pain in my chest and back while breathing.I was admitted to the hospital of asthma attack last month with 17 weeks of pregnancy.it was cured then but it seems has attacked once again.doctor has prescibed me the same medication of Augmentin,Wysolene and nebulisation.Will i get relief",
    "doctor_response": "Hi,Yes definitely these will help in relief from the asthma attack.Nebulization will relieve the symptoms, Wysalone will decrease the inflammation and allergic response and Augmentin will prevent any secondary bacterial infection from occurring.I would advise you not to take Augmentin but rather another anti bacterial such as Azithromycin or Clindamycin, this is because Augmentin can rarely cause fetal developmental issues when given in pregnancy.Some studies have shown it to cause cerebral palsy in children when given to pregnant women. So please discuss this with your doctor before taking Augmentin.It is very important that you control asthma in pregnancy, as uncontrolled asthma can have a lot of negative impact on pregnancy .Asthma usually improves in third trimester.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes 10-15 pus cells in urine?\n\nMAle , 51 years oldI had a full blood picture, VDRL and urine analysis.for med insurance purposes.Blood picture all normal, VDRL negative, 10-15 pus cells in urine is the only symptom not in normal range.I understand there are dozens of possible reasons for pus in urine, including kidney stones (that I had 15 years ago) and a urine culture is advisable.However on a simpler note: Urine analysis was midday, previous day had a vigorous masturbate, could that be the cause?Many thanks",
    "doctor_response": "Hello Thanks for writing to HCMYou are suffering from urinary tract infection(UTI).It is not related to masturbation done on previous day.UTI is indicated by presence of excess pus cells in urine.You need few more investigations like routine hemogram,Random blood sugar,Renal function test,Urine culture and sensitivity and Ultrasound of abdomen. Further investigations can be done if needed.At present you need proper antibiotics after culture and sensitivity report.Hope i have answered your query.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is branchoscopy a good solution for removing mucus collected in the lungs?\n\nmy wife was known to have pneumonia. For six days strong antibiotics have been administered .The cumus is said to have accumulated in the bottom part of her lungs But coughing does not help her to get rid of that. Slight fever continues despite the antibiotics. No infection in the blood is seen now. Her heart is in good shape. Her breathing is normal .But the doctor thinks that my wife is week and cannot breath with enough strength and therefore the cumus accumulated in her lung cannot come out while coughing./ He thinks branchitoscopy may be the solution. Is that a good soluton? If yes ,why?",
    "doctor_response": "Hello,I understand your concern. When the mucus in the airways is not removed with medication, physiotherapy and caughing, broncoscopy removal becomes necessary in order to prevent lung collapse due to a persistent mucus plug. So, in my opinion, her doctor is right and should go ahead and do it, after all else has failed.Completing the course of antibiotics prescribed is also essential to her recovery.Wishing you good health and all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for acute abdominal pain\n\nYes, My friend is having acute abdominal pain. Started Friday and has been mostly constant with only a few moments of relief. Alternates between sharp stabbing pains to dull ache and back to sharp. Abdomen is distended and mostly hard. No rebound tenderness. Pain is not localized. No bowel movement since Friday except for a couple of pellets 2 hours ago, I will not be able to continue, we have no money to pay for this; Reason we didn t go to ER; no funds Thanks anyway",
    "doctor_response": "HI.Funds or no funds , this has to be investigated,...They symptoms of spasmodic pains , distension of abdomen, pelates but no motion, no bowel movement  all suggest that he / she is suffering from an intestinal obstruction. This needs at least a standing X-ray of the abdomen and admission to the hospital for further investigations and conservative management. If the conservative management fails - surgery may be needed to get a a permanent relief/",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this blood test result indicate?\n\nI have several questions actually. what do these lab test results mean :absolute neutrophil count 9.2, erythrocyte sedimentation rate 37, c-reactive protein 2.6, urine epithelial cells 10-15, lupus anticoagulant screen, drvvt with reflex to confirmation 51, prothrombin time 30.0, act. ptt 84??",
    "doctor_response": "Hello and welcome to HCM,Absolute neutrophil count of 9.2 is high value.Neutrophils are elevated in cases of bacterial infections.ESR of 37 and CRP of 2.6 suggests an inflammatory condition.Presence of 10-15 epithelial cells in urine is a non-specific finding. It is normal finding in females.Prothrombin time of 30 sec, activated partial thromboplastin time of 84 sec and DVVT of 51 sec suggest disorder of coagulation pathway.Thus, there is evidence of infection and chronic inflammatory condition.In addition, there is abnormality of the coagulation pathway also.Thus, you need to consult your primary healthcare provider for clinical assessment.You need to consult hematologist for abnormal coagulation tests.Thanks and take careDr Shailja Puri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is high ESR levels in a 75 yr old a matter of concern considering she is suffering from cervical spondylosis?\n\nMy mother is 75 yrs of age and has an ESR of 55. She is obese and has a Hb count of 11.2, while other blood test values are within/close to reference range. She has cervical spondylosis and a little pain in her knee joints. She tends to sedentary but is mentally active and alert. No fever. Is the ESR count a matter of concern and should we do something about it?",
    "doctor_response": "Hi, ESR varies with age, it is increased with age. At the age of 75, ESR=55 is normal, most of the labs gives a fix reference value, which is confusing.i think, that there is no need to worryI hope this will help",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe soreness and stiffness in the legs?\n\nI feel like I have worked out my legs, they are sore. Mostly in my upper thighs and quad area. They have been for a few weeks, I feel all stiff when I sit, sometimes causing me to not be able to rise quickly. I am in the beginning stages of diabetes. I have gained a few, about 20 extra pound, but I don t believe I would be sore. I have had orthoscopic surgery on both knees and had rooster comb injections about 1 year ago.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have severe soreness and stiffness in the legs . Well there can be many reasons for symptoms you mention in query diabetic neuropathy , sciatic nerve pain , arthritis or deep vein thrombosis . I would suggest you to consult orthopedic surgeon for proper examination . Doctor will take history , order nerve conduction test , blood test and MRI of knees to rule out post surgery complication and condition like fibromyalgia . Doctor may recommend physical therapy , prescribe muscle relaxant , anti inflammatory nd supplement like neurobion forte . For now put your legs in hot water tun for 15 minutes daily and take ibuprofen or acetaminophen for pain . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breakthrow pain?\n\nI have been on methadone for 6 years and I started seeing a PM Dr. that wants to switch me to oxycontin. At the moment I take 60mg of methadone with 4-6 oxycodone 5 mg for breakthrow pain. My question is what is the correct amount of MG daily of oxycontin I should be switched too? and will I go throw any withdrawl during the change?",
    "doctor_response": "Ok, there are a wide variety of websites with estimates of the conversion rate. The actual effect is within 50% of the estimate and a large number of factors including the genetic effect of particular opioids on opiate receptors and the genetics of how fast the drugs are metabolized and the genetic effects of how the drugs feel that are NOT taken into account in the conversion rates. are a bunch of charts.basically, one might start with the oxycontin regardless of the previous methadone dose provided the methadone dose isn't silly high. THere is a huge risk of overdose more than withdrawal because methadone stays in the system and if you use oxycontin the same day as the methadone you are basically doubling the dose.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain while breathing and shortness of breath?\n\nAfter lying down briefly I began having trouble breathing as if my neck was too fat or swollen (hard to describe). I have a pain in my left shoulder blade, heaviness in my chest, pain in the left chest when I turn my head to the right and I just feel as if I cannot get a good breath. It also hurts when I take in a deep breath. I have had costochondritis in the past but this feels different. Do these symptoms sound like that as well?",
    "doctor_response": "Thanks for your question on HCM.In my opinion you should out cardiac cause first.Chest tighness, left chest pain, left shoulder pain, breathing difficulty on lying down are seen in cardiac cause more specifically congestive heart failure.So better to get done 1. ECG 2. 2D ECHO.You may have decreased heart functions and due to this all symptoms are seen.So better to consult cardiologist first and rule out heart disease.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for inflamed rib cage\n\nHave pain on my righ rib cage the docto told me it was inflammation that was five years ago and it is still there and the pain is getting worse. I told that it was not form my back pain and was told it was not shingle. It feel hot to the touch at times and sometime it move. How do you get rid of inflammation.",
    "doctor_response": "Hello,The symptoms can be related to costochondritis which is an inflammation of the cartilage of the rib cage. I suggest using anti inflammatory medications such as Acetaminophen to relieve the inflammation. I also suggest using cold compresses for local application.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of excess gum between front teeth?\n\ni 14 and i have excess gum in between my two front teeth and i was just wondering what would happen if i wanted to get rid of it because my dentist said that it wouldnt go away by itself but it would have to be cut out then i would have to get braces to close the gap. i am really nervous and i dont know what to do, please help",
    "doctor_response": "Hello,  Read your query , as you have enlarged gingivae dont be worried so much be relaxed I will suggest you to consult Periodontist specialist and go for oral examination of gingivae if you have gingival enlargement then go for its treatment oral prophylaxis or gingivectomy , after treatment of gums then if you have spacing then go for orthodontist for orthodontic treatment. Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat painful epididymal cysts?\n\nHelp I have been diagnosed with a very painful Epididymal cysts, can I relive it buy ejaculation? I was not given antibiotics I think it's infected it hurts they gave me some really strong drug like morphine buy it's not working should I go back to the hospital and demand an operation",
    "doctor_response": "HIThank for asking to HCMYou can try analgesic medicine If I would be your doctor then I would treat you with the following medicine,1) Tab Ibuprofen 400 mg three times in day 1) Tab Alphachemotrypsin three times in dayI hope this may helps you, take care and have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will I be able to father a child with my sperm test result?\n\nI have done two sperm test within 3 months of period. In first test, sperm count is 70 million and motility is 40% and In second test, sperm count is 95 million and motility is 25%. I am just confused and let me know whether can i able to father a child?..",
    "doctor_response": "Hi,I read your query and I understand your concerns.Following is my reply:1) Your semen analysis looks fine.2) Get HSG done for your wife Let me know if you have anymore questions.Regards,Dr. Mahesh Koregol",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp stabbing pain in abdomen?\n\nWhy do I keep getting sharp stabbing pains on the bottom left side of my chest in a spot in my abdomen and on my side. Simetimes accompanied by a dull alake in my abdomen bellow my right rib cage in my abdomen. I have already seen a doctor but the problem is on going.",
    "doctor_response": "Hi, Thanks for your query. The most probable cause for such pans you described in the lower left chest and upper abdomen can be :-Costo-chondritis due to inflammation of the lower ribs and muscles. This inflammation can travel along the abdominal muscles originating from the ribs, giving pain in the upper abdomen.-Colitis of the splenic flexture of the large bowel - colon.- Inflammation of the left lower lungs and / or pleura.I would advise you to take a second opinion of a General Surgeon, get investigations done and diagnosed to be treated properly. X-ray of the chest, ultrasonography of the abdomen, blood and urine test. Pain on deep pressure on the lower chest on the lower ribs is classical of costo-chondritis and not seen on any investigations. I would advise you to get an MRI of the painful area, telling the Radiologist to be specifically see for the painful- tender area. This will confirm the diagnosis. I would suggest the following treatment.-Rest to the area by means of strapping with the Adhesive tapes during the deep Expiration phase. This will limit the movement, reduce the pain and give rest for healing to occur.-Anti-inflammatory medicines in full dose as per the weight.-Steroids if required for its strong anti-inflammatory role.-Lasix to reduced the edema.This sort of a treatment helps all my patients. and should help you too.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I not interested in studies?\n\nHi doctor,First time, when I was in the hostel I acted like fainting. So, they took me to the hospital and after checking BP, the doctor said it was low. The next day, I got very high fever and came home. Then after some days, I went hostel as I had kidney pain. I was brought here and had a scan. The report said that I have hydronephrosis. So, I joined as a day boarder. While studying I do not understand anything. I got zero in mathematics and I informed my mom that I cannot understand anything. My mom asked me to practice, but I am not getting interest. My exams are getting near and I do not know anything. Whenever there is an exam, I am not going college on that day. Sometimes, when I am alone, I feel something different in my body and I feel as if I am missing the past. When I see a situational scene or a song, I feel bad. I want to make my parents happy by seeing my marks. Please suggest me some ways to interest in studies.",
    "doctor_response": "Hi, Welcome to the icliniq.com. I completely understand that you are feeling a lack of interest in studies and unable to focus on your studies. According to research, there can be various reasons behind the lack of interest in studies and low concentration. 1. It can be due to learning difficulties in children. 2. It can be due to negative past experiences such as having failures, something negative related to study environment or teachers or fellows or due to any other academics related factors. 3. There might be psychological causes behind your lack of interest, avoiding exams and getting affected by past memories. You need to specify your age, level of study and for how long you are experiencing these problems, both academic and emotional issues. You also need psychological assessment of the symptoms you mentioned as feeling something different in body, missing past experiences, getting emotional by watching particular scenes or listening songs. First of all you need a complete psychological assessment by a clinical psychologist. It will include testing related to your academic problems and psychological issues like lack of interest, avoid studying, negative past experiences and unusual sensations in the body.  You will get a feedback of your assessment and then you will be better able to understand the reasons of your problem. On the basis of assessment results, your psychologist will recommend an appropriate treatment plan for your academic and emotional problems.  Here, I am advising you a relaxation exercise. You can do it before starting your study. Relaxation exercise helps to improve concentration. It also relaxes your mind and body out of stress and problems.  Do a relaxation exercise or deep breathing to calm yourself and focus. Sit in a comfortable position and close your eyes. Take a deep breath and focus on the air going in and out. Focus on your muscles from head to toe of your feet and relax every muscle. As your body gets completely relaxed, imagine something positive, watch yourself studying and enjoying the material you are reading or writing. After your necessary adjustments open your eyes. Do this exercise every day. I appreciate you consulted for your problems at initial stage. Do get your assessment done as soon as possible. Delay in the treatment or ignoring your symptoms may increase your problems. Revert back with answers to the above questions to a psychologist counsellor online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can ibugesic and sinarest sufficient for sore throat and cold?\n\nmy child is 6 years old and weighs 14kgs.........she is suffering with cold from the last 3 days and i am giving her sinarest for the same.............today evng she complained of sore throat........will ibugesic will be sufficient along with sinarest or shall i give her clamp kid forte.............",
    "doctor_response": "Thanks for consulting in Health care Magic. Of couse, you can give to her clamp kid forte 250 mg (1 tab) 3 times 6-7 days, because penicillin group is very effective in throat infection.For profilaxis of diarrhea from antibiotic take visilac 1 capsule 1 time 14 days.  Sinarest and ibudesic are identical non steroid anti inflamed analgetics for relief pain and decrease temperature. In addition, i advice:- lozenges and sualin 1 tablet 4-6 times for reducing sore throat;- hot drinks- ginger,lemon,turmeric powder tea; abstain sour and cold drinks;- warms saline and soda, chlorhexidine gurgles;- multivitamins-zincovit 1 teaspoon(5 ml) 1 time 1month for increasing immunity- Tulsi juice 1 teaspoon 2 times is helpful for fever and immunity  I hope my reply will help you. Please write to Health care or me for following up queries.  Recovery soon  Dr.Svetlana Shrivastva",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for flu , headache and cold?\n\nI think I have the flu and cold. It started Wednesday, and has continued to worsen. At the start, I took theraflu (both disolvable and liquid), a cold relief pill (with acetaminophan, dextromethorphan, guaifenesin, and phenylephrine), and Ibuprophen. I alternated them all carefully. I ran out of the cold pills, liquid theraflu, and ibuprophen, so today I went out to get Mucinex DM Maximum Strength and Oscillococcinum. After taking them, I felt a lot worse. I recently took 650 mg of acetaminophan to help the pain. It's helping a little. My symptoms are fever, headache, muscle ache, integumentary pain, soar throat, excessive coughing, and lung pressure. Please help me in anyway you can.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have flu, headache and cold which is because of increased susceptibility of getting infected because of compromised immunity which is leading to common cold. Need not to worry about it. You should use anti inflammatory medications such as Levocitriziine along with antibiotic such as Levofloxacin. Avoid exposure to allergens such as dust. Take meftal P for fever. Take diet rich in multivitamins along with vitamin C pellet to booster immunity. You should use mist humidifiers in room. Visit ENT specialist once if symptoms keeps on persisting and get examined. Start treatment after prescription. You should take probiotics in diet. Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in lower abdomen during mornings?\n\nhalo my name is mercy...my question is am having this pain in my lower abdomen and also i have this pain on my esophagus...especially when i wake up in the morning...and its been like that for the past few days....its such a burning sensational pain.",
    "doctor_response": "Dear Mercy,The symptoms as mentioned in your post can be attributed to Acid Peptic Disease.The burning nature of the pain when the stomach is empty (as you wake up in the morning) is characteristic for this.Investigations like Sonogram or Upper GI endoscopy will be helpful in clinching the diagnosis.Symptomatic relief can be obtained with intake of Pantoprazole preparation (to be taken twice a day before meals) & antacid gel (to be taken after meals).They prevent formation of excess acid in the stomach & provide symptomatic relief.And it is also needed that you take certain precautions regarding your diet & lifestyle, such as:1. Take soft, plain, non-spicy foods.2. Drink lots of water to maintain adequate hydration.3. Avoid fast foods, carbonated drinks & gas producing food products like cabbage, etc.4. Avoid smoking & alcohol.5. Keep away stress, think positive.If symptoms still persist, kindly consult a Gastroenterologist for proper clinical examination.There is no need to worry, you will be fine.Wishing a good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe vomiting, diarrhea and fever in an infant\n\nHi doctor, My baby is 10 months old. For past 2days severe vomiting, loose stools with foul smell and slight temperature. Doc has advised me to give the following medicine.kindly advice I am giving right dosage. Still the baby is suffering from above said problems. Taxim o 1 tablet 3 times daily, loparet 1/2 tablet 3 times daily, econorm 1 sachet 3 times daily.for loose stools. Emeset 3.5ml 3 times daily for vomiting. P 125 5ml for fever. She weighs 10kg. And she eats only solid food. Arrow root water is given in between. Milk simyl mct. Pleawe advise",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query your baby have symptoms of severe vomiting, diarrhea and fever which is due to dehydration which seems to be due to food poisoning and acute gastroenteritis. It could be due to disturbed metabolism of body leading to electrolyte imbalance. Need not to worry. I would suggest you to take acetaminophen and anti emetic medication. Take diet rich in multivitamins and avoid any oily sharp and fast food. Avoid intake of any outside food. Visit pediatrician once and get it examined. You should get blood tests done to find out underlying cause of condition and start treatment accordingly. Your symptoms will resolve in 3-5 days. You should take proper rest. You should take plenty of fluids to re-hydrate.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain with frequent urination and high BP?\n\nI have had severe abdominal and frequent urination for a long time now. I also have un explained high blood pressure and through a recent MRI of my lumbar spine a .8 cm renal cyst. The radiologist recomends I have an abdominal MRI to follow up further but should I be concerned?",
    "doctor_response": "hi thanks for askingi would like to tell you that kidneys are visualized good by ultrasound abdomen but if you are fat or there is some uncertainty on US you would probably need an MRI or CT scan of abdomen........ as you are having high BP,it is sometimes related with some kidney problem.........you should first go for ultrasound KUB in consultation with your doctor........you should not be worried until youhave a clear diagnosis",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had bruising on both shoulders and lower back pain. Done X Ray. Are there degenerative problems?\n\nI had substantial bruising on both shoulders and my lower back and thighs when I fell down a full flight if stairs with a fright hand extra turn at top about 3 years ago at a friends house one night in pitch black. I am now getting bad pain in both shoulders but especially the left one. Also back pain. X rayed during 1st week of falling cos didn't call ambulance but pain and inability to move were getting worse but nothing broken. Could I now have degenerative problems?",
    "doctor_response": "Hi, thanks for writing to HCM.You have not mentioned about your age in the description. Degenerative changes occuring in the shoulder joints is a rare entity as they are non weight bearing joints. So, degenerative changes develop prior in weight bearing joints like Knee joint and Hip joints. As you had a fall with injury to both shoulders, there is a possibility of development of Secondary degenerative arthritis. A recent Xray film of the painful shoulders will show up the degenerative changes, if any.I suggest you to consult an orthopedic surgeon for a detailed evaluation and further management.Hope this information is helpful. Good day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why did my son wake up saying hot, then fainted and had vomiting?\n\nHi today my 5 yr old son woke up saying he was hot. Within 2 minutes of his waking and walking to bathroom he fell down to the ground crying in pain (belly pain-belly button area) then began to vomit- only bile came up. Once he had some water that came back up, toast, crackers, ginger ale- all came back up each time he tried to eat/drink. However, this only lasted 4 hrs... I am wondering if this could have been from being overheated? He slept fine and woke early then went back to bed (in my bed for 2hrs) after is when he woke saying he was hot.",
    "doctor_response": "Hi, I am sorry for the health situation your son is in. If you are sure he slept fine and not overheated, then, the symptoms he is having suddenly might be related to possible viral infection with GI complaints. I advise to:- monitor his body temperature- if he is not able to eat or drink anything, then, send him to ER for immediate evaluation and treatment; he might need intravenous perfusions- if he can eat/drink, then, give him plenty of water with OTC ORS, and light meals (yogurt preferably or juice)- let him rest moreOnce again, if no improvement within the next hours, send him to ER. Wish fast recovery!Dr.Albana",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cerebral palsy\n\nMy daughter is 16 and has Cerebral Palsy,visited her ENT specialist today due to her allergies,whilst there she had a large watery bowel movement in his office,he prescribed enterogermina,one a day for three days,he said she had a virus which will give her that loose bowel movement, that I observed for the last two or three days she has been having at least twice per day.How good is this drug and what are the side effects?,because she is on seizure meds,Epilim and Phenobarbitol",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. Enterogermina is a probiotic based on Bacillus Cluasii, it is used to improve bacterial flora of the bowels. It has no negative effects on health and doesn't interfere with other drugs. Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have difficulty with emotions. Taking celexa. Will it alter personality?\n\ni am currently taking celexa and would like too know something good about it . so far i have only heard bad and read bad makes me scared too continue taking it . i dont want too feel the way i do today about life but i dont want too take something that might alter my personality , i like me !!! sometimes have difficulty dealing with my emotions and feelings towards others.",
    "doctor_response": "Hi,Whoever has informed you that Celexa alters the personality was incorrect. It simply corrects the symptoms occurring from altered serotonin levels in the brain. It alleviates the symptoms of anxiety, depression and some other mental illnesses. Please take it as prescribed by your doctor and you have nothing to worry.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a permanent cure for epilepsy?\n\nHi I ve had epilepsy since I was 18 months old been on lots of meds phenytoin,phenobarbitone,tegretol,Epilim which caused my children to have fetal anti Convulsant syndrome and now I m on Lamotrigine. In Nov 2011 I had 6 grand mal one after another fitting for just under a hour, then 2 further grand mal following day. Since then developed focal partial seizures which are between 3-6 a day and last about 4 minutes. They feel like having a stroke causing numbness down left side,slurred speech,dribbling and shortness of breath with chest pain. Consultant has advised me to now also go back on Epilim along with Lamotrigine but bothered about side effects even though not planning anymore children. I also butrans patches 55mg for low grade spina bifida along with codeine,paracetamol, vitamin D3,Meloxicam,docusate and laxido. I really need to be seizure free with my children s condition and ow can t drive but live rurally any ideas what s best,feeling desperate and trapped right now.",
    "doctor_response": "Hello and welcome to HCM,Epilepsy is a chronic disease which is controlled by different modalities but no permanent cure is available.Depending on the type of seizures and frequency of seizures, medications are prescribed.The dose and type of medicine is varied depending on the symptoms.Surgery is also done in a small percentage of patients but not much success is obtained by surgery.You need to stay in constant contact with your doctor, and take correct dosage of medicine.Do not plan further pregnancy as the medication have a deleterious effect on the fetus and it will be difficult to take care of babies in this state.Avoid activities which involve balancing.You will have to manage your condition and stay in touch with your neurologist.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is exposure to people having chickenpox during pregnancy safe?\n\n1 week ago I had contact with a couple of little girls that have chickenpox, I have already had that disease but today my family will meet to celebrate the new year and there will be some babies and one of my cousins is pregnant and she has not had chickenpox. I want to know if there's a risk of spread the disease to my family.",
    "doctor_response": "Hi,If you have not had chicken pox before, or not taken the Varicella vaccine it is better to avoid contact with chicken pox during pregnancy.If you have the disease ,you are immune to it, and will not get chicken pox.Chicken pox in the first seven months of pregnancy can affect the baby, it can cause the baby to have a lot of problems with development of brain,liver and spleen. Also it can affect its hearing.After 28 weeks of pregnancy if the mother gets chicken pox ,even she carries a 10 % risk of getting chicken pox (Varicella) pneumonia which can be serious in pregnancy.I would advice your pregnant cousin to avoid the gathering.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat blisters in the mouth?\n\nI have what feels like a blister on the roof of my mouth beside a tooth that has broken off. I poked it with a needle to relieve pressure and it oozed a milky yellowish white pus... Is this an abscess from my bad tooth? The pressure has eased up however, it still feels like a blister as if I could pop it again but I'm nervous about swallowing \"infection\"",
    "doctor_response": "Hello and welcome.Thanks for sharing your concern.Please note that there is abscess developed in your upper jaw.This requires immediate care.you must visit your dentist and start with antibiotics.Also the concerned tooth should be treated by root canal.This will prevent further recurrence of the abscess.Please do warm saline rinses after food for three times daily.hope it helps.Thanks.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does one contract gastroenteritis?\n\nmy5 month old  grandaughter contracted gastroenteritis from another baby 5 months old but she did not touch the baby or go near the baby. She is now in hospital on a drip and her father is really ill with it too - how is this contracted, how long does it last and what can be taken?.",
    "doctor_response": "Thank you for your question. I appreciate your concern, especially as your granddaughter is an infant. From the history you have provided, it seems to be a viral, most probably a rota viral infection which is common among infants. It usually settles in 5 to 7 days, although a few loose stools a day can persist till 14 days. The main advice I give my patients is to not worry about the number of loose stools, but to look at the oral intake of fluids and feeds, how much urine she is passing per day and her activity. If any of the above three is decreased dramatically, or she is passing blood in her motions, only then it should be a cause for concern. I would suggest the following:1. zinc supplements for 14 days as it decreases the duration of diarrhoea2. continue breastfeeding if baby is on breast feeds3. if baby has been started on complementary feeds, to give fluids like tender coconut and buttermilk as they are very rich in electrolytes 4. the care takers of the baby to wash their hands well with soap and water after cleaning the baby, before feeding etc to avoid spread of infection.Hope this answers your question. I would be happy to answer any more questions you might have. Wish her a speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Restlessness, unable to sleep at night.  Diagnosed lung cancer with mets to hip, liver and lymph nodes.  On morphine, Haldol, Ativan, valium.  Suggest\n\nmy father is in hospice diagnosis lung cancer with mets to right hip, liver and lymph nodes. he was sleeping 20 hours per day at the beginning of the week and now is up all night very restless has fallen twice since going to inpatient hospice and receiving morphine, Haldol, Ativan and valium. The restlessness started wed any suggestions?",
    "doctor_response": "Hi,      The diagnosis given by you above suggest advanced disease and most probably beyond cure.He must also be heading towards multi organ dysfunction.This results in various metabolic dearrangements which in turn may result in such altered behaviour.The drugs suggest that he is on palliative care only.His treatment at present is aimed more at making more comfortable and giving him pain relief as long as he is alive.A thorough investigation for the reversible causes need to be made including saturation levels,sugars renal parameters,S.Electrolytes,Renal and liver tests.If a correctible cause can be found the she may find improvement from its correction.If everything comes out normal,then the dose of the above drugs may need to be  increased or new ones added.     So, I would advise you to first rule out reversible causes and then just treat him supportively.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for narcissism due to early life trauma\n\nHow can I find a therapist or psychologist in my Geographic area who specializes in treating narcissism brought on by early life trauma?  My husband is 50 and has been to many threapist and psychiatrist over the years and is suffering.  Where can I get help for me to gain understanding so I respond in ways that help him.   Lho",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Post Traumatic Stress Disorder (PTSD) is curable if proper treatment is applied. A combination of osychotropic medicines, psychotherapy, yoga and meditation can do wonders. Change in minset and thinking pattern is supposed to be reprogrammed with the help of psychotherpy and yoga. Meditation helps in streamlining thought. You need to find a psychotherapist who is experienced in PTSD. Alternatively, I can provide you with the required counseling and psychotherapy techniques to overcome these problems ONLINE. Please describe the whole problem in detail and post a direct question to me.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest correct medicine for fever and vomiting\n\nm having fever last night nd m having some kind of weakness too... nd i have vomited last noon but at that time ther was no fever... the doctor consulted me some medicines i want to know whether these medicines are affectablethese are GUDCEF 200NECOTEKFOURTSAWADADEC",
    "doctor_response": "**1. Most fever encountered in general practice are viral, self limiting and require only symptomatic treatment, but as you have already consulted a doctor, he might have look for pallor, jaundice, neck stiffness [since fever and vomiting is there to rule out meningitis], abdomen for liver & spleen and auscultate the chest to find the cause of the fever by evaluating the associated symptoms.2.  semi solid or liquid diet. [soft rice with milk, boiled vegetables,coconut water or electral water]. avoid exposure to wind, avoid bath-only sponging. avoid oily-fried foods, cold drinks, cold water, ice creams.. have bread butter, toast-jam,corn flakes, fruits like: apple, banana,pear, dry fruits, & biscuits.3. It is impossible to understand the last three medicine without knowing the salt of the brand, one thing which is understood is 'gudcef' which is an antibiotic to control/prevent infection.PS. Continue the medicines as advised by your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could a normal life be led with degenerated disc at L4 and L5?\n\nI am a patient suffering from degenerated disc at L4/5 level with posterior bulge causing anteior indentation of the lumbar thecal sac as indicated in my MRI scanning report. I have been doing physiotherapy treatment along with back strengthening exercises. I would like to know whether I could lead a normal life with my daily activities -specially standing , sitting, squatting, carrying an infant who is around 8 kilograms etc. I am already 55 years, a female. Thank you.",
    "doctor_response": "Normal life us of course possible but you have to take some precautions lake avoiding lifting heavy weight and bending forward. Continue physiotherapy. Try tab pregaline 75 mg once daily and analgesics sos. Hope my advice will help you.  Take care.  Don't forget to rate me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment  for premature ejaculation\n\nI have not maseturbated till now because when I pull my fore skin back it will not come completely front. When I leave it like that and sleep in the night and wake up I see some kind of white material is being formed. I was informed to go under Sunthi Operation. Can I have your advise on this ?",
    "doctor_response": "HelloI appreciate  your concernForeskin secrets and acculmutes it's secretion known as 'Smegma' under inner surface of foreskinI would like further information to help you betteryour age and relevant medical historyFrequency of masturbationCircumcision is the surgery advisable to cut the foreskin and prevent accumulation of Smegma which can cause a penile cancer if not removed properly and regularlyIn my opinion you should wash it properly after sex or masturbationConsult your doctor if it's very copious and thick to rule out STIHave plenty of fluids Maintain good hygieneThanks and regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain on the right side post a bike accident?\n\nI crashed my bike going really fast downhill in the rain, I landed on my right side. I was a bit dizzy for a couple hours but that went away, my right side HURTS bad. It was ok after work but when I sat down when I stood back up I could hardly stand up and walk it hurt so bad. is this anything to worry about?",
    "doctor_response": "Hi...if your able to walk with minimal pain then unlikely a bony injury it is mostly soft tissue injury.Things to do.Take pain killer ( tab. Diclofenac 50mg ) twice a day.if any abrasion present do a dressing and keep it clean and dry.Take inj tetanus toxoid.Take rest for next couple of days. But if the pain persists or if the wound is big then visit the hospital.Thank u",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for low and weak flow of sperms\n\nHi doctors can i have our reply and and advice about using the injections .My Uncle(Mr.Khaled ) is 40years old and his wife(Mrs.Mariam) is 32years old and they are from YEMEN .I am his Nephew and working in a company in capital city and I want to help my uncle .My uncle is suffering from the low and weak flow of sperms .So he sell many of his properties of farms and So the encryption doctor  prescribed him injections for one year(one injection once per week(Choriomon 5000 U.V) and another three injections(MERIONAL 75 I.V) per week ).My uncle do about that two months only and could not continue the injections to many reason of being living in village and he tired of injections . So is there any alternative for these injections as  as tablets or capsules .The prescribed injections are (CHORIOMON 5000 IU )&(MERIONAL 75 IV) These injections are for IBSA switzerland company . So please can you advice us if there is  alternative for injections as tablets and capsules have the same medication purpose and result . I am his I would be very much thankful for your kind help and advice .I hope your cooperation and early reply ,Best regards ,Mr. Abdulmalek Alaklan (Nephew for the patient Mr.Khaled)mobile :+0000   email:  YYYY@YYYY              YYYY@YYYY",
    "doctor_response": "Higreetings. I understand your situation and helplessness. I think your uncle is having hypogonadotrophic hypogonadism and his testis may not be producing sperm because proper hormones are not secreted by his pituitary gland in the brain.That is why he is given that hormones of pituitary gland.It has to be taken some times for more than 2 years to see the response .AM SORRY TO SAY THAT THESE HORMONES ARE AVAILABLE AS INJECTION ONLY.no tablets will help him.If he cannot take injections then he will not produce sperm.Then only option is donor semen IUI or IVF.hope you are convinced. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chronic right sided back pain, radiating to buttocks. Due to gall stones?\n\njust came back from radiology and they told me I have a handful, and then some of gallbladder stone and can t make out what it says on the paper but he wrote down 9mm, I have this chronic pain the right side but in the back down to my butt could the stone project all the way down to the butt cheek, and are 9mm big stone?",
    "doctor_response": "hi looking at the history pain in back radiating to the buttocks is not due to gall stones but because of lumber spine . gall stone finding is incidental . kindly consult orthopedic surgeon get your spine examined .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had breast cancer. On femara. Feels blocked nose and blood in mucus, blurred vision. How to control sugar?\n\nI am 61, Few years ago I had breast cancer , one breast removed went thru all chemotherapy , radiation etc Am on femara n heart pills, sugar reduction pills, have cholesterol and sugar levels fluctuate mostly on high side ! Sometimes feel nose blocks then when I blow my nose I see blood on my tissue It isn t much but noticed it on different occasions, My Question is how do I control sugar ? Getting blurry eyes can t even watch Tv as I can t see faces clearly Also want to drive my car as I feel happy when I drive",
    "doctor_response": "For control of sugars first thing to do is to go for regular exercise, diet control and medications. medications prescribed by your doctor need to be strictly adhered to. if there is no control with oral medicines if your doctor things it is necessary. then he will put you on insulin. Your blood pressure also needs to be checked regularly. high blood pressure is a common cause of nose bleed, but other local causes can be ruled out by an ENT specialist only. Your blurring of vision is also likely due to high sugars",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can cancer recur within six months of operation?\n\nHello doctor, My brother-in-law gone through CA tongue right side operation followed by radiation and chemotherapy before six months. From last two weeks, he is getting pain on the left side of the tongue and we consulted the doctor again. Doctor said that there is no possibility for further operation and radiation therapy. He suggested that he needs to go for chemotherapy only. Though we opt to go for chemo, his body is not able to support. He became very weak as he underwent surgery, radiation and chemo already. This also has more side effects and with this he will be unable resist. Also, the doctor said that there is no scope in curing. And, he advised to go for medicine, which is equal to chemo. I kindly request you to give best possible solutions to save his life. Is there a possibility of recurrence of cancer in the left side within this short period? What is the stage of cancer before and after operation? I have attached his current medication. Is it fine to continue?",
    "doctor_response": "Hi. I understand that your brother-in-law has undergone treatment for tongue cancer. For further information consult a family physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for asthma along with knee pain and high BP\n\ndue my all respect to you sir, my father has a known Asthma and both knee pain,High BP and his ECG has shown that he has an old inferior wall MI and he 68 years old please tell me how his future and do we need a MI managememt for him or not? all other systems are in good conditions. and about myself : iam a medical st. thanks & regards. Nabi",
    "doctor_response": "Hi,Your father is having asthma,arthritis( both knee pain),HTN and IHD with 68 years age.First,you can continue treatment for asthma like inhalers ( MDI or Rotacap) of steriods,alpha agonists, anticholinergics etc.I have assumed arthritis for knee pain,so you can take treatment from orthopedician after confirmed diagnosis.Now,if he has old history of inferior wall MI with hypertension then you can continue antihypertensive, antiplatelets or anticoagulants( ecosprin,clopidogrel or heparin),hypolipidemics( statins or fibrates),antiarrhythmic if required etc but after the consultation of cardiologist.His prognosis will mainly depend on his cardiac ejection fraction (EF- on 2D echo)and its activity during rest and exertion.So,better you do a regular follow-up at cardiologist every 6 monthly at least.Other factors are not a big issue in an otherwise healthy individual.He can continue with the treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on soft spot of neck?\n\n2 days ago i developed a small lump (presumably a swollen glad)  on the soft spot of my neck just below the ear lobe.  as the days progress it becomes more and more sensitive and painful.  there is now more swelling around the  area and more and more of my neck (on that side) seem to become swollen or in pain almost feeling like a bruise.   what could it be???",
    "doctor_response": "HI,Dear.Very Good NOON from India.Thanks for your query.I understand your concerns.I studied your query in depth.Need more information to comment on.-I would advise you not to worry still.In my opinion -the swllen neck-lump is of Acute lympadenitis with induartion in surrounding neck tissue.Appears mostly due to aggressive draining teeth,gland  infection around.Remedy-a---Advise-Consult a ER Surgeon who would be the  treatment from  the ER surgeon and would relieve your worry.-Hope this relieves your worry-some query. Wellcome for anymore queries in time to come.Have a Good Day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does a blocked bile duct cause fatty liver and pain in the upper right quadrant?\n\nI have been having pain in upper right quadrant. several years ago I had a totally blocked bile duct-dr put stint in and had no problems-had ultrasound yesterday-came back showing fatty liver-dr has scheduled hydascan-could this be caused by blocked bile duct again-",
    "doctor_response": "Hello, Fatty liver can cause the pain you feel in the upper right quadrant. Let's wait for the HYDA-scan before running into final conclusion. Take strong antioxidants like it. E, and stinging nettle to clear your liver. You should check urinary tract too through urine analysis and ultrasound of the urogenital tract. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Albana Sejdini, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of asthma while diagnosed with pneumonia?\n\nmy daddy is mystenia patient and he is suffering from pnemonia , and has been given augmneton from 3 weeks three times a day. Now when we have done his sputom test , he has got Gram -ve as 2+, so he is been given medicine doxiflow, and have been asked to go for asthama test. I am afraid if this is really a asthama case",
    "doctor_response": "Hello dear , hiWelcome  to Healthcaremagic.comI have evaluated your query thoroughly .*  The asthma is basically restriction of  airway due to  variety of reasons     which may be pneumonia or other .*  Amount of chances depends upon the  severity of pneumonia , host     factors , aggressiveness of  the  treatment  with body response .Hope this clears your query .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for persistent cough and cold in a child?\n\nHello! doctor, my son is 7 years old and he has been suffering from frequent cough and cold .Finally we took him to an ent who told me that his hearing partial due to fluid below the diaphragm.So he advise to go for 3 months medication at the end of which if there is no improvement he should go for adenoid surgery .Please advise on this",
    "doctor_response": "Good morning..!!Its a common problem encountered in children.Adenoid enlargement are cause for  frequent cough and cold attacks in children.A condition called serous otitis media (accumulation of fluid in the middle ear) is the cause for partial hearning loss.Your child is not getting better with medications, hence its better to go ahead with surgical removal of adenoids.Thank you, have a nice day..!!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life expectancy of a person suffering from CMML 2 cancer?\n\nMy dad is 66 yrs of age. He recently got diagnosed to have CMML 2 cancer. He has under chemo by medicine called Decogen from Johnson and Johnson. I want to understanda can this disease be treated fully. What is the life span expected. How many more chemo he will have to take. And will he have a normal painless life.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. He has chronic myelomonocytic leukemia. Prognosis is poor.  Treatment of choice is chemotherapy but it is not fully cured.  Does depens on his count and blast percentage and many other factors.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the sperm count normal now?\n\nsir my husband has vasectomy reversal in march 21 2014 three months after now in semen analysis quantity =4.0 cc colour =opaque white reaction=alkaline Odour =musty viscosity=semi viscous nature of sperm= Azoospermia others =Pusscells 2-5 seen/ HPF Epith.cells 1-4 /HPF RBC 1-3/HPF",
    "doctor_response": "he is having azospermia. means less sperm count. after having some antioxidants and hcg injections count will increase. so do not worry. hope you will have a baby soon. hope my answer helped you. take care. do not forget to rate this answer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lethargy and black outs in the morning?\n\nI am 27 years old, and for the past couple years i have been feeling weaker and weaker, and a couple times when i get up, or while im just walking around my vision blacks out and i have to lean on somthing so i dont fall over. now i am a smoker, and do smoke marijuana, but i have been smoking marijuana for years and this never happened before.",
    "doctor_response": "Hello and welcome to HCM,Feeling weak and experiencing black outs after getting up occurs due to reduced blood supply to the brain.Reduced blood supply can occur due to vaso-vagal syncope, obstruction, spasm of blood vessels etc.I suggest you to consult your primary healthcare provider for clinical assessment and relevant investigations.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could sex with elderly persons cause infection?\n\nI am 15 years old boy and last monday i was on my school's toilet to mastrubate but when i was in the toilet my teacher come and she caught me when i was cumming......when i finished my job she licked my cum and she started to lick my dick very hard and i cummed again when she finished she ride my dick.........and now i wonder do i have something???cause she was 33 years old.........did i caught illness??? cause i loved that but after that i was ashamed and i am afraid if i have aids or something like that.....",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.It would be best to ask your teacher is she has some STDs and then if there is concern, you can do STD testing. I dont think this is required at this point.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swelling and itching near nails. Taking antihistamines and allergy related drugs. Treatment?\n\nHello Doctor, I am having a very peculiar problem, for last two months I have developed swelling and itching in my fingers basically near the nails . I have tried anti histamine and other allergy related drug under a medical supervision but still now nothings has worked. My doctor did some blood test but it was all negative, first they said soap or detergent allergy now they said it is nickel allergy, but even after taking medications there is absolutely no improvement till date. Can you explain what may be the cause for such reaction. Thanks & Regards",
    "doctor_response": "it seems to me fungal rather then allergies yu start with forca 150mg once a wk for 8 week take tab fexofenadine 120 mg od apply antifungal candid ointment tds on area keep area dry and sweat free can use mycoderm powder once a day or twice a day after drying area ofnail may take 8 - 10 wk",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white lump on breast?\n\nHi I am a 55 year old male; for about 4 weeks now (may be longer, but only really noticed it about a month ago), I have had a small, white \"whitehead like\" raised spot on my left nipple. I tried to gently \"pop\" it. but it wouldn't, so have left it alone , but it doesn't seem to want to go. I have had blocked sebacious glands on my back before, could this be similar? It only hurts if I catch it and there does not seem to be any lumps in the breast are. Should I be concerned? Thanks Phil",
    "doctor_response": "HI,Phil,thanks for your  query to HcM.By the story given by you,In my opinion it appears to be chronic-dormant-boil.ALERT-But for your age keep watch if it grows painlessly,as it concerning to have such a lump at this age.I would advise surgeons second opinion or the photograph of it would resolve the issue online.Thnks again.Hope this would solve your query.Welllcome again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for fungal infection around the thigh and vaginal area\n\ni have a itching and burning feeling around the thigh crease area....and also vaginal area....why could it be? i showed a local doctor who told me could be a fungal infection and suggested me a skin cream TRIBEN-XT. But still i feel it is not okay....",
    "doctor_response": "Hello,Welcome to HCM,Fungal infections are more common in the genital and perineal area as these are the normal comensals of this area, which will be kept under control by helpful organisms whenever there is a change in the environment these yeast will activate produce their symptoms.As you are having the symptoms of fungal infection for which you have taken some treatment but your symptoms has not come down, I would suggest you to undergo lab investigations like KOH mount, CBC and urine routine examination. For your symptoms you can try these measures1.Keep the area clean and dry with the help of neosporin powder.2.Apply antifungal cream over the lesions3.Tab Diflucan, 150 mg single dose.4.Oral antihistamines to reduce the symptoms of itching.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump on the spine\n\nHi DoctorMy wife has a small lump on her spine. However it is painful and she limbs while walking specifically the top of her right leg near the joint of the hip. He back aches in the day and at night.She visited a doctor and had her examined. However the Doctor reassured her that it is a muscular knot and she needs a deep tissue massage ?How can we be sure that it is not a tumor?",
    "doctor_response": "Welcome to Health care magic.1.Painful lump on the spine with back pain symptoms. 2.Painful lump will goes in terms of an infective process - which needs attention.3.In this case an ultrasound examination will help in right direction. It will hep to evaluate the nature of the lump, its source and extensions.4.If a mass lesion a needle sample would help exactly what cells are there.5.For back pain an MRI will be excellent investigation of choice.6.Initillay back exercises followed by physiotherapy will be the treatment of choice. Good luck.Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tenderness around the navel after an exercise?\n\nI have had tenderness around the belly button...started yesterday...not sore but tender to touch,was doing sit ups this week (not yesterday though)...when I walk around it feels like I have basketball there...should I have it checked?  I'm a 59 yr old female over weight",
    "doctor_response": "Hi, I understand your concern. From your medical history, I can see that you have undergone to intense physical activity recently (sit ups at your weight). Your muscles have undergone to this stress just recently, and got inflammed (which you feel as pain). It will take a few days until they get used to physical activity so no more pain. I advise to start slowly then gradually increase number of sit ups. Take oral anti-inflammatory meds you find over the counter (paracetamol or ibuprofen) and everything will be ok. No need to get checked for this time unless you have other unusual symptoms. Wish fast recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low WBC levels?\n\nMy daughter had a WBC differential and her neuts# auto was 1.9 and her neuts % auto 32 and her monocytes were high. She was recently diagnosed with sjogrens and is on methotrexate . She has a rising developing under her arm. Could this be the cause of her recent labs being so low?",
    "doctor_response": "Low wbc count may be due to many reasons.  But in your case methotrexate is used. It is chemotherapeutic agent may reduce your wbc count. So consult your doctor for that.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I getting burning sensation between legs?\n\nMy name is Greg. I have had burning in where my legs come together and into the buttock when I sit...and down the right back of the thigh. I thought it was chafing and bought Gold Bond and the redness went away. I do workout everyday so I thought was the problem. Well the burning is still there. I am 58?",
    "doctor_response": "Dear Sir/MadamI have gone through your query and read your symptoms.In my opinion, your symptoms could be due to neural compression in the spine, you will need an MRI for the diagnosis to be madeI hope that answers your query. If you want any more clarification, contact me back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can taking Atenolol be safe for tachycardia?\n\nI am a 49 year old female.  I am 5' 2\" and weigh 106 pounds.  Extremely athletic.  I have only 1 health problem I have SA Tachycardia. Actually had reating HR >100 all my life but was not medicated until age 40.  I take Atelalol 12.5 mg at bedtime.  HR approx mid 80's resting.  Have yearly Echo which is always normal.  I am always cold.  The last few months I have noticed that when I sit or stand for long periods of time my little toes will get cold and turn blue.  Never my big toes.  If put a sock on it goes away.  Should I let my cardiologist know about this?",
    "doctor_response": "Hello,Your symptom is related to atenolol adverse effects. The episodes when your toes turn blue could be explained with Raynaud's syndrome, which triggered by atenolol intake. For this reason, I would recommend discussing with your doctor on the possibility of switching to diltiazem, which does not lead to such adverse effects.   Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Ilir Sharka",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes raised red spots on the shaft of the penis?\n\nNoticed a reddish raised spot appeared on inside shaft of penus after having intercourse - when water hit it - it stung and is a little painful.  what should be done ? never saw before - hadn't had intercourse for a couple of weeks and a little on the rough side but not outrageous. Female gets fever blister which I take Valtrex  but haven't had one in a 45 days (only get them with period).",
    "doctor_response": "Hello,Possible causes like genital wart must be ruled out. STD is a rare possibility,It will be very helpful if you attach a picture in the followup query.A biopsy may be required in case of diagnostic confusion.Hope I have answered your query.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest if the treatment for vitiligo is correct\n\nmy child is 9 years old. he is suffering from vitiligo. Doctor is using following treatment: 1. Tab. Melinocyl half tablet on alternate days. 2. Tab. DICARIS children on saturday and sunday 3. Ointment FLUCORT H & Ointment Topgraf 0.01 %. what should i do ?",
    "doctor_response": "HiThanks for writing to us. The medicines your child has been prescribed are appropriate. Correct combination. No need to worry. You can continue without hesitation. Do regular follow ups. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What dosage of Allergex be given to a child stung by wasp?\n\nHello. I have a 6 year old who has been stung on the nose by a wasp. Her nose and eye area are now red and swollen. I have put anthisan on the sting area and have given her 5ml of Allergex syrup. I have lost the dosage instructions (on the box). Please advise the correct dosage. Many thanks.",
    "doctor_response": "Hello,You can give Allergex syrup three times a day for 3 days for wasp allergy. But if he is having any respiratory distress or stridor,  I suggest you take him to the nearest emergency room.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sumanth Amperayani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic pain syndrome\n\nIve had swelling in my both are mostly left one for a long time have been to drs for years on Tuesday the dr said weve tried lits of meds no relief she said theres nothing else to be down chalked it up as chronic pain syndrome and a compressed nerves neuropathy before i wad offered a nerve block now its nothing i know im not supposed to live the rest of my lifr like this please help",
    "doctor_response": "Hello, As mentioned by you in history you have tried almost every possible thing to reduce the pain. What I figured out is that no exercise is tried. So in all the procedures above the muscle would have gone weak by now and making joints to friction by touching of the end plates of the joints. Also, the muscle weakness will lead to fatigue to set in faster and release more of the lactic acid. Improving the overall muscular physiology with the help daily general exercise and some specified for the muscular system where the pain is more will help to have some relief. This has to be done under a competitive physiotherapist and also for a longer number of days. As the much precisely and more you do exercise the more the benefit will be. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a painful blister with a red spot on the heel indicate?\n\nI have developed a blister with very little fluid and a red circular dot in the middle of my left heel...I stepped on a rock through my house shoes about 2 months ago and not long after this the red dot appeared and now a blister has developed. What can this be. It is painful",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It could be due excessive friction while stepping on stone.If it is very painful interfering with walking then you need to remove it by piercing and taking off fluid. It need to be covered with cotton dressing. So you need medical attention. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for foul smell in child's stools?\n\nHi.  My son, now 12 has always had very foul smelling stools.  Sulphur.  He is healthy, optimum weight, lots of sports and eats well.  4-5 pieces of fruit daily. Meat 3-4 times wily.  Limited take away food.  Limited sweets.The smell  seems to be getting stronger.  He is embarrassed.",
    "doctor_response": "hi having smell with the stools is associated with irregular toilet habits  ie withholding the stools or due to intake of high spicy oily diet with less fibre,fruits and vegetables.My advise is to give him atleast half a kilo of fruits along with banana,carrot.cucumber veggies which will be helpful.Hope it answers your query and ready to help you further",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dark skin tone. Prescribed kojic acid, vitamin c, multivitamins. Not helping. Remedy?\n\nHi Doctor!!I have a dark toned skin. I have visited dermatologist also for skin lightening. He prescribed me kojic acid, vitamin c, multivitamins etc. I used all this for 3-4months but could not get the results. I don't have problems like dark spots etc but have overall dark toned skin. Can you help me in lightening my skin tone???",
    "doctor_response": "Hi Dipa, Welcome and thanks for posting your query to HCM. It seems you are quite stressed with your dark complexion. There are many methods of lightening of dark complexion up to a certain stage but you along with your dermatologist has to see the safety issues with short term or long term usage of these things. Now it is totally Upto  you to what extent you want to go, even you may find some fascinating advertizements regarding fairness but again comes the side effects and actual usage. Now coming to your point directly, you can use glycolic acid and azealic acid creams under dermatological guidance. Both glycolic acid and azealic acid creams are present in low and high strengths, so try using low strength first and then gradually can shift over to higher strength. These are able to give results in 3- 4 months continuous and judicious use and are safe for long term use also. The next thing to tell you behind beauty is that it is not the color but the glow on the skin which actually counts. This can be achieved with good sun protection by physical barrier as umbrella and  sunscreen usage 2-3 times a day half an hour before moving out. Eat a lot of fruits (all yellow and red) containing a lot of carotenoids and vitamins which can act as best sunscreen. Include green leafy vegetables and salads which will act as natural sunscreen ( best for you) and drink at least more than 10 glasses of water per day. Lastly love your skin and love yourself there must be certain things which nobody can match up. Keep glowing!!! Dr Sanjay K Kanodia MD (Dermatology)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have dull headache with burning and tingling at the back of the head. Please help.\n\nHello doctor, I have been experiencing headaches for the last three days. It is more of a burning or tingling feeling at the back of the head that seems to travel to the front sometimes. It is not a severe headache it is more of a dull ache and also my scalp feels sensitive when I scratch or touch in those areas. I have no eyesight problems besides blepharitis and no unsteadiness or vomiting. I have done an MRI of head and neck six months back and it was clear, and I was diagnosed with fibromyalgia four months back.",
    "doctor_response": "Hello. Regarding your concern, I would explain that your symptoms are suggestive of tension type headache, which is a benign type of headache related to psychological stress. A wrong posture can also cause such type of headache. So, in my opinion, there is no reason to panic. I would just recommend taking painkillers (Acetaminophen or Ibuprofen) and try to relax. A warm bath can help too. If the headaches persist, I would recommend taking Duloxetine (considering also the diagnosis of fibromyalgia) or Amitriptyline. There is no need for brain MRI, as I am sure that it will result in normal. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in conceiving after a abortion?\n\nhi i want to get pregnant after an abortion in jan this year.even after having unproctected sex for past 3 months i could not concieve.i get my periods regularly and last month i had bled dark brown bloodclots juz for a day .i had consultated a gyanee she said to wait for 3 months ,",
    "doctor_response": "Hi, I have gone through your question and understand your concerns. Infertility is said to occur when one fails to conceive after one year of successful unprotected intercourse. Moreover, since you have conceived once, so it is appropriate for you to wait for at least three months before undergoing any infertility investigations and management. Chances to conceive in each menstrual cycle is only 20-25 %, therefore do not take stress and try for natural conception for at least next3-4 months.Hope you found the answer helpful.Wishing you good health.Dr Deepti Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain?\n\nFor over one year I have been experiencing periodic pain in my chest immediately after I swallow any type of meat...chicken or red meat.  It is very painful...kind of feels like an air bubble is in there.  Yesterday I again experienced it after eating a small bite of chicken breast.  I became sick to my stomach...felt nausated...starting sweating...felt like I was going to pass out.  I'm thinking I need to get this problem looked at.  What type of doctor should I see?",
    "doctor_response": "See a Gastroenterologist. He or she will likely start with a barium x-ray of your esophagus and may proceed to doing endoscopy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is rabies contagious during the incubation period?\n\nquestion. Is rabies contagious during the incubation period.  Our family cat has had her shots - 1 year and then her 3 year shot.  But she got in a scuffle with something outside and that is when we realized she was literally only 13 days past her due date for her next shot. While cleaning up her wounds she very softly let me know that I was hurting her and placed her tooth lightly on my forearm.  With human reaction, i pulled and it scratched my arm - No puncture wound, but a touch of blood came to the surface.  This was five days ago.  Everyone is telling me,its fine.  But just nervous because of the outdated vaccine.  The cat is heading to vets tonight for her check up and shots.  Any need to be concerned?",
    "doctor_response": "Hi,Welcome to HCM.I see no reason to worry, as your cats vaccination was on schedule and vaccines given every year are boosters to keep the antibody levels against rabies virus high. Proper cleaning of the wound would suffice. I suggest you get your cat vaccinated.No need for any concern.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to continue with yoga for hypertension and BP?\n\nI am 65 years old. Taking care of my health by free hand exercises and Asan (Indian Yoga) since my boyhood. Doing Shirsason ( Head below and legs upone Indian yoga). But I am a hi-per tension patient and my B.P. is quite normal bt taking medicine, 1 Amlodopine, 1, Zestril, 5 mg and no health related major problem. May I continue my usual present daily life or any other suggestion. Please let me know and oblige.",
    "doctor_response": "Hi,If your blood pressure is well controlled with your medications and you have no complaints during your exercises, then you can continue your activities.Take careCome back if you have any further questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat persistent cough?\n\nhi my dad keeps coughing off and on, he is 76, but never had a cough like this one, evne though he is taking his antibicotic and puffer the cough still is pressiant, it reallybothers me, should i take him to the hospital, or back to the doctor. please e-mail me back right away.  YYYY@YYYY",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Yes, you should definitely take him to pulmonologist for chronic cough despite of treatment. Possibility of following is more 1. Uncontrolled of worsening bronchitis2. Chronic lung infection like tuberculosis or fungal3. Lung cancer.So better to take him to pulmonologist and get done clinical examination of respiratory system, chest x ray, PFT and CT thorax to identify the cause for his persistent coughing. Hope I have solved your query. I will be happy to help you further. Wishing good health to your father. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent vertigo\n\nHi I went on a trip to Hawaii and on the landing my right ear felt like it was rupturing. I woke up to severe vertigo and has been lasting for 5 days now. What can I do? Been taking meclazine it helps but not curing the problem. I m a dental assistant and I m having trouble with my eyes moving or it feels like that. Help",
    "doctor_response": "thanks for question. dear as you may have some problem with your eardrum you should have to visit ent especialist that will examine your ear",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cancer on the groin post penile cancer, not on treatment, relieve pain through syringe driver. Life expectancy?\n\nMy dad has penile cancer , he has had the operation to remove the cancer but it has returned in his grion. he is not having any more treatment eg chemo or radio. He is at home now and has his pain relilef through a syringe driver. nurses are coming in every day to check everything is okay. My question is how long should i expect him to stay with us? my email is YYYY@YYYY",
    "doctor_response": "what is stage of the cancer? what and when the operation has done? what is reason for the pain? what the concerned doctor told?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is citalopram and lipitor causing heart palpitations?\n\nHi, I am on Citalopram (altho slowly reducing the dose in view of weaning off them) and Lipitor 40mg for elevated cholesterol. I am experiencing frequent palpitations throughout the day,sometimes for a couple of hours at a time. Is this a serious side effect or should I try and put up with it ? Do all palpitations lead to a cardiac incident ?",
    "doctor_response": "hi dear. palpitations are a cardiac symptom. so i will advice you to kindly not ignore it. visit your docter and get an ecg done. it will help us to confirm if you require any more tests or not.meanwhile reduce your salt intake .. and eat a lot of fibers.. since you have experiencing palpitations more often i will advice you for a cardiac evaluation. hope my answer helped you. please do rate my answer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rash on knees and legs?\n\nHello, I have had CLL for 9 years and am in stage 0 presently.  My white count is up to about 52,000.  I did have shingles a couple of years ago and am just getting over a bad case of stomach flu which my grand daughter brought home from day care.  I have not been sick for 2 years and that took 6 days to get over.  My main question is about the red rash I keep getting all around my knees on both legs.  It itches and I found it went away for awhile when I changed laundry detergent.  What can this rash be when I thought I got rid of it?  I am going in to see my oncologist on Oct. 30.   This rash is puzzling to me and I wondered if it has to do with the CLL?       YYYY@YYYY   Thanks.",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms seem to be related to contact dermatitis due to the new detergent. I suggest using Cetirizine 10 mg to relieve the symptoms. I also suggest using Calamine lotion for local application. I recommend to chage the detergent. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a bruise and discomfort in leg serious?\n\nHi, I have always brusied easily and have had countless blood tests and everything comes back fine. Whilst sitting on my bed working 2 nights ago, I felt this really weird sensation in my left leg, just below my knee, I had not bumped myself or anything and I watched as a bruise/blood pool appeared. Is this serious? I have had 2 blood blots in my right leg (1st was in 2007 and the other was in Feb 2013). It is quite painful when walking and even sitting I can feel it. Should I get this looked at?",
    "doctor_response": "Hi, Welcome to Health care magic forum.                         It appears to be the utricaria due to some allergy to some thing like food, cosmetics, soap, clothes, or wool.  or it may be due to the deep vein thrombosis.                         I advise you to consult a physician for diagnosis and treatment. You may need to have a color doppler for diagnosis .                         Take more of green leafy vegetables, pulses, sprouts, and protein rich foods to have a healthy tissues.                         Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes startling responses in the limbs?\n\nI m a healthy 50 year old male. I m thin,don t drink or smoke. Over the past year or so, I seem to have developed an exaggerated startle response. My limbs shake when my alarm goes off in the morning. I have these tremors in my sleep, sometimes waking me up. Is this just aging or could it be symptom of something more serious? I mentioned it to my doctor at my physical in June and he wasn t overly concerned.",
    "doctor_response": "Hi, Are you taking any prescriptions like salbutamol which eventually leads to resting tremors like side effects? If not, don\u2019t bother. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parkavi Gunasekaran, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes eating habits at nights with nausea and vomiting in mornings?\n\nHi my son is 14years old he has been having problems in the last 3 - 4 months where he gets up in the middle of the night for something to eat and drink , has been drinking and eating alot more than usual says that it helps him to feel better, when he wakes in the mornings he has nauser some times vomiting headaches and saw stomachs . he has had an mri which showed a small mark that they are getting a second opinion on , also his creatinine levels are up and have taken several interval test within 2-3 week period and still remain up , are awaiting kidney specialist appointment have been waiting several weeks now for results or appointment , have also tested for diabetes as this is in both sides of the family and came back ok , other than this all the other test are normal , what i want to know is 1st what your opinion is and 2nd should this kidney appointment be urgent and should i be worried. also he is very tired , goes to bed most nights around 7.30 sometimes earlier and plays rugby but that seems to be a challange as well these days , he comes back so tired and wrecked. i look forwar to hearing your opinion Thank you",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. You should immediately consult nephrologist, because high creatinine can be sign of renal failure, when glomerulus of kidneys died then creatinine can increase",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment swelling of arms\n\nmy mother was recently hospitalized with a recurring bout of C-Diff that she acquired while in a rehab facility being treated for osteomyalitis on her foot due tonow, her a diabetic pressure wound. While in the hospital, she received a large amount of fluids by IV at one point the IV in her arm was infiltrated. She swelled up and now her arm is continually weeping. Is there anyway to stop this?",
    "doctor_response": "Hi, There is excess accumulation of fluids in her body. Please get her admitted in a nearby hospital for proper fluid management. If not, it could land up in trouble. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Jaideep Gaver, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Headache, pain and cramps in stomach, feeling of vomiting and nausea.  Is this stomach flu?\n\nHi, I have these really bad headaches and my stomach starts to hurt and sometimes I feel like I have to puke but I dont and sometimes I feel it coming up and I feel like I might have the stomach flu and right now I've been sleeping a lot my head hurts I feel like I might puke and I feel nausea a lot and my stomach hurts or I have bad cramps",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum.Possibilities may be ,1 Peptic ulcer disease , diagnosis can be confirmed by upper G I endoscopy .Try raising the head of your bed about 4 inches with blocks.It also might help to avoid eating or drinking  for 2 hours before you lie down.To control stomach acid one should not drink alcohol or drinks with caffeine in them or eat chocolates or greasy or spicy foods.Also take some antacid but if symptoms are severe you need drugs like proton pump inhibitors.2 Tension is the 2nd most important  cause in such type of condition , so if any try to avoid.3 Over eating the most important cause ,so avoid it.In my opinion deal according to above mentioned.Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What causes pain in back and legs?\n\nHello doctor, Around 6 PM today I had really bad back pain all of a sudden, I have a cold. So I have been texting so I thought it was just that but around 10 or 11 PM, the pain started to shoot down my leg as well, it hurts when I sit and walk and lift my leg.",
    "doctor_response": "Hello. Looking at your problem from very near, it would be sudden bending causing pressure on disc and protrusion to lumbar nerve causing shooting like pain on leg. The cold and even cough increase the inner disc pressure and causing nerve to more pressure which causes symptom worst. So I would recommend you to use lumbosacral belt on lumbar spine at lower back. I would also recommend some medicine to take for this problem and follow up with MRI for further improvement. Zanaflex (Tizanidine 4 mg PO bid for 1 week, capsule Neurontin (Gapapentin) 100 mg PO bid for one week, capsule Pantoprazole 40 mg once daily for one week.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for choking on chewing gum after accidental ingestion while having asthma\n\nI NEED HELP. I WAS PLAYING A DRAGON BALL GAME WITH MY FREIND AND WHEN HE SNAPPED MY CHARACTERS HELTH IN HALF I INHALED DEEPLY CAUSING CHEWING CUM TO SHOOT DOWN MY THROAT. I ATE AND DRANK AND IT GOES DOWN FINE AND I COULD VE SWORN I SWALLOWED BUT NOW ITS AFFECTING MY BREATHING. I DO HAVE ASTHMA AND IT FEELS LIKE ITS IN THERE. SOMTIMES I FEEL THE NEED TO BURP BUT CANT",
    "doctor_response": "Do you remember choking episode while swallowing chewing the gum?Choking is more sensitive clue to aspiration of contents into windpipe.Post choking you might feel tightness in chest,shortness of breath temporarily.Only way to confirm whether you have aspirated is to take a ct scan of chest.Anxiety also can also cause an asthma attack.If you are on anti asthmatic inhalers i recommend you to use it if there is difficulty in breathing and consult your doctor if needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for head trauma\n\nhi i had a head trauma in two places from falling on ice and hitting my head on a pole, one caused a small fracture and minor bleeding in my brain, and another on the top of my head had no fracture but a lot of intracranial bleeding and my brain had a lot of pressure, after two weeks a mri and ct scan showed that the pressure was going away as was the blood, are there any really bad effects from trying to fly 12 hours two months after it happened except the pain?",
    "doctor_response": "Hi, I have noted the clinical details. It is safe for you to fly 12 hours, 2 months after the head injury. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sudhir Kumar, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can lipitor cause low sperm count?\n\nCan lipitor harm sperm rate? We where able to get pregnant befor these meds that did result in a miscarriage but nothing in a year? Also if you get pregnant and miscarry can this be either parents to blame or just the mother as the egg was fertilized? Thx",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.Lipitor is cholesterol lowering agent, it does not harm sperm count.If you had pregnancy before and had miscarriage then one investigation I would suggest is histosalpingography HSG to rule out tubal blockage. As blockage is common after miscarriage.For miscarriage rather then to blame anyone, is better to find the reason.At first miscarriage no need to worry but if it happens 2/3 time then one has to rule outChromosomal abnormalities,Torch inf ( toxoplasmosis, rubella, cytomegalovirus, herpes).Hope i answers your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat fall mediated dizzy,nausea and seizing?\n\nMy 14yo daughter fell down about 6 wood stairs. She landed on her bottom on concrete. She got up and was talking, but had no color in her face/lips. She started feeling dizzy and nauseous. We got her to sit and she dry heaved a few times. Said she couldn t see or hear. Leaned her back against her dad who sat on the floor to hold her. She was getting worse, her arm started shaking and them her head (seizing). Her eyes were open, but she wasn t communicating. Then she went limp. I ran upstairs for the phone to call 911 while my husband was holding her, calling for her to come back. By the time I got back to the stairway, she was awake again, so she wasn t even out a minute. The 911 call didn t go through before my husband stopped me. She slowly started coming around. Got some color back, felt less nauseous, could see and hear better. Now (about 20 minutes later), she seems ok. A little weak and low on energy, but talking, laughing, asking questions and asking for food. No bumps, no blood, no pain other than her elbow. Should she still be seen, or can we just watch her here at home? If so, what should we watch for.",
    "doctor_response": "Hi,YOU SHOULD SEE A PHYSICIAN AS SOON AS POSSIBLE!What actually happened was the blood supply to her brain stopped transiently resulting in the physical manifestation she had. she might have had carotid dissection. immediate attention is required with thourough body check up. there might be some embolus obstructing blood vessels also. proper aetiology can be derived only by proper investigations which is also important to prevent any further such incidence. hope that helps! take care! :)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fever, sore throat, runny nose, cough, constant rattle in lungs, asthma and COPD, taking mucinex and sudafed, using albuterol nebulizer\n\nI have been sick for over a month. It started with fever, sore throat , runny nose. By the third day I developed a cough. The nasal discharge has all been clear and it stopped by about 7-10 days in. I just can t get rid of this cough. The mucus is thick and white and there is a LOT of it. I have a constant rattle in my lungs. I have asthma and COPD from the result of a propane explosion/house fire I was in 6 years ago which burned my lungs. I am on albuterol nebulizer and inhaler . I have tried mucinex and sudefed. The coughing is so bad I am unable to do my regular daily routine because I cough with any exertion. What can I do?",
    "doctor_response": "You have not mentioned if you are a smoker. If so, pl stop smoking as the first and most imp step. Pl start taking inhalers like Seroflo/Formetrol. Take another inhaler called Tiova once a day and tab Doxyphyllin 400 mgm twice a day. A  course of antibiotic like Augmentin or Levoflox  for 5 days should be taken. If symtoms are very bad take Prednisolone 20 mgm once a day for 5 days. Pantocid for gastritis should be taken as gastritis can aggravate the symptoms. Chest physiotherapy and deep breathing exercises are good for COPD patient.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pinkish discharge after unprotected sex. Implantation bleeding?\n\nI had unprotected sex on may 4th my period is somewhat un-regular so im not positive on when its supposed to start. On Saturday, may 11th i had unprotected sex again, when i went to the restroom, i noticed I had a light pink discharge. I was told it could of been implantation bleeding. Since then, ive noticed white bumps appear around my nipples, my breasts are very sore. I have been experiencing a lot of nausea, and head aches. could I be pregnant? If so when should I test?",
    "doctor_response": "Hello,Unprotected sex on irregular period is quite risky for being pregnant. Light pink discharge may indicate implantation bleeding.Here, you need to undergo one home pregnancy test after one week. If you do not get your period on that time, one blood test for beta hcg is required to confirm. TVS scan gives additional information on positive test.Following test report, consult with gynecologist for next line management. Practice safe sex in future.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had an abortion, will get Skyla IUD. Will pregnancy show up with it ?\n\nI had an abortion a little over 4 weeks ago..my boyfriend and I had sex but he pulled out I m going to get the skyla iud next Tuesday.that will be 2 weeks after the sex if I m pregnant again will it show up before I get it?I do not know when I will get my period because of the abortion and its also diffrent dates each month..",
    "doctor_response": "Hi,IUd can be put after period only.So they may not put IUD.So wait till you get your period.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can medication for HTN and IHD cause needle pricking body pain?\n\nFemale patient age 60 is having HTN and IHD since more then 10 years medication includes Tenormin Norvasc Atorva cardnit Loprin Lowplat Patient complains of a feeling pinching of skin and as if some one is throwing needles on body. what you think which drug is responsible for it.??",
    "doctor_response": "Hi, Assigning a symptom to a particular medicine is quite tricky. some principles that are usually used are: is the medicine known to either cause the problem or to do the thing that will give the problem. So, blood pressure medicines will lower blood pressure. Tingles or needles are typically a nerve problem and none of the medicines mentioned either is a nerve medicine nor hits nerves. Also, the relationship to when the medicine is taken is often a clue to which medicine is responsible and side effects typically occur soon after starting or modifying a medicine. Cannot say in your particular situation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pet allergy with sneezing be alternatively treated?\n\nI'm going to a friend's house tonight and spending the night. I love going there because she's one of my best friends, and we always have a great time, but her house triggers my allergies even when I've taken my medicine. She has 2 cats, 2 dogs, and a guinea pig in her house. I thought taking my medicine (Allegra of some sort) an hour or so before I go would make it fine, but it's always really bad; I'm sneezing like crazy and my nose is runny, and I cough a lot. I'm not allergic to cats or dogs or guinea pigs per se, but they do bother me a little but not as much as they do at her house. I'm only supposed to take it once every 12 hours, but my mom is a nurse and she said it wouldn't kill me to take it again when I was at this girl's house before. So I took it a few hours after I had the first time, and my allergies were fine after that, but I was SOOO sleepy, I was the only one to sleep that night because a few other friends were there too. I want to stay up and have fun, but I don't want to be miserable. What should I do about it?",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your history and would like to make following suggestions for you:1. Yes, antihistamines (commonly used for allergies) can cause sedation. Were I treating you, I would suggest you to take combination of fexofenadine and montelukast which will be more effective than fexofenadine (Allegra) alone. You can take a single dose approx 1-2 hours before going to your friend's house.2. If this does not help you, I would suggest you to keep a intranasal spray like azelastine with you, you could use it when you develop symptoms. As it is a local spray, it causes least sedation.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a Mirena IUD cause cramping and spotting?\n\nI had my Mirena IUD put in mid November. Now, 7 months later, I am having cramps and spotting. I have also recently gained quite a bit of weight around my thighs and butt, not normally where I gain weight. I do still feel my strings but is there a chance there could be something wrong with my birth control?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Cramping, spotting, weight gain are the common side effects of the hormone in the Mirena IUD. If strings are felt in place, then there is nothing to worry. Hope you found the answer helpful. Regards Dr Deepti Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain, chest pressure and faster heart beat?\n\nMy 22 year old daughter (5'4\", 122 lbs) has been having chest pain throughout the evening, chest pressure, flushed feeling, and slight discomfort between her shoulder blades and like her heart is beating really hard.  She wants to go to bed but I am not so sure it is a good idea.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Faster heart beats, chest pain, chest pressure etc in young patient should be evaluated for heart diseases like arrhythmia and valvular heart diseases (VHD).. So better to take her to hospital and get done ecg, 2d echo and Holter monitoring (24 hours continuous recording of Ecg). If all these are normal then no need to worry for heart diseases. Sometimes undiagnosed stress and anxiety can also cause similar symptoms. So tell her to avoid stress and tension, be relax and calm. Don't worry, she will be alright but first rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wishing good health to your daughter. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in left groin?\n\nHi. My husband has had a pain In his left groin since yesterday. It has gotten worse during the night time and pain killers have not taken the pain away. He has also complained of pain in his groin with an erection. It does not hurt when he passes water ??",
    "doctor_response": "HIWell come to HCMThis could be muscular pain, muscular spasm may be very likely and this could be due poor posture this can be best manage with the following drug, ask him to maintain good posture, else this is nothing to worry 1) Tab Chlorzoxazone with Acetaminophen as per needed hope this information helps, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in abdomen which is radiating to lower part of stomach?\n\nhi, I really have a poblem with my abdomen. on 17/11/2011 at 4pm my stomach started eching lie a joke but when ireached 10pm in the night i couldn,t even walk or sleep so i was taken to the nearby hospital.where i was given given an injection together with some tablets.but the pain did not go away instead it moved to the lower part of my stomach on the left side and it still aches upto now.",
    "doctor_response": "Thanks for your question. Your history classically suggests of most propably of renal stones.. The earlier condition you must have got acute renal colic.. witch subsided most propably by taking a analgesic/antispasmodic injection.I suggest you to visit your doctor and get abdominal and pelvis ultrasound done..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rash on the temple and trunk after running a low fever?\n\nHi! My 8 month old has been running a low fever (99-101.4) off and on for the last 4 or 5 days. She is playing and happy and is no longer running a fever, but this morning she developed a rash on her temple, forehead, left eyelid, trunk and lower back. We have a doctors appointment tomorrow afternoon. She seems happy so we are thinking Roseola, but her appetite is not normal so we are wondering if we should go to an ER.",
    "doctor_response": "Hi, Yes. The most probable diagnosis as per your complaints is a viral exanthem (could be a measles, erythema infectiosum etc). As the child is toxic and having high fever, I advise you to take your child as soon as possible to Emergency Room and do not delay the treatment. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a deep cut near the eye socket in a 5 year old?\n\nMy 5 yr old daughter suffered a relatively small (3/4 inch), but somewhat deep cut to her face yesterday. It is to the right of her right eye, in the area of her eye socket and cheek bone. A nurse in a medical clinic stiched her up with 2 or 3 stitches. Should we have a plastic surgeon look at it? I question whether we should have gone to an ER with a surgeon on call.",
    "doctor_response": "Hello. I just read through your question.As long as there was no loss of consciousness at the time of the cut, there was no reason to go to the ER. I generally like to have a plastic surgeon look at anything on the face.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling down, fatigue, random bursts of tears, suicidal thoughts.  History of self harming.  Depression?\n\nI constantly feel down and have no energy to do anything. I have random bursts of tears and have self harmed on and off for about a month. I have a voice in my head that always tells me the worst of situations and i have had the odd suicidal thought. Is this depression or am i just stressed. Im too scared to go to my GP and ask.",
    "doctor_response": "Hi,Thanks for using healthcare magic.I have gone through your available history.It seems that you are having depression. You should consult your psychiatrist for detailed evaluation.Doctor may advise you to rule out physical condition like thyroid dysfunction or vitamin b deficiency etc Doctor may advise treatment after expert examination. I hope it will help you.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take steroid shot for asthma?\n\nHi, my name is Renee and on the 4th of October I received a steroid shot for my asthma. Well I was expecting my period 3 days ago and I am still yet to get it. I am not sexually active, I do not do drugs, I've just been taking the z-pack my doctor gave to me along with One A Day vitamins, what could have caused this?",
    "doctor_response": "Hi,Short course of steroids - 3 to 5 days are recommended in acute exacerbations of asthma. However single dose is generally not recommended in such conditions. There are manyu triggers for asthma attacks like seasonal changes, allergens, pollutants, dust, infections, etc.RegardsDr. Mishra",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes Braxton contractions and  constipation during pregnancy?\n\nI am 30 weeks pregnant and having braxton hicks contractions about every hour, constipated with pressure on my tailbone, and my stomach is very sensitive to the touch when baby moves or i touch it all around the rib cage from left to right. What do i need to do",
    "doctor_response": "HiI have gone through your complaints.dont worry its quite common in most of pregnant woman.regarding constipation,due to pregnancy hormonal effect.it can be overcome by encouraging eating of green leafy vegetables ,fruits and avoid refined deits like bread and biscuits.take luke warm water in morning,facilitates easy bowel movement..start regular walk if you dont improve with this mild laxative syrups areadvised.braxton contractions become more frequent as gestational age increases.some times contractions are painful.as time goes on you may adopt for that.dont worry take rest. Dont think much above those.take good diet.have a healthy baby.Thank youRegardsVasundhara",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I use Deriva MS gel for acne and acne scars ?\n\nI ve acne & acne scars about 3 months old. I m 22 , female, and getting married after 2 months & so want to have a clean clear face . Saw a dermatologist , he recommended Differin & Suprim & Reoccutane (Antibiotic + Tabs), but not much useful. My friend recommended me Deriva ms gel. What should I do?",
    "doctor_response": "Hi!, Welcome to HealthcareMagic forum, Treatment of acne depends upon the severity of acne.What you  have received is good.In fact roaccutane which you have mentioned as an antibiotic is actually not an antibiotic but a retinoid.I hope your doctor has told you all the side effects of this medicine since you are getting married in 2 months time.Roaccutane is a wonderful medicine for acne ,it would give good result in one months time,but it has certain side effects like ,patient should not get pregnant during  the course of medicine and at-least 3 months after stopping this medicine.It has teratogenic effect on the baby.Other precautions are that one should not donate blood during the course ,should not wear contact lenses,should have a normal liver function test & blood counts before start of the medicine.And if you get headache after this medicine then you should stop the medicine.I hope this was told to you before start of the medicine.In your case pregnancy is the most important precaution . If you can take all the above precaution then roaccutane would be best to treat your acne ,provided your hormone profile is normal.Once started this medicine needs to be given for at-least 6 months depending upon your body weight. Deriva ms is just a gel and alone it might help you a little bit.Patient with hormone im-balance with associated acne would need hormonal medicine to treat their acne. So,kindly discuss all this with your dermatologist and then proceed for treatment. regards, Dr.chawda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Have blocked fallopian tube. Are felopio tampons useful?\n\nThe felopio tampons to unblock fallopian tubes, have they been medically researched and are they worth a try. Do they have any negative response so far among those who have used them. Im 33yrs 5ft 4inched. I have been checked like 1 and half years ago an found with a one blocked tube and the other very normal. Have been trying to conceive for 4 years now but so far unsuccessful. I have 6 year old already.",
    "doctor_response": "Hi, Thanks for your query. I have read your query & I understand your concerns. Following is my reply: 1) These felopio tampons to dont work . There is no mechanis, of action of these drug so as to how they act. Hence it is not wise to believe them 2) There may not be negative response from people who used it but also no positive response as they cant open blocked tubes. 3) You can go for hysteroscopy guided tubal recanalisation procedure. If not successful try for pregnancy when follicle grows on the ovary near open normal fallopian tube. I hope I answered your query. I will be available for any followup queries you have. Regards, Dr.Mahesh Koregol IVF & Infertility Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will escitalopram suffice to help with body pain caused by APD?\n\nhi, i am 41 years old and suffering with APD for last about 10 years. I am taking emeprazole 20 mg daily, estalopram 10 mg daily and ALP 0.25 mg daily to reduce Gas and chest and left shoulder. These mediciens reduces my pain about 80%. But I have experienced for last 2 month with abdomen swelling with high Gas pressure in upper abdomen with a little pain. I am also experienced with body pain especially in legs and back at early morning. I have got my test for typhidot and igM found weak positive. I have a little alergy. Please advise me what i required to do more?",
    "doctor_response": "Hello, Escitalopram will not help with the body pain. It will help to elevate the depressed mood. In case the pain is persistent then a mild pain killer can help. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can eating turmeric everyday reduce the chances of cancer?\n\nHello doctor, What are the symptoms of brain cancer and colorectal cancer? One more thing, if I eat turmeric every day the chances of cancer will be reduced or not? Can it be cured in Ayurveda?",
    "doctor_response": "Hello. I just read your query. See there are a number of symptoms which are linked to both these cancers. Moreover, in initial stages, some patient might not feel any symptoms. As far as turmeric is concerned it has many properties including anti-cancer properties. But it can not be guaranteed that taking turmeric alone will help you in not getting any disease in future. Yes, Ayurveda has treatment for cancer but it depends on the condition of the patient. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take Myprodol with tramadol for chronic back pain?\n\nHi I am a 58 year old male 1,72 meter tall 85 kg with cronic back pain for about 15 years Used Synap Forte tablets 2 and 2 tramadol 50 kg tablets in 24 hours They discontinued it in my country Please want to know if I can use Myprodol together with the Tramadol Had back operation 10 years age",
    "doctor_response": "Hi Welcome to healthcaremagic After going through your query I concluded that  you are suffering from chronic pain since at least 15 years. Treatment of it is exercises and analgesic.You want to know that can you take myoprodol along with tramadol for  backache. There is no contraindication in it. You can discuss with your treating Doctor about it. Hope your query get answered. If you have any further questions then don't hesitate to writing to us . I will be happy to help you.You can also write to me directly on below link: you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cause and remedy for loose motions in mysthenia gravis patients\n\nHi sir! my mother is a patient of mysthenia gravis ... she has been prescribed with azoran, wysolone, rozart.  Calcirol sachet for vitamin d, shellcal for calcium deficiency ... now she is having loose motions with consistent headache .... pls help me.",
    "doctor_response": "HiThanks for using healthcare magicLoose motion may be due to any drug or gastritis. If motion is due to some gastric infection, that she needs antibiotic and should get proper investigation done. She has headache also, so in that case, i would suggest her amitriptyline, it is a TCA. It would help to control headache and also help to control loose motion.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "CT scan shows hydronephrosis. Had inguinal hernia repair and reconstructive surgery for breast cancer\n\nMy 78 year old mother is having difficulty with hydronephrosis . CT scans are normal; she had a cystocope a month ago and a stent was placed in the Right ureter as the urologis reported a stricture; the most recent CT follow up scan is now showing hydronephrosis in the Left kidney which was not there a month ago. It is very perplexing; She had an inquinal hernia repair in June laproscoptical. she has mesh in her abdomen from reconstructive surgery for breast cancer 28 years ago. She has a diagnosis of morphea and I was wondering if that could contribute to the hydronephrosis that is occuring. Thank you",
    "doctor_response": "Hi, Welcome to HCM. Morphea is not known to cause this problem. Hydronephrosis is not a diagnosis. It just says there is stasis of urine in that particular kidney or ureter. The cause needs to be found out whether it is stone/ stricture/ tumour etc. She needs compete urological evaluation in the form of IVP, CT, Renogram and urodynamic study depending on the situation. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for nausea/weight loss while having cirrhosis of the liver\n\nI have nonalcoholic scrossis the liver, I am having a lot of trouble with being nausead so I don t eat much I have lost a lot of weight don t eat meat much my granddaughter thinks I should be taking protein supplement Does that sound like something I should do?",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, if this is the liver cirrhosis then under lying cause of this would be matter of concern and this needs to be treated if this is not due to alcohol then second would be viral infection, or other parenchymal pathology  liver function could clear the diagnosis till then symptomatic medicine can be taken for nausea and vomiting and \"Ondansetron\" is drug of choice else nothing would be much helpful   hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do to get rid of the pain in the upper rib cage which hurts only when laying down?\n\nHello, I have had this pain in my upper rib cage for the past 5-6 yrs. First , they thought it was my gall bladder, so we had that removed, then I developed a gall stone, removed that. I was told it was a fat deposit. It only hurts when I lay down and have to use a heating pad and pain pills when it is intolerable. What can I do to get rid of this?",
    "doctor_response": "Hi,Pain near the upper rib cage can be because of costochondritis. Costochondritis, also known as Tietze\u2019s syndrome, is an inflammation of the cartilage in the rib cage. The condition usually affects the cartilage where the upper ribs attach to the breastbone  an area known as the costosternal joint. People with costochondritis often experience chest pain in the upper and middle rib area. Most likely your pain is costochondritic. A chest x-ray PA view, and anti inflammatory medicines are recommended to be taken.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Ramesh Kumar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is fresh blood spotting normal after delayed periods due to pills?\n\nI was on period delaying tablets due to going on holiday. I was on them for 3 weeks. I got my period 2 days after coming off of the course and finished my period 2 days ago (7 day period) I ve now started again with fresh blood spotting. Is this normal or does it need medical help?",
    "doctor_response": "Hallow Dear,Usually within 4-7 days after discontinuation of pills withdrawal bleeding starts. Such bleeding stops within 5 days. However, your withdrawal bleeding started within 2 days and continued for 7 days. Even after stopping the bleeding, it restarted again after few days. This is not expected. It is denoting some hormonal imbalance. It can happen if you have taken Oestrogen only pills. I will advise you not to neglect it. Please report to your Gynaecologist ASAP. You may need low oestrogen birth control pills cyclical treatment for about 3 months. I hope this helps you. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling of lip with cold?\n\nSir I am a Tuberculosis patient and under Continuation Phase of DOTS therapy and have completed 4 months of medication. When I wake up this morning I noticed my upper lip is swollen, slightly numb and has got some light dots. Also I have got cold and runny nose from last 1 day. Other symptoms are that my chest has very slight tinkling now and then. Please help",
    "doctor_response": "Thanks for your question on HCM.I can understand your problem.In my opinion you are having viral upper respiratory tract infection (URTI) mostly. Swelling of upper lip is seen with URTI due to angioedema.It is aleergic reaction.And prompt treatment with antihistamines and oral steroids is needed.So better to consult doctor and discuss all these and start appropriate treatment.With proper treatment swelling of lip will reduce in 2-3 days. So don't worry much, just start treatment. And continue your DOTS treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What course of treatment should be given for cold sores?\n\nalways have cold sores in my nose and fever blister on my lips 2 years ago had cold sore on my mouth and not another one since. I have spread it to my children. It seems to me i only have to breath near them and they get it. I take meds for it. I use cream on it. Dextrol cream helps for a few hours and then its usually starts again. When I have it, people around me have dry eyes and itching noses. I am going crazy over this and think i may even get fired from my job",
    "doctor_response": "Hello, The cold sores are caused by a viral infection. I recommend using acyclovir cream for local application. I also recommend using Acyclovir tablets for oral treatment. I suggest using a multivitamin supplement to boost the immune system. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can mucus discharge from wounds be prevented?\n\nI recently skinned my knee. I ve had the wound covered and I have cleaned it out with hydrogen peroxide for two days. I ve used triple antibiotic ointment. But yesterday and today I noticed that there was a mucus like substance on the wound. What is it and what can I do to go away?",
    "doctor_response": "HiWelcome to Health care magic.I went through the history you have provided here. It seems from the history that you are having discharge from the wound. This indicates infection of the wound and requires treatment by the use of antibiotic ointment. Along with this daily cleaning of the wound and dressing is necessary for early healing of the wound.Hope this information is helpful.Do write back to me for further questions.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bronchitis and sore throat\n\nI have been on antibiotcs 3 kinds over 3 1\\2 week period for acute bronchitis. 14 days ago I delveloped blister like  lesions on backof my tongue. I just started pennicillin 4 times per day for 10 days and today begins my 4th day. When this stared I was on levaquin  500 mg @1 per day. My throat is slightly sore on and off.",
    "doctor_response": "Hello,You are on perfect line of management along with you have to:\u2022 Do gargles with salted lukewarm water and added peppermint oil 3 times/day\u2022 Avoid exposure to dusty weathers/pollen containing atmosphere if required use face mask, honey, turmeric with boiled milk, basil leaves are best herbal supporters \u2022 Avoid smoking/alcohol \u2022 Cough relieving lozenges/OTC cough syrups help in recovery \u2022 Avoid excess sugars, artificial sweeteners, oily, spicy, junk foods, chilled beverages, non-vegetarian stuffs, ice creams, cold drinks, etc.\u2022 Spirometry gives best way to strengthen the lungs with subjective evaluation of lung capacity \u2022 Regular walking in fresh air, yoga is must \u2022 Avoid shouting \u2022 Balanced nutritious diet to combat the infection\u2022 Avoid exposure to excess cold/heatHope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could lower back stiffness indicate after suffering a jerky motion?\n\ni am 64 years old and was in another persons boat and a huge wake appeared and i got thrown up in the air and down hard i felt a squeezing feeling in my lower back could i have put my back out i can walk but have difficulty bending this was 3 days ago i have been taking ibuprofen and vicadin",
    "doctor_response": "Dear patient It seems you have got high velocity  trauma  to your back that needs to be investigated  ad it is not relieved with pain killers.  So you need to ask for Xray of lumbosacral  spine  anteroposterior and lateral views to rule out bony abnormalities. If it's normal do not worry as it's sprain and will be relieved with bed rest and medications.  Take rest for 5 days at least and continue  painkillers.  If Xray  report  appears abnormal  need to consult expert orthopaedic surgeon and get yourself examined.  All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can extreme abdominal pain after a surgery be treated?\n\nMy husband has suffering intermittently with extreme abdominal pain since February 2017 when he was taken to the emergency room while on vacation in another country, at which time they thought they saw something on the CT scan in the small intestine, did surgery but found that everything started to flow when wiggling the intestine.  So, they closed him up, stated he may have Chrones disease and suggested he see his regular doctor or an internist upon returning home.  He did so, had another CT scan and a colonoscopy, but nothing was found.  He has dropped from 165 pounds to 138 pounds since. The pain is very severe and seems rather unpredictable, but it does seem to be triggered by either over-eating or anxiety.  We really need advise please. Thank you!",
    "doctor_response": "Hello, * There must be substantial amount of reason for this agonizing pain and the precise diagnosis is pivotal part of the case. * Either inflammatory bowel disease, intestine ischemia syndrome or   other malfunctions of the GIT may be playing significant role in this   regard. * If the conventional molecules as morphine or Tramadol are not able to handle the pain, epidural analgesia is a very good promising act of pain control till one reaches at the root cause. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "How frequently does stage 5 kidney disease patient need dialysis?\n\nMy husband has Stage 5. He also has a poor heart, with less than 20% EF. He is on BP meds to lower his BP. However, with his low BP (average 83/54) his dialysis center is afraid to remove the fluid that is necessary. So he is gaining weight. We went to his PCP who has ordered a paracentesis for him for this week. He is very swollen and having uremic spots on his body, along with severe nausea. He has both Zofran and Reglan. We are new to dialysis. Started on June 13, so I don t know how much to advocate for him or just trust the dialysis center. I will be calling the M.D. tomorrow. He also is having a hoarse voice now, which I am reading can be due to the ESRD.",
    "doctor_response": "Hello and welcome to HCM.As an Urologist, i can fully understand your concern.It's very essential to know the age of your husband, and present Hb, urea, creatinine,GFR,Na,K,uric acid, sugar/ HbA1C, urine protein,and ultrasound scan of abdomen.  Report the intake / output of urine in 24 hours.Mention the present medication given and send them here, in my name, for an expert opinion, regarding further management.Generally, in this stage, most people need thrice weekly dialysis.Wishing him well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pregnacare conception, possible to take primrose oil together\n\nHi, i ve been ttc for exactly one year now. Last month i started taking pregnacare conception . i m wondering if i can also take evening primrose oil together with pregnacare. if yes, is there a particular time in my cycle to take epo? Please advice.",
    "doctor_response": "Hello. Thanks for writing to us. You can take evening primrose oil supplements with pregnacare. But since you have been trying to conceive for last one year, it is best to consult an infertility specialist for proper guidance and investigations.I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL  Regards, Dr. RakhiTayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How effective is AKT1 for spine tb?\n\nHelli Doc, my wife is of age 32 and suffring from spine tb. her weight is 70 kg..and heigh 5 7 . She is taking AKT4 for the last 10 days. One of our family doc suggest AKT1 insteadof AKT4 since her weight is 70kg. Could you please suggest which is a better option Thank You Sanjeet Singh",
    "doctor_response": "Hello....Tuberculosis of spine needs at least 9 months to 1 year course of Anti tubercular therapy.According to regime, start with 4 line drugs as Intensive therapy then switch over to 2 line drugs as Maintenance therapy. In short form written as: 2(HRZE) with 7-10 (HR). In this H: Isoniazide, R: Rifampicin, Z: Pyrizinamide, E: Ethambutol.As in common ATT drugs are in market is AKT. Accordig to my knowledge AKT 1 means only Isoniazide, AKT2 means Isoniazide with Rifampicin, AKT3 means Isoniazide+Rifampicin+Pyrizinamide, AKT4 means all four HRZE.Because You just started AKT 4 since 10 days. So according to guideline  you have to take AKT 4 at least for 2 months then take AKT 2 for 7 to 10 months according to your clinical response.So in my opinion you can continue on AKT 4 at present, at least for 2 months.Thank You",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can sharp pain in the flank area be a symptom of an interstitial tear?\n\nI fell while walking down a steep trail recently and while falling I felt an intense sharp pain in my flank area. I m not sure if it was the impact that caused it or the pain started before the impact, but there is a constant ache in my left flank now and if I move wrong there is a very sharp pain. Knowing this did not feel normal I went to urgent care within a few hours of the fall. They did a urine test and did not find any blood in the urine and also a chest x-ray where they did not see any fractured ribs. I m really at a loss of what could be causing the pain, but it is extremely painful. It feels similar to kidney stones which I have had in the past. Could it be an interstitial tear? If I had a bruised kidney there should be blood in my urine correct?",
    "doctor_response": "Hello, It could be a renal stone or ureteric calculi. As first line management, you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist better to consult a urologist and plan for an ultrasound scan. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i take conception pregnacare tables along with duphaston tablets ?\n\ncan i take conception pregnacare tables at the same time with duphaston tablets?",
    "doctor_response": "Hi,Fatma, Thanks for query, You can take Pregnacare  tab. as both are different medicines. Pregnacare is prenatal multivitamin supplement. ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for premature ejaculation and erectile dysfunction\n\nSir I'm 32 yr old .I started masterbating wen I was only 15, twice thrice a day which made very weak.in my thoughts I  could get erection but wen near my partner no errection ,only fluids come out of my penis.then I stopped masterbating .but wen I materbate nowadays at night I can't fell sleep n also their mild headache involving my eyes also.now in 32 n I'm engaged wen I'm near my fiance I could not get hard erection .",
    "doctor_response": "DearWe understand your concernsI went through your details.Your current problem is due to anxiety related to ill-information or wrong knowledge. I assure you masturbation is safe and not unhealthy. But anxiety related to masturbation can provide you with mental stress and could give you performance anxiety. You can marry and you will not have any erection problems. You should consult a psychologist for sexology related counseling. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on breast?\n\nWhen I was 15 I noticed a lump in my left breast. I went and got a biopsy and it was ruled as a fibrotic cyst.  Now 5 years later I have another lump but this time in my right breast.  Is this common and is is possible I may have fibrotic breast disease",
    "doctor_response": "Hi,Dear Thanks for the query to HCM virtual Clinic.I studied your query with available details given in your query.I understood your health concerns.Cause of the right breast lump -Though not much information about the location,consistency,size,mobility,fixity of that breast lump is there in the query,On the existing information I would give my opinion herewith.So Don't worry till you get the FNAC Biopsy of the right breast lump, to rule out other causes of such  a breast lump.So consult a ER Surgeon.My clinical opinion on your query is-You seem to have Fibroadenoma or Fibrocystic breast lump and its possibilities are more-due to following reasons-You already had a history of such a tumor 5 yrs back.Its mostly due to the hormonal imbalance and Genetic predisposition in your case.But still  get the mammography and USG guided FNAC biopsy to rule out any chance of malignancy in such breast lumps is needed in your case.If not, Surgical Excision Biopsy with HPR would treat it totally.Don't Self-treat or medicate in your case as the case may go in to further complications.Hope this reply would resolve your query and would help you to plan treatment with your doctor.Hope this would relieve of your health concerns.Welcome for any further query in this regard before final suggestions are given in your query.Wishing you fast recovery..Have a good day.Dr.Savaskar M.N.Senior Surgical Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vaginal bleeding during pregnancy?\n\nHi madam i wana talk to u..... Last mnth 28 i went to hospital about periods so they tested me upt test and said pregnant after 2 days on 31 december i got bleeding so i went to hospital so they said everything over....they took scanning also and doctor didn't said hoe many months pregnancy also.....  please say anything about my prblm",
    "doctor_response": "u had an complete abortion. there may be a genetic abnormality in fetid which have had led to complete abortion",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the elevated Globulin and Albumin ratio is due to the inflammation caused due to gall bladder stones?\n\nI am having gallbladder surgery on this Friday. I just got back all of the bloodwork from my hospital and they said normal but I noticed that my Globulin is 1.8 but normal levels say it should be 2.2-4.2. My Albumin is 4.5 which is normal. my ratio is 2.5 which seems slightly elevated. My glucose was also 98. Could this be affected from my gallbladder inflammation? I also hadnt had anything substatial to eat and was on iv fluids for two days when they took the test. My abdominal ct came back normal except for my gallstones.",
    "doctor_response": "Hi,Dear,Welcome to HEALTHCARE MAGIC.Firstly let me tell you that your globulin level is not that much low to be worried about.Second thing is globulin is a protein which is produced by liver and is responsible for the immunity.So as you know your gall bladder is having stones and not working so the level of globulin may decrease to help your body.There is nothing to be worried about it.You will be absolutely fine.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it possible to get a pressure sensation in teeth due to hard biting?\n\nHello doctor, I feel a pressure in one of my front teeth. It is not painful and does not hurt to eat. Just feel pressure. I remember biting something the other day and it felt a little like I had bitten it too hard. No visible change to any of my teeth and it is not painful. The pressure is inconsistent.",
    "doctor_response": "Hi. I had gone through your question and I can understand your concern. As per your history, it looks because of biting on hard substance, periodontal ligament has been damaged transiently, it is a thin membrane between teeth and bone. There is nothing to worry, it will selfheal within three to four days. Remember that do not keep touching it, this may be enjoyable but it can lead to periodontal tissue damage. Also, take soft foods and do not bite on hard fruits like apple or even hard meat too.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a gap in the upper front teeth?\n\nHi Sir, This is vasanthkumar from chennai ...I have gap in my upper front teeth..Is any solution to clear that problem sir,I am doing software sales and i cant smile i looks like so bad if i just smile to others means they are irritating me please give me a solution.This is my mail address \" YYYY@YYYY \" please send me the solution sir..This is my prestige problem",
    "doctor_response": "Thanks for your query, I have gone through your query.The gap can be closed with the help of braces or tooth color composite restorations. Consult a oral physician and get yourself examined todecide whether it has to go for orthodontic treatment or restoration. If the gap is minimal then it can be restored with tooth color restoration. If there are other teeth are also affected then it as to be treated with orthodontic treatment.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are t-minic and sinarest safe for infants?\n\nHi, my daughter is 8 and half month old. She is suffering from cough and cold since last 5 days. Doctor has given cefprozil and solvin cold. But still no relief. Please tell me is dis medicine gud for her. Someone told me about tminic and sinarest. can i use dis medicine for her.",
    "doctor_response": "Hi...This seems to be a viral illness - No need to use powerful antibiotics like Cefprozil and the other drug T-Minic has the propensity to increase the heart rate. Please do not use them both.Cough and cold are viral 95% of the times in children. For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15mg/kg/dose every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.For cold you can use Cetrizine at 0.25mg/kg/dose every 12 hourly for 3 days.For nasal block, plain saline nasal drops will do, every 4-6th hourly to relive nasal congestion.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for lower back pain?\n\nHello My son who's 13yrs of age has complained of pain in his lower back continuing sometimes to his bottom at times it makes it hard to walk for him pain comes and goes. Is it something I should seek medical emergency care or can I wait to see his Doctor on Tuesday being that Monday is a holiday?",
    "doctor_response": "Hello, Thanks for your query.He might be suffering from Acute mechanical back pain.1. Hard bed rest for 2-3 days3. Hot water fomentation to back 2-3 times a day4. Physiotherapy - Interferential therapy (IFT) to his back will help you relieve the pain5. Avoid leaning forward, sitting for prolonged time or lifting heavy weights. These activities can increase his back pain.Even after a week if his pain doesn't gets relieved, better to get him examined by an orthopaedician. He might ask  to take an Xray of backI do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of pregnancy?\n\nHi, I m worried I may be pregnant but I m not sure...I just got done with my period about a week ago, and the last day of being on my period I had sex with my boyfriend. We started out unprotected for about a minute or two then he put a condom on. The next morning I woke up feeling nasueas and had a huge headache but it lasted most of the day so I don t think it was morning sickness, but the past two days I ve had a very light brown discharge showing up here and there in my underwear and some small bubbly feelings in my stomach. He never ejaculated into me but I m afraid the pre seminal fluid may have gotten me pregnant...or am I just ovulating or something?",
    "doctor_response": "Hallow Baby,You are too anxious. Woman releases egg (ovulation) only once in the cycle and that is around 14 days prior to the nest expected menses. Considering 24 hours' life of the egg and 72 hours' sperm activity, the fertile period is about a week around the day of ovulation. You had sex on last day of your menstrual bleeding. Even if before putting on condom he had ejected precum into your vagina, on this day the chances of presence of egg are almost nil. The brownish discharge was the remains of menstrual blood coming out late. The symptoms of pregnancy like nausea, vomiting appear about 8-15 days after missing a period. So these symptoms have nothing to do with your pregnancy. Associated headache suggests the possibility of stress of pregnancy and/or influenza. If the symptoms have vanished, you need not do anything for them. You should get your menses on expected day. If you continue to be under stress, it may delay your menses. If at all you miss your period, wait for 8-10 days and then get urine pregnancy test done for diagnosing the possibility of pregnancy. I am sure, you will not need it. I hope this clarifies your doubts. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Which medication can be used to treat Parkinson's disease?\n\nHi doctor, My mother is having parkinson disease for the past 8 years. She is taking Syndopa 275 mg 3/4 five times a day, but still she is not feeling good. Any alternative?",
    "doctor_response": "Hello. I understand your concern. Based on what stage of her disease she is in, there are quite a few alternatives available for parkinsonism. The first line of management is obviously the one that the doctor has given to you, Syndopa (a combination of Levodopa and Carbidopa). If this combination is not very effective then, a combination of Levodopa and a Dopamine agonist such as Bromocriptine, or Ropinirole, or Pramiprexole can be given. Even Selegiline, another mode of treatment drug, has showed a lot of efficacy in recent times. Since they are all prescription drugs, kindly get in touch with your physician and discuss the possibilities of switching her over to the medicines I mentioned.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can the kidney stones be the cause of failure in conceiving?\n\niam a 28 year old lady was diagnosed with kidney stones in 2008 while pregnant and never got any treatment. i hard a miscarriage while a month pregnant in March 2012  then went for police training in august same year and completed my training in April 2013. my problem is failing to conceive, can it be due to kidney stones or the training?",
    "doctor_response": "Hi,For not conceiving, you require   gynaec check up and other investigations.Kidney stones and police training has no relation with pregnancy.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for slight abdominal pain,itchiness in vagina and white discharge\n\nHi, I found out that I m 5 weeks pregnant about 4 days ago. I was having slight pains in the abdomin area. So I went to the hospital and turn out I was pregnant. Dr. recommended a vaginal ultrasound and ever since I ve been itchy and my inside is red and swollen. Is this normal? I m very quite worried. Also I have been discharging white liquid that turns into white cottage type. I need help in what this can be.",
    "doctor_response": "Hello,I have gone through your query and understood your concern. The origin of your present complaint dates to the time of your sonogram. Your symptoms do suggest a fungal vaginitis. This has perhaps been caused by the instrumentation you had during the sonogram or improper cleaning later on. You should immediately see your health care provider, get a proper examination and initiate treatment to control the infection. Vaginal medication is preferable since you are in the early stages of pregnancy and anti-fungal medications are not advisable orally. Do not douche or use strong soap solutions; use lukewarm water to clean the genital region. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the feeling of being in flashing lights?\n\nI used to take Zoloft for anxiety then abruptly stoped. I was taking it for about 6 months now and i was taking a dose of an average high amount for my body. About 6 months after i stoped, i have ben getting this weird feeling when i am aroung flashing lights. It is like i am dreaming. i feel like i am not really there and then i come back for a second and then it al feels weird again.i dont know another way to describe it. I am very dizzy almost. My adrenaline starts going and i kind of freak out. It has happend 3 times to me in the span of about 3 months. 2 times were invovled when i was near flashing lights but one happend when i was just at a house party. It scares me in a way a because i have no idea what is happening to me and when i try to describe it to people, they cannot understand.The only way for it to go away is if i lie or sit doen, drink cold water, and closemy eyes. even then sometimes it can take up to 1 1/2 hr for it to go away. Please Help Me.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. I sincerely opine that the problem you are facing now is of your own creation.You know that you are suffering from anxiety disorder. All these given symptoms are related to anxiety and obsession. I think youu had zoloft on a psychiatrist's prescription. You do have anxiety disorder and medicines along with psychotherapy and meditation should help you. Please consult a psychiatrist.If you still need my help, please describe the whole problem in detail and post a direct question to me. I shall definitely help you with psychotherapy techniques to over come your problems.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am diabetic with weakness, shoulder pain and tingling sensation on hand. What to do?\n\nHello doctor, I am a diabetic patient. I am having weakness, shoulder pain, and tingling sensation on hand. I am taking the following medicines: 1. Lantus injection 26 units in the morning. 2. K GEM (Gliclazide 50 mg and Metformin 500 mg). 3. K pio (Pioglitazone hydrochloride 15 mg). 4. Tendia (Teneligliptin 20 mg). 5. Forxiga (Dapagliflozin 10 mg). Blood sugar level: FBS 200 mg/dl and PPBS 250 to 270 mg/dl. What to do for this? Please help.",
    "doctor_response": "Hello. I read your query, and from what you have mentioned, I would suggest increasing the dose of Lantas to 30 units once daily. Try to rotate the insulin injection sites as well. Try to walk for 30 minutes and drink 12 glasses of water daily. It will help the natural lowering of your blood sugar. I suggest taking Neurobion forte one tablet twice daily for your tingling. Try shoulder rotational exercise to help with your shoulder pain, but it should not be a weight-bearing exercise. just do flexibility exercise like yoga for the shoulder. Keep a regular follow up for better diabetes control. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does T2/flair hyper intensity in the white matter mean?\n\nHi. I got test results as I just had Brain MRI. It said T2/flair hyper intensity in the left lobe sub cortical white matter. ? Sequela of chronic micro vascular disease, ?? Remote trauma/ inflammation demyelination or chronic ischemia due to migraine or other vasculopathis ??? So pls help me to explain what are these meaning ??? Thank u.",
    "doctor_response": "Hello!Thank you for your question on HCM!Regarding your concern I would say that it is a past lesion to the brain. It is not very specific for only one disorder. Have you suffered from headache like migraine.It can be caused by low blood perfusion to the brain in that region. Do you suffer from high blood pressure or heart disease?Have you ever had problems like tingling sensation,numbness or weakness in your right limbs?A demyelinating disease like multiple sclerosis can cause similar lesions in MRI. The MRI images should be confronted with your symptoms to find out the nature of this  lesion. Further examination of the heart, blood analysis, cervical vessel ultrasound are needed to establish the cause.Hope to have been helpful!Best wishes Dr Abaz",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I get the vaccination done against typhoid in a kid?\n\nHi, My daughter is two years now. Should I get the vaccination done against typhiod? Also, I looked at the vaccination list and found out that Hepatitis A vaccination is only suggested, is it imporatnt to get it done? Also, if I get get typhiod vacine done now how long should i wait to get Hep A vaccine done? I also wanted to know the app prices of typhiod and Hep vaccines",
    "doctor_response": "Hi.... I suggest that you get both hepatitis A and typhoid vaccination on the same day.Hepatitis A vaccination has to be repeated with a booster dose after 6 months. Cost is around 1000 rupees.There are two types of typhoid vaccines. One is a v i polysaccharide vaccine which is cheaper one and costs you around 200 to 250 rupees, but the immunity is only about 50 to 60%. The second type is typhoid conjugate vaccine which is costly vaccine around 1800 rupees, but the effectiveness is 99%. I suggest just you go ahead with hepatitis A vaccine and typhoid conjugate vaccine on the same day.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I developed rashes all over the body which looks like typical sun allergy. What could it be?\n\nHello doctor, I started developing a rash all over my body. It first started on the lower parts of my legs and looked like ingrown hair or small goose bumps with very tiny white or skin-colored little bumps that do not itch. In the areas where it is more concentrated, it looks more like dermatitis but very small, so it is not very obvious at the first look. I also had areas on my arms. Yesterday, it also started to develop very strongly on my chest area where it itches a bit and also has reddish bumps and it looks like a typical sun allergy. Today, I even see the same rashes developing on my toes and in all the rash has spread all over my body now. Although it is not itching, I feel very uncomfortable because it feels like I have a very rough skin surface. What could this be?",
    "doctor_response": "Hello. I have gone through the details of the history of your problem provided to us, as well as the clinical photos. (attachment removed to protect patient identity). As per the history, distribution of lesions and appearance of lesions on the photos appears to be Miliaria Rubra (in layman terms-prickly heat), which has additionally become flared-up due to sweating, sun-exposure and possibly some local applications. To be able to confirm my doubt about this condition, I would need you to answer my small queries: 1) How is the prevalent weather in your city as of now and as per your daily home and office routine, do you think you may have sustained a lot of sun exposure and sweating or high temperatures of late? If yes, then it goes in favor of this possibility. 2) Is it too itchy? Or itches more on sweating? 3) What kind of fabric do you prefer to wear? It is better for you to stick to pure cotton as of now. 4) Has any procedure such as waxing been done recently? Waxing or any temporary hair removal method may also result in such bumps or may exacerbate heat rash. Based on my presumption that we are dealing with a flared-up version of prickly heat, I would like to suggest the following to you: 1) Try to keep yourself in cool, air-conditioned environment. 2) Take frequent baths with cool water and non-medicated soap. Something like Dove soap would be ideal. 3) Prefer wearing pure cotton and loose garments, to prevent the accumulation of sweat. 4) Apply a soothing Lacto calamine based lotion three to four times a day. It will give you a soothing feel and also expedite the resolution of your bumps. 5) Since it has spread to quite an area of the body, you would additionally need anti-itching drugs by mouth. I would suggest you procure and take Cetirizine 10 mg. Take one tablet daily after dinner for 10-15 days. Although drowsiness is seen in very few patients who take cetirizine, beware of its remote possibility. 6) I would also like to recommend the application of a mild steroidal lotion over the affected parts for at least 7-10 days to expedite the resolution of your symptoms. Apply Desowen (Desonide) lotion over the affected parts twice a day for five days followed by once a day for another five days, and then stop. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in the hand post a pacemaker installation?\n\nHello, My mother in law, 87 years old, had a pacemaker installed on Wed. A few days ago. Today her left hand is swollen, the back of her arm to the elbow has been painful for the last 3 days. She has been walking the past 3 days 3/4 to 1 mile with a couple hills, this is her standard regimen. Is the swelling and back of arm pain normal? Thank you, Mike",
    "doctor_response": "Hello,Brief Answer: Check with your cardiologist to make sure everything is good and no complications happened.Explanation: My opinion is that after pacemaker insertion. Some warnings are given to the patient. First drug therapy and antibiotics to exclude infection. Arm sling is worn and no manipulations to pacemaker site. Some complications happen, unfortunately. Infections and hematoma are common, vascular complications also do happen like deep vein thrombosis. I suggest my patients the following; clinical examination and Doppler on the vascular system of the upper limb. The information provided by you is not sufficient to provide a good opinion. If someone comes to me with this condition I would ask them about electrocardiography of the patient to make sure that pacemaker is functioning.Conclusion: I suggest you check with your physician.Hope I have answered your query. Let me know if I can assist you further.Regards,   Dr. Mahmmad Gamal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pain in back,neck and allover sign of heart problems?\n\nI have been in pain for some years now with pain in my neck, top of my back, sometimes arms, elbows, wrists, lower back very much so, knees, ankles and balls of my feet, also I have abnormal stools for a few years now they are paste like. I ve had an MRI scan they did find a bulge impingement and something to do with my nerves endings, then the bulge went away but not my pain. I keep going to the doctors but feel like he s not listening. I expect it s because when I do see different surgeons nothing is coming back really positive. My blood pressure is often very high and i am on Ramipril 10mg once a day and Bendroflumethiazide 2.5mg once a day. Rencently I ve been having tightness right acrost my chest under my bust and down my left arm but apparently my heart is ok. I ve had three brothers die of heart problems ages 7. 23 and 47 years old. I don t know what to do because I am in constant pain though a few days ago the doctor did give me Codeine Phosphate paracetamol?",
    "doctor_response": "Hi,Pain in all 4 limbs with high blood pressure may suggest coarctation of aorta. Other cause you may have Vitamin D deficiency. And this should be evaluated. Diuretics may be the reason for your symptoms. You need proper evaluation with good physical examination, palpate all peripheral pulse. Take blood pressure in all 4 limbs. Echocardiography,Thyroid function, Vitamin D levels can help in reaching the diagnosis.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Deepesh Agarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause lack of concentration during studies?\n\nmy son is 9 years old and he is studying in the 5th standard. Reading ability is poor and not ablr to write properly his school notes. when he was born, the pediatrician gave a maturity score of 48 hours within 24 hours. kindly tell me what is wrong with my son? thank you",
    "doctor_response": "DearWelcome to HCMWe understand your concernsI went through your details. Reading and writing ability is a matter of training. These abilities tend to improve on practicing and practicing depends mainly on the motivation and sustained training. Some children may have the problem of learning disability, a condition giving rise to learning difficulties, especially when not associated with physical disability. Learning disabilities are neurologically-based processing problems. These processing problems can interfere with learning basic skills such as reading, writing and/or math. They can also interfere with higher level skills such as organization, time planning, abstract reasoning, long or short term memory and attention.If you strongly argue that the training provided to the child by the teachers and parents are up to the standard, then you could consult a psychologist for an assessment of learning disability.  If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does hyperintense foci in white matter on MRI suggest?\n\nDear Sir, I have received my MR angio report where all the artery of righ/left are normal. like common carotid artery. internal carotid artery. but there is impression where it is mentioned Few Hyperinstense foci are seen in the bilateral fronto-parietal and periventricular whiter matter, most likely ischmeic etiology what is the meaning of this.",
    "doctor_response": "HelloHyperintense foci in white matter on MRI may be due to many reasons like ischemic changes,demyelination,post traumatic sequel,lyme's disease etc.You need monitoring of conditions that leads to ischemic changes like hypertension,altered lipid profile,diabetes mellitus so that further progression of disease can be halted.You need investigations like routine hemogram,RBS,LFT,RFT,Lipid profile,ultrasound of abdomen.Treatment depend upon findings.Follow up MRI can be done to rule out demyelinating disease.You also need clinical correlation.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause fingernails, hands and forearms to turn bluish color?\n\nMy 15 year old daughter has noticed twice in the last week and her volleyball team noticed also that her fingernails, hands and forearms were a blueish/purplish color. The second time it was just her hands and fingernails stayed this color longer, then skin goes back to healthy color.",
    "doctor_response": "Hello,Thank you for your contact to healthcare magic.I understand your health concern, if I am your doctor I suggest you that this is the sign of peripheral cyanosis. The reason for such a condition may be some heart disease, or some kind of poisoning, or some large blood vessel disease. But exact diagnosis and so management can only be possible after your confirm diagnosis. In my advice you should visit to the nearby doctor for general check up and diagnosis.I will be happy to answer all your future concern. Thank you,Dr Arun TankInfectious disease specialist.Wish you a best health at health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for panic disorder\n\nI am trying to find a psychiatrist online to prescribe my medications. The DR that I was seeing previously is no longer with the same practice. I am prescribed celexa 40mg daily, xanax 2mg twice daily and adderall 20mg three times daily. This regimen was working fine for me but the doctor that I had to see the last time did not take my panic disorder seriously. He cut the xanax in half. I am struggling with the  one mg twice daily and have had to take more than I am  supposed to. Is there an affordable way to get treatment for my condition.",
    "doctor_response": "HiI had gone through your query.Celexa and xanax both are good medicines for anxiety or panic attack.If you have problem with 1 mg of xanax and you are previously better with 2 mg then you have to consult your psychiatrist.So you can take advise from him.There are alternative like peroxetine /sertraline/etizolam which can be used in panic attack or disorder.Regular exercise/meditation/relaxation/proper sleep/healthy diet can help.Still have query then feel free to ask me directly on  well soon.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sudden change in hemoglobin levels, paleness, loss of energy, loss of weight. Done colonoscopy. What is the cause?\n\nWhat can cause a sudden change in hemoglobin levels in a 65 yr old man. He is pale, no energy and has lost 10 pounds in 2 weeks. His level went from 15 to an 8. He also has had no injury that caused blood loss. He is set for a colonoscopy and a GI study Tuesday. There has been no blood in his stool and had a normal colonoscopy 10 years ago and also has had no stomach problems. I have ideas but looking for input.",
    "doctor_response": "Hello and thanks for the query,It is possible that somewhere in the gastrointestinal tract that he is having a slow and gradual loss of blood.  This can come from ulcers, diverticuli, inflammed blood vessels, or possibly from a cancer.  This is why the endoscopy is indicated.If the endoscopy is normal - a workup for hemolysis is indicated - this is where the body is somehow breaking down blood cells causing a drop in hemoglobin.  This can sometimes be an autoimmune process.Lastly, if all else appears normal an examination of the bone marrow may be indicated.  This would require a referral to a hematologist.  For now - proceed with the endoscopy and then the doctors can determine the next logical step in helping to improve the hemoglobin.One other thing - diet - can affect hemoglobin. In cases of low iron the hemoglobin will be low.  All of this can be assessed with simple blood tests at the discretion of your doctor.Sincerely,Dr. Galamaga",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the concerned symptoms for accidental intake of eraser?\n\nI think my son may have ingested a piece of magic eraser . I didn t actually see him eat it, but I caught him holding one and there was a piece missing from it. Are there any signs or symptoms to watch for to know if I should take additional precautions?",
    "doctor_response": "Hi.... I appreciate that you have taken out the eraser from the mouth. But eraser is not a radio opaque substance.. even if we take an xray it will not be visible. What you can look for is it to come out in the faecal matter or you can be on the guard for other symptoms like diarrhea or vomiting along with nausea. If any of these symptoms develop I suggest you take him to the nearest Emergency Room.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hay fever and sneezing\n\nI suffer from hayfever & am currently going to gym but have noticed that after each session i am so nasally i sneeze & blow my nose for hours afterwards. i am now taking antihistamine. Would the air con if gym be a problem for me. i suffer with allergy asthma, dust mites, damp etc.",
    "doctor_response": "Yes, if your symptoms are aggravated when you visit the gym, most likely, the air conditioner, yoga mats, curtains etc. might be the culprits. Is there a provision to switch off the AC and leave the windows open.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes upper back pain and pressure with slight itching?\n\nHi I have question yesterday I felt like a lil pain on my upper back it's sharpy and I felt so much pressure after a while I started feeling lil bit of fever n itchy so I notice a red/ pink bump and it started hurting more I could feel it and still feel it if I lain back could it be an absess or what I'm scare of this",
    "doctor_response": "Hi,As this development occurred for one day all of a sudden indicates that it might be due to something insect bite causing allergic reaction to surrounding tissue producing this pain and itchiness.Another possibility of having some ingrown hair follicle producing boil or forming abscess.Wait for a day or two, if problem increases then go for one antibiotic medicine course for 3-5 days.Take some antihistamine as  well.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in ribs and dizziness\n\nI'm 15, around 5'5 and about 7 odd stone. I have no medical history that is anything to worry about. Since last night while in bed I all a sudden after streching got an achy pain in the top-middle area of my rib cage. It hurts when I breath deeply, laugh, sneeze, turn around to my right, sit down and when I lay on the same side. Also, for the past few hours I've come over dizzy aswell as still having the pain in my ribs, especially when I lay down as the room feels slightly as if it is spinning. Every now and then this gets worse for a few minutes..",
    "doctor_response": "Hey there,It might be just simple muscle sprain,but i would still advice you to go for chest x-ray to rule out any cause related to lung.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat dry cough?\n\nsir  i am 18 yrs old & my name is juhi.I m suffering from dry khansi from past 3 months...and i have been medicated(homeopathic & allopethic) along this period but there is no good result.....sir i dont know what to do,i am getting frustrated...pleas help me..",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. You are having chronic cough (cough for more than 2 weeks). Common causes for chronic cough are lung infection (tuberculosis) and cough variant asthma. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x ray 3. PFT (pulmonary function test). Chest x ray is needed to rule out lung infection. 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 anti tubercular drugs, inhaled bronchodilator and inhaled corticosteroids (ICS) on the basis of these reports. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for gas trouble and abdominal pain\n\nSir,i am suffering from gastrouble last 4months.inside sounds are coming very irritating,could not work in office. it comes out with very big sound.i do not eat grain related foods and spicy also.in addition to that pain comes sometimes left and it goes to right.but not both side underjone.i have hepatitis B also.please give suggestion",
    "doctor_response": "Hello! Thanks for putting your query in HCM. I am a Gastroenterologist. I understood your concern and I will advise you:1. Avoid food that increase gas like beans, pulses, cabbage, peas2. Avid food that increase acid productions like tea, coffee, citrus and spicy and fatty food3. See if milk make your symptoms worse then please avoid it4. Take capsule containing simethicone\u00a0\u00a0\u00a0\u00a0\u00a05. Also take a proton pump inhibitor like rabeprazole along with a prokinetic agent like domepridoneI hope I have answered you query. Wish you a good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for side effects of Diltiazem medicine for hypertension\n\nyes, I just started taking the drug diltiazem hc 60 mg for hypertension every 12 hrs. the side effect is herendous...put me like in coma state, and could not get out of bed, no matter how I tried. I stop taking it after three days, and only took one in a 24 hour period. I have been taking my blood pressure for the past three days an stable at 117/62 highest was 127/67. I feel a short of breath at times like I do not take in enough air to fill my lungs w/air...I have to make an effort to take in air to fill my lungs. I do not feel I can talk w/out feeling winded. I had phneumonia a couple of years ago which put me in the hospital for 2 days. I caught it as a virus, I never smoked, nor had any kind of lung condition. perhaps nasal allergy but nothing as bad as that. I am a 64yr old femaie. I never feel this shortness of breath when I am exercising at the gym a few days per wk for 1 hour. While I was on the meds I did not have that problem, but then I was asleep most of the time. Do you think I should see a cardiologist? or what could be causing this condition? My email YYYY@YYYY",
    "doctor_response": "hi, diltiazem does not cause side effects that you have mentioned, and your bp readings are normal which do not require treatment, you should see a cardiologist for shortness of breath and a neurologist for sleepy feeling.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower abdominal pain in early pregnancy?\n\nHI WE JUST HAD PREGNANCY CHECK UP AND RESULT IS POSITIVE. DOCTOR SUGGEST TO HAVE ULTRASOUND AND OTHER TEST AFTER 15 DAYS. MY WIFE HAD LOWER ABDOMINAL PAIN SOMETIME BUT DOCTOR ASKED TO CHECK EVERYTHING AFTER 15 DAYS. I AM WORRIED. PLZ GUIDE IF EVERYTHING IS FINE. DOCTOR SUGGEST FOLSAFE TAB, DOXINATE AND SUSTEN. REGARDS Vmkl.,",
    "doctor_response": "Hi Vmkl.Do not worry, some pains and aches can take place in the lower abdomen and pelvic region because of the changes your wife's body is undergoing.Many congratulations to you two, and all the medications prescribed (susten: supports the pregnancy; dominate is for pains and aches; folsafe is a supplement that helps with growth and development of your child).Best wishes sir. :)",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to heal big toe injury?\n\nGood morning. My husband hit his big toe las Friday. It is very bruised, swollen and now has a blister that has formed at the base of the nail. It is very tender to touch but not actually painful to move the toe. Can you advise anything to bring the bruiseing out and reduce the swelling a little faster than leaving nature to take its course?",
    "doctor_response": "Hi Hope this message finds you in good health.I have gone through the complaints and understand your concern.He seems to have injured his soft tissues as well as bones that might be causing the symptoms. Ideally u should get an Xray done and should treat the bone injury if its present.The treatment you are taking is absolutely right,but i guess you are not taking sufficient rest.But still,it will eventually heal.Take analgesics,anti-inflammatory tablets,crepe bandage,rest.Nothing to worry about.I hope your question has been answered.If you have any follow-up queries,feel free to consult me anytime.Thanks,Take care,God bless.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do i need to worry about vaginal spotting after brachytheraphy for uterine cancer?\n\nI was diagnosed july 2013 and had surgery, chemo and brachytherapy for uterine cancer which was clear cell and adenocarcinoma. Treatment was complete on Nov 19, 2013. yesterday had some spotting and wondered how worried should I be. Went in to doctor and had pap, and CA125. I was diagnosed at stage Ia.",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. But vaginal spotting can be the early symptom of local recurrence. You had completed your chemotherapy since November 2013. So not on any treatment since 12 months. This duration is sufficient enough to produce recurrence at local site. So wait for CA125 and PAP smear result. You may need CT abdomen and PET scan to rule out local recurrence.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Baker s cyst cause stiffness in legs?\n\nI have been Dignosed with a Bakers Sist,I would like to know if the sist could cause stiffness in my leg. Also could the sist cause pain and makeithard for meto squat and for meto get Upanishads down without using my arms to push up to assist me into standing up. It has gotten muh harder for me to stand after squatting.",
    "doctor_response": "Hi thanks for your query,Baker'cyst it is a sac contains knee joint fluid, usually presents behind knee joint.Often it does not cause painIt may cause tightness or stiffness behind the knee.Swelling behind the knee that may get worse when you stand.Slight pain behind the knee and into the upper calf. You are most likely to feel this when you bend your knee or straighten it all the way.If a cyst does not go away, or if it is causing a lot of pain, your doctor may drain the fluid with a needle.Rest your your knee as much as you canTake pain killers as per doctor instructionSo i would suggest you to visit your doctor and have discussion him.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had sex, no ejaulation. Taken Ipill. Had bleeding. What does it mean?\n\nHlo I had sex with my b.f on 7th sep. ....nd I took I pill within 2 hours without ny ejaculation as he jst inserted his half penis and the condom torn out and he immediately take it out...bt to b on safer side I took I pill within 2 hours. ..my last period date was 24 aug bt frm 18th I started to bleed is it my regular periods or that unexpected bleeding which occurs after taking the pill",
    "doctor_response": "HelloThanks for your query.The I pill is known for preponing or postponing your normal menstrual period by a week, and sometimes even by 7 - 10 days.Hence, the bleeding you experienced was most probably an early period.However, just to be on the safer side, take a pregnancy test on the 26 th or 27th just to be sure.All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for dizziness with stomach pain along with head spinning and unable to breath while talking ?\n\nHi, i am 13 years old, and I have been a very healthy girl up until this week. In the past few days I haven t been able to stand up with out getting dizzy. Today at school, I had my head down on my desk and all of a sudden I could feel everything spinning. (but my eyes were closed) Then I tried to listen to my teacher and the noise was all jumbled up. When I ate lunch, I wanted to throw up, but I kept it down. I have stabbing pains in my upper stomach every so often. And every time I exhale, my rib cage seems to feel like it is getting pulled on very harshly. I got up from my seat and I fell and almost passed out, but just barely stayed awake. All my senses went away, but just for a couple seconds. Every time I get up and walk from class to class, my friends have to hold me up so I don t fall again. There is a lot more, but this has been the worst. My family can not afford going to to Hospital or anything. There are way too many other doctor bills from me pulling my Achilles tendon , and then forming tendonitis in it as well. Oh, one more big thing; I haven t been able to talk at all this past week because even saying a few words makes me become out of breath . Help?",
    "doctor_response": "Hi,thanks for query,you immediately needs medical attention.You seems to have some problem that needs to be diagnosed.the complaints are many and confusion so physical examination by doctor is must.I can understand your social and financial problem but it is better to take medical treatment at present,if neglected this can lead to more problems and at that time you will be forced to spend too much. wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could breathing difficulties suggest asthma?\n\nHi, may I answer your health queries right now ?Please type your query here.Hi Dr my elder sister age 29 married having breathing problem during walk in steps and doing heavy work and walking, Dr says that the symptoms are like asthma initial stage, please kindly suggest me what is the exact problem she had.",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your daughter's history.I would like to ask you a few more questions like - Does she have other allergies? Does she have wheezing after walking? Does she have chest pain, palpitation, excessive sweating, etc? However, from your given history, I would like to make following suggestions to your sister:1. If she has other allergies or wheezing, asthma is very likely. In that case, I would prescribe her salbutamol inhaler on as-and-when-neede basis. I would also suggest her allergy testing so that she may identify the substances which are causing troubles to her and to avoid them. Regular breathing exercise will help her.2. Were I treating her, I would suggest her to get her hemoglobin levels done. If they are low, they can cause breathing problem after heavy work/exercise. In that case, iron, folic acid, vitamin B12 and other nutrition supplements will be useful.3. If any of above is not there, I would like to ask her symptoms in great detail to know whether she needs a cardiac evaluation. As she is young (29 years), anemia and asthma are more common possibilities rather than cardiac disease. However, it is important to diagnose the cause of her breathlessness.Hope above answer will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you sister the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pain?\n\nI have been suffering with fibromyalgia and cfs for about eight years now. It started when I got Legionnaires disease which lasted six months instead of ten days. Over the course of time I have been using hydrocodone and Savella to control the pain. Unfortunately the pain continues to increase steadily and I find that what really relieved my pain several years ago is now inadequate to control it. I currently take 5-6 hydrocodone daily (which has been one of the few drugs to actually bring me relief) and 2 Savella, 1 in the morning and one in the evening. I do not want to go back up on the hydro [I used to take eight a day, but got down to three at one point.] Is there another drug that would have more of an impact on the pain, but wouldn t be as harmful as 8 hydro a day?",
    "doctor_response": "Hi, Medications that seem to have a good track record of success in patients with FM are Lyrica (pregabalin), Trokendi (Long acting Gabapentin), and Cymbalta (duloxetine), Savella is also indicated for FM and you are already on this medication. Therefore, if you are to be tried on any other medication make certain you your doctor is aware since taking MULTIPLE medications at the same time as the Savella could get you toxic side effects. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does pink discharge in early pregnancy imply?\n\nHello. Well my husband and I have been trying to conceive for almost 3 months now. I\u00c3\u00a2 ?m usually regular with my menstrual cycle and it usually is light the first day the heave second and third day then light 4 day then gone, well I was supposed to get my period this month on the 5th February 5th which I did, but it was weird . First day was spotting then second day was light and then nothing on the 3rd day. Then it stopped for like 5 days then came back very light pink. I tested for pregnancy on the 18 still with the light pink period and I got 3 positive results, but it\u00c3\u00a2 ??s February 22 and I still have the light [pink discharge. What could this mean?",
    "doctor_response": "Hello,I have gone through your query and understood the concern. Since you have had three positive pregnancy tests, you are pregnant. You can get the status of the pregnancy through a pelvic/trans-vaginal sonogram. Usually, implantation bleed is seen at the time of the expected period and is usually a fresh, light bleed which subsides in a couple of days. Persistent spotting is usually observed when there is a hormone deficiency. If the pregnancy is progressing normally, you are likely to benefit from progesterone supplements, absolute bed rest and abstinence. Hope your query has been answered. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the ways to manage snoring?\n\nHi doctor, I am suffering from snoring since last five years. Please help.",
    "doctor_response": "Hi. Snoring can be a serious concern to the sufferer as well as the spouse or partner due to the disturbance. It causes a lot of agony and affects one's mental peace. Snoring is due to some obstruction in the upper pathways of breathing, the upper respiratory tract. The levels can be: 1. Nose : nasal polyp, deviated nasal septum.  2. Nasopharynx : nasopharyngeal growth, cyst, mass.  3. Oropharynx : thick tongue, tonsillar enlargement, thick palate.  4. Lower down : lingual tonsils.  The mode of treatment for snoring depends on the level of obstruction. Also, snoring without obstructive sleep apnea is a harmless condition except for the disturbance it causes. Obstructive sleep apnea on the other hand causes changes in the circulatory system and causes increased effort by the heart to pump blood. It can result in hypertension and can be aggravated by lifestyle diseases also.  It is important to find out if you suffer from obstructive sleep apnea. We need more details as to your quality of sleep, disturbances, lifestyle, occupation, body weight, habits, etc., to arrive at a more decisive diagnosis and give you the right advice. Mode of treatment include medical, surgical measures. A machine called C-pap is very effective to remove the obstruction. Various lifestyle modifications and dietary changes are also necessary in the management of snoring.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes joint pain and fatigue after eating particular food?\n\nHi, may I answer your health queries right now ?  Please type your query here...have started to eat vegan to loose weight since november 2010 - had 3 times since then eat meat and everytime i start to feel extremely bad - my joints are extremely sore, very lethargic and the last time the limpthnodes got very swollen and sore - i've ate meat my whole life and it feels bizarre to have this type of reaction - 1st thought it was psycological but after 3rd time same reaction - why??",
    "doctor_response": "I think you are sufferring from meat sensitivity. Your body is not accepted some of the proteins of meat you eat. for further investigation you should get allergy screening test including non veg panel to be done. only way to get rid of your complaint is to avoid such a food",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could pain on left side under ribs be due to the stone in inferior pole of left kidney?\n\nI have a 9 mm kidney stone in my inferior pole of my left kidney. A cat scan was taken on 8/18/13. I was told it should not hurt but I am having pain on my left side under my ribs. Could this stone hurt where it is or is there something else I should check into?",
    "doctor_response": "Stone related pain should be in renal region.Pain under ribs on left side may be due to some other pathology.Clinical examination & investigations accordingly is important.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Paranoia, stress, anxiety about trust issues in a relationship. How are these prevented?\n\nhi im not really sure if anyone is actualy there but i have paranoia .... my gf went out to a club with her friends and im extremely worried she is going to do something with another guy i know i should trust her i know i shouldnt be worried but i cant help it... and worse case scenario even if she doess something i want her to know i do love her and i am changing for her so i was wondering what can i do to relieve the stress , anxiety ,and paranoia?",
    "doctor_response": "If these symptoms are debilitating you should consider consulting a psychiatrist. Medication and psychotherapy should be able to help you manage these symptoms. Sometimes couples therapy can help as well. Best of luck. I hope this information helps to guide you. Do feel better!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life expectancy of a person with prostrate cancer?\n\nI have a male friend 73 years old has had prostrate cancer approx 4 years it has spread in the last 3 years . He has lost a bone in his leg, has had two tumors in knees now it appears to be in the base of his spine. has lost substantial weight and in great pain. what is his lif expecance he has had chemo and radiation,",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  He has wide spread metastatic carcinoma.  So it is stage 4 of prostate cancer. Surgery will not helpful.  Treatment options are chemotherapy and radiotherapy. Despite of treatment prognosis remains very poor.  Life expectancy is not good.  Onr should not expect much fron this case.  Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should liver enzymes be tested for the yellowness in urine?\n\nhi doctor I had Gall Bladder surgery through LAPROSCOPY 3 months ago, I am seeing Yellow urine in the morning and pale yellow for the rest of the day. Do I need to go for Liver egymes test ? and I feel some pain at the incision area neat the chest after 3 months also, please help me in this regard. Thanks in advance sujeevan t",
    "doctor_response": "hi this is dr.subhadeep thanks for the opportunity to help you.my management plan will be based on 2 steps,explaining about the probable diagnosis and appropriate management.from your description i have  3 probable diagnosis:-1) incomplete gall-bladder removal  with a residual stone in the remnent of gall-bladder2) possible cbd stone or slipped gall stone from gall-bladder to CBD leading to obstructive jaundice3) stricture incomplete or partial leading to obstructive jaundice.firstly you should keep a track on the daily intake of water.low intake of water can lead to yellow coloured urine and can be attributed to hepatobiliary pathology.now coming to management:- kindly do LFT and S.alkaline phosphatase and if it is elevated then we will proceed as per the situaton:1) if it is due to remnent gall-bladder with retained stone then diagnostic laparoscopy with complete removalof remnent gall-bladder with retained stone should be done.2)if it is due to CBD stone then ERCP stenting/open/laparoscopic cbd exploration wih stone removal and closure with t tube in situ to be done or open/lap choledochojejunostomy/roux-en-y hepaticojejunostomy to be done.3)if it is due to stricture CBD then resection with choledocho/roux en y hepaticojejunostomy can be done either by open/lap procedure.4) many gall bladder or cbd pathology is accompanied by an abnormal liver fatty liver or cirrhotic liver. if lft is deranged for that condition it can be supplemented with Liv 52 DS 2-0-1, it has to be taken empty stomach in morning.- Also get your hepatitis panel checked. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dry cough\n\nHi, my name is Jim.  I've had the flu for one week now with mainly wet coughs/yellow discharge, no fever, body chills,  fatigue, and some nose congestion.  Last couple of days my coughs changed to dry and more frequent coughs and my body chills are still there and bothering me a lot.  I have to keep myself warm all the time, where as I'm naturally a cold weather person.  My fatigue is somewhat still there too.  All my doctor prescribed me was Robitussin.  What else should I do or take to help recover faster and get rid of the chills?? any advise?  Thank you very much. Hi, may I answer your health queries right now ?  Please type your query here...",
    "doctor_response": "Hello welcome to the health care magic For dry cough you have been prescribed dextromethorphan which is cough suppressant. You can take dextromethorphan plus phenylephrine combination syrup for dry cough. Your respiratory work up done as follow... _Auscultation _CBC _spirometry if needed _chest x ray According to report further management plan decided Take care Hope your concern solved Consult pulmonologoist for examination",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Depo Provera. Milk discharge from nipples, bloated, frequent urination. Bleeding, yellow and white discharge. Help\n\nI am currently taking the Depo Provera . I am 16 and have been on it for about a year now. I just now starting having milk coming out of my nipples for about a week now. I am bloated alot and i pee about 11 times a day. Today, I have been having old blood come out along with yellow discharge and white discharge. I feel like my stomach is growing! Hellp?",
    "doctor_response": "Hello, you need urgent examination by a gynecologist and investigated for the sameIn case you have any questions in future you can contact me directly on",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can there be on and off chest pain after angioplasty?\n\nHi doctor, One of my uncle had heart attack. He was hospitalized later and treated with angioplasty. He was stable at hospital and discharged last month. But, it seems he has pain in the middle of the chest. It just comes and goes. Is this pain common after the angioplasty? If so, how long it prevails?",
    "doctor_response": "Hi. I have thoroughly gone through your case and can well understand your genuine health concerns. For further information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reddish skin rashes on the back and in the groin area. What are these?\n\nI have skin rash which is pink to red it is not always itchy. The rash does have blood in it which I can by squeazing move the smaller rashes into each other there by making it into a bigger rash. I can also stick pin into it there by letting out the blood. Once the rash heals it leaves a mark like a sun or bith mark. These rashes hace appeared o. My back sides and inner thighs but have also appeared on other parts of the body. I am not sure what it is, what would you suggeta it is?",
    "doctor_response": "hello welcome to healthcare magic forum thank you for your query it look like papular urticaria or allergic one do not scratch or break the lesion trim your nail and do not use pin to break it apply antibiotic cream over it and take anti histaminic medicine avoid sun and wind exposure better to consult dermatologist if not improved i hope i answered your question",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rash on labia majora?\n\nhi,i have a skin disorder.i do not know what exactly it is.i have skin rash on my labia majus, iit peels,redness,itchy,get relief when i scratch but painful when am done.how did i contract this and what is th ecurei am 26,5inch 4,85kg.it has been there for around 3yrs now.",
    "doctor_response": "Hello,Dear it could be contact dermatitis.It is the type of hypersensitivity ,can occur due to using particular type of clothes,underwear or applying some particular type of chemicals or tampons.I would suggest that first of all keep dry this area,and take good hygienic measures.You may change the type of cloth ,which you have been using through years and try to wear cotton wear.Wash your private parts with antiseptic water and you may apply antihistamine ointment on rashes.You should also see a gynaecologist once to rule out any sexual transmitted disease.Hopefully my answer will be helpfull.Regards,Dr.Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does akt-4 take to treat tuberculosis?\n\nHi, I have a cough for tow month? And tested result for SPUTUM AFB for 3 days. The result come Not seen. But CXR revealed that I have some patchy in Right Lung. The doctor says, it is TB. He gave me Akwit-4 and some vitamin for treatment. Please, answer me that how many days does I need for this treatment and it is dangerous. I have to finish my master degree in computer studies in USA. I am afraid that my medicine check up will cancel this.Please let me know the time and it is really PTB.",
    "doctor_response": "Thanks for posting you query to health care magic.tubercular bacteria is a intracellular oraganism require long time to cure .minimum duration of treatment is 6 month but can beincerased up to 1 year depend upon your test rresult during subsequent month .I suggest you to take medicine  regularly without any break otherwise it will further increase duration of treatment. things goes in your favour is in your  case bacteria not found on smear microscopy suggest disease is not extensive so if you take treatment regularly will get cure early.hope you are satisfied with my answer .  feel free to communicate if any query .regards,Dr.Manish PurohitInfectious disease specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes uncontrollable body shivers while having COPD?\n\nMy husband is 73, and woke up with uncontrollable shivering. He does not have a fever, and has not been sick. He does have copd, and a heart condition. He has a defibrillator. Should he be seen in the ER, or can it wait until daytime, and see if it is still happening? Is there anything we can do to make it stop?",
    "doctor_response": "Hey there,With history of COPD and Defibrillator you must go to ER now only.As it could be anything we can't explain online.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for inflamed thumb\n\nI have had pain in my thumb for a while and have been wearing a thumb stabilizing wrist wrap for the past week and a half. Dr. said that the tendons in my thumb are inflamed. When I move my thumb, my wrist feels like it is popping out of the socket. I am worried that there may be something additionally wrong with my wrist. Please help.",
    "doctor_response": "Hi, i am understanding your problem. Tendons of thumb pass through the wrist joint. As your doctor told you about inflamned tendons, so the popping in your wrist is might be related to you tendons only . Not need to worry just follow the advse of your doctor and wear the stabilizer and when inflammation subside. Do some stretching and strengthening or hand muscles. Hope you got the satisfactory reply. wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having pain in my left leg while laughing, sneezing or coughing?\n\nHi Doc, I am having pain in my whole left leg for last 2 month while laughing,sneezing or coughing. The pain is severe durng the morning time when I woke up. Also when I bend to pick some thing then also the pain is severe. I went to orthopedic doctor but he was unable to detect the cause. Can you please suggest what should I do? Thanks.",
    "doctor_response": "Hi I have read the details as mentioned by you.  In my opinion You are suffering from Pressure on the nerves starting in your back( Spinal Column) , either due to slipped disc or spinal canal stenosis.  I suggest that you start pain killers , muscle relaxants and get an MRI of lower back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Irregular periods. Took treatment. Get pregnant?\n\ni got marrid in june 2009,we never intercourse completly bcoz we didn't want baby at that time but we nevr take any sort of external precautions,in dec 2010 my husband came to malaysia and i still remain in pak but juz after my husband went my periods became irregular and after some time it stop i took treatment and finaly periods become regular,now in feb 2013 i came to malaysia my husband and me met after 2 years now we want baby but my periods again become irregular like my last date were as follows 17,jan2013 befor met to husband then after met husb my periods start on 1march2013 nd now i would be on 1 april bt it started on 21 april.",
    "doctor_response": "Hello, There are many causes of irregular periods like stress, hormonal imbalance,thyroid disorders,sudden gain or loss of weight etc. I would advice you to undergo certain tests like  CBC with ESR, Thyroid function tests and an ultrasound of pelvis. Meet your doctor with the reports and if needed you can again take the treatment for regularizing your cycles, as this is needed before you plan your pregnancy. Don't worry,every thing would be fine. Take care. Dr. Rishma Lakhani MBBS,DGO",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am on Abilify and Cymbalta. Could the drugs cause tremor as a side effect?\n\nHi doctor, I have schizoaffective disorder. I take Abilify and Cymbalta. But most of the time my hands shake badly. Do you think it could be due to Abilify and Cymbalta or it could be more related to my disease? Does Abilify cause tremors as a side effect?",
    "doctor_response": "Hello. How long have you had these tremors? Is it present all the time? Did you develop these tremors only after starting medication or did you have some form of shaking even before medication? Both Abilify (Aripiprazole) and Cymbalta (Duloxetine) are known to be associated with tremors. Have you discussed these tremors with your treating doctor or psychiatrist? You need to be assessed for signs of extrapyramidal side effects. Abilify (Aripiprazole) is a proper medication for your condition. Any medication can come with side effects. So after assessment, your doctor can either optimize the dose of the medication or if appropriate consider a medication like Pacitane (Trihexyphenidyl) to control these symptoms. Also try to practise progressive muscular relaxation and deep breathing exercises . It will help to calm your nerves as stress can exacerbate these symptoms. You are welcome to contact us if any further advice is needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain, had unprotected sex, white discharge, chills, weight loss. What is wrong?\n\nHi, I had a question that been in mind a couple days now. So first of all on June 25th my right adomin hurts. Not for long it feels like a stabe. One at a time. I dont know if this mean i was ovalating or not but when i count its the 14 or 15 days before i start my period. Anyways me and my bf had sex that night which is the 25th. He yes came in me and after that i lay down and fell asleep.  Next morning when i got up and went to pee and wipe there was like a lump of white dischager. It not super white kind the white tan i dont know how to explain it. I didnt touch it just flusj it down. Two day later i feel chiles but not sick. And about 7 days after i feel tired but now im ok. Also i having been eating lately and notice that i had lost weight all my old shirt fits me now but my jeans are not fit prefectly now. What wrong me? Can i be pregnat?",
    "doctor_response": "Hello,There is always a chance of pregnancy with unprotected sex during the unsafe period of the menstrual cycle.Get a Urine pregnancy test done to confirm it.If pregnancy is excluded then we can think in term of PID(Pelvic inflammatory disease).You may need a Viginal swab and ultrasound of the pelvic for diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for knee pain and unable to bend knee?\n\nhello I m Kayse Anderson 16 when i was 9 or 10 i got bucked off a horse and went knee first into the concrete last week Thursday i woke up and was unable to bend my knee with out experiencing horrible pain and to today is monday and i still cant bend it",
    "doctor_response": "Hello, I think should see an orthopedic specialist as soon as possible. You need to run X-ray and MRI of the knee. Do not move the knee. Apply analgesic cream locally. Take oral analgesic. Remember to see an orthopedic specialist as soon as possible. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Albana Sejdini, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for swollen,red and itchy skin on my scrotum\n\nI have Thickening, Itchy, rough, red skin on my scrotum. I have no pain what so ever. I have been using Lamisil for about 4 days. it seems to be getting a little bit better but not as fast as I'd like. how long should I continue to use this cream or do you have any other suggestions?",
    "doctor_response": "Hello,Thank you for posting on HCM.I can understand your concern regarding the skin lesions.It seems you have got scrotal dermatitis or tinea cruris but its difficult to point specific diagnosis in absence of clinical examination.Therefore, I insist you to post good clinical pictures to me so that I can help you in a better way.You can reach me directly through the below mentioned link.  Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent UTI with swollen red eyes in a 2 year old?\n\nI m extremely concerned about my two yr old..She s had uti after uti for the past four months. She currently has another including red swollen eyes..I m not sure if this is the right place to ask but I need answers please help my email is YYYY@YYYY",
    "doctor_response": "Urinary tract infections (UTIs) are quite commonly seen in children. Most often multiple episodes could be due to unrelated infections. But anatomical abberations often predispose to UTIs and need to be excluded. A DMSA scan will help in finding it out.Swelling of the eyes could be due to lack of proteins in the blood. It could arise if the child is not feeding well. But a more important condition related to protein loss could be a condition called nephrotic syndrome which could have some connection to the UTI. Please visit a pediatrician and get the child evaluated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to confirm a successful medical abortion?\n\nhi, i had an induced abortion last night. i took mifepristone before that and last night i took misoprostol. at around 2am, my water broke but no fetus comes out. do i have to wait for at least 24hours? or do i need D&C right away? abortion is illegal here in Philippines. thanks!",
    "doctor_response": "Hello,You will have to wait for 48 hours or the entire process to finish and Misoprost to work effectively. Only after 48hours when there is no bleeding or expulsion than only think of Dilation and curettage (D&C).Hope I have answered your query. Let me know if I can assist you further.Regards,   Dr. Mandavi Rai",
    "dialogue_context": ""
  },
  {
    "patient_message": "No periods. Taking duphaston for irregular periods. History of irregular periods. Causes?\n\nHey...i Used duphaston 10mg due to irregular periods and low progestron.my problem is ..i used it 5 days but after used it i have no Menstrual period can duphaston effect on Menstrual period?hen kindly tell me whats should i can do? i have no spotting my fullflow of period day is 22 july 2012 but due to Duphaston 10 mg i have no menstrual period till 25-07-2012 today",
    "doctor_response": "hi, thanks for choosing hcm, dupahaston 10 mg is taken from day 15 to day 25 1 tablet daily so that pregnancy due to progesterone deficiency continues as this supplements or if pregnancy did not occur it causes withdrawl bleeding to occur aiding in regularising your periods and withdrawl bleeding need not be a full flow or heavy flow,it can last for very less time and less quantity also sometimes only spotting is seen you didi not mention your age and marital status so if you are married and had intercourse go fo a pregnancy check up and if positive meet your doctor if not you can go with this medication even in the next month  counting 22nd july as your period date reduce weight if you are obese,this almost clears your hormonal deficiencies and irregular periods hope i answered all your queries feel free to contact me for further queries thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lower back pain\n\nhai, i have a pain in my lower back and dactor advised me to take bed rest for three months.but still Iam not relieved from my pain.now doctor advises to put an injection in lower back.when I went to another doctor he scolds me for taking rest.he asks me to do all sorts of exercises to reduce my body weight.he also asks me to do all my routine work and avoid travelling .which advice should I follow.Iam 34 years old.Iam working as ass.professor.may Icontinue my job",
    "doctor_response": "Hi Welcome to HCMThis  is D Suchda  looking into your query .You  have not given your height and weight ?  Thank god , you have visited another doctor , who has given you right advice . Total bed rest in situation is not good Any way you can resume your proper routine work . only with precautions  that you take care  to take only controlled - balanced and healthy diet  ,no  fried or fast foods . Take proper sleepKeep your bowels clean .Do exercise properly / regularly ,/ but don't do any exercise which involve front bending ,It will do more harm than good .Back bending  slowly , without jerks , will give you instant relief .  A cup of hot milk  with a level tea spoon of turmeric  or Shilajit - a herb will give relief from pain & strengthen bones .Hope this give youreply of your query .All the best .Take care .Dont hesitate to get back if have any further query",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sensation of fullness in chest?\n\nHi...I'm a 59yr old female on norvasc for almost 20 years 5mg to treat a moderate hbp number that use to swing up and down.  I've been more stable on the drug but the bone popping and grinding is not consistent with my age and health.  I'm in pretty good shape and excercise on and off and a little overweight at 158lbs..5'4''.  I also get a chest fullness sensation and that is only relieve when I allow myself to MISS the drug a night or two.  I really want to come off this drug now.  What do you suggest?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, you should not stop the drug by your own. Since you are above 50 years of age and having hypertension, better to first rule out heart diseases for your chest fullness and tightness. So get done blood pressure monitoring, ecg and 2d echo. If all these are normal then no need to worry for cardiac diseases. Sometimes, stress and tension can also cause similar sensations. So avoid stress and tension, be relax and calm. Don't stop your blood pressure medicine by your own. This can be serious. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for dengue\n\nmy friends son has been infected by Dengu which is 3.11 till yesterday and has been hospitalised today in India at Mumbai...the doctor has not prescribed anything since morning and now he as given him Crocin tablet....i want to know if this tablet can be given and which is a good hospital in Mumbai where he can be treated for this disease",
    "doctor_response": "get blood test for platelet count.normal count  is 1.5 lac to 4,5 lac. if  count is more than 10000,no bleeding,no need to hospitalized.take crocin (paracetamol)  if fever is  more than 100.use cold packs,take O R S  with mineral water.indications  for admission are- bleeding, B P  less than 90.you can admit in any  hospital with blood transfusion facility.do not worry.consult your family doctor.feedback.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in chest while breathing?\n\nI have a cold and went to the dr today, they told me there wasnt any kind o medicine they could give me just to continue to take otc meds.  well, i got some soup and gatorade as well, amd noticed when i took a drink there was a pain in my chest right in the middle of my breasts, same thing happened when I was eating.  Its a slight pain when i take a deep breath but mainly just eating and drinking...Ive read that this could be an esophagual ulcer...but i dont know, and my dr is out of town, and i really hate going to the same dr i went to this morning again bc i didnt care for her, but im hurting...",
    "doctor_response": "Hello,It may be due to stomach ulcer. Try having tablet Pantop before breakfast and avoid spicy food and alcohol and smoking.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Siva Kumar Reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is significant blood discharge accompanied with abdominal pain a cause for concern?\n\nI believe I may have experienced an anal fissure by a large, hard BM on Monday. There has been a significant amount of blood in the toilet for the past three days. Today is the fourth day and it has calmed down but I am still experiencing bloating and abdominal pain. I am concerned that there is something else going on that I can t manage at home. Is it time to go to the ER?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.It can be due to fissure or some problems in lower intestinal tract. You should go for ultrasound abdomen once to rule out any mass lesion first.No need to go for ER. It is not emergency. But you need to search the cause.Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is my past relationship making me anxious while seeing an attractive girl?\n\nHello doctor, I have extreme anxiety when I see an attractive girl. I feel like escaping from that place at that moment. I intentionally avoid going out and limit myself to home only to avoid attractive girls, I even stopped watching TV to avoid this. I believe this symptom may have started with a broken relationship I had with a girl 10 years back. I am 35 now but I still have it and it is getting worse, I am not sure if I will ever be able to overcome it. Please help.",
    "doctor_response": "Hello. People develop a fear of various things due to some bad past experiences. Some get over them with time while for some people it gets worse. If your past still haunts you and is the reason for developing these fears then you need to undergo some therapy sessions. You may also need a medicine, depending on the severity of your problem and extent of improvement with therapy. I would advise you to see a psychiatrist at your local place as early as possible because already so many precious years have been lost due to this problem. It has taken a lot from your life. Do not delay seeking help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking ace inhibitors for renal disease. How to develop the ESRD level?\n\nMY CREATININE IS 2.3 AND BLOOD UREA IS 60 MG/DL.GFR 30 HOW LONG WILL IT TAKE TO DEVELOP ESRD.my age is 50 years i am taking ace inhibitors to retard the disease.but are they able to stop progression",
    "doctor_response": "Hello, End stage renal disease (ESRD) is the last stage (stage five) of chronic kidney disease (CKD). This means kidneys are only functioning at 10 to 15 percent of their normal capacity. \u00a0When chronic kidney disease develops into ESRD, dialysis or a kidney transplant is necessary to stay alive. Since you are already having GFR of 30 ,it indicates a stage 4 CKD. What can be done to either delay the progression of disease or, in many instances, prevent it? 1... Control your BP meticulously with either ACE inhibitors or ARB's 2...Control excess body mass 3..If it\u00a0is deemed safe by your physician, low impact exercise for 20 to 30 minutes a day may be beneficial. It is certain to improve the quality of life and well-being 4...Controlling Lipids 5...Refraining from Cigarette Smoking 6... Avoiding Drugs Known to Damage the Kidneys like pain killers and antibiotics like gentamicin At the end I would like to mention that you can simply try to postpone the event of ESRD but you can not totally stop this event. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful rash on legs and arms\n\nWhile tingling in hands and feet are better rash is worse.  I now have a flat red rash on legs and arms.  It stings when it touches my clothing.  I can't get into see my doctor for another week.  I agree it is not from radiation but I don't know where it's coming from.   Last night it seemed better but this morning it was red and painful again. I am not using any new products except a possible change in dryer sheets but I switched to a fragrance free one.",
    "doctor_response": "Hello, Painful rash on legs and arms could be due to exposure to something you are allergic to, scabies or contact dermatitis. You can take oral antihistamines, levocetrizine for relief. You can apply hydrocortisone ointment locally on the affected area. Take care of your hygiene. Wear cotton clothes. If you do not get relieved than you are suggested to get yourself examined by a dermatologist to rule out scabies, psoriasis, contact dermatitis, etc. Cold compress & oatmeal baths or baths with antibacterial soap are effective to give relief. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Nupur K, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for parasitic infection\n\nlooking for a holistic doctor, who is a specialist in identifying and eradicating parasitic infections...family member, very dear to me, afraid of what might happen at an emergency room, not looking to be cut on, dealing with a possible new world species of parasite. two lab results were.. quote unidentifiable",
    "doctor_response": "you can take albendazole or metronidazole tablets , for parasitic infections .generally parasites do enter the body through contamined food and water and children are more prone to parasitic infections.stay healthy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bleeding after the mirena coil placement. Pain in the back. Any suggestions?\n\nHad the mirena coil fitted 3 weeks ago and Been bleeding since got it put in for the 1st 2 weeks I was getting labour pain feelings all in my back and left side ( which is where I have all my pains and problems) I have had my tubes tied so this is not to stop me being pregnant but cos I was still bleeding permanently 18months after having my 4th child",
    "doctor_response": "Hello and welcome,I understand the issue. A few women may continue to experience irregular bleeding for a few months after mirena. Later most [ not all] will experience absent or scanty periods. The backache is also due to the coil and it takes again a few months to get adjusted to it. However if the bleeding is severe and the pain is also severe, it is better to see your doctor to check if the coil is in place and also to see if there is an infection or some other cause leading to pain. Hope this satisfies your query. Thanks for using HCM.\u00a0\u00a0\u00a0\u00a0\u00a0Feel free to ask any more questions that you may have. Dr Madhuri BagdeConsultant Obstetrician and Gynecologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause thoracic back pain and chest discomfort?\n\nAching deep chronic thoracic back pain, also chest discomfort. Had backache for over 20 years but it's worse now. Chest discomfort started in February. Had an EKG all is good. Now sure if it's related to the back pain but no amount of massage or chiropractor can fix it. What could it be?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Chronic chest pain with chest pressure is seen in heart and lung diseases. Heart diseases can sometimes missed on ecg. So better to get done 2d echo and stress test. If both are normal then no need to worry for heart diseases. Bronchitis can also cause similar symptoms. So consult pulmonologist and get done clinical examination of respiratory system, PFT (Pulmonary Function Test) and chest x ray. PFT is needed to rule out bronchitis. Chest x ray is needed to rule out other lung related diseases. So better to 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes irritation at back of throat causing sneezing?\n\nIt s just getting into the summer months and I have started sneezing. After a sneezing fit today I have develops an irritation toward the back of the throat. Kind of feels like it s near the roof of the throat too. It s really irritating when swallowing and I can feel it there all the time. Can t stand it. I have it whenever there is a stark change in weather conditions and I ve always wondered what it is.",
    "doctor_response": "Hello. I am sure this has to do with the change of season. there are several people sho are allergic to things that are naturally found in their environment especially with seasonal change such as pollen, dust petals of flowers, etc. it is the multiple sneezing that is caussing you the irritation at the back of your throat. It is probably a seasonal case of allergic rhinitis that you ar suffering from. Please see a doctor who may prescribe you some anti histaminics, to ease the symptoms. I wish you all the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for epilepsy in a 5 year old child\n\nhello my 5 yr old has been diagnosed with epilepsy . some of the things that is concerning me is that she had 17 seizures in one day i took her to the er then the next day to her doctor who see her about them he said that it was one seizure well she jabs when she walk she say it hurts to walk she still grinding her tongue isn t right and her speech is just now getting right , he put her on depakote 125 2x a day my question why is she still doing the things and what kind of epilepsy could this be what all kind of test could be run on her to find out what is going on ?",
    "doctor_response": "Hi, some tests need to be done.like MRI brain and Electro- encephlo- gram.some questions are still pending, wether there is a history of seizure in family? seizure are contrlled or not?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is ectopic heart beats related to hormonal changes?\n\nhi , i have been geting ectopic heart beats for years and am on propananol , but lately they are alot more before and after my period , i am 38 year old female , its getting me down and tearfull , i am on prozac and have been on them for years . the ectopic beats are all i think about day and night ,is there anything to stop these horrible things , can it be hormone realated ,, please help ....",
    "doctor_response": "hi,hormones do have some effect but not this much.Do you smoke or do any drugs.Prozac has cardiac side, you can ask physician to change it, atleast temporarily and we can see the response.Also these much are not normal, you should get yourself evaluated. Whether these vpc or something else. You will need ECG, echo to Find out the cause. These are precursor for some dangerous arrhythmia.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does having sex after 17th day improve chances of pregnancy?\n\nI have been asked to have sex before the day of ovulation. next day the gyn tested and told me that I have ruptured follicles and have asked to have sex for the next 2 days. we had it on the day told but was too tired the next day. does it affect my chances of pregnancy. Can we have sex after 17th day?",
    "doctor_response": "Hi,I read your query and I understand your concerns.Following is my reply:1) You still have chance of pregnancy.2) Missing one day wont matter much.Let me know if you have anymore questions.Regards,Dr. Mahesh Koregol",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the sperm count of 65 million normal or would lead to infertility ?\n\nmy husband sperm count is 65 million is this ok for infertality?",
    "doctor_response": "my all reports r ok but my TSH is hight n prolactin is 31 im taking 1 tab for TSH befor breakfast n 1 for prolactin.......",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a positive TMT test actually mean?\n\nMy mother is having GB Stones. She went for Laparoscopic surgery but doctors said there was a risk as she was tested positive in a tmt test. What do you suggest? What does a positive tmt test actually means? What are it s implications? What precautions do we need to take?",
    "doctor_response": "Hello, I understand your concern and would explain that being positive at a TMT test means that she may suffer from coronary artery disease (blocked coronary arteries). For this reason, she may be at a higher risk for a heart attack during or after surgery. Coming to this point, I would recommend performing a coronary angiogram in order to examine the blood flow in her coronary arteries. You should discuss with her doctor on the above test. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent dizziness, headache and numb hand?\n\nHello, lately I been having some dizziness (like when you get up to fast) but every time it happens I m most of the time laying down , also been having light but really annoying headaches, my left arm hand , fingers and face feels numb sometimes too... Am I sick or what is wrong with me?",
    "doctor_response": "Hello, After the fourth or fifth decade of life, those symptoms may be linked to transient ischemic attack and in such cases, evaluation by a Neurologist is necessary. In young people these symptoms generally are not linked to any specific conditions, fatigue, stress, unhealthy lifestyle may be some of the reasons. Hope you found the answer helpful. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for rashes all over the body after eating mutton?\n\n:\u00a0Hellow DoctorAfter eating goat meat,my daughter got lashes on her whole body,Its hapoening whenever she takes mutton.How to cure this,she is 2.5yr o...\"\u00a0:\u00a0Hellow DoctorAfter eating goat meat,my daughter got lashes on her whole body,Its hapoening whenever she takes mutton.How to cure this,she is 2.5yr o...\"",
    "doctor_response": "Hello,Thank you for posting on HCM.The condition you have referred to is called Urticaria or hives. Its an allergic manifestation of skin, where an allergen leads to release of certain substances from your blood, leading to itchy skin rash and swelling over soft tissues. Its proper management requires thorough history, clinical and laboratory work-up.You may have to go for specific tests like patch test, food prick test, IgE antibody levels etc. As for treatment part, best would be the avoidance of allergen as far as possible. Try to eliminate possible triggering foods from diet. I would also advise you various anti-histaminics for long duration( atleast 3 months) with or without oral corticosteroids. For non- responding cases there are many other drugs like dapsone, cyclosporine, montelukast, omalizumab etc which can be used in certain selected cases. Hope this will help you in resolving your query.Thank you Dr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tendency towards stealing things?\n\nhi.....i want 2 consult a psychologist 4 my sister,she is 33 yrs old,divorced.she has faced an accident in her childhood....she got her 40%body burnt,she got the habit of stealing jewellery and cash.first she was stealing at home only..bt she started stealing at neighbour's place,temple nd relatives place......v r unable 2 find a solution...v had talks with her many times bt she doesnt speak y she needs money........I am staying in Nagpur..Is der ne good psychologist in Nagpur,...is der a solution 2 dis problem.....v take care of all her living and entertainment expense den also she do dis things...kindly suggest me something.....i had tried many things like don let her go out of home.beaten her also...bt every tym she says...give me 1 more chance dis is my last mistake.......do mail me at  YYYY@YYYY",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  Kleptomania is the inability to refrain from the urge to steal items and is done for reasons other than personal use or financial gain.  Your sister could be a victim of Kleptomania. It is classified as Impulse Control Disorder. Some cases also come under Obsessive Compulsive Spectrum disorders. Expert psychiatric treatment using SSRIs and anti depressants is a must. Please consult a psychiatrist. Cognitive Behavioral Therapy is suitable along with psychiatric treatment which will be administered by a psychotherapist.    If you still need my help, please describe the whole problem in detail and post a direct question to me. I shall definitely help you with psychotherapy techniques to over come your problems.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does it takes to cure Pneumonia?\n\nhi iam 23 years old, 5'4 height 108lbs iam taking my medical 4 working abroad then i notice that i had phenomia vs ptb i want 2 ask if possible that after tretment 4 (6months) taking medication my x-ray will be clear so i can proceed to continue applying working abroad. what should i do step to make my x-ray is clear? i never get cough@ fever, i just feel that my back was hurt when the wheather is cold @ sometimes when iam carrying heavy stuff. pls help me! i really appreciate your help.",
    "doctor_response": "Hi thanks for contacting HCM...You are having some congestive symptom.In your description you have not mentioned exact cause and chest x ray finding....First to rule out pneumonia do chest x ray.It will show consolidation in x ray...For that 2 week antibiotic like cefixime given....X ray consolidation gradually resolve within month depending on severity.....Second if you have weight loss and fever then tuberculosis suspected , sputum examination needed.For that atleast 6 month therapy needed.Here your respiratory physical examination with auscultation first needed to do proper work up...If no significant cause found then it could be simply viral bronchitis like infection.Symptomatic management needed.Decongestive tablet like antihistaminic needed.Take care.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain that radiates to arm?\n\nIve been having bad chest pains the last few days. The pain radiates down my left arm im 33 f . Ive been having this lain on and off but its getting worse. Ice tried antacid thinking it was gerd and still have it. Ive been to the er several times doc cardiologist etc. ive had echo stress test halter monitor all was normal. I wven started to develop a dry cough. What could this pain be. Do u think iy needs emergency attention",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.No need to worry for heart diseases as your extensive cardiac work up is normal.Possibility of musculoskeletal pain is more likely.So no need to rush to emergency, just follow these steps for better symptomatic relief.1. Avoid movements causing pain. Avoid heavyweight lifting and strenuous.2. Avoid sudden jerky movements.3. Sit with proper back support.4. Take painkiller like ibuprofen or acetaminophen.5. Apply warm water pad on affected areas.6. Wear rib belt.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and swelling in knee?\n\nMy Husband has pain and swelling in his knee.  He also does not recall injuring it.   He is 45,  smokes, prone to High Blood Pressure, although it is under control.  He is also prone to gout in his feet.  He thinks it may be a \"Cold\" in his knee.  Is that possible?",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain pain and swelling in knee can be due to causes like Traumatic injury to knee, Arthritis, Bursitis,Gout, Pseudogout,Rheumatoid Arthritis, Baker's cyst etc..I would suggest you to consult an Orthopedician and get evaluated and a thorough clinical evaluation and investigations like x-ray, MRI Scan, blood tests etc can help in diagnosis and treatment can be planned accordingly..You can be advised to take anti-inflammatry painkillers like Ibuprofen for pain relief and topical application of analgesic ointment like Voveran..You can be advised to follow the most common technique that is R.I.C.E that is REST which means refrain from workout, sports, vigorous walking, long hours standing etc..ICE: Do cool compresses over the joint for fifteen to twenty minutes as it will help in reducing swelling..COMPRESSION: Cover the knee using a knee cap or crape bandage as it provides support as well as reduce swelling..ELEVATION:Put pillows under your legs while lying down and raise it from the level of body..By these techniques the swelling will reduce in 3 to 4 days and in case if there is no improvement treatments like Arthrocentesis or surgery can be advised depending upon the cause..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My period is delayed for a month with negative HPT. What is the chance of me being pregnant?\n\nHi doctor, My last period was on April 28. It has been almost seven weeks and I still have not had my period yet. I had unprotected sex on May 24 thinking my ovulation day is over but I started getting very paranoid last week. So I took a pregnancy test on June 10th and it was negative. Then I took one more yesterday on June 14th and it was negative, but if I squinted hard enough it could have been positive. I am very paranoid right now because I do not have a supportive family and I do not have health insurance to go to the doctor to get this checked out, and I am not ready to have a child. I am 21 years old living with my very conservative religious immigrant parents and I do not know if I should take the second pregnancy test seriously. I have been stressed out for the past one month which makes me think I am skipping a month but I am still very afraid that there is a chance I may be pregnant. I have no symptoms of pregnancy. Is it likely that I am pregnant?",
    "doctor_response": "Hello, Welcome to iclinq.com. It is unlikely to be a pregnancy. However, get a serum beta HCG (human chorionic gonadotropin) blood test to rule out pregnancy, as PT has some chances of false positivity and false negativity as it is weakly positive. The likely cause of the delay could be hormonal, anemia, weight gain, hypothyroidism, stress, or change in food and exercise pattern can affect the cycle length and pattern. Hormonal. Serum beta HCG. Pregnancy. Delayed cycle (probably hormonal). If beta HCG is negative, then take tablet Medroxy progesterone acetate 10 mg at bedtime for five days. Menses occur one week after the last dose of Progesterone. Weight reduction if BMI >25.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for OCD\n\nmy son is 16.6yrs old, his psychiatrist has advised him to take attentrol10 medicine daily once. He is showing symptoms of OCD after taking medicine for past three days. What should I do ? Shall i continue or stop the medicine. He is suffering with ADD?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Atomoxetine Hydrochloride in the form of Generic Strattera Capsules (Attentrol Capsules) is a selective norepinephrine reuptake inhibitor used for the treatment of Attention Deficit Hyperactivity Disorder. The judgement of your psychiatrist should be correct in giving the medicine. There is no evidence of OCD as side effect. Still you shall consult your psychiatrist once again and update him about the developments.In my opinion primary ADD and OCD may be cured with the help of psychotherapy without any medicines. Try to find a clinical psychologist. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for severe cough and pain in chest\n\nI believe I have bronchitis. During the day it's bad enough, but night is horrible! I cough so much that sleep is impossible. And now my nose is stuffed up and my ears feel like they pop when I cough. Also, my chest aches with every cough. What can I do to stop the coughing and pain?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Night time cough, blocked nose and ears are more suggestive of allergic bronchitis. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. PFT (Pulmonary Function Test).PFT is must for the diagnosis of bronchitis. It will also tell you about severity of the disease. And treatment of bronchitis is based on severity only. You may require inhaled bronchodilators and inhaled corticosteroid (ICS). Oral combination of antihistamine and anti allergic drugs are also beneficial in your case. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to rule out autoimmune diseases?\n\nMy husband s physician said his symptoms could be the sign of an auto immune disease - fingernails splitting, thin, thickening in areas, deep ridges - also on toenails and bald spots in his facial hair. I cannot even find those symptoms listed anywhere.",
    "doctor_response": "You have to provide entire histort for the same , autoimmune diseases have varied symptoms . There is no single test to rule out these disorders .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are heartburn, fatigue, pelvic pain and nausea symptoms of pregnancy?\n\nI m 85 days late. Both blood and urine test show negative. I have all the symptoms i.e. Heart burn, extreme fatigue, slight pelvic pain, trouble sleeping, smells are bothering me, nausea, appetite has decreased. I m at a loss. I m 42-1/2 years old. No spotting.",
    "doctor_response": "Hello,I have gone through the query and understood your concern. As both the blood and urine tests have read negative for pregnancy, you cannot be pregnant. This delay in the menstrual period can be due to hormone imbalance and this is also likely to be the cause for the symptoms you are experiencing. Considering your age, hormone imbalance is more likely. this menstrual disturbance can also occur with sudden weight changes, stress, infection and use of certain medications. Please get a clinical assessment and a trans-vaginal sonogram to plan further management. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have stone in kidney. Taking homeopathic medicine. Pain in urinary bladder. Solution without surgery?\n\nhi doctor i am having 13 mm and 9.7 mm stone in my left kidney i am using homeopathy medicines since 20 days.. i am not getting any pains,, untill if i dont use water for 30 minutes,, i am not getting pain in urinary bladder,, please suggest what is the solution to dissolve as quickly,, without any surgery,, i just need any thing other than water,,,(apart from using plenty of water)",
    "doctor_response": "Hello!noted your condition, i can just say that to escape surgery, the renal stones should be of minimal size, so that they can pass the urinary system. to drinki plenty of water is said so that the patient may urinate much and the impacted stone comes out through urine.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment for pigmentation\n\nHello Doctor my name is Eva I am from shillong. so i m very happy to see this webside healthcare for pigmentation. at first i have a pimples my pimples never go it keep on comming then i try to consult to dr he give me a medicine after sometime my skin become so ruff that start comming a brown spot scar from my cheek now spread to nose and cheeks cannot notice if we dont see it properly.so can you suggest me a good medicine pills or cream or whateveryyou can do. it will be greatefull",
    "doctor_response": "pimples come when your skin becomes more oily. Your doctor might have given medicines to reduce the oil. So your skin is becoming dry which is not a bad thing. And when you are using medicines for pimples you should not expose to sun light or else your skin will get tanned brown. Right now continue with the pimples medicine. Apply SUNGRACE sun screen  on your face 20 min before you go out. Once the pimples come down then you can apply depiwhite cream every day night to the marks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes an orange small pimple on penis shaft?\n\nHi, im 16 .i noticed an orange small pimple on the shaft of my penis today on an already existant lump in the same place. i looked at it and squeezed it a little and orange liquid (i think pus) squirted out now it has shriveled up . please help me, i am really worried :(",
    "doctor_response": "Hello, Since you didn't mention any think about your sexual encounter. If it\u2019s NOT SEXUALLY transmitted disease then it can be \u2013 Acne, Fordyce spots -  which develop when skin's pores are clogged with natural oil, called sebum, sweat, dead skin, it can also cause infection, Skin tag \u2013 it's normal, happens in age advances. Ingrown hair which is painful can leads to infection, needs medical management. Rough Masturbation/Sex, Bullous Impetigo- bacterial infection due to bad hygiene or use of public pools, towels. If its sexually transmitted Disease (STD). It can be 1. Herpes -  Genital warts (HPV) can be diagnosed by the presence of very painful blisters, sallow ulcers or red base. There are treatment options for genital herpes, but there is no cure. As to the treatment, it is based on relieving basic symptoms, early healing as well as the decrease of symptoms duration 2. If it\u2019s not painful-  Syphilis, diagnosed by  Blisters appear as the first symptoms of primary syphilis. They usually disappear on their own with time, but remains in the body. first blisters on penis appear, important to seek medical help. 3. molluscum contagiosum  - small, painless bumps. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will cap restozeal help me to conceive ?\n\nmy doctor advised for cap restozeal,we r trying for baby for 5 long years and my question in what way this medicine helps me?",
    "doctor_response": "How old are you? 5000 years old yoga ratnakara has a special chapter on vajikaran yoga. A doctor from Pune has developed Navras Pak based on this for male and female infertility. You may send a mail to subbie19@mtnl.net.in for more details.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a broken adult tooth be attached?\n\nHello. My nephew who is about 14 just lost an adult tooth while eating. It doesn't seem to have a root at all and it didn't hurt. He is a HEAVY soda drinker and has pretty rotten teeth. Can this be repaired?Should we put the tooth in milk? Would this help if there's not even any root attached?",
    "doctor_response": "Hi..Thanks for the query..If the adult tooth or the permanent tooth is broken but there are no roots attached then probably the roots are still present attached to the jaw.No, there is no point of keeping just the crown of the tooth in milk as it cannot be re-implanted..So my suggestion is to first of all consult a Dentist and get evaluated.An x ray can be done of the region to check if the roots are present or not.If the roots are present then they can be removed and bridge can be placed..Another option of replacement can be implant..Hope this helps..Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. If I quit smoking, will my RBC, hemoglobin, and PCV levels come back to normal?\n\nHello doctor, I am suffering from hypertension since few years, and I am currently on medication Telmisartan. I am an alcoholic and smoker, and I smoke approximately 15 cigarettes a day for the last five years. My current CBC report suggests\u00a0high RBC, hemoglobin, and PCV. Though it reduced slightly from last year, it is still high. From the past 15 days, I completely quit alcohol and cigarette. Will the RBC, hemoglobin, and PCV come back to normal? If so, how much time will it take approximately? Last year, my hemoglobin was 20.1 g/dL, but now it is 17.4 g/dL, PCV is 55, and RBC is 6.72. Please help and suggest some treatment. Will it ever be normal? I have attached my reports.",
    "doctor_response": "Hi. I have gone through your attached reports (attachment removed to protect patient identity). Hope your concern is solved. For further queries consult a hematologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can cramps be alleviated?\n\nHi... I have a high ankle break & my doctor has me wearing a walking boot cast. I am to wear the cast 23 hours a day & can take it off for an hour for bathing purposes. I m now experiencing cramps in my calf muscle while wearing the cast/boot. Any solutionsfor alleviating the cramps?",
    "doctor_response": "Hello, As these cramps are due to muscle non-moving and due to the muscles having disturbed transmission of the sodium from its channels. As and when you get a cramp having a pinch of salt will be good to avoid the cramps. Also, simple toe movements will help the muscle physiology to be intact. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can HIV be transferred through non-sexual methods?\n\nsir, 2.5 year ago i escorted by one women, she gave me the massage to my penny with her breast for 30 to 60 seconds, then i prevent her to do so, i hv not kissed her, no viginal ses, no oral sex, no anal sex. even she was only topless and i pressed her boobs only...........i ejaculated my self with my hand as i erect....also put condom while mastuburation......sir pl let me know i should get tested for HIV....as my wife fertilty treatment is going on ....for that, i scare when i remebered this inccident",
    "doctor_response": "Hi, Welcome to Health care magic forum.                       As you describe it is not at all harm full.If you are frank enough.                       If some thing happen also, don't worry, and you can get examined,and exclude any possible infection.If you hide it it will be problem for both of you.                         You are in a dilemma of if some thing has happened, so it is better to consult a physician for diagnosis and treatment.                           Take more of green leafy vegetables. pulses, sprouts, and protein rich foods,to have blood, and resistance.                       Wishing for a good health . thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump under the ear?\n\nI got my ears gauged yesterday and today later in the evening a lump under my ear on the left side of my neck appeared out of nowhere. Its sore and I can cover it with the tip of my index finger. The ear lobe isnt infected. its not swollen or super sore so is it just my lymphnode gland reacting to this injury ?",
    "doctor_response": "Hi,It seems that there might be having enlarged post auricular lymph node.Due to ear piercing there might be having some infection.Clean prick site and apply antibiotic cream.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes purplish hands and rapid breathing while having heart murmur?\n\nmy 3 month old daughter has a grade 2 heart murmur, she has had some episodes of rapid breathing, she sometimes has purplish hands but not all the time she has had a cough on and off for 2 weeks she is due to have an echo in a weeks time, should i be concerned?",
    "doctor_response": "hi, having purple hands may be due to cyanosis - cause could be central (related to heart) or peripheral.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is taking paracetamol harmful for liver function?\n\nIs paracetamol & acetaminophen the same drug?  What are the symptoms of liver damage from paracetamol and/or codeine. At times I have taken up to 10 Panadeine Forte a day for severe back pain. is this considered harmful to the liver? I am female, 63 yrs old, weigh 89 kilos, & aprox 5ft 3inches tall. I have Systemic Scleroderma, Type 2 diabetes, osteoarthritis, diverticulitis, irritable bowel, Scleroderma oesphagitis & reflux,a recent onset of gall bladder problems, have been diagnosed with fatty liver in the past, FibromyalgiaRhuematica, Chronic lower back pain, chronic fatigue, Chronic depression, hypertension.",
    "doctor_response": "hi.thank you for posting query at HCM.Paracetamol at \"high doses\" is injurious to liver.however, 1000 to 1500mg (1 to 1.5g/day) will probably be a reasonable dose to treat back pain unless you the pain is severe. In addition, try to avoid \"alcohol ingestion\" and maintain a healthy diet especially eat green vegetables and fruits.furthermore, hot water bag and pain ointments maybe used to subside the pain rather taking high doses of paracetamol. Massage equipment for back pain are also available in the market now.Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .hope to answer your concern.wish you good health.regards,Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will 3ml dosage of Coscopin have adverse side effects in a baby?\n\nHi doc my baby is 5 month old and my doc suggested coscopin 3ml 3 times a day. Is it OK to give so high dosage to small baby. I was hesitant so initially I gave him 1.5 ml then 2.5 ml and 3ml and 1.5 ml. Total 4 dosage. Doc told he has dry cough . I am worried. He has cough from last 1 month. We thought it will be cured by its own. But now me worried for side effects of this medicine",
    "doctor_response": "Hi Thanks for the query to HCM .Sorry to hear that your baby is having dry cough .Coscopin is prescribed ( noscapine 1.83 mg, sodium citrate 0.67 mgwhile ammonium chloride 7.0mg).This is a normal dose for a baby of 5 month , so  don't worry about the side effect of these ingredient as all are safe and dosage are according to age .As you  stated that your 5 month baby is  having dry cough for 1 month.In my opinion , consult one more paed doctor for 2nd opinion for dry cough because cough is for 1 month.Hope this information will be useful for you .Good luck for baby.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of primolut n for a 14 year girl?\n\nhi my daughter 14 years old has been prescribed PRIMOLUT N for 21 days to regularise her periods.in addition etosys,gemcal,and irex are also been prescribed to be taken .. pl advise me should she take primolut n at this age of 14.. any side affects??? looking for genuine advise...",
    "doctor_response": "Hello,Irregular periods are common at this age and a treatment is not always needed. Primolut N and other contraceptive pills may be prescribed since this age but if it is not needed you can avoid taking them.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Olgeta Xhufka, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the red itchy rashes on buttock cheeks? Tested negative for herpes\n\nhi i have a re-occuring itchy red rash on my left buttocks cheek and I have been to the doctor and dermatitis took blood and cultures and tested negative for herpes so what could it be? went to a doctor that says it s poison ivy but wasn t never sitting or rolling in poison ivy",
    "doctor_response": "Hi, The rash could be an eczema or a tinea infection (fungal infection). Eczema could be managed by steroid cream whereas tinea infection worsens with steroid. So, I request you to consult your dermatologist for arriving at a final diagnosis and for initiating proper treatment. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is physiotherapy with electric stimulation the right treatment for facial paralysis?\n\nHello. My wife was suffering from facial paralysis. During our first visit to the Dr, he identified as bells palsy. later when we took a second opinion from an ENT, she said it is \"HERPES ZOSTER OTICUSB RAMSAY HUNT SYNDROME --- HOUSE BRACKMAN CLASSIFICATION GRADE IV\". She has prescribed a steroid PREDNISOLONE 20 mg, ZOVIRAX 800 mg along with Vit B Complex for 2 weeks. She is also undergoing physiotherapy with electric stimulation. Please do let me know if we are in the right direction of treatment? NOTE: Initially she was unable to close her eyes and unable to move her right lips both lower and upper. Also she was facing running water from her eyes with no taste in her toungue. There were few rashes in the ear hole. After 1 week of physiotherapy she is not able to close her eyes but only 10%. Yesterday doctor told that if it doesnt improve she might need to undergo a nerve surgery. We will be really greatful if we get some response.",
    "doctor_response": "Hi and thank you so much for this queryI am so sorry to hear about this facial paralysis that your wife has.Whatever the cause, she needs no surgery to get this fixed. Physiotherapy and time would help her get over it. If it were for real caused by herpes zoster, then prednisolone and zovirax would be of great help. In all, physiotherapy with or without electrical stimulation would help, surgery has no plcae in its management and do not accept it.I hope this addresses your query fully. Thank you so much for patronizing our services and please do feel free to ask for follow up clarifications and information if need be. I wish you the best of health.Dr. Ditah, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does taking Cytotec orally/vaginally terminate pregnancy?\n\nhi iam pregnant 3-4 weeks now and abortion surgey where i live is not legal, i just took cytotec 200mcg now ( 3 tablets swallowing and 3 tablets i inserted them in my vagina and one tablet after 3o minutes , i want to know if iam on the right track and what should i do now ?",
    "doctor_response": "Yes, it does. In fact, this is the medicine my hospital uses for abortions. 300 in the vagina and by mouth is definitely a good place to start if you are trying to abort, which it sounds like you are. Take a second 300/300 dose tomorrow. You should start feeling a lot of cramps and bleeding within the next couple hours.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be concerned of Sudden sense of falling and spinning down while awake ?\n\nTwice today I have had a sudden and very strong sensation that I was falling and spinning down. My vision was also impaired momentarily. Within a few seconds I was fine, however there is this tinge of dizziness that has lingered all day. I ve had this sensation while dozing off before but never while awake. I m otherwise very healthy and take no meds or drink alcohol. Should I be concerned?",
    "doctor_response": "hi,Cactusblossom, Thanks for query, You have not mentioned your age, it may be due to, cervical spondilitis, high blood pressure, Some ENT problem. diabetes, If symptoms persists,consult doctor. ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of tingling sensation in the head?\n\nI am getting a tingling sensation in the top right side of my head, it only happens when IM laying down or waking up in the morning. I m now getting a fluttering feeling like a tapping on the back right side of my head. I no longer like having sex because after a orgasm it feels like someone is squeezing my brain. I made a appointment with my PCP because I m afraid I may have an aneurysm.",
    "doctor_response": "Hello!Welcome on HCM!Regarding your concern, I would explain that your symptoms seem to be related to tension type headache or post-coital headache. I recommend consulting with a neurologist for a careful physical check up. A brain MRI would help exclude possibel intracranial lesions that may mimic these symptoms. A close monitoring of your blood pressure values is also helpful to exclude possible blood pressure fluctuations, which can cause similar symptoms. Hope you will find this answer helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a bump under the tongue?\n\nin the last couple of days, one of my wisdom teeth has started pushing thru. I also have a case of acute bronchitis. being under the stress of this, I assumed the bump under my tongue was a \"lie bump\". I started looking online, and discovered you don't have tastebuds on the underside, so that couldn't be what it was. its very painful, so I've been putting oragel on it. I got a mirror, and started rubbing the gel on the little red dot, when it sort of like, uncurled, and sort of resembles a short, fat string, very pointy at the end. this thing is exactly where my tongue runs across my teeth when I cough from the bronchitis, so I thouggt maybe that was the cause, but the more I look online, I can't find anyone with the same problem. can anyone tell me what this could be?",
    "doctor_response": "Hello,  Read your query,  as you have bump under tongue this swelling can be inflammation of sublingual salivary gland , this inflamation can be due to bacterial or viral infection. For this you should consult oral surgeon and go for oral examination and investigations.  I will suggest you some self care remedies that you can do is maintain proper oral hygiene,  do luke warm saline gargle two - three times a day,  use sugar free lemon drops to increase the flow of saliva . Hope this will help you.   Regards,  Dr. Priyanka tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for severe thyroid fever in a child?\n\nSir, My Daughter , Yashi ( Age : 9yrs Wt: only 15Kg) she is having Typhoid from 25th July till date, before 9th aug she was having fever in every 5-6hrs, from 10th august she has fever at 3am on 10th , 11th and 12th August , we have given by the prescription of Doctor zifi-o 100mg (1 and 1/2 tablet twice a day) and Crocin till 11th but on 11th evening Doctor change the Anti-biotic to Azithral 200 liquid (7.5ml Twice a day) for next 5days . What to do I am worried about her health, we taking all cares about the eating habit and as well as all the test were taken from x-ray to MT and as well as of Malaria but only Widal Test comes +ve.",
    "doctor_response": "Hi             your concern is valid . If fever is not responding to oral antibiotics she needs a switch to parenteral antibiotics , also illness other than typhoid need to be ruled out.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes electric shock in brain and foggy head?\n\nHello, I have just been reading about the electric shock in the brain - mine occur in the morning and leave me feeling with a thick foggy head....I am not withdrawing from drug citilpram (not sure of the spelling. Its is very scary can you advise please",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern, looking to the history given here, as long as  your query is concern this is psychological condition a kind of hallucination, here as you red it and you start experiencing such feeling so this is the psychogenic phenomenon, do not think about this, hope this information helps you, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does Ormus C11 work in end stage renal disease patients?\n\nMy father who is 52 has had end-stage renal disease for 12 yrs and has been doing home dyalisis for the last 6 yrs. Someone told me to get him to start takeing ORMUS c-11 and gave us a few bottles of it. I have never heard of ORMUS before and was wondering if it would hurt him to take it since he does not urinate and wont be able to get it out of his system..Or will the dyalisis take care of this. And do you have any info on patients taking this?",
    "doctor_response": "helloThanks for query .Your father is a victim of Chronic Kidney disease (CKD) since 12 years and is been dialyzed at home since last 6 years .Chronic Kidney disease is  end stage disease characterized by inanability to regenerate the functioning unit of kidney called Nephrone .Hence there are no chances of recovery by any means .The ORMUS  C-11 is a mineral preparation containing 11 various essential minerals However  in  CKD already there is gross damage to the functioning unit of kidney hence any additional burden of minerals will make the situation more complicated .Hence I would suggest you to refrain from using these unscientific productsDr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long will coughs last after taking medication for walking pneumonia?\n\nmy son was diagnosed with walking pnemonia 10 days ago and has finished his meds.  I was wondering how long the cough would last.  Also, as he returns to school in this cold IL weather, should he have a preventative inhaler for the duration of the symptoms.",
    "doctor_response": "Sometimes the cough persists for few days even after the resolution of pneumonia and i usually advise my patients to continue with steam inhalation..If you have an allergic tendency and have prolonged cough and cold with seasonal changes in the past then inhaler therapy for 10- 15 days will definitely help..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I getting cracking sound in my joints?\n\nHi doctor, One year back, while sitting on a chair in office I felt as if my back got stuck and was unable to move. I took two painkillers and managed to sit there for a while, but after two to three hours the pain started radiating to leg. I was diagnosed with moderate disc herniation at L4-L5 and L5-S1. I was advised to take bed rest for three months and felt better after five months. Then I got some manipulation done with my lower back and my condition got worse. After that I had slight pain in my tail bone while walking and the pain got worse when I sit for five minutes. It got radiated to hips, thighs and it was worse when I stood up from a sitting position. Then I left with no option except bed rest for another four months that is a total nine months of bed rest.\u00a0After that I suddenly started walking two to three hours a day in a stretch and started doing some exercises. After few days of getting my body too much into motion I felt my upper back getting stuck and again was unable to move and the pain radiated to my wrist and hand. Then had bed rest for another 10 days and felt a bit better. But, still in pain and resumed with two to three hours of brisk walking and exercises. I noticed that many joints in my body were making cracking sound while I walk or move my body and they were continuous. They are not going away no matter how much I move that joint, the cracking sound will repeat infinite times whenever I move my body. The cracking sound is mostly from lower and upper back, shoulder, ankle, foot fingers, knees also make that cracking sound and it is painful as well. Cracking sound in knees are felt more when I start walking after being in rest state and frequency of cracking sound reduces after walking for two to three minutes. I got my ESR and CRP checked. They are normal, but there is a slight increase in lymphocytes and RBC. Now, I have been suffering from this continuous cracking sounds and pain in almost all my joints for more than a month now. I also suffer from severe pain in tail bone area. Also suffers from some sensation loss (not persistent) in left side of my upper left leg, pain in groin area (but not anymore), pain in lower back and upper back. Also a few days back a physiotherapist did some manipulation, which again increased my problem and after that when I wake up in morning both my hands are badly at asleep. Doctors say that discs are hydrated and it is rather some other thing w",
    "doctor_response": "Hello. I have gone through your reports (attachment removed to protect patient identity),\u00a0but you need to provide me the following details so that I can help you better. Revert back with the asked information to a family physician\u00a0online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does slightly dilated right ventricle mean?\n\nHi, may I answer your health queries right now ?  Please type your query here...son has been to doctor twice with chest pain.  had an echocardiogram yesterday and it show a slight dilated right ventricle or a murmur. what does this mean.  Go to see doctor tommorrow and talk about results",
    "doctor_response": "hi therethere are lot of things to explain in this but ill try to explain you in short so that you can understand. heart has two sides right and the left, right side of the heart recieves used blood that returns from the body parts and right ventricles pump this blood to lungs to supply it with oxygen again and to make it reusable to the tissues now this oxygenated blood is returned from the lungs to left heart which pumps it back to whole body. thats how circulatation is completed.now coming to your sons case, right ventricle (rv) can dilate due to various reasons and we summaries them in two scenarios Pressure and Volume Overload. pressure overload happens when there is some sort of resistance in the normal blood flow as some lung patholohy and volume overload is due to extra amount of blood entering the right side of the circulation from some abnormal pathway like some congenital heart defect or some valve incompetency of right heart.Your son had episodes of chest pain which is not a good sign, he probably needs a bilateral lower limb doppler to rule out any sort of blood clot which could have embolised from there to heart and lungs leading to pain and a dialted RV and murmur.Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in lower abdomen, occurring near appendicular area. Taking medication. Cause of concern?\n\nhello doctor.. day before yesterday i had lower abdomen pain.. and i went to doctor, they pressed that area and said it seems like appendicular area and gave me some pills for 3days. After that no pain for me, but i just want to conform that i have appendix or not. is this danger if i delay this. reply me soon. im afraid..",
    "doctor_response": "Hi. It depends whic pills they gave it to you. If are analgetics then I suggest you to stop taking them and see what happens. IF pain comes back then go to ER again. If you have antibiotics the drink them regularly. Usually when such patients come to my hospital we take blood test and we recommend that patient comes again for 24 hours to repeat those tests and see is there any progression of inflammatory markers.We dont give any pills... Some serious appednicitis infection usually develops through 5-7 days and symptoms are constant pain in right-lower abdomen with loss of apetite and nausea.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can I manage tan, dark, dry and itchy skin?\n\nHello doctor, I am 32 years old. My hands are very tan, dark, dry and itchy. I have this in the whole body. Please suggest me sunscreen for hands and to clear my dark skin as I am getting married in two months.",
    "doctor_response": "Hi. Tanning from sunlight needs few weeks to fade. People having type 4 skin produce more melanin on exposure to sunlight. Tanning is a kind of protection from sun so that we do not burn. To remove this sun tan, avoid further exposure to sunlight, use sunscreen with SPF 50 and Suncros tint sunscreen. Apply sunscreen 30 minutes before stepping out and repeat applying every 4 hours. Sunscreen provide protection for 3 to 4 hours. Hence, need to apply repeatedly. Use Kojic acid, Glycolic acid and Arbutin combination cream (it comes by name Demelan cream) for dark areas at night. Please attach your clinical picture along with your query, so that it is convenient for me to comment on your condition and give you appropriate suggestions. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicine for lump on the mouth caused due to bony projection of maxilla\n\nI have just had a CT scan for a lump in the roof of my mouth right upper jaw, report goes like this. Bony projection is seen rising from the inner aspect of the maxillary alveolar process adjacent to the right first molar and it is continuous with the cortex. It is keeping with a small osteoma. The maxillary teeth appear normal on this study. Incedentally there is prominent maxillary soft tissue thickening in keeping with sinonasal mucosal disease. I am 44 years of age and have no previous medical history in this area.",
    "doctor_response": "Thanks for your query, i have gone through your query.As such there is no medicines for the osteoma or lump secondary to bony growth. It has to be treated surgically. If you have pain then you can take pain killers like diclofenac. Get the osteoma removed surgically by consulting a oral and maxillofacial surgeon. Regarding the sinus problem, which is reported in CT you have to consult a ENT surgeon.I hope my answer will help you. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for asthma,COPD and emphysema\n\nI have asthma, copd and emphysema. I quit smoking six months ago and use electronic cigarette. I am 56 yrs old. Up until last week, no problems. Now wheezing and taste rust or metal when coughing. I called my Dr and they put me on a Z pack without seeing me  I don't feel like I must cough, but I wheeze and taste rust when clearing my throat ( or cough). No fever but very sleepy. Help",
    "doctor_response": "Hi, thank you for posting.I have gone through your query and I understand your concerns.Z-pack is an antibiotic medication and it is used in such cases. But to give a good effect it must be used along with Seretide inhaler and Aspirine Protect 100mg.You should use Z-pack only for 10 days. Seretide inhaler and Aspirine Protect 100 mg are used for a long time.By using this combination your symptoms are going to subside.Contact your doctor to discuss about this treatment.I hope my answer is helpful.Wish you good health.Dr. Behar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathing difficulty and swollen feet while suffering from diabetes?\n\nI am a diabetic and have been for years but for the past couple of months I have had trouble breathing and my legs are like concrete. They are swollen so are my feet and I have no ankle bones anymore that you can see. My feet are swollen also and it is hard to walk after a few hours. I do work on my feet for 8 hours a day.",
    "doctor_response": "Hello,If this is the swelling of the lower limb, then it could be due to a long-standing position that causes the return of blood difficulty it is the most common reason seen if the swelling subsides on its own in the morning.And if this is not the reason, then it could be the renal disease, cardiopulmonary disease, with diabetes such symptom of lower limb swelling need to be taken seriously, I would suggest to get done the test for renal disease and for cardiopulmonary disease.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Akhtarhusain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Had a miscarriage. Low progesterone. Is electrocution related to infertility?\n\nmy fiance thinks he cant have kids because he was electrocuted when he was 12, weve been trying for about 5 months and weve had nothing but what we believed was a very early miscarriage. i have one child already and while i was pregnant with him i had low progesterone, how could i safely increase my progesterone level on my own and do u think thats the issue",
    "doctor_response": "Hi,You have to take progesterone suppliment medicines available in market prescribed by your doctor for improving progesterone.Electrocution is in no way involved with infertility in him. Dont worry.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are ATA and EMA antibodies related to IVF?\n\nHi doctor we are a happily married couple for last 5 years and have been trying to conceive for last two years. We have now resorted to IVF and the doctor has put my wife on Wysolone as her ATA and AMA antibodies are very high (upto 8-10 times higher than normal limits). My internet research shows that there is no correlation between IVF success and ATAs / AMAs and that Wysolone taken over a long term could have significant side effects. request your suggestion / opinion. Regards",
    "doctor_response": "Hello, wysolone has a definite effect and will help in conceiving surelyIn case you have any questions in future you can contact me directly on",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. There is swelling, itching, and redness of face. Please help with treatment.\n\nHello doctor, I am a 20 year old female. There is swelling, redness, and itching on my face. Please help me with a treatment. This problem lasts so long, sometimes more than six months.",
    "doctor_response": "Hi. I have gone through your complaint and you seem to be having dermatitis. I would recommend you to apply topical steroid like Mometasone cream on the affected area twice daily for two weeks and take antihistaminic like tablet Levocetirizine 5 mg twice daily. Consult a specialist doctor, discuss with him or her and start taking the medicines with their consent. Also, use a soap-free cleanser for washing face, avoid sunlight, hot humid weather and stay in a cool airy environment. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pregnancy happen while on birth control pills?\n\ni was taking the carazette, and recently finished my packet, i got to the doctors too late so i had to wait a week to get my new packet, ive started taking the pill again and i'm on around day 6 but i did have unprotected sex.. on day 5 is there a chance i could be pregnant, i've been taking the carazette for 2 years now",
    "doctor_response": "Hi,    Thanks for the query.I understand your concern.  You were one week late in taking pills ( that means you started  between 7th to 12th day of menses.   During this period you had sex on 5th day which is notin f0ertile days... so you apperently do not hsve any risk if pregnancy (unless you had it again on 11th.. 12th or 13th day... for by this tinMe ovulation is expected within 3 days (and mature ovum is valid upto 3 days at the most).     * In spite of  scarce possibility of pregnancy... you would have deayed period this month due to late starting of pills.      In case of doubt.. you should exclude pregnancy   &   incase it runs +ve   you have to get it terminated (oral contraceptives taken during pregnancy cause congenital  fetal abnormality).     Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Panic attacks, difficulty in breathing after gamma knife surgery. Normal MRI, Ct scan. Opinion?\n\nMy mother is 72 yrs old.  she had gamma knife surgery  aug. 12.  since the surgery ,  she has been having panic attacks, feeling like she can't breath.  she also feeling like there's a problem with her heart.  she  has been in and out of the hospital .  they have done - MRI , CT SCANS and the works.  they can't find anything.  we're also to the point to belive it is all in her head.  HELP",
    "doctor_response": "Hi,Thank you for posting your query.Your mother's clinical symptoms are suggestive of panic attacks and anxiety neurosis.Her major investigations including MRI and CT scan of head, as well as other investigations are normal, which rules out any serious problem with the heart or brain.As of now, she needs a psychiatric evaluation.Starting her on anti-anxiety medication such as clonazepam would help.I hope it helps. Please get back if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden breathing difficulties and tremors?\n\nI had someone I know die recently.  Circumstances were very unusual.    He began to breathe so hard, all body and hands began to shake, and his lips were green.   He took some medicine and it subsided, but a few minutes later, it started again.  The ambulance was called, but the person died.  Judging from that, what would you say it was that could cause death so sudden?",
    "doctor_response": "Hi, I am sorry for the lost of your friend. There are various causes to his death; further details on his medical history are needed for a more specific opinion:- what chronic/acute illness he suffered?- was he on any meds? As he has taken some medicine and symptoms subsided, it means that he was taking those medicines on regular basisBreathing hard might be a sign of possible cardio-vascular event, which is commonly occurring in chronic patients taking antihypertensive medications. He was already having signs of being in difficulties, however, a complete judgement will be based on the requested data. All the best!Dr.Albana",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rashes all over body after intercourse?\n\nMy husband eats peanut butter daily and has started adding it to his protien shakes. I am 44 and have been allergic to peanuts since I was 19. I abstain from eating peanuts but lately have been breaking out in rashes that last weeks and usually right after sex. Can peanut allergan show up in semen?",
    "doctor_response": "It's not peanut allergy from semen.The place, clothing ,bed-sheets etc.  at the site of sex need to be evaluated as potential allergens.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tumor\n\nDear Dr.Vineet, This query is regards your old patient Mrs.Gayatree Panda ,59 years ,who was diagnosed with CA Ovary stage III in Apollo ,HYd.She underwent cytoreductive surgery at RGCI on 5.5.08.HPE showed residual disease present,ascetic fluid positive.She was NED till march 2009 when she had inguinal lymph node enlargement FNAC positive CA 125-195 u/ml. Then inguinal lymph node dissection in mar 09.then 3 chemo cycles Gem+Carbo from 23.5.09-response ca 125-17 u/ml.then 3 more cycle chemo given till 3.11.09. presently (10/6/2010)again CA 125 gone up to 170.4 u/ml .RBC 11,Platelate 146000,TLC 6500,RBS101 mg/dl,CECT whole abdomen(8.6.10) Progressive disease by Recist criteria.The report says-There is ascites with 8mm size subhepatic peritoneal nodule. A 24x 20mm cystic space occupying lesion in left subphrenic region .rest unremarkable.We want to know after all these treatments why is coming back again and what is the next path forward? What options we have.",
    "doctor_response": "Respected user, hiI evaluated your query thoroughly.This is microscopic dissemination  of the tumor cells giving this assembly of symptomsReason may be treatment refractiveness or emerging  of other virulent  micro-organisms Next path should be conservative treatment planning in form of evaluation   of the current status clinically as well as Ultrasound , Laboratory test of  ascites Hope this clears your query.Thanks regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rashes on legs and hands?\n\nhello doctor, i dont know what kind of rashes i have if there a threat or not but they started on my feet and burn specially when i put on my socks,these rashes do not itch only burn, well they are starting to come out in my legs and have already came out in my chest and a little bit on my hands, dont know if its allergy to medicine or something i ate idk, what do you think it could be i can post pics if youd like?",
    "doctor_response": "HelloThank You for contacting HCM.I would be in a better position to suggest after seeing the picture of rash & also do mention your age. It could be due to allergic response from socks as you said they occur after you wear them. You might be allergic to that socks fabric. Try to change the fabric and then observe.Do you observe any other symptom besides rash? I mean fever, sore throat, breathing difficulty or visual problem?Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for rice like bites\n\nHi today I found rice-like bits in my 20 months old son, they are not moving and they are wider and shorter that pin worms. He hasn t been eating well in the last couple of days, but I thought May be it s the heat as he will drink lots any agrees to eat juicy fruits, he is diagnosed with toddlers diharria so his stool is soft and watery most of the time,",
    "doctor_response": "Thanks for posting your query at HealthCareMagic. Toddler's diarrhoea is a common cause of chronic (persistent) nonspecific diarrhoea affecting children between the ages of 1 and 5 years. Toddler's diarrhoea is not serious and the child is well and resolves eventually as the age progresses. You can often see bits of vegetable food in the stools (such as bits of undigested rice, carrot, sweetcorn, etc). These have come from a recent meal. Toddler's diarrhoea is not due to malabsorption (poor absorption) of food or to a serious bowel problem. It is also not due to an intolerance of a type of food.Do not give children too much fruit juice or squash. If you do give your child squash or juice, make sure that it is very well diluted. Changing the fibre content of the diet may be helpful, as very low- or high-fibre intakes may make symptoms worse in some children. Fibre (roughage) is the part of plant food that is not digested. It stays in the gut and is passed in the stools (faeces). Fibre is present in many foods, in particular in fruit, wholemeal bread and vegetables. So, if your child has a low-fibre diet, it may help to increase the fibre in the diet to normal levels. This is simply achieved by eating a healthy balanced diet that includes some fruit and vegetables.Hope that will take care of your problem. Feel free to communicate back in case of further queries if any.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it advisable to stop antidepressants on own?\n\nHello doctor, I was diagnosed with anxiety and depression because of work-related issues before two years. Then I was prescribed with Deanxit 10 mg one every day till last month. Now I am trying to withdraw by reducing the dose over a month time, taking one tablet for every two days for two weeks, then half medicine every two days for two weeks. Before this, I tried to withdraw two times under the doctor's supervision. But both times I failed to be able to withdraw as both times, more likely my withdrawal symptoms got severe in three weeks and it was difficult to manage, so put back again on medication. Now I am in a stress-free environment and I hope withdrawal symptoms should be less severe and I might be able to withdraw. If in case, it is going to happen like the previous times causing severe symptoms, what should I do in that case? Is it fine that my method of withdrawal reducing the dose as mentioned above is good enough?",
    "doctor_response": "Hi. If psychologically you are feeling stable for at least six months to a year, then you can try to cut down medication gradually. You can try tapering off the medication over a longer period of time to minimize the chances of withdrawal symptoms. For example, try taking half the dose for one day and full the next day alternately for two weeks. If you are not experiencing any withdrawal symptoms, then reduce the drug to half and take it daily for the next two weeks. If you are not experiencing any withdrawal symptoms, then take half-tablet on alternate days for further two weeks. You may stop the medication provided you are comfortable. This is a rough guide. At any stage, if you develop withdrawal symptoms, step up to the previous dose for a longer period and then try again. Sometimes it may take a few months to completely withdraw the medication. I have to say that Deanxit is not the first line medication indicated for anxiety and depression. It is no longer used in many countries due to difficulties in withdrawal and side effects. I will recommend visiting a doctor locally as well to monitor and support you during the withdrawal period. Also, use psychological strategies to prevent any relapse in mood and anxiety symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest life expectancy of a patient with bowel cancer\n\nmy husband has recently been diagnosed with bowel cancer, following an mri scan we were told that it has pread to both parts of the liver. We have been told that it is inoperable and he is due to start chemotherapy next week, 8 and a half weeks from initailly being told that he had a cancerous growth in his bowel. We have been given no prognosis, we were told that is not possible until his next ct scan after 3 months (4 cycles) of chemotherapy. Iamhaving a really hard time dealing with all the uncertainty and no matter how dire your answer I feel that I, at least, need a guideline as to what my husband s life expectancy may be? He is 53 years old around 20 stone in weight and is 6 foot 2 inches tall. No previous history of cancer",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. He has colon cancer with metastasis in liver.  So it is already in stage 4 where surgery is not possible.  Only treatment of choice is chemotherapy.  And despite of treatment prognosis is very poor.  Sorry to say but his life expectancy is not good.  So consult your doctor and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for loose stools in infants\n\nHi Doctor, My Son is 1 year 11 month.. he is passing frequent loose stool & with slight blood. My physician suggested earlier for Zincorim Syrup (2.5ml) & Enterogeimine (oral solution). But it is not working. I am afraid if he is having some sort of severe stomach infection. Please help",
    "doctor_response": "Mostly infections by bacteria may lead to blood with or without mucus in the stools. lf your baby is also having fever, you need to consult your pediatrition so that he may prescribe some antibiotic. Zinc is good for controlling long term diarrhoea and the probiotic you mentioned is also good. keep hydration of the baby good and consult your pediatririon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in upper back near my right shoulder?\n\nI have pain in my upper back near my right shoulder blade, and it hurts worse when I need to burp. What could this be? I have already had my gallbladder out so I know it isn t gallstones, but the pain is similar to the pain I had associated with a gallbladder attack.",
    "doctor_response": "Hello, It is not a gall bladder effect. This is due to Trapezitis. The Trapezius muscle is inflammed and needs to be treated separately. With hot water fermentation, gentle kneading massage, myofascial release and IASTM you should feel relaxed. Also, neck stabilization exercise, shoulder stabilization exercises and inter-scapular muscle strengthening exercises are advised. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My mother is suffering from severe back pain and upper foot pain. Please advice.\n\nHello doctor, My mother has pain in lower back joints, and upper foot, earlier she has felt current in the left arm. Pain is severe. Please suggest medicine. MRI reports show nerve root pressing. She used to take calcium 500 mg. Should she continue calcium?",
    "doctor_response": "Hello. After taking a look at the MRI reports that you have posted (attachment removed to protect patient identity) it looks like your mother has moderate arthritis in her cervical spine and lumbar spine, which is starting to cause nerve compression. Ibuprofen 600 mg and Baclofen 10 mg, once in the morning and once in the evening is the typical initial starting point to help with some of the symptoms. This will provide short-term management of her condition. Typically that is recommended for about four to six weeks. Once she starts that regiment, she should also start physiotherapy. That will begin to properly rehabilitate the spine and allow for proper motion to occur. Physiotherapy is typically recommended at a frequency of three times a week for six weeks. And it is then reducing the frequency for two times a week for another four weeks. Prognosis varies depending on other comorbidities and how well your mother tolerates treatment. If we are looking at a co-treatment, she should also do a low sugar and low carbohydrate diet. And a menu filled with good protein and vegetables. If she is overweight, she should lose some weight. All of what I have mentioned the need to be done with patience, consistency, and monitoring from a health professional. Proper rehabilitation can take up to six months and can vary from patient to patient.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe pains in spinal cord. Pricking sensation, numbness. What is the treatment get relief from this pain?\n\nI suffer from Spinal problem with severe pricking, stitching pains running from the top of my spinal cord at the neck down to the tips of my toes. Esepecially on the left side just where the Kidneys are there is severe pains on the left side of spine and when I sit or stand for long thee is a numb but deep pain from the left side of my hip to the knee . There ae pricking pains especially on both big toes. There is also numbness as if cells and muscles are dying. I had lifted a very heavy girl and played with her about 14years ago and the pains started then. I have been to several Physyiotheripist Consultant doctors, all they give are painkillers, tractions, and lights treatment, which has not done any good. In fact the pains are moving upwards to the nape of my neck and the shoulders and below the shoulders at the back. Doctors are advising surgery, but I am afraid of landing in a wheelchair or bed ridden if something goes wrong. Doctors say that screws and other item will be inserted and I am not in favour of any part of my body being screwed and whatever. WHAT IS YOUR DIAGNOSIS ON MY SPINAL PROBLEM AND CAN YOU GIVE ANY ADVISE TO RELIEVE THE PAINS WITH EXERCISES?",
    "doctor_response": "Hello, Thanks for posting your query You might be suffering from PIVD. Due to disc bulge , pressure occurs  over nerves & this may cause pain & numbness over big toes. You may require a MRI to confirm the diagnosis & to know how much pressure occurs over nerves due to disc bulge and at which level. You may require surgery if pressure is more , but don,t affraid of surgery. With physiotherpy. spinal extension exercises. avoid forward bending &prolonged sitting ,pressure over nerve can be reduced & symptoms can be relieved. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Got rash like mosquito bites over full body, itchy, reappearing after shower. What are these?\n\ni have been getting mosquito like bites after i shower. Usually around my stomach , behind my knees, inner thigh, around the buttock and sometimes in the underarm area. These mosquito like bumps to itch and are only visible for about an hour. Then they dissapper and reappear after i shower. please help, getting concerned.",
    "doctor_response": "Hello and welcome to HCM. Thanks for your query. According to your description you could have the following: -an allergic reaction to some thing you come in contact with  (accessory) during your shower -Scabies (itch mite) requiring a visit to a dermatologist (but does not dissappear) -A rash which is a symptom of some other underlying infection (requires examination of the type of rash by a doctor) Either way please visit a doctor at the earliest for proper examination, diagnosis and treatment of your condition. Feel free to write back to us for any further clarifications. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat my son s gas and stomach pain?\n\nMy son is 4years old, for the past 4 dayshe has been burping andpassing gas all day long. His feces are big and extra long, he does go to the bathroom everyday. Sometimes he says his stomach hurts. Is this normal should I take him to the dr right away?",
    "doctor_response": "Hi, welcome to healthcare magic. Gas formation in a child is most often related to indigestion usually of fats and protein. Please avoid extra fatty diet and diet which is rich in protein. Also, don't give bakery items like cakes and breads. Give him lots of water to drink and fruits to eat especially banana. Also, give him tablet lansoprazole 15mg once a day in the morning empty stomach. Observe your child for two to three days. If, the problem does not resolves, please show the child to a paediatrician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the treatment for thinning of hair?\n\nHello doctor, My hair is becoming very thin. Kindly advice.",
    "doctor_response": "Hello. May I know your age, and since how many months are you experiencing thinning of hair? Please send the pictures of the scalp.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On depo shot and pills. Started spotting and cramps. Taking vitamin pills. Is this the side effect of birth control?\n\ni ve been on the depo shot for 6 months and on the pills for 3 months after starting the shot in december i started seeing this dark brown color and sometimes i d cramp a lil and bleed or have spotting alot with the dark brown color. I ve been getting tested while this has been going on and don t have any signs of a trasnmitted disease. I also had to start taking vitamin pills last month because my vitamin level was off and wanted to know if these are effects from being on birth control",
    "doctor_response": "Hello mam, thanks for trusting health care magic. In my opinion do a urine pregnancy test which if negative get a pelvic ultrasonography and b HCG testing because it can be an early pregnancy or worse ectopic tubal pregnancy and then visit a gynecologist with reportsIn case you have further questions you can consult me on health care magic forum and i will be happy to helpTake care and wish you all the best.Dr Manisha Jain. Take care and wish you all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of yellow fever vaccine and meningococcal vaccine?\n\nmy baby got yellow fever vaccine and meningococcal vaccine four days ago,he seemed fine but lam scared to death after reading the side effect of both vaccine, he is four yrs old, please tell me what should l watch for and how long inorder to know the vaccine is no gonna harm him.",
    "doctor_response": "Hi,Both these are commonly used vaccines in children and any significant side effect is very uncommon. All possible side effects are listed only to be aware of, and you need not worry. This is like saying there is risk of accident while driving- there is risk but that do happen only occasionally.Most of the children do not experience any side effect other than some fever, soreness at the site, and sometimes a transient rash. As it is already 4 days post vaccination, chance of any major side effect like allergy or anaphylaxis is out. Just be confident. Nothing will happenTake care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam T. K., Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for back & joints pain in elderly heart patientes\n\nDear sir, I am of 70 years old and have undergone an open heart surgery about 8 months ago. My doctor s advice is to keep walking for 2-3 hours daily in order to keep cholesterol level in control.But due to pain in the lower portion of my back( spinal cord ) and right leg s hip joint pain,I am unable to do so.Pain killing pills,OH,fed off .what should I do now?",
    "doctor_response": "Hello,If your physical activity is limited, the best thing to do is to have other types of physical activities (swimming) and try to maintain a  normal weight by following a healthy diet (Mediterranean diet is helpful, and low cholesterol diet).Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in eye,eye brow and head along with neck stiffness?\n\nfor a few days I ve had pain in my left eye the eyebrow and left cheek but the pain also goes up into my head and it feels like the bones in my head are pushing against each other, and the left side of my neck is sort of stiff - I m not usually ill and this bothers me a lot. Thanks.",
    "doctor_response": "I believe that a neurological examination by a qualified neurologist is in your best interest.  Although it is a very low likely possibility something such as a meningitic process may be a consideration for the symptoms you present.  On the other hand you may also have some type of obstructive process of the sinus drainage system on the left side that could be producing unilateral symptoms.  A set of frontal facial or SINUS films (CT SCAN) should easily show any type of congestive or infectious process.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I switch BC pills straight away or should I use protection fir one week?\n\nUsed to bebon microgynon pill which was great got put on cerezette due to having a baby and breadtfeeding. Have now stopped breastfeeding and want to go back to microgynon due to irregular bleeding. Can I switch back straightaway as my last cerezette pill is tonight can I take microgynon tomorro night. And will I have to use extra protrction for 7 days? Please help x",
    "doctor_response": "Hi, Welcome to Health care magic forum.                      As you describe you can start mycrogynon,after finishing the cerazette. You can use extra precaution for protection.                        You told you are using mycrogynon for irregular periods,the reasons for that may be anemia,and infection as well.                        I advise you to consult a gynecologist for diagnosis and treatment.                         I usually prescribe to my patient with such symptoms fluconazole,cifixime,ornidazole, and hematinics.                       Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can a diabetic patient consume barnyard millet?\n\nHello doctor, Is barnyard millet good for a diabetic patient? My mother has fibroids in the uterus of 18 cm, does it impact the rise in diabetes in any case? Her current diabetes is 340 fasting. Please guide.",
    "doctor_response": "Hello. Samak rice (barnyard millet) is good for everyone, more so for a diabetic person as it provides a good deal of fibers, multiple nutrients, and enough calories too. Instead of regular rice, this can be substituted. The presence of fibroids in the uterus has no direct impact on either precipitating or increasing diabetes. Fibroids can cause problems related to the uterus itself. If there are many and fairly big ones, better to get a hysterectomy (removal of the uterus) done. The best judge for this is your gynecologist who can assess the situation better. Follow that advice. As regards blood glucose control, ideally fasting glucose should be less than 100 mg or closer to 100 mg, PP 150 to 170 mg and HbA1c % less than 6.8 %. Maintaining good glucose control prevents the possibility of developing long term complications related to diabetes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cough with phlegm after a gall bladder removal surgery?\n\nI had gallbladder removal surgery Thursday. While I was in the hospital on iv antibiotics, I did not have a cough. Now that I'm home, I have a cough that is bringing up some phlegm. I don't know if this is likely a result of the surgery, or an unfortunate coincidence. I did have a sinus infection treated a couple of weeks before the surgery and that seemed to have cleared up.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. It may be hospital pneumonia and you should do x-rays to rule it out. It can or may not be related to such surgical procedure but in every case it should be evaluated since antibiotics may be required for pneumonia to prevent serious consequences.Hope I have answered you query. If you have any further questions you can contact us in every time.Wish you a good health.Regards,Dr. Ivan R. Rommstein",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest ways to terminate pregnancy\n\nDear doctor I want to do abortion. I have done a sonography, according to the results I m 4 weeks pregnant. the doctor said because you came soon, nothing can be seen in your sonography results. she said me do another sonography in next 10 days. then I can use cytotec pills. I just wondering can this postpone make the abortion be failed? which week is the best time for using this pills? best regards azad",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.1] Please follow the rules of the land where you stay, for the abortion process. 2] termination with pills is safe till 9 weeks of pregnancy, get it done only under medical supervision.3] It involves, Tab MIFEGEST 200mg followed by Tab MISOPROST 800mcg 48 hours later; also an appropriate dose of antibiotics is advisable.I hope my answer helps you.Thanks.Wish you great health.Dr Purushottam",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in forearm?\n\nI have pain in my forearm when straightening and also when leaning on it, for example now while typing it hurts. The most pain is when I try to straighten though. I haven t been doing anything out of the ordinary lately and this has been ongoing for over 1 week now and appears to be getting worse.",
    "doctor_response": "Hello, What it appears to me is that you are a professional typewriter or maybe your job demands typing work a lot. This kind of pain arises due to overuse of the Forearm muscle for typing and which leads to fatigue. There may be even a chance of the nerve entrapment in the cervical region due to which the possible ability of the muscle reduces and fatigue sets in faster. But we can only confirm this with physical examination and if required an MRI scan. You try some Basic forearm muscle strengthening exercises and also some stretching exercises of the Forearm muscles to overall improve the functionality of the muscles. Rest assured, you will be fine if you follow these guidelines in about 2-3 weeks of time. Please note that if your job demands more of the physical work with a keyboard then follow these exercises regularly to avoid future injuries. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sharp hip pain while playing basketball\n\nI was playing basketball this morning and while dribbling up the court, I felt a sort of sharp pain on my hip area. Felt sort of like a strained muscle. It is very sore to get up and down steps or in and out of a chair. Do you think this is a simple muscle strain?",
    "doctor_response": "Hi, It could be a simple musculoskeletal pain. You can try simple analgesics like Acetaminophen or Tramadol for pain relief. Take good bed rest for a couple days. Generally, you will be fine in two days and if the symptoms persist, you can consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should morning after pill be taken after unprotected sex while on Ginette?\n\nAfter i was diagnosed with Polycyst Ovarian disease my gynae recommended that i start using Ginette 35, i don really have acne problems. I had unprotected sex on day 15 after the first day of my menstruation on the first cycle, can i fall pregnant? Do i have to take Morning after pill if i have unprotected sex during my supossed ovulation days when i m still using Ginette 35?",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic.I have gone through your query. I think I have understood your concern, I will try to suggest you the best possible treatment options.1)First of all do not panic.2)If you have started on Ginette35 from day 2 of the cycle then you are already well protected with contraceptive effect of the pills.so there is no need to use additional emergency contraceptive pill like PLAN B or i pill.3) Keep taking your pills regularly. Usually periods start within 3 to 7 days of stopping the pills- i.e. finishing the 21st pill.I hope my answer helps you.Thanks.Wish you good health.With regardsDr Purushottam Neurgaonkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest solutions to the side effects of concerta\n\nWhat are some possible to solutions to the side effects of Concerta? I currently suffer from acute paranoia, loss of appetite, and just overall distance. I have become very unsocial and it is only when I am on Concerta. Most days it ends up with me just sitting in my basement staring at a screen or a wall. Any ideas?",
    "doctor_response": "Hello, It is unlikely related to concorta. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore throat and headache in a 12 year old?\n\nMy 12 year old daughter had an instance last week where she said it felt like her head had fallen asleep and it was tingly. What could this be. It only happened once, but she has had headaches and sore throat without cough. Dr. had her taking aeruis but we know of no allergies at this point.",
    "doctor_response": "Hello. I just read through your question. Headache and sore throat most often appear when there is.a throat infection. This needs to be treated with antibioyics. I recommend consulting with your doctor and discussing this possibility.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Irregular periods, severe hair fall. Trying to conceive. USG shows bulky ovary. Treatment to get pregnant?\n\nhi doc.. i am 33 years old female my height is 4''5' and weight is 58.....my problem is irregular periods and sever hair fall....for which i have been suggested usg lower abdomen...........and it shows my overy is bulky ..right overy measures 16cc and left overy 17cc.......i am not under any medication till now....this problem has started long back12 years ago................i am married for 4 years ...now i want to become pregnant...i want to know what r my chances and what medications should i take to get pregnant soon....my last period was 12days back...but it was scanty.",
    "doctor_response": "Hi,Thank you for choosing Healthcaremagic. Your irregular periods needs to be evaluated, you need some basic investigations like thyroid function, Follicular Stimulating Hormone and Leutinizing hormone FSH: LH ratio, prolactin level and random blood sugar levels. Husband semen analysis is very important. As your married life is 4 years, you need urgent evaluation. I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow-ups. If you like my answers kindly rate it, and write a review as well. Please do not forget to accept it.Thank you,Wish you good health.Regards,Dr ArifYou can consult me again directly through my profile",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the problem in getting pregnant?\n\nHi, I am 28 yrs old Female. I have no major health problem.I got married 3 yrs back. I have had 2 abortions, one after 6 months(in Nov 2007) and another one after another 10 more months(in Sept 2008).I do not take any contraceptive pills. We are only going for external contraception.Now we are planning to have a baby, and we have been off contraception since last 4 months and still we haven't got positive results.Do you think that previous 2 abortions could have affected my fertility?What measures do you suggest to take before getting pregnant?Also, what all should I have to have a healthy baby whenever I become pregnant?",
    "doctor_response": "Hi,   Thanks for the query. I understand your concern.    Were you using contraception for all of these 8-9 years? If not you should go for investigations like-     - Excluding any infection of genital tract.& get  serological tests for STDs      - Ovulation study to confirm normal ovulating cycles.     - Semen analysis to confirm normality,     - Tubal patency test.    * In case of any problem detected- take complete treatment to get rid of it.    * both of you need to be free from any illness for at least 3 months before conception. Take folic acid 5 mg daily/ Vitamin E 200 mg daily( both of you )for three months.    * try unprotected sex on your most fertile days ( around ovulation day )    * consult a gynecologist earliest after confirming pregnancy ( inform about 2 incidences )- for hormone supplement & cervical suturing as per need.    **  If no conception within 1 year.. go for assisted pregnancy with help of  infertility doctor,   Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen feet?\n\nexactly on this date june 3rd my feet swelled not, excessively so but swelled anyways. am not a candy or a sugar eater ever now and then. my legs feels a bit funnny the bottoms of my feet feels a tad funny. am very anxious to get some clue as to why this is happen to me all of a sudden. am not, over weght i don,t drink nor smoke nor do i do drugs can you give me a hint a clue please. constance",
    "doctor_response": "hi constanceYou need x rays of feet to determine any arches defect or bony malalignments present since long, and producing symptoms now.Consult an orthopedic doctor.Aslo medical causes,vascular causes have to be ruled out.Commonly, it is gravitational oedema.try to raise feet on a stool while sitting, dont stand long or walk much, use loose footwear, do contrast bath of feet (alternate dipping in hot and cold water), seek help of a physical therapist alsobest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause headaches,hives,itching and constant urination?\n\nThis summer I had a 14x7 kidney stone removed. One month after that I formed three more kidney stones, labs and blood work r all normal. Now one of my kidney stones is 1cm and I have 5 more. They can't figure out why. I have headaches, hives, itch, urinate constently, tired, and I take flow Max to urinate.",
    "doctor_response": "It looks like you need a detailed workup. This should be ideally done after all your kidney stones are removed. The workup should have a test for parathyroid hormone if there is elevation if your blood calcium levels and some patients will benefit from getting a full metabolic work like a 24hour urine estimation for calcium, oxalate, citrate, creayine, uric acid and others. Once we have an idea what is the cause, the actual treatment for prevention of stones can be done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are eosinophil -544 and AST- 33 counts can cause concern?\n\nMy 9 year old grandson who has a history of asthma but has not been on any medication nor had a reaction in at least 3 months had Eosinophils,absolute of 544 and AST of 33.  doctor didn't seem at all concerned.  Should there be any follow up or need for concern?",
    "doctor_response": "Hi,you have eosinophilia. When absolute eosinophil count goes above 400. It is called eosinophilia. many causes are there and one of that is allergic reaction or asthma. here in your condition you ate dignosed case if asthma.  So it is obvious that your eosinophil count will remains high. Till you have ni difficulties in breathing or dont have any other problem high eosinophil count is ok.no need to concerns for that only. If you ever have any other problems consult your doctor immediately and  take treatment accordingly. .thanks for using health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the precautions to be taken after dog bite?\n\nhello sir....two days ago, i got a light nail scratch by a dog in my left hand, n little blood came out. I washed that place with water. n Dr. gave me Tetanus injection as well as RABIPUR injection. please suggest me sir....what shall be my other precautions...!!thanks..!!!!",
    "doctor_response": "Hello,Welcome to HCM,Rabies is a disease transmitted by dog bite which is 100% fatal but it is 100% preventable by proper and adequate treatment.As you were nail scratched by a dog on your left hand which has led to bleeding from that site and you have properly washed the wound with water and taken a shot of Inj TT, according to WHO it is categorized into Cat III which requires following treatment.1.Active immunization with antirabies vaccine on days 0,3,7,14 and 28.2.Passive immunization with RIGs around the wound.3.Oral antibiotic like Tab Augmentin, twice daily4.Topical T-Bact ointment.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having pain in the left side of my chest. Diagnosed negative in heart check. Urine, and liver test done. What is the problem and treatment?\n\nI am a 25 years old 85 kgs weight 5\u2019 6\u2019\u2019 of height male having pains on left chest since last 8 months went to consult a doctor suspecting cardiac problems. But after comprehensive heart check ups it revealed that no problems are associated with heart. Uric acid raised abnormal studies have been found on liver problems.CAN I TAKE THE FOLLOWING MEDICINES?1). Metadoxil (500 mg) - 1 tab twice after food 2). Librium (10 mg) - 1 tab thrice after food 3). Nexito Forte - 1/2 tab before food 4). PAN-D - 1 tab before b/fast 5) URICOSTAT 40 MG- ONE TAB ON 9.00PM.FOLLOWING STUDIES HAVE COME OUT BY DIAGONOSIS.Weight-85 kgsHeight- 5\u2019 6\u2019S. Tryglycerides(wet chem.)-155Uric acid-9.4S TOTAL BILIRUBIN: 2.90 MG/DL S DIRECT BILIRUBIN: 0.55 MG/DL S INDIRECT BILIRUBIN: 1 MG/DL S TOTAL PROTIEN: 8.4 Gm/dlS ALBUMIN : 4.5 S GLOBULIN 3.9 S A/G RATIO: 1:2:1 SGOT 109 IU/L SGPT: 198 IU/L S ALKALINE PHOSPATE: 141 SGGT : 136",
    "doctor_response": "Hi! Thanks for your query. Firstly let us know why are you on so many drugs. I would suggest see a Gastroenterologist and let him treat you.That should solve your problem and he can advice you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in shoulder blade close to spine\n\nWoke up this morning with a very sore neck but mostly the pain is in my right shoulder blade close to my spine. Didn t do anything physical to cause injury but every time I try to lift my head my neck can t seem to support it. Also when I take a deep breath I feel a popping at the top of my spine/bottom of my neck.",
    "doctor_response": "you have muscle spasm in neck. take muscle ralaxent myospas d one tab two times for 5 day. avoid sudden neck turning.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with hepatospeenomegaly & hypochromic anamia with neutrophilia\n\nhi doc my 3 yr daughter had a fever to rule out dengue her doc advise us to do ultrasound in that she was diagnosed with mild hepatospeenomegaly. her hb was 9  and has microcytic hypochromic anaemia with neutrophilia. she is 11kg and 91cm . she has very low immunity and fall sick every 15 days or so . she has also mild ricket trouble. her appetide is very less its very difficult to feed her but likes to take milk.she also have a severe broncities/asthma trouble and we are giving her singulair 4mg.pls asvise me what to do with her so that her immunity can increase.",
    "doctor_response": "Thanks for your question on Health Care Magic.I can understand your concern. Hepatosplenomegaly and anemia in children need further investigations to search for the cause. Possibility of malnutrition, malabsorption, thalassemia, sickle cell anemia etc is more. And in a these immunity is low. So better to get done reports to rule out above mentioned causes. Continue singular fir asthma. Singular is safe for long term use in pediatric patients. Give her green leafy vegetables, fruits rich in vitamin C (orange, grapes, strawberries etc), high protein diet (pulses, protein powder) etc for good immunity. Do her vaccination timely. Hope I have solved your query.I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes warm sensation on the thigh?\n\nI am a 26 year old female. For the past week I ve been getting a warm sensation on my left upper thigh which lasts maybe 30 seconds and then goes away. This happens a few times throughout the day. It doesn t hurt, burn or tingle it just gets warm. It feels like my dog peed on my lap and you feel warmness all of a sudden and get caught off guard. Any ideas?",
    "doctor_response": "Hello, Your symptoms seem to be related to muscle spasms. I suggest using anti-inflammatory cream such as Voltaren gel to relieve the warm sensation. There is nothing to be worried about. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will EGD with biopsy also check for lymphoma?\n\nMy brother has been treated for sarcoidosis for 18 mos and it is not being helped by steroids. He recently went on methyltrexate. He has 3 lymph nodes in his chest that have tripled in size recently.. He is going to have an EGD W/BIOPSY. Would they be checking for lymphoma?",
    "doctor_response": "Thanks for your question on HCM.In my opinion following are the possibilities in your brother's case.1. Tuberculosis2. Malignant hilar lymphnode3. Lymphoma4. Fungal infection like toxoplasma. Etc.Since he is not improving with steroids,possibility of above mentioned causes is high.To rule out all these tissue material is needed.And for this bronchoscopic ultrasound guided biopsy is needed.It is done through EBUS (Endobronchial Ultrasound).In this FNAC is taken under vision. So yield from the sample is high.So they are doing this to rule out other above mentioned possibilities including lymphoma.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can pain and excess urine pressure be due to urine infection?\n\nHi doctor, My wife is 32 years old. The problem from last three days is that my wife feels excess urine pressure and also a heavy pain in her urinal parts constantly.",
    "doctor_response": "Hi. It could be a number of things. Urinary tract infection can present like that hence you need exclude this first. Is there any chance of pregnancy as earliest pregnancy signs can be similar to what she has been feeling. If not pregnant, then perhaps, she is nearing the time of her menses as that could feel like pressure and pain down there. If none of the above, then you could get an ultrasound of lower abdomen done to rule out cysts. Please get the following investigations done and update me so that we can proceed with treatment. Infection, pregnancy, fibroid. Usg of lower abdomen, urine routine, and microscopic examination, urine strip test for pregnancy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for itchy rashes and bumps\n\nMy boyfriend has very itchy skin and has developed rashes and red bumps on his body in different areas. It started in his elbows. He refuses to go to a doctor to get it checked out and I'm afraid whatever it is is contagious! We have a dog so I wonder if it's something she brought in. But I just had a bump between my toes and itched it and it popped and I am now I'm excruciating pain and there is a red spot there now. I don't know if the two are connected but am wondering of it is a fungal thing or some sort of bug. How can the doctor even know?",
    "doctor_response": "Hi, The rash could be Human scabies or Animal scabies. Scabies is associated with itching which is severe at night. The method of treatment is more important than the drug itself in management of scabies. So, I recommend you to consult your Dermatologist for confirmation of Diagnosis and for initiation of treatment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Siva Subramanian, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat RBC shrinkage mediated anemia?\n\nyes my name billie lively and my dr said my red blood cells were small, which is an anemia disorder but I do not know what kind of anemia I have.........my new blood work shows that im not anemic anymore but my red blood cells are still small and so I was told to continue my iron medication........what does this mean?",
    "doctor_response": "Hello billie welcome and thanx to choose health care magic for discussion of your problem.First i want to tell you that no need to worry for this problem.In medical terminology we called it microcytic red blood cell.As you told that your new blood work is not showing any anemia its mean that your blood picture is improved than earlier.Now you should continue iron therapy to restore  your iron storage of body and repeat blood investigation after one month  including peripheral blood film for anemia.its because after taking iron our blood picture improve but body requires more iron to make storage of iron  as previously.whenever any doubt arise in mind you can ask anytime.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is consumption of milk safe while on Pantocid Hp and VSL#3?\n\nI am taking Pantocid HP and VSL#3 tablets from last 5 days according to doctor prescription. He has advised to take for 14 days. My questions are 1. Is it ok to take 2 cup of milk everyday during the course. 2. What if the H Pylori is found still after finishing the course.",
    "doctor_response": "Hi & Welcome.Yes, you can consume milk while on Pantocid HP & VSL#3.Pantocid HP kit contains Pantoprazole, Amoxycillin, & Clarithromycin. The first one suppresses the stomach acid production & the later two would kill an bacteria H. pylori that is responsible for gastritis & peptic ulcer disease.These medications are usually effective, safe and promote eradication of the H. pylori infection and also promote the healing of the ulcer.VSL#3 is a potent 'Probiotic' that delivers the beneficial live bacteria combat the antibiotic associated diarrhea.1. It's OK to consume milk but see that the Pantocid HP Kit is taken on an empty stomach preferably one hour before the breakfast so as to ensure its adequate absorption from the stomach.2. If H. pylori is still found after finishing the course of the Kit, it could be due to bacterial resistance to the Kit. In that case you may consult your treating physician for 'Quadruple therapy' which includes addition of Bismuth subasalicylate along with Pantocid HP for 2-4 weeks.Hope I could answer your query.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause swelling on arm?\n\nI may have been bit by a spider. May arm above my elbow is swollen. There are a couple of small insect bites like mosquito bites and one larger one that almost looks like a scrape. What should I do? It itches and is hot, so I think there is fever in it.",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.You can analgesic such as ibuprofen for pain relief. As you are also having fever so probably you got infection. So you need to take antibiotics. Vitamin B and C are helpful in recovery. For iching you can take cetrizine. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat mild fever in a child?\n\nI have a six year old girl with mild fever 38.4 C and mild headache very tired, waking up with dreams calling for me. I just checked on her and she was dribbling in her sleep with slight foam at her mouth. I am giving her bed rest and ibuprofuen is there anything else I should do?",
    "doctor_response": "you should take your daughter to her pediatrician  to look for signs of infection , physical exam is vital in your child's  case I hope your child becomes better soon",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to control aggressive behavior?\n\nSir, my son's age is 18 and he is in class 12th. He is not doing well in studies and is distracted by net and chatting. When withdrawn these facilities he became rebel and blackmail us that he don't want to live . What to do? He is my younger son and elder son is doing extremely well .",
    "doctor_response": "Hello,Internet gaming addiction in now being recognised as a disorder and is affecting the adolescents. This condition is difficult to manage.I have some suggestions for you. Donot force your child to stay away from these things. The more you will force, the more he will rebel. Involve yourself with him while he is using internet so that you can keep an eye on what he is doing. Encourage him to use internet for educational purposes.Also encourage him to participate in outdoor games and involve yourself with him. Graduallu you withdraw him from internet usage.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for a persistent cough\n\nMy daughter has had a cough that has lasted for more than two weeks. I have taken her to the doctor who has prescribed her two different antibiotics and cough syrups he has even given her an antiinflamatory tabs given to those with asthma. The coughing has increased to the point to where she cant rest or breathe right. What can I try?? PLEASE HELP ME!!!",
    "doctor_response": "dear, if your child's cough is worsened in the past 2 weeks then you should consult your general physician & do proper investigation for the proper diagnosis & then start medication. tell your daughter to drink warm water & avoid cold food stuffs..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of facial and ear numbness post cracking the root canal cap ?\n\nHi, myname is christina. ihave had a tooth ,rootcanel done several years ago, A year ago it broke, i couldnt afford the dentist ( the check up cost 197 dollars..for 10 minutes make another appointment.. ) two days ago my right ear started to go numb and now my ride side of my face is numb/tingly. i HAVE made an appointment with the dentis ( i been saving up) andmy apponintment is in TWO days . This morning my face was o.k but ,now its numb again.my Question is. should i wait till thursday ( today is tuesday - adelaide time). also have i done some premanent damage?...... the numb ness has spread .slow ly across my face.... and my ear feels od best wishes worried christina S.A Adelaide",
    "doctor_response": "Hello Christina, Greetings from India, As I understand you got a root canal done several years ago and the tooth fractured a year ago and now you are having some indifferent sensation on the right side of face. well whether this is related to your tooth is very difficult to to say without a proper examination. you have not mentioned whether this tooth is present on the right side or not? so can not correlate. but numbness isnt a good sign and it requires immediate attention so you are advised to immediately see a dentist. Take Care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pains which radiates down the left arm?\n\nI'e been having chest pains for the last 2 days that are pretty bad in pain. the pain sometimes radiates down my left arm. I have had a work up of heart tests. ekg, blood work, chest xray, echo, stress test halter monitor...all normal. They diagnised me with GERD. but this time the pain moves from left chest to center to under the left breast. and the acid reflux meds arent helping...could this be something cardiac?",
    "doctor_response": "Hi ThereAfter going through the details provided by you, the symptoms are highly suggestive of cardiac issue. As your antacids are not helping out then it favors more towards cardiac. So its advisable that you should personally consult a cardiologist and get yourself properly evaluated as you might need an Angiography to rule coronary artery disease.Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes inability to conceive a child after having stillbirth?\n\nDr I am 31 years old woman I lost my child a year ago because my placinta got detached at the last moment  and the baby died of soffocation now l have beem trying to conseive but to no avail l dont know whats the problem is my husband have no time to visit DR for the same can u please help me out can there be any infection or somthing else gone wrong inside l am really very worried please do the needful",
    "doctor_response": "Hi, I think you can go for evaluation first.  Do a thyroid profile and prolactin levels and a ultrasound for your uterus and ovaries.  Also a semen analysis of your husband should be done.  You can also do a HSG to see the tubes patency.If everything is fine, you can try naturally for 6 months.  Be in contact with your husband every 2 to 3 days after your periods stop.  It will increase chances of your pregnancy.  If it doesn't work then you can go for some medicines for growth of your follicles.  Discuss with your doctor regarding this.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe pain around the eye and vomiting after VP shunt replacement\n\nSevere pain around the eye & vomiting after VP shunt replacing Dear Dr. Recently my younger brother aged 13 yrs has got VP shunt replacing, which was first introduced when he was 2 yrs . But he is suffering from severe pain around the eye & vomiting. Neurosurgeon observed his part of head & body where VP shunt is placed & commented that no anomalies is found like swelling. Neurosurgeon also told me that his VP shunt is ok inside the head & body and working well. But i didn\u2019t found the exact reasons why my brother suffering from severe pain around the eye & vomiting. Can u told me the what reason behind this? I m eagerly waiting for your valuable suggestions.",
    "doctor_response": "Welcome to Healthcare Magic Good Day Could you tell me why the shunt was put in the first place. There could be a block causing high intracranial tension or could be an infection. If there is infection it could lead of Cavernous sinus thrombosis causing severe eye pain, vomiting, fever. Is there any squint in the eyes. Is the involved eye red and watering. You need to discuss with the Doctor about these issues and seek proper management and relief of the pain. He may take T.Paracetamol 500mg for some pain relief but he needs to be taken to the Neurosurgeon immediately.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of headache and dizziness ?\n\nI have a had a bad headache for aprox. 3 days. Last night after some stressful events, I started having major dizziness when I am walking and going from the sitting position to standing. I thought after sleeping I would feel better. I am sick to my stomach heart racing and still very dizzy. I am 35 and I do take relpax occaionally for migraines. I had not taken it until today thinking maybe the headache was causing me to be dizzy?",
    "doctor_response": "Hi, For headache, you can take a naproxen tablet and for dizziness, you can take betahistine. If symptoms persist, consult your doctor for detailed evaluation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sudhir Kumar, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to increase the size of endometrium to get pregnant ?\n\naftr 4 years of marriage i got pregnant and am blessed with a baby boy. now he is 4 yrs old and i have not conceived yet. so i visited a doctor to find out if there is any health problem. my menst cycle startd june7 2011, Dr suggested to get scanned, i got abdomen scand on 13june2011 in which the report came out normal however the endometrial cavity is empty, endometrial echo measured 6-7mm right ovary 37x19mm left ovary 36x19mm Uterus:retroverted, measures about 74x47x39mm with normal myometrial echo texture. r there chances of getng pregnant age 35, ht 5 ft 1 inch, wt 52 i heard if endometrial cavity is empty chances of conceiving will lessen pls i request ur advice regdng this endometrial thickness and conceving",
    "doctor_response": "Hi,\u00a0\u00a0\u00a0 I feel you have some misunderstanding about the scan.the scan after the menstrual flow. the process of endometrial formation for the next period had just started. so the thikness found has to be lesser. If you have good ovulation, the thickness will grow automaticaally. &also there is no baby in the uterus so the mention of an empty endometrial cavity -in scan report.\u00a0\u00a0\u00a0 Please get your follicular study done(sonographically) From 15th June onwards,it will guide for further treatment plan.AFter ovulation you have sex within 24 hrs.If your dr thinks ,he will add sp. harmone in your treatment. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could enormous hard knot under the knee be?\n\nI have an enormous hard knot on the lower left side under my knee. The pain and burning are excruciating. I had an mri saturday but wondered if I could get some sort of idea of your thoughts. I also am waiting for a knee replacement on this knee. Thank you",
    "doctor_response": "Hi Sir since you are waiting for Knee replacement it means you have advanced arthritis, a hard swelling could be an osteophyte, which are abnormal bony growths on sides of joint in arthritis, dont be over concerned as these are removed when doing a replacement surgery.Have a Healthy knee after replacement.All the best for surgery",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does dried blood discharge when coughing indicate?\n\nI sometimes cough and spit what appears to be dried blood.....sometimes when I sneeze or blow my nose, dried blood comes out there too.  I don't have any chronic health problems, like asthma or allergies, so I don't know how or why dried blood would accumulate in my nose & throat, but what could I do to clear the area of all dried blood once & for all?",
    "doctor_response": "Hi welcome to the health care magic In cough and nasal secretion you are having blood.. Hence bronchitis like upper respiratory tract ruled put first by Auscultation and x ray if needed Bleeding disorder and thrombocytopenia Also investigated by PT, APTT and CBC like investigation... According to cause specific treatment given.. If bronchitis Is the cause than suitable antibiotic and antihistaminic drug needed Avoid smoking if habit Take care Consult physician or pulmonologoist for examination and further work up accordingly",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from nausea. Taking medication for depression. CT scan, thyroid test and endoscopy reports normal. Reason?\n\nHi, My wife ( Sudha- Age 32 years) having problem of nausea ( vomiting) for the past 6 months. Basically she is a psychaitric patient( nervous+ depression for small issues) taking the medicines like SITA S-20, Pregobalamin+ Methyco balamin, Fregium 10 mg and Sompraz(Anti Acidic). But she is not getting cured the vomiting problem, When ever she take even a small piece of fruit is getting vomited. She was undergone CT brain, Endoscopy , Barium Meal following through, RBS, Thyroid test.. these are all test results are normal. Kindly suggest any panasia for this problem. Regards, T.V.Devi Prasad",
    "doctor_response": "Hello, Thanks for choosing health care magic for posting your query. Thanks for the detailed and complete description that you have give, From what you have said, she is on sita s-20 which has escitalopram which is an SSRI antidepressant. SSRI are known to cause vomitings and diarrhea by acting on the gut serotonin. Most of the cases, the cause is not obvious. Her antidepressant should be shifted immediately to bupropion or some other drug. Please do consult you psychiatrist and discuss this issue with him. Also consider stopping all the drugs as of now and continuing with psycho therapeutic intervention until the vomitings settle down. Your psychiatrist may help you with such therapies. Also if she is vomiting so frequently, do monitor her serum potassium levels. 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/dr-srikanth-reddy Wish you good health, Dr. Srikanth Reddy M.D.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have PCOD and my husband has no seminal vas defference. What are the chances that I will conceive with an IVF ?\n\nmy husbund have not seminal vas defference.but there are lots of sperm in his testis.so doctor called us for testtube baby.i have pcod.over 6th tretment was failed . in my second treatment i got 177 beta hcg level.but after two days my pregnancy missed.and my 5th cycle my beta hcg level was 22.but after 2 days report was negative .i want to know that am capable for concieve a pregnancy?how many percent?my period is regular",
    "doctor_response": "Hi Reema, Welcome to HealthcareMagic Forum. Since you said that your Periods are Regular, you will have very good chances, more than 50 % chances of Pregnancy even if you have PCOS, since you will be ovulating regularly. The Problem arises if your Periods are Irregular. You said your Hisband has no Vas deferens which may be its congenital absence. This condition is responsible for 1 percent to 2 percent of all infertility in men. In such cases, you may want speak to your Doctor, your family and Opt for IVF. Good Luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i take asthalin inhaler four times a day?\n\ni have an asthma problem right from my class 12th,earlier i was goin through allopathic treatment,but now started homeopathic,so the doctor told me that if by taking homeopathic medicin for emergency period also not got relief then take the asthalin inhaler,my query is if taken four times in a day,is  it bad or not",
    "doctor_response": "Hi.When you have an asthma exacerbation (acute attack), taking Asthalin inhaler 4 times a day usually does not cause side-effect (except hand tremors in some cases). But it's for a few days only. Once your attack is over and even then you need to take asthalin inhaler for 4 times a day, it's bad. It suggests that your asthma is out of control and you need to add other medicines for your daily treatment.Hope this solves your query.Wish you the best health.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain in chest radiating to back?\n\nI 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 you're warming up for exercise, the pain gets increasingly sharper and almost puts me in tears! What is it and how can I fix it?",
    "doctor_response": "Thanks for your question on Healthcare Magic.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 drugs.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am having indigestion and cramp for 3-4 days. Should i worry about that ?\n\nI ve been having gas, indigestion and cramping the last 3 - 4 days and my breats are very tender, I feel like I want to throw up but I can eat just fine. I ve also had multiple bowel movements which is not like me at all. What could this be?",
    "doctor_response": "This is because you are having low digestive fire according to Ayurveda,for this problem have a small piece of dry ginger,salt and few drops of lemon over it and take and chew this before both meals,and have Luke warm water always when you are having this type of problem",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest a medicine for souring bruise near to spine\n\nHello, I was walking down some stairs in a school building and someone had spilled a clear liquid on them. I slipped and my feet flew up completely and i landed with my spin hitting the corner of the step. I have a bruise near my spine and I am pretty sore. I have a herniated discs in my lower back and I just wonder if this accident could have hurt a discs?",
    "doctor_response": "Yes this type of fall surely could do further damage to the dusc. For soreness without any bruise, you may apply an analgesic ointment and take acetaminophen for 2-3 days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having noticed a tear in the frenulum after having unsafe sex\n\nI started to have unprotected sex with my girlfriend but as soon as I put it in my frenulum torn, there was loads of blood but it doesn't hurt. It's been about a week and half I was wondering if ther was anything that I should do because it has completely disappeared and not attached at all.",
    "doctor_response": "Hello and .As an Urologist, i understand your concern.I would advise that, you wait for total 2 weeks, after the previous sexual intercourse.  Then try masturbation slowly.If there's no bleeding or problem till ejaculation, then you may proceed to intercourse, by next day.If there's any bleeding noticed, apply pressure there with a clean cloth, and see a surgeon or Urologist at once.  He'll treat according to the injury.If you've any doubt, you may send it to me,  as a direct question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath?\n\nHi i'm 15 years old and i have been having shortness of breath. When i try to breath, each breath feels incomplete and as I inhale my chest area near my heart hurts. High cholestrol is hereditary in my family and everyone thinks i have clogged arteries and/or high cholestrol. What do these signs tell you? Do I have either or?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Yes, high cholesterol can block coronary arteries and this can cause chest pain and breathing difficulty. Since you are having strong positive family history of high cholesterol, you should definitely consult cardiologist and get done 1. Serum cholesterol levels 2. Ecg 3.  2d echo. 4. Stress test (trade mill test). If all these are normal then no need to worry for heart diseases or high cholesterol. Sometimes stress and anxiety can also cause similar symptoms. So avoid stress and tension, be relax and calm. Don't worry, you will be alright but first consult doctor and discuss all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for the dust allergy?\n\nHello sir, my sister Monisha Kundu, aged 9 yrs, is suffering from allergy from past 2 years.Her allergy has mostly started from dust and now it has aggrevated.She is now very sensitive to smell of a few things and also to food .Lots of treatment has been done till now but in vain.Also a blood profile and allergy test was carried out 2 months back. She was getting better but since 3-4 days back all the problems have started again.She is now suffering from severe allergy problems.Now local doctors has advised her using nebulizer and steroids.She has now reported also pain in heart.Things are getting worse. Please suggest me any immediate treatment for her? also please tell me about the best doctors/hospitals in India from where she can be treated to put an end to this problem?? We are willing to take her to the best treatments available in India.",
    "doctor_response": "Thanks for posting your query at HealthCareMagic. Allergy or hypersensitivity is practically excessive and improper immune response to something that is not harmful but the body confuses it with something harmful and hence produces a inflammatory response to combat it. So, the stimulus is something that our body does not normally need to react to. Dust is one such allergen. There could be many others and you have to identify the things your child is allergic to. There are two things that can be done. One is to decrease the immune response of the body by the use of steroids, as is being already done in your case. The other thing is to avoid the stimuli that the body is reacting to. There can be no other type of treatment irrespective of where you go in India or abroad. Please be patient and follow the advice that your doctor has given.It would have been really helpful if I could know the eosinophil count in blood. The chest pain that you mentioned need not be in the heart. It could well be due to gastro esophageal reflux or a lung cause and it is difficult to comment further without evaluating.Hope that the above information would be helpful to you. Feel free to revert back in case of further queries if any.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for high cholesterol and triglycerides?\n\nCholesterol level high.CHOLESTEROL 244 mg/dL [ 125 - 200 ]TRIGLYCERIDES 211 mg/dL [ 40 - 190 ]HDL CHOLESTEROL 35 mg/dL [ 30 - 70 ]LDL CHOLESTEROL 167 mg/dL [ 70 - 130 ]VLDL CHOLESTROL 42 mg/dL [ 5 - 40 ]TC/HDL Cholesterol Ratio 6.97 RATIO [ 3 - 5 ]LDL/HDL Ratio 4.8 RATIO [ 1.5 - 3.5 ]",
    "doctor_response": "hello thanks for writingYour cholesterol is high.Treatment is in two parts,LIFESTYLE CHANGES:1) Reduce weight.2) Eat less oil.3) Stay physically active.4) Eat fiber vegetables and fruits.Medication:If this doesnt settle do contact your doctor to get medication .dont worry it will get fine.Best regards.Dr.Ahmad",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for persistent vomiting\n\nI have a 2 month old boy that weight 10lbs 13 oz at birth. At almost a month old he started throwing up real bad and a lot. We took him to the Dr. numerous times and we changed his formula a few times as well. He has been on Infamil Lipil, Enfamil Prosobee, Enfamil Gentlease and he is currently on Similac Alimentum. Changing his formulas has not made a difference at all. He lost 1lb 5oz and the Dr. decided to put him on Zantac for acid reflux (even though they re not sure that is what is wrong). We went back the following week because it hadn t made a difference and they put him on Prevacid and Zantac. Prevacid in the morning and Zantac at night which seemed to have helped for 3 days. The fourth day he begins throwing up again. We have took him back to the Dr. 2-3 times a week for the past 2 weeks for a weight check. He did get back up to 11 lbs 14 ounces. So a few days ago I noticed that he had brown pieces of something in his throw up and had been watching it. Yesterday all he was throwing up was brown. Looked like used snuff that my grandma use to use. We took him to what is supposed to be one of the better hospitals in the area last night and after doing blood work, catheter and x-rays they cannot tell us what is wrong. At the hospital they weigh him and he has lost 4 ounces in 3 days and it seems that he is keeping absolutely nothing down. He only eats 2 ounces every 2-3 hours.",
    "doctor_response": "Hi, She could be having a streptococcus infection, leading to impetigo. She would need an antibiotic if so. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Cajetan, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in the upper back?\n\nHello, Starting yesterday, I began to notice a sore pain in my upper back. Since then it has been getting only worse, and is almost to the point of being debilitating. It has also spread from the right side of my back to the top half of my back. I noticed that if I curve my body forwards, it causes a sharp pain, and a weak feeling in my spine. The pain didn't start with an injury or and specific action, instead it started when I was typing my essay in my computer chair. I often sit in this chair for long periods of time without problems. Although I did notice my posture was slightly more hunched than normal. I doubt age, or arthritis could be part of the problem, because I am only 15, and in good health. I go to the gym nearly every day, and do fairly intense work outs, however, the day the pain began, I did not go to the gym, nor did I the preceding day. I went today and did an unusually intense work out, and for about an hour after the work out, the pain had stopped. However it soon came back, full force. I doubt this could have much to do with my condition, but yesterday was the first day I began taking my Adderall prescription. I know this is unhealthy, but also, since I started my prescription at 8 AM yesterday, I've eaten nothing and all I had eaten prior to taking my adderall were a few tortilla chips. I wasn't trying to starve myself, just the aderall makes it extremely difficult to eat. Last night I slept normally, and the night before yesterday I slept normally as well, so I don't think I could of slept on it wrong. I can't seem to find a reason for this, and the pain is only increasing. Thank you for your help.",
    "doctor_response": "Hello, Thanks for your query.After going through your description the most likely cause seems to be severe muscle spasm of back leading to difficulty in bending movement. My advice for you would be \u20131. Take rest preferably in lying down position and avoid prolong sitting and exercise.2. Hot water fomentation has a soothing effect on stiff muscle.3. I would like to treat you with Tab.Thiosaps A8 along with local gel like Flexabenz. Since these are prescription drugs you may have to contact your local doctor.4. For early recovery you may have Physiotherapy in form of short wave diathermy and TENS.It usually takes 3-5 days time for stiff muscles to relax.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "On tri sprintec.  Delayed periods with brown spotting, pregnancy symptoms.  History of having unprotected sex.  Pregnancy test negative.  Guide\n\nI have been taking trie sprintec  for over six months my boyfriend and I never use condoms he ejaculates in me and we sleep with him still inside  me  well this month my period was three days late and on the fourth day it was only brown spotting when I wiped and only lasted 3 days for the past two weeks I have been having pregnancy symptoms but negative blood and urine test  is it  possible I'm pregnant",
    "doctor_response": "Hello,As you have gotten NEGATIVE blood and urine test, then you have NO chance of pregnancy in this context.Sprintec is quite effective OCP and prevents unwanted pregnancy more than 99% on regular using. It may cause brown discharge sometimes. Maintain genital hygiene properly.Other reasons are hormonal imbalance, old endometrial tissue, vaginal or pelvic infection, weight gain etc. Following initial test report, you need to consult with gynecologist for next line management.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What blood pressure level considered normal in a 87 year old?\n\nWhat is a normal blood pressure for an 87 year old female?  Paramedics were called earlier today and it was recommended that she go to hospital because part of her blood pressure reading was 220. She signed a piece of paper opting out of getting medical attention. I'm concerned for my friend. She is not currently on any blood pressure meds. She has been in bed sleeping most of the day and has only had a few sips of juice...",
    "doctor_response": "Hi,I understand your concern and would explain that these blood pressure values are extremely high. At her age, blood pressure values below 140/90mm Hg would be recommended. You should know that these blood pressure values (220mmgHg) can lead to increased risk for brain hemorrhage or stroke, besides seizures. So, considering her clinical situation, I would recommend bringing her to the nearest ER service for a physical exam and some tests: - a resting ECG- a chest X ray study- kidney and liver function tests- fasting glucose- blood electrolytes- a brain CT scan to exclude stroke or hemorrhageHope to have been helpful. Let me know if I can assist you further. Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for back pain\n\ni have had problem with my back for a long time now amd no one seems to now what is wrong with it. i am 29 and they think this started to happen when i carried my kids. i can haedly walk and my body has started to turn to the side. there is now a lump at the bottom of my back which they think is caused by the way i am walking and there has been tissue that has torn, but every time there is presure put on it the middle of my spine feels like it is on fire",
    "doctor_response": "Hello. Thanks for writing to us. The presence of lump indicates a problem with posture. Get an MRI scan of the back done to find out the cause for specific treatment.I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal . For future query, you can directly approach me through my profile URL  drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain after lumbar puncture\n\ni had a lumbar puncture on last thursday that was severely painful the radiologist gave me 5 shots of numbing medication. i never became numb. he proceded and told me to stay still. i cried bc of the pain i was in and did not want to move for fear of further damage. i left the hospital on a walker because of the pain in my lower back and legs. could the pain be cause from the lumber puncture being done incorrectly.",
    "doctor_response": "Hello,The pain can be related to the lumbar puncture. This is usually felt in and around the area where the needle was inserted. In most cases the\u00a0pain\u00a0will ease after a few days and it can be treated with painkillers, such as paracetamol, if necessary.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of survival from a meningioma removal surgery ?\n\nThank you.  I have surgery scheduled for removal of a tumor in my brain.   my doctor says 90% chance it is Not malignant.  Called it a menginoma and says it is about 2 inches in size.   I'm 66 years old and have pretty good health but have been sedatary for a few years.   Do you think my chances of survivial are good?   From what I read, this surgery is ok for younger people but more risky for those older.",
    "doctor_response": "HIThank for asking to HCMI can understand your worry, I would say that if you do not have any symptoms then why to think about the surgery medical management equally gives the same results and not bad if go for it, surgery have some risk and in my  opinion it should be matter of concern, take care and have nice life.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, low sperm count. Taking fortmid 25, CO-Q, Ovacare. Chances of success with IUI?\n\nhi! i m 28 yrs old now, and married for past 6 yrs, trying to conceive now. But my hubby has low sperm count , it ranges between 15 to 20 million. He is on fortmid 25 and also CO-Q medicines. I m having ovacare tablets. We ll be going for IUI where my husband s sperm injected near my fallopian tube . Are there any chances of success",
    "doctor_response": "hello welcome to HCM the count is borderline and hence the process of IUI helps the chance of more number of sperms to be available around ovulation the success per IUI cycle is between 9 to 14% the cumulative pregnancy rate is around 60% after 3 cycles of IUI please do as suggested and this will help many people trying for a child wish you all the best dr nandita thakkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurrent pain on the left side of the hips and ribcage?\n\nLeft side pain that comes and goes every few minutes. Started this morning at work I was noticing it maybe every 30 minutes approx but now that I\u2019m home resting every few minutes. It goes from very little to no pain to a stabbing pain that is pretty sharp. Then it goes away and comes back. It\u2019s more on my left side between where my hip starts and my rib cage starts. Any ideas? Is it worth going to the hospital or should I schedule an appointment with my regular doctor later in the week? Or I can wait and see if it goes away on its own or gets worse. Thanks",
    "doctor_response": "Hello, The pain you are feeling on left side that comes and goes every few minutes, could be due to colitis or Irritable bowel syndrome (IBS) especially you are also having bloating or other changes in bowel movements (bm). I advise to take over the counter Mephenamic acid and antacid mixture. Start probiotics and Simethicone for the bloating. If it won't ease the pain you feel, then go to ER as might need immediate diagnostic tests and treatment. Try my suggestions and come back to me for further assistance. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling nausea, vertigo and abdominal pain. Liver function test done. Looking for suggestion\n\nHello Dr. Could you please comment on my wife s LFT that is as below: S. Total Bilirubin ----- 0.5 mg/dl S. Direct Bilirubin ------ 0.2 mg/dl S. Indirect Bilirubin --------- 0.3 mg/dl Gamma GT ------- 146 SGPT ( ALT ) -------- 198 IU/L Alkaline Phosphatase -------- 331 IU/L This is the most recent report. Similar test done a few days ago had a worse Alkaline status. She is reporting nausea, pain in around liver and stomach area with vertigo incidents occasionally. Her stool D/R shows 2-4 hpf, acidic in chemical reaction with occasional Macrophages reported. Full abdominal ultrasound does not show any stones but sonologist recommended a re-visit because there was swelling around gall bladder and liver. Thank YOU.",
    "doctor_response": "Dear Sir, these tests and symptoms u ve described definitely means something (liver or intestinal disorder) and it needs to be evaluated. Most common disorders which raise liver enzymes parameters are, alcohol, metabolic syndrom, viral hepatitis and biliary system disorders (inflammation, obstruction). So these 4 should be ruled out.  The best way is to to further tests. So I recommend to do viral hepatitis analysis, abdominal CT(more specific than ultrasound) and liver biopsy. Also she need to avoid fat food and alcohol, lose weight if adipose and do hepatology work ups at least 2x a year. Also this stool finding can mean sometnih or nothing, if she wants to be sure she can do colonoscopy.Wish you good health.Dr. Ivan Romich",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the chances of having primary raynauds?\n\n59 year old female, what are the chances of primary raynauds? Past medical hx is unremarkable. Cyanosis and rubor appears on all fingers , both hands upon cold exposure and subsides within few min. Has been occurring for about 3 years.no other symptoms.",
    "doctor_response": "Hello, These are typical symptoms of Reynaulds. Consult a rheumatologist and he will direct you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing pain in abdomen and lower back?\n\nHi I am 54yr female     I have been having pain on my upper right abdo   and now is radiating to my lower back.  I have had a radical nephrectomy 14yrs ago due to a malignant tumor on my left kidney.  I also have had xrays about 2yrs ago noting that I had moderate to severe spondylitic     L4 - L5    L5 S1      Only relief from pain is lying down        not sure if I should see my GP   or its something that will pass? Thanks Darlene",
    "doctor_response": "Better to see a GP as you are a known patient of the diagnosis you have mentioned. A clinical examination is always one that can clinch the diagnosis and complications. CT scan of the abdomen is better to be done as it will help to find out the reason for pain in upper right abdomen.The probable causes are ::Gallbladder stones and infection ( Cholecystitis)Live problemPancreatic problems Right Kidney problems. CT will also help to see the position of the lower back spine and related structures .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for bruise on forehead and fever\n\nHi, My 1 yr and six mos old daughter fall from the bed yesterday morning, she got bruise in the forehead and fever at 8pm that night. I gave her paracetamol (calpol) at 8pm and 12 am, the fever went down at 1 am. She has no ferver the next day but she sweats a lot, I continue giving her the paracetamol until 8 pm today. She is in her normal activities, eat well and finished her milk. Should I still be worry? should I bring her to her pedia?",
    "doctor_response": "Hi,Welcome To Healthcare Magic.I can understand your problem regarding to your child\u2019s health.These  bruise  type of  external  injuries are not very harmful so you need not to be worried. This bruise injury is on her forehead. So,she might be having  some impact on brain only if she will produce symptoms like nausea, vomiting, giddiness, severe headache, fall down while walking. If this happens, then immediately contact to neurophysician.  So take care for 72 hours after an injury.Your treatment of paracetamol (calpol) is proper and sweating occurs because of effect of paracetamol so no need to be worried. You can start to give her maximum liquid intake to maintain fluid level in the body.After doing all these things, I hope your child will get well sooner and please share your review about my answer on healthcare magic.Take Care,Thank You.From:- Dr. Nupur Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Molar tooth got chipped twice due to metal implant and buffed out. Underlying cause?\n\nA new pfm bottom full bridge molar tooth got chipped due to the top metal implant just showing through the temporary top bridge, and was buffed out, then a couple weeks later that same bottom molar chipped again, can anyone be sure the structural integrity of that botttom molar is sound? Actually hasnt it now been compromised due to the repeated pecking of the top metal several hundred if not thousand times when some of the highest pressures are created? Even if a potential weak spot is not obvious, can anyone truely know how much damage was done to that molar? I wouldnt want a metal beaten ceramic tile installed on my floor, would you?",
    "doctor_response": "hello thanks for your concern the metal implant is putting pressure on your pfm bridge .you need to get your bridge replaced.. the implant should crowned with porcelain so that it does not harm the opposite crown. the structural integrity of molar will remain sound unless the tooth preparation was done ideally.. even if the molar becomes weak there is a option to place post in the distal root of the molar to make it stronger enough to hold the bridge and pressure as well.. please visit your dentist for further treatment...  hope it helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to stop biting fingernails?\n\nGreetings doctor, I have been biting my fingernails (Including the skin surrounding it) for more than 15 years and I am unable to stop it...What concern me the most is that there is a HIV positive housemate and I accidentally touch his feaces with my exposed fingers while cleaning the toilet bowl just 5 minutes after he left the toilet.....5 days later, I suffered some flu like symptoms, sorethroat and some muscle aching and a small swollen lymph node.....Is there a possibility I am infected?",
    "doctor_response": "Hello,Human immunodeficiency viruses (HIV) transmission occurs by sexual, injections, or my mother to child root. Contaminated body fluid in contact with blood can transmit HIV. Fecooral route is not a mood of transmission of HIV. You have touched his feces, but the risk of transmission is very rare. Flu-like symptoms can be due to the psychological stress of getting infected. Still, have any doubts get your P14 essay done for HIV after about four weeks. The test is earliest to detect infection.Regarding compulsive nail-biting, the disorder some times represent underlying anxiety. Onychophagia or nail-biting can result in several complications. Consult a psychiatrist for its treatment. Medicines like fluoxetine are very useful. Behavioral methods help to decrease undesirable behavior.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Seikhoo Bishnoi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for panic attacks leading to diarrhea and retching\n\nmy boyfriend has developed severe panic attacks and now seems to have come down with a stomach bug with dioreahh (excuse spelling) and retching, he just wont go to the doctors as these are part of his panicing and this is beginning to severly effect both our lives, what can I do?",
    "doctor_response": "treatment for panic reaction is to include the general mashers and medicationAre you can avoid panic tax by doing regular exercise by keeping yourself hydrated you can also do biofeedback you should avoid still lacks like caffeine and drinking sodas or coffee or tea excessively more than 2 to 3 cups a day and you should also keep yourself busy with your work or studies or any other hobby keeping yourself ideal can only increase your anxiety and panic attacksIf this journal measures do not work then you should see your physician or a psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to reduce the pain due to ovarian cancer\n\nMy wife has been suffering from ovarian cancer. The surgery was not successful because the cancer is in advance state. Doctor is telling she has a limited life and she has to bear lot of pain. I want to give some treatment, at least it should reduce the pain.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. She has ovarian cancer. In advanced stage surgery is not useful.  It can not cure thr disease.  Life expectancy is very limited.  Pain is the main element to treat in terminal stage cancer.  Morphine based drug are used to get pain releif in terminal stage cancer.  It is prescription based medicine so consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe back pain while breathing\n\nI was running yesterday and I somehow landed wrong when I jumped down onto the cement and my back immediately started hurting since then it s only gotten worse. It s hurting to breath...walking is really painful and bending over is impossible I have to crouch I don t know what I ve done.",
    "doctor_response": "It seems that you have muscle spasm and /or broken ribsGo for a xray and rule out any fracturemean while ice packs and antiinflammatory medicines like naprosyn will help youTake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pains with burps, farts and foamy saliva?\n\nI have terrible pains in my stomach keeps me awake all night. Burping and farting and very painful spots in my upper and lower sides of d stomach. I feel a thumping pulse everywhere and the need to throw up . Foamy saliva comes out occasionally and I pee a lot.i can feel the pulse.its terribly painful and I am 29 and weigh 70kg, 5 1 .",
    "doctor_response": "Hi.Read and understood your problem.The pains are terrible and associated with burping, farting, thumping pulse, vomiting, foamy saliva.The probable reason for such a symptom-complex is gastroenteritis, a waterborne infection.Consult a Doctor as you need to be examined for physical, vitals like pulse, BP, temperature, dehydration, abdominal physical examination to get a proper diagnosis, prescription and an order for investigations if your Doctor feels so.The cause of foaming salvation and vomiting is a reflex whenever the intestines have any problem.The thumping pulse is indicative of dehydration and body's response to keep it going or can be due to hyperthyroidism which in itself may be a reason of gastroenteritis like symptoms.Farting indicated severe infection with bacteria capable of producing septicemia and gases.All these things together cause severe pain in abdomen. IF required get admitted for intravenous antibiotics, antiemetics and fluids to correct the dehydration.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause parched mouth, stuttering, difficulty in swallowing and back pain on right side?\n\nI get tired very easily, if I have been standing for awhile I start to get back pain around the middle region more on the right side. I have trouble swallowing and my speech can be like a stutter which comes and goes. I have had a MRI done but they could not find anything, my mouth gets very dry.",
    "doctor_response": "Hi,Thanks for posting the query,        A thorough checkup is required, this could be due to salivary gland disorder. neurological disorder, infection.I would suggest you to get a checkup done.Take multivitamin suplemnents.Relieve anxiety or stress present if any.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to have an anti-rabies shot without being bitten?\n\nHello! im starting to get worry because last week when I finished  washing my motorcycle, I was playing with my puppy (Siberian Husky) and later on I noticed some scratch on my finger,. i really don't an idea if I got that scratch from my pet or during motorcycle wash, my question is: is it safe to have an anti-rabies shot without being bitten or infected ? please send me some information on my email,.  YYYY@YYYY",
    "doctor_response": "Hello,Unless your dog is sick you do not need to worry about a rabies shot. Rabies vaccines are a series of injection and you really do not want to take them unless you have to. It would be good in general for you to have a tetanus shot and for your dog to get the rabies vaccine. Rabies is usually transmitted through the bite of a rabid (very sick) dog, not through scratches from a puppy.Regards,K. Robinson MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling and numbness in the lips\n\nGood evening, My husband, 50, woke up with numbness on the right side of his lips and a very slight swelling/ droopiness. This is strange, he is talking, eating and breathing fine. It s only on one side. I gave him a Zyrtec in case it was an allergic reaction but it didn t have an affect. My email address is YYYY@YYYY . Thank you.",
    "doctor_response": "Hello,I have studied your case and I think that this can be viral infection involving facial nerve which is causing all these problems. I would recommend you you to get opinion from ENT surgeon to advise about this.    He might need antiviral therapy and steroid to take care of this problem. I hope this answer will be useful for you. Let me know if there is any other followup questions.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recommend a neuromuscular relaxant\n\nHello!i have a cervico-brahial nevralgy caused probably by a pressed or damped vertebra due to my ostheoporosis,i was recomended a drug called neuriplege which is fabricated in France and it`s a neuro-muscular relaxant but unfortunatly i can`t obtain this drug in my country,what could you recommend me?thanks",
    "doctor_response": "Hello,Neuriplege is a cream used to treat muscular pain by using it locally. It contains camphor, eucalyptus and menthol, so, creams with this composition but with different names, may be of help for you. If you have osteoporotic fractured vertebra, best treatment is kyphoplasty.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump on the abdomen\n\nI have felt a hard lump in my side which feels as if they are under the skin but above my side ab muscles. I had an ultrasound scan which found 2 well defined hypoechoic foci which the radiologist report states does not have typical sonographic features of lipomas but are of uncertain aetiology they measure 11x5.4mm and 10x3.4mm. My GP seems concerned and advised that I see a surgeon and have them removed.....I do not understand the radiologist jargon.....should I be concerned?",
    "doctor_response": "Hi,It seems that you might be having Lipomas only.This is common site for lipoma.It requires removal of lumps.You can wait till it increase in size, there is no problem.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does partially opacified-suboptimal evaluation in fallopian tubes affect normal pregnancy?\n\nHi,M trying to conceive for the last 11months but no successs, so I went to the doctor she did HSG and the result says Uterus is normal in shape and outline and Both fallopian tubes are partially opacified-suboptimal evaluation. No evidence of spillage of contrast. so she said that I have some problem with my tube, and she advised me to take Brufen 400 mg daily 3 times, and another HSG will be taken later.So I wanted to know whether this problem is curable or not and will I conceive naturally?Please help me out.Thank youDIsha",
    "doctor_response": "Hi,I read your query and I understand your concerns.Following is my reply:1) If tubes are blocked again in second HSG it is not possible to conceive naturally.2) IVF is the only solution in that case.Let me know if you have anymore questions.Regards,Dr. Mahesh Koregol",
    "dialogue_context": ""
  },
  {
    "patient_message": "What other than paxil, rispidone and trazadonem can help recover from bipolar disorder?\n\nHi, I am worried if I should continue drinking my pills because I didn't had my menstrual yet. Im about to take my pills on tuesday, should I continue it? I had sex while im taking my pills but my partner didn't came inside, we always do withdrawal, is there any possibilities that im pregnant even though I don't feel anything if I'm pregnant?",
    "doctor_response": "HiThanks for using healthcare magicIf you are taking your pills regularly and you have no menses yet, then chances of getting pregnancy is unlikely. Sometime while taking contraceptive pills, female feel some behavioral  changes like decrease sexual desire or slight irritability while taking pills. Nothing to worry about. These symptoms would improve with time.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is cataract operation required immediately for me?\n\nDear doctor, The patient is a 76-year-old male. I am uploading eye check-up report. Kindly advise on the following: Is cataract shown in the report? Is cataract operation required immediately? Is retina covered in the checkup? Any other observations by you?",
    "doctor_response": "Hello. I have seen the reports (attachment removed to protect patient identity). There are early changes of cataract in both eyes but still, the patient's vision is totally correctable with the glasses prescribed. So, no need for cataract surgery as of now maybe a year down the line but not now. About the retinal examination, the only comment is about glow is made, no charting of retina examination has been done. In my opinion, the patient should be prescribed glasses. If the patient is not very active, cataract surgery can be postponed for about a year. Along with your drops, I suggest using Vigamox (Moxifloxacin) eye drops four times a day for seven days and then stop. For more information consult an eye care ophthalmologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain, abdominal pain, dizziness, blood in tissue after anal sex. Cause?\n\nHi there me and my husband had anal sex last night, after I went to the bathroom to clean my self up and had a speck of blood on the tissue paper. I've recently opened my bowels and there's no blood but I've got back ache and abdominal achy pain. I feel abit dizzy but I don't know it's that's because I'm worrying my self sick about it. Please help me",
    "doctor_response": "Hello There can be injury to rectal mucosa due to anal sex.As you may not be doing it routinely ,so that lead to mucosa tear.You can use anaesthetic gelly for pain ,and use laxative or stool softener.If bleed persist you may need to consult doctor.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How do I fade the acne marks without laser treatment?\n\nHello doctor, I have used Benzoyl peroxide gel for my acne and it has almost cleared. But, the\u00a0acne left some red marks and blemishes on my cheek. I wanted to fade that redness on my skin. In the past, I used Epiduo gel. Please suggest me a product and guide me to remove that redness without laser treatment. Thank you.",
    "doctor_response": "Hi. There is redness and some pus filled acne too (attachment removed to protect patient identity).",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for sexual side effects due to anti- depressants?\n\nHi, I have been taking anti-depressents for Anxiety and know they have sexual side effects but they side affects have increased my sexual desire greatly and now it won t go away to point it is painful to have this feeling in me. I have told my doctor and he said it is probably not related to the medication and is just a coincindence. What ways can I fix this urge? Any medication etc?",
    "doctor_response": "Hi,Antidepressants usually cause sexual dysfunction in the form of loss of libido (low sexual drive) or erectile dysfunction.Increased sexual drive is usually not seen.You can consider going off the antidepressants for a few weeks after discussing with your doctor. If that is a possibility, you can determine whether any changes in the sexual desire can be determined. Other options are always have sex before taking the drug or switch to a newer antidepressant.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Saranya Ramadoss, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for having weakness in legs, pins and needles sensations and occassional spiking pains at random lcations?\n\nI have been taking HTC since 97 and after starting I needed Advair and Abuterol and jump forward I now struggle to do a mile on the exercycle and 1 lap in the pool I can still get 25 X2 pushups and 50 X2 situps but legs are week and I have a lot of trouble with long (4 or more hours) periods of activity, pins and needles commons at random locations, occasional spiking pain at random locations, dizziness, confusion. My salt intake is very low and is hardly ever added at the table or when I cook.",
    "doctor_response": "In view of details provided by you it looks like peripheral neuropathy. A clinical examinations and few tests can help confirm this.Please feel free to take benefits of premium category for detailed answers.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in leg and bruise behind the knee?\n\nWas at er couple weeks ago with chest pain. After some test found out heart is great. Found out I have hypothyroidism.  They also thought I had blood clot in leg because of some blood work.  I was and still am having leg pain.  It comes and goes but is worse when I am on my feet.  I also woke up with a big bruise behind my knee.  Leg is swollen just a bit. Should I seek medical attention?  Oh doctors did ultrasound and didn't find a clot.Deanna",
    "doctor_response": "hihypothyroidism  itself is a cause for all the pains, generalised weaknessthis bruise can be due to some unknown trauma what may be unnoticedplease check for your sugar & blood pressure levelskeep the limb elevated when you are resting or lyingapplication of crepe bandage will do wonders by increasing the bloodsupplyif not reduced please meet an orthopaedician or a surgeon  for further evaluationtake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Violent headjerking, painful. Has OCD, nerve pain, stress, anxiety attacks and TICS. Suggest?\n\nEver since I was a child I have had tics, and they have become worse the older I have gotten (I am now 33). I have been to a doctor one time for Obsessive-Compulsive Disorder, and was prescribed an SSRI that lessened the compulsions and tics, but caused me to have anxiety attacks . I stopped the medication and never went back. The problem now is that along with the tics and the Obsessive- Compulsive behavior , suddenly my head has occasionally been involuntarily jerking to the right so hard that it causes severe nerve pain in the left side of my neck that goes away after a few minutes. The pain is so intense at first that it causes me to cry out. The other tics are nearly constant, and occur more frequently with any kind of stress . They are rhythmic drawing of the letter x on each of my fingers with my thumbnail, flexing of the muscles in the back of my thighs in a specific order, and blinking. Those I can live with, but the sudden, violent head-jerking is causing me some concern (not to mention it is VERY painful). Could all these tics be associated with OCD or is there a possibility that they are caused by some other condition? Thank you so much for your help.",
    "doctor_response": "Hello amweeks1202 Welcome to Health Care Magic The tics like sudden blinking of eyes, flexing the muscles of thigh, drawing letter x on fingers etc. are associated with OCD. In most of cases of tic disorder symptoms of OCD are found. The sudden jerking of head to a particular side is also a part of OCD and tic disorder. SSRI medicines like fluoxetine, paroxetine, fluvoxamine etc. are very good medicines for OCD as well as tics. OCD is a disorder of anxiety disorder spectrum. Any SSRI medicine when taken, during initial phase of therapy causes rebound increase in anxiety and this is the only reason you stopped to take medicines. The anxiety usually last for few days only. Over all the SSRI are very good medicine and are effective in OCD as well as Tic Disorder. So don't afraid of anxiety, visit your psychiatrist again and start medicines again for proper relief. thanks take care Dr. Seikhoo Bishnoi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Masturbation, depression, overweight, less erection, no semen discharge. Cure for condition?\n\nHi, i know a young man of 29 years who had been musterbating for a long time. He is ovewight and under stress of dipression due to various reasons. He has told me, in confidence that for the last 3 to 4 years he has getting full to slightly lazy erection but on doing musterbating no material ( serum ) is discharged. He is worried that this may not be a serious impediment to his marriage. Sir, can you give your advice. Regards",
    "doctor_response": "Hi, thanks for using healthcare magic Reduction in semen volume can be due to:(1) psychological reasons (2) short abstinence period (3) retrograde ejaculation (the semen goes in the wrong direction)  (4) blockage of the ejaculatory duct (5) decrease in testosterone (6) problems or disease of the seminal vesicle which make the majority of the ejaculate.The seminal vesicle are glands located near the bladder The psychological stress that your friend is experiencing and his weight (excess weight is associated with hypogonadism which is when the sex glands produce little or no sex hormones such as testosterone) may be contributing to his problem. Your friend should consult a urologist who will be able to investigate him appropiately. I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do irregular periods cause difficulty in getting pregnant ?\n\nI am 29 yr old f.I have always had irregular periods.I was anemic to the point that my Hb was 5 once.I saw a gynaec and she prescribed me regesterone 5 mg from 19 th day.I have been getting regular periods since then.I have been taking it for the last 2.5 yrs now.I wish to get pregnant ,we still have not started to plan for it as of now.I jsut wanna know how should i progress from here on.I am scared i will have some problems of getting preganant.Very stressed at this point.",
    "doctor_response": "hi welcome to health care magic need not worry,if your menses are regular than u can plan a baby.but before planning its it necessary to go for some test done to confirm everything is fine with you. complete blood test to rule out anaemia,ultrasound of abdomen and pelvis to rule out your pelvic organ are normal,and thyroid test for hormone levels,and diabetes profile test. good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What leads to lumps on the ankle?\n\nHi. Last month I appeared to have 2 bruises one on either ankle and they have not gone. However, a week or so ago I noticed they were not bruises but almost like lumps. only a few days ago they started getting painful. Not sure what to do. Any advice?",
    "doctor_response": "Hi, If I were your treating Doctor for this case of ankle lump, I would come up with only one and one possibility that is a sebaceous cyst or folliculitis! Nothing to worry about this and try not to get infected there again and again! You might need to take oral antibiotics for these...I suggest you to go for an FNAC test of the lump for confirmation and to relieve your concerns!Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I having sharp pain in left lower abdomen?\n\nHello doctor, I am 31 years old female, 5'8\", 175 lbs. Three days ago I started getting a really sharp pain in the lower left abdomen. It came on sudden and was gone within seconds but still bad enough to have me doubled over in pain. Thought it was related to period that was due following day. Happened on and off all day.Next day period did start as expected. Normal flow, normal cramps, etc. Then the sharp stabbing pain came back. It is stabbing in a very precise location, down and to the left from the belly button, kind of in-line with the hip. It was radiating hellfire to my low back, groin, thigh, hip, and left flank. I was on the floor in pain for four hours before it faded away enough for me to even stand. That night it happened again waking me from sleep. Lasted for hours, stabbing in the same spot, burning pain spread to the other areas. Later that day my toddler laid across me and his elbow got that same spot and started the pain up all over again but it only lasted about an hour. The area is very tender. I still get the brief stabbing pain when walking or coughing or bending over. I am thinking it is a ruptured cyst. I have never been diagnosed with one before but I think it fits the bill. But can they rupture multiple times within days? Is it likely to happen again? Could it be something related to period or just coincidence it started at the same time? What can I do at home for it, since I am unable to go in to see a doctor?",
    "doctor_response": "Hi. I went through your complain which I must say you have very nicely written down. As per the location of the pain that you mentioned, there are some conditions that need to be ruled out. First is appendicitis. It is followed by vomiting and constipation. Second is renal calculi or stones. This pain comes from behind while passing urine. Third, as you mentioned ovarian cyst but the ruptured cyst is a medical emergency and is unlikely. Get an abdomen and renal ultrasound is done to get a proper diagnosis. If you can, then do it after your periods.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bug bites, started with whitish and red rings, itchy, diarrhea. Are the symptoms related, what can this be?\n\nI am a 34 year old woman. I dont know if this matters but I just got back from the  a few days ago. while I was there I got what seemed to be a couple of bug bites. the past 2 days more of what I thought were bites appeared. they start out whitish with a red ring, but within an hour they fade to red and are very itchy. I have also had diarrhea . Are these two symptoms related? what could this be?",
    "doctor_response": "hi bug bites can cause red wnd white rings.it can also cause diarrhoea due to high histamine or mast cells.it can be cured by atarax 25 mg at night,antibiotic twice daily,alaspan in the morning and application of calamine lotion in the morning and flutibact ointment in the night can cure the condition",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in stomach, headache and eye pain, ultrasound came clear\n\nHi doctor good day to you. I have experiencing stomach pain on my right side it s a very mild pain also I have some times headache accompanied with eye pain.I got my ultrasound down and it is clear. It s been a month time now. It started with stomach pain recently It got accompanied with head and eye pain.pls help doctor .",
    "doctor_response": "Hi,Senthil kumar,thanks for query.Normal ultrasound rules out any major issues in abdomen.The headache along with eye pain that you might be due to ,stress headache,refraction error,high blood pressure,sinus problem,even some times gas problem can rise to it.Visit your doctor and get your blood pressure measured,take light diet,get your eyes examined.bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is black lump on buttocks a sign of some sort of cancer?\n\nhi, i have a black lum on my buttock cheek located near my thigh that i have had for years and no i have notced recently that i am getting a few more black spots. is this a sign of some sort of cancer? please can you help me as i am very distressed thank you",
    "doctor_response": "Hi,Dear,Welcome with your query to HCM.Studied your query in full depth of its details.Reviewed it in context of your health concerns.Based On the facts, You mostly seem to suffer from-Multiple moles in butt cheek with satellite nodules growing in number indicating nodular spread of the Melanoma via lymphatics spread.Excision biopsy would fix the cause of it.Second opinion from Dermatologist or Surgeon would resolve this dilemma.Surgeon and if need be ortho-Surgeon would help you out in this work up.Hope that ,This reply would help you to plan further treatment soon with your treating doctors.Best of Luck and early recovery.Welcome any further query in this regard,which would be replied in next session.Good Day!!Dr.Savaskar M.N.Senior Surgical Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get white discharge in both nipples with small blisters and they are sore to touch?\n\nHello doctor, I am 17 years old. and have a littl bit of white nipple disharge in both breasts but one has it a little worse and the skin on my nipple appears to be white and has little blisters on it. It does not really itch or anything but it is sore to the touch.",
    "doctor_response": "Hi. I see that you are worried about discharge from both your breasts and you are telling it has blister-like appearance. White discharge with blister-like appearance and sore to touch generally points towards an infection, but an infection occurring simultaneously in both breasts at the same time is very rare. Another possibility, is that milk secretion from both breasts which you might think as white discharge. Do not doubt, there are certain conditions where there can be milk secretion even without pregnancy and birth, which occurs due to hormone disturbances. Need some more information too, Do you have a fever? How are your menstrual cycles? Is it regular? Is the flow high? Do you feel any small lump behind the nipples? Do you take medicines for any other problem? Do not mistake me, but your problem needs a direct clinical examination to visualize the breast, discharge and to see if there are any lumps behind the nipples. You would not be comfortable to post pictures of your discharge and blisters, so I would recommend you to visit a doctor in person and have yourself examined. Meanwhile, do the investigations I have advised and try the medicines given below. Hypothyroidism. Hyperprolactinemia. ? Breast infection. Galactorrhea. Tablet Amoxicillin + Clavulanic acid 625 mg twice daily after food for five days, tablet Aceclofenac + Serratiopeptidase two tablets twice daily after food for three days. Avoid wearing tight vests and too much sweating.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible without ejaculation?\n\nSir,me and my boyfriend had a day with each other,we did not had sex.he only tried but it didn't happened.now my periods are late for 5 days...he didn't ejaculated in me.but i m so scared as my periods are late for the first time..i took turmeric containing milk with almonds butmy period did not start...i m so scared as it is very risky situation...",
    "doctor_response": "Hello dear,welcome to Ask a doctor service. I reviewed your query and here is advise.From what you describe I guess you are not pregnant. Your period is late maybe due to hormone disbalance. They will come soon. Hope I have answered the question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes small bumps on penis and testicles and yellow discharge?\n\nI have very small bumps on my pennis n testicles. These bumpps hav no pain n no itching irritation.some times my left testicle getting little pain.. few mnths back i saw yellow disccharge frm my pennis. i after using some antibiotic medicines the white dischare disappered. after one one month i found these bumps on my pennis.? pls give me information of medicines",
    "doctor_response": "HelloThanks for query .Multiple small pus filled bumps over shaft of the penis and scrotum are  mostly due to  staphylococcal infection of hair follicles.You need to take antibiotics like Augmentin and anti inflammatory medication like Diclofenc twice daily .Ensure to was yr genitals with warm water twice daily .It should get cured within a week .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does hyperintensities in deep white matter of bilateral frontal lobe in brain MRI mean ?\n\nI was advised by  Neurologist to carry out MRI of brain and MRI REPORT OF BRAIN FEW T2 AND FLAIR WEIGHTED HYPERINTENSITIES ARE SEEN IN DEEP WHITE MATTER OF BILATERAL FRONTAL LOBE IN HIGHER SECTION LIKELY CHRONIC ISCHEMIC FOCIPlease explain me the disease in detail.ThanksI DR V K JAIN,  (PROFESSOR CHEMISTRY) AGE 51 YEARS",
    "doctor_response": "HiWhite matter Hyper intensities(WMH)  of brain indicate either ischaemia or dementia.They usually represent small vessel disease.They are also useful to assess effectiveness of treatment They are associated with frontal hypometabolism and executive dysfunction.WMH have a stronger effects on glucose metabolism in that region and cortical atrophy,Frontal WMH was associated with memory dysfunction in nondemented subjects.They are more likely to occur in bipolar disorder and major depressive disorder.So I hope this answers your query and if you have any further queries ,you can ask us.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to remove sebaceous cyst on inner thigh?\n\nI have a sebaceous cyst on my inner thigh. I was just in the restroom and noticed it was almost a black color, when I squeezed it, it began bleeding profusely. I got the bleeding to stop after 2-3 minutes. Is this a major issue or is this fairly normal?",
    "doctor_response": "Hi! thanks for your question posted on HCM!After going through the history and short description of the lesion on your inner thigh, I feel, if I were your physician would like to consider/suggest followings:1. sebaceous cysts are best treated by surgical excision only; as the contents once spilled out can initiate foreign-body reaction and recurrent abscess formation, it is always best to remove it before it is partially or completely ruptured or punctured! the remains of cyst wall, if any, can also create new cysts in the surroundings...!2. the cyst, when aged enough, gets black in colour due to silent accumulation of blood components and melanin of the skin3. once this is squeezed, the content comes out; it could be blood mixed pus, pultaceous/chalky material, fluid etc and leaves the cyst open to the environment thereby recurrent infection!4. normal bleeding time is 2-5 minutes so this was normal and always apply pressure to reduce blood loss5. never ever squeeze or poke this but see a general surgeon as this might cause you major impairments due to severe infection!regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am suffering from stomach pain, it feels like it moves around some times.\n\ni have this pain right below my chest in the stomach area for like 3 days now its not a burning pain, it feels like it moves around some times. i ate some burnt toast and it kind a made it feel better. i don t know what it is . help",
    "doctor_response": "Hi.....Mr. eric.., Thanks for choosing HCM.., 1) Stomach pain in right side and it moves around means ....it could be Pyloric stenosis ..it is due to stenosing of pyloric canal...............one type of duodenal ulcer.., 2) Early morning...cap. Omeperazole-d  20 mg before breakfast for 20 days 3) Tab  Normaxin 2 times daily for 20 days.... 4) Antacid syrup.....Mucaine gel 2 spoonful for  3 times daily ...... If not responding .........consult Physician further follow up and evaluation...,goodluck..,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long one has for stage 4 lupus?\n\nNeed answers! I have a very dear friend/family member. She has recently told me she has stage 4 lupus. I ve done my research and from what she has told me (she cant get pregnant) and from that I believe she has APS from SLE. I also know lupus isnt classified in stages its by class. She has told me very little. There is only one other person that knows and that is her husband. In my research I also discovered that class 4 or iv lupus is the only class that renal failure is common in. she also has multiple medical degrees (not exactly sure what in) and she has been in the medical field for 24 years. So she knows plenty about her disease. She hasnt told me much because she dosent want me or anyone to worry about her. Like I said im the only other person that knows aside from her husband. She is very close to me and I feel the need to know if she is more serious than she is leading anyone to believe. Please do not try to discourage me from finding out and telling me she ll tell me when shes ready or its not good to medal in peoples lives. I just want to know the severity of this situation. If hypothetically sje is terminal or will eventually pass from this disease please tell me how long she has. Thank you in advance for your answers.",
    "doctor_response": "Good evening. Stage 4 lupus is  usually when the kidneys are involved. It is one of the most common stages to happen in lupus but it can get well controlled if adequate treatment is initiated. At this stage, it is hard to tell you the severity of her disease without actually seeing the lab values. But if she is taking proper treatment for it, she should be fine. The stage has a good response to treatment. It is not a terminally ill stage at all. A patient is terminally ill in lupus if they are on dialysis. Hope the information was useful",
    "dialogue_context": ""
  },
  {
    "patient_message": "Undergoing peritonial dialysis. Thin veins. Can I ever stop the dialysis?\n\nsir, I am a kidney patient . and under going peritonial dialisis in Bangaloore now. My creatine level was 12 at the time of starting the dialysis. now i wish to know whether i can stop the dialisis in future. hemodialysis was done for the first time ( eight times). My veins are so thin so AVF proccdure was a failure. Doctor says that my kidney are contracting. I have no sugar, no pressure or nothing. I am still healthy now.Electrolytes are also normal. Your suggestions please sir,",
    "doctor_response": "Hi Welcome to HCM. It looks like you have been diagnosed with CKD. You HAVE become dialysis dependent. Only kidney transplant surgery, if successful, can stop dialysis. Discuss with your doctor about AV GRAFT that can help people with thin veins. Be in touch with your nephrologist on a regular basis. Wishing you best health. regards DR GS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on shoulder\n\nmy husband is 52 yrs he has had a lump on his right back shoulder near his neck for about 2 years it has grown but seems to have stopped it is slightly bigger than tennis ball and feels smooth and not painful it is visible and looks like a hump it is painless he wont go to doctors looks like it is growing again",
    "doctor_response": "Welcome to health care magic. 1.The history and features suggest the lesion is possibly fat content - lipoma. 2.I would recommend to get a ultrasound examination done - that will help to evaluate the nature of the lump, its source and extensions and vascularity. 3.FNAC - fine needle aspiration cytology will confirm the diagnosis.4.In case of lipoma - needs monitoring, if increasing in growth excision might be needed.5.Suggest to see your GP and get referral to general surgeon.  Good luck.Hope i have answered your query,any thing to ask ? do not hesitate to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can vaginal itching be due to latex allergy?\n\nI am experiencing vaginal swelling after intercourse when my partner is wearing a condom could I be allergic to Latex? I have also heard that this can be a sign of Cervical cancer? I did have an irregular pap smear and thin prep colposcopy several years ago with continued pap smears every year to ensure no further issues",
    "doctor_response": "absolutely, there is an entity called latex allergy and you have rightly suspected. you also need to see if you can get rashes on your hands if had worn a latex gloves also.surprisingly there also a content of suffering  called semen allergy!!what all you need to be is, be observative next time, while contact with rubber products. and still have same complaints better to avoid them as avoidance is most safe and first step way out of allergies.and with your pap smear issue. i strongly recommend to seek a gynecological opinion at the earliest as this is an entity to be ruled out at the earliest.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Red, itchy rashes on skin, become brown and heal, on thighs, arms, back, treatment\n\nI ve had itchy rashes on my skin for many weeks now. It starts off as a red rash and is very itchy. Then they sort of flatten out and become brownish in colour, still a bit itchy at this point and then heal. I have them on the sides of my thighs both inner and outer and on my arms and back and abdomen areas. My GP has tried treatment for scabies , antibiotic ointment and even steroids but so far nothing has worked.",
    "doctor_response": "Your skin rash may be Miliaria rubra or heat rash. You could try the following measures- 1. You should avoid hot humid work place and  bed room. 2. You can better choose a well-ventilated/ air conditioned room. 3. Take cool water bath Twice daily. 4. Take- Tablet ATARAX 25mg three times daily as your need 5. Apply calamine lotion on your whole body (except face) at night for 1 week Visit/ consult online dermatologist 1 week later.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest infection in child\n\nHi my baby is 7 month old she suffer from chest infection ana Dr sujjested her myteka bretainand sefspan when she was born her tsh level was increase Because of i have taken thyroxine during pregnancy and still i take 3 thyroxine in fasting what should I do for her my baby is on mother feed",
    "doctor_response": "hi ,frequent chest infection is not related to your thyroid status.because you take thyroxin during prgnancy and still on ,you should rpeat tsh level of your baby.now your baby is 7 month old give him home made supplementry food along with milk. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can passive smoking increase chance of tonsilitis & bronchitis?\n\ni had tonsillitis with some bronchitis almost 4 to 5 weeks ago and i still get a cough every now an them from laughing or running but i dont smoke but in the past i been around smokers also i took antibiotics and i am pretty sure i don't have asthma considering this never happened to me before.",
    "doctor_response": "Hello , thank you for posting your query in HCM. Passive smoking has  harmful effects same as the smoking that cause health  hazards. Tobacco smoke contains 200 to 4000 toxic chemicals including nicotine, carbon monoxide,  formaldehyde which cause heart diseases, lung diseases like bronchitis, asthma,  middle ear infections, tonsillitis and  symptoms like cough, sore throat,  nose irritation. If i were your treating doctor i would like to get these tests done.1. Blood tests to rule out infections2. Chest x ray3. ECG to rule out cardiac causes.I would come up with following possibilities like asthma, bronchitis, i would suggest you to consult a pulmonologist for further evaluation.  Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lack of sleep, discomfort. USG shows fatty liver. Prescribed Ursocol. Worried\n\nsir my name is mercy 48yrs female last 2 weeks i have lack of sleep and discomfort ..i consult with a doctor he told me to take ultra sound scan .then i took scan the result shows \"'smooth normal size and fatty liver\"' and the doctor adviced me to take ursocol300 tablet ..but still i am worried about this disease can u tell me what the treatment i want to take and what are the test can useful to know more....      thanking u",
    "doctor_response": "Hi Ms Mercy, Thanks for writing in. Fatty liver is a condition which needs prompt attention . I would suggest the following 1. Stop all existing medications including ursocol. 2. Start tricholine citrate - sorbitol combination.(2tablespoons in a glass of warm water once in the morning) 3. Onithine compounds are needed in the dosage of one tablet three times a day. 4. Dietary modifications as advised by a medical dietician. 5. Regular exercise for at least 30 minutes. 6. Vitamin supplements. 7. repeat USG and liver function tests after 6 months. I am sure your problem will be cured by the aforementioned treatment. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure bald patches on head?\n\nmy 10 weeks old baby got a bald patches on his head.. I m just worried because of hair loss... my pedia prescribed my baby a cetaphil... but 5days after using it the bald still there.. can i use DesOwen now? i found flaky dirt on his head.. i want to return back the hair loss.. does DesOwen is application? hope to get a feedback.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have multiple lipoma on arms, thighs and torso(incl ribs & back) few located on ribs & other awkward locations do sometime hurt... I am also a smoker, having some coughs in the morning...The problem is i am having a stabbing pain in my back from 24 hrs just below the shoulder blade ...its get really nasty when i exhale deeply of inhale.Need Help thanks",
    "doctor_response": "hello, welcome to healthcare magic,this pain if radiates to the chest then please contact a cardiologist ,as you may have infarct as you are having lipoma which is a sign of hyperlipidaemia and hyperlipidaemia accompanied by stabbing pain and radiating towards back can be an emergency i.e.infarct ,please do an ecg as fast as possible and consult a cardiologist immediately",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a painful lipoma in the upper arm be treated?\n\nI have a lipoma on the top of my left wrist. There is a bruise at the same spot. the bruise is small and has been in the same spot for several months. I also has a scan that showed a sac in my right upper arm. Mid arm on the outer side. It inhibits the movement in my arm. I have arthritis (Psoriatic arthritis ) also. Now a lipoma had come up on my right fore arm. The 2 lipoma do not hurt. But the sac that showed up on my scan is painful. advise or concern ?",
    "doctor_response": "Hi, You can consult an orthopedician and get it removed. Lipoma is a harmless condition and does not cause much harm. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a possibility to conceive because of this watery sperm ?\n\nhello doc, I tried to have unprotected sex with my girlfriend and i feel a little spam(kamarash) like water in top of my penis. then i tried to push it but we abort sex(unprotected sex). i just push it about not more than 5 cm and get it out. but did not come the final spam. is there any possibility to pregnancy with that water like spam? normally i fell it when i was very excited and must before having sex? my final Question is Can my girl friend get pregnant ?",
    "doctor_response": "hi, welcome to healthcare magic that water like semen also contains sperms,if your girl friend is in her ovulatory dates then there is a chance for pregnancy",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a large solid scab on the upper back?\n\nWhen my son visited a couple of weekends ago, I was shocked to see that over two thirds of his upper back was covered by what appears to be a large solid scab, or some kind of fungal growth. when I appeared shocked and questioned him, he seemed embarrassed (of course I am his mother) and dismissed it as nothing. He is Sixty two and grossly overweight, but always very clean and well groomed.",
    "doctor_response": "Hello! Welcome to HealthcareMagic! I have gone through your question and understand your concern. The cause of scab is unclear with no medical history (like if the patient is diabetic or hypertensive or currently on any medications or history of family allergies etc). However, a few causes considering the age and obesity can be enlisted.The most common on the list is fungal infection which you already suspect.Fungal infection can cause intense itch which eventually cause scab formation and may also  leave a hyperpigmented patch over the area. Fungal infections are not due to unhygienic personal habit in most cases. In obese it could be the underlying diabetes, low immunity, excess sweating or even frequent use of antibiotics to treat other infections.It could even be a scab from healed decubitus ulcer. Decubitus ulcers appear to be more prevalent in obese patients who spend above average time on their backs. Wound healing is also slow in obese patients and even boils over the skin tend to stay infected for a long period of time with slow healing rate. Psoriasis also occurs more frequently in obese, but the reasons for this are unclear.These are only few causes, they are plenty others. Obesity and skin infections can cause low self esteem and depression which will prevent the patient from seeking any medical help. My advice is to address the issue to a GP as the scab have to examined to come to a diagnosis(like Wood's Lamp examination or biopsy or scrapping of the scab). At your visit expect a few basic test like blood sugars, ESR, thyroid levels and physical examination before concluding the underlying cause after which treatment will be initiated.  Hope this clarifies you concern. Thank you for the query. Take care Regards, Dr. Ayesha Shareef, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat loose motions in 19 month old child?\n\nHi, My 19 months old daughter is suffering from loose motions for last three days...mucus is there,white in color and very much bad smell...15 days before also she had same problem, however doctor gave her OFLOMAC and VISYLAC. That time she cured completely, but with 15 days she has again the same problem.",
    "doctor_response": "Most often loose motions in children is caused due to certain viral infections. Recurrence could be due to reinfection or due to retention of the previous infection. Maintenance of proper hygeine can prevent reinfection. In case the problem recurs, I would insist you to get a routine microscopy of stool done. If the results indicate increased pus cell count, it could indicate a bacterial infection and could require to be treated with antibiotics like Oflomac. But in case pus cell count is normal, there is no need to give antibiotics. Rather giving ORS (oral rehydration solution) to prevent dehydration is more important. Also give plenty of yogurt/curd as it contains beneficial bacteria as in Vizylac.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Done Ayurvedic method of bursting oral tumor. Now nodes in neck. Treatment?\n\nMy mother is 55 years old and is suffering from oral cancer , Doctors advised for a surgery, chemotherapy along with rays. But my mom does not want to under go the surgery as she is emotionally week. we tried the ancient (Aryuvedic) method of bursting the tumor . the Tumor is busted but the nodes are formed in the neck. How do we treat them, whats the life span of a person diagnosed of tongue cancer. Please advise",
    "doctor_response": "Hi, the tumor is not responding to the treatment govern by you. It is urgent to visit the medical oncologist now. So that after assessing, he/she will start the chemotherapy. Prognosis depends on the assessment and chemotherapy tolerance . Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen redness in the legs after placing coronary stents?\n\nMy husband has 17 stents in his heart....he has been working on his semi trailer this week putting cross members under the trailer floor. Tonight his legs are swollen & red...I m worried. Blood pressure was 147/78 pulse 78 but he always has very bad heart beat. It has been that way for some time now, should he just elavate his legs tonight until bedtime?",
    "doctor_response": "he should get his echo done to see how much his heart is working?Get his renal function done?Urine for albuminuriaThere are plenty of causes of swelling in legs,you consult your GP, to rule out its cause and then tk start medications.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes wounds on glans penis?\n\nhi I had sex during the last six month but after that I had oral sex only about a month ago. I masturbated at night and next day suddenly I saw wounds below the penis head open wounds not circular shaped and these wounds are there from 3 days ago im cleaning them with betadine",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern and looking to the history given here it could be said that the chances of infection is very likely and possibility of sexually transmitted infection need to be ruled out and for this you need to see the physician for clinical examination and test, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cure for the red, dry and cracked foreskin and has been diagnosed for Type I Diabetes?\n\nHi yes, I have an extremely red, dry and cracked foreskin. It won t stretch over the tip of my penis and I find little white sorta goo under the foreskin when I do peel it back. Have just been diagnosed with type 1 diabetes had these problems since I started showing symptoms for my diabetes but I don t think it is. Please help!! Thank you Cody Bingham",
    "doctor_response": "WHAT U ARE DESCRIBING IS A COMMOMN COMPLICATION, DIABETIC PATIENTS SUFFER FROM.IT IS BECAUSE OF REPEATED INFECTION OF FORESKIN AND GLANS PENIS CALLED AS BALANOPOSTHITIS.THE LONG TERM EFFECTS OF THIS LEADS TO CONTRACTURE OF FORESKIN RESULTING IN INABILITY TO RETRACT IT BACK CALLED PHIMOSIS.U ARE ADVISED TO UNDERGO CIRCUMSCISION BY A SURGEON OTHERWISE U WILL BE GETTING REPEATED INFECTIONS, PAINFUL ERECTIONS.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for high fever\n\nHello doctor! I am Ranjana. My baby is 19 months old. her weight is 12.1 kgs. She is having high fever since past 2 days (from 10th june 12 noon). The doctor has prescribed calpol (paracetamol) and voltaren (suppos.) and observe till today eod. Since yesterday she did not have any other problem exept fever..but today morning she passed stool twice and I felt that her stomach is upset. Would like to know if i can give her fruits like apple, banana etc. in this condition? I have heard boiled apple is good to treat upset stomach in babies. Secondly what other food and fluids can I give in fever? (We are Indians living in Dubai.) Thanks!",
    "doctor_response": "hi Ranjana, kids ll ve decreased appetite but more calorie requirement during fever so its difficult to feed them. Once she starts taking feeds, you can feed her with whatever she likes and those are easily digestible. Rice based foods, cereals, curd (not chilled and not sour) fruits and vegetables can be given. Just avoid anything that is spicy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from hair thinning and hair fall. On zincovit. Diet of vegetables sufficient?\n\nI am Siddharth, I have been suffering from hair thinning and hair fall. I came to notice it last month when my scalp became visible from the front and back as well, No matter how I comb my scalp is so visible. I shampoo every day with a very mild shampoo-Johnson & Johnson baby shampoo. I seldom put oil. I have taken 30 tablets of Zincovit since last month.Currently taking xtraglo everyday.But with no visible effect.I am 20 years old, I have a mixed diet of green vegetables as well as fruits.",
    "doctor_response": "Hello Mr. Siddharth, Hair thinning and hair fall have many reasons, most important being heredity. Dandruff of the scalp, exposure to pollution, recent illness or surgery, stress and nutritional deficiencies are other common causes. Minoxidil is the specific drug used for hair growth. It is available in the form of oil and has to be applied daily without fail. I suggest that you see a trichologist for further advice. You may continue with  Zinc, selenium and protein supplements. Today, there are many types of treatment available for hair fall, so do not worry. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does scant menstrual discharge indicate pregnancy?\n\nhi i have a question, my period this month came on two days late and it only lasted maybe a day or a day and a half and was very light. i had a peagnancy test done 5 days ago and it said negative should i go get another one done at the health department? could i still have a chance at being pregnant?",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the delayed period with scanty bleeding needs to rule out pregnancy.As the test is negative the chances of pregnancy are rare.I suggest you to repeat the test after a week.If the repeat rest is also negative the pregnancy is ruled out.And the abnormal period can be due to hormonal imbalance due to stress or any.But if this sort of abnormal period continues every month then thyroid abnormalities, stress,overweight or obesity should be checked and treated.Nothing to  worry.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for asthma which is causing nasal infectiom\n\nMy daughter is 12 years old. She has a mild asthama since few years and gets  a bad cough during change of season. Or some time the attack is after an infection. Since 2 days she has a severe cough after a slight nasal infection. Doctor has advised flohale and asthalin inhaler 3 times a day. My question is can she take both with a gap of 1 hour 3 times during the day as I thought they are for the same purpose. Also ithis the right medicine to take as 1 day has passed but the dry cough is severe and does not see to be releving during the night specially.",
    "doctor_response": "Hello dear,The symptoms as mentioned in your post can be attributed to acute exacerbation of asthma, secondary to a respiratory tract infection.Management involves:1. A course of antibiotics to eradicate the causative organism.2. Asthalin & Flohale inhaler- provide symptomatic relief by causing broncho-dilation (dilating the smaller airway passages, relieving the obstruction & increasing airflow to lungs)Asthalin has short duration of action but provides immediate relief.Flohale has longer duration of action & maintains the airways.So, it is advisable to take asthalin first, followed by flohale after 15-20 min.3. Montelukast preparations- used as a maintenance therapy to relieve symptoms of asthma.4. Antihistamine & anti tussive preparations for symptomatic relief from cough.5. Maintain adequate hydration & a healthy balance diet.6. Also make sure that she is well protected from cold, dust & other allergens.If symptoms still persist, kindly consult a Pediatrician/ Pulmonologist for proper clinical evaluation.Wishing her a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning pain in the penis after intercourse?\n\nHi i have a problem that only arises after consumption of alcohol after intercourse and ejaculation i have overwhelming urge to pee accompanied by burning pain in head of penis. This is pretty uncomfortable and lasts for 30 to 40 mins any ideas? Thanks",
    "doctor_response": "DearWe understand your concernsI went through your details. I can understand. Rough sex always effect inflammation of the smooth parts of your penis. After sex urination salinates the rashes and therefore it burns. This is natural reaction. It is also evident that you are practicing rough sex after having alcohol, because without alcohol you donot have any of the give problems. That in itself suggests, your intercourse with the influence of alcohol is the basic problem. Restrain in the case of alcohol and rough sex. Take care.If you still need my assistance in this regard, please use this link.  Please remember to describe the whole problem with full detail.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat irregular periods to achieve successful conception?\n\nhello doctor.... I'm having the problem in mestrual.. i have irregular period since 4 months and happened to be  only a spotted only.. now me and my husband trying to conceive but because of the irregular period we are not succeeded.. please what can we do to cure this problem???",
    "doctor_response": "Hi,   You are correct in trying for regular periods before trying to conceive.    A regular period, along with ovulation is essential for conception.    Treatment for getting your periods regular is first thing you should go for.       Usually a detailed check up by a gynecologist,few routine blood counts, hormonal assay, pelvic ultrasound  are done to pin point the cause.     Treatment depending on causative factor responds ell to treatment.  Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and tightening in foreskin of penis when having sex?\n\nHi, im 28 years old. Recently I got married whenever I m having sex im getting pain as my foreskin on the pennis is tightening. The foreskin is going back till the inner RED Area ut after that it is very tight. So now im considering Sunthi operation. May I know the avg price & how many days it takes to completly cure. Because im doing software job and we don t have much holidays. Thank u",
    "doctor_response": "HelloThis type of condition we call paraphimosis .The surgery require but the cost depends upon place, surgeon , hospital .Sometimes I have treated such cases manually with simple needle holder under local anesthesia .So in my opinion before surgery consult 2-3 surgeon and get their opinion.Recovery period is not more than 3- 4 days.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for red rashes on joints and armpit\n\nHai docter. i am shaji from Harippad Kerala Alappuzha( dist).Sir last five month s i am using cosmelite cream so i have a better result in my face &skin .But i stopped the cream last two weeks then i have growth red rashs in my joints & armpit. How to recover from side effects of",
    "doctor_response": "Hello, Perhaps you have a fungal infection. I suggest you use an otc topical antifungal e.g. Clotrimazole cream. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Kakkar S., Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever and frequent ear infections in a child?\n\nHi..I have a 16month old son who has stayed sick seems like since birth. He had repeated ear infections which eventually led to him getting tubes. He continues to get ear infections that are hard to clear at times but also runs high fevers...which his dr seems to now be a little concerned with since sometimes there are no obvious symptoms or none that would lead them to believe he should have fevers so high. Waiting to see if they are going to refer him to an infectious disease dr.  He also has never slept well and I can't help but think his lack of sleep also plays a part in all of this. What are your thoughts and why should we do??",
    "doctor_response": "High fever and ear infection could be related to tonsillitis or infection of tonsils. His tonsils need to be evaluated as increase in size of the tonsils could often be related to such frequent episodes of catching cold. Some children are more prone to such infections but the propensity comes down with age. If the episodes are too frequent, surgery may be required, but not otherwise.Although it might seem that your child hardly sleeps, please be reassured that your child would get the sleep he requires and you need not worry. Sleeplessness would be unrelated to the recurrent infections.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. There is incomplete right bundle branch block with inferior infarct in ECG. Why?\n\nHello doctor, Yesterday my wife on her annual checkup got an abnormal ECG. The report says: Normal Sinus Rhythm, Incomplete right bundle branch block, inferior infarct, age undetermined. She is 55, a little overweight, otherwise healthy. We are very worried.",
    "doctor_response": "Hello. I understand how worried you are about your wife's health, do not worry she will be fine soon. The ECG shows evidence that points to the fact that your wife has a injury to the right part of her heart. This can cause a disruption of electrical impulse traveling to that area which show cased as (right bundle branch block). I advise you see a cardiologist. She needs to do further investigations like Echo to ascertain how well her heart is working and to know the extent of damage. I wish her a speedy recovery. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low libido and erectile dysfunction\n\nMy fiance jerks off anyway where from two too twelve times a days instead of having sex with me...I am worried that we aren t ever going to have kids in the future and his Stamina is not good and recently he started having issues staying erect before sex...What can I do to help him...he is 23yrs.old",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Yes too much masturbation often leads to loss of libido which in simple words means decreased sexual desire as our body gets used to get all the pleasure from masturbation rather then from actual intercourse. What I would advise you is to take your fiance to a psychiatrist and gets his counselling done. The only way to get his libido back is to abstain from masturbation. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes head rush with shaking and body aches?\n\nHi, I've been having head rushes for the last three days when I stand up and sometimes it feels like I'm going to pass out, as in I will start to see white blotches and feel really faint and start shaking. One time, I did actually pass out from this. Also, my whole body aches. Do you have any insight as to why this might be happening?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, we should first rule out heart related diseases in your case because these can cause similar kind of symptoms. Heart diseases like hypertension, hypotension, dyslipidemia etc can cause similar kind symptoms. So better to consult doctor and get done 1. Blood pressure monitoring 2. Ecg 3. 2d echo 4. Lipid profile If you are having hypertension then you need to start antihypertensive drugs. If it is hypotension then you need to drink plenty of fluids orally. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it alright to exercise inspite of my heart ablation?\n\nI have. Few electrical issues with my heart . Have been a ablated and things are a little better . My efraction is between 35 and 40. With that said, when I exercise I have a sustained heart rate of between 210 and 230. Am I doing more harm than good?",
    "doctor_response": "Hello! Thank you for asking on HCM! You need to be very careful and to avoid excessive physical exertion, facing your reduced LV ejection fraction. I would recommend just waking and continuing to be active  that way, but no exaggerated strain. If you experience such high heart rates again, that you need to see your attending cardiologist for a comprehensive evaluation, and define a possibility of ICD implantation (if life threatening arrhythmia results).Hope to have been helpful to you. Greetings! Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes facial spots?\n\nbad spots have developed on my cheeks and jaw over the past year. my forehead has always been clear and remains clear. i am 23 years old. never suffered from more than one or two spots at a time before now. i have had and still have no other medical problems. im 5'2\" and weigh 8 stone 2 pounds.",
    "doctor_response": "Hello,Thank you for posting on HCM.I am sorry to say the description you have given is not sufficient to reach any specific diagnosis as 'facial spots' could be melasma or any moles or even post inflammatory hyperpigmentation.Thereby I insist you to redraft your question with proper history and description for better understanding.You can reach me directly for any further assistance on the following link: you best of health.Thank youDr Hardik PitrodaM.D Dermatology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting and red rashes on thighs of a 3 year old?\n\nMy 3 year old daughter has thrown up the past 3 mornings within an hour of waking up. After she vomits she feels fine, eats well, and has no problems ths rest of the day. The only other symptom I noticed was that this morning she had a red rash on her thighs and around where her underwear sit, but that also disappeared right after she vomitted. Any ideas?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.BY WHAT YOU QUOTE IT LOOKS LIKE A VIRAL EXANTHEMATOUS ILLNESS.Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rise in the blood sugar level despite taking Metformin and Lisinopril?\n\nI am currently taking 1000mg of metformin twice daily along with 1200mg of gabapentin twice a day, 20mg of lisinopril once a day and 45 units of novolin 70/30 twice a day. Yet my blood sugar continues to rise. 4 months ago my average daily sugar level was 120, 3 months ago it went up to 140, last month it was around 170 and now I average 200. Whats going on?",
    "doctor_response": "Hello and thank you for asking!There are many factors that increase the blood sugar.One of them is weight gain, physical inactivity, uncontrolled diet, infections ect.You treating physician will evaluate them carefully and try find a cause.Meanwhile i would suggest to increase the dose of insuline (the dose of the morning if it is high during the day, or the dose of the evening if it is high fasting) until the blood glucose reaches normal levels.Hope the information will help.Kind regards,Dr.Mirjeta",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for severe muscle aches, headaches, heart palpitations and headaches?\n\nHi, I had 2 venofer iv infusion last Monday and Wednesday. Since then I have had sever muscle aches, respiratory infection, abnormal feelings, headaches, heart palpitations, hypertension, phlebitis at the insertion site, severe ear pain, bach ache, my eyes keep tearing, my nose keeps running, and I have a sore throat, I also feel chittery.",
    "doctor_response": "In my opinion all common side effects of iron injections yet you are having sever symptomsi recommend  seeing your doctor or going to ER immediately Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "On cholesterol lowering drugs, taking aspavor 20mg. Could chloesterol lowering drugs have damaged my liver?\n\nI am 48. I have been on Chlesterol lowering drugs for +- 25 years ( currently Aspavor 20mg). Without medication my Cholesterol is 8.2 with medication 5.2. What worries me is that my Gamma GT ranges between 94-98. I stopped drinking 2 years ago ( never a heavy drinker). Could the ongoing use of Chloesterol lowering drugs have damaged my liver?",
    "doctor_response": "If you stop cholesterol lowering agent, then your liver will get fatty changes which is more dangerous.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain and breathing problems\n\nHello. My husband is a liver transplant patient and last week we went in because he had shortness of breathe - they treated it with pain meds - then basically told us his colon was inflamed, now he has a slight abdominal pain, lower right side and chills - NO fever...",
    "doctor_response": "Hi.Thanks for your query. Read the history about your husband and understood the problems. Liver transplant patients need a careful treatment. Shortness of the breath could have been investigated for possible Pneumonia, asthma, allergy or so, which you have not mentioned anything about. I wonder how the pain medicines could have helped. If the colon is inflamed, he needs more careful investigations and treatment as all the things absorbed by the large bowel - the colon will be filtered by the liver and may cause damage to the transplanted liver. I would advise you the following:Take your husband to the Liver Transplant Center.Get colonoscopy and investigations of the blood, stool and urine- the liver, kidney function.Further treatment will be as per the findings and will be specific for the cause .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in arm with bulging veins?\n\ni have been haveing pain in my right arm and hand and the veins on the top of my hand are bulging. the tip of my ponter finger is also numb and pins and needles. i thought this was tendonitis and had a cortisone shot in my elbow on monday. is this all related?",
    "doctor_response": "Hello, It could be a simple musculoskeletal pain only. As first-line management, you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back pain?\n\nhi, i was at a tennis camp yesterday, and we did a shuffling and running drill to warm up. After this drill my lower back started hurting really bad, and still does. i dont know what i did. do you have any idea? and I have been icing in and have taken ibueprofin but its not helping.",
    "doctor_response": "Hi,It seems that there might be having severe muscle strain leading to muscular spasm giving this problem.Along with Ibuprofen take some muscle relaxant medicine for 2-3 days.Apply muscle relaxant, analgesic cream locally.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I have burning sensation in my pelvic area after a month of lithotripsy?\n\nI had lithotripsy about a month ago, and still have a 6mm stone in my right kidney....I'm wondering if the burning in my pelvic area now could be due to fragments from the lithotripsy or if it's because of the stone in my other kidney. I am a 78-year-old woman. Thank you for your input.",
    "doctor_response": "HIThank for asking to HCMI can understand your query if this is the stone there then this could give pain and not the burning sensation burning sensation could be due to the infection and need to be investigated and for that the urine examination is must hope this information helps you, have good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen neck in infants?\n\nMy duaghter 10 month old she have small swelling at right side of neck and his lab investigation has shown ESR 53mm/1st hr and Platelet 551 %. pheripheral film shown anisocytosis hypochromatic poikilocytosis target cell platelet increase neutropenia.",
    "doctor_response": "Hi,Thank you for asking question on health care magic.Swelling on the right side of the neck may be a lymph node.High ESR suggests a specific infection like TB.Mantoux test and X-ray chest to rule out TB.Better consult pediatrician for proper diagnosis and treatment.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a large lump on the hand?\n\nI have had a large lump, on the back of my hand for almost a year. I went to the doctor today and he tried to drain it but nothing came out! When it get cold it is very painful, it actually woke me up the other night because of the pain (yes the pain was so bad I was crying) I also have a lump on the lower back of the head to the right of the occiput. I was so large and very painful expecially when cold, a few weeks ago I called to make and appointmet which was today. That bump is gone now.",
    "doctor_response": "Hi,Thanks  for  your query.Well, without a clinical evaluation it would be difficult to determine the cause of the lump. Possibilities that may need to be considered include enlarged bursa, lipomas, cysts, growths from underlying connective tissue etc.I would suggest getting this evaluated by an orthopedician for an accurate diagnosis and appropriate management. You may get the X-ray of the area affected and FNAC (fine needle aspiration cytology) of lump under his/her guidance.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Whenever i shag ,i get pimples on my face\n\nsir , this damn serious . i am observing it from 1 year whenever i shag ,i get pimples on my face everytime,dont say no and tell me some remedy for it,please",
    "doctor_response": "Hi, Welcome to Healthcaremagic! For acne or pimples, as they commonly are called, you need to keep patience & take medicines regularly. Apply Clindamycin gel twice a day (morning & evening) & Adapelene gel at night. Clean your face with a normal soap like lux or dove. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itchy rash on chest, inner arms, spreading. Any ideas?\n\nI started having itchy rash 3 wks ago on chest,back & inner arms. Went to min clinic & wasnt sure but didnt thnk poison. Gave rx for itching & antihistine. Itching now spread to include legs, feet & sonetimes palms. No rash on palms but itch. Bad itching. I m beginning to wonder if my nerves or some internal medical problem?",
    "doctor_response": "Hi, it may be irritant or allergic contact dermatitis.take a short and tappering course of steroids. Take antihitaminics till itch is relieved. Apply steroid cream or tacrolimus oint 0.03 percent t wice  a day. Avoid soap and dust,fume and grass particals.avoid soap bath, you can take dettol bath.... You may be improvd",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have asthma. Chest X Ray results differ, tiny lung granulomas. Infection?\n\nI had a recent chest x-ray, the first one says that my lungs are essentially normal while the other clinic says in their reading that I have a tiny lung granulomas. what does it mean? I'm planning to go abroad and my visa just arrived and I'm having a problem with my CXR. Is it infectious or not? I dont have any history of lung ca, smoking and other risk factors however I have an asthma but the last attack was in 1996",
    "doctor_response": "You should go for CECT and Blood Investigation like CBP, ESR, MX and observe whether fever is coming on and off, any loss of appetite and weight.To rule out mycobacterium infection in lung.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat constant burning,pressure and pain in inner ears?\n\nGood evening. I have a continuous burning in both of my inner ears and often with pressure and pain like when you blow balloons. I ve had allergy s and am on daily Claritin and a nasal spray but its not working. I have continuous runny nose as well. Have already got an allergy shot but that only suppressed the sensation for a week.",
    "doctor_response": "Hi, thanks for using healthcare magicThe symptoms may be continuing because you are still being exposed to the allergen.You may need to consider allergy testing to determine what is causing your reaction so that it may eliminated.The use of decongestants- oral and topical (applied directly to the nose), may help  relieve some of your symptoms.These would be available over the counter at your local pharmacy.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Trust pills, had unprotected sex, delayed period. Am I pregnant?\n\ni am a trust pills user for 10 months. and i decided to switch to daphne pills. i tdid not finish the trust pills coz i already got my first period on sunday, so on sunday night i took the first pill of daphne. i had unprotected sex with my husband 3 days after my menstruation but i drink regularly the pills . i am expecting for my period this last week of sunday this month. but it didnt arrived it, and its tuesday now. am i pregnant? but i dont have any signs of pregnancy at all. i already have 1 year old and 3 months son. but i dont think im pregnant coz i dont feel anything at all just like before my first pregnancy",
    "doctor_response": "Hallow Dear,Trust pills are birth control pills having Ethinyl estradiol, levonorgestrel and  ferrous fumarate. The last is iron to complete 28 days. First two are the hormonal components which give the effect of birth control. After getting the menses, you shifted to Daphne which contains  Lynestrenol  (Progesterone). Both these pills are good birth control pills provided they are consumed regularly. However I would suggest you to stick to Trust. You had sexual intercourse 3 days after your menstruation while on the pills. So the chances of the pregnancy are very rare. When you are taking birth control pills regularly, you are well protected from the pregnancy, whenever you may have intercourse. Moreover your intercourse was not during the fertile period. !4 days prior to the next menses (when you are not on pills), the egg release (ovulation) occurs. Egg has got a life of 24 hours and sperms are active for 72 hours. Hence a period of about one week around the day of ovulation is considered as fertile period. Your intercourse was far away from this period. Also, you are not having any 'feel' of the pregnancy too. Further more, you are on the pills regularly. So you are not forming eggs. Therefore most probably you are not pregnant. The delay in your menstruation may be due to change and irregularity in the composition of the pills. Progesterone only pills are known to cause less bleeding. Delay by two days should not be considered as delay. Still to confirm the diagnosis, please wait for 1 week more and then perform urine pregnancy test on the overnight morning first urine sample. Earlier these tests may give false negative results. If you do not want to wait that long, you may go for Beta hCG test which gives reliable results even few days before missing period. This should take away your stress. And finally, even if the pills have failed (which is very rare) and you are pregnant, you can terminate the pregnancy safely by medicines up to 9 weeks. I hope this helps you. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it safe to take MTP kit at home without doctor guidance?\n\nHi doctor, I am a 26 year old married woman. I have missed my period. When I tested using a Prega News kit, the result was positive. I do not like to have a baby now and I want to terminate my pregnancy with the help of MTP kit. Please advise me how and when to take medicine for termination. Do I need to take any other medicine with MTP? Please tell me in detail. I do not like to go hospital for this. Is it safe to get it done at home?",
    "doctor_response": "Hello. Firstly, your decision of not reporting to the doctor itself is very wrong and trying to abort at home is further wrong as MTP can lead to a lot of bleeding complications which you cannot manage at home after taking the medicine as a dosed protocol. The MTP kit (medical termination of pregnancy) is available in the market as unwanted, but the instruction to take the medication is not accurate for requirement of dose depends on the period of gestation first. Hence, it is necessary that you should undergo an ultrasound pelvis to locate the pregnancy first whether it is intrauterine or ectopic. Once intrauterine confirmed, then the tablets can be taken in a scheduled manner under your local gynecologist supervision in a sequential manner with Mifepristone first and then Misoprostol. Sometimes, Misoprostol has to be continued till 2000 microgram maximum dosage in case of failed abortion with the initial dosage, which may lead to surgical abortion or D and C (dilatation and curettage). So, it is recommended that you should meet your gynecologist first and do not attempt any home abortion. It is not safe at all.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can taking metformin result in dry mouth?\n\nI take serveal meds and evert night I get a very dry mouth. Could one or more of these meds be the cause? I tak Dilgizdm 120 mg, Metformin 500, Lisinopril 20 g;Warfarin 2.5 mg six days a week and 5 mg once a day, Amoldipine 5 mg, Prevastatin Sodium 40 mg.  Thank you Bob",
    "doctor_response": "Hi,Thanks for posting the query,     Prolonged use of medications can cause the condition.Take lukewarm saline rinses at home.Drink plenty of water to keep yourself hydrated.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of high blood pressure and high sugar ?\n\nhai doctor! good after noon Ima a little kidney pataient about 6months . doctor has advaised me to take wysolone  120 mg for 3months. after falloped up reduceing10mg every 14 days  till to20mg. due to side effect i have sometimes high blood presser sometimes sugar high. please  explain me. sorry for my wick english.",
    "doctor_response": "HI THANKS FOR POSTING YOUR QUERY ON HCM.THIS HIGH BLOOD PRESSURE AND HIGH SUGAR IN YOUR CASE IS SECONDARY TO INTAKE OF STEROIDS.THESE DRUGS ARE KNOWN TO CAUSE THESE FLUCTUATIONS.I SUGGEST YOU GET A SCREENING ECHO AND HBIAC.FURTHER LOWERING THE STEROIDAL DOSE CAN CONTROL THIS BP AND SUGAR VALUES.CONSULT YOUR DOCTOR FOR FURTHER QUERIES.THANK YOU,TAKE CARE",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for blisters on foreskin\n\nHi doctor,On Last week after I masturbate, my foreskin sudden have kinda like blister appeared. I thought it will clear out after a few days but it didn't until yesterday I went consult doctor where nearby my hostel. The doctor let me try out steroid cream for 1-2 weeks, if it persists he ask me to have a blood check up. He suspect my blood has infected some virus. I am very scare right now. What do you think doctor on your view on my situation?  Thanks",
    "doctor_response": "Thanks for contacting HCMYou are concerned about blisters on your penis and what could they be. If you have been sexually active at any time with another person then you still run the risk of having contracted herpes simplex infection. You did seek medical attention which was a good idea but I think your doctor should have taken cultures of the blister to determine if it was herpes. If the blister was already healed then a culture would not be helpful.I agree with using the steroid cream to see if it helps. I also recommend that you do have the blood work done to determine if you have been exposed to HSV.I hope I answered your question. Please contact HCM again with your medical questions and concerns",
    "dialogue_context": ""
  },
  {
    "patient_message": "For what sporelac,bidanzen forte,rabicip are used?\n\ni had undergone haemmoroids surgery and fistula surgery n dr had prescribed me sporelac,bidanzen forte,rabicip d,movon and tab ceftum in after surgery medication.what these medicines are for as i m felling lot of pain and bleeding is coming when i m passing stool.",
    "doctor_response": "Hello, Sporlac is lactobacillus which is usually given along with antibiotics to keep gut flora normal. Bidanzen is an anti-inflammatory and it might have been given for the inflammation post hemorrhoid surgery. Rabicip is Rabeprazole, an antacid that was given to you because you were prescribed pain killer and other drugs. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Prabhash Verma, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes watery eyes and runny nose in a child?\n\nmy 1 and half year old daughter had suddenly watery eyes and a runny nose,and kept rubbing her eyes endlessly,she doesnt have a cold,and I later learned that while I took herfor a walk,our house was sprayed by an insecticides,and now she had a diarrohea,please tell me is this an allergy?",
    "doctor_response": "HelloThis is likely a reaction to the insecticides and since she's a little too young for me to suggest you give her benadryl, if this continues for more than a day you need to take her to the doctor",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have numbness in chest after undergoing bypass surgery?\n\nHi,  my husband had a 4 way bypass surgery 8 years ago and last march he had a heart attack.  he has been feeling numbness on the left side of his chest, and last night he had a sharp pain on his chest which stopped after doing some breathing techniques.  Is that numbness related or sign of another heart attack?",
    "doctor_response": "Hello! Thank you for asking on HCM!Regarding your concern, I would like to explain that it is very important perform as soon as possible a comprehensive evaluation of that chest numbness, as it may be related to a new ischemic heart event. So, I would recommend to consult immediately the nearest RE service for a physical exam, resting ECG and some blood tests (including cardiac enzymes CK-MB, Troponin).Remember that after 5 years venous bypass grafts are more susceptible to possible occlusion.Hope to have been helpful! Greetings! Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking wysolone for increasing platelets. Gained weight, swelling in feet, leg after stopping. Cure?\n\nmy wife has been advised to use wysolone 40 mg for some time and thereafter that has been reduced to 5 mg for increase of platelets from 0000. The count is fluctuating within 0000 to 0000. The medicine has been used for 6 months and is now stopped. Now, body gained weight and swelling in feet and legs. Kindly advise what to do",
    "doctor_response": "hiThanks for your queryi can feel your concernsweight gain and edema are side effects of steroid use.you need not to worry.since drug has been stopped ,these will resolve in few time.try to keep legs and feet on a support.Along with weight gain and edema,steroids also cause increase blood pressure and diabetese.Moniter her blood pressure and also check her fasting blood sugarwishing her good healthregardsDr.AMNA",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I saw blood in my stool, and I have a small lump in my anus. Any home remedies?\n\nHi doctor, I am a 24 year old female. Last week, I suddenly saw blood in my stool, and I have a small lump in my\u00a0anus.\u00a0I consulted a doctor, and she gave me Dulcoflex and an\u00a0ointment.\u00a0It was fine for 10 days, but now again I feel that lump and saw blood in the stool. What could be the reason? Are there any home remedies for this? I had my periods last week.",
    "doctor_response": "Hi. This is anal fissure, and that lump is an anal tag. I suggest you try doing the following: Do not worry at all. You will be absolutely fine. Consult me again after fifteen days. Revert after 15 days to a surgical gastroenterologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of masturbation for a long time?\n\ndear doctor i m 15 year old and i m watching sex videos due to biology internet links . and that makes my penis to grow up and hard and then i cant stop my self from doing masturbating . and due to a lot of masterbating my penis is becoming a little tword my left side like its turning left . so how can i make it straight again",
    "doctor_response": "Hello, Masturbation is never unhealthy and it is normal and natural. There are no long term side effects for masturbation if you do it moderately. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for the renal inter polar cortical cyst in a 4 year old?\n\nDear Doctor, My son aged 4 and half years has got a Right Renal Inter Polar Small thin walled cortical Cyst Size 13x9mm (Reveled after taking a scan). Request you to give me the reason for the same and suggestive further medication. Also suggest are there any methods so to prevent from reoccurring.",
    "doctor_response": "Hi...this seems to congenital. But I would be in abetter position to guide you after you upload the images and report of the ultra sound or any other imaging you have done to find it out. These cysts can sometimes be multiple and can recur too. It may run in the family too. There is no specific measure to stop them.Kindly get back to me with the reports.You can approach me at the following link. Please find the link below - www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is flying safe with history of having concussion of brain?\n\nHello, my name is Pavla.I had concussion of brain last week on Tuesday. I don\u00b4t have headache, only feel dizzy  sometimes. I went to hospital yesterday for check up and everything is fine. So wanted to ask if it\u00b4s safe to fly on Sunday or it there is some risk?Thank you",
    "doctor_response": "Hi Pavla, Thank you for trusting HCM.Since the hospital said everything is fine, then i think its safe to fly. Just be careful while your going up the plan or on stairs in general in case you felt dizzy, Have a safe flight.Best regards,Dr. Nazzal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sensitivity and pain after wisdom tooth removal\n\nhi i am 35 years old and got my wisdom tooth removed two weeks ago,three days after the surgery got pain and hypersensitivity in the two adjacent molars still persisting kindly tell me is it normal, swlling has gone completely.on 7 day doctor said that it could be due to dry soket and put alvogyl thrice but with that though the pain went away but the ensitivity still persisted and i hav a little pain around taht area, kindly tell me is it normal or i have to go back to the dr.",
    "doctor_response": "Hi,Thanks for posting the query,   I would like to tell you that wisdom tooth removal is often associated with pain, swelling, fever., you just follow the post extraction instructions given to you properly and it will subside after some times by its own, take complete course of antibiotics and analgesics, take lukewarm saline and antiseptic mouthwash rinses.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What could be the reason for bright red blood in my stools?\n\nHello doctor, I happened to pass a large firm stool today. It hurt a bit and I was a little sore after it and the stool had bright red blood on the outside of it. I do have a small internal hemorrhoid that was spotted during a colonoscopy last year. Has the blood come from there or is it a torn vein? There was no blood when I wiped myself and the water did not turn red. I have attached photos for your reference.",
    "doctor_response": "Hello.  I have reviewed your health query and seen the photos (attachment removed to protect patient identity). Hope it helps. Regards. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it safe to take Prozac along with Ashwagandha?\n\nHello doctor, I am taking 500 mg of Ashwagandha a day and would like to also take Prozac 20 mg with it to help. Are they ok to take together or should I avoid it?",
    "doctor_response": "Hello. First of all, take Ashwagandha 500 mg two times a day with water after food for anxiety for one month regularly. As you are advised to take Prozac 20 mg (Fluoxetine), you can take it as prescribed by your physician. But keep some time gap between Ashwagandha and Prozac at least one to two hours. Because sometimes they can interfere with each other's mechanism. So take them separately. Also, take one glass of lukewarm dairy milk in the evening and add some almond powder and green cardamom powder in it. It will also help you. I hope you understand my point. Consult a nearby Ayurveda physician or me after one month regarding improvement and for further management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I had a lower lumbar injury, now it has a pain. How often i have to do x-ray ?\n\nI had a lower back injury in 2004. Dia: Spontaneity , Facet Arthritis, Annular Tear with 2 Protruding Disc.. Lower Lumbar injury - unable to operate my concern and question is... How often should i be getting images done on my lower back to keep an eye on the Spontaneity and Facet Arthritis ? I am only 29 years old and it is really starting to take hold over my life style. I am starting to get minor leg pain and numbness in my toes when i experience the pain. Should this be of great concern to me? And if so should i ask for further follow up with a Specialist? I have had numbness and pain in my legs since the injury... Was placed on HEAVY pain killers and Anti Inflame. drugs from date of injury .. no longer take the medications and i am living with the pain. As you can imagine i have become use to the pain. Just would like to know if any follow up should be taken since the injury is now 6 years old.",
    "doctor_response": "Numbness is really of concern. That does suggest a neurological problem. You should see to it that there is no pressure on your nerves. For that imaging studies are necessary. The frequency at which you should do shall be decided by the Neurosurgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pains in my head along with bloody taste in my mouth?\n\nIm having really bad sharp pains in my head. It doesnt last long like headaches or migrains do. They come randomly and go away in 10-15 mins. Ive also had a blood taste in my mouth when i cough. But none has come out as of what ive seen. Would you know whats causing this or a diagnosis?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have sharp pains in my head along with bloody taste in my mouth  is because of nerve damage , sinusitis , migraine , neurlgia or bell's palsy . Blood taste in mouth can also occur due to acid reflux, or upper respiratory track infection . I would suggest you to consult ENT specialist for proper examination . Doctor may order CT scan , throat swab test along with viral culture test and treat accordingly . Doctor may also refer you to neurologist for head problem . For now do warm saline gargles , maintain proper oral hygiene and take ibuprofen or acetaminophen for pain . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the dosage of Emeset syrup for a 8 year old?\n\nHello my son is 8.5 years old, we only have Emeset 2 Mg (per 5ML) at home and its night time in India, he is vomitting since last 2 horus, my younger daughter has vomitting yesterday and she was prescribed Emeset 2 ML syrup, can i give the syrup to my 9 year old son? if so what is the suggested dosage? please advise",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.As per recommendation you can give 2 mg of Emeset syrup, which is 5ml SOS.If vomiting is persistent, visit a Pediatrician for clinical evaluation.I hope I have answered your query. Let me know if you have any further questions. Regards,Dr. Amit Modi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I get pain in the kidney region?\n\nHi doctor, I wake up with pain in the kidney region every morning after approximately three to four hours of lying in the supine position or on my left side. The pain localizes beneath the left and right kidneys, more on the left and down toward the pelvis on the left side. It hurts the most when inhaling. My body wakes me up in a 10/10 pain every morning as a survival necessity. If I elevate my mattress by 15 degrees with my head higher than my feet, I do not wake up with the pain or it is suppressed approximately 90%. When I get up and walk around for several minutes, the pain goes away. I never experience the pain when I am not lying down. There also seems to be hyperintensities in both the cecum region and renal pelvises. I found the intensities in the cecum region to be upwards of 3071 compared to my bone intensity measurements averaging around 1200. I have testicular pain following urination, sometimes cloudy or semen like urine following the pain. I am unable to completely trace both the ureters without their disappearance and they both seem to be compressed in various regions. I can however find them again around the bladder. I understand that dilation is absent on the CT scan, however the pain only arises after hours of laying down so it would seem to make sense that dilation is not visible on the scan. Also, there seems to be an intense, vascular network posterior or underneath the kidneys that I have been unable to identify. The duodenum appears to be compressed by the SMA and the right testicular vein appears to be compressed by the duodenum. I need your help to review these issues. I feel like I am dying. I am 25 years old. This has been occurring for more than two years. I have extremely itchy skin all the time, probably due to urinary leakage or fistula or vascular issue. My identical twin brother does not have any of these issues. I do not think that I can go much longer. I have attached the reports for your reference. Please help.",
    "doctor_response": "Hi. I have gone through the reports (attachment removed to protect patient identity). For further doubts consult a radiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in conceiving?\n\nI have married in 2 year.my age 25 husbannd age 27 i have trying to a conceive .i have take pfofrt f tablet for 3 month.but not conceive.i have already checked my harmones,thairoid also.but no problem.all very good & normal.but why naot conceive.please help me",
    "doctor_response": "Hi I think you can go for ovulation induction with timed intercourse for conceiving. Track your follicles growth by repeated ultrasound and when follicle is more than 18 mm, take injection for rupture of follicles. Be in contact with your husband for next 2 days. Take progesterone for next 2 weeks after rupture is confirmed on ultrasound. Do a urine pregnancy test after that. You can try like that for 3 to 6 cycles. Hope it helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had unprotected sex. Do I need to take emergency contraceptive pill?\n\nhello doctor, my last menstrual period was on the 3rd of july and it lasted for 4days, i had intercourse on the 25th and 27th of same month without protection,please i need to find out if i should get a drug to avoid getting pregnant before it is too late. i really need your help cos am still in college and am not ready for a baby yet. please also tell me when it is safe to have sex without protection without fear of getting pregnant i dont want to be involved in D&C and i hate having sex with condom cos its painful. PLEASE NEED ANSWERS URGENTLY.",
    "doctor_response": "Hi,Thanks for using Healthcaremagic,You had unprotected sex and by this time you should get your period and there is risk of getting pregnant.If your period is delayed test for pregnancy by urine pregnancy test if positive you need to consult a Gynecologist for proper advice and medical termination.If you get your period then also you must understand that going for protected sex is not only safe but protects from unwanted pregnancy and sexually transmitted diseases.It is not question of like or dislike.If you are exposed to unprotected sex then you must consider use of regular contraceptive like oral contraceptive pills after consulting Gynecologist.In case of emergency the Emergency contraceptive pill may be used but it should not be used  frequently.Hope this helps Take care.Good Luck.Dr.Akhilesh Dubey M.D",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can throat pain with dysphagia during a pregnancy be treated?\n\nhello, I've just found out that i'm pregnant and my throat is in agony - i think from all the sickness. When I swallow or cough it feels like razor blades. I can't sleep and eating really hurts. Is there something that I can take without hurting the baby? Any help would be most appreciated, thanks",
    "doctor_response": "Hi dear, I have gone through your question and understand your concerns.Pain in the throat with dysphagia in pregnancy can be due to oral thrush or pharyngitis.I would suggest you to consult an ENT specialist to get properly examined, investigated and treated accordingly.Hope you found the answer helpful.Wishing you good health.Dr Deepti Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for numbness in left hand with high BP\n\nHi, may I answer your health queries right now ? Please type your query here... \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Where do I begin? I have a LOT of things wrong (C/T/L spine HNP, CM1, EDS, MVP, Asthma, recently developing scoliosis, OSA), and am in pain every day. I am a 25 yo female, 60 tall and weigh 137. My BP was 166/87 today. I wake up 5/7 mornings with a headache and nausea immediatly after getting up (not pregnant). I ve been experiencing this terrible ear pain in my left ear (like something sharp stabbing it) that comes and goes. Can you tell me if this is related to maybe high CSF as I am already on Neptazane (or methazolamide) to reduce the amount of CSF I produce. I also often notice when I change positions that I will have the sensation of sudden pressure in my head and can feel my heart beat. Another problem I was having earlier was my left hand started tingling and curling up (with no offense please, but kind of the way a child with down syndrome s hand might appear). At the same time I was having alot of pain in that elbow, the back of my arm and to my scalpula area on that side. Should I be alarmed? I haven t started any new medication yet, so I m not so sure it was that. I haven t brought these symptoms up b/c I get I don t want it to seem I have multiple complaints.",
    "doctor_response": "Hello There After going through medical query I understand your concern and I would like to tell you that considering your symptoms and current medication it looks like something wrong in brain and is recommended for you to undergo an MRI Brain and consult a neurologist for further treatment. Hopefully this information will guide you properly.Kind RegardsDr. Bhanu Partap",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get relieved from rectal pain and chronic back pain?\n\nI ve had chronic dry heaves for over 1 year. My doctors don t seem to know what s wrong with me. June 2 2013 I experienced preforated diverticulitis, which required colo-rectal surgery and an ileostomy placement which has since been taken down. I experience rectal pain and chronic back pain due to multilevel degenerative disease along with two lateral annulr fissures. I also have hepatis steatosis and hepatitis c. But, my dry heaving is getting worse and it s driving me crazy. What do you think?",
    "doctor_response": "Hello. Thanks for writing to us. Your back pain is due to degenerative changes in the discs. This can improve with regular back strengthening exercises and oral muscle relaxants. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal . For future query, you can directly approach me through my profile URL  drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the possible way to reduce mild vertigo?\n\nHi doctor, I have mild vertigo for the past one month. There is\u00a0no sweating or vomiting. I do not have any pain in the head and there is no problem of hearing and vision. I am only experiencing some balancing problem. My ENG test is absolutely normal. What will be the possible way to reduce this?",
    "doctor_response": "Hello. I understand your concern. I would like to tell you the causes of unsteadiness or dizziness. They are aural (disease of ear) and extra aural. Under extra aural there comes a long list of diseases. As your electronystagmogram (ENG) is normal, there is likely less chance of aural cause. Please consult your doctor for thorough examination and relevant investigation to reach correct diagnosis that may be managed accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Numbness in little finger, tingling in other fingers, have ebstein's anomaly. Treatment?\n\nI consulted my cardiologist about this, I have been passing out I expected it to be from my ebstein s anomaly but I was told my heart beat was normal when having a few episodes, I have recently been having numbness in my pinky and tingling on the rest of my fingers on my left hand . I am not sure what to do from here can you please you please guide me in the correct direction?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern looking to the history given here I could say that your tingling sensation complaint of little finger is nothing to with the hear congenital valve disease these are two different conditions, the tingling must be due to the cervical spine disease, and for this you need to go for x-ray of cervical spine, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Effect of workload on relationship, how to come out of it ?\n\ni am a software engineer i am not finding time to spend with my family ..which is making my relationship with my wife very weak and i am frustrated with this..i donno how to come out of it can i meet a psychiatrist??",
    "doctor_response": "if ur so stressed go out during weekend wid her......cll her in between r smsm her mayb a word r a sentence wud b perfectly 5n....whn u cum bak frm work ask her hw is ur day dear...giv a helping hand for small things nd if u cant do eny above bfore going 2 sleep ask her hw ws her day say abt ur day give her kiss and tap her....say gudnt dear hold each other sleeppp...... it will surely chng ur life........i bet its frm my personal experience",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will mold found in bathroom affect my pregnancy?\n\nWe just found mold in our bathroom floor from a water leak and I am 27 weeks pregnant. We beleive the water must have been slowly leaking for a month or so (not long but long enough to be concerned about myself and our unborn baby). While I am staying at our parents house until the mold is removed I was in the house for the last month until we noticed it tonight and I was also in the house for several hours while the wood was being removed and I am nervous about the exposure with spores in the air as well now. Should I be worried?",
    "doctor_response": "HI,   Thanks for the query on Health care magic platform.    I understand your concern.    Some of the toxic molds have multiple health issues in mother . If you had allergic signs like stuffy / running nose/ cough/sneezing/ asthmatic attack , in last one month.. that indicates you had health problems due to mold. Even if you you had them..  but it may not affect your baby because of your resistance. Still you can have a through pregnancy  check up  to exclude your doubt.     In case of absent reaction to mould, rest tension free.      Actually, it's the mold treating medication which can be more harmful to baby than direct exposure of mother. It's good, that you are away from home.. in these days of mold clearing.    Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful knee\n\nHi, I was out side for there and a half hours and fell asleep, it has been two days with no relief, I have tried everything I can think of and still no relief, I am miserable. The backs of my knees and my hind end are a deep red color almost purple. Advice or idea of how to ease pain. Should I see a doctor?",
    "doctor_response": "hi, if your knee is hurting behind them might be you should see a physician or an orthopedic specialist. You can hot water fermentation and followed by this some little knee strengthening exercises. If your pain is not subsided even doing so then without a delay meet the concern specialist mentioned. During the ligament injury the knee becomes disabling pain. but you can slowly recover with gradual process by the help of a physical therapist. wish you a good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for consistent pain at the back\n\ndear sir, i am suffering from back pain for the last 8 months. I have cosulted 5 doctors till now. but there is no improvements. it started in the month of may on a sudden point. then it got worst over the time. i am working as a territory service manager in Maruti Suzuki India ltd. My job includes sitting in front of laptops and driving. Use to drive at leat 2000-3000km on monthly basis and use to sit atlest 8-9 hours in office. in my xrays there was no issue with the spines. kinldy help in resolving the issue.",
    "doctor_response": "Hello,I had gone through the case and advised you to go for MRI of spine and Vitamin D3 test.Take calcium rich food and Vitamin D3 once a week.Do back and leg exercise for strethening the muscles.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am afraid of dentistry. Is there a way to heal my cavity without visiting a dentist?\n\nHi doctor,Today I came to know that there is a cavity in my last molar teeth. There is a pain in that area. Earlier I thought that it is because of new molar teeth coming out, but today I came to know about the cavity. I am afraid of needles, drilling and other stuff in dentistry. Please suggest some natural cure.",
    "doctor_response": "Hi. Unfortunately, there is no some magic cure for the cavities They cannot be cleaned and then refilled by themselves or through home remedies.  You should take an appointment at earliest to your dentist and talk to him about your fear. He will deal it politely, you should not be scared. Get it filled else decay will increase and may cause root infection. Meanwhile, if it is paining, take some painkiller. As far as home remedy is concerned, it is clove. Bite clove and put it at the tooth that has a cavity, it will reduce pain, but that is a temporary solution. Also, you can apply clove oil. Put a few drops of clove oil at cotton and put it in the cavity.  Stay happy and blessed. Good luck with the treatment. Be strong!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden heavy breathing followed by prolonged unconsciousness?\n\nMy brother whos 36. Collapsed at work; he was breathing heavy when collapsed. Did CT scan & everything clear, did blood tests, blood pressure etc & tissue at back everything ok. at night he woke up with his eyes open and then went back to sleep; all this happen within 26 hours. & now for 14 hours he wont wake up. His eyes wont open, eye lids are flikering & when we put water to drink u can see his throat moving as if he is taking it in. Please tell me what could it be? Its really worrying. & now he has moved in to a ward",
    "doctor_response": "HiRead your queryI am Dr Saumya MittalAnd I will try to explain you the possibilitiesFirst and foremost, dont give him water by mouth while he is unconcious, he may aspirate. In fact the sudden onset of loss of conciousness with breathing disorder may point to lung and/or heart problemSecond, the loss of conciousness usually means a brain problem. There may be a stroke, which may bot show up in a ct scan for 6-24 hours. or there may be an infection like meningoencephalitis. An MRI would be a better test.Third, there may be some metabolic derangement. I would suggest checking his electrolytes and ABG (arterial blood gas).There may be a possibility that he has indeed aspirated, which may show a little late on the chest x ray. The abnormal aspiration causes reduced oxygen supply to the brain, causing loss of conciousness. An MRI would be advisable.A possibility of heart conditions may arise and so and ech and echo are advisable.I hope this helps you. Inform the reports mentioned above so i can be of help further. Best of luck.I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you.Please do understand that some details could be extracted from a detailed history and examination.Looking forward to your return query with the details asked so that I can help you further.(If the answer has helped you, please indicate this)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes black stool, itchy throat and cough?\n\nMy husband was rushed to the hospital for internal bleeding in his upper gastro area. His BP was 98/68 in the ambulance, he was having black stool and breaking out in cold sweat and went unconscious on me. In the hospital they ran blood tests, x-ray and all the test. That night the doctor did an endoscopy but the bleeding stopped. The doctor found an ulcer and did a biopsy but the result will only be known later. My husband was discharged the next day deemed fit to return home. However for the last 3 days since he was discharged, his BP continues to stay at the low range of 113/66. He is having dizzy spell throughout the day. I know he s still unwell because he looks really pale and breaking out in cold sweat. My husband is 59 years old with heart condition. Since his discharged 3 days ago, he s still having black stool. The down side is my husband has gotten a cold while he was in the hospital. These couple of days he s having runny nose, itchy throat and cough. My questions are: 1) How long will the black stool stays in his system after the endoscopy? 2) Is there a possibility that he s still having internal bleeding as he s really pale and dizzy? Thank you for your advise.",
    "doctor_response": "Hello dear , hiWelcome to Healthcaremagic.comI have evaluated your query thoroughly .1.  Usually black stool recovers within 72 hours of ulcer bleed , if it persist      beyond  that  there is suspicious  of  ongoing  bleed .2.  Yes there is strong possibility of the ulcer bleed for pale and dizzy      condition .Hope this will help you for sure .Wishing him fine recovery .Regards dear take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat renal failure?\n\ni am abhijeet, and have been diagnosed with renal failure. doctors have advised me to undergo renal transplant. i am 37 yrs old and my blood group is O +ve and unfortunately i dont have any relative who can donate. kindly advice if it is possible for me to undergo live unrelated transplant if someone is willing to donate a kidney. my contact num is 91-0000",
    "doctor_response": "Hi, You can contact government organisations of your state which coordinates the organ transplantation and they will assist you further. Organ donation is legally bound and there are many frauds also. It is better to go through the proper channel to avoid cheating and financial loss. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Liver Cancer with Hepatoma\n\nMy mom aged 64yrs. Doctor said she got liver cancer due to large liver tumor in the right lobe of liver associated with small porta hepatis lymph node and 2 small lung nodules. Hepatoma with early lung metasis is suspected. But for her full blood test showed that Alpha fetoprotein is 24.5, AST is 88 and ALT is 88. For Hepatitis A , Hepatitis B and Hepatits C is negative. Currently my mom referring to liver specialist for further investigation. But I need your comment please. thanks .",
    "doctor_response": "dear nini, it is possible to have liver cancer with the values mentioned, the final diagnosis will be  based on tissue examination pathologically and IHC.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in walking and abdominal pain?\n\nI am 42, 5, 8\" and am disgustingly 13 stone. I have recently been diagnosed with over 10 stomach ulcers having suffered with abdominal pain since Feb 2011. I've had a colonoscopy which was pronounced clear even though there was 'cloudy fluid' and after my endoscopy when the ulcers were discovered my consultant has requested another colonoscopy be carried out (although noone seems to know why). Anyway my current problem (and I don't know if they are linked) is that I have severe fluid retention from the knees down to my feet on both legs. My skin is also mottled just above the ankles and the soles of my feet are extremely painful. I also find it difficult to walk due to the pain. Should I walk more or sit with my legs raised above the level of my heart ?",
    "doctor_response": "You have got swelling over both the legs. The reason for it may b related with your heart or your kidneys. Please go to a specialist and get your BP checked and get full pathological workup done.The reason for pain and swelling in ur legs can also be varicose veins. So please get yourself checked by a specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome severe depression and lack of sleep?\n\nI m 44 yr. of age female. I am suffering from severe depression and lack of sleep at night. what can I do to self treat? I have no Insurance and currently drawing unemployment. I m starting to always have bad thoughts about myself, I know it s due to lack of sleep and stress.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Almost all depressed and stressed individuals loose sleep because of their mental conditions. That is not a matter of worry. But how to have a positive think over that? Such people sleep for three or four hours. But say can't sleep. They can't sleep more than that because they are not active. Be active and sleep more. Learn relaxation technique and sleep better. Use psychotherapy to sleep much peacefully.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.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for cough and congestion in the chest\n\nmy son is 2 our house hold has had a cough, runny nose but no fever. As of last night his cough has just been horrible every few minutes and he is very congested but has no wheezing either. I dont know if i need to take him to dr or not, i am changing dr s so it would be awhile before i could get him in so i will have to go to urgent care but do not want to expose him to worse if he simply has allergy or something like that.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query your son have symptoms of cough and congestion in the chest which seems to be due to chest infection/ chronic upper respiratory tract infection. I would suggest you to take nasal sprays and do warm saline gargles. You should take honey, ginger paste with hot milk as it  is good for cough reduction. You should take antibiotic Levofloxacin in combination with antiallergic medication. Visit ENT specialist once and get it examined. You should get paranasal sinus x-ray done and start treatment after proper prescription. Avoid oily and sharp food. Drink plenty of fluids.Hope your concern has been resolved.Get Well Soon.Best Wishes, Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this renal cortical scan indicate?\n\nthe right kidney measures 11.0 x 4.0 x 5.0 cm.(LWH) with cortical thickness of 1.5 cm, while the left kidney measures 10.6 x 4.7 x 5.5 cm (LWH) with a cortical thickness of 1.4 cm. There is mild fullness of the right pelveocalyceal system. The cenal Parenchyma demonstrates homogenous ecopattern with no focal lesions seen. The central echo complexes are dense and compact with no ecstacia or lithiases...what is the meaning of that doc?",
    "doctor_response": "Hello and welcome to HCM.As an Urologist,i can understand your concern.The scan shows minimal collection of urine,in the right kidney.That suggests, there's delay in the passage of urine, from kidney to bladder.The cause for this has to be investigated.The tests to be done are :1. blood routine,creatinine,RBS,LFT,and electrolytes.2. CT-IVU. If you've any doubts,you may send it to me,as a direct question.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What diet should be followed when diagnosed with enlarged liver?\n\nI am 27 years old 2 months ago i take a ultrasonography which shown my liver was enlarged & some diluated seen in my liver .After treatment  my liver was mildly enlarged & diluated are not seen.What type of food i Require because any type of food i not digested .I Suffer from Gas problem.",
    "doctor_response": "you should take less oily food,less spicy food.preferably you should take salads and fruits which contains high fibers.avoid large quantity of tea,coffee,carbonated drinks (cold drinks),and also avoid alcoholic beverages.take a good sound sleep and also go for morning walk at least for 15 min",
    "dialogue_context": ""
  },
  {
    "patient_message": "I started having mild upper back pain & chest feels cold. What I can do to relieve the pain ?\n\nrecently i started having back upper back pain that is mild. At times my back feels cold. I also noticed that my left elbow hurts when i touch it and both my legs hurt at times. I have gone to see a doctor and he gave me anti-inflammatory medicine (naproxen). It helps my arm, but my back has not gotten better. I dont know what i can do to relieve the pain. help. please",
    "doctor_response": "Thanks for the query. You can take naproxen upto 500 mg twice daily to relieve pain. for the back apply warmth and also u can apply local agents of diclofenac gel. Have a healthy living",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lack of penile sensitivity?\n\nHi there, I have noticed that I have lost sensitivity in my penis over the last few years. I find it difficult to climax and most times have to masturbate in order to climax. I have always masturbated alot and wondered if I have damaged nerves at all, and if it the situation can be reversed at all. I was recently tested for Diabeties, but that came back all clear",
    "doctor_response": "Hi,A little penile insensitivity may occur with age, you have not mentioned your age so could not be stated, other wise it may be momentary or if you are on any kind of medication esp on steroids. Due to excess masturbation or sex, threshold of the nerves to excite increases, which means it needs more stimulation.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Suresh Singh, Ayurveda Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden fainting and shivering?\n\nI was drinking a glass of water when I had a blockage due to air being trapped then I passed out and my husband said I was shaking as if I was having a fit. I dropped the glass but did not hear it fall and break but felt very unstable after I came round again my husband said it only lasted about 10 seconds. Should I tell my Doctor.",
    "doctor_response": "You have to see the doctor to find out what was the cause of being uncounscious, even when it is for a few seconds. Some of the causes i could name are hypoglicemia, seizure, arrythmia etc.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure paralysis in a 75 year old female?\n\nmy grandmother age 75 is suffering from paralysis and can just only talk and eat very little food. she is being given dexona injection and aptron. is it sufficient for the treatement or some other medications are required and how long this disease will take to get cured?",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your grandmother's symptoms.We need more details regarding her illness to help you understand better regarding the treatment options.What was the cause of her paralysis? Was it brain stroke? If possible, please upload the scan reports.If the paralysis is due to brain stroke, then, complete cure may not be possible. However, with good physiotherapy and exercises, her strength can be partly restored.Please check about \"aptron\" tablets, as i am not sure about it. Dexona is a steroid used to reduce the brain swelling.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do i get dizziness during tooth plucking ?\n\nhi, i had dizzziness while dentist was removing my widom tooth. since i have to remove the other 2 teeth too, i wanted to know if it occures again or not? tannaz",
    "doctor_response": "Hi, Dizziness occured could be due to lack of adequate diet before the surgical procedure, stress. It is possible that it could occur the next time. So have a good meal before the procedure and your dentist could prescribe an anti-anxiety drug the night prior to the procedure to reduce anxiety.",
    "dialogue_context": ""
  },
  {
    "patient_message": "When should the second dosage of Pentavac be given to the child?\n\nMy baby has born on 13.09.2010.On 13.09.2010 he got Hep B birth dose and polio-0. On 29.10.10 (when he was one and a half months that is 6weeks old) he got DPT-1, Hep-1,polio-1. Again on 10/11/2010 (10 days after taking the previous vaccine )  PENTAVAC ( combination of DPT-2,Malingities-1,Hep B-2 ) was injected to my baby accidentally by the doctor.Now,my question is that whether the PENTAVAC given to my baby on 10/11/2010 will work or not (will be able to produce the antibodies or not)? or I will have to repeat the same PENTAVAC given to my baby at 10/11/2010 again? at what date my baby should get the next PENTAVAC ? Will my baby be protected in future if I don't reapeat the previous dose but continue with the next?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns but your question is too late , I mean your baby is now 4 years old , has your baby received DPT boosters of  one and half year , if not best option is to take a quadrovax (DPT plus Hib ) , you have not mentioned about completion of Hepatitis B series , it that is incomplete baby can be given a shot of pentavac now . If your baby received DPT booster at one and half year he can be given only HIB vaccine single dose .Your baby was protected by taking pentavalent  but immunity has weaned  of due to lack of completion of series and booster doses , so he can be protected in future by boosting immunity by taking single doose of HIB alone or HIB plus DPT (Quadrovax) , or HIB +DPT +HB(Pentavac ) depending upon status of other vaccines taken by your baby .Hope this answers your question. If you have additional questions then please do not hesitate in writing to us.Wishing  your baby good health.\u2022\u00a0\u00a0\u00a0\u00a0\u00a0DISCLAIMER: - All the information provided here is for information purpose only   , it is not a substitute for the advice of a physician after physical examination , it is not intended to replace your relationship with your doctor. This information in no way establishes a doctor-patient relationship. Before acting anything based on this information do consult your doctor. I  recommend that online users seek the advice of a physician who can perform an in-person physical examination",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower hip gone numb, then back and abdomen also. Finished chemo for rectal cancer. Is this recurrence ?\n\nI HAD A UPPER G.I.THAT EVENING I HAD TO GO TO E.R. FOR LOWER ABD. PAIN SINCE THEN MY LOWER LEFT HIP HAS GONE NUMB DR. BLOOD WORK AND X/RAY FOUND NOTHING SENT HOME SINCE THEN MY LOWER ABD, LOWER AND UPPER BACK, UPPER ABD NOW MY LEFT LEG HAS BECOME NUMB. ALSO LOST CONTROL OF MY BALANCE, ALSO MY RIGHT HIP HAS GONE NUMB. I JUST FINISHED CHEMO AND RADIATION TREATMENTS FOR RECTAL CANCER THE END OF JANUARY AND HAVE TO GO FOR THE FINAL TEST WITH THE CAMERA MAY. 2 TO SEE IF IT IS ALL GONE PLEASE HELP ME",
    "doctor_response": "Chemotherapy which is given for rectal cancer treatment sometimes can have such side effects. Oxaliplatin which is the drug most commonly used can cause this. You can meet the Dr. who has treated you for physical examination. Usually recurrence causes pain first not numbness. You will need a PET CT or a CT for chemotherapy response evaluation which can ultimately rule out recurrence.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What course of treatment should be given for damaged knee cartilage?\n\nMy son was diagnosed at 17 yrs old with a rare never seen before disease that has destroyed the cartilage in both knees. A cartilage re - implantation was tried with no success as his cartilage is diseased. His surgeon has stated that nothing more can be done for him. Knee replacements are not considered an option because of his age. We live in Australia, I was hoping you may be able to help . Thanks",
    "doctor_response": "Hello, The surgeon is right, at his age we cannot opt for the knee replacement if the cartilages are diseased and knee joint space is reducing. I will advice to look out for a competitive physiotherapist, who can help regain the knee functions by providing excellent strength in the knee joint muscles on both sides. As the function of the cartilage is to act as a shock absorber their absence role can be taken care by the muscles and other ligaments. It's a time consuming process to deal with exercise but it will help to avoid early ageing of the knee joint and using assisting devices like knee brace will also be benefited. But exercise in proper way to maintain the gap between the knee joint is of utmost importance to avoid pain and ageing of knee joint. We can try this out as no one would wish to have an artificial joint. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does recovery from kidney stone removal surgery take long?\n\nI had a uteroscopy on Nov. 10 to remove a kidney stone lodged in my ureter. They put in a stent and I had it removed on nov. 29th. I had not had sex since the procedure til today and there was blood in my semen. Also had pain upon orgasm. Though I was healed since I have not seen any blood in my urine for the past few days. I assume this is normal since taking out the stent was invasive and the catheter used was pretty large. Am I prematurely getting back to my normal life etc? Is this normal considering the circumstances? How long is the recovery process to having a uter stent removed? Also having some lower back pain. May or may not be related since I do have a jam on lower vertebrae. Thank you for you time!",
    "doctor_response": "Hi, The stress and irritation that came from cystoscopy stent removal and from the stent itself while it was in your body may be causing the discomfort that you are feeling now. Symptoms may last for 1 to 2 weeks then afterwards you will be perfectly fine. Just make sure you're drinking a lot of fluids around 2 to 3 liters of water a day in your life to prevent another stone recurrence. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Manuel C See IV, Urologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in the lower gums after tooth extraction?\n\nI have paresthesia of chin lower lip and gingiva on the lower right side where the 3rd molar from the back was extracted and had poweder bone graft. I can feel the chin and lip but they feel weird whe touching or when I move them. On the X Ray post extraction , it showed that the drill went up to the nerve canal. It's been 8 days with no changes as far as I can tell.  The lower teeth in front of the extraction are \" numb \" but feel uncomfortable when I press on them.  Is this possibly reversible? what suggestions do you have ?",
    "doctor_response": "Hi..Thanks for the query..As per your complain it looks like during the extraction of the wisdom tooth or the third molar tooth there has been injury to the inferior dental nerve and it is leading to numbness in the lower gums, chin, lip etc as these areas are supplied by inferior dental nerve..I would therefore suggest you to consult an Oral Surgeon and get thoroughly evaluated and if needed an MRI SCAN can be advised to check for the condition of the nerve.In case if there is only injury to the nerve then it will gradually repair itself and the sensations will become normal and numbness will subside..In case if the nerve is broken or severed in two parts then there can be irreversible damage and the numbness can be permanent..So it will be better to get examined and treated accordingly..Hope this helps..Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pus filled lump on the forearm?\n\ngot some type of bite. have a dime size white (reg skin color) center with spreading purple- bruise like color circling it and getting larger. It s on the inside of my forearm. I helped cut trees today and didn t feel or see any insects, but this appeared afterward.",
    "doctor_response": "Hi, thanks for sharing your health concerns with HCM!           If I were your treating Doctor for this case of pus-filled lump, I would come up with one possibility that is some infection!However, the mode of infection could be some mild penetrating injury, insect bites, folliculitis or small boil!\u00a0\u00a0\u00a0\u00a0\u00a0Therefore, you need to apply ice/cold compress and some gentamycin-like antibiotic cream and if not relieving, swift on to oral erythromycin 500 mg four times for 5 days! Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does sperm count and penis size decrease with age?\n\nDoes my sperm count and penis size decrease after the age of 35?   I just don't seem to be as aggressive in the sack as I used to and it seems like my penis is not as large as it was 10 years ago.  I'm also having an issue getting my pregnant, whereas it has not been an issue in my 20's.",
    "doctor_response": "Hello Thank you for trusting HCM You may notice that your penis size is as large as it used to do, it's original size has not changed at all. But if you have more fat on the pubic bone just above your penis, that area can sag and make it look smaller. The volume of a man's semen and sperm motility (the ability of sperm to move towards an egg) decrease continually between the ages of 20 and 80.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a cat bite?\n\nDaughter, 10 yrs, got a cat bite. It was not deep but just two superficial marks. It blessed a little and the wound was cleaned with antiseptic liquid. The bleeind stopped immediately. We went to ped and gave first dose on arm. Since she got a little reaction(eyes and lips were white, BP dropped for max a minute), the next four doses were given on thighs as per schedule. Now we got to know that immunoglobin is also given along with first dose but it was not given in her case. Though she has taken the TT booster dose as per the pediatrics schedule. Now the fact of not giving immunoglobin is worrying me especially because the cat is not traceable. Can you advise please?",
    "doctor_response": "HIWell come to HCMIf the patient being vaccinated then just forget about any thing that worries you immunoglobin single short would be enough when there is not indication of any zoonotic infection and condition is on precaution level only, hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach cancer, breast cancer, fluid in lungs. Prognosis and life expectancy?\n\nHi Dr., My aunt is in the hospital right now because cancer is pretty much suffocating her. She started out having it only in her breasts now she has it pretty much around most of her body (recently found in her stomach ). However, oddly enough she wasn t admitted because of her cancer, it was because she had fluid in her lungs. Did this happen because of cancer? The doctors are saying she is in horrible condition and may not even last long....",
    "doctor_response": "Hello Thank you for getting in touch with us. As I see, you aunt is suffering from breast cancer which has spread to various parts of the body. If treatment is delayed for any kind of malginant cancer, it usually starts spreading to the lymph nodes and other parts of the therapy. Therefore, treatment is started as soon as the diagnosis is made and sometimes even with a provisional diagnosis in hand. Sometimes, even the medicines which are used in chemotherapy have many side effects and can lead to severe morbidity. One of them is fluid in the lungs. The fluid needs to be eliminated as soon as possible as it can lead to severe complications like infection, inflammation etc. Sometimes that fluid needs to be drained while in some cases, it can be taken care of by medicines. The prognosis for your aunt does not look that good at the moment and you should make sure that you guys provide her full support. Hope this helped. Regards Dr. Gagandeep Dhillon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sneeze every morning once waking up, not living in dusty environment or pollen. Why is it ?\n\nI sneeze every morning once waking up. it would take me 5-10 min sneezing and clearing off my nose . I ve been like this since I was 7 and am now 30! what makes me wonder is that, I ve done changing my mattresses, pillows etc. got no pets at home. not living in a dusty environment nor pollen trees/plants are very rare in our aqea. all these possible causes makes no sense at all since this has been happening to me year round and everywhere! I was even out of the country for a couple of times yet experienced the same thing over and over. every morning about 5-10 min of continous sneezing then voila! sneeze gone and i ll be okay the rest of the day. please help. (you may wonder why now is the only time I had interest figuring out what s wrong. I got used to it! lol!)",
    "doctor_response": "hi, you surly have allergy it can be related to dust or pollen, but its mostly dust allergy because its present through out the year. how much ever you try you will not be able to control dust mites which is present every where,you are lucky your symptoms are only during when you wake up for 5 - 10 min.many people have through the day full year. if your symptoms are not bothering you that much then you can ignore it if it bothers you and you need medication then it should be done in step wise manner first if your symptoms is for few months a year like 2-3 months then you start an antihistamine which you have to take daily at night. if your symptoms still persist then your start using steroid nasal spray, it has no side effect and it controls the allergy very well and you should start 2 weeks before your symptoms start. if this also does not cure you. then get yourself tested for allergy, it is called skin prick test you will know what you are allergic to, then if possible you can avoid the allergen or you can start treatment called immunotherpy. this is currently the best treatment available and your symptoms will easily reduce by 80-90 percent kindly visit your ent specialist he will guide you further. thank you dr.mukesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking lonazep and prodep for drinking, suffering from depression, mood swings. Help\n\nHi I hv been taking lonazep and prodep since 5 years as prescribed by doc ......I stopped I between didn't go go to doc ......I hv been drinking hv mood swings now past 6 months Self medicated and taking lonazep and prodep and suffer from depression .... 2md morning  and night with 20 mg prodep......trying to quit drinking but cannot help........please help",
    "doctor_response": "HelloFirst of all I would advise you to stop taking alcohol immediately because alcohol is a CNS depressant and taking alcohol with another CNS depressant like benzodiazepine may result in severe CNS depression. Now as you left medicines without the advise of doctor and again you starting taking it again without consulting doctor. I would advise you to consult a Psychiatrist regarding proper dosing of Prodep or fluoxetine. Dont self medicate yourself because clonazepam is a benzodiazepine and it has high abuse potential especially when taken without the supervision of a doctor.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for severe pain on the neck\n\nsevere pain on the right side of my neck just below the skulland the shoulder area have taken medications such as pain meds,inflamation ,muscle relaxers,heat patches .ice packs .nothing seems to help.having alot of constant pain,trouble sleeping ,loss of appetite.unable to function without pain .",
    "doctor_response": "A course of physical therapy or chiropractic would likely help. Also, your doctor, or a pain doctor, could perform local muscle trigger point injections. Finally, you could benefit from acupuncture.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for trichophyton rubrum\n\nHi all, About two years ago about six weeks after sleeping with someone, my scrotum and inside of the groin started itch and burning , I have been to doctors several sti clinics and a dermatologist anyway I was diagnosed with trichophyton rubum I have tried all sorts of creams and had a short course of oral anti fungal medication, but I still cant get rid of it, can anyone suggest anything",
    "doctor_response": "Sometimes fungal infection becomes resistant to treat. Fungus thrives on warm and moist skin like groin. That\u2019s why fungal infections are more common in summer. Contributing factors are high humidity, heat, perspiration, diabetes mellitus, obesity, friction from clothes. Fungal infection is contagious. Transmission occurs via infected towels, linens, and clothing. Infection can be avoided by lifestyle and hygiene modifications. Advice 1.\u00a0\u00a0\u00a0\u00a0\u00a0Apply antifungal cream containing clotrimazole, steroid and antibiotic such as Lobate GM cream thrice daily 2.\u00a0\u00a0\u00a0\u00a0\u00a0Tablet Fluconazole 150 mg twice weekly for 2 months3.\u00a0\u00a0\u00a0\u00a0\u00a0Wear loose cotton undergarment4.\u00a0\u00a0\u00a0\u00a0\u00a0Avoid sharing clothing, towels, or bed sheets5.\u00a0\u00a0\u00a0\u00a0\u00a0Wash clothes and bed sheets in hot water with fungicidal soap6.\u00a0\u00a0\u00a0\u00a0\u00a0Do not scratch to much7.\u00a0\u00a0\u00a0\u00a0\u00a0Take high protein diet such as eggs and cheese to boost immunity8.\u00a0\u00a0\u00a0\u00a0\u00a0Investigation \u2013 blood sugar (fasting & postprandial)9.\u00a0\u00a0\u00a0\u00a0\u00a0Consult a dermatologist if you are not getting relief from these measuresThanks!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for continuous stomach ache and fever in a child\n\nmy 9 year old daughter has had a stomach ache and fever for 6 days now, (no vomiting but some diarrhea), i have been giving her calpol for children over 6 and it does ease the symptoms but they come back. i took her to the Dr and he said it was viral and that her glands were up in her tummy and throat and it would go away...but im worried please help.",
    "doctor_response": "You ve mentioned about a condition called mesentric adenopathy. This is common in children of pre adolescent group. Lymph glands in her tummy gets enlarged due to viral infections and they cause uneasiness/ tummy ache. This happens intermittently. Often resolves on its own with growing age when her lymphatic growth reaches a nadir. If there is any blood in her stools or weight loss like symptoms, she will need further work up.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is missing of part of rib termed as?\n\nI was told yesterday that part of my 12th rib is missing. I will undergo bloodwork and total skelatel xrays next week. My doctor said it could be caused by a problem with my bone marrow. Is there a name for this so i can look it up? thanks YYYY@YYYY",
    "doctor_response": "Hi, Missing part of the 12th rib is very common. Unless you have some problem with this, I suggest you forget about it - unless you are sure that it was present and missing now. Sometimes 12th rib is absent or very small maybe on one side only. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the repercussions of wisdom tooth removal?\n\nI have pain in tooth n also in head .then i  go to the dentist . He said the x rays says that ur all wisdom tooth touch the tooth from all sides  of jaws like left, right , up , right.due to this i have headache  all the day .he said that go to the oral surgen and remove all wisdom tooth. After all my question is  if i  removed all the wisdom tooth  then  after  will be any problem to the mouth or teeth or any other issue like jaws pain etc .tell me the answer.",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain in case if you have pain related to wisdom teeth there is a possibiliity that they are impacted and there is also a possibility that the gum flap over the wisdom tooth is inflamed leading to Pericoronitis and causing toothache as well as radiating pain to head..As you are advised for extraction of the wisdom teeth, you should go ahead with it but get it extracted only by an experienced Oral Surgeon..As the wisdom teeth are rudimentary and does not participate in chewing, therefore extraction will not cause and difficulty in eating as well as if done properly there are no post extraction complications too..There can be some pain and swelling after extraction that will be controlled with anti inflammatory painkillers and antibiotics will be advised to you to avoid infection.. So my suggestion will be to get extraction done by a trained oral surgeon and follow the instructions that will be given post extraction for avoiding any complications..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have severe lower back pain and gained 5 pounds overnight. What does it indicate?\n\nI started to have severe lower back pain yesterday and when I woke this morning, I gained 5 pounds overnight. I did not eat anymore than I usually do. Prior to this I have been having abdominal pain on my right side by my naval. The pain in my back is terrible that I cannot bend over or get comfortable at this point. I am getting nervous",
    "doctor_response": "i may advise for this type of symptom in my clinic  rest, muscle relaxtant-thiocolchicoside tablet 4mg twice a day after meal for 3day with investgation like usg of abdomen and xray of DORSOLUMBER spine and like to review.This may be episode of acute muscle spasm but other etiology must be rule out.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed npc, done chemo. Ruled out cancer. Nasal bleeding, headache, breathing difficulty. Cancer symptoms?\n\nhai doctor one of my friend was diagnosed npc and done chemo , later doctor told there is no cancer with her , but she get her nasal bleeding and headache and consulted another doctor and done surgery in her right side now bleeding etc are stopped but she feel dizzy and breathing difficulty , and to day also she got dizzy , breathlessness , and 4 days back she got a painful lumb above clavicle and it disappeared itself after four days , do you think she had cancer",
    "doctor_response": "Nasopharyngeal cancers (NPC)  are treated with radiotherapy and the features you are mentioning may indicate return of cancer. Do get a thorough evaluation by the treating oncologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long the itchiness and swelling will remain in my hands and feet caused by amoxillion?\n\nI had A bad reaction from amoxillion and my doctor put me on pretazone for 5days that ended 6 days ago and I am so itchy I want to rip my feet off. Every time I rub on benedrryl it feels better but my feet and my hands and my legs are still swollen. How long before it should go away.",
    "doctor_response": "HI,Welcome to HCM,After stopping amoxicillin..it could take up to 2 weeks for it to fully clear..i advice you to also take an antihistaminic for itching like tab levocetrizine 5mg at night for 7days...get well soon...",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat TB in abdomen?\n\nHi sir ...I m 23 yr old.and suffuring from TB In abdomen last 1 yr.. I did course of 9 months in mumbai.. But right now I m in Varanasi. I  m not able to go mumbai for checking.. So I want contact with u.my doctor was Dr Akshay Kothari (general physician). Pls guide me.. vikas upadhyay0000",
    "doctor_response": "Hello   Vikas As you mentioned that you took anti tubercular treatment for abdominal tuberculosis for 9 months.  All patients should receive conventional anti tubercular therapy for at least 6 months, including an initial 2 months of rifampicin, isoniazide pyrazinamide and ethambutol.There after rifampicin+isoniazide for 4 months and the cure rate if 99 % according to WHO study.As you mentioned that you  took 9 months treatment ,so there is no question of any further treatment from anywhere.If you have any problem related to tuberculosis in abdomen or elsewhere in body upload all reports and we will advise .I think , if you have no problem , no need of any consultation.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for uncontrolled hypertension\n\nMy dad has high blood pressure he is 75 and the problem is in the winter his blood pressure is controllable with his meds but as soon as summer starts we live in texas so during summer his blood pressure keeps droping low like 62/40 r 90/ 60 if he is moving around it will keep dropping so he has to go lie down and drink water and lay there till it starts going back up but at night he has to take his blood pressuer meds cause it will go up too high at night so we just dont know what to do extre to help him where he dont have to stay in bed most of the day",
    "doctor_response": "Hello There After going through your medical query I understand your concern and I would like to tell you that in summers your blood pressure can drop for which you need to decrease size of your anti-hypertension And increase liquid intake which will definitely maintain the good blood pressure. Hopefully this information will guide you properly Kind Regards Dr Bhanu Partap",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is chronic renal failure, related with random change in creatinine levels?\n\nMy mother has got UTI due to which acute renel failure occured. Her Creatinine level raised to 4.98 then came down to 4.0 and again raised to 4.5 and then 5.2. Now for two days it is stable at 5.2. Is this a chronic renel problem? She has BP and Sugar which is under control. Will this creatinine level go down? Her age is 62 yrs.",
    "doctor_response": "HelloYes, this is at least stage 3 chronic renal failure and it's because of her high blood pressure and diabetes.Her creatinine level may drop some but her kidneys won't get back to normal function at this point.  She may need an ACE inhibitor medication to protect them",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pregnant. Feeling insomnia. Allergic to benadryl. Looking for safe medicine\n\nI am 12wks pregnant with my 3rd child and I have been experiencing severe insomnia over the last week. I have heard benadryl can be used but I can t take benadryl because I get shortness of breath, can t breathe, and my left arm goes numb. I found this out during my second pregnancy. But at this point I don t know what else I can take that won t pose a risk to my baby. Can you please help?",
    "doctor_response": "Hello. Benadryl is a cough suppressant and sleepiness is its side-effect. You are trying to use it as a sleeping pill. This is incorrect. Avoid sleeping pills in pregnancy. Try this: no tea/ coffee after 5 pm, complete darkness in the room (no bed lamp), No TV for at least 2 hr before you go to bed. Sleep in shavasana, if you know how to do it. -Dr. Tushar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe arm pain\n\nMy friend (woman 72) has squeezing pain in right arm. They are not regular or weekly but every few month. She also recently had this in her leg behind the knee and was bulging in back of her knee. Had ultra sound and all was normal. I think she needs to see a cardiologist but she thinks they will say it s nothing unless it is on the left side. What kind of Dr. should she seek for this help.",
    "doctor_response": "Hi you will need consultation with a neurologist first and then if he feels than a consultation with a cardiologist.watch for functional pain in your friend.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the people to feel like their breasts are observed during a converstion?\n\nI m 23 yrs old guy. I m facing a really bizarre problem. Whenever I talk to my female co-workers, my sister or any female out there, they make me feel like I am looking at the boobs but I keep the eye contact all the time. They start put their hand on the neck to show me that I m looking. The things get worse when boys too show me the same behavior like putting hand on neck or by any means they just try either not to make eye contact with me or just they end the conversation with me. The worst part takes place when my very own sister does that. I know myself. I am a nice with no bad habits.I am not a pervert who has sex on his mind all the time. This social phobia is increasing day by day. I am scared to talk to anyone. I cant even tell my problem to anyone becoz they would make fun of me or just say its not a problem at all. But, please help ........I need it......",
    "doctor_response": "Hello You have problem that you always tries to look into the eyes while having a conversation. You feel that people are thinking that you are looking at their breasts. Even with family members you have such problem and this thing is causing loss of confidence. Most probably your complaints are occurring due to Social anxiety disorder and this has reached to obsessional level. You have started thinking that you should not look into the breasts and due to this you continuously look in individuals eyes. You becomes conscious due to that and this has resulted in social impairment. I would advise you to consult a Psychiatrist for that. Behavior therapy will help in decreasing the undesired behaviour. Medicines like hight dose escitalopram, paroxetine, fluoxetine etc are commonly used to decrease anxiety. For symptomatic relief low dose benzodiazepines or propranolol can be used. Consult a psychiatrist for prescription and evaluation.Thanks, hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How do you treat inflamation of the sclera and a swollen cornea ?\n\nHow do you treat inflamation of the sclera and a swollen cornea? My eye doctor has put me on a steriod eye drop , but I still have some inflamation and my left upper eyelid is swollen too.I suffer from allergies and am experiencing sinus pressure , my upper left forhead and my lower cheek, below left eye area, too!",
    "doctor_response": "hi welcome, for the allergies the better treatment can provide by either ayurveda or homeopathy is better. you consult any one belongs to this at your area ,he will make you better being ayurveda doctor i prefer ayurveda contact christyjoseph1@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the abscess behind my wisdom teeth?\n\nI was punched in the jaw 4 days ago the swelling has gone down a lot but I still have what feels like an abscess behind my wisdom tooth that is preventing me from biting down all the way without biting into it. Should I seek treatment or will this just take time and rest?",
    "doctor_response": "Hi i am Dr Ahmed Aly    thanks for using healthcaremagic site ,I had gone through your question and understand your concerns ..   In my opinion it will go with time eventually but the add of NSAIDs non steroidal anti inflammatorry drugs will help in the pain and the swelling , avoid eating hard food on this side , topical gel with little massaging will be helpful if not i suggest Xrays , CT to exclude any minor fissures . Please click THANK YOU and consider a 5 star rating with some positive feedback if the information was helpful. Hope the above information helps you,Any further clarifications feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe numbness all over the body?\n\nMy son 25 years old.All of sudden complaining numbness in body after driving 5 hrs road trip. He does weight lifting too. Is this numbness can be because of that or some thing serious. His all blood reports are ok. Only vitamin D is little low and B12 is 900. Is that s something to worry.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have severe numbness all over the body. Well there can be many reasons for symptoms you mention in query like peripheral neuropathy , vitamin B12 deficiency , anxiety disorder , medication reaction or side-effect , panic attack , hyperhidrosis , diabetic neuropathy or stroke. I would suggest you to consult general practitioner for proper examination . Doctor may order certain test like blood test , ECG and check vitals to confirm the diagnosis . Doctor may prescribe vitamin supplement . For now keep yourself relax , take proper rest , drink plenty of water and do mind relaxing exercises like meditation . Doctor may also refer you to cardiologist in condition like stroke . If your currently taking any medicine then tell doctor about this medicine. Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a chance of conceiving at the age of 41?\n\nI am a woman, I am 41 years old, I want to pregnancy and childbearing. And reviewed more than a doctor. I have all confirmed the absence of anything to prevent pregnancy, note that I have 6 daughters, and I want to have a child, is there hope or is the child-bearing age does not allow it??",
    "doctor_response": "Hello,You are having 6 children, hence now it is not advisable to conceive again. Your age is also high for getting pregnant. Hence, even if you become pregnant it will be a high-risk pregnancy (abortion chance and congenital malformations chance high with advanced age). You can consult a gynecologist for examination and discuss all these issues.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Norethisterone Tablets IP Primolut-N safe during pregnancy?\n\nHi. My girlfriend is telling me she might be pregnant. She went to a doc and took a urine pregnancy test which apparently is weakly positive . She is also telling me her doc advised her to take Norethisterone Tablets IP Primolut-N . But I googled and it says should not be taken during pregnancy. Please advise,",
    "doctor_response": "Hi,Yes, it may be taken safely during pregnancy. Primulot-N (Norethisterone) is a synthetic form of female hormone progesterone commonly prescribed to postpone the period and to regulate ovulation and menstruation. If taken during pregnancy it actually helps to support and maintain an early pregnancy and also reduces the risk of miscarriage or preterm delivery.Hope I have answered your query. Let me know if I can assist you further. Take care.Regards,Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need treatment for cyst on the liver, enlarged pancreas and gallstone\n\nFollowing numerous scans it has been confirmed that I Have a large retroperineal cyst lying on my liver, enlarged pancreas ducts and a 6.5mm gallstone. I am waiting for a follow up appointment with my consultant. In the mean time what do u think his course of action may be?",
    "doctor_response": "Hi and welcome to HCMThe only possible solution would be surgical procedure and I suggest to do it as soon as possible before cyst starts to compress surrounding structures.This may be benign or malignant one and from this it looks like more to be benign, but in every case it should be surgically removed.Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Depression, phobia of exams, difficulty to get along with people, daydreaming, loneliness, anxiety, mood swings.   Help\n\nHello sir,  I am summit from haryana. Sir for the past 3 yrs I have depression just for the reasons.. .    .1. I am not gud luking2. I have exam fobia3.I am not able to talk in crowd I am lost in my self imaginations and not able to focus in class.The main reason is that I feel myself alone .... And u must b knowing when a person thinks that he is alone he enters in the world of fantasies by those imaginations I do some wrong things. All time I feel romance... and dreams also comes of romance.. and I am not able to talk girls in college.just beciz of depression ,anxiety and all time I feel like I m gonna to cry... .I have much mood changes... and don't like to talk with my fronds. Finally ,I m very physcho ... depressed.... alone ...this is becoz nobody likes me ... I am not that smart .. gud at health...and I need someone who loves me and I need someone to love. Specially girls ... please help me out. Tell me the best medicines ayurvadic.and I am very tensed about my future and my wife....bcoz I thinks that she will only love and take care of me.",
    "doctor_response": "Hi there, thank you for explaining. If you do some sport, it can help to boost your self esteem. Many girls are not very pretty, but when they work on their body, they look attractive. It helps for depression too. I wish you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is conception possible with blocked right tube?\n\ni am 37 years ,my height is5.4feet and my weight is 55kg i am married in 2011 since then i having problem for my pregnancy, my right tube is block but doctor told you can conceive with one , i tried so many medicine and injection but no use . thanking you, please help",
    "doctor_response": "Hi!Yes, your doctor is right. You can conceive even with only one patent tube.In a normal cycle, the ovulation happens one cycle to one ovary, and one cycle to the other one. So you have the possibility to pregnant.The only thing you should wish is to have the dominant follicle (which is the largest follicle with the ovum inside of it) to your left ovary.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My sister has grade 4 skin cancer and has recently started to cough up blood\n\nmy sister has grade 4 skin cancer and has recently started to cough up blood . she is due back to her consultant early august. should she make an apppointment sooner. what does this mean",
    "doctor_response": "Hi, Thanks for query, Passing blood in cough means there is secondary in the lungs. You consult specialst for urgent treatment for hemoptysis. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can lump on ovary be treated?\n\nmy daughter age 23 has a lump on her ovary she has been in a lot of pain and had a ultra sound done dr told her it was a lump and it needed to be removed was just wondering what it coul be and if would be a sameday sergerywould she need to stay over night",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. She may have some cyst or endometriosis of ovary.  She should go for complete excision and histopathological examination. Consult your doctor and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blisters on sides of mouth?\n\nHi, i have on the sides of my mouth these blister type things. they hurt to open my mouth and stuff. i've tried regular lip chap to put on them because its like dry skin but its now been a week. i tried blistex to but it doesnt seem to be helping. do you know what will ge rid of these?",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.The mouth ulcers can be due to stress ,nutritional deficiency ,vitamin deficiency and many other factors.I would advice you to apply mucopain /dentogel on the lesion two to three times a day till the symptoms are subsided.For the pain ,take paracetamol .Do betadine mouth wash gargling.Consult your GP and start with multi-vitamin tablets.Lead a healthy and stress free life style.If the ulcers are persisting ,please consult your oral surgeon.Hope this was helpful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this HPT result indicate?\n\nHi doc me and my patner did unprotected sex on 16 jan and then within 24 hrs i took ipill and today even after 20 days i didnt got my periods as my cycle is abt to cum with 2 days  and i did home pregnancy test 5 time sumtime it show 2 proper lines and sometimes it show one proper and one faint line plz help to m i pregnant",
    "doctor_response": "Hi there, I have understood your concern. I will suggest you the best possible treatment options. First of all, as you have taken emergency contraceptive pills within 24 to 72 hours of unprotected sex act, it offers adequate protection to prevent the pregnancy. Secondly, as you have doubtful results of the pregnancy tests, I will suggest you to get morning's first sample of urine tested for pregnancy. In case of doubt blood beta HCG test and USG will be of help. Even if you are pregnant, you can opt for termination of the pregnancy with medicines safely till 9 weeks of pregnancy under medical supervision. I hope this answer helps you. Thanks. Dr. Purushottam Neurgaonkar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for advanced bowel and pancreatic cancer?\n\nHi. My grandmother was diagnosed with advanced bowel, liver and pancreatic cancer about six weeks ago. She was in hospital for 3 weeks before being allowed to return home for palliative care. She had 2-3 doses of morphine whilst in hospital for the pain and has been able to manage on regular doses of weaker painkillers for the last few weeks. In the last 48 hours she has deteriorated rapidly, is unable to eat and is in a great deal of pain. She is cared for 24hrs a day by her daughters, and last night the district nurse was called out to administer morphine. She has been taking further doses every fours hours since. The macmillan nurses are visiting tomorrow with a view to putting her on a morphine drip. I realise that there is no 'crystal ball', but in your experience, how long do patients usually survive once the drip has been administered. Also, can the patient hear whils in the coma-like state? Many Thanks.",
    "doctor_response": "Hello dear. I appreciate your concern for your grandmother. It seems she is suffering from terminal cancer illness and at this pint of time it will be wise to put her on adequate painkillers as she wont be able to tolerate the chemotherapy. Your doctor can also try patch form of medication(buprenorphine and fentanyl) instead of morphine to relieve the pain. She also requires injectable fluids and nutrition. With all thsi supportive therapy her survival will be 4 to 6 weeks. Hope that solves your query. regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and bruise on shin due to hitting?\n\nHey, so I was at cross country practice today and we played Capture the Flag. When I was running to get the flag me and another team mate collided and I guess I hit my shin on her knee, when I tried to stand up it hurt really bad so I sat down for about five minutes before getting back up and running again. It still hurt when I ran but now that I m just walking on it it still hurts really bad and is beginning to swell and bruise. I m icing it right now is there anything else I should do?",
    "doctor_response": "Hi,I have studied your caseThere can be tibial bony contusion.As x ray may be essential to rule out fracture so I will advise to consult doctor.As hematoma is there, you need to take rest and use splint or compressive crepe bandage to reduce swelling.Watch for increase in redness, infection.Take precaution to avoid infection around hematoma.Do not use hot fomentation or massage you can do ice fomentation.If required you may need to do blood investigation for prognosis and recovery.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain my CBC report.\n\nHi doctor, I am a 38-year-old male. I have a question about my CBC report. My lymphocytes are high with 65 %. My neutrophil levels are low. My total WBC is 3200 WBC per microliter of blood. I have these levels remaining the same for about two years. I have constant body pain. I am very weak, and I do not have any weight gain. My thyroid tests are normal. My ANA panel is normal and C-reactive protein level is elevated with 14.2 mg/L. I am taking Tramadol 50 mg for pain.",
    "doctor_response": "Hi. I have gone through the attachment (attachment removed to protect patient identity). Your lymphocyte count is elevated. As the condition sustains the same for the past two years, you might need investigations like flow cytometry or bone marrow aspiration study to be done. For an initial workup, you can investigate serum calcium estimation, sodium and potassium estimation, SGOT (aspartate transaminase), SGPT (alanine transaminase), serum protein estimation, urea, creatinine estimation, and peripheral smear examination. According to the cause, specific treatment are given.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Mirtazapine 15 mg the right medicine for derpression?\n\nI 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",
    "doctor_response": "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 advice 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 drug for next few months.All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the early signs of TB?\n\nDear Dr. Samuel, Recently I went for a medical check up and X ray report says Shows evidence of increased hilae and lower zone markings of chronic bronchitis. I am an asthmatic. My ESR is within the normal range - 21mm/hr.Neutrophil count is 30% and Lymphocyte count is 61%. Could this be ealy signs of TB?? Thank you Marie",
    "doctor_response": "Thanks for your question on HCM.In my opinion you should consult pulmonologist and rule out chronic bronchitis first.Your x ray findings are not suggestive of tuberculosis so no need to worry about it.High lymphocytes can be seen in viral infection also. So you may have viral fever now.But better to get done PFT (Pulmonary Function Test) for the diagnosis of chronic bronchitis.  PFT will also tell you about disease severity and this is important in guiding treatment. Asthma and chronic bronchitis are two different terms so you need to diagnose first. Better to consult pulmonologist and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes slipped disc and gaps in knees?\n\nI HAVE BEEN TOLD BY MY DOCTOR THAT I HAVE GAPS IN BOTH KNEES, I AM ONLY 36 WHICH IS NOT OLD BUT I FEEL 86, I ALSO HAVE PROBLEMS WITH MY ARMS WHERE I HAVE HAD INJECTIONS WHICH DID NOT WORK, I ALSO SUFFER FROM SLIPPED DISC WHICH IS JUST BEING COMFIRMED BY MRI WHICH I RECENTLY HAD, ALSO HAD MRI FOR BOTH KNEES. COULD YOU TELL ME WHY THIS IS HAPPENING AT SUCH A YOUNG AGE OR WHAT IS CAUSING IT ANY OF THEM? OR WHAT THEY ARE CALLED?. I HAVE BEEN SUFFERING WITH SCIATICA FOR 10 YRS WHEN FELL OVER WHILE HEAVILY PREGNANT WITH MY DAUGHTER WHILE WORKING, AND ITS SINCE THEN EVERYTHING HAS JUST GOT WORSE AND WORSE. PLEASE HELP",
    "doctor_response": "Hi, Slipped disc usually develops due to improper exercises. Lifting heavy weights, and in those who are doing heavy physical works, and in knees its all because of bad life styles. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Jaideep Gaver, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "On birth control and azithromycin for strep. Could antibiotics negate the effects of birth control?\n\nI was taking azithromycin for strep earlier last week. I am also on the implanon birth control and It s due for removal tomorrow. Could the antibiotics negate the birth control? Because I started heavily bleeding a couple days ago. Could I get pregnant with all of this occurring at once?",
    "doctor_response": "Antibiotics dont negatevthe effect of birth control especially if you are taking them short term...nothing to worry. ...although few medicine have effect on the metabolism and they r known to cause effect on other medicines but there is no strong drug interactions between azithromycin tsken for short periods and birth control ...provided that you are not skipping your pills",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for toe nail pain and discoloration\n\nmy toe nail (left foot) is paining.it has been partially black for quite sometime.i may have banged it against something.past few weeks i am training to run for half marathon.yesterday i ran 14kms.today the toenail area is paining.my feet usually swell in the evening.can you suggest what i should do?",
    "doctor_response": "Nail injuries are always very painful, due to rich nerve supply getting injured.giv cold compression, and elevate the limb while resting.it eill help",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to deal with anxiety and depression?\n\ni feel like I am going crazy,I dont think I can handle anything  any more ...need to talk to somebody ,forget a lot of things ,find some peace..hv tried medications ..nothing seems to help I hv responsibilities to tc of  ...nd I dont want to prolong this... God",
    "doctor_response": "HiI understand your emotional problem.Anxiety and depression can be treated with medicines along with counseling.Choice uis depend upon symptomatology..Detail history is must for proper assessment and treatment.SSRI like escitalopram/sertraline etc can help but before that you have to go for psychiatric consultations.Say thank you if you are helped.Still have a query then feel free to ask.Get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to use hcg drops while having hypothyroidism/high blood pressure?\n\nHi! I am 53 years old5 3 , weigh 246 pd. and I have thyroid problems (hypo) and high blood presure, sleep apnea, is it alright for me to use hcg drops, I know I can t do the 500 calories,, Itried but felt too tired,I ll eat the right foods and exercise ,which I walk 30 min. on tredmill,,Please help me ! Thank you",
    "doctor_response": "You are in a difficult place and doing the right thing. Your attempts to diet and lose weight will pay off. It is hard, slow and incredibly rewarding. Be sure that you get good treatment for sleep apnea first. With respect to supplementing with medicine, the answer is not simple. If you are considering that route, get help through a recognized weight loss program (not one that tries to funnel you to a surgery). Medicines to help weight loss may help in the short term but cause problems later. Your decision to use them should come after a discussion with a physician and dietician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dry, sore throat, slight swelling in lymph nodes due to smoking. Symptoms of throat cancer?\n\nhello, i have been having a little bit of anxiety because of something i have smoked a few times i am 17 i dont smoke anymore i have been having a dry throat and no matter how much i swallow it still feels dry and a little sore throat and slightly swollen nodes i have looked up all kinds of scary things about throat cancer i just want to know what it is without psyching myself out. please help.",
    "doctor_response": "Hi Sore throat and lymphnodes can be due to infection. Dry throat can also be due to anxiety. Please take antibiotic like clarithromycin and anti inflammatory drug. Get an FNAC(Fine needle aspiration cytology) of the lymphnode and confirm the correct diagnosis. IF you come back with the FNAC reprt,i can clarify further Wish you good health Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pain in the thigh?\n\nWhen getting up on my legs, the pain down the back of my right legs is so bad it causing me not to be able to put pressure on my foot to walk. its like a pain from my thigh down my leg. pain is in the back of my knee. also when standing it feels like muscle tearing in my thigh on the left leg.",
    "doctor_response": "Hi there, thanks for your question at HCM .Pain radiating along your back of thigh and legs, suggests pinching of a nerve in your spine. Since its present mainly on movements and you are painfree at rest it suggests a dynamic stenosis. If its affecting your daily routine, I suggest you to get an X Ray if your spine at first. Most vlikly your pain wil respond well to pain killer medicines. physiotherapy protocol including core stabilisation and muscle strengthening. If you still persists to have pain 6 weeks into therapy , it would be prudent to do further tests whcih will include an MRI. Hope this helps.All the best. Regards.Dr.SBK",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am not able to concentrate in the class or studies. Please help.\n\nHello doctor, I am a 19-year-old girl, weight 38 kg, height 5 feet. So my problem is related to brain concentration. Earlier up to school, I had good concentrating power. After schooling, I started preparing for entrance exams and it has been two years preparing for the same but now I feel that I have trouble concentrating over questions, concepts during class or while doing self-study. Please help.",
    "doctor_response": "Hi. Lack of concentration can be due to several reasons, most common reasons are stress, lack of sleep, disinterests in the project and lack of motivation. Here are some tips and the principle by which they help you. Minimum seven hours sleep helps to reinforce the memory, and re-energize you for the next day. Regular routine, especially sleep timings, starting from your meal times, the time you visit the library, and workouts, keep it regular. Improves your time management, keeps you healthy and prevents loss of time due to sickness. Eat healthy. Eat what suits your taste and digestive capacity. Eat from only hygienic places. Again this helps prevent the unnecessary sick leaves. Non-study activities. It is a must, it gives a break to your mind which is already stressed by continuous and monotonous study hours. It could be anything starting from prayer, meditation, sports activity, work outs, morning or evening jogs. Have a healthy study group. Do not be selfish with your group, be contributory towards your group. It has multiple benefits, it acts like a mnemonic helping you remember facts in relation to place our person you discussed it with. It gives a sense of easiness to find many people are with you on the same boat. It acts as a strong motivation, if there is a healthy and friendly competition among the group members.  Stay away from distractions like the internet. Keep distance from people who speak negative most of the time. Try to be in company of people who are highly charged in energy. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking anti-biotics (Kelfex) and Buscapan for gall bladder infection, but still uncomfortable.\n\nHad pain in right side radiating to back and feeling generally uncomfortable and not well at all.  Doctor diagnosed gallbladder infection and prescribed anti-biotics (Kelfex) and Buscapan - the pain has subsided - still uncomfortable in the area and still feeling sick and unwell - will this ease",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You may have cholycystitis. You should go for ultrasound abdomen to check for gall stone. Treatment of cholycystitis is conservative. You should take antibiotics and dicyclomine. If you have persistent pain and ultrasound shows stone then cholycystectomy is the treatment of choice. Consult your doctor and plan accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the effects of having watery sperm?\n\nI know that i have a watery sperm count and am afraid of not giving birth to a child when married. Will i be able to give birth to a child when married? Secondly, i want to ask that if someone has a watery sperm, is it the same as having a low sperm count?",
    "doctor_response": "Hello. I have reviewed your query and here is my advice. Watery sperm is never problem. Watery semen is never an indication of sexual capacity. If you want to know your sperm capacity get your semen checked.Hope I have answered your query. You can contact me for treatment options. Let me know if I can assist you further. Regards, Dr. K. V. Anand",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why shin is feeling squishy and painful?\n\nmy left shin to to the left side feels squishy when i walk on it and it hurts like there is fluid buildup ... i think it began after i went running without stretching and have had it since last 29th of last month , it went away for a day and now its back more painfull, is this something normal?",
    "doctor_response": "Hello, It is just a muscular pain due to over exhaustion. As a first line management, you can take analgesics like paracetamol or aceclofenac for pain relief. You can take bed rest for a few days. Generally, it will settle in a couple of days. If symptoms persist you can consult an orthopedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have small white bumps in my testicle. What are they?\n\nHello doctor, I have small white bumps in my testicles skin like pimples, one or two looks nearly 1 cm size. I am worried about this issue, usually, it will appear and disappear but this time it is not going. Please help.",
    "doctor_response": "Hi,  Welcome to icliniq.com. From the pictures I saw (attachment removed to protect patient identity), those are called sebaceous cysts the small ones can disappear with time. Keep in mind you should keep the area clean and dry in summer like you can use powder to keep it dry but the bigger ones need to be removed. Do not worry, removal does not need admission. You just need to undergo small operation will numb the area with injection and remove the cyst putting one stitch then you can go home same day with antibiotic and Paracetamol. Follow up after removal is recommended just to make sure there is no infection on the wound. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I get pregnant after taking t.CCQ tablets?\n\nHi I m menaka.we r trying for pregnancy for one yr.my husband sperm count is 100 million and motility 35percent.I recently under gone laparoscopic chocolate cysectomy.Dr prescribed t.CCQ for me and MAXOZA l and Fertisure m tab to my husband. Can we proceed this medicine and can get pregnancy?",
    "doctor_response": "Hi, Welcome to HealthcareMagic.  Those drugs help in improving sperm quality in your husband and ovulation in you. I  suggest you to continue that. This will take minimum 3 months to act.  I suggest you to discuss with your gynacologist regarding use of ovulation inducing drugs like clomephine . This will help multiple follicles to mature and rupture. Thus increasing chances of pregnancy.  Hope I have answered your query. RegardsDr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sore throat, migraine, rashes like hives on inner thighs. Reason?\n\nWhat could a sore throat, a migraine and rashes on the inner thighs mean? The rashes consist of tiny hives and are not itching or burning in any way. I noticed them when I got dressed this morning. I am thin, so it cannot be from chafing. I am a redhead and spent time in the sun a few days ago for the first day of summer, but i vacation often in hot climates & spend time outside often & this had never happened. i have no allergies, am on no medications, have not changed my detergent, used a different lotion than usual or worn new clothes or clothes that belonged to someone elseI wouldn't think much of it if I wasn't feeling light headed & experiencing the onset of cold symptoms. Thanks in advance.",
    "doctor_response": "it mneans chronic allergic sinusitisit is not migraine the symptomps suggest sinusits which causes headachepost nasal drip causing soar throatand this allergy also shift to skin causing rashesyou can take allegra 120 mg bdtab flunarazine 5 mg nightdonot change detergent oils soaps creams and shampooget xray done pns waters view treat it your disease will be cured",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in testicle?\n\nMy husband just went to the urioligist and they diagnosed him with acute prostasis and put him on antibiotics and anti inflamatory medicine but now he is getting pain below his right testicle can it be just another symptom. It has me a little nervous...",
    "doctor_response": "Hello, The pain in your testes if associated with redness than epididymoorchitis also need to be ruled out by ultrasonography of testes. You can continue prescribed antibiotics and anti-inflammatory medication course. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could i be pregnant and get negative results?\n\nhello, i'm 38 and 12 days late for my period. i am so bloated soar breast but negetive pregnancy tests!.i see gyno on friday. could i be pregnant and get negetive results.i have 28 day cycle like clockwork so why am i 12 days late and neg response.thank you",
    "doctor_response": "Hello,I suggest you to undergo one blood test for beta-hCG to confirm pregnancy. It is more reliable in early weeks.Besides pregnancy, late period could be due to hormonal imbalance, mental stress, over weight/ extreme loss, emotional upset, irregular diet habit, high prolactin level etc.You must undergo one pelvic ultrasound scan and hormone test to pinpoint the diagnosis on negative blood test. You may require hormonal pill to induce period. Kindly, consult with your gynecologist and take complete prescription.You should control body wt, avoid stress, take healthy low carbohydrate diet with avoidance of fatty food and sleep properly.Be well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is MPGN type ll and what causes it ?\n\nmy 14yr old daughter has had mpgn type ll for 5 years now what is it? & what causes it?",
    "doctor_response": "Dear Karen, Welcome to HCM. Membranoproliferative glomerulonephritis (\"MPGN\"), also known as mesangiocapillary glomerulonephritis,is a type of inflammation of the glomerulonephrons caused by deposits in the kidney glomerular mesangium and basement membrane (GBM) thickening, damaging the glomeruli. It is one of the primary renal causes of Nephrotic Syndrome. Type II (also called \"dense deposit disease\" is similar to type I. except that in this case, it is believed to be associated with the alternative complement pathway. In short your daughter is unfortunately affected by kidney disease, which requires expert management by a nephrologist. Please carefully follow the advise of your nephrologist. Wishing your daughter speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest risk with heart valve prolapse in children\n\nmy wife had rhymetic heart problem, doctors told her valves are thickned and asked us to do check up in every 2 years They also told it is very common in women. Now we have tested our elder son who s 6 yrs old, found he also ahve same valve propolase, and they also told it is not a diese, just asked as to reduce his physical work and avoid team, cofee please doctor advise us , is it a serious diesase , will it affect thier future life? wife is 34 yrs old, son is 6 yrs old",
    "doctor_response": "Hivalve prolapse and valve thickning both are different thing secondly there are 4 major valves in the heart which on of them have prolapsed, every valve can prolapse and prognosis is different for every valve .Though i would answer considering it as mitral valve prolapseIn many instances, having MVP will not impact your health and requires no treatment. People with an abnormal mitral valve may need mitral valve repair or replacement if:    Symptoms are getting worse    The left ventricle of the heart is enlarged    The heart function gets worseThough it a serious disease , i usually remains dormant for yearsand asymptomatic also.so i would suggest you to  repeat a 2 d echo every 6 months and follow up with a cardiologist , though usually asymptomatic but can some times be symptomatic requiring valve replacement  also",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bad smells from child s body and how to retify?\n\ni have a 3yr old child.i notice that there are times his sweat smells like fresh squid.its funny but its true,i took him a bath thrice a day still he smells bad.though this isnt always but im so curious why sometimes it happened.i wanna know the causes and also the remedy for this..pls help..tnx",
    "doctor_response": "abnormal smell of body may b due to certail metabolic disorders with causes accumulation of certain substances in the body.  you should consult a pediatrician for this smell.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lump on lip, using chewing tobacco. Could it be a tumor?\n\ni found a lump in my lip 2 days ago that was never there before. i have been using chewing tobacco for about 4 years now. is it possible that it could be a tumor? it just appeared and for the size of it i feel like i would have noticed it before if it had been growing for awhile. it does not hurt when i touch it. I am 20 years old, it would be great if someone could help me with this. thank you",
    "doctor_response": "Hi, Any lump in oral cavity/lip should be seen with suspicion in a tobacco chewer. Please see an ENT and get it examined. It can be benign and because of inclusion cyst or mucosal bite or a benign lesion of the minor salivary gland. Still being a tobacco chewer, see an ENT. Also stop using tobacco. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had cervical epidural injection for neck pain and numbness in the arm. Lump on the injection site, pain. Explain the MRI report\n\nHello. I had a cervical epidural injection for neck pain and arm numbness and pain (all on the left side) 11 days ago. I was under under anesthesia for the procedure but did not notice any concerning pain upon waking. When I went home for recovery I had severe soreness, enough I could barely sleep. but it seemed to get better after three days. Six days after the injection I felt the injection site still looked like a hump on my back and that I was having severe occipital neuralgia up the back of my head. My neurologist gave me topamax and told me to visit with my pain management specialist that gave me the injection. I tried to get a hold of him for two days and could not get a phone call returned (since the day before I went to the neurologist). Because my pain increased and I developed the worst headache of my life, like something was sitting inside my skull and hurting the front of my face and the nerves on the back of my head have become so sensitive I cannot touch them without my head feeling like it is going to explode or is on fire from pressure and pain, I went to the hospital the Friday (I think day seven, maybe day 8) after the procedure. The ER Drs. thought it might be a spinal headache because of the pain locations, however, the headache did not, and does not, get immediately better when I am flat, and because it presented itself almost a week away from the injection it made the diagnosis unclear. The Emergency room surgeon talked to me and said even if it is a dural puncture that no one does cervical blood patches because they are too dangerous. They did a CT scan that only showed only a 10 mm sublenticular cyst, incidentally noted on the right side. They sent me home with pain meds and steroids and told me to come back if the pain worsens. I went again to the hospital on sunday night, day 10, due to increased pain at site of injection and increased feeling of pain and pressure in neck and head. Also, when I would lay flat on my back the pressure on the back of my head and/or injection site caused me to feel like my blood pressure around my head was terrible and my heart rate would rise suddenly or fall suddenly . I am unsure if this was due to stress or related to the cause of my pain. The ER doctor ordered an MRI. He said there was nothing that gave him an idea as to what exactly was causing the problem and suggest",
    "doctor_response": "Hi,Thank you for posting this query.I have gone through the details of your symptoms, MRI spine, CT scan brain and the complication you have developed following CESI  (cervical epidural steroid injection) diligently. I understand your pain and have multiple unanswered questions. I shall proceed to provide my opinion which I hope can help you. Should you have any doubts/have unanswered questions, please write back to me. Your MRI cervical spine is consistent  with uncovertebral arthropathy resulting in moderate to severe left foraminal stenosis at C5-C6 and mild to moderate left foraminal  stenosis as C6-7.Uncovertebral joints are formed between uncinate processes below, and the uncus above. They are located in the cervical region of the vertebral column between C3 and C6. Two lips project upward from the superior surface of the vertebral body below, and one projects downward from the inferior surface of vertebral body above. They allow for flexion and extension and limit lateral flexion in the cervical spine. Arthropathy is a degenerative disease and in your case involving these jointsRepeat MRI cervical spine following CESI also reveals the same arthropathy of uncovertebral joints but in different radiology words. These means the major complication - which include Dural and epidural hematoma, epidural abscess, spinal cord rupture, infarction of spinal cord - following CESI has been ruled out. Further compication following CESI depends upon the approaches (which you have not mentioned). By now you would have known that CESI done by two approaches interlaminar and transforaminal approach. Complications reported with transforaminal cervical epidural steroid injections include neck pain, transient increased radicular pain, nausea, vasovagal reaction, dural puncture, non-specific headache, abscess, paralysis, and cord injury. And complications reported with interlaminar cervical epidural steroid injections include dural puncture, bloating, nausea and vomiting, vasovagal reaction, facial flushing, fever, nerve root injury, pneumocephalus, epidural hematoma, subdural hematoma, stiff neck, Cushing\u2019s syndrome, transient paresthesias, hypotension, respiratory insufficiency, transient blindness, epidural transient lightheadedness, dyspepsia, fluid retention, transient global amnesia, vertebral artery injury, paralysis, cord infarction and cerebellar infarction. Lastly incidence of dural puncture with interlaminar CESI ranges from 0.25% to 2.00% and transforaminal CE",
    "dialogue_context": ""
  },
  {
    "patient_message": "Partner not ovulating, had miscarriage, had STD. Any drugs for infertility?\n\nHi am very worried about my partner and i was accaully wondering if you lot could help me and her and help us understand she been going to the doctors recently and getting test for ovulating she been for several tests her bloods been taken we had a miscarriage a few months back also... we got a reply from the doctors not that long ago that she is not ovulating but hey dont understand why she believes that she is infertility but am sure it is just somthing stupid stopping this we had a little problem with a STD before but we got that rid of in just a few weeks but we werent ment to have sex during on the mediction but we did with comdom am accaully just woundering if the drugs you get for infertility could accauly help us if possible to stop our doubt if you have anything and know what could help please let me know thanks as am very worried about her. doctors also said there was a lack of hormones in her body. if there is anything to help how would i approach her with this information?",
    "doctor_response": "Hello. Thanks for writing to us. Lack of proper hormone levels most commonly leads to infertility. It can be taken care of with the help of medicines under the guidance of an infertility specialist. You both need to consult and take the proper treatment. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever and vomiting after hydrocephalus shunt surgery?\n\nMy mother had hydrocephela shunt surgery a week ago. she cant seem to stay awake and she has a great difficulty with speech. sometimes she cant verbalize at all. they originally told us 2-3 days in the hospital and we are going on 7. we had an issue with fever, agitation,vomiting. at times we cannot wake her at all. she was in ICU for 5 days rather than two. I seem to be the only one concerned. staff acts like no big deal. surgeon is supposed to be the best in the area but not concerned. when I ask him I get nothing. any thoughts? very concerned for my mother.",
    "doctor_response": "Hello dear As per your narration, shunt surgery indication is not clear in your case. Shunt surgery is usually done in hydrocephalus due to tubercular meningitis, idiopathic intracranial hypertension, normal pressure hydrocephalus and some other less indicated conditions. Fever and vomiting after shunt may be due to shunt infection or may be part of initial disease. You need to trust your treating neurosurgeon and discuss about the condition. If you are not satisfied with your doctor then you may take second opinion and shift her to some other hospital only when her condition stabilises. Hope you found the answer helpful God bless you and your mother. Dr Neeraj Kumar Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the effects of using amitriptyline for back pain?\n\nHi My Name Is Ray, Iam 76yrs old I Have wide spread pain from my backMy doctor has put me on amitriptyline Tablets one per night for Pain relieve What effect will theses tablets have on me,it  also makes me sleepy during the day which I don't like, thank you.Ray BrowningMy email address is bristol@  WWW.WWWW.WW au",
    "doctor_response": "Hi there. Amitriptyline is basically an anti depressant which also suppresses nerve pains to some extent. Using this alone for back pain is not logical and it usually is used as an adjunct with other medications.I would suggest you to go for pregablin instead of this since this has less drowsy effect and is more potent in reducing pain.I hope my advice has helped. Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for sever tooth decay which has snapped leaving 25% tooth?\n\nYes im having severe tooth decay and last night my front upper tooth just snaped of leaving 25% of the tooth still there.All of my problems with my teeth are my upper teeth. In 2008 Ifound out I had a rare kind of spinal cancer,I dont no the name of it rite of but they did sugery on my lower T4 and T5 disk to try and remove the cancerus tumor.They were able to remove 94% of the tumor.Now my question is can the drugs ive been on for the last five years, that include methadone, ozycodone, steriods, valume,testosterone,and there are others that have been tried that I cant rember but the ones listed above ive been on four years.Dr. befor I started taking the drugs listed above I had no problems with my teeth other than some cavaties from my youth, now i ve lost five molaes plus one front tooth and all the rest of my teeth up top are in some degree of decay,my medicade said that if the cause of my teeth problems stem from my health problems,and the drugs used to treat my condition,thay said I could get help from my insurance to fix the problem,I would love your insite into my question thank you very much for your time.",
    "doctor_response": "THANKS FOR YOUR QUERY, I HAVE GONE THROUGH YOUR QUESTION, The decayed front teeth can be restored with root canal treatment and capping if sufficient tooth structure and bone support is there. the missing teeth can be replaced with prosthesis...since you are telling you had cancer and you are treated for it you have not mentioned about radiotherapy....if you have taken radiotherapy then it can cause reduced salivary flow which causes radiation induced caries....so consult a oral physician and get it treated as early as possible, because once the tooth structure is lost then it cant be restored.. the drugs what you have is nothing to do with decay...i hope my answer will help you..with regardsDr. Mahesh kumar T.S",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of potential malaria?\n\nHi, may I answer your health queries right now ?  Please type your query here... Hi, im an African kid living in Nigeria, i had a sore throat four days ago, so i started ampicilin as adviced by my aunt who's a nurse, the next day a serious fever began, and i didn't have access to drugs for about eight hours into the fever, that night my mom began treatment on me for malaria, with some drug called amatem, now my skin is sensitive to touch, every morning when i wake up i have serious aches all over, and my fever comes and goes. i need your help i need to know whats wrong with me.",
    "doctor_response": "Hello  and thanks for sharing your concern with us.I would like to tell you that first a definitive diagnosis should be made before starting the treatment . For making a definitive treatment , proper diagnostic tests like CBC , Peripheral picture of blood thin and thick smear both , should be done . Such fever with sore throat could be a viral sickness , bacterial infection and can be any other infection as well which should be first be evaluated through proper testing and clinical examination and then after making a diagnosis , the treatment should be begun .I would recommend you to consult with your PCP STRAIGHT AWAY and don't take medicine yourself . Best Regards,DR.S.TOMAR",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe back pain?\n\nhi, i am suffering from back pain and i got MRI but did not understand what this medical term means 1) intervertebal disc desiccation at L5-S1 level 2) right posterolateral disc extrusion at l5-s1 level causing grade iii thecal sac and right root compression",
    "doctor_response": "Hello,Thanks for your query.After going through your query I came to know that you probably are suffering from lumbar disc prolapse. It is already confirmed by MRI scan. Intervertebal disc desiccation at L5-S1 level means disc between L5 and S1 vertibrae is somewhat dry. Right posterolateral disc extrusion at l5-s1 level causing grade iii thecal sac and right root compression means disc between these two level came  out of place  backwards and outwards and it is compressing spinal cord covering(dura) and right sided nerve root severly.There are two treatment options.First option is Rest in position of relief(generally lateral position with both knee bend),NUROKIND GOLD ONCE DAILY and analgesics (Diclofenac three times a day after meals is effective). Sometimes strong analgesic(such as ultracet three times a day after meals) is required. OMEPRAZOLE  before meals  prevent acidity caused by analgesics . This method needs patience as it take longer treatment times sometimes up to  6 months.Second option is go for surgical operation(Discectomy). You can discuss with your treating Doctor about it.I do hope that you have found something helpful and I will be glad to answer any further query. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does multiple liver metastasis indicate?\n\nHello sir , i hv query about my father...........his report shows MULTIPLE LIVER METASTASIS, CHOLELITHIASIS, MILD HEPATOMEGALY WITH Gr. I HEPATIC STEATOSIS & GRADE I PROSTATOMEGALY WITH INSIGNIFICANT PVRU. whtas the meaning of this sir. please help me & tell me the meaning of this that what the real condition of my father",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Your father has multiple cancer spread in liver with fatty change in liver. He may have some cancer in his abdomen.  He should go for ct scan and tumour marker study to search the primary cancer.  Then he should take treatment accordingly. He also have enlarged prostate.  It is common in old male.  It is mostly due to benign prostatic hyperplasia.  He can take alpha blocker like prazocin and finasteride for that.  Check PSA level regularly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for vaginal itching in kids\n\nMy daughter is 7years old now, but from the time she was 3 years old she regularly pleasured herself. I let it go because I was told it was normal. Now for the last 2-3 years she still does it, not as often, but will also constantly grab or pick at it. I mean every few minutes! She says she has to because it is itchy. I ve taken her to the pediatritian and says it looks normal. We even tried Vagisil. It didn t work. What could be going on with her?",
    "doctor_response": "Hello,Worm infestation can cause itchy vagina in the young girls. I would like to deworm your child by using mebendazole.\u00a0Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Omaira",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dizziness, chest pain, increased heart beat, migraine, tingling, cold hands. EKG done. What could this be?\n\nGood evening, I am a 34 year old female who started having dizziness , chest pain , pounding heart, migraine , becoming flush, tingling hands/cold hands about 7 days ago. Menses started 6 days ago, was fairly norma. 5 days ago I sought care at the ER. They did an EKG (it was a 2 second ekg and I am not exaggerating) said I was fine and sent me home. Im still having the same symptoms but the migraine isn t half as bad as it was. I m hydrated. I m 5 5 125. The blood tests they did do came back normal but the BUN came back a tad bit low at 5 and the protein came back a little high at 8.3. My blood pressure was a fine. What could this possibly be?",
    "doctor_response": "most likely you having anxiety disorder and get panic attack. consult nearby psychiatrist. paroxetine 25 mg in night would help in this condition....",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes movable lump under penis skin?\n\nI have had a small movable lump under the skin of my penis, left side, under the forehead, for a year or two! It  It is there whether i have an erection or not and is ticklish. I now wonder what to do about it! Is it harmful and should be removed? Is it what is referred to as sebaceous cyst?!",
    "doctor_response": "Hi,Dear,Thanks for the query to my HCM clinic.I studied your query indepth.Your data is incomplete and confusing-Is it under the foreskin or the shaft skin?If its beneath the  penile-foreskin-for 1-2 yrs,In my opinion-diagnosis-is-mucoid cyst of the prepusial skin  / or? it could be epidermoid cyst of the prepusial skin.Treatment-advised would be-a-Surgeons opinion b,Surgical excision ASAP.Hope you have cleared your worry.Would wellcome you you to HCM for any more queries on it or on other health-problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for hard bloated stomach\n\nHello. My 2 1/2 yr old daughter has a hard bloated belly for about a week or week and a half now. She has been sick with a sore throat so she has not eaten much but still has very regular bowel movements. Should I be worried? She also complains of tummy pain now and again. Thanks!",
    "doctor_response": "if belly hard and bloated, one has to worry especially with no appetite, constipation and vomiting. In the absence of latter symptoms, still I advice to see a doctor for \"hard\" belly. could be just stool mass collected ?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ventricular tachycardia.\n\nOriginally, i had A-Fib.......Taking Coreg & Tikosyn........My heartrate then became slow & Doc said to discontinue Coreg.........after a while, I became weak all over & Doc took me off of Tikosyn ,because he said I had developed a more serious condition of Ventricular Tachycardia......After a few days, my weakness & feeling like i am going to pass-out has overcome me again.........am listed to take a 24 hour holter monitor and echo cardiogram nine days later........also, am having 2 decayed teeth extracted in a couple of days..........Can you comment/advise on my condition/situation ?",
    "doctor_response": "If you have rhythm disturbance and are having episodes that you consider to be near loss of consciousness, your doctor should know and you should have the diagnosis pursued initially under hospital observation. Worry about your teeth later.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause if  blood clots noticed in bladder?\n\nhi my name is mary my boyfriend has blood as he a erecite has now the hosptail say that he has think blood vessels at tne bottem of his bladder but i dont know what to belive as they frist said that he had it on his prostaat he olny bloods when he has a erecite and than the blood is in his bladder with blood clots aswel",
    "doctor_response": "HelloThanks for query .Your boyfriend has bleeding from penis when the penis is ein a state of erection .In majority of cases this is be due to rupture of superficial vein on the surface of prostate .The blood clot in bladder needs to get evacuated endoscopically ,the bleeding point can be seen while doing endoscopic evacuation of clot and will be fulgurated .This will stop bleeding .Taking antibiotic and drug like Ethamsylate will prevent further bleeding . Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to relieve high fever with hot and cold sensations and ear ache?\n\nI am burning really hot, same time shivering and feeling cold.  Head is cool but feel like I have high fever. Body is hurting and joints ache.  Got ear ache.  Sometimes nausea feeling.  Been on antibiotic for 2 days now but still feeling bad unless I take paractomol",
    "doctor_response": "Hello dear,Fever,chills,shivering,and nausea indicates an infection somewhere in the body.We have to find the site of infection,and treat accordingly.Possible sites from your description is either upper respiratory tract or urinary tract.Or,it can be a viral fever also.As you have not responded to given antibiotic,you have to see your doctor to get it changed or may need some investigations like urine routine examination/blood tests to see the exact cause.Meanwhile,take adequate bed rest and take light diet and plenty if fluids.I hope you will find this information useful.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chemical taste on coughing while having asthma?\n\nI woke up a few days ago in the middle of an asthma attack and ever since then I have had a worsened cough that won't go away and everytime I cough it tastes like there are chemicals in my throat.  My voice comes and goes and I am randomly throwing up and can't eat. The nurses where I am at don't really help much so I really need help beause this is really scaring me any ideas?",
    "doctor_response": "HI, thanks for using healthcare magicThe taste of chemicals may indicate that the cough is productive. The use of a mucolytic (medication to help break up the mucus) may help to expel the mucus.eg of mucolytics are bisolvan, mucomyst, guifenesinYou may also need to temporarily increase the dose of your preventor inhaler to help regain control.It may be best to see your doctor for assessment.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicines for lupus with low bp\n\nI have very low blood pressure and a premature heart beat that is controlled by a beta blocker. I have had tennitius for 25 yrs. I recently when laying down, hear my pluse in my ears both sides. And.My chest aches.I have lupus,Ra,osteo arth, and take many medications.Ideas? 65 yr old female, active...",
    "doctor_response": "Dear Friend,Thanks for sharing your queries.It seems that your lupus and RA both are inactive, so no additional treatment needed. If you are not symptomatic for low BP then, no need to worry. However you should get one cardiology consultation for same.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for peripheral neuropathy on the soles of feet\n\nI have developed peripheral neuropathy, non-diabetic, on the soles of my feet and my heels. It is growing more painful and uncomfortable. I am concerned, worried. I am 63, on lithium x 10 months, newly relocated, this won t have medical coverage for up to 3 months. I would not ordinarily go to a walk-in clinic for such a neurological concern. Yet my question is, might I in fact get some help for this in a walk-in clinic? Thank you.",
    "doctor_response": "Hi  You feel that you have developed peripheral neuropathy in your feet and heels which is growing more painful. I think that what you have probably is c condition called plantar fascitis  which causes this type of pain. take any painkillers for 2-3 weeks ,do a hot fomentation twice daily and use only soft footwaer. If there is no relief in 2 weeks then consult your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white chunks in the stools of an infant?\n\nMy 4 month old son had white chunks in his stool earlier today and just again when I changed his diaper. It is not the normal seedy stool. They were noticeably larger white chunks. I am taking him to the pediatrician tomorrow morning but I would like some insight on this. The other symptoms I am taking him to the Dr for is congestion, extremely stuffy nose (hard time breathing while laying on his stomach), low fever, and a lot crabbier than usual. He had his 4 month shots a week ago and also had his first 2 teeth come in a month ago.",
    "doctor_response": "You have not mentioned whether the child is exclusively breast fed or whether supplemental feeds are being given. Most formula milks are cow milk based and hence difficult to digest and may contain white undigested portions in the stool and that is probably what you are referring to. It is normal and you need not worry about that. You can still get the stool microscopy done before you visit the doctor and that will help in confirmation.Children of this age have small nostrils which can easily get blocked. Applying nasal saline drops like nasoclear help in removal of the blockage and give the child relief. Fever indicates infection and probably your child has a viral infection which is associated with such infections.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a bruise on the forehead of a baby?\n\nHello Doctor, my son 18 months old, had fell off from the window, on his forehead, i can see a bruise there just beside to middle part, n the middle part of the forehead is bit swollen, please help me what can I do..he looks okay but I am litterally shivering..after this incident he has breast feeding..what should I do now?? please help",
    "doctor_response": "Hi,It seems that there might be having formation of hematoma over the part due to some capillary bleeding.If there are no CNS signs like nausea, vomiting, convulsions, loss of consciousness etc, nothing to worry.Apply ice pack 2-3 times a day for 2-3 days.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to recover from TB?\n\nhello drs: My sister was tested positive for MBR culture test for TB (something like this) .  I want to know what is condition of her disease, will she survive.  I am expecting your answer as soon as possible.  Please reply to my mail. Regards. Sajida Begum..",
    "doctor_response": "Hi,Welcome to HCM!I am really sorry to learn about your sisters' condition. It seems she has tested positive for MDR TB (Multi-drug resistant TB). It is a more serious form of TB. As the name suggests, this infection is resistant to most of the first line drugs used in the treatment of TB. These first line drugs are more effective and more safe to use.However, in MDR TB as the infection is resistant to some of these 1st line drugs, we use 2nd line drugs to treat MDR TB. These drugs have more side effects.However, I want to assure you that TB is a completely curable disease. With proper intake of drugs and good care of health, TB can be cured and and the patient can lead a good life.I'd strongly advice you to immediately visit a DOTS center and take proper treatment.Wishing your sister a speedy recovery.With warm regards,Dr. Sridhar",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce severe back pain after medical termination?\n\nHi I have a medical termination on 29th of August and was sent one after the foetus and placenta came out. Fr the past 3days I have been exeiencing lower back pain. The bleeding has really reduced since 2days but my concern is the lower back pain which is worse during the evening. It is really given me concern",
    "doctor_response": "Hi there. The back pain which you are experiencing is mainly due to spasm of the uterine muscles the pain of which is being referred to the back.It is a common phenomenon and some females experience it even in the normal course of the menstrual cycle. ........although the pain is of much lower intensity. Treatment :1. Take an analgesic with a muscle relaxant like a Diclofenac-Thiocolchiside combination.2. Take a smooth muscle relaxant like Spasmaproxyvon.3. Local heat to the back area along with a pain relieving gel massage.4. Last but not the least. ...a lot of bed rest.I hope my advice has helpedGood luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to reduce swelling and red lines in eyelids\n\nHi Dr. Prasad,I had my eyebrows waxed yesterday and this morning, I woke up with swollen eyelids and red lines in some areas. It looks as though there are actually cuts. Maybe the skin was actually taken off. I am going to a wedding in a few hours. What should I do to reduce the swelling? Many thanks.Sunita",
    "doctor_response": "HIWell come to HCMThis is allergic condition and this can be best treated with following medicines 1) Tab Levocetrizine 10 mg three times in day2) ketotifen eye dropif symptoms does not improved then you need to see the ophthalmologist for further advise, hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for recurring allergic cough\n\nhi , I am having cough alergy sience 6 monthsi m doing homeopath treatment , but when i will have the medicine it will go off ,or if i will have cetzine then also it will go off, for atlaeat 2 -3 days , then agin it will come. I also did the all blood checkup and allergy checkup(like ESR ,CRP, Chest PA Radiographer), Everything is showing normal. Please suggest to which doctor i shoud consern for this. Thanks",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.You are having chronic cough (cough for more than 2 weeks) with normal chest x ray.So possibility of asthma and bronchitis is more.So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test).PFT will not only diagnose asthma and bronchitis but it will also tell you about severity of the disease and treatment is based on severity only.You may need inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fatigue in case of anemia?\n\nhello my name is lee I am in my early forties I have been experiencing spells of tiredness and fatigue for a while now,  also now and then I get a fluttering in my chest sometimes only for a few seconds but it isn't a plesant feeling when it happens, I was diagnosed in my twenties as being slightly anemic and had some tablets for this, about 10 years ago I had some further blood tests done this found extremely high cholesterol levels and alpha thalasemia trait, my cholesterol levels have come down to a safe level down to statins and supralips, I am however concerned with this fatigue issue as I have had two days off work I came home Wednesday night and went to bed by seven I felt dizzy and week I didn't get up till three pm next day and my work are not exactly sympathetic, i cant get in to see my doctor until next thursday,any advice would be much appreciated.Lee",
    "doctor_response": "HIWell come to HCMIf this is case of low hemoglobin then such fatigue would be very common, again with history of \"thalassemia\" general weakness would be likely and this need to be taken under consideration, underlying cause of fatigue is matter here and this need to be treated accordingly, hope this information helps, take care have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have white specks and my urine, is this normal?\n\ni have white specks and my urine, is this normal?",
    "doctor_response": "Hello.welcome to HCM.yes this is possible to have white specks in urine.It is normal. Get your urine examined.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for nausea, heartburn, dizziness and back pain?\n\nI've been having chronic pelvic pain?I've been having chronic pelvic pain, constant nausea, heartburn, back pain, dizziness. No period for more than a month. Ended twice in the ER, I am not pregnant since I've had three Beta test and two urine test. Two Endo-pelvic Sonograms to which I was told for the first one I had ovarian cysts, they gave me medications \"for the pain and the cysts\", but when I went to the ER the second time cause I was bleeding for three days, they tell me the medicine I was taking was for a urine infection instead of for the pain and cysts. The doctors there did a endopelvic sonogram after they did it i bleed a lot more, they said it was my period but that same day I stopped bleeding, the pain is constant and the thought it could be pancreatitis but all the test came out good. They gave me pain medication but it only gives me insomnia and I am still in pain. Don't know what to do anymore? Can anyone help me? Been tired a lot eating a lot. Can't stand or sit for long periods of time. Headaches and short breath.",
    "doctor_response": "Hello. Thanks for writing to us. Since you are not pregnant there is no need to worry. The pain could be due to pelvic inflammation or endometriosis. Proper investigations like ultrasound scan are needed. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal . For future query, you can directly approach me through my profile URL  drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for bump on bottom of foot\n\nHello--2 weeks ago I suddenly felt like I was walking on a pebble after I removed my shoes at home. By yesterday I could see the bump on the bottom of my foot almost in the middle of the ball. A friend at the market today told me it s a bone spur; he recognized the symptoms as he just had surgery for the same thing. I have no insurance right now and was planning to return to work very soon--don t know what to do.",
    "doctor_response": "Hi,thank you for providing the brief history of you.As per your symptoms i will advice you to first undergo a thorough clinical examination and an x-ray before jumping to any conclusion.Post the clinical examination and an x-ray the treatment plan will be initiated.Also physical therapy will provide you much relief with therapeutic ultrasound therapy and TENS therapy. Performing simple exercises of the foot muscles will help to strengthen the muscles.If it is a bone spur, treatment plan will be same with addition of silicon gel pads for the heel in shoes.In my clinical practice most patients respond well to physical therapy.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Coughing up with some white substances, what is this ?\n\nHi I am coughing up like this whit plaque like substance I can look in the back of my mouth and see it sitting in like a pocket. What is this? once it comes out its soft and smells like plaque.",
    "doctor_response": "hello, its most probably tonsilolith. it is of no problem until it produces any symptoms. you can better visit an ent specialist who can irrigate out the tonsiloliths. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat throat cancer while having shingles on the scalp?\n\nMy husband has shingles on his scalp which has gotten better but still causes nerve pain. History of radiation to epiglottis and esophagus due to cancer 5 years ago. Always has had some problem after radiation with swallowing but has improved. Recently developed extreme difficulty swallowing, even soft foods. He saw his oncologist today who said he had a throat cancer. My questions are: 1. Is the wallowing difficulty a side effect from shingles on his scalp? 2. How does the doctor diagnosis a virus versus a bacterial infection? 3. Best treatment for throat virus. Thank you.",
    "doctor_response": "answer to question one: Shingles on scalp are unlikely to cause throat pain. nerve supply to scalp is different from that of throat. pain is perceived by nerve endings. since nerve supply is different, throat pain is not caused by scalp disease.2. Shingles can be made out by clinical examination. every doctor is trained to differentiate different diseases. so viral infections like Shingles can be made out clinical examination.3. Treatment for throat infection depends on type of infection. can be made out by clinical examination",
    "dialogue_context": ""
  },
  {
    "patient_message": "Multiple calculi in gallbladder, alkaline phosphatase levels abnormal. Is ERCP the next option?\n\nI am 16 year old girl. Doctors have examined me done LFT with two readings of alkaline phosphate as 98 & 130. done EUS, US & MRI. findings are multiple calculi in my gallbladder. largest one measuring 1.4*1.4 cm. what precautions can i take and what procedure can be carried out further. as such doctors have recommened another LFT and then if the alkaline phosphate level is increased then ERCP is the next step. i would like to know what according to you can be done further?",
    "doctor_response": "Hello there!  Thank you for asking. If gallbladder has stones the things we need to worry about is if it involves nearby bile duct and dilates the common bile duct and adds to the yellowish discoloration of the skin(jaundice). Also the pancreatic profiles Serum amylases lipases amylase to lipase ratios .Alkaline phospahtases and bilirubin levels hike means that the common Bile Duct CBD is involved. And yes in that case ERCP (Endoscopic retrogade cholangiopancreaticography) is the next step as it would be both diagnostic and therapeutic.Then you will be prepared for simple laproscopic cholecystectomy/ removal of gall bladder through minimal invasive procedures Providing the anesthesiologists and general surgeons give a green signal after ruling out all the contraindications for it.As you are 16 years old only. This young age with rest of it with out gall bladder might advise a conservative approach. But what your doctors decide for you will be best for you and i am sure you are in safer hands.Hope i was of some help. Take careregardsDr S Khan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Low self-esteem causing marriage to collapse. What might help?\n\nHi doctor,My sister is 36 years, married, and she has four kids. She always faces problems with her husband. The same complaint is always there. He is humiliating me. He sees me as useless. He is neglecting me. He does not respect me. When I tried talking to her, I saw that her self-esteem is low and she is denying that all the time. Her marriage is about to collapse. We tried to convince her to visit a marriage counselor or a psychiatrist. But she refused. She says that all of the family is against her and we are not supporting her. She does not want a divorce nor solve any issue. She gets her full needs of self-actualization from social media educational groups that she participates in most of the time. I am afraid that she is living in her own world and refuses to have support from us. How can I help her? Or how can I wake her up as she is going to lose everything but she is unaware due to denying and blaming others? We do love her and she needs help.",
    "doctor_response": "Hello. It is very important to stay away from social media. It is not a true life. Make her spend time with family and friends. Fix her duration to spend time with mobile or electronic gadgets. Give her books to read. Divert her to spend quality time for creative hobbies like painting, writing, learn new languages, cooking, dancing, music, etc. Keep her busy with the new schedule. Advise her to go for exercise daily at least for 30 to 40 minutes. Get good sleep. If there is any violent behavior, admit her involuntarily to a psychiatry unit. She needs a proper evaluation to treat her. She may have psychotic symptoms or major depressive disorder. Medication can help her. For more information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure blisters on the bottom of the tongue?\n\nA couple of Nights ago, I discovered painful blisters on the bottom right of my tongue. My theory is that because of may braces, my molars have moved so that it cuts my tongue every time I move it.Is this serious? And how long will this take till it heal?",
    "doctor_response": "hello thanks for consulting at hcm..it could be traumatic blisters and ulcers bcz of ur braces,,get back to ur dentist for grinding off the sharp margins f braces and apply topical anesthetics and antiseptics under the guidance of ur orthodontist or dentist,,hope it helps,,kindly consult ur dentist for the prescriptions and trimming of braces,,, tc",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment for fatty liver grade I-II\n\nDear Sir, My ultrasound report shows liver size normal but shows diffuse increase in echotexture. No focal or diffuse lesion seen and intrahepatic channels not dilated. Heptic veins are normal. Under impression the report shows Fatty liver Grade I-II. Kindly let me know is there any thing serious and Treatment for the same. Thanking you sir Asif",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have fatty liver only.  No other pathology, so no need to worry. You should go for complete liver function test to check liver enzymes level and take treatment accordingly. Avoid alcohol. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to improve hearing loss of problem of a 6 year old?\n\nHow can I assist my daughter of 6yrs with hearing loss to improve on her speech development? My daugther was born with hearing loss defect and when we discovered it, we got Hearing Aids for her. Though with the help of the equipment, her hearing and speech have both improved, but her speech needs to be worked on. How do we go about this as parents?",
    "doctor_response": "YOUR CHILD HAD HEARING PROBLEM SINCE THE BIRTH AND SEEMS TO SENSERI-NERUAL TYPE OF HEARING LOSS..YOUR CHILD SHOULD UNDERGONE BERA - HEARING TEST AND CT SCAN YOUR CHILD CAN BE BENEFITED BY COCHLEAR IMPLANT SURGERYFOR WHICH YOU NEED TO CONSULT HEARING YOUR CHILD SPEECH CAN BE TRAINED BY SPEECH THERAPISTYOU NEED TO GIVE SOME MORE TIME TO CHILD FOR THE DEVELOPMENT OF SPEECHAND SPEECH THERAPIST WILL HELP YOU A LOT",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes continuous coughing and chest pain?\n\nI want to understand something about lung related disease. My MIL has been suffereing from breathing issues since last 3 years. She gets allergic to smoke, dust etc. We had been taking treatment of some chest physician but all in vain now she has been undrgoing some ayurvedic mdeicins..but i dont see any improvement. She is suffering from bronchitis, coughing endlessly for half hr to hour at intervals not able to climb or lift any object..gets pain in chest due to continous coughing, has lost lot of weight as well.Can you suggest me as to what is she exactly suffering from?..soem say its related to wind pie as she has to take lot of pressure to breath..some say that her lungs are not working 100%.. I need some advice on the same",
    "doctor_response": "Hello and welcome in HCM.I can understand your concern.So as you explain your mother in law has breathlessness and according to the history in my opinion she should do some examinations especially for the lungs and the heart problems as follows:Chest X RayEKGTroponin,CK-MBCardiac ultrasoundSpirometry with b/dilatatorsIn my opinion it might be a lung disease called COPD and the test of Spirometry will be diagnostic or it might be a cardiac problem in addition to it.The treatment of COPD is based in the stage of diseases and for the cardiac problems will be the cardiologist that will guide you further.I wish you good healthThank youDr.JolandaPulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will it be safe to take wysolone for high neutrophils?\n\ni have a son of 18 year old and his neutrophils are showned high enough in heamogram test . some doctor suggest me to give single dose of wysolone to him. so i just want to know is wysolone is safe for him.? and he is going for a recruitment in airforce so is there is any problem for his medical fittness... while taking wysolone..?",
    "doctor_response": "Hi, welcome to HCM.High neutrophil in blood is mostly related to infection in body.It is not advisable to take wysolone for that.Wysolone has many side effects- high BP, high Sugars, weight gain/obesity, skin stria, bone loss, peptic ulcer etc.Check complete blood count, basic urine report.Monitor temperature.Take Physician's opinion and physical check up with him.I think this would be helpful to you.Best wishes. TC.Dr Jay Patel.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cancer misdiagnosis, tumors in sinus cavity, no hemorrhoids, drinker\n\nLast year we were misdiagnosed with cancer . (multiple melanoma ) he was 2 days away from radiation and then he was told he doesnt have it. They have no idea what he has. The tumor was in his sinus cavity. Recently he has been hurting everytime he goes to the restroom. He drinks on a regular basis. I was just wondering what could be causing this. He doesnt have hemmoroids",
    "doctor_response": "Hi jenny, I would like to know whether it is multiple myeloma or malignant melanoma. Both this can occur in sinus cavity. If there is any brain metastasis due to melanoma he can have some behavioural problem depending upon the the size and location of the tumour metastasis in brain. If it is myeloma then there is a chance of platelet abnormality which may cause bleeding after passing stools. Whatever it is a biopsy from the lesion in the sinus cavity will rule out cancer. An oncologist consultation is mandatory. Dr. Mohammed Ibrahim Surgical Oncologist mdibrahimdr@yahoo.co.in",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the permanent cure for pain caused due to a brain injury?\n\ni have a brain injury i fell out of a bucket truck 7 years ago the pain has not stop since the fall they had to peel my face off to fix my eye sockets and hole on right side of my head what can be done beside the meds i am on to fix the pain .they put me in a coma for two days for the swelling to go down.it just sucks yhat it means take the meds to life life and have no sex which i seem to have work out but the rest of my family dont like that i have too lay down alot till the meds kick in my wife calls me a liar how can i explain the problem",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your clinical details. It is unfortunate that you have been left with multiple neurological deficits after brain injury seven years back.However, with proper medical treatment and physiotherapy, I expect you to get better over time.It is important to make your family, especially your wife understand the nature of your problem. If needed, please make her speak to your neurologist.With good family support, you would improve much faster.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bronchopulmonary segments in lungs\n\nA surgeon removed three adjacent bronchopulmonary segments from the left lung of a patient with TB. Almost half of the lung was removed, yet there was no severe bleeding and relatively few blood vessels had to be cauterized (closed off). Why was the surgery so easy to perform? (4 points). Answer",
    "doctor_response": "Hey there,See in pulmonary tuberculosis inflammation and cavitation occurs As its caseating granulomatous inflammation it damages vessels and lung tissues.Hense no bleeding.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen and painful jaw\n\nHi. My 4 year old daughter just received a root canal to one of her molars. Today is day 3 and her jaw where the procedure was done is swollen and very visible. What could be the cause and how can we treat this? Will this be permanent or will it go away?",
    "doctor_response": "hiAccording to me the chances is more of restoration/filling which is done is high, because child won't be able to judge the high point in the restoration during the procedure, you have to visit the dentist and get it corrected.Secondly, it can be due to RCT procedure is not done properly, the root canal filling material is either short in tha canal or flown out of the canal.Ask your child not to eat or chew from that side, till its corrected.Give the child lukewarm saline mouth rinse 3-4 times/daily.Give the child soft diet.Don't give hot compression from outside.Don't let the child sleep from the side where is swelling.If the child has unbearable pain, give a pain killer tablet.Swelling is temporary it will go away, not to worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for severe pain in hands and feet while having dementia and history of heart surgery\n\nMy dad has other health conditions like he had heart surgery, in first stage of demicha but he has very bad hands and feet a doctor told hi m he had diabetic feet but he not diabetic was just wondering if Lyrica can be taking or do you have any other treatment you can recommend he s in pain all the time.",
    "doctor_response": "Hi with these conditions he could probably be suffering from a condition called Parkinson''s disease . I suggest you consult a neurologist before starting any other treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have memory issues. Fail to recollect incidents. When tested, came out age related normal. Treatment?\n\nHi Dr. Grief,I am a healthy 66 yr old female with a happy marriage , 3 children , and 7 grandchildren.  I'm retired.  I have been having loss of memory issues for about (?) a year.  Nothing horrible like getting lost, forgetting to take my Rxs , or how to get through my day.  My recall of incidents is lacking strength. My  husband forgets nothing which makes my lousy memory seem even more exaggerated and exasperating.  I have had various degrees of anxiety since my early 20's\". I get in an \"overload\" status quite easily depending on my environment at that time (does that make sense to you?) A houseful of my kids, their spouses and my grandchildren does not overwhelm me. But what is upsetting is  constant anxiety over my husband's Hep C contracted from blood transfusions due to a spontaneous ruptured esophagus occurring @17 yrs.ago although his only symptom is he tires easily; he has had several liver biopsies which indicate no cancer  - he has been on 3 treatment plans, the first 2 lowered his liver viral load count to 0 but he is a \"reactor, not a sustainer\";  shortly after going off  2 treatments the viral load goes up again; the 3rd & last treatment was intolerable and he had to come off it.  Now he has a cyst on one kidney discovered during a cat scan and they're pretty sure it's cancerous and will be operated on quite soon. No sign of cancer spreading as far as they can tell now. I feel like I can't be strong for him anymore and I'm always stressed inside. When someone (spouse or kids) say things like \"remember when we did such & such or  why can't you remember we had a whole conversation about this or that. ?\" That's when I feel like something is wrong in my head; and they do not mind sharing their disbelief that I've forgotten whatever it is. \"You need to see someone about your memory\" is an often response. They don't beat me up about it and are well-meaning because they care about me, but I can sense that they are all getting more concerned.  I went to a neurologist and everything came out age-related  normal and  that I should get cognitive remediation therapy. I do not have any dementia or any sign of early onset Alzheimer's. I've been searching the internet to find a therapist  in my area (Frederick or Montgomery County Maryland) who deals with C.R.T. /memory function and anxiety issues as stated above. Would you be able to give me some directi",
    "doctor_response": "Hi thanks for asking to HCM, the friend you talking about, has a sign depression. Need consultation from psychologist.  don't be solely depend upon medicine. Give him support, do join a sport or exercise. Let him do his hobbies and give him challange in between. Take care. Soon things will be fine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the best ways to control, remove and prevent swine flu?\n\nHello doctor, Please tell the best way to how can we control, remove and also prevent the swine flu?",
    "doctor_response": "Hello. Swine flu is caused by a virus called H1N1 and H3N2 group of influenza viruses that are widespread across continents. Since they spread by aerosols, which means that a person having swine flu can spread it by just sneezing and coughing and people around can get infected by inhaling the droplets in the air coughed or sneezed out. Vaccination is one of the effective ways of preventing swine flu although it may not be 100% effective. Get yourself vaccinated before the onset of the flu season every year. If you are an asthmatic or having chronic respiratory problems it is all the more recommended to get yourself vaccinated for flu. The best treatment is prevention, by maintaining hand hygiene, cough etiquette, i.e. covering one's mouth and nose while coughing and sneezing and turning away from surrounding people, frequent hand washing. Once you suspect that you have flu, take adequate rest, hydrate yourself, seek medical help as soon as possible.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Wisdom teeth removed, infection, swelling, pus. Rinsing with warm salt water. Can I cure this without antibiotics?\n\nHi I am 33 yrs old. I have had my upper right wisdom teeth and both lower right and lower left wisdom teeth extracted. I had them removed two months ago. Since then, it has been a very slow healing , I m sure due to my age. A month ago, I had an infection in the hole where my lower left wisdom tooth was extracted. My oral surgeon drained the pus and I was prescribed antibiotics. I now seem to have the same type of infection as I did before. Since I had a terrible experience with my oral surgeon, I recently called my dentist and told him my symptoms. He said to rinse with warm salt water. The pus has drained but I m still experiencing a lot of pain in my cheek. In addition, I think I might be pregnant. (It s still too early to take a pregnancy test). I would like to avoid antibiotics as much as possible. What are my options?",
    "doctor_response": "Hello. Thanks for writing to us. Since there is a hole with actively draining pus, an infection is present. For proper treatment, you need to have antibiotics to control the infection well. Also, you can rinse your mouth with chlorhexidine mouth wash to avoid the spread of infection. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes trouble reading along with visual hallucinations?\n\nMy six year old daughter is complaining that when she looks at words or objects in the room that they are shaky and move around. Having some trouble reading. That is used to happen earlier in the week once in a while and now it s happening a lot. Should I take her to her pediatrician or eye doctor?",
    "doctor_response": "Hi...I suggest you take her to pediatrician first. It might be a initial manifestation of learning disability too. Once medical problems are ruled out, you can opt for ophthalmologist.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is their a cure for Leukodystrophy ? How are hearing and vision losses caused by it treated ?\n\nHi, my sister has been diagnosed with leuckodystropy 15 years back. That docters said there is no treatment for this. She is has hearing and vision problem. She can only see or hear 5% ... lease let me know if there is any treatment now ?? Or can she go for cochlear implanttaion fas hairing aid ??? Her age is now 28 now.",
    "doctor_response": "welcome to hcm cochlear implantation is a good option if there are no contraindications..but if auditory nerve is involved it wont help u..treatment options are very few..hope for the best..take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headache and swollen forehead while having high bp?\n\nI am Sonia, 40 yrs old. Yesterday I woke up with a severe headache and in spite of taking 3 painkillers the headache did not subside and by evening, the nerves on both sides of my forehead had swollen alarmingly with the headache only becoming worse. When I went to the physician, my BP was extremely high. On taking the medication for BP, the swelling has subsided, but I am curious to know why the swelling happened in the first place...",
    "doctor_response": "Headache can be result of elevated blood pressure or even blood pressure can be elevated due headache perse. Swelling may occur due to dilatation of vessel which can be a response to pain.just keep your blood pressure under control. Make a blood pressure chart with frequent readings.Also get your lipid profile regard.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for night fall\n\nDear Sir,I Have Problem during my Sleeping at night the sperms come automatically and i cant able to continue my sleep. How i Can avoid tis? Could u help me? Is there is any treatment that i can able to take means kindly gave suitable advise to me sir?",
    "doctor_response": "night falls are completely normal to oocur every 2 -3 weeks.. but if its causing you discomfort then you can try these useful tips..chew a few garlics every day..take a bath before going to sleep avoid watching porndrink sage tea",
    "dialogue_context": ""
  },
  {
    "patient_message": "When can i get pregnant after stopping 'petogen' injection?\n\nGood DayI was on petogen 3mnth injection last year october and have not taken it after that. How long does it take to work out of my system and what are chances of falling pregnant any time soon? I am 35 years old and would like to start a family soon.",
    "doctor_response": "Hi I think it will take around 6 months for your ovaries to regain it's function because ovulation gets suppressed after these injections. But it can happen earlier also. So you can start trying now also.  Be in contact with your husband every 2 to 3 days after your periods stop.  If you don't conceive in 6 months consult a doctor as you might need some medicines for ovulation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does lactogen in children increase body weight?\n\nhi i have a 2 yr old daughter , i only give lactogen to her in night so i would like to know is it good for her health. she is also put upthe weight , can u plz tel me is it bcz of lactogen or some other reason, i would also like to get rid of her bottle habit she only take bottle in night not in aday time,plz answer my question",
    "doctor_response": "At 2 years of age skimmed milk is preferred. However their may be other reasons also for the gain in weight. her diet should not be very high in proteins and  her plate in a day should have small portions of :vegetables fruitswhole grainslow fat dairy productsproteins as pulses , beans, egg etc.3-4 meals a day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I feel as if something is moving in my throat. It is bothering me a lot. Please help.\n\nHello doctor,I feel as if there is something stuck or moving in my throat around the back of the\u00a0mouth to the Adam's apple. It has been bothering me for a few days. There is no pain associated with it, just the feeling as if something is moving up and down my throat. It goes down if I swallow, and comes up if I let it.",
    "doctor_response": "Hello. A foreign body sensation or a feeling of something stuck in the throat is a very common complaint. There are so many causes like acid reflux, pharyngitis and allergic rhinitis that could cause the feeling. I suggest: Consult your specialist doctor, discuss with him or her and start taking the medicine with their consent. For more information consult an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My mentally retarded sister suffers from epilepsy even after many medication. Why?\n\nHello doctor, My 13-year-old sister has been diagnosed with various mental disorders since the age of 2. My parents have taken her to doctors since then because they have noticed that she was not developing like the other children. Almost every doctor gave another diagnostic such as autism (each doctor suggested a different type of autism) and mental retardation. When she was approximately 6 years old, she was also diagnosed with epilepsy. At first, the crisis was happening only while sleeping and they were detected during an EEG by a doctor. He prescribed the first anti-epileptic drug which was Ospolot. My sister felt very sick from it so another doctor told us to stop the medication. We did and then she started having a different type of crisis, absence crisis while awake. The doctor then prescribed Topram. Throughout the treatment with Topram, another type of crisis was added beside the absence, that is myoclonus. The doctor then prescribed Depakine instead of Topram. The absence crisis stopped, but the myoclonus stayed. Besides Depakine, she started taking Rivotril as well. With this combination, she stopped having a crisis for 3 months, but then the myoclonus started again and nocturnal epilepsy crisis was added as well. During this period, the doctor tried to replace Depakine with Lamictal (Lamotrigine), but my sister became intoxicated from it and started suffering from the Stevens-Johnson syndrome. She had to be at the hospital for one week to detox. My parents went to a different doctor then and he added Topram (Topamax / Topiramate) besides Rivotril and Depakine. This did not work again. My sister felt very sick from this combination while having a crisis both while being awake and asleep. She was then prescribed Depakine and Levetiracetam. The crisis while being awake stopped, but those while asleep still happen. At the moment, she takes Depakine, Levetiracetam, and Ospolot, but the nocturnal crisis persists. We do not know what to do anymore because the side effects of all these anti-epileptics have done a lot of damage. My sister is always very sleepy and drooling all the time. She already has mental issues so this just makes things so much worse. I know I wrote a lot, but I thought you should have as much information as you can. Here in our place, doctors are not that well informed about these diseases, so they do not really know how to deal with it. We als",
    "doctor_response": "Hello doctor. I read your query and understand the feeling and problems faced by you. As I can see epilepsy is the main problem at this moment and even a combination of three drugs is not making her seizure-free. Despite her treatment, she continued to have seizures and in the medical language, she is known to have refractory epilepsy. I must acknowledge here that treatment of refractory epilepsy is one of the most difficult treatment in neurology and need considerable effort on part of doctors ad family members. Despite the effort we are not 100% successful in doing so. Regarding her treatment I will like to consider one of the two below mentioned strategies. Firstly, I need to know the dosage of current medications. If there is anything that can be changed I will prefer doing so as the current three medicines are rightly prescribed. The dose can be increased or decreased for one or more drugs. My second preference will be to try Trileptal (Oxcarbazepine). This meditation is less sedative in compare to her existing treatment and a definite role in the treatment of refractory epilepsy. Before a change can be made talk to your doctor about these two options. I hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes unbearable gums in the tooth at nights?\n\nI am taking metrogyl 200mg, plus amoxicillin 500mg for my teeth why at night do my gums and teeth become so unbearable I brush them at night 2 plus I use listerin trying to get rid of the pain panadol and any other pain killer I can find. Can you suggest what I can do. They are getting pulled out next month. Thank you",
    "doctor_response": "thanks for your query, i have gone through your query.  The pain could be because of the tooth infection. history of night pain is the characteristic feature of pulpitis. consult a oral physician and get it removed. mean while you can consult a dentist and get a eugenol dressing done that reduces the pulpal pain. and continue the medicines. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cause for lumps on breast bone\n\ni have a lump above my breast bone....or on my breast bone it has slowly grown over the last few months.  it did not bother me before but in the last few days i feel a tugging sensation in my neck and shoulder.  i found this enlarged area in April when i had a lump in my breast removed.",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You may have lump in your breast or may be in bony area.  You should go for ultrasound to know site of lump.  If needed go for fine needle aspiration cytology. You may have some serious malignancy. 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for Hypertrophic Cardiomyopathy with mitral valve regurgitation?\n\nYes my father was diagnosed with Hypertrophic Cardiomyopathy with mitral valve regurgitation.  He has not had surgery for it, quit smoking 6 years ago, does not have high blood pressure, is not over weight, and recently has an increase in shortness of breath with light activity and occassional increase in tingling down his arm....what should we do? Our cardiologist cant get him into their office until February 22",
    "doctor_response": "Hello , In hypertrophic cardiomyopathy there is dynamic blockage to passage of blood from the heart to the body giving rise to symptoms you just described.  It's a complex condition which needed detailed evaluation and discussion on treatment.  However as he has started having symptoms.  The best medication to start is beta blocker metoprolol 50 mg and built to maximum dose ( about 200 mg)  keeping a tab on blood pressure and pulse rate . He should not be asthmatic to take take it safely . A blood thinner like small dose aspirin 75 mg would also help till you see your doctor . An echocardiography for gradients , 24 holter if  he has palpitation and other investigation based in his initial evaluation is justified . A Call for surgery can be discussed with your cardiologist based on the reports . Let me know if any clarification needed.  Regards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is platelet count of 60000 a cause for concern?\n\nHi Doctor ,I am 41 years working professional ,I had a mentrual period and Soon after that I had gone for blood test my platelet count is 60000. Is any thing serious about it and what precautions and food should I take to make up my platelet count. Neena .",
    "doctor_response": "Hi i do care for your concern. The platelet count that you have mentioned is well below the normal range. Since you have mentioned that you have taken after your periods, its wise to take a fresh blood testing for platelet count. If found to be abnormal then consult your physician as you need more evaluation.Hope i have answered your question, if you have more feel free to ask. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in lower back radiating to hip and groin area?\n\nI have sharp pain starting in my left lower back radiating around my hip to my groin area. This is new and different pain that I have not experienced. I am able to get around fine, but certian movements are very painful and I have to stop. What is this?",
    "doctor_response": "Sharp pain lower back  region  with pain moving   to hip area suggestive of nerve root compression . This is associated  with disc prolapse  that compresses    nerve.any compression  over nerve must be relieved  as soon as possible . Or this may permanently  damage   that  nerve.you immediately  consult a orthopaedic   surgeon . He will advise   MRI of your lower back to assess  extent of nerve root compression  and further management .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain and backache while on treatment for lung infection?\n\nI started this med for a lung infection that showed up on a lung scan. After a week l was so sick. Flu like symptoms my doctor told me to stop. I m still feeling very sick after stopping it for a week, nausea, chest pain, back pain etc Is this normal? YYYY@YYYY",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Backache can be associated symptom with lung infection or pneumonia. Chest may also occur in lung infection. These symptoms should subside after resolution of your lung infection. sometimes there may be fluid collection around the lung (inside the pleura-layer covering the lungs) which can cause  chest pain. You must consult to the treating physician to rule out definite cause of such pain. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can PTSD along with abusive behaviour be managed?\n\nMy son has PTSD from the Gulf War. He has turned 50 and has progressively changed from the son I know to times when I don t recognize him at all. His marriage of 26 years is on the rocks. His oldest two girls are alienated from him and the youngest two have to deal at home with mood changes from that of isolation to on-your-face shouting at them. They stay in their rooms to avoid some slight infraction to converts to a mountain that comes down on him. There is no physical abuse, only verbal. He is stuck in a job he hates but sees no way out because of the debt he carries especially in a $2500 per month payment, Every other Monday he is at the VA Hospital. They cure nothing, just disperse pills -- lots of pills and I seriously doubt that one doctor communicates with any other doctors assigned too him to see if he is taking a toxic cocktail with this variety of pills he takes. He is convinced there is no help physically or emotionally for him. He is in pain from the top of his head to the bottoms of his feet yet he rises at 4AM every morning and get back at 4:30 p.m. He will heat up a can of soup, eat and then go to bed. He has no energy left for the family. 1 WHAT ANSWERS DO YOU HAVE AND WHERE CAN YOU DIRECT ME OTHER THAN A VETERANS HOSPITAL!J",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As you told your son is suffering from post traumatic stress disorder that is PTSD it's better you consult a psychologist who gives cognitive behavior therapy to alleviate is symptoms and other than that consult a psychiatrist and tell him clearly regarding all the medications which he is currently using so that he will try to cut down the unnecessary medications. Antidepressant along with sedative(temporary use) might be sufficient for your son. If there is no response with this medications it's better to add low dose antipsychotics or mood stabilizers which is to be done under the supervision of a psychiatrist. Regular cognitive behavior therapy that is counselling sessions are at most needed. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "what causes painless lumps near groin in kids?\n\ni just noticed that my 2 years 8 months old daughter has a lump or swelling on the left side of her mons pubis near the groin area. it has no tenderness or redness. she does not complain of any pain at all even during urination. she is a active and healthy kid who weighs 14 kg and stands 98 cm tall.",
    "doctor_response": "You should consult your pediatrician to rule out some sort of hernia. It may happen that it should have been from birth but u didn't notice.....so better to have a visit to your pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI after brain hemorrhage shows haematoma in right anterior inferior frontal lobe, swollen right head of caudate nucleus. Explain\n\nMy daughter recently suffered a brain haemmorage (possible AVM). MRI just completed says:- There is maturing haematoma within right anterior inferior frontal lobe. The right head of caudate nucleus is slightly oedemantous and swollen. There are a few tiny foci of signal change within both thalami and brain stem that raise possibility of an underlying vasculitis. There remains shallow subdural haemtoma overlying the right parietal, occipital and temporal lobes extending mildly along the tentorium. No definite undetlying lesion shown . What does this all mean. My daughter is recovering from her brain haemorage and at moment has loss in right side movements",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern for your daughter, the MRI reports are suggestive of pathology or abnormal changes to internal structure of brain due to the collection of blood that might have escaped from the vascular system and get collected around the internal structure of  brain, such pathology always gives sign of paralysis of concern area, now the hemorrhagic blood will be absorbed gradually and the clinical symptoms will go away too but chances of sequelea would be there hope this would clear your doubt, have good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What abdominal pain in children?\n\nMy son is nine, 54\" and weighs 60lbs.  He has had 3-4 bouts of SEVERE abdominal pain on the lower LEFT side.  These have all taken place months apart, but they have all resulted in him being doubled over in pain for several hours, but resolve themselves eventually on their own.  It does not seem to be due to constipation or hunger so was wondering what else could be the cause.  There is also no evidence of protrusion. We did not have insurance for a long time, but now do and I was wondering what questions to ask the doctor.",
    "doctor_response": "HI.This can be due to recurrent testicular torsion with a referred pain in the left side of the abdomen. During the next attack consult a Surgeon / Urologist and get an urgent ultrasonography and color doppler done of the scrotum as well as the abdomen. Also get a Standing X-ray abdomen during the attack. Once the diagnosis is made , it is easy to treat. Another possibilities are of sigmoid volvulus.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need treatment for sciatic nerve problem and hip pain\n\nI have harrington rods in place (23 yrs) and have started to suffer some different back issues,like sciatic nerve problems and pain in hips. Lately I am experiencing a strange vibration up and down my spine periodically. Numbness in one heel/ midfoot area and some pain when I flex it",
    "doctor_response": "I would get a MRI of the lumbar spine to look for possible issues with stenosis at the area below your Harrington rods.The lower lumbar spine is where the sciatic nerve originates (L5/S1), and I would look at that area closely.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for breath smelling strong when using fer-in-sol for discolored teeth?\n\nmy 5 year old daughter's front teeth are discoloured, they seem to be going black. She brushes twice a day and uses mouth wash also. She is currently on fer-in-sol, (iron .3ml) per day and my gp says that the dose is so low it wouldn't affect her teeth. Also her breath is quite strong smelling, could they be connected?",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM, I have gone through your query, as your  child have discoloration of upper front tooth dont worry discoloration is not related to iron supplement you are giving . This discoloration can be due to caries or due to History of injury causing tooth non vital or due to internal resorption. Consult dentist and go for radiograph xray if it is carious or nonvital then go for treatment. Hope this will help you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Did ultrasound. Diagnosed with small liver haemangiomas. No pain. Blood test shows ALT. Cholesterol high. Problem?\n\nHi A few small liver haemangiomas were found incidentally on an ultrasound scan a couple of years ago. I have no pain or anything.  Recent routine blood tests shows my ALT to be 65. In the past it has varied from 27 to 47 to 36 and now 65. is this anything to worry about. My other LFT are normal (bilirubin,alk phos & albumin). My cholesterol is a little high at 5.9.??",
    "doctor_response": "hi there, liver hemangiomas are common benign tumors of the liver and most often are incidental findings. They are asymptomatic but sometime may cause haemorrhages. If you are a female then one of the causes cited are use of OCPs and discontinuing them and using other form of contraception would be recommended. Isolated raised ALT need not be a matter of concern and please do a follow up after few weeks. If you nave no other complains then you may just leave it along with aperiodic checkup of liver funtion tests and ultrasound just to moniter the activity. Otherwise you can lead a healthy trouble free life. Try cutting down on fatty food and undertake some form of cardio exercises to check the cholesterol level or you can visit your physicaian and let him prescribe some pills for cholesterol control. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having noticed a swelling & bruise on the upper leg near knee cap\n\nI got hit very hard on side of upper leg....i have bruising all the way to my knee and oveer top of kneecap.  i have a knot under skin on side of my leg with swelling. hurts to walk or lay on it and if i bend feels almost like a tearing sensation.  what do i do?",
    "doctor_response": "Hi...It seems you have a very bad contution in your thigh...I would recommend you toDo lot of icing frequently over the thigh...Keep your thigh compressed with compression bandage...Keep it elevated with a pillow under the leg...Don't bear weight on the injured leg...Don't lie over or on to of injured leg...if you have any Anti inflammatory tabs previously prescribed to you have them..Hope this is helpful for you..Kindly revert back in case you need any further help in this regard...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My 6 year old daughter has two skin tag like bumps on her skin. What could it be?\n\nHello doctor, My 6 year old daughter has two skin tag like bumps on her skin near the underwear line. She has had them for several months now and not getting bigger in size. It has been of the same size since it appeared. She does not have any pain or itching. She does not complain about them. But, I noticed another small one starting to appear. I think it is high time I should get her treated for this problem. Please help.",
    "doctor_response": "Hello. I read through your child's problem. This may be due to molluscum contagiosum, if central umbilication (a depression similar to that of navel present at the center of any lesion) is present in each lesion and a white body is present inside the bump or these might be warts (if soft, pinkish, irregular, fleshy and without any umbilication). Both these conditions are viral infections. Both of them can spread and form new lesions. In both the conditions, new lesions keep appearing. These lesions can be removed by different options like cauterization and cryotherapy. Warts can also be treated with topical lotion like Podowart (Podophyllum resin, Benzoin, and Aloes solution) under the supervision of the doctor. Molluscum can be treated by enucleating the white body from inside. Consult a dermatologist online for further follow up and treatment -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat bypolar manic?\n\nI m bypoler maniic. I ve been taken antidepressent meds no for 25 yrs. Five yrs ago I was told I suffered with bipoler mania. I have been on 21 diff meds. Can t seem tofind one that works. I also suffer with a amnisa desorder, also ptsd. Is there a new med that I might ask my dr? I ve been on seriqil olready and after 10 months on it I experiance very painful legs. Which is one syptem. Mr dr and I can t seem to find right med. Help I M have little income and live at home with parents. Sorry I ve waisted your time, cause, that you can t help. I m on disabilty with medacare and small income. If you can still help me great, if not its ok",
    "doctor_response": "Lamictal (Lamotrigine) is one of the best medications for mood stabilization. Bipolar disorder treatment requires high dosages but the symptoms usually are controlled.If you haven't taken lamictal you can speak to your doctor and consider starting it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this sperm analysis indicate?\n\nhello i have gone through sperm analysis month ago and result was- sperm count-12million/ml, motility:- grade a(progressive)-70%, grade b(non linear)-10%, grade c(non progressive)-10%,grade d(progressive)-10%, morpholagy:- normal-60%, abnormal-40%, epithelial cells-1-2/hpf, pus cell-3-5/hpf. impression-oligozoospermia.Based on test result my doctor prescribed me T.Alene& T.Uniwell,maxoza-L SACHETS for three monthS..DO MY PUS CELLS ARE NORMAL OR ANY THING TO FEAR PLZ ANSWER ME?",
    "doctor_response": "Hello Your report suggest persistent decreased sperm count.Normally sperm count should be atleast 20 millions/ml.You may also need culture and sensitivity of semen due to presence of few pus cells.It is important to exclude infection.Sperm motility and morphology of sperm are normal.Motility should be at least 55 % and normal morphology sperms should be at least 16 %.You need proper clinical examination and further investigations.Besides clinical examination you need routine hemogram,hormone assay and colour doppler of scrotum.It is important to rule out any abnormality.You have been prescribed right medicines.You should take it continuously.You should take nutritious food and do exercise.If low sperm count persists then you may need assisted fertilization techniques like IUI.Get well soon. Take Care Dr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal cramps\n\nHi....I have been experiencing severe abdominal cramps (lower abdomen), chills, headache, fatigue.  I ate out on Wednesday night and got severe diarhea within 30 minutes.  On Tursday I was fine...thought it was just a little thing...kept on with my regular diet Thursday but felt bloated, crampy, and gassy off and on.  On Friday my lower back was aching so I went to bed to get off my feet and took advil.  I have a painful lower back which is chronic and I will be starting physiotherapy next week.  But on Saturday I developed a bad headache, chills, I felt achy and crampy.  I had no diarrhea but gas ,really bad chills in my abdomen, and the severe cramps off and on.  No fever that I know of....but this morning I have such severe cramping it is hard to walk... and before I go to the bathroom. Severe cramping and chills again and 99 temp.  The chills feel like they are inside me and down my back.  No gas today.  The severe cramps are on both sides and center of my lower abdomen. I have had my appendix out and this feels different in any case.  I get cramps, go to the bathroom, no blockage, but the cramps are horrendous.  I am 60 years old, do not smoke, and am a teacher and artist.  I am a mother of three grown adults.  It feels like severe gas pains but I feel tired and cold and have a headache.Thanks so much,B",
    "doctor_response": "Hi. Thanks for an elucidate history. This is a classical history of gram negative intestinal infection. And you need to take a very proper treatment to avoid further complication which can occur very fast in such infections.- see you have almost no fever but all the severe symptoms of an infection .Rush to ER / Hospital - admission and intravenous fluids and antibiotics.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can shy bladder syndrome be managed?\n\nHello I m Marty and I ve been on probation a year now I have never been able to go to the bathroom with others around let alone watching I fear I m gonna end up in prison cuz I can t produce a urine sample yet I m 100% clean any advice plz also I have no money to pay you I guess I m fucked six ways to Sunday wow",
    "doctor_response": "Dear Marty,Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The treatment of shy bladder is often accomplished with use of medications and psychotherapy. As you might be aware no two patients are similar and often complete assessment is required before starting the treatment. I understand that you are unable to pay (and I am not charging) so in that case there are self help websites which can help you. In case there is little possibility to pay please see a psychologist in your city as they will guide you to control your irrational thoughts. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medications can be taken for runny nose and sore throat prior to kidney stone surgery?\n\ni am having kidney stone surgery on Aug. 13th. i am having a runny nose (clear discard) and it drains down and has made my throat sore. no fever. i called my doctors office and they said they can t give me anything just load up on vitamin C and zinc. what do you think",
    "doctor_response": "Hello, You can have a viral infection of the upper respiratory tract. For that only Symptomatic management has to be done. The decongestant like levocetirizine also can be prescribed along with vitamin C. Salt water gargle has done with warm water three times a day can be beneficial as well. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever with fits and unconsciousness?\n\nHi My 1.2 year son had a temprature 101 C and suffered svere fits and remained uncounsious for one hour. We went to Doctor and after samll treatment and IV injections he got OK. Doctors said there is no need to have CT Scan as chiled is responding properly, Kindly advice",
    "doctor_response": "Probably your child is suffering from disease called \"Febrile Seizures .\"Febrile Seizures is characterised by episode of convulsions whenever child develops fever and temperature is usually above 100.4\u00b0F. During episode the most important thing is to stay calm don't panic, place your child on a soft surface, lying on her side or back. If episode of convulsion last more than 5 minutes\u200b\u200b call ambulance.Most children who have febrile convulsions do not have any long term health problems. By the age of 6 years, Febrile Seizures completely disappear.CT scan or EEG is required only if he is having repeated convulsions, convulsions lasting more than 5 minutes, or he is developing sensory or motor problems after convulsions.For any further query you can consult me at Healthcare Magic.Dr. Khan Shoeb",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hypertension and abnormal level of liver enzymes with hep c?\n\nmy relative is a female 50 years old      discovered that she has hepatitis c accidentally since13 years she lives normal life ,refusing to take any medication to it, but avoids medication as possible as she can and since 3 years, she has HTN , since months she has mild DM ,the liver enzymes are less than double fold , bilirubin and albumin are normal. what is her prognosis .",
    "doctor_response": "i  welcome to health care magic.The prognosis of hepatitis c virus infection is  difficult to guess without  investigations like viral load and genotyping.However, as her liver enzymes are not grossly elevated and she doesn't appear to have features of cirrhosis, she's probably having a dormant infection. Diabetes complicates the issue by promoting fatty liver. prognosis can only be estimated by keeping in constant follow up with a gastroenterologist as hepatitis can flare up at any time and condition may complicate.hope i am clear",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my heel numb in the back right corner?\n\nMy right heel is numb on the back right corner....it seems to have happened the last 2 days...I did do some workouts at a gym at our office this week...wondering if anything I did could have caused it? I do sit most of the day at my desk....I try to get a walk in during the day, but don t always manage to.",
    "doctor_response": "Hello, There is a nerve that supplies feeling to the back inner corner of the heel called the medial calcaneal nerve. This nerve is sensory only and does not power any muscles. It's possible that if the workouts you were doing were new, and your shoes didn't fit quite right, that you could have irritated this nerve. This nerve isn't commonly irritated, or at least it doesn't bother people enough to come to the doctor. Perhaps you want to make sure you have good fitting exercise shoes, but I wouldn't worry either way because it will probably go away on its own. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Daniel Richard Paull, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the hard bone-like protrusion on the left shoulder that aches while raising?\n\nI have a hard bone-like protrusion on my left shoulder (seems to be fartheroutside than the ac joint and slightly lower).  Also have pain and stiffnesswhen trying to raise my arm all the way above my head.  I'm seeing a doctorsoon, but any ideas what it might be?",
    "doctor_response": "Hello,Thank you for using healthcaremagic.I read your question and understood your concern.It cany be anything from shoulder dislocation or fracture , tumor or infection. I would need xrays or MRI images to give a better opinion.I wish you quick recdovery.Dr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "When will creatinine level normalize after PCNL for renal stones?\n\nHi my mother had operation PCNL on both kidney on 25.10.11. she had stone on right kidney with moderate palvicalyceal dilatation and stone on left kidney also with normal pc system.but her s.creatinine was 1.5. she had PCNL on both kidney with DJ stent on right which was removed on 8th POD. on 15.11.11 she has done a s. creatinine level which is 1.4.(normal value 1.2). she in 58 years ,Hypertensive (on Cavapro) and DM( Amaryl 2 mg) .she also had low dose ecosprin and vastaral mr as her ecg shows septal ischaemia.(echo: normal). is the creatinine level is worried . how long it take to normalize the creatinine level after relief of obstruction.what precaution she need to have",
    "doctor_response": "Hi,Thanks for writing in.I suspect there was a large stone causing obstruction and hydroureteronephrosis in the right kidney. Subsequent percutaneous nephrolithostomy (PCNL) treatment was done to treat the stone. The serum creatinine level goes up due to urinary obstruction, probably the right kidney stone in your mother. Since the obstruction was present for some time in the past, the kidney function might have got affected. As per medical literature, a kidney stone causing obstruction for more than 10 days can cause obstructive uropathy which is  form of permanent damage leading to the kidney being unable to function properly. The raised creatinine is a consequence of this obstruction and a level of 1.4 is borderline high. It is most likely that the kidney was not much affected by the duration of obstruction by the stone. Serum creatinine is to be repeated after 2 - 3 months and it will most likely come down to normal. Since she is having diabetes and hypertension, regular kidney function tests should be done every 6 months. Creatinine can also rise due to hypertension and diabetes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does tonsils cancer with neck lymph node metastasis mean?\n\nMy brother has been diagnosed with cancer.  There is a lymph node in his neck that has tested positive for cancer.  However, his doctor believes the originating site may be in his tonsils.  He is scheduled to have his tonsils removed immediately, then undergo chemo and radiation, then removal of the lymph node.  What does this all mean?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  He has tonsil cancer with lymphnode metastasis.  He should go for tonsillectomy followed by chemotherapy and radiotherapy according to need.  It depends on stage and type of cancer. But surgery is the first step.  Consult your doctor and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What prognosis is recommended for difficulty while walking post cervical laminectomy?\n\nMy brother is in emergency surgery as we speak. Cervical laminectomy and a lumbar procedure to decompress nerves. He is virtually paralyzed and waited too long to go to hospital. He couldn t walk or stand up. What do you think the prognosis is after this surgery?",
    "doctor_response": "Hi, Prognosis is not that much good. Most probably there may be cord involvement and thus prognosis is bad. He can go for physiotherapy and proper therapy can help to an extent. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swelling in the cheek after getting root canal treatment. Is there an infection?\n\nI  had a root canal done last Thursday on the last upper left molar.  Within the hour, my left cheek swelled up and I had minor pain.  The swelling has gone down a bit but still sore and I noticed a small lump on left cheek...this has never happened to me (I had a previous root canal on another molar). Should I contact the endodontist that did the procedure or my dentist?  Could this be an infection?  I have no fever and only the discomfort of the root canal/cheek",
    "doctor_response": "Hello, Thanks for posting your query. The swollen cheek followed with root canal treatment may be due to- Improper instrumentation methods used. Breakage of files inserted. Periapical infection remaining under the tooth. Infected vital pulp remaining within the pulp canals. Take complete course of antibiotics. Warm saline gargle frequently may relieve swelling. Apply cold packs alternatively. Please do visit your endodontist and get further treatments and check-ups. I wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain due to bladder cancer\n\nMY NAME IS GREGORY KING I WAS SEEING A DOCTOR FOR BLADDER CANCER HE WAS PRESCRIBING ME OXYCODONE 30 MG AND PERCOCET TEN MGS ALSO VALIUM TENS THEN HE JUST DECIDES HE CANT TAKE MY INSURANCE ANYMORE IM IN SEVERE PAIN AND I CANT FIND ANYONE INCLUDING A DOCTOR TO HELP ME IM IN STAGE FOUR CANCER CAN YOU HELP ME",
    "doctor_response": "Thanks for your question on HCM.I can understand your problem and situation from which you are going through.But honestly speaking there are not much options available for stage 4 bladder cancer pain.You can try transdermal patch of centrally acting pain killers. Its effect lasts for 72 hours. And has excellent effect.Another way is low dose sedative drugs. They sedate you mildly so that you can percieve less pain.In rare cases debulking surgeries are done to reduce pain but only after oncosurgeon's consultation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to prepare for healthy pregnancy?\n\non the 2nd month of my pregnency missed abortion was happened .the featus never shows heart beat.also there is no development for the featus..my doctor prescribed to take clofert50 after 3 months.      how it happened?whether it happen again. how should i can prepare for a healthy pregnency? pleace answer. we are eagerly waiting for a baby.",
    "doctor_response": "Hallow Dear,The history you have provided suggests that you had Blighted ovum wherein there is gestational sac without embryo inside. Hence, in such pregnancies, foetal cardiac activity is never seen. Once in a while, blighted ovum pregnancies are seen. The subsequent pregnancies can be normal.Clofert 50 is a medicine which contains Clomiphene citrate. Since you had conceived naturally, I do not feel you need this medicine. This medicine is for induction of ovulation in women who fail to release the ovum naturally. To prepare for the next healthy pregnancy, please start Folic acid tablets right from today. They will help the healthy growth and implantation of the embryo. Also have a good healthy diet containing high proteins, moderate carbohydrates and low fat with plenty of vitamins and minerals. If you are non-vegetarian, fish, meat, eggs will provide you proteins; while if you are vegetarian, bean sprouts, pulses and legumes are good protein sources. Include plenty of fresh fruits and green leafy vegetables with other vegetables in your diet. I hope this should give you preliminary guidance to prepare for your next pregnancy. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does patent fallopian tube and cornual blockage mean?\n\nHi,My sitster is 32 years old and she got married in the year may 2011.there is no issue till date her HSG reports shows that  left fellopian tube is visualised with peritoneal spill,right fellopian tube is not visualised.impression is:  left fellopian tube is patent and right sided cornual blockage",
    "doctor_response": "Hello, this is Dr. Herisa answering your question. I read very carefully your problem.As far as you may know the HSG or hysterosalpingogram is the kind of examination used in cases when Tubal Factor Infertility(any anatomic abnormality that prevents the sperm and egg from uniting) is to be detected, which means if the cause of a possible infertility is any of the fallopian tube or both of them. The fact that the fallopian tube,the left one is patent means that it is not blocked, so it is opened and no obstructions are visualized. The right side has a cornual blockage which means that the tubes are blocked at the end near the uterus. This can occur because of infection, endometriosis, dried secretions in the tube, mucus in the tube or scar.Also what I would suggest is that your sister should consult an OBGYN doctor, because there are many clinical management protocols about this problem and this specialized doctor could provide her with a useful solution especially if she wants to get pregnant.Good luck and hopefully my answer would help",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itching in throat, sneezing, runny nose. Taken homeo medicines, no results. Treatment to get rid of this allergy?\n\nhello Doctor,My name is anshul, male, age 23. I live in delhi. i am very much troubled because of my allergy. in this, firstly my throat starts itching, then 8-10 continuous sneeze and then runny nose and sometimes itchy too. I took homeopathy treatment also but it doesn't helped me much. Usually it occurs in the morning time as i woke up and comes out of my room. And sometimes when there is regular 2-3 times in and out of AC room. Even when i leave my house for office, do a 7 mins walk and then board the metro(means from sweating weather to AC metro) this allergy starts. I am very much troubles because of this prob and  now am scared if this prob may harms me in future. Kindly suggest me some treatment or anything which can help me out for this allergy.Anshul Garg0000",
    "doctor_response": "Hi and thanks for the query,A complete clinical review is required to better manage this allergy. First, the nostrils need to be evaluated for any possible polyps that could predispose to allergies.Secondly, it is necessary to measure serum or blood Immunoglobulin E, IgE, this is the main marker of the intensity of the allergic response in the body. based on these findings, treatment could then be started. Avoiding a possible substance or trigger to the allergy is a key component in the management. drugs could be prescribed ranging from steroids oral to injectables, anti histamines, through injections or sprays. You might to consult your internist first. In case the allergist if needed, you shall then consult him.Thanks and kind regards, Bain LE, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with posterior fossa meningioma. Surgery advised. What to expect with recovery?\n\nI have been diagnosed with a prosterior fossa meninganoma 2.7 x1.5 cm. I am going to the Mayo Clinic in AZ this week to discuss prossible surgery. What can I expect with the recovery for such a surgery? I'm 47 and in otherwise good health. I exercise regularly and dont drink or smoke. I'm hoping for a quick recovery but I'm not so sure that its in the cards considering the location of the tumor. Any advice?",
    "doctor_response": "Hi,Thank you for posting your query.I agree with you that posterior fossa is not the best place to get a meningioma, as the surgery needs precision, as well as recovery is delayed. However, meningioma is a benign tumor and long-term outcomes are very good.You may take 10-14 days after surgery to recover well.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of itching after eating prawn?\n\nWhenever I eat prawn, my skin will get itchy. This had taken place for around 2 years plus. Previously I have no history of allergy at all. I suspected that after having the Amoxilin once, my body's immunity had changed. Is there anything that I can do to reverse it?",
    "doctor_response": "HI, thanks for using healthcare magicIt would be best to avoid the use of the prawns and also consider reducing or eliminating any other shell foods.If you wish to confirm these allergies and determine whether it is necessary to avoid them then you can consider allergy testing.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for loose stools in 1 year old kid\n\nMy one year old was put on Lactaid from whole milk after two weeks of loose stool (not watery diarrhea) because her doctor though it might be a lactose intolerance. She has been on lactose free milk for 1 1/2 weeks and there has been barely a difference, if any. Any ideas?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron (as prescribed by your paediatrician).Regarding diet - You can use cerelac...any flavour will do. Avoid fruit juices as they might aggravate diarrhea. You can give zinc supplements & ORS apart from normal vegetarian porridges & soups.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for joint and bone pain\n\nHi Dr. Grief, I had a total hysterctomy in early December 2013. I was 34 at the time and was seeking relief from grade 4 endometriosis. My doctor put me on Premarin .625mg right after surgery. I was still having 3-6 hot flashes/day and night sweats. I was also having trouble sleeping. My biggest concern, however, is bone and joint pain--especially in my shins, calcaneal bones, and the small bones of my feet. I started to experience more excessive bone/joint pain in March, and it s progressively become worse. Sometimes, it s sharp when I step a certain way. I told my doctor and they did blood work. It all came back normal. I m a chiropractor, and I went so far as to do x-rays of my knees and my tibias. I didn t see anything remarkable. This week, I am having a body scan because the pain is so worrisome to me. I ve always been a VERY active person. In the past, I ran 5 days/wk and lifted weights. I ve had shin splints in the past, but this doesn t feel like that. Could this be a side effect of low estrogen? I did trying switching to Climara for a month to see if a different form of estrogen would improve my symptoms. It improved my hot flashes, but not my joint and bone pain. Just looking for an answer to the pain. My doctor just says, well, your blood work is all normal. I don t know what to tell you. Very frustrating.",
    "doctor_response": "Dear user, after reading about your pains, i just simply want to suggest you to go for vitamin D3 and calcium test. Deficiency of vitamin d3 may also cause you pain in joints.take inferential and ultrasonic therapy for 10 days and with regular excercises in the early morning prevents pain and keeps stay healthy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of conception after going through this follicular study?\n\nHi,Recently I did my follicular study.  Its results goes like thisRight Ovary : 22.0 *16.6mm.Left Ovary: TinyE.R: 4.2mmThey told me to go on my 12th day of periods.  The above study was performed on my 10th day.Please explain me the above results whether is there any problem in conceiving",
    "doctor_response": "HI,I understand your concerns. Looking at your sonography it appears normal and i think you will not have any problem conceiving as your one ovary appears to have a follicle which can ovulate and also your endometrial thickness is in normal range. Continue your follicular study and get back to us.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is the tip of my penis turning white?\n\nHello doctor, The skin at the tip of my penis is becoming white from the past three months. There is no pain or any other problem due to that. I feel pressure to urinate, but while urinating the flow is slow.\u00a0I do not know why my penis has become white. Kindly advice.",
    "doctor_response": "Hello. Please send me an image. It might be vitiligo or balanitis xerotica obliterans. Revert with more information to a urologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bumps in head\n\nHello,I bumped my head on the bed metal headboard while trying to look for something.. now it has swollen up on my forehead, it hurts, feel a sort of migraine. it happened yesterday. I tried putting on ice las nyt but still feel the pain in that area.Please tell me what to do.Thanks",
    "doctor_response": "hi,Kindly take a pain killer and antiinflammatory medication like diclofenac 50mg twice a day. was there any vomiting? if headache subsides with medications then don't worry. the swelling shall take 4-5 days to subside. if the swelling is big and has blood clot in it then kindly visit a doctor.Regards,Dr.Riyanka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from cold, cough, allergies. Taking bio-c, slight relief. Safe to recommend?\n\nHi, I am XXXXXXX. I regularly suffer from cold, cough , mouth alcer and some allergy problem.I am taking Bio C for the past 1 month. I don t see much difference. Is Bio C good for health? My sister also having same problem. Can i recommend it her ? she is 40 years old. My mother suffer from joint pain and neck pain . Can i refer her Cal mag tablet from XXXXX. She is 65.",
    "doctor_response": "Hi, Thanks for posting your query. Do you have recurrent watery diarrhea, abdominal pain and bleeding per rectum? There may be possibility of viral induced upper respiratory tract infection with mouth ulcers. presence of cold, cough along with mouth ulcers suggest the diagnosis. You should consult with internal medicine specialist and should go for thorough check up. You and your sister should take multivitamin with zinc supplements, vitamin C, rebapimide and proton pump inhibitors. You should also take cough suppressants along complete antibiotic course. You should also go for colonoscopy if above mentioned symptoms are also present. Take care, Dr. Mayank Bhargava",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain at the upper right rib cage?\n\ni am experiencing a pain at the upper right rib cage when i cough or sneeze, also when i lay down on either side of my body with shortness of breath. I had the flu and it left me with this dry cough and itchy throat and now i am experiencing the above mentioned symptoms. Althea",
    "doctor_response": "Hi, This treatment is being suggested on bases of the information provided. However, I would like to examine & investigate the patient  in detail. Control hypertension, diabetes or any other metabolic disorder, if there is  any. Any way it may be tried: - Dolokind Plus\u00a0(Mankind) [Aceclofenac + Paracetamol]\u00a01 tablet OD & SOS for 5 days. - Caldikind plus (Mankind)\u00a01 tablet OD for 10 days. (You may need help of your local doctor to get these medicines.) - Fomentation with warm water. Let the part not be exposed to cold air. - Sleep on a hard bed with soft bedding. - Use no pillow under the head. - Avoid painful acts & activities. - Do mild exercises for neck and shoulders and hips and knees and ankles. (Take help of a  physiotherapist.) - Do not ignore, let it not become beginning of a major problem. - Do ask for a detailed treatment plan. -  Make sure, there is no allergy to any of these medicines. - For emergency treatment visit nearest hospital. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nirmal Chander Gupta, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the interpretation of my CT scan?\n\nyesterday  i have done CT scan in the brain and got results in CT scan that focal parenchymal calcification is noted in right basiganglionic region. my question is : what happens if calcification exist in the basiganglionic region, can you interpret  me on the above report?",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your CT scan findings. I would like to reassure you that calcification in basal ganglia is a normal finding in most people and there is no need to worry about that.In any case, we would like to know about your symptoms and problems.If there is extensive calcification in brain, then, conditions such as pseudohypoparathyroidism and hypoparathyroidism (both due to hormonal imbalance) should be excluded. I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling sharp abdominal pain with pressure in vagina. What could be causing this?\n\nHi, I have a bloating pressure feeling inside of my vagina . It doesn t necessarily hurt to urinate but I have to intimate frequently. Also, in my lower right abdomen every once in a while there is a sharp stabbing pain. What could be the problem? My sister had 3rd stage ovarian cancer at age 23 which is how old I am now. She was just going in to get a cyst removed when they found it.",
    "doctor_response": "Hi. Because your sister was diagnosed with Ovarian Cancer,you too have to be investigated. Increased frequency of urination may be due to Urinary tract infection.Pressure in the vagina may be due to infection in it or from surrounding structures. Appendicitis,Right Ureteric colic and Right Ovarian pathology has to be ruled out by routine investigations like Ultrasound abdomen. Consult your local doctor. If you review with reports,i can clarify further. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infection in my navel\n\nI have a sac filled with blood and pus in my belly button. if i push down a little bit just about it - whitish-yellow pus spews out. it is very itchy and this morning I woke up with it full of dried blood. I dont see a cut or anything, but I dont know where the pus is coming out from. It started hurting 5 days ago and it started pusing 3 days ago. I amwondering what it is caused by and what to put on it.",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concern..As per your complain it seems to be bacterial infection in the navel leading to formation of a pus filled abscess..As the navel is the area where there can be accumulation of moisture, there can be bacterial accumulation and it leads to formation of abscess..I would suggest you to clean the area with antiseptic solution and apply triple antibiotic ointment and steroid ointment over it..You can take oral antibiotics like Augmentin for relief..You can apply mild pressure over the navel and try to drain off pus for faster relief from infection..In case if still there is no relief consult a General Physician or Surgeon and get evaluated so that a proper clinical evaluation can help in diagnosis and treatment can be planned accordingly..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora..",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can asthma and breathing difficulty be treated?\n\nMy doctor just prescribed levaquin for me for the first time. I have a cold which is now in my lungs? I have asthma and copd. It s difficult to breathe but I still try to walk around to loosen the phlem. No fever, just short of breath. I heard levaquin wasn t a good antibiotic cz I have arthritis, carpul tunel, scoliosis, etc. Past 2 years I ve had 4 hip replacements and lower back surgery. Please let me know if a different antibiotic should be used.",
    "doctor_response": "Since you have had hip replacement sugeries as well as other orthopaedic problems its bette rto avoid LEVAQUIN. In place of LEVAQUIN you can take other antibiotis as in TAB GUDCEF CV or TAB AUGEMNTIN 625 mg two times a day. And along with the antibiotic you can take mast cell stablisier. the medicines you can take are 1. TAB GUDCEF CV 1 tab two times aday after meal2. TAB HISATFREE M one tab a day3.INHALER as advised4. SYP BRO ZEDEX three times a day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchiness in penis and testicles every night?\n\nHi, I'm 28 years old. My penis and testicles itch since I was 14. This happens at night so I wash it every night when I have a bath. Then it is ok. There is not rash or something like that and it does not spread either. Some doctors told me that there is no problem. But I think it's a problem.",
    "doctor_response": "Hello welcome to Healthcare Magic.There is nothing to worry according to your words.Try to change the underwear's and see, it is seen in few people due to tight underwear's, and maintain hygiene, try to be engaged which other things.do not itch too much as it may in future cause rashes.Need to ask ? Do not hesitate. Thank you. Dr. Ganesh.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure weak erection?\n\nHello i am 24 years old and i have previously gone for medical checkup due to the weak errection i usually have during love making(ever since i started love making) and i was diagnosed of staphy and was adviced to take Norbactine for 10 days but i went for check up again after 2 months and they confirmed it was still there please can you help?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Erectile dysfunction may be psychological in origin most probably. Consult the psychiatrist or the dermatologist for the perfect diagnosis and proper treatment. Sildenafil or Tadalafil in low dose at some interval may be helpful along with anxiolytic drug like Fluoxetine. Hope this helps. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness when walking, sitting, standing and lying down?\n\nHi Dr, I have just taken up a new hobby, I am on the trampoline for 1-2hrs at a time and after my last session I have become dizzy at random points when walking around, standing, sitting and laying down! This has been going in for 2days now on and off. Have i coursed some damage or is it am inner ear issue? Never had anything like this before and never get motion sickness. Thanks for your help",
    "doctor_response": "Dear, Welcome to HCMWe understand your concernsI went through your details. Equilibrioception or sense of balance is one of the physiological senses. It helps prevent humans and animals from falling over when walking or standing still. Balance is the result of a number of body systems working together. The eyes (visual system), ears (vestibular system) and the body's sense of where it is in space (proprioception) ideally need to be intact. The vestibular system, the region of the inner ear where three semicircular canals converge, works with the visual system to keep objects in focus when the head is moving. This is called the vestibulo-ocular reflex. I don't think there is anything to worry. it is just your new hobby. The ups and downs in trampoline definitely affects your balance because it affects the vestibulo-ocular reflex. This habitual reflex stays there till it gets used to it. Could take a week or more of continuous habitual practice. Don't worry.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sore throat,cough and body pain\n\nHi there,  I have been sick for 8 days. I'm not sure if just cold or flu or something else. It started with a sore throat which became worse very quickly (within 5 hours) to the point where it hurt terribly to swallow water. I now have plugged nose and sinuses and my throat feels swollen at times and I continually cough up phlegm. I have also thrown up two separate days. I do not have any body ache or head ache. At night I seem to sweat a ton waking up with the sheets damp. This morning  This is the third time since January I have been sick but this time has been the worst as I just feel down right terrible. I am 23 years old, 6'0, 181lbs. I have lost about 10 lbs since January and have not been sleeping well due to a newborn in the house. I have tried allergy medicines (reactine) which seem to do nothing and I have never had allergies before and I have never been sick this much before. Any suggestions??",
    "doctor_response": "You are suffering from URTI caused by post nasal drip and a possible gastritis.Consult a doctor for proper antibiotics and get evaluated for allergic rhinitis and/or sinusitis",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for mid-buttocks pain that radiates to the knee\n\nI am having pain in the mid buttocks, yet not in the glute... I can walk for about 20 steps and then it burns and the pain takes my breath away....sleeping is not happening... it will radiate across the front to the inside of my knee and if it is really bad my knee will be numb... I have had two labrum tear repair surgeries and stem cell injection for the third tear... my latest MRI does not show a fourth tear...",
    "doctor_response": "Hi i am Dr Ahmed Aly    thanks for using healthcaremagic site ,I had gone through your question and understand your concerns ..   For my patients i may suggest the avoidance of heavy lifting and vigorous movements and bad sleeping postures , painkillers when needed like advil tab , hot massages with topical gels , muscle relaxants , physiotherapy  , spinal straightening excersizes and even yoga , B12 vitamin supplementation with pregabalin tab will be effective for such neuropathic pain . If the pain persists i recommend X rays , CT , MRI on spine to exclude cervical disc herniation which may cause such symptoms and evaluate it with your neurologist for proper management and treatment of underlying cause .Please click THANK YOU and consider a 5 star rating with some positive feedback if the information was helpful. Hope the above information helps you,Any further clarifications feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cause and treatment for liver infection in breastfeeding mother\n\nsir my sister having liver infection and symptoms is red dots in face and body,itching, stomac pain, tiredness, vomitting, loosemotion, ulcers in tongue, fever and she also feeding her child 3 1/2 months the child also same simptoms. what is reason and treatment",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It might be a viral fever. The symptoms are not suggestive of liver related problems. Do a basic blood work and an ultrasound abdomen. As of now take paracetamol for symptomatic relief. If symptoms persist, better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does it sound serious to experience blisters in throat and whooshing sound in ears while suffering from tumor in eye and throat?\n\nIn 1997 I was told that I had a tumor under my eye, and in my throat, my insurance accepted to have the one under my eye removed, but not the ones in my throat. I was told to see a cancer doctor every two months. Well I have never been back. The lumps in my throat are getting bigger. The last 4 months my ears mainly my left ear feels like and sounds like I`m under water. This morning I woke up and my throat seemed extra sore, so I looked in the mirror and see a blister on the left side. I do have a lot of cancer in my family. Oh plus I am really tired all the time.",
    "doctor_response": "it seems you are effected cancer- another new one or recurrence or infection.It is better to go to Oncologist now for further evaluation",
    "dialogue_context": ""
  },
  {
    "patient_message": "Planning for a child. Prescribed fertyl 50mg. Will it help in conceiving naturally?\n\nHi stephen I am married from last two years and i am trying to conceive from almost a year. But I am not getting pregnant, I ve recently seen a doctor and she has suggested few tests including a blood test , urine test and an ultrasound , all of them came normal. Now she has prescribed a medicine called fertyl 50mg to me to induce multiple egg formation and later she will inject LH surge to induce release of follicle . I am confused whether i should go for it or I should try conceiving in normal and natural way. My age is 29 yrs. Kindly suggest",
    "doctor_response": "the medicine prescribed is absolutely right,no harm in going with that and considering your age and that you have been trying for a year now suggests that you should go in for the prescribed treatment,just see that you husbands semen analysis is also done before starting your treatment,and take up regular follicular studies. Don't worry and relax everything will be fine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from backpain, spinal stenosis, cyst on kidney. Advised to see an urologist. Cancer?\n\nI am 66 yrs old, with back pain .  I just had two knee replacements and I had the back pain prior to the surgeries onmy knees.  I had an MRI done and saw a back surgeon today.  He told me I had a small amount of spinal stenosis, but the lab results also show a 9 mm cyst on my kidney.  He is sending me to  a urologist for further examination. I have been a smoker for many years and have stopped in March of this year.  The pain in my back has been there for a while and the pain goes doewn to the crack of my butt .  I have to wear a depend because I can't get to the potty fast enough when I need to urinate. I'm scared and I'm making an appointment to see a urologist.  Should I prepare myself for cancer?",
    "doctor_response": "Hello and welcome to HCM,A cyst in the kidney is not necessarily due to a cancer.Smoking is a risk factor for developing cancer however, presence of cancer is not confirmed by presence of a risk factor.Cysts of the kidney are usually benign.Symptomatic cysts are surgically removed and examined histopathologically to look for any evidence of cancer.If it turns out to be benign, no further treatment is required.If it turns out to be malignant, additional chemotherapy may be required.So, consult your urologist and don't worry. The possibility of cancer is low but if present, good treatment modalities are available for its cure.The back pain that you are experiencing is due to the stenosis.You need to consult your neurologist for management of spinal stenosis.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lump under chin\n\ni have a lump/swelling under my chin right in the middle. ive had it for about 3 weeks now. at first it was really stuck out and hard i went to see my gp who said it was a blocked salivary gland but now i am not sure. when i lift my head back there is a slight swelling there however, when i swallow and hold it the swelling appears bigger.",
    "doctor_response": "Hi,Looking to the history there are possibility of,1, enlarged submandibular lymph node, might be due to some infection in oral cavity like ulcer, carious teeth, infection of gums etc.2, as this lump increasing while swallowing or chewing chance of obstruction in salivary duct.Consult oral surgeon and get examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp lower back pain and bloating?\n\nhello, for about 1 week now ive been having sharp pain in my lower back but on the sides, feel a little bloated but crampy as well. 2 weeks ago i had unprotected sex but the next morning i took the morning after pill, shortly after that is when the pain started. what might be the cause?",
    "doctor_response": "Dear lady,whatever you have told as a case history I have gathered that a following taking  contraceptive pill you are havibg lower abdominal pain,bloated feeling and crampy.and yes it can happen as a result of oral pill.In my daily practice I come across  some people who complains of such generalised illness.this is due to tepresence of hormonal elements in those pills.these hormones through their metabolism causes muscle cramps ,water retention and local area irritation.so next time when you have to pop a pill,please be cautious about the side effects it causes.thanks for your patience hearing.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can continued use of Venotin and Montelukast reduce chronic cough with mucus due to flu?\n\nHI DR. Grief, my name is Roberta. At the end of February I had the flu. After the flu started to go away I developed a chronic cough accompanied with mucus. I went to my a physician`s assistant who prescribed Benzonatate 200 MG take 1capsule by mouth every 8 hrs. as needed. I did this for a few weeks and this did not help. My cough was atill persist and accompanied with mucus. I coughed so hard and could not breath when trying to clear the mucus from my throat. I have gone back to my Dr.s office after a month and was seen by a nurse practitioner who prescribed Ventolin HFA 90 MCG inhaler, 2 puffs by mouth every 6 hrs as needed, and Montelukast SOD 10 MG, 1 tablet at bedtime. I was told that this won`t take affect right away, that I have to take this over a period of time before it does! Does this sound right to you?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. In my opinion, you are not taking right treatment. By your history and description, possibility of post infectious bronchitis is more. This condition is common after common cold due to flu infection. And treatment of choice is inhaled corticosteroid (ICS). Ventorlin is short acting beta 2 agonist (SABA). It's action lasts for 1-2 hours. So frequent dosing is required. Montelukast is anti allergic and it has no role in post infectious bronchitis. So better to consult pulmonologist and get done PFT (Pulmonary Function Test). PFT will tell you about severity of the disease and treatment of bronchitis is based on severity only. Better to stop montelukast and start ICS after discussing with pulmonologist. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for vomiting and runny nose in a child?\n\nMy 6 yr old son ran into a boy who stopped suddenly. Brow and zygomatic were a bit swollen and bruised. Son said later he threw up. face red hue for 2 days. couple days later he has a runny nose. Is this related or just by chance? Perhaps slight concussion?",
    "doctor_response": "Hi, thank you for posting!I have gone through your query and I understand your concerns.According to the medical history of the child, I think that your son suffers from the  cerebral commotion and vomiting is a significative sign of this. Also the runny nose is related to the history and shows an injury of the nose bones.I think that your son needs to be treated in the ER(emergency room), and he should get some tests done: head X-Ray, MRI(magnetic resonance imagery), complete blood count, urine test.The diagnosis and the treatment should be done by a neurologist and otolaryngologist. All the best,Dr. Behar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe cough and tightness in chest\n\nso i am a 20 year old male who has asthma i have recently started coughing up mucus and have a hard time breathing there is alot of tightness in my chest and my albuteral is basically usless i have taken a bronchiol tablet and i took an antibiotic today but nothing has helpled",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Worsening chest tightness and coughing in asthma patients suggest acute exacerbation of asthma.This is acute emergency. If you don't treat it now, it will worsen more. So consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test).PFT will tell you about severity of the disease and treatment is based on severity only. You will need inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).Oral corticosteroid is also useful in some cases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking birth control pills to regularize the periods after abortion. Having nightmares, mood swings, dizziness and headaches. Why?\n\nI have my periods mostly the third week of the month ever since I got an abortion . They gave me birth control and its supposed to make me have my periods the fourth week. The first month I took it I got it the third week and now its month two and no period. I had unprotected sex and I missed my period. I sleep a lot some days and less somedays. At first I had a nightmare of a ghost haunting me woke up crying then the next night of my family killing me. Me and my boyfriend have been fighting. I think im getting mood swings I dont know. My boobs arent sore. I get very bad headaches . And I feel extremely dizzy most of my day. I took two pregnancy tests and they came out negative and I also cant see a doctor. What is your perspective on this?",
    "doctor_response": "hello,Oral contraceptive pill has some side effects like irregular period or bleeding, headache/ migraine, nausea/ vomiting, breast tenderness, fatigue, irritability, decreased libido, weight gain & mood changes. These will overcome gradually until your body is adjusted with hormone.However, I suggest to undergo one blood test for beta-hcg (most reliable) to exclude or confirm pregnancy. Take healthy diet, drink more water, avoid stress and need proper sleep.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rotator cuff injury?\n\nI pulled something in my shoulder arm joint trying to open a very heavy glass door. Can that cause a rotator cuff injury or could it be something else. Happened today. Pain level 4-5 .if there is a charge for this question to be answered then forget it I will just wait and see",
    "doctor_response": "Dear patient there is very little chance of rotator cuff injury. You may have sprained the rotator muscles. Start tab diclofenac sodium 50 mg twice a day for pain relief  for at least 3 days. If not relieved ultrasound of the rotator cuff should be done to confirm diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a lump in the lower abdomen area?\n\nHi, may I answer your health queries right now ?  Please type your query here...I gave birth to my second child almost exactly a year ago, and I notice a strange lump in my lower abdomen when I lay down on my back. Its not noticeable when I stand upright, but very much so when I lay down. Dont know what it could be?",
    "doctor_response": "Hi,Dear,Thanks for the query to HCM.I went through your query and understood your health concerns.In My opinion-Currently-you may be having some lump which needs clinical check up from a doctor.As your information is very limited, its really difficult to comment and reply  the reason and treatment of that lump.Advise on Remedy--Emprically I feel,You should consult ER Obst/Gynaec doctor who would do USG /Xray abomen after abdominal check up and would treat it accordingly.Wellcome for further query to HCM in this regard.Wishing you fast recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of an excessive sleep?\n\nmy baby is 30 days old. as per the doctor's prescription i have given him 1 tablet of lanzol 15 as he was vomiting after every feed. After taking the medicine he is sleeping continuously, but took his feed in his sleep afer 3 hrs and agin sleeping after that...is it ok or any abnormality?",
    "doctor_response": "hiYour doctor has prescribed lanzol ie lansoprazole to treat his reflux vomiting. There is no evidence of known side effect of excessive sleep in infants after lanzol.      If your baby is sleeping for more time but taking feeds well ie suckling your breasts well then it is unlikely that your baby is drowsy or sleepy. Quiet and peaceful sleep post feeds is normal.       There might be another reasons for excessive sleep.       Is your baby taking any other medicines? or you are on any medicines? Are there any other symptoms other than sleepiness like fever, vomiting, shrill cry, bulging anterior fonatannel ie soft spot over scalp is swollen.        Wait for one day if it still continues then please consult a pediatrician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heaviness in the chest and shortness of breath?\n\nI work in a building that is seventeen years old five days ago a major waterline broke and flooded the whole north side of the building. The ceiling came down on three floors. So I had to walk through dripping water and flooded floors. About three days ago my chest feels heavy and i have shortness of breath when I talk. My job requires a lot of walking that does not bother me. Is it possible that I might have breathed in mold and if so what should I do.",
    "doctor_response": "Hi, I understand your concern. I think you might be having a lung infection. I advise to consult with your physician and run chest X-ray to determine the right diagnosis. For the moment, I can only advise to take anti-histaminic (e.g. loratadine) until you see your doctor. However, I still think you should go to clinic immediately. If cannot manage, then, go to ER to check your problems with difficulty in breathing. Wish fast recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Other than CT, which is better to scan heart?\n\nHello doctor, I am a 33-year-old female. I am generally fit and not obese. My doctor suggested a CT scan for my heart. I am worried about the amount of radiation and contrast dye I will be exposed to. Are there any other tests I can do? And is this test too critical with my other findings? Symptoms started with lower back and pelvic pain, then after a few weeks of abdominal pain, and at the end of my shoulder, sometimes my arms both right and left. I have difficulty in breathing. Pulsating pain in the left side of the body, which moves around. Tinnitus and hemorrhoids on the left side, too. Two episodes of blood in sputum, which lasted for one day each, with one week gap between events back before three months. It did not recur since then. Occasional ketones and blood in urine at the onset of symptoms. Test results: 1. ECG shows incomplete RBBB. 2. ETT shows depression up-sloping. 3. Echo (taken before seven years) shows mild tricuspid regurgitation. 4. Total cholesterol fasting 183 mg/dL. 5. Triglycerides 70 mg/ dL. 6. HDL-Cholesterol 73 mg/dL. 7. LDL-Cholesterol 96 mg/dL.",
    "doctor_response": "Hello, Welcome on icliniq.com. I passed carefully through your medical history and would like to explain that your symptoms (migrating and pulsating pain) seems nonspecific for any cardiac issue. Also, you have no apparent coronary risk factors (your lipid profile is fine with no known hypertension, you should check your blood glucose level) and your already performed cardiac tests are almost normal. There may be a cardiac CT with a high probability would result healthy without providing any decision making information (you are not in an intermediate pretest probability). Another reasonable and safer diagnostic alternative is cardiac magnetic resonance imaging test (CMR), it utilizes gadolinium-based contrast, which is more benign. You should discuss with your doctor about the issues mentioned above. I hope to have been helpful to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedy for swollen glands, dry cough and body pain\n\nI have swollen glands dry coughing, aches in every part of my body and sneezing/sniffing. I also get very overheated and sweat a lot. I think I have sunstrOke please help me what home remedies can cure this? I've had it for two days now. Thanks, Maisy",
    "doctor_response": "Thank you for the query.I would like to know your age and whether you suffer from any associated comorbidities like Diabetes mellitus, Hypertension or Thyroid dysfunction.As per the history provided, you are suffering from dry cough, bodyache, swollen glands, coryza and occasionally high grade fever (body overheating may imply that), for a period of 2 days. Your symptoms are more in favour of a viral infection. In a sunstroke you will get other symptoms like nausea, vomiting, severe cramps, dry skin, dizziness and severe headache. I would advise you to take bed rest for a few days and drink plenty of water and fluids (avoid alcohol). If your body gets overheated you can go for cold or tepid sponging. A nutritious diet is advisable, and if you are a smoker, you must abstain from smoking (this irritates your respiratory tract and aggravate your cough). If you have nasal congestion and throat irritation, steam inhalation may help. In case of severe bodyache, acetaminophen may be taken (after consulting your physician). Please monitor your urine output.If you develop any of the symptoms mentioned above or your symptoms do not subside in another couple of days, please consult your physician, since you may need a thorough physical check up and a course of antibiotics may be needed.Hope this helps you out.",
    "dialogue_context": ""
  },
  {
    "patient_message": "When can an infant be fed a solid diet?\n\nHi, My child is 7 months old. He is a boy. I want to know what solid food I can start giving him. He is 6.36 kgs right now and not gaining much from last 1.5 months. Pls advice.",
    "doctor_response": "Hello. I just read through your question. The recommended age range to begin solid foods is 4-6 months. So as long as everything else is ok, it is time to start. I recommend beginning with baby cereal. It comes as oatmeal, rice, and barley. It should be mixed with formula or breast milk in a bowl and fed with a spoon, as much or as little as your baby wants.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes if liver is slightly enlarged ?\n\nI took my 3 month old to the doctor yesterday and he said that he could feel her liver and it could be slightly enlarged, but doesn t think there is anything to worry about and they will just monitor it right now (check at the 4month appt, etc)... What could this mean? I m a new mom and pretty worried.",
    "doctor_response": "Hi....at this tender age group, sometimes because of increased respiratory rate the liver may be pushed down and be palpable, and at the same time even because of the pliant rib cage also the liver maybe palpable. So do not worry about this too much. If the baby is active, alert, feeding well and gaining weight appropriately and putting on good milestones, nothing to worry about this.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning of chest during exercise?\n\nHello My 7 year old son has been complaining of chest burning and pain when he excersises. He said it starts to hurt when he begins to sweat. Last night we were throwing football down stairs and after about 20 min he had to lay down. he said mommy feel this. Does it feel hot. I said no baby. he said it is burning. It hurts so bad mommy. I am wondering what this could be. He had SVT when he was younger. probably about 3 yrs old. has been perfectly healthy sionce. He was never on meds cause he only got an attack once in a long while. but has not had any since he was 3.",
    "doctor_response": "thank you writing me maam , actually your son had a history of heart problem in past so you shoul go for basic investigation of hear like Ecg and 2D echo. and if possible TMT. it is beacause from heart related problem in my possibility, other thing it may be heart burn due to GERD so give him Cap Omez D od and syp mucaine gel 7 ml tds. it will help u",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a diet to manage liver disorder?\n\nI had breast cancer in 2013, did well until July of 2015. I was diagnosed with terminal bone cancer then. I. Had been doing well with treatment at Cleveland Clinic until recently. Liver is showing increased growth but little. I just read the 10 signs for liver problems & I have a lot of the abdominal issues. Is there any thing connected to my diet that might help?",
    "doctor_response": "Hello, Your abdominal issue could be due to gastritis like a problem. It can be due to medication intake as well. Kindly mention the gastric symptoms in detail to comment further. The liver could be enlarged due to many causes. But as you have cancer history I suggest to investigate with USG abdomen scan and revert back with any reports if done. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does passage of a clot followed by continuous vaginal bleeding indicate?\n\nHello doctor, My period came on the first of last month. 22 days later, my breasts were hurting. I was cramping but there was no period. Five days later, I went to the restroom and I wiped and there was light pink blood. The next day still no period or spotting. Two days later, I woke up and blood was everywhere but I did not bleed. Next day, there was nothing. Then, I used the restroom and a big blood clot came out of me and I have been bleeding all night. What could it be? My pregnancy test came back negative.",
    "doctor_response": "Hi. I have read your concern. It is good you have already ruled out pregnancy because, in any type of abnormal bleeding among reproductive age, pregnancy is one of the first condition that should be ruled out. The second most common cause of these types of bleeding is a hormonal imbalance. Theoretically, your progesterone hormone should be elevated on the second half of your cycle and decreases when you are nearing the start of your period. So the amount of this hormone is critical in making you bleed. If there is too slow of a decrease or too abrupt or most the time insufficient amount, then it will affect the timing of the bleeding and will cause heavy bleeding. The treatment for this is oral Progesterone or in the form of birth control pills. The third common cause would be a structural problem, the presence of a polyp, myoma or endometrial lining problem, infection, etc. These situations will need ultrasound and evaluation by an ob-gyn. For your case, I suggest you take first Ibuprofen thrice a day for the first 3 to 4 days of your period. This would help in decreasing the bleeding and at the same time avoid pain. You may opt to observe this cycle of bleeding for another month or it would be more helpful to have a scheduled appointment with your ob-gyn for the next month.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Some type of viscous fluid is coming out of ears. Please help me.\n\nDear doctor, I am a 19 year old male. Some type of viscous liquid comes out of my ears and when it dries up, it hardens. Please help me.",
    "doctor_response": "Hi. Viscous fluid coming out of ears indicates a middle ear infection. It has to be attended to immediately to avoid damage to the ear. I request you to meet an ENT specialist at the earliest to prevent further damage. In the meantime, you can take tablet Levocetirizine 10 mg twice a day to reduce the secretions and the inflammation. For further queries consult an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in knee and squishy noise while bending it?\n\nHi I am 23 years old and I have severe pain in my right knee. This has been ongoing for 2 years or so. When I bend my knee it make a very strange squishy noise and hurts. I also have pain in my right hip that comes and goes. I can push my hip in and out when it hurts to stretch and it goes away for a minute then it comes right back. I have mentioned all of this to my doctor. At first he said it was growing pain. I m 23 I should be done growing. I want some kind of relief or answers. Thank you!!",
    "doctor_response": "hi,thank you for the brief history of you. As you mentioned your symptoms you should first take the x-ray of knee in the aeroplane view if it is maltracking of patella or either an MRI of knee for any soft tissue damage.  also as you mentioned you are having pain in the hip as well, I will be interested to know what is the pain like, tingling, numbrness, radiating, burning etc what? if it is of anyone of the above you can take an MRI of lumbar spine to rule out any soft tissue Injury as well. and treatment will be planned accordingly.also, before you go for all these why don't you do some exercises and see if your pain can come down. Try performing knee strengthening exercises and core stability recovery also try performing exercises for gluteus strengthening as well. Pilates will be of good help as well. You can take assistance from a physcial therapsit who can teach you the proper technique to perform.also I hope that this works out for you and no worries bothers you.with the grace of God I wish you a good health and excellent recoveryregards",
    "dialogue_context": ""
  },
  {
    "patient_message": "High creatine level in blood, kidney stones, arthritis. How to rectify?\n\nHi   I am a 47 year old woman with high creatine in my blood when they draw it from vein they seem to think its from to much exercising so they told me to slow down a little then come back for more blood work when I do its still high I have had kidneys stones 2 different times and passed them on my own I myself don't think  its from exercising I have always done this I have arthuritis which they think might be causing it I would really like to know what kind of test they could do to figure out for sure whats going on with me I feel like something is eating away at my muscles tired of worrying",
    "doctor_response": "Hi and thank you so much for this query.From the inforation you have provided, I am concerned that your kidney stones may be interfering with the normal kidney function leading to increased levels of blood creatinine. i would suggest that you meet a nephrologit to evaluate you fully and address these kidney stones as the possible cause of your worsening renal function.Also, many electrolytes and substances lie uric acid are eliminated through the kidneys. I wouldn't want to immediate conclude that this is the reason of your arthritis but your doctor should look into this possibility as a possible cause.I hope this information proves helpful to you. For now, drinking much water would be of help but the best thing is to seek a nephrologist consult to address any possible cause. Also, doing tests would be guided by the various findings on physical exam. So get consulted first before we start asking for test that would be otherwise not related to your problemI wish you well as you take on this issue. Feel free to return to e with ore questions on this. I wish you the best of possible outcomes.Dr. Ditah, Md",
    "dialogue_context": ""
  },
  {
    "patient_message": "How many days should I avoid oil, non-veg, spicy food after diagnosed from jaundice, hepatitis E virus?\n\nI had suffered from Jaundice, Hepatitis E virus,  25 days back & I was admitted to a hospital. Now, my Liver Function test is normal . Right now i'm on plain diet, Can I start eating normal food like oily, non-veg, spicy.? Or for how many days should I avoid?",
    "doctor_response": "Hello,Hepatitis E,  is a self limiting disease,  it will come down on its own,  it is better to avoid fatty meals when you have jaundice because ( fat which is eaten is metabolised and excreted via liver itself ), so when liver has mild infection, it's better to avoidbut you can eat spices, may be for 2 to 4 weeks is better, but there are as such no guidelines as to avoiding them. Hope I could help you.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does taking Statin causes leg pain in a heart patient?\n\nI am 70 and a reasonably fit and active woman who still works part time. I have been taking Crestor 40mg daily along with a blood thinner (plavix) and blood pressure tablet (ramipril 5mg) since having a cardiac stent 8 years ago because of a single blockage in my left main artery. In the last 12 months I have experienced pain in my legs particularly when sitting for long periods driving. Recently I ve been getting muscle cramps in my lower legs during the night, occasionally severe. Could these be the result of the statin and should I take the co-enzyme q I ve just been told about?",
    "doctor_response": "madamyes statins can cause muscle problems.pls do this blood test serum CPK levels.u can decrease the dose of Crestor to 20 mg.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is an ultrasound of the kidney needed here?\n\ngood day. my RCB result is 45-60. Im 38 yrs old 5'4 in height and 76 kls. Do I have to undergo an ultrasound for my kidney. My doctor ask if i have a fever for a couple of days pass but thanks God no fever at all. May I know the symtoms on it doc.? thanks and god bless.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. I assume that you want to say rbc in urine.  You have 45 to RBCs in urine.  It suggest haematuria.  It can be due to urinary tract infection., kidney stones or some mass lesion in kidney, ureter or urinary bladder.  You should go for ultrasound kidney.  It is needed to search the cause.  Go for it and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hypertension and persistent chest pain?\n\nIf a female, 37 year old have hypertension 170/90 and with chest pain when admitted to ER and twitching in the muscles and chilling all over the body, physician has requested heart enzymes test, CPK found high, troponin -ve , but the  patient still have the chest pain even after treatment. What is the probable prognosis",
    "doctor_response": "Hi,Chest pain occurring without associated symptoms like Radiation Of Pain to the Neck, Back, Jaw, Arms, Sweating, Breathlessness is less likely to be of cardiac origin.You also mention that you had twitching of Muscles & a Chill all over the body could also mean Stress, Anxiety. Your BP would have transiently shot up.Have you been on any regular medications for Increased BP?A few Lifestyle Modifications like Exercising Regularly, with some Yoga would help you control your anxieties, if these measures fail you could get a consult and start some anxiolytics.Your diet should be Salt Restricted, Low Fat Diet.Incase you have these symptoms quite frequently then please get your Thyroid Function Tests done along with 24 hour Ambulatory BP monitoring.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. There is blood in urine and the urine dip test shows blood and leukocytes. Please help.\n\nHello doctor, I have been having severe pain in my left side for a few months now. I have been to the doctors who told me it was nothing to worry about but the other day I went to the toilet and I was urinating blood. I went back to the doctor who did a urine dip test and I have leukocytes 500, blood 200 and SG 1.025. I am worried as that is a lot of blood in my urine it is the highest mark. I have been given Ciprofloxacin 500 mg for seven days. I am scared in case this does not clear up I am worried sick as I have MS (multiple sclerosis).",
    "doctor_response": "Hello,  Welcome to icliniq.com. I have gone through your queries. You are having hematuria (blood in urine). When someone gets hematuria, it has to be taken seriously and has to be investigated in detail. Please undergo the following investigations.  1. USG KUB AND PVR (ultrasound kidney, ureter and bladder, and post voidal residue). 2. Urine CS (culture test). 3. Urinalysis. 4. Urine for malignant cells for three days. 5. Serum creatinine. But do not get worried as you are young and the possibility of benign conditions as a cause of hematuria is more in your case. Meanwhile, you continue with the course of antibiotics.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to correct sudden fall in BP in a hypertensive patient?\n\nHi doctor, Since two years my mom is taking Atenolol for hypertension. Her dose is 50 mg per day which she eats half in the morning and half at night. About a week ago, her blood pressure became low and today it was 104/65 mmHg and pulse rate is 51. I would be very grateful for your help. Thanks.",
    "doctor_response": "Hi. I have carefully worked through your case and want to assure that I will manage your mother's case. Revert after two days to a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest soreness, heavy phlegm discharges, bleeding, cough after stent implantation?\n\nHad a stent put 4 wks ago and have had soreness in center of chest, then about a week ago started getting heavy phlegm, big globs of it enough to fill a pint jar not real green, some clear, some with streaks of blood, a heavy convulsive cough normally brings it up, I am taking warfarin, what should I do",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. You should immediately stop warfarin because it is anticoagulant and can cause blood in sputum.So stop warfarin and get done PT (prothrombin time). If it is higher ,then you need to take vitamin k injection to control PT and revert the anticoagulant effect of warfarin. Also get done chest x ray to rule out lung infection. Because heavy phlegm with blood can be seen in lung infection (pneumonia ). So chest x ray is needed to rule out pneumonia.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could severely painful pop in left side while being on antibiotics for cold mean?\n\nI have had a bad cold for nearly 2 months, I went to my Dr and was given antibiotics (z pack) I was coughing today and felt a pop in my left side fallowed by extream pain, it hurts to breath, move cough etc, should I go back to the Dr and what could the cause be, I m a 55yr old female in relatively good health otherwise, thank you for your time cindy",
    "doctor_response": "Hi, antibiotics usually don't work in case of cold bcuz its a viral infection. U got extremely pain on left side,hurts breathing,cough.I think u should get ENT examination done by a specialist. No need to worry .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest dosage for zental tablet\n\nHello,I am Beatrice,I wanted to deworm my stomach so I took a Zentel tablet after asking the guy in the pharmacy........I never knew the most common dose of taking two tablets per dose.Must I take the other one the next morning or should I just stop with one.I am currently not taking any other tablets.",
    "doctor_response": "Hi,The dose of Zental for deworming is generally 400 mg taken single time. This dose is sufficient.If you have taken lesser than 400mg, another dose can be repeated.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Saranya Ramadoss, General and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am looking for kidney transplant\n\ni m looking for kidney transplant. how can i get it condition is really serious. kindly help?",
    "doctor_response": "hi,thanks for query.Kidney transplant is major surgery and need proper pre and post surgery preparation part of patient also.Usually it is a team work which include counselor also who will guide about things in detail.Do not worry.just do as per the advise of doctor. wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest lumps\n\nI have a lump in the ceter of my chest lower end its soft does not hurt. At the bottom of my chest toward stomach I can push and you can feel like the bone push in. The lump has gotten bigger over the last few days and its very soft on top but the deeper you go it gets harder.",
    "doctor_response": "Hello!Thank you for the query.Soft lump in the chest area is most likely a lipoma. Its a benign tumor build of fatty tissue. It does not get malignant. It also does not give any pain.The lump can be also a sebaceous cyst, also benign lesion.To determine what exactly it is, ultrasound should be done.Both lumps can be removed by a surgeon with small incision.Please consult a surgeon with it.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest alternate medication to divalproex\n\nhi! i am taking divalproex and oxycabamazepine for the past 5 months as i got depressed after a psycho deceived me in the name of marriage,now my weight is 5feet 4 and weight is 88kilos , age -38. I want to change medication as i feel dull and sedated at times,please help",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.You have mentioned that you are depressed but unfortunately the medicines that you have mentioned doesn't have anti depressant in it. Both are primarily mood stabilizers. Along with the mood stabilizers you need to be on antidepressants as well. If sedation is a problem then you may choose bupropion or fluoxetine as antidepressants as they are nonsedative anti-depressants.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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for talonavicular luxation\n\nHi there, i am a brazilian medical doctor and suffer from cerebral palsy.While recovering from a fibular reconstruction at the contra lateral foot(the normal one), i had a lateral talo navicular luxation(the talus in the medial position compared to the mid foot.MRI:no neurovascular demage,neither condral injury.Only some calcaneus,navicular areas of bone edema at paretic foot(.Because i am not recovered from the first surgery, i have to wait some months to go to that surgery.Considering that lateral luxation is very difficult to achieve a non open reduction,probably i ll have to submit myself an artrodesis. I don\u00b4t know with it will be a triple one,or a talonavicular,maybe associated with subtalar. I have no signal of osteoarthits.i would like to know how much time i ll need weight bering and the final prognosis(moviments that will not be able to do) . I don,t practice sports ,i just need to return to work with no or mild pain.Iam a psychiatrist.Because of the first surgery i couldn\u00b4t discuss that with my ankle specialist.Sincerely yours,leonardo",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. Based on your questions it seems that you have decided not to seek any medical help till your fibular reconstruction has improved. If you do seek help right away it might be possible to reduce the Talonavicular joint with pinning and since your non weight bearing currently it won't affect your lifestyle much anyways. If you choose to wait and get TN reduced later there is a chance you might ulcerate due to intrinsic pressure on soft tissue that is being created by navicular, not only you are increasing your chance to get a fusion which might over several years cause arthritis in other joints. Locking TN joint right away will reduce motion in subtalar joint significantly. Regarding if you choose to be under TN fusion I would not recommend getting STJ fusion with it because it will limit your motion significantly. In my opinion you should under Talonavicular reduction with temporary fixation right away before you end up compromising your soft tissue.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Samuel Parmar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the discharge of green mucus after bursting of bertholin cyst be a matter of concern?\n\nI have had what I am sure is a Bertholin Cyst develop over last few days. This had now burst this morning to show a bright red discharge with green mucus. The pain I was suffering had now gone almost completley. Will I now be ok, or do I still need to see a doctor? Thanks",
    "doctor_response": "Hi, Thanks for posting in HCM. I understand your concern. Green mucus discharge following rupture of Bartholin cyst indicates that it would have been infected. It is good that it has ruptured and see to it that all the contents are completely drained out. Kindly take antiinflammatory medication like Tablet.Ibuprofen after food twice a day for 3 to 5 days. Continue with Sitz bath until the wound heals completely. Abstain from sexual activities till the lesions heal completely. Hope the information provided would be helpful. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause heel pain?\n\nmy mom is 48 years old. she had chicken Guinea last year. since then she complains of consistent pain in her heels so much so she starts limping at times. is it because of chicken guinea. As suggested by our orthopaedic she is on Vitamin D pills right now. and yes she is slightly obese. please suggest a remedy.",
    "doctor_response": "Hi, Please get her x-rays of both heels, since commonly the cause for such pain is plantar fasciitis. It is generally not associated with chicken guinea fever. Treatment will depend on the x-ray findings. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness in the chest while suffering from blocked arteries?\n\ni got 2 blockages to my  heart they are 20 to 30 percent last few weeks i had tightness in my chest and i been having trouble sleeping .last week i was plie white in my face family worry about me .any way had heavyness and tightness in my chest off and on had a sharp pain last saturday with it almost call 911 took one of my nerve pills went away some .it comes back now and then could it be from the blockages or a heart problem",
    "doctor_response": "hellothanks for posting here. since yoie angiogram shows 20-30% disease, the pain in the chest or tightness does not seem to be heart related. Blockages take time to increase and wont increase from 30 to 80 in few months. So dont worry about a heart issue. Since you said you are on nerve pills, the symptoms may be due to the anxiety. So the treatment is anxiety relief for which you are already on medications. Along with medications, diet, lifestyle modifications, exercise, yoga anf meditation all can help in preventing further progression of your minor blocks in the heart and also decrease your anxiety. wishing you good health. thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the lump on my chest that discharges a foul smelling fluid?\n\nHi there, I have this lump on the center of my chest and it discharges fluid and also a smell like a dead animal. It is small in size and not painful when touched. i have this lump for more than 5 years now and lately it started to give that smell and discharge fliud when pressed",
    "doctor_response": "Hello and welcome to HCM,Foul smelling discharge from a lump on the chest suggests infection in the lump.The cause, origin and nature of the lump has to be known.A X-ray or CT scan of the chest is required to know the site of origin of the lump- soft tissue or bony tissue.An aspiration cytology of the lump needs to be done.In aspiration cytology, cells are sampled from the lump, spread on slide and stained with appropriate stains.This investigations helps to know the origin and nature of the lesion-neoplastic or non-neoplastic.If neoplastic whether it is benign or malignant.After knowing the exact nature of the lesion, further management is done.The pus or the foul smelling discharge from the lump should be submitted for microscopic examination and appropriate antibiotics need to be instituted for treatment of infection.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can massive heart attack affect mental state?\n\nMy husband had a massive heart attack a month ago & thankfully survived BUT now seems to have no desire to do anything & seems to get confused alot. I know that depression is a side effect after an attack but does it also effect your mental state ? We are always together when we visit the doctor so it's difficult to ask these questions in front of him. I'm not sure how to pull him through this - any suggestions?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. As you mentioned, depression arisen out of that traumatic incident could be one angle of approaching it. Motivation and counseling given by the heart specialist should help. Other complication for MI regarding mental state are possible due to so many physiological reasons. Do consult your doctor for other possible complications.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair fall\n\nsir i m finding my hair is falling....as suggested by dr, Sameer mishra Dematologist that you use trigaine solution 2 ml...m using this m not geeting good result.....is there any chances that i can recover my hair...m 24 year old and its not the case of heritage....yogesh sharma",
    "doctor_response": "Hello. Thanks for writing to us at healthcaremagicYou seem to have Androgenetic alopecia. It is a common cause of hair fall and hair thinning in males.Family history is positive in most and but is not necessarily present in family members. Positive family history in grandparents, aunts, uncles, nephews, nieces or half-siblings is also significant.Minoxidil and finasteride have approval for use in this type of alopecia. You are already using minoxidil.Apart from topical minoxidil that you have been using If I was the treating doctor I would have also added oral Finasteride once daily. It is approved for androgenetic alopecia in males and it specifically inhibits the enzyme responsible for converting testosterone to Dihydrotestosterone (DHT) in hair follicles. DHT is the main culprit in this type of hair loss.Results are usually noticeable over a period of 6-8 months of regular minoxidil use and oral treatmentA biotin supplement once daily would also be useful. Biotin supports hair growth  though it is not specific for androgentic alopecia.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes continuous sneezing?\n\nMy wife is continually snezeing from last 2 days. Rate is 20 to 22 sneezing per min. From last 2 days consulted with many doctors they say it s an alergic reaction. And need to wait for 2~3 days more. It s a very horrible codition. Pl suggest Is it normal. Or pl suggest what to do next",
    "doctor_response": "HelloThank You for contacting HCM.yes it is because of allergic response and takes some time to relieve. I would suggest you following things:> Take levocetirizine one at night for 5 days.> Take montelukast one daily for one month. Research has shown that it decreases the allergic symptoms considerably.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. Wishing her good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Gagging, difficulty in closing mouth after being fitted with dentures. What can be done?\n\nHi, I m 38 years old and due to a gun shot through the roof of my mouth.I have worn a partial for years. I m 5 1 amd 91 lbs always been very small child like. I had full dentures put in yesterday and they huge! I m gagging,cant close my mouth,color is very dark,and teeth are like hores teeth. I m horrified. I have called him and he said the will fit when I grow into them. I don t think I m going to be doing anymore of that. What to do? He pulled what 10 teeth I had left now nothing and owe him over 5,000$. Help PLEASE",
    "doctor_response": "Hi, Thank you for the query. First thing is you cannot wear a denture which is bigger than the size of our palate . Definitly you will have a gag reflex as the over extension of the denture is into the  soft palate area leading to gag reflexes . Coming to the growth part, you are already 38yrs old ,at this age there wont be any growth in your body parts. Only thing what can be done is ask your dentist to prepare another set of dentures which are of your size not huge and size of the teeth should be reduced and your occlusion should be checked thoroughly and extensions of the dentures are important so that you wont end up in gag relfexes any more. Best thing is to see a prostodontist. Hope this inforamtion will help you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fungal infection?\n\nI have a skin problem which looks like allergie, once or twice in a day there are multiple rashes comes up on my face, shoulder, skin on the head. they itch and the skin at that time feels very hot. I have consulted a skin doctor, who said it is fungal infection and have given me a lot of medicines along with a special shampoo. Please let me know is it a skin disease or an internal alllergie? What shoul I do.",
    "doctor_response": "Hello,Welcome to HCM,The history and symptoms suggests me that you are having some infection related to skin it may be of fungal origin or allergic origin.You requires physical examination to make proper diagnosis and treatment. With the history it looks like it is an allergic reaction which comes on face and the neck with the feeling of the hotness.I would suggest you to consult your dermatologist for physical examination and to make a proper diagnosis to get adequate treatment.For your symptoms i may advise to take antihistamines and to apply dermadew ointment over the lesions.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Knot present in the middle of my chest, pain on touching. Symptoms related to gallbladder?\n\nI noticed I have a knot in the middle of my chest right where the V is in your chest sometimes it hurts to touch it, it doesn t hurt on the inside it hurts like between the skin and my inside if that makes any sense at all. could you tell me if this is something to worry about or maybe does it have to do with my gall bladder? it sticks out a little bit and it is a round hard knot.",
    "doctor_response": "Hi and welcome to HCM. It sounds to me like you have some subcutaneous lesion of abdominal wall. It is almost impossible to feel your galbladder and you would have crampy pain after meal. It is more like some kind of benign tumor, lipoma, fibroma or atheroma, whichican be easily surgucaly removed. If you think that this is intraabdominal then you must do ultrasound and further examination. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes phlegm deposits around the cheek?\n\ni went to the dentist and had a panaromic x-ray of my teeth and we discovered that around my right cheeks appear to be deposits of phlem. I have been suffering with a sinus infection since September 2011, my right nose is stuffy and especially at night I can not breath from the righjt nostril.  Can you tell me what this appearance in the upper right cheeks indicate?",
    "doctor_response": "Hi,Thanks for posting the query,  Usually waht you said a phlem deposition is not seen over the right cheek, i Would suggest you to get it examined again.   As you have mentioned the primary cause is sinus infection I would suggest you to get it treated first.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i use meftal spas for mouth pain and sensitive tooth?\n\nI am having pain on the left side of my mouth.. I have a sensitive tooth and here in Brussels the temperatures are very low to -15 degrees. So it seems to be induced due to the cold. Can I use Meftal Spas as a pain killer for the time being till I get a doctor's appointment ?",
    "doctor_response": "HelloI have read your query.first of all what is the reason of your tooth sensitivity. if its due to attrion or abration aplication of a dental sensitivity cream or paste can work.if it is due to caries (decay) then you need to get it filled.for time being if the sensivity is increasing while taking any cold stuff then try to avoid it.if pain is also dere then u cn take meftal spas or any combination of daclofenac and paracetamol wud be better.bt for you need a dental visit to get it checked where the problem lies.Hope this ans helpsRegardsDr. Shesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "What increases blood pressure?\n\nI went for an unpleasant smear test last week and after it my blood pressure reading was 140/90.  I was asked to return this week for another blood pressure and this week it was 164/82.  The nurse said if the one next week is raised I will have to have further tests.  Why would my blood pressure be raised it has always been ok before.  Last reading march this year. I am 47 years old, non smoker, 10st in weight, 5 foot 6 height",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern.I will try to explain you something and give you my opinion.You should know that we talk about hypertension if we have mean value that exceeds 140 / 90 mmHg.A person might have high value during emotional and physical strees so its mandatory to judge on mean values.Hypertension is divided into two groups. Essential hypertension is a chronic disease, usauly in older ages.It has not  an identified cause and it should be treated all live long.Secondary hypertension is common in younger ages.It means that its a secondary couse of it.This might be a renal disease, an endocrine problem or a cardiovascular anomaly.So , if I was your treating doctor I will recommend some examination like an electrocardiogram , a cardiac echo to evaluate heart function and walls , a full blood analyze , an abdominal echo to evaluate renal structure, your urinary chatecolamins and of course a holter pressure monitoring to evaluate your values during day and night.After all this we can better judge what we are dealling whith and how to treat it.If you didn't have high values before, it doesn't mean that you would never have, it might happen and we should find the couse if it is any.Hope I was helpfull.Best regards , Dr.Ervina.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower left back pain?\n\nI have pain in my lower back down my left leg to just above the back of my knee.Is this sciatica? or could it be kidney stones?the pain is not constant, but it comes back frequently and will last for three or four days at a time I am a 43 year old male",
    "doctor_response": "Hello Thank you for using healthcare magic . I read your question and understand your concern . I think this is not a kidney stone problem . Based on your description it looks like a sciatica pain referred pain from your back problem. To confirm it you need to do MRI of the spine and the consultation with the neurologist specialist . I wish you quick recovery. Dr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Indent on head. Runny nose, congestion and sinus headaches. Taking allergy shots once a week. Should I be concerned?\n\nHi. I am a 22 year old female. I just recently noticed a vertical indentation from the very top of my head down maybe an inch of my crown. It doesn't really hurt, but because I have been touching it a lot and allowing family members to feel it, it seems a little soar or sensitive now. I just got my hair dyed last week where I sat under a heater for a while. I have not had any injuries, but I have always had crazy allergies. I wake up nearly every morning with a runny nose, congestion, and sometimes a sinus headache. I use to get allergy shots once a week for a while, but that was years ago. I have also lost about 10 lbs, I have been trying to eat healthier and exercise. But this past week or 2 I have been eating junk food.  What is this seemingly sudden indentation on my head? Should I be concerned?",
    "doctor_response": "hello Dear!  thank you for asking. I read your query and i want you to know that if the indent on your head is not preceeded by some trauma or fall then it is probably innocuous and it will go away. If it doesn't in a week you can see Nearby Gp to assess this bump and sort out the etiology for you. If it hurts simple acetaminophen or topical NSAIDs will be enough.Now your main Concern. Allergic rhinitis with allied morbiditiesyou need 3 phases for management1)Avoidance:Avoiding exposure to allergens such as pollen, dust mites, and mold to a minimum and all other environmental control measures.2)Medication therapya-Second-generation antihistaminesCetirizine (Zyrtec) Levocetirizine (Xyzal) Cetirizine and pseudoephedrine (Zyrtec-D) Fexofenadine/pseudoephedrine (Allegra-D)Loratadine/pseudoephedrine (Claritin-D 24 Hour, Claritin-D 12 Hour)b-Leukotriene receptor antagonistsMontelukast (Singulair)c-First-generation antihistaminesChlorpheniramine (Chlor-Trimeton) Diphenhydramine (Benadryl, Benylin) Hydroxyzine (Atarax, Vistaril, Vistazine)d-DecongestantsPseudoephedrine (Sudafed)e-Nasal corticosteroidsMometasone (Nasonex) Beclomethasone (Beconase AQ, QNASL) Budesonide inhaled (Rhinocort Aqua) Fluticasone (Flonase) Ciclesonide (Omnaris) Fluticasone furoate (Veramyst) Triamcinolone (Nasacort AQ)f-Intranasal antihistaminesAzelastine (Astelin) Olopatadine intranasal (Patanase)g-Intranasal cromolynsCromolyn sodium (Nasalcrom)h-Intranasal anticholinergic agentsIpratropium (Atrovent Nasal Spray 0.03%)3) immunotherapiesif the above two precautions could not modify your condition then i am afraid you would need a step up. that is immunotherapyThere are sublingual and subcutaneous immunotherapies SLIT SCIT. you can discuss the possibility with your doctor.4) see the Otorhinolaryngologist for ruling out surgivcally treatbale causes or complications of allrgic rhinitis like deviated nasal septum, chronic sinusitis polyps or turbiectomies for relief.I hope i was of some helpregardsDr S Khan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in the right hip and leg despite taking Tramadol?\n\nI am away from my current home having heavy pain in my right hip and leg. I don t want to go to the ER and I live in Kansas City but I am in Denver with relatives. I have surmised that it is sciatica. I applied heat and it didn t help. I think I need an anti inflammatory drug. I take tramadol regularly but it is not cutting it. What is an OC anti inflamatory? I am a female, 68yurs old and weigh 136.",
    "doctor_response": "Hi, I'm afraid you are having an acute sciatica pain episode. And yes, Tramadol alone can't help you. As you cannot go to the ER, then, I advise to: - apply an analgesic cream on your lower back and on right hip and leg joints - take over the counter Paracetamol alternating with Ibuprofen or Ketoprofen - some sciatic exercise can help you a lot to manage the pain - I think heat won't help but make inflammation worse, should apply cold compresses or Glucosamine packs (ask at your local drug store) - take Glucosamine and vitamin B complex supplement. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Albana Sejdini, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I having stomach pain while eating with unintentional weight loss?\n\nHello doctor, I have had stomach issues for a long time and had the gallbladder removed around four years back. My stomach issues have gotten worse. Then, ten months back I had started getting this horrible burning sensation on the right side near ribs. The doctor thought it was my liver and did blood work, everything was fine. Then six months back I got to a point where every time I ate I was in extreme pain. I have lost around 60 lbs since then. I went and saw a different doctor, they did blood work which came back abnormal (amylase 24 IU/L, lipase 8 IU/L, narrative current ADA criteria for glucose: normal: 70-99 mg/dL, impaired fasting glucose: 100-125 mg/dL, diabetes mellitus: at or above 126 mg/dL). The diagnosis of diabetes must be confirmed on a subsequent day by measuring fasting plasma glucose, two hour PG or random plasma glucose (if symptoms are present). Sodium 139 mEq/L, potassium 3.5 mEq/L, chloride 106 mEq/L, carbon dioxide 26 mEq/L, anion gap 7.0 mEq/L, blood urea nitrogen 4 mg/dL, creatinine 0.70 mg/dL, glomerular filtration rate greater than 60 mL/min/1.73 m*2. A persistently reduced GFR is a specific indication of chronic kidney disease. The eGFR calculation has not been validated in patients greater than 70 years. Calcium 9.1 mg/dL (8.4 - 10.5 mg/dL), glucose 88 mg/dL (70 - 100 mg/dL), protein total 6.5 g/dL (6.0 - 8.0 g/dL), albumin 3.9 g/dL (3.5 - 5.0 g/dL), alkaline phosphatase 68 IU/L (40 - 150 IU/L), aspartate aminotransferase 21 IU/L (10 - 40 IU/L), alanine aminotransferase 42 IU/L (6 - 31 IU/L), bilirubin total 0.6 mg/dL (0.2 - 1.2 mg/dL). Ultrasound impression showed probable cavernous hemangiomas in the left hepatic lobe although the ultrasound appearance is nonspecific. Recommend CT of the abdomen with IV contrast utilizing triphasic hepatic protocol. Then sent for CT and the impression is previous cholecystectomy. The focus of abnormal echotexture on recent ultrasound through the liver is felt to correlate to an area of low attenuation on CT. CT findings are nonspecific. This may represent an atypical hemangioma. Neoplasm is felt less likely. This is well visualized with ultrasound. Short-term follow-up ultrasound in 2 to 3 months recommended to ensure stability. If this is unchanged it can be followed at larger interval increments. Right renal cyst. It states I was given oral contrast, I was not. The doctor had also told me these are something I wa",
    "doctor_response": "Hello. Yes, it is likely to be hemangiomas only. I think your treating doctor is right. Ultrasound is a good investigation for hemangiomas and it definitely shows its presence and also suggested by CT scan. Now, regarding your doubts, firstly ultrasound is a very observer dependent investigation. So, the findings seen by one may be missed by other. And another important thing is, hemangiomas grow with time and hormonal changes, so it might be possible that it was present but of a small size to be detected and has grown over a period of time. Next thing, if you are worried too much about it then you may get another ultrasound of the abdomen done by an independent radiologist. Also, you should get your CT scan reviewed by another radiologist for his opinion. You may ask for a CD having ct images, and get it reported so as to confirm the findings. No need to repeat CT done now. Also, follow up ultrasound should be done after three months to look for a change in size.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a rash due to poison ivy\n\nWhat should I do about my poison ivy? I came in contact with it on Saturday and the rash developed early on Sunday. I don't think it's weeping anymore but I really want it to heal... I have no other allergies, I am a 16 year old girl, and I weigh 120 lbs. Thank you!",
    "doctor_response": "Hello. Thanks for writing to us at healthcaremagicPoison ivy would have most likely caused Irritant Dermatitis. Irritant dermatitis due to toxins or chemicals is usually associated with burning sensation; is sharply defined Or limited to the areas of contact, red to deep red; blistering, oozing/weeping being part of the irritant dermatitis.Take an OTC oral antihistamine e.g cetrizine 10 mg once daily.If I was the treating doctor I would have asked you to use a moderately potent topical steroid, twice daily for a few days. That would help it resolve faster.Topical steroids are prescription products and therefore I suggest you to contact your doctor for the needful.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lumps in armpit\n\nhello i had an lump under my armpit for about 2 days and it causes sometimes some kind of pressure or discomfort what could it be  im a male    and the lump is really high in my armpit  is it a swollen lymph node   i could only feel it when  i put my hand behind my head  thank you very much",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You may have enlarged lymphnode. It can be due to reactive hyperplasia, tuberculosis, lymphoma or metastatic carcinoma. You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest me treatment for sore shoulder blade with bump on it as MRI normal?\n\ni have a sore shoulder blade and neck. i have a injury . which resulting of a bump on my shoulder blade. i went for three MRI and first one they only did my spine and second one shoulder only , third one was only around the bump... i feel where i hurt is over the bump and continuing in my neck.. is it possible they are missing the mucule that hurt. ty connie",
    "doctor_response": "Hi Mr Connie..If I were your treating doctor I would require much more information regarding the bump you have on your shoulder blade...You could have share with us the reports if MRI taken to help you move precisely...I would also like to know the pain details as in which site on shoulder....how is that came up initially..how bad is it..is there any movements limited..was there anything that increases or decreases your pain..The bump can be a trigger point or a shortened muscle point... that can cause pain on pressing it..because of the shortening of the mucle and constant irritation there is always associated spasm which could be responsible for your neck pain...MRI images gives a enlarged and detailed study of screened joint or muscle..so it is very unlikely to miss out key information..as it basically magnifies and displays the image..Don't worry....I recommend you to keep icing your shoulder frequently to get your spasm and pain under control..Hope this is helpful for you..Kindly revert back incase you need any further clarification...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can monofasic cancer cause drowsiness and blankness while walking on road?\n\nmy freind had monofasic cancer in neck before 2 yrs and was operated and is fine from 2 months she has a hard lump on head size didnt increase and yesturday in evening she felt drousy and was complete bank while walking on road for 30 seconds just wanted to know does it have anything to do with cancer as she was said it occurs in 2 yrs",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Black out may occurs due to anemia, hypoglycaemia, hypotension, hypertension.  Chances of tumour causing blackout are very rare.  So first of all you should go for basic investigation for anemia, diabetes and hypertension.  Then you should take treatment according to cause. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My penis is swollen and purple in color after having an intercourse\n\nHi. My wife and I had intense intercourse last night and when I woke this morning my penis was swollen and purple in colour as if it were full of blood. This is still the case as I type this but I did not have any pain at the time nor is my penis bent, etc as appears to be the norm with a broken penis. Do you have any suggestions please?",
    "doctor_response": "HelloThanks or your query.It seems that you have sustained trivial injury to one of the superficial vessel due to rough sexual encounter resulting into collection of blood in superficial plain of penis.Please consult qualified Urologist for clinical examination and get ultrasound scanning of the penis done to rule out any major injury to Tunica Albugenia .You need to take broad spectrum antibiotic like Cefexine along with anti inflammatory drug like Diclofenac twice daily.Ensure to avoid sexual encounters till it resolves completely.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nose area pain with mucus discharge?\n\nmy 11 month baby had a very sudden attack of pain in his nose area. was rubbing his nose & in a lot of pain & distress. thick white muscus came out of his nose... i tried to wash the area to see what if there was anything there. 5 minutes later he seems fine. I m thinking that maybe something got up his nose, but can the nose produce lots of white mucus very suddenly?",
    "doctor_response": "Hello, I think you are right to consider that something got up in his nose. Yes, little noses still can produce lots of mucous even over a short period of time. Other things to consider - did he get close to a plant/flower/outside and get a sniff of pollen that caused his to itch and sneeze out a mucous glob? In general, if it is gone, it's gone and you don't have to worry. If something is stuck up there you should continue to see mucous that will become very smelly and grey. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Lisa Baker, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high platelet count?\n\nlast 10 days i am taking mine med. for early acute liver absess in semant 7. this is 4.5 n 4.9 in size. i m taking ampicillin with metrozile iv thrick in one day. all my test like tlc and other enzyme of liver is normal now without platelat count. this is 5 lakhs. whats may be reson of high platelats count?",
    "doctor_response": "Hello! Thanks for putting your query in HCM.  I am Dr.Amit Jain (DM, Gastroenterologist). platelet count can be increased in any infection. So as soon as this infection will recover platelet count will also recover.I hope I have answered your query. If you have any further query I will be happy to answer that too. Wish you a good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Suffering severe chest pain and palpitation after food and walk.\n\nDear doctor, I have HOCM by birth and suffering severe chest pain and palpitation after food and walk. One year back, I underwent angioplasty and stenting.",
    "doctor_response": "Hi. Hypertrophic Obstructive Cardiomyopathy (HOCM) needs further treatment even after stenting.  Can you tell me exactly what drugs you are on? So that I can help you further. Revert back to a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pressure on chest and breathing difficulty\n\nmy chest feels like big pressure that I can not even breath normally and I have to stop whatever I am doing, it makes me very exhausted and if I continue to exercise or move I feel very short of breath and if I bend over it gets worst and palpitations increase. Mostly on the left side sometimes even I feel my arm weird.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, we should first rule out heart and lung diseases for your symptoms because heart diseases like arrhythmia and lung diseases like asthma and bronchitis can cause similar symptoms. So consult doctor and get done 1. Ecg, 2d echo and blood pressure monitoring too rule out heart diseases. 2. Clinical examination of respiratory system and PFT (pulmonary function test) to rule out asthma and bronchitis. It all these are normal then no need to worry for major heart or lung related diseases.. Sometimes, stress and anxiety can also cause similar symptoms. So avoid stress and tension, be relax and calm. Consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on it's solution. You may need anxiolytic drugs too. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can be done to manage premature ejaculation?\n\nHello doctor, I am 36 years old individual. During intercourse, my penis gets eruction but I ejaculate in less than a minute. It is becoming difficult. Kindly help as I am losing confidence. My height is 5 feet 8 inches, weight 128 kg (severe obesity), waist-line 55 inches, penis size 5 inches, approximately when erected and girth is two inches and not so hard as it used to be. Glans penis (head) is completely covered by foreskin and cannot be seen and when tried to retract, it is painful and not possible to retract but when not erect, the foreskin can be retracted without pain and be cleaned. The main problem is premature ejaculation. Other systemic complications are diabetes and on Gemmer 1 mg once daily from the paat one year. No blood pressure or thyroid or anything else.",
    "doctor_response": "Hello. I have read your problem. Premature ejaculation is very common and is usually not associated with any disease but may be due to anxiety. However, it is sometimes associated with infection of male accessory glands, which is treatable. You can learn to control PE by doing this exercise. Pull your muscles that you pull at the end of urination for a few seconds and then release. Repeat this several times daily. Another is the stop-start technique. When you feel that you are going to ejaculate stop the sexual stimulation and divert your mind, the penis will relax, after some time, start the stimulation again and repeat the procedure. Over a few months, you will gradually increase your ejaculation time. Also, there are medicines to control it but there is no permanent cure. In your case, you should strictly control diabetes and reduce weight by slow walking daily 15 minutes. Your foreskin may be tight due to some infection which is common in obese diabetics. If you get too much pain, then circumcision, which is a small operation can help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Blood in saliva when sleeping or performing oral sex. What could this mean?\n\ni have had this problem for awhile, I ignored it at first but now its really becoming a problem. I have blood , large traces of blood in my saliva . it occurs mostly while im sleeping. I wake up to a mouth full of blood filled saliva. I also notice it when i perform oral sex on my significant other. What could this possibly mean?",
    "doctor_response": "Hello & welcome, Blood in the saliva which is seen when you wake up clearly indicates the presence of gingival infection called gingivitis. It is directly associated with failure in maintaining oral hygiene to optimum level or due to faulty brushing & cleaning habits. First , visit your dentist for proper clinical examination to find out any other related cause if any. Get your teeth cleaned (scaling) by dentist thoroughly. Use soft tooth brush by applying light pressure against teeth surface. Use antiseptic mouth wash for short period. Even you can brush your teeth lightly after having your meals to remove any accumulated food debris which is difficult to remove with just gargles. You can use gum paints along with Antibiotics to reduce the bleeding from gingiva. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "54yrs old, Problem in urinating. History Nephrecotomy. Taking repilif, had ejaculation problem. Is it medicine side effect?\n\nI am 54 years old male. Two years back, nephrectomy was done for left kidney because of renal cell carcinoma . Now I am OK. But there is urination problem for which I am taking repilif-8 once a day. While I take repilif there comes ejaculation problem. Is it for the medicine? May I take such other medicine which will not create ejaculation problem? If yes, suggest othe medicine-D.N.Das,Guwahati,Assam",
    "doctor_response": "Hello Mr Das, You need to consult your urologist for finding the reason for  urination problem. Certain drugs may lead to ejaculation problem, but can only be confirmed after thorough examination. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for nail marks on face of a child\n\nI ve a 2.5 years old daughter. While playing with other children, one of the child scratch her face with nails. Now she got marks of nails on her face which are very prominent and they seems deep in skin. How can I remove those? Need your opinion. Thanks",
    "doctor_response": "Hello,I just read through your question. Apply any over the counter antibiotic ointment to the scratches 3 times per day. This will prevent infection and speed the healing process.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Eric Goldstein",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does\u00a0this blood and\u00a0urine test result mean?\n\nRespected Sir, i was 25 when i had a varicocele surgery done on me way back in 2007, eventually my sperm count increased from 10000 to 20 million then. Later I dint follow up the sperm count i used to masturbate regularly and also had the habit of holding the cum when reaching climax,then again masturbate. In 2010 i was diagnosed with epididymitis then i had antibiotics and i was fine. Offlate i was again experiencing that dragging pain in the scrotum and pain in back if i was standing for long, I am too worried if i could impregnate my future wife as i am about to be married.i consulted the doctor and there is a slight varicocele and i am placing the result of scan below. My doc says i could go ahead marry and if am unable to impregnate in a year i could go for a varicocele surgery. I am too worried scared and stressed.. before two weeks i had a wet dream and the semen was very watery (its been more than a month i quit smoking and alcohol) and am not havin morning woods and even if i have its not that hard. i masturbated today after a 40 days period there was no proper erection and i got ejaculated immediately and the semen was watery although am having proper food habits. kindly advice. my scan reports below. my blood & urine tests showed normal as said by my doc. please help. Right testis -4.0x1.8 cms Left Testis- 4.0x1.6 cms Both Testes are normal in size and shape The echopattern is uniform bilaterally. No evidence of cysts, mass or calcification is seen. The epididymis appears normal bilaterally. THERE IS MINIMAL RIGHT HYDROCELE RIGHT SCROTUM SHOWS MILD DILATION OF VEINS OF 2.2- 2.5 MM AT REST AND 3-3.5MM ON VALSALVA. LEFT SCROTUM SHOWS THROMBOSED DILATED VEINS REVASCULARISED BY COLLATERALS WITH REFLUX MEASURING 3MM AT REST AND 3.5MM ON VASALVA Impression: *EVIDENCE OF GRADE I - II VARICOCELE IN RIGHT AND LEFT SCROTUM AS DESCRIBED ABOVE. *SONOGRAPHICALLY, TESTES AND EPIDIDYMIS APPEAR NORMAL BILATERALLY,BOTH TESTES SHOW GOOD VASCULARITY.",
    "doctor_response": "HelloThanks for query.Your Scan report reveals bilateral grade one Varicocele with apparently normal testicular function ..It would have been better if you could have done semen analysis and posted the report to make precise comments about your  fertility.At the outset I would like to emphasize that Varicocele surgery may or may not improve sperm count .You need to consult qualified Urologist for problem of Erectile Dysfunction and get investigated to find out the cause of ED .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes strain on my back while sitting?\n\nHi I am having some discomfort middle of my back/shoulder area. It feels like having poking my spine constantly, especially when I am sitting. I have an uncomfortable strain on both shoulders and at times they feel sore and weak. I was wondering if you could help me on this please.",
    "doctor_response": "Hi,Thank you for providing the brief history of you.A thorough musculoskeletal assessment is advised.By your history i can understand its due to muscle weakness things are not falling into place. You pain the mid thoracic region is due to interscapular muscle spasm, Also the shoulders are aching and sore is due to trapezitis.Due to this two reasons, your symptoms are arising.Firstly you need a physical therapist who can help with Therapeutic ultrasound therapy and TENS therapy for reducing inflammation and pain in the muscles. Second - a posture correction is needed as well, as due to bad posture the strain on the muscles is high leading to abnormal symptoms.Third - need to perform exercises to strengthen the muscles of the upper back and shoulder.In my clinical practice patients complain often such symptoms and they respond well to the above mentioned plan of therapy.Regards'Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can monocyte count be increased?\n\nMy monocytes count was 3.8 not sure what that means. But I believe that's low?  How do  I get it up.  And I do have R.A. and I'm  60today. Don't eat well but losing weight,  but I'm overweight. Do work out in gym and stay very active.  Can you help.By the way does this cost",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Monocyte usually ll be low. It will only increase during infections or a disease. So I don't think you should worry about it. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which are the ovulation days as my cycle is 45-55 days ?\n\nmy cycle is 45- 55 days which is the best time to concieve?",
    "doctor_response": "Hi , Best time to concieve is from 9th to 17th day of menstrual cycle .Ovulation generally occurs between 12-14th day of menstrual cycle and life of sperm is 72 hours.(3 days).So 12-3=9 and 14+3 =17. Hope this clears all your doubts, thanks dr jignesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach pain\n\nMy wife has been taking pain meds for a week from bladder infection she's  been in bed the hole time and only pee but she hasn't pooped in 7days now when she tries  to sit up she's in real bad pain iin her stomach  area she lays back down and she's fine ..i tell her she needs to move around   and poop",
    "doctor_response": "Hello,Only pain medications may not help in bladder infection. If there is an infection, it has to be treated by antibiotics. If your wife is suffering from bladder infection, she should take Levofloxacin 250 mg (Levoflox) twice a day for five days.She should drink lots of fluids. Infection is eliminated faster from body if the urine output is more. She should take rest as much as she can. Pain medications can be taken for symptomatic relief from pain.If the pain does not resolve in three days, then she should go for urine analysis, culture test of urine and complete blood count (CBC).I hope this information helps. Thank you for choosing HealthcareMagic. Regards,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a swollen spot behind the ear indicate?\n\nI have a swollen spot about an inch behind my ear and at the base of my hairline. It is very painful and causing a headache & neck ache. It is not red and does not look anything like a pimple or boil. I have been quite healthy up until this showed up.",
    "doctor_response": "Hi! just today I came across such a patient of course who was aged and presented with a swollen painful nodule behind his ear for 3/4 days!it is quite a common clinical presentation in day-to-day practice!In such cases I just do a careful and gentle physical examination regarding size, consistency, mobility, feel and tenderness of it; then I do a needle biopsy that generally reveal:1. a lymph node with no significant abnormality2. a small infected inclusion cyst3. an inflammatory pseudotumor4. metastatic carcinomaTherefore you need to see your doctor today for confirmation and to relieve your tension.regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Fedac for seasonal allergies. Any suggestions as to where to get it?\n\nHi! I would like to asks a questions, as I have a seasonal allergies and I am taking Fedac tablet. Which is I am used to it. The problem is Im already run out of it and I am wondering in which Pharmacy I could get it without any hassle. As get it yearly in singapore so now almost done because my seasonal allergies trigger. Any suggestion, please?! Looking forward.",
    "doctor_response": "hi, fedac is a tablet which contains an antihistamine and a decongestant, these drugs are easily available over the counter with any hassle , but it also depends on countries law, some countries it may not be available, what i suggest is you ask the pharmacist for another drug with same combination. also you get better tablet with very less side effects like drowsiness. also you can take steroidal nasal spray which is very effective in controlling symptoms and with zero side.i recommend steroidal nasal spray containing fluticasone it is easily available also. thank you dr.mukesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be concerned about the severe pain and continual seeping of blood weeks after a vasectomy?\n\nmy son in law had a vastemy 2 weeks ago and has trouble ever since really bad pain and is still seeping blood he was hospitalize for 3 days with a hematoma but sent home still in pain and seeping blood is this normal or should he get a second opinion he doesn t seem to get anywhere with the dr that did the surgery.",
    "doctor_response": "Good Day and thank you for being with Healthcare Magic! Hematoma formation after vasectomy is uncommon but can happen even with the best of hands. It would take time for the hematoma to seep out or be absorbed by the body.  Of course you are always welcome to seek 2nd opinion but I fear that he might have the same management as  surgeon who did the procedure.  I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at:   I would gladly help you.  Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is kidney transplantation advisable for an jaundice suffering person?\n\nHi raju, Iam Bhargav and i want one clarification last month my friend's mother was affected with jaundice but due to some problem it affected the kidney.now they are planning for operation.so i would like to know the cost for that operation.her age is 48.please tell me how much will it cost for kidney transplantation and how many days will it take to cure it completely.",
    "doctor_response": "Hello Bhargav and welcome to HCM.As an Urologist,i can understand your anxiety.Some people do develop jaundice after multiple blood transfusions.The cost for the surgery depends on individual hospitals.It varies from centre to centre.Cure isn't assured at any centre,as the kidney can get rejected at any time.The person undergoing transplantation,has to be on anti-rejection drugs.If you've any other doubts,send all your reports as a direct question to me.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath?\n\ni am a 55 yr old woman 5'7' and weigh 206,i've gained 30 lbs since quitting smoking 2 yrs ago..today i don't feel good.kinda shrt of breath,heavy feeling in my stomach and my blood pressure is 116 over 73 with a 102 pulse after a short walk. any suggestions?don't know if it matters but i had a upper banded gastro in 1989...lowest weight was 165..B.P ran around 80 over 60.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. By your history and description, possibility of bronchitis is more. Bronchitis is common in smokers. So better to consult pulmonologist and get done clinical examination of respiratory system, chest x ray and PFT (Pulmonary Function Test). Chest x ray is needed to rule out lung infection. PFT is needed to rule out bronchitis. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid (ICS). So consult doctor and discuss all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does \"hairline triangle fracture\" mean?\n\nhello , my son has a small hairline fracture of his index finger. I was out of town when this happen. he went to ER they gave him a sofy cast and said it was a non something  hairline triangle fracture do you know what this is? also my son took of soft cast and thinks he is fine how long do these take to heal",
    "doctor_response": "Hi,Do not go after name of fracture, your son got treatment which up to mark.It will heal after 2 months.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are excessive screaming and black specks on the roof of the mouth a concern?\n\nI have an 8 month old and I gave him lasagna for the first time last night and he screamed all night and has been screaming off and on all day. He never acts like this. I also noticed some black specks in the roof of his mouth. What s wrong with my baby?",
    "doctor_response": "Hello and Welcome to 'Ask A Doctor\" service.  I have reviewed your query and here is my advice.  An infant may cry(or scream) if he is too cold, too hot, ill; has a soiled or wet diaper, hungry or thirsty, eyelash in the eye, hair coiled tightly around a finger or toe, failure to answer the child's needs for comfort, love, and security, or as a result of trauma.  One cannot always find the reason for a child's crying.   I am unable to say what is the cause of the black specks on roof of mouth.  Hope I have answered your query.  Let me know if I can assist you further.  Arnold Zedd, MD, FAAP",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain,shortness of breath and swollen neck lymph nodes\n\nAge:47 Height:5 8 weight: 135 Sex: Male - I have been having lung pain with Shortness of breath, swollen lymph node/s above right collar bone, Pale face color, some weight loss (10 pounds in last 2 months), odd headaches and woozee feeling, with ongoing low blood sodium (136 down to 125) for the past 2 years. I have had 3 chest CT s. First 2 showed mild lymph node swelling (no masses or malignancy) with the 3rd showing what the radiologist called residual thymic tissue with it s own blood supply (Not present on first 2 CT s). 3rd CT also showed inflammation of Rugal folds, Dodoneum, with contracted Gallbladder, and partially collapsed stomach. Have smoked 1 pack for 35 years (but am quitting due to the above symptoms and chest pain). My Primary Care says that my CBC is fine, CT s show nothing significant and other deficiencies aren t serious (low Vitamin D, elevated CRP, Elevated RH Factor) so it can t be anything serious and to quit smoking change my eating habits (I don t really eat badly). Symptoms have become substantially worse over the last several months. I know what it sounds like and I am worried due to worsening symptoms. Is there anything that stands out given the tests and other items above? Thank You for your time",
    "doctor_response": "Hello Thanks for posting at HCM. I see here that you underwent multiple CT scans, blood tests. But you have not mentioned anything about the lymph nodes which you have above your collar bone or in the chest. havent you ever been adviced a lymph node biopsy? I recommend a lymph node biopsy or aspiration from the collar bone lymph node under USG guidance. The aspirate can be sent for further tests. In view of your symptoms like shortness of breath, weight loss and swollen lymph nodes, tuberculosis must be ruled out. Please go ahead with a biopsy from the lymph nodes. Wishing you good healthRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain in head & shoulder blade?\n\nI am having sharp pains in my head on left side. Had them Friday night, Saturday night and this morning. Having pains between my shoulder blade s under right shoulder. Have been hurting in my back down my leg and hips across the front of my left leg at top. I know this is a lot of pain in dif places but I am hurting bad. Please help.",
    "doctor_response": "Hi, It can be a cluster headache that cause radiating pain to other parts of the body like neck and arms. As a first line management, you can take analgesics like Acetaminophen or Tramadol for pain relief. If symptoms persist, better to consult a neurologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had mirena birth control. Stopped bleeding, random spotting. What does this indicate?\n\nIm 20, and a female, ive had the mirena birth control about 2 years now, after a year i stopped bleeding. about a year later im randomly spotting, about a week and a half ago i got in a wreck, and now for about 3 days ive been bleeding, kinda pretty bad, and some times its globs of blood... im scared to go to the doctor i dont know what they will say, can you help me",
    "doctor_response": "Hello. Thanks for writing to us. The random spotting that you are having now is likely to be due to a mild hormonal disturbance. This can happen while using such contraceptive devices. Please do not worry. This is likely to subside in next few days without any treatment.I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal ,drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach ache and diarrhea in a child?\n\n10 year old had strep throat 9 days ago. Also had what looked like an infected mole show up on her back. (Don t know if that s relevant) Day 3, Developed a stomach ache. Went to emergency clinic. Diagnosed the strep throat. Got antibiotics. Sore throat went away within 2 days. Stomach ache has not. Pretty much sleeps all day in the fetal position. Second trip to clinic on day 7. Blood work done. White blood cells are normal. Still hasn t been able to eat without horrible stomach pain and diarrhea. Has lost aprox 6 lbs. Which is a lot consideringredients she s very thin to begin with. Any ideas?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Diarrhea could be because of antibiotic for strep sore throat (Amoxicillin or Amoxicillin Clavulenate). Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting. You need not worry. I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) and ORS (Each small packet mixed of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment. Apart form this Probiotics like saccharomyces boulaardii will help a lot. Best Regards Dr Sumanth Amperayani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is patellafemoral replacement effective for degeneritive disease?\n\nI have grade 3 degeneritive disease of my patella joint in my left knee. I am considering patellafemoral replacement and i am wondering what the success rate of the surgery . I have had 3 other unsuccessful scopes and i need to do something to improve my condition.",
    "doctor_response": "Hello, Arthroscopic repair will be the first choice but in your case, multiple scopies were attempted and failed. So you can proceed with the patellofemoral replacement. Nothing much to worry and your treatment is in the right track. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe leg pain and back pain\n\nHello I have a back pain and legs pain. I do masterbation almost every day since i was 20 . Im now 29 years old Also my sperm is not like before.now when i come its just a little and very light not like before white. Also im lazy most of the time. I sleep more than 10-12 hours a day. I dont like going out of the house and also i dont like meeting people",
    "doctor_response": "Hi,It seems that you might be having false fear of having any side effect of masturbation.Keep in mind that masturbation does not have any this type of adverse effect on body or there will not be having any problem in your marital life in future.Take nourishing food.Avoid laziness and remain busy with your daily activities.Go for regular physical exercises daily.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "High BP, hypothyrodism, cancer of esophagus, enlarged lymph nodes, fatigued. Chest X ray done. What does it look like?\n\nMy grandmother is a relatively healthy 86yr old with high BP(controlled w/medication) and hypothyroid controlled w/levothyroxine. She has a sister that 60yrs ago when diagnosed with hypothyroid was told she had cancer as well and they removed it. Her brother also passed having cancer of the esophagus. She lost 20lbs  about 5 months ago after a bout w/what she thought was a terrible flu. She then 3 wks ago found a enlarged lymph node on the left side. Large enough that if it wasnt in the lymph node it would be a mass. She is still fatigued and isnt able to lift her arms above her head. she can only put them straight out in front of her due to the pain it causes. Her PCP ordered labs and a chest X-ray. And referred her to a doctor(she did not know if it was an oncologist. Upon his return from vacation 2wks later a biopsy was done with a pathologist present. They drew 3 samples and then left the room. Upon their return, the pathologist asked if she smokes, she responded no, he then asked ever ? In which her response was no again. He then drew 2more samples. It's been 8 days (we were told it would be 3-5 days for results) and 3 days ago she got another bout of the flu- even to the point ofdry heaving, she still experienced naseau, and her stools is black. I asked her if it looks like coffee grounds and she said no just black as tar. She is also very weak. My mother in law had lung cancer and a very large mass from shoulder to bottom of ribs(diagonal across the chest along with cancer in the lymph nodes) and has since passed after fighting the good fight. Even my grandmother knows that she is bleeding somewhere if her stoole is black. She is very weak at this point and her symptoms are beginning to worry me as my fear is that this is what I think it may be. She of course had the sore throat along with her flu(s) I understand I do not have results to give you in this narrative, but that is because they haven't given us any. Along with her brother, she has a sister pass before 50 due to cancer, but I was never told of what. Even an educated guess would help me immensely as I will be be the one she turns to if this is what I suspect. I do have experience in the medical field and I want to be prepared for the worst while of course hoping for the best. I appreciate your time and any advice you can give me.",
    "doctor_response": "Hi, I can not understand why the biopsy has been taken for several times. Anyway what was the report of that? black tar like stool definitely signify upper gastrointestinal bleeding. But you have to be confirmed about that. Many a time patient can not assess the nature of stool. In case of upper GI syptomps upper GI endoscopy  and/ or colonoscopy may be helpful. Consult an internal medicine specialist first. He/She can better guide you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it harmful to drink alcohol with glandular fever?\n\nwhat happens if you drink alcohol with glandular fever because i have it and i have been drinkning at least a two bottles of wine for the past three weeks on the weekends and yesterday i started to get a really sore left rib,like underneath my rib ,i also fell on friday if that has anything to do with it?",
    "doctor_response": "Hi thanks for asking question.You want to know about relationship of alcohol with glandular fever.In glandular fever(infectious mononucleosis ) liver is affected.So if you drink alcohol liver will get further damage.So alcohol drink along with glandular fever can lead to hepatitis development.So it is better to avoid alcohol during this fever.Morever your general well being not maintained if drink excess alcohol.So avoid alcohol.I hope i have solved your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chronic stomach pain, had diaorrhea, pale, feeling drained. Cure?\n\nHi last night i woke up with chronc stomach pain went to the bathroom and had diaorrhea i broke out in a cold sweat wemt pale and felt very very weak. Sat on the toilet for at least 20mins. Regained some strength then washed went back to bed. The stomach pain continued for about 10minutes these were like cramps so came and went. Now woken several hours later and feel drained.",
    "doctor_response": "Hi, Abdominal pain along with diarrhea is common phenomenon. But in your case you had cold sweat, went pale, feeling of dryness, weakness and not able to rise for 20 mts after defecation shows that you have passed large amount of watery stool. Some time single stool may produce symptoms like this particularly if the stool is rice water in nature. So examine the stool, along with routine for vibrio cholera also - which produces more than 1 liter of watery stool in single defecation. as you feel drained, even though you have not passed stool after that consult a dr and follow his advise. Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does high bilirubin level in an infant indicate?\n\nhi  my brother daughter passes stool in pale yellow when we done tests it has shown high levels of bilirubin  doctors suggested to go for a hida scan baby is 5 months old hida scan says that it is suggesting biliary artesia noe they have suggested a liver biopsy we have done it we are waiting for the result.metabolicreports are normal plz suggest me",
    "doctor_response": "Thank you for consulting Healthcare MagicI'm sorry to hear about the condition of your brother's baby.Biliary atresia means the normal passage of bile from liver is impaired. The bile gives the normal color to the stool hence the stool is pale in color.The bile which cannot pass into the intestines get absorbed into blood and causes bilirubin level to rise.The liver biopsy study is done to rule out any pathological conditions affecting liver proper.The treatment of biliary atresia is mainly surgical. Surgical correction method is decided by the level of atresia.Please revert with further details like the complete HIDA scan report for commenting further on the mode of surgery required.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "No indication of ovulation. Done semen analysis test, prolactin tests, LH test. What is going on?\n\nwe are trying for a baby since 14 months...many tests like foliculometry,HSG,LH test,prolactin, my semen etc have already been done..doctor says there is no such problem. This month doctor given HUMOG injection on 3rd day from last period started. As doctor advised to have a self-test of Ovulation through \"ovulation test strip\" from day 11 up to day 18. But there are no indication of Ovulation... What can we do?",
    "doctor_response": "Hi Dear,The description given by you is not complete. Evaluation of an infertile couple also includes their age, occupation, how long married etc..On one hand you says that all reports were normal and on the other hand you were put on ovulation induction medication but than too there was no ovulation. perhaps you are having difficulty in ovulation which require treatment in form of oral medicines and injectables with dose adjustment each month depending on the response.In your case may be the dose need to be increased next month.This treatment requires time.Believe in your doctor and continue with the treatment",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of nasal bone deviation?\n\nI have got my nasal bone deviation. due to nose block frequently, i consulted ENT and he suggested if there is severe problem in brething, we may have to go for a minor surgery. recent past i had breathing problem and consulted a chest physician, he told me to use inhaler and right from childhood i never had asthma/breathing problem. ECG normal. due to nasal bone deviation, did i have developed breathing problem or due to lung misfunction",
    "doctor_response": "Hi,Deviation of nasal septum is found in almost 25 percent of population. It can cause blocked nose and recurrent sinusitis or rhinitis. If it is causing you such frequent infections then surgical correction will be needed. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Nishad B. N., General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes light periods,pimples,mood swings and tender breasts?\n\nHi, I am a 22 year old female who has been having regular sex for the past few months. About two weeks ago I started noticing loads of pimples on my face and chest, tender breasts, mood swings and a really obvious dark ring around my nipples which are also sensitive. My period was due a week ago, I had some spotting a few days early and a few days after it was due but no real period. Have done home pregnancy tests which were negative, except for one which was a very faint positive and a blood test was negative. If I am not pregnant, what else could be causing these symptoms?",
    "doctor_response": "Hi, I think you could be having a biochemical pregnancy, because you got a faintly positive result on your test once. It can also happen due to hormonal imbalances.  If your periods don't come in a week, repeat a urine pregnancy test.  If negative, take medicines for inducing periods.  If positive consult a doctor.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medication can be used to treat PCOD ? What pills can be used to enhance fertility ?\n\nhello. i got married and having a baby girl, who is 4 yrs old. two year back i hv diagonised as pcod. then i used oral contraceptive pills . now i want to conceive. for that from last 2 cycles, i am using letrozole. and from last month, i am also using metformin. but no pregnancy . my age is 28. all other reports are normal. plz help.",
    "doctor_response": "Hi You will have to take letrozole for a few cycles before you see any improvement.You will have to undergo treatment for a while longer.Also ultrasound scanning needs to be done to measure follicular growth.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lumps on the nostrils\n\nHi I have a small white painless lump in my left nostril which is on the septum and visible when I tilt my head. Its been there about a month. Maybe v slightly bigger? have been putting on antibiotic cream for about 5 days but it's not going away. I think I may have cut my nose when removing some nasal hair prior to this? What could it be and how do I get rid of it as feeling self conscious now thanks",
    "doctor_response": "Respected user , HiWarm welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This seems to be nasal polyp .*  Requires confirmation with the clinical check up and decide further  line      of  action  which  may  be  in  form  of  surgical  removal .Hope this will help you for sure .Wishing you fine  recovery .Regards dear take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to relax myself during panic attacks?\n\nHi doctor, I am suffering from depression for the last two years. My doctor had changed my drug recently to a new one, which is Zoloft. I have been taking it for a month maybe. I am traveling now and in the airplane I got tired along with depression and severe panic attacks. Even, after reaching the place I could not settle down. I feel as if my heart is going to stop beating from fear, anxiety and panic attacks. I do not really know the reason. I just need something I can do in order to relax from these symptoms. My flight is after two days and I really do not know how and what will happen. Before a year, when the severity of the depression was stronger than now, I did not breathe and the emergency staff gave me oxygen. How to make myself relax? I am really trying to calm down. I am telling myself not to fear and relax without thinking anything. Please help me.",
    "doctor_response": "Hi. I read your query and understand your concerns. I am glad to know that you are willing to take necessary steps for avoiding similar problems of depression, which had crippled you last year. Although all kinds of behavioral intervention need personal interaction and complete assessment, but deep breathing is the one, which can be used in any situations without much effort. When you feel something is wrong do deep breathing. Allow a single breath of in and out around 10-15 seconds. This will help you to control the tiredness and fatigue. Secondly, keep yourself hydrated. Take at least four to five liters of water every day, including the day of travel. Thirdly, ensure proper sleep if possible. If you are not able to sleep properly without medication, then consult your specialist doctor and ask for a prescription. For further information consult a psychologist counsellor online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why asymmetric face looks different in mirrors?\n\nHi, i m a male with an asymmetric face. It bothers me constantly, but oddly no one has ever noticed it except for me. As a matter of fact, everyone thinks i m cute for some reason. If I stand in front of two mirrors(one slightly tilted), it can clearly be seen that my nose, chin, jaw, and cheekbones are bending so that it looks like someone stretched my face to the right hand side. It s quite an ugly sight. If I ever have a picture taken, the deal is the same and I look hideous. Yet, when I look in the mirror in front of me, everything seems normal! If I tilt my head one way or another, I notice a slight difference if I stare really hard for at least 3-4 minutes. Otherwise, I don t see it. So, i m just confused. It is impossible for people to hide something like that from me because I have met some really mean people who will make fun of anyone they see anything wrong with! Plus somehow i ve had three beautiful girls fall for me in my 20 years and I know it was mostly because of my looks. I have thought many times about how this has occured, but to no avail. Does anyone have an explanation why I look hideous in pictures and double mirrors, yet cute in real life ? Is it something to do with how mirrors and lenses work or something? Any useful comments would be appreciated.",
    "doctor_response": "Hi, Probably the tilted mirror is giving you false images. So better be proud of your face and do not think negatively about it. Rather I would say fall in love with your face\". Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes leg cramps and lumps at the back of leg?\n\nAn 89 year old lady was taking 20mg of diutric, one-half 5 mg of potassium a couple of months ago. She stayed in a nursing home in Kansas for 6 weeks and had to switch to a Kansas doctor. She is now home but is still taking the same diuetric but a whole potassium. She is experiencing leg cramps and the back of her legs feel very lumpy. What can I do at home to help her?",
    "doctor_response": "HiThanks for your queryBased on your query, my opinion is as follows.1. Leg cramps is mostly related to electrolyte imbalance mainly low potassium.2. Since she is already on potassium supplements, you can get serum potassium levels checked to see if she is getting right dose.3. Lumps and cramps in elderly may also be because of varicose veins, which is quite common with sedentary life style.4. If there are too many prominent veins, then she needs to get a Doppler study for varicose veins.5. You can try using elastic stockings to reduce the swelling and improve venous drainage. Foot raise will also allow to decrease the swelling.Hope this helpsRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Z-pack increase your heart rate and cause anxiety?\n\nI had a doctor prescribe Zpack for me yesterday. I have shortness of breath and chest tightness, I was also wheezing, but when he listened to me breathing he didn\u2019t hear it. I\u2019m really worried about taking this antibiotic because even though I\u2019m not allergic to any medicines that I know of, he didn\u2019t really ask me many other medical questions to see if this was a safe option for me. I read this medication can increase heart rate and people have went into cardiac arrest? I already have a resting rate of about 105, and pretty bad anxiety. I just would like some reassurance that this is safe drug and I don\u2019t have to worry about deadly side effects..I\u2019m also a smoker/34 year old female.",
    "doctor_response": "Hello, Greetings from icliniq. I understand that you are worried about the side effect of the prescribed drug. In my opinion, Azithromycin is one of safe drugs, so do take the medicine without any doubt. Secondly, I would like to know your history in detail. And last but not least, according to me its a good time to give a thought about quitting smoking. And I can help you. Do let me know. Take care. Spirometry testing with bronchodilator reversibility testing allergic bronchitis, bronchial asthma worsening due to smoking Smoking cessation. When investigations are available and then as required.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i drink wine and do cycling after kidney removal surgery?\n\nJust had a kidney removed 2 weeks ago, I hav always enjoyed a couple of glasses of red wine in the evenings. Should I give this up?Second question I am 66 years old and have been riding bycyclesfor the past 20 years,maybe 2 hours per day, can I continuethis?",
    "doctor_response": "Hello and welcome to HCM.1.As an Urologist, i must assure you, that cycling and red wine isn't restricted after kidney removal. However, you're advised to wait for a month for cycling.2.You start cycling with half hour for two weeks, then increase by half hour every week, till you cycle two hours per day.It's good to keep healthy by exercising daily.It helps to keep your blood pressure and cholesterol in control.If you've any other doubt, you may send it as a direct question.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Pain increasing gradually even after using a heel pad for plantar fasciitis. Please help.\n\nHi I have been diagnosed with plantar fascitis. Doctor said to use heel pad. Using it but no relief. Pain is increasing gradually. Please help.",
    "doctor_response": "hi, welcome to icliniq. Sorry to hear about you being troubled with plantar fascitis. it's a fairly common problem. heel pad is indeed helpful but apart from it you need to stop walking bare foot as much as possible. don't use any accupuncture type of footwear, use soft footwear. contrast bath is helpful- alternative warm and cold water fomentation one after other for period of 10 mins atleast twice a day is beneficial. if there is no relief after this conservative treatment along with some pain killers, local steroid injection (methylprednisolone) injection at the site of maximum pain can give you immense relief in those symptoms. please get the injection only from orthopedic surgeon. i hope you get cured of your ailment. feel free to ask any other querry. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes child to be unable to breath sometimes?\n\nI have a 7 month old who at times gets strangled easily and at other times will suddenly be unable to breath. He acts as if he were holding his breath; however, he isnt he just cant get air in. He turns blue nearly passing out before finally regains ability. Can the flap that prevents foods etc from going into your lungs be sticking and causing inability to allow air passage also?",
    "doctor_response": "Hello,Many infants go through what is called as breath holding spells. There is no known cause for it, and it seen more often than one would think, these usually last for about 1 minute. Breath holding spells occur when baby is hungry and cries or is seeking attention and does not know how to express.Infant breath-holding or turning blue is more common than you think in babies. As a parent you will be scared to death but please understand that the infant does not have it in him to hold his breath long enough to cause damage. The body\u2019s natural mechanism of breathing will kick in and override the forced breath-holding.You should be concerned if they happen too often or while feeding or happen because of high grade fever or seizures.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Vignan Rachabattuni",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to prepare lactodex supplement?\n\nHi, I have delivered twin babygirls on 8th April 2014, in 38th week .. Doc advised me to give lactodex when babies still feel hungry after breast feeding .. I prepare lactodex suppliment which seems bit curdy in look wise,is that the normal look .. i boil water and use when its cold as per the usage advice on box ,., please suggest if its been used in right way or not ..",
    "doctor_response": "Lactodex supplement for preterm has to be prepared in a correct strength. Add 1 scoop of the powder( use the scoop provided in the container) in 30ml of water. if you are preparing larger amounts always follow the this same ratio. Always discard the left over milk after feeding.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden depression?\n\nI sometimes feel quite depressed but can't seem to figure out why I feel this way in the first place. I'm not always depressed, I feel happy a lot too but Im just slightly worried it MAY be something a little bit more serious that I should have checked out... I think I'm being a bit dramatic so I'm sorry if I've wasted your time!",
    "doctor_response": "HiThanks for using healthcare magicThe common cause of depression is stress. May be due to some work related stress, you have been feeling some depressive symptoms. In that case, you should consult a psychiatrist for mental evaluation. You can try some antidepressant at low dose. That would help to improve your mood. You can also try some relaxation technique or life style modification method if you do not want to take medication. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain while passing urine?\n\ni am a male, and having a hard time going to the bathroom because of harsh pain in my lower abdomen, and it is continuing to hurt although i am not trying to use the bathroom anymore, i had a hernia before,and was wondering if my previous surgery was the cause,or if it is something to be concerned about??",
    "doctor_response": "Hi.Harsh pain in lower abdomen and difficulty / pain while passing urine is due to urinary tract infection, cystitis meaning inflammation of the urinary bladder being prominent to cause pain in lower abdomen. This may not be related to the hernia surgery unless it was done by a Laparoscopy route. I would advise you the following:Blood- complete blood picture, kidney functions tests, blood sugar fasting and post-lunch, Urine- routine,microscopy, culture and sensitivity ( before start of antibiotic)Ultrasonography of abdomen.Get started with proper treatment, antibiotics, alkalinizer , take plenty of oral fluids.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should the ER be visited for pain and tenderness in the jaw?\n\nMy 23-year old daughter is experiencing pain in her upper left jaw - she says it feels almost like an ear infection starting.  Also the area just under her chin on the left side is tender to the touch and hurts when pressure is applied.  She's had this but no other symptoms for three days.  Should she go to the urgent care or wait a few more days to see if symptoms subside. (She will not be able to see her primary care doctor during the weekend hours.)",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The symptoms of pain in upper left jaw with a feeling of beginning of ear infection is pointing towards sinus infection or sinusitis.However it can also be due to any decayed tooth or nerve related pain.So yes, she should consult an Oral Physician or an Emergency room and get evaluated.A clinical examination and if needed an x ray of teeth/sinuses can be done for confirmation..If there is infection then a course of antibiotics like Augmentin, Azithromycin etc can be advised.Along with it anti inflammatory painkillers like Ibuprofen can help in reducing pain.If there is sinus infection then along with it decongestant nasal sprays can help in improvement.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Honey Arora..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in the cheek while on antibiotics?\n\nhi, I had an inpacted wisdom tooth extracted june 30th I was on a course of antibiotics drurning /after extraction - a few days after the amoxicillon ran out i started swelling aging - so after a few days of more swelling and ear ache on same side doc recomended another course of amox - all was well for a week then the swelling started again - now it is August 4th and dock just gave me a scrip for clindamycin - could anything be causing swelling besides infection? i have no bad taste in my mouth or no liquid coming from socet",
    "doctor_response": "As it is vaning off due to Antibiotics it is only because of the infection. As your doc prescribed you another antibiotics you must go with it because most of the times people are resistant to some antibiotics may be in your case too.  As you have undergone Impaction treatment and perhaps post treatment infection, the swelling is only because of it. You don't need to worry. Hope you will be healthy soon. Regards ...........",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for rashes in scrotum\n\nlast year i traveled to austria while i was there i developed a severe rash in my scrotum area on the upper inside of my legs. i lost several layers of skin. now the area is very sensitive and my scrotum becomes sticky several hours after i shower. i shower every day and make sure i dry off well. please help, i have tried powders lotions etc and nothing is helping",
    "doctor_response": "Hi,Hi,You seem to have chronic scrotal dermatitis with intertrigo. There may be erythema,dryness,mild scaling, fissuring and crusting. You might have mild pain,burning and itching. There may be some cause.rubbing or scratching might exacerbate the disease.excessive bathing,wetness,perspiration,soap,detergent,powder,cloth, dusts...etc might be resposible. Fungal infection in groin might precipitate the disease.Vitamin B complex deficiencies,anaemia or nutritional inadequacy might cause the disease...You consult dermatologist for firm diagnosis and treatment of its cause.Have blood tests to rule out any internal disease or vitamin deficiencies.Take antihistaminics to relieve itching. Steroids in tappering dose may be taken. Antifungal like clotrimazole with mild steroid may be applied in groin areas.You may take folic acid 5 mg thrice a day with iron tab. Antibiotics may be needed if there is secondary bacterial infection. Apply antibitic cream with mild steroid like mpmetasone on scrotal skin. Avoid contact with all suspected factors.You might get good result after few weeks. I hope this would help you in your treatment.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain after alveoplasty?\n\nHello, my husband had all of his teeth removed almost four weeks ago . The dentist said they would shave his protruding bones during surgery. Our dentist had an emergency and they called in another dentist who removed the teeth but did not perform the alveoplasty. This last Friday his dentist opened him back up along both top and bottom gums to do the alveoplasty. He is in incredible pain and it goes up into his sinus area. Is this normal?",
    "doctor_response": "Thanks for your query, i have gone through your query. The pain in the jaw is normal after a sugical procedure particularly after bone cutting.Nothing to worry complete the course of antibiotics and analgesics. When you go to get the sutures remove check for any sharp bony edges. If there are any sharp margins then get it smoothened. Do saline gargling.i hope my answer will help you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a painful hard lump in the ear?\n\nI have a hard bump in the entry of my auditory canal on my right ear. It's very painful and is also causing discomfort on my jaw joint. The beginning process was a pimple which when I popped it provided me with a short relief. However, about 2 days later was when I noticed the hard bump. And then 1 day later or yesterday is when I began to feel the pain. Please tellme what I should do?",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .* Acute inflammatory process in the lump with possible abscess formation .* Though primary relief with analgesic as ibuprofen ( 400 mg ) , I strongly   recommend to consult your surgeon for immediate assistance before it   flare up .Wishing you fine recovery .Feel free to ask any further  queries .Regards  .Dr. Bhagyesh ( MS , FMAS - consultant surgeon )",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will using Ketoconazole be useful for itching & rashes on testicles?\n\nI had a case if jock itch and now the rash is gone but my testicles are inflamed and itch like crazy.  nothing seems to sooth the itching and it at a point i cant sleep.  do I still continue to use the Ketoconazole i was given by my Dr.  or is this something else?",
    "doctor_response": "Good day and thank you for being with healthcare magic!!!I would recommend stopping the ketoconazole because it must be causing the irritation in your scrotum. Wash it with mild soap and water and skin moisturizer will Also do to prevent further irritation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the risks, benefits, and side effects of Montair LC kid syrup\n\nMy Son doctor prescribed Montair LC kid syrup for 3 months.5 ml once in a day. weight 13.5kg Is it Ok to give for 3 months? He generally catches Cold which start from running nose and chest congestion and sometimes ended up in cough. But this is not because of his allergy. We found it happens when he eats something cold which make its throat unrest first or if he wet bed in night. Would you like to advice any medicine for my Son to increase his immunity so that he can enjoy icecreams Or else this is age group which gets immuned automatically as he will grow up? Please do advise. Regards",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Unfortunately best treatment of allergic rhinitis is avoiding cold and allergens. Please, do continue given treatment. Increase outdoor activity and sports. If possible teach breathing exercises. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the pain in the arm?\n\nFor a whole two days now, my husband has been complaining of a continuous pain on the upper right arm, and pins and needles in the thumb, middle and index fingers in his right hand. He is unable to sleep because of it. He said it feels like something deep in the muscles of his upper arm.",
    "doctor_response": "Dear Friend.Hi , I am Dr Anshul Varshney , I have read your query in detail , I understand your concern.It seems he has got some nerve compression causing these symptoms.I would advice you to see a doctor. He would do a clinical examination and would give you a conclusion.If inconclusive he might require MRI / Xray off Cervical spine.At present he might take a pain killer like Acetaminophen in moderated dose.A Hot fomentation over the neck should also help. This is my personal opinion based on details available here.  If you still have any query you may please ask me.Stay Healthy. Dr Anshul Varshney , MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take Diamicron with Insulin?\n\nCan I take Diamicron Mr with Insuline? I take 0 Unints of rapid in Morning with Junivia 100mg, 30 units in lunch, 25 in dinner and long acting insuline in night 25 units, but my blood sugar in fasting is 140 and random 210, so doctor suggests diaicro Mr 30mg. for this reply I willnot pay you.",
    "doctor_response": "Hello, You may take this medicine along with insulin. But to control fasting blood sugar under control you may increase the dose of basal insulin at night or intermediate acting insulin in the night. If you're facing hypoglycemic episodes means consult with your doctor he will examine and change the medication. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Penchila Prasad Kandikattu",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and fever in a 2 year old?\n\nMy 2 year-old son has had fever of 99.9-101 off and on for 9 days and has complained of WTO ah pain off and on. When in pain he cries and refuses to eat. Bowels seem to be normal. took him to doctor yesterday who tested for strep which comeback negative. Tummy is not sore to the touch.",
    "doctor_response": "Hi.... intermittent fever for the past nine days could be viral illness or it could also be Typhoid fever.If I were your pediatrician I would suggest doing basic blood workup along with widal test and blood culture. I at the same time will start on a course of Azithromycin for 7 days pending blood cultures. The dose would be 20 MG per KG per day as a single dose.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be done to stop habit of masturbation?\n\nHi, may I answer your health queries right now ?  Please type your query here..doc, how do i stop  my mind to shake my penis .is this dangerous for health or in making girl pragnent protein milk in my penis start leaking out when i touch my penis what should i do .plz help me",
    "doctor_response": "Hi, Masturbation for thrice a week is normal and good to health. To avoid over masturbation, regular exercise, physical games and yoga can help you. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in the arms?\n\nI have an extremely swollen left arm pretty much swollen & tight feeling from shoulder right to wrist/hand it is worst at the top of my arm from elbow to shoulder my veins are showing I also have some broken capilliaries looking a purple colour top of arm area and on my chest area on the same side asf swollen arm - it is an arm that I have previously injured a few years ago in a fall I am not in pain but have had some sharp twinges of pain in and around the inside of my elbow I woke up with this 2 weeks ago I went to Hospital A&E they suspected may be a blod clot but they couldn t see one on an ultrasound scan of my arm - so far the docs I have seen have just not much idea!",
    "doctor_response": "HelloI will also advise CT angiography in neck and arm if MRI spine is normal.If you have done MRI spine send report or film to me.Venous clot can lead to swelling and one sided heaviness which can be ruled out by CT angio.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.\u00a0Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is vascular inflammation and cerebral venous thrombosis of the brain,same?\n\nIs vascular inflamation and cerebral venous thrombosis of the brain the same thing?  We've been getting all kinds of diagnosis for my mom.  MRI/MRV shows something definitely something in her brain.  Her symptons are severe headaches, confusion, nausea, etc",
    "doctor_response": "Hello,Vascular inflammation is different form cerebral venous thrombosis. Cerebral venous thrombosis is a type of stroke. While vascular inflammation is not stroke, but it may lead to repeated stroke.These two disorders have different manifestations on the brain MRI and different clinical symptoms.Sometimes, they may overlap: vascular inflammation can lead to cerebral venous thrombosis. You should discuss with her doctor on these issues.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Aida Quka",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could the pricking sensation on lower back and arms suggest?\n\nHello. My name is Lauren and I m 17.I m very scared because today I had needle like pricking, in my lower back and on both my arms. Yesterday and around two weeks before I couldn t feel my tongue whilst eating.I m not overweight and last time I checked I had a fairly low blood",
    "doctor_response": "Hi welcome to hcmyour symptoms could be related to excess strain.take rest for one week and take analgesics.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump on the collarbone indicate?\n\nHi, I have booked an appointment with my doctor but I have a lump which feels like bone below my collarbone. I had pain across collarbone, which I thought was a pulled muscle. I placed a heat pad on it and the pain is gone but the lump is still there?? Really worried please help",
    "doctor_response": "Hi.This is the most unusual site of development of a lump. Do you have a history of fall or pulled upper limb. There can be a small fracture of clavicle giving a hematoma which appears hard as you have noticed. Well an X-ray would help as is the clinical examination by a Doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe chest pain and rapid heart rate\n\nA lot of things cause my heart to hurt. Almost like its enlarging and all of a sudden it doesn t have enought room in my chest. ex: when I go for a run, cleaning around the house, or even when I take a bath. It just starts this huge thumping and increases in speed and then it s hard to breathe. I understand running and why that can happen. By why also every day activities? I have iron-deficient anemia and tend to that as needed.. But could that have anything to do with it?",
    "doctor_response": "yes anemia can cause sob and fatigue due to poor O2 carrying capacity. Prolonged anaemia may cause enlargement of ht and may cause CHF and fast heart. Get ur anemia corrected. Also get EKG and chest X-ray to check for CHF and to detect any arrhythmia.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for reactive hypoglycemia,low iron and vitamin D levels\n\nI have reactive hypoglycemia and I was just told my iron level is 3 should be 15-30 and I have low vitamin D . I am taking 3,000 IU a day and still came out low. I have fibromyalgia for 20 years. These others things have just happened now. I am 50 years old.",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You are suffering from iron deficiency. You should take iron rich food like jeggary, dates, green leafy vegetables, dry fruits etc. You can take oral or injectable iron supplements.  For vit D3 you should take cholecalcitriol and calcium tablets.  Ypu should search for the cause of reactive hypoglycaemia.  You should keep sugar with you in emergency. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for psoriasis\n\nhi i am mahesh i am suffering with psoriasis since last 4 years first i have tried a treatment in homoeopathy but i did not get any result after that i went to English medicine my doctor suggested me onctorex 10mg is there any side effects of using this medicine for long time and is there any other treatment to get rid of this disease completely",
    "doctor_response": "Hi,You said you suffer from psoriasis. You may be knowining that psoriasis is a chronic skin disease of unknown cause. It is an autoimmune disease. It relapses even after treatment.Stress and dry wheather might precipitate. It is a controllable disease. To prevent relapses,you should continue treatment regularly under observation of dermatologist.You may continue methotraxate 15 mg per week....5 mg at 12 hrs interval 3 dose in a week. At this low dose, toxicity is rare. You should undergo regular blood tests at certain period.Stomatitis,aphthous ulcers may be there due to methotraxate. Folic acid tab may be taken to relieve oral side effects.Cap acitretin 10 mg daily is other alternative. Local application of combined oint of steroid and salicylic acid may be considered.I hope this would help you.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for renal failure\n\nDear Sir, My mother is suffering from renal failure, her later lab report is given below : Creatine : 8.2 Blood urea nitrogen : 64 She is not willing to go to dialysis, hence request you to kindly infrom whether there is any medicine for this renal failure without dialysys",
    "doctor_response": "HIWell come to HCMThe serum creatinine level is too high and in such condition dialysis is the only option is there is no other therapy is there beside the dialysis in my opinion your mother need this, in my opinion this is most advisable, hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI shows foraminal stenosis, causing moderate radiculopathy, loss of strength. Advised surgery. Opinion?\n\nMy MRI report shows foraminal stenosis at c6-c7 and a major extrusion on the left side causing moderate radiculopathy and loss of strength. The symptoms have been ongoing for four months with physical therapy , chiropractic care, anti-inflammatory meds and gabapentin . My doctor has now referred me to a neurosurgeon and believes that surgery is most likely necessary. Would this be ab accurate assessment?",
    "doctor_response": "Thanks for the query, i  have noted your problem, Management of radiculopathy related to disc diseases include conservative followed later by surgical if the patient dose not respond to conservative treatment. Further you have deficits  and there is MRI correlates for the same. I agree with your doctor and you can undergo surgery to get relief. Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant itchiness all over?\n\nHi, may I answer your health queries right now ?  Please type your query here...Hi there, I have had a problem for a few days, feeling constant itches further inside.  I don't think it's a yeast infection, but I could be wrong.  What do think this may be, and would you suggest or recommend?  Please let know, I would appreciate it.Thank you.",
    "doctor_response": "any general allergic response can acutely present with Itiching all over body.dry skin can predispose to itching.maintain adequate hydration by drinking water, use moisturiser to avoid dryness.tab cetrizine can be considered but on advice of a dermatologist.a consultation to local physician will help.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My asthmatic mother's X-ray is negative for TB. What else this could be?\n\nHello doctor, My mother has asthma as she used to smoke and live near roads. Her X-ray showed that trachea is in the midline, the cardiac shadow is not enlarged, pulmonary vasculatures are not prominent, hemidiaphragm is flattened, costophrenic sulci are blunted, right lower lung infiltrates present and pneumonia entertain. Please correlate clinically. Emphysematous changes are also considered. The last X-ray was negative for tuberculosis. She was using Ventolin as nebulizer three to four months back.",
    "doctor_response": "Hi. I have checked the attached report, along with the data you provided (attachment removed to protect patient identity). Your mother has COPD which is a chronic obstructive lung disease due to changes in the lung with age and due to smoking. In COPD the air is entrapped inside the lung with difficulty to get it out, so the oxygenation is impaired. Thus the patient becomes hypoxic with frequent exacerbations in winter with any infection of the lung. The infiltrates found in the right lung are due to pneumonia. The treatment includes inhalers regularly with antibiotics and long-term home oxygen therapy may be required if certain criteria are found. To identify the stage, I need to see her oxygen saturation in room air and arterial blood gas test. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can chiropractic care treat pain in shoulders, neck and back?\n\nI have been experiencing severe pain on the right back side of my neck, down into my shoulder and upper arm, and extending down the right side of my upper back close to the spine.   I have been diagnosed with GERD and had an endoscopy last year.   Will a trip to the chiropractor help this new pain?",
    "doctor_response": "**1. The pain to the hand combined with upper back pain indicates that nerves leaving your spine are being compressed; it is likely happening in or around your lowest cervical vertebrae in the neck, C6 or C7. The compression could be caused by a bulging or herniated disc between the vertebrae, so consult an orthopedic surgeon for necessary examination and investigation [X-ray cervical spine]2. also occupation can be one culprit for the same: postural dysfunction can cause neck/ back pain3.  General Instructionsi. Maintain straight back posture while sitting or standing.ii. avoid bending forwards and lifting weights.iii. sleep on hard mattress.iv. gentle massagev. back exercises: Leg raising in dorsal recumbent position, push ups, swimming. [once acute stage is over]Spine Management:i. Relax the spine completely.ii. Do not lie face down.iii. Lie on your back with pillow under the knee.iv. Lie on the side with a pillow between the knees.v. Distract your mind from the pain, watch television, read light humorous stories, listen to soothing music.4. A Chiropractor or Osteopath can perform joint and spinal manipulations to release pressure on nerves which may be causing referred shoulder pain. PS. People who have osteoporosis, spinal cord compression, or inflammatory arthritis, or who take blood-thinning medications should not undergo spinal manipulation. In addition, patients with a history of cancer should first obtain clearance from their medical doctor before undergoing spinal manipulation.5.  following preventive aspect can be tried in GERD to alleviate symptoms:. bland and soft diet, more of milk . avoid hot drinks and spicy food. give small, non-bulky meals more frequently [since GERD causes hiccups/ irritability]. head high position at night. [since GERD causes regurgitation/choking]PS. Management of GERD in adults is based on disease severity, the degree of symptoms, and presence or absence of complications of GERD determined by the diagnostic evaluation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will my mother s creatinine level come down?\n\nhi my mom she had kidney problem.earlier her creatinine level was 3.2 but last week she had neck pain so she went to ortho dr he prescribed some pain killer, due to her creatinine level increaed.dr said due to pain killer her creatinine level increase. again her creatinine level come down or not plz ans",
    "doctor_response": "You should take ur mother to a Nephrologist and should continue follow up with so  that she can b helped with creatinine level , n for Neck pain u can give paracetamol in severe pain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe collarbone pain\n\nI ve been having extreme collarbone pain on my right side and it s been months. It hurts when I deep breath now and bend over or even laugh. It wakes me up at night and I can t move my arm I have to hold my upper shoulder and slowly move over. Please help!!",
    "doctor_response": "Hello, I have studied your case. I will like to give few differential diagnoses for your symptoms.There can be thoracic nerve compression in spinal canal leading to right sided pain from rib to arm.Due to compression of this nerve root there is pain in your rib and arm.I will advise you to do MRI spine for this.Another possibility of abdominal mass leading to pain on right side.CT scan abdomen with pelvis will help to get further details.Till time for these symptoms analgesic and neurotropic medication can be started.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and redness in feet and tingling in shoulder?\n\nI have had swollen feet the past few years usually after flying. it has become worse and there is redness. I have also been experiencing vertigo, I cannot close my eyes without holding on to something. I feel tingling from my left shoulder down to my elbow about 50 percent of the time. I regret trying meth because I ve been on it almost daily for 14 months. started snorting now smoking. Are these symptoms related. Male, Cauc, 44yrs 601, 200lbs.",
    "doctor_response": "Hello, Your use of methamphetamine is a risk factor in the development of your symptoms of dizziness/vertigo. The swelling in the feet may be due to what we call dependent edema and can be resolved if you are on a plane by taking walks up and down the cabin aisle every 1-2 hrs. The tingling sensation may be due to an entrapped nerve in your shoulder or neck that can be worked on by physical therapy and possibly released. I would recommend you consult your physician or an addiction specialist on the best path to take to be able and suspend this activity on a permanent basis. I formerly did head up an addiction center and so I know how difficult \"kicking the habit\" can be. But if you don't, the long term consequence of meth are unfortunately not good at all. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for a lump on the buttock\n\nI am female and have a skin growth on buttocks cheek for 5 yrs. it is round and puffy no head on it. Looked at lots of photos even sebaceous cysts does not look like them. It is the size of the tip of my finger and is external like attached to the skin. Looks like a sac of puss and the skin around it is now infected and sore not the sac itself. Can I do something myself to get rid of this unsightly thing. Please help.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  You may have some polypoid skin growth like fibroepithelial polyp. You should go for excision biopsy of that growth and go for histopathological examination. Then if needed take further treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could random twitching in left and right foot suggest?\n\nmy left and right foot keep twitching. It doesn't actually move, it just feels like the muscle is randomly contracting and relaxing. I've not experienced any other symptoms. This twitching started at night about a week ago and now occur randomly throughout the day.",
    "doctor_response": "Dear patient muscle twitching is common sign of deficiency of serum calcium ie hypocalcemia. it is also common in patients with anxiety and stress. Are u  anxious or in stress? does this twitching occurs only when you are free and thinking over? if yes it's sign of anxiety. I would like to advise serum calcium levels to rule out hypocalcemia. meanwhile start tab shelcal 500 mg twice a day with tab calcirol 60000units once a week for 4 weeks. Visit to your nearby physician will be helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can wrist fracture be cured?\n\nHi...i am having a scaphoid fracture in the left wrist from last 8 months and i wasn t aware of it until now. CT scan report states fracture scaphoid bone is seen in the region of its waist.tiny fracture fragments are seen adjacent to it. no significant callous and new bone formation is see. rest of the carpel bones are normal. impression:-non united fracture scaphoid bone MRI report states old fracture of scaphoid with displaced distal segment anteriorly.there is aprroximately 3.5mm step-off at the fracture site.mild marrow oedema is observed in the distal segment,appearing hyperintense on PDFS and hypointense on T1 W images.a few small scattered bony fragments are also seen.no degenerative changes are seen.small amount of fluid is observed in triscaphe joint.findings;-scaphoid nonunion (type II). i want to know if this fracture can be fixed 100% and by what method?",
    "doctor_response": "hithank-you for providing the brief history of you.As this scaphoid fracture is old and non united a thorough clinical examination is advised to understand if there is any motor or Neurological functions compromising. After a thorough clinical examination and understanding the MRI reports if the motor and Neurological functions are getting compromise then a surgery can be planned to refix the fractured scaphoid bone.Ofcourse a surgery can fix this issue but the criteria of the surgery has to be met.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain during pregnancy\n\nhiya could u tell me what u fink plzz.... im roughly about 26 weeks pregnant with 3rd baby an past few days ive been havin what i fink is braxton hicks with lower back pain on an off only i woke this morning feeling crampy evrywhere an now my lower back an pelvis r really hurting",
    "doctor_response": "Hi,  Low backache in pregnancy is an expected problem.This is because,spine adopts an attitude of LORDOSIS to bear the extra weight of the uterus.This in turn causes more strain over the low back as a result of which your para spinal muscles go in for spasm thereby causing pain.TREATMENT: low back exercises with hot water fomentation should make you feel better.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will typhoid infection completely cured after having medicines?\n\nHi it was confermed that i have typhoid a month ago in a blood test doc Prescribed me tab for 10days and its been 20days exceded how will i know that the infection is still inside me or not yea i have no fever from 20days but my stomach seems to be upset quite",
    "doctor_response": "Hi,Typhoid can be completely cured after full proper course of antibiotics.We have to observe strict diet plan.Avoid fried, chillies and junk food for about a month.Titre of S. Widal will remain positive there for some time.As typhoid is a disease of intestine it will take some time to become completely alright.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from white spots on whole body. Diagnosed as hypomelonasis. Home remedy?\n\nHi , I am deepa 28 years old and suffering from white spots in my whole body from last 2.5 years. Doctors detected it's a hypomelonasis, but they are not providing any treatment ,as saying it can't be treated. I am currently residing in US from last three months. Can you help me out with it or can you recommend me any home remedies that I can apply on it? Please do the needful. Waiting for reply?",
    "doctor_response": "hi welcome to HCM-i had gone through your query and understand your concerns. i would come up with the possibility of VITILIGO is the cause for your sufferings.important known factors are;-nutritional ; defects in copper,proteins,and vitamins in diet-digestive upsets like amoebiasis,helminthes,chronic diarrhea,dysentery-endocrines;associated with thyrotoxicosis,and diabetes-trophoneurosis and autonomic imbalance-emotional stress and strain treatment option; i advise you taking   Homeopathic medicines gives  safe and permanent  cure for your complaints the principle remedy in homeopathy for effective cure of vitilgo is ARSENIC SULPHURATUM FLAVUM- i seen similar cases in my clinic and treated very well with constitutional similimum. consult your local homeopathic physician for correct diagnosis of the case and remedy to fit your complaints I hope this is helpful for you, thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had back surgeries, muscle spasms. Prescribed hydrocortisone, oxycodone and valium. Will it help?\n\nI have had 2 back surgeries during this year. I for bulging discs and most recently one for a L2-L3 bone fusion. i was prescribed hydrocortisone 10/325 five times daily after my 1st surgery that did not relieve the initial pain problem, and turned over to a pain management clinic for 6 months. After my back fusion recently this week, I am prescribed 2 ea. 10/325 oxycodone 4 times daily along with 10mg valium for muscle spasms 3 times daily for muscle spasms. Should I expect to see better pain relief going forward? Thank you for all of your help",
    "doctor_response": "hi and welcome to healthcare magic....diseases of the spine or surgery on the spine for any cause,causes muscles attach to spine to go into spasm,which is the cause of pain.....treatment regimen should contain a skeletal muscle relaxant and a pain killer of moderate efficacy....vallium 10 mg is a skeletal muscle relaxant ,and oxycodone is amoderate pain killer .....so the regimen is the best one...and hope a pain will go away soon....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have pain in arm, back and abdomen. Burning sensation. X-ray shows gall bladder stones. Guidance?\n\nfollowing are the symptoms which I am having as of now.. 1. Little pain in right abdomen middle and lower Portion 2. Right hand under arm very less pain. 3. Upper back pain and burning sensation 4. Some gaseous things floating in my right abdomen and feels kind of not normal situation 4. Feels to do peeing very urgently but not very frequently based on the water intake. 5. My stomach makes lot of sound ... ( not gaseous outcome .. only inside sound) Recently went through ultrasonic test, blood/ urine test , X-ray about gallstones as I had little pain in upper right abdomen last week of March 2013,,, and found negetive .. Some acidic medicines i am taking it .. Please guide me what kind of symptoms is this.. what diagnosis I should carried out.. Thanks",
    "doctor_response": "Hi Gallbladder stones are better diagnosed by Ultrasound abdomen.Only 10% of gall stones are seen in x ray.As they are negative,gall stones are excluded. Pain in the abdomen may be due to gastritis.Please take Rabeprazole tablet along with itopride. Pain in other regions may be musculoskeletal in nature.Please take muscle relaxant tablets. If the stomach pain still persists,get an upper GI endoscopy Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for red scaly spot on cheek of a child\n\nHello! My 17 months daughter has a round red scally spot on her cheek that doesn t heal (appeared 9 days ago). It looks like a ringworm but I m not sure...She doesn t scratch it at all so it doesn t look like it s itchy or bothers her in any way. Should I take her to the doctor or just get an antifungal cream from the pharmacy?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can exposure to radiation cause cancer?\n\nHello doctor, I am 29 years old and I am worried about bone cancer. I have had two CT scans for kidney stones around my abdomen area as a total of 7 msv. I also had a CT scan of my head. I read that the radiation can cause bone cancer. Should I be worried? Is it a low dose and not to worry? There is no cancer in my family.",
    "doctor_response": "Hello. It is true that radiation may cause cancer but that is one person among one million people. Also, there is no family history of cancer, so not to worry. Eat antioxidants fruits, exercise daily, and make your mind positive. For more information consult a pulmonologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling sensation in my body?\n\nhi i have tingling sensation in my body especially my legs(left) and i met wit an accident 8 months ago where i injured my left knee and had an ACL and MCL tear and i have diabetes from past two years i feel exhausted very soon and not active like before.",
    "doctor_response": "Hi Hope this message finds you in good health.I have gone through your complaints and understand your concern.Tingling sensations are caused by sort of hormonal,or vitamin deficiency,that might be secondary to diabetes. Another possibility is neuropathy,that can be cured by pregabalin tabletsNothing to worry about.I hope your question has been answered.If you have any follow-up queries,feel free to consult me anytime.Thanks,Take care,God bless.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lump in wrist\n\nI have a lump on my left side at my waist. It first just felt like a pea. A few days ago I notice it was larger & tender. It had a small head which was some pus & then blood squirted out. It is smaller now, but still larger than it was, but not as sore.",
    "doctor_response": "hi.based from your description, it is possibly a sebaceous cyst. clinical evaluation by a general surgeon is best. medical (proper antibiotic regimen) and surgical (excision biopsy) management will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cough when suffering from acidity?\n\nDear Dr. I am suffering from cough (productive) since 3 weeks and tried Roxid, Augmentin 625 and cephalexine antibiotics for 3 days each. Chest X ray is clear, sputum for AFB is negative. I do not have temp. except cough. I have acidity problem. Now doctor has priscribed Zedocef CV 200 for 7 days and Deriphyllum - 150 for 7 days.Please inform me what may be the problem with my cough.  My e-mail ID is  YYYY@YYYY",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. In my opinion you are mostly having GERD (gastroesophageal reflux disease) related bronchitis and productive cough. GERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause acidity, chest pain, reflux in wind pipe and trachea. This reflux causes chronic inflammation in airways. This causes bronchitis, cough and expectoration. So we should first treat your GERD to control bronchitis. So avoid stress and tension. Avoid hot and spicy food. Avoid large meals, instead take frequent small meals. Take proton pump inhibitors and prokinetic drugs. For bronchitis, take inhaled bronchodilators and inhaled corticosteroid (ICS). Don't worry, you will be alright with above mentioned things. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for small hard lump on penis\n\nI have a small hard lump ion the shaft of my penis. If I press along it feels as though I have a hard bumpy vein which is about 3cm in length either side if the lump. It is not painful and appeared over 12 months ago but has got bigger, went to gp who gave me light examination but felt he didn t examin deep enough to feel the length of the lumpy string like whatever it is, and was too embarrassed to say. I am worried as it has been there a while now and I don t think it s normal. Thanks Gary",
    "doctor_response": "HelloThanks for query.The 3 cm long string like lump on shaft of the penis is most likely to be a dilated tortuous tributary of superficial dorsal vein of penis .It is not uncommon to find such dilated veins on the shaft of the penis in many individuals and has no significance at all and does not need any active intervention .It is not going to harm your sexual activities at all.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the CML cancer curable?\n\nHi, I have been diagnosed with CML in the early stages.  I am 69 years young.  I am educated and appear to be in the early 50s.  I was put on a drug called Tasigna Caps 150Mg 1 Cap 2 X daily.  I am in the second month of treatment. Is my cancer curable at some point?",
    "doctor_response": "Thanks for your question on HCM. CML is blood malignancy. It is having two phases. CML crisis and remission phase. Medicines are helpful to keep the patient in remission stage. So that crisis should not develop. But with time drugs starting to act poorly due to spread of disease. In present era bone marrow transplant is a good option. So take your drugs regularly, consult your oncologist and discuss about options of bone marrow transplantation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in lower abdomen and back?\n\ni have left pelvic pain, mid abdominal pain, and lower back pain... i have never had regular periods and have been tested for every std out there this past november i had an issue and was bleeding a lot i went to several doctors and no one could tell me what was going on... the only thing they said was to get tested for cervical cancer. I also have recently started bleeding during intercourse that has never happened before. i just need some answers about why im in so much pain. it's hard to move but i don't have insurance and can't afford a doctor right now. please help me!",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query.Irrespective of your insurance status, I am afraid you might have to consult a gynaecologist in your area for a gynecological examination with any other related investigations like am ultrasound abdomen and a pap smear or the like to arrive at a diagnosis for an appropriate management. Till then you could go for an anti spasmodic along with a proton pump inhibitor drug for a symptomatic relief.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Frequent soreness, swelling in throat with white spots. Is there any effective remedy?\n\nHello, I have been getting sick a lot lately and it all seems to start in my throat . It gets very swollen and sore and it makes it impossible to do my job (I teach). I have had strep or tonsillitis many times in the past year, and I get white spots on my tonsils, some of which never fully go away. I have seen a number of doctors, have had blood work done, and I have seen an allergist . All they offered me was a nose spray since my blood work didn t offer much explanation. I m getting sick every other week it seems and it s not going over well at work. Do I need to see a specialist about possibly getting my tonsils removed (I m 27)? Or is there something else I should look into?",
    "doctor_response": "hi there, you need to get a throat swab taken for culture and senstivity and take a complete course of antibiotics. Also get your immunity level assessed and then visit an ENT surgeon who will be able to find a specific cause for your condition. IN the meanwhile you could use betadine gargles, anti-inflammatory tablets and give voice rest .Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest correct time for fertilization\n\nHello doctor,My problem is pcos and doctor advised me to take benforce-m and ferpill kit (from 3rd day of mensus)and go for scan from 10th day on 13th day report was given as follicle ruptured and follicle size is 17mm now can i meet with my husband for fertilization",
    "doctor_response": "Hi,Benforce M will help to reduce insulin resistance and induce ovulation. Ferpill contain Clomiphene. It increase FSH and LH, cause induction ovulation and increase fertility. You have follicle rupture and it was 17 mm size. So it is adequate follicle size that cause pregnancy.Life of egg after rupture is around 24 hours.I would suggest unprotected sex for next 1-3 days to become pregnant. You can also ask doctor for Progesterone pill to support implantation and pregnancy. Avoid stress, take healthy diet, drink plenty of water, and maintain proper pelvic hygiene. Hope this may help you. Contact further of follow up needed.Best regards,Dr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe cough and cold\n\nI had a severe cough and cold, so doctor recommended me TeleKast-L for 7 days. Macrotor 250MG for 3 days & Becasule Capsule for 5 days. The dosage got over 4 days before.  Now yesterday, again I got the throat & runny/blocked nose. Can I again start to have Telekast l for another seven days? Please reply",
    "doctor_response": "Hello,Welcome to HCM,As you had sever cough and cold for which your doctor has prescribed some medicine to relieve the symptoms and you took the medicine for four days following which you are having same symptoms for yesterday.As you are having soar throat and blocked nose you have to take the medicines to control your symptoms. For your present symptoms I would suggest you to follow1.Take steam inhalation with Vapocaps.2. Gargeling should be done with chlorhexideine mouth gargle.3.Continue Telekast for another 15 days4.Tab Bactoclav, 625 mg, twice daily for 5 days. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in knee even after a steroid injection?\n\nI am having some sever acing in my left knee I am currently taking 800mg of ibuprofen I recently had a steriod injuction as well. The pain subsided a little but continues to ace on the top what should I do? I have reported this to my doctor but nothing.",
    "doctor_response": "Hi,thank you for providing the brief history of you.A thorough clinical examination is advised followed by MRI of the knee.As you are taking medication and even had a steroid shot in the knee , initially post steroid shot there will be little pain in and around the knee joint which will subside in a few days of time.Also, for knee pain or knee injuries, physical therapy are actively helpful to regain the full mobility and functions. With physical therapy the pain level can also be reduced .In my clinical practice, most patients with Knee pain are refereed to physical therapy and they respond well to it.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "How safe is giving Ambrolite levo and Monticope for cold and cough?\n\nHi,My kid 3.3 years old is frequently suffering from cold and cough.>We are giving Ambrolite Levo for cough and Monticope for cold.his medicine for. If i gave this medicine for 1 week it reduces and again its starting with running nose, cold and cough, dry cough. its going on for a months time.",
    "doctor_response": "Hi , I'm Dr Suresh K Yadav M D (paediatrics) , I have gone through your question and understand your concerns,It looks like that your baby is suffering from allergic cough,if it is so he needs regularly prophylactic treatment in form of either inhaled steroids or regular use of drugs like montecope, this group of medicines are meant to be used for a longer time to be effective ( for months ). Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.Take care.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Akt 4 and Optineuron since four months for abdomen pain with no relief. How to get rid of my pain?\n\nhai gud evening doctor my name is mohd azhar i was 21 years old iam suffering from stomach pain since last 4 months and i was unable to walk and i was unable to sit also so i went to doctor regarding this so i have visited to the doctor who was surgeon and he told me that it would be abdomen tuberclosis so he advice me to take the test of t b so i went but even through the result was normal i did find any thing in my report so doctor told that we are going to start the treatment of t b for at least 1 month and we will see if it will cure your pain we will continue so iam taking the akt 4 tablets since aug 24 starting i feel very much relax and iam happy but suddenly again the pain was started the doctor is also not responding to me iam unable to sleep at the night time iam taking akt 4 and optineuron and acera d contineously plz suggest me what to do plz i will be very muchj thankful to u mohd azhar (0000)",
    "doctor_response": "what were other symptoms  initialyhad u hist of low grade fever/wt loss/change of bowel habits??/pain in which part  of abdomenmore over akt4 is not to b taken for more than two months in most of cases..u have to switch over to AKT3..and other medicines as per need.acerad also not required for long period.u need to consult good physician and repeat basic investigations",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty breathing?\n\nIt feels like I have an air pocket in my lung on the right side of my chest. When I swallow air to try and release it I feel it there but it will not release. This has been happening for a few years now and it seems to be getting worse. What could this be?",
    "doctor_response": "Thanks for your question on HCM.I can understand your situation and problem.In my opinion you may have bulla or blebs in lung.They are air filled structures in lung parenchyma.So you should consult pulmonologist and get done1. CT thorax2. PFT (pulmonary function test)CT thorax will be needed to know whether bulla or bleb present or not.PFT will be needed to rule out bronchitis present or not due to bulla and blebs.So consult pulmonologist and discuss all these.If both are normal then no need to worry much. You may have anxiety only. So avoid stress and tension. Be relax and calm.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump on shin indicate?\n\nI have a lump on my shin that has been there for a couple weeks. I bruised it playing soccer - it swelled up slightly and I had a huge bruise right away. The bruise is now gone, but I still have a lump/knot on the injury site that is only painful when I touch it. Is this an issue, or will it heal on its own?",
    "doctor_response": "it could be an infected sebaceous cyst or just hair infection or an abscessa course of antibiotics is recommendedin worse case you need to consult a surgeonall the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for wheeziness due to bronchitis.\n\nI can take deeper breaths now, since suffering from bronchitis, but I still have a cough (no Phlem), and wheeziness...lI'm using albuterol, advair 250,...and taking benzonatate 200 mg., and singulair 10 mg....will my wheeziness eventually go away?  I am so tired of dealing with the problem.  I am 70 yrs. old., 5'7 and 190 lbs. I get bronchitis about once a yr. but I've always been able to get rid of it.",
    "doctor_response": "Hi welcome to the health care magic You have been prescribed bronchodilator and decongestant for bronchitis which is proper treatment for that... If needed spirometry can be done assess severity and deciding further course of treatment If wheezing more than nebulization with ipratropium bromide might prescribed for that Avoid smoking and stress One tsp ginger juice and one tsp honey help in soothing Take care Consult pulmonologoist for examination with keeping all this in mind",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had Spine surgery.On oxycodone and Tylenol. Having granular foul smelling stool, and terrible hemorrhoids. On metamucil, colace and miralax. Diet regime?\n\nMy wife just has spinal surgery and is on a combo of oxycodone and Tylenol for pain relief. Her stool is dark sort of grainy soft like baby poop and really stinks.  Her hemorroids are killing her.  She has a supository for the H's.  I have been giving her metamucil in the evening along with a colace and miralax.  What kind of food should she be eating?",
    "doctor_response": "Oxycodone cause constipation. Try to minimise the dose. She should take more of green salad leafy vegetables and soft diet. Avoid having high protein diet for time being. Please take lots of water. More of walking around. Things will improve over a period. If pain is under control then opt for non opiod pain killer. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the dosage for sysflu tablet ?\n\ni got a white rash ion left side of my chest .. i consult a doctor .. he gave me SYSFLU tablate. but i forgot when to take that... plz give me when to use that tablate........",
    "doctor_response": "Hello. I suppose u r asking the dose.its an antifungal to b taken daily for a wk atleast.but im not sure whether thats what ur doc suggested as it can b taken for a longer duration also. Hope it helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Nurse, accidentally pricked myself while preparing used lancet of a patient infected with viral hepatitis. Suggestion?\n\nHi, I m a nurse, 25 y/o. Last week, I was preparing my patient s lancet and was about to prick him for his blood glucose monitoring when I accidentally pricked myself instead. I didn t notice I was holding the lancet backwards and so I pricked my index finger after pushing the releasing button. I asked the patient if the lancet he gave me was new and said it has been used once, a few hours ago. My patient has diabetes and has jaundice . He was tested for Hepatitis B ( HbsAg ) last week which came out non-reactive, but he s still being considered as having Viral Hepatitis. Is there a possibility of me getting infected with whatever hepatitis virus the patient has after a lancet prick? What should I do? Should I get tested?",
    "doctor_response": "Hello, welcome to HCM, I am Dr. Das. Firstly, hepatitis viruses can not get transmitted through needle prick injury, except hepatitis B. As the patient was found to be non reactive, then you have low chance of getting the infection. But, you have to be tested for hepatitis B at the end of 3 month. If that is also negative, then you have nothing to worry about. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for depression\n\nHello dr, my name is rob. Ive been in allot of physical,emotional,and mental stress. Im not very good lately with explaining my self,do to what is going on in the world. Ive had an eray of accidents from two pretty serious car wrecks,one in which i broke my femur.the second i hit my head pretty bad and now suffer from what i think could be from whip lash. and i also hurt my back by compressing my lower discs in the gym. so i have developed a addiction to meds.that is also a long story. my stress level was so bad i had almost had a stroke. I tell my doctors lately and im looked at like a drug addict. i dont have a job, and im doing things that are putting me in jepordy. i wear my heart on my sleeve and ive always tried to help people. but its me this time that needs help. so im crying out for help. ive pretty much aileinated myself in my hometown and need to figure something out. can you get ahold of someone where im from to help me confidentially. i really want to stop the path im heading. my story is long sad but can be considerd amazing to i geuss. plse help",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.From what you have stated it is quite clear that you are having a depressive episode. Depression can occur with regular stress and it can also occur biologically without any stress as well. You need proper treatment for the same. There are various effective therapies for depression like fluoxetine, venlafaxine, bupropion, mirtazapine or escitalopram and they are all very effective and mostly safe. You may also require some benzodiazepines like clonazepam or lorazepam for a short period like 2-3 weeks to reduce the anxiety and help with your sleep.  If you are averse to the drug therapies then there is also an option of cognitive behavioural therapy. This therapy is taken by either a psychologist or a psychiatrist in which the therapist identifies impaired cognitions (Thoughts) and try to correct them. They are 15-20 min weekly session and there should be around 8-10 sessions to help you with your illness.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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffer PCOS, put on Modus tablet, then Siphene, bleeding. What does it mean ?\n\nHi Doctor,I am 32 years old and suffer from PCOS. In mast last ultrasound in April 2nd week, ovulation was seen and I did not get my periods for 3 months after that. Pregnancy tests were all negative. My doc put me on Modus tablets for 5 days and I got my periods two days after( although I still don't know if that bleeding means that I ovulated!!). On my second day of periods,my doc. has now put me on Siphene 100mg for 5 days. I was just wondering if Siphene is going to help me ovulate , then what did Modus do? What does this bleeding mean? I am really confused :(. Is it the right line of treatment or there is something wrong?",
    "doctor_response": "Hi Dear,irregular bleeding and prolonged cycles are very common in PCOS patients.Tab Modus was given to you to get withdrawl bleeding after drug intake which is a usual practice to get bleeding in case of missed periods.So the bleeding which you had was the withdrawl bleeding which is  expectedT Siphene is given for ovulation induction.infertility treatment requires time and a lot many tests. In case of any doubt about a particular thing, you should always discuss it with your doctor who will be happy to solve your queries.Your treatment in on the right tract. Have patience and all the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any way to strengthen my muscle?\n\nHello tast year ago I tore my hamstring on my right leg a and I never got it checkd cause I had no insurance it was purple and red under my buttocks and groin and now my muscle doesn t flex right and I was wondering if there was any way of strengthening it",
    "doctor_response": "dear sir, there are severel exercise you can do.just check on youtube how to do the excercise.remember do it regularly for a couple of weeks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could chronic low body temperature cause infertility?\n\ni am on 150mcg of synthroid for 20 months and still cant get normal body temp. on a good day, 97.0, but regularly between 94.6-95.5 when taking BBT, could this be causing my infertility??",
    "doctor_response": "Hi, high body temperature and not low body temperature causes infertility...So don't worry about this!Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for increased eosinophil count?\n\nMy daughters absolute eosinophils are 957 they told me the normal range is 15-600. They did a CBC and said she was allergic to peanuts 0.39 was the level normal range is .35, wheat was .82 normal is .35 and milk is .56 and the normal is .35. What do i need to do next?",
    "doctor_response": "Increased eosinophil count can be treated with corticosteroids. These drugs are used to manage allergic conditions and reduce the number of eosinophils in the body. They may be taken in inhaled form, topical treatment, pills, or injections.RegardsDR DE",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for tightness in chest, shortness of breath and frequent nightmares\n\nI'm not sure what this is... I'm not sure if the two are related... I went through a very troubled relationship... It's been over for a little while now... But I've found myself to be having some problems... It's quite difficult to explain but I find if I think about something.... Absolutely anything... From going out to making the dinner I find myself having a slight shortness of breath and my chest getting tight. It only lasts for a few seconds. But if I think about it too much I find myself getting panicky... Where as if I just do it... Without thinking... there's no issue.... But I've also found myself to be having flashbacks... Again it's difficult to explain. It's like things, objects, places trigger these flashbacks and I'm right back there... Re-living it... The past... I have difficulty sleeping too and when I do sleep I find myself having nightmares, fighting with my sheets and pillows... I've tried to ignore it but I've found it gradually getting worse...Do you have any idea what this is? Thank you in advance.",
    "doctor_response": "DearWe understand your concernsI went through your details. I can understand. The troubled relationship, as it is highly troubled, gave you ordeal of continuous stress. Stress is a reaction to a stimulus that disturbs our physical or mental equilibrium. In other words, it's an omnipresent part of life. A stressful event can trigger the \u201cfight-or-flight\u201d response, causing hormones such as adrenaline and cortisol to surge through the body. A little bit of stress, known as \u201cacute stress,\u201d can be exciting\u2014it keeps us active and alert. But long-term, or \u201cchronic stress,\u201d can have detrimental effects on health. In your case, the continuous stress you experience, is taking its toll on you. Nothing to be alarmed of. The present symptoms are usually categorized as anxiety neurosis. In my opinion, as these are related to the past stress, could be treated under Post Traumatic Stress Disorder, though not that severe.I suggest for Cognitive Behavior Therapy, Occupational therapy and relaxation therapy. You may consult a psychologist.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for cough and fever?\n\nHi, may I answer your health queries right now ?  Please type your query here... Hi, I had fever and cough for 4 days and doctor says its viral. How come you guys always says its viral what if a bacteria is residing in kidneys and causing the fever.",
    "doctor_response": "Hello,Welcome to Health Care Magic. I have gone through your query and I understand your concern.Your treating doctor that has told you that you might have a viral infection, has evaluated your overall condition and at the end has given the conclusion that the cough and fever is caused from a virus. Actually, we cannot decide to say that the causative microorganism might be a virus, without evaluating your overall condition and associated symptoms. Bacterial infections have normally more severe symptoms than viral infections. If you would have a kidney infection caused from a bacteria, you would have other related symptoms, and one of them wouldn't be the cough you have as a symptom. Hope I answered to your question. For further concerns feel free to ask again.Take Care,Dr. Ina Zaimi",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat back pain?\n\nmy back hurts when i bent it. it has been a couple days and when someone press on my stomach it is quite painful, specially when lying down. i been under a lot of stress lately just to add on to everything. today when i went to the washroom i peed blood but it was only one time. what do you think thats happening?",
    "doctor_response": "With blood in the urine, you have to strongly consider the possibility of a bladder infection, or the possibility of a kidney problem. Therefore you should see your doctor to explore these possibilities.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are mood swings and fatigue common while having Scoliosis and nerve damage?\n\nThank you. I work part time. Mate works full time. I have scoliosis and nerve damage and my back and arm hurts, yet I am the one who does most of the house cleaning and even yard work. I am wondering if I feel angry for no reason, or if most people would be angry, also.",
    "doctor_response": "Hi welcoe to HCMI have gone thru your query & can understand your concern about your swings and fatigue common while having Scoliosis and nerve damage .  Yes dear , your symptems are outcome of your Scoliosis and nerve damage. and it is natural  to face such mental and physical hazards  and become irritated &  angry  at triffles  ,as you are undergoing .In fact,Your body is always fighting something -- an infection, a toxin, an allergen, a food or the stress response -- and somehow it redirects its hostile attack on your joints, your brain, your thyroid, your gut, your skin,your kidneys or sometimes your whole body .It weakens your immune system. You have fewer white blood cells in circulation to fight off germs. This leaves you susceptible to infections.Your immune system is your defense against invaders .But when the immune system becomes weak,due to fauly food habits and deraileled life style , and frequent sufferings , disease cells can grow out of control , the disease overpowers . When disc height is lost, the nerve pathways may become narrowed  and cause Degenerative adult scoliosis and it occurs when the combination of age and deterioration of the spine leads   to the development of a scoliosis curve in the spine and is also often related to osteoporosis  .The lack of space lessens the nerves' supply of blood and oxygen,  which  weakens the bone , making it  more likely to deteriorate and may cause pressure on nerves and possibly even the entire spinal cord. This can lead to: weakness, numbness, and pain in back , the lower extremities. In severe cases, pressure on the spinal cord itself may cause loss of coordination in the muscles of the legs making it difficult to walk normally. The only remedy is suggested to strengthen your immune system .So include essential nutrients in your diet --FIBER RICH , LOW SALT - LOW FAT DIET ,fruit ,green veges ginger , garlic to balance Air factor-- Vayu Dosh -- in our body , vitamins and minerals in natural form -, coconut water , , nuts , almonds , and supplements full of antioxidants as Aloe vera juice + Amla juice 2 spoons , Lemon juice with water and a pinch of salt and black pepper gives immidiate relief . Fish oil and flax seeds for Omega 3 and Turmeric powder + Almond oil is very important for our sound mental and physical health and strengthen immune response naturally Avoid fried fast foods , sugar ,tea ,coffee , alcohol , smoking ,stress ,worry, anger ,Constipation Proper regular walk ,-, Adopt  proper ",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain between scrotum and anus after bladder scope?\n\nIn 2011, my husband had treatment for prostate cancer, brachytherapy and radiation. Last September,he had a kidney stone blocking the tube between his kidney and bladder and his urologist did a scope and used a laser to blast it. In late October he started having severe pain between his scrotum and anus. His urologist did several scopes since, scraping away dead tissue from the prostate and widening the urethra. He has very little appetite, has lost about 40 lbs since March, is very weak and his hands shake a lot. He also twitches a lot in his sleep. He is on a low dosage of dilaudid for pain. He has seen the Dr. who did his treatments and a gastroenterologist. Currently he has a catheter which has been in place since early June. He is scheduled for another bladder scope July 30 and a bowel scope Aug. 7. The Drs. seem to think the pain is from nerve damage from the radiation. Why would the pain start that long after the treatment? It only started after he had the kidney stone blasted, could there have been some damage done during the scope?",
    "doctor_response": "Hello, This is quite common after urological procedures like cystoscope and it will settle by itself. As of now, you can take analgesics like Aceclofenac or Tramadol for pain relief. If symptoms persist you can consult a urologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are symptoms of OCD?\n\nwhenever i want to make a decision i worry about all the things that i could not feel good about and then need to make sure that ill feel good , my doctor told me its ocd but i read up alot about ocd and it doesn't seem to match what i do. For example the way ocd is explained is that intrusive unwanted thoughts, i don't feel my worrys are unwanted, i think they are pretty normal. Also they say that people with ocd realize that their compulsions are irrational but i don't feel that way about myself. please someone help me clarify my issue.",
    "doctor_response": "Hello thanks for asking from HCM Obsessions are any idea, image or thinking that are repetitive, dominating and distressing. Your have thinking that some thing is not well in your body, you consulted a psychiatrist for that so it means that these thoughts were bothering you. So we can classify them as obsessions, but detailed clinical and mental status examination is needed to confirm diagnosis.Such type of symptoms could occur due to hypochondriacal ideas in which individuals have belief that some thing is wrong in body and they need reassurance to decrease the thoughts.Consult a psychiatrist for treatment. SSRIs in high doses are treatment of choice like Fluoxetine, Paroxetine etc. Behaviour therapy like thought stopping is also equally efficacious.Thanks, hope this helps you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain and stiffness in the finger and wrists\n\nI have pain and stiffness in my fingers and wrists. My son has Juvenile Idiopathic arthritis and my mother had rheumatoid arthritis. I don t see any inflammation but I have no recent injuries, etc. Should I go see my general practitioner or reach out to a rheumatologist?",
    "doctor_response": "Hi welcome to HCMI can understand your concern for your pain and stiffness in fingers and wrists .Dear , as you say your mother had rheumatoid arthritis , you have stiff fingers  and now your son also has arthritis  This seems to be Immunity issue . I am  compelled to think that there  must be some fault in  diet & life style , which  is  the basis of our life and  going  thru  generation to generation .It can happen due to many other factors , injury ,overwork like typing etc., Sometimes removing the cause helps remove the problem . The best way is to modify your life style and food habits  Include a proper regular physical activity - walk ,Yoga & Pranayam , meditation - which caters exercise to strengthen each and every part of our body including our mind . Rotating  & stretching  your fingers and thum and wrists , opening and closing fist  all help alley pain and stiffness instantly .  A balanced diet , containing all essential nutrients - fiber, minerals , vitamins ,antioxidants - ginger, garlic , proper hyderation helps boost your immunity fof healthy disease free life .1.A spoon of Turmeric powder with a cup of hot milk + a spoon of Almond oil 2.Aloe era juice 20ml + Amla juice 20 ml  in  the  morning  for 15 days  helps alley pain and inflammation .Lemon juice , Banana & sunlight give Vitmin C & D,and help in bone pains stiffness and inflammation . Avoidance of  fried , fast food , tea , coffee , alcohol , sleeplessness , dehyderation , worry , constipation is defenately a  better option for boosting  immunity . Crepe bandage after Application of  anlgesic ointment  can give instant relief .If problem persists ,it is advisale to consult an ortho expertHope this helps solves your query .Take care , All the best .Don't hesitate to get back if have any further query",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring cough?\n\nI have been coughing for about 3 months and i took the medicine prescribed but two weeks after i finished them the cough came back even more persistant. what could be the underlying cause for my reacurring cough? And Why do i lose my voice completely every time?",
    "doctor_response": "HelloYou are having cough for 3 months , got relief after medicine , recurs .Such type of recurring cough with impact on voice may be due to these possibilities , these include:1 Allergic bronchitis , diagnosis can be confirmed by physical examination by a physician . In this type of cough usually patient come in contact with some allergen like , dust , mite , mold , fine dusting powder , hay , fodder , smoke. These allergen produces antigen ,antibody reaction and causes bronchoconstriction which produces cough as well as laryngeal irritation produces bad effect on vocal cord ( voice).2 Asthmatic allergic bronchitis .3 Laryngeal tuberculosis , diagnosis can be confirmed by laryngoscope examination .In my opinion consult a pulmonologist and get his opinion.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pregnancy happen with average sperm count?\n\nHi, may I answer your health queries right now ?  Please type your query here...We have been married since 2004. I am 31 years old and my wife is 28 years old. We are yet to get a baby. My average sperm count so has been 10 million/ml. motility is around 20 %. We have tested semen analysis for 4-5 times. Initially menses was not regular for my wife. Now she gets her cycle in 40 days around. Whether we have any chance of getting pregnant in normal life or we need to go ahead with advance treatments like IVF, ICSI ETC.. PLEASE SUGGEST",
    "doctor_response": "u take siphene 25mg 3 months to increase count...u can do serum fsh Lh testosterone den testicular doppler to find out cause of decrease count....u can go fr iui....better. ..but if u r not getting results wid iui go for icsi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower abdominal pain, vomiting sensation. Prescribed pantaprosole, vitamin tablets and some pain killers. Suggest\n\nHi,Recently i had lifted a gas cylinder which is of 16.9 kgs and walked till my kitchen from store room, which will be around 15 meters distance.One the next day i had slightly felt lower nerve or we can say as lower abdominal pain. I had neglected that one as i dont see much problem with that to me. Next day morning i had done my regular yoga went to office on my bike, and while returning from office to home, i felt that my legs are feeling numbness and started vomiting sesation. Some times i feel like my heart beats gets variation.But stomach is normal, there is no swelling anywhere in my body.I had consulted doctor on 19th april, when i felt very numbness and weakness and pain in lower abdomen. Docter has given me pantaprosole, vitamin tablets and some pain killers. Its has been since 3 days i am taking rest for 3 days.After this 3 days, i still feel like vomiting sensation sometimes and weakness.Just want to know is it okay, or do i need to do any additional checkup",
    "doctor_response": "you should add antiemetic to pantoprazol[ eg PAN -D ] IF IT DOESNT get relived you need USG abdomen you can add muscle relaxant to ge t sprain relif any symptoms of infection like fever , redness , swelling , loose motion , constipation? any pain in back,groin , thoracic region is pain agrivating on exertion , movement , driving vehicle?",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure aneurysm?\n\nHello! My mum is 73 yrs old and she is in a coma. She has had a 3rd bleed in her brain and an aneurysm, the doctors cannot perform surgery due to mum being in a coma. Please help, will mum be ok, she breaths perfectly on her own. Her blood pressure doesn't seem to decrease.",
    "doctor_response": "Unfortunately, surgery to help with an aneurysm depends on the location of the aneurysm and the patient's condition for surgery.It sounds as if your mom is not doing very well, and I hope her condition stabilizes to the point they will be able to treat it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in getting pregnant?\n\nhi my age is 31 and same is of my wife we got married in the month of Feb 2010 it is almost a six month and we are doing unprotected sex to start our parental life and for this even i am doing sex in her most fertile periods (after the 12 to 14 days) of her menstrual cycle gets over but every time she failed to get pregnant what should i doplease advice",
    "doctor_response": "Hi,    Thanks for the query. I understand your concern.     Conception needs basically - good semen quality & regular menstruation with ovulation.      You need to get investigated (ovulation study &semen analysis after 3 days abstinance ) to confirm the basic normality...       After that you should have un protected sex (determined by LHSurge test)2 days before &after ovulation day.       If there is no result within 1 year of marraige... you should consult a fertility expert for detailed investigations.& cause  specific treatment.    Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain the day after drinking?\n\nI ve googled, I ve taken myself to the emergency department many times and I cant find any answers. For the last 4 years, every single time after I drink alcohol. Be it a quiet night or a big one, the next day I left in bad pain in my pelvis area. Exactly the same as the pains I get monthly, is there anyone who could clear this up for me ?? Or maybe have a small idea that could lead me to answers ?",
    "doctor_response": "Hi. Thanks for your query and an elucidate history.First of all if you know that drinking alcohol is causing pain in your pelvis like menstrual pains, why should you drink.Secondly, Google does not tell everything.Thirdly, the cause of such pains on drinking are as follows:Something in the alcohol is causing an allergic reaction in your uterus, acting directly on the myometrium (muscles of the uterus) to cause such pains as you described.There is a chance that you are suffering from a condition called myometritis , wherein you have got inflammation in the muscles of uterus and they get instigated by the contents of the alcohol. I would suggest you the following:Get an MRI of the uterus to see what changes or disease it has got and to decide about the treatment if you need to be getting like hysterectomy or so.And you should refrain from all the alcohol brands that cause you this type of pains.It is possible that some brands of alcohol may not be causing this.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hyper acidity,swelling on legs and gall bladder stones?\n\nmy mother's(age 47 years) ESR count is 35. X-RAY reports suggest that she is suffering from unfolded aorta. she also suffers from hyper acidity and has swelling on legs which pains a lot. moreover she has gall bladder stones.kindly suggest some measures and what is the cause of this?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern for your mother the given history of your mother is suggestive of having some age related problem for the unfolding aorta this is nothing to worry and this does not manifest in any way and this is accidental finding, for the gallbladder stone the treatment depends upon the clinical sign and symptoms and the size of stone, hope this is information helps you have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be worried about gallbladder polyps seen in my ultrasound?\n\nI have 2 small gallbladder polyps seen in my ultrasound 2mm and 3mm in diameter. My doctor does not seem to be much concerned about these polyps. These were intially seen in March 2009 and I had follow-up scans every six months and they have not increased in size. I dont have any symptoms. Do I need removal of gallbladder surgery ?",
    "doctor_response": "hi.noted history of gallbladder polyps. your doctor is doing conservative management for now. regular monitoring is advised to observe the behavior of the polyps. keep in mind that increasing in number and size of polyps are very important. another important thing also, any polyp has a risk of malignant transformation. it is best if you discuss with your doctor, preferably a general surgeon, re definitive management, which is an elective (not an emergency case) cholecystectomy (laparoscopic or open). other diagnostics (such as blood exams) and management (medical and/or surgical) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for rashes in the scalp & penis\n\nI have a rash in the back of my neck on hairline and on scalp. They are painful water filled like bumps that when scratched enough and drain they scab and dry up. They come back all the time and seem to be more prevalent on hairline. I also have on my shins on both legs a rash that itches all the time and when I itch sometimes they bleed, now I notice a rash between the penis and the scrotum that itches like mad and even when I itch it there is no relief. Are all these connected?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I think most probably you may be having systemic allergic dermatitis. There may be some dietary allergen or inhalants which may be responsible. Consult the dermatologist for the perfect diagnosis and proper treatment. I would suggest Antihistaminics and steroid in tapering dose for few weeks and to apply mild steroid cream. And keep away fro suspected allergens. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilyas Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can anxiety be treated?\n\nStarted taking an all natural herbal formula for my nervousness, worrying, and inability to relax, but wondering if this will react to Benicar hct, and lorazep? The supplement facts are Vitamin D 600 iu, thiamine B1 300 mcg, niacin B3 20 mcg, b6 15 mcg, calcium 21mg, magnesium 15 mg, and a proprietary blend of passion flower, GABA, KL-tryptophan, ashwagandha, root powder, ashwagandha extract, Bacopa monnier, L-theanine, green tea extract. please advise. thanks",
    "doctor_response": "U can carry on with the relaxation...aling with it take propranalol 10mgs in the morning time and take half tablet of clonazepam 0.25mgs when ever you feel very jittery",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does the foreskin retracts by itself or have to be pulled over the gland?\n\nI m male and i m 15. everyone has been saying that the foreskin has to be retracted manually at a small age. However i was unaware of this and i have always imagined that the foreskin retracts naturally and independently. Im a uncircumcised male and i know i don t want to be circumcised. My question is, Does the foreskin naturally retract by its self? Or do you have to pull it over your gland?",
    "doctor_response": "Hello ! The Foreskin does not retract by itself. In some cases the foreskin maybe very tight and adherent to the penis whereby the it obstructs free flow of urine, this condition is called Phimosis. In this case circumcision is adviced as it may lead to infections. It is adviced generally that all uncircumcised males should retract the Foreskin and wash it gently with warm water but not soap as a white Cheesy material called smegma collects between the groove of the penis and foreskin. This smegma sometimes gives rise to unpleasant odour so its adviced to wash once in a while.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does x-ray show pregnancy?\n\nHi doctor, My wife is 24 years old and her period was regular of 30 days. Before two months, we had intercourse after seven days of her periods. She had her period after some 15 days. It was normal for the first two days, but after that it was very heavy. She had abdominal cramps for approximately a month. Our local doctor gave some medications with iron tablets. Then, she did not have her periods yet. From the beginning of this month, she is having nausea and vomiting. We are not sure whether she is pregnant. Pregnancy test has not been done. Now, she had an accident and fell down from a terrace of 10 feet height. Her x-ray was normal and no bone injuries. But, she is unable to move because of pain. Does x-ray show pregnancy? Since she is unable to bear child at this stage, please suggest some medicine to terminate the pregnancy.",
    "doctor_response": "Hi. Without doing a urine pregnancy test it is very difficult for me to tell whether she is pregnant or not. Moreover, early pregnancy cannot be detected in x-ray. You will have to do a urine pregnancy test at home first. She need not go anywhere for this test. Once the pregnancy is proved, then we can go ahead and think of termination. So, please do the test and get back to me with the results. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause and remedy for recurring face allergy ?\n\nsir/madam i have a lots of alergy points in my face , its come and dry with dark points. i used alovera also but not cure. 6 months i have the same problem. only on my face pls give me any suggestion",
    "doctor_response": "better to consult skin specialist because only after examining you it can be determined whethever it is allergy or something else.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chronic pain since ACDF due to severe stenosis. Had discectomy. Taking morphine and percoset. Have depression. How is it possible to have stenosis after surgery?\n\nI have had Chronic Pain for 2.5 years since a ACDF on C6.C7 due to severe stenosis in June 2010 and in July 2010 I had discectomy L5.S1. I never had pain before just little aches and weakness. I now take 30mg morphine 2xs per day and Percocets 2 10/325 tree times per day along with a long list of muscle relaxers, anxiety, and depression medication. I recently had an MRI which states most levels are unremarkable but my C6/C7 has moderate/severe stenosis and my C4/C5 same thing along with random osteothites (spelling). My question is if I have a fustion with Plate, screws, hardwar, how can I still have stenosis in the same location? Any suggestions other than surgery forthe other levels. Pain levels are at a constant 6/7 with medication and spike to9/10 at least once per week. Activity level is low and I do use a TENSE unit, PT one week, stretches, hot and cold therapy. Any information would be greatly appreciated. Also, how do you tell the difference between just bad genes and MS?",
    "doctor_response": "thanks for writing to us.You have valid question. If we operate at particular level then we expect no stenosis at that level. As you said there was marked stenosis then it may be due to disc in the front and posterior spinal structures on the back. Anterior pressure was removed and there may be posterior pressure still remaining. Anyway you need to talk to your doctor about it and you can not go on taking morphine for such a long period as it is always symptomatic treatment and it never change the pathology. I would suggest to discuss with your doctor and consider definitive treatment option rather than taking pain medicine. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for puffy eyelids in a child\n\nHello, my son is 4 years old and has had puffy eyelids to the point one was almost swelled shut twice. This started 4 weeks ago. He s seen the dr weekly had test to rule out nephrotic syndrome, been on amoxil for 10 days with no relief. What could it be",
    "doctor_response": "Puffy eyes are sign of some renal or heart condition.  So consult your doctor,  go for some blood and urine test,  sometime it is seen in anemia also",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stiff tongue while talking with diabetes and high BP?\n\nhi, my mother started facing problem while talking.Earlier there was no problem at all...but from last 3-4 days while speaking her tounge gets stable for1-2 seconds & thus she can t speak clearly.I am bit worried coz don t know what to do??...she is diabetic n BP patient",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms of your mother can be related to peripheral neuropathy due to diabetes. I suggest to try an anti inflammatory medication such as Acetaminophen to relieve the symptoms. If the symptoms continue, I suggest using a prescription painkiller such as Gabapentin. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yellow orange pigmentation of skin?\n\nmy 5 year old daughter is waking up with a yellow orange tinge to her skin with the darkest coloring in her feet and lightest coloring in her face. By the time she is dresses, fed, and ready for school the condition is mostly cleared up. when she comes home from school any indication of the skin coloring is gone. this has been occurring for several months despite diet changes and monitoring for possible external causes( such as dies in her clothing and shoes). She is going to her pediatrician for the second time on the subject tomorrow. Do you have any ideas that I could suggest to her doctor?",
    "doctor_response": "Hi..sometimes when the kid is having diet rich in carrots and papaya, then the skin can get discolored to yellowish tinge. This is called carotenemia. This is not a serious problem. This will get better if diet is changed. Nothing to worry.Regards - DR. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes radiating pain in the rib cage?\n\nHello. I have an undiagnosed pain in my right side flank area. It radiates from bottom of my rib cage, down my side through to my lower back and hip, with constant burning and sharp pain. It feels like either one of my organs is in pain and isn t functioning right or like there is an infection spreading in that area, and I can t pinpoint the source of the pain, as it radiates throughout that area. The pain is sharp and constant, it about a 6 and builds, goes through a cycle of increasing from a 6 to a 10, only calming back to a 6 after I relieve myself. During the cycle my body temp. skyrockets (no fever though) and it feels like my blood is boiling, again, only calming after I relieve myself. Night time is bad and early morning is worse, until I relieve myself. I feel nauseous many times throughout the day and dizzy occasionally. I feel weak and the pain has spread and gotten worse over a 6 month period, while the doctors (internal med., gastroentrologist, ortho) order tests, but no diagnosis. I ve had a CT scan, an MRI of my back, an abdominal ultrasound, kidneys checked, and a colonoscopy. None of these revealed the cause of the pain, though mild ulcers were discovered in my stomach, and a right-side kidney infection; treatments for those were provided. A HIDA scan was recently performed to check my gallbladder function...waiting for the results. Questions: 1. What other tests, could you suggest, to help discover what is causing this pain? 2. What tests could/should I ask for, to check for an infection in my blood or in an organ?, for functionality of my adreanal gland, liver, appendix, small intestines, or other organs on my right side flank area? 3. Are there tests that could show what is happening within, as waste moves through my intestines to the point of excrement (which is when the pain is at its worst). 4. I m concerned that the longer it takes to discover the problem, the increased chance that this worsening problem may create some irreversible, or permanently damaging effect. It s been 6 months since, first going to a doctor. It s been a slow process to get all the tests mentioned above prescribed and performed (averaging one test per month). If needed, how do I get admitted to a hospital (other than through the ER) so to get the attention my issue seems to need, which is access to more immediate and broader testing to get a diagnosis so to move on to treatment? Thank you in advance for your attenti",
    "doctor_response": "you should visit a psychiatrist. Too many test and doctors unable to diagnose you might be because you are healthy. pain might be their in your thought process. you are not taking it but you feel pain. psychogenic causes of pain are also there",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful and swollen tooth\n\nMy mom has a SEVERE toothache, her mouth is a little swollen, and she can't get anywhere because it's raining really hard and we are expecting a hurricane. In the afternoon, a dentist told her he thought it was infected. Please give remedies or advice. Please!",
    "doctor_response": "Thanks for your query, i have gone through your query. the tooth ache could be because of the tooth infection. you need to consult a oral physician and get a radiograph done to confirm the diagnosis, after that the tooth can be treated with either root canal treatment or extraction. Mean while you can take a course of antibiotics like penicillin 500mg TID and analgesics like diclofenac 50mg BID ( if you are not allergic and sensitive to these drugs). do saline gargling. consult a dental surgeon or endodontist as early as possible. i hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cyst in back?\n\nI have a 8mm cyst in my back that causes pain in my legs. I have had two nerve blocks the first one worked better than the second. I also have a bone that is slightly off in my back. Should I cocentrate more on the decompression surgery or the decompresion with fusion surgery. Also can theraphy help this situation?",
    "doctor_response": "Thanks for your question on HCM. I can understand your concern. By your history and description, in my opinion you are mostly having neurogenic cyst. Symptomatic neurogenic cyst should be operated. So better to consult orthopedic doctor and get done 1. Clinical examination 2. MRI of spine. In most of the cases only decompression is required. No need for fusion. But MRI will be more beneficial to decide the plan of surgery. So consult doctor and get done MRI spine. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can neurofirbomatosis cause migranes and chest pain ?\n\nI have a 5 year old daughter that has neurofibromatosis and multiple benign tumors in her brain and spinal cord she gets severe migraines and is taking amitriptyline, neurontin, maxalt as needed and recently added Lamictal. At her last check up the pain management doctor noticed her pulse at a rate of 129. I have noticed and counted even during her sleep it beats 125-135. Is this normal? Lately off anf on she complains of mild chest pain at the same place you can see her pulse almost beating out of her chest and neck. She had an EKG which showed normal sinus rythym. Should i be concerned?",
    "doctor_response": "its really sad. keep an eye on renal profile, because her disease have association with renal involvement. hypertension may also be explained secondary to renal involvement dr husnain",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the appropriate time period for increasing the likelihood of conception?\n\nhi doctor iam married.iam trying to get pregnant. but i have irregular periods.i consulted doctor.she gave me deviry,siphene to get irregular period as well as to get pregnant.this month i got regular period.but how can we know when will ovum is released.we concieve from 10th 20th of my last month period but we failed.so i want to know when will egg produce if we use deviry and siphene tablets",
    "doctor_response": "Hi, I think you should go for follicular monitoring.  In this, you can take siphene 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. I think deviry is not a good option in progesterone.  You can take some other progesterone like duphaston or susten.  Talk to your doctor regarding this.  Do a urine pregnancy test at home after taking 2 weeks of progesterone. You can try like that for 3 to 6 months.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever and shivering while on treatment for enteric fever?\n\nHi My father (64 yrs age) is being treated for typhoid/enteric fever. The widal test yesterday showed -ve values for the typhi bacteria. Today all of a sudden in the afternoon he had very heavy shivering, he was having mild fever in the morning (99 deg F). What could be the reason for this renewed shivering? he's currenlty being treated for urinal infection.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Negative widal test is suggestive of cured typhoid infection.As you are saying that he is currently on the treatment for urine infection, this spike of fever is because of the urinary tract infection.I advice you should go for urine culture and sensitivity. This will guide us regarding the possible pathogen and its treatment protocol. Take the treatment under your doctors guidance.Please take plenty of water, this will flush the organisms from the system. Please maintian good local hygiene as this can be help ful in the treatment.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Allergy, take citrezine. A pure non-vegetarian and also take beer. Are my habits making me ill ?\n\nI am a pure non vegeterian taking chicken 1-2 days/week (mostly chicken fry), fish 2-3 days/week(mostly fish fry), beef/mutton 1day/week. Also I takes 3-4 cans of beer/week. I have allergy , so taking citrezene 2-3 times/week. Since I have to drive to office early morning, and reach home by night (1.5 * 2 hrs driving every day- to and fro) i don t get enough time to do any excercise. I am 28years old and a bit concerned if my habits make me ill in short time..?",
    "doctor_response": "Hello Dear Thanks for your query. I would like to know what health problems are you facing at the moment apart from allergic reactions. If you are having allergy and taking cetirizine for it , its ok but its better to use levo-cetirizine- Montelukast combination OD before sleeping . Your words suggest you have high protein diet and have less dietary fibres.Having high fibre diet in form of vegetables has its own benefits.High protein diet has been often related to increased chance of colon carcinoma.So try to add more vegetables to your diet. You didnt mention your weight or body mass index,It would be better to advice after knowing it.Sedentary lifestyle is related to cardiovascular diseases , so doing regular excercises is always good for your health.You can start with light free hand exercises, it wont take much time. Hope this helps. Update here how you stay. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yellow stools after taking Clacid?\n\nI am on antibiotics (Clacid) for respiratory tract infection and have been in bed for 24 hours now. However, I have been passing yellow skinny stools since three days ago and I m wondering if this is related or something else? I am going 4 or 5 times a day. I am 27year old female. Thanks",
    "doctor_response": "Hello,I read carefully your query and understand your concern.Your symptoms seem to be related to a side effect of the antibiotics that you are using.I suggest to use a daily probiotic.I also suggest using an over the counter option to treat diarrhea such as Imodium.Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards!Dr.Dorina GurabardhiGeneral &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does sore inside the cheeks and swollen lips indicate?\n\nHELLO I HAVE SORE ON THE INSIDE OF MY CHEEK AND A SWOLLEN TOP LIP BECAUSE I HAVE A HUGH GROWTH ON THE INSIDE OF MY TOP LIP. I WENT TO DR THEY NEVA SEEN ANYTHING LIKE THIS AND RECOMMENDED A DENTIST. I AM WORRIED. I HAD THIS SWOLLEN AND SORES FOR A WEEK NOW WITHOUT ANY SUCCESS WHEN USING BENEDRYL ETC",
    "doctor_response": "hello thanks for consulting at hcm,,u might be having angioedema,, swelling of u lips,, sores inside the cheek might be traumatic bite resulting in ulcer,,so kindly consult ur oral medicine r oral surgeon specialist for a check up and treatment,,u might also need x-rays, if it due to tooth problem ,, hope it helps,,tc",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does stopping of medication for TB cause fever?\n\nhi doctor,tb was detected in me in oct 2010. i took medicines continuously and stopped in april 2011.there is no weight loss or any other symptom untill recently. ...im getting slight fever....also after stopping medicine i started drinking. ....should i consult a doctor again",
    "doctor_response": "Hi welcome to health care magic.... You have taken six month full course of AKT.... So chance of reccurent tuberculosis us less.... But if resistant bacilli there than chance can be... For which repeat sputum examination and chest x ray needed..... Fever also can be from other cause like gastrtits,  inflammation,  infection anyware like gall bladder and liver infection etc... For that physical examination done to look for tenderness anyware in abdomen and if needed CBC and USG done... Meanwhile for fever you can take paracetamol tablet... Than if specific cause found treatment done accordingly... Take care. Advise : physician consultation for further examination.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe backache be treated?\n\nHow do I obtain a Medical Marijuana health card  if I don't know a special doctor that does this (have an acute ongoing severe back pain that is worsening since aging (I am age 77) This has been a chronic problem since age 32.  Do not wish to opt for surgery and do not tolerate opiods well (very constipating) YYYY@YYYY",
    "doctor_response": "sir back pain is a complaint seen in majority of population . you need to worry when there are warning signs like urinary or bowel disturbances or sensation disturbance or weakness or pain not coming down even after 3 weeks of rest,my advice is if there are no warning signs give a nice hot water fomentation rest by keeping pillow under legs, and doing backstrenghtening exercises. you will get better if you do the physio, analgesics only if pain is worse",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the long term effects of Benzodiazepine poisoning?\n\nI was wondering about the long term effects of benzodiazepine poisoning in a person who already has near end stage cirrhosis due to hep c? Also have insulin dependent diabetes. five feet nine inches, female, 175 lbs. Was given medicine while in a psychiatric hospital, where i was then sent to local er for poisoning.",
    "doctor_response": "Hi, It can be a life-threatening condition. Since benzodiazepines are metabolized and eliminated from the liver, if given to patients having end stage liver disease, they get accumulated in the body producing toxic effects which can be at times life threatening. Benzodiazepine toxicity can cause difficulty in breathing, bluish fingernails and lips, disorientation, confusion, profound drowsiness, stupor, coma and death. Since this is a medical emergency so she should be treated in the hospital. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mohammed Taher Ali",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in conceiving a baby?\n\nhi im 27 and im on medication for depression im on amitriptyline 150mg aday for (`12months now) and valium 5mg aday.ive been trying to concieve with my soon to be husband for 12months with no luck .I had a abortion 4 years ago and he has already a child of 8years old so surely we both are capable of having a baby together ,im really worried as ive read amitriptyline may be causing the problem if so if i stop taking them will this give me more chance thankyou",
    "doctor_response": "Hello, and I hope I can help you today.Amitriptyline is an antidepressant medication which really does not have any effect on your hormones or ability to conceive.However this medication is known to have an increased risk associated with birth defects, and for this reason, is not recommend to be taken during pregnancy.So it is unlikely that your fertility issues that you have at this point are caused by either of the medications that you take for depression.I recommend if you have not yet done so that you consult with an OB/GYN physician or fertility specialist for evaluation. Even if you or and your partner have both had children previously, that does not mean that new problems can develop with one or both of you. A preliminary hormonal evaluation of you and a test of your husband sperm should be performed at this point. You also should consider discussing your impending pregnancy with your psychiatrist and possibly trying to switch to a medication that can be used more safely during pregnancy.So in summary, I do not believe that your psychiatric medications are actually the cause of your fertility problem, however it would be a good idea to have a plan to switch off these medications as once you conceive they can put the baby at risk for birth defects.I hope I was able to adequately answer your question today, and that this information was helpful.Best wishes,Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for fever\n\nhello doc, my 11 months old daughter is having fever since7 days, her chest X-ray confirms infection,thus  she was prescribed with 3 antibiotic injection named monocef  of which 2 have been given, but her temperature have aroused by from 101 to 102 and she has also started wommitting, so what do u suggest",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query your daughter have  fever since last 7 days which could be due to viral/ bacterial infection of body. I would suggest you nothing to worry about it. You should take NSAID medication along with antibiotic such as Levofloxacin. You should take plenty of fluids. You should take soft and bland food. You should take fresh juices in diet. Visit pediatrician once and general physician once and get it examined. Go for blood tests as well. Start treatment after prescription. Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What might be the cause of severe stomachache in a child for a prolonged period?\n\nmy 5yoa male has had severe stomach pains for 7 days. he has been taken to the RER and told a possible nervous stomach after xrays a blood work. Can you pls give me some more help as to what it might be? I know you can t diagnosis it but any info might help. Thanks",
    "doctor_response": "Hi, Whatever you are describing is called chronic pain abdomen in medical terms. The differential diagnosis of abdominal pain in children varies with age, gender, genetic predisposition, nutritional exposure and many environmental factors. The causes are many including - constipation / acid peptic disorders / inflammatory bowel disorders / irritable bowel syndrome / worm infestation etc. Hope I have answered your query. Let me know if I can assist you further. Take care. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Left tube removed after laparotomy, hypothyroid, PCOD, periods regular. Can I concieve?\n\ni had a tubal pregnancy in 2009 noveber , in laprotomy surgery left tube was removed , now i m sufferin hypothyroid ,& polysistic overy desese also but dr told me it s becoming normal . i m planning 4 next pregnancy . i have a girl -5 years old.. for conceiving next s any problm there , please give me an advise adt this but my periods also regular.",
    "doctor_response": "Hello Welcome to HCM forum If other tube is patent then you can conceive provided you take proper treatment of PCOD medically or surgically Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can blood clot cause pain in the calf muscle, chest pain and shortness of breath?\n\nHi,I'm a 28 year old female, on nuvaring (hormonal birth control). A few days ago I had pain in bth calf muscles after a sports session, the pain in my left calf subsided less than 24 hours later, however, it is still present in the right calf. I have been experiencing some tachycardia, chest pain and shortness of breath.  Could this be a blood clot? There is no swelling in the calf muscle.",
    "doctor_response": "HIThank for asking to HCMI can understand your problem but your symptoms are not because of the blood clot, of course blood clot can cause such symptoms but that is medical emergency, here in your case the reason could be over eversion and the deposition of lactic acid in muscle and this will come around have soda water this will eliminate the lactic acid, take care and have good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent pain in chest?\n\nI am a 28 years old female. I went to the doctor and got a chest xray, ekg done and blood work done. everything came back normal. I was told it could be anxiety and stress that is causing pain in my chest area and an increase in heart rate. Should I keep worrying about the chest pain? The pain hurts when I press on the bone closer to the left side but still right in the middle.",
    "doctor_response": "Dear Patient,     Thank you very much for your question. If you have done ECG, chest x-ray  and blood work it is hard to believe your chest pain related to heart or lung problems. However, I recommend you to do an Echocardiography to rule out the presence of MVP because mitral valve prolapse which is very common among females sometimes gives symptoms like dizziness, palpitations or increased heart rate and chest pain.       Also anxiety and stress as your doctor said can trigger these symptoms. Therefore, my advice is to consult your family doctor and treat your anxiety and do an Echo test to rule out MVP. Apart from medications, you can relieve your anxiety by doing yoga, breathing exercises and meditation. I hope that I answered your question.Good luck!Dr. Dinesh Nuwan Weerasinghe. MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for small bump on the outside of my lower left gum\n\nHi,I have a small bump on the outside of my lower left gums. I am 25 and have used chewing tobacco on and off for 3 years. It is not painful unless pressed on. I also habitually lick this spot with my tongue. I have an appointment with the dentist next week. I notice this about a week ago.",
    "doctor_response": "hello thanks for consulting at hcm..it could be periodontal or periapical abscess,,do iopa radiograph and do salt water gargle thrice daily,,take analgesics for pain relief and consult a dentist asap,, hope it helps,,tc",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms for ear infection?\n\nHave a nine month old that was exposed to walking pneumonia for about an hour. He now has a green cruddy nose and hard to breath, some chest congestion, cough at night. No temp today, but slept very poorly last night, up 4 times. Could this be pneumonia? What are the symptoms for an ear infection? Thank you",
    "doctor_response": "Hi,Thank you for asking question on health care magic.To confirm the diagnosis of pneumonia,an x-ray chest is required.It is not possible to diagnose without clinically examining the patient and looking at the x-ray chest.Ear pain,temperature,some times discharge from the ears usually exaggerated by upper respiratory tract infection.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can carmex be used on lips to soothe after having a dissolvable stitches?\n\nhi, i had a rugby injury where i fractured my dento-alveolar and split my top lip in half, they used dissolvable stitches on my gum and upper lip. Can i use carmex on my lips to soothe them? because they are getting very dry, but i do not want to affect the stitches. thanks steve",
    "doctor_response": "Thanks for using Health Care Magic .Read your query.Yes, you can apply it as far as you are not allergic to any of its products.Avoid applying pressure or rubbing it vigorously on the lip such that the sutures are disturbed.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes knee tenderness?\n\nI have a tenderness on my knee that feels like the skin is raw. On occasion, if I kneel or crawl (as in across the bed) the skin is horribly painful. What comes to mind is a motorcycle accident that resulted in serious road rash. If I forgot the wound it would. I examine the leg and find nothing. This could go on for hours or days. It also could completely disappear for days. I have full use of the leg/knee most of the time, but not always.",
    "doctor_response": "Hi, This condition is generally not the result of any old injury in the knee. You have to rule out any swelling in the skin over knee- could be a bursa. I suggest you visit your doctor and take his opinion regarding bursa. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump on the gums indicate?\n\nMy daughter 6 years old has just found a pea sized reddish lump just above her tooth. She has just told me and tells me she has had it for weeks. She tells me its not sore so didn't tell us. We are currently on holiday in Italy from England but just very concerned. Looks like an abscess? Any thoughts thanks",
    "doctor_response": "Hi..Thanks for the query..A lump over the gums that is looking like an abscess can be due to causes like a gum boil or a tooth abscess if the tooth over which the lump is present is decayed..So  my suggestion is to consult an Oral Physician and get her evaluated..If needed an x ray of the tooth can be done..For now atleast a script of antibiotics can be advised to her to be taken orally as well as topical application of antiseptic oral ointment like Chlorohexidine can also be advised..Also do warm saline gargles..Hope this helps..Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will Chinese herbal medicines and yoga help in curing hydrocele ?\n\nHi. My name is Sam, I am 46 years of age, and I was diagnose with Hydrocel two weeks ago. Does the Chinese Herbal medicine SHY and Mullein - Lobelia really works? Also, does Vajrasana Yoga works? Please advise. Thank you.",
    "doctor_response": "As per ayurveda thought.. You need to get surgery for to cure hydrocele.. there is no effects by medicines.. Dr. Nikul Patel Ayurveda Consultant",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hail fall and dandruff\n\nHello doctor , i am karan, 25yrs male from india. i have problem of dandruff and hair falling from past 10 years. Rightnow i am using minitop forte , but i have eye irritaion after applying this. and also i have a heavy dandruff problem . kindly please advice me to  short out this problem.",
    "doctor_response": "Hello,Welcome to healthcare magic,I understand that you have hair fall and dandruff. Mintop forte is the treatment for male pattern baldness and because you are on it I assume that you have baldness where hair is less on the front and top of scalp. Eye irritation could be because of dandruff and not Mintop, we call it squamous blepharitis. Please continue Mintop forte. Along with this use an anti-dandruff shampoo called Scalpe shampoo thrice a week for 1 month and once weekly thereafter. Hope this helped, Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fatigue , joint pain and shortness of breath\n\nHi! I believe I need to try anew thyroid medicine. Maybe something more natural. I have been struggling with my symptoms for years. I now am taking 125mcg generic synthroid. Not sure if I am dealing with side effects or from the med or even from statin. I hurt a lot in my joints . Regular fatigue, shortness of breathe and up and down weight issues. Brain fog, weakness, feeling down and no zeal for life. My body cannot keep up with my brain. I m 39. Been taking med for 7 yrs. Just tired and tired of being tired. Tired of aching and feeling weak and not being able to think straight. So what option do I have. I feel like a hypochondriac when the docs tell me they don t see anything wrong and my thyroid levels are normal.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have  fatigue , joint pain and shortness of breath. Well there can be many reasons for symptoms you mention in query like carpal tunnel syndrome , rheumatoid arthritis , medication reaction or side-effect , acute sinusitis , viral syndrome or mononucleosis. I would suggest you to consult general practitioner for proper examination . Doctor may order blood test , urine test to check uric acid or take history . Doctor may also order liver function and kidney function test .Doctor may prescribe anti viral like acyclovir , anti inflammatory , multivitamin supplement  or refer you to orthopedic surgeon for proper examination . For now take ibuprofen or acetaminophen for pain  , apply warm compresses to your joints and drink plenty of water . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am using retainers after Invisalign treatment. Should I have to wear them for 12 hours a day?\n\nHi doctor, I finished my Invisalign treatment and received retainers that look like Invisalign trays. But it is thicker. I am wearing them for the second day. I am wearing it for about 12 hours a day. But I am noticing pain on my teeth now, and they are tight on my teeth. Should I have to wear them for 12 hours a day?",
    "doctor_response": "Hi. I have gone through your query, and I can understand your concern. Retainers are a passive appliance, and they do not generate any force. If you feel a pain on the mucous membrane (oral tissue or gums), it can be ill-fitted. If there is a pain on the teeth, then it can be active (imparting pressure). You do not need to wear them for more than 12 hours, especially when it is painful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does cleaning of vagina of sperm after sex prevent pregnancy?\n\nIf you have anal sex then wait 15 minutes and start cleaning your butt then accidentally swiped a rice size portion of sperm across your vagina can you be pregnant even if you cleaned inside and outside and left everything completely dry (meaning inside the vagina too)?",
    "doctor_response": "Hello dear,I understand your concern.In my opinion there is no chance of pregnancy with accidental touching of minute amount of semen as in your case.So relax.There is chance of pregnancy when semen is ejaculated inside or around the vagina during the fertile period.As nothing such happened there is no chance of pregnancy.Avoid stress regarding the thought of pregnancy as it causes hormonal imbalance and might delay the period and confusing the situation.Hope this satisfies your query.Feel free to discuss further.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Blocked fallopian tubes, RHE-FD, missed periods for 3 days, chances of pregnancy ?\n\nI am 29yrs old married woman i m suffering from infertility 2 minths ago my doctor took my many test like hormones and PCR but all test are normal then my doctor advised me andoscopy then she found that my both fallopian tubes are blocked(b/l corneed blocked)she didnt get any resion because my all test are normal then se advised me 3 months course of RHE-FD ( rifampicin ,isonised\u00f0ambutol hydrochloride tablets along with zeed antioxident, multivitamin and minerals capsule and medoliv liver syrup.for any infection occurs in tube.let me know can these drugs helpful for me ?one more thing i missed my period for 3 days is there any possibility for me for conceiving because i m taking these medicines fornear about 2 months please answer me. i will be very thankful .",
    "doctor_response": "Hello. Thanks for writing to us. With bilateral tubal blockage, the chances of conception are very low. The treatment you are recieving is based on the fact that the commonest cause of tubal blockage is infection. This treatment might help you. You can continue with the treatment advised to you by your gynecolgist. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest non invasive treatment for weaker urine stream\n\nmy age is 59 have prostate 48 gm; void 8 ml PSA is .37. I have initial hesitation (specially at public toilets) and have inbetween weaker urine stream.. and take longer to empty bladder; when full; it may take about 2-3 minutes withs low stream; have urge every hour and a half or so; but dont urinate frequently at night. I do take about 2.5 to 3 litres water or so thru the day. I was prescribed alfuzosin 10 mg once after dinner since last one and half year when prostate was 34 gms andPSA was .45. I am now being advised alfizin D (instead of alfuzin) which i am taking for last about 15 days. Pls advise since i do not want invasive surgery if at all needed. Is there any non invasive treatment ? I also suffer from E D.",
    "doctor_response": "HelloThanks for query .You have obstructive voiding symptoms like frequency ,urgency , hesitaancy for  urination and poor urinary stream due to enlarged prostate of the size of 48 gms Your Dr has prescribed Alfuzin D once daily .Alfizin D is a combination of two drugs 1) Dutasteride which helps to slow down the process  of enlargement of prostate 2) Alfuzocin  It is a alpha blocker which relaxes smooth muscles in prostate and bladder neck and there by help to improve urine flow .You can continue taking these medications for years together till the time when these symptoms are  aggravated and affect quality of your life .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does alcohol consumption cause a swollen circumvallate papillae?\n\nHi I've swollen circumvulate papilia for several weeks now and also a white tongue which seems to be worse after a weekend when I've consumed alchohol,also the with brushing it removes a lot of the whiteness on my tongue,I'm wondering if dehidration off alcohol consumption could be the corse",
    "doctor_response": "Hello and Welcome to 'Ask A Doctor' service. I have reviewed your query and here is my advice. Your explanation is pointing towards oral yeast infection or Oral Thrush. It is a fungal/yeast infection and causes white coating over tongue and also can cause inflammation of tongue papillae. So first of all you need to get the infection treated and for this you should gargle with Nystatin mouthwash and suck Clotrimazole lozenges. Also take Fluconazole table for 15 days. Eat more of probiotics like yogurt and garlic. Drink sufficient water and maintain a good oral hygiene. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does meaningless talks and poor concentration in a child indicate?\n\nmy 4.5 year old boy, he is speaking always self meaning less words and no concentration in study (ie write, listen of anything like that).Sir is it any disorder, his pre school school teacher tol to consult any doctor, may be this is because of some hormon problem . Please advise",
    "doctor_response": "your child needs a full assessment by taking history and notes from you and doing a complete physical exam along with special tests which involve questions about his development and specific skills and habits and social relations I recommend you visit the pediatrician to assess him",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any permanent solution for DVT ?\n\nhi i'm 32. I hve 7yrs son. after 1-2 mnths after delivery I got DVT . for 1-2 yrs i took Acitrom then discontinued. again started after 4yrs after gettng aborted because doctors said i'm not supposed to conceive. now 20days back i got it scanned n they say its clear no clottngs but vericose near ankle. and now I find there its become reddish and that part is very painful and hard i'm not even able to wear stockings. Is there any permanent solution for DVT because that leg has become dark and its swollen a bit.",
    "doctor_response": "Thanks for the query If your limb is hard and has changed it's color, please go to the ER now! Dvt does not have a permanent solution, it needs to be treated with anticoagulants. There are chances dvt might get dislodged into a more vital organ like brain, lungs, etc. Meet a vascular surgeon Have a healthy life",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the possible ways I can get an HIV infection?\n\nHi doctor, I would like to know what unprotected sex means. If I penetrate in a female's vagina without a condom\u00a0but do not release any semen, will it be considered as unprotected sex? Also, can there be\u00a0an\u00a0HIV\u00a0infection in such a case?",
    "doctor_response": "Hello. Hope your query is answered. Feel free to ask in case of doubts. For more information consult an HIV AIDS specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for meniscus tear\n\nI had a fall in late February and went to the ER. I had an x-ray and I was told I had a probable meniscus tear and given crutches and told to ice it. In May I went back to my doctor because my knee was still so painful and swollen. He sent me for an MRI which confirmed the meniscus tear and suggested a probable tibial plateau fracture. In June I finally got the CT scan which confirmed the non-displaced tibial plateau fracture. I am concerned that I have been walking on this leg and am worried that more damage has been done. It has not been suggested that I not walk on it while I wait to see the orthopaedic surgeon but from what I have been reading I should not be weight bearing. Should I be on crutches?",
    "doctor_response": "Dear Sir/MadamI have gone through your query and read your symptoms.In my opinion, your undisplaced fracture should have healed by now, and the meniscus needs to be handled if you have pain, and locking sensation in the joint, normally a meniscus is debrided arthoscopically and this leads to decrease in pain, but you will need good physio, if you want to recover fully.I hope that answers your query. If you want any more clarification, contact me back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly tell me the treatment for white itchy spots on penis.\n\nHello doctor, I have white itchy spots on my penis and on its skin inside. Kindly help.",
    "doctor_response": "Hello. I understand your concern but there is no attached photograph in your message. I need to see the picture of the affected area to make appropriate diagnosis and to suggest you the appropriate treatment. Kindly send the same.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the smaller penis size be due to pituitary gland?\n\nMy mom told me when i was younger my penis was growing smaller, and im now 17 and it hasnt seemed to grow any. Im about 250 pounds, and my penis is about 2 inches flacid, and 4.5 erect. Is it something to do with my pituiritary gland? If so, how would i go about fixing it?",
    "doctor_response": "HelloThanks for query .You have feeling of your penis being smaller than what you think it to be ..Looking at your weight for your age it is likely that you have more fat deposited at the base of penis making your penis to be small .The length of the penis of 2 inches in fklaccid state and 4.4 inches on erection is considered to be normal for your age .Please note that you have no problem of Pituitary whats so ever .As such length of the penis in flaccid state has no significance at all .It is hardness of the penis on erection that is important foe sexual satisfaction of both the partners .You do not need any treatment ,However you need to reduce your weight .Consult qualified Dietitian for advice regarding wight reduction .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain after gallbladder removal?\n\nI have stomach pain every day. My gallbladder was removed about 2 years ago because it was functioning at .3% that didn't fix the problem. The doctor found a stone in my appendix about a year ago. I can't drink anything but tea because everything upsets my stomach food does the same thing. Lately I haven't been able to eat without feeling sick or I just don't have an appetite at all. My pains are either crampy and throbbing or sharp. What could be causing my problems?",
    "doctor_response": "thank you for posting query.\"post cholecystectomy pain\" maybe due to stones in common bile duct OR  fat intolerance OR functional pain.need further evaluation.advice:- get an ultrasound (abdomen) to rule out any stone remnants in common bile duct- also get a complete blood cell count(CBC) test- avoid OILY food altogether or as less as possible- you may need to take nexium/pantocid 40mg once daily before breakfast- avoid eating stomach full and mouth full- eat small meals - avoid spicy food wish you good health.further queries are welcomed.wish you good health.regards,Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to relieve kidney stone pain in pregnant woman\n\nim 32 weeks pregnant and have a known non-obstructive 7mm x 5mm kidney stone. Went to the hospital because of increasing pain that has changed location and type. Fetal Monitor showed uterine irritability but no distress. UA showed urobilinogen of 1.0 and trace protein, nothing else. Sent home. Currently pain has increased again, and is now accompanied by nausea. Suggestions?",
    "doctor_response": "HelloThanks for query .You are 32 weeks pregnant and have been detected to have non obstructing stone of a size of 7 mm in your kidney .Taking in to consideration that it is non obstructing stone and you are in 32 weeks of  pregnancy it is advisable to wait till you get delivered following which you can go either for Extracorporeal shock wave lithotripsy or endoscopic removal of stone depending upon the site and size of the stone at that particular time .Till then you can take pain killers in mild dosage as and when necessary under the guidance of your Gynecologist .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in the lungs and rib cage?\n\nWhat causes heaviness in lungs with pain in lungs and ribs? I am currently facing heaviness in lungs with with some sour pain in lungs ribs. I also feel ... of burping and I feel bloated and as if there is something heavy in my lungs /throat. This has been happening a lot as I am 7 weeks into my pregnancy.",
    "doctor_response": "during pregnancy some symptoms like bloating and gastritis are common due to hormonal changes and due to some drugs which are prescribed for nauseayou need to consult a gyanecologist who can guide you though. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Unbearable hot flashes, cured of skin and breast cancer. Remedies?\n\nHi Doctor, This question is in relation to my mothers health. My mother is sixty three, she has been having hot flushes from the age of forty eight. At present they are unbearable , approx nine years ago she was dignosed with skin cancer on her nose, which was treated and cured. As a percaution the doctors did more tests and discovered she had breast cancer . She was very lucky it was got in the early stage, so the doctors operated, removed the lump and then recieved six weeks of radium treatment. Thankfully she has been clear since. At present the hot flushes are very frustrating for her",
    "doctor_response": "Hi!welcome to HCM!The severity and duration of hot flashes varies among women going through menopause. Some women have hot flashes for a very short time during menopause. Other women may have hot flashes at least to some degree for life. To prevent hot flashes, your mother should avoid these triggers: Stress,Caffeine, Alcohol,Spicy foods,Tight clothing, Heat and Cigarette smokeOther things she can do to keep hot flashes at bay include:    Stay cool. Try deep, slow abdominal breathing ,exercise dailyYour mother can go in for hormone replacement therapy (HRT) under the expert guidance of a gynaecologist or an endocrinologist.You both and your doctor may decide that hormones are or are not needed for a short time to help with symptoms of hot flushes.Hot flushes are linked to lower estrogen levels.I hope this will help you!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a fleshy growth on labia majora. What could it be?\n\nHello doctor, I saw a fleshy growth on my labia majora. I am worried about it. Can you explain to me what is this fleshy growth?",
    "doctor_response": "Hello. This appears to be a very small papule or bartholian cyst. It is hard to tell without a direct examination but both of these conditions are not dangerous. Please keep an eye on it, it is supposed to dissolve by itself in the next few weeks. You can use warm compressions if you have pain. No other therapy is required if the size is not increasing or it is not changing color or shape, in this situation you may have to see your Gynecologist. Make sure to get your papsmear.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the consequences arising out of overdose of Rentil medicine?\n\nA friend consumed 100 tablets of some medicine called restil .5 yesterday night, while I was on duty some time back I have taken her to a hospital, the hospital staff and doctors are not sharing anything about her condition, please let me know if she will be ok? Please......",
    "doctor_response": "Hi, Restyl is a short acting benzodiazepine commonly prescribed to treat panic disorders and anxiety. If taken in larger doses it can cause respiratory depression and coma which can be reversed by immediate supportive care and by administration of a benzodiazepine antagonist flumazenil. The length of benzodiazepine induced coma varies depending on the situation it may be only 12 hours, or it can last for few days. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mohammed Taher Ali",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in chest and feeling knot inside breast area?\n\nin january of this year i woke up one morning and i noticed my chest was hurting right away then i starting developing a large almost knot feeling or a lump on my right breast plate it was very tender i couldnt even hug people because it hurt so bad now ive noticed im having chest pains alot more often and at time the lump isnt very vissible and doesnt hurt but other times it sticks out of my skin so bad that its vissible without even having to touch it and it when it becomes larger thats when i start having the bad chest pains. im not sure that it would be a cyst because it isnt squishy at all and it doesnt move it has stayed in the same place for 6 months. what could it be?",
    "doctor_response": "Hello,I have gone through your query.Thanks for using HCM.Your description of pain and lump in right breasts needs evaluation .you must consult a surgeon for physical examination.we need to find out whether it is cyst or a mass.local examination gives lot of information of its size,consistency etc.Then you may need mammography to establish diagnosis and mat need further tissue diagnosis.I request you to go for early check up.My best wishesDr.Rajesh Teli,MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Developed an abscess on tonsil, PCOS. On augmentin, steroids. Do antibiotics affect birth control?\n\nHello! About 2 weeks ago, I developed an abscess on my tonsil and was admitted into the hospital. While there, I was given an IV where I received antibiotics and steroids for 24 hours. After I was discharged I was given a prescription of Augmentin to take for 10 days. During this time, I did have sex for the first time. I am on the pill and I have been for 5 years due to PCOS. We used condoms and didn't have any accidents with the condom breaking. My last menstrual cycle was July 10th. They usually last for a week and begin either on the 3rd day of the white pill or the first day of my next birth control pack. I have yet to have started and I am a little worried (I'm on my second pill of my new pack). I know antibiotics effect birth control, but we made sure to use condoms that had spermicide. Could the antibiotics or even the amount of medication I've been taking (steroids, pain medication, and now antihistamines for an allergic reaction to the Augmentin) affect my period?",
    "doctor_response": "Hello. Thanks for writing to us. Some antibiotics do affect the efficacy of birth control but Augmentin is comparatively safe and shows a lesser interaction with the birth control pills. You may avoid taking an additional protection to avoid pregnancy.I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal ,drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for social phobia?\n\nGood day,I suffer from a real problem. I looked it up on the Internet and found the scientific name of it is social phobia.When there is a group of people with me it becomes very very very hard for me to talk. I become confused and started sweating and i lost every thing in mind. is there a solution to my problem :(",
    "doctor_response": "Hi,I read your query and can understand your distress. From what you have mentioned, it is likely that you might be suffering from social anxiety disorder. Social anxiety is a situation where you avoid social situations, feel that you are always being scrutinized by others and worry that you might embarrass yourself publicly. It would be advisable that you consult a psychiatrist for your problems. Medications like selective serotonin reuptake inhibitors are effective for your condition. In addition, treatment with behavior therapy sessions will help you in controlling your anxiety. You will need regular sessions (1-2) per week with trained therapist for the same.Hope this information was helpful. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can plavix and crestor be taken while suffering from GOUT and allergic reaction?\n\nmyhusband 68 is on plavix crestor spren attacand ( for heart ) which two cardiolgist never picked up fit as we have a healthy lifestyle walks everyday has never had gout now has. he had a allergy reachion 3 rys ago was on betaloc ist time now cant eat crustacions he has 1 glass of red wine a day cardiologist says good for the arteries have been told by a chemist that visits us at home he is on to many tablets We think to many tablets r.",
    "doctor_response": "Hello there! Gout is not mortal. But heart condition is. the two drugs your husband is on are inevitable and they have nothing to do with gout. they cant affect it. Gout has its own management seek rheumatologist for that. and tell the chemist mind your chemistry business, let the professionals handle it. S khan",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat kidney cancer?\n\nwhy do doctors  do ex rays or ct scan  for one thing and discover a dark spot on the kidney by accident and say don't worry its nothing and 2 years of bleeding pain pullups and other stuff then just to discover that when the patient questioned the doctor before was ignored and now diagnose with kidney cancer which could have been cured 2 years earlier tell me that answer  hey why doctors play god and think were all dumb and how dare we question you guys. you may of went to school for this but does not mean you know everything.For example fen fen was a diuretic  used for obese people but it took 50 years for doctors to fess up it destroyed hart vales  why is that hey why you may think this may not be for you to answer but this applies to all doctors for all  things also the cure for cancer if cancer is in all of us and some get it others don't its not an off switch its whats missing in the body it is like the game kerplunk   pull  too many sticks out it all falls apart leave them  all in nothing happens . Its an enzyme people loose  radiation and chemotherapy talk about  old school do a study on what each cancer patient is missing sometimes it does not have to do anything it just has to be their to keep the rest in place  . Yes call me crazy I do not care but long long time ago people believe a simple thing as  a doctors washing their hands before surgery  was a waste of time so I pose to you and your fellow doctors look for the block support of the body if we all carry cancer then our own bodies have the cure sometimes its so simple it is actually looking at you but every one cannot believe it because it goes against whats taught ---Good thing BEES do not believe in the Laws of physics  or they would not fly amazing a big body tinny wings yet it defies all the laws of gravity physics etc imagine if doctors would think in the same path way I wonder you should too all good hiding places are in front of you too see yet blinded by the simplicity of it",
    "doctor_response": "Hi,Thanks for writing in.At times, features of a disease on a X ray and CT scan is not characteristic and obvious to the eyes years before it manifests in to a disease that could be hurting. I guess unfortunately such an incident has occurred with you. The dark spot which you questioned was probably looking more normal and acceptable on the X ray and CT scan earlier. Many doctors choose to follow up such findings and this is subjective. Therefore any such normal findings might be passed as harmless. The patient is usually cautioned to follow up with the doctor.Many medicines are initially discovered for treatment on one disease condition and are later found to help in other conditions. There are clinical trials at multiple levels before a medicine for cancer might be implemented for regular use in patients. The topic about scrubbing before surgery is a time tested practice and confirmed to reduce chances of infection. There are many arguments in medicine and most are sorted out with research and evidence based medicine followed in modern day. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from kidney disease, protein decreasing in kidney. How to treat it?\n\nDear sir, Hope you are doing well. I am Shailen Chandra Das from Bangladesh. My sister-in-low is suffering from kidney disease. We have taken the treatment from an Indian doctor, Dr. Krishna Mohon Sahu, Apollo Hospital, Dhaka, Bangladesh. He told us that protein is decreasing from kidney. He has given us some advice also. We want to come in Velur to get treatment from a doctor. Please advice us about the kidney specialist in CMC, Veluure.Also advice us how can we get the appointment. Also please provide me a contact number. Thanks and regards, Shailen Chandra Das",
    "doctor_response": "Go the website  and fix an appointment before you reach CMC Vellore. It is not possible to contact the doctor directly there. In CMC Vellore, forget about meeting the correct doctor. Once your are into the system you are gaurenteed to get reasonable care before discharge.There are good doctors in Bangladesh and Kolkata. Why dont you try them first.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause bleeding from the scrotum?\n\nMy husband has had bleeding in the area of his back side & what I can see, there appears to be a lesion(?) as well as bleeding from his scrotum. He had a colonoscopy about a month ago. He has hemroids, but he is not bleeding from the rectal area. He has been seen by his primary care provider and we can t find a way to stop his bleeding. I currently us a barrier cream to help relieve some of the symptoms of the blood pooling between his legs.",
    "doctor_response": "Hi, Since it is bleeding kindly consult a surgeon immediately to find out from where it is bleeding and the cause. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on top of pubic area?\n\nI have found a lump about the size of a large marble on top of my pubic area.  It isn't noticeable on the outside, it's more deep.  I just happened to find it while drying off after a shower.   I had an ultrasound last week for some spotting I had had (which is gone now) and it came back negative.  I also had a kidney infection and a culture was done and it also came back negative.  Just wondering what the lump might be.",
    "doctor_response": "Hello!Thank you for the query.This lump is located under the skin and could not be visible in the ultrasound you have had. Most likely it is a benign lesion like lipoma or sebaceous cyst. Both do not cause a cancer. Both can be removed with small incision.To confirm this diagnosis please have soft tissues ultrasound of this area and consult a surgeon.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome the  pulsating pain in my abdomen after playing soccer?\n\nI get this pulsating pain in my abdomen after I play soccer. I played soccer all my life, and I never felt pain like this. I went in for a ultra sound but they said everything was normal. It pulsates at the height of the belly button on the front side of the abdomen. It goes side to side. From the right or left side to the other side and it switches back and forth. I end up on the ground rolling side to side. Its a real sharp pain. It last for about 30 minutes. Real bad pain",
    "doctor_response": "Hi,Welcome to healthcare Magic!short duration recurrent pain in the athletic and outdoor active people may be due to acid peptic disorder or small ureteric stones or simply due to gut infection leading to excessive gas formation causing spasms.You should avoid fried foods and junk foods.Get a urine routine and culture examination done and also KUB ultrasound to detect any small stone or gravel that can be missed in routine abdomen ultrasound.Also get a stool examination and culture.Review to a local physician and manage accordingly.I hope the advise would be informative and useful for you.Take Care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest a home remedy to cleanse system after ingestion of body wash\n\nTwo days ago my 1 year old son ingested some of the Johnson's BedTime body wash.  He keeps trowing up about once a day since then.  I was wanting to know what the side of effect are.  And now his nose is running, and sometimes it looks like bubbles coming out of his nose.  Should I be worried.  Shoud I take him into the ER, or is there something I can do at home.",
    "doctor_response": "HelloThank You for contacting HCM.As child is an infant so i would suggest you not to waste time and take him to ER for effective management.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. Wishing him good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is dizziness caused due to detoxing?\n\nI went to detox like a week ago had no pills or alcohol since the 23 to day I took a milk thisle ive been taking vitamins since my bl wook was low all of the sudden I started to get the chills and leg cramps with a head ache I took1 mg of larazapam my leg cramps are gone but im still dizzy could I still be detoxing after a week.",
    "doctor_response": "absolutely. detoxification or withdrawal from a controlled substance or illicit medication/drug can take anywhere from days to weeks. Typically, I tell my patients that they should start to feel noticeably better at about three weeks after the withdrawal process has begun. however, at any time within the first one to two weeks they may feel quite sick with different symptoms. And therefore, the answer to your question is a clear and present \"yes.\"Best of luck to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for asthma and chronic bronchitis\n\nI am 63 years old obese woman with history of asthma and chronic bronchitis. Yesterday I started coughing which by late last night developed a deep sound. My neck feels tight when I cough and my head. Face.ears,and throats hurts when I cough. Will taking nebulizer with solution that expired nov 16 hurt or help me. I already have a call in to my doctor for my symptoms and for solution and new nebulized.",
    "doctor_response": "If u didnt open the solution bottle and it is sealed then u can take it in emergency. It sounds though u are suffering from acute bronchitis and need nebulisation immediatly. Since u are obese u need to sleep with ur head raised at a higher level so that ur respiratory tract pathway is clear and u can breathe easyTry to take early morning walks regularly and take high protein foods like egg whites or lean meats and chicken without skin and moderate amounts of carbs. This will directly stimulate ur immune system and decrease recurrent attacks of bronchitis. Avoid all heavy and fat foods.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Implanon insert, healed bruising and pain from injection, tenderness again, body rejection to implanon?\n\nI had Implanon inserted about a month ago and all the bruising and pain from injection subsided, but now it s tender again and a bruise is appearing over the length of the implanon. Is my body rejecting it?",
    "doctor_response": "bit is unusual to be developing additional bruising after having it in place already for a month.  is it possible that the area had some trauma like a punch, or did it get struck with something?  if not, I would have your doctor check it out.  it may be infected, or you may have some kind of allergy to the implanon. this is very rare, but still possible.  please let me know of you have any more questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause the infection in c section stitches?\n\nhi i was c section in jan 2012 after that i have problem in my stitches my GP said you have incisional  hernia.my baby is very small how long i leave this hernia without surgery . some time i feel pain at that place i have gas problem also plz sir give me suggestion what can i do please.",
    "doctor_response": "Hi, If I were your treating Doctor for this case of an incisional hernia, I would come up with following notes:1. avoid gaining weight and over-drinking / over-eating and coughs2. take caution not to get infected or frictions in the area3. take some abdominal band / strap in the region so that the hernia does not enlarge!4. avoid straining / some abdominal movements (consult physiotherapist for demonstration!)  and do other muscle strengthening exercises5. do follow the swelling preferably with serial USG or by noting its size!Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having white discharge from penis?\n\nI have small amount of white discarge from penis.  Reoccurring problem, this is the third time.  Tested for STDS, negative; urinary tract infection, negative.  They thought prostate infection.  The only thing I can see in common with each time the discharge started was that I drank beer the night previous.",
    "doctor_response": "Thanks for asking in healthcaremagic forum   Any discharge from urethra need to be investigated for Sexually transmitted disease/ urinary tract infection including prostatic infection.   I dont think there is any relation ship between beer and urethral discharge, may be mere co-incidence.   So, please go for a followup with your doctor to rule out prostatic problem. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat multiple Lupus-like masses proximal to the spine?\n\nHi, yes... I had an MRI and the results came back saying I had multiple Lupus-like masses proximal to the spine. The Dr. Is out of town and I cannot meet with him until Monday morning. NYSE I am in pain and find it difficult to get up and down or walk. It gets increasingly difficult. My question is... What does Lupus-like mass mean? Thank you.",
    "doctor_response": "Dear Sir,This terminology is not used generally , you need to see with your radiologist what does he mean by that . Lupus doesnt result in mass lesions .Dr. Shruti",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the dent between the elbow caused by a hit?\n\nHi, I hit my elbow on the corner of the dado rail as I was running past, my fingers are swollen and feel numb and tingly. I can move my elbow, could I have chipped a bone, I have a dent between the main elbow bone and the other small ball on the elbow",
    "doctor_response": "Hi, In these injuries with distal swelling. It is always better to get X rays to rule out any fracture. So get  X-rays ASAP. In the meantime, take painkillers and use a crepe bandage to grip your elbow up to fingers. It will provide support and compression. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if a child is having stomach infection?\n\nhi, actualy my son is 3 months old and he sufferd from stomach infaction recently and than i went to a doctor  he suggest me a madcin wallamycin than im not feeding him my milk he is having cow milk so please help in this matter what can i do? my e mail is  YYYY@YYYY ..",
    "doctor_response": "Hi...I went through the history points you have provided - I was expecting that there should have been a history of cow's milk and formula feed (this too contains cow's milk protein) given to the baby. I feel that your baby is having cow's milk protein allergy. Unusually babies grow out of this sort of allergy by 1 year of age. My suggestions for you - 1. Mother should go off cow's milk protein completely. This means that you should avoid consumption of anything and everything related to cow's milk - like - milk/ curds/ ghee/ butter milk/ chocolates/ biscuits/ ice creams etc. Even while buying commercial food products, you need to see the ingredients and if they contain milk - do not consume them.2. Feed you baby only exclusive breast feeds till 6 months of age and then start rice based feeds. 3. If this is followed scrupulously - the baby will stop having diarrhoea in another 3-4 days and then start gaining weight too.4. If you feel your feeds alone are inadequate for the baby, then Zerolac is the only option till 6 months age. I request you to keep me posted about the recovery of the baby and follow of the case.Regards \u2013 Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What relieves from stress, tiredness and depression?\n\nI am feeling so bad about my procrastination; I know what should be done, how to organize things, but I am not doing it..day by day I am more stressful, tired and unhappy. Scary too. I have no money , so I can't afford go for therapy - because I am not making any... My project is waiting and I am getting more and more into depression. Any suggestions what can help?",
    "doctor_response": "HIThank for asking to HCMI can understand your problem, this is kind of phase that likely to come in each and every body's life but this has to be tackle with cool and calm mind without loosing the confidence and moral, keep your stress level low, stop thinking negatively, bring back your confidence, try to take enough sleep, eat healthy, think healthy, you can do it, not hard to do this, hope this information helps you, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bump on roof of mouth, painful to touch, pus and blood filled. What could this be?\n\nI had a bump on the roof of my mouth for two days now. I took a small mirror and reflected it on another mirror in order to see it, it is like the size of a pea and has a white head look to it. It is painful if u touch or put pressure on it. i sterilized tweezers and scrapped them across the sore and a small amount of white pus like fluid came out with a lot of blood . What could this be???",
    "doctor_response": "its could be an infection from tooth leading to collection of pus in that area.. consult a dentist asap.. you may require rct or extracion of that tooth .. for the times being you can start tab cefadroxill 500 2times + cap lactovit 2 times + tab zerodol sp 3times daily for 5 days .. do luke warm warm saline rinse remember these medicines are for symptomatic relief only...",
    "dialogue_context": ""
  },
  {
    "patient_message": "While making love, accidently went into the vagina. But not ejaculate. Is there chances of becoming pregnant?\n\nHi, My girlfriend and i were making out and getting reaally hot and then we reached a point where we wanted to feel our genitals rub against eachother. So i first i wiped the precum off my dick and started to rub it on her vagina (no penetration was done) my dick in no way went inside, we only did it for about 30 seconds when i felt my dick slide on the slippery part (sorry not sure what its called but that part of her vagina is always wet, i immediately took it away from her vagina. question is, could it be possible that even after i wiped the precum, more precum developed during the act? and could she get pregnant from this? please answer ASAP. kindaa Freakin out.",
    "doctor_response": "Dear user, welcome to healthcare magic.Occurrence of pregnancy depends on many factors, most important of which is if there was ovulation at that time or not.Anyway it is possible to happen so if you do not want this to happen your girlfriend should use the emergency contraceptive pills as soon as possible.It's effect decreases as time passes by.The sure sign that pregnancy did not happen is when menstruation occurs or when a pregnancy test is negative at the time of menstruation.Good luck.Dr. Ahmed Bahaa.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen gums with puss and blood leaking out of it?\n\nHello Doc! I have a problem with my gums its swollen and has puss and blood leaking out I've have. A brdge where my gum is swollen now it has gotten worse with a yellowish greenish hard stuff on the side of my gums.  Plan on going to the dentist tomorrow morning....what. Is this caused by?i",
    "doctor_response": "Hello,  Thanks for consulting HCM, Read your query,  as you havr swollen gums with pus discharge this can be due to deposition of plaque and calculus in region of bridge result in formation of Periodontal Abscess dont be worried so much I will suggest you to consult Periodontist and go foe examination of gingivae and Investigations Iopa Xray of awollen area of gum and go for its treatment Curretage . In meantime you can do warm saline rinses , Betadine rinses once daily .Hope this will help you. Wishing you good health.Regards, Dr. Priyanka tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes palpitations and coughing?\n\nHi I am 22 years old and have noticed I get palpitations that I can feel in my throat they almost start making me cough.  I have gotten blood work done and also an EKG I am very healthy and everything comes back fine. Could you tell me why I am getting these?",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern.You shoud not worry,its nothing serious.As you describe,my opinion is that we are talking about extrasistoles.This are electrical impulses that generates from different parts of the heart different from that of a normal sinus rhythm.This couses an ectopic heart beat that you feel like a skipped beat or as a palpitation.There are different reasons that may generate extrasistoles.From simple emotional stress to anemia, hyperthyroidism ect.If you tell me that you have done your blood analysis than we have excluded anamia.I will recommended you to sample your thyroid hormons.Hyperthyroidism may cause extrasistolic beats.And of course a holter monitoring.Your electrocardiogram might be normal becouse extrasistoles are random but a holter monitoring gives a full monitoring of 24 hours to see your rhythm tendency.At mean time avoid coffee and caffeine products because they exacerbate your simptoms.My opinion is that you should not worry.Sometimes only a simple stress can couse this extrasistoles and in young age this are quite normal.I hope I was helpful.Take care and wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes gum motion with black color discharge?\n\nHello doctor,i am suffering from gum motions since 4-5days but i dont hav stomach pain but always bubbles like sound comes and recently i had also gone through an ear surgery,and iam also suffering with back pain,and some times motion comes in black colour with gum ,please tell me a solution for this",
    "doctor_response": "Hello,Thanks for consulting HCM, Read your query, as you have black color discharge from gum this can be due to subgingival deposition of plaque and calculus results black discharge from gums . Dont be worried so much I will suggest you to consult dentist and go for examination of oral cavity and go for its  treatment Oral prophylaxis , in meantime do warm saline gargle , maintain proper oral hygiene by brushing twice daily .Hope this will help you. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can symptoms of tandrilax overdose be treated?\n\nHello doctor, a friend of mine had a overdose of tandrilax, it s a remedy in south america, i ve found some english info about it here: WWW.WWWW.WW Now he can t pee anymore, he drank lots of water, even tried to puke but nothing came out, he s having some stomach pain and feeling a bit dizzy sometimes, he s like this for 2 day but he can t go to a hospital right now, what can he do?",
    "doctor_response": "Hi, Tandrilax has to do nothing with the symptoms your friend is having, may be it cause some stomach pain but it does not affect the peeing. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain while suffering from pulmonary embolism\n\nHello, I have severe chest pain on the right side of my chest and I cannot sleep. I am 19 years of age and a year before, I was admitted to the hospital and was told I may have a blood clot ( pulmonary embolism, or something along those lines) I was injected with a blood thinner and told to come back IF i was bleeding blood, what should i do?",
    "doctor_response": "Hey there,If its paining you must consult ER again.Get done reports if clot is again developed or not??",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for water infection due to incomplete emptying of bladder\n\nI had a water infection about five weeks ago it took three lots of antibiotics to cure it as it kept coming back, I had an ultra sound scan today and the nurse said I am not emptying my bladder fully and this could be the cause of the infection. Is there any cure for this?",
    "doctor_response": "HiThanks for your query at HCM.There are lot of problems of bladder which cause such infection. Until unless the main reason is not treated the problem will recur. I would suggest you to visit a urologist for evaluation and investigations into the matter. You must also need suprapybic tap collection done and tested for gram staining and culture sensitivity for bacterial infections and take treatment according. It might be beneficial in your case. Take careDr Sheetal Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and loose motion\n\nhello doc.. i m working lady.. my baby is 9.5 months old and till8 months he was only on breast feed.and from last month and half month he is exclusively on bottle feed. and i used to feed him morning and evening and at night ,,whenever he awakes.. he is teething also.. some days are good..and some times loose motions 5-6 in a day... sometimes temperature 101.. what should i do",
    "doctor_response": "Hi, this is acute gastroenteritis. It occurs due to infection. Start ORS solution. Get child examined by a pediatrician as soon as possible. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heaviness and occasional pain in chest?\n\nHi I am male 33 yrs from Sagar, MP. for the last 2 yrs I have been feeling heaviness in my chest and occasional pain. I am physically not very active but do exercise for at least 30 mins per day. My father had high BP problem so genetically I am susceptible, right? Please advise. Any stress test? I would like to see the best doctor in Medicine in Bhopal, MP.",
    "doctor_response": "Hi welcome to HCM...Here chest pain present with heaviness and no cough or fever...So I want to rule out cardiac cause which seems most likely here ...Consult cardiologist or pulmonologist nearby and investigate with .....1.Blood pressure measurement2.EKG 3.ECHOCARDIOGRAPHY (2D)4.Angiography only if needed According to cause (decided by above investigation )treatment given ....You have positive family history of hypertension so consult doc without delay.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to avoid pregnancy after intercourse\n\nhi....this is sandya m a student.........i had sex wit my boyfriend on my 9th day of period started but nw this month 23rd has to get my period bt still dint get my period so wt cn i do get.......if i m conciev how can i get abort myself in home....plz suggest me",
    "doctor_response": "Hello dear.understand your concerns.first of all, you have sex on 9th day of period which is safe period and have less chance to become pregnant.if you still worried then you can check your pregnancy at home by urine pregnancy test . after 7 days delayed period you can check it.or you can check it by blood HCG test.if you are pregnant then up to 3 month intrauterine pregnancy,you can ABORTION by pills like pregout kit.This kit has 1 mifepristone tab.600 mg ,take it OrallyAfter 48 hours,take another 4 tablets of misoprostol 200ug placed in vagina one by one.I advise,di it under supervision of Gynecologist.I hope this will help you.ThanksDr.sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe back pain\n\nHi Doctor, How are You, Recently i am suffering from severe back pain, i visited the Ortho specialist and he suggested me to take X-ray and he prescribed me pain killers and to do some excercises. After that i didnt feel any reduction in pain, offcourse it really started paining more, so i have consulted a Ortho Surgeon and from Clinical findings he told me that there is no disc prolapse and he advised me to take an MRI. From the MRI report it is mentioned - Minimal Lumbar Spondlysis in L4 and L5 Finally they mentioned all the spine structure is normal. I am really confused. but still the pain is there, i am not getting any relief. i have been advised by doctor to take minimum of one hour walking every day. kindly advise Age : 29 Height : 164 Weight : 68 Kgs",
    "doctor_response": "Hi...I can understand your problem.As most of your report findings as well as clinical findings are normal, there must be some poatural problems or some faulty routine which causes pain. I advised you to start some light muscle strengthening exercises which will make your muscles strong ,will lose your weight and you will get relief from the pain. In case of pain which is not tolerable you can take some painkiller   like ibuprofen, as well as some muscle relaxant. I hope it will be useful to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Born with neuroblastoma stage 3, extensive chemotherapy and surgeries, huge drop in WBC once a year. Is it due to chemotherapy ?\n\nborn with neuroblastoma stage 3, extensive chemotherapy and surgeries with adhesions and occasional small bowel obstructions, now 28, once a year a significant drop in white blood cells, then almost as if the body recharges itself and its fine. Would this be related to the chemotherapy? OR could it be some kind of blood disorder which the doctors aren t catching? Happens every year, but cant find a reason or connection",
    "doctor_response": "Hi, how many time have you experienced drop in white blood cells? can you please mention what component of white blood cells mainly decreased? you have been treated successfully for the disease. now surgeries may be responsible for adhesions causing intestinal obstruction but yearly leukopenia ( drop in white cells) is not very common. you should be screened for other disease. autoimmune disease, lupus, infections like brucellosis also can cause leukopenia. bone marrow exam may be necessary. consult your physician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on either side between my waist and hip?\n\nI have a small lump under my skin on either side between my waist and hips kinda i dont know if its from where my pants rub or what but its been there for a while and is weird that its on both side my mother passed away from blood clots and the bumps worry me they are purple/red in color can u help me?",
    "doctor_response": "Hi,Dear,Good afternoon.Thanks for the query to my HCM online- clinic .I studied your query  in-depth.I  can understand your concerns for the bumps on your waist and hip,as your mother died of  blood clot disease and these lumps are red /purple.-In my opinion these waist / hip lumps are -acute on chronic , and the redness is due to the friction of the waistline on the chronic boils.-The fact  that you are worried more due to the purple colour of these lumps-as they resemble the clot colour.But dont worry  at all-for SURE.-Advise-Consult a ER doctor who, would treat it  and you would be alright  with help from a ER Surgeon if your ER doctor needs.-Alert-A review with ER-Surgeon for the steps to be taken with his advise is a must and urgently advisable in your case.-Hope this would resolve your worry-some query.Wellcome again to HCM .Have a good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Side effects of Redotil and Biophene to cure infertility\n\nHi While consulting for Infertility , my doc has prescribed 1. Ubi Q 300 2. Carvi 500 3. Lenova M 4. Biophene and 5. Redotil While the first 3 seem to be Nutritional Supplements , Could you please tell me what Biophene and Redotil are for? I ve been taking all except Redotil (as it was not available) for 2 weeks now and taking Redotil from today. Do any of these tablets have any side effects, especially with sweating, urinating or dizziness (I d say some state of confused/disturbed thoughts than just dizziness)? Thanks in advance for your anwers",
    "doctor_response": "Hi,   For low motility in the sperm count and so was given Biophene tablets for that.Redotil is an anti- diarrheal tablet. Side effects of Redotil are nausea, vomiting,sleeplessness and migraine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason of mild pain in testicles and irritation in urinary tract.?\n\nI am 33 male. What if the reason that.. the mild pain in my testicles and feel kind of irritation in my urinary tract.? my urine sample has no infection. and my urine flow also normal and no discharges from penis. I feel a kind of uncomfortably. Please help me doctor to sort out this..",
    "doctor_response": "In my opinion you should get a ultrasound done on your scrotum. It will help in knowing  precise cause if there any inflammation in testis or spermatic cord.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes water retaining?\n\nHello. I have a question about fluid retention. I just began a new exercise program about 10 days ago, and I seem to be experiencing water retention at a rate that is higher than what is normal for me. Any suggestions? I try to be mindful of what I eat and drink, but want to know why I am retaining, and how long i can expect to do so. Thanks.",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.Your water retention may be related to higher salt intake. So you should look for foods which are salty can be cause of your water retention. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Hemoglobin is at 9. 8 g/dL at 37 weeks of pregnancy. Kindly advice what is to be done.\n\nHi doctor, My wife is 37 weeks pregnant and the delivery date given by the doctor is 28th of this month. Two months ago, her hemoglobin was 8.9 g/dL and serum ferritin 36.44 ng/mL. The doctor advised drips with Venofer injections. Four drips (100 ml with two Venofer injections each) have been given. The last drip was given on 17th last month. Now today, the hemoglobin is 9.8 g/dL. One doctor has advised taking two more drips (500 ml with three Venofer injections each) while another doctor has advised us to go for blood transfusion immediately. Kindly advice what should be done. Her age is 28 years and it is the first pregnancy. Other than this, there are no complications. Medicines being used are one tablet daily each of Intig D, Iron One, Mecobel and Folic acid.",
    "doctor_response": "Hello. Hemoglobin is 9.8 g/dL. That is less for the third trimester. But, this is the corrected one, previously it was much lower. In delivery, there is a chance of bleeding, changes in clotting factors and hormonal changes at delivery which can cause more bleeding, difficult or complicated delivery or labor also need normal hemoglobin level. It depends on different doctors how they treat the patient according to her history, blood reports, sensitivity to iron, etc. If she remains comfortable with Venofer and does not get sensitivity, vomitings or any other side effects, then it is better to have that as there is less chances of immune reaction as that of blood from another person. Continue to take iron-filled diet like carrot, apples, etc. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain\n\nMy friend never had any medical problem in the past and she started complaining of back pains. After some time she did some tests and nothing came out but after the pain persisted we sent her to a qualified doctor and she was discovered to be having puss in the ribs. What could be the cause?",
    "doctor_response": "Hi,Welcome to healthcare magic.pus in the ribs is due to infection. It can be due to bacterial infection or tubercular infection .other rare causes are also.It require evacuation and treatment. I THINK this will be helpful to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nausea after undergoing angioplasty?\n\nHad an angioplasty last thurs. I was clear. Which im happy about. But im so tired and today i feel nauseated. Ive been having gas really bad since the procedure. Im not eating much. My systolic number has been low 101-115 over 75. But my heartbeat has been 89 or higher and sometimes thats upon waking up. Will it take awhile to feel normal?I",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern.You shoud not worry about this . I will try to explain you something.When you do the angiography a substance called contrast is injected into you blood, into your coronary artery to make them visible and look for stenosis. This contrast is than eliminated through the kidney and goes outside the organisms whith urinary output.During the first 48 hours after the angiography, as the contrast in still in our body it might couse hypotension,  nausea, vomiting.This is quite normal after the procedure. But usauly after 48 h it is eliminated  from the organism.So, if the angiography was normal, if the renal function after was normal and if 48 h has passed  every think should  come back to normal. The blood pressure values of 115/75 are quite normal, you should not worry about this.This values are our goal.So in my opinion your symtoms are not related whith angiography, it might be just a flu that soon will pass.Or it might just be a little streess as you experience even fast heart beats.If the symptoms persist if I was your treating doctor I will recommend a full blood analyze to find a reason why you feel tired or this nousea.Hope I was helpfull. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Planning IVF abroad. Prescribed microgynon. Started bleeding, pills left. Will it be considered period?\n\ni am planning to go for ivf abroad and the drs adviced me to take microgynon that would mean that i can choose the date for my travel since i was told to start it any time and stop 2 days before i intend to travel i started on day 8th of my period and i still have a week of pills left and but i have started bleeding its very confusing as the actual treatment of ivf has to be started on day 2 of my period is this bleeding counts as period or if i stop the pills and start bleeding that would count as period i have booked the flights and hotels i dont know what to do....plz advice..",
    "doctor_response": "Hi, Thanks for your query. I read your query and understand your concerns. Following is my reply: The bleeding you are experiencing is your periods. Unfortunately some people are not responsive to the medication to postpone at this dose. You have to start treatment on second day of your periods. I hope I answered your query. I will be available for any follow up queries you have. Regards, Dr.Mahesh Koregol IVF & Infertility Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a painful, swollen ankle following an injury. What to do?\n\nHi doctor, Before seven months, I sprained my ankle due to a track and field injury. I postponed crutches for a week due to a trip the following day, but went on crutches the next week. I never went to see a doctor. I just went through PT with my athletic trainer. I spent three weeks without rigorous exercise and was able to return. The pain finally subsided after three months. But, it is still swollen and sometimes, painful to flex. Why?",
    "doctor_response": "Hello. You have mentioned injury to the ankle region, which has been managed by you and your therapist. For further information consult an orthopaedician and traumatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tell me the diet once jaundice is cured\n\nhi i had jaundice for 2 weeks and it is been cured with consult of family doctor i wanted to know can start having nonveg food like chicken,egg,fish as my family doctor suggested i can go for it or i have to wait for some more week?please advice.",
    "doctor_response": "hi. good that you recovered from jaundice. see ass your still in recoverin phase i don recomend to directly jump in for non veg and all, start getting back to  your normal veg diet slowly around a week time , then gradually start little oily foods and then after around a month or so you can start with non veg. let your liver recover fully before you load for oily foods. and as jaundice is water borne , be particular about the hygiene.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for white gunk and tear in tongue due to biting\n\nmy daughter bit her tongue quite severely, it was very swollen for a couple days and the frenulum has torn so it appears that there is a gaping slit underneath.  there is also a lot of whitish discharge or build up underneath.  the swelling has reduced, but the white gunk and tear are still the same.",
    "doctor_response": "Thanks for asking in healthcaremagic forumIt is the slough which is visible as white material. If there is a tear which cannot heal itself, I would like to suggest you to go for suturing. So, If I would be your treating doctor I would first clean your infection and do secondary suturing after some time. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tumor on the aorta, intense pain with oral treatment, have advised against surgery. Will cyber knife prove beneficial?\n\nMy mom had a tumor on her kidney 10 years ago. she under went a radical nephrectomy . Recently they discovered another tumor and it s on/next to the aorta . Ct scan results. Her oncologist have recomended oral tx. She has not been able to tolerate it. They have basically stated surgery is not a good option. What do you think of the cyber knife treatment?",
    "doctor_response": "The risk of life loss is there with surgery and also to some extent with radiotherapy. Depending on the size of the tumor, cyber knife treatment will help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the lower back, blood in urine, high blood pressure. Kidney infection?\n\nI woke up two weeks ago with a very bad pain in the lower back right side. I went to the doctor and they took blood and urine sample. the urine sample had a little blood in it. the blood came back normal.  Took Blood pressure and it was 150 over 9o something. They said it was BPH. The prescribe pain pills for pain. Today I am having again on the right side lower back. Some times it radiates down to the groin area. Is this normal and when does this pain go away? To me it feels more like a kidney infection.",
    "doctor_response": "hi mr ..your symptoms of lower back pain, blood in urine suggest that ur suffering frm renal calculi ...as ther isnt fever as such dnt get worried of kidney infection and yes ther is a chance that u may get infection if renal calculi is not attended in early stage...go consulta urologist ,get a usg abdomen done nd x ray kub..investigations reveal the location nd size of the stone if  at all the scan is positive...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could a mass of tissue appearing behind last molar be?\n\nMy 2-year old son has, what appears to be a mass of tissue, behind the last molar on the upper left side of his mouth. The tissue itself appears to be healthy, it's the same pink as the rest of his gums but, behind the \"mass\" the area is a bit red, (maybe an emerging tooth?). 6 months to a year ago, my Son had an illness that caused him to have a severe case of thrush. It was at that time that I noticed a spot on his gum, (where the \"mass\" is now) that was purplish in color. His pediatrician said not to worry about it, it was most likely an emerging tooth but, now, there is this, \"mass\" that looks like a skin tag. What could this be?",
    "doctor_response": "hi.... at 2yr your kid primary tooth are  going to emerge. so it will be bulge tissue mass from where tooth will come . so not to worry so much this the time of eruption of primary teeth till 6 yr. after 6 perment teeth will begun to erupt. if further any doubt you have contact near by dentist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and blurred vision?\n\nHI, I ve had a weird symptom that has been happening for a few weeks. As soon as I sit down after doing housework or what ever I m doing, It takes everything I have not to just drop my head and fall asleep. The scary thing is this is happening while I m driving. The other day it just hit out of thee blue and I tried to force my eyes to stay open then I hit the bumps on the road like I was passing out again and I tried to open them and I kept almost crossing over the lines. This is very strange, it is also happening at home at soon as I sit down and relax that same feeling comes over me like I cannot control it. Sometimes I get the feeling like I m going to throw up. What could this be? It seems as long as I m up and busy I m fine but no sooner than I sit down whether I m in a car or home this happens. If someone is with me or I m concentrating on something it does not happen. What do you think it may be?",
    "doctor_response": "Hello!Welcome on HCM!Regarding your concern, I would explain that your symptoms seem to be related to narcolepsy or sleep apnea. I recommend consulting with a neurologist for a physical exam and some tests: - a multiple sleep latency tests to investigate for the above disorders- pulmonary function tests to exclude possible airway obstruction (part of obstructive sleep apnea)- an arterial blood gas analysis. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of flu symptoms?\n\nMy husband got a flu shot in Oct. However, about 30 hours ago now, he began exhibiting signs of the flu. SEVERE body aches and pains, headaches. . ( no fever that I have been able to detect) but chills. He is moaning constantly and I am trying to decide if I should call an ambulance because there is no way I can get him up to take him to the hospital. He sleeps for about 15 minutes and then wakes up with the moans from the pain. I have tried Theraflu and I even tried 800 mg of Ibuprofen. NOTHING is giving him relief.",
    "doctor_response": "give him xyzal ie levocetirizine. if the symptoms persist u may want to hv an er visit because flu doesnt cause such degree of discomfort which u described .its milder. thanx",
    "dialogue_context": ""
  },
  {
    "patient_message": "Medication for anaemia?\n\nHI, I AM A NAM VET, SHOT 5 TIMES, HIP RIGHR EMBOW AND 3 TIMES IN THE STOMACH AND GASTRO- HAVE HAD 5 CALOSME AND BEEN HOOK UP FOR THE LAST 16 YRS, BUT NOW IT S 10 TO 16 DAYS APART BEFORE I GO TO BATHROOM, WHICH IS DONE THUR STOOL AND LAX- NOW THE DOCTORS ARE ON THE IDEA OF BRI8NG OUT THE ROSE BUD-CAN LIVE THAT WAY- DIET IS POOR, NEED MORE PROTEIN WITHOUT BUlk, I HAVE TO WATCH MY VEGGIE DOWN FOR I TAKE BLOOD THINNERS, I AM ANEMIIC, THER IS MUCH MORE, BUT START HERE-THANK HH",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. As you agree, your diet is poor, which is contributing to malnutrition affecting your overall gut.2. Need to improve diet, with protein rich and moderate fat and carbohydrate diet. Being on blood thinners, should not affect much of your diet. The diet should be rich in soluble fiber from  banana and other fruits and vegetables.3. More fiber intake will lead to more output. Along with it, good hydration is essential. If nutrition improves, anemia should improve. Get a complete hemogram along with peripheral smear. Based on reports, further nutritional advise can be thought of.4. Continue blood thinners and other medications as advised. Diet improvement is foremost and you need to start from here. Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can it be malignant cells if had growth on peretoneum?\n\nYes please, I have been told I have growth on my peretoneum and am supposed to see an oncologist ia have done CT scan, x-rays and ultra sound all these came back with normal results except for the lapscope that showed some abnormalities of cells but again these were confirmed to be normal,can I possibly have malignant cells?",
    "doctor_response": "Just remember that all growths are not cancer. Since growth is seen further tests including scans and biopsy are necessary. Conclusion of specific diagnosis can be made only after HPE report. Understand that even if cancer latest treatment modalities are available that can cure cancer also",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe knee pain be treated?\n\nbad pain in right knee inside hurts to touch about quarter in size. Had total knee replacement in 2012. Dr. said looked fine in xray in Dec. About 7 months ago felt a pop in calf thought it could have been a hamstring. Wore compression sock that helped some then pain went to knee area in Nov. and hurts to lift leg to get into my Kia. Taking Alieve, ibprophen, and tramadol. Using heat and cold packs some. Losing weight has been a major problem because hurts to even walk.",
    "doctor_response": "Hello, Consult your orthopaedic and get evaluated. Get an MRI scan to rule out possibilities like knee joint effusion. As a first line management, you can take analgesics like Paracetamol or Aceclofenac for pain relief. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain, pain under shoulder blades and near spine, couple of hard lumps found. Should be concerned ?\n\ni have what I have always refered to as back pain , under my shoulder blades and near my spine , my daughter offered to give me a massage and felt a couple of hard lumps and when pressed hurt. However after the massage the paid reduced and the lumps moved - should i be concerned i am nearly 50 and have always assumped it was an age related thing. thanks",
    "doctor_response": "Hai, Thanks for writing in. Seems you are suffering from spondylosis of spine. Spondylotic pain can radiate up / down your spine or around shoulder blades or even to your limbs. Those lumps are nothing but spastic muscles caused due to pain. I would suggest you to get your spine examined by your doctor. He might order for an Xray or if needed anMRI of your spine after doing relevant clinical examination. Usually such lumps get resolved with physiotherapy, but may recur if the cause for back pain is not treated properly. Till then take rest on hard surface, avoid pillows, hot packs locally and analgesics/muscle relaxants might help you relieve the pain and spasm. Get well soon. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is facial hair growth a side effect of Isotretinoin?\n\nHi doctor, I am a 24 year old female. My height is 5'3\" and weight 58 kg. I have started to use Isotretinoin 20 mg per day. I have been taking it for the past seven days. But, my facial hair has grown\u00a0more all over my face. They are not dark, but noticeable. What to do? Should I continue the medicine? But, the medicine really cleared my acne.",
    "doctor_response": "Hi. 1. Serum LH and FSH (luteinizing hormone and follicle stimulating hormone). 2. Thyroid profile. 3. Ultrasonography pelvis. 4. Fasting lipid profile. 1) Eflora cream (Eflornithine) twice daily for local application over the unwanted hair. 2) Plan for Nd:YAG or diode laser for hair removal. For further information consult a dermatologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest therapy to control bp\n\nHi. I had a c-section in Feb 2009.. after the surgery, I (unfortunately) developed a \"mother's apron\".. that fatty overhang on the belly. While I was pregnant, I developed pre-eclampsia and sleep apnea - because of the PE, I put on a LOT of excess weight, approx. 60lbs. while pregnant. I have not been able to drop the weight, and have probably gained another 30-40lbs. My diagnoses of sleep apnea and the subsequent use of a CPAP machine have helped me to feel better, and have increased my energy level tremendously, but I am having a hard time moving! Everything hurts. My back most especially. What is a good first step to losing this weight? I gained it so fast, that I sometimes think that my body had no time to adjust to it.. and now it's falling apart! Thank you. :) P.S.. I don't drink alcohol, or smoke, and I eat well... yet my blood pressure is 170/102, and my resting heart rate is 104. I feel so unwell. Again, thank you.",
    "doctor_response": "Hypertension is alifestyle disease which requires lifestyle solution and occasionaly medicines .Please change your diet and lifestyle Stop dairy products Cut down animal protein Eat a plant based dietEat a high fibre diet with adequate fluids Reduce salt intake to 1tsp per dayno processed food like pastries , cookies , pizza , crackers ,carbonated drinks Do not eat from outside Please cook your own food start veggie juicing with clery ,Parsley , Beets preferably first thing in the morning Try one of them for 3 days the next and add the next .exercise daily for 30 minutes do meditation , yoga to reduce stress sleep for 8hrs You will start losing weight as wellas your BP will come down .This is not a short term advice .It is going to be a long term lifestyle change to reduce weight and be off BP medications hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does excessive masturbation lead to delayed ejaculation?\n\nHi, i am twenty three year old guy. i masturbate 2 - 3 times a day since its considered the moste safest practice of sex , but its not affecting my social life in any manner. Yet does it put me at risk in having delayed ejaculation. i have read many articles about it but none could give me a satisfactory answer",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.No, it won't delayed your ejaculation.But it's possible that your amount of ejaculation might decreases.Yes its safest practice to do. You can do it very sefely.There is no harm in doing it you can do it as many long days as you can do.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump in throat developed during medication for bladder infection\n\nI am 49. I have had a bladder infection and 2 other woman infections. Only sleep with my husband. So not an STD. Had been on 3 different antibiotics for this. The last one was flagyl. I think. Half way thru taking it I developed a lump in my throat. At same time my gut is a mess. Have now been on prilosec for three months and it doesn t seem to be getting better. Could it be candida vs. gerd? Had barium swallow and it showed a little reflux but nothing excessive the doctor said. I think I am not to the bottom of this. I have been misserable now for 3 months.",
    "doctor_response": "Hi,Good Morning.This is Dr.Savaskar from India,attending your query to my online HCM Clinic.-I studied your query in depth and Understood your health concerns.-Accordingly on the facts given by you-Treatment I would suggest is as follows-a-Your query facts are incomplete for the demands put by you.So I would advise you to  consult a Surgeon-as the facts given for replies are insufficient to comment-on the type of the lump of throat?which could be due to the oral sex and STD related lumps....Like Gonorrheal Tonsillitis ? LGV?infectious Mono?/  and bladder infection.b-Still-AS your have taken treatments with 3 antibiotics of which-while taking  flagyl you developed throat lump.Gynaec-Surgeon-Doctor would treat it after fixing out of Candida or / GERD.I would suggest the oral smear and or a scrapping of the lump to be tested under MICRSOCOPY, for fixing the cause of the throat lump.b-It would need FNAC- Biopsy before advising any specific treatment.FNAC BIOPSY would fix its cause and Gynaec-Surgeon-would treat it according to the causes.YOu have multiple symptoms and hence I would advise you to consult with Gynaec-Surgeon and STD -specialist,who as a team would treat your complex health problems on the lines suggested as above.c-Before treating the - GERD as confirmed from -Barium swallow-I would suggest OGD to confirm it.I would advise Proton-Pump Inhibitors with Domeperidol for the Reflux control.d-Beside this to avoid any further missery-follow normal Sex-practices with your partners with advise of the Gynaec Doctor, here on-wards,as yours is a complex health issue and you need to be serious about it on the lines suggested herewith.Wishing you healthy living and early recovery of this query.Wellcome for more queries till you get the satisfied.Thanks for your query to HCM Clinic.Have a Good Day...!!Dr.SAVASKAR M.N.M.S.GENL-CVTS,Super specialist and Senior Consultant-and Expert in Non-Curable-Disease therapy for Cancer,Asthama,etc,Rejuvenation therapy and Tissue failure -reversal therapies.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce SGPT levels?\n\nhi there,i have tinnitus my ears are constantly ringing i m just sick and tired of it i dont know what to do with it,i also have hepatitis b my sgpt was 16 but when i started execising and it went right up to 88,can you please help me what to do to lower it down i dont drink or smoke.",
    "doctor_response": "Hello,Tinnitus is due to nerve weakness.So take vit b12 capsule. It will be resolved in some time. Use headphone when it disturbs you alot.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please suggest an Ayurvedic medicine to cure hemorrhoids and bleeding.\n\nHello doctor, For the past two weeks, I am having pain and bleeding on defecation. It started with straining on hard stool. I am not constipated. On touching, I can feel two external hemorrhoids and maybe a fissure (not sure). I have increased the fruit intake and I am applying Sunarin cream to not much relief. Can you suggest any Ayurvedic tablets? I am a 39-year old male weighing about 70 kg. I am currently taking multivitamins.",
    "doctor_response": "Hello. Sometimes external piles do not create problems, but due to some reason like constipation and others it causes health issue. Just you should take care of constipation. I am suggesting you some Ayurvedic medicines. You should continue these medicines for at least two to three months. Please let me know about any other medications you are taking for any other health problems as it is necessary to know for proper treatment. Take fiber rich diet like fruits and veggies to avoid constipation. The treatment plan is as follows: 1. Arshhar vati one tablet twice a day after meal. 2. Abhayarishta two teaspoons twice after meal. 3. Pilex ointment for external application. 4. Isabgol powder at night before going to bed. Please give information about any other medications if you are taking right now or any other health problems if you have. Follow up after seven days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump near groin area?\n\nI have had a small lump near my groin area for several years now. It s soft and it feels like its filled with fluids. I usually leave it alone but now and then it would break and ooze out clear liquid under my briefs and after a while, it would bleed. I have tried squeezing it as it bleed to see if it may contain pus but only more blood just shoots out. What may it be?",
    "doctor_response": "Hi, If I were your treating Doctor for this case of a groin lump, I would come up with only one and one possibility that is a sebaceous cyst! Nothing to worry about this and try not to get infected there!I suggest you to go for an FNAC test of the lump for confirmation and to relieve your concerns!Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat leg pain in calves and buttocks?\n\nHi my husband has leg pain and also in his calves and buttocks. He is 28 and describes the pain as burning and electric shooting up his legs. He thought it was varicose viens and had them removed 5 years ago but the pain was still there and has since worsened with time. It never goes away but slightly lessens with sitting. He cant wear tight trousers or shoes cos they hurt him. He had an appointment with a neurologist who gave him tablets for restless leg syndrome but they have not worked. He has another appointment in november but is going crazy with the pain. any advise and ideas would be much appreciated. thanks",
    "doctor_response": "Hi, Your problem is this shooting pain along the legs and buttocks. Firstly to get relief from this pain he will have to avoid any posture, position, or work which aggravates the pain. He will need specific medication for nerve pain like pregabalin, gabapentin along with muscle relaxants and pain medications available in your area. He will surely need a neuro exam,an MRI of the spine,.Please ensure his sugars are controlled if he is a diabetic and to stop smoking if he is a smoker. Hope I have answered your queries. Let me know if I can assist you further. Take care Regards, Dr. George Verghese",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anger management issues\n\nI have friend who goes absolutely berserk swearing and yelling at friends no matter where he may be at. When something happens he blames everyone around him and creates a bad scene. I m not the only friend of his who is concerned for him as he has a family history of coronary problems. I would guess he needs anger management, but how do we convince him to seek that help",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Anger always comes due to frustrations in life. Frustrations are normal with everyone. People learn to ignore frustrations when they get experienced. Do your friend get angry to circumstances outside his home as he get angry at his house? His office, bus stand, railway station, neighbors etc. If yes, he might need to get evaluated for anger issues. If NO, just make him understand and compare the given  two situations and he can be better himself.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluttering sensation in the chest?\n\nMy heart is fluttering, and has been for a couple of weeks. My cardiologist just retired and I have not gone to anyone else in his office. I am in pretty good shape, I work out several times a week however, I am about 30 pounds over weight. I get pellets for my Low-T from my primary doctor but even with those we do not take me as high as I should be. I also take sleeping medicine - I am a very light sleeper and my primary dr. put me on Temazepam Cap 30mg about 3 years ago.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. After going through your medical query I understand your concern & I would like to tell you that most likely your fluttering sensation is because of anxiety which is why your are prescribed for Temazepam. Kindly get some blood tests done only to evaluate if anything else is underlying. 1. CBC 2. Vitamin B12 3. Thyroid Profile 4. FBS/PPBS, HbA1C Consult a Physician personally for physical evaluation. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the early signs and symptoms of heart attack?\n\nUhh...I had some questions about heart attacks Im a 19 year old female. For about two weeks Ive been pretty worried about a test. I just finished the test though...And dont feel worried anymore. Well I take that back...I DO feel worried. Ive had a strange pain in my left side...Sometimes in the right side.(As of....Yesterday and all through the night on and off).The pain isnt aweful...Just irritating I guess. My stomach is making lots of sounds,My knee feels like it has pressure in it(sometimes),my bottom jaw feels like it has pressure and my tooth hurts(Also sometimes). My period did start earlier that it should have...So I assumed all was due to stress. Could it still be stress? I admit I havent been eating as well lately(junky things)..But now Im trying to drink more water again to get back into my health kick. I dunno...I figured if it was a heart attack it would have hurt worse or Id already be in the hospital...",
    "doctor_response": "it's not heart attack it's due to stress . stay happy don't take stress eat healthy u r v young don't think about these diseases",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for suffering from allergic Cough\n\nI am suffering from allergic Cough. this happens to me evry year at the start of winter. I doc earlier used to me give Montek Lc for the same. But now he is trying to treat me with only Levocitrizine HCL tab. But this treatment is not curing me fully.",
    "doctor_response": "Hi, Since the symptoms are occurring every year same time, the most probable cause is allergic reaction. So montelukast 10mg once daily will help you more to prevent symptoms from occurring.  Better to start this before the appearance of symptoms. Hope this information helps you. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatmnet for bi polar and manic depression\n\nI have been diagnosed with having bi polar, manic depression, and ptsd. These diagnoses have come from a psychiatrist and a different counselor. I have very few manic episodes but a lot of depressive episodes lately. I am only on an antidepressant Lexapro. it does not help at all and I need help I m very confused what I have, can you help me?",
    "doctor_response": "HIThanks for using healthcare magicIn case of bipolar depression, you need both mood stabilizer like sodium valproate or lithium with antidepressant. You are only on antidepressant, in that case antidepressant dose is difficult to increase without proper mood stabilizer back up. Consult your psychiatrist about this and in case you need help, you can consult me.RegardsDr. Abhishek Kapoor",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the chest and lung CT Scan report indicate?\n\nI,am R.k.punsiba from Assam.My brother is suffering in chest &lung problem.Her CT scan report is (1)category IV cyst IN LOWER POLE (2)PULMONARY NODULES: METASTATIC (3) TINY RENAL CALCULI WITH NORMAL VISIBLE CONTRAST EXCRETION . So now we want to bettertreatment.would you please tell me what can we do now? Which hospital, which doctor&treatment will best for her.",
    "doctor_response": "Thanks for your question on HCM.I can understand your situation and problem.In my opinion you should consult oncologist (cancer specialist) and get done1. PET scan2. Blood work up for tumour markers.To search for the primary site of malignancy.He is having metastatic nodules in lung. This suggest that he is having primary somewhere else in the body.Following are the malignancies, commonly metastasize to lung.1. Liver2. Intestine3. Stomach4. Thyroid etc.So ,he needs PET scan to identify the primary site.Because PET scan will give hot spot at the site of malignancy due to high uptake of contrast.So it will help in diagnosis of primary.Treatment is based on primary organ only.Mostly he will need chemotherapy and radiotherapy and other supportive drugs.So better to consult oncologist and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My scalp is itchy, sore and painful with hair fall. Please help.\n\nHello doctor, I am a 20-year-old male. I am having an itchy, red sore, painful scalp with hair loss. Doctor prescribed me Minoxidil, Multivitamins, and shampoo. I am not using minoxidil because of its side effects. Please help.",
    "doctor_response": "Hello. I have seen your attached photograph. (attachment removed to protect patient identity). I hope the following suggestions are able to help you: 1) As of now do not restart Minoxidil as it may end up irritating the scalp further. Of course, you may restart it once the primary issue has settled. Similarly, make sure what kind of shampoo has been suggested to you. I prefer to use a shampoo that has an anti-bacterial, anti-fungal and inflammation-reducing properties. e.g. a shampoo containing Betadine (BETADINE-AD Shampoo). Apply the shampoo gently over the scalp with gentle massage and leave on for three to five minutes, then rinse off with cool water. Do this every day for five days, then alternate days for a week. Then you may resume your normal shampoo. 2) The strongest possibility of your scalp sore is that of a scalp Furuncle, which is a bacterial infection of the scalp roots. For this, take the following medicines (I have mentioned few common trade names of the medicines for your benefit). a) Antibiotic containing Amoxycillin 500 mg and Clavulanic acid 125 mg (625 mg) dose capsules. You need to take one capsule two times a day for five days. Trade names: Capsule Augmentin or Amoclan or Amoxiclav or Clavor. b) Since any antibiotic may cause a little stomach upset, take a probiotic capsule containing Lactobacilli (yogurt bacteria) once a day or you may also take yogurt twice a day. c) Anti-inflammatory medicine to reduce pain and swelling. Take a tablet containing Diclofenac Sodium 50 mg twice a day for three days. Take this tablet after breakfast and after dinner. Trade names: Cataflam or Diclofen or Dicloced or Diclogesic or Volfenac. 3) If symptoms persist, it may be a pointer towards a possible fungal infection, for which you will need a hair root test for KOH (Potassium Hydroxide) 10% to detect the fungus. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "HR CT scan, pulmonary fibrosis, ANTICCP positive, dyspnea on exercise, acupressure the solution ?\n\nHR CT SCAN SUGGEST THE CHANGES PECULIAR FOR THE PULMONARY FIBROSIS .ANTICCP IS POSITIVE.RH.FACTOR IS NEGATIVE.NO JOINT PAIN SUFFERING.NO SIGN OF PULMONARY HYPERTENTION.GETS DYSPNEA ON EXERCISE AND CLIMBING STAIRS.ROGHT NOW ON AZURAN 50MG PLUS 2MG. METHYLPREDNISOLONE. DO WE HAVE ANY BETTER OR CURATIVE TREATMENT IN ACCUPRESSURE.",
    "doctor_response": "hello.please let me know the outcome of medicine you are using.if there is some improvement,then please continue,otherwise on receipt required information,Ishall be happy to do some thing for the treatmentof your problems. dr.mohsin madni",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can breast microcalcifications be treated with lumpectomy?\n\nI am having a biopsy Tuesday for Microcalcifications , deemed suspicious , they are in one cluster and a couple more less than a centimeter away . How likely is that to be cancer and if so can they treat it by doing a lumpectomy instead of Mastectomy?",
    "doctor_response": "Dear mam. Since the biopsy is suspicious. I hope mammogram is done. We need to look into the size of the lesion. If its just focal, it can be removed by lumpectomy with wide local excision and we need to ask the pathologist to look into margins of the specimen. If margins are clear, nothing to worry. If affordable, better that you get a FDG PET scan done and look if its abnormal. If focal same lumpectomy can be done with follow up.If Microcalcifications are diffuse, we need to c if its benign r malignant, extent of involvement and later take a call on how much of brest needs to be remove.Hope this information is helpfulThank u",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the muscle pain in the shoulder blade at the back?\n\nI have a muscle ache in the shoulder blade region of my back. Every morning when I wake up, I find it hard to get out of bed by moving up into a sitting position. Its been going on for about a month now. Its not to the point where it hurts, but I can definitely feel it when I turn my head left and right. Ive tried massaging it but I cant get a proper grip on where it actually is. I believe it is much deeper and hard to massage from the outside. What is wrong with me?",
    "doctor_response": "Hi,Thanks  for  your query.The symptoms you have described are more likely to be symptoms of muscles strain.To get relief from the pain and for quick healing:1. Do hot fomatation at the site.2. Apply local anti-inflammatory gel 2-3 times a day.3. Take anti-inflammatory drugs like Ibuprofen to reduce pain and local swelling or inflammation.4. Do not lift weight or try to do exercise that involve painful muscles. Give proper time to heal.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of Tourette syndrome?\n\nMy 27 year old daughter suspects she may be having symptoms of Turrets. We noticed when she was 12 she would jurk her wrist once in a while then a couple years later it was her wrist and elbow. now the tics appear to be more vocal and blinking. where should we start our research to help find out if it is turrets or something else?",
    "doctor_response": "Hi, Tics - sudden, brief and intermittent movements or sounds are the hallmark sign of Tourette syndrome. They can range from mild to severe. Severe symptoms might significantly interfere with communication, daily functioning and quality of life. Tics can also involve movement (motor tics) or sounds (vocal tics). Motor tics usually begin before vocal tics do. Other possibilities like rheumatoid chorea or Wilson's disease or postviral infection demyelinating disease etc. Until examination is done it is difficult to say what it is. We have to get it done complete central nervous system examination with blood investigation with imaging of the brain. Please consult your doctor, he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could breathlessness and hearing palpitation be related to stress?\n\nhI..fIRST OF ALL I HAVE NO MONEY,BUT AM HOPEING YOU CAN HELP ME OUT. a FEW HOURS AGO MY HEAR STARTED PALPATATING AND THUDDING,I DO NOT FEEL SHORT OF BREATH NOR DO I HAVE PAIN PER SAY. i HAVE A LITTLE PRESSURE. i AM ON PERCOCET, AND ATIVAN WHICH I HAVE BOTH TAKEN,I TRIED BAKING SODA IN CASE IT WAS GAS RELATED. i LOST MY MOTHER 1 MONTH AGO, AND A GOOD FRIEND 2 WEEKS AGO. MY QUESTION IS, DO YOU FEEL THIS IS STRESS RELATED???? OR SHOULD I BE CONCERNED, I ALSO TOOK AN ASPRIN. THANKS SO MUCH.",
    "doctor_response": "You are having anxiety and panic attack.Easily treatable just take a single tab mouth disaolving clonazepam. Whenevwr you have such symptoms.Continue the aspirin.Do some mild exercises.Communicate with family members and friends. Reduce the unwanted stress.So dont worry.  Hope my suggestions helpful and thankful to you. Take care. Don't forget to give ratings.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high BP\n\nim 26/m..feeling dizzy for the past 2 weeks..hypertensive...known smoker..occasional drinker...now my eyelids getting stuck..n red when i getup morning..what u think i hv...plz do help me...n im not in b.p medication..as no doc is giving me a proper drug..either has side-effects..or doesnt bring my b.p down..(170/110)",
    "doctor_response": "Hi,You being an young hypertensive you first go for evaluation for cause of blood pressure. You should undergo test like kidney function test, renal artery Doppler, Sr Cortisol and 24 hour Urinary Metanephrines. Also get lipid profile and sugars tested. You should start on tablets like Amlodipine and other medicine depending upon your blood pressure value. You should follow lifestyle modification like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day till BP is controlled then once or twice a week. Regular exercises like brisk walking, jogging according your capacity at least 30 minutesa day and 5 days a week. Eat lots of green leafy vegetables, fruits, fish once or twice a week, and avoid meat. Avoid smoking and alcohol if any. There shouldn't be abdominal fat deposition or obesity.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "Missed period with negative pregnancy test. Tried IVF and IUI to conceive. Chances of pregnancy?\n\nHey. I haven t had my period for 2 months now. I am 32. We tried IVF s and IUIs and all failed. I took a pregnancy test and they were all negative. I am married but on Jan. 7th decided to try with my long lost lover instead of spending another $20,000 on infertility treatments. My last period was Dec. 13th. haven t had one since. No symptoms. Negative test, but it s driving me nuts . What do you think? Advice? Do you think I could be pregnant? After 5 years of no success?",
    "doctor_response": "Hi, A negative test after 2 months excludes pregnancy. Also, you seem to have had intercourse not during the fertile period, but in the safe period, presuming that you have regular 28-30 day cycles. You could be suffering from unexplained infertility, but the cause of your present amenorrhoea should be elicited. For further evaluation, you may consult your gynecologist, get a trans-vaginal sonogram and a blood test for beta-hCG. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hypertension and kidney problem\n\nSir, I am 40 years old male from New Delhi and for the last 1 year is been suffering from hypertension and Kidney problem, my cretinine level is at 4.8 and calcium is at 10+ , i also develop irregular TSH value.after so many medical examinations doctors have fail to know the reason of kidney going bad.pl suggest?",
    "doctor_response": "sir ...i suggest you should meet nephrologist or endocrinologist ...there are many good ones especially in aiims or safdarganj hospital or medanta ...your is not a big problem ..your yhyroid and kidney disease amd hypertension are to be taken care of ...please do not delay ...i would suggest Gfr ...thyroid status ...kidney function test profile and ct abdomen ...for bp the drug has to be chosen taking kidney function and thyroid function and sugar level in count ...please donot delay ...i can recommend dr saifa kuchaye at medanta .he is endocrinologist ...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for bad odor penis?\n\nMy penis smells like fish. I shower twice a day very thoroughly. I am circumcised. I don't have a lot of loose skin. I have noticed this in the past year or so. The smell will start as quick as an hour after I shower. It is not semem producing the smell.  I do drink beer on a regular basis. I take simvistatin daily.",
    "doctor_response": "Hello, In every possibility, the bad odor has to be due to the sweat coming out of your groin. You said that you experience the odor after an hour of your shower. That itself is clear that the odor is produced by the sweat. You may have excess sweat around your groin. It is very difficult to control this. Reduce salt intake and exercise well. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment for cough and cold without the usage of steroids\n\nMy daughter is 1 year and 11 months old ansd frequently suffers from cough and cold.Recently she has been prescribed with LEVOLIN  INHALER(two puffs every fhrs when there is cough / wheezing. AND BUDECORT 100 INHALER(2 PUFS TWICE DAILY for 8 weeks).hOW FAR IS THE USE OF SUCH INHALERS SAFE FOR A BABY OF this age..WHAT ARE THE SIDE EFFECTS OF SUCH INHALERS? Does it contains steroids.. Are there any other option of treatment without the usage of steroids...",
    "doctor_response": "hi; your daughter is around 2 yrs & it is common for small children to suffer frequent cold & cough .this problem will be off & on till she is 5 yrs or more;but the severity & frequency will reduce.cold gets settled in chest to produce mucus which blocks the airway producing cough /wheeze.Your doctor has prescribed inhalers which is good practice;of that levolin is a bronchodilater & Budecort is a steroid.These inhalers are safe & better than medicines as inhalers contain dosage in micro grams & medicines in milligrams ;micro is smaller so your child gets benefited with the minimum dose.Budecort is a safe steroid and also its dose is in micrograms so no need to worry.Inhalers are safe & can be used as long as they are needed.These inhalers are more effective & safer than medicines for long term use.As for other options you can try to keep away your baby from too much pollution ;cold things ;or few things she may be allergic to but it is difficult in children;so please take care. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of painful head pressure when bending?\n\nHello I am currently having symtoms where everytime I bend down or lay down it feels like this painful pressure or fluid in my head is moving. I have been coughing up really thick green mucus. Sometimes it is so hard I choke. What could possible be going on and how can I stop it?",
    "doctor_response": "Hi,You should know that your symptoms could be related to a sinus infection. That is why, I would recommend consulting with your doctor for a physical check up and some tests:- a sinus X ray study- complete blood count- sinus discharge bacterial cultureYou may need to take antibiotics. Hope to have been helpful. Let me know if I can assist you further.Best wishes,Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore, painful to swallow throat with breathing difficulty?\n\nHi, had a throat problem for couple of days now - sore, painful to swallow. First time had situation like now where just woke up struggling to breath perhaps because the throat is swelling more and more. If this continues I will soon be unable to breath - what is wrong & what can I do",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. By your history and description, possibility of seve upper respiratory tract infection (URTI - pharyngitis) is more likely.In my this, throat is Inflammed and congested which gives you symptoms of sore throat, difficulty in swallowing and breathing. So follow these steps for better symptomatic relief. 1. Do warm water gargles 5-6 times a day. 2. Start levocetrizine and paracetamol combination twice daily.3. Avoid oily and spicy food. Avoid hard to chew food.4. Also take broad spectrum antibiotic like levofloxacin or azithromycin once a day after breakfast.5. Drink plenty of fluids orally and keep yourself hydrated.Don't worry, you will be alright with all these in 1 week.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Rexipra be taken for panic attacks?\n\nHi , My brother was suffering from panic attacks for 8-9 months. while reducing the course of medicine he feels the same issue is coming back again. He is now prescribed lonazep .25  half tablet in morning and 1/2 in evening along with rexipra 5mg. Dr. asked to leave the tablet when he feel ok. what can be effect once he discontinues the lonazep ? is there any chance he can get addicted to lonazep if same issue back again?",
    "doctor_response": "Hi,I do appreciate your concern for your brother. Panic disorder responds well to treatment if provided adequately. Rexipra (escitalopram) is a safe and effective treatment option for panic disorder. However, the current dose of 5 mg/day is sub-optimal. The dose range for escitalopram is between 10-20 mg/day. Lonazep is clonazepam which helps in reducing the anxiety on symptomatic basis. The anxiety remains controlled as long as it is taken, but will re emerge when it is stopped. The problem is, with time, there is a high chance for developing dependence on it. So, it is usually recommended only for a short period of time.In your brother's case, I would recommend that you discuss with his psychiatrist regarding increasing escitalopram further up (to 20 mg as required). It will help control his panic attacks and he won't need clonazepam. Moreover, the treatment with escitalopram should be continued even after the panic attacks has stopped completely (around 1-2 years), so as to prevent relapse.I do hope I was able to answer your query. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with carcinoid tumor, no improvement with chemo since lesions are bigger and spreading rapidly. What is the life span after stopping chemotherapy?\n\nMy father in law was diagnosed with carcinoid tumor (bone mestasis) in march of last year the last dr appt he went to almost a week ago the doctor told him the chemo is no longer doing any good and the lesions are much biiger from 3cm to 4 and new lesions have appeared and that it is spreading rapidly and is very aggressive. He does not wish for hospice and I need to know what signs to look for and about how long he has after the chemo stopped working?",
    "doctor_response": "Hello, Sorry to hear about the condition of your father-in-law. Let me tell you that there are multiple treatment options in carcinoid tumors. 1) He can be put on injection octreotide. Studies have shown that octreotide alone can reduce the tumour growth rate. 2) There is a form of treatment that uses radiation that can be targeted specifically to the carcinoid tumors. It is very effective. The survival of the patients with this form of treatment has been upto 40 months median in several studies in patients with metastatic disease. This treatment is called Peptide Receptor Radionuclide Therapy (PRRT). If you can let me know where you reside, I can possibly guide you with regards to who can provide you the service. I have myself worked in a center where several of the patients who had metastases and failed chemotherapy have taken this treatment and had a good response and survival. With regards to the survival of the patients with carcinoid there are several factors that predict this. If he does not have the heart affected by the disease that is a good thing to start with. There is a marker called as the Ki67 index. This will give an estimate of the growth rate of the tumor. If it is  Kindly check with these results and discuss with oncologist or nuclear medicine physician or you can contact me for further details.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I visit a neurologist for dizziness along with palpitations?\n\nHave been having episodes that come on quickly of dizziness, feeling faint, very rapid heart rate, sweaty. Blood work was normal, CT and MRI of brain were normal. Do these symptomd warrent a visit to a neurologist? Aldo, sometimes my family says I shuffel when I walk.",
    "doctor_response": "Hi, Concern a neurologist and get an ECG done too. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Neeraj Kumar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have ultrasound report for kidney. Can any online doctor help me to read it?\n\nultrasound scanning of abdomen and pelvis Right kidney size : 94*41mm. eri renal areas normal, renal capsule normal. cortical thickness, cortical echo pattern and corticomedullary differentiations are normal. Calculus measuring 18mm noted in the pelvis. No hydronephrosis and no mass lesions are seen. left kindey size : 94*45mm eri renal areas normal, renal capsule normal. cortical thickness, cortical echo pattern and corticomedullary differentiations are normal. Multiple calculi, largest measuring 8mm noted. No hydronephrosis and no mass lesions are seen. sir, my questions : is stone is having in both the sides or only the right side of kidney.",
    "doctor_response": "HiCalulus means stone.You are having 18mm stone in the Right kidney and multiple stones in the left kidney.The biggest stone is measuring 8mm in left kidney.You have to consult a Urologist and take treatment.Wish you good healthRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for spondylitis and shoulder pain\n\nHi, My name is Sudipa karmakar. I m from kolkata. I want to the few details. At 1st I want to tell that my mother is suffering from spondylitis from last few weeks which results pain in shoulder as well as in her left hand and waist also. She is also a diabetes patient. She has low b.p and weakness. I want to do proper treatment for her.",
    "doctor_response": "Hi,Thanks  for  your query.Although it isn't possible to diagnose your mother condition without an examination and a few tests, her history is suggestive of Adhesive capsulitis(Frozen shoulder) or Calcifictendonitis.These conditions are easily managed by regular physiotherapy ( Range of motion exercices,stretching and strengthening exercises). Over-the-counter pain relievers, such as aspirin and ibuprofen (Advil, Motrin), can help reduce pain and inflammation associated with this condition.I would suggest getting this evaluated by an orthopedician nearby for an accurate diagnosis and appropriate management. Your doctor after diagnosing the condition might refer to her a physical therapist.A physical therapist can teach her stretching exercises to help maintain as much mobility in  shoulder as possibleI do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "History of appendectomy and abdominal scar. Have abdominal pain, UTI, headache, high blood pressure\n\nI had open appendectomy 22 years ago and a long scar on the right lower abdomen. I have been feeling pain from this since. I have had series of urinary tract infection , ultrasounds, both transvaginal and pelvic . The pain can be very discomforting at times. A week ago I had a severe pain after a dance exercise, the pain was so severe that I could not walk, stand, sit or turn in bed. I went to the emergency they had a ct scan and blood work everything was normal and I was given vicodin and muscle relaxers. I still feel the pain constantly I cannot stand straight,the pain is not going away. I have been having headaches consistently with the pain, my blood pressure is high. I went see a GI doctor and he suggested a colonoscopy which will be done nextweek. I cannot bear this pain any longer this month I have not seen my period, I noticed a change in my bowel movement . Also I am feeling a foul smell in my breadth. I am 47 years old this really affecting my work, i read articles about stump, ingunial hernia and would like to go back to my doctor and discuss all these, do you have any treatment regimen for me to discuss with my GI Doc. I want to get back to my normal.",
    "doctor_response": "Hi The pain may be due to Incisional hernia occuring in the scar site. Stump appendicitis will be diagnosed in CT scan. Another possibility is Sub acute intestinal obstruction due to adhesions . Please come back with Colonoscopy report,i will further clarify. Till then take Smooth muscle relaxant like Dicyclomine,a Pre and probiotic. As you have not seen your period,please Consult Gynaecologist also. Wish you good health Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for asthma ,cold,shortness of breath,dizziness and palpitations\n\nim a women 35 recent ally getting over a cold about three weeks now\u2026sinus upper chest cold..i have asthma but my concern is as I m feeling better from the cold\u2026I m having a bit of shortness of breath heart seems to be pounding and i get a bit dizzy lightheaded..occasional heart palpations feels like heart fluttering..",
    "doctor_response": "hi, are you on medication? as drugs used for asthma may cause palpitations. you may require steroid inhalers which can give good relief in short term use. hope this helped.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes brown semen discharge with burning during ejaculation?\n\nI'm Recovering from a Kidney infection and find since that infection that My sperm is light brown and watery. It also burns some when I ejaculate. The ER gave Me fluids and Antibiotics through IV and put Me on Cipro twice a day. The Infection has cleared up but having this problem with Semen Now. What do You think?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It could be due to the infection you are having. Since I don't have the details , difficult to comment.I think if you continue to masturbate it might clear up. But please discuss with your urologist before doing that. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why there is pain under the ribcage of the left side?\n\nI fell down some stairs about two weeks ago and the next day was bruised up and my back hurt like hell. Four days later when that pain was gone I ve been having sharp pain right under the rib cage on my leftside. Doesn feel like ribs but more so the tissue underneath. Anything you could think of?",
    "doctor_response": "Hi, As you had a fall over the staircase this will be a direct impact to the bone of the rib cage and then the intercostal muscles must have got inflamed. For a safety side, an x-ray in the AP and the lateral view will be good to see if any hairline fracture is present. also do hot water fermentation, simple breathing exercises while putting the hand over the tender region. this will help the normal respiratory function to be intact and also allow a good healing process. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to treat hypogonadotropic hypogonadism?\n\nHi doctor, I have hypogonadotropic hypogonadism. My FSH, LH, and testosterone levels are low. My sperm count is zero. I am taking HCG 5000 and HMG 150 twice a week for the past three months. After taking it, my testis size got increased from 1.79 cm to 1.83 cm. Now after three months of treatment, my testosterone is 1.1 ng/dL. After three months of treatment, my sperm count remains zero. Please suggest. Please say whether I have primary or secondary hypogonadotropic hypogonadism.",
    "doctor_response": "Hi. There is no primary or secondary hypogonadotropic hypogonadism. But hypogonadism can be primary or secondary. In the primary, the defect is in testis with high levels of FSH (follicle stimulating hormone), LH (luteinizing hormone) and there is low testosterone. In secondary, there is a low level of FSH, LH, and testosterone. So you have secondary hypogonadism also called hypogonadotropic hypogonadism. Do a serum prolactin test. You are taking HMG (Menotropin) and HCG (Human chorionic gonadotrophin). It will gradually increase the testosterone level and testes size, which is small. Since you have zero sperm count, you must wait for at least six months as the testes size is small and the spermatogenic tubules will take time to develop.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for a lung infection\n\ni need your suggestion on appropriate care. i have been on interferon and riboviran and i will complete the treatment in 3 weeks. i have been non detectable since week 4 and it is a 48 week treatment. my cea is 6.4, my alkalinephosphatase is 182. i just had a ct scan and it shows a 1mm lesion rt love of liver wit ct features compatible with hemangioma it says rt lobe of liver , 1cm low density lesion on tip of the rt lobe of the liver with peripheral enhancement. lision is not discernible on delayed imaging. , liver is otherwise remarkable per report, i have a 2 and 5mm noncalcified nodules in my rt lung, bilateral ovarian cysts, 3mm lesion rt lobe of thyroid. small bilateral axillary lymph nodes, small bilateral inguinal lymph nodes, broad based disc buldge l4 l5 and thickened ligamentum flavum with narrowing of spinal canal. what do i need to do? what kind of follow up",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The lung infection remedy guidelines need details of symptoms which are lacking here. As per primary guidelines I can suggest - deep breathing exercises, walk in fresh air, YOGA - antibiotic as per the clinician choice - gargles with salted lukewarm water added peppermint oil. Would appreciate follow up with details of symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes right-sided chest discomfort and breathlessness?\n\nHi.In my US, liver size and shape is normal but mild coarse echo texture seen. Rest everything was fine. In fibroscan the result was 9.2 kPa. Endoscopy was normal. Always remains discomfort in right side of chest. Sometimes very short feeling of nausea. Very short feeling of short breadth. Gall bladder neck has shown small polyp of 3 mm size.Can you pls suggest? Can I take alcohol in moderation once in two weeks? Manish kumar.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.No, you should quit alcohol completely.Your ultrasound report is suggestive of mild coarse echo texture.This is beginning of liver damage.And alcohol is known to cause liver damage.So if you drink alcohol further, this will damage your liver more and cause cirrhosis (permanent damage of liver).So better to stop alcohol habit for rest of your life.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high blood pressure\n\nSir,My age is 21 years my blood pressure increased before 1 year after this I met to Dr.C.B.Maddhesia in Gorakhpur he suggested me some medicines of deprasion and a 0.25 alprazolam tab.My medicines are continue till now.but my blood pressure level is not decreasing I checked blood pressure yesterday it was 152/88.Some time I feel that some light pain in heart. Please suggest me what should i do ??",
    "doctor_response": "Hi,welcome to HCM..Thanks for writing to us.At such a young age hypertension is unlikely though it may be present.At this point of time you should go some preliminary test to find out the cause of hypertension or any associated comorbidity.The following tests are necessary:1.complete blood count.2.lipid profile3.fasting and pp blood sugar4.serum urea and creatinine.                                      Regularly moniter the pulse and BP, atleast once in 2 week.In addition to that you can have antihypertensives like AMLODIPINE after consulting with your doctor.Hope I have answered your query.Stay fit,good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does echocardiography report indicate?\n\nHello doctor, I have done the echocardiography. Can you suggest me what to do?",
    "doctor_response": "Hi. Your echocardiography report is very normal (attachment removed to protect patient identity). One thing you may be thinking is what is diastolic dysfunction grade 1. DD grade 1 denotes that your left ventricle is a bit stiffer than normal. It is usually due to prolonged raised BP. Also, present in obese people without hypertension. So, control your BP if it is raised and lower your weight, reduce salt intake in the diet. Otherwise thumbs up for your echo. It is normal.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed bright red blood midway of taking Levora. Is it normal?\n\nI started taking Levora .15/30 3 months ago (currently midway through my 4th packet) I had protected sex 4/14 and 4/28. And I had my period on the 1st of the month, 5/1-5/6. But tonight, 5/18, I noticed bright red blood on my underwear and I m wondering if this is normal at 4 months? I usually take my pill between 7-10am Thanks",
    "doctor_response": "Occasional breakthrough bleeding in the first 3 to 6 months of oral contraceptive pill use is not at all unusual. I wouldn't worry about it at all. Continue taking your pills on a regular basis. These types of events should be there unless you miss pills.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lumps in butt\n\nI've had a lump on my right butt cheek for about a year now. It was the size of a bottle cap when I got it checked out last year. The doctor said it wasn't cancerous when I got it checked out but didnt do any tests on it. A few days ago i started having kidney trouble. I also started throwing up every meal. Than yesterday, the lump on my butt started hurting for the first time. Could it be cancer or leukemia?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  Lump on butt chik is not cancer or leukemia.  It has no relation with your kidney problems or gastrointestinal problem.  It may be some benign lesion, abscess, fissure, fistula or piles.  You should go for examination. and if needed go for surgery yo remove it.  You should also go for complete kidney function test and take further treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red spots on arms and legs?\n\nmy 18 month old had a bit of a raised temp for about 2 days, then after that came up in small red spots on his arms and legs, its not getting worse but not getting better his only had the rash for 2 days, does this sound like a viral thing? also this morning he has what looks like little bits of blood raised to the skin that are very tiny?",
    "doctor_response": "Hello, It could be any viral exanthematous illness. But as you quote them as itchy blisters - the possibilities are Hand Foot Mouth disease/ Chickenpox/ any other trivial viral exanthem. I suggest you use calamine lotion as its giving results along with oral antiallergics like Hydroxyzine or Cetrizine. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sumanth Amperayani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could chest cough with runny nose in children suggest?\n\nMy 1 year old had a runny nose that started 1 week ago.  He has not eaten for 2 full days, but will take a bottle of milk/formula.  He is very tired, and not himself.  He had a low grade fever yesterday, but not today.  He now has a chest cough.  Does he need to see a doctor?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.Cough and cold are viral 95% of the times in children. For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15mg/kg/dose (max ceiling dose 500mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.For cold you can use Cetrizine at 0.25mg/kg/dose every 12 hourly for 3 days.For nasal block, plain saline nasal drops will do, every 4-6th hourly to relive nasal congestion.If he develops severe repsiratory distress and fever not settling in 4-5 days and feeding difficulty - you need to seek medical attention please.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dry scaly skin on buttocks, upper thighs. Using cortisone, lotrimin. Treatment?\n\nI have dry scaly skin on my buttocks . I attempted to use cortisone initially, but now I think this skin disorder is fungal in nature. I bought a tube of lotrimin and I ve applied 1 treatment so far. I can t believe how bad it s gotten. It has spread all over my buttocks in some upper parts of my legs. I plan to continue the lotrimin treatments. Will it worsen before it gets better?",
    "doctor_response": "fungal infection you are right tak tab forcan 150 mgm aonce a week for 3 months tab cleritin 10 mgm night kee dry no  oils apply quadriderm ointment morning evening in between can use mycoderm powder loose clothers clean sweat immeditely ypu feel 3 months and that is it",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach pain in a child\n\n5yr old daughter came home with severe stomach ache, and fever of 102. Advil given and fever broke. She was feeling fine untill advil wore off and then she had stomach ache, fevet of 102 and now complaining of sore throat. Shes exhausted and mentioned her eyes were burning twice today....not sure how to help her other than keeping fever down.",
    "doctor_response": "Hi Dear Welcome to the HCM,Baby has contacted some viral infection leading to the given symptoms. Paracetamol @ 15 mg per kg can be given 4 to 6 hourly along with antihistamine decongestant medicine  will relieve the symptoms.Plenty of liquids ,.Take care of the nutrition.hope the query is answered.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I use betnovate to get rid of rashes and infection of skin?\n\nskindoctor my face is suffered from the infection before my skin is very smooth but till my skin id rashess and marks and black marks there i am also consult the doctor but there no use now i am using the betnovate gm it is good or bad now i continue this cream this cream using before one day",
    "doctor_response": "Hi, I would not recommend Betnovate-GM cream to my patients as it is associated with many side effects. Especially, for infective conditions, it aggravate the infection as it contains corticosteroid. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does smoking Marijuana during pregnancy slow down the cervix dilation?\n\nI am concerned that smoking marijuana in the last trimester has slowed the dilatation process. The patient has been consuming a moderate amount and has been at 3cm and 70% for 2 weeks, with quite consistant contractions. Also concerning is that they plan to continue smoking with breast feeding",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Marijuana do have effects on babies sometimes, stunts their growth. However sometime it decrease uterine contractions by its antispasmodic effect and also sometimes reduces its dilation. Hope you are satisfied. yes do affect breast feeding and may pass through milk and make the baby drowsy or vomiting. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathlessness and swollen ankles while on Crestor?\n\nI have shortness of breath when walking only I have oedema which is swollen ankles. I have been taking tablets for cholesterol Are I am overweight and have shortness of breath also have oedema. Swollen ankles take Lasix. I would like to get rid of shortness of breath I have a weak valve in my heart also. Maybe not strong enough to move fluid I take Crestor for cholesterol have taken for about 5 years. Is this affecting me I wonder is it a statin.I am 84 years",
    "doctor_response": "These are good questions. Swelling, breathlessness and a heart valve problem may be tied together. Fortunately, the statin, Crestor, is almost certainly not a source for concern. Although each of the problems you describe may be related, they may also have nothing to do with one another. To know of the valve and be taking Lasix, your doctor will have done testing and know the answers to these questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for adenocarcinoma\n\nHi my grandmother is suffering from cancer. she has been diagonised with Adenocarcinoma of right lung. Please suggest from where can we get the best treatment. I am in India. How serious is her illness and which treatment would be best for her. I am attaching the reports. Thanks . Mamta",
    "doctor_response": "this is very serious disease and one of the worst cancers. treatment depends on grade and stage of cancer but usually surgery isnt possible whil echemotherapy is limited but it most be done Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any medication available to help break up of phlegm?\n\nI have a dry non productive cough for the past 7 days, local doctor prescribed anti-biotics and Mucinex DM...but it doesn't seem to be getting any better or help in breaking up any phlegm. Seems worse at night when lying down. I have a constant sticky substance in the middle of the throat and upper chest area.  Is there any other kind of medication available to help break it up ?",
    "doctor_response": "HiYou should drink a lot of water and do physical activity if you can.I agree with your treatmentRegardsDr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes teething child to become restless and constipated?\n\nHi my baby is 7.5 months she seems to be teething as her cheeks are very red and she is producing lots of saliva. She is also constipated, very hard and dark stools. but for two days now she wont settle is very fractious, keeps crying and keeps going to sleep. she is really out of sorts.",
    "doctor_response": "dear parent, the restlessness could be due to sore gums from the teething process. you should give an analgesic as acetaminophen or ibuprofen syrup every 6 hours to relieve sore gums. for constipation you can use lactulose syrup 3 times daily.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the semen analysis report normal?\n\ni am 37 years, 5.6\" and my weight is about 70. My sperm analysis is : colour-grey, volume-4ml, viscosity-viscid, liquefaction-complete within 1hour, motility-25%,count-36x0000, morphology-88%, ph-7 and moderate number of pus cells. please is this result okay? is there any parameter that is not okay? what is your advice?",
    "doctor_response": "Hi,Yes it is absolutely normal. Hope it helps. If you have any other question please do not hesitate to contact us.Regards,Dr. Atishay Bukharia",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to treat migraine and one side headache?\n\nThank you doctor,I have suffered from migraine, and my one side headache is more in every day. So please advise about migraine.",
    "doctor_response": "Hello, Welcome to the icliniq.com. For migraine, Ibuprofen can be prescribed SOS when a headache occurs. If no improvement with Brufen than Sumatriptan or Rizatriptan can be prescribed. Avoid bright light, loud noise exposure. Take atleast six to eight hours of sleep. Avoid fasting and take food both time in the afternoon and evening. Avoid constant work on the computer. You can consult nearby physician for detailed evaluation. I hope I have answered your question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have anxiety and abandonment issues. In rehab for alcohol and substance abuse. Bipolar disorder?\n\nquestion my ex wife is very intelegent very social but is now in rehab for alcohol and substance abuse. when she would drink she was a monster. when she was normal she was very carrying and loves everyone very polite empathy people love her she could lite up a room of strangers in an hour everyone wanted her number also had the highest grades in school and university, but suffered from extreme anxiety and abandonment issues,wondering if she has bipolar or mood or personality disorder she was very wild child her father divorced her mom when she was ten her mother is also very moody loves u then hates in one min thankyou",
    "doctor_response": "Hello.....     Thanks for your query. It is possible that your ex wife only had substance use disorder without any comorbid mental illness or it is possible that she had comorbid mental illnesses like anxiety disorder. The differentiation can be achieved only after a thorough psychiatric evaluation including of the period when she was abstinent for drugs. Hope you found the information useful. Wish her good health.RegardsDr SundarPsychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can stress cause abdominal pain and loose stools?\n\nHi...yes, thanks.  I have been having loose stool of varying color for about 3 months now. No regular stool passing during this time.  It is sometimes coincides with mild stomache aches, but not often.  I eat pretty healthy,  This has coincided with a sustained period of stress at work and I'm wondering if this could be stress related, an ulcer, or something along those lines.  Any thoughs?  Thanks Michael",
    "doctor_response": "Hi,Looking to the history it seems that this problem might be due to stress called spurious diarrhea.As you got this problem since long, another cause might be having chronic gastro-intestinal infection, bacterial or protozoal.Avoid stress.Go for one course of ofloxacilin, tinidazole combination medicine course for 5 days.Avoid junk food.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever\n\nHello Dr.I am 70 yrs old man,My height is 5ft & 9\"& my weight is 64kg.I am having fever for 5days.I am taking Azinix500mg & Zinocin 200mg & Calpol 650.Now my temperature has come down to 98.But my widal report shows S TYPHI O positive upto 1in 60 Dilutions S TYPHI H positiveupto 1 in 60 Dilution.Am I suffering from Typhoid?Do I have to take some other antibiotics?Which kind of food I need to take?",
    "doctor_response": "Thanks for posting you query to health care magic.there are so many causes for fever . typhoid fever appear as continuous fever and never touches to base line . your widal report is also showing insignificant level of typhoidal antibody level so it could be due to some other infection. you need to tell me detail of your symptom and undergo some more investigations :1 .is fever intermittent2.is fever associated with chils and rigor or burning in urination or pain in abdomen or cough or any other associated symptoms. you need to undergo :1.blood culture and sensitivity to detect any bacterial cause of infection and its antibiotic sensitivity.2.Complete blood count 3.serological test for malaria. these all examination will help in making diagnosis and treatment of your condition.the treatment you are taking is empirical so could be effective or not . the definitive treatment I will suggest you after your complete detail as I suggest you.Hope you would be satisfied with my answer .  Feel free to communicate if any query .regards,Dr.Manish PurohitInfectious disease specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cause for swollen gums with sores\n\nHi, My grandson is two. He has purple swollen gums with some sores in his mouth, It is painful for him to eat and the last 2 days he hardly drinks. He just returned from Florida where he started getting sick along with his dad, His dad is starting to get the same thing with his gums. We are worried about dehydration.",
    "doctor_response": "thanks for your query, i have gone through your query. the purple swollen gums could be because of the gum infection or hemmorrhage or ecchymosis of the gums or it can be a mucocoele or eruption cyst. consult your oral physician to rule out these things, take a radiogrpah of that tooth. get you blood investigations done like BT, CT, INR AND PT. Do saline gargling, i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Skin of penis hurts while pulling. Part of penis skin is attached to anus. Is it natural?\n\nSir, I am 25 years old. When I pull the skin of my penis it pains. Actually in the lower part, a small part of skin of penis is attached with anus. May I know is it natural or not and is any surgery is required. May I know the name of the disease and which department of health care I will show my problem.",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have pain while retracting your foreskin over glans and have noticed a tag of skin ( Adhesion) attached to glans.Please consult qualified Urologist for clinical examination to confirm the diagnosis.He may do excision of band (Frenuloplasty) under local anaesthesia.This will solve your problem permanently.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat prominent liver with mild cirrhotic and cyst in ovary?\n\nMy mother is 60 years old,in usg it was oberved that she has the following diagnosis,1.prominent liver with mild cirrhotic changes,mild ascites and cholelithiasis and left ovarian separate cysts is obseved.Please suggest treatment.regards,Vinit Saxena",
    "doctor_response": "Hi thanks for asking question.Noted your mother having cirrhosis with ovarian cyst...As she has cirrhosis care must taken not to develop complication ..For That take low fatty diet.More fruits.Strickly avoidence of alcohol.Give her crushed papaiya seed one tsp with lemon juice...Giver her advise to take grinded carrot and spinach leaves juice ..Meanwhile for ascites take low salt diet.If need diuretic can be started....If variceal bleed occur immediately contact surgeon for banding...For ovarian cyst if need oc pill can taken under supervision of gynecologist if it us troublesome....Take care....Hope your concern solved .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headaches, fever and vomiting in a 5 years old?\n\nMy niece being only 5 has been suffering with headaches, fever, vomiting. I was concerned because her WBC is 31,000 .... sadly on my husbands side of the family a niece died from leukemia and I know basically she just didn t feel well and had a high wbc, she was young only in her 20 s.",
    "doctor_response": "Hiwelcome to HCMI understand your concern  , but if   Headache , vomiting and fever with raised WBCs are of short duration ( you have not mentioned duration of symptoms and other findings) , it is unlikely be leukemia ,   one need to rule out any brain infection.She need to be evaluated for finding the cause of fever .Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "After taking first course of trigestrel, when should I have sex to conceive?\n\nHi , I am a lady 31 years old ,I have one baby 11 years old ,I last have my period 8 months ago ,before I already have a period disorder ,now I am taking my first course of trigestrel so that I ca concieve ,now I am bleeding ,which days can I have sex so that I can get pregnant , yours Cihihijy",
    "doctor_response": "Hi,In a normal cycle of 28 days, the ovulation days are usually 12-16 day of the cycle.  but now that you are taking trigestral, which is a contraceptive pill, which has been given to you for regularising your period. You cannot concieve while on it. Complete the course, and after you have regular periods, you can try on your fertile days/ovulation days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from skin allergy after angioplasty. Tests done. How to get relief?\n\nHi sir...My father age is 52,6 months before he got heart stroke , angioplasty done.from one week onwards my father suffering with skin allergy..some tests are done,here is d reports RBC 4.02 mill/cumm WBC 7950 cumm Haemoglobin 80% Grams 11.60 Poly Netriphiles 68% Lymphocytes 27% Eisnophiles 05% E.S.R. 34mm 1st hour A E C 2500 /cumm Is there any problem with this....sorry for my bad english... ThanQ Sir.",
    "doctor_response": "if parents have allergy children have chances of allergy when surgery is done lot of antibiotica and pain killers are given which causes flaring up allergies or new allergies develop in allergy prone patients esinophils are five pin towards allergic symptopms again the medicines aspiri is used after heart surgeries which also increases allergies you can add simple antialergic ebstine 10 mg once aq day you can continue long and apply local antiallergic ointments over effected skin",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the adverse effects of Buscopan on the fetus?\n\nBuscopan Venus is actually my pain reliever when menstrual cramps attacks me. I took that last week. I got cold also last week so I took Medicol. Until unexpected I found out I am pregnant but not sure how many weeks. How will those medicine can I affect the fetus inside me? I am super paranoid. I hope you can help me. Thank you in advance.",
    "doctor_response": "Hello,There will be no effect of Buscopan on the fetus. It just relaxes the uterus and relieves you from pain. So don't worry about it.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mandavi Rai",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for copd and congested heart failure\n\nMy mother-in-law was just diagnosed with copd and congested heart failure and she lives with us and I don't know what to do because we try to help her eat healthy and she doesn't want to.It's like she has given up and she is a very uneducated person and thinks we are trying to control her eating  certain foods.How can we help her?She doesn't do anything all day but sleep and stay awake all night eating and she eats while laying down.I am affraid me or her grandkids are gonna find her deceased . What can we do to help her? She is 5'3 or 5'4 and weighs at least 300lbs.",
    "doctor_response": "Take it easy...she could eat what ever she wants but in little quantity...decrease her salt intake is the most important not to prevent it...less fat...thats all",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are fluid discharge and painful joints side effect of penis pump?\n\nHi, im 27years old not married.i bought penis pump for enlargement of penis, and I has to do penis excersice like jequeling. After some months I notice there is coming small seminal fluid every day, and my joints an buttocks are paining me.and also it comes ven excinment, ven watch porn, when I go to toilet put force,",
    "doctor_response": "DearWe understand your concernsI went through your details. Masturbation is a normal process and you can do it moderately. Penis pumping is not scientifically helpful in improving the length of penis. Thigh and buttock pain could be associated with the pumping and body position. The emission is normal as your body is emitting the waste product named sperm. Nothing to worry, but penis pumping is not advised.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes body tremors while suffering from bulged disc?\n\nI am a 55 year old female, had auto accident 12 years ago. 5 and 6 disk were ruptured and surgery was performed on them. Now mri shows 3&4 bulging and 7&8 protruding into the sac. EEg shows I am having seizers and mri of head shows Mild nonspecific chronic white matter hyperintensities and narrow blood vessel. For the last 6mo every time I lay down my body jerks until I am worn out and I get very little sleep, also when I am really tired sitting up it also jerks and I am not talking about small jerks, it jerks so much at night my chest starts to hurt from it. After having my mri on my neck I was sent for physical therapy, was told by therapist that therapy would help my neck but I needed to find out what was causing the jerking, also said that my left are reflexes are hyperactive and my right arm has no reflex. My right foot also feels like electricity is flowing in it, but not my leg. I have been to a neurologist and was told the unspecified white matter is from migraines and my jerking is from anxiety and referred me to a Shrink. I don t understand why if it s anxiety it happens every time I lay down, day or night or when I am sleepy sitting up, I feel like they are missing something and this can t be anxiety. I was also told 2 1/2 years ago that I had a cyst in the gland that is in the center of your brain and there was room for it there, but was not mentioned on this MRI. Seeking answers!!! I also had a heart ablation done about a year ago because of frequent rapid heart beats.",
    "doctor_response": "Hello,The bulging discs may cause pressure on your spinal cord in selective posture stimulating it leading to jerky movements in your body. Also depressed reflexes and electricity like feeling in your body parts suggest that the disc is impinging on your spinal cord. I will suggest you to meet or get an appointment to a neurosurgeon and take along your latest MRI of Brain and neck. The best test to differentiate it from a cardiac event is by doing a Holter study for 24 hours.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Muhammad Faisal Bacha, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "History of post micturition syncope. What further evaluation will be needed?\n\nFor a 25 yo male with history of post micturation syncope -- fainted in the theatre bathroom shortly during or after urinating on a full bladder (tried to hold in his urine while watching a movie). What further evaluation will he need? There is no history of other syncopal episodes except in college once due to sleep deprivation involving fraternity hazing. He is otherwise healthy except new onset of feeling intermittent episodes of light headedness and palpitations. He was seen in the emergency room with a normal ekg, normal labs, and an incidental finding of a corpus callosum lipoma which was felt to be a developmental anomalie.",
    "doctor_response": "Hi, Thank you for posting your query. Micturition syncope is fairly common and often not of any serious clinical consequences. For further evaluation in a young person, HUTT (head up tilt test) may be useful. Please consult a cardiac electrophysiologist for the same. Holter test may also be useful. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for my allergic asthma\n\nHi, i am 30 years old. Trying to settle in bangalore. I am married and have 2 kids. I get Asthama, Whizzing and cough problems in bangalore only. Last year i was in delhi and before that i was in US. I was 100% health with no asthama symptoms. Also, was very active. Please let me now why i get asthama problems only in bangalore? I am taking budecort and asthelin. Also, have started Sudarshan Kriya daily(25 mins). I want to be healthy and active again. Please show me the way",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your history and would like to make suggestions for you as follows:1. First of all, to respond to your query, why symptoms in Bangalore, I would like to mention that flora of Bangalore is quite different from that of Delhi. So the pollens you are exposed in Bangalore are quite different.Another reason, of course, Bangalore ranks high in air pollution and is allergic disorders & asthma are quite common in Bangalore. Of course Delhi is also polluted. May be the area where you live/work in Bangalore is particularly polluted more. 2. Regarding treatment, I almost agree with regular Budecort (Budesonide - inhaled corticosteroid, a controller type of inhaler) and Asthalin (Salbutamol - a rescue type of inhaler, to be used on as-and-when-needed basis).I would like to emphasize on technique of using inhaler as if it is not perfect, there is a chance that adequate amounts of drug may not be reaching lungs.3. Were I treating you, I would add regular montelukast in your treatment which may reduce your inhaler requirement.4. I would also suggest you allergy testing which may help you identify the substances causing allergies to you and also to know the measures to avoid them.Based on allergy testing, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which works on immune system to improve your allergy symptoms on long term basis.5. I would also suggest you regular breathing exercises (including Yoga & Pranayama) and a healthy diet rich in vitamins & minerals (adequate amounts of green leafy vegetables, fruits, sprouts, etc) which will gradually improve your lung capacity & immunity respectively on a long run.6. Please try to avoid exposure to dusts, smokes & air pollution as much as possible.Hope above suggestions will be helpful to you.Should you have any other concern, please feel free to ask at HCM.Wish you the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bottom lip burnt with blisters, tried Abreva, slightly relieved. Now spreading to entire lip after eating sweets. Allergy to sugar ?\n\nHi. At Halloween time, I ate chocolate and other sweets which I typically do not eat. The next day my bottom lip burned, was inflammed, and contained a few small blister like bumps. I treated with Abreva as I do have a history of cold sores . However, the blisters are much smaller and less pain and do not crust over. Over the next several days the blisters spread across my lip...each section of bumps healing after a few days. After dealing with this for about 2 weeks, my lips were back to normal until the other night after I ate a very sweet piece of cake. My lip had 2 blisters within minutes, and now the blisters are yet again spreading across my entire lip. Could this be an allergy to sugar.? My everyday diet is high protein, lots of almonds, and eggs . Thank you!",
    "doctor_response": "SUGAR DOES NOT CAUSE ALLERGY IF THE LIPS ARE NORMAL IN BETWWEN THEN YOU ARE ALLERGIC TO SUSTANCE TAT YOU EAT IN BETWEEN THE ALLERGY CAN DEVELOP AT ANY TIME AR ANY AGE BY ANY SUBSTANCE I THINK YOU MAYBE ALLERGIC TO YEAST AS CKE CONTAINS YEAST AND CHOCLATE ALSO CONTAINS AND MANY OTHER SWEETS BUT FOR CONFIRMATION GET BLOOD SERUM TEST FOR SPECIFIC ANTIBODIES FOR YEAST AND OTHER COMMON FOOD LIKE MILK EGG NUTS RICE AND POTATO",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat nocturnal hallucinations?\n\nI have mostly nocturnal hallucinations, with eyes open or others with eyes closed. My eyelids occasionally stick and need to be pushed open with fingers; I bite the back of my tongue and my bottom lip which interferes with my speech - I m told I look like a fish when it happens. I also have charley horse-like cramps on both sides of my neck with/without movement. Neither psychiatrists nor neurologists seem to take my symptoms seriously. I m an 81 year old female who has lived and worked in Bangladesh, Pakistan, Ghana, Tanzania, Rwanda and England (during madcow outbreak). I m late for an appointment so I ll get back to you later.",
    "doctor_response": "HIThanks for using healthcare magicDuring sleep, few people gets hallucination. That is part of sleep. In that case, you need to take benzodiazepine. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard breast nipple?\n\nHello! I had breast aug. 6 mos. ago. I'm right handed, but my left breast is hard & both my left breast & nipple are very painful. My nipple also has an awful burning sensation. I also have a two little bumps on the top right side of that same breast. My doctor put me on an antibotic about a month ago, but is seems as though the issue's above are only getting worse!? I'm very concerned. Please help. Thank you",
    "doctor_response": "These could well be a sign of rejection of implants used for breast augmentation. So its better be direct and ask your bresst surgein to explain these findings and get the implants removed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "79 years.  Feeling of cold in head, cough, sneezing, fatigue, lungs filled with fluids.  Prescribed nasal spray.   Advice\n\nI am 79 years - in January this year spent five weeks in Samuir Island Thailand followed by five weeks in England due to feeling I was ill went to doctor there who prescribeed antibotics - since return have consulted doctor here who has prescribed nose spray as head feels I am most of the time full of cold - have harsh cough and sneezing often -feel hav e build up of fluid on lungs overnight  and much fatique (usually very energetic person)",
    "doctor_response": "Hi, Thanks for using HCM.The symptoms of cold, cough and sneezing may be due to allergy, may be allergic rhinites. You can continue nasal spray with maoetasone furoate for its management with paracetamol as anti inflammatory and alaspan as anti histamine drug For feeling to have fluid in lungs get done one chest xray and echo to rule out any major problem. Or else the above drugs will help. Have adequate regular sleep, plenty of fluids, nutritious diet with required calorie and regular outdoor exercises for your wellbeing. Hope I answered your question. Consult your doctor for further management.Feel free to ask me if you have any further queries.Wish you good health. Take care.RegardsDr. Lohit K",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does metrpolol take to reduce my BP?\n\nI have taken 10 mgs of Bystolic before. My G.P has me on 10 mgs twice daily. I tried metrpolol once per day for the past 6 months but my B.P went up to 149/89. My g.p. has advised me to go back to twice daily. How long will it take to reduce my B.P by increasing my dosage?",
    "doctor_response": "Thanks for contacting HCM. Metoprolol is not a very strong antihypertensive. You should have continued it twice daily. Now get your BP checked regularly as to whether BP is coming down, it should stabilize in 2-3 days, if not then your doctor may have to change the medicine. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a way due to regain the sexual power lost due to masturbation?\n\ni spoiled my sexual power, its been more than 10 years i am doing the hand practice, now i have left this habit but i am sexually finished, my parents want me to get married and i dont feel myself sexually fit for marriage. please suggest me something. is there any way i can regain what i have lost due to that dammed habit.... i really would be obliged, i am 33 now. please help save my life........",
    "doctor_response": "Hello.welcome to Health care magic.1.Not to worry, almost every individual come across this phase.2.The thing is, it look like you have not came across the relationship thats why you feel so.3.This is all in your head/thinking which making you to think this way. You are fit and you will be fine.4.As long as you have no erectile dysfunction, you will get on.Hope helped. Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in my stomach after i eat?\n\nAfter having food within an hour i have a stomach pain and passing out it as a semisolid motion....pplz temme the way to cure it and i have pain oly in left side of stomach my age is 45...before i had a loose motion fa two days continuously but now no loose motion its passing as semi solid with fowl smell",
    "doctor_response": "Hi.Thanks for your query and proper history.Since you has loose motions for two days, I think you have taken proper treatment.The cause for your present problem looks to be :Half-treated or untreated intestinal infection. I would suggest you the following:First of all , consult a Doctor or a Gastroenterologist to get you physically checked, investigated and get a proper dose of antibiotics and metronidazole. This should solve your problem. If no complete relief you may need further investigations:Ultrasonography / CT scan of the abdomen to see if there is a septic focus in the abdomen other than the intestines like appendicitis, lymph node mass or so. Examination of the blood, urine and stool.Colonoscopy if required. And treatment according to the cause fond.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for itchy gums post a root canal treatment\n\nI had a root canal four days ago and some type of putty or cement was placed in my gum until the dentist can put the rod and crown in. My gum around the hardened putty or cement is super itchy. It's itchy to the point it's keeping me up at night and making it hard to concentrate at work. Is this itchiness normal as it heals or should I be concerned?",
    "doctor_response": "Hi...Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns...As per your complain it seems that you are suffering from allergic reaction to any of the constituents present in the temporary filling material and it is leading to inflammation and hardening of the gum in that area leading to itching and discomfort..You should consult your dentist and get the material replaced with other materials so that the itching relieves..As of now you can also take anti allergics like Levocetrizine for relief from itching..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy and side effects of udlive 300?\n\nI am asking the following question for my daughter who is approx. 8 years old., weight approx. 23 Kgs. 1) What kind of remedy provide to consume udlive 300 2) Is there any side effect, if so what will be? 3) Is this medicine effect on golbloder stone?",
    "doctor_response": "Hi,Udiliv (ursodeoxycholic acid) is commonly prescribed for the treatment of liver diseases including hepatitis, gall stones, cirrhosis and cystic fibrosis. It helps in dissolution of cholesterol rich gallstones. Generally it is well tolerated however, it may cause diarrhea, indigestion, vomiting, headache, and allergic reactions.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes head pain in my 24 month old baby?\n\nMy 24 month old has head pains that last for no more than 30 seconds at a time. I was told by my family doctor to take her to the ER. They then admitted her into their peds dept and scheduled an EEG and an MRI for the following morning and afternoon. Everything came back normal as far as the EEG and her brain itself but they diagnosed her with Bilateral automastoiditis. They want her on this antibiotic for 6weeks to 3months and then do another MRI to see if its gone, if not surgery to drain it... I'm completely oblivious to anything he said. He used large words and didnt dumb it down to my level at all! please help explain what this is and whats the worst that could happen? :( Im scared for my little angel",
    "doctor_response": "The mastoid bone is the bony thing just above the angle of the jaw and behind the ear. The MRI has diagnosed infection of the middle ear and the mastoid bone (oto-mastoiditis). This is a long-seated infection and will need long-term antibiotics, after which they will repeat the MRI to see how much of the infection has already got cured. In some cases, they need to operate and remove the infected material from inside the bone by opening up the mastoid from outside. I am confident that your daughter will recover soon. You will need to directly ask the doctor to explain the whole thing again with pictures and so on and so forth. Before surgery, I am sure it will be really important for you to understand every little thing about the problem as they will need you to give consent for the operation, if it is needed. (It may not be.)Dr. Taher",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which is the best facial cleanser ? I have oily skin and blemishes on the sides of my face\n\nCould you please suggest a facial cleanser that will clear my face? My name is Melissa, i m 18 years old and I want to know which type of facial cleanser is best for me. I want to clear up my face, and it has been a struggle for me. I ve used Burt s Bees, Neutrogena, St.Ives and Alba Botanica. I try to use safe and natural products. My T-zone tends to be rather oily and my pores around that area are big. The pores under my eye and on the sides of my nose are rather big too and i have blemishes on the sides of my face. I have also been struggling with blackheads on my nose for a long time. Could you please suggest a product that is safe, and not expensive to use but that will give me the results i m looking for?",
    "doctor_response": "Hi!Melissa, Welcome To HealthcareMagic forum, Melissa ,you definitely have a oily skin .You should use a face wash containing 2% salicylic acid be it of any  good company.Also use an astringent on face there after which would help reduce pore size.You can also use product having mat finish effect (some loreal products have that).Mat effect reduces the oil from face and keeps your face fresh . For your nose which has black heads you can use tretinoin cream (0.025%) at night only .This cream has a peeling effect and also  would cause drying effect .Always use a water based sun screen  3 to 4 times at day time. regards, Dr.chawda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Terminal cancer in breast, lungs, liver, lymph node, brain, left side not working, breathing problems. Taking morphine. Advise?\n\nHi my mom has terminal cancer starting in breast moving to lung liver and limpnoid and brain. After eight years of battling we are told no more can be done. Its been about 3 months and my moms left side doesn't work anymore. She has troubles breathing everyonce in awhile. Wr started morphine is this what could take her.",
    "doctor_response": "Welcome to healthcaremagic. Breast  cancer that has spread to lung,liver,brain is stage 4 diseases and unfortunately outcome is very poor for this stage. You should give her symptomatic mediation and  all possible support in this stage.Patients like her  who have advanced stage disease need good palliative care.It is treatment of problems patient is facing like pain ,nausea, vomitting etc. This treatment is more important to improve quality of life of patient. There are strong pan medications like morphine which can help her.It is good that she is getting pain medication.There are many different pain medicine available and doctor can prescribe him appropriate medication in adequate dose so that he becomes pain free. Regards Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower back pain?\n\nI slipped and fell going down my hardwood stairs I fell and hit the actual corner of the stair. And fell directly on my lower left side of my back. It hurt but I got up and shook it off. Now going threw the rest of the day I am in an extreme amount of pain where I fell on my lower back on my left side of my lower back only. It hurts to the slightest touch and even driving in the car is painful because of my back on the seat. It does feel hot and slight bruising has started should I go get an xray?",
    "doctor_response": "Hi,Thanks  for  your query.Based upon your description, I suspect that you might have injured the ligaments around lower back.An initial xray of the lower back is necessary to rule out any bony injury. If xrays are negative for any fracture, then MRI scan is needed to know the status of the ligaments around the lower  back.I suggest you to consult an orthopedic surgeon for a detailed evaluation and further management.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will taking maxoza l and carnisure increase sperm count?\n\nHai doctor my husband sperm count is 6 million and motility is 2%. His age is 27, hght is 5feet 4inches, wght-59 kgs. He was advised to take maxoza l, carnisure-500, Will it increase his coun? and how much time it will take?.medicines alone would be enough or any surgery or operations shud be conducted?",
    "doctor_response": "Higreetings. First of all he should consult an andrologist and get his scrotum examined for varicocele,size of the testis and any infection of testis and epididymis. If any thing found,treating that will improve his sperm count.if infection antibiotics and if varicocele then the drugs mentioned by you will improve him.The cause for low count and motility has to be found.If no cause still you can try these medicine for 3 months and repeat semen analysis. If improvement is there can continue for another 3 months. If no improvement then assisted reproductive technique will be better.hope my answer helps you. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recommend medication for cortical cyst in kidney causing blood in urine, waist and, back pain and fever\n\nCortical Cyst on right kidney. Symptom blood in urine some time, severe pain some time on back and waist,sometime fever. Need name of medicine and how to take on my e.mail. I am 61 yrs old and presently visiting Sydney. Your early reply will be appreciated. Thanks and regards Mrs. Chaina Rani Kundu Kolkata ,India",
    "doctor_response": "HIThank for asking to HCM I can understand your problem, you stated that there is cyst in cortical region of right kidney, and if it is hurting you then it is to be treated symptomatically, for the pain you can have Diclofenac  injection  1 ampule I/M st. for prophylactic purpose antibiotic can be ensued, the natural remission of cyst is very likely otherwise the surgical treatment is the only way out there, if you are asymptomatic then I would advise you to just forget it, hope this will help you in making any decision have good lick.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Negative Hiv test after 3 months, is it conclusive?\n\nI got a high wbc 1 month before 14300 on 14-jan-2010 and high neutrophils absolute count was also high 9867 and all Is normal...having tonsil, low fever, diarrhea, sore throat, NO-Skin RASHES, No Swollen Gland,.,. again cbc after 10 days m wbc still high but it was 11100 and again high neutrophils 8103 and all normal again cbc after 10 days all normal, wbc 8000, neutrophils 6000, lymphocytes 1920, Eosinophils 0.00 Monocytes 80.00 Basophils 0.00 \"\"I have tested a rapid Hiv test today after 3 months and it come back Negative is it conclusive\"\" Shadowfeat,.Plz.,.Reply",
    "doctor_response": "Yes man why do you worry then. There is no problem at all. But again Rapid tests are not that reliable. The online doctor has said that only it is for immediate situations and not for diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fever, urine test confirmed RBC value is high. Prescribed EPIMAG (Powder). Suggestion?\n\nHi...I m 26 years old, last two days i m in fever and I m feeling heat during urine . Today I conduct my urine test and following r the results: Colour: Reddish, Aspect: turbid Blood: ++++ Pus cells: 20-25/HPF, Eythrocytes: Over count few bacteria Doctor advise me to use EPIMAG (Powder) and after one weak again conduct urine test. He also said RBC value is high (may be kidney stone formation is started) Are these values dangerous What should i do?? Actually i m not married and last 2 month i m too much involved in porn movies (20/per month) i think this cause infection.",
    "doctor_response": "Hi, many thanks for the query!Watching porn movies can not cause infection, but its not a good habbit.You need to do certain investigations- USG (Abdo-Pelvis), X-ray KUB,Sr. creat., Sr. BUN, Sr. Uric acid, CBC, Urine (Culture & Sensitivity).For time being, you may take anti-spasmodics, pain killers, diuretics withyour doctor's opinion.Drink plenty of water so that at least 2 litres of urine is voided in 24 hrs.Wish you a good health. Take care. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the bump on the back of the neck?\n\nMy husband has a bump on the back of his neck. It started off looking like a tiny black head, but when I tried to extract it nothing came out. Now, a month later, the bump is still there, but it's now red and inflamed. Clogged hair follicle or something more serious?",
    "doctor_response": "HI.Thanks for your query.With the history you have provided, this looks to be an infected sebaceous cyst.He needs to take an antibiotic and anti-inflammatory medicines under the guidance of a Doctor and apply liquid povidone iodine locally. This area b( back of neck) of the body is very sensitive and does cause a problem of irritation.After the proper treatment I would advise this to be excised for 2 reasons.One: he gets rid of a disease which can cause recurrent problems of infection as he already got it.Secondly - you get a perfect diagnosis what it is.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Panic, depression, anxiety disorders. History of psychiatric problem. Long time solution?\n\nHi Dr. I realised that i have certain psychiatric problem in 2005 and started with Feliz S 10, Mirtaz 7.5 and Clonotril 0.5. Was asked to take for 2 years and I was fine after that. But the symptoms came back in a worse manner just 6 months later. Again, I was put on Nexito 10mg and clonotril 0.5. Later, the medicine was changed to Fludac 20mg and then to Nexito 10 mg back again from last 1 month. I feel better for some time during medication , but if medication is off, then i return to same panic, depressed and anxiety disorders. What could be a long term solution? I am 31 and married. Thanks for your answers!",
    "doctor_response": "Hello Welcome to Health Care Magic The medicines Feliz S 10 or Escitalopram, mirtazepine 7.5 and clonotril 0.5 are given in Depressive episode mixed with anxiety. You were given these medicines for about 2 years so I assume that you had episode of depression. When symptoms reoccured you ware given Nexito or escitalopram 10 and then fluoxetine 20. Both are of same group SSRI. Long term solution of your problem? Depression is a episodic illness, it tend to occur in intervals or in episodes. So if you responded to medicines and then relapse of disease occurred there is no surprise. You have to continue the medicines for long at least 2 years and also go for Cognitive Therapy for early response. Once you achieve pre morbid level then maintain the condition by Cognitive Therapy. Don't afraid of medicines as they are very safe drug. So visit a psychiatrist for opinion and continue medicines again. Thanks Dr. Seikhoo Bishnoi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pelvic pain and back ache during pregnancy?\n\nI am 33 weeks pregnant and have been haveing lots of Braxton hicks but for the last couple of days have had sharpe pelvic pains and then today they have gotten a lot worse and I have dull backache aswell. Is this anything to worry about or just normal?",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the pelvic pains and back ache need physical examination to rule out any preterm pains.I suggest you to consult doctor for vaginal examination to check for any cervical changes.The causes of preterm pains can be urinary tract infection or any other infection ,dehydration etc.So they need to be ruled out and if present they need to be treated.Usually Braxton hicks are not painful and present during the pregnancy.Nothing to worry.They will subside with apt treatment.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of ischemic colitis?\n\nI am 70, female, 5 6 , & 170#. I have controlled hypertension, hyperlipidemia, depression, osteoarthritis, and have had surgery for episodes of ischemic colitis. I have a red, growing, cauliflower like growth that hurts if it is bumped on both the 1st & 3rd joints of my right index finger. Is it some type of wart?",
    "doctor_response": "Hello,Brief answer: Mostly, a wart needs to be checked as it is growing, ischemic colitis symptoms include acute abdominal pain, diarrhea or blood in stool.Explanation: My opinion is that your finger lesion description is a bit of concern, as growing mass with color variation you said. A wart is a provisional diagnosis but that mass need to be checked. Ischemic colitis presents to us as acute sharp abdominal pain with eating we call it angina of abdominal, some cases may develop diarrhea plus or minus bloody stool. I suggest my patients the following: Do not scratch that mass, if a wart it may spread to other sites.The information provided by you is not sufficient to provide a good opinion. If someone comes to me with this condition I would ask them about type of operations you made as ischemic colitis patient, also level of diabetes and other risk factors control.Conclusion: I suggest you check with your general physician to examine your hands, also continue on your medicines and if any symptoms I mentioned above develop, check in ER.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mahmmad Gamal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain after a spinal fusion for scoliosis?\n\nHi, I have had a spinal fusion for scoliosis. It happened over 2 years ago, but a year and a half after the surgery my back started hurting. I've been told it's muscle spasms, ribs rubbing against each, the rods rubbing on my skin, and other things. The only the thing is no drugs or therapy have helped, at all.",
    "doctor_response": "Hi,The fusion is a mechanical process, and healing requires inflammation also. Any inflammatory process produces mediators that stimulate pain receptors and cause pain. It is not rare however to experience this with this condition or experience. Erros do occur in the process too, and persistence or aggravation might necessitate a review. Kind regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in the joints?\n\nNever done this before, so I m not sure what to expect. I have used the symptom checker before and found it helpful, but it seems to have changed so I couldn t input everything I wanted to. I have been having severe pain in my joints for several months - wrists, ankles and hips mostly. Sometimes my knees and shoulders as well. I do have diagnosed osteopenia from a year or so ago. I am not on any medication with the exception of an OTC calcium and vitamin supplement. I am also experiencing some swelling in my ankles. I also have MS, but I am not on any DMT medications. I have migraines for which I take Gabapentin and Topiramate. I am also on Amlodipine for high BP, and Synthroid for Hashimoto s Hypothyroidism. I have mild stress and exercise induce asthma and I use a Pro-Air inhaler PRN.",
    "doctor_response": "Hi, Severe pain in different joints can be related to arthritis or low levels of calcium or vitamin D3. Proper supplements and a few blood tests will help. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Spine damaged due to an epidural, persistent, swollen nerves. On regular spine stretching exercises\n\nHi, I've got an existing spine problem, my spine at L4 is damaged because of an epidural some years ago. Anyway, I manage this and continue with life the best I can - I have started to feel pain in another area of my spine now ,  in my middle back, it aches but is more of a sharp pain depending on my movement - it also pulses right in my spine. I often suffer with my sciatic nerves swelling as a result of the damage at L4 but this feels completely different -as in not disc or nerve related, but it doesn't feel like muscular neither - it's actually right in the bone??I've been doing new exercises for the last 4/5 weeks which involves jumping and weight bearing and while I do make sure I'm warmed up and I'm careful (due to the existing problem) I'm worried this could be damaging me. I haven't done any exercise other than stretching my spine in the last 7/8 days and I'm not seeing an improvement and starting to get a little worried now.I'm not overweight and I'm quite fit and healthy if it matters.",
    "doctor_response": "I would advise not to do violent exercises or jumping but mild flexion/extension exercise till your back x ray/ MRI is taken  to  show  the   cause.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Headache, dimetapp, hives on leg, allergy\n\ni gave my 6yr old childrens dimetapp for a headache about an hour and half ago when she changed clothes for bed she broke out in hives on her legs which we havent figured out what she is allergic to yet is it ok to give her childrens benadryl for the itching so close to giving the dimetapp",
    "doctor_response": "these are only supportive therapies and donot cure you need to know cause any thing can react at any time at any agemostly milk is cause as the theory states that child need only breast milk for 2 years and nothing after and as we add milk and diary child getting many problems like allergy asthma anaemia eczema and other organ diseasesas animal protein are non competible with human proteinsthese are initial symptomps and as the time goes the increase stop milk and diary proteins completely so child will reverse in diseases and no recurence furtherat moment can give fexofenadine 30 mg bdapply calamine lotion locally on skin for 3 wk",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain with nausea and loss of appetite?\n\ncan you have appendicitis with a normal ct scan with contrast?i have pain in my lower right quadrant and mid belly button,nausea,no appetite,feel very unwell,constant headaches,had upper endoscopy,colonoscopy,capsule endoscopy all neg.Doc suggested seeing a general surgeon to have him take a look inside with a laproscope.",
    "doctor_response": "Hello,There is very low chance of appendicitis.Appendicitis can be easily and accurately diagnosed by ultrasound abdomen and pelvis. CT scan with contrast will provide will be useful to identify other abdominal pathology, if any.Your complaints are suggestive of intestinal involvement. However as other investigations are normal.I suggest you to take a course of antibiotics, anti helminthic medication.Include probiotics and high fiber food in your diet.Ask for stool analysis to rule out parasites, you also need to be investigated for intestinal  tuberculosis.Hope I have answers your query. Wish you good health.Dr. Narasimha G L",
    "dialogue_context": ""
  },
  {
    "patient_message": "What caused heart palpitations with syncope?\n\nwhen I was 13 i was playing basketball. then all of a sudden i was seeing spots, felt faint and I blacked out for about a minute. my heart was beating so fast. and it didnt slow down for a long time. And it still happens to this day. whats wrong with me?",
    "doctor_response": "Hi,This can be arrhythmia like psvt or atrial fibrillation, where your heart rate suddenly goes up and bp falls. You will need evaluation like ecg, thyroid test and holter monitoring. You should also get one hemoglobin levels done. So visit nearby cardiologist for these investigation. Also, to abort such episodes you should try to cough hard. Is there any stress or anxiety associated. Till the time your evaluation is complete, you can ask your local doctor for tab ciplar.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in lower stomach, loss of appetite, dry mouth, frequent urination, headache. Any ideas?\n\nHi,For the past week or so I've had an ache in my lower stomach just above my pubic bone which sometimes changes into sharp pains, I have been suffering from lack of energy, loss of appetite and have felt really thirsty and constantly have a dry mouth, I haven't had any more trouble then usual going to the toilet but have been passing urine more often then usual due to the added amount of water im in taking for my dry mouth. I've also had more discharge then usual and slight headaches?",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum. I think you are somewhat confused as the pain on the left side  just above pubic area means pain in abdomen not in stomach. Anyhow the possibilities  may be of ,Any kidney stones which may present such type of pain with desire of defecation and frequent urination. For this purpose you need to get an ultrasound abdomen and  kidney areas . Loss of appetite , lack of energy are due to sharp pain. I suggest you to consult a physician and get an Ultrasound of abdomen (left).Get in blood as well  urine tests. Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever of 9 year old\n\nmy 9 year old who i might say never gets sick. Her fever will not break . I have been using cold paper towels to keep her  head a little a cool.I have been giving her rite aid brand fever reducer.It is not helping .It has been almost 24 hours. I have been giving her oj ,soup,and cold water.What more? I AM AT TEARS!",
    "doctor_response": "Many thanks.Dont worry at all.Occasional fever due to common cold,FLu etc and fever is manageable easily with good cold sponges with tape water and regular parcetamol.He needs good hydration,bed rest,more liqiuids orally.and takes 4-7 days.He will become  alright soon.If problems persists then needs full investigations for fever of Not known cause.then Refer to pedaitrician for it if needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I get prostate cancer?\n\nI was using mobile phone and then I masturbated. Can I get cancer?",
    "doctor_response": "not at all do not believe to any of this thoughts please there is no connections at all between masturbation, mobile phone usage and cancer at all",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can persistent plaque psoriasis be treated?\n\n1)\u00a0\u00a0\u00a0\u00a0\u00a0I am suffering by Plaque Psoriasis from 20 years. I used various kind of ointment but it was not cured. Ultimately since last 5 years according to our local physicians i have used methotraxate and psoraisis kept in little bit control but during last 6 months methotrexate is not working on me; as a result psoraisis is increasing. I am also bypass surgery patient and after using of methotrexate i was suffered through acidity and indignation also i am becoming very fatty. Please help me .",
    "doctor_response": "Hello. Thanks for writing to us at healthcaremagicDermatologists have long experience of using Methotrexate in psoriasis. It is very effective and takes good control of psoriasis even with the most severe of presentations like pustular psoriasis as well as erythrodermic psoriasis.It is one of the treatments of choice for plaque psoriasis as well, involving large areas of the body.One of the reasons for it not being very effective this time round could be because either its dosage is insufficient for the severity of psoriasis Or it is not being absorbed properly from the gut.Along with Methotrexate, topical treatment forms an important part of  the ovarall treatment of psoriasis and adds to the response.Topical treatment with topical steroids+salicylic acid combination Or topical Vitamin D analogues like calcitriol and calcipotriol can be started along with oral methotrexate.I would suggest that you seek another appointment with your dermatologist who would assess the severity of psoriasis and either increase the dose Or may change the route of administration to injectable (Injectable Methotrexate i/m Or i/v can be tried) and may add topical treatment.Your dermatologist after thorough assessment of the skin condition would be able to guide you properly.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the treatment for impetigo in a 21 month old?\n\nwhat are some treatments for imetago, for a healthy 21month old. A small red spot with what looked like a white head started on her chin 8 days ago. Now she has several more around her mouth some were draining pus but are now scabbed over. But does not look any better. Have been applying neosporin with no releif",
    "doctor_response": "Hello there,Impetigo is very easily treated by applying an antibiotic ointment that is stronger than anything over the counter. Of course is does have to be prescribed by a doctor so I would encourage you to at least call the doctor. Bactroban, Bactrim and Cleocin are the main drugs to treat impetigo. Staph and strep are the 2 diseases that can spread from it so it is very important to start treatment right away. Good luck!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Should I worry about my testosterone level of 335?\n\nHi doctor, I am a 26 year old male. My height is 6 feet and weight is 90 kg. My total testosterone level is 335. My other tests were all normal except 25-hydroxy vitamin D, which is 6.83. Should I be worried?",
    "doctor_response": "Hi. I have gone through your query and can understand your health concern. For further information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for low hb in beta thalassemina minor\n\nhi Doctors i am suffer the problem to weekness after marriage ,my age in 30.,weight is 54 Kg..i talk to the doctors for that prob. he say you check the haemoglobin 1st.i gave the report .my haemoglobinis 9.90 gm%,& say you are  Beta Thalassemia Minor..in that case which syrup or mediacne i use to increase my haemoglobinis ? plz answer it.....",
    "doctor_response": "Hello,Thank you for your contact to healthcare magic.I understand your health concern, if I am your doctor I suggest you that Livozen Z is the best available tablet you can have it one tablet a day for as long until you have good haemoglobin plus 3 month to replenish the store of iron in the body. If you have thalassemia minor than your haemoglobin might going to be down. So for you continuous treatment with the hematinics is necessary. Do not discontinue the treatment.I will be happy to answer all your future concern. Thank you,Dr Arun TankInfectious disease specialist.Wish you a best health at health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this biopsy report indicate?\n\nHello doctor. My father 72 years old has started losing weight in last 6 months. His ultrasound and CT scan was done which shows a mass lump of more than 17 cm and has been referred to oncologist. His various tests and needle biopsy was done. His AFP test is normal and his biopsy shows benign capillary hepogemina. His oncologist says it could be blood vessel tumor or some cancer other than HCC. He asked us to meet his surgical expert in next few days. We want to understand",
    "doctor_response": "Thanks for asking on Healthcaremagic. From what has been written by you I infer that the biopsy report states benign capillary Haemangioma. It is a benign tumor of the blood vessels. Since blood vessels are present everywhere so it can occur at any site. It is benign. Means it does not spread and cause grave danger to life. It just exerts its mass effect or since it is a blood vessel tumor made up of a network of capillaries it can bleed. Rest it will not require chemotherapy or radiotherapy since it is not malignant. Simple excision might provide complete cure. Hope that helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Has floaters, noise in ear and hard to swallow at the age of 8 years\n\nson is 8 has floaters , noise in ear hard to swallow and hard to breath My son is just 8 and having problems with what he calls lines in his vision funny noise in his ear finds it hard to swallow food and say its hard to breath. have been to docs several times been given antibiotics and an asthma pump!!!! am soooo woried. any advice much appreciated.",
    "doctor_response": "Hi, Your son needs a thorough examination by an apt ENT specialist, it can be adenoids and tonsils causing the breathing difficulty and difficulty in swallowing. Regards Dr. Naveen Kumar",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure red spots on tongue?\n\nMy 2 year old has red spots on Tongue. we took her to the doctor and they initially thought it was a UTI. They gave her amoxicillin and she has been on it for 2 days. She has become very cranky now and will not stop crying. She feels warm however does not have fever. What do you think will help?",
    "doctor_response": "hello thanks for the consult at hcm..red spots could be due to papillitis, so requires topical anesthectics if she can follow the instruction of not to swallow the medicine,, eithr way plz tak a consult with her peadiatrican/pedodontist..hope it helps,,tc",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I not able to concentrate while studying?\n\nHello doctor, I am not able to concentrate while studying. What is the problem with me?",
    "doctor_response": "Hello. There could be many reasons for this issue. If you always had problems with concentration, and not just while studying, but have a short attention span, it could be attention deficit disorder. If the problem is of recent origin and you are getting stressed out with the burden of studies, it could be anxiety. If you have lost interest in studying and some other activities, it could also be depression.  Besides psychiatric disorders, being distracted by something else which is on your mind or you do not find the study interesting could be other reasons for lack of concentration. The treatment depends on the exact cause of your problem. Consult me if you feel that any of these explanations could be the cause and you need more help, information, and advice about your problem and medication if needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Edema in legs due to liver failure. Fluid discharge on getting the leg scratched. Need to go to emergency?\n\nMy friend is going through liver failure and has retained alot of water in his legs. I was moving a pillow under them to elevate his leg and accidently scratched it. It is seeping water, it is not a major amount but is steadily leaking, he sees the doctor tomorrow but i am wondering if this is serious and i should take him to a hospital now?",
    "doctor_response": "Hello, apotts6869, Sorry to hear about your friend's condition. If he has retained a lot of fluids , probably he has distended belly with fluid as well. I am not sure if he has been on any water pills or diuretics. Elaevation of the legs will help some but if he has massive ascites (Fluid in the abdomen) this may not be enough. Seeping of fluid indicates advanced condition. He has to be hospitalized, get a complete blood work up , including kidney tests to make sure he is not going into kidney failure also. He needs intravenous diuretics , nutritional support and careful medical supervision to take care of any complications of cirrhosis like bleeding or liver coma. In answer to your question , yes, take him as soon as you can. I wish him well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does fatigue and nausea last after an asthma attack?\n\ni have had a major asthma attack that almost sent me to the hospital for, but after a 3rd breathing treatment at my pediatrician i started to get better, but now i feel extremely weak, slightly nauseous, and fatigued. How long does this typically last? Should I return to school tomorrow or take a day to rest.",
    "doctor_response": "Hi,sorry to hear about your health. After an asthma attack it is common to get fatigue. This may be because while you were breathless your body had overworked to fight it. Also again asthma and congestion can cause lack of sleep. Yes all this can contribute to fatigue. Do take rest until you feel better. Stay home,eat good food and rest. Allow your body to recover. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause green discharge and no appetite in children making them underweight?\n\nMy kids they are 9 yrs and 6 yrs having discharge some times it is green colour from 1 yrs of age both of them have this problem they are very leen and no hungry for food and their weight 26 and 17 is it vaginal prob or kidney problem I don't know they don't have vomitting or back pain",
    "doctor_response": "Thank you for consulting in H.C.M. In view for above I think they need consulting gynaecologist and further management. I appropriate your attention to kids condition. Green discharge from vagina can indicates acute vulvovaginitis. Please get them examined especially vagina and urethra culture for flora and sensitivity to antibiotics. It can be streptococcal, staphyllococcal, E.coli, Candida infection.In addition check their urine analysis. From home remedies you can wash underneath with soda water 2 times 5 days.   I will be in touch to follow their progress   Your sincerely    Dr.Svetlana Shrivastva",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for kidney stones?\n\nHello, I m a sixty one year old woman. I have had kidney stones for last thirty years. Butlastfour years I have been diagnosed with four large stones but due to fact I have Medicare they said they won t remove them, so two years ago I went in hospital for second time, stone pain and Medicare was once again going to send me home. In thirty years I have not one time been able to loose stones at home they are always multiples and to large I m told, and last hospitalization they found mass in my left lung and said that took priority over stones but they sent me home not taking care of either problem again saying it was insurance problem. I have no family, am legally blind , my question is, if I repeatedly have stones shifting and pushing and then shifting and then moving over and over will this eventually cause damage to my kidneys as I have been sick for a week, something different, painful, not. Stones but I hurt and I want to lay downfall day, and as I am hyper and don t believe in laying around no matter how sick I am this thing that started a week ago is scaring me. Thank you for any information you can pass on. Judy kreger",
    "doctor_response": "Hi Judy and welcome to HCM.As an Urologist, i can understand your concern.Large stones in kidneys,must be cleared, as leaving it there will cause complications like,infection,pain,bleeding and affect kidney function.Lung tumor also needs urgent treatment, depending on the biopsy report.If you send your scans(CT-IVU, Lung),biopsy,blood reports, for an expert opinion on treatment to me, as a direct question, i can guide you.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life expectancy for end stage cervical cancer?\n\nmy sister in law had cervical cancer, well now it has pread all through her body, lymp nodes everywhere. Now they said there is nothing they can do for her, and basically called hosoice in and sent her home to die. How long generally do people have to live? (",
    "doctor_response": "The 5 year survival rate for stage 4 cervical cancer is only 16%.The basic aim of treatment at this stage should be basic supportive care to improve qualiy of life.RegardsDR De",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will fingering with semen filled hands cause pregnancy?\n\nhi. i'm sorry but im freaking out.. i gave my boyfriend a blowjob and he cummed after then started to rub his hands on it and got cum on his hands. after that he wiped it all off with a blanket. then fingered me, does this mean i'll get pregnant. please noo:[",
    "doctor_response": "Hello dear,I understand your concern.In my opinion there is no chance of pregnancy in your case.Usually there is chance for pregnancy when semen is ejaculated inside or around the vagina during the fertile period.In your case nothing such happened.And minimum of 2-5 ml of semen should be ejaculated for pregnancy to occur as some  of the sperms are eaten away by the macrophages which are present in the vagina and only a few are left.The semen which was on hands was wiped off before fingering you.And the very little amount if at all remained on fingers will not be sufficient to cause pregnancy.So relax.Nothing to worry.Avoid stress.Wait and check for the period.Hope this helps.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant throbbing pain in the abdomen?\n\nHi, I get alot of abdominal pains and feel like im so bloated and there is a constant dull, throbbing ache. I also have a lump down below but when doctor examined me he told me i had a lower bowel, but told me to have a smear to be on the safe side. Which i did... Then i got my results back within 8 days which was severe dyskaryosis. I have an appointment for a colposcopy in 5 days. Now im slightly worried because i have been to my doctor about these pains before and he told me they were stomache spasms. Ive also had problems with my hormones, they have been hitting through the roof, and i dont know if im coming or going??? Ontop of all this i had blood test on my hormones a few month ago to which they came back abnormal and that i wasnt fertile, then when taking again the next month came back fine??? I have also had to have treatment for facial hair (which i had to pay hundred of pounds out of my own money for) which has layed heavy on my confidence.... I get constant back ache too, i feel my body is a complete mess right now and everytime i get these throbbing/dull ache pains (On a daily basis) i worry more incase these cells are spreading? Please can you give me some advice im only 23 years old and i know that my body doesnt right i feel. Much appreciated. thank you",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query. If I were your doctor,  I after a clinical assessment of your abdomen would advise you for an ultrasound of the abdomen apart from the hormone analysis. with your symptoms of virilisation and history of lump down, you might be having PCOD (polycystic ovarian disease) which if treated might give you relief in your symptoms. I would advise you to take appointment with a gynaecologist and consult on your problem with all your reports. Till then, I could advise you for simple anti spasmodics only for relief of your pain in the abdomen. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should i do for the sore lower back and cold?\n\nHi I am Donna:  I have a cold and my lower back is really sore, making it difficult to move. I tried heat and that seemed to make it worse, so now I am using cold packs and advil which is helping. But I wonder if I should try the hot and cold method. It has been 3 days, with some improvement. any other ideas.  What would massage do?Thanks",
    "doctor_response": "You can take hot compression and along with take analgesic anti infamatery tablets like combiflam tablet two times daily after food. Apply analgesic ointment like relaxyl ointment over lower back",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could throbbing in left shoulder and both arms, headache and neck pain while being on BP medication suggest?\n\nI have been having throbbing in my left shoulder and arm. Sometimes I get the throbbing in my right arm as well. I have issues with severe headaches and neck pains. I am going on day three with this headache and now my neck hurts really bad. I do have issues with blood pressure and currently taking medicine for it.",
    "doctor_response": "Hello, It is not related to antihypertensives. As a first line management, you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist you can consult an orthopaedician and plan for an MRI scan. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am i getting odd soft chemical smell?\n\nI woke up smelling this odd soft (not eye burning) chemical smell.  I thought it was a new body scrub, but I reshowered, rewashed my hair with different shampoo, threw out the new bar of soap and finally discovered whatever is closest to my nose has that smell.  I just had my second spinal cortisone injection for a pinched nerve, is it possible that is leaking into my olfactory",
    "doctor_response": "HiI am Dr Mittal.I have read your message.I think I can help you.The symptom tat you have mentioned in the query is called paraosmia. Or abnormal smell.  Paraosmia is found among people who take Cortisone, especially elderly females with hypertension.So there is a strong possibility that you are have a side effect of the injection- do not think that it is getting secreted in your nose- nothing like that.It is just a side effect. Usually it lasts a few days. And doesn't need to be stopped or changed unless you cannot tolerate the smell.I have tried to make it as simple as possible.Feel free to ask me a follow up query on any aspect of the problem.I will be happy to help you.Thank you for giving us an opportunity to be of help, Dr Mittal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for strep throat with medication for malaria\n\nI am a 20 year old female and am studying abroad in Peru and don't have access to a clinic or hospital at the present but somehow get internet on my phone.  For the past 11 days I have been taking doxycycline(100 mg daily) as I am in a malaria infected area of the country.  Yesterday I began having symptoms of strep throat, which I have been prone to get my whole life and I am in constant contact with a large group of children.  Today my symptoms worsened, I have a fever of 102 degrees, have a bright red throat, and swollen lymph nodes; and without thinking I took amoxicillin(500 mg) this evening-about 10 hours after I took doxycycline this morning.  So my first question is what should I do, continue taking doxycycline to prevent getting malaria or take the amoxicillin to get rid of strep throat? Obviously I would rather have strep than malaria, but is there some other antibiotic I could take?  My second question is about the side effects of doxycycline.  As I was concerned about the previously stated drug interaction, I began looking online and also discovered that vaginal itching is a side effect of doxycycline as well.  I only started noticing vaginal itching this morning and I don't know if this is a serious side effect and what you would recommend for me to get rid of it.Thanks!",
    "doctor_response": "Hi there,I understand your predicament when you have limited access to medical care.  To answer your first question, yes continue taking both antibiotics.  They are from different groups of antibiotics, and tackles different kinds of infection.  The only catch is that doxycycline has been known to reduce the effectiveness of amoxycillin, but I would not have you stop the doxycycline and expose you to the malaria risk.  Go ahead with the amoxycillin if that is what you have on hand, and make sure to complete the full course.  If you find that indeed the amoxycillin doesn't work so well this time (you will be able to tell after 2-3 days), see if you can get antibiotics from another group, like erythromycin or cefuroxime.The answer to the second question is that no, it is not a serious side effect.  It is probably just a yeast infection, also called candida, and is a common side effect of any antibiotic, because it kills off the natural bacteria in the vagina.  You will need to get some antifungal pessaries like clotrimazole to insert into your vagina, or if you prefer oral medication for any reason at all, something like fluconazole will help.  Do not worry excessively about this if you can't get medication for this urgently, it is simply a nuisance condition that does not have long term problems.Hope this helps, and all the best to you.Regards,Dr. Teh",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can threadworm infection harm the foetus?\n\nmy fiance's brother is 3 years old an has threadworms, i am 22 weeks pregnant and i am worried if i catch them then with they harm my baby at all as i know i can not take anythink while i am pregnant also i with be breast feeding and worried if his case dont clear cant they then harm my baby",
    "doctor_response": "Good day and thanks for the question. It cannot harm your unborn baby and please don't feel worried. I wish you a safe delivery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome the pain on my knee cap?\n\nMy husband had a meniscus tear and he had surgery 3 months ago and he is still is a lot of pain. On the inter side and front of the knee cap. He feel like his leg bone is going into his knee cap when he tries to stand on it. Any answer would be appreciated",
    "doctor_response": "Hello, As there will be muscle weakness it needs to be strengthened. Doing hot water fermentation, using a knee cap. doing static quadriceps static hamstring and straight leg raise will help improve the joint space and reduce the pain. Post meniscus surgery the knee rehabilitation program is advised. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and cough in child\n\nI have a 4 year old who has had a cough for going on 2 weeks. His ped has him on albuterol neb sol., prn. It is helping, however, he has had a low-grade fever with this for 3 days now. Tylenol does bring it down and keeps it down for a while. Should I be concerned with his fever lasting this long?",
    "doctor_response": "Hi,Your child requires evaluation of his case.Go for complete blood checking like TC, DC, ESR, Platelet count to know about any infection.If require go for x-ray chest.After report go for treatment accordingly.Give him light diet and avoid giving junk food.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will pneumococcal conjugate vaccination help prevent breathing problem in infants?\n\nHI, My daughter is 5months old. Her weight is just 6.5kg. It s the correct one. In one day, giving two times of cerelac[3 tablespoon] and also giving Lactogen Stage one[6 tablespoon per day]. Night time breastfeeding? Is the enough one for the 5months old baby? Some time, my baby is difficult to breathe.My mother-in law having asthma disease. It will affect my baby. Can i put pneumococcal conjugate vaccination to prevent this breathing problem. Please suggest me.",
    "doctor_response": "Hi, 6.5 kg for a 5 month old child is completely normal. The amount of feeding that is being given is also correct. Mother feed is bvest till the age of 6 months of age. Pneumococcal vaccine prevents infection from Pneumococcus and does not prevent respiratory problems due to other causes like Childhood Asthama, other respiratory infections or bronchiolitis or WALRI.  The vaccine is still recommended in children as it has a good prevention rate.Keep good hygiene and prevent the child from excessive cold conditions.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I felt a lump while checking for the string of IUD. what should I do know?\n\nHello doctor, I have an intrauterine device. I was checking for the strings, and I felt a lump. Not sure if it is normal or not. I got my period today. I had my last period over three months.",
    "doctor_response": "Hello. It is better to have one local examination by Gynecology specialist but better after periods. If vaginal irritation continues, then it is better to have a high vaginal swab, lump examination (may need biopsy or swab), cx (cervical smear)smear; You may have vaginal or pelvic or sexually transmitted infection along with cyst or abscess or infective lesion. Have complete treatment for any health issue you have. Have a balanced diet, weight, and BMI. have a daily walk, exercise, and yoga. Have recreational activities and quit recreational drugs. Follow strict hygiene. Use condoms to avoid sexually transmitted infection. Do sitz warm baths to prevent irritation and olive oil massage. After high vaginal swab, if pain, irritation or smelly or colored discharge persists then, you need proper antibiotics. If lump also continues, then there is a need to evaluate for appropriate management (marsupialization or drainage). Abcess or cyst and infection. HVS, local examination, biopsy, and a swab from vaginal and lump. May need antibiotics after HVS if symptoms persist, may need to remove abscess. As above. As per need.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest natural remedies to reduce androgenic alopecia\n\nhi there whats ur intake on fenugreek seeds applied on scalp for hair loss? are there any side effects would u recommend any other natrual remedies to reduce Androgenic Alopecia, i am 26 years old female, with a very fast receding hair line and miniaturizing hair all over.",
    "doctor_response": "at 26 if you have receding hair line,would like to know your menstrual history.local application of medicated oil containing bhrugaraj,amalaki,maka.gunja will be useful.gunja used in the oil should have gone through the classical shodhan procedure described in ayurved,otherwise skip gunja as ingredient.orally asthi poshak combination and matra nasya with yeshtimadhu ghrit can be used.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am positive for chlamydia and having vaginal itch and smelly discharge. What to do?\n\nHello doctor, During this past summer, I have had one sex partner. Also during this summer, I was told by my doctor that I tested positive for Chlamydia. A day after my doctor's visit, I noticed that on the left part of my upper lip, there seems to be like a rise in the skin. There are no bumps, no burning, or no itching. I have become very stressed about this because as I examined the lips of others, that part of my lip was starting to look strange compared to others. My partner and I both got our treatment for Chlamydia and waited seven days before having sex again. Now I am experiencing a couple of things that I was not before. My partner is not experiencing anything. I noticed that I was experiencing some itching in my vaginal area (at the top where hair grows). It is not a cluster of bumps, but it is white and very noticeable to the naked eye. I am thinking that it is just public lice but not so sure. Next, I have noticed that I have what feels like two cuts (one on each side) near the bottom of my vaginal area. It does not burn or itch, it is just there. I have experienced some smelly discharge but not a lot. I have not been with anyone else except the same guy I had from the summer. Can you tell me if I might have a certain virus or infection?",
    "doctor_response": "Hello. I have read your query. Chlamydial infection is the most common sexually transmitted infection worldwide. You had been advised to take antichlamydial treatment for both the partners and you have taken treatment for the same. But the abstinence period is usually two to three weeks after treatment before any sexual intercourse. Since you are experiencing a mild amount of foul-smelling discharge which is usually present in the chlamydial infection. You are supposed to look to a doctor in your area for the treatment for the specified time and work out on the abstinence period. Viral infection like herpes usually causes painful superficial ulcers over the genital area, and so the little white bumps over your pubic area can be a mere folliculitis. Chlamydia trachomatis. None required. Chlamydia trachomatis infection. Antichlamydial treatment like Azithromycin 1 g for five days or Doxycycline 100 mg twice daily for a week will do. Sexual abstinence for a minimum period of two to three weeks after treatment is necessary. Review two weeks after treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can tumor in belly with water filled in stoamch be cured with operation?\n\nHi, i don t know how to explain this but i will try and ask as i have been told by the doctor. my mum had swollen on her belly and she felt pain. we took her to the doctor and he told us to do few test reports and now that we have got the reports. he told us today that my mum has got a rasoli (Tumor) in her belly and that is because of the cancer and she had water filling up in her stomach so he has given her some medication to take that will help to clear the water out of the stomach. now my worry is that if that rasoli can be dangerous or can it be removed with an operation or can we even operate for that please provide me with professional opinion and let me know whats the best possibilities in this situation and what should we do.",
    "doctor_response": "Hi. your description is quite vague. To give an opinion, I need to know what exactly is the type and stage of cancer. I would recommend you to consult a nearby oncologist (doctor who treats cancer) with all reports. If you have any further questions I will be happy to help",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent cough and coughing fits which lead to pricking pain in the shoulders, chest and arms\n\nI keep getting a nasty cough, feels like a dry spot but last night i was coughing so hard all of a sudden when i coughed i got this very painful prickly feeling in shoulders, chest and down arms..It hurt so sad and happened every time i coughed..Someone told me it might be a pinched nerve in my neck from coughing..What do u think?n",
    "doctor_response": "Respected user, hi I evaluated your query thoroughly .* Symptoms narrated are the systemic manifestation of underlying lung   pathology only .* Recommendations are - avoid exacerbating factors as dusty atmosphere / pollens , if required use   face mask- avoid exposure to excess cold - prefer semi reclining position when ever possible to support lungs - avoid exposure to cooler air , air conditioner till possible- avoid smoking / alcohol / any abuse substances if used- chilled materials , ice creams , cold drinks, beverages, oily , spicy ,    non vegetarian stuffs should be avoided by en large - garlges with salted lukewarm water & added peppermint oil- maintain oral hygiene- balance nutritious diet to combat external pathogens- need of systemic molecules in form of antibiotics , decongestants, broncho  dilators is to be evaluated by physical examination of the patient with   necessary Lab tests & X-ray chest / pulmonary function test Hope this helps you.Welcome for any further assistance.Thanks for using Healthcaremagic.com & giving me an opportunity to assist Wishing you a happy healthy life ahead .Regards dear take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a 11 year old feeling hot continuously a reason to worry?\n\nmy 11 year old daughter is hot all the time. she wears shorts and short sleeves and flip flops when everyone has jackets and pants. her hands and feet are sweating lots lately. she is adopted from china so i dont know her family history.  YYYY@YYYY",
    "doctor_response": "it can be national features, features of vegetative nervous system if she is very emothional girl, you dont worry, just change her clothes when she is sweating.If she is very emothional you can give her ashvagandha 1 capsule 1 time 14 days and see effects, then lets me know",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes oily greenish/brownish loose stools during pregnancy with sluggish gallbladder?\n\nHi! I am 5 wks. pregnant. I have a sluggish gallbladder, output of 27% , was to see a surgeon next week about having it removed until i found out i was pregnant. I am now having frequent loose stools. they almost appear oily or fatty.... greenish/brownish... not sure if its from the pregnancy or i guess my fear is that the gallbladder problem has created havoc on my pancreas and im freaking out",
    "doctor_response": "Hi and thank you so much for this query.I am so sorry to hear about what you are experiencing right now. A gall bladder problem can lead to diarrhea because food is not well digested as bile from the is very important in the digestion of fats. I will not particularly think that your pancreas has been damaged as you are not presenting with signs of pancreatitis which is often a pain. For now, stay relaxed and follow up with your doctors to figure out the exact cause and propose a treatment plan to you.I hope this addresses your query fully. Thank you so much for using our services and please feel free to ask for clarifications if need be. I wish you the best of health.Dr. Ditah, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can ensure be given to a kidney failure patient?\n\nHello, I am asking this for my dad who was recently told that his bladder cancer has returned. As a result, his right kidney is failing and he is anemic. We are having difficulty trying to figure out the right foods to feed him...he is so weak. QUESTION : Is ENSURE OK to give him, or is this too much protein?",
    "doctor_response": "Hello and welcome to HCM.As an Urologist, let me assure that, kindly follow your doctors' advice.Only in people with kidney failure, is 40gm proteins diet/ day advised.Ensure gives additional protein supplement, but the nutrionist will advise you as per your doctors' advice. Bladder cancer recurrence with one side kidney failure, can be treated, by several approaches. Surgical or medical, will depend on his general condition.If you want an expert opinion, you can send a copy of the reports, to me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in lower lip and chin in 24 weeks pregnancy?\n\nHi, may I answer your health queries right now ?  Please type your query here...i am 24 weeks pregnant and for the past four weeks i have been occasionally experiencing a tingling and numb sensation in my lower lip and to the right of my chin,what could this be please",
    "doctor_response": "please don't worry, if you take my opinion then I would like to say that there is nothing much to worry about ,these symptoms may be due to iron deficiency or vitamin deficiency ,so I would advice you to check your haemoglobin level and have a vitamin supplement along with iron tablet",
    "dialogue_context": ""
  },
  {
    "patient_message": "Urinating in bed while sleeping. Started after removing kidney in surgery. Have mild dementia. Advice?\n\nMy husband had a kidney removed last month due to cancer.  Since the surgery, he has been peeing while sleeping without waking (soaking through 2 adult diapers, sometimes 2 or 3 times a night).  He does fine during the day, but every night since surgery, he pees in his sleep without waking.  He is 78 yrs. old and has mild dementia, but did not have this problem before the surgery.  Hope you can help with an answer.  He is on two new meds since surgery but the side effects do not mention urinary problems.Thank you,S. McAdams",
    "doctor_response": "Is be on any sedatives by any chance ?Deep sleep due to these drugs might be causing it.Does he have increased frequency of urine or burning during day time suggesting urinary infection.Whar are the renal functions now?Also take care that he doesn't drink excess water or liquids during evening and night time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for itchy red rashes due to bug bites\n\nI had 18 bug bites on my right arm two weeks ago. They looked like a mosquito bites. They itch immensely. Now they have turned into red rashes. It is a raised rough looking surface. Some days there are tiny little bumps present in the red rash. Other days you can t even notice the rash. I m thinking that the rash has been caused by my constant scratching.",
    "doctor_response": "Hi...Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns...As per your complain due to allergic reaction to the toxin chemical that is injected in your body and as the number of stings are high the toxin concentration is more and you have got itching and rashes due to it..As of now you can take anti allergics like Levocetrizine and fexofenadine [allegra], apply a steroid ointment over the rashes,Doing cold compresses and application of calamine lotion can also soothe the skin and reduce itching..In case if still you do not find improvement consult an Allergist and he can also give to injectable anti allergics and steroids.Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility problem\n\nI was married in the year of feb.2005. after 3 moths she was pregnant. but my bad luck she got abortion. till now she does not get even pregnant. i gave her many medicine such as latrol, zolete, ovuclon etc. Also i gave her pregnil injection 2 times. one year ago doctors has done an operation of Laproscopy. What happened to my wife? Will not she get pregnant again?",
    "doctor_response": "I pills are to prevent pregnancy, but it causes bleeding if not taken in proper way. Continue Metformin and Krimson 35. Use Birth control pills rather than I Pill for contraception, it will help you in regulating your cycle as well as settling your all hormones. PCO is a inherent condition and cannot be cured but can be effectively treated.Yes! You can try homeopathy, as well as can consult cosmetologist for skin problems. In future if you are planning for pregnancy consult fertility physician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes left abdominal pain and swollen ankles?\n\nhi,my sister has chronic lower left abdominal pain and recently had chest problems to which she was prescribed antibiotics and omeprazole for the stomach. now she s having swollen ankles and some blisters/ulcers on both lower legs. is this an indication of some underlying problem?",
    "doctor_response": "Hi I did review your concern. These symptoms of various different regions raise the suspicion of vasculitis/autoimmune disease. I would recommend you to consult a immunologist/rhemuatologist/physician for further testing and evaluation like CBC,ANA,ANCA and also biopsy of local leg lesions if required. Early diagnosis and treatment is warrented.I hope this suggestion helpsWish you both the best of health and success.",
    "dialogue_context": ""
  },
  {
    "patient_message": "After the liver enzyme test the GGT was 120, what does the result suggest?\n\nhello Dr.Yesterday, i had a liver enzyme test done in the morning. My GGT was 120. On the 3rd of january it was 90. I have another one scheduled tomorrow around noon and i need for it to be under 75. Is this possible and is there any vitamins or supplements to expedite the process. Thank you.",
    "doctor_response": "Hi & Welcome.Incomplete data like any history of alcohol intake, details of other liver function tests, any medical illness.The raised GGT level is suggestive of liver disease caused by alcohol intake.To reduce the level of GGT, you must;1. Avoid alcohol or alcohol containing beverages forever,2. Avoid fatty meals, fast n junk foods3. Eat home cooked healthy diet4. Increase intake of fruits and vegetables5. Vitamin E containing supplements are proved to be effective in patients with raised liver enzymes like GGT.Hope I could answer your query.Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having asthma, discoloration on stomach, dull pain in belly button. Why is it happening?\n\nHi, I'm 34, female, slim; no health issues other than asthma. About a month ago I noticed some discolouration on my stomach. It has a sort of marbled look and stretches a few inches around my belly button. I'm very pale skinned but this discolouration is a pale brown in appearance. I've also had a niggling dull pain to the left and below my belly button but it's not a bad pain. It would be great to know what you think.",
    "doctor_response": "Are you taking any medicines for asthma or ar you taking any medicine in between for other problems some medicines used in asthma or other diseases cause this li8ke paracetaol,disprin aspirin brufen and vitamins and dietry suppliments check for these",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain and soreness near hip bone\n\nA month ago, I was playing volleyball and fell forward hitting my hip bone pretty hard on the ground. The next day I fell again and landed on the exact same spot. Like I said, it s been a month and it is still a darkish color and hurts whenever I put pressure on the spot. Is this normal?",
    "doctor_response": "hiProbably it is some blood clot or hematoma common after bruising of soft tissues on impact injuries. Do hot fomentation and apply thrombophob Gel locally.nothing to worry .it will go in few daysRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in the ribs\n\nI have been in pain on my right side under the rib cage. The tests were on the gallbladder,liver,etc. They included CT scan,ultrasound,upper endoscope and others. But no answers. In fact after each and every test the pain has gotten worse.its getting to the point I don t want to eat cause I m afraid of pain. What else can we do?",
    "doctor_response": "It may be due to costochondritis .it's better you can go for analgesic along with antispasmodic may be diclofenac with thiocholchicoside",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high BP and frequent syncope?\n\nMy 63 years old mother has been fainting (syncope) unexpectedly. Her normal ECG and overall condition is fine, but she has high blood pressure. Her doctor recommends to implant Medtronic Reveal. She found out at home she has exercise induced bradycardia on a home treadmill about 10% of the time. Would you still recommend the implantion of Reveal, or see if the bradycardia can be reproduced with an ECG at the doctor?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern for your mother and looking to the history a I would say that if the CT head is not done then get it done this is important, this would rule out the  possibility of cerebral pathology, take care and have a nice day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can change of altitude cause dizziness ?\n\nWe just moved from Kentucky, to the dessert in California.  We have been here for about a week, and I have been feeling weak, nauseous, light headed, low -grade headaches, and swollen ankles and feet.  Is this due to a change in the altitude?  Or the dry climate and high heat?",
    "doctor_response": "Hello!Welcome on Healthcaremagic!Some of your symptoms could be related to the change in altitude. Anyway, I would recommend consulting with your GP and performing some tests to investigate for other possible causes which may mimic this situation: - a chest X ray study- a cardiac ultrasound- complete blood count- blood electrolytes- PCR and sedimentation rate. Meanwhile, I recommend taking plenty of water to stay well hydrated. Hope you will find this answer helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red dots on roof of mouth?\n\nHello. Im a 17 year old girl and i weigh 117 pounds and my height is 166 cm. For the last four days, i have had a dry cough and i noticed that the roof of my mouth is orange with some red dots. I have some type of liver disease. My doctors just cannot seem to figure out what i have because i am not a textbook case. I have all of the symptoms for primary schlerosis cholongitis, however i am negative for it. Please help, i do not know if i should be worried.",
    "doctor_response": "Hello!Thank you for posting in HCM.Yellow to orange mucous membranes,eyes,nails you experience suggest jaundice.Liver obstruction as in your case also leads to poor clotting function. So, this is secondary to liver disease you are suffering from.This must be treated first.I suggest you to consult your physician immediately.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pain in hip bone and joint be due to degenerative changes in hip?\n\nHi, I am a 3 year breast cancer survivor. This past October, I started to have vague right hip pain, which has gotten worse. February of this year, I had a nuclear medicine whole body bone scan done. The results came back as degenerative changes in the left and right hip, but more prevalent in the right hip. It was recommended that I repeat the bone scan, which I did on June 3, 2014. The results came back showing that the same affects were happening not only in my hips and pelvis (right hip more prevalent) but also in both of my shoulders ( right shoulder more prevalent) and the front part of my skull had thickened also. I was told that my scan was fine and no changes had occurred and to repeat the scan in six months. I found this to be questionable, simply because there was an obvious change within the three months. Both scans were done to rule out metastatic disease. Radiotracer activity in the second scan was noted in places that did not show up on the first scan. I want to know; do I have anything to worry about and should I get a second opinion. My right hip bone and joint have been hurting constantly, mostly at night. My lumpectomy was on the right breast and I hurt there constantly also. Sometimes the pain is so bad, it feels like it is piercing through the back of my shoulder. Could I have early signs of bone cancer?",
    "doctor_response": "Your age please?The changes in your serial bone scans seem to be age related.This treatment is being suggested on bases of the information provided.I would like to examine & investigate you in detail.Rule out Hypertension, Diabetes or other metabolic disorder. Any way it may be tried,--.  Dolokind Plus (Mankind) [Aceclofenac 100mg +Paracetamol 350mg] 1 tab.  OD & SOS. X 5days.--. Caldikind plus (Mankind) 1 tab OD x 10days.(You may need help of your local doctor to get these medicines.)--. Fomentation with warm water. Avoid direct flow of AC or Cooler.--. Sleep on a hard bed with soft bedding.--. Avoid painful acts & activities.-- .Do mild exercises for All joints. --.(Take help of a physiotherapist or visit www.drncgupta.com). --. Use no pillow under the head.Do not ignore, let it not become beginning of a major problem.Do ask for a detailed treatment plan.If no relief in 2-3 days, contact me again.  Kindly make sure, there is no allergy to any of these medicines. (Contact your family doctor, if needed).For  emergency treatment visit nearest hospital.I hope I have answered your question to your satisfaction.Kindly rate the answer.Wish you a quick recovery & good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can herniated disc leakage be diagnosed?\n\nI have a herniated disc at L5 S1 which is pinching off left siatic nerve and laying against right siatic nerve plus i have arthritis in the area i have been getting treatment since i found out in October I was recently told that my herniated disc is leaking fluid the mri results did not say anything about it leaking so my question is how does my doctor or nurse practioner know its leaking",
    "doctor_response": "Hello!Welcome on Healthcaremagic!I would like to directly review your spine MRI for a more professional opinion. It is quite common for the herniated disc to degenerate in this way. Correcting your posture and performing physiotherapy to help reinforce your back muscles can help improve your situation. It is also necessary avoiding prolonged standing up or sitting position and weight lifting.  Painkillers and hot packs can help improve the pain. If your situation worsens despite the above recommendations, I would recommend consulting with a spinal surgeon. Hope you will find this answer helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the arm radiating to the elbow and inner arm?\n\nlately i have had a lot of left arm pain. Underneath my elbow on my inner arm. Sometimes it will make my left hand hurt as well. Today it reached my shoulder but went away quickly. I noticed the pain gets more intense when i smoke a cigarette but not always so i m not sure.",
    "doctor_response": "Hello,The symptoms seem to be related to a pinched nerve if the arm. I suggest using anti inflammatory medications such as Acetaminophen to relieve the pain. I also suggest to maintain the the arm immobilized to prevent further damage.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking stamlo beta, telma. Tendency for BP increase. Take losar?\n\nI am 65 yrs of age and reciding in Pune India. I was taking Stamlo Beta for about five years and then our family physician changed that to Telma 40 in August 11 due certain disorder in Creataninine in Kidney Function. After taking Telma 40 for few days I had some giddyness and the medicine was changed to Telma H since about about six/seven months due to dual action on BP and Kidney function control. Now recently I visited some place Kolkata in India where ambient temp was very high and when I returnedd to Pune my BP was found low as 100/64. doctor advised to change to Telma40 and to take some energel powder after mixing with water. After taking Telma 40 again gidiness started and I stopped taking BP tablets since last one week and my present BP level is 120/80. Doctor advised if there is tendency to increase BP again to take Losar 25 in place of Telma40 due tomgiddyness problem. Pl advice.",
    "doctor_response": "Hello,Telmisartan and Losartan help in the long run by slowing down kidney damage, they also have beneficial effect on the heart. However they are useful for the kidneys only if you have increased protein in the I urine.What has been your BP during the times you've been giddy. If low BP is the cause maybe a smaller dose might work.Has your creatinine and potassium been checked recently. If not, check that.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "last month on the day i was suppose to get my period. could it be ?\n\nlast month on the day i was suppose to get my period it was just a little there that went on for the next six days i would see something then there would be nothing for the rest of the day i have had unprotected sex what could it be",
    "doctor_response": "Hi, Thanks for query, There is chance of pregnancy,go for pregnancy test and confirm. ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please suggest the right medicine for my husband's diabetes.\n\nHello doctor, My husband has diabetes for the last five years. Please suggest the right medicine. Recent reports are available.",
    "doctor_response": "Hello. I have gone through the reports (attachment removed to protect patient identity). His blood sugar, lipid profile and vitamin D are deranged. Also, CRP (C-reactive protein) is elevated. Now, he should be on treatment for diabetes. I suggest taking tablet Exermet GM 2 forte (Metformin and Glimepiride) once a day before breakfast. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Let him continue this for a week and get fasting and post lunch sugar done after a week. It can be increased to two times a day after seeing the blood sugar report. Also, restrict sugar intake. Also, for vitamin D, he should have tablet Uprise D3 once a week for eight weeks and then once a month for next six months. For lipid profile, he should have tablet Rosulip (Rosuvastatin) 10 mg once a day bedtime. The lipid profile should be repeated after eight weeks to look for control. He should also have a healthy lifestyle like avoiding fatty, oily and high-calorie diet. Have low salt diet and monitor blood pressure regularly. Regular exercises like brisk walking, jogging according to your capacity at least 30 minutes a day and five days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any.  Hope this helps you and get back If you have any doubts. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can morphine & diclofenac be taken together?\n\ni have possible kidney stones and i am having morephine for the pain but today i was given Diclofenac aswell (anti enflamatries + pain relief) i am just wondering if it is ok to take them both together and also if the pain gets really bad maybee some parasetamol aswell. would that be ok?",
    "doctor_response": "Hello and welcome to HCM.As an Urologist, i must advise you, to confirm, if you've kidney stones first.Kidney stones can be clearly seen on an ultrasound / CT scan.So no doubt should remain in your mind.You're advised to avoid taking morphine and diclofenac, without knowing what causes your pain.  Diclofenac also can cause damage to kidney.See a doctor and after examination,he'll advise you regarding the scan.For my expert opinion on your scan and report,send it as a direct question.Dr.Matthew J.Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can mood swings and dizziness be managed while on Escitalopram?\n\nMy husband has been taking Escitalopfram for about 3 weeks now. Lately his moods have gone up and down. Sometimes he has a lose of interest totally and other times he feels like he is about to crawl out of skin. Also, has been feeling light headed. Is this normal and will he even out eventually after time?",
    "doctor_response": "Hello, From the description, it seems that depression is not getting addressed by the given medicine. You should talk to your psychiatrist. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tooth infection\n\nI went to dentist yesterday and found I had infection in tooth. I'm on elquits(blood thinner) and tooth still bleeding. I'm on amonxiscillin  now for infection.  Should I be worried that my gums are still bleeding.  Should I stop taking blood thinner?",
    "doctor_response": "Hello,I would like to know the treatment recommendation for your infection? Did you have the tooth extracted without going off your blood thinner? I consult, to determine the amount of time needed to stop your medication, with my patient's physician before scheduling an extraction. Dental patients need to stop taking aspirin for seven days prior to an extraction to assist controlling bleeding.Are you planning to have a root canal? Did you have swelling and require drainage? Apply pressure to the area that is bleeding for 15 minute. Avoid irritants. Stay on your medication as prescribed and follow all instructions provided by your dentist. Call your dentist and ask specific questions about your symptoms to find out if this is unusual after your recent visit. Keep in mind a small amount of blood can mix with saliva and look like a greater volume of blood.  Remember, rinsing after an extraction can disturb your initial blood clot and promote bleeding or severely infected tissue can exhibit more bleeding.Do not stop your medication unless advised by your physician or dentist. Make sure that you review your medication being taken and full medical history with your dentist prior to dental treatment.thank you for your inquiry. I hope you will feel better soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high fever and shivering?\n\nMadam/Dear Sir, My son got high fever from yesterday evening 6pm 103degree ,Dr Rao in Raipur said it was due to exposure to heat(loo) in raipur and prescribed ibugesic plus 7.5ml.We gave around 10.30 temp came to normal in 1 hour.But now(4.30 am) he has started severing a lot and temp started rising(100.0 underarm).Please advice...",
    "doctor_response": "Thanks for putting up your query at HealthCareMagic. I am sorry that your son is not doing well. Had I known your son's age and weight, I would have been in a better position to guide you. If your doctor is talking about something like heat stroke, it requires direct exposure to the sun. Unless you mention that it is difficult for me to comment.As of now, you have to keep the temperature in control. You may use cold sponging where you are supposed to sponge the child using water of normal temperature. You may use Crocin (paracetamol) or Ibugesic Plus which are generally given at interval of at least 3-4 hours and can be given upto 4 times a day. It would be best to consult your doctor directly however.I hope that helps. Feel free to revert back with further queries if any.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in left side of abdomen. Sonography shows vascular calcification in both kidneys. Next step ?\n\nSIR MY FATHER AGED 70 YRS ,HYPERTENSIVE WITH STUNT 5 YRS BACK,,,TAKING TELMA 40 MG,METXL 50 AND ASPRIN . ALL OF A SUDDEN HE WAS WITH LIGHT PAIN IN LEFT SIDE OF ABDOMEN AND DOCTOR(PHYSICIAN ) ADVISE TOTOAL ABDOMEN U/SONOGRAPHY...THE IMPRESSIONS ARE ............ VASCULAR CALCIFICATION IN BOTH KIDNEYS.,, SERUM CREATIN (1.0)...SIR PLEASE ADVICE US WILL THIS CALCIFICATION IS A VERY SPEEDY PROCRESS AND WILL HIS KIDNES AND HEART GET DAMAGED SOON OR WILL IT TAKE TIME AT LEAST 5 YRS ....WAHT SHOULD BE OUR NEXT STEP,,,,PL ADVICE US WE DONT WANT TO LOOSE HIM.",
    "doctor_response": "Hi Andey, Thanks for writing in. Vascular calcification of the kidneys could be due to old age, chronic kidney disease and diabetes. I would like to know the size of the kidneys in the ultrasound report. Also, I would like to know the electrolyte level renal function test report and the complete blood count. This will help us know whether he has chronic kidney disease. Also, I would like to know if he is diabetic. If this is only because of old age, then it will not progress rapidly. However, regular monitoring of renal function is required. Your next step should be to consult a nephrologist. He would be the best person to guide you. Hope that helps Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my hemoglobin low?\n\nI'm a 58 year old male in good health, but my hemaglobin is 12.6 and my MCV is 77.  My doctor thinks the levels are low and wants me to have a colonoscopy, even though I had one 5 years ago and everything was fine.  I take a daily baby aspirin and ibuprofen when I have a headache, which my doctor said may contribute to the low readings.  Should I go ahead with the colonoscopy or should I cut out the aspirin and ibuprofen and have another blood test in a couple weeks to compare the readings?",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Your hemoglobin is mildly reduced. Along with hemoglobin, MCV is also reduced indicating possible iron deficiency.2. Colonoscopy is essential every five years and needs to be done to evaluate for any polyps or cancer. This can cause bleeding.3. Ibuprofen can cause gastritis and bleeding. Stool examination can confirm any bleeding in gut. Take iron supplements and get colonoscopy and stool examination done.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any best medicine for bacterial pneumonia and COPD?\n\nI am 63 years old female a year ago I had bacterial pneumonia and since then I am not feeling normal, also pulmonologist told me I have COPD , I am not smoking since pneumonia have SPIRIVA once a day and ADVAIR 500 twice /day, don feel that is doing any good anymore is there any other medicine that may help me to function more normal? Apparently ANORO ELLIPTA was approved by FDA but is not on Canadian market yet, thank you Zofia",
    "doctor_response": "Hello Usually in such conditions we recommend Claritromycin twice orally for some days. Regards Dr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can HPV infection raise/lower WBC count?\n\nWould having an HPV infection raise/lower your WBC? It s something I ve been very concerned about so I got a CBC done and EVERYTHING came back perfect. I had two genital warts removed about 4 months ago and had the CBC done about a week and a half ago.",
    "doctor_response": "Hello and welcome to HCM,HPV infection will not affect the white blood cell counts.HPV infection is known to cause genital warts, epithelial dysplasia and malignancies.However, an increase or decrease in white blood cells is not known to occur with HPV infection.Thanks and take careDr Shailja Puri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes irregular breathing, sweating and anxiety?\n\nGreetings Dr. Carol! How have you been? Can you please suggest possible causes of following symptoms; 1] Irregular breathing / blocking sensation, esp after food 2] Excessive sweating than before 3] Anxiety, but that is due to stress even this lead to hydper-breathing 4] Restleness, due to stress Heavy coffee intake was there earlier but have reduced to minimal, however coffee is one of the regulars since years. Thanks for your time! G'day",
    "doctor_response": "Hi dear. I had gone through your query. I understand your concern. All symptoms that have you mentioned are due to stress.Stress and anxiety will lead to physical/psychological symptoms.Physical symptoms include sweating/palpitation/rapid heart rate/breathing difficulties etc.When it rapidly arise then lead to panic attacks. Anxiety is due to psychological or biological causes require treatment. Biological therapy like medicines will helpful. SSRI aand benzodiazapine will be useful. Exercise and meditation can help. Relaxations method like deep breathing can help.Ensure proper sleep and diet. Consult psychiatrist and get further assistance. Still if you have a query then feel free to ask. .Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with nasobronchial allergy, tired of continuous sneezes with water, no relief with medicines. What should be done?\n\nhello sir, iam suffering from naso braonchial allergy , iam very fedup wi my continuous sneezes. from morning to evening continuos sneezing comes & water also comes . doctor has given me many medicines such as nasal drop flomist,montek, heterazin. my AEC is 650. from all these medicines i haven got any relieve. now what i do? frm, bhawana",
    "doctor_response": "hello bhawana r u allergic with anything like dust,food stuff etc investigation COMPLETE BLOOD COUNT WITH ESR  check for eosinophilia treament tb.citrizine thrice a day",
    "dialogue_context": ""
  },
  {
    "patient_message": "What precautions should i take for follicle becoming cyst ?\n\nWhy ovary follicle becomes cyst?Any precautions for preventing cyst?",
    "doctor_response": "Hi! Thnaks for choosinf HCM.ovary at the time of ovulation release follicle and degenerates into atretic follicle.Incase of non rupture it persists as cyst wherein it is called simple /follicular cyst.Another is after rupture it becomes filled with blood and is called corpus luteum cyst.there is no way of preventing ovarian cyst,You can diagnose it yearly by pelvic exam and also ultrasound check-ups.Take Care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Throbbing pain upper teeth to the cheekbone and lower teeth to jaw bone, tooth extracted. Receding gums and sensitive teeth. Advice?\n\nSudden onset of throbbing pain upper  teeth to the cheekbone and lower teeth to the jawbone on the same side: the 2nd,3rd,& 4th double teeth.  I had the same thing on the other side with a bottom tooth and ended up having the tooth extracted because I chose not to have a root canal.: way too expensive when you have no dental insurance. (That was 3 years ago).  Could this be an infection of the root again top and bottom at the same time? I have been rubbing ground cloves on which seems to alleviate the pain.  This started about a month ago when I tried whitening my teeth with baking soda and realized this was not a good idea for me. I stopped after three days, but the pain comes and goes one day and then I may go several days with no pain at all.  My dentist is aware of my receding gums and sensitive teeth. Any help is appreciated. Thank you.",
    "doctor_response": "Hello,Thanks for choosing HCM,From your present sympyoms I feel there is periodontal infection which means the tissue sourronding your teeth is inflammed..and may involve the pulp inside the tooth causing this throbbing type of pain...You have also mentioned that your gum is receding and teeth are sensitive..the cause is due to deposition of calculus arrond the teeth...due to recession of gum the portion of the root surface is getting exposed and leading to sensitivity...So proper clinical as well as x-ray is required for both upper and lower...if there is cavity in tooth then root canal treatment or extraction have to be done depending on the tooth condition...Go for whole mouth scaling..and root planing...Do warm saline rinses,it will give relief from pain to some extent...Consult with Dentist...Brush twice daily with any anti sensitivity tooth paste...Get your proper treatment done...Regards....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is glucose drops the only option in dehydration?\n\nI am parent of 20 days old baby which have the following symptoms 1. Stool C/S : Wet Mount shows plenty of Budding Yeast Cell. 2. Stool Reducing: ++ 3. On zerolac from last 7 days. 4. Have some fever (Around 100 +/- 1) After series of anibiotic, Docs Suggested to give Piptaz(INJ) and Taxim (INJ) and for Fever (Crocin). Is Piptaz is necessary for such problem? In case of dehydration, Is Glucose drops is the only option?",
    "doctor_response": "fist of all we are dealing with an infant who is suspected to have sepsis because of the fever , so blood, urine and CSF cultures must be obtained first . the choice of antibiotics is very important since this is considered a late onset sepsis , the use of ampicillin + cefotaxim with or without vancomycin OR another combination of tienam + vancomycin is the most appropriate  combinations .the results of stool : budding yeast is seen when the stool samples are left forever before testing it , I recommend repeating that , the reducing substance is suggesting a carbohydrate malabsorption and is confirmed by a hydrogen breath test , and milk should be changed into lactose free milk , soy-based formula is useless. .this malabsorption can lead in some cases to dehydration and intravenous fluid contains glucose and saline is needed .I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can an injury to testicle cause infertility?\n\nHi. My husband and I have been trying for a baby for over 2 months now. Nothing has happened I ve taken pregnancy tests and they all say negative... He was kicked in the balls so hard to where he was coughing up blood and peeing blood. That was a few years ago... Can he still have kids??",
    "doctor_response": "HelloWelcome to HCM.I can understand your concerns.The fertile capacity would be decided conclusively after his semen analysis.Other than this,Does he ejaculate?does he has good erection?Any pain in testicles or while peeing still?The urologist will help you to determine the right cause and proper treatment.Hope this helps.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does fluid in the bone mean?\n\nHi I feel of a latter at work in last September and I broke the talus bone I was2 month in a cast and one month in a both I still have pain and we find out by MRI that I have fluid in the bone what that mean ? a long it s take to recover from that? what is the right treatment for it?",
    "doctor_response": "Fluid in bone is a local benign tumour. This treated within hours by surgical aspiration or open operation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome the depression and loneliness?\n\nI have no energy, depressed. My husband, son, all of my relatives are all gone. I ve trying to sell my home,just to get out of the house. I think I would really be better in another town. I don t really know what is wrong. I do and then I don t . I know I m blessed to be getting around and they say, I don t look 81 and I don t feel 81, but I guess I m just lonesome. HA Ha. Maybe I m just feeling sorry for myself. All by myself. I don t know. Marivonne",
    "doctor_response": "HiI admire your positive outlook and congratulate you for the attitude. Now I guess you have depression and it could be due to some stress in your personal life. In that case, you need some help. However let me give my opinion here. I think a combination therapy of antidepressant and low benzodiazepine would help you. You can try some relaxation exercise like JPMR or deep breathing exercise. That would keep you calm and relax. For this you need expert's guidance by psychiatrist or psychologist . Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes when pushed where the ovary is, it hurts below breasts?\n\nHello night before last my throat felt like it had a lump stuck in it when I woke the next morning I had a mild tummy ache as the morning went on it turned into severe cramps from my lower abdomen to under my breasts it hurt all day and worse everytime I ate or drank anything went to bed last night wiped out and woke today feeling better but sore all over like if I push gently on my lower side like where an ovary might be it hurts in my upper abdomen just below my breasts Got any ideas???",
    "doctor_response": "Hello,Pain in the stomach associated with food or liquid intake associated with some lump like sensation in the throat could be ( either GERD,  Esophagitis,  Gastritis due to some bacterial infection) or any other local causes,  please kindly consult your doctor , get examined, get an USG abdomen or UPPER GI endoscopy, so the cause can be evaluated and hence treatment planned. Hope I could help you.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for severe arthritis?\n\nHi My daughter has been suffering with server arthritis for over 6 years. She is almost bedridden. She is on her 5th failure of treatment of Biologi\u00e7s. She also takes immuran and pedison. She is only 25 and her health is falling. She is a patient of Dr. Purvis in Peterborough and also Dr. Inman at Toronto Western. She also has Cushions from all the seriods and has gone from a size 0 in her clothing to a overwhelming size of 2x. Can you please please please help. The treatment she has been on for over 5 years is killing her I wish she never started them. Is there anything we can do to begin to reverse the damage that has been done by talking these treatments. I pray you can help.",
    "doctor_response": "hiThis is really serious and if biologics have failed your rheumatologists may be looking for other auto-immune disorders,if not, should be with complete blood count, RH factor, anti-ccp,ESR, ASo,ANA, and IGg IGm-possibly they might have done that....withdrawl of steroids may be begun over a period of 2-3 weeks and reliance only on physical therapy.Amazing, there has been no remission in symptoms?- this should be pointing to look for other causes as well by rheumatologists--one may look to alternative therapies also like homeopathy,bichemic or ayurveda, just in case, some remedy may give symptomatic relief. But diagnosis should be ascertained first....best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for torn meniscus due to an injury\n\nI have a torn meniscus due to an injury...since then, i've been in severe pain...can't eat, sleep and wake up in the night sweating profusely...nothing seems to help...feels like i have a fever, but haven't had a chance to take my temperature...can this cause a fever?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Causes meniscus tear are:1. Injury2. Blunt trauma3. Sprain or strain4. Runner's knee5. Improper postureYou can take tab. aceclofenac. Apply diclofenac gel or cream. Apply ice locally. Do x-ray and MRI back and hip region. Consult your physician for prescription. SURGERY is the best option for complete recovery. Treatment mainly depends upon underlying conditions. Kindly follow with detailed history or consult with orthopedician. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Shyam B. Kale",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes loose stools with a foul odor?\n\n7 year old, nearly every morning (as soon as waking up) running for the bathroom, very loose stool and very, very smelly...sometimes he soils himself in his sleep, sometimes it wakes him up during the night...we know he is very sensitive to any milk and have completely removed dairy from his diet....what else could cause it...",
    "doctor_response": "Hi, It seems your kid is having viral diarrhea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic-associated diarrhea. I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron (as prescribed by your paediatrician). Regarding diet - Avoid fruit juices as they might aggravate diarrhea. You can give zinc supplements & ORS apart from normal vegetarian porridges & soups. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red rashes on palm and ankle and swelling of ankles?\n\nI have a red ring rash on my palm and a red rash on my ankles and my ankles are swollen. I took a steroid ahot and did a 2 week regimen of prednisone tablets which cleared 99% on my palm about 85% on my ankles, and 100% of the swelling in my ankles and feet.",
    "doctor_response": "Hi,You could be having an arthritis (inflammation of joint). The rash could be a manifestation of arthritis. I advise you to report to an Orthopedician. If needed, he may refer you to a Rheumatologist or a Dermatologist.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had hysterectomy with one ovary left, gain weight, bloating, cramping. Ovarian cancer?\n\nI had a hysterectomy in year 2000 with one ovary left. I have weight gain with no apparent reason, bloating , and minimal cramping, also gassy. I ve done a lot of research and these system state most likely ovarian cancer is this correct. Oh and I also read with the age I m at there s a higher risk. I m 41. I went to my MD she states go to the gyno which I will. Overall what my I be looking at.",
    "doctor_response": "Hi and welcome to HCM. thanks for the query. Ovarian cancer is not the first thing to think of. It is not so common in your age and usually some other symptoms are present. However you should do ct scan or diagnostic laaproscopy consdiering your previous history. Your symptoms can more likely be sign of hormonal imbalance or gastroenterologic disease such as IBD. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes memory lapses?\n\nI am a 71 year old female in good health. This afternoon I had an episode when I forgot where I was supposed to go this evening and what the date was.  It was an \"out of touch\" feeling.  I forgot that I had just put away  bags of groceries.   Lasted about 20 minutes....then I remembered where I was supposed to go.  No other symptoms.  I am currently taking 200 mg of acyclovir 2 times a day for possible eye infection which did not respond to anitbiotics.  Also, am taking 20 mg of Escitalopram 1 time a day for mild depression associated with daily chronic migraine headaches.  My B/P is 137/73; normally is  120/70. Resting pulse is 68.  Recently, have had memory lapse of a few minutes....forgot my phone number once and forgot my doctors name when I got to building where her office is...  Is there a problem with drug interaction",
    "doctor_response": "HiThanks for using healthcare magicI think, you have dementia. Chances of getting dementia after 65 years of age is 30%. In that case, you need drugs like donepezil or mementine, but these drugs you can not use without neurologist prescription. Better to consult a neurologist for proper diagnosis and you can get your MRI scan done to rule out any underline  abnormality.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the solution for PMS and painful period?\n\nHi doctor, I am asking you on behalf of my friend. Here are the symptoms, which she had around three to seven days before bleeding. All symptoms of PMS along with occasional migraine with glaucoma, nausea, pain in the lower part of spine and cramps. On the first day of bleeding, she is having painful cramps of uterus, dizziness, breathlessness and nipple soreness. On the second day she will look better, but the pain will still be strong. Sometimes, she complains of right ovary pain. The doctor she consulted earlier said the solution to get rid of the pain permanently is to give birth. Please suggest an alternative solution. Her current prescription is Microgynon 21. Her weight is 44.6 kg and height is 163 cm.",
    "doctor_response": "Hello. This is dysmenorrhea with premenstrual syndrome. If the pains are severe and symptoms are uncontrollable, then please follow the following prescription. Consult your specialist doctor, discuss with him or her and take the medicine with consent. Continue the above medicines for three cycles. Pregnancy once planned shall help decrease dysmenorrhea, but till then she can practice the above medication. Most importantly, keep her water intake high for 10 to 15 glasses per day, as that shall play an important role in keeping the progesterone withdrawal effects down, which lead to PMS and menses. Microgynon 21 (Ethinyl estradiol and Levonorgestrel) is an oral contraceptive pill and not necessarily help with PMS, but it shall control heavy bleeding and provide contraception. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Has red rashes on inside of fingers concerned with hair fall?\n\nHi, may I answer your health queries right now ?  Please type your query here... This is a difficut case,  I have gradually been losing hair on the left and right side of my head at the hairline.   I don't know if it will have any relationship, but I also have devoped  some type of red rash on the insides of a couple fingers, as will as on top of the hand.  It is itchy and sore.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It is important to find out the cause for hair fall which is mostly multi-factorial: diet/ lifestyle/ stress/ dandruff/ hereditary/ weather change/ hormonal changes to name a few. For the itchy sore which looks like an allergic spot, you could start taking an anti allergic medication along with applying steroidal cream twice a day.None the less, I reckon get it reviewed by the concerned doctor for proper evaluation and further guidance. Hope that helps!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dog scratch\n\nhey, i was feeding my dog when he jumped and i scratched the skin just below the nail of my hand finger, it bled a little but i pushed more blood out then cleansed it with perfume for any bacteria, its just a little minor rip size of a fullstop, do i need some kind of medication ?",
    "doctor_response": "Defiinitly any dog related injry whether it may be minor or major must be repoterd to the doctor. If you are the owner of dog and you are sure about the vaccination shedule  of the dog ( if it is properly & timly administered ) the you can observe the dog for next ten days from the day of occurance of injury. If the dog is as normal as previous no need to do any thing but if the dog has got change in behaviour or if it is irritable you must rush the doctors . If the dog is not pet or it is wild or rod dog on which you cant keep a watch its better to see a doctor and according to his opinion go for a post exposure prophylaxis of rabis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can ear pricking cause ear pain and hearing loss?\n\nHello doctor, I am suffering from severe ear pain in my left ear. Today is the third day and I cannot hear properly. It resulted due to pricking my ear.",
    "doctor_response": "Hi. After reading what your complaints are, I think two possibilities are there which can lead to the symptoms you are perceiving. It could be that you already had an underlying infection of the middle ear which can lead to an earache and pricking was incidental or that fiddling with ear may have lead to infection of the external ear canal which could lead to symptoms. I would like to know if you had a common cold and running nose or pharyngitis before an earache and decreased hearing appeared. Is there any discharge from the ear? Does moving your pinna cause any pain? In either cases, you need an antibiotic and analgesics. If you had any history of cold, you need decongestants as well. URTI (upper respiratory tract infection). 1. AOM (acute otitis media). 2. Otitis externa.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes joint pain in legs and knees?\n\nI will be having a hip replacement. I want to know why my joints in the lower half of body, legs, knees, all joints hurt so bad. Now it is getting hard for me to walk. When I sit, it s hard getting up so i try to stay mobile as much as possible. Why are my joints hurting so bad? So sorry did not know I had to pay for this service and right now, I do not have those funds. Thank you anyway.",
    "doctor_response": "Hello,I have studied your case. According to your symptoms and findings there is osteoarthritis of your knee.You can start cartilage protecting medication like chondritin sulphate twice daily, that you need to take for couple of months.Take analgesic and add tab methylcobalamine 1500mcg daily.Physiotherapy like ultrasound and tens will help, along with knee exercisesLife style changes will help in reducing pain which include,ACTIVITY MODIFICATION -It is important to maintain as much activity and joint motion as possible, but impact activities will aggravate arthritis. Running and jumping will often accelerate cartilage loss from the joint. The key is to focus on low impact activities, such as swimming or cycling.  VISCOSUPPLEMENTATION: Hyaluronic acid injections given into the joint (especially large joints like knee joint) in prescribed dosages will give good short term pain relief in arthritic joints ranging from 1-2 years. You need to consult orthopaedic surgeon for taking it.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.If you are satisfied with answer do not forget to give rating to this answer. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness around chest with breathing difficulty?\n\nGood afternoon, I am a 50 year old male and have been having these gasps for breath during the night now and then. And sometimes I feel this tidiness around my chest area. I do have a very pressurized and to add there is allot of pressure in my private life too.. How-ever,  I do sport every second day and don\u2019t have issue with breathing then. So am I safe to say it\u2019s not my heart.. Many thanks for your help",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.No, we can not rule out heart diseases without reports.Your all symptoms are commonly seen with heart diseases.So better to first get done ecg, 2d echo and stress test (trade mill test).If all these are normal then no need to worry for heart diseases.You are also having stressful life. This can also cause similar symptoms.So avoid stress and tension, be relax and calm.Consult psychiatrist for counseling sessions.Don't worry, you will be alright but first rule out heart diseases.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My mother is weak after a surgery. Please suggest a diet plan for her recovery.\n\nHello doctor,My mother had undergone a laparoscopy assisted vaginal hysterectomy two months ago. She is 52 years old, height 5 feet and 2 inches, weight 70 kg. She does not have any other medical issues. She was advised to avoid spicy food for a month. She has fatigue, weakness, constipation and gas issues as well. I request you to suggest a complete diet chart for her to recover back and for weight control. Please suggest a vegetarian diet.",
    "doctor_response": "Hello. Your mother needs a wholesome diet that is rich in protein as well as vitamins, and calcium. For more information consult a nutritionist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to remove lung scar caused due to TB?\n\nI have a lung scar due to my TB 10 yrs. ago..is there any quick method on removing my scar? My sputum test was negative..i want to work abroad preferably malaysia..help me please!! Hope there\u2018s a quick relief on my scar..im Paul fr0m the philippines",
    "doctor_response": "Thanks for your question on HCM.Lung scar is healed fibrotic lesion. It will remain as it is throughout the life. Presence of scar lesion on chest x ray does not mean that youare having TB.So to prove that you are not having TB, you need to consult pulmonologist and get done1. CT Thorax2. Bronchoscopy and BAL (Broncho Alveolar Lavage) analysis for AFB.So if both are negative than you can prove that you are not having active TB and not infectious. So you can assure visa authority about not having TB.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure negative thoughts in my mind?\n\nhi...i think i need a cycatrist..........because i have got very much of negative thoughts....like when i study...a thought comes to my mind dat i should not study?...though whatever im studying is going into my mind.....i am intelligent but since last few days this type of negative thought s coming to my mind dat i cannot do anything..........",
    "doctor_response": "Hi,From what you have mentioned, it seems that you are low on confidence. The negative thoughts and inability to concentrate are highly suggestive of underlying depression and anxiety.I would suggest that you should seek a psychiatric consultation for complete evaluation of your condition. You can benefit with treatment with medications like paroxetine or escitalopram. In addition, start doing some physical exercise like jogging daily. It will help you relax. Relaxation exercises like deep breathing or meditation will also help you relax and focus better.I do hope that I was able to answer your query. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes erectile dysfunction?\n\nI had sex with a female last night around 2am than an hour or two around 4:30 am I received oral from another female with no erection difficulty ejecting both times but then around 11am I attempted to recieve oral from another female and my penis didn't even get even semi erect barely but I still ejaculated   What could be the reason this happened  I'm terrified & embarrassed cause receiving oral always gets me extremly erect .....please tell me what are the different reason this might of occur?",
    "doctor_response": "HI Thank for asking to HCM There is certain level of any phsioloical act and limit of secreation of certain hormones and enzyme beyond this limit and level it is not possible to have the same knid of effect if need it even after you try to do it this is kind of psycolocal condition if on perfoeming the such act so rapidly stop this it could be dangerous, take care and have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can variation in SGPT and SGOT levels cause hemorroids?\n\nI had abnormal lft test a year back with both sgpt and sgot at 130s. Now after taking ursocol 300 for 3 months it went fown. Now after a year i testef sgpt and sgot at 31 and 32 respectively. But now i m having problems like piles. Fo liver causes piles. Interesting part of my problems with piles is that i dont hv hard stool. However, 6 months back i experienced blood in my stool but still back then i had no problem with hard stool. My question is does liver causes piles",
    "doctor_response": "Hi, Liver enzymes may be raised because of various causes. In your case, some may be more possible but in every case, it requires evaluation of the cause. Most common causes of such liver derangement's are Alcohol, Viral hepatitis, Non-alcoholic fatty liver disease, Drugs. Gamma GT is most commonly raised due to alcohol intake and in case you take alcohol, you need to keep a control over it.If you don't take it, you need following tests: hepatitis virus markers, Ultrasound Abdomen and HIDA scan. A lot many times, liver dysfunction is due to Non-Alcoholic Fatty Liver Disease (NAFLD). So, if you have any evidence of fatty liver in Ultrasound and your other tests are negative, this rise is liver enzyme would be attributed to NAFLD. For this, you need to reduce your weight, reduce fat in the diet. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ivan R. Rommstein, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does high parietal mean it is located in the juxtacortical region of the brain?\n\ndoes high parietal mean it is located in the juxtacortical region of the brain? this is one of several lesions picked up on a second MRI and they are stating it is highly suggestive of MS, what I want to know is does the term high parietal mean located in the juxtacortical region of the brain?",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your MRI brain finding and your concern regarding a diagnosis of multiple sclerosis (MS).Regarding your query, high parietal does not mean juxta-cortical.Also, a single lesion in high parietal region is unlikely to suggest a diagnosis of MS. Typically, in MS, there would be multiple white matter lesions, of different ages.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluttering feeling in chest?\n\nHi, may I answer your health queries right now ? Please type your query here...- have been having a fluttering feeling in my chest. Sometimes in the middle of the night, in the morning upon waking and now its been during the day too. For the past few weeks, I now have episodes that feel like my heart stops, I can t take a breath, and then about 5-10 seconds later it starts again. I had a PDA repaired 36 years ago at age 6 weeks old. Is this a heart issue that I need to worry about?",
    "doctor_response": "Hi, After going through your medical query I understand your concern and I would like to tell you that possibly you have developed some cardiac arrhythmia which should be evaluated to avoid any unpleasant cardiac event. It's recommended for you to get a basic Cardiac evaluation which includes ECG, Echocardiograpy and a Holter test done and consult a cardiologist for further treatment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump in sternum area in infant?\n\nHi, may I answer your health queries right now ? Please type your query here...he is 8 months old found a small lump smaller than grape bigger than pea in sternum area he had a virus last week with vomiting and diarrhea has recovered what could it be?",
    "doctor_response": "this is an enlarged lymph node in reaction to the virus infection he hadthis is nothing serious and will return to normal within 2 weeks and requires no medication",
    "dialogue_context": ""
  },
  {
    "patient_message": "Completed treatment for hepatitis C. What precautions should we take so that it does not return?\n\ni was the patient of hc positive .now after treatment of sex month injection which is completed on 20yh april 2013 my hgb is 13.3;ast 20 alt23 what is ur opinion sirat this report of 6-9-.13 what should i have to do so that hc never reapeat again",
    "doctor_response": "Dear Friend.Hi , I am Dr Anshul Varshney , I have read your query in detail , I understand your concern.Chronicity is the Hallmark of Hepatitis C.It is good you are taking treatment. Monitor Viral Load.There are no special precautions to be taken , as if Hepatitis C is there inside you , and is not completely removed by appropriate treatment , you will develop it again.General Precautions to avoid contracting Hepatitis B or C are :1.Avoid unprotected sexual intercourse.2.Don't share needles.3.Get injections only from a registered medical practitioner.4.Get blood transfusions if ever required from a registered blood bank.This is my personal opinion based on details available here.  If you want to discuss your issues further, you may please ask usStay Healthy. Dr Anshul Varshney , MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any medicine to take acne from my face ?\n\ni have acne on my face sometimes my face is clean then its burst out what can i use to balance these acne to make my face smooth i have tried clear active pro active and clearsil i try many other things my is still the same",
    "doctor_response": "Hello, Acne is a common skin condition occurring in the sebum rich areas likes the face, upper back, upper chest.  Acne could manifest in different forms like comedones, papules, pustules(pus filled) and cystic nodular. The pustular and cystic nodular ones are known to leave behind scars. Hormonal changes, puberty, excessive use of cosmetics, stress (The National Institutes of Health (USA) list stress as a factor that \"can cause an acne flare.\") can cause or aggravate acne. A few things that needs to be followed- 1) Avoid rubbing your face too hard while washing and wiping (pat dry) as friction leads to the breaking of comedones, which can aggravate. 2) Avoid make up, if you need to use make up go for water based products. 3) Avoid pricking or breaking the acne as it increases the spread.(keep your nails short to avoid accidental pricking) 4) Use a face wash rather than a soap as it prevents drying of skin. 5)Wash your face 2 times/day, or after coming home from outside.  Too frequent washing can dry the skin. 6) Drink plenty of water--8-10 glasses 7) Have a diet rich in fruits, vegetables and avoid junk food, chocolates etc., as these are not healthy. 8) In case of females---rule out underlying diseases like PCOD and Thyroid. Homeopathy has excellent results in cases of acne by reducing the intensity and frequency of the breakouts and treating the underlying cause. The products that you use act only on the skin level, thereby not tackling the main underlying cause, which leads to recurrent breakouts. Visit a nearby homeopath for a detailed case history and treatment as homeopathy would surely help you out !!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe ear , neck and shoulder pain?\n\nI have been having severe ear pain which radiates down my neck. I also have shoulder pain under my right collar bone. Tonight I have ulcers on both sides of my tongue. I recently was diagnosed with benign thyroid masses. I am an embalmer and around formaldehyde daily. Should I be concerned about nasopharyngeal cancer with these symptoms?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have  severe ear , neck and shoulder pain. Well there can be many reasons for symptoms you mention in query like muscle spasm , cervical spondylosis, TMJ problem , nerve compression , ear infection or heart problem like angina . I would suggest you to consult orthopedic surgeon for proper examination and treatment . Doctor may order CT scan , MRI along with nerve conduction test and physical examination to confirm the diagnosis . Doctor may prescribe muscle relaxant , anti inflammatory , nerve supplement along with physical therapy . For now stay calm , take ibuprofen , apply warm compresses to shoulder and arm , do light stretching exercises under expert or acetaminophen for pain and take proper rest. Doctor may also refer you to cardiologist for cardiac problem or to ENT specialist for ear problem . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high mood swings?\n\nIs there a condition that manifests as occasional bursts of manic-like behavior, i.e., rapid fire talking, extreme jumping from one thing to another unrelated, extreme distractability, . My husband does this, especially when driving or going somewhere new. If he has a couple of drinks, it s worse, although it doesn t happen everytime he drinks. Talking so fast, not really listening to my responses, it s almost as if I m not there, he s so busy commenting on things he sees, it s almost like he can t get the words out fast enough. Always in a good mood , or high when this happens. Any thoughts? I can t figure it out.",
    "doctor_response": "hi,What do you think is the problem due to this kind of behaviour. Does he incur losses or get into trouble by deciding on things much faster? Problems due to inability to persists on a task?if it occurs for at least few days at a stretch- it could be HYPOMANIAIf it's not persistent and he also goes for milder slowing, decreased esteem or low mood quite often, then it could be CYCLOTHYMIAMood changes occur normally too. Those people often with high energy are also called HYPERTHYMIA. Unless it is bothering his activities or relationship much, you need not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is an alternative to lyrica for nerve pain?\n\nMy son has had nerve pain on the bottom of one foot.  He has been suffering with this for 15yrs. At the moment he is on 600mg/day of Lyrica.  This is causing him to put on a lot of weight.  Is there a better medication for his ailment or a way of counter acting the weight gain side effect.",
    "doctor_response": "Hi there, Thanks for your query. Lyrica in lower doses, in combination with 1.5mg of Methylcobalamin (B12), is a good alternative (since Lyrica would be equally effective at a lower dose). Alternatively, Carbamazepine - an anti-epileptic drug- is a better alternative for nerve pain, though it has its own side effects. Consult your doctor and apprise him of my opinion. I am certain that he will agree with me and will prescribe the advised drugs in appropriate doses. If you find my response helpful and informative, do not forget an \u201cexcellent\u201d (5-star rating)  to my answer, to ENCOURAGE ALL doctors- engaged in social service- to render sound advice to the FREE queries. Take care Dr. Rakesh Karanwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for increase in size of tumor on 3rd cranial nerve?\n\nmy husband has been followed by the va for 4 yrs now with a tumor on the 3rd cranial nerve, it has grown from a 4 x 4 x 4mm to a 5 x 5 x 5mm. Increased symptoms of discomfort. He is not getting anywhere with the va. I told him to step out of the box. He has a Humana PPO . We are in Port Orange, Fl. don t know where to start?????",
    "doctor_response": "Hi,Regarding your concern, I would recommend discussing with a neurosurgeon on the possibility of radiotherapy or radiosurgery, to help decrease the dimensions of the tumor. From the other hand, biopsy would help determine the nature of the tumor and the possible treatment options. You should discuss with your doctor on the above issues. Hope to have been helpful. Let me know if I can assist you further. Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can magnesium citrate effective for cramps during afib?\n\nHi! i have atrial fib which comes on about every 2 months...very scary and uncomfortable with weakness...could i take magnesium taurate to help prevent this.....i have heard it is very good...i also take my heart med..sotolol..and am on coumadin 9mg i take every evening...i am on no other med could you please advise me on this.am a young 70, very active and dont look my age...i dont have any other health issues..all my blood work came back very good....my problem is the atrial fib,, can you help me to alleviate atrial fib... actually , i do get leg cramps from time to time, very painful...lasts about 2 to 5 minutes. could y ou help me...i already take about 950 mg of magnesium citrate,,,and would like to try magnesium taurate, to see if it helps. many thanks M. Meredith",
    "doctor_response": "DEAR USER,THANKS FOR CONSULTING WITH HCMYOU ARE ALREADY BEING TREATED FOR ATRIAL FIBRILLATION WITH SOTALOL AND COUMARIN.. AS ABOUT TREATMENT, IT IS DIFFERENT FOR ACUTE ATRIAL FIBRILLATION (AF) AND THAN FOR CHRONIC AF..MAGNESIUM TAURATE IS NEVER USED IN AFYOU ALREADY TAKING MAGNESIUM CITRATE SYRUP WITHOUT PRESCRIPTION BY DOCTOR IS WRONG AS IT USED FOR CONSTIPATION AND NOT AFI ADVISE YOU TO TAKE ANY MEDICATIONS ONLY AFTER PROPER CONSULTATION TO YOUR CARDIOLOGISTHOPE I ANSWERED YOUR QUERY. YOU CAN MESSAGE ME FOR ANY FURTHER CONCERNS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do testicular pain and blood in the urine need immediate medical attention in a 66-year-old?\n\nHello and thank you. I am a healthy slender man age 66. I noticed a small amount of blood in my urine (first part of flow was pinkish, clear from then on). Also my left testicle has moderate aching. I don't know if those two things are connected or not, but the blood concerns me. Thank you",
    "doctor_response": "Hi, Most probably it\u2019s due to urinary tract infection conditions affecting your prostate like prostitis or BPH. As of now you can ignore the symptoms and just drink plenty of water. If symptoms persist, you can consult a urologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had partially protected sex after periods ended. Taken Nordette. Will I get pregnant?\n\ngood am to you my boyfriend and i have an interaction right after my period and at first he ejaculate then he insert his sex organ with out condom and at the second time he used condom and we are so paranoid to avoid pregnancy now, so he give me nordette pills (pfizer) and i take 3 pills there is a tendency to get pregnant? i hope u can help me",
    "doctor_response": "Dear patient,Thanks for the query. It has been reported that the use of the morning after pill can have about 85% chances of successfully avoiding pregnancy; your chances may be even higher since your uterus may not have been prepared for implantation given recent period.Yours truly,Dr Brenes Salazar MDMayo Clinic MN",
    "dialogue_context": ""
  },
  {
    "patient_message": "HBsAg positive with billary obstruction, liver metastasis. Proper treatment?\n\nmy mom is HBsAg Positive and her CT scan os w\\a: 1)colangiocarcinoma os eBD e billary obstruction 2)billary obstruction 3) liver metastasis 4)left renal cyst ERCP Is sujested by the doctors but with high risk,then chemo therapy can be given.but the risk of ERCP is very high so we are not willing to do so.please can you let me know is there any other options to treat her.she has a 4th stage cancer.",
    "doctor_response": "Hello Welcome  to health care medicine Dear patient, when the patient is having stage four melignancy and is terminally sick that he/she can't under go any intervention or surgery, then the goal of treatement is always to keep patient free of pain and other sufferings through proper emotional support, proper nursing care, proper nutritional support  and your mother may require anti histaminics to releive her itching due to biliarry obstruction and rest should be left on nature to take its  course May God keep her free from pain and other sufferings thanks Dr Arshad",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will meftal spas cause infertility problems?\n\nsir/madam, i hav unbearable mensturation pain during my periods.i take meftal spas during 1st 3 days of my periods,its been 5 years i hv been taking this medicene....i hav doubt that will it affect my fertility in future,please i would like to know the answer as soon as possible.",
    "doctor_response": "Hi, Meftal-spas (dicyclomine&mefenamic acid) is commonly prescribed to relieve menstrual pain and stomach cramps. Its most common side effects include dizziness, dry mouth, blurred vision, weakness, and nervousness. There is no documented evidence of meftal-spas causing infertility.  Hence, it can be used safely as prescribed by your doctor. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hardness and electric feeling at the tip of the tongue?\n\nok this seems a little odd to me but my fiance said that last night the tip of his tongue felt like he had stuck it to a very strong 9 volt battery ...... This is the second time in about a week or so I thought he was dreaming the first time but he was actually awake last night.",
    "doctor_response": "Hello, Thanks for your query.Tingling tongue can be caused by a wide variety of conditions. Common causes include stroke, head injury, reduced blood flow, vitamin or mineral deficiencies, and neurologic diseases, such as multiple sclerosis (disease that affects the brain and spinal cord, causing weakness, coordination and balance difficulties, and other problems).I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can dilation and curettage procedure help diagnose hyperplasia?\n\nHow accurate are the results of a D&C after a uterine ablation? I am 56 and overweight. I was recently diagnosed with hyperplasia and I am scheduled for a D&C in about a week. The ablation was performed about 5 yrears ago because of heavy, irregular periods. I still have irrgular periods but they are much lighter than beofre the ablation. Thanks. Cindi Maestas YYYY@YYYY",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You had hyperplasia in past and you have gone through ablation.Again you may have endometrial hyperplasia.D & C material should be sent for histopathological examination. It is best technique to diagnose the endometrial hyperplasia. Whether is simple hyperplasia or complex hyperplasia and whether there are atypical changes or not. Then you should take treatment accordingly. So go for D &C and histopathological examination and take treatment accordingly.Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer.Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of belly pain for children ?\n\nsir/madam,my 3 years old baby girl is suffering mild or moderate belly pain, pale stool with some solide and some lequied stool. her previous case history one month ago she got belley pain and vomiting 4 to 5 times, then my dr. prescribe lansoprazol 15mg, and emiset to stop vomiting. then she got loose motion so dr. first prescribed livofloxacin and then ofloxacin. problem was cure for that period, now during 3 to 4 days she again got belley pain, then i given her the medicin neopeptine as i think it was for indigestion, but i found mild or moderate belly pain, pale stool with some solide and some lequied part. what should i do now.",
    "doctor_response": "The first thing to do when the same symptoms are repeated is to get her investigated. Do check her out with a stool test, an ultrasound of her abdomen and a complete blood count initially. Take her to the pediatrician with the results of these tests. Or go to the doctor beforehand and ensure that they order those tests.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I convince my doctor that my symptoms are not mood related ?\n\nHi, about 2 1/2 years ago i had a bad flu and never recovered. I had diarrhea and vomitting for about 7 days and lost 7lb in weight. I started having muscle spasms and pain, so bad that I couldn t do anything for myself. Bloods showed inflammation, raised white cells and auto immune. I was referred to a rheumatologist who retook bloods which came back normal. I have a history of depression and the rheumatologist said my problems were mood related. My other symtoms are night sweats , flushing, fainting , involuntary limb and head movements. I have had occasional episodes of vomitting dark blood and I am now constantly constipated and my stools are very dark. I asked for a second opinion and the new rheumatologist seemed to listen and assured me she would get to the bottom of things. Turned out she knew the original rheumatologist and also gave a diagnosis of mood related problems. Although my bloods showed i was positive for coeliac disease but that this was probably a red herring. She also mentioned carcinoid because of the flushing and sweating but that it s very rare and highly unlikely. She said she had done all she could as a specialist and would not be carrying out anymore investigation. She said she would write to my General Practitioner and recommend Cognitive Behavioural Therapy. I really feel that because of my history of depression that I haven t been taken seriously. Could you advice please? I m female, 40 years, 10 stone 11 pound, 5ft 7inch, I have had a hysterectomy but have retained my ovaries. All bloods except coeliac have come back normal.",
    "doctor_response": "welcome to healthcaremagic from th presentationit seems that you should go for a consultation with gastrenterologist and get atleast an g i endoscopy done to find ou and reach a diagnosis and treatment started hope you get proper treatment and be well",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for stage 4 brain cancer?\n\nmy father in law is having stage 4 brain cancer and is under life support.no oxygen,pulse and heart beat is normel.but he is in coma stage.sleeps all the time,urine and stool passing is normal.how many more days  accordind to u  can i able to c him.tnx",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. Stage 4 brain cancer carries bad prognosis. And since he is in coma, this will worsen the prognosis  further.In my opinion, in stage 4 brain cancer life expectancy is less than 6 months.But with coma life expectancy will decrease further. May be less than 1 month.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe knee pain\n\nHi Doctor, Good day PS my wife is having severe knee pain when body is in Rest ,and changing side, or climbing stairs. Pain is on both knees and moves from top to underneath . it has judt started few weeks back, shee feels some knock sound from knee joint occasionally. Will appreciate your advice and treatment or tests required to be done including x Ray etc. She is 61 years of age . Look forward for your kind response. With Regards Deen K Mohnani Maxdeen@gmail",
    "doctor_response": "dear Mr Mohnanito start with a Xray and a thorough clinical examination of the knee will help.her symptoms seem like supra patellar tendonitis and osteoarthritis. can you share her age and weight as well.please visit your nearest arthritis clinic and get her evaluated, if properly treated conservatively knee replacement can be avoided for a long time.please feel free to ask any more doubts that you have",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness on the hip while sleeping?\n\nI sleep on my side and my hip seems to go numb after a couple of minutes of sleeping in this position. It seems I toss & turn a lot during the night because of this. I am fine as long as I lie on my back, but I cannot get comfortable on my back. There is no actual pain associated with the hip, just this numb feeling that awakens me. I know I have arthritis in my hip but it doesn t bother me during the day.",
    "doctor_response": "Hi Hope this message finds you in good health.I have gone through your complaints and understand your concern.U seem to have  a compressed nerve in the back that causes the symptoms.I suggest u get an mri done to find the cause.Nothing to worry about.\u00a0\u00a0\u00a0\u00a0\u00a0I hope your question has been answered.If you have any follow-up queries,feel free to consult me anytime.Thanks,Take care,God bless.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will preeclampsia during pregnancy lead to potential CKD?\n\nHello doctor, I am a 24-year-old female. I had preeclampsia with both pregnancies as well as kidney infections during pregnancy. I have a history of UTI's as well. My creatinine was up to 1.67 in all of my kidney infections. Few months back, I had a partial hysterectomy in which my left ureter was cut and not noticed and I was closed back up. I returned to the ER six days after my hysterectomy and was taken to emergency surgery because my left kidney was enlarged and not draining. I had a stent placed which remained for six weeks. My creatinine was 1.7. I had bloodwork done after my stent was removed and my creatinine was .9. I had another kidney infection in four months. My blood pressure has been increasing since then and I had to go to the ER because my blood pressure was about 146/121 mmHg. I am now on blood pressure medication and my blood work shows my creatinine at 1.2. I had a renal scan done that came back normal. Is it possible that I had CKD? Or are there any other explanations for my raised blood pressure, flank pain, and increased creatinine? I am currently taking Adderall 15mg two times a day, Macrobid after sex, Lisinopril.",
    "doctor_response": "Hello. In preeclampsia or eclampsia, patients may present with albuminuria. This may lead to progress to chronic kidney disease. Your urine examination report also showing plenty of RBC (red blood corpuscles). But not mentioned what is RBC morphology in microscopy? In case of renal problems, morphology is changed. But if morphology is intact means it is lower urinary tract infection. Also, check for UTI (urinary tract infection) for your husband. There is a chance of repeated urinary tract infection. Please review with urine culture report if unnecessary raising of serum creatinine may a need kidney biopsy. Control your blood pressure which may lead to proteinuria and renal problems.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for depression and sleep disorder\n\nI ve been diagnosed with a couple things such as anxiety, depression, and sleep disorder. I ve noticed a lot lately that I m having a hard time telling weather or not I m dreaming. How often it happens is increasing. What is it? What do you suggest I do?",
    "doctor_response": "Hi.I had gone through your query.Sleep disturbance or insomnia is common in depression.It is one of the main symptoms along with mood variability.Depression can be treated with combination of medicines that improve depression, anxiety and insomnia.Medicines like escitalopram/sertaline and peroxetine can help in depression.Benzodiazapine group like etizolam/lorazepam/clonazepam etc will help in anxiety and insomnia.But do take advise from psychiatrist before taking any medicines.detail psychological work up will give better treatment.So consult and get help.I hope i have answered your query.Feel free to ask.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe back pain?\n\nHi I get severe backpain. It feels like my back is tearing of my bottom. (Best way to explain it). I m not realy overweight and I move around allot. It gets so bad thet I can t stand up and the pain is realy bad. My legs start paining and its like I can t carry my top half. Any advise?",
    "doctor_response": "Hi,Welcome to healthcare magic.After going through your query I think your You are suffering from chronic sever backache.Treatment of back pain exercises and analgesics (diclofenac).Sometimes strong analgesic(such as ultracet three times a day after meals) is required.Sometimes vitamin D defeciency is the cause so get your vitamin D checked .If it is low then vitamin D supplementation can be taken.You need to done MRI TO RULE OUT DISC PROLAPSE and other causes. I think your query answered.Welcome to any follow up query",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever with headaches and joint pain?\n\nI'm very worried about my 29 year old sister who was hospitalized Tuesday for a fever of 104, severe head aches, fatigue and joint pain.  She was born with sickle cell anemia and has battled debilitating pain her whole life.  She is still in the hospital because of an elevated red blood cell count, severe constipation, fatigue and severe headaches.   Any idea what the diagnosis would be?",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Appears to be sickle cell crisis.2. Will require immediate red blood cell exchange transfusion to reduce the amount of sickle cells.3. Associated infection, would have increased hypoxia leading to increased sickle cells. Not to worry. Antibiotics and red cell exchange will improve the symptoms soon.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach ailment caused by chewing gutkha\n\ni am 25, male, i have acquired the stomach problem by chewing gutkha. i think it washed my stomach's internal layer. now i have quit the gutkha but my problem still exits. i have been suffering from loose motions for last one and half months. even i took so many medicines but not benefited. i cant eat anything hot and spicy. i need to go to toilet immediately as i eat anything like that. being a student i have been feeling so much depressed and sad because of this desease. i live away from my family, therefore its very painful fore me to fight with this desease. please help me, i promise you not to chew gutkha or anything like that.",
    "doctor_response": "Hi,Chewing Gutkha does cause gastritis and hyper acidity but problem right now you are having might be due to chronic gastro-ontestinal infection.Go for one course of ofloxacilin, tinidazole combination medicine for 5 days.Afterwards take Omeprazole for few days.It is good thing that you stopped chewing Gutkha and now do not start again.Avoid fried and junk food.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of lump on my neck?\n\nHi I am a 47 year old female.  Non smoker & healthy.  I have a small hard lump on my neck - approx 1 inch below my left ear and half an inch back.  The lump is fixed and not moveable.  It doesn't hurt, but the surrounding area feels tender.  I found this lump approx 5 weeks ago.  Any suggestions?  Thank you very much.",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query. If I were your doctor, after a clinical assesment of the area includng the Thyroid gland, I would instead of waiting more would go for a FNAC (fine needle aspiration cytology) of the lump to have a cytological diagnosis. Further management would depend on the report of the FNAC.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any ayurvedic treatment to increase teeth bone?\n\nMy Age 41, Height 5ft 4in, weight 59 and currently no any health problem.I facing dental bone loss problem, Dr. suggested to remove teeth and use teeth cap. But my question is that, any ayrvedic / homeopathic medicine available to increase teeth bone?",
    "doctor_response": "Hi Welcome to HCMThis is Dr Suchda Naturopath -Homeopath - Magnetotherapisttaken your query. i have come to know that you are keen to enhance the bone of your teeth  . Dear i don't think it is possible in any therapy not to say only of homeopathy or ayurvedic medicine  . It is may be possible in cosmatic surgery.I suggest you to consult some good dentals who can help you All The best Don't hesitate to come back if have any query . we will be happy to help .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for an injured foot?\n\nMy daughter fell getting out of the tub and hit her foot. She hit the side of it on the door frame and now it has a large knot and is swollen (happened about an hour ago). It s just on the side of it and she was able to walk relatively fine. She cried a while and said it s throbbing. Do you think it s broken?",
    "doctor_response": "Difficult to say if it is broken or not.If you are in doubt than get X ray foot done.And to clear show it to pediatrician..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rapid heart beat, shaking hands and too much consciousness on attending high society functions?\n\nhello sir....i am aisha..i hv a big problem whnevr i attend the high society's function i always being concious...pta he nhi lagta ki suddenly mujhe kya ho jata h hath kapne lag jate h...dhadkaan tez ho jati..... sir plzzzz suggest me why all dis happens to me????",
    "doctor_response": "Hello and The symptoms described by you points towards \"social anxiety disorder\".Following treatment strategies can help-1) Anti anxiety agents like SSRIs- Paroxetine, sertraline, Escitalopram etc2) Benzodiazepines like clonazepam, lorazepam etc3) Beta blockers like propranolol ( You can take 20-40 mg propranolol 30 min prior to any social get-together.4) Counselling sessions and Relaxation techniques like deep breathing, Progressive muscle relaxation, yoga etcDon't worry. Consult a psychiatrist for detailed evaluation and treatment.RegardsDr Gourav MongaConsultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling and burning sensation in feet?\n\nI have very tiny parasite in my feet and body around my breast, under and around my arm pits. my hands with my hands and feet there is a tingling burning sensation ,,,,,and I have tried everything...even my lab shows a false negative .....I feel them moving around in my body",
    "doctor_response": "Hi, I am sorry for the situation you are going through. Feeling like having very tiny parasite in your feet, body, under and around your arm pits might be due to infectious skin parasites like mites, lice or even worms. Further evaluation by dermatologist is recommended especially if you are also having skin lesions. As you are reporting to have tingling and burning sensation in your hands and feet, then, they are related to neurological problems. Further examination by neurologist is advised together with running MRI of spinal cord to rule out related damages. For the moment, I can only advise to keep a good personal hygiene and get further consultations. All the best!Dr.Albana",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes appetite loss?\n\nHi! How are you? I am a housewife and i am worried about my 11-month old son who has a cough and cold and suddenly refuse to take his formula. I gave him ambroxol mucosolvan for his cough 4days ago and just yesterday started nasatapp infant drops for his colds... I have a prescription of a pedia made a month before but i am not sure if i am giving it correctly as prescribed... Pls enlighten me with these 2 medicines because i though that one of them may have caused my son to loss appetite over his milk.... Pls help. Thank you...",
    "doctor_response": "Hi,Thank you for asking question on health care magic.When the baby suffers from cold, usually refuge feeds.Normally appetite will be less at the end of one year.Babies triple their birth weight at the end of one year and they only gain 2 to 2 1/2 kg at the end of two years.The medicines you are giving are not responsible for loss of appetite.Take more tine and feed with tender loving care.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get pregnant if husband has epilasi ?\n\nhello sir my husband have epilasi from 1995, he take so many medicine from 1995, from last 4 yrs he takes encorate chornro 500 and lamez 50, we are trying for pregnency, but i am not conceive, so this medicine can lost the sperm quality, plz help us",
    "doctor_response": "Hi, These medicines might effect the semen quality. But you can confirm it by a semen analysis test which is very much predictive of the semen quality. He can start some fertility enhancing drugs after consultation with a doctor.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Khushboo Priya",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to for pain and weakness while breathing for RA patient?\n\nHi, I was diagnosed with RA 6 years ago I was on Humira but I started experiencing muscle burning and very painful, my R-foot is numb. I experienced pain when breathing weakness when chewing, nightly fevers ans night sweats. I was in the hospital for a week done every test and still have no DX. Please help",
    "doctor_response": "Hi Hope this message finds you in good health.I have gone through your query in detail and understand your concern.its due to muscle weakness and calcium and vitamin deficiency.along with RA tablets, also take calcium and vitamin tablets Hope your query has been answeredNothing to worry about, You should eventually get back to normal.Get back to me for any  FOLLOW UP QUERIES anytime.Kind Regards,Dr Mahaveer Patil...(MBBS,MS,Mch)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is heart transplant, suggested during cardiomyopathy?\n\nmy bro-in-law is 68yrs old and until last may was a very fit person. he has been treated for c o p d for the past nine months but recently admitted to hosp with breathlessness. after an angiogram he was told his heart is only working at 20per cent and he has been given 2yrs left to live. he has dilated cardio myopothy and been told there is no further treatment on offer. they said he suffered a serious heart attack last may, which he was totally unaware of. what hope does he have for a heart transplant or other treatment. he is seeking a 2nd opinion tomorrow. many thanks.",
    "doctor_response": "Hello,Heart transplant is certainly an option, but availability of heart is issue. Still he should on entire treatment in order prevent further decline of function like antiplatelets aspirin and clopidogrel, statins like Atorvastatin if he is having any blockages on angiography, beta blockers like metoprolol ace inhibitor like ramipril and spironolactone and diuretics like torsemide. He should restrict fluid and salt. Have healthy lifestyle and regular exercises like walking. Hope this helps you and get back if you have any questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Wisdom teeth pulled, face swollen, hard lump, bruised, painful. How to get cured?\n\nI had my wisdom teeth pulled on the 8th it's now the 13th and my face is still swollen with a huge hard lump and bruised mainly in of my jaw on the right side. I was coughing the other day and felt like something with the lump popped and I got a shot of pain through my entire face. My left side wasn't this swollen for this long or had this big of a lump",
    "doctor_response": "Hello there , Thanks for writing your query, Extraction of wisdom tooth often ends with complications like pain and swelling post extraction . usually it takes 7 to 10 days for the extraction wound to heal and close completely provided if there is no infection . After extraction antibiotic and analgesic coverage is must to prevent infection of the extraction site and to promote healing. i would suggest you to start with a antibiotic and analgesic course consulting your dentist , which helps in subsiding the swelling and relives post extraction pain. follow all the post extraction instructions and rinse the mouth with lukewarm saline or antiseptic mouth rinse. i hope this helps , take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent urination in a baby?\n\nHi my 2 year old son has been potty trained for a little while now and the past three days he s been peeing more frequently and having up to 4 accidents in a half an hour and it s not just little pees. He doesn t drink a large amount of fluids constantly so I don t know why he is peeing so much. Is this normal?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.First of all, I want to ask do you think he has pain while doing pee.If he is not drinking a large amount of fluid, then you should take a urinary analysis because frequently peeing may be a sign of Urinary infection.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Elona Dashi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the feeling of weakness and panic?\n\ni had a feeling of weekness in my body for abt 2 weeks, like as if i cant feel my body, its light and its very scary as i have a fear of death and im panicking. my fingers get cold and blue and i become shaky. im very worried and try to avoid places or activities not to get same feeling again",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  First of all you should consult a physician to diagnose your symptoms. There may not be anything troublesome. These symptoms could simply be related to anxiety and stress. But you should be sure about that. 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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for BOOP\n\nMy mother, being treated Boop. The sputum test is made. We could not reach the doctor, 12 November to 2 boxes used ciproxin. Initially, sputum was stopped and started again after the end of medication. No fever, 12 were taken in November tomography was clean .. Now again we took the test and got the following result .. What do ----------------------------------------------------- 3 .11.2010 Klebsiella sp cephalothin,amoxicilin,cephazolin, trimethopri+sulfamethoxazole,   S piperacillin, cefoxitin, cefepime,  amoxicilin+clavulanate, cefuroxime, cefotaxime,ceftriaxone, gentamycin, ciprofloxacin  R ---------------------------------------------------------------------------------- 11.11.2010 Burkholderia cepacia Ceftazidime ,Levofloxacin ,Meropenem,  Ticar/K Clav:S Trimeth/Sulfa: R ------------------------------------------------------------------------------- 4.12.2010 Bacteri:  PSEUDOMANAS AERUGINOSa Amox.-clavulanete (Augmentin.Klamoks), Trimet/sulfamet(Bactrim,Bactrisid,septr),    Chloramphenicol   ____S Ciprofloxacine(ciproxin,cipro,ciflosin),           Tetracycline,   gentamicin(Garamycin,Genta),           Netilmicin(Netromycin), Amikacin (amikozit  Mikasin,Negasin),              Tobramycin(Nebcin),            Oflaxcin(Tarivid,Girasid,Ofloks),            Imipenem(tienam), Ceftriakson(Rocephine,Forcef,Unacef),                 Aztreonam(Azactam) ,                         Piperacillin (Pipraks),          Ceftazidim (Fortum),      Cefoperazone-sul,       Meropenem ,       Piperacillin+T.Bactam,              LevofloxaciN  ________R",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query for your mother in details  .*  Management  mainly consist of  supportive  care  with  symptomatic      control .Consume plenty of liquids to maintain hydration .Balanced nutritious diet with avoidance of excess sugar , oily , non veg , spicy ,dairy fat , junk foods , articial sweeteners .Gargles with salted lukewarm water added peppermint oil 3 times a day .Deep breathing  exercises , walking in fresh air , YOGA help to recover  faster .Avoid exposure to dust , pollens ; if necessary  use  triple  layer  face  mask Avoid smoking  or  any form of tobacco consumption .Avoid stress , anxiety .Have to continue antibiotics  according to the sputum culture  sensitivityreport and guidance of  your  physician .Tessalon pearls 3 times a day .Basil leaves , turmeric powder in boiled skimmed milk , pure honey , chamoline  tea  are  herbal  recovering  agents .Wishing her  fine recovery .Feel free to ask any further  queries .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for high BP after blood transfusion?\n\nbHi,I got blood transfusion on the 8-11-20--8-12-20,4paints. and yesterday when I went to work my blood presure went up to 190/84 and I have never had blood presure problem before and now I am wondering whats wrong with me.the DR.just gave me med. to lower it down.",
    "doctor_response": "Welcome at HCM    I have gone through your query and being your physcian i completely understand your health  concerns.   what is ur age and sex? why u have done blood transfusion? Any other associated problem? like diabetes or hypertension?               Rise in BP do occur after blood transfusion due to rise in intravascular volume, thats why after blood transfusion it is always wise to give patient INJ LASIX  to prevent the volume overload.    In my opinion u need to be examined  fully by a physician since merely upon the basis of ur history it is very difficult to comment.    it is very imp to look at your kidneys status as well as other comorbidities.      do meet your doctor so that apprpriate management can be initiated in time.      meanwhile stay calm get well soon Hope your query is adequately addressed if you still have any feel free to ask   RegardsDr Saad Sultan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Spotting with abdominal pain. Remedy? History of irregular periods\n\nGood morning Doctor. I have irregular periods and I had my last period for this month about a week ago. Yesterday I started bleeding and as I have to come to learn this may be known as spotting ? My blood is the color of dark brown and I m experiencing abdominal pain . I would like to know what the cause and remedy of this and is it important to seek a gynecologist if must?",
    "doctor_response": "hello.. First of all you didnt mention your age. yes you are right, the symptoms known as spotting. It simply means the exessive bleeding during your menstruation, the condition termed as menorrhagia. these exessive blood discharge clots therefore the clotted blood is dark brown in colour. It may be normal in your menarche (start of menses) or durind menopause, also in conditions like uterine fibroids, as withdrawl bleeding, or in some bleeding disorders but you should consult your gynacologists if the bleeding continues or the abdominal pain continues.. Your doctor may suggest you to get abdo-pelvic sonography to rule out PCOD, fiboids  or some pathological tests to rule out bleeding conditions or endometriosis or pelvic infections.. take care..",
    "dialogue_context": ""
  },
  {
    "patient_message": "How many days after rupture of follicle there is a possibility of getting pregnant ?\n\nhi.......my doctor conducted follicular study and suggested rupture started at my 15th day and stay together with husband.but all of a sudden my husband got some work and out of station for one day...today is my 16th day...can i know how many days there is possibility to get pregnancy after rupture started.please suggest.Thank you.... nandini",
    "doctor_response": "Hello, normally once ovulation has occured, the egg can survive for 24 hours. So, once the rupture started, the next 2 days are considered to be fertile. So, it is advisable to have planned relations for 2-3 days around the time of ovulation. Hope this information was useful to you. Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sharp pain in the neck , groin and leg\n\nI have a sharp pain in my right side of my neck and in my legs that comes on and can be relieved with advil. With the pain I also feel feverish but I have no temperature. I get chills when the pain comes and the I get flush when the pain begins to subside until the point where it goes away because the advil is working. I have been taking advil for these symptoms for about a week now and cant seem to shake it. Occasionally I feel a sharp pain in my groin area and in my legs as well during the time when it flares up.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have sharp pain in the neck , groin and leg. Well the symptoms you mention in query can occur due to may reasons like nerve compression , disc problem , compressed fracture or cervical spondylosis. I would suggest you to take complete bed rest , otherwise condition may get worse, apply warm compresses to leg back and neck , do not lift heavy object and take ibuprofen or acetaminopehn for pain . Consult orthopedic surgeon for proper examination . Doctor may order CT scan , MRI along with nerve conduction test . Doctor may recommend physical therapy along with particular stretching exercises , prescribe anti inflammatory , muscle relaxant , vitamin supplement for quick recovery . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a hard thigh lump with bleeding be treated?\n\nI have a hard lump on the inside of my thigh, it looks like a insect bite, but it had a dark center. when i popped it only blood came out. it doesnt itch or hurt, though it is tender to the touch. should i be worried? or is it just an insect or arachnid bite?",
    "doctor_response": "hi.it is best if you consult with a doctor, preferably a general or an orthopedic surgeon, for clinical evaluation. there are a lot of possibilities including benign cysts, fibromas or lipomas. malignant tumor lesions should also be ruled-out. diagnostics such as x-ray, mri and a tissue biopsy may also be recommended. management (medical and/or surgical) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i take Rivotril along with Xanax?\n\nIs it safe to take 0,5 (half of it) Rivotril same day (8 hrs later) when small dose of Xanax is already been taken (half of 0,5mg) ? It seems that Xanax is too strong for me, and I been on small Rivotril dosage until yesterday. Many thanks in advance!",
    "doctor_response": "Hello!Welcome on Healthcaremagic!You should know that both Rivotril and Xanax interact with each other, leading to increased sedation and a low physical performance. Anyway, Xanax should be taken only as a short term therapy, while Rivotril can be taken as long term therapy. The dose of Rivotril that you are taking is really low. So, it is OK to take 0.25mg xanax. Hope you will find this answer helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medication for swollen lump & leaking of fluid on the molar\n\nI have a swollen bump over a molar that leaks clear fluid and some sort of brown substance mixed in. This has been occurring on and off for the past several months. It hurts but it always goes away and I feel better so I have been putting off the dentist, but it reoccurs sometime or later. Any ideas to what it is?",
    "doctor_response": "Hello!Gone through your query.The leaking fluid is pus and the lump is a abscess.You can take a full course of metronidazole,penicillin and analgesics (make sure you are not allergic to any of these). gargle warm saline water thrice a day.You must get the treatment done immediately. This can sometime or the other lead to swelling if ignored.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes weight loss in child?\n\nMy granddaughter was taking this mirtazpine 30mg tablet and was having a lot of up set stomach with it and my son took her off of it. Now is is looses a lot of weight . She was a size 2 junior , now she is 0 sizes. All of her blood test came back great. Why do u think she is looses the weight? My name is B.M.",
    "doctor_response": "Hi, thank you for posting your question. Mirtazapam is an anti depressant drug which is known to cause weight gain. After having stopped the drug, some weight loss could probably be attributed to withdrawl of the drug effect. But in this case as you said, the weight loss is significant. This could not solely be because of the stoppage of Mirtazapam. As she was already being treated for depression and all her reports have come out to be normal, I would consider the possibility of anorexia nervous as a cause of her weigh loss. In this condition low food intake is considered as the main cause of weight loss. If that is the case then I suggest keeping a food chart and consulting a psychiatrist should help.Do let me know if you have any more queries regarding the case.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Peripheral neuropathy, numbness in back. MRI, CT scans done. Injections taken. History of sciatica, open heart surgery. Advise?\n\nMy father is 80 and has peripheral neuropathy.  He is not a diabetic.  He had a bad case of sciatica after injuring it while shoveling about 6 or 7 years ago and  started treatment with  injections; however he only had one injection before he was diagnosed with coronary artery disease and underwent open heart surgery, so he only had one shot in his lower back.  He has had a few MRI's and CT scans and it appears that nothing shows up that could be pressing on his back causing the numbness.  Is there anything at all that may help him or can you recommend another test that might determine whether or not there is something causing his feet to be numb?",
    "doctor_response": "Hi, Welcome to HCM, Your father is having numbness in feet, which is  symptoms of Neuropathy,pain was due to sciatica, he has be operated for coronary artery disease, I presume he must be taking all treatment. His MRI is not showing any compression, then neuropathy may be caused by nutritional deficiency like B12,other causes includes alcohol induced,any drug induced if he is taking,inflammatory pathology. He should visit a Neurologist and get Nerve conduction study and EMG. You have mentioned he is not a diabetic, once cause of neuropathy is detected it can be treated. In the mean time take good care of feet and treatment like neurotropic vitamins, Pregabalin,Gabapentin may be given to see if gives symptomatic relief. If his pain is severe  he may get good relief with Epidural injections. Please take care. Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for polio\n\nOne of a poor guy from a hilly region is suffering from polio where by his right leg has been affected and he walks with a help of a stick which is very bad to see and feel. so I need to help him in some means where he can walk with out the help of the stick .So can u give me an suggestion for it.",
    "doctor_response": "Hello,I appreciate your concern for the polio affected person. Poliomyelitis is a viral disease that affects the person in the infant stage and causes weakness in muscles. Though it is a preventable disease by timely administration of polio vaccination in childhood, it is not curable. There are treatments that can make a person live life little more comfortably.The person can be given antibiotics to prevent infections in the muscles and analgesics to relieve pain. Moderate exercise and nutritious diet are necessary to stay healthy otherwise. The person can be given rehabilitation therapy. That includes occupational therapy, physical therapy, corrective shoes, braces etc.I do know the region you are living in. There are certain charity organizations that provide these treatments free of cost to poor patients. You can find them online and refer the patient there.I hope this information helps. Thank you for choosing HealthCareMagic.Best,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bruises in arms & legs\n\nTwo weeks ago I noticed a couple small spots that looks like a bruise . Small like the diameter of a pencil eraser or smaller. I found one inside my arms around inside of the elbow and a couple on my legs. Nothing done to cause a bruise. This didn t look like a regular bruise anyway. Kind of dark reddish. They went away after a couple days. Now I just noticed another one on my knee. What is this?Thanks,Mary",
    "doctor_response": "Hello, Your symptoms could be related to a coagulation disorder or small trauma. For this reason, I would recommend consulting with your attending physician for a physical exam and some tests: - complete blood count - PCR, ESR for inflammation - coagulation tests - liver tests. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it possible to get syphilis through kissing?\n\nHello doctor, I have a question about syphilis. I am 29 years old, female. I am not sexually active but I got engaged recently and my fianc\u00e9 had previous relationships. He only kisses me sometimes which I am worried that by kissing some disease might be transferred to me from him. I got skin rash on my palms and feet 5 days ago. And when I was searching I came across syphilis. Can syphilis be transmitted through a kiss? I went to a doctor and he told me it is a skin virus HFMV and gave me antibiotic cream. I did not mention the kissing part to him. But he took blood test, crp was normal, also blood count test was normal. I did not mention this to my partner yet. I am really worried that it could be some other disease.",
    "doctor_response": "Hello. Syphilis cannot be transmitted through kissing. It is only transmitted through oral, anal and genital sex. However, syphilis can cause oral ulcers. If you kissed someone with an active oral ulcer, then the risk of getting syphilis through kissing may occur. Is there anything else I can help you with? Or anything that is not clear to you? I would gladly clarify them.",
    "dialogue_context": ""
  },
  {
    "patient_message": "A dark bleeding bruise in the breast, is it normal?\n\nI had a biopsy for breast cancer and it resulted in the breast having one dark bruise covering the under part and the top part consisted of flakey (sp?) skin that bled a rather allot and needed much dressing. This lasted for about four weeks. How normal is this?",
    "doctor_response": "HIWell come to HCMIf the would is infected then this need to be treated with antibiotic, fungal infection need to be ruled out, you have to stated the report of biopsy, if this is malignancy then this is not normal one and in such condition has to be taken care accordingly,  hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe stomach pain in a 7 year old?\n\nMy 7 yr old daughter has had stomach pains to the left of her belly button for 6 weeks now. Took her to doctor twice and they say virus. Last night she came inside from playing and hitthe couch rolled into a ball from the stomach pain. She also said her head hurt terribly. Her temp is 101 with tylenol. What should I do?",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, if the pain can not respond to treatment or medication then it needs to be sent for investigation as there is history of injury (Abdomen) plain x-ray abdomen and ultrasonography is must, can wait for some time till the virus finishes the course  hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a healthy pregnancy possible despite previous medical termination?\n\nHi, Im a 27 year old married lady. I was diagnosed with diabetes and hypothyroidism when I was pregnant during 12 weeks. My HBa1c came to level 9, so my gynaec suggested to reconsider my pregnancy, because of the risk factors involved for the baby. I went through a medical termination. I still cannot get over it emotionally. I am working and sometimes have a hectic schedule. I get stressed and emotionally drained, which leads me to eat a lot a times. I want to have a baby but somehow I am not able to have a steady diet and a healthy life style. Can you please help me?",
    "doctor_response": "Hi, I think you should do some yoga and meditation . Relax for sometime. Take a break. Have a healthy diet.  Consult a dietician for control of sugar levels. You can start some oral hypoglycemics also. Try for pregnancy once your sugars come under control.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have bad GERD with epigastric pain, erythema and atrophy of antrum. Please suggest solution.\n\nHello doctor, I am a 27-year-old female. I had a history of on and off acid reflux for a few years. Last month, I had a bad episode of GERD and was prescribed Pantoprazole for a month. It got better and I stopped taking Pantoprazole, but I still have epigastric pain on and off. I had an upper endoscopy last week where the findings were all normal except for erythema atrophy of antrum. No more obvious acid reflux signs though. But epigastric pain still comes and goes. I was prescribed Hyoscyamine, but not sure why. What does erythema atrophy of antrum mean and why do you think I was prescribed Hyoscyamine? I have not had biopsy results from endoscopy yet, but I am hoping and praying for the best.",
    "doctor_response": "Hello. Your symptoms likely from your stomach. Atrophy and erythema mean there is inflammation, might be from a bacterial infection (helicobacter), which we have to wait for the biopsy result then to be treated with triple therapy. Hyoscyamine drug for intestinal cramps, help alleviating pain from cramps, also decrease the acidity in the stomach. To be honest, we rarely use it for stomach, PPI (proton pump inhibitors) like Pantoprazole usually are better with stomach inflammation, and decreasing its acidity. For now, we have to avoid smoking, drinking, and spicy food the could irritate the stomach more. Avoid eating before sleep at least three to four hours. Wait for the biopsy. Another thing, if pain persists, I recommend to repeat the ultrasound, we need to see what is going on with your gallbladder.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe fever,sweats and body aches?\n\nMy husband suffered from a bout of flu commencing July 29th 2011 while in Rome at the start of our holiday, we had been there for 2 days. He had all flu like symptons and we presumed given a few weeks he would return to normal. This has not occured. Ongoing symptions include aches and pains in joints which seem to travel to different spots in his body but regularly in his hands. High temperatures and severe sweats. General tiredness and feeling unwell with the occasional bloating and stomach pains. Unable to perform a normal days activity and spends much of his day laying on a bed. He has had 4 separate sets of blood test, for varies virus including Ross River and Bahman Forest Virus. All blood tests have not provided any indication or resolution to the problem. He spend 2 nights in hospital this week with a suspected heart attack, but his heart is strong and blood pressure excellent. He is under our local GP however there is no help other than to say it takes time . His symptons of fevers, sweats, tiredness and aches seem to be worse now rather than better after nearly 6 months. Please help",
    "doctor_response": "Hello,The flu like feeling can be due to a post viral infection that affects the bones and joints. Rest and mild pain killers with a good vitamin C rich diet will help in his recovery.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for abdominal pain\n\ni first started to have apain on the right side of upper abdomen now the pain is on and off but what worries me most is constant pressure i feel under right rib cage radiating to the back more especially when im sitted,im 1.5meters tall,55kg was treated for tb in 2004,have gastritis problem.",
    "doctor_response": "The following conditions often cause upper right abdominal pain right abdominal pain:AppendicitisCholangitis (bile duct inflammation)DiverticulitisFecal impaction (hardened stool that can't be eliminated)Gallbladder cancerGallstonesGastritis (inflammation of the stomach lining)Hepatitis (liver inflammation) liver abscess , pleurisy, kidney stone (right) etc... There are many causes to rule out . I would suggest a CT abdomen to rule out causes and few blood investigation . Consult your physicians.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Sustanton 250 IM and Decadron cause any side effects?\n\nMy 39 year old fiance began injecting Sustanon 250 IM to rebuild muscle tissue in his shoulder which he has repeatedly broken/dislocated over the years. He complained of injection site for days after administration (in his greater glut or quad). He was switched to Decadron with better results as far as injection site pain. Of course, all of these steroids were obtained illegally via internet from an overseas source. He didn t taper his dose when coming off of his last week of injecting the Decadron and is now experiencing night sweats. He claims that these particular types of steroids do no cause roid rage . I beg to differ. I am a nursing student and would like a better understanding of how these steroids work. Is it true that the adrenal glands eventually shut down so that a sudden d/c of this Rx is very dangerous? I m concerned about his Potassium/Sodium levels.",
    "doctor_response": "Hello,I will suggest you to taper off any steroids when used for a period longer than 21 days. Once you taper off slowly, the side effects will be minimal. It is always mandatory to use any steroids under the guidance of a physician. There is no mention of dose duration and frequency of use of these steroids. But the basic rule to handle steroids remain same. It is true that steroids do suppress adrenals and that's why a slow taper off is mandatory.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammad Faisal Bacha, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have chronic kidney disease. Cath. bag had blood. Dialysis is not helping. Problem?\n\nmy father-in-law has chronic kidney disease.Took him to emergency room ina.m. His cath. bag had blood in it. they said to stop taking cumatin for 2 days. also doc. has told him dialysis wasn't helping. hes 82yrs. old. he doesn't let us listin at his appoint ments so we are in the dark. does this mean that he will die soon?",
    "doctor_response": "hithanks for your question.your father in law might be having end stage kidney disease.the prognosis is not good.hope I answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes memory issues while on Wysolone?\n\nHi, My mother is taking wyosolone tablets for adrenal insufficiency.she is normal before but now she is having problem of forgetting and also she got confused each and every day.she is taking tuberculosis prevention tablets AKT 4regularly as prescribed by the doctor.whether this forgetfulness and getting confused lead to serious problem?? Wat should be done to overcome this?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I think your mother may be developing age related dementia conditions like Alzheimer's Disease. As of now, unfortunately, there's no significant treatment for dementia. However, there's medication like Memantine that may help her temporarily. You will need to meet up with a neurologist for a suitable prescription after a considered examination. I have tried to make it as simple as possible. Feel free to contact us for any further information. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have been having headaches, dizziness, cramping in my lower abdomen. I want to make sure my health and my baby s health is okay\n\nI am 16 weeks pregnant with my third child and I ve been having headaches, dizziness , cramping in my lower abdomen , and last night I saw black and white stars in my vision. I ve also experienced tightness in my chest and it feels like my heart is skipping beats. With my first pregnancy, I was diagnosed with preeclampsia and delivered my daughter at 24 weeks. I have an upcoming doctor s appointment, but I was hoping someone could shed some light on what s going on. I may be overreacting but I want to make sure my health and my baby s health is okay.",
    "doctor_response": "Hi wellcome to healthcare magic chances of pre eclamsia at 16 weeks pregnancy are less.To rule out pre eclampsia you should get your urine for albumin ,blood pressure checkup & look for pedal edema.If any two these three are present you are pre eclamptic.you should must consult  gynecologist & get all investigation done to find the cause & treated. wish you healthy & successful pregnancy outcome.Disclaimer",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can infertility be treated?\n\nhi doctor...good morning... im trying to have a baby again i have baby girl she iz 3years old... i need to get concive but i had sex everyday but i din get concive im trying frm 6 months. pls give me a soliushn.... ... what should i do",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Since you already have a kid, it can be presumed that you and your partner are fertile. There might be difficulty in conceiving naturally if the Fallopian tubes are blocked. This could have caused due to pelvic inflammatory disorders. Kindly get your Fallopian tubes checked for potency. Also, you can undergo ovulation study, which will help you to time the intercourse appropriately. That would improve the chances for you to conceive. You may also require hormone assays in addition, as it might suggest that you might require certain hormonal medications to support the pregnancy. You may keep IUI or IVF procedures as a last resort to conceive if it is not possible naturally. Kindly consult Obstetrician for clinical evaluation and appropriate management. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr.Ashakiran.S.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have lung problem and depression.\n\nThis is Tiffany, first of all i want to thank my sister Terri for making this page for me . I can not thank you enough for everything you do for me.I want to thank my fans I have noticed that i have ppl on here that have no idea who i am an i have ppl on here that i no longer talk to. It does NOT matter who you are I want to thank you all from the bottom of my heart I have been batteling this disease since march 29th2008 which is when i had my first attack on a camping trip with my friend Bianca at carls bad state beach, if it was NOT for her I prolly would not b here today something woke her up an told her to check on me an when she woke up she heard me making a weird noise an i got up took a deep breath an i couldn t get the air out, she called 911 an from that day on i have had this undiagnosed lung conditon. Befor all of this iwas a crazy lil party girl an wanted to become an RN sooooo bad. Pretty much I am just trying to say that NO ONE should ever take their life for granted because you never know what tomorrow brings. My life has changed so much an just in an blink of an eye it seems like. I am now on oxygen 24 /7 an they keep increasing the amount. Since i have been Ill i have been on steroids (prednisone) it does what it is suppose to do(keep my airways open) but has horrible side effects . I weighed 110lbs befor an i gained a lot of weight since i have been on them. It all just started with a lung problem well now the steroids gave me more problems. I now have, fibrmyalagia,bone an joint disease ,constant pain, i swell all the time, my toes are always grey, fast heart rate resting rate for me is like (130 +) normal is 60 to 100 I take 10 diff meds an 3 diff heart meds to try an get my heart rate down,because my heart is starting to ware out .Its compusating for lungs because my lungs are not working properly., i also am getting cateracs, all my teeth keep breaking, i cant stand long i have to b in a wheel chair out of the house because i can not stand long or walk very far without changing colors an becoming short of breath.I also have already had a TIA(mini stroke) an a possible mild heart attack, . It does NOT matter what i had befor i became ill or what i use to look like or anything like that its all about what I have NOW an even tho my life has changed so much i am still thankful for being here. I am thankful for the oxygen that i have to help me breathe, my wheelchair to get me around an still try to liv",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. I can understand your emotions. You did go through so many life experiences which are supposed to set your thinking straight and positive. But otherwise happened.We come across so many events in our past. Some are negative and the maximum are positive. We program our brain so as to remember the negative events. Positive events teach us positive lessons and negative events also teach us POSITIVE lessons. In that case, we should forget the negative events and boast about the positive lesson we learnt from it and cherish it.  That is how positive thoughts manifest and our brain gets reprogrammed.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in the chest\n\nI was diagnosed with a minor leaky valve about 6 months ago and everyday I still feel pain in my chest. It feels like a brick is in my chest. I am not on any medication except for high cholesterol. I am soon to be 36 is it safe to get my teeth cleaned? A cavity filled? To get pregnant?",
    "doctor_response": "Hello, Chest pain is really atypical for a leaking valve. For this reason, I would recommend performing an exercise cardiac stress test in order to investigate for any other cardiac disorders. I would like to directly review your cardiac ultrasound report, if you could upload it, in order to be able to give a more professional opinion. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back & leg pain\n\nthis is joe, 29yrs, had back pain with left leg pain (L5, S1) for years back. I took Ayurveda treatment for 14day and 14 days rest was alright for 2 years it again repeated and went back to the same treatment but did not recover. please suggest. now i am 94kg, 182cm.",
    "doctor_response": "Hi,Welcome to health care magic.Primary  treatment of back pain is exercises and vitamin supplementation. so back exercises is  advisable . Vitamin D SUPPLEMENTATION if level is low is required.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medication for seizures\n\nMy TSH levels normal on low end, 1.23 I ve had Hashimoto since 4 th grand I m now 48. I ve had unexplained go unconscious seizures I m on Dilatan. My seizures ALWAYS happen around same time I would have my period. Hysterectomy at 30, 1 ovary remains. HELP! I m sick, body swelling, brain fog, can t sleep, can t poop, so cold all the time. Tonight feels like an Aura night. What is happening ?",
    "doctor_response": "Hi,having seizures at the time of periods while taking tab dilantin. I advise you to tab levipil or tab laconext as add on drug.For multiple complaints like loss of sleep ,body swelling I advise you TFT ,CBC ,RFT , Usg abdomen and consultation with physician.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for severe pain in the wisdom tooth.\n\nI am having my wisdom tooth removed next week as it has gone bad. The problem is that i am in terrible pain and have been for the past 24 hours, what can i do to ease the pain, i have been taking paracetamol but that doesnt seem to be working, i can not carry on with this pain for another 6 days. Thanks tanya",
    "doctor_response": "Thanks for posting your query to HCM.After going through your history, paracetamol doesn't work in severe pain. I would suggest you to take Ketorol DT three times a day for pain relief.Do warm saline rinses 3-4 times a day.Hope my answer will help you.RegardsDr. Himesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes knee pain and swelling?\n\nDear Sir, My Mother is having knee pain from last 1 year she is 46 old.in cold days her faces lot of pains and swelling on knee side area. and not able to walk and stand on leg. I consult with lot of Dr. but we have not gate right treatment and guideline.",
    "doctor_response": "Hello,It may be due to osteoarthritis. For pain you can take tablet acetaminophen. You may require MRI knee after orthopedician consultation. Use knee cap. Use support while walking. Avoid squatting position. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr Shyam Kale Family and general physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have hard liver, tumor in kidney. Have had lap cholecystectomy. On tylenol and oxycontin. Done ultrasound. Is there an easy treatment?\n\nI have just had a lap cholecystectomy for stones and found a \"hard\" liver. I am a nurse who worked labor and delivery and Icu for over 20 years. when I was given the heptovac and recombovac vaccines...I never converted...they gave me boosters , but then figured I had passive immunity. Then in 1989 I was in a devastating mva after 2 laminectomies. After tons of tylenol and Ansaids trying to get me on my feet...I blew out 7 gastric ulcers and started to bleed. In order to live and function, I was then started on long acting narcotics (oxycontin) and was given a diagnosis of lupus as well when I broke out in a full body blistering rash after being in the sun. My liver funcion tests are normal...any ideas? Sorry..also, my sister just informed me that she has a large liver and and abnormal kidney that was congenital...I mention this because I have a tumor on my left kidney in the collection area of the kidney I have yet to deal with that was found on ultrasound when looking for the stones. thank you",
    "doctor_response": "easy tratment go for surgery stop taking pain killers it can damage the kidney and liver stop eating non veg",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rapid heart beat after smoking cannabis?\n\nWell doctor, i didn't want it to come to this. But I'm 22 I've smoked weed for years, lots at a time and could never get too high. Recently my tolerance dropped tremendously. Within a few minutes of only taking ONE hit I start to feel like my heart is well over 120 bpm and I start sweating. I can't talk, I can't lay down, I can't walk. It's like I'm going to die or something. I've done it a few times to see if it wouldn't happen again..but it does. It's far worse than an anxiety attack. I just don't see how I could smoke a lot at a time and be able to do anything (run, play basketball, take tests) all just fine. And now one little hit literally puts my in a concious coma..whats happened to me?",
    "doctor_response": "Hello, I understand just how you are feeling. -You are having palpitations, which most of the time do not pose any danger. They can just be very scary. Smoking, drinking, use of illicit substances worsen palpitations, that is why you are feeling this way. - To help reduce the palpitation, stop smoking, continue exercising and always get enough sleep. Warm regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have large cyst on my tooth. Have numbness in my right cheek and right side of bottom lip. Concerned?\n\nI have a large absist under the root of one of my bottom teeth, Im on two types of antibiotics to treat it untill tuesday when its removed. I had thrown up yesterday morning for no other health  reason except for my absist possibly affecting my body? I also have numbness in my right cheek and right side of bottom lip. Is this to be concerned with? The pain also reaches from tooth across and under right side of jaw, up the side of head to ear and temple right across to the cheek bone and eye socket bone to synise area. Should i be more worried?",
    "doctor_response": "Hi,Thanks for aksing the query,The above symptoms which you have mentioned are due to presence of the cyst. I would suggest you to continue with the course of antibiotics prescribed to you. Root canal treatment of the tooth and complete removal of the cyst should be done. Meanwhile you take lukewarm slaine rinses and antiseptic mouthwash gargles. Start with the course of multivitamin suplements .Hope this helps out.Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes upper abdominal pain?\n\nI had my gallbladder removed in 2001.  Once in a while I would have pains in my upper abdomen like when I still had my gallbladder and it was dysfunctional.  It would hurt for a few days and go away.  I started ortho tri cyclen three months ago due to a heavy period and severe cramps and the pain where my gallbladder used to be has gotten awful.  Somedays it almost has me in tears. I am wondering if the birth control pills are the cause?",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering  your query.If I were your doctor, I would advise you for a review ultrasound of abdomen to rule out recurrence of calculi in the common bile duct , and also with a possibility of pancreatitis as a differential diagnosis specially if you consume alcoholic beverages. Few blood tests like a CBC, a liver function test, a serum amylase and a serum lipase would be worthwhile in your case. I would not consider the birth control pills to be the cause of such intense pain. Till the reports of these investigations are ready, I would advise you with a proton pump inhibitor and an antispasmodic drug along with a bland diet schedule for a symptomatic relief.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be done for a good dental health ?\n\nsir, my mouth is looking very ugly , it is in the color of white and black dots, even i did not have smoking habit! please suggest good medicine for me doctor .. sir, my mouth is looking very ugly , it is in the color of white and black dots, even i did not have smoking habit ! Iam 20 years old , i have this problem about 10 years .. please suggest good medicine for me doctor .....",
    "doctor_response": "sir, my mouth is looking very ugly , it is in the color of white and black dots, even i did not have smoking habit! please suggest good medicine for me doctor ..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sneezing during morning and evening, dust allergy, have high eosinophils count. How can I reduce it?\n\nhello sir, My eosinophils count is 11.for that cause i am suffering from sneezing during morning and evening.also i have dust allergy .so i want to decrease my eosinophils count so that in future it will not lead to asthma .i have cough problem during my birth but after 5 years that is no more.please sir suggest what to do?",
    "doctor_response": "Welcome to HealthcareMagicForum Hi..Spanda.., if there is no family history of Asthma , there is less chances of you being affected.. alos avoid to work or travel in dusty environment, avoid, jogging in early morning..., these may reduce E count.., do not worry, as you are healthy. Take care..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white crusty scabs on the scalp of a child?\n\nMy three year old son has white crusty scabs on his scalp. I have noticed the dry patches before, but they were usually not attached. I have now found quite a few patches that are attached. They feel like lumps on his head but peel off. Can you tell me what they are?",
    "doctor_response": "Hi read ur question Ur child has crusty scab no the scalp Which was attche with scalp  It's mostly seborrhetic dermatitis  For this u have to use antifungal sampoo twice weekly To soften thick patch first , rub mineral oil onto the area and brush gently to help peel scales off .Use warm water and massage the affected area Avoid scratching of head . If not improve then show ur paediatrician or skin specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does left basal pneumonia mean?\n\nmy mother was diagnosed with left basal pneumonia she is 74 yeas old and was discharged from hospital yesterday was given amoxicillin and clarithromycin but now she is being sick and has diarohhea she has had amoxicillin before which hasnt effected her this way will it be the other antibiotics also what is left basal pneumonia",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, her diarrhoea is mostly due to amoxicillin. Amoxicillin can cause diarrhea on second exposure. So you should stop amoxicillin. There are options for oral antibiotics other than amoxicillin like cefixime, levofloxacin, moxifloxacin etc. And left basal pneumonia means lung infection in lower lobe of left lung. So antibiotics are the mainstay of treatment. Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Continuous brown discharge post depo shot. Chances of pregnancy?\n\ni started depo for the first time in December 2011 , i got off depo march 2012 . every since ive been on depo ive been having brown discharge ; on may 9, 2012 i had unprotected sex . i think i started my period (light) on may 28, 2012 i normally have my period for five days will it go back to normal ? is this really my period ? could i be pregnant ?",
    "doctor_response": "Any time you have unproteced sex after stopping the birth control, you are at risk for pregnancy.  It is possible that the brown discharge and light bleeding is related to pregnancy.  However, it is not likely, as most bleeding is not due to pregnancy, but more likely it is just a period, and it ,may take up to nine months after the depo shot for your periods to return to normal.  If they don't become normal by then, you should see your doctor to figure out why your periods are not normal and to get treated for that problem.I would recommend that you take a pregnancy test just to make sure.  I hope this helps, please let me know if you need any more information.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does hot cheeks indicate allergy to tequila?\n\nI just had a few small sips of Tequila and immediately I started to get very red and hot cheeks. Now I'm having a bit of a panic attack that I could be having a bad allergic reaction. I have allergies to anti inflammatories. Do you think there is any chance something could happen to me in my sleep?",
    "doctor_response": "Hi, see tequila is a beverage and yes it might cause allergic reaction after drinking even small sips.If you are facing hot cheeks with redness,then you can take antiallergic drugs available OTC for temporary relief.There should not be any problem after taking antiallergic drug in your sleep.But if you still bother and your problem persists then you better go to dermatologist for complete treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in upper back and chest while swallowing?\n\nRecently I've been experiencing a pain in my upper back/chest when I swallow food or drinks. I've had this pain before, but its only lasted one bite and NEVER more than that. I've had this pain for 2 days now and I have no idea whats wrong, let alone what doctor to go see. HELP?!",
    "doctor_response": "Hello. As you mentioned in the question that you are having this kind of episodes earlier, Its seems the symptoms are related to the esophagus ( the tubular connection from mouth to stomach) any infection or inflamation would cause narrowing in any part of the esophagus would cause the above symptoms.generally general physician is good to deal with above symptoms, since you had repeatedly, i would recommend a gastroenterologist consultation would help you for further evaluation. Hope it helps you, thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hepatic coma?\n\nMy father in law is 61 never had any health problems before in December he complained he was not feeling well.he vomited blood and been already since in 3 hepatic comas the 2 before this one he responded this time he dont respond he has been in this coma for over 48 hours can you tell me anything about this im so sad for him and my husband",
    "doctor_response": "Hello, I would explain that his symptoms could be related to acute hepatic failure. I would like to directly review his blood lab tests and abdominal ultrasound report in order to give a more professional opinion on his medical condition. If the situation is treated properly and ammonium levels are reduced, he may gain conscience again. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have stage 4 metastasis gallbladder cancer. Has A fib, chronic kidney disease, congestive heart failure. Life expectancy?\n\nMy mother was diagnosed 10 months ago with stage 4 metastasis gallbladder cancer into her liver , they were never able to do further testing to see how far advanced because dye would of shut down her kidneys, she also has A fib, chronic kidney disease 3, has had open heart surgery & had congestive heart failure & just came home from the hospital after a hemoglobin of 4.2 from a bleeding ulcer which was repaired & given 5 units of blood. She did have the rapid weight loss & swollen abdomen but no pain. She s 89 & loves life, we take her away as often as she wishes. Since hospital stay she s getting stronger every day. 9 years ago she had Coumidin poisining with a 13. They told us she would die but bounced back, she is an amazing & strong woman. How long can someone like this survive on an average?",
    "doctor_response": "Hi, Actual data in this sort of particular cases are lacking. Your mother has done exceptionally well in this period. Metastatic gall bladder cancer generally has poor prognosis. Your mother is doing well with so many medical comorbidities. I do not know exactly what treatment is she receiving but you should consult your cardiologist , nephrologist and oncologist for better guidance. Let us hope for the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stage 4 Adenocarcinoma\n\nMy 14 yr old daughter was just diagnosed with stage 4 Adenocarcinoma they are not sure if it started in her liver or pancreas but both have tumors, her oncologist is shocked that at her age she has this disease as it is ususaly found in people 60-80 yrs old. In the past she has had Wilm's Tumor and Osteosarcoma of the rib cage so cancer is not a new thing for us but I have never had her oncologist tell treatment might not be an option my daughter is a fighter and WILL fight to the end. Does anyone know someone that has survived Adenocarcinoma, Im trying to look in to some more natural things we might be able to do to slow the growth of the tumors as well, she is in no pain, her organs are functioning fine even her liver function tests came back normal, it was just a routine CT scan that caught the spots. Any help or advice would be greatly appreciated!!!",
    "doctor_response": "Hi sbushay,Welcome to HCM.I appreciate the positive attitude maintained in such an adverse situation. WILL POWER can do miracles.  Give her good nourishment and see that she is comfortable and avoid unnecessary medication, especially the invasive ones. Treat symptoms only if they are an absolute must.I pray to the Supreme Commander of the Universe to bestow your daughter a long healthy fruitful life.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cluster of bumps with yellow crust on chin?\n\na few days ago i had what looked like a cluster of acne about three to four zits on my left side of my chin. the next day it looked like they were ready to be popped but no white heads just clear liquid came out. its been two days since i have popped it and now its got a yellow colored crust over the top of the bumps joining them together..it is a little sore with a slight burning sensation kind of tingling. please help me figure out what is wrong or what this could possibly be thnx! i have attached some recent pictures. for additional assistance i am not allergic to anything i have had shingles when i got pregnant at 16 and i have had scabies once when i was 23. i am a 25 yr old female",
    "doctor_response": "HI, thanks for using healthcare magicThe lesions may be impetigo which is a skin infection. It commonly causes crusting lesions.You can try cleaning the area with a mild anti septic and applying  a topical antibiotic to the area.These can be obtained over the counter.If there is improvement then oral antibiotics may be needed.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Heart stroke. Low BP. UTI caused high fever. Tumor removed. Normal?\n\nhi doc! i am jaz, a filipino. what i want to consult is about my mother. yesterday, she was brought to the hospital due to heat stroke (as per the doctor s initial diagnosis ). she was having a 180/something bp and a fever of 40degrees. she was given two halves of clonidine tablet. after that, her bp went to 120/60 and normalized. the doctor s diagnosis due to the cbc was that her urine was plenty of bacteria and she has UTI which caused the high fever. my question is about her bp, after it was normalized, it posted around 60/40 then as of now it it 100/60. according to the doctor, her bp is still low. however, when i asked my mother, she said that she is feeling fine, she doesnt feel dizzy nor light headed. i did some research and according to that, there are some people that are naturally low blooded. is it really normal for her? she is not athletic but she eats a lot of vegetable. by the was she is already 56 years old without a history of heat disease, however she was operated on her head to remove a tumor , the surgery happened around 2002 or 2001 but thanks to the LORD, she recovered. thank you doctor.",
    "doctor_response": "Hi, Thanks for using HCMFirstly, your mother is very much fine so no need to worry. About you mothers BP of 60/40s was due to clonidine and of her BP 100/60 is perfectly normal. Actually normal BP ranges from 100-120/80-60, some people have the tendency of having lower BP around 100.60 or 100/50 and in your mothers case it is very much normal. And for her UTI, urine culture and senstivity is required according to which the antibiotic will be prescribed. Till the time the report comes give her good antipyertic  and some basic antibacterial like ciprofloxacin or ofloxacin . Tell her to increase her water intake along with Potassium Citrate (200ml) syrup. Hopefully it will resolve her problem",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for an infection in the eye\n\nHello Doc, My baby is 6 years old. She has infection in her eyes since birth. We checked have her eyes by the doctor. He recommend her spectacles. I want to know what is the reason and is there any home remedies which could help in reducing the power as well as curing the infection.",
    "doctor_response": "Hi Dear welcome to the HCM,Thin error of refraction is a natural little abrration in growth phenonmenon of the growing child,.This is not a disease. Requires only correction by the glasses.Hope the query is answered.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there continuous period bleeding in a 11-year-old?\n\nHello doctor, My daughter is 11 years old, height is 5'2\" and weight is 45 kg. She started her periods eight months back. It was normal till two months back. After which, she got her periods twice with a gap of 10 days and duration of 9 to 10 days. Same continued next month also. The next month we had been to a gynecologist and she has asked us to do a couple of tests and scan which came out normal. She has Iron, vitamin B12, serum ferritin and vitamin D deficiency so gave supplements for the same. Again we went to her around fifteen days later as bleeding was still continuing. She prescribed Trapic for three days and the bleeding stopped but is back again. Today we had gone to the doctor. She has prescribed Regestrone 5 mg thrice a day for a week twice a day and once a day for a week. Please advice. I am concerned about weight gain and other side effects.",
    "doctor_response": "Hello. I have gone through your history and understand your concern. As she is bleeding we have to give progesterone to stop it because in her age mostly cycles are anovulatory and deficiency of progesterone may cause bleeding. Do not worry much about weight gain.  For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cysts on the breasts?\n\nhi....i have some cysts on my breast, i had da surgery last year and my doctor removed many cysts but later i found some were still there...is there any way i can treat them myself? also please guide me regarding the use of fucidin H cream for the same purpose.",
    "doctor_response": "hi dear thanks for the query on HCMthese cysts are related to the age and hormonal changes.you need to visit the surgeonif your diagnosis is fibrocystic disease then need to get evaluated regularly. you can take vitamin E tablets daily and primrose oil daily which may give you temporary relief.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain in a child\n\nHello Doctor, My son is 3 years old, since morning he is complaining of abdominal pain, since morning he has emptied his stomach 3 times. His body temperature in the afternoon was 102 Degrees , we have given him 7ml Nimulide. Fever has come down but he is still crying with abdominal pain. Please suggest which medicine he should be given to get rid of stomach pain. Thanks in advance. Regards, Jay",
    "doctor_response": "Hi,Fever, abdominal pain and loose stools indicates acute gastro enteritis / food poisoning. Just give him ORS solution (around 10ml/kg after each stools in small sips), zinc supplementation, and paracetamol. Paracetamol will help fever as well as abdominal pain(if not, i used to give ibuprofen and atispasmodics like dicyclomine also). If fever is not coming down, very lethargic, not feeding well or the stool is blood stained, kindly take him to doctor as he may need antibiotics and fluid infusion. Meanwhile avoid sugary items, juices and fruits now as it can increase diarrhea.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam TK, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is epidural causing pain from my neck down to shoulder and left arm?\n\nhi, i had epidural during labor 5 weeks ago. ive been experiencing severe line of pain that starts from my left side of neck down to shoulder and left arm. i havent been able to use my left arm. just last night those pain along with a severe headache on the left. what is going on?",
    "doctor_response": "Hello, Possible causes like spinal headache symptoms will be a possible cause. Generally the symptoms will persist for eight to twelve weeks with conservative management. Drink plenty of water as hydration will help to improve symptoms. You can also take over the counter analgesics like paracetamol for symptomatic relief. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain, General & Family physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for premature heartbeat\n\nI have been having premature heartbeats for 3 years. I had an ekg, echo, and stress testabout 3 months ago with everything normal. for the last week i have been having 2 to 4 second skips between beats about 2 times a week. They seem longer but I never lose consciousness so im sure its the panic that makes them seem longer than they are. I scheduled an appointment with my cardiologist for 10 days from now but I'm wondering if this is just my panic getting the best of me. As I said all my test were normal.",
    "doctor_response": "I feel u need to under go holter test which will elaborate cardiology how much burden of PVC ..if u feeling much discomfort then can be kept on medication... so don't worry many treatment option available if much symptomatic ...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for schizophrenia\n\nIs there any treatment to cure scziphrenia? Where can I avail good treatment? At present I am using Risdone-2 mg but it is hiding the problem temporarily. Is there any method of meditation or hypnotism to remove the disease entirely? I am great need of help. Please advice.",
    "doctor_response": "DearWe understand your concerns.I went through your details. I suggest you to keep calm. Schizophrenia are of various types. Early detection and proper diagnosis and medication often provides good results in the management and cure. From your description, the details are not clear. There are no other scientific treatment methods to cure schizophrenia other than psychitry and psychology. Hypnotism is a strict NO. Hypnotherapy and Cognitive Behavior Therapy should be of help to you. Do work with your psychiatrist. Trust him.In case if you need more of my services in this regard, please post a direct query. I am happy to reply you.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain on right side gets intense, shaking and nauseous, radiating up right shoulder across mid back. What to do ?\n\nI\u2019ve had pain for 10 days in my right side getting more intense and frequent. I ended up in the ER yesterday bc the pain got to the point that I was shaking and nauseous. Immediately they suspected kidney stones and when it was ruled out from the bloodwork and CT scan, they sent me home with a prescription of painkillers and anti-nausea medicine and told me to FU with my Dr. So, here I am, still in the same pain, even with the pain medicine, which is now radiating up my right shoulder, and across my midback. What should I do?",
    "doctor_response": "Hi ! From your history, it seems like an inflammation of the biliary tract or pancreas along with or without a stone in the same, for which I am not aware if an ultrasound was done or not. Stones in the gall bladder/CBD are best detected by an ultrasound and may be missed in a CT scan. In your CT may be it was more concentrated on the kidney region. Pancreas pathology may be picked up by either an ultrasound or better with a CT if it was kept in mind. I would suggest you to discuss on this with your treating doctor, who may also advise you for some special blood tests like serum amylase, serum lipase, and liver function test. If you take alcoholic beverages, then this points more towards a hepato biliary and pancreatic problem. Wishing you an early recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in the abdomen and constipation\n\nmy 5 year old son is having stomach aches in the afternoon, from 4pm. He eats a good diet, and plenty of liquids. He ends on rolling around on his bed in agony. Been in hospital for 3 days, doc s have mentioned appendisitus but ruled that out. One doc mentioned Cealiac Disease but another doc said no, and we ve been sent home, saying it s mild conspipation, but I m not so sure, as he is pooing. Help?!",
    "doctor_response": "Hello,Celiac Disease is suspected when constipation is from long time with low weight and height for age.I need some answers like:1. Weight and height of baby?2. Duration of constipation?3. Location of pain abdomen?4. What investigation has done and what are their reports?I advise you to investigate the child with ultrasound abdomen, CBC, ESR, TTG.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sachin Kumar Agarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart palpitations with pricking sensation in arm?\n\nHi I have been suffering from heart palpitations and sometimes pins and needles in my left arm. It s def not anxiety but it is making me very tired! I do breathing exercises but it does not improve and often I wake up in the night very panicked. The only thing that has changed in my lifestyle is I had an.implannon implant removed and started the combined pill. Could this be the cause? Thanks",
    "doctor_response": "Hi dear ,Welcome to HCM,Understanding you concern. As per your query your wife have pain in left side ribs, finger tips and shoulder . Well the symptoms you mention in query are pointing towards a condition like angina . Such symptoms can also occur due to other reasons also like acid reflux and peripheral neuropathy .I would suggest you to consult cardiologist without any delay to rule out more serious condition, because it can lead to heart failure and rule out causes like stress and anxiety , muscle spasm and nerve dysfunction . Doctor may order certain test like ECG , troponin t , echo and examine with stethoscope . Doctor may prescribe treatment for restoring your ventricular rate. Beta blockers, like Atenolol, Carvedilol, Propranolol along with isosorbid nitrate . Calcium channel blockers, such as Dilitiazem and Verapamil . For now take proper rest and do not exert your body . Doctor may also refer you to orthopedic surgeon for muscle strain . Doctor may also refer you to endocrinologist for thyroid problem . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the palpitations be caused due to androgel?\n\nI m a 50 yr old 160 lb triathlete. Take lots of supplements incl 50 mg DHA & 100 pregnenolone. Still have low normal test. Been on 3 pumps (37.5 mg of test) Androgel 5 days for 5days . I m having lots of palpitations. Is this common with strong athletic hearts using gel ? Will it go away in week 2 or do we need a different approach? ,",
    "doctor_response": "HelloYes hormonal supplement can sometimes be the cause of your palpitations. If you stop using the supplements it will go away within 2 weeks but if you want to continue with the supplements then you need to consult with your doctor regarding these palpitations.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes underweight and slow development in child?\n\nThis is about my daughter who is 1-1/2 years old. For the past 3 months and even now she is suffering from constipation and was prescribed laxopeg outcome was too much diarrhea after tat she had tonsillitis and was prescribed taxim-o and enterogermina and for some time I am seeing changes in my daughter behavior she cries too loudly banging her head to me or arching her head backward and forward keeps on asking for biscuits, she neither burps after eating her food nor does gas and she is very slow in all her developments she is still not walking she is doing crawling and sitting and when she was born she was underweight. I want to know are these behaviors normal to a child or needs some special care. Her temperment is very extreme, which is very difficult to control. I am worried and would be grateful if you clarify my query",
    "doctor_response": "by 1 and half year a child should be able to walk alone or crawls upstairs or should be able to ask objects by pointing and should follow simple commands so with your history it can be global developmental delay(GDD) but before i label it GDD baby should have delay in 2 or more skills that includes language motor or social development. if your baby is truly GDD a proper diet is required with regular physical therapy, speech therapy and pediatric psychologist opinion with these i would like you to do routine investigation just to rule out any underlying disease",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a spot behind front teeth at roof of the mouth indicate?\n\nThere is a spot directly behind my two front teeth at the roof of my mouth that is sore and inflamed. This makes eating uncomfortable and sometimes painful. This happens every once in a long while. Just wondering if there is something I am doing to cause this to happen? Exactly what is happening?",
    "doctor_response": "Hello!Thank you for posting here.This can be a abscess opening you see as a spot.This is because of infection.A x-ray of the involved tooth area is necessary.Get clinical examination done with your dentist.Discomfort occurs when orifice is obstructed due to any reason.Take a metronidazole 400 mg thrice daily for 3 days.Use a warm saline gargle thrice daily.This antibiotic course will only reduce the infection.A treatment like curettage is absolutely necessary to completely eliminate infection and prevent recurrence.hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rash around nose and mouth after catching cold\n\nMy 5 year old has had a nasty viral cold flu for 3 days. Copious amount phlegm runny nose. Now has 5 or 6 pimply bumps around nose and mouth. I am trying to keep area clean and least amount of wiping . She has down syndrome and hard to get her to wipe or blow her nose. Is there anything I can put in this area. I ve been putting aquaphor",
    "doctor_response": "Hi,Thanks and welcome to healthcare magic.Downs' syndrome children have depressed bridge of the noseHence they are prone to recurrent cold.Because of continuous flow of nasal discharge and saliva they have rash and infection around the nose and mouth.Keep the area dry as far as possible .Application of oil or Vaseline may give relief .He may need antibiotic if infection supervenes .Hope this answer serves your purpose .Please feel free to ask further queries if any..Dr.M.V.Subrahmanyam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of bowel cancer?\n\nmy friend has been diagnosed with bowel cancer, and has had a colostomy bag fitted whilst waiting for results on the biopsy. Now her bowel has prolapsed, and is bulging into the bag. The hospital say nothing can be done unless it turns black - does this sound right ?",
    "doctor_response": "Prolapse is a common complication of colostomy. Normally, it doesnt lead to any problems except uneasiness. If it causes severe pain or turns black (called gangrene), then it needs to be corrected by doing another surgery. So, if there is not much pain and it is not black, then you should not worry about it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it to be concerned about the ear infection in child?\n\nGood Morning ~ I took my 8yr. old son to the doctor s yesterday for right ear pain. The Dr. prescribed Ofloxacin ear drops which I used two times yesterday. A few hrs. after the first time I used the drops, I noticed drainage. However, this morning the drainage is a blackishbrown color filling up the ear canal. He gets many ear infections and has had four sets of tubes. His allergies have been bothering him a lot this month, especially experiencing nasal congestion. The Dr. said she thought it was swimmer s ear because he had been swimming a lot this month and his ear also hurts when it is touched. I m wondering if I need to take him back in to the Dr.s to get an oral antibiotic, in addition to the ear drops I already started.",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns.As per your complain it seems that your son has ear infection leading to earache and the blackish brown discharge seems to be infectious fluid and as the fluid is drained out the infection will resolve faster..You should continue using the eardrop as advised and do not worry about the ear discharge..In case if the drainage continues and your son is not relieved even after 3 to 4 days you can consult your physician again and he can advise him antibiotics to be taken orally and anti-inflammatory painkiller like Ibuprofen to relieve pain and infection..In case if he is also experiencing nasal congestion saline nasal drops can be instilled for relief from congestion..As he swims, till the infection subside he should avoid swimming as moisture and bacteria can further exaggerate the infection and increase discomfort..Avoid picking the ears to prevent eardrum rupture..You should also prevent him from exposure to loud sounds as due to infection the eardrum might weaken and loud sound can lead to its perforation..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for nightfall\n\nhi sir i am ashish i suffering from nightfall from 2011 since now my age is 19 year and i have problem of nightfall is this natural for health or it is normal for our body or it does require any treatment because i worried about this from last 6 months",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn Short: It is normal and not a diseaseExplanation: If you donot masturbate/have sex/ejaculate by any means for many days, your body will try to replace old sperms with new one. SO, with slightest excitation or during sleep you may have ejaculation. So, it is completely normal and does not need any treatment.                 Be happy and enjoy. Hope this helps you. Do let me know.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it possible to get HIV when infected blood gets into the mouth?\n\nHello doctor, I went to a beach and I ordered for coconut water. Possibly when the coconut water was given there was a straw that the coconut vendor put in the coconut with his hands. On that day my lips were chapped or cracked. I drank the water by the straw. After that, I saw that the fingers of the coconut vendor were bruised and blood might have had been put on the straw by him accidentlly which might have had touched my chapped lips. If in case if the coconut vendor had HIV, could it be possible that the blood on the straw could have had touched my chapped lips and infected me?",
    "doctor_response": "Hi. Your risk of HIV (human immunodeficiency virus) acquisition is unwarranted in this case. HIV can only be transmitted by sexual contact, through the exchange of contaminated syringes or needles, blood transfusion or there can be vertical transmission from HIV infected mother to her child during pregnancy, delivery or through breast milk. HIV cannot survive outside the body or even in the old healed lesions or bruised sites.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white color for the scar with bump and pink center?\n\nhi I was hit in the shin bone by a board that was underneath a car tire about 4 months ago. We were trying to give the car traction and the board shot out and hit me in the shin bone area. It almost seemed like the board rubbed all of the hair off at the point of contact and it was really white and not bleeding at first, after a while it began to bleed and I put an ice pack on it. Now that a scar has formed it has a white color surrounding the scar and a pink center also if the scar gets bumped it sometimes takes a tiny chunk or layer of the scar out but it doesn't bleed. my question is should I be worried?",
    "doctor_response": "thanks for posting your query to HCM . If you are not having any discharge , pain  or swelling at your scar no need to be wirried , but if if you are having any of this contact your local surgeon or dermatologist  and investigated for any infection .there are chances of developig infection in damaged tissue so be carefulk and if you have any abnormal feature contact to health facility . thanks .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could small intestine bowel obstruction refer to gallbladder attack?\n\nHi Dr. XXXXXXX,      MY  QUESTION IS ; ' Ijust got out of the hospital because of small intestine bowel obstruction ,and when I arrived at the hospital via ambulance , the surgeon told me how lucky I was in  , you would have died had you not come in .I suspected that I was having a gallbladder attack so I did not rush to the hospital , it had gone on for too long . had I not call 911 would I had died that night  ?",
    "doctor_response": "Hi and thank you so much for trusting us with your health query.I am so sorry to hear about this small bowel obstruction.  They all present with abdominal pain. However, with small bowel obstruction you would have vomiting, absence of stools and the pains are often very severe. It may not be very clear to non professionals but it takes very little for a physician to make the difference. I am happy that you are alive. whether you would have died or not is something we cannot speculate. Though late arrival to the hospital could see complications significantly increased, it cannot conclude that you would have died.Please, always seek  medical attention when sick. It is better to rather than to forgo and face severe complications later.I hope you find this helpful. I wish you well. Thank you so much for using our services and please do feel free to ask for clarifications or more information if need be.Dr. Ditah, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest diet plans before a hernia surgery\n\nMy husband is having surgery for a double hernia tomorrow at 7:30 am. He has had one of the worst days of his life scrambling all day trying to accomplish integral computer tasks. It is now almost 9 pm and he is thinking about eating a slice or two of pizza at a friend's where they are completing the task. I told him he is nuts and not to do it. Can he have some broth or something instead? Pizza seems the worst thing to eat at this time.",
    "doctor_response": "welcome to Health care magic.1.You can eat any thing, 6-8 hours before not ho have any thing orally even water.2.This is to avoid vomiting and aspiration in to the lungs is possible complications.3.Comming to pizza/burger it all depends, its always better to avoid out size food.4.Let him have some salads and fruits.5.Avoid taking any thing 6-8 hrs before surgery.Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Social anxiety disorder,I need help\n\nOk well I am always really nervous no matter what i do. even talking to my closest friends i get nervous. when im in big groups of people i lock up and cant talk. at parties, in class i can never do anything because i am always so nervous. i read alot of things about social anxiety disorder and all the symptoms seem like its what i have. im 19 now, but when i was 16-17 i used to throw up while on my way to see my girlfriend and even on the phone with her. i cant meet people now because usually i just stay home since i get so worked up and worried about going out. and i cant use public bathrooms. i need help but im not really sure what to do",
    "doctor_response": "Happens when you use the computer/internet too much. Are you a gamer/nerd? Try limiting your time on the computer, go spend some time outdoors and just hanging out with your friends. The problem is you think they expect something from you, when they really don't. They just want to be your friend and have someone to talk to - even if you aren't that smart and are nervous of saying something stupid, that's fine just realize no one is perfect. I think I was like this too when I was younger. I played Runescape all day and felt nervous when talking to people cuz of those awkward silences where I didn't know what to say. After a few years of college and a better education, small talk comes more easily. Also, make sure you stay up to date with news and shit and you will have plenty to talk about. You just gotta get involved with something and do your best to enjoy it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes palpitations and irregular heartbeat?\n\nAs I check my pulse, I can tell my heart is skipping a beat intermittently while at rest.  There is no pain and I feel fine, but there has also been an occasional palpitation that seems to correspond with the missed beat.  I have not had a heart attack and I had a routine check-up with my internist yesterday.",
    "doctor_response": "Hello there. Thank you for choosing Healthcare magic . First of all I would like to ask you what is your age and sex. There can be many causes of palpitations like stress, thyroid disorders, fever, too much caffeine. Have you got an EKG done during your routine check up ? if not I would advice you to get it done to rule out any cardiac causes. Also a 24 hour holter monitoring to detect any irregular heartbeats. Get a thyroid profile done. Get a haemoglobin test done cause sometimes anemia may also lead to palpitations. I hope that answers your question. i f you ahve any other queries please feel free to write.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring UTI, yeast infections and white discharge?\n\nHi, may I answer your health queries right now ?  Please type your query here... I have had a partial and since then I have had many urinary tract infections and yeast infections and white discharge that is thick but no odor or pain or itching. What could it be Menopause?",
    "doctor_response": "HI, thanks for using healthcare magicMenopause and the associated change in hormone status can affect the risk of vaginal infections, would not normally be associated with increased urinary tract infections unless this is also linked to vaginal dryness.A swab of the discharge and a sample of urine should be sent to the lab to determine the exact pathogen.You may also need to be assessed to determine if there is anything affecting your immune system eg diabetes, infection , autoimmune diseasesI hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the pimple like bump on the foot of my daughter?\n\nMy 5 year old daughter was complaining that her foot hurt.  We looked at it and she has a pimple like (with white head) bump on the bottom of her foot.  It is almost like a white head, but it has a green color in the middle of the white head.  I'm guessing she may have gotten a splinter or something, but I'm not sure.",
    "doctor_response": "HelloThe Green or black part in the centre of white of an abscess is called punctum.The absess formation is mostly due to secondary infection following any cut injury.Putting the feet in hot saline water will help in softening and drainage of abscess.Apply antibiotic ointment like mupirocin after cleaning with betadine antiseptic solution.Oral antibiotic like amoxycillin will help in healing the lesion.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in the lungs\n\ni am 8 mo. 5 bypass cabg pt.. had a post op pneumothorax. still some aching in pneumo. area as well as incision area especially in cold weather. i have been in cardiac re hab no problems exercising. sometimes very tired mid afternoon. what should i typically expect this far post op..",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. What your experiencing (pain at pneumothorax area) is nothing but a pleuritic pain.Pneumothorax heal by pleural thickening. So pleural layers in that area loose their normal smooth structure and become adherent to each other. This is known as pleural thickening. So some degree of pain while coughing, sneezing, yawning is common after any pleural procedure. Best treatment is application of warm water pad on affected areas. You can take simple paracetamol also. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why the blood clots formed after knee surgery?\n\nAfter my daughter had knee surgey . The next day she found out she had four blood clots. In her calf .The doctor started treating them The following Day she woke with her foot and angle looking Like a grape fruit . That put nerve blockers in befor the surgy. Now she can t move her foot or angle. And the doctors say she may never Be able to. We don t under stand what went wrong.. .",
    "doctor_response": "Hello, The blood clots are formed after a knee surgery due to rest and inactivity. Regular exercise and physiotherapy will help in preventing any such happening. I hope this information has been helpful for you. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can any online doctor help me with my sperm analysis report?\n\nMy husband was on Paternia, Carnisure and Evion for 3 months. His ealier Semen Analysis showed 20 Million, 10 Million and 65 million with an average of 30-40% motility in all the reports. Before our first IUI, the latest SA showed 5 Million. It it possible for the count to decrease so abruptly. Now he has been asked to continue Paternia, Carnisure, Evion, with an addition of Tamoxifen. Will his count increase.",
    "doctor_response": "HelloThanks for query .There are always variations in sperm count which depends upon the factors like time of collection of sperms ,period of abstinence before test etc .To be true there is very little role for medicines to increase sperm count.However following measure will help to increase sperm count to some extent .1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning.2) Take high protein diet rich in vegetables and fruits and Vitamin A,C,D,E.and Zinc3)Take anti oxidants like Almonds 5-6 everyday..4) Avoid alcohol and smoking.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does increase in dosage cause dizziness and rise in blood pressure?\n\nim on metoprolol for blood pressure and pac. I increased my dose from 50 mg twice per day to 75 mg twice per day last night. I noticed this morning a couple of hours after my dose that I started to feel alittle dizzy and nauseous also a little nerveous. I checked my blood pressure and it was high 150 over 106. Its never that high. didn t know if it could be from the nervousness or what.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Increase in dose of antihypertensive can cause dizziness initially.  Your high blood pressure may be due to your anxiety and nervousness. So you consult your physician and check the blood pressure again. Also set the dose of antihypertensive accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do irregular heart beat and left-sided pain need medical attention?\n\nI ve been having irregular heart beats many times a day for about 4 days now... and tonight, a little left-side pain (arm, shoulder, chest) .... my BP seems okay, I think(?) .... 4 hrs ago it was 120/61 and heart rate was 72bpm ..... a few minutes ago, my BP was 112/69 and heart rate was 59bpm .... just wondering if I should be concerned.",
    "doctor_response": "Hello,    What's your age, any other risk factors for heart diseases like smoking, family history etc. From the mentioned symptoms doesn't look like the need to be concerned, but should be evaluated.    You should get one ecg done so as to find out the cause of irregular heart beats. Usually, it occurs due to extra beats which can occur due to smoking, stress, heart diseases, thyroid problems etc. So before going ahead we should have ecg.    Hope this helps you and get back if you have more information to share.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for overactive bladder and mood swings in a child\n\nMy nine year old who does have an overactive bladder seems to be wetting even more than usual , is thirsty and hungry all the time and sleeps a lot more . Has had urine checked so know its not diabetes . Also has become a lot more moody and upset about wetting .",
    "doctor_response": "Hi,Thanks and welcome to healthcare magic.Normally babies are dry at night by 3-4 years.But sometimes children will not become dry upto 12-14 years and even more.This is known as nocturnal enuresis .Restricting fluids after 6-7 PM, insisting them to empty bladder before going to bed will lessen the problem.parents should wake them up once or twice to pass urine.Do not criticise your child before others about his problem, rather appreciate him if he is dry sometimes.Imipramine 25 mg daily at bed time will help in getting over this problem.Hope this answer serves your purpose.Please feel free to ask further queries if any .Dr.M.V.Subrahmanyam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is GERD related with flu, dry cough and lumps on neck?\n\nHi, I have been getting flu like symptoms every month and dry cough. I have been seeing my throat doctor and complaining my right side that I feel a little ball moving on my right side of neck...i only feel it either when i bend over over the way i move my neck side to side or sometimes when i move my tongue. And still the doctor can t find anything. Any suggestions? it s been going on for almost 2 years....they think it s from my gerd....but i m scared it might be from a lump and they can t detect it",
    "doctor_response": "Hi.Understood your history and the concerns about the swelling in the neck that your Doctor could not find. The best solution in such a situation is to get ultrasonography done to get the lump and if present get FNAC done to get the diagnosis of why it is there.Secondly, the recurrent flu like symptoms indicate that your immunity system needs strengthening by taking multivitamins and having proper diet and do exercises. GERD needs upper GI Endoscopy to get a proper diagnosis as well as an opinion and treatment by a Gastroenterologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a Cyst removal in the past lead to cancer or tumor?\n\nHi im Edwin and im suffering pain right where i took cyst removal 6 years ago....it feels like a tearing pain and burning like sensation and is very painful that i have to stop when im walking.....please help me...i just want to know if this could lead to cancer or tumor later....but there was no mass or lump in that area since my cyst was removed.....its just a pain right where my cyst was removed 6 years ago....thanks.",
    "doctor_response": "hi, it all depends on which kind of cyst was removed. is ti purely benign or potentially malignant, whether removed completely or some part may left. takin in to all this matter in account one can say it will leads to tumour or not. however if you dont feel any lump or mass in that area means there is no tumour. your pain may be due to some other reasons. so consult your doctor and take treatment accordingly.thanks for using health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is refractory edema and causes ?\n\nwhat are the causes of refractory edema?",
    "doctor_response": "Generalized edema can occur in a variety of disorders, including heart failure, cirrhosis, the nephrotic syndrome, and renal failure; when massive, the excess fluid accumulation is called anasarca. These patients generally respond to the combination of dietary sodium restriction and diuretic therapy, usually with a loop diuretic. Some patients, however, are resistant to this regimen.In that case its called Refractory Edema.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump in the throat along with severe cough?\n\nHusband \"choked\" on water last night . Very forceful coughing for about 20 min... today feels like \"lump\" in throat, no chest pain. Says doesn't feel \"good\" but acting normal and breathing normal. Worries about dry drowning (?) hasn't been 24 hrs yet and is coughing intermittently",
    "doctor_response": "Respected user , Hi Thanks for using Healthcaremagic.comI have evaluated your query thoroughly .*  This seems more likely in relation with adenoid enlargement or tonsillitis. Thanks .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hypertension\n\nI have been on 5 mg. of ramipril for two months for hypertension that occurs primarily in early morning and lessens by early afternoon . Recently my blood pressure is higher taking ramipril than without and have been experiencing side effects such as neck, upper back pain and headaches for 3 days. I discontinued taking and still have early morning hypertension ( 150/95 pressure) lowering to 123/75 by afternoon which is much better than when on ramipril. I have appointment to see my primary physician but would like an additional opinion. I exercise regularly and feel ok most of the time. I avoid all alchohol now and hope this is helping ( I was consuming 2-3 glasses of wine daily. Thanks for your input.",
    "doctor_response": "please decrease your wine intake and cut short your salty fried foods ..amd go for morning or evening walk ..for hypertension please take ramipril 2.5 mg once a day",
    "dialogue_context": ""
  },
  {
    "patient_message": "hello, I live in a small town that is mostly a farming community. I started off with a lumpectomy in July of 2012, days later I developed mondors disease then months later I had a hysterectomy do to a 2 pound mass that caused pain and abnormal bleeding. My periods would last up to 2 weeks. Needless to say I had aniemia. A doctor from San Diego, cancer specialist stated I should be checked for lymphoma. I recently had a polyp removed shortly after my hysterectomy. anyway the reports stated that it was bening, which sounds wonderful! but I don t feel like myself. I feel that the doctors may have missed something but I don t know where to start! My body is screaming at me to get help, my lymphnodes get swollen on my L side. I feel so drained of energy. I used to work out for hours and work. Now I cant shower without getting tiered. there are more details and I keep copies of all my lab results and biopsy reports. but they confuse me. What is a tumor marker result mean or CA 125? pls help me",
    "doctor_response": "ca 125 raised means that any disease involving ovary. it is raised in ovarian carcinoma, or in non cancerous conditions such as pelvic inflammatory disease, ovarian cyst or any other infections. please get YOUR Hb checked up, as u r telling that u r so much tired. I think you may be having non cancerous condition causing all the symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain?\n\nI am 26yrs unmarried female.I am suffering from back pain since last month.I did X-ray of chest and sonography of entire abdomen since i had history of TB 1.5 yr back.Reports are all normal.what could be the reason for back pain?Day time its bareable but in night i cant sleep peacefully?is it because of constipation?please reaply..",
    "doctor_response": "Hello, I have studied your case.Gyaenacological reasons may also lead to back pain but first you need to correct structural problems if they are present.When such patient comes to my hospital we usually take x ray spine or if required MRI to see for any nerve compression.Medication like methylcobalamine and analgesic will reduce pain; you can take them consulting your treating doctor.Some exercises which can be done after pain has reduced include- Spine extension exercises, lying on your stomach flat lift leg 6 inches from ground, do it for other leg.Now lift both hand and leg simultaneously, 6 inch off the ground and stayPosition for around 10 breathes. Core stabilizing spine exercises will help.You may consult physiotherapist for further guidance. He may start TENS, or ultrasound which is helpful in your case.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you find this answer helpful do not hesitate to rate this answer at end of discussion.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on the inside of the calf?\n\nI have a lump on the inside of my calf of my left leg. It started being small and has grown. I have had this for several years and no one gives me any certain answer. It has probably grown to four times the original size and is very sensitive to any kind of pressure. I recently had a deep vein thrombosis test and some sort of blood flow test and they were normal. What could this be and what can I do to help with the sensitivity. I also have a problem with swelling with this leg.",
    "doctor_response": "Swelling in the calf for years without causing any symptoms like pain or ulceration,mostly likely to be a lipoma or benign soft tissue tumor.. A type of lipoma called neurolipoma can very painful when you touch...it's difficult to say what is it without seeing.. I advice you to get a aspiration test done from the swelling.. In medical term we call it FNAC.. If the swelling is not clearly visible go for an MRI of calf.. Hope I have answered your doubts..have a good day",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in groin and in waist line in a masturbation addict?\n\ni have a masturbation addiction, i also had a smoking adddiction, but i quit smoking around 2 weeks ago. 2 days after i quit smoking i started masturbating a lot. i masturbated 57 times this week. 57th time was around 3 hours ago, and right now i m having urges to masturbate again. i have this slight pain right above my groin and below my waist line like somewhere in the middle. this pain has got me worried. and i m scared if somehow i manage to bring my masturbation number down, i might start smoking again and i dont want that. please help me overcome both of these problems. thankyou! -Abdullah",
    "doctor_response": "Dear, We understand your concernsI went through your details. Excess masturbation always is energy consuming and therefore many areas of your body starts showing the symptoms of lethargy and fluid loss. Among the first symptoms of fluid loss is muscular pain. You should stop masturbation for the time being, for a week. After that reduce your masturbation frequency to three times a week. To stop smoking, you should consult a de-addiction therapist. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which doctor should I consult for stomach pain in front of ribs ?\n\nI have dull ache on the left side of stomach, just in front of ribs in the stomach. Its at one point only and has been more or less persistently for last 4 years. Of late (2 months) i have also developed severe acidity with burning sensation if i eat ANYTHING even VERY MILDLY spicy and have to continue to drink water to eat. IS it serious and if yes, what specialist should i consult?",
    "doctor_response": "Hi, Welcome to HCM. You could be having stomach ulcer. You need to get a gastro-duodenoscopy done to examine the inside of your stomach and duodenum and if an ulcer is found they will do a biopsy from that site for histo-pathological examination. In addition an ultrasound examination is also advisable. The condition may or may not be serious, depending on the finding. You should not ignore it. Consult a Gastroenterologist. Wish you all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for reddish bump on glans, upwards enlarging meatus?\n\nreddish bump on top of glans. actually have had it for 25 years but more obvious now. noticed it after having sex with a girl that seemed to have a bump on uppermost part of vagina ...maybe friction caused it. Also have another issue, meatus has been enlarging upwards, its now twice as long as 40 years, dermatologist advised me it was stretching....",
    "doctor_response": "Hi, welcome to Health care magic forum.                            Previously it might be the grouth, and now probably it got infected, and there is possibility of growing more.                            I advise you to consult a dermatologist for diagnosis and treatment.                           The meatus, you have observed now only, it would have stretched long before slowly to this size, and you need not worry about it.                            Take more of green leafy vegetables, pulses, sprouts, and protein rich foods to maintain a good health.                           Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can I do to heal a canker sore on my lip?\n\nHi doctor, I have had a canker sore on the inside of my bottom lip for a couple of months now. It is not really painful, but every time it starts to heal it gets irritated by my teeth, or I bite my lip and it prevents it from healing. What can I do to help the healing process?",
    "doctor_response": "Hi. I have gone through your question. I can understand your concern. Two months of aphthous ulcer in the mouth that too without a pain is not a good thing. You need to upload certain pictures of your sore so that any dangerous lesion can be ruled out today. Also, if your ulcer is associated with any swelling below your chin. Is this ulcer hard or soft in consistency and what kind of color, is it raised or not? Though as per your history the ulcer or sore looks like a traumatic ulcer but to rule out any unusual thing it needs to be evaluated properly. You can use Kenacort 0.1 % (Triamcinolone Acetonide) two to three times daily, it will help you to reduce inflammation. Also, take Vitamin C supplements one tablet daily for a month.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My mother has IBS-Diarhea\n\nMy mother spends most of her time in the bathroom, has stomach aches , and gas. She has consulted over 25 doctors and none were able to help her. Until recently a psycologist was able to diagnose her with IBS Diarhea. What medication can she take to treat the problem.(Is allergic to soya and milk) Thank you for your time.",
    "doctor_response": "Hi, Welcome to Healthcare magic. You have not mentioned how old she is and about the tests that have been done. There is no specific test to diagnose IBS-D. Before attributing the symptoms to IBS-D, other conditions causing these symptoms like infection, malabsorption, medical conditions should be ruled out. A complete blood count, stool test, blood glucose test, upper GI endoscopy with duodenal biopsy, colonoscopy should be done. if it is IBS -D, then probiotics, antispasmodics and antidepressants may be given.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sperm leakage during night\n\nhi i m 27 year old and i often leak sperm in night while sleeping.. and with less erections.. it happens when i wake in early morning and my penis is with less erection and to touch my metres on bed and sperm comes with in seconds.. and it seems also now i m lack of libido... and now i going very week day by day.... i m worry abt my sex life... plsssssss help plsss",
    "doctor_response": "Hello, Sperm leakage while sleeping or night fall or nocturnal ejaculation is a normal occurrence in human body and is natural and you cannot control it upto an extent. Having sex or engaging in masturbation can in some way reduce the nocturnal emission. Therefore I suggest consulting a skin specialist for physical examination, diagnosis and treatment. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. K. V. Anand",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cough with straining sound, worsened causing wheezing, eased with nebulizer. Which specialist should I consult?\n\ncough during last two months, not frequent but with a straining sound, after visit to a hill station(yercaud) the condition worsened, yesterday i had wheezing for the first time in life at 12:30 in the night, it slowly developed from the morning, i used vapor inhaler with eucalyptus twice during the day, but by evening condition slowly worsened. Neighbour gave me a combihale nebulizer to inhale ( Formoterol Fumarate and Budesonide Metered Dose Inhaler). I had no option but to use it once during the night, for the first time, breathing got easier. Now, again in the morning, i felt uneasy even speaking, so took another inhale from the nebulizer. Which kind of doctor am i supposed to consult. Please advice.",
    "doctor_response": "Hello dear... Wheezing is caused due to broncho-constriction (obstruction of smaller airway passages) which is indicative of Hyper-responsiveness of air passages (seasonal allergy or asthma). Formoterol will provide symptomatic relief by causing broncho-dilation (dilating the smaller airway passages, relieving the obstruction & increasing airflow to lungs) Budesonide is a corticosteroid which takes care of the inflammatory process in airways. Other than that, Montelukast preparation can also be used as a maintenance therapy to relieve symptoms of seasonal allergies & asthma by reducing broncho-constriction. So..it will be better to consult a Pulmonologist for further management. And make sure that you are well protected from cold, dust & other allergens. Wishing you a good health. Thanks & take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have uncontrollable watery diarrhea and so cannot visit my GP. Please help.\n\nHello doctor, I am a 52 year old female. I am 5 feet 9 inches tall and weigh 11 stones exactly. For the past five weeks, I have had uncontrollable watery diarrhea, no blood. Not much pain. I am type 2 diabetic. I am beginning to feel very weak and tired now. At night especially, I find I have been fecally incontinent on waking. I cannot visit my GP as the diarrhea is unrelenting and happens unexpectedly. Please help if you can. Many thanks.",
    "doctor_response": "Hello. Most of the times, diarrhea is due to a viral infection. Maintaining hydration is very important and you can take ORS (oral rehydration salts) or coconut water or clear soups.  Also, check your blood sugar if you have a home glucose monitor.  A visit to your physician is recommended as soon as possible. For more information consult a general practitioner online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to be done for disc annular bulge at l5-s1 with posterior central protrusion?\n\nwhat sould be done if the patient have disc annular buldge at l5-s1 with posterior central protrusion .i started with physiotherapy for the same one and got relief too but now have the pain inthe lateral side of the thigh at right side ...tell me what precautions i should take to get rid of this .",
    "doctor_response": "Hello, As you have a disc protrusion, I will advise focussing on exercise which helps to stabilize the spinal column and strengthen the muscles of the abdomen, hip, spine and thighs. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes radiating pain from my jaw down to throat?\n\ni am 40 years old and im a woman i have hart burth defect of a hole in hart it was repard at age 25 i have been having really bad pain in my thriut in the frount of my throut and the pain is in my right jaw line im scared it cimes and goes but when i start to feel it its very painfil could i be having a hart atack or what could this mean i do have acid problems but this is alot different",
    "doctor_response": "Hello,I can understand your concern. The pain in left jaw may be referred pain because of problem in heart. You are having pain in the right jaw which seems unrelated to the heart problem you had in the past. The pain you are suffering from may be related to the throat or jaw. If you are having pain while swallowing, then pain may be throat related and you should consult an ENT specialist. Alternatively, you might be having tooth infection or infection in the oral cavity which may cause swollen lymph node under jaw and jaw pain. It could also be a muscular pain. To reach a specific diagnosis, you should see a dentist for physical examination of the oral cavity and treatment of the cause.By the time you visit a doctor, you can take Ibuprofen 400 mg or Ketorolac DT 10 mg up to three times a day. Please do not do heat application to the area or salt water gargles as if it is related with infection, it may worsen.I hope this information helps you. Thank you for choosing HealthcareMagic. I wish you feel better soon.Best,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the white hard knot in my gum?\n\nOk hello i have a question, my lower front tooth is fine no cavities, so why wud i have swelling behind it,and in the front of the lower tooth on the gum its a hard white knot so wat could this be please?? Oh and now instead of throbbing pain its went numb cant feel that tooth.Thank u",
    "doctor_response": "Hello,You may have a periodontal problem causing an infection. Front teeth are subject to trauma and can abscess without decay present. Have you have a recent dental exam to know that there is not any decay present? Do you have tartar buildup and need a dental cleaning? A growth or tumor is a possibility. I suggest you have a clinical exam with an X-ray to find out an accurate diagnosis. Do your best to Keep up with daily dental care and rinse the area. Any abrupt change especially with numbness raises a greater concern. I am glad to answer more questions with additional details.Thank you for your inquiry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reddish splotches all over the body with shortness of breath. Allergy?\n\nMy boyfriend has red splotches all over his entire body. Everywhere . His face, arm pits, eyelids, whole entire back, his legs, arms , and hands. And he says he s very warm , like hot actually , and he has shortness of breath. This is the 3rd time weve noticed this. And it s every time we come home from a bar .. But it s gone in the morning . Why does this happen ?? Thank u ;)",
    "doctor_response": "get TLC, DLC, routine blood test, BT,CT PT test..x-ray chest, blood sugar..and tell me the report..ultrasound per abdomen..",
    "dialogue_context": ""
  },
  {
    "patient_message": "in early sixties, constant feeling of incomplete sleep even after sufficient rest, frequent twitching throughout the body, stuttering and jaw locking on speaking. Cause?\n\nI am almost 60, female. I never get enough sleep. I can go on sleeping until I force myself to get up. I have various twitches through out my body which can include fingers, hand , knee , foot , leg, etc. They are quick twitches but they are getting to be more often. I often have trouble speaking to people, which includes stuttering and my jaw locking up before I can say what I am thinking. Until this past year, I have never had a problem speaking to anyone. It is a major part of my job. Does this sound like the beginning of any specific ailment or just getting older?",
    "doctor_response": "Hi, thank you for the query. Based on your age, your symptom profile; what you are describing as twitches might infact turn out to be myoclonic jerks which are involuntary contractions of group of muscles. They can occur at any time but are most common just prior to falling asleep. Other symptoms like speaking difficulties, locked jaw along with these myoclonic jerks are pointers towards a disease known as Creutzfeldt\u2013Jakob disease (CJD). This is a degenerative disease. Definitive diagnosis shall require EEG, MRI brain coupled with detailed history & physical examination. At this point, I would urge you to consult your Neurologist as soon as possible & get a definitive answer. Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for mid-back itch which sometimes become a spasm?\n\nI need tto check my padt lab records. Today I was told that i have an elevAtd AST-268. i am 55 yearold female with fatigue and hair loss siance last December. Hair is growing bqck now, but fatigue remains. Past lab record last year indicated abnormal platelet count. I use rogaine once about every pther day and was started on 5 mg cholesterol in May. Cholesterol has always been high but i was off the drug for two years because i was conceerned regarding the side efcts pf statins. Another stranger symptom...mid-back itch which sometimes becomes a spasm and sometmes feels. like electrical shocks.",
    "doctor_response": "Hello, As a first line management you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persists better to consult an orthopaedician and plan for an MRI scan. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is large lymph node in abdomen sign of TB or sarcoidesis?\n\nthese days i am underinvestigation of my chronical jaundic problem my doctor has priscribed lot of blod test and MRCP,CTC chest,biopsi of liver,two days before he send me near chest phisican for his openion because in my CE CT Chest report limph nod is large and it is large in my abdomen .My doctor wants his opinion in taking decision to dignocis my decisise between tuberclosis and sarcoidesis.so please help me .",
    "doctor_response": "hello there you need a bronchoscopy biopsy of the lymph node to decipher the lesion.. hope we can come to some conclusion then ..",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of bruised blood around my entire eye?\n\nI fell and hit my brow bone on concrete on Friday, May 9, it swelled instantly. I did not lose consciousness or memory nor did I have dizziness, nausea. I did and do get slight headaches every now and again and I have bruised blood around my entire eye. Do I need to get a CT scan?",
    "doctor_response": "Hello thank you for writing us here. Bruises are common around eyes because of trauma on forehead. It would go slowly within a couple of weeks and the skin would become lighter. You can massage it with oil or wash your eyes with cold water so it would heal quickly. Also make sure you don't hit yourself again as it would take time to heal and recover the normal colour around your eyes.Best regards,Dr Gunjan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is swelling on buttocks area post injury a serious cause for concern?\n\nI fell down my basement step. Went up and then down and landed on the edge of steps. I struck both elbow and my buttocks/ hip. I have a genetic blood clotting disorder. MMTH. This happened 4 days ago it is still swollen but no discoloration yet. How long before I need to see my doctor about any possible complications. I have had previous DVT and several strokes.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.No, you should immediately contact your doctor.As you have previous history of the DVT and stroke. This time also it is like that thrombus has formed in the vessels which can release to cause the stroke.If you visit the doctor and start taking the treatment of anticoagulant immediately than you are free from the complication before it can occur.Please start mild exercise as it can improve the circulation and prevents the clot formation.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pus filled bug bite on the head. Not getting cured. Need to get checked?\n\nMy husband has what we thought was a bug bite on his head. We put some drawing ointment on it on friday and attempted to lance it the fallowing night. Very little pus came out. Its been 3 days now and it still hasnt gotten any smaller, and it has not come to any kind of a head. should we be concerned and go to the hospital or should we wait a few more days and see what happens. We have no insurance so we are trying to avoid the hospital untill we absolutly have to.",
    "doctor_response": "hi, Thanks for your query Looks like your husband has developed folliculitis ( pyoderma)over you scalp.. Folliculitis is the inflammation of one or more hair follicles. The condition may occur anywhere on the skin with the exception of the palms of the hands and soles of the feet. They may appear as red dots firstly and then increase in size to become red , hot, tender pus filled lesions... Avoid touching it too much. Avoid using any kind of cold dreams or hair oils..as it might increase the lesion. You can start using any topical antibiotic/antiseptic cream(like mupirocin cream) over the lesion and see if it persists even after using the cream for 2-3 days, then you need to consult a skin specialist as lesions on the scalp are very painful and also they tend to increase in size very quickly...Take some pain killers along for relieving the associated pain and discomfort Hope it helps Dr Geetika Paul",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the hard raised unmovable area below my clavicle?\n\nHello,I noticed a hard raised unmovable area about the size of a quarter on my right side of my chest just below my clavicle.I later noticed that I have a hard raised area on my right clavicle bone.In fact that is what it feels like,bone.These areas are painless.I'm a little worried. Thank You.",
    "doctor_response": "Hi,Thanks for your question.I want to know presence of any symptoms like-- Cough, cold, breathing difficulty.- Fever.- Weight loss.- Decreased apatite.- Habits like smoking.There may be possibility of swelling arising from supraclavicular lymph-node or rarely from ribs (it is unlikely).I would like to advise you to consult your doctor for detailed clinical examiantion.Following investigations may be advisable to confirm diagnosis and appropriate treatment.- Complete blood count.- ESR, CRP.- Chest xray.- Ultrasound of local area and abdomen and pelvis.- CT scan of chest.- Liver and Renal function test.Hope this helps you, is so do vote as helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which milk is best for infant other than breast milk?\n\nim analyn fom philippines i have a baby he is 1year and 3 months wiyh g6pd.,since i was born him im giving breastfeed.,what are the common milk should im going to give him.,that i can afford.and now i like to going to stop yto breadtfeef bec.im pregnant",
    "doctor_response": "Hi,Thank you for asking question on health care magic,Exclusive breast feeding is sufficient upto 6 months of age.Afterwards BF alone will not serve the purpose.You may give animal milk like cow or bufelow milk or any formula milk like lactogen-2.At this age child can take solid foods like rice, chapathi, dal and vegetabes. fruits like adults except spices and chillies.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from chest pain, feel like bruise with back hurt. X-ray normal and UPT negative. Suggestion?<br><br>\n\nfor the last four days i have been having chest pains. the type of pain that just feels like a bad bruise on the inside and eventually makes my upper back hurt. i feel weak and shakier than usual. my nose started bleeding monday night and then again tuesday morning. i have been throwing up after i eat since saturday night. and my stomach feels fine until then. i went to the er and they took chest xrays and did a pregnancy test which as negative. the xrays showed no concern so i really dont know whats going on.",
    "doctor_response": "Hello there, Thanks for posting on HCM, From your description you are having a chest pain that is probably due to peptic ulcer diseases (PUD) or gastrooesophageal reflux diseases (GERD) or acute gastritis or acute oesophagitis. If you would have precised the exact location of the pain or where it pains most ( like the pain is retrosternal) it will orient us better into determining the origin of the pain. If the pain is more on the ribs, then it might be acute costochondritis or angina pectoris. Normally before performing an X-ray, doctor had to examine you physically and locate the area where the pain is most intense either by properly interviewing you and/or examining you before requesting for X-rays or laboratory tests, as this would have oriented the exams asked. I suggest you still get back to the hospital and get examined properly. As if any of the above mentioned conditions are responsible appropriate treatment will be required. If acute PUD or GERD or Gastritis then proton pump inhibitors such as omeprazole or h2 inhibitors such as ranidine and/or associated to antacids to treat the affection will be required. Running a test to determine the presence of H. pylori will also be important to determine infectious cause of the gastritis. Hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe anxiety, rib area feels tight, nervy pain. What should i do?\n\nI suffer from severe anxiety. I wake though night with tingling pain from feet which goes to my bladder lower bowel & travels to my rib area, goes after a few minutes, but I think it has affected my bowel ( can t do healthy stools ) bladder feels bad, full sometimes, rib area feels tight, nervy pain. This is a vicious circle my symptoms make me more anxious. my Dr says I have IBS . & their are no tests for the symptoms I have, I am very depressed.",
    "doctor_response": "Hello Welcome to Health Care Magic Usually IBS or irritable bowel syndrome occurs in a person in situations of stress and anxiety. Anxiety increases the symptoms of IBS and IBS increases anxiety. So a vicious cycle results in deterioration of health. There are no specific tests that can detect IBS with confirmation. All major tests of stomach and bowels come normal. You should visit a psychiatrist for expert opinion. There are various medicines which can be used in anxiety and IBS. Medicines like SSRI as Paroxetine, sertaline are very useful in IBS with anxiety. A specific medicine Librax which contains clinidium and chlordiazepoxide is very effective in controlling bowel symptoms in IBS. In some patients stool softeners are also used to relieve constipation. As you are in pain, have thightness in rib cage, I will advise you to visit a Psychiatrist. thanks Dr. Seikhoo Bishnoi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having allergy problems, difficulty in swallowing, runny nose, cold sweats. How to overcome this?\n\nHello,I have been having allergy problems or infection problems for a while. I cant swallow without my throat feeling like it has a ball in it. My nose is constantly stuffy or running. My eyes just recently started to hurt more and I have been having cold sweats. I can see bubble like stuff in my throat. Usually I've never had these problems. Its been going on for 3 months, feels like it's never going away.",
    "doctor_response": "Hi,   You seem to have allergic cold to start with which has progressed to tosillitis with 2ndry infection.    - First of all try to avoid food you are allergic to, fried/spicy,sour food articles, exposure to cold/smoke/smoking etc Iinhailing steam regularly &  hot saline water gargles would help.    - You will need a range if investigations with blood work,throat swab testing to know the depth the problem has gone.    - this should be followed by a course of antibiotics, ant inflammatory drugs along with anti allergic agents , tonics to raise your immunity,& any other treatment needed.   - Take a guidance of an ENT specialist for proper assessment/managment of the problem.    Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to deal with hair loss?\n\nDear sir, I am Munish Sharma resindent of Ludhiana working in a marketing Job for TATA my concern is about my hairloss, i had lost my hair by almost half in recent four years. What to do? Also is there any relation of smoking with hairloss? (not a chain smoker but usually take 2-3 a day)",
    "doctor_response": "Hi, As per your query you have symptoms of hair loss which seems to be due to fungal infection, hair follicle infection leading to folliculitis, side effects of any medications or allergies to certain shampoos or hair cosmetics. Need not to worry. I would suggest you consult a Trichologist and get evaluated and he can advise you treatments depending upon the exact cause of the problem. In case of fungal infection, antifungal shampoos along with steroid lotion massage can relieve. In the case of Folliculitis or Impetigo, antibiotic ointments and oral antibiotics can be advised. Maintain cleanliness of scalp. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Harry Maheshwari, Dentist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes twitching on knee?\n\nAbove my right knee (outer area) won t stop twitching. Especially when im still for a few seconds, the twitching gets really fast. It did this yesterday but only a few time. Now it wht stop unless I stand up and apply constant pressure on my leg or am constantly moving. What do I do?",
    "doctor_response": "Hi,Thanks  for  your query.It seems that you have muscle twitches or fasciculations over knee. These are small, local, involuntary muscle contraction and relaxation visible under the skin arising from the spontaneous discharge of a bundle of skeletal muscle fibers. You might consult your doctor who can order 1. a few blood tests including thyroid function tests, 2. Serum electrolytes including Serum calcium and potassium levels. 3. Serum B12 levels In case the above tests are normal further testing can be done including - nerveconduction studies, Electromyography, etc. These tests might help to diagnose any underlying neurological issues. I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for palpitations or skipped beats with history of heart transplant?\n\nI had a heart transplant 9/20/2005. I am now experiencing the same problems I had w/my own heart which led to the transplant . . . heart palpitations or skipped beats, whatever you want to call it. Do I need to get in touche w/the transplant ctr immediately? This has been happening for several weeks. Also fatigue.",
    "doctor_response": "Hi welcome to hcmI understand your query and concern.Your symptoms are suggestive of Ongoing Myocardial ischemia. I advise you to get an ECG 2D Echo,lipid profile,he CRP,Troponin I.I also advise you to stress echo done and chest x ray immediately.Also monitor your blood pressure and heart rate.Take drugs like clopilet,Ecosprin,lipid lowering drugs,pantop immediately. Avoid smoking and alcohol.Also take drugs like clonazepam by consulting your doctor.Also take fruits like apple,pomegranate.Take salt restricted high protein diet.Coronary angiogram with or without stenting is the treatment of choice.Exercise regularly for 30 min.Also Meditation,yoga,breathing exercises will help.Consult your cardiologist for expert management.Post your further queries if any,Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can a flu shot be given to 3-year-old kid as a preventive act from coronavirus?\n\nHello doctor, I am asking question on behalf of my niece. My niece is 2.8 years old. Considering the present situation regarding corona virus, can we give a flu shot to her irrespective from her normal vaccination schedule. Also, I want to ask you for a suggestion regarding a travel to do and also meeting a person who came from US. One of her aunt came from US recently, so my sister and my niece were actually planned to meet her but we came to know that she got fever and vomting after she came to India but she told that she is doing fine now but we were in dilemma to send my sister and niece to her in this little confusion kind of period where we do not know what decision to make. So please suggest which you feel good option.",
    "doctor_response": "Hello  I understand your concern. Yes, definitely you should give a shot of flu vaccine which will protect from getting infected. It gives protection for a year. Regarding meeting someone having a fever with international travel history, my opinion is you should avoid the meeting and wait at least 2 weeks till no fever and other symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does it mean to have iliac crest rotated forward?\n\nLets say if the right iliac crest is rotated forward and the left side is either in normal or rotated toward back, would the top of the right iliac crest bone be higher than the left one when standing up - leading to uneven leg length and if so, which side would be the shorter leg side? Thanks Doc.",
    "doctor_response": "hi,thanks for the brief history. as you are mentioning about the hiking of pelvic bone on one side. Well you need get a spine x-ray done to assess the scoliosis present. as due to shortening of muscles on one side the other side make get affected too. only getting some exercise can help you get the limb length equality and hiking of pelvic can also be reduced.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Hydrocortisone cream be used for burning red rash under armpit?\n\nI have developed a red rash under only one armpit that has a clear, a little bit yellowish discharge.  I think it might have been caused by a underarm deodorant, only that one under arm is affected.  It does not itch, but it burns a little.  This being Saturday, I cannot get a hold of my doctor or Dermatologist.Should I use a Hydrocortisone cream on it?  Thank you.Bob Terzick, Fort Lauderdale, florida",
    "doctor_response": "Thanks for contacting HCMYou have recently developed a red rash in your underarms and the most common cause is deodorants. I recommend that you keep the area clean and dry and not apply any additional deodorants. Applying a hydrocortisone cream may help reduce some of the redness but use it sparingly. Hope I answered your question. Please contact us again with your medical questions or concerns",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this X-ray report indicate?\n\nHi Doc. Last 02/28 my colleague xray findings suspicious opacities at both apices then advised apicolordotic view, then last Mar 26 he had again xray the findings apicolordotic view shows no active parenchymal infiltrates can you please tell us what this means. Thank you",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.According to the history, better to do a chest CT to be sure for the chest X-ray findings. Hope I have answered your query. Let me know if I can assist you further.Regards,  Dr. Jnikolla",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in chest,neck and arm?\n\nIv had a lot of pain in my chest, nesck, shoulder and arm. my back also. iv been to hospital for ecg and it wasnt too bad. said i might have infection but i couldnt stay as waiting time was 4 hours. does it sound like an infection to you. throut also very sore.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Yes, possibility of viral upper respiratory tract infection (URTI) is more likely.Sore throat, neck pain, chest pain, generalized body ache etc are commonly seen with viral infection.So better to drink plenty of fluids orally and keep yourself hydrated. Do warm water gargles and steam inhalation 4-5 times a day. Take simple painkiller like paracetamol or ibuprofen. Don't worry, you will be alright with all these in 5 days.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heating sensation in knee caps?\n\nI am 31,female..I have been having this strange heating sensation in my knee caps for the past three days. It occurs about every 5 to 10 minutes. It literally feels like a miniature hot flash on my knee caps. Do you have any idea what this could be?",
    "doctor_response": "Hello, As you feel hot above the knee cap I think you should check your uric acid levels. As due to increase in the uric acid levels there might be burning sensation, Also, if there is any nerve root compression in the lumbar spine then also the burning symptom can come. Need a thorough clinical examination and assessment of the knee and lumbar spine along with lab tests to figure out what should be the problem which is causing such burning sensation. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause very dark greyish purple penis in a child?\n\nmy baby boy is uncircumsized and I went to clean it as I was changing his diaper this morning and he experienced pain. I looked at it and it was a very dark greyish purple. I am going to take him to the doctor in a little bit but I was just seeing if I could find an answer online",
    "doctor_response": "I understand your concern and am happy you are taking him to the doctor. is his foreskin retracted around the main part of the penis? If so, the greyish black colour could be due to paraphimosis in which the foreskin wraps tightly around the penis and decreases blood supply. It is imperative that you see a doctor right away so that he may release it. Hope this helps and he gets better soon! Feel free to clarify any other doubts you may have",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain, acute renal failure, abdominal pain, testicular pain, non obstructive stone found in X ray. On motrin. Further?\n\nHi 37 yr old husband admitted for acute renal failure, presented with severe back pain complaining of pain radiating to abdomen and down to testicles. Kidney function was a 3.5 in 2 days of iv  has dropped only to a 3.2.  ultrasound of abdomen, kidneys, CT, and ultrasound of renal artery all negative no blockage. chest xray noted small non obstructive stone.  Urinalysis no blood or proteinHistory.... Was taking 750mg of motrin each day for back pain (possible cause) and also protein workout supplements otherwise healthy.  Why is function not improving when all tests appear normal and what is causing pain",
    "doctor_response": "Hello. Thanks for writing to us. The back pasin that your husband is having could be related to the renal calculus or may be related to a nerve root compression at the level of spinal cord due to a degenerative disc disease. An MRI scan can help to detect the cause. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a feeling of lump and soreness around nipple?\n\nHi, My son is soon to be 18 at University and i just got a concerning call from him.  He is worried because his nipple suddenly became sore and he felt some form of a lump, squeezed it until a clear liquid came out.  I told him tosleep on it, stop squeezing it and go to the health clinic in the morning.  If they were worried they suggest further investigation.  He has of course read the worst possible on line.  I said that maybe it is just hormonal and the worry of finals has caused his hormones to go crazy.  Do you think we need to be overly worried at this point?",
    "doctor_response": "Hi dear, welcomed to Healthcare magic. I have analysed your question. my opinion is that,your son is having infection  in the areola.i suggest  you the following steps.1.dont squeeze or scratch the lesion.2.maintain good hygiene. 3.apply fusiderm ointment  twice  daily over the area for 7 days.4.take analgesics like diclofenac tablets twice daily for 7 days.Thank you.hope my answer will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to give Xanax for my son before going to the orthodontist?\n\nI am taking my 7 year old son that weighs 40lbs to the orthodontist today for spacers. We had these done a few weeks ago and he flipped out and was very combative because he was scared so we couldn't finish the treatment. I take Xanax on occasion for anxiety and  I was told it would be okay to give .25mg to him 30 min before we go in. I am very nervous about giving this to him. Is it safe????",
    "doctor_response": "Hi Welcome to HCM I personally will not advice you for this medicine because its an alprazolam and your kid is too small for this. Try to convince your child and explain nothing will happen or hurt with space maker in mouth.Or ask some pedodontics, an dentist to convenience your child. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How will omega-3, proteins, and complex carbohydrates help in increasing memory during exams?\n\nHello doctor, This is not a health inquiry, but a problem I would need your help to solve. I would like to know what foods are good to eat before a test or exam? I am getting things like omega-3s, proteins, complex carbohydrates and water. My problem is, I cannot find much tangible information on why these things help us perform during tests? Can you point me in the right direction of where I need to go to get this info? Or do you know? What foods are the best to eat before a test?",
    "doctor_response": "Hello. Yes, as you have searched information is right and coming to its detail. Complex carbohydrates will give you energy and you will not be lethargic as carbohydrates are an easy way to breakdown for its energy levels especially for brain cells. You can opt for whole wheat, oats, muesli, banana, apple, etc. Protein are a good source or considered as building blocks. This will help to manage immunity, help to build tissue tear and keep you manage good health by not letting any infection easily. It can help you to be healthy. You can find these in eggs, lean meat like fish, and chicken. Omega 3 and 6 fatty acids boost the memory as it has antioxidants and increases the memory power like in almonds, walnuts, and fish. Include fibers with fruits and vegetables in the diet as these are rich in antioxidants and anti-inflammatory and helps in good blood circulation, boost energy, memory and good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for the B cell Lymphoma that the Oncologist must follow?\n\nMy mom is 71 and was diagnosed with large b cell lymphoma 5 years ago. She was successful treated with the R-Chop. She had a biopsy from a lump in her mouth last week and was told it was lymphoma. She has a pets can Tuesday and then will follow up with her oncologist. What treatment would you recommend?",
    "doctor_response": "HIthank for asking to HCMI really appreciate your concern for your mother, the over all treatment plan for such disease is depends upon many things, like the classification of disease, general condition of patient, associate pathology if any, and the oncologist is the right person for this this is not the simple etiology that can be treated with the symptomatic treatment, or medicines, hope this information helps you have a good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do difficulty in remembering words and losing things constantly signal dementia and Alzheimer s?\n\nI am afraid I have dementia. I m 59. Around 15 yrs ago I developed problems with remembering the right word. My docs didn t think important. Now I mess up words constantly and lose things a lot. A few years ago My brain MRI showed white matter hole or something but no one thought big deal. Does this sound like azlheimers?",
    "doctor_response": "Greetings,Mild cognitive deficits like the ones you mention are indeed early signs of dementia. However they are also signs of inattention stemming from anxiety or depression. You could undergo a formal neuro psychchiatry evaluation for your problems. In the mean time, try improving your attention by involving yourself in thought intensive tasks like solving puzzles and crosswords.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can bupropion HCl cause plantar fasciitis or neuropathy?\n\nCan bupropion HCL xl be the cause of my having plantar fascitis or neuropathy? I have taken bupropion HCl xl 300 mg for app. 5 to 6 years. I am 58 yrs old. I have had plantar fascitis for 4 or more years and have had surgery on my right foot. I started taking bupropion because I had to force myself to go to work and I ask the Dr. to for an antidepressant the would not make me gain weight. I am now retired and my feet have gotten worse not better. What major withdrawal symptoms can I expect if i decide to quit taking buproprion? Once you have neuopathy can you reverse it if it is cause by a drug?",
    "doctor_response": "Hi, It is possible that bupropion can be causing neuronal dysfunction or neuropathy but that would best be a call made by a neurologist after examining you who can know also the symptoms and the history of evolution. Many times when medications are responsible for causing side effects such as neuropathy then, stopping the medications often relieves the symptoms. In some cases, it does not... hard to predict which scenario you fit into without examining you, however, the first step is to let your doctor know what's going on if they are ones who prescribed the drug in the first place. I am not aware that plantar fasciitis is a direct consequence of bupropion but it could be indirectly caused if reduction in pain symptoms in the foot and/or neuropathy allowed you to walk greater distances which in turn could've helped precipitate the fasciitis problem. However, again, this would be a call best made by a physician who had the advantage of examining you. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does neutrophilic infiltrate with bacilli in a pap smear test indicate?\n\nHi My GF's pap smear test result under Microscopic Description says ''Back ground shround shows red blood cells and moderate to marked neutrophilic inflitrate with bacili. Pls explain what does it mean and if any treatment required or not. She has doen this as part of normall check up.",
    "doctor_response": "Welcome to H.C.M. I ma Dr Krishna Dubey.This is very common finding seen in PAP smear. It suggests Inflammatory smear.It means that you will need full antibiotic course like (Cefixime 200mg twice a day for  five days)  then repeat PAP smear after antibiotic course.You did not tell your age so i expect that you will tell you age next time.Thanx for your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can low platelet levels be improved?\n\nHello doctor, Male, 55, 170 cm, 60 kg, non-smoker, non-alcoholic ,vegetarian. Day before yesterday nose and ear bleeding was there in the early morning. Done blood test and found platelets count 24000 only. The doctor suggested to take rest for 4 days.",
    "doctor_response": "Hi,  Welcome to icliniq.com.  Following is my opinion for your case. Your platelet count is low and suggestive of severe thrombocytopenia (attachment removed to protect patient identity). The bleeding could be due to that. The reactive large platelet also seen in smear. So platelet destruction might occurred in your body. Dengue and viral infection are common cause for that. Your platelet count need to be monitored at 48 hour interval. Drink lots of water. If platelet count still go down and bleeding does not stop than platelet transfusion might given. You can rule out dengue by Elisa or Rapid card test.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can panic attacks and paranoia be treated?\n\nI have serious panic attacks and paranoia to the point I cannot even leave my house. I am a veteran have ptsd and I am 66 years old I am also 100 % disabled. I have a va psychiatrist who gives me lithium but it does me no good. Up until about a year ago I could drive most of the time I even used to go out in my boat and I had a one quarter acre garden. now I am capable of doing nothing but setting in front of the tv or doing things on my computer. Ps my psychiatrist cut off my lithium which does no good anyway. Because I cannot get to my appointments because I cannot get in my truck to go because of I panic and get chest pains and I ged real dizzy, my fingers curl up real tight my legs go numb and I cannot walk. My psychiatrist asks me what I suggest so I am asking you. I have not been taking any medication for 3 weeks because I cannot get to the doctor and she cannot prescribe any prescriptions or refills without seeing me.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. PTSD is the reason of persistent panic attacks which is resulting in impairment in functioning. Lithium can help in PTSD symptoms but for persistent panic symptoms in my opinion antidepressants like Sertraline or Escitalopram etc should be added. This will help to improve your mood. Low dose antipsychotics like Olanzapine can be added in order to reduce the paranoid ideas. Please talk with your psychiatrist for this. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Low iron levels. History of hysterectomy. Reason?\n\nHi Doctor Samuel, my name is Lynda I am 47years old. I have over the last year dropped in my iron levels to a very low level. I am told normal is 20 - 200 and I have gone from 15 to 14, 11 and now 9. I am vegetarian and have been for last 6 years so nothing has changed. I had a hysterectomy at 34 so it is not due to monthly bleeding . Can you advise me what may be going on in my body to have dropped so low. The above figures are from blood tests taken every 3 months for the last year. Thank you, Lynda",
    "doctor_response": "HiPlease get your stool routine and for occult blood tested. I hope your other blood parameters are normal.  You may need tests to know from where you are loosing blood.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having a small lump on my top gum?\n\nHello, I have a small lump on my top gum on the left side. My wisdom tooth is coming through and the left side of my face is slightly swollen.. It's quite painful. I've taken anti Inflametries to help the pain and take down the swelling, it hasn't worked. Please help.",
    "doctor_response": "hello thanks for consulting at hcm..lump inside could be intra oral abscess related t periapical r periodontal..and due to third molar eruption resulting in extra oral swelling as cellulitis..do salt water thrice daily..kindly consult ur oral surgeon for antibiotics and analgesics ,, if reqd radiographs,,hope it helps..tc",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes loose stools in a child after giving Clamp Kid Forte?\n\nDosage of Clamp Kid Forte (AMOXYCILLIN and POTASSIUM CLAULANATE) , 2.5 ML twice in day (since last 3 days) seems causing problem with my 7 month old Daughter s digestive system. Her poops have got very liquid, dark brownish and about 4-5 times a day. Is this fine, or a known side effect. We are scheduled to meet Doctor again once 5 day dosage completes. Should I arrange appointment earlier, or this is a fine behavior. She looks fine though and plays as usual. This medication was given as she was bitten by an insect that caused red swelling that got hard and possibly with pus and did not cure on its own even after 3 days.",
    "doctor_response": "Hi...by what you quote this looks like a simple antibiotic associated diarrhoea and it is very common with the drug -  AMOXYCILLIN and POTASSIUM CLAVULENATE. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. All she needs now is a probiotic with Saccharomyces boulardii and I as this is a prescription drug, I suggest you consult your paediatrician regarding this.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why having burning sensation lasting for short time in kidney area?\n\nHi, i have a weird popping/burning sensation that only alst for a short amount of time.. on the left side of my back near the kidney and spleen area.. but i feel no pain towards the stomach.. that pain is coming from only a small area and goes away quickly.. what is this?",
    "doctor_response": "probably you are suffering from neurological problem, where periodically nerve impulse bursts which causes tingling pain like sensation. Consult neurologist for proper management and you may need physiotherapy. It is nothing to do with kidney. All the best. If you have any questions feel free to contact me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will a cervical polyp interfere with IUI treatment?\n\nHi, I am due to have an IUI treatment, however now have a cervical polyp.  One RE advises removal prior to treatment another does not.  As am 41 in 2 months time i dont really have the time  for removal and would prefer if i didnt have to however could it interfere with implantation?  not sure how to proceed",
    "doctor_response": "Hi, if the Polyp is on external part of cervix, there is no need to remove it. It will not interfere with implantation.  If polyp is extending inside the cervix that means if it is endocervical then also it will not affect implantation but it may cause some problems in doing IUI.  but I think it can be taken care of. So, you may not need removal. Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for enthesopathic arthropathy with joints pain\n\nHi i am girishkumar age 35 years i am suffering from enthesopathic arthropathy i have pain in my all joints,i did all blood test(ESR,CRP,RA test,SGOT,SGPT,HLA B27,HS CRP,CBC,URIC ACID) all test are normal. i am taking SAZO 500 two tab. three time a day & one folvite three time from last one year ,pain is better but not completly better please tell me why? thankyou",
    "doctor_response": "Hi, There is no indication to continue sazo. In case all above mentioned tests are normal, you need to evaluate your test reports again. Sazo is given to reduce inflammatory arthritis like rheumatoid arthritis. Arthritis can be controlled only and not cured, if being on sazo your disease is getting controlled that's good, continue taking the medicine. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Rohan Shanker Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could painful diaphragm after pollen intake, for constipation, indicate?\n\nI had taken bee polen and the first time it worked.. it also heped my ibs ..i had had a bowl movement regularly and i had finally lost my weight that i want off.. then i started getting constipated again. The bee pollen had been the only thing to help so i went back on it. I had no result but my diaphram hurting.. to press,to breath, anything.. it feels as if its hanging down. Ive been taking mineral oil occasionslly to help now and it seems to work beautifully.im still having pain in my diaphram.. it even hurts to have intercourse. Please help!",
    "doctor_response": "Hi thanks for asking question.you want to know about condition that can lead to diaphragm pain.First simply it could be infective causes.like viral or bacterial infection.Second it can be because of trauma to that muscle or nerve.Third it can be because of muscular dystrophy like condition.Even malnutrition can lead to pain.Analgesic taken for pain relief.If cause not clear chest x ray or pulmonary function test done as further work up.Complete blood count also done if associated fever present.In special case nerve conduction study can be done.I hope you understand my concern.wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes respiratory failure in adults?\n\nMy mom has advanced copd and has been told she is in respiratory failure. She is extremely weak, sleepy and tired and has a hard time passing urine. Could she be having kidney failure. She is on 3 l of oxygen all the time.... Pay really ! What a bunch of Bs",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your mother's situation and problem. By your history and description, possibility of respiratory failure is more. COPD patients tend to have type 2 respiratory failure. It is actually hypercarbic respiratory failure. In this patient fails to exhale carbon dioxide. So excess carbon dioxide accumulate in the body and cause hypercarbia (high carbon dioxide). High carbon dioxide causes sleepiness, tiredness, drowsiness, weakness etc. So her symptoms are suggestive of hypercarbic respiratory failure more. Possibility of renal failure is less. In this patient develops anuria (no urine), edema face and lower limbs etc. Best way to differentiate between respiratory and renal failure is by ABG (arterial blood gas) analysis and renal function test. Hope I have solved your query. Wishing good health to your mother. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal for recovery from flu to result in rib cage pain?\n\nhi, I am currently getting over the flu, however I have a pain under my rib cage when I sit down or bend over. Doctor told me it was from coughing. I have not had a good bowel movement since I got the flu, so I have taken a laxative with no relief. Is there anything else that I can do?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Yes, coughing from flu cancer cause chest pain. Actually, coughing causes intercostal muscles and ribs contraction. So forceful cough is likely to produce musculoskeletal pain. So follow these steps for better symptomatic relief. 1. Avoid movements causing pain. 2. Avoid bad postures in sleep. 3. Avoid heavyweight lifting and strenuous exercise. 4. Take painkiller like ibuprofen. 5. Apply warm water pad on affected areas. Don't worry, you will be alright with all these in 5 days. For constipation, you should take high fiber diet like green leafy vegetables, fruits etc. Take curd or yogurt daily once a day. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bladder pain and pain in abdomen while taking medications for fungal infection on feet?\n\nI have a fungus on my feet and toenails its been 5 weeks since the doctor prescribed terbinafine but I have experienced bladder pain, upset & pain in my stomach. The doctor took me off the medicine for few days but my feet need the medicine for 2 more months. Isn t there a treatment that doesn t require such a horrible medicine?",
    "doctor_response": "Hello ,I understand your concern. I am Dr. Arun Tank, infectious disease specialist, answering your concern.Alternatively you can use fluconzole tablet 150 mg once a day for approximatley 2 to 3 months or infection has not cured. I suggest you should think for this medication and can take it under your doctors guidance. Please also take pantoprazole before meal and before this drugs. This will help you control acidity. So you wont feel abdominal pain. Glad to answer your further concern contact me on bit.ly/DrArunWe wish you a best health at healthcare magic. Thank you,Dr. Arun Tank",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat an injury by a food blender blade?\n\nhi i had an accident on friday with a food blender and the blade went into my thumb and right through i went to A&E but id managed to get the blade out before a nurse looked so they asked someone to clean the blood and put a plaster on. im not sure how i should be treating the wound i have been cleanin it every day with cold water and cotton wool and putting a new plaster on it",
    "doctor_response": "Hi,I suggest you leave the wound I disturbed for the next few days with a fresh dressing on. In 3 days time re-inspect the wound. If it looks clean and not red or swollen then you could consider leaving the dressing off to continue the healing process. Regards,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should i do for memory regain after injury in my head?\n\nHi, about two years ago I injured my head while snowboarding. I blacked out and wasn t able to remember anything. I was fine and continued on with my daily activities, only thing I really noticed was that it was harder for me to remember things sometimes. Now after two years (it has been about two months ago) my head feels lightheaded if I m not laying down. I don t get head aches, but my head gets this weird heavy feeling sometimes; maybe it is the light headed feeling. My vision is fine, still 20/20 with no blurry vision but sometimes my eyes feel heavy. I don t remember where I injured my head but theres a slight dent on the top left side of my skull. I tell myself that its been so long and I was doing fine, but just to be on the safe side I figured I would ask for another person opinion. Thank you",
    "doctor_response": "Hi, welcome to our site. I am Dr Saumya Mittal, MD.Read your query. That is a very significant question and i appreciate your problem. I will try my best to answer your queryI have serious doubts that the memory issue is related to your accident, if it is that long back as you say (that you cant even remember it).The other issue is that the post traumatic affected memory is usually limited to the duration of the accident. You may not remember the accident, or the duration of the accident, or the things immediately before or after the incident. It does not affect the memory thereafter. So the regular memory should be okI would suggest an MRI brain and a visit to a neurologist to rule out the possibility of AD  or PD.I hope this helps you. Inform the reports mentioned above/if any other so I can be of help further. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you.Please do understand that some details could be extracted from a detailed history and examination.Please feel free to ask another query. I would be glad to help you. Looking forward to your return query with the details asked so that I can help you further. (If the answer has helped you, please indicate this)Best of luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause a burning sensation in the stomach, constipation and pain in the area around the kidneys while urinating?\n\nI have constipation and headaches, along with burning in my stomach area. I recently had a CT scan because I had pain in my kidney area while urinating. M Dr put me on Flomax thinking I might be passing a stone but my symptoms have continued for 14 days.",
    "doctor_response": "Hello, You have been prescribed tamsulosin medication that is used for prostate problem. If you have stone than usually diuretic prescribed. For burning pain in urine, you need to the given antibiotic course. Before that urine routine microscopic examination has to be done. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Propranolol help me lower my blood pressure?\n\nHello doctor, I had hip pain mostly related to sciatic and hip muscle pain. The doctor gave me Methylprednisolone 1000 mg yesterday. The pain subsided but blood pressure slightly elevated at 135/75 and heartbeat at 110 to 120. Earlier, it was 125/80 and heartbeat at 90 to 95. I feel slight heaviness at center and back. It may be due to long bed rest or something else. Fast heartbeat bothers me. It is like I am in full-time anxiety. What should I do? Can I continue with that or should I take blood pressure lowering drug like Propranolol HCL? Please advise how to relieve these symptoms resulted due to Methylprednisolone.",
    "doctor_response": "Hello. You are having this tachycardia and hypertension due to the intake of steroid in a high dose. Once when you are off the medicine, your vitals will normalize. There is no need to take any anti-hypertensives. For fast heart rate, I suggest you take tablet Metoprolol Sustained Release 50 mg at 8 a.m. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. I suggest you do a D-dimer test to rule out pulmonary embolism. Review with a repeat ECG (echocardiogram) and report. For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for frenulum tear\n\nI think my husband tore his frenulum. We stopped having sex for few weeks to let it heal and it seemed better. But then when we resumed intercourse it was still painful ,bled a little and became swollen. Not sure what to do. Or if it will heal on its own",
    "doctor_response": "Hi,Thanks for writing in.The tear in your penis may get better without treatment. Avoid sexual activity until the tear has healed. Once it has healed, you can try using a lubricant during sex to prevent the problem from happening again.It is not a serious issue and might take 2 weeks to heal. Right now you are required to keep your genital clean and dry. Please wash with warm water twice a day to avoid any infection. You may apply neosporin ointment over the torn frenulum. Please take oral pain killers",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a chance for me to conceive if sperms have been ejaculated to my stomach ?\n\nmy boyfriend ejaculated onto my stomache, he then used tissues to wipe it of,but not sure if he got every single bit of sperm , i then took a shower immediatly after, could i be pregnant from this? (what im worried over is the shower water washing any left over sperm into my vagina?, i was obivously standing up in the shower, and most of the sperm had already been wiped of, if there was any left)",
    "doctor_response": "Hello Welcome to health care magic forum there is absolutely no chance of pregnancy,for pregnancy semen must be deposited in the vagina. Wish you good health Disclaimer",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rash on trunk, above left hip, redness, itchy, growing. Ringworm?\n\nHi. I am a 57 yr. old male with a round rash on my torso just above my left hip. The reddish spot (about the size of a nickel) is surrounded by a raised pink area that sort of resembles a pink and red sunny side up egg (the red spot being the yolk and the pink area being the white part of the egg). The rash is itchy and started this morning and has been growing larger all day. Ringworm? Any ideas?",
    "doctor_response": "Hello,Thanks for the query,You might have developed fungal infection.The area of groin is very moist and is prone to develop these infections.Treatment can be with oral antifungals as well as with topical antifungals.Various antifungal powders like candid are available.These can help reduce the moisture as well as control the infection.Please dont use any steroid, it can worsen your conditionPlease meet a dermatologist for exact diagnosis.Let me know if you have any other doubt.you can ask a direct question to me on this forum, following the below link.  you  good health,Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I missed my last month period and the pregnancy test shows positive. Could this be false positive result?\n\nHello doctor, I have taken a pregnancy test a few days ago and it turned out to be positive. I took two tests, just to make sure and they both were positive. I was supposed to have my period on March 29, but conception happened on March 14 and the first day of my last period was February 29. I do not feel any changes at all, is it possible that that may not be true at all? Or the tests I took were not accurate? If I got my period this April 29, what does it even mean since I already missed my supposedly period on March 29? I am currently taking Myra e and Poten cee.",
    "doctor_response": "Hello. As you checked twice for urine pregnancy test and it turned out positive, it implies you have been pregnant. It is not necessary that everyone experiences nausea and vomitings or early signs of pregnancy similarly, some may not feel any symptoms, or some have mild symptoms. The urine HCG (human chorionic gonadotropin) tests are definitely an accurate way for testing pregnancy, rather than just relying on symptoms and they cannot be wrong as you had missed your periods too, and it tested positive twice. And if you are pregnant, you would not be even getting your periods again this April too. It would be advisable to get an ultrasound to confirm the pregnancy if in doubt, the site (intra or extra uterine), the gestational age, and the fetal viability. Also, you can start using Folic acid tablets. Routine antenatal investigation. Tablet Folic Acid 5 mg daily. Avoid sexual intercourse in the first three months.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat severe back ache?\n\nMy wife got severe back ache. Doctor prescribed Myoril plus. Next morning she got skin rashes at two places on her thigh and a small spot on her fae. She is obese weighing 125 kg. Is taking medication for hypertension. She has sensitive skin. Please advise.",
    "doctor_response": "Hello. Thanks for writing to us. The treatment depends on the cause. Bed rest with pain killers and muscle relaxants are given. Physiotherapy helps after the acute pain subsides.I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal ,drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat sickness thumbs on stomach in a 12 years old child?\n\nMy child has painless, sickness thumbs on her stomach. She is 12 years old. They are really small and about a centimeter in between each one. They will come and go. I don t know if they are allergic reaction to something. She is not allergic to anything I know of. She has had then for 3 days. Do you know what they are?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stiffness and tearing kind of pain in lumbar spine?\n\nhello doc.. am 24yrs old female, suffering from sero negative spondylo arthropathy,since 4 yrs. which is under controlled manner at present. in the beginning was a very severe condition, almost bed ridden. but recently i developed some stiffness n tearing kind of pain at lumbar spine, during flexion. also i have breathing difficuties, pulse over 100/min. has vertigo very often. Are all theses symptoms related? havent done HLA before. ANA negative, ESR and CRP raised. IS this present controlled situation temporary? sued to tak SAAZ, but now not under any drugs. Is this risk?? Thank you.",
    "doctor_response": "Hello, It is very unlikely that the breathing difficulties, pulse rate, and frequent vertigo that have developed have any DIRECT relationship to your spondyloarthropathy. What could be happening is that your low back pain is causing your pulse rate to elevate during those painful periods of time? This can make respirations rapid and shallow which you notice as difficulty breathing.  Vertigo could then, come about as a result of hyperventilation leading to dizziness. If the symptoms are NOT related to actual bouts of pain in the back then, it may be from anxiety generated by the condition or some other situation(s) that could be going on in your life. You will need to talk to your doctor about these symptoms to see which theory seems most plausible in order to develop a treatment plan. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to stop recurring upper respiratory infection?\n\nI have had upper respritory inffectoion for 6wks. My couhing has deminished alot but is still there and I am still coughig up phiegm to the throat but it's not always a strong enough cough to get the phlegm up far enough to get it out. Then it gets stuck and can cut off my air.  This has been happening to me for years towards the end of the infection.  I use a nebulizer and xopenex to open things up and it works sometimes. I also take generic Mucinex. Wat can I do?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. In my opinion you are mostly having bronchitis. And upper respiratory tract infection (URTI) is the common cause for recurrent bronchitis. To prevent recurrent URTI, do following things. 1. Start warm water gargles 5-6 times a day. 2. Avoid oily and spicy food. Drink plenty of fluids orally. 3. Start multivitamin tablet containing folic acid, niacin, vitamin b12 and zinc to improve immunity. 4. Get done annual Influenza vaccination to prevent recurrent infection as Influenza is the most common organism for recurrent URTI. So discuss all these with your local doctor and plan accordingly. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for squamous cell carcinoma\n\nHi my mom has squamous cell carcinoma, she s 82 & will not undergo radiation or chemo therapy. We have an appointment for her to receive an IV of Vitamin C on Thursday. Do you think she should also seek a doctor who will give her a dendritic cell vaccination? What about localized hyperthermia?",
    "doctor_response": "Hi Welcome to HCMI have gone thru your query regarding  your mom's treatment for squamous cell carcinoma . Dendritic cells (DCs) are antigen-presenting cells, (also known as accessory cells) of the mammalian immune system. Their main function is to process antigen material and present it on the cell surface to the T cells of the immune system. They act as messengers between the innate and the adaptive immune systems.Hyperthermia used locally can liquify tumours .But no guaranteethat , they will not reoccur again , In fact, everyone has cancer cells forming all the time. But normally their strong immune system .kills the cancer cells fast enough that a person is never \u201cdiagnosed\u201d with cancer. But when the immune system becomes weak, the cancer cells can grow out of control , the disease overpowers . Gulping on pills ,or undergo any therapies  will not help cure  unless you modify food habits & lifestyle  . Our health depends mostly upon 'what & how & when we eat, and our life style .I wiould like to suggest you to modify food habits & lifestyle to fight cancer is one of the most effective treatment options in my view . Many have been benefitted by These therapies which slow the growth of bacterias and kill cells on mass bases .Our health depends on 'what we eat ,when we eat ,and how we eat .One of the important strategies to achieve healthy body is a diet rich in fresh, raw whole foods .More of Fiber, protein vitamin C and goat\u2019s milk , fruit, egg fish ,fish oil for Omega 3, green leafy veges . quality, organic, biodynamic, locally-grown food will naturally keep metabolism on right path and increase strength of immune system , take all supplements full of antioxidant serve as antibiotics ..Take mixture of extract of Raw garlic , ginger ,coconut water , lemon juice ,mooringa tree bark and honey in equal quantity ,dose is 20 ml with same amount of water half hor before meals . for 4 days and after that without water for 21 days . It is a great antioxidant and antibiotic ,Without any side effect.Bitter gourd juice 20 ml is great antioxidant & antibiotic Turmeric powder , level spoon with with a cup of hot milk with B/F & at bed time , Buttermilk with lunchAloe vera juice 20 + amla juice 2 spoons ml twice a day Add lot of water to eleminate toxins from body . Antioxidants maximizes natural minerals so that your body has the raw materials it needs , to do what it was designed to do. To kill bacteria on mass basis ..Avoid processed foods, sugar , fried ,fast food",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent cold and blockage in nose\n\nHave had really bad cold over last 2wks n then about 5days ago when I blew my nose that was blocked all of sudden The mucous is horrid n smells so gross haven t been able too sleep properly Bcoz of one nostril being blocked n keep taking painkillers for pain in head face, im really concerned it s never going to go away n that it could do damage to brain if left untreated??Is this true??Help;)) Please!!",
    "doctor_response": "Hi, thanks for using healthcare magicBrain damage does not usually occur as a result of sinus infections, it is a very, very rare consequence and is unlikely to happen to you.The odor indicates that the infection is likely bacterial and you need a course of oral antibiotics.In addition to the antibiotics the following may also help: (1)warm compresses to the face to encourage drainage(2)oral antihistamines and decongestants- these are available over the counter(3)anti inflammatory pain killers such as ibuprofen, naproxen, cataflamI hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment to get pregnant?\n\nhi doctor iam planning for pregnancy doctor given me aromatin tablet from the 3rd day of my period and then naturogest tablet from the 20th day of my cycle for 10 days. i had missed my period and now iam feeling morning sickness and nausea full day thus it means that iam pregnant or it is a side effects of the tablet",
    "doctor_response": "Hi,Yes, it is likely you are pregnant, get a urine pregnancy test done immediately. Aromatin is letrozole which helps in egg formation. Progesterone can cause nausea, it also causes breast tenderness, diarrhoea and dizziness.But seeing your history it is more important to consider pregnancy.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have cheesy vaginal discharge with itching and burning. Please help.\n\nHi doctor, I am suffering from an infection of the vagina. I have cheesy discharges, itching, burning, and it is very uncomfortable. Please suggest some medicines.",
    "doctor_response": "Hi. How are you doing? Vaginal infection, which is transmitted during sex (so partner is the source), so both have to be treated at the same time or else you will get infected again during sex. You may have white or yellow or grayish discharge with or without itching, foul smell, pain at the beginning of sex due to dryness (as the lubrication will be reduced) and late towards the end, when fully erect penis touches the inner most vagina (due to inflammation of the structures around the uterus). The pain will be radiating to the back or thighs. Your bowel movement will be affected and also features of gastritis are seen. Bleeding of periods will be thicker, darker, clots or fleshy masses may smell bad, more days with spotting after the periods too. When you have an infection inside the uterus, the blood flow increases as inner lining is inflamed and the blood mixed with the inner lining of the uterus forms a thick, doughy or fleshy mass. As the healing of the lining is not complete, it keeps spotting, or you have blood stained discharge. The pain is throbbing even before periods and lasts after periods are over. Usually, the infection is mixed and not just due to yeast. There will be a family of aerobic and anaerobic bacteria, all of which cannot be detected by culture. When one is treated and cleared, the other will grow. Before treatment, confirm that you are not pregnant. I suggest you and your partner try taking the following: After this, I suggest you try taking the following: Your partner can locally apply any antibiotic and antifungal cream, like Candid B (Clotrimazole and Betamethasone) on the penis twice a day after wash for seven days. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. Do not have sex till the infection is fully gone. Do treat it as delay may send the infection inwards and may affect both you and partner's future fertility. Hope I have clarified your query, do write back. All the best. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rash on inner thigh with lumps and dizziness\n\nHi, I developed a rash on my inner thigh this morning with lumps, my thumbs swell up a little as well as getting dizzy. But I have had a UTI for the past couple of days, I do not know if I developed allergic reaction to the medication for is it something worse?",
    "doctor_response": "Hi thanks for asking question in HCM.You are suffering from urinary tract infection.You have not mentioned about name of antibiotic.Yes rash and swelling can be because of drug allergy for ex.you may have tendency for allergy to penicillin group of drug.So if side effects increasing then you can switch over to other group of drugs.Ex.if taking cefixime and can't tolerated then floxacilin group drug can be used.For treating UTI maintain hydration.Drink more water and fruit juices.Cranberry extract juice can be helpful.Avoid spicy food.If still rash and swelling persist then further work up will be done.I hope i have solve your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for psychopathy\n\nmy son at age 6 was diagnosed with phychopathy.. now he is 17 and way out of control without caring at all ....he is asking please help me to fix this and been to many hospitals and therapist ..just yesterday again he was going to commit to 72 hrs at hosp for another poss treatment the may have... he seems like he wants help badly and is willing to get help.. but after all these yrs and I do understand it... what or how can I help my son before he seriously hurts himself or others... he already has court proceedings etc.. and is excessively violent almost daily... how can I help him.. cuz our health care hosp made this diagnose at 7 and yet only put him on pills that don t work or fix this....and they seem like more so they don t care either... any alternative advice for me other than what our health care providers seem to be missing desperately need help... jfi.. yest ..after all papers faxed to hosp on all his yrs from a pych hosp.. my hosp sent him home when he pleaded to stay for 72 hr assessment treatment... can u help me",
    "doctor_response": "I think that it would be helpful to see a psychotherapist. There are sone therapies that can help your son deal with his problems .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed sore on lips,loss of appetite,bleeding in gums & bad breath\n\nMy 2 yr old has been irritable for 4 days now. Looks like her back molars are coming in, she has what looks like a cold or cankersoar on her lip, loss of appetite, gums are bleeding, and really bad breath. She also has not been her active self, and will not let you brush her teeth",
    "doctor_response": "thanks for your query, the soreness in the lip could be because of the herpes virus infection. the bleeding gums and the bad breath could be because of deposits around the teeth causing gum infection. consult your oral physician and get the teeth cleaned and use topical anesthetic and analgesics for soreness. i hope my answer will help you take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for puss filled boils caused after injury\n\nA got drunk in the night and was arrested after I hit my elbow on something and they threw me in the drunk tank and I got some kind of infection from scraped from the bacteria or whatever earrings they have in the drunk tank  causing this boils coming up and oozing puss",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain it seems that there has been infection in the area of injury and that is leading to formation of pus filled bumps..In case if you have got scraped and exposed to dust, soil ad rust the first thing that you need to do is to get a Tetanus Toxoid injection..You should consult a general physician and get evaluated and he can advise you oral antibiotics like Augmentin or Ciprofoxacin, a combination of Sulphamethoxazole and trimethoprim can also be advised..You can also be advised to clean the area with antiseptic solution and apply a combination of antiseptic and steroid based creams..If the infection seems severe then injectable antibiotics can also be advised..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sensitive teeth and painful cold sensitive gums\n\nThe tooth right next to my top front tooth is sensitive. Heat and cold triggers a sharp pain in my gum. If I tap the tooth it hurts, but if I hold the tooth still and tap it, it no longer hurts and isn't as sensitive. The tooth has had a filling before which does not seem to have weakened. What could this be?",
    "doctor_response": "Sentivity can be triggered if there is dentin exposure, in your case possible recurrent decay in your existing filling. Sensivity could be also due to gum recession. Whatever the cause may be, condition can be treated. Kindly get an x-ray done. You start using desensizing paste for transient relief.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could rectal bleeding during lupus infection suggest?\n\nmy husband has lupus ;and has been treated on several occasions by a gastro dr for rectal bleeding. they usually band a hemroid but with the lupus, he ends up with an infection that makes him very sick.. the bleeding is a lot.. fills the bowl solid red.. is there something that his dr is not looking for that we should ask about.. he has had a colonoscopy on several occasions, and he does take fiber supplements. After apx 2 weeks he is usually anemic and severely fatigued and on two occasions, he has needed a blood transfusion. ..Help",
    "doctor_response": "Hi,Thank you for your query. I can understand your concerns.If  you are constipated and have hemorrhoids then they can get worse from straining .Vasculitis involving the intestine as often happens in Systemic lupus erythematosus (SLE),may cause  bleeding from lower gastro-intestinal tract.Thrombocytopenia  due to SLE may be a recurring problem. If platelet counts are >40,000/L, abnormal bleeding may occur from existing hemorrhoids. Treatment such as Hydrocortisone Acetate is used both for Hemorrhoids and Lupus.Regards Dr. T.K. Biswas M.D.Mumbai",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for yellow nipple discharge in a male\n\nMy 64 yr old husband has been suffering from M.E. for six years.  He also suffers from eczema and osteoporosis (probably caused by his having coeliac disease undetected for possibly most of his life).  He has been suffering from an itch around his nipples for which the gp gave him hydrocortisone.  However, now his nipples are leaking yellow/white fluid.  He is  5'6\" and approximately 64 kilos",
    "doctor_response": "Hello, It can be mastitis. Other possibilities like breast cancer have to be considered. Consult a general surgeon and get evaluated. An ultrasound and cytology of the discharge have to be done. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in conceiving?\n\nHi, may I answer your health queries right now ? Please type your query here..hi I m 33 yrs male ,married 5 yrs ago and i have one kid ,afte one and half year i decided to get another baby mbut to no avail after 1.5 yrs i did spermogram it was very low 3.5million /ml i took multivitamines for one month i repeated after one month it was 0.5million/ml.i did duplex of testes it was negative ,i did FSH,LH,testeron all of them were normal,i went to urologest he prescribed for me clomid 25mg daily for 2 months please i need ur advice if there is any other test missing and if the treatment is ok is it enough 2 months and after when i can repeat spermogram.",
    "doctor_response": "HI,   Thanks for the query.    You had done almost all basic investigations indicated for low sperm count. however, I would suggest few more to assess your general well being like-- blood counts/ blood sugar levels to exclude diabetes/ Koch's .    THe clomid course taken 25 mg daily for 25 days .. To be repeated again after 5 days break. This way you have to take it for at least 3 months.(.Some people need a longer course of medicines.) .. get your semen  tested , if it's normal you can plan for a baby   Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain on right side of mouth and jaw?\n\nOn my way home from the gym for the past three nights I have had a horrible pain in my right side of my mouth, my teeth, upper and lower and my jaw and gums. I just went to the dentist today assuming I had a cracked tooth; and I do not. He thinks I may clench my teeth. I don t know why this is happening now and never before. It lasts about 15 minutes",
    "doctor_response": "Hi,With your query, if your dentist said it is 'coz of clenching teeth then you might be having attrition too along with the vague pain in the jaws and usually this happens whenever you clench your teeth or in the mornings if you have this habit in the night with slight discomfort in the TMJ. So kindly check for these signs and do you have any sensitivity?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is my semen report with spermatozoa count: 112.0 Mill/cc normal?\n\nHello Sir, My Semen Analysis Report as under plz help me what does it mean. Method of collection : Self Manipulation Period of Abstinence: 3 Days Qty: 2ml Color: Whitish Odour:Musty Viscosity: Normal Total Spermatozoa Count: 112.0 Mill/cc Motility Active Motile:65% Sluggish Motile:10% Non Motile:25% Abnormal Forms:Total:15% Head:10% Tail:5% Pus Cells:8-10/HPF RBC:Absent Fructose Test: Positive",
    "doctor_response": "Hi.I had gone through your semen analysis report. It is normal report.Do not need to worry. Sperm count 112 mill. Is normal count.Sperm motility above 60% is also normal.Fructose test positive is also normal.So you have normal all three important parameters in semen examination. Relax. Still if you have a query then feel free to ask. Happy to help you. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of motion sickness?\n\nComing home from the Mtns/Gatlinburg this morning after a perfect normal weekend vac with the family, I looked down for a second while coming down the mountains in a circle/winding roads, when I looked up, I was totally knocked out with the motion sickness or my equilibrium was all of the sudden out of kilter. Is there anyway I can fix this, I ve tried sleeping but it s not better?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Your body has very little to do about the motion sickness. The culprit is the journey, winding roads. Getting yourself accustomed to these situations should make you perfect. Till then you can keep a stack of news paper (around 1 inch thickness) and sit on it while taking such journeys. They work as pacifiers. 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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high BP\n\nhello i am overwieght and i do smoke regually but my blood pressure have never got over 140/90 now today i have been sick all week and i worked all day long when i go home my face started getting really hot and i started getting really tired. i took my blood pressure and it was 151/85 on right arm pluse 97 the 174/102 on left arm with pulse 108 then i took a shower and it was 182/112 pulse 118 then 166/96 pulse 120 left arm i have been really panic over the first time i seen the first one and i am just wondering if there is something i can do now to help lower it real quick and then make an appt with my family doctor or is this emergency room.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. You will have to start anti hypertension drug because 1. Your blood pressure readings are suggestive of hypertension 2. Active smoker 3. Over weight 4. Your symptoms like tiredness, flushing of face etc. So you have to consult your doctor and start antihypertensive drug. At present, you should do following things to lower your blood pressure. 1. Weight reduction. So avoid oily and fatty food. Do regular aerobic exercise like running, cycling, swimming etc. 2. Quit smoking as soon as possible. 3. Strict salt restrictions in diet. Along with these lifestyle modifications, you have to start antihypertensive drug. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "suggest treatment for tumor in lung\n\nMy mother has just been diagnosed with a tumour in her lung she is waiting for an appointment to see what kind of tumour whether its cancer or not and which form.....a couple of years ago she had bowel cancer and had half her bowel removed and was doing really well, we are concerned obviously and wonder whether there will realistically be a treatment available ? She is in her early 80 s too so difficult age to be coping with this.",
    "doctor_response": "Thanks for your question on HCM.In my opinion the present lung tumour might be malignant only. Since your mother had bowel cancer chances of lung metastases are very high. So better to get done PET (Positron Emission Tomography) scan and if there is hot spot than probability of malignant tumour is high. You may biopsy to confirm this.Treatment will remain palliative chemotherapy only, as it is stage 4 cancer so surgery is not indicated.So better to consult oncologist and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat bump on my back and severe headache caused by an accident?\n\nYes please I was in a major at accident I was the passenger and we hit a few poles due to ice..the dr ordered a scan and they only did X-rays of my back its been over 2 days I still have a inch high knot and length and its went down only a touch and have suffered a headache across my eyes and forehead since..no rest except a few hours since it happened at 3 in Saturday..thank you",
    "doctor_response": "Looks like u were involved in a pretty serious accident. Well ur features are quite serious. Ask your Dr, whether u need a MRI/C.T . Also make a note of all  d symptoms like headache etc , in d order they appear. Scale of intensity in pain . Also assess whether u have blurred vision, loss of body positioning , er I.meant balancing. Remember there are recorded incidents of fatalities of people  who have had accidents years ago.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What will happen if i get a tattoo after being diagnosed with dermagraphism?\n\nHi so I have just recently been diagnosed with dermagraphism and was wondering if I could still get a tattoo? I have several already but obviously did not have this condition when I got them. Now I m concerned of what will happen during the process.",
    "doctor_response": "WELCOME. HERE IS UR PLAN. I ADVISE AGAINST ANY MORE TATOOS. USE HYPO ALLERGENIC SOAPS N SHAMPOOS. USE H1 N H2 BLOCKERS WHENEVR SKIN RAISING RASHES ETC SYMPTOMS APPEAR. U CAN ALSO USE CROMOGLYCATE TO CONTROL THE FLARES. THANX",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump in the armpit area?\n\nhello, my son is 16 years old. His upper left teeth have been hurting and he is schedule to go to dentist for cleaning and check his wisdom teeth. yesterday he found a small pea size lump in his left armpit and is saying that it is very painful and hurts. i gave him Ibuprofin and that seemed to help for a short period of time. I am concerned...any idea?",
    "doctor_response": "hi.it is best if you consult with a doctor, preferably a general surgeon, for medical and physical examination. based from your description, it could be hidradenitis suppurativa. these lesions usually occur on the underarm, especially after shaving or plucking and/or usage of deodorants with strong chemical contents. hair follicles get infected. inflammation and subsequent abscess formation occur. medical (proper antibiotic regimen) and surgical (excision or incision and drainage) management will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is lower abdominal pain a result of gallstones and dilated intrahepatic biliary ducts showed on MRCP scan?\n\nI have had MRCP scan and got gallstones. But also found mildly dilated intraheptic biliary ducts in segment 8 and 4a returning into normal calibre of the right hepatic duct and some hypertrophy of left lobe of liver. What does this mean? I have pain in right area under the ribs and back / shoulder pain. But also gas / lower abdomen pain and floating stools. What could be the cause?",
    "doctor_response": "Hi and welcome to HCM. It can be caused by gallbaldder or live rissue and this is most common cause of such pain. dilated intrahepatic ducts are seen most commonly in biliary tree obstructtion due to stones but also any kind of liver fibrosis or hepatitis can cause it as well. rarely tumors are diagnosed after such mri findings. So you should do cholecystectomy if pain persist and have frequent hepatologist follow up.Thanks for the query. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it a serious cut with 1/2 inch width on my palm?\n\nJabbed my left palm early this morning when I the flathead screwdriver slipped while tightening a tool.The actual cut isn't bad or even very deep, but now my left hand middle finger is swollen and can't bend w/o bad pain. The cut/impact is approx. 1/2\" below and slightly to the left of where the middle finger folds over the palm, at the base of the finger and/or top of the palm.  Pain has increased throughout the day. Took aspirin, used ice pack. Remember feeling a tingling sensation along with bad pain when it first happened.Think I broke something or just have a bad bruise?",
    "doctor_response": "It's possible you injured a tendon or nerve. A broken bone is unlikely but can't be totally ruled out without an x-ray. If the impact of the screwdriver was strong enough, it could damage the underlying bone without causing much of a surface cut. A tendon injury might require specific treatment to prevent future problems. You could have a bruise and swelling from it is putting pressure on the nerve or tendon and causing the pain and difficulty bending. It would be best to get this looked at to be sure. You also might need a tetanus booster if it's been a long time. Hope this helps. If you have further questions, I would be happy to answer them.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is C-section performed in case labour pain does not occur in time?\n\nactually i m pregnant . 9th month is running.i want to know  in which condition the doctor do sigerian operation. my age is 29 year and i want to know you that in my case the doctor had done one time laproscopy.actually 9th month running but still i don't fill labour pain.so i m in worry.",
    "doctor_response": "Hallow Mumma,To put in single sentence, Caesarean section is performed whenever the delivery cannot be instituted by normal vaginal way. There are innumerable indications for Caesarean section which cannot be enumerated here. However, if labour pains do not start even after full maturity of the foetus, initially, attempts will be made to start the labour pains with the use of medicines like oxytocin. If they fail or if any complications like cord prolapse, foetal or maternal distress occur, then Caesarean section will be performed. Caesarean section is always performed in the good faith to maintain the safety of the mother and baby. Hope this helps you.Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is flying safe when suffering from small aneurysms?\n\nhi there my partner has just left hospital after having a subarachniod hemorrhage from a burst blood vein, he was also diagnosed with 2 very small aneurysms however these are not treatable due to the size of them. we get married in october and was planning on going away for a honeymoon will he be able to fly???",
    "doctor_response": "Hello, Unfortunately, there are no STANDARD GUIDELINES that have been developed yet that we can appeal to on the question of safe to fly after aneurysmal burst and/or the presence of unburst aneurysms. The literature certainly does contain a number of citations and reports of individuals who have suffered from incidents such as spontaneous SUBARACHNOID bleeding or rupture of unburst aneurysms who have just completed flights. It is unclear though on any standard of practice.  The majority of the recommendations seem to point to a waiting period (without well tested or grounded data) of no less than 2-4 weeks in the case of someone who just HAD a bleed in order to fly vs. up to 6 weeks of waiting in someone's who had a craniotomy to evacuate a blood clot who wants to fly. If it were my patient I would likely ask them to wait 4 weeks if possible to fly AFTER a bleed. 8 weeks after a surgical procedure to evacuate any blood from the head. As far as the risk of flying WITH UNRUPTURED aneurysms there are no agreed-upon numbers therefore, in my opinion whether someone KNOWS or DOESN'T KNOW they have an unruptured aneurysm in their head (or any other organ of the body) it doesn't alter the risk factor (if there is even one to actually talk about) element so to me there should logically be NO TIME CONSTRAINT on when a person could or should fly after finding out they have aneurysms which are inoperable, etc. That needs to be more an individual's feeling of comfort zone action as opposed to a doctor trying to counsel them according to scientific evidence that it is or isn't safe because there's nothing along those lines.  Make sense? Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe stabbing abdominal pain and heavy menstruation?\n\nI had a pelvic ultrasound n the results were a bulky uterus my dr is referring me to a specialist my cycle usually last 6-7 days my cramps make me feel like I m in labor feels like a knife being stabbed in my abdomen pain relievers don t work I cramp a week before I come on while I m on n three to four days afterwards since two months ago I m now staying on 8-9 days I ve always had heavy cycles but the pain kills me every month it gets worse my tubes are tied I ve had three csections",
    "doctor_response": "Helloyou might be suffering from endometriosis and it would be appropriate to visit a gynaecologist asap",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bowel incontinence in a child\n\nDear Doctor, My daughter is 11 & half year old and she is having a problem with motion, she use to do motion in her panty it self (nearly half of the stool) and later she goes to toilet and then she completes . I am very much worried about this.please help..",
    "doctor_response": "HiCan be because of dysbacteriosis,which causes problem with digestion like loose stools,bloating,belching etc.Green color of stool is also because of improper digestion of food.Give  het imodium one tablet stat.It can be irritable dowel syndome also.AdviceDon't panic.Start taking probiotics for few days.Probiotics are live bacteria and yeasts that are good for your health, especially your digestive system.Take lots of fibre rich food like oat ,barley,wheat etc.Atleast 40 grams of fibres should be taken every day.Strict no to fatty and junk food.Tablet pantopraze 20mg.Avoid dairy products.If not relieved go for colonoscopy test.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is knot on back of neck in a child after fall normal?\n\nMy 26 month daughter fell off the bed. Bed height is 2 feet 9 inches. We have hardwood floors. When I ran around the bed I found her sitting upright in the corner. She landed sitting up straight some how. When it happened I kept her awake for 50 mins while we sang and had her move her arms and neck and checked her body for injuries..but she was coherent and just wanted to go back to sleep. She s been acting perfectly happy, energetic i.e. normal for the past 4 days but I just noticed a knot on the back side of her neck on the right side. The knot feels hard..she doesn t want me to touch it. Her neck motion is normal. She can turn her head and neck up, down, to the left and right without and hesitation. What do I do about the knot?",
    "doctor_response": "hi the knot is nothing much but some clotted blood due to her injury and it is painful for some time. as she didn't have any other problem like vomiting a, loss of consciousness no need to worry, it will spontaneously resolve in few weeks.hope this is helpful to you, rate it if you like it. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I identify my allergens?\n\nhi doctor how are you today hope you all doing well .lets get started i have allergetic problems for past five years (i am 26 now) i taking a tablets per day (cetrizine hcl10mg) doctor how do i can identyfy my allergens? may i stop taking medicine or might you can suggest a better medicine for me .your suggetions will be appriciated thanks",
    "doctor_response": "Hello.Thank you for asking at HCM.It is very important to know what kind of allergy problems you have, i.e., nose symptoms, skin symptoms, food allergies, etc.However, I assume you are having nose allergies. (it is the most common form of allergy). I would suggest you to take montelukast and levocetirizine.For identification of allergens, I would suggest you to consult an Allergist-Immunologist who will ask you in very detail and may suggest you allergy testing. Most of nose allergies are due to aeoallergens (allergens in air), so it is not so easy to identify them. The common aeroallergens are house dust mite, molds, pollens, animal dander, cockroach and other insect allergens, etc.As general, avoidance of dusts, smoke and air pollutants will help you improve your nasal allergies over a long run.Hope this will be helpful to you.Wish you the best of the health.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach aches in 3.5 years old?\n\nHi Doctor, My daughter is 3.5 Years old. She is complaining stomach ache some times. We have given Rantac and Bifilac sachet for 5 days. After stopping the medication, she is complaining stomach ache again. Please suggest. regards, Narendra",
    "doctor_response": "HiWelcome to the HCM I completely understand your concerns but don't worry. If the stomach pain is central and not associated with any other symptoms such as fever, jaundice, vomiting, bowel or bladder dysfunction, then it is not likely to be benign. Toddlers are prone to abdominal pains especially due to gut infestation by parasites. I usually recommend to deworm the child with Single dose of Albendazole and repeat dose after 15 days. Along with this give healthy diet with lots of fluids especially water. Avoid spicy and oily food for the time being including fast foods.Hopefully this will help.In case the pain is associated with any of the above mentioned symptoms, then a proper clinical examination by pediatrician will help.For any further questions, you may contact me.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it logical to treat staphylococcal infection they do not know the baby has for sure?\n\nHello doctor, My daughter is almost 11 weeks old and was admitted to the hospital on the 11th. Blood culture came back negative but she tested positive for RSV and also had bronchiolitis. She was discharged on the 15th and readmitted the next day 16th. The primary physician did not like the way she was breathing. My daughter was pinched several times in the ER for a blood culture which the next day came back positive. The doctor performed additional culture as he believes the positive results were due to a contaminate. Blood culture came back negative. The 42-hour culture that tested positive is appearing to be staph aureus. One doctor is suggesting getting a central line and treating her for 10 days. I am just looking for a second opinion as I do not see the logic in treating something they do not officially know she has. She has had no fevers.",
    "doctor_response": "Hello. I understand your concern. Culture positive for Staph Aureus infection needs treatment. A central line is advised and when it is difficult to get, a peripheral line or prolonged course of treatment is needed. Even if the baby is not having a fever (which is a good sign), the antibiotic course needs to be completed, as half a course of antibiotics leads to more complications like drug resistance or partially treated meningitis. If resources are limited in the setting, we also consider clinical findings like if the baby is tolerating feed well, weight gain present, no fever, looking well, and hemodynamically stable. If all are there then usually we consider them. It is possible that not always you get the cause, but when the child is having symptoms, we have to treat it, initially with empiric medication and simultaneously look for the cause. For more information consult a paediatrician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat major trauma to the abdomen?\n\nHI MY name is Sheila, and after an assualt , being punched 8 times in my abdomen by belly button and to the left side, i found that i had trace of blood in urine, high wbc count, and also high neutro absolute level. what does this mean,? thanks.sheila",
    "doctor_response": "Hi Sheila ! Good evening. I am Dr Shareef answering your query.Based on the history of trauma, and the investigation reports, I would suggest you to report at the ER of your nearest hospital at the earliest for a clinical assessment of your abdomen and related investigation like an ultrasound abdomen.It might not be possible to opine on this over net without a clinical examination.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Remedy for quick ejaculation and small penis after erection?\n\nHi i am sonu . I have some problem . I am 26 years old . I am doing hand practice last 14 years now i am suffring lots of problem .1 fast discharge 2.small penise around(4inch)after erection.no thikness.not proper erecrion. Thats why i dont think about marriege.",
    "doctor_response": "Hello SonuI appreciate your concernI will definitely help you in best possible way if you can answer my these questionspresence of any medical or metabolic disease Do you smoke or consume liquorfirst of all it needs to rule out any organic cause for discharge and poor erectionYou need not to worry this condition is very much treatable and size of penis doesn't make much difference for a successful marriage, so consult your doctorI would advise you following guidelinesWatch your frequency of hand practice and look for any injuryYou can  press at the base of the glans when you feel to ejaculate and can stay longerAvoid smoking and alcohol consumptionAvoid stress and anxiety , just relax and enjoy your dayThere are medicines available for erectile dysfunction as well as premature ejaculation, please let me know if you have need any more assistance, I will gladly answer youHope this answers your questionBest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat red and skin coloured bumps all over the feet?\n\nMy 23 month old daughter has red and skin colored bumps all over her feet. No loss of appitite, small rash on bum, usually never gets diaper rash, as she is barely wearing diapers anymore. No fever. She is teething and I can t see any bumps in her mouth. She does not appear to be itching her feet. But she is very cranky this morning! The bumps have grown in number over night.",
    "doctor_response": "hi this bump might filled with fluid or like cheesy substance if it's spreading faster we need to show it to a physician it might be caused by some bacterial infection",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness in the chest?\n\nHave had two bouts of my chest feeling crushed and tight in last 12hrs. first time it lasted only maybe minute and just at center front. had a second experience half hour ago and this time i felt in my back to in same kind of area. i decided to do my pulse whilst this episode went on my pulse was 114 and i was resting. however i am going through crisis of depression and stress. i know its not panic attack as i have suffered from them before. then pain also lasted longer than the first time. it has dropped to 108 now but i am typing?!!! i am 37yrs old",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, possibility of uncontrolled stress, anxiety and depression related chest tightness and pain are more. But better to first rule out heart diseases as you are having left sided chest discomfort. So get done ecg and 2d echo. If both these are normal then no need to worry for heart diseases. In my opinion, you should consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on it's solution. You may need anxiolytic and antidepressant drugs too. Avoid stress and tension, be relax and calm. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What happens if I miss one day medicine for high BP?\n\nmy age is 27 years and my weight is 102 kgs..i am feeding my child nowadays,as she is 1 year old..i was having high blood pressure problem from around 5 months,and also taking medications for the same. .if i miss my blood pressure medicine for one day ,is it harmful to me in any way??",
    "doctor_response": "Dear Mrs,There will be no harm if you miss your medication for one day.So don't worry.Wishing you good healthRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed restless leg syndrome. No help from ropinirole HCL, citalopram hbr. Difficulty sleeping. Recommend\n\nI've been diagnosed with restless leg syndrome and taking 1mg tablet of ropinirole HCL 1 hour before bedtime.  Legs are seeming to get worse.  Doctor recently prescribed 20g of citalopram hbr and just started it.  I haven't really slept the last 5 nights.   Is there a specialist who  I can work with?.  This is stressing me so much I'm not sure the citalopram is helping.",
    "doctor_response": "Hello,Welcome to Healthcaremagic.I had gone through your query and understand your concern.Let me first explain what is Restless leg syndrome. So that you can understand the disease and role of medicine and lifestyle changes.Restless syndrome is considered as the Sleep disorder. Because it deprives your sleep and impairs your quality of life. Restless leg syndrome may be Genetic or familial or diseases like parkinson's disease can cause RLS. Even some medications cause Restless leg syndrome.You have been prescribed Ropinirole and Citalopram by your doctor. Because some studies shows that is RLS is caused by an imbalance of dopamine, a chemical that transmits signals between nerve cells in the brain.But drugs may in some and not in others.Thus Lifestyle modification is essential to cope up with Restless leg syndrome.If you are my patient, My advices are1. Try to make regular sleep schedule and stick to it whatever the work may be.2. Do Moderate exercise regularly. You can do aerobic exercises, swimming, walking. Keep in mind that heavy exercise can worsen your symptoms and again lead to sleeplessness3. At any cost avoid caffeine, alcohol and smoking. Because many people feel better after quitting this habits.4. Try yoga and medication. This relaxing techniques will promote your relaxation and alleviate your symptoms.At times symptoms may worse. I suggest you to try Leg massages and Hot baths or heating pads or ice packs applied to the legsHope this helps.You will definitely feel better after this life style changes.All the best.f you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Regards,Dr.Manjeth.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ulcers in leg\n\nmy mother in law is 88years old and week ago she had ulcers on her leg and her feet are as hard as a rock so i put a bin bag on her leg to let out the fluid and the fluild is draining well but she has pain with it and she has tablets like fursemine 40 grams and warfrin varies and amias 8mg and digoxin 125micrograms",
    "doctor_response": "Hi, If your son does not have any history of trauma then most probably it might be muscular pain only. Better start hot fomentation apply some diclofenac ointment, make rest his arm in arm sling and start pain killer. If then also pain does not subside then should see the doctor. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Gaurang B. Shah, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a herald patch cause back pain?\n\nI was diagnosed with Pityriasis Rosea yesterday. I ve had it for about 4 weeks. The herald patch is on my lower back. I also started having back pain about an inch from the herald patch about the same time as this started. Can back pain come from having this?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.Herald Patch usually doe not cause back pain. It is an asymptomatic condition. I feel that your back pain is entirely different from Herald patch. So, please do consult Orthopaedician for management of back pain.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can we tell if the patient is brain dead after a heart attack?\n\nHusband had a heart attack. Drs. say he had very little oxygen at arrival. He was placed under sedation, however they suspended the sedatives and he doesnt respond to commands . he is on a respitator, how long for us to know if he has brain damage or not.",
    "doctor_response": "Hello madam,I pray to God for you.There are some hallmark signs of brain death-1)when you shine torchlight in the eyes,the pupils don't constrict or react and they remain fixed and dilated.2)when you touch the cornea of eye with a wisp of cotton,eyes don't blink in a dead brain.3)when you turn the head towards one side,in normal individuals eye ball move in opposite direction(doll's eye reflex).In a dead brain,eye balls remain fixed.These signs suffice for calling it a brain death,for all practical purposes..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and pressure, heaviness in the skull?\n\nHi there, For the past week in the mornings severe dizzyness and pressure on the right side of my lover skull and there is a heavyness and tightness. I cannot sleep on my back for the pressure and sometimes my face feels tight and I was wondering if this is a sinus infection and what to do about it. Thankyou",
    "doctor_response": "Hello, It is possible that your symptoms point to sinus congestion but they could also be the symptoms of a headache syndrome such as moderate to moderately severe tension-type or even migrainous headache. In order to have this condition properly evaluated and treated I recommend you seek out the services of a qualified doctor or neurologist who will then, obtain the proper history and perform the proper tests to tell what the diagnosis is which should lead to proper therapeutics. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can be the reason for spotting and delayed periods?\n\nHi doctor, My last 2 periods were very light. The latest one came after 50 days and started with 5 days spotting followed by light flow which is going on for 6th day now and has not stopped. My periods have been regular so far, 30 days cycle and lasts for 3 days with 2nd day heaviest. But, since the last 2 cycles there has not been a heavy day. I have a history of systemic lupus erythematosus since age 14 and now am 31. Recently for acidity I was on Rabeprazole for close to 3 months.",
    "doctor_response": "Hello. I understood that your menses have been regular so far and it is just since last 2 months that you have been experiencing delayed menses and metrorrhagia (abnormal bleeding). It seems unlikely that there is a sudden hormonal deficiency. But, likely stress induced hormonal imbalance and late estrogenization has probably occurred. Date should not be a concern here in the delay as the pattern had been regular till last 2 cycles. The delay can also possibly be due to hyperprolactinemia or recent onset hypothyroidism as well. Hence, I would advise you to get a thyroid profile and serum prolactin levels done as well. However, if the bleeding does not stop in next few days then you can consider opting for Progesterone pills like Meprate (Medroxyprogesterone) 10 mg once a day for next 15 days. This shall not just help control bleeding but also regulate it for this cycle. Observe the pattern for next 2 cycles and try to keep the stress levels low in next cycles. Follow up with the reports to an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pseudotumor cerebri\n\nI was diagnosed with pseudotumor cerbri in July of this year. I had a lp in which csf was drained and I had 3 minor headaches after that. Now I ve had a headache since Wednesday. Friday night I noticed pain in my ear and throat. My right gland is swollen, my right ear is aching and wooshing and my headache is on the right side. What should I do?",
    "doctor_response": "Hello. I have been through your question and understand your concern.Your symptoms does not seem related to pseudotumor. Instead it might be an ear infection or post flu symptoms involving the ear structures.Still, you need an ENT consult or at last getting seen by your GP.Hope this helps.Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of shoulder pain and numbness?\n\nYes, thank you. I have a sore spot under my right arm & some slight shoulder pain. It looks as though under my right arm is swollen compared with my left. Also, for the past 6 months at least I have been woken several times a night with pins and needles and/or numbness in my right hand/arm. It may be that I have a tendency to lie on that side and am compressing my arm? (I can only sleep on my side as lying on my back causes sleep apnea & I can t breathe) however, sometimes I also have the pins and needles in my left hand/arm, but more frequently on my right. What could be causing these symptoms?",
    "doctor_response": "Hi, It sounds like there is a mass lesion in the right axillary region that is compressing portions of the brachial plexus causing the symptoms you describe. The most common sort of problem in this area is an abscess referred to as Hidradenitis which is usually treated conservatively with warm compresses and antibiotics before actual surgical considerations are undertaken. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes no baby movements in a pregnancy?\n\nHi, may I answer your health queries right now ? Pleamy partner is 32 weeks pregnant and all along the pregnacy the baby has been very active but since my partner woke up this morning she hasnt felt the baby move and were both worried somethings wrongse type your query here...my partner is 32 weeks pregnant and all along the pregnacy the baby has been very active but since my partner woke up this morning she hasnt felt the baby move and were both worried somethings wrong",
    "doctor_response": "hai,according to my opinion  first you please go and consult doctor  they check fetal heart sound after that go for ultrasound abdomen and nst.baby movements minimum 9-10 seen in one day in all healthy baby. did you took any tablets yesterday  also matters .so please consult doctor",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tuberculosis lymphadenitis\n\nI was diagnosed of having tb adenitis by simly having the skin test and the presence of lymphnode in my neck. I had taken treatment for tb for only two months, then i stopoed.i got scared of the drugs.i have had doubts of the diagnosis  of my ent doc. I havent gone to other doc yet to have checked. Until now,the hard lymph node in my neck(below the jaw still there) the lumphnode below my ears does not disappeared. My throat not feel ok. Sometimes its hard to breath. Iwant to go to the doctor, whom shld i consult? An internal med doc or the ent? Is this realy a tb adenitis? Is this cancerous? Is there any possibility of lymphoma?thanks",
    "doctor_response": "Hi and thank you for choosing HCM to post your question.I read carefully your question and my opinion is as follows:Tuberculous lymphadenitis presents as a slowly progressive,painless swelling of a single group of lymph nodes more frequently of cervical lymph nodes.Clinical suspicion is important in diagnosing this condition in persons from endemic area of tuberculosis and with positive skin test(PPDtest ).The cornerstone of treatment remains antitubercular therapy but response is slower than with pulmonary tuberculosis.A definitive diagnosis can be made by culture or nucleic amplification of Mycobacterium tuberculosis in an affected lymph node.I would recomend excisional biopsy since it has the highest sensitivity but fine needle aspiration is less invasive and may also be useful ,thereby permitting distinction from other causes of lymphadenitis(cancer,lymphoma,infectious ect)I hope my opinion can be helpful.Wish you good health.Kind regardsDr.Dushi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are antihistamines prescribed for?\n\nHello...I was just trying to explain, in simple terms what the difference is between antihistamines/what they do/how they work/possible side effects and the same for decongestants....I wonder if there s a simple article that does this better than I can that I can send to her...thanks much and have a great weekend...my best, tony miller",
    "doctor_response": "Hello and thank you for using healthcaremagic.Antihistamines, as the name suggests, are used to target histamine which are an important chemical mediator of allergic reaction. antihistamines act best when they are given before exposure to allergy causing agent or environment. if the histamine is mot released, then most of the allergic reactions dont occur or reduce in severity.depending on the type of antihistamines, different side effects can be seen such assleepiness(avoid driving after taking a antihistamine), nevousness etc.decongetants are simply medicines which prevent the stuffiness and running of nose which is common with most of allergic condition.decongestants are to be avoided in a patient with cardiac problem, prostatic enlargement. chronic use of decongestants can lead to rebound increase in nasal congestion. so it is always advised to take decongestants in short intervalsboth are availabe as, tablets, syrups, drops formulation, mostly as over the counter drugs. but it it should be understood that neither of the above cure allergies, but they help to control the effet of an allergic reaction or common cold to some effects.i hope i have been able to provide relevant information regarding your query. feel free to ask any other questions .thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to remove tuberculosis scar on lungs?\n\nGood day! I got Pulmonary tuberculosis when i was in grade school and every time i went to xray for job or any reason the result shows some densities, my doctor says its a scar but i just want to ask is there any way to remove it or appear my lungs clear?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. No, you can not remove scars from lung. Any lung insult (tuberculosis, pneumonia) heal by fibrosis and calcification. They form Scar on healing. And these scars are permanent. Nothing should be done as they are harmless. For your job purpose, you need to prove that that these scars are noninfectious and you are not suffering from active disease. For this, you need to consult pulmonologist and get done CT thorax and bronchoscopy. If both these are normal then you can argue with job authorities. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for the back pain?\n\nI have a question about my pain management doctor. Why after  2 years treating my cronic back pain, he is decreasing my pain meds to the point I need over the counter meds again. My condition  is... Lumbar Discogenic disease, Lumbar Facet Joint Arthropithy, Lumbar Spondylosis, L3 Radiculopathy with Degenertive joint disease , with muscle spasms. I'm a 51 year old man who worked as a iron worker for 25 years.",
    "doctor_response": "Hi, I have read your problem. Usually back pain is managed with pain-killers till 1 month period. If it persists beyond 1 month, then further investigations are done. Since you have a bad pain I will suggest the following: - Back pain can be due to many reasons. You should get x-ray lumbosacral spine done in AP and Lateral done send us report or discuss it with your doctor. Only then further management can be advised. - Avoid heavy weight lifting pushing and pulling heavy objects, because it will further increase back pain. - You can take medicine like painkillers + muscle relaxants by discussing it with your doctor. You may need stronger pain-killers which are available on prescription only. You can try ibuprofen or naproxen till you see your doctor. - Apply hot packs for 30 min in morning and evening . I hope it helps. You are welcome to ask further health related queries.If you have any further query, I would be glad to help you. If not, you may close the discussion and if possible you may rate the answer 5 points for me, so that I get a good feedback. In future if you wish to contact me directly, you can use the below mentioned link:  Let me know if you have any concerns. Thanks.  Dr.Singh.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dog bite\n\nmy son has been bitten by a dog on his bum on the 19th of may. he has been given tetanus and one injection costing rs. 340 on the 20th of may in the morning. the dog is a pet dog n has last been given vaccine in 2010. now when should i give the next injection to my son.",
    "doctor_response": "Hi & Welcome to HCM.I appreciate your concern for your beloved son who is being bitten by your pet dog.Your son must receive a total of 4-5 doses of rabies vaccine.Since he has already received one dose on May 20th (which should be counted as \"Day 0\"), he must take the next dose on days 3, 7, 14 and 28 as well.Meanwhile your pet dog should be observed 10 days for the following signs and symptoms of rabies like biting without any provocation, eating abnormal items such as sticks, nails, feces, running for no apparent reason,  hoarse barking and growling or inability to make a sound excessive salivation or foaming at the angles of the mouth.If your pet dog remains healthy and does not show up the signs and symptoms as described above the remaining doses of the vaccine can be stopped.Hope to have answered your query.A feed back is appreciated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red tonsils with white spot in 6months old?\n\nHi, may I answer your health queries right now ? Please type your query here...hi,i have a 6 month old daughter who weighs 6.6kg. Two weeks ago she had tonsilitis and had amoxil prescribed for 7 days. Today i saw her tonsils when she was crying and they are both red with a white spot each. She doesnt seem to be in pain and eats very well she has no fever. What could it be?",
    "doctor_response": "Hi...by what you quote I feel that your daughter might be having a viral sore throat or a streptococcal infection. I suggest you see your pediatrician and get a rapid streptococcal antigen test done. If it is positive then she will require antibiotics. if it is negative then it might be viral illness and doesn't require antibiotics at all.Cough and cold are viral 95% of the times in children. For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15mg/kg/dose (max ceiling dose 500mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in lower back radiating down the legs?\n\nI broke my left metatarsal and was walking with a limp.  However, my lower back has been causing me pain that radiates down both my legs I find that I have problems standing up from the pain.  I do have a herniated disk on my 5th lumbar for years.  My only relief is to bend at the waist and stretch.  This alliviates the pain somewhat.  The pain is a dull one and it hurts very bad.  By the way, my foot has healed and I am not limping but the pain in my back persists.....Carmen",
    "doctor_response": "Hi,From history it seems that you might be having Sciatica pain due to having prolapsed intervertebral disc.Due to having uneven movement or limping while walking due to fracture of meta tarsal, pain aggravated.Go for back extension exercise and short way diathermy.Avoid more bending from waist.Use hard bed for sleeping.Take calcium and B1,B6, B12 supplements.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tenderness in one side of the body?\n\nHi, may I answer your health queries right now ? Please type your query here... It seems to me that the left side of my body is more sensitive than my right. It also seems skinnier. The bones on my foot are not covered by as much soft tissue. My left shins and joints ache after working out. When I m sick, my left armpit is sensitive, and my left breast aches before my period. Also, if I have a tooth ache, it is on my left side. Am I imagining this?",
    "doctor_response": "Hello,Welcome to Healthcare Magic.First, you should get assessed and investigated by general physician to confirm above self observation of yourself. If general physician finds some problem then got treated for it.If there is no problem (or normal examination), then you can meet nearby psychiatrist, as such symptoms can happen in psychological conditions like anxiety and somatization.Wishing you good health and all the best.www.99doctor.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can hair fall, dry scalp and dandruff be treated?\n\nHi Doctor, I have sever hair fall complaint. Dry scalp and drandruff. My hair becomes so dry and splitens are more. Not at all healthy. Even if i touch the hair it comes with hand. i want to stop the hair fall and grow my hair. My hair should be healthy and dense. Please advice. Thank you.",
    "doctor_response": "Hello dear,Taking into consideration the case history as provided in your post, the complaints of hair fall is related to dry scalp and dandruff.So, the problem of dandruff needs to be addressed before initiation of treatment for hair fall.Dandruff is basically Seborrheic dermatitis & can be treated with shampoos or lotion containing salicylic acid, coal tar, ketoconazole, or selenium.The causes of hair loss/thinning of hair are:1. Environmental factors2. Stress3. Deficiency of certain minerals, vitamins & amino acids in diet. e.g. zinc, Vit B complex, lysine.4. Any incidence of surgery, shock, etc.Management includes:1. Treating the underlying cause2. Avoidance of stress3. Dietary modifications4. Minoxidil solution to be applied locally to stimulate the hair follicles5. Multivitamin & mineral supplementationSo, it will be better to consult a Dermatologist to find out the underlying cause & start treatment accordingly.There is no need to worry. Your hairs will grow back again.Wishing you a Good HealthTake care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat forehead injury in a 6.5 months old child?\n\nHi I dropped my iPhone on my 6.5 month old baby. There is small red bump on her forehead/head where the phone hit her. She cried instantaneously in pain for 4-5 mins. I want to know if I should take her to be checked out? I am really worried. She seems normal otherwise.",
    "doctor_response": "Hello. I just read through your question. This is a very common occurrence. Because she didnt lose consciousness, and returned to behaving normally after a brief period of crying, head injury has been ruled out. You can relax. There is no reason to be concerned.",
    "dialogue_context": ""
  },
  {
    "patient_message": "High liver count, palp on gallbladder. Blood test done, ultrasound scan showed emporium, colorful. Advise?\n\nHi, I am 33 years of age and had bloods taken liver count was high but not real high I also had a ultrasound done report came back with a ? When asking my local doctor what this meant the only answer I received was the word emporium and colorful ??? I am unsure of what this means they also found a palp on my gallbladder ? Will I have to have surgery to remove it?",
    "doctor_response": "Hi, thanks for the query to H. C.M. Forum. Why you get in blood examination ? Why you get in an U/S? What are the complaints for which you are asking about surgery? Any how the meaning emporium and colorful as far as concerned about U/S is nothing. If there are stones in gall bladder than surgery is the only option. If enlargement of liver is there than you have to take treatment accordingly. Have a nice day. Good luck Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump in the groin area?\n\nI have a small lump in the groin area which sometimes seeps puss. It not painful its very small and slightly red. Im a 17 year old girl this happened before i started having sex, i get heavy periods so is it this???? or i take codiene 30mg for a knee problem could it be this???",
    "doctor_response": "Welcome to health care magic. 1.Lump in groin area with collection within - its infective aetiology, possibly hair follicular infection. 2.In this case as a remedy - keep area hygiene, do not squeeze the lumps,scratch as you will complicate in that way. Clean with antiseptic liquid.3.There is nothing to do with periods and your medication, its localised infective features.4.A course of antibiotic would help in this condition.5.Stop shaving for a while until completely heals, as it will cause irritation, use trimming instead. Good luck.Hope i have answered your query.Any thing to ask do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for genital warts\n\nHi, may I answer your health queries right now ?  Please type your query here...I have a severe case of genital warts which started about 6 months ago. I havent been to get treatment as Im extremely embarrased. Each time I went to go I never did. I know this is stupid as they only get worse. Now I feel its too late to go as they are developed so much. Im considering buying cream off the internet to \"self-treat\" just until they arent as severe at which point I will seek professional treatment. I know this isnt advisable but I was hopng you could tell me which cream I need to save me possibly making things worse. Or is there anywhere I can get treatment anonymously?",
    "doctor_response": "Hi, Thanks for posting in HCM. I understand your concern. Genital warts are the most common viral sexually transmitted infection (STI). They are caused by the human papilloma virus (HPV) which can be passed on during sexual contact. Most of the visible genital warts often go away with time, but, the virus cannot be cured once it is in your bloodstream. This means that you may have several outbreaks over the course of your life. Treatment of genital warts is indicated to relieve painful symptoms or to minimize their appearance. Any of the topical wart treatments like imiquimod or trichloroacetic acid or podophyllin and podofilox can be used. If visible warts do not go away with time, you may require surgery to remove them by means of burn (electrocautery), freeze (cryosurgery), laser, or excision. Hope the information provided would be helpful. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes thick sputum in throat when pressure is applied around lump?\n\nI have this Pressure behind my sternum and but I know I have A hiatus hernia And I have Hart burn more than 3 days A week Its Funny but some time s when I push around on the lump spot it couses A real thick sputum to come up in my trout and mouth? Looks like skin or something? What should I do about this and what else could be happening in my chest aria? I also smoke cigarettes?",
    "doctor_response": "Hello hope the answer helps you.As far my understanding sir/madam is that you have a hiatal hernia found on some imaging study but symptoms of GERD as regurgitation,retrosternal heart burn combined with cigarette smoking seems to me the cause and if obese it is aggaravated.Hiatal hernia can be associated with GERD.You dont fear try to stop somking heavy,spicy meals less frequent and small meals after 3-4 hrs and donot lie down after taking food immediately.Also some antacids will work on regular basis 3 weeks and if symptoms not improving than consult doctor as far my knowledge thanks for your response",
    "dialogue_context": ""
  },
  {
    "patient_message": "Causes for sore tongue and gums\n\nI have had a sore tongue , sore gums and a pain under my chin for 4 days. Gums and tongue are unusually red and sensitive.",
    "doctor_response": "hi These kind of symtoms can be seen in high fever  are in case  if u are under any medication ? some drugs will cause these kind of symptoms. And if u had any  tonsils which are infected will lead to fever and pain under your chin as u said. please consult ENT specialist to diagnose the proper cause. And take needfull antibiotics and pain killer in combination with paracetamol will give u good relief.In case of tonsilitis pz take ogmentin 625 mg for twice daily for five days. take care Dr.narayan babu",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are headache, drowsiness and muscular pain signs of chikungunya?\n\nHi, A month ago my husband was in india he had fewer, running nose and headache, he took medicing prescribed by a local Doctor and later after a week he went back to US, from the day one he got headache and drowziness and muscular pain dizziness for past 3 weeks, is that due to chickengunya or some other symptoms?",
    "doctor_response": "Hello,Thanks for posting in HCM.Fever, body pain, headache are constitutional symptoms which can be seen from a viral fever to any infection like as you said chikungunya or malaria or others. It does not point to any specific disease as it will be present in almost all febrile illnesses. Chikungunya usually presents with severe joint pains especially of knee joint so as that patient can\u2019t stand without support. But again it is differently seen in different patients.As it persists from 3 weeks I would suggest getting proper blood checked for presence of any infection like typhoid, malaria or presence of any other diseases depending on other signs he might have after doing a detailed physical examination. It will be advisable to consult your doctor for proper examination and other blood investigations so as to arrive at a diagnosis and treat the causative factor.  I hope I have answered your query well. If you have any more question kindly write back to me, will be happy to help you out.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for asthma attacks\n\nMy son who is 45 years old has asthma from the last 40 years.in the last 3 months he had severe attacks which was very near to DEATH  and was dangerous.THE FIRST ATTACK WAS WHEN HE WENT TO TOILET - HE GOT AN ATTACK WHICH WAS LIFE RISK.   HIS FACE TURNED BLUE - LOST HIS CONCIOUSNESS.ACCIDENTALY BY THE GRACE OF GOD ONE FAMILY MEMBER GAVE MOUTH TO MOUTH RESPIRATION AND SAVED HIS LIFE.    MEDICALLY NOTHING WAS FOUND.HE WAS TRATED BY NEBULIZER IN A HOSPITAL    HIS LIFE WAS SAVED.THE SECOND FEW DAYS - SOON AFTER GETTING FROM BED HE WEN TO URINAL.   WHEN HE WAS ALMOST EMPTYING HIS URINE HE GOT A SEVERE ATTACK OF ASTHMA - BREATHLESSNESS .THE THIRD ATTACK WAS A DAY LATER EXACTLY THE SAME WAY.  FIRST THING IN THE MORNING AS SOON AS HE GOT OUT OF THE BED IN THE EARLY MORNING IN THE END OF URINATION HE GOT HIS 3RD ATTACK - SAVED BY NEBULIZER.CAN YOU HELP ME - CAN YOU DIRECT THE TREATMENT- I AM SENDING THIS MESSAGE FROM   I N D I AEMAIL  -  YYYY@YYYY                 YYYY@YYYY",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your son's history and would like to know more about him as follows:a. He has asthma since childhood. How it was treated? What were the medications used? What are the medications he is currently using?b. Regarding 3 episodes of fainting, what were his symptoms? How did he lose balance? Did he have black out? Was his blood pressure measured at that time? How much time it took to completely recover? I want to know this as such things could be due to postural hypotension or anaphylaxis, a more serious form of allergy.c. As all 3 episodes of fainting occurred in washroom, is there anything special about washroom? Is there mold inside washroom? (mold is a very common allergen) Does it contain fumes of acids/cleaners, etc?d. How are his asthma symptoms in between? Does he have breathing difficulty, cough or wheezing?e. Are there any seasonal variations?f. Does he have any other medical conditions? Does he take any other medications regularly/frequently?g. Does he have nose symptoms? - nose congestion, sneezing, running nose, etc?h. Does he have any digestive problems? constipation, acidity, heart burn, etc?i. Does he smoke? any other exposure to dusts, smokes or air pollution?j. Is stress an important factor in his life? Does stress worsen his symptoms?Above details would help me to know more about his health and therefore to make more specific suggestions for him.At present, from your provided information, I would like to make more specific suggestions for him as follows:1. I would suggest him spirometry with post-bronchodilator reversibility testing. This will help to know his lung capacity, status of his asthma as well as it will also help to better choose his medications.2. I would also suggest him allergy testing for common allergens. In addition, I would also suggest him serum total IgE and baseline serum tryptase levels. (serum tryptase levels are done only at a few centers in India at present)3. If such further episode occurs, I would also suggest you to get him examined by a doctor as soon as possible, get his blood sugar and blood pressure measured. 4. As he has severe asthma, I usually suggest my such patients regular use of inhalers like inhaled corticosteroids. For in-between asthma symptoms, I would suggest him to use salbutamol inhaler on as-and-when-needed basis. Further medications can be suggested only after detailed information.5. In general, I would suggest him plenty of fluids during day to ma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for low phosphorus in bone?\n\nHello, I have problems with low phospherous and normal calcium which is unusual for a.person with 3-1/2 parathyroids removed. I was working on my truck today and when I was finished I walked to.the sink to.wash my hands. I was extreamly tired and shaking and feel really really worn out in a very short prior of time. My heart rate went to 110 and I have a prickley feeling in my left hand and arm. I took phos-nak and hour earlier before this happened. I know you need more history so if you want me to write me please let me know.",
    "doctor_response": "Hi, Yeah, there's a metabolic problem underlying this. Especially if others in the family have had this it is a kidney phosphate wasting disease. OR, it can be an abnormality of the parathyroid. Paradoxically when the situation with the parathyroid gets BETTER, the calcium and phosphorus PLUMMET. (hungry bone disease) it will have to be monitored. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for asthma in kid\n\nMy 6 yr old has chronic asthma, mostly activity induced.  She takes a daily control med and has rescue med to be used prior to physical exertion.  She is complaining she couldn't breath but doesn't appear to be having difficulty.  She said her heart feels like its racing.  Her pulse is 128.  Should I give her the rescue med?  I know this can also increase her heart rate.",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your query and would like to make following suggestions for your daughter:1. It is true that rescue medication for asthma can increased heart rate. So if her pulse rate is 128, it should be given under doctor's guidance.2. If she does not appear to be in difficulty and she complaints of not being able to breath, she could have nasal obstruction. I would like to know whether she has any nose symptoms - running nose, sneezing, nasal congestion, etc.In that case, treating the nasal congestion would help her rather than rescue asthma medication..Hope above suggestions will help you.Wish her the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dull pain after having a temporary filling during root canal treatment?\n\nHello. I am 3/4 of the way through root canal treatment and I currently have a temporary filling in place for 2 weeks. The root canal is completed, the last step being the crown being cemented down permenantly. I am however, experiencing some pain around the area and the area surrounding it. It is a dull ache which seems to linger. Is this normal with temporary fillings at this point in root canal?Thank you for your time.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern.As per your query pain and sensitivity after root canal treatment occurs due to two reasons firstly there can be a infection which causes pain, that remain after root canal. Secondly sensitivity is caused due to periapical periodontal fibers . You should not go for crown placement till the time pain would not heals completely. I would suggest you to  do warm saline gargles several times a day, maintain oral hygiene . Take ibuprofen ( if not allergic) or acetaminophen , which will reduce pain and swelling. Consult your dentist again for proper evaluation and rule out condition like high point. Doctor may order X-ray to confirm diagnosis . He/she may prescribe antibiotics , release the high point or in case the infection doesn't go away with antibiotics then he/she may consider to repeat the root canal again. Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent neck pain?\n\nHi i've had neck pain for a few years with it becoming more stiff, in the last week it has cracked loudly a few times then today whenever i moved my head/neck i get an excurating pain shooting from my neck down my arm and the top half of my body felt numb for a few seconds.",
    "doctor_response": "Hello,Thank you for using Healthcaremagic.I think you should do a neck MRI to rule out that this new episode of sharp pain, is not a discal hernia that is compressing the nerves in the neck and may need surgery.If MRi is OK than needs to be treated with ninsteroidal antiinflamatory and collar neck for few weeks and some ultrasound therapy.Best regards, Dr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fatigued, stomach cramps. Strep, flu and blood tests negative. What is wrong?\n\nMy 6 year old boy has been very fatigued and complaining of stomach pain. He has had no fever, vomiting, or rashes of any kind. He has an appetite . We took him to the doctor and they swabbed for flu , strep , and took blood. All tests were negative. He also had a Cat scan for the bellly to check for internal bleeding and/or swollen glands- again negative. Any thing else we should test for?",
    "doctor_response": "Hi. Abdominal pain is very nonspecific symptom. It can be caused by organic diseases or by functional diseases. In his case it is obvious functional disorder because diagnostic tests that you have mentioned would rule out any organic disorder. At this age pain can be caused by food allergies, IBD or psychogenic. Also any infection of respiratory or urinary tract can lead to abdominal pain. I suggest to wait and see are symptoms gonna persist and getting worse. If yes then complete gastroent. workup needs to be done. Wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can anemia causing dizziness and syncope symptoms be treated?\n\num . hi . um im a vegetarian and i dont take iron supplements or anything like that . and for the last 3 or 4 months i have been feeling really dizzy all the time . i always feel like im going to pass out or fall over . i told a family friend and she said i might have anemia . please help me . and im to scared my parents will make me eat meat . and i really dont want to . is there anything i can do",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some anemia. You should go for complete blood count, peripheral smear examination and anemia profile.  If you have iron deficiency then you can take oral or injectable iron supplements.  No need to eat meat as compulsion.  You can take vegetarian diet with high iron like jeggary, dates, green leafy vegetables, dry fruits etc. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for dry allergy cough ?\n\nI have an allergic dry cough and is peak during day time and quiet at nights Any remedies I AM A MAN OF 50 YRS AND IS GOOD HEALTH AND FITNESS. RECENTLY - A MONTH AGO, SOMETHING TRIGGERED A COUGHING BOUT, DRY COUGH THATS QUITE PERSISTENT. WAS PRESCRIBED ANTI- HISTAMINE LIKE CETRIZINE AND LATER ALLEGRA 120. THIS HAS REDUCED THE COUGH BY 75%. BUT STILL NOT GONE. ANY ADVISE PLEASE?",
    "doctor_response": "Welcome to Healthcare MagicAre you a smoker. Smoking can increase chances of being allergic to smoke, dust causing dry cough. Antihistamine may give relief but will not help in long term. You may need further investigation like blood tests to rule out worm infection, fungal infection which can also cause allergic dry cough. Stop smoking if you do. Use handkerchief when you approach areas of smoke, pollution, anyone who is smoking, gardens to keep away from pollen as well. Consult your Doctor regarding blood tests which may be necessary to make diagnosis to the reason for cough. Do steam inhalation for relief. Yon can try cough suppressant syrups as well to reduce frequency and intensity of cough under medical supervision as well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent vomiting, mild fever and stomach pain?\n\nmy 9 year old daughter started throwing up today - she has vomited 3 times and has a fever, not high grade, but very warm. Her stomach hurts and she keeps having waves of nausea where she thinks she might vomit again. She keeps saying how hot she feels too. It sounds like a stomach flu but should I take her to the hospital to be safe?",
    "doctor_response": "Hi, welcome to HCM. Can understand your concerns. These are symptoms of stomach infection. Get the child examined by a doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Echographie report shows liver increases echo structure diffuse hyper echoic homogeneous and regular contours. Meaning?\n\nhello.this is my echographie report.kindly suggest whet can i do?liver increases echostructure diffuse hyperechoic homogeneous and regular contours.permeable portal vein of normal caliber and flow hepatopetalgallbladder, spleen, head and body of the pancreas of normal appearancetail of the pancreas obscured by deigestifs gas (flatulence)kidney size, well differentiated and cavities pyelocalicielles fines.ils measure rd 119 * 46mm, rg respectively .............. 118 * 52 mm.absence of ascites.absence of deep adenomegaly.finding ..........echographic appearance can do evoke a hepatic steatosis probable.a compare to biology.flatulence + + (or other functional bowel disorder.)Nouveau !Conne",
    "doctor_response": "Hello.Diagnose is hepatic steatosis.Is a pathology related to overweight/obesity, fat food or frequent alcohol intake.It is not an a important pathology but you  must control your weight andfat and alcohol consumption.Your doctor must control your pathology periodically requestingabdomen ultrasound and hepatics enzymes-GOT and GPT- levels in blood.The other abdominal organs are normal.I wish you good health.(In case the answer would have been useful please indicate this)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sprained lower tooth. Area sensitive. Radiating pain on eating. Relief by massaging gums\n\nHi, I have had a problem with my left jaw for the last 3 months. Went to the dentist and he said I had sprained a lower tooth by clenching my teeth . He did an x-ray and the tooth looked clear. He molded a guard and I have worn it for the last 3 weeks with no change. If I eat anything hot or chew on anything cold my jaw seizes up in a piercing pain. It starts in the chin just below the tooth that was sensitive. (4th from the back) Then radiates to all 4 back teeth on the bottom. It then moves to my top teeth on the left, cheek bone area, in front of my ear, below the ear and into the glands below the chin. I have tried heat and cold compresses and the pain is to severe to keep them on. Massaging the gum seems to help a bit. The pain intensifies until the whole side of my face feels as though it is seizing. The episodes happen about once a day for approx. a 20 minute period and then stops. As it is easing, below my eye and in my cheek and in front of my ear and jawline is sore to touch. I am to see my dentist again in another week but was wondering if perhaps it was best to see my family physician? Do you have any idea as to what this could be? Any help would be appreciated, thank you for your time. Pat",
    "doctor_response": "Your case history shows that you are suffering from trigeminal neuralgia. This painful condition occurs unilaterally on the face, along the route of this nerve. The pain can trigger while eating, chewing, drinking, shaving, sneezing, touching the face etc. The pain is shooting type and involves the area around eye, cheeks and lower face. If your tooth looks clear on x-ray, than its not a dental problem. Consult your family physician or a neurologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does dettol help cure psoriasis?\n\nHi, I am a 43 old male and I have psorisis all over my body including my head,back,knees, elbows and legs.I was told that Dettol when diluted with a equal portion of water and put on with a cotton ball on the psorisis will i due time heal it? Is this true?",
    "doctor_response": "Hi,No, not at all. Dettol is antiseptic liquid and used to improve body hygiene by taking bath with dettol containing water. It should not be applied on  psoriatic lesions as it might worsen the condition. There are good remedies for psoriasis. You consult dermatologist and have treatment. Acitretin,methotraxate and other drugs are used by dermatologist. Steroid,calcipotriol and other local cream may be used to apply on the lesions. So, i advise you to consult dermatologist and have proper treatment.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "suggest remedy for allergic reactions\n\nHi My son is 5 years old, He has been having allergic reaction for 4 days now. He has been to the doctor twice and the Doctor prescribed Predcort DS and Aerius Syrup at first. He didn't show signs of improvement on Thursday so we took him back on Friday and the doctor doubled the dosage. Now he says he is cold and he's shaking so what should we do please help...!!!",
    "doctor_response": "HI, thanks for using healthcare magicYou may want to take him back to his doctor for re assessment.He may actually have chills that are associated with a fever. You should check his temperature. If it is high then you should give him an antipyretic such as paracetamol.Dress him coolly and also tepid sponge him as well.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen lymph node\n\nI have a growth on a lymph node and was referred to an ENT Dr. from the ER.....for the past week.....I have taken allergy medicine over the counter meds.....now I am taking predisone.......tramadol....lidiocaine......it does not seem to be getting any better.....I am starting to get real concerned",
    "doctor_response": "Hello, Thank you for your contact to health care magic. I understand your concern. If I am your doctor I suggest you all the OTC drugs you have taken will give you symptomatic relief only. The treatment protocol for your disease is you have to treat the cause which in you caused a swelling of lymph node. I advice you should go for FNAC of the enlarged lymph nodes, and take treatment according to the report. Your current treatment won't improve underlying condition.I will be happy to answer your further concernYou can contact me. Dr Arun Tank. Infectious disease specialist. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on eyebrow after hitting\n\nAbout 5 weeks ago I walked into a large plate glass door and hit my brow bone. Came out immediately into a large lump and had a black eye for over a week. Although swelling has gone down, there is still a lump on the eyebrow bone which feels like solid bone.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have hematoma formation due to trauma.  Black eye is common after any injury to scalp region.  If you don't have any other symptoms then no need to worry.  Your lump will gradually reduce in size.  You can take analgesic and anti inflammatory drugs. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat asthma while on symbicort?\n\nHello have been just diagnosed with adult asthma  and am taking symbicort taken twice a day 2 puffs morning and night, l have also given up smoking and have  marriage breaking down, my problem is l cry a lot it does not take much to trigger it off is this normal??",
    "doctor_response": "Hello,Welcome to HCM,As you are having asthma, it is a conditions due to narrowing of the terminal bronchioles of the respiratory tree.Whenever there is a stimuli like the allergen, emotional and any thing which causes the narrowing of the bronchioles will result in exacerbation of the condition.You can continue with the symbicort which will improves the condition. In addition to this you can take1.Avoid allergens provacating the conditions2.Oral Antihistamine with Mast cell stabilizer3.Continue Steroid inhalation.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can be done for high ferritin levels in thalassemia major patient with factor 13 deficiency?\n\nHello doctor, I am thalassemia major with factor XIII decficiency, HCV+. I transfuse platelet or FFp daily and RCC weekly. All these things are reacting in my body. My ferritin level is 15000 after chelation therapy. This also reacts badly every time. I am 28 years old. How much time do I have to live more?",
    "doctor_response": "Hi. Based on your query, my opinion is as follows:  The serum ferritin level of 15000 is definitely too high. Along with HCV, the prognosis is somewhat poor. However, without knowing the amount of iron deposition in tissues like the liver, heart, etc, and also the amount of damage to liver secondary to HCV infection, it is difficult to say anything. If all are functioning well, then 5 to 10 years should be easily managed well with therapy. Need to reduce ferritin levels, improve nutrition with protein rich diet and need to have a positive outlook. Liver biopsy for serum iron and amount of damage based on liver function tests and histopathology examination could be helpful in further management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having a practice of sticking out of tongue while concentrating\n\nI have recently noticed that when I am concentrating, I stick out my tongue about a half inch between my lips. This is very disturbing because my mom, now 84 yrs, has always done that, but in the last 10 years, it's gotten worse and when she concentrates on anything, her tongue is often sticking out by its entire length and looks creepy. I don't want to get like that. I am a very healthy 58 year old runner and triathlete.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. There is nothing wrong in that. Everyone has some mannerisms. When we overly indulge ourselves in some task, these mannerisms surface automatically. This happens just because we never were aware of it and never tried to overcome it.Here, you want to overcome it just because you do not want it to happen. Fine. The negative feeling about it itself is enough to stop it. Still as an enhancing step, Just put some chewing gum inside your mouth whenever you are doing something. Also good for your mouth and teeth.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it okay to treat acilex and blumox for tooth pain and blister in upper jaw?\n\nHELLO..!!I had pain in one of my lower jaw tooth..and it was found that there is slight PAI in both apices but no bony loss.. should I get that tooth removed or get that tooth dressed...for now  I have been prescribed with ACILEX-P and AMCLAID-625 ...Previously i.e 3 days back I had been taking the medicines BLUMOX-CA, ACILEX-P , SERRALEX 10 mg... presently am also having a blister near to my upper jaw ...and along with that this tooth pain is something really horrible",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. It is good that you have started with antibiotics and painkiller medication for the infection,  as you have mentioned that your lower tooth is having periapical infection. But only taking medication isnot the solution better you should go for root canal treatment,  as once an opening of the tooth is done for the treatment the pain will start improving.Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat Hepatitis C while having history of HIV positive?\n\nHello Doctor Samuel, I have been diagnosed with HIV since 2002 and recently diagnosed with Hepatitis C.I feel like I need a second opinion, please I am looking for a doctor who specialities is infectious decease In Manhattan who is taking Aetna insurance, can you help please?",
    "doctor_response": "Hello I hope you are well. You should know that chronic infection with hepatitis C virus has many advances with respect to treatment. However, you must first know what is the state of liver function, whether or not you present cirrhosis, the genotype of your HCV infection as well as the initial viral load.This is because the different treatment regimens vary according to the genotype of infection, however, currently these new molecules reach sustained viral responses> 90 to 95% so it\u00b4s very important that you go to a hepatologist soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for abdominal pain after taking clindamycin?\n\nI have been on IV clindamycin 1800mg/d5wx22 price/ml for an infection was on it 6 days and now they have me on pill form teva-clindamycin 300mg and teva-clindamycin 150mg. 1 capsul every 6 hours and same with the other one total of 8 pills per day. At first it was ok and now 2 days in and my abdomen middle part hurts every time the pills kick in and burning sensation and feel like something g in my back can t eat. I think I need to stop the pills. Feels like so ethj g is stuck every time the pills kick In and hurts too much. What should I do?",
    "doctor_response": "Hi. Sure - you need to stop the pills immediately start on Ranitidine / PPI, antacid and consult your Doctor immediately. You may need an urgent Upper GI Endoscopy to rule out the gastritis or an ulcer. And also to go for urgent ultrasonography  to rule out pancreatitis and other problems. How are the stools ?",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes muscle twitches along with prickly sensations all over the body?\n\nHi, I have had prickly sensations all over my body including my face for about 4 weeks now. The feeling sometimes makes me want to itch but not severely. I get very anxious and worried and the problem seems to get worse when I do. I started working out which makes me feel better but I ve also noticed muscle twitches for the last few days all over my body as well. No cramping, weakness, ect.",
    "doctor_response": "Hi, You may be suffering from anxiety neurosis or panic attacks. Other possibilities like hypothyroidism or hypokalemia or hypocalcemia, etc. Until examination is done it is difficult to say what it is. Use tablet Ubinext LC once a day for two weeks. If symptoms not improved please consult your physician he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in the tailbone\n\nI fell several days ago onto my bum. A couple days ago while sitting my tailbone popped. Now it is extremely painful to sit down directly on my bum and I cannot bend over without a great amount of pressure. When laying down in bed I have to lay on my side as the pain from laying on my back is awful as well. Is there anything that I can do to alleviate the pain?",
    "doctor_response": "hello....according to me two conditions can lead to pain in your tail bone...first is a coccyx fracture and second one is coccygodyenia....you should get a xray done of your tail bone get precise dignosis....however till the time avoid sitting on hard chairs...also you can use ring pillows to sit on...take painkillers for 7 to 10 days ...apply ice over the tailbone....feel free to discuss your xray findings...thanks and dont worry...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest ayuervedic medication for pemphigus vulgaris\n\nHi, One of my friend suffering from pemphigus vulgaris. Is it possible to treat this disease with ayurvedic therapy? What is the percentage for recovery and where are those hospitals located? Please suggest .My email Id is  YYYY@YYYY .",
    "doctor_response": "**1. Since it is an autoimmune condition causing blistering on skin and mucous membrane, thus treatment of choice is/are steroids,but to achieve a response it has to be taken in proper dose while also considering the adverse effects with regular follow up.2. it is important to see a qualified dermatologist, while Ayurveda drugs can be started as adjuvant to steroids to minimize the side effects and help increasing Immunity by use of Rasayana Drugs [Immunomodulators]3. regarding recovery:  a study concluded that \"Remissions were found to be much more common\" thus one cannot say how much percentage/chances are there. you may consult a Qualified Allopathy/Ayurveda Physician for hospitals in and around your locality.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Losing weight after getting radiation treatment for cancer in the back of the neck. Need a diet advice\n\nMy sister is continuing to lose weight after receiving radiation for cancer in the back of the neck.  Her ability to eat has improved; however, her food intake cannot keep up with her weight loss, and so the weight loss is the bigger issue at the moment.  Is there any place she can go or any type of professional who will give her nutrients and/or food intravenously until she can begin eating again. thank you!",
    "doctor_response": "Dear Ma'am/Sir,Sorry to hear about your sister's problem. Weight loss is a part and parcel of cancer treatment and a person's appetite usually returns to normal within few weeks of the completion of the treatment. You should encourage her to take a healthy, well balanced diet in addition to vitamin supplements.IV supplementation is not a solution to this problem, as it is associated with many side effects, specially infection, which can be severe in such patients. Youcan consult a dietician and have plan chalked out for her.Hoping for the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Medical test showed reactive HBsAg.  No family history of illness and no other symptoms.  Suggestions?\n\nGood day. Sir I just done my medical examination last wednesday then I found out that the HBsAg is reactive in which I don't experience any sexual contact or any family illness like this. I am wondering why I have this illness. Are there any cure about this? This is my first time having a medical examination. Thank you",
    "doctor_response": "Hi,  The HBsAG is hepatitis viral component it can be spread  through blood and bodily fluids. So any blood donation or injection from infected needle  may lead to it.   HBsAG is also component of vaccine that is given for hepatitis protection SO I think the most likely cause is the vaccine which you have received in past is a cause of HBsAg positive in you recent blood work. If you know you had vaccine in past then nothing to worry.  YES Their a cure for hepatitis, various antiviral drugs are available in market.THANKS. Hope it helps.Dr.JAY PATEL.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to stop the loose motion?\n\nI have a son year 10 days old have a lose motion and he is going 5-6 times a day .my mother says home remedy that give the boy water separated from milk and o.r.s please advice further what are other thing that can work and food s requires in this case",
    "doctor_response": "Hi, welcome to HCM. Your child has loose stools five to six times a day, this suggests that your child has probably acute gastroenteritis. In acute gastroenteritis, we need to take care of fluid content in child and look for dehydration. So, you should give ORS solution about 250 ml each time the child passes a stool. Also  antibiotic needs to be given in acute gastroenteritis like tablet oflox-ornidazole two times a day for 3 days. You should also do stool routine microscopy test in child. Review back after 2 days. I hope this will help you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce creatinine level with in 0.8 to 1.00?\n\nHi, may I answer your health queries right now ?  Please type your query here...at present my father is75,due to increase of creatinine level 4 times i admit at hospital from middle of 2008 to 2011 march.at present creatinine level is 1.4.Kindly advice me how to reduce creatinine level within 0.8 to 1.00 ?",
    "doctor_response": "Hello,A creatinine of 1.4 is borderline normal. At the age of 75, he may be having an enlarged prostate, which causes an elevation. He should get the following tests done and see a urologist:1. Urine routine, culture, and ACR.2. Blood routine,creatinine,RBS,LFT,PSA,and platelets.3. Ultrasound-KUB, with residual urine, and a TRUS.According to the reports, treatment can be advised. If you've any doubts, send the reports to me, as a direct question.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Matthew J. Mangat",
    "dialogue_context": ""
  },
  {
    "patient_message": "Injury in pectoral area, pain when taking deep breaths. Need for worry?\n\nYesterday, while playing basketball, a player lowered his shoulder directly into my pectoral area and at first I thought it would be just a sore. It occured last night around 10pm and last night I had pain when taking deep breaths or when breathing facing the ground. Woke this morning an pain is still very presebt when taking deep breaths and certain angles hurt a lot during regular breathing. Is it something to be worried about?",
    "doctor_response": "Hello! Thank you for the query. It is possible that such trauma has caused rib fractures and pneumothorax (air accumulation in the chest). Generally broken ribs does not need any treatment however pneumothorax in some cases needs medical attention as it can be life threatening. That is why you should visit your doctor and have ribs X-ray and chest X-ray. Hope this will help. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause slurred speech during hospitalisation for heart disease?\n\nhi my dad is in the cardilogy dept at a local hospital, suffers from heart and kidney disease went in last week with severe edema in the legs, groin, and water in lungs came out of CCU now in a private room recovering and is on O2, called nurse nurse syas he is doing very good has been in hospital now 10 days, my concern is 2 days ago while visiting him i noticed he was very tired, speech difficult to understand yet he is very coherent otherwise why is this happening his speech is slurred, is this due to the O2?",
    "doctor_response": "Hello,  Because of the fluids in the lungs,  he would have been offered diuretic s,  these drugs flush out extra fluid in urine,  however along with extra fluid they also tend to flush out potassium /sodium.  It is this decrease in body sodium that causes a little  slurring of speech / slowed mentation. So if it was only for a short time,  that is the most common reason.  Oxygen per say will not cause slurring rather it's decrease in oxygen which causes drowsiness.  Regards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes release of strong odour from head after injury which was sealed?\n\nHello, my son cut his head about a week ago, and I ve noticed a strong door coming from the wound (it was sealed with medical glue at the hospital), it s very similar to basalmic vinegar. Is this a normal part of the healing process? Thanks! Heather",
    "doctor_response": "Hi,Thanks for writing in.A wound in the scalp if sealed then should be watched for any signs of secondary infection. A strong odor can be due to the medications and substance used to seal the wound. The smell might be strong but is never foul. If you suspect that the smell is foul and there is some discharge from the area of the sealed wound then please go back to the doctor and get the wound examined. Sometimes the wound can develop infection even after the skin surface is sealed. This happens in contaminated wounds and if there is an infection going on under the skin.If your son complains of burning pain, the skin over wound has become red and there is discharge with foul smell then please have the wound seen by the doctor. They will update you on wound healing and assure you on his condition. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should Valparin Chrono be taken by a 12-year-old to avoid seizures?\n\nMy son is 12 years old, affected by seizures 2 times within 4 years He is continuously taking valparin chrono 300 & fresium 5mg, how long to take medicine and another one doctor advised stopping fresium 5 mg, past 1 week. No side effects till now. Now only take valparin chrono 300 twice a day after meals. EEG took 6 months intervals, the report is normal. Dr.pl. advice how long to take the medicine.",
    "doctor_response": "Hi, Continue the medicine for two to three years until the seizure is controlled and then taper the dose gradually with the advice of your pediatrician or neurologist. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sreekanthababu Polthi, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having noticed small calcification in left side of chest\n\nI am a 37 yrs old male at 6.1 height. as a randomly taken X ray of chest, the report said small  calcification noticed in left hiller. I showed it to a doctor and explained, he says nothing to worry but cut on cigarettes ( since then I have cut smoking by as much as 98%. Please advise when would this calcification go?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. You are having calcified mediastinal lymphnode. It is common in smokers. This suggest old, healed inflammatory process. Smokers are known to have chronic inflammation in lungs due to smoke. This leads to inflammatory enlargement of mediastinal lymphnodes. After certain time, healing take place by its own and nodes become calcified. This appear as calcified spot on chest x ray. This will remain as it is through out your life. And no treatment is required for this because it is old scar, inactive tissue. Smoking cessation should be done as soon as possible. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trouble breathing, bad cough, allergies, numbness in hands and tight face. History of asthma. On ventoline and flixotide 100 diskus. Advice\n\nI have asthma.for 4 days now I have trouble breathing.I have always had my asthma under control but in these couple of days I have had about 10 attacks.i have a really bad cough.i am using ventoline and have now stared using flixotide 100 diskus.i have bad allergies. while having one of these attacks my hands got numb and my face got all tight(i also had all of the other regular simptoms).is that normal?? can you please give me some advice on all of this.thanks",
    "doctor_response": "YOUR CONTROLLED ASTHMA MAY BECOME UNCONTROLLED WITH SAME MEDICINES AS THE DURATION INCREASES THE EFFECT OF DRUGS DECREASES YOU CAN START SINGULAR 10 MG TDS SYP ASCORIL 2 TSF TDS SYP GELUSIL 2 TSF TDS YOU CAN TAKE FOR 7-10 DAYS YOU CAN TAKE OFF ASND ON FOR MANY TIMES FOR MANY NUMBER OF TIMES BUT COSULT YOUR GP TO FIND OUT POSITION OF YOUR LUNGS AT PRESENT AND GET TITRATED THE DOSAGES YOU ARE TAKING",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure swelling on the toe after dog bite?\n\nMy moms dog steped on my foot and landed on the toe next to the pinky toe. At the time it didn t hurt but I started feeling numb an hour later. I thought it needed to be popped and I pushed on it and it hurt, so I stopped. A few hours later I looked at it and it had a bruise on it and was all swollen up. It has a knot near the joint on it. Should I go to the doctor or will it heal on its on. It doesn t hurt too much, just itches. Thank you!!",
    "doctor_response": "HelloWelvome to HCMAfter bitetake tetanus injection.Take immediately anti rabies vaccine.Don't stitch the wound just clear it with running water and soap.Take pain killers like Paracetamol or Ibuprofen.Take prophylactic antibiotics after consulting your doctor.Take care and have a healthy life ahead...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes flank pain along with nausea with history of UTI?\n\nFor 10 years now I have had Uric Kidney Stones and Gout. But this Year alone I have had 5 UTI that have gone to the kidneys due to the fact I always have burning urine because of high uric acid and do not know I have UTI until to late. The one I am currently dealing with is going away however I have constant pain in my left flank more intense burning while urinating as well as external burn on penis glands. ER doc says today the UA showed clear but i m still in quite a bit of pain in the flank , abdomen and very nauseous. Multiple times I have been told Kidneys don t hurt. Well I know for a fact they do because I suffer from that pain. Is there anything else that might be causing this kidney pain that gives clean UA result? And How do I deal with pain that won t let me sleep because doctors tell me the pain doesn t exist. I am trying to get a referral to nephrologist thru my primary tomorrow but I cant deal with this pain while Im waiting for someone to believe me. Any help or answers appreciated",
    "doctor_response": "HelloThanks for query .You have severe pain in flan with your urine analysis not showing infection .Please note that one can have severe pain in flanks due to kidney stone without having any positive evidence of infection in routine urine analysis .Please consult qualified Urologist for clinical examination and get following basic tests done to confirm the diagnosis.1) Urine routine and culture.2) Ultrasound scanning of abdomen and pelvis to rule out presence of stone in kidney .Further treatment will depend upon result of these tests and final diagnosis.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the lower back and hips while on Baclofen?\n\nI have been seeing neurologist for several years. Had nerve in legs, peripheral neuropothy, treated with gauminex infusions. Muscles in legs, thighs and calves have spasims even at rest and this year have been diagnozed with stiff person syndrome. Just within last month started baclofen 10M tablets split take l/2 pill 4 times daily to test. Has helped especially with sleep, muscles were going out aany time I turned. I noticed after a month that my osteoarthritis seems to be getting active (have it in my spine) since taking bacloffen. It seems the pill helps the muscles but now my lower back/hips and sometime side of r leg gets very achy. Is this the consequence of the baclofen. Dr. wants me to increase these pills to a whole pill 2/day. Fear how bad my osteo arthritius us going to flare up. What is common ground here.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Causes for lower back and hip pain are:1. Injury2. Blunt trauma3. Sprain or strain4. Spondylosis5. Spine related problems6. Improper postureYou can take tab. aceclofenac. Apply diclofenac gel or cream. Apply ice locally. Do x-ray and MRI back and hip region. Consult your physician for prescription.Treatment mainly depends upon underlying conditions. Kindly follow with detailed history or consult with orthopedician. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Shyam B. Kale",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why my kid s eye moves inwards just before sleeping?\n\nEvery night, just before sleeping, my 2 yr son s left eye moves inwards. It can take between 30-60 seconds for it to come to its normal position. I took him to an eye specialist and she did visual tests and confirmed its not a lazy eye and he has vision is fine. Then what could it be??? I am very concerned. Could you please help me!!",
    "doctor_response": "HI,Some kids can open eyes a bite an move inwards before he start a sleep phase. If he is smart walking and speaking, and have a normal neuro exam don't worry. Some of the parents could do this too and never realized. If you are afraid go to a neurology and ask some exams.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can dementia be treated?\n\nI am recently assisting my dad with his dementia. He has not been officially diagnosed but recently suffered a fall was hospitalized and thought to have had a stroke. MRI ruled out any ALZHEIMERS and stroke, he tore his rotator cup. It is obvious with his rehab process that he suffers from short term memory loss, easily agitated , very confused. Sun downing very common . A rehab doctor prescribed Lyrica about 3 weeks ago for pain in his back. He suffers greatly with scirliosis and TMJ. 85 years of age and weighs just 107 lbs. I have placed my dad in an assisted living. He has recently relocated from NY to Texas due to accidently causing a fire in the middle of the night at his residence of 50 years . He has no home of his own and cannot be left alone any longer. The caregivers all advise that my dad is a continued fall risk, very impatient. Up and down out of his bed constantly . Easily agitated . He takes a dose of .25 mg of Ativan to help calm him down PRN. I am seeking the care of a doctor as soon as possible ! I researched Lyrica and wondered if that is also adding to his confusion. His behavior has changed dramatically in the last 6 weeks. I am very concerned the Lyrica may be contributing to the confusion. I have his medical power of attorney and would like to stop the Lyrica to see if the side effects have made his dementia worse. I think he could benefit from a different pain medication to calm his pain down and lessen the confusion. Please advise",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. His dementia s purely because of the fall that he had. Taking his age into consideration it is difficult to treat the short term memory loss caused due to his fall and head injury. T.Lyrica that he is on is Pregabalin which protects from seizures and decreases neurological pain. T.ativan which has been prescribed to him his actually a Benzodiazepam which can cause confusion, specially in the elderly. Its important you take him to your psychiatrist or physician at the earliest. As of now it is important to stop T.Ativan, I'm sure that will improve the confusion part. Kindly do this at the earliest and let me know. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness in the chest?\n\nIve had a tight chest for about a week now. It feels as if its hard to get a deep breath at times. What could this be? Chest xray came back normal. Dr ordered blood tests, thyroid etc. I was told by a dr at Urgent Care that he thought it was anxiety. I don't feel its anxiety as this has been going on for a week now and it happens even when Im not stressed about anything. The first day it started my chest was really tight, I felt dizzy, sweaty and had the chills. Everyday after that is just tight chest, hard time getting a good breath and occasionally feeling weird...perhaps dizzy or light headed. What could this be? Im 27 and take good care of myself. Im not overweight and I run 3 times a week.",
    "doctor_response": "Hello!Thank you for asking on HCM!Regarding your concern, I would explain that your symptoms do not seem to be related to any cardiac disorders. Anxiety or musculo-skeletal pain could also explain your symptoms. Nevertheless, I would recommend performing some other tests to exclude other possible causes: - respiratory function tests to exclude a lung disorder- PCR, ESR for inflammation - thyroid hormone levels for thyroid dysfunction- a resting ECG. In the meantime, I would recommend trying alprazolam. If it helps, it would indicate possible anxiety underlying your symptoms. Hope to have been helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can this patient manage her loose motions?\n\nHello doctor, The patient is suffering from loose motions. Kindly help me to deal with it.",
    "doctor_response": "Hello. How many motions are you having in a day and since how many days? It is likely to be enteritis. Most importantly have ORS (oral rehydration solution) 100 to 200 ml with each stool and keep yourself rehydrated. Drink liquid as much as possible. You should also visit a hospital to assess hydration status and whether you need IV fluids. You should get prescribed capsule Vizylac or Sporulac sachet three times a day for five days, tablet Norflox TZ (Norfloxacin and Tinidazole) two times a day along with some antacid like tablet Pantoprazole before breakfast once a day for five days. If stool frequency is too high, we can also start some medicines for reducing stool frequency. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Lamisil cause liver enlargement?\n\nHello About a week ago my husband went to the doctor and gave blood and a few days ago they called him and told him that his blood test came back and that his liver was inlarged.  He been a diabetic for about 5 years now and has never had this problem but recently about 5 months agao another doctor knew he had diabetes and gave lamisil for his toe but never took blood.  Could it be the lamisil even thou he had been off the medicine for 2 months now.  The doctor is repeating the test please help..",
    "doctor_response": "HiYes the Lamisil could be the cause of this liver problem and it may take another few months for the blood work to return to normal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having pain in passing urine, sense of frequent urination. CT scan report showed bilateral small renal calculai focal sol seen in right kidney. Suggest\n\nI am having a little pain in passing of urine and also have sensation for frequent urination and sometimes intermittent urination . I got some tests ct scan says ; 5 mm radiodense calculus noted in middle cayx of  right and  3mm calculs in middle calyx of left  kidney . approximatley 28 by 27 mm hypodense focal solid lesion seen arising from mid aspect of right kidney enhancing with contrast. impression ; bilateral small renal calculai focal sol seen in mid aspect of right kidney s/o of small rcc . serum creatinine is 0.75  ,testosterone is 3.27 ng/ml,  vitamin B12 111, vitamin D 25 hydroxy 14.5, urine test is normal , cbc ; haemoglobin 13.8 , leucocyte count 6900 . monocytes 0 , basophils 0 ESR 04",
    "doctor_response": "Hi! Thank you for your question! Your scan shows that you have small stones on both kidneys and another lesion on your right kidney that seems suspicious. I would highly recommend that you see a urologist as soon as possible so that he/she can examine you better and perform additional tests as necessary. The management plan will depend on these examinations and diagnostic test results. Good luck and I hope that you feel better soon!Dr Galera",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for frequent urination\n\nI went to the doctor wit a water infection. Peeing every 10 minutes. couldnt sleep because I had to pee so often. He gave me some pills for 5 days. took them, within a week it was back again. So he gave me a 7 day lot of pills. I got two days left and I am still peeing a lot and pain in the bottom of my stomach.",
    "doctor_response": "If you are a male, it could be  aproblem with your prostate.  A medicine to relax the prostate is a solution that could help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tender knot on my right temple?\n\nI just got a knot on my right temple a few days ago. It s the size of my little finger. It only hurts when it s touched or if I lay on my right side. I ve not hit it and it s not red or doesn t even look like a pimple. I have no other symptoms other than one day, I had what I thought was pink eye. But that went away the next day. What could this be?",
    "doctor_response": "hi.based from your description, it could be a fibroma (fibrous tissue formation), a lipoma (a fatty deposit) or a cystic formation (sebaceous or keratinous type). other types of lesions must also be ruled-out. a consult with your doctor is best for clinical evaluation, especially if the lesion is bothersome for you. diagnostics and management will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tenderness in metatarsal\n\nI have tenderness on the tuberosity of the fifth metatarsal. it hurts at times when I walk and has a burning feeling to it. If I apply pressure on the tuberosity with my finger or bump it, it really burns. How do I treat it? I do tend to walk on the outside of my foot, that s where my shoes wear, and I ve started walking much more than I used to, 3 to 5 miles a day.",
    "doctor_response": "Hello, I have studied your case and reportsCanal stenosis leads to burning/numb sensation and pain in your foot. MRI shows mild to moderate disc bulge with canal stenosis.Another possibility of metatarsal stress fracture. For these symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.I will advise to check your vit B12 and vit D3 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain when diagnosed with CHF, anaemia and diabetes?\n\nI have congestive heart failure, anemia, diabetes, i am having chest pain on and off at times it feels like a lot of pressure and i have to stop whatever I am doing at the time. The pain does not radiate to any other part of my body. I do not sweat, or feel faint. When I shrug my shoulders its sore.",
    "doctor_response": "Thanks for your question on HCM.In my opinion you should immediately consult cardiologist and get done 1. ECG2. 2D Echo3. Coronary angiography if ECG and echo show abnormalities.As you are at high risk of heart attack , your chest pain is mostly due to cardiac problem only.CHF, anaemia and diabetes can cause coronary blockage. And this gives you chest pain due to poor blood supply to the heart.So immediately consult cardiologist and discuss all these.You may need hospitalisation and intensive treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for symptoms of fibromyalgia when treating cancer\n\nMy husband had stage 4 cancer in his parotid gland on the right side of his face. He recently had a PET scan which revealed he had no tumors. He never feels well, I was looking at the symptoms of fibromyalgia and he has everyone of them. Could it be he has this disease now?",
    "doctor_response": "Treatment for fibromylgia is first relax your body and mind because the symptoms are more when you are in stress and anxiety.Next you can use cold pack and hot pack to pain full muscles alternately to relax the soft tissue.You can also take physio therapy treatment for some more relaxing and healing effect on soft tissues. Here physio therapist will also suggest for few more stretching and muscle tonning exercises do follow that gradually. Also take suggestion on postural correction and follow it.There are couple of medications can be suggested but since he is already on cancer treatment I suggest that should be suggested by your oncologist only. And it may possible that he has pain because of prolong treatment of cancer with more stress on body and no physical exercises.  and it may not be fibromylgia. So you can also discuss about this in detail with your oncologist to have further guidance.I am sure he will be fine with muscular pain if you follow the above steps.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for soreness and swollen bump on the gums\n\nhi, my 12 year old daughter has a sore, gum colored bump behind her two front teeth. she's had it for quite a while but now since she has braces and an anchor band its become very irritated and swollen & is starting to swell between her two front teeth. she's been complaining that the pain has become worse, she has a scheduled tightening next month and today they're closed. i plan to make her an appointment asap but i was so curious that i came here. please help.",
    "doctor_response": "Looks like a frictional gingival hyperplasia or can be due to any infections or impacted food debris under the gums. Gargle with warm saline with salt. If the pain is unbearable she can Be given paracetomol 500mg and amoxicllin 500mg in case if you find it infected",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain and shortness of breath?\n\ni am having a very heavy chest pain everytime i get out of bed ,for the past few days i have had a weak arm(left) and shortness of breath.i always see black spots and dizziness.i get panic attacks while sleeping sometimes,wake up struggling to breath.i have seen many doctors and some says its anxiety,once a doc said it was anemia but the blood results were fine. i am very confused. i need help.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. In my opinion, we should first rule out heart diseases for your symptoms because left sided chest pain, breathlessness are common symptoms of heart diseases.So get done ecg, 2d echo and stress test (trade mill test).If all these are normal then no need to worry for heart diseases. Undiagnosed stress and anxiety can also cause similar symptoms. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You will also need anxiolytic drugs. Don't worry, you will be alright with all these. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any link between kidney failure and HCG? 23yr old female, have HCG levels, 3 positive pregnancy tests, HCG level 4 two days ago, redone blood test today. My sides are hurting like hell, my kidney area. 2 miscarriages in the last 5 months. 2 natural full-term births prior.",
    "doctor_response": "Hi,Thanks for writing in.Elevated human chorionic gonadotropin levels in patients with chronic kidney disease has been studied in women with kidney problems. In a report based on a series of 5 women out of 62 with chronic kidney disease, who had a positive HCG test on routine pre-transplant screening at a single transplant center. Detailed investigation showed elevated HCG levels the cause for which is still not unexplained. Going by this study there a cause for your HCG to be high and having some form of kidney disease. It is suggested that you discuss this point in detail and know if you kidneys need attention. The pain also needs to be investigated by doing imaging investigations like ultrasound scan or CT scan and MRI scan for in detail analysis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low wbc in elderly with mono?\n\nHi. I have a history of low WBC.  My count is a little over 3.  I also have had mono for the past 3 years.  Am waiting to see if I still have it.  As of Feb. Yes.  Yesterday's test results will come today.  History of anemia, also.  So, internist is referring me to a specialist.  Saw one in 2009, he suggested daily injections.  Did not follow through with that.  I am a 55 year old female, principal of a school and pretty active, before mono, that is.  So I took the summer easy, sleep 9 or 10 hours daily, slim, not over-weight at all.  I live 2 hours away from Houston.  Should I just head to md Anderson and get to the bottom of this?  Something is going on.",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. WBC count over 3000 is good, even though it is on the lower limit of normal.2. Anemia along with it, suggests possible vit B12 deficiency. Take B-complex vitamins along with iron. It should improve your counts.3. As the platelet counts are normal, not to worry for now. Get a complete hemogram done along with serum iron, B12 and folic acid assay. Based on deficiency, adequate correction can be done. Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to get treatment for my memory and concentration problem?\n\nHello doctor, My doctor suggested me to have cognitive testing for my problems with memory and concentration. I also cry for no reason. I was let go from work for making too many mistakes and forgetting tasks. I cannot get over that. I feel I will not be able to find other work because I have Lupus SLE arthritis and fibromyalgia. I am really depressed and crying constantly. Currently I am on Wellbutrin for anxiety, Plaquenil for lupus, Procardia for Raynaud's, Lialda for colitis, Lisinopril for high blood pressure and Alendronate for arthritis. I have been taking the same medication for the past six years. Please help me.",
    "doctor_response": "Hello. I can understand your concern. The symptoms like forgetfulness, lack of focus, poor concentration, memory issues, etc., are seen commonly in depression and should be evaluated properly. You have mentioned that you also cry for no reasons and you are 53 years old. It is not very common to have dementia at this age. Secondly, memory impairment in dementia start with memory issues in day-to-day thing. Mood symptoms, crying, focus issues, etc., are seen commonly in late stage of dementia. For further information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bloated stomach with blood traces in urine and stools?\n\nI am a 24 year old male. I had my gall bladder removed 5 years ago and I have acid reflux and Celiacs disease. My stomach has been swelling for the past week with pain and nausea and extreme fatigue. Two days ago my urine started turning pinkish red. Today I my feces is pale with blood.",
    "doctor_response": "Hello, thank you for posting your query in HMC. I understand your concern.  The symptoms you display are consistent with liver disease.  As the gall bladder is already removed there are chances of developing liver diseases. I  would suggest you to consult your gastroenterologist . He or she will be able to carry out further tests and clinical examinations before arriving at a diagnosis.Hope i have answered your question. If you have any further questions i will be happy to help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching and dryness in genital area?\n\nDear sur, i have got a problem that i am facing since my childhood.. i am 25 yr old guy and i hav some fungal like infection in my private area.. the itching is severe during night which causes drying of skin , erruption and discoloration of the affected areas... pls suggest me a ointment to cure this...",
    "doctor_response": "Most often it is fungal infection which is the cause for itching and dryness in genital area. You can use Cotrimazole based cream and apply at bedtime. Donn't use it in combination with steroids. Keep the area in good hygiene.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain while urinating in a four year old?\n\nMy son is almost four and has urinated four times today and complains that it hurts when he urinates.  At first I thought he may have gotten soap in there after his bath.  But he had to go while at the store and then again when we got home and it hurt both times.  Does he have a UTI?",
    "doctor_response": "please test his urine from pathological laboratory,  please check the stream of his urine and so also his prepuceal skin can pulled up so then accordingly i will advise",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for enlarged liver\n\ndocter,i am 24 years old.i had got heppatities B when i was 14 years old.at that time my hbsag result was +ve and it was made -ve after 6 month.a few days ago i had taken the ugs of abdomen,then in that it was shown that i had heppatomegaly with grade 2 fatty changes.is there any treatment for this?",
    "doctor_response": "Hi thanks for asking question....Welcome to HCM...Noted you had infection with hepatitis b ..Now you have negative HBSag ...So you recovered fully....Now for fatty liver life style changes needed to resolve it...Take low fat diet...Trans fat food like non veg, baked pestry , butter , cheese taken very less...Avoid alcohol.Regular exercise needed.Refined food avoided.Use very much less oil in diet....Take udiliv 300 mg tablet daily...If developed jaundice contact doctor...Happy to help you further.....Dr.Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause painful lumps on the back and neck?\n\nHi. I play tennis everyday after school for about two hours. Recently I have been getting muscle aches on my back, and today there is a lump on the back right side of my head. It does not hurt, and decreases in size when back/neck are massaged. Is the lump from muscle tightness in back or neck?",
    "doctor_response": "HI.These are spasm lumps of the muscles. These appear due to localized muscle spam as a result of chronic repetitive stress injury. You have to stop playing the tennis for some time till your muscles are normalized , take a muscle relaxant and anti-inflammatory medicines. Before you start playing again take an opinion of an Orthopedic Surgeon / Physiotherapist associated with sports- injury and when they declare you fit then only you can play again. You also need a very proper trainer who can train you considering your problem of muscles.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Anti coagulant with zotreem plus\n\nI have a history of DVT and I am under anti coagulant till now, does this make any problem with zotreem plus ?",
    "doctor_response": "1. Zotreem plus are slimming capsules made by Nutramax (mtco) company as food supplement. 2. Zotreem plus capsules are not recommended for people under 16 years and above 65 years of age, please mention your age? 3. It is Contraindicated in people with high blood pressure, so please mention about your BP limits?? and women who are pregnant and/or breast feeding. 4. company claims it to be 100% safe and natural herbal supplement, but if you want to continue with it,ask your healthcare professional about the same, probably it won't effect your health situation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure cough and running nose in kids?\n\nMy son has had a cough & runny nose for the last couple days and his eyes have been watery & gooey. Yesterday after he took a nap i noticed his eyes were bloodshot. Today his right eye is swollen. Im not sure what to do other than clean it with a warm damp cloth.",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query for  the  prince in details  .*  Guidelines for the case  -  Keep hygienic care of the nose , mouth , ears .-  Give plenty of liquids , balanced nutritious  diet .-  Avoid  exposure to excess  cold , dusty  weather .-  Antibiotics , decongestants  according  to  the  advise  of  the   pediatrician .-  Maintain  temperature  chart .-  Gargles  with  salted  lukewarm  water  and  added peppermint  oil  3     times  a  day .-  Avoid candies , chocolates  , pastries , ice creams etc .Wishing your  toddler   fine recovery .Feel  free  to ask any further doubts .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rejection to blood transfusion in case of thalassemia?\n\nHi, may I answer your health queries right now ?  Please type your query here...i have a girl that is 18 years old. she must go an change her blod many times. she lives inn thailand. they cant find her type. the body rejects it. i am not sure  wich type her blod is. But maby the give her wrong. they say that it dont look good. what is it inn her body thats wrong. they wont give me anwer i understand. Please help. I am crying my tears. the condision is called talasimia",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. She has thalassemia and already taken multiple blood transfusion.  She may have some unknown antibodies in her blood that react with donors blood.  She should be given compatible blood.  She should go for antibodies panel test once to search the exact type.Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is gall bladder functioning at 25% a cause for concern?\n\nI had a hida scan and my results was my gallbladder is functioning at 25%. I declined to go to a surgeon because I was informed a normal gallbladder functions at 35% or more. My thought was my ejection fraction was a high abnormal so I shouldn t immediately assume my gallbladder needs to be removed. I can go days/weeks without any attacks but when I have one they are severe. What is the pros/cons in waiting until the attacks are more frequent?",
    "doctor_response": "hi.noted history of gallbladder pathology. if it is secondary to gallstones and your symptoms are occurring frequently and increasing in severity, it is best if you consult with a doctor, preferably a general surgeon, for physical examination and clinical evaluation. what you have is chronic cholecystitis, probably secondary to cholelithiasis (gallstones). the most important thing to take note here is that an elective or scheduled cholecystectomy has better post-operative outcomes and less risk of developing complications as compared to the one done emergently. diagnostics (such as ultrasound, liver function tests, blood count, etc.) and management (medical and surgical) will be directed accordingly. definitive treatment for gallstones is cholecystectomy or surgical removal of the gallbladder along with the stones. it can be done laparoscopically (goldstandard) or thru open technique. low fat diet is also recommended.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair loss\n\nMe and other women I now that are 47 and older everything is changeing.  I have lots of hair but I also shed like a dog and my hair is now gray and i wish I could keep my hair.  I take bioten , exercise and eat healthy.  What about rogaine for women????",
    "doctor_response": "Hi, welcome to HCM,Rogaine is for androgenetic alopecia.At this age you probably suffering from telogen effluvium.Wash your hair with volumizing shampoo.Take tab Biotin 10mg + PABA + Ca pantothenate once daily.Apply beclomethasone lotion once daily.Hope this will help you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have pain on biting over a fractured tooth. Is it serious?\n\nHello doctor, About two weeks ago I chipped my front tooth. I went into my dentist this past week to get it smoothed out (very minor) but he also noticed a horizontal fracture across the middle of my front tooth. He does not want to jump into anything too quickly so said just to watch it and if it cracks off he will cap it. Since then I have noticed only when I put pressure on the tooth to bite down I have discomfort, but nothing constant. Should I be concerned about the pain? Is there anything I can do to help protect the fracture like having a sealant put on? And should I be concerned about the idea of a cap changing the way my face looks (looking unnatural, wanting to continue whitening my teeth, etc.)?",
    "doctor_response": "Hi. I had gone through your question. I can understand your concern.  As per your history, you had a recent tooth damage with microfracture, that means you have been put on the wait and watch. If your tooth is vital after a month or two and fracture has not widened, you do not need any treatment. If there is any discoloration or pain than the crown is the option. Nowadays the crown are totally in compliance with your dental shade and it does not looks artificial in any case if done properly.  If you can upload a picture of the broken tooth taken in natural light, I can tell you does it need an immediate treatment. As of now, I do recommend you to use fluoridated toothpaste. Also, keep your teeth clean by brushing at least twice daily because chipped off teeth are highly prone to caries or cavities.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had pernicious anemia, taken spastic duodenal cap, taking B12 shot. Suggestion?\n\nI have a spastic duodenal cap. In 2004, I was told that I had pernisious anemia that developed over three years. My stomach can t absorb vitamin B12 anymore. I will need a B12 shot every three to four weeks the rest of my life. I know that when we get older, our physical and medical conditions deteriate. I suspect that the past scarring of my stomach from my ulcer , plus my age(63) is a direct cause of my enability to absorb B12 through my stomach. Can you give me any confirmation on this matter? Sincerely, E. H. Greene, 4/17/2012",
    "doctor_response": "**1. since you are giving a long history of ulcer, thus apart from scarring 'pyloric stenosis' is also possible, thus analysis of gastric aspiration and Barium meal X-ray of stomach and duodenum is essential.2. since Pernicious Anemia [PA]  is an AUTOimmune disorder i.e. the body\u2019s immune system attacks and destroys the stomach\u2019s mucosal cells: as a result Intrinsic Factor [IF]  can no longer be made, and vitamin B-12 cannot be absorbed, so scarring at most will cause gastric outlet obstruction  [which can narrow or close the intestinal opening and can prevent food from leaving the stomach and entering the small intestine,resulting in vomiting the contents of the stomach]3. In old age [63], as there is atrophy of the glandular mucosa of the fundus of the stomach which is same etiology of pernicious anemia, thus AGE is a contributory factor for the progress of the disease.4. .Take: bland diet,rice with plain dal,boiled vegetables,sweet biscuits,sweet fruits,plain idli..avoid sour fruits like citrus fruits,imli,grapes,instead take sweet/dry fruits. .avoid all chillies..avoid period of starvation:take small meals every 2 hrs.  .do not keep the stomach empty,also don\u2019t take heavy meals.  .avoid tea and coffee.milk is good (cold).for breakfast and snacks:bread/toast jam,cheese or butter,cornflakes.avoid deep fried and hot foods..eat food which are low in fats..eat at a leisurely pace.chew your food well..avoid eating 3 hrs prior to retiring to bed.may cause secretion of gastric acid if meals taken during bed time..include protein in each meal and snacks..antacids are the drug of choice.  PS..avoid gastric irritant drugs like aspirin,all NSAID\u2019S,steroids.. complication of PA is severe neurological deficit, thus regular Neurologist Opinion is must.. diet rich in vitamin B12 are: liver, beef/mutton;chicken,fish,whole egg, milk, cheese, yogurt.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes spasming feeling in the chest?\n\nI'm having a spasming feeling in my chest. I've gone to the hospital about it before and they said my heart looked healthy. The cardiologist said I had SVT, but that he didn't catch the spasm so he didn't know what that was. What else could it be if it's not my heart? it really feels like my heart.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. No, this is not right. SVT (supra ventricular tachycardia) can cause chest pressure, tightness and spastic feeling. SVT is tachyarrhythmia. It causes rise of heart rate upto 200 per minute. At this higher rate, heart does not beat and pump well. So it gives chest pressure, tightness and spastic feeling. If not treated promptly, SVT can be life threatening. So better to consult another cardiologist and start treatment for SVT. You will need anti arrhythmia drug like diltiazem. Don't worry, once your rhythm is normalized, you will not feel chest spasm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for fever and congestion in a child?\n\n3 year old has a 100 fever, congestion, eyes bloodshot in inside corners but no discharge, ear wax is brown and sticky -- lots of viruses going around, 6 year old brother had one earlier this week w/fever and sore throat and some congestion -- just wondering how many days I should let this run before going to a doctor -- she s had fever and sticky ear wax (but not running out her ears, just visible) since Wed. afternoon, congestion started yesterday, bloodshot eyes started last night",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.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 activeWith other family members affected with fever recently almost it is sure that it is Viral illness.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can head and back pain with confusion be treated?\n\nhi doctor,i was really sick 3 years a go,in winter,had verry strong pain in back of my head,and strong pain in my back,was just about to move,and was really a lot perspiration,or heat in my legs too,for about a few weeks,i was thinking thats gona be it,but somehow i survive,just now left the same in back of my head problems,and comfusion,cannot concentrate,ignoring friend,left my job,done mri scan,but they say you ok,i dont believe it i fell i am going crazy,what to do doctor,maybe you can help",
    "doctor_response": "Hithank you for trusting HCMI read you query and understand your concern I am sorry for the symptoms you have sufferedYou should be happy that MRI cam back normal so you have excluded some risky brain pathologiesIt is important the time you took MRI after first symptoms you suffered?It seems that you have suffered a subarachnoid haemorrhage If MRI is done late it result can come back normalLumbar puncture confirm the diagnoseAnyeay as time passes you will be better Wish you good healthPlease feel free to ask for further information or review my answer Stay healthyRegardsDr Eris RanxhaNeurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold and fever\n\nhi.... I am a girl of 20yrs from bangladesh...I had bad cold and fever (101-102) last todays and from last night my heart is beating faster than usual rate and so my whole body is shivering... is it anything serious ? What should I do to get back in a normal state ?",
    "doctor_response": "Hello As you mentioned that this fever is just for 2 days . You are also having rapid heart beat ( as this is natural due to fever ) . Also having shivering , this  may be due to throat infection or flu ( common cold ) .All these symptoms are just for 2 days ,so most probable cause may be flu , so don't take any tension .Only take paracetamol 10 -12 mg / kg body weight 3-4 times in day for 3-5 days .If symptoms decrease then well and good , if condition worsen then consult a physician and take his treatment .For relief , you will have to wait for 5-7 days .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I noticed slight nose bleed a day after fall. Should I get it checked?\n\nHi doctor,Yesterday I was walking and tripped, resulting in a facial injury from concrete. The point of impact was my nose, and aside from several cuts, I am unsure if it is broken. It is not crooked at all and did not even bleed when the incident occurred. But it is quite swollen and hurts to touch. I blew my nose this morning and there was a bit of blood. I have also had a few headaches. Should I go get it checked out or am I fine?",
    "doctor_response": "Hello. You have sustained some bruise and possibly internal injury over the bony dorsum of the nose. This is the area of nasal bones, their suturing with each other and their junction with the frontal bone (forehead bone).  If you were to come to me, I would check for crepitus and palpate the whole area for any deformity, step change, tenderness, bubbles feeling, etc. It may be difficult for you to do on your own and arrive at right inferences. Next, what I would do is to get a CT scan of nose and sinuses. If a CT is not available or not feasible, we can go for a plain radiograph of nasal bones. However, a CT is preferred. The radiological investigation whether CT or X-ray will help us know whether there is any fracture of nasal bone or septum or orbital margins or rim and if there is any collection of fluid or inflammation. Depending on that we can tailor our treatment. If there is a Y-fracture, we correct immediately. Suppose it is more than 48 hours after sustaining the injury, then we wait for two weeks for healing to get over and then subsequently plan a rhinoplasty surgery to correct any remnant deformity. Right now there is swelling and so we cannot infer anything concrete without doing an investigation. Hence go ahead and get the investigation and we shall help you on how to go about with it. Since you are 18 years old and the nose is a prominent area of the face and very importantly concerned with the overall beauty of the face, I would suggest you go and get the tests done and follow up with us. Till then, to relieve pain Tylenol (Paracetamol) as per your weight, taken twice or thrice daily. To relieve edema take Trypsin-Chymotrypsin-Rutopside-Bromelain combination which is anti-inflammatory and helps relieve edema of the nose. For more information consult an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting along with stomach disorder?\n\nhi my 10 monts baby is having vomit when he is fed milk or light food either having loose motions since last four days he has been treated with emeset for vomit he started loose motions when given zettos baby every 8 hours zirol 5 ml a day Gnorm twice a day and fluid was given with drip he stoped loos motion wich was sometime 10 in an hour or 15 to twenty in a day again he is having vomit when is given mother feed or lentil soup no solid is started yet he is just 10 monts and 9 kg",
    "doctor_response": "Hi, It seems your kid is having viral diarrhea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting. You need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic-associated diarrhea. I suggest you use zinc supplements (Z&D drops) & ORS as hydration is a very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron (as prescribed by your pediatrician). Regarding diet - You can use cerelac and any flavour will do. Avoid fruit juices as they might aggravate diarrhea. You can give zinc supplements & ORS apart from normal vegetarian porridges & soups. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes autoimmune hepatitis , lupus and rheumatoid arthritis?\n\nI have been diagnosed with autoimmune hepatitis, lupus, rheumatoid arthritis and mixed connective tissue disease in 2011. I am currently taking azathioprine, folic acid, calcium/vitamin D, vitamin B12, sertraline, prednisone. The prednisone have been off for about 3 weeks and yesterday and the night before I have been getting real dizzy nauseated and really run down. So I went in to the DR they checked my blood and my two liver levels are a 125 &129. The doctor gave me a shoot of a steroid and today I will start taking prednisone 60mg for five days and then 40mg for five days then 20mg for five days until I can get in with my specialist in November. Is my liver levels considered high?",
    "doctor_response": "Dear patient Your liver enzyme levels are high as normal upper level is 40. Yours is almost three  times higher. This is due to hepatic cells damage and may be side effect of azathioprine. You need to consult your doctor for revising the dose or switch over to other non hepatotoxic  drug.  Prednisonolone causes severe withdrawal  symptoms  on sudden stoppage  and hence should be  stopped gradually. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are tightness,sharp pain in chest related to gas,diarrhoea?\n\nMy son is 14. 5'11\" 130lbs. A very good long distance runner and in excellent shape. Plays lacrosse. recently he has been experiencing chest tightness, sharp pain and trouble breathing. It will last a day or two, goes away then returns. He also has had stomach trouble in the last few months. Sick, gas bloated diahrea, severe pain that moves around, more central and left sided. Don't know if they are related or two problems.",
    "doctor_response": "Hello!I would recommend that you take your son to the hospital and he should have a thorough physical examination as the symptoms you describe are very vague and can be attributed to multiple diseases.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How safe is taking Percocet pill during pregnancy?\n\nabout a week ago i had my wisdom tooth pulled whih was fused into my jawbone. i found out about 5 days after the surgery that i was pregnate. i went back to my dentist office today and my tooth has been causing me alot of problems. my dentist told me today that the pain pill (percocet) is fineand wont harm me being pregnate. is this true?",
    "doctor_response": "dearpain pill if it contains paracetamol is safe to take in pregnancybut you should take care of your dental hygiene .take care of your diet during pregnancy include milk, green leafy vegetable , fruitsin your diet. take sproutsremain active & stress freeAll the bestDr.Mira Butani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What reduces the muscle mass and skin on the neck and face becoming elastic?\n\nHello doctor , My issue is some thing different , my total muscle mass got reduce gradually form 6 month it got thinner i can find in my mouth its so soft before it was thick mean ton got reduce , and when i open my mouth it is expanding very freely over elasting mouth joints or not tight i can fee this muscle thinner allover the body my stomach muscle so thinner , chest muscle mass got reduce like water packet like without thick fat ) its very unthick ... and my buttock muscle also got week like unthick fat some thing fat are spreading not combine , my anus part is expand little free its not thight , and my pelvic palce under scrotum muscle like muscle free like not muscle its not tight as well , my neck is not strenghten as well flabbyness moving very freely normally it will be tight for me its is expanding ... and my skin tone is also reduced so provide your detailed explanation i will tell what are the studies i done i cant past all the report detail so please tell the detail . 1. I have done EMG its normal with out issue , and cpk test no muscle loss around 60 to 50 out of 140 ,ESR is normal , CRP is normal , RA is negative ,ana is negative . only i have vitamin D defeciency i taking 60k iu weekly once seems its not the issue cause . 2. Nerve condition study seems some weekness in right hand but i have able to move with out issue , but all the body joints or very free its not in tight position .. 3. MRI brain is normal , whole spain buldge it l5 to s1 and l4 to l5 , but i check with bone doc he told its not the issue cause . 4. check with romatoide doctor he took , RA,ANA, renal profile , iron , calcium all normal ...jut he is saying all right gave calcium tablet... 5. neuro doctor said issue not reated to neuro .. but he dint checked my pelvic as well under scrontam i feel the tone is very low in the above part .... penis muscle tone is little thinner compare to before .ever all over my body not like manly skin with rought and thick its so soft .and waterly ... 6. RBC is normal only wbc is little hight around 12k maide be throught infection he told . 7 . usg scan normal ,, 8. i have done 24 hours urin protine its also 9% .. 9. hormone no hypo thyroide , pth is normal , only cortisol is high 29 outof 19 in the morning with out striod medicie during night then go to test on morning i took... 10. When i touch my check i can see the layer and fat is very water like unthick ... ",
    "doctor_response": "Hello, The reduction in the muscle mass and reduced elasticity of the skin is an age-related change. Dehydration and hormonal changes in the body can also contribute to this. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes semen leakage during urination?\n\nHi i am experiencing semens coming out during urine for two days. I do not masterbate and for two weeks i didnt have wet dreams. Is this normal? i am currently 25  and i am not married. i experience fluid coming out in little quantity from bladder during stool. Is this normal?",
    "doctor_response": "Hello,How do you know weather it is semen or precum? Nocturnal emissions is common but continuous leakage is not common. please get it done urine examination for sperm cells. Few people with not doing masturbation or sexual activity may can cause leaking. But once again consult your physician he will examine and treat you accordingly.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain during erection after inguinal hernia?\n\nI had an inguinal hernia and after surgery my right testis and testicular artery have become hard and stiffened. It also has lots of fluid around it. Its been almost two weeks since the operation and it hurts when I get an erection and the sack is up tight. Cause ? Solution ? Is it something serious?",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn Short: It takes time to heal and to gain normal ability to have erection.Explanation: As you have undergone surgery recently,it takes time for healing. Pain may be there for sometime. If pain is there then erection may cause further pain.                  So,take anti inflammatory drugs as prescribed by your doctor and wait for some more days, you will be back to normal. If you have still swelling or any discharge visit your doctor immediately.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from digestive problems since years with no relief. Please advise.\n\nHello doctor, I am suffering from digestive problems since 15 years. I take Pantin L capsule everyday. But, no relief. I am very nervous. I took treatment with many doctors, but no relief.",
    "doctor_response": "Hello. You are having digestion problems since many years. For that, first rule out hypothyroidism by serum TSH (thyroid-stimulating hormone) estimation. USG abdomen scan is advisable to rule out any organic cause if present. You can include more fiber in the diet. Take green leafy vegetables and fruits. Regular exercise is advisable in case of functional constipation and drink more water. Psyllium husk with milk at night time can be had for constipation. I suggest you consult a gastroenterologist for examination and further management accordingly. For more information consult a family physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can adverse reactions to changed Parkinson\u2019s medication after a fall be treated?\n\nHelp! My husband has Parkinson and recently fell and now has a small tear in the cartilage of his left hip. He was in the hospital over night and after coming home could not get off his chair because of the pain. He is now in a nursing home for extensive therapy and is doing terrible with his mental stability, seems to be over medicated, acts like the energizer bunny taking his carbalopa/lev 25/100 (a different generic from the one he has taken at home for 9 years). All this change in his reaction to his medication has caused him excessive stress even though he now very seldom freezes up and is doing well in therapy. His pain is nearly gone but his mind is severely playing tricks on him. I have contact his doctor at UW Madison but she has not returned my calls and e-mails for 10 days. It is looking hopeless for him to ever return home and everyday he is getting more severe reactions to his meds with spells of crying, hasn t slept for six nights, has spells of agitation and trys to exit the facility. Not sure where to go from here.",
    "doctor_response": "Hello, Though it is possible and even likely that medications are playing a role in his mental status changes and confusion I would be concerned for an underlying organic basis for his confusional states. Even if he really wasn't exhibiting anything significant in your mind until the fall. Also keep in mind that sometimes the trauma from something like a fall followed by hospitalizations and changes in familiar environments combined with medications that could be adding to the mix will UNMASK an underlying cognitive disorder. Therefore, if not already done he should be worked up with tests such as Vitamin B12 levels in serum, Thyroid hormones such as TSH and FT4, ESR and CRP in case there may be an underlying or occult infection somewhere in the body that has not been detected. DEFINITELY, a URINALYSIS should also be done since this test detects of the most common sources of mental status changes in the elderly, URINARY TRACT INFECTIONS. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dry, fair skin. Pigmentation on face, back. Tried fairness lotions, no relief. Advice?\n\nI have a dry skin with Fair complexion . But I have been affected by pigmentation on my face and back from my 18th year. I am using fairness lotions(Olay), Bust still, I cann t get back my actual fairnes and also the brown spots just fades mildly and doesn t vanish completely. Do I need to take any Viatmin supplements . Please give me any solution so that I can get my actual fairness like it was before(my teenage). NB: I was applying some kojic acid creams and other prescribed by a dermatologist before 5 years which doesn t make much difference, hence I stopped. Also I was taking vitamin C tablets for 3 months.",
    "doctor_response": "Hi sujeetha, As far as dryness is concerned, use products specifically meant for dry skin. You can try using cetaphil cleansing lotion and moisturising lotion to keep your skin well hydrated. For pigmentation as a general rule- Avoid sun exposure Use a good sunscreen and repeat application every 3 to 4 hours Take antioxidant and vitamin c supplements You need to consult a dermatologist as dermatology being a visual field, the cause for your pigmentation and the treatment required can only be suggested after proper skin examination. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain below the thumb?\n\nI am a 70 year old male and am having pain in the area just below my thumbs on either hand. Is this arthritis, and if so, what type of arthritis might it be? My doctor gave me an Rx for Voltaren cream but it really doesn t take the pain away. The pain is constant and it is getting harder to use my thumbs for gripping something. Are there any treatments that I might be able to try to correct the problem or to relieve the pain?",
    "doctor_response": "Hello, It could be an arthritis possibly rheumatic arthritis affecting small joints. We have to rule out other conditions like gout and contusion also. Better to consult an orthopaedician and get evaluated. As of now you can continue your pain medicines as usual. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shortness of breath,dry cough and headache\n\nHello, I am 17. I have been to the hospital twice and a walk-in GP. I was concerned over my recent symptoms (Shortness of breath, dry cough, extreme fatigue, headaches, hoarseness of voice.) and a ER doctor performed a X-Ray on me. X-Ray came out just fine. They asked me the basic medical questions. They discharged me assuming that I had chest inflammation and prescribed me ibuprofen. That went horribly. It didn t help my symptoms at all. Went to the Walk-in GP. I was told I was having a allergic reaction... I asked for a MRI to address the concerns it could be Lung Cancer (I will explain my reasons as to why below) but I was denied due to the person currently seeing me being a Nurse. I was sent home there. Also, I do not have Pneumonia or any sort of flu or cold. The reason why I believe it s Lung Cancer is because I am not very active and recent reports suggest that theres a %6 percent chance of obtaining Lung cancer if you sit for more then 6 hours and being around secondhand smokers (which I am alot, due to my family being a very active smoking family) increases the risk by %30-40 percent. Can you help me some how?",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. First of all,  no need to worry at all for lung cancer as it is extremely uncommon at your age ( 14 years).In my opinion you are having either asthma or bronchitis.  As second hand smoke can cause both of the above.And coughing with breathing difficulty are seen in both.So better to consult pulmonologist and get done PFT ( pulmonary function test ). This will also tell you about severity of the disease. And treatment is based on severity only. You may need inhaled bronchodilators and antihistamine drug. So no need to worry for lung cancer,  consult pulmonologist and first diagnose yourself and then start appropriate treatment. Don't worry, you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Bumps around vagina. It bleeds when I have sex.\n\nHi doctor, I have these bumps around my vagina. They look like skin tags. They do not itch, but when I have sex, they start bleeding. I hurt them while shaving, and they started bleeding. What could I have? Or could it be some sort of STD?",
    "doctor_response": "Hi. With the symptoms you have provided, it is not an STD (sexually transmitted disease). But if you have any doubt, I advise you to take an ELISA test. Most probably, you do not have skin tags, but a collection of vasculatures, as they bleed on any injury. You can get it removed by laser or cauterization. And avoid injury to the area as much as possible.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a cancer in spine be missed in bone marrow biopsy?\n\nMy friend recently had a bone-scan which they said looked like cancer in her spine..The bone marrow biopsy says no cancer...There are tiny holes in her bones, now going to do other tests..She is in bad pain, is there still a possibility she could have cancer and the bone marrow test missed it? The Oncologist has no idea what is going on",
    "doctor_response": "Good-evening. Bone marrow usually have a patchy involvement with cancer and it is quite possible for a marrow biopsy to miss the cancer. Ideal way is to do a CT guided bone biopsy rather than a marrow biopsy. Also a PET-CT scan will be an ideal test to look out for the origin of cancer, that is , the primary site from where the cancer is originating as it will help the doctor to sort out the final treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe pain in the ball of the feet and soreness in the ankles be treated?\n\nI ve had NEPHROPATHY for 20+YEARS. I also was diagnosed with CHARCOT about 14-15 years ago. I NOW am experiencing different problems DAILY. I have terrible pains stepping down on the BALL of my feet like directly stepping on a nerve. Also my ANKLES not always BOTH seem to extremely SORE & at times seem to DROP a small distance. I sure a cane in my apt. & use a scooter when I go out for about 15 years. I wore support socks for approx. 20 yrs. due to DIABETES. I recently LOST about 90 LBS & LOST the DIABETES. I still check my SUGAR & check it twice a day & watch my DIET. Have you suggestion that may HELP ? THANKS Dave",
    "doctor_response": "Hi, All your symptoms are due to peripheral neuropathy. Peripheral neuropathy leads to loss of sensation in feet and it feels as you are stepping on cotton. Motor involvement leads to foot drop And high stepping gait. You need special care for your feet.  Minor injury to foot may go unnoticed with flare up. Treatment will be of neuropathy and to prevent complication. Visit to podiatrist is highly recommended. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jayesh Vaza, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe cold and fever in child\n\nHi, My daughter 2yrs and 1 month old had stomach infection two weeks back. The doctor prescribed Zeprox. After one week, now she is suffering from serere Cold, and high fever. Also her motion is becoming lose from today. The doctor assumes some urinary infection but have not prescribed any antibiotics yet. I m not satisfied as she is really ill for past two weeks. Is Augmentin safe to start with?",
    "doctor_response": "thank you for asking querry.As for stomach infection zeprox is good choice.But now you are saying she is having urinary tract infection and you must treat it.What are the urine reports if any,and also get one usg done if urine reports are suggestive.though augmentin is not good choice for urinary tract infection.start antibiotics only after urine report of microscopy and culture.hope this is helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any suggested treatment for flared ribs?\n\nMy son just had the Nuss procedure for his Pectus Excavatum and his chest looks great, no to mention he is breathing better.  However, along with the Pectus Excavatum, he also has extremely \"flared\" ribs, I mean the doctor he had never seen a protrusion like his.  My question, what treatments are out there for \"flared\" ribs",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. If he does not have any issues either cosmetically or for his breathing then it would be fine to leave it at it. Try to maintain the posture straight and exercise to build the muscles. Consult a physiotherapist for the same. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower abdominal pain?\n\nMy son wakes up with lower stomach pain every morning since last Wednesday. It just comes and goes. I have noticed him sleeping a lot the last few days also. When he was small he would have seizures and stop breathing with them, one of the signs before this would be him sleeping a lot a few days before. Should I be worried?",
    "doctor_response": "get a stool routine/microscopic test done as all this could be due to parasitic diseases (worms!)all the best...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I lead a normal life with just one testis?\n\nHello doctor, I am a 25-year-old male. I have only one testis. I have sexual feelings as a normal man would do. I am masturbating about once every week. Will a single testis cause any problem in the future? Recently, I had my first sex with my partner. At that time I was tensed and also had difficulty while penetrating her vagina. Please help.",
    "doctor_response": "Hello. It appears you are having a condition called cryptorchidism in which one of the testes is not present in the scrotum. There could be one of the two possibilities, either your testis has not developed at all or it has developed normally but has failed to move into the scrotum. At your age, if your sexual desire is normal and your secondary sexual characteristics like facial hair, pubic hair growth is normal then your testosterone production is normal. Your reproductive ability will depend on the number of sperms produced by your normal testis. I would suggest you visit your local urologist for a complete evaluation and identify the type of cryptorchidism you have. For more information consult an andrologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have pain in the rigth root canal molar tooth on taking warm foods. Why?\n\nHello doctor, I got a root canal and crown several years ago in two molars, one on each side of my jaw. The crowns are metal with light porcelain on the outside. The teeth have felt fine ever since, until a few days ago. Now I feel pain in the right molar tooth whenever some warm food touches it. The pain takes a second or two to come, it is not instant on contact. Cold food or drinks cause no pain, neither does chewing. The gums around the crowned teeth are irritated, and look like they are possibly pulling down away from the teeth as I can see the dark metal underpart at the gum line. The tooth on the left side does not hurt at all aside from the irritated look of the gums around it. After doing some reading, I think a possibility is that the root canal did not get all the pulp in the right side tooth, and that is now infected again. I do not currently have dental or medical insurance and it may be a few months later I can see a dentist. What can I do in the meantime to take care of the tooth? I also became aware that I grind and click my teeth a lot without realizing it, and possibly at night when I sleep. My front teeth all look worn down now. This is concerning me a lot. I looked into teeth guards for sleeping, but the ones I found in stores need to be heated and placed between teeth to shape them to my mouth, and with my current heat sensitivity I can not use them.",
    "doctor_response": "Hello. I have read your query and it is pretty much clear that the right molar with history of RCT (root canal treatment) is causing the pain. Now the causes of pain may be a re-infection or incomplete RCT, but there can be other causes as well. As you mentioned you have bruxism (teeth grinding), the tooth or in this case the RCT tooth is under continuous insult from the grinding habit. This may have also caused the injury to the surrounding tissues. A prosthetic crown or porcelain crown here if not in occlusion may also be another cause for the pain.  Now as you mentioned that you are having pain only on taking warm foods and liquid diet and the gums around the crown is receding (recession), it looks like you might be having tooth sensitivity in the nearby tooth due to the dentin exposure caused by recession. An x-ray of the tooth will make the things more clear as if a new RCT is required or you just need proper cleaning and fluoride toothpaste. If it is possible, do upload a picture of the tooth and also x-ray of the tooth. Meanwhile, I would suggest you to use fluoride-containing toothpaste and ultrasoft toothbrush. Do not scrub, clean your teeth and gums gently. Maintain good oral health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dry cough\n\nHi i have dry coughing problem since last 2 years, and i have consulted many doctors with variety of tests and reports but the best i could get till now is the temporary solution i.e. Montek LC. I have allergy from dust and smoke as also my father have and i am at age 28 but the signs are showing even now. kindly help me to get out of this permanently",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. By your history and description, possibility of cough variant asthma is more likely. You are having family history of allergy. You are allergic to dust. Both of these are in favor of asthma more. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test).PFT will not only diagnose asthma but it will also tell you about severity of the disease and treatment is based on severity only. You will mostly improve with inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).Continue montair LC, once a day at night. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe back pain during pregnancy?\n\nHello Actually now I m 1 and half month pregnant. My last period was on May 26. I m having back pain, Lower abdomen pain sometime ND also feel like vomiting Bt Thr is no vomiting. So I councle to my doc nd he advice me to take vitagreat tablet,hucos inj (gonadotropin contain) every week till Sept 11,nd one mini luton vaginal spray 2tyms a day wth 4 spray each. So I want to knw is it Gud for me or not ND I want my pregnancy to success. For conceiving I m taking medicine as I hv polycystic ovarian syndrome.. Plz suggest me... Wating... Thnks...",
    "doctor_response": "Dear patient back pain can be normal during early and late pregnancy months. you are taking all the medications for sustaining pregnancy. So no more medications are needed. Regular follow ups with your obstetrician would be required. since it is early pregnancy I would suggest not to take any analgesics as it my affect your baby growth though paracetamol is safe.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can internal knee injury be diagnosed?\n\nMy 13 year old son injured his knee in baseball yesterday. He tripped over the base and went to catch his step and heard a pop in his knee with instant pain and swelling within 10 minutes. The swelling and pain is down. When or how do I determine if it is just a sprain or need to see his doctor for ACL or meniscus tear,",
    "doctor_response": "Hi, As of now we can take it as sprain and manage with \u201cRICE\u201d protocol! Rest, Icepacks, compression and elevation. You can also give him analgesics like Ibuprofen or diclofenac for pain relief. If symptoms persist, you have to take him to an orthopaedician and get an MRI scan done. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Red round rashes on torso and back, suffered from flu. Any ideas?\n\nmy parrtner has red round rashes on her body only the front torso and back.  These rashes are individual round blotches about 1 cm in diameter.she doesnt have an y known alergies.very strange as she suffered a flu type ilness for about 4 or 5 days but is now over this, however the round blotches are still on her torso and back.they havent moved to her legs or arms or face.  very strange   any ideas",
    "doctor_response": "HiThanks for your queryYour partner seems to have developed pityriasis rosea.It is a self limiting condition.It usually follows viral illness mainly cough and cold.Itchy red round to oval lesions seen on upper body.Just apply a topical steroid.Can take antihistamines if there is itching.You need not worry as it is self limiting.Takes about two to four weeks for complete cure.Hope it helpsDr Geetika Paul",
    "dialogue_context": ""
  },
  {
    "patient_message": "Beta carotene can be taken to avoid allergic reaction to heat?\n\nHello# When i visit hot countries I have an allergic reaction to the heat.  Noit sunshine, but the heat.  I dont break out in a prickly heat rash more of a bluish tinge.  The medical surgery in that country then administers a steroid injection. What can I do to prevent this happening before I go on holiday.  It has been suggested that I take beta carotene.  Is this a good idea?  Many thanks",
    "doctor_response": "Hollow,thanks for your question,Beta carotene,helps in some allergic conditions erythropoietic protoporphyriaon-inherited sun sensitivity, exercise induced asthama,sun burns in some cases,many doctors that it should be taken from natural soucea rather than supplements,raddish is good source,but you don't have allergy to direct sunlight,so I guess it won't help to that extent,you can try it if problem persist consult physician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of Myetka?\n\ni just want to ask u that i am taking myetka since one year and trust me my asthma is getting worst..my doctor gave me three doses of steriods..same problem is with my daughter i she is 8 year old ..when she was 1 year old she had that problemshe is also on myetka and zatofen now i m tired of taking pills please sugguest me something?",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your history and would like to make suggestions for both you and your daughter as follows:1. As you have asked, Myteka (montelukast) has mild side effects, like stomach upset, nausea, headache, etc. If you are not experiencing these you can take it for long duration.2. Asthma is a chronic disorder and requires long term treatment and a lot of patience and care.3. As your asthma is not controlled with Montelukast alone, I would suggest addition of inhaled corticosteroids as controller medications. I would like to mention that inhaled corticosteroids are always better than oral corticosteroids.4. I would suggest you allergy testing for common air-borne allergens such as house dust mites, molds, pollens, insect proteins, animal dander, etc. This will help you identify substances causing allergies to you as well as to know the measures to reduce exposure.5. Based on allergy testing, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which works on immune system to gradually improve allergy symptoms and reduce medicine requirements.6. In general, please avoid exposure to dusts, smokes and air pollution as much as possible.7. Regular breathing exercise and healthy diet rich in vitamins & minerals will also help you to improve lung capacity and immunity respectively.8. Please note that all above information will be same for your daughter as well.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you and your daughter the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is repetition of image popping into mind a symptom of OCD?\n\nHi doctor, I am a 25 year old male. I am scared of turning into a gay or homosexual. In the past, I had senseless and intrusive images popping in my head that I am kissing a guy whenever I used to be with my male friends. I never felt an attraction towards any guy. It happened six years before, but never thought about the reason. This thing stopped when I asked about this issue to a doctor and he said it as OCD. Everything was fine for over six to seven months. But, when I over think about why I am getting those images in my mind then the thing gets worse. I check every time when I see a guy whether I am attracted to him or not. Indeed, it sounds like I have gone mad. In my office there is a guy who is very attractive. But, when I fantasize him just to check whether I am normal or turning into a gay, I feel weird. But, I cannot stop myself looking at him. I envy him too, because I always wanted personality, health and voice like him. Whenever I see him I feel something different as if I am looking a girl. I am scared now. Please help.",
    "doctor_response": "Hello. After analyzing your current complaint and taking into consideration your previous history, I am of the opinion that your current symptom is also a symptom of Obsessive compulsive disorder (OCD). An obsession is an automatic, repetitive, intrusive and senseless thought or image which pops into a person's mind. Your previous symptom of seeing images of kissing a guy was an obsession. A compulsion is an action that you cannot resist doing despite knowing that it is senseless and should not be done. Your current symptom is a compulsion. Obsessive compulsive disorder. 1. Cognitive behavior therapy. 2. Anti-OCD medications like Fluvoxamine or Clomipramine. For further details consult a psychiatrist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood vomiting, breathlessness and persistent cough?\n\nWoman 41 unable to keep food down after detoxing from drinking for about a week. Now vomiting with blood. Can not keep water down. Also respiratory problems/cold/cough.Too weak to get shower. Long term drinker. Urging her to go to doctor and be admitted to hospital.",
    "doctor_response": "Respected user , HiThanks for using Healthcaremagic.comI  have evaluated your query thoroughly .*  This is in relation with acute respiratory infection ( either bronchitis ,  pneumonia or effusion mostly )  along with erosive gastritis or bleeding     ulcer .*  Needs  immediate  hospital indoor treatment  with intensive back up .Hope this  clears your query .Welcome for further doubts .Thanks .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain and stomach pain after thyroid cancer?\n\nI had thyroid cancer feb 2013 had my thyroid out. every 6 weeks I get my blood work done for levels tsh .02 synthroid 137 I have chest pain. IF I M. tsh .o6.. synthroid 125 I have the shakes numbness of the face and bone pain and stomach pain. I haven t felt good since my thyroid was taken out!! I am going to change endocrinologist I know he doesn t want me HIGH TSH because the cancer he says may come back. TO COMBAT the symptoms which our unbearable!!! I have now become a secret drinker one or two wines or more if I in agony I feel so much better, but have anger issues now. also I stop the synthroid for two days IF I HAVE CHEST PAIN,then feel normal again I ve done this a lot to stay away from the ER, in the ER so many times nothing but high synthroid low tsh. I M PISSED. I wish I could feel normal.",
    "doctor_response": "Hi,Thanks for writing in.It is suggested that you get a complete review of your symptoms done at the hospital. After cancer, most people become slightly weak and this happens due to reduced immunity. You might be having a lowered immune status which can cause increased susceptibility to infections.Please consult your doctor and get a complete blood count and basic investigations like a chest X ray and ultrasound scan done. These investigations might reveal a possible cause for your chest pain and pain in abdomen which requires treatment. Taking healthy nutritious food and adequate amounts of fluids and fresh juices is good. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having blood tinted crust in nose while sneezing. Please advise.\n\nHello doctor, I have had post nasal drip since last three months. It causes me to cough up mucus from my throat. It is very thick - sometimes bloody or sometimes cloudy. I am also having bloody, crusty issues in my nose with sneezing. I am not sick - no fever, no aches, do not feel bad. I just want to stop the mucus (it sometimes chokes me) and want to stop the bloody, crusty nose with sneezing. I tried Zyrtec. That did not help. I also tried Flonase - no help. I am afraid to take Benadryl because of other medicines I take for sleep and anxiety. What other suggestions do you have?",
    "doctor_response": "Hello.  Are the pictures you shared nasal snort or phlegm from throat (attachment remoed to protect patient identity)? Do you have any difficulty in swallowing or breathing? Is there any cough? Any chest pain? Do you have wheezing? Is there any recurrent bleeding in your nasal cavities? Do you smoke or drink? Our approach would differ if the bleeding is from upper airways and if it is from the lower. In the first scenario, we shall give you some nasal lubricant creams with the sprays and see if the bleeding stops. In the second we will have to rule out cough and chest problems. In either case a nasal endoscopy with a laryngoscopy is essential. Do you have such blood stained mucus from nose/throat every single day? Do revert back to us with all details so that we can help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hallucinations and delusions\n\nSir, my mother is helusinating and hearing people taking and making conspiracy against her but no one really present there.Every 5 minutes it repeat and she can't sleepWe have given her alprazolam to sleep but it's not working. Her age is 60. We want to consult doctor this morning Dr. A. Patnayak in Jamshedpur. Please suggest.Thanks",
    "doctor_response": "Hello thanks for asking from HCM for your health related queriesI can understand your concern. She is 60 and is hallucinations and hearing voices. She is also having symptoms like suspiciousness that someone is conspiring against her. Such time of symptoms are not usually seen at her age and need proper consultation and evaluation. You should get her serum electrolytes checked to find out any electrolyte abnormalities to rule out any organic cause. She also should checked for any organic brain abnormality with proper MRI scan of brain. This would rule out any evidence of ischaemic damage to brain. If both conditions are ruled out then most likely the cause of her symptoms is some psychotic episode. If she has history of any recent fever, or trauma or seizures then consult a physician for proper evaluation.In such symptoms medicines like anti-psychotics can help in improvement of symptoms. Medicines like Olanzapine, Quetiapine etc can help to improve her symptoms. Discuss a psychiatrist for detailed evaluation.Thanks, Hope this helps you. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the report suggest?\n\nWhat does mild nonacute bifrontal white matter change nonspecific finding maybe seen with increased frequency in the setting of migraines alternatively finding could reflect vasculitis less likely sequelae of demyeinating it ishemic inflammatory injury",
    "doctor_response": "Hi, Welcome to HealthCareMagic.com I am Dr.J.Mariano Anto Bruno Mascarenhas. I have gone through your query with diligence and would like you to know that I am here to help you.The report shows that certain areas of brain are damaged a but and are not working properly Hope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in HealthCareMagic at  Best Wishes for Speedy Recovery Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mild enlargement of the liver?\n\nHi doctor..my husband has suffered frm severe stomach pain on 30th dec in the midnight. ..when it was so severe he woke me up n asked to take him to d hospital..bt after smtym pain stopped...we consulted the doctor on next day...he said may b chances of stones..so then doc asked him to go for certain investigations...sonography of whole abdomen..it shws the mild enlargement of the liver",
    "doctor_response": "Hi, thank you for posting.The causes of enlargement of liver are different. This disease is caused from infective(hepatitis and liver abscess), toxic(alcohol), and metabolic causes. To determine the right diagnosis your husband needs:- Blood test.- Liver function test.- Abdominal Ct-scan.- Endoscopic retrograde cholangiopancreatography (ERCP).The results will determine the treatment.I recommend you to contact your gastrohepatologist.I hope you find this helpful.All the best.Dr. Behar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How contagious is cmv?\n\nI have been diagnosed positive for cmv...after many misdiagnosese. My liver started hurting enzymes went up spleen enlarged and much memory loss or problems fuzziness in head, though mri only shows sinitus chronic mild? I have so many questions...I do not have aids.. Its negative...and ive been doing huperbarics and IV with vitamin c daily..i do not know what to expect for the rest of my life.... Can i spread it anytime or just when its active and how will i know? Will I need antivirals and if so how does my iv doctor even go about getting vancyclovir etc etc. no drs seem to even know much about this. Will my head clear yp eventually? 100 percent? Where can I find specialists in this? No one seems to know!,!",
    "doctor_response": "HiThanks for posting on HCMCMV is a common virus that can infect anybody.Most people with CMV will never know and may manifest no symptoms if they are healthy.Once infected, your body retains the virus for life but it may never disturb you.However, whether symptomatic or not, it is a cause for concern in pregnancy.It spreads from person to person through body fluids.There is no cure for CMV  but drugs can help treat newborns and people with weak immune systems when symptomatic.The symptoms you present may signal an active CMV and when any of those symptoms appears, its always good to see the Doctor for evaluation and management.I will advise you take an HIV test to confirm your negative status as it could by one of the things that can weaken your system and make you prone to developing an active CMV infection.Other thing can can weaken your system and increase your risk of CMV symptoms are bone marrow or organ transplant, malnutrition, long use of steroids, chemotherapy/cancer.As for the idea of being misdiagnosed, i will suggest you take the CMV test again in a different laboratory.Management of people with very weak immune system like newborns and people with active infection is usually with antiviral drugs like vancyclovir.These drugs slow progress of the disease.Since when you have the virus it remains in you for life, spread of the virus at anytime is possible during reactivation or active infection.Prevention tips or how to avoids transmitting the virus include: -Avoid sharing food or drinking from same glass-Careful disposal of used items containing body fluid-practice safe sex-Wash your hands always after touching your secretions before touching others like babies.Hope my answer will help youBest regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment advice for neurological condition\n\nhi, I m a resident of Ghaziabad (NCR) and central goverment employee & CGHS beneficiary , my daughter is suffering from neurological problem (fits) from almost 10 years, she has been treated by many doctors in Ghaziabad and Delhi but the problem has increased a lot now. Kindly, tell me the best doc available for this treatment in DELHI/NCR (CGHS).Thanks & Regards. L.R. SINGH, 0000",
    "doctor_response": "Hi, First of all, you should do  an MRI T2-weighted and an EEG to detect the epileptic focus. Then you should go to a neurosurgeon for help. Because some types of seizure do not respond to medical treatment and they need surgical interventions. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mustafa, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is IVF advisable in case of infertility?\n\nhi i am from tamilnadu i married 6years completed but still not get baby i am 42year old my wife 39year old now both of them consult doctor the doctor tell us we cant get baby normal way doctor tell us use ivf better where i can i go for ivf centre",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.You did not mentioned your semen analysis and your wife's report.If reports are abnormal then IUI intra uterine insemination, ICSI intra cytoplasmic sperm injection IVF invitro fertilization are better options.So consult a best gynecologist in your town and take his/her advise regarding these procedures.Hope I answered your question. Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for lightheadedness after removing wisdom tooth?\n\nI just had my wisdom tooth on bottom left removed on Monday.  It's Thursday and I still feel lightheaded at times, I've gargled with salt water as told. I took one Lortab for pain on Monday.  Hadn't really been in serious pain since but just some soreness and tenderness. My problem is that I can't sleep.  Everytime I try to drift off into a sleep and I'm awakened by involuntary shiver or a jerk. I have never done this before taking that med. I also have felt like a burning sensation across my chest (not painful)--when I sleep.  If I'm up and moving I'm fine.  Although last night I felt a little sweaty and light chills.  Any insight would be helpful.  Thank you.",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,   I have gone through your query, you have undergone extraction of wisdom tooth now you feel like lightheadness, chills , sweaty . Dont worry these symptoms are seen in patients as side effect of anaesthesia given during extraction and also due to Anaemia or Malnutrition . You should wait for few days you feel better and consult your dentist and take Vitamin B 12 , B6 supplements , folic acid supplements tablets. Take nutritious diet on time , proper sleep of 8 -9 hours. Hope this will help you. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have burning pain after going to the toilet. Is the edge of the anus torn?\n\nHello doctor,I have pain after going to the toilet. For the past few days, I have been experiencing burning pain after finishing, when I try to wash. It feels like the tip of the anus is inflamed and I cannot even touch. I Feel like the edge of the anus is torn. I notice that there is no blood in the stool. I have been applying Lycor cream. Please help as I am even hesitating to go to the toilet because of this.",
    "doctor_response": "Hello. From what you mentioned, it seems you have an anal fissure, which is a linear injury to the anal opening. Although it is very painful, you do not have to worry. It is a very common condition that resolves over time in most cases. For the pain, GTN ointment local after each time you go to the toilet. Be aware of the headache, Panadol (Paracetamol) will improve it. For constipation, Movicol (Macrogol) three times a day plus Senna (laxative) tablet before bedtime. Also sitting in a warm bath for 15 minutes helps. If you felt a mass coming out from the anus, a surgical clinic visit will be required. Hope you get well soon. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the hand when mentally upset. Reason?\n\nEverytime my feeling get hurt by someone the palm of my hand begins to get a sharp pain, more along the crease of the thumb area, and only on my right hand. The pain is so bad that I have to massage my palm, but I happens every time someone hurts my feeling! I find it so weird, but it's been like that since I can remember!",
    "doctor_response": "Hi, Thanks for using health care magic. Sharp pain over the thumb occurring while in stress is common somatic symptoms of stress. Different persons react differently while in stress depending upon so many factors including genetic vulnerability. Your center of stress reaction might be around your hand. You should develop cope up mechanism to handle stress  by doing yoga, meditation or breathing exercise. You can also consult counselor for better control of stress. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump in throat with nausea and headache\n\ni have what feels like a lump in my throat,food gets stuck and sometimes it feels like its going up my nose? along with this im experiencing extremly tired,nauseas,headaches and blurred vision,dizziness. i can push what feels like the lump in my throat on the outside of my neck around the middle below my chin but above my collar bone,can u help ?",
    "doctor_response": "Hi, Thanks for query to My HCM virtual Clinic.I studied all details of your query.In this background  of the facts given in your query,I would suggest to consult your family doctor who would check it in all its aspects and if need be would refer you to ENT/Physician specialist doctor to check up lump in throat with nausea and headache.Going by the limited facts, In My Opinion you seem to have problem of -Acid reflux with Gastro-Esophageal-Regurge Disease(GERD),for which you need to be investigated and treated accordingly.To confirm this cause,from many other causes, I would suggest you Second opinion from ENT/Physician specialist doctor who is the right doctor to help you out from this worry.Treatment suggested till you check up with your doctor-Take bland diet only.Avoid spicy food/tea/coffee excess intake.Be on Banana Milk Shake.Hope this satisfies your query.Don't forget to hit thanks and write excellent review comments to help needy visitors at HCM.Welcome for any further query in this regards.Dr.Savaskar M.N.M.S.Genl- CVTS.Senior Surgical Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in centre of chest?\n\nIm seventeen. For the past two days ive been having an ongoing, dull uncomfortable pain near the center of my chest, a little more to the left though. Its constant, & hurts . The pain also goes occasionally to my shoulder & neck, & sometimes to my jaw, but all only on the left side of my body . I had a bad scare earlier where the pain increased severely abn i could hardly catch my breath. It lasted about two minutes and than went back to moderate pain. What do you think it could be?",
    "doctor_response": "Substernal pain radiating to  sides of the midline can occur with esophageal reflux.At your age anginal pain is unlikely though not  impossible.Mitral valve prolapse can also cause non-specific retrosternal pain.Get ECG done and if indicated 2-D echocardiopraphy .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the bleeding again after periods due to pregnancy?\n\nI had my periods on 23rd of July and my fiancee ejaculated on my mouth on 31st July...scared of getting pregnant I had an I pill the very day and today 6th of Aug I started bleeding again like periods..am I pregnant or is there any harm since I took I pill!!",
    "doctor_response": "hello,i can understand your concern.donot worry, you cannot get pregnant as your fiancee dint ejaculate in your vagina.oral sex can never lead to pregnancy.ipill conatins levonorgestrel which generally leads to irregular bleed and after its usage. so ,the bleed is mostly due to the ipill.i would advise you not to use ipill frquently as this has many side effects. instead if you get intimate frequently i would suggest combined oral contraceptive pills to be taken. these have fewer side effects and provide more protection also.hope i have answered your concerns.feel free to ask further queries.wish you a healthy life ahead.thanks for choosing HCM",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment for acute sciatica in a 66-year-old?\n\nHello, my name is xxx. I am 66 yrs old. I have been having acute sciatica for about the last two weeks. I have been taking Norco for the pain. My blood pressure has been around 156/84 for the last few days. I have also been having severe headaches that seem to be centered around my neck making a band around my head making the top of my head feel tight and throbe. Thank you for any assistance you you can offer.",
    "doctor_response": "Hello, As I read in history about your age and acute sciatica I feel this is totally degenerative changes occurred over a period of time. You headache the way you mentioned is also indicative of Same degenerative changes I would recommend you to take an MRI of lumbar and cervical spine as it will provide more insight to your complaints. For sciatica there is a set of exercises available but keeping into consideration of your blood pressure we need to go slow and steady so recovery follows. Exercise include - core stability, spinal extensor muscle strengthening, static Quadriceps, static hamstring and straight leg raise. This exercise has been found effective in research for people having acute sciatica. For your headache, I will recommend to use hot water fermentation over the neck region, then using a neck collar for a week and check out if the headache comes down. If so then we can conclude this headache to be cervicogenic headache. Some exercises to strengthen the muscles of the neck, like the static Neck exercises, should be of help Do abundant of deep breathing exercises on a regular basis to have a good pulmonary system so that the fatigue is delayed while performing the exercises. In my clinical practice of over 12 years most cases have been improved and able to have a pain free life. I wish you good luck and pray for your good health. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce depression?\n\nDr Sir, My father who is 75 years old and has been diagonised a bipolar and on continuous medication from last 16 years. Now i think he is passing through a severe dipression phase. He is bedridden never ask for food and basic reuirements even has stopped taking food. Only remembers already died relitives and family member. His weight has considerably reduced. My mother takes care of him. No medicine is showing any sign of recovery. Presently lithium dose and some other mood stablisers as per percription of dr are being given to by mixing in some of food items he takes are fed. Please suggest something family is very badly disturved.I m from Patiala Punjab. He is a retired govt employee.",
    "doctor_response": "HiI understand your concern.Frankly speaking you have to consider about re diagnosis?Defiantly it was bipolar but now it can be like psychotic illness or dementia.Need to reach proper diagnosis to treat him better way.Now in this case it is difficult to treat him at home so please do get him admit in hospitals.Some physical investigation is also necessary to rule out because of age there are medical co morbidity in this age.So it is multi functional approach to treat him properly.Do proper consultations.I hope i have answered your query.Still have a query then ask freely.Happy to help you.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in groin\n\nHie. My problem is I have sharp pains in the lower part of my right abdomen. My groin area just above the penis below my stomach sometimes hurts as well. on days that I masturbate maybe some 5 hrs later I have this sharp shooting pain through the penis on the inside, like on the inside. It persists for a few seconds during which I cant even walk and I gotta maintain that posture until it passes. I masturbate an average one time every day, I don t have hair thinning issues and concentration problems though I think these groin issues are masturbation related. also recently I have started to feel this burning sensation at the tipof my penis. what could be my issue and how may I remedy it? thank you",
    "doctor_response": "Higreetings Your pain is generalised to the right groin and radiating to scrotum.It is not continuous and having burning sensation at the tip.Now I would like to get the urine tested for any infection or any other abnormalities. prostatitis or urinary tract infections can present like this.Also I have to rule out any renal or ureteric stones and either ultrasound scan or a contrast CT may be required.If both are negative a chronic appendicitis has to be ruled out.hope my answer helps you. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes forehead pain in kid?\n\nHi, may I answer your health queries right now ? Please type your query here.. 4 and a half year old girl having pain in her forehead lasting a few seconds. She s scratching at her forehead trying to scratch the pain away. Happens maybe once or twice a day.",
    "doctor_response": "Hi,Short interval pain doesn't have any clinical significance. If a pain in for head is persistent than at this age group first thing you have to do is to see a ophthalmologist, for her eye checkup. May be she is too young to define persistent pain, my advise is to see a eye specialist to rule out any vision error.  Secondly it can be because of sinuses problem, but she should have fever for that.  My advise is to see a eye doctor and make sure her sleep should be good.  Hope I have answered your query. Let me know if I can assist you further. Best Regards, Dr Zeeshan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having pus cell in urine.\n\nmy urine examination showed pus cells and r.b.c. What can be the cause?",
    "doctor_response": "Usually that happens when some infection is there..when last time i had it in my urine report the doc started me on antibiotic and then it went off.. after i have still not got it..she told me to drink plenty of water..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for right upper back pain\n\nRecently I had right uppert back pain before two months, went thru physio and was normal, again two days ago my back started to give pain.............Parallely I have something in my underarm, seems like swollen..and my right breast doesnt seems to be normal...............",
    "doctor_response": "Hi I can understand your concerni would advice you to get a aspiration cytology done of your axillary swelling and also get your breast examined for any lumps bumps or abnormal discharge. Your back ache can be related to these problemsI hope this helpsLet me know the results of your test. early diagnosis is must for early and perfect treatmentWish you good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for swelling of jaw due to tooth decay?\n\nMy side of face by my left ear and my jaw starting hurting me on Monday morning while eating.  When I looked in the mirror, I saw alot of swelling and thought it was a tooth.  I went to the dentist, and he and I both thought I had a tooth going bad, so he put me on antibiotics, but nothing has changed and this is day 4.  I am in so much pain when trying to even sip soup and my jaw ends up locking up.  If this is a blocked gland, will it eventually go away on it's own?  I really can't afford going to the Dr's so am looking for your advice.  Oh...and please note....I've been drinking well over a 1/2 gallon of water/day but  can't do the sour candies....Hurts too much",
    "doctor_response": "thanks for your query, i have gone through your query. the swelling could be because of the tooth infection. consult your oral physician and take a radiograph to rule out tooth infection. if there is infection in the tooth, start root canal treatment. it can also be because of duct obstruction secondary to stone in the duct. if it is tooth infection you can take antibiotics like penicillins and metronidazole. do saline gargling. donot apply pressure over the swelling. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Coccidioides fungi found in lung after surgery. Painful. Did it cause throat cancer?\n\nJust home after a week in Maui memorial hospital, had surgery with heart and thorax dr. he sent me for cat scans and pet scan , to check out throat problem, came out lung likes of newly formed cancer in left lung, thought he might have to remove rib and possibly lower left lobe. when hearing that a COCCIDIOIDES fungi was what they found instead, removed it. sent to a lab in salt lake city ? no definite result back for 5 more weeks. In terrible pain and still said I need 6 weeks of radiation on laranex after biobsy showed some cancer there. this was found before the fungus in lung. but my voice is fine. now wondering if I really did have cancer on throat, or was it caused by fungi also ? what should I ask DR. DANG, radiation still? or was it resolved in surgery on lung ?drs. seem in a quandry. no answer from CDC drs. either. thank you.",
    "doctor_response": "Hi, As your doctor advised for 6 weeks of radiotherapy, probably they have found cancer. From your history it is not very clear where the primary is. but coccidioides can not form cancer , lung cancer may cause superadded fungal infection. If primary cancer in larynx according to stage treatment will be decided.  please consult your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain after surgery for lung collapse\n\nHi, my boyfriend had a surgery years ago due to his lung collapsing...yesterday he was complaining about the side where he had the surgery was in pain when he woke up...then when he got in from work he said he could still feel pressure on that left side..he tried lying on his back to see if it would make a difference but he said it was still the same..I guess he was making sure he wasn't feeling the same symptoms he felt when his lung collapsed..what could it be??",
    "doctor_response": "Hi Dear !! Thanks for your query to HCM.I reviewed facts of your query in context to your health issues.My Opinion-In My opinion, in the given situation you seem to suffer from-Reactivation of Infection on side of past of surgery for collapsed lung.In absence of further information, general comments could be given.As in most of cases, collapse of lung(Atelectasis) is due to infection in the lung, many a times this infection, after many yrs could get reactivated.CT Chest after X-ray chest could fix the cause of it.Other cause of such complaints-  needs to be ruled out by consults with attending Chest Surgeon, who would plan further treatment after physical and radiological/blood tests.Next appointment-xxx .If you update more information/ details upon these suggestions,I would give further suggestions on medicines to correct your health issues.If need be, update any health issue 24 x 7 by a direct question to ME, at following HCM link- Dear,if you don't have any further query in this regard, Do close this query with YOUR pleasing and feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at HCM services. If you want to update more details and ask more update queries , You are most Welcome herewith !! Good Day!! Wishing Good Healthy Life in time to come!! Dr.Savaskar M.N. Senior Surgical Specialist M.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bleeding in penis during intercourse?\n\nI have occassional bleeding in penis during intercourse. I guess it is the tear of the frenellum. Also I have erectrile dysfunction problem. Kindly suggest. My details areas follows Age - 33 yrs, WT - 87 kgs, height - 5'10'', Medical history - recently hypothyroidism detected",
    "doctor_response": "Hello, Erectile dysfunction can be due to bleeding. Bleeding can be due to phimosis or urinary infection. Sharing a picture will be helpful for diagnosis. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the semen analysis regarding fertility indicate?\n\nGood evening sir,i am a 33 yrs old male and i got married six years ago. i am a childless. the following are my semen analysis details. Volume 4.0 mlColour Grey WhitepH 8.0Viscosity NormalLiquefaction 40 minutesCount -- Less than 1 millions/mlMotility : Fast Progressive(a) 5 %, Slow Proressive(b) 10 %, Non Proressive(c) 10 %, Immotile(d) 75 %. Morphology : Normal 5 %, Abnormal %,Head Defects 70 %,Midpiece Defects 20 %,Tail Defects 5 %,Concentration : Leucocytes 1 to 2 cells/HPF, RBC 0 to 2 cells/HPFi got varicocele surgery during august 2010 but the above count not raised as said by the doctor before operation.",
    "doctor_response": "Hello,In your Semen analysis report, abnormal things are less account as compared to normal which is 20 million/ml. Immotile sperms are 75% as compared to normal which is motility should be more than 40%.In the case of morphology it shows normal values, pH is also good. Varicocele is one of the causes of infertility.In most of the cases fertility comes back after the varicocele operation but as per your report I think that there will be another reason for this abnormal semen report. So, I will suggest you to consult to Infertility clinic with the reports.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Which is the best regime to take Femilon, 21/7 or 21/5?\n\nHello doctor, I am on birth control pill Femilon for the last three months and I have followed 21/7 regime from the last three months. I got my last two periods on the 6th and 7th pill-free days respectively. And now I have advised to follow 21/5 day regime by my gynecologist for proper efficacy of pill. I am still being confused, that I have to continue 21/7 regime or 21/5? My gynecologist said to me do not think about your menses just follow 21/5 regime whether menses come or not. So I want to ask is it normal to lost menses for two to three months, because I feel that if my menses came on 6th or 7th pill-free day on 21/7regime, then if follow 21/5 then I have to start my pack on the 6th day after five pill-free days. And if my menses will not come in these five days then after starting the new pack my menses will not start still a month, is it normal? What I have to do?",
    "doctor_response": "Hi. How are you doing? I would sincerely advise you to keep having pill in the 21 pills, 7 pill free cycles. This will avoid all the confusion. Hormone control will be the same if you take 7 pill-free or 5 pill-free cycle. We give the gap for proper hormone withdrawal so that the bleeding will be completed and the inner lining of the uterus is completely lost. So I would say you just follow the three weeks pills and one week pill-free cycle.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i double up on the 150 ranitidine and 10mg cetirizine for relieving allergic rash?\n\nI m having a allergic rash / Hives. I couldn t get in to see my doctor in time but he said to get a steroid shot. My question is - (for the time being). Can I double up on the 150 Ranitidine and 10mg Cetirizine to help relieve symptoms until I can get a shot?",
    "doctor_response": "Hello,Welcome to HCM,The symptoms of allergy and itching suggests me that you may be having allergy to some allergen which should be found out. As you were prescribed Tab Citrizine 10 mg and Rantac 150 mg, these drugs which helps to control the symptoms.The drugs which you are on can only control the symptoms but it cannot cure condition.As you getting back these symptoms after stopping the drug you should be thoroughly evaluated for the symptoms. You need test your blood sample for absolute eosinophil count and it should be followed by skin prick test for more prevalent allergens like dust, pollen, mite and food.This will helps to find out the allergen which is responsible for all these symptoms, then you can avoid these allergens are you can choose immunotherapy.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with migraines on left side with enlarged pupil during attack. Was given seizure medicine post car wreck in the past. Help?\n\nI have a friend of my family who was in a car accident in October. He hit the right side of his head but did not sustain head trauma. He had multiple tests done including a MRI and MRa and CT scan . Initally the Doctor said they saw an anurism on the left side of the frontal lobe . Then another test was done and they said there was nothing. He has been to a neurologist and was given seizure medication. He is 16 and is now suffering from migraines on the left side and when the migraine comes on his pupil get very big. He and his family on scared and getting no answers.",
    "doctor_response": "Hi, Thank you for postig your query. First of all, we need to resolve whether or not your friend has an aneurysm. This can be done with the help of cerebral angiogram. If it has not been done, please get it done after discussing with his neurologist. Regarding his repeated headaches, if his brain scans are normal, then most likely it is due to migraine. He can be started on preventive medications such as topiramate or divalproex to prevent repeated headaches. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reshape and restructure front teeth?\n\nDear sir, I am am,ha, 25 years old male. I have a good health. well, my front teeth are not in proper shape. I dont know what exectly I should call it, but the two front teeth are in bunny like shape. And because of those I cannot completely close my mouth. I want to get rid of these to have a broad smile and to nagotiate the little discomfort I suffer in society. I would be grateful to have valuable suggestion from you.Please guide me in right direction and place. My mail Id is  YYYY@YYYY",
    "doctor_response": "Thank you for your query,Your teeth are not much of a problem.You can go for orthodontics treatment, in which you will have to wear brasses for some time. In this case, they will try to readjust your front teeth within your jaw bone.Otherwise, you can go for cosmetic makeover. In this case, your front teeth are shaved off little bit and will be replaced with new set of crowns on them which will give you desired smile.But, in both these cases the decision will be between you and your dentist as to which treatment is best for you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest alternative treatment for heart disease\n\nHi, My mother had a heart attack on 30.09.2010 and she recovered it by completing 10 clexane injections after each 12 hrs with other medicines as prescribed by doctors during staying at Hospital. She has been now released. The doctor advised us to do Angiogram very shortly to know how many blockages are there. My mother troponin I level was found 180 by blood test which indicates must blockage. In the above scenerioe can you suggest what will we do now as we know during ring implementation, it has a chance to miss my mother whose age is now 57 years. Is there any alternative treatment without surgery?",
    "doctor_response": "Hello, After attack, best treatment available for heart attack is angiography and angioplasty. As it will directly open the blocked arteries. Angiography is now a days a day care procedure and even after angioplasty patient are discharged on next day itself. So it's not a major procedure. Alternatively, medicines are also effective mode of management. She should be on multiple medicines like Aspirin, Clopidogre, L-Statin like Atorvastatin, Beta- Blocker like Metoprolol etc. and procedure can be delayed. Hope this helps you and get back if you have any doubts. Take Care! Regards Dr. Sagar Makode, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shoulder pain and muscle tenderness on the arm?\n\nI injured my shoulder last year sometime. It could have been an accumulation of events. I run outside during the winter & have fallen on pavement a few times on my right shoulder. I feel a dull pain when I sleep on my right shoulder. That comes an goes. I also feel a muscle tenderness on the back side of my arm. I tried to shoot a layup today & I had to stop because it felt like my shoulder popped out of place. could this be a rotator cuff injury or is it another type? When it happened last fall I reduced my running and did some excerises but not enough",
    "doctor_response": "Respected sir, I have understood your concern see recurrent injury to shoulder joint may decrease stability of joint already shoulder joint is less stable joint and muscle weakness also contribute to pain in shoulder joint. see recurrent injury is due to less stability and laxity of capsule and ligaments around the joint. you can take 15day physical therapy treatment which includes ultrasound and IFT modalities for pain relief. gradually starting with pendulum exercises and don't stretch the joint. you need to strengthen the scapular muscles which are back muscles so physical therapists will help you to do that. I hope you have satisfied with the answer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain?\n\nI have celiac disease and have been completely gulten free for 2 mts. I have had a bad pain in my stomach that I have to hold pressure to to be able to stand the pain since Friday. When I bend forward it contracts like a cramp. Please help....thank you",
    "doctor_response": "Hi ! Good evening. I am Dr Shareef answering your query. If I were your doctor, after a physical examination of your abdomen, I would advise you for a stool test for ova and cyst, a urine test to rule our a UTI, a complete blood count, and an ultrasound of the abdomen if need be.Till the reports come, I would advise you for an anti spasmodic and a proton pump inhibitor drug for symptomatic relief only.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Fine needle aspiration shows benign mass on thyroid, but I have throat pain. What to do?\n\nDry cough and tickle in throat pain occasionally from right side of neck to my ear. MRI showed a mass on right side of thyroid had a fine needle aspiration done on it, they poked it 9 times to try and get enough for the screen. The results came back saying: This needle core was done in the possibility that may not be enough epithelium in the cytology specimen. The core; however, does only shows benign soft tissue and skeletal muscle and is noncontributory. And said it is benign. That was 3 months ago and I now have a cough and a tickle in the throat. Also occasionally with a pain in my ear. Should I get another doctor to look at it? FREE T4. 1.29 Thyroid stimulating hormone .95",
    "doctor_response": "Hello.  Good to hear from you. I understand your situation. Firstly, regarding the neck swelling that concerns you, since there is no evidence of malignancy in any of the investigations do not worry about it. As your blood thyroid levels are also normal without any medication, do not be concerned about it. Secondly, about the cough n throat pain that you have, it has nothing to do with your neck swelling. Do/did you have any cold.? The cough might be because of a mild infection or an allergy or a reflux. So if u can get treated for this you\u2019ll be fine. I suggest you to try the following medication.  1. Tab amoxicillin 500 mg twice daily after food for 5 days.  2. Tab levicetrizine 5 mg once daily before sleep for 7 days. 3. Tab pantaprazole 40mg once daily before breakfast for 7 days  4. Syrup gunaphesin 10 ml thrice daily Infection/allergy Chest x Ray URTI medical Avoid cold food. After completing medication.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do you suggest for a red and swollen penis?\n\nHi Doc! My penis and scrotum and the skin around my anus is very red and swollen: In fact all the skin on my penis dried and peeled off but the redness has come back. I have had no sexual contact with anyone besides my girlfriend of 3 years. First symptoms were after I masterbated using saliva but the lubrication was not enough and my penis was a little red after. from there is just got itchy then spread to other areas through scrating. I have had the problem for about 5 weeks now. thanks for your help",
    "doctor_response": "Hi,from history it seems that you might be having fungal infection on the part.due to itching there might be having some bacterial infection causing redness and swelling.Apply anti-fungal lotion or cream locally.If infection is more go for one course of antibiotic medicine course to control bacterial infection.Go for oral anti fungal medicine course like Flucanozole.Keep local hygiene proper.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having pain on my upper neck?\n\nHi My name is Cheryl, I had a total thyroid ectomy in sept. I did have cancer. One day surgery turned into 2 days in intensive care then 6 more days in hospital. I still have stridor and possibly going to have my vocal cords injected. But today I started having pain on my left eide of myuper neck. What could cause that?",
    "doctor_response": "Hi, seems like you had recurrent laryngeal nerve palsy during surgery of thyroid. Hospital stay can also be because of hypocalcemia due to parathyroid gland insufficiency. Serum calcium level estimation will help in reaching to a diagnosis. Calcium and vitamin D supplementation will help over coming this. Pain in neck 8-10 days post surgery is can be because of some infection inside or an infected stich. Local examination of the area will help in finding the cause. If it is so, antibiotics will help resolving this. If this is long time since your surgery, muscular causes are usually the reason for  pain in neck. Pain killers and muscle relaxants will help in solving the problem. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for bleeding ear due to puncture from plug ins\n\nMy baby was playing with his piano's mic that has a plug ins on the end of it and i think he punctured his ear coz i saw a little blood...I don't know what to do pls help..Im in japan and tomorrow is sunday so there's no doctor and i dont have idea where to bring my son coz the doctor said that ear is not part of his area specialty..What remedies or aid can i do?Any help would be very much appreciated..thank you!!!",
    "doctor_response": "Hi..Thanks for the query..It looks like due to injury of the ear canal with the mic tip leading to bleeding from ear most probably due to injury inside the ear canal leading to injury to the lining of the ear canal causing bleeding..Another reason can be perforation of the eardrum caused due to deeper penetration of the metal tubing leading to pain and discomfort..I would suggest you to consult an ENT Expert and get evaluated and a thorough clinical evaluation and investigations like Otoscopy can help in diagnosis and treated accordingly..In case if there is only injury to the lining of ear canal then antibiotic and analgesic eardrops will heal it.In case if there is perforation of eardrum then small perforations can be healed with oral antibiotics and anti-inflammatory painkillers like Ibuprofen and antibiotic and analgesic eardrops.In case of large perforations surgical repair might be needed..As of now you can give him tylenol if there is pain and avoid picking the ear or exposure to loud sounds or excessive water exposure..Hope this helps..Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could delay in conception despite Evion and Gonadil intake indicate?\n\nHi, I am married from last 3 years and no baby yet, I got semen analysis test and doctor told me thee is a problem of sperm lives and suggest me to have tablet EVION & GONADIL-F. Now I want to meet some urologist  to know what the actual problem  and solution for that",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.Both tablets are nutritional supplementary.You didn't mentioned your semen analysis reports. Count, motility or liquefaction time.Although i would suggest to do ultrasound color doppler of scrotum to rule out any pathology like varicocele and to see vascularity of testes as in infection vascularity increases.So consult a urologist and taker his advise for further management.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the pain due to disc prolapse?\n\nyes sir this is s.m karim i have disc prolapse before 20 years and had surgery in dxb but after 2 years again i had pain started before 2 years i took mri it was shown that i had l3-l4-l5and s1 problem dr advised me to do surgery what is your advise",
    "doctor_response": "It depends on the severity of the disc injuries. But the rule in general regarding the spine is to keep surgery only as a last resort. Try everything else first: physical therapy, massage, acupuncture, medications, etc. Then only if things remain unbearable then consider surgery, because the outcomes of spine surgery simply aren't as reliable as we would like (or as reliable as the surgeons would admit!).",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for asthma and allergy\n\nI have been having asthma flare ups from allergies. Had tightness all night so went to Dr this morning and got a breathing treatment and steroid shot. I had a bit of tingling in both hands before the treatments. They stopped for awhile but now my left forearm and hamd are tingling. Is that anything to worry about?",
    "doctor_response": "Dear, The most common causes of tingling in your case is fast breathing associated with Asthma and Anxiety. Fast beathing causes alkalosis in blood which disturbs calcium balance and makes some nerves very sensitive especially upper limbs and face. Just breath comfortably and try to take your attention away from your disease, it should go away.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to measure the size of my son s head?\n\nhi i have a qustion about the mesurment of my sons head for his 9 month check up....when we went 2.5 months ago his head messured at 43 cm there i thought it was wrong so i messured at home and i got 44 cm so then at his nine month check up it messured 46.5 but he did have a flat spot that is shaping out does that have somethign to do with the incearse? but i had also messured at hom and got 46 so how can this be acurte?",
    "doctor_response": "Hi,Head circumference is measured with a non-stretchable tap across the most prominent points on front and back of head- part of forehead about 1 finger breadth above eye brows and occipital protuberance (the bony prominence on back of head).After 6 months, we expect an increase of 0.5cm per month. For a baby with normal size at birth, we expect 44.5 at 9 months. To decide whether the increase is significant, we have to compare with that at birth, and plot on standard chart. Your doctor will discuss with you.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam T. K., Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from infected ear, decayed tooth, swollen tonsils and salivary gland. Recommended Claritin D, ibuprofen. History of sinus. Treatment?\n\nI had a root canal in early may.  Prior to the root canal, my symptoms were a hollow feeling in my left ear and tingling down my jaw.  The endodontist determined that my back lower tooth was not healthy (no infection) and performed a root canal.  The feeling mostly disappeared after the initial root canal, but obviously the endodontist and dentist have been in my mouth several times over the last month and a half, used novacaine, etc. for the crown.  During the entire time, I have had swelling in my upper left cheek (inside), like little pockets of inflammation.  Along with this, my allergies have been bad and I have had sinus pain, only on that left side in my cheek.  After the dentist put my crown on recently, my left gland in my neck became swollen and has not gone down.  The sinus pain comes and goes, the hollow feeling in the ear comes and goes and my jaw below my ear feels stiff and sort of hurts.  I went to the urgent care to rule out an ear infection or strep.  She said my tonsils and salivary gland are swollen and I had a lot of post nasal drip.  She recommeded Claritin D.  I have been taking it, but the swelling has not gone down with that or ibuprofen.  The dentist also looked at my mouth and says my teeth seem fine.",
    "doctor_response": "Hello, Thanks for writing in. The root canal treated has re-infected causing all these side-effects associated. I would suggest you to get a thorough clinical as well as radiological evaluation done. If tooth can be saved,it has to be extracted. Or-else,tooth has to be root canal treated. Please get scaling done. Use soft-interdental toothbrush and dental floss to clean your teeth. Maintain good oral hygiene. Use chlorhexidine mouthrinse to gargle. Take complete course of antibiotics too. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat UTI?\n\nHi goodmorning. Im 17 yrs old and I just had (or still have) UTI. It started the other day when I was constantly peeing, the urge to pee but nothing's there and then the pain after peeing. I went home immediately, but the pharmacies were closed already so I took medicine the next day. The med that I took was Rifampicin, that was what my grandfather gave me (im living with my grandparents). He also said that it had side effects of red urine. I took 2, one in the morning and one in the afternoon. All of the pain went away but the red urine hasn't, and I'm just confused if its my period (i'm supposed to have my period this week, im a regular) or if its still the side effect of the drug. Please help me? Thank you and God bless.",
    "doctor_response": "Hi dear,It seems that the red urine you are getting is not the side effect of the Rifampicin, but blood cells in urine suggesting UTI. Also, Rifampicin is the medicine given mostly in TB cases, so it might be the coincidence of taking Rifampicin and your immunity boosting up.Anyways, I suggest you take Levoflox 500 mg 2 times a day for 5 days and also take Zinetac 150 mg 2 times a day to cover for acidity due to medicine. I would suggst you check if you habe fever by thermometer. If you have, you can take PCM 500 mg as need arises. If symptoms don't resolve within 2 days, go for blood test for Complete Blood Count (CBC) and urine routine test. Do complete the course of Levoflox if you start it. I hope this solves your query. Wishing you a veru healthy life ahead. Thank you for choosing us to help you. Regards,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the saliva to turn brown in color?\n\nI have recently started smoking tabacco and for the past day I have been coughing quite a bit, just now I couldn t stop for about 10 minutes and went to the toilet to spit out and clean my mouth, the spit was brown colour (looked a bit like when you have chocolate and you dont wash your mouth). After washing my mouth the spit was still brown colour (like chocolate or tabacco brown), should I be worried?",
    "doctor_response": "Hi,Welcome to HCM,Coming back to your Query, It seems this can be either an infection in lungs causing cough and brown Expectorant(Sputum) or small bleeding within aerodigestive tract and causing expectorant of altered blood which is brown in colour. It would b worthwhile to investigate yourself with Xray Chest and if required HRCT chest and Upper GI Scopy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dark patches below nose, mouth area, allergic reaction. Using tri o bloc, burning sensation. Cure?\n\nhello! am allergic to certain drugs and i developed some dark patchs below my nose and mouth area. my doctor asked me to use creams like sunnova, meloglow, tri o bloc etc.. when i apply tri o bloc i kind of have a burning sensation and area is slightly red now. should i continue using tri o bloc? or stop it and use the other creams? please suggest...",
    "doctor_response": "Welcome to Healthcare Magic, Yes, you have to stop trio bloc due to burning sensation and slight hyperemia, ask again your Doctor which cream to use and how frequently. Burning sensation and hyperemia is not normal and you need adjust your treatment. I wish you   good luck and speedy recovery, Hope this helps and I have answered your query. If  you have additional queries don\u2019t hesitate to ask. Best Regards, Dr.Mihail",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could a dent and cut on the forehead of a 2 year old be a matter of concern?\n\nhi my almost 2year old son as banged his head this morning he has a small dent in his forheadand small cut and a large lump it has seemed to have gone down a bit as the morning as gone on,my worry is he was sick just after this happend he tripped and caught his head on the corner of furniture should i be worried any advice ?",
    "doctor_response": "Hello  ...Thank you for asking query I read you Query ,your 2 year child got small cut &large lump due trauma this morning , Reg. your son  injury ,i  would suggest you,  child  to be examined by doctor ,as any injury over scalp /fore-head should be of concern ,i should not to  be taken simple injury ,as  below this area -skull -is lying the brain , so  brain  trauma should be ruled  out only by physical  examination,and Dr  will ask some question related to  this injury,like any vomiting, loss of balance, any loss of consciousness  after injury, is child  active after injury or not , doctor can request  x ray  head if required ,so consultation is  needed  in this case.hope  you got the answer. regards,Dr Mohammed  ibrar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump on the toe indicate?\n\nI had a knot on my 2nd toe at the joint below the nail. It looked like it had a center with a round circle on top of the knot. I mashed on it and a clear sac came out filled with clear fluid in it. A round little sac with clear fluid and left a hole in the knot",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .*  This seems in relation with bursa cyst or sebaceous cyst .*  Needs to be confirmed with physical examination or at least a photo pic    evaluation as an attachment  to give more precise  judgement .Wishing you fine recovery .Feel  free  to ask any further doubts .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I walk for more than two miles after a knee replacement surgery?\n\nI\u2019m a 69 year old male. I walk 4-41/2 miles every morning. My left leg has been causing me pain, more of a constant ache for some time. My left knee was replaced 7 years ago. The ache wakes me up throughout the night. Changing sleeping positions does not help. Thanks",
    "doctor_response": "Hello, Is the pain relieved after surgery? After how much time from surgery pain again started?. Is there any deformity left after surgery? Are you diabetic? Now get the X-rays done first to know the exact cause of pain. Till then you can take any over the counter pain killer. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Jaideep Gaver, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am loosing my facial skin color due to the addiction of meth\n\nHi,I m a recovered crystal meth addict, 35 year old female and would like to know how long it will take before my normal facial skin color re-appear???My facial skin color has gone dark!!",
    "doctor_response": "hi it will take 3-5 wk to recover ur facial skin color back u need to apply good sunscreen twice a day . apply moisturizer lotion at night wear cotton and full cloths drink more water better to consult dermatologist .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Who is good gynaecologist in Bangalore?\n\nhi..could you suggest me a good gynaecologist in south bangalore..i stay at h.s.r layout..i have problems conceiving.( have been trying to concieve for 13 months now.so need a good doctor, who will be affordable and wont make us do unnecessary tests for making money..I ive heard horror stories where they unnecessarily make couples go for IVF )..so a bit concerned.. ive shortlisted a few docs..should i consult dr.prabha singan at epmc , dr.nirmala or vidyamani in lalbagh nursing home? pls help",
    "doctor_response": "Try for Dr.Annama Thomas, she is good, it will be better if yo can get a check up or a discussion of your reports with a infertility specailist first to see whether you really need to go in for IVF or not. Have you already done the necessary tests to find out if there is any underlying problem either in you or your husband.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for rash on skin for AA stent patient ?\n\nI am AA stent patient on effient and many other drugs. I have developed a fist size rash below my left rib cage. It is tender to the touch and hurts when I lean forward. I am worried.  Is that possibly spleen related and why would there appear a bruise or rash like on the skin",
    "doctor_response": "Hi,Thanks for writing in HCM.There is high likelihood of the rash being anticoagulant induced rash. I would suggest that you get a coagulation profile and a Complete blood done.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes involuntary semen discharge?\n\nSir, I am 29 years old, my sperms will comes automatically while watching porn movies or think or speak about them in a minutes. I can't able to control it.. So can you please guide me to resolve this issue or should it creat any problem in the future. Please advice...",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.It is a premature ejaculation. Because you are not performing regular hand job.Regular masturbation can free you from such a disaster. In my advice you should do it once daily.This has many advantage. You can control your act of ejaculation. Once you ejaculate all your problem will go. Masturbation relieves your thirst of desire and stress.You can also enjoy good life. This is the natural way of act.This regular act relieve all your problem.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause pressure in chest with throat pain?\n\nI was wrestling and my friend dropped me and I hit the back of my head to the floor and my friends said my legs were raised and spazzing out while my arm was the same. I regained consciousness after a couple seconds and slowly felt better, but my chest feels like I have pressure on it and my throat hurts when I swallow. What should I do?",
    "doctor_response": "thanks for asking your queryi completely understand your problemyou should get a chest X-ray done to rule out any injury ,you can  consult a pulmonologist who can help you by examining if any injury is there.no need to panic ,for now take some painkiller/analgesic and rest.thanks/regardsfeel free to ask more questionsmay god bless you with good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a large bump in vein right above the wrist?\n\nI delivered a baby almost three weeks ago. I have suffered from headaches since 3 days after my delivery. Also I had an IV in my right hand while in the hospital and now there is a large bump in my vein right above my wrist. Could they be related and is this something to be concerned about? I spoke with my OB and he wrote a prescription for some pain medication, however I don t like taking meds due to side effects so I am just trying to fight it off.",
    "doctor_response": "Hello,The present swelling above the wrist is not a serious thing it may be a clot in vein. You may apply a compression bandage from below upward at your hand. You should also apply cold compresses over it. It may go away in next 5-7 days. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mukesh Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen tissue on the neck?\n\nI have soft tissue swelling or puffiness at the base of both sides of my neck, near the collar bone. There is no pain or discomfort; no rash or redness. It feels like fatty tissue, but I don't have any weight gain and am not really overweight. If I relax my shoulders, it almost disappears, but if I raise my arms or shoulders, it puffs up. I first noticed it a couple of months back while brushing my teeth. I am a 46 year old male, about 5' 9.5\", and weigh about 183 pounds. I don't have any major medical problems except I have recently had kidney stones.",
    "doctor_response": "Hello!Thank you for the query.From your description it does not sound like anything you should be worried. If this is on both sides at the same size, with no lumps or masses in this area, no pain or redness, most likely it is a fatty tissue or just a skin. If it causes a discomfort, and you want to make sure nothing wrong is there, ultrasound of this area can be done.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Blood in urine, pain in lower abdomen, bloating. Diagnosed as kidney stones. Suggestions for a speedy recovery?\n\nI have had blood in my urine for 5 days now. Day one, I went to the ER in a lot of pain and found out I have several stones in my kidneys, including one that hasn't passed that is 3mm in size. I am in intermittent pain still, that is mostly in my lower back and wraps down the right side of my lower abdomen. I feel a lot of bloating and pressure. I went to the Urgent Care yesterday and they read the CT scan from day one, I haven't had an ultrasound, should I get one? I am an athlete, am on a reality TV show, and am competing in two weeks and it is going to be filmed, for my work. What can I do, to speed up this process, I need to be practicing asap, but the Urgent Care Dr. said I shouldn't be doing anything physical strenuous for 5 more days, at least.",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum. 3 mm size of stone is not large size and it will pass in urine very easily. Plenty of fluid of different types( juice, water with lemon, soft drinks ). In my patient I usually use diuretic drips and stone comes out within 3-4 days. Disodium hydrogen citrate   (solution)20 ml three times a day will help. I  usually allow my patients to work regularly. Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Took Ovafar 50. Did follicile scan. Follicile size not increasing. Suggestions?\n\nI am 35 and had ovafar 50 twice a day between 3rd and 7th day of my cycle for the last two months. On the 11th day of my cycle this month I went for follicle scan and found that my right ovary had following follicle sizes 12x12 and 10x10 (2). I went back for another follicle scan on 13th day and I was told that the follicle sizes have remained the same and has not grown further. Now I am again asked to come back on 18th day of my cycle. I am really worried. Will I ever get to have an health ovum.",
    "doctor_response": "Hello,You are 35/F. I went through' your report. You have problem in follicle development. For which you are using Ovafar, a drug which has no proven efficiency. You have not revealed about your menstrual history (regular or irregular) and any USG scans report done to assess the uterus and ovum. Considering everything is normal, except the follicle size the drug of choice will be Clomifene 50 mg from the 2nd or 5th day of your menstruation for 5 days and doing a follicular study from the 9th or 10th day of your period. This will clearly indicate the development of follicles and release of the egg cell. Only one ovum will be released either from the right or left in one cycle.  Depending the report we can increase the dosage of tab or change from tab to injection in the next cycle.If your cycles are regular 28/30, Ovum will be released from the developed healthy follicle approximately around the midday of the menstrual cycle.Consult a proper gynecologist and get proper medicine to improve the follicle development.I hope you understand that.Best wishes for you",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long can Folfirinox be used to treat the mass?\n\nHELLO, MY NAME IS PATRIZIA I AM ITALIAN, I AM FOLLOWING CHEMIOTHERAPY WITH A DRUG CALLED FULFERINOX  HAVE CANCER OFNTHE PANCREAS STAGE IV WITH METHASTASIS TO BOTH LUNGS.  THIS IS THE QUESTION:  THE ca 19-9 MARKER WAS IN MAY 2012 OVER 27000, AND NOW IS DOWN TO 900 AND WITH FULFERINOX THE MASS REDUCED 2 CM ( 6.5 TO 4.5) THIS MEANS THAT FULFERINOX IS WORKING WELL..BUT HOW LONG CAN THIS DRUG BE USED AT THE MOST? THANK YOU PATRIZIA",
    "doctor_response": "hello dear. Folfirinox can be used till as long as your disease is controlled by it. Only once you show progression or unbearable toxicity, then it will be stopped. But do not worry, even in second line there are treatment options. Hope you understand now.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause lower abdominal pain post masturbation?\n\nHello,I used to masturbate two-three times in a week. I didn't had any sex. Nowadays, after releasing sperm, i am feeling pain in lower abdominal and pennis for few days. if i didn't ejaculate sperm then i will be fine, otherwise i suffer from pain. I consulted doctor as well. I explained him the problem. He given some antibiotics for few days. then i undergone  urine, bladder and kidney tests. the test results were normal.. i dont know what is the problem. Please help me what i have to do. Please do the needful.Thank you very much...",
    "doctor_response": "Dear userWe understand your concernsI went through your details. This problems seems to be psychological. Because all your test results were normal, there is no need to suspect any serious physical problems. Just ignore the pain. Also look into your practice of masturbation. If it is rough, make it a little gentle and don't stretch your abdomen too much. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why did regular period turn to spotting? Trying to conceive. Any sign?\n\nHello I have a question I have regular menstral cycles every month my last men cycle was march 31 2012 and ended on april 5 ok this month it startedd on the may 3 andd I consesited of 1day regular kind of heavy then the next day it was spitting and only when I wiped that lasted for 2 days then it turned into brown spots my stomach has been hurting for 2weeks and my husbandd and I have been trying to concieve since my daughter was born on april 2 2012 we have a 4 years old and a one year old can u please help me",
    "doctor_response": "Hello. Thanks for writing to us. The decrease in the blood flow during the periods could be due to anaemia or due to mild hormonal changes in your body. As long as you are getting periods regularly, there is nothing to worry. Taking iron supplements will be helpful. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bumpy, painful knot inside the mouth, on the inner part of the cheek, pains on eating, talking. Is it due to tooth decay?\n\nI have a knot on the inside of my right cheek in my mouth , in which I have had it removed once already and it came right back. The actual knot starts back at the back of my mouth at the space between the teeth at the very back on the right side, now on my left side there is no such place it is smooth. And this feels kind of bumpy and it hurts when I touch it, or try to eat or yarn and sometimes when I talk. Now I do have some bad teeth and was wondering if it could be coming from that.",
    "doctor_response": "hello, the lesion u had is most probably a dento-alveolar lesion: most common is abscess from infected tooth esp third molar, any cyst or jaw tumor.. the jaw bone is this region is very prone for ameloblastoma,dentigerous cyst, traumatic bone cyst, etc.. for correct diagnosis one need to go under following examination- clinical, radiographs- IOPA of infected teeth ,OPG, lat oblique,occlusal, then FNAC /incisional biopsy  then as per pathologic examination treatment can be decided.. if its infected tooth abscess  origin- RCT/ extraction of involved tooth if it is cyst or any tumor then surgical intervention is required along with involved tooth RCT Note for any abnormal sensations/paresthesia as it will be critical factor to decide neural involvement in region.. dont delay treatment as long standing abscess can convert to cystic lesion.. most probably ur problem will resolved by RCT of infected tooth.. consul ur dentist soon meanwhile maintain oral hygiene by use of antiseptic mouthwashes and interdental aids.. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it OK to use Garnier face wash and vicco cream for pimples ?\n\nhiiiii i m 21 yrs old,, i m male.... my skin is oily n having pimples on it as well as holes. i have not taken any tratment still.... but these pimples are vanishing for 1 day after tht again it comes so.... i m in big tensn.. i m using garnier facewash.. n also vicko cream on m face.......is ths right????????? plz can u solve m ths big problem.. plzzzzzzzzzzzzz",
    "doctor_response": "Hi, Welcome to HealthcareMagic Forum. It is absolutely normal at this age. Kindly don't worry as you grow older, they will subside gradually. Avoid Oily fried and foods and eat healthy nutritious balanced diet which should include fresh fruits and green leafy vegetables. Avoid stress. If you drink and Smoke, QUIT. Drink plenty of water. Kindly get yourself examined by a Dermatologist so that he can examine you and Prescribe medications. You will require, Antibiotic creams and Solution containing Benzoyl Peroxide either 2.5 or 5%. Stick to your treatment plan and go for regular follow up. Don't wash your face for more than twice daily. You can use Acnoff Soap for washing your face. Wish you Good Health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for an infection in the rectum\n\nHi, may I answer your health queries right now ?  Please type your query here... my rectum itches mainly at night and i have little small hole beside anus that bleed last night for about 6 seconds i squessed it but no more blood would come out of it . is this something 2 be concerned with",
    "doctor_response": "Hi, Thanks for posting in HCM. I understand your concern. Itching sensation in the rectum with a small hole that bleeds is nothing but 'anal fistula'. You need to consult Surgeon and get a per rectal examination to know the status of it. Accordingly, you need to undergo surgery called 'fistulectomy' to cure your illness. You need to avoid constipation by consuming diet rich in fibres along with consuming good quantity of water and taking laxatives, if necessary. Kindly get it done at the earliest so as to avoid further complications. Hope the information provided would be helpful. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can chest and head pains caused by self trauma be treated?\n\nhi,in afit of anger and crying , i hit my chest near my heart , with my hands around six times and hit my forehead with my hands too- around seven eight times. It s been a day, but both my head and the area near my heart is hurting. Pls help!!! I m frightened. I am 29 yrs old , and my husband just left me after 9 months of marriage and I ve been really stressed out .",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  If the reason for the pain and agony around your chest and head, is what you are explaining, then there is nothing to worry. Within another two days, this should vanish. But you should ask yourself why you want to hurt self so badly? This behavior could lead to other self harming actions. Please try to manage your anger.If you require more of my help in this aspect, Please post a direct question to me in this URL.  Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a cold cause blood pressure to rise?\n\nI have had a cold for over a week and have been congested. I have been taking musings. I ve had some pressure in my chest the last couple of days and when I press on my lower sternum I have a little pain. I checked my blood pressure with a cheap BP cup and it read 140/100. Do you think this is cause by my cold?",
    "doctor_response": "Hello, Cold could be due to allergic condition and it may not cause high blood pressure, if this is the high blood pressure noted even if this is taken with cheap kind of machine but still it created the doubt for high blood pressure and it has to be ruled and for that it is better to see the physician, blood pressure reading you have taken can not be taken as final reading but it can not be neglected until and unless proved either right or wrong. Hope I have answered your query, let me know for further assistance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffered burst brain aneurysm, regular headaches. Medicine not effective, nerve block done, facing memory loss. Normal?\n\nI suffered a burst brain aneurysm two years ago and have headaches every day since. My neurologist did a nerve block due to unsuccessful medication regimen. After the nerve block I have been feeling memory loss, confusion and the headaches have returned. he said to continue my medication as I made need another nerve block. My question is, are these symptoms normal and should I have another block if the first one failed? I wonder how many people get as far as I have surviving a brain aneurysm (the doctors implanted a coil in my veins in the brain).",
    "doctor_response": "Hi,Thanks for writing in.Your symptoms might be seen in many patients with burst brain aneurysms. Implanting coils in the brain aneurysms is a safe and acceptable form of treatment nowadays.For patients achieving good results with these temporary nerve blocks, there are a variety of other more permanent pain-relieving procedures that can be performed, including cutting the nerve, decompressing the nerve, or damaging it with small doses of a toxin or with a radio-frequency energy probe.An occipital nerve stimulator (basically a nerve pacemaker) can also be helpful. If you do well with the temporary blocks, your doctor will discuss the pros and cons of these options with you.Hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a muscle pull?\n\nHi my name is Jessica I am 20 and I have a pulled chin muscle and it hurts to move my neck and I can't open my mouth almost at all and my tongue is sore and it keeps seizing up and I have almost swallowed it on numerous occasions it's been like this for 5 days",
    "doctor_response": "Hello,Use warm compresses on the area and take ibuprofen. If it is not improving in a week or so you should see a doctor for an evaluation.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bowel incontinence with pain on the penis?\n\nMy son has been potty trained since 2, he is 3 now. He has started having multiple potty accidents in a day (up to 5 in a day) and even has had some issues with bowel movements. He tells me he doesn t realize he needed to go. He also has complained of his penis hurting. It is very random, it could be 5-6 weeks before he has another bad day. We have gone to the Dr s when it is occurring, no UTI and physical tests show good. I am concerned because he is a very compliant kid, if you ask him to go potty he sits and will go. Just want to make sure this could be an indicator for anything else.",
    "doctor_response": "I think this is a behaviour problem. Make a routine for going to potty twice daily at fixed times. Talk to him to relieve any anxiety. Proper toilet training may take some more time..... If he was profoundly constipated before the onset of this episode a course of laxative can help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Would losing memory and weak eyesight be the result of falling periodically?\n\nIn 97, i first fell down during playing. Hospitalised and after C T Scan, doctor advised Tegretol and two other tablets each day and night. The result was not positive like losing memory, headache, etc. Then in 2000 again was fell down, and doctor advised for tegretol only twice in a day after doing C T Scan. All was good but suddenly in 03, again got an attack serious one for more than an hour and my head was bursted all the day. I was hospitalised and after C T Scan it was advised to take eptoin 100mg twice a day. And then, after two years doctor increased one tablet in day and two in night. But in 08, it increased to 2 each in day and night. And in 12, again getting some indications with headache, losing concentration, etc. During all the period some other disorders i found in myself such as weak eyesight, headache, losing memory (sometime forget what i did or said in last five minutes), not able to speak properly and majorly always feel weakness and stay in high tension sometime without reason. Would really appreciate your suggestions and help ( YYYY@YYYY ) Looking forward to some",
    "doctor_response": "Sorry to know about your bad state of health since 1997. All these appear to me as if you are suffering from seizzure disorder now controlled with phenytoin 400 mg per day. But now your symptoms may be due to phenytoin toxicity.  Kindly ask your doctor to do a serum phenytoin level and a mri of brain for knowing of any pathology.decreasing the dose can help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with mild seasonal intermittent asthma, pregnant. Will taking Romilast, Seroflo cause any side effects?\n\nHi Doctor, I am 5 week and 3 days pregnant, 30 year old female. I am located in Bangalore INDIA. I have diagnosed with seasonal mild intermittent asthma this year. I was prescribed Romilast (10 mg) twice in a day Seroflo (250 mg) and cetrizen once in day for 30 days . I sometimes develop breating out at night after a cold and cough . I have little dust allergy . On wheezing , I always take Seroflo and I feel better with the first single dose. Now I am pregnant so I want to know what are the side effects for these medicines if in continue taking them? Please advice",
    "doctor_response": "hi, what the doctor prescribed is correct,recent studies suggest no harm to baby on using inhaler steroids,u can safely use them.oral thrush and sore throat has been implicated to the patient but by rinsing mouth with water after using medicine can safely avoid above problems.asthma is better controlled by keepng environment clean and use of inhaler sterods as when required.wish you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On Cirpofloxacin for bladder infection. Root canal removed molar. Pressure under molar. Cirpofloxacin helps in dental problem?\n\nWill taking Cirpofloxacin for the bladder infection i have also help with the toothache i have? I will probably have to get the tooth removed after the weekend, already have had a root canal and one root actually removed on this molar.  At least the molar lasted 3 more years.  i am feeling pressure under that tooth. Want to make it thru the weekend and wondered if this cipro is going to help. I just happened to get these two unfortunate conditions at the same time and was given the cipro from dr. for bladder infection.",
    "doctor_response": "Hello there , Thanks for writing your query, Ciprofloxacillin is a good antibiotic and can be used for dental infections as well in combination with analgesics to relive the pain and prevent infection. since your tooth was root canal treated and has gone worse over a period of time with loss of one root , its better you get the tooth extracted consulting a oral surgeon. After extraction antibiotic and analgesic coverage is must to prevent infection of the extraction site and to promote healing. follow all the post extraction instructions and rinse the mouth with lukewarm saline or antiseptic mouth rinse. i hope this helps , take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in the fingers and an itchy skin rash?\n\nI am taking Diltiazem (3 a day), Eliquis(2 a day), carvedol,(2 a day), rosuvasatin(mon.,wed.,fri., and digoxin(1 a day), and a a diuretic(2 a day}. 6 years ago I was diagnosed with congestive heart failure and a-fib. With 1 shock treatment, I was fine for over 6 years just taking 1/2 tablet of digoxin (mon. thru fri.)carvedol 2 a day, and diuretic. Several months ago at my regular family physican checkup he said my pulse was off and prescribed all the other medicines. Since then I gradually got numbness in my little fingers and toes, a progressive rash that now itches me like crazy, and I noticed when trying to exercise after taking my pills, I feel terrible and sometimes get short of breath. If I exercise before I take my pills, I actually feel much better. We went for the last 2 months 1000 miles away to family at the Jersey shore. I am 71 and my medicare advantage plan is not valid out of Florida. I have an appointment with a cardiologist in several days, and wonder if I should stop the newer medicines till then, or wait till after I see him. I moniter myself daily, and sometimes my bp and pulse are actually higher after taking my medicine.",
    "doctor_response": "Hi, It is not the medicine causing the symptoms of finger numbness, shortness of breath and itching, but these are the different conditions having different causes for them. Numbness in the finger could be due to nerve compression and it can be due to improper posture, itching could be due to an allergic disorder. Shortness of breath is a part of congestive heart failure and during exercise, it can be more troublesome. There is no need to stop the medicine. These reasons can be discussed with your doctor and if found correct then can be managed accordingly. Hope I have answered your query, let me know for further assistance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest the best milk for my child\n\nHi.Dr s good day! i just wanna know wts the best milk for 18mos her weight is just 9kg is it normal?ive switch her milk to a similac gain plus to nido1-3 cause ive heard so many good feedback about nido1 3. .but ive Also heard that nido can cause diabetes Coz it has high contend of sugar. is it true? my daughter is a picky eater what should i do? What is d best.suplements can i give to her? pls help me for some advice thanku.!",
    "doctor_response": "Breast milk is the best food for a baby upto 6 months of age after which the child needs additional nutrition and hence mashed semi solid food is to be added. Milk becomes an optional food ingredient after 1 year of age provided that adequate nutritive diet is given. At the age of 18 months, the child basically needs a slightly mashed version of adult food low on spices. No need to provide milk or health supplements. Curd or yogurt is helpful. Do not worry about diabetes in a child if the child has proper play habits along with fibre rich diet. Children are picky eaters, so you will have to identify the nutritive food items that the child likes and plan the diet accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Healthy lifestyle. Intake of savignon blanc every night.  Blood work showed globulin count 1.6, ratio A/G 2.87.  Thoughts?\n\nHi, I recently had blood work done for an insurance policy. Everything was great except for my globulin count which came in at 1.6. When I do the ratio A/G it's high at 2.87. I feel fantastic & have excellent health w/ no genetic/ family history disorders. I drink a glass of savignon blanc every night & live a healthy lifestyle. I'm concerned what this result may be indicating. What are your thoughts? Thank you",
    "doctor_response": "HIThank for choosing HCMYou are really doing great, you went for a blood test just for insurance purpose and not for any diagnosis purpose and not for the any clinical complain, so to me it has got no role at all, I would advise you,,, not to pay any attention,, enjoy the life, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat chronic tailbone/coccyx pain?\n\nHi - I have had chronic tailbone/coccyx pain for the last 2 years. I have had xray's (showing nothing) and there was no trauma that bought this on and the pain clinic can't help me any further - I've tried pain killers and cortisone injections.  I've basically given up trying to find a solution and now just try and deal with it in the hope it will heal itself.  But for the last 3-4 months I have been getting this clicking in my lower spine - its like a ratcheting down of my spine.  Its not painful but quite noticible.  Is it something I should be worried about or is it my lower back starting to relax and heal??  Thanks!",
    "doctor_response": "Hi,Welcome to healthcare magic.After going through your query I think  You are suffering from COCCYXDYNIA. It  not responded to pain killers and cotisone injections  . You should try  hot sits bath ,Avoid  long continuous sitting.Always sit on soft cushions. Avoid sitting on hard objects. Exercises ,NUROKIND GOLD ONCE DAILY and analgesics (diclofenac 100mgSR) can be of help. Sometimes vitamin D deficiency is the cause so get your vitamin D checked .If it is low then vitamin D supplementation(Bon DK 60K weekly with milk) can be taken.Eat milk, fruits and green leafy vegetables daily. To futher investigate MRI of the region is advised . I think your query answered.Welcome to any follow up query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cure for ringworm kind of allergy in abdomen, thigh and peeling nipples?\n\nhi, im a female , and i have ring worm kind of allergy on my lower abdomen , inner thigh , and itchy nipple and skin is peeling on my nipples , when i go to sleep , i feel something is moving here and thr on my body , i tend to scratch too ... bcoz of this i don get sleep at nyt",
    "doctor_response": "Hi,From history it seems that you might be having fungal infection on variuous parts of body.Apply anti-fungal cream locally.Take oral anti-fungal tablet like Fluconazole 150 mg once in a week for 4 weeks.Keep locla part clean, dry and airy.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does cramps after embryo implantation mean?\n\nHi I have just had my embryos implanted on the 17th january and i am supposed to be tested for a pregnancy by the 2/2 but i am very nervous, the doctor put me on crinone gel every morning and a progesterone injection (oil) every evening i have had light cramps on my abdomen and a slight discharge from gel for the past 2 3 days i am worried if this means that i am not pregnant or that it is not normal and i do feel nauseas in the evening or in the morning and my breasts r twice the size and very painful very scared to go for my test please put some light in my questions apppreciate it stax",
    "doctor_response": "Hi,    I have read your query & understood your concern.    After embryo transfer.there will be some bodily reaction.. you are already on drugs to prepare a good bed for implantation in your uterus.mild cramps are also seen in natural pregnancy.  Vaginal discharge increases with pregnancy / pregnancyhormones you are given. The get you are applying daily would naturally come out in form of discharge.   * So don't be anxious/ stressful. Try to follow instructions by your doctor, be positive , go for test when advised confidently... that will help you.   Thanks.    Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shaking while sleeping?\n\nim 33 years old, female. My fiance has just told me that at night, while I m sleeping, I shake a lot to the point that it wakes him up. He says that he s tried to wake me up & but I won t wake up & that I only stop once he nudges me. He says that it happens almost every night for the last couple months. I have no idea of what is going on.",
    "doctor_response": "Hello,Your symptoms could be related to a possible epilepsy seizure. For this reason, I would recommend consulting with a neurologist for a physical exam and performing an EEG and a brain MRI. Some blood lab tests are necessary too (thyroid hormone levels, complete blood count, blood electrolytes).Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of remeron and risperidone?\n\nMy mom has dementia, and is currently in the hospital for psych, depression, the doctor prescribed remeron, and risperidone, is that safe ? SHE HAS HAD A QUADRUPLE BYPASS IN 1997, DUE TO A DOUBLE HEART ATTACK ??????????? I HAVE NO MONEY, AND NO CREDIT CARD, BUT AM EXTREMELY WORRIED",
    "doctor_response": "Hello, thanks for the query. Is your mom a diagnosed case of dementia? If yes, which type of dementia? Since she is receiving Remeron (Mirtazapine); she seems to be suffering from some form of depression or anxiety or both. As such Mirtazapine is fairly safe except for issues of weight gain & deranged lipid profile & hence may not be that good option considering your mothers history cardiac surgery. There are other safer options like escitalopram, sertraline, tineptine for control of depressive-anxiety symptoms. Similarly, risperidone is probably prescribed to your mother to control agitation or other behavioral manifestations which can occur in dementia. Though not entirely safe but if given in low doses & under constant medical supervision, risperidone seems to be OK choice. Other possible alternatives to risperidone which you can ask your doctor are Quetiapine, haloperidol (post your mothers current cardiac status evaluation) or a drug name Trazodone which can take care of depression, anxiety, agitation & all other behavioral problems arising due to dementia. Hope this helps. Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are these head-reeling episodes sue to stroke, seizure or syncope?\n\nHello doctor, I have consulted you over this forum regarding the health of my mother (59 years), who is under treatment for hypothyroidism (Eltroxin 50 mcg), hypertension (Olmezest 20 mg), osteoarthritis (Gemcal D3, Kondro OD) and mild anemia Hb 10.6 [11.5 - 15] (Folvite). I would like to request your kind review for some of her recent symptoms as well, which I try to summarize below along with brief history. Early this year, she had a fever (100 to 101 F) with cold and was on Calpol 650 and Cetirizine for a few days. One morning, right after breakfast, while sitting on a chair, she started feeling reeling of the head along with darkness in both eyes, which resolved on its own after she went to bed and laid down. The same evening, when the doctor visited her for fever, her BP was 130/80 (left arm - sitting position) with pulse 102. She also had a left-sided headache, which took two to three days to settle down along with Calpol 650. Two months later - This time she was too worried about her son's health and recovery and night sleep was affected for a couple of days. She herself was also not too well due to stomach issues, antibiotic, gastritis, lack of appetite, etc. One morning, she started having running nose along with some amount of sneezing, for which she had taken a couple of Cetirizine tablets that day. The next day, right after lunch, while being in the sitting position itself and talking about her son's health issues, suddenly she reported to feel reeling of the head along with darkness in both eyes, followed by she was bent towards her left with left-hand palm shaking for 10 to 15 sec and was almost about to fall down, which however did not happen with help from others. We felt for next 5 minutes or so she was in an altered consciousness, staring at something silently, although the rest of us got extremely anxious. When we tried to speak to her, she was initially making some strange sounds, followed by normal words in hoarse voice and after that she started talking normally. However, she was crying and worrying about her son's health, although my wife was trying to console her. Later she mentioned not to have any memory of the whole incident, except the last part of consolation from my wife. She was back in normal activities in next 10 minutes, but reported to feel too tired and sleepy for at least next two weeks. As per doctor's appointment, I took her to our medicine doctor ",
    "doctor_response": "Hello. It is difficult to comment if the episodes are solely syncope/ fainting spell due to orthostatic hypotension or abnormal heart rhythm. I agree with Holter monitoring. I would also, recommend EEG study for one hour to make sure we are not dealing with seizures. Her hemoglobin is low and needs further workup regarding the cause. Low hemoglobin or anemia can make her more susceptible to syncope episodes. I hope this helps. For more information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For breast cancer, should we do chemo first or surgery?\n\nHi doctor, My grandmother was diagnosed with breast cancer three years ago and had a right mastectomy. She however did not have chemo or radiation. She has a little extra fat to the lateral area of the breast that after surgery it looked like a small third breast. Right over the old incision has developed a large ulcerative cauliflower-like wound. The tumor is protruding and is very vascular. It currently has no odor, but it is bright red and bleeds excessively once the dressing is removed. She is 86 years old with a history of high blood pressure, COPD, CHF, diabetes, CAD, TIA and pacemaker. She still ambulates, alert and oriented. Also she understands what is going on.\u00a0We visited the oncologist and were told she will either need to undergo chemo or radiation. The surgeon, who did mastectomy, is recommending surgery to remove the protruding tumor. Which is the best option to do first? My family is very leery about her ability to handle chemo and frankly does not want her to have chemo. We know that removing it does not cure the cancer. Should we do radiation first then remove it with surgery? If we were to consider chemo should we do some cycles first then remove it with surgery? Which option would you say is the safest route? We want to keep her around many more years if we can.\u00a0Thanks for your time.",
    "doctor_response": "Hi. Here are my suggestions: Assuming that you want to undergo full treatment, the best method would be to start chemo and radiotherapy. The cycles of chemotherapy will depend on the medicine chosen by your oncologist. This will reduce the tumor size. Then go ahead with the surgery and then complete the treatment with further cycles of chemo and radiotherapy. Another option is surgery followed by a few cycles of chemo and radiotherapy. The above options are important because if left untreated, the site may get infected. Other complications are of course to be considered. The other option is no treatment at all. Just palliative medicines to keep her comfortable. This way she can live a comfortable life considering that you have said she is stable. Please note that I am just explaining the option. The choice of treatment would be your decision. I suggest getting a PET scan before deciding. For further information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Black spots on face, which creams will reduce ?\n\ni have permanent black spots on my face since past 3 to 4 years which cream should i apply on it in order to remove it??? i have one even on my nose and it looks very ugly...",
    "doctor_response": "Dear Nirav Thanks forvisiting hcm the problem you are facing could be melasma however better post your pictures before any medicines can be suggested",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will MX-2 solution and xtraglow be helpful in treating hair fall?\n\nHai Doctor, I have been Facing Hair Problem Since few Years.My Hair has become So thin.Recently I visited Doctor and She Suggested me MX-2 Solution,Xtraglow and Glowfer Tablets.After That She Suggested Hair4U2%.But I am Facing more hair problem since last week.Will it be Useful?Please Suggest me.",
    "doctor_response": "Hi there,Your doctor has given you the right medicines.There are many reasons for hair fall in women. Please check for Thyroid profile, serum ferritin.Chronic telogen effluvium and female pattern hairloss are the two possibilities I consider. Detailed history and dermatoscopic examination will help for concluding.There are some additinal medicines which can be given if you dont respond to the above medicines. Eating healthy and a stress free life would add for the improvement. Hope this helps you,Regards,Dr Shilpa BhatBengaluru",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swollen gums with inflamed glands on both sides, pain in ear, head and tonsils, intense pain on one side of the face, taking ibuprofen. Could it be wisdom tooth eruption?<br>\n\nHello, my partner thinks his wisdom teeth are coming through, he has swollen gums , inflamed glands on both sides, pain in his ears, tonsils and his head and agonising pain down the left sideof his face. this is constant agonising pain he is unable to sleep. the doctor suggesting taking ibruprofen and that is all. the pain is now becoming unbearable.",
    "doctor_response": "hello and welcome to hcm forum, as you stated that there is persistent pain on the left side ,radiating to the head and neck, also gums are swollen, it seems to be a case of acute infection,which may or may not be associated with erupting wisdom tooth, to clear out the diagnosis kindly get him checked clinically by a dentist. I would recommend, warm saline rinses or betadine mouth gargles(3-4times/day), a complete course of antibiotic and anti inflammatory is also required. It is highly recommended to visit your dentist. I wish you good health, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a high BP along with no potassium and electrolytes indicate?\n\nMy bp was 195/103 this morning. It ranges from that to153/102&that s the meds! & just had stop the one cuz it was making me a zombie,&wasn t under control with dat either. Went to Er one day & I had no potassium or electrolytes,there s more to the beginning but what o u think so far?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.As you mentioned, you have high BP and no compliance on medicines. Your BP is on higher side and it may cause brain hemorrhage also.Below the age of 85 years, if you are on antihypertensive medicines then your BP should be below 140/90. ACEI is the first line drug like Ramipril or Enalapril in younger age group. The 2nd line is Ca channel blocker but 1st line in older group.Diuretics may be added and combination of these three along with Beta-blockers to control the BP. Lifestyle modification is also helpful.Weight loss, Regular exercise, Quitting smoking, Stopping alcohol consumption, Reducing intake of caffine, salt, fat, sugar and processed diet may be helpful.Avoid meat and have more fruits and vegetables. Regular BP monitoring with medicine compliance is advised.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Ivan R. Rommstein",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are side effects of mixing methamphetamines along with general anesthesia?\n\nMy brother us having surgery in 3 days and he uses methamphetamines.. he refuses to tell his surgeon, and I m worried, I d like to get a professional insight on this, please. I know he won t stop and I know he has to have the surgery, so what could could happen with the general anesthetics, mixing with that crap? :(",
    "doctor_response": "Hello,You have to tell your anesthetist other wise it will cause problems during surgery like resistance to anesthesia and elevation of blood pressure during surgery or arrythmia etc. You should stop the drug one week before surgery. I think I answered to your question still have queries please feel free to ask.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Lulifin lotion dropped into eyes accidentally cause any problem?\n\nHi doctor, My mom accidentally dropped the Lulifin lotion into my eyes. Is there any first aid treatment or should I contact the doctor? Please tell me. I am scared.",
    "doctor_response": "Hi. Lulifin is an antifungal lotion. You should immediately do an eye wash with clean water, and continue this for at least 20 to 30 minutes. You can get some antibiotics steroid eye drops and apply for three times a day for 4 to 5 days. Please remember that if your vision is affected then it is better to see an eye doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the red sore rash on my daughters lips?\n\nHi, my 8 year old daughter has a red rash around lips. It just appeared while she was at school. She said it was sore and it hurt when she opened her mouth. This appeared yesterday, this morning it was still red especially under bottom lip and looked very sore and starting to turn into a graze. Can you let me know what it could be and suggest remedies. I've applied Vaseline so far.",
    "doctor_response": "Hello, Most likely it is a bacterial infection i.e. impetigo. I suggest you use a topical antibiotic e.g. either Mupirocin cream or Fusidic acid cream. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Kakkar S., Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, 25 day cycle. When is the ovulation time?\n\nHi I have a 25 cycle, periods are always regular, me and my husband are trying for a baby and wondering when i would be ovulating ? I am thinking day 10, would I be correct? and should me try say day 10/11&12? Also if a few months were to pass and nothing happens when should I see a doctor maybe 3 months if still not pregnant? thanks",
    "doctor_response": "hello,Pregnancy is possible only,if unprotected sexual intercourse is done with ejaculation around ovulation time in regular period. You should have to try at least one year and after that if you unable to conceive, then you need to consult with your gynecologist for several investigation and clinical examination.Ovulation occurs approx 14 days before due date. In your case, it is around on 11th day of cycle and fertile days will be from 9th to 13th day. In this time period, you need to do unprotected sex daily.You can use ovulation prediction kit (OPK) to predict ovulation and prepare for that day.Avoid stress,take healthy diet with Vit-E & Folic acid supplements,control body wt and proper sleep.Be well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rashes on scrotum?\n\nI play football every day and generally get pretty sweaty. The other day I got a rash on the bottom of my balls and I just thought it was from all the friction of running and maybe becuase there s a lot of sweat but now there s a spot of skin that s red and raw and burns but doesn t itch.. I also haven t had sex in a month and the times I did I was safe.. I don t know what it can be",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.1. Your concern may be intertrigo - secondary to the candidial yeast infection due to excessive sweating.2. You can try eberwin 1% cream twice daily on dry skin.3. Dust abzorb powder twice daily after applying the cream and also as maintenance.4. Bath twice and avoid wet clothes.It's not contagious and won't spread beyond certain areas in the body and it can be controlled easily, don't worry.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sandeep Golla",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this fecalysis report indicate?\n\nHello. My son, 2 y/o, just had a feclysis, these are the results color: yellow, consistency: mucoid, negative adult parasite, Pus cell: 1-4/hpf, Red Blood Cell:0-2/hpf, ova of parasite: none, amoeba: cyst positive... what does this mean? thank you so much...",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Amoeba cyst positive means your son has amoebiasis. Even if he is asymptomatic, he needs metronidazole for 10 days. look for pain in abdomen, blood in stools .Maintain hygiene,wash your hands to prevent the spread of the infection. Repeat stool microscopy after 10 days. See if cysts have disappeared. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for the lump caused on the chin due to fall\n\nIn April 2010, I fell off a moped, but fortunately didn't injury myself too badly.  However, my chin hit the ground with some force.  It was painful to touch for a week or so afterwards.  The pain subsided, but a lump of tissue has formed and has not gone down since. It is \"spongy\" to the touch. Is there anything I can do to reduce this lump?",
    "doctor_response": "Hi,Good Evening.Thanks for the query to HCM.I studied it in depth and I understood your health concerns.-Causes and Treatment-for lump on the chin with bruising on biceps and arm-1- Mostly it appears to be -Fibrosed Hematoma?Sebaceous cyst-as it is spongy-soft?2-To reduce it-You need to consult a Surgeon.If you were in my clinic -I would have Excised it Surgically with Biopsy to find out the HPR cause.3-Dont get scared and uneasy,but be cautious and act fast.Hope this would help you a lot to relieve you.Wish you fast recovery-and healthy life.Wellcome to HCM with more queries till you are satisfied.Have a Good Day...!!Dr.SAVASKAR M.N.M.S.GENL-CVTS,Super specialist and Senior Consultant-and Expert in Non-Curable-Disease therapy for Cancer,Asthma,etc,Rejuvenation therapy and Tissue failure -reversal therapies.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can hair thinning and greying be treated?\n\nhello sir i,m 25 yrs old male person i have a grey hair problum at age of about 15 and now i saw that the problum is grey thin splitends rough and frizzly hair and its started falling evry day i had lost a huge amount of hair and i have aproblum of cold regularly dust allergy and early morning or suddenly change in climate cause me sneezing too much",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The primary underlying reason for Premature hair greying is genetic with contributions from environment and nutrition. Though none of the treatment has proven efficacy I suggest you to take an oral Calcium Pantothenate once a day for at least 6 months. As far as thinning of hair is concerned it is due to Androgenetic alopecia in males wherein there is decreased hair volume and receding anterior hairline. Treatment options include topical Minoxidil and oral Finasteride. Split ends and dry frizzy hair would benefit from using a conditioner and by avoiding frequent combing and cutting your hairs short if you have long hairs. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Kakkar S.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure PTSD and hypertension?\n\n39 yr old male, 20 yr military service. PTSD anxiety and hypertension. Current meds .5 mg klonopin, 10mg zolpidem for sleep.  For hypertension 25 mg hydrochlorothiazide and 10 mg Amplodipine. Symptoms persist, no relief. Heart palpitations regular. Help.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. You are having post traumatic stress disorder (PTSD). This causes anxiety and panic disorder. Both of them cause sympathetic over activity in the body. And this sympathetic over activity causes hypertension and palpitations. So we should first control your stress, anxiety and panic disorder. Only drugs are not sufficient in such patients. Counselling by psychiatrist is also very important. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on it's solution. Counselling plays very important role along with anxiolytic drugs in control of symptoms. Don't worry, you will be alright. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for liver problem\n\nI have stage 2a invasive breast cancer, had surgery and a lymph node dissection. Right before my first chemo treatment my liver showed elevated levels and then after chemo my liver serum was still elevated and even more. I have had every test and scan and have not shown any more cancer but have gallstones, I have had pain in my side and vomiting whenever I take pain meds, but never had a problem with any types of food. How elevated does the liver serum have to get before I need to have my gallbladder out? And is it common to have elevated liver serum from taking pain meds when you have gallstones?",
    "doctor_response": "Hello! Thanks for putting your query in HCM. I am a Gastroenterologist. With the information provided by you elevation in liver enzymes may be due to cemotherapy or pain medicines you have taken.However it can be due to Gallblader also if pain is also present. So to to confirm this get ultrasound abdomen and see whether there are stones in GB, whether the wall of GB is thickened and if yes then it is due to GB.Among pain medicines take Tablet tramadol which is safe for liverAnd if it is drug induced (Chemotherapy Induced), then take tablet ursodeoxycholic acid 300mg twice a day till enzymes are normalised.Also get test for Hepatitis B and C as these are common cause of elevation of liver enzymes.I hope I have answered your query and this will help you . Wish you a good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is portal hepatopathy curable ?\n\nhello sir, my father Dr. PRAVINCHANDRA RAO is suffeing from PORTAL HEPATOPATHY.ON 9 TH FEB HE HAD BLOOD OMITTING 1ST TIME. THEN HE HAD BLOOD OMITTING ON 20TH APRIL AND 6TH JUNE. HE HAVE UNDERGONE 3 ENDOSCOPY S AND DOCTORS HAVE FITTED IN ALL NOW 7 CILESTIC BANDS ON HIS VEINS NEAR LIVER. THEY SAY THAT VEINS HAVE SWELLING.CAN YOU PLEASE SUGGEST ME SOME TREATMENT . PLS SIR REPLY FAST WE ALL ARE LIVING IN PANIC. IS PORTAL HEPATOPATHY CURABLE????",
    "doctor_response": "Hi,The condition from which you are suffering is called Congestive hepatopathy. Due to  chronic passive congestion of the liver, there is venous congestion, usually and most of the time its secondary to congestive heart failure. Please send to me the reports of your endoscopy, your 2d echo reports and other tests reports. Treatment is directed largely to removing the cause, or, where that is impossible, to modifying its effects. Treatment options are very limited and usually the primary cause needs to be treated. Message me all detailed reports.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Ramesh Kumar",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure knee swelling after surgery?\n\nMy brother had knee replacement on Dec 1st. Did all the therapy and did well for 3 months. He has had 3 episodes of terrible swelling of the knee and leg and also terrible pain. Drs don t seem to know what is causing all this. He has had to go on sick leave(67yrs old). He s been given steroids which brings down the swelling, etc. But it flares up again. He also has had a bakers cyst on the same leg. His dr will not drain anything due to infection risk. He is very frustrated. Seems that any fluid goes to that knee joint. Do you have any suggestions. He has been resting and icing it a lot through these times.",
    "doctor_response": "Hi,Thank you for providing the brief history of your brother.A thorough musculoskeletal assessment is advised.As your brother had undergone TKR, and he is having baker's cyst, why the cyst was ignored during the plan of the surgery. Usually, due to the formation of the cyst, there is venous insufficiency, i mean, the back flow of blood to the heart is restricted from the lower limbs. Now since everything is done and steroid is also failed, i will have something to workout here.I have seen, many patients with OA knee and bakers cyst. Now this bakers cyst can be get rid of through exercise and the venous insufficiency can be corrected as well. So, lets come to the point here. Your brothers age is 67, so we can expect his metabolism to be slow and the venous drainage to be slow as well. Getting the proper exercise done should help reduce the cyst and also the swelling too.The exercises to perform are -1. Sit and stand in a chair - 100 timesBegin this exercise by performing 25 and then a non stop to 100 when endurance improves. Having a sit adjustment is needed. Now what is his ROM of the operated knee is to be understood. If he has achieved 130 degrees of ROM of the operated knee than it will be good here.2. ROMAchieve 130 degrees ROM of the operated knee, as this is very important for the joint Stability and mobility.3. SquatPerform squat upto 50 in one go if the ROM is upto 130 degrees. Also, while performing Squat one has to hold the window or the railing to take the assistance.In my clinical practice i have seen Baker's cyst, swelling of lower limbs and OA issues to resolve with simple and accurate exercises.I wish your brother a good healthRegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for azoospermia\n\nDoc is there any treatment for Azoospermia due to Maturation Arrest nowadays? If complex operations like heart transplants can be done, why is Maturation Arrest in the testis incurable? Going through articles saying it is irreversible is indeed devastating for hopeful fathers like me.",
    "doctor_response": "Hello,,Azoospermia means zero sperm count. If you have been diagnosed as azoospermia based on one report only please repeat it again in a standard laboratory to confirm the same.First you need to analyse cause for azoospermia. Hence please get examined by an urologist.You need to get scrotal doppler ultrasound scan done to see if there is varicocele or small size testis. Based on above 2 tests you need to get hormonal evaluation mainly FSH and Testesterone.The treatment can be offered after seeing above reports. these measures may help youStart taking drugs like zinc and multivitamin. Stop smoking and alcoholReduce weight and do excerciseDon't ware tight underwearThank you.void trauma to testicles",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is causing chest pain while breathing and movement of right arm?\n\nHi doctor, I have pain in the chest on the right side and when I take a breath sometime, pain during breathing and also during movement of the right arm or other types of movement and feeling like vomit and weakness in my body. Tell me the symptoms of this pain.",
    "doctor_response": "Hi. Pain in right side of chest with breathing movements and nausea shows that you have some chest infection. Please follow this. X-ray chest to rule out infection, take tablet Zanaflex 2 mg three times a day till you get the report of X-ray (minimum three days). If pain improves and X-ray is clear this means its simply due to muscle spasm. If X-ray shows infection or you get fever or pain does not improve on taking Zanaflex please start some antibiotic like Azomax 250 mg after every 12 hours for a week.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes grey colored stool in a child?\n\nHi, My daughter has had grey stools for almost 2months now.i didn t know it was not normal because for the most part that s the colour of her stools. Been reading about how they might mean liver disease. Is there anything else that the colour could mean?",
    "doctor_response": "HI...this grey colored stools at this age group should definitely be evaluated. This could be the initial manifestation of a spectrum of conditions called Neonatal Hepatitis or Extra Hepatic Biliary Atresia.  I suggest you take the kid to the paediatrician or paediatric gastroenterologist for further evaluation.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can I get rid of round dark spots on the face?\n\nHello doctor, I have got round dark spots on face. It was light initially and became darker later on. Give me advice on how to remove it.",
    "doctor_response": "Hi. It looks like seborrheic keratosis (attachment removed to protect patient identity). Is it raised above the skin surface? Since how long do you have it?",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat bump in the middle of my upper gum area\n\nI have dentures on the top of my mouth. When I removed them two days ago there is a bump in the middle of my upper gum area. Is this caused by the denture or should I be worried. I don't have any insurance and I am hoping there is something I can do at home to get rid of it. It feels like a pimple and hurts when I press on it but when my denture is in it doesn't hurt and I can't feel it.",
    "doctor_response": "Hello, Thank you for consulting with HCM.This bump which you are mentioning, can be a sinus opening, it occurs because of infection, can be a tooth infection or a bony infection.But you can go for full mouth x-ray to get it diagnosed, for which you have to visit a dentist, as these conditions can be treated on your own.You can start with a topical anesthetic ointment till you visit a dentist, to apply on the bump.Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain, nausea, light cramping after having unprotected sex on last day of periods.  Possible pregnancy?\n\nHi. Me and my boyfriend had unprotected sex the last day of my period. Since then ive expierenced back pain, naseua, and light cramping. My period is due in five days. I always know im about to get my period because my face starts to break out, but it has not. Im just wondering if to you it seem like pregnancy could be a possibility. Thank you.",
    "doctor_response": "Hi welcome to health care magic forum.                          Thanks for calling H.C.M.Forum.                         You had unprotected sex on the last day of the period. since then you have back pain, nausea, cramping. your period is due in five days. will it be pregnancy.                            Last day of the period means after the period, or at the end of the period 29th day. if it is the last day of the bleeding pregnancy is possible. if it is 29th day it is impossible.                           To clear your doubt you can have a urine pregnancy test with first urine and mid stream urine.                             I hope i have cleared your doubt.                             Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for hair fall\n\nHi i am 25  year old. 3 year before i have got started hair fall seriously. Till now i have lost my half of my hair from the scalp. I have consulted many dermatologist and have tried many remedies like minoxidil biotin etc but all was invain. Please suggest me some idea 2 get rid from the such problems. Thank you.",
    "doctor_response": "Hi, As per your query you have symptoms of hair fall which seems to be due to improper cleanliness, environmental factors, hormonal changes, fungal infection and could be due to stress. Sometimes it is due to genetic factors as well. Need not to worry. I would suggest you wash your scalp 3 times a week with very mild shampoo containing least chemical ingredients. We have to find the exact cause and start treatment as per that. Avoid excessive stress and drink plenty of water to stay hydrated. Maintain proper hygiene of your scalp and wash hairs every alternative day and take Indian gooseberry powder half spoon. Consult dermatologist once for proper examination. The doctor may prescribe Finasteride preparations and along with that multivitamin preparations as well. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Harry Maheshwari, Dentist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen and painful foot\n\nMy right foot has been swollen for almost two weeks. It was originally thought to be gout. I was put on prednisone but there was no improvement. The second thought, given the lack of response to prednisone is that I have a soft tissue infection. I was prescribed doxycycline hyclate (100 mg 4x/day) and clindamycin hcl (300 mg 2x/day). I have benn elevating my leg and using heat packs, however there no significant improvement. I had a Doppler to check for DVTs that was negative. I had an xray today but have not received the results. My foot is painful to walk on, especially just behind the big toe.",
    "doctor_response": "Hi, I value your concern regarding the symptoms. I have gone through your symptoms, and in my opinion the swelling in your foot is probably due to infection, your X Ray findings are must for us to know, any infective changes in your bones of foot, moreover your blood counts are also must.in case the X ray does not clear the doubts a MRI of the foot is advised.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.Special note-  Any medication prescribed needs to be taken after consultation with your personal doctor only.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the effect of a O positive, diabetic person marrying AB positive partner?\n\nHi.. My age 31... & my blood group is o possitive... I have a diabities around 190 points. My partner age is 25... & her blood group is AB possitive.... we are plan to marry in november 2014. Please advice reg. our blood group... & my diabetic problem.",
    "doctor_response": "Hi, Welcome to Health Care Magic. I have read carefully and analysed your concern. I understand you are worried about that some problems might inherit to your chilren. Let me assure you there is no harm to your marriage, if you are a diabetic or what blood group you have.  Regarding your childrens i must say, if you are a man with type 1 diabetes, the odds of your child developing diabetes are 1 in 17.If you are a woman with type 1 diabetes and your child was born before you were 25, your child's risk is 1 in 25; if your child was born after you turned 25, your child's risk is 1 in 100.If both you and your partner have type 1 diabetes, the risk is between 1 in 10 and 1 in 4.In general, if you have type 2 diabetes, the risk of your child getting diabetes is 1 in 7 if you were diagnosed before age 50 and 1 in 13 if you were diagnosed after age 50.Some scientists believe that a child's risk is greater when the parent with type 2 diabetes is the mother. If both you and your partner have type 2 diabetes, your child's risk is about 1 in 2.  In my opinion, there is no harm in marrying her. I wish you best of luck.Hope I have answered your query. If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i take plan-b pill again after having unprotected sex?\n\nI took the plan b pill already two times this summer. I am not on birth control and i know i need to get on. my question is if i take the plan b pill again this summer is that bad for me health can i do that. i had unprotected sex yesterday and i really need to know. i called planned parent hood but there closed today.",
    "doctor_response": "Yes you can take Plan B again today. It has only minor side effects like nausea, vomiting, abdominal pain, fatigue and temporary alteration in the occurence of your next period.As you have rightly said you need to go on regular contraception. Remember Plan B is not as effective as regular contraception",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from a disease which causes increase in WBCs and decrease in the RBC levels. Name?\n\nI have a close friend in Germany, he just turned 60, and about 2 years ago he was diagnosed with some sort of blood disease, I cannot remember the name, but it is causing his white cells to increase and red cells to decrease so they are both falling outside the normal limits. They have told him to come in once a year and get checked. And it sounds like there is not really any good treatment available. I would like to know the name of this condition so I can research it, and also any info about prognosis . Thanks in advance, Diana O.",
    "doctor_response": "Hello welcome to HCM, I am Dr das Look, many diseases can increase WBC and reduce RBC. It ranges from  leukemia to myelodysplatic syndrome and lymphomas. To come to a definite diagnosis, other parametersshould be checked. Every particular disease condition has other diagnostic criteria. So, without knowing other particulars of this disease, it cannot be commented about the diagnosis. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high WBC,joint pain and low grade fever?\n\nHi my name is Brittany I m 23. 4 11 145lbs I have been having a high wbc for a bout 5 yrs now. I have been to many different doctors and no one can seem to find anything wrong I have joint pain and low grade fever. All the test have been normal what could this be",
    "doctor_response": "Hello, As this sounds to me more of an internal fever. This happens due to internal low-grade infection. That is the reason the WBC is on the higher side. You need to meetup an internal medicine specialist so the proper medicine can be guided. Usually, a long term medicine which is more of antibiotics should work well. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which facial cleanser is recommended for use on dry skin?\n\nWhat is the best facial cleanser to use for dry skin not oily! and also i need a facial lotion for my dry skin on my face what do i use that works best? i have used the neutrogena wave and put cetaphil on the pad and at night i just use the cetaphil also i use equate advanced recovery skin care lotion for my face",
    "doctor_response": "hello you can use a-derma soap free foaming gel for delicate and dry skin. and apply exomega moisturiser in the night. dont use soaps on the face and neck. yes u can use cetaphil lotion for dry skin too",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stress and depression\n\nI get worked up from time to time and it tends to result in me self harming, either by scratching or cutting or mixing pills and alcohol, also I recently got worked up and locked myself in a room repeating 'make it stop' over and over, huddled in a corner with my fingers in my ears and elbows round head, which I know sounds pathetic, especially because it was just because I couldn't see myself meeting the target of work I'd set myself. I have exams coming up as a lot do and I know it's normal to expect stress but I feel as if my behaviour could affect my performance in them. Is this behaviour worth consulting a doctor about or is it likely to be seen as within the realm of normality?",
    "doctor_response": "Hii had gone through your query.You seems to have suicidal ideation with impulsivity.It can be a part of severe depression or borderline personality trait.Alcohol abuse with medicines seems to be like severe psychological distress.You will require indoor psychiatric care with rehabilitation.Detail psychological work up will give more idea about diagnosis and treatment.It can be treated with multi modality approach that include medicines, Psychotherapy and counseling, rehabilitation etc.Consult psychiatrist and get further assistance.Thank you.Get well soon.Still if you have query then feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain first thing in the morning?\n\nI have had painful abdomen for several weeks all the symptoms of water infection sent a sample off but was told no infection showed up but to do another test this week a nurse in work dipped my urine it showed ph levels up I drinking more fluid but still having the pain especially first thing in the morning",
    "doctor_response": "hI thank you asking  HCM your  symptoms  may be related with urinary infection, you need to  do  urine analysis and start the treatment  with antibiotic like  ciprofloxacine. wishing you all the best Dr.Klerida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for depression\n\nthank you for your time. I am suffering with a bout of depression and have been for just over three months. I have been prescribed gabapentin for my anxiety. I have been doing some reading and do not see anything about the drug and my condition. is it ok to take?",
    "doctor_response": "Hi  dear  I  had  gone  through  your  query.Gabapentine  is useful  for  anxiety  but it wont be indicated  in  depression.Depression  require  proper  psychological  evaluation  and  assessment.It  can  be  treated  with  medicine  like  combination  of  SSRI  and  benzodiazapine. In  SSRI  sertraline  /  escitalopram  /  peroxetine  will  help.Benzodiazapine  like  lorazepam  and clonazepam  will be useful  in anxiety  also.Psychological  councelling  and  supportive  psychotherapy  will  be  useful.Consult  psychiatrist  and  get  help.Thank  you .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What increases the strength of penis?\n\nsir, my self vijay . i suffering from dhaat major problem emite with urine whenever i went for toilets to last 7-8 yrs and mistubaration also. hence, my penis veins is so week which i felt every time in my mind. kindly give me strong and satificatory solutions for this problems. thankyou.",
    "doctor_response": "Hello, There is nothing wrong in ejecting semen when you are urinating. such a problem is not a problem at all. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is hockey tape poisonous to a 18 month old?\n\nmy son resently got liquid stitches but he kept breaking them open so we made a homemade split using cardboard amd hockey this morning he ate a chunk of it is hockey tape poisonous? he is 18 months 30 lbs and no history of anything this was his first emerg visit",
    "doctor_response": "Definitely unusual substances should not be chewed. But nothing will happen with small amount of chewing.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pains in the base of the foot\n\nI have hypertension currently 160 / 95 and has been for some weeks. I exercise regularly run 5k 3 times per week. I recently had gout but it has gone and I am back into regular exercise. I keep having pains in the base of my foot to the point it is difficult to walk and go extremely cold. I currently have 2 fleeces on.",
    "doctor_response": "Base of foot pains mainly because of arthritis of foot or bony spurs due to wear and tear of ligaments etc.  This chronic condition is managed by some foot exercises combined with antiinflammatory and analgesics medicines. Your giut could have effected it to some extent.Running should be avoided until it cures fully.To my own such patients, I would have compulsorily added turmeric powder 1/2 tsp to be added to one glass of warm milk and drunk by patients daily. This would help them recover fast. Turmeric is a natural antiinflammatory and analgesic and bacteriostatic.Hope you got it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the sperm count normal?\n\nhi  i am Khan  from pakistan my age is 29  i done my Semen Analysis and Volum ..  3.0 ml  ph..        8.0 Active Motile 55% Feebly Motile ..25% Non Motile ..   20% Count             38 million/ml  pus Cell           8-10  plz  tell me i am married last year  but have no Pregnensy  what is my reports is Saying  is this normal or  ????????",
    "doctor_response": "Hi,Welcome to HealthcareMagic .I read your report . According to your report you sperm count and motility are normal but in that little towards lower range. Pus cells are more which indicate infection. I would advice you following treatment. 1)start antibiotics like ciprofloxacin for 5 days.2)start tablet combination of lycopene , zinc and multivitamin for 3 months. 3)quit smoking and alcohol. 4)reduce weight and have healthy diet.If for 3 months there is no conception then  try IUI.  Here healthy sperms are placed in uterus . This will  increase chances of pregnancy .Hope I have been helpful .RegardsDr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in shin due to hitting?\n\nmy friend hit his shin in a collision with another person and fell. Now he is feeling immense deep pain in his shin on the outer, anterior side. He can move his leg, although it is very painful. I am wondering if there is a chance the bone cracked or broken and I should take him to the hospital immediately or if the bone is possibly bruised and he should just rest.",
    "doctor_response": "Hello dear,The symptoms as mentioned in your post can be attributed to musculo-skeletal injury. X ray of the leg will be helpful in detecting any bone fracture.Symptomatic relief can be obtained by heat therapy, application of analgesic & muscle relaxant gel, intake of analgesics like Diclofenac (to be taken after food) + Pantoprazole (to be taken 30 minutes before meals).Supplements of Calcium & Vitamin D can be included in his diet which will help in strengthening of bones.If symptoms still persist, kindly consult an Orthopedician for proper clinical examination.Till then, he should maintain adequate hydration & nutrition status, take proper rest and avoid stress.Wishing your friend a Good Health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for autism\n\nMy 19 year daughter with autism had a sort of epileptic bout recently for the first time. EEG and MRI done on the same day revealed no abnormalities. Incidentally her periods were also due and started same day evening. She has been prescribed 2 tablets per day of Encorate Chrono 300. I would like to know if this medication is required since reports were normal. What are side effects considering her autism?",
    "doctor_response": "Hello, thanks for the query. I presume that your daughter is a diagnosed case of autism & if yes; is she going for any of social reintegration, speech, behavior therapy? These therapies are administered by Psychologists & are available at apex institutions like PGIMER Chandigarh, NIMHANS Bangalore etc. Coming to second query, can you describe her exact symptoms during epileptic fir? Was there tongue bite, blood from mouth, drooling of saliva, up-rolling of eyeballs, spontaneous urination in pants, falls or injuries during this epileptic fit? If any of these were present, we can say with certainty that it was a REAL EPILEPTIC FIT. As epilepsy & some brain lesions commonly occur in patients of autism; hence MRI & EEG were done. Both normal MRI & EEG do NOT RULE OUT A DIAGNOSIS OF SEIZURES!!  Lastly there is a condition called as catamenial epilepsy which includes women of whom their seizure exacerbation is aligned with their menstrual cycle. The medication encorate chrono seems a good choice; but may require dose hike depending upon your daughter response. Do revert back if you need any further help. Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the success rate of fertility centres in order to get treatment?\n\nHi...I am from Chennai. I am married for the past 14 years and we dont have child. We tried in couple of famous fertility centers in Chennai; but in vain. I want to give a last shot, before accepting our fate and looking for information on Aishwarya fertility center (Adyar) in Channai. Can someone provide information on the quality of the treatment there and the success rate of the hospital",
    "doctor_response": "Hello, most of the hospitals have a success rates of 20-40% and noone can offer better rates of conception.In case you have any questions in future you can contact me directly on",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can mineral deficiency cause severe pain in the joints and tendons?\n\nLAST FEW WEEKS DEVELOPED SEVERE JOINT AND EVEN TENDON PAIN PERHAPS RELATED TO THE NEW ENTRESTO OR BLOOD PRESSURE MEDS I AM ON.(MAYBE POTASIUM DEFICIENCY OR MINERAL DEFECIENCY?... ...DISCONTINUED ALL MEDS FOR THE LAST COUPLE OF DAYS AND RESTED A LITTLE..PAIN SOMEWHAT LESS AND NEW SOME CHEST PAIN I HAVE NOT FELT BEFORE.....PLEASE ADVISE & THAN YOU....xxx",
    "doctor_response": "Hello, As a first line management you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for having twisting feeling in stomach after gall bladder removal?\n\nhello good morning I recently had my gallbladder removed (June) and now it feels like there is something twisting in my stomach. i do not have any pain, just a twisting and turning sensation, which feel bizarre. It s not local to one specific area either....",
    "doctor_response": "Hi and welcome to HCM. Thanks for the query. It can be part of postcholecystectomy syndrome,but if there is no pain,jaundice or some other symptom then you dont have to be worried. It can be just psychosomatic effect. also there could be ston ein ductus choledochus so if this persist you should rule this out and do more detailed gastroenterolgoic work up. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause of joint pain since pregnancy?\n\nyes please since pregnancy i have been experiencing a pain in the hip joint on the right now its been 2 years and the pain hasnt gone away...and i noticed that sometimes i experience tingling pains on my wrists and a crushing noise on my knees. what could be the cause of all these",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Dear joint pain may be due to arthritis or hypothyroidism or anemia or avascular necrosis etc..Until examination is done it is difficult to say what it is. Use physical therapy with regular exercise. Use pain killer medication if symptoms not improved let get it done thyroid profile, serum uric acid and x-ray hip joint and get treated accordingly. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly suggest me a better and effective medicine for cold.\n\nHello doctor,I am suffering from cold from the past two to three days. It includes sneezing, running nose, etc. The basic Cetirizine tablets never work for me. By the way, I do not have any chronic cold issues till now. It just pops up once in a while (once in three or four months) and I depend on Cheston Cold or Allercet cold tablets for two to three days and the issue gets resolved but my situation is different for me now. Even these tablets are not helping me now. Previously, I used to take Avil 50 once whenever I had cold and it used to work like a miracle. So, I thought it would be wise to take an ENT specialist's advice in this case rather than depending on general physician. I do not have fever. So I request you to let me know if you could suggest me a better and much much more effective medicine which I can use anytime whenever I get cold. I am currently taking Allercet cold (thrice a day for cold), Azithral 500 (once in a day, for two days for minor throat infection), Bepozic (antihistamine) ( once in a day for acute urticaria on my body which is almost recovering).",
    "doctor_response": "Hi. I would like to know few details regarding your symptoms. One more thing, you should never take Azithral (Azithromycin) for two days. You should take it for at least three days (for minor as well as severe infection). Taking antibiotics for lesser days will make you resistant to it. You can continue Allercet (Cetirizine) cold as of now, and watch. Simultaneously you start taking steroid and Azelastine nasal spray that is Duonase nasal spray (one puff each nostril twice daily for three weeks and then one puff each nostril once daily at night for another three weeks). Consult with your specialist doctor, discuss with him or her and take medications with their consent. I strongly feel that you have allergic rhinosinusitis based on your history. Please give a detailed history and also investigations are needed to come to the final diagnosis. Taking random medications will not help. For more information consult an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Episodes of unconsciousness. CT scan shows calcified granuloma without edema. Prescribed Epsolin Er with multivitamins. Sufficient?\n\nmy cousin,aged around20 yrs, have episodes of unconsiousness for last 2-3 yrs , duration of unconsiousness is about 40 - 50 secs.she is not taking any medicine. now she contact a doctor & he advised a CT. CT report suggestive of 3 old calcified granuloma with out edema. doctor prescribed her tab epsolin ER 300 mg along with some multivitamins for 2 yrs. i want to know is this treatment is sufficient?? as in her elder brother case CT report was suggestive of neurocysticercosis & he was advised prednisolone, albendazole along with epsolin. plz help me. i will be very thanful to you.",
    "doctor_response": "Hello,Thanks for writing in.You are confused regarding epsolin, prednisolone and albendazole being prescribed for neurocysticercosis and epsolin for old calcified granuloma.In neurocysticercosis I suppose that it was cystic stage where the worm is alive. Albendazole is given to kill worm, prednisolone is steroid given to decrease brain swelling (edema) and epsolin to control seizures. In your cousin for only calcified granuloma (dead worm) only epsolin is sufficient to control seizure activity. Hope this helps.Dr Anjana Rao",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe fever in kid\n\nmy son is seven month old,having severe fever for the past two days,i took him to the doctor she prescriped paraacetomal drop i gave to the baby but still the temperature not decreasing his head is so hot then other area in the body.what kind of fever will be this i am so afraid ply reply me sir",
    "doctor_response": "Hi,Welcome to HealthcareMagic.Thank you for your question. Severe fever with no associated symptoms like cold/cough/loose stools can be due to viral infection. For this it is best to give as prescribed paracetamol drops, lots of fluids and tepid sponging. If your son has associated symptoms of cold/cough and temperature is not coming down you can discuss with your pediatrician regarding antibiotics. I hope this answers your query. Good luck.With best regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Leg cramps. Done blood tests. Echo test shows increase in cortical echogenicity in kidney. Reason?\n\nhello doctor my mother is 55 years old and she had a cramp in her leg and went to the doctor and regarding on that dr has asked her to take tyroid, glucose fasting and cereatine level in the kidney ,the report showed 1.6 cereatine level in the kidney and again dr has advised to take her echo test of the kidney and the report showed both kidneys show mild increase in cortical echogenicity..could you tell what would be the reason for this?",
    "doctor_response": "Hi. Thanks for posting your question on HCM. A high serum creatinine and increased renal cortical echogenecity suggest kidney dysfunction. The most common reason is  diabetes and/or high blood pressure, although there are numerous other causes. She needs to see a nephrologist who will be able to advice further investigations and management. Good luck. AB.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could stomach pain with fever be indicative of stomach flu or UTI?\n\nMy 17 yr old daughter complained of severe stomach pain. I took her to the Er on Friday morning. Anything acute such as gallbladder, pancreas, appendix problems was ruled out. She did have an UTI and was given antibiotics and fluids along with morphine for pain and sent home. That might she had hard chills, back pain and her head and stomach hurts. She has fever up to 102 for the past 24 hours. I am try to give the antibiotics a chance to help but it doesn t appear to be working. I m leaning toward stomach flu.",
    "doctor_response": "HI, thanks for using healthcare magicIt would be best to give her the antibiotics are prescribed if she was diagnosed with an UTI. Antibiotics are required for effective treatment against urinary tract infections.If the antibiotics are not working for this infection then she may need another type of antibiotic (it is possible that the bacteria may be resistant to the antibiotics given).Urinary tract infections can cause chills, abdominal pain, back pain , fever.Stomach flu would normally be associated with a history of vomiting and diarrhea.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is neosporin effective in treating infections?\n\nre-finishing a door, got a splinter deep across the top of my thumb. It pulled out, looks clean (via led light thru thumb), but have infection. Have soaked with hydo/preoxide, an soap and water. It is very tender to touch and when hit on top of thumb. Keep treating as above with neosporin or see a Doc?",
    "doctor_response": "Hello, Thnx to contact us. I understand your concern. If I am your doctor I advice you that neosporin is effective in the treating it untill the infection is limited. If the infection enlarges it is necessary to start with oral antibiotics like cefixime. Also necessary to maintain the local hygiene by dressing and cleaning, it will play a major role in the infection.I will be happy to answer more of your concerns, kindly know me,Wish you a very good health at health care magic. Dr. Arun Tank. Infectious Disease.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes feeling of movement in lower abdomen while sneezing?\n\nI'm 36, male, 5' 10\", 250 lb. a little overweight and have a odd feeling when I sneeze. Feels like something is moving around sometimes in my lower abdomen on the left side, right above my waistline. I can't feel a hernia but maybe it is that. I get sensations sometimes in that spot from time to time also like something isn't right. I've had these feelings for years, what's your take? Thanks!",
    "doctor_response": "helloit could be gurgling bowel soundsplz get an ultrasound abdomen done after a clinical exam. if its clear then you dont need to worry.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Possibility of having helicobacter pyroli infection\n\nmy father was admitted to hospital for 2 days as he had hiccups for 8 days. endoscopy reports say below oesophagus : z line 35cm large hiatus hernia. irregular mucosa at GE junction Duodenum : Erosions in D1 and D2 - Normal Mucosa Intervention : RUT Mild positive. My concern is that the doctor has given him Pan D tablets and Sucrafil syrup.  understand it is a helicobacter pyroli infection for which no medicine is given.  pls advise",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. RUT (rapid urease test) is mild positive. If it is H. Pylori infection then it must be strongly positive. This is the reason why doctor has not given anti H. Pylori drugs. His symptoms of hiccups is mostly due to hiatus hernia and erosions. So better to continue drugs advised by doctor. Along with drugs, your father needs to follow these lifestyle modifications for better symptomatic relief. 1. Avoid stress and tension. 2. Avoid hot and spicy food. 3. Avoid large meals, instead take frequent small meals. 4. Go for walk after meals. 5. Keep 2-3 pillows under head in the bed to prevent reflux. Don't worry, he will be alright. Hope I have solved your query. Wishing good health to your father. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest better treatment for constipation and bloating\n\nmy granddaughter has constipation and her stomach is always bloated. she is 9 years old. she has been to the doctor and they give her miralax. she has had this problem for about a year. I haven t seen any results with the miralax. is there anything we can give her.",
    "doctor_response": "Thanks for the query.It is the common problem to have constipation which is not responding to oral medicines.I would suggest you to try more natural remedies like eating lot of veggies, fruits, high fibre diet.Also let her drink lot of water.Daily walking , and outdoor sports should be encoureged.If the costipation is not responding to above treatment then try glycerin suppository.Hope i helped you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat bloating in stomach of an infant?\n\nhi i have a newborn she is 3 weeks old. she is breastfed and feeds often with many wet nappies per day. she poos on average only every 2nd day. a few days ago her weight confirmed she has put on almost 500gms in 1 week. Howover the last 24 hours she has been very unsettled, with a bloated tummy which has been making alot of loud gurgling noises all day, accompanied by 3 soiled nappies but only lightly soiled with very watery yellow poo. she keeps wanting to feed but it seems only for comfort as her tummy seems very full and hard. she sounds like she is constantly straining which makes her bring up small amounts of milk even as long as 40mins after a feed. what do you think is wrong with her and what should i do to settle her if she is already full?",
    "doctor_response": "Hi, This is called evening colic and is quite common in this age group. This happens when the baby sucks at the breast very fast and in eagerness to drink milk will gulp in air too. Unless the air comes out like burping or flatus this discomfort will be there and next time check if the baby is sucking too fast and gulping in air too. You will be more convinced. Usually, I don't advice any medicines for this as they give only temporary relief. The two best ways to relieve this distress is - 1. Do not put the baby in lying position after feeding till the baby burps out the swallowed air. 2. If still crying - put the baby in prone position and keep patting the back gently so that the baby passes off the flatus and gets relieved. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is consuming Belara safer than Yasmin?\n\nHello, My 17 yr. old daughter was put on Yasmin but I want to change her to something else as I don t believe Yasmin is safe due to one of it s active ingredients. I have heard of Belara. Is this a safer option than Yasmin? Does it have the same active ingredients?",
    "doctor_response": "Hello, I would be happy to help with your question.Yasmin is a low dose birth control pill that contains a low dose of estrogen and progesterone.  Belara contains a slightly higher dose of estrogen and a different progesterone that claims lower side effects.  I would consider that the estrogen in birth control pills carries more inherent risk that any of the different progesterones, and given that Yasmin contains less estrogen, it is actually probably safer.  This is worth reviewing with her / your doctor in terms of the exact medications and doses within the two pills.  Also, you need to review with someone whether there are any contraindications to the use of the pill in your daughter given your concerns.I hope that this helps and good luck!",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can umbilicus lumps with pain be treated?\n\ni got my belly button piecred in august and i swim alot cuase im on a swim team and jus recently i was developing bumps on the top and botton of my belly button. the bottum bump hurts the most and it looks like a bubble i have no idea what to do about it can you help me ?",
    "doctor_response": "Welcome to Health care magic.1. Its an infection after piercing, which is causing the symptoms and collection with in ( mostly bacterial infection ) commonly happened when done in bad aseptic conditions.2.You may need to see your GP and get a course of antibiotic to treat the infection soreness.3.Swimming has nothing much but make sure you dry it well, clean the area with antiseptic liquid in order to avoid new infections from pool water.4.There are chances to get complicated if you leave it un attended.5.Possibly piercing not suites your skin - avoid it for some time until it heals well. Good luck.Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lumps in the ankle area?\n\nI recently saw a lump right infront of my ankle area. It is very tender when i touch it but i am pain free. I had noticed it before and thought of it as swelling but as i closely took a look, it is a lump. What can it most likely be? I am planning to get it checked soon",
    "doctor_response": "Hi.Thanks for your query.Noted the history about the tender but non-painful swelling in front of ankle.Such a swelling can be due to an abscess, cellulitis, infected cysts and so on. I would advise you the following:Get a course of an antibiotic and anti-inflammatory medications so that the swelling is either settled or vanished. Surgery is only indicated if there is no response to the medical management. Use fresh socks, change daily.Apply Locally Liquid Povidone iodine so that the area is kept sterile and further infection is avoided. You may consult a General Surgeon to get a proper management of the case once diagnosed well by proper ways.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reports show high bilirubin, SGOT, SGPT levels. Indications?\n\nhi doctor.my mother has a liver problem from last 8 months.her blood reports are abnormal as: platlets: 46 ESR: 40 NORMAL: 20 BILIRUBIN: 3.6 NORMAL: .2-1.2 S.G.P.T: 187 NORMAL: 5-55 S.G.O.T: 473 Normal : 5-40 her hepatitus A,B,C and E Test are normal. i dont know where is the problem because there is no hepatitus A,B,C,E.",
    "doctor_response": "Hello, rizwan5125, If your mother has had this for over six months, the condition is chronic liver disease. She seems to have a very low platelet count and her Bilirubin levels are mildly elevated and her enzymes are moderately high. I am glad that her Hepatitis profile was negative especially for Type-B and Type-C. They are the bad ones. Type-A does not cause chronic liver disease. I am sure your mother never abused alcohol, so we can eliminate that as a cause. There are certain drugs (Prescription and non-prescrption) that can cause chronic liver damage. Ibuprofen, Naproxen, sulfa drugs, Tetracycline family of drugs can cause liver damage. Check all the medications she is on or has been taking. The other condition is Auto-Immune liver disease. She should be tested for these-Antinuclear Antibodies, Anti-smooth muscle antibodies, DNA &RNA antibodies, Serum complement level, Protein electrophoresis, R.A.Factor etc. Another condition common in women is Primary Biliary Cirrhosis. This may be associated with fatigue, itching of the skin, jaundice etc. Diagnosis is through Anti-mitochondrial antibodies and liver biopsy. You can discuss all these with her doctor and then appropriate treatment can be given. I wish her well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I have a strong urge to urinate?\n\nHi doctor, In the morning, I have a strong and frequent urge to pass urine. It continues for an hour or two. After urinating normally, only droppings take place. Today, a few drops of blood also came. My intake of water is about 2 liters a day. There is no discharge or itching. Throughout the day it is normal. This symptom is persisting for the last three to four days. I am a thyroid patient as well as diabetic and also on medication for high BP.",
    "doctor_response": "Hi. It seems you have developed urinary tract infection (UTI). It is common in diabetic patients to develop infection despite good water intake. I suggest you get urine routine and microscopy along with urine culture sensitivity done. Take antibiotics accordingly. Let me know the result, so that I can help you with the prescription. All the best. Hope you get well soon. Revert back after the test to an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why has itchiness come back in an obstetric cholestasis patient?\n\nHello doctor,I was diagnosed with obstetric cholestasis two months back due to symptoms of itchy palms and feet. My LFT's and bile acids where raised. I was put on Ursodeoxycholic acid 500 gm twice daily and pregnancy vitamins. My symptoms disappeared within a week. I am closely monitored, weekly blood, growth scans, etc. But after 34 weeks, itchiness has come back. Baby is active; blood remains stable. I am not sure what to do. Should I increase my medication? Why has the itching suddenly come back after nearly three months of taking the medication? I would be grateful for your opinion.",
    "doctor_response": "Hi. You are right. You have symptoms and signs of OC (obstetric cholestasis) that shows itching on palms and soles in the absence of rash with abnormal LFT and bile acid and resolves after birth. Obstetric cholestasis has increased the risk of preterm birth especially iatrogenic; fetal distress causes passage of meconium that leads to cesarean section, post delivery bleeding. Due to risk mentioned above, the fetus should be monitored regularly and frequently along with mother's blood investigations to know the level of liver enzymes and bile acid. As you are feeling increased symptoms instead of taking medications regularly, I wanted to know have you been checked for other liver-related diseases at the start of pregnancy? And when you had last CTG (cardiotocography), electronic fetal monitoring for baby. For safer side, you should have one CTG for baby's well being and repeat blood investigations for the most recent status of disease as symptoms reappear and now already you have crossed 34 weeks. Vitamin K specifically you should have for this diagnosis and baby also just after birth. Dexamethasone can be added to prescription 10 mg orally for seven days, then to stop for three days. The Ursodeoxycholic acid dose could be increased after laboratory reports. So, my advice is better to have one CTG in an emergency due to the fetal risk of still birth in OC and to repeat blood investigations for necessary changes in dose or addition of medicines I have mentioned above. I hope you understand my point. You should have laboratory tests and CTG immediately to plan further. Keep a strict check on baby's movements. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it possible to feel poor erection and delayed ejaculation because of psychiatric medicines?\n\nHello doctor, I was on Escitalopram for the past 14 years till date and with Lorel also before five years back but later the psychiatrist stopped. Now, I am only on Nexito 0.5 mg daily for three days and once Nexito plus on the fourth day. I have an erectile dysfunction for which I am consuming homeopathic medicines and this has helped me a lot. But, now also I am not able to ejaculate inside her vagina. I feel like removing out the penis. Please help me out.",
    "doctor_response": "Hello. Taking Escitalopram or Lorazepam without a regular supervision of a psychiatrist for long periods of time is not advisable. This affects the health badly. Nexito is Escitalopram only and this could be the reason for your poor orgasm or delayed ejaculation. If your libido has reduced and you are not able to ejaculate then there is a need for re-evaluation. Drugs like Bupropion can be added to the prescription which will help in remission of symptoms and this will not affect the sexual life too. Instead of Lorazepam, drugs like Clonazepam or Etizolam can be used. Visit a doctor for evaluation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can precum cause pregnancy without ejaculation?\n\nHi. Had intercourse 3 days before my supposed period. I am regular. Condom broke but no ejaculation happened. I am aware that precum can get me pregnant. Question: do i still need to use nordette as ecp? Knowing that no ejaculation happened and I am not on my fertile window? What is the best thing to do?",
    "doctor_response": "Hi,Thanks for writing in.If your periods begin in 3 days time then everything is normal and you do not have a pregnancy. If you do not get periods for more than a week after periods are due then you may have to think about getting a home pregnancy test after 15 days from the date of unprotected sex. This will give an accurate result if you have a pregnancy.Alternatively, if you do not get your periods then you can consult your gynecologist and take methylprogesterone twice daily for 5 days then within a day or two after stopping, you will get bleeding and periods will be regularised under normal circumstances.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of birth control pills?\n\nI started to take birthcontrol pills on may 1st 2012 (mononessa) My period came on the friday which was 05/04/2012. I have been bleeding past my normal period which usually last up to 5 days max. I took my last pill 5/12/2012 and i m still bleeding how can I stop this? or is this normal for my body adjusting to the pills?",
    "doctor_response": "Hello, Most common Side Effects of Birth Control Pills are Spotting between periods (breakthrough bleeding),possible weight gain or fluid retention, breast swelling or tenderness,nausea or upset stomach,headache and mood changes. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. AJEET SINGH",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluttering feeling in chest?\n\nMy husband is complaining of these symptoms: fluttering feeling in middle of chest follwed by feeling of flushing up the back of his neck over his head to his forehead, then feeling stoned for a few seconds. Happened several times last night. He does have CHF, diabetes, kidney failure, has had two CABG s (these are the worst of a myriad of other things).",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. In my opinion, your husband is having arrhythmia. Arrhythmia is irregular heart beats. So this can cause fluttering feeling in chest. He is also having heart and kidney disease. He is also diabetic, so all these also favour arrhythmia more. So better to consult cardiologist and get done 1. Ecg 2. 2 d echo. 3. Holter monitoring (24 hour continuous monitoring of ecg). He may need anti arrhythmia drugs to stabilize his irregular heart beats. Hope I have solved your query. I will be happy to help you further. Wishing good health to your husband. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a painful lump below the collar bone?\n\nI once had a pre cancerous bit of skin removed on my chest area just below my collar bone. there is a minor scar there. but just yesterday I noticed a lump and pain near that area under the skin. what should I do or better yet, who should I go to to check this out a primary care physician or a dermotologist?",
    "doctor_response": "Hi.Thanks for your query.Noted the history and understood your concerns.The scar due to surgery for precancerous lesion on chest below clavicle can be enlarged due to the following reasons:Hypertrophied scar,Keloid formation.Recurrence of precancerous or cancerous lesion.I would advise you the following:As asked by you, meet/consult the Surgeon who operated you.Needs clinical evaluation and examination.The further management will depend upon the actual diagnosis and may need high resolution ultrasound and FNAC that is fine needle aspiration cytology.If this is a hypertrophied scar or a keloid, treatment is conservative and can be application of anti-scar ointments, local steroid injection.If pre cancerous or a cancer then needs wide local excision, send for histopathology and further management as per the reports.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cramps on lower back?\n\nSO i have these horrible cramps in my lower back and I went to use the bathroom and a big clot, between nickle and quarter sized, came off of the tissue..and i was wearing a regular tampon. This happens every time so i just wonder if that s normal or not. Also, i cant seem to stop gaining or lose weight since i had my baby 3 years ago, no matter how much I exercise or eat right, so i want to know if the two might be connected",
    "doctor_response": "Dear- thanks for using our service and will give you my medical advise. Sometimes , if you have heavy menstrual period,you can have some clots or blood getting out although you have a tampon. You want to make sure that this is not a problem having  your regular pap or cytology test with your doctor.The back cramps are coming from your menstrual period , some women are more prone to others , but is considered normal, unless it is a new problem . The problem with weight could be secondary to alterations in the hormones as hypothyroidism , so I suggest to check blood levels of TSH . You can go to your regular doctor for that and he/she can order the blood test.I hope that my advise has been helpful.Dr.Sara",
    "dialogue_context": ""
  },
  {
    "patient_message": "Going through post acute withdrawal. Stopped benzodiazepines and sympathetic nervous system is overexcited. Related to stress?\n\nHi,i have just did a slow taper off of Valium, from 10mg down until I got to 2mg and then I cold turkeyed. right now I am almost 30 days off the benzodiazepines, and going thru post acute withdrawal. As you know when you stop benzos, because of the low GABA, and the broke GABA/Benzo receptor system, this puts you in a fight-or-flight state where the sympathetic nervous system is overexcited, on end, constant palpatations, pounding heart, dreamless periodic sleep, had a EKG done recently, dr. said had a Left Bundle Branch Block, is this related to stress or something else?",
    "doctor_response": "Decreasing Benzodiazepines can cause withdrawal anxiety or uncover anxiety. See a Doctor who can give you non habit forming anti anxiety like Atarax and an SSRI  which will help. Exercise regularly and do Relaxation Exercises.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for muscle atrophy in polio affected leg\n\nhi sir sir I have a question about polio effected disease. sir I am 26 year and my one leg is polio affected and this affect is very low.even i can run also but sir I have problem that size is thin. I want to know it s is possible to increase this leg size. please tell me",
    "doctor_response": "Dear patient Poliomyelitis affects anterior  horn cells of spinal cord and leads to atrophy of lower limb muscles which is permanent. Strength of involved muscles can be increased by excersise but size cannot be increased. Also length of involved limb can be increased by ilizarov techniques.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Thalassemia minor. Have urticaria on my buttocks and thighs, redness, bumps. Done Biopsy. What is the reason?\n\nHelp! I have urticaria on my buttocks and thighs - humidity and tight pants might be a factor. I first noticed the red irregular bumps on my buttocks about 4 years ago in the summer after returning from the beach/ pool. I continued to get it every summer since after sunbathing; it lasts for 2 to 3 weeks and then it goes away. This year however, I got it in February (I was pregnant at the time) and it's been coming back on and off in small bumps since then. I finally saw a dermatologist who did a biopsy; the diagnosis- papular urticaria. In hope for an answer, I saw an allergist as well - turns out i'm allergic to dust mites and cockroach (not known to cause hives). Yesterday I went to a hot yoga class; the room was warmer than usual and i sweated profusely. I got home and my right thigh was covered in red bumps of different sizes, some even expended into a massive red area overnight - they are somewhat itchy and my skin feels as sensitive as when I get sunburn. My left thigh is not as affected - just a few red bumps. I take Allegra on a regular basis and I used anti - itch lotion  for the first time today (Itch Fix,  i believe). I do not have any other medical condition aside from Thalassemia minor. The rash seems to have gotten worse since it first started 4 years ago, it really worries me. What else should i look into? What steps should i take?",
    "doctor_response": "Hello friend,I am a Homoeopath and so my answer will be different from what you have already heard about allergy.Yes you are allergic to several things like heat of summer, dust, mites, cockroach etc.This hypersensitivity is inborn or genetic. But the time of developing hypersensitivity is related usually to a psychological conflict you had at the time of onset of the problem. If you started getting it 4 years back, exactly before that you must have had some shocking conflict which remain unresolved. But your brain associated the urticarea to the external environments like heat of sun, dust etc. instead of associating with the conflict. Now your brain has made a programme associated with these factors and whenever you get exposed to such environments you get the symptoms of urticarea . First of all if you can recollect the conflict, then you can resolve it at the mental level. How you reacted to that is important because that is your genetic, constitutional individuality that made you to react in that manner. This will help the Homoeopathic physician to select the constitutional remedy for you. Therefore my advice to you is to approach an expert Homoeopath at the earliest. You should stop taking any anti- drugs because the purpose of the Homoeopathic treatment is not to suppress the skin reaction but is to cure you. Once you are cured, then your urticarea will go away. With best wishes,Dr. C. J. VargheseHomoeopath,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever, chill and muscle ache?\n\nI have what i think is a high temp but im really cold, almost every muscle in my body is aching, especially lower back, arms and legs. I also have a headache, i cannot get into my car....Ive been told to reduce the number of layers im wearing just in case i overheat; it does not look like a cold day outside. I started getting cold two days ago with minor fatigue but today i can barely move.",
    "doctor_response": "It may be because of common cold or flu which is viral in origin. Get done complete blood count and test for dengue also. Take paracetamol on as needed basis. If condition worsens, consult your physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for pain on scrotum?\n\nLast night, I noticed a pain on my scrotum when laying down to go to bed. Upon checking, I noticed that a small area on the back side of my left testicle had rough skin, and there is a bunch of pimple-like bumps in that area. I m pretty sure it s not an STD, as I am not sexually active currently, but I would like to know what it is, and what I can do about it.",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: It may be sebaceous cyst.Explanation: Usually small bumps on scrotal are sebaceous cyst which are harmless. Sometimes due to friction or your manual handling of the cyst may cause pain or infection.                   You might have noticed this after pain due  to friction. Visit a doctor to clear your doubts. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do thyroid nodules lead to thyroid cancer in a stage 1 endometrial cancer patient?\n\nHi! i had a hysterectomy in Dec for Stage 1,Grade 1a endometrial cancer. How I am having some difficulty swallowing, pressure on my throat, hoarseness, and some pain up to one ear, intermittant. I do have some thyroid nodules. i am callin g my doc tomorrow for and US of the thyroid because i am overdue. I am worried about thyroid cancer. Is there a link?",
    "doctor_response": "There is a connection if you really do have thyroid cancer, its seen in cowden syndrome. Very rare. The symptoms you say are worrisome.There is no point in being worried . you already fought it once . you can fight again.These nodules can also be benign you wont know untill tested so hope for the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does drugs and alcohol affect chemotherapy?\n\nHi, A friend of mines says that he has been taking small packages of chemo through IV for 5 years for a small spot.3 packs a week for like 35 mins.when he comes out of the doctors office he claims that he is doing swell.no sickness and is able to go straight to work and afterwards smokes cigarette, drinks alcohol and plays pool at once.im wondering if this is true.how could drugs and alcohol affect chemo and are their such things as small PACKAGES of chemo?",
    "doctor_response": "Hi,Thanks for writing in.It is difficult to follow the small packages of chemotherapy that your friend is taking. However small dose of chemotherapeutic drugs are prescribed for chronic skin conditions and I guess your friend is having such a skin problem.Alcohol and drugs are not to be used during routine chemotherapy sessions. However, there is no acute adverse effect after taking small amounts of alcohol and drugs if he is on low dose maintenance chemotherapy. It is important to note that taking IV chemotherapy in small packs is to be clearly understood and unless the details are available, it is only making a guess about the entire situation. You and other friends might have a closed discussion with him and try to know the condition he has and the chemotherapy packs and guide him. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I had severe palpitations but my ECG and echo are normal. What could it be?\n\nHello doctor, I had an episode of severe palpitations early this year, following which I went through ECG, 2D echo, stress test, and troponin. All the tests were normal. I have been experiencing intermittent chest, neck, and back pain since two yrars. The doctor started with Nebicard SM 5 mg, which he recently halved to 2.5 mg. Both the cardiologists I visited, have ruled out the possibility of a cardiac problem. I am anxiety-prone. I often feel like I may die of a heart attack. The thoughts of death have increased in the past two weeks. My pulse rate seems to be between 55 to 65 bpm at rest\u00a0and does not seem to rise beyond 80 bpm even while walking. The chest, neck, and back pain still persists. At times I feel dizzy, weak, and very occasionally feel short of breath.",
    "doctor_response": "Hello. I understand your concern. Anxiety is widespread amongst healthy young adults these days. Most often, palpitation is not as a result of a heart problem. I usually advise my patients to engage in exercises like Yoga or deep breathing exercises. Getting adequate sleep of six to seven hours, avoiding coffee, alcohol, and smoking will help your situation. If you stick to these changes, there should be an improvement in four to six weeks. If you do not get better, you will have to see a psychologist. Best regards. For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of pimples in my scrotum?\n\ndear sir i Karthi form tamilnadu, India, 29 yrs old i have problem in my  scrotum..ihave pimples  in that area. when i squeeze it some pimples are breaking but some pimples are not breaking..please give me the solution for this as much as possible.thanking you.",
    "doctor_response": "Hello,I have gone through your query and understand your concern.I suspect these are Multiple sebaceous cysts in scrotum that is why you do not able to squeeze them.They contain the cheesy white materials.These are not pimples and they are arising from swollen hair follicles.Further these are very common in men and at this age and also in scrotum.Another possibility is as you mentioned pimples because skin is moist and more lot of friction from the skin of the thighs, which can lead to irritation and predispose to pimple formation.Do not prick or squeeze these cysts, it may lead to infection.It usually do not need any treatment, unless infected or for cosmetic purpose.If it is infected, you may need antibiotics and NSAIDs like Ibuprofen for pain and swelling.if you need to remove, then complete excision is advised.My advice is do not prick or squeeze these cysts and you may get infection.Maintain good personal hygiene.Hope this helps.Please write back for further queries.Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chronic stomach ache with dilated left lower pole calyx?\n\nmy son is 6yrs old. he is coplaining stomach ache last one month but for time being morning time before going to toilet.he has taken nizonide,metrogyl,o2h pepsiguard,zymino,cyclopalm(prn).vitaminD was insufficient he is taking calshine 60k,and ostocalcium,urine test is normal ultrasound of abdomen is normal.By birth he is having a mildly dilated left lower pole calyx(kidney).please tell me i am very much worried.",
    "doctor_response": "Hi, welcome to HCM.Looking to history, your son has stomachache and left lower pole calyceal dilation.Calyx dilation in children requires evaluation with basic urine report, S. creatinine, Kidney sonography and sometime micturatingcystouethrogram(MCU) to rule out VUR (reflux).Don't get worried. Sometime it can be congenital findings and require no treatment.I think this would be helpfu; to you.Best wishes. TC.Dr Jay Patel.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sweating and shivering after a heavy meal?\n\nHi everyone Before 2 hours. At 6 AM. ( i ate a heavy meal at 2 am ) I was walking outside for a short time like 5 minutes then all of a sudden felt tired, started shaking and sweating a little bit, tachycardia and nothing else. I couldn t stand so i went to my bed and it did t disappear for like 30 minutes , then i slept while shaking for 2 hours and i am feeling better right now. I didn t eat till now ( i can last for a day without eating and that did t happen ). I walk every day, run every day. I m 21, no health problem ( just atobic asthma), non of my relative is diabetic. ( no fever, loss of consiousness, stress or blurring of vision or chest pain ) i m not taking any medication.",
    "doctor_response": "Hi thanks for using Healthcaremagic All your symptoms started after having heavy mealsThe possibilities for the symptoms are1.Reactive Hypoglycemia--after having heavy meals some persons develop Hypoglycemia .This is due to the overproduction of insulin in the body .The main culprit is insulin resistance.To overcome insulin resistance body produces more insulin and as a result patient feels lethargic2.During post Pandial time increased blood supply to the intestines occurs..As a result other body parts receives little less blood that time .this could be one reason..3.Activation Autonomic nervous system could be another reason...But you will have palpitation and dizziness...4.Indigestion also can cause these symptoms.thank you.....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I so bad tempered?\n\nhi im a 16 year old girl i find myself a very angry and down person i have very bad temper which causes me to hit things i also find myself not able to concentrate forget things i just feel like im angry and upset all time and i have no control over my anger is it possible i could be depressed ?",
    "doctor_response": "Depression has varied clinical presentation. The symptoms you have mentioned can occur in depression, if they are quite frequent. A deep routed conflict or stressful life events can cause these symptoms. Personality disorders can also have similar presentations.A detailed evaluation is needed before reaching to a conclusion. Kindly get back to me with more details including .. Age of onset, freqency of symptoms, associated symptoms, comorbid substance use etc.Regards, Dr Arun",
    "dialogue_context": ""
  },
  {
    "patient_message": "Unexplained sleeping seizures. Can be due to lack of sleep or neck injury?\n\nHi my name i amanda. I have unexsplained sleeping seizers since last january. Each time they come in two an they are grandmals. I had my daughter july 5 2011 an she for over the first yr rarly slept due to her exsima and teething. I have two questions. Due to barely getting sleep could that be a factor of my seizers? Iv had two eegs an both clean and two mris and both clean. I have neruoligist but hes not knowing. The other thisng tho is i have a spot in the top of my neck at my scole line that hurts all the time and also before my seizures i had a major headach for two days prier. My second question if not from lack of sleep could the seizures be due to a pinch nurve or injury in my neck?   I dont want to say i dnt like my doctor but i dont feel they are really trying to find the cause   Thank u for letting people ask their questions just for more advice",
    "doctor_response": "Dear AmandaFirst of all I need you to relax and understand that according to a research every 100th person on this planet is prone to having at last 1 seizure in his or her life span. It is a big number. secondly if your MRI and EEGs are normal then the cause of your seizures is at neuron level. Sometimes some part of our brain produce enhanced neurological activity that can lead to a seizure. Now that as your seizure is Grand Mal type, it is most likely that it originates in the cerebral cortex of your brain. If i was your doctor I would recommend you take some anti epileptic medication. I would also recommend you to get enough sleep. There is a more chance of having an epileptic fit if your brain is fatigued so yes it is related to less sleep.As for the injury to your neck; There are a lot of seizures that can develop post traumatic to head injury but mostly these seizures are focal because a certain part of brain is damaged. The pain you have prior to an epileptic fit could be an aura. Auras are very common in grand mal epilepsy. But you should get it checked from a good neurologist/ neurosurgeon.I hope this answer was helpful. Feel free to ask anything regards,Dr. Ammar bin Ahsan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes purple mottle on the body?\n\nMy four year old daughter has intermittent purple mottling of her skin over most of her body. she also has blue veins that are very noticable on her temple and along her jawline. She had a rigourous course of antibiotics at 5 weeks old for viral meningitis that I was told would be hard on her veins.",
    "doctor_response": "this  is normal   in this age    no need to worry   give her more fluid /water intake should be adequate as not drinking sufficient water  can cause this",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be worried about pregnancy due to breast leakage?\n\nI had a baby 8 months ago and I only gotten the depo birth control once was suppose to go back in March for another shot I didn t go I haven t had a period since February and my breast just started leaking again should I be worried about being pregnant again?",
    "doctor_response": "If you are worried as you are not menstruating get done your urine pregnancy test.. Otherwise leaking breast is no issue.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to know the reason for spotting and painful bleeding?\n\nHi doctor, Last week, I had bleeding and pain because of the cyst on my ovary. Now, the pain started to ease and I have been spotting and bleeding for one week. I just want to know if this is normal. If so, then how long will it bleed?",
    "doctor_response": "Hi. I hope you are feeling better now with regard to the pain. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do sore red spots on the tongue indicate?\n\nI KEEP GETTING SPORE SPOTS ON MY TONGUE THAT ARE RED AND INSIDE OF MY LIP FEELS LIKE ITS RAW WITH LOTS OF BUMPS. IT GOES AWAY AFTER AWHILE WITH SALT WATER AND PEROXIDE BUT ALWAYS RETURNS. COULD THAT BE YEAST EVEN THOUGH ITS NOT WHITE OR COULD FLONASE NOSE SPRAY CAUSE IT? I ALSO THOUGHT MIGHT BE EARLY WARNING OF DIABETES . IT RUNS IN MY FAMILY.",
    "doctor_response": "Hi..Thanks for the query..Red spots on the tongue along with raw feeling and bumps on the inner lip can be due to inflammation inside mouth causing Stomatitis and Glossitis and the red bumps on the tongue can be due to lingual pappilitis that is inflammation of the tongue papillae..It can be due to a number of causes like Nutritional Deficiency [Iron, Vitamin B12 and Folic acid] , hormonal changes, acid reflux, tongue trauma due to some sharp teeth or tongue biting habit, excessive intake of sour and citrus foods, uncontrolled diabetes  etc..You need to consult an Oral Physician or a general dentist in this regard to get evaluated and treated..For now you can do warm saline gargles.Gargles with 1:1 solution of benadryl and milk of magnesia can help..You can also gargle with specialised mouthwash like Magic Mouthwash if available in the pharmacy in your area.Apply numbing gel over the sore for relief from pain especially during eating..Take a vitamin b complex tablet for a period of 15 days..Avoid spicy, sour and acidic foods..Hope this information helps..Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "27 weeks pregnant, right choroid plexus cyst, fetal kidneys normal, size of cyst reduced, triple test negative\n\nI am 27 weeks pregnant I went for a scan at 18 weeks and was dignosed with a right choroid plexus cyst and then I went trough triple test which was negative .After this I was asked to repeat the scan at 27 weeks and today I came to know that the size of the cyst was reduced but there was a finding that the fetal kidneys normal in shape and size show minimal fullness of calyceal system with renal pelVis size 4mm in ap dimension bi laterally. Want to know if this is alarming or risky.",
    "doctor_response": "Hello. Thanks for writing to us. A small pelvis size in fetal kidneys may or may not be significant. It is too difficult to correlate this fin ding to any type of malformation. You need to have a repeat follow up scan later to have a clear picture. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Ventorlin good for child for cold and cough?\n\nIs ventorlin good for child cold and cough ?hi,my 11yearS 4months old daughter was prescribed ventorlin syrup.ventorlin 5 ml 6 HOURLY ONCE times 7days ,she was first having cold with runny and blocked nose.i just wanted to know that dr.prescribed her a correct medication or not because ventorlin is a bronchodilator?it will have any side effect or not?she had no wheezing.it is dry coughing i think.",
    "doctor_response": "Ventorlin (Salbutamol) is a bronchodilator and your doctor has prescribed it because often in case of such cough, bronchospasm occurs. He has not prescribed the wrong medicine. But if you feel that she does not have wheezing, you may skip giving it and reserve if for times of respiratory distress, if it occurs. The side effect of ventorlin is increased heart rate but let me assure you that this is a very widely used medicine and well tolerated and so you need not worry about the side effects.Give your child steam inhalation twice or thrice a day and I think that she would get some relief. Also add some antiallergic syrup like Relent which will also help in diluting the cough. The cold has been caused by a viral infection and generally takes 5-7 days to recover. Please be patient till then.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Sjogren s syndrome and fibromyalgia\n\nMy father in law has been struggling for over a year. He was diagnosed with sjogrens syndrome and fibromaylgia. Now, they are saying he does NOT have sjogrens. He went through weight loss, muscle weakness, joint pain, pale, headaches, seizures, etc..... We need an answer. We have been seeing doctors in little rock arkansas and getting NO where.",
    "doctor_response": "Hi,for the fibromyalgia i will wish to help you out here. Usually people tend to lose weight or put on weight based on their body composition and the physiology of the human body varies from one to the another. Muscle weakness, Joint pain and headaches are common in Fibromyalgia. Let me assist you first in brief about Fibromyalgia. It is a condition where the pain is in the fibers of the muscle, due to which muscle pain, weakness, tiredness, headache, etc troubles the patient. For dealing with fibromyalgia one need to first understand that the recovery is slow and steady in this condition. Strengthening the muscles by doing regular exercises, going for long walks for generating enough cardiorespiratory endurance, are utmost importance. Do regular Breathing exercises as the oxygen is the source of energy needed for any metabolic reaction in the human body at the cellular stage. Doing meditation will help control the mind and behavior as in fibromyalgia usually there will be a lot of irritation and frustation too, so meditation will also help. I will strongly recommend to focus on regular exercises, long walks, meditation and breathing exercises. Possibly you has also helped many people along with the previous use. Ofcourse you can see a physical therapist for his utmost guidance and knowledge if you need more assistance.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. 2. 5 year old suffering from stomach ache. Which medicine has to be given?\n\nHi doctor, My son is 2.5 years old. For a week, he is complaining of stomach pain. After farting he is fine. Our family doctor recommended one antibiotic for five days and a medicine to avoid vomiting. He had small vomits twice, but later it was fine. Now, after completing the course of medicine he again complaints the same. His diet is almost nothing and he is not ready to take any food. He just has few mL of milk. He does not have fever. His stool was watery, but it is normal now. Can you provide any recommendation on diet and medicine? Please give me a solution to the problem. Thank you.",
    "doctor_response": "Hi. I can understand your concerns. Complain of abdomen pain with vomiting suggests that your child probably has acute gastroenteritis or food poisoning. Since, antibiotic is already given and now there are no loose stools or vomiting, there is no need to give antibiotic again. For abdomen pain, you can give syrup Cyclopam (Dicyclomine hydrochloride and Paracetamol) 5 mL on SOS basis (as and when required) that is when abdomen pain occurs. Whenever a child becomes sick, there is decrease in his appetite which improves as child recovers. Now, you should give him all the foods that you were giving him earlier. If he is not eating then you can start Glucon-D in water thrice a day for one or two days. Start a multivitamin like syrup Bevon 5 mL once a day for 15 days. Keep patience. Child will eat properly now as he has recovered from illness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to stabilize WBC count which shoots upto 90000 ?\n\nhallo DOCTOR, MY FRIEND(AGE 44,WT 62,HT 5\"10 HAVE PROBLEM IN BLOOD ,WBC IN BLOOD ARE NOT CONTROL .IN SURAT GUJ INDIA. DR PRESCRIBE MEDICINE ARE 1:MYELOSTAT 500mg 2:ciploric 300 when medicine are stop then WBC are in not contol mean increase upto 90000 . please suggest medicine",
    "doctor_response": "hi you need to search for the cause of high blood count. Go to the pathologist for ps examination. it can be anything. it can be leukemia or leukemoid reaction. so first investigate properly and then take treatment accordingly.thanks for using health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a recurring pilonidal cyst be treated?\n\nI have a pilonidal cyst 3 months back, treated with full dose of amoxicilin and got cured, it has now recurred and at a primary stage. need to know which antibiotic to treat this time other than amoxicilin??? surgery is not an option at this point, want to treat it with antibiotic",
    "doctor_response": "Hello!Thank you for the query.Pilonidal cyst can not be treated with an antibiotic. The only thing that can be treated with antibiotic is an abscess due to infected pilonidal cyst. Moreover an antibiotic can be given only in case of diabetes or weak immune system. Otherwise, abscess incision is the correct treatment.Please note that pilonidal cyst is caused by ingrown hair. This hair irritates surrounding tissues and lead to recurring abscess. To get it permanently cured you need to have the cyst removed by a surgeon. Please consult one with this issue.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Liver parenchyma with mild portal lymphoplasmacytic infiltrate grade 2.\n\nliver parenchyma with mild portal lymphoplasmacytic infiltrate grade 2.mild steatosis 20 % accompanied by ballooinghepatocytes focal centrilobular pericellular fibrosis and occasional glycogenated nuclei.trichromebsstain shows features of chonic hepatitis consistent with the hepatitis cand superimposed steatohepatitis likely nash",
    "doctor_response": "Hello and welcome to HCM,The liver biopsy report that you have posted shows features of non-alcoholic steato-hepatitis (NASH).The details mentioned in the report- lympho-plasmacytic infiltration of liver parenchyma, ballooning hepatocytes, fibrosis are features seen in NASH.NASH is liver inflammation caused by non-alcoholic causes.Alcohol is the most common cause of liver inflammation , however, there are some non-alcoholic causes which can also cause these similar changes.Diabetes mellitus is one of the common cause of NASH.NASH causes progressive inflammation of the liver parenchyma thus causing clinical symptoms of hepatitis.You need to consult your physician or gastroenterologist for management of the condition.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and swelling in chest after an injury?\n\nI fell off my bike last Friday and on the Saturday morning the ribs on my right side were sore and I couldn't lift my arm above my head. Today the pain has spread to my chest and now feels swollen across my chest and upper back. Should I go to the doctors?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Yes, you should definitely go to the doctor. You are having blunt chest trauma due to accident and develop increasing swelling and pain. All these suggest rib fractures more. So better to consult doctor and get done chest x ray. Immobilization and painkillers are the treatment of choice. You will need rib belt to immobilize fractured ribs. Apply warm water pad on affected areas. Take painkiller and muscle relaxant drugs. Avoid movements causing pain. Avoid heavyweight lifting and strenuous exercise. Sit with proper back support. Healing will take 3-4 weeks. So follow these for 3-4 weeks and you will be alright.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath and strain in chest?\n\nShortness of BreathI'm 14 years old, I'm very fit and and a perfect weight for being 5'8\". In the past couple of years I have suffered from shortness of breath. everytime I breath I feel like I'm not able to enhale enough oxygen, as if something is blocking the way. when I try to breath my back and chest feel strained. I t hurts so bad.  I can't even fall asleep at night. It's even worse when I'm doing something physical. pleaseeee help",
    "doctor_response": "Hi,It can be related to some spine problems. I would advise you to see your doctor and have a X Rays of spine.Meanwhile try to do exercises for spine, be much in fresh air, make sure you have correct posture while seated . And try to avoid stress and alcohol for some time, eat healthy food.Hope I could help youWishing you good healthIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can fever with lumps on the torso and thigh be treated?\n\nMy 1 year old has a slight fever, a few tiny red rash like bumps on her torso and I just noticed 2 bumps that look like large white head pimples on her inner thigh close to her groin area. What could this be and do I need to take her to her pediatrician immediately?",
    "doctor_response": "Hi...looks like you kid has got a skin reaction due to fever, probably viral illness. By your description, they look like skin infectoin too. There is no emergency, but you can go to pediatrician at ease.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for diaper rash in a 2 year old\n\nmy 2 year old daughter has a sever diaper rash or its a reaction to the pull up she is wearing, her bottom is super red and everything I try to use makes her scream and she wont even set in her bath water without screaming and crying. what would be the best stuff for me to use?",
    "doctor_response": "Use zinc oxide preparations like happy nap cream or ezi napi cream along with oral zinc supplementation...and treatment for diarrhoea.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat lumps under the male nipples?\n\nHello, I am a 23 year old male. I have had a lump under both of my nipples for ten years. At first, I thought it was puberty as it was common for 13 year old boys to get those lumps. However, over time the naive, stupid, and scared teenager I was decided to just ignore them. I have accepted that it is male breast cancer and probably pretty bad. My question is what kind of doctor should I go to. Someone more specific than a general physician. Where do I get started?",
    "doctor_response": "Hi,from history it seems that you might be having Gynaecomastia giving this problem.This might be due to predominance of female hormone.Consult surgeon or Endocrinologist and get examined.You might require some blood investigations.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest alternate treatment for psoriasis\n\nhello doctor,iam suffering from psoriasis for the past 10 yrs.my doctor prescribed tab.methotrexate.but iam afraid to take this medicine due to its sideeffects.is there any alternative treatment available? what r the precautions should i follow to control my disease.any newer drug available for this disease.my age is 37.iam a working lady.my ht is 160cm & my wt is 70kg",
    "doctor_response": "Hello and welcome to healthcaremagicTreatment of Psoriasis is individualized. While topical treatment alone suffices for limited disease, oral + topical treatment are together useful for disease involving more than 20% of the body surface area.Methotrexate is just one of the several options for treatment of psoriasis. It is an immunosuppressive. It has a long history of use in psoriasis and with proper monitoring and follow up , it is considered to be one of the safest drugs. Serious side effects that are reported with its use in psoriasis are bone marrow suppression, liver abnormalities (fatty liver, cirrhosis) etc.Cyclosporin is another immunosupressive that can be used for rapid control of severe widespread erthrodermic or pustular psoriasis. However, it can cause raised blood pressure and raise serum creatinine, therefore requires monitoring for BP as well as serum creatinine levels. It is a sort of a rescue drug for severe widespread psoriasis, not for limited disease.Phototherapy, particularly NB-UVB phototherapy is one of the several treatment options for psoriasis. It is effective and well tolerated by most. Moreover, NB-UVB Phototherapy is one of the safest options for treatment of psoriasis and can also be used even in pregnant females as well as children.Oral retinoids e.g Acitretin can also be used for widespread psoriasis either alone or together with phototherapy.Finally Biologics like Infliximab, Adalimumab, Etanercept are newer remedies and includes monoclonal antibodies, interleukins, interferons and colony stimulating factors etc.Unlike extensive psoriatic disease for which both oral and topical treatment is required, for limited disease topical treatment alone is effective.Specific topical treatment options for psoriatic plaques consist of ointments containing potent steroid with or without salicylic acid. These are available in ointment form for plaques involving the body and as lotions/gels/foam form for scalp psoriasis. Topical Vitamin D analogues like calcipotriol, calcipotriene etc are also effective for localized plaque psoriasis.Besides specific remedies for psoriasis, moisturisers form an important part in the management of psoriasis because of the thick scaly nature of the plaques. Moisturizers enhance the penetration of topical active ingredients as well as prevents or delays side effects like skin atrophy etc.Hope this helpsRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Used amplicox beecham product because of boil. Having stomach pains with brownish discharge. Side effect?\n\nPlease write your query herPlease type your query here...i have been having pains in my stomach because i used amplicox beecham product because of boil. Meanwhile i have been looking for pregnancy and my last period before now was on 13th october, but as soon as i used the drug my tommy started paining me and i had some little blood with brownish colour",
    "doctor_response": "yes absolutely the side effect withdraw this get anti allergics plenty of water and low proteins and antacid to reverse and get consultation from gastroenterologist to find the complication if any",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from tooth ache and sinus\n\nI have a bridge on my upper right back teeth. I have pressure and a pocket of blood and puss high above the last tooth under the bridge. The tooth is not hurting. Its like way high kinda by my sinuses. I push on it and it fills back up. Its sore when I push on it and smells when I break it open. All day it does not bother me. It only hurts when I disturb it. What is going on?",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,    I have gone through your query,  as you have sin us opening and formation of pus dont worry it can be due periodontal problem . It can be due to not maintain proper oral hygiene.  You consult your dentist and go for investigations IOPA Xray and if there is periodontal problem go for  Scaling and currettage.Hope this will help you. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will puking soon after taking crocin and paracetamol reduce its effect?\n\nhi, i took 2 crocin and 2 paracetamol tablets, in a fit of anger, but vomited (by force) immediately afterwards. I dont know if i vomited the tablets or not ( the vomit mostly consisted of what i had for lunch and dinner the night before). Is it ok? Will I be fine?",
    "doctor_response": "Hi,Yes, it may reduce its effect partly. Based on the history you seem to have taken larger doses of paracetamol however within the normal therapeutic doses. Puking will help in removing the un-absorbed medicines from the intestine. There is nothing to worry about it, you will be alright.  However, if you experience abdominal pain, vomiting, or weakness you must go the emergency room for further evaluation and treatment.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Not able to conceive\n\nhi this is AAAAAAA from china . i have been married for more than 2 years and has been living with my husband only for one year . planning for baby but i don t know what s wrong .i am 22 years old.",
    "doctor_response": "Hello,You need to do unprotected sex without any contraceptive pill or method around ovulation time (14 days prior to due date) or fertile days to maximize chance of pregnancy. You can use ovulation prediction kit (LH kit) to predict ovulation time.If you do not able to conceive naturally, then some investigations are required to rule out causes of primary infertility. These include husband semen analysis, pelvic ultrasound scan, complete hormone assay, thyroid profile, serial follicular study, tubal patency test, other serological tests etc.Here, you need to consult with infertility specialist for complete guidance about investigation & treatment procedure.Take vit-E, folic acid supplements with healthy diet, do regular exercise, avoid stress, maintain genital hygiene, take sound sleep.All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for liver cirrhosis and increased ammonia level\n\nHello sir. I am sandeep vasrani from Akola (Maharashtra) my mother is 70 years old & suffring from diabetes since last 9 years. 2 years ago we found that the liver is damaged because of diabetes & doctors said that my mother has a problem called liver cirrhosis. Now in these 2 years she has hospitalised for 3 times because ammonia level was increased. I want to know that how can I maintain amonia level .",
    "doctor_response": "Hello, Welcome to Health Care Magic. I read carefully your query and I understand your concern.The treatment for cirrhosis with increased ammonia level include medication e.g. Lactulos that decrease the absorption of ammonia and also dietary change, that include the use of vegetable protein instead of animal protein, it is consider add  probiotic treatment  that have the same effect, decreasing the ammonium level.The changes in diet that you should do to your mother to improve the survival are also, a sodium restrict diet, a low fat diet and adding antioxidant nutrients e.g. Vitamin E, Zink and adding  also Folate and Vitamin B6.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Kind regard,Dr .Marsida Janko",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it fine to have delsym for cold along with lortabs for back pain ?\n\nBeen havin back pains for the last couple of day in now im starting to get a cold. I been taking Lortabs for my back in I want to know is it ok if I take some Delsym im a female In im 23 yrs old",
    "doctor_response": "Hi,thanks for query.Yes you can take this drugs together.Take more of fluids,light diet and proper rest for faster recovery.bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with kidney disease, taking oxycodone, methadone. Any different combo of narcotics that will help?\n\nI am sufferring from kidney disease and take a large amount of pain meds. Currently I am taking 3 30 mg. oxycodone tablets every 4 hours and 4 10 mg. methadone tablets 4 times a day. Is there a different combo of narcotics that will help as well with the pain only with less pills? I am also allergic to all kinds of anti inflamatories.",
    "doctor_response": "I feel you may have got habituated to Narcotic based pain-killers.You have not mentioned the nature of kidney disease & cause of pain.However, I strongly suggest that you switch over to Tramodol-Paracetamol combination for pain & mention all the details about your kidney disease & details about the pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump between vaginal lips\n\ni have a hard lump between my vagina lip and groin it started off as a small spot like lump which i stupidly squeezed and it is now quite big and feels like two large marbles , when squeezed a very small amount of pus comes out and then a clear liquid and it is quite painful",
    "doctor_response": "Hi,This is most likely an infected sebaceous cyst. I suggest you see your doctor for antibiotics. If this does not clear it up, then you may need a minor surgical operation to remove it. In the meantime, soak the area in warm salty water to relieve the tenderness.Regards,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for headaches and ear pain in a child\n\nMy 6 year old daughter keeps complaining of headahces, ear pain and beeping noises in her ear. We ve been to her pediatrician several times over the last 2 months and he keeps putting her on antibiotics and dimetapp. She has had an ear infection once or twice during this timeframe and has had water in her ears a few times....just last week we went back to her pediatrician and yet again was told she had an ear infection minus puss...just fluid. She s been on antibiotics for 7 days now and today the school nurse called because she was complaining of pain.",
    "doctor_response": "You need to consult ENT specialist. ENT specialist will do detailed examination of ear, nasopharynx by various scopes and will determine the exact source of infection. There may be perforation in the ear drum or the eustachian tube may be blocked or there may be some glue like discharge in middle ear which is responsible for such complaints.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and sweat?\n\nI woke up and was sweaty, I felt sick and was puking up bile. I sat down and the room began to spin. It wore off after a while and haven't had the feeling again. I am 72 years of age. I weigh about 16.5 stone. I suffer with high blood pressure and am an active golfer. I like the occasional glass of red wine.",
    "doctor_response": "Hello Thank you for trusting HCM Many causes for dizziness and sweating May be due hypertension, TIA, hypothyroidism, hypoglycemia, hypertensive crisis etc. Avoid salt, alcohol,Regular exercise, eat green leafy vegetables. Please consult your doctor he will examine and treat you accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from inferiority complex, always get teased, overshadowed since childhood. Difficult to take initiative. How to overcome?\n\nI am suffering frm inferiority complexon, an am smallest in the family and been always ovrshadowd by my bigger brother, my opinion is always givn last or no priority, i was teased by my classmates for being fat, frequently abused by my brother , now i am 19 yr old, and maintained good physic and height but i still have left over of my childwood mayhem, i always find difficulty to take initiative, make new frnds, gal frnds.. Pls adviss e me, i am going to persue charterd accntancy intrnship nxt month, and i am vry nervous..",
    "doctor_response": "Hi,You need to focus on your strengths rather than your weaknesses and the traumatic past. Look at your achievements and feel proud of them. When you like yourself for what you are, it shows in your demeanor and self confidence and attracts people towards you. So make a list of your successes and appreciate yourself. Also start practicing relaxation exercises to get rid of your nervousness. Slow, deep breathing and progressive muscular relaxation are both good techniques for relaxation. You can get detailed instructions online for these techniques.Hope this helps you. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What diet can be followed to help lower cholesterol?\n\nHello doctor, I am having a high borderline cholesterol. Can you suggest me a diet chart? I have attached reports herewith.",
    "doctor_response": "Hello. I have gone through the attachments (attachment removed to protect patient identity). Your weight is on the higher side that is one of the reasons for high cholesterol. Here are a few nutritional tips: Please feel free to contact again for any further help. For more information consult a dietician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should i wait before drinking alcohol and sharing food after being diagnosed with mono?\n\nI recently found out that I have mono. I'm assuming I got it in the past 2-6 weeks. Since mono makes the liver susceptible to damage, how long should I wait until I can drink alcohol? Also, how long should I wait for things like kissing/sharing food and drink?",
    "doctor_response": "hi, It is ideal to refrain from alcohol for at least 3-4 weeks after fever subsides. Sharing food and drink with others is always not recommended in the interest of general health, however for mono patients, transmission stops within 1 week of subsidence of fever. Hope this helped.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have callus due to playing drums, redness, peeling. Why does it not go away?\n\nHello, I started playing drums in October of 2011. I played hard and often and without gloves. I developed what seems to be a callus on both of my hands, mainly my right hand. The areas where the drum sticks rubbed against are red and have not stopped peeling since February. I haven t played the drums at all since February either. If it was just a callus, wouldn t it have gone away by now? It s been 7 months. It s incredibly frustrating. I ve been to the dermatologist twice and have been prescribed a steroid cream and also a cream for fungus. Nothing has helped. And now I m supposed to go for biopsy . Is there anyone out there who could possibly help shed some light? I appreciate your time very much. Thank you!",
    "doctor_response": "Hi jordevansil, Thanks for writing in to Healthcare Magic! Your problem started with the drumming, probably they are the sequelae of bad callosities only. Some people have otherwise thick skin of the palms called familial hyperkeratoses and form very robust callosities. When you quit the activity this will revert back toward baseline but some hardness will remain. It is harmless and would be helpful if you want to resume druming. If you just want them off your hands then use salicylic acid and lactate based cream/patches like Corn cap twice a day for a month. If you have any further query please let me know I would try to answer it for you. Wish you a great health!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does stress elevate cardiac enzymes ck level in blood?\n\nHi, I am 34 years old and went to the doctor for blood work and they said my cardiac enzymes ck was 247 and limit should be 215. I was wondering if stress could cause an affect to that number. the doctor was not concerned, but i have bad anxiety and i am nervous that something could happen.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Mental stress is not a cause of rise in CK. It's level can increase in muscular disorders.  But your level is only slightly high.  So no need to worry. Just be relaxed. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling vomiting, dizzy, headache and weakness. Noticed brown spotting. Taking birth control. What's wrong?\n\nHi , I'm 16 & sexually active . Last night , I felt I was going to throw up , I was dizzy , with a headache , and I felt weak . I woke up this morning , and I used the bathroom at school . I seen a brown spotting in my panties , I squeezed about 3 drops of blood out . I still feel a little weak. I am on birth control , but I've missed quite a few pills . Do you know what's wrong ?",
    "doctor_response": "Hi, as per your history you have missed pills. So,you are at the risk of pregnancy. you have not mentioned anything about your menstrual history. so i cannot comment upon it. i can advise to go for a pregnancy test and take some elder's help to get out of it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can alternative medicine cure AIDS?\n\nsalam sir.i'm student ov bhms 1st prof at iub in pak.i am searching about the scope of homeopathy in treatment of differnt disease.i want to know about this with proves that homeopathy realy works it iz not only plasibo.will u plz tel me that does homeopathy cure HIV AIDS and other diseases e.g infertility",
    "doctor_response": "**1. there is difference between HIV & AIDS, when person get infected he is said to be HIV +ve, but when the symptoms of Disease appear in the body [which could be anywhere from 5-10 years] he is said to be suffering from AIDS.2. In Initial stage, when he is HIV +ve: CD4 count is sufficient and Immune system is strong thus apart from medical management Rasayana [Immunomodulators] Drugs like Amalaki,Madhuka,shatavari, Guduchi, Ashwagandha, Piper longum,can be taken which helps in increasing the resistance of the body.3. In full blown case of AIDS:  Since CD4 count becomes low, and Immune system becomes weak, thus he is prone to Opportunistic Infection [frequent diarrhea, recurrent cold: fever/cough] thus treatment should be started without delay with ART [anti retro viral] Therapy along with Symptomatic Treatment from Alternate system of Medicine.PS. The Diet and Drugs should be aimed at to increase the Immune Power and resistance of the body and to gain body weight, when the Dosha, Dhatus become Normal, the general condition of the patient Improves.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of broken ribs?\n\nI was pulling weeds in the garden in August. Sudden pain, couldn t breathe. Days later pain lessened, no I have discomfort as if something is in my rib cage. I think I see a sunken area at the bottom right of my rib cage. Could it be broken ribs?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you are wondering about symptoms of broken ribs . Well there can be pain associated with a broken rib usually occurs or worsens when you:-- Take a deep breath- Press on the injured area- Bend or twist your bodyAs your mention that there is sunken area also , which also indicate broken rib . I would suggest you to consult orthopedic surgeon for proper examination . Doctor may order x-ray , CT scan or bone scan . Doctor may wrap elastic bandage around your chest along with splint and prescribe muscle relaxant along with anti inflammatory . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pyruvate kinase deficiency causing hemolytic anemia be treated?\n\nHi, may I answer your health queries right now ?  Please type your query here...my.daugter has pyruvate kinas e deficiency, an inherited enzyme deficiency that causes hemolytic anemia.   She has had her spleen removed eliminating the need for blood transfusions (except for during her pregnancy.  Are hickiesd",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.Pyruvate kinase is enzyme. It is necessary for the integrity of the red blood cell wall.The person who is in the deficient state of enzyme will not sustain the integrity of the cell wall.It is inherited disease and there is no treatment for it. But transfusion can help replenish enzymes and help improve symptoms.Such types of patients should avoid factors which causes red cell lysis.I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My 29 day old already has two teeth. What should be done?\n\nHi doctor, My son is 29 days old. He already has two teeth and one more is developing in the left upper jaw. What action do we need to take?",
    "doctor_response": "Hi. It is rare, but babies may be born with teeth. These are called natal teeth. I would like you to just keep a watch on your baby very often. You might have taken too much of calcium during your pregnancy, so it might have come out early for him. Since they do not have a very strong root support, usually these teeth fall off if they are very loose or they might stay until his permanent teeth come later in life. Newborn babies with teeth might injure their gums and tongue. So, just keep watching in case such things happen. If the teeth are very loose, that is hanging from the gums, and are going to fall off anytime, then please see your dentist. Nothing to worry. Some babies grow with teeth without any problems. For further information consult a paediatric dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bacterial infection in the vagina\n\nHi, I'm 23 and I think I may have a bacterial infection caused by an ingrown hair located near my private area, I have been hesitant to go to the hospital because of the location of the infection, the main head of the infection is about the size of a rounded sewing needle head and the swollen area around the head is about the size of an oblong dime. I took 500mg of cephalexin and it didn't seem to get any worse or any better for that matter. What would you suggest?",
    "doctor_response": "Hi, Thanks for posting in HCM. I have read your description and understand your concern. You cannot get rid of infection by taking antibiotic alone, and that too with a single dose. Kindly do the following to overcome the infection. 1. Wash the area with warm water and rinsing with antiseptic solution like Povidine-iodine twice daily. 2. Use vaginal pH balancing solutions like v-wash regularly. 3. Take a course of oral antibiotics containing Amoxacillin & Clavulenic acid. 4. Take antiinflammatory medication like Ibuprofen twice a day after food. 5. You need to take sitz bath with warm water twice daily. Wear loose fitting undergarments and abstain from sexual activities till the lesions heal completely. Hope the information provided would be helpful. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cysts on forehead, increasing in size, hard, non-movable, now soft after taking homoeopathy, treatment\n\nI have been suffering from a cyst on forehead with a size of around 3 cm for last 3 years. it has been gradually increasing in size. Initially it was very hard and non movable.But after using some homeo medicine it has become little bit softer. Please suggest alternate medicine other than surgery.",
    "doctor_response": "hi, you seem to be having dermoid cyst or sebaceous cyst over the forehead. Homeopathy won't help. Get it removed by Plastic surgery so that scars are not there to bother you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for abdominal pain when eating and difficulty breathing?\n\nHi there i am 15 and i have seen several doctors about my chest. Ive had an EKG, Chest X-Ray, Blood work in which all came back perfectly fine. I am a female. All of the doctors said i have severe anxiety. But however my abdomin hurts when i eat. So far every night and alot of the dy i feel like its VERY hard to breathe. Its constant and however does not stop i do not know what could be causing it. Uhmm i go to the doctor again February 17 should i do something. They said i might have some GERD but im taking antacids and they however arent working niether is the ibuprofen. Im currently taking melatonin to sleep. Please help me!!!!!!",
    "doctor_response": "Hi,Thanks for writing to HCM.Yes, it does looks like gerd....and antacids wont help you with that...you need to start on a combination of a ppi and levosulpride... ppi to reduce the acid production and the later to prevent reflux...also you need to avoid tea, coffee, doda drinks, spices and fatty foods as these all increaseacid production and increase reflux... also eat small and frequent meals and dont lie down for an hour after a meal...while sleeping put two pillows below your head....and finally get an endoscopy done to confirm gerd and rule out hiatus hernia...Dr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for noise in the stomach and loose stools in 10 month old?\n\nmy 10 month baby stomach makes a lot of noise and she has loose motion (too watery). She eats well and plays normal but the problem is the sound and loose motion. took her for a check up they did a lab test and said she is fine. Kindly assist me,Tinega Haron",
    "doctor_response": "HiWelcome to the HCMIt seems that your baby has rumbling and growling tummy along with loose stools. These occurs when the baby's feeds have high carbohydrates and sugars in it. Especially lactose intolerance may cause this .Enzymes in gut break them in to simpler sugar molecules which may attract more water from the gut leading to osmotic diarrhoea and rumbling tummy with gaseous distension.I would recommend you to avoid milk and dairy products containing lactose and refined sugars in his diet for 1-2 weeks. Also started her on probiotic such as enterogermina sachets twice daily for next 5 days.Hopefully this will help her.For further questions, you may contact me.Take careDr. Archana Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe anxiety and panic attack be treated?\n\nHi, I am a first year graduate students and I have a huge qualifying exam in three days. For about a week, I have been experiencing periods where it feels like my throat is closing up and I am about to pass out. They normally last an hour, maybe two, but I don t actually have any trouble breathing or swallowing, it just feels like I do. I think I am just having panic attacks, most of my family struggles with and is medicated for various types of anxiety disorders. I guess I am just looking for some confirmation that this is most likely what is going on. The last time it happened I was drinking coffee, and this time I just ate some peanut m&ms s. The overactive brain inside me is convinced I m going into anaphylactic shock, but I ate peanut butter every day last week, and nothing happened, and I don t have any known food allergies, so I feel like that s pretty unlikely. Thank you",
    "doctor_response": "Dear userWe understand your concernsI went through your details. PANIC ATTACK a sudden overwhelming feeling of acute and disabling anxiety. Panic disorder is different from the normal fear and anxiety reactions to stressful events. Panic disorder is a serious condition that strikes without reason or warning. Symptoms of panic disorder include sudden attacks of fear and nervousness, as well as physical symptoms such as sweating and a racing heart. Panic attack always happens due to an underlying anxiety disorder. So you need to treat anxiety disorder. Anxiety disorder is treated with the help of counseling and psychotherapy. You should consult a psychologist. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this semen analysis and ultrasound report indicate?\n\nI am 35 years old and my wife is 33 years old. We have a child aged about ten years. Now, we want another child but my wife is not conceiving. We met a doctor who advised us for some tests and we undergone that tests. Now, I want to understand that reports and the medicines to be advised according to the reports. Please explain our reports and prescribe medicines. Also give certain advice in this regard. I am sending my semen analysis report and the reports of my wife of ultrasound and other blood tests, thyroid, urine tests etc. The period of my wife remains for only one and half days or two days only for few months. Before that it was remaining for 3 to 4 days.",
    "doctor_response": "HelloAs you mentioned that you are are sending the reports of SEMEN analysis and other reports but no report is attached here . Neither ultrasound report or semen or blood reports , so please upload all reports.Since you mentioned that the menses of your wife is only for 1-2 days , so get in blood for hormone tests , ultrasound of uterus , ovaries , follicles size report , ovulation study size of dominant follicle , burst date of follicle.After these reports we will be able to say something.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes body odor in child even after bath?\n\nWhen my son was 6 1/2 he developed horrible body odor and I increased his showers to every other day. Now, he just turned 7 and I have noticed that he has body odor the following day after a shower. I am still using a baby body soap, should I start using adult soap? Should I shower him daily? Thanks for your help.",
    "doctor_response": "Dear parent,In normal course one shall take bath daily. Especially kids, as they are playing and sweating more. If physical activity of your son is high and he is smelling then bating twice is a good idea. As far as soap is concerned any soap is good. But don't over use soap. You can apply moisturizer after drying him up.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please check my reports and tell me if I am diabetic or pre-diabetic?\n\nHello doctor,I just had my liver profile test and also I have very fatty liver and I am trying to reduce weight.",
    "doctor_response": "Hello. I have seen your reports (attachment removed to protect patient identity) and understand your concerns. Your SGPT (serum glutamic pyruvic transaminase) is mildly elevated. This could be due to many conditions or increased alcohol intake. You should reduce your weight by following exercise and diet regime. Your ideal BMI is below 24.5. Please send me the other lab test values in the follow-up feedback. Hope I answered your questions. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I become pregnant if I maintained an elevation position?\n\nHi Doctor Samuel....we are trying for a baby and i was tested positiove with my ovulation kit day yesterday and we had sex(missionary position). My husband wasn't able to have a deep penetration and his liquid came out of the vagina. However I maintained an elevation position for around an hour. Could I get pregnant.?",
    "doctor_response": "hello...thanks for trusting the healthcare magic doctors for ur health related queries.I guess ur concern is about..can you get pregnant if u maintained an elevation position..right.well..my answer is- YES, u can pregnant if u maintained an elevation position after sex, but the ejaculation should occurs inside the vagina. ejaculation inside the vagina is more important thing. at least some amount of ejaculation should occurs inside the vagina. as u told that ur husband liquid is came out from the vagina, but u didn't give info regarding the amount of ejaculation. whether ur husband ejaculate outside the vagina or only some amount of this is ejaculated. so it is difficult for me to comment on this.with the above discussion u can try out my suggestions-1. ur husband try to ejaculate inside the vagina, it gives better result.2. if ur can't able to ejaculate inside the vagina, then u can try IUI ( intrauterine insemination), in this the husbands semen directly injected inside the womb, so that chances of getting pregnancy is high.3. if u r in hurry then visit nearby infertility specialist. he /she can help u.I hope the above information is useful, informative and helpful for u.regards- Dr sudha rani panagar( i can understand ur tense-full situation, DON'T WORRY, EVERY PROBLEM HAVE A SOLUTION. I pray the God that u will be blessed with a cute n healthy baby as early as possible..hopefully TWINS)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal cramps after eating?\n\nabdominal cramping for 3-4 days. They seem worse about an hour after I eat or drink water. There is some mucous and occasionally undigested food but no...abdominal cramping for 3-4 days. They seem worse about an hour after I eat or drink water. There is some mucous and occasionally undigested food but no...",
    "doctor_response": "You are having Irritable bowel disorder most probably.........you need to relax and avoid any kind of stress. Take combination of rabeprazole, dicyclomine HCl, clidinium bromide and chlordiazepoxide for ten days. There will be definit relief, if no regression in symptoms you get back to me immediately. Generally it takes time for IBD to resolve and along with medication you need to follow a healthy life style including proper diet intake with good amount of fibre in form of fruits and salads, not last but least is a schedule of exercise also....tc care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe back pain and stomach pain\n\nSorry I very tired, I work in Torbay hospital in the eau department which as you know is very busy. I was admitted again last Monday while I was at work with terrible back pain and stomach pain, they have again confirmed that I have degenerative spinal disease in the lower back, which they diagnosed in January. Could having crohnes disease have any implications or cause problems? I am 53 years old female and was only diagnosed with crohns last January 2010 and have had part of my Ilinum removed small part of bowel! The op didn't go well and I was in  icu for four days, oh I could go on! But can you answer the question about my back plus what do I do about work I feel useless .",
    "doctor_response": "DearI am sorry for the symptoms you are sufferingIt is rather difficult to make connections between crown desease and back painThe only doubt is in the retaking of calcium as crown can damage the procesYou can do blood test and if is low you need to treat thatIn the mean time you should use pain killer and lumbar fortressIt is reccomended that you schedule a neurological exam Best regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does cysplatin stay in your body? My mother has Stage 3b lung cancer and was treated with cysplatin and etopocide. She also had 30 radiation treatments. She was last treated 3 weeks ago and is now done until her next PET scan in early February.We've heard the term \"chemo brain\" and notice that she is still not quite herself cognitively. She also is extremely tired. The main question is when can we expect her to be more like her \"old\" self.Thanks,Michelle",
    "doctor_response": "Hi,Thanks for writing in.Cisplatin is a chemotherapy agent and disintegrates into smaller metabolites within 30 minutes after it being injected. Medical literature says that the platinum from Cisplatin, but not Cisplatin itself, becomes bound to several plasma proteins, including albumin, transferrin, and gamma globulin.Three hours after an injection is started and about two hours after the end of a three-hour infusion, 90% of the plasma platinum is protein bound. This bound form is eliminated in 5 days from the time of injection.Chemo brain is a condition where there might be weakness and brain fog persisting after treatment. This is usually observed a cognitive change in the person with associated physical fatigue and weakness. No medications have been approved to treat chemo brain and patients might do well with psychological support and involving themselves in cognitive rehabilitation. Rarely medicines used to treat attention deficit disorders, Alzhiemers and sleep disorders might be of help. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a bump on the tip of the tongue indicate?\n\nI really need an answer to whats going on with me. Im a 28 year old male and i have basically scared myself to death trying to google what the bump on the tip of my tongue is. Its a fleshy small bump thats sort of hanging on the tip of my tongue. I can move it around and it has a white-ish looking head. Not like a pimple. I tried to pull it off last night with a pin needle and tweezers last night and it wouldnt come off. All i did was irritate it and it bled a tiny bit. Everything i look up leads to cankors and i ate something hot or spicy etc. The things is, its been on there for over a month now and everything i look up is now leading to a HPV bump or early sigs of mouth cancer.. i have a history of bad teeth on my dads side of the family. Ive never had braces always brush my teeth but lately my teeth have gotten bad. Im worried myself to death thinking i have some kinda tongue disease or early signs of cancer now. I dont have a lrimary dentist to go to. I cant find a single picture online that looks like mine. Its the only bump on my tongue its painless its just in the way bcuz its on the top tip of my tongue and moves around in my mouth all day.  Its embarrassing bcuz i feel it when i kiss my wife. I had an ex gf about 8 years ago that had hpv and had to get anal warts removed from her. Im wondering im starting to get a wart on the tip of my tongue it looks sorta like a fish egg. It cant be popped or pulled off. Any answers or opinions would help becuz im a nervous wreck.. i do drink i do smoke.. ive literally been researchin this for 48 hours strate and am freakin out. A professional opinion would really be nice insyead of the same websotes poopin up leading to cancer!!",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I have viewed the query and here is my advice. From your explanation it looks like an overgrown  tongue papillae  or tongue wart. Without  clinical examination it is not possible  to tell you what exactly it is. So please send me a picture of the tongue growth so that I can guide you better. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cancer remaining after surgery for papillary thyroid cancer. Possibility of using cyberknife?\n\nI have had three surgeries on the left side of my neck for papillary thyroid cancer and three radioactive pills taken afterwards. At my last visit it shows that the cancer is still there. What does this entail. Yet another surgery. My doctor said I would not be able to get any more radioactive pill treatments. How about the possibility of using the cyberknife to get all of the miscroscopic cells out that keep growing back.",
    "doctor_response": "Hi there,Cyberknife and other machines like rapidarc, linacs etc are various machines/ techniques to give radiation only. They may vary in their capacity to accurately deliver in millimeters precision but they all can only be used where radiation has some proven efficacy. In Papillary thyroid carcinomas radiotherapy by external beam has limited data and your oncologists and clinicians have to deliberate if there is a role for external beam radiotherapy and if yes then in your case there may be a role of cyberknife. Though how much cost versus benefit would be hard to tell. I hope this information helps, Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i smoke during TB treatment?\n\nI am 20 years old i have tuberculosis due to Bilateral pleural effusion i used to smoke n drink i have finished 6 months of my medicine but due to effusion my lung still has water left in my left lung  can i smoke or smoke weed i am suggested to continue my medicine three more months though",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. No, smoking is strictly contraindicated in patients with tuberculosis. Smoking is the risk factor for lung and pleural infection. Smoking causes irritation and inflammation. These weaken lung defense system and make you vulnerable for infection. The cause for your tubercular infection is mostly smoking. So better not to smoke because you are already having an infection. If you continue smoking, healing rate will decrease and you may need longer duration. You may also develop drug resistant tuberculosis. So better to quit smoking as soon as possible. It is not a good habit. It will only damage. So avoid smoking. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swollen cheek, hard and painful small bump on jawline, white film with bad odor on tongue.  History of extraction of wistom teeth.  Guide\n\nIt's been 5 days after I had 3 wisdom teeth extracted and so far I just have a swollen cheek that has been getting smaller by each day. However, there's a small bump by my jawline that feels almost as hard as bone, and hurts when I touch it. Also, today I noticed a white film on my tongue that has a bad odor to it. Will the bump go away in a matter of time? And is the white film something I need to worry about? I've cleaned it with a toothbrush, but the the top of my tongue feels weird in my mouth.",
    "doctor_response": "Hi,Thanks for asking the query,I would like to tell you that wisdom tooth extraction is always associated with post operative complications like pain and swelling.As you are on the course of antibiotics and analgesics, the swelling will subside after sometimes by itself.I would suggest you to take lukewarm saline and antiseptic mouthwash rinses.Clean the tongue with the tongue scraper or a soft bristle toothbrush.Maintain a good oral hygiene, drink plenty of water and keep yourself hydrated.Hope you find this as helpful,Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lacey rashes on cheek and severe pain in legs?\n\nHi-My 4 year old developed a dark red lacey rash on his cheeks 2 weeks ago and it lasted 1 week. I thought it was a reaction to changing soaps. He frequently has these reactions to different children s soaps, but the rash is gone within 2 hours. He also has what we feel are growing pains in both legs at night about once every 2 months. Last night he screamed and writhed in pain for 4 hours with pains in both legs. Today, he has a lacey rash on both arms. Rash is not itchy or raised but under skin. He has an appointment this afternoon, but just thought I d ask your opinion now. Thank You!!",
    "doctor_response": "The lacey rash may either be a reaction to some contactant like powder, soap, cream or lotion. It will need only removal of the offending agent. For some time, avoid all these products. Use a hypoallergenic soap.The pain in the legs is a form of growing pain. Just use ibuprofen syrup as and when it is needed. No other treatment is needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What caused recurring rash on both legs of my child?\n\nMy 9 year old has a recurring rash on both legs, front and back, with some itchiness.  He was given an antibiotic, which he finished, but rash came back same day he finished antibiotic.  Any ideas?  The antibiotic did have a warning about being in the sun.  He has been outside to play.",
    "doctor_response": "HIWell come to HCMThis could be hypersensitive reaction, you have not mentioned which antibiotic being given, because the rash could be due to that only, in my opinion this can be treated with Levocetrizine liquid the dose need to be adjusted according to weight, hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What could be the reason for sudden red patches on my baby's skin?\n\nHi doctor, There are sudden red patches on the skin of my 5 months old baby. He had mild fever the previous day and loose motions before that. There is no other noticeable symptom. Crocin and Atarax drops have been given. Same thing happened two days ago and the almost entire upper body had turned red. Currently, I am giving regular Bonnisan and Vitamin D3 drops.",
    "doctor_response": "Hello. Welcome to icliniq.com. Viral infection or allergic reaction. Complete blood profile and C-reactive protein. 1. Crocin drops. 2. Atarax drops. Revert back after three days to a paediatrician online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Coughing green mucus. Have asthma and tendency to get bronchitis. Had nose bleed earlier\n\nSymptoms: day 1 - no energy, coughing day 2 - more energy, worse coughing day 3 - bloody nose in am, worse coughing, tired (had bad reaction to Mucinex DM - felt high ) day 4- bloody nose in am, same coughing, tired day 5 - bloody nose in am, same cough/tired, throat more sore, hurts when I swallow , mainly on right side. Can t really feel swollen tonsils, started to have funny taste on occasion when I cough *every day I have woken up coughing up mucus , but have no mucus throughout the day. Mucus produced has been light green, occasionally hard. My nose has not been stuffy at all I have asthma , tendency for colds to turn into bronchitis",
    "doctor_response": "it is sinusitis all symptomps are of infected allergic sinusitis your allergies converted to sinus and the post nasal discharge can cause swelling of tonsils throat gerdbleeding is cause of sinusitis in infective allergic sinusitis sinuses bleed is ver common which is misdiagnosed vwith other conditions take doxi 100 mg bd(best for sinuses) take montair fx(combination of montelucast and fexofenadine bd syp ascoril 1 tsf bd syp tossex 1 tsf night liquid antacid 2 tsf tds apply neosporin h eye ointmment in nose bd sea water drops 2 drops ach nose night doxi can be stoped after 10 days others to continue for 3 wk drink lot of warm water",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of pain in calf ?\n\nI have an ache in my calf that started last evening. I injured the knee on the same leg two months ago, had an MRI, have a torn meniscus. Was going to have a surgery but decided to wait as it was getting better. But last night the calf started aching and I wonder if it is related or could i have a blood clot?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Torn meniscus can cause pain in calf. It is due to radiation of pain due to similar nerve innervation. It is transient and improves with conservative measures. You can take simple analgesics, like Ibuprofen or Diclofenac for symptomatic relief. Apply ice packs and take adequate rest. If the pain persists, then you have to consult an orthopedic and get evaluated. Wishing you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does smoking weed hamper the effectiveness of a beta blocker?\n\nHello! I'm currently taking a beta blocker just for palpitations. But it always makes me very paranoid about my heart and sometimes I have panic attacks because I'm afraid I forgot my medicine or something went wrong. I know my panic attacks are all in my head. But I was wondering if smoking weed interferes with the medicine? I don't smoke a lot, but occasionally. It just freaks me out when my heart rate speeds up.",
    "doctor_response": "ya certainly it antagonize with drug . it tend to heart rate. blood pressure while medicine try have reverse effects. so you should avoid smoking.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for red itchy rash on calves,chest and neck\n\ni have a red flat rash on my upper calfs, chest, neck, both arms and belly, it is itchy, i have not changed my soap or detergent. I have not changed anything in my routine, i have had this rask for a couple of weeks, no new medicines either. Thank-you Concerned",
    "doctor_response": "Hello,Thank you for posting on HCM.It\u2019s very difficult to approach conclusive diagnosis unless for proper physical examination, anyways from your description it seems you are suffering from scabies.Scabies is a contagious disease caused due to mite and it spreads among people who are in close physical contact and by use of common household articles.Treatment is pretty straight foreword. Firstly, i would suggest treatment of your secondary infection (if any) with oral and topical antibiotics.The key to successful treatment of scabies lies in treating everyone simultaneously in the family and others who are in close physical contact. Your doctor would prescribe oral drugs like ivermectin which will kill the parasite. You might also be advised application of permethrin 5% cream and a corticosteroid with fusidic acid cream. Apply the medicated creams exactly as advised by your doctor. Take antihistaminics as advised to relieve itching and irritation. Avoid sharing of clothing and toiletries and launder all you bedding and clothes in warm water.Hope this will take care of your issue.Wish you best of health.Thank youDr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing body rashes, severe itching all over the body. Is this a sign of HIV virus or Cancer ?\n\nHello Doctor. For last 6-8 months i am experiencing, body rashes , severe itching all over the body, which includes Head, arms, thighs, lower back and sometimes bumps on the forehead . I sometimes get itching on the tip of the penis and around the testicles. Is this a sign of HIV virus or Cancer? I did take Claritin and Aerius medicines but after taking them i get relief for 10 days - but again the itching rashes starts 9-10 days after taking the medication . Lets say i take medice today, all rashes will come back after 10 days. Especially after taking shower it rashes the most. Please advise as ur help is very much appreciated. AAA",
    "doctor_response": "Hi,Thanks for writing to us.From the description i seems you are having chronic  urticaria. In most of the cases no cause is seen but in few there could be association of autoimmune diseases, thyroid disorders, rheumatoid arthritis, diabetes with the same. Sometimes hot or cold weather, pressure, water, sunlight, sweating etc too can induce urticarial lesions. So basically a proper workup and clinical history is required for accurate diagnosis and treatment.Just to allay your doubt its not HIV  or cancer.Hope that helped.take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling around ankle joints?\n\nHi Doctor,I have a problem of swelling around the ankle joints which is recent.I m taking some medications: Isoniazid and pyridoxine due to diagnosis of inactive TB.I m also taking femiplan morning pills because I recently had an abortion but i had spotting due hormonal imbalance.Please let me know what s the cause of the swelling.I M 58KGS,24 YEARS. Thanks:)",
    "doctor_response": "Hi, You have mentioned swelling around the ankle joints with a H/O medications for TB and some morning pills also. I want to actually see the kind of swelling present, any associated pain, skin redness, fever etc? Also kindly send me any relevant investigations done by you especially recent blood tests, so that i can see and let you know. Please also mention your co-morbid conditions and drug allergy. Do not hesitate to contact me if you need any further assistance. You can also discuss your case and treatment plans with me in a greater detail in a private consultation. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Akshay Kumar Saxena",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I expect pregnancy after being on Siphene and Evalon during periods and taking Metformin now ?\n\nhi,Im analysed with PCOS.We are trying for baby for 4 months im currently taking metformin and was said to take siphene 100 from 2nd day of periods for 5 days and contine with evalon from 6th day for 7 days,,can i expect my pregancy this month? will travelling affe",
    "doctor_response": "hi,thank you for the consultation.as you have PCOS,then there may be difficulty in conceiving.so first you have to take treatment for pcos ,reduce weight if overweight and continue the medicines prescribed by your doctor.no need to worry much now as you are trying for baby since 4mths,still time is there.no need to worry much but be in consultation with your gynecologist till you conceive.good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "When can one undergo carpal tunnel surgery after a total hip replacement?\n\nHi, I just had a total hip replacement done 4 weeks ago, and was just told this week that I should have a Carpal Tunnel release done. I am concerned about any possible infection from the carpal tunnel release. Is it too soon to have this surgery done also?I realize I would be given prophylactic antibiotics pre - proceduraly, but I REALLY do not want to risk anything that would affect my hip replacement.",
    "doctor_response": "Dear patient carpel tunnel release can be done anytime after hip replacement surgery. It is minor surgical procedure and can be done on day care basis. If it is not done it may hamper mobilization post hip replacement. Risk of infection is less as you are already on antibiotics. If carpel tunnel release surgery is delayed long term damage may occur to median nerve. Do not hesitate and do not delay carpel release surgery. all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pimples and rashes on the face, using diprovate-rd. Any suggestion?\n\nhello sir i am 32 year old lady who was using diprovate-rd for 5years but recently i stopped using it as i was getting lot of pimples so my skin doctor suggested to stop using it as my skin has become very sensitive. he told me that i need around 3 months to come out of its effect. but i am very sad as i have lost the glow on my face at the same time i have got many rashes on my face. i do not want to use diprovate any more.tell me will my face will become normal.",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum. Diprovate rd is betamethasone lotion and continuous use causes many effect as skin become very sensitive as in your case . It also lower the immunity and many systemic side effects . But don't be desperate as take Vitamin C tablet twice in day for at least 6 month without any side effect . This will not only increase immunity but skin will glow and normal flora  will restore . For local application use broad spectrum sunscreen lotion. Hope I  have answered your question . If further any question I will help. Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain while breathing?\n\nHi,  I am having trouble getting a deep breath EVERY time I eat.  I am currently waiting for surgery to have the hernia repaired.  I thought at first it was just asthma but my puffers make no difference.  I have also tried eno, zantac 'n rolaids.  Any advice? It is bad enough that I can't even sleep sitting up.",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .*  This is in relation with possible diaphragmatic  issue  as  there is raised    pressure  over  the  diaphragm  compressing the lungs when eating or    even  certain  postures  will enhance  the  problem .*  Needs  proper  physical  evaluation with necessary  radiological      evaluation  or  if  done  then  consultation  with  all reports .Hope this may help you to understand the doubt .Wishing you fine recovery  from the surgery .Feel  free  to ask any further doubts .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Persisting cough, asthma. Taking salbutamil and becotide. Symptoms not going. Do I have allergy?\n\nI am in UK. I have this cough started a year ago on and off. I also have asthma , use becotide and salbutamol inhalers. on second course of steroids. started today, took first lot within half an hour I coughed up a lot of clear mucus . chest clear, temp ok, blood o2 sats 98%. but I am coughing until I vomit . all that comes up is clear mucus everyone. I am als constantly clearing my throat. Is this the asthma, do I have an allergy. Sometimes eating dry food or spicey food or just breathing in can trigger a coughing fit too. I am tired, worn out and feel like my GP is not taking this seriously. thank you",
    "doctor_response": "It is allergy You take antiallergics instead of anti asthmatics Stop all milk and milk products take fexofenadine 120 mg twice a day tab singular 10 mg thrice a day syp asthalin 1 tsf tds Syp (codeine +CPM) 1 tsf night do for 10 days all are available in UK",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause fluid in the lungs and blood in phlegm?\n\nHave a deep cough. Thought it was because of allergies.  Lots of mucus in my lungs.  Just coughed and blood was in the flem.  Tea colored flem mixed with a little  blood.  Was at VA medical center earlier today and they gave me anti-biotics, nasal spray for allergies.  X-ray showed a little fluid in lungs.  My wife thinks they missed something . Do you have any idea what is wrong with me?  I don't drink or smoke.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, possibility of pneumonia is more likely. Pneumonia is lung infection. This can cause hemoptysis (blood in sputum) and pleural effusion (fluid in the lungs). Antibiotics are the mainstay treatment of pneumonia. So finish your antibiotic course. Get done repeat chest x ray. If fluid is resolving then no need to worry much. But if fluid is worsening (increasing) then he may need aspiration of fluid. Don't worry he is taking correct medications at present. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes semen leakage during bowel movement?\n\nfirst of all..gd morning sir.. sir,i am 20 year old male student & my problem is when i goes to toilet for pooping ..my sperms leaks immediatly and automatically in too much quantity.As a result my penis is going to be small and small. plz give me a treatment for it sir such that it does not leak....its my humble request to u sir...!",
    "doctor_response": "Hi  Semen is a body fluid like our Saliva which is secreting from group of glands. If you have a myth of Masturbation is sin,  first u break that false belief.  If you start to ejaculating regularly your problems will disappear.  If you ejaculate today the glands will produce the Semen in the next day.  (If you ejaculate 2-3 times per day the volume will reduce ).  Ejaculation through masturbation will not produce infertility and will not lead you to Erectile Dysfunction......  your current symptoms are due to over stagnation of Semen.  there's no relationship between seminal discharge and Penile size reduction.  Hope you got your Answers.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain with frequent urination\n\nmale 72 yrs old back pain above hip pain comes and goes frequent urination unset of pain usually happens when twisting waist",
    "doctor_response": "hello kaith.. \u00e2\u0080\u0098' the above signs are mostly of two diseases named urinary tract infection or secondary diabetes.. go to ur family physician for further concern.. wish u a very good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hurting of tongue while suffering with fever in a 4 year old?\n\nmy son is 4 and has a fever, 39.2 celcius for the last 3 days. We are  told by the doctor that it is viral.  Tylenol and advil are being given to him every 4-6 hours, as recommended by the family doctor.  everything is hurting his tongue, even water.  why does his tongue hurt and how can I make my baby feel better?",
    "doctor_response": "Hi.Thanks for the query..It seems that your son is suffering from viral infection leading to fever and soreness of tongue is due to inflammation inside mouth leading to soreness and pain..There is also a possibility that there can be sores inside mouth leading to pain..Consult a Paediatrician and get him evaluated..As of now give him Tylenol to relieve pain as well as fever..Make him gargle with numbing mouthwash containing Lignocaine to relieve pain especially before meals..Feed him with soft and bland diet..Give him sufficient rest and appropriate sleep..Hope this helps..Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure a bruise with swelling on head after an injury?\n\nHello my 23 month old son fell on the pavement today and bumped his head he has a bump/bruise some swelling and a scrape where his head is hurt. We are wondering if he may have a concussion? or will he be fine. he is sleeping now but should he be or should we wake him? Also he was up last night with a fever. ( I think from teething) if he has a fever again can we give baby tylenol or no as we are worried about his head? Should we go to emerg? He is acting normal and eating etc.",
    "doctor_response": "HiThanks for writing to us.The bump is just a blood clot.Fever after head injury needs clinical examination and neuro imaging if required.Take him to emergency without delay.Tylenol can be given meanwhileWishing good healthRegardsDR ARUN",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I have pain and swelling eight months after impact injury to ankle?\n\nHello doctor,Impact injury to right ankle eight months ago, still painful and gets swollen. MRI was done on it. I am 20 years old, 158 cm, and 52 kg. All healthy apart from this. My daily medication is 20 mg Fluoxetine.",
    "doctor_response": "Hi. The MRI scan does not show any area of strain or gross musculotendinous injury. Keep it elevated as much as possible. Apply Aircast ankle Sturrup orthosis (you can wear shoes over it too). Apply ice thrice daily for two days. I suggest the following medicines:  Take these tablets only if you are not allergic to them. Do not take these tablets if you have bronchial asthma. Follow up immediately in case of any untoward reactions. Physical therapy: wobble board exercises to strengthen muscles. This should be done once the pain reduces. For more information consult a radiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should I wear braces?\n\nhi I have a few questions. so I had my braces on for almost 2 1/2 yrs (about) and I got my elastics about 3-4 months almost or maybe is 5 months now, but anyways, I always wear them and I have a 2mm overbite (about) (I tried to measure it). I m going to the orthodontist on May 22. do you think that s going to be the last visit before I get my braces off. do u think I will get my braces off on that visit or the next visit? when do u think I m getting my braces off? also is there anything I can do to speed up the process of my jaw moving while I m wearing my elastics? also, how fast do elastics work? oh!, btw, I wear the mountain gorilla elastics. ok thank you.",
    "doctor_response": "Hi,Thanks for posting the query,I would like to tell you that orthodontic treatment require a time as the tooth movement take place slowly.I would tell you ta have patience and listen to your Orthodontist properlly.Your braces will get off soon.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can cancer in many parts spread to brain?\n\nmy father blood pressure is 86/66 and heart rate of 166 , had a scan showed cancer in the right leg,hips,pelvis,stomach,lungs,liver,and spine was told he has emphysema and today he doesn't know where he is and is not making any sense is it possible the cancer could have spread to his brain?",
    "doctor_response": "Hi,Thanks for writing in.Your father is probably having metastatic for of cancer which has spread to the leg, hip, pelvis, stomach, lungs and spine. Having such a cancerous spread is a serious condition. His general condition is also delicate and the blood pressure is on lower side with tachycardia or higher than normal heart rate.His disorientation is probably due to poor general condition. With a wide spread cancer the condition of the brain cannot be commented up to without doing a CT scan brain but it appears that his vital organs are in failure and you must talk to his doctor and inquire about the exact vital parameters. People in end stage cancer are vulnerable to multi organ failure and it is a concern. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rashes on back, small, red, flat, non scaly, do not blanch when pressure is applied, pinkeye. Treatment for rashes?\n\nHello.... I have a 10 year old daughter that has a rash on her back in various spots..... they appear small, red, flat, non scaly....I looked up things on the internet and I did the glass test... they do not blanch when pressure is applied...so in my lay man s diagnosis it appears she has a petechical rash....I first noticed this 2 to 3 weeks ago but in a much smaller amount.....she is healthy otherwise.... was just diagnosed with pinkeye 2 days ago but I don t believe the two are related....I am planning on taking her to the doctor in the morning...or could this be something more serious and require a trip to the ER tonight? Thank you",
    "doctor_response": "Hi welcome toHCMForum. the rash appears to be utricaria. but it should have itching. petechea is a big term with less possibility. there is no trgency you take her to a doctor where there is facility for tests. he examine get the tests done",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lack of sleep, body pain, yellow urine, body heat, red spots on penis, chest, boils on face, body pain. Treatment?\n\nHey, am 25 year old male, from last allmost 2 years i am having some problm in my body, am not feeling sleepy and when i sleep my body pains after waking up and i feel like not to get up from the bed , i am having yellow urine and pain most off the time but when i drink loads of water it disapr , body is burning like hell , red color mark on my penis and chest , and its started with loads off boiles on my face and body pain , i use to eat so much off egg mixed with milk with out cooking nad alcohol , can u please advise wat to do",
    "doctor_response": "i think you are having some connective tissue disorder. kindly visit a rheumatologist for more and better treatment. do you have oral ulcers too. you may be suffering from some autoimmune disease. kindly visit and do full range of all tests blood and biochemistry done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain with high cholesterol and fatty liver?\n\nDear Doctor, My name is Sanoj. Recently I have been diagnosed with high Cholesterol, Triglycerides and Fatty liver. Here under is the values exactly:- 1) Total Cholesterol - 254 mg/dl 2)Triglycerides - 252 mg/dl 3) Fatty liver Stage 2 4) SGOT (AST) - 96 IU/L 5) SGPT (ALT) - 206 IU/L This was noticed during a full body check up in a Hospital. I m not an alcoholic but drinks in normal way like twice in a month or once in a month on special occassions. I m overweight with 105kg having a height of 6 ft. And also had a BP of 65/135. The doctor prescribed with certain medicines as under:- 1) Lanzol 30 mg 2) Essentiale Forte cap 3) Astatin 10 mg 4) Sortiva 50 mg I have started this medication two days back and from today onwards I m having a growning pain coming and going on the right side of the top abdomen. This was the first time I m coming across this pain on this region. I m a little worried. Could you please guide me whether its normal on taking the medicines, or would you advice for a detailed check up again. Your advice would be highly appreciated. Thanking in Advance, SANOJ SAFAR",
    "doctor_response": "Fatty liver is not a unsual finding With high BMI . Also the treatment is gud for you..you should continue it.along with this.take an antispasmodic pill naming DROTIN-M.if pain further worse only thn go for detailed check up.yu are also advised to hav excersise with diet control under dieticien.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Very low appetite, severe weightloss after diagnosis of bile duct cancer. Due for treatment. Any medication to improve appetite?\n\nMy husband was diagnosed with bile duct cancer in May and is awaiting treatment. He has lost all appetite and now lost 30Kg in weight since the start of April. He has not eaten a proper meal since then and his diet now consists of 1 build up drink , a small portion of cereal and milk, fruit and half a bowl of soup. I feel that if he doesnt start eating soon any treatment will be of little benefit. Is there any medication that could improve his appetite?",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum. There are two reasons of loss of appetite. Cancer , tension ( due to cancer).Counselling is very important , that too by you . Buclizine hydrochloride syrup and tablets will boost appetite. Cyproheptadine + sorbitol + tricholine combination is available in market ( chemist soap)  2 T S F three times a day will improve appetite. Good luck for your husband. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest a remedy for breast cyst\n\nHi Dr. Rynne, Good day. I am female, 23 years of age.Last 2009 I found out I have breast cyst but I did not consult a doctor (no enough money). I just treat it with a herbal plant which is mayana leaf because there was someone told me so. Does that plant can heal my cyst? Or should I take MX3 because I saw on tv it can cure cyst. Hope you can response on my concern. Because until this time I still have a cyst. Thank you & God Bless, Windy",
    "doctor_response": "hi.noted history of breast cysts. it is best if you consult with a doctor, preferably a general surgeon, for physical examination and clinical evaluation. breast cysts should be monitored regularly. some of these lesions, grow, spontaneously resolved, and some are just there. do you have a history of breast cancer or concerns in your family? breast ultrasound will be requested as an additional tool for evaluation. depending on the findings, if a tissue diagnosis will be recommended or just a regular follow-up/monitoring will do. occasional breast pain/tenderness/discomfort, resolving spontaneously, is usually associated with these breast cysts especially during hormonal changes (such as before and during menstruation). hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for bipolar disorder?\n\nMy daughter was diagnosed with bipolar after telling her dr. she was depressed and anxious. He put her on lamictal and she spent years feeling depressed and suicidal. When she found out she was pregnant she went off the lamictal and there has been no depression. Her psychologist after talking with her several times, thinks she was never bipolar but has ptsd instead. The lamitcal made her feel worse but her psychiatrist kept increasing the dose.",
    "doctor_response": "Hi dear,for bipolar disorder you should take medication and electro convulsive therapy if needed.first of all diagnosis of bipolar is necessary as depression alone without any manic features is difficult to diagnose to have bipolar illness.so consult local psychiatrist for detail history and diagnosis.PTSD is anxiety disorder and is different from bipolar.Lamictal is good drug for bipolar depression and if you are having side effects then stop it immediately and consult your treating psychiatristThank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will hitting the head twice lead to concussion?\n\nHello doctor, I hit my head twice this week and wondering if I should see a doctor. I am a 29-year-old female. The first hit was four days ago on the top right of my head when standing up underneath something metal. It was a pretty hard hit. It hurt on and off for a day, just the spot itself on my scalp. I did not have a headache or nausea, or any other symptoms. Today I leaned forward quickly and bashed the front top of my head onto a wooden dresser. It hurt pretty badly and I felt my teeth chatter. I do not have a headache now other than the spot itself hurting. I am not nauseous, nor do I have any other symptoms of concussion. I have read that if you hit your head twice, two concussions within days, you should go to a doctor, but I am not even sure these are concussions. I am not sure when a simple bump actually is a concussion, or really how to tell. Do you have any advice?",
    "doctor_response": "Hi. I have carefully and thoroughly reviewed all the details related to your case and feel sorry for the health issues you have. There is no major harm to the brain when hitting like this even twice in quick succession. Your concerns are notable but that worrisome situation is when someone gets an impact harder enough to cause some signs of real concussion like nausea, vomiting, getting unconscious, severe headache, vertigo, etc. You did not have that large impact in both cases and there is no need to go for immediate medical care. You need to handle it at home. Take Ibuprofen for pain and apply local painkiller and anesthetic ointment on the scalp if needed. These are available over the counter at any pharmacy. Apply heat to the site of impact and take care of yourself. Remain vigilant on your moves and be safe.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for dengue fever in children\n\nmy child is 5 yrs old.But his growth is so bad. he has no interest in feeding. recently he was suffering in typhoid.As pathological report,some time he suffered in dengu fever. Day by day he is going to be weak & tired. Pl.give me a suggession what can i do for my child",
    "doctor_response": "Brief answer:Do a complete blood count, stool routine microscopy and start multivitamin syrup. Detailed answer:Hi, welcome to HCM. I know that you are very much concerned about your child. If your child has recurrent infections and is very thin, then you should do complete blood count and stool routine microscopy. Also, a multivitamin syrup should be started for 2 months. Further treatment will depend on above reports. I hope this will help you. Wishing your child good health. Take care. Regards:Dr Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have been facing a problem with hemorrhoids for the past 3 years. Please help.\n\nHi, I have been facing a problem with\u00a0hemorrhoids\u00a0for the past 3 years. I have been taking\u00a0Anusol suppositories\u00a0inserted directly into my anus as it was advised by the doctor. But to my disappointment it keeps coming back.\u00a0What option can you suggest to get it treated once for all?",
    "doctor_response": "Hi. If your hemorrhoids is persisting with the medical treatment then there are other options for its treatment. The other treatment options are: Consult a\u00a0general surgeon online\u00a0for further management -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take levobact?\n\nhii got very bad cold for about 4 weeks.nose blocked,cough feverish.i went to see an ent doctor.he prescribed levobact.when I checked online the information i git was very scary.i have gastric problem so i am worried about taking this madicine.my question is if it is safe to take this madicine",
    "doctor_response": "Hi,Yes, it may be taken safely. Based on the history your doctor has prescribed the antibiotic Levobact apparently for respiratory tract infections. Generally it is well tolerated however its common side effects include abdominal pain, diarrhea, photo-sensitivity (skin rash upon exposure to sun light), and very rarely tendon injuries. It is not necessary that you get all those rare side effects, so continue to take it as prescribed and report to your doctor if you experience the troublesome side effects.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for limps in foot\n\nI HAVE HAD FOOT PROBLEMS ON MY RIGHT FOOT, 3 SURGERIES TO REMOVE HEMAGIOMAS. THIS MORNING I WOKE UP TO FIND A SOFT SQUISHY LUMP ON MY LEFT FOOT NEAR MY ANKLE. I GOT A BIG DOG A FEW DAYS AGO AND HAVE SCRATCHES OVER THE LUMP FROM HIS PAWS. WHAT COULD THIS LUMP BE?",
    "doctor_response": "Hello, It could be infection in the foot caused by dogs paws.it must be investigated. Consult a skin specialist as well. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Nirmal Chander Gupta, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i postpone tooth extraction of a fractured tooth?\n\nI just found out today that I have a fractured/cracked tooth. Tooth is #14. But, I have a trip planned to New York. I have to leave in one day. They checked to see if a root canal was possible and the answer was no. The tooth needs to be extracted. Should I wait until I come back to have it extracted? Will flying cause any problems... air pressure? What should I do?",
    "doctor_response": "Hello and thanks for writing in.I would suggest  you to get it extracted before you leave.yes flying causes change in pressure that can lead to toothache. But take a second opinion whether that tooth (#14) can be saved with RCT or not.Even fractured tooth can be saved these days.If RCT is not at all possible then leaving that tooth like that may spoil your trip.even if you get it removed and stiched properly you can be back to work within 24 hours and can take a flight.Keep some emergency medicine with you.for pain aceclofenac plus paracetamol will help.Hope this answers your query.take careRegardsDr. Shesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe shoulder pain\n\nHi my sister who is 39 went to hospital in january complaining with shoulder pain , after xrays and ct scans she was told she has 4 tumors in liver pancreas lungs bones , she was told its now at stage four and very aggressive , outwardly she looks fine ?? I wanted to book a holiday for her and her 3 kids , but can, t bring myself to ask wat kind of time scale are we dealing with , maybe she knows and is just not saying anything , would you have any idear what time scale we could be looking at ? Palliative team has been in touch ? Thanking you donna",
    "doctor_response": "Hi there.It is possible that the tumor could have metastasised and moved to your shoulder and arm bones. This needs to be ruled out by a thorough examination by an Orthopaedic surgeon and get required investigation like X-ray or Bone scan as necessary. Avoid lifting weights. Apply cold sponging for pain relief. You can take Tramadol + Paracetamol tablet combination for pain relief.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can one manage seizures which either look like epileptic or non-epileptic attacks?\n\nI First had an EEG Between 1982-1983 age 16, I was told i had epilepsy and was under the care of Dr SXXXX until about 1998 were i was placed under the care of Dr CXXXX. During the time under the care of Dr SXXXX i never had any further tests or was not offered any further tests/investigations despite being on medication. During the time under Dr CXXXX Care the last twelve years i never had any further tests or was not offered any further tests/investigations. During this time i have only ever been asked to think about a place in the XXXX Centre, a Neural Implant and brain surgery. It was only recently i had a sleep deprived EEG which was on 23rd February 2011, so in the last 28 years i have never been given or offered any further tests or investigations despite the medication not working i.e.: not controlling my seizures. I last seen Dr CXXXX 6th April 2011 to go over my EEG, he stated it did not show my seizure, he also said that i may not have epilepsy i may have non-epileptic attacks and if i don t have epilepsy then the tablets wont work. should i have been given tests sooner than 28 years",
    "doctor_response": "Hi, There's a lot. It's mostly seeing which one works. A combination medicine called. Keppra is the most commonly used one right now. But the old dilantin and tegretol are quite good. Secondary medicines like gabapentin are cheap, easy to take and further improve epilepsy. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the risk of simple limbal epithelial transplant surgery?\n\nHello doctor, I am a\u00a027 year old male. One year ago, there was a chemical injury to my right eye caused by cement. An amnio graft surgery was done immediately following the injury. Recently, a slit lamp examination, post-dilated examination, and a fundus examination were conducted, and my right eye was diagnosed as 'total LSCD s/p chemical injury' and I was suggested a simple limbal epithelial transplant. Now, is there any possibility to get back my vision in the right eye? Is there a risk to the left eye by doing this transplant? Kindly explain.",
    "doctor_response": "Hello, Welcome to iclinq.com. I read your query and understood your concern. Revert with more information to an eye care\u00a0ophthalmologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I conceive while on yasmin pill?\n\nHi, i'm suffering from pcos from last 8-10 years. i'm prescribed to take Yasmin pill and taking it from more than 5 years now. i'm married and 26 years old. I want to have child now. is there anything specific i need to do toge conceived. i'm 59 kgs and 5'3 tall. please let me know.",
    "doctor_response": "Hi,I read your query and I understand your concerns.Following is my reply:1) If you wish to conceive, please stop Yasmin pills.2) I dont think the pill will have effect after you stop it.Let me know if you have anymore questions.Regards,Dr. Mahesh Koregol",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is elavil sufficient to cure dizziness, light headedness, pressure sensation around sinuses while suffering from panic attacks?\n\nI have been suffering this terrible bouts of dizziness/light headedness since October last year and get head aches as well starting from the back of my head traveling to the forehead and the temple. I feel dizzy day in day out and cannot figure what is causing it. Then I get this heart palpitations when I am driving and feel like I am getting a panic attack because of the fear of having an accident while feeling dizzy. This happens occasionally though. I feel pressure around my sinuses but have been told I don't have sinus problems by the doctor despite the fact that I feel pressure and have clogged nostrils most of the time. I just want to know how to stop the dizziness and have seen a neurologist who has put me on Elavil. I don't seem to get much relief from this. Your advise will be very much appreciated. Thank you",
    "doctor_response": "hithanks for choosing healthcare magicThe kind of symptoms you are explaining in towards anxiety disorder. This dizziness, light headache and pressure around sinus could be part of anxiety disorder. Elavil could help u to relief the symptoms. If you are not getting relief, then u could try other drugs like SSRIs. U can do relaxation exercise that woyld definitely beneficial in your case.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain after the intake of liquor?\n\nThis is odd.  52yr female.  on average 1 drink a week.  no prior symptoms/history.  no meds.  I get chest pain after the first sip of liquor.  cheap booze.  top shelf booze presents no symptoms.  I now watch the bartender to make sure.  I know it is not the alcohol, so it must be something that is removed in the process between cheap and premium liquor.  Any ideas what the trigger might be?????",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Since you are regularly taking alcohol, in my opinion, your chest pain is mostly due to gastritis. But better to get done ecg and 2d echo first to rule out heart diseases. If both are normal then no need to worry for heart diseases. No matter whether it is cheap or premium liquor, gastritis is bound to occur with regular use of alcohol. So better to avoid alcohol. Avoid hot and spicy food. Avoid junk food. Avoid large meals, instead take frequent small meals. Start proton pump inhibitors. Avoid stress and tension, be relax and calm. Don't worry, you will mostly improve with all these. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with Williams syndrome\n\nI have a 23 y/o son, special needs with Williams Syndrome, recent c/o heart hurting , PCP ordered a chest xray, results hyperearation of the lungs, ekg was normal, no hx of smoking, we are a smoke free home, always have been, should I have concern? Is this a sign on early COPD?",
    "doctor_response": "Hi....even in Williams syndrome, without any symptoms of shortness of breath and wheezing and respiratory distress, we need not worry about COPD. 23 years is too early for a COPD. If he is symptomatic then we can consider hyper reactive airways disease than COPD.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for defect in the teeth\n\nI have a molar in the back that has most of the tooth broken off. It is now down to the rim of the tooth. The side that is against my cheek has a some small jagged edges and is starting to rub against the cheek a bit. There is no pain from what is left of the tooth. And as of now the tooth is not rubbing against my cheek enough to cause discomfort. My question is---Can I try to file the small jagged edge?",
    "doctor_response": "Almost everyone faces a dental problem at some point in their lives. Sometimes dental issues are caused by the care you take of your teeth, or lack of, while other times they are caused simply by your heredity. The good news is that advances in dental care have made going to the dentist nearly pain free. Dental problems are never any fun, but most of them can be easily prevented. Brushing twice a day, flossing daily, eating properly and regular dental check ups are essential in preventing dental problems. Educating yourself about common dental problems and their causes can also go a long way in prevention.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes increasing cartilage of neck in fibromyalgia patient?\n\nHello! I am a 46 year old female. Over the past several years I have noticed that my neck cartilage seems to getting larger as I age. Now I notice that my Adams Apple area is larger with more a bulge on the left side. No pain. I am a Fibromyalgia sufferer if that means anything! Should I be concerned. I have had Thyroid bloodwork as recently as about 5 months ago.",
    "doctor_response": "Hello, The fibromyalgia is associated with alternation in chemicals in body. The change in thickness in cartilage can be a comparative issue it can appear to you due to age related comparative decrease in muscle mass. There is no relation between fibromyalgia and this.If it continue to trouble yo then it will be better to have a complete clinical examination for any issues. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mukesh Tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "High eosinophil count. Blood test done. Medication for high count?\n\nHello, I am XXXXXX age 45 and wt 61 kg having eosinophils count 13 please tell me the complications of high eosinophils and its treatment(medicine)",
    "doctor_response": "Dear Concerned., Thanks for writing to us. Briefly,the high eosinophilia could be caused by intestinal worms infestation /allergy to helminthic toxins released by worms/pulmonary/tropical eosinophilia. Due to availability of reports only and no clinical examination courtesy the internet ,the doctors scope is left to D/D or Differential Diagnosis. The eosinophilia in Coastal areas ,in addition to worms could be also due to Filariasis ,the vector spreading the same is mosquito. Meanwhile a Stool microscopy to confirm the presence of Ova and Cysts of Worms and a Midnight Blood Sample for confirming Microfilaria can be done in a recognised Lab. The treatment can be started with Tab Albendazole(Combatrin-A or Zentel) 400 mg at night for 01 day followed by T.Hetrazan (Di Ethyl carbamazine)50 mg PO once -Day 01st day T.Hetrazan 50 mg 02 nd Day and 2  TID/100mg thrice daily for 04 to 14  days and then repeat the  Eosinophil count. The allergic symptomatic treatment can be given with Levo-Cetzine/Cetzine-05 mg BID. The gastrointestinal side effects such as Nausea/Hyperacidity can be kept under check with T.Zinetac300 mg taken before breakfast . Usually the Eosinophilia resolves within 21 days of therapy with Hetrazan at the most and the differential eosinophil count drops to 0-1%. Wishing you a quick recovery. Best regards, Dr Lt Cdr ASN Bhushan, Ex-Indian Navy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for multiple myeloma, high creatinine levels and low hemoglobin\n\nA close friend has multiple myeloma.  He is 34...and has been fighting it for 4 years. He is getting blood and platelets about every other day now...creatinine levels are high...hemoglobin is at 3...and he now has fluid behind his lungs...do people come back from this?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. He has multiple myeloma.  His creatinine level is increased suggest kidney failure due to multiple myeloma.  Hs hemoglobin is very low.  So it is late stage disease with poor prognosis.  Treatment of choice is lenolemide plus dexamethasone.  Or bortezomib is useful in some cases.  Definite treatment is bone marrow transplantation.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach bloating and stabbing pain in lower abdomen?\n\nHi ive been feeling bloated in my stomach for two days now i took a laxative but still feel bloated it feels as stabbing in my lower abdomen i just finished my period about 1 week ago what could it be when i put something warm on it the pain goes away",
    "doctor_response": "Hi. Thanks for your query. The hot pad put on any part of the body takes away the pain by increasing the local circulation and carrying away the substances that cause pain. So the cause can be anything. The bloating is definitely suggests the intestines have a problem, and to top up my the problem you have taken the laxative. This can enhance the problem by its action. I would suggest you the following :Intestinal infections Aerophagia, anxiety and stress Indigestion Intestinal obstruction and so on. Advice :Clinical evaluation and examination, investigations like USG standing X-ray of abdominal to get a diagnosis first and treat accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for cough,sneezing and mucus\n\nHey, I've had a cough for the past 11 days, one that I got on the plane coming back from a trip to Africa. It was on a plane from Casablanca, Morroco to Montreal, Canada. I'm still coughing and sneezing, but it only feels like its muccus down my throat/ in my lungs. Should I be concerned, or is a healthy diet and lots of liquids good enough?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Since you are having recent travel history, possibility of viral upper respiratory tract infection (URTI) is more likely.So drink plenty of fluids orally and keep yourself hydrated. Avoid oily and spicy food. Avoid junk food. Do warm water gargles and steam inhalation 4-5 times a day. Avoid hard to chew food. Take levocetrizine and paracetamol combination twice daily. It is available over the counter. Don't worry, you will be alright with all these.If not improving in 3-4 days then consult doctor.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if baby has breathing issues after drinking milk from mother who has typhoid that relapsed fifth time?\n\nhi sir/mam, my wife is suffering with typhoid for last 2 years every time it is relapse and it is fifth time it has relapsed i have one and seven month daughter and she drinks her mother milk too. just now she is finished antibiotic course yet for last two days she is having breathing problem and not able to get up from bed since our doctor is out of station what must i do to make her re leaf",
    "doctor_response": "Hello, I understand your concern. I shall address the two issues separately.1. Child's breathing problem:I would like to know some more details such as if she has a fever, whether she has fast breathing or just has a blocked nose. Count the number of times she breathes in one minute(count her chest movements in and out for 1 minute). If it is more than 40 per minute, take her to see the baby doctor.How is her feeding? You need not be concerned about her getting typhoid from the mother's breast milk. Typhoid does not spread by breast milk.2. Mother's Typhoid:    I would like to know the antibiotics used for your wife's typhoid treatment and how many days it was given each time. It would help in figuring out why she is having a relapse so many times. Also, is she growing the typhoid organism (S.typhi) in her blood cultures or are they treating her as typhoid based only on the WIDAL test? Kindly enclose the blood test reports if possible. Precautions:1. Mother has to wash her hands well (with soap and water) after going to the toilet, before cooking, before eating and feeding the child as typhoid spreads through feces touching food or water2. Vaccinate your child against Typhoid. A typhoid conjugated vaccine is available which can be given to your childSo please tell whether child has a fever, how her feeding is, if she has fast breathing, your wife's treatment and test reports and we will solve the issue. Hope this helps and they both get better soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain in the rectum and the penis?\n\nHey, I'm 22, male, and not very active. I noticed a sharp pain in my rectum and along the inside of my penis when I was bending over to pick something (light) up. And again in my penis when going poop. I was tested for stds a few months back and have since only been with my girlfriend (who I know is faithful). The pain isn't crippling, but enough to warrent worry. Any ideas? Or to vague to know?",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.These symptoms indicate in most cases prostate issues such as prostatitis or hypertrophy and rarely it may be sign of STD infection. You should  avoid intercourse for till symptoms persist and drink plenty of fluids. If symptoms persist it would be good to do prostate ultrasound and check your PSA levels to rule out prostate tumor or hypertrophy and further treatment depends on these findings. In most cases it can be controlled with medications but sometimes, in case of tumor, open surgery is required. And severe benign hypertrophy may be managed endoscopically so you should consult urologist about appropriate options.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does faster heartbeat through stomach with chest pain mean?\n\nHi, may I answer your health queries right now ?  Please type your query here... I am a 19 year old  female and this has been happening since I was about 12 years old. I noticed my heart beating rapidly one evening, and I looked in the mirror and it was beating through my sternum/stomach area. I get really bad chest pains all the time. My doctor prescribed Nexium last April and sometimes I don't feel anything. Also, I have tightness in my chest and left shoulder. What's wrong with me??",
    "doctor_response": "Hello dearWarm welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This means psychosomatic manifestation of underlying stress or anxiety    issue  though     clinical examination with EKG and 2D Echo is suggested to rule out any     of  the  underlying  issue  regarding  coronary  aspect .Hope this will help you for sure .Wishing  you  fine health ahead .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be worried about a light colored bleeding after taking i-pill?\n\nHi, i had sex with my husband ..we used precaution...but when i checked it was torn off...inside...so i was bit scared as i dnt want to get pregnant right now..i took,i-pill..on the same day..and today..its been 7days m hving bleeding...and its very light colored red..,nt like usual periods...m really tensed..till how many days i will get this bleeding",
    "doctor_response": "Hi,Do not worry. You took I pill on same day and it is highly effective in preventing pregnancy. It has just 0-5% failure rate. But it can cause hormonal imbalance as it contain high progesterone. It cause withdrawal bleeding in most off cases after 7 days. It will go by itself with in 3-5 days. Avoid stress, take healthy diet, drink plenty of water, maintain proper pelvic hygiene and do regular exercise. Hope this may help you. Contact further if follow up needed.Best regards,Dr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a tumor in the stomach?\n\nMy sister has just had a ct scan and a 10cm by 6cm by 4 depth tumor was found in her stomach, there is also nodules in her lungs.  She is 29 and collapsed on holidays.  They are flying her home presently as they will not operate.  What are the chances of it being cancer?",
    "doctor_response": "Upper GI endoscopy guided biopsy is neede for definitive diagnosis.Possibilty of cancer can not be ruled out without endoscopy biopsy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of frequent cough in kids?\n\nHi, may I answer your health queries right now ? Please type your query here...hello I have a girl which is 5 years old and every time the winter or fall comes she starts to cough, she misses school a lot during these seasons I have tried with salbutamol, inhalers and stripes for nasal congestion it works for a while but it is not over. How can I get rid of that? Thanks",
    "doctor_response": "Hello, It can be a lower respiratory tract infection. Other possibilities like allergic cough also be considered. A short course of antibiotics preferably amoxicillin may be given after consulting a general practitioner. Antihistamines like cetrezine can also be given empirically. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain, General & Family physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are vomiting and high fever associated with bacterial infection?\n\nGranddaughter has been vomiting and running high fever since last Friday. Was taken to Dr. this past Mon., he said stomach virus, be ok in a day or so. but she still is not ok. I told daughter I think more is going on and she should go to dr. again. What do you think? maybe bacterial infection instead of regular stomach virus?",
    "doctor_response": "Hi, It might be an abdominal infection, caused by a bacteria or a virus. The viral infection is commoner in the pediatric age group and takes longer to subside. Bacterial infection subsides, once the antibiotics start to act. Give her oral antipyretic paracetamol for fever and do cold sponging. Give a soft diet. Please visit the pediatrician immediately if the fever goes over 101 degrees in spite of all efforts (risk of seizures), if oral intake is severely hampered, there are intractable vomiting s or signs of dehydration are seen. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. AJEET SINGH, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for renal calculi?\n\ni had 2mm of renal calculi at uv junction which caused me a terrible pain and for which i had to get admitted then i was discharged on the same day with some iv fluids and pain killers now i want to know how much time it will require to pass the stone bcoz still i do have some pricking sensation......",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern and I would like to say that it is very uncertain that when the stone comes down in to the bladder you need to drink more water that is the best way to bring down the stone, irritation is not the sign of presence of stone, hope this information helps you. take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the urine smelly and red after having kidney stones blasted from sound waves ?\n\nI just had my kidney stones blasted with I believe sound waves. After 10 days, my urine now smells similar to the spray that a cat uses to mark their territory! Sometimes my urine is also dark red. While my doctor said I might occasionally see red in my urine, she didn t mention the development of this odor. Please advise.",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have undergone Lithotripsy for kidney stone last week and noew have Hematuria and passingsmelly urine.This is common to happen after lithotripsy.Hematuria is due to trivial injury to the kidney by source of energy used for blasting  the stone. This usually gets resolved within a week by drinking more water.As regards smelly urine due to fragmentation or cracks in the stone after blasting it the bacteria concentrated in the nidus (Centre ) of the stone are liberated and they cause infection of the urinary system (UTI) and there are basic constituents of the stone like phosphates,oxalate are freed in urine which becomes  smelly .Both these problems are common after lithotripsy and get cured with taking antibiotics for a week and drinking more water.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the permanent relief for fungal infection?\n\nSir / Madam, I have itching in my private parts... I applied Cosvate G cream while the itching is reduced but it is not giving permanent relief. Even I don t apply for day, the itching starts... After applying for a month now, I see the skin color is changing.... fungus also in the entire area, also white colour spots. What is the permenant relief... Pls help",
    "doctor_response": "Hello, Thank you for your contact to health care magic. I understand your concern. If I am your doctor I suggest you that the cream you used is a steroid cream. It has nor role in curing the fungal infection. It gives only symptomatic relief also long duration of steroid causes skin atrophy. You should use candid ointment one without steroid.I will be happy to answer your further concernYou can contact me. Dr Arun Tank. Infectious disease specialist. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in abdominal area during pregnancy?\n\nI am 28 weeks pregnant and about 2 hours ago I started having lower frontal abdominal cramping, it then went into my lower back, It is now currently all over my back especially the middle over to the right. Its already hard for me to take deep breaths, I was wondering if i should go to the emerg?",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the pain might be due to muscular pain or any preterm pains.The diagnosis is possible only after physical examination to rule out any cervical changes.The preterm pains are intermittent associated with cervical changes.Also any urinary infection should be ruled out.The infections ,dehydration might irritate the uterus leading to preterm pains.Take adequate fluids upto 3 litres per day and consult doctor to know the cause for pain.Tab.panadol can be taken to decrease the pain.Dont worry it subsides with apt treatment.Best regards...,Consultant Gynecologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can low serum creatinine level on blood test be the cause of dizziness and sore throat?\n\nMy daughter is 12years old, 165cm and 48.2 kg. doesn t feel very well since 1 year ago. Dizziness and weakness are the major concern. She is pale, sleeps more than my baby with 11months. Some times she has Stomach ache and sore throat but not every month. The last time a two weeks ago, she went on hospital dizzy, vomiting, headache. The blood results low are: Serum creatinine 56umol/L, RBC 3.90, WBC 4.1, Eosinophils 0.08. In February she went on hospital dizzy . The blood results was a little similar.",
    "doctor_response": "Hello,Thank you for your contact to healthcare magic.I understand your health concern, if I am your doctor I suggest you that dizziness may be because of some electrolyte imbalance. I advice you to do serum electrolyte testing. And if deficiency is found you can deal it with accordingly. I will be happy to answer all your future concern. Thank you,Dr Arun TankInfectious disease specialist.Wish you a best health at health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to check if I am allergic to latex?\n\nHi doctor, I had oral sex with a condom. I got a white dot on the top of the roof as well a lesion in the mouth. I have attached the picture. I believe I am allergic to latex. Is this an allergic reaction? Or what can it be? What can I do to make this go away? It has been like this for two\u00a0days.",
    "doctor_response": "Hi. I have seen the picture you have attached (attachment removed to protect patient identity). Here is how to check if you are allergic to latex. For further information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for high blood pressure?\n\nI ve been on 10mg of Lisinopril for a year and a half with much success. BP has averaged 118-135/78-82. Last week I had an incident of over heating and made a trip to the ER for a stint of IV. The Drs suggested I stay for a stress test,ECG, and Nuclear Images due to my family history of HBP. Ever since my hospital stay, my BP has remained elevated from 135/85-170/100. My Dr increased the Lisinopril from 10mg once a day to 10mg twice a day. My BP is still very high. Concerned!!!",
    "doctor_response": "Hi,BP control is generally tricky most of the times. Well controlled bp can suddenly become uncontrolled.As your doctor has already increased to tab lisinopril to twice daily, i recommend waiting for some time to add other drug as addition of many drugs suddenly can decrease your bp to a critical level. So wait & let the doctor decide about the medicine as per your bp record.ThanksDr Sameer MaheshwariCardiologist, Fortis Hospital",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for severe hair loss?\n\ndear doctor i have hair pain in the front side of my head also i have hair loss in the front and in the middle of my head i am 37 years old the hair loss started since 3 years but the last 6 month  ,hair loss increased too much also the hair pain  did not occur only in this 6 months",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The pain in the scalp could be due to faulty hair tie-ing techniques. Make sure your hair is not held too tight. For hair fall there could be multiple reasons: poor nutrition/stress/lifestyle/hormonal changes/weather changes/hair products which may not be suiting you, etc., to name a few. I suggest you first try and determine what could be the cause of the hair fall. I suggest you also visit the dermatologist/the concerned doctor who will assess and guide you further. In the meantime, start taking multivitamins with biotin daily and work on your nutrition quotient. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Smruti Pevekar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for C shaped rashes on thigh\n\nI just picked up my 2 1/2 years old daughter and the nursery teacher showed me a rash that had developed on he thighs. They are in a C shape and about 3 inches in diameter. She has 3 on one thigh and 1 on the other. She has no fever and is not scratching it either, she seems fine. Im taking her tonight to the night time physician but I am worried. Any preliminary suggestions of what could it be?",
    "doctor_response": "Hi, welcome to HCM. Constant shaped lesion of 3 inch diameter on both legs could be a fungal infection. In my opinion, you should apply antifungal cream like zole-f at the lesions for one week. If you provide some good pictures of the skin lesions, it will help in confirmation of diagnosis. I hope this will help you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in the thumb joint\n\nI had a cortisone shot in my right thumb a year ago for pain and joint problems from being a server at a restaurant carrying food trays and now working in a place where I must lift large baking sheets and my thumb is in pain again and my thumb goes out of joint. Is there any cure for this?Should I wear a brace for it while sleeping?",
    "doctor_response": "Hi Hope this message finds u in good health.I have gone through ur msg and understand your concern.u seem to have tendinitis of thumb, u can take a second cortisone shot.  there is definitly cure for this.  get an mri of thumb to see whats wrong.brace should be worn at work ,then only will it be useful Get back to me for any  FOLLOW UP QUERIES anytime.Take care,God bless.Please click \u201cTHANKS\u201d",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does a persistent BP of 138/98 need immediate medical attention?\n\nhi my husband checked his bloddpressure day before yesterday it was 138/98.he dont have any problem with bloodpresssure before.doctor said that if it is140 then go to emergency.now we r checking it it was still138/98.after i get to know abt his bp i m almost not using salt in my cooking.we changed our total diet plan with healthy food like fruits.we have next appointment on july14.waht i m scaring is is that k if we go on july 14.and do we need to take an extra care.please help me i m scaring alot.he is 27 yrs.height is 6 feet 1 inch and he has some upto almost not sure 15 lbs overweight",
    "doctor_response": "Hi, BP above 140/90 needs further evaluation. But only a single reading of high BP does not make a diagnosis of hypertension. So you should monitor his BP daily to see whether he really has high BP. Reading of 138/98 is definitely high but not alarming. I will advise you to go for certain tests to rule out the cause of high BP. These are KFT (Kidney function test), Thyroid function test, 24hr Urinary VMA and catecholamines and a Renal Doppler. These all tests are important as at his age there are very specific causes of high BP which can be treated. Till then I'll advise minimizing salt in the diet, don't eat junk food and exercise regularly for at least 45 minutes/day. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sameer Maheshwari, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for knee pain\n\nHello Sir, This is Vipul Sharma, from Jaipur. 10 Years ago I met with an accident. My right knee was injured but not factured. Now these days when i started jogging or morning walk, i feel alot of pain in my Knee & unable to walk aswell. Please advise. Thanks",
    "doctor_response": "Hello,It looks that at present you are having pain at your right knee. After ten yrs of good performance if there is pain at your knee then this is most probably not due to old injury. At present this pain can be due to:- Chcondromalacic changes in knee cap bone (especially occur during kneeling down or during down staring)- Due to meniscal tears- Due to ACL OR PCL ligament injury- Due to early arthritic changes at knee I will advise you to consult to your orthopedic doctor who may have complete clinical examination and may advice you an X-ray to rule out pathology. Till then you may have a good analgesic like paracetamol or aceclofenac for relief from pain. You may also apply a knee cap to support your knee.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mukesh Tiwari, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can I take for bacterial infection in my gums?\n\nHello doctor, I have a bacterial infection in my gums because of my wisdom teeth coming in. I have taken Clindamycin and Motrin but it does not work.",
    "doctor_response": "Hello. Gum infection can be due to a number of reasons like tooth infection or cavity, abscess, etc. If Clindamycin is not working, I suggest taking Amoxicillin 500 mg twice daily for five days. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Along with this, start with some warm saline gargles at least five to six times a day for a week. Hope this helps you. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rashes and bumps on face after shaving\n\nEVENING DOCTOR, whenever i am shaved with razor blade i develop some pumbs and rushes on my skin? what could be the cause and what is the solution? i have tried to apply some detergents and bump patrol but as soon as the shaving is with a razor blade it comes up. i dont see it when shaved with machineali",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.In my opinion, you rahes are due to folliculitis. Do not apply detergents as they can cause irritation of skin. Apply Fusidic acid cream on bumps for a week. In case if you do not get any improvement, do consult your dermatologist.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Siva Subramanian.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rashes on the chest, neck, ears and face\n\nI started out with what i thought was heat rash on my neck. got it under control but then sunburned my chest.ears, neck and face. I now have had a really red rash around my nech down my chest where i burned, my ears and face ar also starting to get a rash. Its crust like its oozing. very sore. and sore on my ears and face. it is severly red,swollen,tender and warm to the touch. its very painful",
    "doctor_response": "Hi, I would recommend you to apply topical steroid like Cortisone cream on the affected areas and take antihistaminic like tablet Cetirizine depending on the intensity of itching and soreness. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy watery bubbles during sex?\n\nHi.. am suffering from Herperax..since January..am taking acivir tablets ...but if did sex with my girl am getting that water type of bubbles ....is medicine is working or should I change ...plz help me..when it came to me it is so itching on that spot...",
    "doctor_response": "Hello,As you have herpes, you have to continue tablet Acivir as advised. Along with that apply Acyclovir ointment locally. You can take tablet Brufen after consultation.You should avoid sex till it heals completely as it is a contagious disease. Keep yourself well hydrated and maintain proper hygiene.I will suggest you to review here with detailed history or consult with the dermatologist.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes joints pain, headache, weight gain and leg cramps?\n\nHi my name is julie I ve been haing some health problems for about six years or so they are getting worse my bones hurt constantly I feel very weak and worn ou for no reason I ve gained so much weight got no reason I hardly eat because headaches and not feeling well makes me loose my appetite. I m so cold all the time even in the sun it gets so bd my skin feels like a piece of ice I get leg cramps backaches that are unbearable I feel so old like I can barely walkathon times. It feels like something s inside my body jumping around it hurts so badly. Doctor ran blood test a week ago said she hadn t got results but my vitamin is very very low in my blood what should or can I do. Help me I m miserable ?",
    "doctor_response": "hello madam..symptoms:headache joint pains weight gain and cramps..i want some more details like your age smoking drinking or other addiction history..any previous or recent illness..what all blood tests were done?your hemoglobin and protein levels?blood sugars?it would be helpful for me if you can upload all the reports..head ache at what time of day, duration ?hows your vision?SORRY FOR PUTTING SO MANY QUESTIONS..with loss of appetite i think you are in malnourished and deficient of protein vitamins..yes with malnourishment you gain weight..is your thyroid profile done..that could be the most probable cause..something jumping inside body!!i would need above details to solve the problem..and actually it can be solved..donot worry..if you have something bothering mentally dont hesitate to meet a psychologist/psychiatrist..until then start taking vitamin supplements and a balanced diet (with sufficient protein)we will go further with your reports..hope my answer helps youif you have any more queries i would be happy to answer..",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a bleeding and stinging gum abscess be treated?\n\ni have an abscess on my gum, thats not round, and not spherical, ive been rinsing with warm salt water, peroxide, and crest mouthwash (its purple), today, the abscess started stinging as i rinsed, is that good? i also brush gently on my abscess, it bleeds, is that also good?",
    "doctor_response": "Thanks for your query, i have gone through your query. The bleeding and the abscess could secondary to gum infection. the gingival abscess occurs because of the deposits over the teeth and poor oral hygiene maintenance. Consult a oral physician and get your teeth cleaned and if required the abscess can be drained. you can take a course of antibiotics like doxycycline 100mg (if you are not allergic). Do not apply pressure over the abscess by brushing it will increase in size. Do not use hydrogen peroxide to rinse it burns the tissues. you can use saline to rinse your mouth. i hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly advice regarding management of depression.\n\nHello doctor, I am a student and I feel so depressed nowadays. I cannot bear a bit of stress and I have to watch motivational videos every now and then. I am suffering from a lot of mental pain. I cannot stay happy and I also have exam fear. I cannot sleep when it is exam coming in a few days. My hands start shaking and feel so depressed and tensed. What can I do to be happy and tension free? Please help me.",
    "doctor_response": "Hi. You seem to be suffering from anxiety and depression. This is a common problem in the general population. I would advise you to seek professional help. It does not seem to be getting better, instead, it is worsening. Do not be alone, share your feelings with some close friends or family members, make a schedule. If nothing seems to be helping, you can always connect with me. I would be happy to help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could teething in an infant cause loose, foul smelling stools with cough and red cheeks?\n\nHi my 9 month old baby has been having loose stools for about a week now they vary in colour but are foul smelling and have become very mucusy. Sometimes the nappy is full others only slight amount. He has a runny nose and cough with red cheeks could teething cause this?",
    "doctor_response": "Hi,Thanks and welcome to healthcare magic.Teething per se does not cause diarrhea .But the child puts every thing in his mouth during the teething period.This will cause diarrhea .Runny nose ,cough and red cheeks due to viral infection and has nothing to do with teething.Hope this answer serves your purpose Please feel free to ask further queries if any.Dr.M.V.Subrahmanyam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest the usage of lupigest 200 pill and its effects\n\nHi All, I am in my 7th week with no periods and urine test is showing negetive ..did meet the doctor was adv to take Lupigest 200 do i have to insert this or take it as a pill? if so y is it taken for ..can i still be pregnanat even after taking this pill please answer",
    "doctor_response": "Hallow Dear,Since at 7 weeks amenorrhoea, your pregnancy test is negative, you are not pregnant. Lupigest 200 is a progesterone preparation. When there is no pregnancy, this medicine when take for 5 days, gets withdrawal bleeding within 4-7 days. So this medicine is given to you to get your menses. These tablets or capsules are to be taken orally. Take the pills for 5 days and then discontinue to get menses. I hope this helps you. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on testicle\n\nhi , im 13 , african american and im going through puberty and i have a small lump in my right testical and i've had it from the last year at the end of the school smester .. im uncircumsized .. i masturbate alot and im scared to tell my parent about the lump .. it doesnt hurt , but i get s sort of sharp pains in my lower abdomen , my back hurts sometimes and my chest is growing more than my male peers .. i really hope its not cancer",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some cyst, abscess, infection or malignancy.  You should go for ultrasound study.  Don't afraid of telling it to your parents.  It has no relation with masturbation.  You need investigation and treatment. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bump on back\n\nHello. I have a quarter size bump on my back. It s hard and red...similar to a pimple. I squeezed it and a smelly puss and some blood came out. After touching it for a while it starts to hurt. How can I treat this? I thought it was a pimple but I don t think it is anymore",
    "doctor_response": "Hi,Thanks for your query. After going through your query I came to know that you may be having infected sebaceous cyst . Treatment of it is analgesic such as diclofenac and antibiotics. Vitamin B and C will help in promoting healing. If it is not healed by it then excisional biopsy of it can be carried out which will exclude other affections. You can discuss with your treating Doctor about it. I do hope that you have found something helpful. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bad body odor in children?\n\nmy 7 year old daughter really smells by the end of the day-i think it s from her genital area- from smelly knickers due to perhaps not wiping herself well but it permeates through her pores and I m concerned as I don t want other children to notice. She has a bath every night. Could it be just poor body hygiene or also diet or hormone related?",
    "doctor_response": "Hi, We need to consider certain inborn errors and metabolism here and a good screening test would be - Urine test for IEM screening please. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes increased pulse rate?\n\nHi I'm a 28yr old Female. Weigh about 219, 62inches . I checked my pulse rate and it is 109bpm, I smoke pot every so often and last two times I've checked it, it has been beating really hard. As if it wants to burst., is this something to be concerned about or does the marijuana has a significant part in relation to the heavy beating?",
    "doctor_response": "Hi,This is Dr Sameer, cardiologist.Increased heart rate & palpitations can have a lot of causes.It can be normal sinus tachycardia due to anxiety or stress or it could be abnormal supra ventricular tachycardia. For the diagnosis, you need to do ECG at the time of palpitation & tachycardia. If the duration of palpitations are short enough to reach a nearby hospital, we put a 24hr ECG monitoring (Holter Monitor). You also need to do a 2D Echo & thyroid function test to see for any associated abnormality if any.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower abdominal pain?\n\nI am having pain in my uterus an lower abdominal area. It feels like its stretching or pulling something when I take deep breaths or bend. I am not pregnant that I am aware of yet I havent had a period in a month in a half. That's usually normal for me to not get them all the time. Plus i have changed my diet.",
    "doctor_response": "Get your urine pregnancy test done to rule out pregnancy. The pain most probably is due to spasm. It will get relieved by taking Tan Buscopan twice a day.Also i would advise you to have an ultrasound done and get a gynecologist opinion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat pain in tailbone?\n\nWell it started after having sex and hearing my tailbone pop while I tightened my legs and hips during ejaculation. No problems for a while but now I m having pretty bad tailbone pain. It mostly hurts when I stand up. Sitting isn t a problem or standing, just the act of standing up. Any thoughts?",
    "doctor_response": "Hi there, thanks for your question. Tail bone pain is classically present on sitting , since mazum pressure is felt by the bone in this posture. In fact it is quite un usual to have tail bone pain only on standing or during the qct of standing. It would suggest some dynamic instability or manifestation around the tail bone.I would suggest you to get an X Ray  to rule out any fracture around your tail bone.Hope this helps. All the best.  Regards Dr.SBK",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this liver ultrasound test result indicate?\n\nI m a 62 year old female, 5 6 and 150 lbs. I had a recent liver ultrasound and the impression is: Slight coarsening of the hepatic echotexture without intrahepatic biliary ductal dilatation or mass. I was diagnosed with Stage 2, Primary Biliary Cirrhosis about 12 years ago. I m taking Ursodiol and my liver function tests were in the normal range in January. I also have Scleroderma, Sjogrens, Raynauds, GERD and Osteoporosis. I eat a low fat, gluten-free and dairy-free diet, and very rarely have a glass of wine. When researching on-line, it appears the coarsening could be related to fatty liver or cirrhosis. What do the results appear to indicate?",
    "doctor_response": "Hello, As per your history you have already been diagnosed with Primary Biliary Cirrhosis (on ursodiol) and a number of other autoimmune disorders (like Sjogren's, Scleroderma etc). GERD can occur as a result of Scleroderma. PBC is a known cause for chronic liver disease which causes coarse hepatic echotexture on USG. You would need to monitor the liver function tests including INR levels. I would suggest you to discuss with your gastroenterologist regarding a Transient Hepatic Elastography which can indicate the degree of liver fibrosis and damage. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Ayusmati Thakur",
    "dialogue_context": ""
  },
  {
    "patient_message": "Missed taking loette for one day. Will this cause pregnancy?\n\nHi, I've been on Loette for a bit over a year and I realised the other day that I had missed one of my pink tablets and I just skipped it since I couldn't remember not taking it. I only waited 6 days not 7 of continuously taking the pill before having sex with my boyfriend and my period is now 6 days late and I'm quite worried even though I know the chance of me being pregnant is quite unlikely. Should I take a pregnancy test or has my period just been skipped?  I'm almost on medication for miagranes but I've continuously taken that and haven't had any problems. Thank you!",
    "doctor_response": "Hi and thanks for the query, as you rightly put it, it is very unlikely that it should be a pregnancy. The chances are low but nor impossible however. Missed periods in young females of reproductive age is not a rare phenomenon. But I suggest you get a pregnancy test done. I do not think that the migraine medication has actually interfered in anything, considering the fact its never really done so i the past. Exclude a pregnancy and regularize more your birth control medication. Thanks and best regards, Luchuo, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes 13 year old to have lack of interest in  masturbation?\n\nI am aware of a 13 year old boy who is developing well and into hispuberty but has a mental blockage about masturbation. He is adamant that he will never \"do it\" even after demonstrations by his friends. He describes the practice as \"stupid\"and wont be persuaded by argument that it is a quite normal and will not harm him. Does he have a problem ?",
    "doctor_response": "Hi, I can understand your concern for your symptoms, It can be due to testosterone and thyroid deficiency. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Smelling bad. History of sinus, taking prevacid, atacand, inhale albos oil. Whom should i consult?\n\nhi for months now i have been smelling a chemical fume i thought it was my home heater but now i realized i am the only one smelling it and its with me every where i take prevacid for years now i also take atacand daily i have sinus problems so i inhale albos oil all the time whisch specialist can i go to to check this out ? what seems to be happening",
    "doctor_response": "these are allergic sinuseswhen there is infection in sinuses it smells like thatadd metronidazole 200 mg bd for 10 days to counter it as metronidazole  is fastest clearing agent for sinusestake montelucast 10 mg cdand continue othersapply neomycin h eye ointment in nose bdsea  water drops 2 drops nightdo 3 wkxray pns water view required and then cosult doctor for curing sinuses permanently",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is the bump in my belly button full of puss?\n\nI took my belly button ring out over a month or two ago, and it healed i didnt have any problems and i put soap and styff over it, today i was taking a bath and i noticed a bump, i picked at it, and puss came out i was wondering if it is infected or is it normal?",
    "doctor_response": "Hi,It seems that due to applying belly button ring there might spread of infection deep into belly button producing pus.Consult your doctor and clean the inside wound properly and apply antibiotic cream.Go for one antibiotic medicine course for 3-5 days.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a fainting spell with eyes open?\n\nhi my name is anonymous, i am 21 years old, am 85 kilograms and 1.75m tall, i am on no medication, i am a vegeterian-for 3 months now, i have no chronic ailments and am fit and in good shape although i smoke cigarettes, i have recently been on a health binge to purge my system of toxins,(no drinking or narcotics). Yesterday i was out with friends celebrating my friends birthday, i drank whiskey-3/4 of a bottle, tequila-1 shot, 2 beers, i then proceeded with my friends to get pizza at a corner store, i ordered a pizza then went outside and asked a friend for a drag of his cigarette( it turned out later that it was a substance called mr nice guy), i took a puff then went back inside, i began speaking to a friend, then everything began to slow down in my mind, my speech slowed to point of me not being able to speak, i turned to the pizza man and then blackness, with a feeling of euphoria and utter terror mixed into one, which felt like 3 seconds, i then woke up on a chair surrounded by my friends telling me that it is going to be ok, apparently what had happened is that the pizza man saw all colour disappear from my face, i stopped speaking and stared at a fixed point, i was completely unresponsive, my heart was moving at an abnormal pace, i then fainted, but my eyes remained open the whole time, my friends then put me on a chair and i was unresponsive for 20 minutes in real time, but in my mind only 3 seconds had passed, i then regained consciousness and began to speak slowly, i felt completely sapped of energy as if i had been drained, i could not speak and was unable to focus on anything. It was the scariest thing that has ever happened to me, i managed to walk home and pass out but, today i have an incredible headache. My question is this, how did i faint with my eyes open? why did there seem to be so short a time in my head and yet i lose 20 minutes of my life? and finally, what damage have i done to my mind? please help me",
    "doctor_response": "Hi,You had a sudden transient loss of consciousness also known as Syncope. Patients like you who are considered healthy, young, with no previous medical conditions, and with the first single episode of syncope usually don't need to worry or any further investigations. However, to be on the safe side it is better if you could visit your family doctor to get a physical exam and an ECG to rule out heart conditions.Also, he or she might ask for blood test for anemia since you changed your diet lately to vegetarian diet you might be at risk of B12 deficiency and or iron anemia. Moreover, it is advisable to avoid alcohol, smoking, or any substance abuse as this might provoke syncope attacks.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Ahmad Nazzal, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Thoracic radiculopathy feeling of muscles drawing in tightly in upper stomach\n\nthoracic radiculopathy feeling of muscles drawing in tightly in upper stomach Can someone experience a feeling of muscles drawing inward in the abdomen/upper area of stomach if they have thoracic radiculopathy and can this affect breathing by affecting the diaphragm",
    "doctor_response": "Hi welcome to Healthcaremagic hi..., Thoraci Radiculopathy is a rare disorder, in which the nerve roots at the exit of the vertebra will be compressed due to pressure.... The cause may be due to lesions in the intramedullary region or extramedullary region.., only if the pressure is released you will have relief from pain.. Decompression surgery is needed.., consult neurosurgery... Hope I have answered your question.. Takecare..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes left leg pain, painfully swollen knee and tight calf muscles in a diabetic?\n\nI am 66 & recently diagnosed with Type II diabetes. My left leg is very painful when I get up or walk. Tight muscle in calf. Knee is swollen, painful, and unstabale. Same leg upper inner thigh feels like a muscle pulled. Painful when entering or exciting car.",
    "doctor_response": "Hello, Pain may be due to peripheral vascular disease or cellulitis or calf muscle spasm or compartmental syndrome etc. Until examination is done it is difficult to say what it is. Please elevate the limb, use cold and warm compression, use painkiller medication. If symptoms not improved please consult your doctor he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking seasonale birth control. Will i get my period if i stop taking the pill?\n\nHi Dr. Grief. I am currently taking Seasonale birth control . I was wondering if it would be ok/safe to not take the last week of my active pills in order to get my period one week sooner. I am going on vacation and of course that is the week im scheduled to get my period. Im not trying to skip my period, but just to get it sooner. What do you think? A C",
    "doctor_response": "HI, thanks for using healthcare magicYou can consider doing this (stopping early) or you can continue into the next pack to prevent to period from occurring. In addition, there is a medication called norethisterone that is used to delay periods. It is taken 3 to 4 days prior to the onset of the period and continued for up to 2 weeks or until you wish to have your period.You can discuss these options with your doctor to find out which would best suit you.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "On Microgynon 30 last pack, started diarhea, will come off the pill. Light periods. Why ?\n\nI was on microginon 30 n finished my last pill packet saturday last week! during my last pill packet I had diarreah for about 10 days! Myself n my partner decided that that pill packet would be my last n I will come off to start trying for a baby! I came on my period Thursday n today I have finished! My period is a lot lighter and normally lasts for 6-7 days! I started taking folic acid vitamin tablets Friday could this be why my period is so light and different?",
    "doctor_response": "Hi,Thanks for the query.After stopping the pills you will get withdrawal bleeding only instead of normal menstrual flow.And the withdrawal bleeding can be lighter compared with normal menstrual flow.Folic acid and vitamin tablets usually will not affect the menstrual flow.After stopping the pills it will take some time for regularization of the periods.Once your cycles become regularize you track your ovulation and plan intercourse around that period, which will increase the possibility of pregnancy.Refer: more details you can ask me through:  care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for phlegm and loss of appetite in infants\n\nHello Doctor, I have a 10 month old baby and he s got phlegm. He isn t eating his meals or even drinking his milk. He vomited 3 times already since last night. And he had a slight fever for the past two days. Now there s no fever but he s having a bad cough and he s not eating anything. Is yoghurt alright to feed? Pls advice",
    "doctor_response": "himost common cause for 10 month old child is having respiratory illnesses are viruses difficult in feeding might be due to nasal block check out that bad cough might worse on day 5,6 and it ll gradually come down later so no need to panic need to put some nasal drops 10 minutes before each feed no harm in giving yogurt but avoid cool items",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should we switch formula milk due to pain and loose stools in an infant?\n\nmy baby ( 6 days old) is not getting his mother milk hence doctor suggested Lactogen 1 but baby is suffering with liquid loilet and probably stomac pain every time we feed him with lactogen. should we change to NAN 1 or Biomil? need your urgent openion earliest. I am from bangladesh.",
    "doctor_response": "Hi,Welcome to Hcm,There is no urgent need to do that. Lactogen is good enough as long as baby is liking it. Loose stools can happen if unhygiene method used to prepare feed. That needs to be avoided. Be as hygiene as possoble while preparing and feeding him. Stomach pain which you think is happening is actually gaseous distension and can be prevented by burping adequately after feed. May your child gave great health. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes left ventricular hypertrophy, retinal hemorrhages and polyuria?\n\nA 5 6 , 210 lb., 64-year-old male business executive had a physical exam prior to his retirement from corporate work. His blood pressure was 180/115 on three separate days. Further examination showed normal to low plasma renin activity, elevated total peripheral resistance (TPR), cardiac output (CO) of 7.2 L/min, x-ray evidence of left ventricular hypertrophy, retinal hemorrhages, and mild polyuria. Recommended therapy was weight reduction to his ideal level, a low-salt diet ( 2 gm/day sodium), prudent exercise, and a reduction in alcohol consumption ( 3 oz whiskey/day). This change in lifestyle did little to change the condition. Medication was initiated in the form of an oral diuretic and progressed to a beta-blocker; eventually a vasodilator was included to reduce the blood pressure to 140/90. 1. What is the diagnosis for this individual?",
    "doctor_response": "Hello, After going through your medical query I understand your concern and I would like to tell you that all his symptoms are age-related and acquired hypertension for which his physician is giving him stepwise treatment. It's recommended for him to be in the follow up with his physician to maintain healthy blood pressure. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take sizodon & nexito for depression?\n\nHai doctor , I'm taking sizodon 0.5mg and nexito 10mg , I had two attacks of depression while I was studying  , first one 6 yrs back and other 2 yrs back , l was studious nd used to get up early in the morning for studies , bt after this event I lost the drive to get up early and infact lost the drive for anything .but some how I managed to get through my pg entrance exam nd I'm doing ophthalmology pg , bt I'm afraid will I I be able to cope up with the hectic schedule here",
    "doctor_response": "Hi,It seems that you are suffering from recurrent depressive disorder and are suffering from depressive symptoms even at present. Nexito (escitalopram) is an effective treatment for depression. Had I been your treating psychiatrist, considering your current state, I would have increased the dose of escitalopram gradually to 20 mg/ day. I am not sure about why you had been put on sizodon (risperidon). I don't see its need as of now.I would also recommend to continue escitalopram at complete dose (without reducing) for a few years, since you are suffering from recurrent depression. that will help in reducing chances of further episodes.All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes muscle pain with red itchy bumps?\n\nYesterday my left arm muscles started to ache. Today a small skin-colored bump formed in the aching area and started itching like crazy. I assumed it was a bug bite, however I normally don t get muscle aches with bug bites. Should I seek medical treatment? My doctor s office is closed for the weekend.",
    "doctor_response": "Hello, As first line management, you can take analgesics like Paracetamol or Aceclofenac for pain relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "what is the cause for intracranial pressure type sensation?\n\nHello. Three days ago I had a bout of what I believe was food poisoning, as five others who attended the same event as me got severe nausea two days later. I recovered almost completely within 24 hours but ever since I have had a weird intracranial pressure-type sensation that turns painful when I move my head up from a lower point (stand upright after bending down, stand up from a seated position etc.) I have been drinking LOTS water and electrolyte drinks and don't feel dehydrated. Is this a normal symptom or should I go to a doctor? I worry a bit as I did have a brain abscess from an infection many years ago and while I know I am no more likely to get a reoccurrence  than anyone else, the similar pressure sensation makes me nervous! However I don't want to rush off to the doctor if it is a common part of recovery from food poisoning.",
    "doctor_response": "Hello!Welcome on Healthcaremagic!Your symptoms could be related to orthostatic hypotension, which is a common complication of dehydration during food poisoning. For this reason, I recommend monitoring your blood pressure in sitting and standing up position. In case your blood pressure values drop more than 20mm Hg during standing up position, compared to sitting position, it would indicate possible orthostatic hypotension. In such case, I would recommend taking plenty of fluids and have some rest. Increasing salt intake would also help. If these symptoms persist and your blood pressure doesn't drop during standing up position, I would recommend consulting with your neurologist and performing a brain MRI to check for intracranial hypotension. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does hormonal imbalance affect conception?\n\nSir, I got married two years before. when i was newly married after two months i had taken ipill tablet from market. after this my periods came irragularly. thereafter I was trying to conceive with docter's advice. they gave me Hsg inj. and follicular study etc. but no result found about pregency. Now, AMH, FSH, LH tests are done and find imbalance of these hormons. AMH (.56), FSH^, LH (normal). these blood tests have been done after taking a tablet ovanac. one year before these test already done that time my test report was OK. Kindly suggest me for taking right decision.",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.Normal lh/fsh ratio should be 1:1, if greater than this it should be investigated. It may happen in pcod polycystic ovarian disease.I would advise to do ultra sound for follicular study and consult gynecologist.Hope I answered your question.Feel free for further queries.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the sperm analysis regarding sperm count indicate?\n\nMy husband got the following SA done and these were his results:abstinence 2 days (outside normal ref) ph 8.7, volume 4.2 concentration 14, total sperm 59, progressive motility 64, non progressive motility 4, total motility at room temp 68%, immotile 38%, normal spermatozoa 7, leucoytes 0.0, germ cells 0. Comments??",
    "doctor_response": "Hello,Ideally semen abstinence should be for three days. However your mentioned sperm count, motility and morphology seems to be within range. The motility should be at least 40% active motility in normal semen sample which is 64% here. You may need not to worry about semen analysis report.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can thigh pain be related to back pain?\n\nI recently had spasms in my lower back that caused pain in my thigh, front side. I took muscle relaxers and the back pain subsided. I now have really bad pain in the front of my thigh that is extremely painful to touch. The pain keeps me awake at night. Is this related to the back pain or something else.",
    "doctor_response": "Hello I have studied your case Due to compresion of nerve root in back there can be radicular pain in your thigh. I will advise to do MRI spine to see for disc bulge. Neurotropic medication can help to reduce symptoms. Physiotherapy will help to get pain relief. Wish you good health Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe hip and back pain during 34th week of pregnancy?\n\nHi my name is Elise. I am 34 weeks pregnant. And I'm having severe hip pain back pain and some times my back will feel sore. I'm also having cramping like pains in lower abdomen. I'm getting nausea vomiting alot for the last week. And now my belly is feeling weird can you tell me why.",
    "doctor_response": "Hi,    Thanks for your query.    I understand your concern.    In pregnancy, pelvic & hip joint ligaments get softened, being stretched due to growing fetus back ache & some times hip joint pain becomes a common feature in pregnancy/.Gravitational change in posture add to it ( body tends to fall forwards due to growing fetus , the line of gravity tends to deviate in front..while back muscles try to pull the body back & keep balance )/ Calcium & vitamin D deficiency add to the problem by making the bones weak.   In later months of pregnancy abdomen bulges, most of it is occupied by fetus. So the intestinal coils have to adjust in small space with lots of loops/ kinks / also pregnancy hormones make intestinal movements sluggish. This in all hampers digestion. causes indigestion,re3gurgitation of food/ vomiting ,/ with abdominal discomfort & pain.      All of these3 can be managed well by life style changes in pregnancy.   Thanks..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have severe constipation and bloating problem, with slight vaginal bleeding. Please help.\n\nHello doctor, I am a 22 year old female, and I have been experiencing major constipation from the last month.\u00a0Every time I eat, I experience bloating, and I am unable to go to the toilet later on. Have tried taking Sennetabs,\u00a0Metamucil, increasing fiber, and water in the\u00a0diet. I have this problem approximately five days a week. I have also been getting abdominal pains, and four days ago I had a light vaginal blood discharge for two days. I am taking tablet Estelle from a very long time, I am still taking it, so this would not have been my periods. I do not have any weight issues. I also get quite a bit of walking done in my job, so I am not sitting down all day long.",
    "doctor_response": "Hello. I would need a little bit more history, Revert with more information to an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could pain in sternum with severe cough and asthma be?\n\nI was coughing for the past month and have asthma like attack when I wake up coughing at night. A Dr told me that I might have walking pneumonia and gave me some antibiotics. Towards the end of my cough the left side of my rib started to hurt (about two weeks ago). I had that side of my rib injured before (hairline fracture). Which I think may be a reinjury of some sort due to excessive coughing, however, in the past week this pain had traveled from my left side and extend to my right side also. However, the right side pain is more towards the sternum. I don t feel extensive pain going about my day, just have a hard time getting up in the morning when it hurts the most, and when I have any residual cough. Not sure what is wrong with me, and are there thing I can do to get better?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, possibility of bronchitis is more. Bronchitis is inflammation of airways. It can cause excessive coughing, asthma like attacks, chest pain on coughing etc. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT will not only diagnose bronchitis but it will also tell you about severity of the disease and treatment is based on severity only. You will mostly improve with inhaled bronchodilators and inhaled corticosteroid (ICS). Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore and swollen gums after taking antibiotics?\n\nI take lisinopril for high blood pressure along with Verapamil.  My doctor took me off Verapamil and increase the dosage of lisinopril to 2 pills/day.  Since this was done 3 weeks ago, my gums have been sore, red and swollen. I have tried rinses, extra flossing, not helping.  Is this a side effect of lisinopril?  54 yrs old, 5'7' 210lbs",
    "doctor_response": "HiThanks for writing in.It could be due to poor oral hygiene.You need to go for scaling.Maintain proper oral hygiene by regular brushing & flossing.Consult your dentist for further treatment plan.RegardsDr. Neha Sumra",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stiff neck and pain behind ears after hitting\n\nHello, My son whom is 9 years old was playing and fell and hit his head behind the ear (ear bone). He has some swelling but says that it hurts only when you touch it...He has a stiff neck a bit but he can turn it. This happened on Friday afternoon. We are concerned as its still hurting him and we want to make sure everything is okay. Please Advise....",
    "doctor_response": "Hi..this seems to be a trivial trauma of the head and neck region with a mild sprain. Unless he is having vomiting continuously, Seizures, Watery of bloody discharge from ears and nose, Unconsciousness, Altered sensorium or behavior, you need not worry. You can use Ibuprofen for pain relief and if not getting better, consult your pediatrician.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does swelling, mild pain, and stiffness in my left knee mean?\n\nHi. I was in an accident on my moped last sunday. I wiped out while traveling on a road with loose gravel. I landed hard on my left knee cap. Now I have swelling, mild pain, and stiffness in my left knee. Can you tell me if this may mean I tore a ligament or fractured a bone? How long do you think it would take the swelling to go down?",
    "doctor_response": "Hello, As far as I understand the history, it appears to be a ligament strain. Please use the crepe bandage or knee brace while walking for a few days. As ligament strain might take some time to heal. You can even use hot water fermentation to relax the knee joint. With some basic exercise, you should get some good strength and a good range of motion at the knee joint. In case, for a week or so if the symptoms don't subside then you may have to take an MRI to understand the extent of the ligament injury. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic live disease and portal hypertension?\n\nGood Morning to you all, This is re-my mom, diagnosed four years since,with chronic liver disease and portal hypertension,Spleen enlarged to about 15.9cms,gall bladder epidematous,both kidneys are normal,pancreas are normal,intra hepatic vascular bilary radicals are normal ,portal vein patent,no evidence of focal leisions in the parenchyma,Liver apprears hyperechoic and coarse with irregular surface.Span: 10.9cms, ascites.At times irrevlevant talks. Like to have enough of food but unable.At preset admitted to a hospital just a day before. Already on im inj.maxipime antobiotics. I would like to have your good advice on this subject.Anything to do in medical sciences?",
    "doctor_response": "Hi,I am so sorry to hear about your Mom. Your mom is presenting with features of Liver cirrhosis and portal hypertension with hepatic encephalopathy (ire-relevant talk). Liver cirrhosis is divided into two stages clinically 1. Compensated - where the patient has cirrhosis but absolutely no symptoms and 2. De-compensated - (your Mother) where symptoms of liver disease begin to appear - like jaundice, ascites (fluid in the belly), vairceal bleed (vomitting blood) or hepatic encephalopathy (irrelevant talk, sleepiness). Most patients with early decompensated cirrhosis can be managed with medications which includes blood pressure pills to prevent bleeding, water pills to prevent fluid accumulation and lactulose to prevent encephalopathy. But as liver disease progresses, it becomes more and more difficult to manage the symptoms and at this stage the best option would be to proceed with a liver transplant. This will not only remove all problems associated with the cirrhotic liver, but also replace it with a new healthy one. Ofcourse Liver transplant is not offered to everyone and will depend on multiple factors like age of the patient, cause of liver cirrhosis, social support of the family and so on. Hope this helps and please do not hesitate to contact me for further details - rxsuresh@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could an elevation on skull indicate, X-ray found no abnormalities?\n\nhi doctor..please answer me....my sister has an elevation on the parial bone of her skull.and she took an x-ray also it is appear.but she doesnot have any symptom like head ache or something like that.is there any dangarous of having cancer...with my best regards",
    "doctor_response": "Hello, A simple X-ray is not the best tool to examine her brain and skull. For this reason, I would recommend performing a brain MRI in order to put your mind at peace. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of my pregnancy?\n\nhi i am on 13 th day of my cycle ,did my transvaginal and the dr told that on the left ovary a follicle of 17mm has developed . i am on second try with hormonal stimulation taking clomophene and puregon shot. today puregon shot is over but i have cycst in rt ovary and 2 or 3 small follicles developed in the rt ovary ...r there any chance to conceive this month",
    "doctor_response": "Hallow Dear,You may get injection of hCG now to cause ovulation. Ovulation of the follicle of 18 mm size has got good results for successful pregnancy. Then you should utilize next few days for trying conception. Along with, they must have mentioned the endometrial thickness. 10 mm or more thick endometrium is ideal for implantation of pregnancy. Hope this helps you. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest better treatment options for anti-HCV patients\n\nHi I am Nurul Haque from Bangladesh, my wife Ms. Nasrina Haque is suffering for the following, pls give me a better suggestion:-Investigation : Anti-HCV Patient Value : 2.536 Cut-off Value : 0.155 Interpretation: Positive (23)Method: ELISA Treatment : Injection-Peginterferon alfa & Epoetin Beta",
    "doctor_response": "Hi welcome to health care magic... You are strongly positive for hcv as per your ELISA report... For that you are given anti viral medication to suppress viral load... Take more fruits and less fried food.. Take rest.... Green leafy vegetables,  sugar cane juice,  apple,  avocados are good for your condition. Avoid alcohol... You can take one tsp crushed  carom and cumin seed with water daily... Regular follow up done in your case to look for chronic case... Take care Hope this will helpConsult gastroenterologist for examination...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reddish rashes under the breast, abdomen getting bigger in size. No pain or itching. What are these?\n\nHello. I am a sixteen year old female and I've been experiencing a red rash of some sort on my skin for the past year and a half about. It began as a small light red circle on the underside of my breast, and slowly over the past year and a half has been spreading. Now there are many smaller ones about the size of between a pencil eraser and a dime across my upper stomach, and the one on my breast has gotten much larger. There is no pain, itching, and it is not raised (you cannot feel them), but I would like to get rid of it and I was wondering if it could be a symptom to anything more serious (even though I've had basically no health issues since I've gotten them). Thank you!",
    "doctor_response": "Hi, welcome to HCM.It seems that you are having superficial fungal infection .. Tinea versicolo,also known as pityriasis versicolor. It is caused by malassezia furfur.It resides on scalp.It spreads in superficial layers of skin and disturbs the color.Anti fungal ... Itraconazole,fluconazole, ketoconazole will cure the disease.Cream of ketoconazole, miconazole,clotrimazole may be applied.Shampoo containing ketoconazole may be used.Avoid soap bath., use dettol liquid for bath.Have healthy food, good sleep to improve immunity.I hope you will be benefitted...Regads,Dr. Ilyas Patel MD,DVD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Which disease is associated with dry cough and high eosinophils in kids?\n\nHello doctor, My daughter is 8 years old and she is having dry cough since last two months and sometimes she complains of stomach ache in a month. I got the blood test done yesterday and in the report, she had eosinophils high, that is, 8.7 % and the absolute eosinophils count is 59000/microliter of blood. Other findings are neutrophils 36.5 %, lymphocytes absolute count is 343000/microliter of blood. Monocytes absolute counts is 28000, and more. Kindly let us know what is the disease likely to be and treatment for that disease and precaution of the same.",
    "doctor_response": "Hi. Your daughter has hyperreactive airways and she is allergic. And reports show that she has a tendency towards asthma. I suggest you put her on Fluticasone puff and Levolin (Levosalbutamol) as a reliever. Consult your specialist doctor, discuss with him or her and take the medicines with their consent. I suggest please go visit a general pediatrician or a pulmonologist - they will explain to you the inhaler therapy and months to continue it. She will be fine once she takes the therapy. But there is nothing much to panic. Just wanted to ask if there is any other history in the family and has your daughter had seasonal attacks of cold and cough in the past. All these suggest her tendency for asthma. For more information consult a paediatrician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure erectile dysfunction?\n\nhi i am 26yr old married man. We have been in to marriage for about 6 months now. we have had a great sex life for the 1st 3-4 months but recently i am experiencing a fear of wether i would have an erection or not due to failures at certain instance. could you please suggest me a way to et out of this fear so that i can again start havning a normal sexual life?",
    "doctor_response": "Hi, You should take rest from sexual activity for 1 or 2 weeks. Meanwhile try to forget about that few episode when erection not achieved. It's quite normal and sometime during stress time you might not achieve erection. So don't worry about that. You can practice more foreplay to achieve hard erection. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "I get my stomach loose, I am not able to put on weight.Pleasse help\n\nI get my stomach loose after every 5-6 days from the past 10-15 years but sometimes its ok for even 20 days but there is a problem in intestines. I got my colnoscopy test which is normal and shows H-pylori positive. I dont know where is the real problem . My weight is constant 53 kgs at the age of 33 and its same from the past five years. due to motions I am not able to put on weight.Pleasse help",
    "doctor_response": "Tips for diarrhoea  Keep a good hygiene, regular hand wash, hygienic food intake Drink plenty of water Take 2 banana with curd every night before sleep Avoid spicy and greasy food",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does soreness in the jaw indicate?\n\nI just got over the flu, mostly. My right bottom jaw, or really the alveolar surface that slopes up behind where my wisdom tooth used to be, is incredibly sore. not TMJ, not hurting on that joint. other side does not hurt. this started, or I noticed it Friday night when I rushed my teeth and the brush head hit the back bone. (it was sore before this, but I realized now how sore it was)  never had this previously, not sure what it is. no current tooth issues. almost feels like I'm erupting new tooth! any ideas?",
    "doctor_response": "Hello,It can be either due to inflammation of the soft tissue, due to injury caused by the toothbrush or as you had recently been through flu, it can also be due to swollen lymph nodes that can take time to get better even after infection subsides. So my suggestion is to consult an oral physician and get evaluated a clinical examination, and if needed an x-ray can help in confirmation. For now you a do warm saline gargles, with a specialized mouthwash like Magic Mouthwash and also take anti-inflammatory painkillers like Ibuprofen.Hope I have answered your query. Let me know if I can assist you further.Regards,    Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My second anomaly scan shows two markers for DS. Is there a need to worry?\n\nHello doctor, I am a 31 year old female. My first trimester NT and double marker test showed a very low risk of 1:3690 for DS and 1:100000 for two other abnormalities. During the second-trimester anomaly scan, the\u00a0doctor found two markers, CP cyst and mild RPD 4 mm and 4.5 mm. I have given blood for NIPT but did not get any results. I am at 23 weeks now and stressing out and getting really depressed. I have no family history of abnormalities. Is there a need to worry?",
    "doctor_response": "Hello. I have gone through your question and understand the concerns. Hope you found the answer helpful. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i use kojivit gel for dark spots ?\n\ncan i use kojivit gel for dark spots or wht is the best natural remedy i can i hav.since because of dark spots i look older dan ma age..!!!",
    "doctor_response": "Dear vaamsitarun, Dark spots can increase with sunexposure so using a good sunscreen ( SPF 15 or more) will be of help to you. It will be of help if you can mention the sites and the duration of spots. Regrdas",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for liver cirrhosis?\n\nDear Doctor, my mother's age is 74 yrs. She is suffering from cerrossis of liver since last year. Recently a good quantity of bleeding came out from her mouth. Doctor diagonosed as Esophaygal varices. She also suffering by constipation of about 10 days or more. but after that she usually suffering by diarrhea and become very weak and get admitted into hospital repeatedly. Immediate after applying saline she probably become quiet fit. Now, my question is  whether the deases is curable or not. I want to make an appointment with early.                                                                                               Thanking you,                                                                                                 Sajal Halder",
    "doctor_response": "HiI have gone through your mothers complaints.you are saying cirrosis of liver with oesophageal varices.it means portal hypertension developed.in cirrhosis , liver cell death & fibrosis wil be occuring .its irreversible.but its imp to investigate completely like what is the cause of cirrosis.what is the present state and to predict what complications wil occur.blood tests like Hb,Tc&Dc , bleeding & clotting time ,Hbsag  & hepatitis c viral test , liver function tests , serum creatinine ,ultrasonogram.based on the reports  we can assess her status.as you are saying she is getting constipation ,more chance of devopment of altered conciousness called hepatic encephalopathy. We need to know any fluid in abdomen.if liver is stil good we can follow her.if it is severely compromised its important to plan liver transplant.if any queries feel free to write.Thank youRegardsVasundhara",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a torn rotator cuff be treated without a surgery?\n\nHello, I have a question about my shoulder: a couple of months ago I fell and slid - shoulder first - into a piano. I have seen a couple of doctors and a physical therapist and didn t get any results/information. Yesterday, I saw an orthopedist who said I probably had a torn rotator cuff. What are the possible treatments for this (other than surgery)?",
    "doctor_response": "Hi, If it is only a partial rotator cuff tear then it can heal on its own with proper rest and avoiding any further injury to the area. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "How serious is cardiomegaly?\n\nhi doctor..my mom has some problem of chest pain , dizziness and cough.afterthat we hav done her chest xray..from her xray doctor dignosed that she has heart size prominent or cardiomegaly and says dat some swelling on heart..so i want to know dat how it will cure and how much time it will take to cure her.. is it a serious problem..my mom age is 47+...",
    "doctor_response": "Hello dear and thanks for posting your query here.It is not very rare to find a mild form of cardiomegaly on chest X-ray but if it is there then it must be further evaluated by an Echocardiography to confirm the size and function of heart, so that the treatment could be started accordingly.I hope this information would be of help to you.Thanks and all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure pain in nerve and glands after having a circumcision?\n\nMy husband had a circumcision (he's 42) after phimosis all his life. It's been 8 months, and his glans are still too painful and sensitive to touch. He's says it feels like a toothache. I wonder if perhaps he had a low grade yeast infection under the foreskin for years going unnoticed. I read untreated yeast can grow rhizomes, and become more in the mold category, going under the top layer of skin in a woman's vagina, and having nearly no symptoms, other than vulva pain similar to what my husband is now describing. He has tried all pain meds for it, including ones for nerve pain. Suggestions on what this might be, other possibilities.... would be great.",
    "doctor_response": "Hi, Your husband's glans penis was covered by prepuce for the years together. So, it may be very sensitive to mild touch or stimulation after circumcision. There is no need to worry. The time will take for the reduction of sensitivity of the glans. There is no need to take any medicine. Just apply olive oil on the glans. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilyas Patel, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will taking Tylenol cause cold?\n\nHi, I had a bad cold after I took Tylenol cold medicine & bacterium Imy lips have been swollen and sore. And I noticed red round patches on my left hand and groin are. They are warm to the touch . And my lips have been very hot too.why this happened & what should I do?",
    "doctor_response": "Hi,Cannot say in your particular case, especially without seeing the dermatologic changes. AND, while it is rare, someone can have an allergic reaction to tylenol with irritation especially where the drug has contact (the mouth).Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is uncontrolled erection normal in mature male?\n\nHello,I am a 52 year old male and my when my female doctor check a skin tag I had between my legs, I started to get an erection and become wet. I was so embarrassed and I apologized to her immediately, is this something I should feel bad about? I have that this happens to teenage boys, but wasn't sure about a mature male. Thank you",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Answer to your question is - Yes, it is possible. But it cannot happen suddenly and when you are worried about your problem. Before going to the female doctor you must have thought about it and were a bit embarrassed. possibly you fantasized. That could be possible explanation. Even if that is not the case, don't be anxious about the incident. That is over. In future such things could never happen.Hope this answers your query. Available for further clarifications.good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring lump in mouth with habit of chewing tobacco?\n\nHi Dr. My mom got lump or clot like thing along with little blood of bright red color some 7 years back while she was gargling. Then again some 2 months back she felt a lump in her mouth. Again it was same as before. Please. Let me know the reason. She is 73 years old. And has a habit of keeping tobacco-sunthi between her lips and teeth since her childhood.",
    "doctor_response": "Hello,I have gone through his query and understand your concern.At this age of 73, any lump or non-healing ulcer in oral cavity is to suspected and investigated for cancer in oral cavity.She is tobacco chewer from childhood, this further adds the risk factor and increases the suspicion of cancer.You should show your mother to your primary care physician. He may examine the lump. If he feels the lump is to be a cancer, he may refer her to a surgeon. Surgeon may take a biopsy from the lump ( sample of tissue from lump to examine under microscopy) and send for examination.If the report came as cancerous lump, then he may consult a Oncologist or refer to him for further management.Oncologist may advise surgery or chemo therapy or radiotherapy or any combination based on his condition and stages of cancer.Hope this helps.Please write back for further queries.Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful lump on the foot\n\nHi, I stepped on a rusty nail about 2 weeks ago and went for a tetanus shot and antibiotics the foot continued to be a little painful, now this morning I woke up with a hard lump next to the puncture wound. This lump is only painful when I place pressure on it when trying to walk. Please assist me in what this could be and how to treat it?",
    "doctor_response": "HI,Dear,Thanks for the query to HCM.1-I have studied your query in depth.2-DEar,IN my opinion, your lump after  2 wk old nail injury,which proped up despite of antibiotics-is caused due to the infective indurated lump  with  anaerobic organism.3-Pain while walking confirms that-it is chronic-abscess in making4-This would need following treatment-NSAIDs, seropetidase tbs with changed antibiotic to cover anaerobic organisms,and drainage if it does not respond in  5 days time .For this you need to consult Surgeon and treat it under cover of surgeon.5-Hope this would solve your query to your satisfaction.6-Wellcome for more queries to me On HCM.7-Thnks once again for your inquisitive query.Have a Good Day..!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with stage 4. Did kidney biopsy. Have syst on kidney. No MRI. Renal failure?\n\nFemale age 56, stage 4, diagnosed 10 yrs. ago. Runs genetically in the females of my family. Been to many different specialists including a study at Brigham/Women's, Boston. Finally found a younger MD, whom I'm relieved to progress my issues with. My question is, had a rt kidney biopsy a week ago today, she said the preliminary path came back with a lot of scarring of the tissues. Just to continue on wait and watch. I also have a complex cyst on that same kidney, that warranted an MRI but, cancelled due to lab work. What does the scarring suggest? Does that mean stage 5 or renal failure is rt. around the corner? What suggested sites should I be searching? Ty",
    "doctor_response": "Welcome to HCM dear. Thanks for the question. I would like to answer your question in two parts 1. Explanation of physical findings on biopsy -You may already know that each kidney contains about a million tiny filters (called nephrons). We all have damage to these filters after the age of 40years due to normal aging process. Some of us have excess damage due to various different conditions (diabetes, high blood pressure, genetic kidney disease, etc) The scarring (this is the term we use to explain to common man) that was seen on your kidney (I suspect it most likely means filters) is the end result of longstanding damage due to any cause. So, the scarring tells us that there is no active disease to treat now. The complex cyst in the kidney may/ maynot be related to the general ongoing slow damage to your kidney and MRI is the right way to assess any complex cyst.2. Functional status of your kidney -The staging (Chronic Kidney Disease stage 1 to 5) is based on blood test (creatinine and eGFR) and might not tally well with the physical findings of kidneys on scan or biopsy. Your nephrologist will monitor this regularly. Once eGFR goes below 15 we class patients as CKD stage 5. Dialysis or transplant usually become necessary when eGFR goes below 10.Hope the above clarifies your doubts.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful lumps in lymph nodes?\n\nI found a painful lump, about the size of a grape, in my right thigh. A few days later one in my right armpit. A few days later inside of right elbow. Last night, inside of left elbow. Have ultra sound scheduled for Wednesday. Could this be some type of lymphoma? I take oriencia and arava for rheumatoid arthritis.",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You have multiple enlarged lymphnodes. You have chances of tuberculosis or lymphoma.  You should go for biopsy of your lymphnode.  It will give perfect idea whether it is lymphoma or not. 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 health care magic. Wish you a very good health.Don't forget to click thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had gallbladder surgery, belly button hurting, crusty/drainage around it, bleeding, bad odor. What should i do?\n\nhi I had gall bladder surgery about a month ago and noticed last weekend that my belly button was hurting when I looked at it I noticed some crusty/drainage around it. I took a wet qtip and gently cleaned it and saw that it was also bleeding and had a bad odor. It has been doing this all week.I have an appt next week with my surgeon but it is really hurting. What should I do?",
    "doctor_response": "Hi If at all your Gall bladder surgery was done by laparoscopic method,a 10mm port will be placed near belly button through a incision. The scar site might got infected .So,there is foul smelling discharge. Dressing should be done daily. Please take Antibiotic Cefpodoxime and antiinflammatory tablets. Nothing to worry It will come down Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes soreness around belly button after lifting weight?\n\na few days a go I lifted something heavy and later found my belly button area was sore. a day later when I woke up I found my belly button area had leaked and a crusty pinkish fluid had dried  around the area. this went on for a few days. Now my belly button area twinges every time I lift something heavy. Its not a sensation I have experienced before",
    "doctor_response": "Hi.Thanks for your query.Read and understood your history which is very self-explanatory.Lifting of heavy weight has caused your belly button to have leakage which has formed a crusty pinkish fluid. Continued for a few days. Now your belly button area twinges every time you lift something heavy.All these things area suggestive of an umbilical granuloma which has ruptured due to pressure exerted on it. Since this is still there without any proper treatment the pain will persist. I would advise you the following:-First of all get a physical check up done by a General Surgeon to confirm the diagnosis. -Ultrasonography of the abdominal wall, umbilical area and abdomen to see if this thing has an extension as patent urachus or patent vitello-intestinal duct. Get relevant blood, urine and stool done for fitness.Get operated properly and take a post-operative care properly. You will be fine.In the meantime you can clean the area with liquid Povidone Iodine and use oral antibiotics and anti-inflammatory medicines.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated liver enzymes?\n\nI look a urine and blood test recently for life insurance and it came back that I had elevated GGT and ALT levels (GGT 312 and ALT 60). I NEVER drink or smoke. I am about 50 pounds overweight. I m 6 0 and 260. I don t have a family history of any type of disease. I m getting so many mixed answers on what could cause this. Everything says alcohol or pills which I take neither. Could being overweight cause it and what should I do to lower it?",
    "doctor_response": "HelloIncreased GGT and ALT may indicate liver injury.It may be due to many reasons like hepatitis,alcohol intake,obesity,altered lipid profile,medicines,auto immune causes etc.It may be due to obesity in your case.You may need few investigations like routine hemogram,random blood sugar,lipid profile,viral markers,ultrasound of abdomen.I suggest tablet ursodeoxycholic acid 300 mg twice daily for three months to my patients.It helps in regeneration of liver cells.You may need few more medicines after full investigations.You should try to reduce your weight.Take lot of fibers in your diet and go for exercise regularly.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have degenerative lumbar spine spondylolisthesis. Numbness in back, pain in legs and hips. Meaning?\n\nhi, my name is phillip. i have degenerative lumbar spine , spondylolisthesis of L4 on L5, endplate spurring in the proximal lumbar spine, the small of my back goes numb and down the right buttock just to the touch, and pain in both legs and hips. i have a lot of back pain . the same thing with my neck. i have asked my Dr but don t get much of an answer. what does all this mean? i am 35 and healthy. doing activities is starting to be too much, this all started around my junior year in highschool and seemed to get worse over time. your input and advice is appreciated.",
    "doctor_response": "Hello. Thanks for writing to us. Your spine has undergone a degenerative change that is causing a compression of the nerve roots coming out from the spine. This is responsible for the symptoms that you are having.I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal ,drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cramping sensation in head starting from neck?\n\nWhat can cause a \"cramping\" sensation on the left side of the head that runs from the neck, up the back of the head and stops on the top (just above the temple).  I have been having issues with is for a few weeks and resently have started having dizzy spells as well.  What do you suggest? Thank you Connie",
    "doctor_response": "Dear Mr. It seems to be muscular problem.Anyway you need to give me some information about yourself such as age, chronic illness, any medication taking? In the mean time I would recommend ibuprofen 400mg twice daily.I dont see anything to worry.Wishing you all the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes whitish layer on the lips?\n\nI have a lip problem that I hope you can help me with. For quite awhile now, I can\u2019t use lipstick and lip gloss for too long without having a line of white film from the lipstick or lip gloss accumulate on my lips. It is not dry or flaky but just a disgusting looking whitish accumulation that appear on the inside of my lips, the part where my lips are pressed together. This always happen when I\u2019m speaking for awhile in an air conditioned room and it\u2019s darn embarrassing because it\u2019s so unsightly. I always have to rush to the toilet to scratch it off with water and my fingernails!",
    "doctor_response": "Thankyou for the QuestionBrief...Can be contact dermatitis (But skin of lip need to be seen by a doctor)Detail...Your lip skin can be sensitive to lipstick or lip gloss.Other causes can be evaluated if seen by a doctor.As we most of skin problems have particular type of characterstics,so need to be seen by dermatologist.As you said you frequently need to scratch by nails too so lip skin can show signs of anemia (low blood haemoglobin) too.For time being avoid applying lipstick and apply honey in the night before sleeping,and get checked by dermatologist.Dr.Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bladder cancer\n\nHave had bladder cancer and will have another turbt on February 18 to investigate redness. When doing last cystocopy surgeon said I also have enlarged prostrate. Could this be a reason for this redness. I also have bilateral hydroceles. Could there be a link to all three problems?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  Your bladder cancer is not related with benign prostatic hyperplasia or hydrocele. For bladder cancer you should take treatment.  Surgery followed by radiation or chemotherapy according to stage of disease is treatment of choice. For benign prostatic hyperplasia finasteride and prazosin like drug is helpful. For hydrocele surgery is needed.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for inflammed penis, balls and angled urination after stopping masturbation?\n\nHi I'm a 27 year old white male. Lately I noticed my penis and balls were inflamed, itchy, swollen, and burned when touched. This was made immediately worse after masturbation so I stopped that. Recently I noticed that my pee stream was angled to the left. I haven't had sex with anyone but my girlfriend in the past 8 months and even that hasn't happened in a month. So I was wondering what this could be, maybe a yeast infection for guys?What might help?",
    "doctor_response": "HiWelcome to Healthcare-MagicGreetings of the dayFrom the description given by you, you seem to have developed fungal infection caused by candida along with inflammation of glans causing balanitis.The deflection of urine stream is likely to be due tos scab present at the urinary opening. Maintaining good personal hygeine, keeping the area clean and dry will be helpful. Local application of combination of steroid and antifungal ointment after taking hot seitz bath will be beneficial. Take careBest RegardsDr Deepak",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for deep rooted sebaceous infected cyst\n\nsir my mom has sebaceous infected cyst on her back, 3 days before she was admitted to ambani hospital in andheri(W) but the surgery was not succesful. Doctor said that it is very deep and infected, the amount of pus that came out was 25ml according to the doctor. plz suggest me sumthing soon",
    "doctor_response": "Thanks for posting you query to health care magic.Ideally  cyst should be completely removed for cure but some times it is difficult to remove it completely .Pus in the cyst indicate secondary bacterial infection but still you dont need to worry as pus has been drained from the cyst .Next thing is to  follow  culture and sensitivity report of drained pus to know the infecting organism and its antibiotic sensitivity .complete treatment of infection according to sensitivity report will help in fasten complete recovery of your mother .after cure from infection lesion will be heal by immune process of body .But always remember that if part of cyst if left inside body there may be chances of recurrence so be cautious in future and would seek medical attention when required . Hope you would be satisfied with my answer .  Feel free to communicate if any query .regards, Dr.Manish PurohitInfectious disease specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Developing wisdom teeth gives occasional pains. What should I do?\n\nHello doctor,I am 17, and my wisdom teeth started developing from more than six months, I get sudden occasion pains, it is more like pulsating, the pain feels so bad, and it makes my whole jaw ache, I cannot even eat for one to two days properly. The pains are so sharp, and I can see my wisdom teeth coming out like a halfway through, it is so painful, what should I do?",
    "doctor_response": "Hello,Welcome to icliniq.com.  I understand your concern. The wisdom tooth usually has abnormal size, shape, and erupting pattern, which can lead to the inflammation of the surrounding soft tissue or gums. This is known as pericoronitis and often involves difficulty in chewing cheek bites, and ulcers. The most straightforward line of treatment is to go for extraction. Since you have given enough time for eruption, now it's better not to wait. Using topical anesthetic gel (to apply on gums) and lukewarm saline gargle may help you temporarily ease your symptoms. I hope it helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the difference between full dentures and partial dentures?\n\nI have advance gum disease and was recommended to have all my teeth removed and have dentures, I had asked if I could get permanant ones but they had told me I also have a lot of bone loss, I really don't know what to think, I wanted to know what is the difference between dentures and partiel dentures",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM, I have gone through your query,  as you are asking about full denture and partial denture , see full denture is complete denture after removal of all tooth in oral cavity , and partial denture is if partial tooth are present in oral cavity . As your dentist has said that permanent fixed prosthesis can not be suitable for you have bone los , in bone loss condition removable prosthesis can be given so go for removable denture .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does physiotherapy help to cure knee pain?\n\nHi i am referee and im having pains in both knees and its been a month, i went to 4 traumatologist and they dont know exactly what to do, i have bow legs and that seems to be my problem, and i am 22 years old and dont want my career to be over this young, i used to run 4 days per week and now i feel pain everytime i tried, did physiotherapy 8 days and didnt seem to solve and now im very worried. Thank you",
    "doctor_response": "Ok, several points. Number one is that PT is for handling problems not fixing them. There will still be pain and limits.They also do not diagnose or fix problems and if there is bow leggedness, it might not be fixable after full growth but it should still be investigated for the cause such as vitamin D level.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Done follicle scan, had sex, got periods. Reason for not conceiving?\n\nHi Doctor I had been adviced for follicle scan and i was been scan for three days and then doctor told that the follicle is been ruptured need to have contact the day and next day which was followed and doctor said there are chances of preganancy this month but no luck i have got my periods. Kindly suggest on what could be the reason for not conceiving",
    "doctor_response": "Hi,Thanks for writing in to us.The rupture of follicle is a reflection of ovulation which is release of the egg in the female. This is the most fertile time in the menstrual cycle for a woman to conceive. The date of ovulation is usually constant at 14 days before the onset of periods. It is said that a couple should have sex regularly from one day before ovulation and until 4 days after it happens. This will increase the chances of getting pregnant.You must try again during your next cycle, the most fertile days would be staring 14 days from the expected onset of your next periods.There might also be other causes for you not getting pregnant like anti sperm antibodies in your cervix, non deposition of adequate amount of semen in your vagina, abnormal sperm production in your partner and any pelvic infection in you.Please discuss with your gynecologistHope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for problem in chest\n\nI am 35. healthy.  I have had anxiety in the past and was told i have pvc's.  everthing has been calm the past few years.  Last week i started to get chest pain, rapid heart rate, and i feel like i have bubbles in my chest that make me want to cough,  what could this be",
    "doctor_response": "Hi. I can understand your concern. If the chest pain is disturbing your routine activity then get  a chest x ray done to rule out any lung infection .Ideally ecg and 2d echo should be done first in your case. If both are normal than no need to worry for heart diseases. GERD (gastroesophageal reflux disease) can cause similar kind of chest pain. You can take proton pump inhibitors. But along with drugs you need to follow certain below mentioned lifestyle modifications for better symptomatic relief. Avoid stress and tension. Avoid hot and spicy food. Avoid junk food. Avoid large meals, instead take frequent small meals. Quit smoking and alcohol if you have these habits. Go for walk after meals. Keep 2-3 pillows under head in the bed to prevent reflux. Loose weight if you are obeseDon't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I grow any longer by taking HGH?\n\nHi doctor, Can I grow any longer? I am 16 years old. My parents' heights are about 5'5\" and 5'0\" and my sister is 5'1\". I had my knee's and hand's X-ray and both of them are fused. Since then I have grown only an inch or two. I was 5'1\" back then now I am like 5'3\" or 5'4\" in morning. I have been taking Vitamin D supplements along with Vitamin A, Zinc, and Magnesium. Doing yoga on regular basis and body weight exercises like push-ups, chin-ups, pull-ups, and dips. I have been sprinting and skipping rope and my diet is full of protein (junk food only on Sunday). I do not know how I stunted my growth. Maybe late night cravings with junk food and also bad sleeping habits might have contributed to my short stature. I have heard men do not stop growing until the age of 21 or 25. When I compare my legs to my friends we have the same length, maybe an inch or two difference but they are like 5'10\" or 5'11\". I have hairs on my legs from a year an a half. I have little facial hair (not too much). My genitals are not fully grown but I have pubic hairs. I want to be at least 5'7\" or 5'8\". Since taking HGH will not affect my legs (growth plates ossified) but will it affect my spine? I feel like my torso is very short compared to my dad too. If I can get prescription for HGH, will taking it lengthen my spine or harden the long bones which will result in growth (2-3 inches)? I have been looking for answers online but I found none relating to spine growth from HGH. As far as I have seen in gigantism most of their height comes from their torso. If I take HGH will my spine grow like theirs too? Since I am only 16 and not fully matured. I do not want to do the leg lengthening surgery (will affect my athletic performance) and also I forgot to mention I have never got a growth spurt in my life. All my height growth has been gradual. When I looked at my friends after a long summer they shot up to 4 to 5 inches. Whereas I stayed the same. Please tell me if I can do anything regarding my height.",
    "doctor_response": "Hello. I just read your query and from what you have mentioned it appears that you would like to grow taller. Well, your predicted height according to your parents' height is expected to be 5'5\". Even if your X-ray shows that your bones have fused it is still possible for you to grow naturally taller until 21 years of age. Human growth hormone does not work unless a person is actually deficient in it. And, no you cannot have a targeted growth by taking it. You might cause more harm to your self than good. Your habits are good but you need to start doing more of cardiovascular exercises like cycling and playing sports like basketball which involves jumping and stretching more. Every single person is different as to when they can achieve a growth spurt. Of prime importance is proper sleep as natural secretion of growth hormone occurs at night time.So, be positive and keep up the good work. For more information consult an endocrinologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. The 22nd-week ultrasound showed single umbilical artery. What to do?\n\nHi doctor, A single umbilical artery is observed in 22nd week L2 pregnancy\u00a0ultrasound. All other parameters are fine in relation to the growth of the fetus. I want to know how to deal with this. Can we go for amniocentesis or chromosome study? I also have a low-lying placenta with 15 cm distance from the os. I am so confused. I have seen a child, who was born with intestine issues. The child's stomach was stitched to the mother's skin after birth. Please help.",
    "doctor_response": "Hi. I have gone through your question and understand the concerns. Hope you found the answer helpful.\u00a0Regards. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and pain with red line on toes?\n\nFor several months now I have had a horizontal red line across my toes & swelling in the toes. Some of my toe nails have fallen off. I have seen my family a Dermatologist & 2 separate Podiatrist. Taken antibiotics, used several different types of foot creams without success. I had a culture which didn t show any type of fungal infection. I am a healthy 52 yr old female. I take vitamins, phentermine, and a hormone compound specifically mixed for me. No history of heart disease, high blood pressure or diabetics. Some of my toes are very swollen, and even bleed? Any idea what could be causing this?",
    "doctor_response": "In my opinion you need to see a good orthopedic doctor IMMEDIATELY as you are describing onset of gangrene which may unfortunately require toe amputation if i were your doctor i will suspect osteomyelitis  (bone infection )MRI is needed to confirm also doplar should be done Really sorry but i must be honestGood Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe hair fall,  no improvement with medicines, on Desval for neurology problem. Permanent remedy?\n\nI am 24 Years old. Main 7 saal se Desval ER500 Le rahi hun. Because I have minor neurology Problem. Meri problem ye hai k mujhe kai saalo se hair fall hai. maine kai doctors se 1 month ka treatment lia. par sab temporary Results dete hai. I am healthy and fit. meri diet bhi acchi hai. Doctors se medicene ka puchA to wo kehte medicene se koi problem nai hai balki issme to iron hai ye to acchi hai hair fall k lie. now please doctor help me koi permanent solution batayie meri hair fall k lie",
    "doctor_response": "Hi Alka, You seem to be suffering from Telogen Effluvium. Its a kind of hair fall that occurs with stress, chronic illness and prolonged medicine use(desval can cause this kind of hair fall, infact most of the antiepileptics do.So no need to change the medicine). At times thyroid disorders and iron deficiency can also lead to this kind of hairfall. So get your thyroid profile and serum ferritin checked. In the meanwhile  take a good high protein diet. Eggs, nuts, lean meats, sardines and salmon, soy products not only contain protein but also other hair friendly micronutrients. take a good oral biotin and selenium/ copper rich supplement. apply minoxidil lotion 2% twce in a day. You discontinued your doctors treatment after a month, just wanted to highlight one month is too short time to have results with any therapy. you can also discuss PRP., stem cell factor therapy with your dermatologist. Remember stress can also aid hair fall so try some mind calming activities to remain stress free. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a sebaceous cyst at jawline indicate?\n\nI have what appears to be a sebaceous cyst at my jawline. It appeared after I gave birth to my 15 year old son, but it never got larger, until recently. Sometimes it feels as if it is affecting my ear. Occasionally I can squeeze it a little and some white stuff (like a zit) comes out, just a little, and it's awful smelling.",
    "doctor_response": "HiThe scalp, ears, back, face, and upper arm, are common sites for sebaceous cysts. The viscous white fluid (resembling cottage cheese ) ,foul smelling is typical of a sebaceous cyst . but further diagnoses is very important by an oral physician. the treatment includes excision of the cyst in most of the cases. i advice you to get a check up early so that your dentist can rule ou any other possibilities . take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold and cough in a 8 months old child\n\nhi.....my eight month old daughter is having cold and cough since the past week. Earlier was giving her asthma kind P drops and tminic drops. she is having fever since yesterday. now nave changed her medicine to levolin syrup and mycolite drops plus crocin drops. she is also having a chest congestion. please advice.",
    "doctor_response": "HI if your child is not looking dull/toxic looking, mostly she will be suffering from Viral respiratory infection called Bronchiolitis .She needs symptomatic medications to relieve congetion .AS she is not responding to oral medications, consult a child specialist who will advise Nebulisations/inhaled therapy.Hope it answers your query and happy to help you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get pregnant?\n\nHello doctor I am swapna i have irregular periods ,.now marriage finished 2 years ,once I became pregnant with clomid tablet but so sad that one aborted 10 weeks.after 6months of abortion I went to ob gynec doctor she said may be pcos she said to do hormonal profile and she advised to take duphastone 10mg tablet for 21 days ,can I conceive with this tablet ,because I cant track ovulation period,please give to me good advise",
    "doctor_response": "Hello dearI understand your concernYou have PCOS. It cause hormonal imbalance, menstrual irregularity, insulin resistance and weight gain.I would suggest to consult experienced gynecologist and undergo reproductive hormone analysis, USG scan and ovarian follicle study for better management.Duphastone for 21 days will help you to regularize period.Once your period will regularize you can take it in luteal phase of period.Other drugs like metformin and krimsom 35 can be usefulOther drugs that will help you to increase fertility after your period become regular:Clomiphene citrate: it will help to induce ovulation and increase 50% chance of pregnancy. Undergo ovarian follicle study for proper management.Avoid stress, take healthy diet, drink plenty of water, do regular exercise and maintain weight according to BMI.Hope this may help youContact further HCM if follow up neededBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lump above hips, pain when pushing. Afraid of tumor\n\nHello Sir, Today when i rubbed the side of my stomach , just above my hips i found a small knot or lump kind of marble shaped tiny ball inside, when i tried to push it, there was some small pain. Im afraid it might be cancer or tumor . However if i dont touch it im not having problem, What should i do next, is it any cause of concern. God bless you. Best Regards",
    "doctor_response": "Hello! Thank you for the query. First of all you should know that usually cancer in such area does not cause acute pains for a long time. If this lump is near groin region it can be an inguinal hernia. It can get bigger while standing and coughing. If so, surgery can fix it. Such painful lump can be also sebaceus cyst. This is benign soft tissues lump which get painful if gets inflamed. IT can be also removed with surgery. The best way to have it diagnosed is to perform ultrasound of this area. Hope this will help. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My Daughter with warts, what should I do ?\n\nMy daughter is 22months old and has warts up and down both her legs..some are big some are small like little pimples..she picks at them and makes them bleed and they are also spreading. he doctor doesnt seem too worried about it but iam. he tried freezing a couple of the bigger ones off but it didnt work..what do i do ?",
    "doctor_response": "there is no treatment for the warts, it is removed by cryotheraphy the freezing technique, also there is no\u00a0 drug for the wart to prevent from recurring or spreading, wart is treated with removal using cryotheraphy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat skin blemishes on the face and cheeks caused due to pregnancy ?\n\nHello, I am 29year old women with a 4year old kid. I got pragnency blemish on my face around cheeks . I used many blemish cream but there is no result. My skin type is oily. please suggest me what to do as its increasing.",
    "doctor_response": "Welcome to Healthcare Magic You must have developed Melasma or photosensitive dark rash around the cheeks. It occurs due to hormone changes in pregnancy. Firstly avoid sun exposure. You can use sunblock of those with SPF30 during the day. Drink plenty of water. Eat fresh fruits and green leafy vegetables. Do regular exercise. There are many products which will reduce the skin discolouration. Using oral contraceptive pills can aggravate the problem. Creams with hydroquinone, azelaic acid offers some improvement, although laser works wonder in experienced hands. Consult your Dermatologist of the options available to you in this regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "When should Clomid be taken to ovulate at the correct time?\n\nHi, i am trying to concieve but can only meet with my husband 21 days from day 1 of my period for a week as he is a seaman. When can i start taking clomid in order to ovulate around that time. Thanks i'm 44, 5ft 11'', 130kg, ok generally but had hyperthyroid surgery five months ago. My periods are slightly irregular and i've had 3 misscariages in the last 6 months.",
    "doctor_response": "Hello,You should keep relationship between 11th and 18th day of the cycle. Do follicular study after taking Clomiphene from day 2 till follicle size increase to 18 mm then rupture and then keep relationship, then only you will get result or do IUI.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sheetal Agarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low self esteem after a car accident?\n\nI was recently in a car accident not as bad as one I had when I was younger but after the accident I haven't been the same I'm nervous got low self esteem and feel like I don't know who I am anymore I've been getting angry quickly with my partner over everything. What do you think is happening to me?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. The problem you are facing is not just low esteem but PTSD (Post Traumatic Stress Disorder). Only solace is that your problem is comparatively less to other PTSD. possibly because the accident was not that traumatic.Nothing to worry in this regard. Please try to have positive thinking and do some relaxation techniques. Within a few weeks or so, you shall be perfectly alright. Anger is common with every one. Instead of controlling anger, eliminate the cause. Or else adjust with the cause itself.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for broken nose\n\nHi. I play Varsity Basketball and today as a girl went up to the basket, she hit me hard in the nose. This game was about an hour ago, but now I have a really bad headache, and my nose still hurts. Can it be broken? Or maybe is it just a bruise? Thanks for your help.",
    "doctor_response": "broken nose or fracture nasal bone will have nasal bleed with severe pain. it can be diagnosed by X-ray nasal bones. u need Ent consultation for evaluation n rx.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any reason for coughing blood ?\n\nHI , i coughed blood and went to the hospital to check it they did a blood test and a chest x-ray and the results where both good. but when i went back home it happened again, im currently doing a ppd test is there any other reason why this is happening to me any help is appreciated. or any other test that i should do more to find out the reason. am 25 years(hiba)",
    "doctor_response": "Hello. . The commonest cause of coughing out blood is pulmonary tuberculosis. The PPD test is helpful. Apart from this, you can go for ESR, ELISA for IgG M for tubercular antigen to rule out tuberculosis. Also go for sputum analysis for three consecutive days. Dr. Rakhi Tayal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for flu and runny nose?\n\nI am recovering from flu, in the second week now I have a bit more energy but the stuff I am blowing out of my nose seems smelly. The doc said to take paracetamol and drink lots, which I have but I'm not really much better, should I go back or return to work on Monday as planned?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You have flu and runny nose. You may have secondary bacterial infection. you should take antibiotic treatment like amoxiclav or azithromycin. For runny nose antihistaminic drugs like cetrizine or avil will help you. These all are prescriptions based medicine so  consult your doctor and take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be done to eliminate the chance of developing cancer and liver failure ?\n\nA 35 year old female, born in Poland but lives in Sweden for over 20 years now. Is 180 cm tall and weighs around 70 kg. Was heavily over-weight and topped the scale at 123 kg but has lost it in a matter of 6-7 months. Has consistently kept the weight off for 3 consecutive years. Continues to eat healthy. Is a virgin . Has never smoked, used drugs or/and alcohol. Is tattoo free. Is on anti-depressants such as: Zoloft 50 mg (against depression), Risperdal 1 mg (anti-psychotic) Lyrica 150 mg, ( mood stabilizer ), Levaxin 50 mg, (thyroid) and last but not least, Sobril 5-10 mg (tranquilizer). Was diagnosed with Hep C 2-3 years ago. A biopsy test later revealed that she has cirrhosis too. Her blood work is positive and the blood flow is very good. Her liver function is almost like a normal person s. A \u201cfibros examination\u201d determined that the level of the virus is at 12,9 where as some people have 70. She has no liver pains but does have joint and flu- like symptoms. Because of her mental state her psychologist and gastric & hep doctor has warned her that the treatment is very emotionally and physically taxing. Some patients with the same disease have taken their lives. Also she has undergone a examination where a camera was placed in her throat and down to her stomach to check for any changes or any detection of cancer. It showed no changes or cancer. Same thing with ultrasound. Is afraid to take treatment and the doctors feel at this time that she should wait. My question(s) now are the fallowing: 1: What is the best plan of action, what can be done to eliminate the chance of developing cancer and liver failure , and also in some severe case, death? 2: Are there any new studies concerning treatment, some breakthrough remedies? 3: What happens if one does not choose to take treatment? 4: What happens if one cannot fulfill treatment? 5: Is there anything I can personally do to manage the virus?",
    "doctor_response": "Hi, Well the patient is in a condition where medical help is must. things are worsening probably because she is down with spirits. Something bad must have happened to her and on which she is dwelling from long. The depressed spirits are discouraging her day by day. In my opinion along with the current treatment, which of course is must to preserve the vital organs and functions of the body, you shall take the help of some Psychoanalyst. Once she will start taking interest in her daily schedule she will start improving and all the existing medical problems will start improving gradually. Morale and confidence are very essential for an healthy existence so we need to work on it. The only way is to make her speak with all her feelings and expressions. In nutshell kindly carry on with the treatment we should not leave hope and consult a psychoanalyst for the state of mind. Wish you health and prosperity",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of methamphetamine ?\n\nMy daughter has been sober for one year from methamphetamine! Three months ago she was diagnosed with thyroid cancer and had her thyroid removed now she is taking levothyroxine 100mg a day,oyster shell 500mg a day and calcitriol 0.25mg a day, monday she went for drug testing and the results were positive for methamphetamine we were shock......... Could this medication or vitamins cause this?",
    "doctor_response": "Hi and welcome to HCM thanks for the query. there is no direct relation between methamhetsmine and thyroid tumor so this is not cause of it. she obviously did take this drug recently and it should be stopped completely so that tumor treatment can begin.Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "On increasing dosage of fertyl super 100mg. What can be done to get DF into one of the ovaries ?\n\nmy doctor has adviced to take fertyl super 100mg from 2nd day of the periods(5 tablets...in the follicular study, Left Ovary and Right Ovary shows no DF (dominant follicle ). Next month she adviced with increased dose of fertyl super 150mg and then also same result...in the follicular study, Left Ovary and Right Ovary shows no DF (dominant follicle). Please advice whats the problem and what can be done to get DF into one of the ovaries. Awaiting for the reply!!",
    "doctor_response": "Hello. Thanks for writing to us. Absence of any dominant follicles even after taking high doses of clomiphene is suggestive of no egg formation in the ovaries. You need to have a detailed hormonal evaluation to rule out any ovarian failure under care of an infertility specialist. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it ok for a child to have one ear that appears larger with thicker lobe and outside edge ?\n\nMy six week old son has one ear that appears larger and thicker/puffier in the lobe and outside edge than the other. It is not hot to the touch or redder than the other ear. It is his right ear, which he tends to lay on more often. I just noticed this a few days ago. He is just getting over a fairly mild upper respiratory infection.",
    "doctor_response": "Yes, this can be a normal variation, and it could be related to his sleeping posture. Don't worry, unless it remains the same beyond his first six months. Once he starts to sit up, the asymmetry is most likely to disappear.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated PSA levels?\n\nI have an elivated psa test of 5 and I rad an injection of fluorescein to detect problems with my retina 1week ago. It discolors skin, urine etc. I had sex with my wife today and the semen was mostly clear but had a pinkish look to it! I have an appointment with a urologist tomorrow but I\u2019m scared about the ting and elevated PSA. HELP",
    "doctor_response": "Hi, It can be due to conditions affecting prostates like prostatitis (inflammation of the prostate) or prostate cancer. You can consult a urologist and plan for a prostate biopsy to make a diagnosis. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest better treatment for jaundice\n\nmy father,s age of 74 years.he is suffering from jaundice since 7 wks.symptom-yellowish eyes & body,loss of appetite,gas formation & eructation,occasinally nausea & vomiting & weakness.Now serum bilirubin level is 34.7,conjugated-31.sgot-132,sgpt-68,alkaling phosphate-206,usg abdomen-mild hepatitis & no obstruction.endoscopy-mild gastral antritisMRCP-normal study,total protein-6.5,serum albumin-3.4,prothrombin time-13.9,HEPATITIS-A,B,C,E--NEGATIVE,ANA-22.25,AMA-NEGATIVE.What is the probable diagnosis?& what should i do?",
    "doctor_response": "Hello,Welcome to health care magic,Considering your billirubin value (especially high conjugated billirubin) you are suffering from hepatocelluar jaundice which needs to be treated.You will require antibiotic to prevent super infection with symptomatic treatment like Udilive 300 mg for liver enzyme supplements and some dietary restrictions. For diet,you should follow these guidelines,Avoid fatty fried and junk foodHave lots of fresh fruits, fruit juices and vegetables.You should take glucose water 3 to 4 times a day.Avoid oily,fatty or even high protein intake.You should have whole grain food items chapati and Daliya or Khichadi.Do you feel weakness?or How's your appetite?You should check your blood counts and liver function tests almost daily in initial phases.Consult your doctor or family physician for complete treatment.Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excessive thirst and urination?\n\nMy Son 8 Years old went surgery two weeks ago. Septoplasty and Adenoid removal. Surgery took 1hr and 20 min. He was under general anaesthesia. He stayed one night in hospital. Next day he was release from hospital and give antibiotic for 5days. After 2 days we noted that he go to toilet for urine frequently. He is drinking lots of water so we thought it due to excess intake fluid or antibiotic. It is 3rd week and still he frequently urinate, may be once in an hour. I took UTI test and sugar test which are negative. I try to research on google and i found that may be it is cause by general anaesthesia . is he nerugenic bladder or what? is this is the side effect of anaesthesia. He recover well from spetoplasty. no bleeding from nose. He has absorbable packing in his nose. He is very active. He start going school but i inform teacher let him pass urinate after 1hr. Is this condition stay for ever or there are some treatment.",
    "doctor_response": "Greetings. I am a bit concerned at this. As he was absolutely normal before surgery and his urine reports are also normal it could be psychological or neurometamolic cause. You need to do a water deprivation test from laboratory. In a holiday, limit his water intake if he feels unwell it could be a serious issue like diabetes insipidus but if nothing happens then it could be psychogenic polydipsia...  You should consult an endocrinologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pressure like pain in head while bending?\n\nI have been having a pressure like pain on the left side of my head for about to weeks. It really starts when bending down laughing coughing or lately none of these. Wakes me up during the night and mornings. This morning woke up with awful forehead pain. I also have a non milinant tumor that i can t recall the name .",
    "doctor_response": "Hello,        As you have a non malignant tumour of brain can lead to an increased intracranial tension causing pain in head. Skull have a fixed space to occupy brain in it but when there is presence of growing tumour inside , it will  press the brain causing headache. Go for CT scan and MRI  of brain under guidance of a neuro- physician to know that , is there is any type of change occurred in your tumour size from previous one or not. Follow the instruction provided by your doctor. Take rest and avoid such activity which aggravate the symptoms as much as possible .Take care bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes neck pain radiating to back?\n\nI have been having neck pain and it radiates into my back like a muscle soreness. Also it makes me feel heavy headed. I do have some sinus stuff and my ears pop like they would be stopped up. also im on mess for anxiety. Not sure which is causing the head problems. It seems worse if I look at something close then focus on something far... I was thinking maybe some kind of vertigo",
    "doctor_response": "Hello, Most probably it will be a spine-related problem like cervical spondylitis. As first-line management, you can take analgesics like Paracetamol or Aceclofenac for pain relief. If symptoms persist better to consult an orthopaedician and plan for an MRI scan to make a diagnosis. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of pain around lower left side that spreads to back and stomach on left side ?\n\nI've had side pain around my lower left side and now spread to my back and kind of upper back and my stomach on my left side. Maybe something is ruptured, not sure. The pain is tolerable to a certain point but ive been smoking marijuana for 2 years and have had this pain for about the same but it got much worse today and spread",
    "doctor_response": "Hi,there are two possibilities. Either pancreatitis or mesenteric vascular thrombosis.You need to get a CT and a abdominal doppler examination done to determine the exact cause.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can shingles be treated?\n\nMy friend age 61 just got diagnosed with shingles after going thru several bouts of kidney stones. The Dr. Said that because of the stress, and low immune system was probably the reason. I am 74 and in fairly good Heath . It it wise to get a vaccine shot to prevent shingles?",
    "doctor_response": "Hello,Thanks for your query on HCM\"As\"per your clinical history is concerned please follow like this -1)Discuss with your Doctor about antiviral like [acyclovir]and for pain Capsaicin cream or lidocaine spray or oral medication [codeine].2)For prevention point of view you can discuss with your treating doctor about varicella-zoster vaccine (Zostavax) Which can be given to adults above 50 years of age. The shingles' vaccine doesn't guarantee you won't get shingles. But this vaccine will likely reduce the course and severity of the disease and reduce your risk of postherpetic neuralgia and this is a complication of this virus.Hope that helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in breathing after having a hiatal hernia surgery?\n\nI had surgery to correct a hiatal hernia and acid reflux a year ago this past Nov. and ever since, I have difficulty breathing just about every other day. Prior to surgery, it was more frequent. I sleep on a wedge pillow, plus another standard pillow to prevent acid coming up, and I eat by 5:30 to give adequate time for food to digest (this has helped tremendously to the point where I don t need medication regularly, but wonder why it happens every other day and is there anything else I can do? And is it happening because acid comes up to my airway and creates swelling? PS--my pulmonologist prescribed inhalers, but it brought no relief whatsoever.",
    "doctor_response": "Hi, Thanks for your question. I can understand your pain and discomfort. your problem should be evaluated by your doctor to make sure that its not a cpmplication from the surgery you have undergone. Ask your doctor as it could be a gas bloat.A common side effect of the surgery is gas bloat. Air becomes trapped in the stomach, causing pain and discomfort and difficulty in breathing.  Chew your food well. Eat small meals. Avoid carbonation (soda) and drinking from a straw. All of these will increase the air in your stomach.I hope I was able to address your query. If you have any further questions, please do not hesitate to write to me. Wishing you all the best. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of left posterior lateral annular tear L4-L5 level?\n\nWhat are the symtomes due to a left postero-lateral annular tear L4-L5 level,and at the same time an annular tear associated with small central L5-S1 disc protrusion indenting the dural sac without evidence of neural element compression,and also a mild lateral tilt of the lumber spine convex to the left?",
    "doctor_response": "Hello,Thank you for using healthcaremagic.I read your question and understood your concern.The simptoms could be pain and numbness on the left leg below the knee on the posterior and lateral side of the calf sometimes until the tip of the left toe. You may or may not have back pain.From the description I don't expect you to have muscle weakness of the left leg since there is not nerve compression.Dr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for severe hemorrhoids , abdominal pain , back pain and heartburn\n\nHi, just finished my third round of chemo for breast cancer. Caught early stage but hi recurrence score. This past week, have had very painful hemorrohoids and abdominal pain, back pain, hearburn. Are these related to treatment? Did a round of flucanozole anitfungal after first round of treatment due to thrush and fungal infection. Could the problems I have now be related to fungal infection? Doc wrote me a 2nd script for the antifungal in case I needed it. Should I use that or go back? Have had other complications too.",
    "doctor_response": "Problems mentioned now are not related to fungal infection. Though chemo courses may manifest such complications sometimes.You have the option to get herbal Ayurvedics to correct these problems better irrespective of chemo. Your doctor has given II course of fungal saying ' if need be'. You may skip it.Pl find some Ayurveda doctor to address hemorrhoids etc mentioned by you. Back pain may be treated externally if there is no disc problem...that may beanaged by Lumbo-sacral support.Hope it helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for the ingrown hairs with pus discharge\n\ni have two ingrown hairs, well atleast thats what i think it was, they started off really small and swelled up pretty big, it hurts if i wear pants, or stand or even sit and i'm not to sure what to do, when i took a bath a yellowy puss started to come out if i squeezed it how do i get the bump to go down and get rid of this?",
    "doctor_response": "Hi!! According to your history you seem to have developed furuncle which is a bacterial infection. I recommend my patients to take oral antibiotics and anti inflammatory drugs and apply topical antibiotic on the bumps. This will help in resolving the infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for stomach attacks after the removal of gallbladder?\n\none year after gallbladder removal, I started to have severe stomach attacks, feel like passing a stone. This has been happening 3 to 4 tjmes a day, for the last 5 months. I ve seen 2 GI s and have had a; scope, cat scan, x-rays. ultra sound, etc. and they can t find anything",
    "doctor_response": "Hi,Thanks for writing in.You are not alone as following gallbladder removal, there can be the dumping of bile which is now not as easily regulated and can send someone running to the bathroom immediately after eating. A more common side effect is a decrease in the secretion of bile. If the bile produced by the liver becomes thick and sluggish, painful symptoms and bile stones can occur. Bile stones can form in the liver as well as the gallbladder. The pain can occur even in the absence of stones any way in the biliary tract.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for raised lump on lower lip\n\nI developed a small lump, 1/4 inch, raised, below my lower lip on the outside. It is flesh colored and does not hurt. I have had it or a month. The night before it formed I remember skin peeling near the area that almost looked liked lint. It is not a pimple. How do I get rid of it?thanks,",
    "doctor_response": "Hi,Dear thanks for the query to HCM virtual clinic.I studied your query in full details updated from you.I understood your health concerns.Based on your query data, In my opinion ,Dear You seems to suffer from-Chronic Boil and or Sebaceous Cyst with perifolliculitis,on outside  of your lip since 1 mth,mostly with chronic boil on the outside of your lip.This is the cause of these lumps and it correlation with facts of  your query.Gp doctor and dermatologist and Surgeon would be  needed to fix these health issue with you.AS the matter is for 1 mth,I would suggest USG study to evaluate local implications of Chronic Boil and or Sebaceous Cyst with perifolliculitis.Hope this reply would help you to evaluate your case and treat it with your doctors in time to come.Hope this would resolve your query and worry and Anxiety accompanied with it.Welcome for any further query in this regard to ME.I would love to help you out.Awaiting for any further query.Wish you fast recovery from this intriguing health problem.Have a Good Day.Dr.Savaskar M.N.M.S.Genl-CVTS -Senior Surgical Consultant",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath?\n\nI have allergy from changing weather , due to which I get short of breath sometimes and i need to take seroflo 100 mg rotahaler capsules.I have recently shifted to pune around 2 months ago and since then I have to use it daily. Previously i needed to take this once in a while.Please suggest what might be the reason what I should do",
    "doctor_response": "Hi and thanks for the query,It is important identifying the main environmental factor that triggers shortness of breath with you. It might be useful to use some steroids or anti allergic drugs prior to such exposures or to be armed with some drugs like Ventoline or bronchodilators to prevent any respiratory emergencies. A proper review with an allergist for an immune desensitization sequence could be helpful in some persons. Kind regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Memory problems, headache. Family history of Alzheimer s disease. Have bipolar disorder and PTSD\n\ni have started having mild memory problems, constant headaches, ranging from mild to severe, and have started stuttering when i ve never stuttered before in my life. I m worried because Alzheimers runs in my family, although i am a nineteen year old woman with bipolar disorder and ptsd. what s going on? should i be worried?",
    "doctor_response": "Hello You are a 19 years old female with family history of Alzheimer's disease. You have complaints of memory problems and this is causing severe stress in you. You are a known case of bipolar disorder and PTSD. Most likely the memory problems are not related to Alzheimer's disease. You already have BPD so such symptoms may occur due to depression and anxiety. Such symptoms are also called pseudo dementia. I would advise you to consult a psychiatrist for expert opinion. Hope this helps you, thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump near vagina when having constipation?\n\n18 year old female. constipated these past few days with thick, white, stringy mucus discharge after i poop. have a lump that appears between my vagina and anus. if I am successful at having a bowel movement the lump goes away, otherwise its there when I sit to try to go to bathroom.what could be the problem here?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have hemorrhoid ( piles ). You should take plenty of water and high fiber diet. Avoid constipation. This will help you to releive symptoms.  Avoid spicy food. Lignocain gel can be used for pain releif. Permenent treatment of choice is surgery. Consult your doctor and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for cough and fever\n\nMy 1 year baby has cough and fever since yesterday night. Fever was 102 Deg F so, we sponge her body continuously however not much relief. So I gave her Meftal P 2.5 ml. She got relief from fever until morning, but again in morning at about 5:30 she had fever 102 deg F. We gave her Meftal P 2.5 ml again and went to physician. Physician prescribed her JMProx (Cefpodoxime), Flora- BC (Lactic acid bacillus) and Tuslic LS (Levosalbutamol sulphate, Ambroxol hydrochloride & Guaiphenesin Syrup) and Meftal- P sos, but still not relief from fever. Please help me.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. In my opinion, you should wait for atleast 2-3 days after starting treatment. She is taking antibiotic, cough syrup and anti pyretic. These drugs are optimal for simple lung infection. And usual recovery is expected in 2-3 days. So my suggestion is to wait for 2-3 days, continue with the same drugs. If after 2-3 days of treatment, if she still has cough and fever than consult doctor and get done chest x ray to rule out pneumonia. Hope I have solved your query. I will be happy to help you further. Wishing good health to your daughter. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does 30g of protein intake everyday have a negative impact on the kidneys?\n\nMy neighbour is looking after her husband at home. He is 87, has heart problem, alzheimer s, kidneys are not good, has a hernia in his lower abdomen and gall bladder problems. The decision to do anything about the hernia or gall bladder problems is to take no action due age and heart factors. The big problem right now is that he has no desire to eat enough to keep up his strength. He says that he is full and doesn t want anything else to eat. It is difficult to get him to drink enough either and he is on diuertics and getting dehydrated. She has been able to get him to drink most of a Premier protein shake with 30 g of protein that has all kinds of nutrients and part of 19g protein bar. He won t drink water. He doesn t have a swallowing problem. However, I m told that high protein can have a negative impact on the kidneys. Is 30g too high? What about 19g. What can she do? He s getting too weak to get up on his own, and their doctor hasn t been helpful. Oh, and his medications are Toloxin .125 1 tab, Novo-Semide 40 mg 1 tabdepearman, Novo Metoproprol 50 mg 1/2 in AM and 1/2 in EVE, Pantoprazole 40 mg 1 tab, Novo Traziodome 50 mg 1 tab, Mylan Warfarin 1 mg 1 tab, Coversyl 2 mg 1 tab.",
    "doctor_response": "Hi, Protein rich diet doesn\u2019t affect kidneys and you can safely take high protein diet. However diet rich in oxalates like red meat can harm kidneys. Wishing you good health. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussai",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any treatment for meningioma brain tumor other than surgery?\n\nHello I was recently diagnosed with meningioma brain tumor, located in the left external convexity the size is 20 mm. Is surgery the only option? I ve been smoking medical cannabis for over 3 years, I stop for 1 month and it was the first time I presented symptoms so I make the test and knew that I had a tumor. Can I continue smoking or does it affect the tumor in any way?",
    "doctor_response": "meningioma cant be treated by medicine. Many times it can remain silent withiut problem for many years. But if its causing problem, need treatment. And it can only be treated by surgery. I not advice you to continue smoking",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low platelets counts after delivery?\n\nWhat can cause pitika?  My platelets were low (80,000) 5 months ago when I delivered my baby.  Is this a sign that they could still be low, or is it OK to get this once in a while?  I understand what it is but what can cause it other than low blood platelets?",
    "doctor_response": "Welcome to H.C.M. I am Dr Krishna Dubey.My pleasure to help you. Pitika are eruptions on the face of adolescents . In pitika, normal excretory function of skin is disturbed and waste material stagnated inside producing symptoms like itching, pustules and nodules formation.It is not due to Decrease platelet counts.Earlier your platelet counts was low so i suggest you to repeat platelet counts to rule out thrombocytopenia( Decrease platelet counts).The exact cause of pitika  is not known, but hormones called androgens can play a role. Androgens increase in both boys and girls during puberty. Androgens make the skin's oil glands get larger and make more sebum.This blockage of sebum results in pitika.Thanx for query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is is possible to conceive with uterine polyps?\n\nhello i am 35 years old women ihave been examined for polyp in my utreus some times i have bleeding apart from my regular periods we have been trying to concieve for past 2 years but till now i have not concived can you please advice me for this problem can i ever have a baby?",
    "doctor_response": "Hi , 35 yrs is the upper limit for reproductive age, theoretically. But don't get anxious, my patient 41 yrs had twin after treatment ( married 15 yrs) !!I hope the Ultrasound scan reports showed no polyps or fibroidsKindly see if the following checklist of investigations is doneHusband- Semen analysis at least 2-  done 4 weeks apart preferably in an infertility center ( examination done by andrologist), Blood sugarsWife - Blood Sugars, Thyroid profile          Serum AMH in first 10 days of periods, to know number of eggs in          ovaries          Ultrasound scans to evaluate Uterus , Ovaries & adnexa          Confirm tubal patency- most important- Tube is the connection           between uterus & ovaries( the bridge where sperm meets the egg &           forms a baby) this is size of hair follicle & cannot be seen on scans.           So check with HSG( Xray with dye), or SSG ( Scan with dye) or            LaparoscopyDirect examination also to rule out infection around uterus ( PID), where you can have bleeding on & off with vaginal discharge, itching, pain during sex etc. can be corrected by good course of medicines for both husband & wife at a time. If both not treated , can get re-infected when you have sex next time.If all this done & found normal , nothing can stop a pregnancy with God's willIf any of these investigations show a problem, don't hesitate to go ahead with IUI or IVF, as you can't wait too long. After 40 yrs chances of pregnancy is very lowHope I have clarified your queryDr.Balakrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can polycystic kidney and liver disease pain with headache be treated?\n\nhi i am kishan age 52 .i have dignose polysystic kidney and liverdisease .now my bp remains 140/90 taking medicine stemlo 5mg then it remain control. last some days i am feeling pain both side and headache.please advice best doctor for advice and preacaution for control of disease",
    "doctor_response": "Hi pain abdomen in your disease could be due to infection or stones. About head ache,in ADPKD  involvement of brain is very common and a condition called aneurysms are common in brain which could be the reason for headache. Consult nephrologist as early as possible. All the best. if you have any questions feel free to contact me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold, cough and fever\n\nmy uncle is on his 4th day of having and on and off fever. he also has cough and colds for a week now. and during the laboratory tests done, there was an increase in his SGPT, twice the normal. I just would like to know if what causes its increase... or what diagnosis is possible with his condition... thank you really for helping me with this. God bless",
    "doctor_response": "HI, thanks for using healthcare magicSGPT is a liver enzyme, if it is increased on its own and all of the other liver enzymes on the test are normal, it is not likely that he has any liver diseaseIt can also be found in other areas such as the heart or a side effect of medication.His  medication list can be reviewed to see if any could possibly contribute to this problem.He may need to consider a repeat when he is well.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking ferro-f tab since months, no improvement in levels. Will increase in dosage help?\n\nHi Doctor, What does hb level 5 indicates in blood . I ve been taking Ferro-f-tab (which contains elemental iron 100 mg & folic acid 350 mg) twice a day for the last two months. Does not seem to be helping me much. are there any MD doctors in Australia who can help? Could increase in dose of these tabs help or some injections or tonic. Thanks.",
    "doctor_response": "Hello and welcome to HCM, Thank you for your query. A Hemoglobin level of 5, indicates anemia. The Ferro-f-tab has been prescribed to correct this. But in clinical practice a hemoglobin level of 5 would require blood transfusion for proper correction. Iron tablets do help, but usually take a long period of time and are mostly prescribed when there is border-line anemia. I suggest you discuss the possibility of a blood transfusion with your medical care provider. I hope I have succeeded in answering your questions, you could write back to us anytime for further clarifications. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is almond effective in improving intelligence?\n\nIn Indian Ancient considerations it is supposed that almond can enpower our intelligency. Now i want to know that is it right according to medical and physiological contaxt.If yes then will you please tell me how this work?what physiology or concept is behind it?",
    "doctor_response": "hello sirit enhances the amount of omega 3 free fatty acids that help in memory enhancement indirectly.antioxidants will be increased",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for intermittent fever\n\nI'm 45 years old guy, i have been suffering from intermittent fever for the last 1.5 months, i get body pain with the fever. EVery kind of test has been performed however all the lab reports are normal. even the CPK and Brucella test are normal. i get relief from the fever when i take a paracetamol and at times i'm required to take pain killer for the body pain (mostly in the joints). Please advice",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have symptoms of intermittent fever along with body pain which could be due to bacterial/ viral infection and due to underlying medical condition. It could be due to poor immunity of body. Need not to worry. I would suggest you to take combination of Ibuprofen and Tylenol as it is safe combination and you can take that for your present condition. As fever is of high grade at times so you should do tepid sponging as well. Take diet rich in multivitamins, fruits and take multivitamin tablet as well to boost body immunity. Drink plenty of water to rehydrate yourself. Don't combine any medication like Aspirin, Naproxen with this combination at-least 8-12 hours of each other as it will cause GI bleed symptoms and ulceration.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Spot and pimples on my foreskin after using dettol\n\nFew years back while bathing i have applied dettol, which is an anticeptic, directly on my penis. Firstly i feel like burning pain on my foreskin. but after few days pain goes away..but even after few years i have spots and pimples like bumps on my foreskin. How can i get rid of these ?",
    "doctor_response": "One should not put the Dettol like liquid directly on the skin, it is said to me by my Doctor. I think what you have to do is to see the Doctor now.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the chance of enlarged lymph nodes in armpit being positive for cancer?\n\nI have several enlarged lymph nodes in my armpit. there was only acouple a year ago , now there is 8. this past week I have had 6 needle biopsies done on the largest lymph node. there has been significant cortical thickening of the newest ones. What are the chances they are positive for cancer? The hilum is intact.",
    "doctor_response": "There are a wide range of differentials for mode enlargement ,Causes of lymphadenopathy include infections, autoimmune diseases, malignancies, histiocytoses, storage diseases, benign hyperplasia, and drug reactions.we cannot blindly say that it might be cancer or not.you are saying the number is increasing .and what about their nature are they mobile or fixed , firm or soft all that matters . do you have any constituitional symptoms like fever, body pains etc.generally complete evaluation is required to rule out differential diagnosis .such as CBC counts hepatic and renal parameters etc .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this X-ray report of the lumbar spine indicate?\n\nI had xrays of my lower back recently and the following was part of the report. I don t really understand any of this. Can you please help me understand. There is a curvilinear opacity overlaying the left upper quadrant seen only in the AP projection. While pathological calcification within the abdomen cannnot be excluded, this appearance is new from the prior study, decreasing the likelihood that this is a significant finding. This could reflect overlying artifact or bowel contents. A punctate opacity overlying the superior pole of the right kidney on the current view was noted to be projected more superiorly on the prior study and is likely a hepatic granuloma. Impression: Curvilinear opacity over the left upper quadrant of the abdomen is likely artifactual. A repeat abdominal radiograph is recommended and CT would be indicated if this opacity persists.",
    "doctor_response": "Dear sir /madam I would like to know why was the radio graph taken, As for the reporting seems like there is an incidental finding, I would like to know more about the clinical history and also like to know other finding in the radiograph Some incidental findings could be artefacts. So before jumping into conclusions  I would suggest talking to your primary clinician about your primary illness and then decide about this incidental finding",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does someone live with stage 4 rectal cancer ?\n\nMy mother has stage 4 rectal cancer w/mets to the liver , this is 2nd session of chemotherapy , what happens when the chemo stops working, usually how long does someone live with same condition ?",
    "doctor_response": "As it is stage IV  metastatic  Rectal cancer and received twice chemotherapy.ihe life should be limited 9 to 12 months.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to concieve through ICSI. Embryo not implanted due to ovarian hyper stimulation syndrome. Suggested FET. Suggestions?\n\ndear doctor ,i am trying to concive through ICSI process...my egg collection was good and embryoes were formed but i had overian hyper stimulation syndrome at that time so my embro was not implanted ..my doctor said to go for FET.my age is 34 and hormonal level and uterine thickness is fine...will the process be successful?? does ohss increases chance of having abnormal or dead baby?/",
    "doctor_response": "Hi Welcome to HealthcareMagic Ovarian hyper stimulation syndrome is over response of your body to fertility inducing drugs. It is characterized by increase in size of your ovaries, fluid and electrolyte imbalance which may affect your body adversely. So whenever there is risk of moderate to severe OHSS embryo transfer is not done in same cycle and embryos are frozen to do frozen embryo transfer ( FET) in later date when your body recovers from OHSS. FET success rates are equally good. OHSS does not increase chance of having abnormal or dead baby but increases risk to your own body. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in testicles and abdomen\n\nLately I have noticed a pain in my left testicle that feels exactly as if I've been kicked in it. The pain goes up into my lower abdomen and it's quite excruciating. The pain starts off lightly but then gradually gets worse for about 30 minutes or so then it subsides. It happened twice yesterday and today has not happened but it does feel like it's going to and its been like that all day long. Also I don't know if it's related but it feels as if I have to make a bowel movement however I don't. To me this sounds silly but it never happened to me before so I'm a bit concerned thank you for your time.",
    "doctor_response": "Hi.Thanks for your query.This is a thing to be concerned about.The pain in the testicle severe enough to be felt as to be liked kicked in and the referred pain in the lower abdomen can be due to torsion of the testes or severe epididymo-orchitis.Occasionally this can be due to ureteric colic giving referred pain in the testis.Hence I would advise you to undergo urgent ultrasonography and color doppler examination of the abdomen and the scrotum to get an appropriate diagnosis and to get a proper treatment as per the reports.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Intermittent pain on the right side of the penis, what could it be?\n\nI woke up at 3 am thus morning to urinate quite desperately. I had no pain whil urinating. When I went back it bed. About 30 minutes later I started to get intermitent pain in my penis. About every 15 to 20 seconds and last only 2 to 3 seconds. Feels like it s on one side. My right side. The pain starts dull then ends with a sharp pain then disappears then comes back 20 seconds later.",
    "doctor_response": "Higreetings Is there any history of stones in kidney or ureter before ? I suggest you to get a check up done  with an urologist.Infection in urinary system can also cause this type of intermittent pain.hope my answer helps you. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the heavy bleeding at the age of 85 be due to cancer?\n\nIf you blood work come bak ok can you still have cancer?  81 year old mother started bleeding like a heavy period 3 days ago and 195/90 bld pressure.  Her pap was just recently done and was fine they say it is not that area had hyst years ago. They can not tell where the blood is coming from.  Her father had kidney or bladder cancer.  They are taking her to emerg room to see oncolgy doc on call due to losing so much bld.  Concern is my grandfather having the cancer cld this be what is going on with her.",
    "doctor_response": "hi,i dont know what blood test were done from the details provided..i would ask you to get a coagulation profile and abdomen and pelvis ultrasound scan done firstly..this may give us some idea..we need a detailed history along with above reports..causes of heavy bleed neednt always be a cancer..causes could be..infectionpolypsfibroidsTB etcso donot worry..there are more chances for it to be not a cancer..hope my answer helps youif you have any more queries i would be happy to answer..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp, pulsating left sided chest pain?\n\nHi; I am a 51 yo female; 5 3 130 lbs. I started having sharp, pulsating left sided chest pain this morning while folding laundry. Lots of pressure, like I had something heavy sitting on my chest. The pain went through to my spine. I laid down to rest and fell asleep; when I woke, the pain was mostly gone. The pain has returned now, but a dull aching heaviness I can feel pulsating when I fully exhale that feels like it s right up against the ventral side of my spine.",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. By your symptoms and description, possibility of cardiac cause is more in your case. So better to consult cardiologist and get done 1. Clinical examination 2. Ecg 3. 2d echo 4. Stress test. You are mostly having cardiac disease as at your age of 51 years (menopausal), cardioprotective effect of estrogen is decreased and women are at increased risk of heart diseases. So first rule out cardiac cause and get done above tests.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for nagging cough\n\nMy husband has had a nagging cough for two weeks. He had an appointment with his physician for another reason, and his doctor refused to talk about his cough, but only said that if it continued, he may have to order an upper respiratory x-ray. What can be done to alleviate his cough in the meantime?",
    "doctor_response": "HiWelcome to healthcaremagic,As per your query, You can try these remedies for cough, cold and sore throat.1.Saltwater gargle- gargling several times a day with warm salt water can reduce swelling in the throat and loosen mucus, helping to flush out irritants or bacteria.Dissolve half a teaspoon of salt in one cup of water. Just remember to spit the water out after gargling, rather than swallowing.2.You can take Anti-allergic Benedryl or cetrizine, it helps to reduce mucous production3.Lozenges and spray-Sucking on cough drops stimulates saliva production, which can help keep your throat moist4.Honey, ginger paste taken with hot milk is good for cough reduction.Visit a ENT specialist, if problem persistHoping your query is solvedGet well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the prognosis for stage 4 gall bladder cancer?\n\nMy mom has been diagnosed with stage 4 GBC. That was on 9-11-14. She was treated with 2 rounds of chemo and then CT scan which determined the tumors had not stopped growing. Now she has just finished her 2nd round of new chemo and will be have a PET scan on Jan 16 to find out if the new chemo is working. She is very weak, diarhea, and not eating. She drinks Ensure and tries to drink fluids daily. She is not in much pain though. Do you think the lack of pain is because new Chemo is working? Do you think she really has a chance?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  She has stage 4 gall bladder cancer.  So surgery will not help at this stage.  Chemotherapy and radiotherapy remains treatment of choice.  It is just palliative treatment.  It will not cure the disease.  Despite of treatment prognosis remains poor. Life expectancy is not good. Sorry to say but one should not expect much from this. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for painful corns in foot\n\nI have a corn on the bottom of my foot ,it is vert painful, I AM working in a seniors home, so i am on my feet all the time. I have never ever had one of these corns, could ther be some kind of home care that i can do to rid my foot of this painful corn. I do 12 hr shifts, at the end of the day it is painful.",
    "doctor_response": "Hello,Your symptoms seem to be related to painful corns. I suggest to:- Soak your foot in warm water. Make sure the corn is fully submerged for about 10 minutes or until the skin softens.- File the corn with a pumice stone. A pumice stone is a porous and abrasive volcanic rock that's used for sloughing away dry skin.- Apply lotion to the corn.- Use corn pads.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for nerve damage\n\nhello- I had facial reconstructive surgery about 6 years ago. during one of the procedures I woke up while they were taking the wiring out of my gums, the wire had entangled with a nerve I felt like my face was splitting apart. since then I have had nerve damage particularly around my gum lines, along with a constant feeling of a fat lip. is there anything I could try? beside pain medication. thank you",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Ok, any drug we try will be a \"pain medication\". You mean \"is there something for nerve pain other than dangerous narcotics\". The answer is a very very emphatic YES. There are MANY. They are all very safe and non-addicting and most are very inexpensive. Aspirin like drugs worked on me, mostly they don't. They are easy to try. My jaw pain from martial arts dropped to zero within an hour and lasted til the drug wore off and felt like a fire alarm went off in my jaw when it did. And, nerve pills: gabapentin, amitryptiline, lyrica, maybe cymbalta are very effective and work in a day. Lidocaine patch can also work if the nerve is near the surface where the drug reaches it. Direct acting procedures can work, but they are not incredibly cheap. There can be tens unit (applied ONLY by a specialist because it has a warning about use on the head but the risk is highly over rated). There can be implantable tens units that work all the time. There can be local injection to numb or kill the nerve. It is very treatable. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My mother has gallstones. Should we get it removed as an emergency?\n\nHi doctor, My mother is 59 years old. She has gallstone and she was supposed to have cholecystectomy but was postponed due to quarantine. Last month was the supposed schedule and that time the size of the stone in her gall bladder was 3 cm. Now she is experiencing increased pain on her right shoulder. I would like to know if there is something she can do for the pain or should she have her gall bladder removed?",
    "doctor_response": "Hello. I will help you with your problem. Gall stone surgery is not emergency surgery. It should be done in an emergency if there is gall bladder perforation or malignancy. In your case, the stone size is large, and with the age of the patient malignancy is ruled out. I will advise to go for CT (computed tomography) scan if possible. If not at least USG (ultrasound) abdomen should be done. If everything is normal and only stones are there then you can wait for some time. Consult in an emergency if she developed jaundice any time. For pain, she may take any regular pain killers. Avoid fatty diet and get back to me after investigations.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment to get rid of asthma?\n\nI have been having an asthma attack for 3 weeks now, maybe more. i can hardly breathe and it feels like something is crushing my lungs. i have been to the emergency room twice for my asthma and nothing they did really helped and none of my meds are working. I am supposed to go to the hospital tomorrow for a check up with my asthma doctor person. Is there a chance I will be hospitalized?",
    "doctor_response": "HelloAs you  mentioned that you are having asthma ( supposed to be bronchial asthma ). Since this occurs  due to allergy , which causes bronchospasm or bronchoconstriction ,hence breathlessness. When such patient visit my clinic I prescribe them to take monteleukast+ bambuterol tablet twice in day till complete relief.As you mentioned that  you had 3 attacks so also need some inhaler (  for time being i.e steroid ) .Also take terbutalin+ chlorpheniramine maleat+ ambroxol syrup .Hope this information will be helpful for you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Generalized pain in abdomen that intensifies like acute colic with mild fever\n\none of my pt,20 year unmarried female with generalised pain in abdomen from last 2-3 yeas.pain is diffuse mostly mild in intensity,constantly present sometimes increases in intensity like acute coliky in nature.sometimes she is having fever mild degree.she also have h/o dysmenorrhea from last 4 year.usg which was done 2 months ago suggest left renal stone in lowerpole of size 5mm after treatment pain releive for 15 days.but it started again.then i reffered her to gynaecologist.she also advice repeat sonography.which shows small haemorrhagic cyst of 1.5cm on left ovary..but this time stone dissapear.she advice tab o2 along with antacid blood investigatios are within normal limits but her pain was not decreasing at all otherwise it is increasing day by day ,whether there are possibility of abdominal kochs? please guide me on treatment perspective.",
    "doctor_response": "HiThank you for asking HCMI have gone through your query.Genital tuberculosis can be suspected in your condition.Usually 90 percent of cases tuberculin skin test will be positive.ESR will be elevated and  CRP also.Endometriosis is the another condition which should be ruled out.In case of all negative findings for TB and if ultrasound examination also fine then a diagnostic laparoscopic examination can be taken by an experienced gynecologist.Hope this may help you.Let me know if you have any further query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed frequent urination and lipase increased from 412 to 458 after removal of tumour\n\nmy husband had surgery 4 weeks ago on a tumor that was removed from his kidney. He had some complications after surgery and came up with an ileus. He was very ill and dehydrated. Most of that has passed now. Some problems now that he is having are a puff of air or gas passing after urinating. He also feels the urge to urinate more often now. We also got some blood work back and his lipase increased from 412 to 458. should that be any big concern for us? Thank You Lori",
    "doctor_response": "Hi, welcome to HCM.Looking to your husband's history, I would like to advise you to check for injury to pancreas.Pancreatitis can raise S.lipase level.Check basic urine report, CBC, S. creatinine and do CT scan.Then consult gastroenterologist or you can communicate with me also with reports.I think this would be helpful to you.Best wishes. TC.Dr Jay Patel.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to cure addiction to Spasmo Proxyon\n\nI am addictided to spasmo proxyon drug , m taking from past 5 years every day my dosage is increasing , i started takin 5 tabs in a day , But now m taking minimum 40 tablets a day . please help me out i am 25 yrs old and i want to start a new life ASAP . can u help me out",
    "doctor_response": "Hello, You are addicted to this medicine. Take it exactly as prescribed by the doctor. Do not take in larger or smaller quantities than recommended (But now you are taking a minimum of 40 tablets a day). Consult the doctor immediately if you experience any undesirable side effects of addiction. Ensure that the treatment course is completed. Do not stop the use of this medicine without consulting your doctor. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Pervinder Rajput, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can trigeminal neuralgia in the facial area be treated?\n\ni got TRIGEMINAL NEURALGIA, IN MY FACIAL AREA STARTING FROM left side teeth, left eye and left forehead, recently i found it is mostly in left eye. if a dust or hot water poured in left eye i suffer with socking pain prolonging for a 20 secs. as i am working in a dustful country UAE, how can i avoid this or can undergo surgery for this",
    "doctor_response": "HelloThanks for writing in Health care magicI had gone through your query and understood your concerns.there are many drugstake gabarich 300 mg thrice dailyu can switch to tryptomer 25mg hs or topiramate if gabarich does not helpHope this guides you. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you do not have any clarifications, you can please close the discussion. Thank you.Wishing you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Nausea, feeling of floor or ceiling moving, auditory hallucinations, dizziness. Occurs in noisy or crowded places. Related to trauma?\n\nA few years ago I had an incredibly traumatic experience that I am still trying to get over. Since I was a kid (around the time that bad things started to happen--there was one major experience with minor ones before and after) I have had strange episodes in which I get nausea, the floor or ceiling appears to move, mild auditory halluciantions and dizziness. Only once has one of these been directly correlated with the experience (I started to have flashbacks of the pace where it happened along with the regular symptoms). is it related? what's going on? they usually happen in noisy or crowded places. (I am 16 years old if it helps)",
    "doctor_response": "Hello Such type of symptoms can occur due to post traumatic complications also. The symptoms like nausea, feelings of ceiling moving, auditory type hallucinations or dizziness etc symptoms can occur due to some anxiety. Anxiety like symptoms are occurring in noisy places or crowded places so this may be some panic like situation. I would advise you to please consult a Psychiatrist for expert evaluation of this anxiety. Treatment with SSRI, SNRI medicines and behavior therapy helps in quick improvement.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes leg pain during the night?\n\nI woke up during the night with a dull ache in my right leg. When I got up this morning, I had hamstring pain and it appears to be getting worse? Any ideas? If it is a possible hamstring injury, why would it not occur during my run? Instead, while in bed?",
    "doctor_response": "Hi, This appears to be a mechanical type of pain. The most mechanical pains occurs during the period of rest, mechanical pains are common for arthritis and continuous mild injuries. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Rohan Shanker Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My 2 year old son has a small hole in the ear cartilage. What is the problem?\n\nHi doctor, I have a two-year-old son who has a small hole in his ears. It started as a little spot and later degenerated into a small hole in the cartilage. Now it started spreading to another ear. I have gone to many ENT specialist and dermatologist, and they could not be able to figure out what it is. It began as a small dot or spot 17 months ago in the left ear and started becoming a hole. We noticed it in the right ear around seven months ago. The same way it started as a dot as seen in the right ear before it turned into a small hole as seen in the left ear. The one on the left ear is 17 months now. We have been to many ENT specialist and dermatologist, and they said they had not seen such thing before. They conducted a blood test on him and said everything is fine. It is disturbing me a lot and looking for a solution for it as I am scared, that it should not get bigger. I am using Fusibact ointment on the affected area.",
    "doctor_response": "Hi. With your description and after reviewing the pictures (attachment removed to protect patient identity), I can think of a condition called angiolymphoid hyperplasia with eosinophilia (ALHE). It is a benign harmless condition that presents with bumps in the ears. ALHE is common in adults, but there are few cases of ALHE reported in children as well. This is an idiopathic condition, meaning the cause is not yet known. This condition has to be confirmed by skin biopsy. I understand it is difficult to do a biopsy in kids, but I feel biopsy is essential because this problem is present since 17months as you have mentioned. In about 20 % of cases, there will be elevated eosinophils in the blood. You have told that the blood tests are fine. I am not sure if the eosinophils were tested. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excessive anger and aggressiveness while on Effexor in a bipolar patient?\n\nMy daughter in law is bi polar. She is on lithium among other meds. Three and a half months ago she was placed on Effexor. As of right now my son is at home with her watching her burn thngs, break thngs. She had guns, but he managed to get those away from her. As far as we can tell she is angry at the world. Could this be from the Effexor???",
    "doctor_response": "Hi, t her symptoms could be related to Effexor adverse effects or acute psychosis. Coming to this point, antipsychotic drugs may be needed. For this reason, I recommend consulting with a psychiatrist as soon as possible to help prevent her from doing harm to herself and the others. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat pain in lower side of mouth due to injury?\n\nhello sit i during my brushing in the morning stuck toothbrush on the lower side of teeth and it tott i think. it looks white in color ..(its labial frenulum ) its really pains and 2 days are ago .... i took some antibiotics .. but the pain is too much .    can you please help , how long would it take to recover   , should i take some medicine..",
    "doctor_response": "Thanks for your query, i have gone through your query.The pain can be because of a traumatic ulcer secondary to tooth brush injury.Nothing to be panic. Antibiotics will not work.You can take topical anesthetic like 2%lignocaine gel and analgesic like diclofenac gel or choline salicylate. Apply 3-4times daily before food. Do saline gargling.i hope my answer will help you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen lymph nodes?\n\nHi, I have been diagnosed with TB lymphadenopathy. But the FNAC did not find the bacteria( the result of FNAC is Z-N stain in AFB test is negative, granulomatous inflammation suggestive of TB), the chest x ray is clear, and USG showed swollen lymph nodes in left side of neck above collar bone. Can this be anything other than TB? My doc prescribed 4 tablets of Akurit-3 45 min before breakfast, Pan 40 45 min before breakfast and Benadon after lunch for 2 months. He has informed us that this will be a 9 month treatment since it has lesser side effects. Kindly advise.",
    "doctor_response": "Hi, Thanks for posting in HCM. I understand your concern. You have been diagnosed with 'tubercular lymphadenopathy' based on clinical presentation and FNAC investigation. You would not always see bacteria in the specimen. Also it will not always affect lungs every time and it can affect any organ solely in the body. Hence, what the doctor has prescribed is anti-tubercular treatment regimen, which you need to strictly follow for the specified period for the cure of your illness. In case you do not comply with it, you may land up with resistant case of tuberculosis or its complications, which would be very difficult to treat. Hope the information provided would be useful. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can shortness of breath and fatigue be treated while having high BP?\n\nHELLO MY NAME IS EDWARD. I HAVE BLOOD PRESSURE PROBLEMS AND CANT SEEM TO GET A DR TO PAY ATTENTION. LAST WEEKEND IT WAS 163/112. I FEEL TIRED SOMETIMES SHORTNESS OF BREATH, I DO HAVE MORE WEIGHT THAN I SHOULD HAVE AND WANT TO LOOSE IT BUT AM AFRAID TO GO BACK TO THE GYM UNTIL THIS PROBLEM IS TAKEN CARE OF. WHAT SHOULD I DO ON THIS MATTER.",
    "doctor_response": "only way to reduce bp is lifestyle modifications including walking/exercise/meditation with full salt restricted diet along with antihypertensives.as ur bp is not under control its high time to use antihypertensives or escalat the dose or change the drug..otherwise there is high risk of complications..let me know what antihypertensives you are already on",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tremors and profuse sweating?\n\nOk I went camping and The second night was stuck in the rain with a leaky tent the next day I was so cold and absolutely could barely keep my eyes open but was shaking so hard I thought I was going to have a seizure. I got home yesterday and slept basically all day until today but was shaking uncontrollably and was sweating so horribly even with tons of blankets and could not keep my eyes open",
    "doctor_response": "Hello there. I have read through your question and understand that you have contracted Flu due to being in the cold and open for so long. I would advise you to take bed rest . Take tab paracetamol 8 hourly for five days and drink lots of fluid. If your symptoms don't subside or aggravate you should get a blood test done. I hope that answers your question. If you have any further questions please feel free to write. Thank you for choosing healthcare magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to relieve back pain and abdominal swelling in elderly\n\nMy father in law has his bladder removed a year ago stage iv bladder cancer, prostate and urethra removed also . He has been being treated with chemotheraphy since October with not good results. Lymphnode in abdominal region swelled and causing great back pain. They have stopped chemo and want to do a radiation regime 5 days a week to shrink lymphnode. He is 87 years old blood pressure in erratic and had a fever of 108 on antibiotic now. My question is do we call in hospice now and is there anything more they can do to aleve his pain? He is also on Oxycontin. Thank you",
    "doctor_response": "Hi there.Usually there will be severe pain in cancer patients. This is usually treated with Morphine and in some cases nerve ablation if the pain is not controlled even with nerve or ganglion blocks. You must discuss these options with his Doctor for other methods of treatment for the pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the other things should I look for along with high fever?\n\nmy six year old has had a fever of 104.5 for 24 hours and doesn t have any other symptom we have been giving him Tylenol and ibuprofen and the lowest his fever got was 102.0 should I be concerned? what other things should I look for? after four hours of receiving the Tylenol or advil his fever goes back up from 102.0 to 104.0 so waiting the other four hours with his temp being at 104.0 scares me because I can only give it to him every 8 hours.",
    "doctor_response": "I share your concern. Fever in a sis year old in the absence of other symptoms could be considered as viral fever. YOu can give Tylenol every 4 hours at 10-15 mg/kg dose. and also give tepid sponging . I would do some tests like CBC and Urine RE to find the focus of infection after a thorough examination of the systems. YOu look for symptoms like running nose, cough, pain on passing urine.I would in my clinical practice try an empirical trial of antibiotics after careful evaluation. YOu can consult your doctor for further evaluation of your child. Hope I have allayed your fears. Take care regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the treatment available for recurrent pilomatricomas?\n\nHello doctor, I have had three pilomatricomas removed surgically since I was 12. I still have five left in my body. My father also had them too. Is this something that eventually stops occuring?",
    "doctor_response": "Hi. Pilomatricoma is a small benign tumor arising from the base of the hair follicle. Usually, they are not hereditary but very rarely 1 out of 100,000 cases, it can be genetic. Once cured after surgery they do not occur at the same place but in your case, one cannot guarantee you that it will not occur again. All you have to take care of is that it does not become infected and do not squeeze or pinch it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes outer thigh pain while climbing stairs?\n\nFor the past 10 yrs I have had terrible pain in my outer thigh while climbing up stairs or stepping up from a curb ( ilio tibia band syndrome? ). Now I have an added problem - pain in the front of both thighs when getting out of a chair. What could this be? Thank you.",
    "doctor_response": "Hi, I understand your concern. The pain could be due to arthritis, lack of movement, lack in magnesium and vit.D. Please get checked vit.D, calcium, magnesium levels and discuss further with rheumatologist to determine the right diagnosis. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes loose motion in an infant?\n\nmy 6 months old baby is having constant loose stool for 4 days now..the 1st day he had this made me worried bcoz i changed his diaper for 12-15 times 1 day because of his stool...but my friend said as long as he doesn t cry i don t have to worry..pls help me??thankz",
    "doctor_response": "Hi,Welcome to healthcaremagic.com.I know that you are very concerned about your child but don\u2019t worry.By what you quote it seems that your child has acute gastroenteritis.In my opinion, you should give- syrup cefixime (5ml=50mg) 2 ml three times a day for 3 days- enterogermina ampule once a day for 3 days- stop bottle feed, if you are giving- feed child more frequently to prevent dehydration.Review after 2 days.I hope this will help you.Wishing your child good health.If you have any more questions, you can ask me at you do not have any further queries, you can close the discussion and rate the answer.Take care.Regards:Dr. Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for adjustment disorder\n\ndear doc, am a chartered acountant of age 26...i've been married for an yr now..but i never seem to get any praise or appreciatin from my in laws nad my husband.. instead they always pin point my faults, and fight for mundane things line food, cloth line, hangers etc..i've been brought up in a well to do family not used to all this haggling... i just can't tolerate it anymore and am even contemplating suicide or divorce..my bp has fallen to 70-90 and i was also diaganoised with vertigo ... wht must i do?",
    "doctor_response": "Hello, Changes in environment after marriage can lead to adjustment problems. Before taking a major decision of divorce, you must discuss your problems of adapting with new family with your husband. You must share your feelings with your husband.If he does not co-operate, discuss your problem with your parents. Involve them in your every decision. Thinking of suicide is not a solution. Stay strong.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for abdominal pain and constipation?\n\nHusband had cabg  12 wks ago. 3 days after d/c rt. artery graft failed and repaired with stent. Dx with diabetes, high cholesterol, hypertension. all under control with meds, following dietary guidelines, and participating in rehab.Now having rt. abdominal pain and can hear his stomach rumbling across the room. also has constipation.",
    "doctor_response": "Hi.Noted the findings and history.The rumbling, what we call as borborygmi is a symptoms of intestinal obstruction. Both have relation to each other. The pain and rumbling are suggestive of intestinal obstruction and I would suggest such a patient to go to ER and get an X-ray of abdomen in standing position. Get admitted - nil orally or allow only water orally till then. X-ray will tell the site of and extent of obstruction.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from anxiety and panic attacks. Dizziness, nausea and tightness in chest. Symptoms of allergy?\n\nHi, I am 39 years old and although I suffer from anxiety and panic attacks, I am aware of what they are and what they feel like. I have been having all the classic symptoms of anxiety. ( dizziness, the adrenalin rush, ect). However I have been dizzy for quite a while . Not everyday although lately I have been. I have extreme heaviness in my head and feel nausea and tightness in my chest that comes and goes through out the day . I know that these are anxiety symptoms but I feel that because I'm feeling these symptoms it's bringing on the anxiety. I had gone to an allergist asking if these can be allergies that I must be having and he did say yes. I went to a neuro 11 years ago when my anxiety started and everything looked good. I wake up fine and mid day it starts. I've taken Claritin and it doesn't seem to help that much. I'd love to hear your opinion on what you think of all this. Thanks",
    "doctor_response": "Hi, i think you are over conscious about your health. The main complaint is the dizzy ness, it could be due to the infection of the internal ear, gastric irritation, cerebral ischemia, etc.                        I advise you to consult a physician for diagnosis and treatment.                        Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can uterine or cervical cancer delay my periods?\n\nHi doctor, My period is always regular with an interval of 28 days. I never missed my period before. Now, I am late for five days. Today, I had a little light pink faint discharge when I wipe. I have taken 4 pregnancy tests and all were\u00a0negative. When I referred online, it says ovarian cancer. I had a baby last year. As I was at high risk, I had an ultrasound once a month. If I had any type of gynecological cancer, why did not show up in any of the 10 to12 ultrasounds. I am so nervous as I have never missed my period unless when I am pregnant. I just want to know if this could be a cancer. I also had some pinkish brown discharge mid-month during ovulation. Is this normal or could this be a cancer? I had my annual laboratory before five months along with thyroid test, but everything was normal. Please explain me.",
    "doctor_response": "Hello. I had gone through all the data posted. Do not get worried much as you told your periods were always regular. Just with five days late of periods, it does not mean that you have cancer. You said there was light pinkish discharge, so which could be spotted and may be a sign of pregnancy. Kindly repeat your urine pregnancy test again after three days. As you said you had done ultrasound abdomen multiple times, which were normal, ovarian cancer will not come up all of a sudden. Kindly tell me how you are high risk for cancer, so that I can advise a genetic screening, which might be helpful. For further information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is red itchy welps spreading into rashes with white patches?\n\nI have what started out as a small area of what looked like red bites on my outer thigh last Monday that were itchy and so I have been spraying it with medicine to calm the itch thinking it would go away. Unfortunately now they are itchy welps that have spread into a rash with some white patches on them. What could it be?",
    "doctor_response": "Hi, It could possibly be a fungal infection. I suggest you use an OTC topical antifungal e.g. Clotrimazole cream. In addition, I suggest you take an oral antihistamine e.g. Cetirizine tablet. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Kakkar S., Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dull pain in the breast\n\nI have a dull pain in my right breast, on the side closest to the arm. It s dull most of the time, but it shoots through on occasion. It started right before my period 4 days ago and feels a bit like the soreness during my periods. It mainly stays in one place but sometimes moves all around the breast with pain occasionally moving to the left breast. I feel the pain sometimes in the pit of my arm and down the underside of my arm a little ways.",
    "doctor_response": "hi.it is best if you consult with a doctor, preferably a general surgeon, for medical and physical examination. based from your description, it could be a cyst, a benign breast lesion. it could also be a fibroma or fibrocystic lesion. these lesions are best evaluated clinically. further diagnostic examinations, such as breast ultrasound and mammography, will be requested as needed. regular breast examination and follow-up with your doctor is highly recommended in these cases.  management (medical and/or surgical) will be directed accordingly.hope this helps.\u00a0\u00a0\u00a0\u00a0\u00a0good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump on the outer part of thigh\n\nHi, I have a lump on the outer of my thigh invbetween the back of my leg and knee cap..  It feels like it has roots Coming off it.. It is a little bigger that pea size... I tryed to squeze it but nothing has. Come out.., it has been there about 3 eeeks",
    "doctor_response": "Hello! Welcome to HCM.This can be a Morrant Baker's cyst, as you said its coming from knee.Its a benign cyst communicating with the knee joint.Also it can be a lipoma or sebaceous cyst rarely.In my clinic, after clinical examination, I advise FNAC - fine needle aspiration cytology for confirmation of the diagnosis, if in doubt.Treatment is marsupialization for Baker's cyst & for any other benign symptomatic lump, excision biopsy is done i.e. swelling is removed under local anaesthesia & sent for histopathological examination.Complete removal along with whole of the cyst wall is important.Hope this helps.Wish you healthy life.Thanks.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes feeling of electric shocks on upper right thigh?\n\nMy mother is currently recovering from sciatica on her right side. She has been in terrible pain and we are trying to manage her pain with Norco and Tramadol. There has been little relief from the pain. She also has a terrible back including osteoporosis, arthritis, collapsed discs and stenosis. Today she started a new symptom which is a feeling of electricity in her upper right thigh when she standing or walking. It goes away after a few minutes when sitting.Should we be concerned?",
    "doctor_response": "kindly take an appointment with an orthopedic specialist and see if you can discuss about strengthening the muscles. kindly use the hard surface to sleep and sit as will help the muscles to stay in an active state all the time. for the kind of things you have mentioned you need to definitely undergo to a physical therapist and ask for a help. he will surely help with your pain and other factors.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in one side of the body?\n\nI have numbness on my left side from shoulder to foot . It is most noticeable in the stomach area and at night but doesn t go away. I ve had this for about 4 months now. My upper back lower neck area is tight May not be related. I ve been told I have degenerative disc. But can that be making me numb?",
    "doctor_response": "Hello ! Thank you for your question. I understand your concern . Short answer : You should be seen by a neurologist, have a cervical spine CT scan. Detailed answer : I think your problems are related to the cervical spine and intervertebral disks. The tightness of your neck is caused by the muscle contraction , induced by the cervical disk. The numbnes you feel on the left side of your body show that your spine has been compressed by the displaced disk in the lower cervical part of the column. A good physical examination for neurological signs is helpful. You should have a cerviko-thoracal CT scan or MRI , which will show the disk displacement better and the relations with your medulla.  You may need spinal surgery. Hope to have been helpful! Thank you for using Healthcare Magic!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itchy penis, spreading red marks on penis head. What are these marks?\n\nHello...about a week ago...my penis became very itchy...there was no signs of anything there so i just assumed it was from being dry since i work alot with drywall and the dust causes dry skin . but a couple of days ago, i noticed on the head of my penis a couple of red pimplelike marks. now it has seemed to have gotten worse. there are many little pimplelike marks and a couple of bigger ones and seems to be spreading down the shaft more...its increadibly itchy...Im married and havent had sex with anyone other than my wife in years and she has no symptoms...she thought i maybe had an std ...and we recently had a baby and she was checked and is negative for stds...also around the infected area...some of the skin on the pimples is peeling a little.",
    "doctor_response": "Hi itchy red pimples on the penis can be due to fungal infection called candidiasis.it can be due to leukorrhea in the partner or due to diabetes.It can be treated by regular cleaning of penis with lukewarm water and application of nizral ointment twice daily and use of flucanazole 150 mg weekly once for 4 weeks by both the partners",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lumps in canine & gums\n\nMy 8 year old daughter has a lump above her canine on top left gum. I noticed it yesterday, she says it only hurts if you poke it, its pea sized and round and white,at first I thought it was a tooth growilung through but it is not hard. Does it sound like an absess and should we go to the doctor tomorrow or the dentist?",
    "doctor_response": "Hi,From history it seems that there might be having infection in root of canine tooth.There might be having cavity in the tooth leading to root infection.Sometimes deposition of tarter in gum might cause t5his infection.Consult dentist and get examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is this semen analysis report normal?\n\nHi My name is Omar, Iam a 26 years male - 180 cm - 115 kg. Iam married from 9 months, the first 2 months my wife was taking pills to delay pregnancy, Then we used condoms and safe period for extra 3 months, after that we tried to have a baby from about 4 months but we couldnt, so she went to her doctor but he told her that everything is ok with her, so i went from 2 days to make a semen analysis and here are the values; Colour: Greyish White Opalescent Volume: 2.0 ml Method of Production: Masturbation Reaction: 8 Consistency: Viscous Count: 3,200,000/ml Total Count: 6,400,000/ml Liquified after: 30 mins Sperm Vitality: . Motility after 30 mins: 60% Motility after 1 Hour: 55% Motility after 2 hours: 50% Motiity after 3 Hours: 35% Rapid Linear Progressive: 30% Sluggish Linear Progressive: 20% Non Progressive Motility: 10% Immotile Sperms: 40% Abnormal Forms: 25% Abnormal Head Forms: 10% Mid-Portion abnormalities: 10% Tail abnormalities: 5% Spermatogenic Cells: 0-1/ml Red Blood Cells: 0-1/H.P.F. Pus Cells: 2-4/ml Thanks,,",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.As far as your semen analysis is concern, has normal color, normal consistency, normal ph.Has normal count ( 20million/ml should be atleast). Normal motility and normal morphology.Normal liquefaction time.So all parameters are normal of your semen analysis.Hope i answered your question.Would be happy to hello you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should the ER be visited for popping sound from the neck after a muscle pull?\n\nMy 16 year old son pulled a muscle in his neck today while playing golf / swinging a golf club. He said he heard a popping noise kind of like celery snapping. Is this something we should go get checked out at the ER or just wait to see if it heels on its own. Thanks",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It might be due to some minor muscle pull. As of now he can take bed rest, preferably apply a cervical collar. You can also give muscle relaxants, like Baclofen. If the symptoms persist, or in case of pain or numbness, you can consult a physician and get evaluated. Wishing you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat severe knee pain that has led to immobility?\n\nhi! this is Qamer here.. Mai i ask a question ? Q. My cousin has the problem in Knees, swelling, high pain by which could not stand up, could not walk but some time. we got check up from our local high profile doctors from here in (Islamabad) Pakistan . Different doctors shows different diseases. Now the position is so critical because due to eating high potency medicine and pain killer tablets his stomach and kidneys are highly effected and we have no other way to rescue him. please if u can help us then we would be highly thankful to you. Regards Qamer Abbas",
    "doctor_response": "Dear patient there are many reasons for knee pain depending on age. we should confirm diagnosis and best investigation for knee pathology is Mri of the knee.If pain is in both knees likely pathology is inflammatory arthritis in young age and osteoarthritis in elderly age. Blood tests like Serum RA factor  to rule out rheumatoid arthritis.  Mri should be done from radiology centre nearby you. I am not prescribing any medicine as you told you are already taking many of them. please follow up with reports",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for allergic cough\n\ni am living in pakistan, my nephew aged 17 years is suffering from allergic condition and has been treated by all kinds of medication including steroids antibiotics , anti-allergics with no response whatsoever . Symptoms include severe cough which excerbates and become severe at times and subsides itself but coughing continues . consulted ENT, PEADERIATICIAN AND PHYSICIANS and undergone various test all negatives now its been almost 16 months with same condition . can you guide us what to do.",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your nephew's history and understand your concern.I would like to know more details about his symptoms like - Does he have nose allergies (nasal block, running nose, symptoms), asthma (wheezing, difficulty in breathing) or both? If asthma, what is the frequency of episodes of wheezing/breathing difficulties? Does he smoke? or is he exposed to smokes/dusts/air pollution?From your given history, I would like to make following suggestions to him:1. Were I treating him, I would suggest him regular montelukast for at least 2-3 months.2. If nose allergies, I would add an antihistamine like cetirizine/levocetirizine to above treatment.3. If asthma, I would add inhaled corticosteroids with metered dose inhaler to the above treatment.4. I would also suggest him allergy testing which will help him to identify the substances that he may be allergic to and also to avoid them.5. In general, I would suggest him to avoid exposure to dusts, smokes and air pollution as much as possible.6. Personally I would suggest him regular breathing exercises and a diet rich in vitamins & minerals (adequate green leafy vegetables, fruits, sprouts, etc) which will help him in a long run.Hope above suggestions will be useful to him.Should you have any further query, please feel free to ask at HCM.Wish your nephew the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes easy bruising and swollen ankles while treating high BP?\n\nI am a 44 year old white female that has had pretty good health other than my BP. I have had high BP around 140/90 for the past two years and was put on a diuretic that helped get my BP down to about 126/80. I have had extremely bad headaches the past month and went into the ER because I was having trouble seeing. I was seeing spots and with the headache thought I might be having a stroke. At the ER my BP was 225/150 and the doctor took blood to check my kidneys and other tests. Tests came back negative and was put on a Beta Blocker which brought my BP down to around 169/106 with pulse at 89. I have noticed that I have been bruising easily lately and a little bit short on breath when walking a flight of stairs. At the end of the day my ankles are quite swollen.",
    "doctor_response": "Hello Welcome to Ask a Doctor service.I have reviewed your query and here is my advice.Boarder line hypertension may not need any treatment but it can be well managed with diet (Salt free diet, cutdown calorie in diet) stress free life, exercise, the most important is anxiety and depression it should not be there these are the great risk factor in hypertension, this can shoots up the blood pressure, presence of stress may cause hypertension.Hope I have answered your query, let me know for further assistance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hip pain?\n\nI have pain in my right hip, which is better after taking ibuprofen. I wonder what was the trigger, yesterday I sported - as always - but the pain started after my first visit to a therapeut in Alexander s techniek, which just showed me how to exercise my upper back!!!!!!!",
    "doctor_response": "Hello, The two possible causes are prolapsed disc and sciatica. As first-line management, you can take drugs like gabapentin for pain relief. If symptoms persist better to consult a neurologist and plan for an MRI scan. As of now, avoid strenuous physical activities and weight lifting. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this biopsy report indicate?\n\nHi, I just had a prostate biopsy. I had 2 of the 12 samples showing signs of non aggressive cancer. my Gleason scores were 3+3 and 3+4 in the right apical area. My doctor recommended removing the prostrate. My PSA blood work was 7.0. i am 57 years old. Can I just do a active surveillance and have blood work done and a biopsy done again in a year?",
    "doctor_response": "Hello,I would advise you to do surgery followed by chemotherapy with docetaxel for 6 cycles at 21 days interval. You need to do PSA test every 3 monthly.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Monish De",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat hypotonia,dizziness and blood in urine?\n\nMy soon to be 7 yr old, was kinda clumsy as a child and use to fall about 3 times a week, he often will zone out for about 30 sec. at times, in Kinder, he started to fall about the same as usual but this last school yr. he s worsened. His vision decreased, and he now needs glasses, he falls 2-4 times a day and there are always a few bruises on him but he can never tell you how he got them, this summer he had a pt eval and she diagnosed him with hypotonia, this weekend he s complained of dizziness twice (both times after a few minutes of stretching or exercising), he gets plenty of sleep at night (at times he can be restless and snore), but is tired by 2:00pm, he got diagnosed with add/adhd this summer due to behaviors he started exhibiting towards the end of school. Last week he had a renal ultrasound and it came back that both of his kidneys are dialated. Tomorrow he under goes a catherator being inserted for further testing. Tonight, I noticed blood in his urine. As far as bowel movements go, since he was a baby he would have 5-7 a day and it s still that way. When he has to go, he has to go immediately or he ll have a mess in the rr to clean. He had blood test done and it came back good. What could be causing all these symptoms? In two weeks he sees a neurologist but is that too long to wait?",
    "doctor_response": "Thank you for consulting Healthcare. He really has hypotonia, but you can control it:1.Contrast shower in the morning -hot and cool water, in the end -cool water, rubber his back from bottom to the top, this direction of massage will increase blood pressure2.Normal breakfast every morning , vegetables, soup+black tea with bread and butter, 1 chocolate to school every day.3.He should eat 4times every 4hours between fruits,better Apple,pomegranate4.Fresh juices with carrot,beets roots,ooranges5. About blood in urine- if it is red color- it can be from urethra, penis, has he fimosis,pay attention. If it is not fresh blood we can't see this it can be like as meat water . You repeat analysis of urine-if there ar RBC ,it can be gloglomeruphritis or more often dismetabolic nephropathy, because some salts6.Remind him to urinate every 2-3 hours7.You should do cystographia for excluding of nephroureteral influx, because he has dilatation in kidney, also  nephrologist can propose urogramma for exception pathology of kidney8. For treatment without examination I can advice vitamin E 1 capsule 1 time 1 month for stabilizing of membrane of glomeruleIn addition-zincovit 1 teaspoon 1 time 1 month",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could below average height be the side effect of masturbation?\n\nage: 22, Height: 172cm, Weight: 78, Never had any major deseases. If you could please tell me, then i wanted to know that whether my below average height is a result of excessive masturbation since the age of 17 (like 2 times a day), my father is 5'7, so did the above mentioned problem also play its part?",
    "doctor_response": "no not at all.  puberty takes it course in everyone. some will be tall, some will be short.  masturbation has no effect on itPlease rate 5 Stars! I strive to provide the best answers to your questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can poor hygiene cause E coli infection?\n\nHi, I have a preliminary diagnosis of prostatitis with symptoms of fever, chills, painful urination, and pain between scrotum and rectum.  I'm taking nitrofurantion 100mg 2x/day for 15 days.  I feel better now (7th day on meds).  My urine culture came back with some red blood cells and e.Choli bacteria (100,000) count.  I will continue my antibiotics for the 15 days and should again have a culture & sensitivity test.  My questions:1) how long should I wait before doing a culture and sensitivity test after finishing the antibiotics?2) other than poor hygiene, what else can cause an e.Coli bacterial infection?3) what are your recommendations?",
    "doctor_response": "Hello there,I am dr.milan an infectious disease specialist answering your question.You should take nitrofurantoin for 1 week. Than with reducing dose after urine is clear by microscopic examination or by culture report. You need to go for culture & sensitivity test by a reliable Microbiology lab and by a qualified doctor Microbiologist.Because you have already taken drugs for 1 week still it is not resolving than there need to be appropriate reporting of culture.Poor hygiene leads to infection anywhere, but here any anatomical abnormality may leads to repeated urinary infection so you should go for further evaluation of urinary system if you have repeated infections.I suggest you to go for culture of urine sample by suggested lab and than follow the sensitivity pattern of that report according to your physician guidance.Hope i have given appropriate guidance to you.if you have any query you can consult me anytime.Give me star rating, helpful vote & thank you according to your satisfaction level.Thanking you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Acute asthma. Been on inhaler and steroids. Taking seroflo combimist asthalin. Sufficient?\n\nRespected dr. i am 56 old .and i hv acute asthmatic patient. use steroid last 10 yers. nowinhaler is not working in my body .yesterday one doctor prescribeme foracort 200 autohaler is safe or not plz. suggest me now i m using SEROFLO COMBIMIST ASTHALIN AND levocetrizine+montekukast+acebrophylline and deflezacot 6 mg",
    "doctor_response": "iT IS SUFFICIENT IF THIS CONTRO; THE SYMPTOMPS I WILL ADVISE TO CHANGE LEVOCETRIZINE AS IT GIVES MORE CONGESTION YOU CAN TAKE sINGULAR 10 MG ONCE A DAY OR THRICE A DAY IF NEED dEFLAZACRT TAB CAN BE TAKEN INJ BETWEEN FOR 3-5 DAYS IF NEED BE",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for upper abdominal pain?\n\nI have a strong pain in my upper abdominal, accompanied by some nausea. Its sort of a burning piercing pain that is a little worse in the morning... when I eat antiacids it helps for about an hour... when I drink milk... it gets worse then better. And it hurts right after I eat. I also have a little swollen area on the right side of my abs in level with were the pain is. What could be wrong?",
    "doctor_response": "Hi,Thanks for posting your query.I am Dr.R.K and I am pleased to assist you.The two possible causes for your upper abdominal pain are peptic ulcer and pancreatitis. Since there is some relief with antacids peptic ulcer disease is more likely.An upper GI endoscopy and an ultrasound scan of the abdomen may be done to find the cause. Meanwhile you can take omeprazole for relief.I hope that answers your query.Regards,Dr.R.K.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Prescribed seroquel to help her sleep. Seeing a psychiatrist for Charcot-Marie-Tooth. Now stopped seeing. Has seizures. Trestment?\n\nMy daughter was just prescribed seroquel to help her sleep.  She is on Fentinyl, 2mgs clonazapam 3x daily and a few other drugs.  She told me the last time she took it that she would no longer see the psychiatrist she was seeing because she has Charcot-Marie-Tooth Disease and the Seroquel was something she should never have been prescribed.  When I remind her of why she stopped seeing him, she denies it but is back on the seroquel.  This worries me.  She is now having seizures both grand mal and petite and is currently in the hospital.",
    "doctor_response": "Hi, your daughter is having sleep disorder, and now having seizures, so there must be some thing concerned with the hypertension, ischemia of the brain, or epilepsy, she should be tested EEG, CTscan, and other tests, so i advise you to consult a neurologist for diagnosis and treatment. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having memory loss. MRI showing chronic ischemic infarction in right occipital region with gliotic changes. What does it mean? History of CVA\n\nHi, my mother is 75 years old, had a CVA last year. She has now become forgetfull since a month or so and the report of an MRI done yesterday says previously noted ischemic infarction in right occipital region now appears chronic with gliotic changes, rest of the report is same as was done last year....so what does these gliotic changes mean??? Kindly answer, thank u.",
    "doctor_response": "Dear gliotic changes are a report of brain hypoperfusion which in most cases is caused from chronic illnes such as arterial hypertension, mellitus diabetes or dislipidemia.So if you want to treat the brain problem first you have to treat those desease.Aspirin is needed at a dose of 100-300mg per day.Brain protector such as piracetam 1000mg per day or memantine 20 mg per day startinf from 5 mg per day and rising the dose each week.Don't hesitate to contact me for further advice, wishing you all the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taken Nordette after unprotected sex. No periods. Will Nordette work?\n\nMy girlfriend and I had unprotected sex last april 14, but I was able to release outside of her. But we were scared of the effects of the pre ejeculate while having sex, so she took Nordette as an emergency contraception.She took 4 pills at 6pm, then another 4 pills at 6am. However, last april 20, we had another unprotected sex, but this time I released my ejaculation inside of her. Being more paranoid than the first time, She took Nordette again as an emergency contraceptive. But we weren't able to take the specific time she first took the first 4 pills, so we estimated 12 hours after and she took another 4 pills.Yesterday supposedly was her period, but it didn't came. She said that she was feeling some of the signs of having her period. Will the Nordette work? When should she have her period? and Should we still take a pregnancy test just in case?",
    "doctor_response": "Hi dear user, thanks for your query.Emergency contraception prevents pregnancy in 75 % case( not 100%).So, chances of pregnancy cannot be denied.Majority of women have their period on time or early after emergency contraception but in some it may be delayed by 3-7 days.In my opinion, you should wait for for 1 week before doing pregnancy test. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for severe chest pain in a child\n\nHi, my 14 year old son has been experiencing severe chest pain and light headedness. I wasn t concerned until he had me feel his chest when he was having an episode . I could feel and see his heart beating rapidly and strongly for the lack of a better word. I took him to our family doctor and she assured me it was probably just anxiety although my son said sometimes the pain wakes him while he is sleeping. Once the pain was so bad he was crying and he says it is radiating into his shoulder. The doctor had an EKG performed. I don t know the results but I insisted on him seeing a cardiologist. Am I over concerned? Under? He has an appointment this Thursday with a pediatric cardiologist, should he be seen sooner. This has been going on for some time but has really become more frequent in the past month.",
    "doctor_response": "Chest pain radiating to shoulder with increased heart rate, EKG abnormalities probably suggest some cardiac (heart related) problem.Till your\u200b son gets consulted with pediatric cardiologist, take rest and avoid physical exertion, for pain you may use paracetamol or ibuprofen.For further queries regarding this disease or its medications you may consult me at Healthcare Magic under section \"Ask Expert \" >>>\"Ask Pediatrician\".Dr. Khan Shoeb",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen right leg after a bypass surgery in an elderly person?\n\nI have a 71 year-old friend who just had bypass surgery in his right leg to restore blood flow to the extremity. He returned home this afternoon and now has swelling in his right side. It is soft and painless. He has no fever or any other symptoms. No blood in stool or urine.",
    "doctor_response": "Hello,If it is the recently the surgery being performed then such swelling is likely, it is the part of surgery and no need to worry about it, foot elevation may reduce the swelling, at the most it could be soft tissue inflammation due to surgical trauma, if the inflammation increases and develops the symptoms of pain, fever discomfort then it would be a matter of concern and need to be seen by a surgeon on top priority basis.  Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Akhtarhusain",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have a little bit of blood in my urine, what could it be?\n\ni have a little bit of blood in my urine, what could it be? i wiped some on toilet paper and it was a faint orange color, so it was not much, i 1st noticed it this morning when it hurt to pee, the pain was a decent amount, i got back from school and went to the bathroom again and it hurt again but a lot less than this morning. there is no one with diabetes in my family, so it might be UTI (even though i have never had sex).",
    "doctor_response": "First  of all get your urine examination done to confirm whether it is urine in blood or some thing else.Most common cause for blood in  urine is calculus.common cause varies from male to female. UTI can cause  blood in  urine,but not the commonest cause .So to know the cause complete urine & sonography is required .Treatment depends on the cause .Start taking plenty of liquids it will definitely help you. disclaimer",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I get pregnant through IUI with cystic ovaries?\n\ni had laproscopy 2 month back ,next month I had IUI , It did not worked , so I planned for next IUI then on 12th day in my right ovary 52mm cyst was present & also in left ovary in scaning they mentioned 11mm,13mm & EM 7mm please can u tell my condition & in my future iwill be a mother by IUI OR ANY OTHER PROCESS YOU WILL SUGGEST.",
    "doctor_response": "Hi. Was it a diagnostic laparoscopy or any procedure done. However if IUI is being tried now, it means your tubes are patent. But in ovulation study the follicle size on rt. side at 12th day has gone too high. It has become a cyst and on left appropriate size is yet to reach,i.e. 18-20mm.But in any case you can't be given any injection for rupture of follicle at this stage. It might lead to ovarian hyperstimulation. So unless the the follicle ruptures and egg is released IUI will be of no use.So, wait for this cycle.Any other process I can only suggest you after reviewing all your reports.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes choking up and coughing while lying down during pregnancy?\n\nHi, I am having this feeling choking up when I lie down Fromm the last seven day I am 23 weeks pregnant. My O&G tried me on Nexium but thats not helping. I am also taking Claratyne. I also start coughing up when this problem starts. I am also using pillows but nothing helps.",
    "doctor_response": "Hi, I have gone through your problem. Are all your blood reports within normal limits as might have been explained to you by your Obst.& Gynae. doctor. It is advisable not to laydown straight while lying down, instead try to lie on your sides, left side is preferable during pregnancy as lying down straight puts pressure on underlying vessels. Sometimes low haemoglobin level may cause difficulty in breathing. It will be advisable to consult a chest physician to exclude any respiratory problem.You can do steam inhalation two-three times a day, avoid cold drinks and ice-cream, continue with the medicines prescribed by your doctor. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diarrhea, very yellow watery stools with food intake.  History of extracting abscessed, infected tooth.  Suggest\n\nHad an absessed tooth and very infected pulled on Tuesday, having diaharrea very yellow watery every time I eat even the lightest foods...on amoxocillin 500 mgs, its been 5 days, feeling very weak....is this from the bacteria coming out of my system, should I let it come out, or take something to try to stop the diaherra,??? Immodium I find does not help any suggestions if I should take something, thank u",
    "doctor_response": "Antibiotics generally can cause disturbed bowel movements which can results in diarrhea or constipation, just take Capsule Omez 500mg,half n hour before food,twice daily and take the prescribed antibiotics after food.Hope you'll find this helpfull.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever\n\nHi, I've been having fevers last two days, I went to bed at 11pm, I took theraflu around 830pm. My body temp then was at 98degrees, now its close to 3 am. My body temp at 105.5. Should I see a doctor or any other advice. My other symptoms. Sneezing first  night and body aches and fever last two days. I've been getting rest. I've taken medication.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have high fever along with body aches since 2 days which is because of viral infection or common cold. I would  suggest you to take combination of antiinflammatory medication along with antiviral medication. You should do tepid sponging as well. Avoid intake of outside food. Take anti-inflammatory medications such as Ibuprofen to prevent fever and body ache. You should rink plenty of fluids, have proper rest. I would suggest you to visit general physician once and get it examined. you should go for blood tests as well to find out exact cause of infection and start treatment.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is  112/68 BP in normal range?\n\nHi i have checked my puls and blood pressure and got similar results around 110/63 pulse 93, 112/68 p 96. those test were mostly taken ilate evening (i.e after 10 pm) by using regular hand rest electronic device, i'm 37 yrs male, 183 CM, 97 KG.  could those readings indicate something bad?",
    "doctor_response": "Hello, Thanks for posting your query on Healthcare Magic...* Brief Answer: your blood pressure and heart rate  readings are completely normal ,little overweight.*Explanation: My opinion is that high blood pressure on many occasions is an indication for control .That happens on many levels. First, be sure that high blood pressure is not secondary to any other diseases as Cushing or renal failure.Then ,Diet with low salt and less fat content is crucial. Exercise and other healthy activities are also a mean to control blood pressure. If all that dose not help, medications are a must .That is usually decided by your doctor according to your condition and comorbidities .Some drugs that are perfect for patients are not necessary good for others.Regular blood pressure monitoring is as important as starting treatment so that we could assess efficacy of the medication we started. your body mass index is around 28 that means you need to lose some weight.I suggest my patients the following : follow up blood pressure on separate occasions.The information provided by you is not sufficient to provide a good opinion. If someone comes to me with this condition I would ask them about if any symptoms or complaints presents, also personal and family history is important to know.   If you have any further questions I will be happy to help, If not, you can close the discussion and rate the answer. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed a small lump under the arm of about 2 inches\n\nI have a small lump under my arm about 2inches above my elbow the size of a pea. I've had it for about a year but the size back then was barely noticeable when touched. Now it's a little bothersome and feels like it could be affecting a nerve because my arm will feel tingly at times and slightly hurt. What could this possibly be?",
    "doctor_response": "HI. Usually this is lymph node, and being close to the nerve you get the feeling of tingling. Get clinically checked by your Doctor. Also needed is routine and special blood tests like VDRL. High resolution ultrasonography and FNAC=fine needle cytology can help the diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from mental problem. Beating people simply, feeling sorry later, regularly. Treatment?\n\nsir,my father&law have a cycatric or mental problem in which , they are very hyper any time , they beat anyone at that time . and after some time they realaised there mistake. this process is repeated many time in a day . this problem is almost 10 years old but now a days it is in regularity. so please suggest a treatment or best doctor for this.",
    "doctor_response": "Hi,Thanks for using healthcare magic.I have gone through your history.Your father in law has impulse control disorder. Stres, depression or bipolar mood disorder should be ruled out. I hope  he is not having addiction. You should take him to psychiatrist for detailed evaluation and management. Doctor may advise for some investigations including CAT scan if needed. He might be benefited with drugs like divalprorex or fluoxetine. He also require anger management.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heaviness on my cervix and some pain and stinging after urination?\n\nHi, may I answer your health queries right now ?  Please type your query here... I am 12 weeks pregnant and I have some feelings of heaviness on my cervix and some pain and stinging after urination and while sitting. I just went to the doctor and it does not seem to be a UTI.",
    "doctor_response": "Hi dear, I have gone through your question and understand your concerns. Urinary tract infection should be ruled out by proper urine examination.However, if there is no urine infection, then you should be given progesterone hormone in form of tablets or injections to reduce the pain and pressure on cervix.Hope you found the answer helpful.RegardsDr Deepti Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for type 2 diabetes and hypertension\n\nMother, age 82,Diabetic type 2 over past 20 yrs but controlled with Lantus Insulin at 120 - 135 average Fasting Sugar levels over past 10 yrs. Is also Hypertensive with average BP at 170/70 recently shooting up to 190-210 over past month. Creatinine level at 1.9 dcl/mg . Urea at 47 with normal Na Ka. Had CHF recently. Left foot swells occassionally, and has UTI over past 7 yrs Can I give her Crateugus Ox (theta) AND Aposcynum( for URINE flow ) & Berberis Vul ( for Urinary bowel infection ) ?",
    "doctor_response": "no those things won't help much. i f u want oral meds u may give metformin and Januvia. use insulin only if needed. Bp is not controlled. May give Metoprolol, Diazyde, Benazepril in consult with ur md",
    "dialogue_context": ""
  },
  {
    "patient_message": "Depression due to unemployment, do not have positive outlook, disinterested in all activities, undecided about future. Treatment advise?\n\nDr Jyotirmoy Samajdar, I am experiencing some problems with regard to my only son. He is an Hons. graduate and has completed MBA from a New Delhi based Management School. He was offered placement at Noida, but could not retain his job. He is now in Kolkata and looking for an opening. As of now, he is unemployed. It may be one of the reasons for his depression . From his childhood, he is very casual in his studies and commitments. He takes the things very lightly. His confidence is at the bottom level and is totally confused about his future mission and objective. He is totally undecided what to do in his life. He deals most of the issues with negative mindset. He lacks positivity. He is gradually loosing interest in all activities. He loves to watch TV, play with his mobile (Facebook, Twitter, chat etc.) whenever he finds his time. He goes to sleep late at night. Other drawbacks may kindly be evaluated when he is permitted to you. I think he is having serious psychological problems which need to be addressed at the earliest before things go out of control. We, as parents, his well being at all cost. I like you to guide me to overcome this problem without much delay. If needed, I can meet you along with my son on a day and time suitable to you. An urgent appointment is solicited. Tapan Kr. Roy 0000 E-mail: YYYY@YYYY",
    "doctor_response": "Dr Samajdar, This is a condition called either Psychotic Depression or Schizophreniform psychosis. His symptoms can be corrected with medicine like anti psychotics after proper assessment after interview with patient and close related person.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the hip after taking treatment for scabies infestation?\n\nHello Doctor. I took Ivermectin 4 days ago for a possible scabies infestation. Today I experienced sudden pain in my hip/groin area upon walking. It s been consistent for about 5 hours now. I can find some relief when I lay flat on my back on the floor, but sitting causes terrible pain. I also was on my feet for about 6 hours yesterday at an outlet mall. I remember reading that joint pain could be a possible severe side effect from Ivermectin. Do you think I could be experiencing a side effect of the medication 4 days later or could this be a back/disc related problem. I m also having acid reflux symptoms at the same time. Add all that to the horrible rash all over my body and basically I m just a mess! I m a 58 year old female. Thank you for your time, doctor.",
    "doctor_response": "Dear patient  Ivermectin can lead to multiple joint pains but not pain to particular to hip joint.  This can be related to your back issues such as muscle sprain or back spasm. You should take tab diclofenac plus thiocolchicoside combination twice a day for 5 days. Your pain will bee relieved. If not benefited by 5 days therapy you need to consult expert orthopaedic  surgeon with report.  All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can mental illness causing headaches, palpitations, tremor, chest pains be treated?\n\nI have been suffering from mental illness from four years and symptoms of this are headache, palpitations, abnormal heartbeat, trembling, pain in chest and palms and not able to sleep. I  consulted to many doctors and they prescribed me medicines but that does not work. Now i am very worried about my health and not able to do anything. Please tell me a solution about my problem. Thanks and Regards.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. From the description, I can say that you are troubled with anxiety disorder. Possibly Generalized Anxiety Disorder (GAD). For GAD, is a disorder, and not a disease, medicinal treatment may not work.Many researches and researchers confirm that medicines alone cannot cure mental disorders. Life style changes, change in thinking pattern, relaxation etc are as essential as medicines. Psychotherapy can help you changing your lifestyle and thinking patterns. Yoga and meditation help you to streamline your metabolism and neurological balance. Please consult a psychologist for further information.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Body pain originating from stomach or liver. What specialist doctor should we concern ?\n\nWhat specialist to consult for whole body pain originating from stomach or liver Hi, One of my friend have problem of whole body pain that is initially started from stomach/liver then whole body pains. We have consulted with many general physician doctors and doctors says he do not have any problem or disease. Let us know what specialist doctor should we concern.",
    "doctor_response": "Hello, this is Dr Ahmad He needs to see an Internist, which may refer him to another speciality doctor My website",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for hair loss?\n\nhi, i am 32 yrs old & 2 yrs back i deliverd a baby, after delivery my hairfall was started still it is continuing & know i got typhoid fever which again for sure hairfall will be their. so kindly suggest me. thankyou.........................",
    "doctor_response": "Hello,Thank you for posting on HCM.I appreciate your concern regarding hair fall. Hair fall is usually ascribed to multiple factors like diet and nutrition, hormones, stress, acute or chronic medical conditions,drugs,cosmetic products etc.From your description, it seems you might be having Telogen Effluvium, which is hairfall secondary to stress which in your case is the influence of pregnancy. Pregnancy and lactation are highly demanding states and are common reasons for acute hairfall.If i were your dermatologist/trichologist, i would like to recommend some basic investigations like CBC,blood sugar,Thyroid function test, vitamin B12 and D3.Some other special investigations like trichogram and dermoscopy and further aid in diagnosis and prognosis.I would suggest you a course of oral tablets containing biotin and other essential vitamins and minerals for minimum 3 months. Also, would put you on a hair serum containing peptides for hair growth at night.(Q sera etc). I would advise use of gentle shampoo and conditioner on regular basis and use of coconut oil twice a week.Also enquire from your dermatologist about upcoming treatment options like mesotherapy and platelet-rich plasma.Avoid combing in wet hair and let them dry by wrapping in towel. Avoid blow dryers and hair-color/dyes. Take plenty of fresh fruits and vegetables in your diet and try to de-stress your routine life.Hope your queries are resolved and wish you best of health.Thank youDr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for the bad choking fits, congestion and severe cough?\n\nHi my mum is 83 and for years now she has been suffering with bad choking fits every day which seems to come from congestion. She does nt take any medication and says that nothing can be done to help her. As she gets older the coughing is getting worse. Is there anything that can be done to help her? When she coughs she sometimes runs out of breath. It is constant every day.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your mother's situation and problem. In my opinion, we should first diagnose her and than start appropriate treatment. By her history and description, possibility of bronchitis or aspiration pneumonia is more. Bronchitis is common in old age. Choking with thick secretions in old age is common in aspiration pneumonia. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x ray to rule out pneumonia. 3. PFT (Pulmonary Function Test) for the diagnosis of bronchitis. She may need antibiotics, inhaled bronchodilators and inhaled corticosteroid (ICS). So better to first diagnose her and than start appropriate treatment. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a knot at the back of the head?\n\nMy 14 year old daughter has a knot on the back of her neck that she is concerned about. I remember having something similar at her age that I believe was just swollen glands. I want to know if this is common or if I should take her to her pediatrician.",
    "doctor_response": "Hello, It may be an enlarged lymph node. Usually, these are caused by adjacent common infections. If there are no other symptoms, I don't think it is necessary to see the Pediatrician. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest discomfort and heart palpitations?\n\nI have an uncomfortable ache in center of chest where breastbones meet and when I check my pulse in my neck I feel four beats, a pause, four beats and a pause. sometimes three beats but always a pause. Are these things something to be concerned with?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. After going through your medical query I understand your concern and I would like to tell you that most likely you are facing abnormal electrical conduction of the heart which needs proper evaluation to avoid life threatening events related to arrhythmic cardiac activity. Kindly get a basic cardiac evaluation an ECG, Echocardiography and a Holter ( ambulatory ECG ) for minimum 48 hours and personally consult a Cardiologist for physical evaluation. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can mouth ulcers be treated?\n\nMy sister has a really bad ulcer in her mouth.  Is there anything  that used to be sold by prescription that I can purchase at the drug store that can heal mouth ulcers.  I need a medicine that formerly was sold by prescription as the over the counter medications don't seem to work.  She used to use Triamcinolone Acetonide Paste for mouth, but she is out of it.",
    "doctor_response": "Hi..Thanks for the query..From.your explanation it seems to be apthous ulcers or canker sores..It can be a side effect of the medication, deficiency of iron and vitamin B12, stress, physical trauma to the tongue, allergies, acid reflux etc..I would suggest you to consult an Oral Physician and get evaluated and a thorough clinical evaluation and investigations like blood tests can help in diagnosis..Treatment of underlying cause will relieve the symptoms..As of now you can start gargling with a numbing mouthwash containing Lignocaine to relieve the symptoms.You can also take a multivitamin tablet daily..You can take anti inflammatory painkiller like Ibuprofen..Suck ice and do cool water rinses..Avoid spicy food..Hope this  helps..Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does chest congestion persist?\n\nIt started suddenly as lung congestion and persistent cough when I wen to bed. The next day I had a fever, headaches and generalized weakness with some dizziness and impaired balance. Over several days all the symptoms subsided except for the lung congestion and night time cough. How long can I expect this to persist? When it finally disappears will I be totally well and no longer contagious? Thanks for your opinion.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. By your history and description, possibility of post infectious bronchitis is more likely. Bronchitis is inflammation of airways. It causes chest congestion, coughing etc. It is commonly seen after viral upper respiratory tract infection (URTI - common cold). Usually it is self limiting in 1-2 weeks. So wait for 1-2 weeks more. You can do warm water gargles and steam inhalation 4-5 times a day. If symptoms persist or worsen then consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT will not only diagnose bronchitis but it will also tell you about severity of the disease and treatment is based on severity only. You may need inhaled bronchodilators (Formoterol or Salmeterol) and inhaled Corticosteroid (ICS) (budesonide or fluticasone). Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is alternative medicine advisable for adenocarcinoma cancer in stomach?\n\nMYSONINLAW IS SUFFERING FROM ADENOCARCINOMACANCER IN STOMACH WHO IS A DOCTOR IS ON FOURTH STAGE. HE IS NOT ABLE TO SWALLOW EVEN WATER.KINDLY ADVICE ME IS THERE MEDICINE IN SIDDHA PARTICULARLY AT COIMBATORE TAMILNADU AGE 35YEARS HEIGHT 160cms weight 40 kg",
    "doctor_response": "**1. Since the said condition is surgical, and because he is in fourth stage of cancer, your doctor might have given up the idea of doing surgery, thus it is best to have your Doctor to look into the matter, and since he is unable to swallow even water, in best interest kindly treat him in ICU [intensive care unit] with possible intravenous fluid and nasogastric feeding.2. No Alternate Medicine will work orally [as unable to take even fluids], and giving them through nasogastric tube will depend upon your attending doctor discretion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pregnant. Lower abdominal pain, back pain, pelvic area pain, migraines, mucus like discharge. Suggest?\n\nI am 36 weeks and 3 days pregnant with my second child. For the past week my BH have become stronger and more frequent. I feel them in my lower abdomen and lower back. And every time I stand there is terrible pain in my pelvic area. Its become impossible for me to sleep with this pain thats also followed by horrible migranes and an increase mucus like discharge. Last week my ob said I was 2cm 50%. What should I do because the pain is now unbareable?",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for asking a question to H.C.M.Forum. You are a pregnant of 36+weeks, doctor told that you are 2 cm , and 50%. It means you are nearer to the delevery. But the problem is you are getting pain, especially when you stand. You also got migrine, and increase in mucous like discharge. It is a common occurance with every pregnant. Due to more gap between pregnancies, Large baby size, or apprehension you are feeling more pain. As you are feeling the pain unbearable, you enquire your doctor for a relief. Wishing for a quick and complete relief. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for upper respiratory allergy\n\nI am currently having an IC flair up (which I have not had in a long time and it had been controlled with diet); I am also experiencing upper respiratory allergy symptoms (sinus drip, sore throat, coughing). I do have an appointment with my family dr. this after noon. What kind of treatments should I expect? Do you have any suggestions.",
    "doctor_response": "Hi thanks for contacting health care magic...Noted you have flu like symptoms...Sore throat , cold etc...It may be viral or allergic infection....Symptomatic management done...For cold decongestent taken like oxymetazoline.... If it seems pure allergic and if feel by doctor he might prescribe you azelestine antihistaminic nasal spray ....Cetrizine also useful....I would like to suggest you to do your CBC .If lymphocytosis viral and if eosinophilia allergic could be cause....Drink more water....Steam inhalation useful....Avoid excess spicy food...You will recover within few days....If still not improving then according to your physical examination further work up will decided....Take care...Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes coughing?\n\niI have recently been coughing a lot with plemg coming up sometimes.  I went to the Dr and he said I ha a crackle in my chest, gave me atnibiotics but I still have the cough.  Nw i am feeling exhaused can hardly lift th newspaper.  I am breathless and episodes of sweating.  I had a liver operation joining my liver to my small intestine 6 yerars ago.  Can you give me ay ideas.  I also have sore teeth but not toothache",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, possibility of lung infection (pneumonia) and bronchitis is more. Both of them can cause coughing, phlegm production, breathing difficulty, sweating etc. So immediately consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x ray to rule out pneumonia 3. PFT (pulmonary function test) for the diagnosis of bronchitis. You will need higher antibiotics, inhaled bronchodilator (formoterol or salmeterol) and inhaled corticosteroids (ICS) (budesonide or fluticasone). Don't worry, you will be alright. But 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be red gums that bleed and canker sore?\n\nHello. My 24 month old suddenly has very red gums that bleed when I brush her teeth. I know it hurts because she refuses to let me brush now. It seems to hurt when she eats too. She also just had a canker sore heal on the inside of her cheek. I brush her teeth everyday..what could this be?",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,     I have gone through your query, as she had bleeding while brushing it can be due to periodontal problem or erupting tooth .  Dont worry advised her to do warm saline gargle two - three times a day  You can apply ointment Mucopain or Dologel twice daily on canker sore . Consult dentist and go for oral prophylaxis Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I get runny nose and tickling sensation after getting treatment for pneumonia?\n\nI was diagnosed with pneumonia 9 days ago. I had been sick a week before that. i get better, then it seems to come back. Now I have a runny nose (which i didn t have before) and I still have a tickle. 1 day good, 1 day bad, 1 day good. etc. Why the runny nose? what does the tickle signify? I am a singer. Got get well by Sat. this is tues.",
    "doctor_response": "Hello, As you explain the history you don't have to worry you are in the phase of improvement just so correctly the treatment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jnikolla, Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of potential pregnancy?\n\nSo I had sex with my girlfriend 9 days ago and that was 2 weeks after her last period. I wore a condom and it broke when i was outside and then we stopped. We were talking because i m a worry wart and she said she had bleeding for about two days this week and it stopped. Could she be pregnant I never finished and the condom broke outside of her but she had her period like a week early and it only lasted 2 days what does that mean?",
    "doctor_response": "Hello dear,I understand your concern.In my opinion as you haven't ejaculated inside the vagina and the condom did not break when you are in the chances of pregnancy are rare.So dont worry.Relax.But as the period came early and it was lighter than usual a urine pregnancy test need to done just to rule out the pregnancy.The bleeding for 2 days makes the pregnancy unlikely but it is better to test.If the test is negative the bleeding can be considered as period and it might be due to hormonal imbalance.Best regards....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in neck, shoulder, upper arm to fingers, rib cage. Histroy of acdf surgery. Reason?\n\nI have had an acdf surgery in Dec 2011. After I had my surgery, my pain was worse. I still have pain in in my neck and both shoulders, more on left side. The pain is even in my upper left arm all the way down to my fingers, especially ring and pinky fingers. I also hurt are my rib cage on left side. What is causing this?",
    "doctor_response": "ACDF surgery uniformly yield good result. The radiating pain in the arm may be related to nerve pain. However its difficult to establish the reason. I would suggest to get a fresh MRI cervical spine to rule out any residual pressure on the nerve or may be adjacent level degeneration. Another thing how frequently you have this pain. If possible please upload fresh MRI to help you to understand your spine problem.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is angioplasty right treatment for diagnosed 80% and 60% blockage in valves?\n\nMy dad had a Heart attack on 22.11.11 and was hospitalised and taken the angiogram, and the report was he has block in one valve about 80% and in another valve he had 60% , Doctor suggests to have a angioplast. Please advise we have to do the angiplasty immediately. And also let us know the best hospital and doctor for doing the angipplast with the lower cost and what will be the cost to doing that in bangalore.",
    "doctor_response": "HiFor the blocks ranging from 60 --90% angioplasty is the best solution.Please go ahead with the procedures as early as possible.Best hospital with cheaper  rates are narayana hrudalaya centres,still cheaper withbonly stent cost is jayadev hospital.You can discuss the cost at the help desk of the following hospitals.All the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Meloxicam be taken along with Oxaprozin for back pain?\n\nI am taking oxaprozin 600mg twice a day for back pain. I have some Meloxiaam tabs 7.5mg my previous Dr prescribed for back pain . I take the oxapeozin morning and night my question is could I take 1 meloxicam at noon also to speed the recovery of back pain?? Larry @ YYYY@YYYY",
    "doctor_response": "HelloThank you for trusting HCMDear both are NSAIDS may can cause peptic ulcers , kidney damage, elevation of blood pressure etc..There is no relation like if you take more drugs and early recovery. It will take its own time to recover so .  Better to avoid it why because usually twice a day dose is sufficient.If symptoms not improved please consult your treating doctor he will examine and treat you accordingly.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes loss of appetite while on treatment for depression/multiple sclerosis?\n\ni feel hungry but donot feel like eating anything. i have been obese all my life. i am a multiple sclerosis patient and also suffer from depression. i am taking treatment for both. i am 27 yrs old and weigh 96kgs 5 6 tall. i am not feeling like having anything from almost a year. first i gave up vegetables and started having only chicken. but now i dont feel like having that too. what to do?",
    "doctor_response": "Yes depression causes change in eating habbit. Dont worry take some appetizer like livzuyme syrups. It will help you a lot.  So dont worry.  Hope my suggestions helpful and thankful to you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the treatment for rheumatoid arthritis?\n\nHello doctor, I am diagnosed with rheumatoid arthritis. I have swelling on ankles, elbows and some fingers along with deformity in right wrist. Currently, I am taking ayurvedic medication. I need consultation.",
    "doctor_response": "Hello. If you are diagnosed with rheumatoid arthritis, have completed your family, and do not want to conceive further, then start DMARDS (disease-modifying antirheumatic drugs), Methotrexate 15 mg once a week and Hydroxychloroquine 200 mg morning and evening if you have active arthritis. Start low dose of Methylprednisolone (Sterio 4 mg) once daily and Pantop 40 mg before breakfast. If you want to have kids, then instead of Methotrexate take SAAZ (Sulfasalazine) 500 mg morning and evening. Also, mention your C-reactive protein and ESR (erythrocyte sedimentation rate) For more information consult a rheumatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful numbness in the wrist post rotator cuff surgery?\n\nRotator cuff surgery 2 weeks ago and I had a nerve block I ve been in the sling for 2 weeks and I can start loosening it up and stretching my arm down when I noticed that as I would move my wrist around I have numbing in my wrist is this normal to have this numbness and certain ways I turn my wrist it s extremely painful so I m just assuming that because I haven t my arm in a while or is this some kind of nerve nerve damage from the nerve block",
    "doctor_response": "Dear patient Lots of fluid is used during rotator cuff surgery which leads to swelling of tissue around shoulder. Numbness in the operated limb may be seen in many patients. You should start tab pregalin x 75 mg one at bedtime. Keep.moving elbow and wrist joint if not contraindicated by your surgeon. If not relieved within a week please visit your operating surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes seizures after surgical removal of GBM Grade4?\n\nI had 7years ago ,I had removed GBM Grade4,had surgery and chemo oral chemo TEmadar lOOK IT FOR14months and and now I m having seisure like improvement 3 meg 2Mir ,CT scan I m still falling they put me on a small dose of. KEPRA I I don t handle anti sewer meds ,IM very UnStabe I m still falling ,do you think this is it Or do you this my brain overdosed with valium and I need a spy for this? Thanks CArol",
    "doctor_response": "Hi, I'm sure that your medications in some way are contributing to your symptoms and the good news is that there are many other options to using Keppra if you are not able to tolerate that medication without increasing your falls or instability. Maintain good hydration and eat 3 good square meals a day, get some exercise, and remain as active as possible. Nobody can predict the future. However, I think there is definitely room for making things better if you give your doctors an opportunity to go through things in a stepwise fashion. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is stage 4 liver cancer curable?\n\nDear Sir, I am kiran from hyderabad, 5days back we came to know that my father is suffering with Liver cancer of stage 4 with fat stomach diluted with water. Is it curable? which hospital is best in hyderabad. pls let me know. it will be very helpful to me.",
    "doctor_response": "Thanks for your question on HCM.  When liver cancer spreads and involves distal organs like  lungs, kidneys, bones, peritoneum  etc than it is considered as stage 4 liver cancer.And it is inoperable and incurable.  We can only give palliative chemotherapy and supportive treatment. You can consult oncologist for further treatment. He needs PET scan to rule out distal metastases.  So palliative chemotherapy and nutritional and pain management is the only option. Stage 4 liver cancer is inoperable and incurable. .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant lethargy and pounding of chest?\n\ndon't know what to do, so looking for advice.  i have not had any energy in wks, so much so that mentally i am drained.  i have this odd feeling in chest like i can feel my heart.  can't walk up the stairs w/o wanting to just lay down somewhere.about to get fired it is so bad. been to doctor; blood ok (do have hep c), blood pressure ok, listened to my heart and said ok.  yet it is getting worse...ahhh",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.First of all no need to worry for heart diseases as your blood pressure and blood reports are normal.Sometimes undiagnosed stress and anxiety can also cause similar symptoms.So avoid stress and tension, be relax and calm.Consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution.You may need anxiolytic drugs too.Don't worry, you will be alright with all these. Avoid stress and tension, be relax and calm.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is high hemoglobin level indicative of some disease?\n\nHello doctor, I am so worried. I had a blood test and my hemoglobin is 16 g/dl (9.9 mmol/l) and hematocrit is 46 PTC. I am female, 39, and healthy. My white blood cells, platelets, and thrombocytes are in normal middle range. Is a bit high hemoglobin sign of some sickness? What to do next?",
    "doctor_response": "Hi, Welcome back to icliniq.com. So, actually, your hemoglobin level is borderline high and not low. So, you are not having anemia. You are probably thinking about polycythemia. But as your hemoglobin is not much elevated and your total WBC count with platelet count are within range, no need to worry. In the female, normal hemoglobin range is between 13 to 16. I suggest you investigate with serum erythropoietin just to be sure if it is within range. Excess non-vegetarian diet also can lead to high hemoglobin level. Sometimes, if the investigation is done in the dehydration stage, then also such finding can occur. You can revert back with serum EPO (erythropoietin) report to guide you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in face and arms?\n\nhi i need to aski have a male whos 50 years old  he woke this morn was feeling dizzy when he stood up  when he came to sit he look very pale  i had him drink a gatoraid an soup his color came bac about 30 min i went to check he broke out in a heavy pouring sweat and his left side of his face went numb hes answering qestion right  with his name an soforth i checked about ten min ago now his right arm is numb hes telling me hes ok he just wanted to rest hes sleeping ok for the moment",
    "doctor_response": "Hi, welcome to our site. I am Dr Saumya Mittal.Read your query. That is a very significant question and i appreciate your problem. I will try my best to answer your queryI would like to know the previous medical issues.It sounds to me that we are talking about a possible stroke.A stroke usually occurs during bedtime and may present with vertigo. The numbness may in fact be due to the same problemI would suggest an MRI brain, along with MR angiography.And there after a regular aspirin may be advisable.I hope this helps you. Inform the reports mentioned above so i can be of help further. Best of luck.I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you.Please do understand that some details could be extracted from a detailed history and examination.Looking forward to your return query with the details asked so that I can help you further.(If the answer has helped you, please indicate this)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does normal sperm count with prolonged liquefaction mean?\n\nVolume : 1.5 ml Colour : greyish white Appearance : viscid , opaque Reaction : Alkaline (ph : 8.0) Liquefaction : prolonged , more than 3 hrs. motility is 20 % , sluggish \" 30 %, Non-motilie is 50 % . Microscopic : Pus cells : 2-4 / HPF Epithelial cells : occ/HPF Morphology : The majority of the spermatozoa are normal in morphology. Sperm Concentration : 48 millions / ml Total Sperm Count : 72 milions / Ejaculate Impression : Normal sperm count with prolonged liquefaction. ************************************************************ Please let me know any thing is abnormal in my report. I heared that 20 % active , 30 % sluggish will also be considered as a normal",
    "doctor_response": "Hello, Prolonged liquefaction time and itself doesn't cuase infertility and i can see that your other parameters in the semen is very good. Although the most common cause of prolonged liquefaction time is presence of bacteria in the semen and i suggest you do a semen culture to be able to detect and treat this bacteria. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Manuel C See IV",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any treatment for removing fatty tissues in chest behind nipple and aerola?\n\nHi I am 33 year male I have a fatty tissues in my left chest behind nipple and aerola. Its not that much hard but when I gently press it it pains tenderly. I have it for the last 3-4 years not increasing.  Once I have taken anabol 5mg. is there any medicine to cure it without survery.",
    "doctor_response": "hi..i understand your problem.you have inflammation in the areolar region.my opinion is that,1.dont squeeze the area.2.maintain good hygiene.3.apply antibiotic creams like fusiderm ointment twice daily over the lesion.4.take pain killers like diclofenac tablets twice daily for 7 days.thank you.i wish you for your good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "belly button pain\n\nhi. i am experiencing pain around belly button for a week. it comes n goes, just above belly button part is very tight n hurts whn i press my belly there. n this happens mostly when i lift up heavy weights. its said its difficult for doctors 2 to diagonise it. any help?",
    "doctor_response": "HI Your history is suggestive of muscular spasm The another possibility is Gastritis Avoid lifting weight If U r a smoker or alcoholic avoid that Yet if no result contact me I will suggest some medications Make it a point to rate the reply - Get well soon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Liver cancer, multiple organ failure, weak, due to have endoscopy. What is the likelihood of recovery?\n\nMy grandad is in hospital at the moment. He has liver cancer which burst last week and he has had to be put on a ventilator. He has had multiple organ failure and was too weak to go to theatre. He is now due to have an endoscopy. Does this mean he is getting better if he is able to have an anaesthetic and go to theatre. Also what is the likelihood he will recover?",
    "doctor_response": "Hi and welcome to HCM. Unfortunately this sounds very serious to me. Obviously this is terminal stage of liver cancer and this is one of the worst cancers. Today there is almost nocontraindications for anasthesia so it doesnt mean he is better. I cant predict without findings but condition is very serious. I dont know reason for endoscopy,they might suspect of internal bleeding perhaps. All in all I wish you good health and I hope for the best .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mental illness\n\nHiv, emrayy  I ansawner gyourr yhealth queries rigtn ?  Please type your query here...my sister is some time behave like metal she become very angry and she is not in position to leisten any thing and in that movement she can do any incident too is this menatl case or any disease.pls reply",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  From the description given, it is not possible to diagnose the problem correctly. Getting angry and not listening to elders are not considered as mental disorders. Disappointments and other simpler triggers do cause such troubles. Do understand. Talk to your sister regarding this. If you cannot talk to her or if she do not accept your intervention let other elders of the home do it. Don't irritate her. If need be, please consult a psychological counselor.If you require more of my help in this aspect, Please post a direct question to me in this URL.  Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Epilim intake have any side effects?\n\ni have been taking Epilim for 4 years now and now have been suffering with not been able to get it up, i would like to know if Epilim has been causing this as it has stared from when i was first put on Epilim and since my dosage has increased the problem has become worse",
    "doctor_response": "Hello, It is not related to epilim. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will Meloxicam help in gallbladder and RUQ pain with inflammation?\n\nIn the past few days I had a very bad attack of pain in the RUQ and after ultrasound was diagnosed with gallstones and suggested gallbladder removal. My question is, if I have another attack before surgery will Meloxicam 15mg (being an nsaid) help with the inflammation and pain. The last attack lasted 6 hours and needless to say was excruciating. Thank you",
    "doctor_response": "Hi.Thanks for your query.Meloxicam being NSAID will help for the pain and inflammation . but this will be just a suppression of the symptoms and not the treatment.; Gallstones and inflamed gall bladder must be removed within time before complications occur like gall stone impaction in the bile ducts causing surgical jaundice, pancreatitis and so on .. So try to get an appointment, get the gall bladder removed within time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes night fall in men?\n\nHi i am 25 year of age and i frequently experience night falls, when i a get up in the morning i feel so embrassed my undies are wet. i dont even masturbate . i dont understand the problem only i never dream of porn movies in nite also. even then i have nite falls or some time internal flow . so is nite falls is normal or abnormal. is there any tablets to reduce the nite falls. please help me.",
    "doctor_response": "Hello, A NIGHT FALL / nocturnal emission / wet dream or involuntary leakage is an involuntary ejaculation of semen that occurs during sleep or along with urine while urination. Studies show that approximately 83% of men experience a nocturnal emission or leakage at some point in their lives. There is nothing wrong with a person if he or she experiences a nocturnal orgasm or nocturnal emission or leakage, as they are normal and healthy experiences. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. K. V. Anand",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anxiety disorder\n\nI am over 50, female,  and I cry at everything, too much, at work, thinking to myself, watching tv, anything I will start crying. Its starting to interfere with my work. I cant give a presentation, or discuss business with managers, etc,, I don't feel over stress.. Any suggestions?Laura",
    "doctor_response": "DearWe understand your concernsI went through your details. From the given information, it looks pretty peculiar kind of depressive disorder. You are not that emotional Are you? People do have \"faint-heart\" problems. Are you that kind of a person? If not, you should consult a psychiatrist for treatment in depressive disorder.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Nexplanon. Abdominal cramps, white discharge, abdominal weight gain. Negative pregnancy test. Help\n\nhey. I got on nexplanon birth control in mid November last year. and my last period was in the end of December. I am experiencing cramping in lower abdomen, clearish white gooey discharge(no smell) weight gain but only in my lower abdomen area. I had brown gooey discharge almost 2 months ago drs thought I was just gonnastart my period but never did. my stomach cramping gets worse and worse and I don't know what to do. I've take multiple preg test and all look like neg. please help! thanks in advance",
    "doctor_response": "Hi.Thanks for asking in Healthcare Magic.Your symptoms may either be due to pelvic inflammatory disease or bacterial vaginosis. Birth control pills can result in irregular menstrual flow or complete absence of period after stopping them, they may not result in  abdominal cramps and discharge.. The increase in weight in your lower abdomen area may be due thickening of endometrium that is common in delayed periods. Multiple negative pregnancy tests does not necessarily indicate absence of conception as the reliability of home pregnancy tests varies unless you do it meticulously. So, it is always safer to exclude pregnancy through blood tests or through physical examination by a Dr. You should consult a gynecologist to confirm the diagnosis and to rule out pregnancy. You may need antibiotics or anti fungal agents depending upon the type of infection.I hope this is useful to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is anti rabies vaccination sufficient after a dog bite?\n\nHi,my husband was bitten by a german shepherd dog 2 days back.he was badly injured n bleeding from his left back where he got the bite.Immediately took him to the hospital.they gave him first aid treatmenta tetanus vaccine n an anti rabies vaccine  named SII RABIVAX.they instructed the entire course to b completed as scheduled that is 0 day,3rd day,7th day,14th day n 28 th day.with no restriction on diet n prescribed DOLO 650 mg ..n advised to keep the wound open.in case of very high fever...we are not sure if the neighbor's dog that bit him is vaccinated or not coz he didnt show us the vaccine certificate.pls let me know if something else needs to b doneis this treatment sufficient",
    "doctor_response": "Hello,Welcome to HCM,Rabies is 100% fatal but it is 100% preventable by proper and adequate treatment and this is transmitted by dog bite.As your husband was bit by dog which was badly injured with bleeding from the biting site and immediately took him to the hospital and they gave him first aid treatment with tetanus vaccine and anti rabies vaccine and instructed to take  the entire course. According to WHO it is categorized into Cat III. Bandaging the wound is not advised according to WHO recommendations for the management of dog bite. For your condition I would suggest you to follow1.Active immunization with antirabies vaccine on days 0,3,7,14 and 28.2.Passive immunization with RIGs around the wound,if there is a severe bleeding from the site of bite stay suture can be put after administration of serum.3.Oral antibiotic like Tab Augmentin, twice daily4.Topical T-Bact ointment.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Free fluid in POD.Any cyst formation in uterus?\n\nDear sir I am 30 years old I am having 2 children. Ovilation period (After 5 days of period time) i am getting too much pain in abdomen area in past one year. I checked ultra scan sound result. Report: free fluid in POD. Then i checked montoux test. Result: Positive. Then i checked urine & blood test related to TB, Sugar & Anemia . Results are negative. What is the real problem? Why pain is comming during ovilation period. pl explain.",
    "doctor_response": "Hi, Thanks for query, It seems that you have got some pathology in your genital tract. Your Montoux test is positive so we should think of possibility of tb in genital tract. It may be in fallopian tubes,uterus,ovary. Consult expert gynaec and get investigations done. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Frequent fainting. Affecting normal life. Blood tests normal. No apetite. Reason?\n\nI have been fainting for the last 2 weeks, first it was just after a workout then it was doing anything from sitting to walking across my kitchen, i have been to the drs 3 times last week and will be going back tomorrow. they seem to dismiss it and it is very frusterating. they have told me not to go to work, not to drive and not to workout. i need to get back into a routine and need answers. I have had no apetite but all of the bloodwork showed up normal and not conclusive of any viruses . please help.",
    "doctor_response": "Hello,Thanks for the query,I understand your problemThe causes of repeated fainting could be due to  low blood hemoglobin, heart rhythm problem, postural hypotension and rarely could be due to seizures. You need specialized care and investigations. You can consult a local cardiologist and/or a neurologist who will interview you to obtain a detailed of the situations of the spells that you have and this will guide us regarding the further investigations. You would require ECG to check your heart rhythm, CT scan of the brain, holter monitoring, tilt table test etc. Once the  cause is established,  we will be able to offer you the best possible treatmentHope this clarifiesBest wishesDr Gopal K Dash  MD, DM, Post-doctoral fellowship (Epilepsy)Consultant Neurologist and Epilepsy specialistNarayana Hrudayalaya Hospital, BangaloreMy Blog in the Web site:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could redness in eyes with lumps in throat suggest?\n\nHello, my daughter is 6 yesterday her left eye was really red today it is fine. The right eye is kinda gunky and she said sometimes it a little blurry to see out of. Then she said her throat is a little sore. I got the light and looked inside and noticed three small flesh colored bumps on the very back of her throat. Is that normal?",
    "doctor_response": "Hi ! Good afternoon. I am Dr Shareef answering your query.Your daughter possibly has a throat infection, either viral or bacterial which caused both the problems. The eye problem could be due to the sympathetic congestion of the conjunctiva by the throat infection itself or could be due a coincidental conjunctivitis. If I were your doctor, I would have advised her for a throat swab culture and sensitivity test. When waiting for the report, I would have started some mild anti inflammatory syrup for her and advise for steam inhalations apart from gargles with an anti septic solution if she could. I might start some antibiotic as per the sensitivity report if positive.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How does meconium aspiration syndrome affect a newborn?\n\nHi doctor, My daughter born 7 days back is suffering from meconium aspiration syndrome (MAS). I would like to know, how we measure her growth of lung capacity.",
    "doctor_response": "Hi. In newborns measurement of lung capacity is not as useful as in adults. Important clinical signs of respiratory effort, respiratory rate and the x-rays that had showed the meconium aspiration syndrome (MAS) and also the general condition of baby. These are the important parameters that show the improvement rather than just lung capacity.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best medicine for kidney stones?\n\nhello, i am 20 years old and am dealing with kidney stones. i just had a 6mm stone removed about 10 days ago and my stent removed about 5 days ago. i still have small 1-3mm kidney stones in both kidneys and am urinating a lot of blood and blood clots, is this normal? i am worried.",
    "doctor_response": "Hi welcome to HCM....You are having small kidney stones of one and three mm....For their flush out in urine more water drinking done ...Up to 1.5 to 2 litre per day.  .If needed alpha blocker that relax ureter muscle can be prescribed ...Diuretic also help in flush stone in urine ...To prevent infection antibiotic course given...Passing stone leads pain , so ibuprofen can be taken....If stone large in size to pass than only surgical or ESWL management needed Advise : as your stone bleeding better to consult nephrologist...Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pulling mooring rope cause pain in lumbar spine in seaman?\n\nhi doc , my brother is his early thirties and undergo  surgical in lumbar spine,he was not given immediately medical attention for more than 2o days when he was working as a seaman,is their a possibility because of his encountered of pulling a  mooring rope is the cause of his lumbar spine?thanks  .",
    "doctor_response": "hello and welcome.yes..it can cause low back pain because of conti nous use of back muscles and mostly effect tendons,ligaments and muscles  and it is relieved with rest and medicationsbony involvement occurs when there is trauma for example a fall while pulling a rope and it need surgery.may be your brother had some kind of injury while working and he might have ignored it...hope you'd understand.thanks bye",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tooth sensitivity after root canal?\n\nI had root canal done on tooth  30, 2 months ago .after 6-7 wks later tooth became tender on touch on top and side of tooth .my dentist sent me to endodontist .he cleaned root canal again 1 wk ago.when i touch top of tooth and side  it is slight tender . gums do not hurt please advise .thank you",
    "doctor_response": "Hi,Thanks for posting the query,   Pain after root canal treatment could be due to reinfectio, presence of any high point, any accidently left over canal.I would suggest you to get an x-ray done of the region , based upon which the treatmnet would be decided.Take  a course of antibiotics and analgesics.TAKE CARE!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower abdominal pain?\n\nI have abdoman pain. It is in the lower left side and hurts worst if you push on it. I also cannot lay on my left side the pain becomes to hard to bare. I don't have a fever. I also cannot drink pop unless it is flat otherwise I am in severe pain and in the fetal position on the floor. I don't know if the two problems are connected. And I don't have insurance.....I've had the pain for awhile but it has become worst in the past month.",
    "doctor_response": "Hi.Thanks for your query. The causes of the pain in the left lower abdomen can be :Severe colitisIntestinal obstruction as per your history.Left ureteric colic - foetal position I would advise you:X-ray of the abdomen in standing position,Ultrasonography Blood, urine and stool investigationGet started on antibiotic and symptomatic treatmentRest of the treatment as per the reports of investigations.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Gabapentin effective in treatment of chronic pain?\n\nI have chronic pain and have recently been put on Gabapentin. I have been taking Norco and Methadone which have been working just fine. I don t know about changing now. I am 60 yrs. old and have had 3 spinal fusions and a hip replacement and revisions to my hip replacemant. So I have a lot of pain issues. Should I trust this new medication?",
    "doctor_response": "Hi,Sometimes it works sometimes Gabapentin doesn't work. It is an anti-epileptic that damps down nerves especially ones involved with pain and therefore can be helpful; the more the nerve is abnormally activated, the more effective it becomes. It is extraordinarily safe. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can wheezy cough, tightness in chest and fever be symptoms of bronchitis?\n\ni was diagnosed with uvulitis on monday and was given 300 mg of cefdinir twice a day.  on saturday I started running a low grade fever and feel like i have tighness in my chest and and weezy cough.  can this be bronchitis now.  my uvula swelling and puss went away by firday",
    "doctor_response": "Hi. I can understand your concern.  Cough and chest tightness is commonly seen in bronchitis and lung infection. Get a chest x ray done if it is normal, no need to worry for lung infection. Possibility of bronchitis is more in your case. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of bronchitis. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid (ICS)Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dizziness with tingling sensation\n\nIn late July I was hospitalized after reporting to the ER with dizziness/faintness, tingling, etc. I was tested for Lyme and thoroughly screened for stroke (I am in my early 40 s, BMI of 22, healthy eater, relatively active...but not disciplined with daily exercise, non-smoker, weekly drinker of wine/beer while cooking or with dinner). I was admitted for observation to the cardiac unit and underwent EKG, Echocardiogram, MRI, chest x-ray, and connected to a heart monitor. ( I was injected with heparin and remained in bed during the two night stay.) All test were within normal range and I was schedule for discharge. When the nurse removed the IV from the back of my hand ( in the bed, laying upright) I experienced vasovegal syncope and asystole for 10.67 seconds (heart monitor was still in place to capture the event). Recovery took place without intervention beyond verbal & touch stimulation. I am prone to elevated feelings of anxiety with needles, heights, hospitals, medical stuff, ). After five more days in hospital waiting for surgeon to return from vacation, a dual lead pacemaker was implanted. Multiple post op complications occurred including pericarditis, a lead perforation and 7 weeks out infection of the surgical site due to a lack of wound check & surgical glue still in place allowing for bacteria to grow. A referral to an electro physiologist cardiologist took place at week 8 post op and at week 9 post op it was determined the pacemaker would be removed. The explant surgery happened in a day surgery and I have been home for 2 plus weeks without device. My current doctor s approach is one of assessment, with my increasing my fluid intake, adding salt to my diet (blood pressure now averaging 105/69) and wearing an event monitor to capture events. My anxiety is huge and I am just beginning CBT counseling to help. I have not returned to work or any normal routine as I fear experiencing an episode. Logically I know I fainted due to the IV being withdrawn, however experiencing the heart stop has me feeling a real lack of confidence. How common is vasovagal syncope with asystole heart response and was a pacemaker absolutely necessary? I only wish the second approach had come first, as the fear level would not be conditioned into my thought process.",
    "doctor_response": "Hello,first of all let me congratulateyou for giving such excellent description of your history .I personally feel you had simple vasovagal syncope  .regarding pacemaker implantation and its removal I can't give opinion on either side without seeing your ECGs and record of monitoring.Interestingly you are fine without pace maker.And now more or less you have anxiety.It is uncommon to have asystole in vaso vagal syncope,but it is known .This event is not indication of pace maker.I would suggest to overcome fear and you should join your work.You may get 48 hrs holter monitor and if that is normal ,go to your work with full confidence. My best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen lymph node behind my left ear?\n\nI recently just got back from a trip in Europe. During the trip experienced extreme itching on my scalp as well as a swollen lymph node behind my left ear. This began July 3rd. finally that Sunday it got so itchy that I figured it had to do with the shampoo and conditioner I was using so I switched it up. I noticed a difference and thought it was getting better. I came back to the states this past Wednesday and to be safe went to a walk in clinic since I live at college. The doctor checked my scalp and said it must have just been an allergic reaction. Today throughout mid day I experienced extreme hair loss, and it s only gotten worse as it got later. My scalp is still somewhat itchy and my lymph node is still swollen. I have thick long hair and it feels thing and I m very worried because I ve never had this happen before. I don t want to self diagnose myself and with it being Sunday tomorrow I m afraid I wont be able to talk to my doctor.",
    "doctor_response": "Hello.Infection of the scalp (probably caused by fungi) is a possible diagnosis.You should go to the dermatologist as soon as possible for examination,establish diagnosis and prescription.I wish you good health.(if the answer has helped you,plese indicate this)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood clot on foreskin?\n\nthere is a small blood clot on my foreskin (from 2 months). i met a skin doctor and he gave me fucidin H cream to apply. It has been 4 days and there is no change in the clot. What shall i do next? i believe i got this blood clot when i took treatments for Sinusitis and was on some antibiotics. I have discontinued the Sinusitis medication about 2 months ago kindly help",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Small blood clot on the skin never requires any treatment. It will go away with its own.This fact was known to your doctor so they given you fusidin H cream. It is a antibiotic cream used to treat bacterial infection.Sinus medication never causes such blood clot. It has probably some different origin of infection. I advice you should examine yourself by nearby doctor to know the cause.Small blood clot requires no treatment it will go away with its own. You only have to make good hygiene to prevent infection.Avoid sexual intercourse until you are clear with all this things.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for getting pregnant\n\nhi im 29 and had a laporotamy which resulted in 30 staples from my navel to c section scar 4yrs ago, prior to that i also had my last child born by c section 2mnths prem,since then i also had a minor keyhole surgery.my health seems fine and my periods are regular,me and my husband would like to try for another child would it be ok as a little concerned about the scaring?",
    "doctor_response": "Hi, I think it will be fine. You can try for pregnancy.  The skin scar is not much affected by pregnancy.  So, go ahead with your planning.  Be in contact with your husband every 2 to 3 days after your periods stop. Hope it helps. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in legs and scrotum having tumor in sigmoid colon?\n\nMy husband has colon cancer spread to the liver. The tumor is in the sigmoid colon . A stent was put in to try to help his obstructed bowel but it didn't work. A loop colostomy was performed & appeared successful but he has swelling in his scrotum & legs. They are taking steps to relieve him of this, but we are concerned that he may be in liver failure & they aren't telling us. He has had 4 bouts of chemo & his ct scan showed good results on the liver. Thanks for your input",
    "doctor_response": "Good evening. I appreciate your worry for your husband. There can be multiple reason for swelling like low blood albumin level, venous thrombosis in blood vessels of lower limbs or some tumor node pressing on the blood vessels. He does not seem to be in liver failure as he is tolerating chemo well. You can discuss these possibilities as i have mentioned with your doctor and he can advise more test accordingly. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the level of creatinine in blood 1.27 normal ?\n\nafter bus journey or running some time if i measure my blood pressure, then my bp - 160/100 or 150/90 .if i measure after one hour my bp- 130/85 , if i measure after two hour my bp 125/80 or 120/80 or 115/75 . other time 120/80 or 115/75 . is it problem? and is renal disorder cause of high BP. my test result 1.r.b.s - 5.4 2. creatinine in blood -1.27 lipid profile 1.total 181 2.hdl 25 3. ldl 131.4 4.trig. 123 electrolytes 1. sod-144 2. pota-4.2 3.chloride 104.00 ecg ok urine-ok",
    "doctor_response": "Hi Welcome to healthcare magic forum Your all reports are absolutely normal. The creatinine level is absolutely normal. The normal value of creatinine is 0.5 to 1.5. So nothing to be worry at all. Regarding the blood pressure here is the detail. Blood pressure means the pressure of the blood exerts on the wall of the blood vessels during flowing. What you eat that absorbs into blood and transport to all your trillion and trillions of cells passing through blood.  Inside the cells they are burnt (i.e. called metabolism) and the essential substances are produced and the unused materials are expelled out to the blood again and pass to the kidney . for every work you need energy the energy is produced inside your cells from the nutrients and oxygen that comes through blood. When you run you need more energy so your cell need more nutrients and more oxygen  and thus more blood should flow so that the cell requirement can be fulfill. So for this purpose more blood flows and that\u2019s why it exerts more pressure and that is why your blood pressure rises. It is normal phenomena. If you have diarrhoea, or severe vomiting or profuse bleeding your blood pressure will be low. So what you are telling your blood pressure is varying it is normal. Blood pressure will vary according to the situation. Thank you For further detail you can contact at multicare.homeo@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could greyish looking thing like worm in bowel movement indicate?\n\nHello, my 3 year old son has had a bowel movement on the potty and floating in the accompanying urine, I noticed a greyish thing looking like linguini in width and height. Approx size: length : 15 cm, width: 5 mm, height: 1 mm. (can provide picture upon request) Could this be a worm? I have kept it in a jar with water, if I need to show it to a doctor on Monday (no clinic opened Sunday) would it be preserved long enough to allow for examination? Thank you",
    "doctor_response": "Hi,From history it seems that he might be having round worm infestation producing one round worm passing.There are all chances of having more worms in bowel and might come out.Consult your doctor and show this thing.Afterwards he might require one course of anti-worm course like Albneazole syrup.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the shoulder and hands, stress and memory loss. Taking anxozap. Not able to stop the medication. What to do?\n\nRESPECTED SIR MY MOTHER AGED 47yrs IS TAKING tab ANXOZAP 30mg SINCE Dec.2010 . OUR LOCAL Dr. (MD) PRESCRIBED THIS MEDICINE AS SHE FELL DOWN UNCONSCIOUS AND GOT PAIN IN SHOULDER & HAND NERVES BECA USE OF HIGH MENTAL STRESS . SHE HAS DEVELOPED SLIGHT MEMORY LOSS , FRIGHTENESS &LAZYNESS BUT THESE HAVE NOT OCCUR BEFORE . MOTHERS SLEEPING PERIOD IS HARDLY 3-4 hrs .INSPITE OF GREAT DESIRE SHE IS NOT ABLE TO STOP THIS MEDICINE & LOCAL DOCTERS ARE ALSO INSISTING TO NOT TO DO THAT.HER WEIGHT IS 53 kg. KINDLY SEND YOUR VALUABLE ADVISE .",
    "doctor_response": "Hi there ~ Anxozap is a medication that is effective with anxiety and stress.  If your mother is still not feeling better with the medication, it is advisable to gradually go off of the medication, since it may be hard to go off cold turkey.  Memory loss, and some laziness while taking the medication are common side effects.  However there are effective alternatives to these medications.  I would recommend that you see a psychiatrist to change medications.  Using relaxation strategies, like yoga and pranayama, deep breathing exercises and also  keeping up your general physical health will also help with mental health. I hope this helped.  Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Has liver cancer and receiving unsuccessful treatment. Radiation injected into liver caused pain. Suggest?\n\nMy son-in-law has had liver cancer for 6 years and the trial treatment he has been receiving has not been successful.  Friday he had radiation isotopes injected into the liver in hopes that this would work.  He has been in a lot of pain since the procedure and so they did a CT scan that showed the gall bladder was diseased, but not showing and tumors.  Should this have been discovered before now?  Could this be a reason for his pain that he has also had for the last 6 years?",
    "doctor_response": "If his gall bladder is diseased then his pain will be in  the right upper quadrant or epigastric region of abdomen.Your son in law has undergone the procedure called Radioembolization.This newer technique combines embolization with radiation therapy.This is done by injecting small radioactive beads (called microspheres) into the hepatic artery. Brand names for these beads include TheraSphere\u00ae and SIR-Spheres\u00ae. Once infused, the beads lodge in the blood vessels near the tumor, where they give off small amounts of radiation to the tumor site for several days. The radiation travels a very short distance, so its effects are limited mainly to the tumor. Long-term data on this treatment isn't yet available, but it has been shown to help tumors shrink.Possible complications after embolization include abdominal pain, fever, nausea, infection in the liver, gallbladder inflammation, and blood clots in the main blood vessels of the liver. Serious complications are not common, but they are possible.Regards and take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does regular masturbation affect the martial life?\n\nhello, i have been keep on masturbating once or twice a day  from the age of 14, i am 24 now and till now i haven't experience  any kind of health problem physically or mentally or any fatigue problem. at present i am alright nowso my doubt is can i continue my masturbation  habbit, in continuing this will it cause any serious problem in my married  life, can continuous masturbation lead me to impotence.siddha medical science says not to masturbation says it will  lead me to impotence. sir please guide me ..",
    "doctor_response": "masturbating once a day doesnt cause any sexual problem.it prevent early ejaculation.but dont do more than one time a day.if you do more times a day,it may cause watery sperm.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be the normal value for semen analysis?\n\nIam 30 year old,my Semen Analysis report is colour -  grey white, volume - 2.0ml,reaction - alkaline, total sperm count is 45 million/ml, and progressive Sperm is 50%, non-prograssive 20%, non-motile 30%, sperm morphology unremarkable, pus cells 3-5 /hpf, are these report normal..plz reply",
    "doctor_response": "hai,your semen report is normal as per your quoted text.volume,ph,total count were within normal limit.active forward progression should be more than 50 %- your's s 50%-  considerably normal.pus cells- occasional pus cells will be there-it indicates infection, but normal semen didn't contain pus cellsmorphology.is normal (typical cells) I conclude your semen report is normal.Thank youhope i answered your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bilateral renal pelvicalyceal fullness\n\nHello Sir, My mother is 62 years old and undergoes cystoscopy (kelly's repair) almost every 9 months for the past 4 yrs. She is expereincing continuous pain in her abomen esp lower part. The ultrasound of whole abnomen has revealed that she has garde I fatty leve and bilateral renal pelvicalyceal fullness, (more right than left). What should be done.?",
    "doctor_response": "Hi and welcome to HCM.As an Urologist,i can understand your anxiety.Your mother doesn't need to undergo a cystoscopy every 9 months.For the abdominal pain and fullness in kidney p-c system,she must do a CT.A CT is CT-IVU scan,which'll give accurate information about the fullness.It'll show details of the fullness,if it affects the kidney and cause of pain.That'll clear all your doubts.The scan can be sent here,for an expert opinion.Wish you well.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any substitutes for Penidure injection for heart disease?\n\nsir i m sufferd frm rheumetic heart desease nd mild heart leakage from 1996.i m 24 years old nd i m taking penidura injection continously under doctor guidence.becos it is very painful injection is there is any substitute of this injection,tablet or injection.",
    "doctor_response": "Hello and welcome to health care magic forum. If you are living in an rheumatic endemic area like India  then Penidura is the best medicine. You can ttake ciprofloxacin tablet in place of penidura but the protection is not as good .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the procedure for polyp removal which is very big?\n\nI had a colonoscopy today, and the polyp was to big to remove. Colon cancer runs in my family. They sent the piece in for a biopsy and told my husband to call the doctors office today and schedule a time, I guess for surgical removal of the rest of the polyp. Should I be scared? How exactly do the cut out a polyp?",
    "doctor_response": "you need not get scared, as removal of polyp doesn't get u any major serious complications. It is done through colonoscopy and is removed under vision in total with wide excision round the base of polyp",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is nitrofur-marc and pepsid intake safe for staph haemolyticus infection?\n\nHi doctor, I have staph Haemolyticus in my semen. I'm taking nitrofur-macr 100 mg, I take pepsid and tums for my acid reflux , question? Is it dangerous, is it gonna keep coming back? Is it contagious ? Ca I still take the antacids with this med? Thanks",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Yes you can take this antacid. There is no harm in it. Please take the completed course of antibiotics. If you complete the course of infection it won't recurr. It is contagious if it comes in contact with the other person.Please avoid sexual intercourse during this period until your infection is treated. Please maintain local hygiene as it is equally important in treating infection as equally as antibiotics.I will be happy to answer your further concern on bit.ly/DrArun.Please hit thank you for me if you are helped.Thank you,Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intermittent fever in infants?\n\nMy son was 8 months old... he suffered with loose motions with green colour stool .. nd he is getting intermittent fever.. we used so many medications but no change nd no use... it was a third week.. please will you give any suggestions for his relief...",
    "doctor_response": "Hi,Thank you for asking question on health care magic.Intermittent fever in a 8 month old baby for 3 weeks needs thorough investigation and clinical examination.Better consult pediatrician.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tell me about my urine analysis report\n\nPus Cells 20 to 25, epithelial cells 4 to 6 bactiria present, PSA 7.05 Age 79 years",
    "doctor_response": "Hi well come HCM. your report is sugestive of UTI, may be parostate related problem,dur to retention of urine. Drink more of water,take antibiotics like levofloxacin, ciprofloxacin,cefixime etc can be used.Shouls be taken at least for 5 to 7 days.If no bebefit you can go for culture report to find out the sensitivity of organism causing it.  thanaks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden dizziness and disorientation?\n\nmy daughter has been seeing the dr for about 2 months now, they took blood work and sd that her sugar level was normal at 80 but her insulin level was 53 and wanted to see her back this week. staurday i had to rush her to the er cause she was shaky,dizzy,and disorented for a bit, they cjhecked her surger level and it was 151..she also has tachcardia(sp) her hr was 138 normaly its 110-112..is she diabetic,hypoclacemis(sp)",
    "doctor_response": "HiI understand your concern.Dizziness and disorientation is the symptoms of neurological deficit.It can be due to electrolyte imbalance like Na,K,Ca etc.Or due to change in sugar and glucose level in the body.Require proper work up and Manage her symptomatically.Consult neurologist for more evaluation.Treatment of underlying cause will improve her neurological functions.So consult and get help.,Thank you.Still have a query then feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can the rashes on the head of my circumcised penis be treated?\n\nHello doctor, I have rashes on the head of my circumcised penis. Kindly help.",
    "doctor_response": "Hello. I saw your clinical picture (attachment removed to protect patient identity). This is called pearly penile papules. It is not a disease. It is a physiological variant. There is nothing to worry. You can ignore it, it is not going to cause any harm. If you are concerned cosmetically, it can be removed using cryotherapy. No cream or ointment is necessary. Any cream or ointment would cause more harm than help. Kindly do not try any home remedies. You will end up having skin damage. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of chest pain?\n\nI am 71 years old male. Had a lot of gas last week or so. yesterday evening and this evening had sharp chest pain 4 inches above left nipple lasting less than 10 or 15 seconds about for times within the hour. took one regular aspirin. i am type 2 diabetic. I m taking metformin 500mg twice a day. my A1c is 6.1. also taking Losartan25mg, once a day, and,PravastatinSodium 10mg once a day, plus vitaminD, a baby aspirin a day and some antioxidents wine extract and pomigranet for improved urination. I am 5.7 tall and weigh 147lbs. In very good health condition including cholestoral and triglesorites nothing exceeding range limits, as a matter of fact much below range limits. right now i feel great. no arm pain or other pains. might consider visiting urgent care tomorrow for the peace of mind. would aappreciate your assessment. Thank you.",
    "doctor_response": "Thanks for your question on HCM.In my opinion you are having GERD (gastroesophageal reflux disease) mostly.But better to rule out cardiac cause first for your left sided chest pain.You are having following risk factor for cardiac disease.1. Old age2. Diabetes. So get done ECG. If ECG is normal then no need to worry much for cardiac cause.You had gas problem which also favours GERD more in your case. It is due to laxity of gastroesophageal sphincter.Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms of chest pain and gas.So avoid hot and spicy food. Avoid stress and tension. Avoid large meals. Start proton pump inhibitor. Go for walk after meals.Don't worry, you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe fatigue and sleepiness while suffering from high WBC count?\n\nI am a 28 yo female. I have a three year old child. I am exhausted twice every month and sleep for 2-3 days each time. I saw my gyno doc thinking it was PMDD. she put me the low dose pill for three months about two weeks ago. my white cell count has been high for over 10 years. I am also on simbalta  for depression.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. In my opinion the symptoms that you have are not from the high WBC but maybe due to your depression and simbalta use. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed as a MRSA carrier. What can i do to prevent transmission?\n\nHi, I have recently been diagnosed as a MRSA carrier. I am about to become a Grandfather for the first time and am worried about being around my new infant granddaughter. What can I do to prevent any transmission and should I even hold her as a newborn? Thank you very much.... David",
    "doctor_response": "Hi,welcome to healthcare magic forum.It is better to get it treated before you take your kid.The precautions to be taken depends on the site where you carry the infection.It is usually in the nasal cavity,and can be treated with antibiotic cream,and prevented by maintaining good nasal hygiene.Anyhow,you can take the following precautions before touching.1)Wash your face and hands well with plenty of soap and clean water,and dry them with a clean towel.2)Avoid kissing and face to face breathing.3)Avoid visiting when you have cold/flu.3)Cover your nose and mouth with a kerchief during cough/sneeze.I hope you will find this information useful.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On Risperdol for autism and on seizure medication. Multiple knots on scalp due to hitting head against wall. Possible internal bleeding or brain damage?\n\nSon autistic over past month continous hitting head against wall - concrete. may last for 5 minutes then he appears normal. he has bgan a pattern of destrucion in my house breaking throwing anyhting in his sight. He will go along normal ish and calm adn then he snaps into a stranger throwing items and injuring himself. He is on Risperdol and seisure medication. In shampooing his hair tonight i found multiple knot all under surface of his scalp. Could through self injury damged his brain or have internal bleeding? He is 20 years old. He had a recognizable seisure about 5 years ago but have not seen one since. thank you",
    "doctor_response": "Hi friend,Welcome to Health Care Magic          Our empathies are with you...          Lesions on the scalp usually have no relation to events inside the skull.Better get it examined by a General Surgeon or Dermatologist \u2013 for proper diagnosis and appropriate management           The violent behaviour is likely to benefit form Psychotropic medicines \u2013 the drug(s) and dose have to be tailored to the individual / frequent physician visits, patience and perseverance will pay rich dividends...Take careWishing speedy recoveryGod blessGood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever with a sore throat?\n\nmy daughter is sick and has been to the drs for the last 2 days they have done 2 strep tests and 2 UTI tests, a kidney infection test and a apenidx scann all came back negitive both rapid and culture. last night they sent us home with a bottle of atibiotics and told us to keep tylonal and ibprofun in her. this morning the er called to check up on her and i told him she woke up with a sore throat and had a smaller fever than she has had and he said the if she complains of sore throat buy end of day to bring her back in what do i do",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query your daughter have symptoms of fever with a sore throat which seems to be due to upper respiratory tract infection. It could be due to swollen tonsils sometimes. Need not to worry. I would suggest you to do throat lozenges and do warm saline gargles. You should avoid intake of cold carbonated beverages and maintain proper oral hygiene. Do rinses with antimicrobial mouth wash. You should take antibiotic Amoxicillin in combination with antiallergic medication Sinarest. Visit pediatrician once and get it examined. You should get blood and throat swab test done and start treatment after proper prescription. Avoid oily and sharp food. Drink plenty of fluids.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will Sporozole treatment help in psoriasis?\n\nI have a problem wIthaca my skin around the check area and I have been given a couple of treatments before so today I was given sporozole and a and a mixture of ashen m 20 and epizone A, I just want to know what treatment is this and how effective is it for psoriasis.",
    "doctor_response": "Hi. Sporozole (Itraconazole) is an antifungal and psoriasis is NOT a fungal infection. So, it is obvious that sporozole is not going to help with psoriasis. Epizone A, being a moisturizer, would help in psoriasis but is not very effective when used alone. I guess you might have developed tinea (fungal infection) during treatment for psoriasis and the doctor is treating tinea. Hope it answers your queries",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i get pregnant with malpositioned uterus and anovulatory cycles?\n\nHi, I am 38 years old, 1.74meters tall, and 67kg in weight. I had a son 8years ago but have been trying for another child for 5 years now. Early this year my doctor said the womb is not properly positioned and he didn't see any eggs or I may not have ovulated. How's that possible and what are my chances of getting pregnant?",
    "doctor_response": "Hi actually the malpositioned uterus is not much of a problem but if your eggs are not forming which is quite common at your age then it is a problem in conceiving. I think you should go for evaluation. Do a thyroid profile and prolactin levels and Day 2 FSH, LH and a AMH level to see if your ovary has eggs or not. If not you have to go for IVF with a donor. Hope I have answered your question. If you have any other query I will be happy to help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can rashes in baby be cured?\n\nHello doctor, I have noticed rashes in baby since last week. I have applied Sudocream as advised by a doctor. I have also changed the nappy brand. But now there are small bumps on the back too. Here is the photo from one week and today.",
    "doctor_response": "Hello.  I understand the situation you are facing with your child. Baby diaper rash is one of the most common problems encountered with the babies. Keep the private areas dry, clean and hygienic. Clean up soon after baby passes stool. Do not allow moisture to build up in diaper region.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing back pain and temperature\n\nmy granddaughter has been sick since monday with flu like symptoms We went to the dr on Tuesday. they put her on Tami flu and z pack. Thursday she had bacteria and blood in her urine. now waiting for results of culture Her back apin is worse and her body temp is 94.7 is this normal? mu.",
    "doctor_response": "Hello. I just read through your question.It is possible that she has a worsening Urinary Tract Infection. If this is the case, neither tamiflu nor zithromax will help. The result of the urine tests are very important. She will likely need a different antibiotic. I recommend consulting with your doctor about starting a differen  antibiotic while awaiting the results of the urine tests.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it to be concerned about the low testerone level?\n\nMy husband started feeling bad in January hurting all over ,weak ,tired  could not go to work which he never misses,no appetite  lost 30 lbs,bad headache . Went to doctor has had brain scan upper and lower Scopes abdomen and pelvic scans . The doctor stopped all his medicines and his blood pressure dropped for awhile 90's/70's now runs 115-125/70-78 he use to take medication for blood pressure. The doctor gave him a medication to stimulate his appetite and he is doing better on that but  complains of a metalic taste all the time.last couple of weeks the bottom of feet are so painful he is having trouble . We even went to cancer specialist , only found his testerone level low now on androgen . I still feel he may have Lyme disease due to a bite he found on his abdomen that took about 2 months to heal we never found a tick.could it be lyme disease",
    "doctor_response": "I would also suggest the following tests if it has not been done already. TSH, T3, T4 , FSH & LH, complete blood count, Blood urea & serum creatinine . Lyme disease may cause fatigue and joint pains etc. There are blood tests available for that. I presume that your husbands blood sugar levels are ok . I would require more information to give a detailed opinion. Best regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be done to get relief from injaculation?\n\nHi I might just be paranoid but I tried something called injaculation and i heard other doctors advise against it but I ignored it. After I did it I felt light headed for a bit and I am scared to even urinate. Should I try letting that sperm out or am I just being paranoid and should never injaculate again?",
    "doctor_response": "Hi, Welcome to Health care magic forum.                      You are accepting that you are paranoid, use medicines prescribed by your doctors and continue them till they say stop.                       Ejaculation has nothing to do with the disease, you may do or may not the disease wont be effected. If you are not comfortable with it you don't do it. Neither it is use full, or harm full.                         Take more of green leafy vegetables, pulses, sprouts,and protein rich foods to make you comfortable.                       Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe migraine attacks be managed?\n\nHi Dr. I suffer from Migraines and had an epidural in my upper spine . My migraines have got sooo bad since and I was aware that could happen. I don't take any meds except advil and Tylenol to cope. I take care of my handicap mother that has RA. I'm sick all the time more so than ever. I'm 47 and have already gone through menopause, it happens early in my family.  I'm sick of being in sooo much pain I don't know what to do, and I help out at my church and can't be there for the people. Can you help in any way?",
    "doctor_response": "Hello, Migrane headache is treated with NSAIDS, tryptanes, antidepressants with betablockers etc. The suitable drug may vary from person to person. Do regular exercise and yoga. You can use zolmetryptan with sibelium or propronolol may useful. Please consult your neurophysician he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Penchila Prasad Kandikattu , Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there pregnancy chances after taking birth control pill?\n\nHi, I had sexual intercourse last night, without protection. As I am on the loette birth control, and have been on that for about 21 days. My period is due in the next two days. I take the pill every day, without missing any. At the same time each day. How prone to pregnany am I?",
    "doctor_response": "Hi, there is very little chance of pregnancy.  Don't worry about it.  If you have taken your pills regularly, then there is only 1 % chance of failure.  So, I think you should not take tension.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shortness of breath in case of asthma\n\nI m 43 and was diagnsed with asthma when I was 3. Generally it is well controlled but I recently had a cold which went straight onto my chest. Was given a 5 day course of prednisolone a fortnight ago and thought I was getting better but haven t fully recovered. I am still short of breath and fatigued through struggling to breathe. SATs sitting at 94-97%, lingering cough with phlegm. Would a longer course of steroid have cleared this up? Multidosing of salbutamol gives some relief but not enough to resume normal activity.",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your history and would like to make suggestions for you as follows:1 I usually suggest my such patients spirometry with post-bronchodilatory reversibility testing which measures lung capacity and also helps to choose proper inhaler.2. As you have asthma since young age, I would also suggest you allergy testing for common air-borne allergens such as house dust mites, pollens, molds, insect proteins, animal dander, etc. This will help you identify the substances you could be allergic to and also to know the measures to avoid them.3. Based on allergy testing, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which works on immune system to gradually improve allergy symptoms.4. If you have repeated nose symptoms such as nose obstruction, running nose, sneezing, etc, I would also add montelukast + levocetirizine in your treatment, which would help asthma also.5. In general, please avoid exposure to dusts, smokes, air pollution and cold air.6. Regular breathing exercises and diet rich in vitamins & minerals would also help in a long run by improving your lung capacity and immunity respectively.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long does a patient with hepatopulmonary syndrome last if not treated?\n\nHello doctor, What is hepatopulmonary syndrome? How long does a patient with hepatopulmonary syndrome last if not treated? Do patients with hepatopulmonary syndrome get treated easily?",
    "doctor_response": "Hello. I understand your concern. Hepatopulmonary syndrome is a syndrome of shortness of breath associated with hypoxemia (low oxygen levels in the blood of arteries). This is caused by vasodilation of blood vessels in the lungs in patients with liver disease. If liver transplant takes place, the survival rate for five years is 74 %. If no liver transplant, the survival rate is very low. Liver transplant is the key treatment for these types of patients. All the best. For more information consult a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I got periods with blood clots. Is it a sign of miscarriage?\n\nHi doctor, I was due for my periods on 8th, but did not get till 16th. So, I went for pregnancy test which came out negative. On 17th, I got my periods with blood clots and crampy stomach pain which was not usual for me. Was it a miscarriage? If yes, what may be the reason?",
    "doctor_response": "Hi. I have gone through your query and can understand your health concern. As per your query, the pregnancy test was negative. So, no need to worry. It is not a miscarriage. To be on a safer side and to confirm that it is not miscarriage, I suggest you to check your serum beta-hCG (human chorionic gonadotropin) level. High levels confirm pregnancy. You can do this test if you are in doubt. Menstruation can be delayed due to many factors. Such as hormonal imbalance and stress can delay menses. Sometimes, delayed menses can cause heavy bleeding. I think your case too the same. If there is heavy bleeding and you feel sick and dizzy, then check your hemoglobin level. If the menses continues for more number of days, then consult a gynecologist. For more clarifications consult a general practitioner online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there tingling and numbness in arm and hand during sleep?\n\nHello doctor, I have tingling and numbness in the arm and hand, particularly when I wake up from sleep. The right arm evidently has significant ulnar nerve conduction problems. Is there any evidence of nerve conduction problems in the left arm as well because I also have tingling and numbness in that arm at times? Currently, I am on Aloe vera 1-0-1 for blood pressure and cholesterol and Januvia for diabetes.",
    "doctor_response": "Hi. To help you better, I need to correlate your attached report (attachment removed to protect patient identity) with your clinical symptoms. Also, mention if you have got your thyroid profile checked. For more information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for hole in the heart other than surgery?\n\nMy daughter has a hole in the heart which is between two walls of the heart. She's 1yr 9 months old and was informed that she needs a open heart surgery to close the hole since the hole is big. I was wondering if the procedure be done without surgery. Please advice me accordingly.",
    "doctor_response": "Hi,There are two ways of closure, one is open surgery and through device closure. So if hole is big then Surgery is needed. For second opinion, you should upload the reports mentioning the size of the hole.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for neuro improvement in aneurism patients\n\n72 year my mother has aneurism and surgery done, she is now fully bed ridden she cant speak , cannot move her leg and hand whether she will cure from this pr blem tablet eptoin is taking twice a day .this month 25 th 2 month over. kindly gives help.. Any other tablet is required for her for neuro improvement. She can identified persons.and if she don t want she is moving her head for yes or no.Jahnavi YYYY@YYYY",
    "doctor_response": "Hi there.After stroke, there is less chance for recovery but good physiotherapy and medical care will definitely help in improving the chances of recovery. It depends on the type of brain damage and the motivation of the patient in further improvement.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I get off the fentanyl patch completely?\n\nHi my name is Mariana. I m taking fentanyl patch 50 mcg. I have been using it for like 2 months. I think this is giving me nausea and constipation . I am taking xeloda for my cancer treatment 2 weeks on and one week off the xeloda. On the week I m off i still think its the patch that makes me feel nausea and vomit . Cause that week I m off the chemo I still vomit so the only thing I m using is the fentanyl patch. I was using the 75 mcg but then 1 week ago I lowered it to 50 because I m afraid to just stop it once and I will feel the withdrawals. How can I get off the fentanyl patch completely. Oh the patch I used it for my aching back and shoulders. I took Ondansetron 8 mg but still don t help. So I stopped taking it cause when I did I actually vomited as well. So I stopped taking it. I have the feeling the patch is causing the nausea but I m afraid of the withdrawals symptoms if I suddenly stop. What can I do, I want get off the patch.",
    "doctor_response": "Dear,I have not understood what type of malignancy you are suffering fromyes these morphine analogues in the form of phentanyl patch does give the feeling of nausea and vomiting in a very sensitive patient. You can get rid of it by reducing the dose and substitutiing it with tramdol under the advice of your physician. If your malignancy is under control so must be your body pain as wel. In such case you can do away with phentanyl and there will be no withdrawal symptoms and you will have sense of well beingness with the substituted pain killer if at all needed.Truly,Dr. J. Ticku",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intermittent vibrations on the chest after taking Atenolol?\n\nI recently was started on Atenolol to lower my blood pressure. Yesterday I started getting inter mitten vibrations in my right chest. I only take 1/2 tablet for now, but should I make contact with my doctor? I also have Interstitial Cystitis that I take medication for, too. I did get the impression from my regular doctor that he wasn t very familiar with that disease. What do you recommend that I do next?",
    "doctor_response": "Hello, It is unlikely related to atenolol. Consult a cardiologist and get evaluated. Possible causes like cardiac arrhythmia must be ruled out. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can 13 mm gallstone pass through 3.4 mm bile duct?\n\nI have several gallstones in my gallbladder with sizes ranging from 5mm the smallest and 13mm the biggest. My question is, can a 13mm gallstone can pass a common bile duct of 3.4mm? I don't know if the epsom salt will help relaxed the bile duct and become flexible to let pass the 13mm galstone",
    "doctor_response": "Hi, How are you?Thanks for writing in to HCM. my name is Dr Suresh Raghavaiah. I am a Liver and pancreas surgeon and I hope to answer your question today.I am sorry to hear that you are suffering from gallstones and since you have not mentioned any symptoms, I take it that you have none.Gall stones can and sometimes do pass from the gall bladder (GB) into the bile duct and then into the intestine and are then passed out naturally. But this happens when the stone is very small and does not get stuck anywhere during its passage. During its journey from the gallbladder to the outside, the stone, depending on its size, can get stuck in multiple places and can cause serious, sometimes life threatening complications. The first site it can get lodged is the cystic duct (tube draining the gall bladder). This leads to engorgement of the GB and may lead to infection and pus formation in the GB. This will need emergency surgery and antibiotics to take care of.The second site it can get stuck is the common bile duct. Blockage of the bile duct less to jaundice and again infection can set in which can be very serious. This will need an endoscopy (ERCP) to retrieve the stone. The third and most dangerous site for it to get blocked is the lower end of the bile duct after it has joined the pancreatic duct (ampulla of Vater). this is the narrowest part the stone will encounter and hence one of the most common sites for the stone to lodge in. This is very dangerous because blockage of the pancreatic duct could potentially lead to life threatening pancreatitis and its complications. This will also need an ERCP to remove the stone.The final site where it can get blocked is the junction of the small intestine and large intestine. This happens ver rarely and can lead to intestinal obstruction.So in answer to your question, You would rather not have the 13mm son pass through the 3.4 mm bile duct. Please consult a surgeon immediately and consider having a laparoscopic cholecystectomy done.Hope this answer helped you and hope you start feeling better. Please do not hesitate to contact me for further details.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of microvascular disease?\n\nThank you, my aunt (72) just recently had a CT scan of the brain which showed signs of microvascular disease. She also is complaining of her body jumping while she is asleep. She is not a diabetic but does have eczema. Are the body jumping symptoms r/t the microvascular disease?",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!Regarding your concern, I would explain that body jumping is not a typical sign of microvascular disease. Microvascular brain disease is usually related to chronic uncontrolled hypertension and diabetes. It can lead to small strokes or progressive dementia. But it can be a sign of seizures or a sleep disorder. Coming to this point, I would recommend performing an EEG to exclude possible seizures. Hope you will find this answer helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in feet and gait abnormality?\n\nMy question involves my feet. I have been having severe pain or cramping for last few years. It has gotten progressibly worse to the point that many days I am unable to function. Most recenely I have had an increasing intenency to be much worse. I now can feel or watch changes in foot. Will feel foor pulling in a differnt direction than I wan to go. IS THERE A NAME for what I might have?",
    "doctor_response": "Weakness in the legs can be caused by many diseases,first that comes in mind in your your case is motor-sensory  polyneuropathy, that can justify your pain and parestesia, and also difficulty in walking. But also it may be a spine problem, a muscular disease. You should absolutely consult a neurologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to treat persistent itchy rashes on the ear?\n\nHello doctor, I have some rashes on and behind my ear. I have tried everything but it is still there for over one and a half month. I have been ignoring it because I get better quickly but does not entirely disappear, and right now is worst than ever. It is quite itchy and at night it is even worst. Sometimes I feel the itchiness inside my ear. I went to an Otolaryngologist, and he told me to use Clotrimazole, but it did not work and turned worst. Other doctor told me it looked like herpes because sometimes when it is horrible, you can see little red bumps in the ear. I took Acyclovir and at the beginning looked like getting better, but it has not got better. I have not consulted a skin specialist yet.",
    "doctor_response": "Hello. I understand your concern. This is not herpes (attachment removed to protect patient identity), and this is a superficial fungal infection known as tinea corporis. If it involves the face exclusively, then it is called tinea faciei. Kindly consult your doctor, discuss the suggestion and take the treatment with consent. A. Capsule Itraconazole 100 mg twice a day after meals. B. Tablet Levocetirizine 5 mg twice a day. C. Cream Terbinafine apply twice a day. Do this for 10 days, and you will feel better. Follow up after that.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy rashes on knees after a replacement surgery?\n\nI had both of my knees replaced, one in May and the other in August, in the past few weeks I have noticed a a red bumpy  rash that itches like crazy, I called my surgeon and he said it was totally unrelated to my surgery, I then asked a pharmacist what I could use and on it and he sugested hydrocortisone - it doesn't seem to be working very well. No other part of my body itches.",
    "doctor_response": "Hello there,I am dr.milan an infectious disease specialist answering your question.What I feel, this itching is because of irritation of dressing material you have been applied on your knee stitches area. It may be related to post surgery infection, but if infection is there it accompany with fever, pain and may be dischrage. You should not scratch that area. If this itching is mild than it may be related to healing of your stitched area.You can apply some topical moisturizer cream.So not to worry. Just follow advice of your consultant.Hope i have given appropriate guidance to you.if you have any query you can consult me anytime.Give me star rating according to your satisfactory level.Thanking you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will a cast assist in healing dancers break?\n\nHello I have a broken foot its called a dancers break an is not dislocated, the er gave me pain med an a hard sole shoe, our hospital is very small they never offered to cast, ill admit its better to be able to take a bath without a cast an keep ice in it but I absoutely cannot put any weight on the foot base I can on the heel tho. The nearest other hospital is 50 miles, im trying to decide do I go there an go thru all the er stuff I did this morning or just see my local doctor monday here. Will a cast assist in the healing and manuvering around?",
    "doctor_response": "unfortunately cast won t help but there is a walking boor specificly designed for 5th metatarsal avulsion fracturei recommend to get it to avoid surgeryGood Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes temporary memory loss?\n\nI KNOW A PERSON WHO HAS JUST STARTED WITH FORGETTING THINGS, SUCH AS SOMETHING WHICH WAS SAID OR DONE THAT DAY AND SHE DOES NOT REMEMBER UNTIL IT IS POINTED OUT TO HER. IS THERE AN UNDERLYING MEDICAL PROBLEM THAT SHOULD BE CHECKED ON FOR THESE EVENTS.",
    "doctor_response": "Hi, thanks for the query. Memory problems in a person need certain details like age of person, nature of onset of problem(rapid Vs. Gradual), areas of life affected (like difficulty driving, wearing cloths, difficulty in household work etc.); whether person himself/herself is aware of the problems or whether his/her relatives are complaining & the concerned person is unaware or trying to hide his/her problems etc. Hence kindly provide more information. Lastly memory problems are seen in host of conditions ranging from old age related memory difficulties, dementia to as a symptom of depression. Hope this helps. Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why my shoulders hurt while they go in and out fast?\n\nwhere can i get diegnoced with elers danlos syndrom i am pritty shour i have it i have dislocated my knee,hip,ankle,both sholders multipuler times i am vary flecible i am in pt already as well as ocupatinal theripy i would also like to know what can i do for my sholders they go in and out really fast and allways go in on there own but it hurts YYYY@YYYY",
    "doctor_response": "Hello,You need to be seen by an orthopedic surgeon to help with your shoulders going in and out. The orthopedist or an dermatologist could also determine if you have Ehlers Danlos. That is usually done by doing a skin biopsy.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the middle of my chest?\n\nHi Im 21 years old, about 215 pounds, 6 feet tall. Ive been getting pains in my chest, more in the middle and left side. They will come and go every so often but its been a couple months that Ive been experiecing this pain. Im under a tremendous amount of stress these last couple of months. I went to the hospital once for the same thing a couple years ago and they had said it was stress. But now Im a little worried there may be more to it.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, you are mostly having stress and anxiety related GERD (gastroesophageal reflux disease). And this GERD is causing central chest pain. So we should definitely treat your stress and anxiety first. So better to consult psychiatrist and get done counselling sessions . Try to identify stressor in your life and start working on it's solution. You may need anxiolytic drugs too. Avoid stress and tension, be relax and calm. For GERD, avoid hot and spicy food, avoid junk food. Take antacid like pantoprazole on empty stomach. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest a treatment for jaundice\n\nsir i have a problem with my stomach and its going on for about 3 years it happens suddenly after two or three months that i suddenly start feeling vomiting for three or four days and doctord dignose it as a very low billirubin attack as low as 1.3 percent but iam having jaundice every two months what should i do?",
    "doctor_response": "hi.noted history of jaundice associated with gastrointestinal disturbances. it is best if you consult with a doctor, preferably a gastroenterologist or a general surgeon, for physical examination and clinical evaluation. hepato-pancreaticobiliary pathologic concerns (gallstone disease, pancreatic tumors, malignancy, etc.) must be ruled-in/out. diagnostics, such as ultrasound, CT-scan, blood examinations, and management (medical and/or surgical if indications are found) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am more vulnerable to get coronavirus due to a weak immune system. Should I be self-isolating?\n\nI\u2019m 40 & I\u2019ve had glandular fever, shingles, influenza and have an autoimmune condition (Hashimoto\u2019s disease). I believe I may be more vulnerable than the average person my age to get Coronavirus, due to my weakened immune system? Should I be self isolating? I am ok to do so",
    "doctor_response": "Hello! Thank you for reaching out I understand. Bases on the available data, those who are 60 above, and with medical condition such as hypertension, cardiovascular disease and diabetes are the most vulnerable population. Thyroid disease and any other autommine condition is not known to be associated with increased risk of viral infections in general, nor is there an association between these disease and severity of the viral infection However, if you mild symptoms of cough and fever, I would still recommend that you do self quarantine and monitoring. I would still recommend that you wash your hands regularly with alcohol, soap and water and practice social distancing. I hope i wa able to answer your concern. Is there anything else I can help you with?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking cetrizine, avil and allegra for allergy. Need permanent cure\n\nhi i am having a problem of allergy ( hives ) is there any medicine for this, if this can u tell me the name of this medicine bcoz i am pitched off from this problem please help me i have taken cetrizine, avil, allegra bt there is no result since childhood i dont hav a problem bt after marriage i am facing this problem last 3 years please help me",
    "doctor_response": "TAKING YOUR MEDOCINES IS NO ANSWER IN PREGNANCY BECAUSE OF USE OF CALCIUM,IRON AND VITAMINS ,ALLERGY STARTS I TELL YOU SOME PRECAUTIONS DONT USE MUSTARD,COCONUT,ALMONDS,SOYABEAN OIL USE AMLA,OLIVE FOR APPLYING SUNFLOWER,OLIVE FOR COOKING SOAP USED IS NIKKO NIZRAL SHAMPOO AND NUT FREE CREAMS FOR BODY USE TAB METHOTREXTATE 2.5 MGM ONCE WEEKLY DOSE(LATEST TREATMENT) TAB ATARAX 10 MGM AT NIGHT TAB EBASTINE 20 MGM DAILY IF RESULTS ARE THERE YOU CAN POST AGAIN OTHERWISE YOU MAY GO FOR ALLERGY TESTS AND SUBLINGUAL LOW DOSE IMMUNOTHERAPY FOR PERMANENT CURE",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are side effects of rcinex 400 mg tablets?\n\nhi i m 27 female years old suffering from bone tb dieses, i want to know that what are side effects of rcinex400mg tablets on my colour complexion, whether i should take multivitamin or not. i have come to know that tb patients can concieve in future.",
    "doctor_response": "Hi,R-cinex is a combined medicine (rifampicin+ isoniazid) commonly prescribed for the treatment of tuberculosis. Common side effects of rifampicin include orange discoloration of the urine / saliva / sputum, flu like symptoms, and liver dysfunction. Common side effects of isoniazid include peripheral neuritis, hemolysis, and liver dysfunction. You should take vitamin-B6 containing supplements to prevent isoniazid associated peripheral neuritis. Yes, you can conceive while taking these medications as they do not cause any harmful effects on your unborn child.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blisters on feet?\n\nFemale, 5'7, 190lbs.  I have small pimple sized blisted on the bottom of my left foot.  They start off itchy like a healing wound and then become quite painful.  When they are popped a clear liquid comes from the area.  I have been getting 1-2 of these a week for the past 3 months",
    "doctor_response": "HIWell come to HCMAllergic condition may be likely and in my opinion this can be best managed with anti-histamine and anti biotic and the best option are Tab Levocetrizine 10 mg three time in day and Tab Azithromycin 500 mg once in day for three days, if the symptom does not improved then condition need to be examination clinically take care,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Meftal-P be given to a 2 year old for fever?\n\nMy baby is 2.5 yrs old with 12.5 kgs weight having high fever and cough from last 2 days. I m giving him crocin syrup 7.5 ml in every 6 hrs but fever goes down 100-101F only for 1 hr nd then again goes to 102-104F. My friend advised me to give Meftal-P but i m not sure if it is safe . plz advice on the same and if save what dosage i can give.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.PLEASE DO NOT USE MEFTAL OR MEFENAMIC ACID.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 15mg/kg/dose (maximum ceiling dose of 500mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.Meftal-P contains Mefenamic acid which is a NSAID. It carries the risk of gastritis and renal problems in the long run. Please do not use Meftal-P. Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pregnancy happen after taking emergency contraceptive pill?\n\nhello sir, I am 24 yrs old male. today at around 5 pm, I had an unprotected intercourse with my girlfriend (age-22,average health, no serious aliments). within 2 hours, she took a emergency contraceptic pill. But, still, I am confused and worried. what's the next step. how will we get confirmed that no pregnency would occur. what is the right time from, now to have an pregnency test, if necessary. If pregnency occurs, how sooner can she go for an abortion. will it be safe for an abortion in case of ectopic pregnency...please sir, help me...otherwise a mistake at in the heat of the moment would our personal and social life...please sir....",
    "doctor_response": "Hi, I think you can do a urine pregnancy test if her periods get delayed.  If positive consult a doctor if you don't want pregnancy.  Medicines are available for that.  Ectopic pregnancy is very rare and can be diagnosed with ultrasound.  So, if she develops severe pain and bleeding after her menses delay and pregnancy test is faintly positive, ectopic pregnancy can be suspected. Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does my granddaughter vomits at the sight of food?\n\nMy 5 year old granddaughter always vomits at any restaraunt with the sight of food for the smell of food or as soon as the food arrives to the table. This is very embarassing because as much as we try to make it to the ladies room, she leaves an embarassing trail behind. I know this is not normal, but what causes this.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. The behavior from your daughter definitely requires Cognitive Behavior Therapy(CBT). She has developed obsessive compulsive behavior. You need to look back to understand the reason. There must be a definite cause. Understanding the cause the treating the behavior with desensitization therapy (part of CBT) should help. Consult a trained psychologist/psychotherapist.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be done to treat stiff bent fingers which cannot be straightened without pain?\n\nI have a friend who has a problem with stiff, bent fingers that he cannot straighten and are quite painful. That is the little and ring finger on both hands. What can he do about this? Sorry I can t pay for this... Thought this was WEBMD. Thanks!",
    "doctor_response": "If your symptoms are mild you can treated    Conservative noninvasive treatments: 1.Rest. For at least three to four weeks, avoid activities that require repetitive gripping, repeated grasping or the prolonged use of vibrating hand-held machinery.2.Ice or heat. Some people experience improvement by icing the palm several times a day. Others see more benefit with warm-water soaks, particularly first thing in the morning.3.A splint. Your doctor may have you wear a splint at night to keep the affected finger in an extended position for up to six weeks. The splint helps rest the tendon. Splinting also helps prevent you from curling your fingers into a fist while sleeping, which can make it painful to move your fingers in the morning.4.Stretching exercises. Your doctor may also suggest gentle exercises to help maintain mobility in your finger.5.nsaids like naprosyn and ibuprofen helpful. If your symptoms are severe or if conservative treatments haven't helped, you can go for1.Steroid injection. An injection of a steroid medication near or into the tendon sheath may reduce inflammation and allow the tendon to glide freely again. 2.Percutaneous release.3.Surgery. Working through a small incision near the base of your affected finger, a surgeon can cut open the constricted section of tendon sheath.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could constant high BP with pulse 103 after having chemotherapy for pancreatic cancer dangerous?\n\nHi,,I am 70 with pancreatic cancer...had chemotherapy on thurs.....blood pressure then went to 207/85 pulse not sure..I am on Micardis 80mg and the hospital put me on a waterpill...i fell asleep before and woke up freezing..took my blood pressure andit was 155/89 and the pulse was `112...now the pulse is 103 ....Is that dangerous",
    "doctor_response": "Hi and welcome to HCM. Thanks for the query. This is not an emergeny but high blood pressure has chronically bad effects and it shoul dbe regulated by mediciens. So it should never be above 160. Pulse also depends on many things but it should be lower than 80. So I suggest to consult your cardiologist about further treatment. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is bruised and black eye normal after a head injury?\n\nMy two yr old jumped off the couch and hit her head hour before bedtime I kept a close eye on her gave ice pack delayed her goin to sleep behavior was normal no vomitin speech was fine.Went in la ter to check on her and notice a bruise on side of eye. Took her to er the did a cat scan and it came back ok.my concern is i can see a black eye and swellin is that normal",
    "doctor_response": "I understand your fears. aAs the Ct scan was normal there is no need for worry. The black eye you say is contusion and leaked blood and tissue fluid around the eyelid because the subcutaneous tissue is loosely packed here. It may take upto a week or slightly more to disappear. As the baby is otherwise normal , relax. My regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Removed my wisdom teeth. Holes are healing. Now there is red bump in the hole. When poked it is bleeding. Problem?\n\nI got my wisdom teeth out a little less than a month ago. The holes that were left have been healing for a couple weeks now. Just the other day I notice a red bump in one of the holes. I thought it was a tomato stuck in it but it wasn't movin so I left it alone. Today I poked it a little with the tiny squirt tool my doctor gave me and it bled",
    "doctor_response": "Dear friend.Thanks for sharing your concern.The bump that you have seen is due to the accumulation of pus there.The correct treatment for that is drainage,as advised by your doctor.Do not worry if it bleed.The bleeding should stop after 5 to 7 minutes maximum.if not,definitely that should worry you.Further please get in touch with your doctor and start antibiotic and analgesics.This will help in faster recovery.Hope it helps.Thanks.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on collar bone in infant?\n\nMy 8 month old daughter has a hard lump on the right side of her collar bone...It feels like it is attached or apart of the bone itself. I dont think she had this all along because it is very obvious to the touch that there is a lump. I just noticed it yesterday and am a little worried. What could this be and what should we test for?",
    "doctor_response": "HelloLump over right collar bone area may be due to enlarged lymph node.It need clinical examination and investigations.It is a common site of lymph node enlargement.It may be due to neck,scalp or throat infection.Generally it resolves with treatment of underlying cause.Generally it is not a serious problem.Ultrasound can be done if needed.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent pain in the back and breathing difficulty despite taking medication?\n\nHi Dr.  Yesterday i was holding up and folding a king size sheet when I felt a pain in my middle left back and side.  Since that moment it is cutting my breathing and hurting so much.  what can I do to have fast relief because i must work and cant work like this. i took a muscular relaxant and tylenol.  it did not really help.  I too a antiinflamarory voltaren waited 1 hour and still no relief.  I took 2 advil and add little relief.Today a day later I am not better at all.  what can I do to have fast results? Should I worry about anything else?",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. Low back pain usually takes more time to have a desirable relief of pain I recommend the use of an intravenous muscle relaxant with longer duration of action, topical NSAIDs or anti inflammatory gels are highly recommended especially after warm pressings, pregabalin is more effective in such cases as it have longer duration of action and lower dose with rapid onset. Physiotherapy also gives a good relief sensation and allow you to do your daily activities more ideally. The adding of some multivitamins is highly beneficial for your neuropathic pain. Corticosteroid is also good in such cases. If all these trials fail you may ask your specialist for surgery or an endoscopic intervention.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Ahmed Aly Hassan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for heightened sensitivity in gums after removing a wisdom tooth?\n\nCan a dry socket from a wisdom tooth extraction that i had done 8 months ago be repaired because i feel that it is more sensitive to heat and spicy foods back there... and also breathing in and having it dry out affects it... just want to know if im screwed or if there are stuff they do to fix that",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain in case of you have got the extraction of the wisdom tooth 8 months back, there is a very little probability that you have a dry socket and this is because Dry Socket is a very painful condition and if it would have been the cause it would have been very painful, rotten and fatal by now..If there is some sensitivity present in that area there is a possibility that there is any left out root piece in the extraction is or there is also a possibility that the tooth adjacent to the extraction area is getting decayed..Consult a Dentist and get an x ray done to rule out the exact cause and get treated accordingly..As of now you can take anti-inflammatory painkillers like Ibuprofen..Apply numbing gel in that area..Gargle with warm saline solution..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Constant feeling of nausea, depression, suicidical thoughts.  No help from omeprazole, antacids.  History of being diagnosed with hiatal hernia.  Help\n\ni am diagnosed with hiatal hernia year 2009. I'm 21 female and can barely eat because of the constant feeling of nausea. i have been transferred from one hospital to another and been given almost same medicines like omeprazole and some other antacids i can't remember, but none of them made me better. right now, i always feel down and can't sleep. sometimes i feel so hopeless i'm having suicidal thoughts, i pray a lot though, but i always feel miserable. i went to a psychiatrist and i'm in my first day of treatment today. i still feel miserable. please help me.",
    "doctor_response": "Hi,Thanks for using healthcare magic.I have gone through your history.Nausea may be a part of symptoms of stress and depression as you do not have much relief from omeprazole.It is good that you have consulted psychiatrist. The drugs may take some time to start action so you should wait till that time.Meanwhile you can do stress management and relaxation exercise like yoga, meditation or breathing exercise for better control over stress.Thanks,.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is my SGPT level alright?\n\nAge =44 years/Female, Wieght=71Kgs and height 5feet and6inches.Cholesterol Serum=221mg/dl; Triglycerides, Serum- 122mg/dlSGPT= 98U/LFasting Blood Sugar =95mg/dlDoes the SGPT level is alright and what action required on food in-take etc.My email ID is  YYYY@YYYY",
    "doctor_response": "HelloFindings suggests raised SGPT and cholesterol level.Raised SGPT may indicate liver injury.It may be due to many reasons like hepatitis,alcohol intake,altered lipid profile,medicines,auto immune causes etc.You may need clinical evaluation and investigations like viral markers,ultrasound of abdomen.I suggest tablet ursodeoxycholic acid 300 mg tablet twice daily for three months.It helps in regeneration of liver cells.You should take low fat diet and take lot of fibers in the form of salad,vegetables etc.Go for brisk walk regularly.If raised cholesterol level persists then you may need statins like atorvastatin tablet.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have fast heartbeat. Is my ECG normal?\n\nHello doctor, I was recently told that I have nothing to worry about with my heart but when I received a copy of my ECG online I see a number of odd beats and am looking for a second opinion. My heart feels like it stops for a second and then there is a number of fast beats followed by a very strong one. I am currently taking Effexor 37.5x3, Wellbutrin XL 150 mg and Saxenda 3 mg.",
    "doctor_response": "Hello. I have gone through your ECG results (attachment removed to protect patient identity). There PVCs. Majority of the time, they are of benign origin and does not pose a threat. Some of the common causes could include taking tobacco, alcohol, caffeine. High blood pressure, anxiety and rarely heart diseases could also be a cause. In your case the Effexor you are using could make you experience more PVCs. Should it continue to occur more frequently, you might have to talk to your doctor to adjust the dosage or substitute it. You will be fine, no need for worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure foot pain?\n\nI have a long standing problem with my achilles tendon and heal bone on my left foot. I got it from playing classic guitar (left foot fixed on a foot stool). I have been to a foot doctor and two acupuncturists. None of them have been able to help my condition. I have had it about 2.5 years now. I can barely walk becaue of all the foot pain.",
    "doctor_response": "dear friendThere are a lots of options available for treating achilles tendonitis ,if that's your established diagnosis.What helps the most is a proper regimen of physiotherapy.There are formulations with low molecular weight collagen available which also claim to help and in my experience they have helped in quite a few of my patients, a few of my patients have also benefited from platlet rich plasma injections but the option is expensive and needs trained hands to execute, local steroid injections also help.my suggestion to you will be my friend to discuss the available modalities with your doctor and try",
    "dialogue_context": ""
  },
  {
    "patient_message": "Alcohol consumption has led to Hepatosplenomegaly, H.Pylori and Varices. Can this disease be completely cured?\n\nHi, I have hepatosplenomegaly last one year and admitted in hospital for jaundice because of alcohol consumption my bilurubin count up to 21 and albumin was 3.00,now My lft is normal ,but bilurubin 2.7 and albumin 3.7 stopped alcohol last 9 months but i vomitted blood 2 weeks before and done biopsy test it was H.pylori in endoscopy it was grade 3 varices and antrum fats, I just want to know will get back liver in healthy stage because after 2 months my marriage,i dont wish to cheat my lover,please help me",
    "doctor_response": "Hi,It appears that you have developed portal hypertension. Kindly note that this disease is only controllable not curable.Reagrds",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lethargy with hand tremors in children?\n\nMy grandaughter is 10yrs old, pale colouring and slightly built. Ever since she has been about 4yrs old she has suffered from lethargy and lately have noticed slight tremor in hands when she starts to get hungry before regular meals. After eating she is fine again for about 4hrs.",
    "doctor_response": "Hello,Read your concernThere are many causes for which your grandaughter may have these symptoms.Please get her blood sugar level checked to rule out diabetes which may cause such symtoms.Also ,such symptoms may be seen in a condition known as insulinoma which is a tumour of the beta cells of the pancrease. This tumour is characterised by whipple s triad where signs and symptoms of hypoglycaemia are seen with blood glucose levels lower than 45mg/dl. The characteristic feature is improvement of the symptoms on administration of glucose . This leads me to advice you to get the blood glucose, insulin and c-peptide levels tested.These will help us to rule out other conditions of hypoglycaemia as well.A proinsulin level is also adviced , if possible.Diagnostic imaging test would include USG,CT scan or an MRI to trace the tumour,if any.It will be appreciated if you could provide more details about her symptoms at the time of tremor.As for eg: does she get cold and clammy , irritated , anxious, does she sweat a lot  etc. These will be of help too.Hope you get back with the Blood reports.Take care.Hope this helps.Regards,Dr.Pallavi Jain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is an opacity on the bladder?\n\nHi doctor,What is an opacity on the bladder? My husband had kidney stones, recurrent urine infections and minimal blood in urine. He had antibiotics and it got cured. He had a scan and was told that opacity on the bladder. When we consulted a doctor, she said that the report is very vague. Another doctor told us that there is a growth on bladder, bowel and pelvis. We are worried now as she mentioned it as cancer growth. Please clarify it.",
    "doctor_response": "Hi. I can understand the apprehension. Urine for malignant cytology. 1. Foreign body. 2. Calcification. 3. Malignancy. For further information consult a urologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness,tingling in fingers with burning sensation on feet sole?\n\nI have been experiencing dizziness, tingling in my fingers and toes and tingling with a burning sensation on the bottom of my feet and tingling of my tongue. I was placed on meclazine which makes me feel groggy and out of myself. What can I do? Thank you.",
    "doctor_response": "Hello dear, As per your narration it seems that you are having peripheral neuropathy like symptoms. It can occur due to many reasons like diabetes, vitamin deficiency, vasculitic, toxin, drugs, immune mediated or idiopathic. You need a proper evaluation and investigation. You need to consult a neurologist. Some investigation like nerve conduction study, blood investigation and if needed nerve biopsy may be done. As for treatment, in many cases symptoms improve and recovery occurs but prognosis depends upon cause. Hope you found the answer helpful. Wishing you good health. Dr Neeraj Kumar Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in arm in edema type distribution?\n\nI have a patient ,88 year old lady with right arm swelling, in a dependent oeadema type distributuon, she had DVT ruled out, and her CT body did not show any lesions to cause Lmphoedema, and I did MRI of her spine and brachial plexus which is notmal too. Any ideas?",
    "doctor_response": "hithe patient may b having some hormonal problem or hypoprotienemia or raynauds disease..get hus detailed blood profile done thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for abdominal pain\n\nhi I have been having lower abdominal pain that is tender to touch off and on for the past 5 days. I have also been having what feels like menstrual cramps off and on as well. The abdominal pain seems to be worse when I am eating as well.  I am currently in mid cycle. What do you think is wrong?",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.Pain in abdomen , which increases on touch has to have an internal problem.This may be due to intestinal infection of any reason.Ultrasonography may tell us the reason.A course of an antibiotic is a must to start with.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does recurring, sudden feeling of black out and nausea suggest?\n\nI m 60 yr. female. I m just sitting at work working. When all go a sudden I feel like all the blood is rushing from my head and I feel like I m gonna pass out. And then I feel nausea . Sometimes it goes away. And other times it reacures. Very scarery.",
    "doctor_response": "Hi, thank you for asking Healthcare magic.With this presentation, it is necessary for a doctor to thoroughly assess you. Your blood pressure might be having a problem or you may be having shortage of blood. A doctor needs to take your blood pressure, examine your conjunctiva and may be ask for some laboratory tests like full blood count and others depending on what he/she suspects. I would advise you see a doctor for proper assessment.I hope that helpsI wish you well",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does appendicitis can be diagnosed by abdomen ultrasound?\n\nHi, i am winalyn, i was already operated cause of acute ruptured appendicitis. And i think i have wrong diagnose on my previous doctor because they said it was an ulcer and i am only acidic and yet it was already appendectomy. And i just want to ask if it is the acute ruptured appendicitis can be trace or diagnose by abdomen ultrasound?. Thank you",
    "doctor_response": "yes ,acute ruptured appendicitis can be diagnosed by ultrasound abdomen.may be at the time of investigation with u r previous dr ,there might be only appendicitis but either way it can be easily traced by usg-abdomenlpelvis.. I would be glad to provide answers to any further queries. Thanks for using HMC Have a good day! Regards Dr. V.KUMARAGURU  general surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for sore & swollen breast\n\nHi, my father is 92 and was taking Finisteride proscar and bicalutamide and got sore and swollen breast. His urologist took him off the drugs thinking that was the cause of the soreness. Primary dr said he has mastitis. What treatment or antibiotic should he talk with his dr about?",
    "doctor_response": "Hello,The symptoms can be due to the side effects of the medicines taken. Since the urologist has stopped the medicines he prescribed. The soreness & swelling should slowly get reduced. Your father should wear loose fitting cotton clothes, cold compress relieves the soreness, he should drink plenty of water and get enough rest. However, get your father clinically examined by a GP to detect any breast abscess. Mastitis if left untreated may cause breast abscess.Let him get all the required tests done to rule out fibroadenoma, a benign breast tumor. To stay on the safer side the treating doctor may tell to get the mammogram done to rule out breast cancer. The treatment will depend on the pathology detected and the severity of the clinical condition. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Nupur K., General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for fogginess in head, problem with hearing, trouble with sleeping, tightness in chest?\n\nMy head always feels foggy. Ever since I can remember. Here are some of my symptoms 1. I feel that my hearing is affected 2. I have trouble sleeping 3. I struggle in conversation( thinking fast enough) 4. I feel tightness in my chest from time to time 5. I feel as if my head is in a fog all the time",
    "doctor_response": "The symptomatology you are describing is association of anxiety neurosis. No structural organic brain disease explains these symptoms. So I would like to suggest you to stress out perform yoga along with short course of clonotril MD. it will be better if you consult some psychiatrist. Hope my answer will help you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is swollen fingers signs of djd and sarcoidosis?\n\nI woke up at 2:45. I had fallen asleep in my arm and it was completely dead from the shoulder to my finger tips. I couldnt move it. Had to pick it up to shake the circulation back into it. For the past two weeks I have had excruciating pain in my finger joints and swelling When I try to twist the top off something, it feels as if I am ripping my fingers apart at the joints. I have djd of the spine and sarcoidosis. Could this be signs of one or both of my diagnoses",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The pain in the fingers is not related to your actual diagnosis. It seems like rheumatoid arthritis. It should be evaluated by a rheumatoid factor level in the blood. Meanwhile,I suggest using anti inflammatory medications such as Ibuprofen to relieve the pain and swelling in the fingers.Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i go for operation for my fibroid measuring 7cm x 5cm x 7 cm ?\n\ni am 36 years old, trying to conceive. i had a miscarriage 3 years ago. I have been diagonised with a intramural fibroid measuring 7cm x 5cm x 7 cm on the anterior wall, which is compressing the endometric cavity. the uterus size is 10cm x 9 cm x 7 cm. my cycle is regular but painful. kindly suggest if i have to undergo operation to get this fibroid removed or it can be reduced by treatment such as ultrasound . will removal of fibroid by operation hamper chances of conceiving, kindly advice.",
    "doctor_response": "Welcome to Healthcare Magic Good Day For a huge fibroid like this, surgery is the best option dear. Myomectomy may be done to remove the fibroid and prevent further miscarriages.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to get infected by hearing someone vomit?\n\nLanding after a 6 hr plane ride to London, England i had to use the washroom. When i was leaving i heard someone start vomiting 2 or 3 times. I quickly left. I am an emetophobe and was wondering if i should worry about if i will catch something from that poor women.",
    "doctor_response": "Hi,You will not get infected by hearing someone vomit (for sure). You don't have to worry about it!Take careRajesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is my wife pregnant after follicle study ?\n\nhi doc,my wife had undergone follicle study and the egg was ruptured on 19th day so my gyn told to have sex from 17th day itself.Also she gave progesterone tablet to her and told to come after 15 days .We had sex within this time .We did sex for once a day.Also Within this periods she got pain like menstrual pain but there were no periods.now my wife didnt have periods uptil now (15 days after the rupture). Today she went to gyn ,but gyn told her that she cant see anything ? Therefore told to come on thursday dt 19/05/2011.Is she pregnant or not ? I am worried. Please help . Pranati gaware 27 years old.",
    "doctor_response": "Hi welcome to health care magic you must patiently wait until the next menstrual period.. if she doesn't get her periods, then first do an UPT (urine pregnancy test), if it comes positive, then you need to confirm pregnancy by USG scanning..  the pain that she got may be due to the ovulation, which is common in some of the womens..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain\n\nhi sir. I am from bhubaneswar,orissa,india.father(55 age) is suffering from back bone pain from 1month. We did x-ray and found that the region below the neck of back bone is dry and there became a space also.So what to do. please suggest.Thanks ;",
    "doctor_response": "HIWell come to HCMThe given history could be suggestive of spinal degenerative disease, NSAID is the only option till it is finally being diagnosed with MRI study, and the best NSAID would be Tab Diclofenac 50 mg once in day, hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sudden red blotches on arms, under forearms, recurring condition. Causes and cure?\n\nI recently have acquired these red blotches on my arms, mostly my underneath forearms. They get worse after I shower and sometimes itch . They are not raised or scab like and they appear to go away and come back every day. It s been going on for about a few days and its really bothering me. My sister had this before me and I got it about a day or two later. Do you know how to treat this and what is it?",
    "doctor_response": "As it is summer hygiene is prime factor hope u got m point :)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to cure arachnoid cyst\n\nHi, my 20 mth old son has been diagnosed with a large left arachnoid cyst. The doctor just recommended that we keep an eye on its growth and go from there. Is there anything I can do such as a natural or alternative method to try to help shrink this cyst? I can t just sit back and wait......",
    "doctor_response": "Hello, Arachnoid cysts are for the most part believed to be present at birth and typically, we do not believe they \"continue to grow\" nor do we believe they cause any specific pathology or problems in patients. They are often found coincidentally because something else was being looked for so I agree with your doctor that a little \"benign neglect\" is worth much more (and your daughter will appreciate this approach) than any type of further workup since this cyst is not being contemplated for surgery or any other intervention. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is swimming safe for toddler after getting toe hurt?\n\nHi, my daughter 16 mths old just got cut the toe when someone open the door and did not expect the little one at the back, the bleeding was not much, I put the antiseptic on and seems like she is very painful when her toe touching something.1) how do I know if the toe nail has away from the skin?2) can I still swim with her by using the waterproof bandage as no bleeding at all?",
    "doctor_response": "Hi,If nail has separated from its bed, there will be hematoma formation underneath (red-blue-black colour sequentially). If no such colour change, nail is intact. You can take her for swimming. Just clean the wound after that with soap and water and apply antiseptic lotion/cream.Meanwhile, give her paracetamol 2-3 times a day for pain relief, and apply antibiotic creams like mupirocin 2 times a day. She will be alright in 3-5 days. If the pain and swelling increases, kindly take her to doctor to look for any secondary infection needing antibiotic treatment.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam T. K., Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can PTSD be treated?\n\nI am a burn survior in pain all the time. Now-my PTSD is beginning to \"kick in\" and I am headed for a nervous breakdown---I am terrified of what I might do--Was in Augusta Burn unit for about 8 months and was in a coma for 6 of them. I am trying to get through this without re-peated hospital stays,but I can't get a hold of whats going o with me and shake it off....      help!!--Thank you---",
    "doctor_response": "HIThank for asking to HCMI really understand your problem and will also agree with you that it is difficult to forget such bad incidence, but there is no go one has to forget it otherwise the coming days would be even more difficult to manage so it become very necessary to forget it, if you are just keep this thing in your memory every time then youwont able to forget it first you delete it from your memory, enjoy the future, it is not hard you can do it, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain and numbness in the hands and legs\n\nMy feet and hand been feeling numb, I feel pins and needles all over my body, hands and feet are constantly cold even when covered. Is this a sign of ms. Been having numbness and coldness in the feet and hands for 2 months never goes away. The pins and needles comes and goes.",
    "doctor_response": "Dear these are signs of neural involvement and since both hands and feet are involved may be due to vit deficiency. Get serum level of B6 and B12 done also watch for other symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest and neck pain while breathing?\n\nI am 14 years old. 5' 9\" and 134 Pounds. In the past two days i have developed a bad chest pain. My chest under my sternum and my lower neck hurt when breathing in and out. It is uncomfortable and is affecting how i feel throughout the day. What is wrong?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.Possibility of musculoskeletal pain is more likely.So avoid movements causing pain.Apply warm water pad on affected areas.Take simple painkiller like paracetamol or ibuprofen.Don't worry, you will mostly improve with all these in 2-3 days.If still not improving after 3 days, consult doctor.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of arava?\n\nHi my name is GLenda I have been taking arava for the past 2 years now and ihave notice that I have lumps on my upper arms and I was wondering it could be a sideaffect from arava. And I also take predisone and mobic please help me. I driving me crazy......Thank You",
    "doctor_response": "Hello,Swollen lymphnodes or glands seen in few patients who are taking tablet arava. Please consult with your physician he will examine and change the dose or drug.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does painful, tender, red bumps on back of head indicate?\n\nHi, may I answer your health queries right now ? Please type your query here...Yes my mom has two big red bumps on the back of her head. They are two different sizes and they are very tender to the touch and they hurt, can you tell me what they might be.",
    "doctor_response": "Hello hope the answer helps you.As your mother has at the back of head red tender lumps that could be abscess or or boil as this area is prone to cutaneous abscess or soft tissue swelling post trauma after itching as pyogenic granuloma.You donot have to worry needs a regular dose of tylenol tablet 8hourly with antibiotic as Amoxyllin plus clavulanic acid KLAVOX 1gm twice daily for 05 days hope it works in initial phase.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe round ligament pain in lower abdomen?\n\nhi this is meenu . i m 33 years old, weight 130lbs n 5.3'' height. i m 21 weeks pregnant n had severe round ligament  pain in lower abdomen. for this i applied Bengay cream n after 20 minutes i realised that may be its not safe n i wiped it with a wet cloth. so help me n tell the effects.",
    "doctor_response": "The pain in the abdomen is due to tension on the round ligament by the growing uterus. You should not apply any ointments at all. Simplest solution is to lie on the same side where the pain is. This is not a disease, it is a normal natural phenomenon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of pregnancy?\n\nMy girlfriend is about a week late with her period.  We've had sex several times (always protected).  She has been under a lot of stress for the last few months and now that she missed her period she's getting histerical.  I feel like she missed her period because of the large amount of stress since the condoms didn't break (I check them when I take them off) and we are careful afterward to clean up everything, including ourselves.  She's been telling me all of her symptoms that might suggest pregnancy. However, I found that all of them are also related to anxiety disorders.  Please help me and my peace of mind.",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the risk of pregnancy is less as there was no tear of condom.But as the period is delayed I suggest you to take q urine pregnancy test.The test usually gives accurate results a week after missed period.So if the test is positive the pregnancy is likely.If the test is negative the delay in period is due to hormonal imbalance due to stress.So relax.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain, burning sensation, tiredness, weakness, tiredness, constipated, sharp pain, vagina feels smaller, cravings. Help?ab\n\nHave had stomach pain, on the pit of my stomach, burning so much so that it takes my breath away. Feeling emotional, hot, crying, with dizzy spells and feeling weak and tired. Unable to empty my stomach at once, sometimes constipated, sometimes not. Feeling of not being able to emply my bowels all in one. Unable to have intercourse, too painfull, a feeling that my stomach feels like putty, my stomach feeling like not being attached to my body, when I  am emptying my bowels it feels as if I have a sharp pain deep in my vagina, My vagina feels 'much smaller\" the only way I can explain this, I am 55 years old. Cravings of either continuous eating or not being able to eat. Not sleeping well for nights at a time.",
    "doctor_response": "Hi ! Madam, you might be having some hormonal irregularities which should be investigated into. Apart from that you should consult your gynaecologist to exclude any possiblilities of endometriosis which at times gives rise to adhesions between the rectum and vagina, and in such cases you may get deep pain in the vagina while passing stool along with a sense of incomplete evacuation.Go for a a routine stool test for ova/cyst.Also the painful intercourse may be related to this problem.I would also suggest an ultrasound abdomen for you to exclude any intra abdominal/intra pelvic pathology and if thought appropriate by your treating doctor, a CT scan abdomen.At the same time, I would like to advise you not to take too much of emotional stress on this, which possibly is the reason for your sleeping problem and also craving or not craving for food. Try to keep yourself busy and have regular moderate exercise programme.At the end, I would also like to go for a Psychiatric counselling after your clinician has excluded any major pathological problem. All the best and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for seizure and memory loss\n\nI recently lost most of my memory due to what the tests done in the hospital showed to be a brain related seizure .I woke up in a strange environment(hospital) and got up running down the hall in and out others rooms. Thus I was forced back to bed and wrists and legs tied down and a huge plastic tent with zippers all around me. I was sooooooo afraid when I did wake up. I had to assured by doctor s nurse that it was because of memory loss ,etc. Please list the number one reason you think this happened.",
    "doctor_response": "I read your question carefully and I understand your concern.It is hard to give a precise opinion though since you say nothing about your age, other conditions you have, medications, tests you had at the hospital. Causes of seizures can be many, like stroke, infection, tumor, metabolic changes, drugs, alcohol etc. So lab tests, brain imaging as well as electroencephalography are necessary to identify the cause and address it accordingly.If you can ask your question again providing more info I or my colleagues would be happy to try to better answer it.I hope to have been of help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to remove protruding flap inside the cheek\n\nI have a small protruding flap caused by one incident where I bit the inside of my cheek and it will not go away sometimes it hurts but most of time it does not. My dentist said the only way to remove it would be by burning it off is their another form of treatment that can be used?",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.The treatment for the above mentioned flap can be only done with its excision (removal).I would advice you to get it done from a oral surgeon as it is a very small surgical procedure.Hope this was useful.Thanks and regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pounding heartbeat in neck,head and chest?\n\nI have been having a pounding heartbeat in my chest neck and head this has been going on several weeks and is intermittent on a daily basis. I went in and had a normal EKG, hemo was normal and so was throid test. The pounding borders between annoying and painful. I have also been dizzy during these episodes. I had an angiogram done 5 years ago after a problem with a stress test and was told it was clear, they did mention that I had an extra vein in my heart which they said they had never seen before. Questions: Could my arteries have clogged up that fast? What other tests should they be doing?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. No need to worry for major heart related diseases because your ecg and blood reports are normal. So no need to worry for blockage in coronary artery. In my opinion, you are mostly having stress and anxiety related symptoms. Both them can cause tachycardia, palpitations and other similar symptoms.. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on it's solution. You may need anxiolytic drugs too. Don't worry, you will be alright. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "INCREASE OF WBC & POLYMORPHS\n\nHello sir, i am 27 years old (M). On my blood check up Total WBC comes 13800/cmm , ( doctor sail its range is 4000-10000) & Polymorphs comes 74% & Lymphocytes 19%, Eosinophiles 3%. Because of alergy or any infection or any Worm problem, every time ,white cough comes up, my energy level comes very down & some time there is quite breathing problem also. I dont want to go for any alopathy. So PLEASE give me its solution in any ayurvedic way. VERY thankx in advance.",
    "doctor_response": "Hi, The blood report is normal it does not show any features of allergy or major infection as such. Take Revital multivitamins, drink plenty of water and consume plenty of fruits and vegetables. Regards Dr. Naveen Kumar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have symptoms of foot drop. Will previous multi-ligament knee injury be the cause?\n\nHello doctor, I have a chronic onset of symptoms of foot drop, diagnosed by podiatrist last month. I would like to know if this could be caused by the original knee injury, which was diagnosed as a severe multi-ligament knee injury. Is it possible for a severe multi-ligament knee injury, with a complete tear of the ACL, to cause \"foot drop\" to develop years later? I am currently taking Naproxen. Actually my original knee injury happened in 1969 and got repaired in 1980. Knee remained unstable and worn a brace since 1981. I have consulted many orthopedic surgeons, who all state that repair of the ACL is not possible.",
    "doctor_response": "Hello. I understand that the ACL (anterior cruciate ligament) surgery was done in 1980 whereas the injury was in 1969. It must be ACL reconstruction surgery or some other augmentation surgery. The original ligament cannot be repaired after 11 years. It will be beneficial to know about the procedure performed which can suggest what was done. In some cases foot drop may present after the procedure but it may be immediately or within the first few week or a month. It is unlikely to get recent onset foot drop due to the surgery performed in 1980. There might be some other cause of foot drop if it is recent. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower back pain\n\nSo i am having major lower back pain.Ive been experiencing it for a few months now ever since i was in school running in gym class when i had a muscle spasm in my back.I went to the chiropractor for a while.at least 2 months.I would go,she would adjust me and it felt like 2 days later i was back in pain again.When im sitting in the car for over 20 minutes i would say,my back starts burning and pinching and going numb,I really need to see a doctor but my parents cant afford it right now.and i have no health insurance.Also when i had first injured my back i went to my doctor and they never really told me what was wrong they just prescribed me medicine which i did not end up taking.So do you think you could help me figure what might be wrong? any help would be much appreciated.",
    "doctor_response": "HIWell come to HCMI really appreciate your concern such lower back pain may be due to spinal disease and this could be due to herniation of disc and this need to be rules out and for that MRI need to be done, bed rest and traction may be helpful if the condition is not sever one, hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is renal stone causing a pinching sensation in the lower abdomen?\n\nsir iam having a pinching sensation in the lower abdomen at right side after passing urine it vanishishes and any bendings will also leed to that pinching sensation earlier i had a renel stone i have removed it through lithotropsy .kindly suggest me.bye",
    "doctor_response": "HI.Thanks for your query. The commonest cause of pinching pain in the lower abdomen with a history of renal stone and which increases on bending can be urinary tract infection with severe form of cystitis or a stone in the urinary bladder.I would suggest you to send your urine for culture and sensitivity before starting the antibiotic treatment to get a proper result. Also sen blood for CBC, urea, creatinine, and other relevant tests. Get an ultrasonography done. If required intravenous pyelograpy helps  . Get a proper antibiotic treatment, removal of the stone if present, plenty of oral fluids.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Difficulty swallowing plan B pill. Will this compromise the effectiveness?\n\nHi.  I just took the Plan B pill, but I have a tough time swallowing pills; but I felt the need to take it any ways. It dissolved in my mouth (on top of my tongue) when I was trying to swallow it with liquid. Will this at all compromise the effectiveness? Getting pregnant really isn't an option in either my boyfriend's life, or mine. Thanks.",
    "doctor_response": "Hi,Nothing to worry about its efficacy.It will have full efficacy.But see that whole liquified tablet should should go in your stomach.Take full water after taking this tablet.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for diarrhea and vomiting.\n\nHi! My 3 year old has had vomiting diarrhea for 5 days. Went to er on day 2 for dehydration. Today was the first day she ate and felt better. This evening we noticed swollen knees and hands and a rash on her elbows, knees, arm pits, hands. Benadryl has seemed to help. What could this be?",
    "doctor_response": "Hi...by what you say the same virus which has caused the diarrhea might have caused the swelling of joints and rash. It is common in viral illness. Another possibility is that it could be a reactive arthritis to the virus causing diarrhea.If the child is otherwise active, need not worry.Regards -Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stinging red swelling around vein between thumb and finger?\n\nYes, I had a vein to blow between my thumb and second finger. This happens every 9-10 months and often after using my hand a lot in repetitive motion or holding something heavy. It starts out as a sting, turns red, and then stings/throbs for hours and swells. A blister then forms on my hand and it goes away after a couple of weeks. Should I be seeing a Dr. about this?",
    "doctor_response": "Hithis sounds like an overuse reaction. As long as you know that it comes after a long period of handling heavy objects and it occurs on the pressure areas of your hand you can try wearing protective gloves when handling heavy objects for a long time and see if this help prevent your condition",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sensitivity of penis when erect?\n\nhello, i'm a 23 year old male and I have a problem with sensitivity on the head of my penis, it is really sensitive when erect, painfully sensitive and it make sexual activity uncomfortable at times. I wanted to know if there is a possible fix for this or if there is a cause.",
    "doctor_response": "Hello, Your penis foreskin is supposed to be sensitive to have maximum pleasure during sexual intercourse. Are you indicating about your tight foreskin which is causing the pain? Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recurring canker sores in mouth, red spots on the back of throat, no fever. Trying to get off affrin nasal spray, on saline. What is the cause?\n\nmy daughter has had repeated canker sores in her mouth and red spots on the back of her throat for about three weeks now. we thought it was hand , foot and mouth but now think different. she now has them on her tongue and roof of mouth. has no fever or has not felt sick at all., however she s trying to get off affrin nose spray and is on half saline and about half affrin now.",
    "doctor_response": "hello, as per location of sores- it seemed to be some viral infection, but all viral infections mostly heals within 2weeks.. but since your daughter is still facing them, i would suggest you to consult an oral medicine specialist as by clinical examination he can diagnose it whether- infective/allergic origin/side effects origin.. Afrin Side Effects These include but are not limited to: High blood pressure (hypertension),Heart palpitations,Difficulty passing urine,Signs of an allergic reaction, such as:An unexplained rash or hives,Itching,Unexplained swelling, especially of the mouth, lips, or throat,Wheezing or difficulty breathing. I would also suggest you to consult an ENT surgeon for nasal decongestion ..and get proper treatment at earliest.. multivitamins containing Vit-Band C, Lycopene will help in healing of sores in all cases.. if sore are painful then apply local anaesthetic gels.. prior to meals for comfort during chewing.. after consult from ENT surgeon/Oral medicine specialist take medicines/gels- antiviral/antibacterial/antifungal (infection) or antihistaminic/steroids (allergic/side-effect) please try to get her off from Affrin at earliest.. take care..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Irregular bleeding since Implanon inserted, bleeding after intercourse. What is the cause ?\n\na year and halve ago I had the implanon inserted into my arm. Before that I used contraceptive tablets and my menstrual cycle was normal, but since the implanon I have irregular bleeding or no bleeding at all. About 3 months ago I started to have spot bleeding after intercourse, which was getting worse. So I went to have a pap smear done today and immediately started bleeding as soon as dr tried to do a swab. She also said that the cervix does not look normal. She did send the blood sample away as well as the smear for further testings. the results will take 10 days. Can you please tell me what the main causes for this could be. I am 33 years old, had a baby in 2010 and my last pap smear was a year and halve ago, which was normal.",
    "doctor_response": "hello,condition is definitely unrelated to your implanon. however spotting after intercourse could be due to infection of your reproductive tract, pre-malignant conditions of cervix. be cool, relaxed as both the conditions can be treated. wait for result and get treated. wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Enlarged fatty liver. Udizia prescribed. What is the medication used for?\n\nmy liver is mildly enlarged in size(18cm) and normal shape.echotexture is uniformly increased suggestive of fatty liver .no focal lesions seen.the intra-heptic biliary radicles are not dilated.portal vein, hepatic veins and ivc show anechoic lumen and thin walls.portal vein is normal in caliber.cbd is not dilated. sgot (ast) 51 IU/L. sgpt ( alt ) 116IU/L. cholestrol(total), serum 143mg/dl. hdl 51mg/dl ldl 68mg/dl. vldl 24mg/dl. triglycerides 124mg/dl. my height is 165cm & weight is 75kg. what i have to do ? how to overcome the situation? for what purpose udizia-300mg is used?",
    "doctor_response": "Hi,Thanks for posting your query.Udizia contains urso deoxy cholic acid. This medication is prescribed by doctors for many conditions especially cholestasis. In your case, it has been prescribed for fatty liver.You have not mentioned whether you consume alcohol.Based on your liver function test report, I presume you do not consume alcohol.Your fatty liver is probably due to nonalcoholic fatty liver disease.Your cholesterol level is normal. Other factors should be looked in to which includes obesity, diabetes.If you are obese, you need to reduce weight.If you are a diabetic, then you need to take medications to keep blood glucose under control.This will help to resolve fatty liver.I hope that answers your question.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for soreness and inflammation in mouth and fever\n\nMy child started with fever 5 days ago, and developed blisters and red gums 4 days ago. She is complaining about stomach ache. The doctor thought she had strep - but after her gums turned inflamed, they think she has a virus. She is on antibiotics for 4 days now. She is starting to eat and drink, but her mouth is still very sore. How long will it last? She was good all day and now have fever at night - 102.4 Should I take her back?",
    "doctor_response": "Thanks for your question, I am Dr Asanghanwa, your daughter might have an aphtous condition which is an inflammation of the buccal mucosa following an infection. This is generally due to Herpes Simplex virus in most cases. The soreness of the buccal mucosa goes away as the infection resolves and your daughter is already on antibiotics. It will be a couple of days again before the soreness goes away. However i would advise on frequent mouth washes with Hextril solution, or Bicarbonate solution every six hours. Continue with the antibiotics and add a Paracetamol sirop dose for weight measurement four times daily and consult your physician if the fever persists. Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stopped loestrin. If eaten today, am I safe tomorrow during sex?\n\nI recently stopped taking the pill Loestrin (combined) however I have found that it is the easiest way for me contraception wise as condoms are too small for my boyfriend and he loses interest in sex using these. I want to go back on the pill but finished my period last thursday - if I rnew my prescription tomorrow for the pill will i be protected as of tomorrow against pregnancy? If not are there any other methods of contraception i can use that will be immediately effective other than condoms?",
    "doctor_response": "Hello. Thanks for writing to us. If you start taking the pill now, you will not be protected for this cycle. You can use  a spemicidal gel like today before having sex. This is an effective contraceptive when used along with condoms. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for green loose stools with low grade fever?\n\ninfant 8 m.;healthy active .c/o freq [7-8]of loose motions-greenish semi solid-occassionaly watery;low grade fever;caterrh-cough;no vomiting-apperent dehydration.what should be line of rx especially anti ameobicidals/antibiotics if required.----indian standerds.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron (as prescribed by your paediatrician).Regarding diet - You can use cerelac...any flavour will do. Avoid fruit juices as they might aggravate diarrhea. You can give zinc supplements & ORS apart from normal vegetarian porridges & soups.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it necessary to remove lump on neck to have radioiodine therapy for carcicona?\n\nI have recently undergone hemethyroidocomy. i had lumph in right side of my neck. After testing I have been diagnosed carcicona. Now my querry is whether it is necessary to get removed other side thyroid lobe to have radioiodine therapy.Kindly suggest.Thanks in advance Gayatri Pandey",
    "doctor_response": "Hi,Greetings from Hcm.From your description I think you are suffering from papillary carcinoma thyroid.since it is a malignancy it is better to do a total thyroidectomy If you are a young person and if the disease is confined to one lobe  some surgeons believe hemithyroidectomy is  enough .but i think total or completion thyroidectomy is always  advisable with radioiodine ablation.Hope you will be al.right",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing lower back pains. Did nothing other than regular schedule. Reason for pain?\n\nI have been experiencing lower back pains. Why? I only drink water literally and I haven't done anything out of my regular everyday schedule.. If I sit down for too long it hurts if I lay down wrong it hurts and it's not pain I always have it's sometimes but everyday since 3 or 4 days ago. It even hurts when I drink something.",
    "doctor_response": "MRI of lower back is required followed by orthopaedic consultation .A physio will help you out .Please check and correct your sitting posture ; and softness of your  bed matters .Mattess should not be spongy or very soft . Hard matress of 32 density should be tried . Extension exercises of lower back may have  magical relief you have to learn it from physio Dr Lal Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of topamax, klonopin and mucinex?\n\nI currently take topamax, klonopin and singulair I felt a could coming on so I have been taking mucinex the past few days, for a cough and sore throat. The dr put me on medrol this morning and I broke out in severe hives all over my body. What do I do ?",
    "doctor_response": "Hello,Since when you're taking topmax or klonopin? May be your developed drug allergy to topmax or medrol. Better to stop the drug that causes allergy and consult your doctor immediately. Otherwise, it may aggravate the problem. Use tab. chlorpheniramine maleate in case of emergency.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to prevent measles?\n\ni am an adult and do not remember having taken a MMR vaccine. My mother remembers that I had mumps when I was 6 or 7 years old, but is not sure whether the vaccination was done. I have to travel to an African country where there is an outbreak of Measles. Would you recommend my getting this vaccination done? Are there any side effects? Is this done in 2 does? Is there a cooling period between the two doses and also after the two doses for starting the journey abroad?Apologies for the long question and thanks in anticipation.Rajiv",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.In my opinion you should take the vaccine.There is no harm in taking the vaccine.Individual companies vaccine has different guideline as to how to take the vaccine on two or three doses. Its effectiveness also varies from person to person.I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cold sensation and purple discoloration of both hands?\n\nhi, I have a problem with my hands that i think may be due to circulation. They are always cold, and always red if it is warm outside/purple if cold from fingertip to wrist. My hands sweat at an abnormal amount which may have to do with my condition. They turn normal color when i put them above my heart but as soon as I drop them back down they turn back to red/purple. I m wondering if you know what I have and how I could fix it. Thanks.",
    "doctor_response": "Hi, I value your concern regarding the symptoms. I have gone through your symptoms, and in my opinion you judged it right such symptoms could be due to vascular phenomenon. the condition is known as Reynaulds syndrome, and is quite common due to constriction of small vessels of the hand and foot in exposure to cold. The ways out are1 Do not let your hand get cold, use warm water, protective gloves, and be careful only you know what causes them and avoid them.2 consult a vascular surgeon and get investigated on any other cause that may be there.3 some drugs could relieve your symptoms but usually do not cure themHope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.Special note-  Any medication prescribed needs to be taken after consultation with your personal doctor only.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes flu like symptoms in my child?\n\nhi, My son is 3, and he has, what sounds like wet couch in combination with dry cough when he feels hot. I mean after running, or when he is in hot room. It never went away after he had a virus (about 6-7 months ago ), during that virus his fever went as high as 104F degrees, about He also has the following symptoms: dry, stuffy nose(his nose is not running but when he inhales or exhales through his nose i can hear that it s clogged) and very dry chapped lips. My question is what could it be and what causes it, and what could happen if left untreated, and what can I do to treat it.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query your son have symptoms of flu like symptoms which seems to be due to viral infection of poor and due to poor immunity of body. Need not to worry. Take combination of antiviral medication such as Acyclovir along with paracetamol for fever relief. Do warm saline gargles. I would suggest you to visit pediatrician once and get it examined. Doctor may order certain test like throat swab test , viral culture test or x- ray to confirm the diagnosis and rule out other causes. You should do tepid sponging if fever is of high grade. Maintain proper oral hygiene. Take steam inhalation to reduce the congestion of throat. Keep sipping warm water.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for latent TB\n\nis latent TB is needed to be treated before ivf? i am 34 yrs from nepal and have both tube blocked and i had 1st ivf failed 2yrs back. i was sugested recently for quantiferon TB gold test and come positive( gamma interferron antigen tube(2.94) and nil tube (.04). I just dont want to be late for ivf because of age. plz suggest",
    "doctor_response": "Hi.Please get treated for your TB first, always treat TB before considering conception. Also, if both your tubes are blocked speak to your doctor about all the available options to help you with conception and fertility.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for back pain\n\ni have had recent back pain along with serious ankle/feel/body swelling.  Went to Dr. and was told to stop Simvastatin 20 mg. - had elevated CK level - what might I have to worry about?  Nurse told me would recheck in 1 month.  Also, Vitamin D level was down to 11.",
    "doctor_response": "Hi Welcome to healhcaremagic After going through your query I concluded that you are having backache. Your vitamin D3 level is low . Treatment of it is vitamin D3 supplements.Analgesic such as ibuprofen is helpful for pain relief . As your doctor has asked to stop simvastatin , stop it. Back exercises will be started after once pain relief is achieved.  You can discuss with your treating Doctor about it. Hope your query get answered. If you have any further questions then don't hesitate to writing to us . I will be happy to help you.You can also write to me directly on below link: you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal for the formation above the top surface where the tooth will pop?\n\nmy son is almost 1 yr in 1 wk and he has ben teething since 3 mnths so now has alot. my quistion is is it normal for light pus to surface on top where tooth will pop? it is a bigger bottom middle tooth and it sure has ben giving trouble for awhile. it has shown signs of swolloness for 2 mnths and in that time 4 other teeth came through before this one. his appitite is not that great n he just seems out of sorts",
    "doctor_response": "Hi...what you say is not normal. it suggests that he has gingivitis or infection or inflammation of the gums. I suggest you see your pedo-dontist immediately. Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for chronic back pain due to pinched sciatic nerve\n\nHi Doctor Currently being treated for back pain due to pinched sac tic 4-6 veritable 2 years now MRI reveled problem. Completed at least 50 PT sessions moved to pain management and concurrently accupunctre treatment surgical solution is radical surgery.",
    "doctor_response": "Hi i am Dr Ahmed Aly    thanks for using healthcaremagic site ,I had gone through your question and understand your concerns ..   In my opinion from your given past history you may have serious spinal disc herniation . if physiotherapy and medical treatments fail for more than 1 year endoscopic or surgical intervention by your neurosurgeon are recommended . I suggest a new MRI scan and suggest your case with more than 1 neurosurgeon to decide your best choice of treatment . nowadays minor endoscopic interventions are very effective .  Please click and consider a 5 star rating with some positive feedback if the information was helpful. Wish you good health,Any further clarifications feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to increase the hormone in the body?\n\nIam a 50 year s old woman. I recently had a total hystorectomy, keeping the cervic. Iam very scared to use hormones because cancer runs in my family. My sexual relationship does not feel the same as before. Is there any natural herb or any kind of food that can produce some kind of hormone in my body. Please  let me know. Mary",
    "doctor_response": "**1. Women who have hysterectomy undergo \"surgical menopause\" which results in weight gain, loss of hair, hot flashes, night sweats, headaches, and vaginal dryness, as well. Often, psychological changes also occur, from decreased sex drive [in history] and depression to anxiety and memory loss. [watch them]2. Sundari kalp forte, sundari kalp, Pranayam, Sarvangasan are recommended natural medicine and Yoga for you.3. Shatavari:  It is a good food for menopause or for those who have had hysterectomies, as it supplies many female hormones. It nourishes the ovum and increases fertility. This herb is known to increase Sattva, or positivity and healing power. It also enhances the feelings of spiritual love.. By producing estrogens it makes up for low estrogen levels in women who are menopausal or have had hysterectomies or oophorectomies.. Shatavari supports normal function of the immune and digestive system. Shatavari also increases libido",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause pain all over the body when you wake up?\n\nWhat could cause pain all over the body when you wake up in the mornings. It goes away a few hours after being up and around. Also my B/P is 170/100 pulse is 100, my face is flush and I feel nauseous, normally my B/P is avg. 110/70. I am a 56 and male.Thank you in advance",
    "doctor_response": "dear siryou have very high blood preasure you should go and check imediately eith you physician. dont loose time",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in arm after injury\n\nI fell on my butt while roller skating and used my hands/arms to break the fall. I m stiff (understandable) when I squat - but my right hand/arm took a lot of the force and my upper arm is really painful and hard to lift out from my side. I have moved my arm all around and know everything is where it should be - just wondering if I pulled a muscle or tendon or something? And wondering the best way to progress without having to go to the ER or something. I got back up and finished skating 4 miles - just want the best advice to try to heal on my own please.",
    "doctor_response": "if you were able to skate 4 miles after your fall it should be presumed that you are without any grievous bony or soft tissue injury.things should be fine with application of ice pack where it hurts the most .OTC NSAIDS for pain like ibuprofen",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain behind the neck be treated?\n\nHi doctors\u270b im a 45 woman...the day before yesterday i slept on a high pillow and waked up with a little pain in the back of my neck but when i started to eat hard things like bread, i noticed that the pain increases even from inside (between esophagus and cervical vertebrae) and still this is the 3rd day with the same pain please tell me what to do....thanks.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Can EB related to muscle spasm or a nerve root compression. Oral muscle relaxants can help. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rise in heart rate up to 140?\n\nWhy does my pulse keep reaching 140, does that mean i have anxiety? been quite poorly this week and in hospital and they were concerened about my heart rate then but they done an ecg and it lowered eventually but it keeps getting higher as i can feel the palpitations in my chest does that make sense",
    "doctor_response": "Hello. Thank you for your question and welcome to HCM. I understand your concern.Anxiety is commonly accompanied with an increase in heart rate. There are various types of anxiety attacks and all of them are charachterized by a flush of chatecholamines (adrenalin) in blood stream. For example, fear (one type of anxiety, called situational anxiety) is almost always accompanied with a significant increase in heart rate, paleness, heavy breathing (all symptoms of adrenalin flush in the system). My opinion is that, just to exclude the heart origin of this sign with highest probability, you should be put on a 24-hour Holter rhythm monitor. Otherwise, my opinion is that this is only benign and not to worry about. Although, if this situation affects your quality of life and every-day duties, I recommend a consult with a psychanalist or psychiatrist, to further determine this condition and to start or withhold treatment. I hope I was helpful with my answer.Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is genital herpes related with spots on clitoris?\n\nHello, I was just wondering if I have symptoms of genital herpes/ warts or if it is agitation from shaving or is it bug bites? In the past few months I have had protected vaginal sex with several partners, but sometimes unprotected oral sex and fingering has occurred. The last time was a few days ago, but the window in the house i was in was open, and I have had two other red bite like marks on my arms and underarm since that day also. I have three under the skin red spots near and around my clitoris and they are very itchy, along with a slightly less itchy vagina, but these lumps are soothed by sudocream. This occurred on my genitals a day after shaving, but I have never had bumps like before, although i am prone to shaving rash. i was just wondering if this sounds like genital herpes and also how long symptoms take to first appear? Thanks in advance",
    "doctor_response": "Hello and thanks for your question. I have read your description of the problem. It could be bug bites or irritation from shaving but I will give you a description of herpes so you can see if this fits. If you are exposed to herpes it usually takes 2-7 days for the symptoms to appear. The herpes rash is small blisters and they are very painful. The pain is often described as burning pain. If you do not have pain it is probably not herpes. I hope this is helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat painful lump in the shin area due to an injury?\n\nhi dr i caught my shin on the metal bar whilst building a metal framed bed. it bruised and was very painful the bruise has now gone and theres a small painful lump there and it hurts when i stand and walk. i injured it a month ago. whats causing this?",
    "doctor_response": "welcome to Health care magic.The most possible cause could be infection / inflammation in the injury site. The lump you are feeling might be inflammatory subcutaneous collection.Second possible cause could be bacterial infection at the site and abscess formation.  If you are my patient i would have examined, and ask for a ultrasound lump area to find out the nature of the lump, its source and extensions. Treatment will be antibiotic treatment, in bigger collection a small incision and drainage might be needed.Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reddish sore veins under the tongue. Pus formation. What is the treatment?\n\nUnderneath my tongue the veins are red and sore. Prior to me writing this I wiped off like some type of mucus or puss that were formed on the the glands underneath my tongue in little ball shapes . Its painful when I move my tongue around or it brushes against my teeth . What is the cause to this? A few days ago I woke up with this irritation underneath my tongue. What do I need to do? Please help.",
    "doctor_response": "hello and welcome, this is due to heavy calculus and plaque deposition on the lingual side of lower front teeth. this occurs due to increased mucous content in saliva. there is gingivitis and abscess formation resulting in inflammation of gums. visit your dentist and get it checked clinically. get deep scaling and root planning done by your dentist. the absess has to be drained out by curettage using gracey curettes. use soft-interdental toothbrush and dental floss to clean your teeth.rinse your mouth after every meals. use chlorhexidine mouthrinse twice daily. always brush in all aspects of teeth.ie,buccally,lingually,occlusally,incisally, massage your gums using gum tone gel. take tab.doxycycline-100 mg once daily for 7 days to make your gums intact,firm and resilient. regards dr.bindiya",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes groin pain between the thigh and vagina?\n\nI woke up this morning with some pain on my right groin between my thigh and my vagina.. it almost feels like my right labia hurts, but if I press deeper, it feels like a muscle is pulled going all along it. Is this possible? I have degenerative discs in my low back and yesterday, my right hip/butt hurt from a muscle being knotted up (this has happened to me before.. just not around my labia). I m 23 and in good health (minus the back issues).",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms can be related to a muscle strain.I suggest using a muscle relaxant such as Baclofen three times a day. I also suggest using magnesium supplement for muscle relaxation. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for neuro interuptions in hands\n\nI am 51yr. old female...MY blood brother, is Barry E.Breen/liver&heart transplant recipient/due to amyliod/attr fap variable,,I have been diognoised with the same,by Dr.Merlin Benson.I now am experiancing neuro interuptions in my hands,is there any treament ,or trials going on in CA. i AM DESPERATE.i WATCHED MY SISTER DIE,,WITH NO DIAGNOSIS OR TREATMENTI know my brother was quite blessed,to get the two trans.I am also experiancing heart irethmia , not all the time but frequent enough for concern...where can I seek help that wont lock me away and,or pat me on the back and send me home without any discussion of treatment????",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your symptoms and it is unfortunate that you have been diagnosed with amyloidosis (same as your brother). This is because it is a genetic disease.As you mentioned, the best treatment for you would be heart and liver transplantation (as your brother). You can keep in touch with the transplant surgeons for the same.For neuropathic pain, you could use pregabalin capsules.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does liquefaction time 60 and active(progressive):10 indicates?\n\nI am a male 31 years of age, and 165cm . 83kg in weight. Me and wife consulted gynecologist . I ve noticed that my speak count. liquefaction time 60 Active (Progressive) 10 Doctor found 2 problem on my result. And suggest an urologist . With in 3 days I will go to doctor. Can you explain about my problem and are these major problem , how can overcome this situation.",
    "doctor_response": "Hello Though findings are not clearly mentioned,your findings may suggest low sperm count and low motility of sperms.Normally sperm motility should be at least 55 %.Your findings suggests only 10 % motility,so it is low.Sperm count should be at least 20 millions/ml.Besides proper clinical examination,you may need investigations like routine hemogram,random blood sugar,ultrasound of scrotum.It is important to exclude any surgical reasons for low sperm motility and low count.Ultrasound and clinical examination is helpful.Hormone assay can be done if needed.Take nutritious diet and antioxidants.If low motility and sperm count is low then you may need assisted fertilization techniques.Other findings like liquefaction time is normal.You should also try to decrease your weight.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Numb hands and feet, sneezing. Done detoxification from opiates. Related?\n\nMy left hand , both feet , and legs are partially numb and have been for several days. It s not debilitating or painfull. I can still walk and run fine. I m left handed so writing feels strange though. I m not sure if it s related but I ve also been sneezing a lot for the past two weeks. I also detoxed from opiates about a month ago and had some terrible rls . Again, I m not sure if they re related. I hope it s stress related but I fear it s something worse like ms.",
    "doctor_response": "Hello welcome to HCM Thanks for posting your query As per symptoms you have it seems that all are pure alcohol withdrawal symptoms, Running nose or rhinorrhoea is well known early symptoms  ,and decrease limb sensation( numbness) with writing difficulty, unable to concentrate is because of opioid  craving and restlessness /anxiety most opioids withdrawl symptoms are---Agitation ,Anxiety  ,Muscle aches  ,Increased tearing  ,Insomnia  ,Runny nose    ,Sweating  ,Yawning Treatment involves supportive care and medications. The most commonly used medication,  clonidine,  primarily reduces anxiety, agitation, muscle aches, sweating, runny nose, and cramping. on prescription of expert. for running nose you may get benefit from atarax\u2014(hydroxygin) Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is adenoid removal mandatory to get cure from severe ear pain in a 5-year-old boy?\n\nHello doctor, My 5-year-old son has been complaining of severe ear pain (just right ear) and occasionally says that he hears a sound in the same ear. When he is abroad he has a nonstop cold, phlegm and chest congestion. But when he travels here he is absolutely fine. He also suffers from nose blockage and struggles to breathe through his nose. He breathes through this mouth only most of the time. The doctors abroad suggested surgery to remove his adenoids. However, when he is here he is absolutely fine and the doctors are against surgery. Could you please suggest what is the solution for his suffering?",
    "doctor_response": "Hi. Have you taken an adenoid x-ray? Can you upload the x-ray if you have taken it? Do you think there could be some allergen in his place abroad which could be causing allergy and nose block in your son? Does he take food properly? Is there any dust inside the house abroad? Any chance of pollens or house dust mites? Does he have any sneezing or running nose? Does he show any rashes over his body?  The ear pain is there only in the right ear and when only he stays abroad? Does your son have an ear problem here? Do you feel he has hearing loss from that ear? Have you covered his normal ear and checked the hearing from his affected ear, let me know? Can you upload the relevant x-ray and blood tests? What we are worried if the adenoids are causing ear block this can lead to compromised development as your son will have some hearing loss. Removal of adenoids will take care of this problem. You may have to get some ear tests done. Meanwhile, the allergy may aggregate the problem in when he is abroad and here it may not be aggravated. But adenoids will not lessen in size even while in India.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How should sporadic rash with itching be treated?\n\nMy husband has had a sporadic rash for one month he is taking Atarax Zantac and zirtac previously his dermatologist started him on triacinolone 0.1. And clobetasol 0.05 Which has not made a difference Today his allergist/immunologist sent him for CT of the sinuses and chest x-ray. The chest x-ray came back requesting another chest x-ray with dye The itching is out of control he is taking Benadryl Ambien Soma just to sleep In the evening I apply aloe , lidocaine and menthol which gives him some relief Any suggestions??????",
    "doctor_response": "Hello, In addition to the oral antihistamines, I suggest him to also use a soothing lotion e.g calamine lotion to calm down the rash/ itching. Besides his doctor may consider starting him on an oral steroid. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Kakkar S., Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cramps in foot arch and lower legs\n\nWell, I can t pay in order to get an answer, I was desperate for some help as I have sever foot arch cramps that continue into my toes constant, any time day or night. It happens on both feet as well as limited cramps in lower legs. Was just hoping for some help, but I will continue to just search. It would be wonderful for those of us that are not in a financial situation at the moment to get an answer from a doctor. Thank you tho if you even read this.",
    "doctor_response": "Hello,Thank you for contacting me at \"Ask a Doctor\". I will try to answer your question to the best of my ability.It is difficult to say exactly what you're problem is without examining you.  But there are a few possibilities.  Certainly, you could be experiencing cramping in the muscles of the lower leg and feet.  Doing some regular exercise and stretching can certainly help with this.  Some people like to take quinine for cramps which can help.Sometimes if you not wear appropriate, well supporting footwear this will cause pain in the arches of your feet. Wearing some well supported shoes can help this problem.  Sometimes it means, placing an arch support inside your shoes.  You can buy these from the local pharmacy.If you have a primary care physician.  I would suggest seeing them if the condition worsens.  They will need to check the nerves and blood vessels in your feet.  Sometimes in these particular circumstances I will have my patients see a podiatrist.I hope this information is useful for you. Please do not hesitate to message us back if you have any further questions.Best wishes and good luck.Adrian Rawlinson MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any long term contraceptive other than ipill that can be taken on a regular basis?\n\nI m 20yrs old...I m taking ipill as a regular basis after each sex..I come to know the side effect of ipill.As I m studying so ryt now I don t want to become pregnant for 3yrs..so would u suggests me any long term contrAceptive device suitable for my age????",
    "doctor_response": "Hi there thanks for posting your query at HCM  First of all i sould suggest that you are doing a very wrong thing by taking i pill. This pill should be reserved only in very exceptional cases incase there  is a contraceptive failure. Because it a accompanied by many side effects Dear there are ample number of birth controll methods One of the most commonly used at your age is the oral contraceptives containin estrogen and progesterone that prevent the implantation of fertilized ovum  use of condoms by the male partner  or depoprovera injections every three months  or insertion of mirena or paragard device in the uterus  all are   good , though they have their share of side effects and disadvantages as well . So choose one",
    "dialogue_context": ""
  },
  {
    "patient_message": "Elevated creatinine level. Takes less protein, wine, OTC herbal medicines, no anti inflammatories. What to quit?\n\nMy creatinine level was 1.03 on 5/7/13 and 1.27 on 8/8/13.  Both abnormal and elevated.  What does this mean.  My doctor said to reduce protein intake by 20-30%, avoid alcohol and antiinflammatories and reduce OTC herbal meds.  Protein is not much, alcohol is limited to wine and I have not taken motrin, etc in several weeks.  However, I do take OTC herbal meds.  So, which ones do I quit?",
    "doctor_response": "Hi, thanks for using healthcare magicIn terms of the over the counter herbal medications it would be difficult to say which to avoid. The exact ingredients  of many herbal medications is not known.There is also no regulation that requires testing of ingredients or the effect of different body systems such as the kidney.It may be best to avoid them.In addition to the other precautions your doctor mentioned it would also be important to keep tight control on your blood pressure and blood sugar.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in the penis after masturbation?\n\nI am 26 years old .I am suffering from stomach problem since last 3 years. I have gone through all types of test.but all reports are clear expect there may be some swelling inside.I have been living in pain since 3 years.I get aroused from 1 years old .I use to masturbate. i develop habit of doing this activity.Are there any chances that,by doing so I have damaged some thing internally.and that is not being diagnosed.?My friend told me that it may be due to damage of urine bladder sphincter.I f so please suggest me some  medicines or some thing to solve this problem.This is such a cheap activity that I cannot tell to gastroenterologist that I used to visit.IF THERE IS SOME MEDICINES OR TABLETS AVAILABLE PLEASE RECOMMEND ME.PLEASE HELP ME OUT.",
    "doctor_response": "Hello, Masturbation can't cause such an issue. There is nothing wrong in masturbation, more than 90% of men does that. You can masturbate twice a week with out any issue. Symptoms of chronic masturbation can be due to nutritarian issue. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough in an asthma person\n\nMy doctor sad that I have asthma. He has treated me for forty years. Even though I have been on Atrovent hfa and asmanex. Last week afeter Christmas I woke up in the midle of the night with a cough that felt like knife in my chest. The doctor put me prednisone again. What causes this? I have no fever.",
    "doctor_response": "HelloAs you are taking treatment for asthma for 40 years ( atrovent and asmanex ) . Last weeks you had sever cough in the middle of night , doctor advise steroid (prednisolone ).In my opinion such symptoms may be due to these reasons , these include:1 COPD ( CONGESTIVE OBSTRUCTIVE PULMONARY DISEASE ).2 Asthmatic attack due to sever allergy . Sometimes an old asthmatic patient feel such symptoms .3 Cor pulmonale .These symptoms in your case may be due to above mentioned disease and this is common in an old asthmatic patient . So consult a pulmonologist and sort out this problem.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I use to get ovulation pains (pain in the hips) but for the past few months I am not experiencing any ovulation pain. But I am still getting my period which is again painless. My husband and I are trying for a second child for nearly 14 months but no success. Am I not ovulating?",
    "doctor_response": "Hi Esther It isnt possible to confirm whether you are ovulating without tests.If you havent gotten successful for 14 mths,the its time to consult a doctor so that some basic tests can be done and drugs used for treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Explain why some men are not capable of growing full beards.\n\nHello doctor, Why some men cannot grow full beards? Explain why some men are not capable of growing full beards, and can only manage thin, patchy ones. Is this due to testosterone and genetics or something more? How does not being able to grow a full beard potentially impact men psychologically? Can this be emasculating for men or cause issues with self-esteem? Is there anything patchy men can do?",
    "doctor_response": "Hi. Some men cannot grow full beards due to low density of hair follicles in beard area in them and that depends on their genes and hormones. The male hormone testosterone is converted to dihydrotestosterone by 5 alpha reductase. Dihydrotestosterone is a potent steroid and is responsible for beard growth and male pattern hair loss at the same time. There are certain conditions that can lead to patchy beard hair loss that is alopecia areata. It is an autoimmune disease and is treatable with topical, oral and intraleisonal steroids. In alopecia areata, men can have their beard grow back. Men who naturally have few beard hairs can be emotionally upset because may be they feel less masculine, it may lead to anxiety, depression, excessive worrisome and impact on psychological health of the person. Others may not bothered about it much. As hormones are responsible for it, it is not a good idea to take hormone supplements only for beard hair growth because it can have other side effects too. However, good oil massage, along with biotin supplements and latest techniques of hair follicle transplant and PRP have good results.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in right ribs and high blood count?\n\ni had doctors say my gallbladder needed to be taking out over 5 days in the hospital they changed their mind was on antibotics got better for a short while went back to doctor had left arm muscle pain in my lower right rib cage around to my back white count was elevated to 12 my right arm feels very strained hurt in my armpit it almost feels like infection moves around up my back an into my neck I have high blood count at least once a month have had a back fusion my right arm seems to be getting weaker run low grade have been hospitialized 3 times in 6 months very concerned plz try an help",
    "doctor_response": "Hi, Cannot say in your particular case, and if concerned that would be a reason to be examined and treated. Reasons to increase concern is that high blood count is an indication of overwhelming and/or spreading infection. It is doubtful that it can spread directly to gall bladder, arm, back and ribs without a lot of obvious problems BUT, infection going out from the gall bladder to the surroundings could irritate the diaphram and this is often felt widely. There would also often be increased pain with deep cough. It's serious. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes jelly like discharge during urination?\n\nhi im a 12 year old kid , i need help , beacause i had a jelly-like thingy when i urinated, i feel like nothing but , i researchs things about that and they say it might be a uti or a dibetes. pls help me so that i can tell my mom what s going on , PLS HELP!!",
    "doctor_response": "Hi,Many a times passing of more phosphates in urine does gives this type of picture.Having urinary tract infection or passing albumin in urine also giving rise this type of urine.Go for routine urine check up for uti or albumin.Take plenty of water.Maintain local  hygiene proper.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is ovulation with pregnancy possible this month?\n\nI am married for about 4 months.i am getting periods in 45 days 50 days by last one year.i had a problem of PCOS.i dont know its still present or not.On march 19 i got my periods after that i didnt.i consulted a gynec.she gave me dupahsaton 2 tablets 3 times for 5 days.after finishing tat on 4th day i got periods.what is my chance of ovulation this month?.am i get pregnant?",
    "doctor_response": "Hi, I think you should go for evaluation first.  Do a thyroid profile and prolactin levels and a ultrasound for your uterus and ovaries to find out the cause of irregular periods.  It can be due to some thyroid disorder or may be polycystic ovaries.  If anything is abnormal, it can be treated. You can track your ovulation by repeated ultrasound. It will tell you if ovulation is happening or not.  If ovulation is not happening, you can take some medicines like clomiphene for ovulation.  Talk to your doctor regarding this.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to test for MRSA?\n\nIn 2005 I acquired an MRSA bacteria.  I was successfully treated with an antibiotic and no longer have this infection.  Whenever I visit a hospital or surgery center I am treated as if I had MRSA because I have not tested negative for MRSA.  What is necessary for me to do so that I can document that I am free of MRSA to the medical community?  I have had one nasal test that was negative 3 weeks ago.  Do I need another such test to confirm?  I am a paraplegic person who lives in St. Paul, MN and I go to Abbot Northwestern Hospital for my care.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.If you detected as if you have MRSA than everyone will treat you as you are a carrier for the MRSA.Nasal test after three weeks suggest you are free from the MRSA but you should keep a document stating that you are free from the MRSA.Otherwise every time they treat you as if you are having MRSA and give you vigorous treatment.Please maintian good hygiene and clean practice in daily living this will keep you away from the MRSA and other such bugs.Good hand washing practice is the key for prevention of all the infection. So adopting this practice can benefit you.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could the painful lipoma on the shoulder be?\n\nHi my husband has a 13x14 cm lipoma on his right shoulder it was only noticed about 31/2 weeks ago it is causing pain into his neck and it is growing larger since we first noticed it. His mom died from small cell lung cancer and i was just wondering whats the chamce it could be cancer? He sees a surgeon wednesday. Thank you",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. It can be simple  lipoma,  other doft tissue tumour like neurofibroma or it can be cancer.  Definite diagnosis can be given only after biopsy.  You should go for fine needle aspiration cytology or biopsy first.  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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy rash under armpits and back?\n\nyesterday evening I broke out with a rash it was red blotches all over took benadryl it went away and was fine all day the following evening I broke out in the same rash itches very bad the rash is bad under my armpits my boobs my entire back and around my bikini line",
    "doctor_response": "Hello, I have gone through your complaints and it seems to be urticaria which is an allergic reaction. I would recommend you to take antihistaminic like tablet Cetirizine once daily at bedtime for 10 days. This will resolve the reaction. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for psoriasis?\n\nHi, may I answer your health queries right now ?  Please type your query here...I've had psoriasis of hands and feet for years. I've tried everything from creams, ointments,to puva (external and internal) now the doctor wants to us humira, but he's not sure if it with work on Planter's psoriasis   of hands and feet.   The pain that I am in is unbearable. There are times that I feel that I am walking on glass especially when I first get out of bed. Other than Humira if you have another treatment worth trying Please let me know.  Thank you",
    "doctor_response": "Hi,As you said, you suffer from palmoplanter psoriasis. It is a chronic and relapsing skin disease. I can understand your anxiety for you disease. But,you have to keep patience. You might get relief slowly. You consult eminent dermatologist for firm diagnosis and perfect treatment.I would like to suggest acitretin 25 mg daily along with methotraxate 15 mg weekly in three devided doses of 5 mg 12 hourly. Blood tests may be done at regular intervals.Steroid with salicylic acid oint may be applied twice a day. Soap bath should be avoided. All precautions may be taken to avoid dryness of skin.After few months,you may be alright. But, maintenance therapy may be continued.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reddish blotchy rashes on the legs and thighs in summer. What is the reason?\n\nHi, well I live in California and during the summer my legs and Thighs get really red and Blotchy. it s not itchy at all. and I m not fair skinned. but only my legs get red and blotchy. And I have no clue what it is! I hate it so much, because I can t wear shorts. It s just to embarrassing. and also I don t know if this will help but I m a high school student. Please help!",
    "doctor_response": "Hello Thanks for the query Hello Welcome! I would be pleased to answer your question . Your history and clinical picture are suggestive of 'Recurrent Folliculitis ' associated with secondary eczema . 1. Mupirocin ointment twice a day for 5-7 days whenever the bumps come. If there is no improvement within 3 days of this then you will require a addition of steroid cream along with that . 2. Dial Antibacterial liquid soap for bathing. Continue this even when asymptomatic. 3. Mupirocin cream twice a day in the inside skin of the nose for 14 days. This may seem strange since you have no symptoms there but this is the commonest site of carriage of the bacteria that causes this condition (staph). Infection keeps recurring from here through carriage by the fingers to other parts of the body. NOTE: Steroid and mupirocin will require a prescription so I would recommend discussing my recommendations with your GP/family physician. Bacitracin is an OTC alternative to Mupirocin cream. Please feel free to ask if you have any queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for hair loss and itching in scalp\n\nhi..My name is pallavi..Am 21years old..am studying computer science engineering..our college is located at hosur road near electronic city..basically my hairs used to be very thick..now i hav lot of hairfall..it started 2 years back...now my hairs hav so much reduced its almost 25% of what i had before...my hairs are some what dry..before i was using shikakai...now i switched on to johnson shampoo...hairfall is at high rate when i hav headbath and when i apply oil to my hairs...this hairfall has led to mental depression...my family members when they come home they hav lot of questions like why ur hairs hav been reduced it has become so thin and all and this hurts me lot..pls help me out...i hav scalp itching sometimes..i apply almond oil..along with it now am using olive oil too..i need your valuable help on how to reduce hairfall and how to regrow my hairs..my hairs should become long and thick as before..pls help me out",
    "doctor_response": "Hi, I would recommend you to go for certain lab tests to find out the cause of hair loss.Get your hemoglobin, thyroid function tests, serum vitamin D levels, serum vitamin B12 levels and serum ferritin levels checked.Use anti hair fall serum like Anaboom anti-hair fall serum and take hair supplements like tablet keraglo eva. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Several bloodclots in left upper arm. Been on blood thinner, took me off warfrian. Reasons ?\n\nhey i had several bloodclots in my left upper arm after 9 monthes they took me off warfrian at the time the clots were gone i was off warfrian 30 days and they come back now i think there gone again i have been on blood thinner for 2 years they say my blood is ok this week it is 2.7 but my arm is killing me can you still get clots if your blood is that thin?m",
    "doctor_response": "Hello and thank you for sending your question.You have indicated that despite the fact you are on anticoagulation you have significant pain in your arms. The pain could possibly be related to some musculoskeletal problems such as a pinched nerve but in light of your history it is important that your doctor rule out additional blood clots.It is theoretically possible to have a blood clot even if the blood is thinned with Coumadin. If that is the case the Coumadin needs to be changed to an alternative anticoagulants.While it is unlikely that you have a blood clot it is important that you review this with your doctor so that appropriate diagnostic testing can be done.Thanks again for sending your question.Dr. Galamaga",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is RX extended is the better option for the symptoms of ADD and am looking for a short term course of Adderall?\n\nI am a 44 year old male in Fort Lauderdale Florida, I seem to have all the symptoms of ADD. Looking to try a short term course of Aderall. Or generic would probably be wiser $$. I open to non extended release but based on much research on line and talking to others who have tried the RX extended seems the better option?? My primary care is with the VA but they are over the top insane about trying anything but prescription this kind of controlled RX. Which I respect but I need to try to help myself. My ability to function is getting unmanagable. Can you treat patients here in Broward County florida and or write RX. ??",
    "doctor_response": "hithanks for using healthcare magicits seem ur a case of adult onset ADHD. in ur case u need a extended release tablet can could help u to control symptoms. In ADHD u can take either Amphetamine or methylphenidate to control symptoms. U did not mention the dose of adderall. if u r not feeling improvement with amphetamine, u can take methylphenidate 10mg in a day which gradually increase up to 80mg. For further query u can consult ur psychiatrist.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "I had a tooth pulled and it was complicated. What can i do at home for the remedy ?\n\nOn monday I had a tooth pulled and it was complicated. I knew the pain was going to last longer then normal but towards the end of the week it has got worse. I called the office in the middle of the week with no call back yet. I did research and had spoke to some people believe to be a dry socket. I dont smoke and I did everything the way I was told to but like I said the tooth was complicated. Im in extreme pain and evertime air enters my mouth it is even worse. Is there anything I can do for the pain until I get back to the dentist ? He had wrote me a prescription that lasted just for a few days but it made me very sick. Thank you so very much.",
    "doctor_response": "Hi, A dry socket is a complication of extraction of a tooth. It can be managed by irrigating the socket with saline or chlorhexidine and placing a eugenol pack which has to be replaced in successive visits.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I feel swollen feet and numbness when they are not so?\n\nHi doctor, I am having issues with my feet. I feel that they are swollen and numb, but they are not swollen and also there is no discoloration. I do not have any chest pain, lightheadedness, dizziness, shortness of breath or any unusual pain and ache anywhere else. This usually happens while sitting down or lying down on the couch. It goes away when I stretch my toes out or walk. I play basketball twice a week. I am taking vitamins B12, C, E, potassium, garlic and fish oil on a daily basis. I have looked these symptoms up, but nothing matches completely with what is on the internet. I also have noticed a hard lump or knot in the middle or bottom towards my toes, where the numbness and swollen feeling starts. I think this might be something else. Please help.",
    "doctor_response": "Hi. Revert back after a month to an orthopaedician and traumatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Have light bleeding, abdominal pain. What does it mean?\n\nHi thereMy periods started on 17 sep and finished on 24th sep. I am trying for a baby and than I had sex on 25 sep and on 28 th morning. After 30 to 35 minutes I started light bleeding back and lower abdominal  pain. And till now on 3rd oct I am just spotting.I had regular periods this is first time in am facing this problem.Do I get pregnant or some other problem...?",
    "doctor_response": "Hi,Thanks for the query. In case of regular 28 to 30 days cycles, usually ovulation occur on 14th to 16th day. In that case the possibility of conception is somewhat less in your case. As you had bleeding immediately after intercourse, the possible causes are :- Post coital tear. - Local causes like cervical erosion, polyps etc. So, better to consult gynecologist once and get examined.By local examination the actual cause of the problem can be identified and treated. In case of post coital tear, depending on the extent of the tear sometimes suturing may be needed. Cervical erosion etc can be treated with medicines initially. In case of severe problem sometimes cryotherapy etc may be needed. In the next cycle, track the ovulation and plan intercourse around that period. This will increase the possibility of pregnancy. For more details :",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vaginal/anal itching with whitish yellow anal discharge?\n\nHi. Im a sexuallu active 22 year old female. I have itchy areas on my vagina nwar the opening and also near the clotoris. I have an extra fold of skin on the itch side of clitoris. I also have an anal itch and anal discharge that is minimal but thick whitish yellow tjat smells like yeasty fish. What is it and how do i make it go away? It itches and smells.",
    "doctor_response": "Hello, Thankyou for writing in to HCM. The condition you have is a sexually transmitted disease called trichomoniasis. That's whats causing the foul smelling discharge. Take the folloeing tablet -T. FLAGYL 400mg twice a day for 7 days. Once in the morning and once at night.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a benign tumour in a ileocecal valve a cause for concern?\n\nMy daughter has Chron s disease and yesterday had another colonoscopy done. I am worried about the notes written by the doctor . He found Benign tumor at the ileocecal valve which was biopsied. Also congested , erythematous, eroded, friable ( with contact bleeding ). inflamed and plaquish ( white ) mucosa in the terminal ileum. Please let me know if there is any possibility that my daughter will have cancer in that area.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Your description about the tumour is suggestive of malignant mass more. And chron 's disease is prone to cause intestinal malignancies. So wait for the biopsy report. If it is negative then I would suggest to go for repeat biopsy and PET (positron emission tomography) scan to rule out malignancy. Another possibility is tuberculosis. It will be diagnosed by biopsy only. So wait for biopsy report. Possibility of malignancy is more in her case. Hope I have solved your query. I will be happy to help you further. Wishing good health to your daughter. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can arm ache be treated?\n\nHey doctor so my twin has been having this arm ache in her left arm for 2 days now and she says when she bends it it feels like she is losing the circulation of blood to her lower arm I fear she may have MS please please get back to me I am only really worried about her",
    "doctor_response": "Hello Thanks for writing to us, There are various patterns of presentation of MS If your symptoms are progressive and repeated then you should consult your doctor again and do required investigation.You can do the Spinal Tap Spinal fluid analysis holds important clues in diagnosis. You can do Evoked Potential Tests for Multiple SclerosisThis painless test measures electrical activity in the brain to help diagnose MS. THIS CAN ALSO BE DUE TO CERVICAL SPINE DISC BULGE LEADING TO ARM SYMPTOMS.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in lower back after using heating pad?\n\nI put a heating pad on my lower back 4 months ago because of back pain due to a kidney infection. Now, about every other day, my lower back on my right side in a small area hurts when I touch it, and if feels like it's a little swollen. It goes a way in five minutes. Could it be a blood clot?",
    "doctor_response": "With kidney infection it is common to have back pain. Here your back pain could be related to various things like muscular pain, due to kidney issue, or disturb spinal disc at that level.How ever the conformation will be done only by physical examination and different reports like ultrasound abdomen to see the kidney issues and x ray or MRI of spine to see spinal issues.If your back pain is radiating to your legs along with numbness or tingling in legs then it can be related to lumbar disc or at that level nerve compression also. Otherwise it will be a muscular pain or pain due to kidney infection.How ever the swelling over that area represent the inflammation at lumbar level where its paining. Usually when ever there is swelling I suggest to use hot and cold pack in combination to reduce swelling as well reduce pain and I suggest same for you too.further diagnosis and treatment can be plan only after physical examjnatiin and diagnosis so I suggest to visit your specialist doctor as early as possible. If its due to kidney infection I suggest do not delay treatment.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Arms, legs and nose tingling when flying. What is this?\n\nRecently while flying in a small airplane we experienced very bumpy weather, while I am not scared to fly I get motion sickness very easy. My husband is the pilot and I trust him with my life, I have no fear of flying. This time both legs, arms and around my nose and mouth started tingling as if they had been asleep . Also my hands drew together and I was unable to use them. I fly often and have never experienced this tingling feeling. If I was the pilot I would have crashed, it rendered me unable to do anything. Have you ever heard if this? Thank you Renae",
    "doctor_response": "Hello, The symptoms that you are describing can be caused by rapid breathing (hyperventilation) with or without low blood calcium. Is it possible that you were breathing heavy (like sometimes one does when nauseated) before this things started at that particular time.  heavy breathing reduces carbon dioxide levels in blood and irritate nerves to cause this symptoms. These are transient and are relieved sometime after the heavy breathing is stopped. It is also a good idea to get you calcium levels checked. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for spectrum disorder?\n\nmy name is yogesh 24ys mech engg student suffering from 295 spectrum disorder .continuing treatment from 6+ys.but not any kind of +ve improvement feeling energyless,restlessness,cant understand what is going with me.cant take any kind of responsibility,-ve attitudecant understand what to do.madications are flupenthixol20,fludac,amisulpiride50.plzz give me hope.......im waiting(0000)",
    "doctor_response": "HiI understand your concern.295 spectrum has many phases and for treatment it is necessary to go in detail about all symptoms that you have.The medicines are mixture of both anti psychotic and antidepressant.If you have more psychotic symptoms then require dose adjustment and it can only possible when we know all history since beginning.Revert back with detail or consult best psychiatrist in a town for further assistance.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Miconazole cream be used for the diaper rash in a 3 year old?\n\nI have a three year old daughter with what looks like diaper rash but it looks like it could be a yeast rash.  Can I put Miconazole cream on her to help sooth the irritation.  Please help.  She wore a pullup last night to bed and it seemed like it only got worse when she woke up this morning.",
    "doctor_response": "Miconazole is an antifungal. Diaper rashes could be caused due to yeasts which are actually fungi and hence you can use miconazole to treat diaper rash. It will help in relieving the irritation but you have to keep the area dry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes feeling of fullness in chest and throat and breathing difficulty?\n\nI have had 2 surgery for subgltic stenois I was to see my ENT dr last month and he gave me the ok for another year.. for the last 2 weeks I have had this kind of full feeling in my chest throat area that I have to gaspe for air someimes I get my lungs to open and some times if I yawn it will open..  I had a PFT passed that had a chest xray passed that this is not normal but everything comes back ok any help for me?",
    "doctor_response": "Hello According your history you provide you should be evaluated again from your ENT doctor for probability of glottis stenosis.RegardsDr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itching, redness and rashes on the site of dog bite. What does it mean?\n\nHi! My 1 year old chihuahua scratches me on my face, arm, etc. but not intentionally. It then gets super itchy and it gets super red sort of like a rash. Then sometimes she licks the scratch witch makes me even more itchy. Also when I touch my nose after I itched I tend to sneeze a lot since her hair is all over the place, why is that? It s been happening for a while",
    "doctor_response": "it is allergy inmy opinion the rashes and sneezing are signs of allergyyou need to find out the aLLERGIES A SPECIALIST IN ALLERY CAN FIND OUT THE CAUSE AND TREAT ACCORDINGLY CAN USE ANTI ALLERGIC TAB AND OINTMENTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood in semen during masturbation?\n\nI am 45-years old. I once 5 yrs ago, had blood in my semen during masturbation. It went away. Now it came back. I suspect that it was due to accidental pinch on one of the nerves in the scrotal sack. I for now decided to slow down on masturbation anyhow, just to see what happens in the next 2 weeks.",
    "doctor_response": "DearWe understand your concernsI went through your details. If you find blood with semen during masturbation or sexual intercourse, I suggest, you should consult a physician. Prostrate related disorders has one symptom such as this. Take care.If you still need my assistance in this regard, please use this link.  Please remember to describe the whole problem with full detail.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am getting white vaginal discharge. Is it due to ovulation or infection?\n\nHi doctor, My vaginal opening is white, and I have so much of discharge coming out. I am sexually active. I feel like my vagina is really large. I looked at my underwear and it was just filled with a paste-like discharge. I know I am ovulating. But I am worried when I look down there as I see a white discharge in my hole. When I wiped it by myself, it does not have any smell. It smelled regular. Is this a regular ovulation discharge or an infection? I have no itching, and there is no pain.",
    "doctor_response": "Hi. I have gone through the attachment (attachment removed to protect patient identity). The white discharge is thick curdy. Candida infection causes the same. However, in the absence of itching or foul smell, it is recommended that you get a high vaginal swab culture test done to check for any possible infection first. If it is negative, it is likely a cervical mucus discharge during ovulation, and it can be controlled by using alkaline vaginal washes twice a day. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause numbness on both feet?\n\nL have some numbness in both feet (a feeling as though I am wearing socks) This is a new phenomenon and. shortness of breath---greater than normal.  L look after my husband(with some help)who has alzheimers disease and recently had a particularly stressful /worrying  time.  When taking a shower recently the water felt like needles on my skin and l thought l might be in for another bout of shingles but it hasn't developed. I am 73 years old,have never smoked and ,have never drunk much alcohol . And eat a balanced diet.  . My blood circulation has never been good and l have one badly varicosed leg.  I have some heart arrythmia(one of 8people in our family with it) which l have known about for 50years---it doesn't affect me too much. Could you suggest what the breathlessness and feet numbness might be please",
    "doctor_response": "Hi,I would explain that your symptoms could be related to different causes: - the difficulty breathing could be related to pleuritis, pericarditis, heart failure or a lung disorder- the numbness in the feet could be related to peripheral neuropathy. For this reason, I would recommend consulting with your doctor for a physical exam and some tests: -  a chest X ray study and respiratory function tests- a resting ECG and cardiac ultrasound- some blood lab tests (complete blood count, PCR, sedimentation rate, blood electrolytes, kidney and liver function tests, vitamin B12 plasma levels, HbA1C, fasting glucose)- a nerve conduction study for neuropathyYou should discuss with your doctor on the above issues. Hope to have been helpful. Let me know if I can assist you further.Kind regards,Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is causing sensitive penis, rectal pressure and pain after ejaculation?\n\nHello doctor, I am 35 years old male, with a long history of prostatitis, 3 to 4 years, no symptoms. Now a myriad of symptoms including all the following that come and go. Urgency, sensitive penis, rectal or prostate pressure, no pain but happens after ejaculation sometimes and from a bowel movement. Last urgent care said inflamed prostate on DRE and should take Flomax and antibiotics. Another doctor said maybe IC. The second opinion said he would treat for prostate within one month with Cipro. Not sure what to do. Please help.",
    "doctor_response": "Hi. From history and test report (attachment removed to protect patient identity), it appears as CPPS (chronic pelvic pain syndrome) and not to localize prostate as the source of the problem. I would like to add anticholinergic to your alpha-blocker (Flomax) and Psyllium Husk. CPPS (chronic pelvic pain syndrome). Capsule Roliflo OD 2 mg (Tamsulosin with Tolterodine 2 mg), Psyllium husk 3 tablespoon HS with one glass water over it, perineal exercises. Bahy Pranayam, Moolbandh regular two times a day will relax the painful focus in the perineum.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Elevated eosinophil count, early morning sneezing, nose and eye irritation. Remedy?\n\nMy eosnophlia count is 10, other test results of CBC, diabetes and thyroid are OK. I get affected easily from Bangalore climate - sneezing , nosing, nose & eye irritation etc particularly in mornings. My age is 65. I do 1 Hr walking in the morning and take controlled food. Otherwise I m fit and am still working in an Engg Firm. Advise me ways to control this allergic deficiency and to reduce eosnophlia count. YYYY@YYYY 0000 Bangalore",
    "doctor_response": "Hello, Reading your query and the results of the blood tests, I presume that the percentage of eosinophil count is 10% that has several causes. The commonest cause in tropical countries is parasite infections, and antiparasitic treatment is recommended after stool culture studies. This is a must before going through unnecessary tests or treatments. If the eosinophil count remains high and sneezing and rhinoconjuncitivitis symptoms persist, it would sugest allergies as the underlying cause. Pollen allergy, smoke (industrial) are major factors that needs high dose antihistamines and steroid nasal sprays. The duration of treatment will depend on the trigger (i.e., seasonal vs perennial [all year around]). There are several other causes but infections, allergies and rarely autoimmune diseases are causes of raised eosinophil counts. I also hope you have recognised red flags such as significant loss in weight and appetite that should be taken more seriously. I hope this was useful. Best Wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red bump on top of tonsils?\n\nI was having difficulty breathing and saw I had tonsil stones yet again (I get these often) but this time there is a small, painless deep red bump on top of my tonsil. It is only on the right, not the left, same with the tonsil stones and swelling. I just want to make sure I shouldn t be concerned or if I should get it checked out. I am 17.",
    "doctor_response": "Helloi really appreciate your concernlooking at history you might be having  tonsillitis or a peritonsillar abscessin my opinion you should visit an ENT surgeon for examination and tonsillectomy for definitive and permanent curedo warm saline garglesavoid cold drinks and  ice creams ( anything cold)Hope this adresses your questiongood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce hyperpigmentation on forehead, cheeks and side of eyes?\n\nHave hyperpigmentation on forehead, cheeks and side of eyes. One can also say that it is sunburn but in any case visually its a darker area. My face skin is allover bit dark than my neck, which is fair. I am having this problem from around 4 years. Have tried other cosmetic treatments but not satisfied.",
    "doctor_response": "Hello,Thanks for the query.This hyper pigmentation can be removed by using skin lightening creams.Various creams are available like melalite xl, lookbrite, Lumaglow etc.You can take any of them.The following should be procedure to use it.1. Wash your face in evening around 7.2. Dry face and apply cream all over your face.3. Keep it for one hour.4. Wash face again.5. Apply some moisturising cream and sleep.6. In morning apply a sunscreen with spf at least 30.Do this for a month, you will see the results.Let me know if you have any other doubts.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Allergies, CT scan showed ventilation defect, prominence bi later. Had consume water mixed with apartment leakage. Related?\n\nHi recently in mid August my apartment received water from a upstairs units as a result of a flood. i was away from ny home for three days. However I came home my apartment was consumed with large ame. allergies ounts water.Today i have allergies, and four xrays latnd a ct scan showing a ventilation defect and promience bi later. My doactors are.still running test. Could this problem be associated with the water in my apartment flood/leak?",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for choosing H.C.M.Forum. In mid august you had floods and you have used the stagnant water after 3 days. Due to floods there might be more of moisture in the rooms, followed by infection in the lungs. ventilation problem might be of the rooms may be of the lungs. I advise you to consult  a physician for diagnosis and treatment. There also a possibility of fungal infection of the lungs , as a primary infection or a secondary infection due to antibiotics. you may need to have anti fungal antibiotics and stop the antibiotcs. Wishing for a quick and complete recovery . Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI report showing disc desiccation, posterior disc bulge and thecal sac compression. Mild neural foraminal stenosis with nerve root compression. Treatment?\n\nsir i have done my MRI here is the report: Disc dessicatory change,diffuse posterior disc bulge,thickening of ligamenta flava,facetal hypertrophy ,mild thecal sac compression.bilateral mild neural foraminal stenosis bilateral mild nerve root compression at L4/5. straighteing of lumber lordotic curvature curvature is seen suggestive of back muscle spasm. what can i do now? any advice ??",
    "doctor_response": "Hi zafran, As doctors, we treat the patient and his symptoms. Looks like you have a MRI report showing some features of degeneration (wear and tear), but the MRI scan requires no treatment! Please let me know what symptoms you have, how long you have it, what medicines you have taken and for how long and whether it has given you any relief. That will let me know if the MRI report correlates with your symptoms which will help in giving you appropriate advice. Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe abdominal pain and bone spurs?\n\nI have had severe abdominal pain and my dr hasn t been able to figure out why i also found out i have bone spurs in my back my stool is sometimes light in color and i strugle to go the bathroom and make my stomach hurt all the more",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I hope that your ultrasound abdomen is normal . If you have not got ultrasound abdomen done , get it now . If ultrasound is normal , then abdominal pain is being referred from spine .Once your spine problem is cured , your pain abdomen will be handled as well . For spine problem , you need pain killer as Aceclofenic and muscle relaxant as Thiocolchicoside or Tizanidine . As these are prescription drugs please contact your local doctor he will prescribe these . Maintain proper posture of spine while sitting , standing and sleeping .Try sleeping on hard bed without mattress .You should take antacid for stomach ache if ultrasound abdomen is ok . For washroom problem , get urine and stool examination . Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in hip\n\nToday, I got out of a friends pool and slipped and landed on my hip about 5 hours ago. Bruising hasn t shown up very much, but I am in a lot of pain every time I touch it. I fell hard, and my hip had most of the impact. I am very worried about it. Input?",
    "doctor_response": "Give adequate rest to your hip. ...avoid over exertions. ..take a muscle relaxant like NISE MR SOS ..and Serradopaptidase 1 od",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen bumps on face with pain in eyes and ears?\n\nI have four swollen bumps on the right side of my face, next to my mouth and on my chin, that were very painful and caused severe sensitivity on that side of my face for a couple of days.  The bumps seem to be not so swollen anymore, but now have a dark center.  My right eye hurts a bit, and so does my right ear, sort of a burning sensation.  And, the top of my head on the right side is now sensitive to the touch.  I took my temp. last night and it was 97.1.  Any thoughts?",
    "doctor_response": "Hi,From history it seems that you might be having Herpes Zoster giving rise all typical symptoms.It gives clear clue about the condition on personal examination.Consult your doctor and go for physical examination.You might require some antiviral and antibiotic medicine course.Meanwhile you may take ibuprofen for pain and burning.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get pregnant after having an abortion?\n\n\"hello doc, my daughter was born on 25 april 2004. I got my first periods in august and in october i found out that i was  pregnant.my friends advised me to take misoprostol and get rid of the pregnancy. as i was still studying i did so and the tissue was expelled immediately. as my periods resumed the next month i did not go for a d&c, also in january 2005 had a cooper t inserted which i took out on in march 2007. my periods were normal after the abortion working like clockwork and there was no trouble. the purpose of my anxiety is i am not getting pregnant again and have been trying for an tear. the sperm count of my husband is 50% motile. my fallopian tubes are in very good condition as i had a vaginal ultrasound done too. Please help siya\"",
    "doctor_response": "Hello,Do serum TSH and serum prolactin. Then do follicular study after Clomiphene. Go for HSG on 8th or 9th day of period. See that follicle grows to 18 mm and then rupture. Then go for IUI for early results.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sheetal Agarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for gum hanging over wisdom teeth causing pain\n\nHello. I am a 21 year old Male and have all 4 wisdom teeth in. The bottom right has an issue. There is part of the cheek/gum that still hangs over it and it hurts like sin... I was told it would eventually recede but has not yet. What are my options?",
    "doctor_response": "helloo...after reading ur symptoms i can say that it is pericoronitis(inflammation of pericoronal flap)..but dont worry ..its just usual...u have to do hydrogenperoxide mouthwash twice...take antibiotics(amoxicillin+metrodinadazole) and analgesic(diclofenac)..do warm salt water gargle as many times as possible..meet an oral surgeon and get it extracted(if not errupting)..then it will get healed...hope ur benefitted something from this reply..have a healthy day!!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "In what conditions one should start ICSI treatment ?\n\nhey my self Riddhi (india)i had chocolate cyst  & removed by laproscopy...i have done icsi but my first cycle got failed...& 2 pre icsi treatment got canceled...yesterday my folicle size was 23mmtoday i got periods...so can i start icsi treatment from today?",
    "doctor_response": "Hi XXXX. Actually it is difficult to tell that. You have to get a ultrasound done on day 2 or 3. Also FSH, LH and estradiol levels should be checked. Only after seeing those reports, I will be able to give you a definite answer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Small child, painless swelling behind ears. Taking monocef o with ibugesic, not reducing. Tumor or lymphoma symptoms?\n\nmy daughter is 2 ad half yrs old.she has a painless swelling behind her leff ear from few weeks.I m giving her monocef o in combination with ibugesic as per my doctor prescription.other says it is reducing but i am not satisfied.sir i just wanted to know that it is not any kind of tomor or lymphoma symptoms.kindly ans. me i m very worried.",
    "doctor_response": "If it is reducing with drugs given, it is probably due to infection. To know the real cause F.N.A.C. test is required.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dont want baby now, please tell us what to do ?\n\nI am father of 2 months and 3 weeks baby girl yesterday night we both done intercourse without precaution, please tell us what to do and we dont want another baby now?",
    "doctor_response": "Hi.. If your partner is breast feeding, then she would be naturally protected against getting pregnant.. This is called as\u00a0 lactational amenorrhea in medical terms.. This natural protection is confirmed to be active present,\u00a0 if she has not started her periods. But if\u00a0 she has started having her periods, which would indicate absence of this protective mechanism,\u00a0 then you may have to use the emergency pills to prevent pregnancy..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pinworms\n\nA guest at our home has pinworms. The doctor told us all to take Reese s pinworm medicine. We took one dose yesterday. We also washed and vacuumed everything yesterday and again today. When can we assume the pinworms are gone and stop washing everything everyday? Also, I am somewhat dismayed to find that though I had no symptoms yesterday, I do today. Should I take another dose? If not now, when? Thank you!",
    "doctor_response": "You may not need another dose of the medicine but the most important thing is to get rid of all the pinworm eggs by washing clothing and bed linen in hot water daily. You need to take showers, not baths and wash well around the rectum each morning to get rid of eggs. Washing the toilet seat daily is also a good idea. Once everyone is no longer having symptoms you may stop washing the clothing and bed linen daily.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take aztreonam and metronidazole for possible appendicitis while pregnant?\n\nI am 22 weeks pregnant and in hospital with suspected appendicitis I am receiving antibiotic treatment and not surgery right now as am pregnant, am getting IV aztreonam and metronidazole will these work to treat appendicitis or am I going to need surgery whilst am pregnant? I had extreme pain 2 nights ago in right side, am still in pain but doesn't seem as bad, my temperature an white blood count are normal too, am so worried about the thought of surgery and does this sound like definitely appendicitis?",
    "doctor_response": "Hi. Do not worry. Relax. this one of the needs for the better outcome in any disease. 22 weeks is second trimester. You are on a correct antibiotics and appendicitis  may very well subside with these medicines. Just follow whatever your Doctor advises you.Since your counts and temperature are normal , you may not surgery now.Please post the symptoms and findings chronologically for us to tell you about appendicitis ( you have not put in symptoms here).Review ultrasonography / MRI to confirm the diagnosis and see the progress is a good way to follow the disease as well as improvement in your symptoms as abatement of symptoms, a good and sound sleep, good motion in the morning and feeling hungry are the best symptoms to judge the progress.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hypochondriac, strange itch feeling on chest with occasional pain, increased heart rate. Cause?\n\nI am a hypochondriac, In the last month alone I have thought I had multiple diseases. Now I am worried that I have a serious heart problem. I have a strange itch feeling in my chest on the left side as well as occasional pain there. It seems like my heart rate might speed up easier too. But as always, this may be in my head. Because a few months back I had the itch feeling for a while and it just went away.",
    "doctor_response": "hai The strange itch feeling itself might be a part of hypochondriac process.the thought that you might have  a heart problem itself may cause anxiety and  increase your heart rate. Try and divert your attention towards something else you are interested in,though you may find it difficult initially. Bye",
    "dialogue_context": ""
  },
  {
    "patient_message": "For how long should Cefuroxime and Ceftum 500 be taken?\n\nmy wife aerobic culture of Urine shows growth of Escherichia Coli after 48 hours of incubation at 37 degree celsius. culture and sensitivity test shows for taking Cefuroxime and taking Ceftum 500 from two weeks twice continuously but still fever. how long this medicine will be taken.",
    "doctor_response": "Hi,Welcome to HCM.Cefuroxime belongs to a group of antibiotics called cephalosporins which are effective against bacteria which cause urinary infection. This antibiotic is usually prescribed for 10 to 14 days. If your wife is still having fever, she is not responding appropriately to the prescribed antibiotics. I suggest you get in touch with her treating doctor and get a prescription for a different antibiotic. I also suggest intake of at least 3-4 liters of water and keep the genital area clean.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life expectancy for stage 4 throat cancer patient?\n\nhi my dad has stage 4 terminal throat cancer he has recently i@d say the last week been refusing foo and sleeping for very long periods he also complains his feet and hands are cold all the time he has no energy and is completley exshausted can you tell me how much longer you may think he has",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  He has stage 4 throat cancer.  No treatment will cure the disease.  Chemotherapy help as palliative treatment.  If he is not taking food thdn he is at very late stage.  Life expectancy is just few months. Prognosis is very poor.  No treatment should be given. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the purpose of ovigyn tablet?\n\nMe and my wife was trying to conceive for past 1 year without scuccess, We consulted a doctor and did ultrasound and told us that the size of the oveum is only 8mm and he prescribed OVIGYN tablet for that. So whats is the use of this tablet and how safe it is?",
    "doctor_response": "Hi, this tablet is given to increase the number of follicles in ovaries.  Doctor might have seen less number of follicles in your ovaries.  You have to take this medicine for at least 3 months. It is safe to take it. Get a scan done at regular intervals to see the results. Meanwhile you can try naturally by having contact with your husband every 2 to 3 days after your periods stop.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can depression and anxiety be treated?\n\nI have been through sexual assault.. I lost my virginity at a young age. I have been with 6 diff guys since I was 13. I have depression and anxiety I know that for sure. I am in a relationship with a 17 year old who suffers from psychosis. I believe I ve been going through the same thing.",
    "doctor_response": "Hello,You need to be started on SSRIs like Escitalopram drug, which would take care of your anxiety and depression. Discuss with your doctor regarding this.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Soujanya",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chicken pox, flu, fever, headache, asthmatic, nausea. What is possible cure?\n\nHello, my daughter had chicken pox about 10 days ago, despite being fine up until now she has now come down with a strange flu.  Temperature reaches a high of about 39.6 and at times seems delirious. It goes down when I give her paracetamol.  She is complaining of a headache and the front of her neck near her collar bone is pulsating.  A she is also asthmatic I am rather concerned about this.  I spoke to her doctor today and he told me to continue giving her paracetamol.  She is also feeling very nauseus and although she hasn't vomited today she was very sick during the night.",
    "doctor_response": "hello welcome to health care magic.. you didn't mention here that how old is your daughter? i think she is under 10 yrs right? regarding your query she had got complications like bacterial infections(39.6 degree Celsius is an high grade temperature)and you are telling that she is delirious some times,....,so mam/sir dont do delay consult pediatrician(if she is below 14)/general physician.. if the fever goes to head that is encephalitis it is too dangerous.. hope you understand my suggestion.. have a speedy recovery. thank you Dr.siddartha",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes anemia with headaches and lethargy?\n\nHi Doctor,Last week test results indicated my ferritin value is 9.0. I have iron deficiency anemia. For several days now I have had a headache, I'm lethargic, and unable to sleep. A few moments ago I took my blood pressure reading. It is 91/69 with a pulse of 85. Should I try to see a doctor as soon as possible?",
    "doctor_response": "Yes headach may be due to iron deficiency anemia.your ferritin level is too low.start iron therapy as early as possible.and blood pressure is slightly lower range but not worrisome.  Take salt and water.and start iron therapy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does red bump with central black spot on baby toe requires attention?\n\nlittle red bump with a black spot in the center on the top of my baby toe. when i break it open and squeeze there is either/both clear fluid and blood. no pain with direct pressure, slight pain with pressure on the sides but i have been squeezing fluid out the last half hour. had it several months, havnt paid much attention to it. hasnt affected normal life in any way. what is it and should i do somehting about it?",
    "doctor_response": "Hi,Dear Good Evening and thanks for the query to HCM.Cause of the red  lump on the top of my baby toe-I studied your query and understood your health concerns.In my opinion the red lump is mostly  due to chronic infected boil-of the toe.It has not affected teh normal life of the baby and is due the thickened chronic abscess wall of the toe boil.To avoid any further septic complications from it -I would advise you to consult a ER Surgeon ASAP.Hope this would help in planning treatment with yuou Doctor.Welcome for  any further query in this regard.Plz write a Good Review-without fail,as it would help other patients coming to HCM.With Regards.Dr.Savaskar M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for high Blood Pressure and celiac artery stenosis?\n\nMy husband has recently been diagnosed with high blood pressure.  His primary physician had him do an MRI to rule out Renal Artery Stenosis.  The results came back that he has celiac artery stenosis.  However, he has no symptoms from all of the information we have found.  They are discussing a stent.  Does this sound like a good idea?",
    "doctor_response": "Hi ThereAfter reading the details provided by you i would like to tell you that the hypertension in your husbands case is most likely due to the renal artery stenosis. Yes this stenosis needs to be treated because later on it can cause kidney damage due to reduced blood supply as well as can cause resistant hypertension.So its advisable to go for stenting in a good center.I wish him good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red blotches in the skin?\n\nA few days ago I noticed my 5 1/2 year old s skin was covered with red blotches in kind of a mottled red and white pattern that looks a bit like a two toned ariel map. It appears raised to the eye but I can t feel anything out of the ordinary when I touch her skin. The blotchyness is not unique to either a sun exposed area or an area that would be impact by a detergents, etc. It is on her arms, tummy, rear, and legs. Her face, back, and feet don t seem to be blotchy at all. No itching, pain, exposure to new foods, or environments either... no notable health history to report. I assumed it would pass when I first noticed it but we re going on five days now...",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.By what you quote it should be an urticarial or a simple skin allergy. You can use Hydroxyzine at 1-2mg/kg/dose every 6th to 8th hourly for 7-10 days. Most important thing to be remembered is that it has a propensity to recur (called as second crop) within 10-14 days. If this happens, you can start using the same medicine but I suggest you get the kid evaluated with your paediatrician.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for ddd\n\nHello I have DDD, congenitally narrow spinal canal and disc protrusions at C5/6 & C67 with nerve compression. This has been going on for months. I am on endep & celebrex but this doesn t seem to help much. I am 47 years old. I have a Neurosurgery appt. coming up, do you think they will operate or just send me for more useless physio? Thank you.",
    "doctor_response": "Hi, thanks for your query.As you told that you  have congenitally narrow spinal canal and discs protrusions.Treatment planning requires Clinical and radiological exam.If there is severe canal stenosis and cord compression this needs surgery.Mild canal stenosis is managed conservatively.Paracentral disc with radicular pain are treated by anterior cervical dissectomy.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cause for lumps stomach post HCG injection\n\na few months ago, my wife and I tried the HCG injections to try to loose weight. After I stopped the injections, I notices a small lump under my skin in my stomach. It has gradually grown and is painful to the touch. I was told that it will go away in time, but I am getting worried. Any thoughts???",
    "doctor_response": "Hi,DEar,thanks for your query to HCM.I studied your query  in depth.1-In My opinion the lump post-HCG inj under your stomach skin, which is growing lately, is most-probalby a -injection abscess and needs urgent care from your doctor.2-Urgetnly consult surgeon, who would treat it as needed. may  be by Nsaids and antibiotics or by incision and drainage of the abscess-if its there.3-Hope this would solve your query.4-Wellcome for any more questions on new or this subject also...Have A Good Day..!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes warm sensation in leg?\n\nI have the warm sensation in one leg- no pain and this happens fairly often. I see from previous answers many things but wonder about taking statins as I do take medication for cholesterol. I also tripped and fell last summer- no real injury but did fall hard on my bottom and back on my head so wondered if I was having some kind of nerve damage. Sometimes this same leg will get numb if I sit in the wrong position.",
    "doctor_response": "Hello, I have studied your case. Possibility of compression of nerve root in spine, leading to pain and warm sensation in your buttock and leg.I will advise you to do MRI spineI advise my patient\u2019s analgesic and neurotropic medication like pregabalin, you can consult to your treating doctor and do required investigation.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.Another possibility of lumbar canal stenosis which will be ruled out on MRI.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hallucinations\n\ni keep hearing a voice inside my head, i dont know if its my voice or not because ive had it for so long. it calls me by my own name and thats why im not sure. for example if i was standing in a que and theres someone stood infont of me doing nothing wrong at all i get this voice and it tells me to hit the person or pick somethin up and hit em, even though they havent done anything wrong. i picture myself doin this aswell the voice like encourages me and i see myself doing it. i never get hurt back though. i just hurt them. and sometimes it makes me do the things i see, sometimes i cant stop myself. i get really paranoid aswell like i think somethings watching me and im always looking around me in everycorner and behind me to see if somethings there.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. If the symptoms you gave are correct and accurate, then you must be experiencing a mental disorder named parnoid schiophrenia. It is a complicated mental disorder and needs expert psychiatric treatment and proper management. Please visit a psychiatrist in this early stage itself and start the treatment. Please do not delay.If you need more of my services, please post a direct question to me in this website. I am happy to serve your purpose.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurrent mouth ulcers?\n\nHi I have had continuous mouth ulcers/canker sores for the last 5/6 years after having my gallbladder removals. Could there be a connection or is it just a coincidence. They can be quite large and often take at least 1/2 weeks but  by then I get a new one. Fran",
    "doctor_response": "Hi Thanks for the query. You are suffering from RECURRENT APTHOUS ULCER which is causing you the eruption of canker sores in mouth. It can be caused due to a number of reasons like Stress, Nutritional Deficiency [Iron, Vitamin B12 and Folic acid] , hormonal changes, acid reflux, tongue trauma due to some sharp teeth or tongue biting habit, excessive intake of sour and citrus foods, side effects of medication etc.. You need to consult an Oral Physician or a general dentist in this regard to get evaluated and treated. For apthous ulcer you can do warm saline gargles Gargles with 1:1 solution of Benadryl and milk of magnesia can help. Apply numbing gel over the sore for relief from pain especially during eating. Take a multivitamin tablet for a period of 15 days..Avoid spicy, sour and acidic foods. Hope this helps. Regards Dr. Honey Arora, Dentist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain when diagnosed with Myelomalacia?\n\nI am 49 years old woman and last year, I have been diagnosed with c5 and C6 myelomalacia with osteophyt and lumbar area too. the pain is progressing in my chest and neck. Doctor suggested for surgery but I am looking for alternative treatment like ayurveda or homopathy. Pls advice",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.Sorry to say but surgical correction of deformity and stabilization of spine are the only option in your case.Ayurveda and Homeopathic drugs are not useful in advanced stages of disease.So better to consult spine surgeon and get done operation.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for aspergillus?\n\nI am 79 yrs old and have been diagnosed with aspergellis. a fungus was found in my lungs from sputum and I have been treated with itraconosole. I have recently read about symptoms for valley fever. I have always had to use lidex cr\u00e8mes, etc. for occasional rashes. I am continually fatigued and I have night sweats regularly, especially if I take aspirin before bedtime. not always, but often enough to be suspicious that something else is in play besides the aspergellis diagnosis. what do you think?",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern.  Your all symptoms are mostly due to aspergillosis.  There are less chance of having other pathology.  However you should take proper treatment of aspergillosis according to your doctor's advice.  If you don't get complete benifit then think about other pathology. But at this stage you should take treatment of aspergillosis. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be the normal values for the semen analysis to get conceived?\n\nHi,My husband had a sperm count of 11 million and 30% normal sperms and rest 70% abnormal with 45% mobility rest factors are fine, so i would like to know what are my chances for getting pregnant and if i should o for medication or opt for artificial insemination and can i use my husbands sperms for AI",
    "doctor_response": "hai,your husband 's sperm count is less than normal range . it should be between 20 million to 200 million/ml. in that more than 10 million count should be motile.still you need to increase sperm count especially motile sperms count  (grade and grade b  forward progressive more than 50 %) . . so that chance of pregnancy will be more. I advise you to add some food items in your daily food intake that will result in increase of motile sperm and total count.milk and milk productsdates,wheatsesamejaggery,almond,cashew,pista.peanuts.pomegranate,arrowroot,cucumber seed,Avoid junk,fried,caffeinated foods and stress(highly influential)be hydrated,do exercise.Follow this for 2 month period and do a semen analysis. If you still got problem with counts (motilesperm) consult your near by physician and get a idea to prefer artificial insemination.'Hope I have answered your query. If you have any further questions I will be happy to help\". For Follow up queries, end with \"If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had protected sex. Partner had cancer and infertility. Pregnancy chances?\n\nHi my name is Sarah, I m 16 years old and am very concerned about being pregnant! I had sex on Thursday afternoon for the first time, I am not on anything and we didn t use protection because he has had cancer in the past and said he is infertile. Well apparently. I didn t let him ejaculate inside me but we ve been talking and there is at least a 5% chance that i could still get pregnant and when we talk he talk as if i already am pregnant. I m very nervous and worried and I have no idea what to do! Please help me! Should I take a test? When would be the best time? And if i do end up pregnant could i get an abortion? How much do abortions cost in Australia?",
    "doctor_response": "Hi and welcome to HCM. I see you are very concerned. I know it is hard to even thinkabout pregnancy at your age, but first i need to say that possibility is extremly low. Especially considering his infertility. As you said woman can get pregnant even if there wasnt ejaculation inside. You didnt tell me what period of your cycle was? if it was 10-15 days after menstruation then there is a possibility of pregnancy(about 20%,if he is fertile). I suggest you to dwait are you gonna get next menstruation,if not,then do pregnancy test. I ll say nothing about abortion. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could a toddler s headaches, stomach cramps and back pain indicate?\n\nmy nine year old daughter started three days ago with a headache, stomach cramps and upper back pain. She is now complaining of neck pain. She had a low grade fever 99.8. Headache goes away with ibuprofen. Should I take her to urgent care? concerned about triple E",
    "doctor_response": "I would think of a gastro enteritis associated fever and headache and would also rule out an abdominal epilepsy by EEG test and treat for fever after looking for a focus of infection and CBC . YOu have to discuss with your doctor and meet a doctor.  You can temporarily give antispasmodics like dicyclomine. Regards , Need to check her vision also before anything and observer if she has pain on moving head to think of meningism. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I feel pain and burning sensation after intercourse. Is this UTI?\n\nHi doctor, I am 26 years old. I got married recently. After having intercourse with my husband, I feel too much pain in my vagina and also burning sensation while urinating. I also feel frequent urination. Is this urinary tract infection? Please suggest some medicine.",
    "doctor_response": "Hi. You are right. You have symptoms of urinary tract infection (UTI). Please get a urine culture and sensitivity done. We can start the appropriate antibiotic then. Meanwhile, have plenty of water of about 10-15 glasses a day to flush out the toxins. Revert back with the urine culture report to an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How much gap is required between taking two ipills?\n\nMy wife had her periods on 31st July and it ended on 3rd Aug. We had protected sex on wed, after which she took an i-pill on Thursday morning 3am. We had an unprotected sex on Friday afternoon at 3pm. Should she take an i-pill again? Or after what time she can take? She has regular periods with around 25 days cycle.",
    "doctor_response": "Hello dear.Understand your concerns.I pill taken on the thursday does not protect against the unprotected sex done on the friday.If you do not want to become pregnant then take I pill  again as early as possible after second sexual intercourse.But make sure, avoid frequent use of the I pill in future as it cause high chance of hormonal imbalance, menstrual irregularity, and infertility problem.Use barrier contraceptive in future to prevent the unwanted pregnancy.I hope this will help you.ThanksDr.sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower back pain\n\nI have been having lower back pain for about two weeks, which makes it difficult to walk or sit, or anything remotely physical. I have noticed that, in the last few days, a penile excretion. I have not had sex in these two weeks, and have not been exposed to any STIs. I think there may be a link to dehydration. Thanks.",
    "doctor_response": "Hi,Looking to the history it seems that your problem might be due to having some urinary tract infection.Go for routine and microscopic urine check up.After report go for treatment accordingly.Meanwhile take diclophenec, paracetamol combination medicine as needed.Take plenty of water.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dry skin on the chin, spots on the face. Need a cure\n\ni had dry skin on my chin, so used a scrub to get rid of it. i then found that the dry skin made my chin very spotty aswell. ive tried moisturising the skin to then deal with the spots, but that made my skin more spotty, and then i tried dealing with the spots first but that made my skin more dry; making alot more spots.now the spots are open and scab-like and arent healing over, theyre very red, stand out boldly, and i dont know what to do to hydrate my skin and get rid of the spots.",
    "doctor_response": "Hi,Thanks for writing in.You can use a hyaluronic acid containing gel for moisturization.Aloe vera and shea butter containing moisturizer are known to be good.Chemical peels can help in reducing the spots and give a glow to face with even complexion .A dermatology or cosmetology clinic can provide you these treatment options.Hope this helps.RegardsDR Sudarshan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent pain in left arm?\n\nHello, I am a female, age 53. I am feeling pain in my left arm and same side in the back ( whole back up to half)! The pain is more severe in the night and some time during the day! It comes for few days and goes away. This time it is continues from last week! I am under lots of stress. Is it spasm?",
    "doctor_response": "Slight tearing or spasm of connective tissue around upper back region can cause pain in  upper back pain and may radiates to surrounding areas typically as a result of bending, lifting, twisting or shoulders forwards activities or trivial movements, such as picking up a pencil or sneezing. May cause upper back pain with or without symptoms radiating along shoulder, arm, forearm, hand or fingers. Pain may increase on firmly touching the affected level of the spine and spinal movement is often stiff or restricted. Pins and needles or numbness are occasionally present in affected arm or hand. Symptoms may increase with repetitive or prolonged sitting (especially slouched sitting or during computer use), bending, lifting, shoulders forwards activities, coughing or sneezing and are often worse first thing in the morning.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should i do if my child swallowes toilet cleaner?\n\nmy one year old may or may not have swallowed bleach toilet bowl cleaner. i know for sure it was on both of her hands so i washed them very well. what should i do? she seems fine but her hands were on fire for a bit. i gave a small cup of water and she is playing around now. should i take her to the emergency room?",
    "doctor_response": "Thanks for follow up, she can receive poisonous after drinking chemicals. You should stimulate vomiting reflex by making pressure on the radix of tongue or give to drink water with table spoon for vomiting reflex. Then give to her 1 tablet charcoal or other absorbent and then pplenty of water. If she will not have nausea,vomiting, headache, malaysia, then don't worry. Take careBest regardsDr.Svetlana",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe pain in the tailbone when I sit\n\nMy tailbone has been hurting really bad since yesterday. Whenever I sit down it hurts so much worse and my whole leg goes numb. It feels a little better when I stand but I haven t been able to sleep because of the pain or anything. Can you tell me what s wrong",
    "doctor_response": "Dear patient it seems you have got coccydynia. In this condition infammation at the tip of coccyx leafs to pain snd swelling. when you sit pressure at the area leads to pain. I would recommend use of soft pillow while sitting or tyre tube filled with air so as to avoid pressure on coccyx. Star tab zerodol sp twice a day for 5 days. if not relieved pleaseconsult orthopaedic surgeon nearby your area.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low testosterone levels\n\nHello, Dr Shehzad Topiwala! My name is Daniel, and I am seeking your professional advice and expertice. I am 21 years old, male, good health, fit, no smoking or excessive alcohol. I am experiencing low testosterone symptoms such as: no sex drive, ED, depressed mood, etc. My sex life is almost non-existent. I am 21 years old, and should not be dealing with problems like these. The blood work done with my doctor, all came back within the normal range, and my doctor tells me everything is like it should be, yet I don\u2019t feel like it is. I have gotten a copy of my results and did some research online. Aberrantly my T-levels at 14,5 nmol/L (around 350-400 converted to ng/dl), are in the same range as an average 80 year old\u2026 My testosterone levels are not god for a guy my age, and far from optimal. So I went back to my doctor, but now she tells me my symptoms are caused by depression. I admit feeling depressed, but that is a result of my problems, depression is not causing them. And then she continued to prescribe me some Viagra\u2026 I am confident in saying that the symptoms I am experiencing are hormone/testosterone related, not psychological. My testosterone levels are low, but not low enough to get treatment, and thereby no chance to get sent of to an expert on the subject. So I am glad I found your internet service. What am I supposed to do? I cannot live like this, life feels so empty at the moment, and I don\u2019t feel youthful at all\u2026 Some of my friends tells me that they can masturbate/have sex 3-4 times a day. Me, I need a two-day recharge time after just one \u201csession\u201d. Below are my results, please take a look at them, what do you think? Free T4\u00a0\u00a0\u00a0\u00a0\u00a0 18.9 pmol/L 11.0 - 22.0 FSH 3.9 IE/L 1.0 \u2013 12.0 Cortisol 577 nmol/L LH\u00a0\u00a0\u00a0\u00a0\u00a0 9.7 IE/L\u00a0\u00a0\u00a0\u00a0\u00a0 1.0 \u2013 10.0 Prolactin 156 mIE/L\u00a0\u00a0\u00a0\u00a0\u00a0 100 \u2013 400 SHBG\u00a0\u00a0\u00a0\u00a0\u00a0 18 nmol/L\u00a0\u00a0\u00a0\u00a0\u00a0 15 \u2013 85 Testosterone 14.5 nmol/L 9.0 \u2013 35.0 TSH\u00a0\u00a0\u00a0\u00a0\u00a0 0.66 mIE/L\u00a0\u00a0\u00a0\u00a0\u00a0 0.30 \u2013 4.2 Estradiol 0.09 nmol/L 00 \u2013 0.16 Free Testosterone 7.1\u00a0\u00a0\u00a0\u00a0\u00a0 3.0 \u2013 14.7 I was hoping your profession on this subject could cast some light on my situation. Do you see anything out of the ordinary when looking at my blood test results? I am noticing elevated LH levels, along with the low testosterone, does this mean there could be something wrong with my testicles/leydig cells ? One guy told me that my pituary maby needed a kickstart. And that my T-levels would increase with the use of a drug like arimidex or clomid. To my understandin",
    "doctor_response": "Hi, Low testosterone can be treated by hormone replacement therapy and assisted reproduction. Also, hormone affects body processes by regulating the activity of the organs. Estrogen modulator mimics the effect of oestrogen on various tissues, including the breast, bones and reproductive organs. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Monish De, Oncologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in the body?\n\nhello doctor.my age is 24.i am a heart pateint since 3 years.i have done all my reports but stil doctors are saying that there is not any big findings.my left chambes are big in size..i dont feel any pain..but my body start swelling all the time.what should i do doctor please help..",
    "doctor_response": "welcome to HCMAt your age there may be any congenital anomaly or valvular lesion may be the cause you should rule out with 2D ECHO .Do you have any history of Joint Swelling or Sore Throat in Past . also dont forget to rule out any renal pathology which may also cause body swelling for body swelling you can use medication according to your primary physician advise .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with thalaessemic major requiring regular blood transfusions. Would methylcobalamin help?\n\ni m a girl of 22 years.. n sufferin with thallassemic major for the last 22 yeras...requiring blood tranfusion at the intervals of 22- 25 days.. sir i want to know whether methylcobalamin is beneficial to us in any manner. if yes then kinldy let us know about its dosage also.and plz tell some more medicines for hormonal disbalance too.. with regards.",
    "doctor_response": "Hi, I feel that you should take methycobalamine only if you are having macrocytic anaemia( MCV high) & low Vitamin B12 levels or if you are a vegetarian and expericing symptoms like paresthesias.You can get your Vitamin B12 levels and take methylcobalamine(100-1000 micrograms per day) if your are having low levels.Other things which might benefit are drinking tea may help to reduce iron absorption through the intestinal tract. Vitamin C may improve iron excreation .Hope it helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can medication for blade infection cause muscular spasms?\n\nI have blade infection and my dr. prescribe three medicine. it s helping mi and I fill much better.Lately I suffer from spasm muscle every night. it very painful and I can t sleep all night . It is start when taking this medicine. phenazopyridine 200.mg , nitrfuranton- mono-MCR 100 MG,and Vesicare 5mg. Please let me know with medicine can cos the spasm muscle. Thank you",
    "doctor_response": "Hello ,I understand your concern. I am Dr. Arun Tank, infectious disease specialist, answering your concern.Yes muscle spasm is the side effect of the drug prescribed to you. You can change to other drugs.Glad to answer your further concern. We wish you a best health at healthcare magic. Thank you,Dr. Arun TankIf you are satisfied with my answer rate me as five star and close the answer",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe vomiting, nausea, dizziness and weakness after second dose of Clindamycin?\n\nI took first dose of clindamycin yesterday with no problem, but took the second dose today and had severe vomiting and nausea as well as dizziness, confusion, and muscle weakness. Seen at ER and given zofran and told to discontinue clindamycin. Still dizzy and feeling like something is badly off. What caused this?",
    "doctor_response": "hello the problem you got after taking clindamycin happens in very less people .and it is better adviced that in future you should inform your physician about this reaction beforehand..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to have a smear test during pregnancy?\n\nHi my sisiter was given a smear test when she went to the hospital with stomach pain she was 23 +4 weeks a few hours later she went into labour and gave birth to a baby girl that died 47 mins after birth my question is can a smear test bring on labour and it is normaal to have a smear test while pregnant",
    "doctor_response": "Hi there,,Usually smear test is advised after 25 years of age in women who are sexually active. It is not advised in pregnancy unless a previous smear test was abnormal and she was asked to repeat it.Smear test are non urgent unless a previous one has been abnormal and can be postponed to be done after delivery.But, it is not possible for a smear test to cause labour to start.The smear test just takes cells from the outer part of the cervix and does not affect the pregnancy.The smear test is not done in pregnancy as the pregnancy hormones could cause an incorrect reading of the test not because it is harmful to the pregnancy.It is really unfortunate that your sister lost her baby, but preterm labour labour and delivery could be due to some other cause, which needs to be evaluated as it could be helpful for her next pregnancy.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for a baby avoiding breast milk\n\nDear mom... I have 4+ old baby boy. from begining he is not drink enough milk.from 2 month completely refused to drink my brest milk.now we are giving formula milk.per feeding 2oz is the maximum he is drinkin.that also we have to hold him around 1hr.after 3 or 4hr also same...now his weight is 5.6kg like that. Also most of the day he is having cold. what can i do for him mom...can t we start solid foods now?still he can t keep his head straight.Pls help me mom....",
    "doctor_response": "Hi, No you cannot start solid food, you can try food formula like gerber, some boiled potatoes scrambled also is useful. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can vyvanse cause scabs on scalp and nightmares?\n\nmy 12 yr old niece has a few rows of scabs on her scalp about half the size of an adult pinky finger nail. she either has no idea or wont say how they got there. I counted 9 in all. She is on 60mg of vyvanse a day. Also having nightmares every night. could it be a side affect?",
    "doctor_response": "Hello, Yes, both are a possible side effects, rash as well nightmares have been described as common adverse reactions of Vyvanse. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Kamila Seilhan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness on the left side of the face?\n\nI have numbness on left side of face and fingers that comes and goes. No pain. This started when I returned home from Disney world. Could there be some nerve trauma from a couple of the wild rides? I did feel a bit beat up! Sometimes it comes on we I sense a bowel movement coming.",
    "doctor_response": "Hello!Welcome on Healthcaremagic!Your symptoms could be related to anxiety. TIA (transient ischemic attacks) ore seizures can not be excluded either. I would like to know your age and past medical history. Do you suffer from high blood pressure or diabetes? What about the thyroid gland?Coming to this point, I would recommend consulting with your GP for a physical exam and some tests: - a brain MRI - an EEG - thyroid hormone levels- fasting glucose-complete blood count- blood electrolytes- a resting ECG- Doppler ultrasound of the cervical arteries. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for skin rash on chest and cheek of an infant\n\nMy infant (6 month) has a rash starting above diaper line, climbing up chest with a small spot appearing on the cheek. Mild fever for 4 days, this morning it was 99.8. We have the 6 month check up on monday. Should we wait or should we try and see the doctor today?",
    "doctor_response": "Dear parent,As the rash is increasing rapidly along with fever  I will like to suggest to see the doctor ASAP.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen tender breasts and pain in armpits?\n\nFor two months of and on swollen tender breasts along with armpits pain left and right side. Also, had a cold or flu a month ago and still have the phlegmmy cough. Sometimes I cough all night but the cough is always worse in the morning. I have been smoking 1 pack per day for 14 months. I have quit off and on through the years. Maybe 16 years total of smoking. I m a 44 year old female. Thank you.",
    "doctor_response": "Hi,It seems that you might be having some infection in your breast giving rise enalarged, tender lymph nodes in armpits.consult Gynaec and get yuor breasts thoroughly examined for infection or any lump in the breast.After examination she will advice treatment accordingly.Quit smoking as soon as possible.Do deep breathing exercises.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure discoloration of gums after tongue piercing?\n\nI just got my tongue pierced three days ago. My gums just below my six front teeth are very swollen and discolored right where the gums and lip meet. My bottom lip is also noticeably swollen. What is going on? My tongue looks fine. Just a little swollen still but heeling well, no puss, no discoloration. I used sea salt the other day as recommended by the piercing artist. And that's when it all started.",
    "doctor_response": "hellooo....read through your query and according to me its just a local irritation due to pierced tongue...nothing to worry in that....just wait for few more days ...by the time you do salt water gargle...and do listerine mouthwash application....hope you got the reply....be happy and smile....have a nice day!!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can taking Provera and Ovamit cause harm in case I get pregnant?\n\nhi, my ob gyne prescribed me 10 tablets of provera for 10days and hopefully expecting to have my menstruation so that i can take ovamit for my 2nd day of cycle.. i m just worried and wondering if i get pregnant is their a possibility to have an abnormal pregnancy because of the medicine i take?..",
    "doctor_response": "Hi,They are considered to be if you become pregnant. Provera is a synthetic form of female hormone progestin that helps regulate ovulation (the release of an egg from an ovary) and  for absent or irregular menstrual periods. Continue to take it as prescribed for 10 days. It will help to induce period or withdrawal bleeding within 5 to 7 days after stopping Provera.Ovamit is a fertility medication which induces ovulation (the release of an egg from the ovary) and thus helps in conceiving. Continue taking it as prescribed. These medications are considered to be safe if you get pregnant.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How safe is taking prednisone and Advair for asthma?\n\nI have been diagnosed with asthma.  The dr. prescribed prednisone, & Advair, but I developed severe symptons of bone & muscle pain in my his & legs, severe headache, ear pain, & back pain. When I coughed, Iwas bringing up pieces of Advair that did not get absorbed.  I stopped the  Zyrtec last night, but needed only one dose of  Ventilin, & Nasonex today.  Last night I coughed long & hard, & finally brought up mucus.  My chest & body hurt from all the deep coughing.  This afternoon, I noticed that the color of my urine changed to a tea-color.  Can this be blood in my urine, & could it have been caused by the severe coughing?  I have a little pain in my bladder when I urinate.",
    "doctor_response": "HIWell come to HCMIf this is the asthma then this well responds to prednisone, but here looking to your symptoms you must be having other clinical condition ant that must be responsible for the symptoms that you have, and these need to be clinically examined for underlying cause, hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I take Lexapro for poor concentration?\n\nI am very sensitive to the slightest correction for my faults. My head fills with a fog and it is hard to concentrate. It also affects my eyes with a slight pressure. I had taken lexapro for 5 years with results. I stopped it 4 years ago. I have tried shrinks and the meds they have prescribed without success. I experience head clarity but it is short lived. I have tried breathing exercises, meditation etc. Should I go back on lexapro? Ed",
    "doctor_response": "Hello, Please let us know your age. Lexapro is mainly used to treat a major depressive disorder or generalized anxiety disorder. Are you trying to connect your lack of concentration issue with depression and anxiety? I suggest you not to connect those. You should talk to a psychologist first for the assessment. It is possible that your problem could be cleared with psychotherapy. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause high BP?\n\nI quit smoking 3 mos ago. haven t bee well since the. i m coming out with high blood [pressure. my heart beats realy hard at times,I out of breath most of the time and I feel very tired, what bothers me the most is my heart rhythms. and my tiredness. i m 52 yrs old and smoked for 20 yrs. (cold turkey)",
    "doctor_response": "Hello,I have gone through your question.Thanks for using HCM.As such high blood pressure after age of 40 is essential and has no single causative factor.But there are many risk factors.Hereditary factor is most important.In your case smoking has contributed a lot.its really good that you have stopped it.currently some of your complaints are due to withdrwal of smoking.But have patience they will gradually subside.you must start antihypertensive medicine depending upon your BP level.Also get yourself evaluated for any possible complication of long standing silent hypertension.so go for ECG,renal function tests and other necessary tests.and of course follow healthy life style.My best wishesDr.Teli,MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the painful bump in the neck that has turned brown?\n\nI had a bump on my neck that turned brown today it sticks out and is painful when i touch it . im 19 years old and im very concerned about this bump because more randomly appeared on my body in other places that looked just like the one on my neck before it turned brown.",
    "doctor_response": "Hi, It could be an abscess. Consult a general surgeon and plan for an ultrasound to make a diagnosis. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should misoprostol be taken for pregnancy termination?\n\nhello doctor, i have brought unwanted kit to terminate my 45 days of pregancy i have taken Mifepristone  today...and the kit has four misoprostol... when should i be taking the rest of misoprostol...should i take the four tablets in one go or misoprostol daily for four days???",
    "doctor_response": "WELCOMEIF YOU HAVE TAKEN MIFEPRISTONE , THEN YOU CAN TAKE ALL 4 TABLETS (800 MICROGRAM) TOGETHER AFTER 36 HOURS OF MIFEPRISTONE.YOU CAN TAKE ORALLY OR PUT ALL 4 IN VAGINA ALSO..VAGINAL ROUTE IS BETTER..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having pain in the root canal treated tooth inspite of having medicines. Please help.\n\nHello doctor, I had got a root canal done on my teeth. I had seven sittings to complete it. I am still having a dull pain. Sometimes I take mild pain killers. I took antibiotics for three days for this, but still, full pain is there. What can I do?",
    "doctor_response": "Hello. 1. First of all, I would like to know which tooth are you talking about? I would also like to see the X-ray if you have it with you. 2. I am sorry as it took long for your root canal procedure, did your dentist tell about any specific complication with your tooth?. 3. There is still complaining of pain means there is infection remaining or obturation or the capsize did not go well with your tooth. 4. As you are still facing pain, I suggest you go for three-day medication and then follow-up with me after three days. 5. Do warm water, and salt rinses five to six times daily, water should be warm and not hot. 6. Maintain good oral hygiene. 7. Brush in a circular pattern and give soft finger massage to teeth while cleansing. 8. Amoxicillin clavulanate 625 mg twice daily, Paracetamol 500 mg twice daily. Follow this medication for three days and then update me. I hope it helps. Avoid sticky food and food lodgement. Follow up after three days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes an elevation in the ALT and AST levels?\n\nHi I was Dx with Hep A in March 3/1/17 and until today my liver enzymes labs are not getting better I am concerned that there might be some liver damage but my GI doctor does not seem to be to worried. They were like at 4000s when I was at the hospital and they were coming down nicely but for the past 3 wks my labs are increasing again and have not drop down to a normal level. They are at 691 my ALT and AST 450. They had drop down to like 400 but just seem to go higher again. Any advise thank you.",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.These are very high liver enzymes levels. SGOT and SGPT  are sensitive indicators of liver damage or injury from different types of diseases or conditions, and collectively they are termed liver tests or liver blood tests. So the next step is to look for certain liver damage and most common casue is fatty liver disease. It should be confirmed by ultrasound. Other causes are viral hepatitis,cirrhosis, medications, alcohol intake or autoimmune diseases. To verify exact cause, US, bilirubin levels and tumor markers should be additionaly done Then appropriate treatment can be started.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of bumps in the shaft of penis?\n\nI have 4 red tiny bumbs in the shaft of my penis. its been 3 weeks and it multiplied by 2. atm its 8. and 2 days ago i started to feel very itchy in my balls and some part near my penis. the itch is so annnoying. the more i scratch it, the itch gets more. i have applied some creams but nothing work please help. im 21",
    "doctor_response": "HelloThanks for query .Itching of the scrotal sac with small bums over shaft of the penis could be mostly due to what is called s Jack itch .You need to take anti fungal medication like Fluconazole orally as well as Meconazole gel to be applied over scrotum after cleaning the entire area with warm water twice daily .Ensure to wash your inner wares in boiling hot water mixed with antiseptic solution like Dettol .Thanks Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful bruise down the shin bone?\n\nMy son is ten and last week he got kicked in the shin at football he has a bruse down the shin bone which he cant touch as the pain is very soar he is weight baring but limping and said it has been causing him lots of pain tonight when he went to football training it got very soar and his ankle started hurting",
    "doctor_response": "Hello, It is just contusion which is nothing but a collection of blood underneath the skin following a blunt trauma. Nothing much to worry and it will get absorbed by itself. You can apply ice packs for faster recovery. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for herniated disc disease\n\nI have 5 herniated disc and nerve damage L 4&5 was being treated for pain after conclusive MRI and EMG test proved there was reason for all of the pain that I live with . My internal medicine doctor wrote the scripts for oxycodone breakthrough pain 5 mg and a 12 hour time released 20 mg oxycotin all of this was in fort myers fl. I now moved to Louisiana and in the Ville Platte area I can t find a doctor that will write the scripts that I need . I no when I run out of my current pain meds I will end up in the local ER .",
    "doctor_response": "Hello, I have studied your case.Due to compression of this nerve root due to multiple disc  there is tingling numbness in your leg and pain associated with it.Medication like methylcobalamine with muscle relaxant and analgesic will reduce pain; you can take them consulting your treating doctor.You may consult physiotherapist for further guidance. He may start TENS, or ultrasound which is helpful in your case.I will advise to check your vit B12 and vit D3 level.MRI shows disc compressing on nerve root then surgical decompression is permanent solution.You can search doctor in your locality on our website.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility having high sperm viscosity\n\nMy husband and I are trying to conceive our 2nd child. It took us 6 IUI's to conceive our son and we have done 2 IUI's this time with no success. We have been told my husband has high sperm viscosity. His prostate has been checked and there is no infection. What else can he do?",
    "doctor_response": "Hello, high viscvosity can be easily managed via washing which is routinely done before IUI.In case you have any questions in future you can contact me directly on",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which type of food I should have for high creatinine level ?\n\nwich type of food taken in high creatinine level",
    "doctor_response": "Dear Gyan, High protein diet and citrus fruits must be avoided in high S.Creatinine levels. like non veg , dals , lemon , orange, milk,etc. You did not mention your exact lab values. For further queries feel free to contact me at my email or call me anytime. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes ants to get attracted to child's urine?\n\nmy son is just 4 year old, whe he pee , ants come around. i checked the blood and urine tested. both are normal. he also use cepalicine drug for 6 month as he got a UTI few months back and doctor advised to used it until the DMSA test to be done. please answer me",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.DMSA (dimercaptosuccinic acid) is advised for febrile urinary tract infection for children less than 5 years. It is advised for 3 months after an episode of UTI to rule out renal scarring, till then he has to be on uroprophylaxis like septran. It DMSA is normal, then the drug is to be stopped.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Brindha Dinesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "Numbness on the tongue after getting a bite. Is this a permanent damage?\n\nI bit my tongue last night/this morning as I was dozing off to sleep and now the tip of my tongue feels as if I got some of the anesthestic they use when you have some kind dental procedure done. It's been numb now for 2-3 days there's no cut, no bruise, no bumps or lumps have I lost all feeling in my tongue perminently?! Even food tastes differently.",
    "doctor_response": "Hello there , Thanks for writing your query, Your clinical history suggests you have traumatised your tongue during biting , this may lead to numbness due to damage of nerve fibres which is temporary. In few days new nerve fibres will generate and the tongue sensation will definitly come back to normal. meantime , maintain good oral hygiene . start with multivitamin supplements for 7 to 10 days and vitamin C lozenges will help in resolving the problem. avoid alcohol , carbonated drinks , tobacco chewing and smoking as these may worsen the area affected. Apply oral antiseptic ,analgesic ointments like dentogel or mucogel topically over the affected area i hope this helps , take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are breast tenderness and vaginal discharge symptoms of pregnancy?\n\nHi doctor, My cycle is about 25 days. Me and my husband got intimated on day 18 using a condom. We are worried that the semen had fallen near to me while taking out. Soon, I took a Morning after pill within an hour. Can you please tell me is there any chance to conceive? Also, please let me know the symptoms of pregnancy. Today is my date, but I have not gotten my periods yet. Please help me. I am really worried as we got married just two months before.",
    "doctor_response": "Hi. Pregnancy or just delayed period. Pregnancy test after two days from morning sample of urine. 1. If UPT (urine pregnancy test) is positive, then you need advice of local doctor for MTP pill (medical termination of pregnancy pill). 2. Also, I suggest Depo-Provera (Medroxyprogesterone) for contraception. Revert back after two days to an obstetrician and gynaecologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat catheter dependent urination?\n\nAge - 27 years, Hight - 5'3\", Student, Had operated Abdomino Perineal Resection(?) for CA rectum 2 years back. Now problem is- with out catheter coul not micturate. Now what to do? I am interested to take proper treatment. Is it possible in your hospital?",
    "doctor_response": "Hi,Thanks for writing in.It is important to know regarding your history of urination with the help of catheter in detail. The surgical details are also to be noted and recent ultrasound scan will show if your bladder is normal and whether there is any post operative bladder outlet obstruction.In most cases urinating without catheter can be started in steps and the patient quickly learns to pass urine in normal way. Please consult urologist to know where exactly if the problem and if it can be corrected by learning techniques or there is any obstruction in the urethra. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a non-displaced comminuted fracture be damaged further by not immobilizing it?\n\non 11-08-2011 i fell and hurt my ankle. i heard it crack. i couldnt walk on it, was transported to er via ambulance. they told me my foot was seriously sprained. i requested copies of xrays and today i finally received them. i have a spiral essentially nondisplaced comminuted fracture lateral malleolus left ankle. My question is..... I have been in severe pain for two weeks and also have been walking on it. Could I have damaged it further by not having it properly immobilized?",
    "doctor_response": "Hi, According to me, there are many reason for tremors like exercise, fatigue, several medicines, may be some nervous system disorder, Parkinson's disease and many more. Sometimes in depression there are tremors known as intention tremor which does not have any cause. So need detail history to rule out cause of tremor. Thank you. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Gaurang B Shah, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing anxiety, having trouble sleeping. What medications can help me?\n\nhello there my name is Frederick Wilson and i ve been experiencing anxiety having trouble sleeping at night, first i thought i has due to my diet , why was mostly junk, when to the hospital and they ran test and saw that everything was ok just the high blood pressure which was 168 over 80, can t really remember, but then i realized i drank a lot and what i was experiencing was Mild withdrawal from Alcohol, i had my last drink on April 26 around 7pm in the evening, didn;t notice the anxiety until saturday night the 27th when i was trying to sleep, then on my way to work on the 28th, i started feeling anxious again and arms and face seemed like they were goin to sleep or numb, after being in the hopstial the feeling when away had a lil bit of trouble going to sleep but eventually did, then for the next couple of days fine, after changing my diet a lil and not drinking, last night the 6th, kinda feel anxous again,",
    "doctor_response": "Hi Frederick,Thanks for using healthcare magic.I have gone through your available history.You are having anxiety disorder, most likely panic. Your habit of alcohol may be one of the cause of illness.You should consult psychiatrist for detailed evaluation and management.Doctor may rule out physical causes like vitamin B12 deficiency. Doctor may advise you to start anti anxiety drugs like clonazepam or lorazepam and antidepressant drugs like peroxetine if needed.You must stop taking alcohol. Meanwhile you cans tart doing breathing exercise for better control over anxiety.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever and headache?\n\nMy Husband was in a car accident and broke his 12 vertabrea on his spinal cord.  He is paralized from the waist down.  He has been getting fevers as high as 105. and very bad headaches, they had tested him for everything that he could have contracted and everything keeps coming up negative. Could a Thyroid issue be causing his fevers and headaches?",
    "doctor_response": "Thanks to HCMIcan understand your  husband concern very grevious situation ,injury to ribs as well as spinal cord may be the reason for paralyzes lower part here recurrent infection either with virus or damaged cells in hypothalamus which controls the temperature leads this high grade fever .don't worry . thyroid tissue wont cause the this situation ,,fever and headache will be controlled by antipyretics and analgesics.cold sponging is simple method of controlling the temperature .plz do it keep in cool environment and drink plenty of liquids have a blood culture and urine culture ,propably say the causative organisn .cont the family doctor once report came otr HCM .DONT WORRY IT WILL SUBSIDE",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having Dermatitis on fingers possibly due to masturbation\n\nI have dermatitis on my fingers. I have had it four times and got rid of it four times but now I have got it back. I don't know what's making it comeback. I believe it is from masterbation. I'm an 18 year old boy. And I have had jock itch also. And sometimes after I masterbate I get the pimple like lumps associated with dermatitis. Could it be the masterbation?",
    "doctor_response": "Thanks for asking in healthcaremagic forum   I have not heard of allergy to semen causing dermatitis in any ones hand. Masturbation is harmless and cannot cause this. So, please give details regarding your profession, any chemical/cosmetic usage / usage of ornaments like ring for further sugestions. Jock itch is due to fngal infection which inturn due to presence of moisture over there and not related to masturbation.   All the best. Will be waiting for your details.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dull throbbing pain in left side of chest?\n\nI am a 16 year old male, 175lbs and 5`11. I'm involved in sports and there is a dull throbbing pain on the left side of my chest in my heart area. It has been there for several days and comes and goes randomly. I have no shortness of breath and the pain doesn't spread or get worse with breathing. Any ideas?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Throbbing chest pain is mostly due to musculoskeletal cause. But better to rule out cardiac cause first because left sided chest pain is the common presenting complain in heart diseases. So get done ecg and 2d echo first. If both are normal than no need to worry for cardiac diseases. Possibility of musculoskeletal pain is more. So avoid strenuous exercise and heavyweight lifting. Avoid movements causing pain. Avoid bad postures in sleep. Start painkiller and muscle relaxant drugs. Apply warm water pad on affected areas. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is flying safe with an injured knee?\n\nHi, I had a fall last week and my knee is still bruised, painful to touch, and hot. It was a heavy fall so not worried too much as it still moves okay and it feels like soft tissue injury. I to fly on a flight for 1.5 hours on Sunday, I am just checking to see if that is okay?",
    "doctor_response": "hihope this msg finds u in good health u seem to have some sort of blunt trauma to kneeif u dont have any pain u can fly upto 2 hours at a stretch..thanks Take care god bless",
    "dialogue_context": ""
  },
  {
    "patient_message": "Manic depressive episode, wellbutrin, smoking cannabis leads to depression, sometimes blackouts\n\nHello, 6 months ago I had a manic depressive episode. I was put on Wellbutrin 300mg/day, it has worked well however I am feeling much better now and am starting to get back into social life activities. Being 18 and living in an apartment with 4 others we tend to enjoy drinking. My roomates smoke cannabis too however my phycologist told me that cannabis will depress my mood and flush out the Wellbutrin. However I do enjoy drinking and have been drinking about 4 times a week heavily. Sometimes blackouts occur, but drinking is what I enjoy to do sometimes. Of course my health is number one. What health risks are on the line when it comes to heavy drinking and Wellbutrin,, besides blackouts.",
    "doctor_response": "Hi Karl,Welcome to Healthcare Magic and thanks for your question...Wellbutrin is an anti-depressant medication given for depressive disorders. You have mentioned that you had a 'manic-depressive episode' six months back... I'm not sure what you mean by that - I'm guessing that you probably suffered from a depressive episode (maybe a Bipolar Depression), which is why you have been put on an anti-depressant.Now, most substances of abuse - cannabis, alcohol, tobacco, etc. can definitely interfere with psychiatric medication. This is because both of them act on the brain and hence they can interfere with each other's levels and effects. Cannabis, alcohol, etc. can reduce the absorption of such medication or hamper their action or sometimes even potentiate side effects.Secondly, these substances can independently influence and alter your mood / emotional state and thereby can sometimes, worsen the mood disorder itself. Sometimes heavy abuse can also cause new psychiatric problems. Alcohol definitely has effects on the mood and excessive use can even lead to psychotic symptoms (like hearing voices, seeing strange things, fears, false beliefs, etc.)I would strongly suggest that you control your drinking, especially because you already have a mood disorder and as you are on psychiatric medication. If you are finding it difficult to control your drinking habit, please don't hesitate to ask your doctor for help / suggestions.Wish you all the best.- Dr. Jonas SundarakumarConsultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it safe to smoke marijuana following a root canal treatment?\n\nHi doctor, Is it safe or risk to my healing process, if I smoke marijuana following a root canal treatment?",
    "doctor_response": "Hi. It is not safe to smoke marijuana after a root canal treatment. It can increase the pain in the root canal treated tooth. It delays the healing process, and it causes pain. If there is a pain, you can consider taking medications prescribed by your dentist. Stop smoking marijuana, and it is not good for your oral health now. Frequent smoking of marijuana causes dry mouth, and you are at high risk of developing gum disease. Avoid smoking marijuana, and it is good for your health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the high BPM be due to anxiety?\n\nI'm 45 in great shape I workout 5 days a week with weights and cardio. I am going trough a breakup with my ex and have a hard time letting go. I wake up several times a night with fast heartbeats 110. I'm. Im not sure if it's from anxiety or it's something else.",
    "doctor_response": "hiThis can be due to stress &  anxiety induced palpitations.simple anxiolytics like alprazolam 0.25 mgs  under medical supervision at night will help you in relaxing.If the palpitations are persistent, you can go for a cardiologist opinion.Beta blockers   and 2d -echo  to find out for any other cardiac problems.all the best, take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are symptoms of kidney problems?\n\nPlease advise if these symptoms would cause kidney problems and what they could be? and how soon I should look for exam? I had MRI brain looking for tumor or stroke all negative they were not causing facial swelling. nausea/vomiting, skin rash, unilateral eyelid ptosis, upper lip swelling, dental abscess extracted, difficulty swallowing.  HCTZ seemed to increase swelling in my fingers so I discontinued it after two days. lab results have shown low bicarbonate 22,  low vitamin d hydrox-25 at a level of 65, high blood pressure, problem with eyes (eye doc suggested cholesterol might be high but has been normal) and I can SEE urinary casts in the toilet bowl moving around (they look like transparent cigar like shape).",
    "doctor_response": "HIWell come to HCMIf the cerebral pathology is there then could affect the renal function later on and care need to be taken for this multiple medical issues also affect the renal functions later or sooner taking care is must, hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "CAT scan report showing stents needed in the heart. Mass in the pancreas. Chemotherapy needed if malignant. What is the treatment?\n\nMy husband had a ct scan o his heart and needs 2 stents, but during the ct scan, a 1\" mass was found on his pancreas.  A biopsy is being performed.  If it is malignant, and needs chemo, should he have the stents first or the cancer treatment first and How long should he wait after either procedure to have the next procedure. He already has 4 stents and the 2 stents he needs will be placed in arteries that have 75% blockage.",
    "doctor_response": "Hi and welcome to HCM. It is hard to say without more info. If this is only tumour in pancreas tail then only distal pancreatectomy can be done. If this is in the head of pancreas then whipple procedure is necessary and this is very demanding procedure. His anastheologist should evaluate how risky is his heart disease for him. But usually stents are placed first and after 3-4 weeks surgery can be done. Wish you good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for fever,cold,cough and headache\n\nI have fever, cold, cough, headache for the past 6 days.Our family physician has suggested Clavam 625 which when taken relieves for  hours after which the problem starts again. I am currently not in India and unable to go for consultation to my doctor. Need a quick remedy since I have come to work and have been caught in a situation here.",
    "doctor_response": "Hello,You are suffering fom viral infection and it takes 5-7 days to become all right.There is no need to take antibiotics and treament involves....Steam inhalation twice a dayWarm saline garglesTaking more of hot liquids Avoiding cold drinksYou should be all right in next couple of days.If symotoms prolong,then consult a doctor.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for allergic reactions in the chest cavity\n\nMy husband complains of an internal icthing sensation in the chest cavity, that he cannot scratch, what can this be?  and can it be related to the welts he experience every now and then all over his back that looks like an allergic reaction to something?",
    "doctor_response": "Hi, itching in thoracic cavity but since how long and what are the other symptoms apart from allergy u didn't mention. Anyway itching may be due to diaphragm irritation and it usually subsides by itself but if it persists longer with hiccough u should consult cardiothoracic surgeon for further evaluation. Possible diagnosis may be thoracic outlet syndrome, hiatus hernia,reflux esophagitis but all should be properly investigated by CT surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anxiety\n\ni've been having really really bad anxiety lately, to the point where i think i may have an anxiety disorder, but my mum won't take me to the doctor for it. she's big into natural stuff so she doesn't want me taking anything prescription but nothing natural helps",
    "doctor_response": "Hello,You have told you are having anxiety disorders. You have not mentioned your symptoms but if we consider anxiety disorder as your diagnosis then you definitely need to consult a psychiatrist. Natural remedies doesn't help all patients. You need to start on anti-anxiety pills which you should take at least for year. Meanwhile, you start doing some meditation, relaxation, and regular exercise.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Prashant Gohil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had surgery for spinal TB. High ESR levels. Why? X-ray normal\n\nI had spine TB and was operated about one and half months ago and the operation was a complete success by God's grace.The esr test before i was operated was10mm bt after this it is 34 mm but my condition is so much better after the operation and the x-ray too gave positive results and the doctor told that i am in a good condition but why the esr was increased?",
    "doctor_response": "Hi, Thank you for posting your query. ESR is a non-specific test, and not much should be concluded with value of 34 mm. As you mentioned, clinical and X-ray improvement are more important, and they show that you are improving. So, there is no need to worry. Please get back if you require any additional information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is stomach pain normal after a femur fracture?\n\nmy 4 year old broke her femur and was in a spica cast for 6 weeks. She got the cast of a couple of weeks ago and is starting to walk again slowly, but if she falls on her butt she says it really hurts her tummy. Was just wondering if this is normal?",
    "doctor_response": "Hi Dear Welcome to the HCM,Please never let her fall. It may be quite risky. fresh union of the bony may be tender and fragile  for few weeks.Hope the query is  answered.thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to treat bronchitis without inhaler?\n\nHi, I m 28 yrs Old. In 2005 I was having a pain in my chest for which my family doctor suggested me that I was suffering my tuberculosis & diagnosed me for 1.5 yrs. Later when I didn't got well, I tested my body reports in Bombay Hospital for which doctor's suggested me that I m not having tuberculosis but bcoz of wrong treatment now I m suffering from bronchititis. Kindly suggest me how to get treated with it without using any inhaler ? Currently, I m not taking any medicines but sufering from cough ? Does this effects sexual Life as I m getting married ?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Bronchitis is inflammation of airways. And best treatment for this is inhaled treatment. Inhaled treatment reaches lungs directly, so onset of action is fast. It acts on lungs only, so systemic side effects are minimal. Hence it is better to take inhaled treatment as compare to oral treatment for bronchitis. And if untreated, this bronchitis can gradually worsen over period of time. It can cause coughing, expectoration, breathlessness on exertion, weakness etc. Sexual activity is considered as heavy exertion. So untreated bronchitis can also interfere with your sexual activity. So better to treat bronchitis by inhaled bronchodilator and inhaled corticosteroids (ICS). 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",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does fibrocalcific densities in the left upper lobe mean?\n\nsir/maam can i ask a question,what is fibrocalcific densities? because according to the radiographic findings that fibrocalcific densities are noted in the left upper lobe which are likely residua of previous koch s infection impression: fibrocalcific densities left upper lobe... I had PTB before and i took 6 months medication and according to my pulmonologist, it is a scar.",
    "doctor_response": "Thanks for your question on HCM.Your pulmonologist is correct. It is scar tissue.Any lung insult in lung either tuberculosis or pneumonia or trauma, heal by either of the following mechanism.1. Fibrosis2. Calcification.3. Both together fibrocalcified lesions.4. Rarely complete resolution.Fibrosis is the most common amongst all. But any one can be present.Since you had Tuberculosis in past and completed anti TB treatment, the lesions must be healed by now and gives fibrocalcified appearance. It is dead tissue so known as scar. It will remain as it is through out the life.So need to worry much for this. You are not having active , infectious tuberculosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be concerned for light chest pain?\n\nHave had dully, achy chest pain in the center of my chest since last night.  Had slight pain in left jaw, but only lasted about 10 seconds.  No sharp pain.  Went away after I laid down to go to sleep.  Thought it was gone until I got up this morning.  Doesn't hurt to breathe.  Should I be concerned?",
    "doctor_response": "thanks for your questionyou need to consult a physician who can request for a ecg and a echo if needed and diagnose the situationcauses can be gastritis peptic ulcercardiacno need to panicget your self evaluated , which is always safe thanksfeel free to ask more question",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of typhoid?\n\nhi, my grandmother suffered from typhoid(that's what the doctor says) last month and she has been on bed since last 1 month. She can't move 1 of her hands and unable to open both her eyes(she can open 1 eye and rarely opens both eyes). She has been sleeping since last month and is completely bed ridden.She rarely opens her eyes and is always sleeping.The doctor said that some veins in her brain have shrunk(even though he never conducted mri or ct scan to conclude that) and said that it will take a long time to heal if she ever recovers. Can you please provide some guidance?",
    "doctor_response": "hello. Thanks for writing to HCM.I read and understand your question very well.I try my best o help you.Typhoid have symptom like diarrhea , vomitting , fever which increase day by day , abdominal pain , weakness , tiredness etc.As your grandmother bed ridden since one month ,and symptoms so  there are many causes for this.I suggest to consult a good physician for this.I hope my advice will help you a lot.Thanks and Regards.Dr Vijay",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hepatitis B reactive, history of kidney dialysis. Can I work in Abu Dhabi?\n\nMy wife just signed her offer letter as server in abu dhabi last october 2, 2012. As a requirement, she need to undergo medical examination first in our country. She took her medical test in the philippines yesterday and unfortunately, she was diagnosed to be hepa b reactive. She thinks that she got it when she undergone a kidney dialysis during her teenage years. The doctors told her that it is not contagious. Does she still have the chance to come here in abu dhabi? she is schedule already on November 15, 2012? Please advise us what is the best thing to do.",
    "doctor_response": "Hi I had been in Kuwait (Middle East) for nearly three decades.  Most of the countries in the region do not allow Hepatitis B positive individuals  to have residence permits, even for dependants! / less likely for those with work permit / and as a server (hotel?) it is very very unlikely. True, it is not contagious.  It spread by blood or sexual contact. I am sorry to say this - but I feel there is NO chance. You have to check with the local health authority (Joint Secretary, Ministry of Health, Abu Dhabi) to be absolutely sure Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Was on Humira. Had infection, sigmoid removed. Having lymphoma, kidney cancer. Have one kidney. Suggestions?\n\nI was on Humira for 6 months. I had told the dr. that I was subject to diverticulits, but she said it would not be a problem. Well, it was and I ended up with an infection so severe I had to have my sigmoid removed and had I not I would only have lived three to five months. That was in Nov. Now I have lymphoma and kidney cancer and I only have one kidney. What do I do now?",
    "doctor_response": "Hi there,Humira is known to cause severe infections. Are you still on it? What is the type and stage of lymphoma. Also for kidney cancer, what was the stage and pathology report. Have you not seen oncologist for the above conditions. Kindly give more details for me to be able to comment anything definitively. For lymphoma there are various options ranging from observation to chemotherapy to transplants. For Renal carcinoma for post operative patients again one may be kept of observation alone to chemotherapy or immunotherapy options.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high blood pressure\n\nfor a few months,  as soon as I put my head on the pilot I feel like a heart beating in my right ear. After two hour sleeping I woke by the noise in it and decided to take my blood pressure, for my surprise it is 171/110, or 180/108, etc...wat can this be?",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern. I will try to explain you and give my opinion. You should know that we talk about hypertension if we have mean value that exceeds 140 / 90 mmHg.A person might have high value during emotional and physical strees so its mandatory to judge on mean values. Of course your values are pretty high so it is necesary to treat them. Because of this high values you might experience headache,  blurred vision, noise in your ear ect.Hypertension is divided into two groups. Essential hypertension, usaly in older age that is a chronic disease whithout an identified cause and secondary hypertension meaning that is a secondary couse of it.This might be a renal disease,  an endocrine problem or a cardiovascular anomaly. So,  if I was your treating doctor I will recommend some examination like a cardiac echo to evaluate heart function and walls,  a full blood analyze to chek renal function, an abdominal echo and a holter pressure monitoring to evaluate your values during day and night. After all this we can better judge what we are dealling whith and how to treat it. Hope I was helpfull. Best regards, Dr.Ervina.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause elevated heart rate?\n\nYesterday, I took my prescribed 70mg Vyvanse with my new converted 10mg Lexapro (formerly Prozac 20mg) - then last night without thinking clearly, took another 40mg Vyvanse with 5hour energy to stay awake and work, and immediately my heart was racing. This AM, I took my prescribed dose of 70mg Vyvanse and 10mg Lexapro, then an hour later took a 5hr energy on the way to the gym, worked out for an hour, and now my heart is back to racing, I'm nautious and dizzy, can't think clearly, and can't nap because my heart is pounding to hard.... what should I do?",
    "doctor_response": "I don't think medicine should be a cause for it. you need to meet your cardiologist again and plan the future course of action. during the medicine treatment plan running one can't go to a gym for 1 hour workout without a cardiologist guidance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does eating durian fruit help in conceiving baby?\n\nHello Doctor, I have Pcos. having treament for that & taking metformin thrice a day 500mg and follic acid and Actos. Elder persons in my family telling me and my husband to eat Durian Fruit to Conceive a Baby. Is it save to eat while taking these medicines. Please advise me.",
    "doctor_response": "Hai, 1. Durian fruit has many essential vitamins and carbohydrates esp Vit.C, Tryptophan and minerals in large amounts 2. Only patients who are suffering from Diabetes mellitus are not supposed to take the fruit because it has more sugar 3. You and Your husband - if not diabetic - can surely take the fruit.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back pain when diagnosed with hernia?\n\ni think i have a hernia. i have had my left side done, now it seems the right side is acting up. also i have back pain around my belt line, which i didn t have wi the first hernia. i have an appointment tuesday aug 8th. i can walk but it is very sore. any suggestions?",
    "doctor_response": "Hello Thank you for using healthcaremagic I read your question and understood your concern I think that the back pain is from muscle spasms due to not good posture. Because of your hernia you may not stand straight and balanced but lean on one side which causes back muscle tiredness and contracture and lead to back pain.Dr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can HIV cause leukemia ?\n\nIS HIV CAN MAKE YOU HAVE LEUKEMIA ..",
    "doctor_response": "Hi, . Yes, among the Leukemias, Acute Lymphoblastic Leukemia (ALL) is commonly observed in HIV patients. Hope i have answered your Query and i will be available to answer your follow up queries. Wish you Good Health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest tightness and shortness of breath\n\ni'm a 24 y.o woman. generally active (run 5-6 times a week) but I've been feeling fatigued lately and experiencing dizziness, shortness of breath, and chest tension. My normal blood pressure is 100/70 and resting heart rate of 55-60 bpm but i've been measuring 100/60 lately with a resting heart rate of 48-55 bpm. Should I be concerned?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.Resting heart rate of 48-55 is considered as low.Blood pressure reading of 100 systolic is also considered as low.So we should definitely rule out heart block (conduction defect) for your symptoms.So get done blood pressure monitoring, ecg, 2d echo and Holter monitoring (24 hours continuous recording of Ecg).If all these are normal then no need to worry for heart diseases. Sometimes stress and anxiety can also cause similar symptoms. So avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can stress cause bowel disturbances?\n\nHi doctor, I am 44 years old male. I have a good diet. I have been taking good care of my health for the past 20 years as my digestive tract is bad for many years. Can you review my medical records from July and compare it with my CT scan done yesterday? One thing which is confusing me is the prominent lymph nodes in the paraaortic region. I could say neither stress alone is the cause for all my health problems, nor old age.",
    "doctor_response": "Hi. The paraaortic lymph nodes mentioned in the report (attachment removed to protect patient identity) is almost in normal limit. The enlargement will become significant only if you have pain in the abdomen or fever or weight loss. There could be many causes for bowel disturbance example: IBS (irritable bowel syndrome), IBD (inflammatory bowel disease) or reflux of the gastric content that would also cause burning of the chest. In your case, it appears to be benign. We need more information about your bowel habits such as whether you have constipation or not. Stress is a very important cause of bowel disturbance, one should alleviate all kind of stress to get rid of these problems. Treatment plan as advised previously. Preventive measures as advised previously.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intermittent numbness spreading from head to arms, vomiting and diarrhea?\n\nI have episodes or spells to where a numbness tingling that goes from my head to my arms all the way to finger tips but no further not below chest area then pass out ive had two or three episodes where my daughter in law finds me in floor, then i have diarrhea and vomiting after or while im out i have diarrhea",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have intermittent numbness spreading from head to arms, vomiting and diarrhea. Well there can be many reasons for symptoms you mention in query like peripheral neuropathy , food poisoning , gastroenteritis , irritable bowel syndrome , lactose intolerance or side-effect. I would suggest you to consult gastroenterologist for proper examination . Doctor may order stool test , ultrasound along with taking history . Doctor may prescribe anti emetic drug , lopramide , omeprazole along with ornidazole . Doctor may also refer you to endocrinologist for diabetes or orthoedic surgeon for arm problem . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for joint pains\n\nm mother had bad joint pains she too ataflam pain kilers she is also on wafaril for heart promplem ater taking the pain kilers twice she vomoted and her tonque is darish brown 2 days now she hasent been to the toilet and she dont have any energ i am woried",
    "doctor_response": "Hello, Consult a physician and get evaluated, conditions like poly arthritis has to be ruled out. Detailed evaluation is required. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low blood sugar levels?\n\nHello Doctor, I am a 59 year old female, over the last few months I have been feeling like I am shaking inside about once a fortnight, no real pattern to the feeling. A friend suggested I test my blood sugar levels, on one morning it was only 2.3, but was 4.7 on the other three occasions I tested it. Yesterday I felt shaky so when I did the test and it was only 1.7, I had eaten about three hours previously and did not feel hungry. what could be causing my levels to drop so low?. Thank you.",
    "doctor_response": "welcome to hcm...mam as your blood sugar level are coming low ..there are some problems which need to be taken care of ...please get ultrasound abdomen to know status of liver pancreas and adrenal gland ..as there may be problem with any of these ..on the lab test go for liver function test ...thyroid status ...serum cortisol level ...insulin and glucugon level ...epinephrine level ...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with cervical disc herniation and degenerative disc disease. Memory loss and neck pain. Symptoms of the disease?\n\nHi, I am a 40 year old female, diagnosed with cervical disc herniation and cervical degenerative disc disease . I saw a Neurosurgeon last year until I felt somewhat better. I did not have the surgery that was recommended. I tried exercising and apparently hurt my neck again. But this time I am having memory loss too, is this normal? I could not remember my home phone number, my husbands birthday, my insurance companies name, etc. Please advise... Shea",
    "doctor_response": "Hi, Thank you for posting your query. Memory impairment is not related to the cervical disc herniation. It is due to brain disease. The most common reason could be a small blood clot in the brain. A CT scan of the brain can help in diagnosis. Please consult a Neurologist for evaluation and treatment. Wishing you good health, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hepatitis B in blood\n\nHi,My Australia Antigen test shows hepatitis b positive blood.I don't have a severe problem,neither in digestive system nor in any other part of the body.LFT test shows everything is normal.What treatment do you prescribe for me.Which doctor in India shall I consult?My age - 48 years.Height - 5.8 ft.Weight - 90 kg.",
    "doctor_response": "Dr. Hanif warmly Welcomes you!Thanks for consulting me at virtual clinic. I have carefully worked through your case, and can realize your health worries. Being your physician, I want to assure, I will take care all of your medical concerns.I need some more details from you in order to take care of your case completely and guide you according to the latest guidelines of American Society of Gastroenterology and Hepatology. It all depends on the viral load in your body.You have to attach in your Lab reports which you have already done. And; you have to get in some new Labs from the most efficient and authentic lab in your country, so that I may be able to accept its results and treat you accordingly:1. Anti HCV by ELISA2. HBS Ab antibodies3. HBV DNA Qualitative by PCR4. Ultrasound Right Upper quadrant of abdomen5. LFTs (You said you already have them. attach only if they are not more than 2 months old)6. HBSAg (You said you already have it. please attach it too)Hope I answered all of your questions. I will wait for your reply. If you need further, detailed and quick assistance related to your health issues, feel free to click on 'Ask me a question' directly from my profile. You will be able to  attach your Lab reports, directly from that question window, or if you have asked me a question, then just send Lab reports by emailing them to attachments@healthcaremagic.com with the Subject as, Attention: Dr. Muhammad Hanif, and the lab reports and images will directly reach my inbox for review.May you have a wonderful time ahead. Please don't forget to give your valuable positive feedback and 'Five Star' rating to the question, to help me assist you in a better way in future too. Please, write a review by going to my profile, about your experience with me, before you close this discussion. Click on thanks please.Regards!DR. MUHAMMAD M. HANIFPHILADELPHIA-PA, USA",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce swelling after hurting fingers in an accident?\n\nMy husband had a farming accident four weeks ago. Two tips and half of one finger were basically crushed in the gears of a mixer. On his right hand, the ring finger has been amputated down to the second knuckle, and the tips of the middle and pinky finger were taken off. He has swelling (a lot) by the end of the day. What is the best way to reduce the swelling? Heat feels good, but I thought it would be better to put ice on it. Thanks for any help.",
    "doctor_response": "HiPain and swelling are due to inflammation.It will subside witha a course of antibiotic like cefadroxil, paracetamol and serratiopeptidase.Consult your orthopedic surgeon to review him and he will prescribe him especially serratiopeptidase(tablet Danzen) to subside swelling promptly.I am pleased to help you.wish you good heath.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes slow heart beat in a child while taking deep breath?\n\nMy daughter is 3 years old, she was complaining of a head ache tonight and was crying for abuot 15 minutes before she fell asleep. I listened to her heart beat while she was sleeping and for the most part it sounded regular, but when she would take a deep breath it sounded like it slowed down, if this normal for a child or should I be worried? I am familiar with heart sounds so I can tell its a little different, but I am used to adult heart beats. Thanks",
    "doctor_response": "Thanks for consulting at Healthcare Magic.It is normal and physiological. You need not worry. Heart rate increases while breathing in (inspiration) and decreases while breathing out (expiration). This is to compensate for the decreased left ventricular output while breathing in. During inspiration, more blood gets pooled in the lungs so that left ventricle gets less blood to pump out. By increasing the heart rate with a reflex mechanism, body maintains the cardiac output. In contrast, left ventricular output is higher in expiration and heart rate lower.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Zexter injection given for high WBC. Bone marrow test showing myeloid hyperplasia, dysplastic change in granular cells. Explain?\n\nHi my name is mohammed and i am 25 years old 4 days ago i did CBC test and it shows that my WBC was 0000 and doctor gave me Zexster injection and after that i did bone morrow and it show this:Myeloid hyperplasia,sheft to right,granular cells represent in about 59% with dysplastic changeAniso Pickilocytosisleukocytosis neutrophiliaplease help me what is mean?",
    "doctor_response": "Hello and welcome to HCM,Your hemogram and bone marrow report reads that there is myeloid hylerplasia. Myeloid cells include cells other than lymphocytes. This includes neutrophils, eosinophils, basophils and monocytes.An increase in any of these cells is called myeloid hyperplasia.Shift in left means that the mature cells in the myeloid series are increased.In myeloid series (neutrophil series) immature cells to mature cells are present.When there is increase in mature cells it is called shift to right.When there is increase in immature cells, it is called shift to left.Increase in mature neutrophils occurs in bacterial infections and certain malignancies (eg chronic neutrophilic leukemia).Presence of dysplastic cells need to be investigated.Anisopoikilocytosis is the condition when there is variation in shape and size of the red blood cells.This usually occurs in anemias.You need some more investigations to know the cause of anemia and neutrophilia.Stay in touch with your hematologist for relevant investigations and appropriate management.Thanks and take careDr Shailja P Wahal .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recurred thrush in mouth. History of thrush and taking Mycelax, stage 4 CKD. Prescribed Nistatin. Should both medicines taken together?\n\nI had a lung tx 1/12 ago and was givenMycelex to prevent thrush in my mouth.  I stopped taking it at about one year...then developed thrush in mouth for first time, and re started it.  Now I have thrush again and my regular doctor is prescribing Nistatin.....question is....should I quit sucking on these Mycelex tabs while taking Nistatin?  Thank you for your answer.I'm also in Stage 4 CKD            Sorry, I forgot that I would have to pay.                 Joy K",
    "doctor_response": "Welcome to the forum.Both the medicines are prescribed to take care of the thrush and hence can be taken together.Please post your exact question and let me know the form of the medicine, that is tablet/ cream and so on.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My mother had a tumor operation and now she has lost her sensation from below breast region\n\nMy mother she had a operation 12 years back in spinal cord. She had a extra growth which was pressing the nerves of legs.. that was D5.. after they moved the tumor(they confirmed not cancer or TB), but she as completly lost her sensation from below breast region (even toching senstation).. Again with in 15 days she undergone second operation, which she got some sensation back till hip, but still from hip there is no sensation at all... after that all doctors told it can be come back only using physiotherapthy... she did it, from belt and shoes.. she removed.. annd was walking for almost 8 years with walker.. but still no senstation... and due to that no urine control(means when she feels so, she will driple). She is in age of 45, and suffering from past 2 years due to menopause, we meet gynecologists also, they did all examine.. and told everything is normal.. this will be like that only.. but now the problem is that she is unable to walk in walker also.. always her left legs will be like a crane leg(one lifted).. we tried doing excerise.. she cries for pain.. now completly for 2 years on bed... She is taking only Baceloan & valium 5 capsule. she is not at all intersted in visiting any doctors, because she is scared they will spoil this also... Could please any one suggest me how to proceed... we are in bangalore",
    "doctor_response": "Hi sudha, neurological damage after the surgery on spinal cord is common but severity varies, now your mother is having contracture of left leg due chronic immobility which caused muscle shortening and fibrosis, contracture has to be released for functional improvement, this along with physiotheraphy will improve moility but dont forcfully try to do physiotheraphy now as it may be pain full and dangerous.  consult orthpedician soon. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain during sex at the base of the head?\n\nI am having occasional pain during sex at the base of my head where it meets the spine. It only happens occasionally and only after orgasm. It feels like a knife was shoved in the back of my neck. The pain lasts about 10 to 15 minutes..... It is really intense pain.",
    "doctor_response": "Hello and thanks for using HCM.I have read your question and understand your concerns.Sex headaches in most cases are nothing to worry about, but in rare cases, they may be associated with underlying conditions such subarachnoidal hemorrhage, dissection of arteries, arteriovenous malformations, etc. especially if they happen suddenly.So, before to be sure that there is nothing wrong with these headaches, getting evaluated by a Neurologist and by imaging studies (MRI) is necessary.Hope you found the answer helpful.Kind regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does ANA positive and pattern of Cytoplasmic -actin indicate?\n\nHello, I'm 24 yrs old and I've had an ANA test about 3 times the first two times it came back as Positive with a titre of 160, the second time it was Equivocal with a Titre of 80. I just had recently done the ANA again and it came back positive for ANA with a titre of 160 and speckled pattern however the difference this time it has a pattern of \"Cytoplasmic--actin\". The doctor is requesting AMA test to be done. Could I have the ANA/AMA without any indication of symptoms or problems?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You have positive ANA with cytoplasmic pattern. You may have autoimmune hepatitis, myositis, primary billiary cirrhosis or SLE. You should go for further investigation to find out exact cause. then you should take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Huge cyst on kidney, fluid removed. What causes nausea for more than 3 weeks\n\nwhat causes nausea  thatl lasts for more then 3 or 4 weeks.  I have a huge cyst on my right kidney. Last july I had a h huge 2 liters of fluid removed from the cyst on my left kidney, that ended my nausea, till now. the cyst on my left did not come back. I had the cyst on the right side when they drained the one last july but they did not drain it then, they did not think it was a problem.",
    "doctor_response": "Hello!nausea and vomiting is a feature of uremia, i.e when urea and creatinine rises in the body. i think because of your cyst problem, you must be having some renal insufficiency. check your renal parameters and then you will be able to find out the right cause.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful bump on heel?\n\nI am a 53 year-old female, and I worked at an Elementary school as an Instructional Assistant in another city, and played kick ball with our students, fell and hurt my foot two years ago in May. My heel has had quite a noticeable bump on it since then. It hurt for quite a while, and does not bother me as much as it used did at one time. However, I would like to know if I might have problems with it in the future, if I don t see a doctor?",
    "doctor_response": "well this lump could be due to an old hematoma due to injury,a sebaceous cyst or just a ganglion cyst; anyway not to worry much and see your doctor if this one worries you too much!all the best!........",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will the Lung cancer surgery worsen my back pain?\n\nit s has been more then about 2 years since i had tummy tuck follow by liposuction of my back and my stomach since i had a bump in my lower back it keeps moving from one side to another and sometime it is hard to move and it;s hurts alot sometime i feel like my back going to stop working and now im about to have a tumor cancer surgery do you think that will make my back pain worst",
    "doctor_response": "Dear patient There is no direct relation between lung cancer surgery and back pain. But before going for lung cancer surgery metastasis to spine should be ruled out. Also prolonged rest that might be required  post surgery may aggravate your back pain.  Also impaired nutrition  post surgery also affects muscle strengh. So by many indirect ways lung surgery may lead to aggravation of back pain. You should be prepared to face all this and jeep steps to prevent all this  consequences. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for erection problems\n\nHello, Previously I used to get erection by looking at women instantly.  Now I cant get erection even by watching porn. However, when I kiss my wife I get semi erection which is enough to penetrate her and I only get a full erection seconds before I ejaculate.",
    "doctor_response": "viagra will help you last longeryour doc will prescribePlease rate 5 Stars! I strive to provide the best answers to your questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Do I have to stop taking ashwagandha before a surgery?Will it interact with anesthesia?\n\nHello doctor, I am scheduled for sinus surgery day after tomorrow. I have been given a list of medications which should not be taken and I have followed that. However, I have been taking ashwagandha (herb supplement 470 mg once a day) to help with anxiety. I read online that this may interfere with anesthesia. I will be sure to mention this to the anesthesiologist on the day of surgery when I arrive, but I am curious if this is a cause for concern beyond just letting them know, or should I postpone surgery. I last took it yesterday night and will not take it again prior to surgery. Please advice.",
    "doctor_response": "Hi. I have read through your query in detail. Please find my observations below. 1. Ashwagandha or Indian ginseng is a well known ayurvedic herbal medicine. 2. The following constitute its important effects on the human body: 3. Taking ashwagandha before surgery might predispose the patient to perioperative bleeding. It may be a concern for complications during anesthesia. In conclusion, it is suggested that ashwagandha has to be stopped for a week before a planned surgery, unless such a surgery is very urgent to be performed or when the benefits outweigh the risks involved. Please have a discussion with your doctor and reschedule your surgery by a week if recommended. Revert back to an anesthesiologist online for further clarifications -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from nausea and fever. Abnormal bilirubin levels in the blood test. Initial stage of jaundice?\n\nI am 24 yrs old.Previous 2 days i am suffering with the feelings of bomiting but nothing is coming out and also fall in fever but it has recovered just one medicine.Then today i visit nearest physician and after blood test the report is as follows.... BILIRUBIN TOTAL: 1.0 mg/dl BILIRUBIN DIRECT: 0.34 mg/dl.The doctor has suggested me that its an initial stage of Jaundice .Is it true?",
    "doctor_response": "Hi pal, Welcome to healthcare magic! Your liver function test does support the diagnosis of jaundice although you have not told the SGOT/SGPT Report-if they are also normal then probably you don't have hepatitis also. But if if the liver enzymes are raised then your doctor is right that is the initial phase of jaundice. Your fever and jaundice(if it is there really) are symptoms of the disease and not the disease itself. You may be having hepatotropic viral infection, malaria, cholangitis, enteric fever as a cause behind the syndrome. You need a physical examination by your physician and get base line investigations like Chest X Ray, Electrocardiogram, Complete Blood Counts, Renal Function Test, Repeat Liver Function Test, Ultrasound Abdomen, Urine Compete Examination. This work up is expected to detect the underlying problem so a definite treatment could be started. I hope this advise would be helpful for you. Still if you have any queries or doubts, please write me back, I would be happy to solve them. Wish you a great health!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Not had period. Stressed. Why is there pink mucus discharge. What do you understand?\n\nHI, I have been TTC for 7 months now after going off BC. I have not had a period for 2 months ( stress , death in family, seem to be the cause). I am pretty sure I ovulated approx 11 days ago though and for the past week now have been having light cramping, increased temperature (99), slight backache and dizziness . Have seen my doctor since and she told me to wait it out. Yesterday and today only after going to restroom I have noticed pink/red mucus when I wipe. Have taken a pregnancy test this morning and its negative. What gives?",
    "doctor_response": "Hi, Although excessive stress is one of the possibility of delayed period specially in absence of pregnancy as you have negative urine pregnancy test. But stress would not cause cramping, increased temperature, slight backache and dizziness with red mucus secretion. These symptoms can occur in genital tract infection. So, it is better for you to get evaluated and investigated by gynecologist. I hope this information has been both informative and helpful for you. Wish you Good Health. Regards, Dr. Ashish Mittal www.99doctor.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated liver enzymes and fatty liver?\n\nI just had a CT scan done, Awaiting results, but also had labs drawn.  My AST was 37 and ALT 56, and Glucose was 110.  I had taken Nyquil for two days (including night before) to get some sleep because of cough, etc.  My Glucose came back as previously mentioned at 110.  I do have a fatty liver (previous CT scan), and would say overweight.  Social drinker.  CT Scan prior to having labs drawn had with dye. Also had a Hall's cough drop before labs were drawn. Would this affect results.  I'm just nervous. thanks.",
    "doctor_response": "Hello! Thanks for putting your query in HCM. I am a Gastroenterologist. Fatty liver has many cause like Hepatitis B, C, Metabolic disorders, NAFLD, alcohol intake etc. So I will suggest you to visit a Hepatologist for evaluation who will advise tests and then manage accordingly. Meanwhile there are few medicines which I found very useful in my patients are ursodeoxycholic acid and vitamin E. Do regular exercise and reduce your weight if you are overweight, avoid alcohol if you drink.I hope I have answered your query and this will help you . Wish you a good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take Epilim during pregnancy?\n\nHi Drs, I read somewhere that epilim has so many side effects,, a friend of mine was feeling ill and nauseas while on epilim,if you do not have your blood levels tested regularly , 1: you can have a seizure because its to low or you can have one or one because its to high,,, But my biggest concern is the safety of our new unborn babies; spina bifida,,, our pregant girls.....should they be off this",
    "doctor_response": "Hi, Epilem (Sodium Valproate) is a medication given to treat manic depression, bipolar disorders, epilepsy, etc. Its teratogenic risks have been registered & recorded in data studies & research work in many countries, it is dose dependent. It is prescribed in some countries where the government allows it to be given as a mood stabilizer & epilepsy in women of child bearing age. A recent study says that it is safe for pregnancy, though Sodium Valproate in pregnancy remains a subject of debate & further research & study. The teratogenic effects of Sodium Valproate exposure as per records in the different countries include fetal malformations, the risk of neural tube defects like spina bifida & anencephaly. You can get the details from the research study records. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nupur K, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is numbness and itching a symptom of cancer?\n\nI m a 29 year old male and I have a few questions. I have made an appointment with a dermatologist but I am curious to a few things I have going on. I have quite a few flat moles that aren t raised above the surface but are irregular in shape/borders. I have noticed a small amount of possible discoloration in them. The largest one is on my back and what I thought was numb from a previous mole removed, I just realized is no where near the area of the mole I had removed. The numbness is about 1-2 inches around the mole. I m wanting to know if numbness and itching is a characteristic of cancer or not?",
    "doctor_response": "Hi,Thanks for writing in.Cancer symptoms in a mole are1. sudden increase in size2. appearance of hair3. discharge in a more4. change in color of moleIf the numbness is around 2 inches away from the mole then cancer is unlikely a possibility. However it is safe to consult your dermatologist and get is examined clinically.After examination, if your dermatologist suggests a biopsy to be done then it is required for confirmation. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am a 73 year old woman. My husband died of bone cancer when he was 57. My son died of lung cancer at 42. My brother died of brain cancer (Glio Blastoma ) at 66 and my sister died of colon cancer at 62. What are my chances of getting cancer ?",
    "doctor_response": "Hello Welcome to health care magic forum As there is strong family history of cancer ,you must under go regular medical checkup form some good  cancer hospital. Wish you good health Disclaimer",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does my semen analysis findings below indicate?\n\nMy Semen Analysis report is: Volume-2.0ml, pH-8.0, Appearance-Normal, Liquefaction time-30min., Viscosity-Normal, Total aperm count-62M/ml, Active Motile-60%, Sluggish-20%,MonMotile-20%, Normal morphology-85%, Abnormal morphology-15%, Pus Cells-0-2/HPF. What does it mean? My wife is not getting pregnant from last 2 years since marriage. Do I need to consult urologist?",
    "doctor_response": "Thanks for contracting HCMYou are wondering what the results of your semen analysis. Your analysis is completely normal. You are fertile. Unfortunately the problem getting pregnant is result of an issue with your wife. Good luckHope I answered your question. Please contact us again with your medical questions or concerns",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is random sharp pain in chest with fast heartbeat normal?\n\nhello i am a healthy 23yr old male, my heart is beating 20 times in 10seconds with no physical activity...is that normal? it doesnt feel normal. My chest is tight but not short of breath and get random sharp pain 1-10......10being the worst pain its about a 4 and only last a second",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. No, this is not normal. You are having palpitations, tachycardia and chest pain. All these are characteristic symptoms of heart disease. So get done ecg, 2d echo, stress test and Holter monitoring (24 hours continuous recording of Ecg). If all these are normal then no need to worry for heart diseases.Sometimes undiagnosed stress and anxiety can also cause similar symptoms. So avoid stress and tension, be relax and calm. Don't worry, you will be alright bit first rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the heart while breathing?\n\nI had a deep tissue massage this morning in my back , shoulder and neck area. After a couple of hours I started feeling pain behind the heart area every time I breath deeply (Underneath my left breast). Shall I be worried? It is just painful when I breath in deeply and once I'm standing up.Thanks",
    "doctor_response": "Hello, Thanks for using HCM. I have gone through your query.As your symptoms started after massage there are high chances that you have muscular sprain.Heart pain is not agggravated by breathing or movement.SO dont worry and take simple analgesic like Aciclofenac 100 mg twice a day and you will be fine My best wishes Dr.Rajesh Teli,MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can atrial fibrillation be treated?\n\nMy husband, 75 years old, had by pass surgery in 2014.  At that time it was discovered he also had afib.  Each time we see a doctor, not a heart doctor, he is in active afib.  What should be done about this?  The cardilogist says a pacemaker is not needed.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. After going through your medical query I understand your concern for your husband\u2019s health and I would like to tell you that atrial fibrillation generally do not require any pacemaker if not associated with life threatening cardiac arrhythmias. To avoid complications of atrial fibrillation he needs to take a blood thinner along with other cardiac medicines. Warfarin or Debigatren is the choice of drug and you need a medical prescription for this. So, kindly consult a Cardiologist personally for further management. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rashes on babies neck and shoulder\n\nMy 12 month old son has just showed up with a bad rash across his shoulders, neck, tops of his arms, and around his hair line. It is real red and bumpy. But he doesnt seem to itch really. I have tryed giving his benidryl and oatmeal baths. also i have tried baking soda bath and putting corn startch on him. But nothing seems to make the rash better and now he is sleeping a lot and has a very small appitite. I think it might be a heat rash. But when i look up information on it... it doesnt sound like it to me exactly.",
    "doctor_response": "Hi..by what you quote this is looking like an allergic or urticarial rash. This doesnt sound like a heat rash. You can use syrup Hydroxyzine at the appropriate dose. This is a prescription drug and I suggest you consult your pediatrician regarding this.Another option is uploading the images to us and after seeing them we will get back to you with appropriate suggestions.I am telling this because skin conditions are best diagnosed and managed after seeing them.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I missed a pill. I have spotting. Could I be pregnant?\n\nHello doctor, I am going to be really specific so that you can best help me. Six months back, I went to the doctor, and I was prescribed Ciprofloxacin HCl (Hydrochloride) for a UTI (Urinary Tract Infection). I took the antibiotic for 7 days. I am taking an oral contraceptive, and I am sexually active. During the week I was taking the antibiotic, I had unprotected sex once. The following week, I started my period as usual. I started a new pack of my birth control pills on after my periods. I forgot to take the pill on the eight-day, so I took two on the next day. I have not missed a pill or taken it late since then. There has been an increase in vaginal discharge for about 3 days. At first, there was no color to it, but yesterday, I noticed that there was a pink tint to it, and it is still present today. Everything that I have looked at online says it could be a sign of early pregnancy. What is your opinion?",
    "doctor_response": "Hello. In my opinion, if you have had your period this month on time, and you have been on oral contraceptive (birth control) pills, then you are not pregnant at all. Sometimes, spotting continues longer with discharge in the initial days of the cycle because, during the previous proliferative phase, there can be left over endometrium, which is shed after that when you have your period. By \"proliferative\" I am referring to growth. During the second part of your menstrual cycle, hormones which your body produce naturally cause growth to occur in the lining of the uterus also called the endometrium. Oral contraceptive pills usually cause a reduction in bleeding and some cases, may cause spotting. So, please do not worry; it is not pregnancy. This spotting should stop. Continue the pills you are taking, as prescribed. One missed pill is not the cause, as you correctly took two the next day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy lump on upper left side of labia minora?\n\nHi, I have a lump on the upper left side of my labia minora parallel with my clitoris. No skin changes, it feels like a swollen gland, there is no pain, it is around the size of a 10c piece. It is slightly itchy just on that spot, It is soft but doesn't move, it can be hard to find as it's quite deep. I am 27years old.",
    "doctor_response": "HI. This can be a cyst as per your description , yet it is better to get this confirmed and removed by Gynecologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Do my symptoms point toward ARVC?\n\nHi doctor,I am 25 years old\uff0cmale\uff0chad PSVT and did an RFA surgery two months back\uff0ccaught a VT during Holter recently\uff0cUCG clear\uff0cMRI says left ventricular septum thickening about 20 percent. The local doctor thinks it is a viral myocardity\uff0canother doctor that I know says he saw of QRS and he thinks might be ARVC\uff0cwhat is your suggestion? I have high BP sometimes\uff0cand now taking Bisoplor and coenzyme q10.",
    "doctor_response": "Hello. Firstly, the possibility of ARVC (arrhythmogenic right ventricular cardiomyopathy) is less. MRI or echo would pick changes in the right ventricle. I guess right ventricle is normal on echo and MRI so unlikely to be ARVC. Next thing, you mentioned about thickening of the septum in MRI. What is about your echo finding, does it suggest anything pointing towards hypertrophic cardiomyopathy? So we should rule out hypertrophic cardiomyopathy. If possible, please upload your echo, MRI and routine ECG for interpretation. Regarding the possibility of viral myocarditis, it would show some changes on echo or MRI so that is also a less likely possibility if echo and MRI not showing any consistent changes. Also, troponin would be positive in active myocarditis. So I would once like to go through your detailed report and see if we can get some clue regarding diagnosis or else we will have to treat it like idiopathic VT (ventricular tachycardia). For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe anxiety be managed?\n\nI have so much anxiety. I\u2019ve had echos done for panic many times throughout my life - I\u2019m 28 (and female). All have been normal, including one in 2015, but in 2017, my doctor ordered another one, and it showed trivial mitral regurg, mild tricuspid, and mild thickening of the mitral valve \u201cwith normal leaflet mobility and no evidence of stenosis.\u201d This really scares me - is it weird to have this at my age? Can it progress or cause death? My mom has MVP, but I was always told I don\u2019t. The report also mentioned mild concentric LVH with a normal ejection fraction of 60-65%. I\u2019m worried about that, too. I sent my images to a cardiologist in a bigger city (Nashville), and they said they don\u2019t agree with the LVH finding, and that they wouldn\u2019t have had any of those findings if they had done the report. They told me I needed no follow-up and to not worry, but it\u2019s hard, because I\u2019m still so worried about that 1st report. How can 2 cardiologists have such different interpretations? Also, because of my anxiety, my hr during the echo was 111. I don\u2019t know if this could have created false positives for thickness, etc. or not. I worry about my anxiety\u2019s high heart rates damaging my heart.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You must understand anxiety is part of your defense mechanism and you should not worry too much about it because it helps you to face the problems. Secondly, it seems that you have health anxiety. Health anxiety is preoccupation with health matters. In your case your health anxiety is related to heart problems. You also feels that you will, for sure, fall prey for it. I suggest counseling and psychotherapy for you. Because the anxiety is so strong, you may have to take anti anxiety drugs along with the therapy. Hope I have answered your query. Let me know if I can assist you further. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dizzy often during the day with tingling in right arm from elbow to finger. Reasons ?\n\nI have been very dizzy pretty often during the day for a few months and today my right arm started tingling from my elbow to my finger tips ... I am only 26. What is going on?",
    "doctor_response": "Hi, Welcome to Health care magic forum.                      Recently you are feeling dizzy, and now have tingling from right elbow to the finger tips.                       Being the aged of 26 years you should not have any critical problems. It may be due to the cervical spondylosis, if not the infection of the internal ear. rarely may be the ischemia of the brain, or hypertension.                       I advise you to consult an orthopedic surgeon for diagnosis and treatment.                       You may need to have a C.T. scan for confirmation.                        I usually prescribe to my patient with such symptoms neurotropic injections for 10 consecutive days.                       Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be done to have a healthy baby ?\n\nI bivas santra... I am two month pregnant .... now what I do for better & healthy Baby just like Me ?",
    "doctor_response": "hi,bivas santra thanks for query as you want your baby just like you that means you are smart and beautiful. take nourishing diets with high protiens and more milk and eggs. take more green vegetables and fresh fruits. take iron multi vitamins supplements and trace elements. do light physical exercise. read good books and magazines. see good programs in t.v ok & bye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why did increasing Eptoin dosage cause dizziness and visual problems?\n\nI am 30 years old boy and have seizure problem from last 3 years. Doctor suggest me Eptoin 100 mg (3 tablets) per day. Since last 2 years I have no problem and do my regular jobs and doctor also suggest me to take 200 mg daily. But recently before 15 days I have another attack and doctor suggest me to take 300 mg daily sir, after increasing the dosages I have some problems like shades on my left side of eye and feel weekness and i feel the attack will repeat. Sir please suggest me what I have to do.",
    "doctor_response": "Hello,You may experiencing the aura (symptoms before attack). Eptoin intake for long term may lead to encephalopathy, psychosis, locomotor dysfunction, hyperkinesia, megaloblastic anemia, decreased serum folate level, decreased bone mineral content, liver disease, IgA deficiency, gingival hyperplasia, and a lupus-like hypersensitivity syndrome etc. Hence, please consult with your neuro-physician he will examine and take EEG then treat you accordingly.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Numbness in chin, hand. Persisting numbness on chin after taking Mahagaba. What can be done for this?\n\nI got numbness on my chin from last one month. When I feel numbness I consult my doctor (Dentiest) because i was undergo to RCT on last tooth but she said that there is nothing due to RCT, then I go to Ortho. because I was suffering from cervical Pain also and numbness in my left hand also. I am taking medicine Mahagaba 75mg BD. Now, I am O.K. but numbness on chin is not subsidy, what can I do for this?",
    "doctor_response": "Hello, First of all it needs to be clarified whether the numbness in your chin and your left hand is related or not. After seeing you one needs to come to a conclusion about whether it is because of compression in the neck or surrounding area. You need to consult a neurologist and he will guide you regarding further investigation which may be required. he will also give you other medications for numbness. If the numbness on chin immediately followed dental treatment, then it could be related to it also. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I stopped taking Adderall for some days and it is not effective now. Why?\n\nHello doctor, I have recently been diagnosed with adult ADD. My psychiatrist prescribed 20 mg Adderall every morning. I took it for a few days (it worked) and then took a break of two days as I found I was not able to sleep on it. I thought I would get a good night sleep and then resume the meds to see if they were active. After the break, I have been taking them consistently every day and find they do not have any effect on me anymore. My psychiatrist now prescribed 75 mg of Wellbutrin. I also told him that I was having crashes in the evenings when I was taking Adderall. Why would the Adderall stop working so soon? What effect will the Wellbutrin have?",
    "doctor_response": "Hello. It usually takes a few attempts to optimize your ADHD (attention-deficit hyperactivity disorder) medication regimen. It can be somewhat frustrating, but your experience is not uncommon. Your doctor will titrate the dose of Adderall (Dextroamphetamine, Amphetamine) according to your clinical response and tolerability. There is some evidence to show that Wellbutrin (Bupropion) is helpful in adult ADHD, especially if you also have any low mood and anxiety symptoms. So continue having regular reviews with your doctor who will monitor your response. Follow proper sleep hygiene measures and try to exercise regularly. It will have a beneficial effect.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How effective is the cream, Brite, for fairer complexion?\n\nhi my name is neha as i am applying brite on my hand and legs for past 15 days as my hand and leg have dark complexion should continue to apply brite as i find no adverse effect or recomment me good cream for my hand and leg so that it can become fair is brite for fairness????",
    "doctor_response": "Hello Neha, Thank you for posting on HCM.Complexion of any person is has two two components; constitutive, one which is predetermined by genetics and racial factors and usually cannot be changed with any treatment. The other component is due to external agents like environmental exposure, sunlight, use of any cosmetics etc and is amenable to treatment.I would insist to you to avoid BRITE cream as it contains harmful ingredient hydroquinone.Instead, you can get a series of chemical peels, which actually remove the upper dead layers of skin and stimulate regeneration of collagen and thus newer layers of skin. Many options are available in chemical peels depending on the requirement and skin type. (Glycolic peel, retinol peel, cocktail peel etc)Also, chemical peeling can be preceded by a simple procedure called microderamabrasion or commonly known as skin polishing to augment the results.Also, at home you can try using cream containing kojic acid, tetrahydrocurcumin, arbutin etc for several months (Melaglow cream) for additional benefit and maintenance.Always use broad spectrum sunscreen before going out in sun.Use a plain moisturiser like cetaphil DAM on daily basis for healthy and hydrated skin.Take plenty of fresh fruits and vegetables in your daily diet.Hope this will take care of your issue.Thank youDr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to forget things when suffering from dementia?\n\nMy husband experiences aprox. 10 minute episodes of not knowing what he should do next, where he works and who he works for. As I remind him, the memory slowly returns. He began this about 4 years ago infrequently but now he has had 2 in 2 weeks. He has been tested for dementia with the finding of mild cognitive disorder, which they say is due to his age of 61. I do not agree that this is normal. Any ideas?",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your husband's symptoms. Based on the description, his forgetfulness and memory impairment are episodic and they become normal after 10 minutes or so.In a case of dementia, the memory impairment is present all the time and not in episodic fashion.In your husband's case, we need to exclude seizures and transient ischemic attacks. In both these conditions, the person's memory may return to normal after a few minutes or so. Please discuss with his neurologist regarding these two possibilities.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower stomach pain due to ovarian cyst. Now leg pain and numbness. What do I do?\n\nhi my name is kiara hightower i have been in the hospital for right lower stomac pain I found out i had a sisst on my right overy I was not abule to Keep any thing down I was going back and forth to salem hospital and Portland ohsu hospital they did Nothing at all but give me pain meds to see if it would help they were giveing me stong pain meds and Nothing was helping at all I had the Same probulem in June they did the Same thing just like now put they did surgry it help I was doing so good then it happen again but I started to have right leg pain all the way down and then I Lost feeling in my leg from my knee down I cant feel anything at all I cant even move it the Drs say it is Nothing at all to worry about what do i do pelease help there is so much more that is going.on i dont.know what to do",
    "doctor_response": "Hi, Welcome to HCM. Sorry to know about you. Possibilities of your leg problem are-- 1. Deep vein thrombosis of veins of the leg. 2. Spinal cord compression resulting in nerve damage. The ovarian problem is unlikely to cause leg problem, unless it is a cancer and spreading to other areas. Kindly take medical help and get well soon, REGARDS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rash on back, stomach area and neck?\n\nMy 12 yr old daughter has had a rash on her back, stomach and neck for about 4 days. Does not itch or hurt. We have not changed lotion, soap or laundry detergent. Any thoughts? What symptoms should I look for that would indicate this should been seen by a doctor?",
    "doctor_response": "Hi...1. By what you quote it should be an urticarial or a simple skin allergy. You can use Hydroxyzine at 1-2mg/kg/dose every 6th to 8th hourly for 7-10 days. Most important thing to be remembered is that it has a propensity to recur (called as second crop) within 10-14 days. If this happens, you can start using the same medicine but I suggest you get the kid evaluated with your paediatrician.2. Red flag signs or danger signs include - extremely painful joints/ blood in urine or stools/ rash localised to only legs/ sever tummy pain.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can chipped tooth be treated?\n\nHello doctor, I chipped my front tooth two days ago. I saved the broken tooth piece in a cup of milk in the refrigerator. The piece is fairly small (bottom corner chipped off). What are my options to get my tooth fixed? It does not hurt but it is a little sharp to the touch.",
    "doctor_response": "Hi. That is good that you saved the part of the tooth. But actually little chipped off part of the tooth cannot be reattached to the tooth by any means. But if whole tooth and its root somehow got knocked out of socket while you fell down or so and that tooth is kept immediately under your saliva or milk and then re-implanted at the same place within one hour then this tooth definitely gets saved. But, unfortunately, its broken part is hard to re-attach. You should get filling of it done as soon as possible and get sharp edges trimmed else it will hurt your tongue or lips. Stay happy and blessed. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is pulmonary hyperaeration?\n\nI am 19 yrs. old and I have my chest PA (xray) last week for my school requirments and the result was this lungs are hyperaerated with low set of memidiaphragm and the impression is pulmonay hyperraeration. I am afraid of this..what does it mean.........",
    "doctor_response": "Hi. I can understand your concern. Sometimes while doing an x ray if you take a deep breath this findings can be seen. You need not worry if you do not have symptoms like breathlessnees or cough.Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high blood pressure, stomach sickness with temple and eye pressure?\n\nI am a 29 y.o, white, male. Good physical condition with no medical history. I took a pre-workout supplement containing caffeine and other natural stimulants 5 days ago. During my workout I got very ill and had to come home. I had a couple episodes of vomiting and muscle cramps that night. Thought I was just dehydrated. The next day I stayed home and rehydrated myself but still keep a hungover feeling. Felt decent the next day and wanted to go workout. Decided to try the supplement again but only a half dose. Went to my work which is a fire station and obtained a bp of 130/84 on a machine. After taking the supplement I felt ill and had a pressure in my head and the back of my neck. Had a medic listen to my bp which was 196/100. After going home to rest I returned to work and had them listen to another bp which was 210/114. The medic started an IV and gave me a bag of fluid. This decreased my pressure to 180/90. Went to the local ER and had a full cardiac work up done. EKG showed normal, labs were normal, and head ct showed nothing. BP on their machine showed 155/90 upon arrival and 125/75 upon discharge. That was 3 days ago and since then I have made an appointment with my primary doc. I have stopped all supplements and exercise. Check my BP several times a day and it is normal when taken on a machine but it shows still high when listened to by cuff and stethoscope. 120/80 on a machine is showing as 160/90 by auscultation. I am also having episodes where I get sick to my stomach, start shaking, and get pressure in my temples and eyes. I check my bp every time I feel this coming on and it is elevated on my machine. I am at a loss as why a caffeine product would be affecting me 5 days later or if it maybe uncovered or cause a new underlying condition. I have never had a problem with BP and/or any type of anxiety but it has also crossed my mind that the episodes of shaking and nausea could be a nervous response. Any help would be greatly appreciated.",
    "doctor_response": "hypertension use with me is essential that means it does not have any special reason only about 5% of hypertension cases have any special reason like it can have a  endocrinology problems a tumour producing a epinephrine in adrenal glands anxiety and stress can also contribute to hypertensionPressure and the temples  is usually sign of anxiety neurosisTreatment for hypertension in walls are several antihypertensive medication is to be in given by your physicianTreatment for your pressure on the temples can be relieved by biofeedback and if it doesn't work then you may take some medications as prescribed by your physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Would it be required to have yellow fever vaccination ?\n\nI a 72 year old female, going to the Napo River Region of Caco Equador. I her ethave had conflicting information as to whether or not I should take the yellow fever vaccination. Because of my age I was told to us deet greater than 25% on exposed areas and Primetheon on my clothing. Is that sufficiant protection.",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.In my opinion you should take the vaccination.Addition of protection and repellent will help you further in protection.Visiting a risky area without protection should not be done at your age.The area you have mentioned is having high prevalence of yellow fever.I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible despite a negative test report?\n\nHi I have been taking Primulout for 3 months (1/4 tablet once a day for three days before my period is due), I took it over a week ago and still haven t gotten my period. I had protected sex 5 weeks ago and have done a urine pregnancy test through a GP which came back negative, what could be wrong?",
    "doctor_response": "Hi.There are numerous aspects that need to be analysed before narrowing down to the actual problem. But in my opinion, at times even a pregnant woman can return a negative result, this can occur due to hormonal fluctuations, and if you do not get your period until 6 weeks after your last menstrual period, then report for an ultrasound examination for the most accurate confirmation.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What causes loose stools with stomach grumbling and pain?\n\nHello doctor, I am 18 years old. This all started two weeks ago. I started to have some loose stools, abdominal pain (lasts about two seconds, it comes and goes almost twice a day) and grumbling in the stomach. My doctor gave me a three-day course of Buscopan, charcoal, and Apo-ranitidine after which the loose motions and cramps have stopped. But now the problem is that I have frequent toilet urges and feel that my bowel has not completely emptied. I am also experiencing a lot of gas and grumbling in the stomach. I have had gas problems from childhood but since these two weeks, it has turned a little worse. What am I suffering from and any treatment?",
    "doctor_response": "Hi. Occasional abdominal pain, loose stool, urges for toilet all suggest that you might have irritable bowel syndrome. This is a chronic condition. If you experience worsening of symptoms, change in consistency of stool, any episode of any amount of bleeding along with stool then you might need further evaluation in terms of colonoscopy or CT scan of the abdomen. Primary treatment is medications which you suppose to take for a long time (as prescribed by your doctor). You also need to change some sort of life-style modification in terms of avoiding food which worsen these symptoms and also suggest to take high-fiber, low-gluten diet. Might require a colonoscopy. Indigestion, Inflammatory bowel disease. \u00a0|",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I use Nuforce-GM for rashes at opening of anus?\n\nHello Sir, I am having rashes kind of thing at opening of my anus. It causes a lot of pain and irritation especially when i use Jet water while using commode. A little cut has also occurred may be due to rubbing. Should i use Nuforce - GM ? Would that solve my problem?",
    "doctor_response": "Hello dear and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.Nuforce GM is a cream which contains antibiotic and also antifungal ingredients.So, it can be used to treat a bacterial and fungal infection.You can use it to treat the rashes and I think that it will be effective.Hope I have answered your query. Let me know if I can assist you further.Kind regards!Dr.Dorina GurabardhiGeneral &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How should a Asmanex twisthaler be used?\n\nI was prescribed Asmanex twisthaler, I would like to know the instructions better, the phamplet is not very clear, ,my doctor instructed me to twist inhale, hold my breath and exhale. however the numbers on the inhaler are confusing what does the numbers represent?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Asmanex twisthaler is showing numbers on display and it is known as dose counter. These numbers are showing remaining doses. So if your twisthaler is showing 90 then it means that your twisthaler is having 90 doses left. This helps in identifying and knowing whether your twisthaler is finished or not. And technique is very simple. First do normal breathing then put twisthaler in mouth and inhale deeply, forcefully and as long as you can. Don't exhale immediately. Hold your breath for 4-5 seconds then exhale slowly through nose. Wash your mouth after using twisthaler. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment to get pregnant?\n\nhi m sakshi n m trying for baby from last 8 months..my husband s sperm count n mobility z fine n i hav done my vaginal scan ..evrythng z fine inside..i havent taken any drug for pregnancy till nw nw doc z suggesting for IUI n giveing me clofert 100 mg for 5 days ..do u think i shud try first drugs only n dn IUI n dn l8r if necessary ivf..m really confused ..no idea jus wondering n my ol blood reports r normal except i have hypothyroidism bt my recent tsh value z 1.1 n its also normal...pls guide me n show me right path..thnx in advance",
    "doctor_response": "Hello dear,I understand your concern.Usually the infertility treatment need to be started if pregnancy does not occur even after one year of unprotected intercourse.As you are married for 8 months still there is chance for trying for natural pregnancy.Iam suggesting you for natural pregnancy because you both the partners are normal.Ofcourse you are hypothyroid but as it is under control it can be considered normal.Avoid stress or anxiety regarding the pregnancy as it causes hormonal imbalance and delay fertility further.So relax.Practice intercourse regularly to increase the conception chances.If no pregnancy even after a year you can go for infertility treatment.IVF is the last resort.It might be rarely needed in your case.And there is good scope for natural pregnancy in your case.Hope this helps.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have constipation since childhood. Please suggest me a good homeopathy medicine.\n\nHi doctor, I am 30 years old female. I have constipation problem from my birth. Sometimes, I have stomach pain, and I have pain in the left half of the head. Please suggest me a good homeopathy medicine for constipation.",
    "doctor_response": "Hi. Your complaint is widespread nowadays. It will become cured nicely with homeopathy along with proper intake of medicines and follow-ups. You can start taking Cascara sagrada mother tincture 10 to 15 drops in a half cup of water at bedtime. You can take Nux vomica 1M five pills at bedtime every day. Take Alumina 30 five pills in the morning, noon, evening and night. Along with these medicines, have a fiber-rich food. Have a banana, raisins, apple, and fig. You can use one to two teaspoons of castor oil when you make dough for roti. You should have a proper intake of water. Less water intake can also cause constipation. Have a proper sleep because sound sleep helps to detoxify the body and it helps in having a regular motion in the morning. Changes in sleeping time affect your body and tummy. Have plenty of fluids. Load your food plate with vegetables as vegetables are rich in fiber. Have a follow up after a week to decide the duration of treatment and further medication.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for vasculities\n\nHiii my husband was suffering from vasculities 3 years before and he is cured he was hospitilized during the start of vasculities by ulcer ...ulcer is also cured he was on azron tablets and the medicine is also stopped ....now again from one month he is having itching in legs...doctor said for blood test again doctor saying again the symptoms is looking like vasculities ....but the reports are normal he is having high blood presssure pass from 2 months he wad taking medicine for that ... now doctor has again prescribed azoran and omnacortil tab 5mg .....again he will have ulcer problem no na I am worried about it ulcrr was 3 years before doctir is saying it will not happen agsin because the dose is very low.... plz help what is ur suggestions",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.He may have vasculitis. He should go for complete ANA profile. It will give you exact diagnosis. It is auto immune disease so immunosupressive drugs are helpful. Steroids is the drug of choice for autoimmune disease. Go for ANA profile, find the exact cause and take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain, redness and tingling feeling on foot\n\nhi I slipped on water and fell and the top of my foot went under a door and kinda got stuck. it isn t swollen just very red and super painful and now im getting a tingling feeling from the toes up my leg to my knee do u think I am ok? I can move toes but when I do the tingling gets super intense and when I put pressure on my foot it hurts but not unbearable",
    "doctor_response": "It's a blunt trauma and toes are somewhat sprained.Any mild analgesic and anti inflammatory can relieve the pain such as PCM or Ibuprofen 1 sos if it is not allergic.To my own patients I also say to drink little turmeric mixed powder in warn milk or water for few days. It's a powerful herb ( kitchen soice) doing healing and has anti inflammatory properties. Turmeric is tasteless. So no problem. May use Haridra pure herbs capsules too ( its also turmeric inside).Turmeric may also be applied on traumatised site or on open wounds too, by mixing in warm clarified butter for fastest relief. Cover with crepe bandage. But turmeric stains cloths so wear accordingly.Hope it helps you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any relation between low testosterone level and herniated disc?\n\nHi there, is there a relation betwean low testosteron levels en herniated disc? My husband was diagnosed with hypotestosteronism 14 months ago and recently he got to hear dat he have lumbal dicus hernia L4-L5. so I was wondering if those 2 conditions are related. Thanks, Silvy",
    "doctor_response": "Hi, thank you for the query.Testosterone production is regulated through a hormonal feedback mechanism by some some hormones secreted by the brain. So there is no direct link between disc herniation and low testosterone production. I would suggest he sees and endocrinologist for proper evaluation.I hope that answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. We will be delighted to answer more questions from you.I wish him good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood and puss from nose?\n\nI am a 63 year old. And I am Diebeted 2 with vascular decease and also high blood pressure. I just had bypass on my upper left leg two vascular arteries. since then I had problem urine, I have been wearing this foley cat. I notice blood and puss coming thru the clear hose. My G.U. wants to do surgery in a month is there any thing I can do, while I am waiting.",
    "doctor_response": "Hello.High bood pressure can be couse of bleeding from nose. You are probaply using Aspirin or some other pills against blood clots. Concerning your problems about Folley cateter, if there is puss inside and itching, you have to visit your doctor and remove that cathater. After that the doctor will insert new catheter and give you antibiotics for urinary infection.Also you should do lab tests to see the extent of infection.All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Developed bumps near corona. Irritates when touched. Guide\n\nI have developed 2 small bumps around 3mm diameter near corona.  Its in the skin. Palpable superficially but not from inside.  It doesnt pain but irritates when I touched them or my undergarmets irritates them.  I had no kind of sexual activity.   I wash my genital region regularly... Plz help me out as I am getting stressd about it??",
    "doctor_response": "Dear  I understand your concern Small Bumps in coronal region without pain may mean anything. confirm that they are not due to any insect bites or so. Some allergic conditions arises out of new under garments, cologne can also be investigated. Safest bet is to consider consultation with a dermatologist for further treatment. But it seems nothing to sorry. Wish you speedy recovery,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having abdominal pain and bloating?\n\nHello, I've recently been diagnosed with PCOS, (I have 2 children, 3 & 2) & my 3 year old was born following many IVF attempts.  For the last week I've had a dull aching pain on the right side of my abdomen, (which I have experienced before), like someone is twisting something inside.  I've also been feeling very bloated.  Could this all be linked to the PCOS, or something else?Thank you",
    "doctor_response": "Hi ! Good afternoon. I am Dr Shareef answering your query.If I were your doctor, I would go for a clinical examination of yours, followed by an ultrasound of the abdomen to rule out any twisting/sudden enlargement etc, of an ovarian cyst, apart from few other pathology relating to intestines, appendix and the urological organs. Management would depend on the clinical finding and investigation reports.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated blood platelet count?\n\nbloodwork shows an elevated platelet count of 467 absolute reactive lymophcytes of 158 absolute eosinophils of 2212 absolute basophils of 316 been having stomach issues for a few months and dr wants to redo and manual review my bloodwork since it came back as abnormal, should I be concerned?",
    "doctor_response": "I would not be concerned about that platelet count.  Depending upon the lab reference values, the level is most likely just minimally elevated and would not cause anything to be concerned about.  Absolute white cell numbers are difficult to assess without the context of your total white count.  Frequently, a minor cold or other viral infection can lead to a short-lived rise in platelets and different types of white blood cells.  I agree with having your lab work redone, but I would not worry about the current numbers.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bleeding during pregnancy?\n\nIm 8 months pregnant and when i wiped yesday and the day before i was bleeding not too badd.JUst is scray!Then i went to the hospital and i was having miner contractions!Then when i went to the bathroom not very long ago i seen some blood in the toilet!Whats wrong im trying to rest,what should i do?",
    "doctor_response": "Hi dear, I have gone through your question and understand your concerns.Bleeding and mild contractions in eighth months of pregnancy can be due preterm labour.can alUalso 've due to a mild abruption of the placenta.I will suggest you to consult an OBGYN specialist to get properly examined, investigated including ultrasound and get appropriate treatment.Hope you found the answer helpful.Wishing you good health.Dr Deepti Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce swelling and pain in Middle finger after hitting hockey ball?\n\nI got quite a hard hit on the hand by a hockey ball. It was sore at the time and swelled up almost instantly. It now hurts to grasp items and bend. I can move my fingers without much pain but my middle one. Its also quite stiff. Any ideas whats wrong and what I can do?",
    "doctor_response": "Hello dear.Welcome to healthcaremagic.I have read your query and understood your concern.I will advice you to consult some orthopaedician for proper examination so as to exclude any minor fracture. It should not be taken lightly.By the time, you can do icing of the affected part and take some anti inflammatory drugs like ibuprofen etc for symptomatic relief.As per details, this is my best advice for you. If you have further query, you may ask me.Sta healthy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I keep having an upper abdominal pain after I eat?\n\nHello doctor, I am suffering from an upper abdominal pain. It feels like winding as if I am being kicked repeatedly. I feel this pain mainly after I eat. It all started last week, but it was very mild for two days. But, then it got much worse the next day. Then next day, the pain became so bad that I could not sleep at night. I also had a fever. So, I went to the doctor, who said I have high stomach acids, and he gave me Lansoprazole. The medicine helped me for two days, but today the pain is bad again. Please help me.",
    "doctor_response": "Hello. Hope I answered your query well. Feel free to follow-up. For further queries consult a medical gastroenterologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible while on Metatime 500mg tablet?\n\nI am 27 yrs old . I am trying to conceive for last 2 years . I consulted doctors they have given enough of tablets but still I cant. Now at present i have consulted one doctor she told me take metatime 500 mg tablet , and folic acid. Will i able to concieive with these...",
    "doctor_response": "Hi I think you should get yourself evaluated. Do a thyroid profile and prolactin levels and a ultrasound for follicles. Only metatime and folic acid will not help.  You need to take some medicines for growth of your eggs and also some medicines to support your pregnancy. Do a semen analysis of your partner.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause of back pain while sleeping?\n\nHello doc, That one of my friend having back pain while sleeping cause of her body shape well it s perfect and some said me it s common for girls.. But I need some expert advice.. That the thing is her back is not completely touching to the bed and she s having some gap in centre.. So what s the cause if this? And is it normal for girls? And any home remedies? Thank you :)",
    "doctor_response": "HIWell come to HCMThe symptom is suggestive of pelvic inflammatory disease and this can be best managed with Tab Acetaminophen and Ibuprofen three times in day, ask her to maintain the good posture while sleeping, if the symptom does not improved then this need to be investigated for spinal disease, hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to take care of oneself during pregnancy?\n\nhi, i am a 28 year old and i had three miscarriages before. now i am currently 5 weeks pregnant and i am on susten and vitagreat. i just want to know how much i can move around and do chores. i am worried very much about my baby. i want to take care of this pregnancy so that nothing bad vl happen again.",
    "doctor_response": "hello..thanks for trusting the health care magic doctors for your health related issues.in the present pregnancy u have to take proper rest because u had history of miscarriages in past.take 2hour sleep in afternoon and 8hours sleep in night. do moderate household work and take proper diet and medication as advised by your treating doctor.and most important thing- don't take tension and stress. be calm n cool and think positively because these are all affects ur baby.so be happy..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the possible treatments for fluids inside the mouth ?\n\nThere is a pocket full of fluid inside my mouth that keeps growing in not sure what to do about it. It was an excruciating tooth ache for about 2 weeks but I used lots of mouth wash and was massaging my gums with the tooth brush and that subsided but now I have this pocket that feels weird",
    "doctor_response": "Hello,As you are mentioning that you were having tooth ache 2 weeks ago and after that you felt that there is some fluid filled swelling present there , it looks like that the tooth was infected and now the infection has spread to the apical region and there is some pus there which is causing this swelling.Only mouth wash can not solve the problem you have to visit a good dentist, as he will go for root canal treatment of that tooth and the problem will be relieved.Thank YouRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take Metrogyl 400 thrice a day?\n\nMy family physician has recommended metrogyl 400 for intestine infection caused by food or water three times a day for five days. I have taken this drug before and could tolerate without problem. But at that time the dose recommended was twice a day. Advice please.",
    "doctor_response": "Dear FriendWelcome to HCM. I am Dr Anshul Varshney. I understand your concern.The actual dose of Metrogyl is 400 mg thrice a day for Gastroenteritis.You can take it 3 times a day.Just observe following:1. It can cause metallic taste in mouth.2. Don't consume alcohol with this medicine in case you take alcohol.This is my personal opinion for you based on available details. If you have any further query please ask me.Stay HealthyDr Anshul Varshney, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for flattening of the chest on the right side\n\nmy right hand side chest part look flat compare to the left side. i can feel the slope in bone wmy right hand side chest part look flat compare to the left side. i can feel the slope in bone when i touch to my chest. it seems right hand side part hasn't develop...",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Flattening of one sided of chest wall is seen in 1. Lung conditions like fibrosis of lung, collapsed lung, maldevelopment of lung etc. 2. Maldevelopment of intercostal muscles and ribs. 3. Vertebral deformity etc. So better to consult doctor and get chest x ray, x ray of lumbar spine and MRI spine if required. These reports are needed to rule out above mentioned conditions. So better to 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower back pain and testicular pain\n\nI m 36 male who regularly uses meth intravenously. I m having lower back pain and sever testicular swelling and pain. I have looked stuff up and I have many symptoms of Epididymitis. Could this be caused by my use? Is this passable through sex? Do I need to go to the doctor?",
    "doctor_response": "HIWell come to HMCThis may not be because of using of narcotic drugs but such drug are not good for health because this may aggravate the symptoms and may lengthen the course of disease, here the chances of infection is very likely and this need to be ruled out, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Jaundice infection, hepatitis C, high creatinine, brain hemorrhage. Kidney condition, renal transplant done. Life expectancy?\n\nHi, My father is a kidney patient and had undergone renal transplant 2 years ago. There was some virus of Hepatitis C found. From the last one and a half month he was suffering from Jaundice and he is admitted in hospital 10 days ago. Due to infection of Hepatitis C, his Creatinine rose to 7.2 and urea rose to 290. Doctors took him for dialysis and after 2 hours of dialysis he had brain hammerage. Now from the last 2 days he s on ventilation and his situation is very critical. His heartbeat, BP, and pulse are running normal and we have seen minor reactions from his side also. Please tell me is there any chances of life for him and can his life be as normal as before?",
    "doctor_response": "hi, I'm so sorry you're dealing with so many health issues of your father . I wish I could give you the straight answer you  so desperately need; He has multiorgan dysfunction . Please talk to your physician who will be in a better position to answer. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hurt thoracic spine while trying to get erect after bending. The back bones are sticking out. What to do?\n\nI bent over and stood back up while taking a breath and something messed up my thorastic spine. I have really bad pain when I stand up, back, stoamach, or if I move at all. Only relief is lying on my side. when my wife feels my back 2 vertebra's that are about 6 inches apart are sticking out and if I push anywhere on my lower back it makes my middle back hurt.",
    "doctor_response": "Hi and thank you so much for this query.I am so sorry to hear about what you experienced. Please, get consulted for your back to be evaluated. You would need at least and xray to understand what the real problem is before pursuing further investigations and proposing specific management for you. I hope you find this helpful. Thank you so much for using our services and please do feel free to ask for clarifications if need be. I wish you the best of health.Dr. Ditah, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and pain in my gums?\n\nUpper and lower pain in mouth gums feel swollen. This has been going on for awhile been to dentist and oral surgeon. They really don't know what to think and neither do I. Not real painful just feels sore and swollen and real tired of feeling this way.",
    "doctor_response": "Thanks for your query, I have gone through your query.The pain and swollen gums can be because of the gum infection secondary to deposits. Consult a oral physician and get it evaluated and get your teeth cleaned (scaling) once. Do saline gargling.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest best methods for IVF?\n\nHiMy husband 30 and I 27 miscarried in November. I am wondering if it is possible to use his sperm and my eggs fertilized and then place back into me? If so are there any specific things required for this to be done or is the available for anyone?Thanks",
    "doctor_response": "Dear Ms, yes it is possible .you will receive an ovulation induction that will stimulate your ovaries to produce multiple ova. then on the day of IVF these oocytes will be aspirated from you. then your husband will produce a semen sample by masturabtion . then sperms will be taken from your husband's sample providing that he has motile sperms in his semen. these sperms will be used to fertilize the oocytes . fertilized embryos will be transferred to your uterus after 3 or 5 days from the oocytes aspiration",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in left side of abdomen. Normal scan results. Any ideas?\n\nhi dr, my husband has a kind of pain in his left side of abdomen, all tests CT scane, MRI and colonoscopy are normal. but still he has pain? is it hiranya or some thing else. meanwhile he complains more about pain when he is on rest position on chair, or sit for many hours in front of computer,  while laying down gives him relaxation",
    "doctor_response": "Hi and welcome to HCM.If this pain depends on position and moving then this is more probable neuromucular pain and this is why his abdominal scan was normal. He should rule out pinched nerve or pulled muscle in left thoracla and abdominal region. Also it may be enlarged spleen or kidney stone so he needs further evaluation.Thanks for the query. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment to get pregnant?\n\ni was on the depo injection for about 3 years but me and my partner now want to try for a family. the nurse told me i was clear of the injection as of 8th of december but my periods still havent come back although i ahve always been light can i get pregnant before they come back if not is there anything i can do to help it?",
    "doctor_response": "Hello, and I hope I can help you today. It is true that theoretically you should been clear of the injection within three months of discontinuation, however many women after being a Depo-Provera for a long time do not resume having ovulatory, regular, menstrual cycles until 6 to 9 months or even up to a year after discontinuation.Unfortunately, it is difficult to artificially induce ovulation in women who are coming off Depo-Provera. If you were not trying to become pregnant, your cycle could be regulated temporarily with birth control pills, but if you're actually trying to get pregnant the best thing you can do with this point is to just keep trying and wait and see. If you feel any symptoms of pregnancy, and you haven't gotten your period for a while, I would do pregnancy test just to make sure. There is always a possibility even if your periods are not regular that you do ovulate sometimes.So in summary, continue having unprotected sex every other to every three days and give it some more time. 80% of couples will conceive within one year, and if after a year of trying you and your partner are unsuccessful, it might be a good idea to see a fertility specialist for an evaluation.I hope I was able to adequately answer your question, and that my advice was helpful.Best wishes, and good luck getting pregnant,Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My situations are making me curious to know about ADHD and OCD. Please help.\n\nHello doctor, I do not have any official diagnoses, but I am curious to know more about ADHD or ADD and OCD. Recently I was about to sit down to eat breakfast when I got sidetracked and started something else. One thing lead to another and next thing I know it is 45 minutes later, I have half of my room torn apart due to not finishing everything I had started, and I still had not touched my breakfast. I have had more of these types of situations recently, and it makes me frustrated and a little worried. I thought about going to see a doctor about it, but I was hoping for an opinion. Currently, I am not under any medications.",
    "doctor_response": "Hello. Start with one thing on another, and we may behave strangely. But it does not mean that you have some psychiatric diagnosis. The difference between abnormality and normality lies on a spectrum in psychiatry. Some criteria to define if a particular thing needs the attention of a psychiatrist. 1) Persistent in nature. 2) Disturb your day to day routine. 3) Functional impairment. 4) Disturbance of bio functions like sleep, appetite, etc. If all these things are not there, then I would not advise you to consult a doctor. If this last for some time, then contact a psychiatrist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can kitten allergy in family members make me allergic too?\n\nHi doctor, I am thinking about getting a kitten, my father and brother are allergic to it. So, it will be kept in the upper room. I want to know if I have the same allergies. During my college days, I have spent six years with cats, never touched them but you could see them walking around, some even came close and hid under my tables.",
    "doctor_response": "Hi.  Allergy can run in families, you have a chance of being allergic as your father and brother are allergic to cats but not a must. Being close to cats in the past for many years is a good indicator that you might not be allergic to cats but still allergy can develop at any age. You can do a skin allergy test by a dermatologist (skin doctor) to know if you are allergic to cats or not. Skin allergy test. ?Allergy. Avoid contact with cats, if proved to be allergic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffer from kidney stones and fibromyalgia. Need a suitable diet\n\nHi. I produce really large kidney stones and have been put on a foods to avoid diet - which was, basically, my whole diet. I am going to start taking Fosomax and was given a list of food to eliminate in this month before starting and then carry through for the next 2 years. Foods to avoid with my fibromyalgia is, well, another long list. Where can I find a list of food which I can eat?",
    "doctor_response": "You may google search for 'National Kidney Foundation' & various diet options for different kidney conditions are suggested.Meanwhile,maintain a high fluid intake(3-4lit) daily,avoid junk food,bakery food,fried food.Do not take over the counter drugs.Have good amount of fresh fruit ,salad in your diet.Stop consuming tobacco,alcohol in any form if you are consuming it.These are some of the tips which are likely to help you.Best of luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My left hand has felt very weak, itchy/numb and floppy constantly. Concerned?\n\nhello, since saturday my left hand has felt very weak and floppy. i dont feel like i have any strengh in it and its kind of an itchy/numb feeling. its constantly there and doesn't come and go but there are times i notice it more than others. i am 25 years old  and female. I'm just a little concerned and would like to put my mind at rest",
    "doctor_response": "Hello Weakness and numbness is usually attributed to peripheral nerve problems although other causes may be there. First of all, has the weakness increased/progressed since it started? Did you have any injury to your arm? Any radiating pain form your neck or shoulder? In Any case i would advise you to consult a neurologist/ physician as soon as possible so that you can be examined and the exact cause of your symptoms can be known. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling discomfort in abdomen, low blood sugar. Why am I getting this feeling?\n\nIm concerned about my constant feeling of low blood sugar and feeling of discomfort in my abdomen . My doctor says my blood work shows normal blood-sugar levels. This is becoming very stressful and difficult to live with. I feel awful all the time and can hardly go anywhere without the nagging fear of something happening. Please help.",
    "doctor_response": "Hello. Thanks for writing to us. From your description, it seems that you are suffering from severe anxiety and stress. Since your blood reports are normal and you have already been examined by a doctor, there does not seem to be any serious issue with you. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had birth control pills for 3 years and stopped. Periods regular. Undergone pap smear. Please suggest.\n\nHi, I am a 21 year old female, married, and officially trying to conceive. I was on birth control pills about 3 years and I quit about 6 months later. Since I quit I had very irregular periods until April of last year. Since last April, my periods have been back to normal and last 5-7 days (like it always has). However in those 2 years of irregular periods we had unprotected sex all the time and I'm still not pregnant. Now that I'm officially trying to get pregnant and my periods are back to normal, I'm trying an ovulation calender but its been 2 years and nothing. Should I be worried? Should we go get checked? P.S I mentioned it to my doctor when I got a pap smear (in February) and she said \"You're young, keep trying\"",
    "doctor_response": "Hi!As it has been 2 years since you have had regular periods and have been trying to conceive,it is advisable to have a preliminary work up.You and your partner would need to undergo a few tests.Your partner would need to give a semen sample(after 4-5days of abstinence),and you would need to undergo a premenstrual endometrial sampling to check for evidence of tuberculosis.If the endometrial sampling report is normal,a hysterosalpingogram to check for tubal patency and uterine contour is necessary.You can then undergo 2-3 cycles of ultrasound monitoring to check for evidence of follicular development and ovulation(intercourse between 24-36 hrs of ovulation has highest chances of ovulation).Drugs for ovulation induction would be started if there is a problem with follicular development.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chronic runny nose, nervousness. Allergy tests administered. Allergic to rye. Used nasal sprays, claritin, neti pot. Suggestions?\n\nI am 50 and have always had a persistent runny nose -chronic.  I do not appear to have allergies to outside sources i.e.. pollen, grass, etc.  I have been tested both here and in Germany where they poked the skin with the obvious allergens.  Rye was the only one they came up with.  They said I had unspecific allergies. I have tried lots of nasal sprays, claritin, etc with none working well. I use the neti pot but this doesn't stop it.  I find it Impacts my ability to think, talk, and eat.  It makes me nervous and I can't hit the soprano notes consistently like I would like in choir.  Do you have any new suggestions?",
    "doctor_response": "you have to avoid food which was alergic to you completely withdraw that food for pollens you can go for desensitisation therapy for environmental allergens but if that theapy is not avalable then you can choose to take fexofenadine 120 mg od or bd apply neosporin h eye ointment in nose bd sea water drops 2 drops at night each nostril yiu can continue without side effects these i have treted many patients with desensitisation therapy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will it be safe to take Metoprolol for high BP?\n\nI have recently started to use Metoprolol for  high blood pressure, and some days  and nights I get these attacks of pain in my lower back region. I t feels like  \"toothache\" on each side of my back. I can\u00b4t walk straight and it is very pailful and can keep me awake at night. What can it be, and can it be Metoprolol?Esther in Norway",
    "doctor_response": "Dear Esther,Your complaints are rather related to your spine, than Metoprolol.It is not a common side effect of Metoprolol.I would advise you to have a X-rays of vertebra done, or simply see you doctor.Wishing you good healthIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for elevated blood pressure after getting a refill of glimepride?\n\nHi, on 2/2/14 I got a refill of 2mg glimepiride. The pill itself looked different than it had but I had noticed changes in the look of medications before and was told the pharmacy had changed manufacturer so I assumed that is the case. The old pill was green, small, oval and had the numbers 3 and 21 on one side and ROY on the opposite side. The refill is white, rectangular shape and has the numbers 37 & 45 on one side and what looks live a v or check mark on the other. Today my blood pressure was slightly elevated. Usually its abt 130/65 but today was 179/66 at the doctor s office. Earlier in the evening, my head didn t feel quite right and a little while ago I awoke and my head and neck are feeling tight. Do you think I might have gotten a wrong medication? or perhaps my blood pressure has elevated again? I don t have a blood pressure kit.",
    "doctor_response": "Hey.. Hello . welcome. - tab. Glimipiride is a drug used for diabetes.. It can sometimes cause low blood sugar and gastric trouble, but it would not cause high blood pressure. So if the content written in your strip is Glimipiride it doesn't cause hypertension. So kindly regularly check your blood pressure from your doctor and get it treated if it is persistently high. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes 90% non motility of the semen?\n\ni did not have sex with my wife for 6 days because she had periods and on 6th day i had a night fall (not much) after this i waited for 3 days and went for a semen analysis and i got a very bad report 90% non motile and 0.2 million sperm count . did i choose a wrong day for semen analysis please help",
    "doctor_response": "Hello,Your sperm count and motility affected very much. You should repeat your semen analysis again after three days of exposure.If it is still abnormal, then further work up done to rule out causes like hormonal problem, vitamin and mineral deficiency, smoking, alcohol, diabetes, thyroid, drug history et cetera.Your random glucose, serum FSH, LH, Testosterone level should be checked.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i go for an another pregnancy?\n\nWas recently told I have ashermans syndrome and significant thinning in part of my uterine wall.  Another pregnancy will be risky.  Would require hospital bedrest starting at 28 weeks and delivery at 34 weeks.  Not sure if this is worth the risk as I have 2 healthy children.",
    "doctor_response": "If you have two healthy children why to take risk of having pregnancy.. It may get aborted.. So don't get pregnant",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abnormal pregnancy scan\n\nHi, may I answer your health queries right now ? Please type your query here...respected sir,am primi with 25 weaks now i have done scanning and in that left lateral ventricle measures 13.2 and rt lateral ventricle measures 9.4mm and nuchal thickness 6.6 and AFI is 9.94.. rest of the things are normal.. so what should i do? my lmp is 30/3/2010. and my age is 26. no history of abortions or any other disease.please help",
    "doctor_response": "Hi, I have gone through your question, and I think I have understood your concern. I will suggest you the best possible treatment options. 1 ) First of all do not panic. 2 )  I will suggest you to have USG at regular intervals of 4 weeks.  It will help to know if increasing size of lateral ventricles is causing pressure on the brain tissue.  Please request sonologist doctor to mention about cerebro ventricular ratio.  3 )  Rest continue with your routine pregnancy follow up and nutritional supplements.  Have regular follow up with your gynecologist.  I hope this answer helps you. . Thanks Dr. Purushottam Neurgaonkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent urination?\n\nHello. I'm 17 and male and lately I have been urinating quite frequently, and have even wet the bed in the past, however I do drink water much more than I used to. I'm also much thirstier nowadays than I used to be. I have also lost a lot of weight, I'm 5 foot 6 inches and I am now 135lbs when I used to be 160lbs about two months ago.",
    "doctor_response": "HiGREETINGS ARE YOU suffering from Diabetes or any other medical problems.? If not checked till now ,I suggest you to get your blood checked for diabetes and thyroid hormone. Hope my answer helps you. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood in urine after treated prostrate cancer?\n\nMy husband has prostate cancer (diagnosed in 2006).  He opted for brachytherapy and radiation treatments whichi were completed in 2007.  For the past year, he has had blood and clots in his urine which in catheterization for several days during one of the more extreme episodes (~ 4 months ago).   His urologist scoped his bladder concluding that no tumors were present -- his diagnosis was radiation damage to the bladder/vessels.  The bleeding/clotting subsided considerably; however, last weekend, it became more severe.  He was able to pass the clots and did not have to be catheterized.  We have been exploring hyperbaric oxygenation treatment -- do you have any other suggestions?",
    "doctor_response": "hello dear. First of all you should know the exact cause of bleeding. It can be due to some blood abnormality (like low platelet count, coagulation abnormaility), due to prostate tumor growing in bladder or new cancer of bladder or due to radiation effect. Discuss these factors in detail with your doctor.An MRI of the pelvis may be done. If it is due to radiation effects then you can go for hyperbaric oxygen therapy. regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for acute asthma\n\nI am trying to get over a relapse of  moderat acute asthma cause by brochitis. I am still on antibiotics and prednisone and inhaler. I never had asthma before.  Sunday I have a family reunion and I am feeling a little stronger but am afraid to go. For my health as well as being contagiousness to others. Do you recommend being in a crowd yet",
    "doctor_response": "Hi welcome to HCMDear Asthma is a very common respiratory disease, it affects the trachea and bronchial tubes by becoming inflamed and plugged with mucus. It can be triggered by allergies, air pollution, respiratory infections, emotions, weather conditions, This causes the airways to narrow, restricting the amount of air going to the lungs, and makes it very difficult to breathe .You are on  antibiotics and prednisone and inhaler . It is a matter of concern though , but should not worry , there are way to get rid of this problem .What you need to do is , to detoxify your system by modifying your life style and food habits and increase your immunity .1. Moderate exercise  , walk , Yoga , Pranayam - Deep Breathing - slow to  fast , Bhraamarri , Tribandh  , Kapaalbhati will strengthen your heart , chest and lungs , in fact whole body .2. Diet plays very important roll in maintaining your over all health . 3. Include all essential nutrients - fiber , vitamins , minerals and supplements full of antioxidants  and Use extra-virgin olive oil as your main fat.Increase intake of omega-3 fatty acids Vitamin B6 and Vitamin B12 are very important nutrients to treat asthma decreasing the inflammation in the lungs.Vitamin C Is needed to fight infection, increase the amount of oxygen and reduce inflammation. Lemon juice  and amla  are the  best source of vit C .Eat organically grown fruits and vegetables as much as possible. Take a level spoon of Turmeric Powder in a hot  goat's milk at bed time . It is contains natural antibiotics .Take crushed ginger , garlic with a little salt , a T spoon , before meals .Avoid protein to 10 percent of daily caloric intake. Replace animal protein as much as possible with plant proteinAvoid milk and milk products, substituting other calcium sources.Avoid processed foods carbs , sugar , fried ,fast foods , Tea , coffee ,alcohol and smoking , stress , sleeplessness and Constipation all will produce biochemical and metabolic conditions in your body that will decrease your immunity.So avoiding is definitely the first step in the right direction to detoxing the body, boosting the immune system .Always drink plenty of water to detoxify & keep your respiratory tract secretions more fluid.4. Yogic Kunjal - Drink 4-5 glasses or more of warm salty water ,retain for few seconds and vomit - force  vomit   the water . Repeat this daily for a week and twice a week thereafter .  Take tea prepared from ginger , basil , black pepper and honey .  Medical ",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fast heart beat and sweating at night?\n\nHi, last night i believe i had a panic attack, ive had them in the past, there was nothing to bring it on, i was just laying on couch and my heart started racing, which in turn caused me to walk around, etc... iam over weight, have hypothyroid, high cholesterol and blood pressure. i take medications for all three. i slept for an hour and the middle of my chest was sweaty but no where else on my body...weird huh..lol anyways that s my story. im walking around today and feel ok. Last night scared me enough to make an appointment with doctor to get a stress test done.",
    "doctor_response": "Hello,I would like to tell you that symptoms can be because of heart disease or severe epigastric reflux, but an evaluation to exclude heart disease is important.Kindly get an ECG, Echocardiography and stress test done as per your healthcare provider advised so that proper treatment can be given.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhanu Partap",
    "dialogue_context": ""
  },
  {
    "patient_message": "Did epidural cause blotchy, icthy rash all around my neck and down my spine?\n\nI am a diabetic and two weeks ago I had an epidural in my neck yesterday I woke up with a blotchy very icthy rash all around my neck and down my spine its still their could this be a delayed reaction to the epidural being diabetic I often have slow reactions when Ive had medical procedures",
    "doctor_response": "Hello,Hope I have answered your query. Let me know if I can assist you further.The symptoms seem to be related to an allergic reaction.It can be related to the epidural procedure.I recommend using anti histamines such as Cetirizine 10 mg daily.I also suggest using Betametasone cream for local application.Regards,Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How often is fluid removal from the lungs possible?\n\nI have had fluid removed from my right lung within the past 6 months. Now I can tell I am getting some in the other lung. This has been confirmed by my family physician. Is this dangerous? How often can it be removed? Is there a procedure other than a needle that can take it away? Why does it happen? Can I prevent it?",
    "doctor_response": "Hello,Usually, when the pleural fluid repeats, we do pleurodesis however, it depends on the cause of the fluid. Hope I have answered your query. Let me know if I can assist you further.Regards,      Dr. Jnikolla",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diabetic, creatinine serum rising. Prescirbed cilacar, nefita, clacix. Sufficient?\n\nsir, what is use of this tablet for a kidlney patient,patient is dibetic also.my brother is patient,therefore i am asking this for him. furtther, my brother is getting treatment from a reputed hospital in delhi but his cretinine cerum is still in rising stage i mean it has gone from 2 to 7.5 as on today. medicines prescribed by the doctor are : cilacar, nefita, clavix, lhd, zyloric, nodosis, alfalog, livogen,and to control sugar volix.2mg and glide althougu sugar is controlled, mail od YYYY@YYYY",
    "doctor_response": "HiThanks for the query.From your description the patient appears to be suffering from an advanced stage of kidney disease. The various medications you have mentioned are used to treat different complications of kidney disease.If the creatinine remains at this level the doctor may discuss with you the options of dialysis.Hope this helpsGood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the solution for erectile dysfunction?\n\ni need to ask u something doc . i hv been masturbating whn i was 14 maybe now m 23 i had sex before 1 yr nd it was good but recently i was hanging out with someone nd my penis doesnot hv that erection it wasnt stiff enough to hv sex ... its only when i m with her whn i came back nd i tried to see the problem so i start masturbating while masturbating it was stiff plzzz let me know as fast as possible m so much worried abt this :(",
    "doctor_response": "Hi,I have gone through your query.You are not suffering from erectile dysfunction, As you get erection while masturbating. The problem with you is anxiety which leads to improper erection with your partner. Medicine like Fluoxetine can be taken after consulting a psychiatric. There is no need to worry.You can contact me on my page  you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause bump around penis with pus?\n\nHi,I have been having a icy hot burn around the tip of my penis and low intense burn on the penile hole very mild with small spots of light green mucus coming out the tip of my penis hole. There has been a few small pimple bumps appear n but seems to go away over time...could you explain to me what this could be?",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have not mentioned about your sexual history in your query,The pus filed bumps on tip of the penis are likely to be transmitted through unprotected sex.Please consult qualified dermatologist or specialist in sexual medicine and get following tests done to rule out STI.1) Routine urine test 2) Swab test and culture of pus from the bumps.3) Basic blood test to rue out STI.In the mean while take Erythromycin twice daily .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes upper rib tenderness above the diaphragm area?\n\nHi my name is Joe Ann I am having upper rib tenderness above the diaphragm area. I haven t had any recent trauma about a year ago I fell and broke ribs on the left but the tenderness is on both sides. I d really be grateful if you could help.. I do have neck and back issues don t know if that can do anything but just letting you know. Thank you again.",
    "doctor_response": "Thank you, Mr. Joe Ann for your question.I got from your question that you have had trauma to your rib cage a year ago. Now feeling pain on both sides of chest wall. Well . . . To consider the causes of pain, there may be musculoskeletal, neuropathic, and others. Are you sure you ddidn't have trauma (to both sides)? Did you take a complete rest and received systematic and proper treatment after your trauma? Do you lift heavy weights very often? Do you feel pain in other areas of bone? Are you sure the pain does not come out from inside the chest? Any respiratory problems? What investigations have you done? I want to advise you to take a rest and avoid heavy weight lifting for about a month, and if symptoms not relieved, please do some investigations, such as Chest X-ray etc.. I'm looking forward to discussing about that in detail.Thank you so much.Have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain\n\nHi.i had a natural missedcarriage on April 28 2017 and my back still hurts doctor said I had no tissue left what can cuz aback pain . It hurts when Iam setting for a Long time standing and when I get up from bed or a chair. The pain goes to my front of my abdominal .",
    "doctor_response": "dear have you associated uterine prolapse along with miscarriage. uterine prolapse strech to ligaments which cause back pain mild in nature. show yourself to obgyn",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I go to ER fot discolored hand with difficulty in straightening?\n\nMy arm popped around the inside of my elbow while attempting to roll a large tree in my yard today. My bicep feels very sore and cramps tremendously when i attempt to bend it. when i straighten my arm out it pulls very hard on my bicep and inside of my elbow. my hand is dis colored. Should I go to the er? Thank you for your advice I greatly appreciate it!",
    "doctor_response": "yes go immediatly to er because looks like you dislocated your elbow dicolouration means pressure on major arterys or nerves immediate admission to er is recommended Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can acute retroperitoneal fibrosis pain be treated?\n\nI have had RetroPeritoneal Fibrosis for five years.  I am currently under four specialists...have tried absolutely everything from steroids (several) to exercising with a pro personal trainer, to being on Imuran for one year...nothing works.    The pain is, on same days, literally unbearable.  I am on morphine, fast relief and long-term.  I am on the verge of giving up.  Can you suggest ANYTHING ?  Thank you.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Sorry that you have such unbearable pain. Never give up and you have many options in this modern medicine. You said that you used many drugs. Have you used Mycophenolate? Was Rituximab tried for your disease?Rather than Morphine, I hope, NSAID group of drugs will reduce the pain better in your case. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Susmitha Chandragiri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility problems\n\nMy partner and I are undergoing tests for infertility at the moment and his semen test has come back 0% morphology and they were expecting to see at least 4%.  My partner has to take another test but now thinks he will never be able to father any children, is this the case?",
    "doctor_response": "welcomeatleast 4 % normal morphology is required to tell  normal...but its not always that you will not become parent..there are many options availabe.so dont worry..consult your doctorthanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in right temple when clenching right molars?\n\nI have a unilateral headache, that is, only at my right temple. And, there is a sort of pain somewhere in my right molars, i just don t know exactly where. When I clench my right molars together, the pain in my right temple intensifies. What do you think is this?",
    "doctor_response": "you have not mentioned regarding your dental history and your age  or sex. still the things that could bea pocket may be present on ant of the molars of right sideif there is any recent history of dental restoration is there than high point may be a reasonit could be temporomandibular disorder alsovisit ur nearby dentist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Lutera cause back pain, and vaginal discharge?\n\nHi, I am currently taking Lutera (birth control) and noticed a very light 3-4day period during my placebo week. Almost 2 weeks later, I noticed brown discharge for a day or so and then bright red, heavy flow for the next 5days. I m on day 7 and I m still having a relatively heavy flow (having to change out a heavy/max tampon every 3-4 hours). Some other symptoms I ve noticed are severe back pain to where I can t walk and stand up straight. I feel nauseous and have a loss of appetite that I thought was due to stress.",
    "doctor_response": "Hi, Yes. Side effects may be pain or discomfort in the arms, jaw, back or neck; pelvic pain, white curd-like vaginal discharge without odor or with mild odor. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ajeet Singh, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a lump in the right testicle?\n\nHello, i have a small (smaller then a pea) sized lump at the top of my right testical it is smooth and feels almost as there is gel inside of it with a grain of sand in the middle it moves back and forth and hurts if pressure is applied to it, I m kind of worried and wondering what it could be, my mother is a Veterinarian and she told me the symptoms just seems like a cyst and not to be worried, what do you think?",
    "doctor_response": "Hi.I had gone through your query.Whether it is lump or cyst best can be concluded by color Doppler of scrotum.Color Doppler or ultrasound will give more confirmatory idea.Go for semen analysis's also.If it is pain then wear scrotal support or scrotal bike.Analgesic can help to reduce pain and discomfort.Consult surgeon and get further assistance.I hope i have answered your query.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen abdomen and swollen tonsils\n\nHi maybe you can help. debating on weather to see a doc or not. I am just getting over tonsillitis and my tonsils are still swollen. about 5 hours ago I got discomfort / pressure in my left abdominal region right under my rib cage and it also looks puffed out or swollen. Is it normal for this area to look this way since there are organs in the area. I have not noticed it to be puffed out this way in the past. however it does fell (from what I remember) a little bit like when I had mono and my spleen was enlarged as this is what I am worried about; the spleen being enlarged. could it be anything else like maybe gas or something not as dangerous to my health? I also fell very tired and fatigued all the time and get lightheaded a lot. I fell like something is wrong but normally when I fell like this and go to a doctor they never find anything wrong. this statement is why I am debating on going to a doc or not. I am also going paintballing on Thursday and am worried about rupturing the spleen.",
    "doctor_response": "Hi.Thanks for your query. If you have tonsillitis you should see an ENT to get a proper examination, investigations and treatment.The swollen part on the left upper abdomen is not at all normal. This is indicative of some reason underneath.The spleen on enlargement can be palpated to be enlarged, is never seen to be enlarged like this unless it is massively enlarged. This can be due to gases in the intestines.I would further advise you the following:-Standing X-ray of the abdomen-Ultrasonography-EnteroclysisOnce the proper investigations and a consultation with a Surgical Gastroenterologist is done , you get a proper diagnosis and then a proper treatment can be instituted.Till then do not go for paintballing or any strenuous activities at all.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had ultrasound for cyst. Trying to conceive. Nothing seen in the womb. Had circular blood flow around an ovary. Pregnant?\n\nI had ultrasound for cyst, trying to concieve, still have a week before my period is due 6 days and although technician saw nothing in womb she said I had circular blood flow around an ovary is it true that is an early sign?? I have blood clots when pregnant so sooner I know the better although urine test was negAtive.   YYYY@YYYY",
    "doctor_response": "Hi,Thanks for your query. I read your query and I understand your concerns.Following is my reply:1)  It is not possible to predict about pregnancy so soon by doing ultrasound.2) Please do serum beta hCG test after 4 days to check for pregnancy.Let me know if you have anymore doubts.Regards,Dr. Mahesh KoregolIVF & Infertility specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe for a baby to take two antibiotics at a time for a 7-day course of treatment?\n\nHi! My daughter was diagnose with amoeba and urine infection and she s only 7 months and weigh 7.8kg. Her pediatrician gave her metronidazole 3ml 3x a dayfor her amoeba and co-trimoxazole 3.5ml every 12 hours for her urine infection. Is it safe for a baby to take two antibiotics at a time for 7 days treatment? thanks",
    "doctor_response": "Hi, No, it is not proper. Unless it is amoeba trophozoites in the stool routine - the kid does not require Metronidazole. Amoeba cysts in stool - does not warrant Metronidazole. It is not proper to start on antibiotics without urine culture. Hope I have answered your query. Let me know if I can assist you further. Thank you. Regards, Dr. Sumanth Amperayani Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have pain and redness of penis. Please help.\n\nHello doctor, The outer skin of my penis looks reddish. I also have pain at the point where the penis is attached underneath the foreskin. I do not have a problem with erection. Please\u00a0suggest medicines. Thank you.",
    "doctor_response": "Hello. Regards. Revert with more information to a sexologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Constant stomach pains 24 hours a day, what could be the reason for this ?\n\nhi i have hi pylori also a duodnal ulcer on my duodalnal cap and stomach pain all the time my gi doctor says i shoulht have that? any answers y im taking a prev pack atm to get rid of it this started before it tho also think i have ibs i lose a few pounds every week or 2 with the same ammount of food troubles sleeping and waking up nuasea and loss of apetitie alot and bad nausea when i wake up. any ideas what it could be i take 5-8 tyneol a day no help i take dexilant 60mg no help heating pad on high and low no help ideas?",
    "doctor_response": "Hi,You to see a gastro doc,as far as diet is concern,never keep your stomach empty, morning take 1 antacid,then go for Cold milk as bed tea, 2-3 hours later  go for fruits - banana ,apple,anar,melon after 2 hour -have light lunch,avoid fried after three hour have coconut water/cold milk + biscuits next two hours fruits dinner -light dinner Before sleeping drink some milk for night or early morning cramps keep milk,banana,apple handy tea,coffee,cola & frieds are big no no",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does using essential oils cause allergic reaction?\n\nEssential oils are the \u201cin\u201d things around here recently. People are using them to treat everything from insomnia, weight loss, to allergies. They are even telling people to take the oils internally without dilution. One of the main companies is even telling its sales people (they are MLM companies) that people cannot be allergic to essential oils because the molecules are too small to cause an allergic reaction to them and that if a person has a reaction it is a not an a allergic one but the body detoxing. I find this hard to believe. My understanding of allergies is that a person can be allergic to anything their body thinks is a foreign substance, even water. What are your thoughts. I have been unable to find a medical opinion of this online. Here is a link to what they are promoting",
    "doctor_response": "Allergies can be caused by anything on this planet until your defennce mechanism is so strong that anything foreign is not able to disturb your body or functions.In Ayurveda, the principle of balancing Pitta Kapha vitiation by using non toxic safe herbals, may win over such allergies.Hope it helps you to assess an indication to use herbals in such cases, without fear.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause and treatment for boils?\n\nhello dr. i have a two months baby suffering from boil like skin disease especially in her back. they raise, break with pus and leave black spot scars. she has been gien ampiclox syrup by doctors. they go though few come back. wht is the cause and treatment. thanks.",
    "doctor_response": "Hi.... a 2 month old baby getting recurrent boils means she is getting it out of bacterial infection. This is called recurrent pyoderma - this is not normal at this age. Rather than just treating the boils with antibiotic every time we should evaluate and investigate the kid for immunodeficiency.I  suggest that you consult your pediatrician regarding this with this tip and proceed further with evaluation for immunodeficiency.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for headache and shortness of breath\n\nim 18, 125. and 5foot 8 inches and have been taking vyvanse and adderal since I was 6. I take 70 mg of vyvanse for school and 40 mg of adderal for sports. I have been acting out lately when I take the vyvanse and I have been feeling out of breath. I also have been having massive headaches over my right  eye. not enough to make me puke but enough to make me flinch. or wince. but I have been doing things lately that I have never even thought about doing in my life",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. I can see your problem. You have been taking vyvanse and adderal since you are 6. Now you are 18. Therefore, the current symptoms of breathlessness and headache may not be due to medicines. Are you being anxious of late? That could be one possibility. Head ache above your right could possibly mean three things. Excessive stress, sinus inflammation or eye related problems. You need to talk to your physician to diagnose the correct problem and please stop worrying and getting anxious in the meantime.I can help you in this aspect. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes ulcers and burning sensation in genitals after unprotected sex?\n\nDr, 25 days before I have sexual contact with a girl and today I have ulcer type infection inside of the genital and I have burning sensation when I was passed urine , so i went   to the lab and attend vdrl test it's come negative. is it right dr?. than , why can I have burning sensation?.",
    "doctor_response": "HelloThanks for query,Developing ulcer over genital after unprotected sex with burning strongly suggest STD.Please get following basic tests done .1)Routine urine test and culture done 2) Swab test and culture of Urethral discharge .You need to take antibiotics like Erythromycin twice daily .VDRL is  positive 3-4 weeks after exposure and negative VDRL test done on second or third day has no significance.Ensure to wash your genitals with warm water twice daily.Ensure to avoid sexual encounters till it heals up completely.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Clonazepam the right medicine for panic attacks?\n\nI am a Viet Nam veteran with PTSD diagnosed by the Veterans Hospital. I was prescribed an SSRI drug for panic episodes but have a strong reaction to this class of drugs. I friend of mine is a 13 year veteran with the Marine Corps. with a full medical discharge due to his experience in the middle east. He has the same reaction to SSRI and was prescribed Clonazepam (0.5 mg) which helps him tremendously. Should I try to get my doctor to Prescribe this for my to try?",
    "doctor_response": "Hello there I have read through your question and would like to tell you that SSRI is the first line treatment used in post traumatic stress Disorder.  But since you are having side effects with it you can ask your physician for an alternative. Venlafaxine which is SNRI is a good option. Clonazepam does not have a proven benefit in PTSD but works in some people. But you have to discuss it with your physician as it is habit forming. I hope that answers your question. If you have any further questions please feel free to write. Thank you for choosing healthcare magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sore tongue, taking Prilosec. Any ideas?\n\nI have a sore tongue (on the left side) that has been sore for 3 years. There is nothing you can see but it is sore. I think it started after I had been taking Prilosec for about 15 years. Doctors tell me it doesn t have anything to do with it. I have seen my dentist , 2 oral surgeons, ENT, and they just say they can t see anything. It is really annoying. Any ideas?",
    "doctor_response": "Hello and thank you for your question. For a sore tongue that has been sore for three years but does not have any physical markings I would suggest that the tongue may not be the source of the pain.  You may be experiencing what is called referred pain.  In other words you feel the pain in your tongue but it may be originating in another part of your body, like an ulcer in your stomach, or a tumor in your jaw (these are just examples not me stating you have these).  Your tongue pain may be caused by glossitis, inflammation in the tongue as well.  Causes of this include vitamin B12 deficiency,  Sjogren's syndrome, and side effects of medications or chemotherapy. Since you are chronically taking prilosec, this may be due to a vitamin B12 deficiency.  According to one study I read when used over a long period of time, such as three years or more, prilosec can cause a vitamin B-12 deficiency. Signs of a B-12 deficiency include a sore tongue, unusual and unexplained weakness and numbness and tingling in the hands and feet. I hope this helps you in your discovery of your problem.  I recommend taking a Multi-B vitamin and see if the issue subsides in a few weeks. Best wishes and good health Dr. Ward",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for thumb infection\n\nMy wife has an infection under her thumb nail. She has stripes under 2 or 3 finger nails. Has had this off and on for 5-6 years. But The thumb infection is the worst yet. We went to the local doc. and she said fungus and proscriped smz/tmp ds. With a follow up with clobetasol Propionate ointment. Can t find online any reference to fungus with these meds. Jim Wheeler",
    "doctor_response": "hello, doc scratch is minor injury unless there was bleeding. if its only oozing of blood it is a minor injury. You just have to under go minor category vaccination schedule. Apart from that you have to have an antibiotic and tetanus toxoid.     Ideally by washing thoroughly under running water for 20 minutes removes 80% of virus. but don't worry your self of it since you have already taken the vaccination. Hope this helps. thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the reason for tinnitus in my ear?\n\nHello doctor, Recently, my ENT doctor suctioned a lot of fungus from my right ear and it fixed the problem. However, high pitched ear ringing continues to be a problem without any pain. It is more of a pulsating feeling and that synchronizes with my heart rate when I am in the prone position. My hearing is just fine. My only problem is ringing sound in the ear. Is it possible that the fungus could have spread beyond my ear drum into the middle ear? Any help would be much appreciated. I am seriously sleep deprived. The last thing he told me to do was continue with the antifungal for seven days and visit after a month. He mentioned that something in my nose was bent. What is the reason for my tinnitus?",
    "doctor_response": "Hello. You are suffering from otomycosis also known as swimmer's ear. It is the fungal infection of the external ear. The symptoms include itching, ear discharge, ear pain, ear fullness, temporary hearing loss and tinnitus. Although most individuals will get immediate relief from tinnitus following the treatment, some may continue to experience ringing. Standard management includes a course of antifungal drops to be taken five times a day for 1 to 3 weeks. As the name suggests, this condition often occurs due to excessive moisture in the ears. Hence, it is very important to clean and wipe dry your ears after bathing and swimming. Do not clean your ears with bud frequently as frequent cleaning with a cotton bud prolongs the condition. For further information consult an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does bite from squirrel cause rabies?\n\nI was bitten by a squirrel while trying to capture it. It s leg was broken and I wanted to help it. I was bit through a sweatshirt and cleaned the wound with peroxide and warm water and put a band aid over it. I had a tetinis shot a year ago and I am 13. What do I do? Could I have rabies?",
    "doctor_response": "Hi,Thank you for your query. I can understand your concerns.Small rodents, such as squirrels, hamsters, guinea pigs, gerbils, chipmunks, rats, and mice, and lagomorphs such as rabbits and hares, are almost never found to be infected with rabies and are not known to transmit rabies to humans.An injection of tetanus toxoid is all that is required.Regards Dr. T.K. Biswas M.D.Mumbai",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can ADHD be treated?\n\nMy 13 year old son is on 40 mg Focalin that I give him between 6:30 and 7 AM. It doesn t seem to be lasting more than about 5 or 6 hours. He has gym class around 11:30 AM and after that, it seems the medication is gone. He is a very good athlete and plays sports very hard. After gym, his grades drop like a rock. What effect does gym class and how much he s eating have to do with how long the drug is effective? Sometimes he races out the door with no breakfast and that seems to diminish the effect of the medicine, too. What can you tell me about this situation?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Focalin XR is a long acting preparation. The drug action lasts for around 12 hours. If the drug effects are waning even in 6 hours then please talk with his doctor and ask if there is any need to up the dose of Focalin. He should take the drug with food which will help in better actions. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe waist pain\n\nI feel on my bottom and am heavy set person. I didn t feel much pain day but am experiencing pain on upper side of the back above waist area. I can sit slouched and feel some comfort but when I try to straighten up both sides hurt real bad. When I cough or laugh it well hurt real bad and sometimes when I move well get so tight. It feels like someone has a tight grip on the sides of my upper waist. Not sure if this could be a strain in muscles or could I have cracked ribs?",
    "doctor_response": "Hi,Thanks  for  your query.The symptoms you have described are more likely to be symptoms of muscles strain.To get relief from the pain and for quick healing:1. Do hot fomatation at the site.2. Apply local anti-inflammatory gel 2-3 times a day.3. Take anti-inflammatory drugs like Ibuprofen to reduce pain and local swelling or inflammation.4. Do not lift weight or try to do exercise that involve painful muscles. Give proper time to heal.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have breast cancer. Taking antibiotics. Suffering from stomach upset and mucus. Suggest\n\nI have breast cancer in my lungs and one lung is partially collapsed. I have a bad cough so my onc put me on anitbiotics. I'm about half done (5 of 10 days) but the mucus is unbelievable! I have always swallowed it but now my stomach is upset. Is the only thing to stop the mucus production time? Is there anything else I can do while waiting?",
    "doctor_response": "Hello friend,I hope you have breast cancer and along with that or secondarily developed lung cancer also. From the history it appears that the collapse of the lung and the diminished activities in the organ produces extra amount of mucus which is constantly brought out by cough. Antibiotics will not be useful because it is not the bacteria that make the problem, it is the general deterioration you have that make you prone to infection if at all it is there. So what is required is to improve your vitality. I am a homoeopath and so my advise is to take Homoeopathic treatment where YOU and not your diseased organs become important for the selection of the remedy. Antibiots may kill the bacteria for some time and is sure to recur because in addition to the lowered vitality, the strong chemo drugs will again weaken the constitution. Therefore approach an expert Homoeopath who can give you relief from the sufferings, not only from the cough which is less important when considering the disease cancer at present active in you. Homoeopathy can save you. My best wishes for a speedy cure through HomoeopathyDr. C. J. VargheseHomoeopathdrcjvarghese@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for esophageal Cancer\n\nHi.. there was a upper esophageal Tumor in throat..operated during  that..the food pipe got rotten and dr.cut the rotten part and joined the rest Food pipe with stomachafter few days of this operation there was a pinhole linkage though afterwards treated by dr ..but by that food pipe got shrinked.and intake of any liquid is stopped.so please suggest the further treatment for curing shrinked Food pipe.. so that the patient can intake some thing",
    "doctor_response": "I appreciate your  concernew. before giving any comments a patient review is required. but as you have described an esophageal stenting can be done or if patient has good performance status then PEG feeding can be started",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden sweating, unresponsiveness and head drooping in infants?\n\nHi Doctor, my baby of 8months normally very playful, suddenly went cold and started sweating. The baby also began to feel unresponsive and head slightly dropped. This happened a few minutes after cereal feeding. This was so for a few minutes and gradually improved. Now she s absolutely fine. What happened?",
    "doctor_response": "Hello                       Sudden unresponsive with head drop could be to  due to 1. atonic seizures , 2. if there is history of excessive cry before attack it can  breath holding spell 3. I will like know if there is history of choking . If it is a single episode there is nothing to worry , but baby once needs examination by a paediatrician  to rule out any major illness /problem , development assessment of child.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high fever and leg pain in kids?\n\njust curious if there is some sort of virus going around causing high fevers and leg pain? My 4 year old had to be picked up today from school due to a very quick onset of a high fever. She s lathargic but says she feels fine, just that her legs hurt. Just curious if there is something more common going around right now.",
    "doctor_response": "Hello, It depends on the area you live. This season will put children and elderly at risk of catching flu. Take her to a physician or pediatrician and find out the reason. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Jasmine Jagan, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for abdominal pain, coloured urine, headache and blurry vision?\n\nI am a 19-year-old female from Africa. I have intermittent episodes of Coca cola colored urine, abdominal pain, trouble swallowing, headache and sometimes blurry vision. My IgG levels are over 2,200 and my IgG1 in particular is elevated. I had a test that was equivocal for Paroxysmal Nocturnal Hemoglobinuria. I also have Iron deficiency anemia and get regular intravenous iron infusions. This has been going on for a year. My hematologist seems to have given up trying to get a diagnosis because the test was equivocal. What should I do.",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.Obviously go for repeat tests and second opinion of another Hematologist.The history is suggestive of hemoglobinuria. Another possibility is of Porphyria. In this condition you get almost similar symptoms and pathology. The Urine is kept in a glass bottle and exposed to sun-rays for a day to see whether it is turned into the brown color or not. The treatment is obviously symptomatic, to take plenty of oral fluids as the detailed to be followed as per the advise of a Hematologist. Another opinion of a Urologist may help '",
    "dialogue_context": ""
  },
  {
    "patient_message": "How dangerous is adenoiditis in a toddler?\n\nHow dangerous is adenoiditis in a child 2 years of age. My granddaughter has been sleeping almost all day and night for about 4 days now. At the day care she just sleeps with noise all around her. She is on an antibiotic right now but I m concerned about her constant sleepiness.",
    "doctor_response": "HI...by what you quote I feel that she might behaving a sleep disordered breathing or upper airway resistance syndrome. Se might get benefited with intranasal steroids for 6-8 weeks. This is a sort of allergy. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best method to avoid pregnancy?\n\nMy girlfriend is 19 years of age. Around 12 hrs back we had intercourse. It was protected but somehow some semen managed to leak out (i GUESS from the base of the condom...well we couldn t see any leakage from the body of the condom as such). Now there was some amount of semen on her thighs. She freaked out and tried cleaning it. After this she got more scared and put the same fingers in her vagina to check if there was any semen inside. Now we are scared about what to do as the pills seem to have very bad side-effects [and she is pretty young which might affect her life ahead]. Moreover we ll have to wait for around three weeks for taking the pregnancy test. If negative then its great, but if its positive then she ll have to get an abortion done. Please help us with the decision. we re in great distress....",
    "doctor_response": "Hi, I have gone through your question, and I think I have understood your concern. I will suggest you the best possible treatment options. As you said, the unprotected sex act has happened in last 12 hours, it is best to use emergency contraceptive pill like i  pill or Plan B . It is quite effective if used within 24 to 72 hours of unprotected sex act.  If you can use it , she will mostly be protected from getting pregnant.  I will suggest you to get proper sex counselling done. I hope this answer helps you Thanks Dr Purushottam Neurgaonkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in anus and ab muscles every time I cough?\n\njust got over flu took med thera flu cough med with codine been 7 days now when i cough pain in anus area.no issue in going bathroom infact been very easy go comes on fast.AB muscle did hurt from hard cough but that past 2 days ago wondering if i should have conceren. no blood and im truck driver not same as hemroid.",
    "doctor_response": "Dear sirYou shoul go and check yoursel to a proctologicst, surgeon. They will do you an inspection and maybe a colonskopy. Ps. Sometimes there is blood but you cant see it. For that you need do  some analisis for ocul blood.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible despite taking a contraceptive pill?\n\nI was just wondering, I m worried because I am sexually active & my boyfriend and I had sex and he cummed in me (condom broke) in under 5 hours I got a morning after pill & I got my period a bit later then normal. But now it s the 2nd month after I took it and I haven the had my period since... I m 12 days over my due date! Should I be worried?!?",
    "doctor_response": "Hello,I have gone through your query and understood the concern. There is no need to worry about the possibility of conception in the current scenario. The reasons being the use of an emergency contraceptive pill within the stipulated time and the attainment of normal menstrual pattern after the incident. The cause of the current delay in the menstrual cycle is more likely to be a transient hormone imbalance. This can happen due to stress or use of the high progesterone pill in the previous cycle thus disrupting the hormonal milieu of the body. Please check with your health care provider and plan further management. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sore throat, pain on swallowing, hoarse voice. History of allergy related cough. Treatment?\n\nI have a sore area on the back of my throat left side, hurts when I swallow . My glands do not feel swollen but when I touch my adams apple it hurts. My voice is hoarse and I feel a need to clear my throat every once in a while. I did have an allergy related cough for several months, but after several medications which didn t help, i quit eating peanuts/peanut butter and my cough and nasal congestion went a way. I had been fine for several weeks, until this soar throat came on 2 days ago.",
    "doctor_response": "Hello dear patient First of all You need to do gargles with salt and water twice Take Tab;amoxil500 mg three times daily Tab panadol 2three times daily Strepsles 1three times daily All for 5days Take care Regards Dr muhammad akbar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can plan b pill causes abdominal,back,rib pain and headache?\n\nHi, i had sex on thursday, we used a condom, and he ejaculated in the condom but when i came up the condom was half way hanging out of my vagina, the close part was still in my vagina and the open was no where close, on friday i took plan be, ever since i have been have lower abdominal pains, back pains, rib pains and a head ache, is this normal?",
    "doctor_response": "Hello,You seem to be experiencing the pill effects, though rib pain may be non-related. You are safe from conception since you consumed the pill soon after the accident, and more so, if you are in the safe period. You can expect some amount of withdrawal bleeding within a couple of days as the pill disturbs the hormonal balance of the body owing to its high hormone content. Your next natural period may get delayed by a week or two and please contact a specialist for further help if  you do not see a period even after ten days after it is due. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it to be concern about the bumps in the finger along with swelling due to a hit?\n\nWhile playing rugby, I jammed my fingers on the ball. My middle finger got swollen, but not too bad. But in the morning I saw a little bump on my middle finger, right below the middle knuckle. You can only see the bump when I bend my finger. Clenching my fist hurts, but it hurts most to extend my finger, and it only hurts a little when I bend it. The bump is hard, but not solid, it doesn t move around, and only hurts a little bit to touch. It s been almost 2 days and it s still a little swollen.",
    "doctor_response": "Fomantation with warm water should help you.Do gentle finger movements.Do not press it often to judge the degree o pain.You may take paracetamol 250mg BD along with MULTIVITAMIN TAB FOR 2-3 DAYS.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had surgery for tumors in abdomen, adrenal gland removed, experiencing pain, kidney issue . Reason? Treatment?\n\nHello. I had surgery 7 weeks ago to remove 3 benign tumors in my abdomen . I had 2 large dermoid ovarian tumors (size of an orange and grapefruit) and my adrenal gland was removed due to the adrenal tumor being the size of a racquetball. Fast forward to last week and I suddenly began experiencing pain in my lower right side. Sometimes it is in my lower abdomen (similar to the feeling I had when I had the ovarian cysts) and sometimes it is in my right lower back. I am concerned that I am getting another cyst or that I have an issue with my kidney. Other than the tumors, I ve been a very healthy person. I m 5 3 and weigh 105 lbs. Could you provide any insight as to why I would be feeling this particular pain? Thank you, Keri",
    "doctor_response": "HelloThanks for your query.Based on the facts that you have posted it appears that you have undergone surgery for removal of ovarian tumour and adrenal tumour as well 7 weeks back and now getting pain in lower abdomen .Most likely this pain may be due to post operative adhesions in abdomen which develop due to surgery Most of the tie these adhesions get absorbed over a period of time. However consult the surgeon who has performed the surgery for evaluation and further treatment.He may advise to get ultrasound scanning of the abdomen to confirm the diagnosis,In the mean while take pain killers like Brufen available over the counter of medical store. Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can swelling around the knee post an injury be treated?\n\nI fell and went down real hard on my knee, i have a swollen place that feels hot to touch and i am brused all the way down to my foot and it seems to be going on down. I fell a week ago, my knee is better but i still have a large place on the knee that feels like it has fluid in it, what should i do.......thanks",
    "doctor_response": "Hi, You can consult your orthopedician and get evaluated. As the first step, we can go for conservative measures like ice packs and analgesics for symptomatic relief. If symptoms persist, you might require an MRI scan for further assessment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rashes on the back of head?\n\nMy daughter had a rash appear today on the back of her hand. Size smaller than a quarter, an irregular circle shape and red with white ovals (non-raised, not fluid-filled) inside the red area (total of 6 white oval-shaped areas). The best way to describe it is a honeycomb. It doesn t itch and almost resembles a burn of some kind, but she did not burn herself. Ideas?",
    "doctor_response": "Hello, Appearance of honey comb rash on the back of the hand on a single side indicates the possibility of local pathology such as exposure to some allergens or local infection on the affected part. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ashok Kumar, Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I cannot sleep well and I have ankle pain at night. Why?\n\nHello doctor,I am 25 years old, have a job and study besides. I cannot sleep well when I come home. I wake up every one hour. I also have terrible pain in my ankle at night and in the morning but disappears during the day. Moreover, I have a high temper and worry a lot about everything.",
    "doctor_response": "Hello. From the given symptoms, it is not possible to zero in on the exact cause of your present condition. But because you have mentioned you work as well as study and have a tight schedule, the sleeplessness could be due to the stress you are experiencing. We cannot yet say it is stress disorder. But it has to be stress-related. Regarding the ankle pain, when the muscles relax, it pains and when it is stretched there is no pain. It has to be arthritic kind of pain. For that, I suggest you consult an orthopedic. For stress, you should try to reduce the stress you are taking now. Learn relaxation techniques. Start physical exercises and be calm. I suggest you consult a psychologist online or in person. There is no need to worry. Take care. For more information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain after fitting mirena coil with unpleasant discharge?\n\nI ve had the mirena coil fitted for just over a year now and have had abdominal pain in my right side ever since, it feels like it s in my tube. Just recently I ve had stringy sand coloured dishcharge with blood in and has an unpleasant smell to it, I know it s not BV as I ve had that before and it isn t a fishy smell",
    "doctor_response": "Hi ! Good evening. I am Dr Shareef answering your query.Even though you need a gynaecological examination with related investigations like an ultrasound/urine test/culture sensitivity test of the discharge to arrive at a definitive diagnosis, for the present you might go for some kind of anti inflammatory drug along with a proton pump inhibitor, and a broad spectrum antibiotic to be prescribed by your family physician. However, you have to get an appointment with a gynaecologist  in your area for further detailed management of the problem.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I unable to conceive after taking B Long F Tablet?\n\nheloo sirare u therepresent month i am trying ti follicular test and i am alsi take a medicine B-Long- F, i am doing all steps as per suggest by my dr. but still i am not pregenent  why my all test positive also my husbend - simen test  plz suggest me help me Dr. plz my mail id - sharma.  YYYY@YYYY",
    "doctor_response": "Hi, only b long f tablet will not help. You have to take medicines for growth of your follicles and track your follicles growth by repeated ultrasound.  When follicles reach a size more than 17 to 18 mm  , take injection for rupturing the follicles. Be in contact with your husband for next 2 to 3 days.  Take progesterone for next 2 weeks.  Do a urine pregnancy test at home after that.  You can try like that for 3 to 6 cycles. Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes brain fatigue along with drowsiness?\n\nI need a real neurologists opinion. As bizarre as it sounds for around 6 months I haven t felt feel fully awake and alert. When I m walking around it feels like I m in some foreign foggy dream. It s a drowsy/groggy/drugged feeling. It affects my focus big time. It s very uncomfortable. * After awhile I noticed that my brain would fatigue with focus on things like simple that I used to do easily: I.e. reading, memory, conversations, thinking things through, etc. I can literally feel the strain/tensing at times. And that is what truly has me concerned. Did Blood Work: B12 low end of normal. I then went to the hospital and the routine bloodwork and CT scan were normal. Month 2-4: About a month after this my entire head feels semi numb (hard/stiff) from front to back. It doesn t feel quite the same as a headache and it s NOT relieved by ibuprofen. Its also light, as if there s lack of blood flow, oxygen, or normal activity going on. It feels like I can t absorb all the way what s going on around me. My head also feels smaller in size. Month 5: Primary care doctor did full exam and general blood work w/ CRP for generalized inflammation. All normal. My nerves have become much more sensitive. Things seem more intense. (lights, sounds, images, being outdoors) ***This is all day long. Other issues: Vision distorted/foggy (colors look enhanced too) Fatigue Tight neck needing to be popped I can no longer take coffee or foods with sugar If I do I ll feel way more spaced out. sleep is light and sometimes I will wake up feeling disoriented Just 6 months ago I was fairly active, working, healthy sex drive, decent shape. I haven t been sick with anything in years! This did come on shortly after some serious emotional stress from family. But still this is crazy. Any idea as to what could possibly be going on here? I m only 37.",
    "doctor_response": "Hi, If all investigations you did were normal, you could have psychological fatigue (neurasthenia). You need vitamin B complex tablet and sulbutiamine (Arcalion). Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dr/Mustafa, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I play football again after retinal tear?\n\nHello doctor, Can I play football again after retinal tear? It has been seven months after eye laser and I have been great, no more flashing lights for few months and no vision problems.",
    "doctor_response": "Hi. I, unfortunately, have to say no. The fact that you have had a retinal tear which had to be treated by laser tells me that you are at future risk of another tear. The tear by itself can progress to retinal detachment and can permanently decrease the visual acuity of your eye even after treatment. Please avoid all contact sports and attend follow-ups as instructed by your ophthalmologist. Anomalous PVD (posterior vitreous detachment). 1. Indirect ophthalmoscopy. 2. B-scan ultrasound. 1. Retinal hole. 2. Retinal degeneration. Retinal tear post laser. Observation. Avoid contact sports. For more information consult an eye care ophthalmologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruising on the buttocks after stopping injectable iron?\n\nI stopped taking iron (injectable) 15 months ago, but I have the same large bruise/staining ever since and the top of my buttocks always feel like someone has beaten me with a board across the top of my buttocks, which hampers my comfort zone while sitting and laying down. I was also diagnosed with fibromyalgia with chronic fatigue about 20 months ago. Why do I have this constant bruised feeling?",
    "doctor_response": "Hi I did review your concern my friend. Your bruising can be due to multiple reasons. You need to do compelete blood count for hemoglobin and platelets and also PT, PTTK for coagulation profile. DO you experience bleeding from anywhere else. You can send your complete details to me and I can analyse your problem better.I hope this helpsWIsh you all the best for your health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to recover from the small cell carcinoma of the skin?\n\nhi,my father was diagnosed with small cell carcinoma of skin. he's gone under an operation for the lesion on his left shoulder. surgical boders were clean. he is 90 years old and healty comparing his age. doctors say chemo may be toxic in his age and advice follow up. what should we do? thank you very much.",
    "doctor_response": "I agree chemotherapy will be too much for him to tolerate.Close followup is the best course of action.In the event of recurrence at the local site, an option of reexcision is available, if not feasible radiation is also available.In the event of recurrence at any other site on skin, surgery is always available.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes knotted muscle in neck & shoulder?\n\nIt seems if I do much of anything with my right arm, my shoulder, elbow and wrist start to ache. It keeps me up at night. I feel I need to put pressure on them for them to stop aching, but that doesn t always help. It also usually creates a knotted muscle between my neck and shoulder. Is this old injuries popping up, and does the weather affecting these areas? I am 51 years old.",
    "doctor_response": "Dear Patient,it seems you are suffering from disc prolapse in the cervical(neck) region, this neural pain feels like it will improve if pressed, but on pressing it exaggerates.i feel you need to check the neck movements, and if they are painful than the chances are even more.the  investigation of choice in your case would be an MRI of the cervical spine, this will give details of the inner pathology of neural compression.I want you to realize that taking this lightly will increase it much, so please consult your doctor, and get investigated.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lesions in pancreas\n\ni have been told i have a questionnable lesion on the pancrease . dr, is doing biopsey . my liver enzymes are elevated . i have lost alot of weight have i been giving a death sentence. can there be hope for me there is alot of cancer in my family. i am so scared.is there any hope for me .",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have questionable lesion in pancreas so it may be simple lesion or cancer.  Only biopsy cangive you exact.  You shshould go for biopsy. It will give you exact diagnosis. Then you should take treatment accordingly.  Don't worry much about that.  Just be relaxed. wait for your biopsy results. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing my stomach cramps with soreness in back?\n\nDear Sir For months on and of I have been having bad stomach cramps. Usually the left side but it starts on the left side and moves to lower middle of abdomin and then moves to the right. I am in more pain if I am standing than I am if I sitting down or lying down. I ending up in A and E the early hours of Sunday morning as the pain got so bad - the pain was just under my rib cage down to lower abdomin all over my torso - no specific side - was sore al over. since sunday my back has been sore but these pains keep coming and going. I have tried getting an appointment with the doctor but they cannot fit me in Til a week on Wednesday. Can you please help?? Robyn",
    "doctor_response": "Hi! Good morning. I am Dr Shareef answering your query.From the history of your symptoms, it could be a gall stone disease, or a pancreatitis specially if you consume alcoholic beverages. If I were your doctor, I would suggest you to report at an ER of the nearest hospital and till then would advise you for a proton pump inhibitor and an anti spasmodic drug. I would also  consider you for an ultrasound abdomen along with a serum amylase, and serum lipase estimation along with other routine blood tests to rule out the above possibilities.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest natural remedies to get rid of eczema\n\nHi, I have very bad eczema on parts of my body such as the crook of my arm and behind my knees. I use a cream to get rid of the eczema and it works very well but i was wondering if there are any natural remedies to get rid of eczema because the cream is too expensive, but i have easy access to Aloe Vera, tea tree oil and lavender oil.",
    "doctor_response": "Hi,    Eczema is  an inflammatory skin condition of skin, with apparently no complete cure.A life long use of cortisone ointment is not practicable due to it's cost & side effects.It has to be managed naturally with use of medication in exacerbation.     Natural management consists of-   - change in eating habit. eating with maximum vegetables,fruits,salads,nuts,seeds in natural form, to provide Omega 3 fatty acid, vitamin  A,D,E, Avoiding fast food, milk & dairy products.    Primerose oil supplements  reduces inflammation.  - Were loose clothes,preferably cotton clothes, avoid itchy,scratchy clothes like wool. Be sure to rinse with ample of water & remove all detergent while washing them.  -  Do regular exercises. Meditation , listening to music, sound help  remove psychological stress. - Use mild, glycerine soap for bathing,Take a cold water/ warm water bath. avoid hot water bath/frequent bathing.use moisturizer that suits you, keep   room humid( Humidifier) -Use aloevera,Chamomile,Calendulla  gels/lotions for local application.- try homeopathy, acupuncture treatments.   Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will nightfall cause any problems?\n\nHi, I am Gurinder Singh, 26 yrs old unmarried Men.Everybody is saying that night fall has no effects on any part of your body but i would say i feel too lazy & lethargic after nite fall. Though it happens 1 or 2 times a week, but it still effects me mentally with kind of low memory power and loss of enthsiasm. Pl guide me on that.",
    "doctor_response": "Hi,These all are false fear or idea about night fall or masturbation.At this age due to sexual thoughts and seeing sex videos will be resulted in night fall.Having these type of feeling is purely psychological.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe shoulder pain\n\nHi Dr. Rynne, I m a 58 yrs old female American but not a native speaker. I damaged (?) my shoulder (Rt side) one day (unknown reason) and now it s slowly getting worse - it only hurts when I use my arm in fast/sudden motion. thanks for taking my question.",
    "doctor_response": "Hello,Since you are not sure of the traumatic event its possible that this not to an injury.This could be the beginning of an inflammation of the shoulder tendons which connect to the bone. Pain medication like diclofenac or celecoxib can be used(take care to protect your stomach with anti ulcer agents)Try a hot pack after a local cream application and then a round of rotatary shoulder exercises.Physical therapy and ultrasound therapy will help as wellIf you are a diabetic do make sure that it well controlled",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for joint pain\n\nI had lamectomy and discectomy 7 months ago. I had a csf repair 10 days after the first surgery. Now I am having pain in every joint in my body, from my toes up. In the mornings it is the worst. I can hardly walk from the back, leg and foot pain. Is this a reaction to the csf? What do you suggest I do?",
    "doctor_response": "Hello,The join pain can be related to rheumatoid arthritis. I suggest to check the rheumatoid factor level for further evaluation. Meanwhile, I suggest using anti inflammatory medications such as Acetaminophen to relieve the inflammation. I also suggest gentle stretching exercises for relief.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My fourth generation antigen-antibody test is negative. Is it necessary to do a retest?\n\nHello doctor, I had two sexual encounters with women whom I do not know their HIV status. Both were vaginal and a condom was worn. In the fourth and fifth weeks, I had a fourth-generation antibody-antigen test performed and it came back negative. Should I be retested again?",
    "doctor_response": "Hello,  Welcome to icliniq.com. It is a good idea to get repeat testing, here is why. The antibody testing at the fourth and fifth weeks can give you some idea of the HIV (human immuno deficiency virus) status, but the one at 12 weeks after the exposure will confirm the negative status completely. The reason being the window period. The window period is a duration where a person can have HIV but still test HIV negative. The fourth generation is antigen-antibody based testing and the best we have so far for screening. When suspected acute HIV infection or high risk exposure, PCR (polymerase chain reaction) is the best in the fourth and fifth weeks post-exposure. Of note, the window period for a fourth-generation antigen-antibody test is short as compared to other HIV tests available (about four weeks). Usually by this time, 95% of infection will be detected in the blood. In general, there is a three month window period for HIV after a given exposure, and therefore for the fouth generation testing to confirm that a person is more than 99.9% infectious. Hence the 12 weeks retesting is recommended. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for fever,cough,cold,vomiting and diarrhea\n\nactually last week my son was suffering from severe cold and cough so i have gave him taxim-o for four days , but now this week he is again suffering from fever, cold , cough and vomitting and diahoerra , is it safe if i give him taxim-o for seven days again",
    "doctor_response": "Hi  thanks for contacting HCM.You have a son who had  upper respiratory infection last week and now another episode within a period of 1 week now with diarrhoea as well.You would like to know whether you can continue syp.TaximO ( cefixime ) now also.A kid having second infection  within one week has to be investigated.May be an allergy is behind.Cefixime is an antibiotic which has more gram negative coverage.Since your child has both cough and diarrhoea may be u need to have broad spectrum antibiotic and anaerobic antibiotic with probiotic also.Any medicine complete a course at least for 7 days.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for mental health problem\n\nIm out of contacts- moving out of state in a few days and i cant order more until i have an exam. This morning i was really sad and crying and now my contacts are super blurry- i tried cleaning them to no avail. i have to drive six hundred mile in three days! is there anything i can do?",
    "doctor_response": "HIThanks for using healthcare magicIn that case, you can try relaxation exercise like JPMR or low dose antidepressant that would help you to stay calm or relax. Better to consult a psychiatrist and in case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white raised line on lower lip?\n\nsir i have a white little raised line on lower lip vermillion border.it has been ther since 10 years.i have taken flucanozole and applied miconazole but no use.it reduces but when i leave the medicine it retrieves back again.what is it and is this could be treated",
    "doctor_response": "Hello,I can understand your concern. As you are having this line on your lip for about 10 years and you have already tried antifungal agents, it does not seem like a fungal infection. White line on the lip can be due to cheilitis which can occur due to deficiency of Vitamin B12, iron deficiency anemia or allergy to some substance that you are exposed to on routine basis. I would recommend you to start having Vitamin B12 supplements and iron supplements along with including leafy vegetables in your diet. You can also take antihistamine such as Loratidine 10 mg (Lorfast) once a day for about a week to 10 days to combat an allergic reaction, if present.You should give it a month to reduce in size and intensity or disappear completely. If it does not respond to these supplements, I would advise you to go for a biopsy of the lesion as 10 years is a very long time to have a persistent painless lesion on the lip and confirmed diagnosis is necessary. You can visit an oral and maxillofacial surgeon for the biopsy.I hope this information helps you. Thank you for choosing HCM. Take care.Best,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from severe anemia. RBC marked anisopoikilocytosis. Bone marrow test showing drop in the WBC, RBC and platelets. Any further tests?\n\na lab report done in 1995 showed that my red blood cells had marked anisopoikilocytosis with elliptocytes. I am and have severe iron anemia . this lab report was in connection to a bone marrow test that was done. I had another one (bone marrow tesst in 2000. Now my white cells count and red blood cell account continues to drop along with the platelet count. What type of tests should my doctor now think of doing. I am now 70 years old.",
    "doctor_response": "you have mentioned that you were suffering from iron deficiency anaemia.now the present problem is your all blood cell gradually decreasing.in this age,the possibilities are aplastic anaemia,myelodysplastic syndrome and also hematological malignancy.again you need a bone marrow study.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from plexiform neurofibroma\n\ni m suffering plexiform neurofibroma last ten twenty years wanted to know is there any treatment to cure this it is on my hand but im taking homopathic medicine last ten yeras so the grouth is slow  plz answer me what i do it stared on face too my email id is  YYYY@YYYY",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, condition of neurofibroma if it is confirmed or finally diagnosed then it may not be cured but it seldom becomes fetal as long as treatment is concern in any pathies no cures is there but of course natural regression is there, with the condition one can complete the normal life expectancy,   hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for loose motions\n\nHello Doctor , I have a 25 month old daughter who is having loose motion for the past 3 days ..the maximum being 3 times a day. what should i do now to stop it? I have given her furoxone 100 mg tablet (only 1/4th of the tablet ) with honey day before yesterday and today.",
    "doctor_response": "Hello, It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic-associated diarrhoea.I suggest you use zinc supplements (Z&D drops) & ORS as hydration is a very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron (as prescribed by your paediatrician).Regarding diet - Avoid fruit juices as they might aggravate diarrhea. You can give zinc supplements & ORS apart from normal vegetarian porridges & soups. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for sore throat and cough\n\nDr Sahib. I am 60 yrs & on 27th Dec  2010, i Had a heart attack & same day DES was put in one major artery, for 3 months I was feeling very fit, But now i feek weak in walking also & from last 1 month i am feeling sore throat & thick cough .though I am taking antibiotics but no improvement.",
    "doctor_response": "HelloYou are 60 years old with DES after heart attack.Now you are also having cough , with thick mucus for one month , these symptoms may be due to these possibilities , these include:1 Bronchiectasis , diagnosis can be confirmed by sputum for culture and X ray chest .2 Lung abscess .3 Tuberculosis .4 Asthmatic allergic bronchitis .Patient usually feels whistling sound with wheezing . Thick mucus may be due to post nasal discharge . In my opinion consult a primary care physician and get his opinion.Usually I advise my patient to take montelukast= bambuterol , one tablet one in a day ( in few case twice in a day) .Codeine +chlorampheniramine maleate  cough syrup.Since these are prescription drugs , so please consult a physician and get it .Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI showed borderline cerebellar tonsilar ectopia. What could be the reason for numb tongue with dizziness?\n\nI have been experiencing terrible headaches and neck pain for the past eight to nine months. my MRI results just came back and they showed that I have borderline cerebellar Tonsilar ectopia. I was just at work and begin to feel very dizzy and I got a numbing feeling in my tongue which has not gone away as of yet it has been about two hours. What could this be?",
    "doctor_response": "hello there! neurological involvements are always more than a few sentences query, history of cerebellar tonsillar ectopia and such symptoms need to be correlated and assessed for the severity. I suggest seek the neurologist help and sort out the cranial nerve involvement. its almost impossible to shoot blanks at diagnosis from hereRegardsS Khan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I was masturbating and noticed soreness under head of penis. What is it?\n\nHi doctor, Yesterday I was doing my thing (masturbating) and I noticed a little soreness under the head of penis. I have been going at it probably twice a day lately. I am just a little concerned that it may be herpes. But I have not been sexually active for a very long time. Also, I have had two negative herpes blood test 28 weeks post exposure and again 70 weeks post exposure from my last sexual encounter and both negative. I did test positive for HSV1 though. I usually get between one to three outbreaks annually on my top and bottom lip. Anyway, I have noticed irritation in that area in the past when I masturbate so I am not sure if it is just a minor chaffing or friction burn or possibly herpes. I am currently being treated for genital warts that my last girlfriend left me with almost 17 months ago. So I am very conscious of any changes below the belt. I did not happen to notice any blistering but the area looks shiny and a little wet. I am not experiencing any pain either.",
    "doctor_response": "Hi. I have been through your case in detail. Well in short as you know there are two possibilities:  1. Friction erosion. 2. It could be herpes infection. Herpes 2 usually on genitalia and herpes 1 on lips. As now there is no limitation in having herpes 1 on genitalia due to common oral sex. So in my opinion, you may have it as blistering is not the only presentation, superficial erosions also represent herpes. So it is always better to keep pathology of herpes in mind rather rely only on the frictional blister. For management, do the following: All treatment for seven days. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe Asthma attacks\n\nHi, My dad gets severe Asthama attacks. We have visited some asthama specialist and they have prescribbed heavy corticosteriods for him. The steriods are effective for some time but somethimes even then my dad gets the severe asthama attacks. We have taken all the precautions possible to avoid the allergens around him.  Please advise what do I do to stop his attacks. I have read about Thermoplasty procedure conducted in US. Is this method effective. Are any hospitals offering this procedure in India. Thanks Bhavin",
    "doctor_response": "do you have nebulizer at home? if not get it and make him nebulize with prescribed medicine for around 10 minutes everday during the allergy season.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment to get pregnant?\n\nInfertility Doubt: I am 27yrs married Female. Menses is irregular from the day I got my first menses. Have PCOD & BLOCK at RIGHT FALLOPIAN TUBE - took 10 Placentrex injection. Whether this injection would have UNBLOCKED the right tube?? Every month follicle forms at right side, any drugs available to make the follicle at LEFT OVARY?? How should I become pregnant? Please let me know.",
    "doctor_response": "Hi,You have two option you could go for surgery to remove block at right tube. It is called hysteroscopic cannulation and can then try naturally to conceive. Or you could consider IVf .IVF is a costly option but with PCOS you have two factors of infertility and this could help with both.Do keep in mind that any surgery has complications and also that IVF has only a 40% chances of success in the best of hands.Role of Placentrex in removing blockage of tubes is questionable.Before deciding further you should go for a Hysterosalphingography (Dye Test) to know the status of the tubes.Hope this helps.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the right side of the body?\n\nMy mother is 84 and says that she is having a little pain in her right side, right arm and right side of her neck which started earlier in the day about 9:30am. She does not want to go to the hospital what should I do. P.S she does not look like she is in distress she is walking around and taking naps.",
    "doctor_response": "Hello!Thank you for asking on HCM!Regarding your concern, her symptoms may be related to a cervical disk problem causing a radicular pain irradiating in her right arm. Has she complained about neck pain or arm pain before? A wrong position during sleep, can also mimic this clinical scenario. The fact that she is walking around is an indicator that nothing serious has happened (we can exclude a possible stroke, which would have other symptoms too).I would recommend consulting with a neurologist for a careful examination for neurological signs. A cervical x ray and a nerve conduction study may be necessary to establish the cause. Hope to have been of help!Greetings! Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from acne on neck, upper arms during periods. Will steimycin ointment help?\n\nHI I am 24 years old and have been suffering from acne since i was 13 years old. For the past couple of years the acne has been confined to my neck but lately i occasionally get a few on my neck and upper arms especially during my menstrual cycle. I recently purchased steimycin ( erythromycin ointment) in my battle against acne. I would really like some advice please",
    "doctor_response": "Hi friend Welcome to Health Care Magic This is an antibiotic - helpful to clear and prevent infection. In severe acne, the treatment of choice is tretinoin (Retin-A).  It is powerful / but also has side effects / should be taken under medical supervision (Dermatologist) / need follow up / gives excellent improvement. Take care Wishing speedy recovery God bless Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can ADHD along with bipolar disorder and anxiety be treated?\n\nmy husband suffers with anxiety, depression, mood swings and anger. he has been diagnosed with ADHD, Bipoller, anxiety disorder, and demenia. his phyc dr has taken Effexor away and has given him benztropine. I looked this up and it doesn t say it s to treat any of his problems. Should he be taking this?",
    "doctor_response": "Hello,I would like to advise him to start on mood stabilizer and antipsychotic drugs.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Soujanya",
    "dialogue_context": ""
  },
  {
    "patient_message": "My grandfather was recently diagnosed with pancreatic cancer.  He had jaundice symptoms including severe itching.  They put in stents (not sure the name of the procedure) about a week ago.  His color is getting better, his urine is returning to a normal color but the itching is still there and ever bit as bad.  Could this be normal?  How long does it take for jaundice symptoms to completely go away?",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I canWell, it depends on  bilirubin value.  She will have jaundive as long as bilirubin value is more than 30 \u00b5mol/L. High bilirubin may be due toblockage of the bile duct as in her case but also liver diseases such as cirrhosis or hepatitis, infections, medications.Her bilirubin should fall progresivelly in next few days after stent placement. IF not, then it may indicate tumor progression or stent malfunction and tests should be done to rule out repeated obstruction and this includes ERCP or CT scan. If a bile duct blockage is present then surgery may be required. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tick bite on testicles, swelling on posterior cervical lymph with rashes. Chances of developing other diseases as Doxycycline is ineffective?\n\nHello, I am a 25 year old male, no allergies or serious surgery s of any kind. I recently went to Missouri (2 weeks ago) to visit family and got bit by a tick on my testicles. I felt it and removed it pulling the whole tick out. Well a couple days ago my posterior cervical lymph node became swollen, as well as the back right side of my head. A rash appeared as a small bulls-eye and small red bumps/rash appeared in the same area. I also am completely fatigued and have body aches all over. My neck is probably the sorest and also I am experiencing horrible headaches . I went to a Doc in a box, care now, and was prescribed Tramadol for the headaches and Doxycycline Hyclate for the possible infection. The doctor said I could possible have a tick delivered disease such as Lyme disease or rocky mountain spotted fever, or a couple other. He had taken blood samples and sent them off for diagnosis. My question is because I could of possiblly been bitten on the head and not realized it, is there more of a threat with any of these disease as opposed to another place on the body, (blood brain barrier..ect)? Also, given the fact that its hard to diagnose within a month of the bite, are there any other diseases that could be developing with the Doxyclycline not effective against? I m normally not a hypochondriac about anything except my Father passed away from complications of Lyme disease and I m more eager to learn about the possible diseases because of it. I really appreciate it. Sean",
    "doctor_response": "Hi i think ur tick have bitten with superficial areas of the body .first remove the ticks by forceps so that they will not enter blood brain barrier fast.and it should be cured by atarax 25 mg at night.broad spectrum antibiotic twice daily .an anti inflammatory agent twice daily and application of mupirocin ointment over the bitten area",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cold sweats and stomach pain while having high bp/cholesterol?\n\nhi im female 45 14 stone .i am diabetic taking metformin 500 recently got high blood pressure and cholesterol and been presribed amclodipine,ramipril and silvestram last few day having hot and cold sweats stomach pain and nausea unable to eat and feel very tired and have a headache",
    "doctor_response": "Hello!Thank you for asking on HCM!Regarding your concern, I would explain that your symptoms could be related to amlodipine adverse effects. Hyperkalemia, could also explain some of your symptoms.Coming to this point, I would recommend consulting with your attending physician for a physical exam, a complete blood count and blood electrolyte levels. You may need to stop amlodipine and switch to another anti-hypertensive drug. Hope to have been helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause dizziness and balance problem?\n\nI have lightheadedness and a balance problem - my head feels like a hangover and when I walk I feel like I am walking lop sided but actually walking in a straight line. I have had all sorts of tests and nothing shows - right now I am on a high dosage of vitamin D2 and a light dose of B6 - I am at my wits end - keep going to drs to no avail. Any thoughts please! Thanks, Jane! I didn t realize there would be a charge, my funds are limited, so I ll pass",
    "doctor_response": "Dear Jane,The queries asked in this forum are answered free of cost. Please feel free to ask your questions.The symptoms as mentioned in your post can be attributed to pathology in the Vestibular Apparatus in inner ear (it is associated with maintenance of body posture & balance) most probably Labyrinthitis or Benign Paroxysmal Positional Vertigo.Symptomatic relief can be obtained with intake of Vestibular sedatives like Betahistine or Cinnarizine preparations (to be taken only under the guidance of a Physician).If it still persists, then you need to consult your Physician/ ENT Specialist & get a complete clinical examination done.Investigations like estimation of blood pressure, blood sugar levels, serum electrolytes & vestibular function tests will be required to rule out any pathological cause for the symptoms.There is no need to worry, you will be fine.Till then, maintain adequate hydration & proper nutrition status and avoid stress.And also take precautions of getting up from bed slowly & avoid sudden head movements.Wishing you a Good Health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Increased BP, feeling of people laughing at my face due to protruding lips, prescribed nexito. Cause?\n\nI am 57 years old and I am a BP patient. From past few days i feel people laugh at my face. I feel that my lips are protruding out,but when I ask my wife and children they say your face s normal. I feel scared to face people as they laugh at me. Blood pressure is also increased. I had consulted a psychiatrist , he has prescribed nexito 20 mg,. Can you please give me a detailed explanation about the problem I am facing and is it fine to take this medicine?",
    "doctor_response": "Hello and You whole problem is related to the psychiatry because you feel that all the people around you are smiling on you but they are doing their job or talking with each other. Its only the feeling that was created in your mind and you are tensed due to it and ultimately cause harm to you. Just forget about the world the live you life happily because their is nothing happened that changes your face. So just be relaxed and thing that every thing is already. The medication you are taking is quite effective for your problem but if you can change your mind and thing positive than why we need medication. Hope you understand and help yourself. Best Wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does semen retention have any health side effect? Ejaculate once in a month to be safe\n\nDear Doctor, I am a 18 yr old male. For the past few months I have been trying out semen retention. I read about it online, though there seemed to be lot of conflicting opinions and arguments both for and against it. I hold back both when masturbating or when actually having sex with my girlfriend, though i still always use a condom. I ve found that this allows me to stay erect for 2+ hours, which makes it easier for her to orgasm multiple times, and we both enjoy it more. When I do this i feel aroused often and am able to edge or have sex every day, sometimes several times a day. My only concern is, will I have any health side effects from this? I ejaculate once a month just to be safe. Thanks.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. I sincerely think you are overdoing sex. Body produces semen for ejection. Semen is a waste product once it is produced. If you do not eject it during sex or masturbation, body knows how to get rid of it. Body gets rid of semen while in sleep or through urine. You cannot hold it in your body.But, let me warn you, you are practicing something which is against nature and nobody knows what shall be the consequences. So be on the safer side. Practice sex which is conventional and enjoy.Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe some sexology psychotherapy techniques which should help you cure your condition.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes radiating numbness and pain from philtrum?\n\nI thought I had a pimple on my upper lip where it meets the nose. I started to feel the pressure 2days ago. Now I have a lot of pressure under my nose with a sever headache in the front of my face similar to a sinus headache. Today the skin near and on the spot is very painful. This morning my nose and upper lip started going numb and the numbness is starting to radiate outward more and more.",
    "doctor_response": "The area below nose n upper lip is considered as danger area of face.It would be better to avoid squeezing n pressuring any pimples there as there is the risk of spreading the infection to Venous sinuses..Though it may or may not be the reason for your head ache&pain,It would be better you to consult ENT surgeon(Ear-nose-throat specialist) as early as possible .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Duolin and Budecort Nebulization be administered for longer than prescribed?\n\nmy 3 YEAR OLD kid HAS HAD RUNNING NOSE FOR OVER TWO MONTHS NOW.....FOR OVER 3 DAYS HE HAS BEEN COUGHING....HIS PEDIATRICIAN PRESCRIBED DUOLIN AND BUDECORT NEBULIZATION THROUGH MASK FOR 2 MINUTES TWICE DAILY. IS THEIR ANY SIDE EFFECT IF HE USES IT FOR MORE TAHN 2 MINS...THANKS",
    "doctor_response": "Thanks for askingI gone through your question. Your 3 year old kid is having running nose for over 2 months and last three day  he is coughing . he has been prescribed duolin and budecort. you worried about duration of therapy.  There is no side effect if you give nebulization more then 2 min. The medicine by nebulization go to lung , negligible part go to blood , so no side effect.    the other alternate of nebulization which is equally effective is inhalation by MDI with spacer and mask.  this is portable also.  hope  i answer your question.  wish you healthy family life",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause shortness of breath, chest pain and numbness in arm?\n\nHi - i ve had numbness/tingling/aching in my left arm for quite a few weeks now..sometimes my hand shakes so badly i need to sit on it to still it - i carry a lot of tension in my shoulders though.. i have bronchitus at the moment and woke up today with a burning pain through my left arm, starting in my armpit - along with shortness of breath and chest pain i m just a little concerned",
    "doctor_response": "Thanks for your question on HCM. In my opinion we should first rule out cardiac causes as you are having left sided chest pain and left arm pain.So first get done ECG and 2D ECHO to rule out cardiac cause.If both of these are normal than get done chest x ray to rule out lung causes. Also get done PFT (Pulmonary Function Test) to rule out bronchitis as you are having it in the past.So if all the above are normal than no need to worry much. Is is due to stress and anxiety.  So avoid stress and anxiety. Take good painkillers and muscle relaxant.  Avoud heavy exercise and weight lifting.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for constant stabbing back pain\n\nI have a constant stabbing pain in my right side moving just around to my back. It is in line with my belly button. This came on me suddenly last night and I could not sleep with the pain. Today I am having difficulty moving/walking around with the pain. Pain is bearable when sitting. I would rate the pain as an 8. Thank you in advance for your help John",
    "doctor_response": "Hi john thanks for the query.From the details you had described it could be some sudden sprain to your back muscles. Some times the pain could be due to some problems with stomach or urinary pathology. If the pain is from the sprain of your back muscles initially I advice you to cut down your activities and rest for day or two. i would like you to consult your orthopedician and get some analgesics to relieve pain. If the pain is settling of then start on exercises to back.thanking you Dr.A.Mohan krishna.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for staph infection of belly button piercing.\n\nI had my belly button pierced and took it out 5 years ago. Didn't have any problems with it till a month ago dr said it was a staph infection. Gave me an onitment went away. Now its back. I still have the stuff should I just use that or should I go back in to get it tested again?",
    "doctor_response": "Hi,Welcome to HCM.I suggest you get a swab from the belly button tested for culture and sensitivity which will determine help your GP prescribe correct antibiotics. You will also come to know if staphylococcus causing infection has become resistant or not. I suggest you get a prescription for appropriate antibiotics based on the test results and keep the infected area clean.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause chest pain on upper left corner?\n\nHi my name is Billie and i have a serious question. I'm pretty active and walk every day with my son. But in past few days i've been haveing chest pain really bad in upper left corner above my boobs. Not sure what that would be but it won't go away. It's never happend before.",
    "doctor_response": "Dear Billie,Thank you for your question on HCM.It look like you have had a muscle spasm which may have resulted from your walking.thers nothing to worry about ,you can take a muscle relaxant like tab.Myoril plus twice a day for two days.you will definitely be alright by then.please get back to me for any further help.regardsDr.radhika",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mild pain in upper right abdomen?\n\nI have mild pain, which happens randomly, in the upper right abdomen area, Ultra sonography has found nothing, sometimes when sleeping on the stomach, it seems something is bruised which is getting pressed, although the days when I do exercise or have a lot of manual activity like moving around and I have less stress, it seems this pain is not felt.",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.This can be of muscular origin and mild so you forget whenever your mind is fresh or diverted. Request for the high resolution ultrasonography of the abdominal wall. It may show something like i said.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could recurring rashes on consuming outside food indicate?\n\nFOR PAST 1YR  IAM SUFFERING FROM SKIN ALLERGY RASHES FREQUENTLY(THRICE LAST YR)(TWICE THIS YEAR)...I DONT KNOW THE REASON BEHIND IT.....BUT TWICEI GOT THIS ALLERGY WHEN I GOT FOOD FROM OUTSIDE....I AM 30YRS NOW....FOR PAST 28 YRS I HAVE BEEN EATING OUTSIDE....FREQUENTLY....BUT I HAVE NOT SUFFERED ANY KIND OF ALLERGIES,BUT FOR PAST 1ST YR ONLY I AM SUFFERING  FROM THIS KIND OF FREQUENT SKIN RASHES....IS THERE ANY POSSIBLITY TO FIND THE REASON FOR THIS....OR IS THERE ANY REMEDY...WILL MAIDA OR CORN FLOUR CAUSE ANY ALLERGY....WILL A PERSON GET THESE KIND OF ALLERGIES SUDDENLY(I.E..,MID OF THEIR LIFE SPAN)",
    "doctor_response": "Hello,Welcome to HCM,The history and symptoms suggests me that you are having some food allergy, these allergens will stimulate the mast cell to release histamine which is producing all these symptoms.I would suggest you to undergo skin prick test (SPT) for different most prevalent food allergens to identify the food causing these symptoms.By doing to this it is possible to identify the allergen, by doing this you can avoid the food causing these symptoms, if it is not possible to avoid the food you can go for immunotherapy either with sublingual immunotherapy (SLIT) or subcutaneous immunotherapy (SCIT).Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will one be able to conceive without ivf?\n\nhi, can u help me? i'm 30 yrs old n suffering from unexplained infertility for last 1 n half yr. drs have done all necessary tests n all reports r ok. i have undergone 2 unsuccessful iui for last 2 months & there i noticed leutal phase length is 17 & 20days for the last 2 months. is there any problem? can i conceive without ivf?",
    "doctor_response": "Hi,The recommended treatment for unexplained infertility of duration 2 years is IVF.The IUI /Clomiphene does not affect the chances of getting pregnant and I would advise you to continue trying for another 6 months naturally. If not pregnant then it would be best to try IVF, Unless you have some objection to IVF.The chances of IVF success also decrease with increasing age. So it would be best for you to consider IVF at 6 months from now.The Clomiphene and IUI do not have improved pregnancy rates, so will just cause you to delay the IVF.Hope this helps.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will going to a chiropractor help me in getting rid of dowager hump?\n\nYes I believe I have a Dowager Hump. I was in a accident a few years ago, where I was rear ended from the back of my car. I have notice the hump for about 5years now. I would like to know if going to a Chiropactor would help me in getting rid if this hump befor it gets too big.",
    "doctor_response": "Hi,In my opinion I highly recommend it will help you a lot. But it is not the main and only way for treating your back kyphosis but at least it is more safer than other medical and surgical interventions, and their side effects and bruising and stitches marks. I would choose it my first line of treatment with all other specific physiotherapic exercises or maneuvers. I would also try the use of back belts or bracing that also helps in such cases of kyphosis.Hope the above information helps you. Any further clarifications feel free to ask.Regards,Dr. Ahmed Aly Hassan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump on the right side of the rib cage indicate?\n\nhello ok so last night i was in the shower i felt a lump on the right side of my rib. It does not hurt with touch or without. when i do feel it it goes away after as uf it was not there then it comes back. the size is about the size of half a canadian penny . it also to me looks blue but faint. i do get cyst s i have one in my arm that has recently started to pinch the nerves in the area it is in i have had it since i was a child.",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .*  This lump  is likely to be benign soft tissue lesion as lipoma , sebaceous cyst , neuro fibroma   or  some  boil .Wishing you fine recovery .Feel free to ask any further  queries .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is yellow discoloration around the tip of the urethra a concern?\n\nHi I have skin rubbing off the tip of my penis, small yellow discolouration around just the tip of the urethra and it s producing a quite unpleasant smell. The smell come back just an hour after showering and I ve tried applying whisky, that worked for a day. any help will be greatly appreciated.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The symptoms you described suggest distal urethritis. Consult the dermatologist for the perfect diagnosis and proper treatment. Antibiotic like Ofloxacin daily for two weeks and anti-inflammatory drugs would improve the condition. Take Sitz bath in Dettol mixed water. Avoid unsafe sex. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are dark spots on pancreas and nodes around them sign of Lymphoma ?\n\nmy dad is 72. diagnosed with lymphoma of the abdomen in Sept. had 4 chemo treatmenst. all the tumors have shrunk except the ones around pancreas. had to have a stint in the bile duct. no tumor. they say he has a dark spot on the pancreas. the nodes around the pancreas have actually grown thru the chemo. his dad died of pancreatic cancer. he belly was distended very badly in September and was in a lot of pain. the day after his first treatment the paid was gone. the belly gradually went down. im worried he too has pancreatic cancer. is this common with lymphoma?",
    "doctor_response": "Hi...pancreatic cancer and lymphoma are very different conditions... there is no treatment for the former but the later is curable depending upon the stage of disease...Dr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes grinding my jaw during sleep?\n\nhi  my name is sara and my jaw keeps locking and clicking and i dont know if it is a medical problem or a dental problem people have told me it could be from gum chewing or grinding of the teeth but i dont chew gum and when im awake i dont grind my teeth  but when im asleep i dont know because im a deep sleeper this has been going on for more than a year and people say i will grow out of it but im afrade my jaw will pop out of place can you give me any suggestions??",
    "doctor_response": "Thanks for your query, I have gone through your query.The locking and clicking of the joint could be because of the bruxism leading to disc displacement in the Temporomandibular joint. The other possible cause can be because of malocclusion, which results in abnormal forces over the joint.Consult a oral physician and get it diagnosed.  You can take anti inflammatory drugs like piroxicam 20mg twice daily on first day and twice daily on next 6 days. You can also take muscle relaxants like chlorzoxazone. You can give hot fomentation over the joints. Do not eat hard things, do not open your mouth too wide. take soft diet. This can be solved by wearing a night guard. Consulta oral physician and get it treated. Do not take tension, because tension aggravates joint problems.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for breathlessness and cough\n\nMy wife is 34yrs old.she is suffering from breathless without exertion,dry coughing, not able to do normal work since last 6 yrs, conditiin becomes more worsening since last 1 month. Her report shows 30% eosinophilic count, ig e level is 377, ct scan chest is normal, pft show restrictive lung diseases. She is on maxiflow 250 inhaler 2 puff twice a day, tiova inhaler 2 puff once a day, allegra m hs since last one month but she is not responding to treatment . Please say what will we do?",
    "doctor_response": "See a good Chest physician around so that he can diagnose your lung condition correctly. You have a restrictive disease on the PFT and you have been put on bronchodilators, sounds completely ridiculous. It feels that either you have an eosinophilic lung disease which will require steroids or a tropical eosinophilia again which will certainly not help with bronchodilators.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in the left hand ring finger after a head trauma?\n\ni m a guitarist of 18 years, and pianist. I had a head trauma, and lack of oxygen to the brain. when i started playing guitar again, my left hand, in the ulnar fingers, has basically lost most motor functions in the ring finger. OT hardly helped, muscle relaxers or Benzodiazapam (klonopin) temporary relieves about 80% of discomfort. I believe its Focal Dystonia. Ulnar Nerve Palsy has been ruled out.",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, if the finger movement being affected by head injury then it is the nerve damage, physiotherapy can be tried and that is the hope you have else it could be irreversible disease,  hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause of pain and stiffness in the finger joints?\n\nHello, it started 8 weeks ago, when sleeping I was unable to close my fingers like a fist....I would then sleep with my hands closed in a fist, then 4 weeks ago the opposite happened uncle to close my fingers so started sleeping with fingers and hand flat....finger joints in both hands extremely painful more so in the late evening, during night and upon wakening...my thumb locks like a trigger thumb and have pain on the side of the thumb, but all joints in all fingers both hands are painful and its difficult to do normal daily tasks due to stiffness and pain and I feel joint moving in two fingers....my toes feel like they starting now.",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The pain and stiffness in the finger joints can be related to arthritis. Mild pain killers will help you. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain and diarrhea\n\nmy daughter has intermittent abd pain around the umbilicus radiating to the right below the rib cage. no distention noted bowel sounds in all quads. complains of a cramping nausea diarrhea, no vomiting as yet. bright yellow stools times 6 since 12 noon central time",
    "doctor_response": "hello,this could be a case of infective diarrhoea..hope there is no blood in the stools,you can use any anti-spasmodic drug like spasmoproxyvon, and combination of ofloxacin and ornidazole which comes in combination,any ways do show to a doctor and then take the medication as things vary from person to person and what you may say may not be the exact thing what might have happened",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does masturbation in a 19 year old cause any problem in future?\n\nIam studying college..i am 19 yrs old...Im unable to control to see blue film....during seeing blue film iam doing hand shaking whenver seeing movies.....it can occur any problem....what I want do now.....pls explain...some times I will do like in sex film .....assuming girl with me then lying down then dreaming doing sex with girl and releasing sperm......what can I do now.....",
    "doctor_response": "Hi,Nothing to worry, this is common at this age when male hormone is its maximum level.there is no harm doing masturbation but i advice to keep control on this habit.There is no any bad effect in your personal, marriage life in future.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anxiety and depression\n\nHi Doctor i am a 43 year old woman with severe anxiety, and depression. I ve been taking prozac 80 mg along with temazepam or zolpidem for sleep. Have lost about 25 pluz pounds now and my primary physician has change me over to fetzima. Now let me add i also had a bypass surgery about 14 years ago which was a success from 325 to 160 at one point. Now i weigh 181 and still suffer from severe anxiety, My cbc count ok other than vitamin b deficiency which now i take once a month injection. Now doctor i don t miss the weight but neither welcome it back. Going nutz, needless to say last two months at home because of bad fall at work. Wish I had a magic wand and make everything good again",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. I don't see why you are depressed? you had so many negative experiences in your life. Means whole life you were suffering. You had seen almost all the sufferings of a human life. Others are yet to suffer.That means, in future, you may not have anything to suffer. Even though there is something, that should be lesser than what you had suffered. You should be happy. Let those people be anxious, who had not seen sufferings and expecting trouble in their future.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How could I overcome by light weight and the back pain and could this be due to masturbation from a very young age?\n\nHi, I am 19 year old and have been mastubrating since the age of 8. I am a bit light weight for my age and also, my back pains a lot. Is it due to mastubration? Cause i have a healthy diet and was born very healthy. And how should I overcome these effects.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Masturbation i not sin or is dangerous. Masturbation cannot make you sick or unhealthy. It is natural and ven animals do it. In saying that you started masturbation at the age of 8 is a bit exaggeraing. Puberty is attained after around 11. Masturbation before that cannot produce the desired result.Secondly, Masturbation cannot make you thin. But the anxiety associated with it can make you thin. If you are able to take proper nutritious and healthy food, then you should not be thin. Inspite, if you are thin, either you have some aniety disorders or some wasting diseases like anaemia. Consult a doctor to diagnose. For psychological or sexological counseling visit  this answers your query. Availble for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain, nausea, more at night. What could be this?\n\nHi last night I had bad stomach pains. I was also shaking. I started to have stomach pains on Friday night. Now today it still hurts a little bit. We went to walgreens and asked them what it was. They said it was bad constapation. I do have a history of this. But the pain was very painful. I also had nausea and it hurts more at night what could this be",
    "doctor_response": "hi i had gone through your query and understand your concerns. i would also come up with the possibility of CONSTIPATION is the cause for your sufferings.Constipation;-\u00a0\u00a0\u00a0\u00a0\u00a0Always results in a build-up of dangerous toxins and danger of  AUTO INTOXICATION, which is acknowledged to be the main cause of many of today\u2019s degenerative and life-threatening diseases .may result in a constant state of fatigue, sickness ,and lethargy.-\u00a0\u00a0\u00a0\u00a0\u00a0May result in;1. COLITIS;inflammation arising from the decomposition of blocked faecal waste.it may be the cause for your pain2.SPASTIC BOWEL; if the colon muscle is over worked and tense trying to push through faecal matter it will go into a spasm-a chronic tightening of the fibres of the muscles.it may be the cause for your pain3. BALLOONING; when faeces accumulate and stretch the bowel walls into enormous balloon shapes.it may be the cause for your paintreatment plan; i advise you taking   Homeopathic medicines gives  safe and permanent  cure for your complaints consult your local homeopathic physician for correct diagnosis of the case and remedy to fit your complaints.I hope this is helpful for you, thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat lung tuberculosis?\n\nhi this is janakiram from bangalore, i have taken esr test on 3 days back result is 20mm/hr.last year i was suffred with lungs tuberculosis and used tablets upto 9 months, then after an year againg i have taken ESR test it given 30mm/hr can u please suggest me whether the disease is there on my body? should i consult doctor? please replay me",
    "doctor_response": "Hi and thank you for choosing HCM to post your question.I read carefully your question and understand your concern.The empiric treatment of lung tuberculosis consist of the following 4 drug regimens:Isoniasid,Rifampin,Pyrazinamide,Ethambutol or Streptomycin.The first 2 months the patient takes 4 drugs and if the patient remains Positive(means that in the sputum of the patient you can see bacilus of  TB in direct microscopy) he continues even for another month and if still positive one more month(like i think is your case)and the other 5 months the patient takes only Isoniasid and Rifampin.During treatment patient need to do Direct microscopy of the sputum at the end of second,  third, four months and in the end of treatment .Patient is considered healed from lung TB  when  he has at least two negative direct microscopy of the sputum and there is  radiologic and clinical improvement.Esr(erithrosedimentation rate) is a test that detect infammation with conditions such as infection,cancer,immune diseases.It is a nonspecific test that does not tell where in the body the inflammation is(lung,urinary tract ,other organs)or what is causing it(TB,other bacterial infections,rheumatic disease ect)Also ESR can be affected by other conditions besides inflammation so is not an indicator of telling about Lung Tuberculosis.I hope my opinion can be helpful.Wish you good health.Kind regardsDr.Dushi .",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to lighten my skin color ?\n\nHi Doctor , how to lighten my skin colour? actually im fair but my hands and feets are into the darken colour...please tell me suggestion",
    "doctor_response": "Welcome to Healthcare Magic Good Day You need to avoid exposure of those areas to sunlight. Apply sunscreen with high SPF like 20. Eat fresh fruits and vegetables to avoid nutritional deficiencies which can cause hyperpigmentation. Speak to your Dermatologist regarding any topical application or cream or lotion to lighten the skin as many reasons may be associated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of bronchitis?\n\nGood Evening Doctor, Pranesh here, sir since from one month i had a sinusities with pungent smell from nasal discharge & also there was post nasal drip,  my docter in bellary had given me cefuraxime Axetil ( Anti biotic) for aperiod of 10 days but my there was no cure at last i undergone sputum culture i found that cefurexime is resistent. & i taken duenem-200 for 8 days & my pungent infection smell has gone. But docter still mucus generation is more whenever i used expose for cold. am very much scared that wheather am having a Broncitis or what. please let me now sir. what is the remedy. Docter my mail IDis  YYYY@YYYY",
    "doctor_response": "hi pranesh,I have some missing details that need to be verified like what duration after you had sinusitis you had this problem and do you have any specific allergies.I think that you might have this post infection excess mucous secretion from the nasal part which might be normal but its always better for you to get examined by your doctor.Take steam inhalations and vitamin c rich fruits which might bring down the mucous generation and releif to your sinus.Hope I was useful in my suggestion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Kenalog injection cause any weight gain?\n\nI got a Kenalog injection 2 weeks ago in my lumbar spine for bulging discs and the pain from the bulges is still present and I have gained 10 lbs. does it need more time to take full effect and will the weight come back off? My diet has not changed. Thanks!",
    "doctor_response": "Weight gain is a possible side effect. Nonetheless, does this dose ease some of your symptoms. Nonetheless I believe the injection side effects should subside from 1-2 weeks after injection, thus you should no longer feel these effects. As such you must decide, are the benefits outweighing the side effects. I suggest hydration and diet alteration with less carbohydrates, and more proteins and fats. Coupled with possible half day-full day periods of fasting, I assure you, you will see weight loss and or maintenance with feelings of increased energy. Warm Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Must have a frozen embroyo transfer, on progenova. Endometrium thickness less, advised Syldanafril. Thickness change in a day ?\n\nI am undergoing frozen embroyo transfer as part of tat I was on progenova for 12 days . tdy when the dr. scanned told that my utrine thickness is 8.2 mm and has prescribed Syldanafril to be used vaginally for 2 days and to come for the scan. Dr. Informed if the endometrial thickness is 10mm then only will do the transfer or else will cnacel the cycle. Please let me know average how much is the endometrium thickness increases in a day",
    "doctor_response": "Hello. Thanks for writing to us. Usually endometrium increases by 1mm in a day. A thin endometrium will not result in a successful implantation. Thus, it is better to wait for a thick endometrium to grow before trying for implantation to be successful. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is surgery for Sub.Dural Haematoma causing severe back ache?\n\nThis is for my mother, she had burr hole surgery for Sub.Dural Haematoma on April5 this year.She was given Anti . epileptic support like Eptoin & Levipil, as it was making her very tired, weak, appetite loss& severe skin break down her Dr.changed her epileptic medication Encroate Chrono 200(since 2months), her previous symptoms are much less but having severe back ache.Is it a side effect? Should she do liver function tests from time to time?",
    "doctor_response": "Hello. Thanks for writing to us. The back ache is not likely to be related to the medicines. It can be related to a muscle or disc problem. Getting the liver functions done every 2 months will help. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal . For future query, you can directly approach me through my profile URL  drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes inflammation and pain in gall bladder?\n\nI had an inflamed gallbladder about 2 years ago. they told me it was my diet and weight. i lost about 60 pounds and eat really healthy. I now keep having symptoms of a gallbladder attack. But when they run scans and labs everything comes back normal. Can I request the Dr take it out? I ve been in pain for 8 months....?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have chronic cholecystitis.  You can go for cholecystectomy to remove gall bladder and received from pain. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is upper back pain and left hand numbness normal?\n\nHi. My brother has been experiencing pain in his upper back in the neck area and also numbness in his left hand from past few days. His age is 34 and is quite normal in health otherwise. His Blood pressure also seems to be normal. Is this symptom of something or taking pain killer is okay?",
    "doctor_response": "Hi,Welcome to healthcare magic. After going through your query I think your brother is suffering from  cervical spine pain with radiation to left upper limbIt may be simple muscular pain.Treatment is Rest in position of  comfort, NUROKIND GOLD ONCE DAILY and analgesics (Diclofenac three times a day after meals is effective). Sometimes strong analgesic(such as ultracet three times a day after meals) is required. OMEPRAZOLE 20 MG before meals prevent acidity caused by analgesics .Second possibility may be disc prolapse for which  MRI cervical spine is needed  to be done.I think your query answered.Welcome to any follow up query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Possibility of a muscle pull at the center of chest causing pain\n\nI have a dull pressure pain in center of chest when I lay down, no matter if I'm on my side or front/back. Its just a dull ache. I did have what I thought was a pulled muscle in my chest last week but now its in the center of my chest. When I sit up it feels ok.",
    "doctor_response": "thanks  for asking your question i completely understand your question actually pain in the centre of chest can be due to a muscle pull , lung diseases ,cardiac diseases , or diseases of stomach.for now take an analgesic and proton pump inhibitor like pantoprazole after consulting a pulmonologist . he can also request for a chest xray and an ecg to rule out any other disease causing chest painthanks / regards feel free to ask more questions may god bless you with good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Growing number of moles on inner labia. Have undergone LEEP procedure. Is this normal?\n\nI saw my gyn in March 2013 and had pointed out a new mole (light brown, eraser sized w a hair) on my labia - she shrugged her shoulders and said \"it's a simple mole, make sure it doesn't change\" it hasn't changed.  But I have since then noticed 2-3 more very Small, similar sized moles beginning to grow on the inner lips.  I previously had a leep procedure in April 2013 for CIN 111 cells in cervix. (2 good paps since) I have an appointment to see ,my doc in 2 weeks but am FREAKING out... Please help. Why is this happening? What could be the cause? I am an esthetician for a plastic surgeon and am familiar with what skin cancer can look like, this does not appear to be abnormal in any way. Thanks!",
    "doctor_response": "Hi,Thanks for writing to us.The description in no way sounds alarming. It could be a mole, cherry angioma, warts, molluscum contagiosum, angiokeratoma etc. I do not think it is cancerous. However apart from your gynaecologist, I would advise that you seek an opinion from your dermatologist too.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have abdominal pain and bloating with no appetite. All tests done. What can be the problem?\n\nI have been diagnosed with MS, but prior to that had terrible abdonimal pains with nasua.  I went to the GI doctor in NY and he had me go through tests, motility, transit studies and he still has not made a decision as to what is wrong with my stomach.  its very bloated and i have no appretite.  He keeps on saying its dangerous and complicated, i am only 50 years old",
    "doctor_response": "Hello, Thanks for posting your query,                                                                                                                                                                               Add honey in your lemon tea and have it twice a day.Take one teaspoon of lemon juice and mint juice, add a few drops of ginger juice and black salt. Drinking this mixture will cure stomach pain.Extract some juice after grating a few pieces of ginger. Massaging this juice on your tummy will give you relief from stomach ache.                                                         Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fatty liver syndrome\n\nSir, I have fatty lever stage -I , used Udibon for about six month. After leaving the medicine, I feel heaviness on lever side of abdomen. kindly advise me about whether medicinal cure is enough to cure the disease fully. How long I should take the medicine?",
    "doctor_response": "Hello Underlying cause of fatty liver should be investigated.It may be due to many reasons like altered lipid profile,sedentary life style,obesity etc.Fatty liver is a reversible stage.It is due to excessive deposition of fat within the liver cells.Your condition need few more investigations lie routine hemogram,random blood sugar,lipid profile,liver function test.You should increase your physical activity and avoid fried and fatty food.You may need few medicines after full investigations.It may take 6-8 months for complete reversal of fatty liver.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to use calamine lotion for child's eczema?\n\nmy granddaughter is 4 1/2 months and she has excema. The doctor gave her hydocortisone cream but said not to use it on her body. it seems like she needs something to help sooth the rash on her back and sides, my question is, is it safe to use calamine lotion on her body?",
    "doctor_response": "Hi,You can apply calamine lotion insted of steroid cream.There is no harm using this lotion.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of lumps on legs permanently?\n\nI have a two small lumps on different part of my legs, they are like ingrown hair but there isn't any hairs when I try to poke at it, it feels like there is something inside but nothing comes out is just hard, when I shave my legs they bleed as i cut them with the razor, but once it heals it returns to it's original soze.I'm 35yrs old female 167cm tall weight 75kilos",
    "doctor_response": "Hi.Thanks for your query.As the lumps are small and a hindrance as you explained, the best way is to show this to a surgeon and get them removed.You get the following benefits:It is better to get this removed (excised) for 2 reasons.1> your get rid of the disease and 2> you get the histopathological diagnosis- makes you tension-free that it is not 3> there will not be cuts and bleeds again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes testicular pain while having scoliosis?\n\nHi, I m 22 years old and suffer from scoliosis and since I was 18 I ve had prostate pain off and on. This morning my left testicle started hurting. I woke up this afternoon with it still hurting but worse. I went poop and it quit hurting for awhile... Now both of them hurt bad. A few weeks ago I was suffering from symptoms of IBS. My balls feel like they are being squeezed or like something being pinched in them. Any idea what it is? And should I go to the hospital?",
    "doctor_response": "HelloThanks for query .Pain in testicle is mostly due to infection (Orchitis) You need to consult qualified urologist for clinical examination and get following basic tests done to confirm the diagnosis.1) Urine routine and urine culture 2) Ultrasound scanning of scrotum 3)Color Doppler study of scrotum to rule out Varicocele .In the mean while start taking broad spectrum antibiotic like Cefotaxime along with anti inflammatory drug like Diclofenac twice daily .since Orchitis takes long time to get cured you will have to take these drugs for 4 weeks .Ensure to drink more water .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to lower high CO2 levels in blood quickly?\n\nI have copd and am planning a trip tomorrow. I seem to be getting a cold which always exacerbates my copd. How can I lower high co2 levels in my blood quickly? I was hospitalized last year because of hipercapnia but just don t want to cancel my trip. I live at 7,000 feet sea level and will be going to sea level.",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Going down to sea level would improve the oxygenation.2. The cold will definitely exacerbate, you can try bronchodilator along with antihistamines like cetrizine to reduce cold.3. Steam inhalation will also help in reducing mucus in the airway. Not to worry. Oxygen will improve as you go to sea level.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes weakness with bloated stomach with a normal blood test?\n\nhello doctor im a 21 year old male about 135 lbs and ive been feeling weak and tire for the past three days. my stomache feels bloated and full of gas but i havent eaten anything i went to the er and got a cat scan and some blood work and the doctor said  i was fine. i need a second opinion.",
    "doctor_response": "Hello,Some times you just have acid peptic disease or acid reflux disease and these can cause all your symptoms. Its not necessary to have abnormal tests with these illnesses however, i would like to see you lab results what your doctor has ordered and what not. I suggest to take pro-kinetic drugs along with proton pump inhibitors to alleviate your symptoms. If they persist go and see your doctor again to have a detailed examination and treatment if needed.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Sameen Bin Naeem, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Giddiness, head and neck pain, swollen eyelids, normal blood test. What is wrong?\n\nmorning doctor, i am suffering from giddiness and heaviness in head and neck pain on the left side. i feel giddy when i just lie down to sleep or when i turn my head when i am sleeping and when i get off the bed in the morning. eye lids are a bit swollen. my mind has become dull. blood reports and all tests are normal. please let me know whats wrong with me",
    "doctor_response": "Hi Mr Bheemreddy, Thank you for posting your query on Healthcare magic. Based on your symptoms, the most likely cause of your symptoms is benign paroxysmal positional vertigo (BPPV). Please do not get scared looking at this big name, as this can be well treated with medications. BPPV is due to a minor problem in semicircular canals (in ear). The symptoms of giddiness get aggravated with movements of head and neck in this condition. For relief of symptoms, betahistine is helpful. To get fully well, and prevent its recurrence, certain exercises (vestibular rehabilitation exercises) are helpful. This can be learnt under the guidance of a physiotherapist. I hope it helps. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does black fungus depositing on wet walls affecr baby during pregnancy?\n\nHi..I am 7-8 weeks pregnant...and the bathroom (shower area tiles)remains wet as there is no ventilation and hence there is black fungus depositing..(I am not sure if it is called fungus)..I keep cleaning that but it comes back..could you please let me know if it is harmful to me or my baby? and is there any way out?",
    "doctor_response": "it is very unlikely for a black fungus infection to be harmful in pregnancy but the drug used to cure it can cause harm,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe foot pain be treated?\n\nI stepped off of a rather high step and heard and felt a pop in my foot. It is extremely painful and goes from the arch of my foot traveling along the side of my foot to the top of my ankle. I am overweight and my job requires mostly standing and walking. I need to find out what this is and what I can do to treat it.",
    "doctor_response": "Hi, Consult an orthopedic and get evaluated to rule out tendon or ligament injury. As a first line of management you can take analgesics like Acetaminophen or Tramadol for pain relief. Wishing you good health. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump in armpit?\n\nHello I have a lump on the top of my arm pit. I squeeze it and I can feel the pus just pushing out of it. Sometimes it s just long and stringy and is white. Other times it looks like a darker pus (kinda brown). I have it now and this is my third time getting it. The pus don t smell. The bump gets to be about a little smaller than a marble and i can grab with my fingers. What do you think may cause this? I m starting to worry about it now. Is it something I should have checked out?",
    "doctor_response": "Hi. The site and size of the lump tells me about the possibility of infected sebaceous cyst in armpit, a common site for this problem.I would advise to get this checked out and request the Doctor to get this excised as this will be a constant site for non-healing.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a disc bulge with indentation on the ventral cord mean?\n\nWhat does it mean to have a small broad-based central disc bulge at T2 - L1 Level with mild indentation of the ventral cord and 2. small bbroad based central disc bulge at L5-S1 level mildly effacing the ventral thecal sac. There is a mild bilateral neural foraminal steonsis at this level from facet arthropathy.",
    "doctor_response": "You are having prolapsed intervertebral disc though site you have mentioned is unusual. Continue physiotherapy.  Avoid bending forward and lifting heavy weight.  If pain is troublesome then start tab pregaline od and analgesics sos.Hope my advice will help you.  Take care. Don't forget to rate me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe scrotum pain\n\nYears ago I got kicked in the groin. It busted my left scrotum and today, it is painful and the sensitivity is mostly gone in the head of my penis. when I am with my wife I have a medium erection but when I penetrate her it dies. I am 67 years old with 4 stints in my heart",
    "doctor_response": "HelloScrotal injury need immediate medical attention.You need proper clinical examination and investigations.Investigations include ultrasound and colour doppler of scrotum.Ultrasound can exclude many conditions like local hematoma,testis injury etc.Treatment depend upon findings.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure red blotch on the foot after bee sting?\n\nI was barefoot in my yard and stepped on a bee. As soon as I felt it on me, I swiped it off. I looked and there was no stinger, but just a little pain and now just a red blotch on my foot. There is a tiny puncture, but again no stinger. How can I heal?",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.The reaction is mixture of the allergy and wound .So care for both should be included in your treatment regimen.I advice you to maintain good hygiene by frequent cleaning and dressing. This will take care of any infection occuring.Tablet chlorpheniramine and tablet aceclofenac with serratopeptidase and tablet prednisolone can also be taken this will take care of allergy, pain and healing process..Tablet ofloxacin can be taken as it can help in preventing infections.Dressing with dettol, betadine and application of polysporin can help in treating infections.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the treatment modality for stage 3 angiosarcoma?\n\nHi doctor, My mum has angiosarcoma in the leg. Amputation would be the only option. But she is not a suitable candidate for surgery. Will radiotherapy help in this condition? Please suggest.",
    "doctor_response": "Hi. The usual treatment for angiosarcoma is the removal of the cancerous tumor by surgery. However, in those patients who are unfit for surgery, radiotherapy and chemotherapy are alternatives. Radiotherapy involves the use of radiations to dissolve the tumor and chemotherapy involves medicines for the same. Both these nuclear medicine treatment modalities are palliative. They may help control the spread of the tumor and also to a certain extent shrink it. However, the prognosis of these treatments depends on the stage of the disease.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion to treat erectile dysfunction?\n\ni am 18 years old male and two months ago i suffered from hepatitus a and jaundice ...since then i am suffering from erectile dysfuncion ... i masturbated during hepatitus a .. what could be the problem with me or can masturbation make the problem more worst? my height is 5'11\" and weight 57 kg ...plz help me!",
    "doctor_response": "HelloThanks for query .Based on the facts that you have posted you are facing problem of Erectile Dysfunction after you had Hepatitis and jaundice .It is common to get Erectile Dysfunction after any major illness like Hepatitis.Following general measure will help you to boost up your confidence and getting good erection .1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning.2) Take high protein diet rich in vegetables and fruits and Vitamin A,C,D,E.and Zinc3)Take anti oxidants like Almonds 5-6 everyday..4) Avoid alcohol and smoking.Do not worry this will gradually get resolved over a period of time as you recover from hepatitis which  takes 3-4  months .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I get rabies just by a dog's lick?\n\nHello doctor,Last night my friend's dog licked my hand and I ate food with that hand without washing it. The problem is that I also have a bleeding gum. Am I at a risk to contract any infections or diseases specifically rabies? Kindly advice as I am a little apprehensive.",
    "doctor_response": "Hello. Rabies virus is found in the saliva of the infected dogs (not all dogs). Infection can be transmitted through biting of infected dogs where saliva directly reaches our blood. So theoretically you can be infected but in reality, there are very few cases that infection is spread by licking. The crucial issues here are: Regarding other infection, you should not worry. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of radiation for prostate cancer?\n\ni mwriting from pakistan sir my father had a prostat cancer before 3 and half years back with the advice of dr he had surgery in good time at age 64 he dignosed cancer after surgery the radiotherphy also provide with the help of GOD every thing is done in good way my father coming into a routine life he do every thing regular check up with dr psa test check up means everuy test is on routine but sir 1month back he had bleeding with urine every test is again all is correct but we r confused y its bleeding psa is correct everything and dr also said this is sideaffescts of radiation my father dont want to do cystoscopy every test is fine than y its happening after 3 years of radiation yes one think my father is in tension hypersensitive and smoker sir help me i m waiting sir my father age is 67 when he had operation his age was 64 before 64 he is eating medicine of angina ascard loprin lexotnal ezita renitec the blood pressure control he is hypersensitive but after 64 cancer medicine also start sir pls only tell me that y bleeding is coming because every test top to tip is normal regular check up sir i cant come to america i live in pakistan sir or do mea favor my sister also doctor can u talk with her only we want to know y its happening pls answer the cause hurry i mthank ful to you regards doctor radiologist said ok done cytoscopy but father scared and surgen said it is radia side affect sir can u tell me 3 months ago not always bleed but now since 6 days extream bleedin like shower red colour it cause loss blood y it happend dr advice 4 tramaciacid medicine he take 40 tablet little bit better but y bleeding come every test is normal and can u suggest any medicine can we call or can u chat with me free i dont have visa card i want my father in good healt wsir y it oocur it is danger if we not do cystoscopy it not control can we eat anything else yes atlast after 45 year my father today quit smoking he is chain smoker sir answer today i m depreesed i hope u not diisheart me waiting thanks",
    "doctor_response": "Hi, THERE ARE MANY SIDE EFFECTS OF RADIAITON ,DEPENDS UPON THE SITE TO WHICH RADIATION IS GIVEN.  IN PROSTATE CANCER RADIATION IS GIVEN ,BUT AFTER 3 YEARS OF BLEEDING IS COMING IN URINETHAT MAY BE DUE TO DISEASE ITSELF,ANY HOW YOUR FATHER HAVE TO UNDERGO CYSTOSCOPY TO KNOW THE CAUSE OF BLOOD IN URINE, OR HE MAY UNDERGO CECT OR MRI OF PELVIS.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My mother is admitted with chest pain. How serious is her illness?\n\nHi doctor, My mother, who is 62 years old, has been hospitalized for two days due to sudden sweating, chest pain and left hand pain. When she was admitted her BP was 190/110 mmHg. She is also a diabetic (150/270) and undergoing tremendous stress due to sudden personal loss. She underwent ECG and 2D echo. I have attached the reports here. Her doctor said that she was on the verge of a heart attack when admitted. Her ECG is said to be abnormal and 2D echo depicts CAD and diastolic dysfunction. Currently, she has been treated to lower her blood pressure. Her doctor told me to do TMT and angiography, if TMT appears positive. Could you please let me know by seeing the reports how serious the illness is. I would like to know the future course of action in terms of tests and treatment.",
    "doctor_response": "Hi. I have gone through her reports (attachment removed to protect patient identity). 1. Diabetes mellitus. 2. Hypertension. Troponin I value. Non-cardiac chest pain like muscular. Acute coronary syndrome (includes both MI and unstable angina due to sudden obstruction of blood flow to heart). Do trop I or trop T and then repeat after 12 hours from onset of pain, if the initial value is negative. If positive, then do angiography. If still negative, then do a stress test. Revert back with the reports to a cardiologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What causes continuous dizziness with loss of balance?\n\nHello doctor, Continuous dizziness. Losing balance could not sit or stand for more than few minutes. Age:65, Height:6'2'', Weight:220 lb.",
    "doctor_response": "Hi. Your MRI spine reports osteophytes at multiple spinal levels along with bilateral neural foraminal stenosis at C6-C7 level (attachment removed to protect patient identity). These cervical changes though can cause dizziness but persistent imbalance is not usually seen with these spondylotic changes. If you would have presented to me as an outpatient, I would have asked you the following questions to answer your query well-  1. Do you have history of double vision?  2. Do you have history of hearing loss or tinnitus?  Please follow up with answers to these queries. Meanwhile,please start taking- Tablet Tryptomer 10 mg once a day at bedtime. Tablet Pregalin-m 75 mg twice a day. Tablet Calinept-d once a day. Please take medicines under a physician's guidance only.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hot flushes when on preparation medicines for IVF?\n\nmy 2nd round of icsi, using frozen eggs failed. the eggs were never fertilised, so not implanted, but i took the drugs in preparation.  this all happened over the last 4/6 weeks.  I am now experiencing regular hot flushes, and wonder whether this is a known side effect. Thank you",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.If IVF doctor is using down regulation protocol for you, then it involves use of medicines called as GnRH analogues.With these injections, your body stops producing sex hormones from ovaries for some time, this leads to hot flushes.Please do not worry, these symptoms will vanish very soon, as doctor starts to give you medicines and injections for egg formation.I hope my answer helps you.Thanks.Wish you great health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will vitiligo go completely with medication?\n\nmy son is 25 yrs old .he is having white spots in his scroutm .he tested it and doctor said that it is vitiligo .he is taking medicines for the past one week and the white spots also changes slowly to the body colour.willl it go completely?",
    "doctor_response": "Hi ..dear Reena., Thanks for choosing HCM.., White spots on SCROTUM.., it is mucosal area...good treatment is there.., but respond is poor.., Now for scrotum... 1) Intralesional diluted steriod..TRIAMCIOLONE.., affected part will give very good result., 2) Topical Clobetasol on white patches.., 3) Avoid sour items..... 4) Take Iron preparations to replace the .., supplements.., ok thanQ",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathlessness and vomiting in condition like COPD?\n\nHello, i was diagnosed with copd around 7 yrs. ago I am a 40 yr. old F. I ve also been on oxygen@ 4-6 liters these past 4yrs. due to the fact that my heart isn t recieving the oxygen fast enough threw my nostral s so I m wearing the face one.Well around 1yr. ago I woke up to like another bby bone feeling ontop of my right rib cage, my doctor sent me to see if it was my gaull bladder& it was only tested looking@ my guall bladder & it wasn t that & so it s just been left alone, last night I woke up vomiting,really light headed,dizzy& the knot,mini kind of rib ontop of my ribs has grown really big & I have another1 on my left rib cage both are under my breast, my back is killing me,I feel as if I m not getting the air that I need@all & I ve turned my oxygen up to 8 & it s just getting harder& harder to breath & cope with the pain even though I m on both phenogryn& marinol due to my constant vomiting for past 10yrs. over my diverticulitus& my bowels not working but maybe 3times per month, so I m@ a stand still on how can I be soo sick,vomiting,light headed& passing out while vomiting because I cannot breath, please what should I do?",
    "doctor_response": "Hello Welcome to Healthcare magic I can certainly understand your concern There can be co existent heart failure.Get a 2 D Echo and consult your doctor.Post your questions if any Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with kidney stones, urine with balls of blood, warmness inside the body, back pain, pain on wiping after stools. Normal?\n\nHi my doctor told me that i have kidney stones but now i have new symptons when i use the bathroom it dosent burn but when i wipe myself it hirts down there and when i look at my urine it haves little balls of blood nd i feel like is i have fever in the inside of my body nd imy back hurts a little bit not as bad as before is that normal doctor??",
    "doctor_response": "Hi, many thanks for the query!You need to do- USG (KUB), X-ray KUB, CBC, Sr. creatinine, Sr. Uric acid, Urine (Routine & Microscopy).Per Rectal examination & Proctoscopy (if possible) by your doctor is important to know if there is any fissure(more likely) or haemorrhoides (less likely).Drink plenty of water so that at least 2 litres of urine is voided in 24 hours.Eat High Fibre Diet, green leafy vegetables.Take stool softners, anti-spasmodics, antibiotics, antacids, diuretics & local application of lignocaine with your doctor's opinion.Wish you a good health.Take care.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sinus infection\n\nI have been having twinges in my right forehead and temple for the past few hours. They come and go. Also have had sympptoms of sinus infection for two weeks. Went to doctor but he did not think I needed an antibiotic. Saw the doctor two weeks ago. Sinus problems persist and now these head twinges have started.",
    "doctor_response": "hi there... first you should go for xray PNS to confirm the diagnosisyou should consult ENT specialist,  according to the congestion doctor vl prescribe u antibiotics,  antihistamines and corticosteroids... hope it helps... regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it to be concerned about cough, mouth soreness and trout pain when having ear infection?\n\nmy son is 10,51 inches, and 79 pounds and had a fever Sunday morning of 103.3 with fever reducer it went down to normal temp. It then came back around 6 in the pm. and took a second treatment of fever reducer and it went down easily.About 10pm i took his temp and it went down to 96.3 I have been keeping an eye on him and he has been sleeping, sweaty and his body cold.I currently took his temp and it is down to 93.8. His temp has never been low before.  I have 2 blakets on him to try and get him warm. He has been on antibiotics since friday for double ear infection and has been complaining about his trout hurting, stomach hurting,a bad cough, he has mouth sores and can't eat. What do I do? what could it be? whe do i worry about hte low temp?",
    "doctor_response": "Thanks to HCMI can understand your concern don't worry ,fever in most of viral infections have sudden rise and fall below normal once we taken medicine if there is no chills and rigors don't worry ,it wont cause any trouble anyway ear infection wil be controlled by antibiotics to prevent secondary infection just undergo some investigations like CBP. WIDAL,FEVER PROFILE  CHEST X RAY IFFEVER NOT SUBSIDE Let him continue antibiotic till reports comes and antipyretics like paracetamol along with above drugs add cough expextorant also .gentle doing mouthwash will help to relieve soreness of mouth .. ok plenty of liquids orally is better than solids low temperature generally upto certain extent nothing will harm the body.clean the ear with jhoson buds if there is discharge ,, keep it clean he will be normal shortly ..ok",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe pain near right wisdom tooth, white spot. Applied Ambesol. Does it require immediate medical attention?\n\nOn upper back right side near where wisdom tooth would be coming in, my 14 year old has been c/o of pain for a few days that has now escalated to severe pain. She also just got her braces off. There is a white spot/ pimple with what looks like a fiber coming out of it. We had her apply ambesol to the area, but it didn t last long and she is in pain again. Is this considered an emergency that we should call her dentist or orthodontist on a Saturday?",
    "doctor_response": "HiThis white spot is indicative of pus due to infection in teeth.you need to have her radigraphical examination done so that it can be judged whether the infection is due to wisdom tooth or any adjacent tooth.If wisdom tooth would be the reason then irrigation of flap covering wisdom tooth has to be done.If any adjacent tooth is the reason then root canal is advisable.If she had any gum disease then scaling and polishing has to be done.Follow antibiotic prescription.take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "SLE patient, 10 weeks pregnant, on hydroxychloroquine sulfat, azathioprine, lisinopril. Is it safe ?\n\ni am dr AAAAA from iran. i am a rheumatologist . I have a patient with SLE . she treates now with hydroxychloroquine sulfat 200 mg/daily azathioprine 50 mg/daily. she has lupus nephritis and treated with 6 month pulse cyclophosphamide and then cellcept .and after treatment of nephritis she is now pregnant 10 week.she continued lisinopril in this 10 week of pregnancy.is safe continuation of pregnancy in this patient? she has bilateral AVN in both hips and THR in both hip. and prednisolone not given. lupus nephritis of her is in remision.",
    "doctor_response": "Hydroxychlroquine and azathioprine is safe but lisinopril is absolutely contraindicated in pregnancy. So it should be stopped immediately, and definitely risk to fetus will be there. But then the decision has to be taken by patient because risk of deformities in fetus are there.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could chest pain be due to a bony lump near the sternum?\n\nI am a 42-year-old female who weighs 120 lbs.  I normally weigh 128 lbs. but I lost 8 lbs. over the last fours weeks because I'm on an elimination diet (basically a vegan diet) to try and identify food triggers for my chronic migraines.  Three weeks ago I had horrible pains in my upper chest and back that I attributed to heartburn and that were somewhat relieved by TUMS.  Since then I have continued to have sensations of discomfort in my upper chest, something like your chest feels when doing exercise at high altitudes.  The discomfort is pretty constant and doesn't seem to coincide with eating.  A couple days ago I discovered a bony lump on the right side of my sternum, an inch or so below my collarbone.  It's about the size of a marble and it feels uncomfortable when pressed but not painful otherwise.  Is the lump related to the chest pain and should I have it checked?  When I breath in deeply, I feel the most discomfort at the top of my sternum and so I'm wondering if the lump is related?",
    "doctor_response": "It could possibly be related to this mass.  Sometimes, we can get bony non-malignant growths - osteomas (which is a new piece of bone growing from another bone).  This is usually benign, but can cause discomfort.  I would recommend a CT scan of your chest, and I'd have them scan your abdomen at the same time.  The other test I would recommend is an endoscopy, which can be done by a gastroenterologist.  Finally, a right upper quadrant ultrasound can look at your gallbladder and liver, and see if there are abnormalities (this would be lower on the list, as gallbladder pain is usually related to eating).  Hope this is helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump behind ear in an infant?\n\nhello, i just notice a lump behind my 5month old right ear during bath time. he has no fever but was little cranky, i think it might be an ear infection. seems if you touch the lump he moves his head like it might hurts , please give me some information on this matter! thanks chuck",
    "doctor_response": "Hello,I can understand your concern. The area behind ear contains lymph nodes. When ear gets infected, the lymph node in this area swells and causes pain. As it might be minor infection, the child has not developed fever yet, but he may develop if the infection is not treated at the right time.I would advise you to visit a pediatrician or an ENT specialist for clinical examination of the swelling behind ear and further investigations, if needed. If ear is infected, the child may need to start antibiotic course. I hope this information helps you. Thank you for choosing HealthcareMagic. I wish your son feels better soon.Best,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the long brown strings in the stools with abdomen cramps?\n\nHi. Yesterday morning I noticed a long brown rubbery thing in my stool. I have had diarrhea and stomach cramps, weird feelings around my anus like a tingley feeling, and around my stomach. I went to the hospital and they treated me like was crazy and ran NO tests. Sent me with a prescription that is 400 dollars. I m scared and don t know what to do.",
    "doctor_response": "HI.This can be due to worms or a desquamated mucosal lining. You should have preserved it and shown to your Doctors and also sent for the histo-pathology examination. Well, if you are alright now complete the course of medicines your Doctors have given . Go for the usual tests, CT scan of the abdomen as the iodine in the contrast kills many worms and are delineated to be seen on CT. You have to get your stool checked for 3 consecutive days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. The effect of panic attack was severe than before on using MDMA after treatment. Why?\n\nHello doctor, I am a 21-year-old male. I keep getting high anxiety and sometimes have anxiety and panic attacks when around a lot of people. I work in a supermarket so I am around a lot of people all the time and interact with a lot of people. Over a year ago, I was sectioned in a psychiatric hospital with drug-induced psychosis because I was smoking weed every night with my friends and attending raves nearly every weekend taking drugs such as MDMA, Ketamine, and Nitrous oxide balloons. When I came out of hospital I was completely fine and I returned to work and going out with my friends as usual, apart from not taking any drugs. About a year passed and I was completely fine so I thought it would be a good idea to do MDMA at a rave again (this was about 2 months ago). I had a massive panic and anxiety attack and had to sit in the car with my best friend who was trying to calm me down but I could not stop as I was still under the influence of MDMA and I could not speak to anyone properly. After this, I was fine in most social situations but in the last couple of weeks I am now really anxious about going out in public and I cannot seem to speak to anyone properly anymore, not even my best friends. I hate going to work, this has only been going on for two weeks now, so I thought I would seek help here.",
    "doctor_response": "Hello. I have understood your query. You have been using drugs previously and after that, you have been diagnosed and treated for drug-induced psychosis. So as per my opinion, even you are better without drugs for so long. You should not try those drugs again because you have faced problems before and again when you use. It will be more than the previous effect and difficult to control. So I insist that you shud not take drugs for the rest of your life. The experience of anxiety and restlessness that you had before 15 days after taking MDMA (3,4-methylenedioxy methamphetamine) was probably the acute effects of MDMA. You might have taken a higher dose of the drug than usual. After that, you have started worrying about that previous episode, so it has started continuous anxiety in you, that you can not identify consciously. And when it has prolonged, it has caused depressive feelings in you. So, in my opinion, you shud not take any medication for these anxiety symptoms at present. Go for exercises, meditation, and relaxation therapies. Do not use any street drugs. If your rave is the problem then you should avoid going there because instead of joy, you are getting drugs there and making problems for yourself. If your current anxious and depressive feeling do not improve within the next 15 days, then seek help from a psychiatrist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I take dupaston from day 15 or wait for ovulation and then take ?\n\nfor this cycle i had letroze 2.5mg from day 3 to day 7 .Then i did a follicle study from day 9 ...On day 14th the follicle was 18* 15mm and edno thickness 10mm.The same day i was given HCG 5000 iui .....I was asked to take Dupaston twice 10mg from day 15th( next day ) for 10 days .......do i take the dupaston from day 15th or wait for ovulation and then take dupaston ?plz help",
    "doctor_response": "Welcome to HCM. After giving HCG 5000 There will be rupture of follicle after 36 hrs.You have to confirm the rupture of follicle by USG.So for conceiving try to do succesful intercourse after 36 hrs.you can start duphaston after ovulation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does it take to cure lipid pneumonia ? I keep spitting out oil.",
    "doctor_response": "Welcome to HCM, Recovery from lipid pneumona is depends upon the cause and amount of lipid in the lung. Continue treatment under pulmonologist .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have lupus with liver involvement. Ultrasound shows hematology with fatty infiltration. Next steps?\n\nI have recently been diagnosed with lupus (systemic not discoid), and there seems to have been organ involvement - namely my liver. A recent ultrasound showed severe hematology of 184 mm with fatty infiltration. My blood tests showed an elevated AST of 55 (normal 30) and an ALT of 72 (normal 39). This is not alcohol related since I rarely drink (I have had 3 drinks so far this year). I eat very well and up until I became sick last year, rode 100 miles per week on my bike. I m waiting for a referral to an Gastroenterologist but that will take a few weeks, if not months. What do you think next steps would be? Liver biopsy? And since this doesn t seem to be diet related, what can I do to get healthier? Thanks in advance.",
    "doctor_response": "Hello! Thanks for putting your query in HCM. I am a Gastroenterologist (DM).It may be due to lupus itself an autoimmune disease or may be due to some other cause like: 1. If you are obese or overweight you need to reduce your weight2.Other common and treatable causes like Hepatitis B and C virus, Serum ceruloplasmin for wilson disease especially if you are young, ANA and SMA for autoimmune disease3. Lipid profile for NAFLDI will advise you to visit a Gastroenterologist who will advise you for above tests. If they all are negative then he may advise for liver biopsy to see for autoimmune hepatitis.Meanwhile I will advise you to take tablet ursodeoxycholic acid and vitamin E and do regular exercise which I found very useful in my patients with fatty liverI hope I have answered your query and this will help you. If you have any further query  I will be happy to answer that too. Remain in touch and get-well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and pain in the esophagus after exposure to dust?\n\nDust and fumes seem to cause two swollen, slightly painful areas - one either side of the esophagus - just forward of the hinge of the jaw. This has happened many times over the years and seems to occur whenever I am in a dusty environment (such as hiking in desert terrain) or when I am around fumes (such as when painting a portrait with oil paints). Any ideas as to why this is happening and if anything can be done so that it does not occur? In other words do I need to give up hiking, oil painting, etc.?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As you explain the history yes these are signs of allergic reaction. Just.avoid all.the components that makes your breathing worse.and talk with an allergologist specialist for probably further follow up. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in testicles?\n\nHi I had chlamydia once last august and got tested positive the first time. Took medication and tested again but results came back positive. So took medication again and tested myself. Results came back negative. But after about 2 months got a pain in my left testicle and went into the clinic. They tested me again for sti/std s and said results came back negative . They said it could have been a bacterial infection that caused the pain in my testes. Now its been almost a year since all this happened but I am just worried if I should test myself again and not able to get peace of my kind. Any suggestion? Do you think I might have contracted other sti or std?",
    "doctor_response": "Hi,Thanks for writing in.Chlamydia causes inflammation of the epididymis, a structure inside the scrotum (sack that holds the testicles) attached to the backside of the testis (testicles). Signs and symptoms include red, swollen and warm scrotum, testicle pain and tenderness which is usually on one side, painful urination, frequent urination, painful ejaculation, painful intercourse before ejaculation, lump in testicle, swollen inguinal nodes (lymph nodes in the groin), discharge from penis, and blood in the semen.If you have taken treatment and do not have any of the symptoms then there is no need to worry or get checked further. However if you have any of the symptoms then additional check and treatments might be required.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have severe pain and cough. Had a hit earlier. X rays and scans done. Is it to be taken serious?\n\nIn October of 2012 I suffered a closed end concussion just behind my left temple as a result of being hit with a line drive baseball.  I did lose consciousness and was transported to the trauma center.  Fortunately all x-rays and scans were negative for bleeding and/or brain swelling.  Now 6 months later I have this horrific cough and when I cough I get a sever pain where I was hit in the head.  Also, I have developed an indentation where I was hit. Should I be concerned?",
    "doctor_response": "Hi,Thank you for posting your query.Your current symptoms are unlikely to be related to the past head injury.Also, there is no need to worry about the indentation at the site of injury.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do I need a lithotripsy for stone removal after having stent removed from kidney?\n\nHi.I had pain in abdomen, after ct scan stone was found in rt kidney which moved to ureter during hospitalization. So stent was placed. Dr say that as infection was high they did not do the stone removal. Now I have been told that my stent would be removed after 4 weeks. If stone is not found removed, will the stent be again placed after lithotripsy.",
    "doctor_response": "Hello there! Thank you for asking. DJ stents are basically put at the border of pelvis of kidney and ureter where the odds of stones are pretty likely. And these stents help the stones to pass if they are less than 5 mm. Above those they are hardly to pass and lithotripsy would be required and that lithotripsy would also be useless if the stone is in the lower third of the ureter as bone behind there (pelvis) absorbs the shock waves and thus vibration is not effective to breaak stone. so in nut shell. the scenario is incomplete with superadded infection so multiple directions to go for but the good news is it is safe and you will be relieved what ever the way is opted for you. May you relieve with the easiest onecheerss khan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagonosed with beta thallasemia minor. Tests show elevated SGOT, SGPT. How to get values within normal range ?\n\nHi, I got blood tests done for a routine health check. Results showed some elevated results. SGOT -58, SGPT 108, blilrubin 0.8 , GGT - 92, cholesterol 196, HDL -43, LDL -116 . All other counts were normal. I have no health issues or complaints. Left smoking 6 months back and left drinking 3 months back (earlier a moderate/ occasional drinker). I am 41 years old, on the overweight side with a hectic routine/ timings, light/ moderate physical activity, high responsibility/ sapping/hands on control work requirements. I am looking for advise for getting blood levels normal, diet changes(?) or supplements(?). I have to undergo a complete medical in a months time. Is it possible to get results within normal values? Would be grateful for frank advise!! I am diagonosed with beta thallasemia minor - but with no health issues.",
    "doctor_response": "Hello, Alcohol,being overweight and sedentary activities seem to be the cause for your elevated liver enzymes and cholesterol.This is not to be worried and you only have to change your lifestyle to get back normal levels of blood chemistry. What to do... Quit alcohol completely Reduce your calorie intake. Reduce your weight and be in required range of your BMI. Take more of fresh fruits and green vegetables. Avoid junk foods like burgers and pizzas and avoid colas. Avoid deep fried foods. Take a super B complex vitamin along with 1000 mg VIT C daily. Your values should become Normal in another 3 to 4 months. I hope it helps.However if your liver enzymes dont become normal,the consult a gastroenterologist for the required investigations and management. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause severe pain in lower back with vomiting?\n\nhi my name is kaylee and ive been having very bad back pain for about 3 days now. i also have the runs and constantly have to run to the bathroom. i have even thrown up a couple times. i dont have a fever, and everything else seems fine, but my lower back hurts worse then when im on my period. i havent really been able to eat or walk around at all cuz of the pain, do u know what might be causing this?",
    "doctor_response": "Hello,Severe lower back ache with vomiting is most commonly associated with kidney stones.I would advise my patient to take antispasmodic for pain relief. Ultrasound of the abdomen and pelvic may be needed to arrive at a diagnosis. infections may be ruled out due to absence of fever.Consult with your doctor and seek medical help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to have sex when taking steroids, ibuprofen for allergy?\n\nHi my boyfriend had an allergic reaction to some lube we used. We went to the ER because he had clear bumps but the ended up popping on there own. The doctor said it was an allergic reaction and to wait to have sex they prescribed him steroids and ibprophen 800mg. Its now scabby is it safe to have sex now its been 2 days and we have condoms? If not how long should we wait and if so will it affect the scabs?",
    "doctor_response": "Hello,Welcome to HCM,As your boy friend is having allergy to some lubricants be careful once there is a allergy, your body immune system will be primed for this allergen and will have memory cells for the particular antigen, if the immune system is exposed to the allergen it may once again produce the symptoms.If the lesion as completely scabbed out and there is no raw surface on the genitals, you can have sex with out the use of the lube. If there is any active lesion wait until it is completely healed.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for clots in brain ?\n\nhi doctor i m nitesh yesterday my dad met an accident and doctor said that there is 4 blood clots and air block in head he told operation is risky lets cure it with medicines i noticed that my dad is behaving abnormal not interested to take rest in bed and he is getting up and going some where shaking his hands etc doctor said that we cant say anything and asked to wait for 3 to 4 days to measure his activities ie whether the operation is needed or not what to do now. is he correct? Note that my dad had undergone a surgery for sam problem(blood clot in head) before 3 to 4 years. what can i do now? please reply as soon as possible its emergency.",
    "doctor_response": "Dear Nitesh Kumar,thanks for posting query.At times in the brain there are areas which are not accessible easily for surgery and there is risk of injury to underlying brain and which can be quite problematic.In such kind of cases doctors take a conservative approach and will like to wait.He is not behaving normal because due to clots in the brain there is pressure on brain.Wait for some time and see how the things progresses,if you are very much apprehensive you can always ask for 2nd opinion from a neurosurgeon.Bye and wishing your father a speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for extreme weakness and pain in body\n\nLast year i had viral fever, and doctor gave me medicines where my bed became wet and after having medicine for 5 days, all my energy went away and i started feeling weak and my whole body pains if i do even small amt of work, I am tired easily, i am 44 years old and my weight is 72 kgs, so even going to gymn used to make me feel as if somebody has beaten me up, now after one year also i feel the same nerve pain and weaknessplease suggest, i will bless the person who cures me",
    "doctor_response": "Hello, I appreciate your concern for your health. Your Current problem has nothing to do with your past viral fever. With your narrations your weight seems to be in a good range, but still you are feeling weakness.  One important thing is after visiting gym or exertion, you feel weak and exhausted. My advice is please check your Hemoglobin (Hb) level and Vitamin B12 Level. Due to low hemoglobin, your blood's  oxygen carrying capacity is reduced and that's why you feel weak and exhausted. According to your lab reports you may take iron, folic acid and Vitamin B12 supplements.Meanwhile drink lots of water, eat fruits and fruits juices, eat green leafy vegetable, avoid junk foods and carbonated drinks. This will supplement your natural vitamin and mineral store.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from epilepsy and Petty Mals. Prescribed Lamicral and Zoniegran. Concerned about side effects\n\nHello,I have very mild Epilepsy and have been diognosed with Petty Mals. I have trouble having any medication work and am now on 600mg of lamictal and I am being put on Zoniegran starting 50mg as well as the Lamictal. I do suffer side effects from the Lamictal and am worried about the Zonegran. Do you think I could go off all medications and see if I am any different. I was diognosed 3 yrs ago and I am cureently 22yrs old.Thanks",
    "doctor_response": "Hi and thanks for the query,Treatment of epilepsy today is generally effective in most cases, and you should be able to go off medication, in case the seizures are well controlled for about 2 to 3 years on treatment. It is difficult to predict whether you shall develop side effects to the drug or not. It is important to note that the side effects are at times related top the dosage. Changing the doses carefully , under close supervision could reduce the frequency of side effects. Keen follow up from your treating physician is compelling in this case. Kind regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause itching vulgarisms on my kids skin?\n\nMy two children aged six yrs and six months have been diagnosed with itchyosis vulgarisms. Nothing seems to help their skin, any suggestions?  Tried eucerin, cetaphil eczema, epic drum, glaxal base, aveeno, olive oil, avocado oil, omega threes.....Ned help",
    "doctor_response": "You have to moisturize the affected parts with emollients. Sice yo have mentioned nothing has helped in medicine, it would be prudent for you to switch to ayurveda.Internal unctuousness is given inside the body, some Oils or Ripanto Cream (with bee wax) is applied and some herbo mineral medicines are given. But the treatment is prolonged, without side effect. Being hereditary tthere may be some problem to uproot bit but treatment will not be a waste. Hope it helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sore and bleeding gums. Swollen gums with a black hole. Should i be concerned?\n\nHi, my gums on one side of my mouth have been feeling sore. Today I woke up with pain on one side of my teeth. I looked in the mirror and noticed something there - I think a piece of steak, between my second molar and first premolar. It looked a bit green. I brushed it, and afterwards it began to bleed a lot. Now it feels more sore and I notice a small black hole which looks like it is on the gum. Is this any cause for concern?",
    "doctor_response": "Hello,Thanks for writing to us.From the details mentioned,i suspect soreness of gums can be due to deep dental caries of teeth involving cervical abrasion .I would advice you to get a thorough scaling as well as restoration done.Use soft bristled toothbrush as well as d e sen sit i si ng toothpaste to clean your teeth.Avoid acidic beverages,carbonated drinks.Maintain oral hygiene well.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is UTI in 6-month-old dangerous?\n\nhi my baby 6 month baby boy is suffering from infection right now at this moment..clinical findings was his pus cells is 8-10..doctor give us amoxicicilin for his medicine..is it dangerous stage for him when i know he still a baby?is it cureable? and wondering why my baby suffering this when he is a boy...because as far as i know just the girl that high risk in UTI...?THANK YOU SO MUCH",
    "doctor_response": "Hi,1 or 2 episodes of UTI is common in childhood, and not at all dangerous if treated properly. It is totally curable if we complete the antibiotic course (5-7 days). If his symptoms are not coming down by 3rd day, please get back to your doctor as we will need to change the antibiotic.Please note, girls are at higher risk after 1year of age- before that, both are at equal risk, and UTI can happen in both sexes at all ages. For my patients, when they get UTI before 5 years of age, I used to get an ultrasound abdomen to see for any anomalies of urinary tract, which is very rare but better to do as per the standard protocol- you can discuss this with your doctor.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam TK, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with lung cancer metastasized to liver. Is chemo the only treatment option?\n\nHello my dad is 51 years old and was diagnosed with lung cancer which has spread to he s liver in August. Since then he has been going through chemo which he is coping with quiet well considering. We have been told that he s only option is chemo and after that there is no other options. Is this the case? Any information you can give is muchly appreciated. Thank you for your time, tara.",
    "doctor_response": "Hi, Lung cancer is mainly of two types. Small cell lung cancer and non-small cell lung cancer. I do not know what is the diagnosis of your father. If his liver has already been involved then it is a case of M1b lung cancer that is stage IV disease. In this case chemotherapy is the main treatment option but on good response with chemotherapy maintanance with Oral targetted therapy is also an option. For this treatment EGFR status to be known if it is a non small cell lung cancer. Biological therapy is another options which will be selected depending on histopathology. Consult with your oncologist. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes losing personality?\n\nI feel like i ve tottally lost my personality, i get stoned everyday for the past nearly two years i think.. i lost about 2 stone and started to feel like i actually lost my personailty getting stoned dosnen t help but i feel stuck in a serious rut in my life right now i find it very hard in social situations now whereas before i never ever used to help? its affecting eveerything in my life i feel so lost",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Loosing self confidence has become a fashion among youngsters. You need to introspect self and understand why this is happening. There has to be a reason. If there is a reason, try to overcome it. Take the help of experts like psychologists. If there is no reason, forget it. Nothing can harm you. Be logical.If you require more of my help in this aspect, Please post a direct question to me in this URL.  Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever,headache,eye ache and pressure in sinuses?\n\nI have had a fever 100 to 101.8 since Wednesday night.  I have a mild headache, eyes ache when moving them around, feel some pressure in sinuses but no sneezing, snot, congestion etc... I ate raw cookie dough on Wednesday.  Husband was feverish for just a day, ate a smaller amount.  I have no vomiting, no diarhhea.  Also, I have been using an estrogen device (Estring) for about 2 weeks.  Is this just a random virus, or could it be food poisoning.Margaret",
    "doctor_response": "Hi,From history it seems that you might be having acute frontal sinusitis giving pain in eyes and pressure in sinus.You might require one course of antibiotic medicine for 5 days.Take some decongestant analgesic medicine for 2-3 days.Go for vicks vapor inhalation.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for concussion\n\nHello, My husband is 69 and has suffered two falls within a 6 week period, first falling off a boat ladder on to the hard pavement landing on his right temporal lobe, then three days ago tripped on a deck step and landed on the same side. The first fall we rushed him to the emergency room where they said he sustained a concussion. Since his fall three days ago, he has maintained a steady headache, as well as a off and on nosebleed, more on than off. Is this common or does this require a ER visit? Thank you kindly",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Well the symptoms experienced by patient after second incidence indicates head injury. Regarding headache,it may be due to either skull bone fracture or underlying haematoma(EDH,SDH or contusion). Well nasal bleeding may simply be bleed or CSF (brain fluid) due to skull base fracture.You should visit ER and undergo fresh CT scan for correct diagnosis. Further  treatment, whether conservative or operative depends on CT scan findings. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain when had angioplasty for blocked arteries, stent insertion?\n\nI have undergone angioplast  for blocked arteries and inserted one stent.after four months I am facing chest pain even at minimum exertion medication in use: nitract sr 6.5mg revlol xl 50 mg, prasita 10 mg, minipress 5mgkindly advice me to get rid of chest pain",
    "doctor_response": "Hi,I would advise you to see your doctor and perform a stress test. There is a possibility, that you have developed another blocked artery, or blockage in the stent.Hope i could help youWishing you good healthIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe cramps in hands?\n\ni have cramps in my hands that are so bad the bunch up into fists and it hurts and it goes throught my body, head to toe. it happens once in a while. not often ,it depends. is it from a lack of pottasium or iorn or what i dont know some say its parkinsons others say fibromyalga others say multuplural scrolosys please help",
    "doctor_response": "hi,thank-you for providing the brief history of you.A thorough neuromuscular assessment is advised.As you have cramps starting from fists and then later you feel it in the whole body, getting a Neuromuscular assessment is advised. Also, certain times due to fluctuation in the sodium levels the cramps occurs. A thorough blood examination should provide an input. As, parkinson disease is known by the two key symptoms like - rigity and tremor. Both are far different than cramps so you can be assure it is not parkinson disease.Understanding the biochemical imbalance occuring in the cellular levels can help doing correction. Also, your age, sex l, lifestyle, past medical history etc needs and understanding without which it will not sound good to come to a conclusion.once the diagnosis is made than with simple medicine and general exercises things should be fine.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain?\n\nI\"ve been having pains off and on for about a week, the pain comes from the left side of my chest, like directly my heart, I'm female, decent health, take no medications, overweight but in good health. What could be the cause?? I have a high tolerance for pain so I would give it a 4 to 5 at times.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Recurrent left sided chest pain is commonly due to heart diseases. So better to first rule out them. So get done ecg, 2d echo and stress test (trade mill test). If all these are normal then no need to worry for heart diseases. Sometimes muscular spasm can also cause similar symptoms. So avoid movements causing pain. Avoid heavyweight lifting and strenuous exercise. Avoid bad postures in sleep. Take painkiller and muscle relaxant drugs. Application of warm water pad on affected areas is also beneficial. Don't worry, you will be alright but first rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does fertilaid help in enhancing chances of conception ?\n\nI want to go for hsg test on day 7 of my cycle, is it okay. I have been ttc for 7 months, but i noticed i dont have the egg white cervical mucous, what can i use to aid the production of this mucous. Can using fertilaid help enhance conception Trying to conceive",
    "doctor_response": "Hi welcome to healtcare magic yes you can go for the HSG on day 7 of cycle. production of the mucous is physiological...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do high SGOT and SGPT levels after viral infection indicate?\n\nRespected Dr Sahib, My 9 year old son is undergoing treatment for viral ( antibiotic - Oflomoc Forte administered for 5 days). The fever is continuing on the sixth day with lesser interval . Local Pediatrician has after six days asked for the following tests: CBC+ESR+ SGOT SGPT+ Widal+ MP+ Urine Routine. The Widal test report will be received tomorrow. Presently SGOT SGPT repot is at hand (SGOT 180 U/L) (SGPT 110 U/L). Is It suggestive of Liver problem or has the level increased due to antibiotic admistered for 6 days. Kindly reply please Kindest Regards Sandeep R Karwa",
    "doctor_response": "HiWelcome to the HCMMany diseases and conditions can contribute to elevated liver enzymes. Your doctor determines the specific cause of your elevated liver enzymes by reviewing your medications, your signs and symptoms and, in some cases, other tests and procedures. In my opinion it can occur due to Hepatitis, Long term paracetamol use, typhoid fever, pancreatitis, polymyositis, mononucleosis, Cytomegalovirus or Epstein-Barr virus infection in your child.As the levels are moderately raised and no other symptom apart from fever, typhoid is a more likely cause. I would suggest to look at Widal test report and also go for a blood culture and sensitivity test. Changing antibiotic to Cefixime and Azithromycin will help in typhoid.For further questions, do contact us.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hepatitis-c and raised SGPT?\n\nHI Dr my father got hep c  yr back then he took interferon he complete course for six months and when he test after treatment that was negative bt after four months he was not feeling well when he tested again and hep c is positive and his sgpt is 79 can u please tell me why it occur again?? and why sgpt is raised??",
    "doctor_response": "Hi thanks for contacting healthcare magic.Noted he has chronic hepatitis c...In which chances of chronic hepatitis is very high as much as 80%....He might be in active stage so antiviral drug given....It suppress viral multiplication...But now you are hepatic c positive...So yes you are In chronic phase...Regular follow up done.Take more fruits .Use less oil while cooking for lunch and dinner....Protein diet taken in adequate amount...In morning take one tsp licorice with honey...Yoghurt , carrot , tomato good in your diet.Avoid alcohol...So your sgpt high because of liver affection as this enzyme present in liver hepatocytes.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness on penis while sitting?\n\nHi, may I answer your health queries right now ?  Please type your query here... I have numbness on my penis when I sitting for about half and hour that mean something compressing on my S1 and S2 nerve root or something pressing on the arterie that supply to the penis.",
    "doctor_response": "Hello, Do not worry about it. If you feel the numbness during your sexual intercourse, do consult a neurologist. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain in a child while jumping on a trampoline?\n\nMy very athletic 8 year old son has been recently complaining of chest pain while jumping up and down. He went hiking with a fairly large back pack a few days ago and now when he jumps on a trampoline or does jumping jacks he says his chest hurts. What could be the cause of this?",
    "doctor_response": "The cause of his chest pain can be musculosketal due to the heavy backpack he was carrying..The only medicine he requires is a painkiller gel for local application over the site of pain.. And he should rest and avoid strenous exercise till the time he gets relieved of the pain.. And this can take few weeks to resolve..",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat back pain?\n\nMy husband had a triple by-pass 10 weeks ago. These past few days he is complaining of severe back, shoulder pain and pain if he tries to take a deep breath. His BP, pulse rate, and temp are normal. The pain radiates to his chest but is not coming from his heart. Could he have pluerisy?",
    "doctor_response": "Hello,I had gone through the case and found that if there is doubt of pleurisy then go for Echo of lungs and find the cause.If no then go for vitamin D3 test amd it might be only muscle spasm.So go for test then take treatment. If only muscle spasm then take mild painkiller and apply muscle relaxant gel and also take Vitamin D3 once a week for 3 months.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any side effects of taking Seraquel?\n\nMy daughter started taking Seraquel I believe 50 mg at night. She can hardly function. She has 2 small children and a husband who is away for 2 months. She says it feels like her skin is crawling and she simply seems more depressed. Any insights?",
    "doctor_response": "Hi, thanks for the query. Seroquel (Quetiapine) is an antipsychotic & a mood stabilizer. It is usually prescribed for schizophrenia & for maintenance of bipolar disorder. It causes excessive sleepiness & fall in blood pressure. Hence it is usually given at night & its dose is gradually increased to improve tolerance. Depending upon the indication for which your daughter is prescribed seroquel; we can either change seroquel plain preparation to Seroquel-SR (sustained release preparation) which is longer acting, less sedating; or we can change seroquel to lesser sedating options like Aripiprazole, blonanserin, amisulpride etc. Hence, consult your Psychiatrist for the change. You can revert back to me for any further help. Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for nervous disorder problem\n\nDear sir, Good Evening. Iam 26 years old, suffering from cold for last few years. Presently iam consuming Frisium 10Mg and Eption tablets to avoid nervous disorder. From Childhood I had a problem of Fitz if i intake some cold food items. Now iam alright, but still i feel i have nervous disorder problem. so can you please advise me what kind of treatment i have to take now.",
    "doctor_response": "HiI understand your concern.i do not understand about nervous disorder will you elaborate properly.Eptoin and frisium are the remedy for convulsion or fits. You mean to sat you have fit in spite of taking this medicines then need to consult your treating doctor.There are many other anti convulsion medication which will help you.If you have nervous disorder like nervousness and anxiety then medicines like anxiolytic and benzodiazapine will help.Require proper evaluation.Still have question then feel free to ask.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes twitching sensation in fingers?\n\nHello I just recently have been experiencing twitching in my right ring finger....and I was just wondering what could be causing this to happen. ...??? I had surgery back in December 2013 to repair a distal bicep tendon in my right arm I m wondering could it be related to the surgery. ...?",
    "doctor_response": "The distal biceps tendon injury repair is likely to have compressed the nearby ulnar nerve producing the twitching.  However this can be confirmed only by clinical examination and electrophysiological tests.  It's better to consult a neurologist for sorting it out as this can later on progress to weakness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore throat , vomiting and fever in a child?\n\nMy 7 year old son has had a constant virus since the middle of January. It consists of severe headache, fever (100-102), sore throat, vomiting and fatigue. He has seen his pediatrician multiple times and has been tested for strep each time. The strep test has been negative each time. He recently had blood tests conducted and all of the results came back normal. The symptoms seem to get better after 4-5 days and then 2 weeks later he has them all over again. I am extremely concerned and not sure what more to do.",
    "doctor_response": "HI...by what you quote I feel that your son might be having a recurrent viral illness.To relieve your distress I will tell you how a viral illness behaves. So that you will be in a better position to understand.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.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can my friend forget her past events in her life due to stress?\n\nMy friend has fainted and become unresponsive twice in 2 weeks, the first time she wa kept at the hospital for 3 days and they assumed stress, the second was last night and she was abel to sign her self out tonight. however last night and today she did not remember that she is divorced and not been with her husband for 1 year and a half. she did not remember moving, or even being at the hospital 2 weeks prior. She seen the man she was recently dateing and just broke up with and did not know him. what could this mean. she would not stay at the hospital to see a crisis nurse and no one know what to do or how to help We worry once she is alone again she will pass out and no one will find her next time. I know stress can do many things to people, but with her loseing parts of the last year and half of her life I worry something is shutting down. any suggestions",
    "doctor_response": "HiThanks for using healthcare magicThe kind of symptoms u r explaining is towards dissociative disorder. Few feels these kind of fainting episode in which they forget everything or behave abnormally. Take psychological consultation in her case. In drugs low dose benzodiazepine could be effective.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes delay in periods despite having negative UPT?\n\nHello dr. My wife is using contraceptive pills and she is taking it regularly since last period but this time her period got skipped and we have tested pregnancy test which came negative but it's been around 45 days still no sign of period what to do?",
    "doctor_response": "Repeat urine pregnancy test if still negative than she has to take primolut N  twice a day for 5 days after which she will get her menses.Consult mgynecologist if no bleeding after primolut N",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i get success in IVF with my own eggs?\n\nI have been trying to conceive for past 5 years with no luck. Had 2 failed IUIs. My Age is 32, AMH levels are 0.53. FSH levels are 9.36. Can I get success in IVF with my own eggs? Also what help Ovigyn D tablet can provide in my case? I have read on net about DHEA being helpful, please advise for my case.",
    "doctor_response": "yes u can try but it might require more than one cycle due to low amh. dhea does help. the good thing is young ageDr. Prerna Gupta MBBS (AIIMS), MD (AIIMS), (Gold Medalist)DNB, MNAMS, MRCOG (UK)Commonwealth Fellow in Reproductive Medicine (BCRM, UK)consultant Moolchand prernagadodia@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain after consuming juice?\n\nHi, for a long time now have said to people that juice makes me ill.  I don't drink fizzy drinks much but when I do drink them I just feel terrible.  It starts off with slight pain in the stomach area them overactive bowel movements,  itching all over and even more everytime I pass urine. And also just the colour of my complection changes to very pale.  I am also prone to ear infections, coughing fits.  I used to think it was a caffine intolrance but I am now thinking it has something to do with sweeteners?",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.The first treatment of such problems is to stop taking / consuming any food or a beverage that causes such problems. Why should you try to consume, as it can cause severe allergic problems. Now is just an intolerance.As this is giving you paleness with such a severe problems , I would suggest you to undergo angiography of the abdomen just in case to rule out any vascular problems to the blood supply of the intestines and the stomach.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the upper abdomen?\n\nHello.  I'm a 33 year old female.  For a while now, I've had some pain in my right mid-upper abdomen.  I had an abdominal and pelvic ultrasound in February which were normal.  I also had a CT scan with contrast, a small bowel follow-thru, an endoscopy and a gall bladder function test.  All were normal except for some gastritis and some bile in my stomach.  The CT scan also showed a small liver cyst which the GI doc told me not to worry about.  After the CT scan (in April 2011) I started to feel much better with the pain coming and going and sometimes being relieved after a bowel movement.  Now the pain comes and goes but I also experience bloating, gas and constipation.  The constipation I've had my entire life as far as I can remember.  The pain comes and goes and sometimes by stomach gets very hard.  Sometimes I also experience lower back pain on the right side.  I'm so fearful of ovarian cancer.  What are the chances of this?  I have 4 children ages ranging from 3 to 9.  Any advice would be greatly appreciated.",
    "doctor_response": "If you have beeninvestigated properly for almost everything and reports are within normal limits you should not be worrying this much.By description following are the possibilities to rule out,1Acid peptic dyspepsia syndrome,With Gastritis2Cystic Ovary3Constipation and IBS4Take plenty of oral fluids , fiber full diet. You can add TAB pantoprazole with prokinetics before meals twice daily.You can also add lactulose syp once in awhile to facilitate bowel movement .5.Stool for occult  blood also needs to be done.Wish you Speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cyst in breast\n\nhi, i am 19 years old and have had a cyst in my breast for around 2 years, i had a biopsy a little over a year ago and results showed it was just a cyst. the cyst grows and gardens during periods so i have decided to have it removed. i forgot to ask my doctor who i was examined by at the hospital today if i would have it removed under local or general anesthetic, do you know? Or can i request general anesthetic to be used? thanks.",
    "doctor_response": "welcome to Health care magic.1.If it is proven cyst, and not causing any discomfort - you can leave it alone, may resolve by time.2.If as you said causing discomfort during periods - better get rid of it.3.It is generally done under ultrasound guided needle aspiration with no anaesthesia or local. General is not at all recommended. 4.Hope i have answered your questions.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a lump above the penis shaft be treated?\n\nhi there, i seemed to have developed a lump of some sort in the pubic hair region just above the penis and over to the left. it's currently quite small, but is very slightly visible when looking down. it feels like some sort of cyst when pressed with my fingers and is not sensitive to touch. i'm not sure how long it's been there, but i've noticed it this last week. any ideas?",
    "doctor_response": "Hi,Dear,Good Morning and Thanks for your query to my virtual Clinic At HCM.I studied your query in depth and understood your concerns .Causes for lump above penis in pubic area- as follows-Mostly they are ?hernia -inguinal direct /indirect.Check with ER Surgeon to resolve the worry.Don't worry of them,as they could be relieved with proper treatment.Hope above reply would help you to relieve of the issue you have.Welcome for any further query to ME and HCM.Wishing you a Fast Recovery.Write Good review for the benefit of my new patients.Click thanks ASAP after this.Have A Good Day.With RegardsDr.Savaskar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dryness in the mouth and throat?\n\nIn the morning I sometimes wake up with a red stripe in the middle of my tongue. My mouth is dry and also my throat. I am constantly drinking water to quench my dry mouth. I do take sugar free cough drops that do help to alleviate the dryness. Here is a list of my prescriptions: Naproxen 500MG 2 x a day Duloxetine 60 MG 1 x a day (AM) Duloxetine 30 MG 1 x a day (AM) BusPIRone 15 MG 2 at 1 x a day (AM) HYDROXYCHLOR 200 MG 2 x a day Simvastatin 20 MG 1 x a day (PM) Vit C 1 x a day Vit D 5000 1 every other day",
    "doctor_response": "Hi..Thanks for the query..You are suffering from Dry Mouth or Xerostomia and in your case the medication that you are taking seems to be the cause..So my suggestion is to once consult your Physician and get evaluated..If possible the doses of medication can be reduced or medicines can be changed..For now you can use oral lubricants like Oralgel.Chew sugar free chewing gum.Suck lemon drops..At night you can place Xylitol patches over the cheek mucosa as it helps in maintaining a layer inside mouth and eliminate dryness.Drink plenty of water..Hope this helps..Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does BP level of 155/78 and resting 49 pulse indicate?\n\nHi, I have a couple of questions if that's ok to do so.... I have 155/78 blood pressure with a resting 49 pulse. I'm 18 years old and weigh 189 lbs and I'm a male, I work full-time for a summer job which requires lots of cardiovascular exercise, so I would assume I'm getting enough physical activity throughout the days. Just curious if this is normal or if I have a high-blood pressure... If not, then another query would be required regarding why am I always so tired during whatever time it is. I eat healthily, I'm not exactly a couch potato, and I really can't find another explanation other than if I had high blood pressure, I'm not under much stress either at the moment..... Anyways, thanks, and please excuse the wall of text, I know how unattractive they are to read.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. 155/78 is more than normal and 49 pulse is slow. I will suggest that you should take ECG and stress echocardiography. If both come normal then start tab Amlodipine for blood pressure. Also start a multivitamin antioxidant combination once a day. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Backache lasting over a week. What could be the reason ?\n\nam having backache for up to 7days now what could be the reason",
    "doctor_response": "Dear one hello welcome to H C M,as yours question is direct & no history,it seems to be simple one.so donot worry.if you have to ask some thing more pl ask with  proper history.have some muscle relaxant,enjoy physiotherapy. thnx dr s k gupta ortho surgeonry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there an alternative of Nasacort that can be taken for allergic rhinitis?\n\nHi. I am having indoor allergies at work. I believe the building is old and does not have a lot of openings for fresh air. I recently got a septo-plasty and reduction of turbinates through surgery. My ent specialist recommended Nasacort and Affrin (only my need immediate relief and I use it only 3 days and take a break).  My concern is that when not taking affrin my nose is clogged which prevents me from concentrating at work. Is there any other medication I can try other than Nasacor and not rely on Affrin. I do irrigation using nasal saline and have also used vicks spray but none of them work like Affrin. Please advice if there is any alternative to affrin.Thank you,Zain",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Nasacort is having mometasone. It is inhaled corticosteroid. Afrin is having oxymetazoline. Afrin is habit forming drug so better not to take it. You should take 1. Combination of fluticasone and azelastin nasal spray twice daily in each nostril. 2. Oral combination of antihistamine (levocetrizine or fexofenadine) and anti allergic (montelukast) once a day at night. These will improve your symptoms without much habit formation. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need effective medication for acne\n\nhello sir.i am 23 year old college girl.and i m suffering from acne problem from since 6 month.from last 2 months i am taking homeopathic medicine and from last 3 days using TOPI BERBERIS cream at night and day.but its not helping out.suggest me something which can work out faster.recently i m using saslic facewash(by cipla) and olay age defense cream.thank you.please suggest something effective.",
    "doctor_response": "Hi, Acne treatment depends upon the severity and type of lesions. The treatment is given in the form of oral medicines( azithromycin/ doxycycline/ minocycline and/or isotretinoin) along with topicals( clindamycin, benzoyl peroxide, adapalene tretinoin) etc. As you said you want faster results, that can only be delivered after a thorough skin examination so that a personalised skin treatment can be suggested. However, you may follow these basic suggestions to prevent and treat acne 1) continue with saslic face wash. Use it twice daily 2) you any continue with Olay cream, if it suits your skin well 3) get your blackheads and whiteheads removed regularly and apply retino a cream in comedone prone areas 4) treat your active acne lesions with application of clindamycin gel and retino a cream. Depending on your acne grade severity, oral therapy might be required, for the same consult a dermatologist nearby. You may also discuss the option of chemical peels with your doctor as peels give good results in short time and also take care of pigmentation and scarring. Hope that answers your query. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair loss\n\nI am using Richfeel two food supplements as treatment against hair loss. Are their any cheaper substitutes available in the market?Compositions:Supplement 1: Macafem powder capsulesSupplement 2: (Per capsule)calcium phosphate 250mgmagnesium phosphate 200mgpotassium phosphate 100mgzinc amino acid chelate 50mgManganese Amino acid chelate 25mgsilica dioxide (fumed) 25mgchromium amino acid chelate 250mcgammonium molybdate 377mcgpotassium iodide 50mcg",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Yes there are many hair supplements available in the market. You can take Follihair tablet once in a day and tablet Keraglo eva once in a day. They need to be taken for at least 3-4 months to see significant results. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for panic attacks and PTSD\n\nI am a retired service member and have been for several years. I have been to the E R due to severe panic attacks in the last couple years. I was never shot in combat and have always considered ptsd a sign ow weakness to an extent. I witnessed some terrible incidents and one in particular left me with an immediate reaction of violent vomiting due a certain odor and taste. The texture of the air was like steam. Now for example if I were to drain water from a hot water heater and the steam hits me in the face I vomit and that is an easy way to describe the action",
    "doctor_response": "HelloWelcome to HealthCare MagicI can certainly understand your concernPTSD and Panic attacks are predominantly treated by medications like Benzodiazepine s and SSTI's for 6 to 12 months. Sometimes even a longer duration is required. IPost your further queries if anyThank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bright red itchy skin in groin, tried various creams, no help. Had angioplasts inserted through the groin. Related ?\n\nThe skin in my groin is very bright red and itches very much. Further under the groin the skin looks like a bruise . I have tried creams to try to deal with the complaint including Lamisil, Mycil Cream, Corstisone cream and finally an iodine spray, but nothing seems to work. I have had angioplasts inserted through the groin about six weeks ago and I was concerned that this may be related to the situation. Is this something or nothing to be concerned about please?",
    "doctor_response": "Hello ic.brooks, Thanks for posting your query. I think your problem is not the infection but the intertrigo, it is a condition of moist raw itchy skin which becomes reddish and develops in areas that are in contact all the time, like in the armpits, the outer side of labia/scrotum and inner side of the thighs. Wearing synthetic under garments hampers the circulation of air and retains moist making the problem worse. You should avoid tight pants and synthetic under garments and keep the region dry most of the times. Immediately wipe and dry yourself with thick cotton towels after you take bath. You should use a medicated dusting powder containing Clotrimazole/miconazole/salicylic acid, thrice a day. The cannulation for angioplasty through local skin does not seem a probable cause. I hope this answers your query. In case you have any follow up queries or doubts, you can forward them for me, and I shall be glad to help you. Please accept my answer in case you do not have further queries. Wishing you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can MT pill save from pregnancy?\n\nI took a test n I m pregnant I ve had unprotected sex with my boyfriend cuz I m on the Nuva ring I had an unexpected 2 nights with my ex the first night he didn t fully penetrate n the second time we used a condom is there a chance that this baby is my ex s n if so is the mt pill safe....",
    "doctor_response": "Hello, The abortion pill is actually a combination of two different medications: mifepristone and misoprostol. No, EC (Plan B) does not cause an abortion. EC pills work to prevent pregnancy after sex and will not cause an abortion if pregnancy has already occurred. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr AJEET SINGH, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest herbal ways or alternative ways instead of using Cabergoline\n\nI recently had an MRI and it showed I have a tumor 1 x .8 x .6 sonometers.  My prolaction level is 128The Encronologist is suggesting I take Cabergoline to reduce the size of the tumor and lower the prolation levels.  Are there some herbal ways or alternative ways besides taking cabergoline to teat this problem.?",
    "doctor_response": "Yes definitely. Kanchnar guggul and Arogyavardhini vati taken together will show you results in about 8-12 weeks. Firmer 2 bid and latter 1 bid.Avoid sours and heavy food.Do deep breathing exercise - the Pranayam. Learn on International Yoga Daysomewhere near you. It's 35 minute package - freeIt's slow and longer but non toxic. After 8 weeks continue only Kanchnar guggul for reaching desired levels. Totally safe.  Doesn't counteract with other med.Lot of warm water reqd with these.Write back happily when it starts reducing. It's my experience.Hope it brings happiness to you - safely.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will taking contraceptive pills stop me from conceiving ?\n\ni am 22 years old and want to conceive but i have taken 3-4 emergency contraceptive pills in a year is there any problem due to these pills?",
    "doctor_response": "Hi, Welcome to HealthcareMagic Forum. The common side effect of these pills is Hormonal imbalance. If your Periods are regular that is a 28 day cycle, it means you are ovulating and you will have good chances of conceiving. Good Luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it dangerous to have nodule on lung?\n\nmy husbands doctor found a nodule on his lung 5 weeks ago. He had a CT scan with injection and last week a PET scan. Dr. told us today it is probably malignant but wants to do a lung biopsy. What will the biopsy show that the PET scan didn t. This has been a very long 5 weeks. Thank you",
    "doctor_response": "Thanks for your question on HCM. I want to ask you few questions first.1. Age of your husband. 2. Is he smoker or not.Nodule in lung needs thorough investigation.  Depending on the CT THORAX appearance, age and smoking habit, probability of malignancy can be predicted. If nodule has1. Larger size (more than 1 cm)2. Irregular margins3. Devoid of calcification4. Associated lymphnodes etcIn a smoker patient with age more than 50 years, possibility of malignant nodule is high.And biopsy is needed to confirm the diagnosis of malignant nodule.Biopsy gives tissue diagnosis and if it says malignancy than it is 100% confirm diagnosis. PET scan can show positive uptake in infection,  inflammation and malignancy.  So to rule out all these biopsy is needed.So go and get done biopsy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy after condom break during ovulation period?\n\nmy last period started around the 11th of october, i have an app on my phone saying that the 21st-26th i'm ovulating. on the 25th me and my boyfriend of 5 years had sex with a condom (we're always very safe) and it broke, what are the chances of me being pregnant?",
    "doctor_response": "Hi dear and thanks for your query.Chances to conceive after the condom break is as you have unprotected intercourse.As you where in your fertile days and condom break be aware that you may be pregnant .Wait for your date of menstruation ,and if they delay ,take a pregnancy test at home.All the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How safe is giving Cremaffin for constipation?\n\nHi Doctor, My son is 18 months old and he has the constipation problem. We have been giving cremaffin for over 6 months now (5ml once at night). Is there a problem in giving this ? Also, we are giving Fig in the morning time. Initially giving fig did not work out. Hence we started cremaffin.",
    "doctor_response": "Hello,Using cremaffin syrup is safe but for short period because using for the long term is not a solution. Here are some advice for you:- Use plenty of water, apple juice, orange juice.- Use fig in the morning and plum jam.- Use kiwi in the evening.- Avoid eating a banana,- Use abdominal massage to help the abdominal peristalsis increase. - During this time avoid using cremaffin. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Elona Dashi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I conceive another child with problem in blood?\n\nwe have a 8 years female child now we r trying a year for a baby but we r fail i have many test aincludeing hsg test everything ill be normal now my doctor says problem in ny blood & gave me eltroxin50 mcg .i am in tension could i get another child or not i m 33 years pls helm me........",
    "doctor_response": "Hi, I think you are having hypothyroidism.  It can be treated by medicines.  So, don't worry about it.  Be in contact with your husband every 2 to 3 days after your periods stop.  It will increase chances of your pregnancy.  Hope I have answered your question.  Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen feet when taking diuretic for headaches?\n\nMy 15 year old daughter s feet swell. She is an active person, but does not play sports. Her blood sugar does tend to get low if she hasn t had food in a while, and by low I mean 50. She is currently taking a diuretic for headaches, but I m not sure what the swollen feet mean.",
    "doctor_response": "Hello, As for a small girl of age 15, I don't think diuretic will be advised. Because this may lead to loss of fluid and lead to headaches as there will be a fluid loss in the body. For her having to swell in the feet you need to get a proper examination of the feet if there is any musculoskeletal injury. Also, kidney examination needs to be done as due to kidney malfunction there may be chances of swelling. I think a proper examination is to be done before putting her on to the diuretic. For headache, I will advise getting the eye checked up as due to strain in the eye muscles there may be a headache symptoms. I will advise doing complete blood and urine routine, get the kidney assessed, eye examined etc., for coming to a diagnosis and then the treatment part. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could a lump in the wrist indicate, discomfort in entire arm?\n\nI have a marble size lump on the inside left wrist down near my hand. I had left trigger surgery a month ago, and I didn't know if that could be a reason. It is very sore and feels raw and irritated feeling all along the inside of my arm about half way to my elbow.",
    "doctor_response": "Hi,This may be a ganglion which is a swelling in one of the tendons at the wrist. It may be irritating a nerve causing the pain. I suggest you see a hand surgeon for assessment and to discuss options which may include surgical removal. Regards,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for chronic kidney infections?\n\nI have chronic kidney infections. I was given antibiotics on thursday of last week. I have still been having a high grade fever chills etc. . My neck is hurting so bad. I have never had neck pain before. Is it normal or shoudl I be re evaluated? The neck pain is severe.",
    "doctor_response": "Hello, i understand your problem. Getting neck pain after having treated for chronic kidney infections and now you have complaints of severe neck pain. It could be a meningeal irritation due to meningitis. Or it could be just a neck spasm.I would highly recommend you to go n consult your doctor for the same. Because if its just a neck muscle spasm its well n good but if its something meningeal it might need further workup and prompt treatment for the same.I hope you take action on this as soon as possible. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from precordial catch syndrome and pain in the side of the heart\n\ni have precordial catch syndrome and the pain in my side usually doesnt last for more than a few hours but this pain has been lasting for three. Its a constant pain on the left side by my heart. Ive tried taking deep breaths, both slow and fast but nothing is working. Ive also taken advil and ive been stretching but that doesnt seem to be working either. Do you have any suggestions?",
    "doctor_response": "It's better if you mention your age and duration since when you have suffering.Precordial Catch syndrome is chracterized by episodes of cardiac pain for a brief interval of minutes to hours without any underlying cardiac disease.however of you have  found no relief in spite of stretching exercises and advI it's better to get a cardiac reevaluation done. If it yields negative you can try to observe aggravating factors and avoid it.many patients respond well to application of ice packsand gentle physiotherapy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is FSH of 8.9 and LH of 6.02 normal?\n\ni have pcod problem i got married in 2008 , 4 years over still i didnt get pregent now from  past 3 months i went to a Gaygonilist  they are treating me & they  told me to fsh testin that i got 8.90 & lh i got 6.02 is this a normal to get consive please help me",
    "doctor_response": "Hello,Welcome to healthcare Magic.I have gone through your query and Would like to reply in detail as follows:1. The reports seem to be norma.2. Please visit an IVF centre soon for proper evaluation.I hope your doubt is clarified. Let me know if you wish any other information.Regards,Dr. Soumya",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for acidity during pregnancy\n\nI am 7 weeks pregnant and I a m suffering from acid, and sever stomach gas problem which results to headache. Before pregnancy was having same problem which was perfectly treated with unienzyme capsules. Kindly suggest me some medicine for the same that I can take in my pregnancy",
    "doctor_response": "Hello,Thanks for sharing your health concern with us. I have gone through your query and would like to offer some suggestions. You may continue with the enzyme as before. In addition, make some dietary changes like avoidance of beverages, spicy and oily food, frequent intake of small quantities, adequate hydration etc. Take easily digestible food. Hope you find this information useful. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tightness and pain in foreskin of penis\n\nHi sir I m 26yr old and my penis foreskin is tight at top and never down top to bottom.its very painful to do this.plz sir very difficult to sex with girlfriend.and very painful. Is ther any crems or lotion plz suggest me sir.my foreskin tight and never down from top.plz sir do needful for me.",
    "doctor_response": "Hi,It seems that you are having Phimosis.You might require Circumcision procedure to sole this problem.If you do not go for this operation, there might be having problem of having paraphimosis leading to some emergency problem.Meanwhile use condom or some lubricant while doing sex.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swelling and numbness in fingers and hands\n\nHi,I was diagnosed with thorasic outlet syndrome in 2011 and told that i had 2 extra cervical ribs,one on each side.was told that I did require surgery as I have the vascular type,after deciding not to have surgery because the vascular surgeon had only done the surgery 3 times before l have since suffered a mini stroke & my right arm and hand and fingers keep swelling,going completely numb I m unable to close my hand to grasp and pick things up,been to a&e on numerous,occasions when this happens to be told that I could throw a blood clot and when this happens and that this could of been what caused the mini stroke,just wondered is this true and could it happen again.many thanks",
    "doctor_response": "Hisorry to know of the stroke.kindly consult again with the surgeon who diagnosed.This condition is not so common and you may not find a surgeon who has performed thousands of such operations.3 surgeries are good enough for a surgeons exposure , and trust me,he is in a good position to perform on you.Stoke can happen from any cause from clot anywhere in body to clot in brain itself due to atherosclerosis.A MRI -scan of brain and thorax including shoulder  out let can catch the clueconsult a neurologist as wellRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swallowing in feet?\n\nSir I have been detected a stone in my kidney about of 1.5 cms, and as I feel that as much I am consuming the water in that ration it is not being converted in urine passing. Since last few days my feet is swallowed. Please suggest me my course of action",
    "doctor_response": "Hello, with the new addition of the symptoms you are giving i would suggest you to get a repeat USG of abdomen to lkod for any improvement or is there any descent of the stone from its previous position. I would also suggest you to undergo renal function test as your kidneys are not producing enough urine as much you are consuming fluids. It could be possible that the stone has not moved from position and is causing obstruction to urine outflow and is the reason for swelling. So ki dly get 1st repeat scan of abdomen and a renal function test. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Parkinson disease\n\nHi, I am here to consult regarding Parkinson disease..my father is suffering from it.....his age is 62 years, height is 5'4 inches and weight is currently 64 kgs...right now his whole body is shaking...he has shown in Kolkata and the doctors say it is due to overdose of medicine...previously his movement was slower..but right now due to overdose of medicine his body is shaking continiously...he is having problem in sitting at a fixed position...can you suggest what to be done....",
    "doctor_response": "Hello,Welcome to HCM,Parkinson is a disease which causes certain brain cells to die. These are the cells that helps to control movement and coordination.  Parkinson disease most often develops after age 50. It is one of the most common nervous system problems in adult.In Parkinson disease, the brains cells that make dopamine to die slowly . Without dopamine the cells that control movement can\u2019t send messages to the muscles.ts.There is no cure for Parkinson disease. However treatment can help to control your symptoms.Medicines like Levodopa is the most commonly prescribed and most effective drug for controlling the symptoms of Parkinson disease.Dopamine agonists like Requip, Mirapex, and Neupro can be taken after consulting your doctor. Anticholinergics are used to restore the balance between the two brain chemicals dopamine and acetylcholine.COMT Inhibitors like Tasmar and Comtan helps to retain dopamine which is used more effectively to reduce the symptoms of Parkinson disease.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for cold,flu and wheezing?\n\n46 y/o male.  2 episodes of passing out while laughing, also has cold/flu wheezing during these times.  went to pulmonogist who suspected asthma, while taking the pulmonary function test trying to exhaled hard, i passed out 3rd time.  all cardiac tests came out ok.  could asthma exacerbated cause passing out \"vasal vagal syncope\"? thank you.",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. Yes, cough and breathlessness induced vasovegal syncope can cause similar symptoms like you have. In my opinion, you are mostly having bronchitis. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system. 2. PFT (Pulmonary Function Test). PFT is needed to rule out asthma or bronchitis. It will also tell you about severity of the disease. And treatment is based on severity only. So better to get done PFT. You may need inhaled bronchodilators and antihistamines drugs. So consult pulmonologist and first diagnose yourself and then start appropriate treatment. Don't worry, you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain, sore leg, feels going toilet again and again in night, hard to sleep. Symptoms combined or different injuries?\n\nHi, ive had a lower back pain since about six months ago it switches sides and is a shooting pain feeling somedays it hurts more than others and sometimes it hurts when i bend or even sit, adding to that now i have a sore legg /hip which is also a shooting pain when i put it up to the side or kick it up and i can feel it going over anothr bone i also pee alot especially during night in the space of 15 minuits i can be in the  bathroom 7 to 8 times i always feel like i need when there is barely anything there it is hard to get to sleep. What could this be ?are these symptomes combined or different injurys?",
    "doctor_response": "I think  you   get examined  by a spine  doctor/orthopedist. Shooting pains  down  the lower limb  along with back pain  is  often due to disc problems. and might require  an  MRI  to  see the  fault. In  meantime  take  hard  bed,  avoid  forward bends,and  avoid  lifting  weighty  things, do  back fomentation and  lie in  comfortable  posture  which eases off pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can soreness in the male nipples and hardness behind them mean gynecomastia or something else and does it get worse?\n\n23 year old male, recently discovered both of my nipples were very sore to the touch and felt like there was a hard lump behind them. Didn't think much about it until i squeezed them and a clear like fluid came out. Naturally, I became nervous and researched causes. One of the major causes I found was Gynecomastia. I have not noticed any enlargement of the area around the nipple. The nipple is just semi swollen and still very tender to the touch. Another cause was male breast cancer but the symptoms do not match what I have going on. If it is gynecomastia does it progress and get worse? could it be something else?",
    "doctor_response": "Increase  in breast size at your age can be due to gynecomastia.  You can forget about cancer as it can not affect both breast together at same time.  I think you can show to a surgeon,  who will prescribe you antibiotics and pain killers.  How is your body profile I mean are you a little towards fatty  side. This can contribute to big breast.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Heart rate high, have panic attacks. Could this be dangerous?\n\nI have been very anxious the last couple days and my heart rate has been high. It has been over 130bpm at some points and then as low as 80 when I am relaxed. I have panic attacks but usually my heart rate does not get that high. Could his be dangerous?",
    "doctor_response": "!I have read your question carefully and from that I can say from my clinical experince that the heart rate increases due to stress. However, as you are very concerned, it will help you to get an ECG done, and blood pressure checked. Once these turn to be normal, I think you must meet a psychiatrist and get a detailed evaluation done. Only After listening yo your problem and your current status one can decide the line of managment. I have seen that such ceases respond greatly to paroxetine in a dose of 12.5 to 37.5 mg daily.  the doctor may ask you for therapy, which I think will give additional benefit and help you control some part of anxiety and stress.Hope the reply is helpfulfeel free to ask more questionsDr.Manisha Gopal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in chest radiating down the back?\n\nhad a pain in my chest 3 days ago like acid reflux ( i do get from time to time ) but this was like 4 times worse, it last for about 1/2 hour then i got a head ache. Yesterday my arms hurt like they were heavy and today a slite pain in left chest and down my back",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .*  These symptoms are duet to     - reflux of stomach acid - possible ulcer issue - pancreatic insufficiency    - intestine infection - others .Hope this  will help  to clear your doubt   .Wishing you fine recovery .Always welcome for any further assistance anytime .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What to do when periods is missing by more than a month?\n\nHello doctor,I have missed my period by one month and 18 days. I have done Prega news test. There is one dark line and one is light (faint). I am not able to guess whether I am pregnant or not. My last period was just a day after having sex. Please advise me how to avoid pregnancy right now. What medicines should I take and is that available online?",
    "doctor_response": "Hello. I have reviewed your health query and can well understand that you are worried about chances of pregnancy. You have missed your periods and there are many causes for that. One of them is pregnancy. You have done Prega News test at home and got two lines of different intensity colors (one is dark and one light colored). This means either the test is not performed correctly or the strip may be damaged, expired or you may be under the influence of some medications (see the leaflet information given with the test strip for medications that can interfere with your test strip and can give a false result). In such a case, the best next step is to either wait for about four to five days and repeat the test or go immediately to a hospital for a proper pregnancy test and ultrasound evaluation of the uterus. This makes everything clear. In case you are pregnant (that is not sure at this point in time) you need to consult your gynecologist for discussing if you need the baby or not. The management of the case depends on your choice. If you do not need the baby, your gynecologist can best guide you how to proceed. The medications in most of the countries are not available over the counter. You need a proper prescription for the medications to abort the baby. Even if you are able to get the medications over the counter, I would say not to take it without the consent of a doctor as it may cause excessive bleeding and/or a lot more complications in your reproductive life. Sometimes, the situation leads to life-threatening complications. You need a proper cover of a gynecologist for the management of the case. Hope it helps. Please feel free to ask more if you have doubts or need further assistance. For more information consult a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does dark red growth on penis affect fertility?\n\nHi, I am 33 and I weigh 87kg. About four months ago, I observed a dark red growth at the tip of my penis. it is more visible when your part the urethra. My partner was diagnosed with ovarian cyst which has since been removed. I am worried as to the meaning of this growth and its effect on fertility. I also would not like to infect my spouse.",
    "doctor_response": "HIWell come to HCMIf you do not have any clinical symptoms like bad discharge, pain, swelling, fever then this is nothing to worry and this may not cause any disease to your partner neither this would affect the fertility, so this is just nothing to worry, hope this information helps, take care, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Surgery of testicular torsion done, testicle removed, silicon prosthesis inserted, pain and burning penis. What to do?\n\ni have a surgery of testicular torsion on 1 st feb.2012. right testicle is removed and a silicon prosthesis is inserted there. now, after ejaculation i am feeling a mild pain and burning in penis. although urine c/s report is normal with no bacteria. am i need any other tests? what should i do? give me some precosions after the surgery. am a ejaculate now?",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have pain in pain and burning in penis after ejaculation.You have undergone surgery of Orchidectomy for torsion of testis and a silicon prosthesis has been implanted in your scrotal sac.This is in no way related to your pain in penis.During erection and ejaculation blood flow to the penis is increased to 20 times more than normal blood flow resulting in to congestion of entire penis  and urethra The pain that you have is  due to congestion of the penis and there is nothing to be worried about .Drink more water so that this congestion will subside with passing urine after ejaculation.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for constant headache, fatigue and bump on roof of mouth\n\nHi, I have had contant headache and fatigue for the last 2 weeks. About 4 days ago I discovered a red bump on the roof of my mouth and the roof of my mouth is purple. There s also purple vains on parts of my gums and in my throat. It really hurts, most of the time. Any advice? Should I see a doctor",
    "doctor_response": "Thanks for your query, I have gone through your query.The bump on the floor of the mouth can be because of the tooth infection resulting in periapical abscess formation. The fatigueness and head ache is not related to this. So consult a oral physician for the swelling in the floor of the mouth and for the head ache and fatigue, consult a general physician. Mean while you can take a course of antibiotics like amoxicillin and metronidazole(if you are not allergic)I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain while walking after stretching exercises?\n\nI was streching and when i was done i decided to do the splits and heard two loud pops come from my lower butt/groin area. Now I am in horrible pain and can t walk. I know it s not a broken bone, but its still scaring me. Is it a pulled muscle/ tendon?",
    "doctor_response": "Hi, What I feel is this should be called as a piriformis muscle spasm. As in stretching the muscle get stretched and lengthened and post which it take some time to regain it's position. Try having more breaks between exercise and modify the exercises if needed which don't give trouble. Also use firm clothing which do not restrict the muscles to perform actions. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is throbbing pain while breathing normal due to inflamed chest?\n\nhi, a few hours ago i went to the A&E for chest pains, had an x-ray and an ecg with normal results..i was diagnosed with having an inflamed chest wall and given ketoprofen slow release capsules and paracetamol. I took 100mg of the ketoprofen and 1500mg of paracetamol and i am still experiencing pains, in fact it seems the pain has worsened. When i take a deep breath there will be a sharp throbbing pain. Is this normal?",
    "doctor_response": "Hi thanks for contacting HCM..You are having chest wall inflammation...So pain is present ....For pain you had take paracetamol and for inflammation relief ketoprofen...Here continue antiinflammatory drug like ketoprofen for relief from inflammation for five days . ..Avoid strenous work for few days....Hot pad application can be useful ...Avoid bad sleep posture ...Avoid movement causing pain...Take rest for few days ...Take care ...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fits of anger and rage?\n\nHello I was just wondering if you could tell me why when me and my girlfriend argue I get enraged quickly and blurt out things I don t mean then immediately regret them I was wondering if maybe you think I have a disorder or if there s a test I should take to see if I do have one please contact me asap",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Anger happens when we are irritated. Irritation happens when something happens which we do not expect. You must analyze your behavioral pattern and you should know your reason for anger. There are anger tests available online. You can take three or more of them to know the reason for your anger. Anger should not be controlled. Understand the reasons and control them.If you require more of my help in this aspect, Please post a direct question to me in this URL.  Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this ECG report signify?\n\nHi! My ECG report is as follows: P 118 ms PR 160 ms QRS 110 ms QT 370 ms QTC 451 ms QTr 116% FRONTAL VECTORS: P 0.29mV 75 Degree QRS 2.36mV -60 Degree T 0.22 mV -174 Degree Left Axis Deviation Abnormal ECG Specific Findings Noise 17 uV medium Broad QRS QT Dispersion:7 ms Max 20 ms on 7 out of 8 leads QT Dispersion:8 ms Max 20 ms on 5 out of 6 leads Probable Incomplete RBBB / LAFB / Left Ventricular Hypertropy with ST Segment abnormalities. I had bypass surgery in April 2012... I did this ECG today, pls advise",
    "doctor_response": "Post ECG picture. I wpiod like to help u. Also send previous ecgs. Any complains now or routine checkup?",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes radiating chest pain?\n\nI am a 34 year old male a little overweight been to the er multiple times. the chest pain has is constant. They ended up doing ekgs, stress test, and angio gram said its not my heart. the pain radiates to my jaw and left arm. cardioligists says my hearts fine. what could it be cant afford to keep paying doctors with no insurance",
    "doctor_response": "Hello,Do you have any other problem like neck pain or associated tingling or numbness in the neck or arm. Also do you have any history of trauma to neck in the past. Anything which increases your pain or relieves it. Any increase in pain on applying pressure.It could be cervical pain. One neck x ray ap/ lat view is needed. Also neck exercises will be useful but after confirming the diagnosis.  Please get back with answers of above questions.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the prognosis for papillary cancer post thyroid surgery?\n\nMy son is having thyroid surgery now. It is half over and they have said he has multiple lymph nodes involved. It is papillary cancer. One of my daughters and my husband have also had this cancer. They are fine. No lymph node involvement. What is his prognosis as compared to theirs? And thank you, Audrey",
    "doctor_response": "She needs a radioiodine scan after surgery. Initially a diagnostic scan. If the scan shows uptake, then therapeutic radioiodine scan needs to be done. This will ablate all the remnant tissues. once this is done, she is put on follow up. Papillary carcinoma thyroid has a very good prognosis. Most do not die with this disease. In one series cancer related mortality in non metastatic disease is  only 6% after 16years.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I was just told that I have a-fib.  I had a normal EKG a year ago, but also had treatment for breast cancer that included doxarubacin and cytoxin, then taxol, followed by radiation.  The cancer was bilateral, and I had lumpectomies.  Could the a-fib be a result of the cancer treatment?",
    "doctor_response": "Yes Treatment for cancer can cause atrial fibrillation . Ratiation and medication for cancer chemotherapy like Duxoroubicin,  Taxal and to less extent other medications are cardio toxic , such that they affect the Heart muscle causing inflammation.  When this inflammation subsides there is some residual fibrosis in between the heart muscle . This fibrosis acts as substrate for rhythm disturbances , common among them is a trial fibrillation.  A 2 d echocardiography more precise  Cardiac Mri is suggested to know extent of any damage to the heart . In many causes though there is no decrease in pumping of the heart  ( mechanical ) , still arrythmia may happen sue to electrical disturbances.  Let me know if any clarification needed.  Regards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is IVF possible with FSH 17.9 and LH of 4.33?\n\nHi Doc, i am less than 35 years old & diagnose with POF. My FSH is 17.9, estradiol level of 45, LH of 4.33. Just started DHEA a few weeks ago. what is my chances for IVF? should i go for it? is there any cure or help to help in my chances of pregnant?",
    "doctor_response": "Hi, I have gone through your question and understand your concerns. Premature ovarian failure with a serum FSH levels more than 10 is not compatible with IVF using your ovum. There is no treatment for premature ovarian failure as in this condition, ovaries have lost their ability to produceovum.However, you can have IVF using a donor ovum and your partner's sperm.Hope you found the answer helpful.Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for hair loss\n\nHI, This Prakash I am having baldness problem since long back arround 7 years I got treatment from cutis clinic in bangalore in 2007 and medicines \" hair 4 u, sebowash, finabold, xtraglow\", i used these for arround 6 minths and it worked then i again visited the cutis clinic then the doctor gave me some different medicine and lotion which didnt worked so i use the privious one, few months later the improvement level was declined and now in two years i i came to the earlier position that means the same baldness as i had earlier, please advise",
    "doctor_response": "Hi Dear,Understanding your concern. As per your query you have alopecia problem. Well the symptoms you mention in query can occur due to many reasons like genetic factor, fungal infection, covering head with cap and hormonal changes. Nutritional deficiencies and stress are additional factor. Need not to worry. I would suggest you to maintain complete hygiene and avoid excessive use of chemical rich shampoo's. You should consult dermatologist for proper examination and go for skin patch test , blood test and physical examination . Doctor may prescribe you drug like finpecia at least for 3-4 months or anti fungal treatment along with minoxidil spray. Take biotin capsules on daily basis.Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling in fingertips and leg pain?\n\nFor the past month I have had bilateral tingling in the fingertips, toe tips, and pain in both legs, hip to toes. It is nearly impossible to put weight on legs, especially when assending up stairs. I do have DDD, but it has never been this bad. Also, one night of excessive itching drove me crazy. The next night and since there have been no itching. Any suggestions of where to start for a diagnosis? Thank you",
    "doctor_response": "Hello,Thank you for suing healthcare magic.I read your question and understood your concern.I would start to look for diagnosis in the lower back with Xrays and MRI of that region and EMG to evaluate the nerves. Discal hernia might be a cause. Also spondyloarthrosys, spondylolysis or spondylolystesis.I wish you quick recovery.Dr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should the tooth root hanging to the gums be completely removed?\n\ni am 66 years old and i just pulled a primary or deciduous tooth from lower right side about 4 teeth back from center and there is a small piece of the root hanging tough in the gum and perhaps attached to jaw bone. there is no adult tooth below.  what will happen if i just let area heal at this point?",
    "doctor_response": "HiThanks for the query..If there is a small piece of root sticking out of the gum and is not removed with the tooth then it should be removed.It is important as if it is left as it is, it can get infected due to food lodgement in that area and can be a cause of pain..So my suggestion is to consult an Oral Physician and get evaluated so that he can do a clinical examination and if needed can also take an x ray..He can remove the root piece and advise you a 3 days course of antibiotics for avoiding any chance of infectionHope this helps.Take Care!Regards,Dr. Honey Arora, Dentist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the signs and symptoms of cancer in the neck?\n\nI have large bumps that several doctors call fatty tissue on either side of my neck, sort of on my shoulders that seem to be getting larger. They are not hard or sore but look unseemly. They are growing larger and I am concerned about the possibility of cancer.n",
    "doctor_response": "Hi welcome to the health care magic I can understand your concern Your doctors are telling you about Lipoma like lesions... It can be multiple and it is Benign tumour For rule out nature of lesion whether Benign or malignant I would suggest one investigation that is FNAC .... If FNAC doubtful then confirmatory biopsy taken for histopathology examination So for getting relaxed from cancer stress I suggest you to investigate with FNAC or biopsy Take care Hope I have solved your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe back pain after fall\n\nHello Today I slipped and fell on my back. Not a lot of pain standing up, but when I lay down, I feel a horrible pain in my entire back. (Neck to bottom) it was a very hard fall. If it helps I m 58. Previous back problems (bulge disk). What should I do?",
    "doctor_response": "Dear Sir/ Madam,Thank you for posting your query at healthcaremagic.comI would adivise you to take Rest, Icing, anti inflammotory. This should help you. If still the pain is not coming down consult a orthopeadiciian  who would adivice you to get an x-ray done to find out underline cause.Precautions:Do not lift any thing heavyDo not forward bendDo not stand or sit for long hours.Hope you find my answer informative, your thank you will be very much appreciated.If you need any further information, please revert back to me, I will be glad to assist you.With best wishesTehzib Saiyed(PT)",
    "dialogue_context": ""
  },
  {
    "patient_message": "6 year old suffering from upper abdominal pain. Normal ultrasound report. Infection in pancreas and liver. What to do?\n\nHi ,  my son is 6 years old , from last 4 months he is suffering from upper abdomen pain , it started from pain in the urine portion. 3 Ultrasounds have been done since 4 months and they are normal . Initially doctors diagnosed as infection in Pancreas and now the latest is some infection in the liver . He has been put on a very light diet since it started. Can I know by seeing these reports is there something serious or its just a liver infection which will go withing the time and the pain will also go away.As of now his pain sometimes gets lighter and sometimes it aggravates a lot. Kindly suggest. Thanks & Regards, Harsh",
    "doctor_response": "Hi Harsh. Liver and pancreatic infections are very rarely seen in kids. The description which you have given is confusing. A good imaging of the upper abdomen by CT scan correlated with blood reports can only help diagnose the problem. With regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for scaly bumps on the legs of a child\n\nFor my daughter, 26 months old, 29 lbs. A few months ago, she started getting bumps on her legs, approximately one each day for 7 days. They looked like mosquito bites at first, and then within 24 hours they became larger and very hard and red (about the size of a quarter). As they changed in size, the highest point on the bump became scaly/scabby although there is never a head. I thought she got one on the corner of her eye, but it also could have been a mosquito bite. I really can t tell a difference. I took her to her doctor and she was diagnosed with periorbital colitis and given an oral antibiotic, which was supposed to help with the other bumps as well. The other bumps were only on her legs. A few weeks have gone by and she hasn t had any bumps until yesterday, when 4 appeared. One of those is now about 3.5 inches in diameter. Other than this, she hasn t had any illnesses or injuries other than minor scrapes from playing outside.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Do positive MT test confirms the presence of tuberculosis in a kid?\n\nHello doctor, I need to know whether my child is affected by TB or bronchitis? I have attached his ESR, blood test, TST and chest x-ray. Kindly suggest.",
    "doctor_response": "Hi,  Welcome to icliniq.com. I have seen the reports. (attachment removed to protect patient identity).  The very first thing why you suspected that your child may have TB (tuberculosis)? What are the problems he is having like prolonged cough, are any swelling in the neck or any contact with a person who is known for lung TB? Looking at his weight, he seems to be growing well. Except for MT (Mantoux tuberculin test) which 15 mm positive, all other tests are normal, x-ray findings are non-specific. Best if you can get his sputum test to isolate germs (in this age group it is done by gastric lavage), or if he has significantly large glands in his neck, then a needle biopsy of the gland which a safe and easy procedure. There is a very fast and accurate test known as PCR (polymerase chain reaction) to confirm the presence of TB germs. If there is a contact with a confirmed case of lung TB, then with this MT result, you need to start medication. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pain and swelling in lower back?\n\nHi On Thursday night I was training in karate I got thrown by the person I was working with they then proceeded to land on me at the same time as my back hit the groundI have now had severe pain since with a lump on my lower spine although this hasn't bruised I work in a laboratory so it's important I'm standing most of the day so I can't really rest\u00a0my back",
    "doctor_response": "Hi,I advice icing your back for the first 48 hrs then massage it with topical gels. In 3rd day start with hot fomentations using gels, and Advil, Acetaminophen and some physiotherapy with rest from your karate exercises will help. While getting up from lying down position, you should turn on one side and then get up slowly. You can use lumbosacral belt for support,do not bend forward or lift heavyweights. This may aggravate the pain. If the symptoms do not improve after 3 days, you can get a x-ray/ MRI done to rule out a bony injury.Hope the above information helps you. et me know if I can assist you further.Regards, Dr. Ahmed Aly Hassan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause sore throat with increased WBC and liver enzymes?\n\nmy 17 y.o. daughter is suffering from fatigue, has a sore throat, and states she is not getting enough sleep. The physician finds swollen lymph nodes; an enlarged spleen; and tonsillitis. The CBC showed an increased WBC and normal RBC. The liver function test showed increased liver enzymes, and a positive heterophil antibody test what is my daughter's diagnosis?",
    "doctor_response": "Hi,Thanks for asking.Based on the symptoms and investigations, it appears to be infectious mononucleosis. My comments are as follows:1. Sore throat with lymph node enlargement.2. Splenomegaly and liver enzymes elevated.3. Positive heterophile antibody test.Based on above my diagnosis is Infectious mononucleosis.Close followup is necessary for this viral infection by Epstein Barr virus.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be concerned about drinking wine?\n\nI am a healthy 44 year old female, 143 pounds and had blood work done due to extended bowel condition that lasted 3 weeks.  My AST/SGOT # was logged at 51 and my ALT/SGPT at 33.  Also had an abdomen ultrasound and liver was fine.  Should I be concerned about drinking 2 - 3 glasses of wine each night?",
    "doctor_response": "Hi thanks for asking question...Noted you have only elevated sgot with only border line elevation...Here it need not much concern...You have to keep control in drinking alcohol.Maximum safe unit according to few article is max  3 to 4 unit per day with two alcohol free day in week.Maximum safe limit is 20 gm per day....Regular check up and follow up for liver enzymes done.....If any unusual sign and symptom appear you can contact HCM or consultant for further advise.Take care....",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe lower back pain laying down?\n\nI am experiencing severe lower back pain only when laying down. The pain gets worse if I lay on either left or right side, however always worse on the right side. Also if I am laying down and I try to sneeze, the pain is excrutiating and the process of sneezing almost impossible. It then takes extreme effort to get up due to the pain. On e I'm up, I then have no back pain issues. What can this be?",
    "doctor_response": "Hello. Thanks for writing to us. this is likely to be due to a muscular pain. Usual cause is poor body posture. Regular back strengthening exercises will help in gaining the strength of muscles.I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal . For future query, you can directly approach me through my profile URL  drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I heal the popped up cystic pimple between my eyebrows ?\n\nI am a 24yr old female i rarely get pimples , but I just got a huge pimple under the skin right in between my eyebrows (which I later realized was a cystic pimple) I popped my cystic pimple and it is now a red, irritated painful open wound any suggestions on quick healing?",
    "doctor_response": "Hi!Cheryl, Welcome to HealthcareMagic forum, Cheryl start with an antibiotic like azithromycin tab (500mg) once daily for three days.Also apply nadifloxacin gel locally which would help it healing fast.Don't squeeze it as that may lead to deeper penetration of infection and may leave a mark. take care, Dr.chawda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does backache on the left side indicate?\n\nMy husband is 54 and has been experiencing back pain on the left side near the bottom of his ribs and says that it feels tingly and warm to the touch. He also has not been feeling very well at all. Do you have any ideas what this might be? He said that the pain is not a muscle type pain.",
    "doctor_response": "Hi, I had gone through your question and understand your concernsI f I wass his treating doctor ,I will firstly exclude renal problem by doing Abdominopelvic Ultrasound and urine analysisAlso Infection should be excluded due to warmness by doing laboratory investigations CBC,ESR and CRPFinally ,If every ting is ok I will prescribe him muscle relaxant and NSAID.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for constant heart pain\n\nGood evening. i m Ludovica i m 22 years old. i m part of a big italian family: i have 2 sisters and 3 brothers . i m living in London from one year. i m writing because when i was 11, my mother had a cardiac arrest. During the years she had to do other operations always because sometimes the pacemakers and sometimes the catheters were always defective, NOT because she was sick or because she had some other problems. The catheter that she has inside was defective and now the kind of sheath that covers the tip of the catheter is broken inside the heart to 180 degrees (half of it). If it will create infection my mother will die in 3 hours and she will neither have the time to arrive to the hospital in Pisa (Italy). At the moment the doctor of Pisa refuses to do the operation because it is very risky. I don t know what to do. I can t accept that i will lose my mother because someone did a mistake , i maybe could if she was sick but she is not and she is just 50. it s a continuos pain in my heart and in my brain that never stop from 11 years. If i could i would like to give her my heart but i don t think it is possible. I blame myself because i don t find a solution, because i can t save her. i m desperate so at least i m trying to ask help to You and to someone because i don t know what else i can do. I m sorry for the disturb. thanks in every case. Ludovica",
    "doctor_response": "dear it is very sport to hear about tragic story of you..what you are showing symptoms are due to the stress you are having die to woory for your mother ...mother is precious to all ...take your mother to best doctor and rest leave everything to God ...just relax ...u cannot change much in some conditions..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could tingling hands, weak and cold hands after neck surgery be related?\n\nmy brother in law has weakness and tingling in his hands, his lower arms are also weak, they both are also cold.., and fainted. he just recently had neck surgery. and had 1 heart attack. he was rushed into the emergency room today. and so far its all idiopathic?? what can it be, that is wrong with him",
    "doctor_response": "hi,as mentioned about the symptoms, by seeing the history I can understand that the symptoms can be related to the neck surgery. but depending upon what the MRI scan report reveals the further management can be planned. Also the echo of the heart will reveal if any pathology is there. Usually post neck surgery there is a need to strengthen the muscles to avoid the pinching of the nerve. But most patients take it litely and do not perform. And certain times the symptoms recoccur. with the help of a physical therapy things can fall better into the place.with the grace of God I wish a good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sore lump on calf muscle\n\nI have varicose veins, am an active person & have never had any pain from them. Yesterday I have found a sore lump on my calf muscle the size of a golf ball & tender - what should I do - it is swollen - at first I thought I had been bitten by something, but now I am unsure - please advise",
    "doctor_response": "you need to give us more details on your lump. else you can visit a vascular surgeon and get a venous doppler done to ensure that it is not a varicosity.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes runny nose,cough and sneezing?\n\nHi, I have asthma, and this week our niece was here for 4 days who also smokes, although she smoked outside, I feel like I was still exposed to the 2nd hand smoke.  I have had runny nose & sneezing this week, and as of yesterday I have had a really deep cough, coughing a lot, not able to sleep last night from coughing.  I'm wondering if I now have bronchitis.  thank you",
    "doctor_response": "Hello dear , hiWelcome to  Healthcaremagic.comI have evaluated your query thoroughly .*  This is due to effects of passive smoking on the  alveoli and bronchi of     lung.*  It may or may not be bronchitis , rather than worried should get     examined  with  your family doctor and precise  management .Hope this will help you for sure .Regards dear take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What to do when a 12 year old girl is under medication for autism but her hallucinations are not under control?\n\nHello doctor, My daughter is 12 years old, and she always showed a great deal of anxiety started having a lot of school refusal during 5th grade, so we took her to see a psychiatrist who ultimately diagnosed her with high functioning autism and started her on a Lexapro. School refusal continued, but we managed the school year. When she started 6th grade, she admitted to her school psychologist that she had been hearing voices for about a year. The voices were a group of teens about her age, and they were all very negative. We sought treatment again with another doctor who put her on Risperidone, which failed to control the voices, so she was switched to Seroquel, which also failed after a month. We had a move to another state, so we had to change doctors. The move did not go well with our doctor, and she ended up with a suicide attempt and four acute hospital stays and one long term stay. Her hallucinations are now fully engulfing her days, and they are tactile, visual, olfactory, and audio. She also admitted to an early suicide attempt while she was 10. Her new doctor has tried Abilify, Latuda, high dose Seroquel, and high dose Zyprexa. All have failed. She had also tried depression medications like Trintellix, Wellbutrin, Lexapro, Cymbalta, and Zoloft. Nothing has worked for more than two months. Her current doctor is not willing to try another medication and is telling her to live with her hallucinations. My daughter is 13 and has very little quality of life. In our place, there are minimal resources here, even being well insured and willing to pay out of pocket. I am looking for advice on what to do next. Do I travel out of state, do I visit another type of doctor? It is also important to say that she has been diagnosed with schizophrenia. My husband nor I have any family history of schizophrenia going back about five generations, although I do have mental illness frequently on mine (depression and bipolar). I had a completely healthy pregnancy, and she was born on her due date without complications. She was big at 8lbs 9ounce and 21inches.",
    "doctor_response": "Hello. It is common for adolescents with high functioning autism (HFA) to experience high levels of anxiety, especially when they are pushed outside their comfort zone. Many go on to develop hallucinatory experiences like hearing critical voices at this stage when they struggle socially. I presume your daughter had all the relevant investigations like scans and blood tests to rule out any physical causes for her hallucinations. Your daughter has been tried on so many different medications, and you report limited efficacy. In addition to drugs, has she been getting any structured psychological therapy during this period? Modified CBT can help manage voices and other hallucinatory experiences. Try to discuss with your doctor and explore the availability of any skilled therapist with experience of working with HFA kids. CBT can be beneficial but needs patience and may take time. If your daughter is very unwell, she may not be ready but better to discuss with your doctor or therapist to know what is possible? It is paramount that your daughter does not get more isolated. Try to get her doing some educational activity (homework, online classrooms, etc. ). If she likes going online, provide an opportunity to browse with appropriate parental locks and control to prevent her from accessing any inappropriate content. Recovery can be gradual in these conditions. You can contact again if any further advice is needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does percocet help reducing inflammation of pituitary tumor\n\nI have a pituitary tumor and in the process of consulting with neuro-surgeons regarding its removal.  I feel a moderate amount of pressure, especially at bedtime, on the top and front left-side of my head.  Will percocet reduce the inflammation and pressure I believe this tumor is causing until I'm able to go in for surgery?",
    "doctor_response": "HI Thanks for posting your query .    Percocet contains Oxycodone which is a narcotic pain killer . It has no anti-inflammatory properties and will not help in reducing the inflammation . But due to its anagesic effect you may feel relief from pressure in head . ( But sometimes it can worsen the feeling of heaviness in head ).      Percocet also contains Paracetamol which has mild anti inflammatory effect but I don't think it also be any use to you .",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to increase the growth of facial hairs?\n\nDear Dr. I am a male aged 24,heard many good voices about your hospital. Since last three years am seeing unexpected changes in my body.I had lost the greenery in my life. Sever hair fall,no facial hair, Leakage of fluid day long even when I am not sexually aroused,back pain,depression,unsatisfaction,frustration,poor memory,talking in sleep and many more.... Really doctor I had attempted for sucide too due to these problems(but I have lots of hope on my shoulders)... These are not due to genetics,my parents,grand parents have good textures(facial hairs),optimum health. Experts told that my case is of severe harmonal imbalance. Even at work/colleage I am a matter of discussion(A male aged 24 with no facial hair). Approched local doctors but every one told that there is lack of nutrition.But this is not the case. My height is 5.8 and weight is 61. I fear that it these problem continues I will be under  any chronic disease in future. Please doctor help me...whom should I approach..what should I do,,which tests should I undergo... Really I had lost the greenery in my life. With an final hope.. Ashish",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Facial hair growth and pattern are genetically determined and it is difficult to alter the pattern of facial hair. You can try Minoxidil oil which shows some results. You can also consider hair transplantation, which has got very good and results but cost may be a problem. Consult a dermatologist and he will direct you accordingly. Wishing you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Do pain under arm pits and in knee after sex indicate HIV?\n\nHello doctor, I have potentially been exposed to HIV. 20 days back, I had protected sex with a sex worker and at some point during the intercourse the condom broke exposing my entire penis. I do not know how long this exposure took place. Three days later, I started experiencing a fever. The fever lasted up until a week approximately. I returned home and had swollen lymph nodes below my jaw on both sides. I went to my doctor the next day, and told her what happened and my worries, she prescribed me Doxycycline for the lymph nodes. Within a few days, the left lymph node had completely gone down but the right one still remains. The doctor also had me test for STDs (syphils, gonorrhea, and HIV, all negative). I am now experiencing tenderness and slight pain under my arm pits and behind my left knee, there is a pain when I walk or stretch that leg. Are these the symptoms of early HIV infection? How worried should I be about the lymph nodes? I am also experiencing intermittent tingling in my feet and hands.",
    "doctor_response": "Hi. I have read your query in detail. Early symptoms of HIV (flu like symptoms) usually appear after two weeks of HIV infection. The symptoms of swollen lymph nodes, fever, pain behind ears or legs can be no way attributed to the exposure you have had. These could be due to anxiety or some other cause. You can take tablet Paracetamol 500 mg as per your need. If these symptoms persist, you can visit a general physician. Also, I would suggest you to repeat fourth generation HIV after four to six weeks of exposure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can shingles be treated?\n\nI contracted shingles 6 weeks ago. The inflammation is gone but my abdomen still feels \u201cprickly\u201d and irritated, yet the skin itself is numb. Does this disease at the onset manifest itself internally, perhaps with swelling also? Is it \u2018normal\u2019 to have discomfort for so long and for the skin to lose it\u2019s feeling?",
    "doctor_response": "HelloWelcome to HealthCare MagicI have worked through your attached query in detail and can certainly understand your concern.Many of your symptoms are directly related to the late effects of shingles. These symptoms will gradually resolve in the due course of time. These abnormal sensations are a part of the illness and nothing to worry much. Please check with your physician if he/she shares my view and if can prescribe these medications/tests/opinion to you.Hope I have answered all your questions.Post your further queries if anyThank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should IUI be done after follicle rupture or during rupture for conceiving?\n\nI have been undergone IUI in my last cycle. My doctor gave me an injection for egg rupture once the follice size reached 2.0mm. within 24 hours she said that the follicle has started to rupture and did the IUI. Please tell me if IUI should be done after the follicle has ruptured on during rupture.",
    "doctor_response": "Hi,I guess your concern is about should IUI be done after or during rupture of follicle.my straight forward answer is YES. It can be done after or during the rupture of follicle. Let us discuss about the procedure of IUI. In this method the qualified sperm of husband is inserted inside the womb of the wife around the time of ovulation. Ovulation is time during which dominant follicle (size 18-20mm) is rupture, during this time more chances of getting pregnant if IUI is done.  So it is done usually during or after the rupture of follicle. You had gone through the correct method so. DON'T WORRY. I hope the above information is useful, informative and helpful for you. Let me know if I can assist you further.Regards,Dr. Sudha Rani Panagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have gastric problem and passes gas frequently. Please help.\n\nHello doctor, I am 36 years old male with 167 cm height. Weight is 73 kg. I am in good health. Practicing yoga four days a week. Two days walking or jogging like 8000 steps. Daily walking for office and routine is 4000 steps. Sitting job. I have a gastric problem for last six months. Release gas from stomach 10 times a day average (fart). Very difficult to manage in meeting time. No smelling but it sounds. No stomach pain. No problem in toilets. My diet is the same as the previous. Nothing has changed. I am a vegetarian. I drink water 3 liters a day. Wake up in the morning 6 to 6.30 AM and have a breakfast by 8, lunch by 1 o'clock and evening snacks by 5 (light food) and dinner 9 to 9.30. Sleep by 10.30 to 10.45. Yoga 7.20 PM to 8.30 PM. Please guide me.",
    "doctor_response": "Hi. Passing fart up to 10 times a day is normal. However, constipation, gastrointestinal infection, irritable bowel syndrome may worsen this. For you, I suggest you take a good amount of water and dietary fibers. Hopefully, that should improve your symptoms. If you are having constipation, treating it may improve your problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for vacterl syndrome\n\njust out of curiosity..I have a 22 month old with Trisomy 21. He had an EA/TEF . He was never diagnosed with Vacteryl but has four of the signs. He has a 7 mm asd with significant left to right shunting, syndactly of his last two toes on each foot, tracheoesphageal fistula , and esophageal fistula..can he also have Vacteryl?",
    "doctor_response": "Hi,ASD is very common in trisomy 21 itself. Anyhow VACTERL is a possibility as he also have TEF and syndactyly. so its is better to get an ultrasound abdomen (to look for renal / genito-urinary anomalies), and a vertebral X-ray also. You can discuss with your doctor. Treatment is problem oriented and supportive.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam TK, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rashes and itching on face\n\nI have some sort of rash on my skin, it s not red it s appears to be dry patches of skin with wrinkles. It s mostly on my face & chest area and a little bit on my arms. I consulted with a doctor and he gave me am allergy shot, it has been 2 days since the shot & I have even more rashes. And it s itching now, how long till the allergy shot works, or maybe it s not working for me?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Allergy medicines take time to act. Meanwhile, apply Cortisone cream on the affected areas and take antihistaminic medication, like Cetirizine tablet depending on the intensity of itching. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal discomfort?\n\nanterior mid abdominal discomfort, tightening at times - feels like it is a choir to keep back straight up- always a pushing sensation to move back forward to relieve discomfort Later on pain felt in center right side (internally) - had leftt total hip completed 3 years ago and then left hip revision due to increased cobalt and chromium levels. at present pain increasing unable to stand straight up due to pain. also had left hip resurfaced 6 years ago with a metal hip cup.",
    "doctor_response": "Hi.Thanks for your query.Read the history- hip joint pain - tightness in mid-abdomen.The probable cause as per your history looks to be a hernia. Please consult a surgeon who on clinical/ Physical examination can find the cause and be confirmed by ultrasonography.If there is a hernia , get operated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to survive with one lung?\n\nMy father just had his right lung removed 3 weeks back due to lung cancer. The doc said all is clear for him and the nodes is not affected at all after biopsy before the major ops. Was wondering how to prevent it from coming back...he quited smoking 2 months back. Can a person live with one left lung? My doc also told me his left lung also damaged due to smoking but all test shown he is able to cope with that. Thanks",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Yes, person can survive with only one lung but he can not live like normal individual. He gets shortness of breath, coughing, chest pain, palpitations, chest tightness etc even with mild exertion. So he can live normal life on bed but as soon as he does any activity he will have breathlessness and coughing. Your father wad a smoker and damaged his only lung too. So he should do Complete bed rest if he want to live longer. You can enroll him in pulmonary rehabilitation center where chest physiotherapy and deep breathing exercises are done. These will improve single lung functions. You should also vaccinate him with pneumococcal and influenza vaccines to prevent recurrent respiratory tract infections. Don't worry, he will live longer with all these. Hope I have solved your query. I will be happy to help you further. Wishing good health to your father. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of feliz s?\n\nI am taking feliz s since 3-4 months now my doctor has advised me to reduce the dose and slowly stop taking it. Please tell me what are the side effects that i will experience by reducing and stopping dose. And about which I should not worry also about the Symptoms that needs attention and doctors advice?",
    "doctor_response": "HiThanks for healthcare magicFeliz contains escitalopram and if you stop it suddenly, then you could face withdrawal symptoms in form of anxiety, low mood, tiredness etc. Better to taper it down gradually and in this way, you would not face any problem. You can also try some relaxation exercise that would help to control anxiety symptoms. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Thyroid is ok. Got breathless. Am overweight. Suffer allergy, asthma. Had heartburn. Related to nasal drop?\n\nHi, I have just had a full heart check and got the all clear.  Thyroid okay too.  The reason for the test is that I a exhausted after doing physical housework and get very breathless and wanted to know if I was just unfit and overweight.  I have always suffered from allery and allergic asthma.  I have had a lot of heartburn recently (which I had a gastroscopy) a few years ago.  I still have a dry tickle where I want to cough (it's only a little cough) and tightness in the chest area.  Do you think this is just asthma or related to nasal drip? My blood pressure has gone up a bit and so has my cholesterol (5.7).  I am on Zoloft, Karvezide 300mg and Phototens.",
    "doctor_response": "Hi, when there is nasal drip, it is supposed to be the bronchial constriction, and there could be some infection as well so you are week, and could not do the work. The other causes could be the anemia, or hypo thyroidism.                               I advise you to consult a chest physician for diagnosis and treatment. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What caused blood in nostril after mild concussion?\n\nMy 9 year old daughter was diagnosed with a mild concussion on Sunday morning. Now Tues night she just had the appearance of blood in one nostril. No excessive blood just around the lining. Should I be concerned about growing pressure on her brain or possible fracture?",
    "doctor_response": "Mild concussion?Was there any fracture?Were there any symptoms?Ok if it is a minor trauma to head association with mild injury to nose then bleed can even  occur some days after injury if the clot formed previously was dislodged due to breathing or movement of nares. A x ray and endoscopy of nose will get the diagnosis.Usually head trauma do not lead to nose bleed if it is minor trauma. ENT bleed occurs if severe head injuries. Sometimes CSF may be lost from nose in such cases.I do not thinkur child nose bleed is due to direct effect from head injury that is from edema of brain or hemorrhage in brain as it leads to many more symptoms like weakness seizures headaches vomitings altered brain functions. Do not panic and take child to your treating doctor,meanwhile pack the nostril only one which is bleeding with gauze piece like a stack of ironed clothes pressed together ,like a pile,like a treponemal shape,if it is heavy bleeding till u see doctor",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can fever be treated in a baby?\n\nHi doctor,My 22 months old baby has a very high fever. It has been fluctuating from 38 to 40 degrees. I gave him Tylenol but it still did not come down after five hours. I put suppository. Last week he was diagnosed with an infection in the stomach and was prescribed Nortop antibiotic and then the infection moved to the chest. So he is on Amoxicillin but now even after I put the suppository the fever is still not going down. I am really worried about what to do?",
    "doctor_response": "Hi. In view of such high-grade fever in such a small child, I would advise you to take the child to the nearest pediatrician in order to get the child physically evaluated and blood investigations like CBC, CRP (and others as per physical examination be done). Though the WBC count was 12000 last week they may have increased now since the fever is a little high (40 degrees). Also the antibiotics given previously may need to be changed) stepped up. As of now to bring down the fever you can do tepid sponging.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to remove pimples and marks ofrom the face ?\n\nHello, I ve small pimples coming and going on my face and I also have few marks left after the pimple goes.. I had small white patches which on being scratched would peel off the skin. i consulted Dermatologist. and the doctor recommended dermadew cream. Is this cream advisable for marks and pimples? or do i have to use anything else?",
    "doctor_response": "hi neethu, pimples are of various types like black heads, white heads, pus filled ones and even large nodules. every type has a different drug which acts the best way. so, if u can mention the type of pimple u r having, its easy to advice a medicine. dermadew cream is only a moisturizer and it doesnt act on pimples and it may increase the oiliness and aggrevate pimples. so, stop using it. if u have only few pimples and along with pus filled ones, u can apply CLINMAX-A cream which contains 2 tubes. *Apply tube 1 in the morning over the pimples.leave on. *In the evening, apply little amounts of tube 2 first over the pimples.wait for 5min.then apply the tube 1 again over it. if u feel any irritation,wash after 2hrs. Use them for 3-4 weeks and u can see the improvement. For the white patches, u should see the nearest Dermatologist for a better diagnosis of the condition.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lightheadedness , dizziness and shortness of breath?\n\nHi Doctor, I have also been using 409 all purpose cleaner, for about 4weeks now, I m not my normal self, I feel lightheaded, dizzy and find it difficult to breath. I last used it on Friday but I m still feeling sick. Are you sure it won t affect my brain? Other medications I m taking are Diane 45 and deselex but I have been taking them for years so the only new thing is this 409 all purpose cleaner. Is it possible to get a stroke from this? I feel muscle weakness as well",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. No need to worry for stroke because cleaning solution can not cause stroke. Possibility of bronchitis due to inhalation of fumes from cleaning solution is more. Any fumes, when inhaled for long duration, can irritate lungs and cause inflammatory reaction. This is bronchitis. It causes breathlessness, fever, Giddiness, uneasiness etc. So better to avoid exposure to this fumes. Breath in fresh air. Consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). If it shows obstructive airway defect than you may need inhaled bronchodilators and inhaled corticosteroid (ICS). Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful lump below the rib cage\n\nI have found a lump the size of a ping pong ball on my stomach a few inches below my rib cage. It seems to decrease in size depending on if I am sitting down or standing up. When I press on it or apply pressure there iss a little pain/strain. Only other symptoms is that I do suffer from indigestion quaite alot and my stomach in general seems quite bloated. Thank you",
    "doctor_response": "Hi,Dear,Welcome with your query to HCM.Studied your query in full depth of its details.Reviewed it in context of your health concerns.Based On the facts, You mostly seem to suffer from-Painful Epigastric Hernia with Entrapment of Mesentery or Omental tissue.Reflex pyloric and other intestinal spasms would cause bloating in the abdomen.Prominence of the stomach lump on standing -indicates popping up of the intra abdominal contents through  the weakness of the Epigastric Ventral Hernia. Treatment-Repair of the Epigastric Hernia-as a planned surgical procedure is needed.USG study of this lump would help in assesing the surgical plan in your case.Second opinion from Surgeon would be helpful to you.Hope that ,This reply would help you to plan further treatment soon with your treating doctors.Best of Luck and early recovery.Welcome any further query in this regard,which would be replied in next session.Good Day!!Dr.Savaskar M.N.Senior Surgical Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can an infected wound on the knee be treated?\n\nMy sone cut his leg just under knee cap he go 8 stitchers ,a tetanus and antibiotic. As were we were was dirty muddy water. I have noticed today day 3 of injury. It has a slight smell to the wound and the skin flap that they stitched is turning blackish. I cleaned and redressed the wound. It is not hot or red and fluid coming from wound I\u2019d clear. Should I be concerned about the skin smelling and going blackish?",
    "doctor_response": "Hello,This indicates that there is an underlying infection in the skin and it has necrosed the tissue and compromised its vascular supply.Please refer to an emergency department nearby as the wound urgently needs debridement and saline wash and restitching.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Muhammad Adnan Iqbal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Clear fluids in nostril, frequent numbness, ear pain, headache. ENT suggested possibility of allergy. Recommendations?\n\nHi my name is Shelly. I have many issues but a main one is sudden clear fluids from one nostril. I also have frequent numbness, ear pain and uneven eye dilation, headaches, and a darker color around the eye. All on the same side. I've been to an ENT, he looked at my ears and nose and told me it is probably allergies. Other than the fluid, I have no sinus drainage or itchy eyes and throat.",
    "doctor_response": "the clear fluid is csf leakage from cribiform plate making junction of roof f nose and cavity of brainfluid causes also ear syptompsget cytology tests confirm and we need to put graf over the leagage pont to stop it",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is my blood pressure very high although tests are normal?\n\nHello doctor,I am 19, exercise regularly and eat healthy, yet my blood pressure is always very high at the doctor. He says this is only because of my anxiety disorder. It has been as high as 168/110 before. He did a physical and CBC, thyroid, glucose, and kidney function test and they all came back normal. Does this rule out secondary hypertension?",
    "doctor_response": "Hi. Hypertension at your age is not usual and if it is present, a few things need to be evaluated thoroughly, especially your kidneys and your adrenal glands. A renal function test will not be helpful in this case. An MRI or ultrasound of the kidneys would be required to rule out a possibility of adult polycystic kidney disease. Also, I would like to know if either of your parents has hypertension or autosomal dominant adult polycystic kidneys. I suggest 24 hour urinary free catecholamines and metanephrines for a probable tumor of the adrenal gland. Please note that I am not saying that you have either of these but at your age hypertension with anxiety disorder may present with these conditions. So, it is important to rule them out. Also, do you have headaches? That could help identify the problem. Let me know so I can help. 1. MRI or ultrasound of kidneys. 2. 24-hour urinary catecholamines and metanephrines. Pheochromocytoma Polycystic kidney disease. For more information consult a family physician online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in right side, tingling sensation in back and underarm. Weight loss on Atkins diet\n\ni am a 55 yr old male, recently lost 70 lbs on the atkins diet .. for the last few months i have had a strange ache or pain mainly in my right side at about waist level. sometimes it seems to radiate or shift to my mid and upper back region, also have strange tingly stinging sensations in various back and side and underarm regions",
    "doctor_response": "Hi,Pain at about waist level ,radiating to back needs to be evaluated.You should undergo Ultrasound abdomen to rule out Right sided Ureteric stone.Regarding tingly sensations please Sleep in a Flat and Firm bed and also please take X ray Cervical Spine and Lumbar spine.Please check your Blood sugar levels by Glucose tolerance test(GTT).",
    "dialogue_context": ""
  },
  {
    "patient_message": "Finding it difficult to wear my retainers as i am having swollen gums\n\nim recovering from flu, ive had it for 2/3 days now but i have really swollen gums, but i have to wear retainers at night. but only on the 3rd day i have discovered that my retainers cant fit around my teeth, i have to really force them in and it draws blood, what should i do? i dont want to have crowded teeth again",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,    I have gone through your query, as you have mentioned that you have retainers placed as you are under Orthodontic treatment what happened is when patient is under orthodontic treatment there is difficulty in maintaince of oral hygiene so there is bleeding gums now and as you said that you feel like retainer doesnt fits , for this you should consult dentist again and go for Examination ,   Do warm saline gargle two - three times a day  Do chlorhexidine mouthwash 2 times daily Hope this will help you. Wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain at the injury site\n\nI play Rugby and yesterday I had Two games. I got Laid out by a HUGE kid with a shoulder right to the chest. I got Right up and continued playin with absolutely no pain. After the two games I got One and my trachea started hurting. It\u2019s like a bruised feeling. It gets better and worse by the minute depending whether I\u2019m standing, where I\u2019m looking etc. I dont Know what it is so hopefully this can help. Thanks!",
    "doctor_response": "Hi, It\u2019s nothing but a simple contusion at the site of injury. You can take analgesics like Acetaminophen or Diclofenac for pain. Apply ice packs also. If symptoms persist, you can consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes foul smell from ear after rupturing eardrum?\n\nMy 7 yr old s eardrum ruptured last Saturday with no signs of a prior ear infection or anything like that.Today has been exactly 1 week and it seems to really bother him when we try to look at it through a ostoscope and now there is a awful smell coming from it",
    "doctor_response": "Hi...this is bacterial otitis media or middle ear infection due to bacteria. I suggest you see your pediatrician and get a prescription for Amoxycillin Clavulenate. If not getting better I suggest you consult an ENT surgeon.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for abdominal pain\n\nI had a bowel obtruction 10 year s ago . now i have had a 1 bowel movement after 13 days that is with taking pico salax and lactulose and now i;m on my 11 day again i;m bloated and pain in stomach and tired and having some memorie loss and the doctor has me on senokot-s 2 tablets 4 times a day lax a day17 gram lactulose 2 tbs 3 times a day and dulcolax suppository daily and i still cant go . Im having some gas so that is good but now what should i do and how long should i wait to see doctor again .",
    "doctor_response": "HIWell come to HCMIf you have history of obstruction of bowel (Not exactly given which bowel was obstructed) neither stated what type of treatment you have given at that time, if the constipation is due to the intestine pathology then this need to be treated accordingly no question is there for waiting, because this is chronic history, and this need to be brought for investigation and management as early as possible, hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain, fast and slow dumping syndrome, radiation enteritis\n\nyes my husband has severe stomach pains, he has been to Dr and has had a CT done a upper and colonloscotmy done and no asswers, he has had cancer in the past and and has fast and slow dumping synmdrome, radiationenderidise also, he takes pain pills for his condition but nothing seems to help.",
    "doctor_response": "Hi, Thanks for writing in. To be able to help you better, I would need answers to the following questions: a. Which cancer was your husband suffering from? b. Which pain pills has he been taking? c. Was an upper GI endoscopy done for him? d. Has he undergone any surgery? It is possible that your husband is having the pain in his stomach due to radiation enteritis. This would particularly be true if his upper GI endoscopy has been normal and he is not receiving non steroidal anti inflammatory drugs right now. The following would help: a. Avoiding alcohol and tobacco, milk products, coffee, tea, chocolate, and soda drinks with caffeine, foods containing whole bran, fresh and dried fruits, fried foods, nuts and seeds, popcorn, potato chips, and pretzels, raw vegetables and rich pastries and baked goods If the upper GI endoscopy and colonoscopy are normal, please speak with your physician about a small bowel capsule endoscopy. However, chronic radiation enteritis has no proper treatment. The only way out may be to resect the affected segment in surgery. Awaiting your reply",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated heart rate during pregnancy?\n\nhi i am 33 weeks pregnant and 23 years old.i was admitted to hospital and kept in over night with a heart beat of 205bpm.they managed to slow it down and is still 100 plus.im scared of it happening again.could you help as to why it happened and what i should be doing now.thank you. Nikkita.",
    "doctor_response": "Hi, Dr Purushottam Neurgaonkar here. I welcome you to HCM VIRTUAL CLINIC. I have gone through your question, and II will suggest you the best possible treatment options. 1 ) First of all do not panic. 2 ) It is really necessary to ensure all the care for your medical problems. I will suggest to get Holter  test done.  A good 2 D echo and colour doppler will be of help.  3 ) it is utmost important to find out the cause .  As you must be aware that in pregnancy there are limitations on the use of various medicines, considering safety of the baby.  It will be better to have opinion of an expert cardiologist.  4 )  Labetelol is one of the safe beta blocker that can be used.  But still expert cardiologist opinion is must.  I hope this answer helps you. Thanks Dr Purushottam Neurgaonkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of tingling?\n\nHi,what does it mean if I have High Limphosites,Lymph absolute high and Basophyl Absolute is also high.Aa well as S-CI 109,S-Ureum 7.5......I have extreme pain and swelling in left upper arm with needles and pins from shoulder to fingers<Please help????",
    "doctor_response": "Hello!Welcome on HCM!Your blood lab tests result could indicate a viral infection. While pins and needles from shoulder to fingers are indicative of a nerve compression or irritation. As you have swelling in the left upper arm, it could be the site of infection. For this reason, I recommend consulting with your doctor for a careful physical check up and some other tests: - a shoulder X Ray study- a cervical spine X Ray study- a nerve conduction study to examine your nerves. You should discuss with your doctor on the above issues. Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for stress and depression?\n\nI have a girlfriend, and she is getting upset by the fact i still have a nice relationship with my x - girlfriend. She's getting more and more upset and even though shes knows that i cant do anything about it i know that she is getting more upset. I was wondering if you could help me because all i want to do is make her happy :(",
    "doctor_response": "HiIt is not depression It is only reaction because of social and personal issues.medicines are not answer of her illness.Just support her.Try to understand each other.Go for mutual and deep understanding between both of you.Understanding is only way to solve this kind of problem.You can go for psychotherapy and counseling for better understanding and relation ship problemFor that participation of both of you is important.Consult psychiatrist for such kind of counseling.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for addiction to geophagic material\n\nhello doctor,i am a 23 yr old girl,actually i have geophagia...i can't resist eating the clay stones (geophagic materials) sold in the market like baked mud.kindly advice me how to overcome this habit otherwise suugest the alternatives that i can prefer.Also is there any harm made to the body by eating this kind of stuff?",
    "doctor_response": "Hello,This habit of eating non eatable material is called pica. This can occur in nutritional deficiencies. Go for blood tests and get your  vitamin B12, iron, calcium levels checked.You can put a chewing gum in your mouth wenever you have desire to eat clay. The habit will go slowly.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stiff neck and pain under the rib cage\n\nI have pain on my right side directly under my ribs. I have had this for 5-6 weeks. I m told by my doctor it s gallbladder, and can be controlled by low fat diet and no alcohol use. I have followed his instructions with no positive results. I m concerned it s something serious. I also have very stiff neck for 2 weeks, not sure if that s a side effect or something else.",
    "doctor_response": "I think you are having poor liver function test. I would suggest you to get your blood test and ultrasound to see if there is any thing abnormal. I would also recommend  you to take tablet liv 52 one daily and avoid high fat contents as you are doing in past. Avoid alcohol also.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for asthma?\n\nHello doctor,I have asthma and I smoke 1-2 cigarettes daily and trying to quit permanently and often I get cold and chest heaviness and nowadays having shortness of breath and pain in the lower right chest and in the back. 2 months I did chest CT scan and pulmonologist said I also have mild bronchietasis . he suggested me to take mucinac.I live in Bangalore",
    "doctor_response": "HelloYou are an asthmatic patient, having chest heaviness, shortness of breath and PAIN IN THE LOWER RIGHT CHEST & also in BACK ( according to query ) .The most disturbing thing is that 2 months back , you got C T scan. Diagnosed as mild degree bronchiectasis and you doctor advise you MUCINAC ie. acetylcysteine , mucolytic agent .All these symptoms are from last 2 months ( pain in lower right rib , with back pain, shortness of breath) and also a smokers, these symptoms may be due to these possibilities these include:1 Pleural effusion , diagnosis can be confirmed by LATEST  X-ray chest .2 Thickened pleura , again diagnosis can be confirmed by X ray chest .Quit smoking at once , consult a pulmonologist and get his opinion as all these symptoms are a cause of CONCERN .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is there something serious about lymphocytes count that is high?\n\nHello doctor, I have extreme pain in my throat and one swollen lymph node too and 99-degree fever. Before these symptoms I was only suffering from fever which was a low-grade fever I had my CBC done before three days and it shows that my lymphocytes count is 60 % and WBC is 6.6x10 and the rest is normal. But now I am having throat pain too with fever. Please guide me what is happening with me. Is there something serious about my lymphocytes count that is high?",
    "doctor_response": "Hello. Your ESR (erythrocyte sedimentation rate), lymphocytes and IgE are high (attachment removed to protect patient identity). So it can be because of viral inflammation of upper respiratory tract along with allergic involvement. You can be prescribed decongestant like Levocetirizine plus Montelukast combination drug for a week. Do saltwater gargle with warm water three times a day. Diluted Betadine gargle will also be useful. Take Vitamin C 500 mg three times a day for five days. Drink more water. One teaspoon turmeric powder with milk taken daily. Avoid excess spicy foods. If no improvement than will investigate further so after week repeat test. Take care. For more information consult a hematologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for uterine cancer\n\nDear Dr. My mother is facing utrus problem.  She is also having thyroid, sugar and pressure but all the same is under control.  She is aged about 62 years. Weighing about 90 kgs.  Now it was informed by the Doctors that they are suspecting whether it will be utrus cancer and wanted to remove the utrus.  They have also informed me that it is also not quite sure that anything might happen during the time of giving anesthsia or on the table.  Kindly give me your opinion as what to be done right now.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Your mother may have uterine cancer. Thyroid, diabetes and hypertension is common problems. If all things are under controlled then no need to worry. She should go for hysterectomy and take further treatment after histopathological report. Don't worry much. Just go for surgery. Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for loose motion and abdominal pain\n\nHello Doctor , I have frequent abdominal pain on the right side of my stomach but I have done the appendicitis operation 9 years ago itself. I'm 27 now and have this stomach pain over one year. Last 4 months I feel difficulty to go motion. I smoke 3-4 per day. I'm diabetic but I don't drink carbonated water. I don't eat sweet items, I eat spicy sometimes less spicy food. If you prefer me any home remedies to have the loose motion I can try that. Doctor told me my stomach is hard and I have to goto toilet properly but I try it's too hard for me. My stomach pain remains all time.",
    "doctor_response": "With diabetes at so young age may lead to coronary problems and cerebro-vascular events if you smoke even 3-4 cigarettes per day. I advice you to stop smoking at the first. Second for constipation, you may take liquid paraffin for the relief. Initially start with 10-15ml three times a day for a week and then reduce it twice daily for a week and then once at night. Also, you need to follow some dietary instructions as not consuming bakery items, increaase in intake of roughage in diet like fruits and cereals and green leafy vegetables. Drink lots of water. Make a habit to go to toilet whether you have an urge or not and be seated for atleast 10-15 minutes.Diabetes cause decrese in the motor function of the intestines and that leads to decrese in the intestinal motility and causes constipation and pain in abdomen.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red lump on breast?\n\nI have a small red lump on my right breast, looks like a bug bite. It has been there for about 10 days. It has not changed. It does not hurt or itch. It has never developed a center like a pimple. Should I worry about this? I am 59 years old, moderately overweight, and no family history of breast cancer.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some acute inflammatory lesion.  However you should go for fine needle aspiration cytology of that lump to rule out malignancy.  Consult your doctor and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it safe to fly when I am 23 weeks pregnant?\n\nHello doctor,I had my second anomaly scan at 18 weeks and the reports showed the impression that the placenta is at posterior wall mid and lower part grade I. The lower margin of the placenta is 3 cm away from internal os. Also, there is a breech presentation. What does it mean? The doctor told me to take bed rest and to avoid heavy work and sexual intercourse and keep an eye on any kind of vaginal bleeding. I am really tensed about the condition. Is it life threatening for my baby and me? What other precautions do I need to take? Should I go for another ultrasound after one month to check whether the placental position has improved or not? Also, I am a working woman and need to travel approx 40 km daily. What should I do? Also, I wanted to ask if I can fly at around 23 weeks.",
    "doctor_response": "Hello. Breech presentation at this gestational age has no significance. The placenta is 3 cm from os means that it is slightly in the lower segment. No need to take bed rest. Just avoid jerky traveling. It is not life-threatening. There is a slightly increased risk of bleeding. It will ascend in future. Get a repeat ultrasound few days prior to traveling. If everything is fine, then you can travel. A flight journey is safe in the second trimester. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to get pregnant even after taking unwanted 72 pill?\n\nI have taken a medicine for delaying my periods and then have unprotected sex. After that I have taken unwanted-72 within 3 hours. But still I didn't get my periods , today is sixth days after taking unwanted. Is there is posiblity of getting pregnant",
    "doctor_response": "Hi,Emergency contraception creates so much disturbance in the hormonal milieu of the body that the period usually gets delayed and a withdrawal bleed is often observed. Intake of the pill within the stipulated time interval is enough protection to prevent any failure. Moreover, if you have had the intercourse during the safe period, you would be naturally protected. Please wait for your next natural period and if you do not see a period even after 10 days after you are due, see a specialist for further evaluation. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rashes on crack of buttocks and vagina, skin peeling, unable to sit or walk. Causes?\n\n2 weeks ago I started a rash in my butt crack and vagina I thought it was a allergic reaction to toliet paper at work so I stopped upswing it. And not it has got so bad I can t sit or walk. It hurts as in burning and iching 24/7. An not its peeling and the skin that is peeling From my areas are white!! What is wrong with me.? And I have stopped useig the toliet paper that I have at home..",
    "doctor_response": "hi dear, its an allergic reaction. although you have stopped using the toilet paper, but it will continue to be there for few days. you need to apply some mild steriod cream to relieve the itch. as more the itch more will be rash. i recommend you to meet a dermatologist. for now you can use desonide lotion once daily in night and take tab avil 25 mg daily in night. thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for abdominal pain and  hepatoma ?\n\nThis is to get information for my relative;s condition. he is a diabetic , hypertensive and is on treatment. 2 weeks back he developed acute abdominal pain and went in to shock. emergency laparotomy was done and it was found that he was having a hepatoma which bursted  and segmentectomy liver was done. eventhough tumour was completely removed doctors say prognosis is poor. what is the next step? his height is 5 ' 7\" and weight 75 kg and age 74 years",
    "doctor_response": "Hi.Thanks for your query and history about your relative.Diabetes and hypertension cause multiple complications and can cause emergency situations if not controlled.You relative was in shock, means the condition was already critical. IF the Doctors are saying that the prognosis is poor, means either there is a complication of surgical or medical cause or the tumor is thought to be a cancer. Age is another factor against the good prognosis. 74 years is an old person and the recovery time, withstand time for anesthesia or / and surgery can have its own complications.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump in breast?\n\nHello,I have a almond type shape lump in my left breast. It is approx 1cm long and sits above the areolar at about 11 o clock. I have had it for about 5 months now. It came on just prior to my menstruation, and now I notice it more pre menstrual cycle, and less once my period has passed. It feels mostly moveable at least underneath. I am otherwise healthy, and am 29 years of age. My Aunty has confirmed BRCA1 gene. It is not tender. When I press hard at times It is slightly tender, but nothing at all to be concerned over.Thanks you for your help,Kind regards,Lisa.",
    "doctor_response": "Hi Lisa ! Good evening. I am Dr Shareef answering your query.Considering that you aunty has been confirmed BRCA1 positive, the lump in your breast needs close observation, with a present physical examination by a general surgeon followed by an ultrasound of bilateral breast and axilla followed by a mammogram bilateral breast. Your treating surgeon might advise you for an excision biopsy for ruling out chances of any malignancy, although it does not look like from the history of changing size with menstrual cycle, which usually occurs with simple fibroadenosis. The management would at the end depend on the clinical findings in breast with axilla, along with results of related investigations.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe back pain?\n\nhello doctor my name is peter from kuwait i am working in navy as a mechanic i am suffereing from back pain yesterday i try to clean on sheet on the floor that time i get started pain one doctor give to me some tablet that one ranimax150,nicip ,but i am not get relif please tell me which tablet for use that one thank u",
    "doctor_response": "Hello,I had gone through the case and found that it might be muscle spasm So take mild painkiller and apply muscle relaxant gel.Take rest and avoid bending forward.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does sharp intermittent pain in the upper abdomen on the left side indicate?\n\nHi, I have a sharp pain in my upper abdomen, left mid side, about 2.5 to 3 below my my ribs that is not constant. In the last couple of weeks its appeared usually because of some movement but not under strain or physical activity. Today i was just adjusting how I was sitting and it hit. Sharp pain, in that area, enough for it to really get your attention and then it goes away. This has happened twice now and it s starting to scare me a little. Any suggestions?",
    "doctor_response": "Hello,Thanks for your query on HCM\"As\"per your clinical history is concerned please follow like this -1)Do a physical examination by your treating Doctor.2)Do abdominal ultrasound to look for gallstones and pancreas inflammation3)Take [Pancreatic enzyme supplements]after each meal regularly.Do take few preventive steps like this -1)Try to stop drinking alcohol. 2)Try to stop smoking. If you smoke, quit. If you don't smoke, don't start. 3)Choose a low-fat diet. Choose a diet that limits fat and emphasizes fresh fruits and vegetables, whole grains, and lean protein.4)Drink more fluids. It may help to keep a water bottle or glass of water with you when you go outside.Hope that helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can gallstone of 3.2cm be removed without surgery?\n\nI had an ultrasound done a few weeks ago and apparently I have a 3.2 cm gallstone.  My doctor recommended a removal of the gallbladder.  Is there any other alternative to removing the gallbladder?  is 3.2 cm gallstone considered \"big\"?  I am scared of surgery... please help.  thank you.",
    "doctor_response": "hi3.2cm stone in gall bladder is a big stone .dont worry what  ever be the size of stone , recent surgical techniques like laproscopy reduced hospitalised admission dates, early mobility.no need to give big incisions as you  see in open cholecystectomy.dont worry.consult your Dr regarding laproscopic cholecystectomy.Thank uWith best regards Vasundhara",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does tiredness, shortness of breath, enlarged lymph nodes in neck requires attention?\n\nI ve been very tired lately. And I ve noticed while I m talking or eating I get a shortness of breath and I have to take a few deep breaths to catch my breath. I ve had an enlarged lymph node in my neck for several years and I just found an enlarged lymph node in my cervical region. But I am not sick and I have not had a fever. Should I be concerned and get some testing done?",
    "doctor_response": "HIThanks for posting your query .  Enlarged lymph node always indicates that there is some problem in the body . It could be due to infection , inflammation , irritation or even cancer .     This associated with your shortness of breath indicates problems in your lungs which needs to be evaluated .   I advise you to get chest X ray , FNAC of the enlarged Lymph node and revert back to me with reports . Any clarifications feel free to ask . Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for muscle pain and infection due to spider bite\n\nI have been bitten by a spider while at the park.It itched for about a 1/2 hour.. It formed a pimple like bite and then 3 days later I was bed ridden.. all my muscles in my legs calf, thigh, and buttox felt like I had 100 lbs of weight on all my muscles and lower back... that lasted 3 days and I am feeling better .. The bite now is a black circle with pink around it and is sensitive to touch but not unbearable.. I thought I had the flu but then got to thinking this was more than that... any suggestions",
    "doctor_response": "hiThe spider sting is probably sticking at the bite site. show a doctor who may remove it.Anti-allergic, antibiotics and anti-inflammatory medicines are given to combat infection,allergy symptoms, and if need be cortisone is also added if too much toxicity is there. Your dangerous period is over now, but precautionary treatment may be taken if your docotr agreesbest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do fever, weakness and low appetite need medical attention?\n\n24-year-old female diagnosed at ready care with thrush. Has fever of 101 at night time,has no energy, lack of appetite and sweating. She s leaving for a study abroad in about 2 weeks. Shouldn t she see her doctor? What tests should she have? She was told she didn t have mono.",
    "doctor_response": "Yes she need immediate medical attentionFollow health advises given below: 1. Avoid exertion 2. Take tablet paracetamol 500 mg after food (If No Drug Allergy) as and when required for fever more than 99 f (maximum 3 tablets with gap of 8 hr can be taken in a day) for 3 days 3. Lot of fluids to be taken 4. Take proper diet homemade food like moong dal dalia, chapati etc. 5. Avoid wearing synthetic and tight cloths. 6. Capsule Supradyn one capsule after breakfast once a day for 10 daysBy complete history and presence of other symptoms like cough/ throat pain/ burning urine/ stomach pain we will confirm cause of fever and plan for further treatment",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes weird feeling on the chest after a long walk?\n\nI recently noticed this weird feeling in the middle of my chest after long walks or when going up stairs.  Maybe I'm experiencing heart flutters.  My blood pressure is perfect although and for the most part pretty good shape for a 40 yr old male.  Could this be caused by stress or something else?",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern.I will try to explain you something and give you my opinion. You should know that typical heart pains have some characteristics. They are retro-sternal pains like squizzing, tightness or heaviness. They last from 5 to 20 minutes and may be irradiated to arms, jaw. This are typical ischemic heart pains.Heart rhythm issues like tachycardia, fibrillation, extra sistolic beats might  give symptoms like chest discomfort or this weird feeling in the meadle of the chest.But we can not be sure until we do some examinations.If I was your treating doctor I will recommend some examination like an electrocardiogram,  a cardiac echo, a full blood analyze, a holter rhythm monitoring and a strees test.This helps us to differentiate between real ischemic heart pains or just a random extra sistolic beat caused by streess.Hope I was helpful.Wish you good health. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can vomiting with fever and headache be an indication of inguinal hernia?\n\nMy son is 5 almost 6 he will be 6 on the 15th. He woke up with really bad head ache. He has been throwing up with nothing in his stomach and he says that his stomach hurts Also he has a fever is there anything i should be concer with? knowing there is a chance for recuring a ingunal hernia?",
    "doctor_response": "HiI understand your concerns. It seems that your son may be suffering from meningoencephalitis. I would recommend you to immediately visit a paediatrician for complete examination and definitive treatment. They may advice you for neuroimaging such as MRI or lumbar puncture if meningitis suspected on clinical examination as well. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. l got a sore hard lump after the removal of wisdom tooth. Is it normal?\n\nHello doctor,I just got one side of my wisdom teeth removed both upper and lower six days ago, and I have another one scheduled after two days for the left side. The upper is 100 % fine, which they pulled. The lower they pulled the tooth without removing the root because it was too close to the nerve. I do have some stitching in this area currently on the lower cheek. Noticed a hard lump about 1 inch between my lower jawline and cheek area. Is this normal because of swelling or something else. Currently taking Amoxicillin 500 mg and Ibuprofen 600 mg. Please let me know what this hard lump is, also generally on the lower side where this lump is, remains sore.",
    "doctor_response": "Hello. The lump is mostly a hard swelling which forms postsurgical removal of the wisdom tooth or maybe even by swollen lymph nodes due to infection. It takes a week or two for the swelling to subside. Sometimes, if the root is still inside, the infection may be remaining there causing swelling. Get an X-ray done to find out the exact problem and stronger antibiotics like Augmentin (Amoxicillin and Clavulanic acid) along with a painkiller for a week. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for scrotum pimples during tinea cruris\n\nI am a 43 year old married male having two children.  When I was about 13 years old, I had symptoms of tinea cruris.  When the disease started, there was severe etching around my groin which gradually spread to the scrotum and male organ. The etching went away on its own and now there is no etching.   Even after undertaking several treatments, i still have the symptom of the disease. The entire scrotum and about 2/3rd of the penis  is full of pimples.  I have tested VDRL several times but every time it showed negative or non-reactive. What kind of a disease I am carrying and is there any treatment for complete eradication of the disease?  Kindly reply.",
    "doctor_response": "consult dermatologist for physical examination,he may start oral anti fungal tablet & anti fungal cream for few weeks ,keep the body clean & dry,wear cotton undergarments,change twice a day,take bath twice a day.avoid hot,humid,sweating,do not worry,you will be alright.it would be cured though will take some time ,feedback,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for breathlessness\n\nhell doctor, I was recently put on asthma inhalers/ventolin. The reason was because I went to hospital extremely out of breath. now im on ant-biotics and waiting for a chest xray. I wonder if you think this may be the first sign of heart disease, Anne",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, no this may not be the case because hear disease is very easy to diagnosed with help of certain test and some time even with the clinical examination if this was the case then you would have been treated in the same way, still if you have not the EKG then better to get it done to clear the doubt, hope  this information helps, take care, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to get rid of painful lump on wrist\n\nHello, my wrist has a lump on it that might of been caused from playing rugby league , and it has been there for three weeks. For the first two week I rested it and it did not get better that much however recently I went to another sports competition and I might of aggravated it more. But since then ive been stayed off it completely and I ve also been stretching my wrist with exercises the physiologist gave me. and the lump has gone down a bit, but when I press against the lump, I can feel pressure. It also hurts when I do pressing movements but it is pain free when I do pulling movements. Can you please tell me what has happened and how can I treat it so that this lump goes away",
    "doctor_response": "Hi,From history it seems that you might be having Wrist Ganglion.This is a common condition.If it does not give any problem, nothing is to be done.If it increases in size or give some trouble, then consult your doctor and get examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can i change the medication?\n\ngood day to you Doc, i just want to change my pills. i am using trust pills for two years now and i want to change it from althea.. the last time i took the last tablet was on monday.. how will i take althea pills if today was the 3rd day of not taking any pills already? thank you",
    "doctor_response": "Hello, You should use a backup birth control method such as condoms till the end of this cycle. You may need to start the new package of pills on the first day of the new cycle. So take althea the first day of new cycle. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Olgeta Xhufka, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for burn mark on the face\n\nSir my son aged of 15 months had burn injury on his cheeks by falling of hot tea and a little area of skin is gone on cheeks and it is curing but can he get back the same color of skin with a patch.we arr using silverx ointment on it.is it ok or any other better plz suggest me in this concern.thank u",
    "doctor_response": "if it is full thichness burn scar will be there , in that case plastic surgeon can help.Cream and ointment usually wont help other than healing of scar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for albuminuria\n\nhelo sir i am a diabetic and now in my urine sample the albumin present at +++ and ++ it is varies. i examine by kidney specialist. and i tested blood urea and creatinine. and ct scan for kidney they are all normal but the albumin is going in my urine. the doctor say to kidney biapsee. what should i do.",
    "doctor_response": "Firstly how long is diabetes history...if it is more than 5 years and  how much is proteinuria if is less than 5gm / dayand how is ya retina and what's ya serum creatinine levesl. The decision regarding biopsy depends on these four factors.U need to use ACEi or ARBs and have strict sugar control.Biopsy may be indicated if ranal failure is present or proteinuria greater than 8gm /day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of using rotacaps 250 for dust allergy?\n\nHELLO, i have dust allergy and doctor prescribed me for using seroflo rotacaps 250 . its been 10 years for I have been using this seroflo but from last few months, acute abdominal pain and intense non productive coughing start after using the medicine. Is this side-effect of seroflo or something else ?",
    "doctor_response": "hello,thanks for your query,Fluticasone, a corticosteroid, is the anti-inflammatory while salmeterol treats constriction of the airways. Together, they relieve the symptoms of coughing, wheezing and shortness of breath. mouth, throat or tongue becomes sore or that their voice becomes hoarse.Gargling with water and spitting it out immediately after each dose.ur abdominal pain is not related to ur inhaler. kindly visit surgeon to rule the cause.all the best. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high fever, black spots in visual field and headache?\n\nMy daughter (10) has had a high fever today, which we are controlling by alternating ibuprophen and Tylenol. She is now complaining that when she stands up, she randomly gets black spots popping around in her visual field and gets a bad headache on the top of her head. She hasn t felt like eating and has been drinking water when she s awake. Her fever first started yesterday afternoon with a headache.",
    "doctor_response": "HiShe needs immediate medical attentionWhile this could just be the flu, with the headache and the vision problems she may have meningitis and for that reason she needs to see a doctor now",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hypersensitive glans, unable to touch it. Remedy?\n\ni have hypersensitive glans i m 19 years old ... icant even touch my glans ... so what can i do?",
    "doctor_response": "DearWe understand your concernsI went through your details.The problems is not with the glans. The glans is supposed to be sensitive because it has nerve endings which will be stimulated during sexual intercourse. It has to be stimulated when inside vagina and makes up and down movement. That is the reason why the glans has been provided with covering in the form of foreskin. Everyone has the glans sensitive and yours is no exemption. Don't worry about that. Hyper sensitive is not the word to describe it.Hope this answers your query. Available for further sexological clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to stop hair loss post menopause?\n\nI am a 50 yr old woman, who has just entered the menopause phase of life.  About 5-6 months ago, I began to notice hair thinning, almost like male-pattern baldness.  Ob/gyn ran blood tests; hormone levels are \"normal\" with testosterone level @2.7, i think within normal range.  Just recently, I have noticed more thinning and several \"corkscrew-type\" hairs popping out.  Doc put me on Estrace 0.01% Cream, 3x week.  That has certainly taken care of the hotflashes and horrific mood swings.  The only thing that has changed medicinally, is my internist put me on Vicoprofen, 200/7.5 for migraines and arthritis.  My concern is my hair loss.  At this rate, I will be bald in a year!  Any suggestions?",
    "doctor_response": "Hi.As per your case history of hairfall.My treatment advice is \u2013 1. Take good nutritious diet full of green leafy vegetables and milk.2. Use a good herbal shampoo and coconut hair oil for regular use.3. Take an iron supplement once daily and vitamin b12 supplement once daily for 3 months.4. Other treatment options are topical minoxidil, oral finasteride and mesotherpy done by a dermatologist.Thanks.Dr.Harshit Bhachech.MBBS, DDVL.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower abdominal pain and headache?\n\nI am 30 years old history of kidney stones and I have had a hysterectomy, about the last 2 months I have had  pain in my lower left side. I have headaches all the time, very fatigue and confused at times. Went to the doctor thought I had a kidney stone everything came back clear. What is wrong with me? I am a CNA and do a lot of lifting everyday.",
    "doctor_response": "Hi.Thanks for your query.Read  and understood the history of kidney stones and hysterectomy. Now you have pain in left lower abdomen for 2 months, headaches all the time, fatigue, confusion all the time. The possible diagnosis can be a chronic infection of the intestines or PID or may be a mass or lymph nodes.I would advise you the following:CT scan of the abdomenColonoscopyInvestigations of blood and urine and stool. All these tests can give a probable diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yellow discharge from the penis?\n\nGood evening sir .. i am male 26 years studying ...70 kg 5'6\"height .. sir from last one weak some white and yellowish liquid comming out from my penish .. m feeling weak ..,when my dick getting erect more its comming .. what it is and what medicine i should take to make it cure .. my mail id is  YYYY@YYYY   thanks",
    "doctor_response": "DearWe understand your concernsI went through your details. The yellowish or clear liquid you are talking about could be called precum. It is lubricating fluid used to lubricate vagina while intercourse. This is quite common and there is nothing to worry about it. Over and above, you are not complaining about any pain, burning or itching. If any of these complaints are also present, you should consult an urologist.If you still need my assistance in this regard, please use this link.  Please remember to describe the whole problem with full detail.Hope this answers your query. Please feel free to post follow up queries. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why my baby having constipation?\n\nHi my 1month 2weeks baby is constipated,she was using NAN at 1st than she started giving hard stools that made her cry,so I bought her pelagon NAN and everything was good she didn t take out hard stools anymore,so her dad bought he a lactogen and she now giving hard stools and it seems painful because she doesn t sleep at night,she keeps trying to shit but nothing comes out,please help me I don t know what to do",
    "doctor_response": "HiThanks for writing to us.Formula feeding can cause hard stools.I would recommend similac advanced , since it is palmoil free, stools will be natural and soft like breast fed babies.Wishing your child good healthRegardsDR Arun",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy of red bumps on face ?\n\nhello dr..I did a face wax yesterday with fem wax strips..i jst had to put on the strips and peel it..but after doing it..it has caused red bumps on my face nd now the skin has become brown in colour..i boght elcon ointment..will this relieve me from the scars and how long will it take?",
    "doctor_response": "Hello and welcome to HCM.It seems you have got local irritation to the wax cream you have used. It called Contact irritant dermatitis.Nothing to worry as your skin will be fine soon.I would advise you a week course of oral prednisolone in low dose (5-10mg).You can use Elocon ointment which contains mometasone but supplement it with application of antibiotic like fusidic acid cream to prevent any secondary bacterial infection.After good quality moisturiser like cetaphil DAM twice a day over full face.Avoid use of any cosmetics/facewash for few days.Avoid direct sun exposure and use water-based sunscreen before stepping out in sun.Hope this was useful.Take care Dr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can swelling and pain in the feet be treated?\n\nHello, my brother s feet are swollen and are causing him a lot of pain, he had outpatient procedure done on his back about 4 weeks ago to take the pressure off of a pinched nerve in his lower back that was causing him a lot of pain and was also making his left leg swell and hurt real bad and he could hardly walk, the surgery helped with that but like I said earlier now his feet are swollen and when he lays down he says it hurts his back to bad to elevate his legs and feet. He s been putting and ice pack on them but there still swollen.",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The pain and swelling can be related to arthritis or the compressed nerve. Cardiac and renal causes of swelling also need to be ruled out. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get joint pains, 3 to 4 times a month. What to do?\n\nHi doctor, I am suffering from joint pains from last two years. I get pain in fingers, palms, knee joints, heels, and soles. I consulted doctors few times, and they tell me to take Colchicine, Dolo, Myotop, and\u00a0Nucoxia, whenever I get pain. But these days, I am getting the pain very frequently, like 3 to 4 times a month.\u00a0I do not know what to do. Can you please suggest what to do? I have attached my reports for your reference.\u00a0Thanks.",
    "doctor_response": "Hi. Revert with more information to an orthopaedician and traumatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in the back in a 12 year old?\n\nmy 12 year old son has had lower back pain for 6 months and recently had an mri i have just recieved a letter saying the mri showed evidence of a chronic problem in his lower back bones and that he has been referred to an orthopaedic surgeon. what could be the problem with his back",
    "doctor_response": "hi, Welcome to this forum.Can understand your concerns.Pain at lower back region on the backside for which NRI has been done and chronic problem is reported could be due to tuberculosis of spine, and old injury which might have small fracture of vertebra,Disc prolapse.Since mri has already been done and it has been advised to visit a Orthopaedic doctor , the child should be examined by the doctor.In tuberculosis, there is history of weight loss, mild persistent fever, persistent cough. While in other 2 cases there is no history of fever.I hope this will help you.Take care.Regards, dr Deepak Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in jaw along with headache?\n\nFor about a week my jaw has been killing me, then my teeth started to ache and tongue feels swollen and a terrible headache.  I have tmj and I have a night guard to wear at night because I clench my jaw, but it hasn't helped. Ctge pain I have had over the last week is worse than any pain I have felt ( from the tmj) I had an appointment with my neurologist yesterday ( I have multiple sclerosis) he says it's not related to ms at all. What could this be?",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM I have gone through your query , as you have pain in teeth and tmj also dont worry consult dentist and go for investigations and clinical examination . As you have tmj also this Tmj pain radiates to head and causing headache . Consult dentist as early as possible .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bruising and swelling in lower back after falling. Stomach sore with hot sensation. Taking nurofen and paracetamol\n\nFell off a ladder , Friday evening , bruising and swelling to lower back ! Stomach feels sore and funny hot sensation in the tummy, feel like I have been kicked in he tummy ? Very stiff back , ? Been taking nurofen and paracetamol , should I get checked out by my gp ?",
    "doctor_response": "Hi there. According to me you should get an Xray of the back done immediately .Nurofen is mostly Ibuprofen and should be avoided if you are having stomach problems .In fact the stomach soreness might be secondary to Nurofen ingestion. Treatment :1. Complete bed rest2. Analgesic like Tramodol as it has negligible gastric side effects3. Muscle relaxant like Thiocolchiside4. Local analgesic gel massage5. Lumbosacral corset to be worn while you are not lying down. Further treatment will depend on X ray report.I hope my advice has helpedGood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a immovable lump in knee?\n\nMy husband just discovered a hard immovable lump about the size of half an egg on the inside of his leg, beside his knee. It feels like it s attached to a muscle. Is this cause for concern? It doesn t bother him and he s not aware that it s been growing at all.",
    "doctor_response": "Hi,Dear,Thanks for the query to HCM .I studied your query in depth.I feel concerned about it.In my opinion your husband is suffering from-MB cyst of knee joint with ? arthritis of the knee-USG knee would confirm it.Hope this would solve your query.Please contact again and  I would love to attend your queries promptly.Have a good time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does nal1 baby feed causes redness and swelling on face?\n\nHI I am only breatfeeding my baby.He has entered his 5th month yesterday and I gave him 3 ounces milk in a bottle made of Nan1 baby feed.In one hour his whole face and body became red and swollen up.I have given him drops my docter suggested which has made the redness subside.My query is that did nan 1 cause this reaction and should I try and give him some other brand?",
    "doctor_response": "Hi...I went through the history points you have provided - I was expecting that there should have been a history of cow's milk and formula feed (this too contains cow's milk protein) given to the baby. I feel that your baby is having cow's milk protein allergy. Usually babies grow out of this sort of allergy by 1 year of age. My suggestions for you - 1. Mother should go off cow's milk protein completely. This means that you should avoid consumption of anything and everything related to cow's milk - like - milk/ curds/ ghee/ butter milk/ chocolates/ biscuits/ ice creams etc. Even while buying commercial food products, you need to see the ingredients and if they contain milk - do not consume them.2. Feed you baby only exclusive breast feeds till 6 months of age and then start rice based feeds.  3. If this is followed scrupulously - the baby will stop having diarrhoea in another 3-4 days and then start gaining weight too.4. If you feel your feeds alone are inadequate for the baby, then Zerolac is the only option till 6 months age. I request you to keep me posted about the recovery of the baby and follow of the case.Regards \u2013 Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is lightheadedness while bending over normal?\n\nThank you....I often get lightheaded after bending over. I am quite tall (6 3 ) and while I am 66 years old this has been a lifelong issue since I was a young adult. It generally goes away in a minute or so. I am in good health and am not overweight nor do I have any chronic health issues. The only medication I take is 10mg of Lipitor at night. Thank you, Bourke Corcoran YYYY@YYYY",
    "doctor_response": "Hi,Thanks for writing in.The feeling of lightheaded after bending down is explainable. The brain gets its blood supply from the heart through the carotid and vertebral arteries. The carotid arteries transmit the blood along the front and sides of the neck region and the vertebral arteries run through the spine. When bending, it is possible that there is decreased blood flow to the brain momentarily and since you are experiencing it from when you were a young adult, it looks likely due to positional changes of the cervical spine and mild pressure on the vertebral arteries when you bend down. Lipitor (atorvastatin) is used to treat high cholesterol and will help in declogging your arteries should there be any blocks due to ageing. This will enable good flow of blood to your brain. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pregnancy without sex?\n\nI mastrubated and ejaculated in my hands. Then I washed my hands twice with dettol soap and then dipped my hands in diluted liquid dettol and then again washed with dettol soap.After 30 mins I fingered my girlfriend. Is there any chance of her getting pregnant?",
    "doctor_response": "DearWe understand your concernsI went through your details. With the explanation and procedure you gave here, I can be 100% sure that your girl friend cannot be pregnancy. Sperm dies within minutes in room temperature and normal atmosphere. Sperm only survives within vagina. Secondly you had washed your hand thrice using soap. Sperm cells die immediately the moment it comes into contact with soap molecules. No need to worry. Your girl friend cannot become pregnant.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chronic back pain, nerve root damage to L5-S1. Treatment options?\n\nhi been suffering with back pain for about 12 years the last 5 worse chronic pain .got told it was l5s1 with nerve root damage.i got referred to a cosultant who for 2 yrs said he didnt know what was wrong with me.got referred back to the first place i went to and they said its ddd but not worth operating as the nerves are damaged.just wish someone would tell me what it is exactly",
    "doctor_response": "hi, your history is inadequate to answer about your query correctly, You show to a good orthopaedic surgeon or a neuro surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for increased levels of creatinine\n\nmy sister is 35 years old she is suffering from diabetes since 10 years very recently we came to know that she is suffering from kidney problem her creatinine level is 2.6 when her sugar level is under control her creatinine level goes up and vic e versa kindlly suggest what shhould be done in future",
    "doctor_response": "Dear user, I recommend you: step 1) to perform a fundoscopy to diagnose diabetic retinopathy. If this is diagnostic for retinopathy, then it is very likely that your sister has a diabetic nephropathy, although EVERY organic cause should be excluded at least with lab exams (C3,C4, ANA, kappa and lambda free light chains, urine analysis). If your sister has a negative fundoscopy, a renal biopsy should be performed. Avoid every nephrotoxic drug, such NSAIDs.Let me know, Andrea",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can the symptomless ulcer at the back of penile shaft be treated?\n\nHello doctor, Small painless itchless ucler at the back of penile shaft with no other symptoms.",
    "doctor_response": "Hi. I have gone through your case. According to your description and clinical picture (attachment removed to protect patient identity), this ulcer could be a manifestation of primary chancre of syphilis (one of the sexually transmitted diseases, if there is a history of sexual contact as well at least 3 to 4 weeks ago). Sexually transmitted infection syphilis. VDRL, TPHA, test for other STD like hepatitis B and C, HIV. Traumatic. Primary chancre of syphilis. Benzathine penicillin 1.2 MU I/M on each buttock stat dose. If tests are normal then only Fucidin acid cream two times a day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is viral fever fatal enough to cause death?\n\nHai Doctor, We are in a village in tamilnadu my friends wife age35 was diagonised viral fever and was hospitalised,after few days was taken to a specialitily hospital and treated for the sama mean will she had her periods after beging in hospital for 5 days she did not recover and passed away will viralfeaver be that fatal?",
    "doctor_response": "Thanks for contacting HCM. Usually viral fevers are self limiting but in patients with low immunity they can be life threatening. Also some viral fevers are also very severe type where death do occurs as in dengue haemorrhagic fever and ebola virus infections. What you described about your friend's wife appears to be a case of Dengue haemorrhagic fever where blood clotting is impaired due fall in blood platelet levels and patient starts to bleed spontaneously from different sites and unfortunately in your friend's wife's case she had periods at that time and she probably died of excess bleeding. Feeling sorry for your friend and his poor wife. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for back pain\n\nI dove into a river off a dock 4 days ago & i knocked the wind out of myself. It didn't hurt the past 3 days but now it does. Have I pulled a muscle? It hurts my upper/middle back when I take a deep breath. Although, I do get back pain sometimes due to my poor posture.. I'm not quite sure what has happened.",
    "doctor_response": "Hi,The scenario you just described is suggestive of some serious back trauma to be checked and carefully investigated. Pain killers, keeping the back at rest and on a hard surface and doing X rays of the spine would be most useful at this point. Thanks and kind regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will accidental entry of metal shavings into eyes lead to dry eyes and cataract?\n\nHello doctor, I had an injury to my eyes seven months back. I got metal shavings in both and had to remove and left scars on my retina. Since then everything is blurry and went to the eye doctor last month. My prescription has not changed. They say I have dry eye and starting of cataracts. Can the injury be a result of those things? I did not have a problem before.",
    "doctor_response": "Hi. Blurred vision may be due to a corneal problem, cataract or retinal scars. After trauma, all these complications can occur. Dry eyes will improve with artificial tears and cornea will get normal. But any corneal scar or opacity will remain and can hinder in vision. Cataract may be age-related or due to trauma. So if it is visually significant it is treated by surgical removal and intraocular lens implantation and your doctor will guide you when it needs to remove. The retinal scar can cause decrease vision significantly if they involve a central part of the retina called macula responsible for sharpest vision. But we can do much to treat retinal scars. So things to do are treat dry eyes and cataract (if surgery needed). I would suggest you visit your eye doctor and he will guide you accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Parkinson s disease\n\nI am considering taking a supplement called Accel. It has 50 mg of ubiquinol in liquid form plus vitamin E (tocotrinols) in a gel tablet. It is marketed online by Dr. Al Sears via a company called PRIMAL FORCE. (not a trust inspiring name!) I have Parkinson s Disease and when I asked my nuerologist he said a recently completed clinical trial did not bear out the theory that CoQ10 helped with Parkinson s symptoms. In spite of this disappointing news, there seem to be other benefits that might make me feel better i.e. energy, cardio-vascular health, and lower cholesterol, etc. I would be interested in your opinion. Edith Dzubay",
    "doctor_response": "hi..EDITH,, thanks for writing..i have understood your concerns..the parkinson's disease is a neurodegenerative disease, in which the dopamine containing neurons in the basal ganglia region of the brain gradually degenerate over time..there are hypothesis about the oxidative stress as a etiology of the disease..so further research proposed the possible role of antioxidant medications in prevention and treatment of parkinsons disease.variety of agents have been identified and many trial have been done, but none have shown any promising results. so there use is still a debate.. our clinical experience also have negative opinion..for the parkinsons disease in the initial stage when the symptoms are mild, at that time their use can be beneficial for delaying the degeneration but at severe stage they are of no benefit..if there are documented benefits over other systems of the body then you can give it a try..[most of the studies shows that benefits are unreliable]dont expect that it will help you in your parkinsons..i hope this information will be helpful to you..best of luck..wish you a good health..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does increased hepatic echo pattern mean in abdominal ultrasound?\n\n1-i make abdominal ultrasound result is increased hepatic echopattern ,free otherwise what does it mean? 2- And i make liver function tests its all normal value (alt,ast,alk phosphatase,albumin,bilirubin direct and total ,total protein ) all within normal value 3-i make pcr taqman the result is 900.000 iu/ml question is what is increased hepatic echo pattern mean? What is the dangerous from this hcv number? Thank you!",
    "doctor_response": "Hello Increased hepatic echo pattern means fatty changes in liver.Fat appears bright in ultrasoundFatty liver is a reversible stage.It is due to excessive deposition of fat within the liver cells.It is good that liver function test is normal.It is important to exclude altered lipid profile.You should increase your physical activity and avoid fried and fatty food.You may need few medicines after full investigations.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are welts normal after being bitten by chiggers?\n\nI was bit by chiggers and believed there may be some that didn\u2019t bite and are alive in my car that I live in so I went to the mountains over night and it got down to 20 degrees are they dead I left the windows down too. I have had a sore throat since then is there anything I should be worried about. And I have developed new welts several days after since seeing the first welts is that normal . And if I do continue to get a few bites is really any harm that can come to me assuming I don\u2019t get an infection from scratching",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .* Usually minor bites are taken care by body`s immune mechanics .* Primary guidelines for better outcome- keep the part clean with antiseptic liquid .- avoid tight fitting shoes or further exposure to leather for sometime .- avoid scratching till possible .- consult your doctor if any area of redness , tenderness appears on the    body .Hope this clears your doubt  .Wishing you fine recovery .Welcome for any further  assistance .Regards  take care .Dr. Bhagyesh ( MS , FMAS - consultant surgeon )",
    "dialogue_context": ""
  },
  {
    "patient_message": "Emetophobia. Phobia dominates life. How could I relive from fear?\n\nHello. I have Emetophobia . I am 15 years old, and this phobia dominates my life. I constantly worry that someone around me, or even myself will get sick. I freak out if someone even coughs or says that they do not feel well. I constantly feel sick because I worry that I m going to be sick so much. This only makes me feel even worse. What would you recommend me to do to relieve some of my fears?",
    "doctor_response": "Hi Anna, Fearing that you will become sick by staying with sick people cannot be termed as emetophobia, as emetophobia is more of phobia about the vomiting, the act of vomiting or feeling nauseated. The problem you are having is more of negative thoughts that we frequently encounter in conditions such as depression. First and foremost, you did not mention, since when are you having this problem. If this problem is due to a depressive episode, the symptoms can be controlled by taking appropriate medications like SSRI and also cognitive behavioural therapy will also benefit you,wherein you challenge your automatic thoughts. All said, you will be well once you are into treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful lumps on the backside of the thigh\n\nI had a hard fall three weeks ago the bruise has finally cleared up but now I have lumps where the bruise was which is on the back side of my thigh it is painful to bend my leg certain ways still and the lumps are tender. What could these lumps be? What can I do to help them?",
    "doctor_response": "Hello, As due to falling there will be bruise and lumps due to the disturbance in the normal physiological processes of the muscle. Are you having past medical history of blood pressure or diabetes or anything else for which you are taking medicine or getting treated by some other way. If there is no past medical history this will be just the normal physiological process of healing. Doing hot water fermentation and keeping the leg elevated over a pillow while in the supine position should help reduce the symptoms. Wait for a week to look out for any changes in the lumps and pain. If it comes down you may not need to worry. In case if no changes found than get it physical examined by a physician for a safe side. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are stomach pain and headache related to swelling in toes?\n\nMy thirteen year old daughter noticed that her toe next to her pinky toe was swollen and red this morning, this afternoon she noticed that she has a line running up her foot from that toe. Before she noticed that line she was complaining of stomach and headache pain. Are they related?",
    "doctor_response": "Hello, I don't think it's related to a toe injury. It could be due to gastric issues. Having good food and a good head massage will help ease it. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for sinus infections\n\nI have pain at all sinus regions on my face, also plugged ears, swollen behind my jaw/under ears, my upper jaw hurts extrememly bad.  I am not congested at all, I am not coughing, sneezing, have no problems breathing.  I have constant drainage going down the back of my throat which causes severe pain in my throat.  I've taken antibiotics and they did not help at all. I also keep a humidifier in my room which is running constantly, I use saline nose drops.  I take sudafed.  All of these help minutely, but never take away the pain all together.",
    "doctor_response": "Hello, Your best chance for treating this condition would be a combination of nasal steroids, nasal saline and an antihistamine. If these do not work then you would need to see an ENT specialist. They can look into your nasal passages with a scope or order a CT or MRI to get a better look at what is going on in your sinuses.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest ways to maintain erection\n\nif arteries are partly blocked and prevents regular bllod flow to the penis...hence unable to maintain an erecdtion......can eating more healthy and exercise help restore normal function ? also if you masterbate too often can this effect and cause problems ?",
    "doctor_response": "Hello,It may be due to performance anxiety. For that you may require testosterone level, lipid profile, electrocardiogram after physician consultation. Along with that avoid stress. Take proper rest and balanced diet. Till then you can take tablet sildenafil one hour before sexual act Hope I have answered your query. Let me know if I can assist you further. Regards, Dr Shyam Kale Family and general physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please clarify the lesion found in the ultrasound of my 18 week fetus.\n\nHi doctor, My ultrasound report\u00a0showed well-defined anechoic lesion measuring 3.9 cm in length and 1.6 cm width in the\u00a0lower abdomen of the 18 weeks fetus. No echoes are seen within it. It is showing peristalsis.\u00a0Stomach and gall bladder visualized. No evidence of ascites. Abnormal wall intact.\u00a0Kidneys and bladder appeared normal. Please clarify\u00a0the lesion. I have attached the report for your reference.",
    "doctor_response": "Hello. I have been through the report posted (attachment removed to protect patient identity). An anechoic lesion defines a lesion that is clear and simple that means, the cyst visualised is a simple cyst. Ther are some cysts like a mesenteric cyst, omental cyst or neuroblastoma ovarian cysts in female fetus and so on. Showing peristaltic movements and its location intra-abdominally makes enteric duplication cyst as the most probable diagnosis (rare congenital abnormality in gastrointestinal tract). The good thing is that it is not associated with any other anomalies. What is needed now is its regular follow up and surgical excision after delivery to avoid future complications. For further information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can woman with resistant ovarian failure conceive?\n\na female 27yrs of age with primary amenorrhoea.USG abdomen revealed hypoplastic/infantile uterus wid small ovaries.hormonal study shows FSH raised 18times and LH raised 8times..she got withdrawal bleeding after medication but after that again failed to get her periods..was diagnosed as ?resistant ovarian failure..she has normal development of secondary sexual organs.karyotype normal female 46XX.IS THERE ANY WAY SHE CAN CONCEIVE..",
    "doctor_response": "Hi , How are you doing ?With IVF she still has a chance. High levels of FSH , suggest that her ovaries are not functioning . But as she did have a uterus on scan & very luckily as she had withdrawal bleeding on hormones( suggesting that the  inner lining of uterus is healthy when on hormones. So that would mean that the uterus can be prepared. So she will need a good course of cyclical Higher dose Combined hormone pills for 6-8 mths. This will prepare the muscles of uterus , which looked hypoplastic on scan. ( if not prepared she will be prone for uterine rupture , preterm labor.). Once the lining of the uterus is good enough & uterine muscles are healthy, she is ready for IVF. Donor eggs can be taken, each of them injected with husband's sperm & embryos frozen. When the inner lining of the uterus is adequate for the cycle( using selective estrogen hormone), the embryos can be kept. She can have babies as long as the embryos are frozen. She will need a cervical cerclage stitch once at 16 weeks, good supplementation of progestrone hormone through out pregnancy. Now she also needs good calcium & iron supplementation & an eye on the cholesterol level.Hope I have clarified your queryDo write back if any more queriesAll the bestDr.Balakrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for white patches on scalp\n\nhi Doctor I have mild white patches on some part of my scalp. I have been having this problem since 8 years.  as of now i am using 777 oil for applying it on my affected scalp and also taking Zemega -3 medicine. But it cures temporarily Dr says it is mild psoriasis. so please advsie whether it is curable",
    "doctor_response": "Hello. Thanks for writing to us at healthcaremagicDandruff if excessive or resistant to treatment with regular OTC shampoos can be due to either seborrheic dermatitis or scalp psoriasis.While seborrheic dermatitis is associated with faintly red patches, itching and yellow greasy adherent scales; psoriasis is characterized by well defined deeply red patches, with thick candle wax like scales.The diagnosis of psoriasis is clinical in most cases. There may psoriatic plaques elsewhere on the body as well.If I was the treating doctor I would have asked you to use a coal tar+salicylic acid based shampoo, daily or every alternate days for mild psoriasis affecting the scalp.Depending on the clinical severity of psoriasis, dermatologists may also ask to apply a topical steroid+salicylic acid lotion for 2-4 weeks, if there are thick scaly plaques of psoriasis, as shampoo alone might not be sufficient.Other effective options apart from steroids that are available to treat scalp psoriasis are topical Vit D analogues like calcipotriol and calcitriol.Psoriasis can recur again after seemingly complete cure. Therefore, once the patches and scaling is effectively controlled with topical treatment with lotions, a shampoo would be effective for maintaining the improvement.These are all prescription products, therefore, I would suggest you that you talk to your dermatologist for the needful.Your dermatologist would be able to assess whether shampoo alone would be effective or do you require additional topical treatment with lotions.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does too much stress during pregnancy affect the baby?\n\nhi im 31 weeks pregnant and I feel very tired and stressed. I only go sleep past 2 or 3 over weekends sometimes later cause my husbands very busy and we fight every weekend and i get upset and cry alot. I feel so dizzy and tired and just feel like crying cause i dont know what to do? could i be harming my baby by stressing every weekend cause i know there is going to be a fight and does it harm my baby when i dont get much sleep and i cry and get upset?",
    "doctor_response": "Hello, and I hope I can help you today.\"Stress\" itself cannot be quantified, and lack of sleep certainly can make you irritable and short-tempered.  Your emotions have no negative effect on the baby, however, I am concerned about your own health and the environment in your home, as your fighting with your husband and chronic lack of sleep is not the best environment for a newborn baby.  It is difficult to not have your husband around a lot to support you.  I really hope that there is no physical violence that takes place as this is a major risk factor for things getting very dangerous, especially once the baby is born.  There is also a possibility you could be suffering from depression, which is a chemical imbalance brought on by stress and the hormones of pregnancy.  There are medications that can be used safely during pregnancy and I strongly suggest you discuss your situation with your healthcare provider.  There are even medications you can safely take to help you sleep.In the meantime, at least you do not have to worry about the effect this has on the baby, but the environment in your home and your mood concerns me for the time after the baby is born.  Talking to your doctor, a counselor, or social worker about your home environment may be helpful if your marriage is suffering because of all this.I hope this advice was helpful and i sincerely wish you the best for the rest of the pregnancy.Sincerely, Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could painful lumps on armpit suggest?\n\nHi. I am really sorry to disturb. I have had a red , painfull when touched, lump, under my armpit. It goes away after couple of days, but after a while it comes back. It is hard on the inside as well as a bit swallen and red on the outside. Now i have it in a more private area. Same red, hurting when touched, lump. What could it be? I am really scared. Thank you so much for your time.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You may have enlarged axillary lymphnode. It can be due to reactive hyperplasia, tuberculosis, lymphoma or metastatic carcinoma. You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, taking duphaston gives body ache, fatigue, mood swings, feverish. Confused to continue\n\nI've been trying to conceive for almost two years now. I will be 36 in a couple of months. My height is 5'5\" and weight is 70 kgs. My reports are normal and my gynecologist has placed me on duphaston from day 17 through 26 of my cycle to provide luteal support in case there is a pregnancy. My problem is as soon as i start Duphaston, i have lot of side effects such as severe body ache, fatigue, and mood swings and also temperature is elevated. I've been on it for several cycles and feel confused whether i should be taking it or not. Please advise.",
    "doctor_response": "Hi, Thanks for your query. Duphaston(dyhydrogesteron) is a progesteron used to support pregnancy. as such side effects are less but if you have so much of side effects or your test are normal stop using it with your doctor advice. you can use other type of progesteron with your doctor permission. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Using melacare for a fair complexion. Worried about stopping the medication. What will happen?\n\n.I am in a bloody sad situation. You know, I had been using the Melacare cream since a long time. It's been very long. I'm even scared to mention it here. Im OK, and normal now. I have not discontinued it. I donno if that cause me an issue or problem.?? Help me out. I have become fair and magically changed by using this cream.But not sure if I stop this, whether it would change me and I will lose my face and glow. I need real help.... I am not able to sleep even thinking of it daily.. I have stopped applying it from 2 weeks and changes started appearing. Not sure if that's my feel.",
    "doctor_response": "Hello,Thanks for the query,Melacare is a depigmenting agent, You can stop it after desired result is obtained,However some milder depigmenting agent has to be continued.An example of this is kojic acid.Let me know you have any other doubts.Please meet a dermatologist for final diagnosis.you can ask a direct question to me on this forum, following the below link. you good health.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe acne, prescribed doxt s, topcid 40. Effective?\n\nI am 22 years old and i have acne problem...I ve been visiting a dermatologist for the past 3 years and still i am facing Acne problems...The doctor has prescriped doxt s and Topcid 40...Can I take those tablets as prescribed by him..Will i face any side effects..please advise?? I dont have a credit card...Is it possible for you to answer my query??",
    "doctor_response": "Hi Neha, Thank you for asking the question, in public forum you can ask a question and get an answer for free so please do not worry about your not having a credit card. Generally, a drug is prescribed only if it's side effects or in intended bad effects are far outweighed by it's desired treatment or therapeutic effects. This is specially true in patients who have illness which is not life threatening. Cardinal principle of medicine is first and foremost which says 'Do No Harm. Therefore, I will urge you to have faith in your doctor and take the medicines as prescribed. You will get well. With best wishes. Dr Anil G rover MD(medicine) DM(cardiology) Cardiologist and medical specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore throat during pregnancy?\n\nI am 8 1/2 weeks pregnant and have had a sore throat for almost a week now. It gets much worse at night. It is not scratchy but hurts to swallow. Today it seems to have moved to my tongue. It feels as though my tongue has swelled up and also hurts to swallow.",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic.I have gone through your query. I think I have understood your concern, I will try to suggest you the best possible treatment options.As such immunity  is a bit low during pregnancy period.I will suggest you warm salt water gargles, Betadine gargles 3 times a day after food for 5 days.Tab AZEE 250mg 2 times a day for 3 days, Anti cold tablets 3 times a day for 3 to 5 days will be of help.Please avoid deep fried foods,bakery products and cold beverages. Have plenty of water intake in a day.I hope my answer helps you.Thanks.Wish you good health.With regardsDr Purushottam",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stress and depression\n\nMy son who is gay, had been in a relationship with a person for16 yrs. over this time , this person has been found to be a liar , cheater, has lost jobs, ran of the family with his horrible and unacceptable behavior. My son who is very bright, mannerly, with a ton of friends, sees some of these behaviors, but find excuses to excuse them all. He can see shortcomings in others, but not his sig other. The problem is : this guy is a cop who has just been charged with child pornography! He tells my son he's being framed! My son believes him!",
    "doctor_response": "DearWe understand your concernsI went through your details. Relationship between gays are almost equivalent to straight people. The relationship basics are love and affection. In your sons case, there is a blind love and affection and you will be able to see some possessiveness. Possessiveness can be attributed to the gay relationship too. You cannot force your son to distrust his gay friend. Circumstances will do that for you. Wait and be patient. You will get opportunities, where you will be able to expose. But, beware, as your son is a gay, he will find another partner very soon. Then you should not worry.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of sudden jaw and neck pain?\n\nI was sitting up in bed watching television and I had this sudden pain in my jaw that radiated around to the back of my neck near my brainstem. It was a dull aching pain as opposed to a sharp pain. The pain has eased slightly but remains now after 10 minutes.",
    "doctor_response": "Hello,This sounds like a muscle spasm. Use warm compresses on the neck and try some ibuprofen. If it does not resolve see a doctor.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have red blood in my bowel movement. Why have they been watery since then?\n\nI have red blood in my bowel movement . It started yesterday evening. Since then I have had 3 bowel movements, with urgency. Always my stools are watery, fluffy with raggy edges, sometimes exploding out of my bottom. I need to wipe my bottom many times and occasionally I have watery mark on my pants from my bottom (watery and brown). I have gone to the toilet 4-5 times daily since I can remember. I am 45 year old female having gained weight over last 10 years. The blood is bright red and makes the toilet look like I have put a red dye in it.",
    "doctor_response": "Hi, Welcome to healthcare magic! Bright red blood with loose stools indicate you probably are suffering from colitis. The most common cause being infection. A stool test may be done for evaluation. You may need a course of antibiotics like quinolones and metronidazole. probiotics and zince supplements would hasten recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bleeding of gums in kids?\n\nHello my daughter Cadance sutton is 4 years old.. She recently went into Tx childrens hosptal because she had bleeding of her gums small red blood spots and lots of unexpainable bruising. They imediatly did blood work. It came back with a platelet count of 2 and hgb count of 9.8. They diagnost her with ITP. They then gave her an ivig. My daughter then started having a head ache and vomiting. I took her back into er. They said her platelet level was up to 8 and that it might be the ivig that made her ill. Well we went back for our check up a week later Her platlets where down to 2 again and hgbs low as well. They then decided to do a pacu bone marrow asperation. It came back neg for leukemia. Since we have left the hospital again she is on pretnisone and a form of zantac, along with iron. It has been 2 days now.. she recently bumped her head on the door knob... I sent pics to her hemotologist and she said it was swollen and bruised but if she isnt vomiting or complaining she will be fine.. My biggest concern is that I know her platelet count is lower because the red blood dots are increasing and she is covered in bruises. Please help me. Is ITP really this bad.. do you recommend i suggest testing for anything else? I will send you pictures if you give me and email address.",
    "doctor_response": "Hello, Because of her bleeding tendency, the hematoma (swelling) would have been large even after minor trauma. The basic treatment IVIG has been given, steroids i-e prednisone takes time to respond. As your doctor said, danger symptoms in head injury are severe headache, vomiting, or altered/loss of consciousness that should be observed for. ITP has 2 forms acute and chronic. This is acute ITP and continue medication till prescribed time, your daughter will hopefully respond. In case not then still other options of treatment for the next level are there. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shehla Usman, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shingles despite taking Valtrex\n\ni have beensuffering from shingles on my scalp for 3 months started eish rash blisters itcthing now a full line on my left side of scalp been given anbiotics steririod pill shots now prescribed veltrex no relief increase in blisters raw itching loss of hair what can i do?????? /",
    "doctor_response": "Hello,This is a complicated problem. Shingles can be very hard to treat. The valtrex really will not get rid of it but may help prevent post-herpetic neuralgia, which is a painful condition that can last for a year or more after the rash resolves.Antibiotics can treat an infection if that has occurred and the steroids can decrease inflammation, but really do not get rid of the rash. The best you can do is take the medication that is prescribed, keep the area clean with gentle soap and water, avoid scratching or rubbing the area and see a doctor if it looking infected or getting more painful.Also it would be good to get the shingles vaccine.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes feeling of heart beating in throat?\n\nwhy do it feel like my heart is beating in my throat,i am 50 years of age,5\"1 and weight 245lbs and i have high blood pressure ,last i check it was 144 over 112.I do take medication verapmil er 120mg every 12 hours,I also take fluoxetine for anxiety 20 mg once daily and sulfasalazine 500 mg twice a day.OH and by the way i am african american.",
    "doctor_response": "Hello!Welcome on HCM!I carefully passed through your question and would explain that your symptoms could be related to a cardiac arrhythmia. From the other hand anxiety could trigger this symptomatology. Your diastolic blood pressure values are significantly high and this means that your actual anti-hypertensive therapy is not very effective in controlling high blood pressure. Coming to this point, I would recommend consulting with your attending physician for a careful physical exam and performing some tests to investigate for the possible underlying causes: - a chest X ray study- a cardiac ultrasound to examine your heart function and structure- an ambulatory 24-48 hours ECG monitoring to examine your heart rhythm trends during a prolonged time- complete blood count for anemia- thyroid hormone levels for possible dysfunction- kidney and liver function tests for possible dysfunction- blood electrolytes for possible imbalance. I would also recommend adding an ARB (valsartan, olmesartan, etc.) to your actual therapy in order to have a better control of high blood pressure. You should discuss with your doctor on the above issues. Hope you will find this answer helpful!Best wishes, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathlessness with stomach upset?\n\nI have breathlessness, pain in my right side (back) and have now started with an upset stomach. I saw my g.p yesterday and he said the air was not getting into the right lung properly and to go to a and e if it worsens. I have had a bad cold and temp this last week.Can you help?",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .*  Breathlessness is  due  to  lower  respiratory  tract infection with    constriction  of  broncho alveolar  tree .*  Stomach  upset may be associated viral infection , drug or stress induced   gastritis .Hope this  will help  to clear your doubt   .Wishing you fine recovery .Always welcome for any further assistance anytime .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting and creamy white pasty stool in an infant?\n\nmy grandson, 9 mo. has been projectile vomiting off and on for 1 wk....hydrated with pedialyte...had diarrhea, now has pale creamy white pasty stool...still proj. vom at least once/day, and during night. what could this mean....why is stool now pasty white",
    "doctor_response": "Hi thank you for choosing healthcare magic. As your son had gastroenteritis, it takes time for his intestines to recover and probably he was on wholly on milk based diet, that's why his stools are white and pasty. they may have residual gastritis for a few days so try to feed him regularily every three hrs and you can give them anti gastritis medications for few days after consulting your doctor.Hope this has been helpful to you, kindly feel free to contact again for any queries. Kindly rate the answer if so. Take care. Dr J Sravanthi,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Red eyes, eczema, brown spot on white part of eyes, allergies. Will refresh eye drops help?\n\nHello, my 7 year old daughter suffers from constant red eyes due to allergies. She has Eczema , and suffers from other allergies. I noticed after a couple of weeks of red eyes that she started to have a brown spot on the white part of her eyes, I took her to the doctor and they would not give me any antibiotics . They advised me to purchase Refresh eye drops. Should I be concerned or is this part of having red eyes? Thank you for any guidance you may offer.",
    "doctor_response": "this is all alrgies they involve the  different organs as the time of diseae increases you shoud go in for allergy tests which will cure all allergies for time being you can use tab allegra 30 mgm twice a day chromal forte eye drops tds apply mometasone locallyt on skin and neosporin eye oniutment in the nose twice a day",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe bruising in the left elbow?\n\nI have not been feeling well for over a month, extremely fatigued, fevers or hot flashes, not sleeping well...but the last 2 days I had left neck pain that slowly travelled down my left arm - this morning I noticed my left elbow was severely bruised and my left upper arm was really sore.......where did that bruising come from?",
    "doctor_response": "HelloI have understood your symptoms,There is radiating pain from your shoulder to arm and finger. Usually cervical disc bulge leads to nerve compression and subsequently radicular pain in your arm and fingers. I will advise you physiotherapy like Interferential therapy and auto traction for early recovery.Static and against resistance guided exercise therapy may help in this case.You can consult physiotherapist for that.MRI cervical spine will help you to see severity of nerve compression. I will advise to check your vit B12 and vit D3 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain and vomiting\n\nhi doctor... my child is suffering with abdominal pain and vomiting..he had outside food yesterday . i took him to a pediatrician today morning. he has prescribed syp.indowell,syp,cyclopam,and syp.taxim. i have given the doses as prescribed. but he has vomitting and abdominal pain still. what to do?",
    "doctor_response": "It seems that your child is suffering from acute gastroenteritis. Medication is proper. Treatment is not supposed to bring down the frequency of passage of loose stools. Give ORS (Oral Rehydration Solution) and plenty of other fluids. It comes in ready made form or may be prepared by mixing a full sachet in the designated amount of water. Replenishment of the lost water and salts as the mainstay of treatment. The adequacy of the hydration would be evident from the frequency of passage of urine. If that seems to be fine, you need not worry. But unless the child grows lethargic, I would not get concerned. It may still take 3-7 days (from the onset) to stop",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Norditropin or Humatrope better for diabetes?\n\nKnowing that the basic chemical formulation and the desired end result of the two medications in question will be the same - Are there any differences in a patients response to the side reactions of Humatrope vs Norditropin...specifically diabetes?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Both of these are somatotropin (growth hormone) and are used for certain growth disorders.There is no difference between them as far as diabetes is concerned as both of them have to be used cautiously in diabetes and insulin dose adjustments have to be made.Norditropin is better in my experience as it dosen't need refrigarating and is already premixed but it is expensive compared to humanotrope.So basically, it's all indivual based prioritization.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Muhammad Adnan Iqbal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed a lump inside the rectum\n\nhello I want to know if I have a hemorroid or rectum cancer im a little scared. I dont have blood in my stool but I can feel a lump or something inside my rectum when I wipe. it only hurts a little if I squeez my butt cheeks together. and it only itches sometimes. Can you tell me what you think it maybe?",
    "doctor_response": "Nothing to worry, it is a pain less polyp which is benign. donot squeeze it might bleed. for itching u can use xylocaine jelly twice daily, once in the morning after bath and once before going to bed, do not scratch it may lead to secondary infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it normal to have multiple migraines in a week?\n\nHello doctor,I need your advice, please. I am a 44-year-old working mother of three children and normally in great health. In the last 20 years, I have had about three visual migraines. There is no headache and I get back to normal 30 minutes later. This week, I had a visual migraine on Monday, felt a bit nauseous afterward for the rest of the day. I woke up on Tuesday and felt normal. Then about 8.30 AM started with another visual migraine. Then, I had a terrible headache and vomited. The right cheek and right arm went numb that lasted all day. I had another one on Wednesday and a fourth on Thursday. The thing that is worrying me is that I am still not back to normal. I could not remember people\u2019s names at work on Friday and felt totally spaced out and at times confused. I did not remember speaking to my mother on the phone this morning. In fact, I rang her and when she answered through the car speaker I had forgotten it was me that rang her. I saw my GP on Friday and she said no red flag symptoms but she has referred me to a neurologist as I have had multiple migraines and this is unusual. My appointment is on the 20th. The thing that I want to know is should I be going to the ER sooner for a scan? I know myself I am not behaving normally and my close family and friends have noticed.",
    "doctor_response": "Hello,  Welcome to icliniq.com.  Your symptoms could be related to status migrainosus, which causes a temporary dysfunction of some brain regions related to persistent migraine attacks. For this reason I would recommend performing a brain MRI (which would be better compared to the CT scan) and some blood laboratory tests to investigate for possible causes which have triggered these frequent migraine attacks as follows: If a brain MRI (magnetic resonance imaging) cannot be performed in a short period of time, a brain CT (computed tomography) scan would be an option in case of persistent migraine attacks. For more information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Would pots be the reason for constant chest pain and rashes around?\n\ni recently been diagnosed with pots.. and pvcs and my heart doctor has been doing an echo which we already know that my heart muscle itself is fine but the electrical part is bad..even when i breathe in and out i also have the pvcs at that time when i am breathing why is that? THEY DONT KNOW! i always have chest pains and have developed a rash that started around the back of my ears and spread onto my chest,face and back now .they have no clue what is going on with me i feel like i am a mystery diag nosos can u help me i have been looking things up and trying to figure it out myself..my sed rate and cpr protein factor are elevated as well.i feel like they are not doin all they can and i just keep developing new things and they just scratch there heads. amanda",
    "doctor_response": "I think might have started some medication for frequent PVC... pots not easy to treat and multo modalities of treatment needed .. dies Ur rash comes and goes like chest pain???",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do Clomid and Bromergon help to get pregnant?\n\nAm been married for 4months yet no pregnancy I saw a doc and she prescribed clomid 1 tablet daily for 5days,bromergon 2.5mls at night for 1 month can I be pregnant wit those drugs?My Lmp was 19/3/16 which was 4days ago,my circle is 28days.av started taking clomid but av not started the bromergon can I get pregnant the clomid.am 35 years of agethank you",
    "doctor_response": "Hi, Both drugs has specific indications. So you should be discussing with your gynecologist. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. B. Radhakrishnan. Nair, OBGYN",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for vaso vagal episodes\n\nim a 22 year old male taking pro amitine due to vaso vagal episodes  durring gym exercises i get light headed and nauseous it seems to happen everyday and can hear my heart beat in my ears. is there an alternative medication or procedure  because i dont see an improvement",
    "doctor_response": "Hello!Welcome on Healthcaremagic!There is not a specific treatment for these episodes. The main thing to do is to avoid the triggering factor. Anyway, I would recommend performing some tests to exclude other possible causes that may mimic this clinical situation: - complete blood count for anemia- fasting glucose and glucose tolerance test- thyroid hormone levels for possible thyroid gland dysfunction- blood electrolytes- Head Up Tilt test for possible orthostatic intolerance. Hope you will find this answer helpful!Best regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to improve the chance of pregnancy in case of a semen infection?\n\nHello doctor, I am a 45 year old male, and my wife is 26 years. We have been trying to have a baby for the past seven years. I had a sperm analysis in 2011. My count was 68 m, all the parameters were good\u00a0except the presence of Proteus spp. bacteria. The doctor injected me with gentamycin once, and nothing more.\u00a0In 2015, I had another sperm analysis. The parameters were still good. The count was 75 m, but pus\u00a0was\u00a0seen, and the\u00a0doctor gave me Ciprofloxacin 500 mg and Tinidazole 600 mg for seven days.\u00a0Just a week\u00a0ago, I got another sperm analysis test with sperm count 70 m, but abnormal form 18 % with epithelial\u00a0cells, bacteria and a moderate growth of staph aureus,\u00a0sensitive to Rocephin and Augmentin. My wife's hormonal assay says prolactin is 34 ng/mL when the normal range is 5-25. Also, the vaginal swab shows creamy, non-crystalline, pus cells 3-4, HPF epithelial cells, yeast, bacteria, gram positive, moderate growth of staph aureus, sensitive to Rocephin\u00a0and Augmentin.\u00a0Also, my wife was prescribed\u00a0Parlodel\u00a0drug\u00a0(bromocriptine) to\u00a0normalize her prolactin. In what dosage and for how long should she take this?\u00a0Is there an alternative\u00a0that is better than Parlodel?\u00a0Also, can\u00a0it be taken together with the prescribed Augmentin\u00a0and\u00a0tablet Pan 40?\u00a0Please advice. Should I take some sperm-boosting tonic occasionally?\u00a0What are the antibiotics each of us should take? Should we both take Rocephin and Augmentin simultaneously for it to be more effective? In what dosage, and for how long? We are confused and yet to start taking the medications.\u00a0Is it safe to make love when we are still under medication? She will be ovulating again from next week. \u00a0Also, they put both of us on 5 mg Folic acid and her on Ovacare and me on Addyzoa. Should we discontinue these when we take the course of antibiotics? I have attached mine and my wife's reports for your consideration.",
    "doctor_response": "Hello. How are you doing? I have seen your reports (attachment removed to protect patient identity). Let me start on a positive note by saying that she stands a very good chance of pregnancy, but there are some small issues in your infertility treatment which I will try to clarify. Let me explain. If all this is done and found to be\u00a0normal, then nothing can stop a pregnancy with God's will. Let me again reassure you that you will get God's bundle of joy, a baby. Be patient and never lose hope. Hope I have cleared your query, do write back. All the best. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in heart while breathing?\n\nin Michigan  u get your medical marijuana card for a irregular heart beat  or chronic chest pain  im 21     5'11    i  have   a heart  problem  where it hurts when i breath and   walk  and its  stabbing  they say i have a irregular heart beet but don't know where the pains coming from   would u have  a idea  its  coming  from the right extremity of the heart",
    "doctor_response": "Hello!Welcome on HCM!Regarding your concern, I would explain that chest pain that is triggered by deep breathing and walking indicates an extracardiac cause (musculo-skeletal pain, costochondritis, inflammation, pleuritis, pericarditis). It is not related to coronary artery disease. Anyway, I would recommend performing some tests to investigate for the possible underlying causes: - a chest X Ray study- a resting ECG- complete blood count, PCR, ESR for inflammation- a resting ECG and a cardiac ultrasound to examine your heart. An ambulatory 24-48 hours ECG monitoring would help exclude possible cardiac arrhythmia underlying your palpitations. Other tests (thyroid hormone levels, blood electrolytes) are necessary to exclude possible metabolic causes that can lead to palpitations. Hope to have been helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore and bleeding gum?\n\nhi i had my front top tooth pulled out 10 years ago. i have a permanent fixture there now. over the past 2 weeks the gum has gotten red sore and bleeds. i feel like the annoying feeling goes into the hole where the tooth used to be, even feeling it on the roof of my mouth where the tooth would have been. i have never had an issue up until now. what could be wrong? i'm 32 years old 5'5 190 lbs. had a root canal in the same spot when I was 6 years old.",
    "doctor_response": "Hello DearThanks for your query. First of all be relaxed,  I will be most happy if I could help you out so please be relaxed and dont worry.After going through your query it seems that a gap has been created between the gum and the bridge (permanent fixture). And food particles are getting entrapped in this space resulting in bacterial growth and therefore causing gingival inflammation (swelling, soreness, bleeding). But other reasons also cant be ruled out before a proper clinical examination. It may also be due to plaque and calculus accumulation on the adjacent teeth or it may be also due to stomatitis.\u2022I advice you to get an appointment with the dentist as soon as possible and get a thorough clinical examination so that he/she can start the needful treatment.\u2022 Meanwhile you can take antiinflammatory tablet Zerodol-SP or Enzoflam (Diclofenac+Paracetamol+Serratiopeptidase) thrice daily for 2-3 days till you get your appointment with the dentist.\u2022 TAKE THIS MEDICINE ONLY IF NOT ALLERGIC TO IT AND OTHERWISE HEALTHY. \u2022 Apply topical gel like Metrogyl-Dg Forte or Rexidine-M gel (commonly chlorhexidine and metronidazole combination) on the affected area of the gums. Use it thrice daily for 4-5 days.\u2022 Use Betadene/Viodine/Betakind (contains povidone iodine solution) easily available in medical stores, twice daily.\u2022 Hope this will help you. If there is any more query or question regarding this in your mind, you are welcome to ask me any time. Take CareRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a person with polycystic ovaries get pregnant?\n\ni hve polycystic ovaries dr prescribed cetapin xr , natyl. I HAD 3 ABORTIONS &hve no kid. I have thyroid & high bp .  I am 33 yrs old weighing 69kg.I am undergoing infertility treatment.It is possible that i will be able to preagnant and bear a healthy child",
    "doctor_response": "hi, you can get pregnant and have a healthy baby. Do a APLA profile as you had 3 abortions. You can take some medicines like clomiphene for the growth of your eggs. Track your follicles growth by repeated ultrasound and when your follicles is more than 17 mm you can take injection for rupturing the follicles. Be in contact with your husband for next 2 to 3 days. Take progesterone and aspirin for next 2 weeks. Talk to your doctor regarding this. Do a pregnancy test after that. Continue thyroid and bp medicines. Hope I have answered your question.  If you have any other query I will be happy to help.Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Painful scabs on body and head, bleed, leaves white and purple scars, recurs every year. Remedy?\n\nhi my name is jacqui for many yrs now ive had a terrible painful scabbs all over my body and head,causing some baldness over 10 yrs and my docs have done nothing. they last months, bleed run ann leave the most awful white and purple scars behind they come bk every yr i have to cover frm head to foot regardless of weather. i wont even go out i am so suicidle what can i do",
    "doctor_response": "Hello,From the way you express your problems, it seems that you are suffering from a chronic condition which may be either Psoriasis or Eczema. Both the conditions produces the symptoms as you have explained .Consult a proper dermatologist and take treatment. The treatment needs patience. The Dr may give antibiotic, pain killers, steroid injection and steroid applications along with drugs if you have itching.  Personal hygiene, good atmosphere are important. Baldness may or may not be linked with this.Avoid allergic items of any nature. Whatever you use like soap and towel etc., keep them separately.Finally as a routine check your blood for basic investigations + Sugar + STD + HIV. This is only for the investigations and treatment completion sake.Rarely skin biopsy may be neededAll my best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for headache and fever\n\nMy 4 year old daughter started having headaches 3 days ago. She started running fever around 103 that night. Within the last couple of nights her fever has gotten as high as 104. We have been treating her by rotating ibuprofen and tylenol. Tonight she had a bloody nose out of nowhere. She hasn t been eatingwell. What should we do?",
    "doctor_response": "Hi,As your child is having very high fever for last 3-4 days requires to consult doctor as early as possible.This can be viral fever or bacterial but having high fever some blood work is to be carries out.Go to ER and get examined.Meanwhile continue giving ibuprofen or tylenol as and when required.Give him plenty of water and liquids and keep her well hydrated.Give her light diet.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itching and burning in the vagina. Stopped birth control. Severe bleeding. What to do?\n\ni been on birth control for about 2 years- Seasonique that is. I just stopped taking them. I started bleeding like as if it was my period a few days after i stopped. Not sure if it was my period or not by the way. But, now i have my period and i have been itching and burning down there really bad. I just need to know why.",
    "doctor_response": "Hi,Thank you for posting your question here I will try to answer it to the best of my abilities.If your vagina is burning and itching, I think it is quite possible that you have some kind of infection. It could be that you have vaginosis. So go see a doctor,m they will check if you have an infection and if you do what kind of infection and then treat you accordingly.I hope this answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe leg cramps\n\nMy husband has severe leg cramps in the calf with muscles visibly rippling & contracting. He is 58 years old, diabetic. Daughter massages then hot bath helps, but still in pain. He has had off & on for years, but getting worse. I recommended he contact his doctor and may have low Potassium or Magnesium levels.",
    "doctor_response": "I think he got crmps in usually after midday and especially in night.If it is like this just try one multivitamin tablet along with calf stretching atleast 4 to 5 time a day 10 rep hold the stretch for atleast 15 sec.Do this stretch 4 time a day and especially its must before going to bed.Definitely it will help him a lot.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does numbness in the arms and fingers indicate?\n\nHi! Over the past few weeks, I have experienced recurring tingling in my fingers which lead to temporary numbness...bi laterally. In the last 2 days, the numbness had grown up both arms. Like I mentioned before, the numbness is not permanent, but lasts anywhere from a few minutes to half hour. I have Lumbar arthritis.L2-L5 with multiple bone spurs, but this is not related to arm issues, is it? I have thought for years I might have MS due to extreme tiredness and other weird symptoms. What can this numbness be? Sandy",
    "doctor_response": "Hello. The numbness in the arms and fingers can be related to a mild nerve root compression or Methylcobalamin deficiency. Taking proper supplements after a blood test will help. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Nan Gold good for a two month baby?\n\nHello.doctor My babby is 2 month I am feeding her nan formula 1.her wait on born was 2.5 she was born at 1 july and know her wait is 3.5 she offenly get rash on his back and she passes the stool as she drinks milk.plz sugges me is this nan goid for her?",
    "doctor_response": "HiThanks for writing to health care magic.Yes nan gold can be givenIt is safeWishing your child good healthRegardsDr Arun",
    "dialogue_context": ""
  },
  {
    "patient_message": "Difficulty in pulling the foreskin, irritation on touching the head, low libido on erection. Should I go for circumcision?\n\nhello dctr. i am 27 yrs old. and i am going to marry..my problem is the foreskin over my penis (erected size 5 inches).i cannot pulldown the skin when erected.and after erection if i touch the head of the penis i m not feeling good..feels like irritating..and i feel not much power to do an intercourse when erected.i think i have to do a circumcision surgery..please give me advice. Thnks Mr.nair",
    "doctor_response": "DearWe understand your concernsI went through your description. I suggest you not to worry much. If you are not circumcised, then you might feel it difficult to retract the foreskin. I think you should have the surgery. It is safe and painless. Do it and you should feel the difference. The area inside the foreskin is supposed to be tender and should feel irritating on touching. Normal and should vanish after experience. You will not have any problem in your sexual life as you have 5 inches. Your libido also should be good. Weakness might be in your thoughts.You might need psychotherapy and other cognitive behavioral therapies. I can help you through telephone. Please do contact me through customer care of www.healthcaremagic.com for a telephonic consultation session. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mouth ulcer spreading to gum\n\nDear Sir, Im suffering from mouth ulcer spread on gum of upper teeth (patch of 1 sq inch approx) . It is painful only while taking spicy food. I have consulted local Dentists but not getting any relief by Jel & mouth washs prescribed by them .  Kindly advice whom i should consult next.  I m located in Delhi.  .... Regards, D Mitra",
    "doctor_response": "Hi,It would have been great if you could have mentioned the duration of the patch. Anyways, if the mouthwash and gels have been ineffective and you have exceeded 15 days with the same patch/ ulcer, i feel its time you see a maxillofacial surgeon who could exclude any other diagnosis. In the meantime, try rinsing your mouth with warm saline rinses and apply topical dentogel (or a similar formulation) to the ulcer just before having food. This will make you comfortable during eating. This is not the definitive treatment, and is just supportive.Wish you good health. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for back pain after a surgery?\n\nmy father is a 59 yr old man who has many health issues that have gone undiagnosed and affecs his evry day life to the point of him not being able to do everyday nessesities he stoped smoking about 6 yrs ago and started walking a couple miles a day.a few yrs later he started having back prblems wich led to back surgery.after the operation the back problem was still there with more pain,within months his legs also started hurting him to yhe point of him not being able to walk.when he has to leave the house he has to use a cainand can only stand for short periods of time.then in the last year his hands started shaking at times to the point that he cant even feed himself.last night he told me that his head is also starting to shake,and now in the last couple wks he has have had severe hot flashes all through out the day.my father is retired from Chrysler with insurance, but since the back surgery yrs ago he has lost faith and hope in any doctors so much so that he wont even go to a dr to get blood preasure mediction that he needs also he is very stubborn the only reason I am doing this is because I know with all these conditions I know my father does not have much time left if he does not get help soon.so he made a promise to me that he will go to one dr,he finally agreed after I begged n cried that I didn t want to lose him.so he told me to find one doctor and he agreed n promised h ke would go.then this morning he called me to tell that he had a heart attack in 2010he said he laid on the floor and did not call 911 or never told anyone about it till now. this is my only chance to help my dad and he has so many problems I don t no where or what kind of dr to call.as of now I just moved in to take care of him cause hes getting worse evey day. I live in Kenosha wi I am not good at computers,all I know is I need help",
    "doctor_response": "Sorry to hear this. First, you must address his psychological state. He very much sounds like he has underlying depression, which is very common after retirement. And uncontrolled depression makes everything worse, including pain disorders. I know it is often taboo, especially in the older generation, to seek mental health care. But it can be a life saver. Because if he can achieve inner peace, his body has a better chance of achieving outer peace. And besides, the brain does control the spinal cord and peripheral nerves, which controls pain and function in all of these areas.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a painful lump on my breast?\n\nIn June I found a lump under my right breast. It was the size of a grain of rice and did not hurt, so I ignored it. On Monday night I bumped my computer against it and it hurt, so I looked at it. It's now the size of a nickel and it hurts. It was hurting just when things touched it on Monday, but today I can't even move without it hurting. There is a pink ring around it and it's hurting so badly that I'm having trouble getting around. The pain is also spreading. Any ideas on what this is?",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.It looks that the small lump has gone into a stage of fat-necrosis. May be infection too. Please get this investigated , clinically examined and ultrasonography done and if necessary FNAC =fine needle aspiration cytology.Give breast support- get clinical examination and treatment as per examination .",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should I continue giving fenistil drops to a child?\n\nHi my 1 year old daughter was told that she has baby asthma {she kept coughing very often}, doctor gave me fenistil drop to give her twice a day to open her airways {they very narrow} how long I should keep giving her these drops, obviously she is much better now, but I am worried if I stop the cough will come back",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your history and would like to make suggestions as follows:1. Fenistil drops contain antihistamines. So basically they treat nose-throat (upper airway) related cough. They have not a great role in childhood asthma (lower airways).2. If she is not having symptoms and you have completed the duration of the course suggested by doctor, I would suggest you to discontinue the drops. In case, symptoms recur, there is always option of restart them again.3. To be on safer side, I would suggest you to consult the doctor who prescribed fenistil drops to your baby before discontinuing.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish your son the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high bilirubin levels and enlarged liver\n\nI am currently resident in UK and my brother is living in Pakistan. He is suffering from severe jaundice for over a month now.He has lost 7 Kg weight as well. He did some drug abuse in the past like used different brain stimulant drugs without telling any one. Now he is suffering from jaundice and level of bilirubin has increased up to 17 and its increasing day by day.Now it is 20His liver has enlarged by 2 cm as well when doctors in Pakistan did the ultrasound. Doctors also say that he is suffering from hepatitis A. Now I am quite worried because of that.  I just want your suggestion on this condition like if he will recover and what are the risks. What your knowledge and experience suggests you if he will recover or not. Please i really need you help and suggestion regarding that. And if further tests need to be carried out. Anything that could help improve his condition. Any medicine, any diet he should follow.",
    "doctor_response": "Hi,There are many causes of liver enlargement and treatment depends on exact cause. If this is caused by diet, obesity and diabetes then dietary and lifestyle changes will be beneficial in every case. Alcohol and viral hepatitis are most common causes and in this case medical evaluation is required. Also if there is infectious disease or billiary duct disorders then you need to do some tests to rule out more serious issues which require specific medical treatment.I hope I have answered you query. If you have any further questions you can contact us in every time. Wish you a good health.Kindly regards,Dr. Ivan R. Rommstein",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Sporidex safe to give for running nose?\n\nHiii my son is having running nose since morning so afternoon I gave him a dose of sporidex which is for paediatric only but I want to kw weither this is a anti biotic......nite again I gave him a dose which he vomited pls tell me wat to do....is it safe to give this syrup",
    "doctor_response": "Hi,You may give sporidex but as there is only running nose it might be having allergic rhinitis so you may avoid giving this medicine.Give him some anti-allergic decongestant medicine initially to control running nose.If problem continued after 2-3 days you can give this antibiotic after consulting your doctor.Okand take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hip injury\n\nI fell down the stairs carrying my little girl the other day in the rain. I held her up in the air so I landed quite hard on my hip. It happened about a week ago. Although I can get around better now there is a large circle on my hip and upper thigh that is sore to the touch and is reAl red with fever in it? I hate going to the dr but do you think it could be serious?",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.This is hematoma ( collection of blood in and beneath skin). This is likely to resolve gradually with passage of time but as you have got fever so it is advisable to visit a doctor. You need analgesic such as ibuprofen for pain relief and antibiotics to control the infection. Vitamin B and C help in healing. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes brain fog two months after a car accident?\n\nMy husband was in a car accident, two months ago. He is still feeling brain fog and he s having a hard time staying on task. He had an MRI scan two days ago but hasn t heard the results. I would appreciate your guidance on what steps we should take to rule out problems.-Paula",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. \"Brain Fog\" after 2 months from an MVA is concerning.  I'd be concerned about something within the skull such as a subdural hematoma.  Since he's not been contacted that probably means they didn't find anything acutely wrong architecturally.  Perhaps, his mental faculties are down due to medication he might be taking for headaches or other pains from the accident?  If not, then, an appointment with a neurologist is in order so that an neurological assessment may be done. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is taking Sep 10,Movon p and Rantac safe when trying to concieve?\n\nIam 28 years old female trying to conceive. three days back i had a fall and i am suffering from swelling and hematoma in wrist. doctor prescribed me tablet sep 10 , tablet movon p and tablet rantac 150. i am worried whether this drug intake will affect my chances of pregnancy. please do give me your valuable advice.",
    "doctor_response": "Hello, Sep 10 is serratiopeptidase, movon-p is a combination of paracetamol and diclofenac and Rantac is ranitidine. This combination of medicines is only for a short duration because of your injury. None of these medicines is going to interfere with your chances to conceive. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Prabhash Verma, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing lower abdominal pain always?\n\nhi i',m fathima... now i'm in my 4th week 0f pregnancy... but my lower abdominal is paining daily. also i having all those pregnancy symptoms. can i travel in flight alone..? eventhough before by pregnancy while travelling in flight i feel very bad..with my health. pls answer my question",
    "doctor_response": "Hi Fathima, I am sorry for the health problems you are having. I am also happy that you are going to be a mother. Congratulations for that!If you are having abdominal pain on daily basis, if I was your caring doctor would ask to run the following tests before traveling: - urine analysis- vaginal swab testing- abdominal/gynecological ultrasoundThese tests are necessary to determine what is really causing abdominal pain and treat it accordingly. To my opinion, you can travel, but, should get properly diagnosed to get proper treatment. Hope it helped!Dr.Albana",
    "dialogue_context": ""
  },
  {
    "patient_message": "Developed abdominal external bleed, severe abdominal pain. What might be the cause?\n\nI have developed a slight abdominal external bleed. 4 or 5 days ago I have severe abdominal pain. Across the upper part of my stomach and continuing down my right side into the groin area. The pain has subsided with only mild tenderness, now the slight bleed has occurred.",
    "doctor_response": "Hi,   Thanks for your query.According to me the most likely cause of your right abdominal pain  would be a renal colic because of some kidney calculi(stone).I could not understand the bleed you are trying to explain. Is it bleeding in urine or with stools. Bleeding in urine can occur with renal stones.Meanwhile take plenty of fluids, painkiller in form of diclofenac 50mg twice daily and tab buscopan SOS.in case pain recurs kindly consult your GP and get your ultasound abdomen.Hope it helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for high protein in urine\n\nThis question is for my mother.  She is 75 and they recently detected high protein in her urine. She does not have diabetes.  Her appointment with a nephrologist is not until January but she is wondering whether it would help to reduce her protein intake in the meantime until they find out the cause.  Thank you.",
    "doctor_response": "Hi thank you for posting your query in HCM. I had gone through your question i understand your concerns. High protein in urine is a sign of kidney disease. Damaged kidneys let proteins leak from the blood into urine. Medications, trauma, toxins, infections, obesity, diabetes, hypertension, above 65 are the risk factors.Treatment of proteinuria depends on identifying and managing its underlying cause. Untreated kidney disease would lead to kidney failure. Hope i have answered your question, if you have further questions i will be happy to help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does the size of the penis reduce due to excessive masturbation?\n\ni am 37 i have been habitual of hand-job since i  was 9- my penis has left small due to excessive masturbation  and my ejaculation time is only 10 seconds. with erection and touching their is droppings too from the penis. i see myself incurable. can anybody tell me what should i do? i will be really obliged.",
    "doctor_response": "Good day and thank you for being with healthcare magic!No I don't think excessive masturbation would cause permanent damage to the penis and ejaculatory ducts. Just make sure not to do it excessively and allow your body to rest and heal in between.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bump behind ear\n\nI have a small hard bump at the bottom of my mastoid (?) behind my ear.  It seems to be at the base of the bone...does not hurt. Just noticed it.  Maybe pea size. What could this be? I've had like pressure in my ear for some time...like my eustacian tube is blocked.",
    "doctor_response": "Hi,Dear,Good evening.Thanks for your query to Health Care Magic.I studied your query indepth. In my opinion the lump on base of acute mastoiditis with chronic otitis media with Eustachian tube block due to the cholesteatoma-Treatment is a-Consult a ER ENT Surgeon who would treat it-by Mastoidectomy-i.e.incision and drainage of the abscess  causing pressure on the eardrum with blocked eustachian tube, with scraping of the .Antibiotics and NSAID under cover of ER ENT-Surgeon is the right treatment for such a bump behind the ear. Hope this answers your  query and explains the cause of the lump.Hope this would clarify the worry you had.Would love to Wellcome your queries to HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in left ankle,left leg,hands and head?\n\nI have daily swelling in my left ankle, left leg (around my knee) and my hands.  I keep having a dull numbing pain in my left arm.  I get a sharp shooting pain on the right side of my head that last only a couple seconds.  I was diagnosed with a DVT in my left leg in April 2011 and told three months later it was \"gone.\"  What could be causing my problems?",
    "doctor_response": "DVT problems usually do not cause this problem after it has resolved. But after the DVT many times small veins( blood vessels carrying blood back to heart) are damaged. This problem may be because of that. Also these problems may be a part of disc herniation at lower vack level and cervical spondylosis",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for back pain?\n\nHello Dr Iam Suffering BackPain From last 2 Months I am Staying In Saudi Arabia I was Shown To Orthopedic Dr Here Just He was Taken X Ray The Report is Mild Lumbar Spondylotic Changes in the form of Marginal osteophytes formation So in That case Dr Was given An Injetion At The Side Of spinal disc But No Releaf So Iam Thinking To Show Neuro Expert And I have To Come to IIndia Only For 12 Days I Can Get Treatment In This Short Period And How Can I Take Appaointment In NIMHANS Bangalore Thanking U best Regards mohd Miskeen Basha",
    "doctor_response": "HiThank you for asking HCM. I have gone through your query. Lumbar spondylosis should be managed with physiotherapy and pain medications initially. In case of any neurological deficits you should have a MRI of lumbo sacral spine to find out any nerve compression syndromes. In such case you can utilise help of neurologist. For consultation in nimhans you should get a referral letter from orthopedician or physician. Hope this may help you. Let me know if you have any further queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will increased steroid dosage for asthma affect child s liver?\n\nMy eleven year old daughter has asthma and was on 20 mg of liquid steroid each day for five days/doses from 1/26-1/29. On 1/31 I took her back to the doctor and she repeated the steroids for a week but increased the dosage to 60mg/60mg/60mg/40mg/40mg/20mg/20mg and included two weeks of antibiotics. I m now concerned about her liver/kidney function and at this point I don t plan on going back to the prescribing doctor in reference to asthma issues. I read in Prescription for Nutritional Healing that wheezing can persist up to a month and my sister read that she was treated for acute asthma. How is acute asthma determined? Do you have an excellent referral to a asthma/allergy doctor who integrates immune support through appropriate supplementation? I am residing on Eastern Long Island and I don t mind traveling into the city. A NP/nutritionist could also address immune/allergy/asthma support.",
    "doctor_response": "If the child is still on steroids u can taper the dose and gradually stop,as far as asthma is concerned u can give her nebulization with low dose of bronchodilators, encourage her by doing some breathing exercises,acute asthma is what we say patient is in status asthmaticus,in that case to get back normal breathing patient requires oxygen,since ur daughter is already on steroid,give her wysolone 10mg tab thrice a day for a week,followed by twice a day for a week, once a day for next week and one tab alternate days for a week and stop,keep a nebulizer at home,add Asthalin respules and give nebulization twice a day for one week,if she has productive cough,give her Ambrodil syrup 10ml twice a day after food for a week and taxim tab 200mg twice a day for one week",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes racing heart beat?\n\nI am looking for some help....I was on prednisone for a short taper 7 days (for my asthma) and that didn't help so then I was placed on a long taper.  I was on it for about 14 days total.  Now I am having racing heart and I am freaking out.  I am actually going to have a nuclear stress test tomm. to check for pulmonary embolism and blocked arteries...now I am even more freaking out!!!  I am hoping it was the meds but it just seems to be getting worse than better and the more I thik about it the more nervous I get....I am flipping out right now about the test worried I may have a heart attack at any moment or stroke! Please can anyone help me??  I need to see if anyone else has experienced the same symptoms...I have been off the pred since last thursday so almost 6 days...Thanks you!",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, if the steroid being taken in tapper dosage with lowest possible weight then it may not cause any symptoms, now what ever the symptoms you are experiencing are not due to the steroid but it seems to be due to stress only so try to come out of this and no need wo worry about the test you are going have but just take this easy  hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on the vein on my bicep?\n\nHi I am a little uneasy as I don't know what it is that I am touching on my bicep. I feels as if I have a little bb sized bump/lump on my vein on my bicep. I noticed it yesterday and it did not hurt when i touched it and I initially thought it was a knot so i tried to massage it out and know (today) it hurts when I touch it and i think I may have made it sore by doing so. I'm a bit uneasy about what this is can you help?",
    "doctor_response": "Hi,Good Evening.Thanks for the query to HCM.I studied it in depth and I understood your health concerns.-Treatment-for-sore lump-1- Mostly it appears to be -insect bite/mosquito ? spider or  a boil -as its pain has grown today after rubbing yesterday.2-As your are worried I would advise you to check with your ER-Surgeon-who would fix its diagnosis from either of the two and would treat accordingly.Dont get scared and uneasyHope this would help you a lot to relieve from painful biceps lump on the vein.Wish you fast recovery-and healthy life.Wellcome to HCM with more queries till you are satisfied.Have a Good Day...!!Dr.SAVASKAR M.N.M.S.GENL-CVTS,Super specialist and Senior Consultant-and Expert in Non-Curable-Disease therapy for Cancer,Asthma,etc,Rejuvenation therapy and Tissue failure -reversal therapies.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hydrogenation caused after taking seizure medication\n\nmy daughter was having sizers from birth and now she is 8 years and very day she takes following medicine gardener 30 mg tables, encnlite 200 and 300 mg and sodium benzoyate and when went for 3 months once review he has informed that she is having hydrogenation give lobazam 5 .......... i want to know that in future she will develop some other problem because to taking some many medicine she have other health issue ........... please suggest me........",
    "doctor_response": "Hi,Thank you for asking question on health care magic.Prolonged anticonvulsive therapy will definitely cause side effects.But control of seizures is also important.You have weigh the risks and advantages and follow doctor's advice meticulously.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had protected intercourse, having rashes on testicles and back pain. What could it be?\n\ni had sex five days ago and now i have a rash next to my testicals by the upper part of my left leg. It was protected sex. What could it be? My back has been sore also.",
    "doctor_response": "HIthank for asking to HCMI can understand this, looking to the history given here this could be contact dermatitis, this can be minimize with the Diphenhydramine lotion, no need to worry about this it will come around soon, take care and have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat intense pain in the neck while treating bulging disc?\n\nI have bulging disc in my neck I am always getting stabbing pain sometimes I fill like I m being shocked sometimes the stabbing pains burn I have a lot of numbness is there something to fix this I ve tryed therapy, injection,RX meds,massage,accupucture its been over 1 1\\2 years and the cold weather makes it worst is there help out there for this something I would love a day without pain I was hurt at work so it just seems like the doctors I m sent to work for the insurance company not wanting to help",
    "doctor_response": "Hi, I had gone through your question and understand your concernsWith such presentations in my clinic,I advise my patient to wear soft neck collar,avoid lifting heavy weights and doing heavy activities.I prefer having pregabalin 150 mg daily   that could help to relieve your  neuropathic pain .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stopped taking shots, trying to conceive. Worried, will get pregnant or not?\n\nhi doc ever since i used two months injection for 4 years from 2008 to 2011 and on 2012 i didn t go for the shots the whole year the reason being want to conceive i got my period late on last year october now i am trying hard to conceive with my husband and i are worried now if i could maybe be pregnant again if u could help of what to drink to aid me",
    "doctor_response": "Hello thanks for your query. Return to ovulation and fertility is likely to be delayed after stopping Depo-Provera . It is expected that 68% of women who do become pregnant may conceive within 12 months, 83% may conceive within 15 months, and 93% may conceive within 18 months from the last injection. The median time to conception for those who do conceive is 10 months following the last injection with a range of 4 to 31 months, and is unrelated to the duration of use. You should consult an Infertility Specialist, undergo hormonal profile, complete check up, semen analysis of partner, and testing of fallopian tubes. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a defective kidney be treated by dialysis only?\n\nDear Doctor, This is babu rao from Chennai, My father has high creatinine levels of 9.8, Our doctor is advising us for dialysis,My father is not prepared for it and finally we have do him admitted in hospital for full check up, One of my father's friend recommended Homeopathic treatment but our doctor strictly say NO to it and he says homeopathic treatment will do no good and in turn harm kidney, He said once the kidney is damaged then it can not revive. Please Advise.",
    "doctor_response": "Hello Welcome to HCM. I'm sorry to hear that your father is unwell. 1st thing sir, his age?? Going by most adults getting kidney related diseases that shoot up Creat he may be 65 plus? I suggest you few things. 1. Do not panic.. 2. Get him evaluated completely with Renal function tests3. Get a renal scan done. We can know the kidneys better. 4. Generally if Creat is more than 9 as you say, both kidneys are damaged. 5. If he's too old, see his prostate too. Sometimes simple obstruction causes high Creat. 6. Never ever go for homeopathy. Absolute NO. 7. As you said, normal ppl will spoil their kidneys by taking some homeopathic medications. Imagine same with creat of more than 9!!To summarize, get him evaluated completely, find out the cause for such high creat and no homeopathic. And in case he needs dialysis, better to get a fistula done. Hope this helps you and pray for the recovery of your dad.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does irregular heartbeat, fatigue and high blood pressure need Cardiac workup?\n\nI am a 61 year old male, 5'10\", 160 lbs. Have run 7 miles daily and exercised extensively for 30 years.  I have an irregular heartbeat that Im told by a PA at my job, is not a problem. Ive experienced ED for several years, fatigue lately and my Bp is 140/90.  otherwise I am healthy.  Should I have cardiac workup?",
    "doctor_response": "Hi,Thanks for writing to Health Care Magic, I am Dr Asad Riaz, I have closely read your question and I understand your concerns, I will hereby guide you regarding your health related problem.irregular heart beat have many types like Atrial fibrillation, Atrial or ventricular ectopic a , ventricular arrhythmia .. these arrhythmia have different causes but mostly due to cardiac prob but can be due to electrolytes or acid base prob too... U are good at exercise reduced ur risk of having major pathology but not exclude from having cardiac pathology , u having High BP n which itself a risk factor for IHD other factors like obesity , DM, stress, age ,family history etc .. if u were my patient I would like to do ask detail history n do through exam n then do relevant tests like ECG electrolytes n would do holter if u having Herat beat irregular sometime to see whether it is problematic n which type or beat is this .. so I recommend to visit carfiologist n have some simple test n if these are abnormal then go further work up ..I hope this answered your question, if you have more feel free to ask.Regards.Dr.Asad Riaz.General and Family Physician..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain and upper side body pain?\n\nI'm 15 years old, and I was watching tv laying on my side. Then when I tried to move my chest hurt on the right upper side of my body. It got slightly better so that I could move, but I still can't move suddenly or sit up well and it hurts extremely badly when I inhale or exhale deeply. I don't smoke or do any drugs by the way. What is wrong with me?",
    "doctor_response": "Hi thanks for contacting HCM...According to your history it seems to be muscular strain pain....It will heal within few days....Rest done...If needed analgesic taken...Avoid strenous activity.Hot compress useful....Prevent movement causing pain....Take sleep in supine position.Avoid bad posture....If cough like symptom present then xray done to rule out bronchitis like condition...For that antibiotic given....If ribs tender to touch it could be costochondritis....If needed compression bandage might be prescribed....Take care.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach ache and fever\n\nmy 6 yr old son has high fever. he's complaining of stomach ache. its very intense, but for a few seconds. then he's almost normal. for fever i give him crosin ds 5ml every 6 hrs. i have given him cyclopam suspension 5ml for stomach ache. when should i repeat dose for his pain.",
    "doctor_response": "Hi,Stomach ache and fever in child may b due to n number of reasons,what is it associated with nausea,vomiting,diarrhea??? Detailed history is important,It may be worm infestations,amebiasis,Simple gastritis,renal colic,apendicities,You have given him paracetamol and buscopan syp,it will him syomtomaticaly ,but complete physical examination should be done to evaluate the cause,If problem persists,Take an pediatrics opinion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Non-stop bleeding with heavy flow after taking iPill, also periods was very early. Should I consult a doctor?\n\nHi I am 34 yr married women recently i hv takn ipill 12 days after my periods and my periods started 2 weeks earlier. its already 10 days now tht periods are not stopping since yesterday i hv heavy flow..i am very concerned..please suggest a way forward. should i b taking any medicine before goin to the doctor..my normal period woukd hv started 5 days from today..",
    "doctor_response": "Welcome to Healthcare-MagicGreetings of the dayExcessive bleeding, early onset of menses is sometimes seen in individuals taking i-pill .If the bleeding is heavy and prolonged and heavy you may require oestrogen hormonal pills to stop it. Do Consult your Gynecologist if the bleeding still persists.Wishing you healthy lifeTake CareRegardsDr T ShobhaMBBS, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Progesterone pill help in conceiving?\n\nHello doc. ,I want to delay my period by 5-6 days as i am going on a holiday, so I am thinking of taking Regestrone. Also we want to conceive now, so my question is can we have unprotected sex while I am taking regestrone?Can I conceive in that time? Will taking regestrone have any adverse effect if I conceive in those 4-5 days? Or does it helps in conceiving?Or shall we drop the idea for this month and try after I stop regestrone and have my periods. Very much confused, please help.Regards,P.",
    "doctor_response": "Hi.Regestrone is prescribed to many women who are trying to get pregnant, and also those who are already pregnant because it is a pregnancy-supporting medication, and does not in any way prevent it.So you can go ahead and take the medication.Best wishes and baby dust to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long will it take for permanent tooth to come after milk teeth has fallen down ?\n\nDr. My son s upper front 2 milk teeth have fallen its past 2 months from now, still he has not got new permanent teeth . Should I consult a dentist?",
    "doctor_response": "hi.u have not mentioned the age of ur son.upper permanent front tooth generally comes at an age of 6 to 7 years.so if ur son is below 6 yrs then no need to worry,it will come.if ur son is more than 7 yrs of age and the tooth has not come then u need to get an opg xray done to see the position of tooth.wish u good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can combined pill cause vaginal mucus?\n\nCan the combined pill cause excess vaginal mucus. Have just changed to mini pill hoping it will correct this? Wasn`t like this before taking Levlen. If the mini pill is going to work, how long will it take? Would i get faster results by taking no contraceptive?",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, some time hormone medicine can cause such symptoms of leucorrhoea, but possibility of other cause need to be ruled out and this could be fungal infection, if this is due to hormone medicine then this is nothing to worry, hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling feet and legs and painful joints?\n\nHello. I had glandular fever last Nov/Dec time and I have been left with tingling feet legs hands arms finger tips. Mainly my left side. I had blood tests in February and September this year to rule out diabetes anemia,  full blood count and liver kidney function and thyroid.  Both sets came back normal. I slipped a disk in lower back in June and I am still having some physio as it is still not 100%. My doctors and physio have said that the tingling and aching sometimes painful joints are a result of the above. I still worry.  Thank you. Sarah",
    "doctor_response": "Yes,The tingling, aching and painful joints are due to slipped disc in low back. It will take some time to recede as a slipped disc can't be brought back to its normal position conservatively. However medication and Physiotherapy will help in relief of symptoms but you need to have patience.Hope this helps. Let me know if I can assist you further. Regards,Dr. Jenis Bhalavat",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain, loss of appetite, bloating, hard to swallow solid foods. Normal chest x ray. Any ideas?\n\nHi I am having really bad head an tummy pain along with that I have lost my appetite. When I eat I start to get really full an bloated it also feels like it is really hard to swallow solid foods it feel like a big knot in my throat! I have loss at least 35lbs do to this an a lot of hair!! My primary said there is nothing wrong with me and I'm fine.my insurance will not pay for MRI which is what I think I need? I also had X-rays done on my chest because I had chest lumps that are hard like bone but again my DR said everything was fine! Should I go get opinions from different dr or what could it be??",
    "doctor_response": "Hi, it appears that you have gastric hyper acidity, and the head ache may be due to gastric or may be due to anxiety.                              I advise you to consult a physician for diagnosis and treatment.                               I to my patient with such symptoms prescrobe omeprazole, domperidone, antacid gel, and pain killer like acyclphenic . Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the episode of severe pain in my shoulder blade?\n\nI have had a bad spasm from ledt shoulder blade across my back the pain is quite bad and preceeded by diarrhea and then afterwards constant wind. It comea on quickoy with no warning Im 31 yrs old and 5 ft 5. It has happened twice now and the pain is worse this time",
    "doctor_response": "Hi, your pain is of utmost concern looking your age. if you have sprained your shoulder, then what you need now is some rest, heat fomentation, and analgesics. if you do not find relief, in that case you will need through examination and a battery of tests to come to a conclusion.I hope that helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How should MC problems be treated for successful conception?\n\nHello Madam, I am married for 3yrs now and we are planning for baby. My wife has this MC problem from early age. We had consulted Gynecologists who confirmed that she may not be able to conceive. I was wondering if I can send you the scan copy of the reports so that you can suggest what should be our future course. We are also open to consult doctor if you recommend one, we live in Gurgaon which is near Delhi (India). Thank you.",
    "doctor_response": "do serum tsh and serum prolactin den do usg n do hsg on day 8th den do follicular study after taking clomiphene from day two den follicle size increase to 18 mm den rupture den iui fr early results",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump toward the back of neck?\n\nI have a lump on the right side of my neck, towards the back. I ve had it for several years, but recently its gotten a little bigger, about 1inch, and is now visible above the skin. Its painless, doesn t move and is hard. I m not sick right now and I feel fine. Should I get his checked out by a doctor?",
    "doctor_response": "Hi,As you have had it for several years then it is likely to be a sebaceous cyst. However, to be certain, I suggest you need to have your doctor examine it to confirm the diagnosis. Regards,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to avoid growth of anechoic mass and  treatment to get rid of it?\n\nmy liver is with homogenous parenchymal echogenecity. a septated anechoic mass is seen at segment 8 of the right hepatic lobe measuring 3.1 cm in diameter. what shall i do in order for me to stop this from growing or to get rid of it? thanks and GOD bless.",
    "doctor_response": "probably it is a simple cyst...need to get a CT scan for further information...most of time it won't require anything active...",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce nerve pain on the tip of elbow?\n\ni have nerve pain on the tip of my left elbow. My daughter bashed into my elbow when pushing a door open. I guess this would be trauma? NOt a disc issue. Whenever I accidently touch the desk or hard surface, I have a sharp localized pain. I m thinking about getting an elbow pad, like skateboarders have. Any prognosis or other treatment options would be appreciated.",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. The symptom you describe comes is result of trauma. Disc problem has a nerve distribution in a certain part of your arm depending on nerve affected. Localised pain after touch or pressure suggests muscular or bone contusion. If you experience electric passing-like sensation or numbness in your hand or forearm then the nerve is contused too. I think elbow pad woll help. You can use topical NSAID impregnated creams ( e.g Ketoprofene). If you feel you have nerve problems, then I suggest you to consult your primary care Doctor. Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fluttering feeling in the chest with breathing difficulty post taking epi for anaphylactic shock. on routine allergy shots. Normal?\n\nTwo days ago, I went for my routine allergy shots (i get them twice weekly) and for some reason, Thursday, I went into anaphelactic shock. I was given epi and taken to the hospital, where i was monitored for 6 hours and sent home. Since then I have been having some trouble with a fluttering feeling in my chest , and when i get that feeling it becomes a little hard for me to breathe, almost like i just went for a run. At first i thought it might be a normal reaction to the epi and the extent of the anaphelaxis, but 2 days later it is starting to make me a little nervous. Is this normal? or should i be alarmed?",
    "doctor_response": "It seems you are having bouts of palpitations which may have been precipitated by the epinephrine shot. It may subside soon as the effect of epinephrine wears off in the body. If fluttering continues you may need to undergo a complete cardio check up which should also include a holter monitoring. You may consult a cardiologist who may advice you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is recurring yeast infection a sign of STD?\n\nso I had a yeast infection and I used monistat and it gave me relief but I didn't use it as directions said even tho I did use all of it I thought I had gotten rid of it but two days later it came back and ive had it for almost two months now is there a possibility I have an STD?",
    "doctor_response": "hello, recurring yeast infection is a sign that your immunity system is weak, or probably you are taking to much sugars or antibiotics in your diet. candida albicans,yeast, normally grow in female genital tract, and when the immunity system is weak the yeast overpopulation the genital area, becoming harmful. i would command same exams to exclude other STD, properly treatment of yeast with econazole 150mg /ovule for six nights, and what is most important you have to maintain a healthy diet, and taking supplements to improve your immunity.   all the best.dr.Klo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hard, painful,  big formation near the naval. Hernia?\n\nI believe I have a hernia in my stomach.  A month or so ago I laid on my stomach (at night ) and felt a formation by my naval.  Its hard and the pain demanded I turn over.  Well the holidays came up so I delayed going to the doctor.  Then in Feb. I had to have openheart surgery, a triple bypass. That prevented me from laying on my stomach so the mass was forgotten until last night.  I turned over and there it was, bigger and harder than before. Could it be a hernia?",
    "doctor_response": "Hello, Thanks for posting your query, From your description, if the bulge is retractable or reducible then the chances of it being an umbilical hernia is high. As you described that it usually occurs when you lay on your stomach, meaning that your abdominal are highly tensed/contracted and if there is bridge on your abdominal wall, that will force intestines to bulge through the orifice hence you feeling it on your navel. It will be best if you could pay a visit to a doctor who can take a closer look at it to determine exactly what it is. Other possibilities are intraabdominal benign tumors. Abdominal scan could help determine the nature of the bulge. Hope this helps and wish you the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Duphaston, have PCOS, trying to conceive. Should I take Yamini?\n\nHi Doc,My name is Daya 30 yrs old female.I was advised by my doctor to take yamini for 2 months to bring down my progesterone and testosterone levels which was a bit high.After this 2 mnths medication she has advised me to start with duphasthon 10mg and clomiphene.I also have PCOS .Am trying to get conceived.I have a doubt whether use of yamini will prolong my conception .Thank ub",
    "doctor_response": "Hi Daya, Its true that Yamini being contraceptive will prolong your conception, but it will prolong conception only till it is being taken. As you have finished (stopped) taking it, it won't prolong conception further. Its not cprrect to take Duphastan & Clomiphene blindly with monitoring ovulation, at least in first cycle. Its better to consult infertility specialist who can do ovulation induction properly to increase chances of conception. Wish you good health & quick pregnancy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be concerned about a growing clot at the place where needle was punctured to tale blood for donation?\n\nhi doctor, I donated blood two days ago, just few hours after the blood donation i could see a blood clot at the place (under the arm's skin) where needle was punctured..since then that clot size bas been growing and now i can see a clot with atleast 4 cm diameter.. is this normal or should i see a doctor ??",
    "doctor_response": "hello and thank you for submitting your question.If you have noticed an expansion of the size of a bruise or can feels bump in the area, please see your physician immediately.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I take Betnesol during 36 weeks of pregnancy with BP, thyroid and diabetes?\n\nHello doctor, I am 36 weeks pregnant with LMP. My doctor is prescribing me Betnesol. I have thyroid, BP and GD. They are under control. Sugar levels are also under control. I am little worried about Betnesol. My previous baby was a C-section. I had planned normal delivery (for my first) but had to do C-section since the placenta detached. When I had narrated this to my current gynecologist, she suggested Betnesol. I am little worried about this medicine. Please suggest me if it is fine to go for Betnesol.",
    "doctor_response": "Hello. In cases of gestational diabetes mellitus with gestational hypertension at 36 weeks of gestation, there are chances that there occurs delayed maturation of fetal lungs which can prevent the baby from baby breathing after birth due to immature lungs. So considering your history and placental separation or abruption, Betnesol or betamethasone injections have been prescribed for intramuscular use as a prophylactic measure to promote fetal lung maturity with these antenatal corticosteroids. Ideally, the fetal lungs mature by 34 weeks in a normal pregnancy but in GDM with superimposed gestational hypertension and in IUGR cases, it has been delayed to 37 weeks to 38 weeks, so as a precautionary measure Betnesolinjections are being given for the fetal well-being in case, your condition deteriorates any time hence. These are completely safe in pregnancy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Morning sickness, sore breasts after fitting mirena coil. History of ankle operation. Sign of coil slipping?\n\nI had mirena coil fitted jan 2012.after 2 months had to have it removed and refitted as it had dropped 2cms. 2nd time round its stayed in place and periods stopped after 6-8 weeks. I had it fitted due to having enlarged blood vessels all over my uterus and also small bit of enmaditriousis which my gyny removed.i was in a lot of pain.so after rough start its been great up until the last couple of months.ive been feeling sick as a dog.i feels like morning sickness when I think about it also really sore boobs which my nipples get really tight and are erected so much they hurt like hell.also I have put on lots of weight and can t seem to shift it.the worrying thing is this morning I went to the toilet and had quiet a bit of blood.after being to toilet I started to feel soreness in my ovaries, but soreness that I ve never experienced before.it feels like my ovaries are bruised.feel very drained I m jus concerned as I haven t been having intercourse with my partner as I ve had 2 ops on ankle since 28th oct 2012 but jus over the last couple of weeks been having it much more. I don t know if this is a sign that my coil has slip again??? The feeling pregnant has been for few months on and off but especially 2weeks ago more so. But this bleeding has concerned me as the last week I ve had sex everyday.",
    "doctor_response": "HI Dear,Mirena is a progesteron only intrauterine device which is mainly used in cases of abnormal bleeding, Fibroids, endometriosis etc, besides acting as a contracptive.All the symptoms told by you may be mere side effects of its progesterone content. However, since you have a history of displaced mirena, you should get a clinical examination done. The other thing is that you may also be having vaginal infection which may be the cause of your soreness in lower abdomen, which is also common in any intrauterine device insertion and can be effectively treated",
    "dialogue_context": ""
  },
  {
    "patient_message": "Temporal arthritis, eyes close to nasal bridge sunked in post brain MRI. Cause of concern?\n\nI had an MRI scan of my brain last night at 6:30. This morning I woke up and both eyes close to the nose bridge have sunk in. It is very obvious. Is this something I should be concerned with? I am currently under the care of a neurologist and was diagnosed with temporal arteritis . I have been taking prednisone since August. Currently, I am only taking 10 mg. a day.",
    "doctor_response": "Hi,Thank you for posting your query.We need to examine the eye movements in all directions. If the eye does not move to any side, then you should see your neurologist as early as possible. However, if the eye movements are good and normal, then you may wait.These symptoms are not related to temporal arteritis.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My email: drsudhirkumar@yahoo.comMy blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for asthma and bronchitis in a 90 year old?\n\nmom is coughing a lot a night. she is using the nebulizer every 6 hrs. the inhaler every 4 hrs. she has copd, asthma and broncitis currently. of course she coughs more at night lying down. cough medicine every 4-6 hrs as well. cough drops helps. she is 90, diabetic too",
    "doctor_response": "make her lie in a propped up position for chest and shoulders.continue withrest of other medicines.consult a chest doctor for assessment for infected lungs to evaluate if aditional antibiotics are needed to control infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are back pain, ESR count and allergy in eye related?\n\nHiMy husband , for past 5 months gets often allergy in one of his eyes, showed several drs they checked his blood, the ESR was 44, and rest were all normal. Dr concluded saying its some internal problem which increases the esr and due to that the allergy in eyes.. He also have back pain .. it  is more painful while he gets up in the morning. yesterday he again checked his esr and uric acid. the esr was 53 and the uric acid is 7.3. Is the eyes , the backpain and esr and uric acid  related ? will there be any problem with his kidney? because once he had problem of kidney stones.",
    "doctor_response": "My suggestion He needs investigation and orthopedic consultation for back pain and high ESR. XRAY lower back should be the first test. 1. back pain, high ESR and red eyes(uveitis or iritis) is seen in one Spine bone disease also. We need to rule out that too. 2. Less likely any kidney disease. These problems are not related to kidney stones history.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is sperm in urine the cause for pimple on my face ?\n\nhiiii dr. im tarun age 17.. sperm in urine cause pimple on face .??? im getting too many its because of this reason?? plz suggest me wat should i do",
    "doctor_response": "hi tarun dont stress much sperm in urine has no relation with ur acne as you grow younger sperm production start its natural process acne is due to hormonal changes . so dont worry. consult dermatologist nearby you , u will be ok",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does accidental contact with claw of the cat on chin lead to infection?\n\nMy cat stuck his claw in my chin while I was trying to put him on the vets table for his annual injection.  I cannot remember the last time I had tetanus injection.  I didnt really think anything of it but now my chin is trembling.  The cat incident was on Monday it is now Thursday.  Could the trembling be linked to a possible infection?",
    "doctor_response": "Hello,Welcome to HCM,Even if it is a scratch or abrasion or bit of a cat requires proper and adequate treatment. The cat has all the potential to transmit rabies, which is 100% fatal but it is 100% preventable by timely treatment.For your condition I would suggest you to follow1.Thorough wound wash with soap and water2.Antirabies vaccine on days 0,3,7,14 and 28. If the cat is healthy after 10 days you can discontinue last two shots of antirabies vaccine.3.Inj Tetanus, 0.5 ml should be taken.4.If there is any open wound you may require a course of antibiotics like tab Augmentin.Don't take any risk with this disease. Hope you will follow these advises by consulting your doctor.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes slurring of speech with headache after the placement of stent?\n\nI had a stroke and have been stetted during last July. These days I am having some speech problem with head ache. I am diabetic patient having all my clinical parameters are within near limit. I have been prescibed Homo check Tab. 1 - 0 - 1. May I know the reason. I am having regular dose of Ecospirin 150 1 Tab Zomelish-Met 50/500 twice a day Enam 5 - 1 and Prolomet xl 50 1 Tab. I would also prefer to the side effects of Homo Check Tab I am 63 years Male having diabetic and BP since last more than a 10 years",
    "doctor_response": "check your blood sugar and blood pressure during headache.fluctuation in  blood sugar and blood pressure may be one of the reason for your problems.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can blood cause dark-brown flecks in stool?\n\nHello doctor, I have noticed dark (do not know if they are dark-brown, more greenish, or black) flecks in what looks like otherwise very normal stool. Can this be blood, or does blood typically only present as fully-black, tarry stool? Also, I have PKU, and my supplemental food contains 4g Ferrous Sulfate per serving. Could this cause discoloration in my stool from time-to-time?I am 43 years old with a history of anxiety, 6'2\", 190, decent health. Non-smoker. Light drinker. In no pain.",
    "doctor_response": "Hi. Once in a while these kind of dark flecks is normal but if it is persistent then it is abnormal. Also, Ferrous Sulphate can cause blackish discoloration of stools. Blood in stools need not always be fully black, tarry stools but I strongly feel that it is due to Ferrous Sulfate. Still, I advise you get a test called Stool for Occult Blood. This test will detect any blood in your stool. If it comes positive revert back to me as you may require further tests.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any foods to cure premature ejaculation and to last longer?\n\nhow to last longer in bed for men naturally free  semenax and volume pills  cliahttp giver  wearing boxers to increase sperm count  how to make nail polish last longer on natural nails  sperm count more than 100 million  aniversarea rhizome  pills that change the taste of your sperm  steyn floydboe  what is the name for low sperm count  puso hbnetwork lester  volume pills price in philippines  natural foods to help you last longer in bed cure premature ejaculation proven methods to stop premature ejaculation  want to get pregnant but husband has low sperm count  fattadopo ebony luisteren  vitamins that help with low sperm count  sole privinsert martrag  what to do if u have low sperm count  hopeless others guestbooksun  what are my chances of getting pregnant if my husband has a low sperm count  winnings pauljensenz factoring  things to eat to improve sperm count  vorbeasca fachgeschaft egyhazat  what can a guy do to raise his sperm count politici priests  tramite rosin   latihankoord vanishing  attila foregoing",
    "doctor_response": "Hello dearyou need not yo worry, I am here to help you out in best possible waythis could be due to any of following conditions 1.Hormonal imbalances like low testosterone2. Poor nutrition3. Stress and anxiety 4.hostile environment for sexin my opinion you should try to rule out these possibilities one by one likespend more time in foreplay make a conducive environment for sexdon't take too much stress and don't fear about performance anxiety avoid smoking and alcoholhave good balanced diet with multivitamin supplementsHope this helps you please feel free to ask for more clarification I will be happy to help you regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause recurring severe paranoia and nightmares in an former PTSD patient of past events?\n\nWhen i was 7 years old i was run over by a bus, i developed ptsd after the event but it never really bothered me. I am now 18 years old and within the past year the symptoms are becoming extremely strong. I experience flash backs, severe paranoia and nightmares. Is there any reason why it has increased so much as of late? And is there anything i can do to stop it?",
    "doctor_response": "HelloThese are symptoms which you have to discuss with your psychiatrist as some symptoms need clarifications However to such a patient I would put on small dose of say drug generic name Olenzapine 2.5 mg bd .11years on bus accident and ptsd may not be cause for your current symptoms .In my patient I would have not associated ptsd with present status it is more like a condition called paranoid status or paranoia and a  psychistrist can give you nice and beneficial treatment get well soonDr Lal Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain post fall, temporary relief with hot pads. Help?\n\nHi, My name is Shawana. I recently fell down my stairs about 3-4 days ago. I did not experience any pain after I fell. I woke up Saturday morning with lower back pains. I am continuing to have the back pain and I am not feeling well. I feel ill along with the pain. I have been taking pain medicine and using hot pads to get only temporary relief. What is wrong with me? email. YYYY@YYYY",
    "doctor_response": "hello shawana.. sorry for your pain ..but it happens commonly and a little late we come to knw of this back pain after we fall .. its only 3-4 days and ur already on medicines..but u need to take complete rest for atleast 2-3 wks for ur pain to relieve completely.. better u go for an x-ray to an orthopaedician and then take rest completely,,if ur work demands u to move ,, then ur doc will give you abdominal belt to keep ur back immobile for giving it rest.. hope your pain vanishes soon,,.dont worry..take care..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is mild hereditary spherocytosis the correct diagnosis?\n\nHello doctor, I have been diagnosed with mild hereditary spherocytosis. My eyes still yellow. Is it unlikely hematologist who diagnosed me three years ago misdiagnosed? I do not doubt he knows his stuff. More about me getting worried. I lost weight a couple of months ago. I went very yellow in the eyes. I have always felt tired. I have had gallbladder out four years ago, I bruise easily, I do get little red skin dots at times, menstrual cycles can be irregular and spleen slightly enlarged.",
    "doctor_response": "Hello. I have gone through your lab reports (attachment removed to protect patient identity) and they are consistent with the diagnosis made by your doctor.Yellowish tint of the eyes is due to increased bilirubin levels. This is due to the increased red blood cell destruction in the spleen and is commonly a complication of hereditary spherocytosis. It is understandable that you are feeling weak since your body is producing red blood cells at an accelerated rate to compensate for the destruction occurring in the spleen. This is also the reason why your spleen is enlarged. If your condition worsens, your doctor might suggest a splenectomy. This will not cure the condition but will relieve the symptoms since the site of destruction of red blood cells will be removed and your red blood cells will be able to survive for a longer period in the blood. Splenectomy, however, can predispose one to certain bacterial infections and it is important that you receive the appropriate vaccines regularly. You could take folic acid and vitamin B12 supplements since one of your blood tests show macrocytic anemia. For more information consult a hematologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure hydrocele condition?\n\nHI I am vivek 24 m frm india..i had hydrocele in childhood and my parents treated it with homeopathy treatment..and after dat it remained fixed in size (my left testicle is little big then right)..do i need to worry?..what can i do?..as frm last 2-3 yrs.. i m also facing a issue of frequent urination..",
    "doctor_response": "HelloThanks for query.Hydrocele is an accumulation f serous fluid between two layers of Tunica Vaginalis which results from subclinical infection .Ideal treatment for hydrocele if moderate or large is surgery .Consult qualified General Surgeon for assessment and further treatment if required he may advise you surgery.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe depression and anxiety\n\nHi my husband has been diagnosed with severe depression, anxiety disorder and ptsd his meds Lexapro just arnt cutting it and I was wondering about a drug that my daughter with OCD has been put on (Chlorpromazine) and is doing well on it would be an appropiate choice for my husband",
    "doctor_response": "DearWe understand your concernsI went through your details. I do not think OCD medicine is suitable for your husband. If your husband do not find any difference of mental condition with the given medicines, he should consult his psychiatrist and tell him the problem. Proper feed back and continuity in treatment is required for cure of depression and anxiety disorder. Exercise, psychotherapy techniques and meditation are proven methods which should help your husband to manage his problems. Please work with your psychiatrist.If you still need my assistance in this regard, please use this link.  Please remember to describe the whole problem with full detail.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get pregnant after having a miscarriage?\n\ni m suja,my age is 33.now its 10yrs after marriage but i didn't have baby til now so i want your better suggestion for dat.and i m having medicines from 7yrs but i don't have good results.my every test results are normal.once i get pregnant but after 2mnths it started bleeding n i lost dat before 6yrs.my husband test results are normal.",
    "doctor_response": "hello..thanks for trusting the health care magic doctors for ur health related queries.i can understand ur condition but don't u can get pregnant.as u told that urs n ur husband reports are normal... right. so there is more chances of getting pregnant. u haven't give information about it medication so that i couldn't comment on this.with the above discussion u can try out my suggestions-1. relax.. don't worry. u can get pregnant.2. do coitus as more as possible during fertile period ( it is from 10-16th day of cycle). because during this period there is high chances of getting pregnancy.3. visit to nearby infertility specialist. he/she can help you.good luck.regards-dr sudha rani panagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of severe pain under rib cage in a child?\n\nmy 13 yr old daughter has severe pain under her lower right rib cage. she keeps saying it feels like there s a bubble in there. today I could feel it while she was breathing- it felt like air bubbling or a bubbling sensation. We ve already been to dr, they thought she either strained her diaphragm or the cartilage on her ribs. He did not feel the bubbling sensation i felt today. What could it be?",
    "doctor_response": "Thanks for your question on HCM. In my opinion it is gaseous distention of stomach which gives you sensation of bubble. The most common cause for this is gastritis. So try to follow these steps for better symptomatic relief. 1. Avoid hot and spicy food. 2. Avoid large meals, instead take frequent small meals. 3. Avoid stress and anxiety. 4. Start proton pump inhibitor. 5. Go for walk after meals. 6. Keep 2 - 3 pillows under head in the bed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the benefits of sunnath surgery?\n\nHi doctorAm 22years old guyPlz tell me the benefits of sunath surgery and how long it I I'll take to cure How many day's needed for bed rest and after tat can I got to office regularly or need a lot of restAnd can I mange my slef alone Without anyone's help",
    "doctor_response": "DearWe understand your concernsI went through your details. Sunnath surgery is called circumcision. Circumcision is the surgical removal of the foreskin, the tissue covering the head(glans) of the penis. There are some potential medical benefits of circumcision in terms of a slightly lower risk of urinary tract infections (UTIs) in little boys, certain sexually transmitted infections in men, and penile cancer. From the day of surgery, within two days you can do your normal day to day functions. Within 15 days everything will be perfect. You will not be having anybody else's help and you will be able to manage alone.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How much time will it take for the pimples to go?\n\nhi,yes i have got some pimples on my face but for the same i believe in curing the same thru home made remediesas of nw i m using tomatoe juice and its pulp to fade away pimples n its marks,let me knw how much time it will take.my id is  YYYY@YYYY",
    "doctor_response": "for a normal skin it will take 21 days to go off. so when you get a pimple  the surrounding skin area will get dark. around two week it will take to get a fresh skin.you can use aloe vera  and saffron oil to decrease the darken area created by pimples.keep your self hydrated.avoid junk foods and add more fruits and vegetables to be free from pimples.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does my liver function test report indicate?\n\nHi Docs, In a recent Liver Function test following were the results 1. Serum Bilirubin(Total) : 1.5 mg/dl 2. Serum Bilirubin(Direct) : .66 mg/dl 3. Serum Bilirubin(Indirect) : .84 mg/dl 4. SGOT : 23 U/L 5. SGPT 29 U/L 6. Serum Protein : 7.5 gms% 7. Serum Albumin : 4.7 gms% 8. Globulin : 2.8 9. Serum Alkaline Phosphate : 94 U/L Is the Serum Bilirubin high ? I am slightly fatigued till end of the day. I am mild drinker.",
    "doctor_response": "HelloWelcome TO HCMThanks for posting you query in HCM.I went through your liver function test report.All values are within normal range.No need to worry.Normal serum bilirubin levels are less than 2 mg/dl.So your,s is within this range only.So,no need to worry,Mild drinking doesnt alter the bilirubin levels.Also keep a check on drinking,because heavy drinking for prolonged time will cause liver damage and liver failure.Hope you are happy with the answer.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a chance of walking again with osteoporosis in both femur and bone cancer?\n\nMy father has osteoporosis in both femur, bone cancer in the left. He broke the left femur on Friday night. They are replacing both femur as we speak. He is 86, but until this took no meds. He has low blood pressure, cholesterol and blood sugar. Does he have a chance of walking again.",
    "doctor_response": "Hi and welcome to HCM. Thanks for the query. it is hard to say. this is very serious condition and it can be life threatening so it is more important to prolong his life then to force walking again. he ll need to be very strong to pass through surgery and rehabilitation and also results of bone reposition in patologic fractures are poor. So you need to have faith but generally this is bad situation..WIsh you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have constant diarrhea, lower abdominal pain, intestinal pain, had precancerous polyps, have burnt lehs. Why do I have pink discharge?\n\ni have constant diahrhea. alot of pain in my lower left abdomen. i was exposed to heavy water a few yrs ago. it burnt my legs and feet. do you think i now have colon cancer?  as i said there is alot of pain in my intestines.  i have had precancerous polyops removed already.  and when i void, there is always a pink  discharge.",
    "doctor_response": "Hi, having constant diarrhea, pain lower abdomen, had burn of legs and feet, have colon cancer, had pancreas polyps and removed.                         You are already under the treatment and you know all the facts, i to my patients with such symptoms give medicines for temporary relief, as ranitidine 300mg, and dycyclomine hydrochloride 10mg both BID. when the diarrhea is frequent a combination of ofloxacin and ornidazole. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are Levolin nebulization and Budecort effective in managing cough and cold in a toddler?\n\nHello, my child is 2yrs old he is suffering for cold and cough and fever for last 3days I have given him augmentin and Alex junior and Crocin for fever but no improvement so I have started nebulization with levolin and budecort and I have stopped augmentin... Can u suggest if I am doing right...",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I just read through your question. Using the nebulizer the way you described is a great idea. It is perfectly safe to do. However, I do not recommend stopping the Augmentin until you have completed the entire course. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My sister's palm is getting black and hard. Why?\n\nHi doctor, My sister's right hand and wrist are aching continuously since the past few weeks. The pain has become much greater now. She says that under her little finger, the pain is comparatively greater than in the rest of her hand. Her palm has turned black and hard a little.",
    "doctor_response": "Hello. Revert with more information to an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for loose and smelly bowel moments in a child\n\nThere is a boy that I take care of who just turned two. I have been taking care of him since he was 6 months old and have never seen him produce a solid stool. His bowel movements are always runny - almost like diarrhea, and smell like sour rotten olives. He is an IUGR baby who seems to eat normally and does not drink juice. Mom has mentioned the problem to the pediatrician at every visit and the pediatrician does not think it s a problem. However, the pediatrician has not seen this child s stools. I take care of him M-F.",
    "doctor_response": "He may be getting repeated infections. Have you given him rotavirus vaccine? I think his hygiene is not being maintained properly... Of the first things you should do is get rid of bottle feeding or use of any pacifier. The artificial nipples are warehouse of infection no matter how much boiling and cleaning you do.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can stopping of minigynon cause bleeding before periods?\n\nhey i started taking minigynon on the 31th of December 2011,however my period came on the 25 of January 21,2012 and finish on the 2nd of February   i started taking the new pack on the 28 of January  i was after some terrible side effect so i decide to stop take the pill on the on the 3rd of February i stop taking the pill and i started bleeding on the 4th of February  which was yesterday and i am still bleeding, is it because i stop taking the pill why i am bleeding?",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.yes, usually bleeding occurs when you stop such kind of  pills. Your body senses it as withdrawal of the hormones as it occurs when pill pack is finished. I will suggest you following--1]   Tab PAUSE 500 3 times a day till bleeding stops.2] Tab PAN Dsr 1 per day - if you have nausea,vomiting3] Use barrier contraception like - condom, till you resume your next periods.4] you can use low dose pill like Tab OVRAL - L from day 2 of next cycle 1 tablet every night , and take T PAN D 30 minutes before dinner and then take the pill.I hope my answer helps you.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for mental health problem\n\nneed advice about an injury to head I got hit on my head right above the frontal lobe region by an iron pipe. I suffered concussion for over 3 days and many other symptoms like headache, nausea, tremors, dizziness, imbalance, blurring of vision etc. This happened in 2006. I was taking nootropics at the time. I want to know if this can cause Aboulia. :( I am showing all symptoms of Aboulia and my life has gotten worse after this incident. I was suffer from depression and borderline personality disorder but what I am feeling now after the incident is totally different from before. Even when depressed I never used to be inactive. But now I have totally turned into a doll just sitting there quietly. Please help. If it is Aboulia, will it be treated? What should I do to get well?",
    "doctor_response": "HiThanks for using healthcare magicIn that case, better to take help of a psychiatrist and psychologist. That would help you to come out of the situation. You can also try some antidepressant with relaxation exercise. It would help to control these depressive thoughts. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for severe fatigue in a diabetic\n\nRecently noticed that I'm very tired during the day.  Type 2 Diabetic...recently off insulin...controlling diabetes with oral drugs, diet and exercise. I don't know if the tiredness has anything to do with that.  Difficulty falling asleep, at night, and staying asleep (that has been occurring for several years.  Any ideas ?",
    "doctor_response": "Hello, Thanks for the query.If you have T2 DM, and if the blood glucose levels are not very well controlled then there is every chance of feeling excessively fatigued and tired almost through out the day. It is essential to maintain FBG Sleep disturbances tend to occur with increasing age. But if one exercises over 1 hour every day,  follows a proper pattern of going to bed, then chances of getting a good sleep do increase. Plus one should also learn certain relaxation techniques which help reduce the stress and bodily tension and help in inducing better sleep. Supplements like Calcium, Vitamin D3 also help in reducing muscular fatigue. Since no specific details are given it is rather difficult to give very specific answer. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Frequent yellow coloration of urine, pain in genital gland, loss of energy\n\nFrequent yellow colouration of urine, pain in genital gland , loss of energy all time, damaged foreskin of the gland Hi I am 18 years old male, i have frequent yellow colouration of urine, pain in genital gland, loss of energy all time, damaged foreskin of the gland, please do suggest me about testing, diagnosis & treatment for the problems, thankyou!",
    "doctor_response": "Dear occassional yellow colouring of urine is not a cause of worry as normally urine is regarded as straw coloured. Damaged fore skin may be the result of forceful retraction of fore skin that led to cuts, apply jatyadi tail on it to have quick healing. Regarding loss of energy these type of symptoms cause a concern in person and he develops a sort of fear of complex in him that results in loss of energy. Regarding pain in testicular region it can be orchitis which can be due to pressure or infection. Ayurved treats it with tab. Vysex forte2 bd and punarnava guggul1 bd dr_lakhanpaul@yahoo.co.in",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from multiple myeloma. What are the side effects of full brain radiation?\n\nMy husband has 8 very minute tumors which could either be melanoma or plasmacytoma . Radiation is indicated He has had cancer off and on for the past 13 years presently dealing with multiple myeloma . Question what side effects do we expect from the full brain radiation. There is no further chemo indicated. the last offering is the radiation.",
    "doctor_response": "Hi, brain metastases are treated with whole brain radiation. side effects are nausea vomitting dizziness in first few days. increased chance of catch infection as patient is put on steroids. delayed effects are neurocognitive dysfunction. alopacia is a consecuence. it depends on radiation technique. tomotherapy may spare this effect.take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in my left eye and left ear?\n\nhi, i have pain in my left eye socket and my left ear, the base of my head also hurts on the left side. i noticed that i have same symptoms whenever i am travelling or when i had alcoholic drinks. would there be a link between drinking/travelling and this sort of pain?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Yes, there is a connection behind the ear down to the throat to normalize pressure on both sides of the ear drum. If one is changing pressure due to changes in altitude OR changing pressure in the throat by swallowing, then if the tube is a bit closed then it causes the ear drum to be painfully pulled. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. After laser treatment of penile papules, my penis has become dark. Is it normal?\n\nHi doctor, I am 24 years old. I had pearly papules on my glans penis a long time ago. I got them removed three months ago by a dermatologist with CO2 laser. Now, bottom of the\u00a0glans penis is very dark purple in color. I have tried to put some gels on it, but had no success with that. I will attach the picture of my glans. Is this normal? Please tell me your professional opinion.",
    "doctor_response": "Hi. I have gone through the attached picture and provided details (attachment removed to protect patient identity). For further information consult a urologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is slimy stools with chunks of yellow or green normal in a bottle fed baby?\n\nMy son has had slimmy pool with white chunks its sometimes yellow or green. He pools after every feeding and it is very loud. He has had sores on his bottom from the poop. Is this normal for a bottle fed baby. It was not like this before and he has had this for almost a month now.",
    "doctor_response": "the botl feeding infant his lotion more than normal breast feeding infant so don't be warry according the colour of stool you must do stool analysis only",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes spasms and pain in abdomen?\n\nHello Doctor, I had  mild spasms of stomach pain  3 days back. I took Spasmonil and and anitibiotic. The tsomach pain has subsided since yesterday but i developed a dryness in my throat and now its also aching since yesterday and slight difficulty in swallowing. Also my Left eye is watering and am having diffculty in keeping it open as if its having pins inside. Please help me,",
    "doctor_response": "Hi.Thanks for your query. Spasmonil has helped you to get relief from the mild spams in the abdomen .Now you have got Pain in throat, difficulty in swallowing, watering of the left eye and difficulty in keeping it open as if having pins inside. These are suggestive of primary or secondary conjunctivitis, along with upper respiratory tract infection causing all the symptoms. I would suggest you to get checked from a Doctor for proper diagnosis and treatment with :Eye drops, oral antibiotics and anti-inflammatory medicines, and you will be fine. If there is no response you can go for further tests and an opinion of the specialist particularly the Ophthalmologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and soreness in the gum behind the two upper teeth?\n\nI have a kind of triangle piece of skin or gum behind my upper two front teeth that has been swollen and very red. Its very sore and has pulled away from where its supposed to be. Its been sore for a week. I'm just wondering why its like this and if there is anything to worry about.",
    "doctor_response": "Hi..Thanks for the query..As per the symptoms you have swelling and inflammation of the Incisive Papillae that is a triangular structure present at the back of the upper front teeth..It commonly gets inflamed due to causes like trauma to Incisive Papillae caused by biting something very hard, burning with hot foods or chemicals, a habit of placing the tongue against the Papillae, tooth or gum related Infection in the respective area..In case if it is appearing to have pulled away from its place then it can be most probably due to traumatic injury to it..Do not worry s gradually as it will heal it will become firm..Nothing to worry as it will get resolved soon..As of now you can apply Lidocaine jelly over it..Take anti-inflammatory painkillers like Ibuprofen..Suck ice pops..Avoid hot, spicy and hard foods..You can also rinse with cold water and do warm saline gargles for reducing inflammation..In case of it does not get better in 3-4 days then an x ray has to be done under supervision of a Dentist..Hope this helps..Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Brain tumor. On neksium, eptoin, ultaset. Continue? Surgery?\n\nA patient named kuldeep singh, age- 62 is suffering from brain tumor. we got to know it 15days ago. we have consulted neurologist of max hospital delhi. she has suggested a surgery of brain and gave us preription of medicines : NEKSIUM, DECDAK 4MG, EPTOIN, ULTASET AND LASILACTONE. Iwant to ask you that she told us he had sweeling in brain 15days ago.. so hould we continue the medines now or we should change the tablets because we have no money for surgery so please suggest some good medicines for his survival. thankyou",
    "doctor_response": "Hi Based on your history it seems that he is suffering from brain tumor which has produced brain edema for which steroids (decadron 4mg) and diuretics (lasilactone ) needed .Eptoin is antiepileptic drug to prevent seizure. Ultracet is pain killer.I would suggest you to continue all the medicines except Ultracet which itself is a seizure potential drug.Instead of Ultracet he can have naprosyn for relief of  headache.Steroids and lasilactone can be continued and stopped by 2-3 weeks depending on brain edema.Eptoin has to be continued. Temezolamide is one drug effective in brain tumor but chemotherapy cannot be started without tissue diagnosis.So stereotactic/conventional biopsy and excision is needed for final  diagnosis, treatment and prognosis. Regards Dr Sandhya Manorenj Neurologist Hi tech city , Hyderabad.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to control bilirubin levels?\n\nI am 25 years now.previous week I test my billirubin and cholesterol trigliseride.test reports of billirubin is 2.7 andcholesterol is ok.from 4 years I have no problems of joundies but billirubin rates was factured 1 to 3.now I fix my biet for my over weight.how can I improve my billirubin report?  Please help me....",
    "doctor_response": "Hi,Looking at your age and laboratory findings, I am of the opinion that this raised bilirubin could be secondary to a congenital hyperbilirubinemia disorder.As you are not suffering from any causes of raised bilirubin, I think you should be probably screened for direct and indirect bilirubin and enzyme levels of glucoronyl transferase.It could be Gilberts syndrome. It does not cause any complications and can present with asymptomatic hyperbilirubinemia.For triglycerides, you can try medications, high fiber and low fat. diet.Any further queries, happy to help again.Dr. Prakash HM",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed an elevated white blood cell count after Vabcomycin treatments?\n\n34 year old female with elevated white blood cell count after month of vancomycin treatments. Leukocyte alkaline photophase test came back elevated as well as elevated liver enzymes. severe fatigue with  occasional left rib pain and some hip pain...any suggestions?",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Elevated white blood cell count possibly indicates inflammation. Liver enzyme elevation indicating liver injury could be the cause.2. Leukocyte alkaline phosphatase score is elevated due to white cell count. 3. Exact counts is necessary along with evaluation of Arneth count to evaluate for leukemia or inflammation. Severe fatigue with bone pain indicates possible associated anemia. Check for hemoglobin levels.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does removal of stressor environment treat adjustment disorder?\n\nIf I have been diagnosed with Adjustment disorder, and I know the stressor connected to the first occurance of anxiety and other symptoms, will or should removal of the stressor environment lead to a cure of the disorder? The symptoms have been present for over 6 months now, but removal of the stressor is complicated - it would involve leaving my spouse who recently decided she is gay and we have three young children. I need to know if leaving her will be the only way to step forward.",
    "doctor_response": "HiI had gone through your query.Adjustment disorder can be precipitated with stress and it will resolve after removal of stressor.If it wont then it is not adjustment disorder.If anxiety and mood variation persist after stressor removal then it may be endogenous depression with anxiety.Endogenous depression has biological origin and can be precipitated by psychological stress or event.Neurotransmitters ;like serotonin and nor epinephrine play important role in this.Medicines that are acting on this neurotransmitters will be useful to treat it.SSRI like escitalopram and sertraline can help.Need to do proper psychological evaluation and treatment before taking any personal decision.Psychotherapy and counseling play role in it.Psychological and social support is necessary.I hope i have answered your query.Still if you have query then feel free to ask.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe headache and a lump on the sternum?\n\nHi, I was not feeling well last night, just had a baby 3 weeks ago. My chest is hurting, I found a lump on my sternum between my breast, closer to the right side. I was breast pumping for my baby, but my milk dried up. Not sure what this is, or if I should contact my doctor. I have also been having terrible headaches along with the pain in my chest. Any suggestions.",
    "doctor_response": "Dont worry...be calm..mostly this lump and the dring up of your breast milk has no relation..but still you should visit a surgeon once...& get needle biopsy of that lump done..to have a diagnosis..& visit your gynecologist for milk related issues",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for blocked nose and fever in a child\n\nHi dr my son is 36 dys old n hav cough n cold since 10 dys. Last wk he ws prescribed gudcef drops n mucolite drops aftr da prescribed course again hez havin blocked nose wid mild fever. He is evn continuing 2 vomit wat is been feeded. Before these medicines dr hd prescribed mox drops, domstal drops n colicaid drops so plz suggest wat to usenw since hez also havin mild temperature",
    "doctor_response": "Hiwelcome to healthcaremagicIt is very  difficult to comment on illness of 36 days old baby without examining him.If I were treating pediatrician I would have looked for any dullness in baby , activity of baby , any rapid breathing or respiratory distress, fever , if all if ok , baby accepting feed well, passing urine adequately, no evidence of any serious illness , I will prescribe simple saline nasal drops and paracetamol dps  for mild fever.But at the  same time at this tender you need to be extracautious , and report immediately to your pediatrician at any of danger signsHope I answered your querythanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for difficulty in opening mouth\n\ni am mamta unable to open fully my mouth  6month ago i take treatment dr ambedkar  dental hospital  in bangalore  10 weeks but  fail  weekly two injection inside the mouth  right&leftside  so pl given some idea or  treatment  i am normal fimely belong",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.In your query , you have not mentioned what injections had been given and what the treatment was done. The difficulty in opening the mouth could be because of the TMJ problem. I would advice you to consult a oral and maxillofacial surgeon and get it reviewed by giving the details of the past treatment history.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Glasterone help to conceive?\n\nGOOD AFTER NOON! My doctor said that my utress size is below then normal so She recommended me to take Glasterone tablets for 3 times a day. I want to ask you about this ;if it will be helpful to me for fast concieving because i want to conceive fastly.",
    "doctor_response": "Hi. The only thing that I wanted to ask you if you have regular menstruations? Because regular menstruation are the feeding of the uterus. So if you do not have regular ones, you should take E-P (estroprogestative pills). Because they make menstruation regular and feed your uterus to become grow.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for recurring cut at the top of butt crack\n\nHi I have had a cut at the top of my butt crack for a while now that heals and comes back I saw a doctor about a month and a half ago and she said it was not a cyst just an irritation that led to a cut and that is in an awkward spot that has trouble healing. is the best thing to do keep in clean?",
    "doctor_response": "Dr. Hanif warmly welcomes you!Thanks for consulting at my virtual clinic HCM. I have carefully worked through your case, and can well realize your health worries. Being your physician, I want to assure, I will take care all of your medical concerns.This is fungal infection. When the sweating comes down from the back, it accumulates and makes the area of the \"butt crack\" humid. Fungus loves such areas and Tinea is the notorious fungus in this regard.This leads to what is known in medical science as 'Jock Itch'.To treat it:-If I was your treating physician I would have prescribed you with Hydrozole Cream and Loratadine by mouth. Apply the cream on the area after cleaning the skin properly.Yes, cleanliness is the key to remain away from such problems. Use cotton-only dress (especially the undergarments). Wear loose clothes. Don't use tight jeans.Avoid hot and humid environment. Avoid unnecessary sunlight exposure. Take plenty of clean drinking water and after some physical activity (sweating) try to take a shower. Don't use scented soaps. Take shower with Oatmeal Milk and Honey Body Wash instead. It will also help get better fast.Hope I answered all of your questions. Please don't forget to add your precious positive feedback to help me able to assist you better in future too. Have a wonderful time ahead. Keep in touch for a follow-up too to let me know if you have any doubts & need further assistance. I am available 24/7 for your help. Have a blessed time ahead. Regards!DR. MUHAMMAD HANIFUSA",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does this ultrasound report show any abnormalities?\n\nMy Wife is 6 month pregenent and her age is 31 Years, We had an Ultrascan last week the details are below can you please check and tell if there are any issues with the baby health. LMP : 01/01/2010 GA By LMP : 24Weeks 2 Days EDD by LMP : 08/10/2010 Single Live Fetus in cephalic Presentation at present. Fetal Biometry : BPD : 6.40 cm corresponding to 25 weeks 6 day HC  : 23.44 cm corresponding to 25 weeks 3 day AC  : 20.01 cm corresponding to 24 weeks 5 day FL  : 4.63 cm corresponding to 25 weeks 3 days Tibia : 4.03 cm corresponding to 25 weeks 3 days HL : 4.31 cm corresponding to 25 weeks 5 days GEST AGE \" 25 weeks 3 days US EDD : 30/09/2010 Fetal Weight : 766 gms Nasal Bone : 7.5 mm Nuchal Fold Thickness : 5.1 mm Atrium of lateral ventricle : 7.1 mm Cisterna magna : 6.8 mm Trans-Cerebellar diameter : 27.5 mm Head Appears Normal, Limbs Appear Normal to the extent seenVisualised stomach,spine,kidneys,urinary bladder appear normal,Heart four chambered. Fatal Face could not be evalvated as the fetus was facing persistently downwards. Liquor : Adequate. Placenta : is posterior wall, lower pole placenta is 6.2 cm away from internal os not reaching the os. Grade: 'I' in maturity. Cervix length is measure 6.2 cm internal os closed. Impression : Single live intrauterine gestation of 24 weeks 2 days  ( Calculated from menstrual age ) ultrasound shows 25 weeks 3 days growth ( Consistent with toth percentile). No obvious anomalies detected.",
    "doctor_response": "HiI have gone through your sonogram report.every thing regarding fetus is quite normal .nothing to worry.the fetus is growing adequately.all fetal parameters are within normal.liquor and placenta  are good.nasal bone is normal.transcerebellar diabeter is normal and corresponding with gestational age.face is not evaluted due to its pposition.ask in next scan as fetus changes its position .as of now nothing to worry.have proper diet and regular chekups take care.Thank youRegardsVasundhara",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does lower backache on the right side indicate?\n\nWhat could be my health issue. I have had this pain, severe at times in my right side, in the back area between my lower rib cage and my hip. Pain goes dormant for a period of two to three months and returns with a vengeance. I have had scans, exerays etc and they could not find out the problem. The pain is getting more intense don t know how much longer I can take this. The pain is like a bad cramp. I can not lay on my right side it feels like I am laying on a mass the size of a soft ball or a cantaope. Can you possible give me an idea if it is my bowels. I do have IBS. Also I had a blatter sling in 1998 this pain has been going on since 2003 and getting extremely worse with each bout. Please help! My email is YYYY@YYYY , my name Gail Semones.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It can be a muscle spasms due to poor posture or stress. Regular back strengthening exercises can help. I hope this information has been helpful for you. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment to get pregnant?\n\nHi Doctor, Me and my husband have been trying to conceive since last 6 months. Last month we saw an Infertility Specialist for this. We got all our tests done and everything seems fine. My menstrual cycle is also regular and follows a 29 day cycle. Last month I got my period on the 7 September. We saw a doctor then, got our tests, also got Folicular monitoring and regular sonography/ultrasound done. The doctor told me I was ovulating fine. After the ovulation period, the doctor prescribed Duphaston to me (once a day for 13 days). The treatment got over on the 9th October. Today is October 12 and am 5 days late on my period. I did a urine pregnancy test today and it came back negative. My questions are: 1. Is it too early to take the urine test at home? 2. Does Duphaston generally delay the period? 3. Will going to see a doctor help? Will she be able to tell me if I have conceived or not today? I plan to see my doctor today. Is it worth it? Please help. Am desperate to be a mom!",
    "doctor_response": "Hallow Dear,Let me answer your queries one by one.1. Yes, you have done the pregnancy test on urine too early. Usually these tests are reliable 8-10 days after missed period; earlier the chances of false negative results are more. You have got another option to go for Beta hCG test which is very specific and sensitive and gives reliable results  even few days before the missed period. Else you may wait for one more week and perform urine pregnancy test on overnight first morning urine sample. 2. Duphastrone is a progesterone preparation which can delay the periods. I prefer to give progesterone preparations after missing a period; after ovulation, I prefer hCG injections to support the pregnancy. 3. You may see your Gynaecologist after confirming the status of your pregnancy by one of the tests mentioned above. If the tests reveal that you are not pregnant, please discontinue Duphastrone  and you will get menses within 4-7 days. I am sure this is useful to you and you will vote to this answer as \"Helpful\".Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain rushing through my neck?\n\nHad a mini stroke Thursday night. Was checked by MRI, CT Scan, Ultrasounds, and Lab Work and nothing was found to be a problem. Was giving blood thinner to break up any clots I may of had. Tonight I held my nose and blew, wanting to pop my ears. When that happened, I had a sever pain rush through my neck. What caused this? Is or could this be related to my Stroke? Do I need Immediate Medical attention? please let me know thanks.Linda",
    "doctor_response": "hi,thank you for providing the brief history of you.As you had a mini stroke and you are already on blood thinners with all diagnostic test done, on a safer side I will advice you to have a checkup again with your clinical signs and symptoms.Usually, neck pain cannot be due to initiative of the stroke but still judging is not possible until a thorough clinical examination is done.You can try doing some breathing exercises by which the muscles of neck relaxes. Also, such forceful exertion out of nose may not lead to any neck injuries either until the head is shaken up badly.Having a check by clinical examination is not at all a bad thing to do.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump in the neck above the clavicle?\n\nI have a lump in the left side of my neck right above the clavicle since 2010. Doctor said I need to do CT scan, in the CT scan physician said my lump is just hypertrophied muscle, I still have that lump and wondering if CT scan doctor was wrong. I have dull pain in that area",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You may have hypertrophied muscle or some enlarged lymphnode or some soft tissue tumor.  You should go for biopsy of that lump.  It will give exact idea of your lesion.  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 health care magic. Wish you a very good health.Don't forget to click thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for scoliosis\n\nI am having discomfort on my sides. Above my waist,probably about where kidneys are. It feels more sore when I wake up ,like I m crushing something by lying on it. It limits my movement (like trying to wipe)it seems like it s on both sides but right now only my left is really bothering me.i am relatively healthy. Only diagnosis is of thoracic lumbar scoliosis.",
    "doctor_response": "Hello!Welcome on Healthcaremagic!Lumbar scoliosis can trigger all this clinical situation. You should know that lumbar spine  chronic degenerations can cause chronic back pain.I would just recommend performing a lumbar spine MRI study to exclude possible spinal canal stenosis, although your symptoms are not typical of this disorder. A lot of physical activity to reinforce your back muscles would help reduce the pain. A muscle relaxant or gabapentine could be helpful too. You should discuss with your doctor on the above options. Wishing all the best, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could extra skin/ tissue between teeth could be?\n\nMy daughter is almost 4 and last night I thought she had some food in between her teeth when I tried to remove it I noticed it was like a skin between her teeth which is easy to see. I would like to know what causes something like that. It does not hurt her but very visable.",
    "doctor_response": "Hello:)Welcome to HCM.Your kid seems to be suffering a gingival inflammation. Gingiva is more also more visible during the falling of deciduous teeth.I suggest you for a checkup with your dentist to rule out any infection.Gargle after every meal and brush twice daily.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mid back pain after an injury?\n\nI fell very hard on tile floor when I slipped on water. My bottom hit very hard and now I have tremendous pain in the middle of my back. I really thought that it was my kidneys. There is no blood in my urine and no pain when I urinate but the pain is intense. What could be causing this mid back pain?",
    "doctor_response": "Hi,Welcome to healthcare magic.After going through your query I think You are suffering from acute backache after injury.Treatment of it is rest and analgesics . Diclofenac three times a day after meals is effective. Sometimes strong analgesic(such as ultracet three times a day after meals) is required. OMEPRAZOLE 20 MG before meals  prevent acidity caused by analgesics . There are three possibility ,one is simple muscle injury,second is disc prolapse and third is compression fracture of vertebra. To further investigate MRI of the region is advised. I think your query query answered.Welcome to any follow up query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to decrease workload of congestive heart?\n\nYour patient is suffering from congestive heart failure. what will you give to decrease workload of the heart:a. Vasodilatorb. Vasoconstrictorc. Salined. EpinephrineVasodilator yes, but my teacher said no you give epinephrine, and for the life of me I cant see the reason why",
    "doctor_response": "Hello, Epinephrine should be given in case of really low blood pressure, in case of decompensated heart failure when the patient is in cardio-genic shock. But sometimes, it can worsen the renal function by causing renal artery constriction. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for numbness in wrist and forearm?\n\n2 weeks ago i had surgery for gamekeepers thumb. surgery went well but when i straighten my arm all the way i get a pop that feels like an electric shock. it could be that my dressing after surgery was too tight and was pressing in on my forearm and aggrevated my tendons/nerves in my wrist and forearm. i am 35 and in very good health",
    "doctor_response": "Hello, Consult an orthopedician and get evaluated. We have to rule out possible causes like carpal tunnel syndrome. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swelling and tenderness in forearm after an injury\n\nHi,I hit my right forearm around an hour ago, it's really swollen and tender. I've tried to rest it, elevate it and put ice to it for around 20 minutes. I can't move my fingers without pain shooting through my arm or even bend my arm or close my hand to a fist. Did I just hurt the muscle?",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns.As per your complain it seems that you have severe muscle inflammation secondary to traumatic injury to forearm and there is also a possibility of bony fracture as you have restricted and painful movement of fingers and unable to close your fist..I would suggest you to consult an Orthopedician and get evaluated and a thorough clinical evaluation and an x ray can help in diagnosis and treatment can be planned accordingly..In case of a bony fracture reduction of fracture segments and immobilization using casts or splints can help..In case of soft tissue injury taking anti-inflammatory painkiller like Ibuprofen, cool compresses, applying analgesic ointment and doing physiotherapy by doing gentle movement of fingers can help..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medication for Verruca\n\nI had a verruca treated 3 weeks ago (cryo treatment then silver nitrate), although size had reduced, over the past few days it has become more painful when pressure is applied.  after a bath today, I gently squeezed the area around & a lot of semi solid pure white substance came out (what i can only assume was pus?) can you advise further?",
    "doctor_response": "Hello,Welcome to HCM,All Human papillomavirus (HPV) infections can cause warts (verrucae), which are noncancerous skin growths. Infection with these types of HPV causes a rapid growth of cells on the outer layer of the skin.HPV types such as HPV-5 may cause infections that persist for the lifetime of the individual without any manifesting any clinical symptoms. There is currently no specific treatment for HPV infection more often it clears by itself. The body\u2019s immune system clears HPV naturally within two years inr 90% of cases.Podophyllotoxin can be applied by the patient to the affected area and is not washed off. It is use in cycles 2 times per day for 3 days then 4\u20137 days off. Imiquimod cream is applied to the affected area after applying the Vaseline as it causes local irritation.Cryosurgery can be done which should be decided by your dermatologist.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can frequent masturbating causes any health problems?\n\nDear Doctor,                  This is USMAN from Muscat I just want to know I am 34 Unmarried I saw blue movies every night and I masturbate twice daily or almost thrice daily but I ma athelete sports man I just want to find out whetehr its good or bad for health but I really really feel pleasure in mastubating but then again I am afraid that it doesnt effect my stamina can you please tell me in detail some body told me that it effect eye sight and back pain because I am telling you very frankly that after masturbating 3 times still I feel very desperate I can easily mastubate 7 to 8 times daily I do 4 to 5 km running dailyBut plesae tell me that mastubation will not effect my staima because I am a professional runner.Your early responce shall be hihjy appreciated",
    "doctor_response": "Hello dearUnderstand your concernMasturbation is just like sex but without the involvement of partner. It is good if done in adequate frequency (5-6 times in week). Do not think to excessive it can cause psychiatric problem. Disadvantage of excessive masturbationare as follows: Back pain, pelvic pain, Drowsiness, Weakness( due to loss of protein and calcium), Testicular pain, Psychological side effectrarely  decreased sperm count. Not necessary in all person this side effect will occur.You should do moderate masturbation once in a day or 2 days.Hope this may help you.Best regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful blister at tooth extraction site?\n\nMy daughter age 16 had wisdom teeth pulled on June 16 and she recovered well. Four days ago we were on vacation and she was complaining of some pain (rated it a 3 on a 10 point scale). Tonight we are home and now she is complaining about a blister near the lower extraction site. When I looked in her mouth it looks like a blister, puffy, punish white near the extraction site on the gum, near her cheek. Should I be concerned?",
    "doctor_response": "Hello and welcome to HCMi have read your query and understand your concern. as you mentioned its more than one month since the wisdom tooth extracted.by this time the extraction should have healed.in some case of more traumatic wisdom tooth extraction slight pain is normal and it can take more time to heal.blister can be due to some other reason also.if i were your treating doctor i would advice you to use a chlorohexide mouth wash.for pain oragel can be applied to the affected area. usually it will subside within 4-5 days .if the problem persist or increases i would suggest you to visit your dentist.hope this ans your query. take care.RegardsDr. Shesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "Drug interactions between accutane, keppra and xanax. Have panic attacks, seizures and cystic acne. Worry?\n\nI m wondering if there are any drug interactions between accutane, keppra & xanax . I take the keppra for my grand mal seizures, the xanax for my panic attacks and the accutane for my cystic acne but I ve read that the xanax & keppra aren t a good match. Is there another fast acting anti- anxiety medication I can talk to my doctor about?",
    "doctor_response": "Hi, Thank you for posting your query. There are no significant interactions between the drugs you are taking- Keppra (levetiracetam), Xanax (alprazolam) and accutane (isotretinoin). So, you can safely continue to take them. For anxiety, you can also take clonazepam instead of alprazolam. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it normal to have severe pain after complicated molar extraction?\n\nHello doctor, I had my tooth removed befor three days (bottom left first molar) and it was a tricky one to get out, around an hour or fighting with it until it gave in. Before this I have had an ongoing infection in the tooth and had previously around three courses of antibiotics. I finished my last course two weeks before the extraction. The pain on the day once the anesthetic wore off was very bad. I had to take Paracetamol and Dihydrocodeine. Since then the pain has reduced a little maybe 10-20% less painful but it is still causing pain. Today it looks a bit manky, is this normal and expected? Here is the tooth as of today (third-day healing). I have done my best to keep the clot in place. I only had soft foods, not had any kind of sucking motion in my mouth, no smoking, etc. The teeth on the bottom front left are also very painful but the right side of my mouth is fine. Applying any pressure in that area hurts.",
    "doctor_response": "Hello. I have seen the picture. (attachment removed to protect patient identity).  The extraction wound looks normal. The pain you are feeling is also normal given that it was a difficult extraction and your dentist had to struggle pulling it out. You can use salty lukewarm water mouthwash and add Ibuprofen to the painkiller you are taking and take them regularly three or four times a day not as required and you should be fine in a couple of days. Do not forget your diet and eat nutritious foods rich in proteins and vitamins as this is important for the healing of your wound and can get ignored in the middle of your pain. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for nerve damage in neck and shoulders\n\ni have been told that i have server and horrific arturitis in my neck i am not a canidate for surgery my vertabras have fussed together so i can nothave an injection. i broke my neck many years ago. i have been on pain medicine but it does not work any longer. it is in my neck shoulders shoulder blades and runs down my arms. a emg showed alot of nerve damage help",
    "doctor_response": "For arthritis and nerve damage in neck, shoulders you can take some pain killer like biozobid-plus or osteonac-th along with some calcium supplements You can take meganeuron-od plus for nerve pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My fasting blood sugar level is 8. 3. Is it indicative of diabetes?\n\nHello doctor, I have a blood sugar level of 8.3 mmol/l during fasting. Is this diabetic or still at the pre-diabetic stage? Can I reduce the sugar level without medication?",
    "doctor_response": "Hello. This falls in diabetic range. You should also get post-lunch sugar done. You will eventually need medicine. However, you can try a healthy lifestyle for some time period. You should have a healthy lifestyle like avoiding fatty, oily, sweet, and high-calorie diet. Regular exercises like brisk walking, jogging according to your capacity at least 30 minutes a day and five days a week. Try to achieve weight loss which is important. Repeat fasting and post lunch sugar after two weeks to look for the response. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can hypertension cause intermittent headache?\n\nI have had an intermittent headache on the left side for a week. I woke up this morning with a swollen left hand slight pain in my left arm. I may have slept on my left side. My blood pressure was 160/109. I have hypertension and am not on any medication. I took an aspirin. I am able to control my blood pressure with herbal medication. At what point should I consider going to an emergency room?",
    "doctor_response": "Hi There It's advisable that you should start on modern medicine now as your Bp is staying high. Constantly high bp can lead to stroke and debility.If your BP goes beyond 180/110 then you should go to ER.Yes hypertension can very well cause headache.I wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "My hands and legs shivers without temperature, Is it normal?\n\nI am 26 year old healthy female. My hands and legs are shivering suddenly and at the same time i am feeling cold and i am getting goose bumps? Even its happening with 76F. When i am sleeping the same thing is happening. what might be the reason?",
    "doctor_response": "Thanks for the query I am not too sure about the reason, the only thing that is coming to me right now is thyroid so i suggest u to get it checked and also do a random cortisol done Have a healthy living",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pimples on scrotum\n\nI have what appear to be pimples on my scrotum. It started out with just one or two several years ago after I had a vasectomy and had to shave the area for the procedure. As the hair began to grow back it itched like crazy so I have continued to keep that part of me shaved on a regular basis. The \"pimples\" are roundish, white in color and firm to the touch. They don't hurt unless squeezed nor do they itch. My question is whether these are ingrown pubic hairs or some form of testicular wart? Hoping you can help me with some direction.Thanks",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have what is called as Sebaceous Cyst over scrotum.The scrotal skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin.Normally they fade away without treatment however they need to be treated if increase in size or get infected.Please consult qualified General Surgeon for clinical evaluation and further treatment.If needed some of them which are bigger may need to get excised in Toto (Completely along with the sac)Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for muscle pain\n\nHello, i have a right side, muscle pain, just above hip. Goes away, if i use methyl salicylate or heat, its fine in the morning, when i get up, later in afternoon, gets worse. What is it, and how can i treat. When i press on it deep, its painful Thanks",
    "doctor_response": "hi sir/madam,Thanks for your question on Healthcare MagicMuscle aches often respond well to home treatment. Some measures you can take to relieve muscle discomfort from injuries and overuse include:-Resting the area of the body where you are experiencing aches and painstaking an over-the-counter pain reliever, such as ibuprofenapplying ice to the affected area to help relieve pain and reduce inflammation.You should use ice for one to three days following a strain or sprain, and apply heat for any pain that remains after three days.Gently stretching the muscles.Avoiding high-impact activities until after the muscle pain goes away.Avoiding weight-lifting sessions until the muscle pain is resolved.Giving yourself time to rest.Doing stress-relieving activities and exercises such as yoga and meditation to relieve tension.Tips for prevention:-If your muscle pain is caused by tension or physical activity, take these measures to lower your risk of developing muscle pain in the future:-1. Stretch your muscles before engaging in physical activity and after workouts.2. Incorporate a warm-up and a cool-down into all of your exercise sessions.3. Stay hydrated, especially on days when you are active.4. Engage in regular exercise to help promote optimal muscle tone.5. Get up and stretch regularly if you work at a desk or in an environment that puts you at risk for muscle strain or tension.Hope i was helpful.Stay healthy,Stay safe.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How is a high SGPT in normal bilirubin significant?\n\nhi..im 25 yrs old and i recently starting my medication due to elevated SGPT the result is 63 U/L but my bilirubin count still normal.i have yellow sclera. and i have history of alcohol intake for almost 3 yrs.what is the significance of high SGPT in normal bilirubin?thank you for the response.",
    "doctor_response": "Hi welcome to the health care magic Alcohol and it's metabolites can lead hepatocytes injury So by hepatocytes damage liver enzymes can be elevated You have alcohol induce liver damage Avoid alcohol for that USG done to look for liver affection Udiliv tablet can be prescribed for that Avoid excess fried and non veg foods Fruits taken more Consul physician with keeping my answer in mind Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for high blood pressure?\n\nI had an episode today while sitting where it felt my heart stopped.  I felt as if I might faint and then it passed.  A couple hours later I took my blood pressure which was 145/85 and pulse of 93.  I walk about 45 minutes a day with no problem.  What could it be?",
    "doctor_response": "Hi,Missing beats are usually an extra beat followed by long gap. One or two are usually normal things but if have many such then you should get your cardiac check up with simple ECG FIRST then With Echo or if necessary holter monitoring to check for frequency and duration of episodes. Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Deepesh Agarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for back pain with rashes\n\nI ve bad pain in my back (between my shoulder blades, more to the right and pain under my right breast) for several weeks now. Its very worse when I m (trying) to sleep at night and feels like a lead weight when I try to turn. I ve had a cough for several weeks as well. 2 nights ago I developed a shingles-like rash on my back and around to my stomach area only, and have had night sweats. I m very fatigued.",
    "doctor_response": "Hello,The symptoms are most commonly associated with  shingles type of eruptions. I would recommend you to consult a dermatologist as soon as possible. He will be in a position to diagnose and treat your condition after a proper clinical examination.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Santosh S. Jeevannavar, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain, persistent sweating and irregular sleep patterns?\n\nHello i have been feeling unwell for the past week and have been experiencing chest pain on my right side and back pain and tightness in my right shoulder blade major sweating day and night and irregular sleep patterns for past2/3 months my gp is on holidays should I go to the hospital",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Yes, you should definitely visit to the hospital and rule heart related diseases because your symptoms are commonly seen with heart diseases. So get done ecg, 2d echo and stress test. If all these are normal then no need to worry for heart diseases. You are also having sleep disturbances, so this can cause stress and anxiety and they then cause all the symptoms. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on it's solution. You may need anxiolytic drugs too. Don't worry, you will be alright. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Zollinger-Ellison syndrome\n\nHi, may I answer your health queries right now ? Please type your query here...I was recently diagnosed with zollinger Ellison syndrome, I have decided to switch doctors and have an appt with mayo clinic on march 3rd.... I m drained, not sure if I can wait another 2 weeks.....",
    "doctor_response": "Hi thanks for contacting HCM....You have ZES that gastrinoma , gastrin producing tumour..So hyper acid secretion present....So main aim is to reduce acid secretion by parietal cell.For which pentoprazole like proton pump inhibitor given.....Take less spicy food.Coffe , tea , smoking , alcohol , meat like irritant avoided.Avoid stress.Ultimate treatment is along with medical therapy which keeps basal acid output less , surgical removal of tumour necessary.Take care.Consult surgeon for that...Best one is oncosurgeon for that.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will laser treatment be effective in removing the birthmark without recurrence?\n\nHello doctor, I have a birthmark behind the right side of my neck, which looks like a black thick mass. I had once consulted a skin specialist to check if there are any options to get this removed. I was told that even if it is removed by surgical means there are chances that it may reappear. I want to confirm this. Do we have any options to remove it by surgical or nonsurgical means? Are there laser treatments available? Will I have to remove my hair if I need to undergo treatment? I have attached a photograph of the affected area.",
    "doctor_response": "Hi. I have seen the photo. (attachment removed to protect patient identity).  I understand your concern. The condition is known as nevus sebaceous. In case of deep surgical excision in nevus sebaceous, chances of it coming back are very less. The thing is the excision should be deep to minimize the chances of recurrences. Laser treatments are there but not very effective and chances of recurrences are more. Hair needs to be removed as the area should be devoid of it to perform surgery. Cost depends on the different doctors and their location or specialty.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of potential pregnancy?\n\nI have had 2 misscarriages since december or 09, i woke up yesterday and had a feeling that I could be pregnant again. It is to early for me to test, according to my last period I would be 3 weeks today, since I have had problems in the past should i wait to find out or go to my doctor for a blood test.",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the urine pregnancy test will not be able to give you accurate results this early.Usually urine pregnancy test gives accurate results a week after missed period.The blood HCG can be detected as early as 10 days after conception.So you can go for it.Avoid stress.Take healthy nutritional diet.Start taking folic acid supplements.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have eczema on hands. Why does it keep flaring? Home treatments?\n\nI have what I think is eczema on my hands. It keeps flaring up and is sometimes okay, however right now there are oozing small white bumps and lots of cracked skin and redness. I was wondering if this could be anything to do with my diet? I m considering a water fast for 7 days to flush out my system and see if there are any changes. I also know of a product that clears it pretty well however I ve ran out at the moment. My questions are: are there any at home treatments I could use? Does exposure to the sun help? Does my diet affect my eczema? Thank you.",
    "doctor_response": "Hello and Welcome to HCM, Thanks for writing to us. eczema and psoriasis are related by they both involve toxemia, thinning of intestinal wall, excess body acidity, diet and internal cleansing are the most important to alleviate outbreaks. diet should be highly alkaline. although sun is good for 'p' tends to aggravate eczema. this diet has been very beneficial to people with eczema. gluten free diet is very beneficial drink distilled water or high ph water. omega 3 is a very important part of diet excellent anti-inflammatory help maintain proper ratio of good bacteria in your digestive system. Never use any home remedy or other self treatment without being advised to do so by a physician. Hope this helps you. Wishing you good health... Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Am I likely to be diagnosed with asthma after having had the lungs on bronchodilator?\n\nI had a pulmonary function test and my doctor called me back and said that my lung capacity was normal but my lung function improved a little bit after given the bronchodilator. He said that wasn't enough to give me the diagnosis of asthma. why is this?",
    "doctor_response": "The PFT report indicate bout you lung function parameters likeFEV1,FVC,PEFR.There are certain definative parameter to determine whethet you have obstructive airway disorder like change of more than 20% in PEFR,>200ml in FVc etc depending on which you are diagnosed as athama.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair loss in the center of the scalp\n\nAge:36,Male. I weigh 190 pounds and height is 5-06. I just found out that I am losing hair on top center of my head which I have never noticed before. I was thinking of using Komark anti bald shampoo but I have no idea how to get it or if I should see a doctor first.",
    "doctor_response": "Hi, It may be androgenetic alopecia... also called male pattern baldness. Consult the dermatologist for the perfect diagnosis and proper treatment. I would suggest... - minoxidil 10% solution.. apply on dry scalp - tab finasteride - tab biotin - cleanse the scalp with ketoconazole-containing shampoo - relax and have a positive attitude. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilyas Patel, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can masturbation affect memory?\n\nGood day....and merry Christmas am a student,i am in college studying physiology....i am masturbating alot and I think it's affecting my studies after I do it...i forget things I picked up in my lecture and I have been masturbating alot again and I have a big test in two weeks....am scared I won't be able to concentrate what can I do?are there pills to enhance my memory",
    "doctor_response": "Hi...there are a few pill which claim to enhance memory but it has not been proven conclusively... they even have more side effects..so better stay away from them...it will be more fruitful it you decrease the frequency of your act and concentrate on your studies...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could headache and mild dyspnea be due to stress?\n\nhi i have been feeling unwell for 10 days but before i was totally healthy i have dypsnea lightheadness and pulse of 90bpm my blpr was at first 140/85 then it returned to be 110/75 over the next few days i feel tired exhausted very depressed i m 32 years old my hb is 10 and i m taking ferroglobin caps for that i also take procoralan for tachycardia but still have taht light head and headache and mild dypsnea my doctor says i m stressed that s it and that this is anxiety but i really doubt that pls help me i m very afraid",
    "doctor_response": "hiI understand your concern.Yes it may due to stress and anxiety.tachycardia, palpitation, difficulty in breathing etc might indicate anxiety.Anxiety is unconcerned fear which produce physical symptoms.This condition can be treated with SSRI like sertraline and paroxetine.Anxiolytic can be beneficial like etizolam and clonazepam.Do take doctors advise before taking medicines.Regular exercise, yoga, meditations, relaxation exercise will help.Take proper sleep and food regularly.I hope i have answered your query.Happy to help you.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes, cold, lethargy and warm neck and forehead?\n\nMy son has had a cold since yesterday. Neck and forehead are warm to the touch. Today he sees very lethargic with the same symptoms expect his hands are cold now. I have him on children s Tylenol. Do his symptoms warrant a visit to my local urgent care for antibiotics?",
    "doctor_response": "thanks for your query on healthcare magic. From you history its seems that your child has developed a viral infection. it is common in viral infection to have some fever and lethargy. Tylenol, bed rest, and adequate water intake will be suffice for treatment of this.antibiotics will not do any help.Regards- dr deepak vaishnav",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes clogged and stuffy feeling in head after jumping into water?\n\nJumped into water from a high dive held my nose and loud noise as I hit the water if I remember correctly. And my ear and that whole side of my head feels clogged and stuffy and ear fizzles every time I hold my nose and blow air. Happened immediately not over a few days.",
    "doctor_response": "Such can happen if eustachian tube (the small connecting tube between ear and pharynx) get blocked due to pressure changes or water.But if persistant,there can be other possibilities also- ear infection, ASOM, Tympanic membrane injury etc.  you need to consult ENT specialist to get your ear examined",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe anxiety be treated?\n\nHi there, I'm very excited for something that's happening tomorrow.  It only happens a couple times a year and I always get extremely excited for it.  But here's what happens in the hours before the event; I get so excited that my nerves go crazy.  I get butterflies in my stomach so bad that I feel nauseous, and I get very shaky and twitchy, especially in my legs.  I never throw up, though.  Do you have any idea how I can get my body to calm down?",
    "doctor_response": "Welcome to HealthcareMagicAnxiety is a very common now a days you must assure yourself nothing wrong is going to happenyou can take T. Anxit 0.5 mg before such events to calm your self down RegardsDr Varun",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of loss of sensitivity in my penis?\n\nHello.  My question concerns my penis.  I did some stretching exercises and the next morning, i noticed my penis, especially the glans was numb.  I have lost 90% of the sensitivity in my penis and testicles.  This has been ongoing for months.  Do you have any idea what I may have done and if I will ever recover?  Thank you!",
    "doctor_response": "HIThank for asking to HCMThis is functional condition I would advise you to stop doing any experiment on your penis this could be dangerous, just leave it like that only nothing went wrong every thing seems normal, hope this information helps you have good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do brown specks in phlegm indicate?\n\nHello Dr, lately i have been spitting up little brown flakes of mucus it seems i have been having little upper back pain only dull pain but noticable at times, also i have had some blood test done and other things i have high cortisol and high blood pressure we have yet to find the causes, im starting to get worried cancer runs in my family so i dont really know what to think. im only 18 years old and i am a smoker. could it just be a lung infection or something.?",
    "doctor_response": "Hellowelcome to hcmim afraid to inform you that the brown speks are CLOTTED BLOOD PARTICLES and if cancer runs in your family then to be on the safer side you should get yourself screened urgently by getting following investigations(1) XRAY OF CHEST(2) CT SCAN(3) BRONCHOSCOPYonce you get these tests done either send us a scanned copy of your reports or consult your doctor for the evaluation of your reportsregardshcm",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high fever which begins in leg and moves to head?\n\nMy 3 year old has been having high fevers that begin in his legs. They get really hot, then it moves throughout his abdomen and head. This has happened three times in the last few months. Do you know what the cause may be? It goes away in about 24 hours.",
    "doctor_response": "Hello dear,I understand your concern .The most common cause of fever is viral infection,then UTI and eventually enterocolitis . For confirmation of diagnosis I suggest blood,urine and stool tests.Hope I answered to your question.Wishing you   and baby good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high blood pressure and should i take medicines?\n\nHi I am 26 female I am taking treatment of hyperthyroidism for about 4months Initially my blood pressure was quite normal but (in the first month of hyperthyroidism treatment)on another visit to dr after 15 days I got a rise in blood pressure and it was 130 90.dr ask me to take inderal I had been on inderal (40mg twice a day ) for 3months but blood pressure was still not normal it was 127 86 Although my hyperthyroidism treatment is about to finish and thyroid profile is normal.my sodium potassium levels are normal .why I have high blood pressure ? Should I start taking medicines? In this early age",
    "doctor_response": "hello,I have gone through your query.Thanks for using HCM. Basically hyperthyroidism can lead to mild hypertension.and BP reading of 130/90 and 127/86 are marginal and you dont need any treatment for that.Inderal which is being given to you would control this level.Usually treatment of hyperthyroidism lasts for about 2 years.looking to your present reading you just focus on hyperthyroidism along with salt restriction and follow healthy life style.My best wishesDr.Rajesh Teli,MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it possible for me to get ICL or LASIK for eye power?\n\nHello doctor, I am 24 years old and have been wearing glasses for myopia for six years. I have spectacle powers -9D and -11D in left and right eyes respectively with some small degrees of astigmatism. I had been consulting doctors for LASIK and ICL. I was found ineligible for LASIK but each doctor has a different opinion on ICL. Some say I am fit while some say I am not. I am really fed up. Please help.",
    "doctor_response": "Hi. ICl is a surgical procedure to implant an artificial lens on the natural lens. During the workup of taking up a case for ICL surgery, many parameters are considered as it has a high risk of secondary cataract formation later on. Some of them are endothelial cell count, anterior chamber depth, the angle of the anterior chamber, corneal topography, etc. Only if criteria are met, they proceed for surgery. I may be able to help you more if you can send me the reports of your eye exam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for misaligned teeth\n\nHello doc,my teeth are not aligned in a perfect way..After my milk teeth are gone, my permanent teeth have erupted in such a way that a tooth is completely pushed back from the rest of the teeth  on my lower jaw due to  which brushing that particular tooth becomes a difficult task and also it doesn't look good..how can I get the dentist arrange them neatly? Is ther any solution for this?",
    "doctor_response": "Thanks for your query, i have gone through your query.The malaligned teeth can be corrected by orthodontic treatment, that by putting braces. You can consult a otlrthodontist and take a opinion. You have to get radiographs done like OPG and Lateral cephalogram before treatment because we have to see the bone defect and status of the teeth and also to plan any surgery required or not along with orthodontic treatment.i hope my answer will help you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Want to stop taking metroprolol suddenly. Safe?\n\nHi I am on metoprolol 12.5 mg 2 x a day for svt. I have been on it since aug 2012 due to all of the stress my family was put under in the summer. I want to stop it but am afraid to. Is it safe? My doctor said yes and to do it cold turkey but I was on 25 mg once a day and it made my anxiety very high. So I went back on with the 12.5 2ce a day.",
    "doctor_response": "Hi there, thanks for asking. Your doctor is right. You can discontinue the medication if you do not have any stressful situation in the family now. Metoprolol is a medication which does not enter into the brain so much and the most part of its effect is on the peripheral system, like heart and vessels. It means that it controls the manifestations of the anxiety over the body and so it brings a peaceful situation for your brain since it does not feel any alarm from the body. When somebody is under stress, any change in this medication could lead to the anxiety rebound, otherwise he/she can not to take it. I am glad that you have passed the stressful situation and wish you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Could delayed periods be a sign of early onset of menopause?\n\nHi doctor, I am a 53 year old female. My periods have been delayed for two weeks. Till now they are normally regular. Could it be the early onset of menopause or they will eventually come?",
    "doctor_response": "Hello. If you have been regular with your menses these years and this is the first episode at 53 years of age when the menses have been delayed by two weeks, the causes can be a possible initiation of perimenopausal stage where menses are often delayed for a month or two and slowly tend to stop in next one to two years. Perimenopausal stage can be verified with the hormonal FSH (follicle stimulating hormone) and LH (Luteinizing hormone) levels which if high shall indicate an onset of perimenopausal stage. However, it is suggested that pregnancy should anyways be ruled out and if negative then you can wait naturally for your menses to resume. Hence, try maintaining a menstrual calendar and keep a mark for your dates, duration of flow and quantity to evaluate the possible onset of a perimenopausal state. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for asthma and acid reflux?\n\ni just felt a spasm in what feels like my heart along with a gas-like pain/twinge. it lasted about 1 minute. i have not eaten today but had a black iced coffee about 2 hours ago. this happened one other time  a few days ago. i'm a woman, 55 years old, 5' 1\", 135 lbs. with no heart condition. i have acid reflux \u2014 currently not taking any medication for it. I have allergy related asthma, smoked for 30 years (haven't smoked for 7 years) and had non small cell lung cancer 7 years ago--no recurrence after chemo and surgery. I take zoloft, atavan, every several months i take otc acid reflux zegerid or prilosec.",
    "doctor_response": "Focus on the acid reflux part and the asthma will resolve on its own . Add sucralfate  and have a lot of water. Do not keep an empty stomach for more than 3 hours. Have small ,frequent meals during daytime.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can chlamydia infection cause permanent problems in male fertility?\n\nHello doctor, I am a 35 year old male. Earlier this year, I had chlamydia for about four months. I have been clear of the injection since about seven months. Now, my partner and I are trying to conceive. I had a semen analysis and the results were not great. The worst part is the morphology. Only 2 % of my sperms are formed normally. The rest are abnormal. So my two questions are: is it possible that the chlamydia is the cause of this? Can chlamydia cause permanent problems for male fertility? Is there anything I can do to increase this percentage? I am taking vitamins and exercising. I am soon going to cut out sugars and watch my diet. Will this help? Are there other things we can do? Lastly, the evaluation said I have a 'poor prognosis' in terms of my morphology. And overall it said I have 'moderate male factor' circled on my sheet (I assume that means - moderate male factor infertility?). But the person who did the analysis said I am suitable for IUI's. How successful are these in my circumstance? I will attach a photo of the evaluation so you can see all my numbers. I have only blocked out personal information. Sorry for all the background. Again three questions: Did chlamydia play a role in my current situation? Anything I can do to improve my normal morphology? How successful is IUI in my circumstance after looking at my evaluation?",
    "doctor_response": "Hello. Chlamydia is one of the major reasons for this situation along with other factors like smoking, and alcohol. Complete the course of antibiotics given by your doctor to improve your semen. Also quit smoking, and alcohol consumption if you are taking. Yes, there are good chances of IUI (intrauterine insemination) in your case because only viable, motile sperms are inserted in the uterine cavity. For more information consult an infertility specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chills after having mosquito bites?\n\nWednesday night I got two mosquito bites that were immediately very large in size, larger than I've ever received. I had chills today. I live in E. Bridgewater, MA where they have Positive West Nile cases. Could this be West Nile or EEE? Does the size of the bites matter?",
    "doctor_response": "Hi, Thanks for posting in HCM. I understand your concern. Size of the mosquito bites what you have got could be due to an allergic skin reaction. Probably because of that, you are feeling chills too. No need to get worried about it right now. Kindly take the following medications: 1. Tablet. Levocetrizine one tablet a day for 3 days to treat allergic reaction. 2. Tablet. Paracetamol 650mg twice a day for 2 days to treat chills. In case you develop fever after few days, you need to get tested for mosquito borne illness like West Nile, malaria and dengue. Hope the information provided would be useful. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for hot flushes ,irritation and mood swings due to monopause\n\nHI. I AM 51YRS OLD AND GOING THROUGH MONOPAUSE STAGE. WANT TO KNOW HOW TO TAKE PRECAUDIONS DURING THIS PERIOD. LIKE E.G. GETTING HOT FLUSHES, FORGETING THINGS, GETTING IRRITATED ETC... PLEASE GUIDE ME WHAT PRECAUSIONS SHOULD BE TAKEN. AND I WOULD PREFFER HOME REMEDIES OR AYURVEDA... WAITING FOR YOUR REPLY... THANKS.",
    "doctor_response": "menopause is sometimes very troublesome.hot flushes ,irritability, depression are commonly seen.here some medicinal treat and basti treatment is going to help you.i would suggest  a combination of shatavi,dasmul,pushanug curna .sutshekhar,chandraprabha,kumari asava are medicines of choice.brahmi ghrut matra nasya will help you.try out mental relaxation procedures like meditation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful penetration of penis into vagina during intercourse?\n\nhai doc my age is 22 and my husbands age is 29,we got married just 3 months before tried to have complete sex for more than number of times but we dint,the problem is his penis is not entering into my vagina,and if it enters a little bit then i have lot of pain ,i feel that his penis is large,and both of our motto is to have sex only for a child and not in enjoying,so u plz say whether is it enough for the penis just to be placed in the tip of my vagina and then he can release the sperm",
    "doctor_response": "Hello dearI understand your concernDo not worry.I have seen lots of case in my practice in which just entry of glans/tip of penis cause pregnancy.Other advises that will help you:You can take following advises:Insert penis very slowly, once you feel pain then stop more insertion and divert mind toward other thing, do some other movement.In starting day you enjoy sex by just inserting glans of penis and gradually increase length of penis insertion.Breath during mouth at the time of insertion. It will relax anal and vaginal sphincter.Use water based lubricant like K-Y gel during intercourse.It make entry of penis very smooth and painless.Also rule out any vaginal / urinary infection, pelvic inflammatory disorder by consulting gynecologist is problem remain persist.Other things that will use if problem persists:Couple of psychological counselling is given along with pelvic floor training by experts.Medications like Botox  and anxiolytic can be use at last.Avoid stress, take healthy diet, drink plenty of water, maintain proper pelvic hygiene and do regular exercise.Hope this may help youContact further if follow up neededBest regardsDr.Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen painful leg inspite of no blood clots?\n\nhi my name is teresa i am 5 4 i have had two tsi pn the past year i am 34 i had a dvt in my leg that is gone i took blood thinner warfin and lovnox but now i had a ultra sound done and they dont see a cloth but my leg is swollen, has pain and i can barely walk",
    "doctor_response": "Hello, It could be a lower limb oedema or cellulitis. Consult a general surgeon and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump above testicle?\n\nI have a lump just above my testicle it is connected to the testicle by something like a bit of string!then from the other side of the lump is a vein leading into my scrotum!the lump is not directly on the testicle but connected!i dont think its the epydermis because i can feel that on my testicle and the lump i feel is further alon the top of the testicle!what can it be?",
    "doctor_response": "Hi,Welcome.Based on the facts of your query,the lump above testicle you have,seems to be INDIRECT Inginal Hernia/or Epididymla Cyst /or Spermatocele/Varicocele/Lipoma of the Cord.The possibility of it being Spermatocele or Epididymal Cyst is less and seems to be INDIRECT INGUINAL HERNIA,as you have clearly submitted that -a-there is a bit of string connecting the limp to the testicle b-and that lump is not directly on the testicle but connected to testicleb- and that you feel the lump on the testicle further on the top of the testicle.Investigation-USG study of the lump would show,air bubbles and fluid levels of the intestines,and would differentiate Indirect Inguial Hernia from the other lumps quoted above. Hope this would help you to plan further treatment with your doctor.Will appreciate your Hitting thanks and writing excellent review comments to help needy patients like you. Welcome with any other further query in this regard.Good Day!!Dr.Savaskar,Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes feeling of lump post marsupialization of Bartholin gland cyst?\n\nI have a Bartholin gland cyst that has already been marsupialised as of two weeks ago. My stitches have yet to dissolve, and I still feel a small lump there. I was on the substitute for Bactrim, but a week after the marsupialization, she put me on the substitute for Augmentin. I have approximately 10 pills left, ordered to take them twice a day, and I have yet to notice a change. Will it ever go away, or should I do another marsupialization?",
    "doctor_response": "Welcome to health care magic. 1.Generally post procedure status of the cyst - might shows some oedema which looks like a cyst, as its still earl post procedure.2.The other possible cause could be reoccurrence of the cyst again - which is also possible in few cases.3.In case of reoccurrence - you need to wait till the stitches heal - and further monitor and plan for a minor surgical procedure.4.Antibiotis are generally indicated after any procedure for better healing and as anti infective.5.So at this moment - you need to take medication and let the area get healed first, then needs examination again after few weeks - if required a repeat procedure or minor surgery.Good luck.Hope i have answered your query,any thing to ask ? do not hesitate to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump around the elbow indicate?\n\nMy husband has arthritis and has developed a nodule on the back side of his arm near his elbow. He is taking Naproxen to possible relieve the swelling. We were wondering how long it usually take to see results or any other information you may have regarding this",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query for your husband thoroughly .*  The lump  around  elbow  can  be  a  lipoma  , sebaceous  cyst  , boil    or  else .*  Needs  clinical  confirmation  or a  photo pic  evaluation  to  confirm  the    diagnosis  and  further  management  guidelines .Hope this clears your doubt  .Wishing  him  fine recovery .Welcome for any further  assistance .Regards  take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will irregular periods affect pregnancy?\n\nHi i have a doubt that am having regular periods every month and I feel something in my stomach. Is there any chances to be pregnant. Because ihave already completed my periods 10 days back. Am also having lower back pain and stomach pain, also mooring headack",
    "doctor_response": "Hi I think you are having the pain of ovulation. It generally occurs in mid cycle.  So now pregnancy is a little bit doubtful, because you got your periods 10 days back. What you can do is to be in contact with your husband for next 2 to 3 days. This will increase chances of your pregnancy. The first sign of pregnancy is not getting your periods on time. Irregular periods can cause problems in getting pregnant as it indicate that ovulation is not occurring regularly. So a thyroid profile and prolactin levels should be checked.Also a ultrasound can be done to see for follicles count. Hope I have answered your question. If you have any other query I will be happy to help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Vyvanse cause severe hair loss? What are the treatments for alopecia?\n\nMy daughter is 12 years old & has been a Vyvanse patient since she was 7. As a child, always having a full head of hair...she is suffering from severe hair loss. She started off on 20 mg. & now that she has moved up to 60 mg. the hair loss is even more uncontrollable. We were always told she had alopecia, We use steroid topical cream for her scalp, but locations of baldness are changing. Nothing seems to be working for her & we need help!!!",
    "doctor_response": "Hello, Perhaps she has alopecia areata. I don't think vyvanse is the cause of her hair loss. I request you to kindly upload a few images of the affected area so that I am able to have a look and guide you accordingly. If it is indeed alopecia areata then she may require either intralesional steroid injections or topical potent steroid applications. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Kakkar S., Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excessive salivation while taking medication for plural fluid in lungs\n\nHello Doctor,My Mother is 63 and was just found to have plueral fluid in her lungs,she s is taking medicines and has to continue for 6 months,lately shes been salivating a lot,m concerned about her health and at the same time want to know the reason behind excessive salivating?",
    "doctor_response": "I do not think that excess salivation is related to her pleural effusion. She may be taking anti tb treatment which she should continue  and consult the doctor for excess salivation",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Zifi effective in the treatment of stomach infection in an infant?\n\nHi, my baby is 3 month old & is passing green poop since a week, my pead gave him econorm 1/2 in morning & eve but no effect for 5 days, then he asked me to do stool test. The results say Greenish, Watery, Mucus present, pH acidic (6.0), occult blood present, pus 90-95 clumps/hpf, RBC 3-5/hpf, stool macrophages 3-5/hpf Lactose intolerance Reducing substance Present++++ Doc has asked me to give him Zifi drops 1ml morning & eve each Kindly guide me, I m worried",
    "doctor_response": "Welcome to ' Ask a doctor ' service .I have reviewed your query and here is my answer .Please note that zifi is a very good antibiotic and let it continue for the doctor recommended dosage and duration .I hope I have solved your query .Let me know if I can assist you further in this query .WITH REGARDS , DR VARINDER JOSHI .",
    "dialogue_context": ""
  },
  {
    "patient_message": "On depo birth control. Boyfriend cummed inside. Chances of pregnancy?\n\nyes i wanted to know if i have been on the depo brith control shot for a month and my boyfirend cumed inside me just a lil do i have a change of being pergant and should i take a peragancey test? ok so saturday me and my boyfriend deside to have sexual intercourse and i was on top of him he said babe can i cum inside you sence you have been on the shot for a month and said i dont know so as we where in the prosses of having sex he said im about to cum so i let him cum just a bit inside me thanking it wouldnt do anyting and the rest he cumed out of me, my question is knowing that im on depo and not letting him cum so much do i have a chance of being pergant or am i just being to worried about it",
    "doctor_response": "Hello,Depot shot is very much effective in preventing unwanted pregnancy and to be taken once in 3 months. It has failure rate less than 0.3 per HWY. Though it takes some times for fully effective, it is advisable to take some back up method like condoms etc for initial 1-2 months.Some amount cum or ejaculation can make you pregnant if it occurs around fertile days or in case of failure of depot shot. You need to wait for next period to be sure.If your next period delays more than 7 days from expected date, then you need to undergo home pregnancy test or blood test for beta-HCG to rule out pregnancy. Following test report, you can consult with your gynecologist.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Allergy with socks\n\ni am getting alergy while using sox",
    "doctor_response": "change the socks frequently. better to use cotton one.you may get fungal infection on waring these repeatdly without drying or changing.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes inflamed prostate while sexually active?\n\nMy boyfriend was just at a urologist apt and he has an inflamed prostate. The Dr asked if he we sexually active and of course the answer was yes. He then asked if I used tampons....what is the correlation between the two ? He has prescribed a cream...not sure what it is yet as Im not home from work yet to see what its called.",
    "doctor_response": "HIWell come to HCMWhen Doctor want to ruled out the infection then such history being taken to know the source of infection and nothing serous it is just suspicion, but this may not be infection, here the age of patient is more important because of Benign Prostrate Hypertrophy, if he is above 50 years then this is very likely, hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tuberculosis\n\nHI I am Dr Shamshad Alam ...I would like to know about a patient who is suffering from cox A female of age 35 was suffering from tuberculosis and medication was given and dr advise her to close the medicine...but she is still seuffering from same condition like dysnea.fever .cough,headche,weight loss etc what should I adivse to her?",
    "doctor_response": "hello, speaking of pulmonary tuberculosis whether it was sputum positive or negative treatment was started of suspicionor basec on CT scan was not mentioned. if treatment was initiated after sputum AFB positivity treatment duration will be of 6 months provided patient has drug sensitive bacilli. if sputum remains positive at the end of intensive phase then suspect MDR TB and send sputum for culture and sensitivity. if patient not improved on ATT suspect other causes of sputum AFB positivity like nocardia and atypical mycobacteria. kindly review the initial diagnosis if it was confirm tuberculosis, check for compliance with treatment and  then proceed with sputum culture and sensitivity testing.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Numb feeling in lip and nose after filling upper tooth. What is the cause and how long will this last?\n\nI got a filling in my front upper tooth last night (with novacaine). My entire upper lip & nose was numb for a good 3 hours. When I woke up this morning, the inside of my nostrils hurt/burned. I thought this would gradually subside as the day wore on, but it has not. The pain feels similar to the pins & kneedles feeling you get when novacaine is wearing off. Do you have any idea what s causing this & how long it might last?",
    "doctor_response": "Hello,Usually the numbness after LA Administration lasts for 24 hours.Chances of administration of LA Solution in overdose is very high in your case.Apply frequent ice packs over nose and lips.Avoid excessive stress or anxiety.Gargle frequently with lukewarm saline.Take adequate rest.Complete course of antibiotics-analgesics has to be administered.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in the lower abdomen and testicle\n\nI have stopped having full bile movements and now I m having pain in my lower abdominal area. My left testical is hurting real bad today. This started a few weeks ago, but seems to have progressed and not subsided. I had a real high fever last Saturday and Sunday. Something is wrong.",
    "doctor_response": "Hi, I think you may be suffering from epididimitis or funiculitis or orchitis. Also possible with viral fever with orchitis. Until examination is done it is difficult to say what it is. Use capsule Doxycycline twice a day for five days. If symptoms not improved please consult your physician he will examine and investigate then treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful leg cramps?\n\nIs there a correlation? Two friends of mine have had a glass or two of red wine with a nice meal on occasion for years. Both friends are female and in their early 60 s. Lately they have experienced painful leg cramps later on in bed that evening. White wine is fine. Any correlation?",
    "doctor_response": "Hello,I read carefully your query and understand your concern. When you drink alcohol, it is absorbed in the blood and transported throughout the body including to the\u00a0leg\u00a0muscles. Alcohol causes lactic acid the same buildup in the muscles you experience after intense exercise, to accumulate in the body, which can cause\u00a0muscle spasms\u00a0and soreness.So,I suggest using a muscle relaxant such as Baclofen three times a day. I also suggest using magnesium supplement for muscle relaxation. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best cure for Acute and Chronic Hepa B ?\n\nHi Im Joan from Philippines, I have Hepatitis B right now. and i did a series of test yesterday, according to the result. I am positive in HBs Ag and positive with HBc Ab? and the rest HBc Ab IgM, HBe Ab, HBe Ag, HBe Ag, HCV Ab are negative? What is the stage of my Hepatitis? Is it Acute or Chronic. What is the best cure for Acute and Chronic Hepa B? Im very worried about this because im planning to work in Qatar soon. Im just waiting to finish my medical here in the Philippines. Im hoping for your urgent response. Thank you very much.",
    "doctor_response": "Hello Joan As u told you have got your lab report positive for Hbs Ag and Hb c ab Hb c ab? Acute Hepatitis B status : HbsAg, Anti HbCag Ig M positive Chronic Hepatitis B status  : Anti HbC IgG, AntiHbsag, HbeAg, HbcAg positive Hbeag seen in bloode denotes infectivity of Hepatitis B",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in upper teeth\n\nHI DOCTOR I AM 27 YRS OLD I HAVE PAIN IN MY LAST UPPER TEETH SINCE 1 MONTH BACK I TOOK ANTI BIOTICS COZ OF INFECTION.MY DOCTOR ADVISED ME TOO REMOVE MY UPPER AND LOWER BOTH LAST TEETHS.BUT I M LEAVING TO INDIA AFTER 1 MONTH SO CAN I WAIT FOR 1 MONTH COZ I WANT TO EXTRACT IT FROM INDIA,BUT I HAVE PAIN STILL.SO IS IT GOOD TO REMOVE IT NOW OR CAN I WAIT.PLS REPLY ME?",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. If you want to wait for 1 month then you have to continue with antibiotics for atleast 7 days and even for painkillers, as these will help to reduce infection. If pain continues after that also then you have to go for the treatment at your place only.Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart murmur?\n\nHi, I'm a 29 year old female and I've got a heart murmur, very slight, and have been having a strange spasm/vibrating feeling just under my rib cage on my left side, in line with my heart. Could this be related to my heart, or unrelated? What do you think it could be?",
    "doctor_response": "hi,    how do you know that you have got heart murmur? told by some doctor? because it is generally diagnosed by a doctor after listening to your heart beats with stethoscope, the feeling that you get in your chest may be due to irregular heart rhythem or due to some muscular twichings, you should get yourself examined.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for skin infection\n\nI started itching a few days ago. I used Canesten because i thought it was normal thrush, but the itching reduced in intensity only slightly, so I used 500mg Canesten pessaries, but it didn t subside. So i used Gyno-Daktarin pessaries and ended up with a light orange discharge this morning. What exactly am i dealing with here?",
    "doctor_response": "Hi, Most probably this is not a fungal infection since antimycotics didn't work. Do a vaginal smear to check the type of infection. May be you need to use antibiotics. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Olgeta Xhufka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medication for depression\n\nI need a counselor for my fifteen year old daughter as soon as possible. She has been diagnosed with depression by her primary care provider, and finding a counselor who is available within a reasonable period of time has been a challenge. I am able to travel up to 50 miles in any direction from the Andes NY (13731) area.",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.You may get this information from your local GP who would be having the list of local counsellors. 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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Was on implant. Less period, UTI, CT came with kidney stone. Reason for pain and nausea?\n\nHiya, I am 21 years old I have had the Implonan since October 13, 2012. It has been about the right time in my head to start getting into the lighter less frequent periods. At the end of February 2013 I started to get pregnancy like symptoms. I went to the doctor had a test, came back negative, but I did have a UTI . I have finished my antibiotics, but in the last few day I have been feeling even more nauseous, in fact I have been vomiting everything I had to eat or drink within 20 minutes of consumption. Today I had gone into the doctor for sever back pain and vomiting. The only 2 times I have ever gotten so sick in my life was when I was pregnant with my daughter (2yrs old now). And last year when I was found with gallbladder issues that resulted in the removal of it. Today they rules out kidney stones with a CT and took a urine sample, stating that it looked clean they sent me on my way with pills to help me with my nausea. Now I have the frequent urge to urinate still, I still feel sick to my stomach even with the pills they gave me but not as badly so I was finally able to keep my food down (so far). The pain in my back is centered in my mid-upper left side and slightly radiates down my back to my upper hip area. I have less fear of being pregnant now since I have gone to the doctor and they ruled that out for a UTI. But I am still concerned since I read someplace that the implant should not cause frequent trips to the bathroom. And since they took my urine today and said it looked clean and that they couldn t find anything wrong with the symptoms described to them, I am slightly fearful that there is an underlying infection that was missed or that the test could have been wrong. My mother went 3 blood tests before they said she was pregnant with me and just recently my sister did a similar thing and did not find out she was pregnant until she was 25 weeks along. Even after countless tests. I have been on antibiotics twice since having been intimate with my boyfriend, at the beginning of the year for a viral infection and then just recently for the UTI. I know some antibiotics makes some birth controls less effective but I have read that they shouldn t not interfere so much with the implant. With my family history of false negatives and the rule out of another UTI or kidney infections , with the feelings that I have been having could they just be side effects of ",
    "doctor_response": "Hi, implants will have side effects, like you have stated, but what ever the alternative you opt may have the same problems. The other possibilities are peptic ulcer, or hepatitis. So i advise you to consult a gastro enterologist for diagnosis and treatment. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can abdominal pain due to a low functioning gallbladder be treated?\n\nHello I have a 13 yr old daughter who has been in pain for 2 weeks and has had blood work, xray, ultrasound, and a hida scan done. The hida scan is the only one that came back as working less than 24%. Doctors want to wait a week or 2 and see if the pain stops with bentyal and zantac. What would you recommend for me to do. She is in pain all that time and worse when she eats.",
    "doctor_response": "Hi, Well, there are some nonsurgical methods but these are mostly unsuccesful. You need to change your dietary habits first. Need to avoid fried food, carbonated drinks, coffee, alcohol and spicy food. You should eat more milk products, vegetables and boiled food. Ursodeoxicolic acid may be used for smaller stones and may dissolve them and ultrasound waves may do it as well, but success is very limited. If there is no improvement on lifestyle or dietary changes, then surgery is recommended. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Iven Romic Rommstein, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I having double vision even after cataract surgery?\n\nHello doctor, Over the last few years, I have watched and photographed several lunar eclipses (no solar ever). About a year ago, I noticed I was seeing ghost images when I looked at the moon with either eye or both 9 w/left, 7 w/right. Went to Ophthalmologist and they said I need cataract surgery. I went with premium Lenses. Well, surgery pulled the ghost images a bit closer to source but still see them. They are now clearer, along with floaters I could not see before. Ghosts only happen at night (moon, white letters, lamps. As the sun starts rising the ghosts start fading. ITS been 8 to 10 months since the last eye was done and still ghosts with either eye or both. I have tried several types of anti-glares. No help.",
    "doctor_response": "Hi. The ghost images are a normal retinal phenomenon known as after images. You need not worry about it. You can see them clearer after cataract surgery because they are a normal retinal response to any image. The more the contrast, the more the ghost images or after images. The floaters are formed as a natural course of aging of vitreous jelly which fills up our eye. Also, it is better to get your retina examined six monthly or at least yearly to look for any breaks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes leg weakness when diagnosed with scoliosis?\n\nWell I have gone to my family doctor and am low on Potassium and Electrolytes so been taking Potassium vitamins or supplements drinking Gatorade. I have scoliosis which is getting worse it seems every day. Right now I am wondering if I have arthritis in my hips--the worst thing is both my legs don t seem to have muscle strength. My knees have collapsed on me a few times hard time standing from a sitting position-- eating habits need to be worked on--- trying to figure out what it could maybe be - thought maybe a pinched nerve my feet are pretty much numb most of the time",
    "doctor_response": "Hi, It could be due to nerve impingement by malformed vertebrae. Consult a neurosurgeon and he will direct you accordingly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy to increase the platelets?\n\nmy daughter is in the ospital now..sahe was suffering dengue fever stage 1..what is the immediate remedy to increase her platelets?her platelets yesterday is 88 and her vital sign is 120/70 and her weight is 60lbs.she was 11 year old.pls help me doc...",
    "doctor_response": "Hi, first of all there is no need to panic. Platelet count above 20000 will cause no harm to the child. Secondly  adequate liquid diet is more important in dengue fever. Usually, the platelet starts to increase as the child improves which usually occurs around 4-5 days of fever. I suggest you to give adequate liquid diet and daily platelet count monitoring of child. Regards - Dr Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the lower abdominal area after bowling. Why?\n\nI am in a bowling league, which is a new thing for me.   I usually bowl twice a week now and we're about 7 weeks into the season.  All of a sudden my lower abdominal area on my left side hurts a lot when i try to bowl.  In fact, I can't bowl right now.  Everyday activity and other activities (such as golf) do not bother it.  Any ideas?",
    "doctor_response": "Hi welcome to Health care magic forum. thanks for calling H.C.M.Forum. You had pain abdomen on left lower abdomen after bowling. It is again paining while bowling only, and not during other games. It appears to be a muscle catch, due to stretch on the left side, while bowling,that is why it is paining while there is stretch on that side. Other causes could be urinary tract infection, stones in the urinary tract, or infection of the descending colon. I advise you to consult a surgeon for diagnosis and treatment. You may need to have M.R.I. besides other routine tests for confirmation. Wishing for a quick and complete recovery. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Done hystoscopy. Treated for TB. Will IVF have an effect on the baby?\n\nI am 33 year old and recently done histoscopy , removed both tubes(damaged) endometrium tissue sent for tb pcr result is positive, doctor advised that we can go directly for ivf , becasue 2 years back i stoped my tb med. course inbetween(only 2 months med i completed) doctor said now again we start there is no effect just we go for ivf directly. my querry is, safe for ivf or if my cycle sucess any effect on baby. please help me i am confused.",
    "doctor_response": "Write your answer hereHi, Thanks for your query. I have read your query & I understand your concerns. Your doctor is wrong. You cannot go for IVF when your PCR for tuberculosis is positive. Please visit a physician and take complete course of TB. After completion of treatment again repeat PCR for TB. Only if negative go for IVF. IVF when TB PCR is positive generally results in negative. Hence loss of money and emotions. I hope I answered your query. I will be available for any followup queries you have. Regards, Dr.Mahesh Koregol IVF & Infertility Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to get pregnant while suffering from polycystic ovary?\n\nHi. i am trying for a baby since 2 years and i am suffering from polycystic ovary   and is it possible to become pregnant and for this i want to meet good gynaecologist. can you suggest some gynaecologist in bangalore. my email address is  YYYY@YYYY .",
    "doctor_response": "Hi,For polycystic ovary problem regular gynecologist follow up should be done. Lose weight if obese. Life style modification done for that regular exercise beneficial. To support the ovarian function and to decrease insulin resistance metformin can be prescribed. Contraception pill helpful in regularizing period If conception still can't occur and to induce ovulation and to induce fertility pulsatile luprolide or clomiphene drug helpful. After all attempt if conception can't occur than assisted reproductive techniques has to be used. With keeping this answer in mind consult gynecologist or infertility specialist nearby for examination and further work up plan accordingly.Hope your concern solved. Let me know if I can assist you further.Regards,Dr. Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I had Mylanta that was expired. Will it cause any problem?\n\nHello doctor, I had\u00a0indigestion, so I took some Mylanta. I did not check the expiration date and had a teaspoon of it. Then I noticed that it got expired some years ago. Will I be fine? Or what should I do?",
    "doctor_response": "Hi. Revert back with the information to a pharmacologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any natural herb that can be taken for arthritis without side effects ?\n\nyes my mother is 86 and have been on loritab for sometime for arthris, what is a naural herb that she can take without the narcostic affects that she is getting I don't get much rest at night from her having talking out of her head dementia. others have told me this is from long term use of loritab.",
    "doctor_response": "dear, thanks for consulting, here r some domestic remedies which are very much helpful and free of side effects-1) METHI powder- 1 tablespoon daily after breakfast 2) garlic - 5 gram    sunthi-5 gram    Nirgundi- 5 gram      make decoction of these three in 500 ml of water till it approx 125 ml of liquid is left , take this twice a day empty stomach3) TERPENINE OIL  MASSAGE4) HOT water+ salt- fomentation of the affected partREGIMENINDICATIONS( PATHYA)steam bath, fresh hot and easily digestable diet, carrot, methi leaves , green vegetables, garlic, onion, karela, ginger, sunthi, buttermilk, tulsi, curry leaves, black pepper,   hot water as drinks and bath are always usefull, along with exercise and yogaCONTRAINDICATIONCURD, COLD WATER ,MILK,URAD-DAL, SUPPRESION OF NATURAL URGES LIKE MICTURITION,FLATUS, brinjal,kaddu , ice cream, unnecessary anxiety, over eating, excess intake of sweets, ghee ,rice, fish ,these all should be avoided till proper improvement.PREVENTIVE ASPECTS1. USE OF HOT WATER AFTER MEAL AS DRINK AND AS BATH WHILE LIVING IN HUMID ATMOSPHERE2. BALANCED DIET HELPS TO PREVENT  ARTHRITIS which occurs due to VATA DOSHA ACCORDING TO AYURVEDA....U CAN come back to me after following this a month. good luck dear...i wil be happy to help u again.  thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the long piece of skin that came out from the anus of a 2 year old?\n\nI just pulled something out of my daughter s butt. She is 2 1/2 years old and has been complaining of her butt hurting for a month. They put her on Miralax, but she still complains. What i pulled out of her butt looked like a long piece of pulled beef. It was stringy but lumped together. I ve seen this several times now, but this was the longest piece. Any idea on what it could be?",
    "doctor_response": "Hi, the long stringy thing that you removed could be a tapeworm or any other parasite. This is also the cause of constipation which required Miralax and is also the cause of pain in the abdomen. Give your child Tablet Albendazole 400 mg single tablet. Repeat the dose after 1 week. She should be alright in a few days. Give her some supplements in form of Bcomplex as infestation leads to malabsorbtion. Syp A to Z 5 ml twice a day will be helpful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pea sized glands in groin, pain in glands, strings in stools, fungal infections in mouth. Endo removed. Advise?\n\nHi i have pea sized glands in groin & feel unwell so far the specialists have not got to the root of the problem,i was tested for cealiac,it was negative,also i was diagnosed with ibs years ago,ive also got Endometriosis its stage 4 theyve just removed endo off bladder & bowel,but glands still ache terribly! Also ive seen what strings in my stools & i always get fungal infections in mouth & skin,any ideas? Thankyou",
    "doctor_response": "Hello! Thanks for putting your query in HCM. I am a Gastroenterologist (DM).Please get evaluated by a Physician as the presence of lymphnodes in groin, presence of fungal infection in mouth may suggest an immunocompromised state.Get yourself evaluated as soon as possibleI hope I have answered your query and this will help you. Remain in touch and get-well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could swelling and yellowing of cheeks after multiple dental anesthesia shots?\n\nHi I was at the dentist yesterday and I required local anaesthetic. However the first two attempts never worked nothing happened so the dentist injected a third time. However after it wore off I am now in a lot of pain. It was a simple filling so it's not that. I have a swollen cheek and it is looking slightly yellow within my mouth. The swelling is so bad inside I can't see my upper back teeth. Is this a common side effect or simply swelling?. I cannot open my mouth fully and it's painful",
    "doctor_response": "Hi... Normally after injection  there pain at site of injection . its normal . but if your swelling is much and if you have tremendous pain then I would suggest you you to meet your dentist .. Chances of infection or some other complication might be . so have check up by your dentist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does shampooing daily and dandruff cause hair fall?\n\nHello doctor,I have had a dandruff problem for very long. So, I started shampooing my hair every day. Even then skipping even a single day of shampooing leaves my hair full of dirt and makes it completely oily. And an itchy scalp is always there no matter what I do. I have started losing a lot of hair recently and I think it is because of all the above problems I mentioned above. What would you suggest me to do?",
    "doctor_response": "Hello. As you have told, you have a dandruff problem and oily scalp that is seborrheic dermatitis which can be mild or can be severe. And yes hair can fall due to dandruff problem. I will suggest a few things for this. For proper hair growth ensure proper diet with Vitamins and Minerals. For dandruff problem, use Zinc Pyrithione based shampoos. Take Biotin supplements that are very important for hair growth. Apply Zinc Pyrithione shampoo or Selsun blue shampoo three times per week. Take Biotin tablet supplements. Apply shampoo for 5 minutes and then wash it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for spinal injury and paralysis without operation\n\nDear sir ,one of my friend his name is Poory, aged 35 years had suffered from spinal injury with T9 fracture and paralysis of both legs.For the operation of spinal stabilization cost will come around one lakh ,so sir we heard about your clinic performance & help,so without surgery recovering possible what sir?",
    "doctor_response": "Hello, I have noted your friend's clinical symptoms. Unfortunately, there is no medical treatment for spinal injury. Urgent surgery with stabilisation of spine is needed so that his disability can be reduced. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Sudhir Kumar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have recurrent fungal infection on my penis. What should I do?\n\nHello doctor, I had a full body to body contact with someone at a massage parlor three months ago. There was no intercourse or oral sex. I ejaculated. I got diagnosed with scabies and a fungal infection on the penis. I took medications for the same and the symptoms went away. However, the burning during urination did not stop. I took other tests and got diagnosed with BV. I took antibiotics for the same. The fungal infection again came back last month at the tip of the penis even though I had no sexual contact. I took an antifungal again and applied Onabet. The infection cleared up. Today, the fungal infection again came back even though there was no sexual contact. Do I need to take any tests? I have attached the pictures. I have taken all the nine PCR tests after nine weeks of contact and ELISA and VDRL after six weeks of contact. All came negative. I have been having pain in the nerves of my lower back since the contact. It goes away and comes back in a week or so. It is recurring and makes difficult to change postures while sleeping and sitting for long intervals. Sometimes, the pain is very severe. It makes me very difficult to stand or sit. I checked C-reactive protein and it was normal. Both semen culture and semen analysis were normal. But, there is a problem with a backache and itching and infection in the groin. Please help.",
    "doctor_response": "Hello. I have gone through your reports (attachment removed to protect patient identity). If the area is not kept clean and dry, this can happen again and again. It is not always associated with sexual exposure. Your all reports are normal. I suggest you continue with the application of the cream. Are you a diabetic? If not tested, please get fasting blood sugar tests. This has nothing to do with the massage which you took in the past since there was no sexual contact of any kind. Back pain is not associated with the present condition. For more information consult a venereologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Would collagen supplements help to deal with dry skin ?\n\nHi! I am a breastfeeding mum, my skin is very dry and the dryness gets worse when I carry on breastfeeding. I drink plenty of water already but it s not helping. So my questions are, what could I do to deal with the dry skin problem? Would collagen supplements help to deal with dry skin? Is it safe to take collagen supplements when I am breastfeeding? Many thanks in advance!",
    "doctor_response": "Hello; welcome to HealthcareMagic Dry skin or Xeroderma is a condition mainly caused by the difference in relative humidity in winter;washing or bathing with harsh soap;deficiency of vitamins A;D;sunburn;systemic illness;and choline inhibitors and even few medicines.The common treatment for dry skin is with emollients; and moisturizers.Now a days there is a big promotion of collagen creams and supplements but as the collagen is a complex molecule the absorption through skin is not possible and even the assimilation after oral supplement is doubtful.Please use moisturizers and emollients and that should help as you are breast feeding you should not take any collagen supplements orally. I hope i have answered your query. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly suggest medicine for a better control of diabetes.\n\nHello doctor,I am diabetic from last six years and taking Pioplus 2, K-vog once in a day. My Hba1C rest is on 8.9, and random sugar is 236. Please suggest me medicine for better control.",
    "doctor_response": "Hello. I need some more information such as your age, weight, kidney function, fasting blood sugar, and post-meal blood sugar or bedtime blood sugar to answer your question. At least done three days per week. And I need a two-week log. That will help me choose the best medicine for you.But from current review, the following is recommended, 1. Start with diet control, and it is a must. Avoid any sugary drinks, including soda, sweets, tea, and juices. Cut back on flour and sugar. No items with concentrated sugar. Cut back on rice, potato, pasta, roti, and bread only eat small portion daily. 2. You are on the maximum amount of medicine. Your doctor may have to cut back on some pills and instead at one bedtime dose of insulin-like Lantus, or Levemir. If your blood sugar is not controlled on so many medicines, it needs a change of treatment for sure. You are more than welcome to request detail consult, and I will be able to suggest you the right plan.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any instant cure for hair loss?\n\nMy query is for any good Dermatologist...I am 24 yrs old female, and loosing hairs in the front portion. My Mother has baldness. I showed to a Dermatologist he said to use Q-SERA HAIR SERUM but for regrowth hair it will take more than 5-6 month i need instant result. Kindly give your opinion on this matter",
    "doctor_response": "Hello ma'am and welcome to HCMFirstly it is necessary to find the cause of your hair fall. In your case it is most probably genetic. Other things to check for are low iron and hemoglobin, thyroid problems, stress, pollution, fever, typhoid, certain medication etc. hormonal changes, menstrual problems etc.You must keep on mind that hair growth follows a particular cycle and new follicles and hairs have to grow over time. These sera like Q-sera help in this process. There is no instant cure to make hair grow. The underlying cause has to be treated to see best results and prevent it from coming back. Any treatment needs to be taken over a few months to see good results. Nutritious diet and rest is also required to help hair grow well. Add a hair supplement like Biotin or follihair capsule daily.Renocia or anaphase shampoo will help with growth.First hair fall will reduce and then new hairs will grow. You will see improvement in 2-3 months but Do take the treatment regularly.At a later date if there is no change at all, you may consult your dermatologist regarding surgical methods like PRP etc.Hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is wrong if I have lower back pain and increased acne?\n\nHi, I ve been noticing lower back pain and it has progressively gotten worse as of yesterday. I thought it was just usual pms symptoms but I m not too sure anymore. I dont know if any of these are relative, but i ve also been having increased acne around my chin. Last month my period was late for 3 weeks, then when it started it lasted 3 1/2 weeks and didnt stop until I took Levora, (doctor prescribed) my doctor has checked my ovaries and said everrything looked and felt fine. Not pregnant and no STI s. Im just nervous something is wrong with my body",
    "doctor_response": "HiYou need not worryif your back pain is jst before your periods than yes it is part of PMSyou need to take analgesic like MEPHINAMIC ACID ( Meftal spas) for 3 days.There is no correlation between back pain and acne.Acne is because of hormonal imbalanceyou need to meet Dermatologist for this.Wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chances of pregnancy when iud is close to expiration\n\nI have a 5yr iud and I have reached my expiration date several months in. Now I have been experiencing a lot of pain and camping. This morning I woke up to feeling really lightheaded and nauseous. I went to my bathroom where I vomited. I have been having sexual intercourse with my fiance unprotectedly. Another thing is I have no money at the moment to remove The iud. Could I be pregnant?",
    "doctor_response": "IUD's work thru more than one one mechanism. While the drug part is wearig off the general effect of any IUD is still active. The risk of pregnancy is pretty low.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a patch of dark skin on the arm of a 2 year old?\n\nhi my daughter is two and has a patch of dark skin on her arm,it started about the age of 6-7 months she wasnt born with it and it doesnt seem to bother her but as she grows it gets bigger and is now covering up almost her whole upper arm and is going down her back...any ideas what it might be?",
    "doctor_response": "Hi,Dark patch from the age of 6 months which has now increased could be due to allergy, eczema, hyperpigmentation. You should get the child examined by skin specialist doctor to rule out above causes. Since the dark patch has increased in size, you should go to a skin specialist doctor without delay. I hope this will help you . Let me know if I can assist you further.Regards,Dr. Deepak Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can hypertensions medications be dropped?\n\nhi, I am 40 years old. I was diagonised with high BP in 2004 and since then I am taking Losar A - 1 tablet every day. My weight is 78 kgs and I am 5 feet 10 inches tall. I would like to know whether I can gradually reduce the dosage and discontinue this medicine or do I have to take it for life as my BP shows normal on with the intake of this medicine. please advice",
    "doctor_response": "hello,these medicine needs to be continued lifelong. Your bp is normal because of your medicine and if you stopped it, it will again rise.      You should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. Regular exercises like brisk walking, jogging according your capacity atleast 30 min a day and 5 days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn't abdominal fat deposition or obesity. Get your lipid profile and sugars tested once..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can I do for sharp pain in the stomach?\n\nHi. I was awoken last night by a sudden sharp squeezing pain my stomach. I was already im pain due to menstrual cramps earlier. But that night i felt pain my stomach too. This is the first time that it happened. Before i sometimes get stomach cramps when I am on my period but only in a minimal intensity. Last night was intense. It\u2019s like wave-like pain. I can\u2019t move really and when i drank water, it is kinda painful. What is this? What can i take/drink to resolve this?",
    "doctor_response": "Hi, You should go to the emergency room. Pain associated with drinking water may be a symptom of kidney stones. A urinalysis will help to guide further diagnostics. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Anders Mark Christensen",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white patches inside the mouth?\n\nI HAVE ROUGH PATCHES INSIDE MY MOUTH ON MY RIGHT CHEEK ONLY I AM A MALE 17 NO ONE IN MY FAMILY HAS CANCER MY DAD HAS DIPPED FOR 30 YEAR THE PATCHES DO NOT CAUSE ANY PAIN AND ARE NOT DISCOLORED I HAVE ONLY BEEN SMOKING FOR TWO MONTHS SO I DONT THINK ITS MOUTH CANCER WE DONT HAVE THE MONEY TO GO TO THE DOCTOR RIGHT NOW SO ANY HELP YOU CAN GIVE WOULD BE GREATLY APPRECIATED",
    "doctor_response": "HiThank you for your query with HCM,  After looking in to your query you have an smoking habit for which i would strongly suggest you to quit.Coming to the patches do you have any burning sensation or any other symptoms?are they scarpabble or non scrapabble?I would definitely say to visit your oral physician for thorough clinical check up which is mandatory. Donot neglect it since you have a family history of same.Hope i have ansswered to your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for alcohol addiction\n\nmy brother age 26, was very angry and very tensed and hitting all the family members at home while using alcohol. He does not sleep in night and he didnt eat any food. only liquid like Tea and Juice and bakery items he eat. we cannot tolerate at all. so please give a good suggestion.",
    "doctor_response": "COUNSELING ALONG WITH MEDICATION IS NEEDED FOR DE ADDICTION.FIRST OF ALL , WE HAVE TO MANAGE WITHDRAWL  FEATURE, AND THEN START ANTI CRAVING MEDICATION.IF ANY CO MORBID PSYCHIATRIC ILLNESS IS THERE, PROPER MANAGEMENT OF MAKE CO MORBID  ILLNESS SHOULD BE DONE.PHYSICAL EVALUATION IS MUST FOR LIVER ,KIDNEY,BSL.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is fuzzy spot on chest x ray dangerous?\n\ni took a medical exam which included a chest xray and i noticed a small blur on the screen. The technician said if its something the doctor will let you know. Well now i have to redo the medical test for three consecutive days. Can you help ease my worries and tell me a reason why i would have to go for three consecutive days?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Fussy spot on chest x ray is commonly seen with 1. Lung infection like tuberculosis or pneumonia 2. Old fibrotic lesions 3. Lung cyst 4. Malignant nodule. To rule out tuberculosis and other lung infection, sputum sample is needed. And specifically for tuberculosis, sputum should be given for consecutive three days. This is standard protocol for the diagnosis of tuberculosis. So get done three sputum sample reports. Also consult pulmonologist for further evaluation of this spot. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes right-sided swollen collarbone and excessive sleep?\n\nThe collar bone located on each side of the neck is enlarge. We have been told it s due to RA. The collar bone on the right has enlarged and he is continually is tired after 10 to 12 hours of sleep. He is 74-yrs. old and work hard and he says he feel find but his body motions say different.",
    "doctor_response": "collar bone is swollen due to rheumatoid and sleep problem is due to sleep apnea. I hope rheumatoid arthritis I not causing problem to heart or lungs.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to get rid of lumps on face\n\nHi Sir, I got few lumps on my face around 20 now.. It increased.. It doesn t pain but but when i shave it disturb and some time by mistake i cut them also. i consulted on doctor.. she told this isnormal wart.. she given few vitamin tablets and removed all by operating it.. But agagin now i got it.. Please advice me..",
    "doctor_response": "Hi Dear,Welcome to HCM team.Understanding your concern. As per your query you have lumps on face which are increasing in number could be due to  have solar keratosis also called actinic keratosis. As you had surgical procedure done and its still reoccurring, I would suggest you to consult dermatologist once and start with application of diclofenac gel and salicylic acid 12% solution on the lesions. Application of TCA solution on lumps on face would also be very effective. You can go for electrocautery cautery under local anaesthesia. This method is little more expensive. Also apply vitamin C serum at night.Hope your concern has been resolved.Get Well soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could red spot on buttocks be a form of pityrissis rosea?\n\nHello. My 12 year old son had pityrissis rosea 3 to 4 weeks ago. Most of the spots are fading including the herald patch on his chest. There is a spot on his buttock however which seems redder and is not fading so quickly. Is this likely to be a form of pityriasis or something else?",
    "doctor_response": "Thank you for sharing your query on Healthcaremagic, I have carefully worked through your case, I think it could be an atypical variant of the Pytirissis Rosea the disease has described both (typical and atypical presentation) although localized pityriasis rosea is an unusual variant, these variations may involve differences in the lesions themselves (size, color) and differences in how they are distributed or both I suggest to keep the treatment because she is in 3-4 weeks of treatment and the rash can last as long as 6-8 weeks before fading.  Please kindly rate if my advise has been helpful   Wishing you a good health   Dr Tania Portelles-Driggs",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having pain in my groin and back after mirena coil fitted\n\nHi ive had the mirena coil fitted 3 weeks ago and have been suffering with pain in my groin and back. I went back to the gynacology unit and they gave me a scan an internal scan and said my coil was in the right place. The pain is more severe on a night and no painkillers ease it. It comes in waves like contractions. My gp prescribed me antibiotics last week in case of infection. I have finished these and the pain is still the same. Please help i cant handle these pains much longer",
    "doctor_response": "Hi welcome to Healthcaremagic Since the Pain in the groin and back caused after the placement of mirena,  you can remove the Mirena IUCD and opt barrier method of contraception(condoms)... If the pain still persists then investigations like USG scanning is needed to find the cause for the pain eg.  kidney stone may also cause pain.. since you had already treated for the RTI ,do not take further anti biotics, remove the Mirena and observe for pain..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the feeling of depression and isolation?\n\ni'm a student i'm getting into lots of depration because of comments by my mom and friends and i'm not able to concentret on my studies and every day is like hell for me i'm not able to understand the meaning of words ppl are speaking i'm feeling like i've been isolated by every one plz help me",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. I sincerely suggest that you are victim of your own negative thinking. You cannot term your current state of mind as clinical depression. Rather, this is just disappointment. Disappointment which arises out of unforeseen life events do bring such symptoms like sadness, irritation, anger, lethargy, lack of interest, lack of appetite etc. Please understand this fact and make sure to introspect. Talking to your friends, out door activities and being creative should give you relief. Find the reason for your disappointment and consult a psychologist if need be. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Got itching and skin problems during third trimester pregnancy and again facing same problem in 10th week, is cetzine a right medicine for me ?\n\nHi Am new to this site hope i will get answer for my problem very soon...Actually am 10 weeks pregnant..Now 11th week is running...I got itching and some skin rashes when am on 9th week..Still i have them ..I met my doctor then she prescribed me cetzine tablet for 2 days and gave me some lotion..I took those tablets after two days those spots are gone..But had little bit itching..3 days back again i got itchy skin and red spots over my body they looks like mosquito bytes small small red rashes..my doctor told me to consult skin specialist..But due to week end i could nt consult any doctor..Again i took cetzine tablet then got some relief..Now those red spots are clearing slowly but still have some itchy skin..I heard those things will be happen in third trimester but i have them at first trimester..Please doctor any one help me out..Can i take cetzine tablet when i have itch...Really am scaring about my baby this is my first pregnancy is there any effect to my baby ...? please hope you understand my tension...Thanks in advance look for your answer.. Thank you so much for this site..............",
    "doctor_response": "hi welcome to health care magic itching in pregnancy can be related to hormone changes or intake of certain food (Fish, brinjal and so on) Cetrizine can be taken but many prefer the drug chlorphenaramine local applications can be used safely and will help you tide over the crisis Please meet your consultant if there is any further problems they will help hope i have answered your query dr Nandita Thakkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest dosage for propranolol\n\nI look after a 47yr old man with profound retardation and is non verbal, his psychiatrist stopped Abilify almost 3wks ago due to it making him very restless. She prescribed 20mg Propranolol 3 days ago to stop the Abilify side effect and he still cannot sit in one place and keeps pacing back and forth. He also has a sprained ankle, but it cannot heal because he cannot not sit down for more than 2 minutes.....Is the Propranool dosage too low? Please Help!!!!!",
    "doctor_response": "hello,You may increase the dosage of propanolol to 40mg, in form of 20mg in morning and then in afternoon. If that dosent help- start trihexphenidyl 2mg in morning and 2mg in afternoon. I hope by taking this his akathesia ( irresistable moving of legs) will reduce and stop. This (akathesia) is a common side effect of abilify and may also reduce with time. Wish you good health.Dr. Manisha GopalMD Neuropsychiatry",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on arm\n\nI have a small hard lump, non-moveable on my left arm, I believe the ulna. No trauma in the area just a lot of painting when it was noticed. The first week it was slightly red and swollen, a little warm, that has subsided but the lump is still there. It is a little tender and the size hasn t changed after the heat and such left. Should I visit my provider?",
    "doctor_response": "HiLooking at your symptoms it seems to be case of boil or fruncle take acetaminophen for painantiseptic cream to be applied locally If it increases in size or redness take  a course of antibiotics under supervision of your doctor Hope this helps you good luck take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Watery discharge from vagina, how can I get pregnant?\n\ni am  married since last 3 years i want to get pregnent i have water secretion from vigina please let me know how can i get pregnent soon i am worried",
    "doctor_response": "Have both of you got investigated for the cause of infertility",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could clear discharge and burning sensation on tip of penis be due to recurring chlamydia or urithritis?\n\nHi I tested positive for chlamydia 2 weeks ago. I was treated with doxycycline and ended treatment this Monday. The symptoms seem to disappear. I was retested on Tuesday with a result of negative. I am experiencing clear discharge again and have a burning sensation at the tip of my penis. It doesn t burn when I urinate though. I am awaiting results for bloodworm for other stds. Does it sound like chlamydia is back or could it be urithritis or something else?",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have been diagnosed to have Chlamydia infection and treated with Doxicycline for a week Now you have burning sensation and have clear discharge from penis .This is mostly due to inflammation of urethra (Uretritis) ..You need to continue antibiotics for couple of days .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stabbing pain at the base of my tongue?\n\nOver the last 3 days I randomly get a stabbing pain at the base of my tongue which causes me to not be able to talk until the pain goes away. I am unable to get anything out, I have to cough a couple times and swallow then I am able to talk again. I recently had sinus surgery too. Any idea what could be causing this?",
    "doctor_response": "hello thanks for the queiry,,it could be tonsillolith,,it could be tonsillitis also,, do salt water gargle thrice daily,,drink warm water,, u may need antibiotics and analgesics ,,so conslt a ent specialist at the earliest if prblm persists,, hope it helps,,tc",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to get headaches,tingling and numbness in fingers while having encephalitis?\n\nmy daughter is 3 years old and 33 lbs. July 10, 2011 she was diagnosed with encephalitis. She continues to complain of headaches and now is complaining that her fingers are hurting (I suspect they are tingling or numb since she hasn t had any injury) The doctors have said there was nothing they could do for encephalitis except run it s course. It has been almost two months. Should she receive a second option or consult with a neurologist?",
    "doctor_response": "Hi, Encephalitis is an acute event and its effects would not progress for two months. She needs assessment if her symptoms are getting worse. However, if encephalitis resulted in brain damage, the sequelae can remain for long. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Sudhir Kumar, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in my head and stomach while i walk?\n\nMy stomach and head both hurt while I walk. Stomach feels upset like it is turning, like I want to throw up and head pain is slight but constant. I don t know how to explain it much better but it only happens when I walk around and after I sit for 10 minutes or so it goes away until I get up again. What s wrong?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. While imaging and tests are the best modality to determine what is wrong, I would say that your symptoms sound concerning enough that i would see a doctor ASAP. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lump on left breast. Ultrasound said heterogeneously dense breast tissue seen. Worry?\n\nI have a lump on my left breast. 6 months ago they did a ultrasound and on the report it says: Findings: Real-time ultrasound examination of each breast fails to rveal any solid, cystic or complex mass. Impression: Benign bilateral breast ultrasound . If a mas remains palpable, alternate imaging modality shoud be considered. BIRAD 1 Negatie Annual mammographic is recommended. Last Monday I went to see my Dr. and had him check the lump again. He said he clearly feels it and sent me for a mammogram and to see a breast surgeon. I did the mammogram and the report says Findings: Heterogeneously dense breast tissue seen, bilaterally. This finding my decrease the sensitivity of this study for evaluation of underlying masses. Fine scattered punctate calcification are seen bilaterally. There is no suspicious cluster of pleomorphic microcalcification seen. In the bilateral axillary regions, there are few subcentimeter masses, some of which are partially visualized. Bilateral axillary subcentimeter masses, some of which are partially visualied, favoring to represent lymph nodes. This Monday I have to go do another ultrasound and see the breast surgeon. I m kind of freakin out right now. It is possible for them to see something diferent on the ultrasound I m going to do Monday from the one it was done 6 months ago. My mom died of metastatic cancer , so I m really worried right now. Thank you in advance for your information.",
    "doctor_response": "Hi, many thanks for the query!You need to do- FNAC (Fine Needle Aspiration Cytology) of the Lump.Also, on physical examination, if it is soft, freely mobile, without any retraction of nipple, no changes in overlying skin, then more likely it is Fibroadenoma/Fibreadenosis, a benign (non-cancerous) lesion, but if it is very hard, fixed/with nipple retraction etc then it may be malignant.So, get physically examined by a Surgeon.Wish you a good health.Take care.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why it hurts badly on lower right side of back near kidney?\n\ni have been having lower right side back pain where my kidney is i have it every day it gets worse n worse i cant get any relief from it i don't know what do to and what it is could u please tell help me i feel like i am gonna die it hurts so bad sometimes i can not move",
    "doctor_response": "Hello,I had gone through the case and found that it might be either renal infection or spine problem.So go for ultrasound of abdomen,  urine test and MRI of lumbosacral region.After getting the proper diagnosis take treatment.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling in the legs when diagnosed with toxemia\n\nI have some concerns I know it s normal to be swollen... but I m very swollen in my legs an feet an face an also my hands an it hurts... I ve heard of toxemia an stuff an I feel as if something is wrong. I m 36 weeks an I have a pacemaker. I don t know what to do really.",
    "doctor_response": "You should hurry to the hospit immediatly.This is emergency case and if you can call your cardiologist , this will be better. Your swelling peripheries mostly due to infection of pacemaker. This may lead to death. Go quikly to save your self.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible through non penetrative sex?\n\nHello Doctor Me and my girlfriend had sex on 7th day from her starting day of period. During sex she din t have her pantie but I had my under wear on me. But my under wear got wet and its near to my girl friend vegina. Is there any chance of pregnancy for her?",
    "doctor_response": "Hallow Dear,Firstly, your body play took place on the 7th day of menstruation. There is no egg present on this day. The egg is released 14 days prior to next expected menses and has life of only 24 hours. The sperms are active for 72 hours. Hence a period on about a week to 10 days around the day of ovulation is fertile period. This is roughly from day 10 to day 20. So there is no possibility of conception by intercourse on day 7. Moreover, body play with clothes on and no vaginal penetration by penis  has no chance of pregnancy even if the ejaculation takes place in the clothes. However, to avoid such stressful situations in future, I would advise you to practise some reliable contraceptive methods like condom, birth control pills or intrauterine contraceptive device. I hope this helps you.Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to control violent behaviour in a dialysis patient?\n\nhi sir this regards to my brother who is suffering frm renal failure since 2006,undergone transplant that too gt rejected and presently is taking dialysis once a week.the present problem is he has started angry every now and then becoz of no reason started destrying things....what should i do?plz help",
    "doctor_response": "HIWell come to HCM Treating such condition with drugs is not advisable because of the renal disease the best of option is moral support, and do not appose his saying on his face be cool and clamp while he gets excited, assured him that every thing would be done according to him, make him fell secure, hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for severe ankle pain\n\nSevere pain n ankle left. Just started today but has become extreme tonight I have iced. unable to walk or put much pressure on it Have had gout symptoms b4 in right big toe Have experienced this b4 chiropractor said could be associated w sciatica Had shellfish at lunch and beer (4) last night",
    "doctor_response": "dear sir / madam  i would like to know any history of injury to your feet, if not you are most likely experiencing gouty arthritis symptoms again.i would also like to examine your feet to confirm diagnosis,investigate for serum uric acid levels.and would recommend analgesics, and to continue ice fomentation,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low blood pressure and low pulse rate\n\nI care for a 79 year old man...going through a lot of testing...everything within normal range....blood pressure and pulse way to low...very weak and tired.....heart is good...had echo cardiogram done....what else can be done for him? Has dementia/alzheimers going to neurologist tomorrow had mri done...getting results.",
    "doctor_response": "With my exp. all his MRI etc will be normal. His low BP is due to dementia resulting in poor conditioning. Low heart rate is not a problem unless he has heart block to dx by EKG. Best treatment is hydration, keeping him active and engaged esp. walking to increase his muscle tone. must be careful to avoid his falling.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for paranoid behavioural disorder\n\nI truly believe my brother has a paranoid behavioral disorder. How can I get him the help he needs?  He is currently taking meds for anxiety and Atavan.  He has begun the process of counseling however he continues to suffer major meltdowns daily, not able to be alone, maintain a job and daily living skills are difficult for him.",
    "doctor_response": "He may have a psychotic illness. However reaching to a diagnosis and treatment plan need more information about his behavior and illness and interviewing him.Get back to me with more information like duration and nature of illness, does he talk to himself, more details about his suspicious behavior, how does he spend his day at home, any addiction? Etc.You also consult a psychiatrist in yois vicinity as interviewing the patient is key to make a decision.Regards, Dr Arun",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for painful rib cage in woman\n\nI have been experiencing a mild pain in my left rib cage. If I eat, within 30 minutes, I experience severe diarrhoea and belly pains. I am very stressed at the moment. Please help as I am very worried. I m a recently single mother dealing with a lot of stress. Thanks",
    "doctor_response": "Dear Patient, Welcome, and thanks for sharing your concern I went through your query, and I feel, you are not suffering from simple rib pain, but something more serious, as your symptoms include belly pain and diarrhea, you could be suffering from from problems of abdomen, please consult your gastroentrologist early I hope my advice would have been useful, in decision making regarding your treatment, still if you have any clarifications or doubts feel free to contact back.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in abdomen, pelvic area. Taking doxycline. Negative STD tests. Causes for pain?\n\nIm a 22 year old male have moderate pain at times in lower abdomen and sometims in pelvic area on movememts like ggetting up from chair or doing a sit up. I have had a 8 panel screen for stds 4 months post exposure I was placed on doxycline from doctor because my original symtoms were an itch in mornings and night in lower scrotum and anus . All my test results came out negative for stds. Was an igg blood test with urine. Wondering what else could be causing my pain??",
    "doctor_response": "thank you.have you any burning sensation during micturition?your pelvic pain is probably due to mechanical pain.  do rutine exam. of urine & usg of kub region.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for heart ailments\n\nHi, may I answer your health queries right now ? Please type your query here...im 28 yrs old wth lack of oxygen o difilcut in breathing,pain at left chest pain and pain of left uper limb and smtime left lower limb,hurt burn.shortnes of breath when try climb a heel or walking a long distance,these ocur more frequent now.i i hv been told i have heart disease.and given atenol tablet 25mg,soluble aspirin 150 mg and amlodipine 2.5mg.what kind of heart disease i have.nd what should i do.askin frm kilimanjaro Tanzania.",
    "doctor_response": "Hello, I understand what you are going through but all will be fine hopefully. Your symptoms point to \"stable angina\". It is caused by the accumulation of fats and cholesterol in your vessels. In order to improve your condition, these are the steps you should follow:- Lifestyle modification is needed. You have to eat healthily, eat more of vegetables, fruits, nuts, whole grains, legumes etc. - Try to exercise regularly, cardio of at least 30 minutes 5 days in a week. Start with on a slow pace not too fast and better in a good weather condition.-Avoid harmful habits like smoking and drinking if you do.- Take medications that have been prescribed appropriately as prescribed. With all of these suggestions, you should be fine. Warm regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bronchiectasis\n\nI have been diagnosed with Bronchiectasis, I am on antibios every other day, walking is impared quite quickly, and I have regular chest infections although they are mild. what is my outlook I am 55 and an ex smoker 35 packet yrs, although tests have shown no smoking related damage. no asthma/COPD.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Bronchiectesis is permanent dilatation of part of airways.It causes collection of secretions and recurrent infections and inflammation. So if bronchiectesis is limited to single lobe of lung, surgical lobectomy (removal if lobe) is the treatment of choice.But if bronchiectesis is bilateral (in both lungs), you should follow these for better symptomatic relief.1. Deep breathing exercises and incentive spirometry.2. Do warm water gargles and steam inhalation 4-5 times a day.3. Take pneumococcal and influenza vaccines to prevent recurrent respiratory infections.4. Take mucinex (N acetyl cystine) once a day. It is mucolytic and expectorant drug beneficial in bronchiectesis.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the indication of chills and joint pain in 93 year old?\n\nMy 93 year old mother has been suffering from chills in the evening (no fever). Temp in the house is at 70. She complains of fatigue. Last blood work showed Creatinine level at 0.90, low EGFR Non Afr American, low WBC and low Neutrophils, Absolute. Was seen by her primary beginning of the week and he did not seem to be concerned. Of course, at the time, I was not aware of the additional symptoms of chills in the evening and joint pain. Would like to go back to the primary with some idea of what could be going on and what else I should be asking my mother.",
    "doctor_response": "Hello,Thank you for suing healthcare magic.I read your question and understood your concern.It looks like viral infection so you can not do any thing just Ibuprofen and drink plenty of water. If there are complications such as pneumonia then need antibiotic treatmentDr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can molluscum contagiosum in a child be treated?\n\nMy 5 year old granddaughter has Molluscum contagiosum. Her Dr. said there is nothing that can be done about it. It is very bad behind both knees, red and yellow looking. It does not seem to bother her but it definitely bothers me. It is awful looking. She does have Escema and attends a daycare. What can we do???",
    "doctor_response": "Hello,The key issue here is that she receives the correct diagnosis. Generally, Molluscum contagiosum will just appear as small bumps on the skin. It should not change color from yellow to red or look awful as you describe. It sounds like she might have a different type of infection that needs treatment.However, if she does have molluscum contagiosum as your doctor says, there are no real proven treatments for it. Topical cryotherapy, imiquimod, salicylic acid, etcetera have worked for some patients. Ultimately, I do not believe she has a molluscum contagiosum infection if it appears as you describe. It sounds like she needs to see another doctor for a second opinion.Hope I have answered your query. Let me know if I can assist you further.Regards,       Dr. Alexander Underwood",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pericoronitis\n\nI have occassional pericoronitis. I've had all my wisdom teeth out except one which the surgeon is hesitant to touch because of its orientation. Is there an over the counter mouthwash I can buy that is good for flushing out my gums other than peridex?",
    "doctor_response": "Hello ,Thanks for consulting hcm Read your query as you have pericoronitis for this I will suggest you to consult oral surgeon go for curretage and inmeantime do warm saline rinses 2 to 3 times a day and you can do betadine gargle twice daily that will give you releif .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taken unwanted 72, vaginal bleeding, lower abdominal pain. How long will it last?\n\ni has sex with my fiancee on 20th i was careful not to ejaculate inside.it was unplanned and we both were having sex for the first time.i gave her UNWANTED 72 after 3 hrs on the doubt as some part of semen could have gone inside and now she is experiencing vaginal bleeding and lower abdominal pain .how can we neutralize the effect and how long will it last. is there any effect on the coming menstrual period. she is about 5ft 5in and 54 kgs.",
    "doctor_response": "Hallow Dear,The fact that she has taken Unwanted 72 within 3 hours of unprotected sex gives her protection against pregnancy. Unwanted 72 is a preparation which contains reproductory hormones Levonorgestrel . Hence after few days when the raised levels of this hormone levonorgetrel start dropping down, there is withdrawal bleeding which lasts only for few days. You do not have to do anything for that. However, if there is some pain in the abdomen, she may take antispasmodic painkiller to get relief. Because of the pills and this bleeding, it is likely that her expected menses will be delayed by few days. Nothing to be worried about. I hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "To whom should i consult for getting pregnant as i have a high antinuclear antibody with cancer cells in my cervix ?\n\nHi, my name is Amy. i have a very high ana level of 1:2560 and am looking at starting a family soon. i have heard that women with my condition have a higher chance of a miscarriage . I have seen numerous doctors and specialists (rheumatologists) who have said that they cant help me and that i will most likely have lupus down the track, another said that i have mixed connective tissue disease . i have been sick for 6yrs on and off now. my immune problems have made me catch a majority of illnesses from the common cold many times a year, two kidney infections very recently and pre cancer cells in my cervix. I would like to know should i see an immunologist or an obstetrician or both? My doctors have said that they dont really know what to do.",
    "doctor_response": "Hi Amy Welcome to HCM Read your prob, you have been suffering from immunmediated disease eighter it is lupus or other connective tissue disorder. in such type of diease there is high chance of abortion either due to diease or drugs which you taken. but mind it there is only chance not sure, so try to concieve baby as per advise of your doc, when you will concieve rule out all congenital abnormalitis of your baby. along with it you should start Syp Gynatol 10ml three times a day for 5 to 6 month, it is a uterine tonic n helps you in getting pregnant. if you have more confusion ask me on Dr aseem 9982583020 aseemadhuri@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for blood and mucus in stool\n\nMy son is 2 and for the last 7 days, he has been pooping bloody mucus. I have taken him to the doc and the er and they all keep telling me that it s just a virual thing. They took one stool sample and said everything was fine, but than took another to do more test. My son weighs 30 lbs and is about 2 feet tall What could be causing this other than a viral thing?",
    "doctor_response": "bloody stool is never due to viral infection. it may be due to bacillary dysentery or worm infestation.  stool for occult blood/ ova n cyst along with culture needs to be done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Left side of tongue numbness since wisdom tooth operation, taking nervz capsules. Will it subside with time?\n\ni have been operated a year before on my wisdom tooths since then my left side of tongue is numb not fully i can feel some but not full it is like 30% from last 20 days am taking nervz maxx capsule. can i be hopefull it will be alright with time. it has recovered since surgery but some days i dnt feel anythng but some days it is worst.",
    "doctor_response": "Hello, Numbness is a very common complication which can happen because of the wisdom tooth extraction. Whether it shall be better depends on the extent of the injury but as you are saying that it has gt better over the period of the year so you can be hopeful of getting better and improving with age. Thanks Dr. Pankaj Malhotra",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for problem in walking after hip replacement surgery\n\nHello I had hip replacement surgery feb 24 didn t have any side effects until last month since then I have had 2 blood clots that came to the suffice and now I can t walk without limping it hurts . The dr has taken 2 viles of yellow liquid and put me on anti bionics I go back wednesday but am afraid my body is rejecting it",
    "doctor_response": "Hello,No your body is not rejecting hip but you have developed infection in the hip joint. I would recommend you to get crp, ESR and culture test of the pus and then start antibiotics accordingly. if there is pain during walking then rest is better. Make sure that your blood sugar is under control.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will sinus infection occur to a 9 year old?\n\nMy 9 yr old dghtr has a headache and a fever for 3 days. The headache was bad at first but has gotten better however she still has the fever of about 101. Also she seems to be very stuffy. Do little kids get sinus infections? I don t hink that her height and weight are important as she is very average and has no prior medical problems.",
    "doctor_response": "Hi, children also gets sinus infection but in that case there would be repeated episodes of headache. I don't think that it is a sinus infection, it looks like common cold. Give paracetamol for fever with cough and cold syrup. I hope this has helped you. Wishing your child good health. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Adenoxyl-Hb safe to be taken during pregnancy?\n\nHi, i am 29 weeks of Pregnant. I want to know that, is it safe to have adenoxyl tablet? It was prescribed by My doctor. In a website i read that using ADENOXYL-HB during pregnancy may raise the risk of children developing some disorder . Is this true? Can i use this medicine regularly.",
    "doctor_response": "Hello,It's safe in pregnancy. It's to treat folic acid and vitamin B12 deficiency. You can take 1 tablet daily from conception till postdelivery for 3 months.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain and pressure in right leg\n\nHello, I have some kind of pressure in my right upper leg. My parents both work in a hospital and they say that it's nothing, it comes back alot of times though and I'm starting to worry.. It hurts the most when I do something with it .. like walking or something.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You may have some muscular pain due to strain or spasm. you should take muscle relaxant and analgesic. If your pain is not relieved then you should go for examination. Consult your doctor and take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lower back pain\n\nI'm a woman of 24 years old,height 164cm and weight 63Kg, I have backache on right hand side of the bottom of my back specially after night sleep. what is the reason and what should I do to prevent it , because it is really annoying.I have no medical history except that I have back ache at the bottom of my right shoulder too for many years.",
    "doctor_response": "If it is at nyt .. could b the matress u use.. Advised to use cotton mattress.. and visit orthopaedic to confirm ur back to b fine  wth xrays and the doc or physiotherapists wl teach u back extension exercises..in case of severe spasm  u can take muscle relaxants wth mild analgeaic n antacids...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe pain in stomach after removal of wisdom tooth, off pain killers. Any allergic reaction?\n\nHey I am 18 years old and about 5ft 10 inches and about 135 to 140lb it is about the 6th day from my wisdom teeth removal and for the past 3 nights I have been have sever stabbing pain in my stomach . I have been off pain killers for 3 full days now and stopped all meds for 1 day thinking I was possibly having a allergic reaction but again the stomach pain returned. One weird thing is during the day it is not as bad but once it gets night time like around midnight the pain spikes up. If there is anything u can tell me please do because my parents believe it is nothing but the pain tells me it is something",
    "doctor_response": "Hello You seem to be suffering from acute gastritis probably caused by the pain killers. Pain killers are notorious in causing inflammation in the inner lining of stomach resulting in acute gastritis. Treatment is simple Stop pain killers Take antacids Avoid spicy foods You may take pantoprozole 40 mg daily in the morning empty stomach foe a week. Please do inform your doctor about this. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Donating kidney to my aunt- kindly give me information\n\ni(17) want to donate a kidney to my aunt(around 45) whom i consider as mother.is it possible to do it? give details regarding the time it takes and money required for operation.i do not care what happens to me.but give the details about my health with one kidney.",
    "doctor_response": "Since you are 17 you have to go through legal stuff like parents permission until you turn 18 which is legal age. You can live a normal life with only one kidney and not even realize it. I have had 3 kidney transplants two from my parents. You would have to go through lost of blood test to even see if your a match. If you are a match you hopefully have good insurance cause its very expensive and almost impossible to pay out of pocket. You as the door would probably be in the hospital a day or two and your aunt about a week if all goes well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause prolonged chronic cough in a person with good lung capacity?\n\nMy husband has had a chronic cough for many years.  it is now much worse.  there is a smell along with it.  He can not speak 3 words without coughing.  Definitely affected by talking. His lung capacity is good, his sinuses look good.  Drs do not seem to be able to diagnose the problem.",
    "doctor_response": "Hello, If the cardiac condition is ruled out for heart failure, chronic cough can be evaluated with pulmonary function test via different capacity and lung volumes if not done yet. In general, the following can be done for lung better functionality - deep breathing exercises- YOGA- fresh air walking- high protein, vitamin diet- avoidance of primary or secondary smoking- avoidance of alcohol- avoidance of exposure to pollen Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hair on the upper lip, advised Elyn cream. What are the directions for use?\n\nhelo doctor , i went to a beauty clinic to remove my upper lip hair. there they suggested the Elyn cream and also said that the hair will fall automatically and they wont come back. is it true doctor? after reaching i read the detailslip which is present with the medicne. in that it is said tat it slows the hair growth instead removing. now what i want to know is i have to remove my upper lip hairs or without removing itself i can use elyn cream ??? which is effective. please help me. thank you.",
    "doctor_response": "Hello I would be pleased to answer your question . Elyn cream is called eflornithine HCL and slows hair growth . When combined with Laser hair reduction it can result Permanent hair reduction. The cream however works to the extent of reducing the growth. Thanks and Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful lump and swelling in the knee?\n\nI have had a swollen left knee for over a week doctor put me on voltaren for inflammation but I still cannot kneel on my knee and now I have a marble size hard lump protruding on my knee cap and it s very sore and tender no injury to my leg has accured",
    "doctor_response": "Hi welcome to healthcare magic forum,Looks like you are having bursitis or may be effusion or early arthritic changes requires needle examination for diagnosis, get a FNAC=fine needle aspiration cytology and X-Ray knee or if needed ultrasound to confirm. Regards,Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does tendonitis in pectoral muscle hurt during breathing?\n\nhi im a 48 yr. old female smoker, hx of respiratory issues such as copd, astma, i went to the pulmonary clinic they did a thoraic ct, thats when they seen the slight copd, and a nodule on my right lung 5mm, just watching it for, now but i have tendonitist in my pectoral muscle should this hurt when  i breathe",
    "doctor_response": "Yes tendonitis can hurt while breathing or with any movement. The nodule in the lung needs to be kept under observation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i take X ray after hitting hard on rock and getting bruised?\n\nHit a rock really hard the other day while rafting...seriously thought I broke something in my hip/buttocks area. Goose egg swollen and bruised under my left butt cheek. Can still walk, but hard to sit down. Should I get an x-ray, or did I just bruise it very badly?",
    "doctor_response": "Hello, It could be a contusion probably. Fracture is unlikely. As of now you can use analgesics/anti-inflammatory combination like aceclofenac/serratiopeptidase for symptomatic relief. You can apply icepacks for faster recovery. If symptoms persists better to consult an orthopedician and get an X-ray done. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump below the knee\n\ni have a lump below my knee towards the inside of my leg, i hve discoloration, brownish color, in a vein pattern close by, lump is somewhat sore to the touch and gets bigger the longer i stand, i had an ultra sound today but the tech could not see it on screen but of course could feel it, i also have one behind my heel that she could see but that one doesnt get bigger and is not sore to the touch, just looking for an opion on what it might be?",
    "doctor_response": "U may have varicose veins, but i would like to know whether u have to remain long time standing or not. if u r a female, and r u pregnant or recently given birth to a baby. Even it can be vascular malformations. Get a colour doppler. Also consult for physical examination of the lump for its consistency and relation to surrounding structures. There should not be a reason to worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fever, sore throat, back pain. Red blotches in upper chest. Any home remedies?\n\nHi, I am a male 25 years of age and for the past couple of days I have had a few symptoms such as fever , sore throat , but also have had problems with my tailbone. I can t sleep on my back nor on my sides, my tail bone hurts in certain positions. I have also recently noticed some red blotches in my upper chest area. Is this something that can be treated at home or do I need to go see a doctor?",
    "doctor_response": "You have to consult a doctor. But for temporary take some ginger juice(3-5 ml) with tulsi(Ocimum Sanctum) leaves, 2-3 times a day. drink Hot water throughout a day. take rest. Fasting will help you to cure fever and other symptoms if possible do it. during fast drink only hot water. For your Tailbone consult nearest orthopedic Doctor, if needed he will take x-ray and diagnose what is problem, once diagnosed you can take Ayurveda treatment for that also.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is my daughter's fever a symptom of dengue or swine flu?\n\nHi doctor, My 3\u00a0year old daughter has a fever for the past three days, and we are giving her Paracetamol. Since yesterday she has running nose and cough. I gave her Crocin twice in the morning three hours back, but her fever is 101.8. Should I give her Meftal\u00a0P? Is there a possibility\u00a0of dengue or swine flu? I am scared.",
    "doctor_response": "Hi. Revert to me if the fever does not go down even after five to seven days. Hope this will help. Thanks. For further queries consult an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the two small symptom-less dots on the tip of penis?\n\nHello doctor, I have recently noticed two very tiny pin sized skin color or pinkish dots on the tip of my penis. I am sexually active but have not been for about four months which was protected. These dots seem to have no feeling when I put my finger over it. Never burns, itches or leaks, only a bother to my eyes. They never increased in size much. Sometimes, get slightly smaller. Do not inflate when engorged. They have been there for about a month and a half now and have not gotten any solutions. I am a 20-year-old male.",
    "doctor_response": "Hello. I have read your query and went through the pictures (attachment removed to protect patient identity), they look essentially harmless and if you do not have any itching and if it does not bother you much, you can let them be. They are either pearly penile papules or overgrowth of sweat glands (sebaceous hyperplasia) and they can be differentiated only on close viewing. That said, both are pretty harmless and are not STDs if that is what you are worried about, but if you do want to get them removed, you can consult your dermatologist and there are minor procedures like radiofrequency to get rid of them.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will travelling to a place with high rates of pollution affect my lungs?\n\nHello doctor, I am a 23 year old male who has just returned home from a year's trip to a country known for high rates of pollution. I am currently experiencing shortness of breath (no coughing) and excessive burping. I will try to provide you as much detail as possible. When I went, I did not have any symptoms. Three months had passed with no problem. Then I slowly started to become tired while working out and eventually at the five-month mark I was exhausted. The main symptoms I had were fatigue (unable to exercise at all), shortness of breath, pain/discomfort in the upper back, and excessive burping. Now after returning (been back for two weeks), I only have shortness of breath and burping. I still feel some discomfort in upper back but not as severe. I went to the ER and got a chest X-ray and blood work (I have listed the tests), all came back fine. So as of now I do not know what to think and I am debating whether to return there as it is known for its high pollution rate in most cities, and at times it seemed that my symptoms fluctuated with the pollution level. I do not know what to think about the shortness of breath. It feels as though I need to take deeper breaths. I am able to exercise again though. I am currently using Omeprazole for the burping. I have been using it for almost two weeks and it is not helping at all. I also have antacid and digestive enzymes that I use occasionally. What are your suggestions for tests I should take or in general? I honestly want to know if it would be a good idea to return given the information I have provided. Thanks for your help.",
    "doctor_response": "Hello. In case all your investigations are normal then you probably have acute bronchitis or associated anxiety. In your case scenario, my suggestion would be antiallergic like Levocetirizine and Montelukast once daily. Addition of Etizolam as an antianxiety drug would help you further. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. I hope it helps you. For more information consult a pulmonologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a raised area around the suprasternal notch?\n\nI have a raised area just south of the suprasternal notch. 56 year old female. Excellent health, former social smoker (1 pack er week over 3 social events ). Weight diet and and exercise all good. Current on all tests. I am menopausal, and medicated for thyroid disease (levothyroxine.25 mcg). What could this be? It s uncomfortable and feels abnormal. Ideas?",
    "doctor_response": "HiThanks for consulting us.supraclavicular lymph node need to be excluded first,which indicates internal serious lung or stomach condition. Clinical examination is needed first followed by relevant investigations.Hope it is useful for you.Feel free to contactPlease rate the answer",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it normal to see blood collection at internal OS?\n\nHello doctor, I am 17 weeks pregnant. In my USG report a blood collection is found of 52 mm x 20 mm at internal os. I am very worried. What is to be done with the problem?",
    "doctor_response": "Hi. How are you doing? After 12 weeks pregnancy, the risk of bleeding is low. Only a bleed from the margins of placenta is to be worried about. Cause of this collection could be: 1. Erosion and thereby minimal bleed from the raw surface of erosion. There may be mild discharge with or without some altered blood. You can have vaginal antifungal or antibiotics like Cansoft CL or Candid V or Clingen Forte once at night for 5 to 7 days. 2. If you have had sex recently. Above medications can be used. 3. I hope cervical length is greater than 2.5 cm and internal OS is closed. If not, you may need a cervical cerclage stitch.  To be on a safer side, you can have:  A. Injection Proluton depot 500 mg IM once in two weeks for 1 to 2 months. B. Capsule Susten or Dubagest or Naturogest or Vagestone 200 mg twice daily vaginally for 1 to 2 months.  These both can be used simultaneously. They both are Progestrone hormone. They relax the uterus and if the blood has any chance to irritate the uterus, these two will stop it. So can prevent preterm labor pains. It is not easy to prevent pain once it starts, so better to use it before any risk factors. I do not think there is anything to worry, avoid any strenuous work, journey and sex.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have a tooth ache, mouth pain. Done X ray. On amoxicillin. Help?\n\nI went to the dentist on Thursday with a toothache at te back top left hand side of my mouth and he done an xray and said I had an abcess. He prescribed me 250mg of amoxicillin to ake 4 times a day. I am still in pain 3 days later and it feels like a toothon the bottom near the front of my moth is sore. The pain is much worse at night.",
    "doctor_response": "Hello there , Thanks for writing your query, Tooth ache indicates bacterial decay or infection in the tooth that involves the tooth nerve tissues or dental pulp. i suspect the tooth infection has gone worse and you have developed a periodontal abscess due to spread of infection to the underlying tissues. This type of periodontal abscess drains in the oral cavity and may lead to nausea and vomiting. once the abscess is drained the infected tooth needs to be explored for root canal procedure. you need to get an x ray done the affected area to confirm the presence of infection, approach a dentist for the treatment. i would suggest you to start with a antibiotic and analgesic course consulting your dentist , which helps in subsiding the swelling and relives pain. i hope this helps , take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I get pregnant when being anemic and having fibroids?\n\nI am 34 yrs old,5'2,118 lbs,2 kids ages 7 and 12.My last period was on 8/22/11(previous period on 7/22/11) 3 or 4 days late,which was unusual.It was also lighter with minimal cramping.I have been feeling some pregnancy symptoms like nausea,sore sensitive breasts with burning sensations on the sides,twinges in abdomen here and there.Last night when I layed down to go to bed,I suddenly started cramping in the lower right abdomen,moving to the middle,briefly on the left,some centralized back pain.The pain was mostly in the lower right abdomen and it lasted for about 2 hours,it felt like my period was coming again.I decided to go to the ER today to see why I had the pain last night.With my first pregnancy,I did not find out until 12 wks and with my second at 8 wks because I still have what seems to be a period.I told the doctor about this,along with my symptoms.She ordered a pregnancy test,she checked me out vaginally,and ordered an ultrasound.During the vaginal examination,she said the side where I was not complaining of pain was a little swollen,possibly an ovarian cyst.After the ultrasound,she said I was not pregnant,but had fibroids and I'm severely anemic,almost needing a blood transfusion.I'm wondering if I could still be pregnant and if being anemic or having fibroids could make the pregnancy undetectable at this time.Physically,I do feel pregnant,but not mentally because I'm confused about what's really going on.If you have any possible answers,I would feel so much better.",
    "doctor_response": "hi healthcare magic user, please get a urine pregnancy test to rule out pregnancy or other option is get blood test called serum BHCG to confirm pregnancy. if report is negative then definitely cyst and fibroid is cause for continuous bleeding .you need to see location of fibroid and treat it before planning for baby.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest dosage of Nervigen and Vitamin D for numbness in hands and legs\n\nHi, My mother is 75 and she has had a joint replacement of her left hip joint. That was some 7 years back. However her problem now is that she has got various pains in her legs, back and tingling and numbness of hands and feet. Now she walks with lots of uneasiness. The local doctor has prescribed Nervigen and Vitamin D(3L units) injections alternately every 15 days for a total of 6 injectios each. Is that a proper dosage. I mean is that too much? Shantanu",
    "doctor_response": "hi,thank you for providing the brief history of your mother.As she has undergone the Hip joint replacement 7 years back, post which due to the weakness of the hip muscles and change in the gait cycle will lead to long term strain on the spine. Due to which now she is having the symptoms like, back pain, tingling and numbness. Also due to ageing there will be a degenerative changes in the spine as well - cervical and lumbar. Also to understand here is the human body is a self healer, and Vitamin D supplement is just a symptomatic treatment, but the actual Vitamin D is available through the sun. IF vitamin D is a supplement than trees and plants will grow without Sun. So i will advice to take sun bath on daily basis, also to undergo physical therapy as by therapeutic ultrasound and TENS therapy the pain will be lowered, but later on performing regular general body exercises which will be of only 15-20 minutes and no strain on the heart is kept in mind. I have personally dealt with similar cases. I am more focused on geriatric cases, so i look to all corners of them and find the best natural possible way to help them. Ageing needs proper attention and rehabilitation plan, medication is only for symptomatic relief, and for the body to function normal, the body has to rise.I will recommend to take physical therapy and sun bath to help your mother with the non invasive treatment.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump under left rib cage\n\nI am getting spasms under my left rib cage in upper abdomen, I also feel a lump in that location, not sure if knot or something else. I am overweight but been working out for over 6 months... also, pain under shoulder blade on left side that is only helped when I bend over and pop something in my shoulder pain subsides for a while till more pressure. I had Hodgkins 18 years ago.. but overall very healthy. I am 41 5'4\" and 240lbs",
    "doctor_response": "Hi,Dear ,thanks for the query to HCM. I studied your query in-depth.My diagnosis-of your case is-\"Muscular spasm with a lumpy feel in left rib cage in upper abdomen\".-Treatment-a-I would advise relaxyl oint locally, with NSAIDs Tbs,c-Physicians -consultation for the relapse of -Hodgkins Lymphoma-is advisable.d-Physical rest and Good food and Good sleep  would add to rapid recovery.e-Tb alprax .25 mg 2 times a day-would control anxiety factor and would reduce the spasm induced lumpy feel -and hence not to worry much about it.Hope This would resolve your query.Well come again for any more query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a nodule in the lung?\n\nHi, I have recently found out I have a nodule in my lung and 4+ cysts in my thyroid gland. I have been sent for a PET scan, the results of which have shown the lung nodule to be benign. I have lost my daughter to cancer and my father has just been diagnosed with bowel cancer so as a family we have been referred to the genetics board. Is it possible that this nodule may turn cancerous in the future?",
    "doctor_response": "Hellothanks for posting here. I have gone through your history and I do understand your concern. As you said, the PET CT shoes that it has no FDG uptake and hence called a bening one,  however it still needs investigation. The cause for the nodule should be evaluated as it may be as a result of infection including  TB (Tuberculosis) or due to an autoimmune process in which the body attacks its own cells. So a biopsy of the nodule should be done wither under CT guidance or by bronchoscopy whichever makes the nodule well accessible. Biopsy should be able to identify if its an infective process or autoimmune process and also br able to identify the cells and rule out malignancy. After biopsy if you get no answers, then you should not worry and follow up the nodule for increase in size by chest x ray or CT every 3 months to see the doubling time of the nodule. In the meanwhile please continue your genetics evaluation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the constant pain underneath breast that radiates to back?\n\nHi Doctor, I have been getting continuous pain just underneath my right breast since the middle of January this year, the pain moves to the right and towards the back. Most of the time the pain is bearable, however, after i have urinated or passed stools the pain seems to increase. Also, My stomach stays bloated majority of the time. I have been prescribed Zantac 150mg to be taken twice a day, this has not made any difference. Please advice. Salma",
    "doctor_response": "Hello,From history it seems that there might be having some problems with your liver like gall bladder stones, swelling in liver etcetera. Go for an ultrasound abdomen and liver to rule out any problem. Meanwhile, continue with Zantac and take some antispasmodic like Meftal spas or Cyclopam. Avoid fried and fatty food. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Ramesh M. Vachharajani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mild stomach pain\n\ni am prawin rungta. before 1 month i got master heath check in appolo hospital.everything was o.k.Earlier i was using urimax 400 as adviced by mallya hospital urologist since 2 yrs. Appolo dr stopped it.but i am filling mild pain bottom stomach right hand and with urine some jhhag passing. Pl advice me to whom i should go for consultancy. i am in bangalore. i am thinking to go nadiyal,ahmedabad.pl advice",
    "doctor_response": "Hi Pravin Rungta.Thanks for your query.Read and understood your health check-up at Appolo Hospital, using Urimax 400. Now that it is stopped, you are getting Jhaag- frothy urine and pain in the right lower abdomen. Your mentioning your age, other symptoms why Urimax was started and stopped , ultrasonography findings would have helped me. I would advise to consult another Urologist in Bangalore and get investigated so that your problem is solved.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for recurring fever?\n\nMy 23 month old daughter has a recurring fever that appears to go away while she is on antibiotics, but then comes back anywhere from a couple of days to a couple of weeks later.  She has been on antibiotics three times in the last two months.  We just finished the most recent round Friday and she immediately began running a fever again on Saturday.  What could be causing this and how can we efectively treat her?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query your daughter is having recurrent fever which is due to impaired and reduced immunity of your body. Need not to worry about it. Take antipyretic drug such as paracetamol and along with that do tepid sponging in between depending on intensity of fever. Visit general physician once and get it examined to find out the cause of fever after thorough investigation. If required request your physician for any lab tests which may be required and start treatment as per that. You can take Crocin as well every 4-6 hrly. You should take Meftal P tablet as well. If symptoms still persists go for blood tests and then start treatment as per that. Avoid cold carbonated beverages. You should get immunoglobin level tested as well.Hope your concern has been resolved.Get Well Soon.Best wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is walamycin ok for 15 day old baby?\n\nmy baby is 15 days old. since afternoon he has passed stool almost 6 time, stolls are loose but not very. i thing he is also having gastro problem as many of the infants have. my doctor has suggested me WALAMYCIN to give to the baby. is that ok for my baby",
    "doctor_response": "Hi,Yes, it is okay for your baby. Walamycin (polymyxin) is an antibiotic commonly prescribed for infections caused by susceptible bacteria. It can be given safely to treat infective diarrhea in neonates. Continue giving him breast feeding and ORS like electral powder may be given to correct mild dehydration. If he develops moderate to severe dehydration  seek advice from local child specialist.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause asthma attack?\n\nI recently had my knee scoped. Today which is 4 weeks after my surgery I felt something like an asthma attack it came on fast and left me wheezy and a hoarse voice after. I am also experiencing tingling in my left hand. I am on a number of medications including fentanyl patch which is my newest medication update. Is this something to be worried about. Other than tingling in my hand and tired and now a sore throat as a result of my attack I feel better",
    "doctor_response": "HiCatching of infection may come from any source including nosocomial route. In such case it should be well managed.A doctor should advise patient for culture and sensitivity test in such condition.Asthma could be a result of infection in Respiratory tract or Allergy also in you case.If I were your doctor I would have advised you preventive measures to skip the possibility of such conditions.Hope this answers your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Puffy face, sinus pressure, headache. Have asthma, allergy. Taking antibiotics, normal CT scan. Advice?\n\nI have a very puffy face , sinus pressure and bad pain, headache , my ct scan came out clear but I have a deviated septum. I just stopped afrin nose spray 3 days ago . All the DR's at the ER or ENT just give me antibiotics , methyIPREDNISolone 21 tabs 4 mg each . My face looks like a balloon but it is not the steroid . I have asthma and allergies and I think I have damaged the inside of my nose from Afrain . Do u know a very good ENT / plastic Surgen in Las Vegas NV? and a very good asthma/Immunology so I can stop suffering.Thank you,Natasha",
    "doctor_response": "Hello Natasha, Thank you for posting your query through Healthcare magic. I am a Homoeopath and so I am giving you some different thoughts. Finally I will show to you a different path towards natural health. The way to health according to Homoeopathy is entirely different from that of conventional medicine. You have travelled a long way along the path of conventional medicine and still asking for help when you lose your way there. It is a pity to know that you have not understood that you have lost your way. This is not your fault; you have not come to know that there is another path to real cure. You have asthma, allergies, puffy face, sinus pain, headache, deviated septum etc.  Please think about the time when you had simple allergic rhinitis followed by asthma. It was a genetic and constitutional feature of your constitution. It was not cured. You took suppressive chemical drugs. Your doctor gave you drugs to suppress the cry of nature demanding cure, because your constitution is not healthy enough to manage by itself. Instead of getting a cure, your sneezing, running nose, wheezing , cough etc, simple symptoms to start with,  were suppressed to make you more sick. In the next stage you had sinus affections, headache, deviated septum etc. with  more serious symptoms. Then also you got nasal spray, antibiotics and steroids from the side of specialists of conventional medicine. Your condition went from bad to worse. Now you know that they have spoiled your nose and what you do not know is the puffy face is the complication of steroids or because the drugs have damaged your kidneys and you are going to be seriously sick if the same plan of treatment is continued . Now you are asking for other more expert specialists of the conventional medicine itself! Please understand that the whole problems are created by the defect of their approach and not of the individuals. Another ENT will give you stronger drugs. Plastic surgeon will repair your damaged nose, asthma specialist will give you more stronger spray or inhaler. None of these approaches is curative or natural. They all work against nature and make you more sick. There is another path to cure that is the path of Homoeopathy. In Homoeopathy there is no chemical drugs. Only dynamic potentized remedies are there. They are individualistic and the selection of your curative remedy is based on your genetics and constitution. They help the constitution to become stronger to fight the allergens without producing ",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the white patch on my uvula?\n\nI went through surgery 2 days ago. They put a breathing tube in and made an incision in my throat to check for cancer in my lymph nodes. Today my uvula has a white patch on it about half way down. It's also longer and seems to be dragging on my tongue when I swallow. Is the white patch something I should be concerned about? Thank you",
    "doctor_response": "Welcome to Healthcare Magic .. A white patch on your uvula especially with a previous history of surgery in the neck nodes is of concern..  You need to have a consult with your surgeon at the earliest and have a biopsy done for the lesion..  Further treatment will depend on the report... Hope this answered your query...",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to improve tightness of penis?\n\nRespected Dr. Andrew, I have never faced any problem in sexual related. But from last 3,4 months am feeling that my penis as not as tight as it was. In last 6 months I have started a lot of smoking and also I masturbate not by hand but by laying downside with movement. I am also a good doing guy height is 6feet and weight 76. Please suggest any medicine or anything please.",
    "doctor_response": "Hello Mr.  Andrew Chronic regular smoking leads to Erectile Dysfunction.  Avoid smoking and try to do regular exercise.  Check for blood glucose level, Cholesterol level, Serum Testosterone  (preferable sample is early morning fasting blood ),  During your masturbation rubbing against the floor did you felt any \"Pop\"sound and followed by immediate loss of erection and swelling of penis if you felt meet an Urologist as early as possible. If you are a known Diabetic or Hypertension patient try to Bring it under control. PIPE test is a diagnostic investigation. If u do not have any comorbid illnesses - Relaxed Stress free mind is ur best Medicine Hope you got your Answers.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes large lump on upper back?\n\nMy husband has a large lump on his upper back. CT shows it to be 10x15cm with fatty stranding, not well defined, no fluid, nodules or mass, unremarkable lymph nodes and no bone involvement. We are awaiting an appt to see a surgeon for biopsy. My brother was recently diagnosed with a liposarcoma on his spermatic cord so that is where my mind keeps going. Any input or ideas would be much appreciated.",
    "doctor_response": "Hello,Thanks for the question.Upper back region is a very common site of a benign lipomatous tumour called Lipoma. It ususally occurs around the middle age and presents with radiological features similar to your case and CURABLE by surgery alone.However, it can only be confirmed by a biopsy(needle or open) or cytology. In my opinion as a Pathologist,A Fine Needle Aspiration Cytology (FNAC )OR a Incisional Biopsy both can confirm the true nature of your husband's lump. It is mandatory and essential for categorization and treatment.Though you did not mention the duration of the lump your husband is suffering from and I suspect it is a long time(months). If that is the case, it emphasises the presence of a benign lesion like lipoma.In conclusion, I would like to mention that, FNAC is a much faster and day care procedure which can alleviate your mental tension quickly. The only downside is you have to go for a biopsy ultimately if it fails or not done and reported by a person who is experienced and familiar with the procedure.Hope this helps.Feel free to contact again for any other question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Using Lomela cream for hyper pigmentation on face, color changes in face except cheeks and temporal areas. What next ?\n\nhi doctor,   Im am using lomela 18g cream for hyper pigmentation on my face for two week.. i got colour changes all my face except my cheeks and temporal areas... All my friends fearing me it must be a rash... wat can i do?/ further continue the cream or stop it at once... and also black heads also turned to pale ou... is the cream safer or has more effect to cause side effects in furtur?",
    "doctor_response": "Lomela cream contains a mid potent steroid mometasone, hydroquinone and retinoid and it is not an over the counter preparation. It should be prescribed by a dermatologist who knows which condition to start it for and when to stop. We do not recommend it daily for more than a month following which we taper it and stop and add on a non steroidal lightening cream. Moreover it is used in pigmentary disorders like melasma and not for improving skin tone. Long term use can cause steroid induced Rosacea, Acne, Thinning of skin, Redness and increased sensitivity to sunlight. Use a sunscreen with spf 30 or more every 2-3 hrs during the day even if you are indoors. Avoid sun exposure as much as possible. Apply non steroidal lightening cream containing kojic acid at night. Hope this helped Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is a 5-week-old spitting after formula feed?\n\nHi doctor, My son is five weeks old and has been having issues with eating. I was not producing enough breastmilk to satisfy him so we began supplementing with formula. We started him on Enfamil newborn which he did not take well. So our doctor switched him to Enfamil gentle ease and he was spitting that up a lot so she then changed him to Enfamil AR which helped a little with spit up. He still spits up a lot but not as much as the previous formulas but now he is extremely constipated to the point where he strains and screams for hours. I am not sure what I can do to help.",
    "doctor_response": "Hello. I got your concern. It is possible due to evening colic or reflux. Do proper burping after feeding. You can start tablet Junior Lanzol (15 mg) half tablet once a day. At present continue same formula feeds. Monitor his weight regularly. For constipation in infants less than six months: If they are passing stool 3 to 4 times a day or once in 3 to 5 days, it is normal. I hope that all his newborn screen is normal.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will thyroid effect the fertility?\n\nHi, I am trying to get pregnant for the last 7 months.my age is 36 years old. I have a 5 year old daughter. In October 2014, my TSH was 12. After taking levoflox(50mgm daily) my TSH is a bit suppressed -0.2My endo has told me to change dosage and take 50mgm every alternate day. All other tests ( T3and T4) are normal Could the fluctuating thyroid affects my conception.I have consulted a fertility specialist and all fertility test were normal(Tubal patency, pelvic scan , ovary function,Lsh level)But my partners Siemens analyses show total motility  at 27% and progressive motility at 4%.what can he do to increase motility and could this be causing problems with conceiving? Are there any other test you would recommend to check fertility-thanks",
    "doctor_response": "Hi thyroid levels do affect pregnancy chances. Get a repeat TSH done and prolactin levels too. Your husband can take some antioxidant prescribed by a doctor. Do a semen culture for your husband as sometimes infections may lead to decreased motility. You can try for ovulation induction with IUI. It will look be a good option for you considering your husband semen analysis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this report signify and is it enough matched to undergo a transplant operation for CKD patient (stage V) ?\n\nI am a CKD (stage V) patient and now on Hemodialysis since jan,2011. My height is 5 5 , dry Weight 50 kg. My age is 22. I Want to transplant. Here is the report of HLA tissue test and cross match report. I want to mention that doner is the sister of my mother. HLA Tissue Type: Patient: DRB1 : 04,07. Other than DRB1 : DRB4. A Locus : 68,_. B Locus : 44,55. C Locus : 1,_. Others : BW4,BW6. Doner: DRB1 : 07,15. Other than DRB1 : DRB4. A Locus : 1,34. B Locus : 13,44. C Locus : 3,_. Others : BW4,BW6. Cross Match Report: T cell cross match: at 4 degree centigrade : 10%. at 37 degree centigrade : 10%. B cell cross match: at 4 degree centigrade : 5%. at 37 degree centigrade : 15%. What does this report signify and is it enough match to undergo a transplant operation ?",
    "doctor_response": "You have a less than perfect match. If you do not have any other donor,You can still go ahead with transplantation but with the use of an induction agent like Anti thymocytic globulin and higher immunosuppression. You will have an increased risk of graft rejection than others with a better match.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could the occipital lymphnodes be indicative of?\n\nhi, i am 27 years old female, i have two occipital lymph nodes for 1.5 months, which are smaller than 1cm in long axis and stays the same. when I check my chain last week, to control if I have any more ones, I realized 2-3 which are smaller than 1 cm again. (I have 3 USGs and 2 full blood tests, saw 3 doctors and they said no problem these are normal) I just want to learn it is possible to make them more clear by poking every moment since I cannot stop myself from touching and poking.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have multiple occipital lymphnodes.  Most probably it is due to reactive hyperplasia of lymphnode due to some infection in scalp area.  Other rare possibilities are tuberculosis or lymphoma. You should take a course of antibiotics. If it doesn't respond to treatment then biopsy diagnosis is advisable. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will there be any consequences of having intercourse withing ten days of taking Siphene?\n\nHi I took siphene tablet because I'm trying to have a baby but my doctor told me not to have intercourse for the first ten days but my husband couldn't wait for ten days so we had intercourse on day three,will I get twins for not waiting after ten days ?fingers crossed I only want one.",
    "doctor_response": "Hi. It is supposed to be started within 5 days of bleeding and you had an intercourse on day 3. It is highly NOT possible to have a conception unless you have a cycle of less than 3 weeks. so just relax, wait for the next period and if does not come , go for preg test.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child having rash in inner thigh, occasionally itchy and spreading. What could it be?\n\nMy daughter, 8 years old, has what appears to be a rash on her inner theigh. The rash started off the size of a half dollar and now is the size of a baseball and has spread to the other side. This started 6 weeks ago. I have put ointment, she states it is occasionally itchy...also put antiitch cream...any clues of what this might be? The best way to describe the rash is raised looking spider veins",
    "doctor_response": "Hi i think rash in the inner thighs can be tinea cruris.it is superficial fungal infection which is itchy .starts as small patch and on repeated scratching it increases in size and darkness.it should be treated with atarax 25 mg at night.terbinafine 250 mg tablet for fourteen days and application of terbinafine ointment",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for herpes and pneumonia?\n\nI HAD SUFFERED WITH HARPEZ AND PNEUMONIA. I HAD TAKEN ZOVIRAX INTRAVENOUS DEPOMEDROL,TRICOT XYLOCAINE AND FINALLY SEFTUM 500 MG. THE ERUPTIONS AND IRRITABLE SKIN IN GROIN AND ARM PITS. MY FACE LOOKED I WAS OLDER THAN MY AGE. ONE DAY OUT OF A MIRACLE I HAD FORMULATED MY OWN DRUG WHICH HAS SAVED ME. THE DRUG IS POWDERED AMMOXYCILIN 500mg, SEFTUM500mg, ALTHROCIN 500 mg, CIFRAN 500mgIN RIGHT PROPORTIONS. I APPLIED TO MY GROIN, FACE, ARMPITS. ALSO LIKE HOMEOPATHY I TRIED TAKING ONE MILLIGRAM OF THIS MIXTURE RUBBED ON EPIGLOTTIS. MY LIFE STYLE HAS CHANGED COMPLETELY AND WOULD LIKE TO RECOMMEND TO THIS ENTIRE WORLD THAT THIS IS A MIRACLE DRUG THAT CAN KEEP IN ABEYANCE MANY DISEASES OF THE WORLD. NO SIDE EFFECTS. EXCELLENT HEALTH, LOOKING 30 YEARS YOUNGER WITH NO DAMAGE TO SKIN AND ANY SIDE EFFECTS, B.SHANKAR SHARMA, MAIL ADDRESS YYYY@YYYY",
    "doctor_response": "Hello, As you explain the long history you should absolutely believe in your treating doctor and follow his instructions. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Jnikolla, Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the blood test regarding knee pain indicate?\n\nHello Doctor, My mother had her blood test conducted . The Haemotology report came out stating Leucocyte count of 14000. The differential count was neutrophills 64 %, Lymphocytes 28%, Eosinophils 05%, Monocytes 03% and Basophils 0. What does this state ? Can you please advise ? She also currently suffers from severe knee pain . Is it related ? Shes 51 years of age. Iam very worried , is this something critical ? Regards, Vinay George",
    "doctor_response": "hi,thank you for providing the brief history of you.A thorough musculoskeletal assessment is advised.As she is 51 years old and having knee pain, it could be related to early OA changes. Undergoing physical therapy should help the pain reudce and also improve the strength of the knee.in my clinical experience I have seen patients with such complaints and physcial therapy helps majority of themRegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to overcome memory loss\n\nsir , but due to regular medication of EPTOIN & CLOBATOR, i am feeling my memory loss and i am a student , due to this medication their is negative impact on my memory, so please tell my how to overcome this problem, as i have to handle my studies too.plz reply",
    "doctor_response": "Hi,Unfortunately these are the side effects of the way the medication works to decrease the seizures. Sudden stoppage of the medication can result in drastic effects. However if it is becoming too bad to the point that you can no longer bear it, you should discuss it with your neurologist and taper it over a period of months. Do not take any decision without first consulting the neurologist/ epileptologist you are seeing.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for hard lumps in eye\n\nI got hit in the eye over a week ago now, all the swelling has gone apart from a hard lump just under my eye about half way up the side of my nose, its not really painfull but feels really annoying, when I press it I can feel slight pain in my teeth? I'm wondering weather to go doctors or will this just go down by itself? Thanks kevin",
    "doctor_response": "HI,Good Evening.Thanks for your query.I studied the query in-depth.I understand your concerns.In my opinion-you have-? periorbital  contusion with nasal and maxillary arch soreness. Consult Facio-maxillary-surgeon--Treatment would be-a-Tb NSAID-/ b-ice compresses to reduce inflammation.c-Tb serropeptidase for 5-7 days would reduce the lump-which is mainly due to the boney contusion.MRI study would elaborate- on any displacement and facial bone un-displaced-fracture.This would help fast recovery and good health.Wellcome again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Attempts at blood draw left dark and painful bruises. Worry?\n\nI recently had several attempts at a blood draw. Each cite has a very dark, large and painful bruise . Four days later, I had 2 more pokes , and again, both of these have very dark and painful bruises. The bruises all exceed 3 inches in diameter. Because this is happening every time I have a blood draw or an IV, should I be worried?",
    "doctor_response": "hithanks for your queryi can feel your concernsi would like to know if you have any history of bleeding or bruising spontanously or at any other siteMoreover do you have any family history of blood disorder? if no other issue,then usually it is due to faulty technique.and need not to worry.it will resolve in few days.However if persist then you need to see your doctor and you may need some blood tests to rule out low platelet count or any bleeding disorderi am available for your helpregardsdr.imran",
    "dialogue_context": ""
  },
  {
    "patient_message": "What would be the cost of treatment of disease hypospadia?\n\nwhat would be the cost of treatment of disease hypospadia in india.",
    "doctor_response": "Hi, I can understand your concern. It can be at approx. 10000 Rs. plus. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for calcified lesion on cerebral of brain\n\nhii myself arpit i have calcified lession on my right cereberall in brain, likely suggestive of calcified inflamatory granaloma with no edema as suggested by ct scan.......is this really serious that needs to be worried about............is it cancerous or affect in future or not............is there any treatement so that it can be disappear............please suggest me i am waiting for the response.........",
    "doctor_response": "You'd need a much more detailed examination process to tell how benign or not that granuloma is.  An MRI with contrast for example would likely be the test of choice in order to further characterize that lesion.  If it turns out just to be a calcified granuloma then, unfortunately, again you have to find out what caused that inflammatory reaction in the first place in order to know how or if there is some type of treatment.  You may wish to bring this question in the PREMIUM FORUM for further analysis.  This is far too complex for short answers like this.  Feel free to direct your question to DR. DARIUSH SAGHAFI (NEUROLOGY) and I will be happy to go over more details of your condition with you including review of your films and other work you've had done so far.     Please rate this response with a STAR RATING if it contained useful information for your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What caused chest pain, breathlessness and cramps in my body?\n\nHi. I m really scared because I ve been have really bad dizziness and headaches for the past few day. It also hurts to pee and breathe most of the time. Also a lot of the time I feel like I m being stabbed down into my chest all the way to my lungs. I have these really bad Cramps on my right side of my body where it will randomly make me fall on to my knees. I really don t want to see a doctor unless I have to.",
    "doctor_response": "thanks for asking your questionin my opinion you should see a physician who may request for some investigations.in my opinion it seems like a viral / bacterial infection diagnosis can only be confirmed by some simple investigations and accordingly you can get the prescription don t panic visit a physician I my patients I prefer starting them on empirical broad spectrum antibiotics and proton pump inhibitors and analgesics like paracetamol and then examine and investigate them thanks feel free to ask more questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "Went off of birth control. Missing periods. Pregnancy test negative. Is it safe to start the pills again?\n\nHi, I went off of birth control a few months ago, and haven t got my period yet. I was worried and took a pregnancy test but it came back negative, and I figured that my body just needed to get my hormones back on track. Now my boyfriend is coming back and i d like to go back on birth control again to be protected. Is it safe to start taking it again even though I still haven t got my regular period?",
    "doctor_response": "One thing is sure that you are not pregnant now . How ever you are taking risk. There are many safe methods of family planing available for both of you. Discus the matter with your boy friend then consult doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stress and depression\n\nLast night my mom had another outburst. ...i am sitting in living room its 9 pm my 18 year old just got up for work. (3rd shift) he is in shower. My mom who usually stays up until 10 or 1030 is in her room door shut. All the sudden here it comes. I hear noone cares about me noone cares i dont feel good & noone cares im trying to sleep noone respects me why hes gotta shower now...this is my house well i was so tired now i cant sleep well at least the g.d. water is off now and on & on. Then she will do these really loud obnoxious yawns all the time. .... Now my son left an hour early for work just to get away from the loud comments coming from her.... I laid down & amcrying. Im so stressed by her hurtful comments. I woke up around 2 & had took pee so bad...i was terrified to get up for fear she may get upset about the floor creaking. So i suffered for like 2 hours. Then this morning wake up and she s all smiles saying good morning all chipper. To make matters worse i went to her around 5 pm tonight and said im gonna wake kenny at 8 to shower is that a good time or should i wake him sooner? She acts shocked & saus why fo i care what time you wake him? You can wake him whenever u want. I said well i know you ve bern going tp sleep earlier so i just didn t want it to keep you up. She says well you can wake him whenever you want if i m awake or asleep. So she is acting like it never happened and she slways denys it. Drives me nuts. Is she unstable? She is 74. And otherwise functions normally...",
    "doctor_response": "DearWe understand your concernsI went through your details. Please understand your mother. Rather than telling she is unstable, understand her condition. I think her old age and failing organs gives her problems. I think dementia. You should talk to the physician who is treating your mother. Tell him all these symptoms and request for further actions. He should direct your mother to a neurologist or psychiatrist. work with them for a cure. Please do not ignore her current behavior. She did so much for you when you were a child. Now her health demands your attention. Please provide it. Take care.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intense pain and numbness radiating from shoulders to hands post surgery?\n\nHi Dr. Rynne. My name is Troy. I am 52 yrs. young. I just had surgery on my cervical region in April 2017. I had C3-C7 fused. I am having extreme pain, numbness and tingling, from the shoulders, down to both of my hands. A few yrs. ago I had a partial shoulder replacement on my right shoulder, I am thinking with the symptoms I am now having, it is the same as when I had to have the right shoulder partially replaced. The pain is quite severe, and when sleeping, since I sleep on my side(s) that arm down to the fingers goes numb and I wake up and switch sides till that arm goes numb...I had the right shoulder replaced due to arthritis...But I am unsure what is exactly going on now. At times, I cannot lift my arm any higher than level with the shoulder. Lifting above the head is a lost cause, and neither arm nor shoulder can lift above the shoulder. I know I need a CTscan but have not yet went and gotten one...I believe it is arthritis, and now it is in both shoulders and causing me a great deal of pain. Thanks for your help!",
    "doctor_response": "Hi, As a first line management, you can try analgesics like Aceclofenac or Tramadol for pain relief. If symptoms persist better to consult an orthopedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can buttock soreness with redness be treated?\n\nHi, may I answer your health queries right now ? Please type your query here... my little girl has a sore bottom its very red it really bugs her at night time theres no sign of worms ...i think she been ruff when wipeing her bum. We have applied sudocream but no luck shes five",
    "doctor_response": "Dear parent, you should combine an antifungal cream together with sudocream 3 times daily for one week . you should complete using both creams for whole seven days even if the redness and soreness resolved to avoid recurrence",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fatigue in atypical parkinsonism patients\n\nI am writing for my husband. He has been diagnosed with atypical parkinsonism. His big problem is being so tired all the time. He needs to sleep at least 16 hours a day and would sleep more if I did not tell him to get up. Showering or just shaving tires him so much he has to lay in bed. His doctor says he cannot do anything about fatigue.",
    "doctor_response": "usually fatigue medications does not work properly with parkinson plus or (atypical parkinson) patientbut a trial of amantadine is good since it may give some benifit",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is hepatitis B the serious case or what ?\n\nhi !! dr.. am staying in thane.. my father is pateint of hepatitis B, can you suggest me Dr's name in thane . 2) q. this is the serious case or wht ? can you explain me ?",
    "doctor_response": "Thanks 4 ur reply..My dr. said 2 my father he having a Heptitise B+, this is the very first satge but, i want to just ask u..is this very serious ? can we do the treatment on that ? how long is the tretment etc..pls. explain about the same one.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could small bump in scrotum & anus be?\n\nHI, Recently I noticed a Small BB sized (or smaller) bump Inbetween my scrotum and anus closer to my scrotum, and it is deep under the skin, cannot see it. and when I push hard on it I feel pressure, It also moves around, I am going to get a physical but before I do I would like some suggestions, i am very worried and do not want it to be cancerous. Please help.",
    "doctor_response": "Thanks for asking in healthcaremagic forum    A bump may be just a cyst/boil/neurofibroma. If may not be cancerous. Please do not worry instead visit a doctor/surgeon for exaination and further management. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do wrinkles on scrotum indicate?\n\nHi, I'm 17 and when my scrotum is loose it looks a bit too wrinkly for my age. I actually haven't compared this with anyone else so I'm not too sure. When it is tight during colder times it looks somewhat smooth, some wrinkles here and there but overall it looks ok.",
    "doctor_response": "Hi,Nothing to worry, this is normal texture of scrotum.During winter scrotal muscles contracts giving rise normal appearance and during hot season due to loose muscles scrotum looks loose and looking wrinkly.Wear well fitted inner wears.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for warm sensation and tightness in the breast\n\nI am 42. 2 days ago I started experiencing a pain in my left side at my bra line and over the last 2 days it has hurt worse and the pain has spread to under my left breast and I have a warm sensation and tightness of my left breast and if I touch my side or under my breast it hurts to touch. I looked online for possible reasons it could be and I think I have decided that it is cyclistic breast pain. I am suppose to start my menstrual cycle in 3 days. Am I right on this or should I see a doctor and when should I see the doctor?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have  warm sensation and tightness in the breast. Well there can be many reasons for symptoms you mention in query like reproductive hormones , changes that occur in the milk ducts or milk glands , fatty acid imbalance , medication use oral birth control pills , estrogen and progesterone hormone . I would suggest you to consult gynecologist for proper examination . Doctor will take histroy , order blood test and mammogram . Doctor may also refer you to endocrinologist for hormonal problem . For now apply warm compresses , take ibuprofen or acetaminophen for pain and wear lose cloths . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for chest pain and tingling in calf and are they related?\n\nHi I am approaching 42 and female. Sine before Christmas, I have been suffering with pressure in the middle of my chest that never seems to go away. sometime the pain radiates to the middle of my back. I have had blood tests, chest x-rays and an ecg - everything was normal - blood pressure fine and oxygen level at 100%. I was told it was possible muscle strain and to take co codemal 500mg. I still have the pressure all be it has improved but is still there but I now have a tingling in my right calf muscle. Is this related?? Should I be overly worried. I never did get a def diagnosis as to my chest pains - no other symptoms. I did have the flu jab just before all this happened and a cold but the Drs have told me there is no link - please advise.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Tingling in right calf and Chest pressure are not related to each other. And no need to worry for major heart and lung related diseases because your all reports are normal. In my opinion, you are mostly having GERD (gastroesophageal reflux disease). It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause central chest pain and Chest pressure. So avoid stress and tension. Avoid hot and spicy food. Avoid large meals, instead take frequent small meals. Start proton pump inhibitors and prokinetic drugs. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having allergic reaction to clindamycin. Prednisone and benadryl prescribed. Severe itching with hives. Need to go to emergency again?\n\nI am having an allergic reaction to clindamycin , went to urgent care the morning received a decadron 1.4 IM at 10:00 AM (pacific time) and was prescribed prednisone 20mg QD x 5d (took at 11AM). Also took 50mg of Benadryl at po at 3pm. It is now 6:30pm and I still have no relief from itching and hives are still visible. Should I go to ER or wait it out?",
    "doctor_response": "It takes 5 -7 days for  drug allergy to subside Wait.Take 2 - 3 glasses war water bottoms up.Repeat if you can again before sleep You start with atarax 25 mgm at night and ebastine 20 mgm twice a day along apply calamine locally",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does the body's immunity respond to measles?\n\nHow does the body's defences respond to the symptoms of measles.I'm not worried about my health or anything i'm just curious to know because i've tried to find information about it for my science assignment but can't find anything which could be of good use.Samuel AlbertAge: 15Haemophiliac If this could get answered as soon as possible it would help me so much thanks",
    "doctor_response": "Thanks for posting you query to health care magic.Virus enter through respiratory tract, reaches blood and spread to RE system of body which is mainly responsible for production of cells of immune system of body .hence this  virus caused depression of immunity.During measles attack bodies immune response goes down  .In such condition chances of secondary bacterial infection are increases because of week immunity .hope you are satisfied with my answer .  feel free to communicate if any query .regards,Dr.Manish PurohitInfectious disease specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could lumps in rib cage suggest?\n\nAbout 3 weeks ago I noticed a hard pea sized bump on my upper left side on my rib cage. It is noticeable just by looking and there is no discoloration and it does not hurt. Since I noticed this two more have started to develop around the same area. Could this be a sign of cancer? Or is there something else it could be?",
    "doctor_response": "Hello there...Recently devloped pea size multiple swelling may not be normal in nature....To get the ciz behind it...some form of investigation may required... like chest X ray and FNAC from lump to exclude cancer..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal cramps without periods, fatigue and heart burn. What should I do now?\n\nHi, I m expected to have my period in 2 days but I have been feeling some cramping pains like you would your period but it hasn t arrived yet...I don t usually get this pain without having a period a few hours later. I ve had this pain for 2 days now and it comes and goes, I also have some tiredness and heartburn . What should I do regarding these symptoms?",
    "doctor_response": "dear ileana, abdominal cramps are, unfortunately, an usual symptom during and before the periods.  Cramps are caused by prostaglandins which cause uterus contracion. The contracting muscles help push the blood out through a girl's vagina during her period. So this contractions can be mild or very unpleasant and can vary from month to month. Also other hormonal disbalances due to menstruation cause nausea, vomiting, headache, fatigue and abdominal swelling. Girls who are younger when their periods start, who have longer periods or heavier blood flow and smoking are a risk factors for cramps. Heartburn can be related to this story but also it can mean tah you have some kind of gastric problems such as GERD, Ulcer/gastritis so you should do gastroscopy to find the exactly whats going on. Use analgetics( nonsteroid) for pain relief because they decrease prostaglandin production in blood. To be sure that you re healthy do gynaecology examination and pelvic ultrasound to check your uterus and ovaries and steroid hormone levels. Wish you good health, Dr. Ivan Romic (Rominho)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent and constant hunger?\n\nHi, I have been diagnosed with pancreatic cancer. Tests were inconclusive, there is a 3cm mass but brushings didn't show any malignant cells. Have a stent in. I am constantly hungry, eat 5 - 7 small meals a day, drink plenty of fluids. No treatment other than homeopathy and major change in diet - cut out most refined sugars etc. Used to drink up to five cokes a day. Is it usual to be so hungry and to constantly eat?",
    "doctor_response": "Hi,Thanks for writing in.The human body requires meals adding up to 2000 kcal each day. It is best to have a heavy breakfast, moderate lunch and light dinner. In your case, since you are having a possible cancer in pancreas, the diet requirements might be slightly on higher side. Also you are taking small meals which number about 5 to 7 each day. This is fine as long your meals are healthy. During illness the brain signals the body asking for more energy and that is a possible reason for persistent hunger. It will help to know any increase in body weight that has happened. You can continue the treatment with homeopathy but regular scan must be done to know the position of the mass in pancreas. Since you have cut refined sugars, you can continue to have smaller meals with lots of fluids. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness , chronic muscle pain and seizure?\n\nIN 2008, I CONTRACTED GBS APPARENTLY FROM A FLU SHOT. TIME DEFINED THE CONDITION AS CHRONIC, I WAS NOT SATISFIED WITH THE DOC IN SALISBURY, MD. ANOTHER DOC FRIEND OF MINE MADE ARRANGEMENTS FOR ME TO BE SEEN BY DR. NICHOLAS MARAGAKIS @ JOHN HOPKINS. VERY SATISFIED WITH ALL MY VISITS & PROCEDURES. RECENTLY, I HAVE BEEN EXPERIENCING SIEZURES. THESE STARTED OUT AS RLS. HOWEVER, IN THE PAST YEAR WHEN I GO TO BED, IT TAKES ONLY A FEW MINUTES BEFORE THE SIEZURES BEGIN. I KNOW WHEN THEY ARE COMING. THEY SHAKE MY ENTIRE BODY, LASTING ONLY A SECOND OR TWO. HOWEVER, I MAY HAVE AS MANY AS 8-10 ONE RIGHT AFTER ANOTHER. I HAVE EXPERIENCED AS MANY AS 140 IN A 3 HOUR PERIOD. I ASKED THE LOCAL DOC TO PERFORM AN EEG. HE SAID IT WASN T JUSTIFIED! I AM CURRENTLY TAKING ROPINEROLE (4mg) EVERY NIGHT PRIOR TO BEDTIME. BORDERLINE SUCCESS. I AM A 72 Y.O. MALE. I AM HAVING CHRONIC PAIN, MUSCULAR & JOINTS, DIZZINESS, BALANCE DIFFICULTIES UPON STANDING SINCE THE G.B.S. I WONDER ABOUT M.S, PARKINSONS & WHATEVER ELSE. WAS HOPING A EEG WOULD GIVE SOME CLUES? WOULD APPRECIATE YOUR INPUT. RETURN BY YYYY@YYYY THANK YOU",
    "doctor_response": "Hi, I am in agreement with obtaining an EEG based on the need for us to be able to correlate an electrical record with the actual episodes of physical tremors/shakes/twitches you are experiencing. In fact, if these episodes are happening frequently enough I would even suggest putting you in a monitored setting for at least 72 hrs. To perform a video EEG recording which would include sleep deprivation and other activating procedures to see if an episode couldn't be provoked. The EEG is not designed to inform on anything as a test except convulsive or seizure activity in a patient. The detection or testing for the number of other conditions you've listed would have to be done by other methods. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes loss of sensation on the mouth and the tongue?\n\ni have the roof of my mouth and the top of my tongue that feel raw, or like you would drank hot coffee and burnt your mouth,it been like this for several week, i have ask my health doctor about it, my heart doctor, but no help, i have also been haveing gastro problem, acid reflux real bad, had them go down with light twice too look around, have done a smart pill test, bravo test twice, and they have done nothing to help . i am takeing zofram for nausea, which i stay like that all the time,zantax 300 mg. and protonix 40mg twice a day. none off this has helped,i ask to see another doctor to see if they can help, this all has been going on for months now. thank you.",
    "doctor_response": "HiAs you mentioned you might have GERD in which the food will regurgitated after swalloing.Coming to your problem that is rawness of your mouth you didnot mentioned about your adverse habits like taking nicotine or tobacco in any form might be the reason. Most of issues you have mentioned will appear due to hyper keratosis or fibrosis or hylanization of oral mucous membranes. Moreover you are on so many drugs which may have some side effect n mucous membranes. so you need complete oral examination form  a oral medicine specialist.Plz visit your oral medicine specialist and gastro enterologist as well.Hope this is useful.Even acids that coming into your mouth also might be the cause.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a swollen testicle with lower abdominal pain?\n\nMy fiancee moves furniture for a living and came home 2 nights ago claiming he pulled something in his groin and balls area. Now, he is having sharp pains in his lower abdomen area...and his balls are real tender, and swollen. Is there anything I can do for him to help ease the pain he isnin???",
    "doctor_response": "Hello welcome to Health Care magic.1.He need immediate medical help.2.The way you described looks like inguinal hernia for me.3.Tenderness and swelling abdominal pain - He need a scortal ultrasound scan including inginal region to rule out hernia.4.Do not delay.Like to ask ? Do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Burning cramp like pain in abdomen, odd spotting, down with cold, mild acid reflux. Cause?\n\nI am a bit concerned as I have been having burning cramp like pain in my abdomen . I have currently got a horrible cold and finished my period on the 2nd but have had the odd day of spotting yesterday which is very usual for me. I am confused as to whether all the symptoms are because I have a cold ? Abdominal pain and burning sensation is a real worry. Pain is worse when lying down, getting mild acid reflux too. What should I do?",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for choosing H.C.M.Forum. You have got burning cramp like pain in abdomen. Pain worst when lying down. there is acid reflux as well. You had period on 2nd, and had spotting on 26th. it is usual for you. you had cold also. The spoting could be suggesting ovulation, cold is separate entity, with cold medicatio you will be fine. The pain i suppose in the upper middle stomach. is suggestive of peptic ulcer, or gastric irritation due to some irritant foods. I advise you to consult a gastroenterologist for diagnosis and treatment. You may have to get gastroscopy besides other routine tests for confirmation. Wishing for a quick and comfirtable recovery. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can tongue marks caused by teeth bites be treated?\n\nhi doctor, when i was a child i had very bad teeth, i lost both my upper molars when i was 12, so i went to a dentist and he gave ceramic bridges on both the sides, i think due to a bad dental job i used to bite the side of my tongue during chewing food, by the time i realised its due to my teeth it was too late, and those repeated bites left a 1.5cm long and 0.5cm wide black marks on the sides of my tongue, now i am 22 and these marks are causing me a problem i couldn't laugh or open my mouth completely in public. please help me.",
    "doctor_response": "Hi,Thanks for posting the query,   First of all one cannot laugh in such a way that tongue is exposed, so you dont get hesitated, it could be just a feeling, the black marks on the tongue are due to the trauma caused, you take a course of multivitamin suplements for 30 days and see the results,mainatin a good oral hygiene, take plenty of fluids which are rich in vitamin C like lemons, oranges,take complete balanced diet.Hope you find this as helpful,Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can taking aleve cause increased AST and ALT levels?\n\nI had full blood work done during a life insurance application process and had high SGOT (AST) (57), and SGPT (ALT) (61) levels.  These results don't seem excessively high, but I want to stop any possibly problems before they seem seriouse.  I am 31, in great shape, no hepititis, and otherwise very healthy.  I drink alcohol, but rairly have more than one or two drinks.  At the time, I was taking aleve for some muscle inflamation, per my doctors request.  Could the Aleve cause a rise in those levels?",
    "doctor_response": "Hi thanks for contacting HCM...Noted your liver enzymes slight high....Naproxen drug you have mentioned if taken infrequently then not lead enzymes elevation...If used for long time then liver affection can occur....Here you are mentioning some muscle inflammation ....So let me know you myositis like muscular inflammation can lead enzymes elevation.So investigated properly and treated....If needed connective disorders has to be ruled out....Second do your USG abdomen to rule out fatty liver and gall stone.....If you are obese then loose weight....If history of unprotected sex and blood transfusion history then HBSag detected by ELISA....Take care.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the pain in right abdomen be due to bilirubin levels and enlarged liver?\n\nI am feeling pain at right abdomen from past 6-7years ago, different doctors were visited, they found enlarge liver by ultrasonography, in recent 13.12,2010, dr anabildutta ,mbbs, found jaundice, bilirubin 2.30mg. At present iam not escaped from it, im in tension, give me suggestion please",
    "doctor_response": "Hi welcome to health care magic... Your detail history needed like.... -Alcohol history -medication history -acute jaundice history -history of activity suspicious toward acquiring hbsag like blood transfusion -liver palpation etc..... You should than investigated with.... -USG abdomen -Peripheral smear examination -SGPT,  SGOT -Urine urobilinogen -Urine biliribin etc.... These will help in rule out nature of jaundice like hemolytic,  hepatocelluar or obstructive.... If suspected than hbsag and HCV detection done with ELISA testing... First consult physician or gastroenterologist and than you can post follow up report for more comment... According to cause further treatment can be guided Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for prostate cancer\n\nmy prostate cancer has been detected ate rtest result is adonocarcinoma,glean score 3+3/10.age 69 years, psa 18,1 after taking calutide 50 the psa is 7.2 and scan c.t result for bone no abnormality and for wnole abdomen heterogenours enlargement of prostate and what will be the tratment procedure and my email id   YYYY@YYYY , mobile 0000, I am from Calcatta,or kolkata, west bengal, india and address neelambar vihar,block-B,flat-108, 40  dum dum road kolkata-700074 ,india, I nn  need your opinion immediately so that I can start my tratment.bksamanta, my name is binay kumar samanta",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You have prostate cancer with Gleason score 6 and PSA 7.2. You need observation only. You should repeat PSA at every 2 months. Per rectal examination at every six months and go for biopsy after 18 months. No active treatment is required for score 6 with PSA 7.2.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swollen scrotum with small lumps that drain fluid and white in pubic hair\n\nI went to the doctor several times for swollen scrotum they told me of cellulitis and treated me with antibiotics and now it is still swollen what small lumps that drain and the fluid turns hard and white in my pubic hair what is wrong penis is swollen as well",
    "doctor_response": "Hi,from history it seems that you might be having some chronic skin infection like dermatitis or eczematous dermatitis leading to soft tissue infection resulting swelling, cellulitis and pus formation.Go for antibiotic medicine course.Apply triple acting cream after proper cleaning.Consult dermatologist and get it diagnosed.Keep local hygiene clean and healthy.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any chance to get pregnant after taking Plan b?\n\nI had sex earlier today for the first time and we did not use any sort of protection other than the \"pull-out\" method and he did not ejaculate at all in me or anywhere near my vaginal opening. We then stopped and about an two hours later we had sex again. During the first time and the second time he ejaculated because I gave him a hand job then cleaned up and went to the bathroom. I went and got plan b to be safe. What are the chances of getting pregnant from some sperm being in the pre-ejaculate fluid?",
    "doctor_response": "Hi, the chance to get pregnant by one unprotected intercourse is 5 to 7 percent. So, you can be pregnant. But as you have taken emergency pill, there is very little chance of pregnancy.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful white spots on palate and red spots on tongue\n\nI had a high risk before 3 years ago. And was tested -ve for Hiv1/o/2 abs qual after 15 months. and I am Negative . But here is something which worries me. 1. 2 pain white spots on roof of my mouth and a red tongue spots. Im married for 2 years. I got married after I got tested for HIV. So after 3 months from my marriage my wife got pregnant and we have healthy daughter have healthy daughter, and now my wife is pregnant. She need to be tested -ve on Hiv 1/2 ag ab plus O which was her screening at 5 months of pregnancy. I am really worried about her and my case. Should I go for a 4 gen or a NAAT test? And how much percentage will you say that I don t have HIV+? I sometime think that my body didn t produce antibodies so far. Please say your advices?",
    "doctor_response": "Thanks for your query, I have gone through your query.The white spots over the palate and the red spots on the tongue can be a fungal infection like candidiasis. Nothing to be panic, consult a oral physician and get it evaluated. Regarding HIV infection, consult a general physician and get it examined. You need to get investigations done to rule out HIV infection.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly suggest remedies to raise RBC count in anemic.\n\nHello doctor, My mother is suffering from anemia. She was hospitalized with hemoglobin 4.6. After two units of blood transfusion, it came up to 6.8 and gone back to 6.3 after 10 days, then another unit was transfused. Endoscopy, colonoscopy, CT-scan have been done but no concrete reason was found. Then serum iron and ferritin test showed ferrozine, cobas / 6000 at 396 micro-gm/dl and ELFA, mini vidas 10.6 ng/ml. She is currently taking Astier XT one tablet per day.",
    "doctor_response": "Hello. Her RBC count is very low with low serum ferritin and high serum iron (attachment removed to protect patient identity). Also, her anemia is normocytic normochromic which is generally seen in bleeding due to chronic blood loss or in chronic disease. Other causes can be chronic kidney disease or liver disease, both of which are unlike since the renal and liver function tests are normal. Since occult blood is present in stool, a gastrointestinal bleed is the most likely cause. But that has been ruled out by endoscopic tests. However, occult blood in the stool may be falsely positive in the following instances if it is a chemical occult blood test, like Iron medication (which is the most likely cause in your mother's), certain fruits and vegetables, Vitamin C, meat. It is better to get the stool tested for occult blood by the immunologic test as it is not affected by these things. A bone marrow biopsy can be done to rule out aplastic anemia. Other causes of anemia of chronic disease should be ruled out like an autoimmune disease. Blood transfusions will not cure the anemia unless the underlying cause is treated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is surgery essential for the blockage in arteries?\n\nMy wife, aged 56, had a heart attack (angina) last saturday and after observation in Vasai Hospital for 2 days had angiography in S.R.Mehta Cardiac Clinic, Kings Circle on 7 Jan 11 and diagnosed with 4 blockages with one major to be operated within a week. Cost may exceed 1 lac. Do you have any solution. Thanking you.Sincerely Suresh - YYYY@YYYY",
    "doctor_response": "Hello, After going through your medical query I understand your concern and I would like to tell you that an urgent treatment for blocked arteries is must especially after and heart attack. Major blockage should be taken care early to prevent any further cardiac Event and to improve cardiac efficiency. It\u2019s recommended for you to have a word with your treating cardiologist to proceed further. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have sensitivity in my molars while having cold water. Why?\n\nHello doctor, My molars are suddenly sensitive to cold water only. Should I concern about it?",
    "doctor_response": "Hello. It does call for concern no doubt, but you need to be careful now with that tooth at least. Sensitivity means your tooth's outer layer has been eroded, so you need to take care of a few things, 1. Do not over brush that tooth or tooth in that area. 2. Avoid taking very hot and very cold food as they may cause shock to the tooth. 3. Do warm water and salt rinse three to four times a day. 4. Must clean your mouth with fingers properly after every meal. 5. If you have any gastritis or stomach related issues, solve it sooner. 6. Do not overthink. It is no big deal. Do revert for more queries. Do follow-up after four to five days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing dilated lymphatic channels under the skin of my glans penis which become more prominent during erection\n\nHi Dr. ChandanI am familiar with the anatomy of the penis, and it seems I have dilated lymphatic channels under the skin of my glans penis.  They become more prominent when I get an erection.  Any idea what this could be?  These vessels were preceded by a fluid filled vesicle I had years ago which I popped",
    "doctor_response": "HIThank for asking to HCMYou wrongly understood it the lymphatic system neither dilate or constrict, this is only possible with the vascular system, if you do not have any clinical sign and symptoms then why to have such weird kind of thinking, I hope this information helps you take care and have good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest chances of TB transmissions with cough and breathing discomfort signs\n\nmy mother suffered from tb and died 5yrs back, i served her during that period, so many time i had cough problem after that got treatment and chest x-ray was done every time dr said tb is not there now a days again i have cough problem though, physically i am fit. i feel a bit sound when i breath and cough is there can my mothers tb has any thing to do with, i want to be sure.",
    "doctor_response": "Hello,Pulmonary tuberculosis is an airborne disease caused by Mycobacterium tuberculosis. There remain all chances of contact transmissions and it can flare at any time after invasion in the body. Get your physical examination, repeat chest x-ray, complete blood counts, ESR, Mantoux test, sputum for AFB primarily. (GeneXpert, pulmonary function test, diagnostic bronchoscopy with bronchoalveolar lavage, CT thorax are secondary stage work-up criteria).Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rash around body. Diagnosed as chronic urticaria. Taking medication, reappearing.  Advice?\n\nSuffer from a rash around my body and was diagnosed as chronic urticariaHe has conducted many tests including examinationCBCAnd rheumatism and examinations of the liver tests did not show any abnormal resultsBut the problem persists and treated with anti-histamine, but my body did not respondThe Kortizon addressed for 45 days on signing 60 mg per day, 30 mg am and 30 mg pmAnd softened by 5 mg dose every 5 daysAnd now stopped taking Kortizon on 05/03/2013But the symptoms reappeared, but slightly on the arms and abdomenPlease advise me because of such symptomsThank you",
    "doctor_response": "Hi, thanks for using healthcare magicIf possible you should have allergy testing done to determine what you are specifically allergic to. Allergy testing can be done as skin tests or as a blood test, they can check for allergens in your environment, foods, medications , chemicals.This would allow you to eliminate what it causing the allergic response.It is important to avoid mental stress, over tiredness , alcohol, tight clothing as all of these are thought to cause or worsen the rash.You may require long term treatment with a non drowsy anti histamine.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have occasional twitches on fingers and toes. Is this a sign of Parkinson's disease?\n\nHello doctor, I am a 48 years old male. A couple of months ago, I was diagnosed with a bulging disc in C6 and C7. I had pain and weakness associated with such a problem, and after some treatment, the pain subsided. Since then, my left index finger developed a twitch. Always at rest and occasionally twitching on and off most of the day. Some days I would hardly notice it at all if any. Now my left middle finger is starting to twitch the same as my index finger, and I do not notice the twitch in my index finger as I did before. And I also noticed an occasional toe twitch on either foot before falling asleep at night. I could blame the finger twitching on the, disc, but the toes on each foot make me concerned. I am concerned about Parkinson's disease. I researched all I could online. I do not have any of the other symptoms associated with the disease. I also tried to figure out the difference between tremor and twitch. It seems Parkinson's tremors are very rhythmic while mine are more sporadic twitches. I have attached a video of my index finger for your review.",
    "doctor_response": "Hello. I watched your uploaded video and would explain that your symptoms are not suggestive of Parkinson's disease. (attachment removed to protect patient identity). This kind of twitching is usually related to different causes like: 1. A pinched nerve, 2. Thyroid gland dysfunction, 3. Electrolyte imbalances, 4. High uric acid levels, 5. Anemia and 6. Vitamin D or vitamin B12 deficiency, etc. For this reason, I would recommend performing nerve conduction studies and some blood tests: Complete blood count, PCR (polymerase chain reaction), Thyroid hormone levels, blood electrolytes, Vitamin D, and Vitamin B12 plasma levels and uric acid plasma levels. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What could be the reason for the recurrent miscarriages?\n\nHello doctor, I have a history of miscarriage at 18 weeks, and hysteroscopy and laparoscopy confirmed cervical incompetence and my polypoidal endometrium was removed. Recently I conceived again with follicle test procedure during which CG 10000 was injected into my blood, but unfortunately, I had to undergo D and C at eight weeks because of no sign of fetal pole (no yolk sac and heartbeat). My TSH value is 7.44. Please let me know the cause of my first miscarriage and lack of proper development and absence of fetal pole in a second pregnancy. Which is the exact specialty which would be best placed for resolving my problem?",
    "doctor_response": "Hello. It is evident by the history that you have cervical incompetence, and that is what the possible cause of your mid-second-trimester spontaneous abortion. Nextly your TSH (stimulating thyroid hormone) levels are high, qualifying you to be hypothyroid, which is the probable cause of anembryonic gestation, the second time. It is essential that your TSH levels should be rough between 2.8 to 3.2 by taking thyroxine supplementation to attain safe levels for conception and avoid future mishaps. Also, it has to be kept in mind that at 16 to 18 weeks of your next gestation, cervical McDonalds or shirodkar stitch has to be applied to the cervix to avoid spontaneous mid-second-trimester abortion. I hope I have answered your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a tight feeling in the chest?\n\nhey i wake up near enuff evry day not able to catch m breathe my chest feals tight but then 3 or 4 hours later it goes aay till the folowing nites today for the first time i felt reali cold dring this i hve been doctor all he replyed was stop smoking",
    "doctor_response": "thanks for your questionyou need to consult a physician to rule out gastritis peptic ulceranginacardiac diseasesquit smoking and alcoholphysician can request for a chest xray , ecg and an endoscopy if needed to lead to a diagnosisI prefer starting my patients on proton pump inhibitors which helps in relieving symptoms  you can disscuss these modalities with your physician thanks feel free to ask more questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can acute wisdom teeth pain be treated?\n\ni dont have insurance and my wisdom teeth are killing me. i have tried orajel, tylenol and baby teeth tablets. they work for a little bit but then the pain returns and its starting to affect my sleep. what can i do to help ease the pain until i can afford to get them removed?",
    "doctor_response": "Hello, Thanks for consulting HCMRead your query ,as you have pain in wisdom tooth this pain can be due to carious tooth , decayed tooth , or impacted tooth . Dont worry I will suggest you to do warm saline rinses 2 -3 times a day and you can take medicine  like Cap . Amoxicillin and analgesic like Diclofenac sodium or Ketrol dt by consulting with your local doctor . Consult your dentist and go for ots treatment. Hope this will help you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is my follicular study normal?\n\nI m having my follicular study and on 10th day in right ovary- 7 mm and left ovary-8mm, endo-8mm on 13th day- right ovary- 12 mm and left ovary-8mm, endo-8mm on 15th day- right ovary- 13 mm and left ovary-12mm, endo-12mmis it fine or is there any problem?",
    "doctor_response": "HAI WELCOME TO HCM HERE YOUR FOLLICLE IS GROWING SLOWLY.YOU HAVE TO CONTINUE FOLLICULAR STUDY TO KNOW ITS GROWTH RATE.IF IT IS VERY SLOW YOU CAN TAKE FSH INJECTION FROM NEXT CYCLE ONWARDS AFTER CONSULTING INFERTILITY SPECIALIST.YOU NEED ONE OR TWO INJ TO GROW YOUR EGG.YOUR ENDOMETRIUM IS GOOD. REGARDS DR.VANITHADEVI",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I get rid of blackheads and get a glowing skin ?\n\ni am 33 yr old unmarried girl, weight 45 kg, height 5.3, my skin seems to be very dull and blackheads on face appears, what to do",
    "doctor_response": "Hi, Welcome to HCM. You seem to be underweight due to which your skin is dull. You need to have lots of fresh fruits and vegetables along with healthy nutritious food which help you to improve your skin texture as well as your hair.Consume lot of water which will hydrate your skin and eliminate toxins from the body. You can also use basen mixed with haldi or lemon with honey on your face.A facisl scrub will help you remove blackheads. Have a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for controlling high blood pressure\n\nyes. my boyfriend takes workout drinks regulary to workout. they have increased his blood pressure. he has a physical for a job, and beign a bit anxious has raised it a bit more, is there a tip or trick to lowering it for a short time. to get to a more normal number?",
    "doctor_response": "Hello and thank you for using HCM. I carefully read your question and I understand your concern. I will try to give you some advises.In our daily practice in treating hypertension  it is very important to look for secondary causes of hypertension. This is very important if we are dealing with a young person, because in this category secondary hypertension is very common. It means that it is a secondary disease or factor causing hypertension. It might be a renal problem, an endocrine or congenital problem.So first of all, my opinion as a cardiologist is that it is mandatory to do a full chek up beginning with a blood analyses, an electrocardiogram, echo-cardiograph, thyroid  hormones.After this, we might judge for others.The first thing to do when treating hypertension is lifestyle modification. If i was your treating doctor i will recommend to stop every workout drinks. In general, they have caffeine, taurine and stimulant factors that rise blood pressure values.Your boyfriend should reduce alcohol and salt intake in daily eating. They booth rise blood pressure.He should stop smooking if he smokes and have a low fat diet to reduce blood lipids if they are high.This are just the simplest and the first thing to do. My opinion is that you will see a good result. If high values persist than he should make a deeper cardiologist consult.I hope i was helpful. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause for sharp pain in chest and abdomen along with discharge?\n\ni had a mayjor pain, like an intense indegestion, in my chest and a sharp pain in my lower left abdomen, i am two weeks late, took the pill, had intercourse the next day and stopped taking my pill, i also have hardly any appetite, am very hot, to the point were i am not moving ...but still sweating, was constipated, - not any more ( returned to nomal) and have had alot more white discharge then normal, and bloating .... please help",
    "doctor_response": "Hi, Your symptoms seem to be related to a possible pregnancy. You can take a pregnancy test now to determine/exclude it. If not pregnant, the symptoms might be related to hormonal changes due to your monthly period. At this point, I'd suggest to run further tests: - urine analysis- vaginal swab testing- abdominal ultrasoundDepending on the tests results, specific treatment will be prescribed!Dr.Albana",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can infection of tonsils be confirmed?\n\nHi, I have been having trouble with my tonsils on and off for a few months now. I ve recently noticed I have some kind of piece of my right tonsil sticking out next to a hole. I do not have any pain and it doesn t look infected in any way, although it s quite uncomfortable to feel the little piece moving while I speak and eat food. What do you think is going on?",
    "doctor_response": "Hello,Thank you for your contact to healthcare magic.I understand your health concern, if I am your doctor I suggest you that take the swab from the suspected infection site. Do Gram's Staining, culture and sensitivity from that swab. If it is infection it will give a species of bacteria causing infection and also the effective antibiotic on it.I will be happy to answer all your future concern. Thank you,Dr Arun TankInfectious disease specialist.Wish you a best health at health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is an itchy ringworm-like patch on forearm be related to the MRSA?\n\nHello. I just found out yesterday that I have MRSA in my umbilical surgical incision. The hospital has been trying to contact me with the results for 3 weeks, so it has, unfortunately, been untreated for those 3 weeks. A couple of days ago, an itchy ringworm-like patch appeared on my forearm. Could this be related to the MRSA? I have been feeling extremely fatigued and have had a low grade fever for the past 2 days as well. I did start the correct antibiotic today but it is too soon to feel/see any results yet. Thank you for any help.",
    "doctor_response": "MRSA may produce the lesion which may mimic in the early stages but it is usually accompanied by pain rather than itching. As the MRSA infection is quit serious infection my frank opinion to you is that if in doubt do not waste the time & consult your physician as the  exact diagnosis regarding the lesion can only be given after the proper visual impression of the lesion. As MRSA are multi drug resistant proper choice of the antibiotics also required.Even though the patch on your forearm  may not be the MRSA you should be very careful about the MRSA in surgical incision.BUt as said above the itchy patch with the looks like ring worm has less chances of being due to MRSA.But according to me your MRSA of more concern than patch . Take care !!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurrent abscesses on various parts of the body?\n\nMy daughter went to Mozambique Africa for 3 months.  While there she began getting abscesses on various parts of her body.  Since returning home last week, she has gotten another one.  She was prescribed 4 different antibiotics while in Africa.  They obviously haven't gotten rid of the source, which we expect to be a parasite or staph infection.  Once returning to the States, she had blood and stool tests done to check for parasites.  All negative.  Had a culture taken of an abscess to check for staph.  Negative.  I'm trying to find out how a person determines the source of these recurring abscesses so we can solve this problem.",
    "doctor_response": "HI, thanks for using healthcare magicShe should consider seeing an infection control specialist.They are doctors that specialize in the diagnosis and treatment of infections.They should be able to help determine what is causing the repeated infections.Your doctor should be able to refer her to one, or she can locate one in her area using healthgrades, zocdoc or webmd physician directory.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for heart palpitations and rapid heart beat?\n\nHi! i am female 26 yrs old,having problem of heart palpitation .. mostly in the morning time its about 120 - 130 beats per min n remain for about1  or 2 hours .. in day or night tym also heart beats very fast sometimes its about 140 per minute.. symptoms include thrust , light headness , little breathless feling , n feeling of heart racing , n its lyk some1  sequze my neck its lyk ..  weekness ..wht is it ? is it due to heart problem ? or its stress related?",
    "doctor_response": "Hi,It doesn't look like a heart problem. It can be due to anxiety, and low hb. So you should get your hemoglobin done and use some relaxation techniques like yoga, deep breathing to relieve anxiety. Also you need to one thyroid test done. Till that time you can get tab Ciplar LA prescribed from your local doctor.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had flu, cold, mild chest pains. What to do?\n\nhad flu for two weeks, which then turned into a cold , practically every time I go out I catch a fresh cold, this has been going on for nearly three months now. im always well dressed eat well drink plenty of fluids, fruits and veg. mild chest pains from time to time. before my flu I know my immune system was pretty low as I was recovering from two episodes of gastro , 2 days later I caught flu. Never had flu in my life rarely colds either. I am 49 years of age.",
    "doctor_response": "Hi, Thanks for using HCM.You may be suffering due to lower immunity or due to allergy. Continue your healthy practice of taking nutritious food, dressing habbits and do exercises regularly. This will increase your resistance to infection. Allergy can cause allergic gastro enteropathy, allergic rhinites and also asthma. Since you have some of these symptoms get done one skin test to rule out any allergic cause. Get done complete hemogram, HIV and HBsAg investigation once.  Consult your doctor for examination and management.Hope I answered your question. Feel free to ask me if you have any further queries. Wish you good health. Take care.RegardsDr. Vidya",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes functional cyst in ovary with infertility?\n\nI have some query regarding pregnancy.Actually I have been trying to conceive for two months,but somehow it s not happening.Regarding my medical condition i would like to mention that my average menstrual cycle is 33-37 days.Right ovary size is 42x21mm and Left ovary-Bulky, measures 58x44mm.Show functional cyst, measures -45mm.So I would like to know why am i not able to conceive?I m sorry if i did bother you.Thanks in anticipation.With regards,Amrita Chatterjee.",
    "doctor_response": "hello...thanks for trusting the healthcare magic doctors for ur health related queries.I guess ur concern is about..what causes functional cyst in ovary with infertility..right.first I want to discuss about the functional cyst. they are may be follicular cyst or may be corpus luteam cyst etc. among these follicular cyst is most common functional cyst. it is formed, when follicle not ruptured during ovulation n trapped inside the ovary. in this way it is formed a cyst with passage of time. but it is not a big deal. it will resolves with time n most of the cases not required any treatment. but in few cases it can causes abdominal pain or irregular menses etc.so RELAX..KEEP PATIENCE. ur functional cyst can resolves with time. secondly u told that u have no problem in menses, then there is high chances of getting pregnant in ur case.with the above discussion u can try out my suggestions-1. try to do coitus during fertile period(it is from 10th to 16th day of cycle) during which chances of getting pregnancy is high.2.if you are came under reproductive age group( age from 15-45 years came under this group in this group chances of getting pregnancy is high). then u have DOUBLE CHANCES of getting pregnancy.3. if u r in hurry then visit nearby infertility specialist. He/she can help u.I hope the above information is useful, informative and helpful for u.regards-Dr sudha rani panagar( DON'T WORRY...RELAX..RELAX..RELAX. I can understand ur tense-full situation, I pray the God that u will be blessed with a cute n healthy baby..hopefully TWINS)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a hip bone fracture\n\nI have an old hip fracture ,because of war injury which was welded incorrectly. I ve seen doctors who refused to operate on me ,they say that i have bone infection which could be dangerous if the bone was broken to replace the hip joint .I ask if there s a solution to such case . thanks",
    "doctor_response": "Hi, there is a solution, but every solution has a price to pay, the usual routine is to first, remove the infected bone, and start on treatment with drugs, once infection clears, a proper replacement can be done. but lets be frank, this is not as simple as it sounds, first find with blood investigations if there is any infection in the first place, and then only things can proceed further.Hope that answers your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes loose stools in a 4month old?\n\nMy son is 4.5 months old & getting loose motions quite often. He gets loose motions, his dr. suggested him medicines bu which he becomes alright and in next 3-4 days he again has loose motions. Now in a month he has got thrice and the last one he had blood stains. The stoole reports do not show any infection or virus.",
    "doctor_response": "hi, welcome to this forum. Can understand your concerns. Frequent loose stools in a small child can occur due to repeated stomach infection, allergy to elect ocean in milk. Stool for routine microscopy and stool for reducing sugar test should be done. Review with reports. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Delayed periods, lethargy, vomiting sensation, brown discharge.  Had unprotected sex followed by intake of pills.  Pregnancy?\n\nHi, I had unprotected sex on last Thursday and Saturday and I had emergency contraceptive pill on Saturday. my periods were due on Saturday. I still haven't got my periods and I am feeling pukish and lethargic. is there a chance I am pregnent or is can be a side effect of the pill. I am also having brown discharge everyday since Saturday.",
    "doctor_response": "Hi,First of all, you cannot get pregnant with an intercourse just before the onset of period as ovulation occurs 14 days before the onset of a period and this is the fertile period which can cause conception. Moreover, emergency pill contains excess hormone and this causes disruption of the normal hormonal milieu of the body. This results in breakthrough bleed, menstrual disturbances and delayed periods. If you do not see a period even 10-14 days after your period is due, you should see a specialist for further help. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathing difficulty and snoring in an infant?\n\nMy daughter 2 years and 10 months old is mouth breathing for almost ayear and she is snoring in the night as well. when consulted an paediatric ENT he diagnosed her having grade 4 adenoids. Is that critical and how it should be cured. I am so worried as she bresthes very difficultly in the nights. When she is awake she is active and breaths normally. Please suggest the treatment for this.",
    "doctor_response": "Hello... Reviewed your questions...your baby is having breathing difficulty becauee of adenoids that should be corrected with surgery",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itchy rash on arms. Had this before, treated and cured.\n\nI have a rash on my arms....very itchy! Remembering getting this before a few yrs ago. My Dr. back then, during my appt., came back into the room with this little bottle of cold (out of the fridge) worm water. I had never heard of it. He then wet two paper towels, poured the solution on the wet paper towels and placed them on my arms and they brought instant relief. The rash quickly went away after a couple more applications. Is there an over the counter solution like this to help me? My then Dr has since retired.",
    "doctor_response": "Hi, the rash at that time may be different, any how it may be a solution of the steroid mixed with water, it may help, for a minimal invasive rash.                         These days the rashes could be due to any substance allergic to you that is to be found out and ommited to use.                         I advise you to consult a dermatologist for diagnosis and treatment. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can running and training be done during a pregnancy?\n\nI am 26 and very healthy and I just found out that I m pregnant with our second baby. I m about 5 weeks along. I have been training for several months to run a 10 mile run on October 24th. I have run 7 miles already and we run 4 miles consistantly. Is it ok to keep running and training for the 10 mile run in October?",
    "doctor_response": "Certainly not   you may be perfectly healthy and alright but that doesn't mean that you can do any form of exercise in pregnancy.no need 2 put yourself and ur baby at risk.skip the 10 mile run.you may go for yoga and other stretching exercise s if you want",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to correct bow legs problem?\n\nHi, I m a 23 years old guy. I ve bow legs (O-shape, Genu Varum ) since childhood. I appreciate that it s a light angle of varus in the knee. How can I correct this malalignment ? and are there a non-surgical treatment ? after correction surgery, can i return to workout and sport .",
    "doctor_response": "Hi, The only way to correct varus( bow legs) in the knee joint is by surgical correction. At this age nothing else would work, so do not waste time. Consult Orthopedic surgeon for the best possible surgery and outcome. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant dull abdominal pain?\n\nMy Grandaughter, Megan, 9 yrs old, had a urinary tract infection last week, at the time she had a high temperature. A course of antibiotics appeared to make her Semi well again. However, today, 9 days on from that episode, she has a very high temperature, no obvious symptoms of urinary tract problems, as she had previously, total loss of appetite and is generally unwell, she has complained of constant dull abdominal pain.",
    "doctor_response": "Hi.GO for an urgent investigations: routine blood picture, urea, creatinine , liver function tests/ urine - routine, microscopy, culture and sensitivity. Blood culture also.Ultrasonography of abdomen.Consult Pediatrician / Pediatric Surgeon, on clinical examination he would start an appropriate treatment. If the fever has recurred and there is a pain in abdomen, I would advise the patient be admitted and given intravenous antibiotics.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness and swelling on feet and ankles?\n\nI have been experiencing burning and numbness sensations kn the front half of my feet. Now they are swelling on top of the feet, on ip to my ankles. I have had a vascular test as well as a nerve conducting test. I was told I have a mild case of peripheral neuropathy. The swelling has begun since the diagnosis, causing me to question the diagnosis. Can you help me with your insights?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have numbness and swelling on feet and ankles . Well there can be many reasons for symptoms you mention in query like peripheral neuropathy , hypertension , vitamin B12 deficiency , kidney disease or venous insufficiency . There can be other problems also like compressed nerve or injury. Keep your legs in hot water tub with Epsom salt for 15 minutes daily , lower your salt consumption and keep your legs elevated while lying down .I would suggest you to consult orthopedic surgeon for proper examination . Doctor may order CT scan or x-ray along with blood test and nerve conduction test . Doctor may also refer you to cardiologist for cardiac problem or nephrologist for kidney problemHope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful knot and bruising in upper thigh in pregnancy?\n\nHi my name is Haley and I m 11 weeks and 5 days pregnant with my second child. Well about week or so ago I noticed my upper thigh by my pelvic area felt a little bruised. I didn t think much of it so I let it be. Well today I decided to actually look at it and I have a knot in this area. It s not read or hot or anything it just feels like a big knot and it hurts when I touch it. What is this? And could this hurt the baby?",
    "doctor_response": "Dear Haley,Your history and the description of the lesion suggest that you have caught infection at the bruising site which has caused involvement and infection of the lymph nodes that are situated in the groin (Inguinal lymph nodes). You will require an antibiotics treatment. With appropriate antibiotics the infection will be controlled and the gland will subside. If you delay the treatment, it may progress to abscess formation which requires incision and drainage in addition to the antibiotics. Please report to your Obstetrician ASAP. During pregnancy (even otherwise also), infection should never be overlooked, ignored and neglected lest the serious complications. I hope this helps you. Dr. Nishikant",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes slight pain at my urethra after falling?\n\nwhile playing at playground i fell flat on my face.. and felt slight pain at my urethra. It was ok for three to four hours but after that it started to pain and now i can see slight reddish coloured urine and after-pain also. What should i do?? Please help!!",
    "doctor_response": "Hi, If you can't see any visible injury and you pass clear urine then you need to take mild painkiller and wait. If your issue persists then it needs an ultrasound. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for discomfort in the abdomen and dark colored stool discharge\n\nhello iam Doctor muayad from iraq ,my father undergo from optic nerve atrophy result from increase intraocular pressure for 20 years duration and he lost his vision now he control on pressure [on normal level] by medication ,my father age is 55 years old and he donot undergo from any associated diseases ,Is there  treatment and improve my father vision or not ,permenent or temporarily ,how long duration this treatment ,how cost me . my father name is salam majeed hashim please respond me quickly",
    "doctor_response": "HI Hashim. There is no treatment for optic nerve atrophy. For the pain in abdomen and dark colored stools , your Father has to take a course of an antibiotic and supportive therapy for minimum of 5 days.If there is no relief , you may further go for the investigations : Blood- complete blood picture, kidney functions tests, blood sugar fasting and post-lunch, Urine- routine,microscopy, culture and sensitivity ( before start of antibiotic)Ultrasonography of abdomen.This will give an idea about this problem too .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take marijuana after stone removal from gall bladder?\n\nhey i just had a sugery to remove my galbladder after they found small stones in it. I was prescribed tylenol 3 to ease the pain but the pain is still a bit strong at the moment. My sugery was 10 hours ago. would taking marijana be more of a con than pro at this time to help ease the pain?",
    "doctor_response": "Hi and welcome to HCM. Thanks for the query.Marihuana is not justified as analgesia method so from out point you should not take it especially not so early after surgery. it may have very bad effect on your digestion and may interact with anasthetics that were given during surgery. So if you need more analgesia consult your doctors about it and take some of the regular painkillers WIsh you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the stage of my breast ca ?\n\nWhat is the stage of my breast ca size--3.8x3x3 cms nodes axillary nodes 13/15 + apical 2/4+ histological grade 3 nucleus comedo pet/ct scan-sternum c6 d12 i5 increased uptake with few osteolytic changes increased uptake in l234 with osteolytic changes nodes free skin free dctal ca x-ray chest normal ct scan reports c6 involvment",
    "doctor_response": "Hi. You have metastatic breast cancer which automatically becomes Stage IV. Now that you have baseline PET scan, follow up PET scan is the best way to monitor response to treatment. Repeat PET scan is best done 8 weeks after chemo and 12 weeks after radiotherapy. Interim PET (done in between chemotherapy) is best performed a few days before the next cycle of chemotherapy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will the pain in ankles be due to the spreading of AVN?\n\nHi I was diagnosed with avn (avascular necrosis of the hip 2 months ago, I ve had pain in my knee from this, for about a month now I ve had pain in the other hip and knee, waiting to get scans to see if the avn has spread.. My ankles are throbbing and in continuous pain could the avn have spread to them also?",
    "doctor_response": "Hello, I have studied your case. Yes AVN is bilateral disease and can involve other hip also.After clinical examination IF AVN is suspected then you will need MRI.For hip arthritis joint flexion, extension and rotation exercises will help.Physiotherapist will help you better to learn more exercises in proper protocol.Diet rich in calcium and protein will helpYou may need urgent intervention after diagnosis.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does taking Zentel causes constipation?\n\nMy 5 yr old kid was given 5mL ZENTEL SUSPENSION on Sunday night after meals. He vomited at school after having snacks Next day. He had breakfast as normal ( 2,dosas). He vomited only the undigested snacks. Last night he had chicken as well. . Is this bcoz of Zentel. He didn t do his potty in d morning as his daily routine is in the eve..he also had stomach pain just before vomiting.Plz advice.",
    "doctor_response": "Hi, I wonder if your child had any symptoms before he took Zentel. As far as the drug is concerned , it is a pretty safe drug. In a small percentage, there may be abdominal pain and nausea, but usually the pain is continuous. In all likelihood, the pain may be food related in your child's case, especially if not home made. However, if the pain is continuous or recurrent , it is better you report to your pediatrician. Meanwhile, keep your child well hydrated by giving him plenty of water and soft food.  I hope this helped.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red raised lines on the skin in the upper rib cage area?\n\nI  woke up with 4 red raised lines on my skin in the upper rib cage area.  I had buccal   Carcinoma in situ surgery 3 weeks age. By the time surgery was over I had an increase in  swollen lymph nodes. Last night I had a very sharp pain in my lower to mid back( waist level) Maxillofacial surgeon saud  he would monitor the lymph nodes. A hot red pouch hung down from my chin 2.5 weeks ago. Now gone but area is sore. My Sister had lymphoma years ago. I had a strongyloides infection last year when I returned from Mongolia.I had intense neck and shoulder pain and vibratin feelings a lot last summer. Even seizure like tremors in my scalp.Was exposed to bed bug spray last Spring.Don't feel good. Several respiratory infections this past 15 month period.Will see an infectious disease doctor Wed.What could be going on with me?",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .*  This seems more likely to be  herpes  zoster  infection involving the    upper  rib  cage  area .*  Confirmation should be done with physical examination by expert     infectious disease  specialist .Hope this will clear your query .Wishing you fine recovery .Feel  free  to ask any further doubts .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe abdominal pain and tremors after having BP medication?\n\nHead heaviness and upper stomach tremors start in the morning approx 2 hours after a thyroid medication and an hour after blood pressure medication.  Having eaten with blood pressure medication. This eases up at night. Approx 12 hours later.  What is causing this??",
    "doctor_response": "Hi.Thanks for your query, albeit short and specific. Since you have not mentioned the names of the medicines that you are taking for thyroid problem and the high blood pressure that is hypertension, it is difficult to pin pint the cause and effect. Yet your history is classical that the pains caused after a specific time after the thyroid and blood pressure medicines indicate That these are causing the problems and that is lasting for 12 hours. I would advise you the following:Consult the treating Doctor immediately so that the new prescription for change medications that may not cause the same problems. I hope this answer helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from low SGPT, advised to take Heptrol, U/S normal. Suggestion for low SGPT level?\n\nHello doctor i vijay from india. i have suffering high sgpt since last year. at present it is 68. i am so worried. my doctor advised me to take medicine named Heptrol twice a daily. ultrasound is normal, and hetitis b,c reports are normal. so please suggest me what can i do for low my sgpt level. my height is 6 feet and weight is 90 kg.",
    "doctor_response": "Hello Mr Vijay, There is nothing to worry as your hepatitis markers and ultrasound is normal. The most common causes for high liver enzymes \u00a0are alcohol,obesity,diabetes,high cholesterol and triglycerides etc. Since they are just mildly elevated ,there is nothing to worry and just few simple lifestyle changes can make you allright. Normally no medication is required for this. What to do... Quit alcohol ,if taking. Reduce calorie intake and reduce your weight.Be in required range of your BMI. Avoid junk foods like pizzas,burgers etc. Avoid sugary drinks and colas. Avoid sweets and deep fried foods. Daily aerobic exercises for 40 minutes. You should be all right in next 4 to 6 months time. I hope it helps Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of pain in knee ?\n\nI get pain in knee ,whenever I travel long distance , I will make sure to do exercises everyday during morning times, but I need to travel about 2 kms every day to my office . Please let me know how to get rid of knee pain, I am able to walk after travelling 2 hours, but while getting down from vehicle I fell my knee is very rigid",
    "doctor_response": "Hello I have studied your case. According to your symptoms and findings there is osteoarthritis of your knee.You can start cartilage protecting medication like chondritin sulphate twice daily, that you need to take for couple of months.Take analgesic like Aceproxyvon and add tab methylcobalamine 1500mcg daily consulting your doctor.Physiotherapy like ultrasound and tens will help, along with knee exercisesLife style changes will help in reducing pain which include,ACTIVITY MODIFICATION -It is important to maintain as much activity and joint motion as possible, but impact activities will aggravate arthritis. Running and jumping will often accelerate cartilage loss from the joint. The key is to focus on low impact activities, such as swimming or cycling.  USING CANES: Assistive devices can make it easier to go about your day without stressing your painful joint. A cane may take weight off your knee or hip as you walk. Carry the cane in the hand opposite the leg that hurts. VISCOSUPPLEMENTATION: Hyaluronic acid injections given into the joint (especially large joints like knee joint) in prescribed dosages will give good short term pain relief in arthritic joints ranging from 1-2 years. You need to consult orthopaedic surgeon for taking it.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.If you are satisfied with answer do not forget to give rating to this answer. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can surgery by ankle specialist treat fractured heel and broken bones in ankle?\n\nhi i had surgery 2 yrs ago on my ankle, a car wreck caused fractured heel and 3 broken bones in my ankle. they did surgery but apparently it didnt heal correct. i have been to orthapedic dr he said i needed surgery by an ankle specialist. i currently have passport healthcare but will change health plans in order to have this surgery covered. thank you",
    "doctor_response": "hi,thank you for providing the brief history of youA thorough musculoskeletal assessment is advised.As mentioned in your history, it is good to hear that your feet is saved firstly. Also, post surgery, did you perform any exercises to regain the ROM of ankle joint and strengthening of the muscles? also, do you have any current symptoms like, pain, swelling, discomfort etc.Now to understand the healing of the lower limbs, it varies from patient to patient and also from injury to injury. Lower limbs in theory can take upto 8 weeks, but when comes to ankle and foot, it may take longer. Since the patients keeps asking about the walking, they are made walk early with non weight bearing and then full weight bearing. The bones of the feet are smaller and then need adequate time to heal. In that duration, doing physical therapy helps improve the ROM and strength in the muscles which prepare the body for propulsion and weight bearing. Most cases, due to pain avoid physical therapy and the ultimate result turns out to be dissatisfaction.I will advice you to undergo physical therapy as it will help you to regain the ROM and Strength. Also, the post fracture, the remodeling of the bone is provided by the muscles by friction of the muscles over the bones.You may not necessarily need to under go a re-surgery for the foot, if the ROM and Strength are back.I have seen cases with similar complaints so i am aware that what helps to avoid the re-surgery.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause extreme nausea?\n\nI d love you to try and answer it!My 20 year old daughter has had EXTREME nausea without emesis for a week now. Sharp pain on her left side so bad that we went to the ER almost a week ago. Did the whole work up with blood tests that showed nothing elevated but gave her IV saline, morphine for the severe pain and Compazine for the nausea. By the time we left the ER she was somewhat more comfortable but not pain free and was told to follow up with her PCP (who is still her pediatrician). It s now a week later..all she has eaten is some dry toast, tried to eat a grilled cheese sandwich, and some crackers-also a little water but she cannot stand the thought of food or drink with this nausea. She doesn t have an appointment with her dr. until October 10th and doesn t know what to do until then. ANY ideas?",
    "doctor_response": "HiI am Dr Mittal.I have read your message.Having read your message, 3 possibilities come to my mind.1. A severe gastritis. This comes, as you said, with extreme nausea and abdominal pain, often on the left side. Since it is a gastritis, a blood work up will be normal, and the only thing that can actually help diagnose this condition is the test of endoscopy that needs to be performed by a gastroenterologist. The scans, ultrasounds and the blood works would appear normal.In such a case, Tab Omeprazole 20 mg twice a day, should help her gradually regain her appetite. The tablet will need to be taken half hour prior to any meals.2. Gastric or Abdominal seizures. This rare entity comes with the symptoms of gastritis- nausea, vomiting, abdominal pain, and sometimes headache. The patient will not loose consciousness and will not have convulsions like the traditional seizures. However, this is a diagnosis that needs to be made after examination by a neurologist, and no treatment should be started till confirmed as the antiepileptic drugs do have serious side effects. Of course, all blood works would be normal in this case as well.3. Lastly, severe anxiety can present with a combination of any symptom. And is always a diagnosis made when other possible diagnosis have been ruled out. However, medically speaking this is always a possibility that needs to be considered in a young lady presenting with the symptoms you have mentioned, after all the causes have been ruled out. I would suggest observing her with her friends and see if she is more comfortable during this period- which may possibly suggest the diagnosis. I have tried to make it as simple as possible. I understand your concern, and seriously feel that the antacid should be tried. If it does not work, at least that will be one thing that your primary physician will not waste time on, since many authorities consider that giving antacids in a case of severe gastritis is diagnostic- depending on the response. In other words, if she improves, she has gastritis, if she does not improve, most likely gastritis is ruled out. If it does work, she should start to feel better within 15 days.Best of luck, Dr Mittal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Taking duphaston. Started spotting. Am i able to conceive?\n\nHi doc, im 29 years old having hard time to conceive. I consulted gyne and had transvaginal ultra sound , my gyne said i have 13mm egg and capable for pregnancy, she prescribed me duphaston for 10 days and come back after 3 days.. But now, i have spotting and i guess i have my period. Do i lost my capable egg for pregnnancy?",
    "doctor_response": "Hello thank you for your query. The spotting could be anything from your period to implantation bleed. you have to visit your gynecologist and confirm what exactly happened. A 13 mm egg would not lead to a pregnancy. Only a mature 18 - 20 mm follicle can rupture and ovulate. Please consult a proper Infertility specialist. Have proper follicular monitoring and documentation of ovulation. Get your partner's semen analysis done Have your basic hormonal profile done, and status of your fallopian tubes assessed. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from stomach pain. Ultrasound shows free fluid in pelvic, pancreas normal. Reason?\n\nHi Doctor,My brother is 29 years old, yesterday, he suffered from a pain which is initiated at the top of stomach and now in the whole area of the stomach. After Ultrasound test, the doctor says that, minimal free fluid is seen in pelvic, no leakage is seen in intestine, and pancreas is normal, please can you advise me?",
    "doctor_response": "HIThank for asking to HCMThe detection of minimal fluid in pelvic region in ultra sonography imaging, need to be correlated with clinical condition, it may not be indicative, but follow up is require, if it is the same in follow up then, other supportive or confirmative test has to be carried out, here in your case the most possible cause would be, intraabdominal infection, discus it with doctor, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for secondary infertility\n\ni am 36 yrs old female , i have taken anti -tuberculous treatment 8 yrs back for pulmonary t.b , now i am having secondary infertility ,what test should i do , both my tubes are blocked .which test is reliable to confirm uterine tuberculosis & treatment for tubal block .",
    "doctor_response": "As you have secondary infertility and got treatment for tuberculosis 8 years back, had you done with HSG (histo salpingo graphy) ? If not then first do this test.HSG is therapeutic procedure rather than diagnostic.It can help to reopen your fallopian tubes. 2 test to do ultrasound of pelvis.After hsg tubes found block then you have to go for laproscopy to diagnose the blockage in path. So consult a gynecologist and take his/her advises.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest tips to overcome obsessiveness with cosmetically corrected nose\n\nI had rhinoplasty and septoplsty. .....and I think that the tip of my nose is too big....I had a beautiful nose .....but i could not breath and had infection in cheeks....Dr. said he would burn cornets , fix deviated septum and give me a lift.....oh and sand the width...of the nose.... It has been 1 month and a half...breathing is great...but tip hurts a lot and I think my nose is larger and tip is too big.....",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.You know this as obsession. You had that disturbing sensation once. You expected it to happen again and tried. Then you started experiencing it as you were expecting it. Then your body brought the familiar symptom because you are expecting it. Then you started worrying that the symptom is coming again and again and expect it. Body brings it again as you are expecting it. You become worried and so on. That is obsession in simple terms. Ignore it and the problem vanishes. You will overcome this obsessive thought when time passes. You may have it for some three to six months. Once you become active in some other things, this obsession never be your priority. Don't worry.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the trace on the lungs mean?\n\nHi, can i ask question,i had a previous xray february 11 2013 results would be all the rest part of my lungs are cleared..due to my application abroad i need to undergo again chest xray on my medical..but on my xray result i had trace on my lungs says that \u201c persistent right apical lung fibrosis and nodolucalcific with tb residuals apicopleural thickening\u201c...my sputum tested as negative..is there anyone can helped me?",
    "doctor_response": "Hello Your X-ray findings are due to sequel of old tubercular infection.Findings are healed one and doesn't require any treatment unless it compromises pulmonary functions.Infection naturally heals by fibrosis and calcifications.Apicopleural thickening is also related to old infection.It is good that sputum test is negative,it also indicate possibility of absence of active infection.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause of hard lump on calf while taking Bystolic and Albuterol?\n\nI have a hard lump on my left calf that I noticed in January 2014 after a run and don t know what it is. Went to my Dr and he was not familiar with it as he had never seen a lump on a calf before. Then I had sonogram and I was told they dint see anything malignant. Im a 34 yo male and take Bystolic and albuterol.",
    "doctor_response": "Hi.As per your history of finding the lump on the calf after a run indicates me for the most probable diagnosis of herniation of the muscles through a small tear through its covering ( herniation). This can be nicely seen on sonography if examined with a high frequency probe. You may please consult an Orthopedic surgeon to get a proper diagnosis and management, may need require a small surgery. Please keep me posted about the results f diagnosis and treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is surgery needed for tumour in pituitary gland?\n\nHi. i am a pilot and there has been an incidental find of tumour in my pitutary gland. I have no other symptoms as headaches etc. at present the growth is about 9mm. i started wearing glasse about 5 years ago. there is alight reduction in my left eye range vision . what do you suggest. should i go for surgery. Aijaz",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. In my opinion you should definitely get it removed surgically. You are symptomatic with glasses and difficulty in vision. And your tumour is still very small. So prognosis is good if you removed it early.It will slowly grow and can damage eyesight more. So better to remove it at present and avoid future complications. Another point which favours early removal is your job.You are pilot and your eyes are everything for you. So better not to wait, get done surgery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower back pain with gastric problem\n\nDr, iam 35 yr s old, female with 2 kids. Recentl;y developed low back ache. use comp too much, sit in front of it for long hours. When the pain comes slowly it spreads to abdomen and gives the feeling of a FULL stomach. There is gas trouble also. When i massage the back i can feel gas releasing. The pain aggravates with sitting but goes off when i wlak or jog or involve in daily activities. Comes and goes once in a week or so.",
    "doctor_response": "The pain you are suffering from is I feel is due to gastritis. Try regularising your meal tyming and hav lot of plain water through out the day. If it doesn't improve than see a gastrointestinal doc before having an ortho consultation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chronic right sided mid back pain?\n\nI am having some severe mid back pain on the right side. Like a muscle spasm although I have not done anything strenuous. It interferes with breathing and movement. Just trying to get an idea of what it might be or anything I can do to minimize the pain. I am afraid to move",
    "doctor_response": "Hi i am Dr Ahmed Aly    thanks for using healthcaremagic site ,I had gone through your question and understand your concerns ..  In my opinion you have a sort of a muscular spasm or radiating pain due to nerve compression . in mild cases of sciatica low back pain may be resolved simultaneously or with relaxation .  For my patient i may suggest advil tab when needed , hot massages with topical gels , B12 vitamin supplementation with some physiotherapy and spinal straightening exercises  and even yoga will be helpful.  If pain persists i recommend MRI to rule any spinal disc herniation for proper evaluation and management . Please click and consider a 5 star rating with some positive feedback if the information was helpful. Wish you good health,Any further clarifications feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am experiencing heavy shoulders and getting anxious that it could be a heart attack. Please help.\n\nHello doctor, I am experiencing heavy shoulders, and then my hands and legs are feeling heavy and tingly. I can feel it go up to my neck and face at times. But the main symptom is heavy shoulders. I do have low vitamin D and B. I forgot to take my supplements for almost a week. When I forget, my legs become tingly and achy. When it happens, I get anxious that it could be a heart attack and it gets worse. The more I think about it, the worse the symptoms. But the symptoms then subside. I am thinking that I am having an anxiety attack.",
    "doctor_response": "Hi. I have gone through your query and can understand your health concern. Vitamin B12 deficiency can cause weakness, body ache and tingling sensation. But you told that after not taking the supplements your symptoms get aggravated. In my opinion, it is psychological only, that is anxiety related. To relieve this, you can do some relaxation exercises, walk, deep breathing exercises and meditation. Do not miss your supplements. Take non vegeterian food rich in vitamin B12. Try natural ways of reducing anxiety. If not controlled with that, then only go for anti-anxiety drugs.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen ankles and calves with deep pink rashes\n\nHi I am homeless and living I sit in a mostly unheated car at night. Then spend times in libraries during the day my ankles and lower calf are swollen and I have a deep red or pink rash with some pain what is it and what do I do no insurance dr or money XXXX",
    "doctor_response": "Hello, I would explain that your symptoms could be related to the hanging position of your legs during all the day. Another possible cause would be a fungal infection, as your hygiene is not the best lately. for this reason, I recommend trying to hold your legs upright position as often as you can and try to wear compression stocks, and see if they help improve your situation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes knots on face?\n\nmy son is 10 years old and had 2 knots come up one on the side of his face close to the bottom of his ear and the other one at thebottom of his face close to his throat. What could this be and do we need to be concerned. They both are sore to the touch.",
    "doctor_response": "Hello! Welcome to HCM.These are most likely enlarged lymph nodes.Commonly due to some infection in oral cavity, these nodes enlarge.Inflammatory process in them causes pain.In my clinic, I look for source of infection & if found, removed.. antibiotics are prescribed and if there is no obvious source, FNAC - fine needle aspiration cytology of the lump is done.Treatment is done accordingly.Hope this helps.Wish you healthy life.Thanks.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be cause of sharp pain in my left collarbone area?\n\nI am a 42 year old female, in pretty good health, unaware any medical problems at this time, but experiencing sharp pain on my left side of the collarbone area, especially while eating and other times for no apparent reasons. What advice can you advise me on? I m 5 6 approximately 200-205 lbs. Help please?",
    "doctor_response": "Hello, It could be a musculoskeletal pain. As of now, you can use analgesics/anti-inflammatory combination like aceclofenac/serratiopeptidase for symptomatic relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. May I know till what age do girls grow?\n\nHello doctor, I am a girl. My height is 5, but my parents are much taller. My mom's height is 5'6\" and father's 5'8\". Will I grow or is it my final height? When I went to a doctor in my city he said that I stopped growing. Is it true? I have already had a period for a year and a half?",
    "doctor_response": "Hi. I have read your concern very carefully. You are worried about your height. It is an important issue of everyone\u2019s life. Usually, growth occurs up to 18 years. After that growth ceases. Growth depends on various factors like familial, nutritional, pathological. The highest rate of growth occurs between 9 years to 14 years of age when puberty occurs. Because in this time, gonadal hormone starts to release. According to international recognized institute CDC, normal height of girl at the end of 18 years is 60 to 68 inches. Your height is 60 inches. So you are in normal height and your age is in growing years. There are still chances of growing in height further up to 18 years. So, you should not be worried. But if still, you are worried, you should do some test to check whether the normal level is normal and not. Estrogen, LH, and FSH, testosterone, growth hormone. You can also contact with an endocrinologist to take a decision about growth hormone therapy. I hope the above information will help you a lot.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Got appendix removed previously. Having severe pain in the area which increases blood pressure. No help with pain killers. Blood tests, scans normal. Suggestions?\n\nin april of 2012 i was diagnosed with a smoldering appendix . i had i removed . but then a very high peaking pain was happening and this would send my blood pressure to between 180 and 225. pain meds helped but the pain keeps coming back and i can t stay on pain meds for the rest of my life. My blood work is normal and an abdomane ultra sound does not show anything can you help me. laurie",
    "doctor_response": "Hi.After any surgery in the abdomen,there are chances of adhesions formation.These adhesions may cause Pain,particularly near the surgery site.Blood pressure in your case is raised due to anxiety.If the blood pressure is raised even without pain,please exclude Renal artery stenosis.Consult your local doctor for further details.All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold, cough and upset stomach\n\nHi, The last few days I have had a pretty bad cold. Runny nose, sore throat ect. And have recently just had a cough. This morning I woke up and felt really sick in the stomach and ended up vomiting out bile, nothing else. I have stopped with the vomiting now. But I was just curious, does lemon juice kill bacteria? I was just wanting to know if it would help my situation or not? Thanks, Hayley",
    "doctor_response": "Hello ,I understand your concern. I am Dr. Arun Tank, infectious disease specialist, answering your concern.It is a common cold or common viral infection of upper respiratory tract.There is a need of taking the Paracetamol, Chlorpheniramine maleate, and Pantoprazole with domperidone. This treatment will help you cover all your runny nose, sore throat, and also vomiting. Lemon juice contains a vitamic C which helps in such a common cold. You can take it.Glad to answer your further concern. We wish you a best health at healthcare magic. Thank you,Dr. Arun TankFor detailed query please ask me on bit.ly/DrArun.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will birth control pill be effective immediately after taking?\n\nHello, I started taking the birth control pill on Sunday March 16th, but it was after my period had already ended. I had unprotected sex on Monday March 24th. He pulled out, but I was wondering how long it takes for the pill to become effective? And if I will be ok? Some say 1 week some say otherwise. Thank you!",
    "doctor_response": "Hello dearUnderstand your concernDo not worry. There is no chance of pregnancy as you did sex in the safe period of cycle (just after period). It is safe period because ovulation doe not occur during this time.Contraceptive pill started to work from the first pill only but you have to take the remaining pill regularly at the specific time for effective contraception.Just be relax and take you remaining tablet normally.Avoid stress and take healthy diet.Hope this may help youContact HCM for further health queryBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pregnancy happen after egg rupture?\n\nHi, I am Sheeba. My doctor said that my egg got ruptured sday(Thursday) and she asked me whether i had an intercourse with my husband on wed and i said no. Then she asked me to mate on thursday and friday. Now the problem is we had our intercourse on monday and sday v did not have and i am not sure whether v vl have today too.. Any chances this month",
    "doctor_response": "Dear Ms, pregnancy can happen after the egg ruptures in the following 3 days. if your egg ruptures on Wednesday this means that pregnancy can happen till Saturday .",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to increase my serum albumin levels?\n\nI have just had a blood test that showed that I have serum albumin at 33g/l. I had the test because I'm on ppi's for acid reflux and had heard that prolonged use of these drugs caused other issues. I have very low B12, 51ng/l and have started a course of injections. But looking at my test results I see that my serum albmin is also low. No one has mentioned this to me. What do I do about improving the levels?",
    "doctor_response": "Dear I read your scenario .PPI do nothing to your albumine .just take Aminoleban infusion which will maintain your albumin level. After taking this infusion then repeat the serum albumin it should be in the normal range .you should take food rich in protein.hope you get well soon if you any problem regarding this then you can ask me otherwise you should go to concern doctor near toyou. thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of conceiving with TB of uterus?\n\nhi.i am 29 years old ,scopy  had choclate cyst , fr which i had laproscopy but after that operation i cudnt concieve , iwaited fr four months, than gain i consulted dr in which i came to know i m infected with TB in my uterus... my treatment is started but i m very tensed and depressed as will i get pregnant or nor....wat r my chances of concieving..?",
    "doctor_response": "Hi, you can get pregnant after the treatment of tuberculosis.  There is no need to worry about.  You can try once your treatment is complete.  You can take some medicines like clomiphene for the growth of your follicles and track your follicles growth by repeated ultrasound. When follicles reach a size more than 17 to 18 mm, take injection for rupturing the follicles.  Be in contact with your husband for next 2 to 3 days.  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.  Hope I have answered your question .Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore lower back, stomach ache, multiple muscle sore, frequent urination?\n\nYesterday woke up with a sore lower back, nothing else this morning even worse at about noon started feeling weak and tired ate lunch and got a stomach ache now multiple muscles are sore and can t seem to hold in liquids, urinating more often than normal.",
    "doctor_response": "Hello, As first line management, you can take analgesics like Paracetamol or Aceclofenac for pain relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for constipation in infants\n\nHai Doctor, I am having 48 days old girl baby. She is suffering from constipation. I am also having the difficulty. I am giving her only breast milk. She vomits frequently after breast feeding. Now she is 4.5 Kg, at the time of birth she was 2.75 kg. I am taking some ayurvedic medicine as its surgery. Kindly advice me what can be done for her constipation. Waiting for a favorable reply. Thanks & Regards, Navya",
    "doctor_response": "The steady gain in weight indicates that the baby is getting adequate feeds. The vomiting could be due to overfeeding at times. It could also be due to regurgitation. Burp the baby after each feed. Take the baby on your lap with the baby facing you and with the head end raised. Maintain the position like this comfortably for 20 mins after each feed for proper burping and things should be fine. For a breast fed baby if stool is not hard, passing stool once in 10 days is equally acceptable as passing stool 10 times a day. You need not worry in any of these. It is not likely to be constipation is the baby is exclusively breast feed and no medicines are required. No surgery required as well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to stop masturbating and increase weight\n\nhi doctor, i am 28y male student. i did not have any sex with girls yet but i had a bad habit of hand use in my teen. and i am used to see sexy movies once a week. now i feel that i am not sexually fit because i feel very lazy most of the time and my weight is 54kg with height 5ft 8inch. i want to increase my weight and want to quit from these bad movies . . . please advice me. thanks in advance",
    "doctor_response": "Hello, Masturbation is in no way unhealthy or can cause any physical weakness or sexual weakness. But you should reduce the frequency of masturbation to thrice a week. I suggest sexual counseling for you. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fibroid surgery postponed due to high sgot and sgpt levels. How can I reduce them?l\n\nhii, i had my large fibroid surgery on 20th oct but it is now postponed due to high sgot and sgpt levels on 18th oct. i had been prepapring for dis surgery since last 5 months, i ve also taken 3 doses of zoladex 3.6 mg. how do i reduce dese levels so that my surgery can happen in next week?? i am a 27 yr old unmarried female.",
    "doctor_response": "Hello Miss.Ankita, I have gone through your problem. You have mentioned that your SGOT and SGPT levels are high. You didn't mention about any of your complaints like fever, abdominal pain or vomiting. SGOT and SGPT are liver enzymes present in the liver cells (Hepatocytes). When there is destruction of the liver cells, these enzymes are released into the blood circulation. These high levels can be seen when we get an Liver function test done to the patient. Now you need to know the reasons for liver cell destruction. Some common causes are 1. Viral hepatitis 2. Cirrhosis of liver 3. Alcoholic hepatitis Usually in viral hepatitis the liver enzymes will come back to normal after few days of conservative treatment. But in Alcoholic hepatitis and cirrhosis of liver there will be continuing liver cell damage and so these enzymes may be persistently elevated. You need to consult your physician or Gastroenterologist and get his advice. You need further evaluation with an Ultrasound scan of the abdomen to look for the status of Liver and gall bladder. It's always safe to avoid surgery till the liver enzymes revert back to normal levels. Wish you good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower abdominal pain, irregular bleeding, back pain, bladder infection, congestion. On plan B. Help?\n\nHi, I have been having tight lower abdominal pains, when I stretch back, irregular bleeding, which could be caused by plan B a pregnancy contraceptive, or irregular period, I was believed to have a bladder infection (while spotting) Or uti, last night. It burned to pee. I was also congested last week, and a month or so back I had pains on my left side by my rib cage. I am sexually active and I don't know what this could be . Please help !!",
    "doctor_response": "Hi there ! The pain in your left side rib cage could be due to respiratory tract infection as described in your history and also due to a possible infection of the pleurae. The burning sensation while passing urine is possibly and rightly due a urinary tract infection, which occurs not infrequently in sexually active females. This could be associated with infection of the pelvic organs giving rise to pain in the back and lower abdomen. The treatment for both needs proper antibiotics. The irregular bleeding could be due to your contraceptive plan B , but a chance miscarriage can not be excluded. Any foreign body in the uterus may give rise to such symptoms. You should go for routine blood and urine tests, along with an ultrasound of the abdomen and an x-ray chest if advised by your physician and only after excluding pregnancy. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can susten 200mg cause tightness of abdomen and vaginal pathway?\n\nSecondary infertility(after 12 years)April 7th i underwent IUI following that iam taking susten200mg thrice a day per vaginal.i am doing normal activity like travelling ,going for jobetc.today is my 16 th day of iui i donot have any symptoms but i feel very tightness of abdomen and vaginal pathway.should i stop the medication?",
    "doctor_response": "Hi, I have gone through your question. Susten is a progesterone which supports the pregnancy by making uterine environment more favourable for conception. It causes relaxation of the uterine muscles and does not not leads to abdominal tightening or vaginal tightening.I would suggest you to consult your doctor to get properly examined and treated accordingly, with more drugs to be given to support the pregnancy.Hope you found the answer helpful. Please do get back for further queries.Wishing you good health.Regards,Dr Deepti verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful swollen ankles with numbness\n\nI m 34yrs old 207lbs & 5ft 7in I m swelling in my ankles/feet/& legs again however feeling numbness/tingling/pins & needles in my left leg more then my right. Firstly is that bad - ie the pin & needle feeling in such a case or not - already plan to go to the ER was just looking up info til my ride gets here",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have  painful swollen ankles with numbness . Well there can be many reasons for symptoms you mention in query like peripheral neuropathy , hypertension , vitamin B12 deficiency , kidney disease or venous insufficiency . There can be other problems also like compressed nerve or injury . I would suggest you to consult orthopedic surgeon for proper examination . Doctor may order CT scan or x-ray along with blood test and nerve conduction test . Doctor may also refer you to cardiologist for cardiac problem or nephrologist for kidney problem .For now keep your legs in hot water tub with Epsom salt for 15 minutes daily and keep your legs elevated while lying down .  Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does spotting , mood swings and lower back ache indicate pregnancy?\n\nHi, Im a 28 year old female, I have 2 children & I was sterilized 3 years ago this March coming. My periods have been the norm 4 wk cycle since the op, until now. My last period was 11wks ago, I did a hpt 4wks ago & another last week, both negative. Im emotional, moody, lethagic, no patience, heartburn, back ache & an on/off dull bruise like pain on the right hand side lower abdomin. Also about 8-9wks ago I went for a wee & when I wiped myself there was a thin streak of watery blood, as I was at work I put a pad on, next time I went to the toilet there was no blood & none since. Could I possibly be pregnant?",
    "doctor_response": "it might not truly be sighns symptoms of pregnancy and only some symptomatic problem ,get your urine pregnancy done",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can THC, NSAIDs and Riboflavin trapped in her liver cause ALF?\n\nMy friend has been clean of all drugs for a few months now, and suddenly she tested positive for THC. She has also just found out she has Acute Liver Failure (No cause found yet). Is it possible that there was still THC, NSAIDs and Riboflavin trapped in her liver that is now being released do to the liver trying to fix itself?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.No this is not possible and test i sin 99% cases positive due to true positive results which means that he took THC drugs in recent period.Some medications may lead to false positive results but these that oyu mentioned are not these. The best way would be to do hair test or blood test to confirm that he is positive.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could stabbing pain in frenulum during having sex followed by small painful dots on sides mean?\n\nWhile having intercourse with my wife I felt a stabbing pain in my frenulum (when inserting) it was a little uncomfortable afterwards but bearable. Two days have past and its really painful and has developed a small white dot either side and is really painful?",
    "doctor_response": "HelloThanks for query .Based on the facts that you have posted It seems that you have sustained injury to your frenulum mostly due to dry ,vigorous sex with your wife.You need to take broad spectrum antibiotic like Cefexime along with anti inflammatory drug like Diclofenac twice daily.along with topical antibiotic ointment like Neosporin twice daily.for 5 days.Ensure to wash your genitals with warm water twice daily.Ensure to avoid sexual encounters till it heals up completely.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is bleeding around anus typical in outside hemorrhoids?\n\nHello doctor, I have bleeding around the anus when whipping caused by hemorrhoids. Is this typical for outside hemorrhoids? I have hemorrhoid for five days now, just started bleeding last night. I take hot baths every night with Epsom salts.",
    "doctor_response": "Hello. So, hemorrhoids are two types. External will be painful and internal will be painless. Both will have fresh red colored bleeding. Yes, you are right to take laxatives. But I think as you are symptomatic, you need a definitive treatment like band ligation, sclerotherapy or surgical intervention. Also, I recommend you to take high fiber diet. Complete blood count is also required to see if you are anemic or not due to bleeding. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get pimples in my arms and wrist and it becomes dark on healing. Please help.\n\nHi doctor, I would like to seek assistance with regard to my concern in skin. There is a pimple appearing in my arms and around my wrists. I am now using a sulfur soap. I am wondering why this happens. If the pimples were healed, it leaves marks that make my arm and wrists dark. I want to have normal skin. I was looking forward to take antibiotics but I do not know what to take. Please help. I will attach a photo of my arms for your look.",
    "doctor_response": "Hello. I have seen the photo. (attachment removed to protect patient identity). How long it has been there? What are the symptoms of it? Any other area affected? Any history of hypertension and diabetes? Please send a few more photographs taken from different angles.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is augmentin dds safe for baby?\n\nHi.. Is augmentin dds is safe medicine to give a 3 year old child. Many doc have told me that it's the hardest antibiotic which is given only in critical conditions but our paediatrician always prescribe augmentin dds for throat and other kind of infections.",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. You should be worried but not too much. Augmentin is usual amoxiclav . It is very helpful for Streptococcal infection, which causes tonsillitis at babies. The most common side effect-diarrhea , but if child will take also probiotics-Vizylac or Bifilac,then you will not have it.Please let me know if you have further questions before meeting your primary care Doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does mensovit plus helps in preventing pregnancy?\n\nsir, i am married i had seven month baby.now i had delayed my periods four days from normal period time.may i take mensovit plus tab.bcoz to avoid second pregnency .its little bit doubt i have.my mail id is  YYYY@YYYY  for ur replay thankyou.",
    "doctor_response": "Hi.Four days is not too long and even in the life of a woman who has always had a regular cycle, such fluctuations can take place due to factors like stress, diets, exercise, etc. Do not worry, and wait for a while longer, if you do not get your period in the next week, then report to a doctor who will surely help you.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication that can be taken with Co-codamol for sciatica pain\n\nHi im currently taken co-dyrcodamol and robaxtion muscle relaxers, could you advise anything else to take with these to easy the pain as ive got siattica and im finding it hard to be mobile, its been like this for two and a half weeks new diagnose . thank you.",
    "doctor_response": "Hi, I have gone through your medical history carefully and understood your concerns. Sciatica pain is very fastidious and takes a few days to weeks until final recovery. Close consultation with neurologist is highly recommended. Co-codamol and robaxin are good meds to treat. Physiotherapy can help. Discuss with orthopaedic specialist to determine if surgery can help. Wish fast recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Irregular periods. Ultrasonography done. Arcuate uterus. Any treatment?\n\nHi,I am 24 years old. I missed period and today is about 65th day and I am not pregnant. I went to a hospital and undergone Ultrasonography diagnosis and got discovered that I am having arcuate uterus. Please let me know if I want to conceive in future will I have to face problems or complications?? Thanks & Regards,Aparna",
    "doctor_response": "Hi Aparna, Thanks for your query. Arcuate uterus is a congenital anomaly of uterus where uterine fundus dip into the uterine cavity and look like septum in the uterine cavity. Diagnoses are made by transvaginal ultrasonography. Causing mainly the problem of pregnancy losses, frequent abortion. Treatment is hysterscopic resection. You should consult a gynecologist for your problem when you want to conceive in the future. Don't worry. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I stammer due to fear?\n\nHello doctor... Im 25yrs old and I have stammering problem. I stammer due to fear. I'm unable to get through any of the interviews due to this problem. I try to keep myself cool while attending the interview and after entering the room, I become nervous and loose my confidence and start stammering. I'm really worried about my problem. Since my childhood till now, I had to face criticism bcoz of this problem. Is there any solution to my problem? Please help me out.",
    "doctor_response": "Hi,Thanks for writing.Stammering during heights of emotion is a frequent occurrence. May be trying to relax in such situations will be helpful. You can try relaxations and yoga. If need be, you might consult a trained psychologist.Hope this helps,Dr A Rao",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shortness of breath and chest pain\n\nWorking out 3 weeks ago doing dead lift dropped bar and got a hit of pain on right side, kept working out, when I got home and bent down had shortness of breath and pain, went to Chiro and got therapy, got deep tissue massage and finally a muscle relaxer took it away, now 5 days later it is back and have done nothing?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. You are having blunt chest trauma due falling of exercise bar. Blunt chest trauma can cause rib fracture, pneumothorax, Pulmonary contusions, musculoskeletal injury etc. And all these give rise to chest pain and shortness of breath. You are also not fully recovered with local treatment. So better to get done chest x ray to rule out above mentioned complications. If chest x ray is normal than no need to worry much. You are mostly having musculoskeletal injury. For this start painkiller and muscle relaxant drugs. Apply warm water pad on affected site. Avoid heavyweight lifting and strenuous exercise. Avoid movements causing pain. You can wear rib belt to avoid mobilisation. You will mostly improve in 1-2 weeks. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Wolff-Parkinson-White syndrome recur in adulthood?\n\ncan a person who had Wolff-Parkinson-White syndrome as a child have a reoccurence of it as an adult? My 19 year old daughter has been experiencing sinus arrhythmia (according to an ekg at her regular doctor).  Can this be a reemergence of the WPW Syndrome?",
    "doctor_response": "Hi,This is Dr Sameer.WPW syndrome consists of abnormal conduction system in heart in addition to the normal pathway. It presents as abnormal increase in heart rate (AVRT - AV Node Reentrant Tachycardia). It can present anytime during life.Recurrence depends on what treatment has been given earlier. Exact treatment is finding of this abnormal pathway by test called EP Study & burning this pathway by RFA(Radio Frequency Ablation). If this has been done earlier than risk of recurrence is low(3-5%) otherwise it can recurr anytime mostly precipitated by stress or exertion.Thanks.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of blurred vision and black outs?\n\nI've been experiencing lots of blackouts, maybe 1-2 a week. I eat regularly and properly. I've been to the hospital about it and they can find anything. So today I went really hot and my vision went blurry and all I wanted to do was sleep. Any ideas what could be causing this?",
    "doctor_response": "Without more information on your age, medication regimen, and workups it is hard to say but in general the differential you describe can be anything from heart arrhythmias to seizures or TIA's though the latter is less likely if the frequency is as high as you state.  You need to see your primary doctor who will likely run some blood work, check to make sure you are not running too low of a blood pressure due to medications or suffering from drug to drug interactions and if nothing is found send you either to cardiology or neurology. Depending on your age you could also be suffering the effects of orthostasis (low BP) due to occult or subclinical infections in your body (most commonly bladder).  You are mentioning other things that are of some interest to this presentation but the basic workup needs to happen first and I don't want to speculate further without better information. Please rate this a 5 STAR ENCOUNTER and write me at: www.bit.ly/drdariushsaghafi if you would like to more fully discuss your situation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it possible to get spotting due to transvaginal scan during pregnancy?\n\nHi doctor, I have a history of recurrent early miscarriage (before seven weeks). Investigations pointed to high autoimmune antibodies and high NK cells. With medication, I conceived naturally and had a successful pregnancy. I am now pregnant again (unplanned) and am 7 weeks + 3. I had some spotting and cramping three days ago. The spotting was light and stopped within a few hours. The cramping continued for another day. Blood hCG levels are rising very well and are currently over 83,000. A transvaginal scan yesterday showed the heartbeat and we were told all is well. Today, I had some light spotting (dark brown) and discomfort and passed a brown clot. My query is whether this may have been the cause of the spotting the other day, or maybe this was caused by irritation from the TV scan yesterday. I am concerned anyway and any advice would be greatly appreciated. Current medications: Eltoxin, Prednisolone 5 mcg, Clexane. Sarting Intralipids next week to target NK cells.",
    "doctor_response": "Hi. How are you doing?  I understand your concern. From your history, I do not see any reason for you to worry. This spotting could be from mild erosion on surface of the cervix, which may bleed spontaneously or during sex or due to scan probe. In your history as you have not mentioned pain, I can say for sure that there is no intrauterine blood. Scan also did not pick any hemorrhages (attachment removed to protect patient identity).  The medications you are having is absolutely the perfect ones. Most of the miscarriages before 12 weeks are due to genetic problems. But in the present scan as baby's growth has been adequate, you do not need to worry. This clot could be an implantation bleed. This is normal and nothing needs to be done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could topomax be causing kidney stones?\n\nI currently take 150 mg  of topomax daily. Have been for several years.  I recently have had a terrible time with kidney stones.  4 in the past 2 weeks. One 5mm, 3mm, 6mm, and 8mm which had to be removed by surgery.  Could the topomax be causing my stones?",
    "doctor_response": "Yeah topamax can cause kidney stones but there might be some other causes for it like Increased calcium levels so you should analyse the stones and get through check up",
    "dialogue_context": ""
  },
  {
    "patient_message": "Breast cancer. Can I have full mastectomy?\n\nHi I recently had a breast biopsy for microcalcifications they also put in a clip they rang and said nothing to worry about but booked me into have a MRI ASAP why is that. Also I have lost 3 family members die from breast cancer I have 3 children and they only have me now ca I have a full mastectomy I don t want to keep waiting",
    "doctor_response": "Hi, You are at a risk of developing breast cancer, there is strong indication of screening for breast cancer. MRI may be a choice, but without definite diagnosis it is difficult to predict the exact mode of management, anyway BRCA1&2 mutation should be done in your case, Consult your oncologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the abdomen & groin area?\n\nhi, i was leaning against a bench reaching for something not straining but my groin was pressing against the edge of the bench with some pressure. I felt a bit of pain during and after when i looked down i noticed a small buldge to the right of my pubic region, shortly after I felt it and i felt soft rather than hard and went down practically straight after but im a bit worried , i dont think its a hernia i have a very strong groin and abdomen.",
    "doctor_response": "It's may be a inguinal hernia... You have to do less exercise.. ND you have to do strain less... May be it's an early stage....... Take tab. Signoflam twice a day... Tab. Pantocid dsr before breakfast... ND a belt should we wear when u do heavy exercise... Take tab. Spasmoproxyvan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes general malaise with stomach cramps, muscle pains and joint pains?\n\nHi My wife is a 56 year old woman and one week after completing a course of flucloxacillin 500mg (7days twice a day) developed a general malaise with stomach cramps muscle pains joint pains. The next day there was a slight fever and urine became orange, but only sometimes each day, stools appear normal. Last two days eyes now yellow. Some nausea and loos of appetite. Appreciate your advice as in India and uncomfortable attending doctor or hospital here. All recommended vaccinations are current. No fever now, appetite improved. What to do ? Thanks Bob Neil",
    "doctor_response": "Hi YOu are in India and your wife has orange urine , abdominal cramps,muscle , joint pains and now yellow Eyes and loss of appetite. with this clinical picture my Diagnosis would be jaundice involving liver , may hepatitis A. Complete rest , good amount of carbohydrates are recommended . Please get an LFT , Ultrasound abdomen, Urinary analysis  to arrive at an diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing mosquito bite to turn sore and painful?\n\nHi.  I got a mosquito bite  on my leg and within days my leg was sore & my toe became very painful then within the last few weeks my leg is sore every day and my toe is even more painful I have took tablets & pain killers nothing is taken this pain away - can u help  YYYY@YYYY",
    "doctor_response": "Hello there,Are you sure that you were bitten by a mosquito ? What you are describing seems something else. Maybe a tick or a spider. The reason I am saying this is mosquito bites may become red or itchy but they resolve within 2 days and have no lasting soreness . Take antihistaminics(Cetrizine) one tablet twice a day and ensure that you are not driving or doing any activity after the dosage as they cause drowsiness. This will reduce your symptoms and get the bite evaluated by a trained medical professional if it does not go down with this.Thank you for your query.Dr Arun A",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump under the groin?\n\nhi i got out of the bath last night and went bed to watch a movie about 1hour later a felt a pain in my groin i felt around and i came across a lump under the skin it hurts to touch bit like a bruse. then  got up this morning its still there and when i walk i can feel discomfart feels like its getting worse wot can it be",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some enlarged lymphnode due to reactive hyperplasia, tuberculosis or lymphoma. Or it can be some soft tissue tumor. You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe anxiety\n\nHi im a 25 obese male. I have anxiety and not horrible blood pressure. High at times if my anxiety gets that bad. So i went to work today and ibwent to scratch the middle part on the right side of my stomach and i couldn't feel my nails go across my stomach. I describe it as if i slept on that side (which i did last night) for to long and i lost lost feeling in it. Theres not pain or really any swelling. Maybe a little bit of swelling but nothing thats alarming. Bowel movement has been normal. I had this feeling a while ago but just want to be sure im not dying",
    "doctor_response": "DearWe understand your concernsI went through your details. Definitely you are not dying. You are having anxiety and quite naturally anxiety disorder patients do have obsession and psycho-somatic symptoms. In psycho-somatic symptoms, the patient assumes many things and obsess with those things. Thereby increasing the anxiety and worsening the anxiety itself.You could not feel the nails go through because you were not there at all mentally. That so happens because you were obsessive. Anxiety disorders are often treated with the help of combination of medicines, psychotherapy life style changes and relaxation. I hope you are under treatment. Please work with your psychiatrist or psychologist for a cure.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can lower left back pain be due to bladder leakage?\n\nHad pain in lower back when I sit. Or bend over after ice for weeks thought might be kidney,so had my doctor run urine test,he found large amount of microscopic blood Went back 2 weeks later,same result Sent to urologist, found same under scope. So urologist did a scope,bladder is fine, He said I had leakage,which I don t Said I was constipated which I go everyday,maybe not a lot I m don t burn or hurt w hen I urinate.only pain is left lower back,and feels tenderl , which I go everyday,maybe not a lot.",
    "doctor_response": "Hello, I have studied your case.Your  flank and back pain can be due to muscle strain or renal calculi.You may need x ray and Ultrasonography.And also check your vit B12 and vit D3 level.Medication like methylcobalamine and analgesic will reduce pain.You can do yoga exercises and focus on spine extension exercises.You may consult physiotherapist for guidance. He may start TENS, or ultrasound which is helpful in your case.Hope this helps. Wish you a speedy recovery.  Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause of chest pain?\n\nI have chest pain I have had this before(last week) and awhile ago I don t know what brings it on I have not got cold and feel generally very well! But if I breath in it hurts more so I am limiting my movements and not wanting to breath in or move suddenly.",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, this could be due nonspecific reason, some time could be due to hyperacidity, you have not mentioned your age and gender here, this was important here, without this nothing can be said in particular, hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for damaged esophagus\n\nI am 64.75 years old female and had gastric bypass surgery in 2001 and at the same time I had a hiatial hernia repair (glad that happened).  But as a result of many years of acid reflux, I now have a dammaged esophagus.  I have to use Nitro Lingual Pump Spray to control pain which can occure from stress, differences in temperature of the air I breathe.  I hear there is a way to possibly cauterize the tissue to help repair the esophagus.  Is that something I should look into as a friend said it culd turn into cancer or may have already. I am still over weight , but initially after my gastric bypass I lost 100 0f my 316 pounds.  I am a 6 foot tall woman.  I was experiencing many health disorders because of this and was even using a C-pap.  Which I no longer need.  Later I had to have knee meniscus repair surgery on my left knee and that kept me from exercising and now it is my right knee.  So I have put about 30 pounds back on.  I am working with a knee doctor to try to see if we can fix the right knee now. Primary question is related to my esophagus concern though.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have acid reflux and hiatus hetnia history.  You may have Barrett oesophagus whichcsn turn Iinto cancer or you may have csncer due to chronic irritation.  You should go for endoscopy.  It will give you exact diagnosis whether you have ulcer or mass or some other lesion.  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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Domestic issues, depression, anger, cheated feeling. How can I control my ill feelings and prevent them from becoming health risks?\n\nMy name is XXXXXX, 30 years age . while i was 24 my family arranged a marrige for me after 1 week from marriage i ran away from the house . at that time i had a friend who was 4 years less than me , he said i to dont have any one so lets go away and lead a life so we came , after that still now i dont have any contact with my parents. But the guy who came with me is having an affair with onother girl. with in 3 months i came to know that what ever the guy said to me is to impress me and all that was a lie. and within 2years his relations accepted him he is with all relations now. I have been seperated , its not that they dont like me they like me but i could not accept them as my relations . and now we are not in husband wife relationship, I dont have any child , more than that we dont speak to eachother , every time i saw him the thought that he cheated me is comming in my mind . I lost every special relations of my life but he is having all . I coudn t even able be normal with them . but their relations think that he is good guy. I am the one who is torturing him , no one knows about his culprit. Since I am working , my work place is like my mother house . I enjoy being there. but the thought of going home kills me . what should i do. should i leave them and take care of my own or i have to stay with them.",
    "doctor_response": "Hi  aruljayavel. Thanks for your question. You have lot of stress in your life one is your boyfriend affair,your psychical abuse,His bad behavior that all lead to a problem of adjustment disorder develop in you where you are not able to handle small decisions,action of your life .And you have mild depression in you too and that is very usual in your circumstances. So why you wait here and become tortured.God is thankful to you that you have a services so try to deeply involve in your job and immediately leave the person.If you want you can think for a new life also.start at least a daily activity schedule,involve yourself in social,familial matters. In the meantime if you think you can consult to a psychiatrist and take a counselling as i think you don't need any drug but i think to leave this person house you don't need opinion of any doctor. Dont feel yourself alone.we are all with you. Best wishes, Dr Sourav Ganguly",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe shooting pain in the head\n\nMy wife (59 years old) has had a sharp shooting pain in the head for 3 days now. Nothing touches it. This evening she says she smells Clorox, but there is no Clorox in the house. And she has been agitated and angry recently (last 2 months) out of proportion for any particular cause. Also she s had 2 very heavy nosebleeds in the last 10 days. Does she have the beginnings of a brain tumor?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have  severe shooting pain in the head . Well there can be many reasons for symptoms you mention in query like trigeminal neuralgia , cluster headaches , migraines , meningitis , sinus infection , encephalitis or tumor. I would suggest you to consult neurologist for proper examination . Doctor will take history and order CT scan . Doctor may prescribe vasograine , diuretics , calcium channel blockers along with that some times doctor recommend alcohol injection in root of nerve and surgery in case of tumor . For now take ibuprofen or acetaminophen for pain and do mind relaxing exercises like meditation . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedies to stop the tetany in my fingers and toes\n\nwhat can i do here at hom to stop the tetany in my fingers and toes? very painful and cant sleep, what could be causing this? never mind should have known, doctors are all about the money and ths is not in my budget, wow wouldn t it be a better world if you put your God given talents to use to actually help people in need?",
    "doctor_response": "This involuntary muscle movement and spasm can be eased by hot water bath or dipping the related part in hot water( prefer mixed with salt) for hot fomentation. It's better if you do gentle massage of mustard oil (warm) on fingers etc after hot water treatment. Better do with Rumalya liniment. Calcium rich food should be preferred or get calcium supplements ( oral or injectable).Hope it helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there missing periods even after taking Meprate?\n\nHello doctor, I am facing problem of missing periods from last month. Pregnancy test is negative. I have also taken tablets of Meprate. My last period was 62 days back. Please guide.",
    "doctor_response": "Hi. Period normally starts within a week of finishing Meprate (Medroxyprogesterone) tablets. Rarely it can take 15 days for period to start. If it has been more than 15 days since last dose, you need to visit gynecologist to get one ultrasound done, as Meprate will be effective only if your endometrial thickness is good, \u2265 7mm. If it has been less than 15 days since last dose, you can wait. If there is strong suspicion of pregnancy no harm will be done by repeating pregnancy test. Meprate will not induce period if you are pregnant.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there pregnancy chances with non penetrative sex?\n\nme and my girlfriend had intense foreplay yesterday and we were without clothes we want to if sperms not ejacuated inside vagina may be splill on hands and bedsheet could make her pregnant? also she got her periods on 13th last month till this time she did not get til now,so is there chance of preganancy?",
    "doctor_response": "Hi, there can be a chance of pregnancy if by any chance sperms came in contact with vagina.  If her periods  have delayed, do a urine pregnancy test at home.  If positive consult a doctor if you don't want pregnancy.  If negative wait for your periods.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Toxic effect of acetaminophen on kidneys and liver\n\nDoes drinking excess water while taking acetaminophen limit its toxic effects on the kidneys and liver?",
    "doctor_response": "HiThanks for the query.Drinking more water will not reduce the toxic effects of acetaminophen.However its a good idea to keep yourself well hydrated and take all the medications under the supervision of a physician.Hope this helpsGood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe scoliosis. Pain in arm, lethargic. Undergone kidney transplant. Taking tacrolimus, prednisolne, mycrophenolate. Suggestions?\n\nhi, im 28 with severe scoliosis . lately ive been getting terrible aches in my right arm. it feels like ive been hit on the forearm (i havent) my whole arm seems lethargic too. i also had a kidney transplant 18 months ago, im taking tacrolimus, prednisolne, mycrophenolate, amlodipine , asprin, any advice would be very welcomed please.",
    "doctor_response": "Hi , it seems that you are having pain in forearm with weakness . This indicates neurological problem due the severe spinal problem. so consult a Neurologist. You may be required to do some imaging studies of spine. Avoid over the counter painkillers .If req use mmedications safe for the kidney. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will antisperm antibody help me to conceive ?\n\nI AM 25 YRS OLD AND GOT MARRIED IN 2009. BUT DO HAVE A BABY. I CONSULTED THE GYNECOLOGIST ANS SHE SAID MYSELF AND MY HUSBAND HAVE ANTISPERM ANTIBODY. MY COUNT IS 28 U/ML MY HUSBAND COUNT IS 55 U/ML. WAT IS THE SOLUTION FOR THIS PROBELM. PLS HELP ME TO OVER COME THIS BY USING SIMPLE DRUGS. IM VERY SACRED ABT THIS.",
    "doctor_response": "Hi Welcome to HealthcareMagic Anti sperm antibodies are cause of infertility. Simple measure to treat this is to have sexual contact with condoms only for 2-3 months ( Condom therapy ). Prevention of entry of  sperms in your body for certain time will lead to disappearance of antibodies from your body. After 2-3 months you can plan pregnancy. If it doesn't work then there is medical treatment with limited success. IUI can be tried too. consult an infertility specialist. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for enlarged liver and ill-defined heterogeneous lesion in the left lobe\n\nSir, Lever is enlarged in size and I ll defined heterogeneous lesion noted in left lobe p/O developing liver abscess most likely advice clinicopathological correlation and follow up. Gall bladder appears collapsed with edematous wall with small calci within Please advise/elaborate Thanks and regards Dhiren patel",
    "doctor_response": "Hi, Usually, liver enlargement may indicate some types of hepatitis or fatty liver diseases and in most cases, it doesn't require any specific treatment.  If this is caused by diet, obesity and diabetes then dietary and lifestyle changes will be beneficial in every case. Alcohol and viral hepatitis are most common causes and in this case medical evaluation is required. Also if there is infectious disease or biliary duct disorders then you need to do some tests to rule out more serious issues which require specific medical treatment. You need to check your viral markers and do a liver biopsy if necessary. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ivan R. Rommstein, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fever with shivers, vomiting. Had a heart bypass surgery and kidney stones in the past\n\nhello doctor, my mother has severe shivering fever every evening (102 to 108) and she can t eat food all the day and if she try to eat food after second bite , she got vomitting....and my mother s age about 50 and 5 years before she had a heart bye pass surgery and 1 and half year before she had stones in kidney and cured . Now she only drink water . And the blood test shows she only had 0000 blood count day before yesterday and 0000 bc yesterday .. She having this fever for last 10 days..",
    "doctor_response": "HIThanks for the query.From the description of the symptoms it looks like your mother probably has an infection. It is difficult to predict  the source of this infection with the information provided.I will suggest that you take her to a physician as soon as possible. He/She will examine her and perform tests like urine analysis, Chest Xray; urine and blood culture etc and prescribe appropriate antibiotics.Hope this helpsGood luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for extrapulmonary TB\n\nMy name is manohar,MaleAge:28Extra pulmonary TBAfter  extra pulmonary TB  treatment i am feeling drowsy and fatigued and in my left side of my abdomen i feel very inconvenienceand slight headache too.How to over come this .pls help me sir.i had stoped taking madicine on 1st june2010 and started taking medicine oct 2009.after treatment i feel like heavy weight in my chest when i sleep keeping chest on the bed for some time.Earlier i was very strong person and used to do lot of Gym.Now i am not able to do anything and loosing interest on every thing.what should i do and how to rectify all thease sir.PLS...pls..pls help me sir.",
    "doctor_response": "Hello,The most possible issue for weakness after TB (Tuberculosis) treatment is deficiency ofvitamins , iron, trace elements or others.I recommend you to correct the same and get cure early with your physician.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for widal fever\n\nhi i m a lab technician...i m in work from 3years and a patient came to our hospital regularly and from day1 to till now after 2 year her widal is positive..and titre is 1:320 1:320 1:20 1:20 i cant find reason why her titre not getting down..she is taking treatment regurlarly......",
    "doctor_response": "Hi I did review your concern.WIdal test is done for typhoid infection. THe ideal treatment is cefexime or cefepime tablets for 7-14 days or ciprofloxacin BD for 10-14 days. There are few resistant strains that require higher antibiotics. but that requires stool or blood culture and antibiotic sensitivity testing which can be done after a failed course of this antibiotics. Also remember that the serum antibody counts go slowly over 1st week so the patient might be treated but the antibody might remain and hence it can cause a false positive in such a way.I Hope this helps.Wish you all the bestThank you for choosing healthcaremagic",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain when jumping, jogging, or bending. Reason?\n\nI've recently started working out and after about two weeks, i started feeling a sort of pain in my middle/lower back - kind of like a stich. It only hurts when i'm jumping, jogging - basically when i'm landing on my feet. Also, when i bend forward in a certain way, i can feel it too but it's not that intense. I'm only 18 and have never had any major injuries anywhere so I don't know how this happened.",
    "doctor_response": "Hi,Initially when starting exercise you may get this type of pain in the body due to stiffness, strain or pulling of muscles.nothing to worry, gradually every thing will be alright.Start with slow exercise for less time and gradually increase time with heavy exercise.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Autistic child. Feel frustrated and stressed. What should help me?\n\nHello doctor iam 30 year old married women as a homemaker taking care of 2 childern whose age is boy with mild autism and 11 month old girl baby husdand working for a private concern... I use feel so frustrated and feel so stress and get hurt for silly issues and getting angry lot of time burstout... don t know y what should I do?",
    "doctor_response": "Hi, In your case first there is need to investigate cause of your stress and frustration. Care of Following are possible causes of stress and frustration in your case: -Anxiety and depression: due to stress of looking after 2 kids, specially to one kid having autism. -Poor medical condition: As you delivered just 11 month back, so check your hemoglobin level and take healthy diet. -Adjustment problem: Involve your husband and other family members to care kids. You can meet nearby psychiatrist/psychologist to ascertain cause and treatment according to cause. Till that time take healthy diet, accept your child problem and do morning brisk walk. It will relax you and will reduce stress and frustration to some extent. I hope this information has been both informative and helpful for you. Wish you Good Health. Regards, Dr. Ashish Mittal www.99doctor.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for soreness a year after wisdom tooth removal\n\nI had a wisdom tooth removed about a year ago and its been fine but recently I feel like the hole opened up.  Its sore and feels like hamburger. I don't know what I did but chewing back there on accident makes it worse. I started swishing with salt water last night. Any advice?",
    "doctor_response": "Hello, Thank you for consulting with HCM.As you are mentioning that you got your wisdom tooth removed about 1 year ago, in that case the hole should not open again as the tooth is missing. But it can be possible that the tooth adjacent to the wisdom tooth might have become carious and now because of the infection of the root area , there is pus collection in gums which is now discharging  from the gums.Or it can also be possible that there is a traumatic ulcer in the gums.For confirmation of diagnosis you have to visit a dentist and get an x-ray done of that area which will show the infection. And treatment will done accordingly.Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Appendix burst due to ovarian cysts, recurring cysts post operation. Suggestive treatment?\n\nI have a couple of questions and wanted to see if they could be answered, and if I could use your answer in a memorandum to my military Commanding Officer. Once answered, can you also tell me what your qualifications are? My fiance underwent an emergency surgery on October 20, 2012. She had severe stomach pain and admitted herself to the Emergency Room on Fort Bragg at Womack Army Medical Center. I was away for training and unable to come home because we are not married yet. It was found that she had three ovarian cysts and they caused her appendix to burst. The surgeon removed the cysts and her appendix. Following the surgery, she has continually had stomach pain on a regular basis. This past week we admitted her to the emergency room again when the pain became too much for her to bear. Following the same tests that she had the originally had, it has been found that she has 3 more cysts on the same ovary in relatively the same spot. So after giving a brief description of her medical history, my question is this.....Would my fiance benefit from having someone around to take care of her medical needs while she is awaiting additional treatment for her ovarian cysts? As of right now, I am required to perform extra duties on base and I am unable to care for her whatsoever. So in your medical opinion, would it be safer and make sense for my fiance to have me around as much as possible to care for her medical needs and take her to her appointments, or to the Emergency Room if necessary instead of her driving herself when her pain becomes too much for her to cope with?",
    "doctor_response": "Dear sir, as I understand you want to know is it necessary  to be with your fiance while she s having ovarian cyst? Well, you should know that problem comes when ovarian cyst rupture or become torsioned; this will cause sharp pain in lower abdomen and peritoneal inflammation  which needs to be treated surgically in most cases. It can rupture today or never. Usually her gynecologist needs to plan her treatment and follow the size of these cysts. If it becomes too large it can be laparoscopicaly removed. So my conclusion is that you dont need to be around her all the time because many women have these kind of cyst and dont even know it. Also every human can have appendicitis at any time without any risk factors so it doesnt mean that every men needs to have someone around him all the time.  If she s gonna need the emergency procedure for her disease she will definitely be able to drive or make a phone call. Ovarian and appendix inflammation develops through 6-12 hours or even days... Wish you good healt,Dr. Ivan Romich",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is itchy chicken pox blisters in vagina a cause for concern?\n\nHello there, I have contracted a case of Chicken-Pox from fellow family members, and I have been growing concerned about it. Yesterday (Which was day two of my present condition) I found two small blisters inside of my vagina, they didn't have the exact same pearly effect that the blisters had on my stomach, but they itch all the same. They are small, and are a cloudy white? This concerns me greatly, but I have never had anything like this on or in my vagina before I caught the Chicken Pox virus. I am Twenty and this is the first time I've knowingly had this virus. Any answer is appreciated, thank you!",
    "doctor_response": "Hello,Thank you for posting your query to HCM,So, what I am understanding you are in your second day of blisters from the chicken-pox infection. At this point, its difficult to say if those blisters have been there before the infection, of have appeared with the infection.My guess is, you have those blisters from the infection, which in normal to have in the mucosa. They will last for about a week, and should heal after.If you still have them after 2 weeks, then consider seeing a gynecologist and doing the appropriate labs he will recommend to rule that out.If I was your caring doctor, meanwhile, I would recommend to try not scratch the blisters, apply anti-itch powder on them, an take any antihistamine medicine like cetirizine, clorpheniramine, ect, to help with the itch.Hope this is helpful.If you have other questions, let me know.Take care,Dr. Papaqako",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to proceed with kidney transplantation?\n\nHi, DOCTOR BHUSHAN, I'M FROM DHAKA. MY FATHER IS A KIDNEY PATIENT, RIGHT NOW HE TAKING DIALYSIS IN A HOSPITAL AT DHAKA. I'M THINKING ABOUT KIDNEY TRANSPARENT WHICH IS POSSIBLE IN INDIA, BUT  I NEED SOME INFORMATION ABOUT KIDNEY TRANSPARENT, CAN YOU  PLS. LET ME KNOW WHAT I HAVE TO DO I WANT TO PROCEED? HOW MANY TIME WE HAVE TO VISIT TO INDIA, HOW LONG WE HAVE TO STAY THERE, AND WHAT IS THE TRANSPARENT COST WILL BE? PLEASE LET ME HAVE THESE IDEA, IT WILL BE SO GREAT OF YOU.THANKS.MD. AMINUL ISLAM",
    "doctor_response": "HelloThanks for query ,Your father has Chronic Kidney Disease (CKD) and has been advised to undergo Renal Transplant .You wish to get the transplant surgery done in India..Please get following preliminary test done before you come to India to save time 1) Patients renal function assessment 2) Blood group of the patient 3) Donor should be preferably close relative like son ,daughter ,wife ,brother etc and should be of the same blood group 4) Donor should be less than 55 years old and should be in good health and free from any chronic illness .5) Since you are from outside country you will not get any benefits that are availed to Indian patients .6) Patient along with Donor has to come to India with documents from your Govt authorities to prove relationship.Once the patient with matching donor visits any Hospital in India he along with matching donor will be investigated and all the legal formalities will be completed within 2 weeks before Renal Transplant is done ..Patient along with donor will have to be hospitalized for 10 days after surgery .Approximate expenditure incurred will be about 2-3 lakhs Indian rupees .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rashes in infants?\n\nhi i have ababy girl, she is 6 months old, she had high temprture last few days then she was fine but today i noticed that she has a bit of rash on her back, chest and tummy, would you be able to help me and tell me why this rash has happened to her thank you",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.Fever along with rash can be due to a variety of causes. The most common cause is Viral exanthem. Visit your nearby Dermatologist as soon as possible.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On birth control, nausea, sleepy, headaches since 3 weeks after sex. Is there a chance of pregnancy ?\n\nHi I been on the birth control shot since September. I haven t miss not one of appointment nor my period. I been having headaches for the past 3 weeks. Nauseous and sleepy. I also have pink pad that keeps record of my ovulation days and menstruation days. Is there a chance I can be pregnant? I had intercourse on the most affect days",
    "doctor_response": "Hi,Your symptoms could be due to the contraceptive. Though you had intercourse during your fertile period, since you were regular with your contraception, the chances of conception are minimal. Yet, you should exclude/confirm pregnancy. If you wish for an early confirmation, please get the serum beta-hCG test. Else, you can wait for your next cycle and if you miss it, test for pregnancy with a fresh early morning sample of urine 3-7 days later. Hope you find this information helpful. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bump filled with pus and blood on knee?\n\nThree days ago my 7 year old had a bump just beneath his knee that had a white tip. The doctor said it was a flea bite and I agreed until last night. The area is very painful and the white tip filled with pus and blood and was oozing last night after his bath. I applied pressure, cleaned it with warm water and gauze and continued putting Neosporin on it and covered it. Should he go back to the doctor? This morning it bled into the bandaid and looks more like a peak than a bump. Help! and Thank you.",
    "doctor_response": "Hi,It seems that there might be having some bacterial infection giving this problem.He might require one course of antibiotic medicine course for 3-5 days to control infection.Clean the wound properly with antiseptic lotion and do dressing with Neosporin cream.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest therapy for vasovagal syncope\n\nCurrently I have vasovagal syncopy and narcolepsy. I am on propranolol, nuvigil, and prozac. I had an atypical episode (from what I am used to having) where I suddently felt nauseated, then was told to lay down (by my family). I was told that I was completely white in the face. I layed down and apparently was staring, able to move my eyes but unable to respond or move. Cold water packs were used as always for my syncopy episodes but it took about an hour for me to recover. I recall parts of the episode but not all of it. When I was unresponsive but moving my eyes, my family picked me up to move me and I was told that I passed out unconscious. During the unresponsive episode, I was told that my face and feet were gray and mottled. I do recall feeling numb and tingly in my hands and feet. Unfortunatley, I did not get evaluated thinking this was a syncope episode. Do these sypmtoms indicate syncope just in an atypical or more severe way? Or, does this indicate something else that I need to consider. I have never been diagnosed with epilepsy. this is the only episode that has occurred with these symptoms.",
    "doctor_response": "Hello, After going through your medical query I understand your concern and I would like to tell you that your symptoms are of epilepsy attack and you need epileptic drugs continually for a minimum 1 year. It's recommended for you to consult a neurologist personally for proper diagnostic evaluation and treatment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful lump on the forehead and swelling in the upper eyelid\n\nI went to the doctor on Friday because my upper eyelid was swollen. It hurt a little bit for a few weeks but I didn t see the swelling until Thursday. He said I have an eye infection and prescribed me an antibiotic and eye drops. Saturday under my eye became swollen but seemed to go down. My upper eyelid is still swollen and hurts and today which is Monday I noticed a lump on my forehead. Not sure what this could be and if it s related to my eye infection? Please help.",
    "doctor_response": "Hi,From history it seems that there might be having Herpes Zoster, a viral infection.In this disease pain starts before appearance of skin lesion which happened in your case.This is due to involvement of trigeminal nerve giving rise to lesion on forehead.Another possibility of having infected stye giving rise induration and swelling.Consult your doctor and discuss about this.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from itchy skin, caused wounds, dryness. Prescribed paraffin and flucort. Will this suffice?\n\ni am suffering from itchy skin.Rubbing itching areacauses wounds. Consulted dermotologist. Has prescribed parrafin based cream to be applied over hands and legs./and flucort-H.He advised touse regularly to avoid dry dryskin.Will this be sufficient.Additional Medication Should i take.kindly advice.And also Advice on eatables that will help retaining moisture in skin and prevent drying.Aged28.",
    "doctor_response": "Hi,Your dermatologist has perfectly advised you the medications. There is no need of extra medications. If at all there is itching or any irritation then you can additionally take loratadine tablets by mouth. If itching is less then can take for one time and if it is more then can take for 2-3 times. Do not pinch, pop or scratch the area.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My Mentzer's index is 21. Will it affect my baby?\n\nHi, I am 5 months pregnant and my reports say that Mentzer's index is 21. Will it affect my baby?",
    "doctor_response": "Hello. Menterz index 21 means that you have iron deficiency anemia. Yes, it can affect your baby in certain ways if you do not seek medical advice. Anemia may lead to smaller babies, growth restricted babies and also preterm labor ( labor before due date) which can result in delivering baby earlier and complications associated with early delivery. Also, a woman may suffer excessive bleeding after delivery who are anemic. So, I would suggest you see your local doctor, check the level of anemia and get appropriate treatment for that. Hope it has helped you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes discomfort in the sternum while breathing?\n\nI had a terrible cough that started about 2 months ago. It was always a dry cough, never coughed up any mucus, and I never had a runny/stuffy nose. It felt like just a bad tickle in my throat that wouldn t go away. It was worse at night, and I would cough so hard that my whole body ached and my diaphragm was tender to the touch. It felt like it was slowly, very slowly going away, and about 3 weeks into it, I got a bad cold on top of it. Now, I would wake up in the morning coughing up phlegm and then at night it was back to the dry tickle cough with no phlegm. The cold went away after about 2 weeks, and I still have the dry ticklish cough at night. It s not terribly bad, but it is still there. I never feel out of breath, I am not (and never have been) a smoker, I have never had a fever with this cough, and I feel mostly fine except for this lingering cough. My husband also got the cough at the same time (and we both got it from our toddler). My husband and toddler have gotten over it. Yesterday, I started with another symptom (that I think is related to all this coughing)... Every so often through out the day when I inhale deeply, I can feel almost a buzzing or small vibrating on the right side of my sternum near the bottom ribs. It s been happening more and more frequently since it started yesterday, and I noticed now that I seem to get gassy and burp a lot after I do it a couple times in a row. There is no pain involved, it just makes me cough a little more. Just looking for some advice, and any idea what this might be?? Should I be concerned?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.As you explained, there might be gastric reflux or allergic problems which cause this kind of a cough.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Jnikolla",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could abdominal pain be due to thickened endometrium?\n\ni recently did an ultrasound on my abdomen and it states that endometrium appears midly thickened and measures 8.6mm. i have been having recent lower abdominal pain (pelvic), not chronic..is it related in any way? i am 35 yrs and i never had any major medical condition",
    "doctor_response": "Hi.Thanks for your query.Hi the thickness of the endometrium depends upon the day of the menstrual cycle you are at. The ultrasonography showing this much thickening of endometrium may not be the reason for the pain in abdomen. Other reasons of the lower abdominal pain can be enteritis or colitis. Get a course of an antibiotic and antispasmodic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes enlarged eyes in a child diagnosed with tuberous sclerosis?\n\nI have a five yr old son who has a dignosis of tuberous sclerosis complex. He just had a biopsy done in New Orleans on 12-30-11 after this procedure my child has been waking at 4am and staring at me. This scares the death out of me. His right eye is twitching and his eyes are extremly large out of his head. Can anyone explain to me what is going on?",
    "doctor_response": "Hi...by what you quote I feel that it could be a seizure keeping in mind the background of Tuberous Sclerosis. I suggest you consult your neurologist and get an EEG and MRI brain done. Protruding eyes could be due to the neurological manifestation of Tuberous Sclerosis.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in getting pregnant?\n\nHello I am Ruby and, I just wanted get a few questions answered. I have been trying to get pregnant for 3 years now. I am a 26 year old female with one succseseful pregnancy. My partner has been the same one I have been married to for 8 years now. He is older, 36 to be exact. I have tried everything of my part to conceieve. Please help at least some advice would help. Why can t I get pregnant? How long til it happens? Will it ever happen again? I hope to get back from you, thank you?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You and your husband need some basic investigations. For you some hormonal test. And for your husband semen analysis. With above basic investigations we can tell what problem You have. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Soumya",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure a contusion of knee?\n\nLast year I got a Contusion on my Knee, even after i went through the healing process the knee still hurts. When I shower I lift one leg up to shave it and the knee wobbles and hurts. Even writing this my knee hurts. It isn t a bad pain it just is like a nagging kinda hurt pain. If there is anything you may know and can tell me that would be great. Thank you!",
    "doctor_response": "Hello,The painful knee seem to be related to the contusion. Most\u00a0contusions\u00a0simply require time to\u00a0heal. Bone\u00a0contusions take\u00a0a bit longer, usually one to two months, depending on how severe the injury\u00a0is. As you\u00a0recover, you\u00a0can use anti inflammatory medications such as Acetaminophen to relieve the pain. I also suggest to maintain the knee elevated.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is full length stockings necessary after total hip replacement surgery?\n\nhello, i have been operated for Total Hip replacement surgery two months back. Dr. is insisting of wearing full length stockings regularly for min. three months. I find very incomfortable in wearing and continuing as it lead severe itching and skin erruptions. Pl. advise how far it is essential to wear them? Tandon",
    "doctor_response": "Dear Sir/Madam,I thank you for having faith in Health Care magic and for seeking help on your issue; I have gone through your symptoms, and in my opinion, the doctors insistence is because of the fact that it can promote your venous return and prevent any deep vein thrombosis. but as far as I understand its not must to be worn at all times, when you are walking you can get rid of them. I hope I have been able to provide you with a satisfactory solution, if you want to clear any doubts about my opinion, feel free to contact.Special note-  Any medication prescribed needs to be taken after consultation with your personal doctor only.ThanksDr. Narender Saini",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can irregular periods with infertility be treated for successful a pregnancy?\n\nDear Doctors, I have the same problem of infertility but the check up result showed  everything is normal. and i have been taking this Primolut n 5mg tabulate with out having sex just to regulate my ministration. The tabulate regulated my ministration but not continues. If i don't take the tabulate again next month, it will not come. And, now i need to get pregnant so, if i take this tabulate for 5 days  and have a sex after i finished taking the tabulate, does it mean i get pregnant?  if not what can i do? what do u suggest me? I am eager to have a child . tnx",
    "doctor_response": "Hii appreciate your concern In my opinion you should go for hormonal studyThere are good chances of getting pregnant if you can have Sex during the period of ovulation which would be 14 days prior to the next period 2 days before or 2 days after thatI would advise you to consult your doctor before discontinuing primoluteHope I have answered your questionthanks for your query on our site good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in leg\n\nHi, I m a 22 year old female and have increasingly found it painful to get up after squatting or sitting down. It is mostly only painful in my right leg - unsure of whether it s the joints or muscles. Am unsure if it is just a sign of general unhealthiness, but if so, shouldn t the pain be in both legs? I also have quite poor blood circulation - often get chilblains in winter but not sure if this is related in any way.",
    "doctor_response": "hi,thank you for providing the brief history of you.As you have this symptoms I feel this is more of the muscle weakness leading to inflammation in the knee joint. For which we need a thorough clinical examination.Also we may need an x-ray or an MRI depending upon the examination that it is more of a bony issue or soft tissue issue.Most of the pain are due to weakness of the muscles and with simple medication and physical therapy they respond well.In my clinical practice most patients with knee injuries are referred to physical therapy and they respond well with a combination of drug therapy.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for a lump inside the bum cheek\n\nHi, my so is aged 16 years of age and has just noticed a lump inside his right bum cheek. It is painless and he doesn t know its there unless you apply pressure. It doesn t cause him any problems, but it moves around if you apply pressure. What could this be? He also suffers with acne.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have lump inside the bum cheek which could be  haematoma formation which might get fibrosed and cyst formation due to dental infection. You should take proper course of antibiotic. Apply hot fermentation. You should take Motrin 1 tablet with food as well. It can be possible that lump will go away only with medicine without surgery. If condition persist even after completing antibiotic course then again visit dentist or oral surgeon for proper evaluation. Maintain proper oral hygiene.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for impetigo infection\n\nmy boyfriend has a baterial infection called infatago and the doctor gave him amoxicllin trihydrate and he has been very sick since he has been taking it, He has a severe bad stomach and muscle pain and watery diareha and numbness in hands and very dizzy i was wondering if this is normal or if he should go to the doctor?",
    "doctor_response": "Hello,Welcome to HCMI understand your concern.Your boy friend is experiencing the side effects of amoxicillin.As he is having stomach pain along with diarrhoea,better to tell your doctor immediately and insist for change of medications.Do not use anti-diarrhea products or narcotic pain medications if you have the following symptoms because these products may make them worse.Hope you are happy with the answer.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can restlessness in an infant suffering from meningocele rupture be managed?\n\na 6 months baby, pt of meningocele rupture, was admitted to hospital 2 weeks back and is under treatment still now. bt for two nights its very restless. no respiratory difficulty, chest indrawing, dehydration, oedema, anaemiabor other findings. what should its perfer permanent management for the restlessness?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. In a 6 month old child with restlessness specially after meningocele rupture other symptoms are also very important such as fever for any central nervous system infection,also any associated hydrocephalous, electrolyte imbalance,  serum sodium, potassium for associated SIADH, and as the child is on IV fluids, along with serum calcium. Along with symptomatic management of pain, hunger etc. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, polycystic ovary. Taking clomid. Missing periods, pregnancy test negative. Taking norethisterone. Suggestion?\n\nhi doctor, i just have a question to ask. my cycle is 19 days normally and ive been like this for a good few years, my doctor found out in 2008 i have polycystic ovary and now im trying to concieve he put me on clomid . He told me to take it on my second day of period for 5 days. My last period was 12th april and i started taking the pill on the 13th of april for 5 days finished on the 17th of april, and my period have stopped then. Now is 30th of may and still havent had my period yet, i have two pregnancy test and it says negative. But i am having symptoms of my nipples been hurting for about a week, and i am getting discharge regularly for 2 weeks. Can you please get back to me what shall i do? My doctor have given me norethisterone tablets to start my period again. is this normal reaction after taking clomid?",
    "doctor_response": "Hello. Thanks for writing to us. An overdue period with a negative pregnancy test is more likely to be due to polycystic ovaries rather than due to clomid. Clomid is not likely to cause such a delay in the periods. You need to take norethisterone to have a withdrawal bleeding as advised byu your gynecologist. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause severe pain in the abdomen?\n\nYES, MY WIFE KEEPS GETTING VERY STRONG PAIN ON HER LEFT SIDE.  WE THOUGHT IT WQS HER KEDNIES AT FIRST BUT IT IS MORE ON THE LOWER SIDE.  IT A STRAINED MUSTLE.  ALSO, I HAVE BEEN DIAGNOSED WITH SPINAL STINOSISW,  CAN ANYTHING BE DONE ABOUT IT.  I HAD A BONE FUSSION IN 1970 WHICH IS TGE CASUE.",
    "doctor_response": "Hi...for your spinal stenosis consult a neurosurgeon... treatment depends on the degree of stenosis...for your wife...get a ultrasound done as it could be ureteric stone or some ovarian cyst...Dr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for joint pain\n\nI have mild joint space narrowing at the L5-S1 level with moderate bilateral facet joint disease at the same level. The height of the vertebral bodies is normal. The posterior elements are intact. The sacrum is intact. The SI joints are are unremarkable. Impression: DJD at the L5-S1 level. Otherwise normal.As a result, I have back pain the never quits. What treatments options do I have?",
    "doctor_response": "Hello there,After reading your concern the only best suitable option left for you is visiting a Physiotherapy clinic to get the treatment started on priority basis.The more you delay the more it will get worsen.As you have not mention your age & sex, but after reading complaints it appears to me that you are above 50 years. DJD means degenerative joint disease. For this you will have to take anti-inflammatory medicines at the earliest along with the Calcium supplement. in the mean time you can start with Hot water fomentation to the painful site, and mild stretching.If you are visiting physiotherapy clinic 9as it is a must for you)Do not forget to take- Lumbar tractionLumbar mobilisationFacet joint mobilisationneural mobilisationStretching of hamstring muscleCore strengthening The mobilisation technique will help in circulation to the joints and will result in healing of the joint.regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe anemia, cellulite in leg, left feet swollen. Received blood transfusion. No improvement after receiving diuretics. Connected?\n\nHI.  My mother is currently suffering from severe anemia and she is retaining water in her lower body.  She has cellulitis on her legs, and her legs and feet are so swollen she can't walk.  She is received a blood transfusion on Saturday and is currently receiving diuretics in the hospital but there is not much improvement.  Can you think of any connection between the two?",
    "doctor_response": "Hi and thanks for the query,It is important to exclude some fluid retaining conditions that might explain fluid overload. Why she received the blood transfusion is important. Any history of kidney disease, which on its ow could explain severe anemia is a possibility. It is not unusual to have some oedema after transfusion. I suggest evaluation for kidney function first, and in case there is  notion of chronic kidney disease, the opinion of a nephrologist will be most welcome. Diuretics and fluid restriction could be temporal management measures. Kind regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Depo user, Severe abdomen cramping, back pain, brownish spotting, small red clot, miscarriage history. Reason?\n\nI'm on Depo my last shot was 7-17-13 and I have been on it regularly for about 4 years.  Today I have experienced moderate to sever lower abdomen cramping, back pain, and brownish spotting.  I have seen one bright red small clot.  I miscarried 12-15-13 at 9 weeks.  this pain is similar but I haven't had the bright red blood.  I took a pregnancy test around the beginning to middle of August.  Results were negative.  What could this be?",
    "doctor_response": "Hello. Thanks for writing to us. The symptoms that you are having are normal in case of a depo injection. The mild brownish spotting spotting usually subsides on its own in few weeks. Please do not worry.I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal ,drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why did the left spermatic cord swell up and is hurting after swelling is reduced ?\n\nAbout a hour ago my left spermatic cord swole up, and it was about the  width of a quarter and it was swollen up on the whole thing, it only hurt a little bit, i messaged it and the swelling went away after a few minutes...ever since then it has been hurting though.",
    "doctor_response": "Hi, Sudden swelling in the area of spermatic chord needs evaluation. You need to rule out any infection or a hernia. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr B. Radhakrishnan. Nair, OBGYN",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cold Symptoms\n\nI have cold like symptoms;running nose, sneezing, and minor sore throat. What over-the-counter medication do you recommed that are pills ?",
    "doctor_response": "Hi.. Your symptoms are suggestive of upper respiratory infection, or simple flu... You need paracetamol and antihistaminics.. These are available as sinarest tablets or dolo cold tablets.. You may use them once a day or twice a day.. Apart from these medications, warm salt water gargles or chlorhexidine mouth gargles is recommended thrice a day.. If you develop fever, you need antibiotics along with these medications.. It is equally important that you take care of your hydration and diet in such times.. See a doctor for a better care and advise..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness & heart palpitations?\n\nhi there. i am 29, weight 22 stone and i am a smoker. I have recently been have heart palpataiotion, or extra heart beats. i wake up every day with dizzyness in my head, or what i can only describe as pressure on the head, my heart pounds and i just dont feel right. please can you advise...",
    "doctor_response": "Hello,   Most probably these are ventricular premature complexes. These are ectopic or extra beats. These are usually benign and not life threatening. These are frequently associated caffeine, smoking, alcohol, thyroid problems may aggravate these.   So before going ahead we need to confirm it. You ll need ecg, Since these are not frequent Ecg may be normal sometimes, so in that case you ll need 24 holter monitoring which can diagnose these. You should also get echo done to look for functioning of heart.   You should also get thyroid test done.  Avoid smoking, alcohol and caffeinated products. You should also discuss with your local doctor regarding Metoprolol Xr 25 mg once a day, which will suppress these beats, after confirmation of diagnosis. Hope this helps you and get back if you have any questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the symptoms of anemia?\n\nhi, im 26 yr old, 1.6 heigth, weigh 66 now i get all the symtoms for anemia, but when they did the thyroid hormone test it came out absolutely healthy and said i was fine, but the thing is i have all these symptoms and now dont know what to do..can you please help me out",
    "doctor_response": "Thanks for asking to healthcaremagic.I understand your concern.In any form of anemia,the oxygen carrying ability of red blood cell is impaired.This lead to reduced oxygen supply to the tissues/organs relative to its demand.So various symptoms appear like fatigue,dizziness,palpitations,shortness of breath etc if anemia is severe(one of the main reason being heart,which tries to compensate by pumping more amount of blood to the tissues).If i am your treating doctor,would advise initially a basic test called complete blood count(CBC) to rule out anemia.Hope this information helps you.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in ankle, leg and foot?\n\nMy husband is 53 years old. He noticed about a week ago that his right knee was swollen. He had no injury or fall. He spent 8 hours on a cramped airplane with bad weather in Dallas Texas and the next day the swelling started . We have been icing it and taking Aleve. Today the swelling has moved to his leg, ankle and foot. What could it be and should we seek medical help?",
    "doctor_response": "after a long airplane travel, prolonged  immobilization may cause deep venous thrombosis of the lower limbs, whose main symptom is swelling. i suggest to refer soon to a ER, to exclude it and check for other causes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shock feeling in heart?\n\nmy dad had a single episode of a shock feeling in his heart awakening him from sleep 4 days ago, he has had some new confusion and unsteadiness and was diagnosed with a UTI, He had not told us about the episode with heart til yesterday...do you think some of the symptoms may be related to this episode as well? He has a Pacemaker but no AICD",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!I understand your concern and would explain that a heart disorder can not be excluded, even though this type of pain (shock like) is not typical of cardiac disorders. A musculoskeletal pain (from inflammation) can not be excluded too . The UTI infection, would not explain his confusion and unsteadiness. Did he have fever?I would recommend consulting with his physician for a careful physical examination, a resting ECG and some blood lab tests (complete blood count, inflammation tests, blood electrolytes). If the confusion persists and all the metabolic tests result normal, I would recommend consulting with a neurologist and performing a brain CT scan and an EEG. Hope to have been helpful!Best wishes, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathing trouble post a knee replacement surgery?\n\nyes, had a knee replacement on July, 12th now I am so tired, no pep, have trouble breathing, it is now dust and mold time of year and nose is either stuffed . Still walking with a walker and run out of breath easy and fall asleep in a flash when I sit down. No energy or pep, wish I knew what I can do to feel great again",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Possibility of bronchitis is more likely. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test).PFT will not only diagnose bronchitis but it will also tell you about severity of the disease and treatment is based on severity only. You will mostly improve with inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest tests to confirm pregnancy\n\nhello in december i had a normal period lasting 15-19th. january was weird spotting 14-16th in feb. nothing i have all the pregnancy symptoms but i started bleeding march 1st and it lightened up on the second. today is the 3rd and nothing..am i pregnant or just a change in cycles???",
    "doctor_response": "Hello,In the current scenario, I would ask you to go for an assessment of the serum beta-hCG titres, to confirm/exclude pregnancy and also to follow it up with a trans-vaginal sonogram to know the status of the pelvic organs. If negative, this is indicative of hormone imbalance and further management can be planned after a hormone analysis. Please maintain a healthy weight, regular exercise and a healthy diet. A couple of courses of hormone supplementation usually helps to set the cycles back on track. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does nausea and headache after injury indicate?\n\nYesterday, I hit the top of my head on the edge of an open wooden cabinet door.  I automatically had a headache and a small knot.  I felt a little nauseated but did not vomit. I felt better after taking some tylenol.  Today I my head is extremely sore and I have a headache.  Im really worried.  I did make a doctors appointment for today.",
    "doctor_response": "Hello dear,The lump formation after fall is due to accumulation of fluid & blood and it is called Hematoma.The blood cells accumulated are eventually broken down and absorbed in the body.But this is a slow process & takes times to disappear completely.Till that time, symptomatic relief is obtained by taking analgesics like Tylenol, ice compression & adequate rest.If it still persists or there are any other associated symptoms like fever, vomiting, visual disturbance, loss of consciousness, convulsions, etc...then it will be better to consult your Doctor.Under such circumstances, a CT scan of brain will be needed to rule out any pathological cause for symptoms.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and tight feeling in heart?\n\nHi...I felt slightly dizzy in the beginning while sitting on my pc...and then after no more than 5 mins, i felt  heart being tightened.It felt as though someone had grabbed my heart by their fist.Is everything okay with me or do i need to get my heart checked?...Plz reply quickly",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I totally understand your concern. I will tray to explain you something about chest pain.A typical heart chest pain does have some characteristic. Heart pains are  usually retro-sternal chest pains, like tightness, squeezing or heaviness. They might irradiate to the neck, both arms and jaw. They last from 5 to 20 minutes. Usually they exacerbate during efforts.So, if I was your treating doctor and as you are experiencing chest pains i will recommend a full heart chek up like an electrocardiogram, a cardiac echo-cardiogram and a strees test to exclude heart problems.Hope I was helpful. Wish you good health.Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do chest pains, shortness of breath and fatigue indicate a clot?\n\nmy husband thought he had a heart attack, the hospital said no. two weeks later he is still having chest pains ,shortness of breath, tired, and now is swollen and feels as though fluid is collecting in his chest. could it have been a clot? he had pain and swelling in his knee and then it left",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It may be cardiac or respiratory in origin. It is possible that he may developed heart failure. Use tablet Pantoprazole before breakfast for one week. Avoid cool drinks and freeze water, consult your physician he will check for heart failure or Acute episode of asthma or anemia/liver/kidney failure with fluid retention. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for itching and irritation near the penis\n\nHi, I am 35yrs old male and for the past 15days I observed sweaty,Itching & irritation near my penis where the two legs join. I feel like scratching whole day & night as itching is unbearable.Could you please advise what I need to do inorder to get rid of this..",
    "doctor_response": "HelloThanks fr query .Based on he facts that you have posted you have what is called as Jack Itch..Please use topical anti fungal ointment like Meconazole for local application over affected area ..Ensure to wash your inner wares in hot water soaked with antiseptic solution Dettol Ensure to wash the affected area with warm water twice daily ..It should get cured within a week .Dr.patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is glandular neoplasia ?\n\nhi doctor in my fnac report finding are suggestive of glandular ( serous ) neoplasm. i want to know what it is . is any serious thing is there",
    "doctor_response": "hi,thanks for query.Neoplasm means presence of abnormal cells which are not expected.They are not normal and depending the reason for what this FNAC was done,this may indicate some form of malignancy(cancer).But for proper and right diagnosis only can be given by your treating doctor after putting everything together.Please get in touch with him. wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to rule out Achilles tendon injury?\n\nMy left heel has been hurting for a couple of weeks, I suspect Achilles tendon. What should be done for it? I am not an athlete. Seems worse when I wear shoes that don t fit snugly or that allow the heel to slip. I do not wear high heels. Should I ice it? Other?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have  Achilles tendon injury. Well there can be many reasons for symptoms you mention in query like jumping , falling from a height or stepping into a hole . I would suggest you to keep you feet in hot water tub with Epsom salt in it , do gentle massage and take proper rest . Consult orthopedic surgeon for proper examination . Doctor may order CT scan along with physical examination . Doctor may recommend muscle relaxant , anti inflammatory or recommend physical therapy.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes migraine, depression, stomach problems and tiredness?\n\nmy mom has been diagnosied with lupus just recently and i myself hasnt had great health during my life and im only 21 now that im reading up on it i see symptoms that i have been having or had that could be exsplained is it posable i could have lupus my symptoms are migrains my hole life cold hands and toes depression hair lose uti problems stomack problems and gaullblader removel ackyness and just becoming ill aLL TIME WITH no answers whyand tiredness digestion problems can u help me out",
    "doctor_response": "Dear Madam,There exists a possibility but ANA tests and ENA profile needs to be done . to confirm the diagnosis of lupus .Dr. Shruti",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause hydrochephalus?\n\nHi, my wife age 29 is suffering from hydrochephalus problem. She has left side paralyse and she is lying in the bed and she is in unconscious condition. Doctors suggested not to cure by surgical procedure because she is not in that condition. Please suggest me is any diagnose for my wife",
    "doctor_response": "Thanks for your question dear there are lot of problems could cause hydrocephalus one of them is  stroke infection  tumor trauma etc if she is one hydrocehalus now and your neurosurgeon saying she cannot be operated there must be a reason behind this  there are other treatment such as repeat lbar puncture and lumbo peritonial shunt",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am 28 years old suffering from azoospermia,one aborted ibf. Can i go for ivf again ?\n\n28,m,azoospermia.boispy report-production wit few matured sperm....one ivf success last june 2010 but wit abort in 3month due to heart beat stop..treament centr [delhi ivf(dr.anoop gupta).wat to do now..should we go again ivf or iui?",
    "doctor_response": "Welcome to HCM. Success rate of iui is better then ivf.so first choice should be iui. Go for 4 to 6 trial of iui otherwise ivf is second choice.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is thyronorm safe during pregnancy?\n\nhello i am 30yrs femel. Now i am 6weeks pregnant and diagnosed with thyroid My TSH level is 5.1, Doc adviced me to take thyonorm 50mg. Is it safe during pregnancy? Is it safe during pregnancy?Thyroid hormone affect the unborn baby?Pls ans, Thanks in advance",
    "doctor_response": "Hi,Thyroxine is harmless to the baby and in fact prevents hypothyroidism in developing fetus. Continue with 50 mcg of thyroxine. Do not change the dose often. Continue with the low dose and give time for your body to adjust to the hormone levels. Check your thyroid levels every 20 days until it maintains a normal value. Hypothyroid patients should continue thyroxine in pregnancy.Higher doses such as double dose can be required to be taken.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Saranya Ramadoss, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe pain from the middle to the lower back on the right side be treated?\n\nhi, about 1 hr ago i had a severe pain my middle to lower back, on the right side. i was on my to the store and decided to turn around and go home when i felt like my stomach started spasming. i pulled my shirt up and could see what i was feeling. now that i m home the pain isn t as extreme in my back but i feel like i have to urinate every second. Help please! :)",
    "doctor_response": "Hi, Probably you may be suffering from urinary tract infection along with renal stone or cystitis etc. Until examination is done it is difficult to say what it is. Back pain may be due to spondylosis or back muscles spasm. Drink plenty of water, avoid spicy food. Use tablet Norflox twice a day for five days. If symptoms not improved please consult your physician he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can the red spots on back of hands that resemble bruising be?\n\nHi doctor, There are red spots on the back of my hands, close to the thumbs. I do not feel any itching, pain or any other unusual conditions. It is just redness. It is present under the skin and looks like bruising. I do not know if it is caused by sun exposure or something else. I first noticed it three months back. At present I am taking Vitamin B complex tablet and vitamin C tablet. Please help.",
    "doctor_response": "Hello. I have examined your photographs (attachments removed to protect patient identity) and your history details. For further information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cramps and heaviness in leg from heel to knee?\n\nHi, 6 days ago I started feeling my right leg heavy when I slept, It kept me awake so I put a pillow under it and it got better. these happened every night but nothing when I was walking. Two nights ago the feeling was the worst. Not even pillows would take the feeling like gravity was pushing just my leg from heel to knee. next morning I felt it even when I was walking. My leg kept having cramps and stay stiff for a moment or so when I was walking. At this moment I still have the leg heavy and I feel my hands heavy when I lay them or while walking. I did a blood test and everything was on tract, I went to the doctor two days ago and I am doing a hormones check but I want to know if their any other causes because I am not taking hormones and my Dr. looked worried? Please Help.",
    "doctor_response": "HiLeg cramps is common condition.usually it responds to massage with olive oil,giving up heels ,and intake of calcium, vitamin D and Evion capsules.Exploration can be for any veins prominence, history of smoking, circulation issues rule out by color Doppler test.Serum sodium,potassium levels also checked for related causes.Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can immunotherapy process help treat allergies?\n\nGREETING SIR I DEVELOP THE NASAL PROBLEM 3 YEAR BACK WITH POLYP WHICH GOT OPERATED 2 TWICE. SINCE THAT I EVEN DEVELOP ASPERGILLUS FUNGAL SINUSITIS AND ALLERGIC TO IT AND GOT OPERATED. NOW I AM ALLERGIC  TO SOME SUBSTANCES WHICH DISTURB ME BOTH PHYSICALLY AND MENTALLY.. I WOULD LIKE TO KNOW THE IMMUNOTHERAPY PROCESS AND ITS GREATNESS TO DEAL WITH THIS ALLERGIC  sudhir keshri",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your query and would like to make suggestions for you as follows:1. Regarding immunotherapy process, I would like to inform that there are two types of immunotherapy available - subcutaneous (injections) and sublingual (drops to be kept under tongue).The schedule is specific to your diagnosis and treating allergist. It involves gradually increasing dose of the substance you are allergic to in order to \"train\" your immune system, in simple words.If your response is good, usual duration of immunotherapy is at least 2-3 years.2. One more thing, aspergillus fungal sinusitis is a different disease rather than allergy. Immunotherapy is not yet used commonly for treating allergic fungal sinusitis.3. I would suggest you to consult an experienced Allergist-Immunologist who can suggest appropriate allergen specific immunotherapy after thorough evaluation of your symptoms and investigation.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. There is a lesion on my penis. Is that a tumor or is it due to scratching?\n\nHi doctor,I have dermatitis on my scrotum area. I generally scratch my groin and scrotum a lot due to itching, especially at night. Today all of a sudden I saw some lesion in my inner part of the penis. The picture is attached. Is that due to constant scratching? Or is that any tumor or something related to cancer? Please let me know. Thank you.",
    "doctor_response": "Hi. After reviewing the information shared and your pictures (attachment removed to protect patient identity), a few things come to mind. For further information consult a surgical oncologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having lower abdominal cramps,teeth chattering,fatigue feel and symptoms of premenopausal.What does the finding mean?Treatment?\n\nGood evening. For the last day and a half I've been having quite severe lower abdominal cramps (similar to severe period pains) that come and go in severity. Alongside this, chills to the point of teeth chattering (but no temperature). Feelings of fatigue (though I managed to get to work today). However this morning when I got up, for an hour or so I kept blacking out, but managed to control it and it eventually passed (I am prone to dips in blood pressure). I am a working mother (I teach) and it has been a particulrly busy period, plus stressful time with two teenage boys. I'm 50 with some premenopausal symptons. Now in bed and the shivers have gone, but still dull lower abdominal pain.  Can you advise? Mary thanks.",
    "doctor_response": "Dear.I understand your concerns.The symptoms you mentioned can be summarized as pre-menopausal. Cramps and anxiety and stress and lethargic symptoms are common.Anxiety that your menopause period is approaching may lead to these symptoms.Don't lose heart. It is normal.Consult a gynecologist for further advice and suitable medications.Wish speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for rashes and swelling\n\nHi,I have rashes and swelling came today and i feeling itching. Rashes will come whenever i take alcohol and otherwise it will not come. Can you suggest a medicine to cure these rashes and swellings. Also please let me know why rashes are coming whenever i drink.Thanks,Surya",
    "doctor_response": "Hello and welcome to healthcaremagicI would keep a possibility of Acute Urticaria. It presents as itching and skin welts/swellings, which can be distributed all over the body.Alcohol is one of the well known causes of urticaria.Urticaria OR hives can occur due to various causes like(to name a few):--Infections(bacterial , viral, fungal) --Drugs(Pain killers/ antibiotics etc) --Alcohol Intake--Certain foods and food additives/preservatives --Physical Urticaria: Cold temperature, Heat, Pressure(Prolonged Standing, Sitting), Dermaographism etc. --Cholinergic Urticaria: in response to strong emotions, exercise, spicy food etc --Autoimmune disorders like SLE, RA etc. --A few cases have no underlying cause and are known as idiopathic urticaria. An oral antihistamine like Fexofenadine (Allegra 180 mg tab) OR Loratadine (Alaspan 10mg tablet) once or twice daily for a week would be suitable. They are non-sedating and wont affect your alertness level. A topical soothing lotion like calamine would help you symptomatically. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any chance of pregnancy even after periods?\n\nI took a pregnancy test at my doctors office and it cam back negative; however, she still thinks I am pregnant, because i have been having headaches, nausea, and cannot be around certain smells. On Saturday I started having spotting that was pinkish and brown that lasted til Sunday, but on Monday it got heavier like my normal period would be. I still get that nauseas feeling but it doesnt last long, and teh headaches have been rare. I have to scheduled blood test on Thursday. CAn I still be pregnant?",
    "doctor_response": "Hallow Dear,If pregnancy tests on the urine are done too early, they may give false negative results. These tests are reliable about 8-10 days after missed period. If you have done this test before this period, it may be negative even in the presence of early pregnancy. However, you have got your menses also. So negative pregnancy test with appearance of menstruation is in the favour of 'no pregnancy'. However, if there is some doubt in somebody's mind, you have following options to the confirm the diagnosis:1. Beta hCG test is a very specific and sensitive test. This test gives reliable results even few days before missing period.  2. Ultrasonography gives direct visual evidence about the status of pregnancy. However, it might be difficult to visualise the embryonic sac before 8-10 days after missed period. You may opt for either of these tests to confirm the diagnosis about your pregnancy status. I hope this helps you. Dr. Nishikant",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for itchy bumps on earlobes\n\nMy son has an itchy red rash on his earlobes. It's been here for 2 weeks. 3 weeks ago, he had rash on lower right leg. Looked like poison ivy. Doctor said contact dermatitis, given hydrocortisone 2.5% 2x a day with Bactroban ointment. A week later, rash spread to all extremities including earlobes. Went back, given prednisone 6.5 ml 2x a day for 5 days. The rashes on extremities are drying up but his ears are still red with some small bumps, very itchy. Hydrocortisone does not seem to work. Also giving him Benadryl. Also, same itchy bumps are also seen on his cheek.",
    "doctor_response": "Hello, Your son's symptoms seem to be related to contact dermatitis. I recommend using Calamine lotion for local application. I also recommend using Loratadine daily. Cool showers can be helpful. Hope my answer was helpful. If you have further queries feel free to contact me again. Regards, Dr. Dorina Gurabardhi General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Was told a lump in my mouth is a bone, should I be concerned ?\n\nhi i just came from the dentist a few hours ago and was told this lump on the inside right hand side of my lower jaw just a inch from my teeth and was told it was a bone that grew out. can this happen and should i be concerned even tho i was told it was nothing?",
    "doctor_response": "hi, wow I thought I was the only person to have this! I've had mine for about 3 whole years and it hadn't started hurting until now. I saw my dentist, who didn't know what it was so made me an appointment at the hospital, who x-rayed it and confermed it was a bone. It wasn't bothering me so they said there was no point taking it out, but now (about 3 months later) it has grown to about twice its original size?! So I'm going to the hospital tomorrow for another appointment and I will probably eventually get it removed :S",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can paints and cleaning agents cause increase in BP?\n\nI have high blood pressure.  I recently painted the interior of my home, and along with the paint, I used various cleaning supplies such as Brasso and Winemans cleaner. In about 3 days my blood pressure has risen too high.  I also had this happen last year about the same time. I was also painting a room inside my house at that time. Is there any connection that you are aware of with respect to fumes causing a rise in blood pressure. Thanks",
    "doctor_response": "Hi, there is no direct connection in between paints,fumes to rise in blood pressure but one possibility is that u might be having some sort of allergic to this leading to activation of human body response, releasing adrenaline in vivo and it may cause temporary rise in BP but it will subsides as  u will recover from allergy.This is the only possibility. Don't worry get your allergic testing done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower abdominal pain\n\nHello. My name is Tim. I have been having extreme lower stomach pain and constant diahhrea. The pain prevents me from eating and is extreme. It has seemed to settle in my pelvic area all the way around. I went to a GI and had an upper and lower scope. They told me nothing except for moderately inflamed stomach (unexplained). Take pepcid and maalox. No effect of course. None of this happened until I had two back surgeries. A failed laminectomy and a double fusion later in the L4-5 S5-1 discs. They just tell me to go back to my GI (in their group), but it seems a waste of cash since work fired me for my back injury, so no insurance. I am also under psychiatric care for bipolar/manic depressive conditions. Any ideas? I am also getting constant leg and hand cramps/spasms. Sometimes my hand will clamp up and I have to stretch it and wait it out. The leg spasms make me jump out of bed thrashing until it stops. Pls help if possible. It feels like I have a piece of metal lodged in my gut/upper duodenal area.",
    "doctor_response": "Dear Tim,I have gone through your case history very carefully.as your upper and lower scope result is normal it seems that nothing is so serious about your gut.the pain and diarrhoea can be due to excessive acid secretion.so this can be cured by taking medicines like ranitidine regularly .then as far as your pain and spasm in legs are concern it is because the spinal nerves has been affected by failed laminectomy and later double fusion in L45 and L5S1 region.to get relief from this pain try some home regimen of back muscle relieving exercise like flexion exercise.but certainly you should continue your treatment for Bipolar/manic depressive condition.otherwise it will aggravate your pain.my best wishes for you in coming days.thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could sore throat, clogged ears with orange tinged phlegm indicate viral infection?\n\nHi, For the past week I ve been feeling unwell. It began with a sore throat, fatigue and clogged ears. Whilst my throat has cleared, my ears are still clogged and I m still feeling tired. This morning I coughed up a solid piece of orange phlegm. I m now worried i have a viral infection. Are you able to determine the extent of my illness and most effective ways to treat my case? Many thanks, Daniel",
    "doctor_response": "HI, thanks for using healthcare magicViral infections of the upper respiratory tract can result in different symptoms such as those you are experiencing.The symptoms can last 1 week to 10 days.There are medications available that may help. These are available over the counter. Treatment involves rest and fluids. In addition to this you may need a mucolytic to help break up any mucus in the chest.Examples of mucolytics are bisolvan, ambroxal, mucomyst, guaifenesinI hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a cyst in the posterior right hepatic lobe of the liver\n\nI have a 8mm cyst in the posterior right hepatic lobe of my liver and a 14-15mm oval lesion along the medial aspect of the anterior spleen. This lesion measures about 63 hounsfield units and is probably some type of benign complex cyst. What does this mean in my English?",
    "doctor_response": "Hi,Thanks for writing in.The 8 mm cyst in posterior right hepatic lobe is a benign condition and not a serious concern. It is a peas sized fluid filled area that is probably harmless and will not cause any problem to you.There is another 15 mm area in front of the spleen which is having soft tissue density and is classified as a benign complex cyst. In most people such a cyst is not a problem but the exact location has to be visualized on the image to draw a conclusion on its origin. You can discuss with your doctor and if required then do an ultrasound scan in 3 to 6 months and this will confirm if the cyst is benign. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. On shifting from cow milk to formula milk my baby gets fever and vomiting. Why?\n\nHello doctor, My baby is 11 months old. On starting of 10th month I had a problem in my breasts and stopped feeding by doctor's advice. I thought cows milk is better than formula because it is natural so I am giving it for the past one month in very diluted form. Four days before we switched to the formula since cow milk is not available. After that he passes stools many times for two days and got fever. When consulting a pediatrician he advised not to give cows milk and suggested only formula. But now after giving for a day, he passed mucus in stools. Is my baby allergic to formula? He is fine with cows milk, can I give the same? Please help.",
    "doctor_response": "Hello,  Welcome to icliniq.com. Cow milk should not be given until 1 year of age usually, as it may cause calcium and iron deficiency. Any change of feeds in babies can cause some change in stool pattern. Which formula are you giving and how do you prepare it? Proper concentration is very important. Have you started weaning? And how many times the baby is feeding milk? If only two or three times then you can continue with cow milk but do not dilute it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for atelectasis\n\nHi Doc I just took a xray recently and the results stated the i have atelectasis in my lower lung field, I used to work abroad specially in Middle East country and I m planning again to work abroad, can I still work abroad? Is there any medication to clear or removed the atelectasis? thanks",
    "doctor_response": "Thanks for your question on HCM. Atelectesis is partial collapse of lung segment.It is mostly due to retained secretions (mucus plugging) in the segmental bronchiSo I advice you to consult pulmonologist and get done CT THORAX and Bronchoscopy. This will give you clear idea about which segment is involved  and infection present or not. Treatment of atelectesis is 1. Antibiotics2. Mucolytics and expectorant3. Vigorous chest physiotherapy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dent and redness under frenulum?\n\nhi im 18 years old virgin, and i masterbate quite a lot and i have noticed my frenulum is very red and the area under it is dented and more purple then the rest of the penis? i do worry a lot and i dont no if theres a problem or its just me worrying, im not in pain in anyway but it just looks really strange too me",
    "doctor_response": "Hello and .As an Urologist, i can fully understand your concern.The redness you describe is likely to be due to vigorous masturbation.If there's pain,discharge or itching in that area,consult an Urologist.Maintain good penile hygiene.You may use vaseline before masturbation.Avoid moisture in that area, especially keeping it dry, after a bath or wash.Wish you good health.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing bump in penis?\n\nhelloI just noticed a bump on penis. It looks like a pimple that you can get on your face. I have been sexually active. I squeezed it a bit (it was a bit painful) and white puss came out, just like when you squeeze a pimple on your face.Shall i be worried?",
    "doctor_response": "HelloThanks for query .Based on what you have stated I would state that you have Sebaceous Cyst over penis .The penile  skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin.Normally they fade away without treatment however they need to be treated if increase in size or get infected.Take antibiotics like Doxicycline along with anti inflammatory medicine like Diclofenac twice daily for a week .If persists even after taking antibiotics  consult qualified General Surgeon for clinical evaluation and further treatment.If needed it  may need to get excised in Toto (Completely along with the sac) under local anesthesia.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any side effects if Vertin is stopped immediately ?\n\nMy Mother is Suffering from vertigo from past 4 years.She has vertigo attack 3 times in 4 years and has been dignosed with vertigo last year.She is taking vertin regularly from last 1 year and now the dose has been reduced to 24 mg.The doctor is now advising her to stop taking vertin.Please let me know if there are any side effects if we immediately stop taking vertin?Will she get another vertigo attack if she stops vertin?She has vertigo attack after viral infection and she is also suffering from Thyroid and High BP",
    "doctor_response": "Hello,I have gone through your query and understand your concern.As you have said the vertigo after viral infection, probably she was suffered from Labrynthitis or Vestibular Neurronitis.It is possibly a Vestibular neuronitis.Because in Labrynthitis, vertigo or dizziness will go away once the infection is cleared.As she is having the vertigo for last 4 years, it is probably a vestibular neuronitis.Coming to your question.NO. There is no specific side effect on withdrawal of Meclizine( vertin).Thus she may stop the vertin, if she do not feel any vertigo symptoms as directed by your doctor.You have mentioned about thyroid problem and Hypertension.Please check the Thyroid profile and confirm whether it is hyper or hypothyroidism and advise her to take the drug properly.As she have hypertension, Antihypertensives are necessary and she should monitor her blood pressure regularly.There is no co- relation between stopping vertin and her Hypertension and thyroid problem.Hope this helps.Please write back for further queries.Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does bruises with itchy legs suggest?\n\nI feel itchiness in my legs and arms for about 2 weeks now, I blamed the mosquitoes or insects inside and outside the house. Then at 2 this morning July 9, I notice my left leg under the knee bulge and like I have bruised with no apparent reason and felt a little pain when I press it to massages. Do I have to visit a doctor for this",
    "doctor_response": "Hi I did review your condition.Such a bruise with itchiness can be due to a mosquito or bed bug bite since you noticed at night.I would advice you to visit a dermatologist and first get the lesions evaluated and get treated if its a simple bedbug bite.Another reason could be bruising from low platelets or vessel problem which is relatively rarer. For this you might need to get  a blood report and then a coagulation profile. However, the visit to a dermatologist is important to determine what exactly the lesion looks like to an expert opinion as both can be very similar.I hope this helps,Wish you all the bestThank you for choosing healthcaremagic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I feel high pulse in my upper stomach?\n\nHi. I\u2019m 41, African American, I was in Dubai, UAE for a visit, over there I had sever hike in my blood pressure along with sever pulse in stomach. My blood pressure is under control now, but still I get sudden spikes of BP, and high pulse in upper stomach. I have seen heart specialist, and he said my heart is fine. I have seen an ulcer specialist, and he said I was fine as well. I get back pain in the center of my back. I have done lots of tests, still I feel that pulse twice a month, and it is worrisome for me.",
    "doctor_response": "hello.. its a pleasure to answer your query. as i see you are quite concerned with your complaints. i can understand your concern. since you have high blood pressure spikes with pain in stomach, there may be a possibility of an adrenal gland tumour. known as pheochromocytoma. there can be other causes as well.. i would advice you to do a CT scan of the abdomen for the same.. still it maybe nothing but just primary hypertension in which some patients have a pulsing snesation in the stomach.Also if you have persistent high BP , you should be on BP medications.. telmisartan 40 mg once daily would be my recommendation. thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does skipping cause harm for uterus and pregnancy ?\n\nHi my wife is 22 years old & she very conscious about her health.She regular skipping for 20 or 10 minutes and doing about 300 jumps by the rope skipping.But she is tensed about her uterus and pregnancy that is skipping causes any harms for her?",
    "doctor_response": "welcome to healthcare magic .... if she is pregnant , then obviously she needs to avoid skipping. She can go on for a walk - thats the best exercise recommended for pregnant ladies.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can vitamin D deficiency cause fatty tumors on the arm and leg?\n\nI m 48 years old, white female, I had 2 semi-painful fatty tumors for the past 5 years on my arm and leg and now I have about 7 more on my left leg along with bruises (for no reason) and I have intermittent leg cramps (more so in the hip and upper thigh area) and I m very active but the leg & hip pain make it unbearable at times to exercise and I m alwasy tired. Lastly, I was told I m Vitamin D deficient (18). Question - Can this all be related to the Vit D deficiency?",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You may have multiple lipoma. You should go for biopsy  or fine needle aspiration cytology of one of your tumour. Then take treatment accordingly.You have vitamin d deficiency.  However it has no relation with your fatty tumours.  You should tak vit d supplements and diet with high vitamin d.Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.Don't forget to click thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have an ulcer in my mouth that did not go away after antibiotics. What is it?\n\nHello doctor,I am a 24 year old female. I visited a dentist a week back for pain and swelling at the back of the throat at the retromolar region. The dentist took an X-ray, but no wisdom tooth was present. The dentist prescribed antibiotic Metronidazole and I completed the course. The problem is my ulcer at the region does not heal. Is it normal that the ulcer does not go away?",
    "doctor_response": "Hello. I hope it helps you. If the problem persists, you can write to us or visit a dentist\u00a0with a specialty in oral medicine and radiology. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bad burning sensation on the upper right side of the stomach?\n\nhello, I have a bad burning sensation on the upper right side of my stomach. it feels like my flesh is burning and it covers an area about the size of a silver dollar. sometimes when I bend over to tie my shoes it goes into a spasm. the burning sensation is constant now and it gets a lot worse with certain food.",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern and the symptom may be suggestive of hyperacidity and this can be best treated with Tab Omeprazole 40 mg once in day at evening time for few weeks, the symptom would come around with this, no need to worry, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "End stage liver disease, cirrhosis. Constant abdominal pain, immobile, leg cramps. Lumpy calf. What is going on?\n\nHello my sister has advanced End Stage Liver Disease , cirrhosis , and is in severe abdominal pain constantly. As a result she has been mostly immobile for the several weeks now and spends the majority of her time, day and night, sleeping or laying down in her bed. She has recently complained of cramps in her legs and that her hands are tightening into a position as if she is holding a tennis ball. She does have acute ascites which may be causing or contributing to edema in her right leg. I sometimes massage her legs to help relieve some of the cramping however recently her right calf (with pronounced edema) felt very lumpy and mushy such that I could press on a part and an indentation would stay, her calf felt like a bag of mashed potatoes. What is going on here? Thank You.",
    "doctor_response": "Hello and welcome to HCMUsually end stage liver disease is not associated with pain.But if there is associated pain there may be involvement of nerves / nerve plexus in the vicinity of the liver secondary to disease process.The ascitis and the edema in the lower limb is due to the end stage liver disease.Now there are two options. Firstly a liver transplant, which is available in many countries (I don't know whether it is available in your country).However, your treating doctor will be able to tell whether it can be done in your case at this stage.Secondly, it is imporatant to relieve the pain and the disabling edema to improve the quality of life.Therapeutic drainage of ascitic fluid can be done. This implies that fluid is removed from the abdominal cavity as soon as it is filled.Pain can be relieved by drugs or by palliative surgery. In this surgery the nerves causing pain are divided or the the organ causing the pain is partially removed.The curative option is liver transplant.Other options will relieve the discomfort and pain only but will not cure the disease.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes passing of green stool and diarrhea?\n\nHi doc my son 15 month old is suffering from loose motion n motion is greenish in colour so I had given him 2ml of nor metrogyl oral suspension..is this syrup is enough to get him recover ??And one more query, is greenish motion is dangerous or what ?? What is the reason for that type of motion ??",
    "doctor_response": "Hi , I'm Dr Suresh K Yadav M D (paediatrics) ,I have gone through your question and understand your concerns,Nor-metrogyl is most misused medicine for diarrhea , it is not recommended to use with out a prescription, more important is use of ORS and zinc to take care of dehydration  and build gastrointestinal immunity . Most loose stools are viral or self limited bacterial infection of  of 3- 7 days duration , you need to take care of dehydration during this time and keep a watch on dangerous signs like dullness, irritability , lees urine, high fever, very large or very frequent stools , presence of blood in stool or if otherwise child appears sick . In presence of any such signs you need to consult your health care provider urgently . Passage of greenish stool in absence of blood in stools , it not a reason of concern . Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.Take care.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I feel difficult to breathe while sleeping. Why?\n\nHi doctor, I am a 25 year old female with one year old baby. Suddenly from last 10 days when I feel asleep something blocks my breathing. When I wake up and stand for a while, I will get back my breathing slowly. Immediately after that I get some continuous burps. It feels that something has stuck in my throat and my husband says that some sound like water falling also comes in the process. The whole process lasts for two to three minutes and slowly comes to normal again. The problem occurs only when I feel asleep. I have been diagnosed for mucous, asthma, ECG, etc., but all showed normal conditions and the exact cause cannot be identified. I am taking Rablet D and another gas related tablet prescribed by the doctor. Please help.",
    "doctor_response": "Hi. These symptoms look like purely gastritis. At the time of normal acid production while sleeping we will not have any problems. If acid production in stomach is more, then while lying down acid tends to come to esophagus (upwards from stomach). It can come up to throat. Acid causes irritation of diaphragm (sheet separating lungs from stomach), which can cause increased breathing. The sensation of something stuck in the throat is severe irritation of throat due to increase in acidity in stomach. If gastritis is present, then the acid comes up to the throat called regurgitation and causes this sensation. Burping is due to acid and air coming up due to gastritis. Rablet-D (Rabeprazole) is correct choice of a tablet. But, the potency and quality is very less. Gastritis can due to many reasons like not eating food at proper intervals, drinking too much coffee or tea, eating hot and spicy foods, cola and junk foods, less sleep, increased work pressure, tension and too much of worrying. Follow the points mentioned below for a month. Try tablet Pansec DSR (combination of Domperidone and Pantoprazole) one tablet before food in the morning and night. Also, take syrup Mucaine Gel 10 mL after food thrice a day for one month. Revert back after a month to an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Bacterial Gastroentities\n\nHi, I have my 15 months old son suffering from Bacterial Gastroentities (As mentioned by Doctor), He is suffering from this since last 8 days, previous doctor diagnosed Viral Diarhea, and prescribed Nutrolin & Vibact sachets, still my kid s condition did not improve, We had his regular stool test done & found some infection interms of mucus & pus. We consulted some other doctor & he prescribed Oflox 100 syrup, Still my kid is having watery stools & his food intake is redused (which is a bit worrying) Can you please guide?",
    "doctor_response": "Hi, welcome to HCM. Since, your child has loose stools for 8 days, this is definitely not viral diarrhea. It seems that your child has probably bacterial infection as suggested by stool report. Continue oflox syrup and ORS solution, it takes 2 to 3 days for the child to respond. Till then give ORS and adequate liquid diet to prevent . I hope this will help you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the causes of having lower back pain on both sides of spine and feeling of lumps?\n\nI have lower back pain on both sides of my spine. The pain is constantly dull and there are you can feel a few lumps on each side of my spine about 2 from each side. some right next to my spine iv had these for years now the pain can get real bad What is this?",
    "doctor_response": "It can be two causes in this case.  First it can be renal stone.  Other cause can be muscle sprain.  So to diagnose this there us need of ultrasound and spine x ray.  After this we can offer you treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for red bump on shaft after masturbation\n\nAfter masturbation I had a semi hard slightly stinging red bump on the shaft just below the head. I also ended up with a very small cut or abrasion on the pee hole which still stings and it red and irritated. My girlfriend and I haven t had sex in over a month due to her being pregnant and some complications we have had. I figure both are from masturbating but I haven t had a red bump before and the pee hole cut seems to itch and is red still. After I pee it itches inside for a few minutes passes. What can I put on it or do you think somehow I picked a UTI? After I noticed the cut I put on some polysporin but all weekend I was very active and hot and seemed like perfect conditions for Se kind of infection. Please advise what steps should be taken.",
    "doctor_response": "HelloThanks for query .Based on the facts that you have posted I would state that you have sustained trivial injury to external urinary meatus and shaft of the penis due to rough and vigorous shaking of your penis while masturbating .You need to take broad spectrum antibiotic like Cefixime along with anti inflammatory drug like Diclofenac twice daily along with topical antibiotic ointment like Neosporin twice daily.Ensure to wash your genitals with warm water twice daily.Ensure to avoid sexual encounters till it heals up completely.Ensure to drink more water.It should heal up within a week .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of taking metoprolol succinate & diovan?\n\nI am taking metoprolol succinate 50mg once daily and 80mg diovan and 12.5 mg hct and have taken this combination for the last month. I also take metformin 500mg once in the morning along with 5mg glyburide in the morning. I feel really dizzy in the afternoons any ideas what rx changes should be looked at ?",
    "doctor_response": "Hi,You should check your pulse and blood pressure during the day and when you feel dizzy. If you notice that your blood pressure is decreased or you have low heart rate during dizziness, it can be caused by medications, and you will need to see your doctor to correct the doses.If there will be no difference of your heart rate and blood pressure, then you should look for another reason for your dizziness.Hope I could help youWishing you good healthIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Excessive job stress causing hit on ears and finger tips, psoriasis spots on body. Is there any remedy for this?\n\nhi I am 29 years old, I have tendency or can say nature of taking lot more pressure and stress over me, specially when I was starting up my career as Programmer. It s because of my nature while working I undergoes stress and nervousness , I start feeling hit on my ears and finger tips . I think because of this nature of mine, I have caused some skin problems to me, at this stage I have psoriasis spots around neck, one near the forehead , edge of ears and on my right leg. I am working on my mental ability to cope with things and not to take pressure on me but would you be able to suggest me any solution for such problem?",
    "doctor_response": "Hi friend Welcome to Health Care Magic How did you conclude it is Psoriasis? It has an inherited basis. It has no relation to your nature. You have to seek the help of a Psychiatrist.  The chances of modifying your behaviour and return to near normalcy are excellent.   There are medicines and counselling techniques. A dermatologist must see your skin.  He will be able to diagnose correctly.  A proper diagnosis is a prerequisite for proper treatment. You have two different issues. Both of them are easily manageable Relax / see the doctor... Take care Wishing you speedy recovery God bless Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tremors in lips, hands, fingers, blocked ears in elevators, loss of concentration, headache. Cause and remedy?\n\nGood Morning Doctor My lower lip is shivering from last 5-7 days and i felt shivering right hand ring and litter finger also yesterday, is it any disease, i had a problem that a wishlist sound i was hearing continuously in left ear, i consulted and ENT and he advised that it is high frequency loss, now a days i get a feeling of blocked ears as we get in elevators, i have headache also along with loss in concentration, please advise me what exactly is the problem and what sort of doctor should i consult?",
    "doctor_response": "Hi, thanks for posting your concern in HCM. Loss of concentration, tremors and shivering suggest a provisional diagnosis of Anxiety disorder. The ear problem and headache may be due to panic attack or some pathology in the inner ear or upwards. To rule out, any neurodeficit you need to consult a neurologist. An ENT surgeon as you said had diagnosed SNHL and that may be due to pathology in inner ear and requires treatment under ENT specialist's supervision. For any further query, you can write back to us. Best Wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in groin\n\nHello, six months back I was diagonised with Sugar, it was through HA1C test which was reported 6.9%, I Was put on Glucophage 500Mg a day, lately I have started having pain in my groin. I have stopped Glucophage past 5 days but the pain is increased. What do I need to do, also I am confused whether I should continue with Glucophage or should control my diet. Appreciate your response. Thanks you very much in Advance.",
    "doctor_response": "Hello, I don't think that the medicine for your elevated blood sugar is causing the pain in your groin area. I suggest to continue your medicine for the sugar and have your groin area evaluated with the urologist or any general practitioner to evaluate for possible inguinal hernias. The doctor will do a complete physical examination on the area and might request for an ultrasound. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Manuel C See IV, Urologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can cold, fever and excessive burping in children be treated?\n\nMy son is 9 and has been sick with head cold and fever all day. He has also had excessive burping and I don t know what to do for him to get the burping to stop. It s out of control and he s so uncomfortable. I gave him 3 different meds throughout the day today because I thought it was one of the meds but it wasn t. I also gave him pepto at 5pm but that didn t help either.",
    "doctor_response": "Hello and welcome to healthcare magic.Excessive burping in infant alongwith cold is due to excessive swallowing of phlegm.And stomach full of  Phelgm causes decreased appetite and excessive burping.If its troubling your kid alot you can give brochodilator syrup like terbutaline(britanyl) and muculator sachet.To relieve sypmtoms of cold give paracetamol or ibuprofen adequate rest and hot oral fluids.Hope you find this answer helpful.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have darkening of the skin in the folds of groin. I used Sertaconozole Nitrate 2% Lotion\n\nDear Doc I have darkening of the skin in the folds of groin. Sometimes there is slight discomfort. I was using Itchguard but with no improvement. I went to a dermatologist and was prescribed Sertaconozole Nitrate 2% Lotion . I applied once and the skin is peeling off in some areas. Is this normal? Shall I continue the use or stop it. The dosage on the leaflet says to apply and wash after 10 minutes. But the doc said apply and didnt say anything about washing after 10 mts. What should I do? Male 47 yrs, Wt 73 Kgs, Ht 174 cms.",
    "doctor_response": "hi your dermatologist has prescribed sertaconazole cream ( instead of sertaconazole lotion ) for fungal infection. lotion is a wash off and cream is a leave on prepration. so apply cream base for 10 to 14 days. also you can add oral flucanozole tab. 150 mg once a week for three weeks. to avoid recurrence wear loose clothes, let your groins dry properly after bathing, avoid wearing wet undergarments........ bye Dr. Ashutosh Pandya",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pain in stomach?\n\nSince last night I have a dull ache on the middle of my stomach I don't feel sick I'm going toilet normally but this gas been constant it can't be period as I have the implant in but every month gets worse and this is worse than its been help no painkillers help at all haven't eaten I'm hungry but can't eat cause of my stomach",
    "doctor_response": "Hi ! Good evening. I am Dr Shareef answering your query.If I were your doctor, I would advise you for a routine complete blood count, urine routine and culture sensitivity test, an ultrasound abdomen, followed by a clinical examination by a surgeon/gynaecologist to rule out any intra abdominal pathology or a pelvic inflammatory disease. I would also give you a dose of deworming drug. I would suggest you not to eat from outside your home if you do to prevent some intestinal infections from unhygienically cooked food. My further management would depend on the reports of investigation and clinical examination.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal cramping with unusual urinary discharges?\n\nhello doctor...i am 19 y.o....3 days back i went to the gym and did some pushups..while doing pushups i felt some kind of severe cramp in my abdomen on the left side as if some nerves or muscles are contracting..i didn t took this seriously but from next day there is continuously some white liquid coming out and the urine also comes without any prior feeling..in the beginning it was accompanied by some pain in right testes but now its some what ok..due to leakage of this fluid i am also not feeling any arousal...if you can provide some suggestions please..in desperate need of them..is it going to get cured automatically in a month or so or i should try some treatment ...please reply sir..",
    "doctor_response": "Can't find a relation between the two symptoms. If your abdominal cramps are persistent, get an USG abdomen done and tell your problems to a surgeon. However, if by no arousal you meant no erection, it could call upon further investigation into your case. Specify if you have got any urinary symptoms occuring, like pain, frequency or burning sensation during urination. If yes, get an urinalysis done also.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itching and rashes on Prepuce and glans, after using soap solution. Took antibiotics with temporary relief. suggestion?\n\ncouple of weeks back i used some medicated soap solution to wash my genitals, since then i have developed itching and rashes on prepuce and glans as well.. prepuce started cracking, so i applied candid-b cream for a week, took a course of antibiotic .. now two days after stopping the treatment rashes are reappearing over prepuce n glans.. they are small, multiple. white.. pinpoint like spots, Please advice..",
    "doctor_response": "Cracking of prepuce along with small multiple rashes is suggestive of candidial infection(a type of fungus) ,antiboitics and steroidal cream give some relief but relapse again once you stop it.Start with tablet fluconazole 150 mg once a week for 3 wks and apply miconazole gel at night.take anti allergy tablets if itching occurs.I think this will help to cure your problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "what could be the reasons for having sharp pain in lower abdomen, nausea and flu?\n\nMy husband is having sharp pain in lower left stomache area, like 3 knifes stabbing him, off and on all day, he has had nausea for 2 days, there is a flu going around but it only lasts 1 day his has been longer he is 62 yrs old. YYYY@YYYY",
    "doctor_response": "Hi. Such sharp pains in left lower abdomen- can be a serious problem as dissection of an artery or so, Needs urgent ultrasonography. Flu may not be responsible for such a severe pain .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from kidney stone problem, had a laser surgery for kidney stone\n\nRespected Sir, I am Narmada Padhy. My father Mr Chittaranjan Padhy is having Kidny stone problem . He has done the leser treatment juste 1 yr before and it was quite fine till now, But the problem is now again the stone is getting formated. As per the ultra sound report the stone size is 1.1 now. please suggest me how can i take care of my father. shuld i need to do the same leser treat ment once again or it will create any other problem? Waiting for ur kind responce. my personal mail id is narmada.padhy@gmail.com. Thanks Narmada.",
    "doctor_response": "dear narmada ..stones can b compleltely cured wit the help of homeoapthic medicine.. n it will prevent from new formation of stone too..consult a homeopath.. godbless.. drvigsclinic@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal cramps and backaches when on infertility treatment?\n\nHi, i am on day 25 and hoping to b pregnant. i used clostil from day 2 - 6 and on the 12th day ther were 2 follicles one smaller and the other quite mature. My ob/gyn told me i may ovulate the same day or the day after. i hope i did. But at this point i am experiencing alot of cramps and backaches just as if my period is about to come. i also have slight spotting. My cycle is usually 30 to 32 days.",
    "doctor_response": "Haiwelcome to hcm this could be implantation bleeding. Pain maybe due to rupture of follicle. It will settle.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do the semen analysis findings suggest?\n\nhi doc...this is jhohnson here..is my semen test report normal or not semen color.white reaction alkaline volume 2.5 ml viscosty normal liquification time within 5 minutes microscopic examination :-total count 50million/ml motality 20% moephology normal",
    "doctor_response": "HelloYour semen analysis findings may indicate low sperm motility.Normally motility should be at least 55 %.Your findings suggests overall 20 % motility,so it is low.Besides clinical evaluation you may need investigations like routine hemogram,random blood sugar,ultrasound of scrotum,hormone assay.Avoid wearing tight undergarments and avoid alcohol,cigarettes if you take it.You can also take antioxidants.Go for brisk walk regularly and take nutritious,balanced diet.Sperm count is normal.Normally it should be at least 20 millions/ml.Other factors like volume,viscosity,pH etc are also normalGet well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Disc herniation in L4-L5, persistent pain. Undergone physiotherapy. Will epidural injections help?\n\nI had slight herniation in discs L4-L5 about an year ago .. Took the necessary medication course , physiotherapy course and have been doing the suggested exercises regularly ever since .. but the pain is still there and still not able to bend properly or lift weights .. should I go for surgery or for epidural injections?",
    "doctor_response": "Hello, The disc herniation is probably causing compression over the nerve roots and that is causing pain. The disc herniation is only slight so it is not an urgent indication for surgery. You may first take epidural injection and see the response. It will relieve your pain and if during that time the disc heals you may not need any more interventions. So I would suggest that you undergo epidural injection at present and keep the surgical option (if at all needed ) for future. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bronchitis\n\nmy child keeps suffering from bronchitis for which we keep nebulizing him with levolin. when he has fever tan we donot send him to school. but if he has cough which comes after an interval of about half to one hour , than can we send him to school. My child is seven years old.",
    "doctor_response": "thank you for using healthcare magic.Bronchitis is more commonly caused by a viral insult. So there is really a good chance he can get it repeatedly if he will be infected by the common virus (usually from other sick kids in school). So nebulizations (and other supportive treatment) can do the job in this instance. But sometimes bronchitis can be from a bacterial cause which needs to be treated with additional medicines like antibiotics. It is best that you see your doctor in order to distinguish which is which and possibly do some diagnostic test. furthermore, you should also be aware of other illnesses that can have the same symptoms with bronchitis like Asthma which should be addressed/treated differently. sincerely,Mark Rosario MDpediatric pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be the level of blood sugar after eating?\n\nI had a CBC test done about one week ago as a routine before my yearly visit to my oncologist.  It was marked that it was not necessary to fast so I did not.  Copies of the results were sent to my GP, he sent me an order to get a fasting blood sugar test because my blood sugar was at 146.  They did ask me if/what I had to eat and I said I had breakfast 45min to 1hr before I was having the test.  Wouldn't 146 after eating be expected? Aged 51, 5'5\", 115lbs; history of gestational diabetes 13 &18 years in the past.",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You have gone for random blood sugar. Its not high. But we can't accurately decide whether its normal or not because of variable timing and food. You should go for fasting blood sugar and 2 hr postprandial blood sugar for perfect result.  Go for it. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for back pain\n\nHi, I bend down and when I got up I heard a crack in my lower back. I was in a lot of pain that also affected my left left. I went to the ER and they diagnose me with Lumbar Strain. They gave me ibuprofen and muscle relaxer. That helped a lot but I was still in pain. Yesterday, I felt pain that was somewhat like a electric shock in my lower back that shot up the spine. I started to get worried that it's not just a lumbar strain. Please answer me. I need to know if this is serious and if i have to go back to the ER.",
    "doctor_response": "Hello, Thanks for your query.From description , it seems you might developed muscular or ligamentous strain over back .I would suggest getting this evaluated by an orthopedician for an accurate diagnosis and appropriate management. You may get the MRI of the area affected under his/her guidance.Meanwhile following measures will help with the pain\u2022 Lie on a hard bed.\u2022 Anti -inflammatory drugs like Tablet Motrin 1 tablet as and when required \u2022 Avoid forward bending.\u2022 Avoid strenuous activity & lifting heavy weights.\u2022 Apply diclofenac gel on the affected area. Warm compresses will also help.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from PCOS, trying to conceive. Taking medication, no improvement in egg size. Suggestions?\n\nhii i am having PCOS ,i am trying to conceive but i am not able to do thar. my docter have adciced mr ferpill kit plus folliculin 75IU(3 Injections) and 150 IU(2injections)...but there is no improvement in my eggs size...i am also undergoing  follicular monitoring....plus iam taking glycphage 150 mg from last 1yr...pls help me out",
    "doctor_response": "hi.. you are planning for conception.. you are put on ovulation induction and other supportive injection.. you are put on the metformin also.. it is good.. you are experiencing no benefit from this treatment.. you have not mentioned what investigations have been done... need to get FSH, LH on day 2 of your cycle AMH thyriod profile.. probably your ovarian reserve is low... need to take epiendrosterone for 3 months which helps in activation of dormant follicles.. see a good infertility specialist.. all the very best...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain, left arm numbness. Taking pan-d, mayopaz. Treatment?\n\ni am suffering from low back pain on the left side near back theigh. i have taken pan-d and mayopaz with vitamin B tablets for 4 days 1 tb each a day. i can stand, move and if i take rest on a not so soft bed, i can even sit with folded legs for more than 2 hours. but i have stopped the drug as i had some relief from the severe pain. but now my left arm is showing numbness and still have a low back pain on the left side.",
    "doctor_response": "It is advised for MRI scan of LS spine .time being you can wear lumbo sacral belt and an take tab tramadol one tab only after dinner for a week.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am i having fluttering sensation behind knee?\n\nHiI have a fluttering sensation behind my left to knee to the left side - it's intermittent (mostly at night in bed)  and feels like a strong pulse. I am a 60 year old Caucasian male in otherwise good health - only had it for a few weeks and it's not every night) any ideas?",
    "doctor_response": "Hi,Get USG of knee joint done and send me the report.Avoid squatting and weight lifting.If pain occurs then take tab. aceclofenac+thiocolchicoside three times a day.Thanks,Dr. CHANDER MOHAN SINGH.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have bleeding after sex. Birth control, multi rod and taking duoluton L. Do I have chance of getting pregnant?\n\nHello Doctor we had sex in the 3rd day of my period & 5th day I went under family planning like Multi rod & doctor had given me the tablet Duoluton L.Is their any chance of getting pregnant. I had taken ipill for 3 times & I used to have bleeding for every 15days but it was lite flow  & only for 3days.is their a chance of getting pregnant.",
    "doctor_response": "hello,thank you for using health care magic,for being pregnant mating of ovum and sperm is necessary.. during periods there is no chance of ovulation..so by doing intercourse on third day of period there are no chances of getting pregnant..plus you also went under multi rod..do not take i pill like you took it.. that is not right method.. i pill should be taken within 24 hours of unprotected sex end its other dose after 12 hours..in future i will suggest you to avoid intercourse  during periods because it increases chances of infection..take care..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe foot pain\n\nI dropped a moderately heavy can on my foot. Immediately I started laughing uncontrollably because of the pain. The top of my foot started to swell right away. Days later it bruised on the top of foot and had moved to just above toes. My toes tingle and I cannot bend them. I can bear weight on my foot and am able to wear shoes but my toes feel strange. Will this go away on its own or should I be concerned and see a doctor?",
    "doctor_response": "Hi,Thanks  for  your query.From description it seems to be soft tissue injury . You need an x-ray to rule out any bony injury. I suggest you to consult an orthopaedician nearby for a detailed examination. You may get the X-ray of the area affected under his/her guidance. Beside icing and elevating it, you can take anti-inflammatory drug like motrin to reduce pain and inflammation.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "High ALT and AST levels. Done blood test. Cause?\n\nALT and AST raising from 95 to 160 to 260 in 3 months I had the flu in late October 2012, and one evening I suddenly fainted and passed out for about 30 seconds at work but regained conscious without help, and my blood pressure and blood sugar levels were normal according to emergency medical staff. Had my first bloody test a few days later, and my ALT/AST levels were 95 and everything else were normal. A new bloody test was done in mid December 2012 - everything was normal but the ALT and AST raised to 160. Tests for Hepatitis A B C were all negative. In early January, I had another bloody sample taken and also had an ultrasound examination of my abdominal area and nothing seemed to be wrong with my liver, gallbladder , kidney etc. The third blood test results showed today that my ALT and AST raised to 260. I still do not have any symptons such as pain or yellowing in the eyes. I am not on any medication (except some Paracetamol when had the cold, with Phenylephrine Hydrichoride for blocked nose - contained in Lemsip). I am 24, 6ft and 70kg. Generally very healthy. The doctor seems to be puzzled and will refer me to a Hematologist . Has anyone else experienced similar problems? What could be the cause of the slow but steady increase of my ALT AST? PLEASE HELP! Many thanks.",
    "doctor_response": "Hello there,Sometimes viral flu can also result in an elevation of the AST & ALT. The hepatitis viral markers were already negative as you have conveyed. I suggest you get the Liver function tests repeated 3-4 weeks after the flu has resolved. if the AST & ALT are still elevated at that point of time I recommend doing a lipid profile, iron and copper studies and then if indicated after seeing the above reports a liver biopsy may be indicated.Hope I have answered your query you get well soon. I will be available  in case of any further queries.Regards,Dr. Prashantha S. Rao",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will there be any problems in health and getting pregnant after removing bartholin gland surgery?\n\nHi, The gynecologist suggested my wife to have an operation to remove leftside bartholin gland as my wife is suffering from bartholin gland abscess. Its quite painful. Is there any side effects on her health and getting pregnant in near future due to this removal ? Thanks in advance.",
    "doctor_response": "Hello. Thanks for writing to us. The removal of Bartholin's gland does not affect your fertility or your chances of conception. These glands are present on the outside of vagina. Please do not worry.I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal ,drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recommend facial creams\n\nHello doctor I don t have any skin problem don t I am not too dark but I want to a fair skin than what i have now so i keep on trying the every other new skin lightening creams that come into the market but no use.Recently i started wondering if a facial cream really works on one s skin or is it just a marketing strategy.I think you skin reflects what u eat so it should be more internal rather than getting it through external means.If i have to use a cream what should be the purpose and what kind of cream should i use and also please suggest me what are the chemicals that i have to look at or avoid before buying a face cream.Please advise",
    "doctor_response": "hi, welcome to HCM,use kojic acid containing cream (Melaglow cream). it can be used daily upto 9-12 mth. it will make you tanning to disappear. use glycolic acid 2%(ahaglow) containing face wash it will make your face glowing.remember one thin skin type cannot be changed.hope this will help you.thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Vomiting feeling, chills and pain in lower back, mild pain while urinating. Kidney stones?\n\nHello doctor I have a couple of kidney stones that seen to bother me now. This week I have felt as though I wanted to vomit. I have chills and pain in my lower back, but no fevers. I also have pain when I urinated that is mild with no blood. Should I hold off until my appointment  in two weeks or does this need to be an ER visit. Thanks",
    "doctor_response": "Hi,Thanks for writing to health care magic.I can understand your concern.Some of the symptoms you are giving could be because of urinary tract infection.One of such symptoms is pain in the back and pain while urinating. Even though you do not have fever you should be investigated after a physical examination. I suggest you should consult ER and get investigated. A urine routine examination and culture will identify if there is any urinary tract infection.Continue to ask further queries as required.Hope this helps.Take care.Dr Y V Siva Sankara MurtyM.D.(Pediatrics)Associate Professor of Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause pain in early pregnancy?\n\nHi Dr. I am Lipsa Mohanty (Female- 29yrs).I am 2 1/2 months pregnant, and feeling some pain since last 1-2 hrs.Is this a general tendency or some thing could have been gone wrong..! do advise back.Secondly, I am staying at Kalkaji(New Delhi, Near Nehru Place).Can I find the contacts of a good Dr(Gynaecologist - Near My place), shall be greatful for the same.Rgds,Lipsa.",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.Please do not panic.IF USG has been already done, and it has shown healthy pregnancy inside uterus you need not worry.It can be pain arising from intestines.Please avoid outside eatables. Consume fresh, homemade food, fruits; avoid deep fried foods and bakery products.Tab CYCLOPAM can be taken as needed. If you have not done USG yet, please get it done as early as possible.This will rule out conditions like ectopic pregnancy.Secondly, it will be easy to find the gynecologist in your area on net.I hope my answer helps you.Thanks.Wish you great health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have work tension and has no interest in sex. How to deal with it?\n\nHello doctor, I am a 34 years old woman. I have been working in an IT industry for more than 10 years. Earlier I was very confident, proud of my work and job. But now it seems like I am developing negative confidence, building tensions every few seconds, will cry out of tension, will blame myself for why I am still doing IT job but later I cool down by thinking I like IT job and I need to work. My personal life has become hell due to this tension. I used to be proud but now I am afraid. I have recently joined a new job which has offered me a position above my expectations. I am very worried if I can keep up to this new position, I am always in tension. I love my kind of job but getting worried and tension every time thinking if I can meet my manager's expectation. If I can work going beyond my level and work. All my peers are enjoying their job and personal life. I have also messed up my sexual life with no interest in sex and I am not able to. Please help.",
    "doctor_response": "Hello. From your description, it appears to me that you are suffering from depression and you require treatment with antidepressants. Other than that, I would suggest some other things which might prove helpful to you: 1. Manage your time. Set up a fixed schedule and work according to that. Initially it might appear difficult but stick to it. 2. Set your goals for the day, that is, short-term goals. Once you start achieving the smaller daily goals, then you can increase your limits slowly. 3. Devote time to yourself. Go for morning walk, yoga, etc. 4. Take proper sleep and eat green vegetables. They increase body serotonin. 5. Share your emotions (happy or sad) with your beloved ones. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mood swings and severe anger?\n\nMy best friend has been having severe mood swings for the past year. She gets angry about every little thing. Her blood test showed abnormal Aldosterone & abnormal potassium. She is 56 yrs old & i has passed menopause. Other than her over reacting anger she seems very normal. What could this mean? Her Dr told her she just needs anti anxiety drugs.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. There are many conditions which may cause these symptoms,I would recommend you to take her to consult a psychiatrist. If I was your psychiatrist, I would do a complete mental status examination and rule out symptoms of anxiety and depression. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headaches while having hydrocephalus?\n\nHi I m a 19 yr old female with hydrocephalus and lately I ve been have a lot if headaches they r not as bad as and shunt malfunction headaches but they are not going away I ve trying caffeine, Advil nothing is working but I don t want to waste my time at the hospital if it s nothing any advice",
    "doctor_response": "Hello. I have been through your question and understand your concern.While headache might have many causes, in your case it is crucial to rule out any shunt malfunction, which I suppose you already know how hydrocephalus headache is manifested. If the ventricles are within normal dimensions there is reason to think headache is caused by it.So I believe this kind of headache is not related to your past medical history, and might be just a tensive type headache, which is the most common type of headache which does not always respond to caffeine and advil.Hope this helps. Please feel free for further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful lump in pelvic area?\n\nI have a painful lump in my pelvic area by the crease on my right leg. It hurts when pressed on &it's maybe the size of a gobstopper. I do shave that area.I'm 17 years old.I am sexually active and have had only one partner.I am very worried it may be something of concern..",
    "doctor_response": "Hello!Thank you for the query.If the lump has appeared in the area when you do shave, hair follicle inflammation is the most probable reason. Due to hair shaving, sometimes bacteria get into hair follicle. This causes pus accumulation and abscess formation. Such abscess is very painful and hard.The best treatment of such lump is an incision and pus drainage. I suggest you to consult a surgeon.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Meftal and P 120 mg suspension be used alternatively for fever in a child?\n\nHi my Kid 3years old 12kgs of weight suffering from fever from 3 days.we r using P120 suspension 6ml from 3days.In the morning it is normal and from afternoon it is increasing. Its 100 or 101degrees like that.can I use meftal and P120 both alternatively.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Yes you can use them alternating with each other but if the fever started since three days then this is probably due to a bacterial infection. So, I would recommend that you refer to his doctor for a prescription of antibiotics. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause itchy red spots on the scrotum while suffering from chicken pox?\n\nHi! I'm 21 and my chickenpox started a few days back. About 6 days or so. I realised there were spots on my scrotum and it has been itching ever since. Today it gets worse.those on my scrotum are just red spots, no blisters and many holes. And spots are red and yellow in inside.it is so much painful and burning .I'm not sexually active.",
    "doctor_response": "Hi, You can safely take MS Contin while on OxyContin, it won\u2019t interact with each other and doesn\u2019t cause any adverse reactions. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Ball of shoulder shattered. On dilantin. Is this a nerve damage?\n\nmy husband has a right shoulder injury from oct of 2010 the little ball of the shoulder is shattered. He also began having seizures at the same time and was prescribed dilantin . He has been experiencing numbness and pain in his other shoulder, the left. It started gradually a few months ago but it has become more painful and much more frequent. Is this some kind of nerve damage from his shoulder or could it be seizure related or none of the above? The er nurse suggested he was having a stroke , but the numbness has been on going for months. Thank you Cheryl",
    "doctor_response": "Dilantin is not known to cause such specific nerve damage.  it is much more likely it is a pinched nerve in the neck or the shoulder.  it is too small an area to be a stroke and strokes aren't painful. seizures are also not painful",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness with tunnel vision and headaches?\n\nToday at work while sitting at the pc, not feeling rushed or anxious, I suddenly became VERY dizzy, could not focus and had to close my eyes to stop the spinning. This went on for a few minutes followed by a sudden rush of tunnel vision and a light headache which passed after a few minutes. What could have caused this?",
    "doctor_response": "Hello and welcome to HCM,A history of dizziness, inability to focus, lightheadedness and tunnel vision is suggestive of glaucoma.Tunnel vision is very characteristic of glaucoma.Thus, I suggest you to consult an ophthalmologist for clinical assessment, relevant investigations and thus management.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is plasma replacement required in case of elevated MCHC and hemoglobin as shown in CBC report?\n\nYes, I am a registered Medical Technologist. the other night at work, i saw an MLT performing a plasma replacement on a cbc sample where the Mchc was elevated. (about36.7) the Hemoglobin was about 8.2 and the Hematocrit was about 22.3. where the instrument used did not flag a H/H check fail, i thought it was too agressive to do a plasma replacement. If anything, perhaps the possibility of cold agglutinin. the mlt claims she did the plasma replacement because the sample was icteric. i disagreed. What could be the cause of an H/H that elevated.. with the values indicated?",
    "doctor_response": "HIThank for asking to HCMI think that working in medical field so you are having such ideas which are not logical are not allowed on medical ground this is the iron deficiency and can be treated with the iron therapy alone will give result, but before this the other possibilities of disease has to be ruled out which may be the reason of the low indices  have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have bruising even after taking flucloxacillin for insect bite?\n\nI was bitten by an insect and this got infected.  I saw a doctor and I was prescribed flucloxacillin to treat this which I have taken for the last 2 days.  The swelling has gone down slightly but my skin still looks very infected and it has since developed purple bruising.  Is this normal or should I consult a doctor again?",
    "doctor_response": "Hi,Continue taking full course of Fluoxacilin for 5 days.After controlling of infection with antibiotic you will be alright.Apply antibiotic cream locally.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest dosage for vitamin B-12 for someone with secondary-progressive multiple sclerosis\n\nHello I have secondary progressive MS. I have been told to take Vitamin B12 pills to help with my memory and tiredness. I am not sure how many B12 pills to take. I take one 1000mg pill a day. I am also on Citalopram 10mg and Baclofen 10mg. What dose of Vitamin B12 is it safe to take. Brian Measer. I am 64 years old.",
    "doctor_response": "Hi there Brian, The dose of Vitamin B12 that you are taking is ok (one 1000 mg pill a day). It should not interact with or negatively affect your secondary progressive MS. Vitamin B12 is excreted by the kidneys, so any extra that you take (that your body does not need) will be excreted out in your urine. Based on your other medications, it does not sound like any of the other medications you take are for kidney problems, and the B12 dose you are taking is a standard dose. I would continue to take the dose you are on now.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will Antitubercular therapy cause diarrhea?\n\nMy friend is on Antitubercular therapy for tuberculous lymphadenitis since 13 days now. He suddenly had diarrhea today evening. Is it safe to administer Enterogermina to him? Is there any interaction between enterogermina and ATT? Age: 54yrs Weight: 55kgs",
    "doctor_response": "Hi,ATT usually do not cause diarrhea as their side effect. However other causes of diarrhea should be determined and treated accordingly. There is no documented any harmful interaction between the ATT and the probiotic enterogermina hence the probiotic may given to reduce the frequency of loose motions.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful arms with numbness\n\ntwo weeks ago I was attacked and my arms were pulled back and twisted ever since iv had severe pain in my mid to upper neck, my lefy shoulder. I have sharp shooting pain down my left arm most of the time were my left hand and arm ,especially my left hand thumb is numb and tingly.severe pai8n constantly what could this be?",
    "doctor_response": "Hello,What I can infer from what you have told is that you are having an acute cervical strain. I would suggest you take some analgesics of the pain is troubling you. I would suggest you wait for 48 hours and if the pain and tingling still persist then visit a physician. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Santosh S Jeevannavar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What caused dizziness, lightheaded feelings with twitching and tongue movement?\n\nMy fiance had an accident the other day in the shower. He bent down and came back up again but stood up fast (and the water was really hot) but when he stood up he got light headed and dizzy and fell to his butt. I was in there with him and I knelt down in front of him and he was twitching & his tongue was moving in and out a little bit. I thought he had a seizure. Doctors took blood test to check for diabetes and blood pressure, but it came back okay. Then I thought maybe it was just fainting with muscle spasms. He's never had this happen before. And he was lacking food in his system because he had not eaten much a couple days before. I just want to know if this could be something really serious.",
    "doctor_response": "Hi, It can be due to alteration in his BP. Check for diabetes, thyroid issue and blood pressure. For dizziness, you can use betahistine.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Isotretinoin affect future pregnancy?\n\nHi doctor,I am an unmarried woman. My plan is to get into marriage life after two years. Currently, I have been\u00a0taking Isotretinoin for the past 20 days. I have heard that it may cause infertility in women. Does Isotretinoin cause future birth defect? Will it affect my future pregnancy?",
    "doctor_response": "Hello. Actually, it is known that Isotretinoin can cause severe birth defects in the baby if taken during pregnancy. So, you must not take it, if you are pregnant. And if you have taken, then some doctor will advice termination also in early pregnancy. But, there is no study done specifically to find correlation between Isotretinoin and infertility. And if done, then there is no correlation found significantly. So, you can use Isotretinoin if you are not pregnant. If you are planning for pregnancy, then stop using at least two to three months before. If you have acne and you are taking treatment for that, then let me tell you that try to lose some weight if possible. It will also decrease your problem. As far as future pregnancy is concerned, do not take Isotretinoin in pregnancy and stop before pregnancy. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there pregnancy chances with non penetrative sex?\n\nHi my girlfriend and I were fooling around a few weeks ago and I might have gotten some precum on my finger (i think I wiped it off) regardless, i fingered her (not sure with the same finger) but only the outer vaginal flaps no actual penetration is she pregnant?",
    "doctor_response": "Hi, if there is no contact of vagina with the precum or the semen, she can't get pregnant.  But if you are not sure of that, tell her to take emergency pill to avoid pregnancy after consulting a doctor.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for shoulder pain?\n\nI have ongoing pain in right shoulder, neck and behind shoulder blade. I have had it almost two years now. I got shingles in the right shoulder in August which has made matters worse but its not getting any better and I am experiencing limited mobility of my right arm and unable to lift it as high. Might there be an underlying problem which is manifesting itself in the shoulder and neck?",
    "doctor_response": "hi thanks for contacting it seems you are suffering from peri arthritis of shoulder . so i will suggest you to apply hot pack twice along with do some active exercises , light weight exercises . pulley exercises for your shoulder as your symptoms may get worsen , avoid sleeping on involved shoulder and avoid lifting heavy weights . hope you find the answer useful",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is diarrhoea, intermittent fever, racing heart in a child a cause of concern?\n\nHello, On Friday my 8 year old son came down with a fever of 103.8 F and on Saturday he started feeling nautious, Sunday he was vomitting and had diarreah today he still has diarreah and the fevers which only go away with advil and cool showers, but once the advil wears off the fever is back up to about 103.5. Today I noticed that I can see his heart beating fast through his ribcage. I can not get him in to see his family Dr until Thursday and there are no walk in clinics where I live. Do you think I should take him to the hospital. Thanks",
    "doctor_response": "Hi,It seems that he might be having acute gasro-enteritis producing loose motions, nausea with high temperature.due to high fever his pulse rates are supposed to be heavy.He might require Oflox TZ for having GI infection.Give him plenty of water, electral powder and ORS liquid for having high fever and to prevent dehydration.Give paracetamol for temperature.Watch for signs of dehydration like less urine out put, sleepiness, dry tongue.If this occurs take him to ER.Keep cold sponge on head and abdomen.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for migraine attack\n\nHi, I am a retired cardiologist, 62 y/o female postmenopause. I ve had one stroke, aborted by streptokinase. I ve had migraines for 5 decades. Lately I ve had side effects with Maxalt (nausea, one episode of severe pain in legs) and I don t want to take it again. I can t take ergots because I m on Cymbalta. Any suggestions what I should try next? I get migraines only about 3 times a year now",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As per your history, it may be migraine. For acute attack, you can take tab. ibuprufen and to prevent attack, take tab. propranolol after consultation. Prevent exposure to excessive light stress etc. keep yourself hydrated. Take care. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in front of the shin?\n\nI HAVE SWELLING IN MY LEFT LEG IN THE FRONT ON MY SHIN. THERE IS ALSO LIKE A HOLE THAT IS NOT ON THE OTHER SIDE THAT I CAN STICK MY FINGER IN. I DON T REMEMBER HITTING IT ON ANYTHING. WHAT COULD THIS BE AND SHOULD I BE WORRIED? COULD THIS BE A BLOOD CLOT?",
    "doctor_response": "Hello, It could be due to conditions like abscess or cyst. Consult an orthopaedician and plan for an MRI scan. Hope I have answered your queries. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Shortness of breath, chest tightness. Using blue inhaler. History of asthma. How to control symptoms?\n\nmy step daughter has asthma but has it under control,she rarely needs her blue inhaler but today she is suffering from shortness of breath and says her chest feels tight, she is so against going to the GP is there anything that i can do help to control her symptoms, i have read that coffee helps (being a diraretic ) and also putting your head over a steaming bowl of water, please help as i am worried about her",
    "doctor_response": "Hello dear... Asthma is caused due to broncho-constriction (obstruction of smaller airway passages) which is indicative of Hyper-responsiveness of air passages to an allergen. And the inhalers provide symptomatic relief by causing broncho-dilation (dilating the smaller airway passages, relieving the obstruction & increasing airflow to lungs) Montelukast preparations can also be used as a maintenance therapy to relieve symptoms of seasonal allergies & asthma by reducing broncho-constriction. Drinking of warm fluids & steam inhalation also provides symptomatic relief. But...it will be better to consult a Pediatrician if symptoms still persist or aggravate. And make sure that your daughter is well protected from cold, dust & other allergens. Wishing her a good health. Thanks & take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be done to quit habit of masturbation?\n\ni am 15 now.....i have the habbit of masturbating..but now i think it has gained control over my mind and body.. i usually masturbate 5to 6 times a day, which i myself consider as an unhealthy habbit.....but i cant help it...i have become an addict..(I THINK SO).please take up the issue seriously and provide me with apt solutins.",
    "doctor_response": "Hi, You are having excess masturbation habit. You can restrict masturbation frequency two to three times a day to prevent fatigue and groin discomfort like side effects. I suggest you practice yoga and meditation. You can make short term and long term goals in life and try to fulfill it. Don't stay alone in a room for a prolonged duration and meet with friends and relatives. Try to restrict porn watch as well. You can consult psychiatrist for counseling. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dry cough and shortness of breath\n\nOver 4wks ago, I went to Texas and although I love humidity,it started to make me feel \"stuffy\" in the nose. It may have been from the airplane however,I did not feel that way until about the 2nd day there. The only allergy that I had was penicillin,amoxicillin and severe weather change has never had any negative affect on me at all. I am a healthy active 35 yr old girl. In the first few wks I was only congested & had a slight tickle in my throat which I took nyquil & cold eeze for. Then I started getting a hearty cough but it was & still is dry with no mucus at all. Also I have not bbe sick in 5 yes and I would knock out any sign of a cold quick. I also usually take \"airborne\" and keep antibacterial wipes with me at all times.this past week, I've had a worse cough at work possibly due to the air cond. And past week have had a weird feeling in my chest with slight shortness of breath. I work for a foot dr. But asked that he do an xray which did not look super cloudy at all but he says it showed slight white cloudiness & he was not sure what to prescribe,but ended up prescribing \"avelox\" which I am hesitant to take since he didn't even sound sure. Help! Thank you.",
    "doctor_response": "Hi. I can understand your concern. Breathlessness are commonly seen in bronchitis and lung infection. Since your chest x ray is normal, no need to worry for lung infection. Possibility of bronchitis is more in your case. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of bronchitis. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid (ICS)Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain in the nipple?\n\nHi im 17 years old and i workout out everyday. Ive been working out for about a year now and i feel a sharp pain in my right nipple when i touch it. My older brother who also lift had gyno and so did my uncle. Is this a sign of gyno or something else? I dont have much fat on my chest but my lower chest tends to be a bit more fat on both of my pecs. Can you help me out?",
    "doctor_response": "Hello,Rubbing of nipples with hard shirts or T-shirts may cause pain. Other possibilities like hormonal changes in teenage also may be the cause. Wear loose cotton clothes while workouts. use simple paracetamol for pain relief. If no improvement please consult your physician he will examine and treat you accordingly.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why there is a variation in pulse during walking and at rest?\n\nHi doctor, I am 28 year old. My sugar level is normal, TSH is 2.91 and cholesterol is 203. I am facing a problem with my pulse rate. It is between 115-120 when I walk or do any activity. But when I am in rest, it ranges between 80-100. I feel lightheadedness when I walk. Is it normal?",
    "doctor_response": "Hello. Cholesterol is in upper borderline. It will come down with low cholesterol diet and exercise daily. Heart rate more than 100 while walking is fine. From your history lightheadedness is the only problem. Is this lightheadedness significant? Do you feel like falling or black out? Monitor your BP (blood pressure) while feeling lightheaded. Measure your BP while sitting followed by standing after three minutes. Sometimes people have positional hypotension. Also, do a Holter monitoring (24 hour ECG) with normal activity whole day. So, we can see your heart rhythm pattern while lightheadedness and rapid heart rate.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should medicines for diarrhoea be given during teething?\n\ndear DR my 2year baby was having loose motion since 04 days.we gave the medicines now he is ok but now we noticed that the loose motion was due to teething should we continue the medicinefor another dayas advised by dr. the medicines are norfloxin and lactic acid contents",
    "doctor_response": "Hi,What ever is the cause of having loose motions, treatment is to be carried out as there might be possibility of developing dehydration.There is no harm continuing treatment.Give her enough water and ORS liquid and keep her well hydrated.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause swelling in the lower leg while on treatment for COPD?\n\nI am currently being treated for asthma/COPD. My undiagnosed condition, however, is that my right lower leg , foot and especially instep is very bloated. I had an ultrasound performed on the area yesterday and it showed no clots. Blood work was also done but I have not gotten the results yet.",
    "doctor_response": "Hi, Ultrasound is not showing blood clots, no need to worry for deep venous thrombosis. This kind of Unilateral pedal edema is also seen with cellulitis (infection of skin). So start oral antibiotics, anti inflammatory drugs, glycerine magnesium sulphate dressing etc. Limb elevation is also important. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why did my all 3 IVF cycle fail?\n\nhello doc, im 30 n my husband 32 yrs. im 5.2 \" n weigh 70 kgs i have undergone 3 ivf cycles with dr. anoop gupta- delhi. everything was very good(lining of uterus, egg quality, e2), i got good no. of eggs, embryo quality was excellent. i got 5 emb, 3 emb(8 cell) transfrd 0n day 3 in cycle 1 n 2. in cycle 3 i got 2 blastocyst on day 5. all 3 ivfs failed. now what shud i do? shud i undergo some test or 4th ivf? im afraid my eggs will exaust.",
    "doctor_response": "Hello,Welcome to healthcare Magic.I have gone through your query and Would like to reply in detail as follows:1. Difficult to assess reason.2. You might benefit with PGD in next IVF.I hope your doubt is clarified. Let me know if you wish any other information.Regards,Dr. Mahesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have hurting palate, burning, heavy, bumps, difficulty spitting, swallowing, talking, after eating strawberry, waffles\n\nHi, My name is Hailey Jones. I am a 15 year old girl. last night i ate a strawberry and the roof of my mouth started to hurt  but i just find of stopped eating it and pushed it off. This morning a was having some waffles and it happened again but much much worse. The roof of my mouth started to burn, it felt really heavy, got little bumps on it. I could not spit, swallow, talk and it even hurt to breath. I have no idea what to do. water only made it worse. It hurts so bad. please help.",
    "doctor_response": "Hello, The problem seems to be a soreness of the palate. There could be minor  ulcers over the palate which could cause the discomfort. Apply dentogel ointment over the are 3-4 times a day for a week . Avoid hot and spicy foods meantime. Take warm saline gargle 3-5 times a day. Take analgesics as prescribed by your dentist. Consult your dentist. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump on the palm\n\nHi I have a lump on the palm of my hand,my doctor gave me the name,but I don t remember..she asked if my fingers have lost range of motion,which they hae not...My brother-in law has the same but his fingers have pulled back..what is it called and what percipitates this? thank you....",
    "doctor_response": "welcome to health care majicmy name is Dr Ehsan ullahI have been through your concern regarding the lump in the palm ...Palmer lumps can be of different origin depending upon the -onset /duration -features of the lump likesoft,firm , hard mobilityconsistencyfluctuation etc one of the common condition which exists on Palmer aspect of the Hand is Dupuytren's Contractureother pathological conditions includecysts abscesslipomas which are benign fat collectionganglionand off course callus which results from repeated pressure on your hand mostly due to unusual work with tools now how to manage ...your GP will access the nature of the lump and decide whether you need conservative treatment or surgical assessment and management then you will have to follow the directions and treatment accordingly hope this answer covers your questiondo let me know if anything still now clear regards Dr Ehsan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is voiding cystogram necessary to find out the reason of urinary infections of a 6month old baby?\n\nHi, may I answer your health queries right now ?  Please type your query here...Hello Doctor,  My 6month old daughter had urinary infections ?E Coli? given antibiotics, now she is normal. But doctor given appointment to do (voiding cystogram) to find why she got the infection, Is that necessary ? please advice me?",
    "doctor_response": "If it was only for one time this infection has happened, then I dont feel a necessity to do the test.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My tinnitus has worsened. What is my chance of recovery?\n\nHello doctor, I am looking for a second opinion. I got tinnitus from loud noise three weeks ago. Most of the time the noise is constant 3 or 4 on a scale of 1 to 10. Yesterday morning I experienced my best day as the noise seemed to reduce to a 2. However, it went back up to a 3 and 4 again yesterday afternoon and most of today. I did see an audiologist several days who examined and tested my hearing. No hearing loss was found, and he said my ears looked healthy. He was optimistic in saying I should improve in the coming weeks. Should I be concerned that the loudness returned? And do I have a good chance of recovery being that no hearing loss appears to have occurred? I am currently on Bactrim for rosacea, Provostatin for cholesterol and took steroid Prednisone for five days for ears.",
    "doctor_response": "Hello. The cause of tinnitus is usually idiopathic. Every normal person can hear that sound many times in their lives. It goes away as suddenly as it had started. There is no reason for worrying as you have no hearing loss. So relax, do not worry as these kinds of tinnitus is intermittent. Sometimes some situations, some kinds of food can start that tinnitus. As you reported that the sound was on scale 3, please try to avoid it. If the tinnitus is disturbing you, consult audiologist for TRT (tinnitus retraining therapy). For more information consult an audiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high BP with back and neck pain\n\nhi i wonder if you can help me please.my father is 72 years old and his sufring fro high blood oresure,also he keeps having pains on the back shoulder,and neck..he recogn its high blood presure and romatism in the back shoulder.we took him every where in tunisia,geting tablets for his blood presure.also he has been told to keep a good diet and avoid high clestrole food.please can you help.any recomended medication i could send from the uk.im so woried about my dad.thanks.mr khelil.",
    "doctor_response": "Hello, I appreciate your health concern about your father. You have to reduce salt intake and avoid fatty food. Regular blood pressure monitoring, use antihypertensive drugs according to the requirements. Use tablet Tramadol with Paracetamol twice a day for five days. If symptoms not improved please consult your doctor he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Penchila Prasad Kandikattu , Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "My daughter is having a pain in her side. Is it Appendicitis or constipation?\n\nTook my daughter in because we believe she was having constipation and possibly threw up bowel. The er dr thought it might be an appendicitis. Ultrasound couldn't find her appendix. We came home and she had a little bit of lunch and within a minute, she was having the pain in her side again and having diarrhea. Could this be appendicitis and should I have had them do a ct scan?",
    "doctor_response": "go ahead and do the ct scan its better to be safe. Otherwise if it comes back negative..take her to a gastro doctor may need a scope to look, or a stool test.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Ultrasound shows multiple peripheral follicles. Blood test shows normal hormone levels. Trying to concieve. Will it affect the ability to concieve?\n\nA ultrasound informed me that I have multiple peripheral follicles.  However blood test shown that I have normal hormone levels. I went to see an endocrinologist and she says I don't have PCOS. Furthermore I am trying to conceive.  How will my multiple peripheral follicles affect my ability to conceive? Will it be harder for me to become pregnant? Am I infertile?How did I get multiple peripheral follicles? Is this common? Please help!!!!!!",
    "doctor_response": "Hi,Thanks for the query. Usually if the number of follicles in on ovary is more than 10 with size less than 1cm, that is called as poly cystic ovary disease. In early stages of PCOD hormonal imbalance may not manifest sometimes. But there is possibility that it may lead to hormonal imbalance in future. If you are having regular ovulatory cycles, you can plan for pregnancy now. With your doctor's advice, you can go for ovulation induction and follicular study. Then plan intercourse around the time of ovulation, this will increase the possibility of pregnancy. If there is problem with ovulation, better to use insulin sensitizers like metformin for few months. This may help in increasing the fertility rate. Maintaining the ideal body weight for height, exercises, dietary management etc helps in decreasing the changes of PCOD. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does hepatitis c take to manifest after a skin prick?\n\nhi i was pricked by lancet with a patient , i dont know if she is infected with hep c, but im worried, i got my serelogy test after 3 months and its negative repeated after e4 and half months and its still negative, should i still continue to be worried, after the incident happen i did washed my finger and try all my best to withdraw the blood, please help me , im still anxious thank u",
    "doctor_response": "Hello, Thank you for your contact to health care magic. I understand your concern. If I am your doctor I suggest you that as you got tested for Hepatitis C at 3 and 4 month which is negative, and so there is no point of worry to you. Its good you have washed the hand and bad you have press the finger to wipe the blood. I will be happy to answer your further concernYou can contact me. Dr Arun Tank. Infectious disease specialist. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Aten and muslipower cause any problem to kidney and pancreas?\n\nI am operated to remove kidneystones and I am suffering from Annal Fisusres. Iam hypertension patient and I am taking Aten 50 tables once in a day. Is there is any damage to pancreas, kidney and prostate. Can I use Muslipower since I am not getting proper erection.Iam 54 years old",
    "doctor_response": "Hi,Aten is a heart-selective beta blocker commonly prescribed to treat high blood pressure and other conditions. Its common side effects include low blood pressure, decreased heartbeats, cold clammy skin, fatigue and erectile dysfunction.It is not known to cause any damage to pancreas, kidney or prostate. Muslipower is an ayurvedic medicine claimed to be useful in the treatment of arthritis, cancer, diabetes, and sexual dysfunction. However, its safety and efficacy has not been proved on any clinical trials so the FDA has not approved it for such conditions.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long can we take Desval ER 250 - 2 tabs, Sizodon LS - 2 tabs?\n\nRespected Sir, I have been treated now with Desval ER 250 - 2 tabs, Sizodon LS - 2 tabs, and Lonazep .5 -1 tab a day, i have been taking mood stablizer for more than 3 years, now what i have to do and how severe my illness. when can i stop taking medicine.",
    "doctor_response": "Hello, These are psychotropic medications. The decision about stopping medications would be of your treating doctor. Otherwise there would be release of the symptoms. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Shubham Mehta, Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from genetic focal palmoplantar keratosis. Is there any homeopathy treatment?\n\nHi I am Srinivas from India. I suffer from genetic focal palmo plantar keratosis. My father had it and it has been passed to me, my brother and my sister. I am marred with a son and daughter. While my son in affected, my daughter is free from it. Is there any cure or treatment available in Homeopathy for genetic focal palmo plantar keratoderma? Thanks for your support.",
    "doctor_response": "Hi there ~ Please consult a homeopathic doctor for your condition if you have not had adequate help from an allopathic doctor.  I think your genetic condition is treatable symptomatically, however if you have lost hope from allopathic doctors, I would like for you to be seen by a doctor you trust.  Sometimes, it has a lot of effect on the response to treatment. I hope this helped.  Take care and have a nice day !",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hippocampal dysplasia\n\nHello! My name is Lupascu Vasilica and i have a son. He has 27 years old an he was diagnosed with: Skin neuroimaging suggestive of hippocampal dysplasia third bilateral anterior and middle and mega cisterna magna. I would like to know if you can help him and how much does it cost.Thank you!",
    "doctor_response": "Your best bet for information on cost is to check with the doctors in your geographic area since it depends on what type of procedure would most benefit your son.  You would need to provide more information on his clinical symptoms since it may be the case that despite radiographic findings- not \"fixing\" anything could be the best option.  For example, is he suffering from some type of neurological deficit, weakness/paralysis on one side of the body or the other, severe headaches, mental slowing or retardation, other cognitive or neurobehavioral types of disorders?  You may write to me at: www.bit.ly/drdyyyyyyyy with comments to help understand his case a bit better so that I might consider best treatments for him.  Please rate this a 5 STAR ENCOUNTER.  Many thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and pain on right side of the lymph node?\n\nIf I had throat cancer, or cancer in neck would my white and red blood cell counts come back in a normal range? Right side of my Adam s apple hurts and I have had a slightly swollen lymph node on right side for about 3 or for weeks. Normal blood tests and ENT didn t see anything with scope . But my right side of throat/neck really hurts!!!",
    "doctor_response": "HiSince you are having swollen lymph nodes biopsy test should be done to rule out cancer.I will also advise ciprofloxacin tablet for any infection which you can take with doctors advise.RegardsDr de",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in hips and knees after standing from a sitting position?\n\nWhen I get up from a sitting position, my right hip sends nerve like pain in area. I also have pain around my right front knee with tingling down my shin, over top of right foot, through right side of big toe and tingling on bottom front portion of the right foot. I was in an accident 3 mos prior to fusion surgery. What might be causing my present issues, and should I see my physician regarding this issue? I had a fusion of the L-3, L-4 2 years ago.",
    "doctor_response": "hi,thank you for providing the brief history of you.A thorough neuromuscular assessment is advised.As you have pain radiating from the hip to the toe and also the past Injury in the spine there looks to be a pinch of the nerve in the lumbar spine where you getting this symptoms.I will recommend you to undergo physical therapy and undergo some serious exercise sessions to stabilize the spinal column as you should be very much aware of the lumbar spine as it may give trouble in future if the muscles are not strong enough to hold the spine.In my clinical practice when such cases comes it is described as failed back surgery cases. We recommend physcial therapy and proceed until the stabilization of the spinal column is done to safeguard the spine for the future. Majority of cases respond well to physical therapy program.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause for rash only during the morning which disappears in the afternoon?\n\nHi my name is Stew and over the last three days my son has developed an itchy rash in the morning that disappears by the afternoon. It's school holidays at the moment so he has been sleeping in until about 10 am. When he gets up he has no rash, over the next few hours the rash appears but by afternoon its gone. The rash has round whitish raised inflamed lumps, some by themselves and others grouped together. Seems to start on his hands and spread over most of his body. I have taken some pictures if that would help. I can think of nothing that has changed to cause an allergic reaction, washing powder, food etc...My son is 17 and we live in a rural part of Queensland, Australia.",
    "doctor_response": "Hello, The symptoms seem to be related to contact dermatitis. I suggest using antihistamines such as Cetirizine. I also suggest using Hydrocortisone cream for local application. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing pain in left arm & shoulders after going through a bypass\n\nIt s been 6 months since my significant other received a double bypass. He has complained about pain in his left arm and shoulder which seems to be getting worse. He is only able to lift his arm chest high without pain. The pain wakes him up at night. His cardiologist says it s most likely nerve damage from the way they positioned him during the long surgery or a pinched nerve.He never went to any physical rehab after surgery, they kept telling him he wasn t ready yet but then we moved from NY to Texas and the new cardiologist made it sound that after 6 mnths it wouldn t help him anyway. Should he see a neurologist for this ? Thank you for your reply. Joyce Fagan",
    "doctor_response": "Hello, My opinion is It's better late than never. Let's come to the discussion where we can find some possible solution for the patient. It is true that after any cardiac surgery one needs to undergo a proper cardiac rehabilitation program under an expert physiotherapist. Now, you are saying that the patient has Complaints in his left arm and is not able to lift the arm. Please make it assure that the cardiac routine diagnostic procedures are done before we come to a neurological point of view. Is the pain he felt is due to cardiac of not that is the first thing we have to keep in mind. If there is no cardiac issue and is ruled out that one needs to not worry and we can jump over the surgery part. Now, let us make it clear, that due to bypass surgery there will be shortening of the pectoral muscles and it needs a good stretching so the shoulder stays in a normal position wherein the biomechanics of the shoulder do not get disturbed and the functionality of the shoulder remains intact. Coming to the neurological point of view, I don't think he will have any nerve compression. Because if it is nerve compression then the symptoms will be like tingling, burning, numbness etc. Now, let's assume that he doesn't have any cardiac or neurological issue then it is straight the job of the physiotherapist to help him out. Undergoing a proper rehabilitation program should definitely help him lift his arm up. Also a good strength in the muscles of the arm is needed to acquire the optimum functional ability. Also breathing exercises should be made a part of the overall exercise program as it has got to do a lot with the overall well being of the patient. Please take the call based on the guidelines. First the heart needs to be assessed. then the surgical part if any muscle is shortened and leading to change in the posture which is changing the biomechanics of the joint. And lastly, the neurological point of view if we rule out step by step all things then definitely we can come to a proper diagnosis and help the patient to have a good lifestyle change. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling sensation in the abdomen?\n\nI get twinges in my abdominal area at usually at night, but now I am starting to notice all the time. It is on my right side to the right of my belly button. It almost feels like a bubble bursting, or like a small wire bending. It is very disconcerting. I am a 58 year old woman in seemingly good health. The twinges aren't painful, just a weird sensation and seems to have gotten worse, and now travel all over my belly. I have asked a few doctors when I get check ups and they just say nerves.",
    "doctor_response": "Hi.Thanks for your query and an elucidate history, history of what other Doctors suggested, like 'just nerves''.I do not think so, these are not just nerves. You have mentioned specifically about the twinges on the right of your belly, more pronounced at the night; feels like ''bubble bursting' or small wire bending, seems to have gotten worse and now travel all over the belly. I would think abut the following in such a case:-This can be a subacute intestinal obstruction, not sufficient to cause acute pain.- Lymph nodal mass in the center - mesentery,-Rare chance of Gastrointestinal cancer.I would advise you the following, please discuss and insist with your Doctors:-X-ray of the abdomen in standing position;-Ultrasonography and if required CT scan of the abdomen. -Clinical examination of the abdomen by a Gastroenterologist and preferable a Surgeon.-Investigations of the blood- particularly to rule out diabetes, Typhoid, liver and renal functions.-Urine and stool examination;-Endoscopies if required and advised by Gastro.Once a proper diagnosis is made, treatment will be guided to give you a proper diagnosis and may be a cure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Laryngopharyngeal reflux\n\nI have Laryngophrayngeal Reflux, as diagnosed by my ENT specialist and gastroenterologist. I am 18 years old and occasionally I get acid reflux attacks, like now. I keep coughing and fluid keeps slushing up and down my throat..I keep coughing up some food..only rarely do I get these attacks, and it seems that I have precipitating factors..For instance, I ate a sandwich with corn in it, and that s wrecked me...same happened last year twice..what to do? I am so frustrated coughing my lungs out and I am terrified that I choke on my vomit..please help me",
    "doctor_response": "Thanks for the query Looks like u have acid reflux, refrain from smoking, spicy food. Follow a strict timely diet. Avoid full stomach feeds, eat sparingly but many times a day U would prescribe u a pro kinetic like mosapride for the acute excaccerbations Have a healthy living",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden chest pain to a 21 year old?\n\nhello my wife is 21 years old female all of the sudden she got pains all over her chest, sharp pain when she move, breath she cant even hold our 5 month old daughter as her chest really hurt she says..Ramin",
    "doctor_response": "Hi thanks for contacting HCM...If she had history of heavy weight lifting or any unaccoustemed activity then pain could be musculoskeletal pain...For which rest needed.Simple analgesic if needed given...Avoid strenous activities....Heavy exercise restricted.Hot pad application useful...Second physical examination done...If calf swelling present then rule pulmonary embolism like causes...If pain radiating to arm and constricting type pain  then angina and ischemic heart disease like condition has to be ruled out...For above condition investigate with....-ECG -echo-tread mill stress test if neededIf cough and fever like respi symptom associated respi cause searched for like bronchitis and pneumonia by chest x ray ...Take care.Keeping this in mind consult physician...Hope your concern solved.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the significance of lump in groin after having a hysterectomy to treat endometrial cancer?\n\nHi I am a 65 yr old lady, I had endometrial cancer grade 1 4 yrs ago had hysterectomy followed by 25 treatments of radiotherapy, all fine, now got lump appear in inner left area of groin, I have to take movicol as I am always constipated, could this be a build of of my poo as I do struggle to open my bowles, I am quite worried about this, I do suffer with anxiety as well and I am on tablets for RLS , I was on tramadol but have taken myself off it 2 days ago because of its side effects,   any advice would be appreciated, thank you",
    "doctor_response": "HelloThanks for writing to us with your health concern.No, this cannot be a build up of stools.They would not come out and form a lump like this, even if you are constipated.THis is most probably a lymphocele.Owing to the radiation, the lymph vessels get thrombosed and blocked.Lymph gets collected forming a lymphocele.ANother possibility with the history of endometrial cancer is that this could be a lymph node.Please do not ignore it.IT could also be another separate discrete vulval swelling.IN view of previous history of cancer, do not delay consultation.Dont worry , it is most likely to be something benign.All the best.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain under the ribs after an injury?\n\nI fell very hard on Feb. 6 & landed on my right ribs with my fist underneath. I didn t hurt too badly the first day, but then began hurting very bad on the second day & has continued ever since. It doesn t feel like the pain is coming from the ribs, but from under the ribs. Everything I do feels like I m pulling the muscles there. Sometimes it hurts in nearby areas like I ve been exercising or something. Maybe from compensating my movements? I ve also begun feeling mild pressure (almost like indigestion) around my heart/stomach area after a day of movement. I don t have any insurance because I ve been an unemployed teacher since May 2010. I know if it s cracked ribs there s nothing that can really be done anyway so I don t want to make another bill I can t afford to pay.",
    "doctor_response": "Hello, It could be a contusion and inflammatory pain.As of now you can use analgesics/anti-inflammatory combination like aceclofenac/serratiopeptidase for symptomatic relief. If symptoms persist better to consult a general surgeon and plan for a CT thorax. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain due to early spondylytic changes in sacral segment\n\nI m having a back pain. X-ray has been done. Although most of the report is normal it says ``early spondylytic changes present; Bifid variation of distal sacral segment present. What does it mean? What should I do to cure this? I m mathematical researcher and I usually sit for prolonged hours.",
    "doctor_response": "Hi, You need to do neck extension exercises, as guided by a physiotherapist. These are common in people with a sedentary lifestyle or in those sitting for long hours. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sudhir Kumar, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest counseling and therapy\n\nMy son aged 22 yrs finished his eng.and even though got admission for p.g. course and also job opportunities is now doesnt show interest in these.  He spendsentire day with friends and demands nowadayshuge sum of money, doesnt inform us anything .we consulted a psychiatrist who initially prescribed oleanze 2.5 and noe since the problem exists has prescribed dicorate 500(at night) or dicorate 250 in the morning. I haven,t started giving the medicine (he refused to come for counselling nad he is unaware the he is given oleanze) I mix with juice and giove the medicine.  Now after reading about dicorate tabs side effects I am confused whether to start or just wait for sometime giving only oleanze 5mg or consult another psychiatrist for secnd opinion. My son wouldnt come to a doctor.",
    "doctor_response": "HiThanks for using healthcare magicEither he has behavioral issues or manic episode. If he has manic episode, only then there is benefit for giving oleanz and dicorate. If it is his behavioral issues, in that case, you should consult a psychiatrist and get him proper evaluated. If he is not welling to go for consultation, you can get a psychiatrist for home visit. That would help to get a proper line of treatment. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of rheumatic fevers recurrence?\n\nHello Doctoe, I am Arthur. At my age 11 i was affected by Rhumatic fever and doctor advised me to take penidure injection every 21 days . I took injection for next 5 years. Then i Stopped injection and took tablet (pendits 400) for next 2 years. I stopped having tablet also @ my Age 18. Now am 23(Age), am not feeling any health issues and never felt pains in the joints still now. Now my question is, whether i ll have any further health problems regarding rhumatic fever?",
    "doctor_response": "HelloAt the age of 11 yrs , you suffered with rheumatic fever ( it is caused by streptococcus pyogenes , group A sreptococci)and for this got PENIDURE ( BENZATHINE injection for almost 5 years , after this pentids 400 mg for 2 years .This is known as prophylxis treatment , and you got it even 2 years more than recommended period .You are right , now you are not at risk at all but if you get streptococcus pyogenes bacteria again , you may suffer  with rheumatic fever , BECAUSE you can't get antibody or immunity against bacteria .So be careful whenever you suffer throat infection at once consult an E N T and get in throat swab culture for streptococcus infection.Hot saline gargles and local antiseptic solution gargles at once , if any throat infection in future.Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest ways for overbite correction\n\nHi,My teeth are all straight except that I have a overbite,and a gap in my front two teeth(I used to suck my thumb when I was little)I went to a dentist and he told me I would get a retainer to pull the front teeth together and move them inwards to get rid of the overbite and spacing,But the issue I have is that the underbite causes my face to look shorter,when I move my lower jaw outwards to get closer to my upper teeth my face looks much better,Does an overbite mean that my jaw are not align correctly?I d like to know if braces can actually move my lower jaw outward rather than moving my upper teeth inward or is there any other option that can do that, Im a 20 year old female am I too old to have my jaw align since I dont think its growing anymore?",
    "doctor_response": "Positioning you jaws by bringing them in front would not give you the correct idea of how your face would look after the correction of your overbite. Correction of overbite would not make your face looks shorter at all it would rather improve your profile. There are ways when the jaws are corrected and positioned differently to align them more aesthetically called distraction osteogenesis but that would be done only if the jaw alignment is improper. In your case a retainer and alignment of teeth would suffice so you needn't think about the jaw surgery unnecessarily. Also overbite can have lng term effects in the gums leading to more problems so i would suggest you to start the treatment without any further delay.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be done to control BP without medicines?\n\nHi.. My fiance is 22 years old. He has high bp.. Normally 140/90 without any medicines.. He has this problen since the last two years.. He is on medication.. betacap tr40.. His bp sometimes goes upto 160/110 or 168/110. He weighs 82kgs and is 5'10\". He has severe headaches and body ache.. What should he do to control his bp withou medications? If he quits medications.. his bp again goes upto around 140/90 in 2-3 days..",
    "doctor_response": "Hi,first we should try to find cause why he high bp in young age.get hisrenal artery Doppler test,Renal function test 24hr Urinary metanephrines serum cortisol.Start him on low salt diet and regular exercise, including yoga..Bp should be measured at rest of atleast 10 min.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I have nausea, lower back pain, abdominal pain and weakness?\n\nI have pain in the left side of my stomach that goes to my lower back,it also radiates to my lower abdomen and my left leg sometimes. I also feel nausea,sudden weakness, i'm hardly eating what use to and i'm using the bathroom more than twice for num 2.I also feel an urge to do num 1, even if i just finished",
    "doctor_response": "Hi.Thanks for your query.From the careful evaluation of your history; I can think of an inflammatory process going on in the left lower abdomen.The causes can be an inflamed mass, lymph nodes or a mass or abscess of the deep muscles like psoas or so.The best way to get a diagnosis is :-Blood tests to determine the hemoglobin, WBC count for infection, blood sugar to rule out diabetes.-Urine test: routine, microscopy, culture and sensitivity to determine whether there is an associated urinary tract infection as a basic cause or secondary to the problems I have enumerated.-Ultrasonography of the abdomen to screen for the cause and -CT scan to  confirm the diagnosis.The treatment will start as antibiotics and anti-inflammatory medicines.Surgery will be needed if there as an indication for diagnosis and/ or therapeutic importance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling pain in the big thumb after a repair of basel joint\n\nI had surgery to repair my basel joint with tendon work. 9 weeks ago I have a soft splint I wear sometimes. yetsrday I was squeezing my car window trying to pull it up and I felt pain in big thumb not always constant, but when I squeeze something john",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. Do some hand exercises and finger stretches regularly, and just warm up before doing hard activities. And do hot and cold therapy. Hot and cold therapy is to put your hand in hot water (lukewarm) for 3 minutes and in cold water for one minute. Do it 5 times. Hope it will help you. Let me know if I can assist you further.Regards,Dr. Harsh Swarup",
    "dialogue_context": ""
  },
  {
    "patient_message": "Weakness. Lungs were clear. Congestion worse. Why the pain?\n\nGot call from school clinic last Thurs my 7 yr old daughter was feeling weak. They took temp at 99. When I got her home in 30 minutes it was up to 101.6. She got up to 103.1 by a regular scheduled check up on Fri at 3pm. Lungs were clear. She has allergies and asthma . Only other symptoms were cough and some nasal congestion . By Sat. 6pm she was up to 104.6. Congestion has worsened. Tylenol and Motrin every 4-5 hours btought temp around 101. Sun night at 8pm she began complaining of leg pain. Gave more Tylenol for bed and also temp was around 100. Woke up this am (Mon) unable to walk. Pain is in calves on both legs. Sports creme and Motrin before school this morning. At 3:30 p.m. temp around 100.6. Pain is bringing her to tears . More Motrin and sports creme, and ice pack this afternoon and she feels a little better.",
    "doctor_response": "your child fits in milk theoryas child need milk till 2 years and that only breast milkafter 2 years no milk is needed as you add animal milk after 2 yearsit is not competible with human proteins causing allergy asthma and other diseaseswe should add vegetables fruits cereals in diets withdraw milk and diary proteins completely from diet of child she will start improving in  wk to 3 months all diseases will subside try i gurantee results",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could painful ribs with pulsating sensation and nausea indicate?\n\nim getting very worried about a very strong pulse and kind of dull ache just below my rib cage in the middle where they separate it also makes me nauseous at times, this has been going on for around 2 years now getting increasingly worse and I ve had a sore head for a few days now",
    "doctor_response": "thanks or asking your queryI completely understand your problemthe most common cause of pain over that reason in young age group is peptic ulcer disease and much more commoner in smokers and people who take alcohol  . if u r a smoker u should first quit smoking and drinking alcohol ,this will help u a lot with your pain .as for medications u can take a proton pump inhibitor like pantoprazole by asking your physician. if u r more worried about heart issues u can get an ecg done and consult a general physician after which u will feel relieved.thanks/regardsfeel free to ask more questionsmay god bless u a healthy life",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain after eating?\n\nDear Dr, My husband (age: 40, Height: 5.6, weight: 89) is a frequent traveler and when he was out of station in end of February, after lunch he started having stomach pain (upper part). Immediately he consulted general physician and had some tablets which reduced the pain at that time. But, after coming to Bangalore the pain was persisting and he consulted other doctor who had informed us that my husband is suffering from amebic dysenteries and gave some medicines. Unfortunately, the pain did not go. Finally, we consulted a Gastroenterologist who gave medicines for 15 days and simultaneously asked us to do some blood tests. My husband took the medicines and we also did blood tests. After taking the prescribed medicines, he was feeling better and blood reports also are normal except Vitamin B12 ( the count is 125 inspite of being non vegetarian and this test was done in the month of March). We shown this report to our Doctor on 04/05/11; immediately he gave B12 injection and suggested for Colonoscopy and Biopsy test to find out the reason for Vitamin B12 deficiency. Since yesterday (08/05/11), again my husband is having similar stomach pain. Today (09/05/11) my husband again went to for Vitamin b12 test and we will get this report by 10/05/11 evening. Please suggest us what to do next as we are totally confused and I am unable to see him suffering from this pain. He never used to complaint about his health and this stomach pain is really disturbing both of us a lot. Please help.",
    "doctor_response": "Hi.The frequent travelers will have such problems, Typhoid is one of the most common as also amoebic colitis and any form of enteritis. Get blood test for typhoid , tuberculosis.Ultrasonography to see whether there is any organomegaly. Colonoscopy an biopsy as advised by your  Gastroenterologist. Get a course of an antibiotic and probiotics and supportive treatment. He needs o take strictly boiled and cooled water and home-made fresh food. No outings till he is treated fully and recovered well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "History of heart problems and epilepsy. Why did I turn blue and stop breathing? Possible ischaemia?\n\nHi I am a 22 yr old female, with family history of heart problems and epilepsy . Two days ago whilst drinking a fizzy drink I had chest pains and passed out for a few minutes, my mum said that I had turned blue and stopped breathing. After I had come round we went to A&E where I was given an ECG which showed an abnormality, the doctors didn t really explain and just sent me home. My mum wasn t happy with me just being at home with no explanation so we went to our local GP who did another ECG, this time the machine showed abnormal repolarization and possible ischaemia. I don t really know what all of this means and I am really worried now! I had looked on the internet the night before GP appt and had really convinced myself that I had suffered from Swallow Syncope as my symptoms exactly matched. Now I don t know what to think so some advice would be greatly appreciated.",
    "doctor_response": "Hi, . I see you've already suffer with a heart disease and epilepsy, it would have been better if you had specified what kind of heart disease you suffer with. In the back ground of both the clinical history, the episode is more likely to be a syncope/arrhythmia. If there was any history of tongue bite or urine incontinence, a seizure also needs to be considered. It was good that an ECG was documented during the event. Examining the ECG as a whole can give us clue if you've had a serious problem. In other terms, the machine interpretation of early repolarisation has no much significance as they are subjected to many biases. I would instead suggest you to discuss with your doctor/submit the ECG to an online medical advising site such as yours for better interpretation of the ECG and whether or not those can explain the symptoms you had recently. Hope this answers your query. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a deeper problem underneath?\n\nI have a 4 year old daughter who grabs herself. Her primary care talked about looser underwear, no pantys after her bath, good wiping habits. W e have been doing this now for several months. She is now crying everyday about the tickle that she feels and she wants it to stop. Is there a deeper problem?",
    "doctor_response": "Hi... By what you quote I feel that she might be having a fungal infection in the local area. I suggest it is better you consult a pediatric dermatologist and get examined properly and she might get better with 4-6 weeks of topical anti fungal medications or mild steroids.The other possibility is that she might be having worm infestation and she might need de-worming too with Albendazole.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome nervousness and lack of confidence?\n\nI am 43 and facing the problem of nervousness and lack of confidence some times to extreme extent,especially I am supposed to do the things, which generally leads to headache and weakness in brain and like brain starts squeezing and heart sinking. When life is normal then I do not have any problem. The more I do physical work the more I feel fine. Please define me problem and suggest the solution.",
    "doctor_response": "Brief Answer: consult psychiatristDetail Answer:Hi dear, what ever you describe is due to generalized anxiety disorder but without detail history and mental status examination can not say..there are many medication and psychotherapy by which you may get benefit. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of conceiving after having endometerial cancer and PCOS?\n\nIs there anyway on earth useing cells or something that my partner and I cld have a baby from us. I had to have a full hystorectmy (sp) this year after having endometerial cancer. I also suffered from pcos. I cld not afford to harvest and freeze my eggs in the short window I had. I was hoping there was still hope. I just turned 34 and I am devasted as is my partner this is a huge strain on realtionship as we wanted a child. Please help",
    "doctor_response": "HAI WELCOME TO HCMIN OUR COUNTRY SOME CENTERS ARE DOING OVARIAN TISSUE FREEZING FOR CANCER PATIENTS.YOU CAN USE IT IN FEATURE .INSTEAD OF FREEZING EGGS IT IS AN GOOD OPTION .REGARDSDR.VANITHADEVI",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take Reeshape while on Concir and Novastat?\n\nI am on medication for high BP and Cholesterol will there be any problem if I take Reeshape 120 once a day. I am presently taking Concor 5 in the morning. Novastat 5, Flunil 20 and Tryptomer 25 at night. Will there be any adverse effect if I take Reeshape 120?",
    "doctor_response": "Hello, I would explain that it is OK to take all these drugs together, as there are no interactions between them. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am taking lots of water for acne, but there is no improvement\n\nI am 17 male, I am having acne on my face . I was advised to take lot of water, which didn t worked much. i have oily skin too . i need to be advised, so that i can get rid of acne completely.",
    "doctor_response": "hi welcome to healthcaremagic forum acne is due to hormonal and heredity reason there is also infection nows a day many types of treatment is there to treat any type of acne better to consult dermatologist you have oily face ,so you need face wash with salicylic . isotretinoin will do wonder ,must be taken after dr prescription peeling ,laser ,microderma will do better depend upon the type and stage you will require antibiotic avoid oily and spicy ,dairy product only water will not work avoid sun exposure never prick ,popped it keep your nail trim .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is traveling to higher altitude safe while on treatment for atrial fibrillation?\n\nI have been in A fib for many years and this is successfully controlled with Warfarin. I am also on other drugs for this - ramipril and bisoprolol. We are planning several trips which will take us to a higher altitude, between 3000 and 3500m. This will not necessarily involve great exercise other than sightseeing. However we are concerned whether there will be significant risks, for example increased clotting.",
    "doctor_response": "DEAR USERTHANKS FOR CONSULTING AT HCMI UNDERSTAND YOUR CONCERN..BUT YOUR SUFFERING FROM AF WHICH IS A SUPRAVENTRICULAR ARRYTHMIA AND I SUGGEST YOU TO AVOID HIGH ALTITUDE TRAVELLING AS FAR AS POSSIBLE EVEN IF YOUR AF IS UNDER CONTROLAS OBSERVATION HAVE SHOWN SUDDEN DEATH IN PATIENTS OF ARRYTHMIA AT HIGH ALTITUDECLOT FORMATION CAN ALSO OCCUR AT HIGH ALTITUDE.. SO AVOID IT AS FAR AS POSSIBLEHOPE I HAVE ANSWERED YOUR QUESTION.. YOU CAN MESSAGE ME FOR ANY FURTHER CONCERNS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever and jaundice?\n\nI am from Bhadra Hanumangarh (Raj). My Bhabhi is 36 years.She  has open surgery of gall Bladder stone (removed) in Last year 10 March 2010. on 20.03.2011 she has suffering from low fever and jaundice. We went to go Doctor in Hisar Haryana in Jindal Medical & Research Center.Doctor is saying that some piece of stone is in lever and need of again surgery and this type surgery do only SMS Hospital only.Doctor refered to Dr Rupes Pokarana in SMS,Jaipur. Sir, what we do. please help.The patient is poor. Thanking You",
    "doctor_response": "Hello,A small stone has either been left behind or a new stone has formed in the tube draining bile (pith). In my opinion, she does not need open surgery to treat her condition. She needs an endoscopic retrograde of cholangiopancreatography (ERCP) and stone extraction.In this, a camera passed through the food-pipe of the patient and stone extracted from the inside. If everything goes well, the patient usually goes home the same day or the next day. I would advise you to go to a center where the ERCP facility is available.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Suresh Raghavaiah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is unusual sweating and sickness in the stomach a symptom of diabetes?\n\ni have family history both sides type 1 and 2 diabetes. I am female 49 yo and 5 4 tall and 162 pounds. I have been craving sugar and carbs. I have terrible night sweats and day hot flashes. I wake up sick to my stomach every morning and off and non through out the day. Mom tested me with her kit right after I ate. (i was again sweating and sick to stomach but, did not feel hungry) It was 115 right after eating. Is that a normal range? I did start to feel a bit better even though I was not hungry. Do I have a sugar problem? Also a itchy patch on my arm that no one knows what it is from but, hve had it for about 8 years or so and it itches and darkens at times. Dermatologist just said that it was some sort of trauma from what the biopsy said.??? Sugar?? Oh, off and on yeast infections but use probiotics to keep at bay.",
    "doctor_response": "Hi thanks for using healthcaremagic Your symptoms of hot flushes could be due to your peri menopausal ageFemales when they become peri menopausal usually gets these types of problems..we can do Blood tests to rule out diabetes..FBS,PPBS,HbA1C can be done.We can also think of doing Glucose tolerance test to rule out relative hypoglycaemia .Dont worry about the skin lesion if biopsy already had been done..Thank you...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cream should I apply for the pimple and holes in my face ?\n\nI have an pimples @ holes in my face so please give some suggestion I have an pimples and holes in my face give some suggestion and some medicines to cure it. age=20 weight=60",
    "doctor_response": "you should wash your face regularly 3 to 4 times a day. Don't eat oily food. you can take doxycycline tab. under medical supervision.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do as my 6 years old has swallowed a piece of balloon?\n\nMy 6 3/4 year old son swallowed a piece of a ballon. He did not choke at all. Should I be concerned and what should I do? My son is about 48 lbs and 4 feet tall. He is behaving as he normally does. I am worried because I understand it is very dangerous to swallow broken ballons! Thank you so much!",
    "doctor_response": "Hello, Any foreign body consumption is injurious.Might get stuck at anatomical constrictions of Gastro intestinal tract.If stucked even it might causes perforation.Please carry out xrays- chest and erect abdomen to localize it.Diagnostic endoscopy might be of helpful.Please consult.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest side effects of livipills\n\nDr. I am suffering from neurosysticercosis since sep 1997. presently i got a seizure and on meciaction of livipills 1000mg twice a day, epsolin100mg twice a day, frisium 10mg twice a days. my question is whether this dosage is high for me and is there any side effect of it. before 28 May 2014 I was on levipill 1000 Mg twice a day and got seizure. the dignose of MRI is there are multiple cysticercies in the left and right cerebellum some are cancified and some are still alive.",
    "doctor_response": "If you are having cysticercosis at present,  you need to be treated for that with albendazole and praziquantel. Regarding your anti epileptics, levipil can cause mild lethargy, nasopharyngitis and some emotional disturbance.  It is relatively safe compared to epsolin, which can cause many side effects including liver failure. Once you are fully cured of cysticercosis,  the anti epileptic drugs can be tapered.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have swelling in liver. Have fatty liver. Is it serious?\n\nHey doctor,I am suffering from fatty liver with hepatomegaly in going stage 1 to stage 2.I was a regular drinker for about five years.Now I am not drinking from previous 15 days.Currently I m on simple diet,specialy sujested by doctor, 2 Days before I went to my doctor and he suggested some test like LFT,Hepatitis and stool test all are normal,there is no chronic and no cirrhosis but I am suffering from dull pain in my right side due to swelling in liver.current liver size is 17cm.For 2-3 days i m taking beat im my diet in juice today evening  i had red stool(loose motion).Is it because of beat or any thing serious.Vinay kumar",
    "doctor_response": "Hi and welcome to HCM. Thankyou for your querry. This is only mild hepatomegaly and first stage of fatty liver so u you dont have to be very concerned. it is still completely reversible. In the beginning it is treated by changing lifestyle and dietary habbits and this is usually enough. SOmetimes certain medicines can be prescribed. Of course avoiding alcohol ,fats and toxic drugs is obligatory.  Loose motion can be caused by fatty liver,this shouldnt worry you. Just do often lft check ups and see is there improvement. WOish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes infertility in men and women ? How is it prevented so that a couple can conceive a child ?\n\nHey I m 21 ima female , so here we go I m trying to get pregnant and I don t know why I can t , so my man and I have been together for 2 years goin on 3. We have unprotected sex every time since we been together so the first year we were together we had sex non stop and when my period was comnin I would have sex so it would Stop ,and I didn t get my period for the whole first year but after that year it has came regularly. Also my man doesn t take vitamins and he don t eat much so I wanna know is it cuz of me or him that we can t conceive a. Baby?",
    "doctor_response": "Hello There.. Welcome to healthcare magic forum. There are various factors which might be causing infertility in your case.. 1)Are you having intercourse during your ovulation day? 2)Did you find out the cause why didn't have your periods for a year ? I would advice you to consult a OBG specialist and discuss with them about your case.. They would advice you and your husband to undergo few tests which will help to detect the exact cause.. Hope this helps.. Take care..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does feeling of bloated stomach and cloudy urine indicate pregnancy?\n\nHuld i be pregnant if me urin isi cloudy and i hav,e funny feeling in my tummy may I answer your health queries right now ? Please type your query here...could i be pregnant if my urin is cloudy and i have funny feelings in my tummy when i move and im also bloated",
    "doctor_response": "HiIts quite commonly seen in women who are anxious for child. Cloudy urine or bloated abdomen are not signs of pregnacy.its common to feel like this.missed periods , nausea ,vomiting & pain in breasts are common symptoms.early morning sample usually used for pregnancy confirmation.nothing like cloudy urine correlates with pregnancy.hope you wil understand.Thank youRegardsVasundhara",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is Mometasone dangerous to use on Face to clear my acne pimples?\n\nHello doctor, I am seriously facing acne pimples problem. Sometimes they occur on my face when I masturbate. If I use Mometasone, it gives a good result. Is it okay to continue this?",
    "doctor_response": "Hello. Acne is a universal issue in the age group of 15 to 25 years due to hormonal changes in adolescents. However, there are multiple effective treatment options depending on the grade and severity of the problem. Mometasone is a topical steroid and is to be avoided strictly on the face and for acne as it can harm your skin in the long run. Acne is dependent on hormones hence excess masturbation may sometimes lead to an increase in the problem. I would advise you to stop Mometasone immediately and kindly upload appropriate images to help us assess your current grade of acne and treat you better. Regards. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does fluoxetine cause restless leg, headache and increased sweating?\n\nHello doctor, I have been on Fluoxetine antidepressant drug for a few years. I just started to notice few change, but I do not know what to do. I am getting more headaches than normal, restless legs at night and hot sweat most of the day and night. Are my problems related to the drug? Can you prescribe any medicine for this?",
    "doctor_response": "Hello. Yes, the problems you are facing are most likely related to long-term side effects of the drug Fluoxetine. Mild headaches and sweating are known side effects intrinsic to Fluoxetine. Usually this drug is tolerated by most patients only at the lowest effective dose. Also studies have shown that Fluoxetine exaggerates pre-existing restless legs syndrome (RLS) in many patients. From the given information, it seems that the side effects of Fluoxetine are beyond the tolerable levels for you. For further information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for injury noticed on right foot and swelling\n\nI was doing toe stand wings in dance class and injured my right foot. it is badly bruised and swollen. It hurts to walk and I am walking on the inside since it is on the outside top of my foot. I dont have insurance and cant get an xray but will wrapping it help? I am 18 yrs old I have type 1 diabetes and in remission currently for my graves disease. I have shin splints too so im not sure if that will affect this pain.",
    "doctor_response": "Hello,It may be due to fracture foot. For further assessment you may require x ray foot after orthopedic surgeon consultation.. Further treatment mainly depends upon the underlying condition. You may require surgical intervention after surgeon consultation. Use support while walking. Avoid direct pressure. Hope I have answered your query...Let me know if I can assist you further.Regards,Dr Shyam kaleFamily and general physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes throbbing of blood vessels?\n\nMy daughter has been experiencing throbbing of blood vessels in her forearms and thighs. It does not hurt but is disconcerting. It also seems to occur in other parts of her body. Has been occurring for about a month. Do you have any thoughts about what might be going on?",
    "doctor_response": "Hello, Welcome to Ask a doctor services. I have read your query.Throbbing of the blood vessels occurs commonly in Phlebitis. In superficial vein phlebitis patients usually complain of burning & throbbing veins in the legs & sometimes in the arms.Neglect may complicate to medical conditions like varicose veins, etc. You are suggested to get clinically examined by a GP. Get Blood & required Imaging tests done. Get treated the factors causing the symptoms.Hope I have answered your question. Take care.Regards,Dr Nupur K",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever in infants?\n\nHi. I have a 2.5year old that has been running a fever for 6 days. In that time it has ranged from 100-104.4. Also she has had 2 days where she was fever cree for about 6 hours each. She seems to shot up in temp fast. She has been screened for strep, ears checked, and chest fine. She doesn t have any other symptoms. Whether fever gets above 101, usually at night, she whimpers and shivers. How long is a fever too long? What causes just fevers?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.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 15mg/kg/dose (maximum ceiling dose of 500mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rashes all over the body when having external hemorrhoid?\n\nI have external hemmoroids with mucus discharge and developed a full body rash similar to an allergy type rash. Would the rash be related to the hemmoroids and mucus discharge. Have been treated for hemmoroids by doctor for years. But mucus and rash are new. No other symptoms.",
    "doctor_response": "Thank you for your question.I understand your concern. Hemorrhoids are due to stasis of blood in the veins present around anus. They are called swollen or inflamed vessels, which cause severe pain in the anus.Body rash is no way related to external hemorrhoids. Rash all over the body may be due to allergy. There are many triggering causes for allergy like stress, specific foods, exposure to dust etc. Take Cetrizine tablets twice daily for 10 days. If symptoms persists, it is advisable to consult the physician. Blood reports and physical examination of rash may be required to know the cause.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are my symptoms typical of an asthma patient?\n\nHello doctor, A \u00a0couple of months ago, I started feeling tightness in chest, shortness of breath, and overall fatigue. I went to a walk-in clinic, they did an EKG, and everything was fine. They asked me to follow-up with a physician. The nurse conducted a complete blood test and a chest x-ray, and everything came out to be normal. She still recommended me to see a cardiologist for my heart palpitations. I saw the cardiologist, and he did an ultrasound of the heart. He put a Holter monitor on me for a day. All the results came back normal, but I was still having these issues. I feel shortness of breath, chest tightness, and a heavy, dizzy feeling on the back of my head intermittently throughout the day. The heaviness is more pronounced after having meals. Because I felt a bit of reflux too, I went to a gastroenterologist, who confirmed I have acid reflux, and the doctor put me on Omeprazole twice a day. For the shortness of breath issue, I saw a pulmonologist, who said I have asthma after they performed a PFT. He gave me Corticosteroids to use twice daily, and short-acting beta-agonist in the case of an asthma attack. I have been using the Corticosteroids since four days, but I do not feel my condition getting any better. The shortness of breath comes and goes intermittently, and becomes pretty pronounced when I climb a small flight of stairs, or even when I just walk for some time.\u00a0I researched more about causes of these symptoms on the internet, and I found a few serious diseases like pulmonary hypertension and pulmonary fibrosis, which have very similar symptoms to what I am experiencing. Note that till date, I have never had a proper asthma attack. This coupled with the fact that it has been four days, and I do not feel like the Corticosteroids are helping as yet. I am a bit anxious if I have other serious issues like pulmonary hypertension or pulmonary fibrosis. Are the symptoms that I am experiencing typical of an asthma patient? Also, considering I have done a chest x-ray, a heart ultrasound and put on a Holter for a day, is it still possible that the serious diseases would have gone undetected?\u00a0Thanks.",
    "doctor_response": "Hello. Hope this helps you, and get back if you have any doubts. For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does it hurt bad when i take a deep breath?\n\nMy ten year old has been complaining with not being able to get good breaths, he says it is like trying to breathe through a straw. He says that if he takes a deep breath when this happens it hurts really bad. He has been saying this for over a week what is your opinion?",
    "doctor_response": "Hi thanks for asking question.Here first your child could have severe muscular strain by heavy exercise or any unaccoustemed activity ...Rest needed for it.Simple analgesic taken if needed..As your child having history since week.His physical examination done with auscultation for any rhonchi or creps.If fever also present x ray might needed for rule out any consolidation as in pneumonia or changes regarding bronchitis or other interstitial lung disease.And treated accordingly....If ribs are tender to touch then it might be costochondritis like condition.Take care...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medication should be taken for asthma during pregnancy ?\n\nhi i am 2 months pregnant and have a bead cough and not able to breath properly what should i take. i am 27 and have a history of asthma",
    "doctor_response": "Welcome to Healthcare Magic Since you have asthma you can take the medication as advised by your Pulmonologist after you have informed that you are pregnant. Asthma may get worse by 24-32 weeks of pregnancy as well. You will need to understand that all trigger of asthma must be removed from your surroundings. Don't go near dust, gardens, pollution or eat any food that can precipitate asthma. Also you can continue using inhaled beta 2 agonist and inhaled steroid under the discretion of your Doctor only. You can do steam inhalation to relieve your cough as of now. Consult your Doctor and get advise as to what medications you can use and their effect on your baby as well. Have a safe and wonderful pregnancy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Delayed periods. Noticed spotting. Having faint positive line for HPT. Feeling sick, nausea and having low back pain. What to do?\n\nI took a HPT that came out faint positive and i havent had a period this month but i have started spotting today. I have taken other HPT tht came out negative but the one I took was early pregnancy test. Ive been getting sick and feeling nauscoeus. Lower back pain. Im bleeding but not bad and not really hurting with cramps. Hats goin on",
    "doctor_response": "Hello,First of all, you undergo one blood test for beta-hCG to rule out conception. It is more reliable than home pregnancy test. TVS scan gives additional information.Other reasons are stress, hormonal imbalance, pelvic infection, irregular diet habit, over wt etc.Following initial test result, you consult with gynecologist to proceed other investigation. Take suggestive measures accordingly.Maintain genital hygiene properly. Avoid stress and control body wt. Take some muscle relaxant gel to reduce back pain.Hope it helps for you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower back pain\n\ni wonder if you can advise? i have a long history of back problems.  i have been a midwife for 10 yrs and recently changed working areas after being placed in an area with reduced clinical input due to my back.  in april i was told i had to return to the ward area and by may i was again experiencing severe back pain, leg pain and what i can best describe as sharp toothache continually.  i have not slept in months and the medication doesnt work if i done have enough and when i take it i am in the equivalent of la la land and cannot function. i had an mri last week and will find out what the results mean in 2/52.  the report says as follows, what would this mean?  i am struglling on the ward area and in antenatal clinic with partially clerical duties i have coped well with no problems in 3 yrs.  the report says Clinical history: Previous discectomy in 1997. Recurrence of severe low back pain in May 2010 with right lower leg symptoms and suspicion of altered bladder function. Sequences: Sagittal T1 and T2 weighted images of the lumbar spine have been acquired with axial T1 and T2 weighted images. Post gadolinium sagittal and axial images have also been acquired. For the purposes of this report the L5/S1 disc is assumed to be at image 701-03. Findings: The L1/L2, L2/L3, L3/L4 and L4/L5 discs are within normal limits. Mild facet joint hypertrophy is seen at L4/L5 but there is no evidence of significant canal or neural compromise at this level. At L5/S1 the disc is degenerate with significant loss of height. There is a small annular disc bulge and there is minor narrowing of the lateral recesses but no evidence of significant root compression. No significant canal narrowing is seen. The visualised spinal cord returns a normal signal and the conus terminates at L1. Conclusion: Degenerate disc at L5/S1 but no evidence of significant neural compromise. please would you be able to explain and even advise what a reasonable plan of care, treatment and options i may consider. many thanks denise",
    "doctor_response": "HiThank you for asking HCMI have gone through your query.Your MRI gives impression of intervertebral disc herniation with out neural compression.For such problem in patients i treat with NSAIDs like aceclofenac and muscle relaxants like cyclobenzaprine and neurotropic drugs.I also send them for regular physiotherapy and muscle strengthening exercise along with this.Wearing lumbar supporting belts also will be helpful.Hope this may help you.Let me know if you have any further query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes seizures and mucus after a craniotomy to remove abscess?\n\nmy father had a crainatomy to remove the abcess formed due to infection. He had seizures once after the surgery.He had mucus secretion and they sent the mucus and abcess samples to lab. He is dull now. It is one week past the surgery, what are the outcomes of this situation.",
    "doctor_response": "Hello!Thank you for asking on HCM!Regarding your concern, I would explain that the mucus and the abscess are related to an infection. That is why, they have made lab tests for these biological materials in order to find out the possible infectious agent and the proper antibiotic therapy.Seizures are related to the inflammation of the brain covering layers and the brain cortex (the most outer layer of the brain), which can cause abnormal electric discharges through the brain cells, leading to seizures. The recovering period may be long, depending on the type of infection and the affected region of the brain. Antiepileptic drugs, coupled with antibiotics are needed for a long time. Physiotherapy may be needed if he has also motor deficits in his limbs, depending on the affected area of his brain. Hope to have clarified some of your uncertainties!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My anti-TPO antibodies is 278 during my pregnancy. What does this indicate?\n\nHello doctor,I am 28 years old. I got pregnant three months back. At 1.5 months, I went for a regular check-up. Everything came normal except for my TSH level, which came out to be 5.57. I have not gone for thyroid test before. Doctor gave me 50 mg Thyronorm to be taken daily as she termed it hypothyroidism. After one month when tests are done again, TSH came out to be 1.67, but anti-TPO antibodies are present and 278. Please explain what does this mean? Do I have to take medication life long? Does it have any harmful effects on my kids, I am expecting twins. Doctor asked me to continue medication even after delivery. What does it mean?",
    "doctor_response": "Hello. Elevated levels of anti-TPO antibodies indicate you have autoimmune thyroiditis. Do not worry about these terminologies, what it shows is you may have the disease even after the delivery. But that does not mean that you need to take medications life long. It can become normal by itself also. Since your TSH level is controlled now with medication, there are no harmful effects on your kids but keep taking drugs and get TSH frequently tested till delivery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to test for cancer?\n\nMy questions: 1. Is there a blood test or some other type of test that can be done to recognize a cancerous organ or bone in a home situation.? 2. Do you know any form of transportation available for the following person? My son is 53yrs old, 6 2 , 260 lbs. He has been diagnosed with deteriorated hip joints and knee problems. He fears he has cancer. He was scheduled for an operation on both hips for Dec., 2012. He was unable to get transportation to the appointments for surgery----because his knees both will not come together or even close together, he is unable get into a wheel chair or anything else we were able to come up with to transport him. He is in extreme pain if he tries to lie down. He lives in a recliner, struggles with a trip to the bathroom with crutches. His shoulder joints seem to be bothering him more and more. He has had two lower back surgeries, one stomach surgery (blocked intestine due to scar tissue formation caused by the last back surgery which was done through the stomach). He has SS disability, medicare, and supplemental insurance. Please ask if you need any further information. Any additional suggestions you may have would certainly be appreciated.",
    "doctor_response": "Hi,Thanks for writing in.1. Cancer screening and testing is scientific and logic based. There are no home tests that will confirm cancer. However the presence of swelling, abnormal blood discharge, unexplained fever or weight loss and decreased appetite, bone pain and unexplained seizures are all possible symptoms where one must get screened for a cancer2. For patient transportation to hospital you have to talk to patient ambulatory services in your location. There are special services provided for patients like your son who are unable to use the usual methods to reach hospital.3. You can also arrange for a doctor team to visit him at home for preliminary services and then refer his to any hospital with adequate facilities to treat him.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having fever with rash. Is it suggestive of lymphoma?\n\nHello doctor, I am suspicious of lymphoma. In the summer, I had an itchy rash on my neck, it went away, came back, and now went again. I have bilateral hip and bone pain. I have night sweats two to three times weekly. I had a low-grade fever right before my period and will go away. No palpable or noticeable lymph nodes except in thigh about an inch away from the groin. I have had CBC\u2019s and sed rates completed at least five times in two months. I took a chest x-ray, head and abdomen CT scan, and pelvic ultrasound. I consulted an ENT who looked down the throat with a scope, and everything is negative, so doctors will not pursue lymphoma any further. Do you think with everything so far, should I still be investigating lymphoma?I am currently on Lisinopril 20 mg.",
    "doctor_response": "Hello, Welcome to the icliniq.com. In lymphoma, there is a presence of multiple enlarged lymph nodes. If you have lymphoma, then enlarged node could have been detected in CT (computed tomography) scan. If you do not have multiple enlarged nodes then lymphoma is less likely. The fever and itchy rash are not classical signs of lymphoma. For itchy rash, Levocetirizine can be prescribed. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to relieve heart murmuring?\n\nwelcome Dr. Prabhakar appearing online for consultations. I am feeling some heart murmering for the last two days as if the blood being pumped by the heart is passing with some force sometimes. Kindly suggest the cure. I am about 84 years old but quite active in my life............Syed.",
    "doctor_response": "Hi, here history of murmur is of 2 days only.Is there any previous cardiac disease you have that lead to narrowing of valve of heart.narrowing of valve(stenosis) could be due to thematic fever, infective endocarditis,lupus etc. Rheumatic fever associated with involuntary movement,skin patches,arthritis etc.CRP will be helpful.FOr lupus ANA level done.Treatment is according to cause.Regular treatment for hypertension has to be taken if present.If valve stenosis severe then its repair or replacement done.If heart failure present (edema over body),take diuretic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump on the neck?\n\nI have a large lump on the left side of neck-neck-it has been bothering me for about 6 months now and getting larger. I was just in to my heart doc last week and had ultra sound done on neck and leg veins doctor said it sounded gurglie and possibly the vein was blocked. would it keep getting larger and hurting more? He is soposse to get back to me in am, but I am concerned about this problem",
    "doctor_response": "Hi.Thanks for your query.Noted your history and understood your concerns.large lump on the neck for 6 months that is getting larger needs a proper clinical evaluation by a General Surgeon or an ENT Surgeon in view of the ultrasound showing dilated vein. Surely it will get larger. If this is so, you need to consult a Vascular surgeon too.This can be due to an aneurysm, might have been due to some trauma or may be due to inherent weakness in the wall.I would advise you an MRI and angiogram to get the clear picture so that further management can be planned. Also needed is tests of blood particularly for VDRL.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on arm after injecting meth\n\nI injected meth into the crook my arm, the vein on the inside closest to my body. I used a brand new needle, cleaned the area properly, slowing inserted the needle at the right angle, drew back to ensure that I was in the vein, afterwards I slowly injected the meth, with no bubble, pain, or burning of any kind. Then I slowly pulled the needle out and immediately applied pressure to the site for about 30 seconds until the bleeding stopped. Then I noticed a small bump where I injected, there was no redness, no pain, it was soft. Why did that happen?",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. By your history and description, it seems that you are intravenous drug abuser. Your technique is proper and with due aseptic precautions. But repeated injections cause local site inflammatory changes and thinning of vein. So even if you apply pressure for 30 seconds after injection, possibility of bleeding from vein into the subcutaneous tissue is high due to local inflammation and thinning of vein. So you might be having exavasated blood which is giving you feeling of lump at injection site. The best treatment for this is avoid intravenous drug use. This can lead to fatal infection so better to quit this habit as soon as possible.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a ball rolling in the chest?\n\nI feel something like a ball rolling in my chest, especially after eating for the past few weeks. I ve taken tumps but not sure if they help all the time. Almost like I keep swolling something down the from path. could it be heartburn or something?",
    "doctor_response": "Thanks for your question on HCM. In my opinion it is mostly GERD A ( Gastro Esophageal Reflux Disease ). But we need to rule out cardiac cause first. So get done ECG and if this is normal than no need to worry. This is because of GERD. It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms. Try to follow these steps for better symptomatic relief. 1. Avoid hot and spicy food. 2. Avoid large meals, instead take frequent small meals. 3. Avoid stress and anxiety. 4. Start proton pump inhibitor. 5. Go for walk after meals. 6. Keep 2 - 3 pillows under head in the bed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ulcerated eye in a baby\n\nWhat is the treatment for an ulcerated eye in a baby - we are in West Africa and my watchmans baby fell and this has resulted in the ulcer - she is at the eye hospital and they are giving injections but say they may operate - is this standard treatment - the child is 1yr old",
    "doctor_response": "Trauma resulting in ulcer in the eye is a serious condition which can result in loss of vision in that eye.If your opthalmologist is giving injections in the eye and had asked for surgery, then you should proceed for surgery as delay could affect future vision in that eye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for frequent back pain\n\nhello doctor, i am 32 year old female. I am suffering from back pain very frequently.site is lumbo sacral, and around sacro iliac region. i am driving two wheeler daily for around 40 kilometers/day. I work for 6 hours sitting on the chair only. my height is 168 cm.weight is 69 kg. needs ur advise.thanks",
    "doctor_response": "Hi,From history it seems that this problem is due to your life style.Driving two wheeler long distance with sitting of six hours gives some postural strain giving this problem.Take some nap during your work and move about for some time.Do back extension exercises in the morning daily.Take some multivitamin supplements.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is slight breathlessness while having borderline high BP normal?\n\nhello, i am 17, kind of chubby, with borderline high blood pressure as my doctor puts it. and sometimes when i take a shower, for an extended amount of time (i have to stay in about 20 mins when i have to wash my hair as it s pretty thick and long) I start feeling out of breath and slightly weaker, but once i sit down and catch my breathe im fine, i never get out of breathe normally, but would it be cause by the steam in the room, or the length of the shower, or should i go to my doctor and get it checked out?",
    "doctor_response": "Thanks for your quetion on HCM.In my opinion you should consult doctor and get done ECG first. As obesity with borderline HT can sometimes cause heart problems. So ECG is needed to rule out this.If it is normal than get done PFT (Pulmonary Function Test) to rule out bronchitis. As obesity can cause this.Sometimes obesity itself can cause shortness of breath.So try to loose some weight and start exercise.Prolonged Steam exposure can cause cause shortness of breath.So consult doctor and discuss these things.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevation in the heart rate and right-sided upper arm pain?\n\nOver the last couple nights when I go to bed, I have been experiencing a faster heart rate, difficulty swallowing, even just cold water, pain in my right bicep and triceps, almost hard to catch my breath even with my cpap on. Almost like the claustrophobic reaction I haven t had in many months, but worse any thoughts?",
    "doctor_response": "Do you have other ailments at present? As per your case a more detailed evaluation is required before labelling it as a psychological issue therefore it is advised that you consult your general physician to examine you before reffering tota psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Personality and mood disorder from childhood, took medicines, conditions worsened. Recommendations?\n\nHello, I was just wondering if I were to go to my doctor could they evaluate me to see if I have a personality or mood disorder, or do I have call around to a specialist? When I was very young I was evaluated with depression but the doctor who said that I had depression said it could also be a personality or mood disorder but because of my age she just wanted to treat it as depression. I went through many different medications that only made my symptoms worse so I stopped going to her and stopped medication. I am now living in a warm state, it seems to help a little but I still struggle with issues and would just like to find out what for sure it is I have and treat accordingly. Thank you for your time and help.Ashley",
    "doctor_response": "Hello  In your query you have not clearly mentioned that what symptoms you are having exactly. You have mentioned the diagnosis only. Still I would like to tell you that usually Psychiatrist don't label an individual to have some personality disorder in his/her teen years. Personality usually develop at around 18-22 years of age. Yes mood disorder like depressive disorder or bipolar disorder may present in teen years. Abnormal temperament may be a finding only. Still if the problems are causing distress to you and affecting your social and occupational functioning then please visit a Psychiatrist for expert evaluation. Thanks Dr. Seikhoo Bishnoi, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes small lumps in the left side of knee?\n\nI have two small lumps two the left of me knee, that I just discovered a week ago, don t have any pain from them but are both very prominent but feel they are getting bigger and noticed just tonight there s a bit of swelling between them,Just back from Holiday s trying to get appointment to go and see mt doctor.Any idea what this could be,",
    "doctor_response": "these could be benign tumor-like conditions like neurofibroma or lipoma; not to worry much!in worse case these could be hematoma due to injury or sebaceous cysts!all the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My partner start bleeding after first unprotected intercourse. Is it normal?\n\nHello doctor, What does it mean if one has unprotected first-time sex but is not sure whether he discharged inside or not? But his partner starts bleeding day after that. Is it normal?",
    "doctor_response": "Hello. Unprotected first time sex means that both the partner are doing for the first time without using any contraceptive method, i.e., condom during the first time of sexual intercourse, the hymen of the female is intact or may be ruptured prior because of any physical strained. In the first time, sexual intercourse intact hymen may break and that causes the bleeding suddenly or afterward it. So it is normal. First sexual intercourse. Take rest nothing else. If bleeding persists and whether the female partner misses her menses, do follow-up immediately.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from acne. Using minocyclin for bacterial infection. Need a permanent cure\n\nHi I had never had acne problems what so ever..actually people use to tell me all the time how they wished they had clear skin like mine. But about a year ago I start braking out with acne all over my face! I dont pick at my zits at all and it still leaves scars. My family doctor says its a bacterial infection under my skin and has given meds called minocyline for it and I been using for about 5 months maybe longer and it isnt working! any advice on what to do? I just want to get rid of this acne so it doesnt cause anymore scaring! I brake out in between my eyes and my chin ..the skin on my face is normal but it gets oily in between my eyes about and hour after washing my face. I just want to feel pretty again and acne is not very pretty!",
    "doctor_response": "hi dear, dont take minocycline for long duration it may harm u. as u have taken lot of tab i wont suggest u a tab now but ll give u some good cream adapelene gel 1% once in night. apply and keep for 1 hour and then wash, after this apply acnemoist cream and sleep. in morning apply nadifloxacin gel. do this for a month and see results. hope u get back ur complexion. good night",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a tooth infection\n\nHi Doctor,I have infection in my teeth and it is paining like insane, few days ago I went to dentist and he prescribed Taxim-O for infection and Kineto-DP for pain. Since last 3 days I am continuously taking the medicine but I dont find any improvemt and whenever I get pain I take Kineto-DP but it doesnt give any relief. Could you please let me know which is the best prescribed Medicine for tooth infection and also for tooth pain. Please help me it's paining like disaster.",
    "doctor_response": "Hello, Thanks for consulting HCM, Read your query,as you have infection in tooth this can be due to carious tooth or due to periodontal infection dont be worried so much for this pain and infection you should consult your dentist and go for investigations IOPA xray of tooth and if it is carious tooth then go for its treatment root canal if possible and if this infection is due to periodontal infection  then go for Oral prophylaxis. In meantime do warm saline rinses two - three times a day , you can take dispersable Tablet Paracetamol for pain as this medication give you temporary relief so I will suggest you to go for its proper treatment .Hope it will help you. Wishing you good health .Regards,Dr. Priyanka tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is more blood work necessary incase of dehydration in children?\n\nMy 21 month-old son weights 20.1 lbs and our dr ran several tests. They want to redo the bmp because he was slightly dehydrated according to the results. They want to retest him, but all the others (tyroid, cystic fib, etc) have all come in negative. Should I put him through more blood work - it s very tramatic for him!",
    "doctor_response": "Your question is incomplete,  you haven't mentioned as to why your doctor had done blood tests,  what were the symptoms and complaints?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to get rid of sinusitis problem without tablets.\n\nI have a sinusities problem..meaning that I caught with bad sneezing very frequently. I am 38 years old and the problem persists from last 6-7 years. It was not so frequent earlier but from last 1 year I have to take Levocet tablet daily. Please suggest what should I do. I want to avoid taking tablet. My weight is 63 KG and height is 5 ft.",
    "doctor_response": "There r many causes for sinusitis. it can be caused by deviated nasal septum, infection ,dust and pollen allergy, due to sleeping habits and many more. Pls describe the symptoms and your gender too.  also mention whether you r taking any medicines for hypertension. Steam inhalation with menthol or eucalyptus or inhalation of smoke of Turmeric wick dipped in ghee can give very good results as it expells the phelgm accumulated in the paranasal sinuses. Internally taking tulasi juice 1tsp+ honey 1tsp + ginger juice 1/2tsp + black pepper 1 pinch twice a day in empty stomach gives good results.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Shall I restart Cymbalta for my extreme depersonalization feel?\n\nHi doctor, I am a 32 year old man. I have been experiencing panic disorder, OCD symptoms and excessive levels of anxiety. In the last few months, major changes in my life have happened. For instance; quitting my job and moving to another city triggered my anxiety symptoms. I usually feel drowned in fears, health anxiety, fear of losing my mind or becoming delusional, losing my beloved ones, etc. I cannot get rid of those running thoughts. I learn that I have mild Hashimoto's and a kind of mild rheumatologic problems. Also, in the last few days, I feel extreme depersonalization. I strongly feel that I am going to lose my mind and this unreal feeling with dizziness accompany with my anxiety.Three months ago, I visited a neurologist and he prescribed Cymbalta for my neuropathic pain like symptoms and high levels of anxiety. One week later, I visited a psychiatrist to confirm if the medicine is right for me. And, according to my history, the psychiatrist decided to stop Cymbalta and we started Risperdal. I think he had been thinking I have something like borderline disorder. Then, we gradually changed the treatment. I think the psychiatrist thought the responsibility of my anxiety is Duloxetine, however, he could not understand I was more anxious before it. One month, when I took both Cymbalta (30 mg) and Risperdal (0.5 mg to 1 mg) was one of the most peaceful periods of my life. But, the following month I stopped using Cymbalta and my horrible thoughts came back, they are much stronger than before. Nowadays, I am on 1.25 mg Risperdal. Also, I have been on Fluvoxamine for two years for my panic attacks around 15 years ago. Please help me.",
    "doctor_response": "Hi. Thank you for describing your query in detail. \u00a0Please write back with these details so that we can have a better picture. Meanwhile, I have these thoughts about what you have described in the query. Irrational beliefs. Rational emotive or cognitive behavior therapy. Revert back with more details to a psychiatrist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause severe discomfort and diarrhea even after 3 courses of medicine ?\n\nMy sister is 31 yr old weighing now 67 kgsShe is suffering from diahhorea sand vomiting since second July.She was admitted in hospital on 3rd July and was given regular treatment with IV - Metrogyl,Zaomycin,ondem,Pan4.She was discharged after 5 days but still she complained of abdominal pain and vomiting sensation and loose stomach.After two days she was agin readmitted and given same dose and again dischareged after 5 days. Still she has same symptoms.One week before She was dignosed in stool sample for blood and Balantidium coli .Then she stareted taking Enetquinol twice a day .After two days she again got diahhorea so the doctor incresed the dose to 6 tablest in day .Now 2 days have paseed and still she is very restless complainig of pabdominal pain,vomiting sensation,loose stools.She is only on liquis that also very less.Please advise",
    "doctor_response": "Hello, She might be suffering from gastoenteritis, infection of the stomach lining. You may give her Nux vomica 200, three times a day for a week and she will be all right. It is a homeopathic remedy and will help her naturally. Thanks Dr. Ritu Sandhu",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cure for stomach cramps ?\n\nIv e been suffering with stomach pains and discomfort since this morning i thought it would just go away but it hasn t and has just got worse... Two things help relieve the pain and thats laying on my stomach and breathing in deeply and holding my breath I would really appricate your help thankyou ben",
    "doctor_response": "Hi, Flatulence dyspepsia may cause dyspnoea.Endoscopy, Barium meal Xray, USG abdomen may be helpful for proper diagnosis. Avoid oilly spicy food. Drink more water. Take food in small quantity and frequent interval. Do regular exercise and jogging. Milk of magnesia and isapgol (pergative) may be helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes twinges in urethra while sitting?\n\nHi.  I am getting the occasional twinges in my urethra.  I have no burning on PU and my urine has no unusual odour.  The twinges happen about 3 or 4 times a day and come on randomly, but usually when sitting down.  They are becoming more intense over the past few days and my body jumps each time I experience one.",
    "doctor_response": "HiWelcomeIt is wise to rule out UTI Routine urine examination is required.Drink plenty of water.Need of antibiotic can be decided based on the report.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any home remedy for swelling in back bottom molars?\n\nI have swelling, like a balloon, by one of my back bottom molars. About two weeks. It doesn't hurt, it doesn't look or smell weird, but it's swollen. I've been flossing regularly and using mouthwash. Is there any other home remedy I can use before going to a dentist?",
    "doctor_response": "Hello,Cause for swelling in back bottom molars has to be evaluated and treated.Antibiotics such as amoxycillin as well as analgesics has to be administered to relieve underlying infection.I would advice you to visit a dentist and get a thorough clinical as well as x-ray evaluation done.Decayed tooth has to be either root canal treated or extracted.Pus has to be drained and curretted completely.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause a swollen and painful pelvic bone?\n\nAbove my pelvic bone is swollen,and I m bloated most of the time, I have discomfort in that area sometimes shooting pains or I d feel a drop in me uterus region. I have mild cramps and I m constipated, mood swings and a 2day period, one day I ll feel disgusted with food, other days I can t stop eationg",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You really need to see if physician for a physical exam, a pelvic ultrasound, and some blood tests. This could be some sort of mass or inflammation. There is no real way to tell you what this is without seeing you in person and doing an exam and some testing. Please see a doctor as soon as possible. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Red rash around eyes, took Panadol for headache, Piriton. Causes for rash ?\n\nI have red rash around my eyes which i noticed yesterday.  I took 2 panadol as i had a headache about two hours ago I was sick about 1/2hr later and felt better after.  I have been suffering from hay fever symptoms for last two weeks and took one anti-histimine (piriton) 2 days ago.  What is causing this rash which got redder after I was sick.",
    "doctor_response": "Hello,     Rash around your eyes must be due to some allergy, which might be taken place by taking any medicine during your illness and fever. So you may take some anti allergic medicines such as Levocetrizine 5 mg once a day,dexamethasone tab 2 mg twice a day along with some calcium supplements and lactobacillus sachet or tabs,if you have taken antibiotics during your illness of hey fever.Also you must apply some soothing anti allergic cream around your eyes over rashes gently.Hope you will be relieved by this. Good luck and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had lots of alcohol, tylenol for jaw pain, worried about liver failure. Suggestions?\n\nMy names Aaron and I m worried because around 2:00 p.m I drank two 16 ounce beers containing 5.8% alchahol . And around 4:30 took two tylonols (500 mg ) for jaw pain , took another at 6:00 , than took another around 1:00 am . I m worried I m at risk for liver failure . I m only 21 years old , I feel fatigued and mental exhausted but that s due to only getting 1 hour of sleep in the last 20 hours from a bus ride",
    "doctor_response": "Hello! Thank you for the query. Acethaminophen (Tylonol) is quite safe medicine, however when used reasonably. It is metabolized by the liver. The danger dosage is about 6 g (12 tablets) taken at once so you seem not getting even closer to this dosage. However, the alcohol is also metabolized by the liver and connecting high dosage of alcohol (two beers seems to be safe) with this medicine can  bring dangerous side effects. So you should e fine, however you should not connect this two substances. Hope this will help. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Period not coming still after Duphaston\n\nI am trying to get pregnant and this is my 2nd cycle of Clomid. My menstruation is not regular so my doctor gave me Duphaston...I was told that my mens would come w/in 3-5 days after drinking the said meds. it is now the 6th day and I am just spotting and/or blood just goes out when I take a pee and there s not much of it.. I am taking Metformin for my sugar and I am not polycystic. What can I do to have my period?.I really want to have a baby. I am 41 y/o, 5 2, 120 lbs. Liza",
    "doctor_response": "Hi, First you have to look after two matters, 1,keep your diabetes under control, 2,regularize your period. After these two are alright chances of pregnancy is increased. As you are of 41 yrs you should proceed accordingly. Some time  procedure of D and C may be helpful,for this you can discuss with your gynaec specialist. ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can mineral level cause abnormal in ecg level?\n\nI went to the doctors yesterday, and my bp was 120/100. I had an ekg which showed a unspecified abnormal reading. My doctor said it was small, the small waves on the bottom row after the high peaks show something that slighty concerned her. I have been eating more salty foods that usual lately.I had gatric by pass for weightloss and I was taking celtic sea salt washes this week. Could it be that my mineral level is imbalanced and could have effected my ekg reading. My blood pressure has never been and issue before, unless I was having anxiety and it would return to normal after I had calmrd down. I a little afraid of the big one or the onset of any type of illness.",
    "doctor_response": "Brief Answer:Yes, ECG can be affected by disbalanced mineral levels in blood.You should take mineral supplements based on their blood level and correct your diet.Detailed Answer:Hello,Thank you for using HCM.The gastric by pass and the diet may cause a disbalance in mineral levels in blood, which may be reflected in EKG trace. Because electrolytes have so many different roles within the body, their imbalance can affect lot of systems, that's why they should have a special consideration. You should test the level of sodium, potassium, chloride, phosphate, calcium and magnesium in blood in way to correct their level by taking needed supplements as treatment. Meanwhile you can begin immediately correcting your diet. Take plenty of vegetables and fruits that provide potassium and magnesium such as leafy greens, broccoli, cabbage, sweet potatoes, squash, bananas, and avocados. You should give up from junk foods, takeout and restaurant foods, while instead you should cook more fresh foods at home. Eat a lot of fruits such as: Coconut water, Celery, Watermelon, Cucumber, Kiwi etc, to avoid dehidration. Drink approximately 2-3 liter of water per day. Finally, to obtain enough calcium naturally you should eat foods like organic probiotic yogurt, cultured raw cheeses and raw milk. Hope this is helpful.Let me know if you need more clarifications. Otherwise please close and rate the answer.Kind Regards, Dr. Juarda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for pain in lower back,stomach and head.\n\nI fell into a 5ft window well last night while slightly inebriated, falling either on my feet or lower back, I cannot recall. I have lower back pain, stomach pain, pain in the back of the head, and bruising on my arms and legs. Should I see a doctor?",
    "doctor_response": "HelloI have read your query. yes you should consult your doctor for clinical examination. There can associated spine or rib injury. Abdominal organ injury may lead to abdominal pain. You may need investigation like MRI spine and usg abdomen and pelvis. I hope I have answered your questions. If you have further questions please feel free to contact us. I will be happy to answer. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in left side of chest under breast?\n\npain in left side of chest under breast  I've had pain in left side of chest since last night ..Sometimes feels like something is weighing my chest down. And next minute feels like someone is ripping my chest open.. I do have asthma too but it doesn't feel like that.. Very uncomfortable to deal with can't sleep..",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. Left sided chest pain with pressure and heaviness in chest is commonly seen heart diseases like angina or coronary artery disease (CAD). So we should first get done ecg, 2d echo and stress test. If all these are normal than no need to worry for heart diseases. Sometimes stress and tension can cause similar kind of symptoms. So avoid stress and tension. Be relax and calm. Don't worry, you will be alright. But first rule out heart diseases. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is continued pain after two weeks of wistom tooth extraction normal?\n\nI had my wisdom tooth pulled bottom right 2 weeks ago and I am still in pain. The only thing that seems to help is salt water and that only last a couple of minutes. i seen my dentist a week ago and pescribed me penicilan.. Im finished and it still hurts. Is this normal? What should i do?",
    "doctor_response": "Thanks for your query, I have gone through your query.The pain after extraction of the wisdom tooth could be because of the sharp bony margins in the extracted site or it can be pain from the injection site.Consult a oral physician and get it ruled out. If there is a sharp bony margin, then get it rounded off. If it is pain from the injection site, then it takes time to reduce(2-3weeks), do saline gargling.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pressure in head and difficulty in hearing after injury?\n\nI fractured my skull about 2 months ago. I am still recovering and am doing much better. A couple days ago I fly for the first time since my fall and since I have been having so much pressure in my head, as well as been more tired and having a harder time hearing. Does that have to do with flying or is it just a coincidence that I am dealing with this after I flew?",
    "doctor_response": "Hello,Your symptoms could be related to the changes in air pressure. In my opinion, your situation will improve spontaneously. Anyway, if you have fever or persistent headache, I would recommend going to the ER for a physical exam and a brain CT scan.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Infant have red blotches around mouth and lips. Cured after giving benadryl. Sign of allergy?\n\nMy 18 month old has developed red blotches around her mouth and lips a few times now while we ate at out. I assumed it was an allergic reaction and both times gave her Benadryl and it went away. Is this a sign of allergies? There is shellfish allergies in the family and both times she was eating something fried so I think it may have been in the same oil as shrimp",
    "doctor_response": "Hello dear... The symptoms as mentioned suggest that the red blotches around mouth were caused due to any particular food products. Benadryl being an Antihistamine preparation provides relief from allergic symptoms. But it is always better to administer a medication as per advise of a Pediatrician...otherwise it may lead to side effects. So...if such episodes occur repeatedly, then it will be better to consult a Pediatrician & find out the exact cause of development of red blotches around mouth and lips. Wishing your daughter a good health. Thanks & take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to prevent thrombolysis?\n\nHi,My father is a diabetic patient. He recently has undergone angiography for his left calf. but after the diagnosis he is facing lot of pain in his left hand and can see the swelling through which treatment was done.....  we have approached the local Dr... accordng to him he says there are chances of thrombolysis.... Pls let me how strong are the chances for thrombolysis and how sever this could be. What all measures should be taken to prevent it.....Pls let me know",
    "doctor_response": "Hellou need not worry..actually a thrombus has formed at the sight from where dye must have been injected for angiography...apply THROMBOPHLEB CREAM twice daily and give TABLET LYSER-D three times a day for 5 days...he shall be fine",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the possible diagnosis for pericardial effusion?\n\n42 y male admitted with pericardial effusion,dilated cardiomyopathy,noted to be icteric bilirubin 150 mmole L AST112,ALT 170,NORMAL ALP,U.S abdomen hepatomegaly 17 cm span,normal texture, hepatitis serology -ve ,autoimmune work up -ve what is possible diagnosis",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.Difficult to comment on the diagnosis with only the examination findings and test results.many history aspects have to be enquired. However the possible causes coming to the mind are Tuberculosis, Cystic disease, Substance related side-effect etc. 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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lumps on calf\n\nhi, every month , a lump apperes on calf of leg, just the right leg, this has been going on for months now, lately its happening all the time , with really bad pain, im scared its clots, i have been trying to get my doctor to send me for smear but im not allowed until 2012, as i had one in feb 2009 which was normal, but 5 year ago i had treatment done for abnormal cells . what am i to do, i have 4 kids , and really worried and in a lot of pain,",
    "doctor_response": "Hi,thanks for the query to HCM.Dear,Based on the facts of your report,in the background of abnormal cells treatment 5 yrs back, and with a recurring painful calf lump in right leg,You seem to suffer from -chronic infected Venous Lump ulcer.A colour doppler study would fix the cause of it.Treat-Rule out diabetes by Fasting/and Post-meal  Blood Sugar studiesContact dermatologist and treat it with antibiotics / antipyretics/ and anti-inflammatory,with a long term followup.If no relief Check with Color doppler and take treatment from Vasular Surgeon,for the resistant calf lump with pain.Hope this reply would help you to plan further treatment in your case.Good Day!!Dr.Savaskar,Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I have pain in lower abdomen along with fever and cough?\n\nI had a fever last night which has calmed down now. Now I have this throbbing pain in my lower left abdomen which gets worse when I cough or sneeze. It feels like something has burst in my tummy when I cough and the pain is unbearable when that happens",
    "doctor_response": "Hi,Thanks for writing to HCM.You might be having a left ureteric stone with urinary tract infection, to cause those symptoms.Get an ultrasound of your abdomen done along with a routine urine examination.If its a uti with a stone, then you need to show to a urologist for further management depending upon the size and location of the stone and antibiotics to control the infection.RegardsDr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the long term prognosis of having too much paracetamol?\n\nAproxmatly 26g of paracetamol taken staggerd over 4 hours . Hospital addmition after 10 hours of tables first being taken. On 5th 16 hour treatment of antidote. Bloods still showing over 2000 when should be between 0 and 40 not sure what the're mesuring. Has now been moved to surgical ward . Any idea what the long term prognosis would be?",
    "doctor_response": "Hello,Thank you for your contact to healthcare magic.I understand your health concern, if I am your doctor I suggest you that long term prognosis for paracetamol is very good. There is nothing to worry about. Only thing you have to take care for it is the acid base balance of the body. Taking care of balance will almost cure you. Paracetamol overdosing is the safest amongst all the drug overdose. I will be happy to answer all your future concern. Thank you,Dr Arun TankInfectious disease specialist.Wish you a best health at health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had a CT scan. Had little blood in urine. Had my bladder scoped. Now have bleeding in urine, underpants. Drinking habit. Problem?\n\nI just had a CT scan and it came out normal. I had Microscopic blood in my urine. That's why they did the CT scan. Then, I had my bladder scoped and the Doctor found a scratch in my bladder the could cause the microscopic beading.He said he did not see any thing wrong. This last week I had bleeding in my urine and in my under pants. He said to drink lots of water. The other think that concerns me, I do drink three to four daily. Would this have an effect on the bleeding!",
    "doctor_response": "Hi and welcome to HCM.Yes, your doctor is right,in most cases this is nothing serious and may indicated just passed urinary stone or mild uroinfection. Since you had all these tests it ruled out anything serious so you dont have to be concerned. there may be clotting disorder due to your drinking habit where liver function may be reduced. So check your clotting factors, trombocytes and other liver functional tests frequently.Thanks for the query. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Intestine cancer spreading to liver, consumption of liquid food less. Can stent be used for Intestine cancer?\n\nHi, Can stent be used for Intestine cancer My Uncle has a intestine cancer & it is slowly spreading to liver . Already many Chemotherapy are done & now he is under medication but he is not able to have any solid food and trying to have liquid food. Even consumption of liquid food is too less & that also he will puke. So our regular DR suggested to for stents & inserting 2 bottles of blood. So wanted to know if stent is required.",
    "doctor_response": "Hi Its very sad that your uncle is having cancer. Your history does not tell me which part of the intestines it is affected. with the available history the tumour can be either in the esophagus or stomach. In both these location with chemoresistant disease which has already spread to liver, cure is not possible. But to reduce the symptoms mainly vomiting , If it is a esophageal cancer stent can be used. For stomach cancer it is of not much help and technically difficult. Dr. Mohammed Ibrahim Surgical Oncologist mdibrahimdr@yahoo.co.in",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will reprexin cause sore calf and pain in jaw?\n\nI'm under going treatment for what my doctor believes is an MSRA infection. I have been a relatively healthy, albeit overweight 31 year old. (5'3 -270). The infection began as an abscess in my armpit that rapidly grew and had to be opened and drained. While they took a culture at that time the results have not come back yet and that was Sunday. Since then redness spread from my armpit down to just past my breast on my left side. After days of daily packing of the wound, receforin shots and 2 oral antibiotics the redness has begun to dissipate leaving behind healing blisters and hard lumps under my skin. The packing has been removed and the doctor feels we are over the biggest hurtles and on the mend. I have however noticed in the past 25 hours that me calf muscles are really sore, my jaw and front teeth ache like I've been clenching my teeth and I often get nauseas an hour or so before it's time to take another dose of pain medicine. I also seem to have indigestion along with the nausea and have not had a bowel movement in 4 days. I'm just not sure if these new symptoms are apart of the spreading infection or a result of the medication I'm on. Advice would be appreciated. I'm taking reprexain 10-200mg tablets every 6 hours for pain along with clindamycin hcl 300mg (2 twice daily) and sulfamethoxazole-tmp ds (bactrim generic 1 tablet twice daily). Thank you for your time and consideration. -jessica",
    "doctor_response": "Hi Dear ,Welcome to HCM,Understanding your concern. As per your query you are wondering if reprexin cause sore calf and pain in jaw . Jw pain occur due to many reasons like bruxism , dental infection , nerve pain or TMJ problem . Calf muscle pain can occur due to may reasons like sciatica , DVT or muscle cramps .But in your case the symptoms are probably due to side effects of reprexin , so consult doctor who prescribed it . Doctor may alter the dose or prescribe substitute .If condition doesn't get well then consult orthopedic surgeon for calf pain and oral surgeon for jaw pain.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having dual pain with a bulge in the left side of my stomach. What could be the reason ?\n\ndul pain with a bulge in the left side of my stomach next to the belly button ive noticed a dul pain with a bulge in my left side nexxt to the bellu button anxiety mixed with gas... we see a bulge we think cancer... for me wouldnt stop there tbh im picturing this is something to do with inlarged veins or something 5 weeks ago... for 2 weeks i pretty much hit the gym hard each day eating 1200 cals a day only water... last day i smashed bike riding and next thing i know it i seen the lump while chilling at my pc turns out thats when the dull pain kicked in ... acid reflux ? stool blockage ? ....tumor ? im fricking scared my dr said it aint no peptic ulcer or hernia ... my cat scans r coming up soon............. add me or text me if u wanna know how it went jonathonwoodsfansite@hotmail.com i hope... its not stomach cancer grr... the waits killing me... (putting me in harsher pain ) i wish he gave me anxiety pills or something anyway hit me up if u wanna know how i went",
    "doctor_response": "Hello. Thanks for choosing HealthcareMagic forum. The cause of lump can be told only after examining the lump properly as there are plenty of reasons of having abdominal swelling. In most of the cases it is due to collection of some external fat and least likely to be due to cancer. Dr. Rakhi Tayal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does the intake of Diuretic cause pain and burning in feet?\n\nMy Kidney Specialist wants me to take a diuretic to help remove water and lower my blood pressure.  However, after I've been on them for 3 days my feet began to burn and hurt. When I go off them my feet get better.  Is this a side effect or is it just me?",
    "doctor_response": "hai,normally diuretics will excrete water from body along with electrolytes like potassium,sodium which are more  essential for the maintaining  body fluid system in a rhythmic condition.if any of the electrolytes level decrease or increase(pottassiumlevel) the fatigue and weakness will occur.your burning feet and hurt will be because of this(variation in electrolytes) condition.possibly in other conditions like diabetes,peripheral neuritis also will have your problem. but as per your quote when you withdraw the diuretic you feel okay.so i will conclude that problem is with your diuretics intake  and kindly consult a general physician for ruling out the recommendation for diuretics and whether the diuretics really needed for your condition.Thank youHope i answered your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chest pain. Have hiatus hernia. On Ranitidine. Why heart burn? Looks like?\n\nHi, My name is Wendi and I am 39 yrs old. I have been suffering from chest pains that shoot across my chest for over a year, and lately I have been getting milder versions of this pain throughout my chest, under both breasts (more on the left than the right), and I also have a severe pain under my left arm that causes my entire arm (including hand/fingers) to go numb. I also feel like I have something stuck in my throat constantly and it won t go away. I have had x-rays and an MRI that are normal. My dr. has run all kinds of blood work and everything is normal. I have also had a mammogram that was normal. She thinks I may have a hiatus hernia but I am waiting to have an upper and lower endoscopy to see if there is anything there. All chest/heart tests have also come back normal. Could all of this be releated to a hernia??? Most of the time when I take an attack it feels like I have a golf ball on fire in my throat and I get severe pain in my chest, upper abdomen, and upper back. Also, if I bend over a certain way I the pain under my ribs on the left is so severe that I actually can t breath. My Dr. put me on Ranitidine 150 mg twice daily and that does absolutely nothing, so she put me on Pariet 20 mg once daily and that only dulls the pain when I have an episode of severe throat pain. I have alot of heartburn and no reflux . Any suggestions would be very welcomed at this point.",
    "doctor_response": "Any time an internal body part pushes into an area where it doesn't belong, it's called a hernia.The hiatus is an opening in the diaphragm -- the muscular wall separating the chest cavity from the abdomen. Normally, the esophagus (food pipe) goes through the hiatus and attaches to the stomach. In a hiatal hernia (also called hiatus hernia) the stomach bulges up into the chest through that opening.There are two main types of hiatal hernias: sliding and paraesophageal (next to the esophagus).Many people with hiatal hernia have no symptoms, but others may have heartburn related to gastroesophageal reflux disease, or GERD. Although there appears to be a link, one condition does not seem to cause the other, because many people have a hiatal hernia without having GERD, and others have GERD without having a hiatal hernia.People with heartburn may experience chest pain that can easily be confused with the pain of a heart attack. That's why it's so important to undergo testing and get properly diagnosed.Most people do not experience any symptoms of their hiatal hernia so no treatment is necessary. However, the paraesophaeal hernia (when part of the stomach squeezes through the hiatus) can sometimes cause the stomach to be strangled, so surgery is sometimes recommended. Other symptoms that may occur along with the hernia such as chest pain should be properly evaluated. Symptoms of GERD, such as heartburn, should be treated.U can try syrup mucaine gel 2 tsf thrice daily before food for 7 days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does moderate dyskaryosis mean cancer?\n\nI had a smear test 1.5 years ago and all was ok. I had a recent smear test what shows moderate dyskaryosis. I have no other symptons (maybe since I know I feel a bit blooted and have lower back pain) but now I am very worried (I am 37 years old - height 1.74m and weitght 62kg). Could I have cancer?",
    "doctor_response": "Hi,Thanks for writing in.Dyskaryosis is a condition about the abnormal appearance of cells. If your smear shows that there is moderate dyskryosis then the cells in the region show suspected abnormal appearance. This does not definitively mean it is a cancer. Sometimes cells can appear this way and might also indicate a precancerous state. It will help if you can go for a cervical biopsy and this will involve study of more cells and from a the cervix. Please do not worried but consult your gynecologist for a biopsy to be scheduled in the next few days. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in spine\n\nMy Doc has informed me that Hydrocod Will now require a Triplicate RX, for my severe Spine pain. He has recommended a Morhone Pain Patch, yet currently has prescribed Tramadol, which I am not tolerating well. I am on Neurontin for nerve end pain and Cymbalta. I had no probs with Hydrocod, yet am experiencing side effects with the Tramadol. I am female, 68 years of age. What do you recommend?",
    "doctor_response": "hi,thank-you for providing the brief history of you.As the medicine are symptomatic relief for most spine cases and also medicines will be not good on long run as seen by me in the clinical practice, I recommend you to undergo physical therapy and regain the muscle strength and flexibility. By which the pain and aches will be reduced.Also, your age is 68, so you need a thorough body conditioning for which a Geritric rehabilitation will help to avoid much of the medicines due to aches and pains.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicine to improve serum creatinine\n\nMy mother Serum Creatinine is 2.2 nad hb is 8.1 at the moment and doctor is giving one tablet renolog + one injection epocept 4000 U follwed with shelcal and olsar 40 (for BP) + matilda,, so i want to know how critical her disese is now...as i am not getting what is d best to get her improved or are we on right track with these medicines Mother age is 61",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. Looking at her creatinine level I can tell you that the disease is not that critical doest need dialysis at this time and medical management which you are taking is sufficient. If she is my patient I will definitely do the same and you are on the right track with those medications. Please keep an eye on the creatinine level do regular investigations and make sure the creatinine wont go high.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Weight lost after contracting virus. Gallbladder stressed, inflamed. Bloated abdominal, back pain, digestive problems. Cause?\n\nHiA year and a half i contracted a virus overseas, was hospitilized and lost a heap of weight, returned home to see a naturopath due to a decrease in wellbeing, they informed me by gallbladder was stressed and inflamed, since then i have lost a large amount of muscle in the upper chest and middle back i look anorexic while still carrying fat around the buttocks and waist, i have experienced bloated abdonimals and pain, lower back pain, chronic digestive and bowel problems, constipation, dizziness, chronic fatigue, depression and poor memory. erectyile disfunction and size reduction. my body will not absorb the nutrients from food and water properly. . please help me find the cause/root of the problem since i have tried many methods with no result and continue to lose mass and put on pounds",
    "doctor_response": "HelloThanks for writing to HCMYou need proper clinical examination and investigations.Investigations include routine hemogram,RBS,Lipid profile,LFT,RFT,ultrasound of abdomen.Ultrasound of abdomen can exclude many conditions.Treatment can be started after clinical findings and investigation reports.Some of your problems like depression,small size and erectile dysfunction may be due to psychological causes, so consult psychiatrist also.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "20 year old, mood swings, unhappy with life, gaining weight, changing decisions frequently. Anything to worry?\n\nMy 20 year old daughter seems to be really struggling lately with making any decisions and her moods swings are out of control.  She seems so unhappy with life and has put on a lot of weight.  She changes her mind about every decision she makes several times within minutes and this includes everything from  minor decisions to very important life-changing decisions.  She is constantly announcing something new that she wants to do with her life and seems so happy about it but then within days, or sometimes minutes or hours, decides to go a completely different route.  It is driving me crazy, but now it is starting to worry me.  Could there be something else going on?",
    "doctor_response": "Hi,Thanks for using healthcare magic.I have gone through your available history.It seems that your daughter may have psychiatric illness like depression but other illness like bipolar mood disorder or personality traits should be ruled out.You may take her to consult psychiatrist for detailed evaluation and management.Doctor may rule out physical causes like thyroid dysfunction or vitamin B 12 deficiency or substance use if any.Treatment would be directed as per cause.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to rule out syphilis?\n\nHello doc why is it that i have no pain or symptoms of syphillis but when i go for a medical my vdrl/tpha are reactive but this sickness was already treated ive done injectible by penicillin in 4 times once every wk in 1 mnth after this treatment my vdrl/tpha was non reactive my question why is it this sickness after a mnths it is reactive again?",
    "doctor_response": "you have got the wright medicaton  Penicillin is the treatment of choice for all stages of syphilis, with the type of penicillin and dosing based on clinical staging of the disease.Latent syphilis (ie, without symptoms) is detected by serological testing and is divided into early latent syphilis (acquired within the preceding year) and late latent syphilis or latent syphilis of unknown origin.Nontreponemal (RPR/VDRL) titers can be used to monitor treatment response. Successful treatment is associated with a 4-fold or two-tube decline in titer (ie, from 1:32 to 1:8) 6 months after therapy for primary or secondary syphilis and 1 year after therapy for latent syphilis. RPR and VDRL titers are not interchangeable or convertible, so it is important to use consistent testing with a single method to monitor disease activity. The treponemal (FTA-ABS/TP-PA) tests remain positive for the life of the patient regardless of therapy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for yeast fungal overgrowth\n\nI m trying to find a doctor that can help treat my family for yeast fungal overgrowth. we have been going back in forth to doctors for since 2008 which we bought a home in 2007. Every since we moved in that house we started being sick , and we lived there almost 6 years, and i came to the conclusion it was the house making us ill.. I ve done alot of research but no doctor will help me, and t states you can move out of the mold environment and still have the problems and that we gotta get it out of our system or it will keep you sick !!!! Please help find a doctor that can help us .. i live in greenville ms thks",
    "doctor_response": "Hello, Thnx to contact us. I understand your concern. If I am your doctor I advice you that you should be tested for fungal allergen testing. If it is positive you should start with anti fungal medication. Once the treatment is started it gradually disappears.I will be happy to answer more of your concerns, kindly know me,Wish you a very good health at health care magic. Dr. Arun Tank. Infectious Disease.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on lower abdomen?\n\nIn the shower this afternoon I discovered a small, soft mass underneath the skin on my lower abdomen, located just to the left and above my penis. There was no pain whatsoever, nor was there any pain or sensitivity when i touched it. I do not recall it being present when I showered yesterday morning. It extended about one centimeter above the surface of the normal , surrounding skin and was generally oval in shape, about 3 cm on the short axis and 4 cm on the long axis.I am 77 years old, 6 3 and weigh 175; generally I m in good shape, chief exercise being walking. Yesterday I walked 8 miles with 1200 elevation gain and today 3 miles with 250 gain. This was just before getting into the shower.It is now about 6 hours later and when we returned home from a dinner with friends I took another look and the lump has subsided to the point where I can now neither feel or see anything.",
    "doctor_response": "Hello!Thank you for the query.From your description most likely you have an inguinal hernia. This is the only kind of lump which can appear and disappear suddenly. There might be some pain in this area as well however it is not always present. Please try to perform simple test. Put your hand on the area where the lump was present and try to cough few times while standing. If the lump will appear, hernia it is.IN case of any doubts, ultrasound of this area is a good idea.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cluster of painless pimples on scrotum?\n\nI have had very small pimples on my scrotum in a cluster like since about two years ago. They come out in a cluster, painless and disappear on their own. Then they come back again and disappear many times sometimes after three days and even one or two months. They can also develop into one pimple before it disappears and are only on the scotum but different positions. They are sometimes trigered by friction during fore play or even bathing and rarely itchy and completele painless. Never developed into an ulcer but can become one pimple after some few hours. Please help.",
    "doctor_response": "HelloThanks for query .Based on your statement I would state that you have multiple Sebaceous Cyst over Scrotal sac. The scrotal skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin.Normally they fade away without treatment however they need to be treated if increase in size or get infected.If needed some of them which are bigger may need to get excised in Toto (Completely along with the sac).Ensure to maintain a proper personal hygiene by washing the genital area with warm soap water twice daily .This will prevent recurrence of getting cysts .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take Guafinex for more than a week while suffering from COPD and allergies?\n\nI have COPD and have allergies. I have been taking Guafinex (600 MG Guafinacin) every 12 hrs for 7 days. I am also a liver transplant patient (16 yrs. out). Is it safe to continue for a few more days until allegires subside completely? I am drinking plenty of water.",
    "doctor_response": "Hi, It's a really safe medicine that is in most over the counter medicines. Lots of people take it for months. I hope this answers your query. I remain at your disposal in case further medical assistance is needed. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it necessary to put braces on lower jaw if issue with upper teeth?\n\ni am undergoing a dental treatment..just started yesterday i.e. 3rd may.. In my upper jaw, the front two teeth were problematic as they were a little high and very minutely overlapping each other..I am 21 years old. I just wanted to correct my teeth and for that the doctor here had put braces on my 5 upper teeth. I am just worried that for 2 teeth he had to put braces on 5 teeth and then he is saying that in my lower jaw too he will have to put braces..is that necessary?? is whatever he is doing is right??",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. Actually the upper and lower teeth are arranged in a manner that they synchronise each other while chewing or talking. So if there is some improvement done in any jaw upper or lower, it should be adjusted with the other jaw.That is why he is also doing changes in your lower teeth also.Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain and burning urination?\n\nokay, i think i have a uti but it that it hasn't reached an extreme state yet.  symptoms include: a very slight urgency to pee, a very slight burning or buzzing sensation when i do, a low back ache that seems to be more strongly located to my right side than left, but that seems to ease when i'm not so active, e.g.m i slept pretty well, but a walk arund town just now left me achey.  no referred pain to shoulder or other places, but i do have swollen neck glands, a soresh throat, and a slight upper respiratory congestion thing going on.  i['ve gotten antibiotics already but i want to known if it sounds like kidney stones.. or a uti.",
    "doctor_response": "Hello, I have gone through your query and understand your concerns.Your symptoms are more likely of UTI but remember even renal stones cause UTI so to rule out that you need to have a XRAY-KUB done. If the stone gets obstructed then there is more chance of infection and  pain you are facing. As you already received antibiotics please ruleout about the stone with xray and get back if needed.Regards,Dr.Alekhya.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please suggest a treatment for acute lymphoblastic leukemia.\n\nHello doctor, A 39 year old\u00a0female patient is suffering from acute lymphoblastic leukemia. She is currently being treated at a hospital by an oncologist. I am attaching her reports. Please suggest a treatment.",
    "doctor_response": "Hello. I am sorry to hear about the patient's condition. I have gone through the reports (attachment removed to protect patient identity). For more information consult a hematologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of the sensation of my lateral incisor?\n\nHi I'm Having A Sensasion on my lateral incisor and the one next to it like whenever you eat something sweet or something really cold & it's really bothering me . I already brushed my teeth and flossed and I just had a dentist appointment on the 18th & they told me I was clean no cavities or anything and I just wanna know how I can get rid of this feeling!",
    "doctor_response": "Thanks for using Health care Magic.Read your query.The sensations for sweet ,cold is due to the initial decay in your tooth,usually referrred as reversible pulpitis.I would advice you to revisit your dentist and get it checked.Have it filled and the sensitivity will be cured. Hope this was useful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for low blood pressure and lightheadedness\n\nHey there! i am 26 yr old, single, 5'3\" height woman. My current problem is that for max 3-4 min's i feel the room spinning, low blood pressure ( 90 73 with pulse as 64), light headedness an complete control loss. Last yr around the same time i passed out for 2-3 mins outdoors, considerin tht i am from warmer part of the world (pakistan), the doctor's concluded change of weather.. now i do have an auto immune disorder, diagonosed 8-9 yr's back and been on remission for the past 4 yr's. My optholmologist detected vasculitis during an eye check -p, i am long sighted  as well. i was on immuno supressent (neorel) for a couple of yr's as vasculitis lead me to rhuematologist, i was diagonosed with rhuematoid arthritus. during the pass 2-3 days i have been havin the feeling of passing out with the above mentioned symptoms..consulted an ENT as well, my question is do u think the vasculitis diagonosed in my eye has something to do with the brain vessels too? as a local doctor has suggested brain MRI considerin the history.",
    "doctor_response": "my differential diagnosis is it can be a syncopal attack  or presyncope.Syncope,  is defined as a short loss of consciousness and muscle strength, characterized by a fast onset, short duration, and spontaneous recovery. It is due to a decrease in blood flow to the entire brain usually from low blood pressure. autoimmune diseses canalso lead to  blocking of carotid artery a artery which carry blood to brain so i would advice you to go forcarotid artery doppler2d echocardiography(to find ejection fraction of heart,as  bp is maintained by amount of blood pumped out of heart in each contraction)Head up tilt testbasically once you rule out the cause of your low blood pressre ...youcan treat itkeep mri on hold for the time beingand get the test done which i have advised as a initial work upif everything is normal in all these tests then go for mri brain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My father has mild to moderate abdominal pain for the past 5 days. Please suggest medication.\n\nHello doctor, My father is 71 years old. He having abdominal pain in the middle for the past four to five days. Pain is constant and mild to moderate in intensity. He is not having any issue in passing stools or urine but sometimes complains of burning sensation while passing stools. His appetite is good. No vomiting or diarrhea. No fever. His current medial history includes diabetes and hypertension. He is an Alzheimer patient. Can you please prescribe some medication for his abdominal pain.",
    "doctor_response": "Hello. I can understand you must be very upset about your father's health. Well, you see the abdominal pain in such age is often an alarming finding, and I urge you to get him some investigations before giving any blanket cover of medicines. Common possibilities in his age are: 1. Mesenteric ischemia, which is the narrowing of the blood vessel supplying the blood to abdominal organs. This can frequently occur in old age with diabetes and hypertension. The pain arises because of lack of blood supply to organs like small bowel, large bowel, and others. 2. The second possibility is pain due to any organ within the abdomen which is inflamed commonly the pancreas (a gland over the back of the tummy), and large bowel. 3. And lastly, since he has a problem with constipation the gas accumulation can also be the reason of his abdominal pain. But remember, we cannot say that it is because of gas distension unless we exclude all other possibilities which are more concerning. I suggest you to get investigations which I write below. Only after the investigation, we can be able to diagnose the problem and treat it appropriately. I really hope this set of investigations will help us to approach the problem correctly. Mesenteric ischemia. Pancreatitis, gall bladder or common bile duct stones. Colitis, colonic neoplasia. Gas, constipation related. Compete blood count. Serum amylase and lipase. Liver function tests. Serum lactate level and serum CRP (c-reactive protein). HbA1c (glycated hemoglobin). Lipid profile. Stool for detailed report. Stool for occult blood on consecutive three days. Stool for fecal calprotectin. Capsule Esomeprazole 40 mg half an hour before meals. Ispagol husk two tablespoons full with water daily. Follow up after investigation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes episodes of sudden dizziness followed by nausea?\n\nSince 3 weeks ive been suffering from episodes of sudden dizziness that does not last more than one minute but that is followed by nausea and sometimes palpitations and rapid breath.I have done some blood tests incincluding cbc, ferritin, vitamin b12, TSH, T3and T4. All results were normal. What could be the reason behind such repeated episodes of dizziness? Note: such symptons appear once or twice a week and less when I am relaxed.",
    "doctor_response": "Hi,Thanks for writing in.Dizziness can also occur due to stress related anxiety or overflow of emotions. However before saying that your symptoms are due to anxiety, the following other causes of dizziness and nausea must be evaluated.Short duration of dizziness can also happen due to decreased blood flow from heart to brain. When it happens, the blood flowing through the vessels from heart to brain might have a reduced flow. These are by the carotid and vertebral arteries on either sides. This is more significant when you are standing upright and doing any moderate to heavy physical activity. You might require a CT scan or MRI scan of the brain.The best way to analyze if the reduced blood flow to the brain is causing your dizziness is by doing a carotid and vertebral arteries Doppler ultrasound. It will show the flow of blood from the heart to the brain and if it is adequate.Clinical examination of inner ear and vestibular system in the ear is also required. For this you might have to consult the ENT specialist. After clinical examination if there is suspicion of inner ear problems then detailed investigation is required. It might help to do a Electronystagmography (ENG) or videonystagmography (VNG) done to record abnormal eye movements while the head is placed in different positions or your balance organs are stimulated with water or air.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can Lyme disease be treated?\n\nHi, I have Lymes disease. I was bitten by a monkey 18 months ago in a zoo in Honduras while on a cruise. Everyone else was taking photos with the monkeys so they handed it to me and it bit me. I have been sick ever since then. I know Cats claw is good for helping eradicate the spirochete bacterial infection. Is there anything else that you know of that will get rid of Lymes for good. Peggy",
    "doctor_response": "Hello, Thank you for your contact to health care magic. I understand your concern. If I am your doctor I suggest you should first diagnose yourself for the Lyme Disease before you got treatment. You can get tested yourself with ELISA, IFS or Western Blotting to confirm the diagnosis. If you are confirm as having Lyme disease you should take doxycycline 100 mg two times a day for 14 days to cure the disease. The causative agent Borellia burgdorferi a treponema bacteria is very sensitive to the drug and you will be treated for with in 14 days.I will be happy to answer your further concernYou can contact me. Dr Arun Tank. Infectious disease specialist. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest natural methods to remove acne scars\n\nHello there, I've been suffering from acne for three years since I was 16 and recently I've used a product that had cleared most of them but I\"ve been left with scars. I don't want to go to a dermatologist for skin peeling or anything since it would be expensive, so is there another way I could remove these deep scars naturally and inexpensively?",
    "doctor_response": "You are asking is there a natural way to remove facial scarring from acne. Unfortunately there are no treatments that I am aware of that will remove those scars other than laser treatments from a dermatologist or plastic surgeon. You can reduce your chances of getting scarring by not trying to pop the blemishes. You can also try using cortisone on the blemish which will reduce inflammation and reduce scarring. I hope this answers your question. if you have any further questions please contact us again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in lower back, hip and legs?\n\nI have very low back pain and right hip and leg pain. I cant do housework or stand to do dishes without my lower back hurts. My right hip and right leg hurts most of the night that keeps me up. My history is ovarian cancer in 2012 and just had a right knee replacement on Jan 27. any answers what to do or what this could be?",
    "doctor_response": "hi,thank-you for providing the brief history of you.A thorough neuromuscular assessment is advised.As you have a lower back pain which radiates to the hip, thigh and leg it is a symptom of the pinched nerve in the lumbar spine. Also, undergoing physical therapy should help stabilize the core and strengthen the spine & lower limb muscles.As, you had a TKR post which there will be changed in the posture and which may have aggreavted the degenerative changes in the spine leading to the degenerative disc pain.in my clinical practice most patients are having similar complains post TKR as there is a change in the posture from abnormal to normal alignment And leading to sudden change in the anatomy. Most patients respond well to physical therapy.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is rectal bleeding in case of hernia normal?\n\nHello. I am a 40 year old white male. I have a hernia I've had for appx. 4+ years down in my pelvic area. I purchased medical insurance a year ago but have yet to have surgery due to not being able to miss work. Six or more months ago I began having intermitent bright red blood in the toliet bowl during bowel movements. Since it was intermitent I thought it was most likely from a hemmoroid(s). Within the last two weeks I began rectal bleeding on a constant basis that fills the toliet bowl and has a constant drip now. In addition when I pass gas blood comes out as well. Could this be a sign of colon or rectal cancer rather than just hemmorroids or related to my untreated hernia?",
    "doctor_response": "Hello!Thank you for the query.This is not related to a hernia. Such symptoms are usually caused by hemorrhoids indeed. The blood appears on the surface of the stool, is never mixed with it. Itching around the anus can be also present.Colon cancer or a polyp can also give bleeding similar to hemorrhoids. However the blood is usually mixed with a stool. Colon cancer is related with age. It appears over the age of 50. It is rare at your age.However, as the bleeding is present for a long time, I suggest you to have colonoscopy done. You should also consult proctologist.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. There is blood stain while clearing throat in morning. Do I need endoscopy?\n\nHello doctor, I have a sinus problem and very frequently, I have sneezing and coughing problem with phlegm. Recently, I suffered from a cold and since then I am getting a blood stain in the morning while sneezing and while clearing the throat in the morning. One month back, I got a chest X-ray and it was perfectly normal. Can you please specify what should I do? What could be the problem? Should I go for throat and nose endoscopy as the doctor suggested?",
    "doctor_response": "Hello. Was the blood while coughing bright red or altered maroon color? If it was bright red, then it could be from upper respiratory tract only. It can be due to just trauma. So, do not worry about it at all if it repeats also. Suppose you are getting maroon-colored blood then you should be cautious. Get endoscopy done that time. For more information consult a family physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could pain in chest after eating ham and cabbage be due to acidity?\n\nAfter eating ham and cabbage 2 nights ago, i got this really bad pain in my chest, right side. It won't go away. It hurts more as I move my head different ways.  It hurts really bad when I sneese or cough, now swallowing. Is it gas, and how can I relieve it.",
    "doctor_response": "Hi. I can understand your concern. If the chest pain is disturbing your routine activity then get  a chest x ray done to rule out any lung infection or it could be just a muscle pull. Do not lift heavy weightsPossibility of musculoskeletal pain is more. Ibuprofen is anti inflammatory. You will definitely improve with combination of painkiller and muscle relaxant drugs. Also apply warm water pad on affected areas. Avoid movements causing pain. Don't worry, you will be alright in 1-2 weeks. But better to first rule out lung infection.Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain?\n\nHi I ve been suffering with pain on the left side of my chest for about a year, I have a pulling sensation from my neck under my collar bone it also goes through my armpit down to my elbow and into my fingers, I also suffer with pain with my lower ribs on the left side that goes round to my back. The chest pain also goes round to my back.",
    "doctor_response": "Thanks for your question on HCM.In my opinion it seems muscular pain only. But as a rule in left sided chest pain we need to rule out cardiac cause first.So get done ECG snd 2D Echo to rule cardiac cause.If both of these are normal than your symptoms are most probably due to muscular pain only.So try to follow these for better symptomatic relief.1. Avoid strenuous exercise. 2. Avoid heavy weight lifting.3. Avoid bad postures in sleep.4. Take painkiller and muscle relaxant. 5. Apply warm water pad on affected site.6. Wear chest belt to avoid mobilization of affected part.7. Avoid anxiety and stress and be relax and calm.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is vitiligo in a child curable?\n\nHi Doctor, My child is 8 year old and she had vitiligo from last 2 years. The white patches starts from her eyes and now spread on knees and some other are of the body. We are using some creams recommended by the doctor. The growth of white patches is slow but increasing with the time. Someone told me that the recovery chance is good if Vitiligo starts in age under 10 and chances of skin recovery will be high, is it true? Regards, Faraz",
    "doctor_response": "HI We have to find the cause of vitiligo - any autoimmune disorder is associated with it by immunological studies and if needed skin test.Now, a days different treatments are available depending on the progression and severity and recovery will be good if treatment started early. Please consult a Skin doctor specialised in Vitiligo,w ho will recommend medications along with PUVA therapy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tiredness, dizziness, balance problems and sensitivity to noise and light. MRI shows hypersensitivity in right frontal lobe. What is the cure?\n\nHi I am 38yr old female 59kg 164cm. I was diagnosed with menieres 12 yrs ago but more recently for the past 6 months have had chronic tiredness, 24/7 dizziness and off balance, sensitivity to noise and light and some nausea. All of these symptoms have been a constant everyday. I also just had an MRI and it noted an intermediate rounded focus of hyperintensity in right frontal lobe.",
    "doctor_response": "your symptoms of dizziness and balancing difficulties and sensitivity to noise associated with nausea go in favour of menieres. are you still using any medications or stopped? if not kindly restart the medications. how is your hearing ? have you been to any ENT surgeon / Neurologist recently? do you have any headache associated with it? if so if the headache is associated with sensitivity to noise, light and some nausea it may probably be due to migrane also. do you get relief from headache from these complaints after sleeping for some time? you mentioned that there is a rounded focus of hyperintensity in right frontal lobe on MRI - is it on T1W or T2W image pls clarify.is there any mass effect or midline shift on MRI ? what is the size of lesion?if the size is small and no mass effect and midline shift nothing to worry emergently but i suggest you consult a neurosurgeon as early as possible because this may be due to a solitary lesion in the brain may be abscess / granuloma/ tuberculoma/any glioma/ infarct. but the MRI findings should be correlated clinically. hence i sugesst you to consult a neurosurgeon meanwhile take tablet vertin 16mg BD, cinnarzine 25mg OD, tablet paracetomal (dolo 650mg) thrice a day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can seizures cause one-sided body weakness?\n\nGood evening..My mother is experiencing muscle weakness, disoriented, we re having to repeat commands to her several times,left side weakness..the hospital has done an mri,egg, and CT but the only thing that showed up was possible seizure activity..Is it possible she may be having TIA S? Are there any other test that may be done to possibly find out what s causing these symptoms?",
    "doctor_response": "Hi, After going through the reports, it is clear that TIA cannot be ruled out,  though my first thought would be in the form of seizure and medicine thereof. Seizure medicines can cause the feeling of muscle weakness,  disorientation etc. There is at present no test which can confirm TIA. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a painful ear lump with headaches and airway tightening?\n\nI was recently in a situation of domestic abuse. I was punched on the left side of my face and afterwards put in a choke/sleeper hold. I went to the er and no damage to the neck, it was sprained and I have bruises and swelling on my neck. I noticed a hard painful bump behind my left ear after my hospital visit last night. Is this to be concerned about? I have small headaches and feels like my airway is tightened. I m not sure if I am just feeling anxiety. If I need to go back to the er I can.",
    "doctor_response": "Hi,thanks for the query.In my opinion last night hard bump with the chest discomfort felt by you needs urgent attention by ER.Plz report and recheck for any new developments in the neck -which is obstructing the airway.Lump behind lt ear-is traumatic-bony contusion with or without hematoma.I would advise you to take needed NSAID treats from your doctor.In the meand while cold packs would rellieve the pain -a little bit.Thnks.Wellcome again to HCM services.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Levolin inhaler safe for children?\n\nI am giving levolin inhaler to my 3 year old son, he had vomiting for 3 days , due to which fever  was not coming down. please tell me if theres any side effects of inhalers and is it safe for kids? should i continue or should i give some home remedies, else tell me some home remedies to reduce cough in th e chest",
    "doctor_response": "Levolin is a bronchodialator and helps in reducing wheezing which might be associated with respiratory tract infections. It is frequently in children and usually no side effects are observed since it is delivered directly to the target organ without requiring to get mixed in the blood stream. If side effects are to occur, it primarily includes increase in heart rate. Do not worry, it is safe to be given to children.The fever is due to the respiratory tract infection that is frequently caused by certain viruses and irrespective of use of medicines, it usually takes 5-7 days for the fever and cough to resolve. Give paracetamol to bring down the temperature. You would have to be a bit patient.A very good home remedy of cough is steam inhalation. Just place the child before a source of steam. The water vapour will be in the air and automatically the child will breathe it in. It will help in diluting the cough and would provide relief.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. When I concentrate on plain walI, I see tiny dots and fuzziness. Is it due to vitreous liquefaction?\n\nHi doctor, If I concentrate on plain wall or dark surface, I can see tiny dots and fuzziness sometimes. I have consulted eye doctors, and the test results are fine. I have been observing this from my childhood, and I am not taking medicines for it. Is it due to vitreous liquefaction? Does it happen to everyone?",
    "doctor_response": "Hi. You are right. It happens due to vitreous liquefaction with aging. The condition you are describing is known as floaters. They are perfectly normal. It occurs earlier in myopes or people using minus power glasses. They are a matter of concern only if you see a sudden shower of floaters. It may be due to pigment release from a hole or a break in the retina. In that case, a dilated retinal examination is required to be done by a retina specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have balancing problems,kindly suggest\n\nI have balancing problems....cant even balance a cup of tea",
    "doctor_response": "Hi.. Vestibular dysfunctions, central brain related cause and peripheral neuropathies can all cause balancing problems.. Examination is needed.. Consult your doctor..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had gall bladder removed. Why vomiting, diarrhea and bloating? Suggest\n\nI had my gall bladder removed in February 2012 and have had more problems than before. Vomiting, dirrhea, abdominal pain, acid reflux , bile reflux, bile in my stomach and small intestine , bloating . very light color stool and was told my liver was leaking somewhat. Gone to several Drs. and keep getting more pills that don t work or make things worse. I finally had an appt. with a specialist at the Cleveland Clilnic about 2 weeks ago and he has implemented 3 different tests, the 1st one was a gastric emptying test which I don t have the results of yet, the other 2 are a Glucose Hydrogen Breath Test and an MRCP. Do you have any suggestions. I have been totally miserable and cannot function normally because I never know when I will have a bad day or better day, NEVER a good day. Very concerned. Thank you Barbara Ring YYYY@YYYY",
    "doctor_response": "well I think you should wait for the reports as these will make things pretty clear. an d I would like to know the serum bilirubin levels and alkaline phosphatase levels aswell",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should the aching lump in armpit be removed?\n\nI have a lump in my armpit with a dull ache and a weird feeling in the breast nearest that armpit. I had bleeding from this same breast and a biopsy several years ago but they did not find anything? I have a doctors appt in a week but kind of scared and concerned?",
    "doctor_response": "Hello!Thank you for the query.Armpit is where lymph nodes are located. So any lump in this location should be checked with possible enlarged lymph node. Enlarged lymph node can appear due to breast cancer. This is the worst (and less probable) possibility.Other, more possible reason is an abscess due to infected hair follicle. Pain indicates such lump. Abscess should be incised and drained.In case of lymph nodes enlargement possibility ultrasound should be done and biopsy considered.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain. Normal scan, test results. Had gall bladder, appendix removed 6 weeks before. Opinion?\n\nHi, my daughter is 20 and last week collapsed with abdominal pain, and has spent the last 6days in hospital. With continual blood tests, ultra sound, internal scan and ct scan all coming back clear we still have no answer to why she is still in pain. Since June she has had a gall bladder and appendix removed with 6 weeks inbetween in one and now this. Please any answer",
    "doctor_response": "what is the site of pain?if itis in epigastric region then possibly ac. du.ulcer.or colitis .in the lower abd.pain is due to worm inf.d/d pid or uti so kindly do urine routine in the mean time take antispasmodic",
    "dialogue_context": ""
  },
  {
    "patient_message": "Repeated nocturnal emissions, have stopped masturbation, premature ejaculations. How can I fix this?\n\nDear Dr Please help me as I could not bear any more wet dreams. My mental, physical, financial growth has been retarded due to extremely heavy nocturnal emissions. Currently i am 35 years of age. 10 years back, i entered this hell of sexual kingdom, with masturbation. Initially with masturbation, next i stopped it but started getting Wet dreams, with performing a sexual activity in dream. Even I did\u2019nt read or watch erotic material, still i get nocturnal emissions and that too without dreams. So i decided to get married at the age of 31. I am having a healthy baby too. But now I could not indulge in intercourse with my wife as i am having weakness. Stii my wet dream are continued, 3-4 times in a week and 6-8 times a month. Plz save me. I am unable to stand or walk after erection . Lost all valuables hormones as stated in your website. Semen turned thin and ejaculations are so frequent and out of my control. My studies, jobs, career all is suffering. Also suffering from pre mature ejaculations, and ejaculate in seconds while in sex with my wife. Plese help me. I also think that please let me know if I am suffering from Urinary Tract Infection ( UTI )/Reproductive Tract Infection (RTI) or not. Plz confirm. Additional Info Here I also want to add that I am suffering from nocturnal emissions since last 10 years and 5 years back I developed a stone in my kidney and got it removed via laser treatment, since then I have no such problem of recurrence of it. I also want to add that I feel that I am suffering from weakening of parasympathetic nervous system and decrease of serotonin hormone in my brain, due to excessive nocturnal emissions. In addition I am having back pain, shoulder pain, leg pain and if I walk few 1 or 2 km then a terrible pain in my foot I feel. Plz help. Thanks Rohit Kumar (MP) INDIA",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  I do not understand from which website you got that wrong information. Let me clarify.1. Nocturnal emission happens when the body wants to emit the produced semen because semen is a waste product. Semen is produced whenever you are sexually aroused. Such produced semen is a waste product. If you do not engage in sexual activities or masturbation for a week or so, body finds its own way to expel the semen. One way is through nocturnal emission and another is through urine. Very much a normal process body adopts. 2. Semen is produced by testicles. You are ill informed. Production of sperm cells are not at all a tiring or health wasting or losing hormones process. They all are myth. Don't fall prey to such information and get anxious.3. You are worried about the nocturnal emission problem and you are anxious and obsessive about that. That is why you are having this premature ejaculation. Forget sexual problems. Forget Nocturnal ejaculation. Forget masturbation.  Just show love and passion to your wife and your problem is solved.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 sexology related psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does COPD bronchi and COPD emphysema cause cancer?\n\nHi ,my name is Linda ,I live in Myrtle Beach SC. today I had an attack of not being able to breath I started coughing and couldn t get my breath called 911 was told I had COPD emphysema I had already been told I had COPD bronchi. and they found 0.4cm noncalcified nodule inferiorly in the right middle lobe. tell me if you can what may happen and do I stand a greater chance of cancer? I did smoke for 30yrs and quite 15 yrs ago",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You are smoking since many years.  So you have high chance of cancer.  Copd per se not increasing the risk but it is also caused by smoking so it increased the risk of cancer. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer.Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the right treatment for kidney stone ?\n\nHi, i am asking this for my mother .. she is having 14mm stone in the right kidney which is blocking the urinary canal and another 10mm one in the left one ..She is aged 74yrs.. what is the right treatment ?",
    "doctor_response": "Hello. Thanks for choosing HealthcareMagic forum. 10 and 14mm stones are big enough and are difficult to be removed only with medicines.It is best to get the stones removed by laser and have relief. Get an opinion from surgeon concerned if she is fit for the surgery. Dr. Rakhi Tayal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Red rash on left side of neck, burning sensation. Had scar from cervical surgery. Taking thyroid medicines. Advice?\n\nI have a red rash that developed over the last year on the left side of my neck. I have a scar there from a upper cervical surgery to years ago.  I thought it may be discoloration from that. Recently, the rash is on the right side, too. I take thyroid med as I have an underactive thyroid. My Dr wants to treat this as a dermatology issue. I think not. What tests should I be asking for? It has more of a \"burn\" feeling to it. It is also going down the lower neck area.  Thank you, Noel West",
    "doctor_response": "I think it is . pmle.if it is tinea it should be annular with central clearing.use calamine lotion in the morning and fluticazone in the night .calamine acts as sunscreen",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for knotted bruise on shin above ankle with swelling due to hit on shin\n\nI have a knotted bruise on my shinn above my ankle where i evidently hit it on something today. Did not realize it was a problem until i noticed it has swollen into a knot type bruise. I have had ice on it for several hours and it does not seem to be relieving the swelling. Can you advise me as what to do? ?",
    "doctor_response": "Hi Hope this message finds you in good health.I have gone through your query in detail and understand your concern. you should get an xray done.apply compression bandage, keep leg elevated, take anti inflammatory tabletsHope your query has been answeredNothing to worry about, You should eventually get back to normal.Get back to me for any  FOLLOW UP QUERIES anytime.Kind Regards,Dr Mahaveer Patil...(MBBS,MS,Mch)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Procrit safe in the treatment of low RBC count?\n\nHi I was just advised that my husband s doctor is not putting him on a sot called Procrit to assist in increasing his red blood so that he doesn t have to have 6-8 hours of transfusion; however, in reading some of the side affects, I am quite concern as I will be administering the shots to him. Is this something that is widely prescribed and has it worked for people?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The body produces erythropoietin hormone by the kidney that promotes the formation of red blood cells (RBCs) by the bone marrow. In kidney diseases erythropoietin production is affected causing diminished bone marrow production of red blood cells. Procrit  is a natural erythropoietin. It is prescribed in anemia patients caused by kidney diseases, chemotherapeutic agents and HIV medicines. It may also be used to increase RBCs production in blood losses. If you husband\u2019s anemia is caused by any of these disorders or medicines Procrit should help him to increase RBCs. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why has my spurts of semen reduced?\n\nHello doctor, I am a 47-year-old male in good health. Within the last six months when I ejaculated, I only had one to three large spurts. Previously, I had about four to six. The volume is still good. I am on Prestiq and Xanax. Is this problem reversible and is it a sign of more problems to come?",
    "doctor_response": "Hello. I have gone through your query. I would like to know whether there is any decrease in your sexual drive or erections. If there is not any then as long as your semen volume is normal, I do not think there are any concerns as of right now. If the problem persists, I would suggest you visit a urologist for a complete clinical examination. For more information consult a urologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure swelling and lump on the side of blood withdrawal?\n\nI had a blood sample taken today for my annual physical. After the attendant removed the needle she pressed down on the needle hole and I felt a sudden painful sting that subsided slowly after a few minutes.  Twelve house later there is a swollen hard lump in this spot  (peanut size) --- it is now sensitive to the touch and a little pink spot surrounds the needle hole.  The skin is not discolored.  This has not happended to me before but I have had bruised skin several days after giving a blood sample.  I am concerned since I leave for Mexico this weekend on a Habitat build. Should I ice it? Thoughts please.",
    "doctor_response": "Hello,In fact had you pressed the injection site for few minutes,this wouldn't have occurred.There is no problem as it is just collection of extravasated blood from the puncture site.Just ice it 3-4 tomes a day and it should be all right.The skin discolouration would take couple of weeks to go as gradually iron from the bruised site would be absorbed by the body.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to get pregnant without follicle rupture?\n\nI am on D 17 and i got my scan done on D 14 which showed right ovary folicle 23mm and left 27mm..doc said that folicle will not rupture this cycle as it has become too big..is it possible to get pregnant even if the folicle doesnt rupture? Can it rupture later than D 17?",
    "doctor_response": "Hi ,Thanks for writing to HCM .You can't become pregnant if your follicle is not ruptured.  When follicle rupture the egg is relaesed which gets fertilized by sperm.  Yes follicle can rupture after day 17. But generally I wont allow follicle to grow till that size. Once the follicle size is more then 19mm I give my patients hcg injection which help in rupture of follicle.  You can discuss this with your doctor either for this cycle or for next. I suggest you to follow up this enlarged follicles which may become cyst and need to rupture them laparoscopically . Some regress themself and some rupture. From next cycle I suggest you to get follicular study starting from day 9 and alternative days . So that follicles won't become too large.Hope I have been helpful .RegardsDr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to maintain a good mental health during pregnancy?\n\nHi I have one problem can u suggest me how to avoid this. I studied M.C.A and My dream to became s/w engineer.But i got married. After that because of some personal problems i didn t get enough time to reach my goal. Now i am pregnant. My husband loves me a lot.I knew that. but we will be happy in 2 days like talking properly with each other etc 3rd day on wards i am feeling i lost completely now i am unable to do any thing for my career.i am alone.so many irritating thoughts.i just want to come out of this plz give me good suggestions.i am crying every 3rd day and trying to be ok later 2 days.i think this effect will be on my baby.now i am 8 month of pregnancy.so do me this little favour.",
    "doctor_response": "feeling of not able to persue your desired career makes you sad at times, plus pregnancy, bacause of harmonal and bodily changes, put extra stress, and your feel drpressed.There are help options available.beacause of pregnacy medications must be avoided as much as possible.you can seek psychotherapy/counselling, it can help you with your coping and stress handling skills.meanwhile try to keep yourself busy, you can spend time with your hobbies with consulting your gynecologist. keep yourself busyregards, dr arun",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the balls around the knee area that hurt while stretching?\n\ni have several balls around my knee area that really bother me. it hurts to stretch but after i am warmed up i can complete my entire work-out. unfortunately, by the next day i am feeling the pain. i have gone to get a massage where the balls have been broken and the pain goes away. my question is it safe to have the balls broken? is there a general cause to getting these horrible balls?",
    "doctor_response": "Hello,Where is the exact location of as you said bals?  How much is the size of each one.Possible causes are:1. Baker's cyst.2. Bursitis.3. Arthritis.4. Meniscal cyst.5. Boils.Until examination is done it is difficult to say what it is. Please take me a photograph and send me or consult with your orthopedician he will examine and treat you accordingly.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the effects of asymmetrical absorption of material between the two kidneys?\n\nI had a complete body bone scan today. The physician reading the results sent the technician back to ask if I have ever had kidney disease. I had several bouts of pyelonephritis as a 6-12 year old. (40 years ago) It seems that I have marked asymmetrical absorption of the material between my two kidneys. The technician added that one kidney showed lots of activity while the other one was barely visible . The report recommended clinical eval and an ultrasound. What are the possibilities here?",
    "doctor_response": "HI,Thanks for writing in.The most convincing possibility in your report findings is that due to the pyelonephritis 40 years back there was scarring in the kidney. This has caused mild permanent scarring leading to decreased functioning in one of the kidneys. This is not a serious condition and the kidney function has been taken care of by both the kidneys and this is the reason one kidney is showing reduced activity.When doing a complete bone scan, the material injected is excreted through the kidneys and the concentration of the radio isotope in the kidney reflects its absorption. Since on of your kidneys is showing reduced absorption of the radio isotope material, it means that due to scar formation 40 years back, the kidney function is reduced. If your kidney function tests such as serum creatinine and creatinine clearance is within the normal range then there is no concern. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for swelling in the wrist\n\nHi - I got stung by a bee yesterday and I have had allergic reactions in the past. I took a antihistamine right after and had pain and swelling at the site (left palm, in the thumb muscle area). The redness and swelling have moved down into my wrist below the site and it doesn t hurt much now. What I am concerned about now, is I am feeling achy all over like I have a fever. Do you think this is related to the sting or just a coincidence? Thank-you!",
    "doctor_response": "Dear sir /madam Most likely you are experiencing the inflammatory or immune reaction to the sting. And it goes down within a week. You need not worry about it unless you have breathlessness or swelling in other parts of your body. If it still bothers you take some NSAID.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated liver enzymes?\n\nWhat could a high SGPT (134), high SGOT (65), high GGTP (182) and high AP (173) indicate. Just 3 months back I had borderline high SGPT and GGTP readings. Have completely cut don on alcohol and fried stuff. So was actually expecting a better set of results. These are a bit of a shocker. Am on cholesterol reducing drugs (statin). Is there any connection to that?",
    "doctor_response": "Hi thanks for contacting HCM....You are taking cholesterol reducing drugs...But drug you have not mentioned....Certain drug can affect liver and so you might have drug induce liver affection....So you consult doctor for it....You might given another safe drug like atorvastatin which has less chance of liver affection....Meanwhile continue doing exercise and less fatty food....Along with regular exercise advised....USG done for primary work up...If fatty liver or gall stone then udiliv tablet given....If suspicion then viral marker done for rile out chronic HBSag like Carrier...Avoid alcohol.....Keeping these in mind consult gastroentetologist....Take care.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the MRI report regarding back pain indicate?\n\n1. I am pradeep  I have back pain and MRI report given that central &bilateral  paracentral disc herniatiom at l5-s1 level causing thecal &rootcompression2. Right paracentral & central disc herniatiom at l4-l5 level causing thecal & root compression3.spinal canal &neural foraminal stenosis at l4-l5 & l5-s1 disc level and doctor suggested to have the surgery  give me the suggestion whether to take surgery or not",
    "doctor_response": "HiThanks for posting your query.      Your MRI report says that the inter vertebral disc ( a disc like structure between the spinal bones ) has gone out of its place ( herniation) and it is compressing the nerves near the back region. ( Normally nerves emerge out of spine region )       Now whether you need surgery or not depends on the severity of problem . If you are in extreme pain or having weakness in legs or having problems in passing urine or motions then its an indication for surgery.     Any clarifications feel free to ask .       Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medicines can be taken to avoid pregnancy after unprotected sex?\n\nhi doctor,   today noon, almost 7 hrs b4 me & my wife had a sexual inter cause, without precaution. as our first child is 18 mnt old only we r trying not 2 've our second child now. what can we do now. is tre some tablets available now in market 2 avoid pregnancy?",
    "doctor_response": "Hi,  There are emergency contraceptive pills which can be taken within 72 hours of unprotected sexual contact ( more effective when taken as soon as possible )& should be taken under guidance of a obstetrition .  Consult a obstetrition for continuation of any of contraceptive measures  ( IUCD suitable for you) to avoid these kind of situation ( unwanted pregnancy ).Hope this ll help Thanks n regards (dr.kishorekunal@gmail.com)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is cone shaped holes and multiple timorese sign of mesothelioma?\n\nMy husband was a contractor most of his life and knows he was exposed to asbestos. He now has developed what the doctor is describing as cone shaped holes in his lungs as well as multiple Timorese the largest being 7 mm in the lower left lobe. It is too dangerous to biopsy. He has been labeled terminal. Could this be mesothelioma?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. He has asbestos exposure and chances of asbestos related diseases are high.  He may have mesothelioma or other asbestos related lung disease or carcinoma.  He should go for biopsy of that lump.  If needed go for  immunohistochemistry study.  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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How do i get rid of purple skin tone?\n\nhi recently i had what apeared as like a cut onb my face its like a bumpy pinkishi line, i used a ton of vitamin e oil on it and now the cut is gone but there is a piple and the rtest of the spoot is turning purple. how do i get rid of the purple skin tone",
    "doctor_response": "HI Dear                read your problem ......purple skin tone may be due to some damaged capillary beneath the skin...... ideally it should go with time may be in 2 weeks... keep appling vitamin c serum that will help",
    "dialogue_context": ""
  },
  {
    "patient_message": "Advice for 14 months old baby with cough, breathing difficulty and bit hissing\n\nMy 14 month old had a runny nose about 5 days ago and now he has been coughing and breathing with difficulty.. it sounds like he's hissing a bit. My worries are that it could be asthma. I don't know what to do if I should just keep calm with a humidifier or go to the hospital in the morning?  Help please!!!",
    "doctor_response": "Go to a hospital and consult a pulmonologist.Get a X-Ray and if necessary blood counts.From the symptoms it seems that your baby is suffering from obstructive airway disease,would require bronchodialators.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to reduce SGPT and GGT levels to normal\n\nHi, I have just got my blood test and it shows that my SGPT (ALT) is 104 (Normal values are up to 40) and that my GGT is 57  (Normal values between 11 and 43) I am a 27 year-old male, I dont drink or smoke, I rarely eat meat, my diet is normal and I rarely exercise, My weight is 100 KG(220 Pounds) and I am 176 CM (5Ft 10\") tall How can I reduce these values in the shortest time possible Please help",
    "doctor_response": "Hi welcome to HCM...Noted you are overweight....And because of that your enzymes value are high....Investigate your liver by USG ...It will rule out fatty liver or gall stone..You are not drinking alcohol.So it could be non alcoholic hepatic steatosis...Here are few advises....Low fat diet taken...Fried food less...Less oil in cooking...Sunflower , olive oil like good oil useful...Green leafy veg more like.....-bitter gourd -arugula -dandelion -spinach etc...Avocados produce glutathion that detoxify liver ..so taken daily.Beetroots and carrot useful.Avoid smoke.Avoid refined food...Take care.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heat surge in upper thigh?\n\nI am getting a heat surge in upper left thigh. It just started happening in the last few days. The heat is internal and the area does not feel warm when I touch my skin. Seems to be happening whether i am sitting or standing. Any ideas of why this is happening? Not painful just a strange feeling. Thank you ann",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The cause of\u00a0the burning\u00a0sensation of the thigh can be\u00a0meralgia paresthetica.It is is pain or warmth in the outer thigh due to compression of the nerve.If the symptoms continue, you should consult a neurologist for further evaluation. Meanwhile,I suggest using anti inflammatory medications such as Acetaminophen to relieve the symptoms. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it mandatory to get the optional vaccines for a 45 days old infant?\n\nHello doctor, I have a baby girl (45 days old). There are some vaccinations in this period. Our pediatrician suggests vaccination option for DTwP/DTaP-1, OPV1/OPV1+IVP1, Hib vaccination, hepatitis B vaccination by oral administration or by injection. What is the difference between it and which one is better? Secondly, in optional vaccination like PCV1 and rotavirus vaccination 1, they have different options. Here the difference is of doses they said. So can you explain it what is it? Which one is better? Please let me know as soon as possible as I have to get it within two days.",
    "doctor_response": "Hello. I understand your concern. 1. Optional vaccines are given in special and high-risk kids. Does your child is any one of them? 2. Yes, in the market there are various brands of different vaccines. 3. There is no limit for optional vaccines. 4. If a baby is healthy no high-risk factor I suggest go for routine vaccination.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain\n\nHi, i had some pain at my back which later detected as cold abcess, doctor asked me operate it ,which i did in the month of April. i observed that my wife got pregnant while i was suffering from this problem, will my baby have any problem from this because doctor had given me medicine for tuberculosis.",
    "doctor_response": "HelloThank you for writing to us on Health care Magic.Based on your history the response to your question is as follows.1. Tuberculosis is a chronic inflammatory disease. It usually affect people with reduced immune system.2. At present, based on details, your wife should be healthy and with out any infection. As she is not infected, there is no possibility of baby being affected.3. Try to improve her and your nutrition, so that immune system is improved. Protein rich diet along with vitamin supplements is essential.4. You need to continue medications, till you complete the course. Not to worry, baby is safe. Hope this is helpful to you.Do write back to me for further questions.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dark circles and pimple scars on the face. Melalite prescribed. Need better medication\n\nHello doctor im 30 yrs of age(male) I was having dark circles and pimple marks on my face,my doctor suggested me to use melalite xl, which I used for almost a month and found very good results, I still have little more marks on my face,should I repeat the same medicine again? Or pls suggest some more effective cream, my skin is very oily. Thanks you so much",
    "doctor_response": "Hello Gaurav, Welcome to Healthcare Magic Melalite XL contains a mid potent steroid, retinoid and hydroquinone. It is a cream to be used only under doctors supervision and is not meant to be used for long term. It can cause rosacea, thinning of skin, redness and increased sensitivity to sunlight if used for long duration. I would recommend you to slowly decrease the frequency of application to twice a week, then once a week and stop  the cream and add on a kojic acid or arbutin containing cream daily at night. Sun protection with sunscreen is an absolute must. Apply sunscreen ideally a gel formulation as you have an oily skin and you are pimple prone. Reapply sunscreen every 3-4 hours daily. Cosmetic procedure like glycolic peels  will help you. You can consult a cosmetologist for the same. For dark circles life style modification is important. Sleep well, drink plenty of water, avoid spending too much time in front of television and lap top and have a balanced diet. A diet rich in Vitamin C like citrus fruits will help. hope this helped take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Had unprotected sex, noticed spotting. What are the chances of getting pregnant?\n\nHi im 28 and have had unprotected sex.me and my fiance have been trying to conceive for six months ..I got my last period or what I thought was...:/brownish discharge the light to somewhat...flow in turn only lasted three days which is unusywhich is pretty short for my usual cycle.now few weeks later I find myself what",
    "doctor_response": "Hello Thanks for your query. You have not mentioned the exact dates of your periods. Please take a pregnancy test to confirm pregnancy. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. There is itching and irritation with red patches in the skin. Please help.\n\nHi doctor, Few days before, my skin got irritated. I thought it was natural. Last night, just after washing my face with facewash, my skin got red patches in the morning and I have itching type sensation. It looks very awkward. Please help me.",
    "doctor_response": "Hi. Irritation and itching on the face can be due to seborrheic dermatitis, polymorphous light eruption, irritant contact dermatitis, and many more. It would be easier for me to make a diagnosis if I see the picture. Can you please attach your clinical pictures of the face? Any changes in the skin products such as using new soaps, new face creams, any history of exposure to sunlight for longer duration and history of travel to a new place can cause changes in the skin. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I having hair fall and body aches?\n\nHi doctor, I had a history of thyroid issue before pregnancy. Currently, I have an issue of hair fall and mild body aches.",
    "doctor_response": "Hello. The likely cause for hair loss is low hemoglobin and also for body aches is low hemoglobin and low vitamin D. Your ESR (erythrocyte sedimentation rate) is elevated which is due to low hemoglobin (attachment removed to protect patient identity). Your thyroid is fine. So you should have Iron supplements like tablet Fericip XT (Iron and Folic acid) twice a day after breakfast and after dinner. This may cause some gastritis. Also, you should have tablet Uprise D3 60,000 units once a week for eight weeks, followed by once a month for next six months.  For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had 2 seizures, both during periods. Having too much of coffee, coca cola. Hormone problem?\n\nI'm just doing research to see what could have caused my seizure. I'm 29 and had my first one at 27 almost 28 years of age. I believe it's related to my hormones because I've only had 2 seizures and they were both on my period. I weigh 130lbs and am pretty healthy. My only bad vice is Coca Cola but I have recently reduced how much I have. I cheat on weekends if I go to the movies. I made that choice because I read that caffeine can increase estrogen and I thought maybe I was making too much. I'm open to see what could cause me to have hormone problems that is also connected to seizures. Thank You!",
    "doctor_response": "Dear Ms Few patients like your case do get seizures during periods. You are right in concluding that it is related to hormonal imbalances. However, we have not pinpoint a specific abnormality. Research is on. Your assumption of cola drink is not on scientific basis. Caffeine by itself has certain side effects and it can aggravate seizures in some patients. Regards Pratap",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a mons pubis lump with pain be treated?\n\ni have a large painful lump between my pubic area and thigh. the lump is under the skin. its painful without touch. and the pain is radiating into my thigh. ive tried otc meds and heat and ice...nothings working. can you please tell me whats going on from your opinion",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have enlarged inguinal lymphnode due to reactive hyperplasia, tuberculosis or lymphoma.  Or it can be some soft tissue tumor.  You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for yellow colored urine,vomiting and loose motion in baby\n\nOur 2 months 10 days old is experiencing the following symptoms: - yellow urine - occasional slight vomitting - pass motion about 3-4 times a day - mostly on formula milk, plus some breast milk We are based in Guangzhou, China. We had brought him to se the doctor. His blood test returns the following results: ALT=31 AST=40 TBIL=41.4 DBIL=30.5 IBIL=10.9 TBA=82.3 RBP=12.4 SOD=190.8 What should we be doing? The doctor has prescribed Ursodeoxycholic Acid Tablets for 30 days, 12.5mg x 2 times per day plus 9.5ml of pediatric multivitamins drops per day. Should we let the baby consume these? We can be reached at jimmy.beh@ WWW.WWWW.WW Thank you very much Weight= 5.6kg",
    "doctor_response": "Hi, seems like your baby has obstructive jaundice. Blockage in the path of a substance called bile from the liver. You should also ve noticed pale colour stools. An imaging of the biliary tract (bile pathway) under milk free diet is needed followed by other tests see whether it is genetic. It is better if you get a consultation as early as possible",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. A yellow lesion appeared on the tonsil and capillaries have widened. What is this?\n\nHello doctor, I had a cold starting with a sore throat, followed by nasal congestion and post nasal drip/coughing. In the past few days, a yellow lesion appeared on my left tonsil. I have attached a picture. As you can see, capillaries have widened on this tonsil and it appears red. What is this?",
    "doctor_response": "Hello. I have seen the picture (attachment removed to protect patient identity). There is acute inflammation of your pharynx. That is the reason for widened capillaries. The yellow spot could be pus pointing or a tonsil stone. You need a course of antibiotics, decongestant, nasal spray and mouth gargles. For further queries consult an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get fair complexion for baby?\n\nMy baby is 4 months old. I used J &J Oil for 1 month due to skin prob i changed to coconut oil for her.. With some friends advice i changed to Olive oil now, i feel some colour change in her skin.. Which oil shall i used to get a fair skin complexion for my baby.. She is of normal colour now.... plz help",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you want fair complexion of your child, complexion of child depends upon various factors like environmental factors and most important genetic. It cannot be pre- decided. If dark color is due to genetic reasons it cannot be changed. Avoid anything on face as newborn has very delicate skin. You can take omega 3 softgels. I also suggest you to take nutritious diet rich in green leafy vegetables ,fruit , cereals, pulses, milk and milk products. Give child bath in milk for few days. You should give coconut to eat to mother of baby.  After birth of baby you can apply olive oil and almond oil for gentle body massage of your baby as it will nourish skin of baby. Drink plenty of water and you have to give diet to the mother of child which is very nutritious.Hope your concern has been resolved.Get Well soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes loose stools in babies?\n\nMy 2 year old is very healthy, clearly not malnourished but I m ready to potty train and she rarely - very rarely - ever has a solid stool. And, every now and then, it s watery, dark, sandy, gritty, and burns her bottom raw in one BM. The last couple of times this happened, it was after ample amounts of bread/wheat products. Could this be celiac s disease? Should I go to the pediatrician or straight to a pediatric gastroenterologist?",
    "doctor_response": "Hi, if loose stools happen with breads /wheat then child needs to be investigated for celiac disease. In my opinion, TTG levels should be done to confirm the diagnosis. An examination by pediatrician will also help in confirming the diagnosis. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for allergic asthma with dizziness\n\nI have allergies and asthma. Back in September my doctor said she thought dizziness due to allergies. Gave me meclizine. It seems to be everyday not as severe as when I went to see her. Slight swaying sensation mild pressure headache across forehead. I was also started on a birth control pill at end of August to replace medicine to control my endometriosis. I don t want to have to go to another doctor, but this is annoying as I teach school.",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your history and would like to make suggestions for you as follows:1. As there are many causes for dizziness, I would like to know more about your complaints, medications, overall health, investigations, etc etc.2. As you have headache and allergies also, I would first think of dizziness related to problem in middle ear which occurs due to long standing nose obstruction/sinusitis, etc.I usually suggest my such patients regular treatment of allergic rhinitis with levocetirizine + montelukast OR intranasal corticosteroids along with  regular steam inhalation which improves nose congestion and relieves sinuses.However, an ENT consultation is necessary for confirming the diagnosis. More details about your nose and ear symptoms would have helped better.3. Dizziness could be some simple reasons, unrelated to allergies, such as nutrition deficiencies, low hemoglobin, stress, anxiety, inadequate hydration/water intake, etc etc. Depending upon cause, nutritional supplements (for nutrient deficiencies), iron-folic acid-vit B12 (for low hemoglobin), relaxation & meditation (for stress/anxiety), ensuring adequate liquids during day, etc would help.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Broken tooth, gargle with salty water before sleeping. Any suggestions?\n\nMy child has part broken tooth some still hang on the gum, what should I do , wait and let the rest fall , trying to get an appointment with dentist but may have to wait a few days, will he be ok, he hasn't, complained about server pain but a lot of discomfort. I've ask him to brush gargle with salty water before sleeping, will he be ok , I mean chances of him chocking in his sleep eft.",
    "doctor_response": "Hello.Thanks for sharing your problem with us.I have gone through your concern, Generally milk tooth don't hurt that much during exfoliation. But if the tooth is traumatized it can hurt him.Until you visit the dentist,try to keep noticing the tooth,don't touch or move it.Keep notice on cleanliness of mouth and also gargle helps in reducing the infection.As per chances of choking you have to monitor for him,though chances are less and try to visit the dentist as soon as possible.Thanks!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have high prolactin. Will this affect my fertility?\n\nHi, My doctor said that I have high prolactin, almost 200, but I have regular periods. My periods are regular and usually have an interval of 30-33 days. I do not have any othe menstrual symptoms, other than milky nipple discharge. I take ovulation tests every month and comes back positive on my fertile days, yet I have not been able to conceive. My doctor said that, it is just a matter of time and that I should be able to conceive. I want treatment for the prolactin levels because, I believe that is the reason I am not able to conceive. I just want a second opinion please. Thank you.",
    "doctor_response": "Hello. Revert back to an obstetrician and gynaecologist online for further follow up -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes angina and breathlessness?\n\nI had the angioplasty - one stent - LAD - one month back. after which I am taking the medicines  i.e., Ecospirin - 150, Clopitab -75 twice a day , rezavel 40,  as advised by the doctor.  I am suffering from angina  and pain in the neck  and breathlessness ( not always) now and then. What shoud I do , please help me",
    "doctor_response": "hi,was there any other, vessel also involved!? if LAD was only lesions, did you use drug stent or one without drugs, because we need to check the possibilities of instent stenosis.You can go through any stress test, to rule out ischaemia, or CT Coronary angiography, if you are too worried.Meet your primary care physician, and discuss the possibilities of starting beta blockers or nitrates",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stopped Depo provera injection. Will I face the common side effects?\n\nHi, I m just reading forum posts regarding the coming off of the depo provera injection . I came off mine two weeks ago and when i asked my doctor what the side effects would be he didn t say any. Now reading these forums and what people have experienced after coming off of the injection i m worried. So is these side effects being mentioned common? (Headache, nausea , weight gain/loss, tenderness etc). I had an operation a year ago where i had to have a cyst and one of my ovaries out but i was told it was ok to stay on the injection. I just come off the injection because i would like to see that my remaining ovary is working ok and read somewhere that i shouldn t be on it for more than 2 years at a time, but would like to be prepared for the side effects/know what to expect. Would my side effects be the same with only one ovary? Am i likely to find it easier to lose weight now i m off the injection? Much appreciate your advice. Thanks.",
    "doctor_response": "Hi Stephaniejanebrown, Thanks For writing to us, Generally many Women are Diagonised with side effects of depo provera while using it and after stopping it, Depo Provera is an 97% effective Contraceptive and the side effects range from mild to severe. Any way you need not worry much and its good to know that you are preparing before hand , as they say prevention is better than cure, Symptoms after stopping depo provera maybe: 1) Menstrual irregularities 2)Delayed fertility 3) Increased bone density etc. So , If you experience any such side effects adversely , I Suggest you to Consult a Gynecologist Immediately. For any further help you can mail me anytime. Wishing You A Good Health, Dr.G.Gayatri Devi. drggayatridevi@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does itchy navel in children need medical attention?\n\nHi, my 15 months old daughter is scratching her bellybutton whenever she has an access to it. It bled a little few times. She puts her finger into her bits as well and moving it there. Anything to worry about? And how to make her not to scratch herself?",
    "doctor_response": "Hi The area at the belly button is deep, moist, warm , contain loose skin fold and is easy to get assessed by hands of children. Also in this age group children put their contaminated fingers at this site repeatedly and more while playing. So this area becomes prone to the infection. Now infection can be bacterial or fungal type, depends on the symptoms and signs that has to be looked. In your case as you are saying there is itching and sometimes bleeding both of these symptoms can be caused by any type of infection. However, bacterial infection is ussually associated with pus discharge, more pain tenderness, redness , swelling and symptoms will increase if not treated. The other type that is viral usually has mild symptoms lesions can be circular , scaling of skin may be present , itching is so severe it can result in bleeding. Treatment is easy for both the types. Also hygiene has to be maintained. After an age she will not play or put the finger into belly button the problem will be least likely to appear.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bleeding when one is pregnant?\n\nwe lost our baby at 20weeks 5 days , my wife was started bleeding and rushed to hospital bleeeding continued and some time later water broken ?? doctor checked through vagina they see cord lying in vagina and they have to induce pains to get the baby asap and baby won t survive.. any suggestion on reasons why this happened just like that all of sudden..",
    "doctor_response": "There are various causes for this. Like infection, incompetent cervical loss, harmonal problems, genetic  etc. If it's first time then I think infection of lower genital tract could be the cause. If repeated pregnancy loss then you need complete check up.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could extra calyx on kidney cause back pain?\n\nWhen my daughter was 10 years old (she is now 41) she had an I.V.Pyelogram which showed that she had an extra calyx on one of her kidneys.  The test was done because she was showing protein (I believe or possibly albumen - don't remember) on her blood test.  Now that she is much older she is having back pain.  She had a MRI which showed mild degeneration but nothing serious.  Her Dr. suggested P.T. which she just recently completed after many weeks of therapy.  Her back pain has not gotten better and her Orthopedic Dr. suggested she see an internist.  Could this extra calyx somehow be causing some kidney problem and back pain?",
    "doctor_response": "HiWelcome to healhcaremagicAfter going through your query I concluded that you there are having chronic backache. I Don't think extra calyx can be cause of chronic backache . Important cause of chronic backache is vitamin D3 deficiency so you can get your vitamin D3 level and if low you can take its supplements.Vitamin B and C with be helpful in recovery. You can discuss with your Doctor about it. Hope your query get answered. If you have any further questions then don't hesitate to writing to us . I will be happy to help you.You can also write to me directly on below link: you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can i reduce SGOT and SGPT levels?\n\nSir, My sgot is 128 and sgpt is 68. how can I reduce both of these by taking food. Can  I reduce both of these. please advice me.  I have started morning  and evening walk daily and also yog in the morning time.  My stomach is always big in size. How can I control my stomach.",
    "doctor_response": "Hi & Welcome.I can understand your concern.Incomplete data like age, gender, alcohol intake, etc.The raised liver enzymes (SGOT & SGPT) could be due to liver disease, gall bladder disease, or alcohol intake.The underlying cause should be detected and treated accordingly.Beside you need to have certain lifestyle changes like1. Avoid taking alcohol (if you consume), avoid smoking.2. Avoid taking fatty meals, fast & junk foods.3. Eat home cooked foods, increase the intake of fruits and vegetables.4. Do regular exercise, reduce your body weight if you are overweight.5. Drink plenty of water.Hope the suggestions given above could be useful in reducing the raised liver enzymes and the body weight.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is there any way to cure reflux esophagitis?\n\nHello doctor,I have reflux esophagitis as determined by endoscopy last month. They found grade M tear in GE junction and also mucosal atrophy reported. H-pylori was found in rapid urease test. I am on Clarithromycin, Amoxicillin and Esomeprazole medication for 14 days and I have three days of course left. I do not seem to be healing well and reflux is getting worse than before and I need to be able to control the inflammation as I am scared it will get worse. I am 40 years old otherwise fit male. Any suggestions?",
    "doctor_response": "Hi. I have gone through your query in detail. Usually, reflux esophagitis is reported based on the Los Angeles classification, which does not have a grade called M, but going through the report it is mentioned minimal changes of reflux esophagitis with the lax sphincter. Your treatment for H. Pylori is appropriate based on the rapid urease test result. Usually, when a person has H. Pylori infection, the acid production is suppressed by the infection (chronic gastritis, mucosal atrophy is a sign of that). Once it starts getting cleared from the mucous membrane, it is quite common to find the reflux symptoms, especially heartburn worsening, because that acid production is improving due to clearance of infection from the mucosa, hence even though you may be on acid-suppressing agents you might have heartburn. It is a temporary phenomenon and would improve over the next couple of weeks. Kindly continue with the treatment and you may add 10 ml of Gaviscon syrup (if you are abroad you can get Gaviscon tablets too) to be taken three times after major meals for a week.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low grade fever in a child\n\nMy 8 year old daughter had a low grade fever on and off for the past 4 days and now when I took her temperature in her ear, it was 95.5 on the low end and 96.1 on the high end. I took it multiple times and borrowed neighbors thermometer with similar results. Is this low temperate safe or should I be alarmed?",
    "doctor_response": "my dear,temperature of atleast more than 100'F is fever.And if between 99 to 100.5 than low grade fever.low temperature in your daughter is because of the environmental temp so just keep her warm and don't worry about it.take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for small cluster of 8 bumps in the groin area\n\nhello, i noticed today i have a small cluster of about 8 pimple like bumps in my groin area. i tried to pop one and it bled pretty well for a bit. they itch a little bit but nothing serious. i have looked at scabies and folliculitis? any ideas? i am sexually active with 1 partner for a year now. she has no symptoms",
    "doctor_response": "Hi Dear!!Thanks for your query to HCM. Read your query and understood your health concern.Based on facts of you query, you seem to suffer from-Tinea Cruris Or-Ringworm in groin with Jock itch.Other causes need to be ruled out like boils from hair follicles.Treatment-Tab Flucanazole- 200 mg daily x 2 fist day and  1 for 6 days.Good Private hygiene/dilute Dettol sponging of groin area x 3 weeks Get Second Opinion from Dermatologist.This would resolve these bumps in groin area.Hope this reply would help you to plan further treatment with your doctors there.Welcome for further query in this regard if any.Good Day!!Dr.Savaskar M.N.Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy after taking medication?\n\nHi Doctor , i had irregular periods which got corrected by taking Unkei Toh...a japanese herbal medicine for 3 months but now no ovulation for 2 months....trying to conceive...doctor advised clomid to take in the 5th day of the next cycle up to 9th day....what are the chances of becoming pregnant on clomid?",
    "doctor_response": "Hi,You have irregular period. It is important to find out cause of irregular period. It could be due to PCOD, thyroid dysfunction, adenomyosis, endometriosis. I would suggest to consult gynecologist and undergo vaginal examination, reproductive hormone analysis, USG scan and ovarian follicle study to confirm cause.Specific treatment depend on cause. Clomid cause induction of ovulation in 80% case and it increase fertility in 50% cases. But it should be taken after proper evaluation. After taking it consult a gynecologist and undergo ovarian follicle study to know maturation of follicle. If ovarian follicle size will be 18-21 mm then it has high chance of pregnancy. You can also ask for progesterone pill in second half of period, metformin and oviduct NC. All will help you to become pregnant. Avoid stress, take healthy diet, drink plenty of water, do regular exercise and maintain weight according to body weight.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fluctuating body temperature\n\nI have a 10 yr.old that has had fever for 1 week,was diagnosed with strep given a antibiotic was fine for a week and again got 101 to 104 temp again, was said it was sinus and given antibotic again, after 1 day of no antibiotic again has 104 temp. What can this be?",
    "doctor_response": "Hi... by what you say I feel that your child is going through a recurrent viral illnesses.I will explain you how a viral illness behaves so that you can be more confident.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.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain while breathing?\n\nI want to know what is happening to me- I have this issue where a few times a week, the general area where my heart is experiences a sharp pain when I take in a breath. It lasts for about two seconds, and the pain is pretty extreme and for that amount of time, I am unable to breathe. I have not gotten myself checked yet. Do you know what this could be?",
    "doctor_response": "HI, thank you for using HCM!I would say such sharp and short time pains are not dangerous. This pain is not related to the heart for sure. There are some reasons like muscle spasm, rib joints inflammations (costochondritis), pleural rubs caused by the flu, rheumatoid arthritis, etc that can cause that kind of pain. Sometimes is not found any disease at all. However if this symptoms continue to disturb you often you may do some simple examinations including blood count and a chest x-ray at your healthcare center.All the best for you!Dr Eriol.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the itchy marks on my body that are round, raised and red?\n\nI am a 60 year old female who just returned yesterday from visiting relatives in Florida. I have some bite marks on my body. I did not go near the water or to the beach. My husband and I slept in the same bed, belonging to my granddaughter, and he has no bite marks. I have no allergies that I am aware of. The bites are scattered, 2 on my leg, 2 on my neck, my arm. my foot. They itch and are round, raised and red.",
    "doctor_response": "HIThank for asking to HCMIf the red markings are not all over the body and it is just one or two then this could be insect bites, if you do not have history of any allergic condition then this would be insect bites only, you can apply some soothing agent for this and the best medicine is \"Diphenhydramine\" lotion is the best choice have good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could my teeth extraction cause dizziness and upset stomach?\n\nHi, I am 40 years old. I extracted my tooth on my lower jaw next to my wisdom tooth yesterday morning. Early this morning I woke up feeling very dizzy and with a upset stomach.It's been 7 hours and when I lie down the dizsiness get worse. Augmentin was prescribed to me which I took yesterday but not today because of how I am feeling. I have never had any problems with Augmentin. Could my tooth extraction be the cause of my dizziness.",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. As you are mentioning that you got your tooth extracted and after that you are feeling this stomach upset, but the extraction does not causes these kind of symptoms, it can be because of augmentin only, or it can be the combination of painkiller which is prescribed with augmentin. It will be better that you should visit the dentist and get the medications changed.Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for anemia?\n\nHi there, I am severely anemic and have been for a while now, I have stomach pains after eating and they last all day. I have had a colonoscopy, ultra sound, capsule endoscopy, endoscopy, and a ct scan. And my doctor cant seem to find out what is causing my anemia, I was taking iron pills but have now stopped because it is really hard on my stomach, i am now getting iron injections. Any ideas what could be causing this? I have low energy, iregular heart beats, low blood pressure, light headiness, i would appreciate your help very much, thankyou.",
    "doctor_response": "Hi,Sorry to hear about your condition. Have you checked your thyroid harmone levels?That might explain many of your symptoms. Could you let us know your age as that has a bearing as well. All the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can one intake medicines for cough before an endoscopy?\n\nHi, I am to have an endoscopy on Monday, I have at present got a cough and a sore throat, this is handleable using common of the shelf remedies. I am sure i can go without any medication ( I am not coughing up infected phlegm but some clear phlegm ) for the six hours required but may start to cough a little during the process. Do you think I would be aright to go ahead with the proceeder. I really want to have it done as I am going on holiday the next day and don t want to delay my exam any longer than possible. thanks Doug.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Possibility of viral upper respiratory tract infection (URTI) is more. And it will mostly heal by itself in 5-7 days. So if you can manage your cough without medicines then no need to take drugs. But if you want to take cough medicines, you can take. No harm in it. This won't interfere in your endoscopy. So if you don't have much cough then no need to take anything. Also do following things for better and quick relief in URTI. Drink plenty of fluids orally and keep your self hydrated. Do warm water gargles 5-6 times a day. Avoid oily and spicy food. Take sound sleep of 6-8 hours. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a hematoma between the shoulder and neck be treated?\n\nI have a big hematoma between my shoulder  and neck. It was firm now I'm feeling liquid build up in it. What can I do to help it. I'm in some pain.  How i got it had a big fatty tumor removed 2 months. A huge hematoma formed ended up at Er twice. Had a drain tube. Went back to surgery to remove it with draing tube. After 1 week the hematoma is back but not as big. Removed tune Monday and now 2 days later I feel liquid build up. What shall I do?",
    "doctor_response": "Hello,The hematoma formation post surgery suggests compromised bleeding control during surgery or secondary oozing after surgery from various reasons. Primary care with - Ice-application. - prescription of antibiotics and anti-inflammatory medicines with your family doctor. - Discuss the need for repeat surgery. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a lump in a child?\n\nMy son is about to be 9 months. 3 days ago he fell off my sister s bed which is about three feet. We took him to the hospital and they said he was fine, just a bruise. Today I noticed a very large lump on his head about two finger spaces from the bruises. This lump has not been there until today and is very soft. Feels like there may be fluid. I m very concerned should I take him to another doctor to be checked out?",
    "doctor_response": "Hi...this seems like a subcutaneous hematoma which is now getting into healing. It will gradually get absorbed by itself. Nothing to worry.NO need to get checked unless there is -Vomiting continuously/ Seizures/ Watery of bloody discharge from ears and nose/ Unconsciousness/ Altered sensorium or behaviour.  Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes puffiness and pain on the arm after inserting IV?\n\nMy 19 year old daughter had an iv in her right arm, after a few days it is still puffy and she cant straighten her arm witihout it hurting terribly. she goes to physical therapy and cant use it fully either, and they suggested she have it checked. her right leg has started to hurt as well, what may be causing this?",
    "doctor_response": "Hello, The symptoms seem to be related to side effects of the iv injection. I suggest using cold compresses at the area of the pain. I also suggest maintaining the arm elevated. I suggest using Ibuprofen to relieve the pain. The symptoms will go away gradually. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the chance of passing the structural birth defect in my hand to next generation?\n\nHello doctor, I was born with a structural birth defect where my left hand is completely deformed. My left arm is normal from the wrist and above. I would like to know if this defect is hereditary if I try to have a child. What are the risk for me as a father passing any defects to my future children?",
    "doctor_response": "Hello. I can understand your concern. It will be of great help if you can send me the picture of your deformity. I will be happy to help you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do you suggest for a bleeding penis while erect?\n\nafter having sex with my wife few days ago i went to the washroom and notice blood Im also having burning when having a pee 2 : hrs ago I was romancing my wife I had an  erection then I felt something running from my penis I check and it was blood I have a  appointment for wed. Feb. 19th with a uroligist  What should I do",
    "doctor_response": "himy first impression is do you had sex while your wife was in bleeding phase of menstruation?and secondly, i think your foreskin may be to tight to retract back leading to injury while errection.anyway come back and share what the clinical examination revealed.take care and feel free to contact  anytime and manytime.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can psychotic behaviour be managed?\n\nMy son is 42. He has mental illness and gets an injection of Haldol once a month. He went out and did a lot of meth as he has not slept in days. He has a history of meth use. Anyway, he is becoming psychotic , talking to self and people who are not there. He needs to sleep. He has Benztropine which I keep for him. Would one make him go to sleep??? I think he has been up for about 4 days",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Meth is a stimulant and causes insomnia. He needs to be detoxified. Once better make sure he joins some counselling sessions. Benztropine is prescribed for side effects which are caused due to Haldol. It will not aid in sleep. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated immunoglobulin while having polyp in sinus?\n\nI always have a hive(s) on my face, jawline, or scalp.  I've had allergy stick tests and blood work for food allergies. The testing was ordered because I developed a polyp in my sinus cavity.  Everything came back just fine, except that my immunoglobulin (spelling??) was slightly elevated-120 units.  It was suggested that I see a specialist for further testing.  When I went off my zyrtec for the allergy testing, I noticed even more hives.  Any thoughts as to what else could be going on?",
    "doctor_response": "HI, thanks for using healthcare magicIt would be best to see an allergist for additional testing. You may also want to expand the profile to include other types of foods, environmental allergens and medications.It is possible that your symptoms may be related to chronic urticaria- the recurrence of hive/urticaria for 6 weeks or more.There are a number of different possible causes including(1) physical causes (pressure,cold, sun, water, heat, exercise, pressure to the skin, stress),(2)associated with other illnesses- lupus, thyroid disease, infectionWhen you are reviewed by your doctor and additional testing done then it is possible the cause may be found.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which contraceptive pill is recommend for adult acne? Is Yasmine safe to take?\n\nHello Doctor, I m wondering what contraceptive pill you would recommend for adult acne? I used to take Yasmine and it worked for my skin. I agreed with me from a hormone perspective also I felt fine no mood swings etc... the only issue was I retained allot of fluid and put on almost 20lbs. Do you think Yasmine lite would be a better fit?",
    "doctor_response": "HIThank for asking to HCMI if you are male person then no need to take any contraceptive pill because nature has given best contraceptive method and that should be enough for them if you are going to take any of contraceptive pill which are taken by the female then you would face the great trouble, hope this information helps you, take care and have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe knee pain\n\nHello Doctor, I am 35 years old. I have diabetes which is under control with medicine, and BP under control with medicine. I got a knee pain recently. The pain is on my left knee only. I have shown to doctor he is telling it is knee instability. And prescribed a lot of medicine. what I have to do. He has given me to ice pack therapy how to do that.",
    "doctor_response": "Hi thanks for you query.I have gone through case history provided by you.You have complains of knee pain only?? No complains of giving way or not able to bear weight on that limb?? You need better evaluation by orthopedician. Needs better evaluation in terms of radiograph and MRI. MRI will be able to show cause of instability if there.better clinical evaluation is the key. Best luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent fever along with ear infection and sore throat?\n\ni have a five year old boy, who is on day four of fever between 99.7 to 104.00 pink eye symptoms, ear infection, sour throat. he has also had loose stools for two days, he also has headaches. i have taken him to Dr twice . He is on amoxicillin 400 mg/5 ml s he is taking 9.5 ml twice daily for ten days. He is also taking Tobramycin 0.3% in eyes one drop every 4 hours. also he is taking ibuprofen 7.5 ml every 4 hours , he has been on these meds for four days why is he not better?",
    "doctor_response": "sore throat, conjunctivitis, fever with headache, and according to the age of patient three diagnosis can be possible, measles , malaria or simple upper respiratory tract infection. 1. check for any rash , if present it indicates measles2. do blood test thick slide test for malariaeven after 4 days of antibiotic therapy symptoms are not subsiding, I recommend above mentioned tests.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have night sweats after undergoing knee replacement?\n\nGood evening. My dad is 67 years old and had a full knee replacement 7 weeks ago. Hw saw the surgeon after 6 weeks and was told he was doing better than most after 6 weeks, however he forgot to ask about the major night sweats he is having. Is this normal?",
    "doctor_response": "Hello, As your father is doing well after the TKR I will advise for the knee replacement rehabilitation program for best outcome score. Regarding the sweating in the nights, this will be due to other factors like the healing process, past medical history of diabetes or Hypertension. Please see that the sugar levels are fair and blood pressure is not too rise or dropped. This is some of the possibilities which happen in aging. It can be controlled by medication post examination. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden outbreak of red lumps under the jaw line?\n\nHi. I m a 35 yr old male and have suddenly started to get large red lumps and sores under my jaw line. I m taking vitamin d supplements and inner health once a day.. They have become quite painful and have had a course of antibiotics and cream but no relief. It s been 2 weeks now Bh",
    "doctor_response": "Hi, If I were your treating Doctor for this case of a jaw lumps, I would come up with three possibilities: 1. lymph nodes: could be due to viral infection, tuberculosis, malignant or just normal!2. infection of salivary glands could be due to dental problems3. benign and infected cystsbefore taking any medicines, please first confirm the reason:I suggest you to go for an FNAC test of the lumps for confirmation and to relieve your concerns!Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headaches, body aches, sore throat and nausea?\n\nMy son went to the dr. had a strep test and flu test both negative was told it was a cold virus. He has fever almost 104, headaches, body aches, puss on back of throat, sore throat, nausea. another dr said it could be strep and gave him antibiotics he does seem better but, says that he still feels funny and he is still running fever",
    "doctor_response": "hithanks for using hcmthis looks like he is suffering from viral infectionanyways antibiotic one course can help to reduce the secondary infection viral infections  can cause lot of immunosuppression,during their course, but most of them are self limiting from duration of 2 to 3 weeksmaintain good hydration statusplease give good nutritious diet,to prevent the weakness.take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Cannabinol Hemp Oil safe for severe arthritis and permanent nerve damage?\n\nI have permanent nerve damage in one hand and severe arthritis in the other. I also have depression. My current drugs are wellbutrin, cymbalta, and either nucynta or oxycodone. My doctor told me I am a great candidate for medical marijuana but my state does not have it in place yet. Is it okay to take CBD - Cannabinol Isolate Hemp Oil Herbal Drops (100 mg) while I am taking my regular meds? Drug interactions? Side effects?",
    "doctor_response": "Hi, It can help with pain but complete recovery is not possible. It is better to consult a neurologist and get proper treatment rather than going behind alternatives. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pleurisy and ribs agony\n\nBeen sffering 5 weeks now with pleurisy and ribs agony - had a scare of bllod clot from gp blood test but hospital came back no trace - has left me not knowin qhat to belive - now have started with aching legs and lymph gland under arm !just want to get better- I am 40",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Most common cause for pleurisy is lung infection. So in my opinion, you should get done chest x ray first. If chest x ray is normal then no need to worry much. Do following things for better symptomatic relief. 1. Start painkiller and anti inflammatory drugs like ibuprofen or acetaminophen. 2. Apply warm water pad on affected areas of chest.3. Drink plenty of fluids orally and keep yourself hydrated.4. Avoid movements causing pain.Don't worry, you will be alright with all these in 1 week.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does metacarpal swelling take to heal?\n\nI have a small amount of metacarpal swelling on the outside of my hand at the base. It feels solid like bone as opposed to swollen and is causing the vain on top a small amount of inflammation. What are the chances of the swelling reducing to its pre swollen state?",
    "doctor_response": "hi. i suggest you to take some analgesics, anti-inflammatory and ice packs application for 3-5 days. usually it will subside but if not then go for an xray and consult an orthopedician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes irregular heartbeat?\n\nHi, I am trying to establish what may be causing an irregular heartbeat. I have had the condition for a couple of years now and have consulted my cardiologist and GP at various times on the matter. A halter monitor test was undertaken and while some irregular heartbeats were seen, they did not seem to concern the cardio much. He did offer me a low dosage of Lanoxin ( I think that is what it is called) only if I felt the need to take it. At this stage I have not taken it but am taking an aspirin a day as a blood thinner. I am on a blood pressure tablet and on average my BP is 122/85. The irregular heartbeat can happen at any time and can last for days at a time on and off. What could be causing it and is there a permanent remedy to stop it? Thanks A Little Concerned.",
    "doctor_response": "Hi welcome to hcmI understand your query and concern.Persistent palpitations in your case are suggestive of any arrhythmias of heart which means abnormal conduction abnormality of heart.I advise you to get an ECG,2 D Echo of your heart immediately to confirm the diagnosis.I also advise you to get lipid profile,complete blood picture,chest x ray immediately as a part of routine check up.Drugs like Amiodarone,Betaloc,Pantop 40 mg will be helpful in your case.Avoid stress and anxiety.Avoid smoking ,alcohol,fatty foods.Abnormal lipid profile if present in your case should be treated with atorvastatin.Monitor blood pressure and heart rate immediately.EP study and radiofrequency ablation will be the procedure of choice.Consult your cardiologist for expert management.Post your further queries if any,Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I get infection through open wound?\n\nHi, i work as a chef and recently cut myself at work, cleaned myself up and put on a sterile glove as usual as i have a first aid qualification, however i then went to the toilet as i was feeling a bit sick and light headed, as often happens after a close cut! The bathroom was in a state and hadn't been cleaned so i decided to change my glove and then wash my hands in the kitchen, i have since been told that i must wash my hands in the bathroom, surely this is risking contamination and infection? Many thanks Joe",
    "doctor_response": "Hi,There is no problem washing your injured part in bathroom as you have not to touch washbasin or other stuff which are likely contaminated.Simply wash your hands with antiseptic lotion or soap.Washing in kitchen is again dangerous as this night contaminate food causing serious problem to your customers.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain and dizziness?\n\nI am. A 19 year old female with back pain sometimes im dissy and feel like I have to throw up especially when I get hungry. My stomach sometimes gets in knots even if my cycle isnt coming yet. And everyone in a while I think I feel like something is moving in my stomach. I take a pregnancy test like every other week and it comes up negative ive been getting my cycle every month. So idk what it could be. What does this sound like?",
    "doctor_response": "Hi, thank you for posting!I have gone through your query and I understand your problem.According to what you have said above, I think that you suffer from adnexitis, which is an ovary and fallopian tube infection. This condition causes hormonal disorder, which also causes the vomiting and dizziness. The back pain comes as a result of the infection.In order to find the right diagnosis, you need to do the following:- Clinic examination- Gynecological examination- Abdominal ultrasound- Complete blood count- Urine testThe results of these tests will aid in determining the right diagnosis and treatment.Of course you have to contact your gynecologist to discuss more about your condition.Feel free to ask for anything unclear.All the best,Dr. Behar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trembling, shaking arms on coughing, twitching eyelids. On BP, cholesterol medication. Treatment?\n\nI m a 41 year old female 5 8 , sedentary lifestyle and 250lbs. On blood pressure meds and cholesterol with good results. When I cough or raise my arms (or voice) both arms tremble and shake. Sometimes my eyelid twitches too. Never lasts for more than 30 seconds. Slight pain on the right side of my neck. What s causing this nonsense?",
    "doctor_response": "Hi,Thank you for posting your query.These disturbances are due to changes in autonomic, mainly the sympathetic nervous system.On coughing or with other activities as described by you, there is release of sympatho-mimetic amines, which can cause shaking and eyelid twitches.There is no need to worry about them.I hope it helps.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe cramping in abdomen and what is the moving sensation around abdomen?\n\nI believe i have a tapeworm because i have white tissue and slimy discharge all over my stool and a little pink meaty looking slime in alot of it. And i have severe cramping in my abdomen and really fatigue. And a little blood also. I do eat beef medium rare but i am not going to do that anymore. And i also found out i have 2 cyst on my ovaries. I feel something moving aroung in my abdomen like a baby wiggle sometimes and i am for sure not pregnant. Its very nasty looking and smells weird. What can i do about it and or is there something else that could be doing this with my balmovements? Tiffany",
    "doctor_response": "Hi. The sure way to diagnose the problem is to test the stool at least on three occasions. Consult a Doctor about this , who would give you an antibiotic course for nasty looking and weird smelling stool. The feeling of something moving can be a reaction of the intestine to the infection or infestation. Your Doctor may prescribe a medicine for tapeworm too.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat UTI with abdominal pain and burning sensation?\n\nIm a female age 33, for a month been dealing with what I think is a UTI, still hawe a burning, but not while peeing, low abdominal pain and stabing in abdomen and down inside, sometimes pain radiates down my legs, is this a UTI? Im going to see urologist in there days. What to do? Thanks.",
    "doctor_response": "Hello,Welcome to HCM,As you are having symptoms of pelvic inflammatory diseases (PID), the cause for the symptoms should be evaluated by physical examination and laboratory investigations.By identifying the causes for the present symptoms then we can decide the further course of treatment with antibiotics and antispasmodics.As you have a planned to consult your urologist, the causes for the symptoms will be identified and rectified appropriately.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does hard lump on edge of anus indicate?\n\nI am 27, I eat really healthy and workout 5days a week. Over the last few days I have noticed discomfort around the edge of my anus. Its been a few days since I first noticed this. And now there is a small hard lump on the edge of my anus I'd say about a 1/2-1\" in size.  It is an annoying Pain. Not really very painful but yet notice it throughout The day. Just wondering what this could be and if a doctor visit is required.",
    "doctor_response": "Hello!Thank you for the query.The lump is most likely a hemorrhoid. Due to increased blood pressure in the veins of this area (workout can cause it), the veins get enlarged. It can cause visible lump attached to the anus verge, pain and itching. Bright red blood on the surface of the stool can also appear.This condition is not urgent, however it may need surgeon consult. Please note that it wont disappear by itself. Surgery is necessary to get rid of it.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it dangerous to have sexual intercourse with a heart problem?\n\nHello doctor, I and my partner have two children. I am 33 years old and she is 32 years. Over the past four or five years, our sex life has almost completely fallen apart. I have several heart issues, right bundle branch block, bicuspid aortic valve, patent formen ovale and high blood pressure. Right now it does not seem they are major issues but just monitoring them. The other night we had sex and I got heart palpitations severe in my throat which was odd but I do not know why. However, her sex drive is very low now and she says she is always tired. She considered hypnosis to change her sex drive but I do not know if that works. Our biggest issue is our 10-year-old daughter, even if we get her to bed at 8 PM she will not go to sleep until midnight and we are too tired then to have sex. Any suggestions?",
    "doctor_response": "Hello,  Welcome to icliniq.com. I got your concern. The main issue in both of you is fear, you being a heart patient keeps on having fear which you actually do not have consciously but subconsciously this fear is there. And if these kinds of things when the partner comes to know or if she used to be worried about your health, this fear of doing any thing with you let her desire decrease. And both of you started having mild depression also which is causing both of you tired. But I assure you that with this activity you will not be having any problem. Both of you need to do some regular relaxation exercises and some meditation. And both of you are not old enough that your tiredness cause problem in your personal life. Take some break from your work and spend some time together with free minded without any hurry or work stress and try to feel cheerful and confident that we are young and well even when you do not feel so. I promise that these few steps will add freshness and happiness in your life and if there will be no improvement then I would like to start you on some mild antidepressants. But until that time you please follow these steps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could tightness in chest with pain suggest?\n\nI feel a light pain, tightness in the centre of my chest when sitting down, doing nothing. As soon as I move it goes. I am 63, never smoked, still play sports and eat healthy food. Had similar pain a year ago but it disappeared after a few days. I am 6 ft tall weigh 13 st apx. No other symptons and sleep well.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, you are mostly having musculoskeletal pain because your symptoms are associated with specific position. But better to rule out cardiac chest pain as you are above 60 years. So get done ecg and 2d echo first. If both are normal then no need to worry for heart diseases. Sit with proper back and chest support. Avoid heavyweight lifting and strenuous exercise. Avoid sports for few days. Avoid bad postures in sleep. Apply warm water pad on affected areas. Rake simple painkiller like ibuprofen. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why fever, cold and cough is recurring in child after treatment?\n\nDear Doctor, my 6.5 years daughter is having fever, cold and cough since one month. Went to doctors multiple times, with their medicine, it was normal for few days, again it repeats...after two weeks, they did CBP, CRP and Montoux. CBP and Montoux were normal but CRP test which shows 26(actuals are 0 to 5), so doctor suggested for anti biotics for a week. After that course, she was normal..but after four days, the same situation. we went to other doctor, he did CBP, ESR which shows normal results. but he mentioned some lungs issue is there in chest xray. Asked to go Alergy Panel Test. Not able to understand what to do....can any one please suggest us. she is on tegrital syrup.",
    "doctor_response": "HI...greetings from Chennai...by what you quote I feel she is landing in recurrent viral illnesses and as it is associated with cough always it could also be a viral associated wheeze too. I have a few questions for you -Questions:1. How many days per month does she cough or feel breathless?2. How many nights per month does her sleep get disturbed due to above symptoms?3. Does she feel breathless when she runs around or plays with other kids?4. Are the symptoms when there are seasonal changes?5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?6. Is the cough always associated with fever?If your answer is yes for any of the above questions, your kid might be having viral associated wheezing or multi triggered wheezing and I suggest you meet a paediatric pulmonologist who is near your place. No point in using antibiotics every time. It will do more harm than good by increasing bacterial resistance.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat loose motion and vomiting in infants?\n\nMy sister son is in 12 th month he has 4 teeths on top and bottom , problem is for past 8 to 9 days he is suffering with loose motion and vomitting and he is admitted in hospital but no improvement till now given trips ,and he is not drinking water now he likes only well boiled rice we are really scared on his condition , From his 4th month he started drinking awin milk , plz suggest me",
    "doctor_response": "Should be ruled about any intolerance to milk and milk to be avoided along with other medications based on the culture report.probiotics like Enterogermina and zinc supplements to be added.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bloating and reflux after gallbladder removal\n\nI had my gallbladder out about a year and a half ago and since then I Still suffer with nasty reflux, about three days ago I got really bloated and my reflux kicked in again , then  my chest in betweenbreasts hurts everytime I eat or drink anything do you have any idea what is going on?",
    "doctor_response": "Hi.Thanks for posting query at HCM. You maybe familiar with the common mechanism of gastroesophageal reflux disease (GERD) ; however i will briefly explain:Food enters in to stomach from esophagus via lower esophageal sphincter (LES) . If LES fails to close/contract effectively food content from stomach may reflux into the esphagus leading to GERD.Certain food may lead to relaxation of LES and/or increase gastric acid production. :1. chocolate 2. caffeine.   3 Alcohol.     4. fatty meal.    5. citrus fruit and tomatoIf you have a history of GERD that has been treated successfully , then advise is:1. avoid chocolates; carbonated drinks,2. avoid tomato juice, decrease salt intake3. minimum alcohol intake and try quit smoking ( if your a smoker)4. eat your dinner at least 2 to 3 hours before going to bed5. raise your head by placing two pillows under your head before sleepingHope to answer your concern Further questions are most welcomeRegardsDr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shivering of hands along with pressure in chest and diarrhea?\n\nMy hands have been shaking for the last hour, when i sit its not so bad, when i stand i can barely hold myself up. I don t black out like im going to faint. I have breathing problems prior to this but I now have pressure in my chest. And my stomach didn t hurt till just now and I got like instant diarrhea.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Tremors, chest tightness, unexplained diarrhoea, breathing difficulty etc are commonly seen with carcinoid syndrome. It is due to hypersecretion of histamine. So better to consult physician and get done clinical examination and blood reports like histamine levels, ultrasound abdomen, stool microscopic examination etc. You may need antihistamine drugs to control these symptoms. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes delays and a brown discharge in menstruation?\n\nhi, I m 25 years old and married. I am 18 days late period for today. and brownish discharge is there when I wiped at the bathroom. Its too little and some times little blood is there. I have taken 4 home pregnancy test for last 2 weeks and all came negative. am I pregnant? Please help",
    "doctor_response": "If your tests are negative then chances are very very less that you are pregnant.  maybe these brown discharge is indicator of start of periods.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does third nerve palsy have same symptoms of MG?\n\nCan the third nerve palsy have same symptoms of MG?? Two years ago had thymus cancer surgery after chemo and radiation after surgery. How they found my cancer I was having MG symptoms with my eyes chewing and breathing and with a CT scan. I have done great for two years pet scans ever 6 months have been good so now I am having trouble with my eyes the eye doctor said third nerve palsy did a CT scan and a CT scan with contrast to rule out brain tumor and aneurism they came back good. Due for another Pet scan in May. The thymus was removed so I do not know were to go from here!!!",
    "doctor_response": "Dear patient 3 Rd cranial.nerve also known as opthalmic nerve supplies eye muscles. myasthenia gravis affects skeletal muscles of whole body and not only eyes. Symptoms of both are different. thymus cancer is associated with myasthenia gravis  so treatment of thymoma  may lead to correction of MG. you need to consult opthalmic surgeon for detailed assessment. Visit to neurophysician is also required.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any side effects of taking Cypionate?\n\nI took cypionate twice (1cc each 100mg) but have been reading about all the Ill side effects. From unfertile sperm, testicle shrinkage, and bad cholesterol. I threw the remainder of cypionate away, and discontinued use. Can I expect any of the Ill side effects from just the two injections? Male/35 cypionate was for personal use.",
    "doctor_response": "Hello, Every medicine has it's side effects and benefits as well. I want to know why are you taking this medicine and what was the purpose of taking this medicine, if it is advised by the doctor or not. Don't take it on self-prescription as it has many side effects ranging from headache, gynecomastia, testicular pain and erectile problems. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. SAMEEN BIN NAEEM, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could swollen sinuses be due to bleach or chlorine allergy?\n\nMy sinuses swelled up so much the doctor prescribed oral steroids.  I just had had a root canal.  The dentist put straight bleach in my tooth to disinfect the canals before he capped them.  Also, I had swam in a highly chlorinated pool the weekend before.  Is it possible, I'm allergic to bleach or chlorine that's why my sinuses became so inflamed?",
    "doctor_response": "Thanks for your query, I have gone through your query.The swelling over the sinus region can be because of the two reasons, it can be because of the endodontic flare up following root canal treatment or it can be a allergic reaction to the sodium hypochlorite or hydrogen peroxide. Nothing to be panic, You can take a course of antibiotics like amoxicillin 500mg and metronidazole 400mg tid for 5 days (if you are not allergic). Along with antibiotics, you can an analgesics like diclofenac 50mg BID for 5 days. To be on the safer side, instead of steroid you can take an anti histamine like cetrizine twice a day for 2 days. If the swelling does not reduce in 2 days, consult your dentist immediately.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for the pain in the back of the head close to the neck?\n\nI have been suffering for 3 days now pain in the back of my right side of my head close to neck to above my right ear like blood vessel spasms comes and goes at times every few seconds especially at night or early morning. i drank hot water boiled with raw fresh ginger and i massage with peppermint oil. ibuprophen i took once did nothing, took excedrin extra strength once gave me tummy ache i took aleve 2 to last 12hrs helped a bit today during the day but now back to pain again I have no medical coverage and just applied on 12/23/13 to obama care but waiting for medical to call me Please help...from Ms. Tony     YYYY@YYYY",
    "doctor_response": "Hi I am Dr Ramez Mohammed.I had gone through your question and understand your concerns. Maybe you suffer from inflammation of the origin of the cervical muscles or some of the muscular tension. I suggest you take an anti-inflammatory and extender of the muscles and a topical analgesic with warm compresses work before going to sleep to give you some rest and relaxation and painkillers only when necessary in order to avoid stomach ache. I hope you work on the x-rays of the cervical spine and display them on your own doctor. Hope the above information helps you. Any further clarifications feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for scrotum to be swollen?\n\nI woke up the other morning and my scrotum was swollen with fluid about the size of a large orange. It lasted until the next morning. i am 57. A week later my lower lip swelled includinjg the tissue down to my chin. It also lastyed 24 hrs. i took Benedryl and it seemed to help.",
    "doctor_response": "Hi,From history it seems that this can be due to allergic reaction due to something bite or having some food allergy.Try to find out allergen causing this.Take Benadryl or Cetrizine for 2-3 days.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest diet restrictions for elevated SGPT and SGOT levels\n\nI workout regularly I built up good muscles but I take marijuana as well as normal isolate protein supplements. My sgpt is 165 and sgot is 76. Please suggest me a proper diet and what not to take during liver issues. I am losing my muscles day by day getting weak I feel dizzy and tired all the time.",
    "doctor_response": "Hello, Raised SGPT is seen in fatty liver disease or alcoholics or excessive exercise also can elevate SGPT levels. Diet modification are: 1. Get more vitamin D. A damaged liver allows SGPT to seep into the blood. According to a recent study, vitamin D prevents liver damage, which aids in reducing SGPT levels \u2013 those with high levels of vitamin D are less vulnerable to liver disease than those with low levels of vitamin D. 2. Eat a nutrient-rich, plant-based diet. Eating organic foods help regulate the liver, allowing it to cleanse itself of toxins and create new cells to stop the leakage of SGPT into the blood. 3. Avoid high fatty foods which may lead to accumulation in the liver leading to decreased function of it. 4. Avoid foods high in salt or sodium.Excessive amounts of salt in the body, especially in the liver, cause swelling and fluid retention. This makes it harder for the liver to filter waste. 5. Last but not the least STOP alcohol intake, avoid marjuna consumption they may damage the liver. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Feliz have any side effects?\n\nHi, may I answer your health queries right now ?  Please type your querydue to nocturnal panic attac , i have consulted the doctor and he priscribed for epitril 0.5 and feliz s 5 , if i stops using this it will sart again , now he gave the feliz s 10 m . i am using this from last 3 months , is there any side effects for that . hight 5.7 , weight 81 here...",
    "doctor_response": "u have been prescribed feliz 10 mg and epitril 0.5 mg for your nucturnal panic attacks.. feliz is a brand of escitalopram which is a very safe antidepressant SSRI medication.. as a rule every medication has its side effects and so with feiz..common side effects upon starting it may be some gastrointestinal disturbances like feeling of nausea, epigastric burning, acidity, dizziness, sleep disturbancies, yawning, dry mouth etc.. but these side effects disappeares with regular use of the drug..according to my understanding u r interested in knowing the long term n serious side effects of escitalopram..there are chances that u may have decrease sexual desire, delayed ejaculation of semen during sex, very stiff rigid muscles, high fever, difficulty walking, tremors, drowsiness. it can cause hyponatremia due to SIADH [syndrome of inappropriate antidiuretic hormone secretion] symptoms of which are muscle cramps, rigidity, confusion, delirium ,disorientation.it also increase the bleeding risk when taken with drugs like aspirin n N-SAIDS it can cause harmful syndrome known as serotonin syndrome when taken with other serotonergic drugs like SNRIs, MAO inhibitors.so these r the serious side effects but they are not very common so u shudnt bothering about these.. take medications they are more beneficial then harmful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful leg and uneasy feeling while standing?\n\nHi, my name is lola. I have uneasy pain on my right leg starting from my calves down. A little bit of swelling on my carves. I cannot stand a long time without stretching it out. Uneasy feeling while standing. I have been massaging with muscle cream. Please I will appreciate your response",
    "doctor_response": "Hello, As a first line management, you can take analgesics like Paracetamol or Aceclofenac for pain relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with prostate cancer initial stages. Underwent radiotherapy. Passing stools with blood. Suggestions?\n\nMy hubby was diagnosed with prostate cancer in its early stages, he underwent radio therapy for six weeks, between April 2012 and August the same year. He never experienced serious side effects while on treatment except lack of sleep, sweat and feeling tired all the time, which he still does to date and sometimes hard stool . He is now experiencing blood in the stool every time he goes to the loo and sometimes feels passes on soft stool with blood. Is this normal after Radio?",
    "doctor_response": "Hi, actually this may  happen to some patient. radiation to prostate also has chance to radiate some portion of rectum and can lead to radiation proctitis. this is not always alarming. most of the time it is controlled by simple conservative measures. please consult your radiation oncologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can I treat the white pimple on my tongue?\n\nHi doctor,I am 49 years old and have this white pimple kind of thing on my tongue (left side) since quite some time (more than two months). It is not causing me any symptoms or any discomfort. I also have not noticed any increase in size or any other changes. I do not drink, smoke or use tobacco. Hoping to know what it is and remedies for it.I am attaching a picture of the same (the spot is circled in blue in the picture attached). Is it anything to worry? I would wish to also know what exactly it is. I have read that it could be tongue cancer. Hence, I am a bit worried. Hoping to find some answers. I do not have any symptoms such as burning, pain, etc. I also had gingivitis in the past two months which has been controlled by the use of Chlorhexidine mouth wash and dental cleaning. I have never used tobacco or smoked. I just wanted to know if it is anything serious. Also, could you suggest ways to get rid of it? Sometimes, I do feel a little pain or sensation but it is very very minor almost unnoticeable. Also, I want to know why it is not going away for some months.",
    "doctor_response": "Hi. Thanks for the proper detailed history and the appropriate clinical picture (attachment removed to protect patient identity). Since you are not a tobacco or alcohol user the chance of oral cancer is ruled out. Now a few types or differential diagnosis are left. Lie bumps: These are whitish or slight reddish bumps on the tongue that are like 0.5 mm in width. Their cause of occurrence is still under research and they usually go away if you put Chlorhexadineor Metronidazole oral gel on it three times a day for two weeks. Ulcer: Bumps due to folic acid or vitamin deficiency, or any underlying systemic disease like skin disease of psoriasis, or diabetes, etc. Please tell me if you have any? If this is the case, I would suggest some medicines for it. Now, I will be waiting for your reply in case of a second option. If you are having only the first option, then start using oral gel for a week. Watch out for the size of the bump. Is it increasing or regressing? Give me its followup picture after three weeks. If it will regress then good otherwise we will change the treatment plan. Stay happy and blessed. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest possible treatment for Asthma\n\nI've had asthma for many years.  Tapered prednisone normally works very well. i am having severe trouble breathing for the first time in about 6 years and the prednisone isn't working.  had negative chest xray.  this is my second, higher dose series of roids in a week and i dont feel a change.  do i head to the er?",
    "doctor_response": "As per your complaint of asthma you should consult a pulmonologist and sholud do pulmonary function test PFT , to diagnose asthma. For asthma treatment you should taper steroids after consulting your doctor.Get well soon...",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe pain in the hips be treated?\n\ni have extreme pain in my hips when i try to walk.. i can only walk about 2 city blocks before i get a shooting pain in my left or right hip, along with my left leg shooting needles all the way down my leg, then it will not support me for the next steps,, i have seen the VA for the past 4 years, had upper thoracic and lower lumbar injections, and a bunch of mri cat, and x-ray,, but no one seems to be able to find out why or relieve my pain.. what am i suppose to do?",
    "doctor_response": "Hello, The location and movement of a pain gives clues as to what is going on, and it can be the outside muscles (which should be obvious), or the hip joint (standing on one leg and other stresses on the joint would hurt) or a lumbar disk (yanking on the nerve by extending the straight leg up or sitting the wrong way would indicate this). Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shaky and weak after walking outdoor?\n\ncame in from out side & started feeling shaky, weak & sat down, then I went into a sweat. lasted quit awhile after drinking water, eating a banana, stomach started burning, burn has lasted for 2 hrs now feel weak & sick feeling. BP was 106/65-P-75-80",
    "doctor_response": "You should get the fasting blood sugar level done by glucometer. you are suffering from recurrent attacks of hypoglycemia which may be secondarily to the diabetes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen testicles\n\nMy 17 year old son was playing football and got his testicles pinched after being tackled... he said they were swollen and black. according to him the black has gone away but they are still swollen and this happen last friday night... what do you do for this?",
    "doctor_response": "Hello,It may be due to several causes. For that you may require ultrasound scrotum after consultation. Further treatment mainly depends upon the underlying condition. For pain you can take tablet acetaminophen.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, unable to. Hysterolaparoscopy done. Normal semen test. Causes for infertility?\n\nhello doctor,i have undergone diagnostic hysterolaparoscopy on 19/7/2012. Doctor said everything is normal.i dont have pcod, endometriosis .my uterus,b/l tubes , cervix ,cervical canal,b/l oshins are normal. My husband s semen test results shows normal result. i didnt conceive since 2008(after my marriage). What is the reason for my non-conceivement. we are living together.",
    "doctor_response": "Hi, Thanks for query, You have not mention about your age as well as about your menstrual period. A normal 28 to 32 days period is required for fertilisation to occur.If it is irregular the chances of conceive reduces as you may not have sex when ovulation occurs. Usually in a normal 28 to 30 days cycle ovulation occurs on 14 th day.So middle 10 day is important for conceiving.So don't forget to go for intercourse during middle 10 days.That will increase you chances of conceiving. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest precautions need to be taken post surgery in L1 to L3\n\nI am a 20 year old active male that recently had a compression fracture of the Lumbar 2 vertebra and had surgery placing 2 rods screwed into L1 to L3 to stabilize the area.  I'm already off pain meds and just went back to work this past week.  I am in a back brace for the next 4-8 weeks. My doctors restrictions are nothing more than no significant bending or twisting of the back. I plan to see my girlfriend this weekend and was wondering about how to approach having sex safely for myself.  Thanks",
    "doctor_response": "Hi, I value your concern regarding the symptoms. I have gone through your symptoms, and in my opinion there is nothing to worry about, the concern in such cases is that too much bending movement can cause loosening of your metal implant, as far as your approaching your girlfriend goes, do not try to be too experimental, and take it easy.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.Special note-  Any medication prescribed needs to be taken after consultation with your personal doctor only.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How fast does cancer spread?\n\nmy sister has always taken good care of herself.  last year 7/10 she had her first baby at age 40 - the baby is allergic to everything and is a bit \"sickly\" - for several months they passed being sick back and forth - antibiotic, lots of doctor visits - chest x-rays etc. - this past May (5/11) on the x-ray was a cloud on the lung - further tests showed cancer - cancer in brain, lungs, back, pelvis - stage 4 was stated - how fast does cancer spread that it couldn't be found out sooner than stage 4?",
    "doctor_response": "Hi,Thanks for writing in.Sorry to hear about the cancer spread to brain, lungs, back and pelvis. Cancer is a challenging disease and sometimes investigating it can take time and it might have spread to many areas. Considering cancer spread, there are many types, some are locally aggressive and recurrent, others are slow spreading and few are aggressive and spread fast. It will help to know which type of cancer has been diagnosed and the type of cells isolated.There are certain cancers that can reach from stage 1 to stage 4 in a year and this depends on volume doubling time also. Stage 1 through 3 depends on the size of tumor and its local invasion. Stage 1 and 2 disease takes some time but stage 3 and 4 appear with rapid progress. Treatment is usually chemotherapy and radiation in stage 4 cancer. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause whiteheads on penile shaft in a 6 months old child?\n\nI just changed my 6month old son and noticed 3 small like whiteheads on the extra skin on the penile shaft near the head he has a little extra skin from where they curcumsized him I often put A&D ointment on that area to keep yeast from forming and causing the skin to stick. Would this greasy ointment cause whiteheads. They dont seem to be painful to him or red and irritated what could the cause of this be?",
    "doctor_response": "Hi... by what you quote I feel that what you are seeing in the region could be smegma. This is not a disease, it is a physiological phenomenon. I do not suggest applying any cream or ointment in the region. Recurrent washing with soap and water will settle the issue. If still it is recurring then I suggest you consult your pediatrician regarding this.Regards- Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for edema on the knees after an accident\n\nDear sir,i have an accident on 15 may 2014, and i got knee injury, after MRI scan report said;Impression:Grade II, severe sprain/partial tear of MCL with associated edema of meniscocapsular junction.Subtle hyperintense signals noted in ACL, suggestive of edema.Mild joint effusion and adjacent soft tissue swelling.Needs clinical correlation and follow up.Sir this is my report, i saw my knee 2 doctors and both have different opinion, 1st suggest surgery & 2nd refer to wear knee brace and take rest, so my knee rehab in 3 to 6 month itself. I wearing knee brace last 27 days and feel reduce pain and swelling in my knee, but still pain inside my knee joint and little swelling & stiffeness. So i am here for advise from you, what should i do more?I gone to for surgery? Or wear knee brace and rest?Please advise to me, what choice is better for my knee?Continue with knee brace with rest & heating pad therapy?Or gone to surgery?If wear knee brace, so when i gone for physio therapy? And before gone to therapy 1 more MRI scan needed or not?",
    "doctor_response": "If pain is severe associated with swelling and not responding to conservative treatment better to plan for ligament repair or reconstructive surgery",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes spontaneous pneumothorax?\n\n3 episodes of left sided spontaneous pneumothorax( lung function test - normalonset and clearance of all thre episodes confirmed with Xrays.no breathlessness or mediastinal shift.what is available treatment and prognosis?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Recurrent pneumothorax is seen most commonly with cystic lung diseases.So better to get done HRCT thorax. HRCT is needed because chest x ray and lung functions can be normal in many cases.Pleurodesis is the treatment of choice for recurrent pneumothorax. In this, two pleural layers are made to adhere to each others by talc. So there will no potential so ace in the future for pneumothorax to develop. So consult pulmonologist and get done HRCT thorax and Pleurodesis. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the normal sperm count and how to increase it ?\n\nWhat is the normal values of sperm count?How can improve sperm count?",
    "doctor_response": "hi welcome to healthcaremagic forum normal spermcount vary from 30-60 million per ml. it may be vary from person to person you need to eat healthy and do regular exercise there are medicine but must be prescribe by  doctor so better to consult doctor i hope i have answered your question",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could stopping drinking milk in 18 months effect health?\n\nMy 16 month old suddenly no longer wants to drink milk. He eats very well and has cheese and yoghurt daily, but would usually also have 2 bottles of milk a day. Should I be concerned that he has stopped drinking milk. He is still active and does not appear unwell.",
    "doctor_response": "Hello. I just read through your question.Based on your description, it seems like he gets his daily dairy requirement each day. As long as he is taking the yogurt and cheese, he is ok.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the sharp pain between my shoulder blades?\n\nWhen stretching my back the other day, I felt a sharp pain between my shoulder blades followed by so much pressure, I couldn't yake a breath to speak. The pain is concentrated between my spine and right shoulder blade. The pain worsens when standing or sitting for too long, or deep breaths.",
    "doctor_response": "Hello!Welcome on HCM!I carefully read your question and would explain that your symptoms are related to a musculo-skeletal pain from overstretching. Coming to this point, I would recommend having some rest and taking some painkillers (acetaminophen, ibuprofen, ketoprofen, etc.). A muscle relaxant (flexeril) would also be helpful, coupled with a good massage of this region to relive the muscle spasm. Hope to have been helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest alternative of Rcinex,Mycobutol and Combutol for treatment of TB\n\nhi i am suffering for plural infection & water formation in my lung,after diagnosis that is TB. now since 4 months i am suffering from side effects of medicines like rcinex,r-cin ,mycobutol,combutol to lever.I have very high sgpt 300 ,these medicines doesn t match with my lever,so pls suggest me.",
    "doctor_response": "Hi,Advised second line anti-TB medications. Based on the history you seem to have developed liver toxicity apparently caused by the first line anti-TB medications. I suggest you to stop taking these medications and switch over to combination of second line anti-TB medications such as cycloserine, ethionamide, capreomycin, clarithyromycin, or fluoroquinolones.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be done for disease caused by the Coxsackie virus?\n\nI recently am recovering from Hands foot and mouth disease caused by the Coxsackie virus. The initial sickness/blisters was in Feb2014. everything appeared to be healing but now my finger/toenails are separating from the nail beds. I am 56 yr old female. my 19 year old niece was also infected and is also loosing her fingernails. I understand the nails will grow back. But I am wondering if I should be concerned that other things may be happening to my body internally which I do not know about and should I see a doctor to be tested for anything? and if so is there a certain kind of doctor I should see?",
    "doctor_response": "Hi,Am sorry to hear about this disease that you have reported. It is not uncommon with this disease condition. I recommend that you stay on and monitor at this time. The fact that your daughter is experiencing similar symptoms makes it more likely to be caused by  the infection.I hope this helps. i wish you well. Be calm and safe. Unless new information comes up, all would be fine soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fracture and dislocation of ankle\n\nhi im arlene i factured and dislocated my ankle 4/14/14 was told tthat i have a distal fibular facture was tol i can fwb but i have no felixability and its stuff and swelling cant walk foot wont bend i not had thearpy yet will thearpy hlepl with this problem when try to walk on it hurt and swell",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.You are having fracture and dislocation of ankle joint. Treatment of it mobilisation and exercises of ankle joint. Its treatment is best planned after seeing x ray. You are advised to visit a Orthopedician. Till then you can take analgesic such as ibuprofen for pain relief and mobilisation exercises. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lung infection and red spots on whole body?\n\nhi.. Iam suffered with cough from one month.. chest X ray report says, i have lungs infection or pneumonia.. from last 2 days i have red spots on my skin on whole body they are spreading.. what are the causes or which disease i am infecting?can you please help me?",
    "doctor_response": "Hello dearWarm welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  Red spots on body indicate some sort of allergic reaction either drug     induced or else .Hope this clears your query .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicines for Restless Leg syndrome without any side effects\n\nI have been taking Ropinirole for RLS / WED for one week. The side effects are building up and am almost bed bound. I want to give the medication chance to reduce the spasms in pelvis, legs, arms, hands and jaw as I m so exhausted from lack of sleep. I now have blurred vision and very light headed on top of the increased general neuro stimulation. Please can you advise. With kind regards Eileen (I am a 66 yr old female)",
    "doctor_response": "First off double vision is a very serious side effect of ropinarole and you should go to the doctor immediately. here are the things you can discuss with your doctor about reducing the side effects1) Divided dosage 2) switch to gabapentin",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for neck pain?\n\nhi,i m 21 years male..i have neck prom from 1 years ago...i took antibite frm clinic suggest frm doctor....when it going to relef i ate fry n spicy food n my neck paing too much...from few month my neck paning too much..i have gastic also..doctor said neck problem cause is gatric so what so i do now...thaku..",
    "doctor_response": "Thank you very much for contacting healthcare magic. You have gastric problem that give reffered pain .Avoid spicy food and fatty foods.Drink more water.Avoid gaseous foods like cabbage, cauliflower ,turnips, broccoli ,carbonated drink. ...etc.Eat fresh fruits and green vegetables. Avoid alcohol drinking. Avoid stress. Consent a physician for further diagnosis. Proper physical examination and histroy give exact idea. Abdominal ultra sonography is helpful for diagnose. I hope my guidance is helpful to you. Take care. Thank you very much.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does superficial squamous cells in Pap test report indicate?\n\nMy Report for PAP SMEAR saysSmear shows superficial squamous cells,and some intermediate squamous cells,In a background of few polymorphonuclear cells.there are no fungal organisms seen.there is no evidence of dysplasia/malignancy.Impression :Negative for intra-epithelial lesion or malignancy.Can i know wether this is a normal report",
    "doctor_response": "Hi,Thanks for writing in.Your report shows the distribution of cells in Pap smear. The superficial and intermediate cells in the pap smear are normal findings. This means that you do not have any condition suspicious for infection or malignancy. It is completely normal.Negative for intraepithelial lesion or malignancy means that the cells do not show any active division or features seen cancer or precancerous stage. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "what causes palpitation and dizziness during pregnancy?\n\nHi, may I answer your health queries right now ? Please type yo \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Hi Im 32 weeks pregnant. Its 4 in the morning and I am very dizzy my heart is racing my head is pounding and i feel like throwing up! I have Gestational Diabetes but my Blood sugar is 91. It could be high blood pressure. should I go to the ER or wait and call my dr in the morning?",
    "doctor_response": "You should go to your delivery hospital immediately. With your history of gestational diabetes, you are at increased risk for preeclampsia and eclampsia, which can be deadly for you and baby. Preeclampsia is a disease unique to pregnancy- you typically see elevated blood pressure with protein in the urine and a bad headache. Eclampsia is preeclampsia plus a seizure. Seizures in pregnancy can significantly damage your blood supply to your brain and your baby. Please go get evaluated immediately. Good luck!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is liver cirrhosis incurable?\n\nGood day! I'm suffering liver cirrhosis for more than a year. my gastro Dr. saw that there are varices in my esophagus thats why I vomited a lot of blood. my Dr gave me a Propranolol and aldactone but this drugs doesn't cure my cirrhosis its only a maintenance according to him. he told me that this  is uncurable. Is this true? I'm from Philippines .  Do you have branches here because I want To take Liv52 or What medicines are good for me?  YYYY@YYYY",
    "doctor_response": "Hi welcome to health care magic....You have liver cirrhosis....Let me know you it is not incurable...Ultimate treatment is liver transplantation...But it is costly procedure ....You are given propranolol that is beta blocker which reduce portal hypertension so chance of variceal bleed is less ...so less mortality....If ascites also present then diuretic can be given....If transplantation not possible then TIPSS like shunt placement can be done to reduce portal pressure which is less invasive procedure...You have to take care regarding taking low salt diet and high protein diet...Daily early in morning take grined spinach and carrot juice....One tsp crushed papaiya seed with lemon juice useful.Fruits more...Regular follow up done....If variceal bleed occurs immediately contact doctor for ligation...Take care.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause of abdominal pain as I am on hcg diet drops ?\n\nI have left side stomach pain and ive been on the hcg diet drops for a few days. Im wondering what is causing this pain?",
    "doctor_response": "Hi welcome to H.C.M.Forum. left sided stomach pain is harm less. if it is at the top due to indigestion, in the middle due to worms, or renal stones, lower means due to urine infection. any how anti spasmodics and ant biotic is to be used with the advise of a doctor. thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly interpret test results taken after erotic massage.\n\nHello doctor, Can you please interpret my test lab results? I only had an erotic massage a few weeks ago. I did these tests on my own just because of curiosity. The erotic massage was safe. No sex was involved. Just body to body touch. However, I am not sure what they mean.",
    "doctor_response": "Hi. I have gone through your query and the reports attached (attachment removed to protect patient identity). Herpes 1 IgG positive indicates a history of herpes virus type 1 infection which is usually spread by oral contact and causes lesions in the facial region. Active lesions occur during periods of reduced immunity like other viral infections or sometimes spontaneously, rest of the time the virus remains dormant in the body. I would advise you to visit your local dermatologist for a further clinical examination and any treatment if necessary. Positive VDRL (venereal disease research laboratory) test must be taken with caution as there is a good chance of false positive. As the associated TP (Treponema pallidum) antigen test is negative, it is unlikely that you have syphilis. Though your HIV ELISA (enzyme-linked immunosorbent assay) is negative, if you have a suspicion of the possibility of contact then I would advise a repeat testing after six months without any unprotected contact just to be sure. For more information consult a urologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are heat rashes on the neck and forearms along with chills an indication of an infection?\n\nfor the past couple of weeks i have had a severe heat rash all over my neck and inner forearms and have been avoiding sun and heat and washed with coal tar soap and applied aloe vera  gel . today I feel a chill with a slight pain like a fever on the surface of my inner arms .I wonder if that could  indicate an infection",
    "doctor_response": "Hi, Feeling of cold and pain may not be due to infection but it can be due to nonspecific reason it can be temporary. Some time allergic condition may cause such symptoms, it is nothing to take with the soap or gel no need to panic or think about infection for sure it is not an infection nor it is the disease condition. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr Akhtarhusain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is Naturogest prescribed for and is it the same as Endogest?\n\ni am 33 weeks pregnant. I am travelling in 3 days. Doctor had prescribed me Naturogest 200mg. As it was not available in the pharmacy, the pharmacist gave me Endogest 200mg. Are they both equivalent? Why am i precribed with this tablet? how will this help me? wil there b any harm? Your reply would be valuable",
    "doctor_response": "Hello, Both naturogest and endogest are the same and contain natural micronized progesterone. Although Naturogest is prescribed usually for menstrual irregularities, in your case it has been prescribed for maintenance of early pregnancy. Please talk to your doctor about whether it should be continued. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Prabhash Verma, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Which one is better angioplasty or bypass surgery?\n\nHello doctor,Last week, during night time, my relative developed chest pain and was feeling very uncomfortable. He was taken to a hospital and after tests and preliminary medications, he has been advised to do PTCA to RCA. His age is 51 years old. He has a diabetic history. The reports have been enclosed. Kindly suggest whether he requires angioplasty or coronary bypass surgery.",
    "doctor_response": "Hello. I have gone through the reports (attachment removed to protect patient identity). He had heart attack. There are significant blockages. The medicine he is receiving is fine and should be continued until bypass surgery. Regarding, bypass or angioplasty. Immediately after the attack, say within 24 hours, if you do angioplasty, then it is beneficial for the patient as it can be done on an urgent basis, and shorter the time interval between attack and either procedure, more is the benefit. This benefit is for 24 to 48 hours. But at this stage, since this crucial time period has already passed, there is no urgency. He should undergo bypass surgery as he is having too many blockages and stenting will not be possible at all these places. So, discuss with the cardiac surgeon regarding bypass. It should be done as early as possible for best results. Hope this helps you and get back if you have any doubts. For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent pain in lower right abdomen?\n\nI had a tremendous pain in my lower right abdomen like something inside dropped. I went to the ER and through cscan or imaging they ruled out appendicitis and kidney stones. Nothing abnormal showed up in the scan or the blood work. They did specify I had a hiatal hernia. The pain is still there and feels as if somthing moves when I bend a certain way, it also hurts to lay flat. I am 53 5 ft. 5 female weight around 132. The only things I have had done is a colonoscopy in January and 7 years ago a ablation (not sure of the spelling). What could be causing the pain to continue. Would the scan have showed a drop in the cervix etc?",
    "doctor_response": "Hello, It could be a renal stone probably. As a first line management, you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist, it is better to consult a physician and get evaluated. An ultrasound scan is required for further assessment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for depression and feeling of loneliness\n\nHellow...health care magic !I'm from Nepal. I am 19 years old and I have done my high school 2 years before. now I am doing bachelor in science but I couldn't  continue it anymore due to my problem. the problem that I am facing is that...I can't do anything myself. I mean I feel very lonely and depressed when I find myself in a new place. each and every time I need someone by my side in a new place. I can't make friends so easily and I can't talk with unknown person. I don't know what happens to my mind and me... I can't thing anything. my mind goes empty. so due to this I left to go my college since first year. I don't know what to do. some time I think I can't do any thing myself wihout my frnd or anyone.I don't know how to get ride from this. will u please help me......???",
    "doctor_response": "HelloI read your statement and i understand your concern about your conditionYour history suggests that you are suffering from Depression with Anxiety component present. Here are things to do> Start Tab Alprazolam 0.25mg one at night for 8 days (Stop after 8 days)> Start Tab Inderal 10mg twice a day for 14 days> Start Tab Flouxetine 20 mg one tablet at morning for 6 months. in last one month you will have to taper this> Go to psychological and start Cognitive Behavioral Therapy session, about 8 session> Use you bed only when u sleep, do regular exercise and play sports. Try to meet your friends and go out with them to market, movie etcI Hope This will solve your issueThanks Dr Nasir Ali",
    "dialogue_context": ""
  },
  {
    "patient_message": "Small reddish spots on the arms. Allergy due to medications? Taking adderall, prozac and loestrin. Family history of autoimmune disease\n\nHi I have multiple tiny red spots like the size of the tip of a sewing needle on my arms. I do not know if they appear anywhere else since I can not look that close to other parts of my body. I am just concerned as to whether it is caused by seasonal allergies which I have or if it can be caused by any of the medications I could be on (Adderall, Prozac and Loestrin). I was at one time diagnosed with hypothyroidism, then was told I did not have it so I am not to sure if I still suffer from the above mentioned diagnosis. I also know my mother has had her spleen removed for some immune reasons I am not sure of. I have read about cherry angiomas and petachiae.",
    "doctor_response": "i think related to medicines and it occur at any poit when you take drug which is allergicand everytime you take medicine the same spot is effectedpainkillers like pcm brufen dietry suppliments vtamins calcium and multivitaminsso adjustmedicines to the salts which are non allrgictake antiallergic ebastine sos 10 mg for itchapply calamine lotion and anti allergic cream locallyyou can continue till you get right sats y",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What causes low sexual drive?\n\nHello doctor, I am 32, male. There is a huge problem regarding my sex drive. I do not have till now found the root cause of low sex drive but I feel it is due to masturbation and porn. I used to masturbate from 15 years of age but from the last six months, I am watching porn like daily and masturbating once in 2 or 3 days. I usually masturbate by rubbing hard on bed. I am confused that whether my low drive is related to stress or excess masturbation or porn or some other hormonal imbalance. I am going to get married and that is why I am worried. I tried safe sex with a sex worker previous month but not enjoyed at all because of low sex drive. Could you tell me the reason and remedies for the same?",
    "doctor_response": "Hi. Masturbation is normal. It does not cause physical problems or sexual problems. Also, do not give any importance to the advertisement that mentions that masturbation cause health problems or destroys life, and masturbation does not require any treatment. Your problem can be due to stress, anxiety or due to a physical cause. For physical cause, you need to do blood tests Hb, TC, DC, fasting sugar, prolactin, TSH, testosterone. Please upload the reports. Depending on the reports, treatment can be decided.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for difficulty in conceiving and painful sex\n\ni am 29 years old, i have a 12 year old son. i have been trying to conceive for eight years and i have been unsucessful. my husband has no medical issues. i went to speak with a doctor and the only thing they told me was i have a backwards uterus. i have pain when i have sex and i still have not conceived. what should i do?",
    "doctor_response": "HelloBackward uterus(Retroverted uterus) is a normal variant of uterus position.It is most likely not related to infertility.Infertility may be due to some other reasons.It need proper evaluation.Your partner also need proper evaluation.Semen analysis should be done initially.Besides routine investigations you may need hormone profile assay,thyroid profile,follicular study etc.Further investigation depend upon findings.Pain during sex may be due to many causes like dry vagina,problem in cervix etc.This need proper local clinical examination.You may need few medicines after evaluation.You should consult renowned infertility center.Get well soon.Take careDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can MRSA be treated?\n\nhi my son recently was released from prison, he was fine so it seemed he died two days later I was told it was mrsa, there were no signs I don't think he knew he was sick, I think he may have thrown up in his sleep and aspirated. should there or could there have been signs. should I contact that facility ? he did have tattoos he got while in prison",
    "doctor_response": "Hi & Welcome.The suspected bacteria Methicillin resistant Staphylococcus aureus (\"MRSA\") is resistant to most of the commonly used antibiotics such as penicillin, oxacillin, amoxicillin, cephalosporins, azithromycin, etc.Based on the history given, your son seems to have acquired MRSA infection through the tattoos that he got in the prison.He should be examined by a doctor for proper clinical examination and possibly a culture and sensitivity of the skin lesions. Based on the result of this test he would be given an effective antibiotic like Vancomycin, Linezolid or Ceftroline.Hope I have answered your query. If you have any further questions I will be happy to help.Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the feeling of a lump in the throat?\n\nHi there doctor I m very nervous i smoke about 2 or 3 cigarettes a day and just recently i feel a lump sensation in my throat , sometimes it feels really big then sometimes it goes down to a more comfortable feeling but is still there. Please advice me doctor I m so nervous and need advice. I have been smoking for 4 years now. I can eat and drink foods normally but only when i swallow saliva is when i feel the sensation.",
    "doctor_response": "HiTry to quit smoking all together. A lot of help is available regarding that.Get yourself looked upon by a doctor, for a throat examination to look for any problems if any. Can follow up for further advice if everything is ok in the exam. Kindly mention your gender/age/ dietary and lifestyle in as much detail as possible",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can arachnoid cysts found in my brain and nose bleeding episodes be treated?\n\nBack in 2015 I had 3 gran mal seizures out of nowhere they stated it was caused by hypoxia. I had MRI and ct scan and there were 2 arachnoid cysts found on my brain one on the right was 2.2 cm and the one on the left was1.7 cm. In the midst of all that I ve had nose bleeding episodes. Just recently had another MRI and the cysts have grown the right is now 4.1 cm and the left is 3.5 cm. The exact locations is bilateral arachnoid cyst in the anterior aspects of the middle cranial fossa. Please give me some advice as what to do",
    "doctor_response": "Hi, Since size is increasing, you may need neurosurgeon consultation. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Indu Kumar, Radiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for iron deficiency\n\nI want to increase my iron levels so I can donate blood. I am always low everytime I want to donate but this time, I was not too low. My blood level was 12.4 and I have been taking 27mg of iron everyday and eating high iron foods. Should I take a 65mg Ferrous Sulfate pill? Would that be dangerous since my iron levels are normal? Should this pill only be taken during my period? Serious answers please! I was really hurt because I could not donate that day.",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.In my opinion you should continue your current iron treatment.Your haemoglobin is not to much low. Continuing this medication can solve your problem with in short period.You should continue your medication for whole month, not at the time of period.Daily intake of iron gradually improves your ferritin level, which is the stoege of iron in your body.Please take iron treatment until your haemoglobin level reaches normal level plus three month for the replenish ment of iron storage.I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the kidney area?\n\nI have been having issues similar to a uti but what's weird is its testing positive with the dip stick test ad negative at the lab. I have a dull ache in my left kidney and everytime I'm done urinating I still feel like I have this weird pressure like I could pee more. I get the same thing worse when I lay down and try to sleep at night. I go to a urologists tomorrow morning...what the heck could this be it's been over a month. Symptoms were much worse at first and came two weeks before my period. Btw I feel bloated too.",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, if the symptoms need to be confirmed for infection then it is advisable to get done the culture sensitivity test of urine in female patient it may be common, as such you are going to see the urologist then there it will be clear till then drink more water and no need to worry because clinically it may not look like infection,  hope this information helps, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the use of phosphate novartis in groin pain due to a fall?\n\nWhat is phosphate Novartis 500 mg strength diagnosed for an 82 year old male who fell off the bottom step of his motorhome due to a mis-step. He has lower groin area pain and pain up one side of his body along the line of the underarm. This male also has a pace maker. He wants to know what this medication is.",
    "doctor_response": "Hello there,The tablet you mentioned used for phosphate in people deficit of it.Patient fell down and of 82 years of age might be having weak bone.and the complaint you mention suggest that there might be some bony injury.Kindly consult an orthopaedician to rule out any fracture .thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes holes in bones of lower back area?\n\nMy 87 yr old mo-in-law fell 2 mos ago. As a result, it was determined that several discs were almost touching. An ortho doc did a procedure to insert something between the discs to cushion them. While he was working, he found two holes in her bones in that lower back area. He did a biopsy then referred her to an onacologist for further testing. There is no cancer per blood tests.  What could be going on?",
    "doctor_response": "that is up to the oncologist to find out.  there are many causes for the holes including normal degeneration and osteoporosis as well as other types of cancer besides blood cancer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain on the right side?\n\nI have pain in my back on the right side of my spine. It is a pain that feels like a knife in my back and the it lets go. It s like it contracts and then it will relax. the pain is very severe when it hits. Had back surgery 3 yrs ago and had a spacer inserted between the L2 and L3 . Doctor thought this will stop the pain. It did nothing to stop the pain plus all the pain I had from the surgery. Would like a solution to this problem but no seems to know what to do.",
    "doctor_response": "I would have your doctor evaluate your spine again, and get further MRI imaging to see if a nerve is getting \"pinched\".  The spacer is designed to help with lumbar stenosis, but it appears you may still have stenosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for infertility problem\n\nhello Dr. I m 38 years old married man, have 1 baby aged 7 years old, we are planning for our 2nd baby since 3-4 years, but still not success. we have consultant with lady Dr. regarding my wife health but Dr. was satisfied for her health. then i have consult with Dr. for my health. Dr. suggested for my semen analysis, i have done my analysis the report found 15 million total counts, then Dr. prescribed me for Lycored fort Cap. Kindly suggest me is that posible for our next baby.",
    "doctor_response": "HiWelcome to healthcaremagic.I have gone through your question.As far as your semen analysis is concern 15 million total count is very low.First i would like to advise ultrasound color Doppler of scrotum to rule out varicocele, testes vascularity. Medicine prescribed by doctor is supportive and can help in sperm count but you have to wait for atleast 3 months. So continue medicine, do ultrasound.If fail to get increase in count then also your wife can conceive with iui intrauterine insemination and with other methods.Hope i answered your question.Would be happy to answer your further queries.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes irritation with small blisters in eyes of a toddler?\n\nI was told my 3 year old daughter has stye s in her eyes yesterday. She came down with a fever on Friday (102 degrees) and has had the fever since. She woke up yesterday morning with small blister looking irritations on both eyes and again this morning she has more. I don t think it is stye s I think it is something else. She was prescibed Erythromycin Ophthalmic Ointment 0.5% but it doesnt seem to be helping. I am also putting warm compresses, when she will let me. What else could this be? Also, I had an irritation in my nose last week (still fighting it) small blister like, red, painful. I have had shingles in the past and it almost felt like the same pain.",
    "doctor_response": "Hi,It would be more easy if you can send a picture of the eyes. Acute onset fever with painful blisters probably indicates herpes infection, a highly contagious disease. From your description, probably you had the illness first as cold sores, which then transmitted to her. She manifested the disease as herpes ophthalmicus. Uncomplicated stye is unlikely to be associated with fever and should respond to the treatment given already (during initial visit, signs might have been minimal and non-specific). Herpes needs anti-viral treatment with drugs like aciclovir and analgesic support. Kindly review with your doctor. An ophthalmologist will be better.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam T. K., Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes continuous tingling in the body and head?\n\nHi, I ve been experiencing continuous tingling throughout my body for almost three weeks now. It does not just come and go, it s always present, even when I m in a state of complete relaxation. What s more, I feel like I m shaking and moving in slow motion most of the time. I ve already made an appointment with my doctor for this Wednesday, but this feeling is just freaking me out a lot and I just want to be sure it isn t something serious. Due to this tingling and weird feeling in the head, I ve of course been feeling very anxious for the past few weeks, due to this I m also constantly hyperventilating. I know hyperventilation can cause you to feel very tingly, but I don t think it s related, this type of tingling is there the moment I wake up in the morning and does not go away at all. Whereas hyperventilation tingles aren t always there, are they?",
    "doctor_response": "What you describe is not typical of any particular illness. The important information to bring to your doctor is how and when it started. What makes it better or worse and if you've noticed anything else: diarrhea, weight loss, cannot tolerate warm environments, sweating, hair loss and the like.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Body and hands shiver during interview, speech and presentation. what should I do?\n\nHello sir,I am Rupesh, My body with Hands get shivring to much while I go for an interview or a stage, in a meeting while giving  speech, presentation, my voice also get changes and be very hegitate at there, some time without a hegitation it also shakes, I am so upset for it and getting failed to new work, task, interview,,please Advice, I need your helpthanksRupesh shuklaNew DelhiE.id-  YYYY@YYYY",
    "doctor_response": "Hi,You have got nervousness and anxiety.You have got less self confidence and lack of will power.Develop strong will power and self confidence.Talk freely with your friends and discuss various topics among your friends.Decide your self that I will not be nervous while appearing for interview and will give answers very boldly.This will bring your self confidence and will power on top leading to at your great achievement.If require you may go for few counselings with psychologist.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat mild enlarged liver?\n\nHi , I had a ultrasound done and it said , I had a Mildly enlarged liver measuring 20.6 and also a smalll 7 mm hyperechoic shadowing focus in the inferior pole of the right kidney, the right kidney measures 10.2 x 4.3 x3.8 cm left kidney measures 10.6 x 6.3 x 4.1cm. What type of treatment do I need.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You should immediately stop addictions if any including Caffeine or tea. You can take juice & soups. You can take ursodiol, interferon or other liver tonic under your treating doctor. You may also require to take antivirals & medications depending upon your symptoms. Take diet low in fat, avoid oily-spicy food. Take plenty of water, eat boiled food. Avoid sex. Take care. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nupur K.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and numbness in the back side of the right thigh?\n\nHi, My name is Deepna, I am 27yrs running.my height is 5'5\", weight 72Kg. I am married. I was having severe pain in back side of my thigh 1 month back. and i consulted the doctor, doctor told that the pain is due to the spinal disc herniation.and i took LS spine MRI scan also. and scan report is as below, 1.Transional vertebra at Lumbo-sacral level. 2.Bony canal dimensions border line at mid-Lumbar levels(AP: L3=1.15,L4=1.16,L5=1.25cm) 3.L5-S1 posterior protrusion;extruded material lying in the right centro-lateral canal at S1 body level. Thecal compression & B/L lateral recess narrowing (R>L) 4.L4-5 mild posterior bulge 5.cord normal 6.No para-spinal lesion seen 7.Right ovarian cyst(4.6cm). Suggestive of functional cyst.advise USG. And i am having numbness in the back side of my right thigh and genital area, but no pain. My doctor told this will be ok.But dont bend forward at any cost. Is it a serious issue. i am little scare about the numbness",
    "doctor_response": "Hello Thanks for writing to usAccording to report,you are suffering from degenerative disc disease of lumbar spine.It is early in your case.Degenerative changes occurs in spine due to aging and development of weakness in annulus fibrosis.1.At L5-S1 level,there is posterior herniation of disc and extruded material is causing thecal compression & bilateral lateral recess narrowing (Right >Left). 2.At L4-5 level there is mild posterior disc  bulge. Majority of the cases of degenerative spine disease are benefited by physiotherapy,so physiotherapy should be tried first.Surgery should be the last option. There are also medicines like capsule pregabalin available for pain relief.Your doctor has rightly suggested to avoid abrupt forward bending.You should avoid lifting heavy objects.Get well soon. Take Care Dr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for nausea and acidity during pregnancy\n\nHi, my wife has just gone through her pregnancy test and it was positive. We got it done yesterday. She is having this acidity and nauseatic feeling consistently from last 4-5 days. Doctor has given a medicine i.e. 2 tablets each night to avoid morning sickness. Could you please suggest a good gynecologist and immediate course of action.. she is feeling weak.",
    "doctor_response": "HiDont worry.nausea & vomiting is seen in 90% of pregnant women .most commonly due to hormonal changes.some people complain acidity because of stress & hormonal changes.diet & life style modification is important.donot lye down immediately after eating.avoid fried oily foods.if symptoms wont releive drugs can be taken which r safe like pyridoxine / doxylamine.Thank u With best regardsVasundhara",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes right sided and lower back pain after gallbladder removal?\n\nhi my name is rita i have had stomach problems for years, a few years i had my gallbladder removed, i have had every test done and they seem to not be able to find my problem, i am starting to experience the same symptoms again, hurting in my ride side and it goes to my lower back, have seen gastro dr for this problem and he could not find anything says i am a medical mystery. wanted me to go to another hospital if i have this problem agin",
    "doctor_response": "Hi, Small biliary leaks can result in persisting pain abdomen following gall bladder surgey. however, it would have been found out in the search they made. The pain you are experiencing when every thing is normal may be a referred neuralgia. This is not an uncommon problem, but is generally ignored by many due to its mild and intermittent nature. you may try Gabapentin or Amytryptiline, after consulting your doctor.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from high BP and depression\n\nsuffering from high bp 160/120 since 2 months , I am taking bp medicines but there is no effect & have depression issue, plz guide me. Thanks, Hasan Khan",
    "doctor_response": "Dear Hasan Khan If you believe Ayurveda and natural medicine then try 30 ml of fresh juice of dna noni with 100 ml of warm water twice daily in empty stomach. This can help healing your BP naturally and swiftly. Call 1800 425 4325 (India)/ 9500123412 / www.rvita.com for natural, Ayurveda related hypertension management plan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to travel by flight for displaced plateau tibial fracture?\n\nMy husband 51 has a non displaced plateau tibial fracture that happened 5/30/2014 , placed in a mobilizer and non weight bearing with follow up apt in 3 weeks. We had a paid I m full trip planned to Mexico leaving on 6/20/14, the flight is 2 1/2 hr then overnight stay and in the morning another 2 1/2 hr flight to our destination. Can he take a flight if he takes 81mg aspirin for two weeks prior to flight. Should we be concerned. Will have re X-ray prior to vacation to make sure healing ok and may be able to get hinge brace.",
    "doctor_response": "hi,I don't think it will be of any worry to the fracture. you do not need even a re- x-ray for the same. since the fractured limb is into the cast. you can take a flight with confidence and enjoy the holidays but please do a tab on the DOS and donts mentioned by the physician to you like nonweight bearing and all.wish you a speedy recovery",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is calcium channel or Angiotensin blocker advisable instead of Diovan or Losartan?\n\nHi - I ve been on an assortment of blood pressure lowering medication for over 20 years; cozaar, diovan, losartan. Amlodipine bysylate. I m currently using amlodipine 2.5 mg.and have been for about two years. I ve about run out and should order a calcium channel blocker or an angiotensin blocker. I m 87 and in pretty good health. My blood pressure has been creeping up of late (144/90 on average). I m presently heavier than I should be (183 instead of my more normal 170) (I m medium frame Caucasion 5 9 tall). I have substantial left over supplies of both losartan and diovan. What s your recommendation? Did I give you enough information? Jack Wanamaker",
    "doctor_response": "Hello Diovan ( valsartan ) and losartan both are angiotension receptor blocker while amlodipine you are on is calcium channel blocker . It's not wise to change medication just because it's going to get over . I would suggest that you continue 2.5 mg amlodipine and if the blood pressure readings are still higher than 140 / 90 mg , Than adding a small dose of either losartan or valsartan would be an ideal . Regards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should medicine be stopped if blood pressure is well controlled?\n\nHI , i was prescibed with HBpressure since oct 2009 and have been taking metroprolol 25mg. Since then with lifestyle changes and diet over the last two months iv been having readings of 125 and 80.Do you think it is a good time to appraoch my doc about weaning off them?",
    "doctor_response": "Hello, I would explain that this is a really low dose of metoprolol and it has a low influence on high blood pressure, as its main effect is to reduce heart rate. Your actual blood pressure values are quite normal, so you can reduce the dose and even stop metoprolol, but gradually as it may lead to rebound tachycardia. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen and painful testis in kids\n\nHello Doctor.My son is 5 years old having wt approx 18.5 kg & hight of approx 3.5 feet .his right testis is swollen for four to five days having pain during movement(the swelling is not due to accidental trouma).plz suggest which treatment would be better, homeopathy or allopathy.",
    "doctor_response": "Does he had any fever, cough, cold, skin rashes before developed pain?? A history and clinical examination is needed in detail... Plz visit a pediatrician and if required a surgeon for further opinion... As I have learned in allopathy I assure it really works... Can't comment about homeopathy..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can I control anger and anxiety?\n\nHello doctor, I have a problem controlling my anger and anxieties which leads to erratic, eruptive behavior. It is hard to let bad things go for me. My expectations from others are very high and that leads to making them feel bad for not doing enough.",
    "doctor_response": "Hello. Could you please provide more details about the problem? Do you think that the anger issues are persistent since years or are these issues occurring in episodes? Like you become irritable and have anger outbursts for a few weeks and then you are totally alright? The repetitive anger outbursts could occur in some mood disorders like bipolar disorder. But other symptoms like stubbornness, increased activity, the risk-taking behavior, decreased need for sleep, disinhibited behavior, etc., are also seen. These symptoms usually occur in episodes. This could be due to intermittent explosive disorders. Episodes of anger outbursts are seen usually and sometimes after that, individuals feel guilty because of their behavior. Even atypical depression can present with irritability which cannot be explained. Low mood, sensitivity to rejection, anxiety, etc., are seen. You should visit a psychiatrist for evaluation and treatment. Drugs like Sodium Valproate can be used for controlling mood and will reduce the anger episodes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Wisdom tooth extraction, IV insertion, lump on vein, bruised, scar tissue, hematoma. What is going on?\n\nHello, I had a wisdom extraction about 5 1/2 weeks ago. I was sedated by the IV the dentist inserted in my arm. I noticed my vein had damage which is common from an IV insertion. It was a little hard and of course bruised. I expected the swelling to go down by now. Instead, the lump which is the width of my vein has slowly moved up about half an inch. It has increased in firmnessand aalmost feels like there is a tube almost an inch long in my vein. When I press on the lump it moves and feels like there is an edge to the lump at both ends. I have received bruising after pressing on it. When I bend my arm or flex my bicep it feels like its pushing against my bicep. I am a phlebotomist and draw blood mainly on geriatrics for 7 years. I've seen veins with scar tissue and hematoma, but never anything like this. Also my veins are very prominent. Could there be debris or something left behind from the IV?",
    "doctor_response": "Hi, Thanks for asking the query, Your clinical history suggest that you had developed a sweeling at the injected side of your arm which you are feeling as haematoma. If you are comfortable with your day to day activities it is advisable to apply a bandage at the side, so that the haematoma resolves faster. If the skin over the haematoma is showing any signs of unhealthiness, its better to consult a physician and get the checkup done. Follow the post operative instructions given by the Dentist properly. Maintain a good oral hygiene. Hope this helps out. Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the possibility of lung cancer in a smoker with family history of cancer?\n\nHello doctor, I am a 31-year-old male. I am a smoker for 12 years. I am having throat congestion, cold, and now having excess mucus production with no history of weight loss. I have taken a chest x-ray in which there is a white patch on the right side. I wanted to know if it is cancer? My father is a known case of cancer lung. All my blood test reports are normal.",
    "doctor_response": "Hi. I have seen your x-ray. (attachment removed to protect patient identity). The chest x-ray shows a prominent right hilar area most likely due to rotation. I mean you were rotated in position when the x-ray was taken and this might cause a false appearance of right hilar vascular prominence. To me, it does not look like cancer but thought is to be given to your symptoms. If possible please decrease and stop smoking. I will suggest a discussion of your symptoms and clinical examination by your doctor and if there is a need then a CT (computed tomography) chest can be done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffer from sores on the body, crawling feeling. Diagnosed with MRSA and mental disorder. Need help\n\nI suffer from biting sensations which start off looking like mosquito bite with black dot in the center left alone it will become open sore then scabs over with oval shape black scab that has tiny hairs that move are stiff and feel as though there are stickers in the sore left alone the can get as large as a dime and are tender and cause burning sensation if removed the scabs actually move and attempt to crawl by using hair like legs hundreds of them if entire scab is removed sore will heal up in a matter of days left alone they seem to almost go dormant living off host you can actually feel them squirming and burrowing the biting and crawling sensations are so bad suicide seems like an option I have been diagnosed with mrsa and written off as mental case treatment has included hibicleanse soap Bactrim ds bid bactroban oint vistaril Haldol resperidol none work the only treatment seems to be to debred them after scab has formed painful and scaring please help any suggestions have seen cdc and the just say mrsa thxs trudy",
    "doctor_response": "DearWe understand your problemsYou are definitely having skin problems which needs a thorough look and diagnosis from a dermatologist. The medicines you mentioned might have had some side effects in you.For psychology part, you need a lifestyle change and thinking style change. Yoga and Meditation cn streamline your metabolism and thoughts and psyhotherapy can help you streamline life style. Both combined can work wonders.You need to consult a psychologist / psychotherapist. I can help you if you come through \"sk a specialist\" link.Wish speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in abdomen?\n\nI am 38 old woman, i have abdominal pain (right side) from 3 days, and met the doctor; he took an injection and tablets for 3 days to reduce the pain, but immediately after the injection, pain reduced for sometimes, but we reached home then the pain started again. what is the problem for me? please help.",
    "doctor_response": "Hi.The pain in the right side of abdomen can be due to the following reasons: Appendicitis, Salpingitis, Ovarian problems like twisted Ovarian cyst, colitis, right ureteric stone, lymph node mass to name a few. You have to get a clinical examination and investigations of blood, urine, stool and ultrasonography. Get a proper treatment as per the findings.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mental disorder, taking Oxetol, LoboZam, have irritation on using these tablets. What is the cause?\n\nHai Sir,I am suffering from mentally disordered but i had completed MCA and doing job also. EEG scan result is disordered, CT Scan and remaining scanning is good.Doctor suggest to me use Oxeteol 300(1-0-2)dose and LoboZam (0-0-1)dose.I am using these tablets from 5 years onwards.Some times i feel something different.i know all these things.I am irritating about using these tablets.Give me suggestion for my problem.",
    "doctor_response": "Hi, Abnormal EEG show malfuctioning of electrical activity of brain which is a common cause of seizure disorder. In many seizure and related disorder CT scan and other imaging studies may be normal. Oxetol used for seizures and as mood stabilizer. As every seizure can be very dangerous, so it is better to continue with your medicines. I hope this information has been both informative and helpful for you. Wish you Good Health. Regards, Dr. Ashish Mittal www.99doctor.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. After a deep filling in upper molar, my husband has got swelling and pain in gums. Please help.\n\nHi doctor, My husband had a deep filling in his upper second to last molar (left side). About several hours later, he started having discomfort and taking Tylenol and Ibuprofen interchangeably. Now, it has been the second day with severe pain and his cheek is swollen. And the gum over the tooth is in pain but not swollen, and it is a throbbing type of pain. We have no access to the dentist. Please help.",
    "doctor_response": "Hello. In this condition the tooth should not be filled and instead, root canal should be done. As the filling was near the pulp, pulpal irritation is causing the pain. Take tablet Amoxiclav (Amoxicillin and Clavulanic acid) 625 mg one tablet twice daily for five days, Zerodol SP (Aceclofenac, Paracetamol, and Serratiopeptidase) one tablet twice daily for five days, capsule Pan D (Pantoprazole) twice daily before meals for five days, Betadine mouthwash gargle in lukewarm water. If nothing is available right now warm saline gargle will also help for the time being. Take the medication, your husband would be relieved. Do not worry, but I will advise to get the filling out by your local dentist. And your husband needs a root canal. Kindly upload an image of the tooth along with the affected area. Treatment was not done properly. Should have gone with a root canal. Removal of filling and root canal procedure. Upload an image and x-ray available. Your husband will be fine once he gets the medication. But as you both are travelling even warm saline gargle two or three times will help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid the pain in the hands, feet, shoulders and under the hips?\n\nI have pain in my hands feet shoulders and under the hips. Specifically, last two fingers of my hands, toes, upper part of the shoulders and under the hips. My hands and feet swell up, especially when they are dangling. I feel a lot of warmth in my hands. Thanks!",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As per your history, it may e ergonomic problrm or osteoartritis. You can take tab. nimesulide after consultation. IN case of severe pain, do x ray of involved joints, complete haemogram and consult with orthopedician. continue regular exercises.  Take care. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is inflammation of chest wall related with chest pain and burping?\n\nI have been experiencing chest pains, shortness of breath and fatigue throughout the week. I went to my pcp dr and she sent me to the ER. I had an EKG, chest xray and a CT. All came back negative for heart or lung issues. Dr diagnosed it as inflammation of the chest wall. I ve noticed that I keep burping and the pain occurs after a belch, even if I just drank water. Is this an important symptom that I need to share with my pcp since I m still having chest pains?",
    "doctor_response": "Thanks for your question on HCM.In my opinion you are having GERD (Gastro Esophageal Reflux Disease).Your symptoms of burping and belching are suggestive of GERD.Your cardiac and respiratory work up is also normal so GERD is more likely in your case.GERD is due to laxity of the Gastriesophageal sphincter.due to this acid of the stomach tends to come up in the esophagus and cause the symptoms. Try to follow these for GERD.1. Avoid hot and spicy food.2. Avoid large meals, instead take frequent small meals.3. Avoid stress and anxiety. 4. Take proton pump inhibitors. 5. Go for walk after meals.6. Keep 2-3 pillows under your head in bed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do swollen rashes on cheeks and body indicate?\n\nI went to the science center with my son yesterday when we came home he went for a nap and when he woke up he had welt like rash on both cheeks and some of his body the ones on his cheeks were super read one side almost swollen. I gave him benadryl 3 times once every 6 hours which seemed to calm it down but his cheeks are still rosy now. What should I do??",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.By what you quote it should be an urticarial or a simple skin allergy.  Most important thing to be remembered is that it has a propensity to recur (called as second crop) within 10-14 days. I suggest you use calamine lotion as its giving results along with oral antiallergic like Hydroxyziine or Cetrizine. If this happens, you can start using the same medicine but I suggest you get the kid evaluated with your paediatrician.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest vibrations?\n\nHi, I'm getting a vibration in the right of my chest. My wife put her hand in the area and could apparently feel a light vibration. Any idea what it might be? I am still very overweight, but have lost 60 pounds in the last year and am doing 2 hour workouts at the Gym, 4 times a week.  Height 5' 8\", weight 250lbs, Blood Pressure, Cholestrol is all fine.",
    "doctor_response": "Respected user, hi I evaluated your query thoroughly .@ As per the narration certain details are lacking as - type of vibration ,    frequency, intensity , duration , exact location in right chest , associated    noticing anything abnormal around heart region, breathing pattern    & not told whether you are also feeling same or only your wife , may be    her hand is vibrating in some stress & you get the penalty !@ With this information , I will regard this as possible muscular twitching     may be due to heavy work out or else reason , giving light vibration     feeling@ Recommendations for you at present - avoid heavy work out for 2-3 days- maintain your hydration- keep BP , blood sugar under control- avoid stress / anxiety - have regular sound sleep of 6-7 hours - avoid weight lifting as well - consult later doctor if persist after 24 hours ( may require soft tissue  sonography or EMG NCV study for the same )Hope this clears your query .Welcome  for any further assistance .Thanks for using Healthcaremagic.com & giving us an opportunity to assistWishing you a very happy healthy life ahead .Regards dear take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sore neck, dizziness, nausea, heaviness in eyes, fatigue, tingling face\n\ni have a very sore neck ,the pain is on the lower base of my skull . ive been to the neurologist he said that my spine sint oval shaped but heart shaped and it might be putting presure on the back of my spinal cord and i have some disc that are getting thinner. I get very dissy and get nausea, sometines my eyes get very heavy and i become disorientated, very fatigue , tingling in lower part of face, sensitive to smells and sound, very irritable , weird feeling in my head i think thats the dizzyness ,some short term memory loss",
    "doctor_response": "Hi there,Thanks for your query.Firstly, I agree with your neurologist's opinion. Spinal cord compression is causing most of your problems.Further, other problems like nausea, heaviness of eyes, fatigue, occasional disorientation, irritability, short-term memory loss and sensitivity to smells and sounds, may be due to either mental depression, Thyroid problem, allergy to certain smells or a type of epilepsy.Consult your doctor/psychiatrist and apprise him of my opinion. I am certain that he will agree with me, order required tests, and- based on the reports-  will prescribe suitable/modified treatment as advised.In case of any further queries, revert back to me THROUGH DIRECT PREMIUM QUERY (Paid), addressed to me personally. You will receive- almost immediately- my response in great details.If you find my response helpful and informative, do not forget an \u201cexcellent\u201d (5-star rating)  to my answer, to ENCOURAGE all doctors- engaged in social service- to render sound advice to the FREE queries. Fond regards and have a nice dayDr. Rakesh Karanwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have some reddish thing on the top of my molar. Is that a cavity?\n\nHi doctor, I was wondering if my back teeth have a cavity. When I was examining my molars, I came across a strange reddish color on top. I did some research on the internet and read that\u00a0a cavity will be either brown or black in color. I am very confused. I do not want it to spread and I am asking you just to make sure whether it is a cavity. Also, it hurts a little when I poke it.",
    "doctor_response": "Hi. Revert back with the photos to a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should we give liquid diet to 1 year old for vomiting and dehydration?\n\nhi.my 1 year old daughter is suffering from vomitting n dehydrations from past three days.the doctor has given her ORS n kaptin n motillium medicines.but there is no positive result.she doesnt eat any food.should i keep her on liquids? she has loss of appetite.please tell me how do i help her get back to normal.",
    "doctor_response": "Can you do a simple thing. Get coconut husk ( narial jata) and burn it. Make powder of the burnt material. Sieve it ( if needed) to get fine powder. Give little pinches with honey to your child three four times or even two hrly initially. Give coconut water to drink. As the condition improves, give her boiled lentils water.Coconut water as much as you can. Similarly lentils.These are the techniques followed commonly in India on the principles of Ayurveda. No side effects. Natural. Practically no cost. Rich in minerals.In our career we have seen innumerable no. of such cases getting relief.Hope it makes you free if worries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should rabies vaccination be taken for the dog's bite?\n\nHi. I was bitten by a puppy when i was a kid. I think i was 10 y/o that time, and now I'm 24. I told my mom about it but my mom just rinsed the wound on my thumb and thats it. They just leave it that way. As far as I can remember, that puppy died few days later. Please help me. I'm so worried right now. What do you think should I do? Can I still have a shot even tho it happened long time ago?",
    "doctor_response": "Welcome to HCM. I understand your concern. I would like to know why you are worried after 14 years? Do you have any physical symptom or any other reason to be worried? Do you remember or did they tell you why the puppy died? The mean incubation period for rabies is 20-90 days and in more than 90% of cases, incubation is less then 1 year. In very  rare cases incubation may take longer (several years). I don't think that you should worry and vaccinate. Anyway you can ask local health authority about rabies cases in your living place. Feel free for additional questions. Best regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can regular ejaculation by masturbation affect the future in any ways?\n\nhlw doc,i am of 17 and i am ejaculating sperms since i was of 14.now it's being habbit of mine to ejaculate everynight as i can not sleep if i do not ejaculte. After ejaculating i feel tired and sleepy, and if i don't ejaculate i feel that there is so much of energy in me and ican't sleep.so, my question to you is that will it affect me in future??????",
    "doctor_response": "Hi Masturbation at your age is a normal phenomenon. so you should not be so much worried about yourself and your future.  But you should know to control yourself. i suggest you to do some relaxation exercises before going to bed.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to become pregnant with blocked tubes due to infection?\n\nmy husband and i have married for 8years without a child and he has been diagnosed with asthenoteratozoospermia but he thinks that is not a fertility issue, he believes i am the problem because i have also been told i have blocked tubes due to infections",
    "doctor_response": "Hi,Welcome to HealthcareMagic .Azoospermia and blocked tube both are cause of infertility.  For your tubal block you are  adviced to go for recanalisation surgery . If that won't succeed then you need to get IVF done.For your husband problem he is suggested to start drugs with combination of zinc and lycopene after consulting your doctor.  After 3 months repeat semen analysis.  If then also no sperms seen then donor sperms is next option. Your husband is adviced to reduce weight and quit alcohol and smoking. Hope I have been helpful .RegardsDr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For the past two years, I have fishy vaginal discharge and itching. Is it a vaginal infection?\n\nHello doctor, For the past two years, I've been getting a smelly vaginal discharge, more like a fishy odor. I've never had any sexual intercourse. During those two years, my vagina was itching and sometimes it was unsupportable. I never went to a doctor as I don't know what to tell them and via message, it is easier to talk about. Well, it would be great if you looked into the matter as I'm scared of having got a vaginal infection. Thank you for your attention.",
    "doctor_response": "Hi, How are you doing? Hope you & your loved ones are safe and healthy. For a young lady of 18yrs , not sexually active, diagnosis are 1. If you use vaginal wash or douching frequently. Use too many antibiotics frequently for any other reason. This could be Bacterial vaginosis. It's not an infection. It's just an imbalance between the healthy & unhealthy bacteria in your vagina. Every lady has a balance between these good & bad bacteria. They act like a security preventing any new infections entering body. Using vaginal wash or douching or antibiotics can kill both bacteria and disturb the balance. Treatment would be to stop these, use Oral Lactobacillus capsules. Vaginal wash daily for 5- 10 days with yogurt or curd twice daily. 2. If you use vaginal tampons or any foreign body.This could be source of infections into vagina. Then you will need a good course of antibiotics.orally & vaginally 3. Check your blood sugar levels. Especially if you have any family history of Diabetes. If yes, correction of blood sugar levels will cure the problem 4. Rare possibility is vaginal Tuberculosis., Especially if anyone in your proximity is suffering from TB, also if your area has too many cases of TB Can have your menstrual blood checked for TB- Need to contact your doctor then. From your history I don't think it's anything serious to Hope I have clarified your query, do write back if any more queries & for your feedback All the best, take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Am I likely to conceive after starting clome?\n\nMy doc prescribed me to take Clome 100mg Day 3 to  Day 7.Follicular study scan On 12th day (today) showed  one follicle of size 9mm on right overy.So she suggested me to take a injections ( INJ IVF -M) for 2 days and asked to go for another scan on 16th day .is there a possibility for conception this cycle???",
    "doctor_response": "HelloThanks for writing to us with your health concern.Normally, in a 28 day cycle, ovulation occurs on day 14.By this time, the mature egg follicle, which is ready to rupture, should measure around 18 - 20 mm.The egg follicle grows at a rate of 1 - 2 mm per day so by day 12, it should be around 12 mm or more.In your case, it is not of the optimum size on day 12.However, some women have delayed cycles or delayed growth of the egg follicle.In that case, the egg will grow at a normal pace, only the day would be late.Continue having follicular monitoring for a few more days.If the follicle size becomes optimum, then there would be scope for ovulation.Ovulation ( rupture of the egg follicle ) also is confirmed via the follicular ultrasound scan.Once ovulation is confirmed, please remain sexually active to maximize the chances of pregnancy.Take regular folic acid supplements.Also, if 3- 6 such cycles of stimulation fail inspite of good ovulation, then go for laparoscopy to check the patency of your fallopian tubes.All the bestTake care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and constant pain in toes and fingers?\n\nThe joints in my toes & fingers have enlarged, causing constant pain, sweeping with redness. I was diagnosed with osteoarthritis throughout my body, tho from what I ve described, could it be RA instead? One yr ago, it started on my fingers, and now it s affected much more than that- moving very quickly thru my body; neck, low back, hip & ankles. I m scared it s going to cause me to be in a wheel chair before too long because it s happening so quickly. *I apologize, but I cannot pay for this, as I ve been unable to work, thus afford extras, (my ins. Has had to cover my medical expenses).",
    "doctor_response": "Hello, I have studied your case with diligence.If not relieved then possibility of polyarthritis needs to be consideredRheumatoid arthritis may involve small joints and early morning stiffness in joints, do you have such complain?Ankylosing spondylitis typically involve spine and hips with other large joint also. There is reduced chest function in this disease. Stiffness in spine is increased do you have such stiffness in spine? When such patients come to our hospital I advise them blood test like RA factor, ACCP, ESR, complete blood count, HLA B27Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could blood pressure of 98/55 and an angiogram of 50% blockage indicate?\n\nMy husband s blood pressure usually is 136/80 give or take. Last night I noticed his hands were cold and arms clammy the back of his neck was very sweaty. took his blood pressure and it was 98/55 any thoughts. he recently had angiogram and 50% blockage but nothing recommended as yet.",
    "doctor_response": "Hello,Brief Answer: Your husband has symptoms and signs of low blood pressure that needs treatment.Explanation: My opinion is that low blood pressure accompanied by symptoms and signs like sweating and dizziness is important to deal with. First measures to increase blood pressure to normal readings is essential. Then investigations to determine the cause is important. Angiogram with a coronary artery disease may be a cause of low blood pressure if there are chest pain symptoms. Fifty percent of blockage is a general term that needs more details. I suggest my patients the following; good hydration, revise treatment and doses and modify accordingly.Conclusion: I suggest you check with your physician.Hope I have answered your query. Let me know if I can assist you further.Regards,    Dr. Mahmmad Gamal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the difference between heart attack and costochondritis chest pain?\n\nHi\u00a0doctor, I am 21 years old, and I visited my GP today, who thinks that I may have\u00a0chondritis. I just have a question regarding the difference between this and heart attacks. The pain has been varying from the right side of my left pectoral to the left side of my left pectoral muscle. Being fairly young, this had made be worry a lot. Please help.",
    "doctor_response": "Hello. Firstly, to begin with, the probability of heart attack is very less at this age. Costochondritis pain will increases on applying pressure over the area, if yes, it could be costochondritis. This is the most important sign of costochondritis. Heart attack pain will be very severe on the left side, which is associated with radiating pain to the left arm and a lot of sweating. It will not last more than 24 to 48 hours in severe heart attack and more than 20 minutes in a minor heart attack. To clear your doubt, you can get an ECG (electrocardiogram) done. Overall, I do not think it to be a cardiac pain. Hope this helps you and get back if you have any doubts. For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "A black spot on hip in CT scan seen on hip. Surgery done for removing mass from kidney. What might this be?\n\nMy father is 81 year old and on his ct scan a black spot was seen on his hip, I do not know if the right or the left, what could it be? He is havng a procedure done right now to removed a mass from one of his kidney and when they did the ctscan for this, is when they notice the black spot. I do not much because  am in California and he is in Texas. I got this information from my sister that is there with him right now.",
    "doctor_response": "HI, thanks for using healthcare magicI am sorry that your father is unwell.It is possible that the black spot that was seen represents a mass or defect in the bone.If the mass on the kidneys is malignant, it is possible that the black area on the bones represents spread to that area.The mass on the kidney would be sent to the lab for analysis to determine if it is  benign or malignant.You and your father should speak to his doctor.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for numbness in arm?\n\nMy arm falls asleep when I sit down for more than 15 mins ie church at work behind the computer. It is my left arm and I have had c-5 and -c-6 fused. I am a 41 yo male and ride a bike for exercise. I am losing weight because the my doc told me I have fatty liver disease. I am currently 5 6 and weigh 185 lbs.",
    "doctor_response": "Hello, The numbness in the arm that you have can be related to a mild nerve root compression at the level of the cervical spine. This can be due to a bad posture while working on the computer. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Prostate problem, overweight, asthma, no sound sleep, ADHD. Solution?\n\nBoyfriend, age 58...has minor prostate problems, little overweight , drinks daily, smoking with asthma . While in anxiety and fear, not having total control or the feeling he s in control and he constantly repeats himself ( started 2yrs ago ) and then when he s sleeping- he jerks, mumbles with angst and screams oh my god, sighs . It s unsettling and i worry about him. Oh and he s taken Dexometaphetamin (sp) speed for 8 yrs. 10 mg? Brown & white/clear capsules ( 2-5 daily). For ADHD . JG",
    "doctor_response": "Hi there ~ Thank you for bringing up the situation of your boyfriend within a forum like this.  I think your boyfriend needs expert help of a psychiatrist and a substance abuse counselor.  His prostate problems, being overweight and having asthma apart (which need to be seen by a family medicine doctor), he needs to see a psychiatrist for his sleep disorder which might be secondary to a substance abuse condition.  I also feel like he may have a primary mental health problem.  Please consult these specialists as soon as possible along with your boyfriend. I hope this helped.  Take care and have a nice day !",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can taking folic acid, duphaston, siphene by me and levocarnitine by my husband help us in conceiving?\n\nI have been marriedfor 3yrs now, no pregnancy, I have 28daayz cycle, myuterus isnormal, my tubes are okay, my hormones are okay. Can folic acid, duphaston and siphene help me concieve? Can Levocarnitine also help me husband? We are both 36yrs old.thank you",
    "doctor_response": "HelloThanks for writing to us with your health concern.The husbands semen analysis should be normal.Was that done ?Was a laparoscopy done for your tubal patency status - if not please get it done.A cycle of follicular monitoring should be done to confirm ovulation.Folic acid should be regularly taken.At 36, please have the following levels measured - FSH, LH, AMH, TSH, Prolactin, OGTT.Just taking the medications wont help you conceive, unless the problem is pinpointed.PLease consult an Infertility Specialist, and have requisite evaluation and proper treatment.All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the success rate of IVF treatment with donor eggs?\n\nI am a 33 yr old female-wt. 51kg-ht.157cm, asked to go in for IVF with donor eggs as my ovaries have shut down.  Both my family and my husband's family(my mother has breast cancer, my mother in law had ovarian cancer) have history of cancer. Are there any serious side effects of this treatment. what will be the approx. cost for the IVF treatment with donor eggs. Since the baby will not be genetically mine, will I have a stranger for a baby? Will it still be mine? what is the success rate?",
    "doctor_response": "Hello, there will be no problem and difference in rearing of the child.Donor egg will eliminate the need of ovulation induction drugs on your body making it even more saferIn case you have any questions in future you can contact me directly on",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest ways to improve self confidence\n\nSir,I have pigmentation problem from last 15 years..I used lot of mediation,but I couldn t found permanent solution.sir Iamworkinig in bank.because of my prob I can t be confident in my job.is there any permanent solution for my problem.waiting for your answer sir",
    "doctor_response": "Hi dear,Thank you for your query.Your problem is secondary to your pigmentation problem.once your pigmentation is gone away your self confidence is also gets better.First of all consult skin specialist for your pigmentation and if treatment is possible than complete the course.Than consult psychiatrist for your secondary depression and lack of self confidence.You required both medication and psychotherapy for boost up your self confidence.Not to worry all will be good.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome the problem of sweating while sleeping and the depression caused thus?\n\ni have several problems that I think might be from the same thing at night I can t keep my legs still and I have a weird sleep pattern at times I hot enough to sweat, even in the winter and I feel like I have no energy all of this is leading me to feel depressed",
    "doctor_response": "hithanks foe choosing healthcare magicI kind of symptom u r presenting in towards depression. U have to consult a psychiatrist who could prescribe u some antidepressant and Benzodiazepine.Rest depend upon underline cause and symptoms whether to need any CBT or not.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the prognosis for cirrhosis of liver?\n\nMy husband has cirrhosis, end stage. He sleeps in excess of 16/hrs per day, ascites, confusion, decreased appetite. I can't get a clear answer from his Doctors on how much APPX time we have left. I know you cannot say definitely, but I am so lost. Can you give me any idea at all? Thank you!!",
    "doctor_response": "He is in endstage liver disease. Usually in this case only supportive management can be done. Tapping of ascites fluid, prophylactic antibiotics to prevent peritonitis (infection of ascites fluid), laxatives to prevent encephalopathy and altered behaviour), electrolyte correction and so on. His long time sleepiness is also a part of grade 1 encephalopathy. We cant predict his days exactly. I can understand it ll be difficult for u. But there wont be long time since he started developing signs of liver failure. Just be with him and give your care and support as much as u can.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in groin area\n\nwas on vacation and my groin area started to hurt. over the next few days the pain got worse. ended up going to hospital in san juan where an x-ray ct scan and ultra sound all came back negative. in the last two days my groin has started to click every few steps",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn Short: MAy be a muscle pullExplanation: Sometimes muscle pull can cause pain like this. If all of your investigations are normal then you need not worry. Please do inform if you are into any exercising regime or any other physical activity(swimming).                       If not, please visit a doctor again. For time being you can take muscle relaxant for relief.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness in chest with difficulty in breathing?\n\nI was admitted to A & E yesterday with a tight chest and problems breathing, dizziness etc and was told I had had something called an 'svt'. I woke up with it at 4am yesterday morning with it for no reason. This morning I woke again at 2am with the same thing except this time is is still here with me 12 hours later. How can I make it go away?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. SVT means supra ventricular tachycardia. It is type of arrhythmia (rhythm disturbances in heart) common in young patients.In my opinion, you should consult cardiologist and start anti arrhythmia drug (diltiazem) for SVT.Radio Frequency Ablation (RFA) is also a good option for SVT.So discuss about these and start appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for recurrent penis fungal infection\n\nhi mam, I faceing to four mounts this penis fugal infection.As my Dermatologist to me flucanozle 300mg every one week & sertacide normal twice daily. Some time problem totaly solve but some days re feel red - red rash on penis head around.i am very sad this reason.pls help us & sugest. thaks & regards Anil.",
    "doctor_response": "Hi anilAre you sexually active ? If so your partner also has to be treated.If not you will be cured partially because of contamination again from you for partner. Some time  prolonged use of topical antifungal ointment will help.Hope my answer helps you. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "History of root canal. Swelling in gum, no pain, sensitive to touch\n\nI am having a problem with an upper tooth that had a root canal done on it about 5 years ago.  The is swelling far above the tooth where the gum and the cheek meet.  I have no pain but the is area is very sensitive to touch and discomfort is felt when pressure is applied to the area.  There is also swelling.  I do not want to return to the endodontist who performed the root canal, as I have no confidence in him",
    "doctor_response": "Hi,Thanks for asking the query,Pain and swelling can be due to re-infection of the tooth or due to food lodgement between the tooth and cap surface if the tooth is capped. I would suggest you to visit the Dentist and get an x-ray done, if necesary you can go for the retreatment of the tooth or else you can go for complete mouth scaling and polishing. Take antibiotics and analgesic course under prescription of your Dentist.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for sarcome synovial in knee\n\nMy grand daughter has a sarcome synovial BEHIND THEW KNEE she was operated but now they want to amputate , I waould like her to see another doctor just to know if another treatment could be given to her. Excuse my \u00c9nglish i am French .Thank you!",
    "doctor_response": "Dear Grandparent.I understand your concern about amputation. I will explain the line of treatment first. Since Synovial sarcoma is an aggressive malignant tumour the current line of treatment is surgery. The type of surgery -that is how far should we operate depends on the site or location of the tumour. As you have mentioned behind the knee, this means that the popliteal fossa is involved. Synovial sarcomas in such locations spread rapidly through the blood and lymph channels to the lungs. Therefore depending on the location most oncosurgeons prefer amputation in order to save the life of the patient. Please remember that synovial sarcoma is very aggressive, grows and spreads fast . I do not have the biopsy report of your grandchild but from the description you have given I presume that after the first operation, the pathological report and surgical findings may how shown involvement of the popliteal fossa and fascial planes. You may request another specialist opinion if you wish but please do not delay the operation. You may also post the details of the histopathology report for further assistance and guidance. You may also refer websites such as Merck for patients or WebMD which explains further details of this disease in simple English. You may use google translate to convert such explanations into French Best regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes weakness in 30 days aged baby?\n\nmy baby is now 30 day age. when he born his health was good but day by day he become week and cryiny at night .he take milk of his mother .i saw his child spilished he said baby is ok.this cause may be her mother milk but i have three baby later all feed by mother and no problem at all.",
    "doctor_response": "Good evening..!!\"Becoming weak day by day\" is just a perception.Mother's milk is the best food a baby can have.All babies cry at whatever time it may be. Its just normal.Thank you, have a nice day..!!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes wheeze with tight unproductive cough with blood taste?\n\nI am a 52 y.o. W.F who had a total hysterectomy for tx of stage 1 endometrial cancer 1 year ago. Recently I have experienced a wheeze with tight unproductive cough that just happens (sometimes after a laughing spell) and I taste blood but am not spitting up blood. I do not experience shortness of breath. Any ideas?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. You are having momentarily wheezing with tightness in chest. This is characteristic feature of temporary bronchospasm. This is seen commonly with allergic exposure and emotional disturbance like (crying, laughing etc). This can also be seen in stress, anxiety. So better to avoid dust, pollens etc. Avoid sudden emotional behavior like laughing, crying. If you are having stress, tension and anxiety then avoid them, be relax and calm. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bronchitis, wheezing and fatigue\n\nI m in my second round of antibiotics for bronchitis in 5 weeks. Does this mean I m in Stage 3? Besides this my other symptoms have been extreme fatique often, wheezing, and just these past couple of weeks, bloating. I ve asked my nurse practitioner if it is time to make ?!!a referral to specialist and he said no and he sai so fightsd not to worry about stages, but I do. I only have 2days of steroids left and I began with the wheezing again today. My meds are Albutera L",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Best treatment of bronchitis is inhaled bronchodilators and inhaled corticosteroid (ICS). Since you are not taking these, you are not improving. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT will not only diagnose bronchitis but it will also tell you about severity of the disease and treatment is based on severity only. Yoi will definitely improve with inhaled bronchodilators (formoterol or salmeterol) and ICS (Budesonide or fluticasone). 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "6yrs old has behavioral problems, aggresive, looses temper, is sad about being fat. What's wrong ?\n\nmy son is 6yrs old and since christmas has a lot of behavioural problems. he can be very aggressive and has loss of temper tantrams. he freuses to tell me what is wrong but tells me he is fat and nobody likes him. he also says he has nobody to play with in school. he has lost weight and is continually going to the toilet and w\\shing his hands, even waking 3 and 4 times a night to do so. at the moment he has sores on his hands from over washing. he begs me not to send him to school. i have spoken to his school teacher and she has spoken to the children and can not see what is happening if anything at all. he does not sleep well and sometimes tells me and his dad he hates us. i am presently waiting for an appointment to meet a physicologist but may have a lenghty time to wait....my child is suffering and i dont know whats wrong. please help -AAAA",
    "doctor_response": "Hello and welcome to Healthcare Magic. Thanks for your query. I understand that you must be quite concerned by your child's behavioural problems. From the description of his problems it appears that he may be having some obsessions and compulsions. He also seems to be coming out with depressive thoughts and ideas. However, in young children, these symptoms may be more complex than what is obvious and expressed. So, your son definitely needs a detailed psychological assessment in order to arrive at a diagnosis. As you wait for the psychologist's appointment, I would suggest that you continue to be supportive to him and encourage him to talk about his problems to someone he trusts. Wish you all the best. Regards, Dr. Jonas Sundarakumar Consultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i need surgery for disc bulging?\n\nhi am elango frm india....am 22m . i have disc bulg at l5s1 since 7mnths , went to pt nw am somewat ok i can walk for more than an hour without pain but if i sit for long time or twist my hip i l get pain for 2-3 sec.....am a badminton player can i play badminton hereafet doctor told me i may get problme if i play again and i asket aabout surgery he told if i have surgery i can play well.......sooo wanna know weather to have surgery or nt , wat type of surgery they l do....i want to blay badminton again.....",
    "doctor_response": "Hi welcome to HCmI have gone thru your query  about your bulged disc . It is a matter of concern  Dear , A bulging disc is not necessarily a sign that anything serious is happening to your spine and need surgery .On seeing an Exray ,  surgery can not be dagnosed And is not a guarantee  for better future life , and will enable you to play Bedminton.If your doctor insists surgery, I would suggest you to  consult other  specialist , for 2nd opinion .Disc bulges are a common cause of lower back pain. They can sometimes be reduced by doing simple exercises and stretches, and making some lifestyle modifications.Our day today derailed life style and faulty food habits cause our immune system to become weak and lead to various sufferings . Dispacement of disc or joints  is one of such  sufferings  . Balanced diet including all essential nutrients - vitamins , minerals  and antioxidants  in natural form  , fiber ,  fruit veges , Aloe Vera , lemon juice with black pepper & salt .  Turmeric  powder in a cup of hot milk at bed time and BF , regular walk , exercise ,deep breathing , meditation and yoga posture are very helpful in  eleminating inflammation and pains any where ,   and remove  your health problems .Backbends usually give relief to disc bulg. When done purposefully backbending poses increase the C curve of your lower back, and there by help in building strength  of your immune system .Ushtrasan on Vajjarasan & Certain poses, such as setu bandh &   (Bridge ), will help you to build strength in the lower back muscles, which in time may help correct your disc . Also Cobra posture , when done correctly build strength in your middle and lower back. No front bending . Only back bending is allowed . Agnisara , Kapalbhatti and Nauli can strengthen the abdominal muscles and diaphragm. Tadasana ( streching your body ,hands above head to sky and feet towards ground , standing straight) will also help in giving a correct posture.Avoid fried fast foods too much of salt , sugar, tea, coffee ,alcohol , smoking ,stress ,constipation  and dehyderation  , sleeplessness .Hope this helps solves your query .Take care , All the best .Don't hesitate to get back if have any further query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Orange coating on tongue, have asthma. Suggestion?\n\nHiya, my son is 4years + 8 months his tongue has an orange coating on. Its been like this for a week. He s eating + drinking the same (healthy with few treats). His toilet habits are the same. He has got asthma which has played up alittle due to the change in weather. He s sleeping well. Do I need to anything ie take him to the Doctors?",
    "doctor_response": "if contant coating your son is surely allergic to milk you will have to get treated as it will increase after the fisrt time it appears in the mean time stop giving all milk and diary products completely give tab montelucast 5 mgm twice ady for 3 weeks get the allergy test serm ige for milk only i am 100% sure it will come positive and then you can start sublingual immunotherapy for milk allergies",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pregnant. On Nexito Forte. Weight gain more than needed. Any harm for the baby and any chance of coming off anti depressants?\n\nHello, doctor,My wife is 7 months pregnant. Since last 3 1/2 years she is taking anti-depressants. During that tenure, thrice she was on the verge of coming out of medication but treatment was re-started after she again started showing depression symptoms. The most recent symptoms shown before re-starting medicine were constant pain of left side of head and anxieties and crying. Currently she is taking Nexito Forte. I have two questions? Currently, she is putting on more weight than required... can it be because of this medicine and will it harm baby?.  and secondly, being on anti-depressants for so long ....will it impact my wife's health in long-term and will she ever come out of taking anti-depressants?",
    "doctor_response": "Hi,I do not feel that the excess weight gain is due to Nexito Forte as all SSRIs, including escitalopram which is the main ingredient in Nexito Forte, are known to cause weight loss. In my opinion, you must check her thyroid status as hypothyroidism can cause both weight gain and recurrent depression. Please also see if she is taking a diet too rich in fats. Regarding your second question, being on antidepressants for a long time is not expected to have any deleterious effect on her health in the long term. Most patients are able to discontinue antidepressants and I expect she too will be able to do so, provided it is done properly and at the right time.Hope this helps you. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for having lump above the top of implant towards armpit?\n\nI found a lump above the top of my implant towards my armpit on the right side back in October. At times I will have a dull pain deep within the breast are around the same area of the lump. The size has not changed to my knowledge. It is the size if two grapes sitting side by side. I had blood work and a chest xray the end of January results came back fine, with the exception of having a vitamin D deficiency. I then had a mammogram as well as a ultrasound, again was told things are fine. They were not able to visual see the lump via ultrasound though, A few days after I had these test done my gp called to schedule a breast MRI. I do not have insurance now and am unable to pay for the MRI anytime soon. What could this lump be?",
    "doctor_response": "Hi.Please go for a simple test of FNAC= fine needle aspiration cytology if you can palpate the lump- mark on it to be found easily by you and your Doctor at the time of FNAC.This will give the best diagnosis and in less money .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump in the upper left arm?\n\nA 16 year old presents with a lump in the upper left arm. It feels deep to the hypodermis but feels superficial to the humorous. The area around it feels numb. It dies not feel soft and malleable,  but it feels hard.  It is not moveable and when it is touched, but  turns bright red and bruises very slightly. It was noticed about 10 weeks ago. The teen also experiences severe fatigue. What can this be and what should happen next?",
    "doctor_response": "Hi and regards at the website. I have gone through your query. * The narrated lump in the upper arm indicates possible sebaceous cyst, lymph node or other soft tissue lesion. * I recommend to take an ultrasound examination of the local part for the best evaluation and management guidelines. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What will be the effect of Progynova to the baby if i get pregnant?\n\nHi. I m trying to get pregnant and I have just received my Pregnyl injection last March 24 which was the day before yesterday. I took Progynova last night as prescribed by my doctor. However, I am a bit worried about it because I read in the leaflet that came with the medicine that Progynova should not be taken by pregnant women. The doctor said I m fertile on the 25, 26, 27th and 28th of this month so I should try to get pregnant by then. I m also going to be taking Progynova on those days. What if I get pregnant? What will be the effect of Progynova to the baby? Thanks so much!",
    "doctor_response": "Hi there, I have understood your concern. I will suggest you the best possible treatment options. 1. First of all do not panic. Please fully trust in your treating doctor .2. You  might be aware that  organ formation of the baby starts 28 days after the conception.  Your doctor must have given the progynova tablets for 15 days from ovulation. Progynova tablet is a estrogen hormone tablet.  This is to provide good endometrial lining for the implantation of the embryo.  It's well before organ formation.  So please do not worry. I hope this answer helps you. Thanks. May God bless you with a bundle of joy. Dr. Purushottam Neurgaonkar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a chest pain?\n\nI have chest pain in the center/lslightly left side of my chest. it comes ang geos but experience it regularly. I seem to notice it and most often when I am stressed, upset and even after drinking coffee.  My doctor is recommending a gallbladder ultrasound but am not sure that my concerns are being addressed.",
    "doctor_response": "Hello hope the answer helps you out.You are having chest pain on and off as you mentioned but kindly let me know nature of it pressing as heaviness or with heart burn as simple benign things as GERD or muscular spasm can present like this provided you donot have any risk factors as DM,HTN and H yperlipedemia.I think you try some oral analgesic with muscle relaxant capsule as parafon after such episode and see the response if its worth.But still having chest pain better at the time of pain episode do an ECG in ANY EMERGENCY and let it be checked.Donot worry if your doctor recommends U/S GB as sometimes vague dyspeptic symptoms can be due to gallstone disease will happy to hear your response sir/madam",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain with dizziness in wheezing patients?\n\nHello I'm 31ys old female. I have had trouble this last month with my health. I had pneumonia earlier this month. I have been put on breathing treatments due to wheezing and had a test completed on my breathing on the 25 of this month. I woke up the last to mornings short of breath, chest pains, dizzy, sick to my stomach. I'm going to see the dr this afternoon. What do you think is wrong?",
    "doctor_response": "Airway hyperresponsiveness is seen in susceptible individuals when exposed to a viral infection..  It is more likely that you have had a spirometry done and was diagnosed to have hav the same..  Treatment  with inhalers for sometime would be beneficial to treat the symptoms and follow up for at least two months to see for any recurrence of symptoms..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and lump in the leg after running?\n\nMy daughter is a 17 yr old softball playr and twice a week they do conditioning . They have to run for a mile to get their times downa dn on Tuesday she was runnning and her calves were burning and a hugh lump appeared on the outsde of her leg. The trainor immediated stopped her and applied ice and said she really has never seen a muscle like this and to stay off of this for a week. If she continues in pain go to the emergency room. She went to her Chiropractic doctor and he said she had what they call a circulatory problem where the blood flow stays in a chamber and this startes acirculatory problem. He told her to be careful about running for any distance and if this recurs again it could be very dangerous. Sometime s if the circulation does not come back and her toes and feet become numb they may have to slice the leg open to get the blood flow again. What condiion is this and what doctor should we see? Can she continue to play ball? She is an outstanding pitcher and she is going to several college showcases in January. He said the short base running may not be a problem.",
    "doctor_response": "Hi, Based on the information provided there could be following possibilities:1. Muscle / Tendon sprain / rupture2. Local hematoma formation 3. Exertional compartment syndrome.Following investigation would be needed to proceed further X-rays, ultrasound, color Doppler. If above tests are normal, one can think of MRI to establish the cause. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Rajesh Gayakwad, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fluctuating blood pressure, burning sensation in body. On thyronorm, tazlog and met xl50.\n\nHi madam , I am taking thyronorm 25 mcg  from yesterday  , because my Tsh is 5.47.  Also taking blood pressure medicine tazlog 40 H. In the morning & in the evening met xl. 50. Mg but my pressure is fluctuating , I feel burning sensation In the body and also back of my head during day some time pls. Advise what is wrong going on .",
    "doctor_response": "Hi,Thanks for using Healthcaremagic,You are having  High blood pressure and treated for it with antihypertensive medicines if your blood pressure reading are fluctuating take medicines at regular interval and regularly.If you dose is recently increased it may take some time to have smooth control of blood pressure.Recently you also started Thyroxine supplementation please continue to take it regularly.Your burning sensation possibility of some allergy to any of the agent or some kind of neuropathy. It would be great if you see treating physician as he will be able to examine and tell exactly what is happening.If allergy is there it can be treated with anti allergy drug and removing the offending agent.If you have neuropathy we need to know the cause like Nutritional, alcohol.Hope this information helps you.Take careGood Luck.Dr.Akhilesh Dubey M.D.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am just 27, and my vaginal walls are lying outward. Why?\n\nMy vaginal lips are falling out and my age is just 27 any reason why the vagina walls are lying outward. Its just because of sex or some hereditary issue",
    "doctor_response": "Hi, Hope you & your dear ones are doing fine. I would like to put forth few features / symptoms to differentiate normal from pathological labial hypertrophy/ vaginal wall enlargement. 1. If wall prolapse is painful/ tender, associated with excessive vaginal discharge, especially yellow or greenish color, foul smelling & with itching. If swelling increases after sexual exposure . Around the time of periods discharge increases with all above features. Associated mild feverish feeling around periods, cramps in lower abdomen before periods. All these suggest that it could be infection in vagina , following sexual exposure. You need to meet your gynecologist & use medications for yourself & for your partner. 2. If the lips of vagina are not not tender & free of the above mentioned symptoms, then this could be just hereditary as you mentioned. Then it needs no treatment. Hope I have clarified your query, do write back if any more queries & for your feedback All the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can anxiety and depression be treated?\n\nMy mom had a stroke over a year ago. She can no longer stand cannot feed herself as her hands don t have the coordination or strength to do so. She is bedridden, must be bathed, diapered, fed, etc. she gets extremely anxious, and constantly wants you to sit with her hold her hand, etc. she takes lorazepam, one used to help now two are just enough, temporarily. She is depressed and panicky. Is this typical. Can anything be done to improve things",
    "doctor_response": "Hello,In my opinion, she has developed a complication of a stroke. She would need escitalopram that can manage her anxiety. Also, check her renal functions and sodium levels.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Gayathri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of sadness?\n\nCan I tell you some symptoms and you tell me what I have? I am not really sure what I have but I think its urgent. I often feel sad inside, and I cry a lot when something in a story happens because i feel the same way. And they are normally sad ones. I think thats unusual because i normally never cry, I keep it all inside. Its kind of hard to tell you what Im feeling, but Im trying. I feel sick a lot, I shake uncontrollably when Im nervous and my breathing gets kinda faster. If I stand up too fast, I get really light headed and sometimes I fall over. I cannot sleep very well and i get tires easily. I have horrible self confidence and i also have troubles with trust. I also used to cut, but I am now 7 days clean.",
    "doctor_response": "HiThanks for using healthcare magicI think, you have depression and you need antidepressant. You would suggest you paroxetine or fluoxetine as an antidepressant and clonazepam for sleep. These drugs are not available over the counter, so you have to consult a psychiatrist for proper diagnosis and management.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pressure feeling and slight dizziness in head?\n\nHi there, my mum has had a pressure feeling & slight dizziness in her head & now complaining of numb toes. She has had a CT scan of her head & although the results are'nt back yet, he has viewed the scans & believes there is no significant problem that he can see. Dr suspects middle ear infection (this is before he knew about numb toes)or a small stroke.She did sit for a few hours on an uncomfortable chair last night.She is flying next week & she is very anxiousI would appreciate your feedback",
    "doctor_response": "Hello & Welcome to HCM,I had gone through the case and found that these symptoms might be associated symptoms of Vision, neurological or Hypertension.If CT Scan is normal then go for vision test and blood pressure monitoring.If both are normal then consult to neurologist.Hope my answer will be effective for you.Thanks,Dr.Soni Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Triaminic be recommended for cold and cough in infants?\n\nMy great-granddaughter is 18 months old. Following a cold, she has had a cough for over two weeks when she rises from her sleep. Her dr. said this can happen up to four weeks. When my children were young in the late fifties/early sixties, he recommended Triaminic, is this still recommended? Thanks for your answer.",
    "doctor_response": "Hello. I just read through your question.typically, we do not recommend triaminic for children this age.  We can use children's vicks vaporub and saline nose drops for these symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the surgery for broken washer in the knee appropriate?\n\nhi doctor. irecently there is some pain in my left knee i consulted doctor after taking mri scan he told me that washer in knee is broken some part so through surgery that part to be taken away it costs nearly 20000 rs after surgery take rest for 15 days is optable. may i relay upon this info from doctor??",
    "doctor_response": "Hello,As per your description it seems like you have injured your meniscus. Surgical correction is required. Arthroscopic repair will be the treatment of choice. Nothing much to worry and your treatment is in the right track.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough and chest congestion\n\nI've had a niggling cough for about 3 months now, I've also had a virus in that time that lasted 2 weeks and an acute liver injury from some fluoxicillin that was proscribed for an infected cut which all happened about a month ago. Recently in the last 2 days my cough has developed into a chesty cough with mucus and a slight metallic taste in my mouth when I cough. I also have Asthma so have been taking inhalers to relieve my chest when it was tight.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Your all symptoms are suggestive of post infectious bronchitis. It is common after viral upper respiratory tract infection. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT will also tell you about severity of the disease and treatment of bronchitis is based on severity only. You may need additional inhaled bronchodilators and inhaled corticosteroid (ICS) on the basis of severity. Oral anti inflammatory drugs are also useful. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to get hard erections and cure premature ejaculation\n\nI am 25 years old, my penis is not getting hard enough for sexual activity. i dont have sex with any female yet, but whenever i saw any porn movie or try to masturbation, i feel its not much hard and bent downwards. moreover, i do have preejaculation problem as well. pls help",
    "doctor_response": "Hello,I need you to do simpler things first like regular daily exercises, eating healthy, wearing loosely fitted garments and taking your daily vitamins like D, E and C. These simpler doings will improve your sexual life if not, then I suggest you to consult your doctor for your tests and further treatment if needed. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Sameen Bin Naeem, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a short penis and nightfall problem too. Is it normal?\n\nHello, I am a 25 year old person. I have a short penis.\u00a0It is only 2-2.5 inches long in flaccid state, but the\u00a0length and diameter is 4 inches in erect state. I want to increase the size of my penis. Apart from this, I also have nightfall problem which lasts for less than 2 minutes. It will occur 4 to 5 times in a month. I had masturbated a lot during my early ages. I am an unmarried person, going to get married soon. So, will the penis size affect my marriage life? If so, I need a permanent solution for this. Kindly suggest me\u00a0medications with no side effects to solve this problem.",
    "doctor_response": "Hello. I hope, this will help you. Kindly follow up with a sexologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vibrations in the neck and various parts of the body?\n\nHi my name is XXXX. i m working in a private company. I will always sit in front of computer continuosly 8 hours. From few months i m suffering from some type of vibration in my neck and i could not sleep well and also some vibrations are accuring in various parts of my body, some times i will get the headache. Please Dr. anyone can help me to know the reason and the sujjetion for the deseas.",
    "doctor_response": "Hello,The symptoms you mentioned can be caused by stress, vitamin B12 and Vitamin D deficiency. Thyroid hormone imbalance can also lead to this problem so I would recommend you should visit a doctor and do testing for these problems to evaluate the cause.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Wajahat Baig, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "I had a dentist apt today and he indicated that I might need to have root canal surgery in a molar that has extended a bit beyond the other teeth and I am scheduled to have cataract surgery Jan 20th.  Can I have an infection in my molar without pain?  And should my cataract surgery be postponed?",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,   I have gone through your query, as your dentist has advised you root canal treatment so there may be your tooth is carious or attrition or there may be presence of periapical pathology .  Dont postpone your surgery go for treatment of cataract then go for root canal treatment if you can manage your tooth problem . Hope this will help you.  Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am a smoker and have been coughing for longer period. Will it be chronic bronchitis?\n\nHello doctor, I am 23 years female. For about three years or so, I have been coughing up phlegm consistently. It has almost become a routine. When I consulted an ENT doctor, they did not see anything wrong and just said that my nostrils look little swollen, so he prescribed me Flonase. I am still coughing and spitting. The color of the phlegm is generally white, but sometimes it is slightly yellow. I need to know, should I consult a pulmonologist? I fear that I may have chronic bronchitis since I have been smoking from the age of 15.",
    "doctor_response": "Hello. You said that you smoke since, from the age of 15, so the diagnosis goes more in favor of chronic bronchitis. The symptoms are also typical of chronic bronchitis. But you have not mentioned any associated allergic symptoms like running nose or frequent sneezing as it suggests bronchial asthma. The best test to differentiate between both is to do a spirometry test, also called PFT (pulmonary function test). It will give a definitive final diagnosis. Regarding treatment, if it is bronchitis, the first and most important thing is to quit smoking. If it is asthma, then you need to take a controller inhaler regularly. Also, you should get done with your chest x-ray. I hope after reading this, you will take the initiative for quitting smoking and quit it ultimately. I hope this helps. Smoking. Chest x-ray PA (posetroanterior) view. Spirometry PFT (pulmonary function test). COPD (chronic obstructive pulmonary disease). Stop smoking. start with inhalers.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for failed IVF?\n\nI am dr arun. My wife underwent ivf process 2times with failure. She had history of pulmonary tuberculosis for which she took complete treatment. There is bilateral cornual block even after laparoscopy. What should be next step. Is there any reason for failure?",
    "doctor_response": "HAIWELCOME TO HCMEndometrial factor may be the cause for failed implantation even with good embryos.check your karyotyping and sperm fragmentation.donor ovum program will help you to get pregnant in case of repeated failure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can any online doctor help me with the semen analysis results?\n\nhelo sir my self amit kumar sir i have done my seman analysis and the report is given below pls suggest me sir about pus cells and improving total count .......tatal volume- 3ml,                                                                colour - grey(increased)                                                               viscosisty - increased                                                               motility - 60%(20% sluggish and 40% rapid)                                                               total count - 20 million/ml, and non motile - 40%,  2-3 pus cells/hpf seen...",
    "doctor_response": "Hello Your semen analysis findings may indicate semen infection with borderline sperm motility.Infection is indicated due to presence of few pus cells in semen.Normally semen shouldn't contain any pus cells.You may need investigations like routine hemogram,random blood sugar,semen culture and sensitivity.You may need to take antibiotics based on culture and sensitivity report.Motility is borderline.Normally it should be at least 55 %.Your findings suggests over all 60% motility,so it is borderline.Sperm count is normal.Normally it should be at least 20 millions/ml.Fertility is expected to increase with control of infection.If infertility persists then you may need assisted fertilization techniques.Get well soon. Take Care Dr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for polyps in gallbladder\n\nI had polyps in my gallbblader, 3 yrs ago was removed. I still have pain in my right side. My ant have polyps in her kidney she had complication. My question is Can the polyps develop in other part of my body like the liver . I was hospitalize last month, because numbness in my right arm, short of breath , chest pain. I steel with the symptoms. I don\u00b4t like to go to the doctors regularly only for my medicines (high blood pressure) They do not find anything in my heart . What is going on with me. I am 58 yrs. , 5\u00b43 , 179 pounds.",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.No,polyps cant be present in liver  but some other issues may such as hemangiomas or adenomas or diffuse liver lesions such as fibrosis or steatosis. So you can repeat liver ultrasound to rule these conditions out,but also such pain may be seen after gallbladder removal and it should be managed with low fat diet and body mass regulation.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a bump in the armpit\n\ni got a bump like thing in my armpit...whole shoulder till my elbow, from the inside is heavily paining. i had hurt my self there when i had worn a tight shirt and slept i had a small bruise on the day one now it has progressed into a bump..dont know if it forming a cyst...let me know wht to do",
    "doctor_response": "Welcome to Health care magic.1.The possible cause one can think of after a trauma, small bruise increasing in size - infective aetiology with collection of pus within.2.Then vascular abnormality also could be cause, finally lymph nodal enlargement due to local infection / inflammation.3.Definitive diagnosis in this case can be done after examination - i would have send for an ultrasound examination of the swelling / lump.4.The ultrasound will give nature of the lump, its sours and extensions. 5.After that needful treatment steps can be taken.6.Mean while as a remedy - do not scratch / compress  the area, maintain local hygiene,avoid any irritant cloths over the area for better healing, antiseptic cleaning would help. Good luck.Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can infertility be treated?\n\nHi I had myomectomy surgery on 15/12/2017.but the doctor told me I had an infection before the surgery which affected my fallopian tubes therefore I can t get pregnant normally.Please can you advice me as to what to do in order to get pregnant normally",
    "doctor_response": "Hello,As your doctor has noted some problems with Fallopian tubes, I will suggest you to get post menstrual HSG (Hysterosalpingography), this will help to know about the patency of the Fallopian tubes. If your Fallopian tubes are absolutely healthy and patent then you stand good chance to get pregnant.If HSG reveals problem with the patency of the tubes, I will suggest you to opt for IVF, that is test tube baby. As your fibroids are removed, having pregnancy and continuing it should not be a major concern.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Purushottam Neurgaonkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the normal HBsAG value ?\n\nI have hbsag-positive and PV=302.95,is this critical?can it be cure?im 37,156 height,54 kgs weight,110/60 blood pressure ,pulse 80,respiration 16,sthenic body build others normal.thank you.",
    "doctor_response": "I have hbsag-positive >How is your liver function test? What USG indiacates? Do you have liver or spleen palpable? and PV=302.95, >Please write full form of PV so I can understand it better. is this critical? Having HBsAg is a matter of concern. Criticality will be decided by your liver status. Cure? It can be controlled, and cure is possible in few of the patients Dr Vaibhav Banait, MD, DNB, DM Consultant Gastroenterologist, Nagpur",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excessive blinking and squint in eyes of a child?\n\nI have a 6 year old boy that started excessive blinking and squinting of the yes when he does it sometime his mouth twitches a little, now last night in his sleep he was twitching a little. He gets up in the middle of the night and crawls into bed with us almost everynight. He does once in a while get headaches on the top of his head. My son and i were in a car accident about 2 years ago i was hit from the back the van hit us at 45mph when we were stopped. glass was all over him i had no back end of my car the fire department said if i didnt have a table in there he would have died. We are not for sure if symptoms are showing up now from the accident or if it something else it is really concerning us. He just recently pass an EEG test for seizures.",
    "doctor_response": "The description seems like a seizure, and seizures usually don't show up on an EEG if there are no known triggers, he can also be facing post traumatic stress which can at times be delayed, talk to him, ask if he feels something before he starts excessive blinking. You may need to visit a pediatric neurologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high fever & diarrhea\n\nhi my daughter just turn eight months old and she started with diahrea and some fever and was very fussy. i thought that everything was gonna be fine but now its been almost two weeks and the fever came back and its been almost 2 weeks and her fever is getting worst the diahrea stop but now she has been having diareah for almost 2 or 3 days now i dont know if it is cuz of her teething or if it can be a viral infection?",
    "doctor_response": "Hi,Fever and loose stools suggest acute gastro enteritis. Mostly these are viral and need only paracetamol to control fever and fluids like ORS solution to prevent dehydration. But since this is the second episode in 2 weeks and its already 3 days now, we may need evaluation and treatment with antibiotics, zinc and probiotics. Kindly take her to your pediatrician.Meanwhile, give paracetamol and frequent sips of ORS solution to prevent dehydration. Take care of food and water hygiene to avoid future recurrences. Wash hands with soap and water before preparing and giving feeds.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam T. K., Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes full body muscle spasms?\n\nFor a year + I have been getting full body muscle spasms. They have become more intense and more frequent. In the morning sometimes I can t get to the bathroom in time. Sometimes they hit while walking, stops me in mid-step. My husband says I get them at night. I am getting them dozens daily. It makes it hard to do daily activities. I have talked to at least 5 different doctors, all sluff it off. What is causing this, how do I correct this problem?",
    "doctor_response": "hiYou must see a physician or a neuro specialist to rule out mysthenia gravis and fibromyalgia with some tests.She may take clonazipam or diazepam  tabs on prescription or amitryptalie if the doctor agrees.Body massage may also help.Vitamin E, D and neurobion forte may be of help also, so consult specialiststhanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat pain in left chest,tingling and numbness in left arm and lips?\n\nMy husband went to the doctor complaining of left chest pain under his breast, left arm tingling and numb or tingling lips.  He has high blood pressure.   He was told that he had inflmation of the cartilage and sent home.    They did not do an ekg.    When he sits down in a chair at night he is instantly asleep.   I worry that it is something more serious but he is convinced that it is just a strain.",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!I agree with you that his symptoms (especially the tingling lips) are not typical of a cartilage inflammation. For this reason, I would recommend consulting with his doctor and performing some tests: - a chest X ray study- a resting ECG and a cardiac ultrasound- a Doppler ultrasound of the carotid arteries to exclude possible narrowing and low blood flow to the brain- complete blood count, PCR, ESR for inflammation. You should discuss with his doctor on the above issues. Wishing good health, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for migraine headache in a child\n\nMy five-year-old has been suffering from migraines for the last year and a half. Sometimes he goes months without one and sometimes he has a couple per month. It tends to always be above his left eye and the only thing that ever gives him relief is sleeping combined with ibuprofen. His head hurts so bad he is riving in pain and moaning. I have had his eyes checked and they are good. I am very concerned and would appreciate any suggestions. Motrin and napping did not work today. Had to take him out in the cold damp air for a some relief.",
    "doctor_response": "Hi, If I were your treating Doctor for this case of severe pain under the left rib cage, I would come up with three possibilities, these include: 1.Diclofenac potassium 1 capsule once for migraine headache.2.Domstal 1 tablet trice ,you should give together with Diclofenac when ain is started.3.Nootropil -for improvement of blood circulation for 1 month.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing your baby  good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Pus cells are evident in my semen analysis report. Kindly interpret my report.\n\nHello doctor, My semen analysis shows: Sperm Count - 98 millions/ml, Liquefaction time - 25 minutes, Reaction - alkaline. Motility: active - 70%, slugglish - 10%, non-motile - 20%. Morphology: Normal forms - 92%, abnormal forms - 8%. Other findings: Pus Cells 40-45/HPF. Semen culture also shows no growth. Please tell me the appropriate medicine.",
    "doctor_response": "Hi. If you do not have symptoms of urinary infection like burning, frequency of urination, blood in urine or semen, you need not take any medicines. Immature sperms also appear like pus cells on microscopy. One good option is to repeat the semen analysis after one week. Do not keep abstinence from more than two to three days before the next analysis. If pus cells are again seen in the high count, we may have to repeat semen culture for routine bacteria, as well as tuberculous bacilli and then decide accordingly. If you have any of the symptoms described above, you can repeat semen culture once more and take antibiotics accordingly. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can foot pain be treated?\n\nHello, I am experiencing some very bad pain in my left foot. The pain is mostly along the outer edge of the foot, to the heel and then radiates into the middle of the foot to about the 3rd metatarsal. The feeling is like a severe foot cramp. However this feeling has been going on for almost 24 hours and is not getting any better. I have tried ice, heat, massage, walking on it, and stretching as well as taking ibuprofen. None of these things are providing any relief. I noticed the injury after I had been playing volleyball and twisted my right ankle. While that ankle is sore, it is nothing compared to the pain in my left foot that I do not remember injuring in anyway. Any assistance or advice would be greatly appreciated.",
    "doctor_response": "Hi, It might be due to plantar fasciitis. As of now, you can take analgesics like acetaminophen or diclofenac for pain relief. If symptoms persist, better to consult an orthopaedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for abdominal pain\n\nsir my daughter aged 10 years taking valparin chrono 200 twice a day from two years.no seizures from two years.but now she is complainting of abdomen pain and her sgot level is also high.what is the reason?and do we have continue the medicine lifelong?",
    "doctor_response": "Hello, High level of SGOT can be related to hepatic disease. I suggest doing an abdominal ultrasound and Bilirubin level for further evaluation. I also recommend consulting your neurologist for an alternative medication. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurrent pain in the chest?\n\nHi. My name is Kim and I have been experiencing pain that comes and goes right in the middle of the chest area below my breasts. It was so bad two nights ago which caused me to go to the emergency room. And I m having the pains again. They come and go and sometimes are pretty sharp! What is going on?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. If cardiac diseases have not been ruled out then it should be done first because sharp chest pain at night is commonly seen with heart diseases. So get done ECG, 2D echo, and stress test. If all these are normal then no need to worry for heart diseases. Sometimes stress and anxiety can also cause similar symptoms. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic drugs (Propranolol and Flunarizine combination) too. Don't worry, you will be alright with all these. Avoid stress and tension, be relax and calm. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Kaushal Bhavsar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mucus and blood in stool of a child?\n\nMy 4-year old just farted (normal sounding fart) then a few minutes later said she had to poop and her undies were wet. She is potty trained and has not had an accident. When we get to the potty her underwear is filled with maybe 1 tbsp mucus with what looks like blood streaks in it. She is playing and acting normally and this is the first time this has ever happened.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It seems your kid is having bacillary dysentery. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or green bilious vomiting. You need not worry. Antibiotics are needed here as there is blood in the motion . The best would be Cefixime. This is a prescription drug. I suggest you use zinc supplements (Z&D drops once daily for 14 days) and ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment. Best regards Dr Sumanth Amperayani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes skin rash with itching in a child?\n\nMy daughter is 14. Last night she started breaking out with a rash. The first spot that we saw on the underside of her forearm. it looked like a flea bite and it itched. The second area was on her upper back. it had multiple raised areas about the size of a pimple. The area is red and odd shapes with pimple sized bumps within the red area. I gave her a benadryl and she was able to sleep through the night. This morning she woke up to both sides of her feet itching, red with bumps. Now she has it on her back, under her arms running down the side of her body on both sides. On her neck, on her shoulders, butt, behind one ear and on the back of her arms. I put her in our salt water spa which helped the itching and have given her an oatmeal bath and applied cortazone and given her a benadryl. The itching has subsided and is tolerable now. Any idea what this could be?",
    "doctor_response": "Hi, There are multiple causes for such Pruritic Rashes. It might be Atopic Dermatitis/Contact Dermatitis/Urticarial Rashes/some viral infections also give rise to such rashes. You need to pay attention if there is a runny nose, fever also there are not.  Generally, if it's there then this might be a viral infection? You can give antihistamines preparation to cut short the severity of itching. Avoid exposure to cosmetic & suspected stuff which might be causing Urticarial Rashes to develop. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ajaygupta009, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is irregular endometrial mass along with thickened endometrium as per a USG report indicative of cancer?\n\nI had a pelvic ultrasound and the majority of the endometrium is thickened and measures less than 2mm however there is an area of irregular mass with a thickness of 2.6mm. Radiologist says possible blood clot or endometrial irregularity. Does this mean I have cancer. I am 72",
    "doctor_response": "Hello,Normal endometrial thickness is 8-11 mm. In your query, you didn't mention about bleeding. Usually bleeding in the postmenopausal age should be screened for malignancy (cancer). Early diagnosis has good prognosis.Consult gynecologist and go for D & C (dilatation and curettage). Histopathological report says about your endometrial status. If it is normal, then no worry but if it turned out malignant, then you should go for hysterectomy that is removal of uterus.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Siddartha",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bumps and bald spots on the scalp of a child\n\nHi, my four year old daughter who is of afro-carib decent, has developed one large bald patch on her scalp and 2-3 smaller ones scattered around her head. I would say about 2months ago, i took her hair out of cornrows and she had a black flaky scalp in a particular area, when i washed her hair, the area with the black flaky scalp had disssapeard and so had her hair in that area. the doctors have given me keptopine, but this is not helping. she still gets puss like bumps on the bald spot, and hair is not growing back. Pls advise. thank you.",
    "doctor_response": "Hello, She must be given a course of antibiotics for a period. Then skin ointment containing terbinafine locally. Once the lesion heals, hair will grow by itself. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Varinder Joshi , General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes discomfort while passing stools and freckle sized red marks on face?\n\nHi, may I answer your health queries right now ? Please type your query here...my four year daughter had very uncomfortable bowel movements the last two days. She had a softer one yesterday after severe discomfort all afgernoon. This morning she woke up feeling great but had these freckle sized red marks all over her face. Any ideas?",
    "doctor_response": "Hello,Red spots on the face, fever and loose motions for last two days indicates that your child is suffering from viral infection.Please see if it is associated fever or not. Your child needs evaluation by a doctor. Please visit the nearest emergency.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Varinder Joshi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fall of HB count while suffering with chronic lymphocytic cancer?\n\nsir my name is vaseem khan and i am from dhamtari  the Small village in chhattishghar  my quire is my father age 65 yrs. is suffering from  cancer \u201c\u201ctype  of CLL \u201c last 3 month ,   I have checked  blood test every month and get found every month his HB count is low why this happened",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your father's situation and problem. CLL (chronic lymphocytic leukemia) is blood cancer affecting blood cells. CLL patient is at high risk of hemolysis. This hemolysis can cause breakdown of RBCs (red blood cells) and hence hemoglobin will drop. Another cause is decrease production of RBCs from bone marrow. CLL infiltrates bone marrow. Blood cells are originating from bone marrow. So RBC production is also decreased in CLL. This is another reason for low hemoglobin. With proper chemotherapy, CLL can be controlled and once it is in remission phase, hemoglobin will start rising. So consult oncologist for your father and start appropriate treatment. Hope I have solved your query. Wishing good health to your father. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat allergic bronchitis in kids?\n\nHi my child is 2years 11months,she frequently gets cough,cold from last november,pediatrician diagnosed allergic bronchitis and suggested not to give fruits and biscuits,curd,use daily l-mentous kid in the bed time.but how many days should i stop,iam afraid that she is not getting proper nutrition if i stop giving fruits,please suggest",
    "doctor_response": "first try to find out for which food she is allergic to? then try to avoid that particular food  so that nutrition is taken Care of",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe acne with red blemishes, have restricted consumption of dairy products and junk food, taking fruits and veggies. What else can be done?\n\nhello, my name is karan and i am 20 year old guy , i live in india, i been suffering from acne since 6 to 7 years ... i even have red blemishes on my face due to acne . i no longer consume dairy products and i avoid junk food including soft drinks... i also incorporate fruits and vegies into my diet , but still i do have mild acne and some red spots pllz tell me what should i do ..",
    "doctor_response": "Hi...dear Karan.., Thanks for choosing HCM.., ACNE....is due to hyper activity of hormones...., produce inflammation of sebacious unit.., So ther is no role of diet.., Frequent washes with FASHBAR.., Topical application of ZYCLINE-nano ( cadila)., Tab..Isotretinoin 20 mg daily for 30 days.., thanQ",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stiffness in the neck?\n\nI am a female 67 years old. I have had a stiff neck for about a month. Other than that I feel great. I ve been blaming it on a crappy pillow. It is mostly stiff turning side to side. Also I am a side sleeper. Should I be worried or look for a better pillow.",
    "doctor_response": "Hello, Stiff neck may be due to cervical spondylosis or neck muscles spasm or meningitis. Until examination is done, it is difficult to say what it is. Avoid pillow while sleeping, use tablet zanaflex once a day for five days. Use cold and warm compression. If symptoms not improved please get an X-ray cervical spine then consult your physician. He will examine and treat you accordingly. Hope I have answered your query. Regards, Dr. Penchila Prasad Kandikattu , Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had a permanent filling in molar tooth, painful. Suggested RCT. What is going on?\n\nHi, iam 39 years old female. Few months back i had permanent filling in molar tooth ...cavity was slightly deep. Now often i get pain. Same doctor adviced me to provide a medicine in my tooth and have permanent filling and if it doesnot work she suggested me RCT. My question is if the cavity was already deep why didnt she suggest me RCT or medicine that time itself? Ad now i have a doubt whether to go for medicine or straight away for RCT?",
    "doctor_response": "Hi, Thanks  for  asking  th  query, Pain  can  be  because  the  cavity  is  too  deep  and  the  filled  material  comes  in  contact with  the  pulp  , or  the  infection  had  already  spread  to  the  pulpal  tissue . Visit  to  the  dentist  get  checkup  done  . Take  an  x-ray . Take  full  course  of  antibiotics  and  analgesics . The  treatment  will  be  RCT . Unless the  tooth  is  devitalised , disinfected  and  sealed  to  the   apex you  may  experience          pain  . Use 0.2%  of  chlorhexidine  mouthwash  solution gargles   thrice  daily. Hope  this  helps  out  . Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could bumps on clitoris suggest?\n\ni have a red bump on my clitorus, my periods are irregular even though im on birth control. im on alot of pain meds, and i take adderall. is it just my meds giving me problems? or is something wrong? the bump doesnt look like herpes, because its more of a dark pink splotch that hurts alot",
    "doctor_response": "Hi, Thanks for posting in HCM. I understand your concern. Presence of red bumps on the clitoris could be due to superficial skin infection like carbuncle, which is skin infection and is resulting in burning sensation. This can happen when you are using hormonal preparations such as birth control pills. You can overcome the lesions by doing the following: Kindly wash the area with mild antiseptic solution like Savlon twice everyday. After drying, apply Neomycin with Hydrocortizone skin cream over the lesion. Take antiinflammatory tablet Ibuprofen after food. Wear loose fitting undergarments till the lesions heal completely. Maintain clean genital hygiene. You may apply water based lubricant/moisturizer creams at bedtime to achieve soothening effect on skin. The lesions should subside and heal gradually. Hope the information provided would be helpful. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on the wrist with numbness?\n\nHi I have a lump on the radial side of my wrist, it is likely due to repetitive computer use, piece suspect bursitis. The lump is about 1.5cm diameter, and spongy to touch and I can push it without too much discomfort. I am also getting some numbness in my hand and was wondering if that would be related.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some soft tissue tumor like fibroma, lipoma or neurofibroma. You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "what should I do as I spend a lot of time sleeping and I do not want to discuss mental issues with the doctor?\n\nI am currently suppose to be taking 2 10mg pills daily but honestly I feel it is of no help. I don t want it to seem as if I have mental issues so I feel kinda wiry about going into details with my Dr. about how I feel most of the time. I feel and am sure my family would agree that I spend a lot of time sleeping but Im afraid to tell my Dr. to up my dosage. What do I do?",
    "doctor_response": "HI Welcome on Healthcaremagic , I can understand your feelings kindly feel free to share here your feelings mental symptoms express your feelings openly we are here to help you we will guide you because we understand your concern Hence , Kindly share with us symptoms and your mental feelings here to understand your problem. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistently high troponin levels?\n\nGood evening I have question. Regarding 42 y/o female previously healthy presented with history of chest pain pin prick in nature mainly with deep breathing she gave history of URTI  4 days back for which she received klaccid and ibuprofen on examination she was tachycardic pulse 127/ min regular afebrile chest clear and heart s1s2 normal no murmur ECG sinus tachycardia WBC 4.9 kidney profile normal troponin was slightly elevated 0.4 then repeated 0.33 after one day troponin repeated and still high 0.33 D-dimer was 173 so what would explain her persistently high troponin level??? Although pul.embolism renal failure septicemia all are excluded",
    "doctor_response": "Hello,pericarditis is another potential cause of troponin elevation. It can be diagnosed with an ultrasound scan of the heart (echo). The ECG may have signs of pericarditis but they may be lacking sometimes. The pain with deep breaths also fits with pericarditis. Check with your cardiologist if you've done an echo already.You can contact me again, if you'd like any clarification or further information.Kind Regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for low BP?\n\nmy bp has always been low, and accidently found out when at gyn follow-up it was 130/90. not overweight. female age 63 drink one cup coffee a day, no other caffeine, but do smoke a few cigarettes......should i make appt with my family dr for meds?",
    "doctor_response": "Hello, I understand your concern and would explain that a single high blood pressure value does not mean uncontrolled high blood pressure. For this reason, I would recommend you to closely monitor your blood pressure values in the next days and write those values down. If your blood pressure values are persistently above the normal ranges (125/85 mm Hg), I would recommend consulting with your attending physician for a physical exam and some blood lab tests (complete blood count, fasting glucose, kidney and liver function tests, blood electrolytes, etc.) Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment lumps on ear\n\nHi I'm 28 years old 5 foot 7 inches tall weigh about 125 and am female I have a little bit of acne nothing horrible tho and I have a red lump that is about the size of an almond in front of my left ear (kind of between the top of my jawbone & ear). It is a little mushy feeling when i push on it and kind of rolls when i push up or down on it. I poked it w/ an alcohol cleaned needle, blood and this oil like stuff comes out when I sqeezed it. It isn't really painful. What is this & should I be concerned?",
    "doctor_response": "Hi I am Fahim and I will help you with your problem     I have gone through your question. I appears to be a sebaceous cyst or lipoma. Both can be left as such if they are not very big and not bothering you much. Surgical excision is the treatment, in which the lump is removed and skin closed the non-absorb-able sutures. The wound heals in about 5 days time and stitches removed on 5th day. You need to see a general surgeon, who after clinical examination will make a diagnosis and then will guide you appropriately.I hope my answer will help you. Do rate it, if you like it.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What diet should be given to an infant while suffering with fever?\n\nmy daughter how to temperature yesterday afternoon and then vomited once it has been 24 hours about 24 hours and she vomited and 4 hours ago her temperature was 97 point 6 and currently it is 98. 7 so should I allow her to have milk milk or how should I handle her diet diet",
    "doctor_response": "For a child with fever, you can give the child simply normal diet or anything that the child can tolerate. The diet should contain more of proteins as our body is made of proteins and the healing and repair process requires resources. MEat, fish and eggs contain proteins. Spinach, pulses, soya etc. are vegetable sources of proteins. If she is vomiting, be sure to give ORS alongwith. It is better to leave out milk for a week or so but if she can tolerate it, there are no issues. Give sponging with normal temperature to bring down the temperature if it is greater than 100.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could have been the sound from the butt check suddenly?\n\nMy mom slipped and did the splits on my back porch Friday.she said she heard something pop under her butt cheek. She has been to the Dr , they did a xray now she waiting for those results. Her Dr said it was more then likely just tissue damage bur she s an medical assistant and she thinks its more then what the Dr said",
    "doctor_response": "hi,thank you for providing the brief history of your mother.As mentioned she has taken an x-ray for which she is uncomfortable I will recommend to undergo a CT scan of the skull. As certain times injuries to facial bones are not seen in x-ray and also soft tissue injuries don't make much sound.if any bony abnormalities are present due to injury a CT can detect and plan the next rehabilitation processRegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Progyluton be taken while on Lezra for infertility treatment?\n\nHi, We have been actively trying to conceive for one year almost but no success. I have done three cycles (3 month) twice in 2017 but no success so far. Hsg test concluded open fallopian tubes but bicornuate uterus. Prolactin, progesterone normal. AMH low(0.585).Now doc give lezra from CD2 upto 5 days. OVAFLOW. And progyluton. Is progyluton used while using lezra n TTC. I had two abortions n one baby boy.",
    "doctor_response": "hellothanks for choosing healthcaremagic for your queryI understand your concernlooking at your history, tablet lezra and ovaflow will be helpful.but tablet Progyluton will prevent you getting pregnant. it is kind of contraceptive pill. but it will correct your hormonal imbalance too. so generally it is given prior to trying for conception. and then once it is stopped then your actual treatment for infertility it started. so starting all the tablets that is lezra,ovaflow and Progyluton simultaneously is difficult to understand so you can ask your gynecologist the reason behind it.again you mentioned you tried three cycles price in 2017 I really didn't get what you mean. is it the 3 cycles of ovulation induction or intrauterine insemination.knowing your age and pattern up your menstruation is also helpful for me. looking at your AMH levels and duration you tried for pregnancy I think you will need to go for some operative procedures like Diagnostic laparo hysteroscopy and next level of infertility treatment like intrauterine insemination or IVFI hope this helpsfeel free to ask if any further queryregards,Dr Tejashree BhorgynecologistDhanori Pune",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the reasons for having stomach pain even after taking cyclopam tablets?\n\nHello Dr.I'm having pain in my stomach continuously at regular interval for last two days. Yesterday I took Cyclopam tablet and felt temporary relief but now the pain is arising again slowly. So what is your advice.And you are requested to provide information about the Cyclopam drug.",
    "doctor_response": "Hi...cyclopam is an antispasmodic drug...a smooth muscle relaxant....take it if you are having coliky or twisting type of pain...else you maybe having gastritis for which you need to take a ppi..Dr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is cramping pain in lower back after taking HMG injection safe?\n\nI AM TRYING FOR PREGNANCY. TODAY IS THE 16TH DAY OF MY CYCLE. AFTER THE SCAN THE FOLLICLE WITH 1.4 x 1.2 IN RIGHT OVARIAN AND 1.7 x 1.5 IN LEFT OVARIAN HAS RUPTURED. FOR THE FOLLICLE DOC. HAD GIVEN HMG INJECTION. SINCE 2 DAYS I AM GETTING THE CRUPMING PAIN IN LOWER BACK AND THIGHS. IS THIS SAFE. WILL I CONCEIVE",
    "doctor_response": "Hi, you are having pain due to rupture of follicles.  So don't worry about it.  Have contact with your husband for 2 to 3 days. Take progesterone for next 2 weeks.  Do a urine pregnancy test at home after that.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for kidney cancer\n\nHi my dad has stage four cancer in his kidney which has spread to his spine. He s not doing as well he s unable to eat he has been vomiting. He is in a lot of pain barley can take his meds. Is there anything we can do to help him get better I dnt want to loose my dad please help. His doctor is saying we should stop his meds because he s not looking so well I dnt want to give up on him he wants to live he says he wants to live",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Treatment of kidney cancer depends on stage.He has stage 4 kidney cancer with bone metastasis. So now its very difficult to treat. Surgery has no role. Chemotherapy and radiotherapy is the only palliative treatment. It can not cure the disease. Moreover side effects of these drugs worsen the quality of life. So in my opinion no medication should be given. Just let him enjoy the rest of the days. I am very sorry to say but it is fact. Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer.Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to have soy isoflavones vitamins along with metformin to get pregnant?\n\nI have been taking metformin for 2 months going on 3 months for pcos. Im trying to conceive. I have heard of some women taking soy isoflavones vitamins with metformin and it helping them get pregnant. Is this true and is it safe for me to try this? I have been trying to concieve for 5 years now.",
    "doctor_response": "Hallow Dear, In Polycystic Ovarian syndrome, the main disorders are infertility due to failure to release eggs (ovulation) as a result of dysfunction in reproductory hormones, raised insulin levels and raised androgens. Metformin helps bring down the levels of Insulin. It acts as a good adjuvant to the medicines used for induction of ovulation. The success of only Metformin for the treatment of anovulatory infertility is questionable. According to some scientists, Myo inositol brings down the levels of Insulin as well as androgens and hence is more effective in the treatment of infertility due to PCOS. For induction of ovulation, Clomiphene citrate may be tried for 6 cycles (along with Metformin or Myo inositol). If it fails, HMG/hCG combination may be tried. PCOS is characterised by obesity. Please calculate your BMI. You should maintain your BMI between 18 and 23.9 by reducing weight by apt diet and exercises. Soy isoflavones are supposed to improve general health as well as the quality of the eggs, increasing the possibility of successful pregnancy. They are quite safe in your treatment. I hope this will help you to seek for a comprehensive management of PCOS. Please report to your Infertility consultant. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a way to reduce the eosinophil count in my blood ?\n\nhow to reduce eosinophil in my blood ,it is more than normal amount ,i am 18 , male, no treatment done yet",
    "doctor_response": "Hi Michael, Welcome to HCM. Eosinophilia can occur in many allergic conditions as well as in tropical eosinophilia. Consult a Doctor who will have to examine you, before prescribing medicines.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does pain in the muscles and joints along with severe fatigue indicate arthritis?\n\nHi. I ve had increased muscular/joint pain throughout the body, except elbows and spine. Also, great weakness, which was sudden rather than gradual. I ve had brain fog for a few years, and it seems to be worsening over time. Yet Monday, I had surgery to remove (superficial) skin melanoma, and all my muscular/pains had vanished when I woke up from general anesthesia. Would this indicate arthiritis?",
    "doctor_response": "Hi, It can be arthritis, we have to rule out other conditions like musculoskeletal pain which can also present like this. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Normal bilrubin during the course of jaundice treatment, want to eat normal home-cooked non-vegetarian food. Can I eat?\n\nsir as i was suffering from jaundice from 15 days i was in diet restriction till now 3 days back my blood report was biluribin 1.2 and direct 0.4..so its normal now can i start eating normal food like which contains little bit oil and nonvegetarian which is cooked at home with light spices and oil.i love to eat nonveg many are saying not to eat when should i eat sir please advice me",
    "doctor_response": "Hello,          You were suffering from jaundice which has now resolved. By this description it seems you had viral hepatitis which is a self limiting disease. I presume your doctor must have done an ultrasound of your liver. If that was normal, you can now eat and drink whatever you want except alcohol.          Hope that helps.Regards,Dr. Preeti",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take thyroid medication during pregnancy?\n\nHi, I am 23 weeks pregnant and have had TSH levels of 2.99, in the 3 range, and now its at 4. I went to an endocrinologist when my TSH level was 2.99 and he decided not to put me on medication. My obgyn has referred me back to the endocrinologist. Should I insist on being put on medication to control thyroid? What risk has my baby been exposed to since I am not being medicated?",
    "doctor_response": "Hi,We advise women to maintain thyroid levels below 3, after 13 weeks till delivery.For this thyroid supplements can be taken which are absolutely safe.Low thyroid (high TSH) can cause low birth weight, pre-eclampsia, delayed developmental mile stones and increased complications during labour and delivery.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for psoriasis\n\nResp. Sir, i have been psoriase for the last few year and i have been trated by a no of doctor, dermologist and all have same view as the psoroase but all uses diff med. recently i have been gone for dermologist and he sugeest methotexate tab 2.5 mg. (mext.2.5), folvite 5mg & a cream pacroma of ajanta pharmacy. a injection of anacord per month for the last 7 months i have been treated but the result seems to be negilable. kindly advice.",
    "doctor_response": "Hi,You said you suffer from psoriasis vulgaris. Psoriasis is an autoimmune skin disease. It may be precipitated or exacerbated by various factors like stress, anxiety, sunexposure, alcohol,smoking,dry wheather,drugs lke chloroquine..etcI would like to advise to take methoraxate 15 mg per week in devided doses 12 hourly. And I also add cap acitretin 10 mg twice a day for long time. I usually recommend blood test lor liver and renal function at regular interval. Apply steroid cream combined with salicylic acid like clop- s oint on the lesions. And i warn to for use of steroid injection you take monthly,as it may harm more then benefit. It may be responsible for the relapse of the disease. Keep the skin moist by use of moisturiser cream. Avoid smoking and alcohol, if you have habit. Avoid worries and stress. Have patience and positive attitude. You might get good improvement. Continue treatment even after good result. After satisfactory result,you may drop. If there is relapse, restart the treatment. I hope this would help you in your treatment. You consult expert dermatologist and have perfect treatment.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain, strange sensation, sharp stinging pain. What does this mean?\n\nHi there quick ? For ya .I'm a 30 year old female and for about a mth now I have heard and felt this watery fizzy noise in the back of my neck where ur spine meets up, also I have this major pain in my mid back that every time I take a breath it hurts or if I move to fast or the wrong way.the pain feels like a sharp stinggin feeling like someone has pool punch right through me and is squeezing my insides.. Please help I haven't seen a doc yet don't have insurance yet..thank you",
    "doctor_response": "Hello,This is due to muscle spasm of the back muscles at the neck and upper back.Rest and neck muscle exercise is needed to strengthen the muscles.Analgesics may be used to reduce the pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from burning sensation all over my body. Kindly advice.\n\nHello doctor, I am feeling burning in my whole body, especially in ribs and sometimes shoulders. Why?",
    "doctor_response": "Hello, Welcome to the icliniq.com. The burning pain is usually due to nerve irritation by neuropathy. The cause for peripheral neuropathy could be due to diabetes, cervical spinal problem, etc. You need to investigate with random blood sugar estimation an X-ray of the cervical spine. I suggest you consult nearby physician for detailed evaluation also. Meanwhile, you can take because like multivitamin B complex tablets. I hope I have answered your question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Currently taking Prozac for OCD, feeling tired, worried about serotonin-syndrome?\n\nHi, I am on 80mgs of Prozac for OCD . I have started a huge health change which includes working out. Because I am so tired all the time with Prozac most likely being the reason, I tried some pre work out supplments and a pre work out/ fat burner supplment walked Detonate. They worked great for me, and I had a great work out, great focus. However, at the end of the day, ( 7 hours after supplment) I had a really bad headache . I would love to continue taking this supplment but I m worried about serotonin- syndrome . Please advise?",
    "doctor_response": "Hello and welcome to Healthcare Magic. Thanks for your query. Acoording to the manufacturer's information, Detonate supplement contains Dendrobium Extract (Stem), B-Phenylethylamine HCL, Tangerine Extract (Fruit), Caffeine Anhydrous, Green Tea Extract (Leaf), Green Coffee Bean Extract, Asian Ginseng (Root), Black Pepper Extract (As BioPerine\u00ae) (Fruit). Among these ingredients, many are stimulants which act on the sympathetic nervous system and increase the body's metabolism. In addition, Ginseng is a herb which is supposed to have serotonergic properties. Also, it is possible that these supplements can contain other ingredients which are not mentioned in the label. Now, 80mg of Prozac (Fluoxetine) is a high dose and you have to be very careful while taking other medication or supplements along with it. So, my opinion is that it is better to avoid taking this supplement along with this high dose of Prozac, and a risk of serotonin syndrome cannot be ruled out. Wish you all the best. Regards, Dr. Jonas Sundarakumar Consultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for continuous allergy in different forms\n\nI am 37 years old male. Round the year i suffer from allergy diseases in one form or the other. In winter, I suffer from cold and cough. During summer, I suffer itching/skin diseases. During rainy season, I suffer from joint pains, lack of sleep etc. Please suggest me  a solution",
    "doctor_response": "hello, thanks for ur query, utricaria, allergic rhinitis can be prevented by tab. montair- lc( montelukast+ citrizine ) one tab at bed time for4-6 months. all d best. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes slight red, scaly rashes on face when diagnosed with lyme disease?\n\ni have a rash on my face i have been to dermatologist but so far no meds have helped.does not itch slight reddness and scaley.i was diagnosed with lyme disease several years ago also hemochromotosis(possibly)could this rash be a complication of either.what can i do?",
    "doctor_response": "Hi, Erythema chronicum migrans can be a complication of Lyme disease. But, the rash requires thorough clinical examination to come to a diagnosis. I do not think that the rash could be a complication of Hemochromatosis. Chances of the rash being a complication of Lyme's disease are high. So, I advise you to visit your dermatologist for further management. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluttering sensation in the groin?\n\nI have a fluttering sensation in my lower groin on the right side. I am female, 54 years young, 30 pounds over weight and am on my feet a lot at work. Started about 4 days ago. Not constant but more fluttering than not. I have made a Dr. appt. am I over reacting?????",
    "doctor_response": "Hi there.Fluttering sensation in that region needs a ruling out of any perineal infections like urinary tract infections and any STDs. Also electrolyte imbalance can cause fluttering of the muscles in the body. Also recent and ongoing stress in your life can contribute especially if you have been sleeping less lately. Eat plenty of fresh fruits and green leafy vegetables. Drink 1-2 litres of water daily. Get 6-8 hours of sound sleep. Perform deep breathing exercises and Yoga for stress relief. Try this for a week and if it does not subside you may need to get a consult by your Doctor to rule out the above problems. Wishing a speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if child is having pain and discomfort in the foot after a bone fusion?\n\nMy 13 year old grandaughter has just found out she had a broken bone in her foot that has fused. It was not xrayed 2/3 years ago. It has never been right and she always has some pain and discomfort - what will the consultant do please. She dances, ballet, tap etc.",
    "doctor_response": "Consultant at his best can advise to operate. But if the deformity is not likely to affect her future, please avoid operation.For pain if you give her Turmeric powder 1/2 tsp in warm milk or warm water everyday, she will start recovering from pain, sprain, internal trauma, any other cause of pain in foot. Its safe, side effect less and can be taken for long long duration. You may even apply turmeric on foot after mixing in clarified butter. Its a good application to remove pain, swelling, inflammation etc. But it stains the fabric. So be careful.Orally Shigru capsule or Abha Guggul tablet can be obtained (common in India) 1BD for 4 weeks.It will benefit her 100%.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itching on the legs and arms. Took benadryl. Rashes formed. Cure?\n\nArms and legs have recently begun itching. Washed all bedding and clothing, in case of pollen. Stopped a lotion that have used for two months because it contains honey, beeswax, and is the newest of my soaps and lotions. Have taken OTC Benadryl without much relief. In fact, I seem to be getting a rash where I have been itching. Because I have dry skin I am using aquaphore as a lotion, and it is soaking in immediately. What can I do to stop th rash and control the itching?",
    "doctor_response": "Hello,Thanks for posting your query to HCM. After reading your query I can make out the possibility \"Simple Urticaria\". In this skin condition- there are red, itchy and temporary spots remaining for few hours and then disappears by itself without any spots. Specifically, some times the most prominent symptom is itching. It is so bothersome in the individual suffering from this problem that it hampers day to day activity. If the condition is more severe it can cause swelling on face including lips and eyes.There are innumerable causes of urticaria including the things related to our day to day life. These include food, environmental, physical and even most of the times we are not able to find a definite cause of the problem.the other possibility of itching due to dryness also can not be ruled out. You can take loratadine tablet by mouth for 2-3 times a day under medical guidance. If you are not getting better then it is better to consult a dermatologist to give you best diagnosis and treatment.Hope to have provided the best information regarding your problem.Dr Sanjay K KanodiaMD (Dermatology)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My triglycerides level was 207 mg/dL. Is it necessary to take medicine?\n\nHi doctor, Recently, I got a lipid profile done, and the triglycerides level\u00a0was 207 mg/dL, apart from that everything was normal. As it was a festival season, I had a lot of drinks and food for three days before the blood test.\u00a0My doctor told me to take Razel\u00a0(Rosuvastatin) tablets for 3 to 4 months after food\u00a0and told me\u00a0to control my diet. Is it necessary to take medicine? Can the triglycerides level be reduced only by controlling my diet at this stage? And even if I take the pills, will it cause any side effects? Please explain.",
    "doctor_response": "Hi. I will try to explain in detail about the lipid profile. Triglyceride levels in the lipid profile depend on the fasting status. If the blood sample is taken in fasting, the upper limit is 200 mg/dL. But the value changes with the food taken by you. In your case, there is no need to take the tablets as your LDL (low-density lipoprotein) and HDL (high-density lipoprotein) cholesterol are normal. You need to do regular physical activity and control your diet. Rosuvastatin usually does not have much effect in reducing the triglyceride level. It will decrease the LDL levels instead, so no need for medicines. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does bump in belly button indicate?\n\nHi.I have s question. My husband has this bump in his belly button. Its looks reddish and some areas look like it peelef a little. Before he used to push it and he said it felt like liquid went out of da bump. But now it seems like its full of liquid and when he pushes it it just a bump now. (liquid bump) He was wondering wat it cud be.",
    "doctor_response": "Hello!From history, it seems to be an umbilical hernia.In my clinic, I look for impulse in swelling on coughing & palpate the defect beneath the swelling if any, to confirm the diagnosis.An ultrasound is advisable.If confirmed that it is hernia, after routine investigations & fitness, surgery is done.Hope this information is useful to you.Thanks. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sharp pain in the temple area after a concussion. Frequent headaches. Need immediate medical attention?\n\nI suffered a mild concussion in June 2011 and have recently been having severe sharp yet brief pain in my right temple. I had hit my head during a fall right on the bone above my right temple and had pressure all about my head. These headaches came and went for about 3 months and then nothing... now they are back. Should I see my doctor asap?",
    "doctor_response": "Hi,Thank you for posting your query.These symptoms are suggestive of mild head injury and the symptoms should subside in a few days.You can take ibuprofen or diclofenac tablets for pain relief.At present there is no need to worry. However, if you develop vomiting,or double vision, or fits, you should see a doctor and get a CT scan of the head done.I hope it helps.Please get back if you require any further information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could tingling lumps on ear suggest?\n\nlarge painful and sometime tingling lump behind right ear spreading into back of lower head. CT scan with dye shows no tumor just and irregualrity or old injury. I have never had an injury near this area. pain spreads down right arm at times. had shingles 3 weeks ago on head and face but Dr. said this is not from shingles. have also had scleroitis in and off for 1 year and other bady aches and swelling",
    "doctor_response": "HI,Dear,Welcome to HCM.Based on the facts and data of your query,you seem to have  right ear lump tingling from shingles with spread down to aright arm at times.Generalised body aches and pains is from Shingles.Hope this reply would help you to resolve your sever anxiety.Welcome for any further query in this regardWill appreciate writing your feedback review comments,to help the needy patients like you at HCM.Good Day!!Dr.Savaskar,Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes several lumps in the palm of the hand?\n\nI just noticed several lumps in the palm of my hand, I know there are more common conditions than EPITHELIOID SARCOMAS, but saw it is a possibility. When would you ask a doctor to consider this diagnosis, since it is a relatively uncommon condition? 52 years old, 125 lbs, 5'3' good health",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  Epitheloid sarcoma is very rare diagnosis.  You should not worry about that.  Just go for biopsy.  It will give you exact diagnosis.  You may have some soft tissue tumor other than Epitheloid sarcoma.  Biopsy will give you exact diagnosis. If needed go for immunohistochemistry study.  It will give you specific type of tumour if needed.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for the hydrophorosis of the kidney?\n\ni am 21 years old boy my right kidney have hydrophrosis. i meet doctor more than 1 years ,before 5 months i had an stent in my right kidney for three months.but i didn't become good yet if there is any way please direct me what should and how can i solve my right kidney problems... if u want i will send my clinical results....",
    "doctor_response": "HelloThanks for query .Based on the fact that you have posted I would state that you have hydronephrosis of the Rt kidney due to Partial Pelvi Ureteric Junction obstruction which has not resolved after putting stent for 3 months .Please consult qualified Urologist for clinical examination and get following basic tests done to confirm the diagnosis.1) Urine routine and culture.2) DTPA scan to assess the kidney function on Rt side .3) Intra Venous Pyelography (I.V.P.) You may need to undergo surgery of Pyeloplasty which will deobstruct the kidney and help to resolve hydronephrosis .Dr.Patil..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring colloid cyst?\n\nI have a colloid cyst which is recurring and waiting to be removed for a thrid time. I exercise regularly to try and loose weight. I watch what I eat and do bootcamp to try and loose weight but it does not leave me. I am obese and frustrated with it. Can the cyst be the reason for this. I try to watch what I eat but admit when frustrated eat wrong.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I have read your question and understand your concerns. Colloid cysts may result in recurrence often because of the limited possibility of complete removal. These cysts usually don't cause weight gain, only in rare cases when are located near structures such hypothalamus. I think the stress that is causing the presence of the cyst is more likely responsible for the weight gain.I think you should not be worried more than necessary because colloidal cysts are successfully treatable. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does numbness and coldness indicate?\n\nI am having trouble my foot. It started out with one vein. It looked like there was a wire under the skin with a bump on it on the bottom of my foot. I went to a Padiatrist, and she has no clue as to what is going on and has done no tests or anything. It also feels like I stuck my foot halfway up my calf into a bucket of Ice water.",
    "doctor_response": "Hello, I have studied your case.There is possibility of raynauds phenomenon.I will advise you to do MRI spine and colour doppler leg.For these symptoms analgesic and neurotropic medication can be started.Physiotherapy like ultrasound and TENS therapy will give quick relief.I will advise to check your vit B12 and vit D3 level and haemoglobin.Vascular claudication can also lead to  cold feet.Colour Doppler may help in diagnosis.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can stress be the reason to get the symptoms of periods?\n\nHi Doctor, i havent had my period in 4days now, i m getting symptons for periods. could it be cause i am thinking too much or stressed out?? i aint pregnant cause i havent been sick or feeling really ill.",
    "doctor_response": "If you always have regular periods then it is very unlikely to be overdue for 4days. Stress might be a cause but let me tell you, feeling sick or ill is not necessary for pregnancy and you should keep this possibility in mind if you are not on any reliable birth control. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have eruption ernie disc in lower back and migraine headaches. Not much relief with celebrex\n\nYes I'm 51 years old I have 2 eruption Ernie disc on my low back , also I have a very bad Migraine headaches every day in my life but my lowe back it's to much, I take 100 mg Celebrex 2 times a day.and IC butal -acet-caff 50-325-40 for migraine but my back its to much pain full.",
    "doctor_response": "Back pain due to disc herniation has two components.  One is nerve compression  and other is back muscles weakness.  I would recommend you to show to a orthopedics surgeon.  I would recommend you to take pregabalin and methylcobal tablet.  Also learn back extension exercises.  For migraine show to a neurologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dog recovering from splenectomy. Is not eating and is depressed. How long should I expect such a change?\n\nGood morning, my 12 year old male golden is recovering from a splenectomy that was performed on tuesday. Doing ok, however very depressed (not him at all) eating very little (has never missed a meal). Giving him boiled chicken, some peas, and water. Eats just a little, then is not interested. How long should I expect such a change in his personality. Of course surgery can bring on some depression , this is so not him. Thank you Suzi",
    "doctor_response": "Hi, His problem may be due to stress of surgery or due to some post operative pain. The important thing is too maintain his nutrition. If he is not eating properly then some IV fluids can be given. Stress and depressive symptoms usually resolve after few weeks of surgery. For suspected pain problem you meet some veterinary surgeon. I hope this information has been both informative and helpful for you. Wish you Good Health. Regards, Dr. Ashish Mittal www.99doctor.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for low grade fever, hot and cold sweats with rashes on arms\n\nMy temp is 96.5,body aches,pain,abdomen tender,headache,tired and lazy,bla sick feeling not myself please help i know my body and no one will listen hody hasnt been quite right since bad iud infection in october also cold durin day sweat at night,rash on arm,cuts dont heal easy oh the pain i beg u please help",
    "doctor_response": "Hi Dear,Welcome to Healthcaremagic Team.Understanding your concern. As per your query you have symptoms of low grade fever, hot and cold sweats with rashes on arms which seems to be due to viral infection.  Symptoms are because your immunity is lower down because of infection. I would suggest you to start with intake of paracetamol to prevent fever and combination of decongestants and multivitamin tablet. Avoid taking outside food. Drink plenty of fluids.  Your symptoms will resolve in 5-7 days. Avoid touching eyes, nose again and again. If your symptoms keeps on persisting the visit physician and get vaccination done.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment should I take for not feeling tired during Gilbert syndrome ?\n\nDear doctor , I am suffering from Gilbert syndrome . Most often my S. billirubin fluctuates.At that time I feel very weak n tired. what kind of treatment should I take?",
    "doctor_response": "Gilberts syndrome is a manifestation of defective bilirubin handling that has no adverse effect on life. Usually physical and emotional stresses cause an increase in bilirubin. Hence try avoid them as well as dehydration. decrease in bilirubin can be achieved using certain enzyme inducers but they aren't usually required",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can one recover from blackouts caused by alcohol ?\n\nmy uncle who has been drinking since his dad i guess passed away and even before then he drank (Beer) his liver is failing and he knows it but he stopped drinking for like a week then he started again but now i noticed that her has these blackouts that happen randomly he is 43 years old and he has enhailers for breathing he also faces the fact that he produces too much iron i just want to focus on if these could be seizures because he can be talking to you at one point and then if you ask him a question he sometimes forgets he is even asked that question he has been a plumber for a long time i dont know if any of the stuff he works with may have caused too much stress on the brain or something, my twin brother who is 18 suffers from the same thing i just worrie about my brother and my uncle i need help please!",
    "doctor_response": "Hi Kylepesce, Alcoholic blackouts typically mean episodes where the person has amnesia ie. he can not remember an episode. Apparently your uncle is showing those signs. This usually occurs in a period of intoxication (excessive drinking leading to abnormality) rather than withdrawal syndrom (abnormalities occuring when drinking stopped abruptly after the body is dependent on it) Also, yes an alcohol dependent can have seizures both in intoxication as well as in withdrawal. Also, if he is producing more Iron, that physical cause can also lead to seizures. There are many other reasons, physically, why an alochol dependant person can have seizures like vitamin deficiency, low blood sugar etc. Also, loss of short term memory could be an indicator of impending dementia (memory loss) called alcohol dementia....again there are many reasons why the memory, of a person dependent on alcohol, is not right. Also, there is no use stopping drinking just like that, having been dependant on it for so long.....it has to be done either slowly with gradual reduction in dose of alcohol or with cover of many medication if stopped sudenly. It can sometimes be fatal if stopped suddently without support of medication LET ME END BY SAYING...IT IS HIGH TIME YOUR UNCLE GOT PROFESSIONAL SUPPORT OF EITHER ADDICTION PSYCHIATRIST OR DURG&ALCOHOL TEAM IN YOUR LOCAL HEALTH CARE SYSTEM. I would think your twin brother might be having other causes if he has the same symptoms unless, at 18 years of age, he is allready as dependant on alcohol as your uncle. Please contact your nearest psychiatrist/ alcohol/addictions team for help. Good Luck to all of you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can A-fib cause chest tightness?\n\nI have chest tightness and am taking plavix 75mg and coumadin 4mg. or 3.5 mg. I have an LVAD that is working properly and am checked at the LVAD clinic once a month. I also am in constant A-fib since November & the LVAD dr. told me that can be a cause of the discomfort, but I am still concerned. My husband doesn t want me to call the nurse, because he feels she will send me to the hospital for unnecessary tests. I get chest tightness almost every day & then it goes away but is very uncomfortable while it is there. Could it be coming from A-fib. Thank you in advance for your reply. I am 67.",
    "doctor_response": "Hello dear, thanks for your question on HCM. Chest tightness with history of Atrial fibrillation ( AF ) and LVAD should be evaluated for coronary artery disease. AF is a risk factor for blood clotting and embolism. So we need to rule out coronary artery obstruction in your case. So better to consult cardiologist and get done1. 2d echo2. Stress test3. Coronary angiography. If all are normal then no need to worry for coronary artery disease. But better to consult cardiologist and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a male pattern hair loss. Please suggest if Finasteride can help in hair sustenance.\n\nHello doctor, I am suffering from male pattern hair loss for a long time. I had tried saw palmetto for a short duration and got a decent result (as suggested by a trichologist) but did not continue due to lack of information on long term effects. Please suggest if Finasteride can help in hair sustenance?",
    "doctor_response": "Hello. Can you please upload a few pictures if possible to advise the appropriate treatment. Are you married? If yes, did you complete your family?",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if am developing lump on the top of leg after getting lower leg amputated?\n\nI had my right lower leg amputated August 15th 2011. For the past couple of months I have been developing a lump on the top of my leg down by the stump. It is sore when putting on my artificial leg, but doesn t really hurt. Is this something to be concerned about. Thanks, Colleen",
    "doctor_response": "Hi,Dear,Thanks for your query to HCM virtual Clinic.I studied your query in all the details put forth by you.I understood your health concerns.Cause of the health problems you queried-There are many causes of the sore lump on the top of the leg,after leg amputation like,Amputation neuroma,Amputation dermatoses(skin infections/infestations,Amputation wound Granuloma,Cracked stump skin,phantom limb pain/ soreness/ or a compromised skin circulation with skin wound and infection.As the soreness is while putting your artificial leg and is caused around the lump developed,-Cause in your case seems to be  either  from Amputation stump skin tag with   sore skin eczema,or skin infection with soreness/ Or could be due to the Amputation neuroma-due to excessive lumpy mass of the amputated nerve end in the amputated leg stump.As I don't have any first hand information or a photograph of the part, I suggest you to consult ER Ortho-surgeon,who would rule out other causes and would treat it according to the cause of this stump lump on the top of the amputated leg.Remedy-So till the time you consult ER Ortho Surgeon and get his definitive opinion after above investigations,DON'T WORRY AT ALL but you need to be worried as it would complicate into some other serious problem with your amputed leg.And act fast on the above suggestions,which helps you to plan treatment with your ER OrthoSurgeon. Hope this would resolve your query with full satisfaction.Welcome for any further query in this regard to ME by direct question at HCM.Write excellent review and hit thanks, to narrate your experience ,which would improve my rating for many other visitor's to HCM.Wishing you fast recovery.Have a good day.Dr.Savaskar M.N.Senior Surgical Consultant.M.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it advisable to use Minoxidil to manage hairfall?\n\nHi doctor, I am 35 years old, male with no medical history. Over the past few years, I have started to lose my hair. I am not bald visibly, but have developed thinning of hair, especially in the middle area of my scalp. I have been using ayurvedic hair oils for the past free months, which has reduced hair fall visibly, but did not help to grow new hair. Do you recommend to use Minoxidil? If yes, which brand is effective and how to use it? Can I continue to use hairoil, during Minoxidil treatment? I also have very less facial hair. Is this medicine suitable to be used on face as well, to promote facial hair growth? I do not have any dandruff problems, but the hair is usually very dry. Awaiting your response.",
    "doctor_response": "Hello. I understand your concern but there is no attached photographs in your message. Kindly send a picture of the affected area to help better. I need to see the affected area to assess the condition and to suggest the appropriate treatment. Please send the picture of the affected area. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the bump between my butt and vagina?\n\ni have a bump between my butt and vagina. there is no oozing or anything. just very uncomfortable. i had my gallbladder removed and i constantly go to the bathroom so i thought maybe i made it raw. i dont thnk it is  a std. could you please answer this.",
    "doctor_response": "hi dear thanks for the query on HCMyou need to get the bump examined by the doctor.a gynecologist.there are many possibilities like epidermoid cyst, lipoma or bartholin cyst.if swelling is prominent get a ultrasound guided FNAC of the swelling to know the pathological diagnisis and extension ,for further management.hope your query is addressed.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does failed IVF cause urinary tract infection ?\n\ni am 36 yrs old woman married for last 8 yrs without any issues. i am suffering from severe endometriosis . recently i under went ivf cycle which failed. then i suffered from urinary infection is ivf the cause for this. also i have pain in right kidney region",
    "doctor_response": "Hi, Welcome to HealthcareMagic Forum. No, IVF is not cause for UTI, it could be renal stones or Decreased Water Intake. You should be getting yourself examined by a Urologist to rule out the exact cause so that he can examine you and suggest USG abdomen and Urine culture. Drink plenty of water and get adequate rest. Wish you Good Health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump around the neck\n\nI have a slightly enlarged lump on the left side of my neck, which has been there for about a week. I am a very healthy person, I hardly ever get sick. My roommates were just sick with colds so Im thinking this could be from my body fighting of a cold before it starts. I am experiencing no other symptoms. My friend is also a student nurse and she felt my neck and said it feels normal. Should I be worried? Can a lymph node be naturally larger than the other?",
    "doctor_response": "Welcome to Health care magic.1.The history given by you suggest the lymph nodal enlargement.2.Lymph nodal enlargement is seen after any infection / inflammation - it can be localised or systemic. 3.Lymph nodes can be of any size as they grow.4.Confirmatory is an ultrasound neck which will help to assess the nature of the lumps and its source and where all they are extending.5.In this case treat the cause if you are aware of any thing, if not then lymph nodal pathology itself can be possible, also scan results can be followed. Good luck.Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for nasal congestion with mucus secretion\n\nI have nasal congestion. It has been going on since September when allergie season for me started. I am getting yellow out of my nose along with a lot of clear mucus. I am currently taking 1200 MG of mucinex D bid. And also using saline nasal spray when needed and afrin. I also have suphedrine for in between the mucinex. I am not sleeping very much because of the congestion. What can I do to get over this. I do have some keflex 500 MG",
    "doctor_response": "you can use flute as one nasal spray twice a day for few days along with these that will reduce congestion",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is ketafung shampoo good for hair loss?\n\ni am 20 yrs old.i have an hair loss problem of around 2yrs and it becomes baldness in middle of my head. i had consult a doctor. he gave medicines called MX-5 solution and KETAFUNG shampoo. i am using it for 1 month. is this treatment good or not for hair regrowth?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.Yes. The treatment is good for you. And the treatment response is gradual. It will take at least 6 months for improvement. Be patient. You can add biotin tablets in addition.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for fever and sore throat\n\nMy husband has a fever 37 to 38C (up to 102F) for seven days now. He's been skiing one day and developed it after a mild sore throat. Now he's been having a fever, sweats extensively, and has a red flat rash that doesn't itch on his face and torso, but not arms and legs. He coughs extensively and says his chest hurt when he does. His doctor prescribed an antibiotic that I've never heard of. It's called (over here) zymbactar (claritromicine) but when he developed this rash I took him to the clinic, and they said it must be a virus. Help (I'm traveling abroad today and slightly panicking)",
    "doctor_response": "Hello \\Your husband is having fever , cough , chills for 7 days and advised clarithromycin .When cough it hurt ( chest ) .You are travelling , so such symptoms may be due to flu or cold ( because your husband is also having rash at few portions ) .In such cases I advise my patient to take lEVOFLOXACIN 10 mg / kg body weight with tylenol ( 10 -15 mg / kg whenever fever or body pain ).Since  fever is for 7 days and continuous travel is there , so take this treatment along some bronchodilator  cough syrup .After this get in full examination as CBC, CHEST X-RAY and for malaria and typhoid .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What sort of cancer can a blister on the vagina cause?\n\nHi, may I answer your health queries right now ?  Please type your query here...my sister was told she has cancer.She found a very small blister on the outside of her vagina.She had a biopsy done, but was not told what kind of cancer it could be. Do you know what kind of reserch I can do,or what she may have. Thank You",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.She may have squamous cell carcinoma. It is most common cancer of vagina. But it can be other type of cancer also. Please send me biopsy report of your sister so that I can help you further. Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, low sperm count, taking Zinc, oligo care, ocarnix. Advice for insemination process?\n\nhi, im Victor from Bangladesh. im at 33yrs 11months of my age. My wife is 33yrs 2 month. We have been trying since 3yrs for baby. I have seen 2 doctors. They didnt found any major problem. Earlier my sperm count were 40million and there was some infections . I cured from that. And then its been long time we tried naturally. But didn t conceive yet. And then secondly we have seen another doctor, she found my sperm count were low like 10 million, doctor suggested some medicine, Zinc , oligo care, ocarnix etc. Then its increased again. but still now my mobility is 20%. Doctor advising some clinical thing, like my good qlty sperm will be placed to my wife s egg. Actually i like to do it naturally. Im really afraid and doctor said its have hope only 20%. So i dont want to be disappointed and waste money with no result. So please advice. If need i can send you some report if you required. many thanks for your attention. with best regards Victor",
    "doctor_response": "Hello, Thanks for writing to us. Looking at your query, I consider that all your wife's reports are normal. I will suggest you to get examined yourself by urologist and get scrotal doppler done to rule out varicocele  with his advise. If varicocele is there, you may be helped by doing a surgery, which may help you to improve sperm count and motility. Other option is IUI as suggested by your doctors. Hope this information was helpful to you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure swollen and redness in penis hole?\n\nMy penis hole is red and swollen.this problem started a few days ago and has gotten worse.some days however it doesnt feel as bad.ive been drinking cranberry juice and eating Garlic to help from what I red online. It stings when I urinate and ejaculation causes stinging and the swelling to get worse.",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that your external urinary meatus is swollen and red since few days and have burning while passing urine and ejaculation is painful .This is most likely to be due to inflammation of urethra or Urethritis .Please get your routine urine test and urine culture done to find out the organisms causing this infection and antibiotics to which they are sensitive to.Please take broad spectrum antibiotics like Cefexine along with urinary antiseptic like Nitrofurantoin twice daily and urine alkaliser thrice daily.Later on switch on to appropriate antibiotics as per culture report.Get the prescription of medicines from your family Physician.Ensure to drink more water.To keep your urine dilute This will help to control dysuria. Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Instaflex result in headaches?\n\n2 questions plz can instaflex give u headaches taking it for about 3 months just starting getting headaches and not feeling too good. 2nd q taking a urine test in2 days is there anything in it that could cause a false positive my truck driving career feeds my family",
    "doctor_response": "HiHeadache could be unrelated to the drug since you are taking the drug for 3 months and headache has just started.I suggest you to check your blood sugar,blood pressure,vision abnormalities or refractive errors as a first step to identify the cause of headache.Any history of insomnia or stress should also be ruled out.With regard to the second question,Pain killers belonging to opioid group can cause false positive result in drug tests.Hope I have answered your query. Let me know if I can assist you further. RegardsDr.Saranya Ramadoss, General and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will a tear in blood vessel heal on its own?\n\nI tore a blood vessel in of calf today that s what the doctor tells me it s my right calf on the inside of my calf hurts bad he said time will and it will heal on its on. I took a step and it felt like you hit me in the back of my calf YYYY@YYYY",
    "doctor_response": "Hi,from history it seems that you might be having hematoma on the parts due to injured blood vessels.Apply ice pack 2-3 times a day for few days.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Difficulty in breathing, anxiety. Could this be allergy to mold?\n\nI can't breathe. I am not congested, I do not smoke, and I am taking full breaths until my lungs are full. But it feels like there's not adequate oxygen in my breathes and it's not satisfying, leading me to focus deeply on my breathing and starting breathing more heavily and causing anxiety and fear. I am on no medication. I am not overweight. My stomach feels strange and so does my throat. This has happened on and off for weeks and now it's been persistent for 36 hours. Could this be allergy related? I suspected mold in my living space.",
    "doctor_response": "this can be gerd gastric acid reflux comes in throat back causing itor it can be mould allergyor it can be less oxygen supply to body organs like sleep apnea which behaves like thisyou can consult your doctor to diagnose in these guide lines to get your answergo for sleep studies also to find cause",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for low blood pressure and weakness?\n\nhello, my father age is 65, he the congestive heart failure patient. Doctors did angiography but there is no veins blockage in heart.. now doctors suggest only to take medicines.. my father taking a lots of medicines.. but the problem is that he is so week..doctor didn't give any Vitamins tablets. He daily eat lasix 40. Due to Lisix. the minerals are waste from the body. .And his blood pressure is so low every day..Sir tell me what can i do? plz i m waiting for ur reply. thanks",
    "doctor_response": "Vitamin's are just meant to fool the people.Their role is still under question mark?So don't worry about multi vitamins.Lasix is the drug which he will require for lifetime....he has to be on lasix.He can start some cardio rehabilitation to improve cardiac function.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bright red blood-like substance in stool, please suggest\n\nI ate some vegetable crisps, which contain beetroot, on wednesday evening. Thursday morning I saw blood-like colours in the stool and on the paper. The next (small) movement appeared not to produce the same appearance, but on Friday, the first movement of the day again appeared blood-like in the stool and again on the paper. I have not experienced or been aware of this before, but what are the chances that it is a coincidence that I did eat the beetroot and other vegetable crisps recently? I am of course faint with concern.",
    "doctor_response": "Thanks for te query Yes eating beetroot has been known to produce reddish discoloration of stool and each stool slcycle lasts upto 36 hours. Insuggest you wait for three days if it still persists then see a doctor. Have a healthy living",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe upper back pain be treated?\n\nHi I've got very sore upper back pain feels like it's in my ribs really hurts to sneeze cough and breathing deep  i've been to my local GP and he kinda fobbed me off and gave me some exercises to do which are not helping at all it seems to come on every year at winter time a lot worse.can you please advise  me what to do painkillers don't seem to work either kind regards Brent",
    "doctor_response": "Hello,Since the painkillers do not work and you have had this pain for long period of time I would suggest you to do an MRI of spine and consult that with a neurologist specialist. The solution might be surgery if you have advanced discal hernia.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Edvin Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does anti rabies vaccination work in body?\n\nhow long is the effect of anti rabbies in the body when vaccinated? i have been bitten by our cat i think 2010 and i have some scratches too..i had taken rabipur, they vaccinated it to me 3x.. and now, our cat bit me again..the one that bit me is a domesticated cat. do i have to be vaccinated again?thank you",
    "doctor_response": "Hello,Welcome to HCM,Cat is a known reservoir of rabies virus and it can transmit rabies to the humans. Rabies is 100% fatal but it is 100% preventable by proper and adequate treatment.As you were bit by a cat previously for which you have received the entire course of anti rabies vaccine. Once again you were bit by cat recently.According WHO categorization of animal bite, you will be categorized into Re-Exposures. You should receive two doses of anti rabies vaccine on days 0 and 3. The vaccine should be taken to shoulder.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high BP despite taking medication\n\ni have high blood pressure controlled by medication however due to weight loss, my pressure was consistently at lower levels so my dr. instructed me to monitor it and if it went above 140, to take 1/2 dosage. BP good the last few days but today, early morning reading was 143/76 so I took 1/2 pill; at 2pm, BP reading was 150/86 and one hour later 151/87, I took the other 1/2 of pill. I ve called dr office but no response yet? what do you suggest? Tx.",
    "doctor_response": "Hello Welcome to Ask a Doctor service I have reviewed your query and here is my advice.Your blood pressure seems to be in control if you are taking the drugs, if you are going to measure the blood every on and often so it will show different reading every time it will confuse you and may create panic too, so better to see the physician and discuss this  and let the physician read the blood pressure. in absence of clinical symptoms it is nothing to worry.Hope I have answered your query, let me know for further assistance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat chronic A-Fib ?\n\nI am 62 years old, 6ft 2in and 290 pounds.  I have chronic A-Fib for 5 years, non symptomatic.  For one week now I have been feeling the blood flow, pulsing,  in my left upper chest with some pain, but not constant. I am taking a mild blood pressure medicine (losartan-hctz) and coumidin with BPs of 150 / 95.  What do you think? Thank you.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Atrial fibrillation (AF) is tachy arrhythmia. If not controlled, it can cause lethal and life threatening complications. You are now symptomatic since last 1 week. So all these symptoms can be due to AF. And hence you need to treat AF as soon as possible. You are not improving with medical treatment,so you need Radio Frequency Ablation (RFA). Before this you need to get done Electrophysiological study (EP study). So consult cardiologist and discuss all these. RFA is having excellent success rates. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hi, may I answer your health queries right now ?  Please type your query here...i ate a weed brownie yesterday not knowing my roomate put weed in them.  i freaked out for about 9 hours.  I also have a bad anxiety and panic disorder now the next day i still feel weird and scared is it just my anxiety what can i do to make this stop",
    "doctor_response": "Yes, such an anxiety shall cause such problems. So be care of your emotions well and you will be reducing the severity and the frequency of such attacks. Try to do some physical exercise on a regular basis and that shall help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure pain on the sides of thh neck and back?\n\nOut of nowhere my neck on the side and towards the back of it hurts. Also the top of my shoulder hurts. I workout everyday for football workouts but that never effected it. I felt fine until I was driving to a restaurant today. The entire time, I was miserable with neck pain and part of the symptoms are pain in my neck when I breath heavy or sniff and im on ibuprofen but it still hurts when I lay down. Im not sure whether its a spasm or pinched nerve or pulled muscle but its been hurting for the past 2-3 hours",
    "doctor_response": "Hi there, Thanks for your question at HCM. It is most likely muscle spasm. Ice pack application and gel application( analgesic gels) with rest can help relieve the spasm over initial 24 to 48 hours. If your neck hurts when you bend forwards, you should not use a pillow while sleeping. However you should consider and get evaluated for a pinched nerve if: 1.You have numbness of tingling sensation in your arms or fingers. 3. Any pain which is radiating along your arm downwards.( like sciatica pain in the legs) 3. Any muscle in your limb feels weak. 4. The pain does not subside in first 5 to 7 days after medicines and rest.Hope this helps. All the best. Regards.Dr.SBK",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yellow discharge from c section incision site?\n\nDear Doctor, This is to ask you that my got ciss erian baby before 20days back and she got stitches under the naval.Everything was okay but after 10 days the yellowish water started coming through right side stitch doctor gave her some antibiotic medicine after 2 days it stooped but it again started coming from left side stitch. Pain is not there she is normal and okay alhamdulillah. We are worried about this yellowish water. Kindly let us know why it is coming and how it will stop. regards",
    "doctor_response": "Hi,It seems that there might be having infection in stitches area giving this problem.It is advisable to consult gynaec and get examined for having deep seated infection in stitches.If require she will go for proper dressing with removing of infective material and cleaning the wound.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible despite taking Unwanted 72 after intercourse?\n\nMy question is I did sex with my bf on 4 days of periods without condom bt at the tyme of sex may be little amount of sperm get inside vagina bt we both r nt sure about sperm after that in mrng after 6_7 hrs I ate unwanted 72 tablet so nw I m feared about I vil become preagnent or nt after marraige",
    "doctor_response": "Hi,   I understand your concern.   Unwanted 72 avoids pregnancy by postponing ovulation. It's a temporary effect.. may cause irregularity in periods for a couple of months, But later on the fertility returns to normal level.So don't worry.. you can conceive after your marriage.   thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sore lower stomach, pain, feels burning in throat. Cause?\n\nHi I have sore stomach all the time around the lower stomach is. Get pain in middle and right. Like a burning feeling and comes up in my throat . What could this be. I m AAAAAAA 23 years old",
    "doctor_response": "Sean, I have several questions to ask of you. 1.  Have you been having nausea and/or vomiting? 2.  Are you taking any medications, either prescribed, over-the-counter, or illegal? 3.  How long have you had this problem? 4.  Have you noticed if it is in relation to meals or any other time or activity? 5.  Have your parents or siblings ever had anything like this previously? 6.  Have you noticed any blood in your vomitus or stool? 7.  Have you had any bowel movements that are black and tarry? 8.  Have you been having diarrhea (loose stools) or noticed any other changes in stool? These questions will help narrow down the possible problem(s) you are having.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Topamax lower potassium level in blood?\n\nCAN Topamax ever lower your potassium level to approximatly 2.3??; LAST WEAK I HAD ACUTE KIDNEY FAILURE from getting very sick. The main DR blamed all my symptoms on Topamax. In hosp for week - I went because i couldnt keep any food down + kept drinking drunk tons of water. Finally got Potass.. up to 3.1 --- Main diagnosis acute kidney failue due unspecified ALL THEY GET KEPT SAYING WAS TOPOMAX WAS THE BLAME!! i ve CANBEEN ON t for many years -- MIGRAINES for over 30 years {On T for aprox 15 years -but not entire time} Is low P a side effect that I never read about? MY CONCERN THESES HEADACHES. i M ALREADY GETTING ONE A DAY. PLEASE TELL ME IF/IF NOT I CAN T EVER TAKE t AGAIN. THANK YOU - I REALLY NEED AN ANSWER----IN PAIN / CAN t sleep THANK YOU FOR AT LEAST LISTENING ; karen",
    "doctor_response": "Hello,I've never read anywhere about acute renal failure caused by topamax! It can cause oliguria sometimes which means a lower urine volume, which under certain circumstances may aggravate renal function and lead to acute renal failure (for example: in dehydrated patients). Topamax increased the rate of renal stone formation, which may lead to obstruction of the urinary tract and cause renal failure. Obstruction causes severe pain, so you should know it if something like that happened in your case.Topamax may - rarely - cause hypokalemia. Hypokalemia can also be caused by polyuric renal failure. Renal failure may present with either oliguria (less urine) or polyuria (excessive urine) and sometimes oliguria is followed by polyuria. When too much water is excreted, potassium is lost as well. So if you're passing liters of urine every day then a low potassium level can be attributed to polyuria.So in conclusion, I don't believe Topamax caused renal failure to you because there are not any reports that I know about such a side-effect of this drug. Topamax may indeed cause hypokalemia, although this is a rare event.Taking topamax requires intact kidney function. Otherwise dose reductions are required. You should consult your doctor for alternatives or for dose adjustment depending on your GFR (Glomerular Filtration Rate).I hope I've helped!If you'd like further information, please contact me again and I'll be glad to help.Kind Regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the pimples and its black spot ?\n\nsir i have problem of pimples &black mark . i tried more but cant give any better result sir plz help me",
    "doctor_response": "hi u need to take care of ur skin better to consult dermatologist u need to take medicine depend upon the grade of the acne there are many treatment option for acne and its spot and scar only thing u need to take regular medicine for it for 2-3 month drink more water avoid oily and spicy food avoid touch ,pick or popping avoid sun exposure use good face wash with salicylic peeling ,LASER ,microderma are best option for u",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen and painful ankle\n\nHi I snorted coke 2 days ago roughly 48 hours exact. About a hour or 2 after I done the drug my ankles swelled up. There is no feeling lose or pain my breaths a a little shy. My mind seems the same. Only other symptoms is my muscles feel tense when standing or walking. Should I seek medical attention or eat a banana and do the invisible bicycle on my back?",
    "doctor_response": "Hello, I have studied your case. Yes you should consult your doctor.Drinking plenty of fluids to avoid dehydrationStretching your leg muscles or riding a stationary cycle.Taking diet rich in calcium and potassium or oral supplements of the sameCheck your vit B12 and Vit D 3 levels.Till time, avoid lifting weights, You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could cramps in uterus area, headaches and excessive hunger suggest pregnancy?\n\nIve been experiencing more then usual discharge, some like water.. and also getting hungry more often but not being able to eat much without feeling full and like i over ate. My breasts are tender but its mostly just my nipples. Ive also been have a lot of headaches. I usually dont get many head aches. and when i have to pass gas i feel like my uterus is cramping. am i pregnant?",
    "doctor_response": "Hello and i hope I can help you today. Pregnancy associated symptoms vary considerably between women, and many of them feel like other types of hormonal abnormalities- but the most common sign is a missed menstrual period. If your period is late, you can perform an over the counter pregnancy test to find out which is 99 percent accurate.  So I hope I was able to adequately answer today and that my advice was helpful. Best wishes,Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedies for pus filled abscess on the buttocks\n\nI am Jayalakshmi, Age-25,Height-5.1,No-B.P, No-Sugar, I am not a Heart patient. I am a normal person.I had a pimple  like thing on the back side of my butt which was paining also. so I showed it to a doctor in a private hospital he told me that their is puss formation in it so he operated & removed the puss from thier it has been 4mnoths from the operation  but still the pus form in that area .Please tell me any homely medicine  for this problem which can cure it permanently. Please send me the suggestion to my mail id  YYYY@YYYY .",
    "doctor_response": "Hi jaya lakshmiyou csn apply following medicine  as advisedmix jatyadi taila and kasturimanjal powder  in a bowel and heat it upon the water  and apply the paste forj 4 to 5 ti es day to the affevted part note that the heat should not beyond your tolerance thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest congestion in 2 year kid\n\nMy son is 2 yrs 6 months. Diagnoised with severe chest congestion and cough mucolytic. Doc said mild bronchitis. Prescribed Ascoril syrup 3.5 ml 3 times a day for a week. After giving medicine cud see some restlessness and adamancy at night which was uncontrollable. Now 4 days over. He is better but a bit dull. His cough though l not fully gone but bettet. Is it normal",
    "doctor_response": "Thank you for consulting in HealthCareMagic. The condition that you mention, is probably bronchiolitis and not bronchitis. It is a viral infection that affects children between 6 months and 3 years of age. It is characterised by chest congestion and wheezing. In order to dilute the cough steam inhalation or nebulisation is required alongside the mucolytics. Generally it is associated with an allergic component for which the antiallergics like ascoril are given. The side effect of such antiallergics is drowsiness and hence the child seems dull. The cough and restlessness would get relieved in a few days time and I insist that you bear with it till then.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on HealthCareMagic are welcome. Wish your kid good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of AKT 2 tablets?\n\nHi sir this is manoj from bangalore. I just want to know side effects of AKT 2 tablets. My mom is taking this tablet from past 4 days and she is experincing chest pain, all joints pain with swelling, fever, vomiting sensation. So please let me is this related to the tablet or not",
    "doctor_response": "Hello Manoj,  The rifamipicin component of akt 2 can cause what we call flu like syndrome , which will have all symptoms you describe.  However it is self limiting and a simple paracetamol may be taken for symptomatic relief . If the symptoms persists do visit your doctors as the akt medication can cause wide variety of symptoms and it becomes important to examine . A liver test may be considered as all of the components may increase liver enzymes.  Hopefully I could help . Regards Dr  Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to manage painful bleeding piles?\n\nHi doctor,I am suffering from bleeding piles with pain. Please help.",
    "doctor_response": "Hi. Revert back with the reports to a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant body aches and fatigue?\n\nDear doctor, i am feeling some type of dullness .... like i am always dull and could not concentrate, feeling sleepy all the time and my back head feels like hell. I am not active as i was before. i feel a irritation and a constant pain in my whole body sorry for the vague sentences, i am not able to explain it in words. Please help me in this regard. since i am in my final year of my high school. this can affect my final scores.. Yours truly, Amar YYYY@YYYY",
    "doctor_response": "Hello,I read carefully your query and understand your concern. Your symptoms seem to be related to chronic fatigue syndrome. I suggest using a multivitamin supplement,drink liquids and daily exercise.If the symptoms continue, I suggest to do some examinations such as a complete blood count and thyroid hormone levels. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to overcome anxiety and negative thoughts\n\nI have a happy life. In fact Im happier now with my life then I have ever been. Im engaged now. Im in college and loving it. However I have a problem. I have been havng thoughts that are negative. I worry all the time. Its stuff that shouldnt even cross my mind. Like when my fiance leaves for work I think oh my gosh what if he has a wreck. Or the other day I was on my way to class and I started thinking what if someone came into the college with a gun how would I protect myself. I do not understand why I all of a sudden started worrying constantly. Its getting worse too. I do it all the time now. I use to never have these thoughts. Whats wrong with me.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. I sincerely suggest that you are victim of your own negative thinking. You cannot term your current state of mind as clinical depression. Rather, this is just disappointment. Disappointment which arises out of unforeseen life events do bring such symptoms like sadness, irritation, anger, lethargy, lack of interest, lack of appetite etc. Please understand this fact and make sure to introspect. Talking to your friends, out door activities and being creative should give you relief. Find the reason for your disappointment and consult a psychologist if need be. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for hypokalemia?\n\nI have recently had a c-section and gallbladder surgery that have left me with a strange sensation of heaviness on the sternum and the need to breath \"manually\" .  I have been previously diagnosed with Hypokalemia, but had the worst bout last night. I couldn't make my lungs expand enough to take in air for a short period of time, and breathing with the diaphram didn't help...in the mix of the episode, I lost movement of my right arm, and didn't regain use for over three hours...felt it beginning to move to my right leg, but took a potassium supplement to try to help things out...and then finally fell asleep...What could be causing all of this, including the potassium deficiency?",
    "doctor_response": "Hi I did review your conditionThere are many things that can cause hypokalemia and a doctor needs to know much details before considering the special test to identify causes of hypokalemia. Do you have high blood pressure? Also have you been diagnosed with any other illnesss in the past like diabetes and are you on any long term medications?Let me know these anwers and I can tell you more about your problemYou can also consult a doctor for complete evaluationright diagnosis is essential for right treatment.I hope this helps. Wish you a healthy life ahead..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bridge between teeth\n\nMy friend had a bridge done near the canine teeth on the right side. The bridge broke and she had gone to a dentist to take an opinion. They had asked her to take a x Ray and the doctor says that she has to redo  all the root canals which has already been done. She is confused as to what to do. Is it possible to have a permanent bridge. Plus she has dentures in the front six teeth can they be done permanent. Will it give problems in future. The cost is rs.40,000. Can you advice.",
    "doctor_response": "Hi.Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain as the bridge has broken and if there is no pain associated with the teeth over which the bridge was cemented then redoing of root canal treatment in all the teeth seems a bit questionable and I would like to see the x-ray of the region for guiding you better as then only I can rule out that whether there is need of repeating the root canal treatment or not..You can also take an advise from an Endodontist who can take an x-ray and and advise you what to be done..After the confirmation only that whether the teeth needs root canal treatment done again or not, the bridge can be replaced..For the front 6 teeth which seems to have removable dentures a permanent bridge can be placed only in case if the remaining teeth over which the bridge will be cemented are in sound condition or not as they are having sound bone support or not so that they can bear the forces and this can also be confirmed by a clinical evaluation and an x-ray of the teeth that has to be prepared for cementing the bridge..A properly fabricated bridge which is cemented on sound teeth which has a good bone support will have a long life and will not cause any problems after placement..If you wish to get a proper advise before you proceed with the treatment you can send the concerned x-rays to me directly by going to my profile and writing your question there with concerned x-rays so that I can advise you correctly so that you can get treated properly..Hope this information helps..If you find the answer helpful please give me a Five Star Review and click on found the answer helpful as a token of appreciation..Thanks and regards..Dr.Honey Nandwani Arora..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to rule out the cause for erectile dysfunction?\n\nHi doctor, I am a 46 year old male. My weight is 75 kg and height is 6 feet. I do not have diabetes and BP. I have asthma which is under control. I am facing problems in getting erections. It is getting worse with time. I tried some treatments for depression and practiced relaxation techniques with no success. My erectile dysfunction problem is there during each sexual activity. The problem started some five years ago. I used to take Viagra 50 mg. The result was good initially but the hardness lasts only for 30 minutes maximum. I could not bear the side effects like headache and face swelling. Even that tablet is not working for me recently. My problem reached to unmanageable levels recently. I get early morning erections.\u00a0I would like to be treated for this. I would like to know what tests to be done for identifying hormonal or any other deficiency. I will provide any other information as required. Thank you.",
    "doctor_response": "Hi. I understand your problem. Revert back with the reports to a sexologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can alcoholism and vasovagal hypo tension cause unconsciousness?\n\nHi there, my brother who is 36 y/o and heathly has been found losing conscousness and fell down after voiding a couple times. These episodes accompanied consuming some red wines. I quess that these episodes might be related to red wines polyphenol and post voiding vasovagal hypotension. Am I right ? Thanks !",
    "doctor_response": "Hello,I read carefully your query and understand your concern. Drinking alcohol can cause\u00a0blood vessels to expand,\u00a0causing\u00a0blood pressure to fall and\u00a0syncope\u00a0to occur. This may be triggered by pressure on the carotid arteries, and\u00a0can lead to\u00a0low blood pressure and\u00a0syncope.Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Whis is the best alternate for advair other than dulera for asthma?\n\ni have a question about my asthma medicine. i was taking advair for a few years. it was working great till my insurance change and couldnt use advair anymore and switched me to dulera, which is not controlling my asthma. when i was using advair never had to use my rescue inhaler now that im on dulera i have to use my rescue inhaler more often. what should i do?",
    "doctor_response": "Hi,   I appreciate your concern . Actually Dulera contains  formoterol & mometasone and Advair contains fluticasone & salmeterol. Though both contain anti-asthma drugs ,but they differ in there potency and duration of action . In case your symptoms were well controlled with Dulera , it is better you continue taking it . In case your insurance company does not provide you Dulera, then you can try increasing the frequency of usage of Advair,which might help.You can also try taking  drugs like Montelukast for asthma maintanence and prophylaxis Hope it helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Semen analysis test done for physical, volume, high viscosity microscopic motile non motile. Looking for advice\n\nHello, I d been semen analysis test, and This s my result: Physical: Volume: 3ml pH: alkaline Total sperm account: 18 M/ml High Viscosity Microscopic Motile Non motile after 30 mint 40 % 60 % after 60 mint 35 % 65 % after 90 % 30 % 70 % Also Semen Culture: Their s no any growth after 2 days incubation So please, give me your advice, and what s that means?",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have what is called as Oligoasthanozoospermia meaning there by that your sperm count and motility of the sperm is low (almost 0) as per WHO standards.Truly speaking there are no medicines that can increase sperm motility however following measure will help you to improve sperm count and motility of sperms.1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning.2) Take high protein diet rich in vegetables and fruits and Vitamin A,C,D,E.and Zinc3)Take anti oxidants like Almonds 5-6 everyday..4) Avoid alcohol and smoking..Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dry flaky skin of penis\n\nHi i have a problem with my penis. On occasion, more recently, more often than not.. my penis becomes dry and flaky and over time it has developed some kind of scale or shine.. the tip of the foreskin is normally red and gets sore very easily. There is no discharge or itchiness. I can pull my foreskin back but when i do i notice it is very tight as if the foreskin has become smaller or more restricted. When this happens, after sexual intercourse the skin usually splits especially if the foreskin is slightly dry before sex.. i get about 4/6 paper like cuts on the foreskin and this normally takes a few days to heal. Very rarely there is slight burning on passing urine",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: You may be having balanoposthitis(infection of glans and foreskin)Explanation: Your symptoms of dry flakes, difficulty in retraction of foreskin suggest balanoposthitis. So, you can start oral antibiotics with local antibiotic ointment like soframycin for some days which can help you to get relief from this problem.                Please visit a doctor so that you can get yourself examined and can also go for urine test to rule out Urinary tract infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can ADHD be treated?\n\nI have a son, age 45. He had problems in school with not getting homework, etc. and as he became a teenager, he drank alcohol, used some drugs, without my acknolagement, when it was done! In college it even got worse, with the abusment of drugs and booze. He always starts things like classes with loans, really going to do class this time , but just doesn t finish. He can talk to you, and you think he really is going to do what he says this time, he starts, never finish. He just got his drivers license back in November. Got picked up for drinking again. He has been in many classes, nothing helps. He only told me about being told he had adhd about 3or 4 years ago. I thought he was just with the wrong crowd when he was younger, didn t know anything was wrong. I want to know how he can get help for the ADHD.",
    "doctor_response": "Hello,You need to observe for mood symptoms like irritability, aggressiveness, over-talkativeness, decreased sleep to rule out mood symptoms. He needs treatment with antipsychotics and mood stabilizers.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Soujanya",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are R-Cinex and Benadon safe during pregnancy?\n\nI am on r cinex and benadin as I was diagnosed with lymph node tb around my neck. This is my 8th month since I am taking medicine as per doctor I am suppose to take medicine for 9 months so only 1 month is left. I am 7 weeks pregnant and concerned whether taking medicine will harm my baby. So please suggest",
    "doctor_response": "Hi there, I have understood your concern and I will suggest you the best possible treatment options.Please do not panic about the medicines.Tab Benadon is vitamin B 6 preparation and is essential vitamin. It is helpful for pregnancy as well as helps liver to tackle Rifampicin metabolism. Secondly, Rifampicin itself is not known to be harmful for pregnancy as such. It's not known to increase the risk of abortion or fetal anomalies.Benefits of Use of Rifampicin always out weigh the risks with the use of the medicine. Please be in touch with your treating doctor, complete the treatment course rigorously.Opt for a healthy diet and regular exercise regimen.Start on Folic acid and vitamin B 12 supplements.I hope this answer helps you.May God bless you with a bundle of Joy.I hope this answer helps you.Thank.Dr. Purushottam Neurgaonkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Venous thrombosis with hemorrhagic infarct\n\nhollo am 23 year old girl right now am suffering from deep venous thrombosis with hemorrhagic infarct in the right thalamus and adjacent structures",
    "doctor_response": "Hi,It's curable with good results.You needs anticoagulant therapy....low molecular heparin Subcutenously or iv heparin followed by warfarin....u have to keep INR more than 1.8 with freqent monitorings of PT... u have  to rule out coagulation abnormalities like antiphospholipid syndrome,lupus ,homocystine other hyprercoagulable conditions...if seizure occurs u need antiepileptis...Outcome is excellenece with heparin even if haemorragic infarct..get well soon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Lamotrigine advisable for bipolar II disorder and SAD disorder?\n\nMy 28 year old son has been diagnosed with Bipolar II and SAD. Been prescribed lamotrigine. Wondering if there could also been something psychologically going on besides a chemical imbalance. He says his brain as well as his body are just not working correctly. He is so frustrated with himself and life.",
    "doctor_response": "lamotrigine is a good option.To be frank all psychological problems arise from abnormalities in brain.so it is actually a psychiatric disorder which needs treatment.hope he will be better soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath during cold weather?\n\nwhen it is cold outside 10 degrees or less my lungs hurt like they are on fire and get shortness of breath. Also when I go up 10 or more steps and sometimes when working out this happens. Inhaler helps but some times takes a minute or so to work. Lungs hurt like on fire or stabbing pain in both sides. Heart was checked and ok My father died from severe pulmonary fibrosis. Cardiologist said chest has small amount of fibrosis. Former smoker 30 years a pack every 2 days. Have not smoked in 6 years.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.The most possible reason is a weather-induced spasm of bronchi, alveoli which will deprive the lung tissue from necessary oxygenation and hence the difficulty in breathing. Deep breathing exercises will help a lot in this matter. Hope I have answered your query. Let me know if I can assist you further.Regards, \u00a0\u00a0\u00a0\u00a0\u00a0Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe abdominal pain and fever while suffering from a kidney infection?\n\nMy daughter was diagnosed at ER with kidney infection but she\u2019s not having any pain on urination and there were only traces of bacteria in her iTunes sample. Today she\u2019s complaining of severe abdominal pain, fever between 100-104, no nausea or diarrhea",
    "doctor_response": "Hi, It is natural she had infection so fever, vomiting are likely to occur.Because any inflammation in abdomen like kidney infection can cause can cause fever and pain, so don't worry. She needs antibiotic coverage for few days and she will get OK soon. Show him to nearby physician may be she needs a culture test and accordingly antibiotics will be prescribed. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Soheel Hussain Zargar, Dentist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes flu like symptoms and dizziness when taking losartan?\n\nI have been taking Losartin 50mg for 10 days now and feel awful every day with flu like symptoms and dizziness - I had put it down originaly to statins that I had and which gave me awful side effects but have not been on the statin for 2-3 weeks now and only took two and was asked to stop them after they gave me terrible side effects. However the flu like symptoms have continued and I can only ut it down tothe increased Losartin the GP gave me. I feel like stopping them just to see how I am (can t see the GP till after christmas) but don t want to go over the holiday feeling like I do either!",
    "doctor_response": "Hello, Losartan does not usually cause the problems you describe, though rarely they can cause flu-like symptoms. So I would say it would be reasonable to try stopping it or switching to another medication, but I would at least try to contact your GP about this before doing it, to make sure your blood pressure or whatever other reason you are taking it won't be out of control when you stop it. Hope I have answered your query. Let me know if I can assist you further. Take care. Regards, Dr. Aaron Branch, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore throat,headaches and red and yellow mucus?\n\nI got sick on monday, just sore throat and really heavy head, with a terrible headache. The headache is getting better and I don't have congestion in my head too much, I can still breath out of my nose. But I just sneezed and red and yellow mucus came out, and I have been coughing up yellow mucus today. What does this mean?",
    "doctor_response": "Hello,Welcome to HCM,The history and symptoms are suggesting me that you are having upper respiratory tract infection. This infection is may be due to viral or bacterial infection.The symptoms are in favor of bacterial infection, which is leading to yellow mucus from the respiratory tract.For the symptoms I would suggest you to follow1.Steam inhalation with Vapocaps.2.Tab Augmentin, 625 mg, twice daily for 5 days.3.Oral Montek LC, once in a day in night.4.Syp Ambrodil S.The aforementioned measures will help to reduce the symptoms and improve the condition.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling at the mastoid bone?\n\nI have a very hard boney type of swelling at upper part of my mastoid bone. About two week before i notice it. It is totally painless and hard. Plz help me what it is? I visited medical specialist and he told me this not lymph node there for do t worry and leave it.",
    "doctor_response": "Hi, It could be a lipoma or fibroma. These are common benign tumors - you need to worry if they grow in size, become painful or red or develop ulcers on it. It then needs a biopsy. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching in the genital area when on typhoid medication?\n\ni am detected with typhoid ... my typhi dot is positive and widal with O antigen as 1:160 and H antigen as 1:80.... its been 8 days i am taking medecines..Now i am having itching in my private part's skin... every time i had typhoid in past I used to have urine infection with it..Is it again the same? If yes then how is it related?",
    "doctor_response": "Hi, thanks for using healthcare magicThe use of oral antibiotics can sometimes cause a change in the bacterial flora (bacteria that is found normally) of other areas of the body.This change in flora can result in other infections occurring. Urinary tract infections present with : discomfort on urination, frequency of urination, urgency, change in odor or appearance of urine, fever, abdominal discomfort.If you are having some or all these symptoms then it is possible that you have a urinary tract infection.Oral antibiotics can also cause yeast genital infections which would cause itching.This is treated with topical or oral antifungals.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for heart ailment\n\nHi Dr, I had a chest x-rays prescribed by my Pulmonology Dr due to a possible pneumonia and they called me today to tell me that it was not that but they found my heart enlarged, called cardiomelagy mild. What should I expect, do, next step? What exactly is that? I'm a female 41 years old, mom of a 10 month old baby and a 2 yr old girl",
    "doctor_response": "Dear Mrs,The next step is Echocadiography and ECG. Chest X Rays gives us some clues that there may be possible heart enlargement. But we should perform an Echocadiography, which  can show whether there is any problem with the heart or not. If there is a need for any treatment depends on the results of Echocadiography.Take careCome back if you have any further questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for rashes in arm\n\nI have been picking peaches in my yard and have developed a Rash in both forearms. Blistered and skin has now all peeled off. also when eating these peaches, i develop numb and tingling lips?? Never happened before in 10 years. same numbness happens when eating Blueberries.I am 77 and do have allergies to local pollens in my area. are there any fruits I can eat and which should I avoid?? I am a former nurse. I am on numerous meds. diana",
    "doctor_response": "Hi,This is systemic allergic dermatitis. Kindly avoid all known dietary,inhalant and contactant allergens.Apply combined cream of steroid and antibiotic on the lesions. Take antihistaminics like levocetirizine 5 mg daily. For fruits,you can do trial and error,then decide which fruits you can eat.I hope this would help you.Thanks.Dr.Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from allergy, sweating, red patches all over body. On flucanazole. Sufficient?\n\nhello sir , from last night i am suffering from alergy due to sweat as exccesive increase in tempature at my place .there are red patches all over my back and neck. I have   been preiscribed oxflokem-200, fluconazole -150 mg , omeprazole domperid, decdan , cetrizine hydrochloride . Is these medicine adequate ? kindly give suggestions",
    "doctor_response": "Hello, as you are having allergic symptoms ,having red patches with sweating and itching , the treatment you are taking is good , but I want to suggest you to take a deworming treatment also(Albendazole 400) at night once in a fortnight along with treatment you are taking i.e. flucanozole, omeprazole with domperidone , Dexamethasone in reducing doses and cetrizine or levocetrizine for 7-10 days regularly , if there is no secondary infection present than avoid antibiotics as far as possible and keep dry your skin by applying flucanozole powder.I hope you will be benefited by my suggetions. Good luck and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful callus on heels with swelling\n\nHi I am having two calluses on the ball of both my feet and callus beneath the big thumb on both feet.  I am having this for the past 8 years or so.  This is causing pain while standing for long time and walking. Recently I have developed a spur or painful callus on the heel corner of my right foot which causes a lot of pain and the surrounding region is swollen",
    "doctor_response": "Hi, Thanks for posting in HCM. I understand your concern. A callus is a toughened area of skin which has become relatively thick and hard in response to repeated friction, pressure, or other irritation. They can be dissolved by using keratolytic agents containing salicylic acid. Calcaneal sour (Heel spur)  is a calcium deposit causing a bony protrusion on the underside of the heel bone. You would require X-ray of the foot to diagnose weather the condition is callus or calcaneal spur. Conservative treatments to overcome calcaneal spur include exercise, custom-made orthotics, anti-inflammatory medications, and corticosteroid injections. Surgical excision may be necessary if conservative treatment fails. Kindly consult Orthopedic Surgeon in this regard for appropriate evaluation and management. Hope the information provided would be helpful. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does knee swelling and bursa sac damage need knee replacement?\n\nI fell on my knee 3 wks ago..3 yrs ago I had an arthroscopy and was told I would need a knee replacement in 5 yrs. Now my knee is swollen and blood keeps collecting near the knee cap and the bursa sac has been damaged. Will I need a whole knee replacement or can my orthopedic dr. clean up the damage..Don t really want invasive knee surgery",
    "doctor_response": "Hi, Knee replacement is done when knee is permanently damaged and deformed because of long standing conditions and not because of 3 weeks old injury and swelling. Swelling will subside on it own all you need to do is to get adequate rest and ice fomentation, even then of it persists then knee aspiration is warranted, in which fluid will be sucked out of your knee with the help of a syringe. As far as knee replacement is considered it will depend solely on the condition of the articulating surfaces of knee, associated deformity and pain you are having because of that before the recent injury. You need to get an X-ray done, on the basis of it replacement can be planned if required. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Rohan Shanker Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for rashes in body\n\nmy 12 yr old daughter has a red dotted rash over most of the ventral part of her body. Some spots have turned purple after about 2 days and it has gotten worse. It has gone from itchy to painful in most areas.She shows no other signs or symptoms It is not in her mouth, webs. It has gone to groin and one axilla. It is not on her face, scalp,plantars or neck. Yes we are going to the doctors office tomorrow.",
    "doctor_response": "Hi,Your daughter would have prurigo lesions and the lesions may be infected. That is why they are painful. Prurigo may be due to some cause..irritants or allergens. Even insect sensitivity may be responsible. Your doctor would guide you after thorough history taking and examination. He might give her.. Antihistaminics,antibiotics and steroids in tappering dose along with mild steroid with antibiotic cream to apply on the lesions. Soap bath and suspected triggering factors should be avoided to prevent the relapse. I hope this would help you to manage your daughter's problem.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can walking cause pain and slow healing of a broken arm?\n\nMy son was in a car accident 7 weeks ago and broke his arm at the top near the shoulder. He had surgery and metal was put in. He is still in a lot of pain. Since he had been trying to lose weight before the accident he is still walking a mile a day and he walks with a book bag on his back with weights in it . My question is can that be causing the pain and hindering his healing. He starts physical therapy tomorrow.",
    "doctor_response": "Hello, Fracture takes time to heal which is usually between 2 months to 6 months. Since your son was operated 7 weeks back he should not carry weights on back. That may be reason for pain. Also initial pain due to fracture will decrease as fracture starts uniting. He can walk as much as he is conformable without lifting weight on back. You should take advise from operating surgeon before going further. X-ray of involved should be taken before starting physical therapy to assess progress in healing. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for larynx pain\n\nMy larynx is painful in certain areas. When press down in areas, it feels like a bruising pain. I ve felt this for months. It hasnt gotten worse or better. But I also get frequent heartburn so that may be it but I m not sure. No coughing or hoarseness",
    "doctor_response": "Hello I have studied your caseAs per your history and symptoms it looks like lower respiratory tract infection or lyringitis.You may need blood investigation, endoscopic evaluation, and clinical examinationTake precaution to avoid spread of infection.Betadine gargle may help you in reducing symptoms.Decongestant can be started consulting your doctor.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain during erection?\n\nHi....i recently had i a surgery for phimosis about a week ago....everything i going fine but the night erections pain a lotand wake me up with a untolerable pain and thus i am not able to sleep proprlerly .......plz give some suggestions to prevent them..",
    "doctor_response": "Hi,It is quite natural to have pain during erection after Phimosis surgery. This is due to stretching of the stitched areas. Dont worry, ask your Doctor to prescribe some medicines so that you can avoid erections and sleep peacefully. It should be alright within another week or so.Take care,Dr Rishi, New Delhi, India.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please suggest the natural ways to get pregnant.\n\nHi doctor, My marriage life has passed four months. But my partner has not got pregnant. Please suggest a natural way to cure the problem.",
    "doctor_response": "Hi. Many factors cause an effect in pregnancy. Please mention about your partner's menstrual history and history of any other disease or diabetes or thyroid. She needs a complete examination done by a gynecologist so that she can tell whether everything is normal or not. If everything is normal then, try between 11th to 15th day of the menstrual cycle. Ovulation usually occurs during these days. If there is any problem, then treat the problem first and then try for pregnancy. Pregnancy also depends on you. The semen analysis report shows less active sperms than usual (attachment removed to protect patient identity). So you need some treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could loss of sensation in penis head be due to nerve damage?\n\nHi, I recently had my first sexual expirience. Although my penis was initially stimulated, and maintained an erection throughout, I noticed a loss in sensation in the head. Could this be a result of nerve damage from masturbation? I definetly notice that some areas of the head are more sensitive to touch",
    "doctor_response": "Thanks for asking in healthcaremagic forumIN short: No not at allExplanation: Your desensitisation may be due to frequent friction/soreness, so you need not worry about this. Please give rest to your penis for some days and you will be perfectly normal after that. Hope this helps you. Please let me know.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I had my right ovary and tube removed due to a 4. 5 cm dermoid cyst. Was it the right call?\n\nHi doctor, I am a 34 year old female, and I had my right ovary and tube removed during C-section, due to a 4.5 cm dermoid cyst. The cyst was found during an ultrasound scan, five years back. The surgeon said a cystectomy was no possible because the cyst had completely replaced the ovary. Could you please confirm if the attached histopathology report says anything about the ovarian tissue? I had no symptoms, no pain, no torsion, and the right ovary was functioning in spite of the cyst. I became pregnant twice due to ovulation from the right ovary. What is the medical condition due to which the entire ovary is replaced by a dermoid cyst? Thank you.",
    "doctor_response": "Hi. I have gone through your attached reports (attachment removed to protect patient identity). Take care.\u00a0Hope your concern is solved. For more information consult a pathologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling eaten up by parasites due to antidepressant intake. Have constipation. What to do?\n\nAm infected of parasites inside me due to antidepressantBeen damage all my inside body skin faceMy. Stomach doesnot functionCan go poo from last year I go sometimesWith laxative, I can't eat any to much pain in my mouth tongue gums are destroyEaten by parasites , my skin lost a protectionCan't. Wash my skin become red if I do.I got big noiseIn my stomach, am all destroy and I don't knowWhere to go. Am eaten alive by parasites. NeedEmergency help.      Am in london.    No one believe me",
    "doctor_response": "Dear  I understand your concern The disease condition you mention is not at all a possibility. Under stand. No one believes you because,this cannot happen. Not that they don't understand you. Self diagnosis and self medication can trouble you more. Please Consult a psychiatrist immediately. Wish you a speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it to be concerned about torn rotatory cuff?\n\nHi My name is Noel, I had surgery on my right side rotator cuff in 2012 . It healed O.K. and my shoulder got back to normal. In April of 2013 I feel down my stair case and crushed the same rotator cuff and the Dr. had use anchors, screws and skin on the tear. I just found out last week that I have torn it again but the screws were still in place. Will the DR. have to make a large incision again, or might he be able to do the small ones. I was also told that I would need a nerve block prior to surgery. May I ask what that is. I have M.S. and my right side is affected the most with it and Im right handed",
    "doctor_response": "hi,as you had a history of survey in the past for RCI , meeting the same person for the same reason will be advisible. Taking a scan to check which muscles need attention will be easy to plan further.also certain times there are chances to regain the strength and mobility back without surgery too.I had a patient with RCT with two muscles. She was advised surgery at 67. but we worked out well and she don't need surgery. she can life 20-30 KGS of weight. no pain and full mobility.you should try a physical therapist who can help you with your complains. You can discuss the same with the surgeon.with the grace of God I wish you a speedy recovery",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathing difficulty and cough despite taking Azithromycin?\n\nYes and Thank You in Advance, I have copd /emphezima and have had a cold for three weeks ,my pulmonalize preceribe 250mg of azithromycin, however I continue to have an upper respitory problems with a with a deep cough and at times difficulty breathing . aiat like my throat shuts down and I have to gasp for air !",
    "doctor_response": "Respected user , HiThanks for using Healthcaremagic.comI have evaluated your query thoroughly .*  Breathing difficulty is in relation with bronchospasm through the irritation *  Need  additional  management  of  cough along with azithromycin as  -  Decongestants to clear the mucus .  -  Bronchodilators to open up the contracted airways .Hope this  clears your query .Welcome for further assistance .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is blood pressure of 145/53 normal?\n\nMy mother's blood pressure is 145 over 53 is this OK? She is 87 years old. She went to the hospital yesterday with Vertigo, her blood pressure was 225 over 115, they gave her medicine for Vertigo and gave her Atenolol for blood pressure. She never goes to a Dr. unless she's sick.She weighs 145 and is 5' 3.",
    "doctor_response": "Hello ,The blood pressure of 145 / 53 ls perfectly ok for her age . Do not worry about the lower pressure being 53 , It very common to have such reading at her age . The blood pressure of 200 plus was surely high and you made a right choice of seeking doctors advice. Do continue with Aten and keep a tab on her blood pressure readings for the coming week. Regards Dr. Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any ideas about blood during BM after being diagnosed of internal and external hemorroids?\n\nI have internal and external hemorroids.  I have recently noticed blood on tissue after b. Movement.  Today the commode was red!  I usually have to push, some times very hard, today it did not seem as though I was straining.  I had a colonoscopy two months ago, nothing found other than hemorroids.",
    "doctor_response": "HI, thanks for using healthcare magicHemorrhoids can be associated with per rectal bleeding. This is normally bright red blood that is visible on wiping.The normal colonoscopy is reassuring because this would have been able to identify any significant abnormalities.You need to consider the following:(1) increased fiber intake to reduce the need to strain- vegetables, fruits, whole grain foods(2) the temporary use of stool softeners would also be appropriate(3)sitz baths would help this acute flare up to resolve- this can be done in warm water for 10 to 15 minutes, 2 to 3 times a day. There are different additives that can be used in the water such as salt, epsom salt,witch hazelI hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes memory loss when addicted to masturbation?\n\ni m from India ,i m started masterbuting from 13 years,now i m 27 years old ,i notice some past thinks i can not remember, and i forgot very fastly any new thinks ,like any informations,but some will be stored which i talking about that mostly,is this problem related with masterbution?",
    "doctor_response": "Problems are not related to mstrubation. You are having anxiety neurosis. You should consult phychiatrist forpresent problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itching in the private part which produce white scale\n\niam having itching on my private part that produce white scale ,flaky 4oyrs,7okg having dry skin problem allergy ,my hair, ear ,skin itch me alot with scales falling out, my hand sometime break open and blood will come out",
    "doctor_response": "Hello. As per you description of your symptoms, this seems to be related to either some form of dermatitis or psoriasis like condition. You should consult with your physician who can prescribe you antiallergy medication like hydrocortisone based cream. Keep the area clean with washing with antiseptic soap and wear loose clothes. Keep yourself well hydrated. Hope this answers. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to stop infant from passing watery stools after being fed\n\nMy 4months baby girl is discharging Loose Watery light Green motion since last 12 days & whenever I feed her my breast milk immediately after few minutes her loose motion get started. I have consulated three Pediatriciations since last 10 days, one of them suggested to feed only Breast Milk to her & not to give any other food to her. One of them asked me to give breast milk and messed rice+Dal mixed with boiled water, messed banana, messed appale etc. to her. After giving all these also till now she used to have daily 7 to 8 times loose watery motion. Kindly advise me what is the problem & what is the remeady. Is my breast milk infected?",
    "doctor_response": "till 6 months of age only breast milk is advised. In some babies there is lactose intolerance and as a result child passes motions when breastfed. Kindly do stool for reducing sugar. depending on the report we have to change the milk of child.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to heal frequent masturbate related dryness and tenderness on penis head?\n\nhello. i frequently masturbate a lot. due to which i have got dry skin on penis head. sometimes it turns out to be a wound and it hurts a bit. the head of my penis has white coverage and its kind of dry and a bit wrinkly. i am very worried please help. i would be very thankful to all.",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have developed infection of the Glans Penis (Ballanitis).You need to take broad spectrum antibiotic like Cefexine along with anti inflammatory drug like Diclofenac twice daily.along with topical antibiotic ointment like Neosporin twice daily.Ensure to wash your genitals with warm water twice dailyEnsure to avoid sexual encounters till it heals up completely.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there ankle edema even after delivery in a heart failure patient?\n\nHello doctor,My daughter was pregnant and had extreme edema. The doctors said it was normal. As it turned out she was sent by ambulance to another hospital as she went into heart failure, her BNP levels were extremely high and the baby had to be induced. She is now back to her original hospital. The edema around her ankles is severe and nothing is being done about this. What can I do?",
    "doctor_response": "Hi. If the BNP (B-type natriuretic peptide) levels were high, it is probably due to heart failure as you said. For the ankle edema, she needs to be given diuretics (drugs which decrease waterlogging) in the body and fluid restriction should be adhered to. Daily intake should be less than 1.1 liters. In addition, medications for heart failure should be started. Also, she needs an echocardiogram to see the underlying cause of heart failure. For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Right side of face has turned black. How can I get rid of this tan?\n\nHallo Dr. I am NK and 45 year old, I am a S/w Engg. since last six month i notice that the right side of my face turned black. perhaps due to direct sun stroke while driving in the day time. pl advice some medicine / creams to remove these black tans. However would like to tell you that I use Lakme Moisturizer regularly. Thanks.",
    "doctor_response": "Hi NK, You have developed photopigmentation. First thing that you should do is to prevent further photodamage. This can be done by wrapping cloth over the face or by using broad spectrum sunscreen. Oral photoprotective drugs can also be taken. Moisturizer will not play any role in photopigmentation. Already developed pigmentation can be treated by demelanising agents as advised by a dermatologist. Regards, Dr.Ajit Singh MD - Skin & VD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am getting hallucinations after taking Mirtazapine. Is it normal?\n\nHello doctor, I am on Mirtazapine for the past four months, treating episodical depression and panic attacks. Overall it was going good but yesterday I have experienced visual hallucinations for the first time. I will see my doctor in half a month only. Should I be worried?",
    "doctor_response": "Hi. Thank you for taking help from a psychiatrist. Visual hallucinations are due to organic brain lesion (epilepsy) or any substance abuse (alcohol or recreational drug). If it is just once in while then it is not problematic but if it is an increase in the frequency and disturbing your functional life than it needs to be addressed. It is not due to Mirtazapine. Sometimes, it may happen when you are going to sleep or when you wake up from sleep. It is due to mental illness. Just keep a record of your hallucinations details like duration, time of the episode, frequency, etc. All those details will help your psychiatrist during follow up visit for evaluation. At present, you do not need to worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes weakness in the state of excitement?\n\nI have found lately that when I get excited or start a good laugh my knees get weak. If I m holding something in my hands I have to put them down because I loose the power in my arms. It s like my body goes weak and I can t control my body for a second until I stop laughing which I instantly do. What could that mean or be?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  Feeling week after a state of excitement is normal. Body spends a lot of energy during the state of excitement. When I say it is normal, you must understand that it is general and body has a lot of strength left to come back from that tiredness. I think your current situation arises out of you obsessive thoughts. You obsess with that tiredness and when such an excitement comes, body automatically completes your wish. Just ignore the problem and there goes the problem.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vaginal itching and pain in 10 year old?\n\nMy daughter suffers frequently from vaginal itching and pain...she is 10. We have tried warm water soaks, desitin, vaseline, and other creams...nothing relieves her symptoms....she is currently being treated for pin worms although the doctors do not know for sure that is what is causing the problem......I just want something to help her with the symptoms until the problem can be resolved. HELP! she is miserable",
    "doctor_response": "vaginal itching in girls might be due to urinary tract infection also.. there may or may not be fever ect.. do a routine urinary examination. if you find pus or epithelial cells, then it's a urinary tract infection.. get treatment with antibiotics for 14 days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to reduce swelling under jaw and vocal chord\n\ni have a swelling under my jaw and between the jaw and vochal card without pain....can u suggest the treatment and tests and reasons .....i am experincing this problem since 15 days...before this i have not any problems like this...i am 20 years old and 5.5 inches and 54 kgs.i already concerned a doctor ...they gave a treatment for a period of 10 days ....but no improvement....hence they offered me some tests like ultra sound scanning and some tests for neck",
    "doctor_response": "Hello,  Thanks for consulting HCM,  Read your query,  as you have swelling under jaw and vocal cord region this can be due to some factors like carious , decayed or any root stump present In oral cavity ,inflammation or obstrustion of submandibular gland , phayrngitis or laryngitis condition . I will suggest you to consult an oral surgeon for examination of oral cavity and swelling of jaw and neck region , if cause is of swelling is not ruled out then consult ENT Specialist for examination of neck.Hope it will help you. Wishing you good health.Regards , Dr. Priyanka tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I have urge to vomit after consuming food?\n\nHi, may I answer your health queries right now ?  Please type your query here...Hello doctor my name is sonam,I am 21 years old, since 2 days I am feeling like vomiting and even i feel like i will vomit after having food. my period date was 21 july and i have not got periods yet.",
    "doctor_response": "Hi.Thanks for your query, read and understood your problems...The causes of nausea and vomiting after food can be Pregnancy, gastritis, anxiety, stress and so on. I would advise you to :Have urine pregnancy test.Ultrasonography of the abdomen and If these things are normal Upper GI Endoscopy. Get treated with PPI, Domperidone, antacids and as per the findings of the investigations and ask for tablets for anxiety , if you have.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have burning sensation after experiencing discharge due to yeast infection?\n\nI have small chunks in my discharge  no smell .I just recently treated an yeast infection like 2 months ago ..I took a bath and I started to feel burning . I look down there I seen a small cut on inner labia..  Me and my husband had sex and burned even worse I started crying . Last doc prescribed me this monistat like cream and it was the worse I don't want to use it any more. I'm tierd of  getting meds to  hide symptoms I need something to kill the source..",
    "doctor_response": "HI,   - The burning you have with acrack in labia can arise after stressful sex/dry vagina   - Yeast infection has seveir vaginal itching,white discharge like cottage cheese,painful intercourse which may follow  burning in urine.    Both partners need to be treated for yeast infection. If you alone had treatment-there is possibility of  yeast reinfection .     To kill the source---  Consult a gynecologist, both of you take treatment , observe perfect genital hygiene, avoid sex till both of you are cured.    Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest the best treatment for vitiligo in 8 years old\n\nDear sir, Im writing this mail for my brothers daughter..she is 8 years old We have spotted some white marks on her neck.. when we consult with our family doctor.. we came to know that shes suffering from vitilgo\u2026 It was really a shocking news to the whole family as we have seen some people in our village with large white marks all over their body\u2026. I We would like to know some things from u .. can u please reply to the following doubts 1, what are the main causes of virtilgo 2, what to do to prevent these marks spreading 3,what is the best available treatment 4, can u name a specialty clinic or hospital in india for treatment.",
    "doctor_response": "vitiligo can occur due to 1. family history2.auto immune disorders3. thyroid disease4. diabetes5. Addison disease6. pernicious anaemia7.hypo parathyroid hormone treatment is.1, new lesions: topical steroids and calcineurin inhibitors2, old lesions: topical puva solutions3, severe lesions: topical steroids+puva solutions+ oral steroids,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back tooth sheared off to gums exposing nerves. Will clindamycin hcl tablets help?\n\nyes hi there i have a back tooth that has been sheared off to the gum line and has an exposed nerve a friend of mine gave me a couple of CLINDAMYCIN HCL 150mg. capsules  i was wondering if you think these will help my tooth till i can get to a dentist on Monday since the ER said there really isn't anything they can do and i should see a dentist thank you for your time and help in this matter Rich.",
    "doctor_response": "Hello there , Thanks for writing your query, Your clinical history suggests you are suffering from a severe periodontitis. It is a condition where gum line with respect to the tooth shows severe recession and exposure of the root surfaces of the teeth. It is caused due poor oral hygiene ,improper brushing and flossing that leads to accumulation of bacterial plaque and calculus deep in the gum pockets and root surfaces of the teeth. Yes CLINDAMYCIN is an antibiotic which  can be used to prevent infection and supress further damage , but antibiotic will work better when you get the gum treated by dental procedures. It needs to be treated by thorough professional deep scaling of gums and root planing of the teeth to remove all the irritants ,this will help in resolving the symptoms followed by a course of antibiotic and analgesics. i hope this helps , take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can prolonged use of drugs for an enlarged prostate cause erectile dysfunction or testicular atrophy?\n\ndoes extended use of drugs for enlarge prostrate(diagnosed):early stages of Parkinsons(diagnosed):chronic pumonary obstructive disease with sleep apnea and Cpap machine (diagnosed): 3 heart attacks in past 12 years with candesartin and atenolol for long term stabalization;simvastatin for chloresteral for long stabalization: type 2 diabtetes (diagnosed) with janumet 1000/25 or extended use in combination cause erectal disfunction or penile or testical atrophy",
    "doctor_response": "Hi, Basically, yes. The hormones lower testosterone level and that will produce all of the problems mentioned. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trigeminal neuralgia, painful swallowing, high BP. On neurontin. Had chiropractic adjustments. Suggestion\n\nMy sister is dealing with trigeminal neuralgia. So much pain even when she swallows. Can not eat or even brush her teeth without pain.  Neurontin cause her blood pressure to go up. She has been dealing with this for several months. She has been to her dentist, had chiropractic adjustments (which did help some). Also been to a neurologist one day, he will be out of the offfice for 3 weeks. Her next appt in 2 months. She does has an appt with another neurologist next week. But she is having a lot of pain today and for the last several days. Has lost 7 lbs (she cannot afford to lose). Any suggestions?",
    "doctor_response": "Hi,Thank you for posting your query.I can understand the extent of discomfort in your sister, on account of facial pain due to trigeminal neuralgia.Neurontin has been tried but is causing side effects.The best medication to be used in trigeminal neuralgia is tegretol (carbamazepine). I use it in initial doses of 200 mg twice daily, and depending on the response, the dose can be gradually increased to 600 mg twice daily. It is a generally safe medication, however, it may cause drowsiness or dizziness in some cases. Some patients may not respond to tegretol. They should undergo MRI and MR angiogram to find out the underlying reason for trigeminal neuralgia. Such refractory cases may require a surgery called as microvascular decompression (MVD).I hope it helps.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can anemia be treated?\n\nHi doctor. My name is Lisa. My father has been diagnosed with anemia. For 3 weeks in a row now the blood work is showing a decrease in blood count. Mom wasn t positive on numbers but it was like three weeks ago the blood count number was 12 then 10 and last week it was 8. Doctors have already determined he is not losing blood. I hesitate to look on line for possible answers because of course google is gonna have dad diagnosed with cancer and in the grave in a matter of weeks. i am looking for honest answers",
    "doctor_response": "Hello. Fall in hemoglobin from 12 to 8 in just 3 weeks is really worry some.  Either there has to be underlying cause for blood loss or body destroying RBCS.  According, to your say it seems you must have done thorough blood test,  if not get it done along with stool and urine test. If no cause found may need to do bone Marrow study but it better to consult hematologist.  Till that give him nutritional supplements for iron and diet changes. Regards, Dr. Hemali Deshmukh , Homeopath",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes upper back pain and numbness?\n\nhi dr. i'm 26 years old.female.i smoke cigarette.it's about four days i have upper left back pain but it was not continously.the pain is numbness and it's focus on the center.today i have it continously.what is the problem with me?p.s it's almost one month that i'm trying to loose my weight so i don't it well.would u mind help me?",
    "doctor_response": "Hi welcome to Hcmyour symptoms are suggestive of disc collapse leading to nerve root compression.Get ME spine and review with reports.thankyou",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is persistent knee pain post surgery normal?\n\nI had arthroscopic knee surgery for degenerative tear of the medial meniscus and radial tear of the lateral meniscus and outerbridge grade 4 degenerative joint disease of medial compartment and synovial hypertrophy. it has been 2 months and I still have severe pain on stairs. is this normal and what are the chances that I will recover?",
    "doctor_response": "usually it's not possible to have knee pain after arthroscopic repair i suggest to check with another orthopaedic doctor Or the same doctor and go for mri scan of affected knee joint to confirm there is no extra damage.if still there is a damage present in a joint then take the opinion from orthopaedic doctor as well also visit a physiotherapist. he can help you with different physiotherapy treatment as well as exercise Which will help to get some relief from pain. you can also use hot and cold pack at home frequently and regularly to have some more anti inflammatory as well as relaxing and healing effect on your soft tissues and joint. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lump like bruises?\n\nI have noticed a small bruise on the left side of my belly. It came out of nowhere. I ignored it for a few days and just noticed again. This time i felt it a little bit and there is a small pea sized lump in the middle of the bruise. What am i dealing with?",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.''Bruise without history of trauma''- This can be due to insect bite. All the bites do not sting immediately or later. Take an antihistamine and steroid , a single dose may show effects. Consult a Doctor- He may find any possible cause of this problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can cervical degenerative disc disease cause pain in the arms, shoulders and buttocks?\n\nI was recently diagnosed with cervical disk disease. After the cortizone shots I experienced terrible pain in my shoulder and arm first which i attributed to a torn rotator cuff that I already had but the pain went down my arm this time which it never has before, then i had pain in my buttocks from my sciatica so bad I could hardly walk it was a stabbing pain this time not like ive ever had before. Someone told me my neck could be causing all of that is this true? The neck, arm and back all connected?",
    "doctor_response": "Hi, Cervical degenerative disc disease can cause pain spreading down to your shoulder and upper limb. So it may be related with those symptoms, but it should be confirmed by clinical neurological exam (testing for sensory changes, altered reflexes) and if in doubt by imaging and nerve conduction studies. As for sciatica it is not caused by the neck issues, not directly at least. However, degenerative spine disease usually affects the whole spine, not only the neck in isolation. So it wouldn't be surprising for there to be at the same time degenerative changes in the lumbar spine as well, which in turn can cause nerve compression and sciatica. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Olsi Taka, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will minigynon  cause high blood pressure?\n\ni am 32 yrs i was diagnosed with type 2 diabetes i get regular checks my doc says it is controlled i am on 1/2 daonil per day but i just started taking minigynon  over a 3 wk period and now my blood pressure has increased  and i was never hypertensive could this be a result from the pill",
    "doctor_response": "Dear Mrs,There is a little possibility that your medication can cause high blood pressure.Sometimes they can cause high blood pressure in the beginning of the treatment but blood pressure normalizes after some time.So, don't panic. If blood pressure is not more than 150/90, try lifestyle changes for 3 months, cut the amount of salt intake and exercise regularly.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever with green stool and stomach ache?\n\nmy daughter is 2.8 years , she is having 102.5 external temp and having green poop in the end. She was complaining about little stomach ahe day before yesterday and she ate less yesterday . Her face is cold but under arm temp is 102.5. We have given IBUprofen two time since morning",
    "doctor_response": "its mostly due to infection.kindly start one antibiotic. do stool normal microscopy and stool culture sensitivity test.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need treatment for expanded liver\n\nHi hope you can help me My 75 year old father has been diagonsed with an expanded liver He had a ultra scan and had liver function tests ( which were high) He has been for a CT scan but we have drawn a blank as both my GP and the hospital won t provide the results my dad has yellow eyes, has lost alot of weight, has pains in the base of his foot and has lot his appetite. He is also under morfin tablets due to regular dvt problems Would you be able to advise what steps we need to take next as we are very concerned Thanks Paul Jeffers",
    "doctor_response": "Hello Your father findings suggests raised liver enzymes and enlarged liver.Enlarged liver(hepatomegaly) may be due to many reasons like hepatitis,fatty liver,tumour etc.It is important to know which parameters of liver function test are raised.Hepatomegaly is most likely related to hepatitis in your father's case as he has yellow eyes.He may need few more investigations like routine hemogram,random blood sugar,viral markers.He should avoid fatty food.Proper treatment depend upon findings.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tremor felt in hand, lightheadedness, trouble in focusing, communicating. Brain test normal. No relief with xanax. Treatment?\n\nI am curious if there is any medical testing I should be looking into.  I recently took a trip to Florida in June and while I was down there had a tremor start in my right hand along with lightheadedness. I also had trouble focusing for about a week. I have seen my primary and also a MS neurologist. Yesterday, I started to have the lightheadedness and trouble trying to communicate. Like my brain is working fine, but my brain and mouth don't. When I go to talk its slurred and almost like I'm stuttering.  My neurologist told me she had ran all the tests she could and recommended that I go back to my primary to see where to go from here. I would like to get back to my self. Any advice is greatly appreciated as I am at a loss and not sure what to do at this point. I did go to the ER yesterday with these symptoms and they tried Xanax however that is not working.",
    "doctor_response": "Hello.As you refer your doctors have requested the usual tests (CT-Scan. ...) to rule out neurological pathologies  and the results were normal.They thought that their symptoms may be secondary to anxiety-stress and prescribed Alprazolam.I agree with them  but I think it's necessary to add an antidepressant with sedative effects.I treat my patients with Paroxetine 20 mg per day + Alprazolam 0.5 mg per day  when Anxiety is the diagnosis.Please consult your local doctor for a prescription.I wish you good health.(If the answer has helped you, please indicate this)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have severe pain, depression. Took lupron, zoloft. Right medication?\n\nHello I am a RN helping my niece with information gathering.  She was on Lupron in the past and side effects were horrific but did perserve thru it to no avail.  Still having severe pain and she is awaiting a consult with a Pelvic Pain and Endometriosis clinic.  In the mean time her Gyne doc gave her a RX for Visanne.  She has hx of depression is on zoloft.  Can you shed any light on the the similarities with Lupron and this new med.",
    "doctor_response": "HelloLupron is luperolide and it is a drug that is mainly used in various conditions like endometriosis. The drug act on pituitary gland and thus suppresses the GnRH, a hormone of pituitary. Zoloft is sertaline and this is an antidepressant and anti anxiety drug of SSRI group. Both these drugs are different in mechanisms of action and are of different groups.Visanne is a drug that is introduced recently for long term management of endometriosis. It is a progesterone derivative that is free of serious side effects and it has some androgen action also. It is different from lupron if we consider mechanism of action.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching and white discharge through the penis?\n\nhi, i had sex about 2 mounths ago and about a month and a half ago with two differen t girls. now i ve been feeling itching inside my penise tubes and white stuff has been coming out it looks like cum or puss or something, i ve also noticed really small redish bumps under my penise head. I m 16 and I don t want to go to a doctor unless i have to. can someone please help?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Penile discharge after unprotected intercourse always warrants workup for sexually transmitted diseases I would advise you to visit the doctor and get yourself worked up for STD's. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is my anti-HAV IgG reactive?\n\nHi doctor,I have attached my hepatitis blood profile for your reference. I just want to make sure that everything is clear. The report includes\u00a0Hep B surface antigen 0.26 (non-reactive),\u00a0Anti-HBs 1.85 (non-reactive),\u00a0Anti-HBc 0.10 (non-reactive),\u00a0Hbe-antigen 0.34 (non-reactive),\u00a0Anti-HBe\u00a02.02 (non-reactive) and anti-HAV (IgG) 1.56 (reactive). My current medication includes Doxycycline and Echinacea.\u00a0Thank you very much.",
    "doctor_response": "Hi. I have viewed your blood report (attachment removed to protect patient identity). For further information consult a general practitioner online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Done semen analysis. What to do?\n\nBeen trying for two years to conceive. My wife has two kids from previous marriage. No luck so I had a semen analysis done: Abstinence 7 days Volume 5.0 ml Ph 8.5 Liquefaction 60 min Specimen commabnormal viscosity WBC and RBC present Motility 70% Count semen 59.00 mL Morphology normal 88%,coiled tail piece 12% We haven t been to a specialist yet. Trying home remedies.",
    "doctor_response": "Hello, welcome to  HCM, Your semen analysis report indicates normal volume, pH, liquefaction time. Total sperm count is higher than required ( normal is >39 million / ml as per WHO2009). Motility of the sperm is normal ( Normal is > 40% as per WHO 2009). Morphology is within normal limit ( normal is >4% as per WHO 2009). So, overall, your semen analysis report is quite good.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does my skin get extremely dry with cuts in winter ?\n\nDear Sir, I am facing skin problem from my childhood days but still i am waiting for any solution to resolve my skin problem, In winter my skin goes very dry and made some cuts in skin after some time cuts goes black and it s just looking as snake skin.but in summer it s looked like a normal skin.Please provide me solution to get well from this problem. Please contact me on YYYY@YYYY",
    "doctor_response": "Your might be suffering from atopic diathesis or a simple dry skin. This gets aggravated by environment you work in. It might be the air conditioned rooms or also cities where climates are very cold and dry in winter. Use emollients liberally twice daily. once in the morning immediately after bath and once at night before going to bed. Avoid hot water baths , use lukewarm water. Take plenty of water for hydration.  while going out use full sleeved clothes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is mt BP high even while sleeping?\n\nMy blood pressure is running 148/92 and my heart rate is ranging between 92 and 102. I take two different medications for my heart. Should I consult with my cardiologist or am I worrying over nothing. It is even this high while I sleep. It feels like I have race horses in my chest and it feels heavy.",
    "doctor_response": "Hello,Welcome to HCM.Your BP is little high and heart rate are also high.You should consult your cardiologist for changing the doses of current medicines or change to other medicines.Take very little salt in your diet.Do regular exercises.Take care...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of bump on forehead?\n\nI ve had a small bump on my forehead that has been there for over 12 years. I was struck with a rock when i was about 9 and im pretty sure that was the cause. Is it because I had a fracture and the bump is a calcium build up? It feels like bone, not some build up of liquid and it hasnt changed size.",
    "doctor_response": "Hi! Good moring. I am Dr Shareef answering your query.Common bumps on the forehead are dermoid, fibroma, and sebaceous cyst. This bump may or may not related to your history of trauma. If it is hard and have been there since the trauma, it might be an organised hematoma with calcification. However, to be sure, you have to take appointment with a general surgeon, and get it examined physically. The management would depend on the results of physical examination and investigations if any as advised by the general surgeon after a physical examination.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "One kidney, severe chest, lower back pain after consuming alcohol. Bufferin helpful. Is this normal?\n\nThe night before last I had a little too much to drink and I have one kidney, the day after I had a hangover as should be expected however last night I could not sleep due to severe pain all over my chest and lower back and it is still hurting, taking bufferin helps but only for about 20 minutes then the pain comes crashing back. Is this normal and/or will it go away with proper hydration and food or do I need to visit my doctor?",
    "doctor_response": "did this ever happen? i dont think it is related to kidney issue, but would suggest you to go and see a general physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Moxclav advisable for cough while on Calpol for cold and congestion?\n\nHello doctor ,My Daughter is 2 months old , she had cold , stuffy nose and cough , with saline nasal drops and calpol the stuffy nose and fever got cured . But she is coughing too much , doctor prescribed maxclav 228.5 can I give to my daughter , she weigh 4 kg",
    "doctor_response": "Hi, welcome to HCM. Yes, moxclav Syrup is often prescribed for upper respiratory tract infection but it should be given on prescription of doctor only after examination.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be done for penis erection problem?\n\nHi , I am a 28 year old Male.Weight: 80KgsHeight: 174cmmedically fit, no previous diseaseMy problem is: at the time of sex, i x\\cannot not get an erection or if i get one i cannot not keep it for long. generally i need to use my hand to get erection. even sometimes i dont get it with my hand also. also whenever i tried to penetrate,  i could not penetrate because my penis got soft. i feel my penis is not hard enough for penetration sex. my problem is getting bad because we could not have penetration sex even after almost a year  of marriage. Plz help!!please guide",
    "doctor_response": "Thanks for query.according to your symptoms you are probably having erectile dysfunction.the cause for this is a large list and you need to be evaluated and treated accordingly. consult an andrologist .regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which medicines are effective in getting rid of acne ?\n\nmy query is regarding my skin . i m having pimples from last 1 month applying Elinda get faciline n in tablets having AAAAAAA 35. Pimples are less but not getting satisfaction plz suggest me effective tablets and any tube",
    "doctor_response": "Thanks for putting up your quary over this forum. I need to know the type of your skin. If its oily then this kind of skin is very much prone to acne. The best thing to do about is to keep it clean .Wash as frequently as possible. But if you re getting pimples only from last month and they are filled with some yellow or white fluid then apply Clindac 1% ointment over them 2-3times in a day and take tab Doxy 50mg 2 times in a day for 5 days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to heal post waxing redness?\n\nMy daughter had her eyebrows waxed 5 hours ago, and the area just below them is still very red. I put hydrocortisone on them about an hour ago, and she said they've stopped hurting; but they're still red. Should I be concerned or do anything differently?",
    "doctor_response": "it can be post inflammation, and hydrocortisone takes it regular time to heal. you can apply it one more time after 7-8 hrs.redness will go",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abscess under the armpit?\n\nhi there, I have an abscess under my right arm pit. I went to the doctor he prescribed anti bioctics and said to go to th emergency room 2 days later. I went to the ER and whilst I was waiting the thing burst. I saw the doctor any way who advised that I should squeeze it and keep taking the drugs. And should it return or the redness get any bigger I should return. I have drained it all I can but there still seems to be a large hard lump. There is no more pain but the redness does seems to be getting bigger? I have had many abscesses in my time, do I need to get this one looked at again or is it on the mend. Will the larger lump eventually drain?",
    "doctor_response": "Hi,Dear ,Thanks for the  query to My HCM Clinic.I studied your query  in details and understood your health concerns.In my opinion-the cause of your abscess in the armpit -a-Incomplete and improper drainage -and suppressed infection by the antibiotics .b-I would advise FBS and PPS- to rule out any diabetes as the cause of the reccuring abscesses  in the past-as told by you.@ For the Reccuring hard red lump getting bigger- -As the lump is not going to drain on it own and would recurr again if not treated properly, I would advise you to go to ER and plan for the \"Proper Incision and Drainage \" which you could not do last time.Hope this would help you to plan treatment with your ER doctor.Wellcome for further  query in this regard.Wishing you fast recovery.Good day..!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Should I get my wisdom teeth removed?\n\nHello doctor, I have wisdom tooth. Is it necessary to remove it?",
    "doctor_response": "Hi. I have gone through your question and I can understand your concern. If it is giving you any sort of problem or giving you discomfort, you need to remove it immediately. There are chances of cyst formation in some cases too, if the impaction is not treated. You can delay it but my opinion is to get it removed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest diet for a 11 month old baby\n\nHi my baby girl is 11 months old and weighs 8 kgs. She doesn't eat at all. I have been trying since she was 6 months old. For the last 15 days she has not been eating and not drinking her milk also. Her diet is 3 ounces of milk. Our pediatric suggested cypon drops. Should I give this or not?",
    "doctor_response": "HelloDr. Ervis answering your question.I don't find this medicine in the guidelines of recommendation.Your child needs some encouragement and structure from you when it comes to mealtimes (such as regular meals and healthy choices), but not much more. Your child may eat well one day and eat practically nothing the next.Rather than get hung up on the fact that your child has refused everything you put in front of her today, consider what she's eaten over the course of one week. Parents are often surprised to find that their child's food intake balances out. Something must be fueling all that energy!Don't forget to consider how much she drinks in the food equation, too. Milk and 100 percent juice can supply vital nutrients (though too much juice means too much sugar). But because drinking too much milk or juice can also dampen an appetite, you may want to serve drinks after and between meals, not right before. And don't let her fill up on sweets and junk food \u2013 her growing body needs the nutrients supplied by a healthy diet, not empty calories.Here are a few tips to help get through those bumpy patches:Offer a variety of healthy food choices and let your toddler feed herself. This way she gets to exercise a little independence.Don't threaten her or bargain with her. \"One more bite and you get a cookie,\" or, \"No story time if you don't eat your peas,\" makes mealtime into a power struggle. If you want to raise a healthy eater, keep mealtimes positive, and don't use sweets as a reward.Have meals as a family whenever possible. When your toddler sees you or her siblings eating healthy food, she's more likely to want to follow along.Don't take something off the menu if she doesn't like it. Kids are slow to accept new tastes and textures, so if she spits out green beans the first time, try making them again the following week. She may surprise you and decide they're her new favorite food. And be patient: You may have to offer a new food many times before she's willing to make it a regular part of her diet.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for soreness on the edge of the tongue\n\nI have a sore right on the edge of my tongue about half way back. This is caused from Chemotherapy.  What can i do about it?   I do not want it to become worse since I have two more Chemotherapy treatments and it is bothering me.  I have been gargling with water, salt and baking soda.    It seems to be interfering with my speech since I think my teeth ae touiching it when I speak.",
    "doctor_response": "Thanks for your query, I have gone through your query.The soreness secondary to the chemotherapy could be treated with topical anesthetic and analgesics like anabel gel. apply 3-4 times daily before food. If it is not responding then you topical steroid like triamcinolone acetonide 0.1% 4-5times daily after food. You can also do soda bi corb mouth wash.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Autism, asperger syndrome, speech delay, shivering, stuttering, slow understanding, introvert. What is it?\n\nIs my daughter showing enough symptoms for me to take her to get diagnosed for autism or aspergers syndrome?I don't remember if she had a speech delay nor tantrums but she used to bang her head on the floor if she's upset or didn't get what she wanted (all her siblings did.) but she was smarter than kids her age when she was 3 and was a fast learner and did academically well, sh even speaks another language fluently! but I've noticed that she's socially awkward and i thought that she's just too shy and i have to give her a push to go befriend kids her age, she barely talks with them and she's horrible at small talk and when I ask her 'did you have fun with them?' she shakes her head and tells me she doesn't want tot do that again, ever.she has bizarre interests like Spiders, Spider-man, arachnids or rare unusual stuff like names or Cyprine for example, she told me she like its name and that is a precious stone and she also likes some gruesome and/or gross stuff and a normal interest like art, drawing, photographing, comic books, cartoons.. she can go on and on about color shading, blending, smooth lines, rough lines, thick lines, shapes..etc.things that made me suspicious:she notices car plates and tells me if one had a cool number like 0000 or 9000 or something like that, she notices patterns, details, smells, sounds and spaces out a lot she told me she goes to her 'world' that she made, is it normal? she also plays the same strategy game she played 7 years ago on the internet, she locks herself in her room and just plays it or watch a movie or something. the way she acts is selfish and lazy and she says inappropriate things and when i scold her she knots her brows and say 'but it's fine.. why is it inappropriate?'she also gets angry or scared if someone yells or if there's a lot of loud noises and hates parties. she takes a while to register some things i tell her (like instruction or if i was being sarcastic.) she'd be perplexed then she realizes what i meant and find most jokes 'Not funny.'. also she used to stutter and find it hard to pronounce some words or express herself which often made me mistake her for lying..she's introverted but has a few close friends who share some of her interests. i just want to know, should i get her diagnosed or am i over-thinking?",
    "doctor_response": "Hello  You have mentioned that your daughter has symptoms of poor social interaction, she spends her time in playing indoor games, she is intelligent than others in some domains, she can notice unusual number plates and she doesn't like that her routine get disturbed. Most likely these are symptoms of Aspergers Syndrome. She can speak and has normal language development so Autism is very less likely diagnosis. Other possibility that may occur is some form of Bipolar Disorder or some Psychotic Disorder. I would advise you to take her to a good Psychiatrist for expert evaluation and evaluation of IQ. IQ assessment is necessary to estimate her IQ and to rule out mental retardation. Thanks Dr.Seikhoo Bishnoi, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "can allergies to pollen cause ear pain?\n\nAs an athletic 57 year old, I play competitive tennis 4 days a week and I run 3 days a week about 3 miles. Within the last 3 days I ve had ear pain ( throbbing ) and lightheadness on and off during the day.. My doc cleared out the ear wax but it didn t help. It just pulsates with pressure. Today I played tennis and had shortness of breath by the end of the hour. Could this all be due to allergies to pollen? The pollen is high here in Dallas. I played tennis yesterday and was fine. I also took 2 Mucinex tablets before I went to play today. Could that cause a shortness of breath? No stuffy nose but headache pressure and ear pressure. Help, Becki",
    "doctor_response": "HI, thanks for using healthcare magicThe headache pressure and ear pressure may indicate that you have a sinus congestion (which can be caused by pollen) and possibly a ear infection.The use of anti histamines , decongestants and possibly medication for an ear infection, if present , may be needed.Mucinex is not known to cause shortness of breath.If this associated with chest pain, palpitations,then you may need to see your doctor.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. USG report shows mild heterogeneous cervix, bulky ovary. What are the further tests needed?\n\nI am Titir Mukherjee, 35 yrs married woman.have started trying to be a mother. meet Doctor. he asked me for USG. The report of USG shows :1. mild heterogeneous  cervix2. Right Overy Bulky3. a cyst without any internal echo is seen closed to itwhat should my next steps for medical test?Is there any risk for being pregnant?",
    "doctor_response": "Hello. Thanks for writing to us. The mildly bulky right ovary without any polycystic appearance of the ovary may be a normal finding. You can conceive with the help of ovulation induction therapy. Do get it prescribed from your gynecologist. I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL  Regards, Dr. RakhiTayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the left side of body. Tests shows elevated liver enzymes. Experiencing fatigue. Suggestions?\n\nHi. I ve been having pain in my neck (left side), my left shoulder , and I have had some pain in my chest and under my left armpit and down my left arm. My head has also been hurting some. I also had blood work done recently that showed I have an elevated enzyme count in my liver . A normal count is 52, and mine is 500 (just included this in case it would have anything to do with my symptoms). I ve been experiencing fatigue as well...more than usual (I have a TBI).",
    "doctor_response": "Hi and welcome to Healthcare magic.Thank you for the query.There are severalcondition which can cause such pain including heart and lung disease. Most common abdominla causes are gastritis and gallbladder issue. SO you need to rule out these 2 first by doing ultrasounds or CT scan. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "My mother got a stone in her gallbladder. What precaution she should take?\n\nmy mother got a stone in her gallbladder . what are the risks if she will not be operated for sometime ? what precaustion she should take to avoid danger?",
    "doctor_response": "Hi,  The prognosis of the condition depends on the size of the stone. Smaller ones ( < 5 mm ) are left without treatment but placing on fat free diet and a little bigger (5 to 10mm ) need medications to dissolve. If >1cm or multiple stones surgery is needed .The lag time depends on the size from here. Fat free diet can prevent worsening to some extent. Sooner the removal of the stone better is the prognosis, It will be difficult if ones jaundice sets in due to bileduct /cystic duct ( passage canals of bile) block by the stone. Thanks for visiting Healthcaremagic.com Bye",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes getting bright red when talk in front of people?\n\nHi, in class when I've been asked questions by the teacher or asked to read something out in front of the class I go instantly bright red, or even when people come over to talk to me I can feel myself going warm inside and my eyes water.. It's getting really embarrassing and I'm a shy person",
    "doctor_response": "HelloIt looks like you are having performance anxiety.  It is a type of anxiety disorder.  All the symptoms you are having are seen in this condition. You will be benefitted by anti anxiety medications with psychotherapy.  Please consult a psychiatrist who can help you with this.RegardsDr. SushmaConsultant psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can taking Iron pills a few days before ferritin test give false reading?\n\nHello doctor, I am a 22-year-old woman who is struggling with extreme fatigue, muscle weakness, tire easy or poor endurance, treatment-resistant depression, anxiety, panic disorder, skin picking issues, sensory processing disorder and ADHD. I have been a strict vegetarian for 12 years now and for a lot of that time, my diet was poor and mostly carbohydrate based. I have suspected an iron deficiency for a very long time. I had a test for it a few years ago and my hemoglobin was normal but my ferritin was only 39. My doctor said it was fine. I recently had a terrible experience with several methods of birth control and for a few months was having 10 day periods twice a month, and at its worst, I was bleeding for a month straight. I started taking a food-based iron for 2 to 3 months (27 mg) and had my iron checked twice within six months. Both times my ferritin was up to around 80. However, I still feel increasingly tired and other conditions are being ruled out. I just realized that before both of those tests with normal results, I had taken an iron pill within two days of the test. My question is could that have given me a false reading on the ferritin test? If I would have had iron the day before? Is a couple months of food based on iron enough to have raised my levels that fast? And lastly, given the heavy bleeding and relative lack of dietary iron in my life, how could I not be iron deficient? Currently, I am taking Clonazepam PRN, Lamictal 50 mg.",
    "doctor_response": "Hello. Ferritin is an acute phase reactant. This means that apart from reflecting iron stores, it also reflects the inflammatory condition in the body. Taking Iron supplements just a few days before the blood test is not sufficient to raise your serum ferritin levels so quickly. But if there is any inflammation going on in your body, your serum ferritin levels will be raised. It is thus very important to rule out any inflammatory condition before interpretation of serum ferritin levels. Have you checked your vitamin D and vitamin B12 levels?  Deficiency in vitamin B12 & Vitamin D can also produce fatigue, weakness and neural disorders. You should get your blood levels of these two vitamins checked and continue taking your Iron and Folic acid supplements. I would suggest that you take the regular Iron and Folic acid supplements available in the form of pills along with a glass of orange juice or lemon water for better absorption. For more information consult a hematologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do cold, cough and a skin rash need medical attention?\n\nHi my 16 yo son has had mild cold and cough for a week. Yesterday he developed a very sore throat. Today, there are white blotches in his throat. He\u2019s a little run down but not very. No fever. Trying to decide if I should drag him to urgent care tonight or wait till tomorrow.",
    "doctor_response": "You don't need to drag him to urgent care, but you should bring him tomorrow  to his Familiy Doctor because he might have a bacterial infection (Streptococcus).",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for panic attack and heart murmur?\n\nI just checked my blood pressure at a grocery store and the machine said 168 systolic and 68 diastolic. I'm 20 years old! I'm not over weight or have any medical conditions except for a slight heart murmur I was born with. But I did suffer a pretty bad panic attack a few days ago, because of finals and stuff. I'm still kind of stressed, because I'm worried about my health and such. Should I be worried?",
    "doctor_response": "hello,   You shouldn't be worried at this stage, you should buy one bp apparatus and monitor your blood pressure. Of your blood pressure is high persistently then you will some investigation.     yes stress and exertion can certainly raise blood pressure.     You should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. Regular exercises like brisk walking, jogging according your capacity atleast 30 min a day and 5 days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn't abdominal fat deposition or obesity.     If bp is more than 140/90 persistently then You should undergo test like kidney function test, renal artery Doppler, Sr cortisol and 24 hr Urinary metanephrines.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does black sludge in gallbladder indicate?\n\nplease tell what it means to my son,s life if he has . he has upper left or right quadrant pain. he is seeing a doctor where he lives and they are running tests. the doctors have ruled out gallstones so far and found a black sludge in his gallbladder. what does this mean?",
    "doctor_response": "Hi,Gall bladder (GB) sludge is a very frequent finding on ultrasonography. Normally the GB will appear to be one smooth fluid filled sac (esp if the scan was done after an over night fast). This is because, bile being liquid allows the ultrasound waves to pass through easily. If there is a stone, it will reflect some of the waves back and this will make it \"visible\" on the ultrasound. GB \"sludge\" is a term used when the bile, instead of appearing as a single smooth layer in the GB appears as two different layers. This happens when the bile in the GB has two different densities, so one \"sinks\" in the other. This heavier sludge usually consists of crystals made up of cholesterol and pigments. This usually occurs after a pregnancy, rapid weight loss and prolonged fasting. The sludge usually does not cause any symptoms, but has been blamed rarely for biliary colic, pancreatitis and rarely cholecystitis. But more commonly the sludge usually disappears on its own and rarely requires any treatment. Hope this helped and thanks for the question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is Lyme disease? Will it cause joint pain and depression?\n\nHi doctor, Recently, I visited my primary doctor's office, but he was on vacation. I was seen by a nurse practitioner. My main complaint is leg swelling, joint pain, and stomach aches. She asked me to do a series of lab tests and to return a week and a half later. When I went back, she told me that everything came back negative. However, a trace of an old case of Lyme disease showed up but it was nothing to worry about. Then she carried on to give lecture on my weight, and that I need to lose weight. I do, but I am 5'7\" and 215 lbs with three children. I have a long history of bipolar depression. Now I began to think that the joint pain and depression may have some correlation with this \"old case\" of untreated Lyme disease. I need some advice on this, please.",
    "doctor_response": "Hi. I assure you not to worry at all as things may get settled with proper care and follow-up. Yes, depression and the joint disease may definitely be associated with the untreated Lyme disease.  There are a lot of things that need to be cleared right away in history. I have written just for you to alleviate your concerns, once for all. Do answer where I ask a question, send back in follow up along with all the laboratory results you just went through.  There are three main stages of the Lyme disease.  Stage 1: This is 1-30 days after the tick bite. It comprises the vague febrile illness with a typical red rash named Erythema migrans (the rash that appears usually in unseen areas like axillae, groin and the back of the knee areas, almost after a week of the tick bite).  I wish to know, 1. Did you get this rash sometime? 2. If yes, can you please give me details as when? 3. Any eye redness, tearing, neck stiffness at that time with mild fever, etc?  Stage 2: Early disseminated disease which is 3-10 weeks after the tick bite. It includes fever and malaise, eye and vision problems, heart issues, joint pains mostly knees, ankles, wrist involvement.  There are also the neurological manifestations like meningitis, facial palsy, headache, neck pain or stiffness, photophobia. Also memory problems, mood changes, sleep and personality changes, depression etc., with some skin rash.  STAGE 3; Months to years after the initial infection which is latent or chronic Lyme disease, I have seen my patients get a latency period with no disease and again erupted with stage 3 after sometime.  Facial palsy and joint pains are very important and common manifestation of the late disease. Bladder dysfunction, hearing loss, cognitive impairment, other neurological manifestations including depression are common. Treatment plan can be decided on seeing the blood work in follow up along with the details in history.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shortness of breath an chest pain\n\nover the last 3 week ive been experiencing changes in my heartbeat shrotness of air thats not letting me sleep, 2 days ago I had chest pain I felt it was going through my left arm so I had to check in to hospital, the doc said I may have ulcer but I dont even have heartburn or anything like that, I've not been able to get some sleep since 2 am today everytime Im falling asleep I my heart wakes me up with a weird sensation that makes me get up for some air.im 32 never had any medical history I do exercise 4 time a week and eat healthy",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. In my opinion, we should definitely rule out heart diseases for your symptoms. So get done blood pressure monitoring, ecg, 2d echo and stress test (trade mill test).If all these are normal then no need to worry for heart diseases. Sometimes undiagnosed stress and anxiety can also cause similar symptoms. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic drugs too. Don't worry, you will be alright with all these. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of masturbation?\n\nI have mastirbated since last september evver sine that life when down hill im 13 i think i masterbate because of stress but after i do it i feel depressed and punish my self punch in stumoch and it is against my religon i also think i do it because i cant have sex yet can you help.",
    "doctor_response": "Hello,The masturbation is safe and pleasure giving procedure. You may need not to worry about it. If you are doing excess mastirbation like more than three times in week than fatigue, anxiety can develop. Hope I have answered your question Let me know if I can assist you further Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a cracked tooth and it hurts me a lot. What can I do to get relief?\n\nHi doctor, I have a cracked tooth. It hurts me a lot for a week. Now, I can eat only on one side of the mouth. What can I do to get relief?",
    "doctor_response": "Hi. Please say about the location of the cracked tooth. Please mention whether it is present in the front tooth or back tooth. If there is a pain, you can take Amoxycillin two tablets one at morning and night. You can also take Aceclopara (Aceclofenac with Paracetamol) for the pain along with it. You can take tablet Rantac before breakfast and dinner. If the crack is present in a front tooth or back tooth, consider going to the dentist to examine the condition. If it is present in a front tooth, you can treat it by bonding and root canal treatment can also be done. A crown can be placed over it for esthetic purpose. You can go for an implant also. If it is present in a back tooth, you can do a root canal treatment, and it can be managed by placing a crown over it. If the crack is too difficult to be handled by root canal treatment, then it can be extracted.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe ankle pain?\n\nOVER THE LAST HOUR OR SO I VE HAD SOME shooting pain in the front of my ankle. Doesn t last long. No injuries TO THAT AREA that I know of. FOOT AND ANKLE DONT APPEAR TO BE SWOLLEN....JUST A LITTLE TENDER. THE PAIN IS NOT CONSTANT. MY BIG TOE IS FINE SO IT S NOT GOUT...RIGHT?",
    "doctor_response": "Hi, It can be an ankle sprain. As a first line management, you can take analgesics like acetaminophen or tramadol for pain relief. Apply ice packs and immobilise the affected foot. If symptoms persist you can consult an orthopaedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the solution for AVN of hip joint other than replacement surgery?\n\nHi! I have been diagonised with AVN of the hip joint stage 2. I have been advised by my doctor to have calcium and physiotherapy. Its been 10 days since I have been on physio and the pain has reduced quite a bit. I want to know what is the actual solution to this problem apart from hip replacement as the docs are advising. Will the AVn spread to other joints, will it go to stage 3. Will my joint/ bone break if I fall as I feel very weak in my legs and feel that I have no strength in my hip joint. Will physiotherapy help me in the long run. What chance do I have.",
    "doctor_response": "Hi, AVN stage 2 is middle of stages and is likely to progress further. It does not spread to other joints as such. Hip replacement is the only answer but wait for it, until you are not able to do your activities of daily living. Physiotherapy will strengthen your muscle and keep them in good shape for future. There are no statistics to suggest how and when will AVN progress further. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can unprotected sex cause for itching in the bladder?\n\nI have a itchy urethra some time it shots around from my scrotum some times my bladder well I think it s my bladder. The itch is off and on. I have no discharge and I does not hurt when I pee. I had unprotected sex with a girl 14 days ago this felling started about 7 days ago. Can this be a std or uti?",
    "doctor_response": "Hello welcome to Health Care magic.Itchy ness in the genital regions can be removed by hygiene, avoid wearing tight underwear. If you still think its some thing internally related. If there is no obvious findings.1. You can see GP if you feel discomfort.2. Ask the girl if she feels any discomfort.3. Wait for some time only if there is no obvious symptoms to see the specialist.Like to ask ? Do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Combiflam be given to a child for fever?\n\nmy kid is 2.5 years old he is suffering with high fever 103.5 from yesterday first we gave meftal 5ml for every four hours but no use, then doctor recommend to go for combiflam syrup,after first dose fever come down but he told to give for every 8hrs 5 ml now its almost 6hrs completed now again fever is raised to 103.5 can i give 2nd dose now are i need to wait for another 2 hrs?",
    "doctor_response": "Thanks for the query.Yes you can give combiflame syrup for fever.It can be given every 4 to 6 hrly.Also cold sponging should be done.Syrup mefthal should be avoided as there is no adequate data on it.Hope i helped you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will physiotherapy help to treat Erb's palsy?\n\nHi doctor, My daughter has Erbs palsy but we did physiotherapy for three months and the doctor said she is fine but she is still struggling with the hand and this is about six months after the doctor discharged us. Please tell me what should I do.",
    "doctor_response": "Hello. Thank you for providing the brief history of your daughter. I am sorry firstly to hear that your daughter is being diagnosed with Erb's palsy. Well, I would suggest you to continue physiotherapy for atleast three days a week as it will be of good help for her. Usually, cases with Erb's palsy recovers well when they perform physiotherapy for over longer periods in infants. Firstly, in the initial stages the physiotherapist will do passive movements of the limb but off late it will be progressed to toy reaching where she can use the maximum of her efforts and learn proper movements. We need to teach brain the movement. In between there might be a use of infant stimulation which will be of use to activate the muscles which are not active. A competitive physiotherapist for using the stimulation over an infant is needed as they have to analyze to which muscle it has to be given. Also a precaution has to be taken while applying a stimulation to the infant as the kid might not like it, so a competitive physiotherapist is a must for this. In my clinical practice over a period of 12 years I have seen many infants with Erb's palsy. They have responded well with the physiotherapy and with careful attention. Breech delivery. Erb's palsy. Physiotherapy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a hard lump on the back?\n\nI have a hard lump deep in my back. It s located about 2 inches below my posterior rib cage and 4 inches to the left of my spine. It is very tender. It feels hard to me and is not moving. I keep reading it s likely a lipoma but this seems to present differently. I ve seen lipomas before and this is different. The lump is at least an inch in length. I am only 38 years old. The lump has been there for at least 6 months but hasn t been bothersome until now. I appreciate any input. I m nervous it s something bad. Thank you. Gina",
    "doctor_response": "Hi Gina ! Good evening. I am Dr Shareef answering your query. It seems to be a tense cyst feeling hard with secondary infection giving rise to the painful sensation. Even though the swelling did not bother you so long, I would advise you to get it operated (excision biopsy) and send it for histopathology test.If I were your doctor, I would first prescribe you with a broad spectrum antihiotoc, an anti inflammatory drug, get the infection controlled and then get it operated. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should the normal AST and ALT level be?\n\nI am a 65 year old female, height 5 ft 3 inches, 140 pounds.  My cholestrol is just above normal, and my doctor has a liver profile check done every 4-6 months, because some enzymes are usually high. What does it mean when my liver profile shows AST count at 42 and ALT count at 67?",
    "doctor_response": "hi.thanks for posting your query at HCM.There is nothing to worry. Though ALT is slightly high but its considered normal. Usually ALT or AST values higher than \"two times the upper normal limit\", is considered abnormal ( in some countries, ALT or AST values of more than 100 are considered abnormal). So you need not worry.hope to answer your concern.wish you good and sound health.regardsDR Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be done to get rid of cysts?\n\nI am 57(female) and I have cortical cyst(75x70x60mm size) in lower part of right kidney,two cortical cyst(58x45x40mm and 20x18x13mm) in mid and lower part of left kidney & two hypoechoic lesion(36x35mm and 22x18mm) in left side of uterine body. I discovered it only a month ago through sonogram report.",
    "doctor_response": "Helloyou dont need to worry,kidney cysts r normally found in many healthy people and they dont do any harm,just to take extra precaution u need to get this test once every year - RFT\"s i.e RENAL FUNCTION TESTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the possible treatments for weak memory and sleeplessness?\n\nI have short attention span, I forget things, I can't sleep, I feel like crying for no reason, I often think of suicide, I can't get up in the morning. But what bothers me the most is that I can't read a book anymore, because it doesn't hold my attention, I do too many things at once and can't finish any of them. I'm always late because I make myself late by doing other things which are not related to my priority. I can't finish my work... What's wrong with me?",
    "doctor_response": ".It might be due to severe stress with anxiety and development of depression.It usually occurs due to some unfavorable circumstances,lack of self confidence.Inferiority complex is also one of the cause for it.Increase your self confidence,try to avoid stress.Make your mind busy with some positive activity.Flupenthixole with other combination drug will be helpful.Do regular exercise,yoga and meditation.Otherwise consult psychiatrist for proper medical management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the ill effects of neglecting vaccination?\n\nHello Doctor, i have requery regarding the vaccine to baby who was born 15 days back (12 Sep 2010). as per schedule give by hospital, the first dose of medicine (polio and injection) in 1 and half of month time i.e. 26 Oct 2010. But we had not clearly seen the date and had impression of it is 26 Sep 2010 and gave the first dose today. later we realized that it is supposed to be 26 Oct 2010. now i am worried will this cause any problems to baby.",
    "doctor_response": "Hi, It is not clear which injection you have given. It seems you have given the BCG injection and Polio (oral). These vaccine are also given after birth in some institutions. Oral Polio vaccine can be repeated many times also. So if the injection is BCG, you need not worry. Else visit your local pediatrician to get the baby examined clinically. Hope I have answered your queries. Let me know if I can assist you further. Take care Regards, Dr. Arunava Biswas",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any chances of pregnancy as I am passing out an orange coloured discharge ?\n\nim 21 .and i was on depo for six months..i was due to get a shot in may but decided not to..i know the say u spot in between period ...but i was doing to much ..when i would have intercourse with my husband i would bleed afterwards..im doin so much spotting that i dont know when my period is on or off..then im experiencing an orange period..i dont know what going on and i hope it wont effect my chances of getting pregnant again..",
    "doctor_response": "Hello Depot does have a side effect of break through bleeding.But before we rule that a a cause  you should also be examined to rule out cervical erosion,vaginal infection etc. The effect of the depot wears off in a few months and fertility returns soon after.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take Amoxiclav for epididymitis?\n\nI have been diagnosed with epididymitis by my GP and been put on co-amoxiclav 625mg three times a day for 7 days. I'm 3 days in and the pain seems to be getting worse. I've read elsewhere online that co-amoxiclav isn't the right treatment in cases of epididymitis in men under 35 as an STI such as chlamydia is usually the cause. However other websites state that amoxicillin-based antibiotics such as co-amoxiclav can be used to treat chlamydia successfully in pregnant women. Should I contact my GP to alter my medication or can I expect the co-amoxiclav to have an eventual effect?",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have Epididymitis and have been prescribed Amoxiclav.thrice daily.Please continue taking he same antibiotic along with anti inflammatory medication like Diclofenac twice daily.It takes 10 days to get the results and may have to take antibiotics for 3-4 weeks Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Soreness in left armpit lymph node after using nicotine patches\n\nI use nicotine patches and I have some soreness in my left armpit lymph node. I have been to doctor he said could be allergies fighting cold etc. I feel it for a few days then it s gone for months. Can using the patch cause this. The node is not swollen. Thx josh",
    "doctor_response": "It is very rare for nicotine patches to cause lymphnode inflamationi agree with your doctor it was just an allergic reaction",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do body ache, cough and a skin rash indicate flu?\n\nMy husband and I thought we had the standard flu....body aches, headache, coughing and a fever of 101.+ for three days...fever has subsided and now just dealing with a wracking cough but I broke out with a rash on my chest last night and still have it. Doesn\u2019t itch. He broke out with a rash on his back and it does itch...is that from the flu or are we dealing with something else..?",
    "doctor_response": "Hello -Influenza causes a cough, fever, and body aches, and is \"going around\" in the US right now, so there is a good chance that it is flu.  But flu doesn't typically cause a rash.  However a viral infection (which is what flu is) can cause a post-viral exanthem (rash).  Still, I advise you both to go in to be checked as rashes can be from other causes (such as a strep throat) and other reasons as well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest method to treat clot in brain\n\nmy mother got stroke for that we took MRI in that the blood flow in the right side of the brain is fully clotted and there is a small clot in left side also can it be cured through medicine or through any operation like balloon therapy or any stenting method pls explain me",
    "doctor_response": "Hi,stroke patients are investigated by 2D Doppler neck to know carotid vessel status .If carotid vessels are 100% occluded then no treatment is required on that side .If carotid vessels are  more than 70% occluded then stenting or surgery is required.If less than 60 % occluded then lipidlowering drugs are started.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Gum under front tooth infected. X-ray report states crack in mouth. Taking Amoxicillin. Want to pull my tooth?\n\nOn the lower part of my mouth I have a bridge. The gum under the front tooth that holds the bridge is infected and has a small poket of pas...my dentist took an x-ray and said that there is crack in my tooth and wants to pullmy tooth out in two days.Can he do that or shoul I wait until the infection is gone ? I start taking Amoxlicin500mg Three days ago.",
    "doctor_response": "Hi, Thanks for asking the query, Infection in the gum and pocket formation is due to accumulation of food in between the cap and the tooth surface, Go for symptomatic treatment of complete mouth scaling and polishing. Take an x-ray of the tooth, as you mentioned x-ray revealed crack in the tooth , so you have to go for extraction of the tooth.This can be replaced by a fixed or removable prosthetic crown. Take complete course of antibiotics and analgesic, use antiseptic mouthwash gargles and use lukewarm saline gargles. Hope this helps out. Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tender and bruised knee\n\ni fell yesterday flat on my right knee. I was able to get up and walk to my gate board plane and my knee later started showing discoloration over patella. Tenderness as well. I could still walk. It is bruised and tender. I can do leg raises flex and straighten. Possible fracture?",
    "doctor_response": "Hi,Thanks  for  your query.From description it seems to be soft tissue injury .You need an x-ray to rule out any bony injury. I suggest you to consult an orthopaedician nearby for a detailed examination. You may get the X-ray of the area affected under his/her guidance. Beside icing and elevating it, you can take anti-inflammatory drug like motrin to reduce pain and inflammation.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is Mometasone dangerous to use on Face to clear my acne pimples?\n\nHello doctor, I am seriously facing acne pimples problem. Sometimes they occur on my face when I masturbate. If I use Mometasone, it gives a good result. Is it okay to continue this?",
    "doctor_response": "Hello. Acne is a universal issue in the age group of 15 to 25 years due to hormonal changes in adolescents. However, there are multiple effective treatment options depending on the grade and severity of the problem. Mometasone is a topical steroid and is to be avoided strictly on the face and for acne as it can harm your skin in the long run. Acne is dependent on hormones hence excess masturbation may sometimes lead to an increase in the problem. I would advise you to stop Mometasone immediately and kindly upload appropriate images to help us assess your current grade of acne and treat you better. Regards. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feel dejected and fragile. Unable to talk to people with eye contact. Advice?\n\nhi,sir..i am a b.tech student....i used to be very good student and every friend of mine used to see me as a very talented and dynamic person....but i don t know how i become so coward and uncomfortable in chatting with others...i am feeling very dejected,fragile.i have become a nerd and jerk........my problem is that i can not talk with people with eye contact ......i feel very uncomfortable with my and his/her body...i can not concentrate on what he/she is saying after a moment when some feeling of his/her body condition comes into my mind........i am in deep depression .....for that i am able to get a job.....what to do sir???????",
    "doctor_response": "Hi,  You have not specified the cause of your depression, however I will try to help you. As narrated by you, you have performed quite well in your past both in the academic and social field. This reflects that you are an achiever and also a successful and happy person. 1. Many times changes in life relations, financial changes, changes in love life, health problems and more may suddenly weaken us, you need to adapt and accept the changes slowly but steadily. 2. You should learn to love yourself, life is  a gift to you given by God, you should honour God and take much care of yourself. Anyone may treat you in their way, reject you. But you should never neglect or deject yourself. 3. Learn to highlight your qualities, skills, good nature and enjoy life. 4. Try to change your lifestyle, hairstyle, stay active, watch movies, pamper yourself, exercise, eat well. 5. Yoga, meditation will help you get relaxed and make you stress free. 6. Healthy home made food, rich in minerals, protein balanced with fruits, berries, fresh veggies, fish will lighten up your burden. They contain natural mood elevators and anti-oxidants. 7. If you want you can consult a counselor, doctors, but do not make a habit to take anti-depression medications. 8. Avoid smoking, alcohol, caffeine and any other addition. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly see the x-ray of my foot, and tell me if I have Lisfranc injury?\n\nHello doctor, I have been using moon boot from approximately seven weeks, for a fourth base disruption. I have just had x-rays. I would like an opinion on two things, please. Should I be worried about the spacing between the first and second metatarsal (Lisfranc\u00a0injury)? There does not seem to be any space on the oblique view between the cuboid and the fifth metatarsal. Is that an issue? I apologize for the quality of the photos, and I just was not able to get a better photo of the x-ray. Thank you. I am still in tremendous pain as well as any pressure over my midfoot hurts. The original injury was over eight weeks back.",
    "doctor_response": "Hello. I have seen the x-ray (attachment removed to protect patient identity). For further queries consult an orthopaedician and traumatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes brown vaginal discharge with cramps during pregnancy?\n\nHI i'm 10 wks and 6 days, yesterday i started having light brownish discharge that looks like old period, that was with little bit of mucus, this afternoon it started again. Today i felt very, very slight cramping.This is my first baby and i am very scared, is this normal, please reply because i feel like im going crazy wondering. My Dr appt. is in three days, should i wait? this normal",
    "doctor_response": "nothing to feel scared u can have a vaginal infection that can be treated by medications, USG can rule out threatened abortion",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain under armpit of a child?\n\nHello My son is 14 and for 2 days he is feeling pain under his armpit .the pain is more when he move the arm or the press it with his hand . I checked this my hand and there are no lumps at all . I just notice few spots under his armpit . What it can be ? Thank you",
    "doctor_response": "It could be hidradenitis suppurativa. ..infection of apocrine glands...which is caused by sweating, hormonal changes, humidity,  heat and friction from clothing..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sinus infection\n\nI have a sinus infection, I was diagnosed today at the doctors. At night, I am 'salivating' or 'drooling' excessively. It is a feeling I get when I want to throw up. So far, it only makes me feel like throwing up. The worse I cough the more my mouth is watering.",
    "doctor_response": "Hello,Welcome to HCM,As your doctor has diagnosed that you are suffering from sinus infection, because of which you are suffering from all these symptoms.There are many organisms that are causing sinus infection. For your symptoms I would suggest you to follow1.Take saline steam inhalation2. Syp Bricarex A, three times a day.3.Oral Tab Bactoclav, 625 mg, two times a day.4. Tab Levokast, once in a night for atleast 7 days.These measures will help to reduce the symptoms and improve the condition.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medication is suggested for hemophiliac condition?\n\nhi i am heamophilia patient and my joint is weak so how we increase the activity for my joint, and i have a problem for hepatitis c and how can solve the problem but we don t no i do how much costly hepatitis c treatment and tell me. which age may ignore the treatment of hepatitis c. and i have which food intake.",
    "doctor_response": "Currently treatment of hepatitis c is very costly, recent treatment is use of alfa interferon,u should not ignore the treatment as complications may occur,u should avoid taking alcohol and take protein diet... Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the huge lump on the shoulder blade?\n\nI discovered a large lump on the lower margin of my shoulder blade.  There is no redness, skin irratation, or discharge.  It's large, the size of an egg, and it's tender, it isn't hard, more firm, and it can be moved a little bit.I am 38 and have no know health problems. I am 5 8 and weight 150 lbs.",
    "doctor_response": "Hi and welcome to HCM. Thanks for the query.considering your description it looks like some subcutaneous lesion and most commonly we see lipoas,fibromas or ateromas in this area. you should see surgeon and then it can be surgically removed under local anasthesia. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it advisable to take Cyclo Progynova therapy?\n\nHi! I m 28 years old and truing to get pregnant for the first time with my husband. My doctor prescribed me 3 months of Cyclo Progynova therapy, because we are trying for the last year or so. My cycles are somewhat ok, but we suspect that maybe my follicular phase is a bit longer (I suspect the ovulation is on 16th or 17th day from the beginning of the period). Is my doctor right and should I go along with this therapy even though I read a lot about side effects?",
    "doctor_response": "Hallow Dear,Cyclo Progynova comes in two forms, white tablets are estradiol valerate while pale brown tablets are estradiol valerate with norgestrel. These pills are good for hormone replacement therapy in menopausal women. They will regularise your menstrual cycles in you; however they cannot help you to conceive. In fact they may stop the ovulation. Have you undergone the investigations to assess your ovulation, patency of the tubes and semen examination? If ovulation is the problem, Clomiphene citrate tablets may help you; may be in association with Metformin. Before taking these tablets, first get your ovulation monitoring done by ultrasonography. If it reveals that you are not ovulating, then only go for these tablets. However, your history informs that you are ovulating on 16-17 day of cycle. Ovulation on day 16 is not a problem so long as the secretory phase is 14 days. If it is shorter, you may require progesterone supplementation in secretory phase to help good implantation and support to the pregnancy. If there is no problem with your ovulation and secretory phase, the cause of non-conception could be in the tubes or with husband. Please get Hysterosalpingography done for your tube testing and also husband's semen examination. The reports of these investigations may demand for different line of treatment. After complete investigations, you may ask me Direct question for further follow up discussion and advice. I hope this gives you guidance.Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for black colon in heart patients\n\nmy dad went into a cardiac arrest and is still in the hospital and has severe diarriah right now and they did a test on him and it showed he has black colon and they say he might need surgury. My dad has a very weak heart and I just want to know if he even should have this surgury or what else is there to do to treat his black colon",
    "doctor_response": "\"Black colon\" may refer to ischemic colitis.  When there is a lack of blood supply to an organ such as the large intestine (colon), the tissues turn dark, or in the worst case, blackened, if it dies or becomes \"necrotic.\"  That is a medical emergency, and needs to be treated with immediate emergency surgery.  Considering that he as a \"very weak heart\" and just suffered a cardiac arrest, the odds, unfortunately, are very much against him.  He has a very high chance of complications or death related to the surgery.  However, there is no alternative, as leaving an ischemic or necrotic colon in him has a 100% chance of causing septic shock and a very painful death.  I'm sorry to hear of your Dad's situation, and I wish you and him the best of luck in trying to get through this.  Any chance he has of survival would include an emergency, high-risk operation to remove the \"blackened\" portions of his colon and to restore blood flow to this vital organ.  The only other alternative, unfortunately, would be to refuse surgery, sign DNR papers, and make him as comfortable as possible.  That decision, of course, would be determined by him if he is awake and alert and understands the situation, or, if he does not, then hopefully he has a \"Living Will,\" outlining the type of aggressive, life-saving measures he would or would not like to undergo.  These type of questions are things that are best dealt with ahead of time, when our loved ones are alert and healthy and can make their wishes (or \"advanced directives\") known.  It also helpful for them to appoint an official \"Health Care Proxy,\" a spouse or adult child or other relative who knows and understands their philosophies and wishes regarding health care in these life-threatening situations.  Once again--the best of luck to you and your family.  Let us know how things work out.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does physical therapy help in relieving the severe back pain?\n\nDenzel, a 46 year old man, is working with his physical therapist on a set of back exercises. Around four weeks ago, Denzel was helping a friend move and attempted to lift a heavy box. Since that incident, he has had severe pain in his lower back. His health care provider prescribed physical therapy three times per week to treat the condition.",
    "doctor_response": "Severe back pain need rest and medical treatment in the form of painkillers. After controlling severe pain slowly start physiotherapy. First you consult neuro surgeon and take opinion then do accordingly.  You may have disc prolapse.  There are so many type's of treatment modalities.  Drug therapy.  Epidural steroid injection.  Surgical intervention. When you are having severe back pain, and if you try to lift the heavy objects with one side it will further exaggerate disc prolapse.  Kindly avoid those work.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and tingling sensation on upper back?\n\nHi, I gave birth 3 and a half years ago and ever since I ve had bad back pain and pins and needles in my upper back. Both these symptoms come and go, the backpain can last a while but the pins and needles vary around ten minutes. Any help would be much appreciated, thanks",
    "doctor_response": "Hello,Welcome to HCM.I am Dr Rakesh Sharma answering your query.I can understand your concern.Pins and needles are very common in vitamin B complex deficiency.Back pain is common in B12 deficiency.Add these in your routine and you will feel the difference.If not improved see a doctor.Hope , this suggestion will help you.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a sinus infection lead to sneezing and runny nose?\n\nHi: Today, from out of the blue, my sinuses went from great, no problem at all, to the right nostril flowing like a faucet. A series of about six sneezes proceeded this. I have no allergies that I know of. The excessive flowing of the right side of my nose has persisted for six hours. What would be my best course of action to stave off a cold or sinus infection. Thanks, bnbm",
    "doctor_response": "HI, thanks for using healthcare magicSinus and nasal congestion can be related to different causes but the most common are infection (usually viral or bacterial) or allergies.If you have no history of allergies, then your symptoms are likely due a viral infection.There are medications that may help you such as oral or topical decongestants.Examples of topical decongestants are otrivine and normal saline.The oral decongestants are usually sold in combination with anti histamines that are also useful.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for persistent high fever post blood transfusion\n\nMy mom is 89 and had a blood transfusion to receive 3 units of blood after doctors discovered she had a bleeding ulcer. The bleeding stopped and she has been out of the hospital for 6 days recovering. This evening she developed a fever of 101.5. I just gave her 325 mg of Tylenol and after one hour the fever is still 101.3, so I gave her another 325 mg Tylenol.My e-mail address is: YYYY@YYYY",
    "doctor_response": "Hello,If the fever is just a mild reaction to the transfusion it will surely subside after a few hours.If she had a bleeding ulcer before, there are chances she could have a perforation which can be serious. If she has severe pain abdomen, please take her to the hospital.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pregnancy be carried to full term if hypertensive?\n\nHi, may I answer your health queries right now ? Please type your query here... Hello. My friend is 4 weeks pregnant. Her doctor wants her to terminate because she is hypertensive and because she has had numerous abortions. She really wants to have this child. What can she do to have a healthy baby? Thank you.",
    "doctor_response": "Hello dear,I understand your concern.In my opinion any pregnancy with complication is continued only if the complication doesn't hamper the health of the mother.Presence of hypertension at this early pregnancy might be very difficult to control and also to ensure the proper growth of the fetus.So may be it was suggested for termination.Dont worry.The BP should be controlled before conception and then pregnancy should be planned for better results.Avoid stress.Also as she had previous abortions the investigations like antiphospholipid Abs and anticardiolipin Abs might be helpful.Best regards...Dr Srilatha",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having UTI? Which doctor should i consult for this problem?\n\nMy 62 year old mom was told she hsd a Uti that caused a kidney infection they put her on antibiotics and she went to the obgyn and they said they want to wait till monday to do blood work again to see if the infection is still there. My question is what causes this andd should she see someone other than her obgyn?",
    "doctor_response": "hi, at age over 60, UTI is common as there is poor local immunity near genitals. you can take her to a urologist for best treatment.  hope this helped.",
    "dialogue_context": ""
  },
  {
    "patient_message": "help me i have csuedo tumor pappilidema and bppv and it feels like im living in a dream almost hello,im caitlyn im 13 and something has been happening very weird like my life feels like im in a dream like im floating on a cloud and i get all nervous and panicky all the time i cant really describe it but it feels like im watching myself live and its scary i have been known to get lightheaded alot and i have 3 diseases but i dont think they would control whats happening and they are 1.) csuedo tumor cerebri 2.)pappilidema 3.) bppv its scaring me because it feels also like im losing my hearing and my memory all i can stress is tthat i feel like im living in a dream im begging for someone to help",
    "doctor_response": "dear caitiyn it is pseudo tumor cerbri pl contact a neurosurgeon he will be able to help you all the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will junior lanzol cure gastritis in a child?\n\nhi i have a 2 year old boy who had acute gastritis 15 days back n was given junior lanzol 15 mg for 15 days. he was having on n off coughing along with vomittting since 2-3 months. wanting to ask that will junior lanzol make it a chronic problem or will cure it. he is 10.5 kg and 85 cms tall",
    "doctor_response": "Hi, junior lanzol is an antacid drug which is given to reduce acidity in child. I don't think that junior lanzol is needed to be given for 15 days, the usual course is 3 days. I suggest you to do the GERD test to know the cause of acidity. Revert back with reports. Take care. Regards - Dr Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it compulsory to take crisanta on prescribes time can any late will cause problem ?\n\nHi am taking crisanta ls prescribed by my obgyn for this month 6tablets I already had regular at the same time adviced by my obgyn but yesterday the 7 th one I ate was not on the apt time which I had all previously. It's 4 hours delay. So is there any problem or what time I used to have the rest?",
    "doctor_response": "Hello, Crisanta is combination pill so it is not compulsory to take it at the same time exactly. Few hours delay is ok. It is advised so because it helps to take the pills regularly and will not miss any tablet.For progesterone only pill , it is compulsory to take pill at the same time . If there is delay of more than three hours then you should go for back up of another contraceptive.I hope this helps.Regards, Dr TEJASHREE BHORGNAECOLOGIST, PUNE",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there chances of pregnancy even if taking cerazette?\n\nHi, I am currently taking cerazette (POP) and since i started i ve had no periods or spotting whatsoever. i recently missed two pills in a row and i had also missed one pill earlier in the pack. I am sexually active and cerazette is the only form of contraception i use so i m wondering what the chances are of falling pregnant? Also, if the chances are quite high, when is a good time to take a pregnancy test? Because i dont have periods anymore i dont know when i would normally ovulate or normally get a period. Any help or advice would be great! Thanks much!",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.As you rightly said with POP, you do not get periods.If you have missed the pills occasionally there are chances of getting pregnancy.I will suggest to get morning's first sample of urine tested for pregnancy, after 14 to 16 days of your last sexual activity. That will be the most late chance of you be pregnant.If the test is negative then do not worry. Please continue taking Cerazette regularly.Even if you are pregnant, you can opt for termination with medicines safely till 9 weeks of pregnancy.I hope my answer helps you.Thanks.Wish you great health.Dr Purushottam",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for difficulty in breathing\n\nIm about to be treated for h pylori for the third time as two rounds of HP meds didnt work. I also recently was told i have gallstones . Can the pain episodes be simialar and related? I get upper stomach pain.. sharp. Some sweating shaking, difficulty breathing too.. always unconfortable after i eat even healthy meals. Thanks.. Krista",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. Your stomach pain is mostly due to h.pylori induced chronic gastritis and GERD ( gastroesophageal reflux disease ). But sweating, shaking etc can be due to gall stones.Breathing difficulty is seen in uncontrolled GERD. It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms.Along with h.pylori drugs, following lifestyle modifications are needed for better symptomatic relief. 1. Avoid hot and spicy food. 2. Avoid stress and tension. 3. Avoid large meals, instead take frequent small meals. 4. Start Proton pump inhibitors. 5. Go for walk after meals. 6. Keep 2 - 3 pillows under head in bed to prevent reflux. 7. Loose weight if you are obese. 8. Avoid smoking and alcohol if you have these habits. 9. Operation for gall stone is necessary if symptoms are recurrent. So consult your doctor and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure the lump above the eyes after falling down?\n\nI had a fall 5 days ago and saw paramedics....scratches and bruises and a hard hit just above the eye.  It itches and the blue/black and swelling is gradually going down, except the lump above my eye is still there.  How long will it take for it to dissolve?  BTW  I am on vacation when this happened and plan to see my doctor when I get home.",
    "doctor_response": "Hi.Thanks for your query and an elucidate history. This will resolve within 1 to 3 weeks if you stop fiddling it. Allow the body to heal - it heals really fast.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes moles on neck during pregnancy?\n\nHi , I am 37weeks pregnant.I have been taking 81 mg ecotrine for the duration of this pregnancy after suffering two miscarriages over the last three years.I have noticed a significant increase in mole like growths on my neck and chest during the last trimester.my total weight gain is 26kg during this pregnancy.I am not constantly chewing...pleeas may I ask what the mole may be symptomatic of?",
    "doctor_response": "Hello, and I hope I can help you today.Many women see enlargement of molds or skin tags during pregnancy, which is just due to the increased hormones. This can affect any fleshy growths on all areas of the body.However general these usually decrease in size after delivery. If they persist longer than three months after delivery, they can be easily removed by dermatologist.So the molds are not a symptom of any disease, and are nothing to be concerned about.I hope I was able to adequately answer your question today, and that my advice was helpful.Best wishes, Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a sore spot in the head on the occipital bone?\n\nI was rubbing my head and noticed a sore spot. I then tried feeling for an infect or zit but realized a small bump on my head. It does move and feels like bone. The other side does not have the bump. I would say it s on the lower right side of the occipital bone. I have been reading it could be a cyst or an infected *lymph nod. It is sore when touched.",
    "doctor_response": "Hello. Thanks for asking from HCM.I can understand your concern. You have already read about scalp swellings. As you have found that, this swelling is tender on pressing, firm, mobile on bone and present on right lower part occipital bone, most probably it could be a cyst like swelling in scalp layer.Mostly these cysts are benign (non-dangerous). Most common swellings are sebaceous cyst, dermoid cyst, reactive lymph node. It can only be confirmed by biopsy or fine needle aspiration (FNAC). You can differentiate between these swellings to some extent. Like in case of sebaceous cyst, if it is carefully observed, a dark spot (punctum) can be seen over it. It is painless, but may be tender on pressing. Treatment is complete surgical excision of swelling with capsule. Mostly it is down under local anaesthesia if patient is co-operative.Dermoid cyst is similar to sebaceous cyst, but without punctum. If swelling is moved to one side, bony defect below it can be felt. Treatment is similar to dermoid cyst.Reactive lymph node is usually associated with some scalp disease like dandruff, skin infection, may be TB if you are from tropical country. Diagnosis can be confirmed by FNAC. Do not be scared. Thanks. Hope it will help you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does motility of semen affect pregnancy?\n\nmy husband and i are trying to conceive and we had him do a semen analysis. Results showed normal sperm count, but motility was 40% rapidly progressive, 30% not moving at all, and the remainder were moving but either slow or in the wrong direction. does this mean we won t be able to conceive naturally?",
    "doctor_response": "Hi,   I understand your concern.   Yes, motility of sperms does affect conception.  For conception, sperms have to travel all along  uterus to meet mature ovum( on it's way from peritoneal cavity to uterus ) within 32-3 days of it's  release from ovum.So for sperms with less motility can not do it & conception becomes difficult.   But 30% sperms having grade 3 to 4 movements  are sufficient for conception. Your husband seems to have a sufficient motility & should not hamper the task. You can conceive naturally. You can recheck it with his doctor.    Less sperm motility can be corrected by medicines/ surgery ( for Varicocele ) or  IUI/IVF   Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does wound between vulva and anal and rashes on eyelids/forehead indicate cancer?\n\nI was diagnosed with biopsy for Lich Scler, I have had it for 6 years now. Now I have an open wound between my lower vulva and anal, and there is blackened skin. I have also started getting red raches on my eyelids in the corner and painful rash behind my ear and on my forehead and my lips never heaL. cOULD i NOW HAVE CANCER? i AM TIRED ALL THE TIME AND i HAVE BEEN LOOSING WEIGHT.",
    "doctor_response": "Hi,Thanks for writing in.It is possible that you are having a generalized reduced nutritional condition which is causing your symptoms. The symptoms are unlikely to be a cancer and likely most probably due to autoimmune condition causing general deterioration of health.You might be having a reduced immunity and this should be evaluated in detail. If you are having weight loss for more than 10 percent over two months then you should get a complete blood count to be done. A detailed clinical evaluation is also required to know if you have any lumps or lymph nodes enlarged in any region of your body. It is easier for a person with low immunity to get an infection and please discuss with your doctor if you have got any condition from malnutrition. Subsequently nutritional support and rehabilitation is to be given attention. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from Fordyce on lips, scrotum and penile shaft. Please help.\n\nHello doctor,I had HPV warts 25 years ago. A recent bout with Fordyce on lips and a large amount on the scrotum and penile shaft. What should I do?",
    "doctor_response": "Hello. I have gone through your case. In my opinion, Fordyce spots are non-infectious lesions and are not sexually transmitted diseases. These are painless spots which occur in the area of sebaceous glands. It has no corelation with your previous HPV infection. Usually, it does not require any treatment. If cosmetically unacceptable, then pulsed dye laser or cautery are options.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Coughed and split blood, I am ALS patient, on medicine, oxygen, warfarin 5.5mg, INR done. Recommendations?\n\nThis morning I coughed up a small amount of blood,i'm an A L S patient , on a number of medicines,also on oxygen 24 hours a day at 4.5 liters.  i'm on warafin 5.5 mg a day,checked my INR today which is 1.9. informed my family doctor and waiting for a return call. yesterday morning and the afternoon I coughed and spit up blood.  I'm not able to walk.Could I possible have a blood clot forming the warafin is breaking it up?",
    "doctor_response": "Hi,Thank you for posting your query.Yes, the most likely cause of coughing small amounts of blood in your cases, could be warfarin-related. Warfarin makes the blood thin, which results in bleeding at times. The reason for your warfarin use in not clear from your description. The dose of warfarin depends on the indication for using warfarin.I feel the dose may have to be reduced for a few days, after which you should recheck the PT, INR; and then adjust the dose of warfarin appropriately.I hope it helps.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have external hemorrhoids near my anus. how to get rid of it?\n\nMy name is masood sadiq i read your website the treatment of hemorrhoids sir i have also hemorrhoids it is externel near my anus a fiber pimple exist after bath i feel inflamation around anus please recommend me any cream or medicine by which i remove to this inflamation",
    "doctor_response": "hello dear,for piles u need to take homoeopathic medicines.Firstly u get the diagnosis done.try aloe socotrina 200 once daily for 7 days, will relieve.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Please suggest a treatment for swelling on the back\n\nAfter hitting shoulders very hard with my cousin a few times I noticed swelling on my back later that day around my right shoulder blade and and little below it, the swelling has not subsided for over a year and x-rays did not show any damaged bones, i feel discomfort when sitting or laying in particular positions.",
    "doctor_response": "Hello, This is Trapezitis and inter-scapular muscle spasm. You need to first correct the posture. Use hot water fermentation, do breathing exercises, gentle kneading massage, myofascial release, IASTM, neck stabilization exercise, inter-scapular muscle strengthening exercises, shoulder stabilization exercises etc. to improve the posture and muscle strength. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to fix numbness and tingling in arm?\n\nmissing a shot of meth in lower arm. over a week has past and my arm is still numb/tingling. hurts extremely bad and it feels like I cant control my arm, like its retarted or something. can someone tell me how to fix this, I cant undergo this pain anymore",
    "doctor_response": "Dear Sir/MadamI have gone through your query and read your symptoms.In my opinion, you need a proper evaluation of your nerves to see from where this numbness is coming, then may be you will need an MRI for the diagnoisisI hope that answers your query. If you want any more clarification, contact me back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are renal cysts a matter of concern?\n\nI am a 54 yr old feamale with mildly high blood pressure 140-150 over 95- 100 even with medication sometimes I do have 2 renal cyst in my right and would like to know if I should really be concerned with my kidneys , there is kidney disease in my family.",
    "doctor_response": "HiThanks for your query.You have not mentioned the size of the cyst or its appearance.Renal cysts are often diagnosed incidentally. If they are not too big and look benign on the ultrasound then no active treatment is required.All we need to do is monitor them by doing an ultrasound every 1-2 years.Hope this helpsGood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will increasing Furosemide dosage increase urine output?\n\nI am on dialysis. Is it safe to increase - double - my Furosemide 40 mg. Will it increase my urine output? I am also taking Metoprolol Tartrate 25 mg and Felodipine 10 mg. My blood pressure is always high when I get up in the mornings and these two medicines bring it down until about 6OM when I take them again.",
    "doctor_response": "Hi,Increasing Furosemide dose will increase the urine output but this can also cause low blood pressure and also electrolyte imbalance. So it is required to monitor the above said while increasing the dose of furosemide. Hope this answered your query.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be the cause of pain around the palatoglossal arch?\n\nHelloOver the passed 2 weeks I have been experiencing pain on the very back right side of my soft palate around the palatoglossal arch - at it there are no lumps or bumps but when I press my forefinger upwards it feels bruised - I also feel this bruised pulling feeling on the right side when I purse my lips.  There's a slight dull ache in my right ear as well.  My doctor has ruled out a throat infection and my dentist couldn't see anything untoward when carrying out an oral examination.  I'm at a loss as to what this could be - can you advise?  I'm 35 year old female. Thanks.",
    "doctor_response": "Thanks for your query. Professionally I ama sspecialist dentist.with your query you have not mentioned whether you have post nasal drip or maxillary sinusitis which can also be a cause what you have could be a pharyngitis which needs an antibiotic coverage with warm saline gargling. Better to consult your ENT specialist take his opinion and after plz consult dentist if necessary please check whether do you have any posterior teeth infection",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can staph infection in the spine be treated?\n\nmy wife is being treated for staph infection in her spine. part of the treatment is cefazolin injections 3 times daily which also includes a heparin injection at the end of each treatment. we had a call from the home health pharmacy that her last blood tests showed a elevated level of potassium (message several hours ago) the person calling was asking if she had problems urinating or felt dehydrated, both are no, but this person seemed concerned to the point that if she was having problems we should go to the ER . Now it is after hours for me to talk to her or our primary or infectious diseas Drs. With no symptoms do we have an immideate concern. I understand that the antibotic and heperan both will elevate the potassium levels. Any professional advice?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. There is nothing that needs to be done emergently.  However, it would be a good idea to verify this information with your primary doctor and also for your own edification to know exactly what those potassium numbers are since slight elevations are generally meaningless and can be as easily attributable to laboratory error of equipment.  Or they could indicate something in the way of need to make adjustments to medications or levels of hydration, etc.  If you'd like to upload a copy of your wife's laboratory results I'd be happy to look at them and give you a preliminary opinion on the status of that particular lab. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dull pain beneath scalp ?\n\nLately I get twinges of dull pain beneath scalp that are about a 2 in pain that get my attention Upper right back side of my head, it is really weird . I dont get dizziness, or any lightheadedness. My vision is fine. It somewhat is nerve pain I suspect? But with a family history of alzheimers it is getting my attention. Sometimes it is tingling dull pain.",
    "doctor_response": "Hello, That makes sense. Cannot say in your particular case, but generally, pain follows a particular pattern for what is involved and the pattern implies what is wrong. One patch of scalp wouldn't necessarily fit with a common problem. AND, the top nerve of the spine in the neck runs up the back of the head. This is a common nerve to be pinched. neck x rays would confirm it. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intense pain in the upper right thigh radiating towards buttocks?\n\nI ve been experiencing pain in the upper right thigh going into my buttocks for some time now. The pain worsens the longer I sit. Just came off a 5 hour flight from the West Coast to the East Coast and it was not fun. I do a lot of sitting for work and I ve noticed this issue for several months. Walking also gets affected. Any ideas of what this could be?",
    "doctor_response": "Hi...I read your concern...I feel like your pain is radiating from back and not from thigh...I do feel it could be due to disc irritating the nerve or vertebral column covering sheaths...Nothing to worry.. as this has a very effective treatment and excellent recovery.. If I were your treating doctor I would suggest you...to do..Lot of icing.. frequently\u200b...Spine extension exercises twice daily..cobra stretch more frequently like 30 rep in 6 days in a day...Core stability exercise..Glute stability exercises...Kindly revert back after 2 weeks with progression to guide you further in this regard...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can liver damage or thyroid cancer cause higher AST level?\n\nHello, I have had SLE for at least 18 years, probably since I was younger as a teenager. I have just been diagnosed with Papillary Carcinoma. Two tumors, each less than 4cm. My AST level is elevated to 73... Is is more likely that it is Lupus-related liver damage... or metastatic thyroid cancer?",
    "doctor_response": "Hi thanks for contacting HCM...I really appreciate knowledge...Yes here the mentioned two possibility rule out first...1.SLE is Multisystemic disease so can affect liver ...lead to fibrosis or necrosis....2.Second papillary carcinoma via blood may spread to the liver....So liver biopsy done to rule out above two cause....If above two cause not present then there might be fatty liver or gall stone like condition ruled out by USG ...If you have myositis like muscle problem then also it can raised...Temporary cytomegalovirus like infection also can lead this....Take care....Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pcod, regular periods after taking ovacare forte, miscarriages, taking folvit, loprin 75mg, irregular periods, trying to conceive\n\nhi i have pcod because of which my period was not reguler dr prescribed me ovacare forte,then my period was reguler ,i got pregnent 2 times but had misscarriages in nov&dec 2011,i was also taking folvit .i got my blood test done my anti beta 2 glycoprotein antibody screening is pasitive dr ask me to take loprin 75 mg ,ovacare forte ,folvit &try for pregnency.i am taking these medicins for the last one month but my periods are not reguler&we are also trying for baby,my question is do you think my period is now irregular because of loprin 75 mg ?pls reply i m very much tenced .........",
    "doctor_response": "Hello. Thanks for writing to us. Loprin 75 is not likely to cause any irregularity in your periods. The mild irregularity is likely to be due to hormonal disturbance. You need to watch and try for at least six months to have a successful conception. Please do not worry and continue with your treatment. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take lisinopril for high blood pressure?\n\nI have been taking high blood pressure tablets for two months, bendroflumethiazide, not nice, then lisinopril, cough, emotional derangement, and I'm scared, what do I do now.   I am not doing the interesting social things I used to, can't attend groups etc because I feel lousy.   Can I stop medication and start all sorts of other things, acupuncture, allistrol, already in gestalt therapy, walking every day etc.    My blood pressure was 226 and I have never heard of such a high measurement.  I'm scared to stop medication but hate it.",
    "doctor_response": "Hi ThereBlood pressure above 200 is a medical emergency and yours were 226, its definitely a very high Bp that could cause damage to organs like BRAIN, KIDNEY etc causing disability. Stopping an on going medicine that is keeping your BP under control is not advisable at all.If you are not feeling good while on LISINOPRIL you can personally consult your doctor regarding your options to switch to other anti hypertensives.DO NOT stop your medicine. Anything else you wanna try like acupuncture you can try that.Wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dental problem\n\nHi . Im a 18 male. When I was 11, I got braces for four years. During the treatment, I had two premolar on my top side removed. When my treatment ended, accouple months later I noticed that i can only touch the left side of my teeth top and bottom. I took the initative to talk to an ortho about my teeth. i sowed him pictures and he said I have a bilateral posterior open bite. He did not say i need braces or what or what kind of appliances I'll need. I want to know if I need metal braces again. How long do you think it will be and what other appliances I need.",
    "doctor_response": "Thanks for your query, I have gone through your query. the Posterior open bite has to be treated again with braces. the duration of the treatment may take around 1-1.5years. consult a orthodontist and take one more opinion and redo the treatment. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for skin rashes and itching\n\nHello,  My granddaughter is seven yrs. old has a rash in both arm pits and behind the knee.  Heat  brings it on and so does swimming in the lake.  After swimming it was so bad her face swelled up and the itching is horrible.  Please advise.  Thank you",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. If I were your treating Doctor for this case of rash, I would come up with two possibilities, these include: The first possibility is of Sweat rash. Diagnosis can be confirmed by dermatologist and appearance in time of heat wave.  To help control the sweating ,you should use Nyacin or other powder to affected areas.The second possibility is of chlorine water in the swimming pool as it may cause allergy, dry skin, itching. I suggest-Antihistamines-Cetrizine 1 tablet once a day for 10 days.-Before swimming take shower and apply oil for protection skin and hair, after swimming take shower and apply moisture cream.  Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can G6PD causing fever, vomiting and jaundice be home treated?\n\nmy husband has g6pd he is 47yrs old African American. he has gotten to a point of not letting me take him to the hospital where he used to get IV fluids to aid him through the episode. He no longer wants this due to the med bills. me question is what can I do at home to help the vomiting? the hemolytic crisis lasts about 4 days. first a fever then vomiting and jaundice with amber urine. he makes it thru but its so hard on him....any words of advice? all he will allow me to give him is Gatorade or 7up",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I canWell, jaundice is just a sign and not diseases, and treatment depends on exact cause.Jaundice is usually sign of certain liver disease and high bilirubin value.  Causes of jaundice vary from non-serious to potentially fatal. Levels of bilirubin in blood are normally below 1.0 mg/dL (17 \u00b5mol/L) and levels over 2-3 mg/dL (34-51 \u00b5mol/L) typically results in jaundice. High bilirubin may be due to liver diseases such as cirrhosis or hepatitis, infections, medications, orblockage of the bile duct In the developed world the cause is more often blockage of the bile duct or medications. Blockage of the bile duct may occur due to gallstones, cancer, or pancreatitis. Medical imaging such as ultrasound is useful for detecting bile duct blockage.Treatment of jaundice is typically determined by the underlying cause. If a bile duct blockage is present surgery is typically required, otherwise management is medical.Medical management may involve treating infectious causes and stopping medication that could be contributing. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to have Allergex for allergy and sinusitis?\n\nHi, I have secondary Pulmonary Arterial Hypertension to Congenital Heart Disease, treatment I am currently on is Revatio (Sildenafil) 40mg, Digoxin 0.0125mg, Warfarin 5mg, Lasix 40mg, Slow-K, Puricos (Allopurinol) & Xanor 0.25mg (Xanax - Alprazolam) daily. I recently have been suffering with severe allergies due to dairy products & sinusitis and was wondering if it would be okay for me take Allergex to relieve some of the symptoms I have as a result",
    "doctor_response": "Hi,If you have any allergic symptoms with sinusitis then antiallergic drugs will be required with treatment of sinusitis.Your PAH and CAD treatment should be continued as per your treating physician.What kind of allergic symptoms are there? What symptoms you are having from sinusitis?You must consult ENT specialist for clinical examination and get treatment from him rather than taking self medication.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "suffering from back pain. Had a fall, taken physiotherapy. What should be done?\n\nthank u doc,my son ,27 yrs at present in states had a fall from 10' balcony and some l3-l5 small problems. had treatment from quilon& amrita institue and after that he was having some backpain occassionaly.now he is travelling back on 20th and again some severe pain started.he had physiotherapy  courses there. after his return, what v should do for him?",
    "doctor_response": "Hi,Thanks for posting your query.From descrition it seems that your son had injury over back and now he is on Physiotheray. As it looks like muscle strain, I suggest-Avoid lifting heavy weights and forward bending activities. Use a lumbosacral back support. Give rest to the injured part and do not involve in activities which puts additional strain on the injured tissue.Applying muscle relaxant gel and doing hot fomatation will be helpful to relieve the spasm. He can take antiinflammatory drug like ibuprofen to relieve pain and inflammation.Hope this will helps you. Feel free to ask me if you have any further queries. Wish you good health. Take care.Regards.Dr Saurabh Gupta.Orthopaedic Surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for enlarged prostate and frequent urination\n\nI have an enlarged prostate and have more frequent urination than normal. I do take medications like Avodart and flomax. Lately I have experienced periods of pain and stinging at the tip of the penis, as if there were some sort of kidney stones that are stuck there and even when I urinate the pain is still there. What do you think this might be and what can be done about it",
    "doctor_response": "HelloThanks for query,You have voiding urinary symptoms due to Enlarged prostate.and have been taking Dutasteride and Flomax.Ideally you need to evaluate the grade  of enlargement of Prostate and decide the mode of treatment which depends upon the severity of symptoms and symptoms scores .Please consult qualified Urologist for clinical and digital Rectal Examination and get following basic tests done to decide further line f treatment .1) Urine Culture and Routine Urine test 2) Ultrasound Scanning of abdomen and pelvis with specific mention of post void urine residue 3) Uroflowmetry.He may decide the mode of treatment whether to continue with medicines or go for Endoscopic resection of prostate (TURP)Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes left side upper abdominal pain and numb left arm?\n\nI am female 22 in which i have left side upper abdominal pain just near my ribs ...not bad pain but uncomfortable at times sharp but throbbing faint type of pain sometimes nausea to. Could u tell me what this could be. Sometimes left arm feel numb ? Thank you",
    "doctor_response": "Hi,Thanks for writing to HCM.That is mostly due to gastritis. Take a course of antacids like omeprazole or pantaprazole and see, it it improves then continue it for a month.Regarding your numbness in arm, that can be due to compression during sleep or work or due to vitamin deficiency. Maintain a good posture during sleep and work and eat healthy and balanced diet. Avoid tea, coffee, soda drinks and spices.RegardsDr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause and treatment for constant hair fall?\n\nDEAR SIR/MADAM,I AM SUFFERING FROM CONSISTENT HAIR LOSS SINCE 2 OR 3 YEARS AND MY SIBLINGS TOO, THOUGH MY PARENTS HAVE HEALTHY HAIR, I DO NOT FEEL THAT IT IS HEREDITARY.  WHAT CAN BE THE CAUSES?IS THIS IS SOMETHING RELATED TO DIET OR HYGIENE?PLEASE ENLIGHTEN ME.",
    "doctor_response": "Hello,Thank you for posting on HCM.I appreciate your concern regarding hair fall. Hair fall is usually ascribed to multiple factors like diet and nutrition, hormones, stress, acute or chronic medical conditions,drugs,cosmetic products etc.Since you have not mentioned relevant history and description like sex, pattern of hair loss(patchy/diffuse), family history etc, its difficult to put a definitive diagnosis. Still, it seems you are suffering from either Androgenetic alopecia (due to hormones and genetically determined) or Telogen effluvium (Due to any recent stressful event or any other medical condition)If i were your dermatologist/trichologist, i would like to take through history including family history, history of recent major trauma /illness/ stress/ medications etc, your menstrual history and recommend some basic investigations like CBC,blood sugar,Thyroid function test.Also some other special tests like trichogram and dermoscopy can aid in diagnosis and prognosis.I would suggest you a course of oral tablets containing biotin and other essential vitamins and minerals (Tab. Follihair new) for minimum 6 months. Also, would put you on solution containing 5%/10% minoxidil once a day and a hair serum/gel containing peptides for hair growth at night.(Q sera, Grocapix etc). I would advise use of gentle shampoo and conditioner on regular basis and use of coconut oil twice a week.Also enquire from your dermatologist about upcoming treatment options like mesotherapy and platelet-rich plasma.Avoid combing in wet hair and let them dry by wrapping in towel. Avoid blow dryers and hair-color/dyes. Take plenty of fresh fruits and vegetables in your diet and try to de-stress your routine life.Hope your queries are resolved and wish you best of health.Thank youDr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Non-itchy white ring like patches spreading over the body. Darker skin inside the rings. What are these?\n\nHi, I m a 17 year old girl with a perfect medical history. I have rings all over my abdomen that look like white rings compared to my skin color. They resemble cheetah spots. They are starting to become more frequent and spreading to my sides and on my legs. It he spots aren t painful or itchy. The skin inside the rings appears darker. Do you know what this could be or give any advice about it?",
    "doctor_response": "Hi,There can be possibility of ringworm infection or fungal infection in yourself. The only precaution you must follow is not to touch, pinch pop or squeeze any of them other wise it can get infected and can cause complications. You can apply clotrimazole cream and can take by mouth the antihistamine Loratadine or levocetrizine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes runny nose and blood in mucus in a 5 year old?\n\nHI My child is 5 year old and he has regular running nose problem.Is there anything serious about to care of.He was suffered with degue maleria fever few months back and recovered in few days.Today while he was snizzing there was some blood in the mucus.",
    "doctor_response": "hi, most probably your child is suffering from upper respiratory tract infection. send the child has running nose it suggest that child has exposure to home cold temperature. You should take some precautions to prevent cold in children like avoid coldwater, cold drink, ice cream, put warm clothes at night. you should also give cough syrup like syrup Sinarest 5 ml 3 times a day for 3 days. If there is no improvement in 24 hours, then you should get the child examined by a doctor. if there is fever, respiratory distress, vomiting, then also you should get the child examined by a doctor. I hope this will help you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can lactogen intake in new born cause any problem?\n\nHi Dr I am unable to feed my baby properly since his birth due to nipple eczema. .It is really painful when he sucks. .so started giving lactogen1 from the very beginning..as the days passes my nipple is becoming much worse...so use of lactogen1 has increased and breastfeeding is reduced to 1 time per day that too by pumping .so please tell me the giving lactogen1 for 2 month baby causes any problem and also please tell me how many times per day lactogen1 can be feeded to 2 month old baby...",
    "doctor_response": "Breast feeding is best for baby. Get your eczema cured and start feeding.. Lactogen 1 can be used as substitute but only when used properly. Prepare the milk by adding 30ml water to i scoop of the powder, maintain this ratio when preparing milk. Try to feed with cup spoon, as the nipple of the bottle are notorious to cause infection. If bottle is used boil the nipple after every feed. Lastly always discard any left over milk... you can give Lactogen as many times as you want only depending on the demand of the baby.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high blood pressure?\n\nHi, I went to the doctor today and had a BP of 160/100 so I was looking into possible causes. I read up on Cushings  and I fit many of the stereotypes. Overweight, acne, hump on back of neck, easy to bruise, bad sleep patterns, depression. Do you think it is possible I have Cushings?",
    "doctor_response": "Hi, Thanks for your question. After going through your question, I can understand your concern. For better opinion, I would like to know - - Your age and gender. - Family history of high blood pressure. - Family history of obesity, diabetes. Though most of your features fits into criteria of cushing's syndrome you need to know following things - - Essential familial hypertension is most common cause of high blood pressure. - Features like those in cushing's syndrome may present in other disorders like insulin resistance or any drug use also called as psudocushing's. You should consult your physician for detailed clinical examination and if required there may be need for consultation with endocrinologist. Following investigation may be helpful for diagnosis and management. - ECG and 2DEcho of heart. - Renal function test. - Ultrasonography and Renal artery doppler. - T3,T4, TSH. - 8am cortisol. - Other basic lab test like CBC, Liver function test, urine examination. Depending upon clinical evaluation and above test results need for evaluation for cushing's can decided. Hope this helps you, if so do vote.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are pain in the jaw and refracted eardrum related?\n\nI have been having dental issues which have just been determined to be two fractures in tooth #18 (molar), left side of jaw. There is infection and as a result, boneloss. When the pain in the mouth/jaw began, the dentist indicate I have been clinching and is building a mouth guard for me. The pain permeated up into the left ear. I saw my GP who diagnosed me with a retracted eardrum. Could these be related and do I have cause for worry. I have more pain in the ear then the jaw. I am scheduled for a root canal in the next few days.",
    "doctor_response": "Any pain due to injury or deep cavities in both the jaws can cause radiating pain to eat. Have you had any surgery for fracture of lower jaw?if there is pain due teeth it will be resolved by using oral guard to some extent.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shortness of breath and burning chest\n\nI cleaned two days ago with bleach in all the rooms of my house, last night and today i have had burning in my chest, i cant smell anything and shortness of breath, sometimes it makes me feel as if im going to pass out. Is this something i need to go to the er for to get checked out?",
    "doctor_response": "HelloAll  these symptoms , chocking ( shortness of breath ) and burning sensation are due to irritant nature of ammonia produced by bleaching .Since two days ago you cleaned your house and still symptoms present so take some steroid inhalation 2 puffs 2-3 times and stop . This will relieve congestion caused by bleach.Burning of chest will also be  relieved by this but if you feel burning in chest then take antacid ( containing oxetacaine ) and this will provide complete relief.In my opinion this is not case of E R just annoying .",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long to put drainage tube while doing pancreatectomy?\n\nI am scheduled to have a distal pancreatectomy, Splenectomy, and cholecystectomy in two weeks. There are two tumors on my pancreas, and they are planning to remove the lower part of my pancreas. I have been told the surgeon will put in a drainage tube. How long will the drainage tube have to stay in? What is the procedure to remove it?",
    "doctor_response": "Hi.I understand your concernsA drainage tube is placed when there is major surgery like opening the abdominal cavity,to drain any blood or other fluid that collect in the cavity. The drain is removed when the blood or other liquid stops coming out of the tube,it usualy take one week.Wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are cyst, related with swollen jawbone and cheeks?\n\ni have what feels like a ball inside my left cheek right above jawbone. i started to notice swelling,   went to see oral surgeon and clinically you cant see anything, u can only palpate it, i have no other symptoms other than the swelling.  no pain...doc put me on keflex, but i feel like i need a ct scan or something..maybe its a cyst??",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain it seems that a ball inside the cheek that is present above the jawbone and there is no pain can be due to overgrowth of fatty tissue leading to formation of a Lipoma..It is a painless ad harmless overgrowth of fat cells in the area leading to formation of a painless lump..It can also be a benign muscle tumor or a cyst..It does not seems like an infection, therefore taking antibiotic like Keflex without confirmation of the cause..I would suggest you to consult an Oral Physician or a general physician and get evaluated and an x ray or MRI SCAN can be advised to confirm the diagnosis and treatment can be done according to the cause.. In case of a lipoma or a muscle tumour surgical removal can be done..If at all it is due to infection then antibiotics will help in its regression..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe pain in the legs, knees and hands\n\nI have severe pain in my legs, knees, hands and arms. My legs, feet, breast and hands swell so badly that I can see fluid pockets and my legs and feet begin to look deformed. The pain gets so bad that I cannot walk up stairs with the pain being worse at night. My chest gets tight and I get out of breath easily. I do not understand what is happening to me. I have suffered from anxiety disorder for 19 years and this is not anxiety. It has been 9 months and getting worse as daily activities become harder. My muscles in my hands are becoming weak and having trouble even opening a bottle. My legs turn a bluish color. I have tried Motrin up to 800 mg and Tylenol. I even bought compression gloves and socks with no relief. In addition, my vision gets blurry and sometimes experience dizzy spells. I do not drink or smoke. 44 yrs old and was healthy until this started. I m so confused and need help for what I should do.",
    "doctor_response": "Hi, Most probably it can be a simple musculoskeletal pain. As a first line management you can try analgesics like Tramadol or Aceclofenac for pain relief. If symptoms persist you can consult an orthopedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should I do after a dog bite?\n\nthe pet dog of our home has bitten me on my finger today all of a sudden while it was playing with its biteable item, I was sited just behind of it. The Dog is of 6 months plus age, Rabies vaccine was pushed a month ago, Blood came out after its bite from a small bite-injury, What should I do now?",
    "doctor_response": "Dear Friend.Welcome to HCM. I am Dr Anshul Varshney. I understand your concern.Since your dog has been not vaccinated fully, i would advise you to get vaccination.Take full course of rabies vaccination.Take Tetanus vaccinationClean and take care of wound properly.Get your puppy completely vaccinated.This is my personal opinion for you based on available details. If you have any further query please ask me.Stay HealthyDr Anshul Varshney, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shrinking of gallbladder?\n\nmy ultrasound came back negative for stones in the gallbladder.  however, the gallbaldder is smaller than it was a month ago during my first ultrasound. i also have two polyps about 5 mm and 6mm respectively.  what could be making my gallbaldder smaller and should i get it removed b/c of the polyps?",
    "doctor_response": "Hi and welcome to HCM.. I thank you for posting your query here and I'm definitely going to help you out.. I being a surgeon, we encounter so many such cases day in and day out.. I read your question completely and have understood it well enough. I will analyze all your points and provide necessary explanation.. 1. You say your report came back negative for stones! Meaning, you had stones?? As far as my experience of 12 years goes, gall bladder stones once they come, they stay.Unlike Renal stones, they do not pass down the tract. So, either.. A. The 1st report is wrong B. You need re scan.. All this is in case you have had earlier scan which said gall bladder stones. 2. Gall bladder shrunken has no clinical significance.. Some Radiologists report this. But as a surgeon, there's nothing to worry for this finding. As long as gall bladder functions, we don't have an issue out of this.. So chill, do not worry.. 3. Polyps of 6 and 5 mm should not bother you again. Generally, in size more than 1 cm or some say 2 cm and associated problems like A. Diabetes, Uncontrolled B. Along with stones which is symptomatic like pain C. Episodes of infection like cholecystitis These need surgery.. If you are fine without fever episodes, jaundice and pain then do not worry.. We can follow up with regular scans, may be once or twice a year.. Hope this helps you, in case you need any further assistance, please let me know.. Take care and God bless.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can lesion on the kidney be treated by medication?\n\ni have got an evidence of lobulated isodense well enhancing solid lesion of size 23mm(AP)*23mm(TR)*21mm(CC) on the mid pole cortical parenchyma on the left kidney but doctor has advised me to remove the affected kidney so as to avoid any further growth..i have got no idea in removing so it is curable with some medication or no other option other than removing..please help me..if possible i ll mail my reports if u r intrested to see it....",
    "doctor_response": "Hello and welcome to HCM.As an Urologist, i must advise you, that the description you've mentioned, is similar to that of a ? tumor. Only a biopsy will confirm it.A surgical treatment of removal of the tumor alone, with surrounding area of 1 cm may be enough.  Rest of the kidney may be left there.No medication.If you can send me the scan reports with scan, i can confirm this. Also send me the blood reports,your age,and if any other medication is being taken.Send them as a direct question in my name for an expert opinion.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment do you suggest for symptoms of prostitis ?\n\nI'm 6 months pregnant and my husband is experiencing symptoms that seem to be prostitis. He is also having some mild sweating at night. I've been diagnosed with a uti by my OBGYN and I'm on antibiotics. Is sex putting baby at risk? He can't ejaculate right now. He says it itches really bad when he tries.",
    "doctor_response": "Hi prostatis is the just infection of the prostrate gland.i do not think it effects the baby .it is just treated as uti.as u are also suffering from uti .both of u should use ofloxacin 200 mg twice daily for 5 days and taking cital liquid twice daily until pain subsides.once infection is subsided he can ejaculate easily",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and pain in arm.\n\nhi, my nephew is around 4 year old. he is suffering from sever pain in his left arm. even he is not able to move it from last 3 days. but when we give pain killer he is able to all the motion till 3-4 hours. and then again pain attach on him and he stop doing motion. we have done some test like X-ray , blood test, nerve specialist but didn't found any clue.... please  he has been suffering from fever also from last week we had go for test like malaria , typhoid  etc but that also not any result doctor say its viral fever.give some suggestion its important....my e mail Id YYYY@YYYY",
    "doctor_response": "Hi,Thank you for asking question on health care magic.from your history it appears he may be suffering from viral myosistis.It will pass off in due course.Pain killers will cut down pain,hence manage with pain killers till the inflammation subsides.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for boils around the lower abdomen region\n\nSuggest treatment for boils below my belly button Hi I was wondering wondering what's causing me to get boils below my belly button kind of near my ... the ingrown hairs cause I don't shave sometimes I use a buzzer but I'm not too sure what it is: can help m",
    "doctor_response": "Hello dearWarm welcome to Healthcaremagic.com I have evaluated your query thoroughly .*  This is in relation with infected boil  from various type of organisms .*  Suggestions for better recovery-  Keep the part clean with antiseptic liquids , apply clotrimazole ( 1 % )    dusting  powder  3  times  a day .-  Keep blood sugar under control .-  Antibiotic  assistance  with  your  doctor  according  to  the  clinical   evaluation .Hope this will help you for sure .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a heart murmur ?\n\nI have been healthy all my life,  recentkly I haver been having edema in my ankles so a few weeks ago I went for the f=irst time to  an internal medicine dr.  he  said hears a heart murmur  thru his stethoscope no dr ever told me that before and so  a week ago  i went for an echocardiogram  and Monday a liver ultrasound (i have hep c)   which I have not heard back about yet . what causes a murmur is it a serious thing? should I get another opinion. I don't like this dr, he won't do any meds for the edema except tell me to ear compression stcokingas I am NOT an old lady and don't wanna spend my summer in old lady stockings.",
    "doctor_response": "Any noise produced by the pumping action of the heart is called a heart murmur. It can be benign, as in my case.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can back pain be the symptom of ptb?\n\nI have a ptb history, I go for six month medication as prescribed my pulmonologist, he said that i have a minimal ptb. After i take medicine for six month i go for 3 time sputum test and all the result is negitive, i feel pain in my back sometime,ist normal? Because my pulmologist said that this pain is not related to my ptb and also he said this is only my imagination, pls. What is the best thing i can do,thanks a lot",
    "doctor_response": "Thanks for your question on HCM. In my opinion you should not worry much for pulmonary tuberculosis. As it will not cause back pain. Rare possibility of spread of tuberculosis in spine. And this can cause back pain. But chances of these are very very rare.There are other causes too, for back pain. Like osteoporosis,  spondylitis etc.So better to get done x ray of spine. And consult orthopaedic surgeon. But no need to worry for pulmonary tuberculosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair loss with itchy and dry scalp\n\nI have really horrible head hair loss, especially when i take a shower and I m shampooing I always tend to scratch my scalp so that I make sure my scalp ends up extra clean, but I don t know if it s really working. Aside from my terrible hair loss, another downside is that it s more difficult to maintain healthy long hair. I feel like I can t grow my hair anymore. My hair strands feel incredibly dry and my scalp feels really itchy during the day. And, I ve also noticed that I have like this white build up substance like powdery stuff all over my scalp too which gets all over my shirt if I scratch. Please, help?",
    "doctor_response": "Hello and welcome to HCM You seem to be suffering from a case of seborrheic dermatitis or dandruff of the scalp along with hair fall. Capsules and hair oil can be started to reduce hair fall and help new hair growth. But the cause of your hair fall must be treated first.For the dandruff, please continue an antidandruff shampoo regularly at least twice a week, such as Arcolane or Nizoral.  The shampoo must be continued atleast once weekly even after healing, to prevent it coming back, as your skin is oily and prone to dandruff. It is your skin type and it may reduce with age. Avoid oiling scalp or applying gels, styling products. Keep hair clean and dry and try to avoid pollution. it may also be affected by weather/climate change etc. The white powdery stuff is due to scalp flaking and build up of oil due to dandruff, so use the shampoo regularly.Start with this treatment. Be sure to re check with a doctor regarding the improvement in few weeks, to advise regarding further treatment.Once the dandruff clears, hair fall will also reduce. And treatment for hair fall and growth can be started. You will need a multivitamin capsule like Follihair or Biotee daily. Apply Tress Gro hair serum at night to scalp. Use a good shampoo like Anaphase or Renocia. But first treat the dandruff and continue the antidandruff treatment atleast once in 7-10 days.Oiling the hair may be done only before bath for about 30 mins and wash off. Eat a nutritous diet and get rest. avoid stress. Any other illnesses, medication, low iron, thyroid disorders etc can also cause hair fall so check if necessary.Hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for loose stool during teething\n\nHELLO SIR MY CHILD AGE IS 2 YEARS...NOW HE IS SUFFERING GUM MOTIONS FROM LAST 3 DAYS ONWARD..PL TELL ME GOOD SYRUP OR TABS...NOW WE R USING WALAMYCIN AND ORS REGULARLY...BUT STILL GOING GUM MOTION 4 TIMES R ABOVE PER DAY...PL TELL ME GOOD SYRUP R TABS SIR",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. You need not worry unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting.There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic-associated diarrhoea.I suggest you use zinc supplements (Z&D drops once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron (as prescribed by your pediatrician).Hope I have answered your query. Let me know if I can assist you further.Regards, \u00a0\u00a0\u00a0\u00a0\u00a0Dr. Sumanth Amperayani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach pain\n\nHi, may I answer your health queries right now ?  Please type your query here...I have been on femulan for about 4 years by periods was every 21 days till mid feb but with only small amount of bleeding.since mid feb had no bleeding but stomach ache just before my 21 day period done a test to see if I'm pregnant which was negative is this normal. I'm 36 years old",
    "doctor_response": "Hi.Thanks for your query.Read and understood your history of taking Femulan, 21 day cycle of period, small amount of bleeding. No bleeding since mid-Feb, but there is stomach pain just before 21 day period is done. Pregnancy test is negative.This is obviously not normal. There may be a hormonal cause. I would advise you the following:Hormonal studies.Consult a Gynecologist for an internal examination.Abdominal and per-vaginal ultrasonography All these tests will help you to get a proper diagnosis and a plan for treatment, and you will be fine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can ejaculating outside vagina cause pregnancy?\n\nsorry my name is jhon and i just wanted to know that \u00c3\u00bdesterday i had a sex with a gril but we didn't do it i didn't put my thing on her it was out side and finally i was under and she was above me and when i finnished my sperm was on my stomach and the when we get up some of my sperm was on her vagania and after 5 to 10 minutes we went to the shower and took a shower.and i am afraid that will she get pregnent if my sperm is on her vagania.",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the chance of pregnancy is very rare in your case.Usually there is chance of pregnancy when semen is ejaculated inside or around the vagina during the fertile period.But in your case nothing such happened.And very less amount of semen got touched near the vagina which was washed off later.So this resulting in pregnancy appears very rare.So relax.Avoid stress.Wait and check for the period.Hope this helps.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take Citrazine post DNS operation?\n\nSir I had gone through DNS operation one time but all is vain I use to take one citrazine daily if I don't there will be continue sanizzing and water in my nose and slowely 2 cause difficulty to breathing ans slowly 2 headache and start eye blow with tears and eye and nose got heavy sir I m suffering from it last three years but nothing is parmanent solution pls tell a effective treatment sir pls pls sir",
    "doctor_response": "cetrizine is anti allergic if it works itmeans you are allergic to somethingthe answer to your first question is yes you can take cetrizinethe answer to second question is  for permanent cure you need allergy tests and sublingual immunotherapy as the traetment of allergy will help instead of operations",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should I do for the High creatinine levels and high BP having diagnosed with ADPKD?\n\nI am a 65 year old female with ADPKD. My creatinine is 176. My GFR is 26. Uncontrolled hypertensive mainly due to medications that don t respond. Average BP is 170/95. Otherwise I feel well. I have been given different advise from different nephrologists. What should I do?",
    "doctor_response": "HiThanks for your queryThere is currently no medical therapy available for ADPKDHowever if you control your blood pressure to If you could list out your current medications, we would be able to make recommendations regarding their doses or the need of any add on therapy.Mean while you could cut back on your salt intake to less than 5 grams/day.Hope this helpsGood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause clusters of red circles under the head of penis?\n\nclusters of little red circles? on or just under the head of my penis. they sometimes have dry skin covering them which i peal from time to time. They dont hurt or burn unless i have just finished masturbating. Is it hpv? Syphilis? Herpies? Possibly something else? I will get a blood test done soon but i have heard there is no test for hpv is this true? I have had this for 4 months and it has gone away completely for a month but them come back with a vengeance. My doctor says it may be psoriasis because i suffer from it and eczema all over my body but i think its different considering it stays in that general area.",
    "doctor_response": "Brief Answer:STI or inflammation following a trauma during rough sexDetailed Answer:Hello dearI had gone through your question very diligently and I can understand your concern I see such patients in my clinic routinely and I will definitely help you as well in best possible wayLooking at your history  this could  be STI (sexually transmitted infection) or inflammation of penis due to rough sexI would advise you for a battery of tests like blood for hemoglobin CBC liver and renal function test blood sugar urine culture and sensitivity test and swab culture from dischargeyou may require a course of antibiotics under supervision of your doctorTo help you better I would like further information likeany recent exposure to unprotected sex?since how long you are having this problem?Meanwhile please follow these guidelineswash it with antiseptic soap or solutionsapply antiseptic ointment like mupirocinmaintain good hygieneWaiting for your replyFollow up questions are most welcomewishing you rapid recovery and good healthRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for back pain due to bone tb?\n\nmy wife feel pain at her back side, we alreay met with a doctor but he said that she had a bone tb problem and have to do a operation for that we gone to vllore but still she feel bad and agian she is feeling the same problem. what we have to do now please suggest me",
    "doctor_response": "Hello, After surgery for bone TB.We give about 18 month course of anti tubercular treatment. If bone tuberculosis had affected your joints of spine and there are degenerative changes at spine then pain may persist there. For this one may have off and on analgesic treatment. You may discuss this with your doctor. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mukesh Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for mid and lower zone left lung pneumonitis\n\nour doctor suggest for skin biopsy.so we do.result is boderline lepromatous hansen's disease.we are not satisfied so we are going for another suggestion.the second suggested for another few test. LD BODY(AB CELL)-report in negative. ESR-report is 30 mm at the end of 1st hour(method-sysmex xe-2100'/'sysmex xt-2000i'/'advia 2120' cell counter) ACE-ESTIMATION-report is 182.1u/l. (method-kinetic) SKIN SMEAR FOR AFB FOR EFFECTED AREA- report is negative. CHEST X-RAY PA VIEW-report is the mid & lower zone of the left lung pneumonitis. Now we are very confiused. Please Suggest",
    "doctor_response": "Hello,Skin lesion with lung infiltration seen with connective tissue diseases (CTD) and pneumonia. So better to consult pulmonologist and get done ANA (antinuclear antibody) titer and profile to rule out CTD. Get done CT thorax and bronchoscopy for pneumonia. You may need antibiotics if it is pneumonia. You may need immunosuppressive therapy if it is CTD. Hope I have answered your query. Let me know if I can assist you further.Regards,       Dr. Kaushal Bhavsar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does noncoronary sinus of valsalva prominent in CT scan mean?\n\nHi doctor, I have had a CT scan with contrast and they found this: The noncoronary sinus of valsalva is prominent. At this level, in the coronal plane, the aortic root measures 4.0 cm in diameter. What does this mean and should I do anything about it? I am 37 years old male, exercise a lot. Resting pulse is 45. My father died in the late 40s of heart disease.",
    "doctor_response": "Hello. Your aortic root is mildly dilated. If you do not have any other systemic diseases like any diagnosed syndrome like Marfans or Ehler Danlos etc., then this needs no treatment at present, but just observation. At this borderline dimensions, we just observe the patients and if it increases more than 50 to 55, then needs surgery. However, if it is genetic, then surgery is done at lesser dimensions. So, you will need regular follow up and 1 to 2 yearly CT scan to keep watch over the dimensions of the aorta. This could be done with echo as well. You should also have an echo if you did not have any. You should get yourself examined by a local doctor once to rule out syndromes. Also, mild to moderate exercises, avoid heavy activities like lifting heavy weights, etc. Avoid all addictions, if any. Low pulse rate is probably related to activities. Do you have any details about your father? You should try to search and if available will help in prophylactic measures.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump on neck indicate?\n\nHi there, I have a lump in my neck. It appeared when my pins and needles down my arm started. i have had a mri scan and the only thing it shows is that the lump appears as a shadow. It doesnt hurt. I now have to wait ten days for the results to go to my gp, then make an appointment with him to get an ultra sound. this has been going on since August. Could this lump be causing my pins and needles? Its at the back of my neck on the right hand side. Thank you",
    "doctor_response": "Hi.Thanks for your query and an elucidate history. The lump at the back of the neck can not cause a direct problem of pins and needles in the arm.It is possible that the muscle spasm caused by this lump can indirectly cause nerve pressure or pinching. Get FNAC done of the lump and the MRI should have been done to see if there is a protruding disc causing pressure on the spinal cord which causes the pins and needles feeling in the upper limb as you have. It is wise to get an opinion f a Surgeon for the lump and of the Neurologist for pins and needles sensation in the arm.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes squishy feeling around jaw line after getting teeth filled?\n\nI went to the dentis the other day and had a couple of teeth filled on the left side of my face. During the procedure the right side of my face felt heavy. I thought it was due to the nitrous oxide mask. After the procedure I realized that the right side of my face was swollen. That night my eyelid, below my eye, the side of my face, and close to my ear was swollen and it felt like tiny air bubbles were underneath the skin. I used ice every ten minutes on and ten minutes off for two hours with no change. Finally today, two days later my face and eye are back to normal. I still have a little of the squishy, air bubble situation around my jaw line, but not too much. What caused this?",
    "doctor_response": "Hi,Thanks for posting the query,     I WOULD SUGGEST YOU TO GET AN X-RAY DONE OF THE FILLED TOOTH AND LOOK FOR ANY ABNORMALITY, WHICH IS CLEARLY SEEN IF PRESENT, IF NOT THERE IS NO NEED TO WORRY.TAKE CARE!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back injury, legs and feet swelling, Itching. Using Laurika, Aterax, Tecta, Cymbalta, Eltroxin, Urosemide, Fentynel. Advice?\n\nI AM USING QUITE ALOT OF MEDICATION DUE TO SEVERE BACK INJURY.  MY LEGS AND FEET STARTED SWELLING IN EXCESS, WITH RED LEGS, FEET TO KNEES. AFTER 2 WEEKS ON ANTIBIOTICS, SEVERE SWELLING STTLED.  STILL SWOLEN FEET.  DR. ADVISED ME TO STOP ATHROTEC.  NEXT DAY ANKLES STARTED ITCHING, I EEL LIKE CRYING, CANT STAND THIS ANY LONGER, NOTHING HELPS !!!!!  TODAY I STARTED WITH DIAREE.I ONLY HAVE 6\" COLON, NO COLOSTOMY.  LAST YEAR DIAGNOSED FOR NON ALCOHOLIC FATTY LIVER.  PRESENT MEDICATION:LAURIKA  100MGATERAX FOR ITCHINGTECTACYMBALTA 60MGELTROXIN .05MGUROSEMIDE 40MGFENTYNEL 25MCG PATCH EVERY 3RD DAY",
    "doctor_response": "Hi, you are using many medicines due to severe back injury, feet swelling, itching, diarrhea.                            You are on medication for injury and pain killers usually cause swelling ofg foot, as there is itching as well it may be due to utricaria of foot also which also can cause swelling of foot.                            i prescribe to my patients with such symptoms  levocitrizine, and diuretic along with your regular medicines. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is this big blackhead on my nose of which water comes out when popped out ?\n\nI have something that looks like a big blackhead on my nose, but it is not a blackhead. I cant pop it normally so I take a sterile needle and pop it. Clear water comes out of it, and after a few days it comes back to the way it used to be before i poped it. What is this? How do I get rid of it? Please help I am a female, 20 years old. These kind of blackheads usually appear over summer, but this one remained. I know this isn t acne but I didn t know where else to put it.",
    "doctor_response": "Hello, Welcome to HealthcareMagic. It can be a sebaceous cyst. It is a small bump that occur just beneath the skin surface and is common on the face and upper trunk. It can be filled with a cheese-like or oily material as well. Placing a warm moist cloth (compress) over the area may help the cyst drain and heal. If the cyst becomes swollen, tender, or large, your doctor may surgically remove it. Hope it helps you. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning sensation in the tongue and lips after taking Z-Pak?\n\nHistory...had sore throat for couple weeks,  then chest congestion fever, body  aches and total weakness about 5 days. Cough and chestcongestion began at this time had already been on Augmrntiin for 10 days.  Dr. Said viral bronchitis, gave steroid, inhaler and med for cough. Between 2-3 weeks After dr. Visit cough and chest pressure got worse. Dr. Said X-ray machine turned off for day but it could be walking pneumonia and if conditions worsened or didn\u2019t improve in another 3 weeks to see family Doctor again. He gave me Z-pack and now 1 week later cough and chest pressure still bothersome. New symptom throat, tongue and lips are stinging and burning too. Also diarrhea much of this time, sometimes severe. Can take Imodium to control that, but how do I relieve painful tongue, lips and throat. Whew....hope this makes sense, feeling kind of miserabl.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.It looks like you have Apthous Stomatitis that is inflammation of mouth and tongue. It can be due to side effects of medicines like antibiotics that you are taking and along with it, stomach upset can also be a cause. You should start gargling with specialised mouthwash like Magic mouthwash. Suck Cepacol lozenges. Do cool water rinses and suck ice pops. Take Vitamin B complex supplements daily. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair loss\n\nI have thinning hair and my scalp is visible.The condition is due to Hormonal imbalance.I can't be treated for it.Can i use fenugreek on the scalp?will it stimulate hair growth?Age 30 years femaleHt 152 cm weight 61kg.on fertility treatment for last 2 years",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You seem to have Androgenetic alopecia.  It is characterised by thinning and hair loss from the front, mid and vertex part of the scalp, initially manifesting as widened part width in females and later as diffuse thinning in a honeycomb pattern. I suggest you to use Minoxidil 5% solution, 1ml, twice daily.  In addition insughest you to take an oral biotin and an oral antiandrogen e.g finasteride.  Topical minoxidil and oral finasteride are approved medications for Androgenetic alopecia. Treatment is long term and goal is to prevent further loss. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes legs to grow inwards?\n\nhello, i was wondering if you could help. My 16month old son has bowed legs. His feet are turning inwards when he walks. I took him to the gp and he was referred to orthopaedics at london guys hospital. They said that it was normal and would straighten by the time he turns two. I personally think it is getting wors. I massage his legs and feet everyday but i am not seeing any progress. People look at my son and everywhere i go i always get asked by someone who is being kind whether i give him vitamins or i have seen someone about it. I was hurt today when one child tried to copy how he was walking and he laughed. This is heartbreaking to see. Someone mentioned physiotherapy to me. D o you think that this is something i could try and look into. He is getting taller but i am not seeing any progress. thank you",
    "doctor_response": "Hello! Thank you for writing us here.It's a congenital deformity called pes valgus or club foot. Don't massage or go for physiotherapy because it won't make any improvement. It would require a minor surgical procedure for the correct fixation of bones and the recovery would be within 4 to 6 weeks. I highly recommend you to see an orthopedic surgeon for this. Physiotherapy and massage would fix the bone because I've seen few patients who used to massage their limbs and now they cannot move them properly. You can take your time and I highly respect your decision what to do next.Best regards,Dr Gunjan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could feeling of blackout, drifting off and hearing dead pet dog's sound while sleeping suggest sleep disorder?\n\nEveytime I fall asleep, I usually wake up 5 minutes later because I feel as I blackout and my eyes roll to the back of my head. My head now hurts and I felt like I was drifting and I could make a sound and I heard a sound of my old dogs voice who just passed away a month or two ago. Do I have a sleeping disorder?",
    "doctor_response": "HiThanks for using healthcare magicThis is called adjustment disorder. Sometime when we lose our love one, we get such kind of feeling while sleeping. There is nothing to worry about it. You can take some benzodiazaepine like zolpidem or clonazepam to get sound sleep. It would help you to get sound sleep and overcome from the problem.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does osseous structures are grossly unremarkable mean? I m a 22 year old girl who is having problems with doctors an hospitals no one can seem to get what s going on with me. Just about a year ago in mid fall I had to go to the er cause I had this very bad pain in my abdominal aria an they do a buntch of test an tell me that I have function ovarian cyst on my lift an right overy an that the one one there right side is about the size of a golf ball then on the left side I have more then on that s like the size of pirlse. They send me to a doctor for it who puts me on birthcontrl an to see if that would help my pireds an it did for a little bit until things got worse I was in so much pain it was bring me into tears then I was weighting at 109 an in less then a mouth I go down to 98 ponds so I end up going to the hospital an they do test an tell me that my cyst have got bigger an then they send me to a bgyon an she took blood an is doing test an stuff but tells me that its not cyst that its a kidney stone that is big an is trying to pass but could be to big to pass an I seen my xrays an now there saying that nothing is there. What could be wrong I stay in pain most of the time an I can t keep food or drinks down alot I just don t understand. An the pain is like a sharp stabing pain that s heard to go away. Sorry to make this so long I just really need some help an see what someone else thinks",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have ovarian cyst or kidney stones or some other cause.  You should go for ultrasound abdomen.  It will give you exact diagnosis whether it is ovarian cyst or kidney stones.  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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes allergic rhinitis?\n\nHi....I\u2019ve been dealing with constant heavy runny nose, sneezing and watery eyes. I\u2019ve taken Zyrtec and Sudafed. Sometimes it even makes me lightheaded and dizzy to the point of having to take Meclizine. Its been going on for months and only get relief a few days a month. Do you have any idea what could be causing this?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You should take tab Cetrizine as Zyrtec and Montelukast for allergic rhinitis. To avoid side effect as dizzy, you may use steroid nasal spray as Fluticasone. As these are prescription drugs please contact your local doctor he will prescribe these. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for frequent cough,chest infection and fever\n\nmy daughter get infected after every third week coughing chest infections fever etc. As suggested by the pedestrian chest X ray & montoux were examined & found normal all this is happening from last three years. Now she is 6 year old weighting 16 kg. & born as a pre -mature baby.",
    "doctor_response": "There are other reasons for repeated chest infection or repeated chest symptoms, first we have to establish whether it is infection or not. It could be allergy, like asthma. Do you have a family history of asthma or hay fever. Was she ever suggested inhalers by doctor? did it help?It is better to get a diagnosis before starting any medication. Consult a baby doctor and get diagnosis. Other problems could be foreign body or cystic fibrosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are loose stools, fatigue and low appetite side effects of taking Medrol?\n\nThe day after completion of the 6 days of Medrol I felt a little weak and lethargic. Then started with loose stools that are with yellow liquid and what little is semi formed is also yellow. I have no appetite and what little I eat causes almost immediate trip to bathroom. These symptoms continued for the third day after last dose of the Medrol. Is this likely an effect of the Medrol?",
    "doctor_response": "Hello,Loose stools are not a common side effect of Medrol. Maybe you had a viral infection of your stomach and bowel called gastroenteritis. This may cause diarrhea, loss of appetite, weakness and in some cases fever, nausea, vomiting, etc. It generally lasts 3-5 days and goes away spontaneously.I hope this answers your query. I remain at your disposal in case further medical assistance is needed.Regards,Dr. Antoneta ZotajGeneral and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cause or sharp pain around the arms in elderly woman\n\nI am having shooting pain down my left arm I am overweight at 220 # 62 years old and a female.I was wondering if the pain could be related to a heart attack. It is very sharp pain but not continual. I may have an hour or so between pains and then it shoots down and it will do that on and off for a while. Any advise.",
    "doctor_response": "Hello, This is most likely due to cervical pain, due to compression of nerves between spine. Possibility of heart attack is little lower as cardiac pain usually occurs on exertion and relieves with rest. Also, pain of attack is usually retrosternal and associated with left arm pain, sweating uneasiness etc. and will not persists so long. Does this pain increases on neck movement, or any neck trauma, these may be the associated symptoms. You should get x cervical spine AP/ Lat view and further may need MRI. You need to visit physiotherapist after x ray and also orthopaedician. Till the time he can have tab Neurobion Forte once a day which is a nerve vitamin. If this is not helpful then you need to Tab Pregabalin 75 mg bedtime, which is a nerve stabilizer. Hope this helps you and get back if you have any doubts. Take Care Regards, Dr. Sagar Makode, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My father is having bipolar disorder and is restless even after medication. Why?\n\nHello doctor, My father is 60 years old. He is having a psychological problem of bipolar disorder as termed by his doctor. For the last fifteen days, he is feeling restless all day long. He gets relief when he sleeps. So all the day he sleeps or just layover. He is depressed and does not talk much. He is also diabetic and having high blood pressure but both are under control. His current medication are as follows: Lamex OD 50 one tablet at night. Rexipra 10 one tablet day and night. Zona 0.25 two tablets three times a day. Dimax OD 250 one tablet at night. Along with regular medicines of diabetes and hypertension. These medicines are on for last 15 days, but he is not getting relief from restlessness. Please advise.",
    "doctor_response": "Hello. The first thing I like to tell you that as per my knowledge there is no Dimax 250 mg and Lamex 50 mg. I am assuming that Dimax in query stands for Diamox (Acetazolamide) 250 mg and Lamex 50 mg stands for Lamex (Levofloxacin) 500 mg. The problem you described is very much inadequate to make any conclusion, but I will try my best to map out the problem for your father. Feeling restless, feeling depressed and not talking much are indicative of depression. It can be labeled as a bipolar disorder if he has an episode of irritable or elevated mood, decreased need for sleep, over talkativeness, pressure of speech and expansive behavior in the past lasting for at least four days in a single stretch. If he had features of both these things described above at the same time then there is also a possibility of bipolar disorder. I would like to inform you that a pure psychological kind of bipolar disorder is very rare after the age of 50. If his first problem started after 50 years of age then the possibility of organic bipolar disorder is very high when compared to psychological bipolar disorder. The other possibility in his case is delirium. This is a kind of confusional state in which patient has difficulty identifying family members, name and detail of place where they are placed along with disorientation to time leading to the reversal of sleep-wake cycle (sleep in day and remain awake in the night). Many patients with delirium also reports the presence of objects that are not visible to others. The cause of delirium in your father may be preexisting diabetes and hypertension, medication, overt infection or electrolyte disturbance. The third possibility is of stroke as he is having multiple risk factors including age, hypertension and diabetes. At this stage, I have a few suggestions for you. 1. Stop the Zona from today itself. 2. Get his electrolyte done including serum sodium, chloride, magnesium and potassium. If any abnormality found report back with details. 3. If CT scan or MRI not done till date this is high time to get it done. If already done please send the report along with the next query. 4, Do the blood sugar monitoring every four hours. At this moment he needs detailed evaluation along with proper history. For the same, you need to present the other data so a firm conclusion can be made and future management of patient can be decided.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain, spotting, irregular periods. Have contraceptive implant. Pain related to SPD in pregnancy?\n\nI have been having quite bad lower back pain, in the pelvis region for close to 3 weeks now.. I have had constant spotting between periods and they have been very irregular. I have had the contraceptive implant put in about 10 months ago.. I have previously had cin2 but had lettz procedure to remove it and several smears which have come back black although i am overdue one now. I had severe spd in both my pregnancies so im wondering could the pain be related to this. Or my biggest fear is they are cancer symptoms. I am an otherwise healthy 34 year old female. Your opinion would be appreciated. Thank you.",
    "doctor_response": "Hello and welcome to HCM.Thank you for your query.I have gone through your query, and would like to start of by speaking about your SPD (symphysis pubis dysfunction). The only reason why most women are diagnosed with SPD during pregnancy is because the pelvis is directly involved with birth.But SPD can present in women who are not pregnant as well, this is mainly because SPD involves a misalignment of the pelvis, due to which it can put pressure on surrounding structures, especially the spinal cord, which is very sensitive and can easily result in pain (even severe at times).I highly doubt this could be related to cancer. But for your satisfaction, why don't you go ahead with an ultrasound of the pelvis and abdomen and a transvaginal ultrasound (TVS), which will help in superficial suspicion of any such abnormalities. You can also follow this up with an x-ray of the lumbar spine and pelvis, which will ensure that the position of your pelvis is what is causing your presentation.Do not worry, I can understand your anxiety, but once SPD is confirmed as the cause, wearing lumbar and pelvic support belts will surely help you, along with some help from a physiotherapist. Wishing you a symptom-free life.I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at:  . I would gladly help you.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vibration in legs?\n\nIam 45ys old housewife, few days back iam facing a problem my left foot is vibrating dis goes 2 to 3 second, i feel as my cell phone is near by my foot,but which is not...i am disturbed and confused...what is d cause of this? i want to know can i cure dis through pressing d points bt which point kidly guide me...thnx",
    "doctor_response": "Hello, The feeling of vibration in the leg is likely to be a nerve related disorder. This can happen due to a mild nerve root compression at the level of the lower spine. Methylcobalamin supplements can help in improvement. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rashes on face of a child while getting canines?\n\nHi My 1.8 years old daughter has been prescribed levolin 3ml thrice and clamp forte 3 ml twice daily for five days. She reported fever and cough with running nose. After two days of medication I m noticing driness in cough n increase in running nose. A lot of rashes on her face . Shall I consult the doc again or wait for course completion. she is getting her canines (teeth) all four simultaneously. I wonder R the rashes related to it or medication. thanks",
    "doctor_response": "Hello, thank you for posting your question.Your child seems to be suffering from a respiratory tract infection. The most common cause for such infections, especially when associated with running nose is viral. In such cases, appearance of a rash as a part of the disease process may be expected.Apart from this, the antibiotic prescribed to you (clamp forte) is also known to cause rashes and itching. Thus here the rashes could either be a part of the viral infection or due to the antibiotic prescribed to your child. In either case the next best step would be to strictly monitor the progression of these rashes. If you feel that they are spreading to other areas of the body, developing blisters/pus or crusts, involving the oral or genital mucosa etc. immediate medical consultation would be needed. If the drug is found to be the offending agent, immediate stoppage of drug along with appropriate treatment would be needed.If you have any more questions regarding the case, do write back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the solution for swelling and pus formation after wisdom teeth removal?\n\nHi my name is Joe. I went to my dentist on Monday of last week and had my left side wisdom teeth pulled out top and bottom. My left cheek swelled pretty bad worse then normal (how i know worse then normal is all my friends and family that came and saw me said that my face was bigger then theirs when they had it done and i understand that everybody is different) my left cheek swelled up on in the as well not allowing me to open my mouth but also inside of my cheek swelled up between my teeth so i could not close my jaw. its now Sunday morning and i can open my mouth just a little bit more and on side of my cheek witch covers where my wisdom tooth use to be and close to that area i have 3 whitish spots i took a q tip and touch one and all this puss comes out and feels like it will never end and my cheek really hurts.",
    "doctor_response": "Hiwith your query, since you have two wisdom teeth extracted that too if it is with more bone removal, it is natural have swelling with limited mouth opening for the first 2-3 days and slowly by week it will become normal both the swelling and mouth opening and now coming to your pus dischrage one must have an clinical examination since all the infection will be removed or curretted while extraction I wouldsuggest you to visit your dentist if symptoms persist. any how all this will down 'coz already you are on anitbiotics. Hope this is helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should the normal platelet count and vitamin B12 count be?\n\nhi sir , my blood platelet count in 65k and vitamin d is 18 and vitamin b12 is 191 , 2 months back my platelet count was 1.7 lacs , in this period i had no desease or illness . I am worrid about this fluctuation in blood platelet count.what could be the reason???? I also feel pain in my knees while climbing up stairs. My age is 32 years",
    "doctor_response": "A normal platelet count ranges from 150,000 to 450,000 platelets per microliter of blood.Normal values of vitamin B12 are 200 - 900 pg/mL (picograms per milliliter).For pain in legs u can take non steroidal anti inflammatory drugs twice daily for few days.RegardsDR De",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes roughness in the skin radiating from the ring finger outwards?\n\nI started getting a rough patch on my ring finger. I took off my wedding ring for a while and it started to go away. Now it s back and is spreading up my finger and down my hand. And now I just noticed a similar-feeling rough spot on my neck. It doesn t itch. You can t really see it. It s just a distinct change in the texture of the skin.",
    "doctor_response": "Thanks for posting your query to hcm.as I understand it could be because of some kind of fungal infection . I suggest you to consult a dermatologist for examination and treatment .hope it help you .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Seroquel withdrawal cause loss of sensation in penis?\n\nHello doctor,I finally withdrew from the drug called Seroquel. But now my penis has no sensation at all. I have much more arousal meaning my sex drive is back. But it is as though 90 % of the sensation is gone. While on Seroquel, I had more, but I stopped the medicine due to many bad side effects. It has been two weeks since my last dose.",
    "doctor_response": "Hello. Seroquel is Quetiapine, and the drug is an antipsychotic and mood stabilizer drug. In high doses in some individuals the drug is known to result in side effects like reduced libido, sometimes delayed ejaculation, difficulty in orgasm, etc. But Quetiapine is one of the safer antipsychotics if we compare this drug with other antipsychotic drugs.  The possible explanation of reduced sensation on the penis could be mild withdrawal, which might result in numbness like symptoms, and this may present with symptoms like reduced sensation around the penis. But the dose you were taking that is 50 mg is not a very high dose. Stopping this would not result in much withdrawal except mild insomnia. If we link this with sexual side effects of Quetiapine or Seroquel, then this will reverse by own in coming days. In most cases, sexual side effects go by own in less than four weeks of stopping the offending drug. You were not on a very high dose so that the recovery would be earlier. Prolactin levels increase seen with antipsychotic use (in high doses for a long duration, but some individuals even in low dosage). The standards will normalize in some days, and this will result in an improvement of sensation on the penis. No need to worry, and at this point nothing should be done because your erection is relatively better now, this means libido is improving.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes anxiety and gagging when in a crowd?\n\ni had came out of school and i was single. i have started working for a company and had devoted myself to them. Through out the first few months working for this company. I had began to noticed that i have a skin disorder called Vitiligo. This has impacted me as i had went into a depression for awhile. I was my own coach and although my father has it i knew it was genetic. Through the years i had seek help for vitiligo, but came to terms that there is nothing else that can be done but wear makeup. However the field i m in is stressful, and there are many demands on workers like myself. Nonetheless i had met someone outside of my work who has a child and since then we now have 2 other boys of which the older and youngest ones have disabilities. The other thing is my preevious employer, i m sure had feeliings for me and was jealous of my spouse. I felt harrassed many times as my employer was personally picking on me. This employer even made up a lie about my spouse which tried to get me into trouble about breaking confientiality. I had felt stressed to go to work. I had expressed my stress/anxiety by gagging before i arrived at work. About a year ago i had went to one of my sons, touraments, where there was lots of people and when he was presented a certificate, i was happy but i had expressed that by gagging 2 or 3 times. I had embarrassed him and my family and myself. That year, had expierence gagging fits @ my sons soccer games, i did not gag at all of them, i had tried to calm myself or even walk away. That did work sometimes. However the interesting thing is, when i had finished my gagging, (it could be 2 or 5 times) i felt relief or a sense normallity. Since then i work indirectly to my previous employer. I know there are some possible stressors. I am forty years old and I have thought about a possible career change. That alone is stressful in itself. But, now after being out of shape and overweight for about a year. I know my health is also taking a toll. I had went to see a naturalpath who prescribed me (ignatia amara 30 ch), i have yet taken them despite knowing the side effects may be horrible. I know this when i went online and it said that when the person feels horrible feeling the medication is working. However , my girlfriend is on medication and she at the beginning felt horrible and the withdrawwals were bad too. However she continues to be on them. Anyway, I still have anxiety, and i still ga",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.This illness is called agoraphobia and this is treated with relaxation therapy. Further paroxetine is also a good drug for agoraphobia. 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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent fever with lethargy and fussiness?\n\nMy 14 month baby has had a fever for over twelve hours now ranging from 101.5, 12 hours a go to 99.1 2 hours later. after Baby advil. since then has been above 100.5 three times since over next few hours and now 12 hours later had a slightly greater than 100.0. How long should i wait. Baby is lathargic and fussy, but not pulling ears or crying. In the middle of the night shw woke repeatedly, and was grunting as if she had the chills? What is the next step? thanks",
    "doctor_response": "Hello, As per your history, it may be due to viral infection or bacterial infection. As baby is lethargic, so consult with your pediatrician for health status. You can give syp Paracetamol, syp Ondansetron, syp Mefenamic Acid after consultation. He may require complete hemogram, chest X-ray after consultation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes ED?\n\nim 16, and i was very sexually active and i felt like i wanted my penis larger, so i went on google and found jelqing techniques. so i did those, and got lazy so i stopped, and now it seems as if my erections are weaker and my penis is softer. can i sbe suffering from ED? im kinda scared",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Nothing to worry dear. Size of penis never affect the sex activities or pleasure so don't expect large penis. Softness is common after over activities. Just avoid sexual activities for day or two and you will be fine. No need to worry about erectile dysfunction.Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer.Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having pain in my chest if i stand for a long time?\n\nWhen I stand for any length of time or sit up straight for a length of time I get a pain in my chest dead center below rib cage area. I have lupus, arthritis, no one seems to know what it is. I have been told my vertebrae/spine has arthritis as well. email address YYYY@YYYY",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Most possible reason for chest pain after standing for long or other posture is muscle or ligament pull.In our clinic, I recommend analgesic spray, medicines for primary relief, assisted physiotherapy with experts and later on MRI as per the need.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tooth extraction, blurred vision, cataract surgery done. Treatment?\n\nhi sir i am XXXXX. I had tooth extraction 3yrs back (2008-2009). But after one year of that (2010), my vision of eye of that side blurred. Later on I undergo Cataract Surgery . As I eyes are much important for me, I feared every time while hearing dentist. I am brushing daily, but cavities are still in my teeth. I have filled some cavities in my teeth during 2010. I think, I need dental help but fear of eye vision\u2026.",
    "doctor_response": "Hello Sir Welcome to HCM I went through your history & would like to clarify your doubt that there is no relation between extraction of teeth & vision problem.Dental treatment doesn't effect eye in any ways.your cataract problem might have started for some other reason. If you still have cavities that are untreated then you must go for their restoration.Otherwise if  decay proceeds then it may require Root Canal Treatment.Its better to go for conservative treatment. Prophylactically go for fluoride application of other teeth.Also start brushing your teeth twice a day,along with using mouthwash once daily half an hour after brushing. Kindly start your dental treatment without any delay. Take Care Regards Dr.Neha",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be done to prevent transmission of walking pneumonia?\n\nHello, I have a question concerning walking pneumonia. My husband has it, and I am concerned about getting it. We have children also, and I certainly cannot afford to! He began antibiotics tonight, so what else should I do to ensure his recovery and that I do not contract this?",
    "doctor_response": "Hello, Getting the pneumonia vaccine reduces but doesn\u2019t eliminate, your risk of getting pneumonia. There are things you can do instead of or in addition to the pneumonia vaccine. Healthy habits, which help to keep your immune system strong, may reduce your risk of getting pneumonia. Good hygiene also may help. Things you can do include: Avoid smoking. Wash your hands often in warm, soapy water. Use an alcohol-based hand sanitizer when you can\u2019t wash your hands.  Avoid exposure to people who are ill whenever possible. Get enough rest.  Eat a healthy diet that includes lots of fruits, vegetables, fibre, and lean protein. Keeping children and babies away from people who have colds or the flu may help reduce their risk. Also, make sure to keep little noses clean and dry, and teach your child to sneeze and cough into their elbow instead of their hand. This can help reduce the spread of germs to others. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Prabhash Verma, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "I smoking dangerous after stent implantation?\n\nDear sir , My name is Rabinder and i had an heart attack last october 2010 , I had two Stint procedures Sir my queston is i am unable to leave smoking and am trying heard , i had stoped smoking for two months and i got so stressed thing about not smoking that i started smoking again Sir i know it is very bad for me , Sir what are my chances of getting an attack again i am smoking 8-10 sticks a day and before the attack it was 20-25 sticks",
    "doctor_response": "hellosmoking is actually very harmful for you. especially in the presence of heart disease and two stents. smoking also causes lung diseases like COPD and cancer. the chances of another heart attack becomes double if you contnue smoking.there are many available medications to quit smoking. you can do it all with your will power, family support and medications. do it now or it will be very hard for u as you grow older and u may have multiple other diseases.wishing you good healththank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Lisinopril cause irritation and fatigue?\n\nmY HUSBAND STARTED RETAKING HIS LISINOPRIL WHICH WAS GIVEN FOR HIM POST POSTERIOR WALL MI WITH TWO STENTS. hIS MI WAS IN 2005. NO PROBLEMS WITH HIS HEART SINCE. HE TOOK HIMSELF OFF LISINOPRIL BECAUSE OF FATIGUE. hE STARTED BACK ON IT TWO WEEKS AGO AT HALF DOSE. HE IS IRRITABLE, NERVOUS AND FATIGUED. tHERE IS NOT MUCH LITERATURE ON PSYCHIATRIC SIDE EFFECTS. cOULD THESE SYMPTOMS BE CAUSED BY THE LISINOPRIL.",
    "doctor_response": "Hello, No, lisinopril is a safe drug which could be taken by any body. you should seek a psychiatrist consultation.. It seems to me it is a psychiatric problem. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Salah Saad Shoman",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for asthma problems\n\nhello doctor,i am very worried about my mom's athama problem. she is having asthama from long time, these days from last one month she is having more problem. she is very weak also.....she is unale to walk....now i want to know what should best can be done... we are giving her inhaler through nebulizer.....sometime she is ok and sometimes she is getting problem.....doctor please help me......",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your mother's history and would like to make suggestions for her as follows:1. If she has frequent asthma attacks, I would suggest her regular inhaled corticosteroids via nebulizer. Nebulizer is not a portable equipment though, in that case, I suggest my such patients Metered Dose Inhaler with Spacer Device, which is portable.2. If despite use of inhaled medications, she has worsening problem, please consult your pulmonologist who will review the inhaler therapy and increase the dose of inhalers.3. For occasional symptoms of asthma, I would suggest her nebulization with rescue medications such as levosalbutamol.4. Please give her healthy diet rich in vitamins, minerals and antioxidants, which will improve her immunity.5. Although she is weak and unable to walk, practicing simple slow deep conscious breathing will help her gradually help her lungs also.Hope above suggestions will be helpful to her.Should she have any further query, please feel free to ask at HCM.Wish your mother the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anxiety\n\nHi, I feel like I ve just been given a death sentence and told not to worry about it. A carotid Doppler I just had showed mild less than 17 % narrowing. One doctor said I m in danger if stroke another said not to worry it s too low to worry about now and diet (as I am about 95 kg) and change of life style can reverse it. I duffer anxiety also ! That is now 1000 times worse!!!! Can t tell what symptoms might now be a heart attack,strokeir anxiety. !!!!!!!!! Am so scared ?!? Feel like I could die any minute!!! I am 48 and have 2 kids!!! So depressed and stressed!!! Was also trying to when myself off Xanax ... Fat chance now?!?? Help!!!",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.Symptoms of anxiety and heart attack are very similar. Either ways you have to take treatment for anxiety disorder. Improvement of your anxiety disorder will help in making you strong in dealing with the illness. Paroxetine and sertraline are good drugs for this purpose. 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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of asthma ?\n\nhello doctor... i am 25 years old male...i have been diagnose with asthma 3 days before...i was suffering from violent dry coughing especially in early morning hours.chest pain,vomiting due to stressed coughing..and i am allergic to dust and climate change...i am a assistant director in movies ..can i spend my rest of life normally or i have to take medicines whole life..also suggest me what all diet and things i should include or exclude..i am a smoker too since 6 years",
    "doctor_response": "Hello.First of all, my sincere advice is to quit smoking, if necessary, seek professional help also. Smoking harms the lungs and not only worsens asthma but also reduces efficacy of some of the asthma medications. This will be one of the most important step for you for a better lung health.Apart from this, with proper understanding and correct use of asthma medications, you will be able live a normal life, including exercises, sports & adventures. So please do not worry.Depending on the severity of asthma, you may have to take daily regular medicines or intermittent medicines on as & when needed basis. With passage of time, you & your physician will be able to decide minimum dosage of medications to control the asthma.Unless you are particularly allergic to some foods, you may not have too much food restrictions. I would suggest to minimize cold foods (cold water, cold drinks, ice-creams, etc) & sometimes spicy/fried foods (if you feel they worsen your cough). Otherwise please try to have balanced & nutritious diet rich in vitamins & minerals.I would also suggest you regular exercise, breathing exercises, yoga & pranayama. Control stress with relaxation & meditation (stress may trigger an asthma attack).Hope this was helpful to you.Wish you the best of the health.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can without comigan drops causes any side effects?\n\nI have been using comigan drops for treatment of uveitis for about 8 weeks. Ran out of my bottle and was out refills two days ago. I called my doctors office for a refill and they did not respond and now it is a holiday weekend so can i expect being without this steriod for 5 to 7 days to cause any side effects?",
    "doctor_response": "Hi, It's better to keep it continued but this much gap won't cause much side effects. Steroids in high doses withdrawal may cause systemic side effects but in such low dose those are least possible. Local inflammation can recur but slowly tapering the dose on follow up examination is recommended otherwise. Hope I have answered your question. Let me know if I can assist you further. Wishing you a speedy recovery. Regards, Dr. Saddiq Ulabidin, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does oleanz help in getting rid of a suspicious mind ?\n\ni am prescribed with oleanz 5 mg for having suspicion in my mind how will it work",
    "doctor_response": "It will help to control rapid cyling mood disorder and Schizopjrenia. If you have any of these eed to be disclosed to me. They act by blocking D2 receptors in brain,atypical antipsychotic medication.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Normal range of PT and INR?\n\nmy uncle undergone artery replacement open heart surgery, now doctor avised to take acitrom 1mg for 3 days , then dosage will be adjusted based on pt and inr test. so my question is what is the normal range of pt and inr? if pt and inr increased then dosage will be increased or decreased?",
    "doctor_response": "hello,I have gone through your question.Thanks for using HCM.A patient who underwent aortic valve replacement will need life long acitrom.INR is more reliable than PT ratio.You need to maintain INR around 2.5.If INR is more than this you should reduce dose if acitrom and if INR is less than this you have to increase the dose.My best wishes.Dr.Teli,MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Constantly suffering from sneezing, noseache due to being allergic for dust. Remedy?\n\nHi, My sister shifted to Mumbai 7-8 months back after marriage. But in this time span, she is constantly suffering from sneezing or nosache. Visited local doctor but she was told that she is being allergic to aerosols/dust particles, but that doesn t solve the purpose and day by day her health is deterioating. It has become difficult for her to manage between office and home due to her health issues. Please suggest a good doctor in Mumbai or any help will be appreciated. Thanks in advance !! Regards, Varun",
    "doctor_response": "Hello Varun, Sorry to note your sister's symptoms. Dust allergy has become a major problem with the growing urbanisation, changes in housing with little natural light or air and reliance on A/C units that increases the humidity. Allergy testing is highly recommended to know the extent of her allergies, whether it is house dust mite, or mixed with animal dander, moulds, fungal spores, grass pollens etc. There are various private labs in Mumbai that offer blood test (would recommend specific IgE test rather than others) such as Metropolis etc and these need to be reviewed by an experienced Chest physician with interest in Allergy or an Allergist. Long acting antihistamines such as allegra 180 oce daily, nasonex nasal spray 2 sprays/nostril for 3 months is recommended. The tests will guide duration and seasonal therapy. I hope this helps. Best Wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication to control pain post root canal treatment\n\nI had a root canal performed a week ago Tuesday. Afterwards I was in considerable pain. They told me this was normal and could be because the temporary filling was set too high. I returned to the dentist yesterday for my temp crown, and they said again, the pain should subside now that the temp. filling is out. A day later I am still in pain with even the slightest pressure applied to the tooth.Both the specialist that performed the root canal and the dentist that fit me for the crown say the tooth looks normal. Is this common? My worry is that when I go back for the permanent crown in another two weeks, the pain will still be there. Chewing is very difficult.ms",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. As you are mentioning that root canal treatment was done for the tooth and you are experiencing pain after that also it looks that root canal has not been done properly,  as sealing of the canal of the tooth with temporary filling is done after the pain subsides. You should visit some another dentist and ask him to take an x - ray,  as in X - ray the condition will be cleared that whether the infection is still present or it is because of the high filling. Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes appetite loss in a baby after starting lactose free milk?\n\ni had a two month old son,after switching to a lactose free milk,ive noticed that he lost his appetite lately..he cannot finish his usual three oz milk..his usual 2-3 hours feeding interval now its 5-6 hours or more .. im worried what s wrong with him..what should i do?pls help..thank u",
    "doctor_response": "Hello, This might be due to the bad taste of lactose-free milk. However, he will get used to it eventually. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My arm still feels tired after donating blood. What is the reason?\n\nHello doctor,So, last week I donated blood in a blood-letting in my university. The day after the donation, a bruise appeared in the punctured area, and it is a bit painfull. After doing cold and hot compress, the pain in the area disappeared but my donating arm still feels tired. What could be the problem?",
    "doctor_response": "Hi. First, coming to blood donation, you have done a very good thing. You saved one life. Secondly, the bruise may be due to puncture of the vein (double puncture) during needle insertion and it will cause pain and leakage of blood (causing bruise) and this will be healed fast and leaked blood will be reabsorbed. Thirdly, there will be dragging pain and this will take 5 to 7 days to regress. Nothing to intervene. For more information consult a family physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden rolling of the testicles?\n\nmy penis suddenly started to move randomly. the balls are rolling like something is living inside of it and I have several white fibers inbeded in the shaft. we think that we might have a thrip or some sort of bug infestation in our houseplant and have been treating that and now are seeing odd fibers on other parts of our bodies that resemble the plant infestation. could the bugs be infesting out bodies after treating the plants?",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, this is physiological phenomenon and not the disease and not because of anything as you are thinking, testes are highly temperature sensitive organs and this goes on changing its vertical position according to body and atmosphere temperature, no need to worry about this, hope this information helps, take care, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constipation during pregnancy?\n\nHi Doctor, I did IVF / icsi and 2 embryos was transferred in me on 26 th Jan I never concieved before and I m 39 years old and I have Endometriosis in my pouch of Douglas I m getting PMS pains presently and constipated I did a pregnancy test this morning and it s negative could I still be pregnant? Thankyou.",
    "doctor_response": "Hi... I have gone through your case. My advice is post embryo transfer you should not rely on urine pregnancy test as blood levels are sometimes not enough to be detected by urine test. Rather you should do a beta HCG blood test.Constipation is more common after a IVF because you must be on progesterone supplementation for luteal support which is the reason for constipation. Need not to be worried just have plenty of liquids and green leafy vegetables.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can feet neuropathic pain, back pain and impatience be reactions to Cymbalta?\n\nI am taking cymbalta 60 mg and sometimes not always have this feeling of dred. also my boyfriend and I are fighting all the time. I have no patience. I have neuropathy in both feet with alot of pain in both feet. Lower back pain as well. Pain meds, baclofen and cymbalta. Are all of these symptoms of cymbalta reactions?",
    "doctor_response": "Hello,These are not the reactions of cymbalta. Rather cymbalta should improve these symptoms. If you are having these symptoms while on cymbalta, probably drug is not effective for you. Please talk to your treating physician.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anal pain while suffering from diarrhea\n\nmy 2 year old grandson had sickness and diarrhoea recently and whilst this has now gone he is still behaving oddly. He won t let anyone near him except his mother and he gets very upset when she wipes his bottom. There is no rash but he appears to be in pain.",
    "doctor_response": "You can apply some vaseline ointment or other soothing ointment when mom wipes his bottom. Even if you don't see a rash, there can be irritation internally so applying a soothing ointment with a rectal thermomemter as if you were taking a temperature may be a way to a apply the ointment. But do the best you can to apply something soothing to the area and use soft wipes and be very gentle.If symptoms are not better in 24 to 48 hours, you would need to have him evaluated the pediatrician.Wish him a speedy recovery!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain and lump on it\n\nI have been having abdominal pain for awhile now and recently noticed a lump a lump on my lower right side of my stomach followed by a big bruise. The bruise had gone away but not the lump nor the pain and now a few weeks later, another bruise is appearing. What could that be?",
    "doctor_response": "Hi.Thanks for your query, read your history and understood your problems.Lump on the abdomen on the lower side with a bruise is suggestive of an infection in the abdominal wall and not inside the abdomen as by this time other symptoms of bloating, loose stools and vomiting might have occurred.Get an examination done by a Surgeon, get ultrasonography and a course of an antibiotic and anti-inflammatory medicines done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Difficulty in conceiving, no improvement after taking adova, duphaston and all9. What should be done next?\n\ni m trying for baby still 8 months,i had went to doctor he prescribed hsg test and hsg report is normal and after that doctor prescribed me adova, duphaston and all9 for three cycle already i had completed my two cycle still i m not been pregnant.this is my last cycle i m taking my medicine and i m afraid what will happen if this month also if i wont been pregnant,plz suggest me wht to do next.",
    "doctor_response": "Chance of conception after 12 months of unprotected intercourse is 85%. If your age is <35 years, if you are having regular menstrual cycles, Husband's semen analysis is normal & HSG is fine, then you can safely wait for another 4 months even without taking any medicines (Except Folic acid for NTD prevention).",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have asthma and i smoke. I am suffering from chest discomfort\n\nHello, I am 30 year-old female who has never smoked anything other than marijuana and cigars in the distant past. I have asthma (since birth ) and trach due to an Auto-Immune disorder ( Relapsing Polychondritis , diagnosed in 2007), subglotic stenosis. I ve chosen to heal without medications (chemo) and I was doing very well before my neighbors came about. For the past 11 months my next door neighbors have been smoking and producing meth. The chemical fumes are sooo strong and it takes me a few minutes to smell it because of my trach, but by then the fumes are already deep in my airway . Every morning my lungs are EXTREMELY irritated and outside air seems to be contaminated also. When I am away from home I feel better. No one seems to understand my chest discomfort even if they cannot smell it. Since my trach I ve become very sensitive to cleaning products, food seasonings, perfumes, etc. I could only imagine how this is affecting me internally, especially having an extremely sensitive airway. How is this compromising my already existing disorder ? I would like to know so I explain it clearly.",
    "doctor_response": "THanks for the query I dont understand what u mean by 'trach', do u mean tracheostomy? Yes it is possible that the fumes are irritating u. How dont u move to another room? or get yourself an air conditioner with good filter. Every reactive airway disease has to be treated with getting rid of the irritant first Have a healthy living",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for frequent masturbation.\n\nI masturbate frequently - once or twice a day. A few months ago my hand started getting weak/numbness. Most of the time its hard to masturbate because of this pain. Its not painful. Its more like an annoying feeling. I feel the need to crack my arm but I can't. It's coming to the point where the feeling is there and doesn't go away.",
    "doctor_response": "HiThank you for asking HCMI have gone through your query. If you involve in excessive masterbation then it should be controlled. You can involve yourself in some hobbies. When you become idle you will get the feeling for masterbation more. Make friends and socialize. Play games like volley ball or batminton. Doing exercises also is helpful to get mind control as it utilizes your excess energy. These all will help you to get rid off excess masterbation habit.Hope this may help you. Let me know if anything not clear.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of heart attack in a premature baby?\n\nhi i just found out i was born when my mom was only 8 months old pregnant. am gonna turn 21 in a couple of weeks and i have two kids i want to know if theres a possibility that i would suffer from a heart attack or any of those things involving that iwas a premature baby?",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. Don't worry, there no added risk for heart attack in prematurely born babies during their life. The chances of having heart attack is the same as the entire population. Hope I have answered your query. Let me know if I can assist you further.Take care.  Regards,Dr. Lilit Baghdasaryan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and pressure on back?\n\nmy right kidney is .8cm thick while my left is 1.8cm. I have had a lot of pain and pressure on the right side in back...i do have huge uterine fibroids. could this be related? I am 45 years old, female not at menopause. I am scheduled for fibroid embolization but my kidney is really painful",
    "doctor_response": "Dear- thanks for your question and will give you my medical opinion. The size or thickness of your kidney is not a cause of pain. You can have cysts,stones or any other lesion in the kidney that can be causing that. However,you mentioned that have huge uterine fibroids, those can be painful and may need surgical removal in order to improve that. Sometimes, fibroid embolization helps but you might need surgical removal if no improvement. Your back pain could be related to sciatic too. Kidneys are not typically the main reason for back pain. It is advisable to have urine samples and kidney ultrasound for a complete evaluation of the kidneys.I hope that my advise has been helpfulDr.Sara",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in my belly button after lifting weight?\n\ndear sir, i am getting a pause from the belly button, i had lifted weight a week back on my head and there was a pain at the belly premises.. i was getting pain when i urinate, bend, and when i cough and sneeze.. from yesterday i am getting lot of pause.. now the pain is bit low as compared to earlier but the pause is keep on coming.. is my condition is severe can u help me out with this..",
    "doctor_response": "Hi.Thanks for your query. Pain at the belly button is not a normal occurrence and whatever the instigating factor this has to be investigated.Lifting the heavy weight might have pushed the fat pad into the preexisting umbilical hernia. Another possibility is pre-existing granuloma and not getting inflamed and causing pain. The pain is getting increase with urination, coughing and sneezing as these cations increase intra-abdominal pressure. I would advise you the following:Physical examination by a General Surgeon.Any investigations like ultarsonography may be of help, but it us the clinical examination by an expert that clinches the diagnosis and certainly you may need a surgery; be prepared for it if it is needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lung crystallization on CT scan, what does this mean ?\n\nI had a CT scan of my abdomen and pelvis. i was told today they seen crystallization at the lung base. I have to wait to see my regular doctor . what does this mean ?",
    "doctor_response": "Welcome to Healthcare Magic I believe the word is consolidation. If Yes, it means there is lung infection of pneumonia at the lower part of the lungs and will require probably antibiotic treatment after few more tests.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to confirm kidney disease?\n\nLately, my daughter is producing many soggy diapers a day, but her stool is firm, small fecal balls. She drinks throughout the day. When she had a fever a month ago, the doctor said that she had mildly elevated kidney values indication mild dehydration.How likely is this that she could have kidney disease.?",
    "doctor_response": "Hi thanks for asking question.You gave not mentioned age of your child.During fever as less water drinking she might have dehydration and kidney function test comes abnormal..To look for kidney disease like pyelonephritis , stones or glomerulonephritis USG can be done....If kidney disease there causative treatment done...If cause not clear and urine show proteinuria then for further work up if needed biopsy might needed.Take care...If she developed any unusual sign and symptom consult doctor for it...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tab.Gemiflox in Psoriasis\n\nDear Sir,    I am Sanjoy Kumar Saha,Age 30years.I have been suffering from skin disease along 2years.In order to recovery from this disease,I have gone Prof.Dr.M.U.Kabir Chowdury,after showing biopsy report(31.12.2007),he has decided that I am the patient of \"Psoriasis\".He has priscrived me and I have taken this medecines(Tab.Oflacin 200mg,Tab.Biotin 300mg,Tab Acitrin 10gm,Synovate Ointment etc).But I am not cure.Still now I am suffering this problem.Then I have gone to Prof.Dr.Md.Siraj Uddin(date:22/06/2010).He told me that my disease is DH,Eczema.He advise me to take Tab.Gemiflox 320mg,Tab.Acitrin10mg,Tab.Atarax10mg,Betnovate oint.But I am not cure.What can I do now?",
    "doctor_response": "hello! sir  i am divya patil from belgaum its self..... i wanted to know whether....Beauoxi white pills, gluathione skin whitening pills areeffective or no... and are the availabe in belgaum.... plzzz let me know sir.... plzzz",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cervical cancer\n\nI m 42yr old female been having cervical cancer biopsy for the past 2 yrs something about cells 16 and 18 Idk. But for past couple months I ve been having really bad pain at the bottom of my stomach near pelvic area. Feel achy all over , don t feel like eating, what could be causing this problems",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  Treatment of cervical cancer depends on stage.  In early stages hysterectomy is the treatment of choice. In later stage chemotherapy is needed accordingly.  Please send me the results of your cervical biopsy so that I can help you further. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headache,dizziness and light sensitivity?\n\nI have had a chronic daily headache for the past 6 months. The headache is a pressure on both sides of my head, radiating from the temples down into my ears and around the back of my head and down into my jaw. The pressure feeling is practically a constant pain, without ever subsiding. I experience dizziness, light sensitivity, occasional ear ringing sensations, slight visual disturbances and inability to mentally focus at times. I have now consulted 2 Neurologists, during this time I have had a CT of the head, MRI of the Head and Neck, MRA of the Neck, used Nortriptyline, Topiramate and Gabapentin, all with no prevail. I have used half a dozen over the counter pain killers, used Lidocaine Nasal Spray, had blood tested, tried 2 different muscle relaxers, had Chiropractic Manipulations, had several deep tissue massages and had my vision and teeth checked by other doctors, even used 2 different mouth guards. The headache is having a severe detriment to my life. I am a college student, who is unable to focus in class. My headache keeps me from going outdoors and enjoying the activities that I enjoy doing. My motivation levels have dropped significantly and prevent me from working out. I have gained 15 pounds over the last 2 months. I have no control over my life because the only things I can do without being in pain is to sit in my dark, cold apartment. With everything I had tried, I have seen no decrease in headache pain or occurrences. So far the only thing that has SOMEWHAT reduced the headache pain is the Lidocaine Nasal Spray. I see my current Neurologist in 2 weeks. I personally feel that he has no idea what is wrong with me. If you have any thoughts or suggestions, please let me know. I am willing to try just about anything at this point.",
    "doctor_response": "hi well as going through ur history u havent mention the reports of ur ct and mri which would be very help full in diagnosis ur problems as far as u r history shows clasical signs of migrane if all the radiological investigation are with in normal limits.so migraine is the most common in female and the attack is followed by aura and aggravated by bright light , sounds,pungent odour.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for pain in stomach and leg for more than a year?\n\nHi. My 4 year old daughter has been complaining nearly every day with a stomach ache for about a year. Now she is starting to complain with leg pain. We have been to the pediatrician several times and keep getting brushed off saying it is just a sensitive stomach. But I just have a gut feeling its something more serious. I fear cancer. What could this be?",
    "doctor_response": "Hi,From history it seems that she might be having some GI tract infection, either bacterial, amebic or parasitic.Worm infection is common at this age leading to anemia giving rise to weakness, leg pain etc.Go for stool test.After report go for treatment accordingly.Forget about cancer.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes smelly lumps on the throat?\n\nI have been getting grayish, spongy lumps stuck on back right side of my throat. I can feel the lump with the back of my tongue & when I swallow. I ve tried gargling, coughing, etc. to dislodge it, but that doesn t work. Then, it will dislodge & I cough it up. Smells awful. What is it? I thought maybe tonsil stones, but what I ve read doesn t sound like what I have.",
    "doctor_response": "Hi,Dear,Thanks for the query to HCM.I studied your problem in depth and I understood your concerns. Treatment for Smelly lumps on back of your throat-In my opinion you seem to have infected subacute tonsills with infected mucous plugs on them,which pains on swallowing and get cleared out after coughing it out with a bad Smell.What's the color of the mucous plugs? yellow/ green / muddy/brownish?Hence stop worrying about it but do check it up from ER Ent-Surgeon.For Final Diagnosis and treatment  needs clinical data from a Doctor.and Hence for further treatment I would advise you to Consult ER Ent-Surgeon , who would treat it accordingly.This advise is based on the facts from the history you give and needs further clinical check.Hence I would advise you to check with ER Ent-Surgeon.So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you.Hope this would relieve your problem.Welcome for any more query in this regard to HCM.Write good resume and Click thanks if you feel satisfied with my advise.Have a Good Day.Dr.Savaskar M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for excessive night sweats after gastric bypass\n\nOh, wow! I did not know I would be able to ask a question coming to this site. I was researching a bit just from curiosity. I am a 49 year old woman, had gastric bypass 13 years go, am a light drinker, was severely anemic (only had 1/3rd of the blood I should, was hospitalized and given a blood transfusion a year ago. Started having excessive sweats both at night and during the day about 3 weeks ago. Saw my GP who did a whole series of blood work (standard physical). All normal including colesterol, hormones and vitamins. I am on zero medication am within 10 lbs of normal weight, eat a modified paleo diet (way to much dairy) and my liver enzymes came back elevated. I am scheduled for a sonogram and more blood work next week to investigate but just thought I would research to understand more. I am thinking it is a fluke given my good health otherwise. My questions is what to expect next",
    "doctor_response": "HelloYou mention you are experiencing night sweats. The most common cause in a 49 year old lady is perimenopausal night sweats.   Even if your hormone levels ( FSH and LH need to be done), I  will assume they were done and came back normal. Often times the symptoms of menopause start before there is a rise in these hormones. There are several medications you can try called SSRI's that can be used if the symptoms are very bad. Estrogen replacement can also be used,  but I do not personally recommend it as it has been found to increase the risk of cancer and stroke. Another cause of night sweats is an underlying infection,  but you mention you had blood tests already ( at least a CBC should have been done to rule out infection). Best regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it advisable to get Novasure ablation done in a scarred cervix?\n\nHello doctor, I have a lot of scar tissue on my cervix and I have really heavy periods. Tried birth control, had very serious side effects, stopped the birth control. I have tried Provera. My legs got swollen, stopped taking that. She tried an IUD and due to a lot of scar tissue, she could not insert it all the way. I was wondering since I have a lot of scar tissue, can I get the Novasure ablation done?",
    "doctor_response": "Hello. I have a feeling that your problem is of quite serious in nature as you are bleeding heavily and yes you can try for ablation but there is a chance of its failure as ablation devices may not enter into the scarred cervix and additionally associated with injuries like perforation and damage to other nearby organs. I would like to add into your knowledge that another option to control heavy bleeding is a hysterectomy (removal of womb) which is the definitive treatment and is suitable to those with other failed conservative measures. The latest technique is the use of uterine artery embolization to control heavy bleeding is becoming popular these days for those who do not want to undergo surgeries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does the size of penis matters for fertility?\n\nMy husband has a small penis & we've been married for 1 year with no success of conceiving. We're both pretty healthy & I'm kind of worried because I thought size didn't matter when it came to conceiving. Also I had cryosurgery done about  a year ago, but my doctor days  everything healed up just fine...",
    "doctor_response": "HelloI can understand your concerns.I think a better option to decide on fertility would be to go for semen analysis.The report will determine the fertile capacity of your husband.Do consult an infertility specialist.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it necessary to have apnea monitors in infants for esophageal reflux?\n\nmy 3 month old grandson experienced an esophageal spasm and stop breathing x2. My daughter took him to the hospital and they admitted him overnight for obs. monitored and pulse ox. d/c d the next day with that Dx. He has a Hx of esophageal reflux and has been on increasing doses of medication since born. I am an RN and as much as I would like to have all the faith in the world in the Dr. Is there a reason they do not send apnea monitors with babies to monitor for this ?",
    "doctor_response": "Hello.I just read through your question.It is not customary for children with reflux to have an apnea monitor at home. An appropriately treated baby will not have a problem. Additionally, the number of false positive alarms on the apnea monitor this is way too high. Therefore, we typically do not keep reflux babies on apnea monitor at home.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment procedure for the removal of cysts on the penis shaft?\n\nI had an ingrown hair on my penis shaft. And it got infected the hair was removed, but there is a little bump/lump that was left over and it will not go away. I'm pretty sure is a cyst now. So I was wondering if and where I could get it removed. Like what might be the process for the removal. And could a walk in clinic do something like that. because I would like to try to avoid the hospital.  I live in Toronto, Ontario. Thanks.",
    "doctor_response": "HelloThanks for query .Based on your description I would state that you have infected Sebaceous cyst over shaft of the penis.The penile skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin. Normally it fades away without treatment however it needs to be treated if increase in size or get infected. Please consult qualified General Surgeon for clinical evaluation and further treatment.If needs to get excised in Toto (Completely along with the sac) .This is a simple surgery done under local anaesthesia as a out patient procedure and there is no need to get Hospitalized.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the condition to constantly swallow and expel tiny burps?\n\nI believe that my daughter is suffering from anorexia. She has developed this condition where she constantly swallows and expels tiny burps. Is this part of anorexia or could it be something else. Also, she was born with Corrective Transposition with Pulmonary atresia",
    "doctor_response": "Hi...it would have been better if you had mentioned the age of your kid. By what you quote I do not feel that it is anorexia. I feel that she is doing it by habit and it is habit disorder. The best way to manage this is by tender loving care and get her out of the habit. If not it could also be due to attention seeking behaviour in which case it is better to ignore it. If nothing is working I suggest you get in touch with a clinical psychologist.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in hands\n\nWacked my back of my hand hard on a gate heard a crack pain immediately brought me to sit on the floor I don t see and bruising or swelling but get sharp pains goes up my arm. Can move fingers but sore. When close my hand on have pain on the outside of my hand. What should of do?",
    "doctor_response": "Hi, immediately apply ice for ten minutes and strap the hand, and then get it x-rayed. It might be a fracture. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can eating old chicken cause any problem during pregnancy?\n\nHi, may I answer your health queries right now ? Please type your query here... i was just at quiznos and i was eatting chicken it tasted horrible and when i looked at it it was dark grey.. meaning its old.. i am 6 weeks pregnant can this affect my baby in any way",
    "doctor_response": "hellohow are you?if the patient comes to my clinic ,I would ask her,is she having vomiting , diarrhea , fever or any rashes?if the answer to above questions is NOthan Relax.Take care in futureDr. Mira Butani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a little red bump on the shaft of the penis?\n\nHi, I am a 19year old male, is anyone there?About 3 days ago, I noticed a small bump under the shaft of my penis. It's a little red but that is it. It has gotten bigger but has stayed the same size for two days. It's hard, and there is not any white dot or anything. It is a little sensitive but that is it. Any idea what it could be? There is that one bump and that is it.",
    "doctor_response": "Hi,At the outset I would like further information for better assessment of the condition like If possible upload me a photograph. Are you sexually active? Is there any other complaints like burning sensation in urine or increased frequency of urine? Looking at your description it seems to be a treatable condition so you need not to worry just write back to me with all the details so that I will be able to tell you more accurately. Meanwhile apply some antiseptic ointment and keep it clean and moisturised. Don't manipulate or scratch it.Hope this answers your question. Please feel free to ask for follow up question and I will gladly answer you.Best wishes,Dr. B R Hudda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for rashes\n\ni have a rash that started two weeks ago, first in my chest and now it has spread all over the torso, front and back..started with small pumps and they turn to some kind of lesions..second day on predisone but doesn't seem to help...any ideas..regular dr thought last week that it's some kind of allergic reaction but it shouldn't last this long if it was?",
    "doctor_response": "Hello and welcome...Rashes has a list i.of causes ..Yours could be the allergy BUT the pattern of its spread is not suggestive of allergy and its pointing to some kind of infection.What ki d of rash is this? You better should go to a general physician to examine you and he will advise you some tests like blood test etc.You should go to the doctor without wasting any time so early treatment could be possible..Hope you'd understand...Ok see you in good health..Bye",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden deafness and dumbness in a child?\n\nMy daughter is deef and dump after unknown sickness doctors says she is fine some psychiatric problem is become just one before two months she was perfect and going school.her body become shaking for almost 30 days ,there was no fits diagnosed now she is ok but cant speak and listen,rarely she speak and hear.",
    "doctor_response": "HiThanks for writing to health care magic.Brain infection called as.meningitis or encephalitis can cause such effects.Get an MRI brain and EEGWishing your child good healthRegardsDr Arun",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat injury mediated toe and foot cramping?\n\nI kicked my car three or four times as hard as I could (right foot). On a scale of 1-10, 10 being the worst, I'm having an 8 of a cramp like feeling through my toes, top of foot, and right side of foot and its going up through my ankle too. What could I have done? No insurance so no real doctor for it.",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. Its possible that you might have fractured either your toes or metatarsals in your foot. X-rays is definitely first line of treatment but since you are uninsured, I would recommend going to ED at a local hospital where they have to provide you with minimum care, get an x-ray done to rule out any joint damage and recommend getting a cam walker which cost around 35 dollars to take pressure off our toes and metatarsals. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Samuel Parmar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of numbness at the right shin and foot?\n\nMy right shin, the top, goes numb when ever I touch it.  As well as the top part of my right foot.  It's been this way for about 3 days.  I haven't hit it, bruised it, etc and it's only upon touch. There is no swelling or apperent visual changes. I've never had anything like this ever happen before.  What could be causing this and should I be concerned?",
    "doctor_response": "There\u2019s nothing to worry unless numbness increases when you may all for attention of doctor.take neurobion forte and calcium tablets for a week do some massage with  almond and vitamin E oil or physiogel liquid for a week",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do lumps in the breasts indicate?\n\nGood day madam/sir,i can feel a thumb size lump in both sides of my breast amd sometimes feel pain too,im worried that it is one symptoms of breast cancer,i found it out recently,and im taking mx3 now,would it help me?please i wanna know,hope you can help me.",
    "doctor_response": "Hello,Most common cause of both sides painful lump in breast is fibro-adenosis from underlying hormone imbalance.Should not panic of cancer breast, continue mx3 for now. Discuss with your doctor the need of mammography for further management.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long Evion tablets has to be used to have full hair growth?\n\nsir I am a 33 year old half bald man .One  of my friend advised me to apply Evion400 tablets on my head.i am doing it from 15 days.And i can see some improvements.How long i have to continue doing this? and can i take Evion400 orally if yes what is the dose and duration please help..",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.It may take up to 3 months to get real improvement in hair growth but I would also suggest trying Rogaine in addition to the Evion.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Ralph Chambers",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any chance of pregnancy by protected sex on the 16th day of periods ?\n\nHello Doctor , I am 33yrs old male...i had vagina and anal intercourse wid my girlfrnd on 16th day aftr her mensuration.. I hve wear condom during intercourse and pull out my penis before ejaculation.. My penis didnt touch her vagina/anal after ejaculation.. Plz doctor tell whthr there is any chances of getting her pregnant ..Plz doctor reply me soon....",
    "doctor_response": "hiwelcome to healhcare magic forumyou need not to worry as you have done protected sex there is no chance of pregnancy in the way you have done sex so be relax ,dont worry semen must have to go inside female genital to be pregnant i hope i answered your question",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Municous Neoplasm\n\nI have been diagnosed with Municous Neoplasm. Some people say I should see a specialist. A general surgeon told me he would like to do the surgery  to remove the ceacum since the tumor was so close to the wall. He  has never dealt with this before. Should I see an appendix cancer doctor or is this necessary.? The problem is I live in a rural area and I feel that this surgeon just might like to experiment on me so that he has one of these cases on his resume/books.  He did seem knowledgeable but seemed very text book info he was giving me.   I have talked with my family doctor and she really had not additional advice as she is not really aware of what Municous Neoplasm is .  She did say that it was up to me and she would give me a referral.  I am just worried that this general surgeon does not really know what he is looking for and has never dealt with this kind of disease so it's making me uneasy. Is a cancer doctor necessary?",
    "doctor_response": "Surgery for a neoplasm should ideally be done by a surgical oncologist. I strongly recommend that you get referral for a surgical oncologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a fatty liver cause heart burn with bloating and tremor?\n\n35 year old male, 5 foot 0 inches, 185lbs- diagnosed with a fatty liver 6 years ago but still struggle to stop drinking.  Last 2 years my body feels like it is shaking inside (same sensation i get after strenuous exercise).  In addition i have started to get bad heartburn and feel bloated.  Since disgnosed with a fatty liver i have felt a consant pressure inside. Is the internal shakng and heatburn related to a orsening fatty liver problem?",
    "doctor_response": "HiFatty liver does not cause such symptoms. Feeling of pressure around liver area, heartburn & bloating can be due to gallstones. Go for ultrasound abdomen to rule out gallstone disease. Take Capsule omeprazole 40mg once daily. Follow-up with ultrasound report.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood marks on the hands with carpal tunnel syndrome and diabetes?\n\nMy friend seems to be getting what appear to be blood marks on the back of his hands. He is 55yrs and has been recently diagnosed with carpul tunnel. He is also a diabetic. Does this have anything to do with either condition. I had read it could be a type of eczeme?",
    "doctor_response": "Hello,Diabetes is a condition that may cause impairment of blood flow in the most distal parts of the extremities. Carpal tunnel syndrome is characterized by compression of the median nerve and does not cause blood circulation issues. Your friend should be evaluated by a vascular Surgeon for these issues.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment left collar bone pain\n\nI have had a pain under my left collar bone for some time. I am 35, smoker of tobacco and cannabis. I also crack my neck frequently which sometimes I feel is connected to this. It seems burping helps it dissipate some. Could it be indigestion? I am lactose intolerant and have had acid reflux (undiagnosed) for several years. Without health insurance I cannot afford to go to a doctor, but I am growing more and more concerned",
    "doctor_response": "With all the given history you better get a health insurance ASAP . this might be serious. All the symptom you mentioned indicate towards severe avidity and gastric ulcers and you shall need an endoscopy. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Duphaston have any side effects?\n\nI want a baby.As per the prescription of doctor i am regularty taking folvite for last 19 days. AS WELL AS DOCTOR ALSO PRESCRIBED TO TAKE DUPHASTAN AFTER 16 DAYS OF PERIOD.  my last period date was 27th march. But, againg i have period on 10th april. IS THERE ANY SIDEFFECT ? NEED YOUR SUGGESTION.",
    "doctor_response": "Hi,    Thanks for the query. I understand your concern. Folic acid  when taken before conception & continued in first 3 months it helps  healthy fetal development &also prevents certain congenital anomolies in fetus.      Dupjhason  helps development of good inner lining of uterus (   needed for implantation of  embryo in uterus).. it is also essential . as it supports maintenence kof pregnancy.    *So both the drugs given to you are helpful for cinception.     * The bleeding on 10th of April is not likely to be side effect of any of the pills you are taking    - But it is possible following a break in taking tab. Duphaston.... OR..     -It can be ovulation bleeding too.   Thanks.     Thanks..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a chemotherapy ideal to treat thyroid cancer?\n\nI have been told I have thyroid cancer on Friday? I am terrified? is there anything I can do until I see the endocrinologist? will I need surgery or chemo? I am 47 yrs old and have gained 16 lbs in 2 mo? I have been a health nut for 25yrs and always in awesome shape, eat right, etc... why do I have this?",
    "doctor_response": "Hi and welcome to HCM,thank you for your query.First thyroid cancer isnt related to some risk factors that you re mnentioning. it is mostly geneteicaly determined and anyone can be affected. it is hard to say the optimal treatment method since it depends on tumor type and size. but in most cases it can be cured by chemotherapy while surgery is occasionaly indicated.Wish you good health. Regards.0",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does lymph nodes in level II/III/IV on chest x-ray suggest?\n\nCan you answer my questions please? I don t understand. My mom just take an image of her thorax, the conclusions are there are subcentimeter lymph nodes in left level II/III/IV and right level II. Oh yes my mom is still in the chemotheraphy,she has a breast cancer. Thankyou",
    "doctor_response": "Thanks for your question on HCM.There are groups of mediastinal lymphnodes in body. Snd they are devided in stages. So in imaging enlargement is written according to the stages. Breast malignancies are known for lymphatic spread. And mediastinal lymphnodes are most common to involve.So in my opinion these lymphnodes are malignant in nature. And since they are subsenti meter in size, they are in regressing stage. Your mother is also on chemotherapy.  So lymphnodes are in regressing.  So continue chemotherapy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can one cure upper abdominal pain and nausea in a child?\n\nhi my 11 year old daughter is experiencing a undiagnosed upper center stomach pain and nausea for more than 3 weeks.XRAY ,blood test have come normal .pain is worsr at night and goes on for hours .She was on antibiotic for strep prior to 3 weeks. No known allergies lactose intolerance, constipation. Treating her with acid reflux given by doctor. No improvement. Need suggestion on what to test next.",
    "doctor_response": "Hi, Please don't get panic. I would like to suggest you to get Gastro-Endoscopy. To rule out GERD/Gastritis/Acid Peptic Disorder/Hiatus Hernia. Short and frequent diet plan that too non spicy - Non-oily food shall be helpful for the patient. You can take Suspension Mucain TDS. Tablet AcilocRD. These medicines shall be helpful as of now. Take care. Hope I have answered your query. Let me know if I can assist you further.  Regards, Dr. Ajay Gupta, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe jock itch\n\nhow long should I wait to see if an over the counter ( athletes foot e.g.) can clear up Jock itch (scrotadynia).  Itches like crazy at night.  I originally thought this was a yeast infection and went to the doctor and got a steroid shot and am now on amox and it doesn't seem to be getting better.  Although not getting worse.",
    "doctor_response": "Hi, Athlete's foot and jock itch are fungal infections. Amox is an antibiotic and would aggravate the situation. You need anti-fungal treatment: orally and locally as following:- oral: Fluconazole tablet for 3 consecutive days, and repeated 1 dose only after 2 weeks- locally: good hygiene; clotrimazole/hydrocortisone creamCan discuss this further with your doctor. Wear cotton underwear and socks. Wish fast recovery!Dr.Albana",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long do effects of chemotherapy last in body?\n\nI am 68 years young, 5 3 after Whipple surgery on Pancrease I lost 26 pounds (which I don t mind) After surgery one year ago in May I was 108 pounds....now after 6 months of chemo I m up to 112-114 which is fine. But I have IBS and continue to have sleep issues; and am having problems remember things. pancratic whipple surgery to remove cancer from opening of pancreas. Taking enzymes and photonics for the IBS. Having difficulty sleeping. Melitonan not working now. Sometimes Ambian takes quite a while before I get to sleep. How long will the chemo I was given for 6 months stay in my body? I m working with a trainer for Pilates but still feel tired and sleepless. Any recommendations?",
    "doctor_response": "Hello dear. I have gone through your case. The symptoms of IBS you are suffering from are due to pancreatic deficiency. You should take pancreatic enzymes replacement therapy after consulting your doctor. The effect of chemotherapy vanishes quickly after 3 weeks of last chemo, so no need to worry. For sleep problem, there are many better drugs and therapies available now days. You can meet a sleep physician who will help you in this matter. Hope i have made you understand. Thanksregards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing toe to vibrate after removing tape from broken toe?\n\nI broke my big toe 11 days ago and the hospital taped to the toe next to it for a week and I have been resting it. The tape was taken off 2 days ago and it has now started to \"vibrate\" every 10 minutes which is drivig me mad. Is this normal? Is it the nerves repairing?",
    "doctor_response": "This is normal..the toe was strapped to the next toe to immbilise it for the fracture to heal.Now that it was in rest for past 10 days it has become a bit weak and now that the toe is trying to resume back to nornalcy its giving you the feel of vibratiodont worry or panic.. no need for any medications or therapy. this will setlle with timethank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bump on upper lips\n\nI have a bump just one bump on my upper lip its flesh colored maybe a tiny bit red no pain no soreness no dis comfort at all and i can feel it with my tongue a little bit what could this be ? and i kinda bite m upper lip alot but not hard could this be irratation or something ? help",
    "doctor_response": "Hi.Thanks for your query.With the history you have provided I would think of 2 probable causes.1. Submucous cyst, which is a sort of retention cyst of a minor salivary gland. 2. This can be a small hemangioma.Since this is on the upper lip, it would be wise to be seen / examined by a surgeon and get operated . He will definitely see that the lip is not disfigured.",
    "dialogue_context": ""
  },
  {
    "patient_message": "FREQUENT URINATION AND WHITE DISCHARGE.\n\nDOCTOR, I FEEL NUMBNESS IN MY VAGINA. THERE WAS A WHITE DISCHARGE FEW DAYS BACK. NOW I AM URINATING LESS QTY AND MORE FREQUENT. SOME TIMES IT LEAKS OUT DROPLETS IN MY PANTY. DONE A ROUTINE CHECK OF URINE SAMPLE AND ALL ARE OK. DO I HAVE ANY DESEASE? ADVISE.",
    "doctor_response": "Thanks for the query Looks like you are having urinary incontinence and it could be because of the uterus and less to do with white discharge I suggest u meet a gynaec for examination of the pelvic organs and also a pelvic ultrasound is necessary It would have helped if u had told your age to us Have a healthy living",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lack of energy?\n\nI'm 28 years old and feel like I am thinking through cotton wool.  6 years ago I had my T checked and it was low then (I was having Erection issues) but the doctor said it was within normal ranges.I also find energy severely lacking in the afternoons and general motivation very difficult to muster. My latest results of total test were 9.8 nmol/LI also had an undescended testes as a baby (surgically brought down).I went on modafinil thinking I had adhd because of my inability to focus, poor memory and energy though it may not be the case.How much does a healthy difference in testosterone levels make?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Don't worry you may be suffering from major depressive disorder or asthenia. Possible causes are psychological or organic causes. Chronic rheumatological disorders, anemia, electrolyte imbalance or viral infection or nutritional deficiencies etc. Until examination is done it is difficult to say what it is. Please consult your physician and get it done HB, electrolyte level, thyroid status, urine and blood sugar examination, then he will treat you accordingly. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "When is pregnancy advisable post a laparotomy?\n\nhello doctor. i just had laparotomy last month (1st Oct 17) my left tube were removed and and right ovarian cyst were removed too. how soon can i try to get pregnant again? many doctors said i have to wait 6 months to recover and try again. kindly advise",
    "doctor_response": "Your doctor said is correct you should at least wait for 4-6 month. Because your uterus need improvement for better implant of embryo and avoid complications. It is also important for healthy baby. Defiantly you will conceive, but this is not a perfect time wait for it",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for getting pregnant\n\nhi,im 38 years old,im trying to get pregnant for 7 months now but we always failed,my ob gyne advise me to use clomide for 6 consicutive months,im doing my folicle monitoring every month and there is only one dominant folicle but stil im not getting pregnant.my ob gyne also found out that i have myoma measuring 2.4cm but she told me not to bother if will not affect  if i will get pregnant,please help me im desperate to have a child.",
    "doctor_response": "Hi I think the fibroid will not affect the pregnancy rates. You can take clomid for 6 months. One dominant follicle is good enough for conceiving. So don't loose hope. If you don't conceive by this you can go for IUI after a semen analysis of your husband and a tubal patency test.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What do the presence of pus cells and RBCs in urine indicate?\n\nHi doctor,",
    "doctor_response": "Hi. I have seen the reports sent by you (attachment removed to protect patient identity). For further information consult a urologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent bowel movement and vomiting?\n\nhie sir my baby is passing stools which vary from watery stools to granuels type 8-10 times a day n hez too vomiting 2-3 times A DAY n we have just started giving him homeopathic medicine n baby takes breastmilk upto 45minutes n gets hungry every one hour please suggest what is hapening n what should we do .....",
    "doctor_response": "Hi.... I understand your concern but you have forgotten to mention the age of the baby in the query. So I give you two possibilities -1. If the kid is less than 6 months old and exclusively on breastfeeds then this is a normal phenomena you need not worry about it.2. If the kid is more than 6 months old then it could be acute watery diarrhoea due to a viral infection. In this case also if the kid is otherwise active and viiding urine well and not dehydrated you need not worry about this diarrhoea. He  needs only oral rehydration solution and Zinc supplements.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the cause for fever, stomach ache, and loose motion?\n\nHi doctor, I am suffering from fever, stomach ache, and loose motion for the past three days. Please tell me what has happened to me.",
    "doctor_response": "Hi. Now, the season of malaria and dengue has started. Get your blood tested for dengue and malaria. It should be your first preference. Then you have a loose motion for the past three days so, hydrate yourself as more as possible. Dissolve one packet of ORS (oral rehydration solution) in one liter of water and drink three liters per day. It will hydrate you and allow the harmful organism excreted out through the urine. For further management, take one tablet of Norflox TZ (Tinidazole, Norfloxacin, and Lactobacillus) with one tablet of Pan 40 (Pantoprazole) three times per day for two days. For more information consult a family physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Breathlessness, exhaustion, asthma, Taking vitamins. Will I be okay?\n\nfeel fine in morning get up at 6:30am- but by about 5pm i seem out of breath and exhausted. This started with my period sunday at 10am. i have asthma so i have been taking a breathing treatment about 2pm last 3 days but I m don t seem to be wheezing , added a 10-15 min. walk and started taking vitamins last 2 days -also had Epstein bar virus last time active was 16years ago - and been system free since. Is there something else i can try before running to the Dr.",
    "doctor_response": "Newer studies says Viamins fuel sickness If you have asthma and allergies stop taking vitamins and animal proteins You can add anti allergics like fexofenadine bd Singular 10 mg bd Syp Ventrolin 1 tsf bd Syp tossex 1/2 tsf night for 10 days",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest methods to control mental illness/anxiety\n\nI feel very angry frustrated.I cry all the time small things become huge in my mind i think so much.I hate so much.I hate myself bang my head on the wall i went to cut myself with a razor yesterday.I cannot cope with things the way i used to .please help me!",
    "doctor_response": "Hello,Your symptoms suggest depression and anxiety and you have developed a tendency to selfharm, which is not good.You should ideally meet a psyhiatrist. Usually, in such cases we give sertraline 25-50mg, along with a benzodiazapines for acute attacks in 0.25mg dosage.You might need to raise the dosage of sertraline to 100mg - after seeing at the response.If there is sleep disturbance then 12.5mg xolpidem will be very helpful when taken at night time.Dont worry, you will start fellibg much better and almost normal within some time of begining meds.Wish you good helath.Dr. Manisha GopalMD Neuropsychaitry",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can i calculate my ovulation days in order to get pregnant?\n\nhi my name is Heleny. im trying to get pregnant, however I don.t know how many days my cycle last, thats why its impossible for me to calculate my ovulation days :( my last period was june 2, and before may 8 (both last 5 days) before that april 4. please help me thanks",
    "doctor_response": "Hello dearI understand your concernYou have first find the average day of your cycle.I think it could be 30-32 days but you can judge form your next 2-3 cycle.Day one is the first day of the menstrual period and the last day is the day before the next period begins. Ovulation happens about two weeks before the next expected period. So if your average menstrual cycle is 30-32 days, you ovulate around day 15th-17th.So I would suggest to do sexual intercourse during the 10th to 20th day of your cycle.Avoid stress, take healthy diet,drink plenty of water, do regular exercise and maintain proper pelvic hygiene.If you have irregular period then consult the gynecologist for detailed examination.Progesterone pill in second half of period will help in conceiving and regularize the period.Hope this may help youContact further if follow up neededBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain on right side after appendix removeal\n\nI had my appendix removed this august. since then i have daily right flank pain that gets pretty bad at times. I do have a history of kidney stones but i do not feel like these are the pain. it used to happen once every couple weeks or so but now it is daily.it starts in my right flank, sometimes travels to the top of my groin area but then the pain goes back up into my kidney area. i have no problem urinating, it does not hurt when i do so. The pain will go away if i lay perfectly still in bed for an hour or so but sometimes comes back if i get up. I drink a bottle of water when i get up in the AM and this seems to trigger the pain for the day. it doesn t matter how fast or slow i drink it, it hurts within minutes. The pain the past week has been towards the front of my side, not my stomach and not my back but right in between.If i get up in the AM and have no pain, it can start if i am up and walking around for more than about an hour, sometimes shorter.Very confused on what this could be. I am afraid it is something wrong with my kidney.Any suggestions?",
    "doctor_response": "hello greetingsI would like these details from you to help you furtherDo you have nausea, vomiting or diarrhea associated with it?Did you lose appetite and weight recently? If yes how much and in what time?how severe and nature of pain do you feel?in my opinion it could be due to spasm either in urinary tract or biliary treeconsult your  doctor for ultrasound and urine examination Hope I have answered your question. If you have any further questions I will be happy to helpwarm regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold and stuffy nose in children\n\nHi, My baby is 16 months old is suffering from cold for the last 2 days and is not comfortable in sleeping as her nose gets blocked. Kindly suggest any nose drops / syrups or else the steam inhaler would be o.k. for her. Kindly suggest a good steam inhaler.",
    "doctor_response": "Hello.  I just read through your questions. cold symptoms are very common in this age group. The best way to make her comfortable is to use saline nose drops prior to bedtime. If she is unable to blow her nose, as most 16 month olds are, you can use a rubber or plastic bulb syringe to suck out the mucous, approximately 5 minutes after inserting the nose drops. This will clear the nasal passages and make her more comfortable. Inhalers are not necessary. However, a vaporizer with cool water, running in her room overnight, could be helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in my groin?\n\nI played football yesterday during the game i felt a slight pain in my groin, I stupidly decided to carry on playing. I kicked the ball while turning and I felt a huge sharp pain in the same place. I had to stop playing as I couldnt run or kick the ball. I can walk on it buts its very painfull. I also have an achy pain in my lower back on the right side (same side as groin pain). I decied to see a doctor but could only be seen by the nurse. She has prescribed me some strong pain killers. When lying flat on the floor I can't lift my leg at all, there is not much pain when i try to lift it, it just wont lift? Also I cant bring my knee up to my chest, when i try i get huge pain deep in my groin and round to my back. I have been told to go to A&E, im not sure if i should?",
    "doctor_response": "Hello, It is likely to be muscle spasm. Take rest. Do physiotherapy and exercise. Most cases subside spontaneously. If the problem persists, do X ray of hip to see if there is any bone injury. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Sujoy Dasgupta",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the solution for burning sensation of eyes caused by dryness?\n\nHi doctor, I have an issue of eye burning, and it occurs due to dryness in eyes. Please suggest a permanent solution for dryness.",
    "doctor_response": "Hi. The dry eye needs evaluation for identifying the cause of dryness. It can occur due to lifestyle changes related to excessive use of digital devices. It may also happen due to a drop in tear production which can be measured by Schirmer's test. It can also occur due to excessive evaporation of tears due to deficiency of the lipid layer, and it may be evaluated on slit lamp examination of the opening of your meibomian glands. I would recommend you see an ophthalmologist. If the cause is treated, the dryness reduces soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could lumps on shoulder suggest?\n\nmy daughter has a lump on her left shoulder, 3.5cm. doc.say its formed of blood which is good to remove. however, its connected to arteries. is it advisable to do so. i am v. worried, she is only 2.5 years old. however, she is going form mri scan in may before the opt.",
    "doctor_response": "Hi,Dear,Thanks for the query to HCM. I studied your problem in depth and I understood your concerns.Causes-In my opinion your lump on the shoulder -may be of hamartomas of vasular origin/ malformations / angiomas/ A-V malformation.MRI would fix the causal diagnosis.But excision biopsy operation would fix its treatment and HPR would fix its cause.So consult your doctor and don't worry.So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you, but just ask a query to HCM and be comfortable to resolve your health issues.Welcome for any more query in this regard to HCM.Write good resume and Click thanks if you feel satisfied with my advise.Have a Good Day.Dr.Savaskar M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does invasive lobular carcinoma Her2 respond well to chemotherapy?\n\nI had a mastectomy for a 7.5 cm Invasive lobular carcinoma Her2 negative Estrogen positive 2 nodes were positive. Now I am reviewing if Chemo will be effective with this type of cancer. I have been doing research and find the ILC does not respond well to chemo.",
    "doctor_response": "Invasive lobular carcinoma and invasive ductal carcinoma are both treated similarly and have the same sensitivity for chemotherapy. The treatment for your cancer includes chemotherapy followed by radiotherapy followed by hormone therapy. There is no alternative to this as this is the standard that is followed world wide.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for stage 4 bowel cancer ?\n\nHi my sister is 28 & just diagnosed w stage 4 bowel cancer which has already speed to all her liver and lung. She is so strong surely their is alternative therapies that can help her and allow her to live longer than a few years. She was told she will be using a stoma for the rest of her life, why can t they do something to correct this? Cld she have a liver transplant and remove the affected lung? They got rid of a large tumor in her bowel please help we r all devastated thanks Mish",
    "doctor_response": "Hello Welcome to health care magic I am sorry ,she got such an illness in very advanced stage ,at such a younger age .But treatment  has its limitation.all that is expected ,can`t be done. Wish you speedy recovery Disclaimer",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for the pain in the hips while walking\n\nWill i need a per of crutches because i have a really bad hip and we have had x Rae done on it but we have to Waite 7 to 10 days for results but the problem is i cant walk on my hip because it really hurts so can i have a er of crutches as support because my hip is really bad and hurting",
    "doctor_response": "Yes u can use crutches for pain relief till your xray reports are available.Meanwhile you can also take antiinflammatory like ibuprofen to tide over your painThanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Memory loss, involuntary movement of face and hands. Worried\n\nI went to the DR. and complained that i felt like I was lossing my mind . Im have suver . Im having  a lot of memory loss proublems . I can be talking to someone the nexted thing I don't ever rememeber the talk ,go places not remember how I got there  . After going to bedmovements  I'll wake up and roll over and not remember who the man in my bed is ( my husband of 28 yr's ) . My DR. said I have Tardive Dyskinesia , I do have involuntargive  movement with face and hands . But i am more worried about my los of memroy .",
    "doctor_response": "Hi,Thank you for posting your query.Based on your symptoms, you could be having a mild cognitive impairment of early dementia. You require a detailed evaluation by a neurologist to determine the severity and the underlying causes.This would involve doing a brain scan such as MRI, EEG, blood tests such as vitamin B12 and thyroid profile.You would get better with treatment.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My email: drsudhirkumar@yahoo.comMy blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pregnancy happen even after taking I-pill?\n\nHey doctor..I m 19 year old.. Actually i didnt hd proper sex with my bf. I really dont knw whethr semen has went inside or nt..but i hv taken ipill within 24 hr..nd nw i hv abdominal pain.. I m vry tensed abt it..i cnt evn go for chekup.. Evn i hv used ipill one more tym a couple of months back. Is der ny chance of getting pregnant and is der ny side effct in future??",
    "doctor_response": "Hello dearI understand your concernI pill is 95 % effective in preventing the pregnancy as you had taken within the 24 hour of the sex.So there may be 0-5% chance of the pregnancy if you had sex in the fertile phase of the cycle.Following are the side effects:Delayed/earlier period, excessive bleeding, hormonal imbalance, ovarian hyper stimulation and infertility problem on regular use.Do not use I pill as regular contraception.If your period will delay by the 12 days from the normal expected period date then go for urine pregnancy test and or blood HCG to confirm the pregnancy.If you will be pregnant then intrauterine pregnancy will be terminated by the abortion pill under the advice of gynecologist.Abdominal cramp may be due to side effect of the I pill.Take bed rest and tablet meftal spasDrink plenty of plenty of water and take healthy diet.Hope this may help youContact HCM for further health queryBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can psychosis, bizarre behavior, hallucinations with lack of orientation be treated?\n\nMy mother (53 y,o.) has always been emotional, but lately her emtional irregularity has been very extreme. Last night after a heated arguement with the family, she burst into tears and began expressioning symptoms of psychosis. Bizarre behavior (not understanding what the function of furniture was, blank expressions), and then she may have had a hallucination of her deceased mother. When she snapped out of it, she could not remember what happened, but just remembers that she felt she was in darkness with voices around her. 30 minutes later I assesed to see if she oriented x3, but she failed. An hour later she was oriented x3, and was slowly returning to baseline. She currently is doing better, but not 100% herself. She may be in the early stages of menopause, and has no other psychiatric history. Is this common in menopausal women?",
    "doctor_response": "Hello She is 53 years old and after a major argument she has developed abnormal behaviour, expressionless face, complaints of seeing her dead mother, forgetfulness. She was not responding to interactions. As per my opinion though acute psychosis can be possibility, but she might be having severe anxiety and acute stress reaction. There is positive history of major fight at home which was followed by symptoms. She has not shown other behaviours of psychosis like suspiciousness, fearfulness, irrelevant talking. In severe anxiety or in dissociative disorder individuals may stop to interact, may show abnormal behaviour. I would advise you to consult a Psychiatrist to differentiate between these complaints. Medicines like low dose benzodiazepine can be given in her situation to calm her. Clonazepam, Lorazepam are commonly used. Visit a psychiatrist for proper diagnosis.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mild dilatation of calyces in kidneys\n\nhi. doc! i am emelia codjoe from ghana west africa, accra to be precise. i was diagnosed of mildly dilation of a calyses in my left kidney. i was put on lysinopril for almost two years now. i sometimes does'nt feel the pains at times too it becomes more serious. please help me is there any medicine to cure it? i am 40 years and will be 41 in september 2010. thank you. waiting to here from you. bye",
    "doctor_response": "Hi Emelia and welcome to HCM.As an Urologist, i can understand your anxiety.Mild dilatation of the calyces,isn't something to worry about.Lisinopril is being given to control high blood pressure.Drink about ten glasses fluids daily.Repeat the scan after 6 months, to check if there's any change.Wish you well. Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the white pus like things on my gums?\n\n(20 years old, 6 foot, 135 pounds, no serious medical issues, recovering smoker) White pus like substance on gums, easily removed with brushing... but it comes back. there's no redness underneath, just normal pink gums. It's no where else in my mouth (i.e. Not on my tongue or back/roof of my mouth). Should I be concerned?",
    "doctor_response": "Hello,I have read your inquiry. My initial screening would include an evaluation for:-Periodontal disease-Ulcerating gingivitis- Heavy plaque and tartar accumulation-Fungal oral yeast infection-Changes in your salivary glands-Dental infections with drainageA review of your medical history may show changes that could affect the mouth and gums.  Have there been any recent changes to your diet?Have you started to use any new products? Allergic reactions are possible. Are there changes in medications or vitamins? Do you experience a dry mouth? A recent change such as stopping smoking can change your oral environment. Do you have any gastric disturbances? Do you have any sinus congestion? These are some questions that I would review with my patients upon a clinical exam.More details would be helpful. I recommend a clinical examination. If you are not up to date on your dental exam please schedule a routine visit and cleaning.Please maintain good oral hygiene. Warm saltwater rinses have a cleansing effect. Please follow through with a dental visit if this does not resolve shortly.Thank you for your inquiry. I am available to answer additional questions and would be glad to assist you further with more details provided.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a snapping feeling in neck shooting up to head?\n\nevery so often I if i turn my head suddenly i get a snapping feeling like an elastic band snapped in my neck and shoots up the left side of my head  first i am wondering what this could be happens often second this last time it has left like a sensative feeling inside my head any ideas",
    "doctor_response": "Hello!My name is Dr. Aida and I am glad to attend you on Healthcaremagic!Your symptoms could be related to occipital neuralgia. As the pain is triggered by neck and head rotation, it could be related to chronic degeneration of the cervical vertebral column (cervical spondylarthrosis). For this reason, I would recommend consulting with your GP and performing a cervical vertebral column X ray study. Physiotherapy and painkillers can help improve your situation. Hope you will find this answer helpful!Best regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a swollen arm indicative of a fracture?\n\nI fell on impact on my wrist and I heard a slight pop and wen I was observing what is happening my arm started to swell and it is hot to the touch I have no idea if I fractured my radius or just broke it I need exact answer if I should go to the doctors or or not?",
    "doctor_response": "Hello, The swollen arm that is painful and hot can be due to an infection or a hematoma formation. The exact cause can be determined only after a direct examination and an X-ray of the area. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for hypertension\n\nOn blood pressure medication 50 mg.. blood pressure has been overly high last couple days have not been feeling myself. 181/111 took a extra Atenolol didn t do anything keeps going higher not sure if I should be concern about this? Pulse is only like 60. Do I need to go into a urgent care or wait till tomorrow and see If it goes down??",
    "doctor_response": "Hello and welcome to HCMI have read and understood your queryI hope this will helpYou are having uncontrolled hypertension.. Which is a risk factor for heart ,RENAL and cerebrovascular diseases..I think you should keep on waiting for ATENOLOL 50MG to work for you ..you should consult your GP again and there are two options:Either dose of atenolol should be increased to 100mg per day (or)A second anti hypertensive drug should be added to it..Mean while try to lose weight, do regular exercise, eat less salty and fatty foods and avoid taking stress..I hope this was useful.. You can reach me any time with an otgeru questionRegardsDr faeza",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for high blood pressure when on clonidine?\n\nI have high blood pressure I am on medicine but it still stays high they put me on .1 milligram clonidine last night to take when I think I need to, my arm also hurts from elbow up and also my neck and head, could this be caused from blood pressure, they also said I had arithritis in my shoulder",
    "doctor_response": "Thanks for contacting HCM. Dear patient you have not mentioned why you are on clonidine, as clonidine is not used for normal high blood pressure cases. Usually when kidneys are affected then clonidine is needed and that too on a regular basis not when you need to. You have not mentioned which of your arm hurts as pain in left shoulder and arm can be due to cardiac problem like Attack or angina. Please get your blood urea and creatinine done to rule out renal damage. If there is renal damage you can take clonidine 3 times a day and if necessary add prazocine 5mg at bed time. please also get an E.C.G. done to rule out cardiac cause of shoulder pain. regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a delay in speech?\n\nMy 28 month old is not talking.....he is very affectionate....loves to hug and kiss.....he plays well with others....concentrates and focuses well whe nhe is playing or watching tv...is good at puzzles and hide and seek....Im just nervous about his speech.",
    "doctor_response": "Hello,I can understand your concern. If your child can hear well and obeys what you say, then he is only having speech problems. It might be a problem related to the muscles related to tongue that may not allow free movements of tongue necessary for pronunciation of words. I would advise you to visit a dentist for examination of his tongue and to check if his tongue movements are fine. If tongue is the problem, then oral surgeon can help with the problem. If tongue is fine, then speech therapist can help. You and other family members should take care not to use signs to explain him thins and not to accept his signals in place of words. Work with him to speak little words aloud and slowly. However, if your son has problems with hearing too, then his tongue may be fine and he is not talking because he does not know what to speak in absence of hearing ability. In that case, ENT specialist should be consulted for problems related to ear.I hope this information guides you well. Thank you for choosing HCM. I wish your son can communicate soon with speech.Best,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it to be concerned about the pain in the chest region?\n\nhave pain in the chest region when I breath in, have had a ct, ekg, and nuculer stress test and all are normal. pain will go away after a couple of days and then return after maybe a month, however the pair appear in a different area of the chest each time, sometimes it will be accompanied by a low grade fever.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, you are mostly having costochondritis. No need to worry for major heart or lung related diseases because all your reports are normal. Costochondritis can cause recurrent chest pain on different chest areas with fever. So follow these steps for better symptomatic relief. 1. Avoid heavyweight lifting and strenuous exercise. 2. Avoid movements causing pain. 3. Avoid bad postures in sleep. 4. Apply warm water pad on affected areas. 5. Take painkiller and anti inflammatory drugs. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I try to conceive while suffering from supraclavicular tuberculosis?\n\ni am suffering from supraclavicular tuberculosis again after treatment in 2008 to 2009  i try for second baby but misaccrige in jan in march 2012 i know suffered with same tb again  so is it safe for me in 2013 i try for baby or no im 33 my husband is 39 year  now i m on medication for 1year again",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Practically, there is no harm in getting pregnant while on anti tubercular drugs. Amongst anti tubercular drugs, only streptomycin and levofloxacin  are teratogenic and can harm developing fetus. So if currently you are taking any of these drugs then you should first stop these drugs and then you can conceive. Maintaining good immunity and nutrition is also important while conceiving with anti tubercular drugs. So also take multivitamin tablet containing folic acid, vitamin b12, b6. Also start high protein diet. So above mentioned precautions should be taken while conceiving with anti tubercular drugs. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are elevated liver enzymes and increased calcium levels the same?\n\nHi recently I had blood work that showed slightly elevated liver enzymes. My Dr wants to retest in 3 months. This week I went to my Hematologist and received a call the next day that my calcium levels have also increased. Are the two connected? I have to go back in 2 weeks so I am freaking out waiting.",
    "doctor_response": "Well, I don't think there is any problem in retesting your liver enzimes before the three month time. As for the calcium level I don't think there's a relation between the two. Is more a coincidence. Liver enzimes should be monitored for the six months to come. The frequence could be i.e once a month.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are side effects of arip?\n\nmy son,32 years old,hearing impaired,was taking 10mg aripMTfor past 6 months..He was alright but to clear an obsession risdone liquid was given.he developed stiff neck and other problems so bexol 2mg was added.My physician spoke to the psychatrist and risdone was stopped and arip increased to 15mg.this gave him stiff thigh muscles and urine problem so for two days the psychtrist stopped arip completely.Bexol 2mg continues and i am to restart arip 5mg now. My son looks and behaves better ever since he stopped taking these medicines.They were actually giving him anxiety and the anger increased.should i restart arip or just keep him off all medicines.",
    "doctor_response": "Hi, It would depend on the underlying disorder. The increased muscle tone feels alarming and is generally not actually a serious condition and is easily treated. Anti-psychotics are quite helpful for a number of serious psychological conditions. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long do muscle spasms last?\n\nMy brother recently (3 days ago) had a combination pace maker and defribulator installed.  He has had sever chest muscle spasms and has had difficulty sleeping.  He went back to the ER and they assured hime the pain was not heart related but just muscle spasms.  How long will these muscle spasms last and is there any treatment for them?",
    "doctor_response": "Hi,welcome to HCM..Thanks for writing to us.In your case i would like to have a EKG done at the first hand and consult the cardiologist.If the pacemaker is properly working,its better not to worry.For the muscle spasm you can tjke analgesic like paracetamol or ibuprofen or any other muscle relaxants.Hope I have answered your query.Stay fit,good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can high FBS levels be brought down while on Metformin and Invanka and a suitable low carbohydrate and low sugar diet?\n\nI have Diabetes 2. I am a 65 year old female....I take Metformin and Invanka.....Lately, even not eating sugar or bread or flour...very little carbs...my sugar is running over 200 in the mornings before eating. This morning it was 283....I go to my physician for my 6 month checkup in April....I want to get this down...I don t want to go on insulin....what can I do?",
    "doctor_response": "Hi, If the fasting blood sugar is high then there's will increased glycogen lysis by the liver. So it may lead to high fasting sugar. It may be due to the dawn phenomenon also. It may also due to the insufficient dosage of before night insulin or drugs. So you may have to take sufficient dosage of oral antihyperglycemic drugs regularly. So you have to change your oral antidiabetic drugs. Please consult your diabetologist, he will examine and treat you accordingly to your fasting, postprandial blood sugar reports. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any chances to get pregnent when both fullopian tubes are blocked Is there any chances to get pregnent when both fullopian tubes are blocked ?",
    "doctor_response": "Hello, Yes this is possible. There are several techniques that had made pregnancy possible with both fallopian tubes being blocked. You must consult your gynecologist so that you will be guided to the technique that is best for your case. If you need more help, please visit: www.med50.blogspot.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "As per Follicular study report when should pregnancy be attempted?\n\nHi, Iam 28 yers old ,My weight is 56 kgs .My doctor suggested Follicular study , Yesterday was 11 th day and the 11th day report -right ovary -nil,left ovary-DF:13mm endometrium -8mm POD-free. Can you let me know when i should have intercourse to get conceive . Generally how will the normal report look like",
    "doctor_response": "Hi, hanks for writing..I understand your concern.. Repeat follicular study on alternate day till the follicle size reaches 20 mm. It is time you should have intercourse. Repeat scan need to be done to see for ovulation status after 2 days. Post ovulatory period take progesterone for luteal phase support. Hope I have answered your query. good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe knee pain\n\nI went to my doctor several weeks ago for severe knee pain...back of the knee. He gave me some obscure diagnosis without even looking at my knee, just moved it around. It s not any better and now I have ankle swelling on the same leg. The ankle doesn t hurt, but I m concerned.",
    "doctor_response": "Dear User, What is your age?How did the pain start?Did you get injured? What was the diagnosis given?Ankle swelling with knee pain is usually after trauma if any. Otherwise ankle swelling may have some other separate cause. Which medicines were advised to you?",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dark brown bleeding and pain during intercourse?\n\nHi I have had the nexplanon for 7 months now at first it was ok now for the last 2 months I ve had this dark brown muscus like with small clots of blood.. everytime I use the restroom..sex is impossible it hurts...and I m sluggish and sick at my stomach all the time",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, because of the hormone changes such irregular menses is happening and it might be due to age, or may be IUD of course IUD can not cause the hormone disturbances but it may cause the infection and trauma, as long as the possibility of IUD is concern better to see the doctor  hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat short term memory loss?\n\nhelp please. im a 23 year old with short term memory loss. not like I forget where I left my keyz.. more like i cant remember things me and my boyfriend do or the last movie I watched and I just watched it a few days before. any idea what it could be?",
    "doctor_response": "DearWe understand your concerns. I went through your details.I suggest you not to worry much. The symptom you are mentioning does not point to short term memory loss. It could just be selective forgeting. Your brain hs the capacity to forget something which you do not want to remember. The same thing happens in the case of undue anxiety and restlessness. The case of forgetting keys is one example and the other one what you are experiencing now. Therefore, unnecessary worries may trigger selective forgetting.You can post a direct query to me in case you further need my services in this case. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have unrelenting back pain between my shoulder blades. What could be the reason?\n\nHello doctor, I am a 30 year old female. For the past few weeks, I have had an unrelenting back pain between my shoulder blades. I also have a sharp, tearing chest pain above my left breast area or along my sternum on my right side. The sharp pain will last a few minutes, then stop. At times, it radiates to my shoulder. When it happens, my pulse and blood pressure increase for a few minutes and I feel short of breath. What could this be? I had PE ten years ago but the pain was not quite the same.",
    "doctor_response": "Hello. After reviewing your health query, I want to add that there may be anything from a list of possibilities. So, as the next best step, you need to consult your PCP (primary care physician) and get referrals to consultations for a pulmonologist, a cardiologist and/or a gastroenterologist. Your PCP is capable of ruling out at the preliminary level on his own. He would refer you either to all of the aforementioned specialists or only one of them as he feels comfortable with. Once ruled out, we can better assist you and this hopefully will all be managed accordingly. Hope this helps. Please feel free to ask me more if you need further assistance. For further queries consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the natural home-remedies for glowing skin ?\n\ncan any one tell me any home remedy for face glow pl thanks",
    "doctor_response": "eat  healthy balanced diet full of fresh fruits & vegetables.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high GFR in stage 3 kidney disease\n\nmY DAD  BLOOD WORK WITH  STAGE 3  (38 GFR) KIDNEY HIGH CALCIUM URINE CEL occa ua BACTERIA RARE A Desperate here:  heart patient, borderline diabetic, prostate cancer survivor 3 years past, now kidney problems...they say drink more water...we need advice",
    "doctor_response": "Hello and welcome to HCM.As an Urologist, i can fully understand your concern.Kidney function is reflected by GFR estimation,and blood creatinine levels.Kidney failure is divided into 5 stages,depending on GFR level.So now you know about stages of CKD(chronic kidney disease), and stage 3.With prostate cancer treatment,diabetes and heart disease, stage 3 kidney disease, will need a Nephrologist care to decide, if dialysis, is indicated.Drink water depending on urine output only,with low salt and protein diet.If you've any doubts, send the reports to me as a direct question.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can cough with phlegm be treated without antibiotics?\n\nhi my baby just abaut 2 months having cough and phelgm and getting worst. i know abaut that its not good to give antibiotics right now . so i want to know how to treat traditionally without any complication and what is the complication if the baby on antibiotics in future.",
    "doctor_response": "Hi, Cough and cold are viral 95% of the times in children. For cold you can use anti-allergics like Cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given every 4-6th hourly, that too only if fever is more than 100 F. I suggest not using combination medicines for fever, especially with Paracetamol. Generally for cold you can use Cetrizine every 12 hourly for 3 days. For nasal block, plain saline nasal drops will do, every 4-6th hourly to relive nasal congestion. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking birth control pills. Had sex during periods. Now bleeding stopped. Can I get pregnant?\n\nhello doc pls my quest is \u00ed am on birth control pills and am in the week where i hve to wait for one week before continueing,but my menstrual period started on the 10th of thhis month.just two days to my flow i had sex with my man and yet i have stopped bleeding .can i pls get pregnant within this period.i normally bleed for 5 to 6 days",
    "doctor_response": "Hi, Thanks for the query. There is less possibility for pregnancy. As: -You are on birth control pills with regular usage. -Had intercourse before the onset of periods. Menstrual cycle can undergo changes while being on pills. So your scanty flow can be because of that. You continue your tablets as usual. You will get your withdrawal bleeding as usual but if you miss better to for pregnancy test once. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for enlarged live condition\n\nSir, I undergone gall bladder stone removal surgery by 2 months before. At that my liver was in normal by ultra sound. Now I have pain in my upper abdomen,so I undergone CT scan. Now reports come out with enlarged liver by 17cm in craniocaudal axis. What medication can I need?",
    "doctor_response": "Hello Enlarged liver may be due to many reasons like hepatitis,infection,fatty changes in liver,tumour etc.Your liver size is mildly enlarged in size.Besides clinical correlation,you need investigations like routine hemogram,random blood sugar,complete liver function test,urine RE/ME,lipid profile.You may need to take some medicines after complete investigations.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What kind of diet should I take when suffering from epilepsy and thyroid problems?\n\nI have epilepsy, I take Topamax twice a day, I also have diabetes. I get so tired during the day I fall asleep sitting up about 2-3pm. My diabetes is well under control. A1c's are 5-6. I have them tested about every 3 months. I do have seizures if I get upset or stressed or if I exercise. I have thyroid problems which makes my weight heavy. I do not eat much which is not good for my diabetes. Is there a better diet for me I should be eating?",
    "doctor_response": "Hi and thank you so much for this query.I am so sorry to hear about this diabetes and epilepsy. I have a strong feeling that your hypothyroidism is not well managed. This is because despite decreased food intake, you still complain of weight gain. Also, your fatigue is suggestive of symptoms of hypothyroidism. If your treatment has not been evaluated, I will suggest you get the TSH measured to see how well you are doing on treatment. At least, you know stress and getting upset would provoke seizure, try to stay clear of these provoking factors to spare yourself repeated seizure episodes. I understand it is not easy but then, it is worth it if you want a better quality of life.I hope this addresses your query fully. Thank you so much for patronizing our services and please do feel free to ask for follow up clarifications and information if need be. I wish you the best of health.Dr. Ditah, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will taking penicillin help cure kidney infection?\n\nI have just been to Vegas and Mexico and I came back last weds. Fri I was really hot, sat I just didn t feel right and about 8pm I was shaking violently to keep warm.then I got so hot I had to strip off. Sunday I felt a bit better and went out for tea couldn t eat anything and by the time I got back I had yellow frothy dhiarohea.i had the violent shakes again that nite.mon went to docs and she said I have kidney infection and prescribed penicillin. I still have stomach noises and the dhiarohea is pouring out of me after drinking.",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, this may not be kidney infection because you do not have any renal symptoms that could prove kidney infection but this could be more look like intestinal infection could be because of water born organism might be due to travelling, most of the time this is self limiting and hydration is the matters only, if this does not come around then you can try \"Tab Doxycycline 100 mg twice in day for 5 days\" take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent back pain\n\nHi, I am 29 years old male. I have upper back pain for the last 6 months. It started after my static car was hit at the back by another car at about 30 km/hour. There was apparent injury but my back started hurting. X-ray showed mild thoracic rotoscoliosis and no degenrative changes. what should I do to get rid of the problem because I am having many off days from work due to pain.",
    "doctor_response": "Hi, I am sorry for the accident you had 6 month ago. I am happy to know that no serious injury was apparent. The persistent back pain is due to the hit and rotoscoliosis (which is a severe curvature of your spinal cord with rotation). You say that X-ray showed mild thoracic rotoscoliosis with no degenerative changes. Good that there is no degenerative changes, but rotoscoliosis itself can cause upper back pain. I advise to consult further with orthopedic specialist in order to find the most adequate ways to help with rotoscoliosis and ease the pain. Take OTC analgesic and can apply analgesic cream locally. Wish fast recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the pain in the legs be due to blood disorder?\n\nsir i am suffering from blood disorder.my both leg bones r paining & hardened. i want to feel rub both legs on rough cloth after that i will get some relife.my hb level is between 6-7.my apatite is good & my body weight is 60kg.earlier it was 58.in bone marrow report dr. suspected that it may be a myleofibrosis.they gave me a steroid up 8 months that time my hemoglobin was increased up 12.if i stoped steroid hb will decreases.finally i started taking wheat grass juice know i am free from steroids.sir please sugest me wether it is a milofibrosis or what is your advice for me to get relief from bone pain & improvement of hb level.",
    "doctor_response": "Hello and welcome to HCM,In order to know whether the problem that you are suffering from is due to myelofibrosis or some other disorder, you need to get a bone marrow biopsy done.In this investigation, a piece of bone is taken out, is processed and examined to look for any abnormality or disease.I am not sure (not clear in your report) whether a bone marrow biopsy has been done or not, however, if it has been proven to be myelofibrosis on bone biopsy, you need to take treatment for myelofibrosis.Steroids are the mainstay of treatment for myelofibrosis and thus you will need to take steroids only.Consult your hematologists for further work up.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for oral submucous fibrosis\n\nI have OSMF for last few years and I could not open my mouth properly (25mm) and last year I have given 5 nos. of oral vitamin injection. I do't have any problem in eating but I am suffering for dental problem. Ple suggest what are the other alternative treatment.",
    "doctor_response": "Thanks for your query, I have gone through your query.The dental problems are due to the limited mouth opening which make the maintainence of the oral hygiene difficult. You have to get your oral cavity checked every 3-6months once, get the teeth cleaned every 6-8months. If any decayed teeth are there, then get it filled when they are in the initial stage prophylactically. Get the wisdom teeth removed prophylactically. For improving mouth opening, take intralesional steroid like dexamethasone and hyaluronidase bi weekly for 6-8weeks which improves the mouth opening and makes you to maintain the oral hygiene.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is having intermittent chest pains common in children?\n\nMY DAUGHTER IS 12 YEARS OLD, SHE HAS CHEST PAINS PRETTY OFTEN. I VE TAKEN HER TO THE EMERGENCY ROOM AT THE CHILDREN HOSPITAL. WHILE THERE THEY PERFORMED AN X-RAY OF HER HEART FROM DIFFERENT ANGLES. THEY SAID EVERYTHING LOOKED FINE. THEY SAID IT IS COMMON FOR CHILDREN TO GET HIS PAIN AND TO TAKE ADVIL WHEN IT OCCURS. TODAY MY DAUGHTER SAID THE PAIN LASTED FOR ABOUT TWO HOURS. IS THIS STILL FALLING UNDER THE CATAGORY OF NORMAL FOR ALOT OF KIDS?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.The symptoms you quote might fit into chest pain which needs evaluation. But chest pain if it's serious won't last like this for 1 hour without any complications. Keeping in mind the age and gender of the kid, I feel you should consider hyperventilation and other conversion reaction like symptoms. But I reiterate the fact that this is a diagnosis of exclusion after ruling out all other physical diagnoses.I am considering this diagnosis as the symptoms you quote do not fit perfectly into any known clinical syndrome. I suggest you see your paediatrician.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Regards - Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have an itchy swelling on the inner labia. What could it be?\n\nHi doctor, I had unprotected sex with my husband a week ago. I felt some pain during sex and after a day I started getting itchy\u00a0on the inner side of my left inner labia. I tried to rub a cotton swab to check it and there was fresh blood on it. It happens even now, although itching and irritation has stopped. There is no pain or foul vaginal discharge. I tried checking myself in the mirror and saw a bit swelling on the left inner labia and something like a sort of cut on the swelled portion. I feel mucus like smell when I touch the swollen part. Also, my vagina is too dry. What could it be?",
    "doctor_response": "Hello. Revert back with the photos to an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe pain in the lower spine area\n\nI hurt my back while lifting a heavy object. When I was in the process of lifting this object, I felt something shift in my lower spine area. At the same time my legs had almost givin out as if I had no control of them. Since then I cant sit or stand for long periods of time. I cant do any kind of excersizes without being in the worst pain that brings tears to me. The worst part is I cant keep a job due to the bad pain that I am having. What should I do?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I would explain that your symptoms could be related to a bulging disc in the lumbar vertebral column. For this reason, I recommend consulting with a neurologist for a physical exam and performing a lumbar spine CT scan or MRI study. In the meantime, I recommend having some bed rest and avoiding physical activity, especially prolonged sitting or standing up position. Painkillers can help. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taken Addyzoa for abnormal sperm count. How to correct sperm morphology?  I was diagnosed with abnormal sperm count Thank you",
    "doctor_response": "Hi, You can continue the medicine you have mentioned. Try to loose weight. Stop smoking and drinking if you are doing. Have balanced diet and excercise daily. Check semen analysis at a good laboratory next month again. Regards, Dr. Mahesh Koregol IVF & Infertility Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can birth control pills lead me to hairloss?\n\nI have been losing my hair alot lately. i'm not sure why. I have been on birth control pills for about 5 years. I ran out for a month and that's when i started losing my hair is when i ran out. i went to my docot and didnt notice it then she gave my some new pills to take but it was doing this before the new pills. Is it my pills or something else?",
    "doctor_response": "Hi, I have gone through your question and understand your concerns. Hair loss is not a side effect of oral contraceptive pills. Hair loss occurs due to hypothyroidism, anemia, autoimmune diseases, or poor nutrition.I would suggest you to consult a dermatologist to get examined and investigated properly so that appropriate treatment can be done.Hope you found the answer helpful.Wishing you good health.Dr Deepti Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a chance of pregnancy after having i pill after unprotected sex?\n\nhello, i had sex with my boyfriend and during the intercourse we noticed that the condom was hallway off. The head and top were still in the condom but not the button part, he never ejaculated and the condom was not broken nor completely off. Still, I was worried so I toke the morning after pill around 2 hours later. am I pregnant?",
    "doctor_response": "Hello dear.Understand your concerns.not to worry dear.There is no chance of the pregnancy in your sexual act.As condom was remained on the top, less chance of  sperm to enter into the vaginaAlong with that you alos took morning after pill with 2 hour.It is highly effective in preventing the pregnancy around 95-97%.So just be relax, take healthy diet, take healthy diet, do regular exercise.Period may be delayed/earlier and excessive bleeding will occur due to hormonal imbalance caused by pillHope this may help youContact HCM for further health queryBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the lump at the back of my neck along my hair line?\n\nI found a really hard lump at the back of my neck along my hair line. I also found a lump on the left side of my skull (lower part). Both lasted for about a week. The one on my neck shrunk but is still there and the one on my skull is gone. Oh, I now have a small lump, one on each side, of the back of my neck. They are all painless. Should I be worried?",
    "doctor_response": "Hi . You should not be worried.These are small boils/ sebaceous cysts. Many times they resolve on their own due to body's resistance power.You have to worry only if they persist or increase in size or cause pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red sores on labia minora?\n\nHello, my concern is that I have red scratch like sores on my lower labia minora. There is a tiny bit of bleeding from these sores. There is no discharge or bumps, just the \"open\" sores. I don't feel any actual itching, only irritation in that area when I wipe after urinating & when I wash the area as well. The only thing that seems to alleviate the irritation is cream for vaginal itch. Please help me, I need to know what it is that I might have. Thank you.",
    "doctor_response": "Hi thanks for asking question in health care magic.Here are few possibility in your case.First there might be infection condition to labia along with vulva involvement.Antibiotic needed for treating it.Second you might have allergy to particular soap or cloth.So for few day it is better to wear light loose cotton cloth.If associated foul smell vaginal discharge complaint possibilities of bacterial vaginosis is there.And if have eczema to other place then possibility of contact dermatitis has to be ruled out also.Here no other symptoms present like itching , so chances of fungal infection are less.Apart from that mostly you have no other cause.I hope i have solve your query reagarding causes of sore over labia",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of colicaid?\n\ncan u pls tell the side effects of colicaid for 20 days old baby. I mean 2 ask weather colic aid has any side effects if given 5 times daily for 20 days old baby. sometimes he faces sever gas problem because he is 80% formula fed baby. Email YYYY@YYYY",
    "doctor_response": "Hi, There are no reports of any side effects due to this medication. However, tell the doctor if your child experiences any unpleasant effects while taking this medication. A very serious allergic reaction to this product is rare. However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. Hope I have answered your query. Let me know if I can assist you further. Take care. Regards, Dr. Ajeet Singh, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes discoloration of lips with burning sensation?\n\nHi, My daughters lips turned white toward the inside suddenly. She says they burn. She is 11 years old. She ate a grilled cheese, tomatoes, spinach with balsamic vinegar, and then ice cream. There is nothing else unusual. She is a very active ballerina. Anemia would not show immediately, would it?",
    "doctor_response": "HI your kid had this symptoms due to the spicy diet she had resulting in burning causing some apthous ulcers in the oral cavity.Please avoid hard and spicyb food and give her fluids and bland diet.YOU CAN TRY MUCAINE GEL TO DECREASE PAIN AS THEY WILL HEAL GRADUALLY",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. First the right ear was infected, and now the left. Please help.\n\nHello doctor, My daughter is 5 years old. Last month, we noticed that she had pain in her right ear and the thing continued for three to four days. On 5th, we noticed lots of wax in her right ear. It seemed to be pus. So, we took her to an ear specialist. After diagnosis, the doctor told us that her ear is infected. But he could not investigate the ear well as my daughter was scared and she did not let the doctor investigate the ear properly. Then the doctor advised the following medicines for her:  Syrup Fimoxyclav 100 ml 1.5 teaspoon (1+1+1) for seven days. Syrup Telfast 1 teaspoon (1+0+1) for seven days. Candibiotic ear drops three to four drops in right ear three times daily for seven days. Rynex nasal drop 0.025 % two to three drops in both nose holes three times for seven days.  As per the doctor's prescription, we started the medicine. But we cannot use the Rynex because my daughter did not let us use it in her nose. But her ear condition was improving and after ten days, we went to the doctor again. The doctor investigated her (this time also my doctor did not let the doctor to check properly) ear and told us that she is now fine. After several days, my daughter again told us that she is feeling pain in her ear. But this time, not in the right ear but in the left ear. We took her to her regular pediatric doctor. Actually, she went to visit her grandma on summer vacation and that is why we took her to this doctor. Doctor investigated her and he could check her both ears well. My daughter knows this doctor very well, so she let him check the ear well. As per the doctor, her right ear is fully alright but left ear is infected. So, he suggested the following medicines:  Syrup Renova two teaspoons two times daily, if there is any fever more than 100 F. But till now, we did not observe any. Syrup Cefim 3DS one teaspoon every 12 hours for 10 days. Syrup Brodil 1.5 teaspoon every 8 hours for 10 days. Tablet Ritch 60 for 15 days. Rynex nasal drop 0.025 %.  Then, the doctor asked us to visit him again after 10 days. In this period, her ear was improving but it seems to us that her ear has not recovered properly and also we noticed that when we give nasal drop both her ears were getting wet. After 10 days, we visited the doctor again. He told us that her punctured right ear has not yet fully recovered. So, he extended the medicine Cefim 3DS for another for four days. And also asked us if aga",
    "doctor_response": "Hello. Ear infections in children are very common. Children have a straight and wide eustachian tube that helps throat microbes to reach the ear easily and cause infection. So whenever she has a chest infection or throat pain or cold or flu, there are chances that her ears will also get infected. Once the ears get infected, then subsequently more chances that throat and nose infections will go up to the ear. Once ear gets infected, it is very painful and pus is produced inside. The pus breaks open the eardrum and come outside. Thereafter with medicines and the body's immunity, the ear condition resolves. But the hole in the eardrum does not close very soon. It takes a few weeks. During this time, water should not go into the ear while bathing or swimming, etc. You should take care that your daughter does not insert any cotton or match stick or anything inside the ear. Talking about the medicines given by ENT doctor and the pediatrician, both are almost the same. They both have given a different set of antibiotics and the pediatrician has added Salbutamol, which is mostly because your daughter might have been having chest problem or wheezing while going to him. Talking about staphylococcus, it is a dangerous organism when it becomes resistant to common antibiotics. Many times, it is a commensal in our body, commensal meaning routine organism. In the C/S report that you have attached (attachment removed to protect patient identity), the organism is sensitive to Ciprofloxacin. I suggest you instill two drops of Ciplox (Ciprofloxacin) in either ear thrice daily for a week and continue the medicines that the doctor has asked you to. Continue Antihistaminic medicine (Telfast) for two weeks. Go back to your ENT after that time and ask him to put an otoscope and check both ears. Tell your daughter to be bold and friendly and bribe her with chocolates so that the doctor is able to look into the ear and tell you clearly what it is. If possible ask the doctor to show the findings using an oto-endoscope which can be connected to the TV screen and shown to all including your daughter. Till then the precautions you take are: 1. No water inside the ear. 2. Can apply the drops I suggested. 3. Do not continue nasal drops (ENT drops or pediatrician drops) for more than four days in continuity (it can cause other nasal problems) 4. If she develops throat or nose problem, immediately show her to ENT and take adequate treatment. 5. Avoid cold foods and juices, give homemade ju",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mental health with no mingling\n\nmy son aged 25 years completed B E computers from NITK suratkal karnatak in year 2006 & he worked for tow years.He left job stating that i will not work under somebody.now he is sitting in front of computer doing something.he is not taking timely food.not brushing,bathing regurlarly.not mixing with frinds,relatives& not properlly talking with parents. kindly advice thanks.my contact no 0000",
    "doctor_response": "i can understand your concern regarding your son. he is having internet gaming syndrome newly diagnosed problem of the society. but do not worry as it is treatable.follow my instructions.first of all talk to him about this problem. visit a local psychiatrist. he needs a counselling side by side. drugs lie fluoxetine and bupropion will help a lot. he will be fine. try to make him involve in outdoor games. remove internet connection. i knw it is very difficult but it will help a lot.make the schedule of daily activities. sleep early and wake up in morning do some light exercises.for job counselling will help a lot to put a insight.hope my answer helped you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach and rib pain with difficulty in breathing?\n\nyes. hi. My 12 year old son has been complaining all afternoon that his stomach hurts and cannot seem to find comfort even with tums, gas-x or pepto. He is now saying that its hard to breath and he says that he has no energy. He is complaining about his rib cage. Not sure what to do\u2026doesn t seem to get any better.",
    "doctor_response": "Hi dearWelcome to the HCM,He may be having some infection/inflammation in the lung and its covering called as pluera. Pain in the chest while deep breath is indicator of such problem.Needs to be evaluated with CXRay. CBC. ESR. UPPER ABDOMEN USG,ETC.Get him examined by your pediatrician so that he can come out with exact thing.Hope the query is answered.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having rashes and itching during 34th week of pregnancy\n\nhi, I am 34 week pregnant and having tremendous itchy skin . It was not that severe. But 1 week back it became worse and everyday it is getting worse. I normally use johnson and johnson baby oil after shower and cocoa butter lotion , Ucerin lotion whenever i feel my skin to be very dry. 2 days back I called my OB for the suggestion as Itchy skin is getting worse and having rashes on my stretch marks on my abdomen . As her suggestion I have applied Cortaid cream but it is not helping me. I am not able to sleep on my bed as the skin touches on the bed or with the contact of my clothes,it starts itching tremendously. Please help ..... sruti",
    "doctor_response": "Hi, Thanks for your query. It's not uncommon to feel itchy, particularly around your growing belly and breasts as your skin stretches to accommodate them. Hormonal changes may also be partly to blame. It usually disappears right after delivery. But you should remember severe itchiness in the second or, more commonly, the third trimester can be a sign of intrahepatic cholestasis of pregnancy (ICP). The itchiness can be extremely intense and is typically worse at night. This ICP has very bad effect on fetus. So better to visit your obstetrician first and if he/she suspects, you should do a liver function test with special mention on bile salt and acid and also frequent Ultrasound monitoring of the fetus to see his well being. Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Clofert 50 help in conceiving?\n\nHi, Im married since one year and four months. We are desperate to have baby now.Our gynecologist advised me to take  Clofert 50 mg for three months (5 days every month). Kindly let me know what are the chances of getting pregnant with this medicine? My period is regular , and I have been having Clofert 50 for last 2 months but did not conceive. Please suggest me something with which I can conceive as  early as possible.Also , I took Gennet 35 for three months to regularize my period before I started Clofert 50 .Do I need to go for IVF treatment at this stage?",
    "doctor_response": "Hi, I think only taking clofert will not help. 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.  The chance to get pregnant in one cycle with clofert is 7 to 10 percent. IVF is not needed at this stage. Hope I have answered your question. Regards Dr khushboo priya",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to stabilize my mental problem?\n\nI HAD CLASSIC NIGHT TERRORS FROM AGE 9 UNTIL 10. THEY WERE TERRIBLE,AND I NEVER REMEMBERED THE CONTENT IN THE MORNING. I CRIED, SWEATED,SCREAMED, ESPECIALLY IN THE MIRROR.... SAYING THINGS LIKE...IT S SO AWEFUL... I AM SO UGLY... AT THE AGE OF 20, I HAD AN ABORTION. I HAD A NIGHT TERROR ON THE TABLE. I ASKED THE ABORTIONIST TO STOP, HIS NAME WAS ISMAIL ELGUNDI. HE WOULD NOT, AND I FOUGHT HIM... I REMEMBER THE NURSE SAY SHE THOUGHT I WAS LOSING TOO MUCH BLOOD AND WOULD POSSIBLY DIE. I CALLED AN OLD BABY SITTER THAT WITTNESSED THESE NIGHT TERRORS, AND SHE KNEW NOTHING OF MY ABORTION. SHE SAIDTHE ONLY THING SHE REMEMBERED ME REPEATING( AT THE AGE OF 9) WAS the stomach monster is after me ... now, I have found I the abortionist compromised my uterus, my tubes and I can never have children. The father of my baby is now a doctor, Stuart Barre, and his father is my Godfather. I was baptized on October 9th, 1977,... and that was the day of the abortion at WestSide Women Services... October 9th, 1990. I found the date the day I came home from the abortion in the bilbe the Barre s had given me....if haunts me and has ruined my life.",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.Night terrors can be first treated by prescribing benzodiazepines. However if it still persist then it would be wise to get an EEG done to identify if it is due to some seizure activity.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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can using anti-dandruff shampoo to wash penile area result on painful urination?\n\nMale 53, I have severe pain when I urinate. It is only in the tip of my penis. It started immediately after I showered. I thought I grabbed the body wash, but used an anti dandruff shampoo with pyrithione zinc in it, to wash myself, including my penis. Is this a temporary discomfort as it would if I got it in my eyes?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. You are right. The burning sensation and discomfort could be just a spontaneous reaction by the sensitive penile skin. Wash it thoroughly with mile soap and the sensation could be better in some hours. Also eep the area clean. Drink plenty of water and fruit juices. This will increase the urine an the urine will wash the inside of your penis.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high BP, cholesterol and breathlessness\n\nHi, my dad is 47 yrs old and is suffering from diabetes,high BP and high cholesterol,high level snoaring and weakness problem,is overweight and encounters uneasy breathing immediately after climbing a single stair.He consumes 3 pegs/180 ml alcohol twice a week and smokes 15 ciggaretes a day.At present he is on allopathic medication to control the above mentioned problems.PLEASE ADVICE FOR DAILY AMWAY SUPPLEMENTS. HEIGHT:5 8 WEIGHT:116 KGS.",
    "doctor_response": "Unfortunately, he is going to need more then just a vitamin or supplement. Just based on history, and no physical exam or blood work, his heart score and framingham score are well above the index for heart attack and major adverse coronary event. He has about a 50-60% of a heart attack or major coronary event to happen within the next 10 years. You should bring him to the emergency room immediately so they can help modify his risk factors such as high blood pressure, high cholesterol, diabetes, sleep apnea, and obesity. Once it gets to this point, vitamins or supplements wont control the current problem - he will need coronary intervention or medications.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe fatigue and pain in the arms?\n\nLately, I have been extremely tired. My left arm hurts, feeling like it generates in the shoulder--and the inside muscle cramps if I move it the wrong way. I don t think I m sleeping well because of that. Additionally, it seems like my breathing might be somewhat compromised.",
    "doctor_response": "Hi, The fatigue and pain in the arm can be related to frozen shoulder, cervical spondylosis or due to low levels of calcium or vitamin D3. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Whats the advisable dosage of fenistil drop in infants for red rash?\n\nHi, My infant is one month old, he has small red rash on his face, can i give him fenistil drops? if yes what is the dose. he is in normal health and hos doctor gave us a cortisone cream since three days that did not work till now. Thank you in advance",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Fensitil and other related antihistamines are not recommended for children less than six months of age. You can apply steroid ointment for symptomatic relief. If the problem persist,  better to consult a dermatologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for epididymitis?\n\nHi, I had a vasectomy 6 yrs ago.  Prior to that no problems.  About a 1.5 yrs ago I developed my first episoe of epididimytis.  I have since had 3 more episodes.  With each one it involves my L testicle, which gets swollen, tender and hard.  Have had an US w/each one and tx was antibiotics.  My L testicle has stayed very firm from the first episode, but went down in size.  This time on the US after I completed the ABX, it showed my testicle has increased in size from 2.5 x 3.2cm to 3.1 x 4.1 cm in 8 mos. w/mild heterogeneous echogenicity but no mass, and now I have a varicocele on the L side, and microscopic blood in my urine. Went for a CT of A/P, it shows multiple small retroperitoneal lymph nodes  around the AA measuring up to but not exceeding 8mm, and  small nodes in the porta hepatis and portacaval, but no obstruction or mass,  I am miserable.  My L testicle is hard as a rock,it aches, I am uncomfortable most of the time, I feel bad in general, and now I am having a pressure like pain up around my L lower abdomen/pubic bone area.  Is this just part of the varicocele?  Do I need to push for further testing? If so what?  My urologist seemed surprised that the hardness has never went away from day 1, although before this episode my other symptoms of epididmyitis would always resolve.  Please advise, I am at my wits end.  Thanks",
    "doctor_response": "Hello, Antibiotics must be started and most cases respond well to antibiotics. Consult a general surgeon and get evaluated. A short course of antibiotics must be started preferably ciptofloxacin. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain, General & Family physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for having allergy to dust mitten?\n\nI recently noticed nasal congestion, running nose. It normally becomes too much after 4 hours of sleep. I got checked up and was told that Ihave allergy to dust mitten. Cna you advise? following are the reading - Immunogloubines 353 snf Absolute EOSINOPHILS...",
    "doctor_response": "Hello,Welcome to HCM,Your history and symptoms are suggestive of allergy to dust mite. As you have undergone absolute eosinophil count (AEC), which is also evident of some allergic reactions in the body.These dust can stimulate the mast cells to release mediators like histamine which is producing all these symptoms.I would suggest you to undergo skin prick test to identify the proper dust causing all these symptoms. This will help to avoid the allergen otherwise you can go for immunotherapy.You can go for sub lingual immunotherapy (SLIT) or subcutaneous immunotherapy. For the present symptoms you can take Tab Montek LC, once daily in night for atleast 15 days.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes muscle twitching and spasms on exposure to mold?\n\nA bit paranoid because I'm not sure if I was exposed to toxic mold.  I was cleaning out the fridge because it was a little messy and throwing things away, but then I found a small container hidden in the back of my fridge and it was about half or 3/4 filled with a large quantity of of whitish/a little gray mold.  It also filled all the way to the top of the container as well. I spent about two hours trying to search online for what kind of mold it might be but there is many types of each toxic mold harmful to humans, and also a bit misleading because some have different colors too.  I've had some possible symptoms of what I've read on the internet, but no sure still if it's anything serious or what kind it was.  I read that inhaling the spores can cause problems, and I think I may have as the texture of the mold looked fuzzy, and I had opened it close up in my face not know what it was.  The symptoms I believe having minutes after were constant muscle twitching and spasms, I recall becoming very confused for a couple of moments when I was trying to Google more things and couldn't remember because of major confusions all of a sudden.  I have had tremors, dizziness, foot feeling like it was asleep/crawling under skin ( I was not sitting on it, I have moved it around often ) and I stood up and walked around a couple of minutes or so and the feeling was constant and didn't go away.. during and a little after that my foot experienced some numbness momentarily.  Then finally I've been getting this migraine and I have no had a migraine in over two years now, so I got something to eat and took a couple Excedrin migraine hoping that it goes away.  If anyone is to help, I'd really appreciate it because I'm a little concerned and just want to clear up my paranoia.  Thank you.",
    "doctor_response": "Hi there,Welcome to health care magic,I understand your concern regarding getting exposed to toxic mold but based on the details mentioned in your query I am suspecting paranoia about fungal exposure.Most common fungi which grow on food stuff are saprophytic fungi like zygomycetes and aspergilli.Most common symptom of inhalation of fungal spores is usually allergic asthma or respiratory symptoms like sneezing, wheeze and cough.The symptoms you mention indicate some kind of neurological weakness which needs to be examined and thoroughly investigated.Coming to your migraine, stress is the most common factor which triggers migraine.I suggest you quit worrying about fungal exposure and get the muscle twitching and spasms examined by a neurologist.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have some burning feelings in my tummy\n\nHi, i am having tummy (not sure if it is my tummy or not) pain a sharp stabbing pain directly to the left above my belly button it is on and off but it really hurts when it happens sometimes it is a burning feeling it changes from time to time",
    "doctor_response": "I had the same symptoms you describe. I went to a gastroenterologist who did a gastroscopy and found I had about a dozen stomach ulcers. See a GI doctor ASAP!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and pain in the left calf while walking?\n\nI m 75 year old male in good health. Did a Life Line screening last month and everything was very good. But in the last 3 weeks I would walk 1 block and the back of my left calf in the middle would knot up and be pretty painful to walk. I stop and stretch it out and would help a little but would still hurt. I jog for at least a minute at night at 5 mph and do a 100 reps on a exerciser.",
    "doctor_response": "Hello, As your age is 75 we can expect some physiological changes in the body. Due to aging, there will be a reduction in the endurance of the muscular system along with other systems. Having done a regular exercise in low intensity will improve the overall physical ability of the muscle to function and also will improve the endurance and delay the fatigue. What you are facing is fatigue, and fatigue can be handled by improving endurance. You are doing sit and stand exercise in a chair for about 1 minute, which is not enough. So try doing sit and stand exercise 45 times. I know it sounds a little stupid but just tries it out. If you can withstand for 1 minute and continuously do 45 repetitions of sit and stand, then you will get the best outcome score. In my clinical practice of over 12 years, I always take this part of the exercise to improve the endurance in geriatrics. In fact, results achieved are 60 seconds 45 sit & stand, which is a big number. But really good outcome scores. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Cepodem right medication for cough, fever and loose stools in an infant?\n\nMy 08 months old baby  boy is suffering from cough & fever.  docotor has advised him Augmentin Duo (as an antibotic) but after today after knowing that baby has passed gone some 10 times stool in between 5.00 am to 2.00 pm, he advised to stop Augmentin syp..  One of my family Doctor has now advised to yake Cepodem instead os Augmentin.  Please advise what to do next",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.Before starting cepodem , pre-probiotics  sachets or  oral ampoules can be added with ORS to see if loose motions decrease or not , many a times loose motions may be part of illness .If diarrhea is severe and appears to be side effect of Augmentin  , it can be replaced with cepodem but only if treating doctor is of opinion that it can take care of infection for which augmentin was started .If there is valid reason to give augmentin type of drug only , but if diarrhea is severe and not responding to pre-probiotics, decision to start parental antibiotics may be taken with consultation to your doctor.Hope this answers your question. If you have additional questions then please do not hesitate in writing to us.Wishing  your baby good health.\u2022\u00a0\u00a0\u00a0\u00a0\u00a0DISCLAIMER: - All the information provided here is for information purpose only   , it is not a substitute for the advice of a physician after physical examination , it is not intended to replace your relationship with your doctor. This information in no way establishes a doctor-patient relationship. Before acting anything based on this information do consult your doctor. I  recommend that online users seek the advice of a physician who can perform an in-person physical examination",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can red scabs, dry skin with bumps on stomach be mosquito bites?\n\nYes, my 11 year old daughter says she has a lot of mosquito bites on her belly. I just looked at the bites, they appear to be bites and are red and some have scabes on them, the skin looks dry on some bumps. Can you tell what you think they are. Apparently they have been there about a week or two.",
    "doctor_response": "Hello, It can be an allergic reaction or insect bite reaction (IBR). Generally, it will settle by itself without any definite treatment If the lesion persists better to consult a dermatologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headaches after taking nasal flu vaccine?\n\nMy daughter had the nasal flu vaccine on Wednesday. When she got home, she said she had a headache. I gave her Tylenol. She was fine. That evening the lympnodes behind her ear and upper neck swelled to the size of golf balls. No exaggeration. I took her to the MD on Thursday morning. No strep. No mono. And her cbc is fine but they sent me home with an antibiotic. Before we could leave the office, my daughter starts complaining of a headache then she starts crying and screaming then she vomits. She feels a lot better. It is now Saturday, the swelling has not went down or gotten any bigger. Whenever she starts getting a headache, she starts feeling nauseated so I give her Tylenol about once a day. She has a low grade temp of 99f. She can turn her head and neck fine and it does not hurt to touch. What is this and what should I do. She is eight by the way.",
    "doctor_response": "Thanks for following up.It is side effect of flu vaccine, she has hypersensitivity reaction .You shoud give to her daily1. tylenol which will do anti inflammatory effect2.antihistamines-levocetirizine 1 tab 1 time in the evening 7 days She also has reactive lymphadenitis, that's why continue your antibiotic till 7 days.Keep to her hydrated with plenty of water.Take careDr.Svetlana Shrivastva",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for itchy rash in legs & genitals\n\nI have a very red, itchy rash in the crease of both upper legs down to my private area.  It is very sore and itchy.  I am overweight and sweat alot there.  I have been using powders and they usually work, but I suddenly came up with this itchy rash.",
    "doctor_response": "Hello. Thanks for writing to us at healthcaremagicYou seem to have developed Fungal infection of the groin/tinea cruris. Being overweight is definitely a predisposing factor that would have favored the development of fungal infection in you.If I was the treating doctor I would have asked you to use an OTC topical antifungal e.g clotrimazole 1% cream, twice daily.Combining topical antifungal with an Oral antifungal e.g Fluconazole would be more effective. Oral antifungals are prescription drugs, therefore, I would suggest you to talk to your dermatologist.Once the fungal infection is well controlled with this treatment you must continue with an antifungal dusting powder regularly.An antifungal dusting powder would keep the area dry and also be inhibitory to fungal growth.An OTC oral antihistamine e.g cetrizine 10 mg once daily would provide you symptomatic relief from itching.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure elevated alkaline phosphate level of 480 and low platelet levels after diagnosis of alcoholic liver cirrhosis?\n\nMy husband has been diagnosed with alcoholic liver cirrhosis a year ago and his billrubin level is always at 6-7. Thou his sgot and gamma gt are in control is alkaline phosphate is elevated and stands at 480. Also his platelets are always low. How to cure and will his jaundice come down?",
    "doctor_response": "Hello, Cirrhosis results from damage to liver cells from toxins and inflammation. Damage and dead liver cells are replaced by fibrous tissue, which leads to fibrosis (scarring). The fibrous tissue decreased blood flow and it can back up the spleen causing it to enlarge and sequester blood cells. Most often, the platelet count falls because of splenic sequestration. ALP and Platelets test result with your husband shows that his liver is functioning not well. Cirrhosis of the liver is irreversible but the treatment of the underlying live disease may slow or stop the progression. Such treatment depends upon the underlying etiology (cause). Termination of alcohol intake will stop the progression in alcoholic cirrhosis and for this reason, it is important to make the diagnosis early in a chronic alcohol abuser. So his platelets low it may come back better if he stops drinking alcohol on time. There are many complications from live cirrhosis and it can lead to life-threatening. So you should go to follow up with your doctor for further prevention treatment to prevent complication. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Heang Chan Raksmey, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to decelerate the wearing out of joints in tall people?\n\nI am 30 years old and about 200 cm tall. Since my mid-20s I have increasing orthopedic problems with hip and knee joints involved and also spinal troubles. I grew extremely fast and also have a weak bodybuilt. Other tall people which I know with the same issues. Is there anything very tall people can do (additionally to strengthening muscles) to decelerate the wearing out of our joints?",
    "doctor_response": "Hello,Regular physical activity during teenage and a balanced diet can help improve the situation in toll persons. It is true that this is a common problem in toll persons. It is also important checking vitamin D plasma levels for possible deficiency and take vitamin D supplements if necessary.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump on the scrotum?\n\nhi,i am 20 year old male,i have this problem,i have grown a lump in my ride side of the scrotum,it is not painful,i have got this 2 and half months ago,firstly it was small,then it grew upto 1 inch and it is of same size from last 2 months.can u please tell me wat is the reason",
    "doctor_response": "Welcome to health care magic. 1.The history suggest the possibility of the testicular lump, next possible cause collection in the scrotal sac, chord thickness.2.In this case if you are my patient, i would have examined and ask for a ultrasound examination.3.The ultrasound will clearly assess the possible causes, weather lump or collection or thickness of chord, if lump what is its nature and where it is arising from and where all extending.4.Its vascularity, and any abnormal calcifications. If required an FNAC - fine needle aspiration cytology for assessing the nature of the lump.5.So suggest you to see you GP, get it examined and treated accordingly. Good luck.Hope i have answered your query,any thing to ask do not hesitate to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Blood in my excreta, but not piles\n\nHi, i am getting blood in my excreta, i consulted a doctor,he checked for piles and said i dont have any.he gave me some antibiotics and used for 10 days.but i am worried, can you tell me the health issue i am facing",
    "doctor_response": "hi i m 21 year , and i found blood in my excreta, so kondly suggest me is it is any kind of diesease or any defficency.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for bone TB\n\nHi I am Liavi, My father in-law (63) is suffering frm Bone TB (Spine). x-ray shows that one gap is missiong (Two segments of spinal bone have become one). He still feel the pain. Can he be healed with medicine without sugery? His MRI report is waiting.",
    "doctor_response": "Hello,If there is fracture or neurological impairment, surgical fixation is necessary.Consult a spine surgeon and he will direct you accordingly.Hope I have answered your query.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicines for lichen planopilaris\n\nLichen planopilaris.this the major problem for 10 years.i'am 24 yrs old.at the time of my puberty the small eruption started that was when 13th yr.now wit recent symtoms i got to know that have benn suffering from hypothyrodism,hyperandrogenism.apart fr this wen i was months baby i used to get herpes.till to date i getting it frequently.so, please just suggest me which is the best kind of medecines to use.for these past yrs i have tried a lot.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Lichenplanopilaris causes scaring alopecia that means that the hair which are lost will not regrow. But remaining hairs can be prevented. Anti inflammatory medicine like Methotraxate can stop further hair loss. So you consult some nearby dermatologist so that some appropriate anti inflammatory medication could be started. Thank You",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for sleeplessness\n\nI work 3rd shift and I am really having a hard time sleeping when it is light out I have tried everything except for sleeping aids I have use them before but they make me feel funny so I have stopped my dr believes it could be work shift sleep disorder is that true?",
    "doctor_response": "Hi,Thanks for writingThis is a common complaint of those who work in shifts. There are medicines to help you with this, but that requires professional supervision. Kindly visit a psychiatrist for the same.Hope that helps,Dr A Rao",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for rash caused by a flea bite\n\nhello, i was bitten by a flea about a year and a half ago, the bite was on my crotch which caused a rash that wont go away. ive been to the dr and he prescribed different ointments such as ketoconazole, cortizone and even anti biotics and when i use the ointments it gets worse. foot powder helps a little because it keeps it dry but it doesnt go completely away. what do i need to do ?",
    "doctor_response": "Hello, Use a soothing lotion e.g calamine lotion. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Kakkar S.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have undergone liver transplant, donor. Have knee pain, heavy legs. Take nutrilite, glucosamine HC1 with boswellia?\n\nI am writing this for my mother who is 54 years young. Last september, she underwent liver transplant surgery and she was a donor. Even after 6 monrths of the operation, she is having knee joint pain and  she feels heavy in her legs.  Can I suggest her to take \"NUTRILITE\u00ae Glucosamine HCl with Boswellia\" . I heard it's a very good suppliment to heel knee problem. Please suggest. Thanks!",
    "doctor_response": "Hello!  I appreciate your concern to your mother. Yah you can give Glucosamine for  pain. Along with this you can give her Tab Tramadol for pain. It will not harm liver like other pain killers(NSAID). I hope thos suggestion will help you. Keep in touch",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a hard neck lump be treated?\n\nmy son has a lump on his neck he is 2 years old!!it is on the right side below his jawline between his ear and bottom of neck!!it a hard lump bout size of a pea which is movable but it has a hardening all around it which seems to be alot bigger what do you think this may be? should i be worried?",
    "doctor_response": "dear, parent this seems to be an inflammed lymph node. this needs to be treated with an antibiotic as amoxiclav 457 mg every 12 hours for 5 days",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for staph infection\n\nI had a staph infection on the front of my calf a few years ago.(bottom of shower curtain scraping under nail then scratched my leg). I recently cut my 5th and 4th toe almost halfway off and receive stitches at the emergency room. Does staph lay dormant in the body or once I got rid of the infection of staff did it go away?",
    "doctor_response": "Hello, thank you for your contact to health care magic. I understand your cconcern. If I am your doctor I suggest you staph can remain in body as a dormant organism. It may be a MRSA in your case which I suspect will come again.  I will be happy to answer your further concernYou can contact me. Dr Arun Tank. Infectious disease specialist. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can chicken pox relapse?\n\nmy daughters - 4 & 6 have both had chickenpox when 2 & 8mths but recently virus is at youngest's preschool and both are crabby, irritable, hot and bothered etc. is it possible they could be being affected by the chicken pox virus youngest also has a bad cough and croaky throat",
    "doctor_response": "HI, thanks for using healthcare magicIt is not possible that the acute infection is repeated, a person only experiences chicken pox once, then is immunized against future infection.It is possible that she may have an acute cough and cold infection that may be  causing her symptoms.If this is the case, the use of over the counter cough and cold medications would be helpful.If the symptoms are severe or non responsive then you can take her to the doctor for assessment and treatment.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get sores often in mouth and my doctor said it as autoimmune related.\n\nHello doctor, I have got sores in my mouth which the doctor said was autoimmune related, but a week ago, I started getting what feels like sores on the inside of bottom lip and I often get pain on the back roof of the mouth, should I be worried?",
    "doctor_response": "Hello. I understand your concern. Autoimmune responses are the best met with the particular drugs, which your doctor might have already prescribed. Also, get checked your vitamin B12 and blood sugar levels. You can use topical anesthetic gel (like Benzocaine), Triamcinolone, and which will ease your soreness. Apply them alternatively, three to four times a day for four to five days. Check with your doctor if you need antacids, and continue medicines for GERD (gastroesophageal reflux disease). Sjogren's syndrome involves dryness of eyes, as well as dryness of the mouth. A saliva substitute is recommended. See the ophthalmologist about his opinion on any opthalmic issue (if any). I hope it helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe anxiety be treated?\n\nI am prescribed xanax for panic attacks (newly presecribed) I am to take .25 mg 3 times daily as needed. Today at 2pm I took 1 tab of .25 mg and another at 530 pm. I went out to dinner and had 2 light beer (last beer was around 1030pm) It is now 12 am. Am I okay to take my 3rd xanax for sleep? Also, I am feeling quite anxious about this and can feel a attack coming on!",
    "doctor_response": "HelloYes you can take your third tablet now as prescribed by your doctor.. No issue in that. Wish you good health.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe back pain from tailbone to neck\n\nQuestion Im a dancer and about 4-5 week ago i've had horrible backpain. it started in the arch of my back and now it streches from my tailbone to the top of my neck. it hurts to lay down, sit, straighten my neck,and at times it hurts to much to move. its getting worse even though i took a break from dance",
    "doctor_response": "You have rightly taken break in dance. Vertebral column and spinal chord are affected due to extreme postures or shocjs and the portion of V.column say lumbar, sacral , cervical etc which is affected, give rise to nerve pain of those regions which radiates along supply area of the nerve. Tailbone is in Coccygial region. There may be multiple spots affected.Relax the muscles. Get checked for any intervertebral disc space reductions or other problems for vertebra.For the time being bath with warm water. Try to drink warm water. Avoid cold drinks etc. Avoid physical and mental stress. May apply gentally any muscle relaxant on the back post hot water bath. Avoid A/C.Hope you will take these initial steps instantly. Upon knowing investigation repirts, will guide you natural methods and herbals to regain strength and avoid pain.All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to increase the ferritin level\n\ni have been having a cough with a recent cold but when i cough it brings up a bloody taste in my mouth along with the plem. it was discovered in a recent blood test that my ferritin level was extremey low. jus I am now taking iron but then this taste started. i have a history of stomach ulcers",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some chronic blood loss due to ulcer.  You should take treatment of that first.  For low ferritine level you can take oral iron supplements like ferrous sulphate or ferrous fumarate. Or injectable iron like iron dextran or iron sucrose. You should take iron rich food like dates, green leafy vegetables, dry fruits, jeggary etc. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medication is suggested for back pain and difficulty to lift hand?\n\nSince two months i am suffering from back pain (right side) in the middle and towards the right hand and some times i find it very difficult to lift my hand / stretch it up at a stroke and i can t lift any weight except light weight and when ever i do any job like moulding or when i wash clothes i find it difficult i am 53 kgs in weight and i am 5 ft. working on computer and i am 43 years old",
    "doctor_response": "Hello,The symptoms seem to be related to a pinched nerve in the hand that causes difficulty in lifting weight. I suggest using anti inflammatory medications such as Acetaminophen in case of pain. I also suggest to avoid high weight. If the symptoms continue, you should see a neurologist for further evaluation.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have been diagnosed with Essential Tremors Syndrome of my hands. What should I do to eradicate this problem ?\n\nHello Doctor , I have been diagnosed with Essential Tremors Syndrome of my hands. Whenever I am in fear, strain or done any labourious tasks, my hands starts to shake which is visible. Its very shamefull for me because I am just 22 yrs old boy, and Shaky hands at this age is very uncommon. Few months before I consulted a city based neurologist and was undergone some tests of Thyroxine (T4), iodothyronine (T3), and calcitonin , everything was found to be normal. Please suggest me what should I do to eradicate this problem?????",
    "doctor_response": "Hi, Thanks for query, As thyroid tests are normal you have not to worry, You have got anxiety and nervousness. develop self confidence and cultivate strong will power that as I am normal I will not get tremors or hand shaking. ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have had a pimple bump on my lip for years\n\nI've had a pimple bump on my lip for years now and was wondering what it could be? i cant pop it and it doesnt really change size or puss or anything.",
    "doctor_response": "It could be a submucous cyst which means a collection of mouth secretions.They look pink and are soft and may disappear for a short while and comeback, Or it may be some other kind of swelling .In any case it needs to be examined to know what is it.See A dentist or a surgeon for opinion.With regards rahulchhajlani@rediffmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why have I suddenly developed itchy rashes ?\n\nHi my friend is at my house and she has just gotten a few rashes and they are ithcy",
    "doctor_response": "get a cbc done with aec. It might be an allergic reaction. Try levocetrizine in the night",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for numbness in the left leg and low blood pressure\n\nHello.. My left side of the body especially my left leg is getting numb.. My blood pressure is getting low 50/ 70 and when i wake up in the morning i feel extremely thirsty.. I also have cravings for sweats at night and i sweat a lot.. why is that so..",
    "doctor_response": "HelloI have read your query. Your blood pressure is alarmingly low .you should urgently go to ER .low bp can lead to numbness. drink lots of fluid and juices till time. I hope I have answered your questions. If you have further questions please feel free to contact us. I will be happy to answer. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recurring UTI. On cefalexin medication, no relief. Hysterectomy, catherization done. Can I take nitrofurantoin?\n\nHi I have a reoccurring UTI , apparently the same bacteria as I have had 3 times previously this year! Didn t help I had a hysterectomy 4 weeks ago and being catheterised didn t help. Anyway I was originally put on cefalexin for close to two weeks, but still I ended up at A&E in agony they prescribed ciprofloaxin that I took for ten days and still no joy. After a culture test it turns out bacteria was resistant to the cafelexin ( so took it for no reason) now prescribed nitrofurantoin which makes me terribly breathless, I m at my wits end.should I stop taking it? The doc is away its Saturday. Just can not cope with being so breathless. Also I m allergic to penicillin and NSAIDs what other meds could I take?? Please help",
    "doctor_response": "if no allergy, then yes take a low dose daily to prevent UTIPlease rate 5 stars. I strive to provide you with the best answer possible to your question!",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat dry skaily skin for my kid?\n\nHi. My six months old baby boy who was born preterm at 8 1/2 months is having dry skaily skin even in scalp since he was 2 months old. Apllied olive oil,almond oil, sunflower seed oil did not help.Now glycerin and rose water at equal combination, made it bit smoother. How long will we use this/ Is there any side effects. Somebody said to apply liq.paraffin.I did nit pply yet. Please advise.",
    "doctor_response": "HiThanks for writing to health care magic.Use moisturisers like dermadewIf not improving may need low dose steroid oinments like desonideWishing your child good healthRegardsDr Arun",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will having kutki, chirata in empty stomach helps to cure skin allergy?\n\nHello doctor, I hav skin allergy from past 10 years now and have taken allopathy, homeopathy nd ayurvedic but none have cured it or rather hav worsened it further. As of now, I read sumwher tht by taking kutki and chiraita, the skin allergy can be cured. I take 5 grams of kutki nd chiraita each ( in stem form) and soak it in the water and have tht water empty stomach and dont have nethng thereafter for four hours.Pls suggest if I am going on the right track, will this cure my allergy problem and does this herb have any side effects?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern for the allergic disorder purpose the allopathy is the only best option and gives good result than the other pathies, hope this information helps you have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stiffness in neck, severe headache, nausea during loose bowel movement. Another episode of nausea and vomiting on driving. No BP, sinus, ear infection. Root cause?\n\nHello Doctor.... Yesterday my wife experienced a stiff neck , a severe headache and naussia during a bowl movement. She claimed that the BM was loose so there was minimal to no straining but she thought she was going to explode. She went to see her MD and no issues with blood pressure, sinus nor ear infection was identified. An appointment for a catscan has been made. Now this afternoon, she had a similar situation but ONLY a strong neck ache resulted. Do you have any ideas on the root cause? Just another tidbit, she also felt nausseous when driving home 2 days ago (1 day before headache) and vomited. Not sure if all of this is tied together with some sort of allergy or virus but would love your opinion.",
    "doctor_response": "haiall symptoms except loose bowel can be attributed to some sort of pathology related to head and neck region likely within the head but will need more history and clinical evaluation then further a ct scan. seems to me loose stools r all together a different pathology. straining is there at defeacation however mild it may be and such straining can increase a head pathology. cannot comment more with just such lithe info. needs a very close careful look - take her to a specialist neurologistGod Blesstake care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can left abdominal pain after ingestion be treated?\n\nI am a 19 year old female. I am having severe upper left abdominal pain every time after I eat. It usually lasts for about an hour to an hour and a half. I have small ulcers that are being well treated. I do not have an appendix or gallbladder, when they took them out both looked normal. I have tried to eat bland foods. I can not handle eating oatmeal, plain no flavoring oatmeal. I have been tested for several stomach diseases and they were all negative. Any advice",
    "doctor_response": "helloIf your reports are normal than you need not to worry.By changing food habits you will feel better.I would suggest you to,Take light food,avoid fried & bakery products.Take buttermilk after lunch & milk after dinner.Take Dashamoolarista 3tsp with water twice a day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes foul smell and cloudy discharge from penis?\n\nHi my name is Chuck and for the past week my penis has been stinging and releasing a cloudy discharge, I haven't had sex in two weeks but recently I had oral,I googled it and it could be irritation,infection,caused from masturbation constantly,or stds I have no insurance and I need help please.",
    "doctor_response": "Dear, We understand your concernsI went through your details. The symptoms of cloudy urine with strong odor, discharge from penis, frequent urge to urinate and frequent urination indicates many physical problems such as Urinary tract infection (UTI), Diabetes, type 2, Vesicoureteral reflux etc.As there are many conditions associated with cloudy urine with strong odor, discharge from penis, frequent urge to urinate and frequent urination, I suggest you to consult an urologist without wasting time. Early treatment cures well and early. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from eczema, how to control brown spot on face?\n\nhi my 4year old daughter she has eczema when she is 6months old. now she is getting brownspots on her face. we are using sunscreen lotion with spf50. she is going to scool and she is playing outside. ow to control the brown spots and why it is coming on her face",
    "doctor_response": "Hello,Thanks for the query.This hyper pigmentation can be removed by using skin lightening creams.Various creams are available like melalite xl, lookbrite, Lumaglow etc.You can take any of them.The following should be procedure to use it.1. Wash her face in evening around 7.2. Dry face and apply cream all over her face.3. Keep it for one hour.4. Wash face again.5. Apply some moisturising cream and let her sleep.6. In morning apply a sunscreen with spf at least 30.Do this for a month, you will see the results.Let me know if you have any other doubts.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could liver enzymes cause urine to be insufficient or invalid for drug test?\n\nMY AUNT HAS HAD HER CHILDREN TAKEN AWAY FROM HER FROM CPS BECAUSE THEY SAID SHE FAILED A URINE TEST AND COME OUT POSITIVE WITH OPIATES AND ANPHETAMINES. She has the prescriptions and discharge summary with her, but that still did not help. They have continued to give her ua drug tests and most of them have came out negative but there are a couple a test that came out insufficiant for invalid, but not positive. My aunt has just found out that she has hepatitis c, cirrhosis of the liver and constant urinary track infection. I currently have her children and need to know if this can cause her urine to be insufficiant or invalid. Her creatine level was .8  I have gone with her to get her ua's. She is not allowed to take anything with her in there is no sink and the toilet water is blue. Can having these diagnosis or her liver enzymes cause this her urine to be insufficant or invalid? Please help her children want to be home with her so badly especially since their father has past way from stomach cancer 1 month ago.",
    "doctor_response": "Hi there,I'm so sorry to hear that. That sounds like a difficult situation. Let me try to answer your questions one at a time.  First of all, if the urine test was done while she was in the hospital, pain medications such as norco, vicodin, percocet, oxycodone, morphine, dilaudid, fentanyl or other opiate based pain medication will cause her to be positive for opioids.  In terms of the amphetamines, adderall is a common medication that can cause her to be positive. My recommendation would be to get a list of every medication she was given at the hospital and the emergency room - the discharge summary simply lists the medications that she's supposed to take at home and doesn't mention what medications she was given in the hospital.A creatinine level of 0.8 is normal, and her UA won't really make a difference in terms of false positives.  The diagnosis of liver cirrhosis won't make her urine results invalid, especially with a normal creatnine.  Your best bet here is to get a list of every medication she was given during the hospital and have that reviewed by CPS. Remember, the discharge summary doesn't tell what medications were given in the hospital.  I hope this answers your question. Please feel free to contact me if you have any further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Laser therapy for hair removal\n\nI am srikanth and i am 23 years old. I want to get rid of my back hair through laser theraphy. can you advice me?",
    "doctor_response": "Surgicaly permanent removal of hairs is possible. You can trust a Trichologist for expert opinion and Treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. MRI spine showed intramedullary mass at T4. Is it a cyst or malignancy?\n\nHello doctor, I had an MRI of the thoracic spine and it showed an intramedullar mass at level T4. I was told it is likely to be a cyst and is not malignant. However, everything I have read online says that intramedullar lesions are almost always malignant and cysts are rare or maybe evidence of MS, which my uncle had, so now I am worried. The reports says it is a fusiform mass with hypersignal intensity at T2W1 and hyposignal intensity at T1W1.",
    "doctor_response": "Hello.  Can you attach the MRI images and upload it so that I can see it? For more information consult a spine health specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have underdeveloped jaw bones, scoliosis, and swollen face. Please help.\n\nHi doctor, I am 20 years old. I have one kid and I am seven months pregnant. Since I started puberty, I got a lot of health problems. The left side of my underjaw is not fully grown. It feels like pieces are missing. You can also see the big difference between the left side of my chin and the right side. My cheekbones are also not fully grown. I have poor blood circulation and my face gets very very swollen. Mostly in the morning, my face looks quite normal and my skin color as well. Later, in the day, my face gets swollen and big and also when I eat and when I eat a lot and unhealthy it gets more swollen. When I lay down the swelling lessens. I also have mental stress and an anxiety and I have a scoliosis. I get tired quickly and my skin is very dry. I have dark or purple undereyes and dark patches on my ankles, knees, etc.",
    "doctor_response": "Hello. I just read your query. See the issues like scoliosis, underjaw shape, and underdeveloped cheekbones are anatomical issues which are related to the natural structure of your body. They can not be corrected with the help of medication. You may take help from artificial modern techniques, which you can learn from a nearby physician. The poor blood circulation, swelling on face, stress and anxiety, tiredness can all be related to pregnancy. I advise you not to take any random treatment or any supplement without consulting your gynecologist. This is the crucial time of your pregnancy. So visit a nearby gynecologist and ask for the help for all the issues you are having.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My teeth or gums are bleeding and paining for more than a month now. What to do?\n\nHi, I'm 14. I really never cared much about brushing my teeth, and it's been awhile since I haven't brushed them. I woke up one day and it felt like the right side of my gum was hurting, and I went to go brush my teeth, cause I figured maybe it was a tooth growing in or something, and to my surprise, when I went to go brush them, my teeth or my gums started bleeding, as I noticed on the toothbrush. I kept brushing because I figured I got something. This gum or tooth pain, I don't know which one, has been going on since a month.",
    "doctor_response": "Hi! Greetings for the day! As you said you are 14 years old and at this age it is very common to have bleeding gums. There could be two reasons as you are getting new teeth and another one you are attaining puberty. When you attain puberty there will be harmonal imbalance which is happening inside body which leads to swelling in gums and further bleeding whenever you touch it. If it is painful you can take paracetamol tablet whenever it pains otherwise just use mouthwash and keep ice on the area where there is swelling. It would be of help if you would send me a picture of the area concerned. Don't worry it happens during this age and you will fine. Follow up after a week if the problem doesn't resolve will prescribe other medicines. Regards Icliniq.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes navel cramping during pregnancy?\n\nHello; My daughter is 18 and in her 6th month of pregnancy. She is (10 min. ago) having some distress as both sides of her navel are cramping severely and the baby is very active. She just went to the hospital 2 days ago for being dehydrated. She feels a little better today when this started. Any ideas? Thanks, scared Mimi.",
    "doctor_response": "HiDont  worry.nothing to anxious.its quite common and normal complaint by many women.its due to streching of umbulical folds(1 median , 2medial & lateralligaments) and abdominal muscles due to underlying growing uterus. Hope you got reason for your tension.Thank youVasundhara",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are there any medicines to treat epididymal cysts?\n\nHello doctor, I was operated for cryptorchidism when I was nine years. My left testicle is 3.5 by 2.5 cm. I feel this is too small. Please suggest tablets to increase its size. I have epididymal cysts 7 cm long in both testicles. I have burning sensation and numbness and pain. Suggest tablets for this as well. Some days ago I put Flexabenz or Chlorobenzene and Linseed oil cream for joint pain by mistake on my right testicle side, but I washed it immediately. Will it cause any damage or shrinkage of my right testicle? I am worried. Also, I have white spots called elevated Meissner's corpuscles on the left side of the urethral opening on the glans penis. I have elevated lunar and semilunar elevated papillae on inner foreskin. I have white spots on inner foreskin also. I have numbness, loss of sensation, itching and burning sensation on both glans and inner foreskin. Please suggest medicines for all these. Please do not suggest topical gels or creams. I am scared of those. Please suggest only tablets.",
    "doctor_response": "Hello. The normal size of an adult testis is 3 by 4 cm with an approximate volume of 12 to 19 cc. Patients with a history of cryptorchidism may have a slightly smaller size of the testis at adult stage. However, the size of the testis does not matter as long as the semen functional tests are normal. Moreover, there are no medicines available to increase the size of a small testis. In your case, the size is just borderline and nothing to worry. I would advise you get a semen analysis done to see the functioning of the testis. Also, the spots that you have mentioned are physiological and represent the oil glands on the genitalia. They do not warrant any treatment. With regards to the use of Chlorobenzene and other oils, they can at times lead to an allergic contact dermatitis. But otherwise, do not affect the testicular size. For more information consult a cosmetologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fluctuating blood pressure in an elderly person\n\nMy blood pressure at rest in the evening is between 128 85 hr 62 . Today it is have been 150 98 to 144 97. Iam 48 years old 5 foot 7 and weigh 170 pounds I exercise 4 days a week at least. I have never smoked and eat a relative healthy diet but I do enjoy doughnuts and cookies.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  You blood pressure is slightly on higher side.  You should take treatment of your hypertension.  You should take salt restricted diet. Repeat your blood pressure  2 to 3 times.  If it remains persists high then you should take drug treatment. Drugs like losartan, atenolol, amlodipin are commonly used in hypertension.  These all are prescription based medicine so consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should I do to conceive and treat lower back pain?\n\ni m 25 year old female, i aborted 2 times in previous one year, once in the month of april 2013 and another auguest 2013, after that i have continues lower back pain, and this time i conceive another times, and i want to continue with this? what should i do for my lower back pain",
    "doctor_response": "Hello,I had gone through the case and found that you must know the exact cause of abortion.So I will advise you to consult your near one gynecologist and go for proper checkup and also advise you calcium for lower back pain and also for fetal growth.Please take care of yourself and take proper treatment under supervision.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the gums after wisdom teeth removal. Taking clindamycin. Hole and swelling in the gum. Chances of exposed nerve?\n\nI had two wisdome teeth removed 8 weeks ago, 1 upper and 1 lower. I have continued to have a lot of pain , mostly in the lower socket. Have been back to Oral Surgeon several times and was told I might have a bone infection. Have been taking clindamycin for 4 weeks (150 mg x 4 a day) and am in slightly less pain. Today I inspected the lower socket and still see a small hole, I used orajel and got some relief but pain has now returned. Could this be an exposed nerve or dry socket and not an infection. I have no fever or swelling except for a little gum swelling.",
    "doctor_response": "hello & welcome after wisdom tooth removal pain & slight discomfort is obvious, but if its getting worse after 3-4 days of extraction than this may be a case of dry socket, for that you have to visit your dentist. but if there is no such complaint than this may be because of improper oral hygiene because after wisdom tooth extraction bone remain exposed for some time and any food lodgement can cause pain, so maintain proper oral hygiene start up with warm saline rinses, betadine rinses. you can take painkiller like ibuprofen (SOS) thanks & take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for the swollen and bruised foot?\n\nI slipped walking down a small ramp coming from the shed when I fell I slipped with my right folk causing me to bend my left foot forward I herd a crack and fell to the ground. I got back up and could walk on it with some pain. But as time passed the pain went up. I got off my foot and soaked it in cold water. The big toe is black and blue the foot is swollen. I can t put any weight on the foot . I tried warm water but the pain went up , I tried elevation and the pain went up I took 292s for the pain what else can I do. I am 45 miles from the nearest medical help. And am by myself.",
    "doctor_response": "Brief Answer:Most likely Ankle sprain of left foot requiring cast to immobilize ankle and x-ray to rule out fracture.Detailed Answer:Warm Welcome. I appreciate your trust in HCM and assure you are on best portal on the globe for expert online medical services.I have thoroughly reviewed health query you raised, and well realize all of those concerns. Being your physician, I will take care all of them today and will extend my expertise to solve the problems.Based on what you said, it is most likely that you have an ankle sprain. It has caused your ankle to swell up. There is a slight chance of ankle ligament tear and does not come up on x-ray. It requires an MRI scan but I wouldn't that far yet. You need an x-ray ankle to rule out any fracture.To be on safe side, you may require a cast on ankle for 2 weeks to prevent it from mobilization. You use tab. naproxen 20mg once daily for pain and swelling.Hope I addressed all the concerns you have. Let me know if you have further questions. I will be more than happy to clear any doubts. Keep a follow up to see how you doing.Regards!Dr. Ali Raza",
    "dialogue_context": ""
  },
  {
    "patient_message": "What diet should I maintain to reducce cyst and fibroids in my right ovary ?\n\nHi, I have a choclatte cyst in my right ovary & also i have 3 small uterine fibroids .Pls tell me the diet that have reduce the cyst as well as the fibroids",
    "doctor_response": "there is no specific diet which can reduce your cyst or fibroids. you will have to take treatment from gynaecologist to treat cyst or fibroid.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to remove acne scars on nose ?\n\nhi, my name is khan from bangalore. i have acne scars in my nose and chin. my nose color got changed due to acne and whiteheads also around nose. please give me a way to get rid off this acne scars",
    "doctor_response": "Hi Khan, Welcome to Healthcare magic forum, First u can cleans and tone ur skin by good cleaner and toner available in the market, see a good skin specialist for further treatment. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any remedies for beef, prawns, crab and stingray allergies?\n\nHi! I'm an allergy sufferer of beef. Whenever I take beef or products with contains beef, soup, seasoning or anything, I will have rashes on my skin. And also sometimes, allergy to crab, tiger prawns & stingray...Is there any suggestion to prevent or cure it?",
    "doctor_response": "Prevention is better than cure. In my opinion you should avoid those food items to whoom you are allergic. This is the only and the best prevention. Regarding cure there is nothing to cure about as your body is functioning normally without these food items. Allergy is as per say not due to problem in human body but it is due to reaction of our immune system with foreign substances and this reactivity varies among all of us.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for muscle popping in forearm after injury\n\nSeven months ago I was cutting the grass with a pair of barber shears. I did this several times each time it took me alittle more than an hour. After the third time my forearm started to pop and I could hear the pop and it hurts like hell when I turn my wrist. I think I may have torn a muscle in my forearm. I tried immobilizing it with a wrist brace but the popping still happens.",
    "doctor_response": "Hello,The symptoms seem to be related to a turned muscle. I suggest using anti inflammatory medications such as Acetaminophen to relieve the pain. I also suggest using cold compresses for local application.  I recommend ti maintain a brace to prevent further damage.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a childhood asthma?\n\nhi!! I have asthma since my childhood,, am from Tanzania east Africa and now am 30yrs old, the whole of this week I have been sick I do receive asthma attack frequently. is this problem cured? or what best medicine I can use cause is giving me hard time",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your history and would like to make suggestions for you as follows:1. As you have asthma since very long time, I would suggest you spirometry with post-bronchodilatory reversibility testing which will help to know your lung capacity, type of airway problem, etc. It is will also help your doctor to choose appropriate inhaler for you.2. I would also suggest you allergy testing for common air-borne allergens such as house dust mites, pollens, molds, insect proteins, animal dander, etc. This will help you identify the substances causing allergies to you as well as to know the measures to avoid them.3. I usually prescribe my such patients appropriate use of regular inhalers (\"preventer\" inhalers) such as inhaled corticosteroids and inhalers for as-and-when-needed basis (\"rescue\" inhalers) such as inhaled salbutamol/levosalbutamol etc.However, to suggest appropriate inhaler for you, details of frequency and severity of your symptoms as well as spirometry would be required.4. In general, please avoid exposure to dusts, smokes and air pollution as much as possible.5. Regular physical exercise including breathing exercises and nutritious diet rich in vitamins & minerals will also help you to improve your lung capacity and immunity respectively.hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes walking difficulty while on Prozac?\n\nMy daughter has taken Prozac for 3 years and is now 16. Since a little over a month she has been walking like she is unsteady and unsure of walking and has a little trouble keeping her hands steady. Should I take her off the meds and see if it clears up??",
    "doctor_response": "Hello,Prozac is an activating drug and it can sometime cause such symptoms.Do not take off the medication because it can bring back her symptom and may cause withdrawal symptom as well. Consult your psychiatrist who will take care of her problems.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Rohit Kothari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and redness around the tailbone?\n\nI had a pilonidal cyst about 10 years ago. It was drained a couple of times then packed. At its biggest it was about the size of a grapefruit. I noticed today that my tail bone felt sore and looked in the mirror to see a red line and maybe a bit swollen. Is there any thing i can do before it gets really bad again?",
    "doctor_response": "Two possibilities. There may be regrowth of pilonidal cyst or some boil/ abscess in the offing. If redness or swelling is not marked, it could be onset of Coccygial intervertebral affection.Better to get it checked physically before getting opinions for treatment.Hope it helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I was suggested orchidopexy for testicular torsion. Is there any alternative to this?\n\nHello doctor,I am a 25 year old male who was recently diagnosed with bell clapper deformity and intermittent testicular torsion. We are unsure if it was onset by trauma or supplement use. The current recommendation given to me by the doctors is to perform an Orchiopexy as a preventative measure for testicular torsion. I was told this is a low-risk operation and would likely eliminate any issues I am currently dealing with. However, I would like to avoid this at all costs and was wondering if there are any alternative methods I could try beforehand.",
    "doctor_response": "Hello. Bell Clapper deformity is congenital (since birth) but may have been noticed only now. In this, the testis is suspended at an abnormal angle and is more prone to torsion. The muscle around the testicles is oriented in an oblique manner and so when it contracts during exertion, it twists the testis. Normal testis will not rotate, but bell clapper types can rotate and pinch its own blood supply. Fixing the testis is best, ideally on both sides. There is no conservative approach. I would suggest you go ahead with surgery. For more information consult a urologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can chicken pox be treated?\n\nMy son has chicken pox and is refusing for me to apply the calamine lotion ,does it sting the sores?i thought it would make him feel better but it s a fight to put it on him,Is there another alternative ,we are on day 3 now with it as well how do I know it s healing?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.The calmine lotion is only for your son's benefit. It does not have healing effects, but it soothes the skin. So if he prefers not using it, that is fine.You could try neem leaves. Besides that paracetamol for the fever is adequate, as the lesions will start resolving on their own. You will start seeing the lesions start to scab and fall off.Ensure your son does scratch the scabs as it could cause scarring.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Pranav Balakrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sharp pain in the thigh\n\nMy mother in law, 83 years old, has a sharp pain in her inner thigh...new onset. It is the same lag that had a hip replacement 15 years ago...and thinks it may be related to that. The pain is better with rest. Considering her age, not sure if we should seek immediate attention. It is evening here so it would require a trip to the ER.",
    "doctor_response": "Take one x ray to rule out impending periprosthetic fracture.Tip of the prosthesis can erode the femoral cortex medially and weakens that part and can give rise to this type of thigh pain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can smoke less tobacco cause cancer?\n\nHi Doctor, I have been using this kind of smoke less tobacco for past 4 year. But now i am feeling that i should haven't used this and not any more , but i am not able to control this. Even i have fear of cancer ??? please give me a best way to make my self calm Dr.. ??",
    "doctor_response": "Smoke less tobacco causes cancers such as oral cancer, esophageal cancer, and pancreatic cancerThere is no safe form of tobacco. At least 28 chemicals in smokeless tobacco have been found to cause cancer. The most harmful chemicals in smokeless tobacco are tobacco-specific nitrosamines, which are formed during the growing, curing, fermenting, and aging of tobacco. The level of tobacco-specific nitrosamines varies by product. Scientists have found that the nitrosamine level is directly related to the risk of cancer.In addition to a variety of nitrosamines, other cancer-causing substances in smokeless tobacco include polonium\u2013210 (a radioactive element found in tobacco fertilizer) and polynuclear aromatic hydrocarbons (also known as polycyclic aromatic hydrocarbons).So i advise u to totally stop using smoke less tobacco.RegardsDR DE",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Could oral surgery be the cause of seizures in my little one?\n\nHello doctor,My daughter had an oral surgery because she had a lot of cavities. They had to put her to sleep soon after the surgery. I am assuming less than six months that she started having seizures. Could the surgery or medicine they used made her develop these seizures? She is on medications for the seizures.",
    "doctor_response": "Hello. It is highly unlikely for the medicine used during the surgery to cause the seizures now. Regarding the surgery causing this, the only possible explanation is the development of a stroke during or after surgery which can lead to seizures later. But, I guess she did not have stroke symptoms like facial deviation or limb weakness. So this is also less likely. However, we can get an MRI (magnetic resonance imaging) of the brain done to look for the cause. If it is showing some structural abnormality like the previous stroke findings then we can assume that it might have occurred during the surgery. If not, then this is epilepsy which occurs due to electrical problems in the brain and is not related to any specific cause. Regards. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Deteriorated cervical spine. On norspan patches. Done CT scan. Will it help?\n\nHi there,I am 63 years of age. I know I've had some problems with my 'Spine' in general. 3 months ago my GP organised a season with Physio. That was 03/07/13. I have been in agony basically ever since. I had CTScan done last week. The easy answer is that I have a VERY SERIOUSLY deteriorated cervical spine. I have a 'collar' but that puts all the 'pressure' o the from and almost no support for my spine. I NEED something to really support my SPINE not my neck. Do you have any suggestions?  My Dr put me onto Norspan  5mg patches yesterday.Thanking you,Ella Demp",
    "doctor_response": "Hi, it appears that the condition is due to the osteoporosis, and may be hypovitaminosis D. When these two are corrected you can go for surgical correction of the cervical spine.                        Any how orthopedic surgeon only can decide the treatment.                        I advise you to take green leafy vegetables, pulses, sprouts, and proteine rich foods. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe tail bone pain\n\nfrom past few days about 10 days,,if i sit in office chair for a long time and getting up, my tailor bone pains a lot At home if i sit in bed or car seat or couch i dont have any pain i am a female 36 years old, i had c section 5 years back with epidural",
    "doctor_response": "Hi,Thanks  for  your query.The pain in the coccyx that you have described can be related to coccydynia. You need to do hot sitz bath to decrease the inflammation in those joints.Do hot fomentation over sacrum. It will take weeks to months to subside.Use ring cushion and take sitz bath [sitting in lukewarm water for 10 min]Take analgesic like nucoxia 90 once daily along with tab methylcobalamine 1500 mcg once daily.If not relieved with all these methods then local injection may be required. You can take this consulting your doctor.Clinically spinal origin of pain needs to be ruled out, if required MRI spine can be done.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is MCV level of 95 in a blood test considered to be high?\n\nIs an MCV level of 95 high? The blood test results I have just received have me with a level of 95 within limits of 80-98. Also, I have eGFR >59, which was flagged by the lab, but my doctor did not mark. My Vitamin D level was at 22 on an accepted scale of 32-100. My doctor did mark this and suggested 4000 units of Vitamin D daily. I have been on HBP medication most of my life, but my hypertension is well-controlled (116/73) with 100 mg of the generic for lopressor (50mg 2x daily). Is there anything I should be concerned about with these results? The only result my doctor flagged was the one for Vitamin D, but I am now concerned about kidney disease. Thanks!P.S. I also have a hematocrit at the high-end of normal- 43.2 within limits of 34-44.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Your vitamin D3 level is low. You should take treatment for that. No other treatment is required. Don't worry about kidney. Your MCV and hematocrit is also normal. Continue with your antihypertensive medicine. No need to worry. Just be relaxed.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for discharge from penis?\n\nGood morning sir, i have some sexual problem means some liquids will flowout from my internal part and am not controled that.How can i control these sexual things and these liquid, due to this problem am feel very weak and my body will fall weak. So what can i do sir plz reply me, if you said to meet you then am going 9th april in bbsr.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.You are facing the problem if sweet dreams.In this condition your semen gets leaked from the penis.You are grown up now. Its time you should masturbate and control the secretion periodically.By this will you will never face sweet dreams. Its a false belief that because of this your body is going weak. It will never affects ones body in any way.Many people who do not masturbate face this problems. And those who do masturbate can't face this problem.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen cheek due to abscess?\n\nHi. I woke up this morning wt a swallen cheek due to my abcess. I think it may hav to do with the fact I lost my tooth n now the tooth that was next to my tooth that came out hurts. Should I just wait for the swellen to go down or go to the dentist. It was not in pain untill noon and my cheek has gotten harder.",
    "doctor_response": "Hi! Welcome to Healthcaremagic.I read your query.Check for any cavity in that tooth or adjacent teeth. Your symptoms are of dental abscess. I suggest you to visit a dentist and get an x-ray done. You need to get either RCT or extraction of tooth depending on condition of tooth.You need to have an antibiotic course on prescription. Painkillers like acelofenac etc will help easing pain a bit. Do warm saline rinses if warm water does not hurt. It will help in releasing pus.Final treatment is done by dentist after examination.Hope the answer helps you. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of pain in my upper jaw?\n\nHello sir/madam Yesterday pain started in mu upper left jaw all of a sudden. I think it started while i was eating sandwitch but did not pay attention to it. But while dinner if i open my full mouth it pained. Today iin the morning its the same. it while opening my mouth upper jaw hurts alot. Please suggest something that would easy the pain. Thanks",
    "doctor_response": "thanks for your query, i have gone through your query.  the pain on opening the mouth could be because temporomandibular joint disorder. or it can be radiating pain from any tooth infection. consult a oral physician and get yourself examined. you need to take a radiograph of the whole jaw like OPG and TMJ views to rule out any tooth infection or TMJ disorder. if it is tooth origin then we can treat the tooth. if it is of TMJ origin then you can take piroxicam tablet twice on the first day and once daily for next 5 days. do not open you jaw to wide and do not eat hard things for 15 days. i hope my answer will help you. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How should PCOS be treated for successful conception?\n\nHi , I am 30 years , married 4 years ago. I am trying to conceive. Doctor did all the test and confirmed pcos.He said you need to reduce weight. My height is 5 feet and weight 60kg. I do normal situps at home. I have still not conceived and getting worried as this november I will be 31 years old.Please advice how to overcome pcos and conceive fast.",
    "doctor_response": "HelloFirst of all  get rid of tension , now you are 31 years but so  what? You will conceive once pcos cured.Poly Cystic Ovarian Syndrome ( PCOS), cysts are often caused by hormone changes . Using birth control pills can sometimes help regulate hormone levels so that the cysts can be taken care of . Some times doctor also prescribe cyproterone acetate for pcos. Once you stop the oral contraceptive as long there are no medical concerns, you shouldn't have problems with future conception.So need not to  worry , take a  treatment for PCOS and once cured you can conceive in future.Hope this will help you.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain from upper back to right abdomen?\n\nI have this pain on my right upper back near the rib cage going through my right abdomnen. I went to the emergency, found all to be normal but the pain is really #6 on a scale of 1-5. I am schedule to see my primary doctor next week but I am suffering from this pain. I am taking tylenol because I have side effects on the pain medication hydrocone.",
    "doctor_response": "Hi,Welcome to the HCM,It could be because of gall bladder or liver abnormality.you may need Ultrasound abdomen and liver function test to rule out any stone or infection.Regards,Dr.Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment for womb cancer\n\nwomb cancer second stage. which is the better treatement?",
    "doctor_response": "Hello Thanks for your query. Total  pan hysterectomy with radiotherapy and chemotherapy with regular follow up  is the best line of treatment. \u2018Hope I have answered your query, I will be available to answer your follow up queries, \u201cWish you Good Health and trouble free speedy recovery\u201d",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for postpartum knee and hand pain\n\nI am 4 weeks postpartum and I am having pain in my knees and hands still (the same pain I started getting in the third trimester of my pregnancy). My hands are still swollen and I cannot wear my rings. It feels like what I imagine arthritis to feel like. My knees hurt each time I sit or go to stand from sitting or walk up and down stairs. I would of thought this would be gone by now (all the water retention and swelling that is) Any idea why I am still having this and should I be concerned about the pain in my hands and knees? What could it be?",
    "doctor_response": "Hi Hope this message finds you in good health.I have gone through your query in detail and understand your concern.its occuring due to low calcium and hormonal changes.take calcium tablets and paracetamol if required.hot fomentation will helpHope your query has been answeredNothing to worry about, You should eventually get back to normal.Get back to me for any  FOLLOW UP QUERIES anytime.Kind Regards,Dr Mahaveer Patil...(MBBS,MS,Mch)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Neurontin drug recommended for neuropahty patients?\n\nI have been on Lyrica 75 mg 3 times a day for 10 years for neuropathy in feet due to a bad fall hurting both feet as well as thyroid cancer with radio active iodine treatment. I use a tens unit everyday which has been extremely helpful. This past month, I have gradually gone down to two 75 mg a day with success. Do I dare change to neurotin which would be much cheaper?",
    "doctor_response": "Hello, You can safely change to Neurontin safely. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pregnancy happen after non penetrative sex?\n\nMe and my girlfriend were fooling around. I want to present a few scenarios and get your opinion.  I was wearing boxers and she was wearing nothing.  I had a little precum in my boxers and rubbed it around the outside of her vagina. Obiviously there is some chance, but what are the odds of her getting pregnant from that? scenario two.  I had wiped come off my penis after digital sex.  It was a few minutes later ( most of the sperm had likely dried) and then engaged in digital sex on her? what are the odds of getting her pregnant? and this is some side information.  She has only had one period and it was a few months ago.  ( four months to be exact) please give me your advice. I realize i was careless and am seirously freaking out. thank you",
    "doctor_response": "sperm travels in liquid media. ...it dies in solid media lik clothes...u do urine pregnancy test test fr her...as she didn't get periods frm last 4 months....sperm has to travel in vagina cervix up til uterus...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will emergency contraceptive work if sex is after ovulation?\n\nCan any of the emergency contraception options work if sex was after ovulation? I had sex (with a condom issue) on day 20 of my cycle. My cycle varies between 21-23 days. Do any of the options (next choice or ella) prevent implantation? Or is it so late in my cycle that there is no risk of fertilisation because no viable eggs exist? I am 41. It is now hour 60 after the condom broke. I waited to see if my period would arrive but it hasn t yet. Research seems to doubt whether next choice would work after ovulation, but that Ella might. I can t tell the pro lifer agenda from the anti and wanted medical advice rather than newspaper reports. I don t know whether to take Next Choice today (I have 12 hours left to hit 72) or take Ella in the next day or two if my period doesn t come. Thanks for your help.",
    "doctor_response": "Hi,Thank you for posting your question here, I will try to answer it to the best of my abilities. Normally, you can only get pregnant if you have unprotected sex during the time when you are ovulating, if ovulation has already occurred that means you cant get pregnant in this cycle, this is what was taught to me by my teachers, so unless I was taught wrong, you should be okay.But taking an emergency pill wont hurt your chances, as such I recommend you take the ella pills, since they work upto 5 days after unprotected sex. I hope this answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is detachment of white clot from tooth extraction site normal?\n\n2 weeks ago this Monday, I had one lower wisdom tooth taken and both lower 2nd molars taken. Clots formed just fine without much pain. The white film has came off both extraction sites and they look like craters (excuse the crude term). Mild pain where wisdom tooth was, just feels irritated/sore from eating. Is it normal for the white clot to come off? I'm paranoid that I'll develop a dry socket. I rinse often especially after eating. Am I far enough along now that I won't develop one?",
    "doctor_response": "hiaccording to the details which you have given me looks like dry socket. when the healing in under process, there will be a soft tissue covering over the extraction socket. After the extraction there is formation of blood clot- then there is white colour flim- pink color tissue and finally the gum formation.home care instruction:Avoid spicy food, it leads to irritationAvoid alcoholic and tobacco for a weekDo not suck anything, like ice cubes,etc, it leads to dislodgement of the clotAvoid having food from the extracted site for2-3 daysDo lukewarm saline mouth rinse 3-4/dailyDrink lots of water it will keep you hydrated.Consult your dentist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain on the arch of foot with muscle spasms?\n\nthe arch of my left foot has been sore. My foot has will not move sometimes. There (for the past two week) has been a constant Charlie horse thru the arch. About ten minutes ago I went to step on the ball of my foot and there was a horrible grinding sharp and sudden pain. It took my breath away and now I cannot put any weight one it, It still hurts. Why? and What?",
    "doctor_response": "Hi,Thanks  for  your query.From your symptoms, it seems that you are suffering from plantar fasciitis. It happens due to inflammation of the plantar fascia.It hurts the most with the first few steps in the morning because the plantar fascia is tight and has not stretched out yet, and throughout the day it loosens up. The best thing you can do is when you wake up in the morning, before getting out of bed and taking a step, give yourself a little foot rub.There are many things you can try to help your foot get better:Give your feet a rest. Cut back on activities that make your feet hurt. Try not to walk or run on hard surfaces.Use shoes with good arch support and a cushioned sole.Do toe stretches, calf stretches and towel stretches several times a day, especially when you first get up in the morning.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stressed and have lost virginity. Why is period delayed?\n\nI recently have lost my virginity , we ve always used protection ( condoms ) and have been active for the past 1 month. I am under a lot of stress right now. (School, work etc) and have noticed that when I was stressed out a lot for the years before (I m 18 started period in 8th grade so around 12) my periods were extremly out of order. So to be careful I started a birth control 1 month ago (I am finishing month one now and I am on the second pill that is suppost to be my period week) And it hasn t come. Could losing my virginity and stress set my period to go back? Should I consider a test if I haven t gotten my period by the end of green pills (period week pills)? This is the first period I should be getting after losing virgintiy",
    "doctor_response": "hi allison, i would like to inform you that there is connection between the virginity and the periods. however its advisable that you should be careful about the possibility of pregnancy (because the OC Pills might not work for the 1st month of the use). and its important for you to remember that Stress would lead to changes in the basic hormones of the body which might lead to changes in the periods both in the time gap as well as duration..",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of testicular pain?\n\ni am a 26 year old man, since 4 years i am suffering from testicular pain. due to continuous gym exercise i had swelling 3 times and pain for which i had medicine and pain vanished and due to masturbation also once i had swelling and pain in my right testicle now i cant even walk or drive a two wheeler and even i cant have sex with my wife, i have done all the test and shown to all best hospitals and surgeons in india but all reports are normal and doctors say that they cant make out what is the cause for it  it really pains hard, whenever i have pain in my testis i get swelling in my testis also please suggest some remedy to get rid from testicular pain PLEASE HELP ME",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Most common causes of testicular pain is infection. So you need to rule out prostatitis also. Is there any chance of std? I suggest you to consult an urologist and evaluate further. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for wheezing\n\nMy son who is  almost 8yrs is having wheezing for last 5months off and on. But last one week it is been continuous. Is there a safe way with out steriods to get this into control. His symtoms seem to improve with antihistamin. But brochodialator syrups (terbutaline) did not work that well at least this time (for the one week). Please advice",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your history and would like to make suggestions for your son as follows:1. Were I treating him, I would prescribe him montelukast and levocetirizine for at least 7-14 days.2. I would also prescribe him levosalbutamol in inhaler or syrup form.3. I would suggest him to avoid exposure to dusts, smokes and air pollution as much as possible.4. If severe wheezing or breathing difficulty, I would suggest you to get him examined by a pediatrician who can advise appropriate medications. For severe symptoms, corticosteroids may be needed. A short course (5-7 days) of corticosteroids usually does not cause long term side effects but can alleviate suffering.5. As he has symptoms for last 5 months, I would suggest him allergy testing which will help him to know the substances he may be allergic to and also to know the measures to avoid them.6. A healthy diet rich in vitamins & minerals (adequate amounts of green leafy vegetables, fruits, sprouts etc) and plenty of warm fluids to maintain hydration are also important.Hope above suggestions will be helpful to him.Should you have any further query, please feel free to ask at HCM.Wish your son the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am sneezing continuously only in my hometown. Can it be due to climate?\n\nHi doctor, I am living in a tropical coastal area. I used to travel always. When I am outside my place or abroad I do not have any problem. But, when I enter my place and as soon as I enter my house, I will start sneezing and then after sometime my nose will start dripping. This happens only in my place. When I go outside even for six months I do not get fever or cold. But, in my place every day morning I will start sneezing. I do not know what is happening. Is this because of the climate or dust allergy? What all tests should I do? Which doctor do I need to consult?",
    "doctor_response": "Hi. Do not worry. I worked in such a place for some time. For further information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can appendicitis surgery cause weight loss, weakness?\n\ni m an 18 year old girl. my appendicitis surgery was on 10 february 2013 and from that time my body became so weak. like hair loss, weight loss, skin problems, weakness in my body occurd. so im very much deppressed about my body what i do for it i didn t know plz help me...",
    "doctor_response": "Appendix surgery doen not cause weight loss and weakness. Have you also loss weight? You should consult your doctor. Iwoul suggest you get the following tests done1 Hemogram2. TSH",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing sweating,loss of sleep,restlessness & joints pain\n\ni sweat a lot at nite though its winter such that i have to change my nighties twies,i also feel restless,hae less sleep and my joints are painful,in the morning i wake up tired and drowssyi.m currently on arvs,cardiovascular medication and on petogen injection. what could be causing this",
    "doctor_response": "HIThanks for using healthcare magicI think, you have panic disorder. In that case, you need antidepressant and low dose of benzodiazepine. You can consult a psychiatrist for proper management and diagnosis. You can also try relaxation exercise that would keep you calm. In case, you need further help, you can ask.RegardsDr. Abhishek Kapoor",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I impregnate my wife if my semen analysis is like 8%?\n\nhi there...actually we are trying for a baby for last 6 months but still there is no result...we had a complete check up including semen analysis for me..it was like 8 % and doctor said anything above 4 % is normal...can you please help us to increase the chances of my wife being pregnant.. thanks ravi",
    "doctor_response": "Hello, Understand the period cycle of your wife and try to have sex during the fertile periods of your wife. You will succeed to get her pregnant. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in urethra and scrotum?\n\ndear Sir since last ten days i have has slight irritation in my urthera or penis tip , this develobed the very next day i had small act of oral sex performed on me , doctor has put me on levofloxacin 500 mg per day for 7 days , today i took the 6th tablet and still feel some discomfort , and now since two days  there is slight pain in my scortum on the right side , not exactly on the testicles but above them , please give me some  , urine detail report show lekocytes 2/HPF , rest of the things are all fine",
    "doctor_response": "Do get a urine culture done to see what infection you are harboring. Medicines given are correct for UTI without a culture report. If the culture report is negative then you need not worry. If it is positive, it will suggest what antibiotic to take. Also, I would suggest you take atleast two weeks of antibiotics as Urinary tract infections go away with difficulty. Take care,Dr Rishi, India.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is cotcellularmantana and how can I cure it ?\n\ni don t know...",
    "doctor_response": "Hello. Thanks for writing to us. We have received your query in an incomplete format. You need to provide more details regarding your problem so that we at healthcare magic can help you. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drtayalrakhi@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could high heart rate consistently be a sign of something serious?\n\nI am training to join the Marines and a few hours ago i ran 3 miles, my heart rate is still very high, im very uncomfortable, my chest hurts right in the center, and i have verdigo. I am not sure what to do, im 19 years old, 180 pounds and very athletic.",
    "doctor_response": "Hello and thank you for using HCM. I carefully read your question and i totally understand your concern. But I think you should not wory. I will try to explain you something and give you some tips.It is quite normal during exercise to have high cardiac  frequency. For your age we expect that your maximal heart rate might be till 201 beat for minute. Normaly, after exercise we expect your frequency to go down slowly.When your heart beats to fast it is normal to feel a little uncomfortable and even to experience a chest dsicconfort. You are to young to young to thing of other possibility of your chest pain. Sometimes excessive exertion may be the cause of fatigue or this kind of vertigo.If you experience a high  cardiac rate during a normal day than we can think of some examinations.If I was your treating doctor I will recommend a blood analyze, electrocardiogram and a echocardiography. It is advisable a holter monitoring to see that really happends with your rhythm.I will advise you to do this simple examination to continue your journey to the marine. Just for reassurance because it may be only a little stress cousin all these. All sow avoid coffee or cofein products because the rise your heart frequency. Hope I was helpful. Wish you good health and good luck in your future",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dry mouth with salty taste\n\nHi Doctor,I have been experiencing dry mouth and salty taste in my mouth for more than six months already. My doctor gave me Diflucan for oral thrush.  I felt relieved somewhat but he doesn't want to give me any more. What should I do? It's driving me crazy! Thanks!",
    "doctor_response": "Hello, Thanks for your query.There are a number of simple dry mouth syndrome treatments that are designed to restore moisture to your mouth. Your dentist may recommend:Sugar-free candy, sugar-free gum or gum specially made to stimulate saliva flow.Specially formulated oral rinses.Artificial saliva (saliva substitute).More fluid intake (frequent sips of water, sucking ice chips).Oral moisturizers (sprays or gels).Oral prescription medications to induce saliva production.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever, digestion issues and sleeplessness\n\nmy 2 year old son had very smelly poop 2 weeks ago. Now he has a high fever and farts a lot.....we called a doctor but he has no symptoms to be seen ( throat,ears, breathing ok). it s been 2 days we give him Tylenol to bring the fever down....he does normally though , does not look sleepy or else. What could he have that creates the fever and the digestion issues ? could it be related ? like a gluten issue ?",
    "doctor_response": "Hi...this looks like viral illness. This definitely doesn't look like a gluten problem.Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pin prick type of chest pain in left side?\n\nhi, i am 27 years old woman.working in it company. having more or less healthy food, height 5.1 inch and weight 55 kg. I am having very mild but sharp pin pinch type of chest pain in left side of chest. it lasts for 1-2 seconds some times little more seconds. feeling nurvous . please suggest.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Left sided chest pain should be evaluated for heart diseases first. So better to get done ecg and 2d echo first. If both are normal then no need to worry for cardiac diseases. Sometimes anemia and vitamin b 12 deficiency can cause similar kind of pin pinch type of chest pain. So get done hemoglobin estimation and vitamin b 12 level. If deficiency then you need supplements. Don't worry, you will be alright. But first rule out cardiac diseases. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat persistent pain in the testicle and groin despite a holistic approach?\n\nhello, my brother has experienced pain in the testicles and surrounding groin muscles for multiple years, this pain is usually aggravated when sitting for long periods of time, and is increased with stress. he has had mri s and injections with no positive results, he has been seen by 2 separate urologists with no success. he recently has been seeing a holistic doctor that has made some muscle and nerve manipulations in his nerve posterior to his testicles which has given him huge relief but it has only been temporary. suggestions?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Is he sexually active? We need to rule out any genital infection.commonest cause could be  infection which may not be detected in MRI. You can consult an urologist with this idea. Physical exam can confirm. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. B. Radhakrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes jelly like vaginal discharge with thrush discharge during pregnancy?\n\nhi doc, I am 24 weeks pregnant and suffer from recurrent thrush which I have kind of learnt to live with. Today, while washing my private parts, something chunky and jelly like came out of me along with the thrush discharge. I am  really scared. what could that be?",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the candidial infection or thrush is the most common infection in pregnancy.Candid V6 vaginal tablets can be taken and they are effective.Candid dusting powder is also effective for itching over the vulva.But in  a few woman the recurrence of infection might be the problem.Dont worry.It will subside spontaneously.As there was jelly like discharge it might be mostly vaginal discharge.If you dont have any pain abdomen,backache nothing to worry otherwise you might have to see your doctor once.Best regards....",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes an effervescent taste in the mouth?\n\nI've been tasting an effervescent taste in my saliva when I chew. Its like carbonation from soda pop in a sense. Not on any medications besides blood pressure medicine that I've taken for a few years. Once in awhile I'll use ibuprofen or aleve for pain. That's all .. Thank you.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.Effervescent taste in mouth  can be due to infection in mouth and throat  while at time salivary gland infection can also be a cause. Also high sugar levels can be a cause. It can also be due to nerve related problems. So it is advisable to once consult an oral physician and get evaluated. For now chew sugar free chewing gum and gargle with antiseptic mouthwash. Drink plenty of water.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest future management for tracheoesophageal fistula\n\nMy father of 78-year of age has a Stage IV esophagous cancer for over 20 months. He has completed 35 Chemos and 15 rounds of radiation. He suffered fever on the last day of his radiation 10 days ago and the medical team has determined that the infection that caused his fever was due to pneumonia resulting from Tracheoesophagel Fistula. The pulmonary specialist, and the surgeon do not recommend surgery due to cancer and both doctors think my father has short time left to live (about 1 to 2 months). However, the oncologist thinks that there is a possibility that with time, though very slowly, tracheoesophagel fistula may heal itself with the ongoing antibiotics treatment given the pnumonia my father is suffering is not sever. What are your thoughts on differences of opinions among the doctors and what is the best care for my father going forward (LTAC or Home Health Care)? Thank you in advance for your help.",
    "doctor_response": "Hi,Thanks for writing in.Sorry to hear about the progress of disease in your father and the development of tracheoesophageal fistula. In this condition, there is a communication between the airway and food pipe and the patient can aspirate food contents in to the lungs causing a severe infection.As early as 10 days after radiation, the area might still be raw and surgery is not a good option. This can complicate the situation and worsen the disease. If the fistula is small then with time, the area around the tracheoesophageal fistula can heal and form fibrosis. This is a healed scar tissue ad can help in spontaneous closure of the fistula.Also the pneumonia is not severe and antibiotics are being given to take care of the infection. At this point in time, your father must be made comfortable and his pain reduced as much possible. The first step remains curing him of the pneumonia and extend his survival by a few months. I understand that he is taking ryles tube feeding. Then next we have to provide him adequate pain relief and that can mean increasing his medications to make him feel comfortable. This can be followed by waiting for the tracheoesophageal fistula to heal.If the initial part of pneumonia can be taken care of in a hospital then he can be provided home health care after he is stable.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which is better between hemodialysis and peritoneal?\n\nI was just told I need dialysis. Which would you advise,hemodialysis or peritoneal. I ve been going thur all the info I can find on the web, and I still can t decide. Although I am leaning towards peritoneal,because it s benefits seem healthier. Thank you!",
    "doctor_response": "HiThanks for your query.Hemodialysis and peritoneal dialysis have similar short term and long term outcomes. Each technique has its benefits and drawbacks.Often the decision to use a particular therapy is guided by patient's lifestyle preferences. A nephrologist has to determine if you are eligible for PD or HD.If you prefer to do your own therapy without having to go to the hospital, then PD is preferred. Ultimately, if there is no contraindication then the most preferred treatment is to get a kidney transplant.Hope this helpsGood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need help with interpretation of my semen analysis\n\nmy semen analysis report: Quantity- 1.5ml Color - Grayish White Viscosity - Viscous PH- Alkaline Total Spermatozoa Count : 55 million/ml Morphology : 85% Normal Motility: Active-motility -65% , Feedly-motility -10% , Non-motility 25% Epithelial Cell : (+) RBC : Nil Pus cell : 0-1/HPF Comments: Normozoospermia. Now my question Can I become father? because I got marriage past 6 years & my wife have no problem",
    "doctor_response": "Hi,Welcome to HealthcareMagic .Yes you can become father with this report.  It is normal study. I would suggest your wife to start taking ovulation inducing drugs like clomephine . This will increase chances of pregnancy . Since you are trying from 6 years I would suggest you to go for IUI with clomephine.  Here healthy sperms are placed in uterus .Hope I have been helpful .RegardsDr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I feel vibration in my lower right groin area?\n\nHi Dr, I need some answers regarding a vibration in my lower right groin area. I've been told possible pinched nerve.  The vibrations has been going on for over a week and a half now. I do hot yoga and there is a weakness on the right side from neck down to my thigh.  Also tenderness in the pelvic area.  The vibration has gotten worse since practicing yoga today.",
    "doctor_response": "hifrom the symptoms you have mentioned you seem to suffering from a neuropathy ( weakness in the nerve supply in that area )you need to get your vitamin b12 levels done, you need to be done a blood test to rule out viral infection like herpes infection.you might require to do ct scan of brain to rule out any problem.i would suggest get reviewed by a physician to do the necessary tests.hope to have answered your querythanking you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump on the side between ear and shoulder?\n\nI have had problems keeping food down this week, I have pcos and have recently found out it is precancerous I now have found a lump on the side of my neck that is very sore. Should this concern me or is it just a viral infection I should be worried about, Its not my lymp node behind my ear or jawline it is literally on the side of my neck between ear and shoulder.",
    "doctor_response": "Hello!Thank you for the query.This sounds a little concerning and should not be left alone. It might be an inflammation of this area however some cancerous lesion is also possible. That is why I suggest you to have an ultrasound of this area done at first and consult laryngologist.Hope this will help. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could an arm skin lump with soreness and redness be?\n\nI ve had a pea-sized lump just under the skin on my upper arm for about a year now. It wasn t discolored or painful at all. The other day, I noticed that it was a bit larger and the skin around it had some redness to it. It doesn t hurt, but it feels sore to the touch. What could it be?",
    "doctor_response": "Hello and welcome to healthcare magic.I am dr Asad sami.I have read your question and can understand your concerns.If i were your treating physician i would have examined that lump and looked for its mobility under the skin.LIPOMA is usually mobile under tge skin and one can pinch the skin above this swelling.In your case inflammed lipoma would have been top on my list.lipoma is abenign condition and can be treated conservatively.If it is causing problems then surgical excision is done.i would have prescribed non steroidal anti inflammatory drugs such as aceclofenac 100mg or diclofenac 50mg for the inflammation.i would have prescribed prophylactic antibiotic such as ampicillin plus cloxacillin 500mg to cover staphylococcus bacteria which is usually culprit in skin infections.I would also have looked for sebaceous cyst in which skin pinch cant be ellicited.it is treated by surgical excision of the cyst.I would have felt it to rule out warts and any ulceration on its suface .. Some skin related carcinomas would also have been on my list for which i would have excised the lesion and would have sent it for histopathological examination.I would suggest you to meet a general surgeon or a dermatologist for further opinion.In the mean time stay calm.Thanks.Hope the answer is helpful.Feel free to ask further questions.Regards dr Asad sami",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had IUI, given HCG injection. Dizziness, white discharge after taking Susten. Why ?\n\nDear Doctor, I am 30yrs old .I had my IUI on 16thJan 2013 and was given HCG10,000- for rupture, I am on FolicAcid, aspirin ,Glycomet and Duphaston , ,i am taking Susten 200 for Vaginal insertion after IUI,but that was giving me diziness and also i was having a lot of thick white vaginal discharge ,should i take it orally for gud result? I had 2 miscarriages,one on my 7th week(2yrs bk) and the other was tubal pregnancy(last year jan),tuk methotraxate injections for clearing the pregnancy.this is my first IUI........hope this would work.. i want to know that susten is effective in pregnancy or not ?is there any side effects?",
    "doctor_response": "Hello, Thanks for your query, Susten is a brand name for progesterone. Many studies have shown its usefulness in preventing miscarriage and maintaining pregnancy. Side effects include Susten (Progesterone) include: Cramps in the stomach, diarrhea, bloating or nausea Hot flashes Pain affecting the breasts or joints Vaginal itching. Susten is definitely helpful in pregnancy. I recommend you to continue with the same. Hope this helps. You may write to me anytime for further clarifications to following link:  regards, Dr Nilofer",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the best treatment for migraines?\n\ni take amitriptyline & Depakote to keek migraines away.Amitripyline is givng me problems with toooth decay.My dr's though is to give me more of the antiseizure drugs often used propylactically but I had a bad experience this weekd  When I increased the depakote, I was constantly  hungry and wanted to eat everything so I began putting on weight.So the next strategy wwas to take zonzamide which does not stimulate hunger; food acti\\ually tastes bland, no appetite but when I increased to 2 pills of zonisamade at first my appetite disappeared andmy mouth began getting blisters - painful in the mouth so I stopped.  Blisteres very painful.I need prophylaxix meds for migraine (I take depakote 500 er and amitriptyline150 but the amitripytilin is giving me dental problems. How can I get off amitriptline         .Increasing my depakote makes me put on a lot of weight",
    "doctor_response": "hi thereread your query and this is a significant questioni wish you had mentioned the measures you took so faranywaysi will answer assuming you were on medicines and took no other precautionsi am also assuming that your neurologist is right about the diagnosis of migraineyou know the easiest way to avoid migraine is to avoid the trigger.every migraine patient usually has a trigger- chocoloate, sunlight, lack of sleep, and sometimes even coffee. So the best thing is to avoid the trigger. very frequently, this itself brings down the incidence of migraine episodes.now the best thing about migraine is that there are many drugs that can be used to treat migraine prophylactically. as you said this includes the antiepileptics. But you can try the lower medicines as well like propranolol, flunarizine etcalso, make sure that you do not have sinusitis or vision disorder. these also can masquerade as migraine. and besides a ct scan may be suggested to make sure there is no other symptompersonally i would have avoided amitriptiline and anti seizure drugs as far as possible. they have many side efectsI hope it answer youDr Saumya Mittal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe itching on the glans of the penis with sores?\n\nHelo sir,I am 29 year old I had typhoid when I was about 15 years and doctor prescribed me some tablets .I had severe fever just one day night and on the same day I was having severe itching on the glans penis and by the next day it became sores.The next day itself I again consulted the doctor and he changed the medicines.He said that might be because of allergy to sulphar or something.That sores became worst and took around two weeks to heal leaving many marks and uneven skin.What type of allergy was it?or was it a symptom of something else like any STD?Is there any way to remove that marks on the glans penis?Please help.becouse of shyness I never discussed these with a doctor",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You should not be delaying to consult an urologist just because of shyness. Most of the treatable problems will aggravate if not treated initially. Find out is it because of allergy or std .Blood tests will help you. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sharp knee pain\n\nI can not fully bend or straighten my left knee and experience sharp pain when attempting to do so, no swelling, no redness and no other symptoms. I recently started jogging again but do not recall any injuries or incidents. any idea what could be wrong",
    "doctor_response": "The pain at knee after initiation of jogging without any history of injury suggest some sort of muscle pull or spasm . Most common muscle group which causes such pain are hamstring group of muscles which are situated to back and inner side of knee. avoid jogging for few days and starts stretching exercises of knee muscles by fully extending and flexing of knee .if pain is severe and disturbing normal walking then you can start some anAlgesic such as ibuprofen and muscle relaxants (thiocolchisides ).if pain does not subside in 5-7 days then you will have to visit your rehab specialist .Hope this answers your question .if you have further questions i will be happy to help .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain after strenectomy and flap reconstruction\n\nI had a sternectomy and flap reconstruction done oct 11, 2013. I then took a fall the 1st of this year. The pain has debilitated me to where I have no quiality of life, and the pain drs blame it on a neuroma they cant see on scan and are treating me with a lidocaine cream. The fact that I have little to no chestwall protection also scares me. I m at a losss as to what my next step should be",
    "doctor_response": "Hello, According to the history you provided, you don't have any other choice but only to be more careful with your health and to stay close to your doctor. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jnikolla, Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ear infection\n\nI took my 9 mo old for a well child visit and they said both ears were infected and bulging with white pussy fluid around the ear.  They want to put him on antibiotic.  I really don't like giving my child antibiotics.  We have worked so hard to keep him off.",
    "doctor_response": "HIThanks for posting your query.     Its not the question of whether you like or dislike to give him antibiotics . If it is really an ear infection with Pus accumulation then yes he has to be put on Antibiotics else it may turn into some serious infection even spreading to face or Brain .    If at all you doubt the diagnosis done by that doctor take a second opinion and if the second doctor too opines the same kindly get him the antibiotics. Hope this information was useful to you. Any clarification feel free to ask .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the different types of dentures with lighter weight?\n\nWhen I was shown the different types of dentures , meaning the one was lighter weight. But it had a different look to it when I was shown then when I GOT THEM. Can you show me the different types of dentures that are lighter weight. I swear the ones I was shown had a redish look to them but not when they brought them in yesterday",
    "doctor_response": "Lightweight skeleton dentures leave the roof of your mouth clear so that you can still taste your food and so that there is nowhere for debris to collect when you eat.The metal conducts heat so that you get the correct temperature sensation from the food in your mouth and the clasps grip your teeth tightly so that the dentures stay firmly put when you chew sticky food.The cost of a denture depends on the type of base material used and the quality of the teeth used. The cheapest teeth, wear rapidly, chip and look poor after a short period of time. The very best teeth are all porcelain which are very expensive but look excellent. In between there are many extremely good acrylic teeth to choose from.The cost will be between \u00a3800 and \u00a31000.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I get pregnant if my husband is diabetic?\n\nhye doctor.. my husband 40 years old. v married for 1 year plus.. no baby.. do semen analysis shown my husband sperm count less but for me everytin ok.. my husband got diabetic just diagnosed few months after our marriage.. so doctor I can still be pregnant ar if my husband condition like tis...",
    "doctor_response": "hai, with  wellcontrolled diabetes  without any complication you can get pregnant.as your husband got diagnosed diabetes recently., so major complication will not be there.but with less sperm count it means less than 20 million/ml will not be able to make it.consult a infertility specialist for treatment and management for low count.thank youhope i answered your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "When should I seek medical attention for hives?\n\nMy three year old has hives all over his body. We noticed it about 2 hours ago. We have no idea if it\u2019s food or environmental. No known allergies. He\u2019s sleeping now. Should I have concern about anaphylaxis? Or would that have happened by now? Can I let him sleep in peace?",
    "doctor_response": "Hello, As you explain the situation it is an allergic reaction probably due to any food mostly. If she seems quite let him sleep and after discussion with his pediatrician to get further advice if needed. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jnikolla, Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure cough,lack of energy and lump in the glands?\n\nMy husband has been experiencing allergy type symptoms, constant cough and lack of energy a lot for the past few years. We have assumed it was the allergies but has not found a lump in his glands. Any suggestions where we should go next. He manages to go to work but often comes home and falls asleep right away. Any suggestions where we should start?",
    "doctor_response": "Hello dear, thanks for your question on HCM.I can understand your problem and situation.In my opinion you should consult pulmonologist and get done1. Chest x ray2. PFT (pulmonary function test).In your husband's case we need to rule out bronchitis and infection.Because cough with lack of energy is seen commonly in both of these.So chest x ray is needed to rule out lung infection.PFT is needed to rule out bronchitis.So consult pulmonologist and first diagnose your husband's condition and then start appropriate treatment. Don't worry, you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching around the penis with redness and cracks?\n\nhi doctor I was having itching between thighs for the last 20 years. i used b tex, pragmtor flu cream and many it used to go n come. Now  for the past 2-3 years my penis is itching,red around its head, crack on the skin. my wife also getting itching and small bumps inside her vegina.  please suggest how to go about it. Regards Rahul",
    "doctor_response": "Hello,This might be due to fungal infections you and your wife encountered probably during sex. However, I still suggest you to visit your doctor for detailed local examination to rule out other possibilities as well like other bacterial infections. Meanwhile, keep yourself clean and dry. Abstain from sexual activities till diagnosis and treatment.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Sameen Bin Naeem, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe abdominal pain after eating. Twice treated for enlarged fatty liver because of hepatitis C\n\nHELLO, I have been having severe pain in my upper and lower abdomen everyday. Worse after I eat. It never really goes away but after eating it gets unbearable. Sometimes I feel nauseated and I could sleep all the time if not for the pain.I have an enlarged fatty liver because of hep c. I have done treatment twice , since the last treatment i have not been myself at all. I had a blood transfusion in 1983 after I had my first child. So I have had it for 30 years just an FYI.Thanks for any help!",
    "doctor_response": "HIThank for asking to HCMI really understand your problem If I would be your doctor then I would surely treat you with the proton pump inhibitor and the best molecule would be Omeprazole 40 mg just at evening time for six week along with \"Chlorodiazepoxide\" three times in day will give good result, with this you need to keep your stress level at lower side, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the possible causes of random episodes of choking and unable to catch breath?\n\nmy son has random episodes of choking and unable to catch his breath or clear throat of something while in the shower. with his episode tonight, he almost passed out. what are possible causes of something like this. he s been checked out for asthma, been allergy tested and had his tonsils out.",
    "doctor_response": "Hello,Welcome to HCM,Your son may be having upper respiratory tract infection or allergy to detergents he using.As he was tested for allergy and positive to some of the allergen, he needs to avoid that, but your is not complete.If he is having sore throat, mucus, fever and cough it will be in favor of upper respiratory tract infection.He requires thorough medical examination in some investigations to rule out the causes of choking he is having.Thank You.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am 19 year old and i just lost baby teeth. When will i get my permanent teeth ?\n\nI m 19 and just lost my last baby tooth, will my permanent tooth still come in? My mom said it may not and I m kind of freaking out.",
    "doctor_response": "Hello, I read your problem,19years for milk tooth shedding is too late.now permanent tooth may or may not come itself,so i will suggest you please visit to your near by dentist and go for an x-ray,so that exact situation can be confirmed.so please go to a dentist as soon as possible.If permanent tooth is present and will not erupt itself,you have to go for proper treatment like minor surgery or braces.But nothing to get worried.take care Dr.Gunjan Gupta",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are rapid movements with rushing sensations in the womb normal?\n\nPulled muscle type feeling whith a rapid movemnts by me. Only when turning over or getting up from lying position. 27 weeks along. Also a weird feeling like a rushing sensation that starts when baby moves and goes up into my chest and head making me feel as im having an adreniline rush",
    "doctor_response": "Hi,You are experiencing fetal movements and as the baby is growing its movements are being perceived by you much better.I would like to know if all your scan reports have been normal and is there any evidence of increasing Amniotic fluid around the baby.sometimes in pregnant women when you are lying down the weight of the womb on the inferior venacava which is the veins which carry blood from limbs to heart is blocked.When you change position this pressure is lifted and there can be a sudden rush of blood to the heart.What I would advise you is too sleep in left lateral position.Also this feeling will get more as pregnancy advances.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can metastatic breast cancer wtih uptake along periphery of hepatic lobe and spleen be cured from chemotherapy?\n\nhi. i was just diagnosed with metastatic breast cancer in my liver via a pet scan- a right hepatic lobe lesion measuring one centimeter - suv 4.0 -and another at the level of the dome measuring the same with suv 3.3. there is also uptake along the periphery of the right hepatic lobe. associated with hypo density adjacent to the right hepatic lobe. are these issues that can be dealt with through chemotherapy. there is also uptake along the peripery of the spleen with suv of 6.3",
    "doctor_response": "Hi, Welcome to Health care magic forum.                       As you describe it appears to be the dermoid cyst, or a lymph gland due to some infection in the surrounding area.                       I advise you to consult a surgeon for diagnosis and treatment.                       You may need to have an excision or incision for complete cure.                        I usually prescribe to my patient with such symptoms ofloxacin, ornidazole, serratiopeptidase, and diclofenac .                        Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does my husband have a kidney problem with frequent urination and extreme fatigue?\n\nMy husband is 46, smoker, creatinine is 1.5...sodium is 134..wbc 13.5...rdwcv is 14.7...rdwsd is 47.1...neutrophils 76.7...lymph 17.1...Eos .09...neutrophils absolute 10.5...glucose 165...he has \"cycles\" of frequent urination along with extreme fatigue. Does he have a kidney problem?",
    "doctor_response": "Hi,  From the results provIded, it can not be told that he has any kind of kidney problem. is his glucose reading fasting or prandial? his frequent uriation and fatigue may not be related to his kidneys and may be related to infection or diabetes.consulting a physician will help in identification of his problem.All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dark spots on chin and parts of nose\n\ni have been using melacare cream for the past 3 yrs..now i have got dark spots in the chin and in some parts around the nose!if i continue to use that,dark spot is mild...if i fail to use,its getting worse...waht is the remedy doctor:(:(:(i got really fed up with tis cream...kindly help",
    "doctor_response": "**1. melacare is bleaching agent containing hydroquinone, tretinoin, and mometasone (topical steroid) and ADR [adverse drug reaction] on stopping the drug is hyper-pigmentation [which is there in your history]PS.  prolonged use results in post inflammatory hyperpigmentation or if it is used over long periods of time results in cutaneous ochronosis, which is permanent.2. In best Interest it will be wise to see a Dermatologist for proper evaluation and management, prior to appointment you can/may incorporate following guidelines:. Stay away from the sun during peak hours [11 AM to 4 PM] or ensure a good sunscreen applied on the area to limit damages.. wash your face with Besan and luke warm water after coming from outside (best natural bleaching agent), removing excess sebum and dead skin cells, and acts as a deep cleanser.i. Use fresh vegetables and fruits, stay hydrated (drink 10-15 glasses of water/ day)ii. Avoid: Sugar (in any form), caffeine, cheese, oily-spicy-dry-fried food, chocolates, cakes, iodized salt, soft drinks.iii. Avoid exposure of the skin to severe climatic conditions.PS:  . take a proper guidance and follow up with a good dermatologist, get your vitamin B12 level checked, as its deficiency can cause darkening of skin. . To get proper result, you are suggested to use any face pack or cream for 3 to 4 months. You may ask for Prescription Drugs, maily: aloe vera cream, kumkumadi oil, khadira arishta,saariva assav.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tooth loss?\n\nI'm a well raised 44 year old female, who grew up with good dental care.  In my adult life, I have my teeth cleaned every three months and practice good hygiene.  In the last 5 years, I've been forced to replace 5 teeth with implants and another tooth has chipped.  Why are my teeth failing?  As a professional, this is crazy!",
    "doctor_response": "Thanks for your query, I have gone through your query.The loss of teeth can be because of aggressive periodontitis, even though there is no deposits. This is caused by aggregator bacter which results in severe bone loss. Nothing to be panic, consult a periodontist and get it treated with root planing and grafting with bone graft. You can save the remaining teeth with the above said treatment, but the extracted teeth can be restored with implants or a bridge.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Replaced dental fillings on top molars, increased contact between incisors resulting in severe pain. Next step?\n\nDentist replaced fillings on two molars on top right. Fillings were made too low/short so there is no contact between the top and bottom molars on the right and slight contact on top and bottom left molars. Now lower incisors and canines hurt as they have increased contact. Advice. What are the next best steps? It s been three weeks. Pain with chewing. Slight chip on lower left incisor as a result of off bite.",
    "doctor_response": "Hello Welcome to HCM I would like to tell you that you have got deep bite due to faulty restoration & only way to get it corrected is get your filling redone.Otherwise there will be traumatic bite & stress on anteriors while biting.If this problem of dislodgment of filling occurs again then you should go for capping because that's the permanent treatment. Regarding chipping of lower left incisor, i would suggest you to get clinical check up done. If its very minute than can be corrected by composite build-up otherwise capping would be other option. Consult your dentist for further query. Take Care Regards Dr.Neha",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe pain under the rib cage\n\nHello. 32 year old female with constant pain under right ribs mainly in back. Helps to put pressure on my back side by ribs. Lots of discomfort and seems a tad worse after I eat. Have been exercising with turbo kick and wondering did I pull a muscle in this area or is it something I should go in for?",
    "doctor_response": "your symptoms suggest that you have spasm of chest muscle due to exercises.you need not to worry a lot. analgesics such as ibuprofen,muscle relaxant (thiocolchiside) and ice will decrease pain .deep breathing exercises will also be beneficial. if pain does not subsides within 5-7 days then consult to an orthopaedician . Hope this helps.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cysts in the lung and liver\n\ni had a chest ct scan done and it shows cysts in my lungs and liver. my primary physician will only order an ultrasound of my liver. He feels lung cysts are normal. Should i be concerned? I have had multiple tests for neurological symptoms possible myesthenia gravis. Im having trouble with vocal cords and hoarsness when i speak throat and neck ct all normal sally",
    "doctor_response": "Hello Generally simple cysts in liver and lung are benign findings.It is important to know size of cysts.It usually doesn't require any treatment unless there is any complications like pain,size enlargement etc.However,you need clinical correlation.If you don't have any symptoms then it may only require follow up scan.You may need pulmonary function test(PFT)and liver function test(LFT) for proper evaluation.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Acne scars on the face. How to get rid of them?\n\nI was looking in the mirror and I saw little like pits in my face they look like freckles but they aren t and I just noticed them today I don t think they are scars grime acne because I rarely get acne but I am breaking out more then usual lately but that s not the problem the problem is the 3 or 4 little random pits in my face they are all located on my cheeks so I was wondering what are they?how do I get them ? And how do I get rid of them?",
    "doctor_response": "Hello.The scars you are referring to may or maynot be related to acne.They all however require surgical intervention.Consult your local dermatologist for the treatment options available.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for bruised and painful stomach, dizziness and nausea after stomach injury in an accident?\n\nI was in a car accident yesterday, and I escaped alive, but very bruised. Over the course if the day, a bruise has been forming on my stomach, where i believe I smashed into the steering wheel, but can't remember. I have been experiencing sharp pains in my stomach, and brief periods of nausea and dizziness.",
    "doctor_response": "Hi...you may have injured your spleen which is very common after this type of accidents...better show to a surgeon asap and get a usg abd done...dont delay...Dr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the treatments for sneezing and itching and tears in eyes after sneezing?\n\ni am having continues sneezing ..it has been such a long time now..when i wash my face or take a shower n then i start sneezing  horribly..plus my mouth starts iching n my eyes get fill with tears..m so scared plzz help me..what should i do m fed up of this..",
    "doctor_response": "HIThanks for writing to healthcare magic.Looks like vasomotor rhinitisTry monteleukast and levocetrizineYou can also consider budesonide nasal spray twice daily if no improvementTry avoiding sudden hot/cold waterDont worryWishing you great healthRegardsHave a pleasant dayDR ARUN",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for an itchy skin rash\n\nmy boyfriend currently diagnosed with a skin rash, he says its not contagious, but im super itchy all over and i think i may have gotten it. im not sure what its called but i know he got a shot in his butt for it and the doc prescribed him some steroids.",
    "doctor_response": "HiThank you for asking HCMI have gone through your query.If you got a itchy rash from your boyfriend then it is most likely a fungal infection like tenia corporis.The shot he got could be antihistamine which even can give to allergic rash.For itch with fungal infection i treat with ointments of clotrimazole or powder or soap of ketoconazole for local application.I also advise fluconazole tab for oral intake weekly once for 1 month to stop recurrence.Anyhow it is better to confirm it with a dermatologist.Hope this may help you.Let me know if you have any further query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe headache, nausea, lethargy, trouble lying on back.  Has AF.  CT scan shows lacunar infarct on top left and right parietal subcortex, brain atrophy.  Explain\n\nHi My Mom has AF (Atrial Fibrillation) and currently in the hospital.She has been complaining about severe headaches that didnt go away with medication. She also has nausea and very lethargic. How likely it is that this symptoms are caused by ruptured brain aneurysm?She had CT scan a couple of days ago which shows \"Lacunar Infarct on top Left and Right parietal subcortex, and brain atrophy\"They suggest to do MRI to test what causes the severe headaches, but she usually has trouble lying flat on her back. She gets short breath if she lies flat on the back. Would you reccommend MRI?Is there another effective test besides MRI to test the cause of the severe headaches?",
    "doctor_response": "Hi,Thank you for consulting H.C.G..Your mothers CT Brain shows Infarct(Brain Stroke) Which can cause the headache which will be relived with time after stroke.In AF is a source of blood clots that migrate to brain and cause the stroke.Cardiac ECHO and Doppler Neck Vessels is the next best step.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shock in my left leg while doing squats and leg press?\n\nHey, I have a problem with my right leg and also my traps. So since november or december i was working out doing squats and leg press and i felt a shock in my left leg, i didnt think of much untill it went a bit numb. After that i told my wrestling coach and he sent me to see an osteo and they said it is a nerve pinch and said it is fine. I continued the rest of my wrestling season and didnt feel any shocks cause i didnt workout in the gym during the season that much. But now the season has finished and im back in the gym, when i squated today i felt a shock in my right leg and also i felt a little shock in my trap. The leg didnt really go numb but my trap sorta did.So now im super scared and wondering if this is something you guys have seen or know anything about.",
    "doctor_response": "Dear Sir/MadamI have gone through your query and read your symptoms.In my opinion, you are suffering from PIVD which simply means that, you have disc problem impinging on your cord, please do not repeat it again and again , as repeated episodes, will cause you to keep the disc herniated and would prevent its going back to space, Take some rest and than under guidance of a good physio start spinal muscle building exercises, so that this does not reoccur. Avoid lifting heavy wights, and stop your gym at present and only resule after your doctors advise.I hope that answers your query. If you want any more clarification, contact me back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My wife is suffering from severe stomach pain and bleeding after taking abortion pills. Kindly advice.\n\nHello doctor, My wife is two months pregnant. As she got pain and a little bleeding, we consulted a doctor. The doctor told that one is unhealthy, so she advised for abortion. We took one tablet and the next day she gave four pills. Two she inserted inside the vagina and two to take orally. After that, she got bleeding and severe stomach pain. Already 24 hours over but still the bleeding and pain have not stopped. When I informed this to our doctor, she advised us to get hospitalized for abortion. What can we do?",
    "doctor_response": "Hello. Stomach pain is a usual side effect of abortion pills. For that, your wife can take simple pain killers such as the tablet Buscopan or Spasfon. Secondly, bleeding happens just like periods or maybe heavier and may last for 8 to 10 days sometimes. If you feel that she is bleeding heavily, then you might seek medical help, and get her admitted. Otherwise, you must wait for 2 to 3 days, and bleeding will become lighter by itself. I hope it has helped you. If you have any further queries, please do not hesitate to contact me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Frequent urination, occasional pain of abdomen and kidney. UTI or enlarged prostrate?\n\nHi, I am 22. I started to urinate frequently these few days. I am not sure whether its due to drinking too much beers or masturbation. I don t feel any pain when I urinate but sometimes I feel my left abdominal and left kidney . Is it UTI or enlarge prostate or something else. I am quite worried as I have already seen a doctor and have been on antibiotics for 3 days, but I still feel the urge to urinate.",
    "doctor_response": "Hi, Your symptoms are related  to Urinary Tract infection as you are already taking Antibiotics from the last three days. Please perform Urine R/E to see any pus cells and blood cells. If there are that will resolve. Do urine R/E after 02 days after completion of Antibiotics for 05 days. If there is pus cells and blood perform urine C/S 48 hours afetr discontinuation of Antibiotics to check for sensitive ones that can resolve your problem. I hope I am sucessful in solving your query If there are further you can ask me Take care Regards, Dr. Azhar Sattar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high protein levels in urine?\n\nHi, my 8 year old daughter is a type 1 diabetic and also has Hashimoto s Thyroiditis. She recently had urine tests done that revealed protein levels above 730. She s been very moody, lethargic and her lymph nodes have been swollen to where you re able to see them poking out her neck. Her doctors are not telling me much just maybe a kidney issue. Please help. I pretty much diagnosed her with both conditions after several doctors visits and no results. I began googling her symptoms and ask for specific tests and viola. It makes me uncomfortable when they seem to be sure to even know where to start. What am I looking at here. Possibilities? What should I ask them to do next because it seems nothing is getting done without me asking for the tests.",
    "doctor_response": "the child is having Type 1 DM, in such cases, child might be going into Diabetic Nephropathy where child's kidneys are going into failure. That is the reason for massive proteinuria. This might later lead to swelling of whole body and worsening of condition. Mood swings are due to hypothyroidism occuring due to Hashimoto's.your next step is to get a KFT done. take child's BP and start the child on tab Enalapril. Get a fundus examination routinely done and get and Ultrasound Doppler done for kidney blood flow.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen and painful knee\n\nI fell on my knee 10 days ago and it swelled up quite a bit. I can walk fine, but cant put any pressure on it. The whole lower half of my leg turned black. I went to the doctor and he took xrays and said it was fine. He said that I had a contusion in the knee that was seeping down the leg. I don t know if I landed on my ankle or not but it is swollen and bruised to the point that my whole foot doesn t have any definition anymore.... it is very very painful. Is this normal?",
    "doctor_response": "Hello,I have studied your case and I think that you have developed ecchymosis in the leg with swelling and due to this you are having pain and discoloration. I would recommend you to follow these steps.1.Hot water fomentation2.Compression bandage and tablet Voveron if pain is there .3.Rest4.If ecchymosis increases then you need to check your blood coagulation profile as some time this can also cause increase bleeding tendency and such symptoms.I hope this answer will be helpful for you. Let me know if there is any other followup questions.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it to be concerned about low BP which causes unconsciousness?\n\nHi, I am a 23 yrs old female. Last week I felt unconscious due to low BP and I felt pain under my upper left abdomen and shortness of breathe. I got admitted to hospital and after few bottles of saline I became normal. All the tests including ecg, blood tests seems to be normal. One thing which is alarming in reports was high triglyceroids which went up to 470. I had gaestric problems earlier as well. Now aftet 4 days I got the chest pain, nausia and breathlessness again, which last for about 2 hrs.",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You may have some cardiac problems.  You should consult physician.  Low blood pressure may sometimes leads to hypotensive shock and fainting.  Life threatening events may occurs. So investigate properly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pleurisy cause chest pain?\n\nI have a fast heart rate all the time and some chest pain sometimes i'v had stress test and echo EKG s and they said the everything looked good with my heart they seem to think it is stress and anxiety and also they my cardo doctor  said my chest pain was caused by pleurisy will it cause this?",
    "doctor_response": "Hello dear , hiWelcome to Healthcaremagic.comI have evaluated your query thoroughly .*  Usually pleurisy is associated with sharp , stabbing pain which is     aggravated  by  deep breathing , coughing .    In some of the instances  it  can  give  constant  dull ache  as  well .Hope this will clear your query .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat hives like rashes on legs, arms and abdomen? Have eczema and applied cortisone cream\n\nMy grandson has what appear to be hives (vs a rash) on his legs and arms (mostly) I see one on his abdomin. Any idea what this may be, or how to treat? He does have exzema, and today, we put chortisone cream all over his body (which we do as part of his regmine. Ususally just where he is dry, but my daughter did put it all over him today).Thank you!",
    "doctor_response": "Hello,Welcome to healthcare magic.From your description, the possibilities of the rash on the extremities include nummular eczema or papular urticaria. While nummular eczema is a type of eczema, papular urticaria is a reaction to insect bites commonly mosquito bites. This is commonly seen in children who are predisposed to eczema.While cortisone cream will help in treating the rashes, remember that you cannot use it \" routinely\". It is a mild steroid and has to be discontinued once the rashes subside. (2-3 weeks)To prevent recurrences, use a moisturizer twice a day. Use full arm shirts and trousers so that his extremities are covered and mosquito bites can be avoided.Hope this helps you.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What treatment is there for tongue tie in an 8 weeks old baby?\n\nHello doctor, My 8 weeks old baby girl has a lip tie and posterior tongue tie. She is gaining weight adequately as I have a good supply but I have noticed latching problem. Her latch is shallow and makes a clicking sound on breastfeeding. It pulls on and off frequently. As she is nursing frequently, her weight gain is normal. Should I get her treatment? What type of treatment is there and is it painful for her?",
    "doctor_response": "Hello. What do you mean by a lip tie? Is it a cleft? Is it possible that you take a picture and send? If your baby is taking breastfeeds adequately and gaining weight adequately, then do not worry about the tongue tie now. We shall wait. If there is any problem with speech then we can remove the tie using cryoablation. In a kid, we will need general anesthesia for tongue tie correction. It is a safe procedure done in operation theatre. Please tell us if there is any other abnormality. Did you get a neonatal hearing assessment done, OAE (otoacoustic emission) or BERA (brainstem evoked response audiometry)? This is just to rule out any syndromes in her. For more information consult an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the painful lump formation after having had a root canal?\n\nI had a root canal and crown done to a molar several years ago to treat a tooth that had grown in without an enamel. Now 7 years later I have a painful lump on the boney part where the gums connect to the jaw. Its located directly below the tooth that has the crown. I am getting a throbbing pressure like pain in the bone of the jaw and feels as though there is pressure in the tooth. There is no swelling of my gums or face, no redness or any other symptoms. Just a painful lump on the bone conneccting the gums to the jaw.....do I have an abscess?? Or could it be something else?",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,    I have gone through your query, you have mentioned that you have undergone root canal treatment and crown placed on teeth several years back now you had pain dont worry may be there is Periodontal Pocket formation due to not proper maintain of hygiene , you do is consult dentist and go for investigations done    If there is pocket formation or Periodontal Abscess then go for sacling and currettage and if due to Periapical Pathology then RE -RCT should be done   Hope this will help you.   Wishing you good health Regards  Dr. Priyanka tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for yeast infection?\n\nOk so I had a yeast infection before and I think I have one again I went and bought monistat just like I did last time and it stopped the itching and everything else inside my vagina but this time my clitoris is a little red and sensitive and when I pee it burns a little and I can see little white specks on it just 2 or 3 of them but I think it might just be some left over medicine",
    "doctor_response": "Hello, Thnx to contact us. If I am your treating doctor I would like to advice you that You must confirm the Infection whether it is yeast or something else; I advice you to start with Gram's staining, Culture & sensitivity. After that start taking drug according to organisms and their sensitivity pattern. Some yeast like candida krusei are inherently resistant to fluconazole group of antifungal agent so if you take resistant drug to that fungus it wil not respond. If you have anything else to ask please contact me. Thanx. Dr. Arun Tank; Infectious Disease Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had Hepatitis B. Unable to walk. Told as Guillain Barre Syndrome. Taking Cabernet Savuvignon.\n\nDr. Romic just answered my question with very helpful information. This is my 1st. follow-up ? I had Hepatitis ?B in the early 80 said to be result of undiagnosed mono that ended up with me unable to walk or have anything touch my legs in hosp. UNC Chapel Hill - also said could be strange Guimme Barre(?sp) - JUST REALIZED that had the same symptoms when diag. approx. 1 yr. later with genital herpes {same fiance & later 2nd husband) - lasts approx. 1 week+ & cannot function - past decades, left hand effected xs 10 & whole lower body xs 2 - what effect poss. on liver????? what is fatty liver - I drink approx. average 21/2,21/2,poss. 21/2 40z. glasses Cabernet Savuvignon per wk. since age 50-52 - very irradic(sp) - sometimes none -sometimes 3, at which time I am definitely under the influence - no tolerance ever - am LCSW retired with much drug & alchol. in profess. hx - thank you so for you time as I currently live in St. Augustine,Fl. -very small town _ same thread -COULD THIS HX OR CURRENT ETOL USE HAVE MORE OR LESS AN EFFECT ON CURRENT LFTS THAN CURRENT RXS ? Thank you for your time, Alyce Holt",
    "doctor_response": "HIThank for asking to HCMThe history which you gave here is not in proper order moreover the sens of this is very unclear, while describing medical history try to be more precise and clear do not use short forms, what I could understood, I could say that it is not Guillian barre syndrome for sure, for your other complain it could  be because of alcohol consume, cut down the alcohol, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My mom has ear pain and itching in inner ear due to cold. What should be done?\n\nHello doctor, My mom has an ear infection for more than one month now. She had a cold which led to her ear pain. Then she took Aplosyn for two weeks and now she is taking Nasoflo. The back of her ear until her neck has pain now. What can we do?",
    "doctor_response": "Hello. Is there any swelling around her ears or neck? Is she a diabetic? Any throat complaints? If yes, send me a clear picture of her throat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Pazopanib safe to be given for liver metastasis?\n\nmy husband aged 64 has just been diagnosed with cancer of the kidney which has spread to the liver, the doctor wants him to try a trial drug called pazopanib, but I have read that is can damage the liver, should he go ahead, what would be his survival expectancy if he doesn't take the drug and if he did providing of course that the drug works",
    "doctor_response": "HiPazopinib will increase his survival by 8 months.If he does not take the drug he will only live for 3 months.Liver damage is very minor with this drug.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anemia\n\nI had my gallbladder out a few months ago, due to biliary dyskinesia and I recently started having itching everywhere with breathing difficulties and headaches. I think it s anemia, but I m not sure of the cause. Would an iron supplement help with the anemia?",
    "doctor_response": "HIThanks for posting your query to Healthcaremagic .       First of all it's very unlikely for anemia to cause Itching though it can cause Headaches and Breathing difficulty .    We need to find out the cause of your problems and then comes the treatment .     I advise you to get CBC , Chest X ray , test done , Get your BP checked and eyes tested . Revert back to me .  Any clarifications feel free to ask .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain behind my leg?\n\nI feel like I have stressed or tore a ligament in the back of my leg. Behind my knee and down my calf is very painful. I can t think of a way I could have done this. My real question is, which is better,heat or ice on leg to help with the soreness.",
    "doctor_response": "Hello, Cannot say in your particular case, but generally, ice immediately to help the pain but after a day, while ice will still deaden pain, it won't do anything to the injury while heat will lower inflammation after a day. So will naproxen. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for emotional breakdown every night?\n\nso ever since my boyfriend has left my house from a visit, (We are in college and on summer break see each other every two weeks) I have been very emotional just at night breaking down about everything self confidence stuff and all that. and I break down every night atleast once",
    "doctor_response": "Hi,You seem to be under stress due to some reason involving you and your boy friend which is resulting in your current symptoms. You need to overcome whatever has happened or is going in your mind. You can consider seeking a psychiatric consultation. You may find supportive therapy sessions helpful which will help you let out your emotions and de-stress yourself. Relaxation exercises like deep breathing and meditation would also help. If still the symptoms persist, consider treatment with anti-depressant medications like escitalopram which will help you overcome your symptoms.I do hope that I was able to answer your query. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Should I worry about low platelet count with fever if dengue test is negative?\n\nHi doctor, My son is five years old, and he was suffering from fever, headache and body pain. He also had some rashes on his face and in some parts of the hands and legs. His fever was ranging from 101 to 102.5 degrees. After a couple of days, on medication, his temperature became normal between 97.5 to 99.5, degrees and he is fresh now. His platelet count went down to 160000 from 280000 in two days. His lymphocyte count is high, and neutrophils counts are low. He did not have stools for the past two days, but he passed out stools three times in normal consistency and one time with a loose stool this morning. He is feeling fresh now. We have done NS1 test for Dengue before two days, and it came out negative. Does he require any particular attention to control platelet count or is it normal? Please suggest.",
    "doctor_response": "Hi. The report suggests some form of viral infection (attachment removed to protect patient identity). You have ruled out dengue. He has platelets of 160000 platelets per microliter of blood, and it is in a normal range. There is no medicine available to increase platelet count. I advise you repeat CBC (complete blood count) after two to three days to see the platelet count. I am pretty sure that the platelet count will get increased.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lumps under skin over the jaw line?\n\nI've got a lumps under my jaw line under the skin that aren't visible but can be felt with the hands. They do not hurt although they can catch (it feels as though the lumps have been caught by the jaw bone).  I don't feel I'll but they can be uncomfortable when they catch. What are these lumps?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern.Thanks for your concern . The symptoms you mention in query are can occur due to two things . Firstly there are many lymph nodes in that area so the lumps can be lymph node swelling , which usually occur due to infection. Secondly the lump can be due to blockage of submandibular gland duct , which occur due to stone or any foreign body such lump is called mucocele.I would suggest you to consult ENT specialist  (ear,nose,throat) for proper examination . Doctor may order X-ray or CT scan of that region to confirn the diagnosis .In case of lymph node swelling doctor will prescribe antibiotics at least for week along with anti inflammatory drugs .If it is mucocele then doctor may remove it surgically or perfoem marsupilization.Sometimes the lump that is immoveable ,hard and slow growing could be a cancer so it is important to visit doctor and get it checked.For now give warm compresses and take advil (if not allergic to it ) or tylenol for uncomfortableness and swelling. Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will nightfall resume after stopping masturbation?\n\nsir i used to masturbate at an average 3-4 times a week. i am 19. Then it suddenly came to my mind that why not stop doing it for a while and see whether nightfall resumes or not, just to check whether everything is normal or not and to make sure that i did not do it excessively. I asked one of my friends and he said it will never resume. please tell me whether it will resume or not? and if yes then how much time it will take for it to resume?",
    "doctor_response": "Hello,The duration of night fall and time for night fall cannot be predicted if you stop masturbation. Three to four times a week masturbation will not cause any harm. You might have night fall if you stop masturbation because after few days to weeks semen need to be ejaculated from storage genitals and so night fall is obvious.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can Asperger syndrome be managed?\n\nI am a retired Lawyer and I have a close relative that I am helping with personal problems at work. She was suspended from work for not being able to work with a new director who made more demands than she had been used to. She advises that her Psychiatrist diagnosed her with functioning Asperger condition and an independent Medical assessment confirmed it. How can I guide her in interactions at work and general speaking?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Asperger's is a developmental disorder affecting ability to effectively socialize and communicate. Communication training and behavioral therapy can help people with the syndrome learn to socialize more successfully. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are do's and dont's for paranoid personality disorder?\n\nMy husband has been diagonised with Paranoid Personality Disorder.Please advise the 'dont's ' and also a daily regime which will ensure him a healthy life. I would also like to know if this disorder can be fetal in any possible way ?await your reply ..thanks",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Paranoid personality disorder (PPD) is a mental disorder characterized by paranoia and a pervasive, long-standing suspiciousness and generalized mistrust of others. Individuals with this personality disorder may be hypersensitive, easily feel slighted, and habitually relate to the world by vigilant scanning of the environment for clues or suggestions that may validate their fears or biases. Paranoid individuals are eager observers. They think they are in danger and look for signs and threats of that danger, potentially not appreciating other evidence.The following can be of use:1. Recognize and accept their own feelings of vulnerability2. Increase their feelings of self-worth3. Develop a more trusting view of others4. Verbalise their distress, rather than use counterproductive strategies such as shunning or intimidating them.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden bruising and swelling at the back of the calf?\n\nA few days ago I developed a sudden 2 inch diameter area of bruising and swelling at the back of my calf. It appears to be associated with a bulging vessel. There was some tenderness. It is now less tender and appears to be clearing up slightly now several days after its onset. Any idea what this is?",
    "doctor_response": "i understood your problem.. might be you involved in standing work for which there is engorgement of veins this could be result in vericose veins or deep vein thrombosis..i suggest my patients limb elevation by applying pillow during bed time and avoidance of much standing work..i generally suggest ultrasonography colour doppler to evaluate this kind of situations if not correct...hope you will be satisfied..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Prescribed Levaquin, Azrithomycin and amox for strep pneumonia but having nausea and headaches\n\nMy husband (age 63 and in great health) was diagnosed with strep pneumonia and spent 3 days in the hospital, he was released with antibiotic Levaquin, after 5 days I had to bring him back to the ER because he spiked a fever of 101. They discovered that the original pneumonia of the right upper lung was almost gone but it had spread to the lower lobe. They discharged him with prescriptions for Azrithomycin 500 mg once a day for 7 days and Amox TR-K CLV 875-125 twice a day for 10 days. The Amox is making him very nauseated and he gets headaches from it. Can he stop taking it after 7 days instead of 10? Generally he is feeling better, no fever since beginning the two antibiotic combination?",
    "doctor_response": "It will be better if he takes it for 10 days. In order to prevent from nausea and headache you cam give him combination of antacid with antiemetic i.e drugs like PANTOP D OR NUPENTA DSR OR GEMPRAZ DSR ONCE A DAY for the rest of the treatment period.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes gurgling noise from chest?\n\ni have a gurgling nose coming from my chest as well as a cough that i have had for 1 1/2 months the doctor took an xray of my throat and lungs at the beginning of the month due to my cough however everything looked fine though in the last 2 weeks i have been hearing the gurgle nose. at the beginning i was treated for viral infection and i had excessive mucus.. could it be the mucus is in my lungs now? What should I do ?",
    "doctor_response": "Gurgling noise usually is related to your food pipe esophagus and stomach when food is either passing or digesting in it.That can be transmitted to chest .Check to make sure your stomach digestion is not a problem and you do not have reflux disease.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent headache and fatigue while having high BP?\n\nHi, i m a 60 yr old male. i m in fairly good health, my main problem is high blood pressure that s controlled by medication. My current symptoms (continuous headache, brainfog, fatigue) seem to point to non-celiac gluten sensitivity but i don t have any intestinal problems. What else could be causing these symptoms? Paul Burgman",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, headache, fatigue, could be due to infection apart from the brain fog, actually brain fog could be due to cerebral pathologies but it need to be confirmed without this it can not be said for sure that it is the brain disease, headache, fatigue are not due to sensitivity of anything related with diet not even due to gluten.                        If the headache and fatigue are the most concern symptoms and it is not associated with any other symptoms then it may be functional kind of symptoms, so try to come out of the stress, I would even advise you to take better care of hypertension hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic renal failure\n\nMy brother has chronic renal failure. He s having surgery, didn t understand nurse totally on the phone, surgery is cystoscopy right ritrogrand polyogram ?? Inject dye goes from kidney to ureter to bladder - check for blockage, possibly uretoscopy, possible biopsy, possible stent in kidney. Sorry for my messed up medical terminology, can you explain this in English to me.",
    "doctor_response": "hello,you said your brother has chronic renal failure.for chronic renal failure dialysis is the treatment depending on the serum creatinine levels.kidney replacement is the permanent solution. the things you wrote here are the invasive investigations to assess the condition of kidneys.   Thanks,hope this may help you.have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cervical cancer\n\nHi, My mother is suffering from Cervical cancer.Doctors diagnised it,and tod that it is 3B stage. Doctors prefering to go for Radiation theraphy or chemotheraphy. But I heared that with this two theraphies thare are many side effects. Could any one of please advice?",
    "doctor_response": "Hi,Thanks for writing in.Cancer at stage 3b means that it has limited surgical options. The tumor has spread away from the cervix and into surrounding structures in the pelvic area. Neoadjuvant chemotherapy and radiation therapy can be given and this can cause the tumor to become smaller.Chemotherapy and radiation therapy have to be given as a part of treatment. Side effects are there and the benefits in extending survival of the patient are more. Therefore giving treatment by chemotherapy and radiation therapy are a must.Many patients are taking treatment by these methods and the side effects in present day chemotherapy are less and varies with the patient. The doctor will guide your mother and what are the expected side effects of the medication given in chemotherapy. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the shin?\n\nSunday night my right shin started to hurt when walking or when pulling my toes up.  It is now Tues and it still hurts.  there was a bit of redness (pink) on Monday night and tonight I would say it is about 4\" by 2\" of slight red area.  It is a wee bit swollen.  I am 70 yrs. old.  No high BP.  So sign of a bite.  Yes I am over weight.  205 and am 5'4\" tall.   Not quite sure what to do.",
    "doctor_response": "Hi,Given the history do hot and cold therapy (do take a bucket of luke warm water and another of cold water, dip your leg in hot water for three mins then dip in cold water for one minute, do it 7-10 times). Avoid too much walking, do relative rest and no staircase climbing also. I hope within 3-5 days it will recover.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Harsh Swarup",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Galvus a safe medicine?\n\ni m diabetic type 2 aged 26 with sugar around 180-200. previously i was prescribed glyciphage and now shifted to galvus met 50mg half a dose after lunch and the rest after diner. i read galvus met is not recommended in USA, so is ti safe to take it or can you prescribe an alternative? any side effects u came across",
    "doctor_response": "Hi, Yes, it is a safe medicine for the treatment of type 2 diabetes. Galvus (Vildagliptin) belongs to a class of drug known as DDP-4 inhibitors which works by blocking the breakdown of \u2018incretin\u2019 hormones in the body. These hormones are released after a meal and stimulate the pancreas to produce insulin. By increasing levels of incretin hormones in the blood, galvus stimulates the pancreas to produce more insulin when blood glucose levels are high. It is widely used either alone or along with other antidiabetic drugs like metformin in the treatment of type 2 diabetes. The most common side effects of galvus include headache, nasopharyngitis, cough, constipation, dizziness, and increased sweating which gradually wean off over a period of time. The most common side effects of metformin include abdominal cramps, diarrhea, and very rarely a serious condition called 'lactic acidosis'. Every drug has its own side effects but it is not essential that everyone will get that. There are many drugs used for treating diabetes. But there is not a single drug which does not has its known side effects. If you are not comfortable with the side effects of galvus met you have to discuss with your doctor to prescribe an alternate effective but a safer medication for the control of your blood sugar. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump on the face indicate?\n\nHi I have a question I will try to explain it as well as I can possibly can. I discovered a very hard bony like bump on the right side of my face about 5 minths ago, it doesn\u2019t seem to have grown but i don\u2019t exactly know. it starts in my eye socket close to my tear duct & extends down the side of my nose almost to the bottom of my nose where the bottom of the cheek bone is. It hurts a tiny bit when I mess with it too much, but only when it\u2019s pressed. I have chronic sinusitis, constant post nasal drip, & stuffiness in my sinuses not in my actual nostrils ever. I\u2019m so scared what could this be?",
    "doctor_response": "Hello dear , hiWelcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This is most likely to be related to Dacrocystitis ( inflammation of tear     glands ) , however  a  photo pic  attachment of the same  is      recommended  to get  the  further  line of action .Hope this will help you for sure .Wishing you fine recovery .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from liver cirrhosis, peritoneal nodules in liver. CT scan does not show malignancy of nodules. Treatment for acidic fluid in stomach?\n\nHi My father has liver cirrhosis and in addition to that some peritoneal nodules were found in liver. CT scan report confirms the presence of nodule but blood test didn t confirm the malignancy . His stomach is getting filled with ascitic fluid in 3 days. he was given laci lactone bit that didnt help. can somebody please advise.",
    "doctor_response": "Hithank you asking  HCM IF your father has liver cirrhosis  with ascetic fluid    he need  treatment  with  human albumin  and diuretics. wishing him fast recovery All the best Dr.Klerida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does \"distended gall bladder with prominent CBD\" on USG suggest?\n\nmy impression as per usg for abdomen and pelvis isright renal cortical cyst as described-(bosniak-2)well distened gall bladder with mildly prominent cbd and minimal to mild ihbr dilatationmildly prominent pancreatic duct.please inform the details....",
    "doctor_response": "Hi thanks for contacting health care magic...You have renal cortical cyst and distended gall bladder....Here if renal cortical cyst small that is less then 2 to 3 cm small then you might need no treatment and only follow up needed.If cyst large and symptomatic then surgical treatment needed....Second gall bladder dilated with duct because downward there might be some obstruction by some stone , parasites or stenosis....So investigation for it done by magnetic resonance cholangiopancreatography like investigation to detect cause....According to cause treatment guided.Consult surgeon for your condition.If surgeon needs then he will take opinion from gastroentetologist for your case Take care...Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have a herniated disk to the lower back, disc bulge. MRI shows neck, back, having protruding disc. Treatment?\n\nnow i got to add a herniated disk to my lower back, a disc bulge to the L3-4 impinging on thecal sac, disk bulge L4-5 with left posterolateral annulus tear and facetal hypertrophy also impinging on thecal sac causing mild bilateral neuroforaminal compromise with com pression of the exiting L4 nerve roots? disc desiccation L5-S1 with reduced height, proterocentral protrusion type hernation with annulus tear and facetal hyertrophy impinging upon thecal sac? lumbar lordosis with mild dextroscoliosis, minimal retrolistehesis seen alsoPamela Mahrouch: and thats just my backPamela Mahrouch: and i got the mri reports from last year on my neck and back showing the only thing i had wrong with my back before this accident was a protruding disc at L5-S1, C3-4 and C4-5 disc bulges impinging upon thecal sac, C5-6 loss of disc height and hydration, left paracentral/foraminal herniation with annulus tear and uncofacetal compromise with resultant compression of the left exiting C6 nerve root, mild spinal stenosis, multi level disc desiccation seen with loss of the bright nuclear signal on T2-weighted images, Pamela Mahrouch: thats what he done to my neck?",
    "doctor_response": "hallo dear friend ,thanks for writing to HCMi have studied your casewhat is your age? this is you first episode or repeatedly having same problem is there any weakness in your lower limb or upper limbyou need methylcobalamine , muscle relaxant with analgesictake rest , , hot or cold fomentation avoid lifting weights sit with taking support to your back continue spine extension exersizes physiotherapy - SWD ,IFT WILL HELP if pain doesnt relieve then you need spinal decompression surgery for lumbar vertebrae ,for further query contact drvaibhavg@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for clinical/major depression disorder\n\nHi, Im 13 and i think i have a clinical/major depression disorder.I have only told one of my best friends about 3 days ago. I want help but i have some problems in my way.. i think my parents will think im lieing for attention or something.. also i would like a little more confidence in that i might have it or not.(this all started with me just feeling sad for no reason for a good amount of time, and then i took some online tests, witch all said i had depression and i read more about it. And i have almost all the symptoms.) I just would like your opinon if i should go see a doctor and if i should tell my parents. By the way no one in my close famliy has any type of depession. I would love your feelings, Thanks!",
    "doctor_response": "HiI admire your positive outlook and congratulate you for the attitude. Now I guess you have depression and it could be due to some stress in your personal life. In that case, you need some help. However let me give my opinion here. I think a combination therapy of antidepressant and low benzodiazepine would help you. These drugs would help you a lot. You can try some relaxation exercise like JPMR or deep breathing exercise. That would keep you calm and relax. For this you need expert's guidance by psychiatrist or psychologist . Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is using Gavilyte-G for a colonoscopy preparation safe while suffering from chronic kidney disease?\n\nI have recently been diagnosed with Stage 3 CKD. I have also been scheduled for a routine colonoscopy. The prep I was given was Gavilyte-G. According to information I have access to, that is contraindicated and may cause additional damage. Is that true and if so, what prep would be kidney safe? Thank you for your response.",
    "doctor_response": "Hello, Bowel preparation can cause fluid overload and is not recommended in patients with severe kidney disease, You can consider alternatives like peglec. Consult your gynecologist before starting bowel preparation. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could recurring yeast infection be due to birth control pills?\n\nHi I ve had a yeast jnfection for almost 2 weeks. Uncontrollable itching burning and irritation. Very uncomfortable. This has been my second yeast infection. My last one was in January and I used monistat 7 to treat it. This time however I had to go to the doctor to relieve my symptoms he have me difluncan. After 3 days on the medication it still hasn t cleared up so I went onto monistat 7 again. I am on birth control pill sprintec generic for ortho tricyclen. I believe it s the birth control pills causing this yeast infection making it not go away. Once I finish my birth control percription I plan to get off of it. Do you think my reoccurring yeast infections are because of the birth control pills? My yeast infection as of now comes and goes but I m tired of it. Even monistat isn t working anymore.",
    "doctor_response": "Hello,Thank you for your contact to healthcare magic.I understand your health concern, if I am your doctor I suggest you that yeast infection has no relation with birth control pills. Many women's are taking it but not every women is having yeast infection. There must be some other underlying condition favouring yeast infection.I will be happy to answer all your future concern. Thank you,Dr Arun TankInfectious disease specialist.Wish you a best health at health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on spine that hurts\n\nI have a lot of pain in my middle an upper back, like tension that only goes if someone else rubs the muscles. However i have a small lump on my spine that hurts when pressed hard but also makes the muscle pain go away. Doctors just send me to physio but this doesnt help.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some soft tissue tumor like lipoma or neurofibroma or something else. You should go for biopsy of your 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cancer on tongue\n\nhi, my mother is suffering from oral cancer and has undergone through radio therapy and later onco-surgery. In a recent pet scan , it has been discovered that the cancer has recurred now on tounge, back of the ear and in the neck. what is the solution",
    "doctor_response": "Good morning.  I understand your concern. Your mother is suffering from recurrent cancer and since radiation has been done already, chemotherapy is the only option left. You need to consult a medical oncologist for chemotherapy.regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for frequent ear and chest infection in a child\n\nHi doctor, My daughter is 3 years old and from last 1 year she started going to day care. After she started going to day care, with in 2 months, she develeoped mnumonia and from that month on wards every month, she is falling sick once with Upper Respiratory infection, ear infection, viral fever. and from past 2 months, she started breathing through her mouth while sleeping than with Nose, We took her to ENt specialist and found taht she had adenoids. She is almost falling sick every month. Is this because of Adenoids. If so, what can be done for her condition. We really want to avoid surgury if we can and really wanted to know if there are any medications to treat her condition",
    "doctor_response": "adenoids are a rectangular mass of lymphatic tissue in the posterior nasopharynx. They are largest in children age 2 to 6 yr. Enlargement may be physiologic or secondary to viral or bacterial infection(prone in multiple children at a child care center), allergy, irritants, and, , gastroesophageal reflux ,   otitis media,  sinusitis.inderlying allergy is treated with intranasal corticosteroids (momentasone), and underlying bacterial infection is treated with antibiotics.  Surgery is  recommended for younger children with recurrent epistaxis or significant nasal obstruction ( sleep disturbance, voice change) or persistent middle ear effusions or frequent otitis media.take a trial of momentasone and antibiotic if no improvement  u go for surgery as baby was mouth breather and recurrent chest infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stroke, blood clot on the left side, right side paralysed, piles, redness and swollen anus post continuous stools, prescribed strocit plus. Permanent remedy?\n\nmy 76 yr old mother has suffered frm a brain stroke ,there is a blood clot too on her left side of brain.her right part of her body has been paralysed.the problem is that she is passing stool continously after half and hror immediately after we have cleaned her.she has piles problem too and the continous cleaning aggravates her piles problem.that part has gone red and swollen.dr has prescribed her strocit plus.how to solve this problem of hers permanently? her speech is also affected. thank you.",
    "doctor_response": "hi rusika thanks for ur query on HCM stroke - blood clot - rt part paralysed is she taking any medications rt now???? speech affected probably d/t stroke now ur mom stool passing continuously and u said also had piles problem continue strocit u need to consult a gastro surgeon proctscopy colonoscopy needs to be done i think piles been aggravated now need to properly stage the piles and manage accordingly surgary is needed for permanent recovery from piles thank u u also need to take her to neurologist bp control is essential to prevent rebleeding in brain along with some other medication need also physiotherapy for paralysed rt part...it ll be of help though it ll need time thank u",
    "dialogue_context": ""
  },
  {
    "patient_message": "What makes my knee cap sting after popping?\n\nHi my 13 year old son was at his dads house all week till about 10:15 tonight apparently he dislocated his right knee cap yesterday at about 7:05pm while helping to move a picnic table and he poped it back in place and his dad said nothing was wrong with his knee and made him walk on it till he got to my house at about 10:15pm today and now he says it stings and he can move his leg but he can t move his leg all the ways you usually can without it stinging really bad what do we do?",
    "doctor_response": "Hello,I have studied his case and i think that he must have injured his ligament which is useful for knee patella stability. It can be confirmed with the help of x rays and Mri. If there is ligament damage thence will need plaster for three to four week. if there is severe damage then he might need surgery. If you want then you can share his MRI details with me. I hope this answer will be useful for you. Let me know if there is any other followup questions.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden temperament with tiredness for slightest things?\n\nI don t know what s wrong with me, i feel like i can t trust anyone, i always feel tired, and i can t stand being home. I get angry at the slightest things and i keep getting into trouble. I don t want to get into trouble. it just happens. i can t control myself. My boyfriend broke up with me and now i just feel hopeless. death would be so much easier than dealing with all of this stress. What s wrong with me?",
    "doctor_response": "Hello.You appear to have personality associated with short temperament and low frustration tolerance. This got exagerated in anxiety and depression specially after stressor like you have.You need to meet psychiatrist for help in form of assessment and treatment. Take care99doctor.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes greenish palms in the morning?\n\nHi, i am a 20 year old female , 167cm and 85 kg. I have mild asthma and allergic to dairy food. I ve recently woken up with very greenish palms, then the next couple of days some of my capillaries started to appear on my left arm on different places but couple of hours they dissappeared. This happens every other day for the past 2 weeks now,i have no other symptoms of dizzines or headaches. So i was wondering what it may be and if i should worry, thanks in advance.",
    "doctor_response": "DEAR FRIEND, I HAVE UNDERSTAND YOUR PROBLEM, NEED NOT TO WORRY... FIRST WE NEED TO WORK FOR WEIGHT REDUCTION SO THAT YOUR BODILY NEED TO MAINTAIN STRUCTURE REDUCES, THEN PREVENTION OF ALLERGIC MATERIALS, THEN DESEISITIZATION OF ALLERGY GRADUALLY BY PRANAYAMA AND SIMPLE YOGASANAS.... YOU WILL RECOVER VERY WELL WITHIN 2 MONTHS, JUST ACCORDING TO YOUR AGE AND HEIGHT WEIGHT IS LITTLE MORE....",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are chances of conceiving with ruptured follicle?\n\nhi...............i m 31yrs old n my husb 37yrs old......v r planning for a baby....i m PCOD patient n my husb has low sperm count with 20millions per ml with showing 0% motility....i hav a ruptured follicle now......n my doc hs advised for trying for couple of days...........i want to knw is der a chance of getting pregnant",
    "doctor_response": "Hello,Do IUI for better results. Repeat semen count of husband from some other lab along with do serum FSH, LH, and serum testosterone of husband. Do testicular Doppler of husband to know why there is low count. Meanwhile, start Clomiphene for husband.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sheetal Agarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diabetic and has blood pressure. Half brain happened cerebral infarction. Scan report showed cerebral hernia. Cure?\n\nDear Dr.,This is lucy from Beijing China. I am writing in ask your kindly advice for my farther' disease. He is 62 years old, 7 years diabetes and hypertension. 7 days ago he felt uncomfortable and were sent to hospital, found around 80%right half brain happened cerebral infarction, and 3 days later, due to edema,cerebral  hernia started shown from CT.  We immediately arranged operations to decompressive to reduce the pressure. Kindly see below CT films before and after operations. He is in deeply coma now and high fever. The doctor now is using dehydrating medicine mannitol.if he getting worse and worse,is there any other medicine or operations we can consider? Sorry I hope I explained clearly. I really need your kindly help for information and suggestions. I will highly appreciate it if you can help. Thanks in advance!Lucy",
    "doctor_response": "Hi, it appears that your father may be having tuberculosis of the menenges. As it is a cerebral surgery, it may take some time for recovery. if there is decline you can try the anti tuberculosis drugs, as a trial and error method.                        When he become conscious give him juice of palatable vegetables.                        Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have copper IUD. Have panic attacks, vertigo, ringing in ears, headaches, runny nose, heartburn. Reason?\n\nHi there. I have had copper iud for 9 years altogether, last one has been in for 4. I have recently started to suffer with panic attacks out of the blue. I have had severe vertigo and a ringing in my ears for last 2 years. I am a very busy hairdresser and very sociable so as you can imagine it is hard work. I have been getting a lot of headaches and feel very low and 2 weeks before my period I get very tired- dizzy and very moody.  Also seem to always have a runny nose and heartburn as well as constantly getting bv and other infections- nail infection- athletes foot and now experiency really itchy armpits- possibly yeast infection.  I have been looking into copper toxicity and wandered if it sounds possible that this may be as a result of my coil?",
    "doctor_response": "Hello, It is very unlikely that your problems are because of your coil. Copper toxicity due to copper T IUCD has not been reported. The dose of copper in the coil is very small and it primarily is released into the uterus and acts locally to p roduce contraceptive effects. First, you need a thorough general checkup including an ENT check up. You also seem to be suffering from premenstrual syndrome which explains the problems you are facing before your periods. It is very important for you to have a check for Diabetes. Frequent infections may point out to undetected Diabetes. Fungal infections may be related to your occupation. Finally you may be stressed and you may have to consider to slow down a bit and find some relaxation techniques. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy holes with puss?\n\nMy sister and I have the same oddity. We both have discovered we have 3 small holds starting at the top of our buttocks crack and spaced about 1/4 of an inch apart. The largest hole could fit a round toothpick in it. And from time to time it brings on the most incredible RIGHT NOW ITCH! And then drains with the consistance of runny yougrt. In a tanish color with the most putrid stench! I try to drain it daily as I shower. I can feel a small pocket inside about the size of my pinky tip ( 1st joint ). Once while draining it, it flipped over my tail bone and LITERALLY dropped me to my knees in the shower! My sister s Doctor told her it was her Anel Gland. And that her s drains outside her body. Is this possible? Do we indeed have anel glands like animals? What the heck is this? Do you have any idea? Please help? Embrassed.",
    "doctor_response": "HiWelcome to HCMI appreciate your concerns for the itchy holes with puss.I have gone through your problems described in your query.I am of the opinion that both of you might be having fistulas in ano.A fistula-in-ano is a hollow tract lined with granulation tissue, connecting a primary opening inside the anal canal to a secondary opening in the perianal skin. Most fistulas are thought to arise as a result of infection of the anal glands with resultant abscess which is recurrent in nature.You are therefore advised to consult a surgeon for proper examination and relevant investigations like fistulogram which is done to find out the extent of the tract between the two openings.The fistulas have to be removed surgically with total excision of the tracts to prevent recurrent infection. Surgical removal can only be attempted after the infection has been controlled with a course of appropriate antibiotics.Hope this answers your query.A feed back is appreciated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pimples, marks on  face, taken treatment, no relief. What to do?\n\nHello Sir, I have a query. I am 26, still getting pimples on my face and back regularly. I have taken treatment 2 times before and recently shown to other Dermatologist . He suggested me to take Doxylab tab, Beplex Forte tab and to apply Deriva MS Gel. Also I have marks on my face. Last month suddenly I got many pimples on my face. Please let me know, it this problem curable and how long it will take to get all marks cleared. Thanks, Neha",
    "doctor_response": "Dear Neha, 26 is the noveau 16! smile :) I note your age & your tratment history. However, it needs more htan this to formulate an effective acne treatment regime. This is usually tailored to suit individual needs..so please consult a dermatologist near your place or you may consult me privately if you so wish to through this portal. Firstly, one needs to evaluate your goal..if my understanding is correct, you desire clearance of both acne & the marks left behind. Second, you need to do a battery of tests assuming we will start you on systemic isotretinoin therapy as a 'definitve' treatment if one can call it this. Please check the details of the medication & the side-effects & precautions et al (as the blood tests required are tailored with these in mind) with your treating doctor. It may take anywhere from 3-6 months for a decent result & your treating doctor again will be best placed to discuss this with you. Cheers & all the best...am sure you will do well with this treatment. Regds. Dr Praveen Rodrigues MD Dermatologist, Cosmetologist & Venreologist, Bangalore, India",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will urinary output increase with BP medicine?\n\nHi doctor, Before two months, I had one stent put in the complete blocked artery. Scans showed heart muscle damage from an old heart attack this was caused by me not taking my BP drugs. So for the first time in my life I have stuck to taking all my prescribed drugs, these were Aspirin 75 mg, Amlodipine 10 mg, Atorvastatin 80 mg, Bisoprolol 1.25 mg, Ticagrelor 90 mg. It has been eight weeks I felt a great minus few chest niggles presumed this was stent settling and I am still smoking 20 a day. Now for the last one week I have a severe dry mouth all the time despite drinking and my urine output is 5 liters to my input of 1 liter. At night I am going after every two to three minutes. My doctor is thinking I have a UTI despite being negative for it. Now they are testing me for gonorrhea and chlamydia. My suspicions are that the drugs I am taking causing this? I feel like stopping them all together or halving the dosage I cannot see my cardiologist until next year. Is there a link between my drugs and these symptoms? And am I safe to temporarily stop a few of them to rule them out? If so which ones are crucial and which are not? I am eternally grateful for your help.",
    "doctor_response": "Hello. All the medicines you are taking are essential medicines and should not be stopped except in case of severe allergy. None of these medicines cause increased urination. Amlodipine is a blood pressure lowering medicine, it can be changed to some other medicine. This medicine may cause fluid retention and swelling of feet in some patients. Regarding increased urination possibilities include maybe you are taking medicines called water pills or diuretics which are sometimes given in heart patients, these increase urine output. Please review your medicines. UTI (urinary tract infection) may cause increased urination. Raised BP itself may cause increased urination. Keep BP (blood pressure) in control. Please reduce weight. Take Mediterranean diet, do regular exercise, and have a proper sleep. Never stop or switch to any medicine without consulting a cardiologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is blood platelet count of 108 a matter of concern?\n\nAbout two years ago I started becoming fatigued and my platelet count began dropping. It has gradually become lower, now 108, and the fatigue is at times debilitating. The doctors do not seem concerned but I can no longer perform the activities that I used to. Is the 108 platelet count a concern? My white count remains slightly low around 3.80. My primary concern is the platelet count.",
    "doctor_response": "Hello, If you are symptomatic in my opinion you should have further examination. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Esmeralda Sera, Oncologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is surgery necessary for removal of non-cancerous cyst on liver?\n\nYes. A friend of mine who is 74 who is in good shape and works out three times a week, and Yoga twice a week, had a CT scan, which shows she has a non-cancerous cyst on her Liver. Her doctors are not overly concerned, but she is very upset and is afraid that she might have to surgery. Can you suggest anything that I can said to her, to possible make her feel more at ease?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Benign (non cancerous) cyst in the liver are generally harmless and does not require surgery. Hepatic surgery is an extensive procedure and is not recommended for a non-cancerous lesion especially for this age group. However frequent follow-ups are required and we a have to check whether the size is increasing or not. If the tumor grows rapidly or in case of symptoms like bleeding, we have to operate. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes upper abdominal pain with a warm body?\n\nMy 13 year old daughter woke up yesterday morning doubled over in pain from a piercing pain in her upper abdomen.......that lasted about 15 to 10 minutes......it happened again today while she was at school and said she felt hot and like she needed to throw up....she feels a little warm to me at this moment.",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.This can be due to stomach flu or gastroenteritis. (Considering the age- just observe for adolescent behavioral changes on a safer side- just a precaution).Get to the Doctor for clinical examination , symptomatic treatment to start with and specific treatment if the definite cause is found.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of pain in finger and loss of grip?\n\nI have a pain in my little finger which runs down and over my hand and up my arm and I lose all grip in my hand and can t bend my fingers it comes and goes and sometimes worse than others the pain is so bad it throbs like its broken but its not what could this be",
    "doctor_response": "Hi. It sounds like nerve pain which can be due to pressure along the nerve supplying the finger. You need to see a physician who can do nerve studies to assess where the impingement is, and advise further management. Hope this answers your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does my cousin have deteriorated mental condition?\n\nDear sirMy cusin name is Mr.B.,m. 29 years, education 3rd std, married(5 years back) no childrens,, he will work hard, but he dont know money calculation and he behaving like a child.Any treament is there for his problem , he is only one son in their familly.RegardsMu;k;andra0000Chintamani",
    "doctor_response": "HiThanks for using healthcare magicI think, he is mentally retarded. In that case, he needs IQ assessment. Better to consult a psychologist and get his IQ done. If his IQ come below 70, then he has mental retardation and there is no medicine that would increase IQ. Even you behavioral issues, you can consult psychologist, she could give you some solutions.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can you conceive with cyst in ovary ?\n\nevidence of cyst measures 1.9x 1.8cms in right ovary with low level internal echoes . no solid elements within. what is the solution for this and can I conceive with this problem.",
    "doctor_response": "hi welcome to healthcaremagic forum most probably it will be functional cyst.just wait 3 mths rescan if it is not there well and good.if it persist then do ca 125, if it is not growing and ca 125 normal then nothing to worry ,leave it as such, othervise you have to remove it laperoscopically.you can conceive with this cyst.you haven't mention your age it's important",
    "dialogue_context": ""
  },
  {
    "patient_message": "Husband is a heavy smoker. Works as a boilermaker. He experiences sleep apnea. Now losing weight. Also asthmatic. Suggestions?\n\nHusband is a heavy smoker. Works as a boilermaker. He experiences sleep apnea where he can hold his breath for a whole minute then exhales with a large shuddering breath. Recently is losing very noticeable weight loss. He is also an asthmatic. Wont go to his doctor for he says he is here for a good time not a long time.When he sleeps his lungs make a \"popping \" sound. The day after having a few beers his hands shake alot. Suggestions please. Karen.",
    "doctor_response": "hiThanks for your queryi can feel your concernsi advise him to reduce smoking and then try to stop it recent weight loss is something to be taken seriouslyheavy smoking is associated with many malignant changes as wellhe need to be examined by a doctor and need investigations like chest Xray and CT scan i advise him to use a mask especially when go outgive him green tea and honeysteam inhalation also improve symptomsavoid cold and soft drinksgive him plenty of fluidssaline gargles are effective remedywishing him a speedy recoveryHope i have ansewered your queryi am available for your help regardsDr.imran",
    "dialogue_context": ""
  },
  {
    "patient_message": "Would continuing Minigynon for long cause delayed periods?\n\nHi am writing to you today for information on a matter... I started a pack of minigynon about a month been taking them irregularly and now I have decided to try and stop my period my continuing taking pills from another pack I need to know if it would delay my period once I continue taking it without break for the next two weeks????",
    "doctor_response": "ocp lik minigynon should b taken regularly...same time...it s help in regulating hormonal balance...it in fact wil cause timely periods if taken for 3 to 6 months.....as u took ur pills irregularly it may cause delay in period..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to prevent ejaculation during haircut\n\nhi, am 27 year old, male virgion, I had a problem that while getting haircut, i get ejaculate without any stimulus in my mind, mean while the barber just settles my hair and get throug, it happens rarely, i just wanna know any remdy to it as it is quite embarrasing. thanx",
    "doctor_response": "Hi, There are different types of sexual aggravation for each individual. You have a thing for hair. There is nothing to be embarrassed. There are few people who gets stimulated by shoes, dolls. So talk to your partner regarding your likeness for hair and talk to a psychiatrist for counseling. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Using birth control pill, missed pill. Do I need to use another form of contraception?\n\nHi. I am on rigevidon birthing control pill and have been on them since May, so just over 6 months. I have never missed a pill and have always had my period on time. However this time after taking the 21 tables over the 3 weeks and then the week break, I forgot to take the first pill of the new packet. I was meant to start them again yesterday and so took one today as soon as I realised and then will take one later for today at my usual time of doing so. My question is am I still protected or do I need to you another form of contraception?",
    "doctor_response": "Hello. Thanks for writing to us. Missing the very first pill of the pack does not make much of a difference. Since you have taken the pill as soon as you remembered it, there is no need to worry. No additional protection is needed in this cycle. Please do not worry.I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal ,drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "IVF, trying to conceive. Surgery to remove fibroids. History of miscarriages. Treatment?\n\nHi, I had a natural conception in 2009, but had a miscarriage 5months later because of fibroids ,the fibroids degenerated after the miscarriage, had a surgery to remove the fibroids 3 months later. Started ivf 2 months ago. Had 27 eggs retrieved,22 survived, 12 fertilized, but had only 2 blast which were transferred on 14th July .i am now in the 2ww, did a HPT last night 12dp5pt and it was BFN. Should I be worried.",
    "doctor_response": "Hi, Thanks for your query. I read your query and I understand your concerns. You have got blastocyst transfer. This is excellent news. There are good chances for your pregnancy.  Please get serum beta hCG to know the accurate pregnancy status. All the best I hope I answered your query. I will be available for any followup queries you have. Regards, Dr.Mahesh Koregol IVF & Infertility Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for chest pain and slow heart rate??\n\nI have chest pains alot every day for almost 3 years i was finally tested for lyme and i was positive i took the meds and still have chest pain seen heart doc and he said it was healthy now i had pain and i took benadral now can that slow ur hheart rate?",
    "doctor_response": "Thanks for your question on HCM. Benedryl can no cause slow heart rate.In my opinion lyme disease is the cause for your slow heart rate.Lyme disease affect the conduction system of the heart and damage it.Thus cousing poor impulse conduction and bradycardia (low pulse rate).So you may require pace maker as you are symptomatic and slow heart rate can cause decrease coronary perfusion and thus chest pain occurs.So consult your cardiologist again and discuss about pace maker.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Atorcia TG and xirtam right medication for cholesterol 203, HDL L17 and LDL 63?\n\ni am 48 years old I regularly taking Atorcia TG tab daily , Xirtam 20 my lipid profile are given cholesterol - H 203 triglycerides - H 813 cholesterol HDL - L 17 direct LDL cholesterol - 63 KINDLY INFORM ME ABOUT THESE PRESCRIPTION & GIVE YOUR SUGGESTION",
    "doctor_response": "Hello, You have very high levels of lipid profile and I think these medicines are appropriate for you. Take these regularly. beside that, do regular exercise and have a diet control of fats and sugars. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Loveleen Sharma, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Bactrim cause abdominal pains?\n\nI'm seventeen, 5'7, and I have a healthy medical history. Recently, I developed UTI and I'm taking Bactrim for it. I'm also scared that I may be pregnant. I have been having like sporadic, few second abdominal pains, but that's pretty much it. Could that be from the Bactrim or something else?",
    "doctor_response": "Yes, Bactrim can cause gastrointestinal disturbance, and not a good antibiotic to be taken id pregnancy is suspected . Get urinary pregnancy test done to be sure about ,. Urine culture and sensitivity tests and pregnancy status can certainly help your Gynecologist to give you the best choice of antibiotic. Also take plenty of oral fluids",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could painful gas bubbles on rib cage suggest?\n\nHello! I m Jamie, and I keep having this gas bubble in my rib cage area. It s on the left side of my rib cage on the bottom of the rib cage. The gas bubble will pop and come back approximately 20+ seconds. It s been causing a lot of pain, and it is hard to breath when it comes. What should I do?",
    "doctor_response": "HelloI have read your query. There is possibility of pneumothorax leading to symptoms. I will advise you x ray and CT scan. CT guided aspirations will help you. You may need clinical examination and further blood investigation. i hope I have answered your questions. If you have further questions please feel free to contact us. I will be happy to answer. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for gall bladder stones\n\nHi, my sis-in-law had gallstones  as well as an 8 mm stone in bile duct and told to do ERCP and cholecystectomy. What are the best places in Delhi for the surgery. Cost is the major priority for me, so can u suggest any institute that does the surgery in a package system as usually hospitals do admit and later on charge and keep charging. Please advice. Thank you in advance.",
    "doctor_response": "Hi,Cholecystectomy is routine procedure which can be performed by any abdominal surgeon in any centre so you should not loo for some specific one.  You can also wait and see if symptoms will improve on conservative therapy such as  lifestyle or dietary changes, then surgery is recommended. I hope I have answered you query. If you have any further questions you can contact us in every time. Wish you a good health.Kindly regards,Dr. Ivan R. Rommstein",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and redness in lower leg?\n\nhi, i have a question regarding my dads lower leg, specifically his calve and foot . it has been a month or so now that he has been having severe pain in his leg and it is red and swollen. the swelling has now gone down into his foot...the skin is very red and hard. Do you know what the cause is and how it can be treated",
    "doctor_response": "Hi, It can be due to bacterial infection. Need to send a picture of the affected part to comment more on it.Is he diabetic? In case of uncontrolled diabetics skin and soft tissue infections in leg is a common issue. Do blood routine investigation and sugar levels in blood to rule out infection. In case of infection antibiotic therapy will be required. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Nishad BN",
    "dialogue_context": ""
  },
  {
    "patient_message": "PTSD diagnosed, get disturbed by hearing past incidents of wife. Reason?\n\nI was diagnosed with PTSD upon returning to the states from Afghanistan.  Can my wife be a factor by bringing up her past constantly.  It drives me nuts and I am going to Loma Linda VA in CA. for one and one treatment but she drives me nuts about her past, I am thinking about seperating from her for a while!  I want to get better for all of us, or is the wife exonerrated from this torment-these feelings I get and I wish I was back in Afghanistan",
    "doctor_response": "In fact, contrary to your expectation, talking about the issues that gave rise to PTSD, should help overcoming it. But, it should no be talked about all the time. It should be discussed half an hour daily one to two times. rest of the time, you mind other business.The fact that your wife does keep on speaking about this might indicate that she also has been perhaps traumatised, in the inner psychologial sense.Therefore, I would suggest both of you, to seek a psychiatrist / therapist who might put you on medication, too. This helpsSeparation is not the solution and might worsen the issues, in such cases",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fibromyalgia syndrome\n\nI have been taking 3- 4 hydrocodone tablets per day for approx 2 years (prescribed for fibromyalgia syndrome .) To detox, I went to a pain management clinic and was prescribed 0.1 mg. clonidine HCL TID the first day and was told to start buprenorphine 8-2 mg SL BID the following morning. I had to stop the suboxone after the first day as I developed severe itching (mostly face and scalp). I had two C-sections (the last in 2000) and experienced the same side effect (severe itching) after being given morphine. My questions: How long is typical for someone to detox from the amount of hydrocodone I was taking and length of time I was on it? Is it necessary to take both clonidine and suboxone to detox from hydrocodone? Can I detox on clonidine alone? Is severe itching a side effect of either/both suboxone and/or clonidine? Many thanks.",
    "doctor_response": "There are several stages in detox. For the acute withdrawal symptoms 1-2 weeks. But there are several other features of addiction such as the altered mentation, cravings, triggered use that require a longer period of time. clonidine helps some people with the initial symptoms of withdrawal (such as agitation, and goose flesh). But that is all clonidine does. Suboxone blocks the effects of other narcotics taken legally or illegally along with it. As such it provides a safe haven for evaluating ones relationship to narcotics. Severe itching is not a common reaction to either clonidine nor suboxone, but it is more common with suboxone.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are EDS and pituitary tumor related disease?\n\nHave you ever come across a relationship between ehlers danlos syndrome and pituitary abnormalities? Specifically, pituitary adenomas, hypopituitarism, empty sella syndrome, growth hormone deficiency? I have EDS, but also a pituitary tumor that apparently destroyed most of my pituitary. I m just trying to learn if the 2 conditions are related. Thanks.",
    "doctor_response": "Hello,I understand your concern and would explain that there is no direct connection in the literature between EDS and pituitary gland disorders. So, this is just a coincidence and an incidental comorbidity. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathing problems and tightness in throat?\n\nHello Doctor, Im a 39 year old female who has suffered from anxiety for over a year. For the last few months I have been having a feeling of not being able to get a full breath into my lungs and a tightness in my throat. Is this related to the anxiety or could it be something really bad?",
    "doctor_response": "Hi welcome to the health care magic You are having history of anxiety problem... Hence your symptoms most likely seems to be related to anxiety induced panic attack... Here before labelling it as anxiety induced rule out respiratory problem by chest x ray and spirometry...... If this comes normal than treatment for anxiety started with alprazolam like drug and behavioural counselling sessions will be beneficial... Yoga and meditation will be beneficial Take care Consult pulmonologoist for examination with keeping all this in mind Hope your concern solved",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cold,headache and painful lymph nodes?\n\nMy boyfriend & I have a horrible cold. He's had it for 9 days I had it for 4. It started out with a bad headache which hasent gone away for my boyfriend yet. I had pins & needles in my arms & legs with weakness the 1st day. High fever, horrible sore throat which hasent gone away for eith of us. Swollen, painful lymph nodes, chills. Nasy....just fell horrible. It wont go away with any medicine we take. I dont have a clue if its flu, menegitis, mono???",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC.I have gone through your query and can understand your concerns..As per your complain the symptoms of high fever, headache, cold and swollen lymph nodes seems to be due to Influenza commonly known as Flu and is a viral infection..As your boyfriend had the infection, you have communicated the same from him..As the viral infection runs its course and it will get resolved gradually on its own, so as of now you can start taking supportive treatment like antibiotics like Augmentin or Azithromycin to prevent bacterial infection secondarily..Take anti-inflammatory painkillers like Ibuprofen..Take Tylenol for reducing fever..Take decongestants like Pseudoephadrine..Do saline nasal irrigations..Avoid chilled foods..Do steam inhalations, warm saline gargles and use a humidifier in your room..Sip on plenty of warm water..In case of no improvement in 5 days consult an Otolaryngologist and get evaluated..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lightheadedness, nausea, ringing in ears and chills?\n\nToday is the 4th day I have felt light headed, nauseous, and experienced ear ringing and chills - burning hot/freezing cold. I have NO fever, aches or pains. I am uncomfortable riding in a car and don t trust myself drivng. I can t go to work like this. What s up???",
    "doctor_response": "Hello,Your symptoms could be related to a viral infection, although you do not have fever. An inner ear disorder can not be excluded either. For this reason, I would recommend consulting with an ENT specialist for a physical exam, performing labyrinthine tests and some blood lab tests (complete blood count, PCR, ESR). I would also recommend to closely monitor your blood pressure values.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes uncontrollable anger and stress?\n\nHi I m just wounderimg if you could help Im on tablets for like being stressed and argumentative all the time and I feel like I m getting worse I m more angry more stressed and more letting every little thing get to me my bf noes how to get me angry with stupid little things and u feel like I m not good enough cud you tell me what wronwithmw",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Anger and aggression are emotions. Anger comes when you become irritated. Irritation happens when you don't like something, or when something is repeated. As anger is an emotion, it should be vent out. You should be able to throw anger out instead of controlling it. But more perfect will be, know the frustrating situations and stop being emotional. If practiced properly, you will not get irritated at those circumstances at all. Those techniques are much easier to understand. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does pain in the lower abdomen along with mucus in stool indicate?\n\nI\u2019m having pain in my lower abdomen thought it might be kidney stones but the pain has persisted all day started a 6 this morning and the pain was pretty strong but then during the day had 2 bowel movements and the pain was reduced but not gone have eaten very little today an apple and half a sandwich and have been drinking water all day and some cranberry juice and the last vowel movement looked like there was mucus mixed with the stool so what\u2019s going on here.",
    "doctor_response": "Hello, It could be many things and nothing. In an acute setting, I would suspect infectious colitis (salmonella, yersinia, amoebae, etc.) or, alternatively, debut of inflammatory bowel disease. If your discomfort and mucus bowel movements continue or get worse, I suggest you see a doctor. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for multiple cyst in breast\n\nMy wife is 26, mother of a 3 month old boy child.... Cesarean delivery.....recently USG showed multiple cysts in rt. breast ( cysts size 5-11 mm). Surgeon advised FNAC.... what is yr opinion? Which branch of medicine should be approached for treatment? Plz suggest...Thanks",
    "doctor_response": "Hi,Thanks for asking.Based on your clinical history and query, my opinion is as follows:1. It appears to be a benign breast lesion probably fibrocystic disease which needs to be checked with FNAC.2. Get a FNAC done and then you can discuss with a surgeon for the possible course of action.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excessive anger while having complex migraine?\n\ni am a therapist working with a 13 y.o. w/f who has been diagnosed with a complex migraines. i am seeing her because she displays impulsive anger outburst, than can last for several hours. she frequently does not remember the outbursts when the rage subsides.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. My understanding is that intermittent explosive disorder and complex migraines are separate conditions.  The only connection of which I am aware is that emotional stress is a common trigger for complex migraines and tension or pressure in the patient's head increases before an episode of intermittent explosive disorder occurs. The stakes are high and I want you to be successful with your patient. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood clots in periods?\n\nmy wife is having one month preganancy only and this is her first preganancy we took the medicine reff by gunecologists doc, clots has been out on the same day when she took the medicine on that day she got bleeding but form next day she not get any such kind of major bleeding as doctor told us she will got lots of bleeding, what does its mean she is fine? some protion of clots still inside ? ya we have to wait for her next month",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic.I have gone through your query. I think I have understood your concern, I will try to suggest you the best possible treatment options.1] If her pregnancy is confirmed with urine test, I will suggest to get USG done.2] USG will help to assess viability of pregnancy, it will rule out incomplete abortion if any and most importantly - it will help to rule out ectopic pregnancy.3] Please do not panic or do not worry but get USG done to get exact diagnosis. I hope this answer helps you.Thanks.Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Amlovas safe for hypertension on a long term?\n\nI am Kh Mohon Singh,Associate Professor of Geology, Imphal College,Imphal.I am a patient of hypertension.My height is 5ft.6 inches, weight 70kg,aged 54.I am taking amlovas 5+ cilakar 10 regulary.Please advise me about taking medicine for longer time.",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern.I will try to explain you something and give you my opinion. We talk about hypertension if we have mean values that exceeds 140 / 90 mmHg. When we treat hypertension our goal is to keep blood pressure values below  140 / 90 mmHg.Only whith these targets we can say that we have well treated hypertension. Hypertension in your age is usaly  an idiopathic  disease.This means  that it has not an identifiable couse. It is a chronic disease and it should be treated all live long.If you stop your medicine your values will rise again.So, you can keep your blood pressure values in control only through regular medical treatment.You descripe to type of medications.These are two different drugs but they belong to the same class of medications that we call calcium blockers. Usaly when we treat hypertension we use different classes of medications that act in different ways  helping in better control. So my opinion is that you should discuss this whith your doctors to prescribe you the best alternative for you.Hope I was helpfull. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of abdominal pain that does not reduce on taking ciplox-tz?\n\nwell im having lower abdomen pain from last two weeks and from this sunday its my third week.. at first i thought its coz of menstrual cycle date coming near... but it persisted and so i consulted for a gynaec thinking its something related to periods... but on scanning its says \"bladder distension with post residue\" i.e. urine infection... the gynaec gave ciplox-tz for 5 days two times a day... even after taking the tablets the pain is still there...",
    "doctor_response": "Hi.The post -residue is uncommon in female patient. This is suggestive either some obstruction to the urine out-flow or bladder problem itself. Get the urine tested even for the culture and sensitivity. I would advise you to consult an Urologist who on careful medical history, clinical examination, tests and cysto-urethroscopy can tell what is the problem.Infection::: UTI needs  weeks course of an antibiotics..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for the pain in pinky finger above knucle\n\nI injured the top knuckle (right under the finger nail) of my pinky finger a couple of months ago. Tried to catch a swinging door that opened and pulled on it real hard. It now has an indintion to the left of the knuckle and is always sore to squeeze or if it gets hit with anything. Solutions?",
    "doctor_response": "Hello, The symptoms seem to be related to a strained finger. I suggest to ice, compress and elevate the hand. You'll need to rest the joint and apply ice packs on (and then off) for 20 minutes at a time. Never apply ice directly to the skin; wrap the ice pack in a towel. I also suggest using anti inflammatory medications such as Ibuprofen to relieve the pain. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does severe pain in the middle back indicate?\n\nI seem to be having gallbladder problems. I have had a severe pain in the middle of my back and in my upper/middle of my stomach along with severe nausea along with vomiting and occasional diahrea. Fatty foods tend to set it off. I need to know what I can eat and what NOT to eat to avoid these attacks.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You seem to be having gastritis and need to consult gastroentelogist for the same. Upper GI Endoscopy may need to be done and he will be in better position to guide you better. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and inflammation in legs?\n\nMy fathers legs get really red and swollen he s stubborn and hasn t seen a dermatologist this is happening more often now a couple moths ago he was out of work for a month he couldn t walk. Now it s back his dr gave him an antibiotic and sent him home but obviously that didn t work. I don t know what it could be.",
    "doctor_response": "Hello, Well, a little more history could have provided some input. Few questions here Is your father diabetic? High blood pressure? any skin infection? age? Since he is getting swelling of the leg, it might be due to poor venous return, which can be corrected by proper medication. For reducing swelling one needs to keep the leg over the pillow and perform ankle toe movements. If any Infection is related to skin then should definitely get examined by a skin specialist and a proper medication should be taken. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pulled chest muscle causing pain\n\nFor roughly a month I ve had a pressure on the left side of my chest above my heart that feels like someone is pressing down. It s not painful just like a slightly pulled muscle but it doesn t bother me more if I do things like shovel snow it stays constant",
    "doctor_response": "Hi welcome to the health care magic As left sided chest pain is since one month,  I prefer to investigate you with EKG,  chest x ray, Auscultation and echocardiography if needed (EKG for rule out cardiac cause and x ray rule out costochondritis and respiratory cause if present) If no organic cause present then it can be considered as musculoskeletal pain For that ibuprofen prescribed for five days. Hot compress helpful Physiotherapy beneficial Avoid strenous activities for few days Avoid heavy weight lifting Take care Hope your concern solved Consult pulmonologist for examination and discuss all these",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is x-ray needed after hit on head after fall with history of having stroke and aneyrysm behind eye\n\nHi, my name is Etta. I had stroke and a aneurysm on my left side behind my eye and they put a stint and a corl last Februry. I was in the hospital from Feb 7th thru Feb 23nd. my question is, i fell last night and hit my head, Do you think i should go to the ER and be xrayed?",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your symptoms and past medical history.Based on the description, you seem to have suffered a mild head injury and there is no need to go to the ER now.Please watch for warning signs such as severe headache, vomiting, drowsiness, weakness of arm or leg, etc. If any of these symptoms develop, you should get a brain CT scan done.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in ejaculating in condoms?\n\nWe have never had to use condoms before as I have always been on the pill or used the ring.  the both effect me and I no longer want to feel awful.  My husband can not finish in a condom.  We've tried different ones,sizes all to no avail.  any advice?",
    "doctor_response": "Hi,There could be many reasons for this. Psychological, insufficient lubrication, material and thickness of the condom and relative insensitivity of the receptors. You can use alternative methods of contraception but rest of the ,methods don;t provide protection against STDs. Good lubrication is another method you can try. In case of some psychological factors or difficulty or failure to have orgasm or ejaculation, you should contact your GP / family doctor, who can give you good advise or refer you. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Azeem Ullah, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Clicking or popping jaw on opening the mouth wide, bad bite, no pain. Have complete set of teeth, no impacted tooth. What treatment is advisable?\n\nHi, I want to ask the problem about my jaw . My jaw is clicking/popping for almost 4 years now everytime I open my mouth wide. Though until now, I don t feel any pain or caused me troubles but it just pops. It s kind of irritating as it is not normal like any other people I knew. I consulted several dentists for their opinion but they had different insights/procedure to treat it. Some say I need to wear splints or mouth guard then wear ortho .. some say I need my 3rd molars to be removed. As I am confused with the procedures and worried about the assurance of the treatments , I still need guidance. By the way, I only have 2 third molars (not impacted and grew in the right alignment) located in the ends of my lower jaw. I never been extracted and my teeth are complete. I also have no impacted tooth and all grew in right direction but I have spaces in teeth but not so much far apart. Most of the dentist also said that I have a bad bite. Sometimes I find myself in the morning with a different/abnormal bite but get backs to normal as minutes passes. Please advise me what to do/follow. I really appreciate it. thank you",
    "doctor_response": "hi.from ur history it appears that basic problem is in the temporomandibular joint.clicking sound on opening widely is basically seen when the disc of tmj interfere in the movement of condyle, this condition is known as internal derangement of tmj.there r several ways of treating it.1.take muscle relaxant and analgesics for 2 weeks and avoid wide mouth opening. 2.tmj arthrocentesis can be done, in which lavage of joint done by normal saline and then hydrocortisone injection is given 3.in rare circumstances discoplasty and meniscoplasty can be done. 4.occlusal correction should be done and splints can be used.go to oral surgeon for ur problem.wish u good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could sore and stiff joints be due to lyme disease?\n\nFOR ABOUT THE PAST TWO YEARS I HAVE HAD SORE AND STIFF JOINTS. I AM ALSO TIRED A LOT AND MOST DAYS NEED AN AFTERNOON NAP AFTERHAVING A NINE HOUR SLEEP AT NIGHT. I HAVE A SORE THROAT THAT NEVER SEEMS TO GO AWAY. LAST YEAR I FOUND THAT I HAD HIGH IRON LEVELS SO IHAD THAT HANDLED VIA A PHLEBOTOMY. I HAVE TRIED EVERY TREATMENT UNDER THE SUN TO TREAT ARTHRITIS AND NOTHING WORKS. I HAVE SPENT SEVERAL THOUSAND DOLLARS WITH NO JOY. I HAVE ALSO HAD ABNORMAL LIVER FUNCTION TESTS FOR YEARS. COULD THIS BE LYME DISEASE?",
    "doctor_response": "dear friend what made you think of the possibility of you having LYME?also what all have you tried in effort to investigate the reason for your joint stiffness and painthe symptoms suggest an inflammatory or an auto immune origin of your illnesshave you been investigated in detail for that?kindly share more details so that clearer picture emerges for a better diagnosis",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had elevated LFT parameters previously. Stopped drinking, underwent treatment. Levels reduced. Advised to stop medicines. Opinion?\n\nsir , i had under gone treatment for liver as MY GGT level was 350 plus but SGPT n SGOT test were slighter above normal and was told by DR that this is due to high intake of alchol sir now i totally stopped taking alchol and undergone treatment for more than one year but three month back a super specialist Dr stopped d medicines and advice me active lifen not to worry about GGT high level n adv not to take alchole. sir now my GGT report is142 SGOT is 69 n SGPt is73 pl advice me wat to do",
    "doctor_response": "Hi and welcome to Healthcare magic.Thank you for the query.if there is fall tendention then medicines arent necessary anymore and you should stop it and continue with healthy lifestyle. if there is aggravation after this, you start with medicines again,but it is always recommended to use drugs as less as possible. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Morphine sulphate an effective alternative to Oxycontin?\n\nMy husband has severe back pain and has been in treatment in Ohio for the last three years.. We recently moved to Alabama and the drs here don t want to treat him with Opanna which is what he has been on for three years.. The insurance will not cover oxycontin. So the next step that the insurance will cover is the morphine sulphate.. is it equal to the opanna or the oxycontin.??. The insurance called tonight and they are changing him to the morphine sulphate 30 mg.Thats only what they will cover..She also said something about the timed release, what is the difference..",
    "doctor_response": "Hi, They are both opiates. They have the same action and are about the same potency. People tend to have different reactions to them and to have strong preferences. Timed release puts a small amount out for a long period of time. The level can be adjusted. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it normal to bleed after taking emergency contraceptive pill?\n\nHello doctor, I had sex with my fiance 10 days back and took the 72 pill on the next day but did not bleed. I had sex again a week later and took the 72 pill that very day. I began to bleed soon after taking it which lasted for two days and now I am having a slight lower stomach and back pains. Am I pregnant now?",
    "doctor_response": "Hello. It can take up to 21 days to have bleeding after taking emergency contraception and although it is good that you took it very soon after unprotected intercourse, you should not use this as your primary method of birth control. It will cause cycle delays and unpredictability. Emergency contraception is not 100 % effective, even when taken as directed. There is always a chance of pregnancy when you have unprotected sex. A pregnancy test is advised and a reliable form of birth control in the future is strongly recommended.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Electric shock feeling in armpit, painful. What is causing it?\n\nI keep getting this strange electric shock type of feeling in my left armpit. It s very brief, but hurts and can happen from 10-30 times a day. It s been happening for about three weeks now, and I am concerned about what s causing it. It s more annoying than painful, but I want it to go away. Any ideas or suggestions about a cause or cure?",
    "doctor_response": "Hi friend, Welcome to Health Care Magic Shock like feeling occurring repeatedly could be nerve irritation - arm pit is supplied by T-3. If there is nothing locally, you may have to see a Neurologist / you may need X-ray of Chest and Thoracic spine It is difficult to suggest a cure without a diagnosis... In the meantime, drugs like Gabapentin which raise the pain threshold may be tried - discuss with your GP and get appropriate prescription. Take care Wishing speedy recovery God bless Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to control extreme emotions causing anger and raise in heart rate?\n\nI've always been easy agrivated. If im doing something and someone intervenes on me doing what i was doing i get very angry. My heart races to the point to where i can feel it pounding in my chest. I get really hot. It happends all of the sudden, i dont even realize it sometimes. That lasts for about 15mins, if im by myself. If the person is still in the room it lasts much longer. Lately ive even become emotional over little things. I try then to talk about it but i cant explain. So then i get in an argument with that person because i cant explain and i get angry because i cant get them understand. I get angry to where im yelling, crying, shaking and my chest is pounding. When i calm down about 30 mins later, I can go on throughout my day like nothing ever happened. This isnt me, ive always been a naturally stressed out person but ive never been had these many emotions impact me so hard. My \"outbursts\" are happening more frequently. Help? Before i lose my love.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  This is what aptly called EGO. You think you are always right. Are you right? You think other person know less than you. Is it correct? You should think that your opinions are as good as others. You are right as others are right. You are wrong as others are wrong. You have no existence if others don't agree with you. Same is applicable to others also. That is why sages say \"destroy your ego\".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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain on back part of the leg\n\nI have pain on the back part of my right leg it feels like someone is stretching my vein like a rubber band, I have been putting ice and taking advil and rubbing ben gay on it works for a little while then the pain starts all over again. do you know what else I can do?",
    "doctor_response": "Hello Leg pain can be due to electrolyte imbalance.Take plenty of water, fluid intake will dilute toxins.Physiotherapy with ultrasound and Tens will help you,Yes you can do exercises like swimming, riding stationary bicycle, but do not overexert yourself.Take potassium rich diet.Hot and cold fomentation to leg. Add tab methylcobal 1500 once day.You may need MRI if not relieved.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the home remedy to reduce weight apart from exercise ?\n\nHI..I M 17 YEARS OLD..I M A GIRL...AND I WEIGH 80 KGS.....PLEASE SUGGEST ME HOME REMEDIES OTHER THAN EXCERCISE TO GET RID OF MY BAD PHYSIQUE.....REP ASAP..",
    "doctor_response": "Hi Welcome to healthcare magic forum Weight gaining has 2 major causative factors 1) from any medical conditions of any endocrinal disorders like cushings syndrome, hypothyroidism - that needs proper treatment 2) taking extra caloric foods with sedentary habits - this is 90% cause of gaining weight. The simple solution is to take low caloric diet like no fried foods, fatty foods, junk and fast foods, more fruits and vegetables, low carb diet too. Eat moderate amount and in time. Homeopathy treatment will be helpful also. For further query contact at multicare.homeo@yahoo.com thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hairloss\n\nHello doctor, i am a student ,age 20 from pune.i am suffering from hair loss from 18 and have lost my lot of hairs from top portion of head.In the mean time i visited doctors who have recommended me to take calcirol plus and multivitamin tablets. also a lotion to apply on scalp everyday named-Hair4u 2% (minoxidil and aminexil topical solution)",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.Do apply Minoxidil continuously for life long. But treatment response is gradual. You will get signs of improvement only after 6 months. Please be patient. And do continue multivitamin supplements.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have headache, vomiting, vertigo, numbness on head and double vision. Done MRI, Ct scan, spinal tap. Cancer?\n\nmy son is in the hospital with double vision in his left eye when both eyes are focusing, severe headaches, numbness on the top of his head & in the back of his head.  He had vomiting & has vertigo along with it.  They did CT scans & an MRI showed something but they don't know what it is.  A spinal tap was done this morning & one doctor said it 'could' be cancer.  What type of cancer could he possibly have?",
    "doctor_response": "Dear friend Thanks for your query to Healthcare Magic....I read your concern and your son is more likely to have tumour / growth in parietal lobe of brain which can be due to trauma or genetic variation .You can get a higher opinion from Neuro specialist who can definitely save your son from double vision and vertigo .Sometimes oedema which can be drained by Neurosurgeon can reduce intracranial tension and can reduce symptoms in a week .Hope this will be usefulAsk me if you have furthur queriesRegards'Dr.J.Kingson John David",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hardness on muscle where Seftiaxone injuction IM is given?\n\nHi, I am Repon From Bangladesh. about 3 week ago doctor suggest my baby (17.08Month Baby) . seftiaxone injuction IM of 500 mg 12 hourly. after 3 days my baby come round from the infection. now i find that the babys muscle where the injection pushed is hard. something like round shape of muscle. What can i do now?",
    "doctor_response": "Hi, You can apply alternate warm and cool compresses and at the same time you can use Thrombophob Ointment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have neck pain, stiffness and numbness in my hands. Is it due to syrinx?\n\nHello doctor, I am having significant neck pain that goes out into my shoulders a bit. Pain is accompanied by severe stiffness. Also, my hands have been falling asleep about seven or eight times a week (roughly) and even ache a bit. I thought I might be dealing with a pinched nerve, but all my symptoms are fairly bilaterally equal. This last week I was put through an MRI for a lipoma in my left shoulder and neck area and they found that I also had a lower cervical syrinx at C6 about 3 mm. Could this be causing the pain and numbness that I have been dealing with? Or is the syrinx something that should be removed? I am awaiting an appointment with a neurosurgeon but I thought I would reach out in the meantime. I appreciate any information that you give me.",
    "doctor_response": "Hello. It may very well be the syrinx. A syrinx can cause pain and temperature sensory deficits to occur early but may not be recognized for years. Syringomyelia typically causes numbness, weakness, atrophy, and often fasciculation, and reduced reflexes of the hands and arms. The pain and/or numbness is felt as a sensation in a cakelike distribution over the shoulders, arms, and back. It may be decompressed surgically a bit for that you would need an MRI (magnetic resonance imaging) of the C-spine to look for a more detailed anatomy. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pregnancy test is positive despite consuming Ipill. What can be done now?\n\ni haven t got my periods yet.. today is my due date and my pregnancy test is poistive, i actually took an ipill so i never had this in mind. i actually have a baby and she is 1.4yrs old, so i am not yet ready for a second one. please help me with this situation",
    "doctor_response": "Hi, Thanks for using HCM.5% of emergency pills fail to prevent conception. As your pregnancy test is positive and you have taken pill in this cycle, so this pregnancy needs to be terminated. Consult your doctor for further management. For early pregnancy medical line of termination is preferred.Hope this helps you.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "An old head injury\n\nTwo years ago I fell on the edge of a sidewalk and hit the back of my head. I had a cut that was about 4 to 5 inches long. I was so disoriented that I just fell asleep and the next day blood covered my whole head, the mattress and the walls. I didnt get it checked cause I didnt want a doctor to shave my hair. Now 2 years later its healed but it still feel like a bruise and somedays I still feel it pounding. What could be wrong with it and should I spend the money to get it checked?",
    "doctor_response": "It could be a hypertrophic scar. Do not cause excess pressure or friction etc over it. It might be at danger to rupture.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain in big toe ?\n\nOK this is my first time, I am 59 yrs , female (Hispanic) decent. I have been experiencing a sharp pain on my big toe mostly on the left foot (sometimes both foot) as if someone were pinching-squeeze them. I have had this going on for about three months. Also I have started getting a strong burning like sensation on my left leg somewhat pass the knee beginning on the top of the leg, and it would last for about 5-7 minutes. Can you tell me what you think it could be?",
    "doctor_response": "Hi,Thanks  for  your query.According to your description , pain over your big toe seems to be inflammatory in nature. It could be an acute attack of gout.I advice you to give you rest to the part affected, take anti-inflammatory drug like motrin 1tablet with food as and when required (upto 4 tablets daily) to reduce pain and inflammation and consult your doctor for thorough examination and rule out any infective cause.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Penis discharge, taken ciprogen, allergic to soap\n\nHi, About 3weeks ago I started noticing clear discharge coming out of my penis . 2 weeks later after discovering this I took Ciprogen pills as in order to cure this, however, nothing has happened. The discharge is still there...what could be causing this? I had the same thing about 4years ago and the nurse at the hospital told me I might allergic to the soap I use. Therefore I changed the soap and the discharge stopped. But this time I ve changed my soap but it s still there...",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have not mentioned any thin about your sexual history in your query whether you had any unprotected sex before getting discharge from penis .Please consult qualified Urologist or specialist in sexual medicine for clinical examination and get following basic tests done to confirm the diagnosis.1) Routine Urine test and culture.2) Swab test and culture  of a urethral discharge .3) basic screening tests for STI.Further treatment will depend upon the results of these tests and final diagnosis,In the mean while you can start taking Erythromycin twice daily.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the treatment for primary premature ejaculation?\n\nHello doctor, Tell me the treatment of primary premature ejaculation. I am suffering from many years, facing from the beginning of sexual life. I did not consult with a doctor and did not take any medicine for this problem yet now. I have no other health or physical problems without this. No erectile dysfunction.",
    "doctor_response": "Hello. Premature ejaculation in most individuals occurs because of anxiety and psychological reasons. Lack of experience, less foreplay, stress, etc., result in rapid ejaculation. Relaxed mind helps to improve the time. Distraction during sexual intercourse helps to increase time. Try to divert mind away during sex and this will help.  Drugs like SSRIs are the mainstay treatment for premature ejaculation. Dapoxetine is used commonly. The drug can be used on SOS basis and help to improve the time. It is safe to use. Please talk with a psychiatrist for the prescription.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the precaution to be take for sprained ankle?\n\nI have sprained my ankle and want to know: How long should i rest? Should I use two ace bandages wrapped on it so that there is more compression, support and a thicker wrap? How long should i have it bandaged? How do I walk on it because I haven t got crutches but it hurts, so what can I do to walk as little as possible? How do I sleep with it do I keep it bandaged and put it on a pillow?",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms seem to be related to a sprained ankle. You should feel much better after 2 weeks. Once the swelling has gone down and you can walk without pain, you can probably start exercises to build flexibility and strength.You can use anti inflammatory medications such as Acetaminophen to relieve the pain. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing pain and a bubbly feeling in my legs and arms. Underlying cause?\n\nHello I am 28 years old and lately I have been experiencing pain and a bubbly feeling in my legs and arms. It feels almost as if something is pushing from the inside out. This doesn't hurt but it is usually occurs with a dull pain. Sometimes it lasts for hours. I a worried that it could be blood clots and poor circulation because I do smoke and am overweight. Can you tell me what this is?",
    "doctor_response": "Hi,Definitely, this is due to smoking and overweight.You should quit smoking and have morning walk and have balanced diet including fresh fruits.Add skimmed milk to your diet.You will feel energetic with in a week.I hope it helps.Thanks.Dr. CHANDER MOHAN SINGH",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever during pregnancy?\n\nI recently found out I was pregnant with three positive home pregnancy tests and am schedule for lab work in a couple days. Today I have been feeling really nauseated and have been running a low-grade fever 100.4-100.6 with chills. No other symptoms. Should I be concerned?",
    "doctor_response": "Hello, and I hope I can help you today.Unfortunately, being pregnant does not prevent you from getting sick just like any other person.Fortunately, you have to have very severe and/or certain types of illnesses to put the baby at risk.  A low-grade fever and some nausea likely is just a stomach flu or some type of food-borne illness and does not pose a threat to the pregnancy.I suggest you start a bland diet with simple, starchy foods and sweet liquids.  Products made from ginger (tea, candies) are soothing to the stomach and can help with nausea, and Acetaminophen (Tylenol) is safe to take at the normal adult dose during pregnancy for pain or fever.Also if you are sick, there is no problem with getting the routine prenatal blood tests as the results are not affected by your illness.I hope I was able to answer your question today and that my advice was helpful.Best wishes for the rest of the pregnancy, and I hope you feel better, Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "Missed periods, HPTs show positive results. Had taken 2 Aspirins. Does Aspirin interfere with these results ?\n\nI had taken two tablets of aspirin (325 mg each ) on Feb 24 . The second tablet was taken in the evening of Feb 24. I took a home pregnancy test on Feb 25 at around 2 PM and another around 7 :15 PM on Feb 25. They both showed positive very clearly. Just to confirm I took another home pregnancy test on Feb 26 around 2-3 PM that again showed positive. All the tests were checked for expiry dates and done and read within stipulated time. I took these tests after 18 days of my missed period. I am yet to see my OB/ GYN but meanwhile I was wondering if ASPIRIN might have played a part in showing false positive results of HPTs. I am on no other medication . Please advise.- AAAA",
    "doctor_response": "Hi, False positive pregnancy tests may be observed when medications containing human chorionic gonadotropin are administered as when performing ART procedures. Aspirin does not interfere with the results. With three consecutive positive results, you are pregnant and there should be no doubt about it and you can get a trans-vaginal sonogram for further confirmation. Please consult your doctor for further support. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness, faster heart beat, high cholesterol and tightness in neck?\n\nthe last two months I have been getting dizzy spells were i feel like i cant move, I have no energy My heart races and I become flushed and I feel my heart pounding in my head and my neck becomes tight on both side of my neck. I seen my doctor and they said my cholesterol is 281 and they told me to diet and deal with stress better. I need answers..please.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, we should rule out arrhythmia (rhythm disturbances in heart) in your case because your symptoms like fast heart beating, flushing of body, pounding sensations, chest tightness etc are commonly seen with arrhythmia. So consult cardiologist and get done 1. Ecg 2. 2d echo 3. Holter monitoring (24 hours continuous recording of ecg). If all these are normal then no need to worry for arrhythmia or other heart diseases. Sometimes stress and anxiety can also cause similar symptoms. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on it's solution. You may need anxiolytic drugs too. Avoid stress and tension, be relax and calm. Don't worry, you will be alright bit first rule out arrhythmia. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bulging vein in armpit, with two knots. Any ideas?\n\nHi,I have a bulging vein in my armpit.  I belive it is an axillary vein.  It looks like a vein threw the skin, and has two knots.  Does not hurt, and is squishy.  My doctor is sending me for an ultrasound, but he didn't seem to have any idea.  I am a 31 yr old, female, taking over the counter PPI.  Thanks for your help.",
    "doctor_response": "HelloThanks for writing to HCMBulging structure in your armpit needs evaluation.It is described as vein by you, it can be confirmed on Doppler study.Also cause for dilatation should also be searched for.You can take second opinion if radiologist is not sure about nature of dilated structure.knots are normally present in veins. Don't worry about this.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dry and pale skin on penis head, no pain or itching, had unprotected sex, negative tests for gonorrhea, syphilis. Is this herpes?\n\nI have noticed that the skin on my penis head has dried up and turned pale. it doesn t hurt, I have no itchy or burning sensations and it does not burn when i pee. I am currently applying some monistat cream as I am thinking it is a yeast infection . If i stop or choose not to treat it, the skin begins to dry to a point where it begins to flake and crack up. I have had unprotected sex and this is why I am currently worried. I tested negative for gonorea and syphilis and thought that I had been tested for herpes but wasn t. Could this be herpes",
    "doctor_response": "Hi dark pale skin over the penile head cannot be herpes because herpes presents as painful erythematous grouped papules over the penile heaf.this condition can be only fungal infection candidiasis.It can be cured by application of nizral ointment twice daily and use of flucanazole 150 mg weekly once for 4 weeks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bulging disc\n\nFor the last year, when i am at work mostly, after walking for thirty minutes to a hour my chest all the way thru to my back starts hurting real bad. I have had a mri and they say i have a bulging disc. Physical therapy did not help and im tired of pain meds. Is there any other thing that could possibly be causing this pain that is maybe not a disc?",
    "doctor_response": "Hello, Mild cases can be easily managed with conservative management with postural adjustments and physiotherpay. If you are experiencing pain, you can take analgesics like gabapentin will be effective. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe abdominal pain, chest and leg pain and stomach ache?\n\nMy son is in the hosp with severe abdominal pain. He is eight yrs old. His pain is being treated with morphine 2mg iv every 4 hrs prn as needed. They are saying it is a stomach virus, but he is hurting in his legs, chest and bilateral lower stomach. he is running a temp of 103. he is yelling out when pain starts until morphine kicks in.",
    "doctor_response": "Hi.Thanks for your query. The commonest causes for severe pain in abdomen in a child of 8 years old are to be ruled out by investigations:Blood-CBC, Widal, Urine -routine, microscopy, culture and sensitivity.Stool- Routine and microscopy, Culture and sensitivity if loose stools.Ultrasonography of the abdomen. A consultation with the Pediatric Surgeon is a must as it helps for better diagnosis. A course of an antibiotic and metronidazole with intravenous fluids should help and the further treatment will depend upon the findings of the reports and a definite treatment can be carried out. Appendicitis, lymph node mass, pyelonephritis are a few common causes . Stomach flu is said to be a reason only if all the investigations are normal and an occasional cause like abdominal epilepsy has to be borne in mind. Morphine should be avoided as much as possible. If the child is needing Morphine there is more than the stomach flu.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mild diarrhea with pain in the back and kidneys. Due to dehydration?\n\nLast night I was sick pretty much on the hour from midnight until morning. Had a slight bout of diarrhoea as well although nothing to actually pass. Also have painful kidneys / lower back which I think is probably dehydration ... Any advice other than drinking lots of fluid (currently trying that but brings the sickness on)?",
    "doctor_response": "Hello, Welcome to HCM, Along with water you can add electrolyte powder which will help in combating dehydration. For pain you can take anti spasmodic s like dicyclomaine. If the diarrhea doesn't subside you can consult your doctor. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for severe scoliosis\n\nI am on the pill and not due for 1 week break for another 6 days. I had sex 9 days ago, after wards I bled. There was bright red blood on toilet roll when I wiped. This lasted for a few hours. I had sex again 4 days ago and since then there has been pink blood on toilet roll when wiping. Also frequent urination and fatigue",
    "doctor_response": "Hello!Thank you for asking on HCM!Regarding your concern, I think that your symptoms may be related to a hormonal imbalance or an infection. An inflammation of the cervix uteri could also cause similar symptoms. I recommend consulting with your gynecologist for a careful physical examination, a routine blood test, urine analysis, and an abdominal ultrasound. A colposcopy may be needed. Hope to have been of help!Best regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat yellow tongue?\n\nI have had a yellow tongue since march.  My regular doctor sent me to a specialist.  He ran some test they came back positive.  I do have herd and my doctor is treating me for that.  Some days my tongue looks better and some days it looks horrible.  Now I'm wondering if everything I eat and drink is staining it.  I'm tired of dealing with it especially when its noticeable.  Do you have any suggestions?",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain the yellow coating over the tongue seems to be Yeast infection known as Thrush and it can be treated with antifungal medicines like Nystatin mouthwash gargles, clotrimazole lozenges and taking more of Probiotics like Yoghurt in diet.. In case if it is not Thrush the other cause for it can be simply poor Oral hygiene and deposit of dead cells, food debris and bacterial over growth over the tongue papillae.It can be cleaned by regular cleaning of tongue with a tongue scraper or a soft toothbrush..Gargle with 1:1 solution of water and hydrogen peroxide can also help..The chances of Yeast infection are more probable and you should ask the diagnosis to your treating physician and can contact us at HEALTHCARE MAGIC for further guidance..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can eye power be reversed by eating carrots and vitamins?\n\nHello doctor, My son is 8.11 years old. He had an eye injury one week before, which caused left eye corneal epithelial defect (3 mm, no infiltrate). He was adviced for constant use of single vision white glass. His reports are, Right eye (SPH=+0.00), (CYL=+0.75), (AXIS=95), (VISION=6/6). Left eye (SPH=+0.00), (CYL=+0.25), (AXIS=90), (VISION=6/6). Does he need to wear glasses? Or eating a carrot, beetroot will help him to be normal?",
    "doctor_response": "Hello. I understand your concerns and have gone through your son's eye records. I can confirm that the power given cannot be reversed by eating carrots and vitamins. This type of power is called a cylindrical power, and if he does not wear the glasses, he can develop weakness of his optic nerve in the long run, along with short term effects like blurred vision and headache. A drug called Low-dose Atropine in a way can be used to control eye power in children and halt progression but it is only tested in minus powers and not in plus powers. My suggestion is to advise him to wear glasses regularly and follow-up with the ophthalmologist every six months. I hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen limbs with pain\n\nI have pain in both my lower limb thereby restricting my movement, pain is not stationery but keeps shifting from one place to the other, centre of the pain is usually accompanied with a swelling. I am taking ice bath four times a day, have replaced my footwear to a softer one and doing the knee press and foot front & back exercise twice daily but no relief for the past 45 days, please suggest a permanent remedy.",
    "doctor_response": "Hello,If your pain is with swelling and in both lower limbs then there are some other reasons for that like:- Anemia- Lung or heart disorders- Kidney problems- Fibromyalgia- Rheumatic arthritis In that case, I shall advise you to consult to your doctor and get yourself investigated. But if pain is only at knee then you should do following to have relief:- Avoid frequent up or down on  stairs.- Avoid cross leg positions.- Start doing some exercises like quadriceps strengthening exercises.- Take a mild analgesic off and on like advil for relief from pain.- Apply a local analgesic ointment and do warm water fomentation with water bag over the knee.- Take some preparations like glucosamine, chondroitin or collagen preparations. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mukesh Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can depression medicines cause tremor, weakness and fast heartbeat?\n\nHello doctor, I have taken Clonil 10 mg, Olonex 25 mg, Valprid and Serlift 50 mg only at night for two days for depression. After the second day, in the morning, I fainted and heartbeat were excessively fast along with muscle of all over body feeling warm. I stopped taking them since then but my body is weak and I feel a tremor, shaking hands and today also heartbeat is getting fast with little nervousness. It is the fourth day today. Please help.",
    "doctor_response": "Hello. All the symptoms you described could be due to anxiety disorder per se and not because of medicines as they are out of your system now. Sometimes there are few problems when medicines are started but they usually go spontaneously within 2 to 3 days. Medicine dosage can also be adjusted accordingly. So, stopping the treatment is not a good option. In my opinion, you shall consult the treating psychiatrist and start treatment with dosage change as per the current situation. Remember, every problem has a solution. You just need to try solving it and help is just a step away. For more information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Vision goes black for a few seconds, dizzy, off balance. Reasons ?\n\nHello, This has been happening to me since I became a teenager. My vision goes black for a few seconds and I get dizzy creating a sense of lost balance. I am female and have been a partial vegetarian for a few months now. Could you help me figure out what this might be. I have glasses for nearsightedness but I do not get headaches often.",
    "doctor_response": "Dear friend, welcome to HCM. there are many causes of this dizziness, imbalance. can you elaborate more as to what else happens? nausea? missed/ heavy heart beats? sweating, loss of consciousness? do you fall down? have memory of the event? it may be a heart rhythm disorder, anaemia, autonomic imbalance, neurogenic syncope etc. pl. feed more details for a better answer. I hope to have answered your query satisfactorily. Take care and please keep me informed of your progress. Good Luck ! May I request you to rate your experience here before you close. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pressure with breathing difficulties?\n\nGood day. My name is Grigor.I am from Bulgaria. In the last month I started feeling pressure in my chest. I feel like I am having air deficit, but thats not the case.I feel like my chest is expanding even when I don't bread.I started weight training late July. I also started swimming a month ago, 2 days a week. My trainer wanted me to perform breathing exercises.",
    "doctor_response": "Hi thanks for asking question.Here you don't seems to have any organic disease.The anxiety or severe stress can lead to panic attack and breathlessness..So try to avoid stress.Morever if you are obese then chest pressure and apnea can occur.Loose weight by regular exercise.Take low fat diet...If still condition increasing chest x ray , spirometry and ECG done for further work up...Take care....Dr..Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Excruciating pain due to hydrosalpinx\n\nI was diagnosed with hydrosalpinx and in excruciating pain what can I do? I was refered to a gynecologist but they keep giving me the run around and I m hurting real bad.",
    "doctor_response": "hi welcome to healthcaremagic i think u need to get a hysterosalpingogram to find out the cause..do u have any other symptoms like painabdomen,fever and any swellings? first get completely evaluated..if the pain is very severe take tab tolpa-d..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can parasites clog arteries?\n\nHave you heard of parasites that can clog arteries?  I have symptoms of a possible blocked artery (pain in left arm, in neck) and am going for some tests (echo, etc).  However, I have been tested 6 months ago on standard tests and all were fine.  I've been taking a parasite cleanse as a 2 were identified in a previous test.",
    "doctor_response": "Hello , none of the routine parasites you are considering can clog the coronary arteries per say.However parasitic infection of lungs or stomach may mimic chest pain . So if you have risk factors like hypertension,  diabetes,  smoker , family history of heart disease . Than it's wise to rule out underlying heart disease .A Treadmill stress test and 2 d echocardiography would be the combination test to rule out any significant heart disease . Regards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can forehead indentation be treated?\n\nI am a male, 58 years young and in good health and shape and about 30 minutes ago after I got out of the shower I noticed an indentation on my forehead from the top of my scalp to the middle of my forehead! What is this, what caused it and how can I get rid of it ASAP?! Thank you.",
    "doctor_response": "Hello, Welcome to HCM. If you did not bang your head, you probably have it for some time. You should see a plastic surgeon who might correct it with Botox injection or with filler. If it is not correctable with these,  you may require plastic surgery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is HDL 30 while being on medication after angioplasty normal?\n\ni am a cardiac patient with DM II. angioplasty done in 2006. presently HDL is 30. Pls advise.Mu email is  YYYY@YYYY . I am on regular medication.Presently taking Clopivas AP150 and Olmesar 40.For DM taking Guconorm fort before break fast.and gycifage 500 mg before dinner",
    "doctor_response": "Hello Sir , Indians per say has lower Hdl cholesterol.  Hdl is the good cholesterol and in an male adult should be more than 40 . So higher hdl it is better. Though 30 is not an urgency and will not put at immediate risk of heart attack , however we should treat to prevent future eventsOf all the medication you have mentioned there is no statin,  which should be taken considering your past angioplasty so future new blocks don't develop and will also decrease your bad cholesterol Ldl and increase hdl . Another way to increase Hdl cholesterol is regular 45 mins of aerobic exercise everyday . Hoping I could help you . Regards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can loss of weight and dehydration be caused due to taking Z-pack for Bronchitis?\n\nMy husband has been sick with Bronchitis for a week he was given a prescription for z-pack and cough syrup, He has had watery stools today, which he was warned about due to taking the z-pack. For the last 3-days he hasn t been able to sleep he has the need to move twitching. He stopped taking the cough syrup 2 days ago as he thought that might be the cause, He has lost 13 lbs in this one week of illness. I think maybe dehydration may also be a problem. When we called the Dr. we were just told to take the cough syrup(w/codene) during the day.",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query for your husband in details  .*  The dehydration is due to diarrhea from z-pack side effect and weight    loss as secondary effect of the same .*  Can continue cough syrup without any problems .Hope this  will help you for sure   .Wishing him fine recovery .Welcome for any further  guidance .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "In wheelchair. Hemoglobin and blood test done. Said bone marrow failed. Am weak. Ultrasound shows endimetriosis. Cancer?\n\nThank you.I am 74 m in a wheelchair, and have been heaklthy most of my lfe, just a few surgerites, no illnesses and suddenly I an becoming so tired \\I hardly propel.Doc checked my blood and my hemoglobin was 80. he ordered G. T. series to checking for losing bloo--but not.            then another doctor who had 15 vials of my blood (eough, I need it) told me my bone marrow failed. I am just no makinh blood.I am so weak, live aone, and can scarecely moce. could I have a transfusion to tide me over to to the bone marrow session or am I just being ignire to  die.I had a lot od symptoms and an ultra sound shows very thick endimetriosis-- supposedly mine is obe thin at mya ge--I suspect cancer,whaddya say?",
    "doctor_response": "Hi, anaemia i.e decreased hemoglobin is the most common cause of tiredness in your age. so you need to have investigations directed to find the cause for anaemia. The bone marrow examination is done to rule out any hematological(blood) diseases which are common in elder age group. you also need to under go stool for occult blood, complete hemogram, serum iron and transferin saturation to know the type of anaemia and followed by investigations directed towards cause for the same. the bone marrow may fail in elderly but needs repeat testing to find out the exact cause. Yes, transfusions could help you, but it is only a temporary improvement and the exact cause needs to be found out and treated for a long lasting cure. as your ultrasound shows mostly it is the thickening of endometrium, needs a biopsy to rule out cancer.Hope i have answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can hepatitis-C virus be contracted through a skin cut caused while cutting chicken?\n\nHey, I m a butcher and I just received positive test results for hepatitis c, I have only used introveineous drugs a hand full of times and every time the needle was brand new. Is it possible I could have contracted the virus by cutting myself at work via cow, or pig, or chicken fluids?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Human are the only carrier for hepatitis C, animals are not infected neither  they transmit it. IV injections are the main cause, other include transfusion, or accidental needle or sharp injuries with infected objects. There are other less common causes, and even yet unknown routes of transmission. So probably it's not your work that has done it. I hope I have answered you query. If you have any further questions you can contact us in every time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to determine ovulation period?\n\nHi I am 29 yrs old and trying to conceive, it's been 5 mnths bt no luck I am not sure of my ovulation days coz my cycle is not regular it changes for past 3 mnths I had 30 days cycle bt this month Its 27 days as I got my periods on 26th of June . Should I go for ovulation kit ??",
    "doctor_response": "Hi I think ovulation kit may work for you. You can try naturally for 2 to 3 months. Be in contact with your husband every 2 to 3 days. If it doesn't work then you should get yourself evaluated. Do a thyroid profile and prolactin levels and a ultrasound for your uterus and ovaries.Also a semen analysis of your husband should be done. Consult a doctor because you may need some medicines for ovulation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for varicocele\n\nHi my husbad was diagnosed with a varicocele this year we dis bot go through with surgery but we have been ttc for 5 yrs i have pcos & takin clomid his morphology i remember they said was not that good is there any vitamins he can take to improve his overall sperm?",
    "doctor_response": "Hello and .Varicocele surgery is definitive treatment for varicocele. It helps improve the motility and morphology of the sperms formed. If done to improve fertility,he should take Clomiphene 25mg daily till pregnanacy. The semen analysis should be repeated after 3 months.Taking Carnitine and Vitamin E,also helps. This will be prescribed by your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for tight and painful knee after football injury?\n\nHi I was playing football yesterday and both myself and a team mate went in for the same challenge, her knee went straight into my back just to the left of the spine. I now can't bend down as I keep getting 'stuck' like I've a trapped a nerve. The whole half of my back feels tight and hurts to touch. What should I do?",
    "doctor_response": "Hello,Thank you for using healthcaremagic.I read your question and understood your concern.I think you should go to ER for evaluation of your spine.It can be anything from simple to complex injury that may need surgeryDr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes wandering eyes in a child?\n\nHey, my little brother is 6 years old and we noticed that a few day s ago his eyes are like wander around, We have asked him if it hurts but he say s no. My question is what can the wandering eyes come from? he have never had this before. / Angelica",
    "doctor_response": "DearWelcome to HCMWe understand your concernsI went through your details. Your child's problem could be Exotropia which is the outward deviation of an eye. When the eye turn happens some of the time, but not all the time, the outside observer might conclude that there is no serious problem and fail to seek help. Or they might think the person is simply daydreaming, lazy, or not paying attention. Even worse, without knowing that there is a physical problem, the observer might feel uneasy or mistrustful of the person with intermittent exotropia who gives poor eye contact and comes off as distracted or \"shifty-eyed.\"Treatment options consist of Vision Therapy, patching, eyeglasses and/or, very rarely, surgery. The most successful form of treatment is in-office supervised Vision Therapy with home reinforcement. Please consult an eye specialist.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest a method to remove white patches in gums\n\nHi. Seven months ago I got upper dentures. I changed dentists because my mouth had such big huge bones that my dentures wouldn't fit right and it was very painful. My new dentist referred me to an oral surgeon for alveoplasty and to remove two mandibular tori's under my tongue. Needless to say, my mouth is now full of dissolving stitches. My question is...how do I clean the nasty thick white buildup all over my gums? Rinsing with salt water isn't removing it. Since I can't brush because of so many stitches, what can I do?",
    "doctor_response": "HiWith your query, what you see those nasty thick white tissues or plaques are nothing but healing tissues or granulation tissue so please dont disturb those healing process by doing so may disturb or delay the wound healing.Kindly dont bother those and leave them like that f you are so much discomfortable along with the warm saline gargling with your finger you can try to with mild pressure clean those ares. This healing process may take 7-14 days. For any further sugesstions or treatment you can consult your dentist.Hope this helps you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe lung infection affecting kidney. Dialysis suggested. Have diabetes. Can she be cured?\n\nHi Mom is a patient of Diabetics for last 10 yrs and has High blood pressure, 3 weeks back she was admitted to hospital with Severe Lung infection (neumonia) and was on ventilator for 5 days and in ICU for nearly 7 days now doctor says she would require dialysis as infection has effected her kidney, She did not had any problem prior to this , I have consulted another specialist nephro and he asked me for getting Kidney profile and Hemogram test which i did where i saw a Urea level of 23 and creatinine level of 4.6, My question is can this be due to the fact the she had infection and it effected kidney also and can this be cured or she wil need regular dialysis from know on.",
    "doctor_response": "Hi friend Welcome to Health Care Magic Sorry to see several problems - The best one to seek in the situation is a nephrologist - you are right in consulting one. Infection can cause all these - often leading to shock and Multi Organ failure. Ther chance for reversal are not predictable until after the infection has cleared. There is one thing that needs attention - Urea of 23 and creatinine of 4.6 ?? - this is rather unusual' If it is not your typing error, it suggests skeletal muscle problem, rather than kidney! The nephrologist will assess and assist Take care Wishing speedy recovery God bless Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I received handjob. Can STD transmit this way?\n\nHello doctor, I went to a massage parlor and got a handjob. I was told by my doctor that STDs are not transmitted this way. Is this true?",
    "doctor_response": "Hello. I understand your concern. This is true. Only direct genital contact or contact through cuts on genitals, blood, semen or saliva can lead to STDs, not hand job. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for itch in urethra\n\nhello , i am a 27 year old male and for the past two days i have had a slight itch in my urethra just inside the head of the penis , it does not really burn and it \"feels good\" when i urinate like i am scratching it . any ideas what this could be   YYYY@YYYY",
    "doctor_response": "HelloItching in urethra just inside the head of the penis may be due to allergy etc.You may need proper clinical examination and few investigations.You may need routine hemogram,random blood sugar,urine RE/ME.You may need anti-histaminics like cetrizine 10 mg twice daily for five days.However it is important to examine for fungal infection etc.You may need few more medicines after complete evaluation.Drink lot of water.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant pain in my stomach?\n\nHi, may I answer your health queries right now ?  Please type your query here...I have been having pain in my stomach, during the day it is more of a soreness, then once I lay down it gets more severe, like a constant severe burning sensation, sometimes it feels as if my entire stomach is going to burst. NO matter how I lay or where I lay, as soon as I lay down it starts and won't stop. This has been going on for a few weeks now and just keeps getting worse. What could be causing this to happen, the only reason I haven't gone to a doctor yet is because I have no insurance and no money for medical expenses.",
    "doctor_response": "Hi.Thanks for your query.NO insurance is no reason to get at least bare minimum investigations and treatment. Get an upper GI endoscopy , ultrasonography and few blood tests to see any infection in the intestine or something like Typhoid. Get a course of an antibiotic, PPI / Ranitidine/ probiotic and metronidazole.. See the results in 5 days , you may be alright .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hot and cold sweats, headache, sore throat, shaking. Related to insect bite?\n\nHi I have had hot and cold sweats since saturday/sunday, with a headache , achey body, and have no energy.My throat is also sore and I get shakey at times. It has got progressively worse. I also got bit on sunday, and i cant identify the bite. I have suffered insects bites badly the last few months, however i can t identify this one. I dont know if it is related?",
    "doctor_response": "it look like viral you get your tlc done get platelets counts seems to be lower is viral pharyngytis with fever you take meftal sos post after results take liquids more",
    "dialogue_context": ""
  },
  {
    "patient_message": "Son diagnosed with ts at early age. Now have constant seizures, dropping down tonic clonic and absences. Recommendations?\n\nhi my 32 year old son was diagnossed with ts when he was 14. living in Ireland i feel very much on our own. At the moment he is getting constant seizures, dropping down tonic clonic and absences. He also suffers from severe depression the doctors are saying that is seizures are stressed related and that they are not real seizures what do i do where do i go to get him proper care please help im desperate right now",
    "doctor_response": "Hi,Thank you for posting your query.Seizures can occur in TS. One needs to confirm whether these are true seizures or pseudo seizures (related to stress). This can be done with video EEG monitoring. In any case, seizures need to be treated.A neurologist can help you in confirming the diagnosis and planning the treatment.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does pain in the lower back and knee joints indicate?\n\nHi I ve been having wierd feelings around my body I have tremendous amount of pain in my lower back it increases and moves around I ve been having that for weeks now and my knee joint hurt and also my elbow joints hurt I ve been a little anxious and I don t know what s happening",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Polyathritis. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is allergic bronchitis curable ?\n\nhi sir my sister is suffering from allergic bronchitis . she lives in delhi. could you please recommend any specialist of this problem . and is this allergy curable ? please reply as soon as possible. my id is ksugandha @ymail.com.",
    "doctor_response": "HI ksugandha allergy and its symptoms are linked to genetic setup of the individual..though some spontaneous cure has been reported but in majority it runs throught the life......but symptoms can be alleviated by simple medications and when controlled these may be taken on as needed basis. best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Seroquel safe and effective in treatment of hallucinations and anxiety?\n\nHi my father is 64 years old and has been diagnosed with leeway body dementia. He suffers from visions and hallucinations and also anxiety issues. His doctor is a pschicogeriatrician and is recommending seroquel and I'm concerned about the risks?He is also on sodium valproate?",
    "doctor_response": "Hello Dementia with Lewy Body usually presents with psychiatric symptoms like hallucinations and other symptoms of dementia. Parkinsonian movement symptoms are also associated. Seroquel is quitiapine and this is an antipsychotic drug. The drug is very useful drug to control psychotic symptoms like hallucinations. Low doses of the drug can be used in elderly and it is devoid of serious side effects. There is no risk in giving this medicine as this is relatively safe. Show him to his attending psychiatrist regularly.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can chewing skoal cause bloating and head pressure?\n\nI am 49 with CHF. My question is I have been bloated most of the last 2 months and have terrible head pressure. Can hardly put my shoes on or walk to the car. Heart Dr says all fine but this is not fun. I chew skoal everyday and thought maybe this was it. I just want relief.",
    "doctor_response": "Hiit can be because of acid peptic disorder or severe gastritis.you should tke  proton pump inhibitors like  pantoprazole or esomeprazole for 14 daystablet antacids can also be taken along with it , once problem of bloating and belching goes away, head pressure wil also reduces .As your doctor says that  you are clear from cardiac side , most likely reason is acid peptic disorder.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to control elevated SGOT, SGPT and triglyceride levels? Under medication for left ventricle hypothyroidism\n\nHi , My husband is 32 years old, when we got a blood test done, the report says his SGOT is 48 and SGPT is 58, his triglycerides are 86 in count, also he is under medication for Left Ventricle Hypothyrodism, he is taking beta blockers, can you please advice me what has to be done to control SGOT, SGPT and Triglyceride levels.",
    "doctor_response": "Dear Madam,Thank you for posting your query on HCM.Well looking into your problem I will like to tell you that  yOu should get a USG abdomen to see if he suffers from fatty liver . He should reduce weight and avoid fat .Take care.Dr. Shruti",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for persistent cough?\n\nI am suffering from cough for last two and half years. I used to face cough every month for 5-6 days and after getting cough syrup and tablets i used to be cured. But for the last one month i am having cough regularly and even syrup and tablets are not showing any effect to cure it. I get cough only in day time means whenever i do work, i dont get cough a single time in night while sleeping but as i awake, cough is again started. I need to know the exact reason for this, and what should i do to get myself permanently cured from this disease?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. You are having cough only in the day time. So possibility of allergic cough is more. Allergy to environmental things like dust, pollens, mites, animal fur, smoke etc is causing you cough. Another possibility is chronic lung infection like tuberculosis. So better to consult pulmonologist and get done clinical examination of respiratory system, chest x ray and PFT (Pulmonary Function Test). Chest x ray is needed to rule lung infection. PFT is must for the diagnosis of allergic cough. You may need inhaled bronchodilators and inhaled corticosteroid (ICS). Oral combination of antihistamine and anti allergic drugs are also indicated in your case. So better to 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for speech problem\n\nMy child have slight speach problems, he also have reading problems and don t progress in school. He been to speach therapy, occupational therapy, now a clinical psyco test suggest that he had oxygen problem with birth. Is it possible...is there a cure for it?",
    "doctor_response": "Hello,Yes, it is possible. Due to oxygen deficiency or delayed cry at birth can cause damage to the area of the brain which related to speech and intelligence. Supportive treatment as speech therapy, occupational therapy, etcetera can help, no definitive is available.Hope I have answered your query. Let me know if I can assist you further.Regards,     Dr. Sachin Kumar Agarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can history of pleurisy cause chest heaviness?\n\nFor the last week or so I have noticed it to be tough to take a nice deep breath. I need to have a good yawn to make it happpen. My chest also feels slightly \"heavy\". I have had pleurisy before and wonder if it is that again. No other symptoms of any kind.",
    "doctor_response": "Yes it can. You may consider having a chest x-ray as a start to evaluate for fluid accumulating in the pleural space that can cause this.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Holes in the pallet, painful, on hydrocortisone. What can I do?\n\nI have 2 tiny pin seized holes in my pallet. Both on the right side. One on the hard pallet, due to sticking a hard doritos in mij mouth, the other on the soft pallet, due to my dentist sticking her tool in the wrong way. I can not seem to get ride of it. I am gargling with salt water. And taking hydrocortisoon tabl. What else can I do? It takes away the joy of food and is truly painfull. Many thanks",
    "doctor_response": "hi as per the information provided by you, both in injuries are traumatic in nature . do not gargle with salt water as this won t allow the healing to complete. stop taking hydrocortisone either. all you need is a mild pain killer for few days along with with mucopain which is to be applied locally on the injury site. with in 3 to 4 days you feel start feeling good. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i be pregnant after taking i-pill ?\n\ni had unprotected sex after taking i pill will i get pregnant? i had unprotected sex after taking i pill will i get pregnant?",
    "doctor_response": "welcome to healthcaremagic one thing for sure the i pills are not conyraceptives and should be never used as regular contraceptives and if some body takes frequent i pills will head for serious hormonal problems it is better to take consultation with gynecologist if you have intercourse soon after taking i pills it is possible hat you wiil no get pregnant",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat low platelet count, also have aortic regurgitation and stenosis?\n\ni am 48 years male and suffering from low platelet count i am also a known case of bicuspid aortic valve server stenosis with aortic regurgitation on 25 mg metaprolol my physician advised me to take wysolone 20 mg morning 20 mg after lunch and 10 mg at night with half tablet of ditide 10 mg in morning at present my platelet count is 90,000 please advise me",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Platelet count of 90000 is not be worried about. It is a bit below the normal limit.2. Due to aortic regurgitation and stenosis, increased risk of thrombus formation and hence low platelet count is possible. Also ITP and Vit B12 deficiency needs evaluation.3. Get a bleeding time, and bone marrow study for evaluation of low platelet count for evaluation of immune thrombocytopenic purpura.4. Platelet count below 20000 is serious, otherwise, nothing to worry. Cause needs to evaluated. If severely low, platelet transfusion can be given. Continue all other medications including steroids, ITP could be a major cause.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Effexor the right medicine for panic attacks and anxiety disorder?\n\nI have taken Effexor for 5 years and I fell so much better. I am 65. I have general anxiety. Panic attacks. I do have very vivid dreams but a concern is that I feel it takes my brain longer to catch up to my words. My brain seemss slower. I am lots calmer. Slow reaction",
    "doctor_response": "Effexor has good results with Anxiety. It does not lead to any cognitive disturbances like how you have described brain seems slower.I will suggest you to continue using effexor for your anxiety.At the same time I suggest you to ask your treating psychiatrist to get some cognitive test done for you. I will suspect Mild cognitive impairment in the patient with 65 years.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What precautions should i take after hip joint replacement?\n\nI had a hip joint replacement in my left hip. It was in july 2011 and being one year over now. How precautious i should be? Can i go on with my regular activitites. Am aged 33 now. Not working for now. But waiting to get a job in OFFICE ADMINISTRATIONS.",
    "doctor_response": "Hi, This question is best discussed with your surgeon or rehabilitation team member since we do not know your pre-op condition nor the type of hip used or the present condition. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hyperpigmentation of my shaft and glans\n\nI have  hyperpigmentation of my shaft and a couple of small round hyperpigmented lesions on my glans. They are not raised and have been there for almost 12 years. I have not noticed any significant change over this time though it may have become a little more widespread. Cause for concern?",
    "doctor_response": "Hello, As a first line management, you can apply low potency steroid creams like betamethasone for symptomatic relief. If the lesion persists, it is better to consult a dermatologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling around the ankle in the same leg which has an abrasion that is slowly healing?\n\nMy doctor prescribed sulfameth/trimethoprim 800/160 mg tb for two weeks. Reason for the prescription is an abrasion on my right leg several weeks prior. While having this abrasion it affected the same leg ankle and swelled. I am a RA patient Enbrel 50mg , plaquenil 200 mg 2x daily. The abrasion is healing slowly after two weeks of antibiotics. The swelling continues but only the evening hours until the next morning when it disappears again. The swelling concerns me. Is this normal ?",
    "doctor_response": "Hello and welcome to HCM. It seems that what I are facing may be because of rheumatoid arthritis flare.Flare is like worsening of symptoms of RA provoked by stress,injury or certain medication.In your case,it might by because of all these factors.But you need not worry as it is manageable.If I were your treating doctor,I recommend--Tab ibuprofen or naproxen twice a day for 3 days.-Applying cold compress for 20 min 3-4 times a day till swelling subsides.- sit or sleep with ankles elevated-have adequate rest-practice yoga,meditation to de stress yourself.If still the symptoms persists,blood tests for checking status of RA will be required .Further action to be taken accordingly.Hope this information helps. Thanks and regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chloangiocarcinoma\n\nI have cholangiocarcinoma. I am finishing my last cycle of chemo (gemzar/Cisplatin)in two weeks. Had 25 days of radiation in June. Would like to hold out on long term supplemental enzymes until my immune system recovers and the bowels learn how to work with what pancreas I have left from Whipple. I can experiment with creon now or wait a month or so. I am 60 years old, in excellent mental and physical state, and working at appreciating my cancer diagnosis. Unfortunately, I m spending far too much money now with a great team that is up in the Northeast U.S. and just wanted another, perhaps global, perspective on my rare cancer. Thank you for your time. You may know that I am well ahead of the curve in terms of recovery and tolerance of the regimen prescribed compared to most patients with this cancer. I just need to put this in a larger framework for now.",
    "doctor_response": "GOODMORNING YOUR TREATMENT SEEMS TO BE FINE. BUT YOU NEED TO BE ON REGULAR SURVEILLANCE AS CHOLANGIOCARCINOMA HAS HIGH CHANCE OF RECURRENCE. DO KEEP VISITING YOUR DOC REGULARLY FOR CHECK UPS.REGARDS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes popping sound from the knee?\n\nmy wife is 30 years old and is about 40 kgs. Recently she has popping sound from her knee while unbending but having no pain. She has no family history of osteoarthritis. Recently she has started some yoga stretchings for 3 to 4 days a week. Her lifestyle does not include any hard physical work too. What should we do as an early step ?",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.I think she doesn't require any treatment as she is not having any pain. However she can get her x rays and vitamin D level.  If these tests shows any abnormalities then she require treatment. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it necessary to repeat the pregnancy test after multiple negatives?\n\nHello doctor, I had sex on the first day of my period. I took an ECP on the same day eight hours after the act. It is one month now and I am six days late for my period. Previously, I had a regular cycle of 30 days. I had taken two pregnancy tests, one on the first day of the missed period and the other four days later and both are negative. Please suggest.",
    "doctor_response": "Hello. I have gone through your history and understand your concerns. As you had an I-pill, the chances of pregnancy are not there in your case. The delayed periods could be due to hormonal imbalance caused by I-pill. You can just wait and watch for your menses for three more days and repeat your home urine pregnancy test to rule out pregnancy. Hope you found it useful, feel free to ask more information. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for knee, leg and sole pain and varicose veins\n\nThanks. I am having knee pain and also my leg and soles are paining and burning for the lst five years. I am also suffering from varicose veins. I had consulted nuero surgeon and after a test he was of the opinion that the blood flow in both the legs was hampered and he prescribed me Pregalin M M75, Aldonil 50 and Rejunex OD and was taking these medicines for the last one year but I am not getting any relief. On the contrary, the pain has increased and I am finding difficulttowals even onem. Pl. advise.",
    "doctor_response": "Hello, In this case, I do agree with treatment of your doctor. He has already prescribed you right medicines to help you. But if you are feeling continuous pain which is hampering your routine activities then there are some nerve block procedures which can be done by expert neurosurgeon or a neuro-physician. You may ask this from your doctor. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mukesh Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Red blood in stools and pain on left side, uncomfortable, tiredness. Awaited colonoscopy. Can this be cancer?\n\nHi, I am a 24yr female engineer. I sometimes have red blood in my stools (no constipation/pain) and occasional pain in my left side. When I visit the toilet, I usually feel as if I still have some left in my bowel - v. uncomfy feeling. This has been going on for the past 7 months now - intensifying. The worst thing is constant tiredness. I consulted two Gastroenterologists and they both suspect cancer (after an *cough* examination, one of them said he spotted polyps?) because my mom had breast cancer . They want me to do colonoscopy but my mom and uncle have had them done and it was so painful. Can I be experiencing some other symptom? Is there an alternative to colonoscopy? I can t believe I m asking this on the internet, but feeling pretty ill today (very rare), browsed the web and found this great site so gave it a shot! :)",
    "doctor_response": "blood in stool can be due to multiple causes and not always due to cancer.  But understand clearly that you need get properly investigated to find out the cause of bleed. there are other tests like virtual CT, but nothing can replace colonoscopy. colonoscopy is done under anaesthesia if you feel you cannot tolerate it. But understand that accurate treatment can be offered only after confirmation of diagnosis. Even if cancer colon is diagnosed, nothing to worry since it has very high cure rates. so go ahead and get scopy done",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of old memories?\n\nhello i am 27 yr old female,married....actually i have sme problem...i cant forget memories 4rm the past....actually after getting married...i saw my hsband ex affairs dairy and video...though he is a good person now..but still....how can i cope over my problem...please help me",
    "doctor_response": "Hello,Your situation is difficult & I can understand your dellima. But you have to move on. Everyone has a past in one or the other way..but what is important is how he takes care of his present. How does he behaves with you, how is he emotionally with you? If these things are good and he dosent give you any reason to complaint, then you must forgive him.I know that you cannot forget all what you saw and neither im telling you to forget it...it is waste to try such a thing...but at the same time tell yourself that it was his past , when you were not there in his life. He had emotions and did few things under emotions...and so do many people..Let this thing stay there somewhere in your heart and try to move ahead with him.Donot do injustice to him like this, he dosent deserve to be handled in this way ..( provided he is good with you now). The best way to get out of misery is to make fun of that issue...may be laugh out loud about that thing with him..or may be tease him ..and just try to accept and let it go. This is what is right and this needs to be done now.I hope you understand May God give you courage to have a big heart.Dr. Manisha GopalMD Psychiatry",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for lump under left armpit and left sided chest pain\n\nI am a nearly 40 year old female...I was diagnosed with Sarcoidosis about 3 years ago through a right breast biopsy...when I was 22 I had an ablation for Wolfe Parkinson White Syndrome, I have had pericarditis and recently diagnosed with chronic lung disease and AFib with Syncope...I am now suffering with a lump under my left armpit and it is extremely painful and have some moderate left sided chest pain that radiates into my armpit on exhillation...could this be related to Sarcoid. i know it can affect the lymphatic system but so far it has not been involved. I also have an implanted loop recorder and was wondering if maybe that is causing some of my problems...any ideas would be appreciated...I am scheduled for an ultrasound of that armpit in the near future but was wondering if I should be worried especially with the chest pain...Thanks so much.",
    "doctor_response": "The lump under the forearm could be a gland. It could be due to infection since it is painful. It could also be due to sarcoidosis. An ultrasound is a must and if required, a fine needle aspiration biopsy should also be done to arrive at a diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in rib cage?\n\nTwo days ago it started hurting really bad any time I bend my rib cage left. It feels like its grabbing on to something and letting go right where my floating rib is. Could this be rib cage related or abdomen related? I feel pressure when I m laughing or coughing as well. Could it be gastritis?",
    "doctor_response": "Hi, Given your description, you seem to be suffering from gastritis which is related to smoking and stress. The following measures will help: a.  Stop smoking and avoid alcohol. b.  You can try taking Tablet Prevacid OTC once a day, half an hour before meals. c.   Avoid spicy food. d.   De-stress with yoga, meditation or breathing exercises. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ivan R. Rommstein, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. 2. 5 year old suffering from stomach ache. Which medicine has to be given?\n\nHi doctor, My son is 2.5 years old. For a week, he is complaining of stomach pain. After farting he is fine. Our family doctor recommended one antibiotic for five days and a medicine to avoid vomiting. He had small vomits twice, but later it was fine. Now, after completing the course of medicine he again complaints the same. His diet is almost nothing and he is not ready to take any food. He just has few mL of milk. He does not have fever. His stool was watery, but it is normal now. Can you provide any recommendation on diet and medicine? Please give me a solution to the problem. Thank you.",
    "doctor_response": "Hi. I can understand your concerns. Complain of abdomen pain with vomiting suggests that your child probably has acute gastroenteritis or food poisoning. Since, antibiotic is already given and now there are no loose stools or vomiting, there is no need to give antibiotic again. For abdomen pain, you can give syrup Cyclopam (Dicyclomine hydrochloride and Paracetamol) 5 mL on SOS basis (as and when required) that is when abdomen pain occurs. Whenever a child becomes sick, there is decrease in his appetite which improves as child recovers. Now, you should give him all the foods that you were giving him earlier. If he is not eating then you can start Glucon-D in water thrice a day for one or two days. Start a multivitamin like syrup Bevon 5 mL once a day for 15 days. Keep patience. Child will eat properly now as he has recovered from illness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pregnancy be the reason for bloating?\n\nhello,,my period last month was for three days and very light. This month my period was only one day and mostly brown and only spotting. I have been very very bloated and feel bloated too!!! You can notice it when I where clothes. I can feel a pulse on my right stomach and feel a kicking sensation in different parts of my stomach at times. Is this possible I am pregnant and or is it all in my head and just gas?????",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the light period needs to be evaluated.I suggest you to get a urine pregnancy test done to check for the pregnancy.The symptoms of pregnancy like nausea,vomitings,increased urination,sore breasts start 2 weeks after missed period in case of pregnancy.But the symptoms alone will not be sufficient to confirm the pregnancy.So a urine pregnancy test need to be done to confirm.Usually the urine pregnancy test gives accurate results a week after missed period.And the fetal movements are felt around 5 months of pregnancy.So it might be too early to feel fetal kicks.Anyways kindly do the pregnancy test.If it is negative the chances of pregnancy are ruled out and the cause for scanty bleeding like any thyroid abnormalities,stress need to be evaluated.Hope this helps.Best regards.....",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe swelling in penis?\n\nHello I m a 81 year old uncircumcised male. Hospitalized recently with severe kidney infection and place on a levaquin drip for 4 days. Released and sent home taking oral levofloxacin and have noticed a severe swelling of my penis. I m unable to get out of bed to toilet but have a supra pubic catheter so urine is no problem but feces has been an issue. Wondering if swelling issues from oral levofloxacin or maybe balanitis from the hygiene issue from feces? Thanks",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: Renal infection can cause scrotal and some times penile oedema.Explanation: As you were hospotalized for renal infection and were on treatment for that, your renal infection could have caused scrotal oedema or penile oedema.                  It is unlikely that antibiotic causing oedema at this juncture. Even balanoposthitis is a probability if it is only foreskin swelling.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Overweight,lump under armpit,no family history of cancer.\n\nHey.. I m a girl aged 17, 85kgs (:( overweight ), approximately 165-175cm tall, no previous breast cancer or other diseases in my immediate family (that i know of) and i ve found a lump underneath my armpit.. It s not sore most of the time, only occassionally and sometimes if i use roll-on deoderant.. I don t know what it is or what it could mean.. Could you help?? Thanks...",
    "doctor_response": "hi... please try to feel the lump urself and assess whether it is hard, non mobile, any change in color size and the surrounding skin of the lump... the best investigation is Fine needle aspiration cytology(FNAC) .. it ll give a clear cut reason behind the lump... hope u get well soon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medicine should I take for high liver enzyme?\n\nHi, I have fatty liver and my liver is high on enzyme production. So I'm on a strict diet and avoid oil in any form. I'm down with fever from the past 3 days due to severe cold & flu and very skeptical to take any tables thinking it may affect my liver. I'm 32 years old and weigh 65 kilos. Can you please advise?",
    "doctor_response": "Hi thanks for your query.fatty liver is an indication of liver disorder in an early reversible stage....it is associated with elevated enzymes when complicated by infection of liver- HEPATITIS.....THE DIETARY MEASURES WHICH YOU ARE FOLLOWING  CURRENTLY UPTO TO MARK.ALSO THERE SHOULD BE COMPLETE CESSATION OF ALCOHOL INTAKE IF ANY...YOU NEED TO GET TESTED FOR hbsag a liver infectious antigen +ultrasound of the liver to narrow the diagnosis.consult an expert hematologist.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fluctuating BP levels\n\nI have Parkinson s disease and have been taking Mirape, Stalevo 200 and Amantadine. my symptoms were pretty much controlled until I fell a year ago breaking my hip. After surgery for hip replacement, I had to have a second surgery due to failure of the first replacement. I have recovered from the effect of the surgery but have experienced a number of health problems since the surgery. I have had several back problems that have been treated by pain care physicians . I still have some pain in my lower back. My greater problem is my blood pressure which fluctuates from 185/104 to 85/54 and my feet are both excessively swollen and my movement is terribly affected (these are recent developments). I have been freezing up, have difficulty turning over in bed and my tremor is much worse. I have taken Mirapex (1 mg 4 X day) for several years; have been taking Stalevo 150 for several years but less time than the Mirapex. I was taking Stalevo 150 (4 X day) but changed to the 200 during the past few months (4Xday); The Amantadine was added in January of this year(twice a day). Can you help me?",
    "doctor_response": "hi and pleased to answer you.first, from the medical litteratures we learn that in parkinson people there is a major reduction of bone mass density. a low bone mass is related to the fracture and to the spin pains. second, blood pressure abnormalities have been known in parkinson's diseases patients.and last, your parkinson diseases is badely controled.I suggest you to consult an internal medicine to check you osteoporosis, and your hypertension, in order to controle it both and to change the modalities treatment of your parkinson diseases.may this help youbest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pneumonia like symptoms and shoulder pain?\n\nI would like to ask what are the common cause of shoulder pain which I'm feeling now since July 2011. Can this be also related to pneumonia? I have been diagnosed with viral infection in my right lungs and after taking medications, I feel relief. But in the later months, I was diagnosed again of the same illness and at the same time, feel relief after taking medications. This time, I felt the same symptoms but now, this is accompanied with right shoulder pain and right side of my neck aches sometimes.",
    "doctor_response": "CONSULT AN EXPERIENCED DOCTOR TO RULE OUT ANY OTHER PATHOLOGYIN LUNG,CHEST,LIVER,GALL BLADDER.HE WILL ORDER FOR .BLOOD TESTS.X-RAY CHEST.ULTRASOUND.TREATMENT DEPEND ON DIAGNOSIS.MEAN WHILE YOU CAN TAKE PARACETAMOLE/IBUPROFEN FOR PAIN.APPLY,PAIN KILLER GEL LOCALLY.HOT FOMENTATION.ASK AGAIN WITH DETAILED HISTORY.AVOID SMOKING,ALCOHOL.FEED BACK TO HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mild fullness of the kidneys in the fetus during pregnancy?\n\nHi It s my 5th month of pregnancy..Dr. told me that there is some issue in both kidney of my baby.. According to radialogist report both fetal kidney shows mild fullness and fetal bladder is empty..i am much worried.. plz tell what to do..whats the reason?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. While development of kidney, utters & bladder in fertal body development. The reading of full kidneys &empty bladder can be seem while the things are yetto fully matured. So one finding is not to be considered for final diagnosis. Repeated readings after some in feral are taken before such diagnosis is made. Many a times normality is found in subsequent readings. So be cool. In case the repeated readings have same findings. Certain specific tests are done before coming to final conclusion. So just be positive and follow your doctor's advise. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of  seizure disorder?\n\nI went to see a neuro physician and he said I have a seizure disorder because I have periods of wetting the bed while I am sleeping.  My testing showed a small abnormality but they cannot be sure it is a seizure disorder.  They are baseing their diagonsis on the bed wetting.  I have starting to ween myself my afternoon dose of medication.  I have anappointment in a few weeks with my physician and will be asking him to take me off all the medication.  What is your feed back?",
    "doctor_response": "Hello!My name is Dr. Aida and I am glad to attend you on Healthcaremagic!You should know that it is not advisable to stop anti-epilepsy drugs on your own decision, without consulting with the doctor. These drugs should be continued for a long time (at least three years after the last seizure), because they may lead to uncontrolled seizures, if stopped before. A prolonged EEG or sleep deprivation EEG would help give more information on the EEG and seizures, and also help reassure you about your diagnosis. You should discuss with your doctor on these issues. Hope to have been helpful to you!Kind regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Azee, timnic and crocin be given to a child for throat pain and fever?\n\nhi, docter my daughter is 6.5 yrs old & she is having cold since tom. it stated with throat pain in morning till night she was having high fever, throat pain , cold & nose blocked, so I gaved her timnic & crocine ds yest. night, but she is having fever in morning also ,so can I give her AZEE 200 along with timnic & crocin ds pls advice. Thanks.",
    "doctor_response": "Hi you can give t-minic and crocin(paracetamol) but for a prescription drug specially antibiotics you need to consult your doctor for type , doses and duration  of antibiotics if required.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have acne problem. Not cured by clinda c gel and diprogenta cream. Safe remedy?\n\ni have never had any major pimple or acne problem till now. but some 2 months back i started getting very small rash like stuff on my cheeks. after some 3 weeks they kind of receeded. however again in a weeks time they resurfaced. this time some of them started converting into full blown pimples . i visited my dermatologist and he prescribed me clindac gel and dipgenta cream. i have been using it for the last one month and it hasnt given me any results yet. my small rash like things havent yet disappeared and few of them keep turning into pimples leaving behind dark scars..could you please help me with a fast cure and a safe remedy??",
    "doctor_response": "Hello I would recommend that you stop diprogenta cream. That is giving rise to pimples. You can treat with pimples with benzoyl peroxide 2.5% gel once in the day and clindamycin gel once in the day. Also use a facewash regularly. Do not pick on the acne or it could leave dark marks or scars. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can lactogen cause diarrhea in an infant?\n\nMy Son is 3 weeks plus and ahas been using Lactogen 1 as the mother breast feeding do not suffice. Bust for the past few day he has been having a loose stool after having been given Lactogen 1 though this is not the case when breast fed normally. What may be the cause ? What is the alternative bearing in mind that the mothers milk is not sufficient ? Thanks, Chris",
    "doctor_response": "breast milk is the best milk for baby . usually mother milk is sufficient for the baby , its is just about building in yourself that you can feed your baby well and the milk output will be fine . if milk is prepared hygenically lactogen 1 per se does not cause diarrhoea. try to prepare the milk morre hygenically with the proper dilution.otherwise you can use full cream milk without dilution. i hope this satisfies you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain and infection on the back of neck\n\nI have had staff infection about 4 or 5 times in the past 5 years. I am currently having same as the past but I cant see this time on the back of my neck. I had a friend look at it and said it is red and infected should I go to the doctor tomorrow or go to the emergency room now? Neck and back pain about 6 or 7. Darlene Black YYYY@YYYY",
    "doctor_response": "HI, thanks for using healthcare magicIt would depend on the severity of the infection.If it is extensive or painful then it may be best to be assessed as soon as possible so that treatment can be initiated.If it does not involve a wide area, does not appear to be severe, then you can consider waiting to see your doctor in the morning.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it necessary to take second dose of cytotec for abortion?\n\nhi Cytotec was perscribed by a doctor to me for abortion. on Friday night i inserted 3 tabs and within 5 hours i started bleeding heavily. i had severe pain and slight fever and upset tummy. He said i was to swallow 2 more tabs after 5 hours of insertion but i didnt do this as my bleeding was so heavy. Should i take those two tablets tonight or should i just leave them? and should i assume my abortion was successful?",
    "doctor_response": "Hi.Thanks for your query.Read and understood that you have already inserted 3 tabs of cytotec and bleeding and pain and slight fever started. Yes, you have to swallow 2 tablets after 5 hours of inserting the first 3. Anyways since you have not taken the oral dose, better to consult your Gynecologist as she would know everything related to your pregnancy, duration and may also examine you. Completion of the abortion can be confirmed by the sac expulsion and ultrasonography the next day to confirm the the cavity is empty.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will prednisone cause swelling in the arms?\n\nI m taking prednisone for a rash. The rash has gone away but, I work outside and now my arms and face are red and swollen. Especially my ears. Do I need to go see the doctor or just keep those parts out of the sun? I have four days left on the prednisone.",
    "doctor_response": "Hello, Prednisone does not cause any swelling, instead, this medication is used to relieve the swelling. The symptoms seem to be related to sun exposure. So, make sure that you don't expose yourself to the sun too much. I also suggest using Calamine lotion for local applications. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of Albuterol Sulfate?\n\nMy 35 yr old son has always used thee inhalation aerosols: Salbutamol /Assal......a new prescription of Ventolin HFA (albuterol sulfate) has been prescribed however he failed to ask thee Dr. regarding ANY side effect to the Albuterol Sulfate. Do U think it s OK to use IT or R these ingredients a danger? If U should answer....I thank U much, this is my 1st time using",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Albuterol is a bronchodilator (helps in opening the air ways) commonly prescribed for the quick relief of bronchospasm and wheezing associated with bronchial asthma and other air way diseases.Its most common side effects include increased heart beats, palpitations, and tremors.HFA (Hydrofluoroalkane) is a propellant (spray) used in the inhaler to move the medicine Albuterol out of the inhaler to get better deposition into the airways to produce bronchodilation.This propellant is safe and has no harmful effects as such.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mohammed Taher Ali",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and swelling on finger due to thorn/splinter?\n\nCutting down brambles in garden yesterday and got a small splinter/thorn. Finger was red, swollen and painful last night. Managed to remove the splinter and put on antiseptic cream. 12 hrs later and finger not as swollen but still a bit, hard to bend and stiff and painful. Oozing clear fluid if I press (looked to see if any small part behind and cannot see anything though hard when swollen (and on left hand which is my strong hand so needle wobbles!!!)",
    "doctor_response": "Hi there and thank you for your question.I appreciate your concern here and I shall try and help where I can.Bramble thorns break off quite easily and can lodge under the skin due to their size and sharpness. The issue though is that the tips of the thorns tend to break off and embed themselves under the skin.In effect, the body regards this splinter as a foreign body under the skin and an inflammatory reaction occurs. Blood rushes to the site of the wound in order to get white cells in the area so as to try and destroy the foreign body. That is why the finger would swell and become red and tender.The swelling then came down as you removed the splinter and the healing process can continue without there being a foreign body in the way to complicate matters. The clear fluid would be plasma that escapes which was formed as part of the initial foreign body reaction.You can continue applying the antiseptic cream for a couple more days just to help prevent an infection from occurring. The issue should then resolve on its own with the swelling decreasing on a daily basis.If the swelling, tenderness and redness starts to worsen then I would suggest seeing your doctor to assess the situation. Either there's then a secondary infection or there still is a foreign body stuck at the site of the wound.I hope this helps and good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does arthritis and hypothyroidism affect by-pass surgery and valve replacement?\n\nMy 62 year old mother had a heart attack requiring by-pass surgery and valve replacement.  She was in good physical shape except for r. arthritis and hypothyroidism for which she was on meds for.   She did not make it out of surgery.  Any reasons her arthritis/hypothyroidism had anything to do with it?",
    "doctor_response": "HIWell come to HCMThank for choosing to HCMI had gone through the history given here, if both the condition are well under controlled then she can be taken for surgery, but the latest test and the physical examination would give the final result whether the patient is physically fit or not, else it is nothing to worry if she is having thyroid dysfunction and arthritis,  hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Aching teeth. Have cavity, sinus troubles, pains when hungry. Rinsed using listerine & peroxide. Problem?\n\nyes! my top and bottom back teeth on my left side have been aching lately, but when i rinse with listerine and peroxide it goes away until i apply a lot of pressure. i have a cavity on the bottom, but it never bothers me until recently. I should also mention that i have sinus troubles and have been sick this week which is when this started. also, it hurts more when im hungry, but not  while i eat",
    "doctor_response": "Hello, Thanks for posting your query. I understand you are facing lot of dental problems. Listerine and peroxide help in prophylaxis or maintenance of oral hygiene. If you are having pain with your teeth, there is a possibility that you have decayed teeth which needs to be treated. Cavity also needs to be taken care of. If the cavity is not deep, filling can be done. Meanwhile you need to see an ENT to check your sinuses for infection. Take Care Dr.Sushma Rajesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is taking consolidation flag treatment safe for type M2 ?\n\nI am an aml patient type m2, now receiving a consolidation flag treatment. The initial induction was a different one ,but cr was achieved. I am currently responding well,no infection, only WBC is .05.and ply is 10. My question is if the consolidation is fine,do I need a transplant. Thanks.",
    "doctor_response": "Hi,Thanks for asking.Based on your clinical history and query, my opinion is as follows:1. Consolidation is necessary before a transplant.2. Yes, you will require a transplant as there is still mutation in your cells, which are capable of starting leukemia.3. Transplant will put new cells, which will proliferate and help you in complete recovery.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to donate my liver being a chain smoker?\n\nsir i am here for liver transplant of my father and i am the donor.i smoke 20 cigrattes a day and is smoking from 4 years and now i want to detoxify my lungs as quickly as possible because surgery is planned after 6 days.what u advice that i should go for surgery or not and if yes so whta should i do?",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.It is safe,but it casrries somewhat increased anasthesia risk. it wont affect the surgery process or rate of efficiency.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.DR. Ivan Rommstein",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can high fever, constant cough and inflamed tonsils in a child be treated?\n\nmy daughter is 4 years old she is suffering from high fever for the past three days, her tonsils are inflamed and are red, she is wheezing as well with constant coughing, we are giving levolin .63 for wheezing , do we need to give her an antiboitic as her fever is not coming down",
    "doctor_response": "Hi Dear,Understanding your concern. As per your query your child have symptoms of high fever which seems to be due to strep throat which is a bacterial infection. It could be due to poor and compromised immunity of body. Need not to panic about it. I would suggest you to 1)  Avoid giving child spicy and rough food. Take diet rich in soft food.2) Sip on lukewarm water and take throat lozenges.3) In case of fever you can take Calpol or paracetamol for relief as well as it will relieve throat pain too.4) Hot milk with a pinch of turmeric boiled with it at bed time for 2-3 days as it has antimicrobial action. 5) Take anti inflammatory drugs such as Levocetirizine.If symptoms keeps on persisting visit pediatrician once and get it examined. Maintain oral hygiene. Take proper course of antibiotics. Get blood tests done if required.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the purpose of Microdox in the treatment of infertility?\n\ni am 31 yr old ,Gender Male ..my wife & me are trying for a baby but due to health problems we were not able to suceed ..while consulted a doctor they have suggested me to have microdox lbx tablet for my health problem.. could you tel me why is this required to have",
    "doctor_response": "Hi ,Thanks for writing to HCM .Microdox contain doxycycline . It is antibiotic given for infections. I guess your doctor must have suspected sexually transmitted disease (STD)in you and prescribed microdox.The treatment for STD is antibiotic and avoiding sexual contact with wife, maintain good local hygiene . Once it is treated you can plan for pregnancy.  You should confirm from your doctor that the disease is cured.Hope I have been helpful .RegardsDr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the prickling feeling in my toes and fingers?\n\nHi Dr, I have pricking feeling on my toes and fingers. There is also a numb feeling on my right feet ball. Recently I have been having a bad cough and i have history of back acne. I have also been eating apples and oranges before going to bed at night. What is the lightly caused?",
    "doctor_response": "hi i apprecite your concern.you have not mentioned ur age,ther may be deficiency disorder of vit b12, vitD,and also any diabetes.you are advised to consult your family physician to rule out these by doind blood tests.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sharp pain in the left quadrant occasionally\n\nI am getting an occasional sharp pain in my left Quad, close to the pelvis on the outside side. It is only occasional, but feels like a hot iron. I am concerned that it could be a clot. I am about 40 lbs. overweight, have kidney disease and do Not smoke.",
    "doctor_response": "Hello, It left iliac region pain may be due to colitis or ureteric caliculi or cystitis or normal muscular pain. Until examination is done it is difficult to say what it is. Use tablet cyclopam twice a day for three days. Avoid spicy food and drink plenty of liquids. Please get it done ultrasound abdomen then get treated accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Penchila Prasad Kandikattu",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How do I control my anger?\n\nHi doctor, I have anger management issues and I am physically abusive in my relationship. I do not know how to control this and really need professional help. I cannot live without my girlfriend. I love her so much. Am I supposed to consult a psychologist or a psychiatrist? What am I supposed to do about this? Please help.",
    "doctor_response": "Hello. What you are describing sounds like intermittent explosive disorder which is an impulse control disorder. In it, there are explosive anger outbursts during which your anger makes you do and utter things which you repent after the episode. It is treated with medicines, prescribed by psychiatrists, as well as anger management techniques learnt in therapy with psychologists. If it is frequent and you need immediate help to prevent complications in your relationship, then I would advise you to see a psychiatrist to begin medication and start therapy with a psychologist. If it is not frequent or severe, then you can start therapy with a psychologist first and consult a psychiatrist if required later on. Hope, my advice is pretty clear. The core elements of therapy for anger issues has three aspects:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are pros and cons of home dialysis?\n\nmy partner had sumfng ibserted into his leeft arm fr a home hemodialysis in january ds year. three wks ago it started swelling on ds arm n da scar hs kinda moved . is there infection in ds arm n cn u explain the pros n cons of the home haemodialysis wts da difference between home hemodialysis n dialysis. email to YYYY@YYYY . txu",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.In every case of this is available, it should be always accepted to have home dyalisis since this is more practical and may spare you lot of time and be less psychologically traumatic. the obvious advantage of peritoneal dialysis is that regular visits to a dialysis unit aren't required and it can be carried out at home without needing any bulky haemodialysis equipment. One of the main disadvantages of peritoneal dialysis is that it needs to be carried out every day, which you may find very disruptive and another major disadvantage of peritoneal dialysis is that you're at risk of developing peritonitis however this is rarely seen and usually signs of this infection will be obvious so you will consult doctor on time if it happens.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for sharp breast pain and shortness of breath?\n\nI am a seventeen year old female. For the last couple of weeks, I have been having a sharp pain that lasts for a few seconds right underneath my left breast. The pain would  be a 7-8 (with 10 being the most painful) and last anywhere from a couple of seconds to more than ten minutes. However, lately, the pain has gotten worse (up to 9-10) and come more often, to the point that I must stop whatever I'm doing and concentrate on breathing. The pain is a sharp stabbing one, and whenever I breathe in or out it is as if a hot knife is being wedged between my ribs. I have a slight cough that I believe is credited to a cold that I have caught, but I have no nausea nor fever. Sometimes the pain moves to my right side or up my left arm or  into my stomach area. Recently, I have had chest pains (6-7) that feels as if my heart is squeezing itself. I am also plagued by constant migraines and shortness of breath as well as increased heart rate. I was put on some medication (Motrin 600 mg) however that did nothing to relieve the pain. I have gotten a blood test and a xray, and nothing has come up that is out of the ordinary. I have never smoked or done drugs or alcohol, nor been pregnant. I am healthy and relatively in shape.",
    "doctor_response": "Hello dear , hiWelcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This seems  in  relation with different  issues  as    -  rib  inflammation  -  ligament  sprain  or  strain  -  muscle  pull     -  neurovascular  bundle  related  issue  -  others  .*  Suggestions  at  present -  MRI  is  mandatory  to  evaluate  the  issue .-  Deep breathing  exercises , YOGA will help to some  extent .-  Tramadol  will be  better  option  instead  of  Ibuprofen  for  pain  relief .Hope this clears your query .Welcome for any further guidance .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Depo shot lead to worsening of IBS symptoms?\n\nIm a 27 year old women and I was diagnosed with ibs before I got pregnant. This all happened about a year ago and and back on depo again but now stomach pain is worst it fills like my stomach is pulling. My stomach is always tight and im still not going to the restroom. My question would be is the depo making my ibs worst or is it getting worst on its on",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. The depot may worsening IBS. Yes, progesterone does cause bowel symptoms. Please consider alternative birth control methods.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Aarti Abraham",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen and painful gums\n\nmy son is 18 mths old he is getting his first set of molers,the problem is that his gums are very swollen and sore and i think he is also getting in his eye teeth.will he be able to eat solid foods soon and how long does the swelling and pain last i have been giving him teething rings and baby orajel for the pain for food he is drinking well lots of milk and water baby food and mashed potatoes and apple sauce, will he be back to normal soon i hope so it started ruffly on Jan 10/15 todays date is Jan 13/15 i called my dentist they said there is nothing that tey can do for him.",
    "doctor_response": "in case of swollen gums the line of treatrment is  use warm saline gargles and gum paints.if scaling is necessary go with scaling",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long do cracked/broken ribs take to heal?\n\nHello, 2 years ago I fractured a couple of ribs on my left side. It still causes pain when I turn over in bed or move certain ways. Also, at times I will get a funny tingling feeling in that spot, like pins and needles. My doctor says the ribs have healed and should not still have pain. Just had CT scan and don t know results yet. It worries me because I am a heavy smoker and I m scared that this pain may be something other than the rib injury. Any thoughts on this problem? Thank you.",
    "doctor_response": "HiRibs heal in 3 ti 6 weeks, your aches and pains may be muscular or soft tissue, rib joints pain.Take diclofenac tabs, apply voltage gel locally after hot fomentation..it will be okay..Since a heavy smoker, get x ray chest done for lungs assessment for any bronchitis symptomsSee a physicianThanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nausea with pain in sternum?\n\nHi. I just had some roast beef on bread with mayonnaise-based horseradish sauce. About 30 minutes after, I started having nausea and some pain. The pain was about a 1 to 1.5 and located directly below (as in floor direction) my sternum. I also had a little pain in my back like a slight burning. It's starting to go away now, but I still have a slight bit of nausea and it feels like there's a slight \"lump in my throat.\" I took some omeprozole to help and it seems to have had some effect. Could this be my gall bladder? I have been having this same thing happen on and off for about 3 or four months now. And last time I went to the ER (about a month ago), they did an ultrasound on my gall bladder and had said I do have a stone.",
    "doctor_response": "Hi, Yes, there are a high chance it can be due to gall bladder. Doing an ultrasound again will help you to know increase in stone size/ number or inflammation. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for primary infertility?\n\nhello doctor, i am undergoing treatment for primary infertility. my tubes were detected unhealthy through HSG test. i have undergone laproscopy. Elisa for tb came positive so my doctor prescribed me 6 months antibiotics medicines. After this they will start with IUI and IVF. can u  recommend what type of diet should i take? also any chanced for me that i can conceive naturally? thanking u, gorgis",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.For IUI intrauterine insemination your one tube should be patent atleast.I would advise to avoid junk food, Do regular exercise, Do yoga.To conceive naturally, your ovaries must be ovulating, your tubes should be patent.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for treating cold and nasal congestion in a 10-month-old\n\nHi, My baby boy is 10 months now, suffering from cold since 5 days.My pedestrian gave Dr.Reddys mucolite syrup but since it was not available got Sinarest drops.Still the cold has not reduced can u suggest me what other option do I have.Running nose n sometimes nose block.",
    "doctor_response": "Hello, Cough and cold are viral 95% of the times in children. For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. For cold, you can use Cetrizine. For the nasal block, plain saline nasal drops will do, every 4-6th hourly to relieve nasal congestion. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to control my mother's blood pressure?\n\nMy 90 year oldmother has had a blood pressure reading of 121 over 70 the last 3 weeks. SHe is already on 40 mg of lisinipril. Her bp varies a lot. She has back and knee pain and is not getting much exercise due to the pain. She woke up the other day with a ruptured eye bllod vessel.Her doctor has been reluctent to increase her meds because he does not want her to fall. Suggestions?",
    "doctor_response": "Hello ,I am Dr. Most and I would be addressing your concern . The blood pressure you may mentioned is pretty much perfect and there is no indication of increasing the medication for 121 / 70 reading . Also her doctor has taken an appropriate decision , as you have to be very gentle at the age of 90 years as any decrease in blood pressure can be detrimental.  Also there is some narrowing of brain  vessels at this age and hence many doctors prefer maintaining the blood pressure in higher range to maintain the perfusion to the Brian .Regards Dr. Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurrent adenovirus infection?\n\nmy family has all had adnovirus the last couple of weeks with all the typical symptoms including conjunctivitis.  Mine has returned again without even a weeks break from it.  What is the cause of that.  we are washing and cleaning around here like crazy!",
    "doctor_response": "Thanks for your query at HCM!Adenovirus, a DNA virus which causes respiratory infections, pharyngoconjunctival fever, keratoconjunctivitis, diarrhoea, etc depending upon serotypes of virus. It spread occurs via the respiratory route and contact with ocular secretions during the acute illness among  family members.Most infections are mild and require no therapy or only symptomatic treatment. You can use topical antiobitic for eyes.If your problem still persists with disturbance in vision then you must visit an ophthalmologist. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes these symptoms?\n\nI have had an almost cold for 10 days now. It started with my nose occasionally running from nothing though not being blocked and a pain below my eyes. Since then I cough up an occasional bit of phlegm but my neck is hot, my head is tired, I have a hot back, nexk and sometimes chest and a lightness or ache in my arms and legs. It feels like the start of a cold but never turns into one and I m being lethargic and tired all the time yet not being visibly ill to others",
    "doctor_response": "HI, thanks for using healthcare magicThe common cold can sometimes last up to 2 weeks. Symptoms of fatigue can persist even after the other cold symptoms have resolved.There are over the counter medications that would be able to help you with the pain, nasal congestion, coughing, fever.Paracetamol would help with pain and fever, ibuprofen can also be used instead or along with this if the paracetamol on its own is not effective.There are oral and topical decongestants (eg normal saline or otrivine).If the cough is wet then you need to consider the use of a mucolytic to break up the mucus. Examples are mucomyst, bisolvan, guiafenesinRest and using enough fluids are also important.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Esophagus cancer, chemo done, tumor is protruding to the upper most part of the stomach. Advice?\n\nmy father has stage 4 esophagus cancer he has had a year of chemo and today they stented the tumor area and took another biopsy. The tumor is protruding into the upper most part of the stomach stightly, but everything else looks good the dr said. I am just wanting to know what the chances of his survival with this cancer now protruding in the stomach area? what other steps other then the chemo should be done. They have done a wonderful job so far but cancer is just one of those things to me that Is treatable but is it curable?",
    "doctor_response": "Hi and welcome to HCM,thank you for your query.Stage 4 is practically not curable,even stage 3 isnt. Esophageal cancer is very serious disease with poor prognosis,but you should fight and give your best to make all this easier for your father. If this isnt operable and obviously isnt if there is involvement of surrouding tissue and organs then chemo is the only possible treatment- Everything else is palliative . He may have resection of stomach and ileostoma formation when obstruction develop and thats everything that surgery can do.Wish you good health. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is undergoing third brain tumor operation safe?\n\nHi,my sister already underwent twice brain tumor operation. now again  doctor has adviced her to undergo another operation. otherwise she will not  be able  to survive for more than a year. under the circumstances, is not it a good idea  to go suicide.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  She may have some high grade tumour.  So she needs surgery.  Please send me her reports of brain tumour so that I can help you further.  And if she has suicide thought then consult psychiatrist also for treatment of depression. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had hit the top of head in a pool and was kicked at same spot. Head hurts now. Suggest?\n\ntoday i went to the pool and i hit the top of my head at the bottom of a pool trying to do a back flip mean while i landed on the top of my head so i got out and sat for a little then i got back in and was playing with my cousin and he kicked me in my head in the same spot now my head hurts worse than before. What should i do/",
    "doctor_response": "Hi,Any head injury should be observed for 24 hours for having signs like vomiting, nausea, giddiness, loss of conscious etc.At present if you do not have any signs, wait and watch the condition.It is advisable to consult your doctor to have any clinical signs of head injury.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce stress in life?\n\nI am under a lot of stress right now, my husband surgery, me working, not enough time to do everything, no one to help me, every day late afternoon I feel like I can't breathe, same thing when I get home & see equipment all over the place, then I go out walking w/my dog and come back feeling better.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. You are lucky. You are managing well. There are so many people who does not. Let me assure you. You are on the right path. Everyone are stressed in one way or other. How to manage. Thinking that they are stressed increases the stress and they become more worried. Running away from stress is possible for some time. But stressful situations come again and again. Where to run? The only way out is to understand and stress and live happy with the stress existing and you not worrying about it. There are several ways like Cognitive Behavioral Therapy and Logo Therapy. Prescribing a therapy here is beyond. You can ask a premium question to me with all possible details. Be as descriptive as possible. I am sure that you will be able to manage stress successfully. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I treat cerebral atrophy and kidney deformation while undergoing depression and anxiety?\n\nrecently diagnosed with symmetric diffuse cerebral atrophy mild to moderate degree. I have 3 misaligned, herniated bulging discs in neck as a result of car accident, 2 herniated bulging discs in back and several tarlov s cysts on sacita on right side. Doctor said not to worry. Rencently found out my right kidney is deformed and have moderate occult blood in urine, GERD, chronic PID and IBS since in my 20 s. Also have had severe depression, anxiety, cognitive changes, chronic fatigue and pain for past three years. Is there any connection between recent MRI of my head and other health and physical problems. Been told my problems are due to depression.",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern and this is very right because you do have lot of health issues and you are really fighting with all of them, with your strong will power and this will become more powerful if just leave your stress, anxiety, depression, and other functional entity aside, then it will be winning shot for you If I would be your doctor then I would put you on Tab. \"Chlorodiazepoxide\" one tab, three time in day this will help you lot, take care and have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had breathing problem and cold coming from lungs but died of liver cancer\n\nI m have a question about my brother that happened years ago. He died at 34. My mother told me he had liver cancer when he died. He was having problem with breathing and alot of cold coming out of his lungs. when i went to see him he was sudatied. they let him die under when he didn t know. Thats elizabeth",
    "doctor_response": "Hi and welcome to HCM Thanks for the query. there are several possible scenarios. he might had lungs metastases so in this case it was inoeprable liver cancer and treatment is only palliative,also he could have pneumonia or respiartory insufficency which is usually seen in liver cancer patientsWish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could delayed period be a sign of pregnancy?\n\nHi, you see, I have recently lost my virginity. My boyfriend and I had sex for the first time on Dec 31st. We had sex a couple of times on that same date, and the same happened on Jan 1st. We used protection, condoms to be more precise and we are pretty sure that these were not nor did not break during our sexual encounters. The problem realies on the fact that I was supposed to get my period on Jan 1st. (So the days that we had sex on were certainly not fertile days for me) now, my period has not come and I took one of those pills for the next day on Jan 3rd. It is almost Jan 5th and my period has still not appeared. My belly hurts like if I was to get my period but I have heard that those are also symptoms of pregnancy. My question is? What are the possibilities that I am actually pregnant? Also, I have read online that it is usual for some girls to get their period delayed if they had sex for the first time, and especially if they had it around the date that their menstruation was about to come. In this case, and knowing that I took the pill, how many days do you think that my period will get delayed for? Thank you very much for your time.",
    "doctor_response": "No chance that you've got pregnant.as you had relation a day before your period.prolongation big your period is mere physiological or the pill you've taken can cause.so Don't worry. Keep calm and have safe relationship.THANK YOU.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why have I missed my periods for past 2 months and have abdominal pain?\n\nHello, I was diagnosed with endometriosis after having laproscopy in 2010. I kept having periods fo as long as15 days. However, for the past 62 days I have not had a period. My lower stomach is a bit swollen. I had very little pink discharge found on my toilet paper. (sorry for the information but i have to be clear about what is going on.) I do not have any pain but I just feel very swollen. I also had a bit of blood discharge after sex. I took 2 pregnancy tests (EPT) and they were negative. Please give me some feedback. Thank you.",
    "doctor_response": "Hi ! Good evening. I am Dr Shareef answering  your query. Even though the EPT could be negative, I would suggest you to go for a serum HCG estimation and an ultrasound of abdomen to confirm or rule out with certainty an unsuspected  pregnancy. Apart from that an ultrasound would also give the treating doctor the latest information on your endometriosis. I would suggest you to anyway consult a gynaecologist for a clinical examination and related investigations for a definitive diagnosis, and further management.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of sleeping pills?\n\nHi my dad took 2 sleeping pills about 20 minutes ago. And he has been dozing off and on. He is incoherent and has a horrible fever. He has had a cold for a couple of days but for the past two nights in his sleep he has been wheezing very badly and will wake up for about a minute and will talk almost like he is sleep talking and then will go back to sleep. is this a sign of an overdose or what is going on with him?",
    "doctor_response": "Hello, I\u2019m worried that your father has an infection because you say he has a fever, wheezing and had a cold before. The cold might have progressed to something more serious in his respiratory tract. You should bring him to a doctor so they can listen to his chest/lungs and examine him and make sure example does not have bad bronchitis or a pneumonia.With regard to the sleeping pill. If he took a double dose it can certainly be to much medication and cause him to be confused and \u201csleepwalk\u201d.  It should eventually clear from his system and he should be OK. Of notebis b\u00e1t infections can cause confusion in order adults as well. Adults over the age of 65 in general should not take sleeping pills because there is a higher risk of side effects after age 65. Good luck. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Kamila Seilhan, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are ganglion cysts?\n\nHi Dr Samuel, I have just found out from my daughter, that she has leaking wrist, (not that I understand that is) but she said, it is called, Ganglion Cysts. Can you please explain this to me, and is it or can it be life threatening? I have Fibromyalgia, could this be associated with her getting this problem. Your Sincerely Michelle Moke",
    "doctor_response": "Hi,A ganglion cyst is a fluid-filled swelling that develops near a joint or a tendon. The cyst can range from the size of a pea to the size of a golf ball. This is not a serious complaint. Ganglion cysts look and feel like a smooth, soft lump under the skin. They are made up of a thick, jelly-like fluid, called synovial fluid, which surrounds joints and tendons to lubricate and cushion them during movement.There is no need to seek medical attention unless she experiences pain, swelling or stiffness of the area. They can be removed surgically if needed. Regards,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a large growth on the top of the head a concern?\n\nMy Husband has a growth on the top of his head. Has been there awhile, just scaly but the past 4-6 wks it has grown up out of his head and gotten about the size of a dime or larger. I showed a pict of it to a Dr friend she thinks its a basil cell crater. My husband is in an Alzheimer s facility Does this sound like what my friend said? And if its a crater does that indicate it is growing inward? I m not sure how invasive to take this What are the pros and cons to treating this?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice I would advise you to do a CT scan of head. If non-malignant in biopsy test then the growth on head can be removed by surgery. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can formula feed cause irritation in a child?\n\nHi. My baby is 2 weeks and 2days old. I m not breastfeeding her, but she seems very irratable everytime she has a formula feed, and cries alot. Due 2 complications after the birth i. Did not breastfeed. Can I start 2 breastfeed now 2weeks later. Thankyou.",
    "doctor_response": "Hello. I just read through your question.As long as you are able to produce milk, you can definitely begin to breast feed now. In fact, it is encouraged. I recommend consulting with your doctor to help guide you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have typhoid. Taking indocin200, olzep-d. Started loose motion, allergy all over body. Should I stop medicine?\n\nHi,Am suffering from typhoid ,doctor prescribed indocin200,olzep-d,phase-am,himococid for the last 2weeks course.After 2weeks course i have loose motion.The last course has started since yesterday.she prescribed olzep-d,woflox,multivitamineral softgels,....Lootion motion hasnt stopped yet plus ive allergy all over my body so again i visited her today.She prescribed darolac,calapure,redeotil and setr something which is not visible.She injected me as well.After 30mints it was fine.Now again i could still see allergy all over my body.i just wanted to know y am getting allergy? Should i stop my course medicine.Please advise..",
    "doctor_response": "theseare drug allergies and if you dont require you canstopbut if you require change salt of drug in consultation with doctoreven if you stop it now it will take 3 wk with medicine to go fullystop vitamins as they trigger allergycontinue anti allergic and add cpm 1 tab at nightapply antiallergic ointment locallyand calamine odtake lot of water3 wk required after stop drug takin",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for atrial septal defect\n\nDx with ASD hole, cardiologist stt born with it. At the time Dec 1, 11 I was told they could do cath. surg to fix. But not seems like there putting that off, I m also anemic... not sure why Doc. now want to wait, tell me to take my time... I m 47 and do not want to wait till I get to old. I m on warfarin, ferrous, something for gerd, and simavistan, what should I do?",
    "doctor_response": "Welcome and thank you for asking on HCM!I have gone through you question carefully. there There is no hurry to close the ASD now. Its an elective procedure and can be done after complete treatment of other conditions like anemia etc.Hope you will find this answer helpful!Wishing all the best, Dr. D Sunil Reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have ankle pain in my left foot while walking and massaging does not help. Why?\n\nHello doctor, I have a history of ankle pain at the base of my left foot, and it causes pain when I walk. I went to physical therapy a few years back when it started, it worked for a while, but it came back a few months later. Massaging the area causes a lot of pain, and makes it more difficult to walk. I am not sure what has been causing this? I am taking Lexapro.",
    "doctor_response": "Hello. I understood your concern. First, you stop massaging it is contraindicated. It will promote more swelling and pain. Apply ice for 10 days. Physical therapy should be continued but in the observation. Take ultrasound therapy over heel with an analgesic gel for 10 days. Ask your doctor to provide manual therapy for ankle joint for mobilization and strengthening exercises to improve the strength of muscles surrounding the ankle joint which gives more stability, and gradually the pain decreases. Continue this protocol of exercise for one month dedicatedly. I hope this helps. Continuous overactiveness. MMT (manual muscle testing). Ultrasound therapy. After 15 days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is invasive intraductal breast carcinoma curable?\n\nHello doctor, My mother has been recently diagnosed with invasive intraductal breast carcinoma. I am currently outside the city and have not seen the reports. But, she told me that it is malignant and has spread to two lymph nodes. There is no metastasis. Doctors have told to start chemotherapy for four months followed by surgery. I need to know how bad the condition is and is it curable?",
    "doctor_response": "Hello. I would definitely like to see the reports. But, as per your history if it has already spread to lymph nodes then it has locally advanced. What is usually done in such cases is to give new adjuvant chemotherapy followed by surgery and radiotherapy. Though I have limited information, the stage would be at least II, might be III also. Breast cancer has different subtypes based on its molecular profile and treatment might also differ according to that. What I told you is a general outline. Yes, it can be cured in around 70 to 80 percent in this stage. But, depending on other adverse factors, the figure may come down to 50. For more information consult a medical oncologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest possible diet food for a 8 month old?\n\nHello, I am a grandma of an 8 month old girl. She weighed 6lbs 6 ozs when born last May. She is now 8 months and weighs 14lbs 8 ozs. She is happy and healthy, but never seems to be interested in food or milk. My daughter breast feed until 6 months, but because she wasn't gaining well she decided to switch to formula. She has been getting cereal, vegetables and fruit for about 3 months now, but every meal is a struggle for my daughter and at the most she will only eat a couple of tablespoons of cereal or an ice cube size portion of vegetable or fruit. The most she will take at a bottle feeding is 5 to 6 ounzes, but most times this is much less, around 3 or 4 ounzes. My daughter sees other friends that have younger babies and how much they eat and is worried. Do you have ant advice?",
    "doctor_response": "The most important advice I can give you is that every baby is different and have different rates of metabolism. Some kids need more food to generate the same weight gain, some, less. In my humble opinion as a pediatrician, I think your granddaughter is doing quite well, weight-wise, so I would not worry. I would suggest you stop bottle-feeding her completely and let her decide how much she wants to eat with a feeding cup. This is completely possible - and you will find that she will accept milk more readily.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain under the left breast?\n\nHi I am a 43 yr old female smoker and have been experiencing ''''pains'''' under my Left breast.  Not all the time, BUT does stop me in my tracks.  Lasts less than a minute?.  Think maybe stress, But heart problems run in my family and a tad concerned.  Any ideas???",
    "doctor_response": "I need to know whether these pains are related to exertion. Do you have any hypertension or diabetes? Any other chronic disease? If these pains just come and goes on its own they must probably be due to stress, or musculoskeletal in origin. just visit you general physician for detailed history and examination. i do not think you need to worry at this point of time",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. If routine and culture urine tests are normal, is chlamydia and gonorrhea test necessary?\n\nHello doctor, If a persons routine and culture urine test is normal, does he have to do separate tests for chlamydia and gonorrhea? The patient has headaches and sleepiness throughout the day and burning sensation in urine at times.",
    "doctor_response": "Hello. No, not needed if there is no pus cells on routine examination. This also depends whether one is having symptoms or not. Occasional burning usually occurs due to dehydration and most of the times this burning is also associated with yellow urine which further suggests dehydration. So should drink plenty of water to avoid dehydration and burning. Also, patients with gonorrhea and chlamydia will have frequent urination, constant burning, fever, pus in urine, etc., which suggests infection and then needs some specific investigations, but not in your case. Do you snore at night? Do you get episodes of interrupted sleep, frequent awakenings or temporary stoppage of breathing as noticed by others? If yes, then there is a possibility of obstructive sleep apnea which will lead to excessive sleepiness, headaches, etc. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have bad tooth, soreness in gum, swollen face. Suggestions?\n\nI have a bad tooth that has behaved itself mostly for some time.  it has been sore to press on the area under my nose above the gum and to bit hard on it . .or if food gets into the decayed area . .but otherwise no biggie.   This morning I woke up and my face is swelling in that area and sore . . . . the tooth no longer hurts however even to bite hard on it.  Suggestions",
    "doctor_response": "Hi,Thanks for asking the query,According to your symptoms i suppose that you have developed infection in your tooth this had spread to the periapical tissue leading to pain and swelling.I would suggest you to visit to an Dentist.Get an x-ray done.Start with root canal treatment of the tooth.Take complete course of antibiotics and analgesics.At home take lukewarm saline and antispetic mouthwash rinses.Hope this helps out,Regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having pain in right side towards back and above hip?\n\nFor the last few days have a pain in my right side towards the back about a handsize above my hip. Could it be liver or kidney? Had Liver function Test done, only my ALT was 78 s.b. between 0-45, I am 87 y.o. male. Years ago I was told I had a Fatty Liver??? Kindly advice. Carl.",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have pain in back on Rt side .This is most likely to be due presence of stone either in Kidney or Ureter.Please consult qualified Urologist to clinical examination and get following basic tests done to confirm the diagnosis 1)Routine urine test and urine culture 2) Ultrasound scanning of the abdomen to rule out stone.In the mean while take broad spectrum antibiotics like Cefexine along with urinary antiseptic like Nitrofurantoin twice daily and urine alkaliser thrice daily and pain killers like Diclofenac twice daly..Later on switch on to appropriate antibiotics as per culture report.Get the prescription of medicines from your family Physician.Ensure to drink more water.To keep your urine dilute Further treatment will depend upon the results of these tests and final diagnosis,Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will medicines help in improving major depressive episodes?\n\nHello doctor, I Just went to GP today for medication. I had to force myself. Only 30 and suffering major depressive episode. Had it before I feel I left it too long. I have tried some treatment medicines without success. I did not really want Seroquel but I just got 25 mg and 50 mg of pristiq. My depression is that bad I am basically stuck in my room. I know tablets cannot probably get me out of this cause this time it is really bad. If they can give me some boost to then be able to do things that could help. Is that combo possibly effective sometimes they say it might be by adding one. I know they have there nasty side effects though. Would you recommend taking it long term or one month until antidepressant takes effect or what, I am so confused.",
    "doctor_response": "Hello. I can imagine how hard it is for you to be in this situation. Depression takes a toll on us in the worst ways possible, you should appreciate yourself to be able to reach out to get help, because many people cannot even find the strength or awareness to reach this point. You are correct that only medications will not be able to pull you out from this. However, you need to continue medication atleast for 6-8 months even after you start feeling better because that's the minimum duration required for medication to balance the neurotransmitters involved and to be able to prevent the relapse. Secondly, I would suggest you to start counseling therapy session. What you can do is start therapy online. Most of my patients who are not yet willing to go out every week and travel to a therapist opt for therapy sessions online. Psychotherapy and cognitive behavioral therapy will help you with your thoughts and getting a control over the negative thought patterns which are keeping you in the loop of negativity and Depression. Medications when combined with therapy is going to show good and faster results.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high blood pressure , heart palpitations and headache\n\n3 weeks terrible pressure headaches, BP elevated 170/99, main problem I feel like my heart pauses, with a heavy lingering beat, and then a Rush of pressure to my head, I freak out because I think I m going to have a heart attack, worse at night, I used to love to sleep, not anymore",
    "doctor_response": "Greetings. Thank you for your question and welcome to HCM. I understand your concern. Well, the added symptoms like insomnia are coming from the fear that something weird is happening to you. Everything can be explained by your anxiety, you are experiencing from these episodes. Psychological stress is a major factor one producing high blood pressure, which in turn produces the pressure headaches, and the anxiety, which is accompanied by a flush of adrenalin, can cause extrasystoles. Extrasystoles are extra heart beats, not generated by the normal pacemaker of the heart, but from an ectopic \"beacon\". The normal heart beat that comes after extrasystole, is more forceful and produces the feeling like heart is pounding out of the chest or throat - palpitation. Anyway, every single phenomenon you described has a logical and physiological explanation. However, even though my suspicion is low, regarding a possible cardiac origin of your problem, I would like to recommend some tests, to exclude the cardiac origin with the highest certainty, or confirm a possible heart problem:- echocardiogram - to evaluate the function and size of heart chambers and valves - 24-hour blood pressure monitor - to see if these high figures happen one time a day, during stress, or if they are constant throughout the day, in which case proper and immediate treatment should be started to control blood pressure and keep it under 140/90 mmHg. - EKG- cardiac stress test, if seen reasonable by the cardiologist that assesses the above mentioned tests. I hope I was helpful with my answer. Take care. Best regards, Dr. Meriton",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Do I need crutches for grade 1 ankle sprain?\n\nHi doctor, I had a basketball game, and someone landed on my leg. Now, I have a grade one sprained ankle. I have a basketball game next week. I want to play, and I am wondering whether my ankle will heal soon? Or if I want to play, should I need to use crutches for a bit? Currently, I am taking tablet Melatonin, Concreta, and Lovan.",
    "doctor_response": "Hi. Crutches are advised if you cannot be able to beat the weight. If it is the case, then you will be having more than a grade 1 sprain. I will advise you walk without crutches, ice the area, elevate and use a compression bandage. Also, take anti-inflammatory tablets. For more information consult a physiotherapist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain under left rib while breathing with heartburn and indigestion?\n\nI get pain every so often under my left rib it can be severe where it hurts to breath to just like a pinch off and on during the day it seems to go away if I burp and take a gas X . I get heartburn and indigestion alot And I  have alot of stress in my life . I am 40 years old 5'8 180 lbs . I don't have any other medical problems other than having this every so often .",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, possibility of GERD (gastroesophageal reflux disease) is more.. GERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause symptoms of chest pain, burning epigastric pain, burping, belching, chest tightness, pressure etc. Along with antacid (gas x), you should also follow below mentioned lifestyle modifications for better symptomatic relief. 1. Avoid stress and tension. 2. Avoid hot and spicy food. Avoid junk food. 3. Avoid large meals, instead take frequent small meals. 4. Keep 2-3 pillows under head in bed to prevent reflux. 5. God for walking after meals. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for mild pain in my lower back\n\ni started a mild pain in my lower back last evening. I went off to sleep but did not have a good sleep as it would pain at night. In the morning when i woke up it again started to pain and it became worse with me getting severe pain at times. Now the situation is such that I am better when I am lying down on my sides but i find it difficult to stand. What could be the reason and is it very serious?",
    "doctor_response": "Welcome to health care magic. 1.The possible cause could be age related degenerative changes in middle and elderly patients, where as positional abnormalities in the younger patients. 2.In this case the treatment will be simple back exercises. 3.If does not gives relief - you may need to get an x-ray spine for a over view of the spine and intervertebral disc spaces, depending on findings physiotherapy will be helpful.4.Finally when no betterment - an intervention / operative treatment is recommended, before that an MRI to confirm the diagnosis.5.For back exercise please follow the link.  luck.Hope i have answered your query,any thing to ask do not hesitate to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain on the right side. Undergone tests. Increase in parenchymal echogenicity in liver. Suggestions?\n\nI have been having pain on my right side so I visited a clinic in Abu Dhabi (UAE) - am working here - A CBC was done and an ultrasound. The spleen, pancreas, gallbladder, kidneys and bladder are all normal. The liver shows a mild increase parenchymal echogenicity. No focal solid or cystic lesion noted. The cbc found the ALT was 54.7 and 0-50 being normal. The AST was 29.7 and 0-40 is normal. What do you think?",
    "doctor_response": "hi.. you have pain in the right hypochondrium.. mild raised liver enzymes and altered liver ecogenicity in the ultrasound examination.. could be viral hepatitis/early alcoholic liver disease.. get one HBsag and antibodies for Hepatitis A to rule out viral hepatitis...if it is ruled out, alcohol if you are taking should be abstained.. take multivitamins and liver enzymes.. take fresh fruits and vegetables..see your physician for getting liver protectives like silymarine..all the very best..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in arms?\n\nMy left arm has been hurting all day I woke up to it and I can t lay on it or it hurts really bad. It s hurting mostly my lower arm and hurts bad in between my elbow. My hand hurts every now and again but my arm is throbbing and very painful... It s not swollen but it s almost had me in tears... What could this be?",
    "doctor_response": "hi you have throbbing pain in your (L) hand , elbow and lower arm . I think it is due to pressure on one the nerves in your neck which is radiating to elbow and hands . I would recommend Pain killers , pregabalin , Neck Exercises for 7 days and if there is no improvement then I would go For X Ray cervical spine AP/Lat",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in back of neck, pins and needles in upper back?\n\nHi, your advice please. MALE  age 54 // Dated 17.03.2011 Blood test - Vitamin D 25 Result 28.614 nmol/L & UltrasoundBones Densitometry Result : 41.24  dB/MHzACTUAL SITUATION  On Health Aid Vitamin D - 500 iu \u2013 one cap per daySevere pain and burning from back of neck ( C2/C4) upwards to head. At time acute  pain  and  pins & needles  at a fix point at left upper back Burning sensation over face \u2013 cheek, chin , jaw-bone  & forehead Pains in both  hands - fingers-bones & wristSleep not sound ( short and disturbed )",
    "doctor_response": "Here as per your explanation looks like you are deficient with calcium and vitamine D but you have also inform that you already have started having vitamin D and calcium tablets. Here,  I suggest good you have started with it but as per my suggestion I always give natural organic supplement source tablets for vitamin D and calcium. So you can have check once in what you are taking,Apart from this neck pain and pins and needle sensation at back could be related to spinal issues like problem at spinal curve, problem at spinal disc, inflamation in entire spine ( spondylitis ) , degenerative disc issues, etc. How ever the conformation will be done by MRI of entire spine. And based on report here ortho pedic doctor will suggest for treatment. If there is major issue then you need to go for possible surgical correction and if there is mild to moderate problem then doctor will ask you to follow up with medication and physiotherapy treatment.I suggest also take suggestion from physio for postural correction and spinal exercises for long term relief as well to improve strength and stamina of spine.You can also use hot and cold pack for some more relief.I am sure you will be fine if you follow all above advice a step by step. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. After 96 hours of phototherapy, my baby's bilirubin is fluctuating. What can be done?\n\nDear doctor, My 18 day old baby had gone for 96 hours of phototherapy. Her total bilirubin is fluctuating from 19.5, 14.5, 13.5, 13, 11, again 14 in 12 days. What can be done now?",
    "doctor_response": "Hi. Before advising you about the child, I need some information: Bilirubin may fluctuate during the treatment with phototherapy and the level of bilirubin depends on the maturation of the liver. And the rate of production of bilirubin in the child depends on the cause of raised bilirubin. If there is any incompatibility of blood groups between the baby and the mother, the bilirubin may rise in spite of phototherapy. But nothing to worry as the level of bilirubin of 14 is not dangerous around this day of life in case of babies with normal birth weight. It can be managed by phototherapy and adequate feeding of the child with breastfeeds to maintain hydration, which in turn lowers bilirubin. In spite of phototherapy, if the bilirubin is increasing, then the child needs further investigations to look for other causes such as hemolysis, hypothyroidism, and other problems. If the fluctuations persist, consult a paediatrician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe lower chest pain that radiates to my ribs and back?\n\nI have had severe lower chest pain that radiates to my ribs and back. I have tried numerous carbonated beverages over the last 24 hours and I can't get complete relief. In the last 30 minutes or so, I started belching up a foamy substance. What is wrong with me?",
    "doctor_response": "thanks for your question I completely understand your question chest pain radiating to back can be due to variety of reasons/ causes like gastritis , peptic ulcer , or cardiac causes.you should consult a general physician who can request for an ecg , chest xray to rule out certain causes.for now you can take a proton pump inhibitor like pantoprazole once daily after consulting your physicianthanks feel free to ask more questions may god bless your family with good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes light headedness, heart palpitations and feel of blood rush?\n\nI have heart palpitations, sometimes I feel as though I feel a rush of blood or something going thru my chest, I know it sounds weird, I get light headed and I am always tired.  I have an appointment in November to check my heart.  Should I be worried?",
    "doctor_response": "I have gone through your question and appreciate Your concern. U may be suffering from arrhythmia and Ecg should be done To rule out this.If required holter monitoring can also be used to know the type And severity of irregular heart rhythm. Thanks. U can write me back for any query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should one wait before trying to conceive after removing Minera IUD?\n\nhad minera IUD places approximately 3 1/2 years ago.  I am scheduled to get it removed friday November 19th.  have read a lot of personal experience stories and am scared from all of the stories about women who get pregnant almost immediately only to miscarry.  How long should you wait before trying to conceive after removing minera?",
    "doctor_response": "Hi, I think there is no problem in conceiving after mirena removal. You can start trying anytime after its removal. Generally it takes 6 months to one year  for ovaries to regain it's function after removal of mirena. So, it may take some time to conceive, but there is no risk of miscarriages even if you conceive immediately after removal.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for regular masturbating\n\ni masterbate daily 2 to 3 times i m getting weak i want sex but i dont have girl friend i never made any sex in life i m 23 male",
    "doctor_response": "Hi,Thanks for writing in.It is said that masturbation is normal 2 to 3 times a week. At your age, even if you want to do daily, please do not do it more than once a day. You need to keep yourself interested in other areas like study and work. Eat healthy food and go for regular exercises. Do not allow sexual thoughts to come to your mind. Having sex with unknown partners can be dangerous and give you diseases like HIV and STDs, besides if you have a sex addiction then it will be difficult to control your impulsiveness and this can cause further trouble.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lumps in testicle\n\nI have a lump on my left testicle. It was found at a urologist appointment. In a year it has doubled in size. He said it was nothing to worry about. no tests of any kind was done. It doesn't pain me unless you squeeze it a little. It is now half the size of the testicle. Should I get a second opinion?",
    "doctor_response": "cysts arising from the epididymis are common and nothing to worry  about.  get a scrotal usg to confirm",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of dicorate 750 intake?\n\nhi, i am a 25 year old woman prescribed with dicorate 750 once a day by my doctor. What are the possible side effects, anything related to pregnancy? will it cause weight gain? will the dosage increase in due course or be a condition where patient is addicted to medicine and will have a tough time coping up?",
    "doctor_response": "Hi, Purpose and duration of taking dicorate-750 not mentioned. Dicorate-750 (divalproex) is commonly prescribed to treat various types of seizure disorders, manic episodes related to bipolar disorder and to prevent migraine headaches. Dicorate-750 is unsafe to use during pregnancy as it is known to cause fetal malformations like spina bifida, small face, cleft lip and palate, and multiple defects involving heart, bones and kidneys. Its common side effects include dizziness, nystamgus, drowsiness, ataxia, weight gain, loss of hairs, and liver dysfunction. Its initial dose is 750 mg per day in divided doses. The dose may be  increase to 1000 mg/day to have desired beneficial therapeutic effects with a maximum dose of 60 mg/kg/day. This medication is not liable for addiction hence you need not worry about it. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for 1 grade bilateral renal parenchymal disease\n\nMy mother when got an ultrasound, the report shows all organs have normal study and no calculus found in gall bladder as well as in kidneys. But the impression of the radiologist is that she has 1 grade bilateral renal parenchymal disease. What is this , what is the implication and what is the treatment",
    "doctor_response": "Hello and welcome to HCM.As an Urologist,i can understand your concern.To know the significance of the scan report,she'll need to do certain tests :1. urine routine,culture,ACR or a 24 hours urine protein.2. blood routine,creatinine,RBS,LFT,platelets and electrolytes.Show the reports to your doctor,or send them to me,as a direct question.After seeing these reports,i can give you an expert opinion.Wishing her well.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had tonsillitis, ear pain, swollen lymph nodes, cold sensation in throat. Quit smoking. Cancer?\n\nHey my name is tristan and I m 17 years old, about 2 years ago around this time in 2011 I got tonsillitis when i quit smoking (i smoked since i was 11 but not regularly until i was about 13) i remember one night my right ear hurt so bad inside i cried, and since then my lymph nodes have been swollen and i get a cold feeling in my throat sometimes, i got head rushes before around that time and i m scared i might have cancer , would that be possible at my age?? i still smoke but i plan on quitting right now for good",
    "doctor_response": "Hi, Your presentation suggests you are suffering from chronic tonsillitis. That is common at this age. Cancer is extremely uncommon and in your case it can be ruled out. You should quit smoking as soon as possible. At present have a course of antibiotic it will be cured. Consult your ENT specialist for more details.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic headache and numbness in the ankle\n\nI ve been getting frequent headaches; they re usually pretty bad in the morning but get better. Sometimes they don t get Better, or come back later. I ve been really fatigued lately and no matter how much or little sleep I m still tired. I ve been sleeping between 6-9 hours recently. Sometimes my hands get tingly/numb along with my ankles. I sometimes feel like I m struggling for breath like it s hard to breath or painful and I also have had a cough for a while now. Random parts of my body will start hurting and then suddenly go away too but that probably has something to do with growing? Oh and I ve also had a shorter temper lately and I just feel weird. I hope you can help me figure out what s up, thank you so much.",
    "doctor_response": "This chronic headache is covered under SHIRSHOOL disease in Ayurveda.This is vitiation of Kapha and Vata humors. Best remedy for it is to use Shadbindu oil which is to be administered 2-3 drops in each nostril in the early morning. It's very pungent. Be careful. You may increase to 6 drops slowly. If you can, you ll be winner.Second thing is 'Shirshooladi Vajra Rasa' 2 pills to be powdered and mixed in pure honey and licked. Twice daily. Follow hot/ warm water sips.Third thing is Pathyadi Kwath liquid. 20ml + equal water twice a day before meals.For proper and sound sleep and mental energy use Ashwagandha and Brahmi capsules 1 bid each.Four weeks time will indicate the results itself. You may continue still if headache still occurs though frequency and intensity would be reduced by now.No side effects, totally safe. But find out somewhere. In India its common to find at classical Ayurveda stores.No heavy n spicy food please. Simple good, light food advised.I not only hope but am sure that you will be 100% OK.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for allergic reactions to antibiotics\n\nHi . Recently i had taken some antibiotics that stripped what was left of my intestins of bacteria. My doctor then reintroduced them with a probiotic, align. I am experincing all kinds of new and not so welcome allergic reactions. I can hardle go outside. I live in the Sedona area, Hiking is my passion.",
    "doctor_response": "The best solution to allergies is avoid the causative allergen . Its better you stop those medications that cause allergic reactions. If still these reactions persists you can ask your for a prescription of oral steroids.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Puffy eyelids after exposure to bleach. What to do?\n\nHi a lady was dying my hair and got a good amount of bleach in my eye! I tried to rinse it out as soon as it happened! i didnt go to the hospital after it happened i let them finish my hair. I came home cause i was still able to see but this morning i woke up and my eye lid is so puffy and its red in my eye still?? Should i see someone or will i be okay?",
    "doctor_response": "Hello dear,Bleach is a chlorine based chemical which is alkaline in nature.Chemical injury is considered a medical emergency.The eye tissues being very delicate may get seriously damaged due to its exposure.The pain, puffiness & redness may persist depending upon the amount & potency of the bleaching agent.So, it will be better to consult an Ophthalmologist & get a proper examination done.Based upon that appropriate management steps could be taken.Kindly let me know if you have any further queries.You can ask me a direct query on this website using the below link:  you a good health.Thanks & take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can cancer be cured with sodium bicarbonate?\n\nGreetings. Overtime, i've learned to not to believe everything thats online, and recently, i came across several articles about curing cancers with Bicarbornate Soda/Sodium. Significant article in question: WWW.WWWW.WW and this long winded passage about how Baking Soda works to cure cancer: WWW.WWWW.WW Which, to go so far even to give a general explaination of how cells devolve into cancer cell, and Quote: \"But just like a toy balloon that cannot stick to the wall in wet weather, oxygen cannot stick to a blood cell if the ionic balance of the blood is acidic. This is what the physicians and oncologists are overlooking. Every damned one of them has observed the ringing alarm bell going off but have muffled their ears and closed their eyes because they are looking for some expensive and complicated cure for cancer when both the cause and the cure are actually very simple.\" Can i know how legimate this article is?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. cancer can not be cured by sodium bicarbonate.  There are no evidence in medical field that cancer can be cured by sodium bicarbonate.  Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for annular disc bulge\n\nI had a Mri scan a month ago amd the results show at L5S1 thedisc is dessicated and shows diffuse bulge with annular bulge and the right S1 ISrobably slightly contacted in the recess so wat is the treatment for thicm.problem as I am constNtly back ache",
    "doctor_response": "Dear Sir,Thank you for posting your query at healthcaremagic.com.I advice you to do back strengthening exercises.1. Bridging exercise-    Lie flat on the floor on your back with the hands by your side and your knees bent. Your feet should be placed around shoulder width. ...    Pushing mainly with your heels, lift your hips off the floor while keeping your back straight. ...    Slowly go back to the starting position as you breathe in.2. Abdominal curl-Place your feet on a wall so that your knees and hips are bent at 90-degree angles. Tighten your abdominal muscles. Raise your head and shoulders off the floor. To avoid straining your neck, cross your arms on your chest rather than locking them behind your head.3. Isometric of back - with hip knee flex, pleace the roll of towel under the low back and press. Hold it 15 counts and relaxdo it for 10 times**All the exercises do it twice a day. Do not hold your breadth while doing the exercise. 4. Hot water fermentation. Cover the hot water bag with towel and place it on pain full for 10 minutes. Do it twice a day.Some important points---1. Sleep on firm mattress2. Do not lift any heavy object3. hold  objects close to your body4. Do not bend forward 5. Maintain your body posture correct. Use mirror to correct itAll this points will help in reducing pain.If you need any further information, please revert back. With best wishes,Tehzib  Saiyed (PT)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be worried as i am having a lump on upper part of my ear?\n\nHI. im having headache for few days. my eyes seems hurt and got headache in both sides of my head. but i just noticed that in right side of my head on the upper part of ear there's a small lump... im so worried about this.. doctor, can you tell me what do i have suffering rightnow? thank you",
    "doctor_response": "Hi, dear I have gone through your question. I can understand your concern. You have lump in upper part of ear.  It can be some cystic lesion like sebaceous cyst or dermoid cyst.  Or it may bd enlarged posterior auricular lymphnode. You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for burns in leg\n\nI have been burn in my leg on a lasser sesson. I think because they did not us enough gel.can this be the cause? the person that did is 16 (I did no know) can a 16 yr old use the LP machine? I am willing to go legal with the establismen and need some answers",
    "doctor_response": "Hello,The burns on the leg can happen due to different reasons. This needs a direct examination of the area to find the possibilities. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can chronic meningitis cause instability during walking?\n\nhi, my brother he is 33 trs old diagnosed with chronic meningitis,increased icp and ? tb meningitis . he is on medications now. treatment started 2 months back.still he is c/o mild headaches,intermittently and when he walks he feels unstable,kind of wavy feelings.is it normal or not?",
    "doctor_response": "Hi, TB meningitis needs prolonged treatment, lasting for 12-18 months. So, it could be natural effect of infection. However, if in doubt, get a brain scan done to rule out hydrocephalus. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sudhir Kumar, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest dosage of Eltroxin during pregnancy\n\nI am 5 weeks pregnant and was on 50 mg eltroxin for a month(since dec4 2010 to jan 3rd 2011)I had a check of TSH hormone on 3rd.Both T3 and T4 levels were in the normal range.so my physician asked me to reduce the dosage to 25 mg.but my gynaec says that throxine requirement is more during pregnancy..just confused as to wether i should continue with 50 mg or 25 mg?",
    "doctor_response": "Hi,The range of TSH to be followed for pregnancy is different than in non pregnant women.The normal values for first three months of pregnancy is less than 2.5 mIU/L, for the last six months of pregnancy is 3.0 mIU/L. For, the non pregnant it is 4.5 mIU/L. So everything depends on your present TSH levels if they are below 2.5 then you can take 25 mg of thyroxin , but if they are above 2.5, I would advice you to take 50mg.High TSH values have shown to affect the pregnancy and it is advisable to keep levels in the range described above.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are headache, numbness in arm and difficulty in speaking signs of stroke?\n\nI have had symptoms of a stroke for a couple weeks. Headaches, numbness in my right arm, right arm involuntary movements, my knees buckle under me, etc. I know this because I ve had 3 previous strokes. The important thing is that they go away within a few minutes, and then I m fine. My speech becomes difficult. even though these episodes eventually go away. I went to the Dr. and did nothing but said she would order a referral to see a Neurologist. What is wrong with me? Thank you, Rhonda Emmersen",
    "doctor_response": "Hi, I am Dr.Bruno.  I have read your question and understand your concerns. Let me try to help you Question : Are headache, numbness in arm and difficulty in speaking signs of stroke?Answer : Yes. I would suggest you to kindly consult your Neurologist as soon as possible Hope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have had a miscarriage, cannot conceive ever since. What can help?\n\nhi am 24 yrsold and my 0problem is infertility 6yrs married and i have 1 miscarriage 1yr back and till now am not concieve pregnancy and and i also have pcod problem and many doctors advised me to do laproscopy and i dont want i want my treatment by medicines pls help me pls my email address is YYYY@YYYY what is my answere how i can i do",
    "doctor_response": "Hi, Thanks for your query. I read your query and understand your concerns. Following is my reply: If you dont want laparoscopy, please visit an IVF centre and request for regular folliclular monitoring. Have intercourse or IUI on the day of follicular rupture. Laparoscopy is not compulsory. You can try with medicines and HMG injections. I hope I answered your query. I will be available for any follow up queries you have. Regards, Dr.Mahesh Koregol IVF & Infertility Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does spinal tap cause severe shoulder pain?\n\nIs it normal (or common) to have severe shoulder pain after a spinal tap? 5 days post procedure, with 4 of those days having had severe headache. Now the shoulder pain is worse than the headache. Waiting for script for hydrocodone and muscle relaxer. I know about the headache, but want to know if the shoulder pain is normal. I am 21 years old.",
    "doctor_response": "Brief Answer:Yes, headache with spinal tap spreads to neck and shoulder causing pain.Detailed Answer:Warm Welcome. I appreciate your trust in HCM and assure you are on best portal on the globe for expert online medical services.I have thoroughly reviewed health query you raised, and well realize all of those concerns. Being your physician, I will take care all of them today and will extend my expertise to solve the problems.Based on what you said, you are experiencing Post-Dural Puncture Headaches. There is severe headache after some time of the procedure and the pain radiates down to the neck and shoulders. Moving around increases the pain. If I were your treating physician, I would advise you the following:\u2022\u00a0\u00a0\u00a0\u00a0\u00a0Bed rest for 3 days.\u2022\u00a0\u00a0\u00a0\u00a0\u00a0Drink tea or caffeine containing drink which helps with pain.\u2022\u00a0\u00a0\u00a0\u00a0\u00a0Tab. Diclofenac K 50mg twice dailyHope I addressed all the concerns you have. Let me know if you have further questions. I will be more than happy to clear any doubts. Keep a follow up to see how you doing.Regards!Dr. Ali Raza",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does polybion syrup will help to increase appetite?\n\nHi Doc, my son is 19 Month old and he is not eating good. In fact all he eats is snacks that too in a very little quantity. So I was suggested by a friend to give him polybion syrup to increase his apetite and cover any vitamin deficiencies that he might have. But I am not sure how much dose to use and whether giving polybion would really help increase apetite? Looking forward to your answer. Thanks!",
    "doctor_response": "Hi,Thank you for asking question on health care magic.Polybion syrup does not improve appetite.It only redresses symptoms due to Vitamin deficiencies.2.5 ml once or twice daily will do.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Side effects of Doxypal dr , Ascazin , Acutret 10, crixan gel & Acnemoist\n\nI ve prescribed to use Doxypal-dr , Ascazin , Acutret 10 , crixan gel & Acnemoist , Acne aid soap for my acne problem , but after using it for 10 days I ve now problems with my lips , my lips cracks like winter cracks & it also burns , is it the side effect of these medicine please help me.",
    "doctor_response": "Hi!, Welcome to HealthcareMagic, yes dear its is side effect of the ACUTRET (10MG) which you are taking for acne.It a common side effect which occurs usually after 2 wks of the therapy.But this side effect goes off once you stop the medicine.Usually it is given for approx  6 months depending upon your body wt.It is good and very effective medicine.There are other precautions which needs to be taken while one is on acutret..some investigations need to be done...Kindly talk to your dermatologist about these precautions.You can apply CETAPHIL MOISTURIZING CREAM on lips as and when required or any lip balm to keep it moist. take care, Dr.chawda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swollen gum in between the teeth. White lines on the gums. Do I have mouth cancer? Have the habit of smoking\n\nHello, on the left side of my mouth my gums are swollen inbetween two teeth and the whole left side of my gums are red and tender. The lining of my gums hurt and there is white lines. Also underneath my jaw (i think it is my glands) hurt to touch. What could this be and should I see and doctor or a dentist? Thank you for your help. I am really worried this is the beginning stages of mouth cancer . I am scared because I did smoke on and off for 7 years. I am 23 now.",
    "doctor_response": "Hello on the basis of your dental history these white lines could be white precancerous lesion like leucoplakia. But proper clinical diagnosis and biopsy will confirmed it.i would advice advice you to show this to a oral pathologist and get a biopsy done .plz maintain your oral hygiene.use mouthwash twice daily and get cleaning of your teeth done since you are a smoker. Plz give up smoking because this will worsen the condition. Have high nutrition diet.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fatty liver and high triglycerides of a 18 years old\n\nHello, I am 18 years old and I have recently got a blood test . I have very high triglyceride level (660) and the SGPT is 57. My father says that we have genetic non-alcoholic fatty liver disease . Am I in danger?",
    "doctor_response": "hi welcome, at present any complaints for you? any way this will not make you into trouble if you are strictly following medicines and follow the advises of your doctor the best treatment available for the liver disorders is available from ayurveda only you contact good ayurveda doctor in your area if not so write to me in detail i will guide you what to do thanking you christyjoseph1@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Prescribed Ovigyn and Folinal. Trying for baby. Had D&C for blighted ovum. Forgotten pills. Help\n\nHello Doctor, I am trying to concieve again after having an D&C six months ago due to blighted ovum . my doctor has prescribed ovigyn d 25mg thrice a day with folinal 5mg once a day. i have been taking this tablets since last two months though in betweens i forgot to take once or twice but still i am unable to concieve. i am 34 years old and we are trying for a baby since last one year. your valuable advice is needed. thank you. Bidya",
    "doctor_response": "Dear Bidya, It would be important to know why you have been prescribed ovigyn d as it is usually prescribed to women with low ovarian reserve. It is ok to have missed a tablet or two in between. If your hormone reports, tube tests and semen analysis is normal, then you should try naturally for another 3-4 months after which you should start active treatment by visiting an infertility specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can swollen fingers be healed?\n\nhi? i hand washed my clothes on Sunday and afterward my index finger was swollen like i it was squeezed by a door. later on Tuesday the area around the joint on my index finger turned black and itchy.. it still swollen and painful when i try to bend it. what could be the problem",
    "doctor_response": "Hello, As this is a skin reaction to the soap is one. Second, there will some skin tissue wear and tear due to friction and since it was squeezed by the door so there will be a muscle injury. Just apply coconut oil and do gentle massage and use hot water fermentation for the finger muscles to relax. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes palpitations by excessive Paranoia, anxiety and panic attacks?\n\nHello. For the past couple of weeks, I've been experiencing weird stuff with my heart. It started when my heart started beating really fast, which I had never experienced before and it freaked me out. I went to the hospital and they did an EKG, blood work, and a sonogram. They found nothing wrong with my heart and ruled it as anxiety. But recently, its been acting up again. Two weeks ago my heart was beating fast enough that I couldn't go to sleep. I was checked out again and they said it was another panic attack. I've also started experiencing chest pains and I've started to have trouble sleeping. Now, my heart is beating again, although it is noticable unless I feel it directly. Is this something to be worried about or just heart palpitations brought on by excessive paranoia, as I have been pretty much thinking about my heart a lot. I am 19, I don't drink, smoke, or do drugs. I eat fruits with every meal and I excercise five days a week.",
    "doctor_response": "Hi,  as a 19 year old you are too young to get any heart problems.  So I would like to assure you for the same.  Yes anxiety will make your heart beat faster because of the adrenaline pushed  into your bloodstream due to anxiety,  panic.  However if you worry so much and test s are available I will suggest 2d echo to rule out any structural disease specifically mitral valve prolapse,  seen in your age group and if symptoms are everyday a 24-hour holter to see what actually is happening Regards Dr priyank mody Priyankmody86@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is mild pelvictasis shown in ultrasound concerning?\n\nhi , My husband had a light pain in the kidney portion and gave his ultrasound test. Mild pelviectasis is detected in test. When we contacted urologist, he said he needs CT scan to be done. Could you please let us know if this needs immediate attention? Is there any other test to detect the cause for pelviectasis?",
    "doctor_response": "Mild Pelviectasis (if an isolated finding) could be due to obstruction in the urinary tract or just a benign condition. Since he had symptoms, it's better to rule out the urinary tract conditions like stone, infection, stricture, etc. You may consider discussing with your urologist about the need for further investigations along with renal function tests. CT scan or isotope Renal scan may be chosen as per the clinical profile. In some centers MR renography is also done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Patient has painful papules on both sides of hands. Please provide diagnosis.\n\nHello doctor, The patient is a 12 year old female. One month ago, she presented with drenching sweating and cold feeling with cold hands. Two weeks later, the skin of hands became erythematous and blanched on pressure. Then, they gave her measles vaccine in the school. Two days later, she developed painful papules on both sides of fingers and palms. All these symptoms are associated with malaise and generalized muscle pain. Blood pressure is 130/90 and pulse is 130 per minute. Endocrine investigation, echo, CXR, abdominal us, abdominal CT, autoimmune Ab all negative. IFAT for brucellosis negative. No sign of arthritis, only arthralgia. Now she takes Prednisolone 5 mg and Chloroquine tablet and Lyrica capsule. The rash is improving, but malaise and myalgia with arthralgia are still present. I would greatly appreciate it if you can provide me with your diagnosis regarding this case as our local physicians have confused us with multiple diagnoses. Any information about the disease is greatly appreciated. Is it life-threatening? Kindly advise on what you find necessary. Thank you. Attached is the patient's medical test results as well as some photos of her hands.",
    "doctor_response": "Hello. I went through your post (attachment removed to protect patient identity). The significant problems mentioned in the post are: All these could be manifestations of vasculitis. However, I have not seen her LDH (lactate dehydrogenase) and CPK (creatine phosphokinase) level documented. The possibility of chronic infection is there. So, hepatitis serology needs to be done which can also cause similar symptoms. I will treat this patient has hypocomplementemia vasculitis after doing nail foldcapillaroscopy and skin biopsy. I suggest giving her Prednisolone dose of 0.25 mg/kg per day for two weeks and simultaneously do the investigations as mentioned. Consult a specialist doctor, discuss with him or her and start the medicines with their consent. For more information consult a rheumatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause pressure and pain in the lower abdomen?\n\nI have a pressure type pain in my lower right side. It is a bit tender to the touch but over all the pain isn't too intense until I stretch or bend to that side... It started last night but I really thought it was just gas pain because it was more full belly.",
    "doctor_response": "Hi, * As per the symptoms narrated here, the pressure and pain in the lower abdomen indicate possible inflammation of intestine, gravels or calculus in the urinary system or others. * It is recommended to get evaluated with your PCP for further assistance in this regard. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having lightheadedness and muffled hearing. Have pain in the left side of bottom of rib cage and back. Whats happening?\n\nHi recently when I stand up I sometimes experience lightheadedness and muffled hearing, also sometimes when lying on my tummy and lifting my head up (this one I have had on and off for years) I am 40 not overweight with normal blood pressure. I have also had a pain in my left side around the bottom of the ribcage front and back for a couple of weeks. Defo not kidneys, I can make it worse by bending my head towards my chest. I feel fine when being very active - just spent the weekend running around with v energetic nieces at adventure playground. Any ideas?!",
    "doctor_response": "Hi thanks for using HCM.Your history suggest that you may have postural hypotension.Get checked for BP at lying and then standing for 30 s to 1 min from lying position. The pain at left side and back may be due to musculoskeletal pain. Take Tab Aceclofenac with Muscle relaxant(Chlorzoxazone) combination three times a day for 2 days. This will relive your pain. If not cured consult a doctor and take one xray chest PA view to look for any problem in lungs. Hope I answered your question.Wish you good health.RegardsDr.Lohit",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for the child to make him speak?\n\nhi doc, i irwan from brunei. my child is now 4 years old but he cannot speak yet. i have brought him to see the specialist but the result is negative. this year i school him at kindergarder school. the teacher has spoken to me that my child didn t concentrate to much and he confusing about language. how could i do doc.. i do anything to make sure my kid can speak. at least he can call me and my wife, daddy and mummy. please doc, is there any treatment or anything that my kid can speak",
    "doctor_response": "DearWelcome to HCMWe understand your concernsI went through your details. Developmental disorders is a group of psychiatric conditions originating in childhood that involve serious impairment in different areas. In this case your child could be troubled from communication disorder. Young children with communication disorders may not speak at all, or may have a limited vocabulary for their age. There are many areas required to be tested. Communication disorder could happen due to autism spectrum disorder, Aspergers, expressive language disorder, mixed receptive-expressive language disorder, aphasia etc.For every communication disorder, effective treatment is available. I suggest you to consult an ENT surgeon first who will provide you the necessary guidelines.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause sharp elbow pain?\n\nI work at a daycare and work with 1 year olds. It was naptime and I was begining to pat one of the children on their back to sleep. I pulled the child s blanket from underneath them to cover them and had a sharp pain run from the pinky side of my wrist up towards my elbow. It lasted just a few seconds. A minute or so passed and I began to pat the child. I had to lightly pat the childs back so my wrist wouldn t hurt. About 10 minutes later I went to clean a chair and put a little pressure on my left wrist while wiping out a chair and got the sharp pain again in the same place. It then brought tears to my eyes. What could it be?",
    "doctor_response": "Hello, The symptoms are consistent with inflammatory conditions like tennis elbow. As of now you can use analgesics/anti inflammatory combination like aceclofenac/serratiopeptidase for symptomatic relief. If symptoms persists better to consult an orthopaedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe, painful squeezing edsensation in chest, fatigue. How to get cur\n\nHi, The other night I had a severe, painful squeezing sensation in my chest while I was laying down in bed. This lasted for several minutes. Now, I feel a sort of warm, liquid sensation that is somewhat difficult to describe. I've been feeling incredibly fatigued lately as well.I'm not quite sure what to do with this. I'm hesitant to go to the ER because it would be embarrassing to be told it's just stress and to waste people's time like that... however, it was pretty scary and this current sensation is very strange.",
    "doctor_response": "Hi, thanks for using health cae magic. You should go to ER to rule out the physical causes of your symptoms. Once it is clear that is is becuase of the stress, you should do two things. 1) be happy that is is becuase of stress only and not becuase of any physical problems 2) consult psychiatrist fro the stress management and detailed evaluation. your psychiatrist may prescribe anti depressant or anti anxiety drugs or may refer you for a sessions of councelling, meanwhile you can try stress management exercise like relaxation techniques , yoga, meditation or self motivation. avoid use of excessive csffine, nicotine or alchohol which may in turn , increase anxiety. I hope you will be fne soon. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest solution for memory loss?\n\nI am 37 years old male. I have a very big memory loss but not dymensia. I forget everything i do even words names . i dont thing this is normal cause i have very bad memory even near everyone near me(friends,family etc.) i dont smoke, drink alcohol, taking drugs, i am nervous . i work about 55 hours a weak . still i am always tired . i wish i can become normal in memory,",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  You are just 37. Memory loss at your age is supposed to be non existent until there is serious underlying problem. Busy and professional people do have some problem with their memory and therefore the always keep schedules and carry a pocket book. This does not mean that they have memory loss.  I think the same is applicable to you. On the contrary, everyone forgets so many things in their life and unless they can recall at a later stage, such forgetfulness cannot be called clinical memory problem. Don't worry. You are clear from my side. do not get anxious and apprehensive. Keep a log and schedule.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for painful inflamed wound by wasp stung\n\nI have a couple, thanks for hearing then. 2 weeks ago, I stepped on a rusty nail through my flip flops. It bled pretty good. I immediately washed it. Was a little sore, but no real problems. In the meantime I got stung by a wasp twice on my knee. It was pretty sore for a day or so. Now my knee is really swollen, sore and inflamed about 5 inches down and 5 inches up from my knee, especially painful if I put pressure on it like bending down on it or walking up/down stairs. It feels sore deep inside, like thick, hardness inside.",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain the symptoms of soreness, hardness and swelling after wasp sting seems to be due to allergic reaction to the poisonous chemical that is injected under the skin by the wasp sting..Nothing to worry, the first thing that you should do is to have a close look over the sting site and if the bee stinger is present embedded in the skin you should remove it or if not able to remove get it removed by a physician..Take anti-allergic medication like Levocetrizine or fexofenadine [allegra].Take anti-inflammatory painkiller like Ibuprofen..Apply a steroid ointment over the swollen region..Do cool compresses..Elevate your feet while lying down..Do not scratch if there is itching to prevent infection..Hope this information helps..Thanks and regards.Dr. Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which one of Fentanyl transdermal patch and Butrans patch are strong and effective?\n\nWhich is stronger and more effective Fentanyl Transdermal System ( 75mg patch every 2 days ) Butrans (buprenorphine) ( 20mg patch every 2 days ) OxyContin (oxycodone) 60 mg 3x a day",
    "doctor_response": "Hi, Butrans is limited to the extent of its effect. It does not have a full effect. Therefore, while all the others can be increased to give more effect, this is NOT true of butrans. Otherwise, which gets you to drink more? beer, wine, or whiskey...well... you can get fatally drunk on any, but whiskey is more concentrated per ounce. Fentanyl is more concentrated per ounce but oxycontin can also give fatal narcotic overdose. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason of having puss cells in Semen\n\nwhat is the cause of PUS CELLS in Semen . Why it is there and how it can be avoided",
    "doctor_response": "ths is sm kind of infection , may be sexually transmitted disease, bt u dnt wry u need antibiotics n u l b ok consult ur doctor",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with herpes complex 2, severe vaginal irritation, taking Valacyclovir. What are the symptoms for uterus cancer?\n\nI was recently diagnosed with herpes complex 2, I have severe vaginal irritation that will not go away its like an open wound. I have been taking Valacyclovir for 2 and a half months. Is an outbreak known to last this long? I m beginning to think this is something else. What are the symptons for uterus cancer?",
    "doctor_response": "Hi and welcome to HCM. Thanks for the query.Cancer is the last thing to think of and these are not sign of any female cancer. this is probably herpes and herpes infections are usually refracter and bothering and easily treatable in some people. You should continue with valacyclovir.Outbreaks can alst even longer and it is hard to predict how long. Uterine cancer is usually seen in postmenopausal women, it goues with pelvic pain,prolonged and excessive vaginal bleeding. YOu should do testing for other STDs.Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for shingles\n\nIn the past I have had shingles and am having the same symptoms as previously.  My Question:  I understand that there isn't much that can be done for this condition....so should I just wait it out or see a physician?  Are there any complications that can happen, if left untreated?  Thank you.",
    "doctor_response": "HelloYou know that much can't be done for this condition ( for shingles ). I want to tell you that if untreated patient may have \"POSTHERPETIC NEURALGIA .Note this report.One study showed twofold faster resolution of postherpetic neuralgia in famiclovir-treated patients with shingles than in non-recipients of treatment .In my opinion consult a primary care physician and take proper treatment as local applicant as well as oral tablets.Hope this information will be helpful for you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can feeling queasy after bad hit on the forehead a cause of concern?\n\nHi I was cleaning out my closet yesterday t about noon and my closet collapsed. A board hit my forehead and right above left eyebrow. I had a slight knot and put ice on it. Today I felt fine after sleeping but feel a little queasy now. Should I be concerned?  YYYY@YYYY",
    "doctor_response": "Hi,No need to worry much as there are no features suggestive of brain injury.Apply ice packs and take NSAID like ibuprofen for pain with plenty of water. This will subside.Hope this helps you.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to quit masturbating\n\nmy age is 19, height is 160 above, weight 70.. sir i started hand job  before 2 years . i wanna leave it. cause i wanna study with full concentration. but it effects on sitting ability. after do it i feel sleepy and weak due to which i do not able to exercise better like before, which results in increasing my weight cause i do not burn fat in me.also now excessive fat is resulting in breasty shape of my chest. sir please tell me some ideas  and ways to leave it.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.I suggest you not to worry much. Masturbation is not a sin or any negative behavior. It does not create health problem if done moderately. You can masturbate thrice or upto 7 times in a week at your age.If you feel anxious about it, that is the reason for your troubles. Masturbation cannot hinder your concentration. You have the capacity to take all these together and be energetic and happy. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. K. V. Anand",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful and hard lump in toddler?\n\nHello dr. My son is two years old. All three of my kids were born with dimples above the buttholes thebonly was to see it if you change their diapers. I was changing my son and i notice there was a hard moveable lump and it was painful to him when i put pressure on it. It was never like this before. What coukd it be?",
    "doctor_response": "Hi....as you say its a movable but hard painful lump in the buttocks area, the possibilities could be - 1. Neurolipoma.2. Simple lipoma.3. Sebaceous cyst.4. Dermoid getting secondarily infected.I suggest you see your pediatrician for this.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Spine degenerative disease, severe pain. Prescribed diprofos injections. Side effects of long term use?\n\nI have long lasting spine degenerative disease , in cruciating pain for years . The only medication that relief my pain is diprofos injections . I wan to know how frequent can I take it IM with least side effects of the streroid . I looked it in the drug web site dosage and there is no specific dose and the only warning if you take it too much it will cause all the side effects of steroids that we all know.",
    "doctor_response": "PLS DONT CONTINUE ON STEROIDS FOR LONG.TRY TAKING DRUGS LIKE TAB .TAPAL(tapantadol 50 MG )three times a day if severe pain.that shoulb be taken only as a short term for 2-3 times for severe pain. the dose is 1ml(7 mg) diluted with 10 ml normal saline. If u take too much it will definitely cause all the steroid side effects where u have severe gastritis,steriod myopathy,weakness of bones n easy susceptibility for fractures etc.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be worried about the non stop hiccups?\n\nhello. i am a 37 year old male, 5 1/2 tall, and weigh about 144 lbs. my past and present medical history incudes cirrhosis, (2) hernia s, iga n, and both of my hip bones are dead (for over a year now). my medical question is that i recently have had my verceas re-banded (2) months ago, and now i have the hiccups non-stop for the last (2) days/nights..should i be WORRIED??",
    "doctor_response": "Yes you should be worried this is a sign of liver failure .i recommend you see your doctor as soon as possible sorry , Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain in the left side?\n\ni m 40 years old. for the past 18 months i had been suffering from chest pain particularly on the left side and slightly on the right side. i have undergone several blood tests which are normal my ecg also normal. i am taking bp and thyroid tab.for the past 18 months. now bp and tsh are normal but the pain continues. can u clear me the reason for the pain. my doctors could not trace the reason.",
    "doctor_response": "Brief Ans-Dull pain under right ribs.../ Under EvaluationHi Dear!! Thanks for your query to HCM.Read and reviewed facts of your query in context of your health concerns.My Impression-Based on the facts of your query, you seem to have-Could be from Angina with uncontrolled High Bp and thyroid problems.You need to talk with your attending  doctor and tell your health issues frankly.Treats-Anti-anginal Medicines , whenever needed from your physician's advise.Check with your Physician and review dosages of blood pressure medicines and thyroid medicines.Check up with Stress Test/ holzers Nuclear test is more sensitive indicator of coronary and heart functioning.Regular exercises would take care of Natural Bypass creation in your case.so don't worry.Act fast as suggestedReduce weight / No smoking / No alcohol -or moderate with doctors advise/would go a long way for healthy living in your case. Hope this would resolve your health issues and would help you to plan further treatment with doctors there.Good Day!!Dr.Savaskar M.N.Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the motions and vomiting caused by intake of loose motion tablet?\n\nhi doctor, i was on diet and i had food once and had to put them off from my body. so my friend suggested me to take loose motion tablet. so i did and every 5 minutes i had to go for motions from last night till now. and i am even vomitting what i had. what do i do? please suggest me.",
    "doctor_response": "Hello,The symptoms seem to be related to side effects of the loose motion tablets. I suggest using an over the counter option such as Imodium. I also suggest to use daily probiotics such as Enterogermina and eat a plain diet.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in gums of a child?\n\nMy 7 year old just woke up and his gum is swollen like the size of a pea. It s in the bottom right jaw where a wisdom tooth would be. Should I be concerned? I mean I am very concerned, but do I need to remedy the issue at a hospital? No temperature, otherwise healthy child.",
    "doctor_response": "Hi...ti seems like a gingivitis and it is inflammation or infection of the gums. I suggest you seek your dentist's consultation regarding this as it might require oral antibiotics too.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do i need to continue taking the pill to avoid pregnancy?\n\nI have an sexual intercourse last july 27, and unfortunately,he didnt know if he withdrAw it on the right time.. We decided to in take a pill on aug 2. I was expecting my menstruation 2nd week of august. But its already aug7 but still no menstruation yet. Do i need to continue taking the pill to avoid to get pregnant? Os it effective to the the pill after sexual intercourse. Thanks.hope for your reply",
    "doctor_response": "Hello dearI understand your concernEmergency pill is effective only for 72 hour after the sex.As you did take after 72 hour then it will not protect against the pregnancy.Wait for period to come as pill can cause delay in the period by 8-10 days.If period will delay by more than 12 days then go for pregnancy test and or blood HCG to confirm the pregnancy.If you will be pregnant then intrauterine pregnancy can terminate by the misoprostol and mifepristone under the advice of the gynecologist.Avoid stress, take healthy diet and do regular exercise.Hope this may help youContact HCM for further health queryBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for tonsillitis and asthma in a child?\n\nFriend has a very sick 3 year old little girl with many issues. Trying to help her out. Child has very red swollen throat, swollen tonsils, has to have a breathing treatment every 4 hours. Has been diagnosed with asthma, but breathing treatments aren t helping much. Has never been able to eat anything solid due to even more health issues.",
    "doctor_response": "Hello, Asthma can be life-threatening if worsens, I strongly suggest you take her to hospital for monitoring and further evaluation. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr RAVI, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for a node on the left side of jaw\n\ni have node on the left side of my jaw beside nerve.ihave seen ENT specialist does think needs any intervention at moment but advises to return if change in any way and will do needle biopy -I am worried and wonder if a needle biopsy would better done now",
    "doctor_response": "Hi,Dear,Thanks for your query to HCM virtual Clinic.I studied your query in all the details put forth by you.I understood your health concerns.Cause of the health problems you queried-There are many causes of the lumps on your left of your jaw besides nerve.Hope the data in your query is confusing and needs more clarification on the exact site and location-as it could be-- pre-auricular node around the facial nerve near the tragus of your ear, ----and / or it could be node in the left neck besides the jaw.And each of these locations would indicate-Either a lump with Lymph node due to infection post-parotitis  post parotid duct stone/ or from Pleomorphid Parotid Adenoma with nodal spread, or could be Lymphoma of the lymphnodes due to NHL(pre-auricular) or HL(Neck) .To rule out other causes, I would advise you to consult ER ENT and ER Surgeon, who would examine it and treat it accordingly.Still with my expertise and experience and with the given data in query,I would suggest you to rule out following causes with your ER OrthoSurgeon.Cause in your case-As the lump is opined by your ENT Surgeon as not to be intervened now,seems that he wants to observe and treat it withe antibiotics and anti-inflammatory drugs if need be.If not relived with drugs(antibiotics / anti-inflammatory) he would go for FNAC biopsy to rule out either of the causes and other causes.Treatment-In the mean while you are waiting for needle biopsy decision-Anti-biotics and anti-inflammatory -to rule out any infective causes in parotid or teeth or in Ear could be started if need be after ENT surgeons and or ER Surgeon's opinion.-In the absence of more information,I would advise Second opinion in your case, who would examine it and  investigate it to treat it as per the cause of the lump. So I  would advise you to consult ER ENT Surgeon and ER Surgeon , who would rule out other causes of such a lump and would help you out with the fist hand information.Do take his Second Opinion, on the above suggestion,as he would advise you with fist hand clinical information.Hope this would resolve your query with full satisfaction.Welcome for any further query in this regard to ME by direct question at HCM.Write excellent review and hit thanks, to narrate your experience ,which would improve my rating for many other visitor's to HCM.Wishing you fast recovery.Have a good day.Dr.Savaskar M.N.Senior Surgical Consultant.M.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pericardial effusion be treated without surgery?\n\nMy sister has been diagnosed with pericardial effusion...between 300-400 ml. She has just finished treatments for small cell carcenoma of the lung and neck. Her cardiologist told her today there that there was nothing he could do; said that using a needle could cause cancer cells to enter the sac. She has Sneddon s Syndrome and is not a candidate for surgery. She just turned 59. Any suggestions?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. After going through your medical details I understand your concern and I would like to tell you that Sneddon's syndrome is a rare disease and effects women of young age. Considering her carcinoma history and sneddon's she is not a candidate for invasive treatments. Only option she is left with is medication which might help. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have had frequent bladder infections since i was little. I was put through MRIs, and body scans several times. They were trying to figure out if my uterus was tilted, and it's not. I read that typically women get UTI's once in there lifetime. Maybe a bit more. But i usually get 2-3 each year. And they are severe bladder infections. What's going on?",
    "doctor_response": "Hi Nikki, Since  you have already gone through lot of investigations and they appear to lead nowhere. I suggest you drink plenty of water and take care of your hygiene and avoid unnecessary medication. That should help!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump in anus with pus?\n\nSo I have a small pea-ish sized lump on the outside of my anus. I have had someone take a look, and they said it looks puss-filled... It is really painful when pooing and for a small time after. I have experienced fresh blood when wiping but this is only when I have to strain.. I haven t yet experienced any puss seeping out. :/",
    "doctor_response": "Hi,From history it seems that you might be having forming abscess over the part.Go for one course of antibiotic medicine for 5 days.Another possibility we should keep in mind having fistula in ano.Apply antibiotic cream after proper cleaning.If problem persisted then consult surgeon and get examined.Keep local hygiene clean and dry.Avoid constipation.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes changes in blood thickness while on 'acitrom'?\n\nmy wife has undergone Mitral valve (Mechanical valve) and Triscupid valve repair in Oct 2010. She is taking Acitrom 2 mg daily. last month the blood thickness was 1.1, 1.3, 4.1 & 1.4 four weeks time. What food she can take? and y the blood thickness is varying drastically?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern and I would like to say that if your wife had a heart valve replacement surgery and mechanical valve is there then her INR should be maintain and for that she need to get done this test from time to time and medicine need to be taken accordingly least concern with the diet, hope this information helps you, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood in semen and pain in the groin area?\n\nI have an appt to go to a Urologist this coming week.  A week or so ago I noticed blood in my semen, and i've since experienced a dull ache/discomfort in my groin area.  I had my GP check me out and run some blood and my psa came back good as did my blood panels etc, so the specialist is the next step.  Trying to understand exactly what I could be dealing with",
    "doctor_response": "Hi, Consult a urologist and get evaluated for prostate related conditions which might cause blood in semen. You can go for an ultrasound-KUB and prostate biopsy if needed. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the upper and lower abdomen?\n\nI have had pains in my upper and lower abdomen for quite some time, I have also had hard small black stools, some times my penis is also sore and the skin is dry and sticky. the pains won't go away my gp has tested for helicobator this was negative, also this issue suddenly came on in febuary. I have had countless blood tests and urine samples which seem to be clear I have also attend gum clinic which all results have been negative. My sex drive has also been at an all time low as I cant really get an erection :(",
    "doctor_response": "Hi.The worrisome part is '' black stools'' . This is indicating of bleeding somewhere in the intestinal tract. You have to go for upper GI Endoscopy, Colonoscopy to find a lesion that is causing the black stool ( malena ).Another problem is Erectile dysfunction.The usual problem is stress and psychological upset that causes erectile dysfunction. Get the help of the Doctor to see if there is a functional problem or an organic one .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated gamma GT value having fatty liver?\n\nHi.. i have a fatty liver ..i never drink... my Gamma GT is at 107 .. ALT is 65.5 and AST is 40 ... what can i do to reduce GGt level ? is there any medicine that will help ?  sugar is normal and all other tests as well.  Can liver tests improved by itself if i reduce my weight? i am 110 kg now \" 124 before \" and my hight is 180cm. thx a lot.",
    "doctor_response": "Thank you for posting your query.further evaluation and diet restriction needed.is hep A, B C viral serology Negative??do a lipid profile test and and an abdominal ultrasound.if above test normal,and incresed weight is the sole cause of elevated GGT, then liver test maybe improved by strictly following advice.advice: abstinence from \"Alcohol and drugs\" - LOW or fat free diet should be followed- NO red meat- vegetables should be ingested daily- Moreover, less activity should be carried out (no sports). - use lemon juice (lemonade) once in a day- walk 30 to 40 minutes everyday.- or swimming is alternative to walking- NO sports and NO jogging-\"recheck liver enzymes after 6 to 8 weeks\".wish you good health.further queries are welcomed.Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health.regards,Dr Tayyab Malikwish you good health.further queries are welcomed.Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health.regards,Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the causes of lower back pain, painful urination and blood in urine?\n\nI am a 25 year old male (Married). I have what I thought was a kidney stone (According to urgent Care). I have lower back pain, painful urination, as well as visible blood when I urinate. when I went to the bathroom a few minutes ago, I also had blood after I urinated.",
    "doctor_response": "Hello,I had gone through the case and found that it might be renal stone or urinary tract infection.So immediate go for urine routine and culture test and ultrasound of lower abdomen to ruleout stone or any internal hemorrhage.After the proper diagnosis take treatment. Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest test to confirm pregnancy\n\nmaine 18th jan ko ovofar tablet liya tha period ke 3rd day se aur follicular study kiya toh egg thik tarikese tha uske bad doc ne foolicular study nahi karne bola aur 7th feb ko fir mujhe thoda bleeding hua sir 2 din uske bad nahi aisa hota hai kya aur kya main pregant hu plz ans",
    "doctor_response": "Hi.The follicular study would have been cancelled as either your follicle would have already ruptured or that particular cycle would not have produced a good enough egg to be studied. Please be patient and work with your doctor to improve your follicle health.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to reduce weight soon by following diet?\n\nHi doctor, I started to follow a diet to lose weight and tried eating foods with low calories. I exercise a lot. I am scared to eat foods with high calories. I am not taking heavy meals. I am taking only my breakfast, lunch, and dinner. Also, I feel like foods in our house cause fattening in me. Please suggest.",
    "doctor_response": "Hello. These simple procedures will help you to reduce weight by one or two kilos per month. For more information consult a general practitioner online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for heart ailments\n\nI had a baby 18 months ago and previous to that suffered from Hyperthyroid due to a virus. I was suffering from significant tachycardia and excessive sweating at that time. RAI Uptake was done etc, Virus resolved rendering my thyroid now Hypoactive for the last 4 years. I am currently taking Synthroid 150mcg. I have been a runner my entire life however first trimester complications caused that to cease. I am not just getting back into it and training for a half marathon. I have noted that my heart rate even after 5 minutes of running is around 186 bpm. I went to my GP to have my TSH and T4 checked to be sure I wasn t over medicated. Everything was normal. His response to this high BPM was to add a Beta-blocker. I have leary of taking it because I have read it will greatly affect my performance while running. I also get a quivering type feeling here and there through out the day in my heart. I get extremely flush almost purple in my face when running. I m wondering if there could something significantly more wrong than the thyroid affect as my GP has mentioned. I asked for a stress test and he said I didn t need one. I am 34 years old, slightly overweight still from post-partum. no other medical conditions, no history of any previous medical conditions other than Gestational Induced Hypertension and ecclampsia which clearly has resolved and Gestational Diabetes which also resolved.",
    "doctor_response": "Hi, Get an ECG done. Are you still hypertensive? There are other drugs that can be added to control your heart rate. But before that, you should rule out all the causes of tachycardia in this setting including endocrine causes, serum electrolytes, Holter if necessary. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Swarup Pal, Cardiac Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does clomid have any side-effects like surging of LH ? Can it cause burning sensations in the lower abdomen ?\n\nI took clomid a few weeks ago. I ook ovulation test and had an LH surge for 5 days. Now I am having loer left side abdominal burning",
    "doctor_response": "hi,thanks for query.Some mild discomfort may be there during ovulation and that should be fine in couple of days.Any form of major discomfort in not expected.Take light diet,more of fluids and avoid heavy form of routine household work. Please talk to your doctor in case of more of problem. wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for severe abdominal pain?\n\nHi, My ten year old daughter has had abdominal pain for about two days now.  When the pain first started, she also had lower back pain but this has subsided.  In the last couple of hours she has also had very frequent urination.  She says that it does not burn when she urinates.  Also, her urine is clear.  Can you tell  me what this might be? Thanks, Karen",
    "doctor_response": "Hi,It seems that she might get starting of her period if not started.Initially starting of her first menstrual period this type of problem might be there.Another possibility of having urinary tract infection.If require go for urine check up for infection.Meanwhile give her Meftal spas or Cyclopam, half tablet.Give her rest.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for high temperature in a child?\n\nHi, My 3 year old has had high temps for 2 days now which I have given paracetamol for but stretched out as far as possible between each dose. All day today he has been lethargic, not eating or drinking much and within the last 4 hours his temp has become so high that the whites of his eyes are now red, he has a barking cough and paracetamol doesnt seem to be lowering his temp. He has had croup before. Can you tell me if the red eyes with fever is normal please and should i continue treating him at home or seek medical attention. Thank you, Worried Mother",
    "doctor_response": "HI...right now swine flu epidemic is going on in some parts. The symptoms you are quoting either fit into a viral illness or it could be swine flu. I suggest that you consult your pediatrician regarding this.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to combat flaring up of asthma attack during winters?\n\nEvery fall through the spring, especially when the weather gets really cold, my asthma flares up really bad. I'm on a medication treatment plan year round - but I usually get bronchitis two to three times during this period. Is there anything I can do to prevent the flare ups. I live in Ohio. I've been advised to move south.Thank you",
    "doctor_response": "Hello and welcome to HCM .I shall try to give general self help tips to the best of my knowledge and experience ,as you are already on medication for asthma .Asthma is an allergic condition which can be affected by stress, diet , exercise , lifestyle and atmospheric conditions .While there is not much you can do to change the atmospheric conditions ,still wearing masks and wearing appropriate clothing to keep you warm would help .There are certain blood tests (comprehensive allergy tests ) which can also help in finding out the specific allergens to which you are highly sensitive and thus help in managing the allergy betterYour diet can also play a significant role in aggravating asthma . Occasionally, people with asthma may have food-based allergic triggers and will need to avoid foods such as cows' milk, eggs, fish, shellfish, yeast products, nuts, and some food colorings and preservatives.So test and try each individual item for a week and see if it makes  a perceptible change .Including more ginger , garlic and green tea has been shown to help .Regular exercise like brisk walks or indoor exercises(when weather is not compatible ) which improve your heart rate and respiratory rate will alos contribute to better control of asthma episodes.Meditation and deep breathingexercises alos help in reducng stress induced asthma episodes .Avoid smoking ,passive and active both .I am a homoeopathic practitioner and I have seen good results with homoeopathic treatment in improving pulmonary function in acute asthma .So if you have a Homoeopath around your place ,you can give  homoeopathy a try besides the above tips .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in the right chest\n\nright chest pain..i eat some nuts,, mainly peanut, and now this strong pain for the last 2 hours.. now sweating, now numbness, maybe a bit dizzy but otherwise i have been moving around normal, driving etc... Please tell, I just took two low dose aspirin to see if it will help PS: I have been feeling some symptons ie allergies.. I had taken a claritin early this morning..",
    "doctor_response": "Thanks for your question on HCM.In my opinion you should immediately consult emergency department and start treatment.Your symptoms are suggestive of peanut induced allergy mostly. Peanuts are protein rich food. And proteins are very notorious for causing allergy. So peanut induced allergy is commonly seen in susceptible individuals.Your symptoms like sweating, dizziness and numbness require urgent treatment.So consult emergency department and start treatment.You may need injectable antihistamines and corticosteroid.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fainting episodes with pale bluish lips in 5 year old?\n\nHello. My 5 year old son had a near fainting episode at school last week. Symptoms included facial pallor, pale bluish lips, sweating and nausea. Right as his symptoms were beginning he said he needed water. The teacher gave him some apple juice and by the time I picked him up (15-20 minutes later), he looked better although his lips were still pale. He had lunch on the way to the doctor s office and had normal coloring by the time we got there. His extremities stayed a bit cool until well into the doctor visit. His exam was normal and no follow up except to make sure he stays well hydrated. Thank you. Lauren",
    "doctor_response": "Hi, welcome to healthcaremagic.com. Brief answer - It could be hypovolemic shockDetailed answerHi, this looks like a hypovolemic shock which occurs due decrease in water in body. Since, he was also asking for water, it also points to this. Your physician has examined the child and he found no abnormality, this also points towards hypovolemic shock because you were giving him water and food so the shock corrected gradually. I think you should advice your child to take liquid adequately and on regular interval. I hope this has helped you. Wishing your child good health. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can nasal decongestants halt embryo implantation?\n\nage 37, 5ft tall, weight 10 stones, relatively healthy, did ivf due to male factor infertility and it failed,  i have a son who is 15 to a previous relationship and he was a natural conception and birth by c section as he was 9lbs when he was born, i expected my ivf to work. the only reason in my opinion it did not work was maybe i use nasal decongestants called sudafed. do decongestants halt embryo implantation",
    "doctor_response": "HIWell come to HCMLook as long as the side effect of drug are concern on fetus so the drug effects mainly works organogenesis phase it may not affect the implantation of embryo and the drug called Sudafed may not be having any effect on developing of embryo in case of IVF, hope this information helps you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "normocytic normochromic neutrophilia in blood picture, vitamin d :4.98 ng/ml\n\nI have seen normocytic normochromic neutropilia in my blood picture whats this? and I do also have vitamin D deficiency, my vitamin d report shows 4.98 ng/ml. Kindly suggest.",
    "doctor_response": "Hi, I think your neutrophilia might be due to any infection in your body.For your low Vitamin D , you need Vitamin D supplementation either in injectable form or weekly tablets or sachet.Along with Vitamin D take calcium rich diet like dairy products such as milk, cheese and yogurt.Hope it helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe abdominal pain after knee surgery?\n\nHi, My son has just had knee surgery and returned from hospital yesterday afternoon. He slept well last night but woke up this morning with severe (7/10 pain rate) upper abdominal pain (about a hand span down from nipple line) The pain comes in spasms which last for 7 - 10 minutes and occur every 20 -30 minutes. Medication has been panadol (last dose 27 hours ago) and tramadol (last dose 22 hours ago). He ate normally last night and toileting is normal. Any suggestions/thoughts appreciated.",
    "doctor_response": "Hi.Thanks for your query.Your son has developed severe pain in the upper abdomen days after Knee Surgery, hand-span down the nipple line. Pain comes in spasms lasting for 7 to 10 minutes, and occur every 20 to 30 minutes. Taking Panadol and Tramadol.Ate normally yesterday and toileting is normal. The possible causes are:Acid peptic disease wherein you get gastric or duodenal ulcer or esophagitis.Pancreatitis.I would advise you the following:Start giving him PPI like pantoprazole.Antacid liquids at 3 hourly interval.Get an Upper GI Endoscopy and CT scan of the abdomen.Clinical evaluation and physical examination by a Doctor, preferably a Gastroenterologist helps more.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment should one take for subdural hematoma in a 5 month old ?\n\nMy son born on 13th September 2011 and next day he got some problem for which we took him into Government hospital where we were told that he got hypoglycemia and later his heart beat stopped. The heart beat they recovered and gave us manual ambu to pump. We did for 5 hours and when enquired how long we have to do that, we were told that they do not have any working ventilator and then we shifted to different hospital where he treated on Octroid at first to control insulin and then diazoxide for controlling sugar and saved the life but because of hypoglycemia and non supply of oxygen to brain , his brain has a gross damage. The second MRI reflected many pot holes at different place and in the left brain there was a clot also (subdural haemotoma) which later drained out surgically and placed a shunt there. Now as were told there is no chance of recovery of brain and he surely be moving towards spastic. I want to know if any thing we can do to revert such damage?? If required, I will post all the reports (MRI, CT-SCAN, Discharge summary etc). The baby boy is now 5 months old.",
    "doctor_response": "Since the convenctional mode of treatment is of no help, Homeopathy can help you if you believe in the science. You can give you child the following treatment, since thesee medicines have npo side effects it can safely be given to the baby. 1 dose of Nat phos 200. Either 1 drop on the tongue of rub the medicine in the web of baby's finger Arnica 200  repeated every six hours to be given in the form of drop on the baby's tongue or can be rubbed on the web of the baby's finger.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the prognosis of CHF stage IV?\n\nmy mother has stage IV CHF, she experiences shortness of breath, cannot get up a few stairs without rest and often has dizzy spells, when she was in hospital she also suffered from acute kidney failure. She has been advised that she is not a candidate for heart transplant and she was advised here heart is at 10% function. Can you advise what can be done at what is approx life expectancy.",
    "doctor_response": "Hi ThereIt's very unpleasant to hear that and I completely understand what you are going through. Stage 4 is the last stage of ChF ( congestive heart failure) and medicines barely provide any relief to the patient. The only option at this stage is a heart transplant but again unfortunately due to the complexity of the surgery and many other factors very few patients qualify for it.90% of the patients will pass away within one year of stage 4 Heart failure. Just try to keep her happy all the time be with her don't let her feel lonely.May god bless",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a test to determine if chest pain is due to an anxiety attack?\n\nMy husband past away in Sept...I had been his caregiver for 2 years. I had mild chestpain at night several times, I just relaxed and did breathing and fell asleep. I figured it was just end of day tension. Recently I had the same feeling but much worse.My Dr took a electrocardiogram, it showed a small heart attack.Went to cardiologist, passed stress test, echo cardiogram showed no blockages. Recommended exercise. Last night had same problem. I am thinking it is anxiety attack. Is there a test to determine that.",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Yes, troponin I blood test is the answer of your question. Troponin I rises in heart attack. So if your chest pain is due to heart diseases then troponin I will be high. But if it is due to anxiety then troponin I will be normal. So get done troponin I test at the time of chest pain. In my opinion, your chest pain is mostly due to stress and anxiety because your all cardiac reports are normal. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic drugs (propranolol and flunarizine combination) too. Don't worry, you will be alright with all these. Avoid stress and tension, be relax and calm. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure irritable bowel in children?\n\nSir. my child is suffering from irritating bowel movement. Soon after eating he gets stomach cramp and feels like passing stool. Sometimes he does too he also has fever and his stool first two days was neither normal nor watery but today he did watery. I started his medication as prescribed zifi 100. Drotin ds and bifilac from today as prescribed by his dr pls let me knowe what are these symptoms of and if these medication are ok m very stressed looking at my childs condition",
    "doctor_response": "Thanks for following, it is usual interstine infection. She has enteroclitis now.After 5 days antibioticotherapy she will be OK. Bifilac is necessary to continue till 1 month for normalization flora in interstine. For treatment of irritation intestine after course of zifi you should start giving boiled cool water with flaxseeds and fenhell 3 times after 1 hour before meal 14 days, mentha tea will also calm down irritation and decrease spasmus. For better digestion add enzimes during 14 daysBest regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain\n\nI have suffered with a back pain (L5) for 2 years after and prolapsed disc and had recovered but got worse recently and experienced lower back pain and pain in both legs. After 10 days this escalated into numbness from the waist down and admitted to hospital and diagnosed with Caudia Equina Syndrome and had surgery to remove the compression within about 24 hours. It is now over 3 weeks since the operation and still have little feeling in the right foot, have lost a large percentage of muscle tome in my calves and backs of legs and buttocks and still have no feeling artound my saddle area. It is also very difficult to predict when I need to empty my bowels. Whatg are the chances of a full rcovery in this instance",
    "doctor_response": "Dear you have come out of a crisis due to timely intervention of the treating surgeon. Cauda equina syndrome is a urgent indication for surgery and that so because, it causes compression on nerve supplying our bowel and bladder. now since decompression has been done you will have no further deterioration, but the neural deficit you already developed before surgery takes tie to recover and this time depends form 4 to 6 months and sometimes year.Be patient follow the instructions given to you regarding physiotherapy. and you will get ok with time",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes redness and pain around Cortisone injection site?\n\nI got a cortisone shot several months ago in my elbow for tendonitis and my elbow was fine for a month or so but then I developed a couple small sores. One has never healed and it seems to be at the injection entry site. and it hurts to touch. It seems like a deep hole. Its very painful. The skin around it is red and feels like a burn. It does not itch! Also the skin round my elbow looks like it is a different color than normal. I m wondering if that is normal after a cortisone shot?",
    "doctor_response": "Hello, Discoloration or redness after a injection of Cortizone is a possible side effect. One can also form a scar tissue at the site of injection if your skin is very sensitive or prone to it. Importantly also, an infection at the site of injection should be excluded. Infections at the site of injections are not uncommon and if they occur they usually require an antibiotic treatment. I recommend that you return to your doctor and have them check the area of concern to make sure that there is no infection going on. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Kamila Seilhan, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for kidney problem\n\nhi this is siva my grandfather has some problem in kidney our family doctor said test PSA and the result is 4.64 then the doctor said trus guided biopsy presently we are in vijayawada which doctor can do this test.can i know famous doctor for nephrologist in vijayawada city",
    "doctor_response": "Hello! It is not clear from your question whether the doctor suspects a problem in the kidney or the prostate gland. PSA is done to evaluate prostate status. Your grandpa's PSA is 4.64 which is minimally elevated probably due to mild inflammation in the prostate. I would advise you to get an ultrasound examination of the abdomen and then meet a urologist. All the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing my daughter s recurring headaches?\n\nHello sir, My daughter suffers from daily headaches. They started at age about three years back. she is now 11 years old. what could be the cause. Most importantly, she has photosensitivity during these headaches. There have been no problems in her vision. Please suggest how would I go further.",
    "doctor_response": "Hello, Daily headaches are very disruptive! I'm sorry to hear this. Since she has been having headaches for 3 years, it is not likely to be because of a tumor because this would have gotten worse. The fact that she has photo-sensitivity would lead to the diagnosis of migraine. She should see a neurologist to try a daily preventive medication. There are several to choose from and try. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Lisa Baker, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does the TSH value rise during pregnancy?\n\nI am six weeks pregnant. In 2002 I had Grave s disease treated with radioactive iodine. I had a healthy pregnancy and birth in 2003-2004. As soon as I conceived then, my tsh went right up to 6 or 7 and my meds had to be adjusted. I had a miscarriage in December of 09 and then my tsh and free t4 were normal. My tsh and free t4 are now currently normal at 6 weeks as well - tsh 3.05 and free t4 21. I was just wondering if tsh automatically rises with pregnancy and should I be concerned this pregnancy isn t going to work out either?",
    "doctor_response": "Hi there,,I understand your concern, but TSH values being normal is a positive finding not to cause you more anxiety. TSH values do rise in normal and in persons who have had hyperthyroidism treated before. The radioactive iodine destroys the thyroid gland and thyroid supplements are required through out when TSH levels go high, more so in pregnancy.You have linked your first pregnancy with high TSH to normalcy and thinking that your second pregnancy where you miscarried due to Low TSH,     but that is not so. 1 in 5 of all pregnancies miscarry even in women without any medical condition so we cannot attribute the lost pregnancy to thyroid.You need to make sure that the TSH levels stay normal in this pregnancy and that you get this checked three monthly atleast.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Incest nightmares. Never suffered incest as a child. Result of curiosity. How can I get rid of it?\n\nHello Dr.XXXXXX,I have a problem, regarding incest nightmare.I'm a male 24, In my childhood i'm not sexually abused by family members.They love me like i'm 5 years old. My father is expired 5 years ago. My mom is overprotective and annoying sister.i read too many action comics, and suddenly i started reading incest comics out of curiosity. Now weekly i have incestuous dream(nightmare) twice. Its hurting me too much. How can i get rid of it. i want to live a normal life as a loving son and brother to lead them in a right path to the future. i have too much of responsibility. Please help me.",
    "doctor_response": "Hello,welcome to Healthcare Magic.Dreams are dependent on following factors: memory of past, current life events and nocturnal stimulation. Reading comic may be one of the reason reason related to incest dream.Following steps will help you:-Do not worry and focus on your dreams.-Follow steps of sleep hygiene-If you are much distressed, then visit nearby psychiatrist. Wish you good health and all the best.Regards,Dr Ashish Kumar Mittalwww.99doctor.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful lump on the neck\n\nI have a lump on the left side of my neck. It has been there for about 2 weeks. It s about 2 inches away from the bottom of my ear lobe. It s hard & doesn t move. Recently it started hurting whenever I turn my neck & today I started to feel a throbbing pain by the lump. I also have pain in the back left side of my neck. I do have a smaller lump on the left side of my neck, but that one is small & doesn t hurt, and it moves around a little. I was just wondering what could cause this. Could it be cancerous? I do plan on going to the hospital tomorrow night (I d go tonight, but I have to work early tomorrow morning), so I will talk to a doctor in person & have them check it out, but I just wanted to get an idea of what s going on.",
    "doctor_response": "hi.it is best if you consult with a doctor, preferably a general or an ENT surgeon, for medical and physical examination. two things to consider primarily based from your description: 1. a possible cervical lymphadenopathy (inflamed lymph node) probably secondary to a recent upper respiratory tract infection 2. a possible lesion of thyroid or salivary gland in origin. other considerations may be fibroma, lipoma or cyst.. clinical examination from your doctor will be of great help. further diagnostic examination such as neck ultrasound, ct-scan or x-ray, thyroid function tests and tissue biopsy will be recommended as needed. malignancy and other tumor types must be ruled-out. subsequent management (medical and/or surgical if indications are found) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for phimosis?\n\nHi, may I answer your health queries right now ?  Please type your query here...hi name is priya , isaw a case of phimosis,men about 36years old , he  had compliants of  swelling in the prepuce since 2days, slight pain along with sediments of white discharge under the foreskin since one week. please tell medicine and also the scope",
    "doctor_response": "Hello, He is having a balanitis infection of glans penis. He can be given anti-inflammatory medicine and antifungal topical cream over the affected area. If phimosis persists after resolution of inflammation than circumcision operation can be done to relieve phimosis. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could on and off pain in joints of wrists,elbows and knees, headache and sharp pain between spine and shoulder blade suggest?\n\nConcerned Symptoms I am a 27 year old woman and have been experiencing some concerned symptoms of some sort. I have achimg joints from time to time mostly in my wrists, fingers, elbows and knees. No usual time when aches occur. Happens in morning, noon amd night. This has been goinf on for over 10 years now. There are times it feels as if the pain is stemming from inside my bones specifically my forearms and above my knees. I ve been having bad headaches off and on for about 3 years now. Sometimes it feels as if someone hit my head with a baseball bat. Some headaches make my eyes sensitive to light. Headaches are typically felt on between my eyelid and eyebrow. It can last anywhere from a few minutes to an entire work day. There are times when I feel as if I m just about to faint kind of a woozy/fatigue feeling similar to when laying down and standing up really quickly. It s difficult to carry on a conversation or concentrate on a ny given thing. I feel as if I need to hide underneath a blanket in complete darkness. I ve also had a sharp/dull/burning like feeling & pain between my spine and right shoulder blade. I got an xray and a blood test done for all sorts of things and the results came back with everything checking out alright. The Xray did not reveal anything significant according to primary physician (whom I don t trust or any other doctor from where I m from -Guam). The pain started in 2006 when I was sitting down at work just having a conversation w/ colleagues. The pain at first was unbearable then slowly started to be a dull pain with a similarity of a burning sensation. Family Medical History- Heat Disease, Diabetes, Cancer, Lupus. I hope this can help me. Doctor s here just keep asking for blood work and its hopeless.",
    "doctor_response": "Hello, It could be a musculoskeletal pain. As a first line management, you can take analgesics like Paracetamol or Aceclofenac for pain relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for erectile dysfunction\n\nHello Doctor, I am married since 6mts, every thing was going on good all these days. But from last one week i am not able to have sex with my wife. My temptations will not stay for long time. My penis wll not have good strength. Can u plz suggest me wat is the reason for this.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.There are many reason for this thing to happen.It may be lack of foreplay, improper atmosphere etc.Many a times monotonous atmosphere can cause such a problem. I advice you should change the sex positions frequently. Always think about the best things while doing the act.You can use sildenafile as aphrodisiac. But it should be taken under your doctors guidance. It will give you a good eraction.Watching a porn movies before the act can help you achieving the good eraction, penetration and ejaculation.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why hasn t injury to trap muscle healed yet?\n\nHi the last sports injury doctor told me i tore my trap 3 months ago, swelling is about half way gone, won t go away fully. When moving through full range of moition i hit muscle failure for a second. He told me it should have healed within the first couple of weeks.",
    "doctor_response": "Hi, Consult an orthopaedician and get evaluated. In severe cases surgical correction may be required. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Should I go ahead with varicocelectomy to improve my sperm count?\n\nHi doctor, I have been diagnosed with bilateral varicocele grade II and III. My urologist recommended microscopic varicocelectomy after reviewing my test results. I am 32 years old and all of my blood test results, including hormones were in the normal range. However, my semen analysis showed that there are approximately 34 million sperms and out of which 60% are of good motility that is approximately 20 million. My semen analysis from 6 years ago was nearly 90 million sperm count with 60% motility. I understand that my current sperm count is at the bottom of the normal range. Me and my wife are not planning to have kids for the next one or two years and have not tried yet. My doctor recommends the surgery because there is going to be some improvement in the sperm count if he performs the procedure. I prefer to avoid the surgery if not necessary. I have a few questions.\u00a0Is the sperm count going to be significantly different three years from now after performing the procedure?\u00a0Is there a downside with leaving a permanent suture in my body for the rest of my life? What happens to the permanent sutures if the veins shrink or get absorbed by the body? I am not comfortable with leaving an external object (silk in my case) in my body for the rest of my life, especially if it causes problems in the future and I have to remove it later on. I am a highly active person and play soccer and go to the gym regularly. I am\u00a0not sure how experienced the doctor should be for this procedure. My doctor is relatively young and obviously less experienced. Please help.",
    "doctor_response": "Hi. Revert back with the report to a sexologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly suggest a treatment for corneal dystrophy.\n\nHello doctor, I had a consultation with a local doctor, and she told me that I have corneal dystrophy. It is genetic here as my mother also have that. I can see bubbles moving around when I concentrate at any point, it is like tiny white color dots on cornea. I am using spectacles since last few years (cylindrical power, -2(L), -1.5(R)). This dystrophy is not a big problem for now, but it creates a problem when I study or read something. It creates a headache, which distracts me while studying. Can you please suggest me a treatment either prevention through surgery or medication (any eye drop)? Please let me know if you need further details. Thank you.",
    "doctor_response": "Hello. Dystrophies of the cornea are divided based on the layer of cornea involved. If the dystrophy is the cause of your headache, then your dystrophy must involve the outer layers of cornea. More than frank pain, these conditions cause irritation which increases on blinking, more during early morning hours. If this is the case, then the best over-the-counter medication is Lacrigel (2% Hydroxypropyl methylcellulose acetate). This medication is essentially a gel formulation of the drops your doctor has recommended and just like the drops, it will cause no side effects except for mild blurring soon after installation. The exact diagnosis of such dystrophies can be done by a cornea specialist. In case you need any further information, please send a very clear and magnified photo of your cornea. I will do my best to help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for dust allergy and cough?\n\npatient:Rajaram-Male,48years.suffering from dust alergy & cough for 3 months.lost weight 6kg.consulted doctor with chest x ray.advised to take montec-lc, levofloxacin,monto4,adliv forte & Blong.cough subsided 80%.a strong apetite, playing shuttle, medicine(monto4) continued last 25 days. like to know healthiness of lungs and further treatment.",
    "doctor_response": "Hello Rajaram,Thank you for asking at HCM.I went through your history and would like to make suggestions for you as follows:1. I would almost agree with your current treatment and would suggest you to continue Montec-LC for sinusitis.2. To know healthiness of lungs, I would suggest you spirometry which measures your lung capacity. 3. For diagnosis of allergies, I would suggest you allergy testing which will help you identify the substances causing allergies to you and also to know the measures to avoid them.Based on the report, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which works on immune system to gradually improve allergy symptoms over a long period. This consists the further treatment of allergies.4. In general I would suggest you to avoid exposure to dusts, smokes and air pollution.5. Regular breathing exercises and a healthy diet also will help you in a long run.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes redness on tip of penis?\n\nHello I have been tested for stds and all results negative I have some redness on tip of penis and underneath shaft of penis also sugar is normal to rule out diabetes taken a fungal cream still no change my brother is a neurosurgeon talked to him he said go see dermatologist",
    "doctor_response": "Hi,Thanks for writing in.There is no need to get worried if your tests for all STDs are negative. It can be a fungal infection or mild bacterial infection. A fungal cream usually takes a week or two weeks of application to show any visible change but the itching disappears in 2 to 3 days. The other possibility is a mild infection of the foreskin (if uncircumcised) or the glans. This might require a short course of antibiotics. Many times color changes in the tip of penis without any symptoms can be a normal occurrence. A dermatologist will confirm your condition and give you more specific treatment. Please maintain genital hygiene and wear cotton inner clothes if you sweat a lot.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reddish stripes on the body before menstruation. Rashes with irritation and pain in the hand. Treatment?\n\nI am facing   red strips as cut marks on body before 2-3 days of menstruation period.  from two years earlier it was on above backbone then last time it was on my chick and face.  I have consulted to a skin doctor and  took medicines. But this time I have different type of  red rashes with  little irritation and pain in a the same hand from shoulder on hand above elbow.  Please advise me any home or other treatment.Thanking you,with regards,seema",
    "doctor_response": "Hello,Thanks for the query,Rash on the body in association of menses might be related to hormones.Near menses, levels of progesterone is high in body There is an entity called as autoimmune progesterone dermatitis.This is associated with skin rash near to menses.Let me know if you have any other doubts.Please meet a dermatologistyou can ask a direct question to me on this forum, following the below link.  you good health.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hand and feet numbness?\n\nok, i have been drinking since college heavy on weekends for about 20 years but about 5 years ago got hooked on cigs. Have high blood pressure but being treated. now i have numbness at night in hands and feet. mostly hands cause I rest them on my chest to sleep on back. is it my high blood pressure, cigs, booze or all above. add to that stopped working out. ugh",
    "doctor_response": "Good day! It is possible that you are suffering what is called \"Peripheral Neuropathy\". It is where the alcohol and its affiliated nutritional deficiencies and dehydration involved will deplete much of the energy and nutrients needed to supply the nerves which provide adequate and accurate sensation to the limbs. I highly recommend of course that you discontinue alcohol and tobacco as they are of course very detrimental to your health. However in the immediate future, I would recommend supplementation to ensure your body is receiving the proper nutrients for proper nerve energy (These are: Multivitamins, B-12 + Folate). You can find these over the counter. I hope you receive some alleviation of your symptoms!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Continuous shaking in hands and legs during hunger, emotional distress, stress after putting braces. What could the disease be?\n\nhi i am 28 year old girl my problem is that my legs specially my hand shake continiously. but when i am hungry or when i hear people argue in loud voice on im happy when people say do work quickly or when i am sad my whole body specially my limbs shake very fast. i am gatting weak.all the time i feel very tired and depresse.kindly tell what is my problem/disease. i got this problem after i wear breases and taking antibiotics till 3 months continiously",
    "doctor_response": "still needs of lot of information.. however looks like you might be having anxiety disorder, and needs a consultation and medications",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dark patches around nose and mouth, face darker than body. Suggest a remedy\n\nHi this is manoj and I ve dark patches around nose and mouth, how to get rid of thid? And also I have dark scene color where I normally shave over the face as compare other skin color on my face. In short my face skin color is dark as compare to body. Pls suggest me something to remove this ftom my face as I am getting married soon and this is really annoying me. Thnx.",
    "doctor_response": "hello, welcome to HCM, as per the descrition you have been giving, i suspect the skin condition of yours will be 1. DARK PATCHES AROUND NOSE AND MOUTH POINTING TOWARDS A CONDITION CALLED MELASMA OR IT MAY BE PHOTO-PIGMENTATION  , DUE TO EXCESSIVE EXPOSURE TO SUN-LIGHT 2. DARK SKIN IN THE SHAVING AREA OF BEARD POINTING TOWARDS- POST-INFLAMMATORY PIGMENTATION, EITHER DUE TO ROUGH SHAVING OR REVERSE SHAVING OR USAGE OF CHEAP QUALITY TRIMMERS any how you need to be exami9ned properly and should be seen directly by eye to know the level of pigmentation u have and perfect treatment required for you... i advise you to consult a dermatologist for further evaluation and treatment..until then start using good non-oil based sunscreen lotion .. MANY OF NEWER TREATMENT MODALITIES FOR UR CONDITION..MOST EFFECTIVE IS CHEMICAL PEELING... CHEMICAL PEELING WITH SLC peel system (salicylic acid +lactic acid +citric acid ) will be more effective for u....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Baby was given DTP and Jaundice injections, should my baby take other 2inj of brain fever ?\n\nI have a girl baby she is 4months old, First 2 months she was given DTP and Jaundice injections, in 3rd month as there was no stock of Jaindice Injections. My baby was only injected with DTP inj and after 3weeks from that inj. I took her to a private hospital for jaundice inj, dr asked wheither brain fever inj is given when i told no he told that he will give both jaundice and brain fever inj at a time, i agreed and after giving inj he told to come again for remaining 2 doses in next 2 months my question is should my baby take other 2inj of brain fever",
    "doctor_response": "yes, u should give remaining 2 injection of brain fever. if u not give same , the effect of 1st brain fever injection was not come & ur baby was not protected from same. so u should give all vaccine to ur baby in future to prevent ur baby from all vaccine preventable illness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hemolytic anemia?\n\nHi! Doctor I am a patient of haemolytic anemea now I am suffering from jaundice earlier the billiubrium value raised to 50 but now I am discharged with the billiubrium 10 value .now 5 days are already passed . how much time it will take to recover fully.",
    "doctor_response": "There are many causes of hemolytic anemia. Some causes are due to problems in the genes such as THALASSEMIA , G6PD deficiency , sickle cell anemia etc. Other causes are acquired such as due to certain drugs or autoimmune diseases. The term HEMOLYTIC means red cells are being destroyed at an increasing rate. Normally our red cells live for 120 days after that they are destroyed. To put it in a simple way when they are destroyed , their waste products are bilirubin ( yellow in color)which in normal people doesn't accumulate. However in hemolytic anemia the life span of the red cell is reduced and the red cells get destroyed faster so the bilirubin that is produced accumulates causing jaundice. As you have not included your complete blood report I cannot offer you an explanation of the type of hemolytic anemia that you are suffering from. If the hemolytic anemia occurred suddenly after say taking a medicine then one of the possibilities is hemolytic anemia due to G6PD deficiency which is an enzyme within the red cells. There are many causes of hemolytic anemia. Different treatments for different causes so I can give you a detailed explanation only if I have more information on the blood tests that have been done for you. Warmest regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is medical marijuana recommended for psoriasis treatment?\n\nHi, i have Psoriasis and it started small, but is spreading fast. i haven't tried anything for it yet. But it is always irritating my skin, and i think i might be catching arthritis too. Everyone i have talked to who has it said there doctors recommend Medical Marijuana? should i go for that too?",
    "doctor_response": "Hi, welcome to HCM,Psoriasis after long time affects joint and known as psoriatic arthritis.There is nothing like medical marijuana which is prescribed for psoriasis.I usually prescribe Tab methotrexate in weekly dose.super potent steroid mixed in salicylic acid and urea for local application. Emollient for whole body application.All these need medical supervision and titration of dose.Hope this is helpful.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can there be chances of pregnancy while on birth control?\n\nhello, me and my partner got a bit carried away last night, we didnt have a condom, but we still had sex for not very long, he pulled out before he ejaculated. Im worried about pre-cum, i do not know if he did or not, also im on the birth control patch, and have been for about a year now, is there any chance of me being pregnant?",
    "doctor_response": "Hi , How are you doing ?If you are taking the birth control patch regularly without any break, then you need not worry about pregnancy. But if there is any chance that you have forgotten to use it or removed it earlier, then there is risk of pregnancy. Even if he did not ejaculate, the preseminal fluid is rich in healthy & faster moving sperms. So Pregnancy chances are still higher . If you have missed the patch & also come in contact with preseminal fluid, I would advise you to have Emergency contraceptives immediately.Hope I have clarified your query, do write back if any more queriesAll the bestDr.Balakrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Olmezest Beta be stopped after BP comes under control?\n\nHi I am 27 years old and diagnsoed with hypertension having b.p. at 150/110 usually. I have been prescribed Olmezest Beta 50, I want to know if there is a possibility of stopping the medicine in futute once the blood pressure is under control.ThanksAnupam",
    "doctor_response": "Ideally antihypertensive medicines must never be stopped.but as you are 27 you must undergo investigations to find out any cause suggesting you may secondary hypertension.if u find cause then first address the removeal of cause and then it may be first reduced and then stopped.if no cause found then it should be considered primary HT starting at young age and u must continue medicine life long.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have experienced mid-back pain. Which is sometime sharp and some time dull.\n\nI am a 35 y/o male in general good health. Within an hour of eachother I have experienced Mid- back pain . Sharp and dull pain. About a half hour later the pain shot down my leg also causing sharp and dull pain. My leg hurts just below my knee cap on the front side. My back had the sharp pain when I try to straighten my back and the pain in my leg is sharp when I lift it. I have no history of muscle pain or back issues.",
    "doctor_response": "dear one why are you avoiding such a serious condition of yours back.Back-spine is the main structural bone,which help us in daily life.you have compression of spinal nerves,it is very serious,must be investigated properly,as early as you can,only then it can be treated to cure you.pl go to orthopedic surgeon immediately,it may be infection or simpley compression. dr s k gupta",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the chances of contracting HIV through unprotected anal sex?\n\nHi doctor, My fiancee and I are not known HIV positive. But we have had unprotected anal sex ten times so far. Can we be\u00a0infected with\u00a0HIV?",
    "doctor_response": "Hi. If you both do not have HIV (human immunodeficiency virus), then from where can HIV come? Hope your query is answered, but if you still have any other query, please revert. Best wishes. For more information consult an HIV AIDS specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes upper quadrant abdominal pain radiating to the back?\n\nBeen ill since early April. Suffering from right, upper quadrant abdominal pains, stabbing feeling which radiates through to the back. This lasts for 1 hour + and I struggle to sleep on my right side when I m having an episode . Joint pains, mostly in right knee and ankles, although I have had injuries in my right knee and left ankle before. Diarrhoea, nausea and severe fatigue and weakness, headaches occur 1/2 times a day and are usually located on the right. I noticed yesterday that my upper arms were boiling hot, as was my neck - felt similar to fresh sunburn. My doctor has hinted at kidney problems (family history too) but any idea of what this could be? Much appreciated!",
    "doctor_response": "Hi , after reading your summary , it seems that injuries to your knee  or joint pains have no direct correlation to your (R) Upper quadrant abdominal pain radiating to your back. Yes, Your doctor is on the right track, so should follow his line of investigation and therapy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How serious is ear infection and kidney infection in a 2 year old?\n\nhi Dr,my 2yr and 8 months old baby girl was suffering from high temp and continuous vomiting few days ago.we consulted a Dr and he told she is having ear infection ( dark reddening deep inside the ear) and kidney infection.when he touched he back side,she yelled in pain.she is having head ache also.today morn her leg also aching.antibiotic treatment started.i want to know how severe is this.is it completely curable.she is 12.5kg .but born as premature weighing only 2 kg.she had 3 times malaria since her first Bday.and more than 5 times sorethroat.please give me ur valuable answer.",
    "doctor_response": "Good afternoon..!!Ear and kidney infections occurring simultaneously could mean that your 2 year 8 month old daughter has low immunity levels indicated by frequent sore throats and malaria three times.Yes, they are completely curable with proper treatment. Nothing to worry much.So if the problem is recurring, it's better to visit pediatric ENT surgeon and pediatric nephrologist for further evaluation and management.Thank you, have a nice day..!!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does the MRSA infection spread?\n\nMy sons girlfriend was just diagnosed with Mrsa. She has infection in her breast... They were going to do surgery, but called it off until they get it cleared up. How contagious is it? The doctor said as long as you don t touch it.You cant get it. Is this true?? I thought that it was very contagious",
    "doctor_response": "HI, thanks for using healthcare magicMRSA (methicillin resistant stap aureus) refers to the presence of a bacteria that is resistant to standard antibiotics.It occurs mainly in persons with a history of frequent antibiotic use though it can also be spread from one person to the other.There are some persons who have this resistant bacteria and are not aware of it.As her doctors mentioned, it may be spread by contact with the infected area.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe OCD be treated?\n\nI suffer from OCD, I stay in China. I am a Neuroscientist. From last one year I was on Fluvoxamine. I started with 200 mg and my intrusive thoughts are checked. Then after 4 months I reduced to 150 mg, and this was also effective, again I reduced to 100 mg, and my symptoms were in check. Recently week back the dossage I reduced to 50 mg, but ocd retuns full fledged, So I am now with 100 mg for last 4 days, but symptoms are stll same. Could you suggest what exact dossage I need to check?",
    "doctor_response": "Hello,Fluvoxamine drug can be given up to 300 mg. Once you are stable on a particular dose, keep that dose. Do not reduce the dose as next time you might need a higher dose if you have reduced or stopped it.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Rohit Kothari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a persistent cough\n\nmy kid is 3 years old. he is seroflo inhaler for close to 1.5 months and asthalin inhaler is given as and when required. this time we gave him for about 5-6 days as per doctors advise. thereafter doc suggested sal mucolite. that too we have him close to 5 days. cough still persits. am very worried as my son is perpetually on medicine for something or the other. kindly advise.",
    "doctor_response": "Hello, You are following correct medication plan. seroflo inhalation will reduce inflammation of air passages. Asthalin will help to keep the lung open. mucolite also do the same. Sometimes cough may present for a few days though the inflammation is over. This is due to irritation of air passages in the past. you can wait for a few days. Otherwise, you can give Cetrizine syp in the night after consulting with your family pediatrician. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Rajmohan, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for loss of concentration\n\nHi, may I answer your health queries right now ? Please type your query here...i will think about others more then myself ...even in the exam hall i will show the anwers without completing the total question paper by which i lost my % and one subject as invigilator has taken my paper and gave to me at last 10min ...and i failed by 4m...i very much confused at exam hall and know i have that exam on 15 and i am feeling very much distrubed and not at all concentrating on the subject plz sir help out as",
    "doctor_response": "Dear User,Thanks for using health care magic.From the available description it appears that you might be sffering from attention deficit hyperactive disorder which is found in almost 3-4% of boys and 2 % of girls. Most of the cases remain undiagnosed in country like India because of lack of awareness and unavailability of health professional at grass root level.In my view see a psychiatrist along with your parents  (preferably mother) to get thoroughly investigated. Your psychiatrist will ask more history like hyperactivity and birth details from your mother. Please get informed about the same disorder yourself and educate yurself so you can take better care.Currently there are multiple medicines are available which are approved for ADHD and this disorder is largely treatable. 'Hope I have answered your query. If you have any further questions I will be happy to help\".Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red, itchy patches on torso, collarbone and face?\n\nI have recently developed red, itchy patches on my torso, collar bone and (sometimes) face. I have been drinking Herbal Life shakes & protein for approx 2.5 months and also taking some of their supplements. Today, I found out that many people have developed these conditions after taking Herbal Life....I definitely think stopping the products is in order, but am wondering what ingredient I could be allergic to???",
    "doctor_response": "HI, thanks for using healthcare magicIt is possible to develop an allergic reaction to any herb, medication , food or drink consumed.The risk of possible reactions would vary from one person to the next.It would not be possible to know which ingredient you are allergic to unless you have allergy testing done for each one.You can ask your doctor whether one of these allergy profiles is available.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for psoriasis ?\n\nHi Doctor , I am suffering from psoriasis since 3 years....nowadays it has become increased. kindly let me know the best dermatologist to consult. I am living in chennai, Tamilnadu, India. plz help me know.",
    "doctor_response": "HELLO WELCOME TO HCM... FOR YOUR PSORIASIS THERE SO MANY GOOD MEDICINE IN HOMOEOPATHY. THAT GIVE YOU RELIEF IN LONG STANDING SKIN PROBLEM . SO , CONSULT HOMOEOPATHIC CONSULTANT OR IF YOU WANT FROM ME ONLINE HOMOEOAPATHY THAN MAIL ME drvipul2001@yahoo.com MEET AGAIN FOR BETTER HEALTH..TAKE CARE",
    "dialogue_context": ""
  },
  {
    "patient_message": "Side pain and nausea after 5 months of hysterectomy\n\nI am a 35 year old female, had a hysterectomy 5 years ago. For about 4 days I have had a bruise like pain on my left, lower, back rib area and nausea . After I eat it seems to get worse. Also for the same amount of time I have been having terrible acid reflux (lump feeling in my throat ) and have never had it before.",
    "doctor_response": "thanks for choosing health care magic.you seems to have possibly either stomach infection and indigestion.take light diet and drink more fluids.Avoid eating late,and fried and spicy food,take some antacids.Try to sleep with couple of pillows under your shoulder for couple of days.If this does not improve you need ultrasound to rule out gall stones and urinary stones.then consult your doctor,try to avoid strong analgesics.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold due to allergy\n\nHello Doctor, My Son is 4 years old.He always sneezes in the morning and is always has mucus in his nose.I have tried all medications but his cold never seems to reduce.Is it got anything to do with eosinophil count or any food allergies.What do I do",
    "doctor_response": "Hi thank you for choosing healthcare magic.Is your child having itching near his nose and picks his nose? If so he may be suffering from allergic rhinitis which is causing all the symptoms. You can try simple anti allergic medication like Levocetrizine or monteleukast for a few weeks after consulting your paediatrician. If they are showing no response your can also try intranasal steroid puffs.Hope this has helped you. Your vote of thanks is appreciated,Good luck,  Dr J Sravanthi, Peadiatrician and Neonatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is eye floaters an optical problem or neurological or a combination of both?\n\nHi doctor, I am a 35 year old male. I have floaters in both eyes which developed after severe eye infection at the age of 28 with the use of welding light. Previously, I received treatment for stress. I had tablet Cipralex (Escitalopram) 10 mg for around 3 years. Currently, I am not on any such medication. While taking Cipralex, I used to get good sleep and my light sensitivity suppressed. I had undergone brain CT two years and four years ago, both were normal. My MRI and angio of scalp and brain done this year are also normal. I got meningitis vaccination in 2010 due to gulf visa requirement. I used to get routine eye check up and fundus examination every six months. My eye pressure is maintained at 18/20. In perimetry, there is no glaucoma. I have normal sharp vision of 6/6. I also got OCT recently to check retina. My problems are light sensitivity\u00a0and disturbed sleep. The light spot does not go away quickly. I am disturbed with dreams at night and no proper sleep. I have sound intolerance too. I would like to know whether my light sensitivity is a neurological problem or optical issue or a combination of both. My neurologist prescribed Flunarizine and Escitalopram for light sensitivity. I am concerned with these drugs as they are SSRI. I am bothered about my light and sound sensitivity along with disturbed sleep pattern. Kindly guide me.",
    "doctor_response": "Hi. Eye floaters. 1. Eye infection. 2. Migraines. 3. Sleep disturbance. Continue with current medications. Sleep hygiene. For further information consult a neurologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is sharp, tight pain at the base of throat when breathing heavily be normal muscle spasm?\n\nWhen I breathe too heavily or laugh too hard, I get a sharp tight pain for about 3-5 seconds in the base of my throat that spans up on occasion. It goes very quick, but it s happened a couple of times in the past week. Is this a normal muscle spasm? My heart is in good condition, beating normally at about 70-80 beats per minute, and my blood pressure is normal. But I do get stressed alot and anxious.",
    "doctor_response": "Hi, With this condition, when you feel sharp tight pain in the base of the neck on stressed breathing - cardiac condition cannot be ruled out. I suggest a complete cardiac check up with stress echo. Do visit a cardiologist. Hope I have answered your query. Let me know if I can assist you further. Thanks Regards, Dr. Gopal Goel Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in my neck and shoulder?\n\nHi! I am 29 year old female. From last 2 weeks I had pain in mony neck and shoulder region.I was applying moove and the pain subsided a bit. But from past 3 days I have developed swelling under my right jaw near the ear and its pretty painful. It is painful to touch also and I have difficulty in moving my neck too. I dont have trouble swallowing or pain in my throat. What could be this?",
    "doctor_response": "Dear patient You are showing  signs of parotitis. This  condition is characterised by  inflammation  of parotid gland.  This lies just anterior to ear and below the jaw.thia condition is usually bilateral bit infective cases may have unilateral affection. I would like to advise ultrasound  of local part asap. You need to consult expert  ENT  specialist nearby your area with report. Avoid solid foods and take tab diclofenac plus serratiopeptodase combination twice a day for pain relief.  Do hot water fomentation locally.  All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore lump under left arm?\n\nI have a history of left breast lobular cancer in 2003. I have a hard red pimple size growth under my left arm about 2 inches from hte armpit. It is sore to touch and has been there for a while. I have not noticed pain until the past week or so. I have an appt with my oncologist in July. What should I do?",
    "doctor_response": "Hi, Thanks for query to My HCM virtual Clinic.I studied all details of your query.I understood your health concerns about causes of sore lump under left armpit.Cause of sore lump under left armpit-From the data of the query it seems that you lately had a lump,which is mostly a Boil,as its painful on touching since 1 week.But the location which your query gives,indicates this painful lump is near  to axillary tail of the breast.In this situation I would suggest you to Take Second opinion from your Doctor,as it could be metastatic nodule tethering overlying skin and so has become painful lately since last week.These explanations need to be confirmed by physical check from your GP or Surgeon/and or OncoSurgeon.As your next appt with your Oncologist is there,I would suggest for a Second opinion from your ER Surgeon who would be right doctor who would help in planning treatment with your Oncologins.Hope this reply would help you in resolving this complex query and anxiety with it.I would appreciate if you hit thanks and write excellent review comments to help needy visiting patients at HCM.Welcome for any further query in this regards.Good Day!!Dr.Savaskar M.N.M.S.Genl- CVTS.Senior Surgical Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cramps in the center of the stomach?\n\nmy son has stomach cramps - center of stomach - no fever. He was nauseated for 2 days vomited the first day  - held food the second but still complains of stomach cramps. Wants to sleep and lay flat - does not want to get up and walk around because of the pain.",
    "doctor_response": "HI.The symptoms of  vomiting , pain in the abdomen and pain on walking is definitely an indication for investigations:I would advise you the following:Take him to the Pediatric Surgeon to get a physical examination done to get a clinical diagnosis , to be supported by ultrasonography, blood and urine tests and stool tests. It may be due to : -Tummy tonsils- meaning enlargement of the lymph nodes of the abdomen.-Appendicitis- by default this has to be ruled out in every case of pain in -abdomen of a child.-Worms.The best diagnosis is a high resolution ultrasonography. some blood, urine and stool tests.A therapeutic trial with a course of an antibiotic, metronidazole and probiotics under the guidance of a pediatrician / Surgeon always helps to solve the problem and to get a diagnosis.Also given is a dose of medicines active against worms in intestine.I hope a consultation with a Pediatric Surgeon, investigations and a course of an antibiotic and metronidazole should solve the problem.If this is indicative of appendicitis , please go for the surgery of appendectomy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hyperpigmentation, sensitive skin. can cosmo peel help me?\n\nHi doctor, I have hyper pigmentation and skin is really sensitive. I have mix of hereditory pigmentation and pigmentation due to acne . I also have lentigens. A beauty clinic suggested me to go Cosmo peels. But one of the dermotologist told me that there is no cure to this. There are treatments available but those treatments may have side effects i may loss the colour of my skin. I would like to know if cosmo peel can help me out, but am also scared of going for it.  I would not like to take any risk",
    "doctor_response": "hello this is dr satya, welcome to health care magic facial pigmentary lines, lentigenesare inherited and acne leads to pigmentation which is acquired. satisfactory treatment is not availble for such conditions. cosmo peel is expensive and may not adress the condition. lightening of the skin of the face color may be done by a few sittings of q swithched laser. the results are going to be temporary. camoflage is a good alternative which hides away the abnormal color temporarily without affecting your sin. it is posssible to continue treatment later on thank you dr satya",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest congestion, cough and discomfort while breathing\n\ni was having chest congestion, took antibiotics, cough syrup all went well but now even after a month in the evening whenever feel cold my throat get congest what should i do now.,i feel coughing and breathing discomfort. what should I do now? please suggest",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Your further work up done in case of Auscultation and chest x ray for rule out bronchitis. Spirometry should be done to check whether any restrictive or obstructive lung disease if present. According to cause specific treatment given. CBC, sputum examination like investigation done for further work up. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pulsations and soreness in the shoulders?\n\nive been lifting for about two years, i play football as well.. but i was bench pressing and i knew my form was off now my left shoulder pulsates randomly and hurts at random times. I keep working out but my shoulder still hurts, ive had this pain for about 4 weeks",
    "doctor_response": "Hello,I have studied your case and I think you are having sub acromial bursitis. In this condition there is fluid accumulation in the shoulder and this can cause such pain. For confirmation you need to get MRI of the shoulder.it is good that you are not doing any hard work but you need physiotherapy and hot water fomentation. Also some time there is injection of steroid needed. I hope this answer will be useful for you.Let me know if there is any other followup questions.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for throbbing pain in back of neck\n\nI am a 40 year old woman with a throbbing pain in the back of my neck on the right side.  I have currently been losing weight without exericse (about 1 pound per week).  I had bloodwork done and everything was fine.  I am 5' 5\" tall and about 153 lbs.",
    "doctor_response": "hello memi think you are suffering from cervical spondylosis. it means arthritic changes occur due to age and prolonged neck erecting job. this arthritic changes occur in cervical vertebra. cervical arthritis cause friction upon nerve and cause throbbing pain and numbness in upper arm and back and neck.please follow these treatments-do regular exercise of arm, neck and back=do isometric exercise of neck. it will strengthen the muscle of neck and back which eliminate the friction on the nerve-do hot water fomentation at back and neck. it improves circulation as well as removes waste products which produce pain.it increases the nutrition that repairs the damaged part-take ultrasonic waves treatment at physiotherapy clinic. it cause micro massage effect at micro level and repair that.i think this may helpthis treatment absolutely will relieve your painthanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach tightness with pain in kids\n\nI have a one and a half year-old that woke up screaming in pain. His stomach is tight and it s obvious that his stomach is hurting him. When should I be concerned that it is something other than gas and needs medical attention? Is there anything I can do to try and relieve his discomfort other than gas drops and tummy massage?",
    "doctor_response": "Thanks for posting on HealthCareMagic. Your child could be suffering from gastritis although there could be many other reasons. Try giving decolic or coliza drops and see if it is releived. Give small but frequent meals. If not resolved or if associated with passage of loose stool or vomiting, consult your doctor. I would not suggest tummy massage.Hope that helps. Feel free to revert back in case of further queries if any.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is heavy (platinum) therapy a logical treatment for lung cancer spreading to kidney and liver?\n\nMy wife was just diagnosed with lung cancer. It has spread to her kidney;s and liver as well as skin. What type of action will be taken by an onconologist? The doctor here says the oncologist will most likly use the heavy (platinum) therapy. Does that sound logical?",
    "doctor_response": "yes platinum agests are the mainstay in treatment of lung cancer. combination of which drugs to use depends on many factors including the patient condition and histology of the disease. It is the treating doctor who decides what to use depending on the clinical condition",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing breathing difficulty, shoulder and back pain at a young age?\n\nI have difficulty breathing? Like I have asthma and stuff, but sometimes like when I take deep breaths I feel good, but if I breathe normally sometimes, I will get shortened breath. And also I have back pains like by my shoulders, it might be stress and tension in my muscles. I m only 13 about to be 14, so it is not because of old age, what could it be?",
    "doctor_response": "Hello, In my opinion, we should first rule out asthma in your case. So consult pulmonologist and get done a clinical examination of the respiratory system and PFT (Pulmonary Function Test). If PFT is normal then no need to worry about asthma. At the age of 13, stress and anxiety can also cause similar symptoms. To avoid stress and tension, be relax and calm. Consult a psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic drugs too. Don't worry, you will be alright with all these. Avoid stress and tension, be relax and calm. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Kaushal Bhavsar, Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a cure from super bug Klebsiella possible?\n\nHi, a friend of mine in intensive care suffering from the super bug klebsiella, after leg surgery. His been in intensive care for over 48hrs and he has very low blood pressure .... his breathing is a bit better than yesterday. We know its hard but is it possible to beat this bug? Does it take weeks?",
    "doctor_response": "Dear sir       thanks for posting your query to hcm.It is possible to get cure from super bug .If you are having antibiotic sensitivity profile of isolated Klebsiella ,we can treat according to it . drug which is found sensitive in that profile will be administered in proper dose for a definite duration than only we can treat that .hope it will help you .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best medicine for sinus and cold?\n\nCan I take Aleve-D Sinus and Cold, which contains naproxen sodium (22mg) and Pseudophedrine HCl (120mg) along with the Amoxicillin I was prescribed for my ear infection? I have tremendous pressure, pain, runny eyes and nose. I have had symptoms for the past 3 days and went to the Dr. on the third day and was diagnosed with an ear infection (I thought was maybe a sinus infection, which is why I started taking the Aleve D, to relieve symptoms until I was able to see a professional))Thanks",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain it seems that although you are diagnosed with ear infection the symptoms of congestion, runny and stuffy nose and pressure and pain are all due to sinus infection and for both the conditions taking amoxicillin, aleve D is suitable and along with it you can also take saline nasal irrigations, decongestant nasal spray like otrivin or nasivion, do steam inhalations and do warm compresses around nose..Antibiotic ear drops can also help.Sip plenty of warm water throughout the day..Avoid chilled foods.Hope this information helps..Thanks and regards.Dr. Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and skin rashes in a child\n\nMy name is jackie and my 12 year old sister and her friend have rashes on there side, back, and face. It started as just 3 spots which looked like bug bites. But when she woke up the next day, it spread. The day before that, her and her friend were swimming in their family pool. But my mother thought it was mosquito bites. also she has a fever and she said it does not itch but it s very painful. Please help",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query your sister have symptoms of fever and skin rashes which is due to viral infection mainly due to herpes and it is due to poor immunity of body. Need not to worry. You should avoid intake of outside food. I would suggest you to apply calamine lotion on these rashes. You should take antiviral medication such as Acyclovir. take plenty of fluids and avoid intake of any outside food. Visit dermatologist once and get it examined and start treatment after examination. In some cases it will develop bacterial infection as well so you should apply mupirocin gel on these sores and take antibacterial medication. You can go for application of tretinoin cream over the affected area with proper medical supervision. Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will joint hypermobility cause serious effects in the future?\n\ni am mrs tapanita chatterjee, 30 yrs. i am suffering from hyper mobility joint. now i have severe pain in every joint of body. and it happens after 7 to 8 months gapping .it stayed for 20 to 25 days.rehumatologist suggested for phisiotheraphy. what will be the future effect of it? may i become invalid?",
    "doctor_response": "Hello, As mentioned in the history of the hypermobility of the joints, I think you need to work on with the physio to focus on the joint stability exercise and weight bearing. This will be low intensity and high energy consumption exercises. But effective for sure. Research supports the effect of physio in cases with hypermobility of the joint with using the right pattern of the exercise implementation and joint stability. In my clinical practice of over 12 years, most hypermobility joints have responded well to stability, strengthening and controlled movements exercises. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pelvi-ureteric junction cause urine infection?\n\nmy husband is having PUJO in right kidney with BOO. since 10 years as we came to know.he has a history of stone formation as well. from past25 days he is complaining of pus cells in urine..please guide...he is taking antibiotics...can it be due to pujo.....will it be needed to be operated.",
    "doctor_response": "Hello, Pelvic ureteric junction obstruction and stone both predispose for urinary tract infection. So his urinary tract infection could be due to that. He needs to be given antibiotic according to urine culture report. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Unprotected sex. Used nordette as an contraceptive pills. Vomiting occured. Did vomiting cause less effect of the pill?\n\nHi, good day! Me and my girlfriend had unprotected last Sunday which is Oct. 28, 2012. We bought nordette and used it as an ECP. She took the 4 pills at 1:00 PM after the day we had unprotected sex(Oct. 29, 2012) and she took the other 4 pills at 1:00 AM(Oct. 30,2012) then after 4 hours she vomited. I am thinking that the effect of the pills is lessen because she vomit, am i right or what? Please advise, should she repeat the procedure i mean should she take another 8 pills? Thank you very much!",
    "doctor_response": "Hallow Dear In fact Nordette  is a regular birth control pill. However, since she has taken 4 pills, it should act as an emergency contraceptive pill also. The first 4 pills were sufficient and they were retained. Next day, she has repeated the same dose again. Then she got vomiting after 4 hours. Within 4 hours, the pills leave the stomach, so the pills would not get vomited and they will have their effect. She would avoid pregnancy due to this unprotected sex. 8 pills was quite a high dose and hence she vomited due to stomach irritation. Now please give her a tablet of Pantoprazole every morning on empty stomach for a week or so to control the stomach irritation. I hope this helps.Dr. Nishikant",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for sinusitis with foul green discharge\n\nHello, For the past month I have had foul sinus drainage, neon green in color and an odor that smells like horse manure....no kidding. Using a netty pot helps briefly. No fever, minimal sinus pain but truly ugly drainage.. Have not resorted to antibiotics yet. Thoughts? Thanks, Lee",
    "doctor_response": "Hello, We usually suggest decongestants (not antihistamines) and neti pot or frequent nasal saline. If that does not work after a few weeks you may need an antibiotic.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will removing fibroid increase the chances of pregnancy?\n\nHi, I am 39 year old and no kid. I got pregnant once when I was 20. I got my ultrasound result now and I have 6mm fibroid. I have been trying to get pregnant for 6 months now. Considering my age, I was wondering if I should have my fibroid removed to increase my pregnancy chance. I read thousands of websites and they all talk about the risk of miscarriage. I would appreciate your opinion. Thanks.",
    "doctor_response": "Hey thanks for your faith in the health care magic.i have gone through your question and understood your problem.It will definitely get better in some time and may be by next cycle itself.But after 3 months try the best for conception and its very important to conceive as soon as possible because fibroids have a tendency to regrow while in reproductive age group.All the best and in case you have any questions I will be happy to help.Hope I have answered your query. If you like my answers and wish me to answer in future, bring it to my attention",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a small dark spot at the bottom of a tooth?\n\nIm in the process of getting braces for my teeth. Today I went in for my final xrays, the tech pointed out a small dark spot at the bottom of one of my teeth on the xray sheet...she said I should not worry, but I am since I take extra care of my teeth. :-/",
    "doctor_response": "thanks for your query, i have gone through your query. the small dark spot on the radiograph could be normal marrow space or mental foramen or any anatomical variation or it could be any pathology. consult a oral physician and get it ruled out. if any pathology is there then we can treat accordingly. nothing to worry. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain\n\nI was fine this morning and had breakfast however right after lunch I felt a tiny sharp pain in my lower right side abdomen almost right below the belly button. I wear a belt to work which made it worse and I felt bloating. I also got my period yesterday. Anyhow I started feeling more tight around my lower abdomen towards 2 pm. I took off my belt at work and walked home. On the walk home I felt my back as if it was being pulled apart and my legs started to feel weaker. I got home and felt a little chilly and jumped in bed I tried to close mg eyes and sleep. I slept very little but I rested. Now I notice as I lay on my back that when I breath in fully a feel a pain in my right lower and abdomen and when I put pressure on it with my hand I feel pain again. Not severe but enought to worry me as its something that s never happened before? What are your thoughts on this?",
    "doctor_response": "Hi,From history it seems that there might be having some food poisoning effect after lunch giving rise abdominal colic, fever, chills etc.Take antispasmodic medicine like Meftal spas and ofloxacilin, tinidazole combination medicine for 3 days.Take plenty of water.Take light diet for two days.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Kidney infection, delayed periods, UTI. Negative pregnancy test. Treatment?\n\ni have a kidney infection i resulted from a uti from how the dr explained i took a preg it came neg also took one at dr it was neg i have a reg cycle i never miss or come late can you help me out mind you when i found out the kidney infection i was already 2 days late last period was 08/04-08/07 and this month suppose to been 09/01-09/04 but nothing",
    "doctor_response": "check ur urine c/s.if positive take full treatment approx 2 wks from ur doctor.also get usg abdomen done,look for thyroid status.get urine examination done for AFB for three days with morning samples.also check for serum ANA test.are u having some symptoms like hair fall, joint pains,any rash.check ur CBC ,mainly HB,this will tell about anaemia and type if present.check for weakness",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a deep tear at the end of the jawline?\n\nHi Doctor, There is a deep tear on the inside of my mouth at the end of the jaw where the upper & lower jaw meet. It has some discomfort to offer me on opening the jaw. My mouth doesn't open fully. Please tell me if there is anything to worry. My age is 49yrs. I am 5 ft 5 inches tall. My weight is about 75kgs. I am otherewise fine having no concerns. Regards, Mamta",
    "doctor_response": "Hello,I have read your inquiry. I am concerned that you describe a deep tear and do not tell me the circumstances that caused this condition. If you have had trauma to the jaw and it does not function properly, please consult an oral surgeon. You may have damage to the TMJ joint.If you have a cut or ulcerated conditon with inflammation, you can take steps to reduce inflammation and reduce discomfort. If the area is infected or gets worse, please seek professional care with your dentist or oral surgeon.Rinse with warm salt water to cleanse and soothe the area. Avoid any irritants such as smoking, alcohol, acidic foods and liquids, spicy, crusty and hard foods. Do not stess the jaw and keep a soft diet. Keep well hydrated to assist healing. Follow proper nutrition with balanced vitamins. Vitamin B complex is helpful to healing. There are gels available with benzocaine or other anesthetic medications to offer relief if you experience great discomfort. Take some anti-inflammatory medication such as Tylenol, Advil or Benedryl. Follow good daily dental hygiene.Plan to visit your dentist if area does not improve in afew days or condition becomes worse. You may need prescription medication such as an antibiotic to treat an infection. You may have an undiagnosed dental condition contributing to this damaged area. A prescription rinse combination of pain relief, anti-inflammatory medication and anesthetic may be very helpful with the location of your damaged area. Anti-fungal medicine can be included in the rinse if needed.Thank you for consulting Healthcare Magic. I am available for additional questions. I hope you find my recommendations helpful and will feel better soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I feel sleepy, tired, and headache with high Hb and hematocrit. Do I need blood thinners?\n\nHello doctor, I am having too many health issues for the last three weeks. I feel sleepy all the time even I sleep eight hours already. I am feeling weak, tiredness, dizziness, and headache on the right side of my head (pressure and dullness). My bowel habit changed to three to four times a day. I have attached my blood work. Do you think I have any abnormality in blood? Do you think I am having a stroke or heart attack? Do I have too much thickness in blood as high hemoglobin and hematocrit? Do I have any kind of blood cancer like polycythemia or polycythemia vera? In spite of having too much hemoglobin and platelets, why am I having weakness? Do I need to take blood thinner medicine?",
    "doctor_response": "Hello, Welcome to the icliniq.com. Hereby I am giving opinion regarding your case. First, let me know do you have any stress or anxiety issues? As severe stress can lead to hyperventilation and dizziness. Stress can change bowel habits as well and it can lead to headaches as well. If stress is present consult a psychiatrist for counseling and anti-anxiety drugs. If stress is not present, then the causes for weakness are overexertion, lack of exercise, depression, kidney problems (for that urea, creatinine investigation done), myositis, etc. As for three weeks you are not improving you can be investigated with EMG (electromyography), EKG (electrocardiography) investigation for further workup. Answers to your questions are as follows:  I do not think this blood report is abnormal. It should be repeated as two weeks passed. In stroke vision problem, half part weakness, slurred speech like problem present. So the stroke chance is very less. But EKG investigation can be done here as dizziness present since many times. Your Hb and HCT are not much high that needs immediate concern. I do not think it is polycythemia vera case. Repeat CBC to check HCT and RBC value now. For weakness rule out the above causes No n\u00e9ed of taking any blood thinner. Include green leafy vegetables and fruits more in your diet.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for angiokeratoma spots on testicles\n\nI was diagnosed with Angiokeratoma spots on my testicles by a dermatologist. He stated I can use over the counter lotrimin or hydrocortisone cream to relieve the itch and a lubriderm type of cream to keep that area mosturized. I still periodically get an itch and these creams do not seem to be makign a difference. Do you have any other suggestions on a stronger cream",
    "doctor_response": "hellothank you for trusting HCMdear these are benign nature may won't cause much problem. but if they are bleeding or cosmetic purpose you may go for surgery, cryotherapy,laser therapy, sclerotherapy etc...I think I answered to your question if you have more questions feel free to ask.take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Focalin be taken with Fluoxetine HCL with no interactions?\n\nMy child, eight years old, has ADHD and OCD. His doctor has removed his ADHD medicine (Focalin XR) and put him on GuanFacine and Fluoxetine HCL. He cannot concentrate or be still in class. Can the Focalin be taken with the Fluoxetine HCL with no interactions? Can we stop the GuanFacine",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Guanfacine is drug used to treat ADHD. Don't change medications yourself. visit your doctor before deciding further plan. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffer from panic attacks. Heart beating fast, feels floating. How to rectify?\n\nI have always suffered with panic artacks from the age of 14 i am now 21 but the past couple of nonths they have been teally bad i can breath just heart goes really fast feel sick and feel like i am floating and need to go asleep i have had the ambulance out a couple if times and calmed down but to feel like this everyday i dont think they are panic attacks it is taking over my lufe i have 2 children aswell i am worried there is something wrong when i feel luke this it feels like i am going to die its the worst feeling ever people just say get on with it but its scary tbe feeling can you tell me if there is something wrong i have hqd my bliid pressure done she said its perfect heqrt rate was 111 but that was with me panicing",
    "doctor_response": "dear sarwahl, from the description  given by you ,   I think you are likely to be suffering from generalised anxiety and panic attacks.But before reaching a definite diagnosis,other medical conditions mimicking panic attacks( like hyperthyroidism ,hypoglycemia ,some cardiac problems and rare conditions like pheochromocytoma-a benign tumor of the adrenal glands)have to be ruled out.This can be easily done by a psychiatrist or a general physician with a medical examination and necessary investigations. After doing this ,you have to undergo evaluation by a psychiatrist for ascertaining the diagnosis and finding out other coexisting psychological problems.Most anxiety disorders are easily treated by medications,a form of non drug treatment called cognitive behavior therapy(CBT) or a combination of both. In CBT  treatment ,you are given extensive education about the physiology of anxiety and relaxation training to get control over your anxiety .In a deep relaxation state you are trained to artificially induce panic attacks by active visualisation and imagination techniques and you do it regularly,first under supervision and then independently everyday at home.Gradually you get control over your panic attacks and the frequency and duration of panic attacks diminishes.The sessions continue until you can no longer invite panic attacks finally realising that these attacks are harmless.But if you have other psychiatric problems like depression, medications are likely to give better results.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mild cardiomegaly\n\nhi..am 45 year old woman with mild cardiomegaly.My doc says that it is due to my obesity..i am 80 kgs with 5'2. I have increased bronchovascular findings too in my CT scan report.Kindly guide me the treatment i should follow.",
    "doctor_response": "Hello,Cardiomegaly on x-ray may not be correct always, so you should not worry about it. However, you should get one echo done to look for heart function and ruling out cardiomegaly.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back muscular pain on opposite side of pulled muscle?\n\nMy son (14) recently pulled a muscle on his rib cage (possibly from pitching).  As soon as that went away (which took almost a month), he now has back muscle pain on the opposite side.  I have been giving him advil and ice/heat but symptoms seem the same.  Should I be concerned?",
    "doctor_response": "Hi welcome to HCmI can understand your concern regarding your son's back muscle pain one after another .  Muscle aches are extremely common. Almost everybody has likely experienced discomfort in his or her muscles at some point. There can be several  factors causing  it -- Overuse of muscles ,  lack of  physical activity and lack of proper intake of essential nutrients , lack of sleep  .Often,  this is because most instances of myalgia result from too much stress, tension, or physical activity. Some common causes include:over stretching the muscles ,avoiding high-impact activities until after the  weight-lifting sessions until the muscle pain is resolvedTaking proper rest and right balanced  diet including fiber , vitamins ,minerals ,protien ,antioxidants -ginger , garlic, lemon juice , Aloe vera , turmeric powder with milk in proper proportion  .All this will help  boost immunity  increase resistance  from diseases  .Incorporate a warm-up and a cool-down into all of your exercise sessions.Stay hydrated,  .Engage in regular exercise to help promote optimal muscle tone.Get up and stretch regularly if you work at a desk or in an environment that puts you at risk for muscle strain or tension.The following can be a sign of a medical emergency. Get to the hospital as soon as possible if you experience any of the following along with aching muscles:Some medical factors  for myalgia include:hypothyroidisfibromyalgiainfections, such as the flu lupusYour sore muscles might be due to something other than tension and physical activity. In this case, your doctor will best be able to advise you on how to fully resolve your muscle pain .  Hope this helps solves your query .Take care , All the best .Don't hesitate to get back if have any further query",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can it be confirmed that tubercular lymphadenopathy is cured,what is duration of treatment and can we plan a child?\n\nhi sir ,my wife has tubercular lymphadenopathy in right axilla since june 2012 and she took medicineafter that for 11 months. after completion of course it again reoccured after 2 months and she is again on medicines since  march 2013 to till date. pus culture was done in the month dec.2013 and t.b. was detected very low. so sir my question how it will be confirmed that disease is completely cured and how much time duration will be for further treatment and can we plan for child ?",
    "doctor_response": "Thanks for your query at HCM!According to me either your wife is undertreated which caused relapse or she is a case of Multi-drug resistant TB/ Extensively drug resistant TB.I suggest get the ZN smear & culture and sensitivity done for Mycobacterium TB by BacT/Alert. Also get the Hains test done to detect resistant to first line or second line TB drugs. Also it can help to identify if she is suffering fro a rare type of TB called Non-tuberculous Mycobacteria (NTM) which requires absolutely different treatment.Let her treatment be guided by evidence based medicine.I  am sure she will respond.Visit a pulmonologist/ ID physician for correct dosage of drugs. She will require prolonged treatment based on sensitivity results.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "what is the tablet for Acid Reflux problem in baby?\n\nHi, I will be coming back to India/Bangalore in the last week of jan 2009. I have a 2.5 month old son & he is having the Acid Reflux problem, here we give the Prevacid Solutab medicine to him everyday. Will this tablet/medicine be available in Bangalore??",
    "doctor_response": "The medication which you have mentioned is Lansoprazole. The medication is not available in the brand name of Prevacid, but it is available in other brand names like Lancid, Lanpro, Lansol, Lanzol etc. The main treatment for the acid reflux for the baby is to properly burp the child after every feed which will help the air to come out of mouth which it has swallowed while taking feed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have knee stiffness and cracking sound in the knees with walking difficulty. Do I need surgery?\n\nHello doctor, I am 30 years old. I have pain, stiffness and cracking or creaking sound in both the knees and joints. Pain is persisting for 24 hours and there is difficulty in walking. There are some other symptoms apart from pain which I have listed below: Locking of joints and stiffness if I sit in a specific posture for long. Weakness in joints all the time in standing and walking position. I cannot sit down in a squat position due to enormous pain and even if I do I would not be able to stand without any support. Not able to climb up and down the stairs properly. I can only able to bend the right leg knee on the stairs. No history of any injury, but I have bow legs. During a consultation for the same issue, one of the doctor did say that my axis is little twisted and advised to wear a correcting innersole in my shoes, which unfortunately I was not able to wear as no shoe was fitting me after inserting those soles. My height is 5 feet 11 inches and my weight is 80 kg so I am a little overweight but not much. I am not a fitness freak, in fact, I do not do much of exercises and the majority of my time goes sitting in front of my computer owing to my IT profession. Chronology of events: The pain started in my right knee ten months back. The pain was not much at the start and only happened when I used to stand for long. Consulted a couple of doctors who gave certain medicines like Novovartalon and Ccelebrex capsules. The medicines did not help and the situation only deteriorated further. Approximately two months back I played football for a little while and the pain started to occur in the left knee as well after which I again went for a diagnose. This time it was told to me that I have damaged the meniscus and cartilage in both my knees and thus a surgery will be required. I went to another doctor who tried with exercise and medicine Celebrex for three weeks which ended last week without any significant improvement. I am currently living abroad due to my professional assignment. Language is one of the biggest barriers here, therefore I wanted to be sure that is this the only safe and best option before proceeding with any of the surgical solution.",
    "doctor_response": "Hello. I have gone through your reports. (attachment removed to protect patient identity).  The main findings of the reports are as follows: Left knee: rupture of anterior horn of medial meniscus and posterior horn of lateral meniscus. Right knee: rupture of posterior horn of medial and lateral meniscus. X-ray of both knees suggest chondromalacia (softening of cartilage) in both knees. To summarize you have meniscal injury in both knees. They are unlikely to develop without prior trauma. And as such, based on the MRI (magnetic resonance imaging) reports both your knees require arthroscopic (key hole surgery) repair of the torn menisci. Non-operative treatment is likely to cause continuous pain on the long-run. Arthroscopic surgery has been associated with good results. However, I would advise you to consult a well trained and experienced knee arthroscopic surgeon for your condition. It is a good sign that the rest of your cartilage are relatively normal in MRI, though the exact picture is likely to be confirmed only during arthroscopy. Unfortunately the images in your rar file did not open up. Kindly send in JPEG format if possible. At present, I would advise you pain killers, relative rest, brace in both knees to prevent further injury to your menisci and cartilage before you plan for surgery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Report from MRI suggest Superior sagittal sinus thrombosis\n\nDoes a white upward (point up) Triangular shaped spot in the bottom section of a MRI/MRA image indicate Superior Sagittal Sinus Thrombosis (SSST)? Some picture I also noticed the same thing on the top of my brain but the point to the triangular shape is pointing downwards. I have been having chronic migraines for 7 years every day practically and am lucky if it feels like it s just a bad headache. The people that did my MRI/MRA gave me a disc with special software of my images and there are 60-70 images of this bright white triangular shape in the Superior Sagittal Sinus of my brain. Note: The software with my images is complicated and at first only shows 26 pictures on it, but then I accessed a option on it by accident and found about 300-400 more pictures in categories and subcategories, so I think it would be easy for someone to miss or skip them.",
    "doctor_response": "Yes it may indicate that you have superior sagital sinus thrombosisAlso its more suitable for your daily headache more than migraine",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for pain in the lower abdomen?\n\nI am a 55 year old female whom due to my place of business closing ,I am currently without health insurance. I am positive I have an UTI and need a prescription for ampicilin 500mg. I have used this in the past which is most effective. I have pain on my left lower abdomen ,and a little bit of burning when I urinate. Can you please help",
    "doctor_response": "I would suggest u to do a urine routine and a culture sensitivity. This helps in diagnosis. Nitrofurantoin orally is most helpful in urinary infection. Take plenty of fluids.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of muscle pain in the arms and shoulders?\n\nMy husband has had chemotherapy for DLBCL and has now been in remission for 1.5 months. Is it normal that he is having a lot of muscle pain in shoulders and upper arms? It is waking him up at night. Pain level is between 4 and 6 out of 10. He is also seeing a physiotherapist to regain his muscle strength.",
    "doctor_response": "Here if the muscle pain is due to his present medical history or treatment then it's difficult to cure completely. When I have patient like this I keep them. On frequent use of hot and cold pack.  And will check with their doctor (oncologist)  in a safe way is there any medication can be given.  Apart from this he is already under physio so I am sure based on his current situation Physiotherapist will also be making him do some sort of muscle tonning,  stretching and strengthening exercises.  So continue with that.  Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for infection in finger causing numbness and pain\n\nI have an infection on my right pointer finger - it does not apear to be around the nail but in the pad of the inside pointer finger.  It started on Monday, got worse as the day went on, by bedtime it was throbbinh with pain,  Today (wed) it is still swollen (twice the size of my pointer finger on left hand)and hot to the touch.  If I touch the fingerpad it feels like it's not my skin, kind of numb I am trying to keep iit clean and put neosporin on it, but it has not helped yet -any suggestions??  I am currently on an antibiotic for a throat/thyrioid problem - I thought that would have been enough?",
    "doctor_response": "Hello,This could be serious. The antibiotic for your throat may not be one that treats skin infections. You need to see a doctor right away and have your finger evaluated.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the lower back, neck and pelvic area?\n\nMy wife and I both started with a painfull stiff neck then pain in the lower back on right side moving around to the front pelvis area and moving down the inside of the leg. My right testable hurts along with everything else. The only difference between my wife and myself is she has a cough. No fever or nausea for us both. What could we be looking at? And what kind of tests should we be expecting? Have an appointment with our Doctor tomorrow ?",
    "doctor_response": "Hi, Consult an orthopedician and get evaluated. You have to get an MRI scan done to rule out spine related problems. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any alternative to Nitrofurantoin?\n\nI was prescribed Nitrofurantoin for a UTI. After suffering for a year with symptoms from ulcers, digestive issues, pain, stomach problems, etc. It now seems as if all of the digestive symptoms have subsided since I began the Nitrofurantoin. I was wondering if in fact I may have had an e coli infection in my digestive track and therefore the medicine is getting rid of it. Is this possible, or is that antibiotic only  used for UTI's?",
    "doctor_response": "**1. Nitrofurantoin is an urinary antiseptic given in acute as well as prophylaxis of uncomplicated urinary tract infections. [only indication], and is given in E.coli infection [commonest] for 5-10 days.2. since ADR [adverse drug reaction] of nitrofurantoin is/are epigastric pain, diarrhea, vomiting thus  any benefits in alleviation of digestive symptoms are minimal.3.  For digestive related issues kindly consult a Gastroenterologist for necessary examination and Investigation or you may consult an Urologist for any urinary tract abnormality.[since he may distinguish lower tract infection from upper urinary tract infection] 4. To prevent recurrent infection:. drink plenty of water/fluids and take fiber rich diet [to avoid constipation]. avoid spicy/acidic/citrus fruits.  avoid alcohol, coffee, quit smoking. you may ask for prescription medicine like chandra prabha vati,chandan asav, usheer asav,gokshuradi guggulu, tablet/syrup cystone.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is severe depression and rapid weight gain a sign of high BP?\n\nMy face has been getting really hot at times lately...probably 3 times this week. I know I am depressed. I feel like my heart is racing...almost like i ve had too much caffeine...I have also gained more weight lately and am wondering if I may have high blood pressure. I was borderline about a year ago.",
    "doctor_response": "HiThanks for writing to HCMsuggest to get the BP checked from a doctor and lipid profile and share the lab results to comment furtherwish you good healthRegardsDr Sridhar K",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for bloating.gas and pain during BM in a child\n\nmy grandson all of a sudden has a protruding stomach, a little gas, and he says it hurts when he is popping. My daughter took him to his doctor and she gave him a rectum exam and felt allover his body and found nothing. He is on a mild diet and every so often complains his tummy hurts. What is the next step?",
    "doctor_response": "this is Very common issue Patients Face, just give him enzyme syrup.get his thyroid profile done. give him plenty of liquids like water,  juices,  curds",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. l got a sore hard lump after the removal of wisdom tooth. Is it normal?\n\nHello doctor,I just got one side of my wisdom teeth removed both upper and lower six days ago, and I have another one scheduled after two days for the left side. The upper is 100 % fine, which they pulled. The lower they pulled the tooth without removing the root because it was too close to the nerve. I do have some stitching in this area currently on the lower cheek. Noticed a hard lump about 1 inch between my lower jawline and cheek area. Is this normal because of swelling or something else. Currently taking Amoxicillin 500 mg and Ibuprofen 600 mg. Please let me know what this hard lump is, also generally on the lower side where this lump is, remains sore.",
    "doctor_response": "Hello. The lump is mostly a hard swelling which forms postsurgical removal of the wisdom tooth or maybe even by swollen lymph nodes due to infection. It takes a week or two for the swelling to subside. Sometimes, if the root is still inside, the infection may be remaining there causing swelling. Get an X-ray done to find out the exact problem and stronger antibiotics like Augmentin (Amoxicillin and Clavulanic acid) along with a painkiller for a week. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain and swelling in hip\n\nLast Friday I was longboarding down a hill I fell on my left side and rolled alittle bit I hit my head which is still sore now but I m sure is fine. But my hip really hurts on a scale it s about a 5 maybe a 4 but it s a little swollen around my left hip, it doesn t hurt to walk or run or longboard just hurts when you put pressure on it. Trying to save a trip to the doctors.",
    "doctor_response": "hiit could be traumatic reaction (synovitis) in hip with some fluid collection. Do fomentation and take advil tabs after meals two-three times a day for 3-5 days.wait and watch.it should help, by resting for a week. if doesnt, then consult orthopedic doctor for x ray/MRIbest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for a worst teeth alignment\n\ni have the worst teeth alignment ever!! each one of my teeth is heading in its own direction. i came from over seas with bad dental hygiene but with a scholarship covering all health insurance which includes also dentistry and orthodontics. so basically im looking for the BEST , LUXURIOUS (money don't matter) orthodontic treatment ever !",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. For worst teeth alignment you should go for fixed orthodontic treatment, as it will take atleast 1 year for the treatment depending on the condition of the tooth,  and after the treatment you have to wear a retainer for sometime and teeth will be properly aligned.Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could feeling of tightness and gagging with blood in stone indicate recurred kidney stone?\n\nHi. I have a history of kidney stones and I recently just passed another stone back in December. I woke up today, though, in terrible pain. I feel like I'm going to vomit, like something tight is gagging me around my neck. I'm very hot. There is blood in my stool and I don't think I'm going to leave the bathroom any time soon. Could this be another kidney stone? Or is the blood in my stool from something else? Your response is very important to me. Please and thank you!",
    "doctor_response": "Hi,  Renal calculus when passes through ureteric wall it irritates it n have severe pain in flank which can radiate to groin thigh umbilicus scrotum /labia majora associated with nausea vomiting and other urinary symptoms including haematuria . It never causes blood in stool which can be due to pathology in GIT.  So visit a gastrosurgeon for bleeding PR and Urologist for ur Renal calculaus .Hope this ll help Thanks n regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome fear of public speaking?\n\ni am 27 year old and 5ft tall and 53kg weight. i am having stage fright. i cannot speak in public properly.My voice starts shivering and i am not able to understand the people who are asking me question and i am not getting proper words to make my reply. i feel like i forgot the words. my face starts shivering.",
    "doctor_response": "HiThanks for using healthcare magicI think, you have social phobia. In that case, you need to take antidepressant drugs like paroxetine that would help to control anxiety symptoms. You can also try some relaxation exercise like JPMR or deep breathing exercise. You can also try some benzodiazepine on sos basis with beta blocker before any performance. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for asthma\n\nMy son was running in a cross country event when he started to have problems with his asthma. (This does not happen very often.) He completed his race and then used his inhaler. It took awhile to work and  his right hand began to cramp up and feel numb. His hand was not cold and when we pressed his fingernail it turned red quickly showing that there was blood reaching his fingers. After his breathing was under control the feeling began to come back into his hand and it uncramped. What could of caused this?",
    "doctor_response": "Hi, Asthma problem may be the cause for his numbness and cramp due to decreased oxygen supply. Usually before any exercise or sports better  to give one puff of inhalation drug. This will prevent his symptoms to appear.  Sports or activity may act as a trigger for asthma attack. Daily montelukast will also help in preventing exercise induced asthma.Hope this helps you. Feel free to ask for any further queries. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can right leg being little short after cementing due to accident be corrected?\n\nim 53 years old, 5 6 height, 70 kg weight and asthmatic. my right leg is short due broken bone to accident when i was 12 years old. this was cemented not surgical operated. after that i notice this was short of 2cm. is there any way to correct this problem. thanks",
    "doctor_response": "Hi,You have mentioned that you had a surgery when you were 12 yrs old but why was some kind of cementing done is difficult for me to understand. Anyways, what I want to see now is:Your lower limb X rays to actually see what is the cause of your shortening?CT Scanogram of both lower limbs to measure combined length and individual lengths of femur and Tibia.Now as far as correction is concerned, normally we operate only if the discrepancy between the two legs is more than 2 com and it also correlates clinically. Any difference less than that is normally managed by shoe Insoles which make it equal on both sides and make it easy for the patient to walk. You can also discuss your case and treatment plans with a doctor in greater detail in a private consultation.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Akshay Kumar Saxena, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chest pain and indigestion. Took gaviscon. Why is it spreading? What will work?\n\nHi, last night I started getting a pain in my chest which I thought was an indigestion. I took some gaviscon and it didn t shift it. As the evening went on the pain got worse and started moving down and into my stomach and my lower stomach. I kept going really hot and cold and the pain will not go away. I woke up this morning and the pain is still there but not as bad. It feels like I have a stitch all over my stomach and hurts when I walk around. I have taken painkillers and liver salt type things and nothing has worked.",
    "doctor_response": "Hello, jackiehands90, Your heartburn symptoms suggest that you are sensitive to acid in your stomach. The different types of food and drinks we take have a direct effect on acid production. Tomato based products, too much milk (Contains calcium which stimulates acid), caffeine in coffee or tea, alcoholic beverages , all add to the problem. Smoking will make the reflux worse because of it's effect on the sphincter at the junction of espphagus and stomach. If you are not getting relief from taking anti acids such as gaviscon or Maalox, try taking 15 mg. of Lansoprazole or 20 mg. of Omeprazole about an hour before your main meal of the day. If needed you can take it twice a day. If symptoms persist after 4 weeks, I advice you to see a digestive disease specialist for further work up. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having noticed penis curved towards left after masturbation\n\nHello dr i have benn mensturbating for like 3 years since i was 16. and now at 19 my penis is curved towards left please help me. I have gone to many doctors and they werent so helpful. please help me my e mail address is please do contacr me as soon as possible.",
    "doctor_response": "DearWe understand your concernsI went through your details. Your penis is curved towards left side because you are using your right hand for masturbation. If you use left hand, your penis will curve towards right. That is pretty normal and almost every penis has curvature. You should not worry about it. Curved penis will be able to make more friction inside the vagina than straight penis. In that sense curved penis is more pleasure giving and women like it very much. Therefore, stop worrying about it and stop seeing doctors further.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain, loss of appetite and constipation?\n\nMy 5 year old is having mild stomach ache around his belly button for a week.The pain comes and go several times a day(twice).He has no fever,vomiting or diarrhea kind of thing.Now he is losing appetite and does not go to loo (as frequently he used to).Doctor say it is stomach viral but he is showing no other symptoms of it other than belly pain.He remains agitated.IO am clueless,please help",
    "doctor_response": "hi  welcome to health care magicmam as you say symptoms  it looks like your baby is constipated and due to bloating she is experiencing pain ..make her to drink plenty of water and juices so she passes stool and check whether she passes air ...once she passes air and passes stools her stomach pain will get relieved ...try to avoid constipated give her high fibre diet and water....if pain persists even after that try to do a motion test routine and consult a physician for further investigation",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for my child s persisting fever and congestion\n\nHello doc My baby is 9 months old and he is suffering from high fever ,cold and cough with a lot of phlegm .. visited so many doctors but didn t wotk out.. once a doc had given him an injection for phlegm and he had high fever that day .. it was around 100. 3. This is since 2 weeks.. Please give me some better medicine .",
    "doctor_response": "HiThanks for writing to healthcare magic.Please let us know what medicines have been prescribed before.Persistent fever and cough for 2 weeks needs complete evaluation to rule out pneumonia. Get chest Xray and mantoux test done ASAP.It is better to get your child admitted if fever persistsWishing your child speedy recoveryRegardsDr Arun",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment for dysthmia, panic disorder, ADHD?\n\nI ve been diagnosed with multiple things. Dysthmia, Panic Disorder, ADHD and Borderline Personality Disorder. I think ADHD, and BPD are primary. I probably actually have both. Through great research I decided I wanted to try Abilify, and I asked a Medical Practitioner, and it works very well with certain symptoms. Especially it stops me from losing emotional control and having stress induced emotional outbursts where overwhelming surges of emotion (easily triggered) overpower my better reasoning. For this it is 100% effective, incredible. Literally I have been on it for a year now and not lost emotional control a single time. Part experimenting, part by flook (ie luck) I discovered that 400mg per day of Modafinil significantly augments the effects of the Abilify. I do not only not lose emotional control now, but I don t feel overwhelmed by stress and negative emotions in the first place. I feel well, positive and able to cope with life. For the first time I am also motivated, and my concentration has improved quiet dramatically. I have had various tests, and know that physically I am in good health (blood tests all fine etc). But I am not sure what to say to a doctor, that basically through experimentation (without informed medical supervision) I have stumbled across a miraculous combination of medications. Literally like I am basically cured of my problems on this combination. I have spend decades of my life FAILING to find such a combination, and finally I have it. I have been on Disability for these problems for 1.5 decades, now I believe I am fit enough mentally to consider working. As I have been keeping my Modafinil use a secret- what should I do? Its not an approved indication for it. My belief is both the Abilify and Modafinil are likely improving the functioning of various areas (especially the medial area) in my prefrontal cortex. Abilify modifies various serotonin receptor types in the PFC and Modafinil, apparently increases Dopamine, Noradrenalin, and indirectly Serotonin in the PFC. Basically they are both PFC enhancing medications (if you read the latest literature and research). I don t know how to explain it to him, but it was from reading THOUSANDS of pages of scientific literature that I suspected my problems likely occur due to Prefrontal Cortex under-activity , especially Medial and perhaps orbit-frontal areas in regards to the emotional and stress intolerance aspects of my problems Any adv",
    "doctor_response": "HiThanks for using healthcare magicYou are right behind your logic that your problem is related to prefrontal cortex and you need medication that could maintain the balance between serotonin and dopamine. In that, you can use an antidepressant like paroxetine or stimulant like modafinil which would increase the level of dopamine at frontal cortex. Abilify consists of aripiprazole and it is a partial agonist  of dopomine. You can take it in low dose with modafinil and antidepressant.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes scrotal pain?\n\nDoc, I m having what I assume to be prostate issues. I have some pain in my scrotal, almost feels like pressure on my scrotum. My penis is sore, especially toward the tip and during urination. I was already on CPRO for a bacterial infection, this developed right at the end of that cycle. Another doc prescribed Docy for a week. I m trying hot soaks, drinking water, but nothing is really healing at the moment. Your thoughts.....",
    "doctor_response": "HelloScrotal pain need immediate medical attention.It may be due to many causes like infection,torsion etc.You may need proper clinical examination and investigations.Investigations include routine hemogram,random blood sugar,urine RE/ME,ultrasound and colour doppler of scrotum.Ultrasound can exclude many conditions like orchitis,torsion,fluid accumulation etc.Treatment depend upon findings.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be done for this pimple which bleeds with a fluid ?\n\nim barely 14 and i cant tell if i have cancer or if its just a pimple but i dont think pimples bleed with a fluid and then white stuff coome out in between the middle of your chest .",
    "doctor_response": "Hello melissa; welcome to HealthcareMagic If you have a pimple like swelling or bump which has some whit stuff coming out and even bleed then it may be either a pimple or a sebaceous cyst but surely not a cancer.Cancer does not have any white stuff coming out it is more complex.What you have is either a sebaceous cyst or pimple so get examined by a doctor and she will treat you. Take care. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause for pain in the arm and chest?\n\nI had open heart surgery (orthoscopic)  in April to remove a myxoma tumor from the left atrium. I had an appointment a week ago with my surgeon and he said everything looked good, but, for the last 3 days I've had periodic pain radiating down my left arm and very tight chest, pain with any deep breathing. I am over in Germany and wondering if I need to see a physician or if this is usual to the healing process.Thank you",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. In my opinion, you should definitely consult doctor and get done ecg and 2d echo to rule out heart damage. Your symptoms are commonly seen in heart damage and you are you just underwent heart surgery, so possibility of heart damage is more. So immediately consult physician and rule out this. If ecg and 2d echo are normal than no need to worry much. Normal healing process can also cause similar symptoms. So take painkiller and anti inflammatory drugs. But first rule out cardiac diseases.. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for upper back pain on the left side\n\nI have pain in my upper left back. It is worse after eating or drinking, and when I m tired. I noticed the same area had a tiny itchy spot in the last 2 years (with no rash or redness). The pain has been present for 1 1/2 years, but it has gotten substantially worse in the last 6 months. I have Crohn s disease (have been in remission for 15 years), and am treated for related arthritis.",
    "doctor_response": "Hello,Please get these tests done-Ultrasound abdomenLiver function testSerum amylaseSerum lipaseAnd report to a gastroenterologist. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Mohammed Abdullah",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white spots on the foreskin of  penis?\n\ni have small white spots on my foreskin that started to appear around 6 months ago, i gnored it at first and thought they would go but they have only spread and got worse,, i have been with my partner for 9 years and never had sexuall contact with another girl in all that time, do you have any ideas what it could be",
    "doctor_response": "Hello, Some white spots, called \"pearly penile papules\" are common and normal. If your spots are not causing any problems like pain or itching, simply observe them. However, it is always safe to get them checked by the doctor to make sure that they are normal. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Sujoy Dasgupta",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pH 8 and rapid progression 30 normal in semen analysis?\n\nMy Semen Analysis says: 2.5 ml, pH 8, Rapid Progression:30, Slow Progression:15, Non-progressive Motality:10, Immotile 45%. while Morphology is: Normal 60, Abnormal 40, Head Defects 10, Tail Defects 15, Head & Mid Piece Defects 10, Cytoplasmic Droplets 03%, Headless 'pinhead' 02%, Puss Cells 3-4, RBC 4-6, Epithelial Cells 0-1, Misc. Nill.",
    "doctor_response": "Hi, Yes. It is absolutely normal. take Milk with turmeric powder daily at bed time to improve sperm quality and quantity. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Pramod Kokare, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to bring down swelling after surgical removal of wisdom and eye tooth?\n\nhello, I am 14 years old and I recently got my 4 wisdom teeth and eye tooth surgectly removed on Thursday and the swelling on my face hasn't came down! I have a concert tomorrow and I really want to be back to normal! what can I do to make the swelling go over night? please",
    "doctor_response": "Hi,Thanks for posting the query,     I would suggest you to take lukewarm saline and antiseptic mouthwash rinses.Take the complete course of antibiotics and analgesics.Take complete rest, the swelling will subside after sometimes.Avoid smoking and drinking of alcohol.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be worried of small lump on top of testicle and pain in lower abdomen and back?\n\nLast Sunday I noticed a small lump on top of my testicle. Went to MD on Monday. After PE she thought it was a hydrocele. I underwent an US that same day and the DX was epididymitis. Rx of levofloxin and 800 mg of ibuprofen 3-4 times per day. Saturday and I still have mild pain in testicle and low back and abdomen. I'm thinking it's lingering infection. Should I be concerned of anything more serious?",
    "doctor_response": "Hi. This is the diagnoses case of epididymitis. It take a longer duration of time for it to get a relief due to its typical anatomical structure.So continue treatment. IT may take a bit longer than usual other infections.Put a scrotal support, drink plenty of water.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could red,hot burning cheeks be due to slapped cheek syndrome?\n\nI am a 48 year old woman. I work in a preschool. I have had a mild cold all last week and now have bright red, hot burning cheeks. I have had a mild headache, back ache and a have a slight cough/sorethroat. Slapped Cheek is going throught the school. Could I have caught it?",
    "doctor_response": "HiThanks for your query at HCM.I understand your concern and situation.I see no reason for you to think of any syndrome. You are having flushing of cheeks which can be seen in viral fever. You could contract viral fever from anywhere. You must take rest, acetaminophen and eat protein rich healthy diet with multivitamins and calcium supplement. You must avoid going to school for about week. You must also do chlorhexidine gargle 5-6 time per day.Best of health.Hope I answered your query.Dr Sheetal Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. A patient with a fresh knee replacement has taken pre-medication Amoxicillin 2g. What antibiotic can be given for her tooth abscess?\n\nHello doctor, I have a patient with a fresh knee replacement, and of course takes premedication Amoxicillin 2g, one-hour pretreatment. She now has a tooth abscess, and I want to give her antibiotics. My thought is, since she has to always use Penicillin as a pre-medication, I would change the antibiotics.But she also has a colon resection, and Clindamycin probably would not be a good one to use. Can I give her Ciprofloxacin? Also, on her next appointment, should she go ahead and take the 2g of Amoxicillin as usual, or Ciprofloxacin or what can be used as a pre-medication? Thank you.",
    "doctor_response": "Hello.I have read through your query in detail. Please find my observations below. The above information is as per latest updates on pharmacological treatment of a dental abscess. Please keep in mind any allergy the patient might have to any of the medications and prescribe an alternative choice. Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen heel after a bee sting?\n\nMy son came to me and said a bee stung him but it s not a fresh sting from what I see so idk when he got stung. I thought it was a splinter so I tried to put it out tried and pus and blood came out and his heel to his foot is a little swollen, what should I do? Mary",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern looking to the history given here I could say that if this is the bee sting then this need to be  examined clinically and if the sting found there then this need to be removed this is the ideal way to handle the bee sting if the sting left there as it is then chances of infection is very likely, hope this information helps you, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a red rash on the legs?\n\nI have a red rash ring around both of my legs, close to my ankles.   I have high blood pressure and have a lot of water weight.  The rash looks like shingles but don't hurt, itch... it just looks nasty.  I thought maybe i was allergic to my socks but can't quite figure that out",
    "doctor_response": "Hello,Thank you for posting on HCM.I can understand your concern regarding the skin lesions but its difficult to point specific diagnosis in absence of clinical examination.Therefore, I insist you to post good clinical pictures to me so that I can help you in a better way.You can mail pictures to attachments@healthcaremagic.comwith subject titled ' ATTN Dr Hardik Pitroda'.ThanksDr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking chemotherapy and doxorubicin for primary peritoneal cancer. Will it cure completely?\n\nI HAVE PRIMARY PERITONEAL CANCER I WAS IN REMISHION FOR 3 MONTHS IT CAME BACK NOW I AN DOING CHEMO AVASTIN/ AND DOXORUBICIN MY MARKERS WENT FROM 44 TO 25 IN FOR WEEKS AND NOW 4 WEEKS LATER ONLY DOWN TO 24.4 IS THAT GOOD I AM UPSET I TS NOT WORKING AS GOOD NOW",
    "doctor_response": "usually for disease you mentioned, doxorubicin is not optimal drug, it should be treated with combination of paclitaxel and carboplatin. and with intraperitoneal platinum drug. so, I suggest, please it is not to feel good and better change  chemotherapy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for diarrhea and vomiting in a 2 year old\n\nMy son is 2 years old. He has had diarrhea and been vomiting occasionally for the past 5 days. Took him to the doctor Wednesday prescribed him nausea medicine. Didn t give it to him for a day since he didn t throw up for a couple days then tonight he has vomited twice",
    "doctor_response": "Hello,No need of antibiotics, only give Low-Osmolarity Oral Rehydration Salts Zinc 1 tsf once a day. Syrup Domel for vomiting. Keep the baby well hydrated. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Hina Javed",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes increased bowel movements with odor?\n\nHello, My son is 6 months old, i recently started him on solids gradually (rice, pears, apples, pumpkins) and changed his milk from a hypoallergic type to a follow on formula. Since 4 days though, I noticed he is having more bowel movements a day (used to be once a day, now its more of 2-3 times a day) and the stool is yogurt smelling. Should I be concerned? Thank you",
    "doctor_response": "Hiwelcome to HealthCareMagic2-3 stools for a 6 month baby are normal, provided they are not large and watery , baby is active, passing urine normally , there is no blood in stool .Yogurt smelling of stool is normal.  I do not think any reason to concern , take care.Hope I answered your queryRevert back if any other querythanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from regular blood loss, low haemoglobin levels, all reports normal. Suggestions?\n\nhello dr , i am abhishek from india (u.p),i want advice for my 61 yrs old uncle who is suffering from regular blood loss and hemoglobin counts below 6 due to blood loss,we have consult the local gastrologist and all the tests like ct scan , indioscopy,chlonoscopy, biopsy ,urine test,stool tests, liver function test etc. but all the reports are normal and there are no symptoms of blood loss. kindly please suggests us regarding with our problem for future consultation.",
    "doctor_response": "Hi Abhisheik, Where is the blood loss from ? Is it from the motions ? If yes and the endoscopy and colonoscopy are normal then you need to go for something that is known as capsule endoscopy. In UP , SGPGI lucknow probably has it ... if the hemoglobin is really    Hope I have answered your query. If you have any further questions I will be happy to help Regards Dr. Om Lakhani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swollen, rubbery lymph nodes on both sides of groin after a break of chemo for stage 4 hodgkins. What could it be?\n\nHi, I had stage 4 hodgkins with b symptoms and now doc said I m on a break from chemo . She say I m still I m remission. Been off chemo since Dec last year, I had many blood trans and platlets etc. I was really sick andway for 6 months now on both sides of my groin I have swollen lymphnodes , very firm slightly rubbery. CTO scan say still in remission. They are painless , very nervous!!",
    "doctor_response": "Dear Brupp, I understand your concern. However, almost every person has palpable lymph nodes in the groin. In your case, they are of concern if they have more than 15 mm in its largest diameter or if they start to enlarge. If you have done recently a CT scan of that area and it says you are in remission, that means that you have normal lymph nodes. So calm down and do not worry, unless these lymph nodes start enlarging. Hope to have answered your query. regards, Rute Alvarez Hematologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching and electric shock like pain on back?\n\nFor almost a year I have an itch on the upper left quadrant of my back just below the shoulder blade that's becoming more chronic.  Also, sometimes I feel a brief sharp pain almost like electric shock on the upper right quadrant of my back.  What can this be?",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Get an X-ray done to evaluate for vertebral compression.2. Compression of nerves in between the vertebrae can cause electric shock like pain on back.3. Nerve compression might be causing different sensations, and itching may be due to this. Get an X-ray done or MRI.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for infertility problem\n\ncan you suggest the best doctor for a case of primary infertility for a pt aged 35, female. I would like to provide the details (previous investigations, gynae & obs history) of the pt if you need this. Do you suggest CMC Vellore for this kind of treatment or somewhere else?",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic.I have gone through your query. I think I have understood your concern, I will try to suggest you the best possible treatment options.1] she needs to have basic reports of USG -abdomen and pelvis, HSG- x ray for patency of tubes, and semen analysis.2] basic blood reports-FSH,LH, Prolactin,AMH,TSH3] any history related to menstrual problems and previous pregnancy/ abortion if any.4] This basic information will be needed when she visits any expert gynaec doctor.I hope my answer helps you.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does brain damage run in families ?\n\ni know my question wont make much sense but im a hypochondriac..and i am lately obsessed with cerebral hemorrhage ..i am terrified and im costantly thinkin it will happen to me.the thing i wanted to ask is..could it happen to me?i am 21 female,no high blood pressure(sometimes even lower than normal) non smoker and no family history of brain damage of any kind.so i know everyone has chances but just are mine high or low?if someone could answer to me to calm me down i would be more than happy.i know i am paranoid but thats what hypochondriacs do. sorry if im wasting time of more serious problems but i just want someone to reassure me i ll be fine..thanks",
    "doctor_response": "THanks for the query Since u are not a hypertensive, non smoker no family history of cva Young There is very minimal chances of u developing a haemorrhagic cva Have a healthy living",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring, flat red spots on forehead of a 4 year old?\n\nMy 4 year old has two flat red spots on her forehead. She has had them before and they lasted for a few weeks then went away. She has now got the, again and has had them for about 3 weeks. They do not cause her any discomfort but I don't know what they are and why they have come back?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Anxiety and depression. Remeron and Diazapem  insomnia. Can i have both the medicines together?\n\nMy Doctor has me taking Remeron for Isomonia, he said I had the worst case he has ever seen,its been going on for 6 years when I had several family members die all at once and it has not stopped.I have gone for days without sleep trying to work and take care of my everyday duties,however I was let go because of this and I do not remember what happened its like Iam functioning yet it seems like I am sleep walking. My anxiety level is out of control which makes my depression  not improve. . Iam taking Remeron 45 mg at bed time and 10mg of Diazapem 4 times per day..Should I take the Diazapem at bedtime with the Remeron?  I read that you should not take them together however I have not had a bad reaction to this but I dont want to harm myself or worse. I am see a specialist as well as my family Dr of 20 years. What do you think?",
    "doctor_response": "HelloYou have witnessed many losses in family in a short span of time and this resulted in depression and loss of sleep. The problem of insomnia is only due to the depressive symptoms. You are currently on Rameron (Mirtazepine) 45 mg per day along with 40 mg Diazepam per day. There is no contraindication in using one dose of diazepam with rameron in night, but please avoid to take all doses in night as this may cause sudden fall in night. If you are not getting proper relief with these drugs please consult your psychiatrist for expert management.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and numbness on the left side of the body?\n\nHi my question is ive been experiencing for a few years now a variety of strange symptoms and they are as follows muscles aches mostly on the left side of the body as well numbness and tingling on my left arm and muscles twitching all over my body. Also a tension that runs down my left leg as well as pain at the top of my left foot left knee and left upper shoulder. And lastly at times full body numbness and dizziness. So my question is what do all these symptoms mean? ive been to my primary care doctor and he performed blood work for fibromyalgia as well as rheumatoid arthritis but everything comes out clear.",
    "doctor_response": "Hello, I passed carefully through your question and would explain that it is important performing a comprehensive differential diagnosis between different possible causes that may lead to this clinical situation: a bulging disc in the cervical column, vitamin D deficiency, fibromyalgia, etc. For this reason, I would recommend consulting with your attending physician for a physical exam and some tests: - a cervical spine X-ray study - complete blood count, PCR, ESR for inflammation - blood electrolytes for possible imbalance - vitamin D plasma levels. A cervical spine MRI study may be needed, coupled with nerve conduction studies. You should discuss with your doctor on the above tests. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach ache and running fever in a child?\n\nI have a 6 yr old that has a stomach ache for 6 days has had a bowel movement and also running fever is eating and layed in the bed on day 5 all day got up to play for about an hour to an half hour and on day 6 got up complaining about stomach again ate some breakfast and the threw it up about 5 minutes later says legs hurt but went on to school should i take her and have her checked out does this seem serious",
    "doctor_response": "Hello, This child seems to have a significant tummy pain loss of appetite fever suggesting there is a gastrointestinal infection. The child has been having poor activity or lethargy since she has been sleeping for the last five days. I would like to know how many times has the child passed urine in a day, its colour? You have mentioned the child is not eating and has vomited the food. There is a leg pain as well? This child needs immediately taken to the nearby hospital/ emergency room. We need to investigate the child for gastrointestinal infection, by doing a few blood tests like total and differential counts, serum electrolytes, ultrasound abdomen. The leg pain seems to be significant and needs to be evaluated as well. I would request you to get her back from school and do the necessary tests soon. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr ASHWIN BALIGA, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have chicken pox inside mouth?\n\nmy 4 yr son has chicken pox but people said he shoudnt get them in his mouth or its not normal if he does get them in his mouth, but now he has them in his mouth is this harmful/serious, i am really worried and also are they inside his body or just his mouth? ty much appreciated",
    "doctor_response": "Hi & Welcome.I can understand your concern.Yes, it is normal to have the chickenpox rash inside the mouth.There is nothing to worry, it will subside after 1-2 weeks following eruption.The rash commonly appears in clusters and the common sites are on the face, behind the ears, over the scalp, on the chest & abdomen & on the arms and legs. However, the rash can be anywhere on the body, even inside the mouth &  ears, on the palms of the hands, soles of the feet and inside the nappy area.Hope this answers your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Vomiting, dizziness after drinking bubble tea. Allergic reaction?\n\nDo you think I m allergic to soy as the other day I drank bubble tea that was dairy free (not sure if it was soya or not) and I threw up six times and almost fainted, I don t think it was a sickness bug because none of my family caught it, and also we all had some of the bubble tea so there wasn t anything wrong with it",
    "doctor_response": "Hello, I am unsue what was in your bubble tea but checking the list of ingredients will help. Soy allergy is not very common and a soy-free diet is very difficult and almost impossible to continue for more than a few weeks. If you have a problem with drugs such as pain killers (NSAIDs) or aspirin, occasionally salicylates in tea can cause such problems as it gets concentrated. Hives on skin, vomiting after ingestion of foods (within 1 hr usually) is a sign of allergy and needs to be checked in detail. Keep antihistamines (cetirizine 10mg) handy for future but get this checked if it happens again especially if you have underlying asthma. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful bump on head\n\nthe symptons are painful bumps at the crown of my head that hurts to the touch and has been going on for months maybe even a year and once it was off and on and now it is consistent. The doctor has tried antifungal and antibiotics but nothing seems to be working.",
    "doctor_response": "Hi,From history it seems that you might be having some chronic infection on your scalp like fungal infection, seborrhic dermatitis, eczematous dermatitis,dandruff etc.This requires evaluation of your case.Consult dermatologist and get it diagnosis properly.After proper diagnosis proper plan of treatment can be made.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from bladder cancer. Given pyridium. Incontinence. Reason?\n\nMy father is a 86 year old gentleman that has bladder cancer. After one of his TURBT's he was given pyridium. He suffered from urgency at the best of times, but when the catheter came out and of course with having to drink the extra fluids after the procedure, he was unable to hold his urine and was incontinent on my carpet. I have been unable to find anyone that knows a way to remove this stain and realize this is not really a medical question but your site popped up and I figured it was worth a try as you would probably have heard of the problem before.Thankyou so much for your consideration and time,Brenda",
    "doctor_response": "Dear Ma'am, Sorry to hear about your father's problem. Incontinence can be  a complication following TURBT. In some patients it is transient but in others it can persist for a long time. If he is having incontinence, then it is better that he is catheterised for a few days. As far as the stain is concerned, you just need to wash it a few times or get it dry cleaned. Hoping for the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can backache be treated?\n\nHello, I'm looking to confirm that the pain/discomfort I'm feeling in my back is a back strain and if so, how I should treat it. The pain started about a week ago, is moderate and dull, no sharpness or stinging but is ever present and only so far only relief has been lying down. Stretching and taking Advil hasn't helped at all. The pain is in the center-left of my back, not lower back but below the shoulder blades. I am in excellent physical condition but I play golf 2-3 times a week and I am pretty sure I started feeling the pain soon after my round last week. I played again yesterday and it didn't really bother me while playing and didn't seem any worse today. Is there anything I can do other than lying down to alleviate the pain? Would continuing to play golf risk actual damage?  Thank you.",
    "doctor_response": "HiIf it\u2019s been strained muscles gaming,movements would hurt..since it\u2019s dull pain,continuously,it needs to be checked with X-rays of dorsal spine.consult an orthopedist since it\u2019s over a week old without relief by Advil.A physical check by a doctor will reveal more.Try hot fomenting and local application of voltaren gel or any OTC pain gel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for skin darkening?\n\nhello, i am ragini 28 of age, its been over an year i have shifted to new place the water over here is really hard my skin has darkened i had a good complexion. my skin became more sensitive i never had breakout earlier , had good skin... i need help cause i feel depressed due to my skin....",
    "doctor_response": "Hi Ragini,Do not worry or depressed. Your dark complexions may be due to genetic factors,tanning due to sun,systemic diseases like anaemia,endocrinal diseases,nutritional deficiencies or some other factors. You consult dermatologist. You may take vitamin C And E for long time. Glutathion and nicotininic acid containing tablets might improve the complexion. Apply kojic acid containing gel like kojivit might be helpful. Kojic acid containing soap may be used for bath. You may be improved with this much treatment. I hope you got my answer.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Suffering from subclinical hyperthyroidism with anxiety and palpitations.\n\nDear Doctor, I am trying to figure out what is wrong with my 15 year old daughter. Her symptoms have developed most significantly over the past few months, and include depression, weakness, constant light-headedness, shortness of breath (even when sitting still), difficulty taking a deep breath (causes pain), episodes where breathing becomes especially difficult, a complete lack of energy, continual exhaustion, continual muscle soreness (especially in the calves), cold hands and feet (to the point of turning blue), intolerance to cold and heat especially, episodes of a racing heartbeat, and episodes of anxiety and disorientation. At first our focus was on her was depression but now our focus is shifting toward her problems with physical activity and breathing, especially as she has now come to the point where she can no longer participate in any sports. We have seen a psychiatrist for her depression who discovered the MTHFR Mutation, which has since been addressed with a megadose of methyl folate. After three weeks on the medication there has been no improvement. Her paediatrician tested her for asthma and the results\u00a0were negative. We have put her on various vitamin B supplements and have made sure she is getting proper nutrition and rest. Again, nothing has helped. Other labwork, as well as some of her symptoms, has made us consider her thyroid. The thyroid results are as follows:  TSH: 0.059 ulU/ml. AntioTPO-Ab: 84.9 IU/mL. Anti-Thyroglobulin: 134 IU/mL. Total T3: 130 ng/dL. T4: 10.5 ug/dL. Other labs that were out of the normal range are as follows: \u00a0- Ferritin: 31 ng/mL (her other iron results were normal).\u00a0- Differential (Audo Diff) Neutrophils: 66%. In spite of a low TSH we have been told that as long as the T4 level is within normal range there is no need for attention with the thyroid. Yet, I canno\u00a0help but keep coming back to the thyroid and wonder if this is not\u00a0where we should focus our efforts. Any thoughts please?",
    "doctor_response": "Hi, It is really sad to know about your daughter. 1. As a matter of fact your daughter seems to have acute thyroiditis. Though the thyroid profile has not shown full blown thyrotoxic state, she has subclinical hyperthyroidism with TSH being suppressed. Since how long has she been like this? Thyroiditis might take 8-12 weeks to settle. How old are the reports? Thyroiditis might leave the patient hypothyroid. 2. Secondly she is 15, puberty is another phase of major hormonal and emotional change over. How are her periods? Has she put on weight? or lost some? You have supplemented with multivitamins, please see if B12 upto 1500 mcg is being given and Vitamin D 1000 IU daily or 60,000 IU once a week is going. Also supplement her with calcium and magnesium and check these levels as well. Treat her with Propranolol 10mg twice a day to beat the anxiety and palpitations. Get back to an endocrinologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dog bite\n\nHi, may I answer your health queries right now ?  Please type your query here...My two month old puppy is very playful and active. He scratches and bites while playing. He was bought from a nice family having a male and female dog and the puppy parents have been  vaccinated. I have a small scratch mark in my hand with little bit of bleeding. Would like to know whether i would have to take anti rabies injection. Should i take the vaccine everytime he bites. I have a 12 yr old son who loves the puppy and iam very worried about him being bitten/scratched by the puppy",
    "doctor_response": "Hi,Welcome to HCM.I understand your concern about you and your son getting scratched by your newly acquired pet. It is not necessary to get rabies vaccine if the vaccinations of the puppy are complete. However, make sure you clean the wound thoroughly with soap and running water. Also make sure that your pet gets vaccinated regularly. Training of the pet is also necessary to avoid accidents at home especially with young children.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back & abdomen pain with acid reflux\n\nhi... i am having a pain in my left lower abdomen.. i sometimes have issues with incomplete bowel movement.. and also since i travel for long hours and mostly have sit during my work.. i am getting back pain.. in the left side.. and i am a poor eater with acid reflex.. please let know the right kind of food when i take lazol junior..",
    "doctor_response": "Hello!Thank you for the query.Lower left abdominal pain is characteristic for diverticulitis of sigmoid colon. This condition is caused by chronic constipation which you seem to have.Back pain and lower pain can be both also caused by urinary tract infection. Both issues can not be healed with diet. You need diagnostics first. Please consult your doctor, have abdominal ultrasound, blood work and urine analysis. Colonoscopy should be considered.To improve your bowels condition and avoid acid reflux you should avoid fatty foods, spicy foods, alcohol, coffee. Increase fiber rich products, mineral water intake. Start some physical activity.Hope this will help.regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had unprotected sex after periods. Taken unwanted 72. Again had sex after 3 days. Will I get pregnant?\n\nsir my girl friend age of 26 after her completion of period time, we involve in sex.... her period time stop on 19th to 25th we involve in sex on 5th and 7th of next month and used unwanted 72... but my doubt is at 11th date again we involve in sex ... with out precaution... so now she get pregnancy or not.. please tell me..",
    "doctor_response": "Hello,Pregnancy is possible only,if unprotected sexual intercourse is done with ejaculation around ovulation time in regular period. Ovulation occurs approx 14 days before due date.If your girl friend's due date was on 19th in next month,then ovulation occurs on 5th of the month.You did sex on ovulation time and your girlfriend took unwanted 72.It is very much effective in preventing unwanted pregnancy with failure rate less than 1%. A withdrawal bleeding may occur and next period may be delayed/earlier.You also did sex on 11th day and it was almost safe period with low risk.If she does not get period,do a home pregnancy test with urine for B-hcg after 1 wk of missed.Practice safe sex by using safe period/OCP/Condom etc to avoid unwanted pregnancy.Be well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold and wheezing in a child\n\nDear Doc my daughter is 2 year 11 months old and since two months she has developed cold n wheezing as prescribed by doctor i m giving her Asthalin but really worried bcoz she never had any issues in the past. Doc say its becoz of Bangalore weather but I don t know how it started suddenly n how to get my child out of it. Please advise",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Greetings from Chennai.By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze. I have a few questions for you -Questions:1. How many days per month does she cough or feel breathless?2. How many nights per month does her sleep get disturbed due to above symptoms?3. Does she feel breathless when she runs around or plays with other kids?4. Are the symptoms when there are seasonal changes?5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?6. Is the cough always associated with fever?Please revert back to me with answers so that I can guide you better.You can approach me at the following link.Once the page opens there will be an option below my image as \u2013 ASK ME A QUESTION \u2013 click on it.Please find the link below -www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cold and abdominal pain?\n\nCharlie is sitting in my bed watching a movie and I ve no I just had a cold and my stomach closer to my head I think it s the scrotum but I m not sure so I went to the back I got to go to the bathroom and I found the toilet I started pushing and when I started to push nothing ever happened it was a hurts so bad it felt like a knife was going up my butt and I cannot Sabe and is this is the first time ever happened please help",
    "doctor_response": "HI.From the improper history  what I could get is you tried to push something in and got more pain. This ca n be an obstructed Hernia. get immediate Medical help as you may need an operation if this is not reduced within a few hours. If one can you will need a proper repair later on.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe backache be treated?\n\nmy back is killing me--- i did have back surgery 2 years ago --backs has been ok started taking pravastatin switched to ezetimibe--- pravastatin gave me muscle ache ---woke my up in the middle of the knight the ezetimibe-- now my back is hurting badly-- every time i see my dr. its a pa--doesnt care about the aches ---just my cholesterol",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Can be due to muscle spasm. Oral muscle relaxants and regular back exercises can help. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is change in attitude in a person suffering from stage 4 cancer be considered normal?\n\nHi I have a friend who has stage 4 cancer, and I have noticed a change in her attitude is it because of the stage of denial, or is it affecting also her brain in anyway. Her attitude severely changed as soon as her health deteriorated. She tells lies she is moody and easily angered in any situation.",
    "doctor_response": "Thanks for your question on HCM. Both are correct.Stage 4 cancer can cause great impact on psychology of patient and this start reflecting in motor behaviour.  So patient becomes very roudy, irritated and depressed. Spread in brain can also cause similar symptoms.So we need to get done MRI brain first. If this is normal than psychological counselling is needed.In any case prognosis is not good.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest ways to control emotional depression during pregnancy\n\nNow i am in my third trimster of pregnancy, 32-33 weeks. I seek my husband s support almost everytime. Sometime i feel that he use to get iritate with this. But it s not so that he does not love me. he do. But i can not control over my angerness and feel so depress. May i have some useful suggestion pleas.",
    "doctor_response": "emotional instability during pregnancy may make you irritable and sad at times it is all due hormonal excess and will go off of its own so during this period you have to keep your self relaxed as much as possible.you can have daily exercise, deep breathing exercise, morning and evening walk.start  dairy writing whenever you get time to keep yourself busy so that you need no help from your family members.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the ways to conceive with irregular periods?\n\nHello doctor, I am 19 years old, soon to be 20. I and my fiance are trying to conceive for the past four years. We are having trouble getting pregnant due to my absence of a menstrual cycle. When I was younger I did not get my period when I was supposed to and had to be put on birth control pills in order to get my first period. Since then I have been on and off on birth control pills and said Depo-Provera shot. I stopped getting my Depo shot four years back and I have not been on any method of birth control since. I only had my period twice after discontinuing the shot. The last time I had my period was four years back and then I spotted the whole entire first week of the very next month. Since then I have not had any type of spotting or bleeding. Of course, I need to be having a menstrual cycle in order to conceive but I am just in desperate need and I feel so hopeless because I feel like I am not be able to have any kids or if I do it will be in a long time. What can I do to get my period? Should the Depo-Provera be completely flushed out of my body by now? I just want to have my period already and at least a normal cycle so I can finally have a baby.",
    "doctor_response": "Hi. Definitely you need a regular cycle to conceive. A regular cycle signifies a normal ovulation and thus a fertile status. I presume you are suffering from anovulation, which means absence of ovulation. There are 100 causes of anovulation whereas the most common cause of anovulation is polycystic ovarian syndrome (PCOS), a complex endocrine disorder of uncertain etiology, where ovaries turn into cystic structures. Other causes are obesity, thyroid disorders, underweight, anorexia nervosa, stress, overt exercise, and usage of some medications. You have a body weight only 40 kg with BMI 17.28 (attachment removed to protect patient identity). This is a bit lower than normal weight.You were on antidepressant, which you have left, also which could cause anovulation. Are you suffering from any psychiatric illness still now? These all could cause anovulation and amenorrhoea. You have taken also Depo shot one year back. I do not know why you had taken, but this medicine itself can cause absence of cycle. Whatever may be the reason, you need a detailed evaluation. You need to increase your body weight, need hormonal screening (LH, FSH, thyroid, prolactin, testosterone) and an USG screening for polycystic ovaries. Just get a regular cycle and then try to conceive when you will achieve this. Anovulation. 1. Serum level of LH, FSH, prolactin, thyroid, testosterone. 2. USG lower abdomen.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to regulate high blood sugar?\n\nHi doctor. I am suffering from type 2 diabetes. My last blood sugar level was 400 mg/dL. I am on Insulin. But it is not coming back to normal. What shall I do?",
    "doctor_response": "Hi. Since you have not mentioned the duration of diabetes, I have to assume that you may be having it for a minimum of 5 years. Coming to your values, your blood pressure (BP) looks fantastic and you have excellent weight for height. We will control your sugar in stepwise fashion. I think you are taking only Glimepiride. Change this to Glimepiride plus Metformin combination. Go for Euglim M2 one tablet in the morning before food and one at night before food. Insulin resistance. 1. Urine routine. 2. Lipid profile. 3. ECG. Uncontrolled diabetes refractory to treatment. 1. Diet. 2. Exercise. 3. Altering drugs. 4. Control of complications. Absolutely no sugar should be added in diet. Avoid chocolates, sweets and rice at night. Reduce the intake of oily foods. Revert back with the answers for the above questions to a diabetologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and elevated liver enzymes\n\nmy son is having flu like symptoms / headache. We have taken him to the ER and they are saying that his liver enzymes are high. They ran tests yesterday checking for hepatitis. The test results showed negative for hepatitis A & C but subjective for B, but they thought that maybe from the his vaccine. What does all this mean??",
    "doctor_response": "Hi thanks for contacting health care magic.Noted your child have flu like symptoms with elevated liver enzymes...Your report negative for hepatitis a...If you had taken hepatitis b vaccine then you have protective antibody antihbs by it.But usually HBSag positivity not there.So do your test for detection of HBSag by ELISA test...Meanwhile take low fat diet to rest liver.Fruits given more.Hydration is maintained...Avoid heavy work....Udiliv tablet can be given...Regular follow up needed.Esp.check for HBSag positivity after six month just to rule out chronic infection.Take care.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the early symptoms of bronchitis?\n\nIv had a cold for 2 weeks now and I lost my voice for a few days last week. But yesterday I kept having cough attacks where any time I took a deep breath I had issues breathing while coughing. But a friend of mine is getting over bronchitis and i was wondering if I got it?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. In my opinion, you are mostly having post infectious bronchitis. It is very common after viral upper respiratory tract infection (URTI). So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is must for the diagnosis of bronchitis. It will also tell you about severity of the disease. And treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid (ICS). 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump in the lower abdomen?\n\nhi, my situation is kinda weird, I know I dont have a hernia because I went to my dr today for a check up, i will have a cat scan next week. I have a lump on my lower abdomen on the left side, i have no pain, and and slightly feel discomfort when pushed. Ive been constipated since I got that, harder for me to use the bathroom. I had an std before, clamydia and gonorrea, but got a shot and a pill for that , and got that taken care of about 3 months ago, maybe it has to do something with that? What do you think it might be? thanks.",
    "doctor_response": "This lump could be because of loaded left side  large intestine with solid lump of stool.Nothing to do with std.You must start medication for chronic constipation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicine for mild stomach pain\n\nSir Is Meftal P syrup a medicine for curing mild Stomach ache?. The patient is 11 Yr old and is taking antibiotic (Syr Oflox 100 two times 5 ml). He is also taking Tab Buscopan for the same. He is taking the medicines for last one day only. Since the stomach pain is still continuing so I was asked to give the meftal P Syrup (10 ml two times). I want Your opinion.",
    "doctor_response": "Meftal and buscopan are temporary pain relieving drugs and of pain continues after 72 hrs get him examined by an expert and take appropriate measures.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a feel of food being stuck in my throat. Why?\n\nHello doctor, More than two months ago, I started getting this constant feeling of food being stuck in the top back of my left tonsil. I looked in the mirror and did not see anything suspicious in my throat. Since I get tonsil stones often (even though I do not feel them), I thought it was the same and would go away. One and half months later, the feeling became stronger, and whenever I swallow, I felt something on my left tonsil. When I looked in the mirror, I could see some redness and a few small veins close to my tonsil on the left side of my throat, and the tonsil itself was a little swollen and red. I made an appointment with an ENT doctor. He examined with the light and did not see anything unusual, so he suggested that it is nothing remarkable. Since I was very nervous about the constant feeling for more than a month, he felt my tonsils with his fingers and said if it was cancer, he could feel it and assured me that it is not anything significant. After two weeks, I still feel the same sensation of food being stuck on the top back of my left tonsil, but stronger and itchy. I looked in the mirror last night and noticed a big white circle on the top of my left tonsil. I have no fever, no pain in my ear or my tonsils, and no flu symptoms. When I swallow, it is harder on my left side, and I feel something on the left tonsil. The right tonsil is completely fine, and I do not feel anything unusual. I am currently on Rosuvastatin and Levothyroxine. I will include pictures and would appreciate any help.",
    "doctor_response": "Hello. Is there such a feeling when you do not swallow anything? Is there any pain or fever or soreness? Is any mucus dripping from the back of the nose to throat? Any nose block or nasal discharge? Any problem of sinusitis? How is your diet? Do you smoke or drink? Have you tried any antacid medicines or gargles? Do you have diabetes or hypertension?  Can you take another picture wherein both tonsils are seen and also the back wall of the throat?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fibromyalgia\n\nHow is it that a medical expert could use the 1990 ACOR criteria for Fibromyalgia in July of 2009, when was the preliminary available? I don t have any money, I am now disabled and not working, I need help and some answers. Is this questionnaire set up to help or to make money? Sorry about the attitude but I am tired of trying to find the truth about my case and because I am unable to make the living that I once made because of the Fibro, I am left in the dark.",
    "doctor_response": "hi,thank-you for providing the brief history of you.A thorough clinical Musculoskeletal assessment is advised.a little knowledge about the fibromyalgia is needed. Fibro-myal-gia is a condition where the pain is in the fibres of the muscle. Each muscle is composed of multiple muscle fibers and inflammation happening there will lead to the dysfunction in the circuiting of the muscle fibers to produce the contraction and relaxation.also to understand here that the medication is a symptomatic relief and not a long term solution as the body is a medicine of its own and medication used acts as a supportive therapy to allow body to heal on its own.Also, in my clinical practice most Fibromyalgia cases we recommend physical therapy, meditation and breathing exercises.As physical therapy will help improve the muscle refunctioning and also improve the metabolism and immune system to reduce the inflammation. Also Therapeutic ultrasound therapy and TENS therapy have been useful to reduce the pain but importantly exercises are the choice.meditation helps improve the control over the anxiety and leads to cooling of aggression.Breathing exercises helps to improve the oxygen carrying blood cells which acts as a fuel in the metabolism and reduce the metabolic waste as well.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cold flashes and shivering in body?\n\nIm having cold flashes, ill be freezing for a minute or two then it will go away. My house is nice and warm right now but im Freezing. Im all bundled up. Plus, my scalp hurts but just the top by where my soft spot is, and i have a swollen spot under my chin on the left side of my face, and it all happend last night after dinner. When i woke up i was covered in sweat and i was freezing????? Any idea what this is?",
    "doctor_response": "HiYou may have a viral illness like the flu starting and you should get checked out since prescription Tamiflu can treat it quickly and effectively",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring nocturnal bleeding?\n\nA couple of months ago my husband experienced some blood in his underwear, he then had a pain and a clot seemed to come out. Bleeding stopped. It happened again and this time there was no pain, he had blood in his underwear when he woke up. We have not had sexual intercourse for over 2 yrs. so it is not from sexual activity. What would cause it to happen 2x's? Why periodically in over a couple months?",
    "doctor_response": "Hello,It may be due to several causes. For further assessment you may require complete hemogram, urine analysis, ultrasound abdomen after urologist consultation. Further treatment mainly depends upon the underlying condition. You may require detailed evaluation to rule out any other possibilities for urinary tract infection or renal stone. You may require antibiotics after consultation. You can take syp cital Hope I have answered your query...Let me know if I can assist you further.Regards,Dr Shyam kaleFamily and general physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the merits and demerits of Gemcal medication?\n\nwant to know about merits and demerits of medicine called gemcal my younger brother who is now 11 years old is marked to be suffering with a disease called dmd he take this medicine with one more medicine called wyeth now he has become more fat than before and is having weight 47 . plz help",
    "doctor_response": "Hi,Thanks and welcome to HCM .Gemcal is a calcium preparation .Wyeth is not a medicine it is company's name.Children usually become fatty if they are taking steroids for a prolonged period.Hope this answer serves your purpose .Further queries invited .Dr.M.V.Subrahmanyam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to help someone with suicidal tendencies and low self-esteem?\n\nMy Younger brother is having severe inferiority complex about his physic, identity, health (probably sexual also). He is 26 yrs old, ht. 5'10\". He is reacting very aggressively, always talking to finish his life. In family no one is there to share his actual problems, so he is having some misunderstanding also about his sexual matter also, probably he have some boyfriends also, so they are also misguiding him about life. we are not able to talk anythings about this matter, he is hiding very badly. he is taking some medicines that he has purchased from correspondence. all the times he is talking to finish his life, he has stopped to eat since several days. what to do doctor? its very tough to manage.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. You could be right. Your brother is lacking self confidence and self esteem. He is also into some misguiding thoughts. This attitude should never be allowed to last, otherwise, suicidal tendency may become real suicide. Please take him to a psychologist or counselor. Let him understand his worth. From your side be motivation. He needs psychological treatment. Please do not delay.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest ways to stop masturbation at a very young age\n\nI have a 15 year old nephew that has had a facination with womens underwear. He goes as far as stealing them and then hidding them. He is still in middle school and rides the bus with chilren from 5 to 13. It has just been brought to our attention that he is masterbating on the school bus. What do we do?",
    "doctor_response": "Hello, Masturbation is common in this age, but stealing women's garments, or masturbate in the bus or obsession regarding masturbation may be problematic. for this counselling may require so consult good counselor for that age. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Adish V. Doshi, Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring acute lower back pain?\n\nI ve been having acute pain off and on with my lower back right side above my waist to just below my rib cage and just investigating possible relief remedies and trying not to worry that it could be other internal problems. I m 44 years old. This has been going on for a couple of weeks and am finishing up a road trip driving for three days. Thank you for your help.",
    "doctor_response": "Hi,Welcome to healthcare magic.After going through your query in my opinion it is muscular pain. It may be related to overexertion of muscles due to overwork. In acute  stage rest and analgesics is its treatment. Sometimes vitamin D deficiency can cause this so serum vitamin D test is advised if it is low than vitamin D supplementation will be required.Other causes of pain can be seen by doing ultrsonography of abdomen and MRI of spine. I think your query answered.Welcome to any follow up query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for swelling with lumpy bruise in lower leg?\n\nI was hit by a chair a few weeks back on my lower leg had very bad brusing and some swelling, now I have a hard lima bean size lump (where the chair leg hit ) with pain  and servire leg cramps at night the swelling and brusing have somewhat gone away. What is the hard lump",
    "doctor_response": "This hard lump could be because of old clotted blood at that site. Do you must use ointment Thrombophob to be applied every four hourly just spply and minimum rub.start tab chymorsl forte plus three times daily.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with Arteriovenous malformation & a procedure with brain glue resulting in vomiting\n\nMy brother-in-law has been in a coma since March 20, 2012.  I'll give you the short list, diabetic, high blood, high cholesterol and overweight.  He suffered a stroke will in ICU.  He was later diagnosed with  Arteriovenous malformation - cerebral and had the procedure with the \"brain glue\". Currently he's in assisted living, with a trach, and feeding tubes.  Yesterday they informed us that he's been vomiting but there's no need for concern.  Should we be concerned?  The family knows someone that had a similar situation and was told he started vomiting and then a few days later, she lost him?",
    "doctor_response": "Vomiting can be a symptom of raised intracranial pressure, and so in someone who has had a stroke, we will worry about the possibility that this is a sign of increasing pressure in the brain.Often times we will order brain imaging just to make sure.However, if it is clearly related to another issue (feeding tube, slow stomach emptying, etc) then a scan may not be necessary.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes child to want to snuggle and sleep after falling down?\n\nBackwards fall onto a hardwood floor My two year old fell back wards off a 2 foot stool on to hardwood floor. He cried right away but settle and started to play again. I woke him up every 2 hours last night to make sure he was ok. all went well. This am if he is not playing he want to snuggle and fall asleep. Should I be concerned?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. I understand your concern. First be reassured that your kid is normal. I will suggest you danger signs of head injury -1. Vomiting continuously2. Seizures3. Watery of bloody discharge from ears and nose4. Unconsciousness5. Altered sensorium or behaviour.If none of them are present, I don't think you should worry about his trivial head injury.For pain you can give oral Paracetamol in the dose of 15mg/kg/dose(max ceiling dose 500mg) every 4-6th hourly.But as he is preferring to sleep, I suggest you get him checked at the nearest emergency room, first thing in the morning.Regards - Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Should my son wear specs for cylindrical power of 1 and 1. 25?\n\nHi doctor, My son is 5 years old. His doctor told that he has a\u00a0cylindrical power of 1 and 1.25. He also said that his muscle power is weak. Is it a must to wear eyeglasses?",
    "doctor_response": "Hello. I can understand your concern regarding your child. Revert back with the prescription to an eye care ophthalmologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a white discharge during pregnancy?\n\nhi i am 9-weeks pregnant, and today i found a white flaky thing in my urine, is it normal or do i need to see my gynecologist?? apparently it didnt hurt or have stingy sensation but i think i might be running very mild fever i am not sure about this but tomorrow morning i will get a clinical thermometer and check it out. so did the white discharge is a thing to worry??",
    "doctor_response": "Hallow Dear,During pregnancy there is little increased discharge due to raised hormones; however it is clear discharge. White flaky discharge you are describing seems to the Candida (yeast) infestation. This is fungal infestation. It can be treated by antifungal vaginal pessaries like Candid vaginal. Please report to the Gynaecologist for confirmation of diagnosis and treatment. You should follow following instructions to avoid re-infection:1. Since this can be transferred sexually, both the partners should take the treatment simultaneously and follow the instructions given below.2. Observe sexual abstinence till both of you are declared completely cured.3. Shave private parts clean.4. Boil underwear daily.5. Use panty liners (for you).6. Clip the nails short.With this you should be cured of the infestation. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does morphology affect IUI?\n\nMy husband and I are coming up on 2 years of trying to conceive. We recently finished all the testing and found my husband's morphology is at 2 percent. We are waiting on another analysis to confirm the results. Our doctor recommended IVF (which we cannot afford) as our only option stating our odds of conceiving through IUI was at 6%. We were both crushed and went online to research but we have found very conflicting information. We have found studies stating morphology (the only abnormal result) can't predict the outcome of an IUI where other studies stated a 2% kuger score said there was a slim to none chance of IUI working. IUI right now is our only option. What is the real story about morphology?",
    "doctor_response": "What you have read is partially true. Sperm morphology as measured by the so called Krugerberg Strict criteria does correlate with pregnancy outcomes, but I would also like to know the sperm count. If the sperm count is very high, a low morphology will not be very detrimental, as you should understand that even among men who have conceived normally, the sperm morphology as measured by the strict criteria will be quite often only 5-8%. We have seen people with 1% morphology conceiving and therefore this is not the end of the world. See if you can start making lifestyle changes and start yourselves on nutraceuticals to help me improve morphology, especially if you cannot afford a test tube baby at this stage.All the best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent bowel movement in babies?\n\nHi Doctor, My son is 8 months old. He is having frequent bowel movements but normal. My doctor prescribed zinconia 1ml 2 times a day. My son is normal in his activities. His stools are also normal. Normal in color and ador. Please suggest. I am so much worried.",
    "doctor_response": "Hi...nothing needs to be done. You need not worry unless he is extremely tired/ not passing urine/ there is blood in the motion/ abdominal distension/ listless.I suggest you give him plenty of oral fluids, avoid aerated drinks, avoid fruit juices and start on Zinc supplements. But the zinc supplements you are giving him is not adequate. Zinconia syrup contains 20mg of zinc in 5ml and you need to give 5ml once a day and not 1ml twice a day. He will get better soon. If he develops any of the danger signs mentioned above, kindly consult your pediatrician.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic obstructive pulmonary disease\n\nI have COPD, I have been sick for about 2months now. I had a sputum test and it came back Staph. My lab work was Immoguloblun G 654, Red blood count 3.90, Hemacrit 36.8, Eosinophils 8.7. I also have a mass in my chest that showed up on CT scan. Your opinion?",
    "doctor_response": "Hello dear, thanks for your question on HCM. In my opinion you should get done fine needle aspiration cytology from lung mass to rule out malignancy. Because COPD ( chronic obstructive pulmonary disease ) patients are at increased risk of lung cancer. So first rule out lung cancer. Treatment of COPD is as follows. 1. Smoking cessation.  This is the most important step.2. Inhaled bronchodilators and corticosteroid. 3. Pulmonary rehabilitation programme.  In this chest physiotherapy and deep breathing exercise are done. These will improve your lung function and decrease the symptoms. 4. Adult respiratory vaccines like pneumococcal and influenza to prevent future respiratory tract infection. So better to consult pulmonologist and discuss all these.  First rule out malignancy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is delayed menstruation while on Petogen a sign of pregnancy?\n\ni was using pertogn since this year my retuning date was 8october,last month so i didnt retun after 2weeks i start feeling the is something in my stomach and is moving ,so i took 2 pregnecy test they come negetive and now movement a strong than before ,so i was asking that it is posoble that it is a pregnecy\uff1f",
    "doctor_response": "Hi,  I understand your query & concern.   Pitogen is an injectable progesterone.. it's a contraceptive which offers contraception for 3 months after injection.    It has a known side effect of delayed/ no/ irregular bleeding. So delayed period while on Pitogen is not a sign of pregnancy.   thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes short temperedness on certain matters?\n\ni have anger issues my fieance does stuff my ex wife does which done me very wrong in so many was and when my fieance does them i just go off in anger and i cant controll it it just makes me feel like its all happing again i trust her but the thoughts just keep going through my head what can i do please help",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Anger always comes due to frustrations in life. Frustrations are normal with everyone. People learn to ignore frustrations when they get experienced. Do you get angry to circumstances outside your home as you get angry at your house? Your office, bus stand, railway station, neighbors etc. If yes, you might need to get evaluated for anger issues. If NO, just understand and compare the two situations and you can be better yourself.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for controlling high blood pressure\n\ngood evening all doctors. Respectable SIR i just  want to know about that my mother has blood pressure and blood sugar . every time day and morning i check my self BP IS 240/120 OR MORE AND B:SUGAR IS 480 , SO CAN YOU TELL ME which tableates are good for to normal BP AND B:SUGAR?",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!I understand your concern and would explain that your mother suffers from uncontrolled high blood pressure and hyperglycemia. What is her actual therapy?It seems that her blood pressure and diabetes therapy (if she has one), is not effective and some changes are needed to be done. You should know that there is not a specific treatment for these disorders.I recommend consulting with her GP for a careful physical examination, a resting ECG, a chest x ray and some lab blood tests (complete blood count, kidney and liver function tests, thyroid hormone levels, HbA1C, cortisol plasma levels, blood electrolytes, PCR, sedimentation rate,etc.), to exclude other possible secondary causes of uncontrolled high blood pressure and hyperglycemia. Some changes to her hypertensive therapy (a dose increase or adding another drug ) are needed. Besides, you should also consult with her endocrinologist for some changes to her diabetes therapy. She may need to start insulin therapy if necessary. I recommend you to consult her as soon as possible with the above specialists, to avoid possible complications of this situation (a possible brain stroke or coronary artery disease). Hope to have been helpful!Best regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for fever and swollen glands\n\nMy son started out with high temps for a day the next morning woke up with a swollen gland on the left  side under his chin near his neck and was  very noticable and still had high temps, day 3 there is no temp, and  the lump has moved down to his neck do you think he needs.medical attention he is7",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query high fever and swollen glands which could be due to upper respiratory tract infection, enteric fever typhoid, viral infection or infectious mononucleosis. I would suggest you to keep temperature under control by using Ibuprofen or Paracetamol every 4-6 h. You should avoid dehydration by giving him plenty of fluids. I suggest to consult a pediatrician as soon as possible to find the right cause of this. You should get blood test done. You should give anti inflammatory medication such as Levocetrizine Give him diet rich in vitamin B12. You should do tepid sponging to lower down the temperature. Avoid taking hot, sharp and oily food substances. Take multivitamins to booster immunity.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat intertrigo in groin area?\n\nhi, for about 10 years i have suffered from intertrigo in my groin area. i am over weight so as imagined the area does not get much air. I do take measures and i am super clean , wear cotton undies and use drying powders. the condition just fades and flares up one its own accord. I have tried all types of creams ( from doctors) and it just is a temp help. I was wondering if a ultraviolet lamp would help to dry the area? or is there any other way of drying the skin to help it heal?",
    "doctor_response": "Hi and welcome. I suggest simply keeping the affected area dry and exposed to the air. You may control oozing with moist compresses of an astringent called Burow's solution. Then air-dry with a hair dryer set on \"cool.\" Shower and dry off thoroughly each day. Keep your skin as dry and cool as you can. Sometimes, short-term use of a topical steroid to reduce inflammation in the area may be required. If the area is also infected, your doctor may prescribe an antifungal or antibiotic cream or ointment. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What tests can help to understand why the liver counts are abnormal ?\n\nI dont expect a full answer, but maybe you could just steer me in the right direction. My neighbor is 70 yrs old, has had bladder cancer,(they removed the cancerous part only), no radiation or chemo. This was abut 5 yrs ago. She has no thyroid and major back problems from a car wreck. The car rolled 5x. she was completely twisted 180 deg at the waist. Recently, as in the last few months I have noticed a decline in health. I finally got her to my DR and she did blood work. Her liver count was three times normal, she has dark urine, and occasionally very dark streaks in her pee. The Dr has ordered an ultrasound for the 15th. Is there anything else that should be done? or do I need to just relax and let things take their course?",
    "doctor_response": "Hi thank for contacting healthcare magic.Which bladder cancer does she had???Although she had accident but now after few month of accident she is complaining these symptoms....Here let me know you it could be progression of cancer.It can metastasise to liver and so liver enzymes can high....The picture will more clear after ultrasound and if needed CT scan done....for further work up.....Proctoscopy examination also done for rule out anal fissure , piles or inflammation...Hope your concern solved.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the recurring rash on chin?\n\nHi, I have this strange rash like thing on my chin that goes and comes back without warning. It doesn't hurt or itch and my doctor can't do anything without it being on my skin, yet it goes before I can call the doctor. I'm very worried do you know what it could be? Thankyou",
    "doctor_response": "Hello, An evanescent rash could possibly be due to hives, however, hives are usually itchy. Anyways, I suggest you click a snap of it next time you develop the rash and post it to one of the specialists here. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Kakkar S., Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for depression and sleeplessness\n\nhi i am a 16 year old girl, who lost her father to suicide 2 weeks ago. i cant sleep or eat, and im always going to call him fogetting whats happened. i always feel sick cause i cant eat and always feel tired and angry cause i cant sleep. should i got to a docter for antidepression and sleeping medicine?",
    "doctor_response": "HiI admire your concern.I guess it is grief reaction due to decase father.It is comon reaction after lost of loved one.I can understand your emotion.No need of antidepressant. it will only given if symtoms are persist for more than 1 month.This kind of condition can be treated with mild dose of anxiolytic and which is also help to get good sleep.I prefer low dose of etizolam or lorazepam orclonazepam etc in such kind of patients.Besides this you have to keep your self busy.Try out to maintain daily routines.Keep taking with friends and family members.fix sleep schedule and stick on itno day time sleepexercise.stress free activities and meditationsavoid alcohol and smokingAvoid tea coffee soft drink at night.All of this will help you to restore good sleep.Hope for the best.Get well soon.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I having varying temperature?\n\nhi i am 19 yrs old female, and I have been sick for the past three weeks. the first week, I had a stomach pains, mager head aches body aches and chills, my temp went up and down from 99.2 to 101.fer. and did not have the strength to get out of bed. the second week,  same symtoms but fever went up(101.2-101.9) and coughing went away and I gain some strength back, this week, the same things as the first week, but again fever has gone up. 101.5-102.1, I just checked it again about 5min ago and it is 102.3. is this normal, I have never been sick for more then 2-3 days. and only once has my temp been over 103.5, (I was7)",
    "doctor_response": "Hi,From history it seems that you got long period of having fever and requires evaluation of your case.This requires some investigations to conclude proper diagnosis of having your fever.Go for complete blood checking like TC, DC, ESR, MP, platelet count.S. Widal.Go for routine urine check up.If require go for x-ray chest.After all reports your doctor come to diagnosis and plan of proper treatment can be started.Meanwhile take rest and take light diet.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for painful lumps on foot\n\nI have a small white pain painful lump on the bottom of my foot. It is surrounded by red infected type colour. I first thought I had something stuck in my foot but I can't find anything. It's getting more painful every day and getting quiet hard to put any pressure on my foot.",
    "doctor_response": "Hi,Dear,These painful foot  lumps need to be reviewed and consulted by your ER Surgeon.The lump in the throat seems to be abscess of the plantar tissue of the foot.Take antibiotics / anti-inflammatory drugs under cover of ER Surgeon.So consultation with ER Surgeon would fix solution to your intriguing lump problem at the site.This would resolve your query.Write excellent review if you feel that this reply has helped you a lot.Welcome for any further query in this regard to HCM and to ME.Have a good Day.Dr.Savaskar M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of an itchy lump on inner thigh?\n\nHello. Four months ago I've notice an itchy, red lump on my inner thigh & just few days went to my Dr and said maybe it was just an insect bite so I didn't buy the cream he prescribed me. I noticed that Everytime i get itchy on the part where the lump is and I don't even know that the lump is still there. It's like a round shape size & it feel hard inside. Any idea what this might be?",
    "doctor_response": "Hi. This is 4 months old you say.No insect bite can last this long. This may be some kind of a reaction like fixed one,- Does not change position. The treatment can better be done after a careful diagnosis by a Dermatologist. Stop applying anything including the soaps as this may change the character and making a proper diagnosis difficult. A gradually reducing dose of steroid and an anti-allergic tablets can help a lot. Please discus this with your Doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am trying to conceive, Pls Help\n\nDear Doctors, I am trying to conceive since last 1 year first six months i used to take novelon pills . My husband sperm count was initially 8 ml whcih was done in dec 2009 later in feb so we consulted Surgeon he has prescribed him paternia tablets twice daily and his last sperm count was 21 ml in feb month . We also visted gyneac she suggested for IUI but my husband could not masburate on his own as a result we could not give the semen required for IUI and they do not allow the semen collection from home. Would be really very thankfull if you could suggest the best advise which is affordable as i amd from a middle class family and could not afford high price medical treatments like IVF Awaiting for reply at the earliest . Thanks Regards, Rina",
    "doctor_response": "Hey the count is good enough for you to conceive.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough with phlegm\n\nhi my 7year old has had bad cough loads of phelm and fast breathing and high temp he gets very weak when this happens it lasts for about 4 days he has nebuliser which helps he has already been sick 4 time since sept with this and has missed 15 days from school doc doesnt think its asthma",
    "doctor_response": "Hello,A high grade fever with cough requires nebulization to be responded favoring diagnosis of asthma.Still require clinical examination, chest auscultation, chest x-ray, and blood examination for allergy profile.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sachin Kumar Agarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child have fever and vomiting?\n\nI have a 3yr old child who had fever & vomiting this morning. We took him to the doctor who inserted some tablet in the rectum & prescribed ondem & meftagesic syrup. Now my child is passing stools everytime he is eating. He has only eaten biscuits & we have given him ORS water. Kindly advise.",
    "doctor_response": "Hi,Thank you for asking question on health care magic.The doctor has prescribed right medicine.I do not know what tablet he put in the rectum.Continue feeding and plenty of fluids orally.You may try Sporolac sachets one per day.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can bleach fumes inhalation causing parageusia be treated?\n\nI'm a cosmetology student and have accidentally inhaled powdered bleach when mixing several times (it makes a cloud of dust when you pour it). Ever since i've been using it, i'm noticed that my tongue and mouth \"taste bad\" and my mouth feels like it's burning. At the same time that i was learning to work with this product, i had a tooth pulled, which was traumatic and developed into dry socket, so for the last 3 months i've been thinking the tooth caused the mouth problem. But after being checked by my dentist and an oral surgeon several times, i'm starting to think maybe the chemicals are stuck in my lungs. I will now wear a mask for future highlights, but what to do i do to \"clean\" my lungs?",
    "doctor_response": "respected user , hiThanks for using Healthcaremagic.comI have evaluated your query thoroughly .* Management of lung damage depend upon the extent of involvement to    lungs which can be evaluated with help of diagnostic bronchoscopy with or   without pulmonary function tests , x-ray chest according to clinician    demand* Till then can opt for deep breathing exercises regularlyHope this clears your queryWelcome for any further assistanceRegards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had skin cancer and was removed. Have growing lump above scar on neck. Has Hay-fever. Related?\n\nHi there, my husband had skin cancer which was removed in early sept with skin taken from neck and added to head..he has also had an MRI scan on his head and neck and was all clear! Just a few month on he was saying he could feel a lump just above scar in neck and been for follow up and again all fine, but with pulling and pushing this area it seems to be getting bigger..any advice apart from me telling him to leave alone he is also suffering bad from hay-fever and wondered if this was anything to do with lump?",
    "doctor_response": "Dear Ma'am,Sorry to hear about your husband's problem. From your description it looks as if he had the cancer in his scalp and skin was transferred from his neck to the scalp. If he has now developed a lump in the neck, it should be evaluated as it could be a lymph node. It might turn out to be reactive (due to hay fever) but considering his history of cancer, it is best to get it evaluated.Hoping for the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have dizziness, ringing ears, headaches. What can I do?\n\nI have symptoms of positional vertigo and tinnitus (dizziness, ears ringing, occasional headaches). Eating any high- sodium foods makes them worse, but ginger capsules and coffee help me feel better temporarily. I tried the Epley maneuver but it doesn t really help. I saw an ENT for initial screening who found nothing physically wrong with my ears and wants me to take an expensive balance test which I cannot afford. I don t know how much more of this I can take. What else can I do about this?",
    "doctor_response": "Hello Your problem has its origin in the malfunction of inner ear. Inner ear assists our body in keeping balance and is in close proximity to our hearing apparatus.Your symptoms are suggestive of Meniere's disease. Tests of hearing also are part of the work up. Unfortunately there are not many good tests of balance which definitely assist in the treatment. You can discuss with your ENT specialist regarding the utility of the tests that he wants to do. As for as treatment is concerned, avoid triggers which you already have realized. During periods of dizziness many medications can help. If problems persist in spite of that then there are surgical options available. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for red rings around the eyes\n\nMy 3 year old son has red rings around skin of eyes. We put Vaseline on daily but it s not going away. He has allergies (peanut, dog dander, season allergies) so at first I thought it was due to fall seasonal allergies. However, we re in MN, and fall is over.",
    "doctor_response": "Hello, If a similar patient comes to my OPD, I would suggest to apply calamine lotion for a week and wait for the change. as he's having a history of allergy, it can go away with the application of the lotion. Even after application if it's not reducing kindly meet your doctor and meet a dermatologist. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Jilu Joseph, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on collarbone\n\nGood afternoon,I have had an olive size lump/bump on my left collarbone, I want to say for over 5 years now.  Well a couple years ago I asked my gynecologist about it and he said it was nothing to concern myself with.  Now just a week ago my sister had informed me that I should have my doctor look at it cause it could be a lymph node.  I just left the doctors office and he said it was a fatty tissue build up.  This is caused by my bone protecting itself from an injury.  He then proceeded to inform me that this would not be covered by my insurance since it is cosmic procedure.  I'm a little skeptical of his diagnosis, what type of doctor would you recommend for me to see regarding this matter?",
    "doctor_response": "welcome to Health care magic.1.Generally most common cause are lymph node enlargement.2.Other causes are Lipomas ( fat), Brachial cleft cyst lately identified.3.To confirm the consistency get an ultrasound soft tissue lesion done.It will give exact content and where it is arising from.4.You need to see surgeon appointment.Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for getting pregnant\n\nWill IVF work for me with FSH 10.09,LH 4.35,AMH 2.08 IAM 23 yrs old.On a fertility diet,5.1 ft,waight is 75 kgs,Husband has 10% sperm that are good,a varicocle, weight is 69 kgs, IVF is already failed two times. Give me the the right guidence for me.",
    "doctor_response": "Hi I think IVF with ICSI will be a better option for you as problem is there with your husband. ICSI selects only the good sperms and it gets fertilised with egg. So chances are higher than that in a normal IVF. Ask your consulting doctor about this.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever, vomiting and swelling on the right side of the back?\n\nMy 10 year old daughter went to school yesterday and felt sick and vomited mid morning. she went home and slept most of the day and through the night. she stayed home from school today and said she has felt fine all day. Tonight I was giving her a light back massage as I normally do before bedtime. I noticed that the Right side of her lower back was swollen and tight. She is active and plays basketball and could strech more to help out with flexability so her low back is always a little tight but I have not seen it this swollen before. She said it did not hurt when I pressed on it but saw her flinch a few times when I would press my thum close to the spine on the right side only.( Swollen area.) Any advise would be greatly appreciated.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. By what you say - this looks like a muscular spasm and I feel just Ibuprofen, thrice a day for a day would suffice along with plenty of water. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a purple bruise on the neck with pus formation?\n\nI was camping on the weekend and Saturday late morning noticed a purple round mark on my neck that looked like broken blood vessels. Later on in the day, the purple went away and it turned into a red swollen bump with a black spot in the middle. I tried to squeeze it and pus comes out of it. It is still very swollen and red 3 days later.",
    "doctor_response": "Hello!Thank you for the query.Pus presence clearly indicates an infection in this area. Such bump can be caused by a bug bite (as you have been camping recently). It can be also some bacterial infection due to a scratch for example.If it is not healing, and does not get better, I suggest you to consult dermatologist with this issue. Some antibiotics might be necessary to heal it.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to be done for the red spots on my children s forehead?\n\nHi,My two children were born with red spots in their fore head, the doctor told me that it was due to the pressure cause by gong through the birth chanel. They are 4 y 6 years ole now and still got it, and is more obvious when they are hot or running, looks like a bit scratch right in the middle. When my son was young he use to vomit a lot and shake but nurse told me was coz he was hungry, the shaking stopes but the vomit didn t till he was 1 and a half old. His head has a strange form ( like dad) and his front head is big, my doughter has a flat head. Should I worry?",
    "doctor_response": "HiI have gone through your question and understand your concerns but don't worry. Your kids seems to have capillary hemangiomas which as harmless and uaually do not need any treatment. Also, minor variations in skull shape do not need any treatment. If your feel it's really disfiguring then visit a pediatrician and clinical evaluation. If needed laser therapy can be of help.Hopefully it will be of help.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the bruise on my 16 month's old cheek?\n\nHello i have a quick question. My 16 month old hit herself in the cheek on Monday night. An hr later the bruise began to show.  Now its black and red and has a huge bump. It's also a bit black on the inside.  It seems like it's getting bigger and darker. Should we take her to the ER?",
    "doctor_response": "Hello,Thank you for using Healthcaremagic.I read your question and understood your concern.I think you should take her to ER to ensure that there is nothing serious with her.Dr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the use of ovi f for ovulation?\n\nhi,doctor,, i,am 28 yearz old FEMALE, have been married from 6 yearz last year ,ve miscarrige.&no concive again,, i,am suffering FROM PCOS ,,  Lh surge is low irregular mensis becox prolectin high..now its normal after taking doperdin, DOSTINEX, from 3 months mensis are regular,nowMY DOCT, SUGGEST ME to take LEZRA  insted of ovi_f {clomid} is it better then other medincn? how it works and helpful for ovulation?",
    "doctor_response": "letrozole) is an oral drug which can be an effective fertility treatment for women with ovulation problems, or for those with unexplained infertility.When the enzyme aromatase is inhibited by the letrozole medication, estrogen levels are suppressed in young women. This results in the brain and pituitary gland increasing the output of FSH (follicle stimulating hormone).In women that have polycystic ovary syndrome or anovulation (a problem with ovulation) the increase in FSH hormone can result in development of a mature follicle in the ovary and ovulation of an egg. Doctors call this process \"induction of ovulation\".In women that already ovulate on their own, treatment with lezra  can result in development of multiple follicles and multiple eggs releasing.Release of multiple eggs can increase the chances for pregnancy as compared to release of a single egg with a natural menstrual cycle",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump below ribs with occasional pain?\n\nI have a lump on my left side right below my ribs. Its been there for about a year. Some days it doesnt hurt at all and sometime it hirts really bad. Its thr sizr or a nickel I would say. If you push on it hurts sometimes. No color differance in the skin. And you can kinda see it just by looking at it",
    "doctor_response": "welcome to Health care magic.1.It looks like a mass arising from the bone (ribs).2.Needs confirmation with the chest x-ray., to see if the ribs are involved.3.An ultrasound of the lesion to see the content of the lesion ( solid/cystic/mixed) and the extensions.4.If not identified you may have to go for a CT for better evaluation.5.The cause should be find out.Take a near possible appointment and get the things initiate.6.As the mass/lump might complicate.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the lump on the hand in the area of adductor Pollicis?\n\nI have a slight lump on the top of my hand in the area of the adductor Pollicis Brevis Muscle. It is slightly painful (not too bad though). FYI I play a lot of tennis and am a personal trainer so I use my hands a lot. Could it be arthritis ? (I do not think it is ganglion since I do not believe it is next to a joint or tendon.) Should I get it looked at ? What could it be?",
    "doctor_response": "Hi it should be checked by x ray.if not from bone, then may be from soft tissues.Wait and watch if it grows or produces symptoms or interferes with movement, then consult doctor for evaluation.meanwhile apply voltaren gel and use wrist band or strapping.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does pituitary tumor have an effect on pregnancy?\n\nI have been experiencing spotting since my last period. I have a pituitary tumor and have been trying to get pregnant for 3 years. I am currently on bromocriptine and my periods started to become regular until 2 months ago. Mid way between my last period, I had bright red bleeding when I would wipe. That only lasted for about 3 days but now for the last week I have had really light spotting when I wipe. I m scheduled to go to the doctor in 2 weeks but I m worried. Any suggestions?",
    "doctor_response": "dearwhich type of pituatory tumour you have??size & site of tumour ?your prolactin level?dr. Mira butani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for bead stuck in ear of a child with severe pain in ear\n\nbead stuck in 4 yr old ear and just got back from clinic,nurses could not take it out tries tweezers alike and vaccum,my child has got ear ache now but i ve been given a date on thursday to go see a specialist what should i do?is it ok to leave it that long?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.If he allows you to calm and comfort him and if he is able to sleep without being bothered by the pain, it will be safe to wait until he is seen by the ENT doctor. You may give him acetaminophen for pain and place a warm, moist washcloth on that ear as often as it is easing his discomfort.The ENT doctor will have a large microscope that will enable him/her to get good magnification to see into the ear canal and find the bead. He will use small instruments to carefully remove the foreign body. Small children are always putting something in ears, nose, mouth. The majority of these objects are taken out without any complications.Hope I have answered your query. Let me know if I can assist you further.Regards, \u00a0\u00a0\u00a0\u00a0\u00a0Dr. Arnold Zedd",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump on the knee post reconstruction?\n\nHi, I had a reconstruction on my right knee in febuary last year, I recently noticed a hard lump at the incission point about the size of a 5-10 cent peice australian. Its sore to touch if I press around medially. Any ideas what this lump is? And how best to treat it?",
    "doctor_response": "Hi,Dear,Thanks for the query to HCM .I studied your query in depth.I feel concerned about it.In my opinion your hard lump at incision point is -keloid / and or /chronic cellulitis with abscess -at incision point of surgery done 1 yr back-as it hurts on touch.I would advise you to consult the knee surgeon whou- would treat it with -antibiotics and NSAIDs with pus smear study-if its chronic cellulitis /and or/ with Injection kenacort in multiple sittings-if its proved to be keloid by -USG/Excision biopsy.Hope you would recover fast with these health tips.Please contact again and  I would love to attend your queries promptly.Have a good time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shortness of breath\n\nI am a 62 year old water aerobic instructor and a retired PE Teacher.  Recently while teaching class chemicals were placed into the pool which caused chemical burns on my lungs.  This happened on Dec 2nd.  I have been out of the pool since then  My work scheduled consist of eleven 1 hours classes per week.  Is there any kind or respiratory therapy I can discuss with my lung specialist on Monday.  I still have shortness of breath and cold air is a trigger.",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. In my opinion you should get done following tests when you meet your pulmonologist. 1. Clinical examination of respiratory system. 2. Chest x ray. 3. PFT ( pulmonary function test ). Possibility of either allergic bronchitis or asthma is high in your case.PFT will be helpful in diagnosis of these conditions. It will also tell you about severity of the disease. And treatment is based on severity only. You may need inhaled bronchodilators and antihistamine drug. So consult pulmonologist and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is letrazole OK for the treatment of cysts in ovary?\n\ni am 25 years old married woman.got married 1 1/2 yr back..my periods were i rregular from last 2 months.. doctor told me to get ultra sound and homones test on 2nd day of menses ..there were multiple cysts in my ovaries 3-8 mm..and in hormones test LH -14.5 INSULIN-6.46 ESTRADIOL-27.24 THYROID 1.63 FSH-6.03 and other were fine..doctor recommended me LETRAZOL..its was not available in market thts why i am having LETAVOL..just want to confirm that letavol in fine for this treatment",
    "doctor_response": "Hi.. I am not able to comment on the reports that you have typed as this does not mention when you have performed the tests.. I can comment on the drugs though.. Both the drugs are same and you can take them if the doctors have suggested you to take.. Do know, that these drugs have many side effects which should be discussed with you.. Check with your doctor if you do not know the side effects..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My dad lost consciousness and a liquid oozed from his mouth. What could it be?\n\nHello doctor, Yesterday, my 70 year old father woke up at about 8 AM. He was sitting on the sofa. Just after a minute, he started losing his consciousness and was trying to speak, but was unable to do so. His body and hands started twisting. Some liquid started coming from his mouth. We immediately took him to a\u00a0hospital and his life was saved. The query is what was this that happened? He is having a high blood pressure problem from the last 15 years.",
    "doctor_response": "Hello. Hope it helps. Please feel free to ask more if you need further assistance. Regards. For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain. X ray shows thin spine, suggested for scan, got ovaries removed. Osteoporosis?\n\nHI MY NAME IS LESLEY, I HAD A FULL HYSTORECTOMY AND BOTH MY OVIARIS OUT. I AM NOW 53 I HAVE HAD A BAD BACK FOR 9 WEEKS, MY GP SENT ME FOR AN XRAY HE TOLD MY SPINE IS TO THIN. NO HE WANTS TO SEND ME FOR  A SCAN. HE HAS TOLD ME I COULD HAVE OSTIOPAROSIS. I HAVE BEEN POORLY FOR YEARS EXERSISE GIVES ME PAIN ALL OVER MY BODY THANK YOU I HOPE YOU CAN HELP",
    "doctor_response": "Hi, Thanks for writing. As you are of 53 yrs age and post hysterectomy individual, your spine will be definitely osteoporotic which will commonly present with backache. You need Calcium supplementation of atleast 1500mg/day along with Vit D3 (1000mg)/day to keep your bones strong. Otherwise, at times very trivial trauma will result in osteoporotic compression fractures in spine which are very disabling and will need rest for 2-3 months. Hope this information helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause for pain at the head of penis and burning sensation in urinary tract?\n\nHi I am suffering from pain at the head of my penis and burning sensation in the urinary tract. Also the urine pass is not satisfactory and I feel the urge to pass urine. Sometimes there is pain in pelvic region too. I have done my urine test reports and it seems normal. please suggest",
    "doctor_response": "What is your age? How long have you had these symptoms? You could be having infection of the urinary tract. I suggest you get a Urine and Semen Culture test done and let us know the reports so as to guide you with further treatment. Also let us know whether you have had any unprotected sexual encounters in the recent past which could lead to this problem. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I get angry and irritated feelings?\n\ni feel as if im high on coke or something (and im not and havent been) its been this way for 2days now just hit me out of no where yesterday. Im even getting irritated and angry feelings, i cant sit still (or atleast not long) and could fall asleep untill 2 in the morning and woke up around 430 ready to go. its not that i hate this feeling its just \"strange\" and ive gotten it a few times now and everytime it passes i tell myself \"your tripping\" but im really not. what could this be?",
    "doctor_response": "Hi, Thanks for choosing Healthcaremagic.I have read your query carefully and understood that you have had few episodes that lasted few days in which you have disturbed sleep (difficulty in initiating as well as decreased need for sleep), feeling high progressing to being irritable and angry, difficulty to remain seated for long (increased psychomotor activity or restlessness). These episodes described by you suggest hypomanic episodes and need detailed psychiatric consultation. I would advice you to visit a psychiatrist near you.Hope I have answered your query, let me know if you need any further information. RegardsDR. ASHUTOSH SINGH",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is LCZ & bricanyl syrups effective for cough in children?\n\nMy son is 3 yrs old and he is suffering from cold and cough since last week. Also he had fever in the begining. Doctor has recommended the following medicines but he has no relief yet. Request you suggest if the following drugs are right for the child: 1. LCZ Syrup 2. Bricanyl Syrup 3. Crixan Syrup",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.LCZ and Bricanyl syrup are for cold only. But you need to follow some precautions also like: avoid cold drinks, avoid ice creams, avoid fried food from outside, cover mouth while sneezing, and no handshake with a person having cold.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Deepak Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can we conceive if my husband has colon or prostate cancer\n\nhi i want to have ababy but my man have colon or prostate cancer can he still reproduce",
    "doctor_response": "you have not mentioned the age of both of you if you are below 35 then there are chances of having baby .if he has been operated for that &the reproductive parts have been removed then you wont be able to conceive.if not so then you can try for the same.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for leprosy with defect in ulnar nerve\n\nhi there.i am suffering from leprosy since one year. now it is effecting my ulnar nerve and i am on medication with mdt(rifampicine+clofazamine+dapsone)kindly advise me how it can be cured early as i have lost my musle at wrist and left hand fingers regards",
    "doctor_response": "Here good news is there is complete treatment treatment available for leprosy and you just need to talk to your doctor. Usual way of taking treatment is as below: Dapsone, which is bacteriostatic or weakly bactericidal against M. leprae, was the mainstay treatment for leprosy for many years until widespread resistant strains appeared. Combination therapy has become essential to slow or prevent the development of resistance. Rifampicin is now combined with dapsone to treat paucibacillary leprosy. Rifampicin and clofazimine are now combined with dapsone to treat multibacillary leprosy.Now for nerve pain generally specific treatment is not there but you can take nerve block injection to reduce pain as well do regular physiotherapy to improve the functional ability along with muscle girth. It will also help to give you some more pain relief.Once you get over with your problem of leprosy I suggest to have good enough omega 3 suppliment  on a regular basis. Because this omega 3 is a insulation material for nerves which will help you to recover even better and early.Further I suggest to talk to your doctor for detail discussion. You may take secondary opinion from another well known doctor too if needed.Here I have given you general guideline but specific suggestion can be given only after complite check up and examination only. How ever I still suggest to follow the steps I have suggested and I am sure this will be helpful for you.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal and back pain while having elevation in the BP level?\n\nMy 17 yr old son is complaining of abdominal pain that gos around to his back. Dr did blood work creating was 0.61 norm 0.76-1.27. All phos 156. Norm 61-146. Alt/.sgpt 42. Norm 0-30. Urobilinogen ua. 0.1 norm 0.2-1.0. When he has the pains his bottom number on blood pressure is 110 or 120. If no pain it\u2019s usually 75-80. He has been occasionally running a fever low grade",
    "doctor_response": "Hello,I passed carefully through your question and would explain that your son's symptoms could be related to an infection. The high diastolic blood pressure values could be a normal reaction to the pain.For this reason, I recommend performing a urine analysis and an abdominal ultrasound. Inflammation tests (complete blood count, PCR, ESR ) are needed too.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Ilir Sharka",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can shingles be treated?\n\nI HAVE SHINGLES AND MY DOCTOR SUGGEST THIS MED FOR ME AND SHE ONLY GAVE ME A SAMPLE PACK, SO MY QUESTION IS HOW MANY TIMES DO I TAKE IT, AND DO I NEED TOTAKE ALL THE SAMPLE PACK THAT HAVE ABOUT 21 PILLS AND THEY ARE ABOUT 50 MG, SHE ONLY WANTS ME TO TAKE ONE PILL AT 7P.M., AND ITS PRETTY MUCH DRYING UP NOT MUCH PAIN AND INCHING BUT STILL HAVE RED AND SORENESS",
    "doctor_response": "Hello,As such you have not given the name of medicine given to you, so it not possible to say anything about dose and timing, although no specific medicine is there for viral infection (Shingles) it is the self-limiting condition.I would suggest to come back on this forum with particular name of medicine given to you, just a pain can be managed with Paracetamol tablet as per needed.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Akhtarhusain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have swollen tissue in spine and pain in hip. No medication till now. Can it be CMV and diverticultis disease?\n\nI have swollen tisue n back/lumbar spine-and knife like pains in hips and head-my hair hurts to touch scalp. I have burned tissue on my back due to pain-and getting relief via heat. I know there's arhtritis in knees-and a cyst on cervical spine. Known-is active CMV-and diverticulitis disease. I am a mess-and I don't know how to cope.",
    "doctor_response": "Hi, Thank you for posting your query. I can understand your discomfort on account of your current problems. At this stage, the neuropathic pain can be relieved by using pregabalin or gabapentin capsules. Please get back if you require any additional information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is an Epidural shot effective in the treatment of leg ache?\n\nmy doctor suggested the epidural injection for my wife s leg pain, but I still hope to give time a chance to heal her pain if it might happen. My question: what is the real chance of getting better from this injection and risk, and what is a good decision at this point?",
    "doctor_response": "Hi, Epidural shot is a last resort and you can try analgesics like Tramdol or Gabapentin for pain relief. If routine analgesics fails, you can go for epidural shot, it is temporary option and you have to refill the drugs for sustained pain free intervals. Nothing much to worry as it is a safe procedure. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low semen volume?\n\nHey so I\u2019ve been producing extremely little semen, I\u2019m 21 not overweight. I did sorta recently start a medication for depression called Wellbutrin but I was fine even when I first started. Not sure if I should see a primary care doctor to have my prostate looked at. Or if it could be something else.",
    "doctor_response": "Hi, Consult a urologist and get evaluated. We have to assess the hormonal status and diseases of prostate as low testosterone can cause similar symptoms. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen tonsils and lips\n\nMy granddaughter has very swollen tonsils. She was sent home from school this morning. After her nap, her lips were swollen. Is this a serious problem ? She couldn t be seen at her pediatrician today. Should my daughter take her to urgent care ? There is only a slight fever.",
    "doctor_response": "Hi there,Thanks for using HCM.Swollen tonsils with fever most often is due to streptococcal throat infection. A throat swab would confirm this diagnosis. A course of antibiotic like Augmentin  would provide relief.Sometimes swollen tonsils with fever could be due to viral infections like infectious mononucleosis. This can be confirmed with a blood test.But the swollen lips could indicate injury, insect bite or an allergic reaction like angioedema.It is prudent to take her to urgent care for treatment.Is this answer helpful?",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could painful, purple bump on birthmark where leg and butt meet with no help from antibiotics indicate?\n\nI have a 9 cm lymphnode and my doctor put me on an antibiotic to see if the swelling will go down. It s so far not working and now I have a very swollen and very painful bump on my birthmark near where my leg and butt meet but inner and it s purple and red like.",
    "doctor_response": "Hi,Dear,Thanks for the query to My HCM Clinic.I studied  your query in depth.I feel concerned about the worry you expressed.In my opinion-the  painful-bump non-responding to antibiotics-is-mostly-a Lipoma at the Sacral Dimple with a subdued spina-bifida underneath a purple-reddish-Birthmark.? ant thats why antibiotics not working-for the pain.?or could be Pilonidal Sinus ?I would advise -MRI study of the bump and consultation with a paediatric surgeon / and ortho-surgeon / and or-neuro-surgeon- who as a team could be of help in planning right treatment.The pain does not appear to be due to infection / inflammation, but is due to the stretching of the neural fibers around tyhe lipoma over a spina-bifida, which is the possiblity from the facts of the query.Hope this would help your query.Wehe llcome for more queries to HCM.Have a good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for enlarged liver?\n\nI am 70 year old senior with \" enormously enlarged liver \" ,color of my nails,skin,urine & stool are now very very yellow ( like yellow mustard ), I dont eat any kind of fat,meat,fish, but only vegeterian food,oatmeal with skim milk & little \" splend sweatner \". Would be eternally grateful/thankful if you could prescribe a treatment. Thank you & may GOD bless you. Anwar.",
    "doctor_response": "Hello,You are having jaundice and acute hepatitis is strongly suspected here. Investigations to be done are as follows: \u2022 USG abdomen \u2022 CBC with PS examination and reticulocyte count \u2022 Serum HBsAg detection by Elisa \u2022 HAV and HEV by Elisa \u2022 Serum bilirubin For jaundice stop oily diet. Boiled vegetables and skimmed milk are beneficial. Take apple juice, sugarcane juice, orange juice, and coconut water more, mashed green leafy vegetables can be taken. You have to completely take rest for jaundice. Udiliv syrup or tablet can be prescribed. Consult a physician for examination and discuss all these.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this semen analysis report indicate?\n\nHi. I and my wife are looking to have a baby. I did a semen analysis and this is my result. Do you think is it a good for pargency ? Appearance : normal Volume : 1.5 pH : 8 Viscosity : normal Sperm count/ml : 234,000,000 Total sperm count/ejaculate : 351,000,000 Motility: 50% Progressive : 35% Non progressive : 15% Immotile : 50% Spermatogenic cells : 4-6 RBCS : 1-3 Agglutination: ( ++) Normal forms : 25% Abnormal heads : 50% Abnormal midpieces : 20% Abnormal pieces : 5%",
    "doctor_response": "welcome to hcm ..sorry sperm parameters are not adequate ..please wait for sometimes to improve sperm quality if you can wait for 3 months ..in the mean time your BP and blood sugar level and thyroid level must be adequate ...cut down on smoking alcohal and excessive weight ....avoid hot shower ...take nutritious diet take mulivitamin antioxidant combination ..you may take tab speman a Himalayandrug company drug 2 tab two times a day ..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdomen, back and buttock pain, headache with soreness?\n\nHi, it started this morning. I have a pain in my lower abdomen (my left side) and it is also in the same place in my back and buttock. I have a bad headache (had it for 2 days) and cannot stay awake. It also feels like my insides are going to come out of my bottom and my bottom is sore but not painful (I can sit down).  Any ideas please as I cannot get an appointment with my Doctor until tomorrow.",
    "doctor_response": "Hi.Tanks for your query. The causes for the pain in the left lower abdomen and the buttock, headache can be :Severe Enteritis particularly Colitis or diverticulitis with attendant peritonitis, I would advise you to take a course of an antibiotic, metronidazole, probiotic... Colonoscopy and CT scan of the abdomen to get a proper treatment . Proper diagnosis will lead to a proper treatment .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Strained hamstring, palpitation. Diagnosed as Sciatica. Taking prednisone. Opinion?\n\nI was give prednisone 20g (3/single daily) for 5 days because of scaitica. It is the end of day 4 and my back hurts, my hamstring/calf are strained and palpitate frequently.  I make myself get up to have mobility but mostly lying on the floor.  I used the bathroom this morning and my right glute tightened causing me to fall. The flute has been palpitating all day. What can I do?",
    "doctor_response": "Hi Thank you for your question to HCM.The symptoms you have described are related to the muscle spasms. Muscle relaxant like chlorzoxazone or cyclobenzaprine are helpful.  Cyclobenzaprine is available in 5 and 10 MG and is supposed to be taken 3 times a day. Physician supervision is necessary to monitor for side effects.If oral steroids (prednisone) are not helpful epidural injection of a mixture of a steroid and local anaesthetic can be tried. These are done by spine surgeons or pain specialists.Hope this is helpful. Wish you the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the suggestion for venous sinus thrombosis and neonatal meningitis?\n\nHi, I am from Nepal. I have baby girl of 10 months she has a problem of 1. chronic venous sinus thrombosis with wall calcification 2. sequelae of chronic Neonetal Meningitis and 3. left temporo- parietal lobe atrophy diagnosed from CT scan. Please suggest me.",
    "doctor_response": "Good evening .You have an infant with neonatal meningitis and sequelae thereof.Hereone has to take special care since you have a special needs infant .Make sure that her growth is maintained normally with adequate nutrition ,in terms of formula ,vitamin supplementation ,and trace elements .a Simple measurement of the head circumference and maintain record will help you assess her brain growth and also whether she is going in for atrophy causing a smaller head (microcephaly)or hydrocephalus .Routine check up for hearing and vision is a must and may invovle special procedures .One common complication of meningitis is seizures or fits .You have to consult a pediatric neurologist because he will assess the electrical activity in the brain by EEG and prescribe medications if the EEG shows abnormal electrical activity ---very likely,he will start on specific medications to prevent seizures .She will also need a physiotherapist to help her muscles from getting too tight or too loose and floppy.The progress is ascertained by periodic regular evaluation and harnessing all resources needed for a special needs motor and behavioural development .",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure pain at the back of the neck and vomiting?\n\nMy 7 year old daughter began running a temperature 100.7 earlier today, so I gave her children s tylenol and of course it brought it down. The tylenol wore off and her temp has reached 101.8. I have now given her a dose of children s ibuprofen. I also have an ice pack on the back of her neck. She was complaining earlier about the back of her head down to the nape of her neck hurting, but she stated is feeling better. She has vomited once and no diarehha. Is there anything additional I should be doing or on the watch for or do I just need to continue alternating tylenol and ibuprofen every 4 hours?",
    "doctor_response": "Your daughter is 7 years of age ,vulnerable for infections ,which she most likely picks up from school.The fever has been brought down appropratly but we still hve to treat cause of the fever.The sign that you mention ,pain in the back of head down to the nape of her neck ,is indicating that she may have an infection in the throat .check if she has pain on moving her neck down in front .shine a torch inside her throat and see if it is red .I suggest that in adittion to simple remedies of bringing down fever ,see a pediatrician and get her examined .she may need blood tests like blood counts and close follow up next few days .She may also need admission ,further tests to rule out an infection called meningitis and correct early antibiotics to get rid of bacteria.I am sure she will get better soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for fever and vomiting?\n\nHi I am Sasi from Chennai India. My baby boy just crossed 6 months and step into 7th month on 26th Dec 2013. From birth my baby is feeding with NAN PRO 1. On 25th Dec, we changed to NAN PRO 2. 2 hours after feeding baby affected by fever and got vamtings at evening. On 26th Dec night he is continuously crying for 3 to 4 hours and no fever at this time. When I taken to doctor on next day, Dr told that baby is doing good and no worries. But later also he cried for one to two hours for 3 to 4 times. I am not sure why this was happen? is it beacuse of NAN 2. If so which milk I need to feed my baby. Please clarify me with above question.",
    "doctor_response": "Most formula milks are cow milk based and hence difficult to digest. Sometimes children take time to get used to new food items. That could be due to the reason that NAN Pro 2 has not yet been tolerated well. After a few days, you can try it in double dilution and see if the problem persists. I think that it would go well. But rather than concentrating on which milk formula to give, I would rather suggest introducing semi solid food items, introducing one new item a week. In due course milk would become just an optional item provided the nutrients get procured from other sources.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Had sex during last month periods, taken i-pill and missed period this month. Am I pregnant?\n\nHello doctor, Actually, I had sex with my partner during period. And after that, I have taken i-pill within 12 hours. After two days my period stopped and now about one month passed but my period did not start yet and I tested with pregnancy kit with negative results. Some white liquid is leaking and some symptoms make me to feel like I am pregnant. What should I do? I am confused because the kit shows negative. Please help.",
    "doctor_response": "Hello,  Welcome to icliniq.com. I have gone through your query. As the urine pregnancy test is negative, you are definitely not pregnant right now. Sometimes the premenstrual symptoms can also be similar to pregnancy because of similar hormones acting in both the situations. Some amount of menstrual disturbances are known side effects of the emergency contraceptive pill. So if you still have a doubt you can recheck it again after three to four days with an early morning sample. If still negative, you can be sure you are not pregnant. Just wait for a week for periods to come. Please use a better and consistent method of birth control in the future like oral contraceptive pills or condoms, and repeated emergency contraceptive pill can take a toll on your hormonal balance. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat pimples in the genital area?\n\nHi about a year ago I started developing pimples in my genital area. I now have 3 on my penis and maybe 4 in the scrotal area and above in the pubic hair area. I usually shave everything. Occasionally I will be able to squeeze the pimples and get some white flow like a regular pimple but most often when I squeeze them, they do nothing. They don t hurt but are worrisome. I thought maybe they were ingrone or infected hairs from shaving but with 3 on the penis shaft, that wouldn t be the cause. Help! Thanks Rob",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: If its not aching may be its a cyst/wartExplanation: If its not hurting you, I dont think its a furuncle/boil. May be its a cyst or wart. So, do not meddle it with. Please visit a dermatologist for further treatment of the lesion.                  You may trim your hair by trimmer to avoid boils over there",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have pain in the abdomen. Am fatigue. Blood work, scan no problem. Colonoscopy scheduled. Suggestions?\n\nI have been experiencing a dull mild pain in my lower left abdomen for weeks and this past week I have also been experiencing fatigue and feel like I have a fever since I feel hot, but no temp. My bloodwork and ct scan did not show anything.I have a colonoscopy scheduled, but I am very worried. What could I have and what should I do?",
    "doctor_response": "HI Thank for choosing HCMIf your blood test, scanning test are negative then there is strong possibility of ulcerative  colitis and the colonoscopy is the only way to confirm it, if turns negative then go for stool examination this will clear the picture, or barium meal study, if every test shows no abnormality then this could be anxiety depression related problem, Have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen lymph nodes in back, neck and shoulder?\n\nI am 43 years old, and about 2-3 months ago started having pain and swelling in the right side of my back. Gradually over time, I have started having pain and swelling in my joints. Yesterday evening my neck swelled up on the right side, with one very large lymph node. I have noticed all my lymph nodes are swollen somewhat, but especially the back, neck and shoulder on the right side. I have within the past 2 months taken a zpack, acyclovir for shingles, and now another zpack. I have blood work pending. Any idea why I would have so many lymph nodes swollen for so long? Just started running a fever last night.",
    "doctor_response": "HI, thanks for using healthcare magicEnlargement of lymph nodes most commonly occurs in response to infection or inflammation in the particular area but they can be due to other causes as well.The other causes are autoimmune diseases, leukemia,lymphoma, other forms of cancer.These would not be as common as infectious causes.Your blood work would help to identify the exact cause.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause for increase in blood pressure during nighttime?\n\nI take benzapril 10-20 mg. My blood pressure rises at night when I lay down. I\u2019ve been doing this for almost a year. About 2 1/2 months ago I started having pain in knees, legs and ankles. Some swelling in right foot. However cutting down on salt consumption has stopped the swelling. I still have leg pain and the worst is at night when I go to bed. The most pain is in the back of the leg behind the knees. I\u2019ve had blood work for kidneys and diabetes and liver. Also an ultra sound for liver. All good.",
    "doctor_response": "Hello, During a nightmare, an increase of blood pressure occurs due to anxiety, nervousness, sleep disorders, sleep apnea, restless leg syndrome, etc. However, you are suggested to get thoroughly examined. Get blood & Imaging tests done. Your treatment will depend upon the pathology detected. Cut on alcohol, smoking, addictions if any. Certain medications may also cause an increase in blood pressure. Get nightmares, depressions, PTSD, heart diseases, sleep deprivation & obesity be treated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Nupur K, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in abdomen, back, low grade temperature. Took methylprednisolone. Blood test were normal. Is it pinched nerve?\n\nI have pain and extreme sensitivity to touch on the right side of my abdomin, back and side.   It was excrutiating pain a couple of weeks ago waking me up in the middle of the night.  I also had chills, low grade temp and fatigue for a week.  My doctor gave me an antiviral med for shingles then ruled that out since I never got lesions.  Then he gave me Methylprednisolone.  He did a blood test and also an ultrasound to rule out gall stones and said the ultrasound didn't show any problems.  Now he thinks I must have a pinched nerve.  What other things should he consider in addition to a pinched nerve or what other tests should he do for me?",
    "doctor_response": "HI, thanks for using healthcare magicNeuralgia is pain due to the abnormal function or structure of the nerve. It can occur in any aspect of the body.There are different possible causes of neuralgia such as : (1) diabetes (2) vitamin B 12 deficiency (3) trauma (4) side effect of medication (5) the cause can also be unknown There are not many diagnostic tests for neuralgia but you may want to consider visiting a neurologist who may be better able to diagnose and treat you.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause rashes on the entire body to 4 year old?\n\nMy 4 year old son has what seems like a rash on almost his entire body his cheeks are really red and the rash is veiny red line lacey pattern and skin color is only slightly discolored in between. He doesn t have a fever or seem to even be ill. The rash becomes brighter then fades and comes back. It resembles hives but not exactly. I thought an allergic reaction but nothing has change in his environment.",
    "doctor_response": "Hello The rash could be due to atopic dermatitis or drug hypersensitivity or a viral infection. The treatment options could be considered only after confirming the diagnosis. So, I would recommend you to kindly visit your Dermatologist/Physician.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. After meningitis vaccination, I am getting headache with visual aura and dreamy sleep. Please help.\n\nHello doctor, I have taken meningitis vaccination for visa process. I suffered headache with visual aura with dreamy sleep and less sleep for three months. I started treatment in India and took Cipralex, and Escitalopram. CT scan was normal. My symptoms relieved for about 80-90%. I gradually tapered off the treatment. Later, mild dreamy sleep problem with mild and sound sensitivity occurs. I did not took any medicine for that. I also suffered from scalp pain in head and treated for three months with Phenergan, and Neocalm plus. I felt only temporary relief. MRI was done in consultation with neurologist. Results are normal. I was on Cipralex 10 mg, Naproxen sodium 250 mg then gradually tapered. After that I am suffering from dreamy sleep all day and localized head pain episodes 2-3 times in a week when sleep disturbed in the previous night. Meanwhile, I was heavily stressed due to family issues and job pressure. Once again I was prescribed the same medicines but I did not take and tried to control it with yoga and meditation. I have mild light and sound sensitivity which is quite tolerable. My major problem is disturbed dreamy sleep and episodes of localized head pain in the scalp only. I took vitamin D, B12, calcium for six months. My elevated triglycerides are due to SSRI 230 mg/dl. At present, I am alright but want to get rid of symptoms. My symptoms are muscle tension and nerve pain. I did eyes test OCT and my eyes are normal. My questions are even if I am not stressed I do not get dreamless and refreshing sleep why? Which is suitable medicine in general? Can Flunarizine cause more deficiency of calcium as already I am deficient? Cipralex and Esclitopram are habit forming but I was very comfortable with that it causes weight gain and elevation of triglycerides so I tapered off to end. But after some time dreamy sleep and scalp mild pain comes back. What to do? Kindly suggest and advise some medicines.",
    "doctor_response": "Hello. Your symptoms seem to be related to tension type headache, which is a benign headache. Light and sound intolerance are features of migraine, but the other symptoms you explain, are more compatible with tension type headache. Nevertheless, I agree with your doctor treatment regarding Escitalopram. You should know that the sleep disorders are related to different causes depression, daily stress and anxiety, vitamin D deficiency, an abnormal sleep regime, caffeine intake, etc. I would recommend taking Vitamin D if there is low plasma levels of this vitamin. Regarding your sleep disorder, I would recommend starting Zolpidem for a couple of weeks 10 mg before sleep. You can try half a tablet before going to 10 mg. Melatonine intake can regulate your sleep rhythms too, but it is taken for a more prolonged time than Zolpidem and its effects are lower. A good sleeping hygiene (sleep always at the same time, avoid straining physical or emotional activities before sleep, avoid caffeine intake) would help too. If all these tips and drugs are not helpful, a prolonged brain EEG (electroencephalogram) during sleep would help diagnose any possible sleeping disorders. Regarding Flunarizine, I would explain that this is a calcium channel blocker and as such it can interact with calcium or vitamin D in high amounts. But usually it does not affect the calcium levels. You can try taking Escitalopram for three months initially and then try Flunarizine, if no good results on Escitalopram. I would not recommend taking them both initially. You should know that Escitalopram achieves its effect after three weeks from the starting, and the main changes to be seen are a reduce in the frequency of headaches and also mood changes (optimism). You can try taking Amitriptyline too, if you do not have any symptoms relief after the first month on Escitalopram. It can be really helpful with the sleep too. All the drugs have some adverse effects, but the benefits are higher. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for social anxiety disorder\n\nHi doctor,I am 32 years (male) old and suffering from social anxiety .I am scared of speaking in public like office meetings etc,going to new places and talking to people even relatives.My mouth dries up,heart beats faster,voice chokes,face twitches.My doctor suggested me censpram 5(for 6 days then censpram 10 to be continued)melzap 0.25(for 20 days).Are these drugs safe to take?Is there any long term side effects?Many thanks for your help in advance.Regards,M.Bardhan",
    "doctor_response": "Hello thanks for asking from HCMSocial anxiety disorder or social phobia is a distressing anxiety disorder. The symptoms you have described like dryness of mouth, palpitations (racing heart), chocking of voice, twitches on face etc are due to anxiety only. Combined approach using medicines and behavioural methods prove most useful in social phobia. Commonly SSRIs are used in treatment. You have been already prescribed Escitalopram for that and this is right drug for social anxiety. Melzap or clonazepam is a benzodiapine drug and the drug should be taken on sos basis only. The drug helps to reduce the symptoms of anxiety. Other drugs like Propranolol are used specifically for special events like before presentation or in group discussions. The drug help to reduce acute anxiety symptoms like palpitations, sweating, tremors and increase confidence of individual. For this drug you can discuss with your psychiatrist.Over all escitalopram and clonazepam are safe to use and are not associated with serious side effect. Escitalopram may cause nausea, diarrhoea, dizziness as side effects. On long term use in high doses it may cause delayed ejaculation or anorgasmia as side effects, but these side effects are reversible on dose discontinuation. Clonazepam at 0.25 mg doses is relatively free of side effects except sedation. The drug has abuse potential so don't take this drug for long time.Thanks, hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest alternate for Nexto prescribed for psychological problems\n\nsir,My daughter is suffering from psychiatric problems ,on the advise of NIMHANS she is taking 15 mg NEXTO tab dialy. Is there any substitute for this medicine,as she loosing her mortar movements, suffering unkonwn fear and not able sleep also. Mallesh",
    "doctor_response": "Hi.I understand your concern. Nexito cantain escitalopram and it is SSRI. It is ggood medicine for anxiety and depression. If she has response and ddo not have side effect then need to take medicines Regularaly. Do take advise from your treating doctor. It will take time to show response. Still if you have a query then feel free to ask. Happy to help you. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itchy, red bump rashes filled with fluid on right arm from elbow to wrist. No relief from antibiotics. Suggestions?\n\nlast april I broke into a rash on my right arm from the elbow to the wrist only on the top of my arm  I went  to urgent uicare they gave me antibiotics and they still havenent gone away?  they itch and I did notice I have some red bumps, and they are filled with some fluid and when they itch I put  heydracodizone 1% on them also I cant seem to stop picking at them BUT I DONT KNOW Where I Got THESE AND ONLY ON 1 ARM???any suggestions of where they started It all seems when I got on the metadone,but wouldnt they be all over???",
    "doctor_response": "Hello,Welcome to healthcaremagicFrom your description it could be Herpes zoster. Herpes zoster is a viral infection caused by varicella, the same virus causing chicken pox. Usually it presents as small blisters along the distribution of a nerve, only on one side. It could be painful and sometimes itchy. Vesicles will become scabs and then fall off usually in 2 weeks time. I suggest you see a dermatologist for confirmation of the diagnosis. If you can upload a photo it would help.Hope this helpedTake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest the treatment for neck pain\n\nHi, I am having severe neck pain on both sides from the base of my head down my neck. It is very painful to turn my head at all. I have had no recent injuries. I am a 32 year old in shape female. This has been going on for 3 days and I also started losing my voice today...not sure if that could be related or not. Thanks for your help.",
    "doctor_response": "Hello, Most probably it is due to something called cervical spondylitis. As first-line management, you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist better to consult an orthopaedic and plan for an MRI neck. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness, nausea and tingling sensation in the feet?\n\nMy husband has had a few episodes over the last two days. It starts with a light headed, dizzy feeling with sense of deza vu, then a rush of nausea and warm flushed feeling along with a tingling that moves from feet thru the legs and stops at the middle. Happened whether sitting or standing. Remaining symptons now are dull headache and still some nausea. Tired feeling.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I would explain that these episodes could be related to focal epilepsy seizures. For this reason, I recommend consulting with a neurologist for a physical examination and performing an EEG and a brain MRI. Hope to have been helpful! If you have any other questions, please don't hesitate to ask! Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can C-diff cause dysplasia recurrence?\n\nHi, I was diagnosed with C-diff about 3 weeks ago I am on my second round of antibiotics as the first round did not work...  I also have had severe dysplasia that has required a leep and laser about 3 years ago.  Can the c diff affect the dysplasia in any way to make it reoccur?",
    "doctor_response": "Hi & Welcome to HCM.Recurrent dysplasia is not associated with Clostridium difficile infection.Clostridium difficile infection occurs after the normal gut flora has been altered by antibiotic therapy. It is one of the most common caused of antibiotic associated opportunistic infection resulting in severe bloody diarrhea, abdominal cramps, dehydration, etc. The recurrent infection which sometimes occurs in about 30-40% of cases following a course of antibiotics (such as Metronidazole and Vancomycin) does not cause dysplasia of the colon. Recurrent colonic dysplasia could be a pre-cancerous condition which needs to be investigated by doing a biopsy.Hope I could answer your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain near jaw tooth\n\nHi. for two days a jaw tooth was cracked, it was not painful as I can eat and drink.  yesterday it was  warm slight pain, now the tooth next to this  cracked tooth is slightly red. I think it has an abscess. wanted to extract it but.... I have a tumor on my left temporal lobe and may have surgery within a week or 2.",
    "doctor_response": "Hello, Thank you for consulting with HCM.Yes it looks like your tooth was infected a few days back and now there is abscess in the apex of the tooth, it is not necessary that you have to go for removal of the tooth, you can go for root canal treatment of the tooth as well, as it can also reduce the infection and you can start with the treatment before the surgery for tumor. Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bruises on body. Taking Crestor. Suggestion?\n\nI have been taking Crestor for 3 months and just this past week I have developed several bruises on my body.  I bumped into furniture leaving bruises on my legs.  I had bloodworm leaving another.  A bracelet watch left another.  Another large bruise appeared and I don't know where that came from.  Now a small bruise has come up on my leg.  I see my Dr.  This coming week but I am concerned.",
    "doctor_response": "Hello,Thanks for the query.Crestor is a lipid lowering drug.Although it doesnot appears a drug reaction,But any drug including lipid lowering agents can cause damage to platelets and hence bruises.You can apply oint thrombophobe.A change in doses might be required.Let me know if you have any other doubt.you can ask a direct question to me on this forum, following the below link.  you a good health.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cramps in the leg and foot?\n\nI am waking up every night with severe leg/foot cramps. I take vitamins, potassium, and drink plenty of water. It only started this year. I am not do any strenuous exercise. Sometimes my hands are also cramped. I am wondering what kind of doctor I need to see and what I might be suffering from.",
    "doctor_response": "Hello, This condition is Nocturnal Cramps for which the actual cause is still not very clear. But as my experience goes to the clinic where I practice, I have seen cases of a similar symptom present with calcium deficiency. Hence I would suggest you get your calcium levels checked. The normal range of Blood Calcium is 8.5 to 10.2mg/dl. You can discuss the same with your physician and get it done. Along with this, I advise my patients to have a diet added with almonds,  hazelnut, cashew nut, fruits like mango, Kiwi, etc which are rich sources of Vitamin E and have found to be very useful in this condition. Start the dietary changes for two months. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Mahesh T S, Ayurveda Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be concerned about the bruised spots due to insect bites?\n\nI have insects bites on my ankles, which were swollen for 2days. Now the bite on my legs and some on my waist are looking like bruised spots. At beginning looked like aunt/mosquito bites, also my legs are aching. Is this serious? Do I need to go to hospital? This is my 3rd day since 1st symptom.",
    "doctor_response": "HiThe lesions are getting serious and might become superinfected.I suggest you go to the hospital and get examined.You might need a course of antibiotics and pain/antiinflammatory medication to get over it.This will be decided by the Doctor after examining the lesions.Best regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for bump near tailbone?\n\nI started working out this week again after taking a break since I sprained my ankle. At first I thought I hurt my tailbone because I did something wrong when working out. Now I m thinking it may be a pimple but I don t see any pus or anything the skin looks perfectly normal but there is a bump.",
    "doctor_response": "Hi ! Good morning. I am Dr Shareef answering your query.If there is no pain in the bump, then one could rule out an infective process. This has to be some kind of benign lesion like a dermoid, or a sebaceous cyst, or a fibroma. This needs to be examined clinically by a general surgeon. So take an appointment with one in your area, and go with his advice which could mean a surgery to remove it or as the case might be followed by a histo-pathological report of the lesion.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing chest pain and pounding of heart\n\ni have some chest pain for a couple of days, and it s exactly where my heart is. also, i can feel my heart pounding when i put my hand to the chest, strong as if i put my fingers to the vain,,, what can cause this? i don t have any fever nor tachycardia... no pain anywhere else, and normal breathing,",
    "doctor_response": "Thanks for your question on HCM.I can understand your problem and situation.In my opinion, we should first rule out cardiac cause for your chest pain and chest pounding.So get done1. ECG2. 2d echoTo rule out cardiac cause.If both are normal than no need to worry much for cardiac cause.Get done CBC and thyroid profile to rule out anaemia and thyroid diseases. As both can cause chest pain and chest pounding.If both are negative than probably you are having anxiety and related symptoms mostly.So avoid stress and tension. Be relax and calm.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is yellow discharge from ear normal while undergoing treatment for otitis external NEC?\n\nI was diagnosed with acute otitis external nec Wednesday. I ve been taking ciprodex optic suspension. Taking it 2x daily but still have a lot of pain. I am also seeing a yellowish crystal discharge from the ear. Is this normal? When can I expect relief of pain?",
    "doctor_response": "This pain is due to inflammation of your ear. you should contact your treating doctor and take medicine to reduce this inflammation of your ear. A pain killer on your doctor advise will help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have high liver enzyme levels. Is this something i should be conserned about?\n\ni am 53 years old, had blood work done earlier this week, reveived a call that my liver enzyme levels were 134 and 80, the dr will run additional test. I drink alcohol daily, do i need to stop drinking until they run more test. is this something i should be conserned about.",
    "doctor_response": "YOUR LIVER ENZYMES ARE HIGH DUE TO ALCOHOLIC LIVER DISESASE AND YOU SHOULD GO FOR USG ABDOMEN .  YOU SHOULD STOP ALCOHOL AND AVOID HEAVY , FATTY FOOD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. An ant has entered my nose. Is there any possibilities for it to reach my brain?\n\nHello doctor, A small live ant has accidentally gone into my nose. I tried to blow it out but not sure about it? Can it enter the brain or lungs? And lay eggs there? What are the symptoms?",
    "doctor_response": "Hello. The ant, by all means, will be dead and blown out of your nasal airways because our nose has the following protective mechanisms. 1. Nasal vibrissae (small hairs) which block particles size of an ant. 2. Viscous secretions (mucus) upon which still smaller particles like dust get glued (about the size of 0.5 microns). 3. Sneezing is a protective reflex action whereby foreign bodies irritating nasal mucosa is thrown out vigorously followed by copious secretions which wash out rest of noxious items in the nose. 4. Immunity, specific immunoglobulins, complement proteins, ions, and other molecules.  Hence the ant cannot survive inside the nose. Leave alone laying eggs. Now in case, it does survive, next most possible event is it getting washed and glued to the mucus and then swallowed along with saliva and reaching the stomach where the acid will kill it. Nasal secretions follow a natural path towards the throat, then esophagus and finally stomach. If it does make any attempt to pass anywhere else, it will bite you, and you would wince in pain. There is absolutely no possibility of it entering the brain without your having experienced the pain of its biting. There is no direct communication with mind unless it navigates through the skull base (bone). There is no possibility it entering the lungs through the air you breathe because our protective mechanisms prevent particles as small as 0.5 microns. If you are still worried put a few drops of saline nasal drops on either side of nose and rest in flat sleeping position for five minutes. This will add bulk to the mucus (nasal secretions) and wash off the impurities. You can spit what comes into your throat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does headache, fever and pain in throat suggest?\n\nMy daughter has a frontal headache and fever of 102. My dad gave her 160 mg of acetaminophen about 6 o'clock. It has not helped her fever. Her neck is not stiff. Her throat hurts a little, but she described it as achy, not scratchy like a traditional sore throat.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understamding your concern. As per your query your daughter is suffering from headache, fever and pain throat which seems to be infection from streotococcal bacteria leading to strep throat. It could be due to viral infection as well. Need not to worry about it. You should visit pediatrician once and get it examined. You should start medication after lab tests, blood tests and proper diagnosis. Till then give antobiotic along with Ibuprofen / Acetaminophen. Give anti histamine such as Levocetrizine to her. Avoid use of cold liquid substances. Give her steam inhalation. Use mist humidifiers in her room. Avoid spicy, sharp and oily food. Give diet rich in multivitamins. Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take rocephin shot for staph infection?\n\nam a lady of 24 years old, 1.65m tall and have been having a recurring set of infections in the past 10 months, firstly it was heavy growth of staph aureus and after months of medication and relapse, a 10 dose IV injection of rocephin seems to have sealed it,only to find out a month later that i am diagnosed of infection due to proteus merabilis,i have only one sexual partner and its the same with my husband, how do I stop them permanently",
    "doctor_response": "Hello there,I am dr.milan an infectious disease specialist answering your question,First you need to go for complete treatment schedule as per sensitivity of proteus infection.DOse and schedule is varied according to site of infection.I need to know proteus infection is from which of your body site.THough rocephin also covers this proteus infection as well as staph aureus. But if it is Staph.aureus which is MRSA than this rocephin is not found usefull.So, check your report is it mention there it is MRSA negative or something like that. If it is MRSA negative and you have taken rocephin that have cleared staph infection. and now you have been encountered proteus infection from somewhere so you need to treat that only.Simultaneous your husband also need to be treated according to sensitivity pattern.Hope i have given appropriate guidance to you.if you have any query you can consult me anytime.Give me star rating according to your satisfactory level.Thanking you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lumps on cervix\n\nI am 17 and my mom recently died from oral cancer caused by Human papillomavirus also know as HPV. I recently found a lump in side my vagina on what i BELIEVE is my cervix. Its between the size of a nickel and a dime in diameter and about half a cm in height, I also have pain in my ovaries. like im on my period even when im not. My periods have lately became longer and more painful and i have them ever 21 days. For the past 3 months ive been very lethargic, I always want to sleep and have no energy and i feel sick all the time even when im not. Im scared  to death it is cancer can anyone shed some light on what it could be ?",
    "doctor_response": "Hi,DEar,thanks for your query to HCM.I studied your query  in depth.1-In My opinion the  lump on your cervix,is mostly due to-Cervical Cyst-with polymenorrhagia.2-I would advise gynaec consultation and FNAC / or excision biopsy of the cervical lump-3-Treatmen is by -Surgical Exicion and biopsy to rule out cancer-as you have fear of death , as your mom died of oral cancer.3-Hope this would solve your query.4-Wellcome for any more questions on new or this subject also...Have A Good Day..!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can itching with small bump be herpes?\n\nHi, earlier today my top began to itch a little bit on a small spot right in middle of the left side. I scratched the itch with my bottom teeth, and right after scratching it I got a small bumb with a tiny hole in it. What could this be? Is it herpes?",
    "doctor_response": "Hello, Welcome to HCM,With the history provide it is very difficult to make the diagnosis. If you are thinking about the herpes affecting your mouth area.Usually it starts with dryness of the lips, itching which will be followed by eruption of vesicles filled with clear fluid and it is very contagious at the early stages.It never involves the mucosa of the oral cavity and it is obviously seen outside around the mouth. It is a self limiting condition.For few days there will be pain and it will heal by itself the antiviral drugs will not cure the condition but it will inhibits the multiplication of the virus and prevents the complication.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Gallbladder removed, pregnant, lower abdominal pain, nausea, reg bowel movements\n\nHi, had my gallbladder removed 1 week ago. Gallstones started when I was 38 weeks preg, I m healing fine. My problem started yesterday, dull ache about 2 inches aboove my belly button this discomfort does not subside, a also have sharp pains in my lower right side/ abdomen , this pain comes and goes. I feel naucious at times. Both pains increase when I push on the area. I have reg bowel movememtsand haven t eaten since dinner at 5 and that was a small healthy meal. what could be the problem?",
    "doctor_response": "hello since your pain is in central and right lower abdomen, it can be due to appendicitis it will be better for u to consult a surgeon and get routine blood examination and ultrasonography of abdomen",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes wrist pain on bending?\n\nMy wrist hurts when i bend it back. I hurt it skateboarding and i had a half cast on for 4 days and when we took it off i tried to move it back and forth and it hurt really bad in my whole wrist. I need to know what to do because if i take a fall it will hurt extremely bad",
    "doctor_response": "Hi, You had an injury to your wrist and got treated by 4 days of half plaster. this is grossly  inadequate. It usually needs 3-6 weeks. Rest depending on the severity of the injury.  You should take adequate multivitamins and antioxidants along with anti-inflammatory medicines. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nirmal Chander Gupta, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are vomiting, loose stools and swollen legs symptoms of liver failure?\n\nHello, my mother used to drink for 12-14 years then sobered up for about 7. Then she met a man that drank, and for the last 10 years has been drinking as well. She now is sick all the time, with vomiting, hives, loose stools, and has extremly swollen legs and ankels, should I be worried that she is in liver failure?",
    "doctor_response": "Hello,With the kind of symptoms you are telling it is quite sure that she is having increasing liver failure and may be some renal diseases also.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. B.dinesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for weakness, chills and racing heart?\n\nIm in bed now body feels weak chills a lil no fever light headed and bad headaches grouchy want to sleep life away been like this over a few years no good diagnosis yet I have small children I WANT TO HAVE MY LIFE BACK TO MUCH COMODTION MY HEART RACES i sit still my body feels like im spinning sometimes?",
    "doctor_response": "Hello, After going through your medical details I understand your concern and I would like to tell you that racing heart rate and weakness can be because of fever. Kindly consult a physician personally for physical and diagnostic evaluation of fever and further treatment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can thyroid levels during pregnancy affect the fetus?\n\nhello sir, im in15th week of pregnancy, just now we took test and came to know that my thyroid level is 7, my baby brain got affected already because of this? i started taking tablets from today on ly. pls give me a reply, that will help for me. im in so confusion.",
    "doctor_response": "Hallow Dear,Confusion also can happen due to low function of Thyroid. Thyroid deficiency definitely affects the development of the baby. Hypothyroidism during pregnancy is associated with adverse pregnancy outcome which includes:\u2022 Increased incidence of miscarriages, recurrent pregnancy loss, preeclampsia, anaemia, Diabetes, placental separation, heavy bleeding after delivery\u2022 Foetal growth restriction, foetal distress during labour, foetal death, preterm birth\u2022 Cognitive, neurological and developmental impairment in the baby.Guidelines recommend screening of all pregnant women at risk for hypothyroidism.  Please get your complete Thyroid Function; i.e. T3, T4 and TSH estimated.The normal ranges for First trimester: 0.1 to 2.5 mIU/L; Second trimester 0.2 to 3 mIU/L; Third trimester: 0.3 to 3 mIU/LLevothyroxine is the drug of choice for treating hypothyroidism. Starting dose can be 25 mcg /day while for TSH level > 10 mIU/l it should be 50 mcg/day. Thyroxine should be taken early morning on empty stomach. L-Thyroxin ingestion and the ingestion of iron supplements, calcium supplements and soy-based food should be separated by at least 4 hours.TSH should be repeated after 4-6 weeks of starting the treatment to see the response. Target TSH levels should be kept below 2.5 in first trimester and below 3 during second and third trimesters. If target TSH level is not achieved, the dose should be increased by 25 mcg/day. Dose should be adjusted according to TSH levels. At any time TSH below 0.1 should be avoided by decreasing the thyroxine dose by 25 mcg from the current dose.After delivery, most patients need to decrease thyroxine dosage received during pregnancy. It is very important to continue monitoring thyroid function tests for at least 6 months after delivery.With this treatment of Thyroid you can prevent the further damage of the foetal brain. I hope this helps you. If you feel so, you may vote for 'Helpful' answer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I make my lip color pink ?\n\nWhen i was small that time my lips was in pink colour, now it has been changed to brown colour. How to get back my old lip colour. Could you please suggest me a way to change it to normal colour. Could you please explain what would be the reason for colour change",
    "doctor_response": "Hi,Welcome to HCM.You have not mentioned whether you are a male or female.Most of the time childhood pink colour of the lips gets faded. The pink colour is due to the profuse vascularity of the area and the thinness of the skin covering it. With age the skin becomes thicker and this results in fading of the pink colour. Smoking also causes the lips to become darker due to increased pigmentation.If you are female, apply lips stick which is the only remedy available.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is anti rabies shot necessary after being scratched by dog?\n\nmy daughter have scratch from my puppy when she played my puppy 5 days ago...the puppy dont have a anti rabies vaccine yet and my daughter too dont have anti rabies shot...i just want to ask if, is my daughter need the anti rabies shot???..how about my puppy,she is 3 months old,is it okay to give her anti rabies vaccination today???or when is the right time to give my puppy the anti rabies vaccine???",
    "doctor_response": "Hello,Welcome to HCM,Rabies is 100% fatal but it is 100% preventable by proper and adequate treatment.As your daughter was scratched by your unvaccinated puppy which is a cat II bite according to WHO categorization of animal bite.Your daughter should receive active immunization with antirabies vaccine on days 0,3,7,14 and 28. She should receive a shot of TT injection.Your puppy should receive anti rabies vaccine at the age of 3 month and there after one more dose within 1 year.Secondary immunization should  be given every year.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and back pain\n\nVery, very sick and doc can t figure it out. Fever for 6 days and I never get a fever and am rarely even sick. Other main original complaint was a pain of my right side/back, but that s eased up a bit now. However, my head is pounding, and I awoke this AM w/ a large red blotch on the left side of my chest that is warm to the touch. All the bloodwork has come back negative so far, but doc just did some cultures yesterday. Also had catscan on Tues. Up until today, there s been no vomitting or other typical flu symptoms. Today I vomitted bile and water and ibuprofen == haven t really had an appetite since Sunday. Any thoughts?",
    "doctor_response": "It's clear Pitta vitiation and 'mandagni' as per Ayurveda.If you get Shatavari, Amalki, Guduchi, Tulasi capsules of Himalya, pl start taking 1 bd each of these for two to four weeks. See the change. These are pure herbs.Avipattikar chooran may not be available everywhere otherwise I would like to add that also.For any further help, pl ask direct question.Hope it helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Seizure, white spot in right temporal lobe, toes, right foot numbness. Taking Keppra. Reason for numbness?\n\nNew onset seizures (multiple simple with aura and one grand mal) at the age of 35 with a white spot found in the right temporal lobe. No other medical or health issues. On 500 mg Keppra twice a day. I believe no seizures since the start of medication on 5/28/12. However I have had numbness in my toes on my right foot . Is this related to the lesion , seizures, or medication?",
    "doctor_response": "Dear friend, welcome to HCM. the symptoms are most likely due to seizures. but need to know the cause of the lesion. is it fully evaluated? what has your doc told you was the cause of the temporal lobe. was a CSF exam . done? need to make sure it is not progressing, as you have new symptoms. pl. see your neurologist about the same. take care and pl. keep me posted on your progress.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a tear in the calf muscle?\n\nI tore my calf muscle last week. I saw an ortho surgeon he said no surgery but me in a boot and crutches but my pain seems to be getting worse and my brusing is behind knee all the way down my leg should I be feeling this much pain and I have spasms throughout the night how do I stop them?",
    "doctor_response": "Hi, there!Its true, that calf muscles heal without surgery.You need compression socks to avoid sweling, non-weight bearing and elevated leg. Start with local gel Ibuprofen based to relieve pain.Recovery will take 4-6 weeksI hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feel nauseous, fatigue. Hurting tooth. Root canal tooth. Ate some old potato. Suggestions?\n\nI have felt nausous, dizzy and faint like, fatigue with stomache pain for the last 36 hours.  I'm afraid I might have taken too many Alive for my athritis pain. Also i have a tooth that suddenly started hurting. I have made a dentintal appointment.  The tooth is a root canal.  Also ate some potato salad yesterday that might have been too old.  It tasted ok but was left over from Labor Day dinner",
    "doctor_response": "Hello and welcome.Thanks for sharing your concern.According to the history given by you I would like to suggest you few things.Nausea,dizziness and stomach pain could be due to stomach infection due to consumption of stale food products.Toothache is probably due  decay.To confirm the diagnosis an x ray is required.Coming to intake of pain killers for arthritis,I would say please see your physician for correct dosage,as too much of any medication can lead to adverse effects on your vital organs like kidney,brain and heart.thus avoid self medication please.finally i would like to say visit your dentist first,get the tooth examined.your dentist might prescribe you antibiotics and necessary analgesics for three days.This will take care of other symptoms too.if you donot feel better even after taking prescribed medication then you can see your gastroenterologist for further help.Hope it helps.Thanks.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness on side of head while had cognitive behavioral therapy?\n\nI have had my first cognitive behaviour therapy session last week for driving anxiety. Being the worrier I am, I am now worried about not being able to drive ever again. I have been getting lightheaded during driving which he says is a normal anxiety symptom. However, now I am experiencing numbness on the right side of my head which is staying with me all the day (not just during driving). What could this numbness be?",
    "doctor_response": ". Light headache, numbness and medically unexplained symptoms are common in anxiety proplem. It will improve with management of anxiety. For better outcome you can opt for combined treatment (CBT and Medicine).Take care99doctor.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diarrhea, dizziness, hot sweats. History of extraction of back lower molar. On Metronidazole. Reason?\n\nI had a back lower molar (in front of wisdom) removed under sedation 5 days ago. I am taking Metronidazole antobiotics. I had a reoccuring infection prior to the extraction. For the last few days I have had a foul taste in my mouth and have been cleaning with corsodyl and salt water. Whilst the socket looks better and the taste in my mouth is improving, I am suffering from diarrhea, sickness, hot & cold sweats, dizziness and generally feeling unwell. Is this the last of the infection clearing or should I ask for other antibiotics?",
    "doctor_response": "Hi, Thanks for asking the query, I would like to tell you that pain, swelling, fever, malaise, dizziness are common complications after extraction of tooth.You dont worry about the symptoms as they will subside after sometime. Follow the post operative instructions given by the DEntist properly. Use Lukewarm saline gargles 3-4 times and antiseptic mouthwash gargles twice daily. Diarrhea and abdominal upset is due to the use of antibiotics prescribed to you. If you are uncomfortable with that, i suggest you to visit the concerned Dentsit and get it changed. Hope this helps out. Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes left sided pain in abdomen?\n\nWhich organ is located just under the left rib cage and toward the center of the abdomen? I have pain there that hurts mainly when I take a deep breath or have to sneeze. I don t believe it is my stomach. The pain comes nod goes....this time lasting for just over 3 days.",
    "doctor_response": "Hello! Welcome to HCM.On left upper side of abdomen is the spleen.Did you have any trauma to abdomen or chest?This can cause splenic injury, if trauma is on left upper part of abdomen.Also, this can cause pain on tip of left shoulder which is referred pain.Pain can also be musculoskeletal or due to increased secretion of acid in stomach.For correct diagnosis, clinical examination of abdomen by your doctor is necessary.In my clinic, after clinical examination, I advise ultrasound abdomen & pelvis, CBC.Treatment is done accordingly.Till then avoid hot/spicy food, alcohol, smoking, late night meals, reduce stress if any with yoga & meditation.Hope this helps.Wish you speedy recovery.Thanks.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do the following test results mean?\n\nwhat do the following test results mean: Cratinine 1.08 Glomerular filtration rate, nonAfrican American 60 Glomerular African American 60 Lipase 19 Estimated Average Glucose 235 Hgb Alc% 9.8 0-29mg/dl 200 Specific gravity, UA 1.026 Protein, UA09 mg/dl 30 Urobilinogen, ua Hgb 17.4 Hematocrit 51.2 MCV 94 Amylase 45",
    "doctor_response": "Hello and welcome to HCM.As an Urologist, let me confirm your reports suggest normal kidney function, with uncontrolled diabetes, with high uric acid level.You should mention your age, gender,body weight and height, to advise you.You should also check fasting blood sugar(FBS),a 2 hours after meals,blood sugar(PP2BS),lipid profile(fasting),and ultrasound scan of abdomen.Take sugar free diet now onward and exercise daily, with low fat diet.You can send the reports to me,as a direct question, for an expert opinion.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could hay fever cause pain in gums and teeth?\n\nHello, I have been suffering from hayfever for a few years. This time I have all the usual systems as before but I have been having quite painful teeth and gums which I have not had before. I go to my dentist regularly. I was wondering if this could be caused by hayfever.",
    "doctor_response": "Hello,  Thanks for consulting HCM,  Read your query, as you have fever so pain in gums can be due to Viral stomatitis , carious tooth , gingival or Periodontal problem it can be due to periodontal pocket formation or inflammed gingiva dont worry consult your dentist and go for examination of gums and teeth to rule out the cause of pain. In meantime you can apply ointment like stolin gum paint on gums and do luke warm saline gargle two - three times a day. Hope this will help you. Wishing you good health.Regards, Dr. Priyanka tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment should be given to the person for this behaviour ?\n\n8 years ago my husband admitted in a mental assliam for 1 and 1 8 years ago my husband was admitted in a mental asilam for 1 and 1/2 months his age was 23 years. Then he continued medicine for 2 years. Now his behaviour is changed. If some noise arised he tempted and shouting in slung language and even sometime he torchered me.",
    "doctor_response": "hi he has mental illness dont wait he need urgent psychiatric treatment. do not make him irritant. keep him in dark ,cool place. keep sharp object out of his reach",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does numb hand with sharp pain to touch mean fractured hand?\n\nIs my hand fractured? So I fell on my skateboard about a month ago and hurt my hand bad I think its my lunate. It was numb and it hurt. Yesterday I was skating and fell and hurt it again and I had to take some medicine to reduce pain. And today I fell on it again really hard and it was numb and had a sharp pain I have hurt the same part of my hand 3 times in the past month. Should I go to the doctor? If its fractured can I just let it heal on its own without going to a doctor?",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.You are advised to visit doctor.You can get your x ray to see fracture. You can get your x ray of wrist joint. It will be better to see the doctor then to allow it to heal itself. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having lower abdominal pain, feels like period cramps. Not cured by paracetamol. What is going on?\n\nHello, I have lower abdominal pain , it feels like period cramp but my period passed 2 weeks ago and I almost never suffer from it. It is worse on my right side but I can also feel this in my lower back. I am usually very healthy and am 37 year old mother of three. I have tried paracetamol but it has not eased it at all. It has also got slightly worse as the evening has progressed.",
    "doctor_response": "Hi, It will be better to have a check up with gynecologist /surgeon . The pain is not related to your period . There may be some other reason like pelvic inflammation . appendicitis to be excluded .A CLINICAL CHECK UP AND INTERNAL EXAMINATION WILL HELP REACHING A DIAGNOSIS .AN U S G WILL BE HELP FUL IF REQUIRED . For the pain you may take dicyclomin tab. Get a check up and be all right with treatment .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of hot sweats and stomach pain?\n\nHi I have really hot sweats rib and stomach pains when I stand up I feel dizzy and have really bad headache I wake up in the middle of the night feeling like I'm going to be sick and every bone in my body hurts when I breath proper I cough really bad had this for about 3days now I am a female 20 years old 5 ft 10 and 10 stone",
    "doctor_response": "Hi,It seems that you might be having flu type of symptoms, might be viral.Take paracetamol or ibuprofen for a day or two.Take rest.Take plenty of water.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring fever and muscle pain in a person with hepatitis C infection?\n\ni have hepatitis c for about ten years I am running a fever, muscle pains itchy skin nausea and am tired all tne time this happens to me every few months also ringing in my ears and headache I have never been treated for hepatitis only told that I have it what should I do each time I get sick it is a little worse this time my fingers and legs seem to be swelled",
    "doctor_response": "Hi welcome to HCM..You are having hepatitis c virus infection. ...It is since ten years so chance of cirrhosis and portal hypertension is there ...USG and serum albumin will be useful for that ....If portal hypertension there ( suspected by splenomegaly and ascites if present ) than beta blocker needed ..For edema low salt diet taken and diuretic if needed ....If needed than HCV RNA done to detect if it is in active stage...for which antiviral medication needed ...Daily take grined spinach and carrot juice ...According to your disease severity treatment individualized .Take care Advise : consult physician ...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have large inflamed lingual follicle on tongue. Can it be cancerous? Nervous\n\nI have a rather large inflamed lingual follicle on the back side of my tongue . It s far enough back that it s tucked under the right tonsil when the tongue is relaxed, but when the tongue is extended to the maximum, its just at or in front of the tonsillar arch. It seems like a rather large flap with a white crest. It doesn t seem to be painful. I m extremely worried about it being a tumor or some sort of cancerous growth. I have an appointment at the ENT tomorrow, but I can t even function, and keep looking at it and information on the internet... I m very nervous.",
    "doctor_response": "Hi, it is a normal elevation on 2 sides of the posterior end of the tongue, on one side probably it has swollen, or the size may be larger.                           Any how as you had appointment with the doctor, he will give the diagnosis, and treatment. Don't worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest possible treatment for severe depression and parkinson's\n\nI really need advise from some one,  My mother is 53 years old and is diagnosed with severe depression and parkinson's (which they say may be caused from being on depression medicine for a verry long time, I think it is Tardive Dyskinea from taking Zyprexa) and she also takes something for sleeping, i know the meds if you need them but i am very concerned, she is practically mute, when she answers you she kind of pauses and doesn't know what to say she rarley ever talks, she is very lethargic and sleeps all night and is sort of in a sedative state during the day, although she can feed my daughter her cottle, she can help cook but she doeesn't clean dishes or anything else, she has VERY poor hygeine she doesnt really bath herself at all, she is kind of emotionless or has no feelings what so ever, she has been like this for almost 2 -3 years it wasn't as bad but it got worse I need help please she won't go into the hospital and the doctors appointments are not helping, she used to be VERY active and never stopped, she was funny, crazy and very LOVING!!!! I need HELP PLEASE!",
    "doctor_response": "Hello In most of patients suffering from Parkinson's disorder psychiatric symptoms like depression are see. Depression is some time main presenting symptoms in Parkinson's disorder. Zyprexa is olanzapine and the drug is a second generation antipsychotic drug. It is very uncommon to see Tardive Dyskinesia with olanzapine. Other Parkinson's like side effects can be seen with olanzapine. You have mentioned that she is very depressed, she doesn't interact with others, doesnt do work, she remains in blocked state. She also have poor hygiene. Most probably these symptoms are due to negative symptoms of severe depression. I would advise you to consult a Psychiatrist for expert opinion. Medicines like Amisulpiride can be used, as the drug will show both anti-psychotic and anti-depressant effect. It will help in improving negative symptoms. Ask her doctor to lower down the dose of sleep medicines, this will help in increasing mobility and resultant mood. As she is in severe depression then ECT is other treatment of choice. Consult her psychiatrist for detailed treatment.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My recent scan showed intrauterine fetal demise. Is there any way to get the baby back?\n\nHi doctor, I am ten weeks pregnant, and my ultrasound report\u00a0showed a single intrauterine gestational sac in the uterus. A small yolk sac and a small fetal pole\u00a0are seen in the gestational sac, with good cardiac activity. Bilateral ovaries are normal in size, shape, and echotexture, and CRL is 4.53 mm. It said early pregnancy of six weeks, so the doctor said to get HV injections and to repeat scan after three weeks. But, the pelvic ultrasound this month showed a single gestational sac in the uterus. A fetus is seen in the gestational sac, but the fetus does not show any cardiac or somatic activity, and CRL is 6.96 mm. It said intrauterine fetal demise. What should I do? Please help me, I want my baby back.",
    "doctor_response": "Hi,\u00a0 Welcome to icliniq.com. I am very sorry for your loss. Do not lose hope, you have something good waiting. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can THC levels during a pregnancy be lowered?\n\nI am 34 weeks pregnant and I had been ingesting (cooking with) marijuana to help my appetite... my doctor says I may be delivering in the next two weeks and I am freaking out. I do not want anything to happen to my child. What is a safe way to, at the very least seriously lower my THC levels, if not rid myself of them completely?",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.I will suggest to stop consumption of Marijuana at once.It may give you some pleasure but it definitely affects baby inside.THC is the chemical that gives you effects of marijuana, and it can pass to baby and affect learning abilities of the child.So as a sensible parent, quit it at once and do not consume it even during breastfeeding the baby.Please consume plenty of water to get it out of your body through urine.I hope my answer helps you.Thanks.Wish you great health.Dr Purushottam",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment for swelling in brain and scar tissue in temporal lobe?\n\nmy dad is 86yrs old and suffered a fall with some swelling to the left part of the brain and scar tissue to the rt temporal loeb. he has depression and is taking lithium and sertraline. He was treated in a hospital, and transferred to a rehab center. He was discharged to a nursing facility for therapy. What is the best treatment for this type of injury as I want to be sure he is receiving the best care for his recovery.",
    "doctor_response": "Hi,Thank you for posting your query.In most cases, the swelling of the scalp would subside on own in a few days. However, anti-inflammatory drugs may be taken to hasten the recovery process. If there is brain swelling (as seen on the CT scan of brain), then, medications such as mannitol and oral glycerol would help. You can discuss with his neurosurgeon regarding that.Good physiotherapy and rehabilitation would also help.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could muscle ache in thigh and testicles be due to hangover?\n\nI m 22yrs old (as of today) and last night I celebrated my birthday. Today I had a hangover but not a bad one until I got muscle aches in my thighs and now in my testicles. more so on the right side behind the scrotum where the pelvis meets the testicle. my left one is tender also but i can feel it on the right side all the time. it has been sore for about three hours and I don t want to go to the doctor if its something the hangover caused. Josh",
    "doctor_response": "Hello, It could be due to hangover, however take over the counter painkillers and apply hot fomentation, it will relieve your pain. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Jaideep Gaver",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I accidentally ingested nail polish remover. What are the possible side effects?\n\nHello doctor, I have a question about the side effects of ingesting a small amount\u00a0of nail polish remover. Here is the scenario. My girlfriend used the nail polish remover on her hands to take off her polish. Immediately after that, we were making out. So, I kind of sucked her fingers and nails. I felt this weird taste on my tongues and lips. A few minutes later, I remembered something about nail polish removers being posionous. I rinsed my mouth, but only about 30 minutes after licking the nail polish remover. I brushed twice, and since then I have had dinner and brushed again, but my mouth still has that weird taste. Do I need to worry about poisoning due to licking the nail polish remover or is there no reason to worry?",
    "doctor_response": "Hello. If you have any further queries please ask me. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the treatment for mitral stenosis?\n\nHello doctor, I am a male and I am 30-years-old male. I have a mitral valve problem, and it is moderate mitral stenosis. What remedy do you advise? If I did the valvoplasty surgery will there be any other problem? If there is a problem, is there a possibility to do the valvoplasty again? I am afraid. Please relieve my tension. The left atrium is 46 mm. I am currently on Spiromide 20 mg and Tinormin 50 mg daily once. Please help me.",
    "doctor_response": "Hello. There are specific criteria for surgery in case of mitral valve stenosis. Surgery does not resolve the problem and you may have to stay on anticoagulation therapy for your entire life. It can help improve your physical performance and avoid pulmonary edema (shortness of breath during physical exertion). Anyway, as you have mild mitral valve stenosis, I would recommend anticoagulation therapy and follow up with your cardiologist with a cardiac ultrasound every six months. Hope this would be helpful for you. For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are abdominal cramps and brown vaginal spotting symptoms of pregnancy?\n\nHi, I am on the pill called microlevelen. I have been on it for about 6 months, no issues at all. I have been on placement the past two weeks, very stressed and forgetting to take my pill at the same time everyday. Since Tuesday (it is now Friday) I have been having cramps with quite a bit of brown blood, I have done pregnancy tests and they have come up negative but my Doctor won\u2019t give me any other alternative issue other than pregnancy. Please help",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Microleven is a combined pill. If you miss doses for two days in consequence than protection is ruined so you can use a backup plan (emergency contraception or condom, etc.). The spotting may be either infection, pregnancy or hormonal disbalance. Wait for 5 days after day of expected period before taking pregnancy test. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Olgeta Xhufka",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest and back pain with slight pain in right arm?\n\nHi i am 35 years old and have been having these pains inmy chest for the last 2 days. Normally when i run or walk i dont get tired but nowadays i feel very weak even after a short walk. I feel sleepy and exausted most of the time.Having chest and back pains with a slight pain in my right arm (just beneath the shoulder joint) please help or am i being concerned over nothing",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, we should first rule out heart diseases. Your symptoms like easy tiredness, fatigue on minimal exertion, chest and back pain etc are more suggestive of heart diseases. So consult doctor and get done blood pressure monitoring, ecg, 2d echo and stress test (trade mill test). If all these are normal then no need to worry for heart diseases. Sometimes simple musculoskeletal pain can be the cause. So avoid movements causing pain. Avoid bad postures in sleep. Take simple painkiller like ibuprofen. Apply warm water pad on affected areas. Don't worry, you will be alright with all these in 1 week but first rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dengue causing continuous vomiting\n\nsir my brother is suffering from dengue fever.He admitted in hospital from last 4 days but he has continuous vomiting problem from last 3 days.He isnt eating or dinking juice.Platlets count was 65000.There is no any positive result of treatment.What can i do sir?",
    "doctor_response": "Hithanks for contacting HCMIf you will mention his age  then it will helps better to answer to any questions.There is no specific treatment For dengue fever. No any medicine which helped to build Platelet faster. What are the status of dengue NS1 antigen test and Dengue antibodies ( Ig G Ig M)?First not be panic about 65000 of platelet count. Platelet Transfusion is only option to increase Platelet  if platelet falls below 20000. If needs any platelet transfusion  please ask to doctor for Single donor platelet apheresis which will helps to increase platelet 30,000  to 70,000 in a single transfusion.   For vomiting and nausea please ask to doctor about Pantaprazol or ranitidine and ondesetron injections I/ V, if physical condition and vitals are stable ,according to body weight.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swelling due to synovitis\n\nDear Sir ! I m having pain & swelling which sometimes goes more & sometimes less.In mri done,it s said that sinovitis is most probably the reason for the problem from last one year.What s the probable & easy cure as it is hindering in walking,sitting & in other activities. Regards Ashraf",
    "doctor_response": "Hello This can be synovitis stage of arthritis.Yes you can take lubricant injection.Arthroscopy may also help you.In arthroscopic shaving damaged cartilage is smoothened and loose friable cartilage is removed.Avoiding steps and using western style toilets etc would be helpful.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause the wrist pain while bending backward?\n\nI ve had wrist pain on and off for years now. It hurts the most when I bend it backwards - I have a limited range of motion because of this. There doesn t seem to be a trigger for the pain either. I work at a computer all day and it never hurts when I type, only when it s bent backwards or if there s any pressure on it. I m wondering if it could either be tendonitus or maybe early onset arthritus? I m only 24 and it s been on and off since I was about 17.",
    "doctor_response": "Hi, This treatment is being suggested on bases of the information provided. However, I would like to examine & investigate the patient in detail. Control hypertension, diabetes or any other metabolic disorder, if there is any. Any way it may be tried: - Dolokind Plus (Mankind) [Aceclofenac + Paracetamol] 1 tablet OD & SOS for 5 days. - Caldikind plus (Mankind) 1 tablet OD for 10 days. (You may need help of your local doctor to get these medicines.) - Fomentation with warm water. Let the part not be exposed to cold air. - Sleep on a hard bed with soft bedding. - Use no pillow under the head. - Avoid painful acts & activities. - Do mild exercises for neck and shoulders and hips and knees and ankles. (Take help of a  physiotherapist.) - Do not ignore, let it not become beginning of a major problem. - Do ask for a detailed treatment plan. -  Make sure, there is no allergy to any of these medicines. - For emergency treatment visit nearest hospital. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nirmal Chander Gupta, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Panic attacks, dizziness in crowded, loud places, unable to breath, stress. Treatment?\n\nI normally get panic attacks, but decided to learn to control them without the use of medication . Besides that, I Always feel dizzy, like im floating.. the room will spin out of no where like I got up to fast.. it happens everywhere, Especially if im in crowded or loud places. I hardly drink water. im 5 7 130lbs male. Sometimes, I feel like im so full and its hard to breath , as if my lungs are full of bricks, and I have only a tiny space for air. I get tired really easy.. but I work from home.. on the computer. I don t drink or smoke . ... I am just tired of being dizzy all the time.. I don t feel myself at all and havent been for 8 moths. I do, however have alot of stress in my life as well. any help ?",
    "doctor_response": "HI. I AM DR. KAVITHA. I WOULD LIKE TO HELP. THE WAY TO EXCLUDE ANY MAJOR UNDERLYING MEDICAL PROBLEM IS TO VISIT YOUR FAMILY PHYSICIAN WHO CAN GIVE YOU A PROPER PHYSICAL EXAMINATION AND RUN A FEW BASIC TESTS TO EXCLUDE ANEMIA,DIABETES  ETC. A CARDIOLOGICAL EVALUATION IS ALSO NECESSARY IN YOUR CASE. IF YOUR JOB IS A SEDENTARY TYPE YOU MUST ALSO RULE OUT CERVICAL SPONDYLITIS . A LITTLE MORE EXERCISE  CAN ALSO  HELP BOOST YOUR \"HAPPY HORMONES\" AND HELP YOU FEEL BETTER. A VISIT TO A QUALIFIED CLINICAL  PSYCHOLOGIST CAN HELP YOU DEAL WITH YOUR PANIC ATTACKS AND STRESSORS. SINCE  IT HAS BEEN 8 MONTHS  IT IS NOT ADVISABLE TO IGNORE YOUR SYMPTOMS ANYMORE. TAKE CARE  BYE",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the chest scan showing patch / shadow between the lungs indicate?\n\nMy father's chest scan showed a small patch / shadow between the lungs . There was a little blood in his sputum . The X ray showed nothing . Early diagnosis is Pneumonia but he has been asked to undergo a bronchoscopy tomorrow . I'm really worried . Can this be a tumor ? There are no other symptoms .",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your father's situation and problem. Yes, this can be tumour. Hemoptysis (blood in sputum) in old age is commonly due to either pneumonia or lung cancer. And his CT scan is also showing shadow. So if he is smoker than possibility of malignant lesion is more. Since he is having central lesion, bronchoscopic evaluation, BAL (bronchoalveolar lavage)  and biopsy is needed to confirm the diagnosis. So bronchoscopy is must in his case to confirm the diagnosis. Hope I have solved your query. Wishing good health to your father. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could squishy lump on the right clavicle be fat pad?\n\nI found a squishy lump on my right clavicle, my pa sent me for a ultra sound and she said that it is probably a fat pad. should I get a second opinion? my chest xray is normal as well as my mammogram. I was diagnosed with a mild case of sarcoid in my chest --not my lungs but it has since went away. I am very worried about the \"so called fat pad\" I used to smoke on and off, could this be throat cancer?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You have lump in right clavicle area. ultrasound report suggest fat pad. So it may be lipoma or some fat containing soft tissue tumour. Chances of throat cancer is very rare. So no need to worry about that. You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long will a viral infection last and is it contagious?\n\nHello, I am 51 and was diagnosed with viral infection yesterday and symptoms are sore throat and as well as some swelling of throat. The symptoms began late Thursday night after working at a soup kitchen. I had fatigue, body aches and dry throat but woke up fine on Friday and spent half the day with family. I have been working there for over 9 yrs but I think I caught it there during the day by someone sneezing or coughing that is caring this virus. How long can my symptoms last and do I avoid all contact with individuals since it is contagious and is my family in any danger? Thank you. I wasn t paying attention and didn t realize that there is a fee. Thank you anyways for your time,",
    "doctor_response": "Hi,Welcome to healthcare Magic!You have posted the query in the free consult so you would not be charged but I hope it is not too late for the answer.The viral infections are contagious and can spread to other family members.Keep a distance of approximately one meter so that others do not get the cross infection from you.You should ensure good nutrition and hydration and remain indoors resting.It usually takes about a week's time to recover fully from viral infections, although it may vary depending upon the causative microorganism.I hope the advise would be informative and useful for you.Take Care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Spermatocele, causing pain, don't want surgery. Looking for natural or herbal remedies\n\nI ve been diagnosed with a spermatocele and although it s very small, it s causing me an immense amount of pain. From all my research, this seems wrong, especially for such a small cyst . Is there something similar to a cyst that would fool a Urologist (he did both a physical check and an ultrasound)? Also, are there any natural/ herbal remedies for this? I DO NOT want surgery, but this pain is pretty unbearable.",
    "doctor_response": "There are none that will cause the spermatocele to disappear. It may be painful because it is infected, so I would try one week of ciprofloxacin antibiotic.  This may help.  If not, then I agree that surgery is next step. Please rate 5 stars! I strive to provide the best answer I can to your quetsions!",
    "dialogue_context": ""
  },
  {
    "patient_message": "How much Bacigyl-N suspension should be taken for diarrhea?\n\nI am in India with my 4 childrens and 3 of them with diarrea. The 9 year old yesterday was going very often to toilet. The other 2 are pretty ok, playing and eating but still with diarrea for a long time, now like 10 days. Sometimes it looks that they get better but is a long time now. I've just bought Bacigyl-N (norfloxacin and Metronidazole) suspension. Is it ok to give them this medicine? and how much it will be the dose? Kids 9 years old, 6 years and 2 years and a half.I would really appreciate your time and your answer. Thank you!Candelaria",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics (LIKE NORFLOXACIN AND METRONIDAZOLE) unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron (as prescribed by your paediatrician).Regarding diet -  Avoid fruit juices as they might aggravate diarrhea. You can give zinc supplements & ORS apart from normal vegetarian porridges & soups.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Prescribed Minscalp, betadip lotion for hair loss but having dandruff. How new hair will grow?\n\nAm having hairloss and no growth to my new hair ..only existing hair is growing .i consulted doctor he gave me minscalp ,betadip lotion and onablete vitamin and hair stimulising tablet.Previously i dont have dandruff and now i have the same.Please help me and i need growth to my new hair.",
    "doctor_response": "Hello. Thank you for writing to usYou seem to have androgenetic alopecia or male pattern baldness, as can be judged from the medication that has been prescribed i.e topical minoxidil solution.Androgenetic alopecia is characterized by gradually progressive thinning and hair loss from the frontal scalp and vertex. It is also associated with receding anterior hair line.Topical minoxidil and oral finasteride are approved remedies for androgenetic alopecia.Goal of treatment of androgenetic alopecia is to arrest or slow down further progression.New hair regrowth may be seen if the problem is not a very long standing.Treatment is long term. Noticeable improvement is usually seen after 3-6 months of regular use.Response to treatment is variable and varies between individuals.Dryness/ dandruff to minoxidil is a known side effect and is due to crystallization of minoxidil on scalp and also because the solution is available in an alcohol base which can cause dryness ans scalp scaling.Therefore I suggest you to add an antidandruff ketoconazole based shampoo along with minoxidil to take care of dryness/ scalp scaling.If I was the treating doctor I would have also added oral finasteride in addition to topical minoxidil.Finasteride and minoxidil together produce better results as compared to minoxidil alone.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could dull pain in lower back going to front left side be recurred kidney stones?\n\ni have a dull pain in lower back that sometimes goes to front lower left abdomen and maybe a twinge on my left side. It is very much like when I had a kidney stone before, but there are so many illnesses with similar symptoms I don t know. The pain comes and goes.",
    "doctor_response": "hisymptoms you are having are very much consistent with renal stonei will advise you to do ultrasound KUB and urine analysishave plenty of oral fluids to keep yourself hydratedregards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I sense an air bubble under knee cap?\n\nIt feels as though I have an air bubble under my knee cap. It is painful and at times non-weight bearing. This has been consistent for nearly 24 hours. Is there something I can do to help the air dispurse? I have tried heat and as much movement as I can stand. I got a little crack from applying heat, tried again and nothing.",
    "doctor_response": "Hello, It can happen when the tendons or ligaments snap over the bony structures in the knee, torn cartilage, or osteoarthritis. If you don't feel better after some days make MRI. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Blerina Pasho, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is pregnancy not happening after miscarriages?\n\ni suffered a misscarriage back last june and since then me and my husand have been trying for a baby since then. I didnt have a period for two months last november and december but iv had one since then on 24th december.so im wondering what is wrong my husband is fine . I know i can concieve as i was pregnant last year",
    "doctor_response": "Yes you can conceive beause you had miscarriage  do thyroid profile also do torch test and what is your blood group?",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does granulomatous lymphadenitis mean?\n\nhello today i go the report for FNAC test, The report says: FNAC OF RIGHT CERVICAL LYMPH NODE HEMORRHAGIC ASPIRATE, FOUR SMEARS MADESMEARS SHOW NUMEROUS EPITHELIOD GRANULOMAS AGAINST OF BACKGROUND OF REACTIVE LYMPHOID CELLS & RBC'S NO NECROSIS SEENIMPRESSION: GRANULOMATOUS LYMPHADENITISKINDLY HELP DOES THIS MEAN TBTHANK YOU",
    "doctor_response": "Hi welcome to health care magic....You have diagnosed granulomatous inflammation....It could be by......-syphilis -leprosy -tuberculosis -brucellosis -sometime malignancy -fungal infection-sarcoidosis etc....You are right .Most common cause TB.Here in report no caseation present.If it was there TB chance very high.So confirm TB by sputum smear examination and chest x ray along with prepared smear checked for TB by AFB smear....Serological test useful for syphilis and other infections.If needed biopsy taken ....Detail history and examination needed.If TB proved AKT can be taken....Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffer from cramps in lower abdomen and back. Have spotting, blood in urine and kidney stones. Could it be due to tubal litigation?\n\nIts been 4 days haven't passed kidney stone its 2.5 my breast are very sore !! Cramping in lower abdomen and achey lower back pain my period was only 1 day spotted 3 days  i had tubal ligation 10 yrs ago so i d think tubal??? They did ct scan on abdomen said everything looked good except small stone but no infection. I also had blood in urine ???help",
    "doctor_response": "Welcome to HCM.Lower abd pain due to passage of stone.Low back pain,cramp in abd and sore breast occur during period.There is no any relation to your tubal ligation.Start NSAID with dicyclomin three times a day.Drink enough water and other liq. like fruit juices,vegetable soups,lemon water.Consult your doctor for further guidance and proper medical management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this semen analysis test result indicate?\n\nMy semen analysis. Liquefication: Normal Days of absteinance: 5 Volume (ml): 4ml Viscosity: 1 Density (Mio/ml): 0 Mio/mL Total motility(%): Normal forms (%): Round cells (Mio/ml): 0.1,Colour: Normal,Agglutination: - Debris: ++ Remarks: 7/16 Motile Sperms Cells Seen Per Slide",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The given report is incomplete. You haven\u2019t mentioned the count and motility. We can make inference only after assessing the count  and motility. Please provide a complete report. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated liver enzymes and water retention?\n\nMy annual lab tests showed an elevate BUN, and elevated Liver enzymes. Should I be concerned? Last year the BUN was elevated but not as much and now the liver enzymes are elevated. I take daily glucophage, aldactone and was taking a fat burner for awhile. I am 32 years old, female, 5'3\" and 123 pounds. I have been retaining water and its getting out of control. I recently gained 15 pounds over the last 3 months. I exercise 5-6 times per week 60-90 mins of cardio each time. My T3 was LOW however my T4 WNL and my TSH on the low end of normal. I was diagnosed with insulin resistance after the birth of my second child in 2003. Any advice or insight to this issue?",
    "doctor_response": "Hi, You should take both your raised BUN and liver enzymes seriously and try to bring them down with effective Diabetes control, fat regulation, and medication for both. Please consult your Diabetologist/ Endocrinologist for this. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes small raised lumps in the foot?\n\nI ve had these small raised bumps on the inner side of my left foot since childhood, however these small raised bumps have become somewhat bigger and have been migrating along the inner side of my left leg as well. I have seen several dermantologist and have received different diagnoses. All I want to know is what it is and how can I get it go away. I have tried a few different steroid creams and topical meds that have seemed to make it worse. It has even been diagnosed as a linear nevea, which could be removed with surgery and leave a long scar. Please help...",
    "doctor_response": "topical medicines won't be helpful in your case; however not to worry about this also!these are small lipoma or neurofibroma-like tumors and you should consult a general surgeon for opinion they should really be removed or not!an FNAC test can confirm the diagnosisall the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for difficulty in pulling foreskin of penis?\n\ni am 21 years old...and i had a problem regarding with the foreskin of my penis,i could not pull it down, however i am able to pull it down now but i seem to have alot of smegma covering around my glan, what measures should i take that would help me remove it ?",
    "doctor_response": "HelloYour findings may suggest phimosis.It is a surgical condition in which fore skin can't be retracted over glans penis.I suggest to go for circumcision.It is a minor operation in which foreskin is cut out and skin is tied over coronal sulcus.It is better to get rid of this condition earliest because phimosis may cause surgical emergency if it is stuck over glans penis.It may compromise distal blood supply.So,you should consult surgeon for proper management.Increased smegma may be related to poor genital hygiene.You should clean are regularly be everting foreskin.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes 94% abnormal forms in semen analysis?\n\nMy partner has recently had a semen analysis for infertility. It cam back that he had 94% abnormal forms, but motility and count were very good. He had a pyrexia about 6 to 8 weeks ago, and it says in the microscopy comment about this, could this be the cause?",
    "doctor_response": "HelloThanks for query .The abnormal sperms indicate deranged spermatogenesis by Testicles .It could be secondary to infection of testicles .get semen culture done and take appropriate antibiotics as per culture report .Repeat semen analysis after one month .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having body aches, feels like lump in the upper back. Sleeplessness in nights,   suicidal tendency, no interest in family. Suggestions?\n\ni ve been tired for so long. every day my body aches, my upper back feels like it has a knot in it. i don t want to do anything anymore. i have no interest in anything except sleep. i stay up all night and cannot sleep, then sleep away the day....when i wake up i feel guilty for being so worthless. i put a gun in my mouth last night to see what it felt like...it wasn t as cold as i thought it would be. i wasn t really planning on killing myself...i don t think.....but if i accidentally did....it would have been ok. i can t keep a job, i sometimes do not shower for a week at a time, the thought of it make me tired, it seems like such a chore. i have no reason to feel this way. nothing tragic has happened. i have no energy. i think a lot about dying, it doesn t scare me like it used to. i don t really want to...but really don t care. its rather embarrassing...i have children...i avoid them. i m afraid they will see how i am and think badly of themselves....then i feel bad for not spending time with them...my poor wife. i don t know why she has not left me.",
    "doctor_response": "Hello.......... I can understand your concern. Your symptoms point towards either an underlying chronic depressive disorder or a dysthymic disorder which is a milder variant. You might also require assessment of your personality profile. Active suicidal thoughts are a psychiatric emergency. I suggest you undergo a thorough psychiatric evaluation as early as possible and get yourself admitted as an in-patient considering your suicidal thoughts. Effective anti-depressant medication and psychotherapy (eg. cognitive behavioural therapy) are available for management. Hope you found the information useful. Regards Dr Sundar Gnanavel Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning sensation in heart and sweating?\n\nI ve been chewing tobacco for about 7 months and a lot. I just started to get chest pains when I put a lip in and can t take deep breathes without pain. It felt like I had a heart attack today my heart was burning really bad and I was seeing black sparkles like I hit a funny bone and I was sweating a lot. What s wrong with me ? Today I stopped chewing and will be done forever",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!Your symptoms don't seem to be cardiac related. A musculo skeletal pain and pain related to pleuritis could be modulated by the respiratory movements, but would not be related to the tobacco chewing. Another disorder would be esophageal spasms or gastritis, which would be exacerbated by the tobacco chewing. Have you tried to take any painkillers (acetaminophen, ibuprofen)or PPIs (lansoprazole, omeprazole)?The pain relief from painkillers would indicate a musculoskeletal pain. The pain relief from PPIs would indicate a gastro esophageal disorder. I recommend consulting with your GP for a careful physical examination, a resting ECG, a chest x ray and some blood lab tests (complete blood count, PCR, sedimentation rate, kidney and liver function tests, etc). A fibrogastroscopy would be necessary to exclude a possible gastro esophageal disorder. Hope to have been helpful!Best wishes, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Periodic swelling on either side of nose, bump near the eye that gradually subsides, diagnosed with food allergies, sinusitis. Alarming?\n\nI have periodic swelling on either side of my nose . It s strange. sometimes it s a bit itchy, othe rtimes I don t even feel it. I ll notice a little bump on the outside near my eye and it will get larger and larger then gradually go down. I have food allergies and chronic sinusitis ...I told my physician and he seemed like it wasn t a big deal. Should I worry?",
    "doctor_response": "Hi, There is nothing to worry about these are related to sinusitis and rhinitis that is causing itch nose. You can just use simple antihistamines such as combination of loratidine and pseudoephedrine for itch nose and lump near the eyes. This will respond a great deal after initial dose. I hope I am sucessful in solving your query If u have further you can ask me Get well soon Take care Regards, Dr. Azhar Sattar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dizziness, difficulty in standing, heartburn. Suffering from seizure disorder and HIV. Recommendations?\n\nI am a 59 year old woman with hiv and I have what they call partial seizure disorder as well all the meds have been causing me to be very dizzy and unable to stand for very long. I can't walk one aisle in a store without sweating a lot and feeling anixiety and weak needing to sit down. I have chest pressure and heartburn and neck and headaches every day can you tell me why. I take zoledimide for seizure, lisipril, reyataz,norvir,truvida,",
    "doctor_response": "hi, you are on the treatment with HAART, and  anti epileptic for partial seizure, but you have not mentioned the duration of this complaint and from how long you are taking. and have you undergone investigations like CT scan for the diagnosis of partial siezure. i would suggest to see your physician for this.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Aspirin advisable for elevation in the BP level despite taking Losartan?\n\nHello, I am a 60 year old female who started taking 25 mg of Losartan daily about 4 months ago. my blood pressure has dropped some since I started taking it but is sill not in the normal range. Was 170 s over 90 s when I started taking it and is not normally 140 s-150 s over 70 s. I spent the last 24 hours with my daughter who is going through some traumatic circumstances and returned home this evening to find my blood pressure is measuring around 165-175 for the top number and 99 -102 for the bottom number. I am trying to relax and my blood pressure has gone down a bit since I got home (167-98) but I m wondering if I should go to the ER or if I could just take an aspirin to help for the moment? I actually have a physical scheduled for tomorrow afternoon so that will be handy but would like to know:1) exactly what my blood pressure needs to be where it is bad enough to go to the hospital (obviously not where I would like to spend the evening) 2) Is were something I can do right now, such as take a low dose aspirin to help reduce my blood pressure without having to go the hospital? Thanks for your help! Marie",
    "doctor_response": "Hello,Your blood pressure is a little high despite the use of losartan. I can understand that you have had a stressed day and that may contribute to higher blood pressure. If you don't have any other disease (renal disease), you can take another Losartan. If you were my patient, I would give you hydrochlorothiazide starting with early morning. It takes a few weeks to start acting. Meanwhile, you take daily or twice a day Losartan. It can low your blood pressure. Aspirin does not play a role in decreasing blood pressure. It only might increase it a little.Hope I have answered your query. Let me know if I can assist you further.Regards,   Dr. Anila Skenderi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does an MRI showing broad base posterior disc bulge suggest?\n\nMy daughter just had an MRI of the Lumbar Spine and results as follows: L5 - S1 There is broad-based posterior disc bulge indenting the ventral tecal sac and causing mild central canal stenosis. L4 - L5 There is type II Modic endplate changes. There is a right asymmetric posterior disc protrusion resulting in severe central canal stenosis and bilateral neural foramina narrowing. The most posterior aspect of the herniated dis chows mild contrast enhancement indicative of fibrotic component.",
    "doctor_response": "Hello, These MRI findings indicate that there are protrusions of the intervertebral discs in two levels of the lumbar spine. The narrowing at the L5-S1 level is mild, at the L4-L5 level is severe and nerves are compressed as well. Mild contrast enhancement means that there are inflammatory changes in the disc. It depends on the symptoms and neurological findings, however, the severe stenosis at L4-L5 may require surgery. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for premature ejaculation\n\nMy self Rahesh kirti and  I am 32 years old. Sine 15 years I have been handling my penis for my self sex satisfy. But today when I am going to be married with my girlfriend i feel that i am fully unable to satisfy her sexual life . I have tried to intercourse her 3-4 times in between 6 months but I am fully unable to satisfy her. when I am trying to penetrate  my penis in her virgin its discharge quickly and it also not erected  properly. So now  today  i am highly mental depressed. Please help me sir .",
    "doctor_response": "Hello, As per your history, it may be due to performance anxiety. For that you can take tablet sildenafil one hour before sexual act. Along with that avoid stress. Take proper rest and balanced diet. Avoid strenuous activity and smoking. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes wheezing in a child after swallowing plastic piece?\n\nhi, My two and half year old daughter swallowed a plastic toy piece some two days back. while trying to get that out by his hand my father accidently scratched her throat. blood came from her mouth and nose. we rushed her to hospital where doctors took x rays of her neck, chest and stomach. nothing was visible and my daughter although frightened by incident but stopped crying and kept silent. we were told that plastic piece had gone to stomach and may not be visible in x ray so we have to wait to see if that comes out in motions....we brought her home and she started eating and behaving slightly better by playing with her sister.. some time complaining pain in throat..which we thought is due to scratches in throat. During night i heard some wheezing while she was sleeping i was afraid but thought that she might be suffering from cold...But early morning she suddenly woke up and started crying and yelling that some thing had stuck in her throat. She was trying to breathe but cant suddenly my father again put his finger in and to his surprise he pulled out the plastic piece around 1 cm in diameter..she was relieved so were we..its been two days since then and she is behaving okay but i still hear some slight sound when she sleeps...i am afraid and in doubt that is there be any thing else in her throat...where was that piece stuck in her for around 20 hrs...why doctors cant trace that...can there be anything else...What to do???",
    "doctor_response": "Go for chest x Ray. Some time foreign body in bronchus present with this type of symptoms.  And there is strong history.  Most probably u will get normal cxr.but it is better to remove doubt. Some time URI present with this noisy breathing.  But with h/o foreign body can't be overlooked.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe back pain below the shoulders\n\nHi I TOOK MY MOTHER TO DOCTOR AS SHE WAS Having sever pain on back side just below shoulders. Also skin was red with watery blisters. Doctor looked and told harpies and gave 800mg tablet and ointment. Today is the first day she is taking the medicine but the pain is too much, how much time generally it takes to cure.",
    "doctor_response": "sign and symptoms suggest herpes zoster.along with oral acyclovir add cap tramadol and ondensantrone. its due do spinal nerves involvement thats why pain is so much intense and burning.nerve facet block is the best option to combate this severe pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for infection in the eye\n\nI had an eye infection 4/19/2015 and got a prescription for ciprofloxacin 0.3 % and proceeded to put drops in my eye every 2 hours for 2 days while awake and then 1 time every 4 hours for 5 days i still have, burning running eye [left one] It feels like something is around the back of my eye stuck there what should i do besides go to the eye dr. as not sure if my insurance will cover it. Thanks Bonita e-mail is YYYY@YYYY",
    "doctor_response": "Hi thanks for asking question in HCM.For eye infection cure continue to use ciprofloxacin antibiotic eye drops.Besides that follow some instructions as below.Remove sticky discharge with cotton wool soak in water.Frequently do your hand washing.Take more fruits and nutritional diet.Drink more water.Do not rub the eye with bare hand.If pain is there simple analgesic can be taken.I hope these measures will help you.thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and blurred vision?\n\nI m a dancer and I am 15. I consider myself very healthy, I do have allergies and I take some medications for that, but usually no other medications are taken besides Ibuprofen (sometimes). My problem is that whenever I am at dance and we have to do backbends (which is where you bend your back as far as you can go while standing), I get a terrible headrush and an awful headache. I often get really dizzy and have pretty bad vision, basically everything in my eyesight just goes away/becomes a red mass. This has been happening almost as long as I can remember, it has just come to a point where I can t do certain dance moves anymore because even though I haven t fallen, I feel like I am going to. This problem also happens when I stand up, not all the time, but when it does happen, it tends to be much worse then just bending my back. I do drink a lot of water and my sleep habits are as normal as they can be (I m a teenager). Is there anything I can do about this? Medication? Exercises? Changes?",
    "doctor_response": "Hi, I am Dr.Bruno.  I have read your question with care and understand your concerns. Let me try to help you Question : What causes dizziness and blurred vision?Answer : You have a problem with blood circulation. Please consult a Neurosurgeon for Evaluation. After finding the extend and nature of problem, we can cure it with relevant  Medications, Exercises, Life Style ModificationsHope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower abdominal pain, pressure and vaginal discharge?\n\ni have lower abdominal pain/ pressure ! and discharge and my vagina smells ! my partner smokes alot of weed and it might have bad stuff in it i dont know but when he ejaculates in me it causes a very bad smell ever since then the smell been up inside me and it wont go away do i have an std ? what is going on",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.I have read your history and understood your problem. Your symptoms are related to STD, this  is common among many couples ans usually starts if there is a long gap between intercourse,. This allows the vaginal environment to change and the next act causes the vaginitis in females, balanitis in males. This continues till both of you get a proper diagnosis and treatment simultaneously. I would advise you both the following:Get blood sugar checked. Both of you to get a medical check-up and STD panel check.Get a course of an antibiotic, metronidazole and anti-fungal tables. Use condom during sex till both of you are cured. This will solve your problems.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Delayed periods, trying to conceive. Negative pregnancy test. History of miscarriage. Measures to improve fertility?\n\nDear Doctor, my period is late for 11days, i check in test (pregancy test) in which it is negative, so how should i know that i m pregnant , plz doctor help me out i am trying to conceive from 6 month, but no more result is coming. My age is 25, 2 yr back i suffered from miscarrage also, the period for my marriage is about to complete 6 yr.so family are blaming me regarding baby. plz help me out.",
    "doctor_response": "Hi Sonu. Thanks for the query. Have you put on weight recently ? Any hair growth on your chin recently ? There could be many causes for delayed periods like emotional stress, lack of sleep, hormonal disorders like Polycystic ovarian disease or PCOD, ovarian disorders etc. Eat a balanced diet. Drink 1-2 litres of water daily. Do daily brisk walking for 40 minutes a day. Do Yoga everyday. Sleep for 6-8 hours a day. Try to reduce stress at work by taking frequent breaks or reducing work hours. All this will reduce stress and help in maintaining normal menstrual cycles. You will need to consult a Gynecologist and get an ultrasound scan of your pelvic organs including ovaries, uterus. This will be able to find out any problems with these organs. You may also require to test hormones like FSH, LH, Estrogen, Progesterone, Androstenedione, Thyroid hormones as all these can affect periods and fertility as well. If pregnancy test is negative, it is usually correct. If you have doubts, kindly get Beta hCG level tested at a Hospital as this is more accurate to diagnose pregnancy. Kindly follow up with me after you consult your Gynecologist for good advise. Wishing speedy recovery. Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for bronchitis along with coughing, mucus in lungs and headache\n\nmy wife has serious brochitis , possibly bodering on pneumonia. Has has a lot of hard coughing and I can feel the mucous in her lungs when she breathes.  She has had abad headache over her left eye and side of her head all last night and this morning. She is woried she may have an aneurysm. please advise",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Most common cause for bronchitis is lung infection. So in my opinion, you should consult pulmonologist for your wife and get done 1. Clinical examination of respiratory system 2. Chest x ray 3. PFT (Pulmonary Function Test). Chest x ray is needed to rule out lung infection. PFT is must for the diagnosis of bronchitis. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. She may need antibiotic, anti histamine, anti inflammatory drugs, inhaled bronchodilators and inhaled corticosteroid (ICS). Don't worry, she will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I masturbate excessively and feel depressed with guilt. Please help.\n\nHi doctor, I am 18 years old. I am a student and I am excessively addicted to masturbation. I cannot concentrate in fact I started doing sex with my partner regularly. I just treat her as satisfactory material and this causes a deep regret in me. I am not good at studies anymore as well as I just cannot concentrate. Everything in my life is stuck out with my problem. It started when I was in class 7 I saw a porn film then all this has been started and now I am just like addicted. Please help me out I am in a great depression, sometimes I feel like I should end up my life how should I overcome with it?",
    "doctor_response": "Hello. I can understand your problem. First of all, it must clear to you also that it is harmless practice, which is done by almost 100%male and 70% of females in there lifetime. I mean it common in your age. Do not feel guilty, this activity will not affect your married life, you will be able to produce children. Yes, it is a release process, and not have any ill effect until it becomes an obsession and interfere in your functioning. You can quit it by diversion of your thoughts, try to seek interest in other activities and make a friend. Involve in your hobbies, do moderate exercise. You can have sex with your partner no problem in it. If unable to relief with above you can go for pharmacotherapy like Prodep.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could lumps and bruises hip bone suggest?\n\nmy son got a bruise on his hip bone last fri. it was very blue then purple...a few days later a white pea sized lump appeared. the bruise is now a week old and is brown but the center where the lump is is white. the nite I noticed it he had been vomiting but no fever...the next few days he had flu symptoms so I went to er and they said it was a virus. I didnt think to mention the bruise but now im concerned because of the lump.",
    "doctor_response": "Hi! Good morning. I am Dr Shareef answering your query.I think you should have mentioned about the bruise with the central white discolouration in that. With the history of fever, this could be an abscess due to super added infection of the hematoma formed after the injury. Therefore, I would advise you to take your son to the ER for a review with a definite mention of the lump over the injured part. Till then, you could give him an anti pyretic and an anti emetic which might be available over the counter in your city.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.0Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for fever,back pain and cough\n\nHello, I ve been sick since 3 days ago when I worked on a mold removal project and ate a Reuben and burger at two restaurants. No one else is sick but they didn t eat the same thing I did. I ve had a fever about 100, headache, back pain and coughing. I m thinking the coughing might be from my smoking and back pain from the work. The morning after the work I felt really sick and tried to throw up but couldn t. Any advice would be very appreciated. Thx mack",
    "doctor_response": "thanks for sharing your health concern with us!well, take some cough syrup like ZEDEX 3 tsf thrice a day for 2/3 days and Tablet AZITHROMYCIN 500 mg once daily for 3 days only!.all the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medication for low grade fever & red bumps on legs & arms\n\nHi! My son had a low grade fever a few days ago. We thought he was cutting a tooth but then woke up the next day with red bumps all over his legs and arms. Now they are on his feet too. They don t seem to itch or bother him and he s not showing any other signs of sickness. What could they be?",
    "doctor_response": "Hi....by what you quote I feel that your son might be having a viral illness called hand foot mouth disease. This is one viral illness among all other exanthemas which can cause fever followed by rash over palms and soles. It is a self-limiting disorder and itching can be really worrisome. I suggest you use any over the counter antihistamine if you have one with you now. You can use Hydroxyzine at 1-2mg/kg/dose (Maximum 10mg) every 6th to 8th hourly for 7 days. This can even cause some peeling of skin in the next 4-6 weeks and do not worry about it.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for huge, senstitive, swollen bump with severe pain in nostril?\n\nHi, I have a huge, very sensitive, very painful, swollen bump that seems to keep getting bigger on the inside of my nostril. I've had it since saturday but it hasn't gone away. I am currently 8 months pregnant. What could it be? Will it go away? Is there any type of treatment for it?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some nasay polyp or other mass.  You need examination.  It can be antrochoanal polyp or allergic polyp.  Consult your doctor and take treatment accordingly.  Surgical excision is the treatment of choice. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can acid reflux affect the SGOt & SGPT levels?\n\nI was diagnosed with acid reflux early this year, this morning I had my blood test with SGOT at 47 , the normal value is 14-36, and SGPT at 58, the normal value is 9-52. May I know if the acid reflux is in any way connected with the SGOT and SGPT results? I am 57 years old, 5 ft in height, female. Thank you sir.",
    "doctor_response": "Brief answer : SGOT and SGPT levels are not related with acid reflux.Detailed answer:Hello. Thank you for sharing this question in HCM.High SGOT and SGPT levels are not related to acid reflux. There are some reasons why SGOT and SGPT can be elevated , such as hypercholesterolemia, medications, alcohol , hepatitis etc.Eventhough this levels of SGOT and SGPT are not to be worried , you should not take medications that may harm liver such as Acetaminophen,  amoxicillin-clavulanic acid, nitrofurantoin.You should avoid alcohol use.You should make a blood check of cholesterol levels ,trigliceride levels, hepatitis B antigen,and hepatitis C antibody, to explore for the possible cause of high levels of SGOT and SGPT.Hope this is helpful to you. Please feel free to ask for any other explanation needed.Kind Regards,Dr. Juarda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Struggling with opiates, take suboxone, methodone. Permanent cure?\n\nI have been struggling with opiates since a back injury in 2002. I have gotten to the point where I hate opiates, yet I keep using them on and off for flair ups. Then I have to run to another doctor to get medication, ( suboxone , methodone) to get off of the opiates. It has become an evil cycle that has and continues to ruin my life. I need help!!! please!!!",
    "doctor_response": "Hello You can take epidural injection to get rid of opiates.You may need to  start physiotherapy and continue some holistic yoga and meditation or accupuncture.check your VIT B 12 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if feeling unhappy, worthless and cannot cope up with daily tasks following flu?\n\nHave recently had flu and suddenly feel very unhappy, worthless, scared and cant cope with simple daily tasks. Irritable, frightened of being alone, might be better if not around for everyone else. Been offered sertraline by doctor but concerned about potential side effects. What can I do?",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.From what you have stated it is quite clear that you are having a depressive episode. Depression can occur with regular stress and it can also occur biologically without any stress as well. You need proper treatment for the same. There are various effective therapies for depression like fluoxetine, venlafaxine, bupropion, mirtazapine or escitalopram and they are all very effective and mostly safe. You may also require some benzodiazepines like clonazepam or lorazepam for a short period like 2-3 weeks to reduce the anxiety and help with your sleep.  If you are averse to the drug therapies then there is also an option of cognitive behavioural therapy. This therapy is taken by either a psychologist or a psychiatrist in which the therapist identifies impaired cognitions (Thoughts) and try to correct them. They are 15-20 min weekly session and there should be around 8-10 sessions to help you with your illness.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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat muscle cramps on the left side of the rib area?\n\nI WAS SITTING ON A OTTOMAN PUTTING ON MY SLIPPERS AND MY THE SLIPPER FOLDED OVER, SO AS I PUSHED WITH MY FOOT AND PULLED WITH MY ARMS I GOT A BAD CRAMP IN MY LOWER CHEST. ON MY FIRST RIB ON THE LEFT SIDE, I HAD TO LAY ON MY BACK FOR 30 SECONDS OR SO TO RELIEVE IT. TODAY MY RIB STILL FEELS TENDER. IS IT COMMON TO GET A CRAMP THERE?",
    "doctor_response": "Hello Thank you for using healthcaremagic I read your question and understood your concern I think this is not a serious problem. it is somehow nornal tonhave muscle contracture. You may need muscle relaxant  medication localy and by mouth and stretching exercises.It will take few weeks for you get back to normal I wish you quick recovery Dr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I use metrogyl DG Gel for lip swelling post injury?\n\nHi, may I answer your health queries right now ? Please type your query here...My daughter is 4 years old, fell down from bed accidentally, hit her mouth on the floor and had her upper lip cut. Bleeding stopped but she had a cut in upper lip and a large swelling. Can I use metrogyl DG Gel in the area, and what else I can give her. She is not complaining of any pain. There is no fever whatsoever.",
    "doctor_response": "himetrogyl  dg gel contain metronidazole -an antibiotic used for preventive or therapeutic for anaerobic infection.there is Little Chance of getting anaerobic infection this  highly vascular lip.so by applying it will be very little useful.topical  cream of gentamicin g  can be given if the cut is deep enough to produce infection.  if the cut is not deep much, no other antibiotic required.you should give some anti inflammation medication (ibuprofen) to reduce swelling and pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have a severe chest hurt\n\nMy nephew got hit in the chest really hard while playing football is short of breath and can't talk but when asked if he is ok or needs to go to the doctor he shakes his head that he is ok and doesn't want to go to the doctor that he will be ok.  Should we insist that he goes anyway or just keep an eye on him? He writes on a white board that he did this last year and was ok.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your nephew's situation and problem. In my opinion you should definitely consult him to the doctor and get done clinical examination of respiratory system and chest x ray to rule out internal lung injury. He is having blunt chest trauma and breathlessness, not able to speak etc can be due to pneumothorax or Pulmonary contusions etc. So we need to rule out all these. And for this chest x ray is needed. So better to consult doctor and get done chest x ray. If chest x ray is normal than no need to worry. But at present don't wait at home, take him to the hospital and rule out all these complications. Hope I have solved your query. Wishing good health to your nephew. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the possible reasons for infertility?\n\nHi Doctor,I am working women but trying to conceive from last 2 years. It has been 2 years 9 months for my marriage. Physically we both are healthy and there are hardly any issues till date expect my husband sperm count being 20 millions with 50 % motile good quality ones. I have gone through 1st IUI with cycle of last month but even that had failed . I am 28 years old and worried about my growing age. Are there any reasons of unexplained infertility. My height is 154 cm and weight is 57 kg. Trying to reduce the weight. I have never taken any contraceptive pills.",
    "doctor_response": "HelloNo doubt both of you are perfect and healthy . You mentioned that your husband is having sperms count 20 million with 50 % motility. Your height , weight and age all are up to standard for pregnancy . Let me explain about the scientific proof about INFERTILITY , please note down.Studies suggest that normal fertility is associated with SPERM counts of >48 million/mL ,WITH A MOTILITY OF >63% , with  12 % exhibiting normal morphology.Whereas  SUBFERTILITY is seen with SPERM counts of You din't use any contraceptive pills , so this is a good thing i.e. no imbalance in hormones .You mentioned that there is 20 million sperms but please mention total or / mL .Also mention volume of semen.Hope this information will helps. So consult infertility specialist and get his opinion.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had copper-T IUD. Vaginal examination shows missing threads. Should IUD be removed?\n\nHello Dr, Iam Shifana,25yrs old.I had a Copper-T IUD 2.5yrs ago.I went a vaginal examination of IUD yesterday. The thread of IUD was missing. The Dr requested to undergo an X-ray to check the IUD presence. After examination,found the IUD s presence without threads in the correct position and advised to continue having the IUD. But while removing,how can it be done without threads and how will they locate the IUD.The Dr who examined is an Oncologist . So she had no idea of removal process.Can you please state about this case.Can i continue having or remove IUD? How will you remove?",
    "doctor_response": "Hello and welcome, I understand the problem.In my opinion it is better to get it removed and insert a new one as you will not be able to feel the thread. So inadvertant expulsion or displacement of IUD will not be detected early.The removal of IUD is easy even if the thread is broken. The doctors have an IUD hook that is inserted inside the uterus and the IUD gets entagled in it. It is a very simple procedure requires just 5 minutes but must be done under anesthesia. So do not worry about this at all. Hope this satisfies your query. Thanks for using HCM.\u00a0\u00a0\u00a0\u00a0\u00a0Feel free to ask any more questions that you may have. Dr Madhuri BagdeConsultant Obstetrician and Gynecologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can tetralogy of fallot repair cause this vomiting?\n\nMy 4 1/2 yo grandson had Tetralogy of Fallot repair at age 6 months. Yesterday he threw up what looked to be all of his stomach contents. He does this at preschool and at Sunday school, too. It seems to happen most often after he s eaten. I m thinking he has to slow down, calm himself before eating anything but he can also throw up when getting too energetic after eating. Am concerned that this is heart-related. He did not require a valve replacement. His surgery was done by Dr. Teodori at Phoenix Children s hospital and he is well respected. There is no follow up visit scheduled until May of next year...should we pursue an appointment before that time?",
    "doctor_response": "Hello,I don't think that there have to do with the cardiac problem. It may be an infection ,or stress from school. I think that you should go to a general doctor for a routine examination.Hope I have answered your query. Let me know if I can assist you further.Regards,     Dr. Anila Skenderi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medication should be taken for sore throat,running nose and slight bronchitis?\n\nHiI had 2 old monk drinks between 8.30 and 10 pm. Now I have pain in the throat, a flowy noise and slight bronchitis. Can i take an Azicip 500 now (It has been 4 hours since my drink). Also, can I have a cetrizine and a theo asthalin with the azicip. I just came to Mumbai today for a holiday and the humidity is not suiting me. The theo asthanlin is for my bronchitis and the cetrizine to not have any sneezing kind of allergy tomorrow. Please let me know what medicines to take.RegardsAKash",
    "doctor_response": "Hi Akash. You have rightly noticed that Mumbai humidity does not suit many. No need to take antibiotics at the moment if you do not have fever. Continue with cetirizine and theoasthalin. Try to leave Mumbai if it is for holiday and can enjoy at a better place.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to give celestamine tablet to a 13 year old kid for allergy?\n\ngood day, I have a son who is 13 yrs old, for about 2 weeks he usually experienced allergies in his body particularly in upper part, I tried to let him take celestamine tablet 250mg and after taking it in an hour or two allergies subsides, just wondering if this is safe to be taken for his age. I only allow him to take 1 tablet in a day but not everyday only when he got allergies. is there any bad side effects if this is taken whenever allergies occur? please advise.Thank you.",
    "doctor_response": "cELESTAMINE CONTAINS A STEROID AND an ANTI HISTAMINIC and is used as an anti allergic. If taken sparingly under supervision of a medical practitioner, it will not have much side effects but if taken regularly over a long period of time, child may develop certain side effects of steroids. Hence i suggest you consult his physician for proper guidance. An alternative anti allergic like montair lc can be give.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be worried about the pain due to kidney stones?\n\nI have had numerous stents and lithotripsies for my kidney stones, all on the left side. I had my last stent removed in January and I still have a stone yet to pass. I have had moderate to severe pain, the exact same as when a stone is trying to make its way out. My Urologist has done urine and ultrasounds and says he sees nothing that should be causing me pain. I am really in a lot of pain. Should I get a second opinion? Or go by what he is saying? I am almost at the point where I sometimes need to go to the ER again.",
    "doctor_response": "Helloif u r having constant pain n ultrasound dont show anything u should get a test named INTRA VENOUS PYELOGRAPHY and XRAY KUB REGION",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for diarrhea and vomiting\n\nMy daughter is suffering from diarihia from last 4 days, initially she was also having vomiting, I had given her Lopamide, Domstral",
    "doctor_response": "Hi,She is having acute gastroenteritis. I guess she is not having fever, and the stool is not blood stained. Just give her ORS solution (around 10ml / kg after each stools, in small frequent sips) and syrup zinc sulfate for 14 days (2.5ml once a day if she is below 6 months and 5ml otherwise). In such cases, I used to give a probiotic also for 5 days. If not getting well in 2-3 days, we may need an antibiotic too.meanwhile avoid sugary items, fruits and juices till recovery, this can increase diarrhoea. If she develops drowsiness, lethargy, poor feeding or passing little urine, see your doctor immediately, this suggest dehydration. I also suggest you to stop lopiramide immediately, not at all recommended for children.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam TK, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I use Kojivit gel to get fair skin?\n\nHi doctor, I am a 22 year old female. I have a dusky skin that is brown skin. I want to become fair. Can I use Kojivit gel? Or any other dermoatology cream can I use? My hands are also brown in color and full of tan. Do you suggest any creams to get fair? I want to become fair as my marriage is going to get fixed by next year. Please suggest me some creams, so that it should not show any side effects. Also, how long I should use it? If I use anything, then will it have any effect in case of pregnancy, etc? Please help me. Thanks in advance.",
    "doctor_response": "Hi. One's skin color has 2 components. First one is genetic, which cannot be changed. Every skin color is beautiful in its own way and we should learn to love our skin color and augment it and not hide or lighten it. The second component is acquired, which is due to the influence of environment, sunlight, hormones, aging, etc. We can only target the acquired component of fair skin color while attempting lightening procedures. I suggest you antioxidant capsules like capsule Antoxid HC (Beta-carotene) and apply sunscreen lotion Lashield gel at 8 AM and 12 PM. Also, you can apply Glyaha koj lotion (Hydroquinone) at night time. Start with an alternate night application initialy as it may irritate your skin a bit and after a week or so, shift to daily night application. Consult your specialist doctor, discuss with him or her and take the treatment with consent. You can go for chemical peeling or microdermabrasion from your dermatologist which will help in exfoliating and give you a clearer skin tone. All these treatments are free of side effects. You may use them for three months. For further information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Bell's palsey or a concussion cause tongue numbness and difficulty blinking?\n\nI fell on Sunday and hit my face kind of hard and of course tensed up my neck  - this morning woke up and have a hard time blinking my right eye one side of my tongue feels like novacane and some strange feeling in right side of face- my question is it from a concussion or bells palsey and can I fly with these conditions?",
    "doctor_response": "Dear patient difficulty in blinking one eye and one sided face decreased sensations are signs of Bell's palsy and since this has happened after trauma should be taken seriously. Please consult neurophysician nearby you for detailed evaluation and further treatment. Please avoid flying till you are examined by neurophyysician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful swelling in the left lower leg after a fracture?\n\n2 years ago my friend broke her lower left leg. Has several plates and lots of screws. Within the past month her leg is swelling more than normal...pain is severe. Tonight her leg is so swollen she can t bend her knee. Skin looks like going to split. She has a huge knot on the side of her knee that is hard. - resident thought it was her menscus(?).....any ideas...what does she need to do?",
    "doctor_response": "hi,i am afraid this could be a problem with the plates or screws could be also infected if they were not removed before, so she needs an Xray done ..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the CECT scan showing early cirrhosis correct?\n\nDear sir, My LFT shown that ALT is 75 mg/dl rest of all readings are with normal including CBC tests, but in the CECT scan shows early stages of cirrhosis, but when consulted with Gastro surgeon, it is not cirrhosis, and he prescribed me the following tablets for three weeks i.e Morease SR. please answer me is it ok?",
    "doctor_response": "HelloIt is important to know details of CECT (abdomen)findings like liver size,presence of nodules,surface irregularity,its appearance,enhancement pattern etc.CECT may detect early stages of cirrhosis.As there is diagnostic dilemma,I suggest for FNAC/Biopsy of liver.It can only assess exact stage of liver pathology.Elevated ALT may indicate liver injury but it is important to assess underlying cause.Elastographgy is also helpful in such cases.Treatment depend upon clinical findings and investigation reports.You can these medicines empirically.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there pregnancy chances with non penetrative sex?\n\nMy boyfriend and I were fooling around. We were grinding on one another. He had nothing on, and i had underwear and yoga pants on. He ejaculated on my pants in the butt area. There wasn't a lot, and I couldn't change until I got home. Which was about an hour afterwards. I was just wondering if there was anyway the sperm could have moved down to the vaginal area, through the underwear, and still managed to get inside, and gotten me pregnant. Please help.",
    "doctor_response": "Hi you are right in thinking that sperms might have moved to vagina because they are mobile.  So better to take some precautions to avoid pregnancy after consulting a doctor.  Don't be late. Medicines should be taken within 5 days. Hope I have answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white spots on one side of brain?\n\nI had an MRI in 2011 and it showed 3 extremely bright white spots on one side of my brain. The neurologist told me it s nothing to be concerned about, But, I have found that the bright spots are actually something to be concerned about. I have balance problems, attention problems, swallowing problems, difficulty in expressing myself and feel clumsy. My mother is 92 and has had dementia for 3 or 4 years. I have read about Leukoaraiosis and I m concerned that the 3 bright spots and how it may be affecting me. I am a female age 73 I m sorry, I should have known, you don t anything free. I don t wish to continue because when I started to state my situation, there didn t seem to be any indication of having to pay.",
    "doctor_response": "Hi,Thank you for posting your query.First of all, I would like to reassure you that there is no need to worry about the three hyperintense (bright) lesions on the MRI brain. In that regard, I agree with your neurologist.These bright spots are non specific and can occur in a variety of conditions, ranging from migraine to ischemia and demyelination.At your age, the most common underlying cause could be high Blood pressure.Since about three years have passed, you may repeat the MRI brain to look for any disease progression. If there is no increase in the number of lesions (spots), then, there is no reason to worry.However, if there has been a progression, then, you would require evaluation to find out the underlying cause.I hope it helps.Best wishes,Dr Sudhir Kumar MD DM (Neurology)Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I get pregnant with an average sperm count?\n\nHi i got married for last 8 months. And we are trying from the 1 month itself. Before marriage my cycle was exactly 28 days but now it has changed to 29 or 27. My husband sperm count is average and dr. Has prescribed ubiphene . I fell pain during intercourse and my vaginal remains dry. Do i have any problem. Few days before i was having irritation in urination. Dr. Prescribed me citralka(disodium hydrogen citrate) and now i am felling better. Am i normal ? Will i be pregnant or not. Please help",
    "doctor_response": "Dear Ms, yes you are normal and you can get pregnant with average Sperm count. as for vaginal dryness do not try to use any lubricants as they have negative effect on the sperms and may hinder pregnancy . tou husband should try to increase the foreplay time in order to stimulate the vaginal secreations.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sternum pain?\n\nI was kicked in the chest yesterday and now I am having pain in my sternum and it hurts when I take a breath. Doesn t feel like I am getting enough breath and when I take a deep breath the pain gets worse. Am I just sore from the blow to my chest or should I be concerned about something else?",
    "doctor_response": "Thanks for your query. I have gone through your query.The pain in the sternum can be because of the impact or fractured bone. Nothing to be panic, consult a general physician and get it evaluated. You need to take a chest radiograph to confirm the diagnosis. Once the diagnosis is confirmed, we can treat accordingly. I hope i have answered your query. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to control blood sugar level?\n\nI have sugar levek upto 12, i am taking good diet like RAGI roti, PAste, vig juice including karela, and some fresh vig with AMLA powder, Weet gross power, walking every day up to 5 KM in beach sand. bt still my sugar level not coming down. i am a smoker per day 10 avarage. pl sugest me how can i control my sugar level. i use dainil 5 mg tab 2 per day.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You are suffering from diabetes. Your sugar level is not controlled with diet with one drug. You should consult your doctor and need to increase the dosage of your antidiabetic drugs or add one more antidiabetic drug to control your sugar level. Consult your doctor and take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do these shoulder and neck MRI test results indicate?\n\nHi,Back in November I started having numbness on my right armpit and tingling. My pcp order an emg, of my right arm which came back negative. She then ordered an MRI of my right shoulder and neck. The neck MRI showed mild disc profusion a c5-6. The shoulder MRI showed a 70% of the depth of the tendon of the posterior fibers of the supraspinatus and anterior fibers of the infraspinatus, a type 3 downslopping acromion spur . I saw a PA today but i wasn t totally convinced with his evaluation, to begin he mentioned that the tear was of 50% then I asked about the spur he then told me that with PT the tendon can be deviated from the spur. Im totally confused. should i go for a second opinion?",
    "doctor_response": "Dear patient your shoulder mri is suggestive of partial tear of supraspinatus and infraspinatus muscles extending upto 70 percent of tendon depth. This can progress to complete tear with minor trauma. Your acromio is type 3 meaning curved and might impinge on rotator cuff muscles resulting in pain and tear. you need to be examined by arthroscopic surgeon in details and he can guide you for proper treatment. sometimes partial tear needs  repair to prevent progression of pain is significant and associated woth weakness. Physiotherapy helps in many ways if done properly under supervision of sports physiotherapist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes assymetrical legs in babies?\n\nMy daughter is 3 years old and I have noticed that her left leg is assymetrical. She swings her left leg in when she walks and my sister (who is trained in sports rehabilitation) has said that her hip rotates inwards. I have always thought she was just very flexible, as she can get her legs in the most unusual postitions, but now I beginning to wonder if this is more. Could you please explain to me if it is likely that her hip is dyslocated, if so, would this have been present at birth or something that has happened at a later date. If this is the case where do I go from here and what would be the treatment. Not sure if this is relevant, but she was on steroids for the first 9 months of her life due to treatment for multiple segmental haemangiomas. Thanks in advance.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.It is important that your daughter should be examined by a doctor to find out what the problem is. A doctor needs to see her walking or to do different physical examination to find out the cause and to give the right treatment. Better visit an orthopedician.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Emilda Belortaja",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My 6 year old son is reluctant to eat. Please advise.\n\nHello doctor, This is regarding my 6 year old son. He is\u00a0reluctant to eat\u00a0and normally we have to change his focus from meal to feed him (by showing him television or something else). He smells things as well and does not eat if he does not like the smell of it. He likes\u00a0cold drinks, chips, candies\u00a0etc. We met a doctor and he said that we have to reduce or even stop giving him cold drinks, chips and any other outside food. Instead he asked us to give him home made food. But the problem is that he rarely likes to eat home made stuff. We tried many options but he rarely sits and eats. He is very active or I may say\u00a0hyperactive, good in studies but we have to force him to focus on studies while teaching at home. Doctor recommended to have some tests of his blood and urine. Please advise us regarding this issue.",
    "doctor_response": "Hi. From the details you have provided, your kid seems to be a fussy eater. This is a common problem with kids of this age. Reasons for this problem are: Does he fall ill often? What is his weight? This is to ensure that he does not have major health concerns and is thriving well. Weight between 17 to 27 kg are approximately the lower and upper limits for this age. If the reason is 1 or 2, you can try the following measures: These are few ways which can be tried to avoid junk food and outside food. If the reason is 3 and if his tests are all fine, then he does not have major health issues and is well grown. Overactive - extremity of it is called ADHD (Attention Deficit Hyperactivity Disorder). But it is difficult to diagnose without seeing the child and examining in detail. You can consult a paediatrician online for further queries regarding his hyperactivity -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for increasing sperm count\n\nsir i have a problem .that i am habituated in realising sperms since 5years......i am not married what should i do..........it ill harm me later or what.................and i tried to stop it many time but,,,,,,,,,,,,,,,,,,,,,not possible.what should i do to increase my sperms",
    "doctor_response": "Hello, I am sure you are talking about masturbation. Masturbation is normal, natural and healthy. It will not harm your sexual health. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain and rapid heart beat\n\nHello, Doctor. I found this Web site on a search engine link after typing in the keywords, Saline IV causes stomach bloating? . My name is Nicole. I was 27 in January 2014 when I experienced very tight chest pain & the sensation of feeling like I couldn t breathe when I finished my plasma donation at a new Plasma Donor center. The last part of the donation calls for saline to run through the IV so it can calm the heart rate & sort the blood back to normal preventing clots. I alerted the employees at the facility that my chest was very tight. That employee had a nurse come in to check me. Later, paramedics made two trips to see me. I had told them to leave since I was feeling better. After several minutes of monitoring, sitting up in the waiting room eating gold fish & sipping on water, my heart rate never got below 120. When paramedics arrived the second time & placed me on the gurney, heart rate was at 150. I told one of the paramedics my heart was never this high when at rest or sitting down. After being hooked up to an IV at the ER, my heart rate never got below 99. That didn t shock me too much. I went in the plasma place feeling anxious due to the frigid temperatures outside & having a lot of anxiety-induced thoughts in my mind. However, I felt fine until the saline went thorugh my system at the end of the donation process. Keep in mind this was only my second donation. My first donation was a success with no issues a couple of weeks prior. Do you think the saline solution might have caused my chest to become tight due to bloating my stomach?",
    "doctor_response": "I dont think so. as saline only helps maintain the necessity of the body functions. you can meet a cardiologist for the same and get yourself assessed with possible advised tests. post that if the cardiologist permits for some small exercises under guided physical therapist kindly do it. it will help you retrain your cardiac system and get your heart rate fall under the normal parameters. but do meet a cardiologist before any exercise.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dog bite bruise\n\nHi, Yesterday morning my dog scratched my eye leaving me with a very sore, red, swollen, tearing mess! I woke up today and it was completely crusted and gooped shut! I put a warm washcloth on it. But now my head aches, it really hurts and I know I need to go to my eye doctor. BUT ... I don t have any health insurance. This happened to me a couple years ago with my right eye. I did go to the doctor and had antibiotic drops. I checked the label and they expired 5/14. Do you think I could still use this medication safely? Can I use a pressure pad and rest my eye and hopefully will it heal itself? Thanks!",
    "doctor_response": "Hello,Thanks for posting in HCM.Kindly do not use medications with expired date already. Use pressure pads on eyes. You can buy same new eye drops as were prescribed to you previously. Take paracetamol tablet for headache and also to keep fever low if at all it comes due to infection. It will also help reduce the inflammation.Use and see for not more than 5 days. If there is no improvement in that time then kindly see ophthalmologist as soon as possible as the injury could be worse than before. It will actually advisable to show the doctor right now but if you feel it\u2019s same as before then you can wait for few days due to your insurance problem.   I hope I have answered your query well. If you have any more question kindly write back to me, will be happy to help you out.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness and lump in throat?\n\nHi, I'm a 31 year old female. For the last 2 months i've been having a tightness in my throat, its more tight on the right side. I also feel like i have a lump in my throat under my adams apple. The doc says he thinks i'm having anxiety. I don't have any pain or swelling and i swallow fine. I am a smoker. Please help!!!",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.Your Doctor may be right in one sense. This type of a problem is seen in female patients of your age group only. BUT: this is true ONLY if the investigations prove that there is no organic / somatic problem.This is confirmed by doing an endoscopy, CT scan or MRI of the neck and Pharynx. If these two investigations are normal , one can say this is a psycho-somatic problem. Get a medicines for this if you feel it is required OR just be assured that there is nothing to worry about.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe pain in the lower back be treated?\n\nwas diagnosed with prostate ca two years ago as the result of an Mri to diagnose lower back pain. a single stage 4 tumor in the sacral spine was discovered and surgerclic removed. no other mets were found to date. Radiation to surgical area and prosthetic was,applied. casodex was startered as wel as lupron inj. pea went from 37 to 0.024. after a year and 4 months lupron break was given. some body hair and side effects of ADT made a partial reversal. PSA returned to 2.5. Any way to live without ADT side effects. I was trying to find a ner partner and life after 45 years of marriage and a divorce. want to continue.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Can be due to disc disease. Surgery may be needed. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is back pain a normal symptom during pre hysterectomy?\n\nHi I m on lupin for pre hystorectomy and I m having terrible joint pain wrists knees ankles & back I m also taking livial hrt which I thought would help I have my last injection on 2 nd May ready for surgery on 16 may is this normal & will it stop after surgery I also am having weight gain",
    "doctor_response": "it's difficult to tell whether you had multiple joint pains due to injection per se or it's altogether a different scenario. However if you are having multiple joint pains with weight gain it could be rheumatoid arthritis / thyroid disorder etcBut if started with injections then rarely some patients might develop flu like illness with multiple joints involvement.with your symptoms above it's difficult to guess what cause your illness whether a drug reaction or preexisting disease",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is kidney transplant advisable at old age?\n\nHello      I want to consult about my father in law. He has kidney problem from two years . He is on dialysis but now a days he is facing extreme weekness , not able to stand even. Our consulting Doc  suggested us for a transplant . But we want some more information before taking any such decision . His age is 57.Is there anyone help me please .....???",
    "doctor_response": "Hi,Research has been done on kidney transplant on patients above 60 years of age. It shows that the graft function, as determined by serum creatinine level, is significantly correlated with the donor age. It is concluded that in the patients more than 60 years old, free of ischemic coronary disease or after correction of such a lesion could be safely get a transplanted kidney. If your father in law does not have any other risk factors done for pretransplant screening including immunological and viral status and urological examination; cardiovascular risk factors systematically estimated by medical history, physical examination, echocardiography, femoral arterial doppler then there is no additional risk to do a transplantation if the donor is matching.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Red blotches on lower body after showering, itchiness. Due to usage of hot water?\n\nHi, for the past month or so I have been getting red blotches on my skin on my lower body after showering, and they can be itchy too. I didnt think much of it but it keeps occuring. Its not the soap or shampoo I use because I have changed those. Could it be from hot water? Because I do tend to shower with hot water... let me know if I should see a dermatologist or if its nothing to worry about",
    "doctor_response": "H Thanks for posting your query. Your problem seems to be due to heat urticaria which occurs due to heat, hot water etc. You may change to cold water and see if it disappears. Otherwise consult a dermatologist. As urticaria resolves in ten minutes you need not worry about it. Good day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for mild spring cold and sore throat\n\nI have a 4 year old who has a a fairly mild \"spring\" cold and sore throat but also complains of tummy ache around her belly button, she looks a bit pale and is off her food but seems otherwise OK - should i go to the doctor, this has been for 5 days so far?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your daughter's situation and problem. Possibility of viral Upper respiratory tract infection is more in her case. So ask her to drink plenty of fluids orally. Give her antihistamines and anti inflammatory drugs. Ask her to do warm water gargles 5-6 times a day. Don't give oily and spicy food to her.Try all these for 2-3 days and if she is not improving than consult pediatrician and get done clinical examination and blood reports to rule out bacterial infection. Hope I have solved your query. Wishing good health to your daughter. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can erectile dysfunction in a type-2 diabetic be treated?\n\nMy husband is a type 2 diabetic with ed but we can t afford Viagra and we are trying to find a way for him to get and keep an erection sorry to bother you dont have alot of money we are a disabled family thought i could just ask a question but I m truly sorry for bother you dr.",
    "doctor_response": "Unfortunately many treatment options for erectile dysfunction are costly. However sublingual apomorphine or oral phentolamine can be tried apart from viagra. Vitamin E and ginsing may also help. Last but not the least is the strict glycemic control that is helpful.Stay blessed and feel free to ask. Will be happy to answer you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side-effects of Liv 52 DS ?\n\nHi, I was down with Hepatitis A and Jaundice in Janurary and took almost a month to recover enough of join office. Now I am taking Liv 52 DS once a day. My question is that I feel drowsy in general and it becomes very unbearable after lunch specially. What shall I do? What shall I eat? I am on fat free diet .",
    "doctor_response": "Hi, The liver is one of the most important organs of your body and also one of the most sensitive. That's why it takes more time than many other organs to recover. Drowsiness is common post-jaundice because the liver is still recovering from the virus and is not able to digest the food you eat optimally. A dysfunctioning liver manifests excess sleepiness and drowsiness as one of the symptoms. Continue with your fat-free diet, but don't let your liver get used to no fat. Continue with Liv 52 till your physician suggests and slowly restore yourself to a normal diet. You can try a simple home remedy. Have a teaspoonful of honey every night before you sleep. When you wake up in the morning, squeeze the juice of one lemon in lukewarm water and drink it. It will help your liver to recover faster.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in rib cage while inhaling?\n\nI just woke up and I have a pain in and under my rib cage on left side three inches from my sternum, in the ribs and under, like a rib is out maybe, it hurts more when I inhale but hurts all the time, like something is stuck or lodged under there, I very dizzy and my arms feel a little weak, I feel whoozy... Anxious too",
    "doctor_response": "Thanks for your question on HCM.I can understand your situation and problem.Your chest discomfort is on left sided with arm weakness, so we need to rule out cardiac cause first.So get done ECG first to rule out cardiac cause.If ECG is normal than no need to worry much for cardiac cause.Chest pain on inhalation is also seen in pleurisy (inflammation of pleura). So get done chest x ray to rule out possible causes of pleurisy like pneumonia, pleural effusion, tuberculosis etc.If chest x ray is also normal, I think it is musculoskeletal pain mostly due to muscle pull.So try to follow these for better symptomatic relief.1. Avoid strenuous exercise and heavyweight lifting.2. Avoid movements causing pain.3. Avoid bad postures in sleep.4. Take good painkiller and muscle relaxant.5. Apply warm water pad on affected site.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Do we need to remove the uterus for a clot in it?\n\nHi doctor, My mother is 45 years old. Two years before she had pain in her lower abdomen. We went to the doctor, and they said that there are many sores in the uterus, took a biopsy test and said there is nothing serious. After one year when she again had periods problem and pain in lower abdomen, the doctor said that there is 8 mm clot in the uterus and we can manage that with medicines and prescribed medicine. Within one month the pain subsided, and she was fine. Now she has slight bleeding continuously, discomfort in the lower abdomen feels very tired and is unable to do household chores. So again she met a doctor yesterday. Now they are saying that the clot has grown to 17 mm and we need to remove the uterus and no other options are available. Also, they said that if we leave it as such, it will change into a cancerous tumor. We are very much confused. Is it so serious? Do we need to remove uterus for this? Can this not be cured using medicines? Please give us clarity and possible options to cure this problem.",
    "doctor_response": "Hi. I do not see any reason for you to worry and there is no need for any interference. Let me explain. Fibroid and adenomyosis, the two conditions mentioned in the report, never become malignant or cancerous (attachment removed to protect patient identity). What she has is not a clot, it is thickening of the muscles in the uterus. Every month when a lady has periods, her blood flows out. But a small amount of this also flows into the muscles of the uterus, which is called adenomyosis. This can never become cancerous.  Fibroids are very common and formed by the thickening of the muscle layer of the uterus. These both conditions keep growing till the time lady has periods, which means, as long as the hormone estrogen is produced by ovaries. But these never become cancerous. Both these conditions have a common presentation. They cause pain in the abdomen during periods, excessive bleeding, weakness, and back pain. Anyway medications are the best treatment option. Surgery is never the first option. There are medications which can stop the hormones and periods, with no side effects and the symptoms will fully disappear. The best option I can suggest is tablet Novex-DS or Sevista 60 mg (Ormeloxifene) twice weekly on Monday and Thursday or Tuesday and Friday or Wednesday and Saturday. Over a few months, the periods will stop, these problems will disappear, she will have periods once in three to four months. Do not worry; periods are not necessary for health. Over some time, the adenomyosis and fibroids will shrink. She can have it for five to six years. By then, her periods will stop on its own, and then the two conditions will not trouble anymore. Other option is using Mirena or Emily (intrauterine devices), both are Copper T like devices which contain the progesterone hormone. They stop periods and also have a suppression of hormones and the symptoms disappear. This can be kept into uterus for five years and will gradually reduce size of fibroids. Anyway, surgery is never the best option. Better try these medications, and I am sure she will be relieved of the problems. For more information consult an infertility specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had a ureteroscopy to remove the kidney stone. Constipation and severe back pain after taking medication. Cure?\n\nHello doctor I had undergone a procedure for uretroscopy to remove kidney stone, the medicines that I had to take has resulted in constipation. Please advice how I could have regular bowel movement along with the meds aim taking. Iam having severe pain on the back side close to my left kidney, is it because of improper bowel movement.",
    "doctor_response": "hi, perineal injury, or injury during procedure will lead to reflux spams and poor bowel movement. take analgesics and antispasmodics for the pain. take lot of water, increase fibre intake and fruits and vegetables. do regular exercise.. dont postpone the normal reflux. if it does help, see your physician for stool softners. all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes infertility?\n\nhai doc ,we are trying for a baby around 6 months,but  i am not pregnant.my menstruation is not in time. on october  i did nt get my period (oct 23 is my date),i think  i am pregnent, but test is negative,doctor gave medicine(restrogen) to get my period..then i get my period on dec 16,( onlysmall bleeding on this time not like period ).i am very confused becoz why i am not pregnent..we have daily sex..",
    "doctor_response": "oh dear dont worry.i can understand  what situation u r facing.but u should know about ur  or ur husband,s problem as most of the time women think that they r not having baby becoz of them only.but its not true dear.in 80-90% cases decreased  sperm motility and less count is responsible for infertility. let he be also investigated and for u dear i will say that u r suffering from polycystic ovary disease, or irregular period due to thyroid disease so consult to doc and if u have only pcod then u can start today onwards evecare syrup twice daily,folvite 5 mg  and b complex once daily and after one month tt u take clomid 50 mg from 2nd day menses for 5 days.then try .best of luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low sperm count?\n\nHi,i m 24yrs old, i almost masturbate daily from the AGE of 18 and never had sex......now i m finding that my sperm is not as thick as it used to be and the volumes are also very less.........i am just confused, i just wanted to know why is that so and is it possible that sperms can get over or there could be a problem in having a baby from my wife...... pls no joking on this i want a good answers from u",
    "doctor_response": "Thanks for asking in healthcare magic forumIn short: Sperms are produced daily(takes total three months for a sperm to mature) But do not get confused.Explanation: Please do not go by your volume, thickness it can vary from time to time. Sperms are produced continuously so if you are a normal male your sperm will not get over till you reproduce. So, do not worry if you have so much of doubt then go for semen analysis and you will find the answer for your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen glands in front and back of neck?\n\nHi how are you? I've had swollen glands in  the front and back of my neck for about 3 weeks. And I've also noticed I've got this small lump in front of my ear that moves around when I touch it. I've not got an infection anywhere that I know of. What do you think could b causes this? Thank you",
    "doctor_response": "Hi. welcome to HCM. Do you have symptoms of evening rising fever, wt loss, lethargy, past history of TB. That may be enlarged lymph nodes due to TB, which requires fine needle aspiration cytology (FNAC). other rare possibility is lymphoma. It can also be nonspecific simple glands which do not require any treatment.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Creatinine, serum level high, coke colored urine, low grade fever, severe headache, eyesight poor. Reason and cure?\n\nHi, my creatinine, serum level is 1.33, what does this mean? I have coke colored urine, low grade fever, and terrible headache that wont go away. Also my eyesight of 20/15 (checked last year) has gone down considerably. When I went in to get my license renewed, I was told I am considered legally blind in one eye. Please help me figure out what is wrong. I know I have to go to a specialist but no one has an appointment for weeks and I don't wont to stay in the dark that long. Thanks",
    "doctor_response": "Hi dear, welcome to HCM. Kindly see your physician straight away (urgently). You need to check your BP, have certain blood tests (CBC, KT, LFT, Clotting, etc), scan of the kidney (ultrasound) at the very least. The doctor will have a look at the back of your eyes (retina) as well. Creatinine of 1.33 is mildly abnormal only but once again it depends on your age, sex, race and BMI too.CONSULT A DOCToR PRONTO!!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can rupturing follicles of 15-18mm normal?\n\nHi, Im 29 years old and i have taken course of letoval 2.5mg,twice a day from 3rd day of period till 7th day. And duphaston from 16th day till 25th day. This month my period was late by 3days so thought i concieved n done home pregnancy test where in that T band showed an faint line so thought that im prregnant. but after 3 days it started bleeding ., so im not sure whether i can continue the course prescribed by my gynae or not.? So plz giude me.,eagerly waiting to conceive and my follicular study says that follicles are 15-18mm and got rupturing at that. not sure of the ovaluation.",
    "doctor_response": "Hi, a follicle ruptures when it reach a size more than 17 mm. So, it might have ruptured in your case. It can be confirmed on ultrasound. Sometimes biochemical pregnancy occurs after which you can get your periods.  So, if you have got your periods, stop all the medicines except folic acid. You can try same medicines next cycle also. 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 next 2 to 3 days.  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.  Don't get stressed too much.  Hope I have answered your question.Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain,itching and burning sensation in penis after oral sex ?\n\niam 36 years male,5.6 inches,75 kilo,last one year we are doing oral sex with my wife,after ejaculation iam suffering pain,iching and burning sensation in my penis.some times pain in my hip,thigs,pelvic and rib.some times trembling my back side.my motion is going very smelly and clay colour.i did blood and urine culture.that all ok.my bilurumin is little high(2).what i can do doctore pls advise me.",
    "doctor_response": "Higreetings. Pain and itching after oral sex could be because of infections.Oral cavity harbours lot of organisms more than vagina.Bacterial,fungal and viral infections can be spread from mouth.Urine microscopy or even the culture may not show the infection always.We may have to collect the prostatic secretions and examine it.Always take proper hygiene before and after oral sexFor your present complaint you will have to consult an urol5snd get your scro6and Penis examined and proper treatment may be taken. Since the bilirubin is elevated a gastroenterology consultation also indicated as that could be the reason for clay coloured stool.Hope you understood the situation and will take the experts opinion at the earliest. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the kidney and liver spots indicate?\n\nWhat do red and blue spots/markers/splotches indicate on a kidney and liver ultra sound?  Is it an ominous sign? I am 35 years old female, 68kgs  with a strong family history of bowel cancer with both my father and grandfather dying from the disease - my father had secondary cancer in his liver.",
    "doctor_response": "Dear patient,you are probably observing color Doppler ultrasound. Blue spots indicate a blood flow that goes away from the probe, while red dots indicates when blood is coming to the probe. This patterns need interpretation, and this is what radiologists does.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could breathlessness be caused by an anxiety attack?\n\nwell i cant breath i went to the hospital an they sent me home saying if my chest starts to hurt or i get fevers an the breathing doesnt get better to come back but its been 3 days an i cant breath no chest problems i was just wondering what are some reason that that would happen.. they told me it was like an anxiety attack but its going on all day an night i cant sleep .. an theres nothing troubling me",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This is more probably due to underlying stress , anxiety manifesting as    breathlessness .*  Needs  proper  management  with behavior therapy , concentration    techniques , relaxation exercises , deep breathing  exercises , YOGA    to  recover  faster .Hope this clears your doubt  .Wishing you fine recovery .Welcome for any further  assistance .Regards dear take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedies to reduce esr in baby\n\nmy baby is 1.9 year old and he has esr level 25 . what should i do. and is there any type of home remedy. he is a boy and having lymphocyte is 71  and haemoglobin 10.3. he is a very fussy eater . i am using pediasure in his milk one time. my email id is  YYYY@YYYY please suggest me some home remedies.",
    "doctor_response": "**1. Normal value of ESR: \u226410 to 20 mm/hour for 1 month to 12 years old, so it could be normal variation of the same, also ESR reflects changes in plasma proteins, and is not diagnostic but suggestive of some ongoing pathology so going by baby age [1.9], I won't suggest any home solution but recommend for Pediatric Consultation",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be concerned about WBC 4.0 and low neutrophils level?\n\nHi there. I m going away for 6 months shortly, I ve been required to have a medical which I ve recently received the results for, I m generally healthy except my neutrophils level has been flagged as low (1.9 - x10e9/L) my wbc is 4.0. Am I to be concerned? I have been prone to infections recently, I ve had a few infected sebhoric cysts, and my lymph nodes have been inflamed several times this year. Thank you",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Your total wbc count is low normal with slightly low neutrophil count. It may be due to some normal variation or viral infection.  If you don't have any symptoms like fever and bodyache then nothing to worry. Just be relaxed. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure lump on shin ?\n\nhi there my daughter knocked her shin on a climbing frame around 4 weeks ago there was a sraping of the skin and a bruise... which disappeared after a few weeks however there is still a golf sized lump under the skin which i am worried about what could this be??? She says it is not painful and is not complaining of any discomfort.",
    "doctor_response": "Hello!Thank you for the query.Such lump is most likely a hematoma. Due to recent injury some small veins have gotten ruptured so the blood has appeared under the skin. Such hematoma if is large enough, can not be absorbed by itself. Moreover it may get infected and turn into painful abscess.That is why I suggest your daughter to consult a doctor and have it drained with needle. In case of any doubts, soft tissues ultrasound should be done.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I kissed my partner before he had a cold sore. What is my risk of outbreak?\n\nHello doctor,My partner has a cold sore. I kissed him before it actually looked like one. I already carry HSV1, but I have never had a cold sore. Did I put myself at risk?",
    "doctor_response": "Hello. Herpes simplex virus (HSV) if once acquired stays lifelong. When it is dormant it does not produce cold sores. When there are risk factors like stress in any form, physical stress, mental/emotional stress, recent illness, surgeries, prolonged sun exposure can trigger cold sores. When there are active sores with blisters and fluid in it, the person who does not have HSV can contract the virus and produce cold sores. Since you already carry HSV, you can have a cold sore with above-mentioned risk factors and it may not increase the chance of getting a cold sore as there were no blisters at the time of contact (kiss). Hope this answers your query. For more information consult a venereologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes muscle spasms when suffering from copd?\n\nhi,my mom has copd , she is on oxygen at home, she is now having bad twitches and musle spams with her arms and legs while awake and worse while sleeping ,she is very tired,and breaks out in severe sweat and her legs are very weak and she is so tired what does this mean",
    "doctor_response": "Hello, As first-line management, you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take Ovasafe and Fertisule to get pregnant?\n\nhai docter.am zainab.i got married 1 year before.am not getting pregnant.my periods are regular.i and my husband done hormonal test n semen count test.i also done hsg test.everything normal.my family docter suggest me to take such tablets are ovasafe...ccq 100...fertisule...please give me some suggestion to get pregnant....thank you...",
    "doctor_response": "Hello,I have gone through your query and understood your concerns. You need to have coitus in between 14th day to 21st day of your menstrual cycle as that is the period for fertilization. As every report of yours came back normal no need to worry much about this. Along with the above suggestion that I gave you ovasafe will help you to get pregnant. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chronic swelling in right nostril. Taking montelukast sodium. History of asthma. Treatment options?\n\nMy son,9yrs old had swelling in rt nostril for about 5 months.He got epistaxis frequently & I suspect something,so I look his nostrils with torch light&i found it.He had past history of asthma since his age was 8 months old. He took montelukast sodium 5mg at night continuously.I am also a general medical doctor& I would like to know your opinion,what shall I do for this. With thanks",
    "doctor_response": "Dear Concerned., Thanks for writing to us. Chronic Swelling in right nostril when you have put Torch light could be due to either (A)Polyposis-mucosal pedunculated/sessile polyps ,may even be originating from maxillary sinus (B)Inferior Turbinate Hypertrophy- For the above complaints consult an ENT Surgeon for a detailed ENT assessment/Endoscopic Surgical Clearance of the above lesions from their root. For Asthmatic Complaint Pls take him for all Baseline Blood and Urine investigations/Chest X-Ray/Pulmonary Function Tests. For maintainance dosage regularly use brochodilator inhalations.In an acute attack pls nebulise him with locally acting Glucocorticoids and Bronchodilators.Avoid Tablets and Parenterals to prevent systemic side effects. As the child grows ,gradually the bronchioles and bronchi grow and expand ,he will also not suffer any attack as the bronchoconstriction will not effect air entry at all.Thatswhy childhood asthma is less dangerous compared to adult onset asthma. Wishing your son a safe and speedy recovery., Best Regards., Dr Lt Cdr ASN Bhushan., Ex-Navy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hello, its been almost a month in a half, to be specific it happened on Sep. 20th. I got bit by something behind my left thigh but it was just a small red bump that grew a bit larger, smaller than my palm. It hurt when i would push on it but within the next 2 days it went away without a trace. Then i started to get joint pain or cramps when i would stretch or bend down on my left leg where i got bit, also with shortness of breath. Now it feels as if my left arm is weaker and i get stomachpain that stinks but goes away. It all feels kind of like arthritis and joint pain. Im bad at explain but I would like to know if its bad or if it'll pass.",
    "doctor_response": "Hello,Thanks for writing to the same,I have read your question,It looks like the body is undergoing reactions into some kind of toxin or an enzyme released by the thing that bit you,  the effect of various toxins can be different and without knowing about the exact toxin it is difficult to conclude anything.I suggest you to consult nearest general physician first and if the problem persists consult a dermatologist also.Arthritis is generally not not caused due to bites so we can rule that out, taking prescribed medication will help you to recover very soon.Wishing you a good health and a speedy recovery,Dr K Sanga Reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Accidentally cut the testicles with razor while shaving causing wound & bleeding\n\nSo i was taking a shower and got a gillete razor and was shaving my testacle and i cut my left testicale and i put a peice of toilet paper on it and let it heal when i thought it was healed i took it off and touched it and it burned and started to bleed again should i be worried.",
    "doctor_response": "HelloYou should wash it with antiseptic soap or solution and keep it cleanYou can apply antibacterial ointment like mupirocin to avoid infectionyou should avoid further injury wear loose fitted underwear.Let it heal.If you can upload a photo I will be able to tell you more accuratelywishing you good health and speedy recovery",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cough, numbness in gluteals and lethargy?\n\nI have been coughing up catarrh/mucus for 9 days now (usually just in the mornings shortly after waking up) but now I have what I feel to be associated numbness in my gluteals and also thigh/calf/ and joint areas on each leg - in addition to a general lethargy. The cough has moved to the next level over the last 2 days and is now quite dry and sore indeed - any ideas?",
    "doctor_response": "Hello dear , hiWarm welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  Cough is  in relation with respiratory infection .*  Lethargy and numbness in muscles are in relation with systemic  issues      as -  low  blood pressure  -  underlying pyrexia condition  -  deficiency of    nutrients , trace elements  or  others .Hope this will  help you for sure .Wishing you fine recovery .Regards dear take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I wait until delivery for tooth extraction?\n\nhi i am almost 6 months pregnant and the gum behind my impacted wisdom tooth is sore and inflammed. i went to the dentist and he said for me to salt water rinse and good oral hygiene and i should be okay. The pain isnt that bad only a little sore when my tongue touches it. Do you think i will be able to wait after i give birth to remove my tooth? i have only 3 more months.",
    "doctor_response": "Thanks for your query. I have gone through your query. The pain could be because of the pericoronitis means infection of the gum around the wisdom tooth. You need to take radiograph to see the amount of bone covering around the tooth before removal. Since you are pregnant you cant go for radiograph so take symptomatic treatment like topical anesthetic and analgesics like anabel gel. Do saline gargling. Do not take any other medicines without prescription.. after delivary you can get it removed. I hope my answer will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sore and itchy tailbone. Applied hydrocortisone. Difficulty walking down stairs\n\nHello these past 2-3 days I ve noticed that my tailbone very sore. It s been itchy for a week and I might have been itching to hard? I applied hydrocortisone but it seems to help for an hour or so. Now I hav somewhat a hard time walking down the stairs I have to old my butt in order for it not to hurt and I can t sleep on it",
    "doctor_response": "Hi,Thank you for posting your query.Based on your symptoms, it could be coccydynia, a painful condition related to the tail bone. As of now, you can take analgesics such as ibuprofen or diclofenac tablets. If the pain persists even after 5-7 days, you can consult an orthopedic surgeon. An MRI of lower back may be required for evaluation.As of now, there is no need to worry.I hope it helps.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for the congestion, irritable nose and redness around eyes?\n\nmy daughter has been diagnosed with pollen allergies since she was 3...she is 6 now....we ve been on different medications, but the longest she took something was l-montus kids, for a yr.....she gets congested, irritable nose and redness around eyes from the pollen...rt now its winter in georgia, USA....pollen levels are minimal...but I still have to give her the medicine or her eyes get red and swollen....any suggestions?...want to minimise medicine usage",
    "doctor_response": "Your daughter seems to have quite a severe form of pollen allergy ,normally called hay fever ---it appears that there is quite a lot of discomfort --inspite of monteleukast medication inaddition to symptomatic decongestants ---at this point the main idea is to take her away from the allergen --pollen --sometimes when this irritating agent can be given in small doses may desensitise .The plan of management includes --keeping away from pollen ,decongestatnts ,creams ,she may need steroids short courses to help her during acute discomfort or pain.the good news is her airways seem to be free and no cough",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes an increase in the heart rate during workout?\n\nI was recently working out with a trainer for the first time. During the workout I felt fine. It was after the stretching that I felt my heart rate up and my arms tired and tingling. When walking to the car I felt a bit nauseous. I am still sore from the workout a couple days later, but are fine otherwise. Is this just from a lack of activity? I am 47, weigh 178 and have no health issues nor have had any. Last physical 2 years ago showed everything fine",
    "doctor_response": "Hello, After going through your medical query I understand your concern and I would like to tell you that heart rate is ever changing phenomenon depending on your physical activity, stress and physiological changes. After workout, you might have low blood sugar levels and you felt a rapid heart rate, so it is recommended for you to have 2 digestive biscuits or a cup of juice before workouts. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes coughing with metal taste in mouth?\n\nI have a really bad cough for the past week, and at first it was just a bad cough then it started to taste like I was coughing up blood but there was no blood and now I have this awful metal taste in my everytime I cough or sneeze.  What could be causing thia",
    "doctor_response": "Hi thanks for contacting HCM.Noted you have main complaint is of cough.Let me know you whether it is dry or wet cough????You might had viral flu infection ....So it can lead cough as by infecting respiratory tract....Let me know you if you have acid reflux disease then also by irritation cough can occur.Do you smoking?As here bronchitis like condition might lead cough .chest x ray useful which show prominent bronchovascular marking...Metallic taste here I think need not much concern.Maintain oral hygiene for it.Drink more water...Avoid respiratory irritant like pollution smoke, cigarette smoke, spicy food etc....I hope your concern solved.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for frequent sneezing\n\nhello, sir i'm 25 yrs old and i'm suffering from  sneezing   for a last 5 yrs and i take many treatment in alopathy homeopathy and aurveda but i'm not well  plz send me your complete add and fee thanks",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your history and would like to make following suggestions to you:1. I usually prescribe such patients regular montelukast and levocetirizine.2. I would suggest you allergy testing which will help you identify the substances causing allergies to you and also to know the measures to avoid them.Based on the allergy test, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which works on immune system to improve allergy symptoms gradually over long time.3. I usually also prescribe my such patients vitamin C for 2-3 months.4. In general, I would suggest you to avoid exposure to dusts, smokes and air pollution as much as possible.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce penile sensitivity?\n\nhey I have a problem .. it is not masturbating , the problem is that my penis head hurts when i touch it since I am young , the problem is the sensitivity I guess because I didnt touch it before my phimosis operation .. now I dont't know what to do to make it less sensitive ( it looks very healthy , but it is just too sensitive )",
    "doctor_response": "Hi, It may be because of your operation and the tissue is still healing. Please give some time before starting sexual activity or masturbation again. Meanwhile you can apply local anaesthetic jelly. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Sujoy Dasgupta, OB & GYN Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat penile infection?\n\nI am a diabetic and continously suffer from penile infection in which my foreskin cracks after intercourse.  What are the disadvantages and advantages of getting circumcision done?  What medical term do you refer to in this cracking of the foreskin in diabetics?",
    "doctor_response": "Hello,Welcome to HCM,The histroy and symptoms are suggesting me that you may be having Balanoposthitis. This type of infection are more common in patients with reduced immunity like diabetes. I would suggest you to follow1.Proper hygiene and regular washing of prepuce is useful for the prevention of     balanoposthitis.2.Topical antibiotics like metronidazole cream and antifungals clotrimazole cream.3.Circumcision is helpful in recurrent cases like you.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated CEA levels in blood?\n\nHi, I just done my yearly blood test screening. All result are okay, but CEA is 20n. I don t have cancer history nor my family do. I don t sense any cancer symptoms as well. I just have c-sec delivery 1/2 ago, not sure if this affected. What should i do for this high level CEA? Should I redo again the blood test ? What should i do for",
    "doctor_response": "Hi,Thanks for writing in.The normal value of CEA is less than 3 in healthy non smokers. It can indicate cancer of bowel, pancreas, ovary, breast, liver and lung among many others. However it does not always indicated cancer in a person without symptoms.The concentration of carcinoembryonic antigen (CEA) in serum should not be used to screen asymptomatic individuals for neoplastic disease, and the diagnostic efficacy of CEA measurements in high-risk groups has not been established. Single values of CEA are less informative than changes assessed over time. Please discuss with your doctor and get the test repeated after a few weeks and to check if it is a concern. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing my upper back pain on the left side?\n\nI am having upper back pain on the left side.  Started just about 5 days ago and came out of nowhere.  It is a deep, burning pain that is always there and at times gets even more severe.  It's is so painful.  Any ideas what could have brought this on?  I am taking tylenol daily for wrist injury but only take 600 to 1200 mgs a day.  Have been taking it for a month now.  Is that making things worse?  Could it be referred pain from my liver?  Google is giving too many options of what it could be.  I need a doctor's opinion.",
    "doctor_response": "Hi,From history it seems that due to taking tylenol 600 to 12oo mg daily since long might have produced severe hyper acidity or gastritis giving this problem.Stop taking tylenol.Take omeprazole or pentoprazole daily one for some time.Go for stool test for occult blood.Take more milk.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for back pain when on simvastatin?\n\nI have been suffering from really bad lower back pain, like I never have before, for the last 2-3 months. as far as I can tell the ONLY thing I did was start using simvastatin at about the same time. My lower back, left and right just below my ribs and a littler higher off my hips feels like glass ready to break. I deal with it but serveral times a day the pain make me whinise. I havee an appointment with my doctor friday. I am 66 and have been in great health all my life, 6 2 215lbs and drink red wine 4-5 days a week..2-3 glasses per night.",
    "doctor_response": "Hi, Welcome to Health care magic forum.                     As you describe it appears to be the arthritis of the spine, stenosis,or deformity of the spine,also may be due to the urinary tract infection or the stone in the ureter.                       I advise you to consult an orthopedic surgeon for diagnosis and treatment.                      You may need to have a C.T. scan for confirmation.                     I usually prescribe to my patient with such symptoms neurotropic injections for 10 consecutive days,and then periodically,calcium suppliments, and pain killers.                      Avoid taking potato, other tubers,tomato,egg, chicken,and and sea foods.                      Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the ideal dosage of colic aid?\n\nHello drToday morning my baby was continuously crying,after some time we came to know that she doesn't release the gas. so we given 0.5ml colic aid to baby. My baby is 1.9yrs old. Now she is sleeping .i'm little worried about the dosage given.plz suggest and advice me",
    "doctor_response": "For a child of 1.9 years age of average weight, 0.5-0.75 ml is fine to be given and therefore you can even increase it slightly without worrying. 0.75 ml would be around 15 drops. When the child cries continuously, it could be suffering from colic and hence colicaid is generally given. You have done the right thing. Do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Our 2 months old baby poops all the time. Please suggest some medicine.\n\nHi doctor, Two months ago, my wife delivered a baby boy. 10 days before, we brought the baby home from my wife's place. Since then, he\u00a0poops all the time and it is mostly mucus-like with a little odor and watery. I guess there is some fungal infection around the baby's anus. We went to the doctor and he prescribed a few antidiarrheal syrups. But, there is no recovery at all. The baby is crying most of the times. They also suggested to use a dusting powder, but it seems that it is not helping much. He still has pain. We cannot seem to find where we went wrong or the doctors we went to do not take their jobs seriously. Everyone at home is so tensed for the baby's health. Also, from birth, the baby is making some sound when inhaling. The doctors used nebulizers and the suction machine. But, the sound is still present. The pain issue has been present for two weeks and the infections have worsened after medications. Please help.",
    "doctor_response": "Hi. You seem to be very worried and I think this is your first child, which is why all the worry is taking place. For further information consult a child health specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does ovarian cyst cause complications in conceiving?\n\nHi doctor, i got married 2 yrs back still have no child. I have choclate cyst on left ovary of size 23x18 mm, my weight is 58 and height is 156 cm. i am 26 yrs old. Is there any big complication. My husband also has low sperm count. Is this cyst size safe for pregnancy. Pl help me",
    "doctor_response": "HAI WELCOME TO HCM you need laparoscopy surgery to remove your choclate cyst. then only we can stimulate you for ovulation. low sperm count will need IVF to conceive. endometriosis removal followed by IVF will gelp you conceive soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shortness of breath\n\nHi my name is Michael I am a 11 year old Boy. What is happening to me occurs every couple of months like 4 months. I have shortness of breath and I have to yawn every couple of minutes... And it doesn't get worse. Sometimes I am able to get a good breath. And when I have my mind off of the fact that I can't breath it goes away...",
    "doctor_response": "Hello Thank you for trusting HCM Dear Michael just answer me for few questions?? Is this problem accuring particular season in the year?? Have you feeling nasal congestion or sneezing during episode?? If you feel dysnea how much time it will subside?? Any triggering factors?? Like cold, dust, food or pollen?? Have you feeling palpitations during attack? Any chest tight Ness?? Dear probably your suffering from like panic attacks or bronchial asthma or hyperventilation etc.. Your history not proper to come to diagnosis, so there may be a chance of Adenoid hypertrophy. Please consult your doctor he will examine and treat you accordingly. I think I answered to your question if you have more questions please feel free to ask me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure heaviness on left chest that is radiating towards back?\n\nI feel a heaviness in my upper left chest and a pretty constant pain. It feels like there is a lump in my throat about half way down and even constant swallowing doesn t help. The pain is extending to my back on the left side. I am a 54 year old female, 5 feet 3 and 198 pounds. I have high triglycerides (440) but am on medication for blood pressure and it is well controlled.",
    "doctor_response": "Hello MaamAfter going through he medical details provide by you i would like to advise you to consult a cardiologist personally and get one EKG as well as an ECHOCARDIOGRAPHY done because you have high TRIGLYCERIDE levels as well as Hypertension both of them are a risk factor for developing CORONARY ARTERY DISEASE. Also the kind of chest discomfort you are telling it fits into the ANGINA picture.Female after there menopause become twice more prone to CORONARY ARTERY DISEASE as compared to men.So get your self evaluated on time. Till then take a baby Aspirin as a precaution.I wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes left side chest pain, nipple pain and burning sensation in head?\n\nHi, i am 15 years old. I keep getting pains in my left chest area, then my nipple starts to burn. Also when this happens the right side of my head it burning. What is this? what can i do to help? why is it only happening at nights and when I am alone?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Since your symptoms are occurring only at night and when you are alone, possibility of stress and anxiety related symptoms is more. At your age of 15 years, heart and lung diseases are very uncommon. So stress and anxiety appear more in your case. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic drugs too. Don't worry, you will be alright. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent bowel movements even after medication?\n\nmy kid(3 years) got Viral stomach infection , it started from vomiting and than loose motions . she told to give sporlac for 2-3 days , now 3 days are over but she still passing stool 4-5 times in  a day  and not eating much do i need to continue with sparolac?",
    "doctor_response": "Thanks for your query at HCM.I understand your concern and situation as a mother.Most of the cases of diarrhoea are due to viruses like rotavirus, adenovirus, etc. These are self limiting and resolve in week time. Till that you just need to keep your child hydration maintained by oral fluids like ORS after each episode. Feed child properly with light diets no spicy or too oily whatever she likes. Don't give beverages and sweet juices. Sporolac can be given. As prophylactic measure get stool routine microscopy examination done and culture sensitivity test for aerobic and anaerobic bacteria. If child look dehydrated needs emergency management by hospitalization.Take care.Dr. Sheetal Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could hepatitis-A with nausea suggest?\n\nI had a hepatiti-A 4 yrs ago but still sometimes I feel nausia whenever I take too much spicy food & also sometimes a little bit of burning in my eyes but although my LFT & other blood profile shows normal whenever I tested. The doctor said I'm normal",
    "doctor_response": "Hi,Your symptom (nausea) may be due to underlying acid reflux disease especially if your are feeling heartburn or metallic taste in the mouth in the morning. Avoid overeating, coffee and fat-rich food, no alcohol and try to quit smoking, If you are a smoker, you may take Nexium 20 mg once daily before breakfast for 2 to 4 weeks. If symptoms persist, visit a gastroenterologist or treating physician. Wish you good and sound health. Hope I have answered your query. Let me know if I can assist you further. Regards,D. Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Loneliness feeling, want to stay indoors all the time, get angry over small instances, have frustration. Was an outgoing person earlier. How can I get over this?\n\nhi i am 29 years old and i feel alone all the time, i have a boyfriend and all i do is fight with him, if he leaves the house i get angry at him and just feels like leaving and never coming back, i don t want to go anywhere, i just want to stay at home all the time, there is times i sit down and cry if i am alone and i when i don t get what i want. it is really taking over my live and i am sick of feeling like this all the time. i used to be an outgoing person and loved to go places but now i am just angry and frustrated all the time.",
    "doctor_response": "hi..your symptom-profile indicates towards depression..so just visit a psychiatrist and get well..have a healthy life..thanks..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have primary igadeficiency. Got osteoarthritis in knee and spine, asthma, depression, anxiety. Taking ceftin bid, hizentra sub q\n\nI HAVE PRIMARY IGADEFICEINCY AND WAS RECENTLY TURNED DOWN FOR MY DISABILITY, I AM AN RN AND DO NOT FEEL THAT SS REALIZES HOW THIS IMPACTS MY JOB. HAVE SEVERAL OTHER HEALTH PROBLEMS-OSTEOARTHRITIS IN LT KNEE AND SPINE, ASTHMA, DEPRESSION AND ANXIETY. BUT THE IGA IS MY MAIN PROBLEM. WHERE MIGHT I GET INFO TO GET THEM TO UNDERSTAND? I CATCH EVERYTHING THAT COMES AROUND. ON CEFTIN BID AND HIZENTRA SUB Q WEEKLY. THANKS.",
    "doctor_response": "Hi and thanks for the query,I do think it might be necessary to get a comprehensive care, and the opinion of an internist for follow up and your primary care physician could be helpful. A complete clinical and biological review to determine the actual causes of the symptoms, rhuematological review and the opinion of a psychologist/psychiatrist could be useful in drawing up the initial management plan. I think what is important is not the drugs only, but the feedback and being constantly in touch with your doctor. thanks and hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is blood clotting disorder hereditary?\n\nMy son has just found out that he has a blood clotting disorder that was passed on to his three children. He has a sixteen year old daughter that had to have a kidney removed last year because of a blood clot to her kidney. My question is this a disorder that comes from both parents?",
    "doctor_response": "HiThanks for writing to us.There are different types of clotting disorders.Most of them hereditary.In some one parent may be affected , in some ( autosomal recessive ) both parents may be apparently normal. Only blood tests can reveal if they are carriers.Do complete workupWishing good healthRegardsDR ARUN",
    "dialogue_context": ""
  },
  {
    "patient_message": "Insecurity, feeling of fear of being caught in thoughts leading to acts that would make people laugh. How can I overcome this?\n\nI have a fear that if i walk in a street/ public places absorbing in some thought unware of what is happening in the surrounding people will laugh at me. The fear is such a strong that I end up doing the act in the street and people laugh at me. Same is the fear when i am working in a computer in office. I have avoided working in the computer in the office for the reason.Please help me.",
    "doctor_response": "Hi Forum. as you have described it is the insecurity. First thing you have to do is consult a psychiatrist for diagnosis and treatment. Besides treatment i advise you to go out of the feeling of insecurity. try to do yoga and meditation.  engaged in extra curicular activities like reading. music gardening etc. I advise you to have healthy diet as have green leafy tegetables pulses sprouts  egg meat milk fruits and tuices to keep your mind healthy. i hope you are satisfied with my repl thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness, fatigue and disoriented?\n\nHi, I m feeling lightheaded, dizzy, somewhat disoriented, concentration poor, fatigued, awkward. I just got off my treadmill after walking 5 miles. It is very humid out, however I did drink while I was on the treadmill . These symptoms are continuing; lasting about 3 hours, so far. My Blood pressure is fine as is o2 sat.",
    "doctor_response": "Hi ,these symptoms are due to excessive sweating leading to dehydration  hypotension  and electrolyte imbalance.I advise you to take rest and plenty of water and energy drinks. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for a bee sting\n\nI got stung by a bee yesterday on the side of my foot at about 2 pm it made sure the stinger was out but it was still very painful for a good 30 mins after hours later the pain is just gettin worse hurts to move or touch my foot and very awollen but its the top of my foot above the sting that hurts and swollen it doesn t hurt where I got stung also I m 32 weeks pregnant what should I do?",
    "doctor_response": "Hello,Welcome to HCM,The sting can result in an allergic reaction due to the secretion of venom. Allergic reactions can be immediate or delayed, though immediate reactions are more common.The treatment varies slightly according to the severity of the reaction. In severe reactions (decreased blood pressure, increased pulse, hives, difficulty breathing) hospitalization is required for treatment.Where there is only swelling and rash, you can treat at home by the use of oral antihistamines such as benadryl. In addition, if the area is painful, you can use paracetamol.If the severity of the reaction worsens, then you would need to seek medical attention.If you haven't had a tetanus shot in the last 5 yrs, you also need to take a booster dose.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the lifespan of a person suffering from stomach cancer?\n\nhi,my husband had a stage i stomach cancer dectected in late sept.2010.he had 2/3 stomach removed after a month and the doctors said he  does not need chemo or radiation  but must review once a year.Till now is is fine n eats everything.At this rate how long will he live?.He is 50.thank you",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Hevhas stomach cancer of stage 1.  And he is treated by surgery at very early stage. So life expectancy is very good.  Don't worry much about that. Just be relaxed.  Just go for regular follow up. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are the signs of urination and no sperm production due to elevated PSA?\n\nI had a 2.89 PSA test 16 months ago. My Dr sent me to a uroligist for the 2.89 score, He did a prostrate biopsey and test was good 16 months ago also. Then my new PSA 16 Months later jumped to 5.0, shouls I have another biopsy done? I have all the signs urinating at night a few times, no sperm production etc.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.PSA or prostate specific antigen is the marker for the carcinoma or malignancy.Its rising rapidly, this is the indication for the carcinoma of the prostate.Yes, in my opinion you should go for the second biopsy. Because biopsy is the only method which can confirm the cancer and its type.Method for the treatment can only be known thereafter.Till that time you can continue with the medication you are currently taking.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can difficulty in breathing, neck pain and back pain be related?\n\nFor several years now I've had difficulty breathing due to what feels like the muscles around my rib cage constricting. It feels like I can't expand my chest properly. In addition i've had severe back, shoulder and neck pain accompanying this. For awhile i had tingling in my hands, feet and face, but this went away after awhile. Tests were negative for cancer, lupus, arthritis, and pericarditis. Chest Xrays were normal. Blood tests /did/ show severe anemia, but improving my diet by adding more red meat only stopped the tingling. Medication allergy was ruled out by taking me off them. Anxiety ruled out. Anti inflammatories and inhalers are NOT effective against it. Every doctor I've seen about this has been stumped. The sleep supplement Melotonin has actually been /very/ effective against it. But the supplement started causing rapid heart rate. Still, when i finished, the condition was 95 to 99 percent GONE. The most recent Doctor insists its asthma because he ordered a methocholine test. But the methocholine test made it WORSE. It caused an acute asthmatic reaction where i'd previously had NO history of asthma, undid /all/ the good done by the melatonin, and then made a bad situation worse. And the doctor REFUSES to believe that it /wasn't/ asthma causing the problem. Present in the place i was living at at the time were high amounts of bleach and ammonia based cleaners, dust, mice, insects. The woman I was renting a room from used easy off EVERY time she cleaned and the smell of the easy off, ammonia, lysol and bleach would cause a breathing reaction. In addition, she lent me something she said was a tylanol sleep aid, was marked as a sleep aid, but after things I went through with her i do NOT trust her anymore. Preexisting conditions:  Aspergers disorder, lypoma (benign fatty growth), Fibroma (benign fibrous growth), /extreme/ period pains, intestinal difficulties, dust allergies, wool allergies, occasional pet allergies, and hayfever. Family health problems that I don't have but are genetic to my mother and father include high cholesterol, diabetes, obesity, depression, and anxiety. Everyone i've seen has tried to make it seem like anxiety or attention seeking behavior, believing its all in my head when I'm in REALLY serious physical distress!  I need a list, something that I can look up and reference and BRING to my doctor.",
    "doctor_response": "Hello,Seems most likely due to decreased immunity of the lungs (due to chronic exposure to bleach and ammonia-based cleaners, dust). Neck pain has to do with pulling of musculature during strain but back pain is separate (muscular or other). In my opinion now the only thing left for you is naturopathy including:\u2022 Highly dedicated deep breathing exercises\u2022 Concentrated meditation sessions \u2022 Regular walking in fresh air, exercises at home \u2022 Yoga\u2022 Balanced nutritious diet to combat all possible pathogens invasion\u2022 Avoidance exposure to all nasty particles, liberal use of face mask\u2022 Avoid stress, anxiety, regular sound sleep of 8 hours \u2022 Avoiding all alcohol/tobacco products if using\u2022 Strict dietary management \u2022 Control of BP, blood sugar, cholesterol, oxygen saturation, weight levelsHope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have some rashes that itches due to hair dye\n\nOne month ago I dyed my hair and now I have this rash that itches and drains liquid on the back of my ear , i went to the doctor and he said it was chemical burns. He recommended neosporin cream, but it still hasn t gone away and it stings. This isn t normal, how do i fully treat this?",
    "doctor_response": "Dear, welcome to healthcaremagic It may be due allergic itching due to color and dye. I recommend you taking some Ayurvedic preparation iontment available in the market 1. six c 2. Gerbex i hope it wil help  you Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the lump on the left clavical at sternum?\n\nI have a lump that comes up on my left clavical at sternum, it is there in the morning but goes down after few hours.  It has been doing this for about a 8 weeks.  Now there is pain in my arm at the deltoid and sometimes in my neck.  I am a 52 yo healthy woman.",
    "doctor_response": "Hi ! Good evening. I am Dr Shareef answering your query.It might not be possible to suggest a diagnosis of your problem without a personal clinical examination of the lump when it occurs. Therefore I would advise you to see your family physician/general surgeon while the lump is there, who after a clinical examination might also suggest you some investigations like an ultrasound/MRI of the area and an FNAC if need be to arrive at a definite diagnosis. Further management would depend on the results of the investigations. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having guilt by doing wrong at the past. Depression, anxiety, pain in stomach. Is it due to guilt?\n\nI did something wrong a while back, and now I feel like I have guilt and perhaps depression/ anxiety . My stomach has been in pain for months now. Could this be the guilt? Or should i see a doctor? I m really worried and it s caused a lot of discomfort. I haven t taken any medication in about 4 years. So far all I feel is an upset stomach and as a result, I have a hard time enjoying myself, and often don t want to interact with people or go anywhere.",
    "doctor_response": "Hello, Thanks for using health care magic. Yes anxiety can present with many types of physical complains including abdominal pain. However abdominal pain can also have many different reasons . So firstly you should get a USG abdomen done to rule out any organic cause. If not then then you should treat yourself for some psychological causes. If USG is normal you should contact a psychiatrist who can involve you in some talk therapy to ventilate your guilt and make yourself think rationally. Hope I am able to solve your query. I will happy to help you if you need any further clarifications. You can contact me directly on the link:",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can central disc protrusion and cervical osteophyte be treated?\n\nI have central disc protusion at C3-C-4, angular buldge at C4-C5, and at C5-C6 there is broad based disc ridge comlex eccentric toward the right with effacement of central CSF.  In additional progressive cervical osteophyte formation and bilateral dilated root sleeve cysts of C7 nerve root.  Why does the orthopedist want me to see a neurologist?",
    "doctor_response": "welcome to Health care magic.1.The disc which is suppose to be in the centre between the vertebral bodies have moved from its place and causing compression on the nerve and chord.2.Osteophytes are generally seen in age related or excessive usage (hard working conditions) generally treated by minimising the mobility in particular area.3.Why you have been asked to see neurologist id because the disc is causing pressure in the nerve and chord and CSF space effacement, its little more toward nerves than the bone.4.In your case i think the treatment is operative / intervention procedure.Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fainting along with dizzines and nausea?\n\nI was air lifted to hospital 1.5 weeks ago because I passed out. They ran all the tests: Cat Scan, MRI, Heart monitor, Echo and everything was normal. They could not figure out what it was. About three hours ago I started feeling the way I did then. It started with a little nausea, feeling hot and dizziness. I am not sure if I need to contact a doctor again. Does this sound familiar to your?",
    "doctor_response": "Thank you for asking Healthcare majic. My name is Dr Ehsan Ullah & I have gone through your query.well wats the status of sleeping habits.are you experiencing insomnia??any sorts of palpitations??do take omeprazole 40mg once a day before meal or breakfast.take proper rest and free of mental stress i hope you will feel fine soon.Hope this may help you. Let me know if anything not clear. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any need of INH in case of borderline TB igm?\n\nhi.. m a doc with tb lymph on treatment.. my spouse is keeping unwell for quite some time..to b precise he complains of chills at night... got all possible prelims done..the pulmonologist suggested.. cbc,esr,crp,widal,malarial smear,urine routine,lft... all normal.. but the mountoux came in strongly positive an induration of 15mm..he isnt having any cough,phlegm, etc..chest x rays look perfectly right too.. lymph nodes normal..so the microbiologist suggested a tb igm.. which gav a borderline 0.8 result(normal is 0.0 -0.8).....hes maintaining a temperature chart.. temps in normal range sinc a week...wondering whether to unnesseraily put him on INH?.....MEANTIME I AM NEARING THE END OF MY INH TREATMENT.. AND AM KEEPING PRETTY WELL..",
    "doctor_response": "Hi,Welcome to HCM,TB Igm borderline reactivity with MT positive strongly in countries where TB is endemic than no treatment is required but in countries where incidence of TB is low wld require inh treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the forceful snatching of wrist by a 2 year old be a matter of concern?\n\nmy 2 year old snatch away from my wife holding his wrist area and it seems as though he really hurt himself... My question is should i go get an xray or see if he is seriously injured or if it is something that we the doctors will not be able to much more than we can do on this matter?",
    "doctor_response": "Hi,If baby is alright then do not take the baby to anywhere but take your wife to psychiatrist for such violence on such small baby. Don't mind but do not make your babies suffer for your own personal conflicts. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Hina Javed",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause bleeding for a person diagnosed with Fybromyalgia?\n\nMy mom has been diagnosed with Fybromyalgia about 7 months ago so she always has head aches but they have been more severe just three days ago she started bleeding from the left side of her noes and is becoming more frequent and just today we discovered her left to be bleeding what could be the cause of this???",
    "doctor_response": "Hello,I am Dr. Selmani and I read carefuly your questions.in order to give you a better answer for your question, i would like more infornation regarding what medication takes your mother for fibromyalgia treatment.I presume that she is taking non steroidal antinflamatory drugs which may have side effects on rasing the  blood presure and making the blood thinner.So i suppose that this two side effects of medication may have caused the nose bleeding.I suggest you to check the blood presure and medication for fibromyalgia.All the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is conception possible post family planning operation?\n\nhi doctor, i am 29 years old and my weight is 65 kg. I have two daughters aged 13 years and 8 years. After that i got family planning in 2006. By 2012 i got a ectopic pregnancy and undergone a major operation. But now due to some family issues i want to get conceive another baby. Is it possible and kindly give suggestions in this regards.",
    "doctor_response": "Hello dearI understand your concernConception is depend on the type of the operation.It Fallopian tune has been removed then conception is not possible.If tube is clamped then after recanalization surgery conception is possible. Success of this operation depends on length of healthy tubes left behind after sterilization.If recanalization is not possible then in vitro fertilization is the only option.So consult you gynecologist and take proper advises.Hope this may help youContact further if follow up neededBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy due to mistake in wearing condom?\n\nHi, I had sex with my girlfriend 10 days ago and I started to put the condom on backwards by mistake, but then I flipped the correct way. I only rolled it down a little before I realized my mistake and then I put it on correctly. I have seen various answers for this question online. Can you tell me what the chances of pregnancy would be in this case?",
    "doctor_response": "Hello dearI understand your concernI do not think there is chance of the pregnancy.You  put the condom backward and rolled just little.So there is chance that precum was contacted with the condom.But this precum is very less and it dose not cause pregnancy.Precum can cause pregnancy when it was enter into the vagina before ejaculation in full penetrative unprotected sex.So I don't think there is chance of the pregnancy.Avoid stress, take healthy diet, drink plenty of water, do regular exerciseHope this may help youContact HCM for further health queryBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes papules on scrotum?\n\nMy son is 4. I am extremely concerned about a sudden outbreak of what looks like warts or boils on his scrotum. It started as 1 now it s 5. This has happened over the past 7 days. His pediatrian says it s popules and told me to use triple antibiotic ointment. I have been for 3 days. Nothing has changed except the most recent one has gotten to be about the size of all the rest. They all started out looking like a fire ant bite but he has not been bitten. Not even a option. They are all now the size of a wart or larget mole. They do not itch or hurt.",
    "doctor_response": "Hi...it can be scabies or eczema. I suggest you see a dermatologist for it. But, Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excessive hiccups with vomiting in an infant?\n\nmy 28 months daughter hiccups alot , recently she started throwing up randomly without a pattern not everyday not even every week , she just vomit out of nowhere especially at night around sleeping time i tried to find any connection between these days but nothing everytime she d a different thing at dinner so what could be the reason",
    "doctor_response": "Thank you for posting your question.Hiccups occur due to diaphragmatic irritation and this could be due to a variety of reasons one of them being over distention of the stomach.Here hiccups and vomiting could be two unrelated symptoms or could be due to a condition called gastro oesophageal reflux.In this conditions the contents of the stomach regurgitate back to the food pipe manifesting occasionally as frank vomiting. This may be preceded and caused by gastric over distention leading to hiccups. This may also be due to dicreased tone of the lower oesophageal opening leading to recurrent regurgitation.I would suggest, you try some changes like putting him to sleep atleast half an hour after his meal, keeping the head end high or putting her to sleep on his left side.If there is no change then I suggest you take a medical consultation and consider taking medicines like proton pump inhibitors to decrease the acidity of the stomach and thus the reflux symptoms. If you have any more doubts, do write back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for itchy scrotum\n\nHi, I am suffering from someone sort of reaction or irratation on my scrotum it could be the new soap I used or I recently shaved the hair under my penis which I rarely do. It is not dry down there but extremely itchy at certain times especially at night. any help?",
    "doctor_response": "Hello dear,The symptoms as mentioned in your post suggest that you might be having chemical dermatitis (due to the new soap) or fungal infection (Tinea) in the scrotal region.Management includes:1. Keeping the area dry & avoid too much exposure to water or sweat formation.2. Antihistamine preparations like cetirizine to reduce the itching sensation & provide symptomatic relief.3. Application of topical antifungal cream like Clotrimazole to tackle the causative organism.If symptoms still persist or aggravate further, then it will be better to consult a Dermatologist & get a proper examination done to find out the actual cause.So that appropriate management steps could be taken.Also avoid wearing tight undergarments & trousers...as it will cause sweating & predispose to fungal infections.Wishing you a Good Health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had klebsiella pneumoniae in lungs now in kidney. Related? Dangerous?\n\nIn 2008 I had Klebsiella Pneumoniae in the lung and didn't know if i was going to recover. Now i have klebsiella pneumoniae in my kidney. How are the two connected, and how dangerious is this in my kidney. I have weaken amune system from cancer in 2005.  Please let me know if the two are connected and if it is dormate in my body.  Thanks",
    "doctor_response": "Hi and welcome to HCM. It can be related, and probably is. Klebsiella isnt common causative agent,but it happens in imunocompromised and in hospitalized patients. Lung infections lead to bacteriemia,it means that bacteria has entered bloodstream after which it can be transmissed to any organ( kidneys, heart, brain). It should be treated agressively by intravenous antibiotics and this is usually enough for healing. In rare cases it can lead to serious kidney damage,but in most cases it heals without consequences. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for the skin attached to the head of the penis\n\nHi i was told at my last physical that i still have a little bit of skin attached to the head of my penis that was suppose to break away when i was little or something. I am 16 now and he said that if it ever bothers me to go to a doctor and get it cut but i was wonderin if it really mattered if i went to a doctor or if i could just cut it myself. Im wonderin how to do it if its just simple and cut or if i have to cut it in a certain spot?",
    "doctor_response": "Hello,If foreskin is attached than you might suffer problem in performing sexual intercourse in future. So it can be removed surgically by aseptic precaustion. It is called circumcision operation. Don't try to remove it by your own. Hope I have answered your question.Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful lump on the hip and indigestion\n\nI have been having pain in my right side a bit like a kidney infection,and now I have found a small lump close to my right hip on the front . I have had a lot of stomach problems lately, indigestion, bloating feeling like food was getting stuck. I have just recently had a camera down into my stomach and one into my bowels and all was clear apart from some small ulcers and my tube going into spasm so have been on medication for that. I am 48 years old, 5 ft 3in and about 11st . Female.",
    "doctor_response": "Hi,A-Opinion-Reply-1-Rt hip lump in front-photograph-to be mailed for study and fixing the issue,2-Mail -Any treats reports and medicationsB--Adv-till then-1-Take bland non-spicy diet with curd and vegies , 2-Follow-up for 3 wks by wkly queries to fix this issue.thnks.Wellcome.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to concieve. Prescribed clomid, Duphaston. No periods. When should I test for pregnancy?\n\nHi I am 28 yr old female, i am trying to conceive for last 1.5 yrs. after my studies we found that i have low AMH. but my cycles are very regular. I always get my periods on time. so my doc suggested me clomid for 5 days along with Osure for a month and i ovulated on 13th day of cycle. also after ovulation she suggested me duphaston for 14 days. its 15th day post ovulation. but i have not got my periods when should i expect them or i don t then when should i test for pregnancy. Please suggest",
    "doctor_response": "Hello Thank you for your query. Clomid contains clomiphene citrate which helps to induce ovulation in women with anovulation due to various causes. Oosure is generally given to women with polycystic ovaries, who have a high AMH, so I do not understand why it was given in your case. Women with low AMH are generally prescribed DHEA for support. As you have ovulated with Clomid, chances of pregnancy are there, and as you have regular cycles, you can either do a pregnancy test, or better still, consult your gynecologist to confirm a pregnancy. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does high coronary artery calcium score indicate?\n\nIs there anything to worry about with a calcium score of 71-non-obstructive disease of anterior descending coronary artery 25-50% stenosis and right coronary artery 0-25% stenosis with ejection fraction that appears reduced?  Was denied insurance coverage because of this but my physician told me all was normal.",
    "doctor_response": "Hi Thank you for query As per your question CT coronary angiogram has very low sensitivity of about 60%Only stenosis more then 755 are normal.developing plaques is a natural process and it starts soon after age of 10 years,Every one has some amount of blockage ,however clinically blockages which are more then 75% are significant only.Pleasespecify your ejection fraction value clearly.Yes if ejection fraction is critically or moderately low then detailesd and specific test like coronary angiogram has to be dione",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in the arm, weak hands and chest pain?\n\nHave been having left arm going numb, also my left hand has been feeling weaker than usual. My neck has been having crackling noises every now and then, and I often feel dizzy/about to throw up, I wake up every morning feeling tired and sometimes my chest hurts. If you know what any of this might be, please help. I was told it was my anxiety, but have a hard time believing it..",
    "doctor_response": "Hello, It could be an attack of peripheral neuropathy. Consult a neurologist and get evaluated. Detailed evaluation is required including nerve conduction study. Hope I have answered your query. Let me know if I can assist you further. Wishing you all the best. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Getting UTI frequently. Urine test done, pus cells seen. Did uroflowmetry test, have high capacity bladder. Suggestions\n\nHi doc,I am a 22 year old female,Past 2 months I have been getting UTI frequently. When I gave my urine for routine test it showed plenty or 15-20 pus cells 2-3 times. But all this times cutlture test didnt detect any. As per my doctor's advise I have done an ultrasound scan and a uroflowmetry test. Everything has been normal and scan result impression was UTI with insignificant post void volume. All my doctor could say after analysing the report was I have got a high capacity bladder of 1 litre and I have to void withing 2 -3 hrs which I am doing regularly even before visiting him. I am drinking almost 4 litres of water everyday. My doctor has now prescribed me Niftran and a citralka syrup. I have taken all these before and despite I have developed the symptomes of UTI again. But doctor asked me to take the same medicine again. Please help me with this",
    "doctor_response": "Hello,Urine should not be accumulated in the urinary bladder more time.This creates a good nides for the bacteria to grow and multiply rapidly.This is what that is causing you trouble by repeated UTI.It is basically cystitis which is nothing but infection of the urinary bladder.This infection may ascend or descend to cause infection to other organs of the urinary tract.Backflow of urine may cause hydronephrosis.Regular voluntary voiding of urine is advised.Alkalinize the urine so that bacterial growth is prevented.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can u suggest me treatment for numb feeling in my middle of back?\n\nI m 17 and female. Usually popping my back reliefs the pain but for the past few months It still hurts and still feels like it needs to pop. Also sometimes the middle of my back the muscles feel numb to the touch I can feel I m touching it but it s a numb feeling. What can I do?",
    "doctor_response": "Hello,i had gone though the case and found that it might be pressing of nerve which affect the muscle.You go for x-ray/CT scan of spine to find the location of spine which is affected and also do vitamin B12 test. Then consult to Orthopedic doctor.Meanwhile take rest and gentle massage of back.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest best remedy for leg pain caused by cartilage damage\n\nhi there, i was born with a clubbed foot on my right leg and after 10+ ops to correct this but have now found out that the cartilage has all but gone and im now in constant pain. and because of my job i am unable to take anything stronger than paracetamol is there anything i can do to help reduce the pain?",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.Your cartilage has been damaged. So it causes pain. Diacerine and glucosamine are best medicine to help you. You can take analgesic such as ibuprofen for pain relief. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for joint pain\n\nMy five year old had slapped cheek syndrome 10 days ago. 6 days ago I developed a bad cough and had headaches. 5 days ago I got a rash on my arms and legs which disappeared within 36 hours. At the same time I developed joint pain, which has got increasingly worse. My fingers have also began to swell. I am in agony.",
    "doctor_response": "Hi,You have reactive Arthritis to the infection. It will help to take steroid to reduce the active swelling and pain. Sometimes, high doses of NSAIDS for a week will help reduce the pain and swelling. The Arthritis usually subsided and does not continue. If it does, please see a Rheumatologist who can run further testing. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Priya Sadanandan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for the big indent on chest area\n\nhello, there is a big indent in my chest area, ive just read that it might be something called Pectis Excavatum? or something.. i am 16 my weight is about 120 lbs, and im around 5''10 and i was wondering if i could make it ''normal'' by working out cewrtain muscle groups or something?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Yes, that indentation on chest wall can be due to pectus excavatum. It is actually developmental defect of rib cage. Most common cause for this is calcium and vitamin D3 deficiency. So get done calcium and vitamin D3 levels and if deficiency then you may need supplements. Actually surgery is very difficult in such cases.  Surgery is indicated only If you have any symptoms like cough, breathlessness, recurrent chest infection etc. If you are not having any of these symptoms then no surgery is needed. Exercise or muscle strengthening will not be helpful in this.  Better to consult orthopedic doctor and discuss all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of white discharge?\n\nHI, Fifteen days back, i had an IUD placed, a multiload, i still have whitish discharge with some menstrual cramp like pain in my lower abdomen and back. Today I went for pelvic examination and she gave me Clingen.  I hope i am on the right path or shall i get rid of the IUD.",
    "doctor_response": "Hi, I think you should wait for some time. You may be having some vaginal infection, that's why you are having cramps and white discharge. If infection goes by using clingen, then there is no need to take IUD out. You should also take some antibiotics for this. Discuss with your doctor regarding this.  Hope I have answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a bump below the jaw a matter of medical emergency?\n\nHello, my 13 year daughter was home today with a soar throat and just had a slight fever today 99 being the highest. She now has a bump right below the right side of her jaw. I cannot get in to see a doctor right now, I am now sure if this would be an emergency or not.",
    "doctor_response": "Welcome to ' Ask a doctor ' service .I have reviewed your query and here is my answer.Madam , your child has developed mumps .Its not an emergency and you can see your doctor in 2 or 3 days .Just maintain oral hygiene , give medicine for cold as levocetrizine plus phenylephrine ..Paracetamol for fever .Donot massage the swelling .The enlarged gland will come to normal size in 2 or 3 weeks .I hope I have solved your query .Let me know if I can assist you further in this query .WITH REGARDS , DR VARINDER JOSHI .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause constant fatigue and headache in a child with bloodwork being normal?\n\nI'm taking my 6 year old to ped today. She is pale says that she's always tired and has headaches. She is typically are asleep by 8:00. We had bloodwork done in July and it came back normal. Should I be asking the doctor for add'l bloodwork and if so, what specific tests should be given?",
    "doctor_response": "Hello. I just read through your question.Though the blood work in July was normal, it easily could have changed by now. I would consider a complete blood count (CBC), an ESR, a CRP, and Mono.Nothing here sounds all that terrible, but this could possibly lead to a diagnosis. Then, at least, you know what you're dealing with.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dull back ache and lower abdomen?\n\nMy husband has lower back dull constant ache all around and lower abdomin pain on his lower left and right in a\"v\" shape down.He said he hasnt felt right and doesnt know what the problem is.He gets hot sometimes.He still has his appetite.If he stays still standing to long he cant really squat down without a lot of pain(back will hurt and a lot of pressure on lower abdomin)",
    "doctor_response": "tab mahayogaraja guggulu 1 thrice a day.mild massage with mahanarayan tailaavoid standing for long time.put pillow below legs while sleeping..panchakarma ( kati basti) wil help him.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is there a permanent remedy to get rid of psoriasis?\n\nHello doctor, I would like to know a few details of the tablets which\u00a0I have been taking for my scalp psoriasis. Winolap 5mg once in a while when itching is too high (without doctor's prescription). Isotretinoin drugs/other drugs (with doctor's prescription). I have been taking these medicines on a regular basis and were very effective. But only till I take them. If I stop the medication, I have to visit my doctor again and start medications again to get some relief from itching in scalp. I want to know if these medicines will cause harm/side-effects in future? Can these be taken continuously?",
    "doctor_response": "Hello. Isotretinoin is a potentially dangerous drug and in many countries there are very strict guidelines over its use. It basically contains retinoids which in simple language is a derivative of vitamin A. It is primarily used to treat severe cystic acne and I fail to understand why your doctor has prescribed it to you for psoriasis. Its side effects include: Well, I need some more information: 1) For how long have you been suffering from scalp psoriasis? 2) Exact name and exact dose of the medicines which you are taking? 3) For how long have you been taking each medicine (in detail)? 4) Any medicine which you had taken in the past but not taking now? 5) Do you feel any side effects which I have mentioned above? 6) How much relief have you got in your scalp psoriasis from these medicines or no effect at all yet? 7) Do you have psoriatic lesions anywhere else on the body or just on scalp? Kindly provide these information, so that we can evaluate your case in detail and prescribe you with the best possible treatment. Revert back to a dermatologist online for further follow up -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stones detected in kidney, urinary bladder. Prescribed neeri, cital, buscopan, plenty of water. Correct medication?\n\nhello doctor I have been first time detected 3 stone in a sonographi one in left kidney 4mm and one in right 3.5 mm and one in urinary bladear 7.5 mm my phy who is a m.b.b.s has given me tab neeri ,syp cital and tab buscopan 2 time a day and have advs to take 7 to 8 lits of water a day want to have your advice kindly sujest",
    "doctor_response": "hi! I appreciate your effort to seek medical advice in so much of distress.. Well, the treatment prescribed by your physician is understandable but i would not suggest so much of water everyday as it put unnecessesory load on kidney(3-4 litres is sufficient) and at the same too much of antispalsmodics are also useless.....stop worrying probably stones will pass out on its own wish you a good health... bye",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause and treatment for redspot at the bottom of the foot near heal?\n\nMy son (8) has a small slightly red spot on bottom inside of foot near the heal. Its pretty painful and there are two red streaks going up inside of foot about 1 inch from the spot. This same thing happened a couple of months ago in the same spot. We soaked in epsom salt and it got better. This just appeared again today. Any ideas what it could be or how to treat?",
    "doctor_response": "Hi dear,I understand your concern .I suggest you -Sudocrem, it is helpful in the management of Nappy rash,symptoms of Exema or Abrasions,-Calosoft can be used to affected area to stimulate healing.Hope I answered your question, if you have any further questions ,please don't hesitate to write us,we are always happy to help.Wishing your baby good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and itchiness in the foot?\n\nHi, I had my right foot swell a over a week ago, to the point that I have no arch. It iched and was hot. It lasted for 2 days. Now today my left is doing the same thing. I am 51 a fairly active. I dont smoke. I am a female. The only thing different in my diet is a stinging nettle tea that i have been drinking.I have not stoped drinking it since I started a few weeks ago. I also have Hep C",
    "doctor_response": "Hi, Generally, tea does not cause any swelling like this. I suggest you get a blood test for uric acid and blood counts. Look for your footwear also, if it is new or biting. If nothing works,  then it will be better to have a direct consultation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for back pain due to an injury\n\ni was thrown to the ground playing rugby,i landed on my bak,it hurt alot when it happened after a few mins i got bak up and carried on,but my bum cheeks hurt at the bottom ov my bak,,my tail bone is ok it just on either side ov it which hurts...what could be wrong please.",
    "doctor_response": "Hi,Welcome to healthcare magic.After going through your query I think  You are suffering from acute pain due to soft tissue injury.Treatment of it is rest and analgesics(diclofenac) .Diclofenac three times a day after meals is effective. Sometimes strong analgesic(such as ultracet three times a day after meals) is required. OMEPRAZOLE  before meals  prevent acidity caused by analgesics . You can discuss with your treating Doctor. You  may need to done MRI TO RULE OUT DISC PROLAPSE.I think your query answered.Welcome to any follow up query",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain on left side chest above nipple?\n\nHi, I m a 22 year old male 1.9m tall and weigh 110kg. I m experiencing a radiating pain on the left side of my chest, above my nipple, on the breast. It started of feeling like a muscular pain but know the pain has increased and affecting the whole top of my left breast. I worry if its possible an insect got onto my clothes from the clothes line and now into my breast. Is this at all possible ?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Insect bites are possible in your case. These can cause infection, inflammation, cellulitis and abscess formation in breast tissue. All these cause severe pain in involved breast. So better to consult doctor and get done local breast examination and ultrasound examination of breast. If ultrasound is normal then no need to worry for breast diseases. Musculoskeletal pain can also cause similar symptoms. So avoid heavyweight lifting and strenuous exercise. Avoid movements causing pain. Avoid bad postures in sleep. Apply warm water pad on affected areas. Take painkiller and muscle relaxant drugs. Don't worry, you will be alright, but first rule out breast diseases by ultrasound examination. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden rapid decline in mental function in an aged person?\n\n98YO FEMALE, 1MO RAPID DECLINE IN MENTAL FUNCTION, SEEMS TO UNABLE TO EXPRESS THOUGHTS. MILD R EYE LATERAL DEVIATION, INTERMITTENT SLOW TREMOR, POOR RECENT AND REMOTE MEMORY. NO LATERALIZING SIGNS, ABLE TO CALL RELATIVES BY NAME AND EXPRESS NEEDS. HX OF LUMPECTOMY FOR BREAST CA 4 YRS AGO, PACER, A FIB, HTN MED MS & BENADRYL OCC FOR SLEEP. WAS MENTALLY SUPERNORMAL 2 MONTHS AGO, 2 COLLEGE DEGREES.",
    "doctor_response": "hiiiiiat the age of 98 almost most of the brain function shows more or less kind of dysfunctionsif cerebral atrophy become more prominent than it seems more sudden worsening in symptomsand she had a lot of medical history tooso at age of 98 it is expecteddue to medical illness with HTN there are possible chance of small lacunar infract in brain also but can be confirm by CT scanage related senile atrophy also produces same changesso if it is fast in progression u need to consult neurologistbut as per my opinion it can be possible to stop progression but we will not reverse back all damages that she had alreadyso supportive and only symptomatic management is possiblethank u hope for the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "High prolactin, irregular periods, trying to conceive, taking leptaden and bangshill. Treatment?\n\nhi iam 26 year old female, iam married for 6 years we are trying to have a baby since 4 years, in betwwen i went to consult a doctor and told me that i have high prolactine thats y iam not concieveing and gave me tablet (metperformin, cybergoline) and i became pregnent then after 3 months i had a miscarriag, after that i did not become pregnant , again went to same doctor she gave me same tablets and gave me injections also but nothing happened after i started consulting ayurvedic and now iam taking leptaden and bangshill, i also have irregular periods, please can you suggest any medication and help me to be normal",
    "doctor_response": "Hello. Thanks for writing to us. Since your periods are irregular, a hormonal disturbance is likely. You need to consult an infertility specialist for a thorough evaluation and appropriate treatment. Taking irregular treatment from multiple doctors will not help. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could lump on lower spine in a child without bruising suggest?\n\nMy 6 yr old daughter has been complaining about her lower back hurting for about a wee. I checked and saw nothing. I checked again and she has a Lump just off to the side of her lower spine and there is no bruising.. What could this be? I calling her ped in the am",
    "doctor_response": "Hi.... by what you quote I feel that it could be a small lipoma or accumulation of fat. The Other possibility is that it could be dermoid cyst which has been overlooked. I suggest you see your pediatrician regarding this as the diagnosis can be made with certainity only after seeing and touching the swelling.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sleep apnea\n\ni WAS DIAGNOSED WITH SLEEP APNEA IN LATE OCTOBER. I HAVE BEEN USING MY CPAP MACHINE SINCE THAT TIME. I HAVE HAD A COUGH AND BACK PAIN BETWEEN MY SHOULDER BLADES SINCE. MY HUSBAND AND I GOT A NEW MATTRESS BUT THAT WAS NOT THE PROBLEM. IS THIS A COMMON PROBLEM WITH CPAP MACHINE?",
    "doctor_response": "HelloYes it is a common problem and the pressure needs to be adjusted. Meet your physician.RegardsDr. Srikanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with non alcoholic steatohepatitis. Normal liver function reports after taking medical marijuana. How did it get cured?\n\nI was diagnosed with NASH (non alcoholic steatohepatits), a hereditary form in my family, 19 months ago and was immediately taken off prescription pain meds (Opana and Morphine ) and obtained my medical marijuana recommendation. 10 days ago my liver function was tested and there are no signs of liver disease . I was very ill when I was diagnosed so I m wondering if the multiple infections I had at the time caused a false positive or if daily use of cannabis (mostly in food) has cured me.",
    "doctor_response": "Hi there,There are a lot of things that can cause your liver enzymes to elevated. As a general surgeon, I often see patients with elevated liver enzymes, and am asked to evaluate them.  NASH is a chronic process, and usually your liver enzymes won't be elevated until there is a significant amount of damage done.  This means that just because your liver enzymes are normal doesn't mean NASH has resolved. What NASH basically means is that you have a fatty liver, and the fat can damage the liver over time.  In terms of your liver enzymes being elevated, you are correct in saying that it was likely due to your illness.  Any illness can cause your liver enzymes to be elevated, and this will usually resolve over time. Drugs like acetominophen (tylenol) and alcohol can cause your liver enzymes to be acutely elevated.  I think the marijauna, while a better pain reliever than prescription pain meds, didn't cure your liver.  Time and stopping the pain meds helped your liver enzymes go back to normal.With patients who have NASH, I recommend a low fat diet, minimal alcohol use (really try to limit it to 2 drinks a week, and cut it out totally if you can), and avoid tylenol use (try to limit to 2grams per day, and only if you absolutely need it). Marijuana won't harm your liver acutely, but we still don't know the long term effects of marijuana on the liver, lungs, and the brain.  I hope this answers your question. Feel free to contact me if you have any further questions!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any side effects of taking Mifegest kit?\n\nhello mam, i m 25 year old married women i had taken mifegest kit on 18july (after 50 days of regular period) and got bleeding next day.i took only 3tablet.After 13 days of heavy bleeding it was stopped on 31july.but now after 4 days of rest today my bleeding has become start again.pls help me.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You should be examined by a gynecologist because it seems that your abortion was incomplete. You may need an ultrasound to be evaluated and maybe a D & C will resolve the situation. Hope I have answered the question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could facial, body and fingers swelling be due to arctic allergy?\n\nWhenever it touch down to this time of year when it s very cold or even snowy my son tends to get Wales all over his face and body and his fingers sometimes gets swollen but Benadryl seems to help Is there an allergy called arctic alergy? Can you please educate me on that thank you",
    "doctor_response": "hi,yes its case of allergy.you should dress him properly particularly in winter.a warm gloves,socks,cap ,and warm cloth will prevent such episode .if inspite of these there is swelling of finger ,keep them in slightly warm water or massage it with warm oil....thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tell me about my blood analysis report\n\nhi i just made my blood analysis and noticed that the TGO (AST) TGP (ALT) gama glutamil transpeptidasa and f. alcalina total are considerably high what does this mean?? i also have low iron and hi cloro",
    "doctor_response": "hi,thanks for query.First of all this could be simply because of consumption of alcohol before the test.Apart from this any form of viral infection,damage to the liver due to any cause can also lead to this.Please talk to your physician and get more investigations done like ultrasound for liver,blood sugar,blood counts and other liver function tests and others as per the need.avoid high fat diet and alcohol. wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does radio nuclear medicine cure bone marrow transplant patient?\n\nhi sir, my best friend is under going for radio nuclear medicine at vallore hospital,he under went bone marrow transplant few years back but the problem has come back. will this medicine help him for sure ? and what this medicine do for this kind of patient ? Regards",
    "doctor_response": "Hello,Thank you for your contact to healthcare magic.I understand your health concern, if I am your doctor I suggest you that it will surely improve the condition. But it won't cure the disease for sure. It will destroy the malignant cells in the bone marrow and dose not affect the normal cells in same way. Your friend should go for it.I will be happy to answer all your future concern. Thank you,Dr Arun TankInfectious disease specialist.Wish you a best health at health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itching rashes. Tried different treatment, no improvement. Recommendations?\n\nhi.. i am suffering from itching rashes from qite a month back.. earlier on lower back, latter the rashes spread to my thighs n lower legs. i had avil n betnovate-n but it didn't work quite well.later i consulted a doctor who gave me wysolone , vozate , n zentel tablets,  hhfudic cream n caladryl lotion..... but its yet again not working.. i am having these tablets from 4 days.. can u plzzz sgst what to do?",
    "doctor_response": "these are allergic rashes as you are taking antiallergics and even steroids these can only subside the symptomps but nut curethe cause of allergy must be known to remove it clearlyanything can develop allergy at any age at any stagethe causes may include medicines used for other ailmentscooking oils shampoo application oilsointment creams lotion and other body application materialsit can be food or cloth o pollensyou need to crelate with history or get it diagnosed by taking allergy specialist consultationnd you can treat it accordingly",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does one treat weeping blisters near the groin?\n\nMy husband had a weeping rash near his groin in the crevice between his thigh and stomach. it is hot and extends around his hip in a band about 4 inches in diameter . it is only weeping and rash-like in the crease. The rest is hot and inflamed. We were at a football game on the weekend and he used a portapotty there. But we have been home for 10 days in our own beds. could this be a spider bite or a bed bug. None of us has experienced itching or bite like symptoms. He has felt a little under the weather with flue like symptoms the last few days. He said this started on Wed. but never showed my until last night. I am very worried. He is on metformin only. Generally very healthy and 71 years old. XXXX",
    "doctor_response": "Hello, Welcome to Ask  a doctor services. I have read your query.It looks like your husband is suffering from fungal infection. Fungus grows easily in sweaty, moist skin. Since you were in football game, he got it (due to moist/sweaty) skin.He should take shower, pat himself dry. Wear cotton clothes. He needs to take a course of oral fluconazole and apply clotrimazole cream in the affected areas. He can take a course of non sedating antihistamines.It should go away in 3-5 days. However, you are suggested to get it clinically examined by a dermatologist.Hope I have answered your query. Take care.Regards,Dr Nupur K",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Having on and off pain around pelvis and femur junction. What could it be?\n\nHello doctor, I am a 16 year old female. For a year now, I have been getting regular, on and off pains in my pelvis around where the femurs connect, and the lower spine. Sometimes it can only be fixed when I put pressure on one side, but other times it hurts to put pressure on it. It started off with slight pains in either side, but now it has spread to both the sides, and now to the front of my pelvis, where the femur connects. It hurts when I stand, when I twist my leg, and when I lie down I am not comfortable. Sometimes when I make sudden movements, the pain is excruciating. Sometimes it will feel sightly better if I crack one of those joints somehow. What could it be and how can I fix it? And additional that I have to include is, this pain may persists for two to five days, then stops for about a week.",
    "doctor_response": "Hello,  Welcome to icliniq.com. These symptoms that you describe can be due to the following: 1. Bursitis: which your doctor says there is a gland that is inflamed. Bursitis may occur occasionally but, if not taken care of, may last for months. In such a case, complete bed rest for a few days, along with Voltaren (Diclofenac), would help for sure. It is a self-limiting disease. 2. This could be the initial phase of arthritis, as your mother also suffered the same. In either case, anti-inflammatory drugs are the first choice of drugs which is being given to you. However, it is important that you investigate with x-ray hip and blood reports like CBC (complete blood count), CRP (c-reactive protein) to rule out any other issues. If anti-inflammatory drugs do not work then, DMARD (disease modifying antirheumatic drugs) drugs followed by monoclonal antibodies.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have had asthma. Getting thick and black mucus. Chances of COPD or  pulmonary edema?\n\nI am a 21 yr old male, I ve had asthma as a child and bretahing through my nose troubles as a child as well. I have been experiencing lots of mucous production , which when I cough up is sometimes very thick and foal smelling (dark in colour), but otherwise always froth-like. Sometimes I also cough up little hard chunks that feel like powder or cheesy inthe center that smell identicle to feces. Some insight would be helpful as past doctors have put me thru unsuccessful tests and diagnosis ssuch as post-nasal drip and just yesterday an upper GI barium test...because I mention slight difficulty swallowing. I am a nursing student and giving my symptoms, I am assuming something is causing irriation in my lungs, possibly re-occuring asthma symptoms , but I want to know if I should be worried about other problems such as COPD , pulmonary edema . etc. Thank you",
    "doctor_response": "Hello dear... Asthma is caused due to broncho-constriction (obstruction of smaller airway passages) which is indicative of Hyper-responsiveness of air passages to an allergen. Nebulisation will provide symptomatic relief by causing broncho-dilation (dilating the smaller airway passages, relieving the obstruction & increasing airflow to lungs) And the presence of foul smelling sputum indicate lower respiratory tract involvement such as Bronchiectasis (a condition grouped under COPD, in which there is irreversible dilatation of the air passages due to damage to bronchial wall) So...it will be better to consult a Pulmonologist. And make sure that you are well protected from cold, dust & other allergens. Other than that eat a healthy diet, avoid stress, get good sleep, think positive and stay happy. Wishing you good health. Thanks & take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicines for anxiety\n\nHi, i suffer from anxiety and have had a prescription to xanax for the past two years. it is .25 miligram. i dont take it daily it is situational. i have developed a pressure in my left eye and my eye doctor would like to check for acute narrow angle glaucome. i noticed that xanax should be stopped immediataly if i have it. are there any other anxiety medications you know of that will not make it worse and dont need to be taken daily AKA (make me a zombie)",
    "doctor_response": "Hello thanks for asking from HCMYou have anxiety and are taking Xanax on SOS basis for relief. Now due to pressure in eye you have been diagnosed with Acute narrow angel glaucoma (ANAG). Yes Xanax should be avoided in glaucoma. Other commonly used drug like Propranolol should also be avoided in glaucoma. But some anti anxiety drugs like Buspirone, combination of flupentixole+melitracen (banned in some countries) can be used on SOS basis and help to reduce anxiety symptoms like Xanax. These drugs are comparatively safer to use in glaucoma.Consult your psychiatrist for prescription.Thanks, hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cuts\n\nHi, im a meat cutter. i cut my middle index finger deep (2 months ago). I have been getting pains recently in the wound area, the knuckle on the right index and now around the thumb as well. More or less just feels stiff and i seem to notice the pain more when lifting weight.",
    "doctor_response": "Hi and welcome to HCm. Thanks for the query. There is no some specific treatment which can be done now. this cut had to be properly managed by cleaning and wound suturing. if there was damage to nerves or tendons then plastic surgeon should have seen this and do proper surgical management. now,you can have physical therapy and do neurologic exam. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for semen leakage while urinating and pain in leg\n\nI m an unmarried person. I did masturbate 2-3 times in a day since last 2 week ago . At present I ve stopped masturbate for pain of my leg bone but i m feeling some problems now. I am facing with semen leakage during toilet or bathroom. And nightmare is occurring after 2/3 days now. Regarding this I have still pain in my leg bone. What can I do now?",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.There is no need to take the treatment for this condition. In turn its not the disease at all.When you mastirbste your semem will come out with each act. As you have stopped the act, semen start accumulating. Once accumulated enough it will cone out with night mare.It will never come out in urine. I think it's your belief. If you are suspecting it than you should examine the urine microscopically. If the sperms are found in urine microscopically than you need surgical correction for leaking semen in the urine. If you have leg bone pain, than even you can masturbste. There is no harm in it. Masturvstion is very common act in day today's life if possible you can also do it with your leg pain also.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes muscular pain in jaw?\n\nHi, I have a pain in my jaw (not inside my mouth) it feels like a muscular pain in my face but only along the jawline. I have tried applying pressure to massage it, which helped slightly, but i can feel like nodules/air pockets when i apply alot of pressure. It feels like i have a bruise.I was wondering if i need to seek medical advice by visiting a doctor/if this could be stressed related?Please kindly adviseThanks",
    "doctor_response": "hello thanks for consulting at hcm..it could muscle twichings, along ur jaw line,,either ways plz chck with ur dentist for checking whether it is coming frm within mouth due to pockets in the gingival region..hope it helps..tc",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the sore lump on my head causing headaches?\n\nI ve been having a throbbing headache in the top of my head. I just realized a knot around the bottom of my hairline on the corner of my head. Its sore more around the lump than the actual lump itself..I m wondering what this is and how to get it away?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have dermoid cyst or skin adenexal tumour.  You should go for excision biopsy and histopathological examination.  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 health care magic. Wish you a very good health. Don't forget to click thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a bruise on the hip at the site of pain?\n\nHi. So I ve been told I have bilateral acetibular hip impingement (surgery is scheduled) my hips flare up hurting so bad it s hard to walk. Today is one of those days, but now I ve actually noticed a bruise right on my hip in the exact spot where it hurts....however I didn t do anything to cause this bruise?!? Is this something to be alarmed by? Thank you.",
    "doctor_response": "Dear Sir/MadamI have gone through your query and read your symptoms.In my opinion, not to be alarmed of but to be careful of ,as the bruise is sign of you hurting yourself and causing some minor bleeding, one thing you should take care of is to get your coagulation profile, although this investigation will be done prior to surgery.I hope that answers your query. If your want any more clarification, contact me back.Dr Narender Saini",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe cough\n\nHi, my husband is suffering from a severe cough from past 15 days. this cough occurs every years in the month of September or November it last for almost 3 to 4 weeks i took him Apollo twice but nothing helped still his cough is not come down. Please suggest me a nice solution.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your husband's situation and problem. He is having seasonal cough. Allergy and viral infection are common cause for this. So better to consult pulmonologist and get done clinical examination of respiratory system, PFT (Pulmonary Function Test). He may need inhaled bronchodilators and inhaled corticosteroid (ICS). Combination of antihistamine and anti allergic drugs are also helpful in his case. Annual vaccination with Influenza vaccine is also helpful in prevention of recurrent respiratory tract infection. So consult pulmonologist and discuss all these.. Hope I have solved your query. Wishing good health to your husband. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high fever in a child\n\nHi, my daughter who will be 11 years old on July 11 was running high fever about a week ago. As it became somewhat uncontrollable even after she was given paracetamol syrup [Lotemp] and we witnessed abnormal movement of her limbs we shifted her to a hospital. Doctors failed to diagnose the cause of the fever although she went for certain blood and urine tests and even a CT scan was done on her brain/head. The fever subsided for a day or so after she was given three Nimesulide tablets (Nise) one each after six hours interval but it reoccurred. On this a different whom we consulted advised to go for Widal, Liver Function and urine tests which we quickly got done at a private laboratory. The Widal examination showed salmonella (O) at 320 on which the said doctor prescribed Ciprofloxican antibiotic medicine and also polybion which we are giving her for the past couple of days. There has been little improve though. What should we do now to get better results. .",
    "doctor_response": "Hi,Now as proper diagnosis is made and treatment is started, it will take still some days to come temperature normal level.Antibiotics takes some time to start its action.Give her liquid diet like milk, buttermilk, fruit juices, rice.Give her plenty of water.Give her reest.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the large lump behind my knee?\n\nI had an arthroscopy of my knee 3-1/2 weeks ago and a meniscal tear shaved off. In the last couple of days I have noted a lump behind my knee on the back side of my leg. It feels about the size of an egg. Could this be an infection, blood clot, Baker s cyst. It is warm to the touch.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have history of meniscal injury.  It can be somr hematoma formation or abscess or backer cyst.  You should go for ultrasound study and if needed go for fine needle aspiration cytology.  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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for excessive sweating and rapid heart rate\n\nThank you. My PCP diagnosed me with a medical term I am unable to discern from her handwriting. My chief complaint is excessive sensitivity to heat, rapid overheating with symptoms of excessive sweat from head (dripping) and my upper torso gets so hot and sweaty too. I am prone to break a sweat even doing light house cleaning or sitting at my work desk if I feel, the room is too warm. What I can make out of the Dx looks like hyperlyd?? . Can you possibly assist me with the Dx name she wrote down? Any assistance would be helpful. I have also attempted to locate the condition in my EHR but cannot locate it. I am writing a letter and need to be able to correctly spell and identify my given Dx. Thank you SO much!",
    "doctor_response": "Hi welcome to HCM.I understand your query and concern.Your symptoms are suggestive of arrhythmias of heart secondary to anxiety.I advise you to have a baseline 2 dimensional echocardiography,ECG and lipid profile to assess the basic cardiac reserve of your heart.Restrict the intake of salt to less than 6g/day.Regular physical exercise in the form of brisk walk for 20 min a day for 5 days a week is pretty useful.Drugs like antihypertensives and antiarrhythmics,betablockers,pantoprazole will help.Reduce the intake of fatty and fried food.One pomegranate and apple a day will help to keep your heart at good pace without clot formation.Continue your present medication without stopping. Consult a Cardiologist for further expert management.Post your further queries if any.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I contract chicken pox infection from previously infected source?\n\nmy friends little boy has chicken pox and has had it for about a week and a half and she wants me to babysit i have had them before and im goin on holiday in 2 weeks is there a chance i could catch them even tho iv had them and the child has had them for about week and 4 days?",
    "doctor_response": "Hello Thank you for writing to HealthCareMagicI understand your concernChickenpox (varicella) is a viral infection that causes an itchy rash with small, fluid-filled blisters.It is highly contagious to people who haven't had the disease or been vaccinated against it.Chickenpox is most easily spread from 2 to 3 days before the rash appears until all the blisters have crusted over and It usually takes about 10 days after the first symptoms before this happens (all blisters have crusted over).After you have had chickenpox, you aren't likely to get it again. But the virus stays in your body long after you get over the illness. Best Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistant left-sided hip pain despite taking Ibuprofin for GTPS?\n\nI have severe right ankle pain. I started out with left hip pain where I could barely walk. For 3 days, Friday, Saturday and Sunday I stayed home and did little but rest and Tylenol. I woke up Monday with severe pain my my right foot, like a charly horse in my foot, like the muscle would not contract or relax, I could not put my foot down, unbearable. I ankle could not move hardly at all. My ankle was solid frozen and in severe pain. The pain was a 10/10, It hurts contantly. I had a back injury and sciatica on both sides due to injury a2 months ago, but had been doing physical thereapy to help that. Now I have constant left hip pain, the doctor at Urgent care diagnosed it as the Greater trochanteric pain syndrome (GTPS) for the left side of the hip. He did no xray. He said he think I used my right foot to cover for the left hip, basically my right leg and foot supported the left side. I have tried 600 mg ibuprofen with 1 vicodan at night and flexiril 1. during the day I use tylenol. I am in constant pain. It is not going away. I dont know if I broke something or its gout.",
    "doctor_response": "Hello, Consult a neurologist and get evaluated. The possibilities are neuropathic causes like sciatica. You can try analgesics like Gabapentin for pain relief. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the precautions and diet for a patient having kidney stones?\n\nWanted to know certain things regarding kidney stones. My grandfather aged 75 has been detected with stones in kidney. Kn doctors advice he went for an ultrasound n certain things can be ruled out. Since he stays in kolkata n I am in haryana I cud only ask him to read the report. It says 9.4 (pm) right n 9.2 (pm) left. Prominent trabetulacions are seen. Porticomedullary central wcho complex in lower right solitary calculus left kidney 5 mm. Nephrolitis of both kidneys. What does this mean. What precautions he needs to take and diet advised. He usually has a swollen feet sumtimes which is very painful. Then he was suggested to go for ultrasound. Pls advise. Regards",
    "doctor_response": "Hi Sir,Welcome to healthcare magic,I understand your query and concern.Your symptoms is suggestive of a renal stone located somewhere in the Right lower ureter.For this you need to get him Intravenous pyelography for accurate assessment.I advise you to have Tab Tramadol and Tab.Pantop 40 mg,a course of antibiotic taken under medical prescription to control this pain.Further expert management depends on the outcome of the IVP result.If the size of stone is more than 5 cm then depending on the location of stone Extra corporeal lithotropsy can be done.Meanwhile you need to take soft and less spicy foods.Drink 3-4 litres of water everyday.Fruits,fruit juices,vegetable salads,soups should be taken.Consult your urologist for expert management.Post your further queries if any.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for high blood pressure\n\nHi, may I answer your health queries right now ?  Please type your query here...My mom is 92 years old, her blood pressure yesterday was 84/89 and today it is 90/60.  I am concerned as she had a stroke about 4 years ago and is in a wheel chair - any thoughts?  Thank you.",
    "doctor_response": "HelloAfter going through the medical details provided by you i would like to tell you that the blood pressure of your mother is on the lower side which can cause her weakness and easy fatigue or even giddiness.So its advisable to consult your doctor and get her bp medicines adjusted accordingly. Also for the time being give her little more water to drink and add a pinch of extra salt in her diet to help bp come up a little.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pancreatitis in a 53-year-old\n\nMy friend is a 53 year old man with pancreatitis. He is in constant pain and has frequent attacks that last from 3 hours or more. He was tested, and says his lipase levels are off the charts high. What can he do to prevent this and get off of the many drugs he is taking for the pain?",
    "doctor_response": "Hello, Pancreatitis has happened when the enzyme of pancreas activate before they are released to the intestine and begin attacking in the pancreas itself. The cause if from alcoholism, gall stone, some kind of medication. You would experience nausea and vomiting, upper abdominal pain radiation to the back, abdominal distention, or fever increase heart rate. The management for mild acute pancreatitis is NPO (nothing by mouth) a couple of days to give your pancreas a chance of recovery and IV fluid for rehydration and stay at the hospital. Avoid alcohol or fat food, or smoking, and medicine that cause pancreatitis. Pain relief medicine for mild pain we use paracetamol or Ibuprofen, for stronger pain relief we use codeine or tramadol. If not better you should go to a specialist doctor to help you. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Heang Chan Raksmey, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for stones in the kidneys\n\nHello Dr, I am 45 years female.Have kidney stones due to intake of calcium. Have a hairline fracture on my arm so begun taking calcium for a few days normally I avoid taking calcium tablets.Since yesterday blood in urine but the stone passed.  Today again severe pain unbearable.  Taking Cital.  Took a pain killer for pain.  Should I continue taking cital and pain killer",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I understand your concerns and I will try to help you as much as I can.Most kidney stones pass spontaneously and this is usually a painful experience. YOu should continue with painkillers and Cital and drink plenty of fluids and raspberry tea. If there is no urination in 24 hours, you should see urologist and do tests to rule out ureter obstruction. ALso, you need to avoid high calcium food and high protein food for few days. If fever or pus in urine occur, you should see doctor as well since it may indicate kidneys infection.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stiff painful neck after an injury?\n\nLast night I did a reverse somersault, I must have done it wrong, because as I went through it I heard one or two cracks. Today my neck is stiff and when I turn to either side at 90 degrees I can feel pain where my neck meets my shoulders. I just tilted my head back and same thing. Should I be concerned?",
    "doctor_response": "Hello, You may be suffering from acute neck muscles spasm may be due to overstretching or cervical spondylosis. Give rest, use cold and warm compression. Use muscle relaxant to relieve spasms. If symptoms not improved please consult your doctor he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Penchila Prasad Kandikattu , Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the elevation of WBC?\n\nI found out that my white blood cells are elevated for a while now, what exactly does that mean? I have a Dr appointment later in July but instead of stressing me out till then, if I could find out something about it I certainly would be appreciated. Thanks in advance for your effort and your time. Sincerely, Clairma Matherne",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern regarding your wbc count.  Most common cause for high wbc count is infection.  No need to worry.  Just be relaxed.  You should consult your doctor and take antibiotics accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain while suffering from shingles?\n\nHi...I am currently being treated for shingles. I am a female, age 63. My breakout is on my torso....specifically under my left breast and goes around to my back. My back does not have as many blisters, but I am experiencing backache on my left side. I have something for pain, but my question is: does back ache normally accompany shingles? Thanks for taking my question.",
    "doctor_response": "Hello,Based on the history given you seem to be suffering from a painful nerve conditions following shingles infection i.e. Post herpetic neuralgia.It is a complication of shingles which affects nerve fibers and skin, causing burning pain that lasts long after the rash and blisters of shingles disappear.There is no cure, but treatments can ease symptoms. For most people, post herpetic neuralgia improves over time. However, your doctor may prescribe Gabapentin or Pregablin drug for the symptomatic relief of pain.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mohammed Taher Ali",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have chronic cough and cold with chronic idiopathic pancreatitis. Please help.\n\nHello doctor, I am a 32-year-old male. I am having chronic idiopathic pancreatitis. I am regularly on Agna 25000 three times, Cretox CP three times a day. My problem are cold and cough for two years approximately. Almost four to five days a week. Even sleeping under the fan my nose gets blocked in the morning and nowadays I feel uncomfortable when dust is around as well. Did total IgE report is quite high? Please diagnose and suggest medicine.",
    "doctor_response": "Hello.  We are happy to help you. I understand that you have these complaints for a few years. It most probably is a manifestation of allergic rhinitis. The total IgE in serum is just an indication of the allergy status at the time of taking the blood sample. It is not very significant in allergy practice. Nevertheless, it shows that you have an allergy. You need some medicines to keep allergy under wraps and prevent the blockage and cold. You also need to find out which allergen is offending and causing the problems. The best way to diagnose is getting a skin prick test done at a good allergy diagnostic lab. Meanwhile, you will be benefitted by an antihistaminic with leukotriene inhibitor combination, steroid nasal spray, and allergen avoidance. You would need to be taking these for about two to three months. Allergen avoidance is the best solution. Could you provide us more details about the complaints so that we can guide you better? Is the problem seasonal or perennial? Does it only occur in the nights when you lie down under the fan or any time of the day? Does it get worse in winters or when you visit any hill station? Where do you live? Do you smoke? What is your diet like? Do you get exposed to vehicular exhaust pollution or smoke and dust of any kind? Have you tried nasal sprays before? Is the cough wet or dry? Is there any breathing difficulty or wheezing? Is there any change of voice?",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain and vomiting in a child?\n\nmy 10 year old has been sick for about a month with stomach issues. she went to white water and came back with pink eye about 2 weeks ago. her blood results indicate a very high alk phosphatase level (304) and high atypical lymphocytes (6). No parasites have been found and the pink eye is gone but she is still very sick. Any ideas?",
    "doctor_response": "Hi...this looks like a prolonged viral infection. The blood picture with atypical lymphocytes and the red eye are indicative of that. Sometimes viral infections can have a prolonged course too. If you are still worried, please consult your pediatrician for a thorough physical examination and a relook at the diagnosis.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with hepatomegaly, have elevated bilrubin even after taking udiliv, razo. How can I normalize it?\n\nHI SIR, I HAVE BEEN DIAGNOSED WITH HEPATOMEGALY ( FATTY LIVER ) AND MY LIVER ENZYMES ARE ELEVATED SLIGHTY. THEN MY DOCTOR ASKED ME TO TAKE UDILIV 300 AND RAZO 20 FOR 1 WEEK. AFTER 1 WEEK MY LFT REPORT SHOWS NORMAL BUT BILIRUBIN IS SLIGHTLY ELEVATED. I AM A NON - SMOKER AND NON-ALCOHOLIC. I AM TAKING UDILIV 300 AND RAZO 20 FOR MORE THAN ONE MONTH. PLEASE SUGGEST ME TO HOW TO PROTECT MY LIVER AND HOW CAN I MAKE IT NORMAL.",
    "doctor_response": "Increase the dose of udiliv .Take Essentilae L Cps and Lornit tabs alon with your prescribed medication,your levels will reduce.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach pain and irregular bowel movement\n\nHi, For the past 2 days my son is having stomach pain, and his bowel movement is kind of foam..i gave Albandazole suspension(given bya paediatrician)....but still his bowel movement look like a foam..can u suggest me any medication to regular the bowel movement?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron (as prescribed by your paediatrician).Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for androgenetic alopecia\n\nHello doctor, I am 30 years old male and i have started facing androgenetic alopecia. I am suffering from receding hairline and hair thinning in vertex area. I have used livon hair gain but not very regularly it showed slight improvement. I have visited few hair gain clinics like batra s and richfeel but they were nit convincing and their reviews are not good. Pls suggest what should i do to arrest hair thinning and improve hair density and hair line.",
    "doctor_response": "Thanks for asking in healthcaremagic forum  I appreciate your concern. Baldness and receding hair line is mainly hormonal in cause and also has genetic predisposition. So, Homeopathic and ayurvedic treatments are not much effective as they claim. I have seen many doctor visiting Homeopathic clinics for hair growth. So, try hair transplantation and be ready to accept the reality if you donot get positive results. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be worried about Sed rate of 34?\n\nI had my sed rate level checked a month ago and it was 47.  Due to my level, the doctor tested me for lupus which came back negative.  Today, I had my sed rate rechecked and it is down to a 34.  I know this is still elevated but it a 34 something to be very concerned about?",
    "doctor_response": "I dont think so, esr is a non specific test for inflammation, unless you have some symptoms clinically, there should not be any problem.otherwise the best thing would be to get your crp tested which is more specific for inflammation",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated WBC levels, blood discharge from ear and dry cough?\n\nI have just been told that my blood work shows elevated white blood cell count. No known infection at this time. Had a bloody discharge from one ear a few months ago. Just had a mole removed last week (after the blood work). Have a dry cough....quit smoking a year ago. what could be causing this...l",
    "doctor_response": "Hi.Welcome.I have gone through your query.Elevated wbc count indicate infection. Sore throat might be the cause, as you have mentioned about dry cough. Regarding the eat it need to be examined, so I would suggest you to see ENT specialist.Hope this helps.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be done for my skin which was pulled out while waxing ?\n\nHello, While I was getting wax, the upper layer of my skin was pulled of and is red what should I do?",
    "doctor_response": "Hi welcome to Healthcaremagic If there is no bleeding then leave it as if.., it will get back to normal skin by a week... if in case there is bleeding or pain then apply cotton by pressure or use ice cube which will stop the bleeding.. and you can consult dermatologist tomorrow... Hope I have answered your question.. Takecare...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hard lump on ankle\n\nl recently got a hard lump on the front of my ankle, i did not sprain it or hit it off anything it has just appeared out of no where and it has been there for almost 2 weeks, it does not hurt and it makes a squeaking kind of feeling, like a finger rubbed on your teeth, any idea? thanks",
    "doctor_response": "HI,Dear,Thanks for the query to HCM.1-I have studied your query in depth.2-IN my opinion,this  hard  lump in front of your ankle-of nowhere -is Synovial Cyst of the Tibialis Anteriour.3-The squeaking feel is due to the inflammed tissue rolling over each other and nothing to worry much.4-I would advise-to see you ER-Ortho surgeon-who would do X-ray ankle,CBC, to rule out any infective cause -?TB-a chronic cause which may be underlying its occurence and would treat accordingly by proper antibiotics ,NSAIDS and by surgical removal if it needs.5-Hope this would solve yoru query to your satisfaction.6-Wellcome for more queries to me On HCM.Thnks once again for your inquisitive query.Have a Good Day..!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for discolored spots on back of neck ?\n\nBIO/HISTORY: 19 female, one child, 5 7, 150 lbs, hypothyroidism , ISSUE: 6 or 7 discoloured (light brown) spots on back of neck, no irritation, just there.. but what are they? Also have recently been wxperiencing dizziness/black vision upon standing, over-average fatigue and headaches. Am I just dying? Wtf is going on? I have a doctors appt, but have to wait a few days. Thanks for your time. -N",
    "doctor_response": "FROM history ,it seems you are having anaemia,but also get yourself checked for diabetes. After proper diagnosis,you will be alright with treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recovery and Improvement of Persistent Vegetative State, please suggest\n\nMy son was a PVS than he recovered and now fully conscious and aware but without any motor function.Same is with another boy here. It is our sixth year. Have you anything for us.",
    "doctor_response": "PVS is a very bad to happen with anybody it seems he has recovered consciouss, but what he needs to recover is function, function is a learned behaviour, it needs a persistent and contsistent stimulus from the parents to the child to recover the function, here medications are no use. persistent stimulation with cortical electrical stimulation may cause recovery of the function. all the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for kidney stones and bladder pain\n\nhello sir i have 7 stone between 4 to 9 mm.....in my kidney and 7.5mm in unirany bladder which have pain......doctor give some medicine and urofit syrup which i have to take 2 spoons in 1 glaas water 2 times in a day... does it helps to remove my stones completly without pain",
    "doctor_response": "Good Day and thank you for being with Healthcare Magic! Yes the urofit medicine would try to dissolve the stone so that it will disappear thereby not cause pain when it passes in the ureter.  Drink plenty of water also around 2-3 liters and avoid coffee chocolates and strong teas. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at:   I would gladly help you.  Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the alternate remedy for wisdom toothache other than extraction?\n\nhi my age is 28 and i am suffering a lot with wisdom tooth pain and having loose motion also. is there any relation between the development of wisdom tooth and loose motion. the wisdom tooth is visible at the backside of my molars. can i have some other remedy other than extraction.",
    "doctor_response": "Hello,You seem to be having trouble with the function of your jaw and cannot open well?My concern is that you have an infection. You should be seen by a dentist to determine if the position of the wisdom tooth is causing any interference. If you can keep the tooth clean and it will be in function, you can keep the tooth. If the tissue around the tooth is infected, the tissue can be cleaned out and sometimes needs to be removed. If the infection resolves, yes you can keep the tooth. The tooth may cause discomfort while errupting. Do you know if the opposing wisdom tooth is present and erupted to allow the teeth to be in function? If the tooth has decay or an abscess has developed, you would need to treat the tooth further with a filling or root canal. It may be best to remove the tooth. If the tooth is tipped or can't errupt fully, it may flare up with an infection over and over. This indicates that it is best to remove the tooth. You do not want an untreated infection to spread or get worse causing more pain.Other options rather than extraction may be available. Plan a visit to the dentist to discuss your situation and make an informed decision. Rinse the area and take some anti-inflammatory medication to feel better before your visit.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for bed wetting problem in teenager\n\nI am a 17 year old male, that wets the bed nightly. During the day I am completely dry. I have very rarely had a dry night. I am currently using goodnights (I m small) but they are quickly going to be to small. My doctor (last seen 7-8 months ago) knows and keeps telling me I will grow out of it. What sort of protection will be good when the goodnights get to small? Also is there a second opinion on the medical side?",
    "doctor_response": "Hello, It is good of you to come forward and seek help for this problem.  Some are too shy to ask for help. The information you have given me indicates that you have primary nocturnal enuresis(meaning you have never had sustained dryness at night). Causes for this type of night-time incontinence include: -Impaired arousal during sleep-the arousal centre in the brain fails to respond to full bladder sensation; adolescents with night-time wetting have diminished arousal during sleep. -There is a chemical in the brain, that when active, causes the kidney to hold on to water and make less urine, but in some adolescents, this chemical is not working properly. Therefore the kidney does not hold in as much water and so more urine is produced which can spill out at night. I don't think you ought to wait any longer for your body to correct this problem on its own. You might wish to find a pediatric urologist to investigate your enuresis.  This specialist will probably want to study a sample of your urine. One last piece of advice: drinking caffeine-containing beverages may make night-time wetting worse. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Arnold Zedd, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Skin itching, turning pink, skin colored bumps due to mild abrasion, redness near hairline. Causes?\n\nfor the past several months if something brushes against my skin, it will turn pink and itch . while itching, flesh colored bumps appear. OR, if i have a small itch, let s say on the leg, i will itch it and then pretty soon, the entire leg is itching, then all over the body... plus, if I rub across my forhead, a spot of pink near my hairline will show up. It seems I turned 50 and wierd things are happening.",
    "doctor_response": "Hello Thanks for posting your query. You seem to be suffering from urticaria and dermographism. urticaria produces circular weals. dermographism produces linear weals on the line of scratch mark. You need to be thoroughly examined for any source of infection. And blood test to be done which includes usual tests with additional test like thyroid profile, CRP, IgE leves etc., You may need a long term anti histamine under your doctor's advice There is no need to worry as these are simple problems which can be easily tackled. If possible try to avoid egg, sea food and fish which may definitely help you Have a good day Prasad PVS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for facial sores\n\nafter popping a pimple, i now have two large sores that are indented on my forehead between my eyes and nose. around the sores i have red peeling dry skin that burns & the skin is tight feeling. the scabs dont seem to be filling in the dents, i'm worried they're going to scar as an indention. i've tried neosporin, clobetasol, desoxmetasone, and alot of oher creams to make it heal but nothing is working. what do i do please help!",
    "doctor_response": "Hi, I have gone through your medical history carefully and understood your concerns. A photograph of the sores is requested to evaluate them and give a more specific opinion. I advise not to apply anything for the moment, Wash your face with warm water and salt. Apply only betadine locally for a few more days. Give time for the soreness to subside. If no improvement, then, can apply tetracyclin cream locally for a few days until clear up. All the best!Dr.Albana",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of stress?\n\ni am 21 years old, male. i have had good skin for almost my whole life. however in the past year i been stressing alot. n sudenly i broke out. n i cant seem to get the thought of acnes out of my head. do u think if i stop thinking bout them and stop stessing about them they will go away?",
    "doctor_response": "HiI admire you for positive outlook.Psychological stress is due to physical problem can be treated with motivational counseling and support.Proper treatment t of acne can cause relief in stress.Without treatment it wont go away.Just relax and do not think about that which can lead to mild relief in acne.Sometimes stress causes pimples and acne.So treatment from both the side is mandatory.consult dermatologist for acne.For stress Do not think much.Divert your thought.Exercise ,meditation,deep breathing and hyperventilation, Relaxation.Healthy diet and antioxidant,proper sleepstress free activity.do pleasurable activity,music and hobbiesDiscuss with friends and take advise.see all thing with different anglePositive outlook and confidence All this will help you to counter daily stressStill have a query then feel free to ask.Thank you.Happy to help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes scrotal rash,sore throat and neck pain?\n\nI am a 28 healthy male currently deployed to Qatar. I noticed a rash around my genitals and it itches really bad. This has never happened before. I haven t been sexually active for 6 months. The rash is in the creases of my legs, on my penis and my scrotum sack. What could this be? I have also had throat soreness along with neck, and jaw pain.",
    "doctor_response": "Hi! sorry to inform you that you got some infection that needs immediate medical attention it might cause infertility in future!As per your description, I would like to consider few possibilities in your case as follows:1. genital mumps infection2. systemic viral infection3. fungal infection around scrotal region Therefore you some tests, clinical examination and necessary steps; please see a physician right now!take care...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could gym workouts lead to fast heart rate?\n\nI am 26years old(turning 27 in june) I am 5feet 11 inches tall and 240 pounds. In the past 6 months my heart has been beating really fast and i get headaches sometimes. I have been lifting weights as well what can you advice you to do as far as gym workouts are concerned.?",
    "doctor_response": "Hi,Gym workouts can lean to elevated heart rate only during exercise. If your heart rate is fast during the hole day, then another reason should be considered. I would advise you to regulate your sleep, try to sit in front of computer and TV as little as it is possible, be much in fresh air, avoid stress, try to lose some weight (no strict diet). If you still experience elevated heart rate in 2 months, I would advise you to see your doctor to undergo some tests, such as ECG, blood electrolytes etc.Wishing you good healthIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Vertigo, nausea, sweating. Cause?\n\nI woke up this morning with severe vertigo , and when I sat up in bed I felt severe nausea and had to run to the bathroom, followed by a sudden sweat that accompanied the nausea. the room is spinning and the vertigo does not go away even when my eyes are closed. The only time the nausea is lessened is when I lie down. once I sit, stand, or walk, the nausea becomes so unbearable that I have to immediately lie down again. 8 hours have passed since the vertigo started and I still feel the same. What is this sudden vertigo, nausea, sweating?",
    "doctor_response": "Dear it is better to consult a doctor to exam your neurological status anyway symtoms you are suffering seems to be periferic vertigo and are treated with betahistine 24 mg twice a day starting first week with 24 mg per day.Wish you all the best dont hesitate to contact for any other question",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for reacurring kidney infections\n\nhello i am in need of advise my 7 year old daughter has reacurring kidney infections the sample shows ecoli we believe this is happening from ibs with constipation.  So this is her 7th one, the last one put her in hospital for 5 days on iv anti biotics .  this time the dr perscribed bactrum prior to getting the ecoli finding, she was on it for 3 days with sever burning with urination, sever flank pain as well as 103-105 temps that were not easy to control even with meds.  So on the 4th day the st called and said they needed to change her anitbiotic because bactrum has become resistant to ecoli and they put her on cipro 500 2  per day for 7 days ,  these are all gone as today is day 8.  the fever has subsided some what but still sever flank pain and burning with urnination.  She just dosent feel good, she is dizzy and has little appetitite, low energy, and overall just miserable.  Please any advice??Thanks worried  mommma in the NW!",
    "doctor_response": "A child with frequent urinary tract infections needs to be seen by a pediatric urologist. This is not a normal thing to happen and she needs additional testing to determine why she has these infections. I would be very insistent that your daughter be seen immediately by a pediatric urologist. Your daughter may have kidney damage or have a congenital abnormality of the bladder and collecting system.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure chest pain after an accident?\n\neversince a car accident i was in 3 months ago, i have had an uncomfortable pain in the bottom of my throat, above the top of my chest. i left it thinking it would ease but it shows no sign of getting better. when i go running it feels like i am constantly running in cold air which makes it almost impossible to run. do you have any idea what i have done? if so how can i help it heal?",
    "doctor_response": "first of please do xray chest r/o any flail chest and xray sinus or 3d imaging of maxillofacial r/o any sinus injury or cribiform plate injury if everything fine take pain killer and antibiotics otherwise go and visit to ent and chest physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat kidney stones of 10mm and 3mm on both kidneys?\n\nHi I'm 35, male, I have a regular 15 km walking exercise for 20 years, when I suffered couple of months ago lassitude and was sensitive to slight sickness, head to a doct. two kidney stones detected; one 10mm in lower pole of the left kidney the other 3mm mid pole of the right one, eswl applied for the one in the left twenty five days ago but I could not discharge the whole particles, I try exercises, and plenty of water but unfortunately I fail to drop the rest? what should i do",
    "doctor_response": "HiI usually advice my patients to go for swimming if they can, to drop those stones. Dependining on the configuration of the kidney, the fragments may or may not pass. If they dont pass then you may have to have an operation called PCNL or flexible ureteroscopy to remove it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long will be the effect of lubic jelly on sperm?\n\nHello Doctor, I am using Lubic jelly to overcome insertion problem. As jelly usage is not recommended while trying to conceive, can you please tell me how long will be the effect of lubic jelly on sperms. When can i have the next intercourse(without lubic) inorder to try to get pregnant.",
    "doctor_response": "Good Day and thank you for being with Healthcare Magic! The effect of the jelly would be gone once the vagina has already expelled the jelly inside it. The jelly would not have an effect on the sperm cells that you have not ejaculated. You can have inter course again after washing the penis and the vagina clean of the lubricant. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at:   I would gladly help you.  Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to heal a prolonged chronic cough?\n\nhello my husband has a chronic cough for at least 10 years he has been to specialist and doctors who havenot given us an answer or helped he is now on Montelukast hasn't helped he coughs so much he vomits his voice is raspy we have tried nexium thinking it might be reflux of some sort aiso asthma preventives he cannot have cortisons as the hospital injected him and he had a serious anaphylaxic reaction we are both at our wits end he is very drained and tired  please help",
    "doctor_response": "Dear i have seen a lot of such cases ...so first of all  my advice is to add a pinch of black pepper to ur husband's  bed tea.  Take 2 tsf honey twice a day after meal. Avoid smoking , alcoholDont take curd n bulky fatty meals at dinner.Repeating blood test  are of no use at present.If  the cough is dry then most probably its a case of pulmonary eosinophilia. Keep bowl movements normal....dont get constipated.. U can also take some herbal medicines of Himalaya drugs .These r1Tablet Bresol 2 Bd2. Tablet Herbolax ( for constipation)3. Chew 1 cardamom after every meal4.drink hot water after every meal n especilly before sleeping.Follow this n i am sure u wil  feel the change.Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Nodules in liver and lungs, biopsy shows non cancerous, growing. Help\n\ni have multiple nodules in the liver and lungs i have done a liver biopsy twice and it is found to be non cancerous but the nodules in the liver are growing bid in size will it turn cancerous after a few years i am confussed and very unhappy because i do not smoke and drink then why should i get this nodules in the liver and lungs. Please help i would be grateful to you all. Thanks and regards",
    "doctor_response": "If your liver function is normal then these nodules may be benign however there are chances of them getting malignant.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a ganglion cyst occur on the foot?\n\nCan a Ganglian Cyst occur on top of a foot? my wife s left foot is swollen and she is on medication to treat that swelling - a blood pressure water pill - and now that the swelling is decreasing - there is a knot on the top of her foot that is more noticible now than it was before. some other history - my wife has had Shingles once in Dec 2015 and once again in Aug 2016 and she has had the single shot 4 weeks ago (mid-Mar 2018) and has taken a nerve pain pill from Aug 2016 to Aug 2017 she thinks that the foot issue may be another outbreak of shingles but when she went to her primary care physician earlier this week - it was due to the swelling in her left foot and to insure that there was no blood clots",
    "doctor_response": "Hi, As per your question- ganglion cyst can occur in the foot, Dorsal side( upper side). This is generally a small swelling of about 2-5 cm max. The large swelling in her foot is unlikely to be due to a Ganglion or a swelling due to Shingles. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain after childbirth. Discomfort in ribs\n\nHello my names is Diana I m 19 and I had my baby about 6 months ago . I never had a problem with my back during my pregnancy but when I had my baby , a month later .., I have severe back pain like I rather die . It s unbearable and I always end up puking during the pain I get ! I feel like my ribs are squishing my lungs and my stomach ! It happens evey once a MONTH like no lie I m to young to be even having this ! I also had the epidural but they assured me that it wasn t it ..",
    "doctor_response": "hi diana back pain after pregnancy and lactation is very common . this is mainly because of increase lumbar lordosis and laxity of abdominal muscles, nutrional deficiency of vitamin d and calcium which is very common after pregnacy and lactation . Take proper calcium vitamin d suppliments, abdomonal muscle strengthening excercises as advised by your gynaecologist and the physio therapist . and if you still have pain after doing all this things consult orthopedic surgeon i diana",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for knee pain\n\nI have knee pain beneath, and around knee cap, mostly on the interior side of knee cap. Knee feels stiff, but no swelling. I have had this issue for some time with no relief. Shooting pain comes with stress on joint, especially when trying to lift with resistance. What type of injury is this likely? What stepa should I take moving forward?",
    "doctor_response": "Thanks for contacting healthcare magic. You have problem of stifness of knee and pain problem that may be because of arthritis problem. Take one x ray  for further diagnosis. Consent a physician for further diagnosis. Any injury may cause bursitis means inflammation of bursa.Avoid excessive straining of knee.Proper physical examination and history give exact idea. I hope my guidance is helpful to you. Take care. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tiredness while on  treatment for gordonia renal?\n\nMy partner is 3 months through his treatment for Gordonia Renal TB. The night sweats have more or less stopped and it seems reasonable to assume there isn't much he can do about the severe tiredness except rest but is there any pain relief he could take for the pain he is experiencing on the right side of his kidney area (where he has 6 cysts) hip and pelvic area. He said it is like being kicked. Thank you Natasha",
    "doctor_response": "Hello dear,welcome to Ask a doctor service. I reviewed your query and here is advise.He can take buscopan or spasmex for pain derived from kidneys. Hope I have answered the question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe bruising and pain in thigh after injury\n\nFour weeks after a fall against a hard object which caused severe bruising and severe pain of the left leg thigh and calf, severe pain continues in the back part of the leg down to the ankle. I have been treated at a rehab facility 5 times but the next day I still get severe pain in parts of my lower leg. I take a Hydrocodon-Acetaminophen for the pain. Is there anything else I can do to help stop the pain?",
    "doctor_response": "Dear, pain is one phenomenon of body that has a very strong psychological reaction, and this is where mental strength in feeling pain depends, so be strong and do not be always be in pain consciousness, rather be active and involve yourself in family and friends. as far as medication is concerned, let me tell you that you can try Tab Tramadol 100 mg two times in a day, but if you can be without drugs, than that is the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat abscess between rectum and scrotum that started out as an ingrown hair?\n\nMy boyfriend has an abcess between his rectum and scrotum that started out as an ingrown hair. It is now very long and hard,when i squeeze it i get puss and blood and it is very painful. He has stated that it feels like its in his scrotum. He is not liking the idea of going to the Dr.but i don't know what else he could do. I'm just trying to get some kind of idea what this could be,and what we should do.",
    "doctor_response": "Hi,From history it seems that your boyfriend might be having abscess in anal region.If abscess is already formed then it requires excision and drainage of pus followed by regular dressing.There is also a possibility of having Fistula in ano.Consult surgeon and get examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My baby is avoiding breast while breast feeding. How to feed her?\n\nHello doctor, My three months baby is avoiding breast while feeding. Is there any other option to make her drink breast milk without direct feeding?",
    "doctor_response": "Hello. You can express breast milk (either manually or by using a breast pump) and give that milk to the baby using a spoon. But the reason for avoiding breastfeeding needs to be evaluated. Nose block is a common cause for refusal to feed. If the child is having a nose block, you can use Nasoclear drops two drops prior to each feed. You have mentioned the baby's current weight as 6 lbs, for a three months old baby 6 lbs fall much below the normal range. Was the child preterm? How much was the birth weight?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the sperm count normal?\n\nAge 42, ht 173cms, wt 77 kgs, Slight hyper tensive,no diabetes.My Sperm Analysis is Vol : 2.4 ml pH; 8.0 Fructose : Adequate Active Molity at 0 Hr: 40% at 3rd Hr: 20% at 6th Hr: 10% Total Count 77.6 Million Normal: 61% Amorphous : 6% Cyto Droplet: 5% Bent Neck : 4% Coiled Tail: 6% Pin Head: 3% Mixed Defect 15%",
    "doctor_response": "According to WHO criteria your count is with in normal limits. And you can be a father. Take care. Hope my answer is helpful to you. All d best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is PCR test reliable to detect TB infection?\n\nhi I got my PCR report which tested positive for TB , am put on AKT 4 but after reading few blogs I learnt that it is not a very reliable test , am very confused as I have already started the dose and think should not stop it, is there a test which wud tell me for sure bout the infection.Also, my tubes have not been checked yet , is it safe to get them checked or there r chances that the infection  cud spread?Can I stop medications if a confirmatory test is negative for the same? age is 28 trying to conceive for 6 months",
    "doctor_response": "Hi, Thanks for posting in HCM. Tuberculosis is diagnosed by finding Mycobacterium tuberculosis bacteria in a clinical specimen taken from the patient. Generally, the organism is looked for as acid-fast bacilli (AFB) by Zeil-Nelson (ZN) stain.PCR test is a reliable test for tuberculosis.  PCR or gene probe tests can distinguish M. tuberculosis from other mycobacteria. It is mainly used to detect the bactria in extra-pulmonary lesions rather than pulmonary tuberculosis and whose culture is negative. Once you have been diagnosed and AKT 4 has been started, you need to take the drugs regularly for the specified period even if the tests done are negative. If the treatment is discontinued in between, it gives a chance for organisms to strike back with resistance, which would be difficult to treat. Once you are done with the treatment course and your evaluation suggests good recovery, you can go ahead for conceiving. Till then, keep it on hold. Hope the information provided would be useful. All the best and wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life span with bile duct cancer and hypertension?\n\nhi! my father in law was diagnosed with a bile duct cancer, no metastasis found.he s 71 yrs.old this oct.4, he had hypertension before but now that he is suffering from the so called bile duct cancer he s blood pressure now is 90 - 70, or 110 - 60, what perhaps is his life span... i am worried coz my husband, his son is just 1 month away",
    "doctor_response": "hi.noted history of bile duct cancer and hypertension. when was the last work-ups done? with regards to his life span, it is dependent on the cancer staging and/or the advancement of his disease. it is best if he consult with a doctor, preferably a general surgeon, for physical examination and clinical evaluation. complete metastatic workup must also be done. diagnostics and management (medical and/or surgical if indications are found) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this pelvic ultrasound test result during pregnancy indicate?\n\nHello doctor.Im sangeetha kotha of 33 yr oldand have 5 yrs old girl baby and had 2 miscarriages in nov 2015 and june 2016 at around 10 and 11 weeks.... now im carring .. its 11wk and had Nt scan done which shows the thickness of 3 to 5mm... can u pls tell me the risk of abnormalities...",
    "doctor_response": "nt scan of less Dan 3.5 mm is normal..nt scan is a screening test for down syndrome...u can combine nt scan with blood test called combined test ....increased Bhcg and decrease pappa is seen in downs syndrome",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for enlarged prostate?\n\nI am male 70 years old with a very enlarged prostate (BPH) I'm scheduled for a colonoscopy on Tuesday and wonder if it's safe o have it with such an enlarged prostate. My prostate is 160 cc. Had a biopsy and I do not have cancer. Should I opt for a virtual colonoscopy. I'm 5'10 and weigh 180 lbs.",
    "doctor_response": "Hello and .As an Urologist, i can fully understand your concern.Definitely, you've an enlarged prostate,larger than average, in size.It's good to know the biopsy is non-cancerous. A TURP is advisable, before you develop retention of urine,which's imminent.The prostate gland doesn't cause any problem for a flexible colonoscopy.Your height and weight are also not factors, that affect colonoscopy.If you want an expert opinion on any doubt, send it as a direct question.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "After oral surgery developed rash from right arm to left leg. took bactrim. Positive for staph aureus. Suspect contamination. Suggestions?\n\nI had oral surgery in June 2011 and developed an itchy skin rash within a week  after surgery around the iv site..the surgeon missed the vein the first time so got it on the second try....the rash spread from my right arm to my left arm and then to my legs ....went to a dermatologist and he took a slide of one of the sores and it came back positive for staph aureus..he put me on bactrim...all I know is I went into his office rash free and came out with a very significant rash.... I am a nurse and acupuncturist..i suspect contamination of something...equipment..iv fluids...would their,office document it...also my 4 extractions with 2 dental implants went terribly awry with pain and infection until I lost a row of teeth and the 2 implants abscessed..what are your thoughts",
    "doctor_response": "Hi,Thanks for asking the query,According with your clinical history i suspect that you have developed an infection at the site of i v infusion, i would suggest you to continue with the medications.Abscess at the implants and extraction site can be because of amny reasons like poor oral hygiene, food lodgement ant the extraction site, hormonal changes like diabetes, i would suggest you to visit the Dentist and get the checkup done take an x-ray . Take complete course of antibiotics and analgesics.Use antiseptic mouthwash gargles twice daily. Maintain a good oral hygiene.Hope this helps out.Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diarrhea, headache, pain, nausea. 7 teeth removed, taken antibiotics. Advice?\n\nI have gotten 7 teeth removed 4 of them were my wisdom teeth which had to be cut out. On September the 9th. They put me on steroids and antibiotics. I went in for my one week appointment I complained of pain and diarrhea, I was told it was from the antibiotics. I still have diarrhea,headaches,nausea,upset stomach,and pain.",
    "doctor_response": "Hi,Thanks for asking the query,I would like to tell you that pain, swelling, nausea, dizziness, fever are common side effects after wisdom tooth extraction you dont worry about the symptoms as they will subside after sometimes.Abdominal discomfort is due to antibiotics and analgesics prescribed to you, visit to the concerned Dentist and get the prescription changed, also take an antacid along with the medications.Also take lukewarm saline and antiseptic mouthwash rinses for early recovery.Hope you find this as helpful,Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having cramps in the left lower abdomen. Unable to diagnose. What could it be?\n\nHi, my 11 year old son has lower left hand side abdominal cramps.  He has had them for some time, and we have seen a doctor who cannot find any reason for them.  He has just had like an explosion feeling tonight in his lower left hand side and says the cramps move up and down that side of his lower body.  I looked up and noted the appendice was on the right hand side, so not sure what it could be.",
    "doctor_response": "Hi ! Does your son get increased frequency of going for wash room associated with the cramps and a habit of eating junk foods form outside ? If yes, then possibly he suffering from simple collitis which needs a stool test and culture sensitivity test if required. Your family physician may prescribe some anti amebic drugs and some antibiotics along with some probiotics depending on clinical findings and also result of the stool test. Next diagnosis which has to be excluded is a urinary tract infection, which may give rise to similar kind of situation. Go for a routine urine test and a culture sensitivity of urine if need be. Show the results to your family physician for further action. You are right ! There is a very remote possibility of the pain being due to a appendicitis on the left side. I hope this helps you in solving your problem. Wish your son an early recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causs wounds with puss in under arms?\n\nhi doc......i m 37 years old male. 10 years back i had tuberculosis tumor under my both arms. i got oprated and doctors removed it and after that i used medicine for nine months{miren p + treptomicine injections}. but now i m sufering from the same symtoms. i hv wounds under arm with puss. wt do u suggest me to do ?",
    "doctor_response": "HiI understand your concern and situation.It seems that you have some bacterial infection which is drug resistant or tubercular infection. You must also take tests like gram staining, ZN staining and culture sensitivity for aerobic and anaerobic bacteria and mycobacterial infection. You must take treatment according with regular drainage.Take careBest of healthDr Sheetal Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in head when trying to sleep, have canker sores, ear and throat pain. Help\n\nHello, Im a 43 yr old woman that has been having lymph noid, ear and throat pain, and I do have canker sores with it. Its like a flare up from month to month for some time now and can last weeks at a time. When I sleep or try to sleep i get excustiating pains that shoot thru to the top of my head, some lasting as long as 30 seconds, some as fast as a flash of lightening. The pain is terrible the worse ive ever felt and on occassion happens during the day. But i have noticed if i sleep with my face pointing downward its more apt to happen. not to mention that I get pain with my teeth that cover all way around my face, even where i dont have teeth. I feel as tho it could be a nerve isssue but not a clue what to telll a dr to get help",
    "doctor_response": "Hello,Thanks for writing to us.The severe pain which is aggrevating as well as excruciating in nature,will be due to deep dental caries in which pulp is inflammed.Grossly decayed or impacted wisdom tooth can also cause such pain.Take ciprofloxacin as well as diclofenac tablets to relieve the pain as well as underlying infection.Meanwhile,visit a dentist and get decayed teeth restored or extracted depending on severity of lesion.Always maintain oral hygiene well.Apply lidocaine gel to relieve the pain due to canker sores.Avoid spicy foods.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for panic attacks along with headache\n\nMy son has episodes of what seems to be a panic attack with headache and other symptoms.  Thanksgiving day he experienced one and had to go home.  He said he could feel something coming on...he experiencedheadache, and he said he felt like he wanted to scream of blurt out something.  He is still not 100% and still has a headache.  What do you think?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Your son is school going. His case should be different than other adults. Panic attacks always happen due to underlying anxiety. Therefore you must address the underlying anxiety first. Please understand anxiety and related problems. Once you understand your anxiety, you will be able to keep yourself away from panic creating situations. Therapy always starts with avoiding such situations along with coping techniques when forced to be in such situations. Start slowly, progress gradually, attain neatly. Ask your son to understand anxiety and address it. Consult a psychologist if need be.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intermittent seizures, convolutions and headache?\n\nMy husband-22 started having random seizures. Has seen a neurologist who said his CT scan and eeg are fine. Right before the seizure he gets really hot. He will pass out eyes roll back and convolutions. After he comes to he can get really angry and not remember it, then complains of lower chest pain and a headache. He hasn\u2019t had any falls or hit on the head but tonight started coughing up blood. I\u2019m at an end because every time we go into the er they automatically think drugs until the screens come back normal. The neurologist doesn\u2019t want to start meds even though we\u2019ve had 20+ seizures! What do I do??",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. If the seizures are true, they need to be confirmed by a prolonged video EEG. If this examination confirms the seizures, treatment based on the type of the seizures should be started. You can get a second opinion by another Neurologist. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How severe is stage 4 congestive heart failure?\n\nMy dad was diagnosed with stage 4 congestive heart failure, and was told that only 25% of is heart is pumping.  This was 2 days ago and has really scared us, can you please help explain just how severe this is, what to look out for, and what to expect?",
    "doctor_response": "HiI would like to know if you were told the cause for the heart failure. Did he have a heart attack earlier? Did he have any other illness prior to this time that required hospitalization? Most likely its is the echocardiography report that would have been mentioned as Ejection Fraction - 25%. It indicates the efficiency of the heart which in your dad's case is on the lower side. Once he comes out of this current period of hospitalization, it is essential that he takes his medicines regularly which may include medicines to reduce the amount of work that his heart performs by reducing the bodys water content(diuretic). There are several other effective medication too which can be prescribed depending on his blood pressure and other factors. I am sure your physician will be able to guide you on this. Ensure that he reduces his salt and water intake. His body cannot handle too much water. Any infection especially of the lungs is to be treated promptly with antibiotics to avoid complications. With adequate medicines, some of the patients that I see with a heart failure having an ejection fraction of 25% , also live upto 3 to 5 years.Wishing him the best health!! I hope I answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can uterine fibroids affect a pregnancy test report?\n\nHi I have fibroids I was bleeding three months on and off finally stopped last week I have been having pregnancy symptoms last couple months with growing belly . took a pregnancy test today said negative my question is can fibroids make the test negative when it is really positive.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Uterine fibroids can not affect the outcomes of a pregnancy test so you are not pregnant. Hope I have answered the question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Burning sensation, numbness in fingers. Had ACL surgery. Will numbness spread?\n\nHi, I had ACL surgery in my left knee about 4 years ago. After surgery, I used ice treatments to reduce swelling . I think a few times I left it on for too long, and some areas of my thigh were in direct contact with the wrap. Now, there is an area of my thigh that is numb, to the touch, but I still have the function of the leg and can still feel pressure when I push the numb area with my fingers. At night there is a burning sensation in that area when I lay down to sleep. I didn t notice this immediately after the surgery, but have been bothered by it for a few years now. Will the numb area eventually spread further, or will it remain localized? Thanks for any advice you can provide.",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. It is difficult to say if the numb area will spread or no. You need a nerve conduction testing (ENMG) in order to evaluate the degree of nerve damage and the exact place of damaged area. This and clinical observation ( if you are experiencing worsening of numbness in time) can show if the numbness will progress or not. Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is femilon tablet safe?\n\nCan you please answer whether femilon tab is safe or not. My mrs. has endometriosis on left ovary. Last november she had undergone s c section drlivery for a boy but he survived only 5hrs. Doctor suggested us to take femilon from the first day of period.",
    "doctor_response": "HiFemilon is a combined oral contraceptive which is useful in reducing menstrual bleeding and regularising the cycles.Abdominal cramps can also be reduced in the subsequent cycles.Femilon is a safe drug for short term use and should not be used for long duration such as more than 6 months.Hope I have answered your query. Let me know if I can assist you further. RegardsDr.Saranya Ramadoss, General and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain, lack of appetite, hypertension. Pancreatitis diagnosed. Treatment?\n\nI have had very bad abdominal pain for the past two days. I originally thought it may be muscle pain as I had painted and tiled our laundry the day before. I feel like I am full of gas, but I m not, I can only lie on my side curled into a ball, and when sitting I have to bend over in the chair. My appetite has vanished, and that has been over the past week or so, but as I am diabetic and have high blood pressure, I know I need to eat to take medication. I was feeling a little better today after not eating yesterday, but then I had breakfast and I am in agony again. I am going to the bathroom okay, and I am not vomiting.  UPDATE: It was Pancreatitis. I was in hospital for five days on IV drip with fluids only. However, there were no gallstones, (Ultrasound and CT scan were performed) and I am not a drinker, so now they are looking for another cause. An MRI is booked for a few weeks time and a blood test to check for an auto immune def has also been performed.",
    "doctor_response": "Hi and thanks for the query, Diabetes deserves careful monitoring, and abnormalities in glucose levels, leading to hyperglycemia could cause many of the symptoms, including those you just described. High serum glucose levels can cause nausea, vomiting, fatigue and abdominal pain. Frequent drinking, thirst and urination are also very common associated signs. I suggest you get your serum blood glucose controlled and see what is actually going on., This might require compliance to your medication, or adjustment of the medication. Meeting your primary care physician for examination and discussion about the treatment plan is very important to actually elucidate and confirm the causes of the symptoms you are experiencing, and also to exclude other possible causes of these symptoms. Thanks and best regards, Luchuo, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high fever with cold\n\nMy 17year old son has a temp of 106! Clearly was showing symptoms of a cold but now seems more like flu, he has a 5 hour exam tomorrow. I have given him paracetamol as he told me he'd taken ibruprofen for headache, and took him to drink plenty and keep wiping down with a cold flannel....what more can I do??",
    "doctor_response": "HI, thanks for using healthcare magicAt the moment you are doing what needs to be done. He should take the paracetamol and ibuprofen regularly at the recommended dose.\\Cool liquids might help to reduce his temperature as well.Because he is not well, he may not be able to concentrate in his exam and may not be able to do as well as he would normally. You may want to consider a doctor's certificate to see if he can take it at a later date.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do hurting ribs radiating to back and shoulder after being treated for pneumonia mean?\n\nHi, may I answer your health queries right now ?  Please type your query here...I have been to the doctor 2 times. First time, it was a severe sinus infection, week later had to go back, turned into pneumonia, had to go back third time. All 3 times I was given a shot, antibotics & c-pack first time, steroids, antibotics & shot second and antibotics & shot third. I have been hurting under my ribs and has gone to my back and shoulder. Do you think the pneumonia has gotten worse? Do I need to go back to the doctor?",
    "doctor_response": "Hello dearWarm welcome to Healthcaremagic.comI have evaluated your concern in depth .*  This indicates lung pathology giving nerve endings pain with hurting ribs    radiating to back and shoulder .*  If  not  carried  out  x-ray chest  with or without  CT thorax is a must for    proper  diagnosis and management  guidelines .Hope this clears your query .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can persistent pain following a back surgery be treated?\n\nHi,I have had back surgery and I have been on moraine for years primary Drs say I need a pain management dr I am not able to find one willing to to take. My insurance I am in the Fresno Californa area do you have any ideas . I have tried the shots with no relief.",
    "doctor_response": "you can try other medications like lyrica, gabapentin, cymbalta, lidocaine, icy hot, Effexor. you can also try yoga and stretching",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from halitosis for the past 15 years. Kindly suggest a solution.\n\nHello doctor, I am a 26-year-old female. I am suffering from halitosis for the past 15 years. Consulted many doctors and they could not find out the reason. Please help me.",
    "doctor_response": "Hello. If it is such a long history, it will surely need good investigation, medication and regular check-ups. And as you are saying it is not possible in your area I can only give you oral home remedies which may or may not work without timely scaling. This condition can either be related to your mouth or to your stomach even. Many a times this may be due to stomach conditions, upsets or poor oral hygiene. For now I would suggest you to get a full mouth scaling and root planning done if possible in your area, after that follow these: Drink plenty of water. Avoid things like raw garlic, onion. Take more fresh fruits and vegetables. Chew parsley, it helps. Clean your tongue after you are done with tooth brushing. Floss at least once daily. Rinse off properly after every meal and clean your teeth with fingers. Do warm water and salt rinse three to four times daily. Do not take in more of sugary things as they stay for longer time in your oral cavity and cause bad breath. Keep clove in your mouth. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump under the breast appear and disappear?\n\nmy daughter who is age 19 1/2 went to gynocologist and has a lump in her right breast.  about 1 1/2 years ago she had a lump and it disappeared and now reappeared.  the doctor pressed on it and she felt a slight pain.  she is going for an ultrasound next week but i am nervous about it.  why would it disappear and then reappear almost 2 years later.",
    "doctor_response": "Thanks for your question on HCM. I can understand your daughter 's situation and problem. In my opinion she is having breast swelling due to fluctuations in hormones. In young age, hormonal fluctuations can occur. And this causes fat deposition in breast tissue. This fat deposition can be perceived as swelling in breast. But better to get done mammography for conformation of fat swelling. Also get done hormone levels to rule out hormonal imbalance and consult gynecologist for treatment. If it is fat swelling then no need for any treatment, just treatment for hormonal imbalance is needed. Hope I have solved your query. I will be happy to help you further. Wishing good health to your daughter. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stiffness in the tongue?\n\nHi, my dad has bone cancer, and about a month ago his tongue started to get stiffer. When he's asked to pull his tongue out, it always goes to the right. can a fungus be the cause, since he is anemic? Stopped chemo couple of months ago.Radiation treatments still undergoing for his neck and sternum.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern.Thanks for your query . The stiffness of tongue along with restricted movement is always a cause of concern . In your case the most probable reason for stiffness of tongue and restricted movement id radiation therapy.When person is undergoing radiation therapy it causes dryness of mouth as a side effect which further causes stiffness of tongue . This dryness and the anemic condition as you mention in qery further make the tongue pron to infection .I would suggest you to consult your radiologist and oral pathologist for proper evaluation of the condition and rule out causes like oral thrush ans any malignancy . Doctor may take small tissue of tongue for biopsy biopsy .Doctor may alter the radiation dose , prescribe iron supplements , prescribe saliva substitute and recommend certain tongue exercise .Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for depression, confusion, memory loss and fear?\n\n28,5.6 inches,55 kgs.I have a family history of suicide attempts,seizures and anxiety.I have taken depression pills like zen 200mg,volprol 300,etc,mascular seizure has occured once, i get often panic anxiety attacks in severe anger in which i harm and wound myself.I have gone through a major brain operation after i shot bullet in my right side head. I remain in constant fear and considers myself quite a psychic patient.plz help with my problem of depression, confusion, poor memory, anger fits and fear.",
    "doctor_response": "HiThanks for using healthcare magicIn that case, you need to mood stabilizer with antidepressant. You need to take higher dose of valprol and zen. That would help to control both mood as well as seizure attacks. You can also try some antidepressant like paroxetine or escitalopram. That would help to control depressive symptoms in control. Better to discuss about them with your psychiatrist. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have severe nasal congestion. Can I use Pseudoephedrine and Otrivin together?\n\nHello doctor, I am a 22 year old girl. I have severe nasal congestion from a suspected cold or sinus infection (I have not been to the doctor yet). When Pseudoephedrine (Sudafed tablets) was not working, the pharmacist suggested to try Otrivin Plus nasal spray. Both give slight relief but I forgot to ask if I can take both together. Is it okay if I take both simultaneously until I can get to my GP?",
    "doctor_response": "Hello. With the details provided, I understand that you are a 22 year old female suffering from cold or sinus infection causing nasal blockage. Currently you are taking Sudafed tablets and Otrivin plus nasal spray. Presuming that the Sudafed tablets you use contains only Pseudoephedrine, I would say that it is perfectly alright to take Sudafed and Otrivin plus together. Both have similar actions and will act to decrease the nasal congestion and relieve the blocked nose. Pseudoephedrine tablets will get absorbed into blood and act systemically. However otrivin nasal spray being sprayed into nasal mucosa will act only locally with very little systemic absorption through the blood vessels. The two compounds have slightly different mechanisms of action as well and use different set of receptors and messengers to bring about their action. You need to worry about their combined action only if you suffer from hypertension or elevated blood pressure. Otherwise till you meet your GP it is fine to take both together. However, do not take Pseudoephedrine more than twice a day in normal strength. If it is maximal strength tablet then take not more than once a day unless advised by your GP. However follow these general instructions till your GP makes a decisive diagnosis and institutes the most appropriate treatment for you. Consult an allergy specialist online for further follow up -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain, swelling behind ribs. Taken gas medicine\n\nhi my girlfriend is having some abdominal pain ...its on the right side...she said it feels like its behind the ribs...like a swelling feeling feels like its moving....been to the er 3 times and they have said they have found nothing... have tried gas meds. they worked for a min but she feels the pressure build back up, and that s without eating.",
    "doctor_response": "Hi ! Good morning. If your she has gone to the ER three times and the doctors found nothing on clinical examination, apparently she does not have any palpable mass or organomegaly in her abdomen. But to be sure, because her complaint is persistent, I would advise her to go for an ultrasound abdomen to rule out any pathology in the gall bladder/liver. Till that, she can have a proton pump inhibitor, a prokinetic agent, and an anti spasmodic in case of pain. Further management will depend on the investigation reports. Thanks and good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for frequent urination with lower back pain\n\nOVER THE PAST WEEK OR SO I HAVE NOTICED I AM URINATING AT A VERY FREQUENT RATE..USUALLY EVERY TWO HOURS OR SO. AT NIGHT ESPECIALLY. I ALSO NOTICED EVERY ONCE AND A WHILE ILL HAVE DULL PAIN IN MY LEFT LOWER BACK. NOT SUPER PAINFUL, ALMOST LIKE IT FEELS LIKE A PULLED MUSCLE. SOMETIMES I FEEL LIGHT HEADED TOO OR CONSTANTLY WORE OUT. I WAS JUST WONDERING IF THIS IS SOMETHING SERIOUS IF YOU WOULD KNOW, OR AM I WORRYING/.",
    "doctor_response": "Dear Patient,please perform a urinalysis, urine culture, CBC and CRP. Very likely for a UTI. Let me know",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat cough?\n\nHi I have this cough for about 2 weeks which I think could of been caused by been exposed to bleach as one day I used it too much to clean with and felt in my chest since that something is not right.what should i do ?am I in danger and what kind please thank u",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Cough is common after bleach inhalation. But it is usually self limiting and resolve itself in 1-2 days. But in your case, you are having cough since 2 weeks, so we need to rule out bronchitis. Bleach inhalation actually causes inflammatory reaction in the airways. This reaction is short lived. But if patient is smoker or the exposure is severe than patient can develop Bronchitis. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of bronchitis. You may need inhaled bronchodilators, inhaled corticosteroid (ICS), oral antihistamines and anti inflammatory drugs. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lumps on leg, shin and ankle?\n\nsmall lumps have been suddenly forming on one leg, on the shin and near the ankle. no sign of varicose veins... there is a burning sensation, I suspect nerves. I m a klutz, and have too many injuries to remember. last was a badly sprained ankle that didn t mend well",
    "doctor_response": "Hi,Dear thanks for the query to HCM virtual clinic.I studied your query in full details updated from you.I understood your health concerns.Based on your query data, In my opinion ,Dear You seem to suffer from Varicosity of the Short Saphenous Vein with multiple bumpy swellings on shin/ankle on one leg.Burning pain sensation is due to sural neuropathy due to pressure from engorged Varicose Lumps and stretch of the surrounding soft tissue.Multiple injuries could only expedite the basic defect of Varicose Veins in your case,but should not be directly correlated to cause the burning swellings on shin and near ankles.So your suspicion is wrong and could be confirmed by second opinion to evaluate your  case clinically.Color doppler study would confirm this.For this treatment Gp and Surgeon and Vascular Surgeon team would be needed to treat your case.Hope this reply would help you to evaluate your case and treat it with your doctors in time to come.Hope this would resolve your query and worry and Anxiety accompanied with it.Welcome for any further query in this regard to ME.I would love to help you out.Awaiting for any further query.Wish you fast recovery from this intriguing health problem.Have a Good Day.Dr.Savaskar M.N.M.S.Genl-CVTS -Senior Surgical Consultant",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting, diarrhea and low appetite?\n\nMy 13 months daughter (78 cm approx 10 kg.) name Dorothea every night in the last 6 days wake up in the middle of the night in pain and then vomit probably a coffee cup size of food ate the night before. Now is usually around 4 am. The first 4 days of the week there were also the symptoms of Diarrhea. For your information my daughter has only 2 teeth (bottom part) and in the day she walks around like nothing happens the night before. I noticed her appetite has decrease. Thank you for much appreciated help. Mr Enrico",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron (as prescribed by your paediatrician).Regarding diet - You can use cerelac...any flavour will do. Avoid fruit juices as they might aggravate diarrhea. You can give zinc supplements & ORS apart from normal vegetarian porridges & soups.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is loprin safe during pregnancy?\n\nmy wife is 3mths pregnant. she is hypothyroid and her tsh is 9.5 and also her ANA test came weak positive(1:100). her doctor prescribed her loprin75mg once a day along with her routine medicines. is loprin safe during pregnancy since i have heard lots of side effects of aspirin.",
    "doctor_response": "Hi, Yes, it is considered to be safe during pregnancy. Low dose aspirin (Loprin) is commonly prescribed to prevent miscarriage, clotting disorder and also to prevent or delay the onset of preeclampsia. It is found to safe hence the doctor has prescribed her. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mohammed Taher Ali",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in lower abdomen due to strained groin. Concerned, specialist help required?\n\nI have pain in my lower right abdomen (belt line) and my doctor told me it was a strained groin .....the pain is still there and i also have to hold up my testicles to help alleviate it...i am a plumber and have to lift heavy things but this has never been an issue before...i wear jock straps and brief boxers but the pain is still there....pushing on the site of pain seems to help but it just hasn t gone away....there is no swelling and my doctor said it would just go away...i don t know what to do and i m very concerned........should i go to a specialist?",
    "doctor_response": "hello sir, thanks for your question.such pain in the area you described mey be an infection in the testis or spermatic cord (epididymo-orchitis), pain which usually resolves when the affected side is raised. you need to ge for STI screening and treatment.specialist help would be needed if persistence.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pleural thickening with patchy opacities in the lung?\n\nMy chest xray says: left plueral thickening with patchy opacities of the left upper lung zone.The left hilum is elavated with comparative volume loss of the left lung. The pulmonary vessel on the left shore a hanging down appearance. Foci of calcilification on The right upper zone. Heart size is normal.",
    "doctor_response": "Thanks for your question on HCM. In my opinion you should nit worry much about this report.It is old lesion and must be due to old lesion.You may have old TB and due to this fibrosis occured and long standing fibrosis causes pleural thickening,  fibrosis and calcification and volume loss.So you are having left lung malfunctioning. So better to take pulmonary vaccines like pneumococcal and h.influenzae for prevention of future infection.Better to start pulmonary rehabilitation and chest physiotherapy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Inability to read texts, letters seem like patterns, loss of memory. What is the cause?\n\nWhile reading I sometimes lose track of words and find myself following patterns on the page which form between letters. I find myself somewhere near the bottom of the page but have no memory of reading the text, I can see the letters but not the words and the pattern of space on the page standout clearly. This happens regularly when I read. What causes it? Other times I see red or green lines around the sentences and recognize the letters but not the words. Is this related to the pattern problem?",
    "doctor_response": "Hi there, this could be related to concentration problem. It may be related to a medical problem or a psychiatric issue. You should pay attention to see if any other changes has happened, like tremors, palpitations, etc. You may also pay attention to see what is the pattern of your sleep. Reading problem can also be related to refractory problems in the eye. Sometimes we need an eye glass or it could be related to change in the eye pressure. For example some medications change the pressure inside the eyes, like some antidepressants, etc. Let me know more about it. I wish you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I feel severe pain in my left testis, please help\n\nI am dr. monowar , dentist from bangladesh.I am 26 years old and married 3.5 years ago. I feel severe pain in my left testis about 4 years ago.An urologist said that it is testicular torsion and he gave me some medicine.after 1 month it become smaller and smaller.But now(4 years later) i can not feel my left testis.And also feel little pain in my scrotum always and right testis become smaller for 2 month.my wife get pregnant about 3 times but we abortion it.ultrasound is done of my testis Is any way to keep my right testis normal size and well functioned and not become further smaller . please give me the solution. now what i am do?",
    "doctor_response": "Hi,Dr.Monowarji, Thanks for query. It seems that you might have atrophy of left testes. It is possible that due to this testes your right testes may affect. So I think get it removed so your rt testes is saved. Consult urologist and discuss about this. Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bleeding during intercourse and burning while urinating are normal symptoms of taking depo provera shot?\n\nHI, I am 18, 5' 3\" and 194 lbs. I was wondering about the depo provera shot. I just got my second shot maybe 2 months ago. After intercourse I bleed like for a couple of days and when I go to use the bathroom it burns, are these normal symptoms for this shot?",
    "doctor_response": "Hello and welcome,Bleeding during intercourse is not a symptom caused by depo. However it may cause an erosion of the cervix [ change in the lining of the cervix ] that tends to bleed. Also it may cause irregular bleeding or spotting that may be coinciding with your sexual activity. Other reasons may be a cervical polyp which is a non cancerous growth of the cervix. You will need a per speculum examination for this so please get it done. Also burning in urine indicates either a low water intake or a urine infection. So you will need a urine examination. Also please drink plenty of water to flush off the bacteria. Hope this satisfies your query. Thanks for using HCM.\u00a0\u00a0\u00a0\u00a0\u00a0Feel free to ask any more questions that you may have. Dr Madhuri BagdeConsultant Obstetrician and Gynecologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment should I take to get relief from abdominal pain which is more while walking and standing ?\n\nI am a 33 yr old female .I have lower right sider abdominal pain which goes toward my inner thie since last 4-5 month also same sided back pain .month ago my laproscopicappendectomy is done but the pain haven t stopped infact increased(my abd ct andsonography and bld test are normal) pl. advize..it is kin of very much of tension coming on my nerves also my stomch feel very heavy and give me pain more when i m standing and walking although it is continuous even after taking pain killer .some relief i there only when i lie down. also i have motions 3-4 time a day i m really worried and feel like misguided .(what is this exactly ibs, or nerve or anything else)I would like to add some more points which according to me must be considered as I don\u2019t want to keep a single point to be neglected, yes this is my life and I have to be really concerned about it at least now looking into the past history. I had a small accident before 2 yrs back where I was collapsed from nearly 2ft high platform unknowingly ,that time I had ligament rupture in my right foot and ankle after 2 month of rest and physiotherapy I started walking gradually. I am really worried and want to seriously look into not only for present issue but for the future.",
    "doctor_response": "Hello Snehal, . Do you have Nausea or vomiting? It need not necessarily be IBS, but get yourself examined by a Gastroenterologist to confirm it. Get a repeat Ultrasound scan and a CT scan done after consulting your Doctor. If everything comes to be normal, Kindly get yourself examined by a Urologist so that he can examine you and suggest Urine routine or Blood Work up to rule out Urinary Tract Infection or Kidney stones, since your history suggests dragging type of pain to your Thigh. Get a Ultrasound scan concentrating more on your Kidneys to rule out Kidney stones. Once confirmed the treatment has to be started. Drink as much as 2 to 3 liters of water everyday. The treatment depends upon the size of the stone. No treatment is required if the stone is less than 4mm. Eat less salt and less protein diet. Eat Fresh fruits regularly. Wish you Good Health, Take Care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have tobacco addiction and psoriasis. Family history of asthma and cancer. Advice?\n\nMy husband aged 40 is eating 3 to 4 packets of gutka everyday mostly at night,since last 15 or more years. His weight is 80kgs & height is 5.5ft. His father has asthma , & is now ailing from foodpipe cance. He himself has psorasis. Would like to know about the concerning health hazards. He drinks around 3 pegs of whisky thrice a week. Please guide.",
    "doctor_response": "There are many health hazard that your husband is facing because of his personal habits. Most common in his case is cancer of mouth, tongue, throat and food pipe. If he is swallowing the tobacco, he may also be at risk for cancer of other organs. He will have poor oral hygiene which may lead to many dental problems beside the foul breath.Beside this, he may develop high BP, heart problems, bastritis, excess acid secretion and digestive problems. He is drinking in moderation which may not be very harmful but adverse effects of excess alcohol intake are liver damage, high BP and heart problems, gastritis, pancreatitis, effects on the brain and psychiatric problems. These are just to name a few and the list is quite long.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does pain under the ribcage indicate?\n\nIn my exercise class we were doing reverse sit-ups and I had a pain in my lower right side just under my ribcage. I put heat/ice on it and liniment and tried to rest that area as best I could. It began to feel better but then I began using it again and it started hurting once again. I can t seem to get it to heal.",
    "doctor_response": "Hi, It might be a simple musculoskeletal pain due to muscle pull or contusion. You can take simple analgesics like Diclofenac for symptomatic relief. Generally, it will settle by itself in couple of days. If symptoms persist, Better tom consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from chyluria for a long period. Took some injections. Symptoms worsen on taking oily food. Advice?\n\nhi i am residing in Saudi Arabia i have been suffering from chyluria since last 11 years i have consult with many doctors in indian hospital AIIMS (All india Institute of Medical science) doctor inject some medicine in my kidney through penis but after one year problem started again. when i start taking oily and milky food it start again. so sir pleas suggest me what to do.",
    "doctor_response": "It is very common for recurrence of chyluria.You can have a repeat session of injection & in all likelihood the problem may stop permanently.Other option is to undergo surgery.You also may try Alternative medicine in the form of Homeopathy,Ayurved",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does scrotal abscess develops and how it causes cellulitis?\n\nGood evening Doctors,My name is Clark B. Llamera a graduating nursing student here from the Philippines.Can I ask a question can you tell how an scrotal abscess develops and how it causes cellulitis? I mean its pathophysiology?...Your answers well be much appreciated...Thank You",
    "doctor_response": "HelloThanks for query.The scrotal abscess develops due to Staphylococcal infections of the hair follicles in scrotal skin (Folliculitis)or due to infection of the epididymis and testicles which in its turn is secondary to UTI.It may result from the bacterial infection through blood born infection any where else in the body.This is very common in person with Diabetes.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes infertility inspite of all treatments?\n\nfirst myself and my wife have taken gynotrim kit after two months of trying then doctor gave anolet tablet to my wife for five days then follicular study have been done . The doctor advised me do sex for day after the follicular study and given sofia medicine for ten days but at last periods happend .what we will do ?",
    "doctor_response": "HIWell come to HCMPregnancy is more natural phenomenon some time even after every thing is normal conception does not happened and some time with obvious sterility conception happens, so keep trying in natural way, do not give the hope, good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for upper respiratory tract infection\n\nI was diagnosed with an upper respiratory infection and on a z-PAC and 4x a day ventolin for 2 days and chest rattling seems worse. My temp is at 99-99.5 and usually runs at 97.3. I feel very light headed when I walk and cough. I also black out for a few seconds when I take my inhaler. Should I go back to the dr or wait?",
    "doctor_response": "Hello,        Thanks for the concern. You have upper respiratory tract infection and had azithromycin antibiotic with ventolin (bronchodilator) for 2 days. Still you have fever and cough. So for that you can take hot steam twice daily, avoid cold foods and cold drinks, continue ventolin and start antibiotic like combination of amoxicillin(500mg) and clavulanate potassium(125mg) twice daily for 7 days.     So you should immediately consult the treating physician get investigated and start treatment accordingly. Hope you might get help.    Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pink phlegm while recovering from ear, sinus and respiratory infection?\n\nwent to urgent care had breathing treatement to open lungs and was given arithrimyasin and prednisone and codine and an antibiotic shot.  still no fever.  diagnosis was infection in both ears, upper resp, infection, and a sinus infection.  in the beginning had severe chills and no energy then coughing started then nasal stuffiness then ears. now phelgm is almost like gelatin and is pink i that ok, does it mean that i am getting better or should i go back?  prior to the arith.  I gad been given augmentin but it didn't work even though i stopped taking my doxycycline.",
    "doctor_response": "Hello, hope you are feeling better now. To paraphrase your question, I understand that you had chills and a cough, stuffy nose and then a ear infection. After treatment with azithromycin, you have pink sputum, is that correct? When my patients come with pink sputum, if they are not breathless or sick (in which case I would think of fluid in the lungs or heart failure causing the pink sputum), a small amount usually is not a major cause for concern. It should settle once you complete your course of antibiotics, as it could be due to the infection itself producing the colour. Do see a doctor if you have any of the following:1. Breathlessness2. High fever3. Loss of weight4. Blood in the sputumWish you a speedy recovery. Will be happy to clarify if there are any other issues.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for suffering from vertigo, vomiting after radiation treatment and taking vimpat for low grade glioma?\n\nmy wife has been diagnosed with a low grade glioma. its located in the cerebellum area of brain. near brain stem. she has received radiation treatment and is currently taking VIMPAT. she is experiencing a tremendous amount of vertigo and vomiting. the dizziness and vomiting is daily.",
    "doctor_response": "Hi,Thank you for posting your query.It is unfortunate that your wife has been diagnosed with low grade glioma, a cancer of brain.Moreover, a vital part of brain, near the brainstem is affected.I am glad that she is receiving radiation and VIMPAT. I hope that she shows good recovery.Dizziness and vomiting are related to the tumor, as well as radiation and medications.Dizziness can be relieved with betahistine tablets and vomiting can be prevented with ondansetron tablets.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fluctuating fever\n\nMy daughter, who is 42 years old, had a fever of 104 on Saturday. She has an Rx for Azithromysin 250 (one time daily) which she started to take on Saturday. She is 300 lbs. Now, in the morning, the temp is 98.6, but this evening it shoots up to 102.6. Is this normal? Does she need a new Rx that is stronger?",
    "doctor_response": "Hi,Thanks for writing in to hcm.I understand your problem and will try my best to help you out.300 lbs is around 136kg which shows your daughter is definitely obese.Azithromycin dosage is usually 500mg one tablet per day for adults for 5 days. so 250mg may be lesser. Also since your daughter is 136kgs the dose needs to be adjusted likewise. Also she may need antipyretics lie acetaminophen to control the fever.Kindly consult a physician regarding the medication. Certain blood tests like complete blood count along with liver function tests shall help in the diagnosis.You must seriously consider consulting a physician regarding her weight and get her hormone levels tested to know the reason of obesity and this shall help cure the problem.Hope this answered your query.Get well soon.Dr.Riyanka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with mild to moderate stenosis. Is this a serious condition?\n\nhi dr. I am diagnosed with mild to moderate stenosis on c5-6 right greater than left. disc bulging 3mm. it all happened after bad fall I passed out and fell down in tub while on the toilet seat. is it common or too much serious condition. please answer.",
    "doctor_response": "Hi, Stenosis and disc bulges are not due to your injury. you must be having them before. They are common and generally donot produce any symptoms. you need not worry about that. Hope this helped.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What do the echo reports of an 18 days old baby suggest?\n\nHi doctor, Please find the attached\u00a0echo reports of my 18 days old baby boy. Please review and give your feedback. Thank you.",
    "doctor_response": "Hi. I have gone through the echocardiogram reports (attachment removed to protect patient identity). 1. Normal breastfeeding and monitoring of symptoms. 2. Keep close contact with pediatricians. For further clarifications consult a paediatrician online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a purple tinged lump on the leg?\n\nMy daughter has a light purple tinged lump on her leg, it is around 6cm long and half as wide, it has been there for many months now, the first diagnosis was a keloid, second diagnosis by a skin specialist a benign mole. Yesterday it appeared to break open and some yellowish pus came out followd by a watery discharge. Is this a normal thing for a mole to do, and is purple a common colour for a mole?",
    "doctor_response": "Hi,Dear,Good Evening and Thanks for your query to HCM.I went through your query deails indepth.-In my opinion,in relation to the facts told by you,the purple lump appears to be -mostly-Infected Heamatoma(caused by unnoticed hit on leg- with Chronic-Abscess formation.-To rule out the benign mole-I would advise a Excision biopsy of the burst out lump with its wall, to rule out  any cancerous lump with necrosis with resultant abscess formation.This would fix the cause of the lump  in your case.Hope this would resolve your worries about the lump on the leg.Wellcome again for many more queries to HCM online Clinic-from you and your freinds",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain behind the ear lobe and sore throat?\n\nI have had pain behind my ear lobe going down to my neck, a sore throat and teeth pain on top and bottom all on the same side.  The doctor said it was fine and to go to dentist. He pulled a back molar and said that could be the problem. Now I woke up with my ear, same side, congested. I have used Claritin, Zyrtec , a Nettie pot and steamed my head. I have anxiety so I don't like Sudafed. What can I do?",
    "doctor_response": "Hi..Thanks for the query..Well,  your problem looks more like either ear infection or inflammation of mastoid process causing Mastoiditis..If your ear is congested you can consult an ENT Physician and get evaluated..An ear examination can be done to look for infection and fluid behind the eardrum..For now you should take a course of antibiotics and anti inflammatory painkillers like Ibuprofen and along with it use decongestant like Xylometazoline..Continue netti pot..Hope this helps..Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have kidney stone, severe pain every time during urination, incomplete bowel movement, stomach ache. Is it normal?\n\nI am having kidney stone in right kidney. The 3mm stone is located in the lower urethra . It was first diagnosed two weeks ago. I am still having severe pain. The worst experience lasted for 12 hours. Each time the pain associated with problem in urination , incomplete bowel movement and stomachache. Are these symptoms typical for kidney stone? Thanks for your assistance? Cynthia",
    "doctor_response": "Hello Cynthia, You must be having typical attacks of renal colic which is due to ureter stone. Go for a Urine routine microscopic examination and Urine Culture and sensitivity tests and if there is infection, you ll need antibiotics according to the sensitivity results. you may take tab nitrofurantoin or levofloxacin too. Take lots of water and a diuretic like tab lasix 20mg to flush out the stone. Urinary alkaliser like Potassium citrate may help. For pain , use tab drotavarine sos.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in left arm?\n\nI have been having pain in my left arm for about 3 weeks and it gets worse at night.  I cannot sleep because the pain is so bad. I put ice on my arm and get some relief but it still hurts. I had shoulder surgery for frozen shoulder in October but my orthopedic doctor doesn't think that is causing all my pain.My pain starts just below my shoulder and goes all the way to my wrist. Pain meds so not stop the pain.",
    "doctor_response": "In my opinion I think your past surgery in october decreased the pain of your frozen shoulder but still you have some neuropathic pain due to neurovascular  compression of your nerves . I suggest  you ask your neurosurgeon for some imaging on your cervical spine like CT, MRI, x-rays for proper diagnosis.For now I recommend some physiotherapy withe topical gel massaging or even yoga is very effective. Advil, muscle relaxants, Acetaminophen will be effectiveHope the above information helps you. Any further clarifications feel free to ask.Regards,Dr. Ahmed Aly Hassan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Got an injection of tpa, bleeding into brain, on life support, fever, high BP. What does this mean?\n\nMy friend's father got an injection of tpa and now has bleeding into his brain and is on life support, he also has a fever and high blood pressure. What does this mean? Will he ever recover? Does it take time for the effects to go away? Is it too late for him from having blood in his brain and from maintaining a high temp of 105 which has decreased to 102? Is there anything at all that can counteract tpa or generally be done to help bring him back? He has been on life support for 5 days.",
    "doctor_response": "Hi, Thank you for posting your query. Tissue plasminogen activator (tpa) is used for treating acute brain stroke (lack of blood flow to brain) and is generally safe and effective. However, in about 5% of cases, bleeding does occur. If the bleeding in the brain is large, a surgery can be done to remove it. Fever is most likely due to unrelated causes such as lung infection. This can be treated with antibiotics. The ultimate receovery depends on the damage caused to brain due to his initial brain stroke as well as bleeding in the brain. Please get back if you require any additional information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be the cause of fever?\n\nhi my son is 4 years - 3months he has fever since last 4days and not controlling he has been hospitalized and the treatment Drs are providing but the recovery is very slow. This is happening within every 6-9months every year. I wanted to know what do we do, will this will effect to other part of the body. Please advice...I am very afraid...",
    "doctor_response": "Thanks for posting your query at HealthCareMagic. Fever usually indicates infection. You have not mentioned the symptoms associated with the fever. Many of the children of such an age suffer from respiratory tract infections. These are generally viral infections and where antibiotics are not likely to be effective. These conditions resolve spontaneously in 5-10 days and probably that is what you are talking about. Many children may have enlarged tonsils with a tendency to have recurrent infections. With age the frequency of such infections generally comes down.The fever has to be kept in control by the use of medicines like paracetamol or cold sponging.Hope that will adequately address your query. Feel free to communicate back in case of further queries if any.",
    "dialogue_context": ""
  },
  {
    "patient_message": "is there anything to get the pain down as having swelling in the skin behind the teeth due to braces?\n\nMy son has braces on his top 4 teeth and the skin behind the teeth is swollen and very painful.  He goes back to the orthodontist next week, but is there anything that I can do to relieve the pain and get the swelling down.  He brushes 2x a day and flosses once a day.",
    "doctor_response": "Hello,Actually in case of orthodontic treatment a special care should be taken for gums because oral hygiene can not be maintained properly, so what you can do is that there are special brushes which are made for  patients with braces, even you can get cleaning of tooth done with dentist as it will resolve the gum infection as well as redness.Till then you can start with mouthwash twice daily.Hope t will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the moving air pocket in the stomach caused after an accident?\n\nI have a problem where what feels like a pocket of air is inside my chest and stomach and it moves around and causes pain I was told after a serious car accident that it was a air pocket??? Has been going on almost 3 years now and lately its getting worse",
    "doctor_response": "Hi. This is a classical sign of an intestinal obstruction (sub-acute). A simple X-ray in standing position may diagnose this and confirm with barium or preferably ''enteroclysis '' examination .It may need a surgery if the constricting cause is narrow.This happened due to a contusion to the intestine at the time of an accident followed by a stricture formation as a result of over-healing.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i get infected by scratching pubic area with my hands?\n\ni have probably athlet\u00e9s foot on my toe not yet severe but i havve to touch it when i wash it with soap n apply cream, but i lso need to wash my genital area with the same hands, well i wash my genitals first the next is my toe, after i took a shower n washed my hands i kinda scratch my pubic hair area with ym hands. could it get infected,",
    "doctor_response": "Hi,It is possible that in spite of washing your hands before or after and scratching the part with nails does give rise of spreading infection to pubic area.Apply anti-fungal cream regularly.Keep your nails well cut and clean.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Discomfort in neck, back of head, strained eyes, sore to touch head. Taking Ibuprofen. Should I be worried?\n\nWhen laying down in bed last night I had some discomfort in my neck and back of the head, eyes felt strained. Woke up this morning and had a knot on the back of my head on right side that was very sore to touch and burning when not touching. My head hurt on the whole right side with just my right eye feeling strained. I also noticed my spine is really sore to the touch about the middle of my back. I have had back/neck pain for years but usually just take ibprophin and carry on. Should I be worried? What might this be?",
    "doctor_response": "Take ibuprofen 400 mg  tds after meals  along with methacarbamol 750 mg bd and do fomentation, relaxyl ointment to pain areas. It should help otherwise get Xray spine and consult orthopedician Sometime  stress also aggravates neck and headache and relaxation  by rest in bed for a day or two will also be beneficial along with medicines",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in let flank, slight blood in urine. Scan was normal. What could it be ?\n\nHello, i just went to the hospital as my family and girlfriend were concered for my pain in my left flank and the barley noticeable blood in my urine. ive had this problem for about a year now, a ct scan was done and the results look normal with no inflammation or free fluid in the abdomen or pelvis. Then a urine test showed with traces of ketones and a small amount of blood and mucus 1+ then with the blood test there glucose at a 6.1 and a CO2 at 32 both messured at mmol/L they belive that its not kidney stones. Which i was hoping it was only scared for the worst.",
    "doctor_response": "Hi ! From your history, I still feel that perhaps you have got very minute calculi in your kidney which is causing minimal amount of bleeding by friction against the kidney tissue. Such minute calculi may not be visualized in any of the scans. The pain may be due to the calculi blocking the ureter which possibly was passed out subsequently in the urine for which it was not visualised in the scan. I would suggest you to keep yourself well hydrated by taking of plenty of liquids which will also help flushing out any of residual calculi.Wishing you an early recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bump on foot near spider veins?\n\nA few months ago I flexed my foot and noticed I had a bump when I did so. I had completely forgotten about the Matter until recently, more bumps appeared. They are on the side of my heal, I also have spidery veins very close. Do you have any idea what may be wrong?",
    "doctor_response": "Hi,It seems that you might be having Varicose veins of leg giving this problem.Due to poor circulation bumps can appear, might give rise to infection.Consult vascular surgeon and get examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is cyra-D for acidity and Formoflo-250 inhaler for Bronchitis good?\n\nMy age 34, ht=5 8 Wt=56 kg I am suffering from acidity along with pain on left side of the chest. In x-ray it is found that I have Bronchitis (Increased bronco vascular marking on left side) I consulted the doctor He gave me cyra-D for acidity and Formoflo-250 inhaler. Please suggest",
    "doctor_response": "Hi, I think the treatment given to you is fine. Cyra d helps in reducing gastric acid secretion and so will help you to reduce your stomach pain and acidity. Formoflo inhaler relaxes the muscles of air passages and makes it easier to breathe. So you must take all your medicines regularly. Also, try to focus on your diet. Take less oily and spicy food and drink plenty of water, 2-3 liters per day. Avoid smoking. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Milinda Gupta, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the knee after spraining it while playing soccer?\n\nHi, I am 16 years old. I hurt my knee 3 weeks ago playing soccer and the doctor just said it was a small sprain. It still hurts today and I feel like my knee is going to give out while walking up and down steps. It also hurts when I stand up or when I m bending my knee while laying down. It s my right knee in the central left side of the knee. any idea what this could be?",
    "doctor_response": "Hi, You have an internal injury of the knee caused by a twist injury while playing soccer. In addition to the ligament on the sides of the knee, there are cartilaginous discs inside called menisci and a ligament which connects the two bones of the knee. As you are having a giving way of the knee, its possible you have a injury of this main ligament.An MRI is necessary to study the internal aspects of the knee and physical exam of the knee. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. George Verghese, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for hole formation in teeth?\n\nhello i am 26 yers old female. i have a dental problem. before 2 months i found a crack in the bottom side of  my front theeth, after some days there are chak like some thing out from that teeth and become a hole. and after 2 months  i found that the same thing in another teeth . please tell me what is this problem i dont have any pain or bleeding in my teeth. how to recover from this problem",
    "doctor_response": "HelloI have gone through your query.it can be due to caries(cavity) in your teeth.plz mention your profession or any habit if u hv.chalky substance can be a sign of early caries or any defect in enamel.there is nt mch to worry bout.as there is no pain i suggest you to visit a dentist and get it filled.Hope this ans fulfills ur queryRegardsDr. Shesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Aspirin reduce the risk of stroke during flight travel in a patient with high RBC, Hb, hematocrit?\n\nHello doctor, I am a 49-year-old male, 6'4\" and 300 lbs. I take very low doses testosterone, an estrogen blocker, and HGH. All very low dosages. I will be on a six hours international flight tomorrow and I am concerned about some health risks. I have high levels of the following: RBC of 6.61, hemoglobin of 19, hematocrit of 57. I tried to have blood drawn today but the facility cancelled the appointment. Will aspirin help reduce the risks of stroke?",
    "doctor_response": "Hi. I agree with you. There is a risk of leg vein thrombosis in deep veins of legs due to prolong sitting. Aspirin do help according to some studies, might be not as beneficial as full anticoagulants like Heparin, etc., but take Aspirin 325 mg (not 75 or 81 mg) one hour before flight with meal. Walk during flight in aisles frequently. Keep yourself hydrated. I believe you will be fine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Ibuprofen recommended for sharp shooting pain in back after having had a vasectomy?\n\nHi,I'm a 28yr old male. I had a vasectomy about 9 months ago without complications. Since the surgery, I have had on and off sharp shooting pains in my testicles that come and go at random times. I am now concerned because I found a lump a little larger than a pea in my right testicle. It is sensitive to the touch. I'm expierincing a sharp stabbing discomfort feeling that feels like a spasm. Now I also have extreme back pain (about 8/10) on the left side. I have taken ibuprofen with no relief. Also, about a week and a half ago I had some urine leakage after urinating. No burning or pain with urination, and it has not happened since. I'm more concerned about the lump on my right testicle with the discomfort and the severe pain in my lower back on the left side. I also have had no recent injuries or traumas. Any information would be great as I can't get into the urologist for another week and the pain seems to be getting worse.",
    "doctor_response": "hi.   post vasectomy you should not experience pain,rarely due to neuroma    you may get some pain. your left side pain looks unrelated to vasectomy. it may be due to stone in kidney/ureter.you may take buscopan for pain relief till you see a urologist.other alternate is to see a surgeon or emergency physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the lump with foul odor on the lower cheek?\n\nMy husband has a lump about the size of a grape on his lower cheek. Can not see it from outside but he can feel it. He says it's been there a lil over a year and now he is noticing a foul odor when he scratches that side of his face. It smells like infection to me but I don't know. It doesn't hurt and is smooth andmoves around a little bit. Any ideas???",
    "doctor_response": "welcome to Health care magic.1.You are giving history of 1 year, it is suspicious.2.I would recommend you to see doctor as soon as possible and let it examined and request for a swab / sample. 3.because infections / inflammations generally won't there for so long.4.Hope it helps.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for soreness and heaviness in chest\n\nI have a sore chest as well as an occasional feeling of heavyness on my chest, i went to the doctors and they tested me with an EKG a oxygen count device a blood pressure moineter and they tested my blood sugar and briefly listened to my heart, everything came back fine and they said it was probubly a pulled muscle, Is there anything i need to worry about? I am a male age 15 with no history of drinking smoking taking drugs diabetes or heart defects.",
    "doctor_response": "Hi, I understand your concern and would explain that your symptoms are probably related to a musculo-skeletal pain, considering your young age. Anxiety can mimic this clinical situation too. Anyway, if the chest pain is triggered by deep breathing or manual massage on the chest, it is probably related to a local musculo-skeletal pain or inflammation. In such case ibuprofen or acetaminophen would help relieve your symptoms. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am under treatment for anal fissure. If there is no relief in 10 days, will I need surgery?\n\ni have pain while passing stool and also blood with it sum time spots and some time much more, and i have physical exam to a doctor, who said it is not piles, it is anal fissure then i ask whtat is this he said in simple words its a cut. he suggest me gtn 0.2% and brixin tab if there is no relief in 10 days there will be need of operate please suggest me",
    "doctor_response": "hello I will definitely help u regarding your problem anal fissure is a cut in the anal pessage due to hard stools it may present with pain and bleeding in 99 percent cases surgery not required but proper medicines and prevention is necessary here I will advise you complete treatment only one gel and tablet will not help follow my treatment, you will get better in 5 days follow me after 5 days so I will modify your treatment anal fissure Sitz bath with betadine 2 times for 15 minutes Syp Duphalac 4 tsp HS ointment Diltigesic locally 3 times Ointment Smuth locally 3 times Tab Enzoflam 2 times daily Tab Pantop DSR OD plenty of water avoid spicy and fatty foods high fibre diet 5 days",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of conception if suffering from Polycystic Ovarian Syndrome (PCOS)?\n\nHello doctor, i am 33ys. i have married from last 3 years, i have taken fertomid 50 mg, then 100mg, then 150mg. But after taking this, an ovarian cyst seems in my ultrasound (67*48mm). After taking a treatment for this from 2 months, now poly cystic problem seems in my ovulation study. plz tell me whether i can gett pregnant or not.",
    "doctor_response": "Hi,Polycystic ovaries do respond very well to treatment and conception is seen in most of the cases. Only, the prior assessment should strictly adhere to a protocol and this includes a complete hormonal study including thyroid status, insulin resistance, serum Prolactin and DHEAS levels, tubal patency tests and trans-vaginal sonogram. Induction is usually done in ascending doses with regular monitoring for a maximum of up to six cycles. Addition of Metformin to reduce insulin resistance has shown to be beneficial in many cases to help ovulation and conception. Please have timed intercourse, maintain a healthy weight and a healthy diet. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swelling and burning on foot due to insect bite\n\na bug or a spider or something bit my foot, maybe an ant, and it was red and swollen after a few hours in a large circle around the bite, that was yesterday, today i woke up and my entire foot was swollen and red and burning and super hot now i cant even walk on it its 1.5 times the size of my other foot, i have it elevated and i took benedryl. i can barley move it its so swollen what do i do?",
    "doctor_response": "HI,Welcome to HCM,I read your query and i appreciate your concern regarding this issue.As per its allergic reaction after insect bite / Bee Sting so do not worry.If i will be your treating doctor I would advise you to- Take simple painkiller like Acetaminophen 1000mg after meal- Take Antihistamine like cetrizine 10mg at night- Do icing of affected area- keep your foot elevated.Report to hospital if:> Condition remain same after 2-3 days> Any unusual symptom appears> Condition deteriorates.> There is difficulty in breathing.Hope so it will be helpful.You can write again in case of any query or follow up.Wish you good health.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in knee s?\n\nHi doctor, I am a 16 year old that does alot of contemporary dance and ballet. I have been having extreme aching pains in my knees and everytime I move my knees they crunch and click. This has been happening from over a year and gets progressively worse- It is very painful and would love it to stop! What is wrong with my knees?",
    "doctor_response": "Hello,I can understand your concern. If you had said that you have danced all your life and having such symptoms, I would have diagnosed osteoarthritis, a degenerative bone disease that degenerates the joint causing friction between bones while movement and causes pain and clicking sounds. However, 16 years is a pretty young age to have this disease. It is possible that you are not balancing well on two knees or the knees are deficient tin strength.I would advise you to visit a orthopedic surgeon once and get an x-ray of the knees so that any bone deformity or problem can be ruled out. If he does not find anything, then you can visit a physiotherapist or chiropractor to work on possible balance or strength problem.I hope this answer helps you. Thank you for choosing HealthcareMagic. I hope you can dace pain-free soon!Best,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have lesion on the roof of the mouth, advised to follow up. Have a family medical history of oral cancer. What to do now?\n\nI have had a \"lesion\" on the roof of my mouth for at least a month. My dentist ran a scan of some sort and measured it. He said to follow up in 3 weeks. It is still there and hurts some. My mom and grandma had oral cancer and neither smoked or drank. Should I wait the two plus weeks to get in with an oral surgeon or would that make little difference. How fast does this grow??",
    "doctor_response": "Any lesion that is for a month and is also painful raises suspicion of malignancy if that is associated with ulcer (nonhealing) but as your Oral surgeon has carried out some tests and advised you to visit for followup it will be prudent on your part to wait two plus week (any way your lesion existing for almost a month now so waiting for couple of weeks will hardly matter)If necessary your Oral surgeon may do some specific tests like biopsy to ascertain or rule out possibility of oral cancertill then best wishesDr Chowhan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I experiencing sudden dizziness with nausea even after taking Z pack and meclizine?\n\nFor the past 10 days, my husband has  been experiencing occasional dizziness.  The first time, he thought he might pass out and his face got very red.    It goes away after a short time.  He went to his doctor who gave him an antibiotic (z-pak) and  meclizine.   The meclizine gives some relief, but he is still having the dizzy spells sometimes with nausea.",
    "doctor_response": "HI, thanks for using healthcare magicDizziness and vertigo are some of the more common  problems. The main causes are: (1) benign paroxysmal positional vertigo- in this case the vertigo only lasts a few seconds and comes on with certain head positions.This is treated by the doctor performing a specific maneuver (epley or semont).(2) meniere's disease- lasts minutes to hours, may be associated with ringing in the ears and hearing loss.This is treated by a low salt diet and diuretic medication.(3)vestibular neuronitis- in this case the episode lasts for days at a time. Nausea occurs, may be related to a previous viral illness. There is medication that is used for a short time that would helpIf his symptoms do not resolve, he should re visit his doctor for another evaluation.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain in chest with occasional breathlessness?\n\nI m having a pulling sensation in my chest every so often and when I exercise and gets so bad to the point that I must stop exercising. Also, I will get a sharp pain in my chest out of no where and it only lasts a couple seconds but I feel very dizzy when these pains occur. I m short of breath occasionally and get dizzy often.",
    "doctor_response": "Thanks for your question on HCM.In my opinion you are having musculoskeletal pain only. But better to rule out cardiac cause first.So please get done ECG to rule out cardiac cause.If this is normal than it is mostly muscular pain only.So try to follow these for muscular pain.1. Avoid strenuous exercise.2. Avoid heavy weight lifting3. Avoid bad postures in sleep.4. Take good painkillers and muscle relaxant. 5. Apply warm water pad to the affected area.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes ulcers on the tongue?\n\nHi, I am 70 year old. I have finding problem inside the tonge.Always two wound comes twin side of tonge. I hd checked so many times. It will correct for some time. after some day it will automatically started with pain. for that I am not able to eat. Plz suggest me what I will do",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..As per your complain recurring episodes of eruption of ulcers on either side of tongue points towards a condition Recurring Apthous Stomatitis or Recurring Apthous Ulcers..It can occur due to a few common conditions like tongue injury caused by sharp teeth, Nutritional Deficiency iron, Vitamin B12 and folic acid, stress, immune deficiency conditions like Diabetes, acid reflux etc..You should consult an Oral Physician so that a thorough clinical evaluation can be done to rule out the exact cause and treatment can be planned accordingly..Aa of now for relieving the pain you can apply a numbing gel containing Lignocaine or Choline Salicylate over the sores for relief..Gargle with 1:1solution of milk of magnesia and Benadryl can help..Soda bicarb solution in water can also be used for gargles..Sucking ice pops and gargle with cold water can also relieve by reducing Inflammation and pain..Hope this information helps..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever for days and suggest treatment?\n\ni am rahul,i stay in washington ...i am suffering with fever since 15 days,i went to doctor and he did all tests including lambar puncture..but noting is there in reports,every report is negative,,but my fever is not controlling ..its getting reduced only when i put tablets i have lot of headache also.plz advice me ..the doctors said its an viral fever or flu..",
    "doctor_response": "HelloWelcome to HCMYou are having what is called as fever of unknown origin (FUO). As you have undergo all the lab test andall have come negative. Fever for 15 days withall investigation coming negative fulfill the definition of FUO.You sbould be managed symptomaticaly. You need anti pyretics, antibiotics and NSAIDs. If the symptoms are not coming down you may require hospitalization.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes multiple cavities with ear itching?\n\nhi Doctor, I have a 4.5 year old baby boy and he has multiple cavities on atleast 8 teeth. recently he is diagnosed with having a eyesight of +3. he always complains about his ear itching and usually has a running nose. do you see any relation and do you suggest any mediaction? he is on spects now, but no specific mediaction for his teeth yet apart from brushing twice a day. Please suggest.",
    "doctor_response": "Thanks for your query, I have gone through your query.The decay involving multiple teeth can be a rampant caries secondary to improper maintainence of the oral hygiene and improper diet. The running nose and eye sight is not related to the teeth. Consult a pediatric dental surgeon and get the teeth filled. For the nose and eyes consult a ENT and ophthalmologist and take opinion.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Delayed periods, swollen breasts, mood swings.   Had unprotected sex after stopping cerazette.    Possible pregnancy?\n\nHello, I have taken cerazette for about two years. I stopped taking cerazette about two weeks ago for numerous reasons and I have had unprotected sex with my partner several times. I am usually regular (every 2-3 weeks) on my period and I have worked out I am Atleast two weeks late. I have taken two different tests clear blue and a cheap one within a few days of each other. My breasts are swollen and ive been having alsorts of mood swings. I'm really worried as I'm never late and I would prefer to find out sooner or later. I can't get in to my doctors for Atleast two weeks!! HELP!!!!!!!",
    "doctor_response": "Hello,Here, you need to undergo one blood test for beta HCG to confirm pregnancy. It is more reliable than home pregnancy test.Other reasons of late period are hormonal imbalance, ovarian cyst, thyroid disturbance, over wt, irregular diet, pelvic or vaginal infection, stress etc.Following blood test, you need to consult with gynecologist for other relevant investigation like USG scan, hormone assay etc. Take suggestive measures accordingly.Take healthy diet with iron supplement, avoid stress, maintain genital hygiene and take sound sleep. Hope, it helps for you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a red spot in bruise after spraining a wrist?\n\nHi, so I got a bruise on my wist from hitting something a few days ago. Yesterday I spraigned the same wrist. I have been wearing a brace and I just took it off and on the bruise there s now a bright red spot in the middle. Could this be a blood clot?",
    "doctor_response": "Hi, The answer is yes, in all probabilities. I suggest orthopedic consultation with X-rays ASAP. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Secondary bronchitis, lump in roof of mouth, tender, sensitive. Related?\n\nHello my 17 year old daughter has just been Diagnosed with secondary bronchitis on monday. And is now saying she has a very saw lump on the roof of her mouth that is tender and very sensitive when touched I was wondering if this is all related to the\u00a0bronchitis or is another issue on it s own. Also her tounge is very saw to move around ??",
    "doctor_response": "Hello, Thanks for posting your query. Some swellings can caused by infections from teeth or saliva glands. A torus palatinus is a lump of bone that grows on the roof of the mouth. You may consult to dentist for diagnosis and treatment plan according to it. Hope I have answered your query. Wishing you good health. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump in the pubic region?\n\nI AM CONCERNED ABOUT AN IMMOVEABLE LUMP ON MY PUBIC AREA.IT STARTED AS SMALL AS A PEA GRAIN BUT NOW IT IS HARD AND BIG AND NOT ROUND. I WAS THINKING IT IS A SEBACEOUS CYST BUT ONE DR. SAID IT COULD NOT BE AS IT DOES NOT HAVE AN OPENING AND IT IS NOT ROUND. WHAT DO YOU THINK?",
    "doctor_response": "HI.I do think it was a sebaceous cyst , which has gone into its complication of infection so lost the so-called characters.You need a course of an antibiotic and anti-inflammatory medicines for a week.If this settles well, great.If not you may go for incision and drainage / deroofing / excision whatever is possible by the surgeon at that time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does hepatitis C need treatment again?\n\nI took interferon and Ribavirin treatment for my hep C 10 years back, my genotyoe was type 1b, with PCR OF 27 mEq , after 1year treatment it came to 1.4 mEq , now it is 3.5 mEQ. I have vericose veins which are trouble some now , please tell if I need treatment again, my age is 38, I am 78 kg my height is 5ft 8 inches",
    "doctor_response": "Thank you for posting query.further evaluation needed.get results for liver enzymes and clotting profile (PT and aPTT).take all results (PCR, LFT, PT ) and visit a hepatologist at the earliest.also get an appointment with gastroenterologist to undergo endoscopy and treat the varicose veins.meanwhile:- abstinence from Alcohol - LOW fat diet should be followed- NO red meat- vegetables should be ingested daily- REST more, Less activities- use lemon juice (lemonade) once in a day- Liv52 maybe used after visiting a hepatologistif any further questions, feel free to ask.Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health.regards,Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could back pain, bloating with morning sickness be a sign of pregnancy?\n\nmy doctor gives me dofaston,dates 2nd day she gives me clomaid after 13 day she gives me ivf injection and now she again  gives me dofaston,,,some days later i have back pain.bloting ,morning sick ness but i dont know i am pragnent or not i want to be pregnent again..should i go to her again?",
    "doctor_response": "As you have taken treatment to conceive and now you telling that you dont want to pregnant again.!!!First you should do pregnancy test and if you are positive and you dont want to continue then you should consult dr again to terminate or to continue. But you should consult your dr..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for throat inflammation in a eosinophilia diagnosed patient.\n\nI have eosonophilia diagnosed 9percent.currently for last 6 months i have throat inflammation.it pains a lot.now i see pores in the inflammation.yellow food particles gets stored in my throat pores while i swallow food.it irritates a lot.what should i do?",
    "doctor_response": "Hello,        Increased eosinophil count signifies some kind of 1. allergic reactions like asthma, hay fever, drug/ food allergy 2. parasitic infection 3. idiopathic eosinophilia syndrome 4. autoimmune diseases. But your throat inflammation is indicating towards tonsillitis leading to chronic upper tract infection by some bacteria. Allergic reactions can be associated with nearly in almost all cases recurrent upper respiratory tract infection and eosinophilia due to immune abnormality. So you should consult a physician for further evaluation. Go for total blood count, skin allergy test, throat swab culture and sensitivity. You can take tab. levocetrizine once in a day. Do gargle with warm salty water for 3-4 times in a day, avoid taking spicy food which can irritate your throat. Follow the instruction of your treating doctor for taking antibiotic and also for manage tonsillitis problem.Thank you for consulting HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold urticaria with rashes\n\nOur 8 year old daughter was diagnosed with cold urticaria 2 years ago. It reached -10 today and her rashed appeared again. We gave her Benadryl and within 1/2 hr it improves. Should we let her outside when she is at school. Also, what are the chances of her out growing this? Thank you",
    "doctor_response": "Hello, It may be due to dermatitis. You may apply hydrocortisone ointment. Can give syp cetirizine after pediatrician consultation. Watch for symptoms like breathing difficulty, swelling, fever. In case of fever, you can give syp acetaminophen. Till then maintain proper hygiene and hydration. Avoid allergens. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long can I live with COPD?\n\nHi, I am 49 and it looks like I will be diagnosed with COPD. I was a long time smoker (25 years) very recently quit. I don t have a smokers cough and I am relatively healthy otherwise, workout at the gym. The only reason I was diagnosed is because my bad cold turned into a lung infection. I just want to know, if I take super good care of myself, can I still live until 80?",
    "doctor_response": "HelloIn your case diagnosis is established and your question is life expectancy up to 80 years ( now you are 49 years ) .Yes, you can live even longer than this ,but you should take many precaution and treatment under pulmonologist and physiotherapist and counselling.I will not say any thing about the treatment .In COPD aim of O2 is to increase base line PaO2 to >_60 mm Hg(8 kPa) .INAPPROPRIATE USE OF O2 THERAPY MAY RESULT IN RESPIRATION DEPRESSION.Pulmonary rehabilitation :Include exercise training ( from a physiotherapist who is expert in lungs ), nutrition counselling.With these measures ,if no relief then consult a a surgeon and bullectomy , lung volume reduction surgery are other option .The last one is lung transplantation.Hope all these will be fruitful for you.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How safe is taking Depran-10 for OCD?\n\nhello doctor,I have been taking Depran-10 for the last 30 months to cure my OCD as my physicist prescribed . As soon as I decrease the dose, the symptoms like sleeping disorder, anxiety start coming back. Till how long, would I need to take this medicine ?Thanks & Regards,ABC",
    "doctor_response": "HiI understand your concern.I had gone through your question.1st Depran 10 mg is very low dose to treat classical OCD.If you have anxiety sleep problem and mild obsessive features then it can help.2nd Depran 10 mg is very safe dose and you can take it for long/.It has very minimal side effect and no need to worry about that.If you are better and all your symptoms are under control then need to take it properly for better outcome.Thank you.I hope i have answered your query.Still have a query then feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes child to have nose smelling like cheese?\n\nMy bf took our son to the doctors because it s been two weeks since his breathe or nose smells like cheese , & before it started to smell like that , he had a sore under his nose which I thought was a cold sore and I thought that was where the smell was coming from but the sore is gone , and he still smells so bad , it s terrible , anyways I guess the doctor just gave him so pennisilyn to see if maybe it s an infection in his throat , cuz he has been sick for a bit now .",
    "doctor_response": "HI....nose smelling bad suddenly could be because of 2 reasons.1. An intra dermal boil of infection of the subcutaneous or mucosa of the nose.2. A forgotten foreign body and this might be the nidus for infection and bad odour.I suggest you take him to an ENT surgeon and get a rhinoscopy done and then let him decide what to do.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of cut mark by blade?\n\ni had cut my arms by blade 6 yrs ago till now marks are thr i m 26 yrs old .plz help me how to get rid of dat.dont hv money to go 4 expensive treatment i wl b greateful if u tell me the ointment name.thx",
    "doctor_response": "i got a cut marks on my chin since from 8yers and i,m now 29, any cream or medicine to fade such cut marks?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking tramadol. Have anxiety, depression, ocd, restless leg syndrome. Is it because of their opiate nature?\n\nI'm curious about something- well, I guess it's your take on something - I am very well informed (and in the profession somewhat with counseling and mental health issues) I have been taking low levels of tramadol - I had to take them 2 years ago because of an accident - but what I found was they evened me out.  I have major anxiety, depression, OCD and restless leg syndrome.  Is it because of their opiate like nature that they are not being utilized or prescribed?",
    "doctor_response": "Hi Welcome to HM You are right Try to wean off and you will feel better consult a psychiatrist  to wean you  off from present drug  andfor  treatment for you OCD Anxiety etc which are interlinked Dr Lal Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does harsh pumping of blood with palpitations suggest?\n\nI am feeling what i thought were palpitations, but they honestly feel like too much blood is being pumped at times- like moments where my heart pumps hard then normal. What does this mean? Sometimes I get this, it goes away for a while, then is back. Happening more often lately even though i'm eating better, lost some weight.",
    "doctor_response": "welcome to Health care Magic             many causes of palpitation few of them as following1)Anxiety is one of the important cause when u are anxious for anything or you fear something at that time you can feel your heart beat as in panic attack also2)any cardiac arrythmia that is cardiac rhythm abnormality can be felt as palpitation for that cardiac evaluation should be done3) some time hyperdynamic circulation may cause this feeling as in severe anemia       So please evaluate this thing with your primary physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes wheezing and dry cough?\n\nAbout 2 weeks ago, I became ill with an upper respiratory virus. I was running fever for a few days but had very little cough but did have wheezing. Last week, I developed a dry cough and still wheezing, especially with activities like walking, going up or down stairs, etc. This week, I still have the same cough and wheezing as well as some shortness of breath. If this was a virus, should I go to the doctor?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, possibility of post infectious bronchitis is more likely. Bronchitis is very common after viral upper respiratory tract infection (URTI). Bronchitis causes bronchospasm and this in turn causes breathlessness, wheezing, cough etc. So consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT will not only diagnose bronchitis but it will also tell you about severity of the disease and treatment is based on severity only. You will mostly improve with inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone). Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bleeding in the urine?\n\nGood evening. I have had polycystic kidney disease for many years and under a consultant nephrologist. Having had a recent test I was found to have slight furring of a coronary artery so as a precaution he placed me on a daily dose of 75 mg aspirin and avorstatin once a day! I am otherwise fit and get plenty of exercise whilst on a healthy vegetarian diet! After 2 days of taking the aspirin I have developed blood in my urine. I feel well in myself but would like to know if I can stop taking the aspirin until my hospital appointment at the end of the week? I have read that this can cause blood in the urine! Advice wether the abrupt cessation of the aspirin until I see the consultant is advisable please?",
    "doctor_response": "Hi,Aspirin has ante-platelet action which help in prevention of abnormal blood clot formation but it may lead to bleeding tendency. In your case presence of polycystic kidney and aspirin treatment both are risk factor for blood in urine.I will advise you to consult your doctor immediately or if it is not possible then it is better to stop aspirin till your consultation with your doctor.Because many of the time intra-cystic bleeding may not be associated with blood in urine and we cannot estimate actual blood loss externally without doing investigations like complete blood count, ultrasound of kidneys.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is salsalate prescribed to cure tendonitis or capsulitis in shoulder?\n\nI have a tendinitis/capsulitis left shoulder - am controlled DM2 with CKD level 3 - miserable because of shld pain - also a PT - narcotics and ice no help, PCP prescribed Salsalate 750 stating safest of all NSAID in regards for kidneys - (short term use only) do you concur?",
    "doctor_response": "I need to be told the scientific name of salsalate. The scientific generic name is important in classification of this drug. I hope follow up with your case.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest diet plans to treat infertility\n\nHello mam Im 29 years old, got married 4years 9 months back. My husband is 36 years old. I want a baby, I have consulted 3 doctors, they are saying there is no problem for both of us. But both of us are under weight we tried many food habits but our weight is not increasing. We dnt use any preventive methods. We are trying for baby right from the day of marriage. Please help me with some suggestions. thank you.",
    "doctor_response": "Hi wwlcome to healthcaremagic.I have gone through your query.As you are case of unexplained infertility. In present days 10-20% inferile couple having this problem. In which no cause is found.I would advise to go for IUI intra uterine insemination, which is the best option for you guys.As far as food is concern avoid oily, fatty food. Take fruits, vegetables which are rich source of anti oxidants.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heaviness in chest, drowsiness and anxiety medicines losing effect?\n\nHello, recently ive been having horible heaviness in my chest, like there is something literaly sitting on my chest making it harder to breathe. Im curious as to why i have this because its starting to affect my every day lifestyle. Ive also recently been very sleepy and my other medications dont seem to ever be working for me. I am on medications for anxiety, depression, and ocd. im unsure if this could be the cause of why im having these pains. I would really appreciate it if anyone could answer my question with any sort of advice, thankyou.",
    "doctor_response": "HIWell come to HCMFrom the history given here I could guessed that you must be female patient, but for age I am not sure and you did not mentioned it here, this was very important  because lack of this information cause the restriction.                                             Overview This could be anxiety and depression some patients may experience  physical symptoms, this is common psychiatric disorders, your involuntary thoughts matters here, some time fear to some situation may be the reason.                                             WorkupIf this is pure psychiatric disorder then no need to go for any investigation.                                             TreatmentSelf confidence, positive attitude, high moral, broad mind thinking, control bizarre thought, take sufficient sleep.                                             Medication Newer anti depressant tricyclic drugs can be used, but I in fact advised all my patients, to come out of this situation without anti-psychiatric drugs, with general measures only,  like meditation, yoga, exercise, balance diet, avoid smoking, and alcohol, if this fails to respond then and then Tab Amitriptyline can be tried one tab twice in day.                                            Comment Your history of OCD nothing to do with this. hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe head pain post angioplasty surgery\n\nMy mother had undergone angioplasty 8 years back but recently she is experiencing pain in head after talking/exerting for some time. Firstly, she experiences heavy breaths and then followed by head pain. Sometimes she experiences head pain without heavy breaths as well. Recently, we took her to hospital for angiography and results are fine. Stents are working fine. We are not able to get the diagnosis right in the first place. Please suggest what could be the possible reason. Her heath functioning is close to 37-40%. She is experiencing pain for the past three to four months.",
    "doctor_response": "hi,thank-you for providing the brief history.As post angioplasty surgery there is a proper vascular flow and this is a good thing about the angioplasty. Also, as the ageing progresses there will be a degenerative changes in the body leading to slow cardio respiratory endurance and less oxygen supply to head leading to headaches.In my clinical practice most patients with angioplasty are referred to physical therapy for PTCA cardiac rehabilitation. As EXERCISES help imporve the Cardiorespiratory endurance and also the blood oxygen balance . Also exercises helps on a slow progress for fighting against ageing process as well.In cardiac rehabilitation free exercises are the initial platform to regain the Cardiorespiratory and muscular blood and oxygen imbalance correction.In many cases with PTCA cardiac rehabilitation is always a positive approach for overall health status of the patient.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having swollen lymph node in my neck. Will it be painful after adjusting my neck?\n\nHello doctor, I went to the chiropractor and got my neck adjusted. I had sore on my neck more in the back left corner then the pain passed down to my left arm. After checking, they said it was a flare-up and to ice it. The next day I had it adjusted again, and he pointed out that I had a swollen lymph node on the left side. I still had sore in the same spot and was worried about my artery and my lymph node. Could my lymph node be painful because they adjusted my neck or because my muscle was sore and irritated?",
    "doctor_response": "Hello. I do not think that because of chiropractor there will be any trouble to the lymph node. If the pain is radiating in nature, then it can be related to intervertebral disc injury which can be a past injury and due to which you had a sore neck. As the intervertebral discs are located in between the two vertebral bodies and the muscles are the supporting structures any trouble to the disc can first make the muscle sore and change the normal curvature of the cervical spine. The radiating symptoms can arise due to nerve root entrapment by the muscle as well as the intervertebral disc. Having an MRI scan of the cervical spine will be useful to avoid further injuries. Also, doing hot water fermentation will help to reduce the muscle spasm of the cervical spine region and the trapezius muscle by which the normal alignment of the cervical spine is achieved. Using cervical soft collar will help to reduce the mobility of the cervical spine leading to stabilization of the joints and less nerve root entrapment. Exercises like static neck exercises, shoulder stabilization exercises, interscapular muscle strengthening exercises will help to regain the muscle strength and correct the cervical spine alignment. If you have any more questions, you can ask me anytime.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for white discharge from penis\n\nI am 35 years old and am experiencing some thin white discharge in my penis in the morning in the last one month. sometimes i have to milk it to see it clearly. I have taken taken Ciprofloxin in the last two weeks but still experience the same problem again. No burning and paining and sometimes with continuous peeing it disappears for sometime. I have experience something similar some years back and didn't know how it went off. What can  i do?",
    "doctor_response": "this could be a sexual infection.You need to have a culture done.The antibiotic of choice is doxycycline to help treat these things.Please leave 5 star rating!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump near anus after radiation for anal cancer?\n\nI just finished chemo & radiation for anal cancer. I had a tumor around my anus, stage 2 that was first surgically removed along with hemorroids. within the first month after treatment, I have a soft lump from front of anus towards my vagina. it is very painful to touch. what could it be?",
    "doctor_response": "Hello....You have got surgery and chemo radiation for your anal cancer...nd as u have lump near ut anal canal may be due to some cause.... as it is painful its more likely to be infectious...Becoz chemo and radiation also lowers the immunity of body...Better to confirm and rule out new malignency primarily a sonographic scan would be a better option...along with routine blood investigation...That will lead us to a proper dignosis and treatment",
    "dialogue_context": ""
  },
  {
    "patient_message": "I still have back pain after undergoing operation. I took a nerve block injection.\n\nHi I had surgery on the 19/5/2011 it was s1decompression and I still have a lot of pain in left buttock and left leg also 7days after op had a nerve block injection and still have pain and sometimes I think I have worst pain now then before op please help",
    "doctor_response": "I do not know the reason for the back surgery. I suppose due disc pathology or spinal stenosis in lower level of the back(L4-5 and L5-S1). During surgery there might be touching of surgical instruments of the nerves which leads to edema and more pain which can last up to 3-4 weeks and treated by fysio and pain killers.A more serious situation might be nerve damage due to edema or trauma to the nerve by the surgeon.To solve this an NMR after a periode of 4 weeks needs to be done. Important is : do you have loss of power (standing on heel or toes)or sensory disturbance on the frontal or posterior part of your leg.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could i be pregnant with dermatomyositis and fibromyalgia ?\n\ndear doctor, i am suffering from dermatomyositis and fibromyalgia . my reheumatologist told me to take steroids and plaquenil for my dermatomyositis. lyrica and arcoxia for my fibromyalgia. i just want to know my chances of getting pregnant. thank you.",
    "doctor_response": "hi both these condition will take long time to controlled u r on heavy drugs right noe so dont think to be pregnant right now. chance of pregnant is there in u r case. but u need detail discuss with gynec before going for it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to conceive with pcod?\n\nhi sir i a me  having pcod problem but i had intrested to concieve. i started using ova shiels tablets this month but i get periods without completion of my tablets but i am not getting my periods properly. so please suggest how i want to use this tablets.",
    "doctor_response": "Hi, As you have PCOD problem, you should get your thyroid profile checked. Also do a serum prolactin test. You can also do a follicular monitoring on ova shield tablets and can see for the growth of your eggs. May be you will need some medicines like progesterone in later half of your cycle. Contact your doctor. Getting periods even without finishing ova shield is okay.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Khushboo Priya",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why has my child not started walking by his own?\n\nHi doctor, It is regarding my son. He is 14 months and 1 week old. He has not started to walk by his own but started to crawl since 12 months. Is there a problem with his leg muscle?",
    "doctor_response": "Hi. Do not worry. Some children are a little slow. The very fact that the child is able to crawl shows that leg muscles are working fine and have enough strength to lift the weight of the body. Give the child some time and he should be able to walk also. You can supplement the child with calcium and vitamin D for providing more strength and nutrition. For more information consult a child health specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in the lower lip?\n\nMy fathers bottom lip is swollen , last week I took him to ER because his toung and throat had swollen . The ER Dr gave him Pepcid and asteroid shot released him and the swelling subsided . It had Happend before lips swelling his family Dr took him off of any Blood Pressure med that the name ended in Pril . He had his right kidney removed four years ago , the Dr thought only having one kidney the med was building up and he wasn't ridding himself  of the meds .",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As per your complain it seems that the symptoms of swelling of lips  can be due to Allergic reaction causing Allergic Angioedema of lips....It can be due to any food or medication while other causes can be allergic reaction to any skin cosmetic, soap, lip balm etc..I would suggest you to consult an Emergency room or a  Physician and get evaluated and a clinical evaluation and investigations like blood tests for allergies like RAST TEST, Patch test, Food Challenge test can help in ruling out the exact cause of the symptoms and treat accordingly.As he oy has single kidney taking any medicine without proper doctors prescription is not advisable.. Do cool compresses over the lips .He can be advised injectable steroids and antihistamines to reduce swelling..Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause tightness in the chest and shortness of breath after a meniscus surgery?\n\nI had a meniscus repair on Thursday. On Friday I had shortness or breath and tightness in my chest. This continued throughout the weekend until present time. I called my dr, and was told to go to the ER ASAP. I did on yesterday, and was released from the hospital today. They did a CT scan, chest x-ray, lung scan, eco 2 for my heart, leg scan and did not detect any clots. But I still have the tightness and shortness of breath. I really just don\u2019t know what\u2019s going on?",
    "doctor_response": "Hi, It is good that you do not  have any clots, so probably the problem is not related to surgery. Go to a chest physician for examination and he will start medicines to take care of your breath problems. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes small hard lumps across the palm in the left wrist?\n\nI had a left wrist fx last July and am now noticing four small hard lumps across the palm of my hand that seem connected to the tendons. Is this the result of the fracture or of the exercises following the cast removal? Does it require a return office visit.",
    "doctor_response": "Hi.It could be cyst or just union of fracture, so get xray of wrist in AP and lateral view and send me the report.You must visit orthopedic surgeon.Thanks,Dr.CHANDER MOHAN SINGH.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough and cold in a child\n\nHello sir I have 2 son 1 is 3.5 & 2nd is 7 the month both are regular suffering from cold & caugh and taking prescribed medicine by doctor getting normal for 2 or 3 day s but next again suffer by cold & cough so sir what would be ur suggestion ? Pl se ansr me -----",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Cough and cold in child's are because of the viral infection and need not requires antibiotics therapy every time.It will be given only once. Since both the child's are kids the infection is keep rotating in both of them. So symptomatic treatment is required for both the person.You can give both of them paracetamol suspension and chlorpheniramine suspension. The combination is available in the market. Please take the advise of your doctor before you take the drug.Please give them good hygiene practice. Good hand washing and keep the handkerchief while sneezing can prevent the cross infection to one another. You can also keep both of them separate while sleeping this also prevent cross infection.Give them one glass milk or one egg daily. This will help to boost up their immunity.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes throbbing pain in thumbnail?\n\nRandom Throbbing pain under my left thumbnail.It s been going on for about a week or so can t really say. A pain in my thumb isn t something I pay too much attention to. However, now that I ve realized it s not stopping, I m getting curious. What s up with my thumb?",
    "doctor_response": "Hi, Throbbing pain in thumb is most likely due to paronychia, i.e., pus in subcutaneous plane of thumb, apply ice pack, consult in nearby hospital for proper antibiotics. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jaideep Gaver, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest natural treatment for metallic taste in mouth\n\nHi, I am experiencing some metallic taste with food. This is annoying and I d like it to stop. Do you know what it might be? Also, do you know how to find a doctor who is interested in more natural treatments? If I look at supplements, it always says to ask your doctor, but where I live, the doctors say just be careful and look up the information. Does anyone know what is going on? How to find a physician who has knowledge of herbal and other alternative therapies.",
    "doctor_response": "Hello, thank you for sharing your problem with us.There are many reasons for metallic taste in the mouth, it can be because of any medication that you are taking, because of cold when your nose is blocked or can be because of smoking also.First thing you should do you should rule it out why it is happening and find out the cause because without knowing the cause no treatment will be effective for you.And also one thing you can do to drink a lot of water to reduce this sensations.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a discolored lump on shin after an injury?\n\nI was kicked in the shin about 3 months ago. Swelled to baseball size and after much icing I still have a 1/2 golf ball sized lump with some discoloration. In the weeks after being kicked, foot, below ankle was sore with bruising as in severe sprain. What would cause lump not to go away?",
    "doctor_response": "Hi. After such a long period it is possible that the hematoma has stopped resolving and gone into stage of organization- a bit irreversible process. The nerves going through  the area will cause referred pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure severe back pain due to gap in spine?\n\nSIR, I VITTHAL MORE, AGE- 45 YEARS. OPERATION IN LOKMANYA HOSPITAL IN THE YEAR DEC, 2009. BECAUSE OF MAKE SMALL GAP IN MY SPINE. SO THAT TIME  ONE SYRGERY MAKE ON MY SPINE AND FIT A CAGE IN THAT PLACE. BUT TILL I HAVE NOT FEEL WELL. I HAVE VERY LARGE BACK PAIN ON FULL SPINE AND MONKEY BONE ALSO. I CAN NOT SIT ON ONE PLACE MORE THAN 15 MINUTES, BECAUSE PAINS HAS BEEN STARTED. I HAVE MEET SO MANY DOCTORS, BUT I HAVE NOT GOT RESULT.PLEASE GIVE ME YOUR SUGESTION.",
    "doctor_response": "Hello, I have studied your case.You may need to do MRI spine again to see for nerve compression If your new MRI shows disc bulge with nerve compression then surgery may help.Due to compression of this nerve root there is tingling numbness in your leg and pain associated with it.For these symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and TENS therapy will help.I will advise to check your vit B12 and vit D3 level.You can consult me at my hospital in aurangabad.You can contact my profile directly this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Diagnosed homozygous C677t MTHFR. Prescribed duphaston, how long to continue? Had miscarriages before\n\nHi I m 33 years old ttc I had 3 miscarriage ( all during 1st trimester ) my forth pregnancy completed ( i was on clexane 40 , progestrone, baby aspirin and prednisolone ) till I had preeclampsia at 29th week so they have to terminate the pregnancy the babies where died after spending 20 days in ICU , now I m ttc and was tested for a gene mutation MTHFR I m a homozygous C677t my doctor described me duphaston 10mg twice daily for ONlLY 10 days from16th to 25th and I should have intercourse during the ovulating days my question is what if I stopped duphaston and I was preg. Is this will affect the pregnancy is it better to complete the duphaston till I menstruate or it should be stopped then waiting for either menstruation or pregnancy?",
    "doctor_response": "Hi, Thanks for the query. Duphastone is a progesterone often prescribed to support the pregnancy. You can take progesterone from 16-25th day and then wait, if pregnancy is confirmed restart it again. Also take folic acid daily since you are planning. Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will shift in gravity affect heart post surgery?\n\nI am currently 29 years old. 6 years ago (age 23), I had to have an emergent double cardiac bypass related to inflammatory occlusion from my Takayasu's aortitis. I am otherwise very healthy an have not had any complications following surgery and my grafts are patent. Is it okay for me to ride steel roller coasters? Is there anything about the shifts in gravity that would be contraindicated?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, you should not ride on any roller coaster ride. These rides can damage operated vessels. Actually, there is sign board stating that bypass patients are not allowed in roller coasters. This is because they are not safe such patients. So better not to take ride in such roller coasters as it can cause sudden death in such patients. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does bug bite cause bloody diarrhea?\n\nmy son was bit on the forearm, back, abdomen, and cheek by something.  Within 24 hours severe redness and swelling.  MD prescribed OTC Bendadryl and prescribed hydrocortisone cream.  Swelling and redness disipated and within 6 hrs he started with bloody diarrhea.  Is there a bug bite that can cause that?",
    "doctor_response": "Thanks for contacting HCM with you medical concernsYou are concerned about your son developing bloody diarrhea after being bitten several times by an unknown insect. Since your son has bloody diarrhea I recommend that he be seen immediately by a medical professional. This is a medical emergency and should be evaluation as soon as possibleHope this answers your question. Please contact us again with your health care questions and concerns",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard non moving bump on collar bone?\n\nMy fifteen year old daughter who is an athlete just noticed a hard bump , smaller than a pencil eraser, ON her collar bone. It just popped up, because she had a physical two weeks ago. It doesn t hurt. Seems not to move. We are headed to doctor tonight. What could it be?",
    "doctor_response": "Hello, Most probably it will be a benign (noncancerous) bone swelling like osteoma. Consult an orthopedic and plan for an X-ray. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be concerned about my dropping blood RBC count?\n\nHello,  I received a physical and a CBC but was not ill.  My blood counts were low (red, platelets, neutrophils, white) and was advised to stop drinking alcohol.  I consistently had 2 drinks per night, every night for about 6 years.  Six months later, my blood counts all increased after quitting alcohol (red form 4.01 to 5.22, platelets from 110 to 242, hemoglobin, hematocrit, neutrophils from 1.5 to 2.0), but my overall white cells went from 3.1 to only 3.9.  Many things I read online associate low blood counts potentially to hiv.  I have not been involved in risky behavior for many years.  Should I be concerned?  Thank you.",
    "doctor_response": "HiThanks for your queryBased on your query, my opinion is1. RBCs and platelet count is within normal limits, WBC count is on the lower side of normal.2. You should not be concerned about these values as long as you are asymptomatic.3. Low counts need not necessarily mean HIV associated. There are many more causes for low counts, commonly when the marrow is suppressed by infectious or hereditary cause.4. Since your counts are back to normal, di not both much.Hope this helpsRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for knee pain while standing\n\nI fell in a crawl space hole... and my right leg is throbbing in pain, swelling and is scratched up and a little bloody. But my left leg is what I am concerned about it Looks fine don t think it is swelling doesn t really hurt at all until I try to stand and every way I put presser on my foot it gives me a bad pain up my whole leg but main pain is in my knee. I also hurt on my lower back on the left I believe I hit right there when I fell. My question is how do I treat it? I have had ice on it for the passed 30 minutes and the ice feels good on the swelling leg but I feel like warmth would feel better on the leg that doesn t show signs of swelling but does have sharp pains when I stand. Is putting a warm pack on it a bad idea?",
    "doctor_response": "Dear Patient, Welcome, and thanks for sharing your concern I went through your query, and I feel, the main thing you need to be concerned about is the fact that you would not have hurt your ligaments in the knee. For the time being that is one week,Take rest,Ice packsanalgesics as and when required,then get an MRI done of the knee after your clinical examination is done.if that comes out to be normal, need not worry.I hope my advice would have been useful, in decision making regarding your treatment, still if you have any clarifications or doubts feel free to contact back.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes my daughter s painful lump on the side of her neck?\n\n7 year old female with a quarter size knot on the right side of her neck about 2-4 inches above the clavicle. Complains of pain to touch and with neck movement, no fever, fatigue, or other symptoms presenting at this time. Its important to note that the size has gotten larger in past 24-48 hours. Pediatrician cant see her until next Wednesday, any thoughts as to what it may be?",
    "doctor_response": "Its supraclavicular gland inflammation mostly due to throat infection. Give a course of 7 days antibiotics ( syr augmentin, dose could not be mentioned as body weight unavailable). If the nodes recedes in size then ok, otherwise a biopsy has to be taken from it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is treatment for CML needed after blood test returns normal?\n\nHELLO DOCTOR.. MY SON 14YRS.OLD .. HE SUFFERRED  FROM JAUNDICE.. IN THE MONTH OF APRIL. AFTER THAT HE STARTED LOOSING HIS WEIGHT. .. ON TEST OF BLOOD SAMPLE IT WAS FOUND THAT THE SIGN IS SHOWING  \"CML\" .. AFTER BONE MARROW TEST DOCTOR CONFIRMED .. CML. AND STARTED GIVING ORAL MEDICINE.. FOR THE LAST TWO  MONTHS HE IS TAKING ORAL MEDICINE. NOW HIS BLOOD SAMPLE IS SHOWING EVERY THING NORMAL.. AND HE GAINED THE WEIGHT TOO. NOW PLZZ GUIDE ME WHAT SHOULD I DO... WHETHER TO GO  FOR ANY SPECIAL TREATMENT . ? OR KEEP CONTINUE THE ORAL MEDICINE..?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  He is on treatment of CML. He should continue with his oral medicine if he is improving.  No any special treatment is needed.  Just hi gor regular blood test to monitor his count. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medication for fatty liver condition\n\nhi..doctor i have fatty liver my liver size in 160mm my qustion is what grade this  and what chekup ..help me what time period reverse fatty liver to normal liver what type food to eat this, is dangers..razo-D and razo-20 medicine is good for me...plz reply and any chekup",
    "doctor_response": "HelloYour findings suggests mildly enlarged liver with fatty changes.Fat deposition in liver may be the cause of mildly enlarged liver.Fatty liver is a reversible condition.It usually reverse with treatment of underlying cause.Mildly enlarged liver with fatty changes may be due to many causes like obesity,sedentary life,hepatitis,altered lipid profile,metabolic disorder etc.You may need few investigations like routine hemogram,random blood sugar,lipid profile,liver and renal function test,Urine RE/ME,ultrasound of abdomen.You should avoid fatty and fried food.Avoid saturated fat and take lot of fibers in diet.It may take 6-8 months to reverse the findings.Razo-D and razo-20 are medicines for acidity,you can take it safely.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low memory and agitation at the age of 62?\n\nMy husband is a retired Fireman aged 62 . He is getting increasingly forgetful & his personality seems to be changing too, he gets agitated over the slightest thing.  At the weekend we bought a picture for our home that we have been looking for, then the following day he went out on his own & bought the same one, & became very defensive when I pointed this out to him.  He had no recollection of buying the one the day before.  This is just one of numerous incidents.  He also got lost taking something to the car with a friend after insisting that he knew the way. Can you help.Regards Sharon",
    "doctor_response": "If I were at your place I would have consulted a neurologist to confirm the kind of memory loss. Older peoples suffer from Alzheimers disease more frequently. Its progression can be delayed with medications.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red scaly rash on inner thigh?\n\nHello, my son has had a rash on his inner thighs for more than a month...it is red, scaly, and will not heal, even with daily treatment with zinc oxide applications. The pediatrician said it looks like contact dermatitis, though no changes have been made in diet or clothes detergent, etc. He has also had persistent mild stomach upset, just enough to curb his appetite slighty for the past month. Now the rash is on the back crease of his knees and is very red (looks like what I had on my inner elbows with scarlet fever as a child.) I am wondering if there is a bigger picture here or if these are separate unrelated issues. Thank you.",
    "doctor_response": "Hello, You have not mentioned the age of your son. However, if it is contact dermatitis, it should go away with the local application of hydrocortisone ointment & antihistamines are quite effective. Scaly rash on the inner thighs or back of elbows can also be due to tinea cruris (Jock Itch). Jock Itch can be treated with an oral course of antifungals & application of topical antifungal ointments like clotrimazole or miconazole in the affected area. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Nupur K, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching on body and high levels of histamine in blood?\n\nAt my doctors appointment this week he observed what appears to be a large amount of histamine in my blood (I turned red very easily and it lasted awhile) and I also noticed I get red and hot randomly while indoors or out and it take awhile to cool down, I am a 33 year old female. He suggested Zyrtec at night but the next day after taking it I got red and itchy on my arm and other areas became uncomfortable like needing to continually crack my neck, back and mainly my two fingers on my right hand. The pharmacy suggested Benadryl but that did not help. Now it s been going on a few days, my itchy red fingers hat continually need to be cracked for relief were swollen and red this morning and very painful near the joint and continue to be painful although swelling went down a good bit throughout he day. Now I am becoming itchy in other areas like my left hand and my left ear is now bright red and very hot. I also suddenly have unexplained brushing across my lower back and right side. I am very worried, what could this be?",
    "doctor_response": "HI, Thanks for using healthcare magic,Itching and redness all over body like fingers,arms,neck etc and high levels of histamine in blood could be possibly an allergic reaction to something. You should consider the use of an anti histamine to dampen the response. An example would be levocetrizine or fexofenadine a good choice inplace of benadryl.There are also some creams which may soothe the itching,examples include calamine lotion or menthol in aqueous cream.You need to be further clinically examined by dermatologoist for proper diagnosis and treatment.I hope this helps,Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is age a constraint in administering a pacemaker?\n\nMy uncle is 92 years old, never been sick, and has all of his faculties.  Recently he has been having \"episodes\" where he becomes light headed and has even passed out for a time.  Doctors are monitoring his heart medication and thinking about a pacemaker.  Is he too old to consider this?",
    "doctor_response": "Hello, SirWelcome to healthcaremagic.I can certainly understand your concern.I have worked through your query in detail.Pacemaker can be considered in your grandfather's case.His age is not an absolute contraindication fo a pacemaker.Infact a pacemaker implantation performed by an experienced operator is a safe procedure for patients of advanced age. The patients who are above 70 years old may have less complication rates than the younger patients according to various scientific articles in various studies.Hence you can go ahead with your doctor's opinion and advise.Complete cardiac evaluation is required before implantation of a cardiac pacemaker.Its advisable to take an expert opinion from an interventional cardiologist before going for the procedure.Please check with your physician if he shares my view and if can prescribe these medications to you.Post your further queries if any.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sever abdominal pain. Diagnosed bowel cancer. Treated for fibroid. Help?\n\nI have just moved onto the next page of this website and realise i cannot go any further as i have no credit card. My apologies. Eighty year old women treated for urinary infection for number of years then severe abdominal pain then series of tests to find cause 1. bowel specialist gave the ok although 15 years ago diagnosed bowel cancer was removed. 2. thyroid test came back positive 3. next specialist looks at Cyst on ovary as scan discovers this who now wants to do a biopsy as he said thickening of uterus needed to be investigated. Oops pain much more severe at night. Has also lost stone in weight last three months while pain and investigations take place. What does all this mean Regards very worried relative ps i am only looking to understand what is happening and the thinking of the drs. as this is a close relative i also wonder about heredity diseases. I have been diagnosed with hyper and now hypo thyroid. Daughter has been treated for fibroid which has been 18cm in length and appeared to compete with baby in womb for both pregnances. I suppose i was also wondering with all these problems associated with three generations what measurements can be taken to avoid the 80 year old plight ie food, vitamins etc not thinking of long term medication just lifestyle changes to avoid certain scenarios",
    "doctor_response": "Hi and welcome to HCM. This isn easy to answer. I am afraid i didnt understand the question but as I see you are woried about 80year oold woman and possibilityof cancer development in her relative including you. Well, affinity to certain cancers(especially breast, ovarian, uterine and colorectal) is associated with genetic predispositions. There is no doubt about it but it shouldnt concern you and make your life insecure.This is still small possibility,it is impossible to calculate it. All you need to do is to look for sign and symptoms more carefuly then the others and do often examinations and preventive tests especially after 40.year. Your doctor will know about these tests. This patient hasserious symtpoms and cancer in history so it definitely needs to be investigted and treted. All you can do is to live healthy, eat healthy food, avoid alcohol and smoking. You cant change your genetics but can change life habits and think positively. Every human can get cancer no matter about his genetic potential and it is apsurd to be concerned about this possibility because someone in our family has it. WIsh I ve been helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is swallowing Mylanta and Benadryl dangerous for children?\n\nMy 13 month old has HFMD. I was told by the dr that we have to wait it out. Tonight he was beyond miserable due to his mouth sores. I have never heard him cry like this. In desperation I tried the magic mouthwash; mixing 1/2 tsp of mylanta and 1/2 tsp of children s Benadryl. In an attempt to get him to swish it around he swallowed it...is he going to be ok? Should I take him to urgent care? I am worried.",
    "doctor_response": "Thanks for posting your query at HealthCareMagic. Hand, foot and mouth disease is a a common and highly contagious viral infection caused by Coxsackievirus A16 or Enterovirus 71 (EV-71) and is characterised by painful mouth sores. So it is natural for your child to cry like hell.There is no harm if the child swallows Mylanta and you need not worry about it. All that can happen is that the child may feel sleepy for sometime.Currently, there is no specific curative treatment for hand, foot and mouth disease. Disease management typically focuses on achieving symptomatic relief. Pain from the sores may be eased with the use of analgesic medications. Infection is typically mild and lasts approximately 1 week, but may occasionally run a longer course. Fever reducers like paracetamol and lukewarm baths can help decrease body temperature. It is a self containing disease and corrects on its own but with time.Hope that I have been able to clarify the matter. Feel free to revert back in case of further queries if any.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the pain in abdomen and urge to urinate while eating food?\n\nI am a 26 yr old female, Yesterday I ate dinner and had intense pain in my lower abdominal and pelvis both on the left side, the pain caused me to regurgitate my dinner and I had an urge to urinate the whole time but did'nt have to go. The pain lasted a few hours then became less intense. I woke up the next day with no pain then again after eating breakfast the pain came back. I didnt regurgitate this time but the pain was the same and same urge to urinate and again became less inentense . What is the cause of this?",
    "doctor_response": "welcome to Health care magic.1.Urge to urinate and abdominal pelvic pain and regurgitation symptoms  - It looks like renal / ureteric calculus.2.The other cause is if there are symptoms after the intake of food - then it goes towards the bowel pathology ( but you have not mentioned any bowel symptoms) so we take it as incidental.3.Mean wile you can take a pain killer and see if resolves fine. If not then you have to see your doctor and get an ultrasound abdomen done, which will help to reach diagnosis.Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have developed gestational diabetes with FBS 130 mg/dL. Do I need to start Insulin?\n\nHello doctor, I am 2.5 months pregnant now. And I have developed gestational diabetes and consulted with a gynecologist in the nearby polyclinic and made HbA1c (blood sugar monitoring test) and the result is 6.4 % reference range normal up to 6%. Before pregnancy diabetes range used to be always in normal range. Nowadays blood sugar while fasting is 130. Do I need to start insulin? I need your advice. I am 24 years old. My height is 5.2 feet and weighs around 105 kg.",
    "doctor_response": "Hello,  Welcome to icliniq.com. I just read your query and from what you have mentioned it appears that your blood sugar is not very high as to start insulin treatment as of now but you need to be closely monitored as regards to blood sugar, ultrasound fetal monitoring by an obstetrician and a dietitian for low carbohydrate diet consumption. Try to eat more vegetables like green leafy vegetables and not potatoes which contain high carbohydrates. You need to check 50 gm oral glucose tolerance test fasting and after 1 hour and 2 hours. If still high we need to assess the results and do further tests for the same and then decide whether to start insulin or not. Maintain blood sugar chart by checking it fasting, 2-hour post-meal, and before bedtime. Be in touch with a physician. Avoid rice, sweets, and sugary drinks. Take Folic acid 5 mg once daily. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on ankle\n\nHi, may I answer your health queries right now ?  Please type your query here...Hi, I fractured my ankle 14 months ago and now I have a fairly big hard lump on the fracture site. It seems to getting bigger all the time. Is that calcuim deposits and will it cause problems?",
    "doctor_response": "Hi,Dear,Good Afternoon and Thanks for the query to HCM.I studied your query in details and understood your concerns.@My impression of your lump on ankle-is as follows-It could be-? Peri-ostitis with Abscess- with Acute on Chronic ?Osteomyelitis OR could be Chronic Abscess of the subcutaneous Tissue, of the  ankle. -Treatment-I would suggest -is as follows-a-Consult ER Orthopedic and ER Surgeon who would check clinically and would do Xry of the part and fix its diagnosis.b-Antibiotics -appropriately under doctors guidancec-Tab-Voltarend-If no relief -Surgical drainage and evacuation would be needed.This would help you to plan treatment with your doctor.@Hope this would resolve your worrisome query.Welcome for any further query in this regard,and would love to help you to resolve this problem till it is solved to your satisfaction.@ One Small Request to you to Write strong recommendations promoting my services for the benefit of my new and old patients at HCM clinic.Wishing you fast recovery..!!Have a Good Day.With Regards ,Dr.SAVASKAR M.N.Super-specialist in NCCD-Non-Curable Chronic Disorders and Rejuvenation therapies in tissue and organ failures.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from bowel cancer. Spread to liver. Taking morphine for pain. Weight loss, swollen feet. Any suggestions?\n\nDad 81, has stage IV bowel cancer with mets to the liver . He hasn t responded to treatment and is now at home on long acting morphine tablets for pain. He never complains but its so awful to see him decline in front of me. He has lost weight although he is on a steroid every morning and his appetite is great. His feet got very swollen and he wear strong stockings which help. He cannot be left on his own for a minute as he often falls if he attempts to walk on his own. Confusion is more noticeable now and he is forgetful too. I m so sad, but strong enough to care and love him so much that I would really like to know what to expect and how long I ll have him realistically. Many thanks.",
    "doctor_response": "Hi, thanks for using health care magic, I am so sorry for the pain you and your father must be in It would be impossible to tell you the exact time period that you and your father have together but in general the 5 yr survival rates for stage 4 colonic cancer is 6%- 6% of persons with this diagnosis survive beyond 5 yrs. In cancer patients there are certain signs that are often associated with the dying phase, these include:the person becomes bed bound, the person is semi comatose, able to take only sips of fluid and  not able to take oral medication. In addition the mental status may change. I hope this helps and wish you the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can stress or food allergies cause rashes on the stomach and thigh?\n\nI broke out in a rash today on my stomach and thighs...I heard drinking red bull can cause this (as I drink 3-4 per day) I also heard stress can cause this (as I have an interview later this week) and I also heard insect bites can cause this (as I was knocking down cobwebs earlier today) Which of these are most likely???",
    "doctor_response": "Hi, You seem to have developed an urticarial rash. It seems to be most likely due to insect bites followed by a red bull drink. Take antihistaminic like tablet Cetirizine. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please suggest some medicine or exercise to pronounce R words correctly.\n\nHello doctor, I am suffering from R related words in speaking, I practiced a lot, but problems remains the same. Kindly suggest any specific medicine or exercise for the same.",
    "doctor_response": "Hello. First of all, I hope you consulted a speech therapist. Because he can help you correctly and quickly than you can do it by yourself. R sound of the retroflex is the sound where the tongue performs a vibrating motion to produce the sound R. For correcting the sound you first need to start practicing with the placement of the tongue then you progress to vibrate it. If you are finding it challenging to understand, consult a proper speech therapist as you need to practice the first steps to articulate. You first need to produce individual sound and then words. I hope it helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is hard spot below surgery site after laproscopy?\n\nmy wife had laparoscopic cholecystectomy just over a week ago.  She is feeling fine, other than tenderness around surgery entry sites.  However, the umbilical site has a firm spot directly below the cut.  There is no redness, swelling or fever just the hard area under the cut.  When she pushes on it it does not move, just a hard spot.  She has a follow up with her surgeon in a few days, what could this firm spot be?",
    "doctor_response": "hi.if the surgery was unremarkable and there are no post-operative complications, then it is not worrisome.the firm spot directly below the cut you are feeling is most probably a fibrosis underneath.. it's like scarring, only on the inside. this happens during wound healing.have a follow-up with your surgeon as well.hope this helps.good day!~dr. kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a child suffering cold and cough with itchy ears and teary eyes?\n\nHello Sir, my baby is 3 yrs old and suffering from cold and cough, currently she is having constant itching in her ears and tears in the eyes. my wife gave her Alerid syrup 5ml today. After discussing with her pediatrics he suggesting giving her Relent+, can you please suggest if the provided medication is correct for her to get faster recovery.",
    "doctor_response": "HiWelcome to the HCMIn my opinion your child is suffering from an allergic episode. Alerid and relent are both fine but I would recommend you the following measures for better results:1. You may start Syp. Maxtra for better relief. It will be soothing and more comfortable due to mild sedation and better allergic control.2. Try to find out any allergens in the surroundings of the kid. If possible, avoid them.3. Apply lactocalamine lotion on ears and skin to relieve itching if it's present.Hopefully this will help you. In case of any further questions about this, you may contact me.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Disprin advisable for treating heart ailments?\n\nI take 10mg Disprin in water once a day to thin my blood and help protect me from possible Heart & Stroke problems which I ve encounted (TIA s in 1990 & 2000+ a heart murmer diagnosed 10 years ago which has remained unchanged since then) in the past & for which I continue to take a low level of drugs. My wife takes a similar amount of Disprin in the hope she is better protected against possible Heart & Stroke problems. Can you please advise us?",
    "doctor_response": "Hello and welcome to ask a doctor service. I reviewed your query and here is my answer.In your case it is advisable to take aspirin to prevent stroke and other cardiovascular event. but you didn't mentioned why your wife is taking these? Is she also a cardiac patient or have stroke or any other thing for which it can be indicated? If she is having good health and no problem in her heart, then she shouldn't take this. It is not advisable for her. She should stop taking it as it has got side effects as wells.Hope i answered your question.  Feel free to ask more if you need further assistance.  Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please let me know the do's and dont's after wisdom tooth removal.\n\nHello doctor, I just got my wisdom tooth removed. So, I was wondering if I can get a guidance of the do's and dont's. Like tips regarding eating or drinking to avoid problems.",
    "doctor_response": "Hi. Take precautions for 24 hours if the wisdom tooth has been extracted non-surgically but, if the tooth has been removed by surgical intervention with sutures placed, then take precautions until the sutures are removed. Consult a dentist online for further help -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are side effects of not having spleen?\n\nMy spleen was removed about two yeas ago and there are things that have happened. I have to take daily medication. My body is not taken or absorbing my medication there are other medication as well. What else is happening because I do not have my spleen",
    "doctor_response": "Thank you for posting query at HCM.Spleen is a very important organ and plays a vital role in defense against microorganisms (bacteria) and regulation of lymph.A person without spleen is very prone to get infected from bacteria especially encapsulated bacteria. therefore, usually all patients undergoing spleenectomy receive vaccination against \"encapsulated bacteria\" (hemophilus infuenzae and streptococcus).if your not vaccinated, get a vaccine shot asap against these bacteria.wish you good health.further queries are welcomed.Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health.regards,Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest a list of vegetables that may cause allergy\n\nWhere can I access on line an index or chart that shows related food groups - for example if I am allergic to say red beans are their specific beans I should also avoid? that are catagorically in the same food family or perhaps if I m allergic to a certain melon should I avoid other types of related foods",
    "doctor_response": "Human body is unique to everyone and you cannot generalise allergens. It's one's own monitoring over sometime to judge which things do not suit him or her. In our career we have seen people allergic to one category but same category's other food or anything else doesn't cause allergy practically to the same human.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there continuous release of gas from my stomach?\n\nHello doctor, I am suffering from a gastric problem for the last one year. There is a continuous release of gas from my stomach. The stomach sort of puffs up all the time, gas production is in every 10 to 15 minutes and it goes out through the anus or mouth. After 10 to 15 minutes again I have the same symptoms. I have visited many doctors but they are unable to cure completely. Recently I visited a doctor and he prescribed me to take some capsules like Panlipase 25000, Velgut, and Medigas and after taking these capsules, I feel better. He advised to continue the medicines and now I am in the third month. But still, the problem persists. What is the reason behind the release of gases and how can it be cured completely?",
    "doctor_response": "Hello. Gas formation is not always abnormal and need not always be treated. You can take precautions like avoiding foodstuffs which can increase gas production. Other measures are to regularise bowel habits, avoid constipation and have an adequate intake of water daily up to two to three liters. Tablets like Velgut (Probiotic) help temporarily. For more information consult a medical gastroenterologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I gaining weight steadily?\n\nHi doctor, I am 53 years old and have been gaining weight steadily even though I eat fairly small portions and very healthy. I run 2 to 3 times a week and drink plenty of water. I do not have any health problems, however, I do not sleep very well. According to my doctor, my thyroid function is normal. What would you recommend?",
    "doctor_response": "Hello. I have gone through your reports (attachment removed to protect patient identity), they are completely perfect, no need to worry. Change your exercise at some days interval, as the body is habitat to the same exercise so you have to challenge your body strength by changing exercise. Yoga is good for weight loss and even for mental calmness. There are many asanas to perform for good sleep and to lose weight. Along with above lifestyle changes you can start Phytolacca berry two tablets in the morning, noon, and night. Passiflora mother tincture 10 drops in half cup of water in morning and night. To decide further medication and duration of treatment, I need to follow up and details. Have a good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain on the top of one testicle, chest and stomach pain after vasectomy. What could be the cause?\n\nI had a vas preformed about a year ago and have been having pain on top of my left testicle since then I have had antobotics for infection. Now with the teticle pain at the top im also having chest pain and pain in my stomach . what could this be. my doctor said the epidtimus we probaly need to be removed but would that cause these problems?",
    "doctor_response": "Welcome to the forum.Unless examined, a diagnosis cant be reached.Post vasectomy sperm granuloma can cause the pain which may need removal - as your doctor had suggested.But the chest and stomach problems seem unrelated.Sincerely,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for autoimmune hepatitis\n\nim 57 years old 6years ago I was diagnoised with autoimmune hepitis the doctor said my liver would stop working in 10 years my symptoms where yellow skin and eyes I haven t had these symptoms since do you think my liver has healed itself I also was told that it was hereditary but I don t know of any family members with this",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have autoimmune hepatitis.  It means your body produces antibodies against your own liver cell. You should go for this auto antibodies level test.You need immunosuppressive drugs. Steroids and other immunosuppressive drugs will help you. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching and body pain 3 weeks after chickenpox?\n\nGood day, i had chicken pox about three weeks ago and in one week, it was clear for me to start my duty at my place of work as directed by my doctor. but this week am surprise that i have itching, headache and body pain. does it mean i have chicken pox again, or is it shingle?",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.No, it can't be chicken pox. It can be shingles.Chickenpox never recurrs in a week period.I think it is some different thing that is causing itching.Shingles occurs with blister and burning pain as it is absent in your case it is not shingles also.You cab take the visit to the dermatologist as skin disease can't be diagnosed by description only.You can take the cetrizine for itching and paracetamol for fever. Please take the above medication under your doctors guidance.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mild cervical spondylitis in C5-C6 vertebra, dizziness, insomnia, chest tightness. Curable condition?\n\nHi, I am XXXXX here . I am recently diagnosed with mild cervical spondylitis with obes in c5 c6 vertebra. I am having dizziness , tiredness, insomnia , pain in left leg, arm ,hand,chest tightness and broking sound in my neck. I am this problem for past 15 years but now only diagnosed and went to doctor. Is it curable desease? Pls advise",
    "doctor_response": "Hi, Welcome to HCM, Cervical spondilitis is a degenerative changes in spines due to age and there might be having osteoporosis in the bones. This is not curable but further damage can be prevented by physiotherapy, cervical traction and Short way diathermy. Go for branded Calcium, vitamin D and A. Go for regular physiotherapy. Consult orthopedic surgeon and follow his advice. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "History of breast cancer. Have surface numbness in leg, no pain. Taking Exetimibe for high cholesterol. Is this MS?\n\nHello, I am 64 years old.  Had breast cancer with a Becker implant 8 years ago.  In my early 20s I had ?MS although it wasand never properly diagnosed as the symptoms of supersensitivity, tingling and loss of vision subsided after a lengthy period of steroids.  I now have surface numbness which started around the knee and has gone down my left leg and is quite noticeable around and under my left foot.  There is no pain - just like the sensory nerves are affected.  I am presuming this is the return of my earlier ?MS symptoms and have asked for a referral to a Neurologist.  I just wondered if it could be anything else.  I am taking Exetimibe for high cholesterol",
    "doctor_response": "Just by history it is very difficult to say if it is  MS or not, It may be other neurological disorder as well but more possibility of MS because of past history.You should visit a Neurologists who will conduct  physical examination,MRI of brain and spinal cord, spinal tap for oligo clonal bands and NCV to arrive at a diagnosis.Hope this answers your question",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for swelling in cheek?\n\nhi. i started getting pain in my tooth and left ear starting 2 or 3 days ago...thought it was an ear infection at first and started to get into immense pain...my mom had some amoxicillin so i started taking that and ibuprofen 36 hours ago....now my head aches and ear pain are mostly gone but i have swelling in my cheeks/gums... i now believe i have dental abcsess and my left cheek is starting to swell out pretty large. it is 2 am....can i wait for the morning to see my dentist?",
    "doctor_response": "Hi,Thanks for posting the query,          I would suggest you to take amoxicillin and ampicillin along with clavulanic acid and aceclofenac and serratiopeptidase combination instead of the above combimnation it will be more helpful.    Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can mono be transferred to an infant by breastfeeding ?\n\nCan mono be transferred to an infant by breastfeeding? My daughter in law delivered a month early and she had been diagnosed with mono 2 weeks before she delivered. She has been breast feeding the baby from the start and I wonder what if any, damage this can do to the baby?",
    "doctor_response": "HI no need to worry as it is not transferable by  breast milk.Only, she should be careful not to be with the baby all the time with having symptoms of cough, sorethroat as she can transmit to her baby.Hope this answers your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is GERD(Gastroesophageal reflux disease) curable permanently through medicines?\n\nDear Doctor, Is GERD curable through medicines permanently? If yes, kindly prescribe the medicines. I have consulted many doctors and taken tablets, but after a few days it is troubling again. Please prescribe some permanent solution to this.",
    "doctor_response": "Hi. GERD (Gastroesophageal Reflux Disease) can be treated effectively with medications like omeprazole, pantoprazole, and with combination of prokinetic drugs like domperidone. In addition to drugs, the modification of life style is important such as: And also go for investigations such as upper GI endoscopy with the doctor's advise and if any underlying surgical conditions, they should be corrected accordingly. So, I advise you to consult a gastroenterologist for examination and investigations. Hope I have answered your query. Revert back to a surgical gastroenterologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for polycythemia vera\n\nIam54years old, 176 cms tall and 64 kg weight. I am a polycythemia veera patient on asprin. I had a cvt in1996 and heart attack in2002. I am on asprin anticoagulantslike warfarin cardivas and beta blockers. I also take hydroxyuria500 mg per day to control platelet increase . Pl advise",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern.  You have polycythemia vera. Aspirin is useful to prevent block in blood vessels.  Periodically phlebotomy is useful.  Hydroxyurea is drug of choice.  Permanent treatment is bone marrow transplantation.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am trying to conceive after stopping my birth control injections. Please guide me.\n\nHello doctor, I came off the Depo birth control injection about seven months ago. I have been trying to conceive, but nothing yet. I have prolonged periods, some lasting 38 days. For the past few months I have been using ovulation tests, but I never get a positive result.\u00a0I have an application on my phone where I key in the date of my period each month, and it tells me my most fertile days. I take ovulation tests every day, even more than once a day sometimes, and still nothing. I am so confused. At the moment, I am on a 22-day cycle. I\u00a0have been having a terrible breast pain, for the past week, which I never had previously. I feel totally sick and tired. I am experiencing mood swings as well. I am totally confused. I do not have any medical conditions except for fibromyalgia.",
    "doctor_response": "Hello. How are you doing? Hope I have been of help to you. Do write back. All the best. For more information consult an infertility specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling in cheek and lower lip\n\nspontaneous swelling of left cheek and left lower lip, from just below the nose to the chin. This is the 4th incident in 4-5 months. I know of no allergies. My eating habit are very consistent. I took Benedryl. The prior incidents subsided within a day.",
    "doctor_response": "Hello.Thank you for asking at HCM.If you have had no other health issues apart from spontaneous swelling of left cheek & left lower lip which subsides with Benadryl, I would first think of angioedema, which may be allergic or non-allergic.I would advice you to keep a watch on your diet (& drugs, if any) and try to correlate occurrence of swelling within 2-4 hours of any food (or drug). Common food substances can be fresh fruits & vegetables, cheese, fish, packed & preserved foods, etc.If you cannot identify the reason, I would suggest you to consult an Allergist-Immunologist who may suggest you allergy testing and identify the cause.Hope this will be helpful to you.Wish you best of the health.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can chest pain be due to anxiety attacks?\n\nhi i have a question i m 22i weight 110 i have no medical history. i worry and stress alot about life and lately for several months, feels like all my life, before I go to sleep and when i wake up mostly, my heart is pounding very fast and unsteady and i feel i can t get air. this happens alot and it lasts for about 30 minutes sometimes longer. lately i have been having sharp chest pains feels like each side of me is being pulled together and squished. I ve delt with depression in the past...am i having anxiety attacks?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. am i having anxiety attacks? Possibly yes. Does happen after prolonged stress and anxiety associated with stress. But you should confirm your health by visiting a physician and undergoing the necessary checks like ECG, blood work etc. Once that angle is cleared, visit a psychologist who can determine your depth of stress and give you counseling as well as psychotherapy.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can swelling of toe be subsided?\n\nI dropped a jar on my toe nail and it looks as if it slightly lifted it doesn t hurt when I walk but i feel pressure when I try to put on running shoes. I missed a week of they gym and would love to get back to excircise. How do I reduce some of the swelling",
    "doctor_response": "Hi, It could be a contusion. As of now you can use analgesics/anti-inflammatory combination like Aceclofenac/Seratiopeptdase for symptomatic relief. If symptoms persists better to consult an orthopaedician and plan for an X-ray. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Missed period. Done blood test, negative. On duphaston. Is it safe?\n\nGod day to you.I missed my period this month.I am trying to get pregnant since a few months ago and, but the blood test shows negative and doctor gave me to take \" Duphaston\" ( twice a day). I would like to know that taking this medicine will effect to my planning of pregnancy and usage of this medicine is safe or not.Thanks.",
    "doctor_response": "Hi,Duphaston is Dydrogesterone, a progesterone and is safe for use even in pregnancy. Your doctor might have wanted to test and see if you get a withdrawal bleeding with this medication. This will happen if you are not pregnant and in case pregnancy has been missed in the blood test, use of this medication is safe. This will not affect your ability to conceive as it is helpful in maintaining the endometrium in case of conception. Hope you find this information useful. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "6 month old has a eyelid rash on right eye. Tried topical cream, no help. Any opinions ?\n\nMy 6 mo old daughter has a eyelid rash on her right eye mainly, even though both eyes have dark circles under them. We have tried perscribed topical creams and childrens allergy meds... So now we believed it maybe from soy formula use. She has been on soy for the past 4 months due to what seemed like cows milk sensivity, now we are back on regular formula for a week with our docs guidence. We are still not sure what is causing it and have considered everything from seasonal allergies to mold and mildew or cat allergy. Our current doc seems to think a dermatogist won t help a infant so feel stuck. Any other opions?",
    "doctor_response": "OTHER TAN MOTHER MILK SHOULD NOT BE ADDE BEFORE 2 YEARS YOU GET BLOOD SERUM TESTED FOR SPECIFIC ANTIBODIES FOR SOYA AND COW MILK AND THEN DECIDE ACCORDING TO REPORTIF YOU THINK OF OTHER ALLERGIES GET BLOOD SERUM TESTED THERE ARE ONLY ALLERGIES BUT TILL YOU GET REPORT YOU CAN USE SYP PIRITON 1/2 TSF NIGHT APPLY NEOSPORIN H EYE ONTMENT ON THE EFFECTED AREA YOU CAN ALSO ADD FEXOFENADINE SYP 30 MGM 1/2 TSF ONCE OR TWICEA WEEK YOU CAN CONSULT AFTER REPORTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Valsalva method to release the blocked eustachian tube does not work. Why?\n\nHi doctor, I had an ear infection about two weeks ago and just finished the antibiotic. In the past two weeks, I have had a fluid stuck in my middle ear with no relief. There is a lot of uncomfortable pressure in my ear and my hearing is completely blocked on that side. I believe my eustachian tube is blocked. I have tried a number of decongestants and also the Valsalva method, but nothing has worked. I have a few very clear photos of my eardrum. I could show you if that helps. Also, in the past few days, bubbles are present in the fluid behind the eardrum. Please help.",
    "doctor_response": "Hello. I have seen the photos. (attachment removed to protect the patient identity).  It appears that after the ear infection there is some fluid accumulation inside the middle ear. We call it otitis media with effusion. This is quite common after an ear infection and usually occurs due to some remnant inflammation inside the eustachian tube that prevents the flow of mucus from the middle ear into the throat through that tube. This can be confirmed clinically by otoscopic or endoscopic examination. Additionally, the hearing loss can be quantified by pure tone audiogram (PTA) and the fluid confirmed by the B curve in impedance audiometry. Do you have any pictures of the drum or the tests? If so please share it with me. Usually, the effusion takes a couple of weeks to resolve and needs a different type of medicine than the one given for infection. You need decongestants oral and local, nasal sprays, antiallergics, and a mild anti-inflammatory agent. Do revert back to me with more details and we shall discuss what has to be done. Do not do Valsalva if there is any nasal block or congestion still as that would push the mucus further into the tubes and increase the block.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome pain in body due to calcium decay?\n\nHi my self brajbhushan mishra,age 56 years. i am suffering from thyroid problem and taking thyroxine medicines from last eight years, bur from 3 monyts i have pan in some time hand,leg, neck. doctor saying it is due to calcium decay from body. what i should do to overcome from this problem.",
    "doctor_response": "Hai, all hypothyroidism patients are more prone for calcium deficiency and electrolyte imbalances, sugar problems, generalised body pains, weakness, obesity, thyroid hormone is an excellent energy booster for the body, so such patients are asked for regular thyroxine tablet s.u can go for calcium and vitamin d3 and cholecalciferol tablets.for pain simple paracetamol 650 tabs will do wonders in ur case, causing no side effects",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could rapid heart rate be due to high BP?\n\nHi, From some times my heart beats runs faster than the normal speed. Some days back I have gone thru the medical checkup and doctor told me that your BP is hing. So you need to controle on it. Is this related to the heart beats issue. Swet is more than normal peoples. Please guide me waht precaution should I take to overcome this issue? Can I stop taking Sault in my food??",
    "doctor_response": "Hello, After going through your medical query I understand your concern and I would like to tell you that for high blood pressure you need to take low dietary salt and do good physical exercise. Heart rate depends on your physical activity, stress and physiological changes, a healthy lifestyle help to maintain healthy blood pressure and heart rate. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in rib cage while breathing after an injury\n\nI fell on the side of my bathtub and hit really hard, I hit the right side on my back of the rib cage but my back, my abdomen and front ribs hurt. I have a big purple bruise where I hit. Sometimes I get sharp pains in my abdomen or side and it has only been 2 days. It hurts to take deep breaths and move period. What should I do?",
    "doctor_response": "Thanks for your question on HCM. You are having blunt chest and abdomen  trauma.And bruise indicated cutaneous bleeding and this may seen in internal damage too.So we need to rule out internal organ damage especially lung and abdomen viscera.Possible consequences in blunt trauma are1. Rib fracture2. Pneumothorax3. Pulmonary contusions4. Muscular injury. 5. Damage to abdominal viscera. So get done chest x ray and ultrasound examination of abdomen to rule out all of the above.If both are normal than no need to worry. It is muscular injury mostly.Try to follow these. 1. Avoid heavy weight lifting and strenuous exercise. 2. Avoid bad postures in sleep. 3. Take good painkiller and muscle relaxant. 4. Apply warm water pad on affected site. 5. Wear chest belt to avoid mobilisation of affected area.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can social anxiety be managed?\n\nGood evening. I m 21 and I ve always been a shy person, when I was younger I used to sweat a lot because of it and I could barely speak with anyone. As I got older I became more and more sociable, now I ve got friends, I m getting along with everyone at work and I m feeling quite good with myself. I ve never been depressed and I m a really happy person. The problem that I m facing is that whenever I talk to somebody, with anyone at all, my heart starts to rush and my face becomes red in just one second. I blush like I ve done some dumb thing and it s intense and very very red, anyone notices it. I ve tried to get it gone by going out as much as possible and I ve learned that when I get comfortable with someone, the blush and red face thing disappears (but it took 2 years to get comfortable with my boss for example). I m aware the problem might be associated with anxiety, but I ve never taken pills for it. I just want the blushing to go away, as that will make me less awkward and better in general. I ve got a mitral valve prolapse and a ventricular hypertrophy",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I see that your personality itself is more of an anxious personality. The way you have managed it all these years has worked well. As of now I do not see the need for any medical treatment, the choice is yours if you think medicines will be of help then may be you can consult your psychiatrist and take Benzodiazipines or anti-depressants for a short period of time.Meeting people often will be the best therapy to overcome your problem. If you have anymore doubts you may very well clarify the same here as and when required. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is liver cirrhosis curable by medicine or is liver transplantation required ?\n\ncan lever cerrosis is curable by medicine.If apatient suffering from lever cerrosis can not afford cost of lever transplant than for how long he can survive with medicine. age of patient s age is 60 yrs and his health is in general good. Also he does not take alcohol & he does not have any bad habit.Pl. advice",
    "doctor_response": "hello, i am sorry to inform you but cirrhosis is a irreversible condition. the functioning of the liver can not be changed by the medicines. however with medicines we can prevent complications arising from cirrhosis and improve the generl health of the patient. you need to monitor the weight, look out for symptoms like swelling of abdomen and legs, vomiting of blood etc. if symptoms worsen i would advise you to consult your physician. i the mean time continue the prescribed medicines. i hope i have answered your quey. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes ulcers in the inside of the lip during periods?\n\nI get an aphthous ulcers on the inside of my bottom lip every time I come on my period. They're very very painful, covering most of the inside of my bottom lip, my lip swells up, my jaw area swells up (only the right side) and I can't eat properly or speak properly because it hurts to much to do so. Lately it has 'spread' (I wasn't aware this could happen) onto the bottom of my tongue and my tongue has swollen up too. I've had various blood tests for all types of deficiency, but they've all come back normal, and I've had two blood counts, HIV - all normal. But obviously this isn't normal. Whenever I take zinc or feroglobin, during the month before the episode, the ulcers still show up but never hurt as much, and aren't as big. So what exactly could it be?",
    "doctor_response": "Aphthous ulcers are associated with no particular reason. They may signify stress or they may not . The treatment is symptomatic . Use chlorhezidine mouthwash and warm saline rinses.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden spike of pain in my brain?\n\nRecently I felt a sudden spike on my brain while walking and my vision blurred for up to 10seconds, and my eyes began to tear straight after that spike. I feel numb on my brain for the same period of time. Before this, for a couple of weeks I had been feeling tensed especially over my shoulders to the back of my neck. My breathing is also affected. What has happened? Thanks!",
    "doctor_response": "Hello, I would explain that your symptoms could be related to ice peak headache, which is a benign type of headache. I would like to know your age and your past medical history. Anyway, I would recommend performing a brain MRI (in order to exclude a possible TIA or any other brain lesions) if such symptoms persist. Hope I have answered your query. Let me know if I can assist you further. Wish you good health. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of dirt from a scraped knee?\n\nI was doing the hurdles at school and my track is a dirt track, and I fell and scraped my knee and hands. It doesn t hurt, and they aren t that deep, I just cannot get the dirt out. I ve cleaned and scrubbed it with soap, water, and a paper towel. What should I do? I also tried tweezers, but the dirt isn t like pebbles more like... Ah... Patches...? Thanks.",
    "doctor_response": "HiThank you for asking HCM. I have gone through your query. You can use hydrogen peroxide to clean the debris. After that you can wipe with gauze piece. Again can clean with saline. This will help to clear everything. Then you can apply betadine ointment. Tetanus prophylaxis shot should be taken if you are not immunized. Hope this may help you. Let me know if anything not clear. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for recurrent hives like rashes despite trying Zyrtec and Allegra\n\nI m taking hydroxyzine but I still get hives or skin rashes, I can t really tell which one. I ve tried zyrtec, benadryl 25 ng tablets, allegra, benadryl for children, trimetron, nothing works. Can you suggest possible causes and natural remedies? Will polyphenols or probiotics help?",
    "doctor_response": "Hi, Hives or skin rashes seem to be most probably due to an allergic reaction and it can be due to causes like an allergy to any food or medicine, skin cosmetics, detergents, leather, latex, any metals etc. I would suggest you consult an Allergist and get evaluated and a thorough clinical evaluation and investigations like allergic tests like Patch test, RAST test, food challenge test etc., can help in diagnosis and treatment can be done accordingly. The tests will help in ruling out the exact cause of the allergen and once you know the cause of the allergic reaction you can avoid exposure to it to prevent an allergy attack. The allergist can advise oral anti-allergic as well as injectable steroids for relief. Do cool compresses. Application of calamine lotion can help in soothing the skin. You can also be instilled an Immunotherapy that will help in reducing the severity and frequency of allergic attack. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Honey Arora, Dentist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for hair loss in my crown region\n\ndear sir,nasaste.recently fot 6 months,I couldn t have sufficient sleep at night due to mental pressure.now,when I move my hand over my hair,I observe,losses of hair in my hand,specially from the front portion of head?sir,what treatment should I take? thank u, taposh, batanagar Kolkata.",
    "doctor_response": "hi, welcome to HCM,you are suffering from telogen effluvium most probably.start taking biotin 10 mg tab daily it is a effective supplement for hairs.rinse your hair with volumizing shampoo.you can also apply capixyl serum once daily.hope this will help you. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal for pain to kick in days after a bike injury?\n\nMy bike slipped out from under me when I hit an icy patch a week ago. A massive bruise formed over my greater trochanter and the coloration spread all around my thigh, but there wasn t too much pain. 6 days after the fall, I started getting intermittent sharp stinging pain from my thigh. The pain is so intense that I can t stand on or move that leg much, and this lasts for minutes to a couple hours at a time. Is it normal for pain to kick in days after an injury, or is this some sign of a complication? Also, is it typical to have symptoms of whiplash develop a week after a hard fall?",
    "doctor_response": "Hi, thanks for using HCM.Pain after a week of injury could be due to nerve compression due to swelling in thigh or damage to femur neck. Examination required to confirm condition. Consult your doctor for examination and further management.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring spots on the penis shaft?\n\nI have been getting recurring lesions in identical spots on the shaft of the penis for several years now. They last 4 or 5 days and become very painful when touched or when rubbing against underwear. They seem to rec\\cur several times a year. Is this dermatological disorder or is it a form of genital herpes? Is it contagious?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I feel that probably it may be herpes progenitalis. The vesicular lesions occur frequently and there may be burning pain in the lesions. It is a contagious skin disease. It is sexually transmitted diseases caused by herpes virus. Consult the dermatologist for the perfect diagnosis and proper treatment. Antiviral like Acyclovir might control the disease. Hope this helps. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does small calcified granuloma in right lobe of liver indicate?\n\nSir, six months back i fell and it hurted my abdomen right side since then i am felling discomfort in right side of abdomen. I done Ultrasound 15 days back. The report shows there is small calcified granuloma measuring 20mm \u00d7 13mm in right lobe of liver. I am taking ppi drug for gas. Please advice is it serious matter and what should be done further ?",
    "doctor_response": "Hi, hepatic calcifications are of various causes and calcified granulomas the most usual one. I don't see a serious situation in your case and I'd suggest you just an abdominal ultrasound  following every 6 months, seeing changes in size and structure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a lump in the arm?\n\nmy husband all of a sudden as of today has a 3/4 wide and 9 long on the inside of his upper arm, trying to figure out what it is... he donated platelets a little over a week ago, other than that no heavy lifting and nothing constricting in that spot which could have caused it.",
    "doctor_response": "Hi. It could be a blood collection or hematoma. It would be difficult to say without examining him. I suggest you see a Doctor or your GP so that he can examine him and advice accordingly. Take care. Dr Rishi, New Delhi, India.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to ascertain that one is safe from pregnancy?\n\nmy last period were on 24th oct. then i had sex with my boyfriend on 2nd nov. it wasn t unprotected sex but suddenly the condom broke there was only precum then on 3rd nov. i took unwanted 72 within the recommended time and my periods started on 7th nov again....7th was my periods date from long time but before my date changed 2-3 times...i am safe from pregnancy????",
    "doctor_response": "You are not pregnant for sure. I pill can cause irregular cycle.  so this early period is due to I pill.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain and tightness in chest\n\nyeahh actually you could help me. hopefully! ive been having chest pains and stuff all over christmas and i thought it was just due to alcohol but it just hasnt gone! i end up struggling for breath at night and i begin to panic! getting up results is extreme dizzyness! and simple day to day activities leave me completely out of breath such as even eating! i have constant chest pains and i feel as though its all tight too. ive tried getting in with my local doctor but i cant get in for weeks",
    "doctor_response": "If you are having chest discomfort and don\u2019t know the cause, the associated symptoms that you report indicate that you need to have the problem evaluated right away.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggestions for taking contraceptive pills?\n\nHi, I'm 21 and I've never ever taken contreceptives before in my life and I'd like to start with the Pill. I bought these contreceptives 4rm the local Doctor called trigestrel, but I'm still a bit uncertain with when I can start taking them and which colours I should start with because I just got done with my period testerday. Please help",
    "doctor_response": "Hi.Thanks for asking in Healthcare Magic.Trigestrel is a triphasic oral contraceptive pill with three different doses of estrogen and progesterone (brown, white and yellow pills) and non hormonal red pills. Generally OCPs are started on the first day of menstrual cycle with non hormonal pills (red pills). But, since you have completed your periods, you should start with the brown pills (6 in number) and take it continuously, one on each day for 6 days, followed by 5 white tablets, then 10 yellow tablets and finally 7 red inactive tablets.You should take the tablets exactly on the same time every day. Never miss the tablet. If you happen to miss one tablet, take 2 on the next day at the usual time. If you miss more than 2 tablets, then you should discontinue the strip and use another contraceptive method till you get your period and restart with red inactive pills on the first day of period.You should not stop the pill if you get bleeding/ spotting while taking the pills. Some of the antibiotics and other drugs will interfere with the action of OCP and will result in contraceptive failure. So don't take any self medication without consulting your treating Dr.I hope this is useful to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could HCG level of 7500 normal during 4th week of pregnancy?\n\nI am approx 5 weeks pregnant from my LMP and I had a vaginal ultrasound which show just a gestation sac which measured 7.5mm but nothing else and the Dr said this shows around a 4 week pregnancy so either I am earlier than calculated or it has stopped. My HCG levels were 7500 or so. What do you think/ Should I be worried?",
    "doctor_response": "Hello dear,I understand your concern.In my opinion a variability of 1 week might be normal.The HCG level appears normal.Dont worry.I suggest you to repeat the ultrasound after 2 weeks to know the pregnancy status.Definite diagnosis cannot be made with present status.Wait and repeat the ultrasound for accurate diagnosis and apt treatment.Take folic acid and if suggested by your doctor progesterone supplements too might be needed.Avoid stress and physical strain.Take rest.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is weakness common in case of excessive masturbation habits?\n\nI m 18 years old... and i m doing hand practicing since 4 years 3times in a week....... my weight is 46kg... i feel weakness after hand practicing and my hand are also very thin.... here many doctors ans that hand practicing does not harm health but i feel very weakness after hand practicing.......! how can i left this habit?? what should i eat after hand practicing to overcome weakness..???????????",
    "doctor_response": "DearWe understand your concernsI went through your details. Whatever you read here is correct. Handpractice cannot cause any health problems if practiced with moderation. In your case you are masturbating thrice daily which is in excess and you should reduce the frequency. Masturbation is not unhealthy. But when you masturbate energy is spend. If you masturbate thrice daily thrice more energy is spend. Naturally you will feel tired and your health will deteriorate. But it is more trouble if you be anxious about masturbation. I suggest you to reduce your masturbation frequency to thrice or four times a week. You will see the result within a month. You should also engage in physicial activities and games.If you still need my assistance in this regard, please use this link.  Please remember to describe the whole problem with full detail.Hope this answers your query. Please feel free to post follow up queries. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fat nodules development?\n\nHi, This is Apurva here. I am 23 years old and my weight is 74kg. I am suffering from a problem, that i have Fat nodules developed within various parts of my body. It doesn't pain, but it feels like fat nodule accumulated in the shape of a marble. i have continued to various prescriptions but all have only been a costly prescription rather than any visible benefit. Please confirm me that these are not Tumour cells in growth as i have these at various parts of my body. please suggest something.",
    "doctor_response": "Yes, your concern is very true.These are most likely multiple lipomas, very common in occurence, benign tumors of fatty tissue, provided their consistency is soft & are freely mobile there.Get local examination done by your doctor once & if necessary FNAC - fine needle aspiration cytology.Treatment for lipoma once confirmed is simple excision under local anaesthesia by a general surgeon.Rest treatment is done accordingly.Hope this information is useful for you.Wish you healthy life.Thanks. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excessive crying in a child?\n\nMy 6 month old daughter had a difficult night settling 3 nights ago so she was crying a lot. The next day I noticed her cry had changed and has become very raspy. She has no fever or other symptoms that I indicate pain. What has happened? It has been 3 days. She has otherwise been very healthy.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.This is called evening colic and is quite common in this age group. This happens when the baby sucks at the breast very fast and in eagerness to drink milk will gulp in air too. Unless the air comes out like burping or flatus this discomfort will be there and next time check if the baby is sucking too fast and gulping in air too. You will be more convinced. Usually I don't advice any medicines for this as they give only temporary relief.The two best ways to relieve this distress is - 1. Do not put  the baby in lying position after feeding till the baby burps out the swallowed air.2. If  still crying - put the baby in prone position and keep patting the back gently so that the baby passes off the flatus and gets relieved.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain around the eyes, temple area and neck?\n\nDear Doctor. Help. I have terrible pain always in around one eye neck temple always same side since early 20s im now 52. I bang my head i can smell perfume etc for miles. The pain is worst ever and painkillers take forever. I scream and rock with pain. I get a few then nil for months. They are ruining my life and work. They sometimes wake me up. I get excessive yawning my eye droops my eyes and nose run. Can you advise",
    "doctor_response": "Hello!Welcome on Healthcaremagic!Your symptoms seem to be related to Cluster Headache or SUNCT, which are similar types of headaches. For this reason, I recommend consulting with a neurologist and discussing on the possibility of starting preventive therapy with Verapamil for a reduce in headaches severity and frequency. Steroids could also help for short periods of time. If drugs are not helpful, occipital nerve block can help. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is neuropsychological evaluation effective in assessing cognitive functions?\n\nI am 50 yo. I have to have a Neuropsychological Evaluation. At age 10 I had an IQ of 168. I have had Strokes, TIA s, Seizures, PTSD, Concussions, Family History of Dementia, Parkinson s, Heart Attack, and Cancer. I am not looking forward to testing, not trusting that Doctor is being honest about possible Diagnosis. Don t enjoy the Guinea Pig feeling like when I was age 10.",
    "doctor_response": "Hello,Neuropsychological testing is always an effective tool, possibly the only one tool, in assessing cognitive and neurological functions. Please don't feel guinea pig way just because it is done only when the doctor feels it is necessary. Hope I have answered your query. Let me know if I can assist you further.Regards,  Dr. K. V. Anand",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can severe pain in the abdomen symptoms for carcinoid cancer?\n\nI am currentlly battling stage 4 carcinoid cancer with mets to my liver. In the past few months I have experineced charlie horse pain in my abdomen (upper left side and some on the right). It balls up in ball and leaves me screaming trying to straighten out and rub out the not. It just happened 3 times 20 minutes ago while I was using the bathroom. The pain is a 10. I did go to my Gastro and the NP patted me on the head and said it was my stomach and sent me on my way. This is NOT something that I can live with.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Your pain is mostly due to carcinoid tumour.  So you should take treatment of carcinoid cancer.  Treatment depends on the location and stage of cancer.  In terminal stage chemotherapy is the treatment of choice.  For terminal pain you can take morphine for pain relief. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can discoloration on the scrotum be treated?\n\nI have a dark discoloration of my scrotum and a mass going from the back of my scrotum to just about my butt, I have been to the doctor they gave my a antibiotic ibuprofen and oxy codeine its been 3 days now relief and now I feel like I have the flu please help",
    "doctor_response": "Hello, Consult a urologist and get evaluated. You have to get an ultrasound scan done to look for any scrotal mass. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Normal to have involuntary shaking? Have headache\n\nHi, I can t stop shaking and am wondering if this is normal? it s not little shaking like shivers , it s more, I just want to run around, but I can t, my leg keeps shaking, i need my hands to be doing something right now. when I stop to think about what im going to say, and stop typing, my hand starts shaking. almost uncontrollably. I can stop, but when I do, I start to get a slight headache (just because It s hard to concentrate) and I need to think about stopping. I felt the same way about 6 months ago, but I also thought about suicide , I went to the hospital and they determined that I don t have depression and that this was just a side effect to being upset at the time. I don t smoke , I don t do drugs, so, its not withdrawals from any physical substance, maybe a person i miss. but other than that, should I worry at all? have you ever seen breaking bad? well, there are parts when walter throws burning matches into the pool. right now that sounds like a good idea. I ve tried drinking fluids, fresh air, but It s been about 30minutes. it s not that bad I m just wondering if it might be anxiety or something.",
    "doctor_response": "Hi, Thank you for posting your query. The commonest cause of involuntary shaking is anxiety. So, this could be the case in you too. Other common cause is essential tremors, where there generally is a family history. A deficiency of vitamin B12 and excess of thyroid hormone could be other causes. These can be tested in blood test. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Inablility to trace placed implanon for removal after expiry. X-ray unable to detect. Regular periods and sex. Possible infertility?\n\nHey doctor, I really need to be helped. My implanon expired last year 1st oct. I went to a doctor to get it removed. Unfortunately the doctor culdnt trace it. I went for a scan and even xray none was able to detect it Am worried Its now 1yr down I normally get my periods n do av sex at regular basis. Culd it lead to infertility ? Am 28yrs Thanks in advance",
    "doctor_response": "Hello. Thanks for writing to us. If the X-ray is unable to detect the implanon, then it might have been expelled during your periods. If it stays inside then you might face some problem in conception.I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal ,drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of tiredness and loss of emotions?\n\nPlease help me. I have developed a problem that seems to surface in my brain. Whenever it gets late, not even really late just a little late I start getting really out of it my face seems to change even a little bit. And I feel this overall extremely weird terrible feeling and I can barely feel my face and not connected to my body. I get this look in my eyes like this soulless look, it's really scary I feel like i have brain cancer something. when I feel like that's I can't feel any emotion I know I need to sleep but I can't feel tired I can't feel anything. If I'm not able to sleep good that night and the whole next day I can barely function I look completely terrible, like I'm completely not even there. Somehow I force myself to get through my day which I barely can make, I get extremely sick. I was never like this before but it's to the point where I'm actually suicidal. Does anyone of any idea what this could be? Will provide more answers to questions if needed. Btw it makes it extremely hard to think all the time too, and I was always an extremely intelligent person, now I feel like I'm not even really here..",
    "doctor_response": "HIThanks for using healthcare magicI think, that may be due to your personality or some underline anxiety disorder. In that case, you should try antidepressant that would help to control the anxiety. You can also try relaxation exercise that deep breathing or JPMR, that would keep you calm and help to control yourself in tense moment. Better to consult a psychiatrist for proper assessment.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Psoriasis, broken skin under feet, pain. Taking tricort-40 injections. Cure for psoriasis?\n\nmy son aged 12 years suffering from psoriasis for more then 3 years, skin under feet is becomes very fragile and broken paining heavily. we were consulted one homeopathic doctor but he suggested tricort-40 injection every month for next 6 months. its been more then 3 months we had given. but when I search on internet for tricot injection, I see there are lot of side effects. I just pledge you to suggest best process or why to cure his psoriasis.",
    "doctor_response": "Hi, There are very good drugs other than tricort for psoriasis. Steroids are not the treatment for psoriasis.On stoppping tricort psoriasis may increase suddenly. Please consult a good dermatologist for treatment of psoriasis. Discuss the option of Methotrexate and NBUVB phototherapy for psoriasis. Cyclosporine is also a very good option. Hope this helps. I will be available for follow up. Regards. DrSudarshan",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to confirm pregnancy?\n\nIs it still possible to be pregnant even if you \"think\" you have your period?  Im 25 and My breast are really sore and seem like they are bigger but my breats have NEVER been sore throuhgout my cycle in my life.  I got my expected period on wednesday nov 8th and its light.  When can I take an accurate home pregnancy test?",
    "doctor_response": "Hello, and I hope I can help you today.A pregnancy test will be accurate at this point if your period came on time, but many things can affect the amount of breast tenderness you have during your menses, like weight changes, salt intake, and irregular hormones for other reasons (like a missed ovulation) which can also give you a light period.So you may accurately do a pregnancy test if you are at risk for conception. However, the greatest likelihood is that you are not pregnant.I hope I was able to answer your question today and that this information was helpful.Best wishes, Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be the reason for pain and cramps in the stomach?\n\nHello, My daughter is 16 and not sexually active. She is feeling nausea and pressure in her stomach. She has vomited once and now is saying she felling cramps and a bubbly feeling in her stomach. She has no change in pain when she moves or stands but she gets more nauseous. She is worried and now I am and I was wondering if we need to go to the er. We also had seafood this evening but I nor her father are ill. Ty",
    "doctor_response": "I wonder if she has taken sea food first time.If it is so then she might be allergic to sea food.Sea food is knwon to cause allergy'. If not she is suffering from acid peptic dyspepsia and colic. She should take tab pantoprazol with domperidon empty stomach. Bland diet. Even If  allergy  is not known it safe to give an antiallergic pill like levocetrizine will do no harm.  It is not necessary that it has not affected you and your husband. It depends on ones state of stomach and and/or antibodies. If she does not improve within 2-3 hours pleaze see a doctor.L",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to have an ectopic pregnancy?\n\nI went for a checkup with my OB last friday and there is a chance that I am pregnant in my left tube. My hcg levels were tested 3x s and keep doubling. My ob seen a mass in my tube and a very small mass in my uterus. Is it possible to have an ectopic pregnancy and have doubing levels? Thank you Erin",
    "doctor_response": "HI,    Thanks for the query. I have read & understood your concern. Beta HCG level that shows doubling in consecutive readings .. may not be  a distinctive sign to diagnose an ectopic pregnancy.     There is usually history of pain in one side of abdomen/ slight bleeding in case the pregnancy is ectopic... These are alarming signs & once experienced, the trans vaginal USG is indicated for diagnosis.      Your USG with a mass in tube & another small mass in uterus is a bit confusing, you should proceed for follow up USG  for confirmed result.    Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicine to avoid pregnancy\n\nHey i and my boyfriend yesterday were about to hav sex he didnt inserted his penis completely but a lilttle i am afraid that will i get pregnant? His penis wa lilttle wet before inserting what shoul i do to avoid pregnancy?i already had an contraceptive pill (ipill) on 3 march.i am 21 years old",
    "doctor_response": "Hi, I think you can take some emergency contraceptive to avoid pregnancy.  It should be taken within 72 hours.  Hope I have answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes muscle tightness throughout entire body?\n\nsince about november i have been experiancing muscle tightness in most of my body. if i sit down for any length of time and get up my knees ,legs, and back really are stiff. once i walk a little ways the muscles loosen up somewhat and walking is bearable. if i stand in one place for very long the same thing happens.also at the same time this started my shoulder joints get a stinging pain in them when i lift my arms about halfway up.",
    "doctor_response": "Dear Patient, Welcome, and thanks for sharing your concern I went through your query, and I feel, your symptoms look like arthritis, so to move in that direction we need confirmation with help of investigations, and that will include blood as well as x rays, for this you must see your doctor, and take medication and tests as advised, i must tell you that role of healthy diet, regular exercise and active lifestyle is more important that drugs as far as osteoarthritis is concerned.I hope my advice would have been useful, in decision making regarding your treatment, still if you have any clarifications or doubts feel free to contact back.Dr Narender SainiThanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Low Temperature. Abdominal pain, cramping, diarrhoea. Possibility of kidney infection. Ask a doctor?\n\nMy daughter- in-law e- mailed me today to say that she is running a low- Temp. of 95.7( oral)   Has abdominal pain, cramping, and it feels like the onset of diarrhea. She is concerned about a possible kidney infection. She says that the only way she can get comfortable is to lay on her bed and pull her knees up to her chest. I have recomended that she go see her Dr. ,  Would you have any other ideas?",
    "doctor_response": "HiThanks for the query.From the description of the symptoms it looks more like colitis than diarrhoea.We need to do some tests like a CBC, urine analysis and if needed an abdominal ultrasound to determine the exact cause.So its best that she sees a physician as soon as possible.Hope this helpsGood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Difficulty breathing, frequently yawning. Have perimenopause. Is it anxiety or asthma?\n\ni have been experiencing a feeling of i cant get enough air when i take a deep breath i also yawn alot which feels better for the time being then i am out of breath again. i keepb doing that over and over again. I am going through peri menopause and i was wondering if it is anxiety or is it asthma . I have been to the doctor and they told me to take claritin it doesnt seem to help.",
    "doctor_response": "no link wth menopause your must be having post nasal drip of sinusus which causes these you get xray pns done and consult ent specialist to treat allergic sinusitis cleritin is antiallergic but it does not control the symptomps evertime in every patiet take montair fx (combination of montelucast )once a day syp ventrolin 1/2 tsf bd syp tossex(combination of codeine and cpm 1/2 tsf night add liquid antacid gelusil 2 tsf bd you will be relived continue til you start with final treatment ater diagnosis no side effects of these medicines",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hepatitis B\n\nI'm a hepatitis b carrier for 4 years. I was leave for 3 mos on my job due to diziness, My ent found out that i have a sensorineural impairment. vertigo. now it's fine but my neurologist found out that I have a high esr june 90 mm/hr aug 71 mm/hr. now im suffering muscles pain thru my pelvic, back, shoulder & neck. Wat disease probably these?",
    "doctor_response": "Hi thanks for asking question.Because you are infected with hepatitis b , so your ESR is high.Hepatitis B can usually lead to generalized weakness, headache like constitutional symptoms.You have muscle pain most probably due to infection with Hepatitis B.The sensorineuronal deafness is not here related with this infection directly.According to few study, inner ear may involve in this infection and lead to deafness,but no conclusive evidence for it.Vertigo is associated here.For it rule out hypertension and smoking history.Since you are suffering from this infection you have chances of development of cirrhosis and cancer.So regular monitoring is necessary.I hope my suggestion will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain on feet with numbness and red skin?\n\nMy feet are very sensitive on the bottom. The smallest thing I step on hurts. I can t go barefoot any more. I have constant foot pain. Stabbing pain and sometimes they feel like they were hit with a hammer. They re numb on top up to my knees. The skin is blotchy red on the top of my feet. They have been this way for over 5 years",
    "doctor_response": "i recommend you to visit an ortho specialist and also a dermatologist. mean time you can use room temperature water for dipping your feet. skin needs always a new growth. try walking on grass or a sand or a mud. it will help your feet get acclimatized for the conditional changes. also try doing some small feet exercises by grasping a marble and lifting it up and putting into the bowl.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mouth numbness\n\nThe inside of my mouth has been feeling numb and has the texture of being burned by really hot food, but I don t have any pain. It has been like this for about 6 weeks. This is the first time I have ever had this condition. What could this be? I m male, 47, have high blood pressure (taking norvasc), had testicle cancer 8 yrs. ago (radiation treatment), have been drinking 5-10 beers a day, 4-6 days a week for about 27 yrs. Dave.",
    "doctor_response": "Hi, You have to get your self examined by a dentist. Clinically only the problem could be identified. Stop drinking beer. Any other habits like smoking or tobacco chewing could be a causative factor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fibromyalgia, migraine and degenerative disk disease\n\nHi, my name is Angela and I am 33. A brief history, I have fibromyalgia, migrains, & degenerative disk disease.i also have unexplainable vision loss. I have had many head and neck traumas starting at 19months, none in the past 2 or 3 years!! And MRIs and CT 2 years ago show some old injury to my occipital lobe and a couple other spots they weren t sure of but said weren t a concern. 3 weeks ago I was told by the ER I was experiencing vertigo but before when I had it (2other times, and over 10 years ago) I was unable to have any balance or walk. This time the symptoms were loss of memory for 3 days(or very foggy) lack of hand eye coordination, foot and eye coordination, dizziness, headache, blurry vision, ringing and nausea. **Everything got better for about a week then I woke up one morning very confused, nothing really made sense, everything was very loud in a deeps bass like time, everything smelled like chemicals (the rain, snow, shampoo, water, perfume, food) All foods tasted rotten or like chemicals except candies or high sugary foods! I had a huge headache and blurry vision which has yet to go away completely. This induced some panic. I also have had an increased heart rate, almost painful and could not eat or sleep for about 4 days because of it all. Things are better now, smells and taste has returned but only like 90% and the vision issues comes and goes, no dizziness, and the headache has changed to a dull thick one. My doctor is out of town and we were scared to go to the ER again. Thought they might think I was crazy talking about the tastes and smells and sounds. I have since talked to some friends that think it could be very serious. When my doctor gets back I will be making an apt but I am pretty worried about this. None of my meds have changed. I take 1 8mg tab bid of subutext and have for 2 or more years. It replaced a long list of meds I have been off for years now :) The following are prn and have been used for years as well: I take 1 cyclobenzqprine hs prn, 1 800mg IBProphin tid prn, and a low dose of prednisone prn. None of the above symptoms seemed to have been effected by any of my meds and I haven t needed to take prednisone in about 4 months. Thank you for your input!! Any advice would be nice and greatly appreciated! I m not one to really worry and I usually try working through things but seems like this one may be a little different! And I m a bit scared ",
    "doctor_response": "helloIn all probability, a neurosurgeon or neurophysician may advise an CT scan or MRI of brain,as symptoms point towards some lesion in the occipital area of the brain, either space occupying or some kind of vascular impairment, aneurysm etc, also anosmia and vision loss give a clue towards that.Consultation with neurospecialist is a must therefore, as with modern knowhow, the lesion could be removed by operation or by angiplasty of vascular lesion if any and cure rate too as , surgeons say, is good in majority cases, so seek earliest appointment for scans and consultation.I am sure this shall help you to get cured.The physician will make broad assessment of your drug therapy also and modify a per necessity.Migraines can also cause varied symptoms, but anosmia and vision problems herald to look for organic causes in occipito-parital region of brain substancebest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of conception with IVF?\n\niI just had an operation and 6 large fibroids were removed. there is still one remaining. am 37 and want to have a child. docs say since the fibroid is growing i should not wait for normal conception but try ivf. what are my chances and how much will it cost?",
    "doctor_response": "Hello,Welcome to Health Care Magic.Thanks for writing.I am Dr.Nitasha Khan. I have read you question completely, i understand your concern and will try to help you in best way possible.if you have fibroid uterus and you removed it than you can cncieve children as such i se no cause that is hampering your conception also if there is a single fibroid left it may cause trouble because sm fibroids tend to grow big as pregnancy continues ......so that was about it now cming to ivf some times it is difficult to cncieve with normal methods so people try for ivf methods it is very much succesful has very good out comes and if your doc advises it take another opinion as wel and if the other doc prescribes as wel than go for it ....talking about the cost wel its a lil too expensive i can not tel you about the exact cost as every country is having different rates but you just need to knw that it might cost you alot ....I hope this answered your question.If you have more queries I am happy to answer.Otherwise rate and close the discussionRegards.Dr.Nitasha Khan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Ct scan of abdomen post abnormal ultrasound showed calcification on the wall of duodenum, mild dilation of bile duct. Diagnosis?\n\nI had a CT scan of the abdomen after receiving an abnormal ultrasound with the following impression: Small area of calcific density noted in the region of the medial aspect fo the second portion of the duedenum. This is in the vicinity of the sphincter of Oddi. Thi could represent some calcification in the wall of the second portion of he duedenum, but coul also represent a small partially stone lodged at the sphincter of Oddi, but note is made that there is very little dilatation of the common bile duct or hepatic ducts. Thank you",
    "doctor_response": "Dear madam, i think that everything is said. It can be only calcification which means nothing. But it can also be a stone.  You didnt mentioned the exact symptoms which led you to these diagnostic tests, but if it is a stone lodged in sphincter of Oddi you would have typical biliary colics or even jaundice from time to time. So I recommend you if u have these symptoms u should do cholecystectomy, if not u can do i too or you can wait for symptoms to appear. Dilatation of duct goes with biliary obstruction due to stones or tumors. Wish you good health. Dr. Ivan Romich",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Developed painful swelling in the upper arm, vaccinated site. What is the treatment?\n\nHi doctor, I am a 53 year old lady with controlled DM for four years and mild hypertensive for two years, I have received Influenza vaccine and Meningococcal vaccine on the same day in both upper arm sides before one week. Today, I developed painful swelling with redness in my left upper arm at the injection site.\u00a0What is the home treatment for my case?",
    "doctor_response": "Hi. High blood sugar or poor control. Blood sugar profile and HbA1C. Cellulitis. Injection site infection in people with diabetes. Antiseptic cleaning, reduce blood sugar and dose adjustment of Glucophage. For further information consult an internal medicine physician online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get recurrent cold sores which are not healing completely. Why?\n\nHi doctor, I get cold sores about every 2 years over the past 15 years and they go through the five stages of healing which take about 10-14 days to heal. Over the past two years, I have got two cold sores that have not completely healed. One was before a year and the most recent one was in February of this year. They are faint but apparent to me and every time I move my lips, eat, have hot food, shower, sweat, or just about do anything I can feel them on my upper lip. I have been to multiple doctors and two dermatologists. I have been prescribed Valtrex, Tacrolimus, and medicines for the pain. I have used many over the counter medicines such as Neosporin, Abreva, Hydrocortisone, Vitamin E oil, face cleansers, tea tree oil, Aquaphor and kept it moisturized and clean throughout. Nothing has worked or even made a slight difference. I get the constant tingling and it is not super painful but I can feel it there as if it has not healed or subdued. My current dermatologist has suggested a biopsy but I am not sure if that is the next step. If it is not a cold sore or cannot be healed with what I have been prescribed I nor my dermatologist have any idea what it could be. How I can be rid of it? Please help.",
    "doctor_response": "Hi. As per your information and photographs (attachment removed to protect patient identity), I can see there is swelling and some small pus-filled rash and small scars. If it is recurrent then there are some possibilities like herpes labialis, cyclic neutropenia, neutrophilic dermatoses (localized), granulomatous cheilitis. Yes, punch skin biopsy will give a more close clue for diagnosis. Along with it, you need to do Tzanck smear from lip area, CBC (complete blood count), absolute neutrophil count, and ANCA (anti-neutrophil cytoplasmic antibody). Do you have diabetes or high blood pressure or on any medicines for the same? Or any other complaint? From your detailed information, recurrent herpes labialis or neutrophil (WBC) related skin disorder are more possible. Tingling, and pain indicate nerve fiber involvement which is more possible in herpes virus infection. For time being you can start tablet Pregaba M (Pregabalin plus Methylcobalamine) 75 mg one tablet in the morning and night after food for 15 days, tablet Prednisolone 10 mg in the morning after food for 10 days, Flutibact cream apply at morning and night for seven days, Vitamin C 500 mg one tablet at night (dissolved in water) for 15 days, and tablet Famcivir 250 mg TDS after food for seven days. Review after investigation reports.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from abdominal pain with cramps. Why?\n\nHello doctor,As of now, I experience abdominal pain with cramps in the lower right of my abdomen. What could be the problem?",
    "doctor_response": "Hello. This could be as simple as digestive problems with gaseous distention. It requires medications for indigestion or gaseous distention like Charcoal tablets, passing by symptoms of gastroenteritis. If diarrhea and vomiting develop, food poisoning is one of the reasons as well. Also, it can be a kidney or ureter problem (stone or salts). This site can suggest acute appendicitis as well, which should be dealt with as an emergency. In all circumstances, I recommend a visit to your general physician or internal medicine specialist for further history taking, clinical examination, and evaluation. Visit your doctor for further evaluation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is Fertyl tablet used for and should it be taken?\n\nhello doc,i wanted ask you that wat is tablet fertyl 50 mg,and also productivity tablet,my doctor is asked to start from 2 nd day of my periods,and the other tablet for 30 days,i want to start planning after this periods.so should i take this tablet.my age is 26 and married since two years.",
    "doctor_response": "Ya take dis tablets along with it do serum tsh and serum prolactin den do hsg on day 8th den do follicular study after taking clomiphene from day two den follicle size increase to 18 mm den rupture den iui for early results",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lumps in throat with acid reflux post a postnasal drip?\n\nI just rececently got postnasal drip and with 2 days it's gotten really thick where im swallowing a lump in my throat and now I can't breath out of my nose, and I'm having a hard time breathing. I'm using over the counter products but it nothing is working. I'm getting acid reflux, a bad cough and I'm really tired. Do you think I should see my doctor? I'm wondering if it's turning into an infection?",
    "doctor_response": "Hi,It is possible you are developing an infection. Try paracetamol and ibuprofen, steam inhalations and nasal decongestants. You may have nasal polyps so I suggest you see an ENT doctor for a full assessment. Regards,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching in the stomach during pregnancy?\n\nI am a 9 month pregnant lady. 2 months ago, i started feeling itchness with wound in my stomach. I contacted local doctor who said that this might be due to allergy especially because of consumption of Kola fish (Traditional fish in my area). Then I stopped eating that fish. But the problem still continues. Please tell me reason.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.The itching is due to streching of the skin because the volume of baby is increasing significantly the third trimester and especially last month. It is quite normal and isn't related to allergy or other pathological condition. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the cause of body itching and how to prevent it?\n\nHello doctor, I have itching all over the body and different part itch at different time. And whenever it itches skin becomes pink like you can see in the photo attached. Also whenever skin itches I have some pain or movement in the stomach, I also have pain during bowel movements. What is the cause and medication for this and how to prevent it in the future?",
    "doctor_response": "Hello. Your history and clinical images are more in favor of acute urticaria. It is an immediate kind of skin allergy, and once it starts, it usually tends to last 4 to 6 weeks if appropriately treated. You could even try to identify any possible exacerbating factor. The usual ones are pain killers, flowering plants, pet animals, artificial colored food items, nuts, seafood, cement dust, etc. You can start taking tablet Allegra 180 mg (Fexofenadine) once daily in the morning, and tablet Teczine 5 mg (Cetirizine) once daily in the evening for three weeks regularly. You can apply Calosoft lotion at sites of itch.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the pain in lower back be due to drinking of hot water with lime?\n\nI stopped drinking coffee a few days ago because of tendinitis, I read where stopping it may help, which it seems to so far. But in place of the coffee, I decided to drink just hot water with a slice of lemon in it. The next morning I had a lot of pain in my lower back, thinking maybe my hip was out of place, and this lasted three days. On the third day I quit the lemon water, thinking maybe it was irritating my kidneys. The pain is almost gone. I have had several bouts of kidney infections and bladder infections in the past where I don't have pain or burning, so then I end up with a kidney infection. I haven't had one for over a year. I have been told not to take cranberry capsules because they can be irritating to some people. I have been tested before thinking I had an infection, when it was only something acidic I ate. No infection. So is it possible, like the cranberry capsules, the lemon water,especially on an empty stomach could be causing the pain? I have no fever, chills, lethargy, bladder irritation. Just low back pain, but now minimized. I am 48, 145 lbs, 5' 8\". Take no meds,have no medical conditions at this time.",
    "doctor_response": "Hello my FriendThanks for your question on HCMDrinking water with lemon makes bad to stomach..because it will increase acid stomach ..it is not related with back pain. I advice to you to see if this pain is related with your kidney or it is really back pain.If it is back pain you have to do:1.Alway  strait you back when you walk or stay 2.Dont lift high weights3.When you have really a bad pain take on tablet of Ibuprofen 200 mg4.If the pain goes bad go to a doctor to make phisical examination.Hope it is helpfull Best regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for infertility?\n\nIam 32 and mu husband 33 - my fsh level is 12 (took for 3 years ago). I am getting IVF treatment but not pregnant yet. What can i do for get pregnant. My eggs are fine and my husband sperm is fine - we match and in earlier ivf my eggs fertilized but they wont be in uterus. what I can I do? Please help me",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.Your fsh value was within normal limit.Your reports and your husband s semen analysis is normal. Still you are not conceiving then its \"unexplained infertility\". Then only option is ivf.Consult a gynecologist and ivf specialist for this problem.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does pain in anterior shoulder area indicate rotator cuff problem?\n\nI have deep throbbing pain in my anterior shoulder area which radiates over my collarbone and sometimes up into my neck and ear.  Sleeping on the afftected side makes it worse.  Is this a rotator cuff problem.  I am able to lift my arm above my head, does hurt to take a shirt off over my head though.",
    "doctor_response": "Hi..Before suggesting you anything I would like to know various details of your issue...Had you been to any kind of investigation to pin point your diagnosis of shoulder issue..I suggest you to go for an MRI for your shoulder...With your way of narrating symptoms the source of your shoulder pain could be from the corocoid process of scapula...I would like you to do...Icing frequently in your painful anterior aspect of shoulder...Do shoulder stability workouts to improve shoulder stability..should include retraction work...Do share with us the MRI reportDepending on the report... management protocol changes...however above suggested recommendations hold good to help you recover faster...Hope this is helpful for you..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it dangerous to have polyps in the gall bladder?\n\nhi, i had a scan of abdomen as part of the routine check and it showed that there is 5mm polyps in the gall bladder and everything else is normal. my surgeon is suggesting to get it removed as the gb polyps are pre-cancerous. i had under gone total thyroidactamy and it was turned out to be papilary maligancy. what would be your suggestion/recommendation",
    "doctor_response": "Hello and thank you for asking HCM.I have read your report and understand your concerns.Most of the gallbladder polyps are benign in nature,but  malignant polyps are found in some cases. Symptoms don't help much here,since both types of polyps have poor symptoms. Any gallbladder polyp that is felt to be symptomatic should be removed.A lot of studies have been done to determine the factors when a laparoscopic cholecystectomy should be done. The cholecystectomy should only be undertaken in cases where there are clinical signs of gallbladder polyps (symptoms like pain ect), polyps with diameters greater than 10 mm, fast-growing polyps.Polyps under 10 mm should be followed-up with serial ultrasound examinations each 6 month. My opinion,in your case,if you don't have any symptoms is to wait before doing the surgical procedure. Each 6 months you need to do ultrasound of your gallbladder/EUS or MRI. And if you have symptoms do the surgery.If you have any other question,feel free to ask me.Dr.Endri Katro",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause testicular lump?\n\ni have a small lump  not on my testical in my sack i dont really know what it is but i have hade testical torosion before but my testical blew up really big but its not swelling  its just a small lump on the back of my sack its only sore if i touch it",
    "doctor_response": "Hello Thanks for query .A painful lump at the back of testicle could be either swollen epididymis (Epididymitis) or a Sebaceous Cyst .However diagnosis can be confirmed only on clinical examination by a qualified General surgeon .You may need to get Ultrasound Scanning Of he scrotum to establish diagnosis .Take antibiotics like Doxicycline and anti inflammatory medication like Diclofenac twice daily .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes extreme diarrhea in liver patient?\n\nMy wife has end stage liver disease and is on regular doses of lactulose and xfaximin.  She has to stay next to the bathroom most of the day because of extremem diarhea.  Does that mean the meds are no longer working? She does not seem to have  the encehalopathy yet that doctors predict.",
    "doctor_response": "Hello,1) Reason for diarrhea is Lactulose medicine which is being prescribed to prevent encephalopathy2) But it must be continue to reduce chances of further episodes of encephalopathy. In case of increase frequency of stool (>5) or liquid consistency of stool, dosage of it should be reduced. Semi-solid stool up to 5 time/day is acceptable criterion for dosage of Lactulose",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for white patch on face while allergic to sunlight\n\nHi, may I answer your health queries right now ?  Please type your query here...hai  doctor..........my  husband  is  having  white patche on his  face.consulted  2doctors.one  said  its  allergic  to  sunlight,another  doctor  said  need  phototherapy  treatment.what  we  will  do  for  this",
    "doctor_response": "HIWell come to HCMSuch hypo-pigmented patch could be due to vitamin deficiency and this could be worse in sun light, numbers of pharmaceuticals agent are there to minimize this but best is start eating more vegetables, green salad would be fine and avoid going in sun, be patience it may take some time to come around, hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pregnancy happen after non penetrative sex?\n\nMe and my girlfriend were having a moment. She gave me a hand job and I cum in my underwear. The problem is afterwards when she rubbed herself against me a part of semen stuck to her underwear from mine. Is there any possibility of she getting pregnant from that ?",
    "doctor_response": "Hello dearI understand your concernThere is no chance of the pregnancy.To become pregnant, full penetrative sexual intercourse or penetration upto vaginal intoitus  with or without ejaculation in the fertile phase of the period is require.You did not mention about the period date and when you did the sex.Sperm can not pass  through the cloth in to the vagina. So rubbing with part of semen does not cause pregnancy.Avoid stress, take healthy diet, drink plenty of water, do regualr exercise and maintain proper pelvic hygieneUse condom in future to prevent the unwanted pregnancy.Hope this may help youContact HCM for further health queryBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lumps\n\nHi i'm 25 female and have noticed a few months ago a lump about 3 fingers above my belly button. It is about a pea size doesn't hurt. I am also a type one diabetic but don't really do my shots in that spot. I do bloat very easily and get a lot of pain when i eat certain things..... not sure if it has anything to do with this lump??",
    "doctor_response": "Hi.Thanks for your query.By virtue of a classical history and area of the lump, this can be just a small lipoma or a small epigastric hernia. Lipoma will be mobile, not tender at all, will not enlarge of reduce on any movement or coughing.The epigastric hernia if small has the fat tissue inside as a content and may behave the same way as explained for lipoma. BUT it can be reduced on pressure and will enlarge with coughing. Both the conditions do not cause bloating, it needs to be investigated by ultrasonography and other investigations.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated monocytes with high fever?\n\nThe health query is for my grandchild, a 9yr old boy who's Monocyte count is high as of Monday 8/22 he was taken to the hospital with a very high fever that did not reduced even after being given Tylenol.  after the blood count the doctor diagnosed a viral fever, although I am clear about the funcion of the mocytes what concerns me is what infection is there that elevated the monocytes.  Is it possible to know the type of infection that triggered the monocytes?  thank you   My name is Ruth Durand and I am 60 yrs, I am concern about my grandchild.",
    "doctor_response": "Infectious mononucleosis,viral fevers cause this.Former confirmed by some more tests like paul-bunnell and or monospot test.it will subside in few days, just follow treatment prescribed and follow up with doctor to screen from complications",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a brown bump on the back with pus formation?\n\nHello.  I have a brown bump on my back.  It appeared as if a balckhead was in the bump so I squeezed it.  Brown (what I assume to be puss) came out  and it seemed to be quite a bit.  The bump did flatten some once I squeezed some of the puss out.  I squeezed it and more brown puss came out but no bleeding.  Seems to be a lot of puss.  The bump is about the size of a dime.  What is this?",
    "doctor_response": "Thanks for your question on HCM. By your history and description, you are mostly having infected sebaceous cyst. Back is the most common site for sebaceous cyst. It is skin swelling in which sebaceous cyst are enlarged due to obstruction in the sebum flow. So sebum accumulates in the cyst and enlarge. This sebum can get infected and cause pus formation. The most common association is diabetes and poor skin hygiene. So better to get done sugar level to rule out diabetes. You need surgical dressing to prevent recurrence. You also need antibiotics and anti inflammatory drugs. So consult surgeon for all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can an online doctor suggest me a treatment for liver serosis ?\n\nGood afternoon sir. I am suffering levever serosis since 5 months. my SGOT 127 SGPT 174 ALKALINE 814. M y legs are swelling and stomach is also swelling. I am under treatment by Dr. K. Raghuram in Best Hospital since 4 months. I am requesting you to suggest me for treatment. Hope you will help me by suggessing me for consulting or where i have treat for my lever problem. THANKS",
    "doctor_response": "Iam suffering from lever cirhosis problem since 5 months, i have been taking treatment by gestrotologist, my legs and stomach are swelliing during sitting in chair and some times pain also in legs, my SGOT TEST shows 127 SGPT 174 ALKALINE 814. Requesting me to suggest where and whome to consult for treatment,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for phobia of germs in 8 year old\n\nwhat makes a 8 yr old child become phobic of germs,such as washing hands,she says she dont know what she is breathing in her mouth so she breaths thru her nose an exhales const thru her mouth,like she is flustrated,an she has thoughts of harming herself",
    "doctor_response": "Hi...your kid is having symptoms suggestive of - OCD - Obsessive Compulsive Disorder. She will require psychological counseling. I suggest you get in consultation with a pediatric clinical psychologist.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for discomfort in chest and back\n\nOk,,Um dont know how to start this out...here goes. For the past few weeks I have been worried that I may have health problems. Just slight discomfort in the chest and some discomfort in my back. I work in a pretty high stress pharmacy so i dont know if that may be my problem but I do go to a cardiologist in about a week. Just wanted to see what any of you thought?",
    "doctor_response": "Hello, After going through your medical query I understand your concern and I would like to tell you that sudden onset of chest and back discomfort can be and cannot be cardiac but an evaluation is a must. It's recommended for you to get an ECG and Echocardiography done and consult a physician for further treatment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dry penis head after circumcision\n\nHi I am 16 and I am cut but I don t want to be, because with out the forskin my penis has formed little cracks that run from the base of the head to the tip. Its only on one side of my penis though so Im thinking that its from lack of moister. From what Ive been reading the reason why there is a lack of moister is because the forskin protects the head from dryness and I was wondering if there was a way to make a fake forskin I know that there are websites that sell them but Im too young to buy them and It would be okward to receive them in the mail with out my parents finding out. So is there a way to make a homemade one or is there a easy way to stretch out the forskin, I know that there are also devices for that but again I am too young to buy them.",
    "doctor_response": "Hello, Foreskin have many purposes including it keeps the penis head moist as well as protected to maintain its sensitivity. It is not a necessity to use artificial foreskin because it will not be useful for you. Dry skin on the penis is not typically a sign of a serious condition. Common causes are allergies to chemicals in soap or detergent, too much friction, psoriasis, or eczema. If a person experiences dry skin on the penis and does not know the cause, they should see their doctor. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does mild LVH cause sudden palpitation and dizziness?\n\nHello doctor, I am a 26-year-old male. I am doing regular exercises, but one day at night I got sudden palpitations, dizziness feeling, high bp, so I went to the emergency room my ECG was regular, sinus tachycardia after that few tests were also done. Lipid profile was normal with no diabetes, and no cholesterol, TMT was negative, but in ECHO it was showing mild LVH, but my doctor said my heart is fine no problem with it. He said it was due to anxiety. So I want to ask is mild LVH a problem. I get anxious because of my heart health.",
    "doctor_response": "Hello. I believe by regular exercise, you mean that you are involved in some muscle-building activities and some aerobic exercises. The symptoms you described were sudden onset palpitations associated with dizziness continuously, and by the time you reached ER, the palpitations were settled. Is that correct? Next, you had a normal ECG (done when symptoms subsided) and normal TMT. Although this is reassuring but does not entirely rule out disease. Now, your Echo revealed mild LVH. My assessment will be following diagnoses based on some assumptions above in order of likelihood, 1. Normal - Although I have not seen the echo films or it the report but assuming it is mild concentric LVH, this can be found in athletes and is nothing to be worried about. This is the most likely possibility so you can rest assured. 2. Supraventricular tachycardia which subsided by the time you reached the ER and only fast heart rate was present due to anxiety. Less likely possibility but not a condition to be worried about now as this condition is usually intermittent and not at all dangerous. It is diagnosed often when ECG did while symptoms are happening. If you had symptoms when ECG was done, this is even less likely. 3. Ventricular tachycardia in a structurally normal heart, very less likely. This also is a benign condition in a normal heart. So, in a nutshell, your doctor was correct. Most likely this is nothing but regular sinus tachycardia. Kindly follow these things, 1. Rest assured. 2. Continue with your regular exercise. 3. Maintain a healthy lifestyle- no smoking, low carbohydrate diet, maintain body weight (BMI <25.5 kg/m2).",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest solution for problem in conceiving\n\nhello doctor .. we are trying for pregnancy for one year ..but  we r not succeed...i hv done all my test they are all ok ...even mi husband's test are ok... before three months i consulted the doctor he gave me carmax and duphaston for three months...and he if u r not able to concieve in these three months then go for ur tubes test...but last month  i feel i hv concieved..symptoms of pragnancy were there ....but with my mistake ..i hv done some heavy work as washing cloths and cleaning floor ... i got my date on the same day ..what should i do doctor?",
    "doctor_response": "Hi, thanks for writing..I understand your concern.. Since you both are normal, it could be unexplained infertility. You can take an ovulation induction drug on the second day of the period for 5 days and follow up with follicular study to see for ovulation. Have intercourse in and around the time of ovulation. Take duphaston from the time of ovulation for 10 days. This can be repeated for 6 months along with IUI. If still nt conceiving, go for tube testing after 3 months. Hope I have answered your queries. Good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for atrophy and thinning of kidneys on MRI\n\nwhat actions should I do, My MRI report says both kidneys appear atrophic with cortical thinning. There are small optical high signalT2 lesions that may represent small cyst. There is a 9 mm cortical lesion arises from the anterior right kidney that is low signal on T2 and could represent a complex cyst or solid nodule. There is a proteinaceous or hemorrhagic cortical cyst arising from the posterior left kidney measuring 1.4 cm.",
    "doctor_response": "Hi,Thank you for your query. I can understand your concerns.Renal atrophy with cortical thinning essentially means the shrinking of the kidney. The kidney is basically getting smaller because the cortical nephrons (on the outside of the kidney) is thinning out.Cortical thinning eventually leads to renal failure.You have also multiple small cysts in both the kidneys. Autosomal dominant polycystic kidney disease (ADPKD)usually gives rise to large kidney.The presence of two or more cysts in each kidney is associated with a sensitivity and specificity of 90% and 100%, respectively. To differentiate it from benign cysts,you may undergo mutational screening for ADPKD-1 and ADPKD-2.Treatment is conservative(medicinal) and eventual renal replacement therapy (dialysis ) as the need arises.Regards Dr. T.K. Biswas M.D.Mumbai",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is Chlorthalidone used for?\n\nI was prescribed chlorthalid or clorthalid for high B/P, (can t remember the spelling) by my doctor. It worked really well and fast in lowering my B/P, but is it for B/P or cholesterol? I could not find it in the drug book and I would like to know it s function.",
    "doctor_response": "Hello,I read carefully your query and understand your concern. Chlorthalidone\u00a0is a prescription drug used to treat high blood pressure.It is also used to reduce extra salt and water in the body caused by conditions such as heart failure, liver disease, and kidney disease.Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are constipation and burning during urination be due to Hepatitis B?\n\nI am to shy about going to doctors about this dort of problem but my boyfriend just told me he had hepitis b and I have been sexuraly active with him and now when I go to the toilet it is so stingy wen I pass water and I have constapation are these related or wat is wrong with me I am 18 years old x",
    "doctor_response": "HiThis sounds more like a bladder infection and simple constipation but neither of those would be related to hep BBut you do need to be screened for hep B",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore ascending colon?\n\nHi, thank you for taking my question. Im 59 years old man with a sore ascending colon. I went to the doctor not knowing it could be my colon but last week I figured out it must be. It hurt more when Im have a high sugar intake. Do you know what it could be? Thank you",
    "doctor_response": "hi,thank you for providing the brief history of you.A Thorough clinical examination is advised.As per your history I do not think it is about soreness of the ascending colon. But to understand and sort out having a thorough clinical examination and laboratory tests we can come to a conclusion for the same if it is really a sore ascending colon.Also, your age is 59 having so physiological changes in the body is accepted and also doing regular physical exercise should help improve the metabolism.As ,you found sugar intake has led to aggregation of the symptom I advice you to undergo a thorough clinical examination and laboratory tests.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "On peritoneal dialysis, has loss of appetite, weakness, diagnosed to be down with infection. What kind of infection could it be?\n\nHi Doctor, My father is on Peritoneal Dialysis since last 2 years. Suddenly few days back (about a month Back) he has started losing his appetite . Infact in last 1 week he has not eaten anything. He says he doesn t feel eating. He has become very weak, loosing nearly 2 Kg of his weight every week. We got some blood tests done and the general practitioner says all are normal. The fluid after dialysis is showing cloudiness. So today we contacted our nephrologist who asked us to admit him immediately as it seems to be clearly infection. I am still not clear what kind of infection ?? Is it the site entry/exit infection or peritonitis ? Our doc said that he just needs to clear out all the infection from the peritoneum. He won t be shifted to HD during this period and PD would continue.",
    "doctor_response": "HiThanks for the query.Cloudy fluid is often a sign of peritonitis. This can be confirmed by testing the peritoneal fluid after it has been in the abdomen for 2 hours. We need to do cell count, Gram stain and culture.Your doctor will also suggest the appropriate antibiotics which need to be instilled in the abdomen.Usually PD is continued during an episode of peritonitis and there is no need to switch to HDHope this helpsGood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to relieve mid back pain\n\ni have extreme pain on both sides of mid back.also,on diagnosis doctors tell me that besides backpain i am suffering from either fibromyalgia or chronic fatigue syndrome,i have consulted numerous doctors but only to get frustration.please sir please guide me about the best doctor to consult with this menace as the quality of my life has drastically destructed.",
    "doctor_response": "Hello,You haven't mentioned if you got it looked at by a spine surgeon. And also if or not you had imaging done on your mid-back. Most of the pains are generally due to muscle strain, and they get spasmodic. If the pain has been persisting for more than a month or two, it is indicative of radiculopathy where the nerve roots get impinged by an extruding disc or by either a bulge or herniation.In that case, you should get an MRI of your mid-back, and also know the general condition of the full spine, you can go for a whole spine screening too. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Hardik Sanghvi",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get pregnant if one was on cerazette pills ?\n\nHi I've been on cerazette pill since April and haven't had a period since thenAnd I'm getting terrible headaches all the time I am wanting to try for a baby at the end of the year but I'm worried that I'm not having any periods I've had 2 pregnancy tests which are all negative what do I do?",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. Cerazette is contraceptive pill containing low progesterone. Pregnancy is not possible when you are on this pill. It act as contraceptive pill. First you have to stop to take cerazette pill. Once your period become regular, you can conceive. Do sex in fertile phase of period.Once your period will delay by 8 to 10 days (after stopping pill) then go for urine pregnancy test and or blood HCG test to confirm the pregnancy.You can take folic acid supplements. Avoid stress, take healthy diet, drink plenty of water and do regular exercise.Hope I have answered your query. Let me know if I can assist you further.Best regards,Dr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intermittent sharp left-sided abdominal pain radiating towards the leg?\n\nYesterday, I was having intermittent sharp pain in my lower right abdomen. Today, it moved to the left side and got MUCH worse. Pain is sharp in one area, but also felt across lower back and down into leg. Can t stand straight and walking is difficult.",
    "doctor_response": "Hello, It can be due to iliotibial tract spasm. Try taking Orphenadrine citrate and paracetamol combination for 3 days. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Rana Ahsan Javed, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for difficulty in conceiving\n\nhi, call me rae, i've  been married for more than 4 years and i almost feel hopeless if i could be still get pregnant.. i have PCOS and my hubby has a 4 million and 200 thousand sperm count..10 percent motility and 70 percent morphology.. i'm having a menstruation monthly and i am not overweight..i just want to ask some advice and hope if i could possible get pregnant.. your advice will be much appreciated.. Thank you.",
    "doctor_response": "HiGREETINGS Semen analysis of 4 million is not enough to conceive naturally in almost all couples .It has to be repeated. 16 million per ml with more than 40 % progressive motility with more than 4 % normal morphology is required for normal conception. Hence your husband needs to repeat semen analysis and follow up with andrologist. Hope my answer helps you. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat epilepsy?\n\nHi i had epilepsy when i was ten (five years from now) my doctor said that it was only mild . we had a few eeg and my doctor said its getting lesser then i stoped drinking med w/o her permission and i havent seen her and drinked med for 2 yrs already and no seizure happend .am i cured ?? or it will come back (i  only had seizure once)",
    "doctor_response": "Dr. Hanif warmly welcomes you with thanks for a consult!   I have carefully worked through your case, and can well realize your health worries. Being your physician, I want to assure, I will take care all of your medical concerns according to the latest medical guidelines.It is least likely to come back if there is no major physical cause related to brain. You only had a single episode so I think it was only temporary problem and less likely to come again.But I will preferably suggest you to at least once see your treating physician to exactly rule out the outcome of the disease and prognosis.   Hope I answered all of your questions. Please click on 'I Find This Answer Helpful' and don't forget to add your precious positive feedback to help me able to assist you better in future too.For any disease you have, a timely follow-up regarding the treatment efficacy and to see if there is any need to change the treatment options is very necessary. So keep a follow up to see how you doing. Remember to write down my name in the start of your question next time, & I will be with you right away. I am available 24/7 for providing you expert medical opinion on any health issue. Have a blessed time ahead.Regards!DR. MUHAMMAD HANIFUSAFOR DIRECT QUESTIONS:",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can clogged ears in a child be treated?\n\nMy 10 year old daughter has a hard wax build up in her ears ...she also has one blocked ear due to swimming underwater.... it is not getting cleared with bud... i am using candibiotic eardrops 3 or 4 drops each ear twice a day... will it work... its been 2 days... no relief",
    "doctor_response": "Hello, Please seek medical ear wash by warm saline to clear wax. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for Chronic Lymphocytic Leukemia?\n\nI have been told that I have Chronic Lymphocytic Leukemia and I would like to know will this cause my bones to hurt? I have been getting very fatigued and my bones in my legs are starting to hurt. I am 58, 5'4\",weigh 147 lbs and pretty good medical history. No BP problems, high cholesterol but taking medication,taking thyroid medication and hormone medication.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You have chronic lymphocytic leukemia. It will not hurt your bone in initial stage. There is no treatment is required in early stage. Just wait and watch approach is sufficient. In later stage chemotherapy is used. Bone pain in not very common in CLL. You should search for other cause also. Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain and irregular heart beat with poor memory?\n\nHello I have been having multiple issues. The concern comes because all of my lab work shows normal, but I have all of theses symptoms. Irregular heart beat, sweats, tremors, upper back pain, excessive flatulence, poor memory and confusion, irregular bowel movements, aching. Have all of the symptoms of someone with a thyroid issues. Heart, Throat, Stomach, and Nuero has been checked and everything is negative. What might this be.",
    "doctor_response": "Those are consistent symptoms of hyperthyroidism. But u need to get your thyroid function tests done before starting any treatment. There can b various differentials ranging from latent infections,  to increased lead levels. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will the fluid oozing out from the wound of my scalp go away?\n\nI had some stitches in my scalp about 8 days ago. Will be removing them in about 3 more days but there is still a pinkish oozing coming from the wound. I think is is a dime sized area that wasn t stitched but the skin hasn t grown back yet. Will this eventually go away. Chris",
    "doctor_response": "Hello.Welcome to HCM,As your wound was stitched following the injury and there was a discharge from the wound.The discharge is may be due infection of the wound, it should be kept clean and dry for rapid healing of the wound.As you a mentioned regarding some part is not stitched but it will heal, no problem. You require physical examination to see for the granulation tissue which is a good sign of wound healing. Keep the wound dry and clean. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low blood sugar followed by vomiting and headache?\n\nIm type two diabetic. I woke up at noon feeling like my blood sugar was low. I had a neighbor take me to get some lunch. Half way through the meal I through up twice I have a headache and nausea and a temperature of 99.8. I keep track of my readings if you want them.",
    "doctor_response": "check your HBA1c you will come to know the avarage sugar lever of 4 months n adjust your medication accordingly",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for numbness and swelling in the leg\n\nI have a two compacted discs and ruptured disc ( L4 and L5 area). I am on anti inflamatory and pain management pills. Sometimes my left leg goes numb when swollen and traps the nerves in spine. Last couple of days my left hand is numb. Is this related to spine?",
    "doctor_response": "Hello, I have studied your case.If you\u2019re MRI says L 4-5 disc then Due to compression of this nerve root there can be tingling numbness in your leg and pain associated with it leading to walking difficulty.Medication like methylcobalamine with neurotropic like pregabalin will reduce pain; you can take them consulting your treating doctor.You may consult physiotherapist for further guidance. He may start TENS, or ultrasound which is helpful in your case.I will advise to check your vit B12 and vit D3 level.MRI shows disc compressing on nerve root then surgical decompression is permanent solution. You can send your MRI films or report. So that I can help you better.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe congestion and cough\n\nI have had congestion in my chest for five months now. Been told it was uri, or pnumonia. But my x- rays and ct scan showed nothing. I cough so hard and so much, nothing comes up and a think I finally broke a rib.  Need help. Can't get to a pulmonoligist till next month.",
    "doctor_response": "Cough going on for a long time can be due to multiple reasons like COPD, asthma, acid reflux etc.You should get spirometry first.Rib fractures heals by itself. It does not need any surgery unless its causing trauma to lung. You can take ibuprofen for pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen and pain in legs\n\nat night , i was stretching and my leg muscles tightened up , it happens a lot and it hurts for a while , but this time i woke up in the morning and it still hurted a lot , now i cant walk on it right and its swollen and the pain went up to my thighs , and my legs feel a little heavy , what do i do",
    "doctor_response": "Hai, acute pain, sudden onset could be due to sciatica or any other  cause,pls check out for any dilated veins on the leg.keep ur limb elevated at least for 30 degrees, at restdo not keep standing posture for long timeu can go for tab ultracet (pcm+tramadol) for pain.pls check out for ur sugar levels, thyroid profile, venous doppler of ur leg.do slow physiotherapy to release the spasm.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes muscle pain and weakness?\n\nFor months, I have had muscle pain and weakness. I have a pacemaker due to heart block. I also have levels of vitamin b12 and d3. I also have Hashimotos thyroiditis. I am wondering why my joints and muscles are in so much pain! I take Levo thyroxine and b12 and d3 supplements but I am in constant joint pain.",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern. Constant pain can be due to fluctuations in thyroid hormone levels. You should get your thyroid level and if found low you can adjust level according.Also you have to get vitamin D and vitamin B12 and if found low you can get its supplements. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest dosage of hucog 5000 for endometrial thickness\n\nmy doctor did tvs yesterday endometrial thickness ws 11mm and two dominanat follicle on right side measuring about 20,21mm. i ws taken clome100mg.. for 5days...... nw tell me when to take hucog 5000iu.my doctor adviced me to take it yesterday only,but i forgooten.now worried to take it what to do?",
    "doctor_response": "Hi,It is given in the dose of 5000 to 10,000 units once a day. Injection hucog-5000 is a human chorionic gonadotropin hormone commonly prescribed to induce ovulation along with clome-100 and thus found be useful in treating infertility.It stimulates the maturation of the ovarian follicles and subsequent release of an egg from the ovary. If you have forgotten to take it yesterday, it may be taken now.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do coil strings hang out from vagina with lower abdominal pain?\n\nBasically I had the coil fitted two weeks ago Today I felt a strange feeling like a tampon string but thought nothing of it as I ve been bleeding heavily and thought maybe a little blood clot from the period was coming out. So in the last half hour it has started to come out more one string is hanging out my vagina completely about 1cm.. And the other to the left is on its way out. I ve got tummy pain and pain lower down on the right and left side of my tummy . I m a bit scared please help. I m new to this",
    "doctor_response": "Hello,Thanks for trusting us with your health concern. In the current scenario, I would ask you to seek help immediately from your health care provider. Your symptoms are suggestive of a possible displacement of the IUD. You need hemo-stabilization, medications to control the bleeding, identification of the location of the IUD through a sonogram or MRI  and plan further management. Do not exert or try to pull on the strings. Take bed rest preferably with foot end elevation while you seek medical attention. Take plenty of liquids. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with AML. Had bleeding gums. Given platelet transfusion. Had stroke. Feels nausea. Suggestions\n\nMy grandad has just been diagnosed with aml... He did have bleeding from the Gums but has now been givin a platelet transfusion and also 2 blood transfusions which has now stopped the bleeding of the gums, he is 73 years old and had a stroke last year in August... The hospital has now took him off the tablets he was taking to thin his blood to prevent him having another stroke... Now they have stopped him taking them what are the chances he could have another stroke also by what I have just told you and some of the symptoms I will give you now what stage of aml would you say he was at, I just want to know so that i can prepare myself.... He is short breathed, did have bleeding of the gums but that has stopped now loss of appetite and since taking a tablet they have him at the hospital today he is feeling abit nausea... Kind regards Charlene",
    "doctor_response": "Hello CharleneThis answer is from a Homoeopath. We do have a different approach to cancers. We should get the individuality of the patient, his genetic traits both in the mental and physical make ups. I do not know whether you understood or not. Please stop all the chemical drugs and allow him to express. What exactly was the life situation just before he had a stroke? How he reacted to that situation in mental level? Is he frightened due to the attack of stroke? Is he having fear of death? His present mental and physical symptoms can be very well picked up by an expert Homoeopath and give him relief. Please do not lose hope. Homoeopathic medicines will improve his general conditions like appetite and thus improved physical conditions will give him more hope and confidence to return to normal. A good counselling also will be helpful. Avoid all chemos. Hospitals may further frighten himMy best wishes for a speedy recovery through Homoeopathy.Dr. C. J. VargheseHomoeopath",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What causes white vaginal discharge with irregular periods?\n\nHello doctor, I am 19 years old and I am experiencing problems with my periods for some time now. Three months back I had my period on regular date and experienced bleeding for 1 and a half month. I am experiencing similar problem of prolonged periods for about 4 years now. It happens once or twice per year. I have been on short medications every time I had the problem. Also when I was 17 I did not have my periods for 2 months and a local gynecologist prescribed me birth control pills for 28 days and I completed the course after which I was told that my prolactin level has raised up for which I was on medication for a month. Currently I am on an ayurvedic treatment and my last period lasted for 5 days and with a normal bleeding but I am having a white vaginal discharge for a week or so now which is also a bit smelly and does not seem to be normal. What should I do?",
    "doctor_response": "Hi. You have got vaginal infection. If you need treatment then kindly follow up. Also for period problem, is it controlled after taking Ayurvedic medication?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair fall\n\nSir, I am 29 yrs old man and unmarried. from Last one yrs , I faced to much problem for hair fall. After going to the doctor he prescribed me curlzvit tablet with finax tablet. Also prescribed to use Q-Sera Serum and logidruf lotion. Very recently I will marry. I used both the tablet for four days but its came to know that both the tablets have side effect in sex life. I am very much worried for that. Can you suggest me whether I will use all those tablets or stop them? Whether the side effect of the tablet effect sex life permanently.",
    "doctor_response": "Hello and welcome to HCMThe treatment advised will help you with your hair loss. Finax tablet sometimes does have a mild effect on affecting sex drive but usually is not seen at the low dose given for hair loss. Also it is not usually permanent. Any such effects, if at all, are reversible on stopping the tablet. it is not necessary to stop the tablet before marriage but if at all you feel any effect on your libido or sex drive , feel free to consult your treating dermatologist and ask him regarding stopping the tablet and taking an alternative treatment. You can continue the Curlzvit tablet, and applications including Q-Sera serum. Minoxidil can also be tried.Also try to find the underlying cause, such as genetic, stress, illness, typhoid, thyroid problems, etc which can be done through blood tests if needed. You may consult your doctor regarding the Finax tablet and take it under his supervision. In case of severe hair loss or balding, surgical methods like PRP, etc can be considered later.Hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Right sided lower abdominal pains radiating to leg, headache, dizzy spells, nausea, eases on transferring weight to leg. Cause?\n\nhi there I been having severe pains on the right side of my lower abdomen .The pain travels to my back and also down my leg.I got my period for the last three days,the pain as gotten more severe and i am getting unusual headaches ,dizzy spells and nausea .When I transfer all my weight onto my right leg it eases the pain a little.wat could be the cause of this",
    "doctor_response": "Hello it could be due to abdominal or spinal cause get ultrasound of abdomen and pelvis,  xray KUB,  urine examination and lumbar spinal xray as peliminary examination",
    "dialogue_context": ""
  },
  {
    "patient_message": "Done sperm analysis. Do I need medicine?\n\nDear Dr Aniruddha, I am Bhaskar, Married, 34 years. I have recently done my semen analysis . Sperm Count is 50 million/CC pH 8.0 But Motility says Grade IV(Active) 10 says Grade III(Moderate) 20 Grade II=30 and 40 non motile. Please can yo suggest if I need to go for medication , if yes which medicine? We are trying for pregenency for last one year.",
    "doctor_response": "Hi Bhaskar, Welcome to HealthcareMagic, This report suggests poor motility of sperms. Normal sperm motility should be more than 40% out of which 32% should be progressive ( WHO 2010). There are various causes which may lead to low sperm motility. You need to undergo complete clinical, hormonal and genetic evaluation to reach at cause of low sperm count. Please consult a Fertility specialist or Urologist.  Antioxidants and multivitamins will help you to improve sperm motility. You can take them in tablet form and include in your diet also. Include lot of fruits, salads and green vegetables in your diet. Avoid oily and spicy food. Try to maintain or reduce your weight if you are overweight. Mild physical activity will help your cause. Avoid smoking or alcohol. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pains from shoulder blade to armpits, numbness in fingers?\n\nI am 29yrs old. weighing 75kgs. i am experiencing sharp pains in my left shoulder blades to the armpits, and somewhat numbness of the fingers. I have 3 EKG test and each one seemed better than the previous one. kindly advise on what this health problem could be. thank you",
    "doctor_response": "Hello,It sounds like you may have throacic outlet syndrome. In this syndrome the nerve in the brachial plexus in the shoulder get inflamed and can cause shoulder pain, and some arm and hand pain and numbness. See a physical therapist or naturopath that is skilled in treating this condition.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can abdominal and back pain be treated?\n\ni Have a pain in stomach due to cylinder weight uplifting at home. Some times pain are at back and usually in below chest and towards left part of body. such pain always comes when i pick up some heavy weigth lift things.pls provdide remedy as i have taken all medicines",
    "doctor_response": "HI.The diagnosis is obvious. This is due to muscle strain or a sprain and the first thing to follow is to avoid lifting such things which cause you this. Get an examination done by the Orthopedic surgeon to ascertain that there are no other causes like problem with the spine or unequal muscle imbalance in the back.Take anti-inflammatory and muscle relaxant medicines and rubrafacient liniments to sooth the muscles .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from infertility,taking clomid but not satisfied with the treatment\n\npls is there any drug that will help me to make babies i have tried clomid but nothing happen yet since last year i have been trying can fabroid make one not to have babies?",
    "doctor_response": "HI, Welcome to HCM, First u need to find out the reason for infertility, please consult ur doctor and both spouse had to be evaluated for the diagnosis and then treat accordingly. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can UTI be treated?\n\nToday, I have a positive urine culture for Klebsiella Pneumonia. Have been on cipro for 3 days waiting for the results of the culture. I was also treated 3 weeks ago with augmentin for a post surigical wound infection after mastectomy. The wound is still not totally healed either. I m worried that these two infections may be related. My pcp wanted to send out macrobid for the uti, but wondering if Keflex would be better. I ve had a c.difficele infection in the past after multiple abx for uti two years ago, that weren t being treated properly, and Keflex worked well. So worried about several issues and asking for your opinion.",
    "doctor_response": "Hello,The antibiotics to treat urinary tract infection (UTI) caused by Klebsiella Pneumonia should be selected based on the culture and sensitivity testing report. Please send the culture report to me for further suggestions.Meanwhile, while you are under antibiotics, please take probiotics to stabilize intestinal flora to prevent any gut issues. Drink plenty of water. Take cranberry supplement or tea. Hope I have answered your query. Let me know if I can assist you further.Regards,      Dr. Albana Sejdini",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should have liver transplant. On regular injections. Worried about the operations?\n\nMy grandson has to have a liver transplant,he is having to have all his injections within the next 8 weeks because when he has the op he will not be able to have them, he is 9 months old and within the next 8 weeks he will be on the transplant list, my grandson and my son and partner were at kings college last week for three days digusing all that was going to happen, my son has put his self forward as well to be a donor for his son which is my grandson which is a scary for me to think about as i do worry about them both, is this operation safe for them both i know if ralph dosent have it he will not be here but just need to know as my son only tell me what he thinks i should knowCan you please answer these questions for me thankyou",
    "doctor_response": "-Hi and welcome to HCM. Thank you for your querry.This is complex surgical procedure,very complex. but it is very safe for donor and less safe for baby. If your son is in good shape and health then he will recover very soon after transplantation. Transplantation is obviously the only possible treatment for your grandson so I am sure that you can ignore all possible risks of surgical treatment and give your best.Hope I have answered your query. If you have any further questions I will be happy to help",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does severe fatigue, vision of images like bacteria and growling stomach mean?\n\nHi, my names aj im a 19 year old male. For about a year now  ive been feeling really weak  and different    like the begining of the year it wasent so bad it was just me feeling a little weak not really tired but over the months it has progressed  my body feels like im 50 or something like an old man  i feel worse when i drink water i get pain under my heart very bad stomach pains my neck cramps up i get weird feelings in my head   i have like little dots when i look at the sky or in a dark room and when i look up at the sky it looks like there swimming around  and looks of like a bacteria under the microscope  on my eyes both of them they've been there for 4 months   my body does though freak out when i drink water my stomach keeps growling like its hungry    and im not but then when i eat lots of food i feel better  ive been to multipul hospitals doctors had blood tests done everything come back normal  i have light colored stool everynow and then",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. I sincerely suggest that you are victim of your own negative thinking. You cannot term your current state of mind as clinical depression. Rather, this is just disappointment. Over and above, you are imagining things which are common to all people. The \"bacteria\" in your vision area is a common sight for everyone. Regarding your stomach gurgling - We broadly call it obsession. You had that disturbing sensation once. You expected it to happen again and tried. Then you started experiencing it as you were expecting it. Then your body brought the familiar symptom because you are expecting it. Then you started worrying that the symptom is coming again and again and expect it. Body brings it again as you are expecting it. You become worried and so on. That is obsession in simple terms. Ignore it and the problem vanishes. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the risk factors associated with doing root canal treatment in a child under general anesthesia?\n\nHi doctor, My son is 3 years old and has serious tooth decay. The doctor has suggested root canal treatment and that procedure will be done under general anesthesia. The whole procedure will take three hours of time as number of tooth is eight. My question is that is it safe to go through three hours of anesthesia for such a small kid? What is the risk factor?",
    "doctor_response": "Hello. As a parent, I can understand your nervousness. First thing it is inhalational anesthesia and most commonly used in pediatric procedure, it means there is no use of any kind of drug for anesthesia. Only a gas mask placed on face and a balanced ratio of N2O (laughing gas) and oxygen release for a conscious sedation. For continues monitoring an anesthesiologist should be present all time during procedure. After procedure within a minute child will wake up from sedation. So, please do not worry about this. It is safe and used world wide for child procedure. If you do not want a long sitting then you could ask your dentist for two or more settings but it may be more expensive.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for chronic back pain and severe RA\n\nI suffer from chronic back pain and severe RA. I have had three back surgeries and four on my left foot. I was diagnosed with depression about 30 years ago and I take an SSRI and Xanax for sleep. My problem is that no one will treat my pain. Do they all think that people with depression don t feel pain. I know a few people with chronic pain and they all are given pain meds for when they are needed. If I wasn t depressed before then this would cause it. I really hate the way doctors treat me personally - it is humiliating. I am tired of suspicious looks and accusations of drug seeking. I have become afraid of doctors and will no longer raise this problem with them",
    "doctor_response": "hi,as mentioned by you, it is sad to hear you have now bias against doctors. Well to help with your pain I will give you some tips. As mentioned by you that you have a severe chronic back ache and even you have RA. let us take one by one each of it.Back ache - as you mentioned you had 3 surgeries of your back what was that and why they were performed. Also, before of after the surgery did you try physical therapy. As physical therapy will help you with therapeutic ultrasound therapy and TENS therapy for controlling of the pain symptomatically. Also, then you need to strengthen the muscles of the spine and the core. As one has to understand that the muscles are the support system of the joints and any weakness in the muscular system will lead to pain in the joints. As the body has to adapt and heal on its own, that is the greatest creation of the god, what Medication and physical therapy can do is to provide support till the body takes its role for action. RA - for RA, you need to do a regular exercises like - meditation, breathing exercises and general body exercises. Exercises should be focused on improving the muscle strength and maintaining the joint mobilityAs we need to understand that the body is a self healer and any external effort is symptomatic help till the body takes its own call to recover. Also, metabolism of the body varies from individual to individual and only you can improve the metabolism of your body by performing the exercises. There is no external device which can help improve the metabolism. Self induced effort is the only one which can regenerate the bodily functions and provides the optimum relief.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long will my cough last in spite of taking medication?\n\nI have had a cold or virus for 10 days now.  I have had a bad cough and alot of sinus problems.  I was coughing up yellowish flim and I called my Dr. and she perscribed antibotics for me I have been on the antibotics for 6 days.  My sinuses seem better but still have a cough but not as bad.  I do smoke maybe 5/day.  How long will my cough last?",
    "doctor_response": "Hi thanks for contacting HCM...If your cough still not improving than digital chest x ray and spirometry (pulmonary function test done for further work up )To detect causative organism throat swab or sputum collection done and send for culture report ...According to which drug given.....You have smoking habit ....So it can lead more cough production ...It is better if you can get rid of smoking habit ....Meanwhile if trouble some dry cough present than codein syrup given and if cough with mucous ambroxol syrup can be used ...Your physical examination also necessary with auscultation also ...Avoid excess fried food and spicy food as it will irritate respi mucosa. .Hope your concern. Solved ..Take care .Advise : pulmonologist consultation for examination...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for HPV virus\n\nI am a 33 year old female and have been diagnosed with the hpv virus in 2009. I was due for a pap smear this past february for follow up but have yet to do so. But the other day I used a douche for the first time in about 10 years as I had a strong odor during menustration the week before and when I removed the douche it had an orangey red discharge on some of the holes. So i rinsed it off and repeated the process but it came out again. Do you think this is something I should be concerned with since I have been diagnosed with hpv and the fact that my grandmother on my mom's side had hpv and died from vaginal cancer?",
    "doctor_response": "HiThanks for your query at HCM.I understand your concern and situation.I would like to tell you that you are too young to get genital cancer. It is usually seen after age of 45 years. In your case it seems to be part of menstruation. I see nothing to worry. But yes if you have the persistence of symptoms then you may go to gynaecologist for evaluation. Yes I suggest you to get PAP smears regularly done as you are high risk. You must also take the vaccination for HPV as prevention.Hope I answered your query.Best of healthDr. Sheetal Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat ear pain,cold in a 3 years old child?\n\nmy 3 years daughter got ear pain cold n cough but no fever  few days back..i gave her zifi 100 by pharmacist mistakes instead on cefoprox 100 prescribed for 7 days..today dr. diagnosed n prescribed cefoprox 100 for 7 more days.my daughter looks ok otherwise no fever n throat infection.shall i give or not?",
    "doctor_response": "Hi dear,I understand your concern, you can use Cyprofloxacin ear drops 4 drops 3 times in ear during 5 days.Drip Otrivin 2 drops 2 times to open Eustachian tube and improve ventilation of middle ear.You can treat without antibiotics. Give Kuka or Ambrodil syrup 1/2 teaspoon twice a day.Hope I answered your question. If you have more questions, then don't hesitate to write us,I am always happy to help.Wishing your daughter good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chronic abdominal pain with spasms\n\nI have chronic abdominal pain for more than 20 yrs. In 1999 I have got ideopathic terminal ilium perforation & managed by laporotomy 15 days after peritonitis, but pain continued until now. 5-mths. back incisinal hernia was repaired , developed after old opn. Nature pain- usually spasmotic in ipigastrium or just above the umblicus in left side. pain site is usually slight tender & firm. Pain subsided with girgling sound. USG = normal. upper & lower GIT endoscopy is normal, CT scan of whole abd. shows SPLENIC FLEXOR SYNDROME. Pain increase by fatty & spicy meal. Usually pain occurs after fullness of abd. There is sometimes pain free period for 1-2 mth, I have already taken 2- courses of ATT. long courses of PPI & t/t of IBS. Now I need your expert openions.",
    "doctor_response": "hello farhanhasen.4, pain in left side of abdomen, increase by fatty &spicy food advice- upper GI endoscopy, & biopsy, untill take tablet- pentaprazole 40 mg on empty stomach for 21 days,pain after fullness of abdomen- liver function test, HIDA scan,some time there is malabsorption syndrome -due to short bowel syndrome or ileum resection- in that case need supplementation with-vitamin B12,bile salt malabsorption occur due to ileal resection, if ATT not respond fully advice -sputum culture &sensitivity, some time Tuberculosis associated with HIV or AIDS, in that case advice- HIV test, hope my advice is useful to you, thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am suffering from pain while motion and blood bleeding\n\nHi, I am Shetty and i am suffering pain while motion and blood bleeding almost month . I need help and what treatment should i take ?",
    "doctor_response": "Dear anonymous, the bleeding your suffering from might be from piles or a fissure or any other rectal complication. I suggest you better go to the nearest physician and get checked up. he might suggest you to undergo a minor operation if it's piles or fissure",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is conceving at the age of 40 possible while having heterogeneous endometrium\n\nI am 40 years old with no kids I have a pelvic ultrasound done an my doctor says I have endometrium is heterogeneous in echotexture throughout and poolr visualized measuring 8.6mm can this be fix and if so do I have a change of having a bady I have lots 5 by miscarraige",
    "doctor_response": "Hi,You can conceive but first of all you need to do some investigations for your recurrent miscarriages. Do a thyroid profile and prolactin and APLA profile to see for cause of abortions. Uterus alone can not cause abortions. The other thing is that with age the quality of embryos decrease anxiety thus abortions occur. I think you should go for an IVF for good embryo selection and then they will be transferred when your endometrium is good. This will reduce chance of abortions.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Khushboo Priya",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes loss of erection while standing?\n\nPlease sir help me my name is asad , and my age is 24. i am unmarried. I dont Have girl friend .  i am so tense with this problem i noted last 5 days . My problem is that I maintain my erection while I am resting on bed but as soon I stand, my penis loses erection in few seconds. Kindly suggest solution as I am very much disturbed . and i have Good morning Erection.. can anxiety lose my erection when i stand. :(  Before 1 month i have anxiety problem because of erection. when i fell morning erection i wakeup and then i stand beacuse of ckechk hows my standup erection :( but few seconds my erection lose ... i fell to much Depression.... please suggest solution :(  is this possible  a blood flow decrease problem when i stand ? .. please i am weating for ur reply...thanx",
    "doctor_response": "Hello, There is nothing to worry about losing erection for some time. I think you are getting an erection after that. Don't worry. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low pulse rate while on Atenolol?\n\nI have been taking Atenolol for the last two years. I have lost weight and my doctor has been reducing my dosage since my pulse was getting too slow and irregular. Currently I have been taking 12.5mg in the morning for the last 5 days but this afternoon my pulse shot up to 130 and with deep-breathing and biofeedback I could only get it down to 100-110 resting. Could this be rebound tachycardia 5 days after a reduction in dosage? We have been titrating down from 50mg daily in a divided dose (25am and 25 at hs) over the last two months.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I don't know much about your medical history, but I suggest you to do an ECG to see the heart rhythm and possibly a 24-48 hr ECG Holter monitoring, and a cardiac sonography. After doing these, the doctor would be able to decide if it's a rebound tachycardia or something else. I suggest you to get another Atenolol dosage in case of high heart rate, like in your case of increased heart rate up to 130. All the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pain and swelling in abdomen after an umbilical hernia repair?\n\nHello, I had an umbilical hernia repair June 2014.  Approximately 10 days ago my dog a black labrador jumped and his two front paws hit me in my stomach.  After I had the umbilical hernia repair i did not have pain.  But after my dog jumped I had periodic pain from my belly button 3 inches to the right. (the size of a tennis ball) in radius for the next several days.  Then the pain seemed to go away, i also wasn't doing anything strenuous.  But after afew days I have had pain sometimes constant and also intermittant.  It really hurts if I bend my head past my knees or with exertion.  I also have 2 oximatelylarge fibroids (one inside my uterus and one outside my uterus) and 2 ovarian cysts and am currently scheduled to have a total hysterectomy on April 3rd 2014.  I called my gyn doctor and also called the doctor that did my umbilical hernia repair.  The doctor that did the hernia repair did not think that i reherniated it.  He thought that i have an abdominal wall contusion.  It has been approximately 10 days since my dog jumped on me there is no bruising on my skin since this happened.  I have been in pain 6 out of 10 pain scale sometimes constant and sometimes intermittant (usually at rest).  What do you recommend me to do? The hernia doctor and the gyn doctor I have appointments on 3/31/14.  I do have some swelling from my belly button 3 inches to the right the pain area is like the size of a tennis ball.  I am not nauseated and my bowel movements are regular.  Thankyou for your expertise.",
    "doctor_response": "HI .It must be 2013 June -The swelling and pain must be from a hematoma which has formed due to either a direct trauma due to dog's paw hitting or due to severe protective spasm which is automatic. This should resolve soon. TO confirm you can undergo high resolution sonography , it will tell either this is a hematoma or contusion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for food allergy in a child?\n\nmy daughter is 5 months old tomorrow she will be completing 5 months. Actually she had a food allergy last evening and Dr prescribed ATARAX , after giving that medicine this morning i noticed my daughter s suffering from cough , for cough can i use T-MINIC",
    "doctor_response": "Hi..no need to use another antihistamine. Atarax already contains Hydroxyzine which is a good antihistamine and this will take care of that mild cough and cold too. But if she is becoming breathless then yes, you need to get her back to a paediatrician.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the natural remedy to cure neurofibromatosis?\n\nI have been diagnosed with neurofibomosis. The back of my head is filled with bumps, etc. I am now 46 and I had smooth skin until last year. I m perfectly healthy and have never been on medication. What natural remedy (that works) would you recommend?",
    "doctor_response": "Hello,Welcome to HCM,Neurofibrometosis is genetic problem. It can be treated with proper homeopathic medicine without side effect. This problem is connected with many factors in physical and mental sphere like stress anxiety, shock, etc.So it is necessary to understand detail case history for permanent cure.Homeopathic medicine can be selected after analysis of detail case history. So if you want proper homeopathic treatment for permanent cure then consult to good classical homeopath or contact me.I think homeopathy can help you and you will be free from this disease.Have a better health.subhashponkiya@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Restless, difficulty to sleep, something rotating in head, no head ache\n\nI feel restless most of the time, difficult to fall asleep, experience very wierd feeling that i might die because of stroke or something like that. i am doing fine someday like a normal person but suddenly starts feeling something is rotating in the head but there is no headache . i don t know what is this, please help",
    "doctor_response": "Hi Priya, Welcome to Healthcare Magic and thanks for your question... Some of the symptoms which you have described may to be indicative of an anxiety disorder. Feeling restless / inability to relax, excessive worry, tension, difficulty in sleeping are some of the symptoms suggestive of an anxiety disorder. In addition, one can also have physical symptoms like trembling, excessive sweating, dizziness, headache, dry mouth, palpitations, etc. However, it is to be remembered that to be diagnosed to have an anxiety disorder, symptoms should be prominent, affect your day-to-day functioning and be there for a significant period of time. Moreover, anxiety can arise due to a variety of causes and anxiety disorders are of different subtypes. Sometimes, we may experience anxiety symptoms due to a stress which we are not able to cope up with. In some persons, anxiety can also be associated with fear of having health problems or a major disease. So, you will need to give a more detailed history and will need a detailed assessment to get a proper understanding of your problem. All the best. - Dr. Jonas Sundarakumr Consultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent fever, nausea and loose stool when diagnosed with strep infection?\n\nMy daughter was diagnosed with strep 3 days ago and has been on meds. She is 23. Her tonsils are huge with white patches, almost swollen shut. I\u2019ve never seen anything like it. Still having fever. Upset stomach. Vomited this morning. Went back to the doc today. They gave 2 more shots and topical cream for nausea. Problem. Her gums are bright red and bleeding and painful.",
    "doctor_response": "Hi,I am sorry to know about yor daughter and understand your concern.Streptococcal throat infection is sometimes difficult to treat.In the same type of condition I'd have prescribed azithromycin 500 once daily for 3 - 6 days.Please ask her to do warm saline gargles 3 - 4 times daily which will help her extremely.Do not give her spicy food.Ask her to drink warm water only.So far as nausea is concerned,you can give her a mouth dissolving ondencetron tablet in the morning.Vitamin C 500 once daily for 5-7 days will help in gum bleeding.I hope the answer helps.Please feel free to ask another question.Thanks,Dr.Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the diet of a patient suffering from jaundice?\n\nhi doc, i am suffering from jaundice for last 22 days, recently i had done LFT where report shows may TOTAL PROTEIN-7.8, ALBUMIN-4.0, GLOBULIN-3.8, TOTAL BILIRUBIN-22.75, DIRECT-15.45, ALT(SGPT)-26,AST(SOGT)-36, ALKALINE PHOSPATE-93.Pls suggest me what to do & what will be the diet?",
    "doctor_response": "Hello.Most cases of jaundince are coused by hepatitis B or bladder stones. There are also some other couses. Sometimes even too much carrot eating is bad.I would suggest to visit your docter, and meanwhile you should eat lots of fruit, avoid fats, alcohol and drink at least 2 liteer of water a day.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a rash all over on back\n\nHi, I returned from Thailand 10 days ago and I still have a rash all over my back. They are small bumps and not as itchy as they used to be. I did have itchy rash on neck and chest but that is not as bad now. I am a 30 year old female, 169cm tall and weigh 59kgs.",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms seem to be related to contact dermatitis. I suggest using Cetirizine 10 mg daily. I also suggest using Hydrocortisone cream for local application. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes soreness and itchiness of vagina?\n\nHi, my vagina has been really sore and itchy for the past few days. The last time I had sexual intercourse was about 2 weeks ago. My partner and I have only been with each other and no one else. I ve looked it up and I was concerned I might have a yeast infection. I just did a vaginal exam and I saw some scaly skin peeling off inside and hanging. It hurts when I touch it. It is kind of white around the area. What could this be? Thank you.",
    "doctor_response": "It could very well be a yeast infection. This is not generally considered a sexually transmitted disease, and is very common in women. A topical cream or a prescription pill can be used to treat it. However, it would be best to have a doctor do an exam to confirm it's yeast. You might also have something else going on like a blister or abscess. The fact that it seems pretty localized suggests that possibility. With yeast the redness is generalized and there is often a discharge. Have it looked at to be sure what it is. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Under treatment for infertility. Prescribed clomiphene and duphastone. Its correct dose and duration?\n\nim under treatment for infertility ,my doctor gave me clomiphene 50 mg daily for five days and dhuphastone .i wanted to know about dhuphastone tablet she prescribed me dhuphastone from the 14th day of my cycle ,twice daiy, for ten days .but other doctor says you should take it till date of your periods.what is the right way",
    "doctor_response": "Hello , Thanks for the query, You should continue to take  Duphaston tablets 10mg for as long as your doctor recommends, which may be for 5 days, or taken continually for several days a month and repeated each menstrual cycle for several months as needed. If your doctor has prescribed duphaston for infertility , then following is the dosage. Duphaston 10 mg twice daily from day 11 to 25 of the cycle. Treatment should be maintained for at least six consecutive cycles. If you conceive, it is advisable to continue treatment for the first few months of pregnancy . Hope This helps regards, Dr Nilofer",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is extracting infected molar with intact wisdom tooth next to it right procedure?\n\nI had a tooth removed Monday a molar next to me wisdom tooth that grew in sideways. the dentist only pulled the molar which was decayed and infected prior.. my question is shouldn't he have pulled the wisdom tooth also it feels sore and also should the extraction site have a bitter taste?",
    "doctor_response": "Hello,Removal of an impacted wisdom tooth is a more involved extraction. Oral surgeons     evaluate the position of the tooth with particular relation to nerves to assess the risk associated with a surgical removal.  X-rays, along with a clinical exam are important details needed for this decision. Surgery removing bone is most likely required to expose the wisdom tooth and you may not have the best circumstances for healing when another tooth has an active infection. Antibiotics, prior to and after the extraction, often are prescribed and help control the spread of an infection. Often a general dentist will extract erupted teeth, but refer impacted teeth to an oral surgeon for removal. Your choice of sedation options may be different for an impaction surgery as well. If your visit was more of an emergency, this may have been a factor. Yes, often multiple teeth can be extracted at the same time when treatment planned ahead of time and pre-surgical conditions optimize healing conditions. The advantage is one visit and healing on the same side.I am concerned that you report soreness with a sour taste. A condition called dry socket can be extremely painful, require antibiotics and a return dental visit for the socket area treated by your dentist. This may occur 3-4 days after the extraction. Some soreness is common as the socket continues to heal. Call your dentist to update your healing progress. Continue with warm salt water rinses and follow all post extraction instructions provided by your dentist including medications. Reduce soreness by taking an anti-inflammatory medications such as acetomeniphen and ibuprofen. Keep up with a balanded diet and adequate vitamins.I hope you find my comments helpful and feel better soon. Thank you for your inquiry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bubble like feeling in upper back\n\n24 yr old male, 6 3 215 lbs, i started getting injuries recently from weightlifting and 2 of my worst injuries are both of my rotator cuffs and in my upper back i feel like there is a bubble and only time I get any relief is when I bend down and stretch it. Any suggestions how to take care of these problems, thanks",
    "doctor_response": "Hello,You have both rotator cuff tear of shoulder joint along with upper back pain. I advise you to consult your orthopedic specialist to get both your shoulder and upper back assessed and if requires to get an MRI done before you get back to the gym. Once these are done then you can go back to weight lifting as per his advice. Till that time, I would advise you to go slow in the gym.Wish you a speedy recovery. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Santosh S. Jeevannavar, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the lump on the inner thigh?\n\nI have a large lump on my inner thigh. Its soft but around it is hard. It usually comes up when I have my menstrual cycle & then disappears. This time its painful. It has no color and its warm to the touch but not hot. I want to know what it could be.",
    "doctor_response": "Hello!Thank you for the query.Its is really hard to give precise answer not being able to see it. But from your description it sounds like varicose vein. However other soft tissues lesions like a cyst or lipoma are also possible. With varicose vein there is a risk of veins thrombosis. Especially if you take any contraceptives or due to injury. Hardness and pain can be a symptom of such thrombosis.The best way to find out what are you dealing with is to perform an ultrasound of this lump.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My son has social withdrawal and isolation. Yet, he refuses treatment. Please help.\n\nHello doctor, The problem started in 2010. Social withdrawal, isolation, inability to continue at a\u00a0job, negative talk, jealousy, lack of initiative, low self-esteem and fickle minded behavior. What could these point to? The prescriptions are lost in transit. No medicines are being taken.",
    "doctor_response": "Hello. I can understand your concern. The symptoms of withdrawal from society, loneliness, difficulty in continuing the job, negative thoughts, lack of motivation, indecisiveness, etc could be due to some severe underlying mood disturbance. Since the symptoms are persistent and are resulting in impairment they should be evaluated properly. It could be either depressive disorder or bipolar depression. Depressive disorders or bipolar depression can be treated properly with medicines. Most of the newer medicines are safe to use and have no serious side effects. These medicines have great efficacy. So, taking proper treatment would solve your issue. Please describe your symptoms in detail, right from the beginning of the illness: Thanks. Take care. Revert with more information to a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sudden dent in back of head. Was hospitalized for unexplained high BP. Medication helped. Reason for dent?\n\nHello! My husband has a sudden 'dent' in the back of his head. Lower left side. Very strange; indentation behind/near left he, looks triangular, quarter size, sinks down in  the middle.  He was about 3 wks ago hospitalized for sudden, unexplained high BP which they could not control in the ER after 9 hrs of pounding him w/2 dif kinds of BP meds. He was admitted and floor doctor added a new med ('for lower number'), which seemed to help. His BP's been fine post release.  He just turned 50, white male, white collar but high stress level job, very active & health oriented. Was competitive body builder through 1994; still in the gym regularly, eats healthy diet, etc.  Thoughts?",
    "doctor_response": "HIThank for asking to HCMLook mam the history given here is indicative of Blood pressure problem as such you have not given reading of his pressure it became difficult to comment on it, again the dent you said has nothing to do with the blood pressure neither with any other clinical condition it might have been there since birth, it might be sighted coincidentally by you so just forget about it, it wont harm to your husband any more, the blood pressure will also be in well control soon just take it easy and have faith in your/his doctor have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have toothache. Taking toradol, clindamycin and percocet. Are they safe to be taken?\n\nMy girlfriend is experiencing some massive toothache pain.  We went to see a dentist today, and recieved some perscriptions for toradol, and percocet, as well as an antibiotic called Clindamycin(i believe that's roughly how you spell it.  She has taken the antibiotic and a toradol about 4 hours ago, and is still experiencing quite a bit of pain.  Would it be safe to take some percocet now?",
    "doctor_response": "Dear friend.Thanks for sharing your concern.you can give her one percocet tablet now.but please see that you maintain an interval of six hours.As, it is given every six hourly.Tooth pain gets relieved by opening the canal in the tooth,so that the built up pressure can be relieved.I would say please continue the medication given but also meet your dentist and discuss regarding opening of canal in the teeth,if root canal has been advised for that particular tooth.Hope it helps.Thanks.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Numbness in the upper lip, nose and eyes after taking novacaine for a dental procedure. How can I get back to normal?\n\ni had dental work done 6 days ago and had to have novacaine before the procedure. I am still experiencing numbness in my upper lip , nose , eye, and ear. As well as a thickness in the throat . Very similar to the feeling you experince as the novacaine is wearing off. The feeling isn t constant and comes and goes but I would say it is present 75% of the time. Any suggestions.",
    "doctor_response": "Hello, Thanks for the query. Usually numbness after local anaesthetic administration lasts for 5-6 hours. Since in your case the numbness persist even after 6 days. This may be due to many factors- 1.overdosage of local anaesthetic administration. 2.cheek/lip biting during the time of LA action. 3.neurological disturbances associated. I would suggest you to- visit a dentist at the earliest. apply cold  ice packs on the affected area. consult with a neurosurgeon. muscle relaxants can be administered. REGARDS DR.BINDIYA",
    "dialogue_context": ""
  },
  {
    "patient_message": "On Neoral after kidney transplant, diverticulitis, anemia, advised Vit C, iron. Does rose hips have negative effect on Neoral ?\n\nMy wife is 19 years out from kidney trnaplant and taking Neoral.  Recent diverticulitis and anemia resulted in RX for vitamin C, iron and antibiotics.  Some Vitamin C oferings contain rose hips, can rose hips have negative effect on Neoral?Can she also take Geritol in addition to the iron (niferex) with no negative side effects?",
    "doctor_response": "Hi, Your wife aged 19 years had kidney transplant, now diverticulitis and anemia, treated with vit.C, iron and antibiotics. some vitamin .C contains rose hip did it have negative effect on neoral.                          She has crossed kidney transplant and is under the supervision of the doctors, If it has any negative effect also it is not always, and you enquire with your doctor and try to have another alternative with out rosehips.                          Dont try to give her the one with rosehips, as the doubt play a role in creating negative effects. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes arm and shoulder pain?\n\ni have been having pain in both arm in shoulder and mid arm,,and every time i go to the doctor they admit me in and find out there s not problems with the heart,,but i need some relief it driving me resting,,what can i do to have some relief til i go and see my doctor,,please tell me",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.You may be having bilateral frozen shoulder. For confirmation of this you need clinical examination by Orthopedics surgeon.You will be benefitted by mobilisations exercises of shoulder and analgesic such as ibuprofen for pain relief. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Gonapeptyl injection helps to conceive as I got my periods?\n\nHiI had my gonapeptyl injection on the 5th December 2012. I am due to start my menpur injections on the 25th December 2012 but I have had a period today so I'm concerned that the Gonapeptyl injection hasn't workedThis is all part of an IVF cycle - thank you",
    "doctor_response": "see gonapeptyl inj helps to concieve. ...but dere r lot of other things which should be taken into account in an Ivf cycle...in my opinion go for serum tsh and serum prolactin den do hsg on day 8th den do follicular study after taking clomiphene from day two den follicle size increase to 18 mm den rupture den iui fr early results. ..provided husband semen analysis normal or  do icsi fr early results",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the treatment and symptoms for Leptospirosis and typhoid?\n\nive recently been sick with mild cases of leptospira and typhoid, during the time ive had abdominal pain which caused my period to come on the whole time I was sick, while on the levlen pill. Now that its not in my system anymore my doctor said it should dissapear and to",
    "doctor_response": "Hiwelcome to HCM & Thanks for your queryif your fever isdiagnosed as typhoid  you have to start on antibiotis like Tab Ciprofloxacine 500mg B D for 7 days, if it is not reduced then you may need to continue for next 5days.TipsTake plenty of fluidsdrink Boiled waterHave properly cooked foodtake restIf the above method didint resolve your problem you may need iv Inj CeftriaxoneSame antibiotics work for leptospira infection.FOR confirmation you can give your urine sample for Leptospira culture test after visiting your physician Thank youTake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Deprovera injection cause infertility?\n\nsir iam 28 years oid ,iam married ,ihve 2 years old baby ,after delivery i took deprovera injection for my safety , now i need a child but iam not getting pregnent , my menses cycle is stoped after taking injection , imany doctors told that injection is harm full ,now iam worried ,my scanning report says that no follic is seen,iam really worried ,i take 2 injection interval of time 3 months , plz answer my question",
    "doctor_response": "Hi, I have gone through your question and understand your concerns. Depo provera injection is a progesterone contraceptive. It has the side effect of irregular or no periods at all due to its hormonal effect.However, the periods do resume with 3-4 months of stopping the drug and it does not generally affect the future fertility.If your ultrasound shows no follicle, it means thereis anovulation, which can be due to ddisturbances of several hormonal changes.I would suggest you to consult an infertility specialist to get properly examined, investigated and treated accordingly.Hope you found the answer helpful.Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hotness in sole of feet during night?\n\nThe sole of my feet are feeling hot in the night and makes me feel very uncomfortable i cant even walk.i usually put a cold wet handkerchief on them or step on a wet cloth for relieve!kindly tell me what could be the reason???what should i do???kindly advice.",
    "doctor_response": "Hello, Pins & needles feeling (hotness) in the feet, difficulty in walking is an indication of nerve disease or nerve inflammation. It looks like Peripheral Neuropathy. You are suggested to visit a GP & get physically examined. Get all Nerve Conduction tests, Nerve biopsy, skin biopsy, Imaging tests & blood tests done. Your treatment will depend upon the severity of the pathology detected. In the meantime take vitamin B6, B12 with folic acid & minerals (calcium, zinc, magnesium). Stay away from addictions if any. Maintain blood sugar levels to normal else it will trigger nerve inflammation. Do not get overweight. Avoid oily food. Take berries, fruits, veggies, whole grain, food rich in calcium, protein & iron. You can take low-fat dairy products. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nupur K, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing the infected lymph node under my jaw?\n\nI have swollen lymph nodes under my jaw and by my ear and a very pronounced lump on my forehead approximately 2 inches long by 1 inch wide.  Doctor says it's probably infected lymph nodes and prescribed antibiotics but could it be more serious and what is causing it?",
    "doctor_response": "HelloEnlarged lymph nodes are  most often due to infections in the drainage areas. Antibiotics or treatment to the underlying infection would suffice. However if lymph nodes persist even after treatment or if there are multiple nodes, painless enlargement, then it would be a cause of concern.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the treatment options for ischemia?\n\n. My age is 48 weight 55 height 165cm and do not have BP or Sugar. I have done TMT stress test. And Dr. told from 9th Minute to 11th Minute heart rate achieved 150. No other signs. No symptoms of breatless or fatigue. But Dr. told it is ischemia. Is it a serious issue. Further what is to be done?",
    "doctor_response": "Hi Sir/Mam,Welcome to HCMI understand your concern.Ischemia in your case is suggestive of block in the vessel.Coronary angiogram will be needed in your case to know the site ,vessel and the extent of block.Depending on the block ,Coronary angioplasty can be planned.Drugs like Antiplatelets ,Anti hypertensives,lipid lowering drugs will be helpful.I advise you to consult cardiologist for expert management.Post your further queries if any,Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to increase chances of conception?\n\nam ram 33 years old married 2 years back am trying for a baby but not succceeded, my penny is not going fully inside and foreskin comes back after ejacuation and sperm count now is 70% after taking oligo care tablets and am very upset kindly advice",
    "doctor_response": "both of you get a complete infertility work up. reason whatever will beruled out to give you the best management option available.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taken overdose of Naturogest, negative pregnancy test, had light period. Am I pregnant?\n\nIm 35years old female. doctor prescribed Naturogest200mg 2 tab from 14thday to 30 th day by mistake i took 10 days extra and doctor gave fertile injection it is 39th day from my last month period I tested with Preganancy urine test kit, but got Negative result and i contacted doctor she said to stop Naturogest200mg after stopping i had very light period for five days have no special symptoms for preganancy and again i dint had my periods for a month and did urine pregnancy test is negative again contacted doctor she told me to after a week i am really confused i wnt know wheather i am pregant or not please tel would be the result L or I have to wait for some more days? if so, How many days? Thanks in advance to HealthCare Magic !",
    "doctor_response": "Hello. Thanks for writing to us. Naturogest is a natural micronized progesterone and since you took it for longer than usual without a confirmed pregnancy, it has caused a mild bleeding which is lesser than normal. You can get your serum beta Hcg levels tested to rule out the pregnancy. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is abieraterone safe to take for prostate cancer?\n\nmy husband has advance prostate cancer for 3 years, recently he s been on new drug Abieraterone for 6 months, all stabled untill now, he has bruises appeared on his hands and legs for no resons and a little tired then normal! please can you tell why? is it urgent to be seen by oncologist asap? thank you.?",
    "doctor_response": "Bruises without trauma usually indicates an underlying clotting insufficiency. It can be due to low platelet count (platelets are responsible for clotting blood). Although abiraterone is not known for decreasing blood cell count but this possibility should be ruled out. The other possibility is prostate cancer progression affecting marrow and blood counts.The tiredness can be secondary to disease progression OR mineralocorticoid deficieny  or hypokalemia (low potassium levels) associated with abiraterone.Please discuss this with your treating oncologist. An early appointment is suggested.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Possibility of getting pregnant on having sex on last day of period?\n\nI ended up having sex the last day of my period which was 2 weeks ago. I was wondering if it would be possible to get pregnant then, and if so when would I have to test. My cycles are very irregular so I m not sure how long until I ovulate again. I m having some symptoms but not too sure if its my period showing up again or just in my head. Any help is appreciated.",
    "doctor_response": "hi cole, i read your query, usually its safe to have intercourse 5 days before and after your menstruation ,no ovulation takes place at that time. So,you are in safe period and nothing to worry,you wont concieve as you had your periods after intercourse,it makes the chances to zero if you further had any doubt,just do an HCG card test,its most reliable, i understand that your stressed and worried about being pregnant,that itself make you feel like having the symptoms of getting pregnant Regarding irregular periods ,consult an gynaecologist and have an expert opinion take care dr.g.surendiran",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood while urinating with pain below stomach?\n\nIam 38yrs, 5\"5\" and 67 kg male , having a stone measuring 4.2 mm in my right kidney from last one year but yesterday while urinating blood drops peeps out from penis Iam having very bad smell of my urine moreover today iam having pain below stomach right side.Pl advice and help.",
    "doctor_response": "HelloThanks for your query .The pain in loin with hematuria and foul smelling urine strongly suggests stone with UTI .Please consult qualified Urologist for clinical and digital rectal examination and get following basic tests done to confirm the diagnosis.1) Urine routine and culture.2) Ultrasound scanning of abdomen and pelvis.Please take broad spectrum antibiotics like Cefixime   along with urinary antiseptic like Nitrofurantoin twice daily and urine alkalizer thrice daily .Later on switch on to appropriate antibiotics as per culture report.Get the prescription of medicines from your family Physician.Ensure to drink more water .To keep your urine dilute This will help to control dysuria.Further treatment will depend upon result of these tests and final diagnosis as regards position of stone and degree of obstruction to kidney due to stone Dr.Patil...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for acute liver damage\n\nhi my father is living in india,he is 60 year old,he is hypertensive controlled with atenolol 50mg & amlodipine 2.5mg,he also take fibrovas 3 times in a week,she had fatty liver from atleast 15 years,he now dsnt drink from atleast 3 years,now 7 days earlier he suffered from dengue & getting treatment for it he is taking paracetamol 500mg b.i.d.,vit.c 500mg b.i.d.,cefoxime &oflox combination o.d. from two days,for the previous 3 days i dnt knw about his prescription,we jus t got his blood test results,blood urea & sr.billiruin  are in normal range,platelets are 170000,but his sgot is 97 &sgpt is 57,actually now i told him not to take paracetamol unless u have fever,actually i m worrying lot about him,is this acute liver damage will subside soon,can you please tell me what medicine & precautions he should take,or we need to go for some other blood tests too  ?i will be very thankful to you.",
    "doctor_response": "thank you for posting query at HCM.yes, acute liver injury is reversible.increase in the level of liver enzymes(AST,ALT) reflect an INJURY to the Liver. medically, the condition is know as \"Hepatitis\". it maybe caused by:1. Virus (A, B, C, D, E) 2. Alcohol                    3. drug induced (medication)4. Gall bladder or common bile duct pathology 5.\"Fat excess\" most likely , its due to drug induced.advice:- continue abstinence from Alcohol - LOW fat diet should be followed- NO red meat- vegetables should be ingested daily- Moreover, rest more- use lemon juice (lemonade) once in a day-\"recheck liver enzymes after 4 to 6 weeks\".if liver enzymes still high, You may visit hepatologist as soon as possible.if any further questions, feel free to ask.Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health.regards,Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I do outdoor works while suffering from mini stroke and heart palpitations?\n\nJust got the craziest diagnosis.I am a 52 year old female. Supposely I have two leaky heart valves, (don t know which ones) and I m having mini strokes. Heart palpatations and heart flutters, feeling dizzy and like my heart skips a beat were the symptoms that would not stop are the symptoms that caused me to seek help. I also had sharp pains in my jaw, back and left arm one evening. I am a very physically active person, I mow my own grass and my job is outdoors not sitting at a desk. When this first happened I thought I just got over heated outside and thought I was going to pass out but it did not go away. I don t like to go to the hospital, I went to the clinic and they put me in an ambulance to the hospital! After stress test, echo cardio, cortery test and a lot more I don t know. The Dr has prescribed blood thinners and told me to go back to work at my regular job? So with this condition and mini strokes ok to shovel dirt and carry stones around? What will he look for in a month after blood thinners?",
    "doctor_response": "Hello Thanks for posting at HCM. By your description seems like you have got atrial fibrillation which means irregular fast heart rate. This causes symptoms like palpitations, fluttering sensation in the chest, feeling dizzy etc. Due to irregular fast heart rate, clots tend to develop in the heart which then migrate to other organs including the brain. This is why you get ministrokes. Your doctor has put you on blood thinners so that the clots don't form. Please continue taking the  thinners. You can go around doing your normal activities. but start gradually to see how the body responds. After a month your doctor has called you to see response to the treatment and a ECG and 2 d echo may be repeated if indicated. Wishing you good healthRegards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for headache and low blood sugar levels\n\nYes my blood sugar keeps dropping to a bit below 70 then I eat a glucose tablet and get it up to 98 or 105 in 30 - one hour back down again. I am afraid to sleep I have a blazing headache and my sister died ib her sleep from low blood sugar she was brain dead by morning...blind, etc.",
    "doctor_response": "Hi,Thanks for your question.After going through your question, I would like to know-1) Your age and gender.2) Are diabetic or not? If diabetic then What medicines are you taking?3) If not diabetic then Are you obese? Is there unusual hunger? Any other medications are you on?If you are diabetic and on treatment for it, in that case there is need for -1) Consult your treating doctor as early as possible for appropriate changes in medicines.2) Till that time -      - Stop taking antidiabetic medicines.     - Monitor your blood sugar level frequently.     - Use glucose water and  eat at regular interval to keep your blood sugar level above 70.If you are not diabetic in that case-1) Consult endocrinologist as early as possible for further evaluation for insulinoma (insulin secreting tumour of pancreas) or other metabolic disorders.2) Till that time -      - Monitor your blood sugar level frequently.     - Use glucose water and  eat at regular interval to keep your blood sugar level above 70.You symptoms of headache and low blood pressure are most likely due to low blood sugar level.So maintaining blood sugar level above 70 may help in relief.Hope this helps you, if so do vote.Keep in touch.Regards,Dr. Abhay Mali.Diabetologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a swelling in the ankle\n\nMy husband had knee stress fracture for no reason.His nerve L5 was affected.There was no trauma, he does not exercises, no issues with back hip.He did MRI and they did not show anything.After 2 spinal steroid shots he started walking and after 1 month his ankle started to swell same leg that had issues.",
    "doctor_response": "Hello,I have studied your case. Ankle swelling can be different from nerve compression. I think it can be ankle synovitis. In this condition there is collection of fluid in the ankle along with pain and difficulty in movement. Patient needs to get CRP, ESR and Ra factor to confirm the diagnosis. If there is any abnormality in these tests than he needs to take anti inflammatory drugs. Along with this he needs to take Hot water fomentation and elastocrape bandage. I hope this answer will be useful for you. Let me know if there is any other followup questions.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated SGPT and SGOT readings in liver function tests?\n\nI am 36 yr old male. weigh 68 kg. i am a teetotaler, i have conducted the liver function test in July,2011 & Now(5 Nov,2011). The following is the report details 17July 2011 - SGOT : 38 U/L ; SGPT : 98 U/L 5Nov,2011 - SGOT : 65 U/L ; SGPT : 130 U/L. I request you to provide the below details... 1) What will be the reason for this upword trend of the SGPT & SGOT readings ? 2) whom need to be consulted furhter for this, means any specialist? My loaction is Dombivili(Thane)",
    "doctor_response": "Hello Thanks for writing to HCMIncreased SGPT indicates liver injury.Increase in SGPT may be due to many reasons like hepatitis,alcohol intake,altered lipid profile,medicines,auto immune causes etc.You need few other investigations like routine hemogram,Random blood sugar(RBS),Complete liver function test(LFT),Viral markers,ultrasound of abdomen.Further investigations can be done if needed.Proper treatment depend upon findings.You may need few medicines after investigations.Get well soon.Hope I have answered your question.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it dangerous to have 3 livogen tablets in 6 months?\n\nhi i have sex with my husband after that we see the candom come apart then i eat levonjin tablet but in last 6 months i had 3 levonjin and now i m worriedi heard this tablet is not god and in 1 year women can eat just 2 of them but in 6 month i had  3 tablet is it dangerouse?",
    "doctor_response": "Hello,It is true that emergency contraceptive pills have to be used with very much restriction and only once or twice a year, but taking more than those at large intervals is also harmless. This is because spacing out the medication lessens the side effects. So, please do not worry. Instead, if you can club another form of regular contraception in addition to condom usage, you will feel much better and are safer. If possible, you can go for either oral pills or an IUD. Hope you find this information useful. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for aching arms and shoulders with breathless\n\nI was diagnosed with about 80% heart arteries blockage several year ago. I walk every night about 1 mile on the treadmill. The past couple weeks, I have noticed my arms are aching and I have a pain between my shoulders. Also, my arms feel heavy. I do feel a bit out of breath. If I do stationary work outs, such as a bike and other machines at the gym, I feel okay. What does it mean?",
    "doctor_response": "Hi there. Welcome to Healthcare Magic. I have read your query. You seem to be at risk of heart disease due to your previous history of heart artery blockage. Now you are having pain over upper body and limbs after exercising. Do you have any chest pain which occurs along with the breathlessness ? Any unusal sweating ? These could point to possible heart condition which needs to be addressed promptly.Avoid stress and heavy exercising for now. Eat fresh fruits and green leafy vegetables. Drink enough water. Kindly consult your Doctor or Cardiologist for the same. An EKG or Angiogram may be necessary if your Doctor suspects heart condition which is causing the same. I hope I have answered your query. Thanking you. Regards, Dr. Aashish Raghu",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes small raised lump between the eyes?\n\nMy 5 year old has a soft raised lump in between her eyes. She hasn t recently had any head trauma, but has had a few goose eggs in her time right where this lump is. She says its tender and you can see it at an angle. She only complains of headaches once in a while. Curious and worried as to what this could be?",
    "doctor_response": "Hi welcome to HCMI have gone thru your Query regarding small raised lump between the eyes . For your info , Lumps can occur for a variety of reasons. Some may be avoidable and some just happen , are caused by elevated lipid levels, then they serve as a warning to make diet and lifestyle changes . Small skin colored bumps that form in clusters around the eye from benign sweat gland tumors are known as Syringomas  and  can be removed using heat from an electro-cautery or laser device but they may recur, or removal may cause scarring. Treatment usually involve using warm compresses for 5-10 minutes, three to six times a day and possibly using prescription antibiotic ointment or drops. Never pop or squeeze either of these eye bumps. Take care to  make diet and lifestyle changes . You follow a diet having fibers,fresh veges & fruit , diet  low in saturated fats and cholesterol.  As she is  just 5 years ,You may also need to increase her activity level ,  Make sure she eats right , plays well jumps well ,and sleeps well, regular deep breathing ,panayam,yoga for proper blood circulation and detoxing your system will help you alley such problems . to eradicate toxins from her system .Avoid fried , fast foods and junk foods , ,constipation which produce toxins in your system .  If problem persists , consult your doctor for proper guidance .regular deep breathing ,panayam,yoga for proper blood circulation and detoxing your system will help you alley such problems .Hope this helps solve your query Take care All the best. wish you good health ahead",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes weakness in the torso and legs?\n\nDuring the last year I have experienced loss of strenght in lifting my torso off a level service and the flexibility in both legs. Simple tasks like putting on socks and shoes, getting up from an upholstered chair, and getting in and out of an automobile require an effort. I have deteriorated from an extremely active do-it-your-selfer to someone with limited physical capabilities.",
    "doctor_response": "Hi, You should keep yourself well hydrated & away from too much stress/anxiety. Electrolyte balance of your body is important, a deficiency of potassium(hypokalemia) or a deficiency of sodium(hyponatremia) may cause the symptoms that you are experiencing. However, there can be other factors like peripheral neuropathy, chronic fatigue syndrome, GBS, thyroid dysfunction, developing RA, DM, Hypercalcaemia, etc which may cause the connection between your brain, nervous system or muscle get affected by some developing pathology. T This causes muscular weakness. Get a general health check-up, get physically examined & get all the necessary investigations done. Your treatment will depend upon your investigation reports. Take sufficient sleep & maintain a healthy lifestyle. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for paranoid schizophrenia\n\nHello Doctors..One of my family member was diagnosed as suffering from Paranoid Schizophrenia when she was around 23-24 years of age. Now it has been fifteen years and she had a relapse after she changed her psychiatrist and changed her medication. Since then she went back to her original psychiatrist and is started taking injection every month with 4 other medication as well. This family member is married and has children as well and her husband with very demanding job..Now she is not doing much work at home and the kids are at the mercy of her parents supporting her in daily life.She get angry very fast and is sometimes abusive to her parents, husband and kids. Please suggest a if Cognitive Therapy will help this family member to improve their functioning on a daily basis so that she can care for her children and more involved with her spouse..Also please let us know where can we get help in South India(Tamilnadu)",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Many researches and researchers confirm that medicines alone cannot cure mental disorders. Life style changes, change in thinking pattern, relaxation etc are as essential as medicines. Psychotherapy can help you changing your lifestyle and thinking patterns. Yoga and meditation help you to streamline your metabolism and neurological balance. Please consult a psychologist for further information.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden rise in BP after the change of medications?\n\nage 62 height 6.0 weight 245--diebeties--3 months ago the doctor changed my blood pressure meds. at that time it was 130/85 she took away hydrochlorthiazide and switched to 1/2 atenolol 25mg. i just stuck my are in a blood pressure checked and it was 188/121. bought a checker today. and about the same.pulse mid 65 - 75. any ideas",
    "doctor_response": "Hi welcome to HCM, I think you should add half a tablet of hydrochlorthiazide (12.5mg) to the atenolol. It should settle down. But it should be done under your doctor's supervision--regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medication for swelling & pain on ankle due to an injury\n\nI was strunk on the ankle bone 5 weeks ago by a line drive. The injury site immediately began to swell and turn color. I was able to walk on it with a little pain so i figured nothing was really wrong. Did the whole RICE process for a few days. Swelling went down a good bit. However the point of impact is still very tender to touch, still bruised looking, moderate swelling and now I m unable to put full weight on heal and toes hurt a little. Did a good bit of walking today and now the entire ankle and foot are swollen like a balloon. Does this require an ER visit or should I hold off to see orthopedist in 4 days. Thanks Brandy",
    "doctor_response": "Hi BrandyNo need for an ER visit but you'll need x-rays and maybe an MRI once you see the orthopedist to check for a fracture or ligament damage since if neither of those were the case the pain should have resolved by now",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I have i-pill after unprotected sex?\n\nHi doctor, I am a 19 year old girl. I had unprotected sex. My last periods was before two months and still I have not got any. Is there a chance of pregnancy? I have had i-pill twice last year in a gap of 6 months. My periods are sometimes a day or two late. But, I am really worried as I really cannot afford a pregnancy now. Please help.",
    "doctor_response": "Hi. I totally understand your situation. Handling an unwanted pregnancy can be very stressful. As you had unprotected intercourse within the safe time of your cycle, it is very unlikely that you might be pregnant. If you still have a doubt then get a home pregnancy test kit and check yourself in case you do not get your periods in next two weeks. As far as i-pill is concerned, it does cause alterations in the hormonal balance and cause period disturbances. So, you should wait for a couple of weeks. If periods do not resume, we can start you on oral hormones to get your periods as well as regularize your periods. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat hair loss?\n\nhello doctor me 17 year old girl .i am having hair loss for 2 years and its not stopping.i ad my hormonal test nd everything normal.i have pain in my scalp can\"t have a ponytail sometimes.my scalp gets oily after one or 2 day of washing but hair ir very dry nd thin.i am on a good diet wat should i do",
    "doctor_response": "Hello, I suggest you try Minoxidil 5% solution, 1ml,  twice daily. In addition, I suggest you take an oral biotin supplement once a day e.g tablet Revilus or H Vit forte. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Kakkar S., Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for mild pain in chest\n\none year before my chest xray showed lymphadenopathy but my doctor said no concern because no symptoms. Now today my chest xray says coarse and prominent bronchovascular markings seen.Symptoms are not too much but i experience very mild pain in left side of chest deep inside that comes and goes.Pls advice.",
    "doctor_response": "Hi welcome to hcmI understand your query and concern.Your symptoms are suggestive of Myocardial infarction leading to Right sided heart failure and pulmonary edema.I advise you to get an ECG,2D Echo of your heart,lipid profile,hsCRP.Troponin I and chest x ray immediately to confirm the diagnosis.Monitor your blood pressure,heart rate immediately.Drugs like clopilet,ecosprin , atorvas, betaloc,pantop.Avoid stress and anxiety.Avoid smoking and alcohol.I also Exercise daily for 30 min.Coronary angiogram with or without stenting will be the procedure of choice.Exercise regularly for 30 min.Stress management is mandatory in your case.Consult your cardiologist for expert management and follow up.Post your further queries if any,Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i have Lorzone along with muscle relaxants for chronic back pain?\n\nI ve been prescribed several muscle relaxers (flexeril, skeleton, robaxin, baclofen) for chronic back pain without getting relief from any of them. Dr. just prescribed Lorzone. What is the difference between these? I also take 3-4 Tramadol daily for back pain as well.",
    "doctor_response": "Thank you for your question.I would suggest that you consult a spine surgeon. You needto have an MRI of spine for finding out the cause.Also take help of a physical therapist for back exercises,massage, hot fomentation or diathermy.This shall lessen the need for too many pain killers and muscle relaxants.Lorzone is cloraxazone , a muscle relaxant, different compound than your previous meds. It is effective",
    "dialogue_context": ""
  },
  {
    "patient_message": "There is no improvement after taking treatment as the mouth automatically shakes and does not have any control on facial muscles\n\nhi my father is shaking his mouth automatically. he canot control his mouth ....we feel so sad.......he is taking treatement but no improve .....please help dr",
    "doctor_response": "Hi, welcome to H.C.M.Forum. he must be having some problem with his tongue. he should use neurotropics in high dose, and anxiolytics. ct scan is to be taken and treated if some thing is wrong accordingly, under the guidance of a neurologist . he is moving his mouth to compensate the defecit of the tongue. thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause pain in the hip and shoulders?\n\nHi, I m a 41 years old female. For about a year I ve been experiencing right hip pain around 3am every night, and for about 3 months I ve been getting left shoulder pain also at night. What can that be? The area is not tender to touch, hot, red, or swollen.",
    "doctor_response": "Hi, The pain in the hips and shoulder can be due to low levels of calcium, vitamin D3, magnesium, decreased fluid intake or arthralgia. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal for my hand to swell post arthroscopic surgery on my wrist?\n\nI had arthroscopic surgery on my wrist Tuesday under general anestesia. I was fine post. Today hand is really swollen and now am getting a scratchy / itchy feeling in my throat and lips. Is this normal? I have only a Taken Tylenol for pai, and just took 25mg Benadryl.",
    "doctor_response": "Hi, Post arthroscopic surgery this will be a common thing to happen. you need not to worry much. Swelling happens as a protective mechanism and it gets vanished once the hand is started to use. Also you can take some sessions from the physiotherapist so that you regain the full ROM and full strength of the hand. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Advise diet for a person suffering from primary biliary cirrhosis\n\nThanx Doc, my daughter,24yr old was diagnosed with primarybiliarycirrhosis 6mths ago. She is presently on a list for liver transplant, when the timing is right. At present, she is waiting for a biopsy and as each week goes she is becoming more extremely tired and worn out. I am interested in finding out what could she add to her diet or healthfoods to help her through this very tiring wait. Thank you, Fiona",
    "doctor_response": "HiEat lots of fruits and vegetables. If you can, go for five servings every day.Opt for moderate amounts of lean meats. The recommended amounts will vary.Go for unsaturated fats like Omega 3fattyacids, extra virgin olive oil, nuts and fatty fish like salmon.Choose whole grains and complex carbohydrates.  Whether it\u2019s cereal, crackers, breads or rice, always choose the whole grain variety.Coffee and Tea should be limited to once a day.Hope I have answered your query. Let me know if I can assist you further. RegardsDr.Saranya Ramadoss, General and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why my knee is popping?\n\nHi every time i Bend down my knee cracks then when i sit down my knee feels like it is out of place. And then i walk and my knee sounds like its popping. And i am only 15 so i dont think it should me happening. Do you have any.idea what is wrong any information would help. Thank you for your time",
    "doctor_response": "Hello,Can you describe it better? Does it feel that when you bend the knee cap ( patella) goes to the lateral/ outside part of the knee and when you extend the knee it seems to go back to place? I think that you should visit an orthoped in order to do a physical examination and to estimate the health condition of your knee.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Emilda Belortaja",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I increase my body mass?\n\nhai sir. i am krishna. my age is 22 .my body weight is 46 kgs. at the age of 22 i really looking like a 18 years boy. At my working place all the employees see as a child and not providing any information to me and they said that he is able to conducting audit really. I am facing many problems on college , and office. i face mental tensions regarding the issue. Please give solution to my problem.",
    "doctor_response": "hi Krishna.thank you for providing a brief history of you. For improving the body mass there is no as such a medicine. Body mass is directly related to the physiological status of the individual humans. If your dad and mom are lean then you have a genetic working behind this. Still you can try out taking some proteins on a little raised scale in your regular diet. Taking the natural source to get good physiology and body composition is advised rather going in Pharmacy shops and asking for protein powders and all.after taking a good amount of protein in your daily diet you need to even spend some time in doing some regular slow exercises. Never overdo any exercises and please take guidance from expert to learn what exercise you should perform to make the muscle mass. It's advised to take advice because most of the people land up in injury. so avoid injury I will advice you to take an expert's help.also to mention that \" Rome was not built in one day\" something like this that once you start taking natural form of protein like dal, egg white, etc do not expect a sudden increase in muscle mass. You have to keep patience and go slow.With the grace of God I wish you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for soreness in left knee?\n\nHi, my left knee has been sore for the past 2-3 months. It was sporadic and not consistent. Now it seems to be more consistent. It is sore at the top of the knee, towards the outside of the knee itself. When straightening it while sitting or walking, it pops or cracks. However, there is no pain in the cracking/popping. Is this reason for concern?",
    "doctor_response": "I expect chondromalacia patella and or iliotibial band tightness..consider seeing a physiotherapist for stretching and kinesiotaping ..ultrasound therapy and laser can also help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Short term memory loss\n\nmy close realtive is having a problem of short term memory loss. for the time being he used to forget everything. frequency of occuring is fast. he is of 62 now suffering from even high blood pressure bt is under control now. can u please help me out in this.",
    "doctor_response": "Hi seema; welcome to HealthcareMagic There may be some age related changes in brain like atrophic changes or mental stress that can cause loss of memory .So at age of 62 with hypertension it can happen.Please get the patient to examine by a neurophysician to find the cause of short term memory loss if require get investigated.Once the cause is known the treatment will be easier to do so please consult a doctor. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heavy feeling in arm and pain near spine?\n\ni have woke up and my right arm is feeling heavy and weird. i have a strange feeling hard to describe in my shoulder, not pain but not pleasent. i also have the same pain near my spine under my right shoulder blade. Its quite warm, and I am stressed out over work related issues. please help.",
    "doctor_response": "Hi, Firstly, Sorry to hear about your condition. Coming to the history, I feel this is due to tightened trapezieus muscle. This is a common condition in most people due to weakness of the muscle and this may lead to painful symptoms. This condition to be provisionally diagnosed as Trapezitis. It means inflammation of the trapezieus muscle. Using hot water bag over the region and strengthening the neck and trapezieus muscle should be of help. Many things this is a major condition but in my practice I feel one can get rid of symptoms if assessed properly and guided properly. Rest assured, performing regular exercise for the mentioned group of muscles you should be fine in 2-3 weeks of time maximum. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for kidney stone\n\nMy brother in- law have Kidney stone (7.2 mm) and blood suger having about 400 and by Insulin injection it falls down to 130. He has also renal infection and temperature was also high and now normal. During investigation stone was found a fews days ago. He he is now under treatment. Now please advisie me whether operation should be done to remove the stone or medicine to be taken to dissolve the stone and for renal infection.",
    "doctor_response": "HelloThanks for query.Your brother in law has Diabetes with kidney stone of a size of 7.2 mm with infection .I would suggest following line of treatment 1) Control his diabetes with Insulin and proper monitoring of sugar levels.2) Treat UTI with appropriate antibiotics after doing his urine culture 3)The stone of a sizeof 7.2 mm is likely to pass down spontaneously.4)Once his diabetes and infection is well controlled repeat Ultrasound scanning after 2 weeks and if the stone is in a same position he may go for Extra Corporeal Shock Wave Lithotripsy  to frament the stone so that the gravel will pass out through urine.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Renal transplant patient, creatinine level raising due to medication. Any need to continue medications?\n\nHi. I am a renal transplant patient. I have had my transplanted kidney for 16 yrs. As of recently my creatinine levels are raising.. I believe it is due to the medication i take. I believe the meds are now becoming toxic to my transplanted kidney. I've researched post transplant patients getting off all meds. can you tell my why this is not something that is more common. I understandthe need for the immunosuppressant pills - but after this long wouldn't the transplanted kidney be \"my own\" at this point. My way of thinking is, the kidney now has my blood running thru it and has for years.. Would my body still try to attack it after this long?",
    "doctor_response": "HIThanks for your query.There is a risk of rejection of the kidney by the recipient's body at any point in the lifetime of the patient.So it is absolutely essential to continue the immunosuppression if we wih to preserve the kidney.If one particular pill is causing problem, speak to your nephrologist whether it can be substituted.Hope this helpsGood luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ovarian cancer\n\nmy daughter-in-law has stage 1 ovarian cancer her red blood count has been very high her doctor wants her to do radiation or chemo but she is refusing both she has golf ball size cyst on her ovaires and has already had  a lot of cyst removed she is currently taking shots to help bring down her red blood cells  so my question is what is she looking at for the future and can you live a long life  she is 25years old and her family has a history of ovarian cancer she has had to family members pass from it she is not taking this very serious",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. She has family history of cancer.  She has ovarian cancer in early stages.  So she should go for oophorectomy with chemotherapy and radiotherapy accordingly.  Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I have an uncomfortable feeling in my chest?\n\nGood Evening sir I am 40 male.Recently I am feeling uncomfortness in the left side of the chest. I feel littlie tightness in chest and occasional shortness of breath which will usually go off with belching. some times I feel this this pain is external to chest bones. I have regular habit of walking for 4 km which take 40 minutes. I have done ECG, 2D Echo , TMT, Lipid profile tests. All are fine. ( Total Cholesterol:161, Triglycerides:106, LDL:88, HDL:52,VLDL 21). The doctor told it may be due to acidity and prescribed antacids. Can I simply forgot about this pain. Afyer how long I have to go to tests.",
    "doctor_response": "You have not mentioned how you feel after taking antacids..Take atleast 15 days of regular antacids and if you feel better then you dont have to worry about anything..It appears from your details that you are probably suffering from gastric acidity an as all the tests are normal it is less likely to be related to heart..Just need to ask you few more history:1) are you allergic to strong smells or cold foodstuffs2) do u hear whistling sounds from your chest during these episodes..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I having uneasiness in breathing?\n\nHello doctor, I am an asthmatic for 15 years. Right now I am using Foracort 400 mg since three years. I am also hypertensive and using Telma-AM. Since past six days I am facing uneasiness in breathing and because of that maybe my BP has raised. Last week before all this happened I got a master health checkup done and my uric acid level was 9.1 and traces of albumin were there. Just to mention, that was my sixth day of keto diet when I got the checkup done. Later, I stopped Keto. Kindly guide me.",
    "doctor_response": "Hello. As you know, asthma is the chronic inflammatory airway disease with waxing and waning episodes. If you have asthma, your airways are always inflamed. They become more swollen, and the muscles around the airways can tighten when something triggers your symptoms. This makes it difficult for the air to move in and out of the lungs, causing symptoms such as coughing, wheezing, shortness of breath and chest tightness.There is no permanent cure for asthma, and current guidelines suggest to keep it under control with the inhaler medicines. Foracort 400 mg is the best inhaler, and you should continue using it two puffs twice daily. As far as the diet is concerned, diet can increase or decrease inflammation in the airways, depending on what you eat. But the ketogenic diet per se is not responsible for worsening underlying asthma. Rather in some cases, it seems beneficial for the patients. So, the ketogenic diet is not at blame for asthma worsening. Might be there is another reason for the change in asthma pattern that is causing uneasiness or difficulty in breathing. So, it is advisable to see your treating physician and get the necessary investigations done to find out exact control of your asthma. Also as you said, the master check up uric acid value is high and needs evaluation by the doctor. Environmental changes as high pollution, colds, drop in temperature might cause asthma flare-up, and you may need to take inhaler like Levolin (Levosalbutamol) for the time being. So overall, only after proper physical evaluation, we can decide the exact cause of your discomfort. For more information consult an allergy specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i get pregnant post unprotected sex despite being on birth control pills?\n\nIve been on the pill for 11 months. I stopped taking the pill for three days and got my period which I believe is due to withdrawal of the hormones , on the forth day I had unprotected sex and took the pill again.I have then continued with the pill for 7 days and had unprotected sex. Is it possible that I am pregnant? I have not experienced any symptoms",
    "doctor_response": "as u have stopped d pill for 3 days...yes u may get pregnant as after dat u had unprotected intercourse for 7 days..if u miss ur period do upt on day 3rd ..n check",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness with itching buttocks and chest pain?\n\nI sometimes feel dizzy when standing and talking with a person.  My buttocks is itchy and only when I press on my upper chest I feel a small area (size of nickel) of pain.  I had my upper chest checked out a while ago and the doctors could not find anything with an x-ray, bone scan. I am 37, 5,4\", and 123 pounds",
    "doctor_response": "Hi, Dizziness, pain in chest and itchiness all the symptoms are not related to each other. Blood pressure either high or low may be responsible for the dizziness. Get a regular checkup of BP by your GP. Pain in the chest may be a vague symptom. Take anxiolytic to get relief. Itching on buttocks may be due to fungal infection or dry skin. Consult the dermatologist and get a perfect remedy to get cure of the skin condition. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilyas Patel, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be the red blister on my hip?\n\nhi wayne here from ireland, i got a rash on my hip red with little blisters. my friend got it too in the back of his leg.the same thing, we go to this house for band  practice. the had a lot of animals in the house, i think when i sat on the couch i got it.",
    "doctor_response": "Hello,Welcome to healthcare magic.from your history and description, I would like to consider the possibilities of an insect bite reaction/ bed bug bites, Scabies and a fungal infection (Tinea corporis).Insect bite reaction can be treated by applying a mild steroid containing mometasone furuoate / hydrocortisone twice a day for 10-14 days. You could also take an antihistamine like chlorpheniramine maleate at bedtime for the itching.Scabies is caused by a small mite and is contagious. It causes rashes in the finger webs, wrists, around the umbilicus and in the groin areas typically. It can spread from one person to another. It should be treated with 5 % Permethrin cream applied overnight and washed off in the morning. A single application would be sufficient. The bed clothes need to be washed and changed as the mite can harbour there.Funagal infection like tinea could occur from fungal filaments present on the animals. It needs to be treated with an antifungal cream like 2% ketoconazole or 1% Terbinafine applied twice a day for 3 weeks.The exact treatment depends on the diagnosis.You could google the above diagnosis and try to narrow down the option.Hope this helps you.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lightheadedness and nausea?\n\nTonight I did a bootcamp class that was intense, but I got through it and felt good after.  On the way home, about 15 minutes later I started to black out.  It started with tingling hands, then the blackout feeling (I've had this happen a few times before) so I pulled over.  I laid the seat back, but couldn't shake the feeling.  After a few minutes I puked.  I almost could not make it in the house.  Its been 2 hours since the workout and I still cant sit up without feeling lightheaded and naseous. I am in decent shape, I go to the gym and do cardio 3-4 days a week. (running, elliptical) I ate a normal diet today and was hydrated. I'm 26 with no other health issues.  I also am having vision issues, almost like I'm seeing spots making it hard to type this.",
    "doctor_response": "HIWell come to HCMThe symptoms given here might be possible because of the indigestion problem or at the most could be due to the hyperacidity and this comes around with little bout of vomiting some time, if you do not have any other symptoms like fever headache then this is nothing to worry, hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes enlarged spleens in a child?\n\nMy 12 year old daughter (5 foot 2 inches - 125 lbs - funtional heart murmur) woke up with a high fever October 23.  Doctor said next day it was a virus.  Laster in week sore throat doctor prescribed zithermax, and enlarged spleen.  Bloodwork came back negative for mono.  Spleen is still enlarged.  yesterday morning she had an xray and ultrasound.  We were told if problem we would get call yesterday afternoon.  Would it be ok to give her milk thistle to reduce spleen.  My daughter is very active and is restricted from sports.  She really wants to get back in the pool and soccer field.  How long does it take for spleen to shrink?",
    "doctor_response": "Hi, Consult a pediatrician and get evaluated to find out the exact cause for this condition. She needs a detailed evaluation to rule out conditions like leukemia and hematological causes. Treatment will depend on the cause. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome my depression?\n\nI have major depression since the suicide death of my daughter Oct 2011. I am currently on wellbutrin and have just been prescribed Prozac.I am fighting suicide and alcohol abuse. I have been sober for 29 months. What would your recommendation be. They had me on pristiq, Zoloft, abilify and venlafaxine. They made me gain weight so we stopped them.",
    "doctor_response": "Greetings !Well prozac is a decent anti depressant but it is unlikely to work for you since you have already exhausted many anti depressants belonging to it's class such as zoloft, etc therefore by now your body must have developed tolerance / resistance against prozac and therefore use of this drug may not solve your underlying symptoms.So i reckon that you ask your doctor to choose a different class drug such as remeron ( generic -- mirtazapine ) at dose of 15-45 mg / day to be taken at night while on the other hand raise the dose of wellbutrin to 450 mg / day to potentate it's action. These two drugs shall have a good cohesive action against your severe reactive depression.I hope this makes sense.Wish you all the best.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the level of carbon dioxide in blood that is fatal?\n\nHello Sir. My grandmother (aged 75) is admitted in the hospital because of a chest infection. Her carbon dioxide levels have been increasing continuously. Right now, it is 170 mEq/L. We are really worried, the doctors have suggested us to not go for an incubator as that will simply mean postponing what her death, as she cannot be cured now. I wanted to know the threshold limit of this carbon dioxide level, i.e., at what level this becomes extremely dangerous and leads to death? Thanks for your help.",
    "doctor_response": "Normal level of co2  in blood is 23-29mEq/L. Retention of co2 in blood is known as hypercapnea and it suggest that lung are not able to remove the co2 and going into the failure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. 2. 5 year old suffering from stomach ache. Which medicine has to be given?\n\nHi doctor, My son is 2.5 years old. For a week, he is complaining of stomach pain. After farting he is fine. Our family doctor recommended one antibiotic for five days and a medicine to avoid vomiting. He had small vomits twice, but later it was fine. Now, after completing the course of medicine he again complaints the same. His diet is almost nothing and he is not ready to take any food. He just has few mL of milk. He does not have fever. His stool was watery, but it is normal now. Can you provide any recommendation on diet and medicine? Please give me a solution to the problem. Thank you.",
    "doctor_response": "Hi. I can understand your concerns. Complain of abdomen pain with vomiting suggests that your child probably has acute gastroenteritis or food poisoning. Since, antibiotic is already given and now there are no loose stools or vomiting, there is no need to give antibiotic again. For abdomen pain, you can give syrup Cyclopam (Dicyclomine hydrochloride and Paracetamol) 5 mL on SOS basis (as and when required) that is when abdomen pain occurs. Whenever a child becomes sick, there is decrease in his appetite which improves as child recovers. Now, you should give him all the foods that you were giving him earlier. If he is not eating then you can start Glucon-D in water thrice a day for one or two days. Start a multivitamin like syrup Bevon 5 mL once a day for 15 days. Keep patience. Child will eat properly now as he has recovered from illness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Blood clot in brain. Paralysis in left side. Unable to control movements?\n\nMy mother is 48 years old.  She suffered a blood clot on the right side of her brain.  While trying to remove it she hemorrhaged so the procedure was immediately stopped.  Although she was paralyzed on her right side she was doing surprisingly well.  She was able to whisper immediately after the vent was removed and could write with her right hand (she is left handed).  She alps recognized everyone that went to visit her.  She then suffered from vasospams and became unresponsive and went back on the vent.  She has also suffered 2 cardiac arrests and struggled with pulmonary edema. She was on 3 pressers.  One of which was episode set at 60 mg.  The pulmonary edema has pretty much cleared up, she is off the epi (still on 2 other pressers), and her CO is rising.  Her vasospasms are also slowly improving.  She has shown signs of posturing but also pulls away each extremity in response to pain.  She opens her eyes and has equal reactive pupils but does not follow anything or follow commands.  Her face really looks like she is trying to do what they ask.  Is it possible that she is aware but cannot yet control her movements?",
    "doctor_response": "Hi,Thank you for posting your query.It is difficult to ascertain the level of neurological recovery without examining the patient. However, based on your description, she seems to be improving. Yes, it is possible that she is aware of what is happening, and still not able to control her movements.Investigations such as EEG and PET scsn of brain would help in determining the extent of neurological recovery and functioning.Best wishes,Dr Sudhir Kumar MD DM (Neurology)Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for persistent fever and stomach infection\n\nHi my son is 4.8 yrs old, has fever 101.6 f n has loose motions, givin him zanocin 6ml twice daily, pantop tab before food twice daily and crocin suspension every 4-5 hrs, still fever not comin down, he has severe stomach infection, few enlarged lymph in rif n lds, 17*13 mm...",
    "doctor_response": "Thanks for posting your query at HealthCareMagic. I am sorry that your son is not well. He probably has a gastro intestinal infection which is often caused by a virus called rotavirus though it could also be caused by certain bacteria. Antibiotics have been given to control it but in case the cause is viral, it is unlikely to respond. The temperature needs to be kept in control by cold sponging and use of medicines like paracetamol. Although you have not indicated the location of the lymph nodes, let me mention that in case of an infection, the lymph nodes try to limit the infection from spreading and get swollen in the process. So that is probably the case here.To keep the temperature in control, I would suggest you to sponge the child with water at room temperature. You can give him a bath too when the temperature is high. Do not wipe dry and let at least a part of the water dry directly on the skin.With the little information that I can get from your query this is all that I can say in order to guide you. Feel free to revert back in case of further queries if any.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on foot of a child?\n\nHi, may I answer your health queries right now ? Please type your query here... My daughter is 3 on the 26 of this month she s about 3 half stone and over 3 foot, she has a sore raised lump with a circle around it. I thought it might be ringworm but doesn t look like it as i ve just searched through a load of pictures on the internet. We have no animals and she has no medical history",
    "doctor_response": "Hi,from history it seems that there might be having some insect bite giving rise localized allergic reaction producing raised ring type eruption.Apply ice pack for a day or two.Give her some antihistamine like Benadryl or cetrizine for 2-3 days.If require apply triple action cream on the part.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for soreness in elbow after holding baby for too long?\n\nMy 12 month old likes to be held ALOT. For the past couple of weeks, I have had continuous elbow soreness-really up and down the inside of my left arm-but worse of course after holding baby. But it is still sore in the morning after sleeping all night. Is this something like Tennis elbow, or what? Should I just not hold the baby on that side anymore?",
    "doctor_response": "Hello, It is due to contusion. As of now you can use analgesics/anti inflammatory combination like aceclofenac/serratiopeptidase for symptomatic relief. If symptoms persists better to consult an orthopedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "After shower irritation in eyes, start to burn on rubbing, runny nose and sneezing. Allergic to water?\n\nFor the past few months i would take a shower feeling fine but for some reason my eyes would start to irritate me and i would rub them but after doing that my eye would start to burn. Along with that my nose would start to run and after getting out of the shower i would start having this sneezing fit but after a 10 - 15 minutes of being out of the shower would go away. Also this shower is at my college and i would get like this after every shower but on the weekends i go home i would use my parents showers and be absolutely fine. Do you have any ideas on what it could be? Am i allergic to the water at my college?",
    "doctor_response": "you can be allergic to pollens but even if you are allergic to anything you are increased symptomatically by exposure to water as the pollen in the area of your parents can be different sdo no effect of waterget allergy doctor advise to find the cause meanwhile can use anti allergic tabs and anti aallergic drops and ointments to contrioli",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for numbness in the arm?\n\nHello! I banged my arm pretty hard against my desk the other day, and apart from a couple of faint bruises, there is a faint numbness to my forearm. I can feel it if I pinch the area, but it feels very strange. Also, when I move it in a specific way, a sharp and brief sensation of pins and needles goes through my lower arm. Thank you!",
    "doctor_response": "Hello!Thank you for asking on HCM!Your symptoms could be related to a pinched nerve in this area. It is a temporary compression of the nerve from the trauma. I recommend holding your arm straight for some days and your symptoms will recover spontaneously. You should just try to be patient. Painkillers (ibuprofen, acetaminophen) could help in the next days. But, there is nothing to worry about!Hope to have been helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower back pain\n\nHi there, I have had some history of Acidreflux for the past 2 years. However, recently, after taking some medication, i have recovered from the problem. During this time I have developed lower back pain and am not sure if it is linked to acid reflux. The back pain is usually present when i wake up in the morning, and especially if I am sleeping on my back. I also get numbness on my lefthand and left leg at certain angles if lay on my back. The pain however goes away once i stand up and go about my daily activities. I also have a suspicion that my bowel movement is also being affected by this as my stool is now flaky and is in small chunks. Does this mean that I have injured my back or is it connected to me not fully recovering ffom acid reflux? Thanks",
    "doctor_response": "Hithank you for trusting HCMI read your query and understand your concernFirst I am sorry for the symptoms you are suffering but you have to be calm as your symptoms don't lead to any risky disease In my opinion you probably are suffering a new problem, neck relatedIt is reccomended that you schedule a neurologic exam to identify the suffering topic which as you explained seems to be cervical region As you have suffered gastritis earlier I wouldn't recommend to start pain killers as they are contraindicationed at reflux problemsYou may use miorelaxants or analgesic to avoid painDiscuss with your doctor about my opinionHope I have been of helpWish you good health and fast recovery Feel free to ask for further questions or doubtsBest regardsDr Eris RanxhaNeurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in area of epidural injection\n\nI had a doctor inject me with a epidural , due to lose of fluid in the vertibra, and he hit a nerve, what can be done.? I am in a lot of pain in the area of the injection, and my legs and feet are swelled to the point they are also in a lot of pain and it hurts to walk, but my back hurts even worse while walking or standing.",
    "doctor_response": "How many days back epidural was given?. I think you should see an orthopedics surgeon or spine surgeon and get a MRI spine done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes joints pain in the hips and ankle post a knee replacement surgery?\n\nI am a 52 year old male. I played many athletics in my younger years. I have had a partial knee replacement on my right knee 2015. In the last two years I have been having problems with my hips, shoulder and left ankle. X-rays show I have moderate arthritis in my hips. My left ankle in the last 3 months will randomly swell and act like it has a severe sprain. Exray showns I have calcium build up in my ankle and I was told this is due to prior injuries. I have sprained both ankles many times playing sports. I have two questions, 1. Are my hips , ankle, and shoulder truly different injuries or issues. My frustration with pain in all joints is making me think I should go to a rheumatologist. My primarycare doctor treats each indepently and feels I should go to a ortho doctor for ankle and hips. 2. Am I having normal joint pain for my age? Again, my pain interferes with my excercise program and energy level. I just feel like there is something I should do before it continues to get worse.",
    "doctor_response": "Hi, Consult an orthopedician and get evaluated. As a first line management, analgesics like Aceclofenac or Tramadol can be taken. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat injured numb finger with white knuckles?\n\nMy boyfriend cut his middle finger while gardening last week but didnt apply any antiseptic straight after. He applied some days later. Last nite, his fingers looked swollen and he had white knuckles. He said there was some numbness but that didnt last long.",
    "doctor_response": "I think you people should definitely meet a doctor. It sounds like that wound is getting infected. It looks like it may need some antibiotics, regular dressing with at least betadine, and of course an injection of tetanus toxoid.Please do try to go to a doctor. Dont try to diagnose and treat it yourself.Best of luckDr Mittal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is bleeding normal after multiple positive pregnancy test?\n\nI took a pregnancy test on January 4th and it came back positive I then started to bleed like my normal. I went to the doctor and they took the HCG blood levels the first one came back 79 and the second 74 I ve also looking for different pregnancy test and they ve all said I am pregnant what does this mean",
    "doctor_response": "Hallow Dear, I do empathize your confusion because of bleeding with positive pregnancy test. Any bleeding during any stage of pregnancy is considered as a risk signal unless and until proved otherwise. Your urine and blood tests have proved beyond doubt that you are pregnant. Now because there is bleeding, I would advise you to go for ultrasonography which will provide you information about:1. Whether the baby is viable or not. It takes abut a week or more for the pregnancy test to get negative even after the baby has become non-viable. Ultrasonography can give you reliable visual evidence. 2. The site from where the bleeding is coming. If it is from behind the chorionic tissue, you may have to restrict yourself to the bed and support the pregnancy by Progesterone. Folic acid may hep you. Any way, start Folic acid tablets to safeguard your pregnancy and baby. I hope this helps you. Dr. Nishikant",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for kidney infection\n\ni have a kidney infection, just started an antibiotic but also had a kidney ultra sound which shows some blockage on both sides of the kidneys. each day that goes by i hurt worse. today my body is stiff, very sore hurts to sit, stand or lay. cramping, peeing every 30 minutes, i also have a terrible headache.",
    "doctor_response": "HelloU need to tell me the exact n detailed ultrasound report n u also need to get complete urine examination",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have pain between hip and belly button, nausea. Have pain due to ovarian cysts also. Appendicitis burst?\n\nWhat does it feel like when or after your your appendicitis bursts?I am having sharp pain in my right lower side in between my hip and bellybutton. My bellybutton never hurt but I am feeling nauseous. I get ovarian sists and might be mistaking this for a sist, but the pain is different. I dont believe I have a fever but i get lightheaded like my face is getting real hot when i move to fast, only for a few seconds. I have been to the bathroom. It doesnt hurt while I am going but hurts after. Once it bursts will I feel relief or will the pain become worse? I do not no if you can get use to the pain if you get sists and are use to that pain, but I dont want to mess with this if I need to go see a doctor.",
    "doctor_response": "Hi, it seems that you already have ovarian cyst right side. You have already experienced pain due to that. Now you are having a different pain which is located between the hip bone and belly button, nausea , pain after defecation and fever like hotness of face. It is typical location of appendicular pain. Possibility of appendicitis is more in favor. your expression of pain and other symptoms does not favor perforation. Get USG abdomen to rule out appendicitis & stone in the KUB area. The differential diagnosis for your complaints is ureteric colic either due to stone got blocked or recent passage of stone. Consult appropriate dr. as per the result of USG. and get treatment accordingly Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the home remedies for vaginal bleeding?\n\nhello i have been bleeding now for over a month i am female 47 years old and my regular doctor told me that it is caused by pre-menapauseal bleeding but im a great deal of pain  in my back because of it and in the past year had to have to have blood due to this is there any thing i do from home or any non prescription medicines that will aid with this problem thank you in advance",
    "doctor_response": "**1. going by your age it should be POST menopausal bleeding and should never be treated symptomatically, but a Gynecologist Examination is necessary to determine the source of bleeding and how heavy it is. [1 month]2. At your age, standing instructions to rule out carcinoma cervix should be done along with screening for STD's [sexually transmitted disease] as compulsory routine.3. An ultrasound combined with a sample of tissue from the inside of uterus will generally identify the problem.4. Since knowing the serious concern of the pathology, don't wait for bleeding to stop or to look for any home remedy, seek a Gynecologist for further management, since treatment will depend upon cause of the bleeding.PS. what can be done at most is:. elevation of foot end.. restricted movements.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for chest pain\n\nMy 6 year old came home from school complaining of chest pains. He took a little nap, but is still complaining. He said it came on like Kapow . Now he is saying the pain is not that strong, however the left side is sore. He will not let me touch it. Should I take him to an Urgent Care",
    "doctor_response": "Hi...unless the kid is having loss of consciousness or severe breathlessness you need not worry.I suggest you give him 1 dose of Ibuprofen and observe and if not better in 1 hour, take him to the urgent care.regards - Dr Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness in a child?\n\nMy 5 year old has started saying she feels weird the best I can describe it is maybe a little dizzy it only last a seconds and she it fine other wise no other signs of anythings else this has been going on and off for a month but at first I thought she was having a headache I noticed today she has a bottom molar coming in could that be it? She has been a little whinny lately also",
    "doctor_response": "Hello.  I just read through your question.the most common reason for this symptom in this age group is mild dehydration. Usually, if fluid intake is increased, the symptom resolves. However, if the dizziness continues even after increased hydration, I recommend consulting your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for left-side back pain\n\nI have left back pain. I have had it for 3 months and getting worse. Worse when I get up in the morning or lay down at night. But lately I feel it throughout the day. At time the pain is sharp. The np I saw felt it was a muscle strain but did no testing",
    "doctor_response": "Dear patient Pain in left side felt throughout the day is most likely muscular pain. Since it is for 3 months Bony pathology also needs to be ruled out.I would like to advise xray of lumbo sacral spine anteroposterior and lateral views. please get it done from radiology centre nearby you. meanwhile start tab myoril 4 mg twice a day with tab ultracet twice a day for 5 days. If xray report is abnormal please consult orthopaedic surgeon nearby your area. Avoid forward bending and weight lifting.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the ill effects of binge drinking?\n\nHi, I ve had a blood test today which I belive is an LFT test to measure alcohol consumption. I don t drink on a daily basis, perhaps have 4-5 beers a week. However, on the odd occasion I go out (once a month, if that), I drink quite a lot (4-5 beers, 3-4 vodka/lemonades, few shots). Last time that happened was about 4 weeks ago. I last had a drink 24 hours before the test (2 glasses of wine). I ve been told the test is to show consistent heavy drinking on a daily basis, but concerned that the binge drinking might also have an effect. Can you comment? I m a 26 year old male in good health.",
    "doctor_response": "Hi. I totally agree with my colleague that prescribed this tests for you, to see how your liver is working and if thre is some damage caused by this \"drinking pattern\" of yours (binge drinking) and not to measure your alcohol consumption. Even binge drinking can be harmfull to the liver, so I'd like to discourage you to this kind of drinking wven without knowing the LFT results ( I hope they're normal).",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can weakness due to masturbation be cured?\n\nHello doctor, I am 29 years old. I had practised masturbation for the past 12 years. Initially for 4 to 5 years, I was masturbating for 2 to 3 times a week. For the last 3 years I am a bit in control (used to masturbate 1-2 times a week ). For the past 2 to 3 years I am feeling general weakness all over the body. I am having back pain and mild neck pain for the past four years. I am underweight (55 kg, height 178 cm) and have some digestive issues too (my digestive fire is less). I am about to do marriage in five months. I want to be physically prepared for the marriage and want to regain my lost health due to excessive masturbation. I request you to kindly suggest siddha medicines for improving my sexual health and digestive health.",
    "doctor_response": "Hi. Continuous involvement in masturbation leads to some loss of protein (weight loss) as well as general weakness. The body undergoes excess pitham (excess heat at eyes and also on internal organs). We need to correct these two things through the following Siddha drugs. Capsule Rathina purush- one capsule at night after food. Nannari legium - 3 grams (one spoon) morning and one spoon at night before food. Diets : Eat more drug grapes, cashew nuts, banana, fruits, pumpkin juice, pumpkin halwa, buttermilk daily. Oil bath - apply dil oil (nalla ennai) or kumari thailam or karisaalai madakku thailam or santhanaathi thailam 30 minutes before bath. After 30 mintues, take bath. Practice this daily.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for heart problems\n\nI had a stent put in 5 months ago in my lAD. I had not had previous problems just never feeling good. Went gor post stress test yesterday and found out I have abnormalities so I am scheduled for a cathurterization tomorrow and possible more stents. Picture of heart looked worse than before initial stent. I have eaten right taken mess faithfully and don t understand what happened. Any thoughts?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.  I have read your question closely, I understand your concern and will be helping you with your health related problem. Drugs don't effect every one the same day, you are undergoing cath tomorrow hopefully you will have fine results, and many things will clear up tomorrow.After that your doctor will be able to decide if your treatment should be kept same or change, I would suggest you to keep calm and hope for the best. I would suggest you to share your cath result with me it will let me help you in a better way.I hope this answered your question, If you have more queries I am happy to answer you.Regards,Dr. Muhammad Ahmad",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning sensation in the muscles?\n\n2 days ago my 6 yo daughter and I had a low grade fever. She presented with runny nose, cough, sore throat and is symptom free now,although maybe tired. I am symptom free with increased energy,no fever but have noticiable whole body muscle burning, especially in quads. I flush my body with increased daily water. I am concerned. This is distracting me from my everyday life. Any suggestions?",
    "doctor_response": "Hi there.She is experiencing flu symptoms which comprises of body and muscle pain as well. This will take 7-14 days to resolve. Give her plenty of fresh citrus fruit juices as this will help built immunity against the viral infection. She should be well hydrated with plenty of water. Avoid junk food, cold drinks. She can take Paracetamol tablet 100mg once a day for pain relief after consulting with a Paeditrician ONLY.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in the legs?\n\nWhen I go to stand up after picking something up or picking up my baby, both my legs feel like jelly and have the feeling like my legs are about to collapse beneath me and have to sit down right away. This feeling lasts about 5 to 10 mins and happens quite often in the day as I m having to pick up my baby (newborn) for any needs for her and when I m tidying up a bit. This started without cause and am going on day three with this. I haven t been picking up anything that weighs no more then 20 pounds maybe. I am 6 weeks post partum with a natural delivery. I m 25 and weigh maybe 130 pounds and 5 4.",
    "doctor_response": "Hi, Consult a neurologist and get evaluated. It may be due to neuropathic causes. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nausea, vomiting and yellow urine after gall bladder removal surgery?\n\nHi, I had surgery to remove my gallbladder about a week ago. In the past 24 hours, I've had the following symptoms develop or worsen: nausea and vomiting, itchy hands, extremely bright, almost neon, yellow urine, abdominal pain in the upper right of my stomach. Thank you for your help.",
    "doctor_response": "Hi thank you asking HCM you need to be reevaluated with abdominal ultrasound and blood work. Your symptoms are indicative of choledochal  problems like infection or lithiasis. please consult your surgeon or go to ER. DR.Klerida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with mild scoliosis, diffused degenerative disc disease with loss of signal. Alternative for surgery?\n\nDiagnosed with mild scoliosis and diffused degenerative thoracic dis disease with loss of disc signal and disc height at multiple upper, middle and lower thoracic levels @ T10-11 with mild kyphosis . Pain is debilitating. Pain feels like it s radiating into chest cavity area around breast area. Been in physical therapy , water therapy powerful meds, only temporary relief. Lately no relief. Are there any other treatments that may help which does not include surgery?",
    "doctor_response": "Hi,Thank you for posting your query.It is unfortunate that you are not better despite physical therapy and pain medications. If you have not used pregabalin or gabapentin, you can try them, as they are very effective for neuropathic pain. In some selected cases, epidural injections are helpful. You can discuss them with your doctor.Best wishes,Dr Sudhir Kumar MD DM (Neurology)Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful lump below the rib cage\n\nI have a mass just under my ribs on the right side and it feels like it is spreading it is starting to cause issues with my breathing when I try and sleep. I have had 5 surgeries since 2010. 3 of them on my spine I have a time distinguishing the pain from my back and my ribs",
    "doctor_response": "Hi,Good Morning.I am Dr.Savaskar-M.S.CVTS -super-specialist- From India-attending your health query to HCM virtual-online Clinic--I  studied your query in-depth and Understood your concerns.-In my opinion -Remedy would be-a-Consult a Surgeon-who find out the cause of it-?Gall bladder disease?Hepatitis-as mass is under right ribs and increases while sleep and presses on your breathing.-b- I would advise -CXR/USG /MRI to fix the cause of the painful lump?c-To distinguish from the back pains,trial treatment with Tb NSAID -if pain reduces-possibility of back pain ?related to spine is more.IF the pain remains still, possibility of Liver / Gall bladder/ Lungs disease-is more.-Wish you early recovery.Wellcome for any question if it worries you still.Dr.Savaskar-M.S.CVTS-super-specialist in non-curable disorders- ,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for the movable lump  on the pubic bone near penis?\n\nHave a lump or swelling like a ball moveable and on the pubic bone area near my peni and it has been there for months no am worried.haven't taken any medicine.. Secondly all over my body,I have groths like balls beneath my skin which when I press do not pain but have been there for long,I am worried bout them too.",
    "doctor_response": "Hi.All these lumps are classical of lipomas, independent fat balls. They are NOT cancerous, so nothing to worry about.One should get removed the once if :Increasing in sizeCausing painOn joins On pressure points / areasCasing disturbance to muscular actions.Problem for aesthetics/ bad appearance Otherwise you can leave them.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sharp pain in right rib cage\n\nSince end of May I have this sharp pain on my right rib cage and I have been to the doctor 4 times and the emergency room once because they thought I had a blood clot but I didn t. They did a cat scan and they said I pulled the liner from my rib cage and I want to know is the possible and how long does this take to heal. Its been almost 5 weeks and I am so tried of taking pain medicine.",
    "doctor_response": "Hello, Most probably it is due to conditions like costochondritis. As of now, you can use analgesics/anti-inflammatory combination like aceclofenac/serratiopeptidase for symptomatic relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes impression-faint hyperechoic area[28.4x23.3 mm] in left lobe of liver?\n\nhello dr. my mom aged 55 year,in past year she had a breast cancer we do all treatment like-cimo,radio thearapy in last year.1year left she has stomach pain in last week.then dr. said do the abdor.sonoghraphy the report is impression;-faint hyperechoic area[28.4x23.3 mm] noted in left lobe of liver.asked me what the causes of this or that is danger.",
    "doctor_response": "HISINCE YOUR MOTHER HAD BREAST CANCER 1 YR BACK,I WILL RECOMMEND YOU TO GET THIS LIVER MASS EVALUATED FURTHER.CT ABDOMEN WITH CONTRAST WILL MAKE PICTURE CLEAR TO US.IN THIS CASE I AM CONCERNED AS IT MAY BE METASTASIS TO LIVER.YOU CAN KEEP ME INFORMED AND I WILL TRY TO ANSWER YOUR FURTHER QUERRIESTHANKSDR PRANAY BUDKULE",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could tingling, prolonged swelling in sprained ankle despite no fracture indicate?\n\ni sprained my ankle 5 weeks ago. I try to stay off it and my job is a sitting one. I also wear a wrap to secure the ankle and help with the swelling. I originally had an xray that showed no break and I iced it and kept off the foot for a week. However, the ankle swells quite a bit each day and if I stand too long or walk to much, the swelling increases and the leg hurts. I ve also noticed a little bit of tingling in the top of the foot, along with a little pain above the heal and quite a bit of tightness from the heel to the calf. Another item I ve notice is that the leg seems to be cold to the touch. Is this normal for a sprain? I did not have an MRI but I have called by family doctor to look again at the xrays. I m not thinking that the sprain was more than a stretch of the legaments.",
    "doctor_response": "Hello, Thanks for writing to us, I have studied your case with diligence.As per your history and injury pattern there can be  tear in ankle ligament leading to pain and swelling.Instability may increase due to laxity of ligament.I will advise to do MRI ankle for soft tissue involvement.Till time you can continue use supportive splint or brace.Physiotherapy like ultrasound and TENS will help in early healing.Persistent pain after ankle injury is common and may take 6 months to heal.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Under CRF stage, a heart patient. On dialysis. Will kidney function improve by drinking cranberry, wheatgrass juice?\n\nhello sir              my father is a crf stage 5 patients and he is on dialysis last one year, so i want to know is dialysis will be stopped once started and he is also heart patient and can he drink cranberry juice and wheatgrass juice and kidney function will improve after drink cranberry juice and wheatgrass juice",
    "doctor_response": "HiThanks for the query.With the information you have provided, It is difficult to provide a definite answer to your first question, ie whether your father can come off dialysis. This really depends on how his kidneys are functioning. This can be determined by finding out his urine output in a day and also specialised tests like 44 hour creatinine clearance test. His pre-dialysis lab results will also help.The second part of the query: there is no evidence to prove that drinking any particular juice cures kidney failure. In fact drinking too much juice can increase the potassium levels in patients undergoing dialysis.Hope this helpsGood luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does stick stools indicate in infants?\n\nmy daughter is 6 weeks old. she was having sticky poop which turned to be frothy in 4-5 days. the doc got her stool examination done, PH level was 6, pus cell 6-7hpf, bacteria present (name not mentioned) and no mucus or blood cells. she was put on monocef o for 5 days. the color of poop is yellow and the frequency is 4-5 times a day. the frothiness is gone by poop is still like blown nose. she is entirely breast fed. I am also taking care of foremilk and hindmilk. please let me know wat is the severity of 6-7 HPF pus cell and is sticky poop normal",
    "doctor_response": "At six weeks this is a normal pattern in many breast fed babies and doesn't warrant any further test or change in your diet or breastfeeding pattern.If baby is gaining about 180- 200 gms per week feel relaxed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can platelets count be a symptom of blood cancer?\n\nhello, my father is suffering from ITP, he is also a patient of diabetes and taking insulin since two years. He is in hospital now but after giving steroids and IViG there is no improvement in platelets counts? some says it is the symptoms of blood cancer,is it true?",
    "doctor_response": "It is rarely a symptom of blood cancer and had your father been suffering from blood cancer it would have shown in other tests. A small % of ITP patients do not respond to steroids and IViG. These patients need to undergo a surgery for removal of their spleen (splenectomy). That cures them forever of their condition and corrects the platelet counts.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen and painful knee\n\nI had a heavy chair fall on my leg today on the inside of my knee and it looks like the blood vessel burst or something. I had an instant black and blue mark and quite a bit of swelling. It s still very tender and swollen 6 hours later. Is this something I should have looked at or is there something I can do for it at home?",
    "doctor_response": "Apply a pressure bandage & a splint on the injured knee.Go to a hospital for X ray & further treatment.You may take Paracetamol 250mg for pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could weakening of right limbs indicate, taking Riscalm, Amantrel & Parkin?\n\nsir i am taking riscalm ls at night daily 1 tablet for fast 12 years now i am using left hand more than right hand so i consulted doctor now he priscribed amantrel 100mg and parkin 2mg after taking this after 4 months now my right hand and right leg is become weak i cant move as left side so now what can i do sir",
    "doctor_response": "Hi, I have noted the clinical details. Based on this, you could be suffering from Parkinson's disease. The diagnosis can be confirmed by clinical examination in most cases. In some cases, 18F DOPA PET CT scan may be needed. After this, the correct treatment can be decided. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sudhir Kumar, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Straightened lumbar lordosis, spondylotic changes with marginal osteophytes, disc degeneration and bulge. What does it mean?\n\nMr findings straightened lumbar lordosis spondylotic changes with tiny marginal osteophytes of opposing G VEPS raduced bright T2 signal of L4/5 disc denoting its degeneration L4/5 posterior disc bulge with left posterolateral protrusion effacing the ventral epidural fat and encroaches upon both exit foramina, more on the left L3/4 and L4/5 apophyseal joints effusion",
    "doctor_response": "Hello Thanks for writing to usAccording to report,you have degenerative disc disease of lumbar spine.Degenerative changes occurs in spine due to aging and development of weakness in annulus fibrosis.1.There is straightening of lumbar lordosis,it may be due to muscle spasm.2.There are spondylotic changes in lumbar spine with formation of tiny marginal osteophytes.Osteophytes are formed due to chronic stress on annulus fibrosis.2.At L4- 5 level,there is  posterior disc bulge with left posterolateral herniation and it is effacing the ventral epidural fat and encroaches upon both lateral neural foramen, more on the left side.3.There is also apophyseal joints effusion at L3/4 and L4/5 level.Majority of the cases of degenerative spine disease are benefited by physiotherapy,so physiotherapy should be tried first.Surgery should be the last option. There are also medicines like capsule pregabalin available for pain relief. Treatment can be planned after consultation with neurosurgeon.Get well soon. Take Care Dr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take Oxetol during pregnancy?\n\nNamaste sir my wife taking oxotol300 since 3years oxotol300 taking throw out the pregnancy and she had a18 month boy the boy still not walking due to left leg abnormal groth we done all vaccination at time is birth difect done due to intake of oxotol 300 in pregnancy? Please help our neurologist says no problem to take oxotol duering pregnancy please help my wife again pregnant and also taking oxotol300",
    "doctor_response": "Hi, Oxcarbazepine is considered safe during pregnancy to treat seizures. It is not related to fetal malformations. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Olgeta Xhufka, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why having wrist pain when bending it forward?\n\nWithin the last hour or so, I discovered that my left wrist aches when I bend it forward. Normally I d be able to pop it, but this is a different feeling that I can t help so easily. There s no swelling. I may have just been leaning on it for too long without realizing it, but I m not sure.",
    "doctor_response": "Hi, As of now you can use analgesics/anti inflammatory combination like Aceclofenac/Seratiopeptdase for symptomatic relief. If symptoms persists better to consult an orthopaedician and plan for an MRI scan. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should i do for my on and off sickness and stomach, back pain?\n\ni have been ill on and of for a year now lower back pain bad lower stomach cant move my bowls and fells like thers a heart beat in my stomach i am lucky if i open my bowls twice a week but only little and the pain is getting worst i have lost a lot of wheight but now very bloted",
    "doctor_response": "Hi there,I had gone through your query and understand your concern.Mutiple problems like Low back pain,bowel disturbances with losing weight are usualy related to Stress in your lifestyle.Pain in the stomach may be related stomach ulcers but losing weight rapidly need to be evaluated with a complete examination .I suggest to consult a Internal Medicine specilaist or General Physician at the earliest",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in arms and head?\n\nIm 39 yrs old, I smoke,6 1 , 180 lbs...once this happened, I dont have enough sleep, ate too much rice or stresses,I feel some pain in my nape ,numbness on my 2 arms and head .Today, I ate a salty food and feeling same things. Are this signs of hypertension ?",
    "doctor_response": "Hello,General heaviness in head and mild tingling sensations in arm after improper sleep is very common. These are signs of inadequate rest to body. But if all these occurred again and again and without any reasons then this may be due to high blood pressure. There are easy methods to check blood pressure. You may order by online for blood pressure checking machines or you may consult to your family doctor to check blood pressure.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mukesh Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is my son having continuous chest congestion?\n\nHello doctor, My son is 5 years old. He is dealing with continuous chest congestion and coughing with change in season. Doctor suggested Foracort 100 for two to three months with two shots in the morning and two at night after using nebulization Levolin 1.25 mg and Budecort 1 mg in the past for chest congestion. Will it affect his immunity? He eats healthy food with no junk at all, but still gets cough and congestion so frequently. Please suggest some medicine. Is it due to pollution? Or as he grow, will the things be better for him?",
    "doctor_response": "Hi. Revert back after the tests to an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stroke like symptoms in neck and throat area. Have heart problems, taking medication. Cause of neck and chin pain?\n\nyes, my mom has heart disesa and has several medications to control Bp blood thinner slurred speech for 3 days then it goes and goes away for a few days andcomes backtc.... in the past six months she has been to the er 3 x with stokr like symptoms in the neck and throat area  all tests shoe it is not a result of cardiac issue,  can there be a side affect of medication that may cause her to have symptoms of neck and chin pain slurring of the mouth and",
    "doctor_response": "HI Thank fro choosing HCM, NO it is not the side effect of drug, but this might be brain problem, either the insufficiency of blood supply in certain area of brain, we call it \"ischaemic\"  and this is the thing happens with the patient having uncontrolled Hypertension  with poor compliance, now you need to take her for MRI study of brain, and have opinion from Neurophysician, Have nice Day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a red, hard and painful lump on the right buttock?\n\nHi,I am a science girl, but for once I can t find the answer. I ve read others peoples similar problem but I can t find an accurate and we ll accustomed answer. On my right butt cheek right by the crack and inch below the start of my crack is a very painful lump that s red, hard, and rather swollen with shiny white blood mixed fluids. I have no idea how to ease the pain, and what it really is. I can t get to the doctors for awhile. Is there home remedies? And what is this lump? It would really help.",
    "doctor_response": "Respected Science girl  HiI evaluated your query thoroughly .* Till your narration it is most probably peri-anal abscess likely, though require   confirmation by physical examination .* Need surgical evaluation as soon as possible till that time you can- manage to have soft stools with high fiber diet, plenty of liquids  as hard   stools will increase  the agony- Sitz bath ( sitting in a tub filled with lukewarm water for 10-10 minutes   morning , evening & specially after passing stools ) help a lot- avoid sitting on hard surface for prolong period of times  - Local application of Xylocaine (5%) jelly give soothing action- refrain from any anal sex activities ( if involved ) - avoid smoking / alcohol if consuming - Systemic antibiotics & anti-inflammatory agents fasten the recovery as   prescribed after in person evaluations- avoid oily / spicy / non vegetarian stuffs - take analgesic tablets 3 times a day after meals for pain controlHope this helps you .Welcome for any further assistance .Thanks for using Healthcaremagic.com & giving me an opportunity to assistWishing you fine recovery from the same.Regards dear take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pressure on my chest and breathing problem?\n\nI have severe anxiety and panic attacks with longstanding depression. Xanax helps but cannot get a physician to prescribe dosage strong enough that I feel is beneficial to me. I am not looking to get high I am just looking forward to be able to have a more normal life. I have panic attacks that make me feel as like I have PRESSURE ON MY CHEST AND CANNOT BREATHE . I have tremors that are noticeable .by other people which make me feel more anxious. I am in a horrible cycle and I feel as though doctors think I just want more Xanax. It helps me tremendously by decreasing the intensity of the attacks . Please any sugestions? Severely Nervous and sleepless in New York.",
    "doctor_response": "Hi..i think a good psychiatrist can solve your problem..either your dose needs to be increased or some other medicine can be added...bt psychiatrist can tell you better than me..but definitely you can live a normal life through it..dont worry..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain under rib cage with bloated and hard stomach\n\nI am having horrible pain that is mostly on the right side under my rib cage.My stomach cant get any bigger or harder.Pressure like someone is pushing my ribs up,and pain from time to time radiates all around my rib cage.....Lately noticed I am a full blown narcoleptic....Please help.......Milena B.",
    "doctor_response": "Hi Milena ! Good evening. I am Dr Shareef answering your query. Even though it needs clinical assessment for a diagnosis, from your history, it seems that you have inflammation/calculi in your gall bladder/biliary system giving rise to such intermittent severe pain. If I were your doctor, I would advise you to avoid fatty/oily food which would precipitate the pain more due to contraction of the gall bladder to empty bile into the intestines.  I would advise you a bland diet, some routine investigations like a CBC, a blood sugar, liver function test, a serum amylase and lipase to rule out associated panreatitis, and an ultrasound abdomen to see the status of the biliary tree including the gall bladder to exclude a stone causing cholecystitis and also to know the status of the pancreas. Further management would depend on the result of clinical examination and reports of the related investigations. Till then you could go for an anti spasmodic along with a proton pump inhibitor for a symptomatic relief.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Unprotected sex, ejaculated inside vagina. Taken plan b, spotting, blood clots in urine. Normal side effect of plan b?\n\nHello, a friend of mine is having a freak out because yesterday, her boyfriend ejaculated inside her, and they were not using proper protection. She took Plan B and is experiencing spotting and clotting in her urine . Is this a normal side effect of Plan B? Also, how long does it take for Plan B to work, what are signs that it is working?",
    "doctor_response": "Hi, Thanks for the query. The spotting she is having could be due to post-coital tear or could be a side effect of the emergency pill, as that can cause menstrual irregularities. The plan B to be taken within 72 hours of the act. Earlier you took the pill, the possibility of protection will be more. Experiencing symptoms like bloating sensation of the abdomen, breast tenderness etc can indicate the effectiveness. But exact evidence is absence of pregnancy and resuming normal menstrual flow. For more details: Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat elevated st waves?\n\nMy 24 year old son has elevated st waves and at resting pulse of between 45and 52.  Doctor said this is a normal variant for him and doesn't need any further investigation.  Should we get another opinion and if this is repolorization can this be corrected or is possible it will self correct.",
    "doctor_response": "Hello. Thank you for your question and welcome to HCM. I understand your concern. This ST elevation, found particularely in young people, w\u0131th an upper slope deflection, is called early repolarization or accelerated repolarization. No harm comes from that, it ,s a variant of normal. This can be easily mistaken by some doctors as acute myochardial ischemia, but I, as your doctor, would tell you that there is nothing to worry about. As for the hert rate, it is considered normal from 60 - 100 beats per minute. However, in young people, highly trained athletes and vigorous physically active people, it is accepted down to 48 per minutes, referred on most studies. So, this is another thing you should now worry about. Should frequencies lower than 40 beats per minute occur, consult your cardiologist. I hope I was helpful. Wish him a good health. Kind regards, Dr. Meriton",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurrent dizziness, loss of vision and syncope?\n\nI have experienced several episodes of lightheadedness, with a crashing waves sound in my head, temporary loss of vision, and syncope. The whooshing sound changes or pauses if I turn my head either way. Episodes last about 20 minutes and gradually return to normal",
    "doctor_response": "Hello!My name is Dr. Aida and I am glad to attend you on Healthcaremagic!Your symptoms could be related to different possible causes: a inner ear disorder, orthostatic hypotension or low blood pressure or seizures. The fact that these episodes are modulated by head movements is very suggestive for an inner ear disorder. For this reason, I would recommend consulting first with an ENT specialist for a physical exam and performing labyrinthine tests. A Head Up tilt test for orthostatic hypotension and an EEG for seizures, would be the next step, in case an inner ear disorder is excluded. You should discuss with your doctor on the above tests. Hope you will find this answer helpful!Best wishes!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sleeplessness in infants?\n\nMy newborn son is a week old today. He usually doesn t sleep much but tonight all of a sudden he seems to be really out of it. He seems to be breathing fine and pulse is normal but we can t wake him up. He will open up his eyes occasionally but that s about it.",
    "doctor_response": "Hi,Thanks and welcome to healthcare magic.Most of the babies suffer from colicky pain during first three months of life.This physiological and clears after 3 months of age.This is because the peristaltic movement of the gut is felt by the baby.Colimex-DF drops 5 drops 3-4 times daily will give relief.Hope this reply is OK for you.Please feel free to ask further queries if any.Dr.M.V.Subrahmanyam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does tiazac contain sulfa?\n\ndoes the drug tiazac contain sulfa as i have recently started taking this medication and have developed a systemic bumpy skin rash.  I am a fifty year old woman being treated for hypertension.  I am 140 pounds and am 5 foot 6.  I am allergic to sulfa.  I also take diovan.  I take no other medications.  Thank you",
    "doctor_response": "Hello, Tiazac is a popular brand of cardiac drug \u201cdilitiazem\u201d. It does not belong to sulpha group and you can safely take tiazac without worrying about allergies. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing back pain on the right side of my back\n\nback pain on right side of back in kidney area, age 78, COPD, on oxygen ,3 back surgeries 15 years ago, had staff infection from surgery. on IV for 6months. Saw doctor last Thursday for a follow up after blood draws and general check up. On aricept .",
    "doctor_response": "U might suffer from spondylosis or spondylolisthesis or spondylolysis. Better take one dynamic flexion-extension view of LS spine. U got multiple comorbidities. Better to get treated conservatively",
    "dialogue_context": ""
  },
  {
    "patient_message": "Gap between the teeth after getting treated for periodontitis. Lost gum tissue during surgery. Food getting stuck in the gums. Remedy?\n\ni got treatment for periodontisis.now i feel i am free of swelling , redness, bleeding of gums. but i lost gum tissue which was removed during surgery. now d problems was in b/w tooth at upper region i have gaps. every time wen i am eating food particles are placed within those gaps n one more thing is i found yellowness and plaque formation at that location. wt my present condition is?",
    "doctor_response": "Hello Welcome to HCM I would like to inform you that Periodontitis is an inflammation of the periodontium, i.e., the tissues that support the teeth.You might have gone through scaling & root planing that ivolves removal of plaque & calculus resulting in empty space & loosening of teeth.Its quiet natural after scaling.Need not worry, just start with gum massage with some gum paint like Rexidine-M gel for 15 mins,2 times a day.Also start using 0.2% chlorhexidine mouthwash 10ml half an hour after brushing once daily. All this will definitely help you out.Still if your problem persist than talk to your dentist about periodontal flap surgery. Its also good option in severe cases. Also maintain proper oral hygiene by regular brushing & interdental flossing for cleaning that gap. Take Care Regards Dr.Neha",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever with crying?\n\nMy boy is 11 day old. Doctor suggested merotec 125mg, mextra, vomnu, coscoril for rashes, heart beat and cold. After taking 3 dose , baby is suffering from fever and crying for last 10 hr. When mother is providing feed then he is not crying else crying. How long mother can provide milk to baby and what could be the reason of cry?",
    "doctor_response": "Hi...I feel that you kid has to be evaluated further as any kid less than 3 months old with fever should not be prescribed antibiotics without proper blood test and blood culture. I do not recommend giving so many medicines for such an young infant of 11 days. The crying could be due to nasal block or also could be due to irritability due to an infection in the brain. I suggest that you take him to an institution set up where his fever needs to be evaluated.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bleeding & spotting during pregnancy?\n\nI have taken a pregnancy test 5 days ago said I was positive I did not have my period for the whole month of feb. now I have been experience some bleeding/spotting I have had two ceaserons I think pregnant about 1 month and got sent home from work to rest I am 29yrs old and it has only been happening when I urinate so far",
    "doctor_response": "hallow Dear,Any amount of bleeding during any stage of pregnancy should not be taken lightly. It may indicate unwanted conditions like abortion, ectopic pregnancy, etc.; or may be even just a false alarm. Ultrasonography will inform you whether there is any risk to the baby or pregnancy resulting in bleeding. Please report to your Obstetrician ASAP. Till that please take complete bed rest. Probably, if the baby's heart beats are seen, you may be put on some Progesterone preparation which helps to stabilize the pregnancy. I hope this helps you. Dr. Nishikant",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for redness and swelling in legs\n\nMy mother takes 9+ medications ! stresses too much doesnt exercise doesnt eat healty,and bruses extremely easy. 10 years ago she had 4 stenses placed on her heart valves . About 2 months ago she started developing a realy bad redness on her legs from the knee down with some swelling. These are the names of her meds Diovan 80 mg. Zelozoc 50mg. Crestor 20 mg. Aspirina 100 Cimbalta 60 mg. Pantoplazal. Plavix. 75 mg. Dimeticoma. Allegra",
    "doctor_response": "Hello, I have studied your case.Your symptoms suggest possibility of Deep vein thrombosis.Ultrasonography/colour Doppler leg will help to rule pathology leading to pain and swelling like deep vein thrombosis. I will advise you to do MRI spine if Doppler is normal. We can see for any nerve compression leading to pain behind knee.Clinical examination and further investigation can be performed after consulting your doctor.If required you may need to do blood investigation for prognosis and recovery.I will advise to check your vit B12 and vit D3 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will I get a permanent tooth after losing baby tooth at the age of 19 ?\n\nIm a 19 year old female and just lost my last baby tooth will my permanent tooth still come in Mom said it may not, and I m kind of freaking out.",
    "doctor_response": "Hello and welcome to hcm, Its not clear that which tooth you lost recently and how many permanent teeth got erupted. Usually your permanent successor may be erupted already. The retained milk teeth has lost now. Please do get a check-up with your dentist. If any of your permanent teeth has not erupted,an x-ray will help to find out the condition of tooth. Treatment can be planned based on this. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had copper T implant removed and started Ovral L contraceptive tablets. What is the dosage of the pills?\n\nDear Doctor,I am 29 years old, married with a 5 year old boy. After my first delivery on November 2008, I had copper t inserted. I removed this implant on September 2013. (My periods have always been regular). I started taking Ovral L (21days) contraceptive tablets for the first time from 01/11/2013. (My last period was from 25/10/2013 to 31/10/2013). and completed the 21 day course on 21/11/2013. My period starts today (26/11/2013). Generally, I have a shorter cycle. I have 2 questions and doubts in this regard,1. When do I start the next course of Ovral L.2. I am leaving on a trip, without my husband on 09/12/2013 and will be back on 03/01/2014. I don't have sex during periods. My expect my period to end on 02/12/2013. (my period usually lasts for 7 days). DO I need to take pills during this period?Kindly advise.Thanking you!",
    "doctor_response": "Hello madam, ovral -l is a low dose oral contraceptive pill.....you can start the pill within the first five days of your menustral cycle that is from day 1 to day 5 .....you need not take the pill during your trip as you are travelling nearly a month without your partner...But remember once you return back you need to start your pill within first five days of your menustral cycle...hope i was helpful to you.....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could tumor in kidney with fluid around spleen and thickening of fat cell suggest cancer?\n\nkidney cancer my dad has a tumor in his kidney and fluid around his spleen and thickenning of the fat cell. we are waiting on results from petscan. doc told us he most likely has kidney cancer. but lately he has been weak, nauseated, taking 4 naps a day, had a fever, and has pain in his right side. to me that all indicates something additional bc the symptoms are more than what kidney cancer says. what are those symptoms sometimes to?",
    "doctor_response": "helloThanks for query .Based on the Ultrasound Scan findings that you have posted I would state that your father has Cancer of kidney which has penetrated through capsule of the kidney and infiltrated in to perinephric fat   with reactionary fluid being formed around spleen .The other symptoms like fever, pain in Rt side of abdomen ,weakness etc are due to generalized debility associated with  cancer of kidney and do occur like with cancer of any organ .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower back pain and pain during ejaculation\n\nI have been experiencing lower back pain for the past cople of years, mostly it is not too bad but recently it flared up and I was practically unable to move, my GP prescribed me diclofenac and that helped to get me on the go again but the pain remains almost constantly and radiates to my groin. I believe in my heart that its a back problem but I also experience pain during ejaculation. I have been to see specialists about this and they gave me the all clear as far as my prostate goes but suggested there was nothing they could do about the pain. Nobaody seems to be able to give me a defintive answer, can anyone help?",
    "doctor_response": "Cannot say in your particular case AND...that is not a usual case for a pinched nerve in the back. Look at yourself sideways in the mirror.... see where the lower back curves? That bendy area has strains and that's wherre all the pinched nerves and popped disks occur. The area supplying the groin is much lower down. Urine cultures can be specifically targetted to look for prostate infection BUT if the prostate exam and bloodwork were ok... it isn't infected.Congenital funny bone shapes (SPINA BIFIDA) can cause problems in lower spine and give those sort of symptoms; Xrays and MRI's can look at it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain\n\nhaii sir,,im 25 year old,havinga height of 174 cm and weight of 64 kg have a back pain caused while working in gymnasium.it was a m ild pain iniatially and occured 5 years back.Gradually it increased and radiating pain occured to my left thigh and to left hip.reports show its due to buldging of disc L5-S1 and affecting sciatic nerve.i have under gone so many treatments.but not been cured yet.doctors suggested surjery ,even they are not confident.pls tell a suggestion other than surgery and side effects of surjery.Waiting for your keen reply",
    "doctor_response": "Hello. Thanks for writing to us. The pain while exercising I likely to be a muscular pain. You need good muscle relaxants, rest and a hot fomentation in the area of pain. Physiotherapy will also help. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal . For future query, you can directly approach me through my profile URL  drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lightheadedness?\n\nI have been feeling light headed today and when bending over to tee a golf ball, nearly passed out within 5-10 seconds. It would take me 20-30 seconds to recover. BP 123/68 pulse 80 and oxygen level at 98. What could the problem be. Currently on Qsymia 7.5 mg per day and blood pressure meds. 50 yr old male. Non smoker non drinker.",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. It could be postural hypotension or dehydration.2. Get your blood pressure evaluated with change in posture. If its normal, take good amount of water.3. Blood pressure and oxygen levels are good. Possible dehydration. Take good amount of fluids. Continue with your healthy routine.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for heart palpitations\n\nAround the 6th of Dec I started getting sick with broncitis or walking pnuemonia.  My doctor gave me prescriptions for an antibiotic, congestion and inhaler.  The inhaler was ventolin.  Right before I started these I was having heart palpatations.  Got worse and looked up side affects and the ventolin contained albuterol which can cause the palpatations.  I stopped using it and I am still having them.  Went back to doctor, did an EKG which was fine and she said my lungs and heart sounded perfectly fine.  I have cut alot of caffine and nicotin out and they still continue.  Some days I dont have them at all and then some days, like today they are driving me crazy.  Any suggestions?",
    "doctor_response": "Despite eliminating some of the obvious factors for these palpitations, i would suggest to have a Holter monitor or preferrably loop recorder on the go to ascertain the exact nature of these palpitations. Further workup may be warranted if any suspicious rhythm recorded.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe knee pain\n\nhi um 23 years old , female... recently i have been experiencing a very bad pain in my knees ( like inside the bone on the sides and in the back of the knee) i ran a test for my ESR and it was 49 in the first hour and 74 in the second ... what should i do , b coz um really scared and in pain ( i go to work so i have to be healthy) n.b: i have a history of rheumatoid fever. thank u very much",
    "doctor_response": "Hi,Thanks  for  your query.There are numerous causes and conditions that produce pain in the knee joint. One of the commonest conditions that affects your age people is Patello-femoral arthritis (wear & tear in the cartilage of the kneecap & thigh bone)A detailed clinical examination & a few investigations are needed to establish a correct diagnosis of your problem.The general recommendations for Anterior knee pain are as follows -- Avoid any activities that increase the pain such as climbing stairs and deep knee bending movements.- Use over-the-counter pain relievers such as acetaminophen, ibuprofen as & when needed- Weight loss alone will often fix the problem if you are substantially overweight.- Specific exercises can strengthen the muscles that support your knees and control limb alignment, such as your quadriceps, hamstrings and the muscles around your hips.I suggest you to consult an orthopedic surgeon for further management.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for swollen and paining left leg in brain cancer patient?\n\nHi my daughter is 24 and has brain cancer, her left leg is swollen and she has leg pain, I called the on call doctor and they indicated we could probably wait til morning to take her to the ER, I think she may have a blood clot but. I am not sure? Do I wake her up and take her now?",
    "doctor_response": "Her symptoms are very much suggestive of deep vein thrombosis or blood clot. It would be better to seek medical attention at the earliest. DVT are common in brain cancer patients especially if they are bedridden.the clot can be confirmed by Doppler and injections and tablets can lyse the clot",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do you suggest for veneers on my upper front teeth?\n\nI have veneers on my upper front teeth. There was a crack in the back of one. The dentist drilled out the back a little and bonded the back of the tooth. The dentist said it would be sensitive for a couple days. It's been months now and anytime I eat something hard or hot it will swell up and get sore again. There is a oval red circle that looks like it has a hole in the middle directly behind my two front teeth. I got the dentist to check it but they said just put a calming gel on it and eat on the side of my mouth. Should I be concerned that it's been months now and it never goes away or just have to be careful of the area for all time? The bump was not there before the procedure.",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,     I have gone through your query,  as you have undergone veneering in tooth now you have swelling of gingivae in that area , dont worry prosthesis has causing irritation in your gums now ,     Do warm saline gargle two - three times a day    Wait for sometime apply ointment Gum paint twice daily   If wont get relief then consult your dentist and go for removal of prosthesis and go for new prosthesisHope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes penis bleeding?\n\nI am a 20 year old just crashed with my bike and got hit in my testicles and now I can see the above part just under the penis was bleeding just a little bit. It now isn't bleeding anymore and I don't have much pain in my testicles. I wondered is this some major problem that it started bleeding? does this cause sterility?",
    "doctor_response": "Hello Thank you for trusting HCM Dear bleeding means where is it from skin?? Or from urethra??? Have you observed any swelling?? Any bruising?? Nothing to worry about your fertility first get examined for urethra injuries or blunt trauma injuries. Please consult your doctor he will examine and treat accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can SVT reoccur if i take magic mushrooms?\n\nhi i currently got a SVT ...with my heart pumping 200 - 210 BPM for atleast 1 1/2 straight...after 5 hours in the hospital they said this might of been caused by Illegal Drug Use, Caffeine, etc....I do use drugs sometimes for example MDMA and Marijuana. I currently wanted to take magic mushrooms before this occurred... If i were to take mushrooms can the SVT occur to me again?",
    "doctor_response": "Hi ThereMDMA, Marijuana, Magic Mushroom all these substances can trigger any Cardiac arrhythmia which could later prove to be fatal also.So its not at all advisable to consume any of these substances due to their potential toxic effects.Yes Magic Mushroom contain some psychotropic substances which can trigger SVT or other life threatening arrhythmia.I wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes respiratory acidosis?\n\nmy father had a severe swelling all over his body and collapsed one day.He was with no respiration, no heart beat for few minutes Luckily we were in the hospital one day and he could get a ventilator immediately. He was on ventilator for 7 days in i.c.u. The reason was respiratory acidosis. I want to know the reasons and the precautions we should take to avoid such condition in future.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Respiratory acidosis within swelling all over the body are commonly seen with Cor puomonale.Cor puomonale is right sided heart failure due to pulmonary diseases (most commonly COPD).So if he is smoker then smoking should be stopped immediately. Give him medications and inhalers regularly. Fluid restriction should be done (less than 1.5 liters per day). Salt restricted diet should be followed.Get done adult respiratory vaccines like influenza and pneumococcal. Do regular follow ups with your doctor about his health.Hope I have solved your query. I will be happy to help you further. Wishing good health to your father. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dark spots on the chest and stomach?\n\nMy daughter is 20 months old. She is Irish, Scottish, Trinidadian, Jamacian, and Japanese. She is a light brown, but she has dark brown spots all over her stomach and chest. What could this be? They don t seem to bother her, should I take her to a doctor?",
    "doctor_response": "Hello dear!A picture of the spots would help m a little more in diagnosing the condition.To me,it seems like cafe au lait spots.In about 50% patients they are idiopathic but in other 50% they can be a sign of neurofibromatosis type 1.I would recommend to get her checked by a pediatrician as soon as possible.Hope it will help.Wishing yourchild good health :-)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower right abdominal pain, swelling. Elevated liver enzymes. Total hysterectomy done. Treatment?\n\nMy best friend has lower right abdominal pain . She has had a total hysterectomy . You can visually see that her lower right abdomen is swollen and gets bigger and hurts more by the end of day. She went to local ER friday and they said CAT scan was normal, blood work was normal with the exception of her liver enzymes being slightly elevated. She has had continued pain all weekend and this morning she started complaining about pain in her tailbone. It hurts so bad she can barely sit and it hurts when she stands. She doesn t have a regular family physician. She always went to OB/GYN for everything lol She had a partial hysterectomy and was left with one ovary until it caused problems and was removed this past November. Should I take her back to the ER and see what other tests or should we wait and just try to get her in to see a family physician? Thank you",
    "doctor_response": "Hello! According to your friends surgery history there is a probability of post-surgery adhesions. Especially she have had two of it.  Adhesions may cause partial intestines obstruction (called subileus) which can reveal with intermittent abdominal pain. If your friend has also constipations, diarrheas or both associated with abdominal pain and  flatulences, nausea and this symptoms may come and go, subileus is very probable. Lower right abdominal pain is also characteristic for appendicitis (what has to be always ruled out!), right urinary tract infections/stones. Backbone diseases can also show up with symptoms mentioned by you but (backbone MRI may be required if all abdominal diseases are ruled out). To rule out intestines obstruction abdomen X-ray is necessary (abdomen CT might not visualize it). Blood tests needs to be repeated as white blood count and CRP may elevate after few days of disease appearance. This tests may be negative on the beginning of pathologic process. Urine tests should be done as well. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stoppage in periods?\n\nHi, may I answer your health queries right now ? Please type your query here... \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0hey im 19 i have been having unprotected sex my period hasnt come in one mounth and 22 days i took a test but it was negative i have no signs that in pregnent but i do get mild cramps could i be",
    "doctor_response": "Hi,  if your periods are delayed and urine test is negative, then it is just a missed period.  It can be due to absence of ovulation. You can simply wait for the onset of periods or induce the periods with Tab Regestrone 5 mg twice a day for 5 days.  I hope this answer helps you. Please thank me, if it helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the treatments available for chickenpox in an adult?\n\nHi doctor, What are the treatments available for chickenpox in an adult and secondary bacterial infection of the skin due to chicken pox?",
    "doctor_response": "Hi. Treatment for chickenpox in adults is tablet Acyclovir 800 mg five times a day for seven days. For secondary bacterial infection, you can apply Soframycin (Framycetin) ointment over the skin lesions three times a day for one week. You can also take some antihistaminics like tablet Allegra 120 mg (Fexofenadine) once daily to prevent pruritus. Hope it helps. Consult a general medicine physician online to know more about chickenpox -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hearing of voices and images in mind?\n\nI am 16, my father has a history of schizophrenia. Im hearing voices and seeing images in my mind. I don't sleep at night. My mood will be perfectly calm one second and the next ill be depressed.  When im alone the voices speak aloud to me and cause me physical harm. My mother doesn't believe that this is happening to me. I don't know what to do. Im afraid for mself. This is my last resort to find help, otherwise I fear I will have to live with this not knowing what could possibly happen.",
    "doctor_response": "Dear User,Thanks for using health care magic.From the available description and family history it appears to me that it is beginning of schizophrenia. Most of the schizophrenia problem start during adolescence. You need to seek help from a doctor and need to convince your mother for a consultation. Tell her that this causing lot of problem for you and meet a doctor. I hope your doctor will do the necessary counselling so your mother understands the problem.'Hope I have answered your query. If you have any further questions I will be happy to help\".Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Co2 laser surgery cure penile papules?\n\nHi, my name is Jordan & I have pearly penile papules on the underside of my shaft.  They've pretty much ruined my life.  On ABC there is a show called \"The Doctors\" and they removed a man's ppp by co2 laser resurfacing surgery.  Can co2 laser surgery be the light at the end of my tunnel?",
    "doctor_response": "Hello Thank you for trusting HCM Pearly penile papules are acral angiofibromas,  that can appear in up to 38 percent of men during the second to third decades. Despite reassurance of their benign and noninfectious nature, PPPs can be a source of significant psychological distress to the patient and his sexual partner. Their appearance may be easily mistaken for a sexually transmitted disease, such as genital warts.Although several therapeutic options have been documented, anecdotal reports tout the nonfractionated CO2 laser as the most effective treatment strategy.dyspigmentation, erosions, ulcerations, and scarring did not occur with it. Cure percentage up to 90%..Please consult your doctor he will examine and treat you accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chest pain, diarrhea, fatigue, depression, menstrual problem, short temper. On Paxil and clonazepam for anxiety disorder. Help\n\nI have been sick for years. Seen docs, lots of tests, now I was sent to a shrink. Put on Paxil and clonazepam for anxiety disorder. Symptoms are constant left side cest pain heaviness or numbness of left extremities constant diarrhea horrible snoring causing sore throats extreme exhaustion weight gain depression daily headaches blurry vision feAr of leaving the house crying a lot menstrual problems short temper isolation slow heart rhythm or fast heart rhythm usually slow and constant sweating. Help me please I can't live this way",
    "doctor_response": "DearWe understand your concerns.You are diagnosed with anxiety disorder and you slipping into depressive disorder now.Be very careful and informed.Time and again it has been proven that medication alone cannot cure depression and anxiety.You need yoga, medittion and psychotherapy.Yoga and meditation helps in streamlining body metboliusm and thinking process.Psychotherapy help you streamline life style.Consult a psychologist and  yoga therpist for further advice.Wish you speedy rec overy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart racing, spasm sensation and elevated BP when falling asleep?\n\nWhen just falling off to sleep, my heart starts racing and pounding, spasm sensation to right of sternum.Arms, hands, legs and feet are hot, BP feels elevated. Left side of head, face feels numb and hot,Arms look redder. Just can't cross over to sleep without this happening.",
    "doctor_response": "Hello. Thank you for your question and welcome to HCM. I understand your concern. Most of the people sense the heart beat as normal and understand this and accept it as a normal, physiological phenomenon. Some people, like yourself, sense this as a pathological phenomenon. I understand that. Every minimal change in perceived \"physiological\" or normal functioning, is interpreted like pathological things. This is a cause for anxiety or fear (situational anxiety) in these people and may or may not be followed with a panic attack due to one questioning him/herself \"am I going to die?\" \"what is wrong with me?\" etc. Every time we assume a lying down position, our heart, that beats by vibrating our chest wall, comes closer to a certain area of the ribcage. If lying on the left side it is so close to the chest wall that can even vibrate the bed you are lying on. All the other symptoms you mentioned are triggered by the anxiety attack you have, because all types of anxieties have one thing in common: flush of adrenalin and noradrenalin in the system, which then produce the symptoms you perceive. Every thing you feel is real, but it is not pathological. Therefore, if the heart rate is regular, every symptom is attributed to the anxiety, which I depicted above. If this is the case, then there is nothing to worry about. But, if this phenomenon affects your quality of sleep, by reducing its hours, then I would recommend a consult with a psychiatrist about the possibility of being put on a trial with sedatives for one to two weeks. I hope I was helpful with my answer. Take care. Kind regards, Dr. Meriton",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best birth control pill to take? I am will be starting birth control soon and am wondering from personal experience what is the best birth control pill to take? I have heard there are issues with women gaining weight or breaking out while on birth control and I don't want these issues. Are there any birth control pills that you can recommend that wouldn't cause one to break out or gain weight? Or any that are non to help a person lose weight? Thanks in advance.",
    "doctor_response": "Hallow Dear,There are varied types of birth control pills. Some contain low progesterone and high oestrogen, some are balanced while others are low oestrogen and progesterone dominant pills. I do not want to bother you with the continuous and sequential and such types of pills. Generally, the women who are having oestrogen dominance should take progesterone dominant pills, those with Progesterone dominance should prefer Oestrogen dominant pills while the balanced women may take any type of pills. Oestrogen dominant girls are usually short statured, having gorgeous breasts and their menses are heavier; while Progesterone dominant girls are taller with smaller breasts and have lighter menstrual cycles. You can decide about your hormonal balance and accordingly choose the pills. Any pills you take, they do increase weight due to water retention. Also there is some fat deposition as these hormones are cholesterol based. With restriction on salt and dietary fat intake, you can control the weight gain. Break through bleeding usually is more common in Progesterone dominant pills; however, any pills may cause it. It is not an issue and can be controlled just by taking an additional pill. I feel you should have little more positive view towards birth control pills. The pills do get adjusted to the body eventually. I hope this helps you. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is Mometasone dangerous to use on Face to clear my acne pimples?\n\nHello doctor, I am seriously facing acne pimples problem. Sometimes they occur on my face when I masturbate. If I use Mometasone, it gives a good result. Is it okay to continue this?",
    "doctor_response": "Hello. Acne is a universal issue in the age group of 15 to 25 years due to hormonal changes in adolescents. However, there are multiple effective treatment options depending on the grade and severity of the problem. Mometasone is a topical steroid and is to be avoided strictly on the face and for acne as it can harm your skin in the long run. Acne is dependent on hormones hence excess masturbation may sometimes lead to an increase in the problem. I would advise you to stop Mometasone immediately and kindly upload appropriate images to help us assess your current grade of acne and treat you better. Regards. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling numbness on the left side of my face and sleepy for 3 days now\n\nI ve got slight numbness on the left side of my face and arm. Extremely sleepy, bloodshot eyes, heart palpitations, scratchy voice. I only really feel ok when I m asleep.....????",
    "doctor_response": "i think u r suffering from severe mental stress. take tab clonazepam 0.5 mg od for a week. n if no relief consult a good physician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the chest?\n\nI have had a pain in my chest I have a small tumor non cancers in my r. lung but I still feel bad and I had a sputum test and the diagnosis wasfungal organisms morphologically consistent /candida species what could have caused this the dr has gave me Diflucan",
    "doctor_response": "Thanks for your question on HCM.In my opinion you should first rule out cardiac cause by doing ECG. If this is normal than you should consult pulmonologist and get done repeat evaluation of your right sided lesion.I advice CT Thorax for better evaluation of lung lesion. If lesionis same as previous than no need to worry. But if the lesion is worsening than I advice you to get done bronchoscopy and BAL analysis with biopsy to rule out other cause and proper diagnosis.So consult pulmonologist and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the possible consequences of a fetus without heartbeat?\n\nHi doctor, My wife is now 8 weeks and 5 days pregnant. She started to bleed three days back and felt little cramps. We had our first early trimester scan and they said that they are unable to detect fetus heartbeat. They arranged for another scan in some 15 days. She is taking Pregnacare Folic acid.\u00a0Our questions are, whether the fetus has grown in previous cases after 8 weeks?\u00a0What are the possible consequences for the\u00a0fetus without a heartbeat?\u00a0Can we still stay with hope? Should we take it as miscarriage if they could not see heartbeat in the next scan?\u00a0Please help.",
    "doctor_response": "Hello. If she is 8 weeks and 5 days gestation as of today and still there has been no heartbeat or a fetal pole, then it is likely to be an anembryonic gestation or a chemical pregnancy with just the gestational sac. If the fetal pole and the heartbeat have not arrived till now, then it is unlikely that it would arrive. The bleeding is a sign of natural miscarriage being underway and she shall miscarry naturally by the next scan. However, you have not attached the scan reports, which would give a definite idea of the situation. Please attach the reports. Revert back with the reports to an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for throat pain post a dental procedure\n\nMy 7 year old daughter had some dental work done on Tuesday and last night she started complaining that her throat hurts and  is running a low grade fever since last night off and on today.  Now I just seen red splotches on the roof of her mouth what is going on?",
    "doctor_response": "HiWith your query, it would have been better if you had mentioned what dental treatment she got it done. I think what you see on her roof of the mouth are might be ulcers or inflammation due to the materials that have used for the treatment please dont be afraid if this wait 3-4 days if still symptoms persists consult your dentist ance again till then for symptomatic relief you can use dologel or mucopain. Hope thus helps you avoid hot foods for some time",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling on face,arm and leg when suffering from osteoarthritis?\n\nI was recently diagnosed w/ lumbar and dorsal osteoarthritis and spondylosis. Now I am having tingling on the left side of me face, left arm and left leg. Could this be the cause as I have no other symptoms that are normally associated w/ the tingling. No numbness, weakness, blurred vision.. etc...",
    "doctor_response": "Hello, Osteoarthritis and spondylosis of the dorsal spine are anatomically inconsistent with any type of changes in sensation of the face as you describe. I recommend you have that looked at by a neurologist as soon as possible.  If the symptoms return you should head to an ER because you may suffer from a stroke which could have devastating consequences. There are other less catastrophic causes of those symptoms but you do not want to miss the opportunity of diagnosing something that can be very critical so you must go to the ER the next time this happens. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes discomfort in the kidneys and testes in a 57-year-old?\n\nLast week I woke up with severely itchy bites and rash from head to toe. I looked for every sign of a bug infestation but there was nothing. I itched till I bled. The itching and bites have mostly cleared now but my veins in my legs and feet are now extremely visible and there is a place on the side of both my left foot and keg that feels like a bug is crawling on me but again... NOTHING is there. 3 days ago about 5 hours after I left work on a shipping dock both of my hands swelled up and all of my fingers as well and it s still the same right now and feels like they were bludgeoned with a hammer and pain now going up my wrist also. Also have been having severe chest pains and shortness of breath today. I have no idea what is going on",
    "doctor_response": "Hi, It might be an allergic eruption. As a first line of management you can try antihistamines like Pheneramine. If symptoms persist, better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any relation between psoriasis and meth?\n\nCAN LONG TERM METHAMPHETAMINE ABUSE BE THE REASON I HAVE PSORIASIS AND PSORIATIC ARTHRITIS?",
    "doctor_response": "hi; Psoriasis is an auto-immune skin disorder it come on due to some trigger like stress mental/physical ;odd working conditions & as sudden impact of some bad news like death of a close one;or accident & occassionally aggravated because of some allergic thing .Psoriatic arthritis is a complication of it.Now the big question is whether you had psoriasis before abuse of Methamphetamine .If yes then you see the reason is not abuse ;& if you did not have before then it can be because of abuse.In any case even if Methamphetamine abuse is not the cause of Psoriasis ;it will always act as the aggravating factor so please discontinue abuse of the said drug. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Inflammation and hard knots in stomach after taking injections for uterine cancer. Switched to Warfarin,lump on leg. Is it clot ?\n\nMy 84 year old mother has uterine cancer and was put on injections for 3 blood clots a couple months ago. She developed inflammation and hard knots in her stomach from the injections and was switched to warfarin a couple weeks ago. Her INR is 2.8 now. A few days ago, she noticed a marble sized round lump in her lower leg. It is cool to the touch, is not red (today it has a faint yellow ring discoloration) is not painful at all. She called her doctor this morning but has had no response (It s 5:30 PM here now). Could this be a blood clot? Should she apply heat or cold to it? Thank you.",
    "doctor_response": "Hi, you are on injection for uterine cancer . but I am not sure what injection it could be. because uterine cancer rarely need any injection. if her hemoglobin count is low then she may have given erythropoetin. she may have given enoxaparin to treat deep vein thrombosis. but now her INR is within normal limit so it is unlikely to have a clot. clinical examination of the lump is necessary. consult your oncologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful burning sensation in the knee despite taking Cataflam and Tylenol?\n\nHello,I have been dealing with knee pain with it popping and upper thigh swelling and unable to bend leg for 3 weeks. I have been taking Cataflamm and a Tylenol 800 mg but still no relief. I have leg weakness and blurred vision and shortness of breath. I have no injuries to leg/knee I am overweight. Ice seems to help but just a short fix. It feels like its on fire but not hot to touch , at times it will be all of leg(right). I am frustrated other than above prescriptions I am not currently taking anything else. Thank You Debbie",
    "doctor_response": "Hi, Consult an orthopedics and get an MRI scan to look for possibilities like arthritis. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chronic RA, scheduled for radiation treatments for breast cancer, lupus test positive with low numbers. Guidance?\n\nHi. I have RA for years now and was recently tested for lupus , just got results which are positive with low numbers.I was told 142. Since I am suppose to get radiation treatments for breast cancer , I was told that having Lupus would not qualified me for radiation. My question is what does these numbers mean (142), and what can I expect . It is really Lupus? Thank you for your time, I am a bit lost",
    "doctor_response": "having lupus doesnt contraindicate radiation therapy. the numbers dont really suggest anything much.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for child suffering from eczema\n\nPlease help. I have a nearly five year old son who suffers terribly with eczema. Although we use diprobase creams daily and apply an anti-steroidal cream on fair ups we still struggle with the bed time routine. We use nothing but warm water to wash him in the bath before bed. When he gets to bed he suffers REALLY badly with itchy scrotum. So bad that he will scratch and make them bleed. If you hold a piece of toilet tissue to the underside of them to blot the blood away there is a watery substance, like sweat I presume. I have tried baby powder to no avail. Any suggestions welcomed. Thank you in advance - Alison",
    "doctor_response": "do consult a skin specialist if problem is so much.do not the skin dryuse emolientuse soap like tedibar .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe nightfall and disturbed sleep\n\nHi. I need your help. 2 years back when I intended to stop masturbating, I didn t even have wet dreams for 20 -25 days. But now I am in big trouble. I am so weak as I started masturbating at the age of 10, of course that s when our muscles and bones are growing but that was an unfortunate happening. Now I am 19, that makes 17 and before that I was alright. But after 17 something really bad happened and I started having wet dreams every day. That made me really weak, my mind was flustered. I stopped doing work because my body was not getting the energy as it was lost during wet dreams. But the main thing is that its half slippery water and half sperms. Now I have become very weak, and I just want my sperms to get out. I have no pleasure while masturbating and I am 19. I have become very sensitive, when my penis touches anything it gets erect. I am losing alot of energy. If my wet dreams occur at the same rate after 20-25 days. Then I ll be very happy. I don t know what to do. Help me, thank you.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Its totally a false belief that masturbation or wet dream affects your health. It will never affects our health.Many people masturbates daily and its very safe act to do.It also don't affects the development of body as if you are worrying at the age of 19 years.Starting a masturbation will gets your wet dream away. So you can start doing act now.I also suggest you to eat high protein diet. Also start doing exercise. Early morning one hour exercise makes you fit and strong. It also increases your will to do sex.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to transplant kidney from dead person?\n\nI'm 64 yeas old on home peritoneal dialysis. I'm on the kidney transplant list. Because of my age I'm getting older kidney, which i will get the kidney faster. At the moment my energy is low and the faster i get it the better for me i was told. The kidney will be from a dead person. Is there any chance that this people died from censer. Should I go on the internet and ask if anyone is interested donating a kidney. I heard some people have done this. Is this wise to do. Thanks",
    "doctor_response": "Hello,Thanks for choosing HCM. Dont worry about that ofcourse you can have a cadaver kidney of old age person. If there is anything that wrong about the patient then even doctors wont transplant that kidney they will have the complete history of the dead person so rather going for other option you please carryon with the cadaver kidney and mostly you wont have any other issues except the acceptance of your body to take that kidney.ThanksDr.Alekhya",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will IUI under anesthesia be painful?\n\nHI I am scheduled for an IUI tomorrow. This will be my first time. Doctor is performing IUI under anesthesia. As in previous intravaginal scan It pained me lot and screamed like hell. I would like to know that under anesthesia will I stills feel the pain. Doc said it is not local. Very scared.",
    "doctor_response": "Hello,Welcome to Health Care Magic.Thanks for writing.I am Dr.Nitasha Khan. I have read you question completely, i understand your concern and will try to help you in best way possible.there is no reason to be scared of local anesthesia is not painful at al you wil just feel a needle in the start of procedure and tht wil be al aftr that you wil nt feel a thing and you wil be fine just a lil needle at start ....I hope this answered your question.If you have more queries I am happy to answer.Otherwise rate and close the discussionRegards.Dr.Nitasha Khan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Gonorrhea\n\nI am a male, 32 years old, 170 pound, and have had no medical problems in my life. I recently contracted gonorrhea(tested negative for chlamydia) and was given a shot and 2 pills. That was on Monday (noticed that I had it the wednsday before but was unable to see a doctor due to the holidays). It is now friday and I am still burning when I pee and have excuriating pain when I get an erection. What should I do?",
    "doctor_response": "Hello, Welcome to HCM,Gonorrhea is a highly contagious sexually transmitted bacterial infection and is characterized by thick discharge from the penis.Ciprofloxacin  500 mg a single dose. You have to wait at least 7 days after taking the dose before having any sexual contact. To avoid re-infection sexual partners should be treated too.It's important not to have unprotected vaginal, oral or anal sex until treatment is completed & the infection has cleared up.Certain strains of gonorrhea bacteria have become resistant to antibiotics like quinolones and sulfa drugs. When bacteria become resistant to an antibiotic, they no longer can be killed by that medicine.If you have been treated for gonorrhea and don't get better, you may be re-tested by gonorrhea culture to see if there is bacterial resistance to the antibiotic you were taking.Based on this we can give antibiotic which you are sensitive.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could the raised lump on inner thigh be?\n\ni have a raised lump on my inner thigh which is a bit red and kind of big it doesnt hurt, its not very noticable it look kind of like a bruise but its not hard. It dont know if my leg could of just got irrhitated by something as i noticed it when i woke up.",
    "doctor_response": "HiWelcome to hcmMostly it is some insect bite during night. Just apply antibiotic ointment over it that will heal it. If it is increasing in size and painful you requires antibiotics tablet and show it to  surgeon.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Constant jaw pain after tooth extraction. Anything a doctor can do?\n\nHi, please help! I am suffering tooth abcesses which has caused me to have 2 teeth extracted. Though the pain I am in, is still horrendous! My jaw is constantly aching and throbbing (burning sensations and sharp shooting pains on my left jaw) I don t know what else I can do. At a dead end with the dentist . Is there anything a doctor can do. (I have had to visit the doctors for a sick note, due to do much time off work) I am only 27 and frightened that nothing is going to help. I have been on 4 lots of antibiodics and constantly taking pain killers.",
    "doctor_response": "hello and welcome to HCM forum , i would like to inform you that pain in jaw following extraction needs a thorough examination y your dentist, i would advise you to see an oral surgeon for the same. until you visit a dentist, kindly perform warm saline rinses(3-4 times/day), antibacterial mouth wash(twice/day), Do not worry, your dentist will take an ,x-ray to make sure no other tooth is causing these symptoms. i hope i answered your query, i wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat severe pancreatic infection?\n\nhi..my grandma( age 79, residing at chennai ) is suffering from serious pancreatic infection...she was hospitalized fr 10 days in icu n now being rested ..but she is suffering from illness n pain...can u give some  control measures to prevent it..it would so much helpful if any any information is provided..thanks",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.As the infection is severe it is likely that the infection is spread in the blood circulation.I advice you should do blood culture and sensitivity. Once the report received taking the drug as per the report will cure the infection readily.If you have placed the line in the pancreas fluid from the line can be cultured and drugs can be taken as per the report.This method will be very effective and can cure the infection very rapidly.Feed them with high protein and carbohydrate diet.Good hygiene maintainence is key in infection control.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Should one worry about heart attack at the age of 32?\n\nHello doctor,My wife had an echo, stress test, and several EKGs and a 30-day event monitor done about three and a half years ago. She still gets a slight pain in the chest area from time to time. Her grandparents were the only ones that had any heart trouble. She also has extreme health anxiety about her heart. Should she be worried about SCA or heart attack at age 32? I want to put her fears to rest. She takes Atenolol 25 mg for her fast heart rate because of the anxiety. She is 5\u20191 and weighs 175.",
    "doctor_response": "Hello. Unfortunately, I got no clues on what were the results of those cardiac investigations. If possible, can you please elaborate a little bit on what was the outcome of those hearts tests you mentioned earlier? If I assume there was not much they found abnormal in the cardiac evaluation three and a half years back, then she need not worry about the heart to be arrested suddenly. If there are no major risk factors, she is less likely to have SCA (sudden cardiac arrest). Females are less prone to get SCA compared to men. Getting pain in chest at the same time every time is not so relevant to the heart-associated pain unless there is a specific activity that triggers that pain at the same time every day. She should definitely take her medications on time and I would suggest getting all the heart investigations done afresh. Consult her cardiologist for a follow-up visit in order to get a re-evaluation. Hope it helps. Please add some details regarding her past cardiac test results in order to get a more personalized response. You can add a follow-up query here. I would be happy to assist as soon as possible. Revert with more information to an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach ache and diarrhea with foul smelling stool?\n\nHi, My daughter is 3. I ve just realized that it seems every time we take her to the Doc they ask if she had a bowel movement today... (interesting) She has been complaining of her tummy hurting for well over a month. I took her off of milk but it s not helping. The other day she had diarrhea that had smelled very awful and actually now that I think about it, the last time I saw her go #2 just a little came out and it wasn t very solid. hmmm",
    "doctor_response": "Hello,It seems your kid have viral diarrhea. Once it starts, it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting. You need not worry.There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic-associated diarrhea.I suggest you use zinc supplements (Z and D drops 1ml once daily for 14 days) and ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is a very important and crucial part of treatment. If there is vomiting, you can use syrup Ondansetron (as prescribed by your pediatrician).Regarding diet - You can use cerelac any flavor will do. Avoid fruit juices as they might aggravate diarrhea. You can give zinc supplements and ORS apart from normal vegetarian porridges and soups. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sumanth Amperayani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sertoli\n\nhello doctor... i am from panipat i got married last year now we are planning to increase our family.but after simen test my husband get nil sperm count pls find the below report.Fine needle aspiration smears both  testes show sertoli cells and few Leydig cells. NO GERM CELLS OR MATURE SPERMATOZOA ARE SEEN in the material examined.  The findings are suggestive of SERTOLI  CELL ONLY.  Biopsy confirmation is advised pls advise me is it possible to treatment for this ????? do we have any type of treatment ??? pls advise me ASAP",
    "doctor_response": "Hello,Don't worry, your husband may be having testicular male infertility probably. Many causes for it like hormonal imbalance or trauma or alcohol or cryptorchidism or infection like mums etc. Please consult your physician / infertility specialist he will examine and treat you accordingly.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had tooth removed. Having pain. Had to cut gum to remove tooth. Cleaning with salt water. Suggest\n\nI had a tooth out last Wednesday . It wasn't easy to get out and came out in 4 so my gum had to be cut. I am in agony now, rinsing with salt water as recommended. I am very frightened of the dentist and have read about dry socket. I had to have a sedation as I get distressed. What should I do and how do they clean the area without pain? Thxs",
    "doctor_response": "Hello,Thanks for writing to us.Take complete course of amoxycillin as well as diclofenac tablets.Torn gums will usually heal by its own.Take rest and avoid anxiety,stress.Gargle frequently with warm saline.Maintain oral hygiene well.Rinse your mouth after every meals.Dressing the socket with ZOE/POVIDINE IODINE can enhance wound healing.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ITP\n\nhihis is srihari my daughter P sneha suffering with ITP from septemer'13 still now last one week back her platlight count is 17k. at the time of diagnosis they used IVIG & anty D after few day again platlights dorps down. now we are taking christen medical college Vellour. now given 3 months course of folic Acd & Dapson 50 mg per day. is this cornic or acut ITP. kindly giveme correct treatment for this  mobil.0000",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern.  You have idiopathic thrombocytopenic purpura.  It may be chronic if long time. In that there is immune mediated destruction of platelets take place.  So you should take immunosuppressive drugs like steroids to control that.  Consult physician and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Implanon Removed, irregular periods, hips ache, nausea, pregnancy test negative, trying to conceive\n\nI got my Implanon taken out about 6 weeks about. I had a one day period last month. And my husband and I are trying to get pregnant, so I have been keeping track of my ovulation cycle and around the date I was supposed to be ovulation it said I wasn t. But my hips ache, I m eating everything in site, I am always tired and I get nausea at night. I am expecting my period around the 27th of this month. i have taken pregnancy tests and they come up negative. Tomorrow I go the the doc for further testing from an abnormal pap , should I have them run a pregnancy test and see?",
    "doctor_response": "hi, after removing Implanon it will take 3 to 6 months for regularization of cycles. that may be reason for your anovulation. because of hormonal changes induced by hormonal contraceptives pap smear can come abnormal sometimes. you better wait for 1 week after the date of missed period and repeat the test as some urine pregnancy test kits are less sensitive. or you can go for blood test for pregnancy which can be done now. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have kidney stone and had put stent to crush it. What measures to undertake?\n\nHi Doctor, I have an 19mm stone in my left kidney. Doctors put the stunt and after 4 weeks they will crush the stone . They can't do it earlier as the stone is hard. I am taking all precautions in food then why these stones occursI don't eat spinach, black grapes, beetroot, arvi, but I eat mushrooms once in 15 days. Please tell what other precautions I have to take. meena",
    "doctor_response": "Hi, meena, the kidney stones are common in some areas depending on the salt content of the water.in addition due to some foods, besides your selection, tomato and palak green leaves are supposed to cause the stones.                       I advise you to take more of water and fluids. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest and lung pain with coughing?\n\nI started out with a cold about a week ago and then it went away, then was replaced with a light cough a couple of days ago. today it is a full blown cough and after I'm done coughing my chest lungs hurt. my neck right under my chin to my throat feels swollen. after I'm done coughing I feel week and my arms and especially my wrists ache really bad. It takes everything out of me after I cough. I took some robittusin about 3 hours ago to help, it hasnt helped that much, though I am coughing up some mucas when I cough now. it is a greyish color.",
    "doctor_response": "Hi thanks for contacting HCM.According to your complaint it seems to be viral flu like infection....It could be viral bronchitis or bacterial one...Sputum examination helpful.If it is infective by bacteria neutrophilia will more and lymphocytes in viral....Avoid smoking....Take broad spectrum antibiotic like levofloxacin....Healthy and balanced diet ...If cough not coming easily ambroxol plus salbutamol containing syrup can be taken...I blocked nose also  present then azelestin nasal spray given....Take care.If still worsening chest x ray done to look for consolidation...Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for burning and pain during bowel movements after anal sex\n\nim 16 years old. i have had anal sex for the first time. im male. it hurts when i sit(talking about my bottom), have bowel movements, it also burns in that area when i do have bowel movements.. i took a handheld mirror and looked at it. and i see this little red circle(ringworm looking thing but dark red/purplish in the center) and i squeezed it and it feels like a ball in my cheek.. i am in sooo much pain right now its unreal. i am unsure of what my condition is. and i need help..  is there any way i can get rid of it, if you know what it is?",
    "doctor_response": "Hi. It could be one of two things. Either its a fissure which is a tear caused by undue stretching of the anal skin or it could be a perianal hematoma which is a small blood collection due to the injury or pressure of the penis onto the anal verge. Either way it will take 5 to 7 days to settle down. The pain will slowly go away as the condition heals. You should sit in a pan of warm water 2 to 3 times a day and apply Lignocaine ointment over it after washing and drying the area 2 to 3 times a day. You can take stool softeners like Syrup Lactulose at night which will make the stool passing activity a little less painful. If still painful take oral pain killer tablets. Take care and avoid such misadventures in the future.Dr Rishi, New Delhi, India.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have body and penile irritation. Is it safe to take Ofloxacin?\n\nHi doctor, I have body irritation and irritation in the penile area. I have body weakness and pain in the back and waist. I have a mild fever and malaise. Please go through my reports. Suggest me a suitable treatment plan. I want to know an answer. Is it safe to take Ofloxacin 400 mg for a longer time?",
    "doctor_response": "Hi. I have gone through the attachment (attachment removed to protect patient identity). Based on the reports, it is probably prostatitis. If there is no improvement with a short course of antibiotics, then it can be chronic prostatitis or recurring prostatitis. In such cases, you can take a course of antibiotics orally for six weeks. You can take Ofloxacin orally for six weeks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does a good diet and exercise help with a fatty liver?\n\nQ : Hi, I had recently test my ultrasound scan found early fatty changes in liver. Then I had a LFT(liver function test) That is Total billirubin 1.20, Conjugated billuribin 0.29, A.S.T.(SGOT) 56 A.L.T.(SGPT) 89 Alkaline phosphatase 159. In my Lipid profile shown that Cholesterol 227, triglycerides 290, HDL cholesterol 39, LDL cholesterol 130 VLDL 58. Doctor prescribed the medicine named as Hepexa M, Fibator EZ, VSL-3 Rabium dsr for 3 month,. i had already avoid alcohol, fatty foods and controlled a lot of my diet having exercise, after 2.5 month i lose 8 kg weight (81kg to 73kg), now my lipid profile is normal,may this type of case occures after heavy diet control and above medication use in 2.5 month, my age 33, height 5.6 inch",
    "doctor_response": "Hi.thank you for posting query at HCM.definitely, exercise and strict diet along with medication aids in weight reduction and improving the abnormal liver enzymes reading. however, you need to monitor your liver enzymes and lipid profile every 6 months to 1 year.secondly, visit your treating physician and take his advice for discontinuation of drugs and/or dose adjustment. Prevention is better than cure. So, try to maintain ideal weight to avoid complications of being overweight.any further questions are welcomed.hope to answer your concern.wish you good health.regards,Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have athletics induced asthma. Chest pain, exhaustion\n\nOkay. I have athletics induced asthma and almost for the past week I have been having chest pain . I ve been taking my inhaler but it only helps with the pain somewhat. It seems to get even worse if I m laying down in bed on my back. I ve been exhausted the past few days due to this and haven t been able to concentrate on school.",
    "doctor_response": "INHALERS ARE SOMETIMES NOT ABLE TO CONTROL ASRGMA AND AS TIME OF DISEASE INCREASES THE DISEASE BECOME MORE DANGEROUS AND EFFECTS MORE IRGANS YOU CAN ADD ANTI ALLERGIC TAB SINGULAR I TAB BD SP VENTROLIN 1 TSF BD ADD LIWUID ANTACID YOU ARE YOUNG YOU CAN GET ALLERGY TESTS AND GO FOR SPECIFIC IMMUNOTHERAPY FOR PERMANENT CARE PF DISEASE",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on right side of neck?\n\nI have a visable lump/swelling right side of neck near thyroid. Many test done Doctors feel its a swollen muscle with no explanation I do have a 11mm nodule with goiter but they say this is not the problem. I have had CT scan ultrasound biopsy with no answers My blood work is coming back all fine, but my thyroid is coming back heteregenous/calcified. Just don't know where to go from here",
    "doctor_response": "welcome to Health care magic.1.The lump near the thyroid - can be from thyroid gland or from the lymph nodes.2.11mm thyroid nodule is not an issue if its not symptomatic and feature of malignancy ( cancer)3.If it is heterogeneous, i think it need to be operated before it gets complicated.4.If you are my patient and there is visible swelling causing cosmetic causes - I would suggest for an excision.5.So its for you to decide and get back to surgeon and get needful things done.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yellow vaginal discharge ,pain during intercourse and irritation in the clitoris?\n\nhi I m experiencing yellow vaginal discharge and burning pain during intercourse as I am very sexually active ive been with my fianc\u00e9 now for 3 years and their is no way I have a std burning vaginal pain in general mostly in the area of where the clitoris is redness swelling cramps in my abdomen my gyno thinks there might be some infection and he hasn t gotten back to me so far he has no clue whats wrong with me pain during urination itching irritation I m mostly inflamed every day it hurts so bad I can hardly walk . please help.",
    "doctor_response": "if you get pain during urination you might get candida infection also known as splash dysuria n another diff diagnosis is bacterial vaginitis for yellow discharge get medicine topical antifungal for candida n tab fluconazole or visit to ur gync  thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes prickling pain and heaviness in legs?\n\nI have been battling tremors, needle prickling pain, and heaviness in my legs for almost a year now. I have been tested for MS, Lupus, and Parkinson only to be told I am depressed and stressed. I assure you I am neither and refuse to go back to my doctor.",
    "doctor_response": "hi,as mentioned by you, it looks more of the lumbar disc degenerative pathogy. As due to the pinch of the nerve the functions of the sensory nerve gets disturbed and leads to abnormal sensation. Taking up and MRI of the lumbar spine will reveal it's pathogy. Also, getting and NCV study done will help in differential diagnosis and can be looked further.based on the Neurological findings and assessment along with MRI and NCV the next rehabilitation plan will be implement.99% cases recover soon if followed with a combination of medicine and physical therapy.With the grace of God I wish you a long life without any medical issues.Regards.Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is knot in abdomen causing funny feeling when applied pressure?\n\nI am 29 years old and I have 2 children ages 12 and 9 years old.I found a small knot in my lower abdomen that is about the same size as a marble.It doesnt hurt really but if I apply pressure to it I have a real funny feeling go through the bottom of my stomach.What could it be?",
    "doctor_response": "Hi,Dear,Good Afternoon and Thanks for the query to HCM.I studied your query in details and understood your concerns.@My impression of your Lower abdominal lump-is as follows--its mostly ?spigelian hernia ? boil-early stage.Spigelian weaknes gives herniation in the para-umbilical region in lower abdomen.I would advise -a-Consult ER Surgeon who would check and fix its diagnosis.This would resolve your lump issue in leg.I would suggest to consult ER surgeon and test blood for-fbs / pps -levels.This would help you to plan treatment with your doctor.@Hope this would resolve your worrisome query.Welcome for any further query in this regard,and would love to help you to resolve this problem till it is solved to your satisfaction.@ One Small Request to you to Write strong recommendations promoting my services for the benefit of my new and old patients at HCM clinic.Wishing you fast recovery..!!Have a Good Day.With Regards ,Dr.SAVASKAR M.N.Super-specialist in NCCD-Non-Curable Chronic Disorders and Rejuvenation therapies in tissue and organ failures.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Biopsy of pancreatic mass showing cytomorphic findings with mucinous neoplasma with mild atypia. Is it pancreatic cancer? Treatment options?\n\nHi. My mom is 74 years old and the recent biopsy results of pancreatic head mass showed that cytomorphologic findings consistent with mucinous cystic neoplasma with mild atypia. Is this classified as pancreatic cancer? What procedure/s are recommended for this condition, taking into consideration her age? What is the success rate of people at this age surviving or recuperating well after such procedures? Hope you can elaborate.",
    "doctor_response": "Dear What are no. of atypical cells/hpf. If more than 5 then it seems it is a Ca. T/t options at this age is 1) Surgery - if operable & GC / co-morbidities allow. 2) Con. CTRT 3) Chemotherapy only after seeing all records. Actually, Ca. pancreas is usually diagnosed in locally advanced stages, in which case the cure rate is very less. All the Best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are my moles normal or suggestive of any disease?\n\nHello doctor, I have two moles that seem kind of weird. One is a small mole and the other one is like a wart but very small. Even though they are small, I am always thinking the worst, so probably I am overreacting. Can you help me find out if it looks bad or not?",
    "doctor_response": "Hello. The moles look pretty benign to me (attachment removed to protect patient identity). One is a flat one whereas the other one is raised. The flat one is usually a junctional nervous (superficial nevus) whereas the raised one is usually a compound nevus (has both epidermal and dermal component). Both are well defined, uniformly colored, symmetrical and small in size and look pretty benign. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does abnormal morphology of liver suggesting hepatocellular disease mean?\n\napparent areas of sclerosis involving the T11 vertebral body,slightly thickened walled gallbladder,areas of low attenuation in both kidneys also compatible with cy6sts. small areas of attenuation in both kidneysalso compatible with cycts. abnormal morphology of the liver, which suggests underlying hepatocellular desease.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have cyst in kidney. Abnormal morphology of liver suggestive of some hepatocellular disease means you have some liver pathology like cirrhosis or fibrosis or fatty changes.  You should go for complete liver function test. 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a painful lump on the vulva?\n\nI have a pea sized lump on my vulva. It is between the opening of the vagina and the urethra and seems to be maybe in the tube - it is visible only when I lift the inner flap. It is extremely sensitive and hurts to touch or urinate. Can I fix this at home? I am using colloidal silver and oil of oregano internally at the moment, but it doesn't seem to be shrinking.",
    "doctor_response": "Hi,Welcome with your query to HCM virtual Clinic.I reviewed all the details of your query,in context of the of the painful lump on your vulva.Based on the facts of your query,You seem to have Bartholin Cystitis,as itssoar to touch,but is not reducing with colloidal silver and oregano oil.Hence I would not suggest you to apply it,as it would complicate by its side effects.As its a cystic swelling with mild infection,the painful lump is not reducing in your case.Consult your family Gp or Gynec doctor who would treat in the best possible way for you.Hope this reply would help you to plan treatment with your doctors and resolve your worries.Will appreciate writing excellent review comments to help the needy patient visitors like you at HCM.Welcome any further query and information in this regard.Good Day!!Dr.Savaskar M.N.M.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can shingles be prevented?\n\nI have a friend who just found out today she has shingles she is 82 I had chicken pox as a child I am 67 I had shingles 6 years ago I have to pick up groceries for her could she pass it on to me it was the most pain I have ever had it was terrible what medication does doctors prescribe for shingles",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.I have had shingles too, so I know how painful they can be! You are not at risk of getting shingles from her. Shingles come from the chicken pox virus you had as a child which goes dormant in part of the nervous system called the dorsal root ganglion.Your antibodies keep it in check there. When our antibody levels specifically to them get low, or our immune system is weaker, then they can sometimes come out as shingles. Because it is a virus, it can't be killed with an antibiotic, but an antiviral, such as acyclovir or valacyclovir can lessen the symptoms and complications, particularly if it is started soon, within the first 72 hours.For prevention, there is a new shingles vaccine to help boost one's antibodies to the chickenpox/shingles virus (varicella zoster). The older vaccine was not extremely effective, and it's hoped that the newer one will do a better job, but as it is new, the data on it is mostly limited to experimental trials and early use.So in answer to your question, there is no way your friend can pass shingles on to you as you already have the virus, it is just not active.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bonnie Berger-Durnbaugh",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cause and medication for back pain\n\nHi doctor. I am facing back pain since four years. My X ray report is clear, My MRI show some minor problem. The orthopedic doctor that i have consulted says that i dont have any problem. Still i am having this troubling pain which is letting me down. Is my problem a neurological problem or what. What and whom should i consult to get rid of my problem",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern looking to the history given here I could say that your condition of pain can be treated with the following medicines 1) Tab Acetaminophen 500 mg three times in day, Tab Diclofenac 50 mg once in day, it is advisable to keep the stress level very low, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for blisters due to allergy?\n\nHi...I get a reoccurring blister on the side of my hand two or three times a year.  At first I thought it was a plant allergy that occurred from gardening, but now it comes at any time of the year and lasts for a couple of weeks.  What is so odd is that it occurs in exactly the same spot every time.  It hasn't spread or changed over time but has occurred over the past four or five years.  Is there anything I can do to get rid of this?  It is both irritating and unsightly!",
    "doctor_response": "Thanks for writing It could be 1. Pompholyx- where one gets very itchy blister over the sides of the finger and palms 2. Scabies red itchy lesions over finger web space , wrist , arms , chestIn case of pompholyx it requires use of anti allergic like cetrizine and steroid application Scabies it requires use of permetrin cream application .",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat depression and change attitude?\n\ngood morning doctor, my son is aged about 30 years well educated abroad. after return mother land lazy idle and always eat without timings and variety and reluctant for systamatic life, habits. He says no job comes and plan for small business of hawkers. how to get treatment and flourish of his attitude n life. is is problem/diseasce.",
    "doctor_response": "Hi,I read your query and can understand that as a mother you are highly concerned about your son. However, its difficult to say that he has any disorder just because his daily routine is not fixed. More details like his mood (whether he remains sad and irritable), any sleep disturbance, feeling tired, etc will be needed. If possible send more details that will help in making a better decision and help in guiding you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Continuous back pain, back muscle spasm from lower back to shoulder, temporary relief with co-codamol. Suggestion?\n\nI have had back pain for two weeks now, it began when I lifted my grandson over a low fence. Since then I have been taking pain killers to allow me to move. I went back to work for a week and then went on holiday to Brighton, while there the pain returned and I had a very bad muscle spasm and have been in agony since then. It is across my lower back and travels up to my left shoulder . The only thing that brings releif is co-codamol, when that wears off the pain is back and I am almost immobile with the pain. I have also had several chriopractor appointments. Can you help?",
    "doctor_response": "YOU CAN WEAR A LUMBO SAGRAL BELT DURING THE DAY WORK. please take tramadol tablet everyday after dinner for 7 days. AND  combination of ACELOFENAC+PARACETAMOL+CHLOROXAZONE TWICE DAILY ONE TAB AFTER BREAKFAST AND ONE TAB AFTER LUNCH FOR 10 DAYS. THESE WILL RELIEF FROM THE SYMTOMS. PLEASE DON`T APPLY ANY LOCAL ANTI INFLAMATORY CREAM/OINMENTS.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does yasmin reduce the appetite?\n\nDoes Yasmin reduce the appetite. I have just completed my first month of Yasmin, and I feel as though my appetite has been greatly reduced. Also, I seem to have a feeling of intense stabbing pains intermittently at my cervix, which I usually don t get with my periods. Could this be related to Yasmin?",
    "doctor_response": "Hello, Yasmin does not reduce appetite. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in kidney and testicle, urination problem. Kidney stone?\n\nMy son is 23 and last 5 days he has had pain in kidney area and in left testical. He is a minor league umpire and said when he runs it fills like someone kicked him in the balls. This morning he called and said it was a little hard to pee. We to a urgent care yesterday and said he may have epididymis and having ultra sound today. I was wondering maybe even a kidney stone . Have heard of men having same pain with that. Thank you",
    "doctor_response": "Dear Shandra Jenkins, Pain of kidney stones usually starts around the mid back on either side of the spine. The pain then moves forward and downwards towards the groin, by when the stone is usually reaching the bladder. However pain in the scrotum is unusual in kidney stone. Epididimitis is a possibility, but also torsion of testis should be kept in mind. A good clinical examination and ultrasound will help confirm the diagnosis Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is diffuse bulge with minimal compression of the thecal sac with hypertrophy of the ligamenta flava a serious concern?\n\nin my mri diffuse bulge with minimal compression of the thecal sac with hypertrophy of the ligamenta flava and posterior articulating facets in levels L2-3 level ,L 3-4, L 4-5 and L1-i have back surgery in 2012 and neck sugery in 2013. what can be done?",
    "doctor_response": "Hello dearWelcome to Health care magic family .I have evaluated your concern in depth .@ MRI report suggests moderate level lumbar spine compromise .@ As already operated in 2012  , if symptoms are not that severe , first opt    for medicines with physiotherapy component sincerely for minimum of 3    weeks period & further management guidelines according to the      response   of the same .Hope this will help you .Feel  free to ask any further questions .Thanks for evaluation of my answer .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Nukast-4 syrup safe for severe cold in an infant?\n\nHello doctor, This is Manoj. I have a baby girl and her age is just 7 months. She is having severe cold, she is not able to breath properly through nose as both nostrils are blocked. doctor suggested me to give her Nukas-4 syrup. Could you please suggest me to usage of the dose? Thanks a lot...",
    "doctor_response": "Hi...Nukast is Monteleukast and is not a drug to be used for severe cold. It is a drug to be used to control allergy on a long term basis. For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do.For cold you can use Cetrizine at 0.25mg/kg/dose every 12 hourly for 3 days.For nasal block, plain saline nasal drops will do, every 4-6th hourly to relive nasal congestion.But if you want Nukast dose it is 4mg once a day only for as long as your doctor has suggested.Regards - DR. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "I drink a 250ml can of redbull a day, also several glasses of water. Can redbull cause kidney stones? For the past several years (mostly during winter) i develop kidney stones, the last one was 1/4 inch in size which i passed. Any thoughts on this theory? Thank you foe your time.",
    "doctor_response": "HelloThanks for query.Drinking 25o ml of Redbull can not be a cause of having stone in kidney.Following are the  primary causes for developing stone in kidney 1) Drinking less water that results in to urine being concentrated which tends to precipitate calcium salts in kidney to form the stone 2) Abnormal high levels of Calcium and Oxalates in blood.3) Frequent UTI 4) High levels of uric acid in blood Drink more water to prevent forming kidney stones  and avoid taking foods rich in calcium and Oxalates like Cabbage ,spinach ,milk products ,Tomato etc.Dr,Patil,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why painkillers after wisdom tooth surgery are not reducing the pain ?\n\nHi, I just had a wisdom tooth surgery yesterday. I was given some antibiotics and painkillers (Voren 50g). I've taken the medications as told but the wound hurts so bad till I couldn't sleep! The painkillers seemed to be not working, should I ask for a different type of painkillers? And what should it be?",
    "doctor_response": "Dear user,Thanks for using healthcare magic,I understand your problem,but don't worry it can happen.you should gargle with warm water and salt,that help to clean your wound that relief your pain also.If you taking painkiller two time a day,you can take three time a day that also help relief your pain.Thanks,Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can cause low WBC count?\n\nHi doctor, My father-in-law is 58 years old. He had a stroke a year back and has been diagnosed with non-critical CAD. Within a period of two months, his WBC count has reduced from a range of 7.5 to 2.8. But, there is no sign of infection. The overall count of ANC is more than 1000 and platelets are 140. We consulted a doctor and he has advised us to take few multivitamins and keep a weekly check on the count. How should we proceed further? Please guide.",
    "doctor_response": "Hi. Based on your query, my findings are as follows. Vitamin B12 and folic acid deficiency. 1. Reticulocyte count. It has to get repeated after 15 days to check if there is any rise in number. 2. Vitamin B12 and folic acid assay. Megaloblastic anemia. Improve your nutrition by having eggs, chicken, red meat, pulses and green leafy vegetables. Revert back with the investigation reports to a hematologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden rapid heart beat?\n\nI was drinking water and having a snack and all of a sudden my heart started beating so fast I could see my whole chest moving. I ve felt like this in the past but it s been years. I lasted a good 10mins. I was also very hot and sweaty. I m scared because I m 25 weeks pregnant and don t want anything to happen to my baby. What could it be? Last time I felt this way was right after I gave birth to my 6yr old. What could it be?",
    "doctor_response": "Hi welcome to HCM.I understand your query and concern.Symptoms of rapid heart rate in your case has to be seriously addressed since you are in 25th week of pregnancy.A fetal doppler has to done for good outcome. Maintain your blood pressure under 130/80 mm of hg.I advise you to have a baseline 2 dimensional echocardiography,ECG and lipid profile to assess the basic cardiac reserve of your heart.Restrict the intake of salt to less than 6g/day.Regular physical exercise in the form of brisk walk for 20 min a day for 5 days a week is pretty useful.Drugs like antihypertensives and antiarrhythmics will help.Reduce the intake of fatty and fried food.Preeclampsia and Eclampsia has to be strongly screened out by complete serum check on uric acid and electrolytes.Drugs like Magnesium sulphate will be helpful in your case to maintain both fetal and maternal well being.One pomegranate a day will help to keep your heart at good pace without clot formation. Consult a Cardiologist for further expert management.Post your further queries if any.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of peeling skin on penis?\n\ngoodmorning doctor, during the sex ,the skin on my pennis peeled of and started burning.This happened to me for the first time.I dont know where to go and which docter should i consult.I want to know wheather the skin gets healed by itself or should i consult a doctor. Thank you in advance",
    "doctor_response": "Hello Thank you for trusting HCM Have you had itching??? Redness?? Burning micturition?? History of multiple partners??? Most common causes for peeling of skin 1.fungal infection 2.STD3.contact dermatitis 4 .Penile psoriasis .It may be due to friction during intercourse also cause this problem. Consult your doctor he will examine and treat you accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is aortic abdominal aneurysm associated with abdominal pain & diarrhea?\n\ni am a 71 year old female who has enjoyed excellent health. I have been experiencing lower back pain nd lower abdominal pain for the past 5 days. Started with diarrhea and vomiting; now just dull aching. Had a similar episode about 2 years ago and it was diverticulosis. I worry that it might be an aortic abdominal aneurysm since my mother and sister had one.",
    "doctor_response": "HIWell come to HCMjust forget about the aneurysm, the symptoms are suggestive of some functional problems and not the indication of any disease, you really need to keep the stress level low and control your thoughts, at the most intestinal infection could be the cause of your symptoms, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest natural ways to control bp\n\nyes doctor i'm 31 male  5.7 height & 79 kg weight recently when i gone for a medical checkup they told i have high blood pressure  but last year i was 65kg without any issue - so i really wondered about this change - can u please help me out to bring my BP normal naturally?",
    "doctor_response": "Hi I have gone through your query . I am unable to find the description about your BP count and since when you are having it ? what are the syptoms you are facing  ? Anyway , before going to get any remedy , you should find out the cause of trouble .In Ayurveda  , the 3 factors dominate our metabolism of Vat ,Pitta  , Kapha  imbalance among these 3 , cause different  health problems . BP is normally outcome of disorder equilibirium of Vayu  , due to  psychic and physical factores  like  mental strain ,worry,  enxiety , lack of exercise , excessive intake of  salts and fats , indiscrimate use of alcohol  are few to count , persistant constipation IF you try to keep control on them ,half of the battle is won .  Correction of your life style is the  biggest Home remedies , regularity in taking meals, wALK exercise and rest shuold be maintained .PANAYAM  / DEEP BREATHING  , ANULOM -VILOM , BHRAMERI SHAV-AASSAN VERY HELPFUL  TO BRING DOWN  BP   Our two Nosril have differnt role to play . The right one is surya naadi --for controlling heat of body ,and left is Chandra naadi for cooling process . In case of HBP generally , right nostril becomes active . In day time  our left nosril should work and at night ,right nostri functions , If you are having HBP always check your nostril ,if it is right nostri  ,close this with you thumb  and start the left one . Lie down straight , calmly .keep your mind calm and quite ,without any tention , Within 10 minues BP will calm downThis a instant remedy .supplement are to be used --Garlic 5-6 cloves cut into pieces  , gulp with  glass of water  in the morning . Take lemon in water twice before meals ,  Take buttermilk with simple meals containing  low fat , fiber , veges fruit  vitamins ,minerals , coconut water , garlic , ginger in every meal   oranges guava apples are good . Avoid fried ,fast foods tea , coffee , alcohol , mental strain .Almond oil 1 tspoon in cup of hot milk  at bed time , help relaxing nerves of brain If you hold magnet south pole in your right hand  sitting on a woggen stool  feet also on wooden plank  ,will bring down your BP within  10 -15 minuets  hope this will help to solve your query Take care All the bestHave any doubt mail at drsuchda@gmail.comDon't hesitate to get back if have an further query . Meditation also helps  for peace of mind",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pus discharge from nipple in a male?\n\nHi I am 26 and male, been noticing that my right nipple is overly sensitive when brushed, today I squeezed it and puss came out a little at a time, it isn't directly on my nipple just slightly shifted, is this a form of Montgomery tubercles and is there a remedy? Thanks",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. According to history you have mentioned that you are having pus discharge from nipple and so it can be acute infectious condition or abscess. Your breast palpation examination should be done first and then if needed ultra sonography done to check any infection or abscess if present. According to examination and report I can guide you for that and you can be prescribed antibiotics if only infection is present. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment about Milk Protein Allergy or Lactose intolerance for Babies\n\nHow to find and treatment about Milk Protein Allergy or Lactose intolerance for Baby Dear Friends / Doctors, My son completed 30 months old has a problem on Cow's Milk and Milk products, when he intakes these he will have a problem in breathing and become red in his skin all over body and getting itch. Please any one guide me to find whether it is Milk Protein allergy or Lactose intollerance and refer me the Specialist who will provide treatment for this. Thanks",
    "doctor_response": "hi parent this is allergic reaction to lactose in cows milk better avoid cows milk to give him lactose free food consult a homeopathic Doctor who can give some solution.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat 4th stage cancer in thoracic and lungs?\n\nmy name is Norman i was employed as a car driver in Dubai until recently i was detected with cancer in the thoracic and lungs (adenocarcinoma) 4th stage, i have gone through 3 chemo therapies with medications on account of my insurance and now that my insurance has expired i need to pay - which will be difficult for me to do.. i will be residing at Bangalore from next month onwards and would like to carry on my treatment should be good and not expensive as i will not be in a position to afford the cost...kindly hilite me on the condition and cost....rgds Norman",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have adenocarcinoma of lung stage 4.  It is very late stage.  Surgery is not helpful.  Treatment options are chemotherapy, radiotherapy and receptor specific treatment.  Despite of treatment prognosis remains poor. Life expectancy is not good. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can trigger finger with soreness that takes a while to bring back to normal be treated?\n\nFor a month now I have been waking with my pinky finger folded into my hand and takes a while to get to unfold it without help of another hand. All during the day it is sore and starting to take a funny shape. Also have a very itchy rash on my scalp for two months. No flaking, just bumpy.",
    "doctor_response": "Hello, Consult an orthopaedician and get evaluated. Most probably you have to go for the surgical release of the abnormal tendon. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can you help for the anxiety problem having weird adrenaline rush and shaky voice along with weird tremors?\n\ni have an anxiety problem. at times i have this weird adrenaline rush which looks like im on an attacking mood when talking to people. i cant keep calm at these times and cant control or even think straight about what im saying. this weird rush occurs many times. i need your help . and at times this also affects my talking cuz my sound becomes shaky and  i get weird neck tremors",
    "doctor_response": "HI, I have read your query and according to me you should start meditation and be relax .You also start mild antianxiety and antidepression.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is this red dots on my itchy wrist ?\n\ni have red itchy wrists , when i dig them really hard they burn and its little red dots what could this be ?",
    "doctor_response": "Hello. As per the description of your symptoms, the red itchy wrists could be due to contact dermatitis due to allergic, fungal or bacterial related infection. You should firstly avoid itching and take over the counter antihistamines. Consult with your dermatologist for further advise who can prescribe you the appropriate ointments for local application after clinical examination. Hope this helps. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "As I am suffering from DVT and taking Warfine i have stomach pain and feel hydrated ? What is the reason ?\n\nhi doctor , i m a patient of dvt and taking a medicine warfine for it during this treatment my stomach is disturbed and have a stomach infection , having lose motions , feel to throw out..pain in stomach , pain in tommy , feeling dehyderation..so what is ur advise",
    "doctor_response": "You can temporarily continue with it.and besides that you can take ars alb 30 one dose of 4 tabs before eating which will help you to clear stomach upsets. For DVT  you can take lachesis  1m 1dose once in week for 4 weeks and than report back to us. Hope this helps, thanks, dr jignesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for swollen small intestine and hernia?\n\nHe has a swollen small intestine and a hernia, and had a swollen gallbladder and he takes Dexilant for the small intestine issues. He has been throwing up on and off again with burping alot and now has a lot of pain down where his gallbladder is. Also it seems down where his gallbladder is bulging out a little more than the other side...",
    "doctor_response": "Hi,please give me a detail history.I am not able to understand which type of hernia you have.To me your gallbladder pain is due to cholelithiasis which require urgent physical examination and evaluation.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fluid on knee cap\n\nIm having some knee pain, I have always have had some fluid on my knee cap due to me working on hard surfaces alot(vet nurse) and the past 8 years, i have delt with a little fluid on my knee, we have had weather change and my knee has cracked at least 20 times today already and at first cracking my knee felt great and now its super pain full",
    "doctor_response": "Hi, Thanks for your query. Fluid on knee cap could be due to bursitis. Get an xray of knee done to see any arthritic changes. Meanwhile you can take antiinflammatory drug like ibuprofen to reduce pain and inflammation. Hope this helps you. Warm regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fever, back pain, cold hands, feet, night sweats, blood in urine. Cure for symptoms?\n\nMy husband has flu like symptoms every two to three weeks. Fever, sore back, cold hands and feet, achy all over. The fever is highest during the night. Night sweats accompany the fever. These symptoms go away for a couple weeks and then return. This has been going on for a few months. There was a trace of blood in his urine. A scan showed no kidney stones . They treated him for a kidney or urinary tract infection with a round of antibiotics, but the symptoms are back.",
    "doctor_response": "Hi. If your husband has persistent symptoms inspite of antibiotics he needs to see a physician for a thorough evaluation. The physician may order further tests to determine the cause of fever which may help in further appropriate management. Good luck. AB.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the bruising on cheek after extracting wisdom tooth be treated?\n\nHi i just got my wisdom teeth removed 4 days ago.  Ive discovered this large hard bump on the side of my cheek that really hurts.  It a large lump that i can feel on the outside of my cheek and feels like a big bruise. I was wondering what it could .. be and should i contact an oral surgeon",
    "doctor_response": "HiThanks for writing in.It can be cheek biting. Due to anaesthesia you might have bitten cheek & that might have caused bruising.Slight swelling after extraction of wisdom teeth is normal.Do warm saline rinses.If still problem persists consult your surgeon.RegardsDr. Neha Sumra",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red rashes on the body with fever?\n\nMy daughter joined a parade. Its too hot her dress it too tight after the parade she got sick. she drunk biogesic for her high  fever and  later in the morning her skin turns red  i thought its sun burn but in 2 days it spread on her hands do you think she has an allergy in paracetamol or alcohol because i put alcohol in cotton under her arm or its just A SUNBURN please answer this thank you and god bless",
    "doctor_response": "Hello,I read carefully your query and understand your concern.The symptoms of your girl seem to be related to a viral rash.I suggest using anti inflammatory medication such as Acetaminophen to treat the fever.I also suggest using a mild steroid cream Calamine lotion for local application .Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest method to confirm attention deficit disorder\n\nhello I have some concerns with my mental health. its nothing severe I think I may possibly suffer from ADD and possibly anxiety or depression. I have taken several online tests and they all say I have moderate to severe adult ADD. I have been experiencing these problems since I was around 8 years old. I just wanted to speak with a doctor other than my own before I went to her because I don t want to go to her with concerns and she tell me there isn t anything wrong and then have to face her every time I go to the doctor. I don t want to look weak",
    "doctor_response": "HiI understand your concern.I appreciate you that you have made research on net about your illness.But only way to diagnose ADHD is clinical history in detail.And best diagnosed by psychiatrist.There is no blood test or any other investigation for ADHD.Psychiatrist can diagnose it with your history and clinical presentations.So consult best psychiatrist in your town.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is garlic good for high blood pressure and cholesterol?\n\nthey say garlic is good for High blood pressure and helps to lower the cholesterol. so if you eat 2 cloves of raw garlic daily will it help? Also if you eat 2 raw garlic cloves daily is there any harm or side effects? please let me know doctor. /",
    "doctor_response": "Hello, I would like to tell you that according to naturopath studies garlic is good to keep healthy cholesterol and blood pressure, you can give it a try by regular cholesterol and Blood Pressure monitoring. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a yellow tint to the skin mean?\n\nA yellow tint to the skin could be jaundice, hepatitis ...what else could cause this. The person recently started a diet and lost a significant amount of weight, was also hospitalized for diverticulitis, before that. I just do not like his coloring and his doctor didn t even mention it at his last visit.",
    "doctor_response": "Hi there,Thanks for posting in HCM.Yes, jaundice is the most common cause of yellow discoloration of the skin.A closely mimicking condition in hypercarotenemia. In jaundice the sclera (white of the eye) also turns yellow, but in hypercarotenemia it remains white.Hypercarotenemia occurs due to excess carotene (precursor of vitamin A) in blood. It occurs due to intake of carrots and similar yellow  orange food ietms. It can also occur in conditions like hypothyroidism and diabetes.You can discuss with his doctor about these possibilities.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tooth abscess and toothache\n\ni have a abcessed tooth that is causing me  major pain. The only thing that helps is cold water. However if I stop using cold water for even 30 seconds i am in excruciating pain. The dentist today identified i have a dead tooth and prescribed me t3's and an antibiotic. The pain however seems to have localized to a specific tooth now that was not the one identified as dead. What can I do to get some relief to be able to sleep?",
    "doctor_response": "Thanks for your query. I have gone through your query.  Nothing to be panic, the features you are giving are the characteristic feature of pulpitis.  To reduce the severe pain during night time, just take a ketorol dispersible tablet(if you are not allergic.). You need to take a course of antibiotics like amoxycilin and metronidazole (if you are not allergic. The affected tooth has to be treated with root canal treatment. I hope my answer all help you. TTake care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the reason for cold feet three weeks after hip arthroscopy?\n\nHello doctor, I had a hip arthroscopy three weeks ago and today, my feet are very cold with no other symptoms. No symptoms prior to today. Could this be a result of the surgery or something else?",
    "doctor_response": "Hello. I understand your concern and would explain that your symptoms are not related to the arthroscopy. A possible deep vein thrombosis could cause these symptoms. Do you see any change in the color (pale or bluish) in your legs? Can you feel the pulse on the dorsal part of your foot whenever touching? I recommend trying to move your legs, and wear warm socks. If your situation worsens, and you experience pain, inability to walk, swelling or changes in the color of your legs skin, I recommend going to the ER for a physical exam and a Doppler ultrasound of the leg vessels. I remain at your disposal for any further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cause and medications for tooth pain\n\nHad a root cannel done 10 years ago, tooth just start a few days ago being very sensitive to cold liquids & now has a slight pain. Could there be a crack in tooth letting air in causing pain. The root area is beginning to show more now. What could be the cause for slight pain?",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,  I have gone through your query,  as you have undergone Root canal treatment 10 years back now you have pain and senstivity , dont worry it can be due to Periodontal Pocket formation . For this you do warm saline gargle two - three times a day Consult dentist and go for Scaling and Curretage .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there pregnancy chances after missing periods for months?\n\nI am 49 and had a period last July.  Then not until this past March.  Last night my husbands condom came off.  Do you think I am still ovulating?   Do i have a chance of getting pregnant?  How long do I have to wait to take a pregnancy test to know for sure?",
    "doctor_response": "HELLO DEARI understand your concern , dear it is very unlikely you will be pregnant but then also you should ruled out pregnancy by performing urine test after 7 to 10 days, the reason behind these is mean age of menopause is 51yrs .THANKS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower abdominal, groin and lower back pain, urine culture showed E.coli. Help?\n\ni am having an lower abdomen pain, groin pain and lower back pain i did the urne culture test and below are the result pls help Organism isolation : E.coli Colony count : 0000 CFU /ml Sensitive to : AMIKACIN CEFOTAXIME GENTAMYCIN NETILMICIN NITROFURANTOIN PIPERACILLI+TAZOBACTUM TOBRAMYCIN GENTAMYCIN Resistant to : AMOXYCILLIN+CLAVULANIC ACID AMPICILLIN COTRIMOXAZOLE NORFLOXACIN",
    "doctor_response": "HI Mr Dinesh I think you mistaken the colony count of E Coli, any way if it is more than 100000/ml then it can be diagonosed as UTI(urinary Tract Infection) if you have following symptom present- 1)Burning sensation during urination. 2)fever If so you have to start antibiotic (choice will be a sensitive one as per report), as well as Urine alkaliser.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tumour on adrenal gland\n\nI had high bp for 10-15 days before I was diagnosed for very small tumour on adrenal gland and treated. During this period, investigations revealed that I have basal pnemonia. The doctor discharged me saying its fluid that will go away. I however feel warm yet my body temperature is 97 deg C. Do I need medication for this basal pnemonia?",
    "doctor_response": "Hi,Thanks for writing in.A small tumor in the adrenal gland is most likely a benign one. Adrenal tumors can be functional or non functional. If there is a small non functional tumor in you then treatment is not required. However periodic evaluation by doing scans is recommended to judge any increase in growth of the tumor.Basal pneumonia is infection of the basal segments of the lungs. The basal segments refer to lower lobe segments and you might be having pneumonia in one of the lungs involving the lower lobes basal segments. There need not be fever in every patient having pneumonia in the early stages. Some can only present with chest pain and discomfort and coughing. It is important that you get it checked by a pulmonologist and take required medication and get treated early. Delaying treatment might cause severe pneumonia and complication. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment should i go for white blisters?\n\nI have a white blister on my glossopalatine arch it has been there on and off for around two years it is sometimes larger than times but is always in the same place it has now began to be slightly painful like a mild throbbing pain but the pain may be due to the fact that I m more aware and my tongue searches for it regularly, I have a sensitive tooth nearby not sure if this is relevant. I ve seen my GP dentist and a specialist over the two years since it started but due to the nature of it coming and going it has only been seen once by my GP who was not sure what to suggest, it is now present a lot more frequently the specialist did not see it but said I should not worry about it",
    "doctor_response": "what is the frequency and how do they disappear. do you have burning sensation in those patches while eating. u can apply any anaesthetic ointment on blisters for symptomatic relief. but exact diagnosis can be done only after a thorough examination of your blisters.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have high amounts of microalbumin in my urine, what should I do and what could be the cause ?\n\nI am a 21 year old white female who weighs 115 pounds and I m 5 4 . I have high amounts of microalbumin in my urine. I went to my physician where I have had two other urine tests done. The first test done 11/18/2010 results found my microalbumin levels at 45.3 ( and should be between 0-17 ug/mL) and the second test done 12/01/2010 my microalbumin was 70.8. Other than my vitamin d level being 16 and should be at least 100, they found nothing else and nothing in my urine (no creatine,etc.). What should I do and what could be the cause?",
    "doctor_response": "Hi.  Welcome To HealthcareMagic An elevated microalbumin level is the first sign of kidney damage.Both diabetes and high blood pressure \u00e2\u0080\u0094 among many possible causes \u00e2\u0080\u0094 can damage the kidneys. I recommend the 24-hour urine test which provides the most accurate micro albumin results. Also some connective disease can cause proteinuria. I recommend ANA, RF. At the tests, consult urologist. Regards, Dr. Jagdish",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard and fast beating heart?\n\nDr. when I go to bed my heart begins to beat hard and fast, especially when I try to sleep on my side. I usually take 500 mg. of metformin and Ambien CR when I can, just before I retire. I cannot sleep. Last night I only slept about 15 or 20 minutes because I didn t have any Ambien CR. When could be the cause?",
    "doctor_response": "Hi,welcome to Healthcare magic.Thanks for posting your question on this forum.I understand your query and concern.You probably seem to have orthostatic hypotension.This can be due to autonomic nervous system dysfunction.This condition needs review of your body electrolytes and a 24 hour holter monitoring.Maintain adequate hydration with 4 liters of water each day.Drugs like fludrocortisone will help to control your symptoms.I advise you to have a baseline ECG and 2 dimensional echo on the follow up to have a recent quick review of your cardiac functional reserve.Consult an expert cardiologist for further expert management.Post your further queries if any.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a person having cheek lesions subjected to oral cancer by the consumption of drugs?\n\nHi there, I was curious if over the course of a two year period, a twice-a-month oral consumption of recreational illegal drugs, coupled with the daily use of marajuna and tobacco whilst suffering from semi-recurring cheek lesions (caused by sharp wisdom teeth) could lead to oral cancer in such a short period of time?",
    "doctor_response": "Hi,Thanks for posting the query,  I would suggest you to get an examination done by an Oral Surgeon.A complete physical examination is required to determine the cause and treat accordingly.Get the sharp cusp of wisdom tooth trimmed.Take a course of multivitamin suplements.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do PHOTODERMA SPF30 a very effective remedy for brown sport and skin lightning ?\n\nDo PHOTODERMA SPF30 a very effective remedy for removal of brown spots caused due to acne and sun burn. if yes, please tell me the direction of its use,its effectiveness ,in how many days it will start showing results,how many months of its usage help me to get rid of these brown spots and also does it helps in skin face color toning and lightning.",
    "doctor_response": "hi it depend on the spot and  its depth u need to consult dermatologist for this photoderm has sun protective and moisturizing effect it has little effect on brown spot so dont try such product without advise better and safer treatment are there in dermatologist's tool",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sensation under the skin?\n\nHi dr . From the last three months .. i felt there is something like moving under my skin in my whole body ..in every part ..but specially my leftleg and feet and in my hips as well.. and i still feel that sometimes  What could is that be ? P.s. I was tired and i had adepression and i was worried in thst time till this moment ..",
    "doctor_response": "Hello!Welcome on Healthcaremagic!Your symptoms could be related to different possible causes: anxiety, an electrolyte imbalance or seizures. For this reason,I recommend consulting with your GP for a physical exam and some tests: - complete blood count- blood electrolytes- vitamin B12 levels - vitamin D levels- thyroid hormone levels. If all the above tests result normal, you should consider anxiety as the main cause of your complaints. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough after pneumonia recovery\n\nmy daughter is 4 years old , she suffered from pneumonia ,and got curred one month before, now she is again suffering from cough?doctor suggested to use montair -LC Kid tablet  daily for 3 months?what is the acutal problem ,whether tablet is safe to us",
    "doctor_response": "HI if your child is getting recurrent cold/cough it may be mostly allergic in nature and so your doctor had prescribed this medication.Its safe to use and can continue.Hope it answers your query and ready to help you further",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicine for fever in baby\n\nHello doc, My baby boy is 1 y.3 months old now...he was having fever, as suggested by doc here i gave p250 and bactoclav ds 457 syrup too...he is suffering from fever even after 2 days. Doctor mentioned bactoclav d syrup and medical shop give bactoclav ds 457. Whether both are same ....pls help",
    "doctor_response": "Thanks for putting up your query at HealthCareMagic. Had you mentioned the weight of the child, the temperatures recorded, the nature of fever and whether he is having associated symptoms like cough , it would have been easier for me to commentt. Most commonly such fevers are due to viral cause which are not relieved on treatment with antibiotics. These are self correcting conditions that automatically resolve in a few days.Bactoclav is same as Bactoclav D Syrup and contains Amoxycillin+Clavulanic Acid.However, it could also due to typhoid or certain other reasons and might need to get investigated. Please consult your pediatrician about this.I hope that helps. Feel free to contact back with further queries if any.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there no period after stopping Primolut N and taking I-pill?\n\nHello doctor, My wife took Primolut N when we were about to get married (for 17 days) and then on the 15th, 16th and the 17th day we had unprotected intercourse. In order to avoid pregnancy, she stopped her Primolut N dosage on the 17th day and tool an I-pill. In spite of doing so, she has not got her periods. Can she be pregnant?",
    "doctor_response": "Hi. Although history is not complete, she got an overdose of hormones which might effect withdrawal bleed as well as periods. Stress, overwork, illness, medications, hormonal imbalance all can delay periods. Have serum beta hCG to check pregnancy. If no pregnancy, then wait for weeks at least before menstrual induction (tablet Primolute N 10 mg twice daily for five days and wait for bleeding for 1 to 2 weeks). Next periods could be irregular after withdrawal bleed but gradually periods will get back to normal as soon as the body gets rid of externally induced hormones (I-pill, Primolut N).  Missed periods post pill. Beta hCG. Beta hCG if negative have menstrual induction. Cocp (oral contraceptive pills) for regulating cycles.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat high AST and ALT levels?\n\nHi, I got my AST and ALT test in a normal range on 4/10 and just about couple weeks ago, I did another blood test and the numbers came back suprisingly high, in 200s, is something wrong with me?  Also I did take a lot ot supplements from Standard process from about mid of March until present, will these affect my ASL and ALT score?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.AST and ALT are liver enzymes. Their levels are increased in liver damage. It can be due to alcohol, toxins, drugs or viral hepatitis. you should go for complete liver function test. Search for the cause and take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Numbness in legs, severe headaches. MRI shows two hyperintense flair foci in right frontal lobe. Significance?\n\nI had a MRI recently and these were the findings...my Dr. says everything was normal.\"Two small hyperintense FLAIR foci in the right frontal lobe subcortical white matter are nonspecific and do not meet MR criteria for demyelinating disease.\"  If it was normal...why are my headaches so severe, whyare my legs and feet numb and why is my memory so terrible?  I have 4 family members withMS....",
    "doctor_response": "Hi,Though MRI brain does not meet criteria for demyelinating disease, but MRI brain is not normal, it has two small hyperintensity in R) frontal lobe which can produce pain and weakness in left half especially L) lower limb(leg), these area  also precipitate seizure hence episodic headache can be the only manifestation at times.Hence this lesion to be considered as ischemic and should be treated with antiepileptic especially sodium valproate with antiplatelets.Further blood sugar , thyroid profile and lipids to be checked and treated accordingly.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for brown spots on butt crack which is spreading\n\nI have brown spots on my butt crack and now they are spreading to my chest arm pit area knees and thighs. It has been almost a year since my doctor told me to use a special shampoo, but that didn't help.. what can i do to get rid of them? What are they?",
    "doctor_response": "HiThank you for asking HCM.I have gone through your query. Your problem can be due to fungal infection called tinea versicolor. If you send a picture of that then it will be more helpful to identify. For such case in my patient i usually advise fluconazole tablet orally weekly once for 1 month along with terbinafine or ketoconazole lotion for local application. Ketoconazole soap or powder also can be used.Hope this may help you. Let me know if anything not clear.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in back and front side of the ribs\n\nI fell a couple weeks ago and hit my back right rib and the front area under my breast bone is killing me. The last couple days it felt better but today I went to my chiropractor and he said a rib in the back was sticking out -I even felt it.  He adjusted it andr now it hurts in front again.  What do I do?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. You are mostly having rib fracture due to blunt chest trauma. First confirmation, you should definitely get done chest x ray. Chest x ray wil also identify if internal lung damage is there or not. If chest x ray is normal then no need to worry for this lung injury. Follow these steps for better symptomatic relief. 1. Avoid movements causing pain. 2. Avoid heavyweight lifting and strenuous exercise. 3. Avoid bad postures in sleep. 4. Take painkiller and muscle relaxant drugs. 5. Apply warm water pad on affected areas. 6. Wear rib belt to prevent minimal mobilization of affected areas. Don't worry, you will be alright within 2 weeks. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in my lower middle back?\n\nTwo weeks ago I had a cold and was sick with a pretty bad cough. Well I started a coughing fit and I felt something pop in my lower back while I was sitting at the table. After it popped I had severe pain, I could hardly move it was hard to get up and sit down and even use my hands to reach over the table. It has been about two weeks since it happened and it still hurts. Especially when I try to look down I feel the pain in my lower middle back.  What could I have done and do I need a doctor? Will it heal on its own?",
    "doctor_response": "Hi,It seesm that due to bad cough there might behaving some strain and spasm of mid back muscles producing this pain.Take analgesic medicine like Diclophenac with muscle relaxant to get cure.Apply muscle relaxant cream on the part.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the  chances of getting pregnant with PCOD?\n\ni went through medical check up then they found that i am polysystic ovarian.. i gain weight 40% of my normal weight ang i dont have monthly visit. doctor give me metformin to take 2x a day. is there any posibility i will get pregnant im 28 and just get married.",
    "doctor_response": "Hi, you can get pregnant.  In pcod patients the problem is with ovulation.  So, the periods doesn't come in time. Medicines are available for that . Metformin helps in PCO patients by increasing insulin sensitivity.  Whenever you plan pregnancy, consult a gynecologist.  You can use some oral contraceptive for now if you don't want pregnancy because it is also a treatment for pcos. Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to continue Paxidep CR for depression when planning to conceive?\n\nHi, I am taking Paxidep CR 12.5 mg for depression, at the same time I am also planning for baby (not pregnant yet), Is it safe to continue with the medicine as I have read many posts that it may cause heart deffects in new born baby. Shall I stop taking medicine or I can stop later after I have conceived?",
    "doctor_response": "Hello, If you are trying to conceive, you should review all your medicines(and not only PAXIDEP) with your clinician, to ensure that they are safe to take. Please visit your clinician. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr AJEET SINGH, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nausea and persistent fever when SGPT is elevated?\n\nA patient of 17 yrs complaining of nausea,head ache,vomitting,persistent fever ( 102-102 f)......MP test no parsite seen......Full blood count shows elevated esinophils....while liver tests show bilirubin low and SGPT is also elevated.......Diagnosis???????????",
    "doctor_response": "Hellou need to get a ULTRASOUND OF LIVER and complete liver function tests along with test for HEPATITIS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to do exercises when having high BP?\n\nHi. I am on benicar , low dose 20 mg.Over the last month for some reason my bp has been about 152 over 110. I have (without cunsulting my physician) increased my benicar to 3 times a day  (20 mg).I feel very bad, shortness of breath, feeling very bloated,  pain in chest ir maybe back, cant tell,so all encompassing. Still bp remains high. Is it safe to excercise in this state?",
    "doctor_response": "Hello. Thank you for your question and welcome to HCM. I understand your concern. Physical activity has a prominent positive effect on the circulation and, thus, on arterial hypertension. So, it is highly recommended that you excercise while with hypertension for 60 minutes a day: jogging, swimming, brisk walking, going to the gym or other light to moderate physical activity alternatives. Olmesartan should not be adjusted to 60 mg a day and I would strongly recommend you to not change the treating regimen without consulting your curing doctor. If these figures of blood pressure are a constant finding, then I would recommend adding a second agent to your hypertension treatment. So, a beta-blocker, calcium channel blocker or a diuretic would be a good choice. The aim is that the blood pressure be maintained under 140/90 mmHg, because it is proven that long-standing higher than these figures cause gradual end-organ damages. I hope I was helpful with my answer. Take care. Kind regards, Dr. Meriton",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stoppage in periods?\n\nsir i hv missed my regular periods by 7 days, im 24 yrs old, last time had unprotected sex with partner was 2 weeks ago, from last 3 days feeling uneasy,hv frequent cramps in left lower portion of stomach, last night was feeling nauseatic, tell me what should i do, i dont want a child rt nw as i m working, if im pregnant tell me the soltion to get out of it.",
    "doctor_response": "Hello dear,Welcome to healthcare magic.I understand your concern.If a regularly menstruating sexually active woman complains of missed period then the pregnancy is the first thing to rule out.As your period is 7 days delayed I suggest you to consider doing a urine pregnancy test.The urine pregnancy test gives accurate results a week after missed period.In case if the test is positive the pregnancy can be terminated in two ways depending on the age of pregnancy.The medical termination of pregnancy is possible upto 7 weeks.After 7 weeks surgical procedure like D&C is required.So as it early pregnancy the medical termination can be tried.It is effective upto 95%.The medical termination of pregnancy includes usage of mifepristone and misoprostol tablets.The bleeding usually starts after a few hours of taking misoprostol.A ultrasound need to be done 14 days after to check for complete abortion.But these medicines are associated with complications like heavy bleeding,incomplete abortion etc.So they need to be taken under strict medical supervision to avoid complications.In case if the test is negative I suggest you to repeat the test after a week.If the repeat test is also negative then the pregnancy is ruled out and the delay is attributed to stress induced hormonal imbalance.So relax and consider doing the urine pregnancy test.Hope this satisfies your query.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lethargy despite taking anemia treatment\n\nAfter a blood test at my last Dr. s visit it was discovered that my hemoglobin was 6.3 so I was sent to the hospital for 2 units of whole blood! The next blood test showed hemoglobin at 7.6 and I am so lethargic I can t function. What next? P.S.: I am 70 years old, male, and have had Crohn s Disease for 50 years",
    "doctor_response": "Hello. Thanks for asking on Healthcaremagic. A hemoglobin level of 7.6 is quite low for a male. You need to further investigate the cause and take appropriate supplements and treatment. The lethargy is due to anemia. Anemia can be due to reduced intake of iron b12 or folate. In old age it could be due to impaired absorption despite adequate oral intake. Sometimes injectable haematinics are required to overcome impaired absorption. Moreover anemia could be due to occult blood loss from any hidden site. So a thorough investigation is a must. Also you can get your thyroid hormones checked to rule out hypothyroidism. Hope I was helpful. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for depression\n\nFeeling very low at the moment I have been to c a doctor and has put me on venlafaxine plus go am taking mirtazapine also zopiclone to help me sleep .Today has been my worst day live even looked for a mental health hospital nearby .I hv been depressed before but that was over 22 years ago when I hv hd postnatal depression but I hd to hv electric shock treatment .Please can anyone help me",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behavior, feelings and sense of well-being. Depressed mood is not always a psychiatric disorder. It may also be a normal reaction to certain life events, a symptom of some medical conditions, or a side effect of some drugs or medical treatments. This is what you should know. Depression need not be treated with medicines, in the first hand. It requires life style changes so that the mind acquires the capacity of coming out of the current negative feelings. These things are practiced in psychotherapy. Plenty of oxygen through deep breathing relaxation techniques, plenty of water and exercise are essential part of therapy which surely results in total cure.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a missed period despite taking Ovacare\n\nI have pcos problem, I m have been prescribed by doctor to take ovacare 2tymes a day along with lycomin at night .For 3 month. I want to consive ,I was not getting my periods regularly,bt after taking medicine I don t see any result my period is still irregular and very light bleeding occurs during period .. what to do",
    "doctor_response": "Hi there, I will suggest you the best possible treatment options.First of all do not panic.At the outset I will suggest you to get USG done to rule out PCOS- Polycystic ovaries as a cause of your irregular periods.Thsi is a lifestyle disorder and can be tackled by healthy lifestyle changes.Secondly, get post menstrual HSG- Hysterosalpingography done. This helps to know about the patency of the Fallopian tubes. Also, partner's semen analysis with 4 days abstinence should be done, this will help to know about the quality and quantity of the sperms.If these reports are normal, you can seek prescription support from your treating doctor for ovulation induction medicines. Follicle study from day 10 of the cycle will help to know exact date of ovulation. You can opt for IUI- Intrauterine insemination on the day of ovulation or opt for natural unprotected sex activity on and around the day of ovulation.Please start on Folic acid and vitamin B 12 supplements regularly.Think positive.Meditate regularly.May God bless you with a bundle of joy.I hope this answer helps you.Thanks.Dr. Purushottam Neurgaonkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Increased SGPT, taking medication. Guidelines to make it normal?\n\ndoc, my first sgpt reading is 135. so the doctor told me to have a medication for 1 week and advice me to take godex 2x a day for seven weeks. after 1 week, i go back again and see wat happens. i was so disappointed with the result because i took medicines for 1 week and then my sgpt result becomes higher. it reaches 160 instead it decreases..wat should i do?please give me guidelines for wat i have to do to make it normal.",
    "doctor_response": "Hi, Welcome to HCM, You have high liver enzyme called SGPT, first it is most important to know the cause of such rise then treatment becomes easy. Commonly liver enzymes rise due to Viral Hepatitis,drugs( many), Alcohol intake, diabetes and fatty liver. These are some of common causes, it is not clear from your description what was the cause of liver dysfunction. Please visit a Physician /Gastroenterologist and examination followed by required investigations like complete liver function test, abdominal ultrasonography. Treatment depend on cause so no specific therapy is there for liver. In some cases these enzymes may take some time before they come back normal. We must remove cause to improve this, take care of diet and do not take alcohol if it is there. I am sure this is mild derangement of live and in few weeks time it will come back to normal. Take care Good Luck. Dr.Akhilesh Dubey M.D.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe cough\n\nI have had a severe cough x s 5 days. 4 days ago I started getting a severe burning sensation to the left of naval area when I cough, breath deeply or lay on that side. I also feel blaoted on left side, around kidney area as if there isn t enough space as usual. I have had kidneys stones and the burning is different.",
    "doctor_response": "HelloAccording to your query it seems that you are having two troubles . As you mentioned that you are an old case of renal stone .While cough , which is severe in nature is for  5 days . This cough may be due to some allergy or due to some infection . Physical examination by a physician will decide the type of cough.While burning sensation in naval area is due to renal stone . Bloating , burning sensation may be due to pain in stone .In my opinion consult a physician and get his opinion as physical examination is important.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could stress fracture cause painful knot on the ankle?\n\nI play lots of tennis. Yesterday pain occurred in my lower right leg, 2-3 inches above ankle. Appears to be a knot in this area. My wife, an RN says could be a stress fracture or stress on the lower tibial tendon? I am 58 years old. Currently putting ice on every 4 hours and elevating. Anything else I need to do??",
    "doctor_response": "I will suggest you some Ayurvedic medicine it will cure your problem along with prevents from complicationstab yogaraj gugglu 2bd cap shallaki 1tds",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility problem\n\nHi Doctor..I am karthik..I am 32 Years Old..I am trying for a baby...I did a semen test last week and was observed to be 6 ml..with motility of 70%..Since My wife also has a PCOD problem..Our doctor has suggested me to take Maxoza l Powder for a month and again repeat with a semen test after a month...Also i was informed that my wife has to undergo a medication for the Egg Formation as currently the egg formation is inconsistent and has a periods only once in 2 months..Also it was suggested that IEU is the only way to treat this..please help me out in this if by havin the Maxoza-l will there be any increase in Sperm Count and if there is an substantial increase in Sperm count cant we try normally if my wife s treatment for egg formation is positive...",
    "doctor_response": "Hello,Welcome to Health Care Magic.Thanks for writing.I am Dr.Nitasha Khan. I have read you question completely, i understand your concern and will try to help you in best way possible.your sperm motility is ok but it shuld be bettr so doctors prescribed you medicine to increase it and soon you wil have a good count and motility if you follow the treatment eat regularly and eccercise and have healthy diet secnd problem is your wife if she is having pcos than its difficult to cncieve children without treatment if she undergoes treatment and mean while you under go treatment i dnt se there is any thing stopping you from having babies than you wil have them just stick to the treatments and hope for the best I hope this answered your question.If you have more queries I am happy to answer.Otherwise rate and close the discussionRegards.Dr.Nitasha Khan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does discolouration in gums indicate?\n\nI woke up this morning and my gum around one tooth is a dark purple color. It doesn't hurt but feels swollen and a little tender. The discoloration is only on the outer gum the roof of my mouth and the gum surrounding the tooth toward the inside of my mouth is a normal color. When I brush it it does not bleed or anything and I dont think I cut it. I have an appointment with the dentist but not for another 2 days. Do you have any ideas what this could be?",
    "doctor_response": "Hello!Thank you for posting here.This discoloration can be calculus or a piece of food struck which can be causing pain and discomfort.Do not try poking it.Do warm saline water gargle thrice daily.Brush gently.Do not panic.Your dentist will remove it with a scaler or a curette.Avoid this area for chewing if possible till you see your dentist.Your dentist will be suggesting you a floss or interdental brush after clinical examination.Take a OTC pain killer if necessary.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain started from left, now in right mid back, stiffness in right hip. Could this be pleurasy ?\n\nmy husband went to the ER last night with rt side back pain.  it started in the left side and is now in his right mid back and stiffness in rt hip.  the doctor took chest xrays/no blood work/no urine sample.....  he cannot lay down and rest he can sit up and the pain is not so bad.  the doctor said she thinks it is muscle related and just said to take an antiinflammatory that he had in the past for back pain...mobic.  This has been going on for 4 days now and it seems even worse today.  it hurts when he tries to take in a deep breath or sneezes etc.  today he is running a fever and is having even more stiffness and pain.  he took the mobic last night and again this morning.  he says his jaws Could this be pleurasy?  Would that have shown on an xray?  Should he go back to the ER tonight?",
    "doctor_response": "Hi, thanks for using healthcare magicIt is unlikely that muscle related pain would cause a fever, there may be a slight increase in warmth in the muscles affected but it should not cause a fever.This makes it less likely to be only muscle strain or trauma.Pleurisy is inflammation of the lining (pleura ) of the lung, it would present on pain that is worse on taking a deep breath. There are different causes such as trauma, infection, pulmonary embolism, caused by a side effect of medication, due to autoimmune disease, heart disease, pneumonia.The changes on xray would depend on the cause of the pleurisy.In light of his fever and the fact that the pain is not relieved by his medication , you should consider going back to a doctor for reassessment.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for runny nose,cough and swelling of gums\n\nHi Doctor, I have a 22 month toddler who is currently have fever n runny nose n cough with phlegm. But I don t understand why is her gums swollen as well n she also has a pus on her tip of her tongue. Her gums are so swollen that upon starting to brush her teeth it started bleeding. Pls advise. Thank you.",
    "doctor_response": "Hello,Thanks for consulting HCMRead your query as your child has runny nose , cough and swelling of gums dont be worried so much this can be due to viral infection I will suggest you to consult child specialist for cold  and examination of oral cavity .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are all the diseases that could be acquired from our pets and how to treat them?\n\nHello doctor,What diseases can we potentially catch from our pets and how to prevent and treat them?",
    "doctor_response": "Hello. 1. Toxoplasmosis is an infection from cats to human. We have to wash our hands, maintain cleanliness, and avoid contaminated food. 2. Ringworm can be contracted from spores that survive without a host. Personal hygiene and cleaning of clothes and utensils with hot water as preventive measures. 3. Campylobacter from cats to humans if not washing hands with water and soap after being in contact with cats or their feces. 4. Roundworm, cat parasite causing gastrointestinal problems and blindness if left untreated. Practicing proper hygienic measures can prevent infection. 5. Salmonella and giardia can occur through contaminated cat feces. Should practice proper hygienic measures.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are moxikind vc 625 capsule and moxikind tablets same?\n\nI have some infection in my teeth , doctor suggest me for moxikind vc 625 capsule , but in medical owner give me moxikind tablets , can i consume it not, I have some infection in my teeth , doctor suggest me for HCG with Amino Acid complex , but in medical owner give me moxikind tablets , can i consume it not,",
    "doctor_response": "your problem sounds to be a perio endo lession...which should be treated simultaneously...it sounds you must go for rct( root canal treatment ) for infected tooth by the same time get perio treatment done...because treating 1 at a time wont let your body respond to another treatment .... meet your dentist asap !!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pregnant having contractions, greenish vaginal discharge. Need medical attention?\n\nim 37 weeks pregnant and have been having very mild contractions i am having a c section on the 7th but i have been having a discharge it started out clear then went to yellow and now it is green it is like a mucus i have a appointment in the morning but if it get any worse should i go to hospital oh and no burning or anything when i pee",
    "doctor_response": "hiii,You are 37 wk pregnant and present with greenish vaginal discharge with contraction.It is probably MSL (meconium stained liquor) and a leading cause of fetal distress.It is an emergency and need urgent delivery of the baby by C-section.So consult with your doctor and admit to a hospital as soon as possible.Be well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for running nose and cough during teething\n\nmy grandson is teething and after two teeth he has been no trouble. these last three days he has had a runny nose and a cough, hes screaming every time he coughs (he also breaks wind same time) he wont settle through the day either, and cries more or less constantly",
    "doctor_response": "In infants running nose is most common presentation... Running nose with cough need antibiotic.... Get the patient examined with local pediatrician...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe chest pain and shoulder pain\n\nHi, I keep getting chest pain & a dull ache in my left shoulder, sometimes my whole arm & neck. I also occasionally get a coppery taste in my mouth. I have been in hospital with this once over the last two years & I ve also recently had a check up after moving surgery & my Dr had no concerns really but it keeps happening & is really worrying. I also keep getting very painful, large spots in the centre of my chest that never go away, they just get larger then smaller, then larger again & when they get big, it s agony. Any ideas?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. I can understand your concern. By your history and description, possibility of stress, anxiety related symptoms is more. But since it is left sided chest pain better to first rule out heart diseases. So get done ecg and 2d echo. If both are normal then no need to worry for heart diseases. Your symptoms are mostly due to stress and anxiety. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic drugs too. Don't worry, you will be alright. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and a painful lump on the buttock\n\nMy husband is wheelchair bound and is complaining of his butt hurting....upon inspection there is a hardened area on his left butt cheek and there is a smaller area that is open in the middle of it...he is complaining of being achy and is running a 100.5 temp...could this be a pressure sore or possibly something else",
    "doctor_response": "Thank you for asking Healthcare majic. My name is Dr Ehsan Ullah & I have gone through your query.in wheel chair bound or bed ridden persons , pressure sores are common at areas where bony land marks are close to skin and there is weight on those spots.This can be pressure sore but since he is running temperature of 100.5 then probability of perianal abscess is also there.in that case, such swelling should be evaluated by the doc via clinical examination so that he should further guide your husband about treatment plan which can be either via Conservative approach or via surgical approach depending upon the size and condition of the lump as well as the condition of the patient,Hope this may help you. Let me know if anything not clear. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore throat along with cough and nasal congestion?\n\nMy daughter (6) and son (4) both have the same symptoms. Sore throat, cough, lots of nasal congestion and drainage, very red and swollen in both eyes and yellow drainage in eyes. Very low grade fevers, 99.6-100.0. I would guess allergies if it were just one child, but two makes me think its something else. No rashes observed. A little more tired than usual.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. By what you quote I feel that your kid might be having a viral sore throat or a streptococcal infection. I suggest you see your pediatrician and get a rapid streptococcal antigen test done. If it is positive then she will require antibiotics. if it is negative then it might be viral illness and doesn't require antibiotics at all. Cough and cold are viral 95% of the times in children. For cold you can use anti-allergics like Cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15mg/kg/dose (max ceiling dose 500mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "SHOULD BE WORRIED FOR ANABOLIC STEROIDS AND FERTILITY\n\nMY HUSBAND HAS USED ANABOLIC STEROIDS IN THE PAST AND FEARS IT HAS AFFECTED HIS ABILITY TO HAVE CHILDREN, WE HAVE BEEN MARRIED FOR 4 MONTHS AND HAVE BEEN INTIMATE ABOUT 15 DAYS IN THOSE 4 MONTHS (HE S IN THE NAVY) AND HAVENT BEEN ABLE TO GET PREGNANT , DO YOU THINK WE SHOULD BE WORRIED? SHOULD WE SEE A SPECIALIST?",
    "doctor_response": "welcome to healthcaremagic only 15 days intimacy in 4 months is not enough time for pregnancy to occur may be you had only few fertile days together in that cycle it will be better for your husband to get a semen analysis done to rule out any defect in it these 15 days were in single month or in few days each month in 4 months you shoul keep record of your onset of period and try to be together in mid cycle",
    "dialogue_context": ""
  },
  {
    "patient_message": "Constant lump on the testicle, hurts on touching, increasing in size. Sign of cancer?\n\nIm 17 and i have a little lump on my left testicle it was about 1mm and only hurt a little when I touched itthe lump has been their for a long time and I m not sure when it came or if I was born with it (I ve only noticed it in the last year or to) recently it has grown to about 2mm and is about more sore when I touch it ( it only hurts when I touch it). Im worried this is testicular cancer and I don t want to lose a testicle, what should I do",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have what is called as Spermatocele.This is a benign condition and needs no treatment unless it increase in size or becomes painful.Do not worry this is not a cancer of the testis at all.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest prognosis of health conditions\n\nmy aunt is in the final stages of melanoma. she has hospice and in the last week i noticed she has more difficulty breathing and has started coughing up mucus with alot of blood. about 6 weeks ago the doctor gave her a few weeks. based upon the changes in the last week, can you tell me what the next symtpoms will be and roughly how soon? Im trying to spend as much time as possible with her.",
    "doctor_response": "Hi,Thanks for writing in.Cancer is a challenging diagnosis and the life expectancy, survival and prognosis depends on the stage of cancer and response to treatment with chemotherapy and radiation therapy.Melanoma is an aggressive tumor and spreads to other organs even after the primary cancer is operated. Your aunt might be having spread to other organs as you have described her condition is in the final stages. She must be a strong willed person and that is the reason she is exceeding her doctors prediction of her life expectancy.It is possible that she might survive for a few weeks more. Coughing up blood is not a good sign and that itself might cause her to give up. This is causing blood loss and therefore the next symptoms might be that of severe weakness, increase in blood loss and probably she might catch an infection in her lungs, a pneumonia sort of. It is nice to know that you are spending a lot of time with your aunt in her final days. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child have sneezing, running nose and throat pain\n\nHello, I m having a bad day. Last night I started to sneeze, I thought it was normal. But I guess wrong. When I went to school my throat was hurting me and my stomach, also I had a bad running nose. I told my dad, but he said it s just a cold. To be honest I don t even know if I have a cold or not. Please help. Thank you, doc.",
    "doctor_response": "Probably you are suffering from common cold which is basically a viral infection. There are a number of viruses that could cause this. Antibiotics are ineffective in such infections. Even if it is streptococcal sore throat, irrespective of the use of antibiotics, it will take 5-7 days to go away. Just take steam inhalation and gurgle with lukewarm water and you will get relief. Also take some antiallergic like levocetirizine. It will help in reducing the sneezing. You need not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chronic pain under rib cage. Colonoscopy, endoscopy normal. Ultrasound shows fatty liver. Medication?\n\nCurrent issue is chronic pain in upper right GI area just under rib cage. Colonostomy normal, endoscopy normal except some diverticulitis, ultrasound of GI normal except fatty liver; gall bladder function tested at 92%. Doc says 92% is normal so gall bladder is fine. Online resources disagree that 92% is normal. Some say it should be less than 85% or it is considered hyperactive / hyperkinetic. Which is true? Also could the constant pain be coming from my liver? My PA says your liver has no nerves so it can t hurt. I am hurting and need help. What should I do?",
    "doctor_response": "Hi I read carefully all you concern and  I can say that your pain is not from fatty liver.yes you may have a hiperkinetic gallblader  and it is associated with abdominal pain. your chronic pain may be related to  bowel (large colon )spasms,So  you should eat bit and frequently, and please try to avoid stress. All the best DR.Klerida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back pain radiating to the groin?\n\nI am experiencing pain in my lower back left side going down to my goin area. My feet and legs are red and very swollen. I have had tests run but no diagnosis to date from a physician. I am a smoker,and drink an excess of beer. I thought I had a Hernia but the doctors say no. No one has prescribed any medication other than local pain medicine. I do not take any other Medications. Do you have any suggestions as to how my goin pain is related to the swelling of my feet and ankles ?",
    "doctor_response": "I think u may have cellulitis which can cause swelling of limbscheck for renal function testdo an ultrasound abdomen and pelvishaemoglobin can be checkif everything normal do Doppler for diagnosing deep vein thrombosis",
    "dialogue_context": ""
  },
  {
    "patient_message": "Soreness in calves & thigh a side effect of Bactrim & Pyridium intake?\n\nI went to the dr this morning for a UTI. she put me on Bactrim and Pyridium. This afternoon i started to notice that my calves and thighs are VERY sore. and my feet/toes hurt really bad. they hurt like their freezing cold, but there not. Is this a side affect of the meds and should i call my dr in the morning?",
    "doctor_response": "dear Sir I have understood your concern, please mention do you have any history of injury or heavy work done by you? see pain or soreness in legs and calves due over load syndrome or due to deficiency of minerals like calcium and magnesium and phosphates see the reasons may be due to drugs interaction your gastric absorption may be affected. you need to ask your consulted doctor again. if it's due to muscular fatigue or delay onset of muscle soreness and give rest Apply ice and do little active movement within 3day you will recover. I hope you have satisfied with this answers.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for uncircumcised Penis\n\nHi, I am cercumsized (not sure on spelling) but for some time now I get a tight band nearthe head of my penis . When I have intercourse I get painful \"cuts\" or breaks in the penis skin itself and it takes about a week to get better. I was trying different techniques to enlarhe my penis (jelquing) where you exersize the area to allow more blood flow. It worked, but now that Im having these issues Im afraid it is jepordizing my relationship.",
    "doctor_response": "HelloYour findings may suggest phimosis.It is a surgical condition in which fore skin can't be retracted over glans penis.I suggest to go for circumcision.It is a minor operation in which foreskin is cut out and skin is tied over coronal sulcus.It is better to get rid of this condition earliest because phimosis may cause surgical emergency if it is stuck over glans penis.It may compromise distal blood supply.So,you should consult surgeon for proper management.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for vomiting , nausea , high blood pressure and dizziness\n\nI was diagnosed with high blood pressure last Oct. when I was extremely dizzy to the point of not being able to stand up, vomiting and nausea. Since then and once on medicine, I had side effect of dizziness that lasted 5 weeks. Two weeks I was okay after the 5 weeks of side effect and since November 2014, I am dizzy 24 hours a day with a different type of dizziness (more severe than the side effect dizziness) that I was unable to walk straight, etc. for 4 months...now it is milder but dizzy all the time for the exception of sitting. I have been tested and it is not vertigo or any vestibular disorder. YYYY@YYYY",
    "doctor_response": "as you were diagnosed as hypertensive and all your vestibular battery tests are normal as said by yougo for a  mri brain this dizziness can be because of  some migratory thrombus which may have occluded any minor vessel in brain...though a feeling of asociated nausea and vomiting are again pointing more toward any peripheral disorder ( like labyrinthitis or  possible meniers diseaseright now i would suggest yoou to go formri braincarotid artery doppler(look for occlusion of main artery to brain)pure tone audiometryserum  vitamin B12 Levels",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My calcium and potassium levels are high. Please help.\n\nHello doctor, I just had a biometric screening. My calcium was 10.3 and potassium was 6.1. The doctor said my calcium and potassium levels were a little over what they should be, and that my MCHC was off. I have tried to ask if I should be concerned, but they refuse to talk to me about it, until I make another payment at their office. Help.",
    "doctor_response": "Hello. Do you have any symptoms like cough, weight loss or an underlying disease? Do you drink a lot of\u00a0milk? Hope this helps you. Get back if you have any doubts. Revert with more information to a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I have sex during 17 weeks of pregnancy?\n\nHello doctor,Currently, I am 17 weeks pregnant. I had spotting which started during 13 weeks and lasted for about a week. I was put on bed rest and advised to take Susten 400 mg. Everything was fine in 16 weeks ultrasound. The doctor said no need of bedrest hereafter. But did not say anything abt sex. Can I have sex with my husband? Is it safe now?",
    "doctor_response": "Hi. It would be better if you could send me your detailed history and scan report that you had recently. Mild bleeding at 13 weeks could be due to local pathology like cervical erosion, polyp, threatened miscarriage or just low lying developing placental at a very initial stage, etc. You got a Progesterone supporting form of a tablet that helped you and now you are asymptomatic.  If you have not had any previous miscarriage or cervical incompetence history or recently not had any diagnosis of threatened miscarriage or cervical incompetence or low lying placenta or any polyp or cervical erosion, can have sex but very gentle with lubricant. (Talking about penetrative vaginal sex). Try to have a valid exclusion of all the above with proper history and examination like a prepregnancy normal cervical smear or outpatient hysteroscopic normal examination and recent normal scan and normal cervical length measurement recently can make things easy for you. (That is why I needed your complete history and investigation reports). In case of any symptoms, you report treating obstetrician or nearest tertiary care center to exclude any emergency.  For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the tailbone area?\n\nMy daughter has had tailbone pain for a couple of weeks. Had an X-ray and no fracture. Dr. Said to watch for worsening symptoms and to advise if any problems with bowel movements. Last couple of days she has seen a small amount of blood when she wipes. What could this be?",
    "doctor_response": "Hello, Please let me know whether she had a history of injury, sprain, heavy weight lifting. For that, you can take tab. motrin and apply diclofenac gel or spray with heating pads. In case of not getting relief, I would suggest you to MRI back after orthopedic consultation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long after tooth extraction is a fever expected?\n\nMy 3 year old had a tooth extracted yesterday afternoon.  Yesterday evening she had a temp of 102.2 and again today she has had readings this high two additional times.  Her jaw is red and swollen.  She has been on Amoxicillin since the night before the extraction and is still taking it in addition to Motrin every 6 hours.  should I be concerned about her fever?  How long after tooth extraction is a fever expected if at all?",
    "doctor_response": "Thanks for your query, I have gone through your query.The fever following extraction could be because of the inflammatory response of the body(normal). You can take the course of antibiotics and analgesics. You can continue the course of antibiotics and analgesics and follow the instructions of the dentist. The fever should come down in 1-2days. If it is not reducing, then consult a general physician.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the  strep and vaginitis virus?\n\nIve been sick for months with viruses streap and vaginitis ive never been sexually active i still feel sick frequent urination headaches nausea swollen lymph nodes and severe back pain now chest pain im 16 what is wrong with me because my doctors arnt diagnosing this and im so weak and tired. Help please",
    "doctor_response": "Hello Dear. You might be having Urinary tract infection. Since you mentioned that You were never sexually active, the possibility of Sexually trsndmitted infections are ruled outTo identify a UTI, keep an eye out for the following symptoms:A burning feeling when you urinateA frequent or intense urge to urinate, even though little comes out when you doPain or pressure in your back or lower abdomenCloudy, dark, bloody, or strange-smelling urineFeeling tired or shakyFever or chills (a sign the infection may have reached your kidneys)Some of the key preventive factors are maintain perineal hygiene, drink lots of water and take medicines as prescribed by your doctorHope i have answered your question. Feel free to contact me if you have any more questions. I ll be glad to help you. All the bestWith warm regardsDr Sanjay Kini",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sinus,nasal drip and difficulty in swallowing due to choking\n\ni have had sinus problems for several years. Recently, I have nasal drip in my throat but after a while I feel like I can't swallow and am choking.   Then I throw up clear thick mucus  and am ok for a couple of hours then it started again.   What is wrong?",
    "doctor_response": "Hi, I have gone through your query .In my opinion , you have chronic rhinosinusitisStart steam inhalation,warm saline gargle , Mucolytic syp , saline nasal drop , Antihistaminic levocetirizine + Montelukast , Antibiotic azithromycin for 10 days.Hope this information helps you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is lump in the breast to be concerned about?\n\nI just found a lump on my left breast. It was not there last month. There are two almost connected together, pea size, hard, no pain. Where they are located, the breast feels heavy, like there is lead.  I am very thin due to my celiac disease, so you can see these lumps.   I am on birth control for my endometriosis and had surgery March 2011 for +HPV and Grade 2 lesion in the cervical region.  I guess always the first concern is Breast cancer.  Is it likely that this can be a cyst.  I do have a Gyn appt in 2 wks to obtain my second ( dr wants me to have 3 total before going yearly, now every 6months)  pap and HPV test since my surgery in March 2011.",
    "doctor_response": "Hello!Thank you for the query.Yes, it might be a cyst. Cysts are the most common reasons of breast lumps. However breast cancer needs to be ruled out at first. Especially that the lump is painless.Please have an ultrasound of breasts and armpits and biopsy of this lump if there will be any doubts.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for betterment of health in case of tuberculosis\n\nhi  i am  janti lal amersi from karachi pakistan, just come to knw by a mt test that my wife got a tuber clauses what are the precautions we should take like she stoped feeding milk to our daughter what else can you suggest to better ment of her health except medication from doctor",
    "doctor_response": "Hi,    I understand your concern.  -  First of all, 6you have to get her fully investigated from a chest physician & know about the extent of her infection.. if it's active  tuberculosis  passing the infection to others via coughing, sneezing )& she needs isolation or  her disease is non infecting & under control.. she can be treated at home & she can feed her baby at this stage.    Speak to her doctor & decide  - Medicines , regular consumption & regular follow up is a must . Tuberculosis can be fully controlled & patient can lead a normal life if she follows treatment plan exactly.   - Apart from this personsl care in form of-      - cleanliness,     - high protein , vitamin, iron ,mineral diet .         She needs high proteins in form of milk 2 glasses in a day , boiled egg/ protein powder available in pharmacy mixed with milk./ fresh vegetables & salads at least 10 glasses of clean water .. apart from her routine meals.     - light exercises ( yoga/ walking/ respiratory exercises) .. to help  good appetite & digestion     -Iron & vitamins in form of tonics as per doctor's advise.   Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get electric current like sensations on the right side of my body. Why?\n\nHello\u00a0doctor, I have been dealing with anxiety for almost a year now. I have also been having weird electric current type zapping, which is\u00a0very uncomfortable and painful. They go through the whole right side of my body, sometimes coming and going for minutes. I think it is from my anxiety, and not because of my medication. I take Librium, Gabapentin, and Seroquel. I did experience similar currents a long time ago, but they went away. This time, they will not go away, and I need help.",
    "doctor_response": "Hello. Hence keep these points in mind while you consult a nearby psychiatrist for your examination. Take care. For more information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be worried about rd urine after urethral surgery?\n\nI had surgery to enlarge my eurethra a week ago and this morning my urine was red.  My recovery has been going well and I started back on my blood thinner Xarelto yesterday.  Is this anything to worry about?  Should I contact my surgeon or primary doctor?",
    "doctor_response": "Good Day and thank you for being with Healthcare Magic! If you have bleeding weeks after your surgery and on the resumption of the blood thinners then yes I would contact your doctor whether it is safe to stop your blood thinners to stop the bleeding. It is not normal for the blood in the urine to come back. In the meantime drink plenty of water to avoid clots inside your bladder that may possibly block your urination. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at:   I would gladly help you.  Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I having troubled breathing with pain?\n\nI have sudotumorseribri and have an lp shunt ive been having trouble breathing lately what s the problem? Im also in a lot of pain. Nothing helps Im on percost and soma it doesn t help for te pain. Before I moved here im march the dr turned the shunt off, when I moved here I totaled my car an peralized my legs for 10 hrs is there a problem with my shunt?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have troubled breathing with pain. Well there can be many reasons for symptoms you mention in query like COPD , bronchitis , asthma , angina emphysema or pericarditis . I would suggest you to consult chest specialist for proper examination . Doctor may order chest x-ray along with physical examination . Doctor may  also take sample for lab test . Doctor may prescribe antibiotics along with anti inflammator and anti spasmotic . Doctor may also refer you to cardiologist or allergy specialist . For now take anti histamine like benadry along with ibuprofen or acetaminophen for pain . Also take steam . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure sensitive penis?\n\nhi, i am 23 years old. my penis is so sensitive. means, when my penis erect, i can't touch more because it ejaculate. And my back side of my penis is thin & front side is fat. some times i do masturbation also. Is mustard oil massage is good for penis? Please help me.",
    "doctor_response": "Hello,It may be due to anxiety. For that kindly avoid stress and take proper rest. Take balanced diet. Avoid smoking and alcohol. Avoid harsh cosmetic products. You may require complete hemogram, lipid profile, electrocardiogram after consultation. Till then you can take tablet sildenafil one hour before sexual act.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes knee pain post workout?\n\nI am getting lot of knee pain recently. I have started gymming since past 2 months. And I do cardio sprinting every alternate day. It hurts my knee when I try to sit down cross legged or even fold my legs. Should I stop sprinting or take some medicines for this.",
    "doctor_response": "Hello, I have studied your case. There is early osteoarthritis of your knee may be associated with osteoporosis.You need to take cartilage protecting medication like chondritin sulphate [glucosamine], that you need to take for couple of months.If required MRI knee can be done and if there is severe destruction of menisci then arthroscopic shaving can be done.Physiotherapy like ultrasound and tens will help, along with knee exercisesMild deformity can not be corrected with just medication, but further progression of deformity can be corrected.Yes you can stop sprinting.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the ways to treat ear fungal flakes?\n\nHi doctor, I am having ear fungal flakes according to my doctor. I want to know how much time it will take to cure and what type of medication generally is prescribed in this condition? And this condition can be cured without medication?",
    "doctor_response": "Hi. The condition you are describing is called otomycosis. This is a very curable condition in which topical antifungal drops have to be used along with the above medication. The mainstay of treatment is antibiotics, topical antifungal drops like Clotrin plus or Candibiotic plus ear drops and Levocetirizine tablet. The main thing is the water precaution. You have to keep a thick cotton while bathing and remove it after taking bath. Swimming and water activities are completely prohibited.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe psoriasis in scalp, joint area followed by itching. Which type of treatment to follow?\n\nI have severe scalp psoriasis and also having it in joints area.. in joints its read color.i have got scaling too. i have got ayurvedic treatments for 3 years and homeopathy for a year now,I also have itching in scalp as well as in joints like elbow.In legs its worst.I have heard that allopathic steroids make it worst.Should i go for allopathy or continue with ayurveda as i have got result from that...",
    "doctor_response": "Hello,Thanks for writing here.Psoriasis is a disease with frequent relapses.Oral steroids aggrevate the condition and not locally applied.You need to take methotrexate,topical steroid and other treatment.It will be better to consult a dermatologist and start treatment accordingly.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring swelling and soreness on skin after bitten by a mosquito?\n\nHi there I was bitten about 2 months ago by possibly mosquito and it got badly infected. It s lower part of spine. Was given fucidin cream 0.5% and it took swelling down but still left me with small red marks. It s suddenly swelled up again and very sore and looks infected. Why is this? What can I do?",
    "doctor_response": "Hi,It seems that there might be having secondary bacterial infection following something bite.In this case only local application is not enough.You might require antihistamine like Benadryl or cetrizine and a course of antibiotic medicine to clear infection.Consult your doctor and get examined.Apply triple action cream on affected area.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in left side of thigh, bikini area, lips, cheek?\n\nI have numbness in my left thigh and left side bikini area following a laproscopy and DnC last thursday. I just spoke with Gyn who did my procedure and he says no connection I should call my internal medicine doctor. I also feel numbness in my lips and cheek left side. i had Iv anesthesia followed by morphine torodol and benedryl.",
    "doctor_response": "This is mostly simple systemic allergic reactions which not related to laparoscopy. This is mostly due to drug allergy or anaesthesia allergy. Start taking oral H2 inhibitors and topical cortisone derivative cream on affected sites 3 times daily for one week.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have been suffering from social anxiety. Is there any treatment to get rid of these problems?\n\nHello doctor, I am a 29 year old male. I have been suffering from social anxiety. Following are the consequences that I am facing through in my daily life: I am not at all confident to talk with new persons, especially in group meetings. My heartbeat used to raise and I will forget things to be discussed. I cannot remember and pronounce properly even with the people whom I meet daily. I do not know how to react when they wish me or when they talk to me. I am trying my level best to get rid of this anxiety by facing it but once in a while, only I could handle these situations up to my expectations. Also, I have intrusive thoughts especially when I go to the temple or when I see the photographs of god, I will feel like something bad would happen to me. If I read a book and implement that in a big project also, I could not remember even the titles. Somewhere I have read, social anxiety can cause memory loss. Recently I forgot my card pin number which I used 2 months back. My concentration power is very poor too. The other problem that I am coming through is uncontrollable daydreaming, even though if I try to keep my mind busy I will get into it unknowingly. I could not do anything to improve my career because of these problems. I am not sure whether it is any disorder or normal behavior of people. Please suggest me if I require any treatment to get rid of these problems.",
    "doctor_response": "Hello. You have Obsessive Compulsive Disorder (OCD) and social phobia. I can understand your concern. I have read through your history and from that, it is clearly evident that you have anxiety spectrum disorder. The symptoms like difficulty in talking with persons, increase in heart rate, forgetting things easily, inability to pronounce things properly, difficulty in reacting to others, difficulty to talk in arguments, etc., are due to social anxiety. The symptoms like daydreaming, poor concentration, inability to divert thoughts, etc., are due to anxiety only. The intrusive thoughts, repugnant thoughts like bad thoughts when you go to the temple, etc., are related to obsessive thoughts, and this needs proper evaluation. Social anxiety does not cause memory loss but due to persisting distraction and lack of concentration individuals find it difficult to focus and concentrate. This will cause feelings like loss of memory. Considering your history, I would suggest you visit a psychiatrist for evaluation. Medicines like SSRIs such as Fluoxetine, Paroxetine, Sertraline, etc., can help to reduce these symptoms and you will feel better. These medicines are free of serious side effects and are better tolerated. Apart from medicines, relaxation exercises like yoga, progressive muscle relaxation exercises are also equally helpful in anxiety and obsessive-compulsive disorder.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What kind of discharge is there in early pregnancy?\n\nme and my husband are trying for a baby and about 2 weeks ago when i wiped i had a slight tinge on pink in my cm. yesterday my cm was like fertile mucus and the day before it was a big blob of white/creamy cm. today though its like water with slight bits of white in it. what could all this mean i am due on in about 3-4 days.",
    "doctor_response": "this could mean just the thick mucous discharge which is normally present after ovulation till onset of the period. Please , also do the pregnancy test if period is late.",
    "dialogue_context": ""
  },
  {
    "patient_message": "back and shoulder problem, left pinched nerve, done evasive and fusion surgery.\n\nhello,I have had back problems for the past 7 to 8 years. I also have had problems with both my shoulders for the past 10 years. I hurt my shoulders playing softball when I dove for a ball and came down hard fully extended with my arms and hurt both shoulders. my back problems are  from a degenerative disc on L5 S1. I have had two minimal evasive surgeries on my back but to no avail, so recently I had a back fusion surgery done which fully resolved my problems with pinched nerves on the left side but now I am having worst pinched nerve symptoms on my right side. my question is could there be any way possible that my pinched nerve problems in my back are related to my pinched nerve symptoms in my shoulders?",
    "doctor_response": "hi i had gone through your query and understand your concerns. i would come up with the possibility of CERVICO BRACHIAL NEURALGIA due to CERVICAL SPONDYLOSIS.yes the pain in the shoulders due to pinched nerves in the cervical spine like lumbar spondylosis.the problem caused by degenerative changes.treatment option;- i advise you taking   Homeopathic medicines gives  safe and permanent  cure for your complaints -without treating the underlying cause even number of surgeries for lumbar or cervical regions cant give you cure without stopping the degenerative changes.-consult your local homeopathic physician for correct diagnosis of the case and remedy to fit your complaints I hope this is helpful for you, thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for pain and fluid on ribs?\n\nHi Doc I am a 38 yr old male 60kg i had a average pain in the btm of right hand side ribs yesterday, the whole of this area tightened up somewhat and as i felt it i felt only what i can describe as a hot pad on my right hand side ribs which contains fluid, which i could push and prod with no pain. I checked my left hand side of ribs and there is a similar fluid pad like thing but on the upper side of my ribs and not as big as the left hand side. I can push these fluidy pad like things around a little. My wife was pretty scared when she felt the big pad on my right side. Any info idea s would be greatly appreciated. Many thanks",
    "doctor_response": "Hello, In case of fluid in lower chest area there are chances of having issues with respiration and discomfort,so it looks that there are less chances of having lung issues. Looking at your details it looks to be growth of fat tissues (LIPOMA) or a soft tissue swelling. Looking at seriousness of issue i shall advise you to consult to your doctor & get a complete clinical examination.Your doctor may order you a x ray and/ultrasonography to check the issue. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mukesh Tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes clear discharge after unprotected sex?\n\nI had sex unprotected almost two days ago and I have a clear-like discharge that keeps coming out after a few hours . It s not really heavy and its odorless. Is it possible that semin could still be oozing out after that amount of time after ejaculation. It doesn t hurt when I owe or anything.",
    "doctor_response": "HI, thanks for using healthcare magicIt is unlikely that semen would still be present in significant quantities. After 2 days, any semen that would have been present should be gone.It is possible , since there are other symptoms associated with the discharge, that what you are seeing a the vaginal discharge that can normally be seen by some women.Yeast infections are normally associated with white/yellow discharge that are associated with itching. Bacterial vaginosis causes a discharge that has a fishy odour.Chlamydia and gonorrhea may or may not cause symptoms but the discharge that can occur would normally be yellow/green.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need treatment for numbness in the upper area and problem for erection with constipation\n\nI get numbness in upper extremities when I hold my head and lie down as well as when I put my lone leg on another leg. also, i have some problem with erection. sometimes my shoulder shakes involuntarily. i have digestive problem and constipation. My job is Medical transcription. I am intolerance to wheat, milk. I feel I am weak. My natural erection is somewhat missing and also i cant maintain erection harder. Pls help me.",
    "doctor_response": "Erectile dysfunction should never be ignored as it may be due to some serious organic diseases, apart from psychological causes. Please get a check up by doctor and take drugs accordingly. Kegel's exercise can be useful. Get rid of stress and avoid smoking and too much alcohol. Please read the link-",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any treatment for aligning teeth without braces?\n\nhello doctor.. im a student of 18 yrs old.. my teeth is arrnged in improper way so im not able to smile confidently.. is there any treatment without using clips and which do not align any problms further in future?? if so how much it costs to the treatment and also the time taken to it??",
    "doctor_response": "hello thanks for consulting at hcm..kindly take a consult ur orthodontist/dental orthopeadics for alignment of teeth and for surgical option with oral surgeon..either ways these specialist will take a call on what to do after doing a series of radiograph such as opg, lat ceph, hand wrist etc,,so plz take a consult and money depends on what procedre ..hp it helps..tc",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning urination, back pain with small bump on head of penis?\n\nMy boyfriend has the following symptoms and he is freaking out, I don't think it's a big deal. Slight burning when he urinates, some back pain, and now a small bump, on the head of the penis. The bump is small and it almost looks like a scratch. He already took one round of antibiotics, urine samples are okay, blood sample is next.",
    "doctor_response": "Hi, Urine issue can be due to urinary tract infection. Doing a urine culture can help diagnose. Also, check for blood sugar. Bump in penis can be sexually transmitted infection - get detailed past history from your partner. If not, it can be bacterial / fungal infection. Share a picture for confirmation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red patch and swelling in left calf?\n\nMy left calf swelled the other day. I had a minor pain so I puy a ginseng salve on it and sleepy with a sock om. It swelled worse during the day especially where the sock band was. It had no mark. I ent to the drop in clinic, she wasn t too concerned and prescribed penny in and an ultra sound. Swelling has greatly reduced but now I have a red patch in one are. Everything is minorly tender but watt better",
    "doctor_response": "Hi there.There may be small clot and contusion which will take time to resolve. You can keep the limb elevated and apply crepe non-adhesive elastic bandage if you wish for earlier recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain and swelling in knee\n\nHi,   I fell off my high heels and hurt my knee 7 days ago...not sure how I handed ....and it wasn't too painful at the time.   It is pretty swollen ...painful...and I cannot put direct pressure in it ...such as washing the floor on my hands and knees.....Thanks for being here to answer peoples questions.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.The initial treatment for knee swelling after a fall is ice pack for the first day with intervals of 20 minutes on and off.Keep the leg elevated with 2 pillows and rest for few days.Use non-steroidal anti-inflammatory medication such as Ibuprofen and wrap the knee with elastic bandages.Then after the swelling diminished you can go ahead and do a knee MRI to evaluate the damages inside the knee as some of them needs surgery repair (meniscus and anterior cruciate ligament tears).Wish you a quick recovery.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Edvin Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes redness and swelling on nose of a baby?\n\nmy one year old baby fell out of his bed 2 nights ago and has redness and possibly some swelling on his nose. He also had a small amount of bleeding straight after it happened. He has a blocked nose but also has a cold at the moment so it is hard to tell if that is from the fall. Could he have a broken nose?",
    "doctor_response": "Hi... it is very unlikely to be a broken nose as the bones in the face of babies of this age are very very soft and pliant. If there is a broken nose there would have been deviation or angulation of the bridge of the nose, which was not too obvious for you. Otherwise you would have told that as the presenting complaint. So I am confident that your baby is normal. If you have any doubt you can confirm it after examination by your pediatrician.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a person to entertain the gay relation?\n\ndr doctor, for a while now my girlfriend has said while during the night she awakes to find me touching myself. i find this really embarrassing as i dont think it is normal for me to do. i am in a gay relationship and need to know is there something wrong with me, i am 26, female thanks",
    "doctor_response": "Totally normal. In a new relationship with someone who shares your bed, I don't think anyone would NOT have increased sexuality.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have had blood in my stools, i am on methadone\n\nhere recently i have had blood in my stools sometimes i strain and sometimes not is it normal i am on methadone",
    "doctor_response": "hi,thanks for query.It seems that you might be having something like fissure or piles.In case of fissure there is wound in the wall of intestine, when ever your strain or have hard stool it leads to friction and bleeding.In any case it is  advisable that you see a doctor and get your self examined.Proper treatment is needed and please do not ignore. wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticing delay in periods after taking Lutera birth control\n\nI have been taking Lutera birth control for 9 months. I've gotten my period a few days early twice before, but this month, it came 2 weeks early. I did miss one pill, but I made up for it the next day. Does this mean the birth control is not effective? Am I at risk of getting pregnant?",
    "doctor_response": "birth control pills r to b taken regularly at d same time den only it is effective.it provide 99 percent contraception....if u miss one pill..take 2 pills within 24 hrs...but maintain first 7 days of contraception if u miss 2 pills in a row...u can do urine pregnancy test in home it self n check...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from abdominal pain & blood stain in motion\n\nhi doctor i have slight stomach pain and found blood stain in motion please help...",
    "doctor_response": "Welcome to Healthcare Magic Do you have any fever or loose stools or occasional hard constipated stool habit. Any pain while passing stools. You could be having haemorrhoids if your blood was fresh seen over the stools. You could be having an intestinal infection which needs treatment. Eat plenty of fresh fruits and vegetables, drink plenty of water. Consult your Doctor as soon as possible, get examined and treated appropriately.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cold and running nose in a child\n\nmy child is 11 months old, he caught cold, running nose(starting stage, not severe)... previously he got severe cold at that time doctor suggest to give levolin, azibact and some other syrup. can we give levolin & azibact now also without consulting doctor, whether any side effects...",
    "doctor_response": "HelloI read your question and understand your concernI would like to ask that* is he running fever also* any cough along with cold* any vomiting along with coughIf only cold is there i would suggest to give only symptomatic treatment like plenty of fluid try to give steam and keep him warm and you can use antiallergic syrups as wellAnd if his symptoms gets worse take him to his pediatrician for proper checkupI hope my answer will satisfy youGood luck & tc",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain, period cramps, weakness, discomfort, diarrhea, pink mucus, excessive sleep. What is the cause?\n\nHello, I m Nola ~ I m 48 yrs., not pregnant & while shopping yesterday I developed a severe lower back pain, cramping like period pain in lower bowls or female area (not period), pain in between my legs. At this time I tried using the bathroom with no luck. So I tried to continue shopping & got water (I m abnormally thirsty) to drink, couldn t bear drinking because I started to get super weak, my face felt hot & flushed. My heart was throbbing so hard I could feel it in my neck & face (cheeks); even my arms became so very week I couldn t hold on to the shopping cart. The Manager & Pharmacist assisted me & wanted to call Paramedics, but I needed to get home to my daughters, so they wheeled me to my car. Now, upon arriving home I needed help once again & I went to bed....Woke-up this A.M. & still in great discomfort & very weak I tried to cook brunch for my girls but kept burning the food (I d like to think that this is rare for me)! After my attempt I had great sharp pains in my back & gut & then had diarrhea (just a little bit) & it was pink mucus & further into it, it had gotten a bit brighter & a little more red in color, no odor.....I was so weak & panting & my lower back was screaming in pain & my pelvic & lower right abdomen aches! As I ve been writing this; it seems after half a word to a few words I keep fallllllling asleeeeeep!!! Not liiiiike me at all.....And it s taken me a few hours to complete this note to you! Ridiculous! Thank you in advance & any thoughhhhhhts would be great! Sincerely, Nola Mumzeeeee",
    "doctor_response": "Hi Nola,Welcome to HCM.I am suspecting a gut infection based on your symptoms. Infection of gut might have caused abdominal pain, diarrhea, and dehydration. Sometimes this pain can radiate to the back and upper thighs.I suggest you get a stool exam done for microscopy and culture to rule out infection. Mean while I suggest you take Tab Buscopan twice daily after food. Drink adequate water. Take fluid diet for the next few days. Rest as much as possible.If stool exam shows infection, get in touch with your GP for a prescription of appropriate antibiotics or antiparasitic medications.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back and abdominal pain after eating certain fruits, vegetables. What's the problem ?\n\nAfter eating certain fruits and vegtables (raw carrots, corn on the cob, blueberries, etc) I sometimes have back pain (in the middle right wear my bra strap is ) and upper abdominal pain . It will go straight from my middle back to the middle front. I also have a gas build up and it causes me to burp. It is quite painful and will last for a few hours and gradually ease of . I have had this problem for about ten years. I get these attacks maybe two or three times a year and it always seem to be brought on by the foods I mentioned above. thank you for any suggestions as to what my problem",
    "doctor_response": "Hello. Thanks for writing to us. The pain in the back that you are having is likely to be related to gas and indigestion which gets precipitated by the particular foods. Most of the times these symptoms are self limiting and subside spontaneously. Taking peppermint oil will also be helpful. I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL  Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump on the the roof of my mouth?\n\nYesterday, while eating I felt a swelling on the roof of my mouth. It felt like pehaps some food had attached somehow to the tissue. After investigation, I saw a football shaped lump, dark in color perhaps the size of a nickle.Today it remains tender to the touch with my tongue and has changed color. It is about the size of a dime with a boarder of darker pink and a irregular center of a white color. I was eating a salad with peppers when I first observed this.  I also wear a full upper denture and the location is just behind the plate.  Any ideas????",
    "doctor_response": "Hi.Thanks for your query and an elucidate history. The diagnosis is certain- this is a hematoma, caused by either food or the denture. Consult an ENT as aspiration will confirm the diagnosis ans is sort of a treatment.  Check with ENT or Dentist whether the dentures are ill fitting or have gone loose causing mild movements but also the chronic trauma.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Irritation in penis. Abdomen USS normal. On antibayotic Norflox. Further?\n\nI am 44 years old male. Height 163CM, weight is 66Kg. Inside my penis an irritation is there sine last three months. I consulted A physician, urologist with abdomen USS with normal and tested urine R/E. The Physician gave me one course antibayotic Norflox for 7 days. But my problem is not at all rectified. Please help me",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have irritation in your penis since last 3 monts which has not resolved even after taking Norflox for one week.Most likely this is due to Prostatitis.Please consult qualified urologist for clinical and digital rectal examination and get following basic tests done to confirm the diagnosis.1) Routine urine and urine culture to find out the organisms causing this infection and antibiotics to which they are sensitive to so that you ca take appropriate antibiotic as per culture report.2)Swab test and culture of prostatic fluid obtained after prostate massage.3) Ultrasound scanning of bladder .You need to take antibiotics for a long period of 6-8 weeks.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause a tubular like formation behind tonsil?\n\nI have one slightly enlarged tonsil with this strange looking white tubular thing that if I pull the tonsil back I can see.  My ENT says get it removed, could be cancer because it is asymetrical by being a little bit larger.  I have a lot of nasal stuffiness, always have, post nasal drip.  Don't know if this makes the tonsil chronically enlarged.  He says no enlarged lymphnodes and calls it a soft diagnosis and would gladly observe it too.  Should I just have them removed?  I did take a 5 day z pack azthromycin.I think it cleared up my nose and headache I was having.  Please let me know your thoughts.  Obviously it is hard to tell without looking at my mouth.  One ent said the tubular thing behind the main tonsil was a cyst. his colleague said a tonsil stone.  I don't think it is a tonsil stone according to what I have read.  I think it is part of the tonsil but behind the main one.  Also have had this going on since 2005, this one tonsil being a little larger.  Sometimes it makes me feel a little queasy when it is enlarged more",
    "doctor_response": "HI. We have the facility to see the photographs if you can put on our site. * years is a long history - so obviously this does not look like cancer for sure. Take few more courses of antibiotics, it may just vanish.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be worried about flat feet, twisted ankle and closed knees?\n\nhello dr i m hbbvnaa i have a 3 years and 7 months daughter, she has flat feet and her ankle is twisting outside. i have start using inserts since she was 2 years, but the ankle showed no progress. this is causing her pain in her back knee and her back. and sometimes she wakes with the knees close to each other. please advise what treatments i have? orthopedic Dr said that this is because she has calcaneal valgus or prenatel and the advised to for me to leave her with out a help. one more thing they said that she has extra mi-liability thanks in advance",
    "doctor_response": "Hi thereit is very common for children to have flat feet (20 % of children have flat feet) this is because of  ligaments being still very loose but as they grow, ligaments toughen up and the medial arch reforms. If she stands on her toes and her feet forms arches on the inner side there is no reason to worry she will do fine. If however she stands on her toes and the feet remain flat and the heel still pointing outside then I would recommend that you sought second opinion from an orthopaedic surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there heart beat below my throat after drinking hot?\n\nHi doctor, Before a month, I had a feeling of heart palpitation and some beats below my throat after having a party meal. I am a vegetarian. So after checking ECG, I started taking Pan IT in the morning and evening, Gaviscon and Ciplar for ten days. My heartburn has gone. But I have a little bit of throat pain when I yawn or swallow food. I have lost two to five kilograms weight in one month. I changed my lifestyle. I had foamy poop thrice in these days. Is it because of antacids? How long is the course of Pan IT safe?",
    "doctor_response": "Hi. It is safe for a short-term period, for a month or two. But if necessary then the long-term is also continued as the side effects are not very serious. So I would suggest that you have it for a week. Then make it once a day and then take in a week or two. Most probably it is due to acidity and gastritis. Do you have upper abdominal pain, nausea, bloating, burping, increase in pain on food intake, sour water feeling in throat or chest burning? These are the other symptoms and may be associated. You should avoid fatty, oily and spicy diet. Have some walk after having food instead of taking rest. Have multiple small meals instead of heavy meals. Have regular sleep habits and avoid stress. Take lots of green leafy vegetables, and fruits. Avoid smoking and alcohol if any. If not adequately relieved, then you should add Syrup Sucral O (Sucralfate with Oxetacaine) or Gelusil (Aluminum hydroxide, Magnesium hydroxide, and Simethicone) two teaspoons three times a day for a week. Elevate the head end of the bed or use pillows during sleep and rest. For more information consult a medical gastroenterologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can one use cephalexin to treat rashes?\n\nmy husband is being treated for mssa with oral cephalexin---dr. asks about a rash on each visit and recently he has now gotten a rash several cluster type rashes in different areas of body.  Internet says with cephalexin if rash occurs call dr.  any thoughts",
    "doctor_response": "Hi Dear,Understanding your concern. As per your query you have symptoms of skin rashes which occurs due to infection of hair follicles leading to folliculitis. It could be due to contact dermatitis and allergic reaction of body. Need not to worry. I would suggest you to make use of product containing benzoyl peroxide. Take Multivitamin supplements. Apply topical antibacterial ointment such as mupirocin and do yoga and meditation daily. Cephalexin is also an alternative option. Drink plenty of water daily and add fresh fruits and vegetables to your diet.  Also wash your face with mild soap and cold water twice a day , exfoliate your face once a week. If condition doesn't start getting better in a month then consult dermatologist and start treatment accordingly.Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is vegetarian diet advised when function for one kidney is lost?\n\nMY 23 yr old son who is a neurogenic bladder has lost the function of one kidney he was a case opf lipomyleomenengoceal(not sure of the spelling)now is having 97% FUNCTIONING OF ONE KIDNEY FEELS HE IS HAVING aLBUMIN IN URINE  ,HE IS VERY FOND OF NON VEG FOOD .....SHOULD I PUT HIM ON VEG DIET TO REDUCE HIS PROBLEM",
    "doctor_response": "Hi,I understand your concern.Since your son has a condition which puts his kidneys at risk of damage,hence in view of presence of albumin in urine it will be advisable to avoid excess proteins in the diet.Vegetarian source of protein is thought to be better than nonveg protein.Therefore,you can safely change over to veg diet.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How effective is Norpak in preventing unwanted pregnancy?\n\nDear Dr. While have a sex, the condom broke so I bought ECP from the pharmacy with a brand name \"Norpak\". how effective is this pills to protect from pregnancy?  Is it possible to take more than one pills keeping certain hours of gap? Please suggest. Thanking you",
    "doctor_response": "Hi, Norpak contains Levonorgestrel and is very effective as other emergency pills. If they are taken within 72 hours you don't have to worry about pregnancy. Don't take another pill. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for ileum inflammation?\n\nI have thickening of the ileum.....no one seems to be able to get to the ileum thru a colonoscopy.... my symtoms are my stomach gurgles a lot so loud that other people can hear it.... I never know when I have an urgent bowel movement.... I always need to be by a bathroom... I have no pain at all and do not have any fevers.... a couple of years ago I did have h pylore.... i have taken a ct scan and it only shows thickening of the ileum.... please help",
    "doctor_response": "Hi I did review your concern.I would advice you to go for further testing in form of barium follow through in which they will help you see the ileum from inside. Thickened ileum can be seen in infection, due to edema or rarely due to unwanted growth, A biopsy may also be needed if you are having weight loss or blood in stools.i hope this helpsWish you all the bestThank you for choosing healthcare magic",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pressure in upper chest?\n\nHi. I am a 48 year old woman. received a Picc line on Monday for IV antibiotics for Lyme disease. Beginning yesterday I have had a sensation of pressure in my upper chest upon taking a deep breath or coughing. Pressure is worse if my chin is pointed down towards my chest. X-ray after Picc insertion looked good. Is this something I should worry about?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. No need to worry for this symptom (pressure in upper chest) as your chest x ray is normal.So PICC (peripheral inserted central catheter) is not causing this symptom.In my opinion, you should not pay much attention to this symptom. Just do deep breathing and be relax and calm. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it dangerous to inhale rubber smoke?\n\nmy son threw his sticky rubber toy on to our light fitting and did not tell us. We did not realise until we saw the thick black smoke. Some of the rubber was still intact and the rest was melted liquid.  The house now smells awful.  Are the fumes toxic?",
    "doctor_response": "Hello dearWarm welcome to Healthcaremagic.comI have gone through your concern in depth .*  The  smoke of rubber is some what noxious to lungs , but in  small      amount  it is cleared  from  the  natural  immune system clearance  of      the  lungs .*  If in large amount  can  give  rise  to  serious  detrimental  effects      ranging  from  chocking  sensation  to  severe bronchospasm .Hope this clears your doubts .Regards dear .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it to be concern about the lump with hernia?\n\nI had a left indirect inguinal hernia repaired a few months ago, I now feel pulling and burning in my right side, I didn't notice a lump with the first hernia and don't see one now.  I feel sick to my stomach and have constipation.  Could this be another hernia?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have high chance of hernia.  So you should go for ultrasound study.  It will give you exact diagnosis whether you have hernia or not.  If it is hernia then you should go for hernia repair surgery.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Shall I follow yoga to reduce my BP?\n\nHi doctor, I am a 34 year old unmarried male. My weight is 70 kg and my height is 5'7\".\u00a0Recently, I checked my BP and it was 150/100 mmHg.\u00a0Please suggest some medicine to reduce my BP. Shall I follow yoga or pranayama for lowering my BP?\u00a0What all foods should I take and avoid?",
    "doctor_response": "Hi. Anxiety, tension, stress, excessive salt intake, cardiac ailments, etc. ECG (electrocardiography). Hypertension. 1. For one week, take only fruits for breakfast and dinner and salt less food for lunch. Any kind of relaxing techniques you can practice during these days. 2. I suggest you Cardimap tablet twice in a day. Consume morning and evening after food. 3. Apply Ksheerabala oil on the nails of the toes and to the head before going to bed. It should be avoided if you feel cold or fever after applying oil. Control weight and do regular exercise. Revert back after two weeks to a yoga specialist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does Methylprednisolone side-effects of dizziness and fuzziness last?\n\nhi sir , i have taken 2 dose of 16 mg methylprednisolone in two days , 3 months have been passed ,i feel dizziness and poor brain performance . i want to know how long the side effect remain and also want to know the side effects on brain and brain performance . regards ajay",
    "doctor_response": "Hi, Methylprednisolone is a steroid. Do take it as prescribed by your consultant. The information regarding oral or IM formulation is missing. Irrespective of that, it is highly unlikely that you can attribute the vague symptoms you are mentioning to methylprednisolone after 3 months. You need to be evaluated further for other causes if you have significant dizziness. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nishith R. S., Diabetologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat epidimytis with hard and swollen testicle while on antibiotics?\n\nMy left testicle was swollen and tender. I went in the doc diagnosed it as epidimytis (or however you spell it) it s day 3 of taking the anti biotics. I just recently masterbated and ejaculated. The teaticle that was swollen and tender to touch is now hard and still swollen. I m worried about it being hard...where as it was swollen and felt soft/mushy by the epidimytis before. Is it normal? What should I do?",
    "doctor_response": "HelloThanks for query.You have infection of Epididymis and Testis (Epididymo- Orchitis).Continue taking antibiotics along with anti inflammatory medications like Diclofenac and Serropeptidase twice daily .Please note that Epididymitis takes long time to get cured hence you may need to take these drugs for 3-4 weeks .Ensure to drink more water.To keep your urine dilute,Ensure to avoid sexual encounters till it heals up completely.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and hardness at the site of dog's bite?\n\nmy dog of five years bite me last tuesday. his top two k-9 teeth went aprox 1 in. into my fore arm. i emediatly cleaned the wound and continued every day with peroxide rubbing alco. and neosporine. now the wound has heald but i have a swollen area at the bite marks and it is hard as well. is this normal or is it infection? I have no pain or other symptomes!",
    "doctor_response": "HIWell come to HCMwound due to animal bite may be infective and better to have antibiotic, hope you must have completed the rabies vaccine too, but for the safe side better to have anitibiotic and best option is \"Tab Cefdinir 300 mg twice in day for five days, if swelling does not come around then wound need to be explored, hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for a hole on my inner left buttocks\n\ni had a hard lump on my inner left buttocks for a few days i was told to go my some hemroid cream after that i apllied it that day and the next day it burst drained pink blood .now it seems i have a hole there about the size of nickel..my question is thie and abcess or something else?",
    "doctor_response": "Hello,Welcome to HCMThanks for posting your query in HCM.The bump on your inner left thigh is most probably on abscess or infection of hair follicle called folliculitis.Usually it will subside by its own if its small by bursting open.Hemorrhoid ointments like Preparation H contain phenylephrine, which is a vasoconstrictor that constricts  anal blood vessels.Usually it is used in the treatment of haemorrhoids.As your bump is already bursted,and size is relatively small,the wound area will close by itself.Keep the are clean and dry.Hope you are happy with the answer.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should I take extra protection with cerazette?\n\nHello, I have been taking Cerazette for one month and I have forgotten to take the pill yesterday. I took it today together with today's pill and I haven't had sex past seven days. I have been reading different answers on question how long you should have an extra protection (e.g. condom). Some say 48 hours, others 7 days, I hav even read a whole monht. What is the correct answer? Thank you",
    "doctor_response": "Hello dearUnderstand your concernCerazette is contraceptive pill. For better effect should be taken regularly on same time.According to your history, you just missed only One pill and you took two pills together on next day. So in your case there is no requirement of extraprotection is needed in your case. Take the remaining pack regularly till the end.Take pill regularly every day by making habit. (put mobile reminder of specific time every day)Hope this may help youBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shortness of breath and sneezing\n\nI have a boy 6 yrs 8 months old ( 25 kgs weight).When he starts to sneeze he continues for 5 to six times with white thick nasal discharge coming out after two or three discharges.This condition is present in him for about three years.Of course, this does not mean that he sneezes frequently.But when he starts to sneeze it does not stop quickly.Three years back once when he had fever with cough and cold he started wheezing particulary after repeated coughing.So far I have seen four episodes in him with rougly eight months to one year gap between each episode.During the second and third such episodes he also complained about slight pain in the chest muscles and shortness of breath.During the first episode I took him to a pediatrician who told to my shock that he may have Asthma.He asked whether anyone in my family has it or not.My mother developed Bronchial Asthma at the age of 45+ due to over load of work and climbing of stairs and also because we used to have pet dogs and later cats in our family.She is still having the same problem.However, now netiher we have any pets in our house , nor there is any chance of vehicular pollution or cigarette smoke.I don t know how my child could get asthma.The doctor gave salbutamol to him and some antiboitics also.But I did not give the salbutamol tablets to him fearing that once it is given it may permanently damage his lungs.During the second such episode after about one year.I took him to my company hospital where the doctor suggested to give nebulizer with asthaline for 5 minutes.This time I obeyed and my son told that he felt releived .During the third time also as per the advice of our Company s doctor I gave him nebulizer for 5 minutes .Recently, he had fourth such episode after about one year gap.This time the doctor sggested nebulizer for 5 minutes at Hospital and also 2 salbutamol 2 mg tablets daily for five dyas along with Cefpodoxime 100 mg for 5 days ( 2 daily).When he was a small baby we used to keep him near to our closed wodden window as our bed was situated near the window) during sleeping after covering him with sweater and all other precautions during cold seasons.Is it that due to exposure to cold her lungs got damaged.The place where I used to work then used to get very cold during cold season.Anyway I used to keep a room heater below him also.Please confirm whether my child is asthamatic or not.Earlier to this episodes I used to give him cetri",
    "doctor_response": "Hi, I have gone through the detailed history you have given. A possibility of asthma is more likely in his case. In my opinion, you should definitely get done PFT (Pulmonary Function Test) with reversibility testing. If there is significant reversibility then asthma is confirmed. In my opinion, he will need intranasal spray containing steroid (fluticasone) and antihistamine (azelastine). Oral combination of antihistamine (levocetirizine or fexofenadine) and anti-allergic (montelukast) is also beneficial. So consult a pediatrician and discuss all these. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Kaushal Bhavsar, Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for eosinophilia\n\nhello doctor! i got my CBC report today. it says mild eosinophilia. my eosinophil counts are 480cumm. I am allergic to dust and i sneeze and have running nose everyday in the morning. What can be the possible cure and will multivitamin tablets would be of any help?",
    "doctor_response": "HIThanks for posting your query to Healthcaremagic.      See you are having high eosinophils due to your allergic . This condition is called Atopy. This is a hereditary condition where your body produces excess of Eosinophils in response to dust / Smoke / Cold Air  or certain food or medicines.    The best possible cure is avoidance of the  allergen, dust in your case.            Apart from avoidance there is one more modality of treatment called Allergen Desensitization. In this condition first you will be tested for what dust you are allergic and once that is found you will be injected small but incremental quantities of dust over a period of 6 months . But this procedure is used only is serious cases.     Multivitamins will not help. Take more of Pomergrate , ginger and black pepper.    Also ask for Montelukast+ cetrizine medication prescription and you can use it whenever sneezing is too much. Hope this information was useful to you. Any clarifications feel free to ask . Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is the swelling with toothache an abscess?\n\nHello doctor, For a few days, I have had a bad toothache. I noticed swelling and begun taking antibiotics. I woke up today and the pain is gone but it is even more swollen. I have been using cold and heat compresses, as well as salt water rinse. I am worried I may have developed an abscess but I do not have the money to seek out a dentist.",
    "doctor_response": "Hi. Understanding your situation, I am prescribing you a proper antibiotic regime that will help in diminishing abscess and infection. Take Augmentin 625 mg twice a day, tablet Metronidazole 400 mg twice a day, tablet Brufen 400 mg twice a day. Take all these medicines for three days. It will work hopefully and will dry up the infection, but again you know it is a temporary solution. The permanent solution is the extraction of the culprit tooth. You may look for low-cost dental visits and ask in your locality when will it happen. Keep doing saline water mouthrinses at least 3 to 5 times a day. Give me follow up after three days. Stay happy and blessed. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for soreness in elbow\n\ni have a soreness at my elbow like i had badly bruised it, but havnt hit it or bruised it.. it has been like this for 3 weeks if i try to hold something up out in frnt of me like a platter of food its hurts..  it acts like i may have injured a ligament or tendon.. i had stressed this arm and the other over a month ago installing a lrg window into a second floor opening. but the other arm is fine? when it is hurting its also warm like its fevered.",
    "doctor_response": "HiThank you for asking HCMI have gone through your query. Your problem can be most likely tendonitis in elbow region. From your history it is most likely Golfers elbow which is tendonitis on medial region of elbow. For this Rest , Ice , over the counter NSAIDs like ibuprofen (motrin) will be helpful. If there is no improvement then consult an orthopedician. You may need to take a X ray to rule out problems like arthritis in such case. Wearing brace and corticosteroid injection like triamcinolone will be recommended by orthopedicians for this.Hope this may help you. Let me know if anything not clear.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is a human brain transplant possible?\n\nHello doctor, Is a human brain transplant possible?",
    "doctor_response": "Hello. Human brain transplant or full body transplant is possible theoretically. Research is going on in this field where we have a case of head transplant from one dog to another where the dog died after a few days. There are a few reports of surgeons who believe it can be a reality in humans in 2 years. The most significant barrier in head transplant is the inability of the nerves to regenerate fully. A scarred nerve will not be able to transmit signals properly. Let us hope it would be possible someday and that would be a great achievement for humanity.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had unprotected sex. Took a i-pill after which got my periods. Is it required to take medicine again?\n\nhiee.. My date was of 1st... I had an intercourse in the same week after my chums got over. I took an i pill.. I got my chums again on 20th of the same month. Now i dont understand which date should i calculate. I had an intercourse on 28th of d same month without precaution assuming it as a safe day be it either 1st (4days before)or 20th ( within 8days)Its going to be 72hrs now.. Should i take d risk of having an i pill again.. I know its too risky and i dont wana have it.. Or ahould i wait for my chums for 20th.. Also i am feeling giddy may be its jus my thinking.. Please help. Awaiting your response",
    "doctor_response": "Hi,Thank you for posting your question here, I will try to answer it to the best of my abilities.I pill doesnt stay in your system for a week, its already gone, as such I recommend you go to your doctor and ask him to prescribe you some ulipristal acetate, it is an emergency contraceptive pill that works upto 5 days after having unprotected sex.I recommend you start using contraceptive pills, that way you wont have to worry like this. Also your period can be earlier and later than usual depending on how stressed you are, so that can explain why yours is early this month.I hope this answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it necessary to take antibiotics before tooth extraction?\n\nHi,My mom is 67 and had her lower teeth scaled (cut below the gums today) and they scheduled her for an appt. on Nov 2 to have 12 upper teeth pulled on the same day.  They did not provide an Rx for an antibiotic prior to the Nov. 2 appt.  I'm scared she will have a heart attack.  Am I over reacting?",
    "doctor_response": "hi, tanks for your query.patients having heart diseases and who are at high risk of developing heart problems are prophylactically given antibiotics. if your mom is not having any systemic problems then there is no need to worry.please mention to your dentist regarding if she have any problems to her systemic health prior to any treatment.hope this is helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump on bottom right hand side of head\n\nHi, I have a small lump on the bottom right hand side of my head. It felt like a very large bite, but now I have noticed I have a few of them going down the right side of my neck (gland area). As the day has gone on, I have noticed more small lumps and they are more painful than they were earlier today.",
    "doctor_response": "Hello, If symptoms persist, it is better to consult a physician and get evaluated. It could be a swollen lymph node. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taste of blood in mouth, taken pain pill, dry lips, sores near lips\n\nHi doctor! I m 15 years old, and I have this weird blood taste in my mouth when I eat, its always there, I woke up with the taste yesterday, and it won t go away, the internet said it could be a filling, or a kind of medication , but I haven t been on any, except this pain pill my friend gave me from when he broke his arm .. And that was two nights before I got the taste, the insides of my cheeks are also pale! And I have very dry lips , and sores near my lips on the inside of my mouth, please help! I m really stressing! :(",
    "doctor_response": "hi as per the information provided by you it seems that there is inflammation in your gums and that's why you are having this feeling. you haven't clarified as to why you took the painkiller but your feeling of blood in your mouth has nothing to do with it. just see a dentist and let him see what exactly needs to done . the sore mouth is another sign of inflammation so removing the calculus and plaque from your gums will fix everything. don't worry and visit a dentist soon take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Dianette contraceptive pill. Light periods. Could I be pregnant?\n\nI have just started taking Dianette contraceptive pill on the first day of my period - I ve only taken two pills so far and my period is already a lot lighter than usual. Could the pill work this fast in affecting my period or is it possible that I could be pregnant? I would say that I have been careful taking precautions.",
    "doctor_response": "Hi, Thanks for the query. Yes, sometimes the pill can alter the menstrual flow by altering the internal hormonal levels. So if you sure that you used protected intercourse all the time, no need to worry about the pregnancy. It will take some time to get adjusted for the pills. Sometimes minor side effects can occur, but they will subside soon without need of medication. As pill is having high protection rate and compatibility, you can continue using it. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe pain since gall bladder removal. Also diagnosed with slight cirrhosis. What could be the cause?\n\nI had my gall bladder removed about 8 weeks ago.  When they did the surgery they determined i also had lite cirrhosis of the liver.  It took me about 6 weeks to get rid of the severe swelling from the surgery but ever since, gas or needing to go to the bathroom have been is so painful i double over.  It is extreme pain.  The kind that makes you cry and be ready to face the firing squad.  This pain is ruining my life.  My work has suffered, my home life has suffered and the mental place it has brought me is scary.  I told my doctor and they ordered some other tests, colonoscopy, endoscopy and ultra sound of witch they say shows no reason for the pain.  i am about at the giving up point. I SEE NOW, ITS ALL ABOUT MONEY, CANT DO ANYTHING FOR ANYBODY THESE DAYS.  THERE ARE NO MORALS LEFT IN THIS COUNTRY.  THE ALMIGHTY DOLLAR RULES NOW INSTEAD OF THE ALMIGHTY GOD.  WHEN THE TIME COMES WILL HE KNOW YOUR NAME?  HOW IMPORTANT TO HIM IS YOUR WEALTH?  GET THAT MONEY WHILE YOU CAN.",
    "doctor_response": "Hello!Thank you for the query.Every surgery causes some adhesions creation in the abdominal cavity. After laparoscopy this adhesions are usually minor and do not cause any problems. However it is possible that in your case, some adhesions impede bowels movements and cause partial bowels obstruction.The other possible reason is some bacterial infection due to antibiotics usage (if there were any antibiotics used during or after the surgery).I suggest you to have stool test done. Also liver tests (AST,ALT,GGTP,AP), bilirubin level and amylase should be checked.Next step is abdominal CT with oral contrast (enteroclysis). And finally if nothing will be found, you should consider with your surgeon diagnostic laparoscopy.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for psoriasis in the soles of the feet and leg\n\nhi ,i am 28 yr female.i am suffering from psoriasis from more than last 15 yrs. already hve tried all the forms of medicines like ayurveda ,homeopathy ,& allopathy out of which homeopathy lead to severe flaring up of disease.plz tell if i ever be able to get rid of this disease,.right now i have this disease in both of my soles & on leg also.plz suggest me the best possible treatment for psoriasis in delhi.",
    "doctor_response": "Hello and welcome to healthcaremagicI can understand your concern and frustration regarding the chronicity of psoriasis. Psoriasis has a chronic course, the course being fluctuated by remissions and relapses, however there is no permanent cure for psoriasis.Psoriasis is characterized by the presence of well defined, thick scaly plaques mainly involving the scalp, and extensor surfaces like hands, feet/soles, elbow, knee, lower back etc.Specific topical treatment options for psoriatic plaques affecting the soles and legs includes potent topical steroid,either plain or in combination with salicylic acid.Topical Vitamin D analogues like calcipotriol, calcipotriene etc are also effective for localized plaque psoriasis affecting the soles and legs.Oral agents includes Immunosuppressives like methotrexate, Oral retinoids(Acitretin). Although they are mainly indicated for widespread disese involment, however, they can be used for limited yet disabling disease involving the palms and soles.Biologics like Infliximab, Adalimumab, Etanercept are newer remedies and includes monoclonal antibodies, interleukins, interferons and colony stimulating factors etc.Treatment depends on the severity of the disease. While limited disease can be managed with just topicals, widespread or extensive disease may require hospitalization.I would suggest that you seek an appointment with a dermatologist in your vicinity, who would be able to assess the severity of your disease and advice accordingly.Hope this helpsRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling achy and tired for months. High creatinine, ketone and cholesterol levels. What do they indicate?\n\nHello. I ordered lab testing for myself because I do not have insurance. I have been feeling very fatigued and achy for several months. My test results I indicated high Creatinine (22), abnormal ketone (+1) and high cholesterol . I am a 31 year old female and fasted 12 hours before blood was drawn. What do the combination of these abnormalities indicate?",
    "doctor_response": "hi high creatinine, high ketones and high cholesterol due to following reasons like diabetes, cardio vascular diseases, muscular dystrophy, kidney diseases,  hypo thyroidism etc so to prevent further damage of your internal organs  you must consult general physician for further evaluations and for the treatments. take care. get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get conceived with one normal fallopian tube?\n\nHi, we have completed 5 years of our marriage. Me & my hubby is 30 years old i m trying to conceive last 5 years but till here is not any issue. I have done HSG & Laproscopy. According to doctor my one tube is patient but till i don't conceive.so what you suggest us for conceiving",
    "doctor_response": "Hello and thanks for the query, Since you have already attempted pregnancy for 5 years, I assume that husbands semen analysis has been done and is normal. I also assume that endometritis and endometrial tuberculosis have been ruled out by histopathology and culture tests after laproscopy. If this has not been done, it needs to be ruled out as if a tube is blocked there was most likely a tubal infection sometime and a concomitant endometrial pathology may be present. If the above reports are normal then you may go for a ovulation study and if the ovary on side of the open tube is ovulating, get an Intrauterine insemination [IUI] in that cycle. Sometimes there is problem with ascent of sperm inside the cervix to the tube, so IUI helps in such cases. If there is still no luck either a tuboplasty procedure to open the blocked tube may be done. Hope this helped. Best of luck and I am sure you will conceive. A few more efforts and a positive attitude will help.Thanks for using HCM, have a good day.Dr Madhuri BagdeConsultant obstetrics and gynecology.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Lactogen advisable for a 6 month old child?\n\nMy son is 6 months old now. I have started with mashed foods like carrots, apples, vegetables and cerelac. The doctor also asked us to start with lactogen. But he does not drink lactogen at all. Is it really necessary that he takes lactogen? If yes is there an alternative?",
    "doctor_response": "Weaning with semi solids is recommended from 6 months of age. You can give mashed rice boiled along with pulses and the vegetables that you mentioned. Basically it is a transition to adult food and practically any adult food low on spices can be introduced gradually but in the mashed form. Lactogen or milk is an accessory and may not be given if other nutritive principles are included. If the child is not taking lactogen, it is not a cause of concern and you need not worry and there is no need to look for alternatives.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. There is a pressure feeling in the bottom of my throat. What could it be?\n\nHello doctor, I have been suffering from severe health issues since six months. My main problems include difficulty to burp, fatigue, pressure feeling in the bottom of my throat for which I have done gastroscopy which yielded no results. Also, I have done an MRI and barium swallow test. The barium swallow clearly shows an air bubble, which I am not able to burp out. This bubble is in the same location where I have the pressure feeling. I have overlayed the MRI and barium swallow, which shows the air bubble that is stuck underneath my thyroid. Can you please have a look at my thyroid MRI images and tell me if there are any anomalies. If there are no anomalies then what other things could be preventing the gas to pass my neck? I have attached all the images for your reference.",
    "doctor_response": "Hello, Welcome back to icliniq.com. I just read your query and saw your pictures (attachment removed to protect patient identity). Hope you find my advice beneficial. For more information consult an endocrinologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does multilevel spondylosis with broad-based disc protrusion causing moderate central canal stenosis suggest?\n\nMild/moderate multilevel spondylosis, most pronounced at C5-6, with a broad-based disc protrusion causing moderate central canal stenosis and bilateral neural foraminal stenosis minimally progressed since prior study. No abnormal cord signal.",
    "doctor_response": "Hi, Findings suggests degenerative changes in spine. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for back pain\n\nMy 10yr old son is being treated for a water infection for the second time in two and half weeks both containing blood and white cells he had been conplaining of back pain for 3wks before any symtoms of water infection but as wasnt ill put it down to growing pains we are now waiting for hospital what will they be lookin for",
    "doctor_response": "Hi,From history it seems that he might be having some problem in his kidneys like infection or kidney stones.Ultra sound of kidneyes will be more helpful.After reports of urine check up and ultra sound, plan of treatment can be decided accordingly.Meanwhile give him Meftal spas or Cyclopam for pain as needed.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat UTI?\n\nI've had a mild UTI for the past six days or so. I have mild chills and feel the need to urinate, even after I've gone. This isn't my first time having a UTI but it's the longest I've had one. It's not as strong as the others, just longer. And now I kind of feel like I have a somewhat mild throbbing clitoris. Is this from the UTI? Should I be worried? And is it possible that I may be pregnant?",
    "doctor_response": "Fever and burning urination are symptoms of an UTI. However, you should visit a physician and have an examination done. Your doctor will run some tests such as a urine routine-microscopy and antibiotic susceptibility testing before starting you on antibiotics.As far as being pregnant is concerned, I need to know when your last period was and whether your cycles were regular. In any case, you can know whether you are pregnant or not by taking a Urine Pregnancy Test (UPT). The UPT kit will be available with your local chemist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in the right lower pelvis?\n\nI am a 38 yo female. 230lb. 5'8. I have had past history of kidney stones but that has been ruled out through blood tests and ct.  I have pain in my right side and on right side of my back.  It seems as though anything I eat or drink makes me cramp.  I had a ultrasound and blood work and no stones were to be found and blood test results were normal.  Whatever that means!!! Today, I have a Hida Scan and after laying there an hour I was again injected.  I became severely naseous to the point I felt lightheaded.  My stomach fellt as if it was burning in the right side and cramping in the lower right side of my pelves.  Does this mean that my gallbladder is not pumping correctly????",
    "doctor_response": "The problem during HIDA scan would have been  a reaction to the drug.Only the report can tell whether you have a functioning gall bladder or not. The cramps you are describing can also be due to IBS or so. Get a proper treatment with a course of an antibiotic and antispasmodic tablets for 7 days , your problem may be solved. You have already undergone the CT scan and an ultrasonography, which you have mentioned to be normal . It would have already picked up the other problems. I would think opf IBS and other reasons . I would advise you to go for a test of barium called Enteroclysis under a fluoroscopy control to see the real time movement of the bowel, any obstruction or motility disorder.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can i do for dry skin?\n\nI have dry cracked knuckles and dry skin in general, just winter of course makes it worse, THe thing is i work with my hands a lot and in the past week i have torn the skin back on 2 of my knuckles by just knocking my hands into things at work, ooks bad but not very painful. what can i do?",
    "doctor_response": "Hi,Welcome to healthcare magic.I have read your query and I suggest you following measures to avoid drying of skin:1.Avoid frequent hot water baths as these cause evaporation of water from body,prefer lukewarm water.2.Stop using soaps with plenty of chemicals,instead use of mild soaps like dove will provide appropriate moisturization.3.Do not rub the body too much which will increase the water loss.4.Avoid sun exposure as far as possible,at least cover your hands when you go out to prevent further drying of knuckles.5.Application of petroleum jelly/vaseline 2-3 times in a day to the exposed parts  specially after bath will keep the skin moist by preventing washout of oils from skin.Hope this solves your query.Regards,Dr.Tushar Tamboli",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mitral valve prolapse\n\nI was diagnosed with mitrol valve prolapse about 30 years ago and my cardiologist told me to forget I have it.  Recently I have been experiencing a rapid heart beat at various times during the day.  It comes and quickly goes away.  I have low blood pressure.  I am under a considerable amount of stress.  I have been attributing it to that but am wondering if I should contact my internist/cardiologist for an appt.  Just had my yearly physical and ekg. 6 months ago and everything was normal",
    "doctor_response": "Greetings! Thank you for your question and welcome to HCM. I carefully read your query. Mitral valve prolapse (MVP) is a benign condition that is estimated to be found in 16% of young ladies, and it may take up to forty or fifty years to produce symptoms, only after a chronic mitral regurgitation is installed. I would go on and say that further clinical investigation should be in order at this time, but I am quite confident that, if something was wrong with the mitral valve and the mitral regurgitation was there, it would have been told to you during the before 6 months echocardiogram. It would be only when a mitral regurgitation produced by a mitral valve prolapse that would enlarge the left atrium, when the high pressures in the enlarged left atrium would produce shortness of breath and, maybe, rapid heart rate corresponding with a atrial arrhythmia. And it would have shown in the echocardiogram, if the left atrium was enlarged. My opinion is that your problem is not being produced by the mitral valve prolapse, at this moment, at least. However, if this a worrisome situation to you, then another echocardiogram should be done. Of course, if mitral valve is found on a bad shape, after carefully measuring the function, size, and grade of regurgitation, adding to the possible symptoms, it is only then when mitral valve should be surgically replaced. As for the stress side, indeed substantial amounts of stress have their clear effect on the heart, by putting it to a significant dynamic state and by producing adrenalin that acts directly or indirectly in your heart electrical and conduction system. There are a lot of natural means to reduce stress, starting from self-fighting of the stress to yoga or other methods. If this becomes problematic to you and affects your quality of life and work, I would recommend you a consult with a clinical psychologist regarding a course of sedatives to reduce it. I hope I was helpful. Best regards. Dr. Meriton",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dengue fever\n\nHi,My mother is suffering from dengue fever. Her platelet count had dropped to 20000. After platelet transfusion it went up to 41000 but has again dropped to 33000. She is vomiting and passing loose motions. Her age is 71. We are really worried. What is the best treatment.",
    "doctor_response": "Hi there. The platelet level is really low and your mom is elderly - I strongly recommend that you immediately take her to the nearest hospital for treatment.You need to understand that there is no cure for dengue infection - treatment given at the hospital is supportive through rehydration and platelet and other blood parameter levels are closely monitored. Should platelet levels dip too low -platelets may be transfused to prevent internal bleeding. It is very necessary that you take your Mother to hospital ASAP.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the other alternate options for kidney transplant?\n\nmy father is a CRF patient undergoing dialysis twice in a week, starting from DEC 2009 & already 24 dialysis has been completed. he is 58 years old. is there any way out of treatment except transplantation. now from the test report the level- urea:66.2, creatinine:5.6 potassium:5.3 heamoglobin:7.7. if i want to go vellore for my father's thorough checkup how can i proceed? we live in kolkata. please help me. email:  YYYY@YYYY  mob:0000",
    "doctor_response": "there is no way other than renal transplant, if he is medically fit for this. you can visit their website",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are acute diarrhea and weight loss symptoms of giardia?\n\nI have had symtoms of acute diarrhoea and weght loss of 9 lbs over a period of nearly 3 weeks.  I have been staying with my son-in-law  who was diagnosed with giardia after a stay in New Zealand.  My daughter is also showing symtoms.  Analysis of my stool sample shows nothing.  Should I still take anti-biotics as suggested by my local nurse?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Your stool sample is negative for parasites and you have completed the course of antibiotics   then no need to take antibiotic now.  Take proper fluid diet.  No need to worry. Just be relaxed. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can afib be caused by stomach problems due to irregular eating?\n\nYes, I recently started to have afib, It started last year, and happened when I tried reducing my Bystolic to 2.5MG, I am now back to 5mg. In the past few weeks I have started to have afib more, with a heart rate of 140. I am on a 21 day monitor. We thought it was alcohol related, but this past Monday, I had episodes, and hadn t drank in two days. The previous event was after 3 beers, on Saturday. All of the events seem to be when I lay down. Can afib be caused by the stomach, eating late?",
    "doctor_response": "Hi Welcome to HCM.I understand your query and concern.Yes definitely your symptoms are suggestive of AF due to undue stress and anxiety. .Increase in heart rate is known to alter the blood supply to the brain leading to impaired function in a transient way.Few drugs like beta blockers are certainly known to reduce the heart rate and accelerate the dizzy spells.I advise you to have a complete 24 hour holter ECG which can accurately determine the cardiac conduction abnormalities.Monitor your blood pressure and heart rate.Drugs like Isoproterenol will help to increase the heart rate.Drugs like amiodarone can also help to minimise the rhythm irregularities.A 2 Dimensional echocardiography will help to assess the functional reserve of the heart ruling out organic heart lesions.Electrophysiological study and Radiofrequency ablation will also help to eliminate abnormal foci of rhythm.Consult your cardiologist for expert management.Post your further queries if any,Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Has pancreatic cancer. Been diagnosed with low hemoglobin. Why fatigue and lightheadedness?\n\nHi. My sister has pancreatic cancer and has been diagnosed with low haemoglobin and is having a blood transfusion . I understand how serious this is, but was wondering what to expect now. She has been very light headed and very fatigued. She has just had two treatments of chemotherapy, after having treatment for the last four months on a weekly basis, and will now miss her treatment tomorrow. She has a stent in her duodenum and bile duct and she has a temperature.",
    "doctor_response": "Hello Very sorry to learn about your sister's problem but the fact is that nothing beyond chemotherapy can be done. This treatment is palliative and not curative. Till she is alive,she has to be managed conservatively only as nothing aggressive can be done. Take care of her nutrition,manage her hemoglobin levels and give full psychological support. Look for any sign of infection as she is having fever. Infection has to be treated with antibiotics only. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a tender lump on my neck?\n\nI' m in my mid-20's and have a tender mass on the left side of my neck. The more I touch and try to feel ot, it becomes more and more tender. I've also had intermittent (severe) dizziness. I had a baby 1 year ago and have had all kinds of strange medical issues from fluctuation thyroid (started out hyper now on the hypo side), gastroparesis, hypoglycemic attacks, and whatever is going on with me now. Please help!!",
    "doctor_response": "Welcome to Health care magic.1.The way you have described, it seems like an infective cause ( abscess, infective collection) tenderness on touch with pain and dizziness.2.With your previous history thyroid mass can not be ruled out.3.In this case you need to get an ultrasound neck done - which will hep to evaluate the nature of the lump, its source and extensions.4.Even before that it needs to be examined and palpated - may be a course of antibiotic is enough to treat.5.The scan will be confirmatory to start treatment. Good luckHope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medication for hypotropic cardiomyoptia with Angina\n\nI am a hypotropic cardiomyoptia patient with Angina, AF (lots of ER trips) recently my meds have been changed 1. Amiodarone hydrocloride added to control AF prescribed by AF doctor. The nex step if this doesnt work is putting a quarter size coin in my heart. However I am currently taking riveroxaban 20mg. It is my understanding that one of these meds would preclude surgery (i.e. coin in heart ) due to the fact that it stays in the blood stream for up to two years. So may need heart surgery but AF has me on an anticoagulane? This is all through the Heart Science Centre, London, Ontario. Any suggestions?",
    "doctor_response": "Hello,  Let's individually address the problem.  1)   in hypertrophic cardiomyopathy,  the angina is due to  increased muscle mass leading to imbalance in oxygen demand and supply. Secondly due to continued existing coronary artery disease.  So here increase dose of beta blocker to max tolerating dose (would help in AF as well),  add diisopyramide after beta blockers If you are above 40 check  for coronary artery disease and treat like wise  2) about atrial fibrillation.  You are on rivoraxabn for anti coagulation so a blood  clot doesn't form in the heart.  However you may  be put on alternative meds for that  and a coin machine ( a cardiovertar / defibrillator)  to prevent sudden cardiac death can be planned, no need to wait for 2 years for the same. 3) the heart surgery depends on the gradient,  also atrial fibrillation may persist even after surgery,  more likely if left atrial volume is increased  If you can send me all the reports and meds you are taking,   I would be able to help you further Regards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for the discomfort in the chest?\n\nfor the past 6 month's or so ive had some chest problems. where the 2 halfs of my ribs come together is where i feel pressure. 6 month's ago in the same place the was like something loose in that area like a bone or something that would kind of pop out..so i would pop it back in. recently ive been having trouble breathing though..and it seems like its coming from the same place. I burp way too much, and i feel like i have too much gas in me always. I suffer from anxiety but i dont think that has to do with this at all. I feel fine when i first wake up..but it seems to get worse as the day goes on. My doctor gave me omeprazole because i was having trouble breathing like a month and a half ago. I have no allergies. Im 20 years old, Im 5'8, i weigh 183 lbs. I also have a lump under my right rib cage but as of 2 days ago it was determined that it was like a group of fat tissue or whatever, and the doctor said that wouldnt affect my breathing at all. also lately my stomach seems to go numb, and my hands get tingally when im just sitting down.",
    "doctor_response": "Respected user , HiThanks for using Healthcaremagic.comI have evaluated your query thoroughly .*  There seems issue with costochondritis most likely .*  Strongly recommended to get high resolution ultrasound , x-ray of the     part with further need of MRI  if  required .Hope this clears your query .Welcome for further doubts .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can normal Prolactin levels and laproscopy report ensure successful IUI conception?\n\nmy age 37.hieght 5.3 weight 70. i got marriage just 4 years back.my husband semon analysis report very low.so i tried IUI BABY with doner sperm.First  time it sucess.and it abortion-on 52 days.then after many times IUI failure.My prolaction report-39.after taking cabgoin 0.5 tablet.-it is normal -8.my labroscope repot is normal. shall i get iui baby very soon?",
    "doctor_response": "Hi,Welcome to HealthcareMagic.Normal prolactin level and laparoscopy increases chances of conception by IUI. It won't ensure 100% success.Success of IUI depends upon the reaction between sperms and egg and also the gene composition of embryo and its capacity to attach to uterus and grow.Hope I have answered your query. RegardsDr Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can surgical treatment cure arnold chiari malformation?\n\nMy wife has been diagnosed with Arnold chiari malformation and is in extreme pain what can I do for her she s crying and confused with what she can do and if having surgery will do anything since she has around 13 cyst in her spinal cord what can I do please help me. !!!!",
    "doctor_response": "Hello, Very sorry to hear your wife is in terrible pain.  The disorder is no longer referred to as Arnold-Chiari malformation rather just Chiari malformation (along with various types, I, II, etc). The definitive treatment to this problem is in fact surgery and this should relieve the headaches and neck pain so long as the diagnosis is accurate. If you or she have any doubts on how well surgery will work then, I recommend you seek a 2nd opinion on the case before committing to the surgery. It is true that many get surgerized but do not experience significant relief.  Unfortunately, even when the diagnosis is dead-on. Still, surgery does not seem to completely relieve symptoms because in some patients they also have other underlying problems such as HEADACHE DISORDER or cervical spine arthritides. A 2nd opinion may help identify other comorbid issues that could make it appear that surgery was unsuccessful since neurosurgeons and radiologists are not always in search of anything except strict measurements of the cerebellar tonsils. Was a CSF flow study accomplished?  What are the details on the multiple cysts you mention? Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Peeling of skin in knees, used lotion. Healing time?\n\nThe skin on my knees has begun to peel. I put lotion on it, but it has continued. I lotion everyday after the shower, so this is different. I drink about 6/10 oz.  water a day and eat very healthy; veggies, proteins, whole grain, natural sugars from fruits and general foods, run 4 miles a day 4 days a week and sleep well. My Mom and grand mother have underactive thyroids..please advise",
    "doctor_response": "Hi, is there any inflammatory signs around knees like pain, swelling, redness. Is there any other symptoms.How this started and which lotion you are using. Please mention these for better discussion.Peeling of skin may be due to many condition and only around knee area may be due to local trauma or infection or rarely psoriasis. So better if you upload the photo of the lesion with the above said information for further discussion. Continue healthy habits.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach pain in a child\n\nmy 7 yo daughter has stomach aches almost every day around her navel. Lately she is also falling asleep as soon as she comes home. we have run some basic test but ped gi dr says it is a blockage, milk of magnesia is not increasing size or qty of bowel and miralax does not seem to change anything either....she moves her bowels everyday...",
    "doctor_response": "Hi, By what you say I feel that your daughter might be having non-specific mesenteric adenitis. This is a self-limiting condition usually caused by viruses and will settle by itself. Please discuss this possibility with her pediatrician. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hives and fever after taking prednisone?\n\nhi, my son is suffering from hives and fever for 4 days now.  he was prescribed prednisone and today he had his 3rd dose but soon after taking it his symptoms worsen for about a couple of hours, now he is quite better but still has hives and slight fever. please advise",
    "doctor_response": "HelloAs you mentioned that your son is having FEVER and hives for 4 days .He was advised prednisolone ( steroid ) and once , he took , he develop hives ( rashes ) and also fever.Since ,still fever and hives present , so I recommend ,stop prednisolone because it may mask the clinical features of fever ( what is the main reason of fever ,is not known ).As  far as concerned about rashes and hives , may be due to allergy so montelukast+fexofenadine will provide instant relief.For fever get in blood for CBC, malarial parasites .I recommend you consult a physician ( 2nd one ) and get his opinion.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will i get pregnant with this medication?\n\nHello Doctor, I am trying to conceive for my 2nd child and my age is 26. For my first child, since I had PCOD my Ob Gyn prescribed Clomid and got pregnant in the first month itself. But now, I m with a different doctor and she prescribed duphaston for the past 3 months. I did not conceive and this month she asked me to take anasom tab and continue to take duphaston. Will I get pregnant this time. Also please let me know why clomid for first time and anasom this time. Which has more success rate in pregnancy. Thanks",
    "doctor_response": "Hi, clomid and anasom both are drugs used for increasing the growth of your follicles.  There is no major difference between the two.  So, you can take anasom also. You can 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 every 2 to  3 days after your periods stop. 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.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is there any skull fracture seen in my father's CT head report?\n\nHi doctor, My father had a CT scan for head injury. I have attached the two CDs for your reference. One important thing is different in the reports. It is about a crack of parietal and temporal bones. Could you take a look and describe them to me?",
    "doctor_response": "Hi. I have seen the images of CT scans (attachment removed to protect patient identity). Revert back with the answer to the above question to a\u00a0radiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a kidney cyst\n\nI may need to have a large kidney cyst removed. I have a terrible history of UTIs and my three doctors have stated I should never again have a transurethral foley catheter as I am now allergic to all antibiotics except one used for treatment of infections. Is it possible to use a suprapubic catheter for my surgery/early recuperation?",
    "doctor_response": "Hi, Kidney or Renal cysts are round fluid-filled pouches that form in kidneys which sometimes may be associated with serious disorders that may prejudice the normal functioning of the kidneys. But given that your USG report mentions it to be a simple cortical cyst, you don't have to dread as they seldom cause complications and they, by and large, don't entail treatment. You are at peril of acquiring them as you get older and I would want you to be wary of symptoms like fever or severe pain on your lower back or sides as the cyst might get infected because of urine draining into it. You might want to take instant medical assistance in such circumstances. If it is bothering you now, you can discuss it with a Urologist and get it removed surgically. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ivan R. Rommstein, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat oozing pus from penis?\n\nHi I'm seeing yellow and green pus come out of my penis and I'm scared that its gonnerrher what do I do I'm in fort walton I'm afraid of needle this is the first time this has every. happen for 8 mos I. found out my wife was cheating on me I need some advice",
    "doctor_response": "HelloI share your concern Looking at your description This could be caused by infection like STI or inflammatory reaction as a result of repeated trauma or allergyHere I would like to know about your age and related medical history like diabetes or history of unprotected sex?I see patients with similar complaints in my clinic and I would advise them for a battery of tests like blood for hemoglobin, CBC Liver and kidney function test, blood sugar And investigations to rule out STI like gonorrhoea herpes and VDRL for syphilisMeanwhile maintain good hygienewash it with antiseptic soap or solution and apply antiseptic or antibacterial ointmentYou may require a course of antibiotics under supervision of your doctor.Hope this answers your questionBest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is cocaine usage during a pregnancy harmful?\n\nhi i am asking this question on behalf of my sister, she is nearly 4 months pregnant and did drugs last nght- cocaine she says itwasent a lot, she just wants to know if it was going to cause anything serious like a miscarriage would it of happened there and then?",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic.I have gone through your query. I think I have understood your concern, I will try to suggest you the best possible treatment options.Any kind of substance abuse is harmful for pregnancy.Addictive drugs can cause mental retardation or learning disabilities in the baby. In any case it harms mother as well as the unborn baby. SO the best advise is to avoid them.I will suggest to get counselled with a proper counselor in this regards.And she should adopt proper diet and exercise regime. Also start with IRON, CALCIUM and PROTEIN supplements.I hope my answer helps you.Thanks.Wish you good health.With regardsDr Purushottam",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the sub mandibular gland?\n\nhello sir, i m 29 yrs old male & i feel slightly pain in my lower neck (submandibular gland) while i eat , my lower neck(submandibular gland left side) swells when i eat & after meal it goes away. what can be the causes of this? only during meal time it happens.",
    "doctor_response": "Hello,I read carefully your query and understand your concern. Your symptoms seem to be related to swollen salivary glands.I suggest:- massaging the affected\u00a0gland. -applying warm compresses to the affected\u00a0gland. -rinsing your mouth with warm salt water. -sucking on sour lemons or sugar-free lemon candy to encourage\u00a0saliva\u00a0flow and reduce\u00a0swelling.If the symptoms continue, I suggest to see an ENT specialist. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for complete spinal cord injury,IBS and mega colon?\n\nI m 28yrs old& April 2003 I was n a serious car wreck but it lf me w/a COMPLETE Spinal Cord Injury... I m a T9&10 paraplegic&n2012 I started2have a lot of UTIs&it got so bad&I went from a lively life&goin2college2settin/o 2yrs well I got a urine&bowel dyvrgn The procedures have a nacro which are the MONTI- The entrence&inverted stoma that goes2bladder&am able2Self-cath however I also got a MACE-this stoma we cath but then use syringes&flush water thre however b4I was hurt Ik I had IBS but we didnt kno i had1of worse cases of mega colon as well which thats where I hv ben kinda stuck bc he said a reg bowel gets cleanned/o w/7 Which if you need my surgons name2learn about these stomas he is a#1surgon that helped profect these procedure&his name is Dr.BIRHEL From IU Medical",
    "doctor_response": "Hi, I have noted your details. Unfortunately, there is no medicine available for this condition. i request you to be under regular follow up with your surgical gastroenterologist and urologist. Hope I have answered your query. Let me know if I can assist you further. All the best. Regards, Dr. Sudhir Kumar, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why has my baby's weight reduced drastically ? Is there a difference between Nan and Lactogen?\n\nHello Doctor, My Baby boy is 1 month 22 days old. His birth weight was 3.1Kgs, but thereafter it reduced to 2.80 kg in next 10-12 days and after 1 month he was 3 Kgs. When we consulted our local Pediatrician , earlier he said theres nothing to worry, but after 1 month since he was only 3 Kg.. he suggested us to take Nan or Lactogen 1. At that point of time i was not aware about the difference in those two formulas. Now after 1st week of Lactogen (30ml, 3 times a day) he was weighing 3.2 kg. And now for last 2 weeks we are giving him 45ml, 4 times a day. He is passing stool only after 4-5 days, but he pee s atleast 10 times a day. Should i switch to Nan, as it is easily digestible..or should i continue with Lactogen 1.",
    "doctor_response": "Hi baby  father, nothing to worry, some time babys wt. reduce for 1 or 2 week, after ward it increse slowly. I may like to suggest u to give him cow or befellow milk. I think  baby will pass the motion regularly and wt. may also increase. If mother milk is there, it will be the best option.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause chest burn associated with increased asthmatic spasm?\n\nHello, I am having bronchial asthma for last 15 years. I am now 40 years old. Recently ( last two months) i have developed symptoms like chest burn or heart burn associated with increased asthmatic spasm. As per my observation , i feel better when i drink more cool water.  Is this related to acid reflux or gastroesophageal reflux disease...?",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your history and would like to make following suggestions to you:1. First of all, yes, from your complaints, I would first think of acid reflux/GERD.2. I usually suggest my such patients regular antacid like pantoprazole before meals for at least 6-8 weeks.3. I also suggest them to avoid hot/spicy foods, caffeinated beverages, alcohol, smoking.4. I suggest my GERD patients to take a brief relaxing walk after evening meals.5. GERD is a very important consideration in patients with asthma as many drugs used in treatment of asthma can worsen GERD - salbutamol, theophylline, corticosteroids, etc.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes decrease in platelet count and negative test for dengue?\n\nHi, Though Malaria Typhoid and dengue is negative on reports doctor still suspect it to be malaria as platlate count is only 35000 thus advised 3 days bed rest and the medecines below. Zocef 250 - 3 times . para xt 2 times synriam 1 time a day and glycomet-gp0.5 1 time a day... And also asked to take electrol regularly. So my question is is the treatment ok and is it ok to stay at home or get admitted?",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.In my opinion taking a rest is good.Doctor provided you a right treatment. Malaria can decrease the platelet count. Take the complete course of treatment.Rest is necessary to take care of platelet count. If the rest is not taken there is risk of hemorrhage. Such hemorrhage once started is unable to control. I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can there be crawling sensation post penis surgery?\n\nHello doctor, I am 32 year old bachelor. For the past one year, I have a feeling that something is crawling throughout my body. I am feeling this sensation after my penis frenulum surgery. It starts from penis glans and spreads across my whole body. Right now, I do not want any medication or treatment since I am taking ayurvedic treatment. So, kindly suggest me tests for diagnosis of my problem. Please suggest me tests that would help me find, if any infection is spreading in my body as well as face. I already consulted a neurologist, he says it is a psychological issue.I am very worried, Please help me find a solution for the same.",
    "doctor_response": "Hi. The feeling of insects crawling inside your body is mainly a psychological condition known as delirium. There are no tests or investigations to prove it. Rarely, it can be because of parasitic infection inside the skin, lungs, and muscles. Anti-helminthic tablets Albendazole and Mebendazole can treat it. For your relief, you can get these following investigations and check for the presence of infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be the itchy rashes below my belly during pregnancy?\n\npresently I am 10 weeks pregnant and about 7cm below my belly botton i've noticed a rash. It's red clusters of tiny  buttons that group together in a rash. It's very itchy and blisters when I scratch it. Can you possibly diagnose and recommend something?",
    "doctor_response": "Hello. Thanks for writing to us at healthcaremagicThis seems like a Fungal Infection/ Tinea Cruris; patches of Tinea usually start as bumps which tend to expand and coalesce to form a peripheral raised margin with central clearing. Itching is common in fungal infections.The location too seems to suggest that it is most likely a fungal infection; fungal infections are common at sites such as waist and pubic region.I would suggest you to use an OTC topical antifungal clotrimazole 1% cream, twice daily for 4-6 weeks, regularly.Oral antifungals may be avoided during pregnancy.An oral antihistamine e.g hydroxyzine is safe in pregnancy and can be taken if itching is bothersome.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What diet should be followed when suffering from recurrent chicken pox?\n\nHello, I got a chickenpox on 14/11/14, now I got black coat on all blisters. I know that I should avoid non-veg for at least 2 months but can I take milk products like butter, paneer, ghee etc.... Please suggest some what should I eat or avoid. Thanks, Chandan Singh",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.No, you are having false belief of diet restriction in case of chicken pox.You can eat whatever you want to eat. You can eat chicken also. Only thing you have to avoid the spicy foods.Chicken pox is caused by the virus. Its infection progression and multiplication has not influenced by your diet.You have to check for the status of your vaccine and according to you have to consult your doctor.Please take bath with medicated shop which can be available in nearby medical shop.Please wear cotton cloths as it can prevent secondary infection.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the treatment for itchy bump and rash on buttock?\n\nHello doctor, A red rash with white tiny bumpy spot has grown on my buttock. It is very itchy. I guess it is a fungal infection.\u00a0Please help.",
    "doctor_response": "Hi. Revert back with the asked details and pictures to a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible despite taking Postinor 2 after intercourse?\n\n..hi I had sex on 3rd may and 4th may  and both days I took Postinor 2 after 5 days my breasts are tender heavy I have headches, abdominal pains and bloating lack of sleep I fear that I could be pregnant ,could I? please help",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As you took emergency contraceptive pills within 24 hours of unprotected intercourse the possibility of pregnancy is less. The possible causes of your problem are : -There should be at least two months gap between two emergency contraceptive pills. As emergency contraceptive pill contain high dose of hormone, repeated intake with very short interval can increase the severity of side effects. Analgesics and antacids can decrease the symptoms to some extent. -Usually the effect of emergency contraceptive pill is less if ovulation already occurred in that case, we can not rule out the possibility of pregnancy. So, you better to wait til your expected date of periods and if you miss your periods, please go for urine pregnancy test once. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are heavy head and weak legs related to low WBC or a symptom of HIV ?\n\nmy head is heavy, feeling no power in legs and feeling fever inside body but when checked no fever. i have done cbc and sgpt test, my wbc is 2900 and sgpt is 84.9u/l i was admited in hospital for 5 days docotor says me liver and astmaic problem and given 15days medication after discharge i was fully fit but once medication finish im again loosing my wbc and sgpt is 84.9u/l. can it be a symptom of HIV",
    "doctor_response": "Hi. I am glad we connected. HIV and AIDS usually takes a few years to develop. This is when the immunity level is low enough for the symptoms to show up. This is when one can observe the symptoms that you have mentioned. It would be a good idea get a HIV test done at 4 weeks and then repeat after 3 months. This would allow one to pick up the virus and determine if one has HIV. Do let me know what the doctor says. I hope this helps. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rapid heart beat?\n\nMy heart goes really fast when I think of it going fast, like 150 to 190bpm. I was told that adrenaline and cortisol get released when you fear and the flight fight mode is being activated by the mind which in turn speeds up the heart. How come I fear my heart going fast then it does? I mean I didn t think I would have thought control over a heart. I can think or tell my heart to go 60 but it s not going to go and do what I say or think. So is this just a part of a panic attack? I have been checked out left and right including stress test(s), halter monitors, thyroid and adrenals were checked and I my doctor also checked just about every blood test available. If I am ok...then why all the fast heart beats? Thank you for your time. ~ Tommy",
    "doctor_response": "Hello, I would explain that your symptoms seem to be related to anxiety. This is a quite normal physiological reaction to anxiety or physical activity. The fact that you are focused on it, means that you are a sensitive person. But, it doesn't mean that you are ill. I would just recommend practicing Yoga and regular physical activity. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be done after a toddler ingests chewing tobacco?\n\nI\u2019m in Japan and don\u2019t have a number for poison control but my 20 month old baby took a sip out of my chewing tobacco spit bottle. I don\u2019t think it was that much but he coughed then puked a little bit and cried for about 20 seconds. He seems to be happy and running around now but I am still concerned. What should I do?",
    "doctor_response": "Hello, Your child has vomited it out. Do not worry, just relax. Keep an eye on your child as any abnormal behavior as over excited or palpitations occurs, child should be taken to hospital emergency immediately Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Varinder Joshi , General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Emtophobia\n\nim wondering if you can help me ...i suffer with emetophobia really bad and last nite my 3 year old was sick ...only once though and i didnt clean her up i stayed in another room whilst her dad sorted her out ......can u tell me if im safe or not please as im an anxious wreck right now :( thanks",
    "doctor_response": "earWe understand your concernsI went through your details. I suggest you not to worry much. Emetophobia is an intense, irrational fear or anxiety pertaining to vomiting. This specific phobia can also include subcategories of what causes the anxiety, including a fear of vomiting in public, a fear of seeing vomit, a fear of watching the action of vomiting or fear of being nauseated. You need to get evaluated for your exact cause. You may undergo psychometric test to determine this from a qualified clinical psychologist. Psychotherapy techniques like desensitization therapy should help you.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Continuous nasal discharge, sneezing, passing urine due to strain. Using asthalin rotacaps. Treatment?\n\nHello doctors, i am a 28-year-old lady. suffering from less phlegm , but continous one for the past one and half months and now for the past 2 weeks i have been suffering from sneezing , when it comes it was continous. Because of the strain, i am passing few urine also. I am using asthalin rotacaps for the last six months more... so advice me what i have to do....",
    "doctor_response": "Hello. You are being treated with bronchodilators indicating that your doctor has probably diagnosed you as suffering from a reactive/ allergic bronchitis. Salbutamol (asthalin) is just a reliever (like crocin for a fever) and does not alleviate the root cause. I suggest you to take a rotacap with fluticasone + formoterol combination. For your sneezes, a nasal spray of fluticasone + azelastine will help but try cetrizine initially. You need to rule out infection and if found, take antibiotics. Any cough for more than 3 weeks is a warning symptom and a X-ray chest is advisable as also is hemogram with eosinophil count. Now regarding urine incontinence. Don't worry. It is quite common phenomena in ladies. A pelvic diaphragm normally supports the urinary bladder and helps it to hold urine even if intra-abdominal pressure rises (such as in coughing). After delivery of a child (and also in elderly ladies), this diaphragm becomes loose. Hence the urine dribbling occurs during a cough bout. The treatment is simple. Do pelvic diaphragm exercises. These are similar to Moolbandha of yoga. You have to constrict the muscles around the genitals, pull the genitals up and release after 10 seconds. Do this 20 times a day and in a week or two, the muscle should be strong enough. Also, the cough also would probably stop by then. -Dr. Tushar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible for the placenta to move up and later cover the cervix again?\n\nI am currently 31 weeks pregnant and was diagnosed with complete previa in my 19th week. I was then sent to a high risk OBGYN at 21 wks and the placenta was over the cervix 2.38 cm. A few weeks later a vaginal u/s was done and it only measured .86. I had a small red bleed on January 15th. I then had a dark red old blood bleed on Jan. 31st & Feb. 4th. Nothing since then. I just recently started having contractions this Wed. and am still having them 5-8 minutes apart. I had them check to see if the placenta had moved away from the cervix because I wasn t bleeding with the contractions and they are now saying that it is covering the cervix at 2.46cm? Is it possible for it to move up and I got bigger & more weeks along it move back across the cervix again?",
    "doctor_response": "Hello, and I hope I can help you today. First of all, at this time if you currently have a placenta previa and are contracting, your situation is very grave. The gradual dilation of your cervix can all of a sudden cause hemmorhage which can make both you and the baby lose a lot of blood, and even cause death of the fetus. So yes- it is true that if your pregnancy went to full term the placenta may move, but if you are having a short cervix and contractions and they do not stop you will need emergency cesearan delivery. So it is imperative that you be treated to stop your premature contractions. I recommend you consult as soon as possibile with a high-risk OB or go to the hospital for evaluation of your contractions. I am sorry that my answer may alarm you but I want to make sure you and your baby are as safe as possible. Please consult with your local doctor so you may get immediate care. I wish you and your baby the best for the rest of your pregnancy.Take care, Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of itching in scrotum and penis skin?\n\nI have problem with my scortum and penis skin and it itches a lot and itching never stops. The skin shed in every two-three days and there is also a very bad smell which at times frustating. It is bound to happen on the day when i miss my shower but anyways it happens at regular intervals and itching continues throughout the day ,the smell stays on the cloths and is permanent , i have been applying candiderma daily once and it is not helping, i am a virgin , the skin becomes dry like our lips and sheds off like scales on our lips when rubbed , the skin devlopes red cut marks sometimes and the thigh skin in contact with scortum also has red patch , initially my skin used to havr burning sensation when soap was applied but i am not having that problem from past 6 months, pls help",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern looking to the given history here I could say that this could be nonspecific type of itching generally this does not need any treatment just take care for hygiene and the thing would come around no need to worry about this, take it easy, hope this information helps you, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for headache and fever in kid\n\nmy 5 year old daughter toldus yesterday that she swallowed a penny during naptime. she didn t tell us right away because we have told her time and time again to never put money in her mouth. this afternoon she has a 101.5 fever and thechills and is complaining of headache and said she felt like throwing up. but I just asked her again about her tummy and she says it feel fine its just her head. What do u think? any corilation with thepenny. I have no clue if shes passed it or not",
    "doctor_response": "Hi...this seems like a viral illness unrelated to the penny ingestion. Do not worry. If you do not know whether it has come out or not, I suggest you take an X-ray abdomen including chest and it will show up if it is still there.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My father has developed enteritis and his abdomen is swollen. Please help.\n\nHello doctor, After receiving 10 radiations, my father has developed enteritis and his abdomen is swollen. Antibiotics and IV treatment are being carried out. I need further advise here.",
    "doctor_response": "Hi. I understand your concern. Radiation enteritis is a very common side effect of radiation therapy. I need to know the following:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning lungs with difficult breathing?\n\nwent swimming and i choaked on some water. it immediately left me with a burning sensation in my lungs, and when i tried to continue swimming i felt nauseous  and like i couldnt breathe. I left it 24 hours and went swimming again and the same thing happened - burning lung with nausea and a feeling of not being able to breathe. what is wrong?",
    "doctor_response": "Hey,Are you diving deep in swimming pool?If yes then stop doing that now. You could land up in air embolism.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Primolut N taken during pregnancy affect the baby?\n\nHi doctor..I have taken primoult n tablet twice daily for 5 days to delay my periods in the month of march.I was not aware of the pregnancy at that time but now when I tested in April month it is positive in pregnancy.so my question here is does this tablet effect my baby",
    "doctor_response": "Hi,     Thanks for the query. I understand your concern.         Primolute  N-a hormonal preparation of female sex hormone... is contraindicated in pregnancy.      It can cause fetal congenital abnormality &so such pregnancy (with intake of pills like promolute n ) needs to be terminated.   Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe joint and muscle pain\n\nfemale patient admitted in the hospital complaining about joint and muscle pain, accompanied by fever her lymph nodes and spleen were enlarged patient exhibited a butterfly like red rash on both cheeks and across the bridge of the nose. what might be the problem. and what would be suggested as a treatment regimen",
    "doctor_response": "hi,thank-you for providing the brief history of you.a thorough musculoskeletal assessment is advised.as you were admitted in hospital for systemic pathology. Due to the stay in hospital, medication, immobility, etc there is joint and muscle pain.It happens to most patients admitted in hospital. Where post discharge they can undergo some physical therapy for maintaining their muscle property and joint mobility.As with meditation, Breathing exercises and general body exercises you will be back to normal.Also, exercises improve the metabolism and immune system which helps the healing of the body and also improve the overall feel.the aches and pains arises is due to the imbalance in the physiological system occured due to the systemic illness. with exercises most patients bounce back.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does costochondritis happen in diaphragm bones?\n\nCan costochondritis also go along the diaphram bones as well as the sternum. Have it in the entire rib cage and into my upper back. Have had this before, but how do you know if it's just the costo or GI related as well. I have had ultrasounds and all is OK.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. If your pain worsening with movements, breathing, coughing etc then possibility of costochondritis is more. And if your pain is worsening after eating hot and spicy food then possibility of GI related pain is more. In my opinion, you are mostly having costochondritis. And yes, it can affect sternum and diaphragm bone. So follow these steps for better symptomatic relief in costochondritis. 1. Avoid movements causing pain. 2. Avoid bad postures in sleep. 3. Avoid heavyweight lifting and strenuous exercise. 4. Sit with proper back and chest support. 5. Take combination of painkiller and anti inflammatory drugs. 6. Apply warm water pad on affected areas. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cold, cough and upper chest pain when coughing?\n\nHi doctor, I had a cold which turned into a cough as usual. I thought that maybe the cough would go away this time on its own but it didnt. Most of the time i have phlegm but sometimes i dont. The last 4 days my right upper chest hurts when i cough. Whats the problem?",
    "doctor_response": "Hi, thank you for posting.All your symptoms shows us that you suffer from acute bronchitis.Acute bronchitis is a complication of a viral infection(flu).The treatment of bronchitis is complex. It contains antibiotic medicines,  expectorant cough medicine, pain killer and vitamin treatment.You need the following tests to find the diagnosis.1. Pulmonary X-ray, to exclude pneumonia.2. Complete blood count.3. Urine test.4. Liver function test.5. Physical examination by your doctor.Contact your pulmonologist that will determine the treatment.I hope this information is helpful.I wish you a fast and healthy recovery.Dr. Behar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i go for a chest surgery?\n\nThis question is for an Orthopedic doctor. I was born with severe Scoliosis, because of that I also have deformation in my ribs. The front of my chest sticks out as well as the right side of my back. Due to that, my breast point in opposite direction, rather than straight. On top of that they are also small so they sit in such away that they are almost non exstistant. So I decided to get a breast augmentation. My question to you is if I should wait to get the breast augmentation until after I have a Thoracoplasty surgery and surgery on my chest or if i can get breasts first and then later go back and get Thoracoplasty and the chest surgery? Would it make a difference which one I did first? Would I potentially mess up the out come if I did one before the other? Thank you for your time and I do apologize for the long question.",
    "doctor_response": "Hello, As per my surgical experience, the priority of scoliosis surgery is most important before breast augmentation, because the results of scoliosis surgery will give you a definite answer to the question, whether you require breast augmentation or not. I hope I have answered your query. I would like to assist further at anytime. Regards, Dr. Bhagyesh V. Patel General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can seizure cause stroke and paralysis?\n\ni was so healthy and then i got on essuire then i started have problems im 35 years old and i had a stroke and im on blood thiners and others suff i was paralized on my right side is it possible that essuire have somethimg to do with it i dont want it to happend no more",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern looking to the history given here I would like say that if your are taking blood thinner medicine and you have not taken care in dose and duration then could cause leaking or oozing in cerebral region and this called cerebral hemorrhage which might be responsible for weakness of limbs, hope this information helps you, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hallucinations, over excitement, difficulty in concentrating, forgetfulness.  Habit of taking zolfresh, multiple tablets.  Recommend\n\nMy brother has been taking zolfresh 10mg on a regular basis. Sometimes 1 pill is sufficient but at other times he takes upto 5pills a day. He tried to drop the habit 2 and half months back but suffred from hallucinations, over excitement and now cannot concentrate in his study. He forgets things easily.He has started taking it again since past 3 weeks. How can i help him drop this habit? Any medications",
    "doctor_response": "Zolpidem regular intake or withdrawal can cause such symptomsYou need to find an alternative medicine or solution for the problem for which you are taking zolpidemFor getting rid of zolpidem habit regular counselling and detoxification in a deaddiction centre will help",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does general anesthesia prolong the effects of concussion?\n\nWould having general anesthesia (twice) after a concussion prolong the effects of the concussion (memory loss, concentration, focus, tracking)? And if my current diagnosis (after 17 months) is right parietal lobe damage, with cognitive issues in working memory and memory retention, ever reverse? How long should I hope for spontaneous recovery realistically?",
    "doctor_response": "Hello and welcome to \" Ask a Doctor\" service.I have read your query and here is my advice.After that time, general anesthesia does not prolong any effects of brain injury.The damage also is very unlikely to get better after that time.Hope this helps.Feel free to ask if you have further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Azoospermia curable by medicine?\n\nhi sir i m from pakistan.i got married 4 years before n im 36 years now.i have problem of azoospermia n dovtors told me for FNA but i dont want to do it.plz tell me cn i am b cured with ne medicine if yes then plz prescribe me. i shall b thankful to u.plz help me",
    "doctor_response": "azoospermia means absent sperms in your semen. It could be either due to absent sperm production or due to any obstruction in the ejaculatory duct. biopsy will tell where exactly is the problem and then only we can decide on treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Broken tooth. Had root canal. Unable to have a bridge. Is tooth implant essential?\n\nI had a root canal to my two upper back teeth but was not told about having a crown. Now my tooth has broken below the gum line and my dentist says I need a tooth implant. Can't have a bridge as the last tooth which also had the root canal is not strong enough to have the bridge attached.I have had my broken tooth temporarily repaired. Is there anyhing else that can be done to save the tooth. I'm concerned about the implant as I have heard that they can get infected and are much harder to look after that one's own teeth. I will need to see a periodontist.",
    "doctor_response": "Hi,Thanks for asking the query,As the tooth is root canal treated and bridge cannot be placed you can go for post and core, consult an Endodontist for the opinion.Placement of implant depends upon health of the surrounding structures.The cost of the treatment is also high i would suggest you to visit Periodontist get the checkup done and discuss the matter.Hope this helps out.Regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for allergic insect bite\n\ntwo days ago, when i went to lay down in bed, i felt a bad sting, and i got up and ask my husband to look at it and when he did, i had a huge knot on my right shoulder blade at the top with a hole in it, with pus and blood coming out of it. So he squeezed all that out, and put alcohol and peroxide on it for me. It burned and stinged so bad, to where i couldnt lay on that side for two days and it still hurts to touch it and lay on it. I have been experiencing pains in my heart and drowiness, coupled with diarrhea. Did i get bitten by a spider? And it also now has a black head and is still swollen.",
    "doctor_response": "Hi, Thanks for posting in HCM. I understand your concern. Experiencing pain, drowsiness and diarrhoea followed by insect bite could be due to biting by black spider. It is mainly due to allergic reaction what he is experiencing such things.Kindly take the following measures to overcome the problem he is facing: 1. Tablet. Loratidine for allergic symptoms. 2. Tablet. Ibuprofen + Paracetamol for pain, swelling and inflammation. 3. Clean the wound site twice everyday with mild antispetic solution like Savlon. The symptoms should subside in about a week time. Hope the information provided would be helpful. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a boil between buttcheeks with whitehead in a child concerning?\n\nHi, my four year old daughter Has a boil in-between her buttcheeks. She has no fever and doesn t seem to be really bothered by it . She s had one for awhile and it popped.. Then another grew. I m taking her to be seen soon. It s not very big and it has a white head on it. I just want to make sure it s not that big of a deal.",
    "doctor_response": "Hi.... by what you say, I feel that this could be a bacterial infection of the skin and subcutaneous tissues. This might require an antibiotic therapy.But....Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Regards - Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get unusual headaches and vertigo with migraine. Is CT or MRI required for further diagnosis?\n\nHello doctor, For the past eight months or so, I have had some problems with unusual headaches and sort of momentary feelings of lightheadedness, vertigo but it is like everything just shifts for a second instead of spinning. I have a background of stable migraine headache. I have had some face pressure as well and some momentary stabbing headaches. Some chronic low-grade nausea that can disappear for weeks at a time and is not usually accompanied by a headache. I went through the gamut with GP, he then referred me to an ENT, and then to a neurologist. I am still getting some headaches but have had a clear CT scan of sinuses. A full neurological exam was done and that was normal, and the neurologist did not seem to think that additional imaging (MRI) was needed because my exam was normal. Even though it was a CT scan of the sinuses, they would have seen the brain (particularly frontal lobe) and notified of any abnormalities they could see. I had a clear MRI approximately one year ago for some twitching and muscle pain. Do you agree that further examination is not warranted? In other words, with the above information is a structural problem unlikely?",
    "doctor_response": "Hello. You have been elaborate in providing your medical history and that always helps to form an opinion. Coming to your straightforward query, I really do not see any indication for a fresh brain imaging study like CT (computed tomography) or MRI (magnetic resonance imaging) in view of your transient, very short lasting symptoms and a normal MRI brain, just one year back. Instead, I would suggest here to get one electroencephalogram (EEG) done to look for abnormal electrical discharges in the brain during those episodes. EEG done during the time frame when you are frequently having those episodes will be more rewarding in terms of diagnostic importance. With a normal neurological examination and normal MRI, you should stay calm and assured that it is nothing serious. Lastly and importantly, anxiety is the commonest cause of such symptoms. Please start doing mental relaxation exercises, meditation, yoga and observe for improvement. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for motor neuron disease\n\nHi Doctor,I am Avadhesh kumar saxena from sitapur (u.p), suffering from MND Disease from last 4 years . now my present condition is very worst such as not able to move alone ,speak,eat walk, and my left part of body is getting affected more by this disease, so kindly help me out please.kindly revert me with positive response.Regards A.K. Saxena 0000",
    "doctor_response": "Hello awadesh Motor neuron disease are due to many reasons and you must have consulted a neurologist to get it confirmed and evaluated. Idiopathic motor neuron disease like amyotrophic lateral sclerosis is a progressive disease with poor outcome. Only drug approved with some benefits is riluzole. You need to be in consultation with your neurologist to guide you properly at different stages of your disease. God bless you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to get pregnant while having thyroid problem?\n\nsir 1st report is +ve ani vachindi nenu treatment em tisukoledu 2nd time -ve ani vachindi symptoms are hair loss and irregular periods  if i got thyroid.in future iim getting pragnancy on not getting. my hight is 5.4 and weight is 58. how to weight loss",
    "doctor_response": "Hi, you can conceive even with a thyroid problem  . Take your medicines regularly.  Be in contact with your husband every 2 to 3 days after your periods stop. Maintain a healthy diet with lots of fruits and vegetables. Try some exercises and yoga. Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this lab report of spine indicate?\n\nHi! What does T12-L1 broad based annular bulge that leads to mild impression on the intrathecal sac mean? And syrinx at T9-T10, T4-T5, C6-C7 levels? And mild diffuse disc bulges at T12-L1 and C6-C7? And thoracic dextroscoliosis? and levoscoliosis? And disc space is narrowing at T12-L1? And T12-L1 central focal disc protrusion effaces the ventral thecal sac? And concentric annular bulge and facet hypertrophy present at L3-L4, L4-L5,L5-S1? Also what is the treatment and how serious is all of this?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. Levo and dextroscoliosis ( left and right abnormal bending of vertebral column) together with disc space narrowing, bulge, and fascet hypertrophy means there is degenative disc and joint disease of vertebral column.Syrinx means abnormal fluid cavity of spine and is created usually by the closure/ narrowing of cerebrospinal fluid circulation. Treatment is guided by a careful symptoms evaluation and neurological examination in correlation with MRI findings.In this case I think there's need for surgery.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does hemangiomas gallbladder and common bile duct means?\n\nI have had Right Upper Quadrant pain for the last week.. I have a sudden change in my stools becoming black and mucous consistency. went to the ED yesterday and after an ultrasound was told I did not have gallstones but did have some noted hemangiomas in my gall bladder and common bile duct. Do feel better today after much pain last 10 days. What does this all mean?",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can. I am not sure if you meant on hemangiomas in gallbladder or liver but these are probably hemangiomas in liver and this is benign condition and this should not cause your difficulties unless there are really big hemangiomas. Galbladder issues may lead to such pain even if there is no stones so cholecystectomy should be considered as well.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.DR. Ivan Rommstein",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does itchy anal area suggest a hemorrhoid?\n\nHello. I'm only 13 and my anal area is irritated, more of itching than anything. I'm not bleeding and there is only one spot that burns, but that's only if i touch it. Should i just leave the area be, and wait for it to go away? Is it even a hemorrhoid? Sorry for the bother. Thank you in advance.",
    "doctor_response": "I do not think you have any cause to worry. If you are 13 and you are just experiencing itchiness in your anal area, it does not suggest a hemorrhoid. It must probably be caused by a small wound produced by hard stools passing through the anus. It could also be due to pin worm infestation. The worms can cause itchy anal area. If you see worms you need treatment for that. If not just try to eat vegetarian diet and stool softners for a week and see if it is relieved. You may also apply an antiinflammatory or antibiotic cream to the area. Please try that and consult again if you need more help. Take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain. Moved heavy things. Is it serious?\n\nHello, I ve been moving and have been helping my father with heavy stuff such as a cal king bed + mattress, a China cabinet really heavy, antique dining table and many boxes full of plates, cups, etc. I m 4 11 weight 132 .. not too much body strength. Now I have a sharp pain on my left side on my abdomen is this serious. What can I do?",
    "doctor_response": "Hai, Thanks for writing in, Seems you are suffering from spasm of abdominal muscles due to heavy work load. Nothing to worry as rest and few medications will improve the condition. You are advised not to strain or do any stressful activities like lifting things or bending your back etc., A course of muscle relaxant along with pain killers will help you a lot. Hot packs at the painful site will reduce your pain too. Rest and relaxation to spastic muscles is very important. Discuss with your doctor and get clinically examined if the pain progresses or associated with any other symptoms like vomiting, nausea etc., Get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome high anxiety?\n\nHello doctor, I was a cocaine addict for almost a year, I have been sober for 2 months now, I am suffering from lack of motivation, tiredness and fatigue, I also have a hard time being around people because of suspiciousness and high anxiety. There are some thoughts of paranoia about the world also. I feel my mind is constantly talking and worrying and this is when I have bad headaches and tiredness. I have seen a psychiatrist and he prescribed me many medications but has not worked, I also received psychotherapy, I am exercising 1-2 hours a day in group exercise classes which helps, all of my symptoms I noticed are slightly getting better as days go by since I have been sober. Any advice can you give me will be appreciated",
    "doctor_response": "!What you have currently is very usual presentation after quitting cocaine. I prefer to prescribe Venlafaxine 37.5 to 150 mg to such patients( at night). With that you may need an antipsychotic like- olnazapine for some weeks ( to help in paranoia). I'm sure that this will help you out. The constant use of drugs, when stopped- lead to decline in various chemicals in brain and cause anxiety and depression. it takes time and lot of hard work to come out if it. you are very right in doing workouts daily, it is very very helpful. Also, take more of nuts, salads and veggies in your diet, take lots of water in form of sips every few minutes. This will hydrate your body  and support neurons in getting better. Worst and toughest part was quitting substance which you have achieved, now with each passing day you will get better. Hope this helps youWish you good health!Dr.  Manisha GopalMD Psychiatry",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have unsuccessful IUI. Advised for IVF. Missed periods. On orgamed. Started mild fever and body ache. Concerned\n\nI ve been under treatment for infertility related problem. I ve had IUI twice. But unsuccessful. My doctor has advised me for IVF . I m preparing for that too. But in the mean while I missed my period last month. Urine test suggest Negative. So, I m presently going through the course of Orgamed for the last 8 days. 2 doses are remaining, as per my physicians prescriptions. But from yesterday late evening I m experiencing a mild fever but huge body aches specially in my lower body. Please suggest which drug should I take to control this ache which is unbearable. I ve already taken paracetamol but almost no effect.",
    "doctor_response": "Hello. Thanks for writing to us. Since your periods are overdue and pregnancy test is negative, you need to have hormonal treatment for withdrawal bleeding. The symptoms you are having are likely to be pre menstrual symptoms and these will subside once the periods start. Meanwhile you can take mild pain killer like ibuprofen every 6t hourly. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pressure and pain in testicles?\n\nsir, for 1.5 years, i had to travel on byke more than 200 kms per day, my testicals got too much pressure, besides, my pents were too tight so both testicals remained under pressure, so i m suffering from pain in testicals while under pressure. When i put on loongi, without under garment, at that time testicals do not suffer, DOLO 650 were given by experts, but nothing worked under pressure, so guide me.",
    "doctor_response": "Hi, If you are providing too much compression, it can restrict blood flow to your groin, which could also lead to testicle pain. It's about getting the balance right. Also the spermatic cord could get twisted with tight pants and pressure. It can also leads to pain in testis. I suggest you to take rest between rides and avoid putting on tight clothes. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sameen Bin Naeem, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sensitivity of mankind pregnancy\n\nWhat is the sensitivity of mankind prega news home pregnancy test in MIU ?",
    "doctor_response": "Hi,thanks for query.All the test kit available in market today are sensitive and produce reliable results.When kit is not stored properly or packing is damaged the sensitivity is decreased.This kits are good and in most of the cases can pick up pregnancy as early as one day of missed period. wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can blushing while getting too much attention be due to mental illness?\n\nHello doctor, I am 18 years old and I have been having big problems with making friends since I was 7. I go to school and I do not talk at all (only if someone or teacher asks me something). I just cannot find any topics to talk to people and the worst is that I do not know what should I say back when I somehow succeed in starting the conversation. Besides all my life I feel like I am the one that jumps around people and tries to talk to them and they just do not care so I quickly give up and end up alone. And my house is so stressful too, it is so loud because my parents scream so much and I spend most of the time locked in my room because when I hear them screaming it feels so stressful (all this stress is like sitting on my back and I cannot make it stop). Is it even possible for me to make friends? It has been half a year since school started and everyone is occupied by their friends. How can I stop blushing when I am given too much attention? Is it possible that I have some kind of mental illness or maybe autism?",
    "doctor_response": "Hello. First of all, this is not a serious mental issue. Just remain relaxed. You have social anxiety most likely and this anxiety is resulting in symptoms like blushing when you are getting attention, difficulty in making friends, etc. This is social anxiety and a lot of individuals of your age develop. So do not think that you have any abnormality. Just continue to make your efforts to make friends and you will gain confidence with time. No need to get worried.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is rabies a contagious disease?\n\nHello doctor, I was bitten by a dog 13 days ago. I took anti-rabies vaccine after 25 hours of the bite. I have taken three vaccines until now. I had oral sex with my wife and by mistake, I bit her at neck two days ago. Should she also receive the anti-rabies vaccine? The dog is still alive.",
    "doctor_response": "Hello. Contact with someone who is receiving rabies vaccination does not constitute rabies exposure and does not require post-exposure prophylaxis. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe abdominal pain\n\nI noticed it last night. When I went to sit down or I put pressure on my abdomen it really hurt. And tonight, my stomach hurts whenever I stand up like whatever is inside is being stretched out. My past medical.... My pancreas was inflamed. (Actually it could have been my appendix) I'm not sure. But I can't suck my belly in, it hurts too much. Am I dying lol?",
    "doctor_response": "Hello! Thanks for putting your query in HCM. I am a Gastroenterologist (DM). It may be acid peptic disease or recurrence of pancreatitis. So I will advise you to visit a Gastroenterologist who will evaluated you and treat accordingly. Meanwhile for pain you may take a proton pump inhibitor and an analgesic containing tramadol and acetoaminophen.I hope I have answered your query and this will help you. If you have any further query  I will be happy to answer that too. Remain in touch and get-well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for psoriasis on leg and palm\n\nI wanted to mention that I had a small spot of psoriasis on my right foot, on the top, near the start of the leg. I broke my ankle nearly 7 years ago and was casted. When the cast was removed only 2 weeks later, my psoriasis was completely gone and has never come back. I wish I could figure this out as I also have psoriasis in both palms, more so on the right hand. I've thought of having my right hand and wrist casted, without breaking a bone, to see if it would cure the psoriasis there too. I am hoping that you can see if this happened to anyone else, or if this could help others.",
    "doctor_response": "Hi,As you said, you suffer from psoriasis. It is a chronic and relapsing skin disease. I can understand your anxiety for your disease. But,you have to keep patience. You might get relief slowly. And due to some factors it might relapse...Remember it is a controllable disease. And there is no perfect treatment in ayurvedic or homeopathy.You consult nearby dermatologist for firm diagnosis and perfect treatment.I would like to suggest few things as follow....- acitretin 25 mg daily- methotraxate 15 mg weekly in three devided doses of 5 mg 12 hourly.- Blood tests ..routine & LFT may be done at regular intervals- Steroid with salicylic acid oint may be applied twice a day on the psoriatic lesions...on trunk and extremities- But, please avoid the use of betnovate on psoriatic lesions on foreskin and soft tissue areas..as it is a moderately strong steroid. You may apply mild steroid cream like mometasone.- Soap bath should be avoided.- All precautions may be taken to avoid dryness of skin. Winter might worsen due to dry weather. So, take care.And please do not think of plastering the affected part, it is of no help. You had benefit in past by plastering..but there is no scientific reason.After few months treatment..you may be alright. But, maintenance therapy may be continued. And if there is relapse, you may restart the treatment.Have patience...Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a pain in the chests and numbness feeling that resists talking?\n\nI'm a male of what has been excellent health my entire life, now turning the corner to 33 years of age. I have been a smoker (pack a day) for 18 years as well. I have had a few instances lately in which I have felt unbearable pain in my chests center and it lasts for well over a minute usually. I do not experience any numbness but it incapacitates me to where I cannot talk and have some issues breathing correctly. After a few minutes things seem to clear up and I can resume daily tasks pretty much normally. Are there any phenomenons outside of heart attack that could be occuring?",
    "doctor_response": "With the history given it could be acid reflux or could also be related to smoking which might have affected your lungs. Hence it would be advisable to consult a doctor as it could be a symptom of a COPD as well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pain in lower back?\n\nI fell slid down a fire pole and landed hard on the back of my feet. When I landed I felt the brunt of my fall on the base of my neck. It has been a day and now my lower back is sore and the base of my neck hurts and is tender to the touch. What should I do?",
    "doctor_response": "Hi i am Dr Ahmed Aly    thanks for using healthcaremagic site ,I had gone through your question and understand your concerns ..  For my patients i recommend icing it for the first 48 hrs , massaging with topical gels , painkillers like advil , muscle relaxants , bed rest avoid vigorous neck movements will be effective for you if no progress i suggest Xrays , CT , MRI to exclude minor fissures or fractures and proper evaluation .Please click THANK YOU and consider a 5 star rating with some positive feedback if the information was helpful. Hope the above information helps you,Any further clarifications feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the causes and cure for Hepatitis C ?\n\nHi, I am very happy to see in internet i am very upset because i am severing in (haptic ''C'' last 4 year so tell me about me Thanks Khalid Yousuf YYYY@YYYY  I am a very poor man i have treatment in Hospital (SUIT) In Karachi Pakistan",
    "doctor_response": "Salaam and hiThanks for posting query at HCMHepatitis C is caused by Hepatitis C virus (HCV).Hep C infection is treatable with oral drugs and/or injections.Follow treating physician and follow up accordingly.wish you good healthRegardsDr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause bleeding to grow onto what ever touching it?\n\nWhenever I bleed, like a cut on the leg, anything that touches the place thats bleeding, like long pants, blankets, etc, the blood will sort of \"grow onto\" whatevers touching it, when i seperate them it feels like pulling of a scab and can be painful, Im just wondering if this is normal",
    "doctor_response": "Hi,Thank you for your query. I can understand your concerns.It seems that you are suffering from mild variants of Bleeding disorders.  You need to undergo FBC (Full blood count), peripheral blood smear examination, platelet count, Bleeding time,Whole blood clotting time and a coagulation screen Activated partial thromboplastin time (APTT)Prothrombin time (PT)These initial tests can be done in any good primary laboratory. If coagulation screen is abnormal pointing towards coagulation disorder you may have to undergo in special hematology laboratory-Specific factor assays - factors VIII or IX ; factor VIII and vWF in vWD.if  these tests are all normal,then -tests for deficiencies of clotting factors other than FVIII, FIX, and FXI ,which are rare Bleeding Disorders but can cause relatively minor problems as you have mentioned,though often remains asymptomatic.Regards Dr. T.K. Biswas M.D.Mumbai",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there chances of pregnancy if the condom breaks during sex ?\n\nI have a 30 day cycle. We had a protected sex on Jun 11 evening. But the condom tore.. :( My periods are due on 18 Jun. Are there any chances of Pregency. I am getting paranoid and strange feeling.",
    "doctor_response": "hi welcome to health care magic.see there are less chance of pregnancy but it knows only if you will miss your periods.till that time wait and watch. thanks dr.dhara dhara.shah84@yahoo.in",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in right upper back along with headache\n\nGood morning in the middle of this year i seen a chiropractor who found that i had stage one scoliosis but i never went back for treatment because of the cost. Now my right upper back is cracking and im experiencing headaches and lightheaded moments. Not sure whats wrong",
    "doctor_response": "upper back pain and headache. both r different pathology. if you r doing investigation MRI CERVICAL SPINE and diagnosed the pathology according to your complaining.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for having abscess in liver\n\nhi my father is affected by some 10 cm size of abscess in liver, we have taken blood test, CT scan, 3 times biopsy but still no dr says whether it is a tumor or any other kind of adscess. Drs suggest for PET scan. He is suffering more main he cant take food cant sleep. Please suggest how to proceed further and also guide what to do next. I am from a lower middle class family . I almost spend 50k for this so far",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.Surgical resection of liver is the best and the only permanent solution for this type of the disease so this is my advice. No matter if this is abscess or tumor, the therapy is surgical.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.DR. Ivan Rommstein",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for UTI\n\nI have hep c and will see a specialist next month to begin treatment. I have a UTI & took cipro which caused me to have a rash. I was then given ceftin, pyridium & phenergen with no relief. My back hurts just under my shoulder *very badly! Should I go back to the dr?",
    "doctor_response": "Hello,Welcome to HCM,I have gone through your query.For conforming urinary infection you should do a urine routine test first.If puss cells are more there is sign of infection and can start on antibiotic empirically.I usually give Norfloxacin initially for my patients and then send for culture and sensitivity test and change antibiotic if necessary.You should take antibiotic for the proper course duration.I also recommend them to take barley water or cranberry juice to alkalanize urine.You should treat this as soon as possible because it can affect even kidneys if left untreated.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this follicular study report indicate?\n\nHi my follicle size is 18 mm on 8th day  and endometrium is 6mm itself so pls suggest should we have intercourse today......and my doct says its not a gud cycle..and follicle grow is fast.and sugests to go for iui if endometrium improves....pls sugest",
    "doctor_response": "Yes in your report follicle is with good size but the problem is with endometrium size. You need at least 12 to 14 mm, so it's not possible to implant in this endometrium size.If this type of patients come to me I suggest him to do uttarbasti treatment of Ayurveda before also IUI treatment. Some times patient not need to IUI treatment also they can get conceive naturally. I would suggest him in this stage to take Sida cordifolia powder 5 mg with milk two times before food. Since this is prescription base medicine,so you should consult Ayurveda specialist doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "After angioplasty how long should I be in medication?\n\nSir, I underwent angioplasty on 09th july 2012. Since then i have been taking nikoran 5mg, asprin 75mg, clopidol 75 mg and metoprolotartrate 25 mg per day.   2 d echo test and lipid tests were taken after one  month of angioplasty gave normal results and I do not have B.P. and sugar.  I have been walking for 2 hours per day after 1 month of angioplasty.  Please advise How long i should be on medication?",
    "doctor_response": "hello,I have gone through your question.Thanks for using HCM.Once you have undergone angioplasty with stenting you have to continue aspirin for life time.continuation and  duration of clopidogrel depends on type of stent which has been deployed in your case.If you have drug eluting stent then you may have to continue clopidogrel life long,but recent drug eluting stents may need clopidorel for shorter period.Your cardiologist would definitely guide you for that.If you are hypertensive  Or if you had Prior Heart attack,then you must continue metoprolol life long.additionally you must take atorvastatin 10mg for rest of your life to prevent new blocks at other sites in your arteries.Nikoran may be stopped after 3 to 6 months if you Don't have major blocks in other vessels.My best wishesDr.Rajesh Teli,MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is Mometasone dangerous to use on Face to clear my acne pimples?\n\nHello doctor, I am seriously facing acne pimples problem. Sometimes they occur on my face when I masturbate. If I use Mometasone, it gives a good result. Is it okay to continue this?",
    "doctor_response": "Hello. Acne is a universal issue in the age group of 15 to 25 years due to hormonal changes in adolescents. However, there are multiple effective treatment options depending on the grade and severity of the problem. Mometasone is a topical steroid and is to be avoided strictly on the face and for acne as it can harm your skin in the long run. Acne is dependent on hormones hence excess masturbation may sometimes lead to an increase in the problem. I would advise you to stop Mometasone immediately and kindly upload appropriate images to help us assess your current grade of acne and treat you better. Regards. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could extreme pain in tailbone mean recurred tumor in rectum?\n\nHello Doctor, My tailbone has been killing me for the past few months. The pain is a heavy - pressure kind of pain. My MD had X-rays taken, this showed nothing. I saw him the other day and told him I still have this pain. He said he is not sure what else he can do for me other than use a donut when sitting. I sit at home on a nice soft leather recliner, my tailbone still kills me. I end up leaning on my side when I sit, but when I get up, the pressure/pain is terrible. I notice the pain/pressure even when I walk. Hurts when I sleep, especially turning over. I do want to mention that I had a colon resection back in 2005. I had a tumor in my rectum. The surgeon could feel my tumor, that is how low it was. I am worried I may have another tumor. PLease give me some advise what I need to do. THANK YOU FOR YOUR TIME!",
    "doctor_response": "Hello! I read your question and understand your concern. In my opinion the pain you have may be related to a sacral bone problem. I would like to know if you have fever or problems with the  stools . these problems may be caused by a tumor infiltratin the sacral and coccigeal bones, by an infection of this region like an abscess or osteomyelitis, or by irritated nerves of the region from radiotherapy. Your past medical history is very concerning. You didn't mention radio or chemotherapy . So I would recommend a good physical by your GP, a full blood work for infection and a CT scan or MRI of the pelvic region to exclude these causes.Hope to have been helpful!Best wishes Dr. Abaz Quka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are diarrhea dry mouth & fatigue common post lymphoma?\n\ni had hodgkins lymphoma the cancer is in remission the after afects are numerous d.v.t. scarred lung.diahrea,dry mouth,loss of teeth,loss of sex drive,fatigue,diabetes,chemo and radiation was used on neck and throat and chest was stage 2a cancer had a report sent by endoctronologist that was sent to w.s.i.b.that did not support after effects that were instant or progressive ,went for 2nd.opinion and code of ethics for fellow phys.is not helping me.have lots of medical evidence that say these symptoms are common.your opinion please",
    "doctor_response": "HiDiarrhea and fatigue is common post lymphoma treatment.I would advise you to take protein shakes and eat plenty of fibres like green leafy vegetables in your diet.RegardsDr dr",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes premature ejaculation with weakness and constipation?\n\nSIR I AM SUFFERING FROM DHAT ROG AND PREMATURE EJACULATION WHICH IS CAUSED BY OVERMASTURBATION FROM YOUNG AGE MY AGE IS 26 YEAR. I FEEL PHYSICAL AS WELL AS MENTAL WEAKNES AND CONSTIPATION PLEASE SUGEST ME MEDICINES, THANKS                           EMAIL-ID  YYYY@YYYY",
    "doctor_response": "Thanks for writing.I understand your concern about Dhat and premature ejaculation. I understand that you believe these are due to masturbation.Dhat (mucus like fluid that comes during stool passing or voiding urine) is a fluid of sex organs and tiny glands in the way of urine tube come out from penis. This is not semen. The smell of the fluid and consistency may be like semen.Physical, mental weakness and premature ejaculations are secondary to anxiety of your perceived semen loss.When patients with similar problem comes to my clinic, I suggest them Capsule Fluoxetine 20 mg to be taken daily in the morning after breakfast and Clonazepam 0.5 mg to be taken at bedtime. These medicines should be taken under medical supervision. There are some behavior modification techniques proven to be useful for premature ejaculation.1. Stop-start technique of behavior therapy.2. Female on top with active role.3. Double condom5. Pelvic muscle strengthening exercise. (As if try to hold urine intermittently during voiding)6. Penile squeeze technique applied at the point of ejaculatory inevitability.7. Applying a local anesthetic ointment to glans penis prior to penetration. I recommend you to consult psychiatrist, who will guide you how to utilize all these techniques effectively best suited for you. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do the symptoms of fatigue with high Type 2 Diabetes, Hypertension and Neuropathy indicate?\n\nWhat would you call these symptoms?  I fall a lot and have weakness and shake when I try to get up from sitting down.  I have type 2 diabetes with high blood pressure and neuropathy in my legs and hands.  I also have sleep apnea and a horse shoe shaped kidney the right side is smaller so the doctor put a stint in that side the needs replacing every 3 months.",
    "doctor_response": "Hello and Welcome to 'Ask a Doctor'I have reviewed your query regarding your symptoms and the question of what do they indicate.The symptoms you describe are typical of the ravages uncontrolled high blood sugar and blood pressure have on your body, nerves, autonomic nervous system and other organs. The kidneys are not receiving adequate blood flow, the neuropathy will affect balance, coordination and tremors and any excess weight typically associated with type 2 diabetes will worsen sleep apnea.My advice to you is to get your blood sugar under control through a carbohydrate/calorie controlled diet with an emphasis on water soluble fibers and low glycemic load carbohydrates. You may wish to speak to a Registered Dietitian about setting up a diet plan for you.In addition, the hypertension can be helped with a sodium diet with added potassium if medications do not contraindicate. Some blood pressure medications require potassium monitoring. A dietitian can also assist you with these changes.Good blood sugar and hypertension control will assist you in regaining balance and coordination while slowing down any nerve damage that may be occurring.I hope I have answered your query.Warmly,Kathy J. Shattler, BS, MS, RDN",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for neck pain after falling\n\nHOCKEY MISHAP..FEET WENT FORWARD..LANDED FLAT ON MY BACK BUT PREVENTED MY HEAD FROM HITTING ICE. IMMEDIATELY FELT NECK PAIN. 4 YEARS LATER STILL PAIN IN NECK, MRI REVEALS 6TH VERTABRA PINCHING. TRIED CHIROPRACTOR (LASER THERAPY), MASSAGE THERAPY, ACUPUNCTURE,  AND STILL NO RELIEF. SHOULD I CONSIDER INJECTIONS TO MANAGE PAIN? CHRIS",
    "doctor_response": "hithanks for using hcmpinching or compression of the cevical  vertebral region ,these are all recurrent chronic problemschange of life style is very importantplease use a soft cervical collar ,to immobilise or avoid excessive movement of the joint,which progresses the injury.relaxation physiotherapy exercises will helpyou can try with preparations pregablin or gabapentin added with metylcobal amine on daily basis.these are safe on the kidneys for long term therapy alsotake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the lower back radiating to the legs and arms?\n\nHello I don t understand why I feel like I do I know I have scardosos, I have had 5 neck surgeries over the years, and now I have problems with my lower back pain, which is now going down my legs my arms and hands are weak, I have trouble catching my breath lime today we went and picked strawberries I felt dizzy like I was going to pass out or vomit what is wrong with me",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!You should know that weakness of your hands is not related to the lumbar spine. In fact it can be explained by cervical spine degenerations or spinal canal stenosis in this levels. Other possible causes to consider would be polyneuropathy, especially considering the fact that this is a common complication of sarcoidosis. Coming to this point, I would recommend performing a cervical spine MRI study and a nerve conduction study for polyneuropathy. You should consult with a neurologist and discuss about these issues. Hope you will find this answer helpful!Wishing all the best, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe back pain while breathing?\n\ni had an injury 8 weeks ago, a bale of hay fell on my head, and i went to the hospital they did xrays and said nothing was broken.... i ve been back to my dr. 2x she said i have torn all my muscles and liagaments in my upper back and my back is still very sore, and when i breathe deeply it hurts...",
    "doctor_response": "Hello Thanks for writing to us; I have studied your case with diligence.Due to fall there can be injury to rib or spine.I will advise you MRI and CT scan to confirm diagnosis.Watch out for breathless ness, dizziness, sweating.Avoid sudden movement, take rest, use rib supportive belt.Medication like muscle relaxant and analgesic will reduce pain along with it use rib support belt.You may consult physiotherapist for pain management. He may start TENS, or ultrasound which is helpful in your case.You may need to take rest for early healing.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you find this answer helpful do not forget to give rating at end of discussion.Wishing you good health.Take careRegards Dr Vaibhav",
    "dialogue_context": ""
  },
  {
    "patient_message": "History of back surgery. Have painful lump on back. Reason?\n\nI had two back surgeries almost 3 yrs ago.......the second was a fusion of my upper spine , as of about 6 months ago, I have started to have a lump pop out on the left side of my fusion very large, pain radiating down my hip and does not go away - it is beginning to occur more frequently and not sure as to why....... Shaun",
    "doctor_response": "Hello. Thanks for writing to us. The appearance of a lump on the right side of the fusion surgery is a worrisome finding. You need to get the lump directly examined to find out the cause of the lump. A CT scan will help in a better diagnosis and treatment. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump on the breast indicate?\n\nI found a lump on my breast 3 months ago and thought nothing of it. Three weeks ago I noticed several changes. There was a change in size of the lump & the breast, the nipple is flattened and slightly inverted, there is dimpling on the lower breast, hardening around the nipple, dull pain in the breast and under the correlating arm, and a blistery rash between the breasts. I went to my physician and an MRI and mammogram were referred. They are scheduled for next week. This seems like a long wait especially when a biopsy may be required after screening. That could take another week or two. Is this normal?",
    "doctor_response": "Hi Thanks for your query. Noted the history and understood the concerns. This is surely not normal. A lump in the breast with inverted nipple, hardness and all the changes are surely indicative of a cancer of the breast unless proved otherwise.When there is a wait the best way to get a referral for cancer surgeon and get at least FNAC of the lump so that you can get appropriate diagnosis and a plan of management. MRI and other investigations are to get a stage of the disease and thus changes plan according to the diagnosis thus made.If this turns out to be a benign lump still it is better to get an excision biopsy for two reasons:You get rid of the problems, lump is out and thus the disease is out.You get the confirmed diagnosis.Take Care Regards Dr. T Chandrakant, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment do you suggest for hypo-echoic liver , mild fatter infiltration of pancreas ?\n\ncomplete loss of apatite , cannot eat , constant pain in epi-gastric , umbilical region and right illiac, pain increase with intake of food .  Stool formation is loose and sticky .Ultrasound report says , hypo-echoic liver , mild fatter infiltration of pancreas .blood report states no band stabs , neutrophill 50 , eosinophill 10total bilrubin > 1.60conjugated > 0.5indurect > 1.2sgpt > 25.0sgot > 32.0stool test > bacteria 4+ motile bacillus",
    "doctor_response": "Hi and welcome to HCM.The main treatment is changing dietary and lifestyle habits. It includes eating less fatty and unhealthy food, avoid alcohol,smoking and certain drugs. Second line of therapy is medical but the most important is to regulate body weight and diet and regulat blood lipids and sugar. This is still reversible liver condition but it can progress to liver cirhhosis which is serious disease.Thanks for the query. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is one vein in my breast sometime hard and sometimes soft?\n\nThank you, I am 78 yrs. old, Some time ago I had a bad fall hitting my breast on concrete.  Checked for broken ribs, but could not tell before 6 months.  I never went back.  much later I saw a vein.  sometimes it feels hard, sometimes it feels soft.  I feel changes all the time.  I never went to a doctor.  Could there be other problems besides cancer in the breast?",
    "doctor_response": "It can be a traumatic fat necrosis which can present as a lump after trauma. Kindly do a best self examination to look for any other hard nodules or lymph nodes in the axilla.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cure for swelling of Parotid gland and papilla hard and swollen?\n\nHi , I am 43, male, non-smoker. I have unilateral left sided swelling of the parotid gland of 6 days duration. The papilla are oedematous hard and swollen. No purulent discharge is present. The papilla have been mildly enlarged for one year when I had a painful attack while on vacation. my left cheek is swollen as well. I have had no fever.",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have infection of the Parotid gland.(Parotiditis).Considering the long duration you need to consult qualified General Surgeon for clinical examination and get following basic tests done to rule out presence of stone in the Parotid duct. 1) Plain  X -Ray of the face 2) Sialography of the Parotid gland.In the mean while You need to take broad spectrum antibiotic like Cefexine along with anti inflammatory drug like Diclofenac twice daily.Ensure to have ave mouth wash twice daily with microbial lotion like Betadine or Chlorhexidine twice daily.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is left sided facial and hand swelling related to elevated level of liver and pancreatic enzymes?\n\nhello, I had an ERCP done about 3 weeks ago... liver enzymes where in the 1000s... I am 27 years... I then got pancreatitis lipase was in the 1000's also, i had a pancrease stent put in and it made my levels drop down... and I am still having diarreha and pain, I also woke up last night with left side facial and hand swelling... could this be related??",
    "doctor_response": "Hi thanks for asking question.If you have chronic or very severe liver disease then liver is affected and it is unable to function properly.Liver cannot produce albumin which is necessary to maintain oncotic pressure in blood.So defective albumin production lead to decreased oncotic pressure and patient suffer edema.The effective blood volume decreased in cirrhosis , so compensatory increased ADH also lead to sodium and water retention to produce edema.In systemic vein pressure also increased.If edema increasing with ascites diuretic can be given.For pancreatitis symptomatic management done.Rest your Gastrointestinal tract with not taking solid food for few days.So yes this swelling can be because of liver problem.I hope i have solve your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mycosis fungoides\n\nHi my mum is suffering from mycosis fungoides and has been receiving various treatments including the latest light therapy treatment which she has been having twice a week for one 1min per session - it has burnt her legs so badly that she had to go to the hospital today due to severe pain - is there any other solution for her?",
    "doctor_response": "Hi, The treatment of mycosis fungoides is light therapy, radiation, chemotherapy, corticosteroids to name a few. Depending upon the severity your doctor will decide the treatment. In case of severe pain in the treated area, I suggest you visit the doctor for a thorough review and further treatment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Smruti Pevekar, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fluid leaking from leg/knee after knee replacement surgery\n\nmother in law had knee replacement surgery. She has had problems with swelling in the leg/knee area. She was dismissed from hospital today and now has clear fluid leaking from her forearm. Is this related to the swelling and the body trying to release all of the built up fluid? She is on 2 diuretics.",
    "doctor_response": "Hello, As she has undergone knee replacement surgery, post-discharge there needs to be measured taken for having medicine which is described to avoid infection and pain. Due to infection, there may be chances of having fluid discharge and antibiotics are advised. Diuretics may have been given to avoid swelling and that is common. If her vitals are stable then there is nothing to worry. You can start the simple exercises like knee range of motion exercises, static Quadriceps, static hamstring, ankle toe movements, straight leg raise to help muscle activate and regain the muscle property. Post the removal of the stitches exercise which is focused on strengthening the muscles will be good. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for adult ADD\n\nI have recently been informed that I might have Adult ADD by my peers. I didn t really think about it too much, except I think they might be right. I am unorganized, often unable to concentrate for long periods of time, unable to listen to long conversations, and low on self esteem. Im not sure I am hyperactive, but I definitely feel I have ADD through the symptoms subscribed to me. What steps would I need to take to find out if I can get medical help for this supposed ailment?",
    "doctor_response": "DearWe understand your concerns.I went through your details. I suggest you to keep calm. Please do not trust your friends' guidance in this regard. From the symptoms given, ADD is a long shot. Low concentration level could be due to loss of interest and confusion. People are normally unorgnized when there is no real compulsion. Low self esteem could be due to loss of interest level and disappointment. Introspect yourself about disappointments that happened in the recent past. If you want to have correct diagnosis please undergo a psychological test for ADHD. No self diagnosis and worries. Ignore for now.In case if you need more of my services in this regard, please post a direct query. I am happy to reply you.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent vomiting in a 15 month old?\n\nMy 15 month old baby is has vomited once every day for the last three days. There is no fever cold or cough, she seems happy otherwise, but has hardly eaten anything or had much to drink. The times she has actually had a little to eat the last couple of days, she has thrown up within 45 min.",
    "doctor_response": "Hi,Vomiting once a day without fever, cough or diarrhea has very little significance. I think there is nothing serious. Please make sure hygienic conditions are clean and after every feed or meal, your baby doesn't lay down on the bed. Let him burp properly. If at any time you feel he is running fever or having diarrhea, than you see a doctor for consultation. Wishing your kid a healthy life. Hope I have answered your query. Let me know if I can assist you further. Best regards,Dr Zeeshan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes liver enzymes to increase suddenly?\n\ni am a resident of internal medicine,  we have  patient 67yrs old, known DM with complications  admitted  with SBP  his asitic  tap was  haemorragic but liver enzymes initially  were  normal, later  raised  , hepa viral screening  negaitive, tumour markers  are  negagtive,cultures negative,AFB  negative..he is on dialysis  almost  every other  day... on USG abd and pelvis  no  mass? what  could  be  the  cause  of  diagnosis ?  what else  we can do  for  him?",
    "doctor_response": "Hi, How are you? My name is Dr Suresh Raghavaiah. I am a liver transplant surgeon and I hope to help you out today.I am sorry to hear about all the issues your patient is having and Let me congratulate you on your interest  in helping her.One piece of information you left out is the patients BMI. Going by the clues, your patient seems to be suffering from Fatty liver disease and its complications (I say this because of the DM, which a common complication of obesity , which in turn also causes NASH). NASH is one of the leading causes of non-infectious liver failure in the current age. The sudden \"decompensation\" is obviously due to the SBP. And the dialysis could be due to hepato-renal syndrome. If you haven't already done so, Please do get a \"fibroscan\" of the liver to rule out cirrhosis, and an endoscopy to r/o varices. Your patient might also need be worked up for a transplant if his condition does not improve.Hope this helps and hope your patient gets to feel better.Have a great day and please do not hesitate to write back for further clarifications.Dr Suresh Raghavaiah",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do stomach cramps and severe abdominal pain indicate?\n\nYesterday at 4pm i started having severe stomach cramps and pain in my upper abdomen. It comes on suddenly and its very painful. If I eat or drink it immediately gets worse and if I bend over it gets worse. It kept me up all night and is still bothering me",
    "doctor_response": "Hello. This is Dr. Herisa Palla. I read your concern very carefully. The way you describe the location of the pain and the way it comes very suddenly it suggests toward a stomach origin of pain. It may refer to gastritis which is the inflammation or irritation of the lining of the stomach. The other probable diagnose  could be Gastroesophageal reflux disease (GERD) which is a condition in which the stomach contents (food or liquid) leak backwards from the stomach into the esophagus (the tube from the mouth to the stomach). This action can irritate the esophagus, causing heartburn and other symptoms.I would suggest you should avoid hot and spicy foods, alcohol too.You can take antiacids such as Ranitidine or Omeprasole in order to reduce the pain. But I also recommend an upper endoscopy in order to check the condition of the stomach, esophagus and to discover the origin of the pain.Feel free to ask for anything unclear to you.Best regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is non-hodgkins B-cell mediastinal lymphoma?\n\nMy husband is 57 years old, 179 kg., 6 5 who has had pneumonia over the past 4 or 5 winters. He was diagnosed with non-Hodgkins B-cell mediastinal lymphoma. The tumor begins at the base of his diaphragm and extended into his neck, compressing on his neck in several places causing him to feel as if he were being strangled. He also has SVC syndrome with the SVC being 95% occluded. His left arm and chest were greatly swollen with swelling in both legs as well, but less severe than in his left chest and arm. He was given one round of chemo using the R-CHOP, but in less than 48 hours he started feeling a tightness and pain in his left chest. He was given pain medicine and a CT was done. Cardiologist, Pulmonologist, and Radiologist were consulted. Multiple PEs were found in the lungs and a DVT was found near his left ankle. Previous testing before R-CHOP showed heart to have no problems. After chemo, PEs, and DVT, testing showed right side of his heart was enlarged due to PEs, entire body, including face swelled tremendously -- his face was unrecognizable for several days. Doctor started heparin for PEs and DVT. Also, his neck became swollen and had what we called a doughnut around it -- it eventually resolved along with the choking sensation. Within a day or two of the heparin being started, he developed a bleed in his back, near T-10 -- as if the pain in his chest went straight through to his back. This caused him tremendous pain. As the pain increased in his back, it decreased in his chest. Before the second round of R-CHOP two weeks later, my husband expressed his concern that if he were given the chemo before the hematoma in his back resolved that he would bleed again expanding the bleed. The doctor said he did not think that would be a problem, but that if it did, he would give zinecard to avoid muscle damage. The morning following the second round of chemo (a Sunday), my husband had a severe burning pain in his back (he was still on pain meds due to the pain in his chest) and he felt and we could see a huge mass in his left lower back that was very warm to the touch. Dr. on call said zinecard would not be helpful and refused to give it and only authorized increased frequency of pain medicine. This, of course, did nothing for shrinking the mass and did little for the pain. The blood began tracking down his back and a new bleed started down low, just above his backside crack and then began spreading below t",
    "doctor_response": "You can opt for Homoeopathic mode of management.As Homoeopathy is side effectless and very mild to act in oncological cases where immunity gets very heavily deranged.Homoeopathy treatment needs a thorough Case taking to select proper Medicine which needs thorough detailed Case history and reports.HOMOEOPATHY MAY WORK WONDER IN THIS CASE IF TREATED CAREFULLY.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching and white discharge on penis tip?\n\nHi,i'm 23 yrs i had unprotected sex 2 weeks ago now in the morning i find i white discharge at the tip.its itchy and burning especially when urinating.i feel like there is something stack and i feel urinating more and more.The girl is okay no pain.what do i do?",
    "doctor_response": "DearWe understand your concernsI went through your details. From the description, it seems your penis could be suffereing from inflammation due to the unprotected sex. Frequent urination also suggests that angle. STDs can be tested later, but for the time being, consult a physician for treatment of inflammation. If you still need my assistance in this regard, please use this link.  Please remember to describe the whole problem with full detail.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excessive hair fall after using Minoxidil?\n\nI am 26 year old male, my hair fall problem started while I was living (hostel)another city from home for study, now my doctor suggeste me to take minoxidil 5%, but when I started use minoxidil twice in day,(in a week) hair fall increased so I got worried and stopped this solution,please help me this hair fall after using minoxidil is normal during starting or not,",
    "doctor_response": "Hello dear,Initial increase in hair fall after starting Minoxidil is normal, and there is nothing to worry about it.Male pattern baldness (Alopecia areata) usually follows a pattern of receding hairline & is related to genetic makeup and male sex hormones.Management involves Minoxidil preparations (5%) applied directly to the scalp helps in hair growth by stimulating the hair follicles.So, the treatment suggested by your doctor is correct, please continue as advised.In addition, you can also use:1. Finasteride preparations (like Finax) which interferes with the production of male hormone linked to baldness..2. Multivitamin supplements containing Biotin.These medications have to be used regularly under the guidance of a Dermatologist.Wishing you a Good Health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What ceases urination in patients with kidney stones?\n\nHiI am Dr. Sachin, an Ayurvedic physician from India. One of my patient with H/O kidney stone taking a herbal supplement for stone has suddenly stopped urination. What may be the possible cause and what should be the line of action?Thanks in advance.Dr. Sachin",
    "doctor_response": "Hello Dr.Sachin and welocme to HCM.As an Urologist,let me advise you, that a bladder stone is the most likely.You can confirm it, by doing an ultrasound scan of the abdomen and pelvis.As there's a history of kidney stone treatment, a stone may have slipped down and caused this block to the urinary passage.  It's very common situation.The patient should be catheterised to relieve the acute retention of urine .Thereafter, once stone is confirmed, it can be treated endoscopically.If the patient is a male above 45-50 years of age, prostate gland is a cause.If you want my expert opinion, you can send it as a direct question.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in kidney post lithotrispy\n\nI have a history of kidney stones. Almost 2 years back, I had the last of 3 lithotrispy to remove stones. Since last 2 days, I am having mild pain on the left side. It s not severe pain that is usually associated with kidney stones, however it s still uncomfortable. Are there other treatment options than lithotrispy?",
    "doctor_response": "Hi,Thanks for writing in.Since you have had 3 lithotripsy sessions 3 years back, it is important to consider possibility of multiple kidney stones in you. Some of the stones might have been too small on earlier scans and have increased in size during last two years. This can cause acute pain since the last two days. It is possible that the pains vary in intensity and severity depending on location and size. Drinking lots of water an fluids can flush tiny stones out of your system. Getting an ultrasound scan or CT scan KUB region is most important for you right now to know the exact cause of pain and if there is any urinary obstruction in kidneys.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to get pregnant\n\nhi, am female 23yrs, i am getting problem with my ovulation, and am taking clomid, today is the 13days of my cycle and i went to the doctor, n after scanning he said that that my ovules are 7mm,and its too tiny, give me a solution, i want to be pregnant",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.Clomid contains clomiphene which stimulate ovaries, develop follicles. If i am your treating doctor then i will start Clomdi  with 50 mg and dose can be increased upto 100 mg from 3rd day for 5 daysContinue this with 3 cycles then switch to other medicines or injection can be started.Consult gynecologist for further advise.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is parkinson s plus syndrome?\n\nI have a friend who has Parkinson s Plus Syndrome, and he has been seen by a doctor with Neurological Associates, Inc., but he wants to have a second opinion. We don t know who to contact that is not with Neurological Associates, Inc.. Do you have any recommendations for a very good neurologist in the Richmond, VA area?",
    "doctor_response": "Hi, thank you for trusting HEALTHCAREMAGIC.COM!I'm Dr. Elton Halili, General & Family Physician from Albania.I will answer to your questions, as below:1- Parkinson Plus syndrome, formely known as Shy-Drager syndrome, it's similar with Parkinson syndrome, but has some additional features that distinguish from Parkinson syndrome and gives his name \"Plus\".2- I don't know any neurologist in the Richmond, VA area, but you can trust to neurologist in our website.Thank you again!Take Care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does severe pain in lower abdomen with dizziness mean?\n\nLast night, I had sudden stomach and lower abdomen. I have never experienced the pain before, and it was almost unbearable. I started to become dizzy and thought that I would faint. The pain worsened when I tried to move, go to the toilet and stand up. This morning, my stomach still aches, but the pain is not as severe.",
    "doctor_response": "Hi, thank you for posting.I have gone through your query and I understand your concerns.Based on what you refer I can say that you suffer from colonopathy.To treat this disease you should take proton pump inhibitor medications.But, before starting the treatment you should confirm the diagnosis.To do that you need liver function test, abdominal ultrasound, complete blood count and urine test.Consult your gastroenterologist.Take care.Dr. Behar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain on the roof of the mouth?\n\nWe have a four year old boy who has been ill today, stomach flu maybe but he is complaining the roof of his mouth hurts when he tried to eat toast. He has been crying and complaining for about 15 minutes since trying to eat some toast. What can we do to ease the pain?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Apply Delracortil and Glycerine gel inside mouth 3 to 4 times a day it may be due to some oral ulcer due to acid regurgitation. Also give him syrup Polypep thrice a day for 2 to 3 days.I hope I have answered your query. Let me know if you have any further questions. Regards,Dr. Hina Javed",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any home remedy for jaw pain and facial swelling\n\nRecently quit smoking about a week ago and have been chewing tobacco while I try to ween myself off nicotine. Currently have extreme pain in the left side of my jaw with facial swelling. Should I see a doctor or what can I do at home to help the swelling and pain?",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.Its good you have stopped smoking and it is also not good that you began chewing tobacco as both are equally bad to your body.Please stop both smoking and tobacco.The swelling and pain in the jaw can be due the presence of a abscess in relation to one of your teeth . Please visit your dentist and get it checked as to which of the tooth is decayed and is the cause for the swelling and pain.For the pain you can take Ibuprofen (if you are not allergic to any medicine).Have your teeth cleaned by the dentist and maintain it well.Hope this was useful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Primolut affect pregnancy tests?\n\nI took primolut to delay my period. I took it for 3 days only. My last mens was on 27/09/12 n was due on 24/10/12. I had unprotected sex also. I did a pregnancy test today and saw a pale line which shows that I could be pregnant. Is there a possibility that Primolut affect Pregnancy test?",
    "doctor_response": "Hi, Taking Primolut N can affect the results of some blood and urine tests. Do not take Primolut N if you are pregnant or breast-feeding. If you think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ajeet Singh, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the stabbing pain while breathing be due to asthma?\n\nhello i have uncontrolled asthma (i sumtimes forget to take meds) i am on seretide 250 and salbutamol im having very bad back and shoulder pain feels like something is stabing me when i breathe but then its constant pain too and hurts more when i breathe or even when i move ? could it be to do with asthma ? pain is at top of my ribs on my back mayb its my ribs stabbing me ?",
    "doctor_response": "You need to get an x ray chest done to rule out any underlying lung problem. If you are having hectic cough, some times there can strain over ribs or even fracture of the ribs. Hence consult your local physician for a complete check up. Also, you have to take or inhalers regularly for proper control of asthma.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to relieve pain in back and chest\n\nLast night I was using wire cutters and used my body weight to push on one side and my right arm against the other. I felt a sensation of pain from my left chest area around to the back side same area. I swear it felt like a pop. Today I can not pull open a door or sneeze without feeling pain. I want it gone ;)",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It could be due to muscle strain in the left side of chest caused by strenuous work.You need to take rest, apply ice on the painful area, take analgesics oral or topical for pain relief,your pain will subside over few days,do not worry. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will an elevated area cause problems for one with COPD and breathlessness?\n\nI have moderate copd. I am 76 yrs old. I live at sea level in a tropical climate with high humidity. I plan to travel to an area at 5,000 ft elevation, and moderate climate. Will I have more trouble breathing? (At home, I do not require oxygen, but have shortness of breath with activity)",
    "doctor_response": "Thanks for your question on HCM.Yes, you may have breathing difficulty at that level.Usually at sea level oxygen concentration in air is around 21%. And it is sufficient for humans.But when we are going towards high altitude, this oxygen concentration decreases gradually. And this decremental oxygen can cause breathing difficulties even in normal individuals.  So COPD patient will definitely face low oxygen related breathing difficulties. Better to achive good control of COPD. Start deep breathing exercise. And SOS you may require oxygen at 5000 feet.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Usually while looking towards right noticed dizziness & pounding of heart\n\nWhen I only look to the right I get dizzy and have a pounding (like i feel my heartbeat) in my head. Only when I turn to the right. It started yesterday. I am fine when I get up from lying down. I is only when I look to the right. Do I need to see a chiropractor and get adjusted or is something else possibly wrong ?",
    "doctor_response": "I would recommend seeing a Neurologist or an Otolaryngologist (ENT specialist--Ear, Nose, and Throat), rather than a chiropractor.  What you describe sounds possibly like vertigo, a condition that occurs due to an abnormal interaction between the body's balance system in the inner ear and the nerves that conduct those impulses to the brain.  There are medications and certain exercises that can treat this condition--if that's what a workup and evaluation proves it is.  There are several other possibilities as well, so the evaluation should begin soon with a history and physical exam by your physician, who may possibly want to check an MRI of the head and inner ear; a hearing test; or certain head, neck, or eye-moving maneuvers to try to confirm the diagnosis.  Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sore throat after having wisdom tooth removed. What are the hard bumps on soft palate?\n\nHi,I have two hard bumps on my soft palate that are symmetrical to each other they are to the side and a little further back from where i got my wisdom teeth removed once again. I am starting to get kind of a sore throat as well is this something to be concerned about or have i always had these and just never noticed them?",
    "doctor_response": "Hi Thanks for writing in.Wisdom teeth removal is surgical procedure & having fever or sore throat in such condition is very normal.It is temporary condition & may be referred pain in that region.Swollen bumps can be due to effect of anesthesia. It will resolve on its own.You just need to do warm saline rinses.Complete your course of medicines as told by your dentist.Visit your dentist for check-up.RegardsDr. Neha Sumra",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for infertility problem\n\nsir, i married before three years ,wife not yot conceived..we are under teatment in an infertility clinic .Dr.says my sperm count is normal..it is as follows active-33%,sluggish -30% dead-44% total count-26millin/ml...70% are normal sperms..i had verecocel  surgury.my wife under govne laproscopic surgeury.she had moderate endometriosis..nothing else..its all happended one year before one year...wife still not conceived...we had iui...last month....not even an indication of pregnency showed even now..today also we had done it.doctrs not saying any reason for our infrtility..kindly give  prper advice wat we should do...",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.Your wife has undergone endometriosis surgery, so she has been treated completely!?Your motile sperm has less than normal. But it is not worrysome.I would advise to do histosalpingography HSG , ovulation profile for your wife. Then consult a gynecologist he/she will advise you further.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the bruise on my right hand extending to my thumb?\n\nI have a bruise on my right hand extending my thumb at the web between the 1st and 2nd fingers up about 1/2 inch onto the 2nd finger.  It extends about two inches onto my top of my hand and about one inch onto the palm.  It is shiny and a funny red purple color except in the center where it is almost the normal color of my skin.  Is this a bruise or could it be a bite?  It is painful but only to extreme pressure.",
    "doctor_response": "Hello,Thank you for using Healthcaremagic.I read your question and understood your concern.These are signs of inflammation or infection that could come from bite or brusing so you should see the doctor to give you antibiotics.I wish you quick recovery.Dr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart palpitations and fainting in kid?\n\nHi, I have a nine-year-old son who s experienced two instances of heart palpitations/fainting or feeling faint during the past weeks. First time it happened, he hit his head on a wall and we went to the hospital where he got three stitches. The doctor there didn t seem to think the fainting was anything to worry about, but now that it s happened again, I m a bit concerned. He s grown a bit over the summer and I was thinking that maybe that could cause low blood pressure and fainting. Also, he doesn t drink very much fluids unless forced to... Should I see a physician about the heart palpitations/faintings? Or wait and see how it develops while making sure he gets enough fluids? // Anna",
    "doctor_response": "Hi...I feel that your son needs work up for rhythm disturbance in the heart. Palpitations with fainting episodes are not tho be taken lightly. When the kid has hurt himslef up to the extent of requiring suturing then it means he has lost consciousness completely. If I were your pediatrician I would suggest - 1. ECG2. Echocardiogram3. EEGIf nothing is found out in these then I suggest going ahead with Holter monitoring of ECG. All this requires a pediatric cardiologist's guidance. I suggest you consult a pediatric cardiologist and go ahead on his advice.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for infertility due to irregular menstruation\n\nhi. me and my husband are trying to get pregnant but the issue is that i have had an irregular period since i was 13 and i have been on birth control pills on and off to regulate my period. if i dont take my birth control pills my period will stay and wont stop. or it wont come at all. i dont know what i should do to begin trying to get pregnant. and i was diagnosed with endemtriosis and i had a laprospic surgery done to remove the tissue that was on the lining of my uterus",
    "doctor_response": "Hello,Welcome to healthcaremagic.I have gone through your question.You has been treated with endometriosis in past and now having irregular periods. So i would suggest 3 investigations for you.1 hormonal study,ovulation profile, thyroid profile2 histosalpingography HSGThese reports help in find where the problem is.Then consult gynecologist with these reports and he/she will advise you further.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes irregularities in menstruation?\n\nHi, i am 23 years old and have always had a regular period. I recently had unprotected sex and I got my period 2 weeks later but it has now been going for 9 days. This has never happened before. My period started normally but is now very light with some little clots. Could I be pregnant?",
    "doctor_response": "Hello dear,I.understand your concern.In my opinion the delayed period with prolonged bleeding definitely needs to rule out pregnancy.I suggest you to do a urine pregnancy test.If the test is positive the bleeding can be considered as miscarriage.If negative the bleeding might be due to some hormonal imbalance.Avoid stress.Relax.Consider doing a urine pregnancy test.Whatever may be the result consult gynaecologist.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic yeast infection\n\nI have a chronic yeast infection (i hope) that i can't get rid of.  I've been to my nurse practictioner 3 times and she insists that it's yeast.  She thinks I'm making a mountain out of a molehill because I don't have much discharge, but I am truly uncomfortable.  I've used creams of all kinds, and the discharge has never left. Is there anything you can suggest? Please help",
    "doctor_response": "Hi,If there is yeast infection, along with local anti-fungal cream you have to go for one oral anti-fungal medicine like Flucanozole 150 mg once in a week for 4 weeks.Keep local hygiene clean, dry and airy.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i conceive with follicle size of 2.2mm and 1.5mm?\n\ni am 30 years old i had miscarriage one year back i m trying to concieve from last 10 months still no sucess .my present endometrium line is measured at 6mm on day 13th and ultrasound shows dominat follicle in left ovary one of 2.2mm size and another of 1.5mm size is this normal to concieve ?",
    "doctor_response": "hi for conception to occur the dominant follicle should reach a size of 18 to 20 mm.just see our ultrasound report carefully is the size of ur follicles mentioned in mm or cm.your et is 6 mm which is normal.if your follicular measurements are in cm then it is the right follicular size and conception is very much possible.if it is 18 to 20 mm you can take an inj of hcg  5000 units to make the follicle rupture and have daily intercourse for 5 days.all the best and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for brain metastases\n\nHi my name is JoAnne and i have a history with melanoma of the brain n spinal cord. I was diagnosed when I was 25. First I had a tumor in the frontal lobe of my head yhe size of a golf ball and a small one deeper in my brain. I hhad the big one removed. the other one was gammaknifed. I had fill brainradiation chemo. 7 months later a molecule from the surgery hooked onto my spinal cord and became a small tumor that was also radiated and lasered. I had small problems after that. To make this story short . . side effects were doublevision (had surgery to tighten muscles in one eye). Went to Germany to get a vaccine amd did that for 2 and a half years. In 2012 my spinal cord had to be operated on. The tumor they just had radiation around it and had to be taken out, it was petrified and had a large cyst w small melanoma cysts. I know a lot about pain n medication. My fiance has a fractured foot from slipping on ice and they gave him pain medication. I always had a high tolerance for pain. But he was still complaining about it. He is already on high blood pressure medication, he is over weight, and he is on 2 other meds for his heart. They gave him after complaining again that he still had pain, everybody has a little pain with these things even with meds and your on bed rest. He is a sergeant major in the army. so he goes to doctor again and complains again about pain thry put him on roxicodone 1 pill every 4 hours and i do not agree that he needs that medication. He is a smoker and has not been drinking alcohol thank god. How do you feel about this pain medication for a foot fracture. I dont agree. Is this a wise choice for the doctor to be prescrbing him? this medication of course.",
    "doctor_response": "Hi, I am Dr.Bruno.  I have read your question and understand your concerns. Let me try to help you 1The Topic of the question is \"Suggest treatment for brain metastases\" But you have asked about Pain medication 2. Question 2 : Is this a wise choice for the doctor to be prescrbing him? Answer 2 : Madam, You have to understand that pain tolerance for each and every individual is different and so the doctor has to prescribe more drugs for persons with low tolerance and less drugs for those with high tolerance Hope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness, tingling and burning in my fingers and arms?\n\nHi, Im Stacy , I have had off and on for years when over use of my arms and hands, recently has gotten worse, interallable ,and wakes me up at night. Both arms from elbows down to fingertips, numbness, tingleing,burning, sometimes when i like reach for something, it feels like im touching an electric fence in my wrists. I 1st got htis folding denim all day at Nordstroms, now i have been working with babies at a learning center,lifting them all day. So afraid im going to drop one of them cause i go numb.",
    "doctor_response": "Hi Stacy, your problems are from a a nerve which has got pinched at the elbow mostly as a result of your occupation which made you do repetitive bending of the elbow. this nerve called the ulnar nerve as at the outer side of the elbow and  when stretched or pinched can cause the above symptoms.This calls for nerve conduction and EMG studies.Also to be ruled out is nerve affection at the neck.you will have to modify your activity by avoiding excessive bending of the elbow and by using pads or supports at night.Surgery  can be sought later.this will be decompressing the nerve by releasing the tunnel or changing the position of its path.",
    "dialogue_context": ""
  },
  {
    "patient_message": "History of kidney stones. Blood in urine, bloating, headache, back pain. Source of blood?\n\nI have had multiple kidney stones in my early 20s up unroll around 29-30. I'm 35 now. I had many lithotripsys along w/ a percutaneous removal through my kidney. Few days ago I realized my left kidney was hurting, few mins passed then realized it was most likely a stone due to groin hurting and back. Moved around pacing back n forth went per a lil to realize pretty bright blood in pee. Soon after pain was gone and I felt fine. Total of 20 mins. Figured I got lucky and passed it. Few days pass still no pain however I'm still passing blood in pee. My urine color goes from almost dark looking blood to redish blood then nothing, clear as can be.  Question is my back had hurt 1 day, 5 days ago. However I'm still passing more blood in urine than I ever have. only symptoms I have currently as well as past week are Headaces, bloated along w/ unusual amounts of gas/air. Could it be a stone stuck and that's where the blood is coming from.? W/o any pain? I have had probably 15 stones from 2001 -2007/2008 most were removed surgically...I have passed few on my own. Or is it something else?",
    "doctor_response": "HiThanks for the query.Common causes of blood in urine are infections, stones and cancer. In your case the first two seem more likely.You need to get a urine exam and culture; CBC and an ultrasound or a CT Scan of the Kidneys and bladder to determine the cause.Meanwhile keep yourself well hydrated.Hope this helpsGood luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning and swelling of tongue?\n\nI am 63, about 2 weeks ago my tongue was sore (like I had a pimple on it).  Now the inside of my mouth feels like it's burning, swollen tongue, sore throat, lots of salivia and i am not a juicy person.  the burny part of my mouth has spend to the inside of my lower lip and is moving to the other side of my mouth.  there are no ulcers, but it looks like a pimple with a yellowish center, small as the head of a pin.  No fever and I don't have time to get sick.  Had a flu shot a week ago and have been using Voltaren Gel on arthrituc joints.   I have osteo arthritus all over.  I would rather not go to the dr unless I have to.   I started using warm salt water solution....no change so far.  Thank you very much",
    "doctor_response": "HelloUse a vitamin B complex  tab daily and soem local anaesthetic  ointment.If no relief  after one week go  see  a doctor.check your sugar  level and make sure it is under control.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair fall\n\nhello doctor due to hair fall and blades i have gont to the doctor she had given mr the keaglo tort tablet i just want to know is there any side effect of that to m eyes since i work in computer 8 hours  my eye visions is littel bit i cannot view the things far is that becoz of the table",
    "doctor_response": "Hi...Keraglo forte tablet is multivitamin with biotin. So do not worry. You may take it for long time. No side effects..ok Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "When to take pregnancy test?\n\nHi, i am 26 years old and my fiance is 32 and we are ready to have a baby. My last menstruation was 22nd September 2010 and googled to findout when i could beovulating and workded out to be the6-8 of October 2010. My partner and i basically had intercourse like everyday. i did my pregnancy test today 18th October and its negative My period wont be due till the 22nd of this month. How is that possible??",
    "doctor_response": "Hallow Dear,You have performed the pregnancy test on the urine too early. For these tests, overnight first morning urine sample is the best sample as it contains concentrated hormones. It should be performed a week after missed period; earlier, there are chances of false negative results. Alternatively Beta hCG test is very specific and sensitive test and gives reliable results even few days before missed period. I hope this serves the purpose. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Soreness on tip of tongue, pain on swallowing followed by burning, no fever, eases with cold water. What could it be?\n\nHello, It started a few days ago, I noticed tip of tongue sore,almost like a canker sore, by next day swallowing was semi painful. Day three portions of tongue feel like there on fire,and its feels like im swallowing lumps . I am currently working as a nurse in long term care. I do not wish to pass this on of its strep . I don t have a fever , very uncomfortable,and taste buds are shot. It feels good if I drink ice water, or something scratchy going down my throat . I have a slight pink tongue. Thank.you so much for your time.",
    "doctor_response": "hello and welcome,this can be an ulcerous condition called aphthous ulcer.it can be treated with tab.flanzen-10mg;3 times daily for 3 days and tab.wysalone-5mg-3 times daily for 3 days.please discontinue any oral habits like tobacco or pan chewing if you have any;as it can lead to burning mouth and limited mouth opening called oral submucous fibrosis-osmf.please add vitamin-b containing food to your diet.hope you get well soon.always clean your mouth after every food intake.use soft-bristled tooth brush and tongue cleaner to clean your teeh.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in right upper arm?\n\nYes my question is my right upper arm has been causing me Extreme Pain. I wan that on the outer side do my ran the muscle is so sore that the pain is like sharp pain and I can only lift my arm half way up. I had an ultra sound done today and there are no blood clots there My doctor had blood work drawn and the test showed a positive for high risk for clots the test was negative.He also drew blood for my thyroid those results will not be ready until Monday. I am in so much pain do have any idea what is causing me this pain.",
    "doctor_response": "hi,as mentioned by you what I can understand is the pain is radiating in nature from the shoulder to the elbow. This nature of pain is due to the nerve getting pinch in the cervical spine. As the nature of the pain is sharp shooting this is what I can understand.Also for differential diagnosis - it can be trapezitis or bicepital tendonitis.But by performing specialist test it will be easy to come close to the root cause. Taking an MRI of the cervical spine will help visualize the soft tissues and also the extent of injury to the soft tissues.Also take a hot water fermentation to the neck region and upper back. followed by this apply the same at the shoulder and upper arm region back side.Taking therapeutic ultrasound therapy and TENS therapy will help reduce pain for this you may need to visit a physical therapist.Also, after the pain comes down performing neck strengthening and upper limb strengthening exercises will help improve the strength in the muscles and avoid future pains.Usually 99% of patients with similar symptoms recover with physical therapy .with the grace of God I wish you a good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the early signs and symptoms of pregnancy?\n\nI am 18 and I have a very regular cycle. Exactly 30 days and it lasts 5 days. On March 23 I began my period. It was very light and only lasted 2 days. Since then I have been experiencing nausea, tender breasts, bloating, mood swings, food cravings, many trips to the restroom, and some tiredness. Also, April 21st I noticed light pink blood when I used the restroom that morning, and again around noon that day. I have yet to start my period and was wondering if I may be pregnant.",
    "doctor_response": "Hallow Dear,Since for two months, you had very scanty to light period, and you are suffering from nausea, tender breasts, pica, frequent urination, etc. you need to rule out the possibility of pregnancy. The first cardinal symptom of pregnancy to appear is missing period. Though you have not missed your period, your last two (?)periods were suspiciously scanty. The other cardinal symptoms of early pregnancy are nausea & vomiting with pica, frequent urination and breast symptoms which include engorgement & tenderness, dark discolouration of nipples & areola with areolar widening, Montgomery's tubercles under the areola and secretions from the nipples. You have many of these symptoms. Since your last two cycles are suspiciously scanty, pregnancy test on the first early morning urine will reveal the diagnosis. Else, by this time ultrasonography also can give you direct visual evidence about the status of pregnancy. I hope this will resolve your dilemma. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes continuous cough which has lead to chest pain?\n\nI have had a cough for about 5 mnths now. I seen a doctor last Friday. She said I have underlying asthma issues. I am still coughing alot. For the past hour I have kinda had pain in my chest. Could something be strained from coughing or is it possibly something else?",
    "doctor_response": "Hi thanks for asking .Here long duration cough is there.if associated history of fever and weight loss then sputum for TB done.You do your pulmonary function test to rule out ashrhma and about restrictive or obstructive lung lesion.Avoid smoke strictly.Don't take spicy food.Here cough can be because of chronic bronchitis.So better to do sputum for TB and PFT first.Then according to report further work up done.If dry cough troublesome dextrose thorp han tablet or syrup taken.Don't worry.you will be alright.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lumps on each side of the neck?\n\nI have a growth above my left breast near my armpit, it is about the size of a small grape.  recently (about a month or so) I have noticed that I have lumps, one on each side of my neck. I am not sure if these are enlarged lymph nodes.  I also seem to bruise very easily.  I have also noticed that my hair is thinner.",
    "doctor_response": "Hi.Welcome t HCM.You may be having enlarged lymph nodes. You should show it to surgeon. Fine needle aspiration cytology of it can tell exact cause. Thin hairs has no cprelation with it but eaay bruessing needs blood platelet investigations.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of breathlessness?\n\nwhy is it that people sometimes don t get enough air ? is because i am doing a children s book that we have to explain about respiratory system but with a story i am doing this so far: One day while Samantha was playing @ the park, she was getting really tired because she was playing tag with her friend. she had run 5 minutes straight without stopping. She felt like she couldn t get any air. She went inside and sat down to get some rest while she told her mom what had happened. Then on that same night, she felt very weak. And she wasn t getting enough air. Next morning, she felt the same as last night. Her mom planned on taking her into the doctor so they could check her. When Samantha and her mom went inside, the doctor asked what had happened. So they both told the doctor about the situation. and idk what else to say... we have to explain the respiratory system but in a child level So please please please, answer ASAP because is due tomorrow, April 15, 2014 @10:00 A.M. ! thank you very very very much!",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.As you explain the history, I think this is an anxious situation and not a real clinical situation. It will pass soon. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Jnikolla",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do recurring mouth ulcers need medical attention?\n\nHi I've got a mouth ulcer on cheek of my lower lip and it's not as painful only when I try to squeeze it. Once I broke it, if didn't appear for about 3 days and again it seemed to develop again.I'm worried because It's been there for a while now plus it's recurring. I want to know if it's cancerous in nature and should I be worried or let it take time to heal.Mindy respond Thanks",
    "doctor_response": "Hi..Thanks for the query..It looks like there is recurring mouth ulcer and if there is pus formation then it is most probably due to infection..So my suggestion is to apply antiseptic oral gel like Chlorohexidine over it and gargle with antiseptic mouthwash..You can also apply a steroid ointment like Triamcinolone Acetonide over it..Do warm saline gargles..In case if there is no improvement then you can consult an Oral Physician and get evaluated so that further diagnosis can be done..Hope this helps..Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause for jaw soreness with ear pain and headache?\n\nHello, I have had a stiff, sore jaw for 2 months now. I thought it was because of excessive stress that started around that time period. (Perhaps I was grinding my teeth in my sleep.) Today however, I have pain in my jaw that is radiating into my inner ears and causing a headache. Should I make a Dr appt for this, or do you think it is caused by stress?",
    "doctor_response": "u need to visit a dental specialist. pain is more likely due to joint pain in your jaws. grinding of teeth and stress can  cause excessive pressure on your joints leading to severe pain. consult doctor before it gets severe.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do proctitis, colon polyp, haemorrhoids and hiatus hernia cause knee and back problems?\n\nHi I am 20 years old 5\"2 and around 8 stone and have been having severe abdomen pain and cramps since November last year. I have recently been diagnosed with proctitis, a colon polyp, haemorrhoids and a hiatus hernia. I have suffered from mouth and tongue ulcers since I was 4 but my doctor said it was normal but they have been coming along much more bigger and are making it hard to talk and swallow also my knees and back are causing me a lot of trouble",
    "doctor_response": "Hi.Thanks for your query and an elucidate history. Since you have got Proctitis, colon polyp, hemorrhoids means you have a severe Gastrointestinal upset.Till this is cured the aphthous and aphthoid ulcers (more than 3 mm) will be recurrent..Since all these disorders do not allow the important food contents like mineral , trace elements and vitamins to be adsorbed properly you get multiple problems including bodyache, knee pains, backache and any sort of problem related to the fitness.I would advise you to get a proper treatment of all your medical problems, take multivitamins, get colon polyp operated, have proper diet , whichever suits you, and you can improve a lot. Have periodic check-ups.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a movable lymph node on the neck?\n\nI have a movable bean sized lymph node( I'm guessing lymph node) on my upper left side of the neck near the crease below my jaw line. It is not painful, red, only noticeable when I touch it. This ha been there since december of 2010. I do not have any other symptoms no cough, fever, or congestion. I have this since I also have a bigger movable lymph node or cyst in armpit I had this checked by two places one said lymph not one said cyst I had an ultrasound for my breasts and underarm they said it was nothing it is still there and that was last year. Im getting really frustrated of noone taking me seriously I'm so nervous about that it may be lymphoma I always get things checked right away and because of that they think I'm not being serious and this on neck has been awhile now and I'm scared if I seek medical attention they will be like it is nothing since I'm 24 and it is not fixed but cancer is usually not painful and I'm not feeling in pain what do you think it might be?",
    "doctor_response": "Hi,Dear Good Evening and thanks for the query to HCM.Cause of the red  lump on the neck-I studied your query and understood your health concerns.In my opinion the red lump is mostly  due to the non-specific lymphadenitis in JD area.Its asymptomatic and hence you seem to be worried more.From the facts of the query, I assure you that it is not cancerous or of lymphoma.Else they would have done further investigations and told you the severity of it to you.I would advise you to consult ER Surgeon who would  help you  out by FNAC Biopsy if need be.Hope this would help in planning treatment with yuou Doctor.Welcome for  any further query in this regard.Plz write a Good Review-without fail,as it would help other patients coming to HCM.With Regards.Dr.Savaskar M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am i taking too long to conceive ?\n\ni being trying to conceive for about 3 years now and i have tried 2 pregnacy test before and it came out negative. I dont know why am i taking long. please help me. im worrying , because i do want to have babies. thank you.",
    "doctor_response": "good morning first  of  all  you  must  know  the  cause  of  infertility,go  to  your  doctor  and  ask to  take  all  the  tests  of  harmones  and  vitamins,you should  consult  radiologist  also  to  rule  out  p c o d when  you  will  come  to  know  the  cause of  the  disease then  it  will  be  easy  to  treat thanks dr  vinod  raina md  medicine",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fatigue, muscle aches, cough and fever?\n\nI have had flu like symptoms over the past 5 days including severe fatigue, muscle aches, productive cough, low grade fever. My concern is despite taking tylenol and motrin around the clock my heart rate is persistently 110-120 s even at rest. I did get the flu shot 2 weeks ago from the time my symptoms started. I am otherwise a healthy 31 year old woman with no health problems should I be concerned or let this run it s course?",
    "doctor_response": "Hi welcome to HCM...According to history you can have acute bronchitis or pneumonia like infection ...In which due to infection heart rate can be high....I would suggest you to get your chest x ray done ....If pneumonia is there consolidation will be seen....You might need cefixime like antibiotic for 7 days....Steam inhalation useful....Drink more fluids...Excess spicy food , oily food like irritants avoided....For cough ambroxol syrup can be taken...Auscultation done to heard for rales or rhonchi ....If bronchoconstriction present because of bronchitis then bronchodilator needed....For congestion relief antihistaminic drug needed....With keeping my answer in mind consult pulmonologist ....Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do polyps in the uterus impact fertility?\n\nHi I'm trying to get pregnant and i just found out that i have a polyp in my endometrial lining? what are the chances that this is what has been inhibiting this from happening for the last year and a bit! what should I do? I'm 3o years old i weigh 138 lbs and have been healthy",
    "doctor_response": "Hi, thanks for writing..I understand your concern..Polyp in the endometrial cavity can cause distortion of the uterine cavity causing defective implantation. It better to get a gentle curretage after consulting your gynaecologist to get a clear uterine cavity which helps in healthy implantation. Some conceive with the polyp on and in some others it gets shed during periods. Consult your gynaecologist to know the size of polyp to plan a proper treatment. Hope I have answered your queries.. Good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I able to conceive after an abortion?\n\nhi doc , I'm 32 yrs old married on  jan 30 2012.i conceived on mar & later aborted on jun since no cardiac activity found in foetus.i hav thyroid too  TSH 0.560, Free T4 1.29,Free T3 2.12 & prescribed to take 100 mcg of thyronym & metformin diamet 500.can i able to conceive or need more treatment. thanks.",
    "doctor_response": "Hi, I think you can conceive.  Your thyroid profile is normal. Just take progesterone next time when you conceive.  Be in contact with a doctor at regular intervals. All the best for next pregnancy. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could blurred vision and subsequent diagnosis of Bell s Palsy suggest?\n\nHi goodday, my sister sumtime last week said she was getting blurred vision in her right eye, also she felt numbness in the right side of her face. She spent a night in the hospital under observation and she did CAT scans and blood tests and still they found nothing wrong. She was given some meds to take, and after a visit today, she said the doctor told her that she has Bilpulsey . I m not sure if its spelt correctly, but this is what she said. Can you shed some light on this situation please.",
    "doctor_response": "Hello,I can understand your concern. We all have facial nerve on both sides of the face that has branches that run from temple, cheek, towards jaw and then to the neck. If this facial nerve s paralyzed due to some reason, then all the branches and the muscles they supply get affected and face loses sensations on that side. Usually, this nerve paralyzes when there is some lesion like tumor or trauma which compresses or injures the nerve. However, if your sister had one of these reasons, it would have been diagnosed in the investigations at the hospital. Thus, she is either suffering from viral infection or idiopathic reason (the cause that is not yet deermined).Symptoms of this palsy include loss of sensation and numb areas on the side of the face that is affected, dry eyes due to loss of tone of eye muscles, dropping of lips and drooling of saliva from that side of mouth, loss of saliva causing dry mouth etc. Treatment usually involves supportive therapy for dry eyes, dry mouth and facial massage is advised to regenerate the nerve sensations. Usually, the situation is healed on its own in absence of any obvious reason and the nerves will regain the sensation. If you consult a neurologist, he/she can she more light on the disorder by doing in-depth examination and investigations.I hope this information helps you. Thank you for choosing HCM. I wish your sister feels better soon.Best,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the withdrawl symptom of zolfresh?\n\nDear sir past five year i am exertion of my one teeth by doctor and after that some type of sensation start in the right side of mouth i am going to physician and he will prescribe medicine (Zolfresh) for one week after that my problem was cure only when i take medicine But after some time problem start their is no any type of pain in my mouth only sensation start but i use zolfresh long time . what is the withdrawl symptom of zolfresh because i cannot use this drug more time. E mail-- YYYY@YYYY",
    "doctor_response": "Hello, If you suddenly stop using this medication, you may have withdrawal symptoms (such as nausea, vomiting, flushing, stomach cramps, nervousness, shakiness). When a person becomes dependent on zolfresh and stops taking it, they may be unable to sleep. This is known as \u201crebound insomnia,\u201d a withdrawal symptom in which the inability to sleep returns, often worse than before. When users stop taking zolfresh entirely and suddenly, the risk of rebound insomnia is increased.Sep 12, 2019. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. AJEET SINGH, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can an infected surgical lesion be treated?\n\nhello there i recently had an operation on an ingrown nail,it has been a month now since the operation and i was just sitting here and i found a loose piee of scab,i made the mistake of pulling it off and beneath the scab it is mooist,yellow and up close smeels fishy.Is this normal or is it infected?",
    "doctor_response": "Hi i do care for your concern. The yellowish color and moist skin without any discharge points to good wound health. Consult your physician only if any discharge or bleeding at the site present. continue the drugs if provided. Keep the region neat and dry. Hope the wound heals soon. Hope i have answered your question, If you have more feel free to ask. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have allergy to food. No medication as off now. What is the cure for this?\n\nI ave become allergic to a lot of foods and things over the past 5/6 yrs and take benadryl to relieve the allergic reactions; hives, itch and such.  I always take one then two then three to help it settle down and a shower.  The other night I had to take 5 and it was horrible, took a while before I was okay. Is there somthing else I should be doing?  I had an epi pen twice but it expired and then I wasnT sure if I really needed it.",
    "doctor_response": "Hello and Welcome to HCM, Thanks for writing to us. The only way to avoid an allergic reaction is to avoid the foods that cause signs and symptoms. oral immunotherapy (OIT) as a treatment for food allergy. If you have any suspicion at all that a food may contain something you're allergic to, steer clear. visit the allergist and get the treatment according to that. Hope this helps you. Wishing you good health... Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly help me to get rid of thinning of hair and male pattern baldness.\n\nHello doctor,I am suffering from thinning of hair and seeing male pattern baldness which has been passed genetically. It has been quite a few years from where I do not see any growth of hair on the frontal section and crown area of the scalp.",
    "doctor_response": "Hello. Please send me pictures of your scalp to advice proper treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have distal ureter stone, calcification. Flank pain. Blood in urine, groin pain. Is it serious?\n\nI was told I have a small distal ureter stone and several calcification that are low in pelvis and persumed pheboliths.I was having left plank pain and the doctor sent me for ct stone study. No stones found in kidneys but i have gallstones. Last 3 urine test showed blood in urine . I have no pain when urinating but I do have pelvic pressure and burning around belly button. Lately some dull pain near the groin area. Dr. sending me to urologist. My question is it serious or just something I need to live with. My blood work came out in all normal ranges also.",
    "doctor_response": "Hello,l Welcome to HCM, I am Dr. Das Look, it is not a normal condition that you have to live with. Here urgent intervention is necessary. You have to consult with urologist for removal of the stone. If you neglect it, then many disease can be caused by this like profuse anemia, pain in abdomen, and many more. So, do not waste time. Consult with urologist immediately. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could continual stomach pain with cold and fatigue indicate?\n\nmy seven year old daughter has been complaining off and on of a stomache ache for the last few weeks. It improves with food. She also has some mild cold like symtoms, runny nose congestion, seems tired. last night, she has developed a cheek stain and it has persisted today. no fever. what is the best way to fix this?",
    "doctor_response": "Well, let us not try to \"fix\" anything! She is a human, not a leaky fawcet. Having said that, it appears that she has a virus that has affected her chest/respiratory system as well as her skin, and the gut. You should keep treating her symptomatically. Give her paracetamol for fever, benadryl for cold, plenty of fluids including hot chicken soup, and a light diet - as much as she wants. Allow her to decide her activity level. Neither force her to move nor to sleep. Encourage her to play and do interesting things to avoid getting her from being bored and tired. I hope this helps.Best wishes and praying for her speedy recovery.Dr. Taher",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment can I take for a diabetic person who is suffering from psoriasis ?\n\nMy wife has been suffering from chronic psoriasis for a long time (15 years). She is 48 years old with two children. Her weight is 86 Kg with 5 feet 3 inches height. She also suffers from diabetics. I would like to meet you for her treatment . Would you please suggest me when and how I can approach you? What is the first treatment? would you please let me know in My email address abdulmaleque@yahoo.com with regards abdulmaleque@yahoo.com",
    "doctor_response": "hii welcome to health care magic. i went through your case,i feel that homoeopathic medicines would be of great help. coz psoriasis being a chronic immune mediated disease that appears on the skin, well u have not specified as whr is the psoriasis affection as such,coz there are different types of them.Homoeopathy has well defined German origin medicines that would prove effective if u take it on a regular basis and following up the necessary diet and regimen.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pressure on head,pain and ringing sound in ears and nausea\n\nI have been feeling a lot of pressure in my head. Almost like when I am in the airplane taking off and you feel that tight pressure. Also pain around my ear and ringing sensation in my right ear. Feeling nausea on and off and Today just got a weird smell of ammonia in my nose",
    "doctor_response": "Hi there.This could be part of a Vertigo attack with Tinnitus due to problem in the Inner ear. You should show to an ENT Doctor or Neurologist to rule out Inner ear disorders, Migraine, Epilepsy. Take Tablet Stemetil for the nausea and any giddiness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Numbness on right side of the body due to neuro problem\n\nHello doc My mother is facing some neuro problem. One toe on her right foot has fallen numb, she gets the \u2018sleeping hand\u2019 feeling on her arm when she keeps it one position for 2 mins. She has a feeling numbness on right side of face occasionally and gets blackouts when she tries to get up suddenly. Can u suggest what could it be?",
    "doctor_response": "Hi Welcome to HCM Read your prob, most common cause of these symptoms is calcium deficiency n cervical spondolysis. she should get X ray n MRI of cervical spine, serum calcium leval. then consult with your doc n start its treatment. symptoms can be subside by medicine n physiotherapy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can mitral valve prolapse cause dizzy spells?\n\nI am a 37 year old female that has mitral valve prolapse and I have been experiencing dizzy spells that my doctor has diagnosed as vertigo from an inner ear issue. Physical therapy treatments aren't really working and I am having anxiety attacks from these spells. Can my heart valve be the cause of these dizzy spells?",
    "doctor_response": "Hidizziness is very different from vertigoinner ear disturbances can cause vertigo and dizzyness. Mitral valve prolapse usually remains asymptomatic ,breathlessness is the main symptom in most of the patients.Although it can cause dizziness  but is very rare.If your physcian has diagnosed it as verigo then donot do any physical rehabilitation therapy till it fully settles downtreatment of vertigo is done in two stages1) Acute attack-anti vertigo medications are given like betahistine and prochlorperazine maleate2) chronic phase-- vestibular rehabilitation therapy and  physical therapy are indicated .IF ITS SUSPECTED AS VERTIGOcaloric test and pure tone audiometry  is advised",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for neck and shoulder pain caused by an injury\n\nMy 10 year old son fell on ice over the weekend and hit his head and back resulting in left side shoulder and neck pain along with electric shocks. His doctor has diagnosed him with whiplash but took an xray that revealed no broken bones. However he called this morning and said that they found either a bone island or a shadow on his shoulder bone. We are medically minded people, but until today I d never heard of a bone island. He has ordered an mri to make sure if what it is. Of course I m worried and the internet has only made it worse. Any insight to this would be great.",
    "doctor_response": "Yeah friend as a pediatrian I would suggest you to follow expert opinion given by orthopedician... If you have doubts visit other orthopedician with all previous reports...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could explain abdominal pain and frequent bowel movement?\n\nHi I have been having abdominal pain, for about a week now. I also have been having frequent bowel movement, many times thru out the day and night. It is usually of the the liquid nature with very few solids mixed in. I quite often here rumbling noises from my abdomen. No vomiting involved and no blood in the stool. Any ideas? Thanks Chris.",
    "doctor_response": "Hi Chris.Abdominal pain and loose stool without vomiting or blood in stools is suggestive of an intestinal infection called enteritis. The rumbling noises indicate harsh movements of the intestines for removing the infected material. I would advise you to consult a Doctor TO GET A PRESCRIPTION OF an antibiotic most suitable for such types of infection along with a probiotic .Take curds and banana and soft diet.IF there is no response, you may please need few investigations like  Blood- complete blood picture, kidney functions tests, blood sugar fasting and post-lunch, Widal for typhoid and whatever is thought by your treating Doctor.Urine- routine,microscopy, culture and sensitivity ( before start of antibiotic)Ultrasonography of abdomen.The further treatment will be dependent upon the reports.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can you start chemo if your liver function is high sgpt is 220\n\ncan you start chemo if your liver function is high sgpt is 220 hi my aunt has stage 4 breast cancer metastasized in liver, lung and bone, she is going for a clinical trial similar to Herceptin (she is HER2 3+) with paclitaxel. But the doctor does not want to start her with chemotherapy because her sgpt is high at 220 ..... what do you suggest we do??? we are losing time and i feel her doctor is quite slow in making her decision.",
    "doctor_response": "Hi.. Continuing with chemotherapy might c ause liver toxicity and since she already has liver dysfunctions your doctor is right in holding the chemotherapy.. There are other modalities of treatment such as radiotherapy and hormonal therapy available too.. You may discuss with your doctor for the use of these..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Gums in bad shape, bleeding after fixing braces. Using Hi-prodent tooth paste. Worried?\n\none month ago dentist cut my gums,scaling etc. Because my gums were in very bad condition.After this i got Braces on my teeth ,but still my gums are bleeding and in bad condition i am using Hi- Prodent tooth paste. Simply i wanna ask what i should do now. Am every time worry . am from Pakistan. am 23 years old, please....................................................... guide me. I will be very thankful to you. sir simply detist cut my gums....................",
    "doctor_response": "Hi, Thank you for the query. According to the history it suggests  of long standing  gingivitis . I would advise you to take an OPG and see your dentist  . Because presence of infection in the gums will lead to repeated swelling and bleeding in the gums. This has to be treated by flap surgery and the x-ray  will help you know the amount of infection and bone loss present . You have to concentrate on your oral hygiene and should maintain it by brushing twice and flossing and gargling thoroughly after every meal . A course of antibiotics is required to control the infection. See your dentist for clinical examination to rule out the exact cause . Hope this infromation helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for high BP of 126/91\n\nHi. My husband is 26 and very athletic, but he seems to have high blood pressure. The last time we took it it was 126/91. He has tried taking HTZ, but said it made him feel awful. He thinks this is just his normal, but I''m concerned. What should we do?",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!Regarding your concern, I would explain that his systolic blood pressure values are within the normal ranges. His diastolic blood pressure values are a little high and may be indicative of first stages of high blood pressure. Coming to this point, I do not think that HTZ is necessary. I would just recommend some lifestyle modifications: - reduce salt and caffeine intake- perform a lot of physical activity (walking, aerobics, recreational sports, etc.)- try to loose some pounds of he is overweight. Hope to have been helpful!Wishing all the best, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and vomiting in a child?\n\nWhat can cause my kids to get dizzy and then vomit out of nowhere they are fine then they get dizzy vomit a couple of times then go to bed its happenned more than once 2 of my for kids do this when one just gets dizzy and never vomits i m going insane not knowing the cause of this plz help me",
    "doctor_response": "Kids are very prone to gastritis mostly due to stress from school and bulling. This gastritis causes nausea after feed and dont allow kids to take full feeds. As it causes discomfort and nausea kids progressive take smaller amount of feed and also occasionally vomits. Avoid too sour, too hot foods, avoid fruit juice or 1 month. Try to solve the stress factor if any. Give Nexpro junior sachet 1 such in early morning every day for 1 month.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Coumadin cause dark discolored skin around the ankles?\n\nMy son has been on Coumadin for five years after the placement of his aortic valve with an Onex valve. Not sure of that spelling of the valve. Now he has dark discoloration of his skin around his ankles and lower part of his legs. Is this to be expected with the use of Coumadin? My email address is YYYY@YYYY",
    "doctor_response": "Hi & Welcome.Coumadin (Warfarin) is an anticoagulant (blood thinner) which reduces the formation of blood clots and is used to treat or prevent blood clots in the blood vessels or prosthetic heart valves like On-X aortic valves to reduce the risk of stroke or other serious conditions.Based on the history given, your son seems to have developed bleeding underneath the skin that has resulted in dark discoloration around the ankles.Bleeding is one of the most important side effects of Coumadin. So, consult his treating physician to adjust the dose of Coumadin in such a way to have a normal prothrombin time and International normalized ratio (INR) in the range of 1.5 to 2.0.Hope the advice given above would be useful in preventing the side of bleeding caused by Coumadin.Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intermittent pain in the chest while having COPD and emphysema?\n\nI am 91, have copd, emphsema, kidney disease and starting about a week ago I get this pain on and off inside the rib cage at the bra line.I seem to be always cold w/ low temp. Is it possible I am allergic to the parakeets I just got about 2 weeks ago. Years ago I had Cockatiels but had to give them away because they were so dusty. I was hoping I could haandle the keets????????",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Yes, it is quite possible that you are allergic to Parakeets. Better to get done allergy testing and if it shows that you have parakeet allergy then you need to keep them away from you. Start montelukast (anti allergic) and levocetrizine (antihistamine).Take your COPD treatment regularly. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Developed a blister on the lip. What is it?\n\nHi doctor, I have a blister on the lip, which developed in the morning today. My medical history includes hypothyroidism, and I am on regular medication for the same. Here, I have attached the photo.",
    "doctor_response": "Hi. Revert with the details to an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are painful muscle spasms indicative of ALS?\n\nMy daughter is 39 years old with 3 children 7, 5 and 2. She works as a speech pathologist 3 days a week. She has been taking different anxiety meds since she was in college. She recently switched to Trintellic (sp?). She has been seen by a psychiatrict s assistant and was given this med. She stopped it because she is having muscle spasms in legs and arms at different times and she says it is painful. Also, she has perioidic chest pains which has been checked out at a hospital in the past year. She has started to have headaches also. She just had blood work done by her own insistence) for lupus. She is most worried about possibly having ALS. She is currently freaking out waiting for these results. Would you have any idea if ALS is a possibility for her pains? Sorry for the explanation being so long. Thanks.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I passed  carefully through your question and would explain that the muscle cramps could be related to trintellix adverse effects. I don't think that her symptoms are related to ALS. Anxiety could be the cause of her complaints. Anyway, nerve conduction studies would help exclude ALS and calm her anxiety. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from mental illness, kindly suggest her\n\nmy mom is suffering from mental illness for the past 5 years she thinks as if someone is looting everything from ours and something strange will happen always there is a fear angry towards something she is also very adamant she doesnt act like normal people dont mingle with people ,thinks that all were bad. .during the time of depression her negative thinking gets bigger and she doesnt eat properly this is the situation of our family we are suffering a lot along with her............ my question whether this can be cured 100% or she will be in this stage for her whole life. she is also under treatment and taking medicine, but it attacks her frequently.",
    "doctor_response": "Hi, welcome to health care magic forum, your mother is having illusions and hallucinations, this is a mental problem which can be treated 100% with homeopathy, there are many reasons why people suffer from such kind of problems,other modes can give you only sedatives which will make her sleep. i want you to have a watch to this video and that how very severe cases of such kind of hallucinations and delusions are treated very effectively with Homeopathy  after seeing this video you can decide what to do, for more info mail us at info@drkackerhomeopathy.com or visit us at www.drkackerhomeopathy.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. A transparent fluid releases from my scalp. Is that due to head lice?\n\nHello doctor, I do not know what happened to my scalp. A transparent fluid releases from my scalp and because of this, my scalp becomes hard. I am unable to comb my hair. After scratching it feels like burning. Can this problem arise due to lice in the head? Kindly help.",
    "doctor_response": "Hello. Yes, this is happening due to excessive scratching of the scalp that is rupturing the membrane of the scalp, and thus a white discharge is coming out. Please do not scratch so much. Please wash your hair daily with some anti-lice shampoo or neem water. You may also use some anti-dandruff shampoo also that should be mild because scratching can happen due to dandruff also. Apply Aloe Vera gel on the scalp to give you a soothing effect and heal the injury naturally. You have to keep your scalp clean by washing your hair daily for a few days, and lice will diminish.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Was on birth control for long. Got bleeding during intercourse. Due to birth control?\n\nMy husband and I went off birth control 2 months ago after being on for 7 years. We have not been using protecting but I did get my period last month a week early and this month after 19 days (counting from when the last cycle started) I started to bleed during intercourse but it did not last the entire day. Then a few days later we had sex again and I had a little bleeding after we were done is this something to worry about or is it just my body getting used to being off the pill? (I m 25)",
    "doctor_response": "Hello It is very common after using the birth control for years, to have altered menstrual bleeding on stopping its use, This is because the hormonal effects take time to wear off. However, bleeding after intercourse is definitely not normal. It could point to some local lesion on the cervix I would advise you to go for a check up for post coital bleeding. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could Symbicort be taken for allergy while being on Proventil for bronchial tightness?\n\nI m taking Proventil as needed for bronchial tightness. During allergy season is the worst time. For the past two weeks, I ve needed my inhaler nightly. I told my doctor about this, and he suggesting I go on Symbicort. I am reluctant to do this. What is your opinion?",
    "doctor_response": "HI, thanks for using healthcare magicIf your present medication is not controlling your asthma, it would be best to step up or change it.Uncontrolled asthma is associated with both short term and long term risks ( long term changes to the lungs).If the symbicort will control the asthma, then you should use it. You may not need to be on it permanently.If the asthma is controlled, step down to other medication may be tried.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for persistent dizziness and strong metallic taste in mouth\n\nFor about 3 weeks, and at random times, I get dizzy, have a strong metallic taste in my mouth, feel nauseated and of all things, my teeth will hurt at the same time. As if my jaw line gets tighter. Weird and causes me to stop everything and just lay down.",
    "doctor_response": "Hi welcome to HCM I have gone thru your query regarding dizziness and strong metallic taste in mouth .It is a matter of concern  ,Dear , we face  health problems , due to our faulty food habits and derailed life style . Lack of essential nutrients  - vitamins , minerals , antioxidants  fiber in natural form or accumulation of  toxins in our blood can create health problems , as,  dry mouth, medications, regular  spoiled foods, a mild health condition, such as regular constipation ,  common cold, or a serious condition, such as poisoning or cancer can cause metallic taste in mouth . Deficiency  of Iron (anemia with fatigue and paleness) Zinc  (anorexia, fatigue, diarrhea)  , Copper  (fatigue, paleness) ,Vitamin B2, B3, B6 or B12  (bright red tongue, cracked lips in the corners of the mouth, scaly skin, pernicious anemia, weakness) , all can cause dizziness and strong metallic taste in mouth and affects over all health , dental health also . Our health depends upon physical activity level and  the diet we take.    Strengthening your immune system by Modifying your life style and food habits  is the fist step towards your healthy trouble free life ,  Include essential nutrients  - vitamins , minerals , antioxidants  fiber in natural form  to eradicate  toxins and for proper blood circulation , regular physical activity  is essential for long lasting healthy life .To get rid of metallic taste treat the cause . Sugar-free mint or eucalyptus chewing gum can help mask the metallic taste. Homeopathic Pilocarpine  30 , 2 drops in 3-4 table spoons of water ,3 hourly 3 times .Consult your dr, if problem persists .  She / he  may advise  examination  by a dentist, an ear, nose and throat  specialist, gastroenterologist or neurologist  needed to determine the cause of a metallic taste .Hope this helps solve your query Take care All the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why there is pain in the cut area of my leg?\n\nI cut my leg with a weed eater yesterday - I applied hydrogen peroxide to clean it out and then put neosporin on it. However - tonight it is throbbing with sharp pain. I applied more neosporin, but it doesn t seem to help. It didn t really bleed much, but there is one area that looks like it was cut rather deep. Do you think it is infected or is the pain just part of the healing process?",
    "doctor_response": "HI, thanks for using healthcare magicThe throbbing is part of the inflammatory and healing process, does not necessarily indicate infection.If you do not have a recent history of tetanus injection (within the last 10 years), then you may need to consider having this done.Outside of this injection , the main aspects of treatment would be to keep the area clean using a anti septic and continue applying the antibiotic cream.Signs and symptoms of infection are: increased warmth, tenderness and pain, discharge, increased redness (after the initial stage).I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the nodule found in the kidney?\n\nmy father just had an MRI done and they found a Nodule on his kidney 17mm.  Also his kidney is functioning at 11%.  Please advise if the nodule can be cancerous.  He is 70 years.  We were told by the nephrologist that he is close to getting dialysis.  However, we are also worried about the mass found in the MRI if its cancerous.  Please advise.",
    "doctor_response": "Dear patient,you should refer to an urologist and make sure the radiologist indicate some hypotheses. Nephrologists can be a good reference point, but the recommendations to do just observation or to perform a biopsy or a partial/complete nephrectomy can be made only by the urologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I get pregnant easily after having miscarriages?\n\nhi...doctor, I had 1 abortion due to typhoid, and 2 miscarriages, i had undergone several tests like, chromosome, anto ph..., ATTp and all are normal..can i have my next prgnency without any difficulty.. and why is progestrone taken.. and why is cysyt formed..",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.You can have your next pregnancy. Start taking folic acid 3 months before conception. Get Hb1ac done. When you get pregnant, for first 3 months no relationship with the husband is adviced.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sheetal Agarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for blood in urine with penile pain\n\nThis is pretty embarrassing considering my circumstances, but I have just urinated a small amount of blood. I admittedly masturbate excessively on a daily basis (at least 3 or 4 times a day), could this have caused me to urinate blood even if it was only a small amount? Currently, only the tip of my penis hurts, the rest of it has no pain, so I don t know if I ve damaged my urethra or not. In any case, I am very scared, any help would be much appreciated.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Your local urethra examination should be done in your case. Mild urethral injury can be possible. Second acute urethritis like urinary tract infection can lead such presentation. Urine routine microscopic examination should be done for that. If pus cells and bacteria present than urine culture should be done and antibiotic course prescribed. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headache and double vision in child?\n\nMy son (6 years old) He was sent home from school yesterday. He has a headache, was sick once and is now experiencing double vision. His temperature is 36.8. He's usually bouncing off the walls, but has lay on the couch all day today. Any thoughts on what this could be? We're giving him him plenty water and the odd dose of paracetamol.",
    "doctor_response": "Hi...a 6 year old with double vision should not be ignored. That too a usually active kid is not his usual self and is on the couch all day. This too is a symptom which is a red flag. It could be an intra-cranial lesion due to double vision. I suggest you take him to the his pediatrician or nearest physician or emergency room immediately.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mild lower back pain\n\nI've been having mild/uncomfortable lower back pain since late yesterday night, and at times it can be somewhat nauseating. It fades in and out, and sometimes feels as if my spine my crack or pop or something if I move a certain way that normally wouldn't be so uncomfortable. Should I call my doctor or rest until the pain subsides?",
    "doctor_response": "Dont take any medicine without doctors advise ...but first u can take rest in ur comfortable position its mostly prone line condition and tk prospered rest till doctors advise ..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for blood in stool and loose motion\n\ndear doctor my baba is 1 yr and 1 month old he passes first stool with some red dots of blood and after giving him banana he passes a liquid motion with clear dots of blood what i do now n what i give him for eating? i m a working woman..please help me thanks mother bushra",
    "doctor_response": "Hi,Thanks and welcome to healthcare magic.Your history suggests that he may be having some injury at the anal opening like anal fissure.Better consult your doctor who will advise you properly after examining the anal region.Hope this answer serves your purpose .Please feel free to ask further queries if any.Dr.M.V.Subrahmanyam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why the lower part of my abdomen feel swollen ?\n\nThe lower part of my abdomen feel very swollen. It also feels like the insides of me are very swollen. Not sure if it is intestines or female parts or both.",
    "doctor_response": "Welcome to HCM There are many causes for that. Indigestion,Gaseous problem,over eating,urinary involvement,pelvic inflammatory disease. You have to go for complete investigation like CBC,urine,USG abd to rule out any diagnosis. Consult your physician for further guidance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Am I pregnant with bloating,fuller breasts in spite of regular period?\n\nhi Doctor, i have 28 days cycle and i expect that am pergnant this month.But i got my periods today my 28th day.Is it possible still am pergnant? i had symptoms like morning and after meals i feel acid reflux,mild pinches on my right lower abdomen 3-4 days before ,joints pain 2 days back,sudden increase in my breast size and stomach bloat.Please advise am i pregnant.",
    "doctor_response": "It is highly unlikely but the pregnancy test would show if you are. The blood test is more sensitive.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hyper-pigmentation ?\n\nJust did a routine check and ESR is 40 and i have patches all over my skin and hyperpigmentation on my face and neck. Please what can be the cause Just did a routine check and ESR is 40 and i have patches all over my skin and hyperpigmentation on my face and neck. Please what can be the cause",
    "doctor_response": "Hello joy; welcome to HealthcareMagic The increased ESR can be a sign of many things like all sort of active infection in body;anaemia;tuberculosis;fever etc so it needs to be seen due to what you have it.If there is no infection or you do not suffer any problem may be anaemia can be the reason.Hyperpigmentation of skin is due to exposure to sun and also age related and should not have any relation with the increased ESR. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood and a smelly discharge from scar?\n\nHello. About 5 years ago I had surgery done to remove a perennial abscess/cyst from the cleft of my buttocks right above the anus. There was only thought to be one cyst but when the surgeon removed it they found several others beneath the skin, and while the flesh that was cut away was supposed to be tested, it was discarded by accident. They cut a section of flesh 5 inches long, 1 inch wide, and 1 inch deep. It healed but I have had a tender scar there ever since. Recently I had been experiencing more tenderness than usual and today I realized their was blood and a smelly discharge coming from the scar. I looked in the mirror and it looked like there is a small slit/hole where the scar is. The soonest I can get in to see my doctor is thursday. Another thing is I just went to the hospital two weeks ago because of a cyst on my back that wouldn t pop(I ve had them before) it was a pretty big one and was putting pressure on my spine. It wasn t the first one I ve had on my back, I am very hairy and keep having problems with abbesses. They drained it for me and prescribed me antibiotics. When I was rinsing the wound with salt water like they told me to, some of the water travelled down into the cleft of my buttocks where I had the surgery. Could this be the cause of whats happening to me currently? I just have two more questions, 1. What do you think the problem is? and 2. I just went to the drug store to get bandages to keep it clean and tidy until my doctor appointment, I remember being told to use a product called bactigras when I was healing from my surgery 5 years ago. Is it a good idea to use this again right now to prevent infection and get rid of smelly discharge/bacteria? Any help and input would be greatly appreciated.",
    "doctor_response": "HI, thanks for using healthcare magicIt is likely that you have a recurrent cyst in this area that may also need to be incised and drained.Bactigras is an anti septic dressing that may help to keep the area clean and prevent progression but it would still need assessment.The continued use of an anti septic soap  or cleanser would help to prevent future infections.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying for pregnancy, getting delayed. Semen analysis report says low motility. How to treat it?\n\nHI, I got married and am working in aborad.My wife will be with me for a period of 2 months since she can stay for a short term only with tourist visa.After one year of our married life she got pregnant and happened a mis-carriage of 8 weeks pregnancy. Still we are trying to get her a pregnancy but it s delaying. In my Semen Analysis , the repoort is as follow as Volume : 2.5 ml Viscosity : Increased Conc.(10^6/ml) : 46.5M/ml Motility : 49% Grade of motility : 39% (rapid progressive) 10%(slow progressive) 10%(non-progressive) 41%(immotile) Agglutination: Nil Round cells (10^6/ml): 1 Debris: slight Colour : White Morphology Kruger s strict criteria % Normal : 2 Comments : Asthenoteratozoospermia Total no. of sperm : 116.3 M/ejaculate Total no. of motile sperm : 57 M/ejaculate Total no. of normal motile sperm : 1.14M/ejaculte. Is there any abnormalities found in my semen report. Please give me a brief answer thanks & regards.",
    "doctor_response": "Hello. Thanks for writing to us. Your semen report suggests decreased motility of sperms as well as altered sperm morphology. With only 2% of normal sperms in the semen, conception with natural methods is difficult. You need to consult a urologist for proper treatment. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause and medication for lump on the upper lip?\n\ni have a lump under the skin of my upper lip, i have drain it a few times , but it wont go away. some times when i drain it i can squeeze out a lumb of clotted blood, but it just fills back up. there is not a blister or scab. this has been going on now for about five months.",
    "doctor_response": "HI. This looks to be a small hemangioma or a submucus cyst. . Do not press . Please consult a surgeon and get this excised out under local anesthesia",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could explain bloated stomach and headaches?\n\nlately i have been feeling really bloated, my stomach feels really strange after i eat or even before i eat. i have been going to the restroom constantly, because i have these urges to pee, even if its just a couple drops. sometimes i even have headaches and even feel like throwing up.",
    "doctor_response": "Hi.Thanks fr your query.IT looks that you are suffering from urinary infection and may be you have a infection into the kidneys. This has caused the reflex problems of bloating ...Please get blood , urine .,blood culture and urine tests, ultrasonography to get the proper diagnosis in consultation with the Urologist. Take care , there may be a serious problem hiding within .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for headache and back pain\n\nI ve been having headaches everyday for over a month now. I think I may have a swollen lymph node of the left side of the back of my head. Only for a couple days I ve noticed when I pee it burns and was painful the other day. Today it just burns without even peeing. I ve always had really bad back pain mainly in my lower back. My last two periods have always been really adnormal. Last moth it was a week late and when it came it was really bright red blood and really heavy lasted over 5 days. This month it lasted 2-3 days and was very dark but very little bleeding the whole time. I didn t see any red which is very uncommon for me. I ve also had pains in my lower stomach as if I was on my period but I m not. Today I had a really sharp pain in my lower stomach area and had to bend over it was pretty bad. I m really wondering what this could mean? And if I should see a doctor?",
    "doctor_response": "Hi,1, headache might be due to enlarged painful occiputal lymph node giving headache.This might be due to having some infection on the scalp.2, having pain in the back and abdomen might be due to having acute urinary tract infection.Go for one antibiotic medicine course for 5 days which might cure your both the problems.TaKE PLENTY OF WATER.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hi I'm 24 year old guy.I've been doing kegal and reverse kegal excersices for more than two or three weeks from now. My EQ is good. Is it normal to get precum from morning erections? I'm so worried about precum. It drenches my undies very easily. i'm so worried. Will kegal and Reverse kegal help? Please advise..Thanks in advance",
    "doctor_response": "HiGREETINGS Precum is a normal physiological phenomena indicating your genital system is working perfectly balancing hormones.So  you should not try to stop it .Hope my answer helps you. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does pleural thickening in chest x-ray indicate?\n\ndear doctor during medical checkup (Chest X-ray) report indicates that pleural thickening findings for me, what are reasons for this problem. what type of medicine is advisable for this issue. whether it is curable with short period of time. thanking you",
    "doctor_response": "Hello You have absolutely benign findings.Pleural thickening is generally due to sequel of infection and it is a healed stage.In majority of the cases,it doesn't require any treatment.Decortication(surgical removal of thickening)is required in very few cases.So,this condition doesn't require any medicines because it is not a infective/inflammation condition.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes seizures and irritated behavior problems?\n\nmy son is of 6y and 2 months having cerebral palsy with seizers.He can't speak.his walking is also rough.recentally his doctor shifted him from valporin200 of 7ml-7ml-7ml with clobazam 7.5mg per day TO levipil 2.5ml-2.5ml and clobazam 7.5mg per day. but he still have seizer including irritated behaviour problems. i can't understand why his seizers don't stop.can u suggest me????????????",
    "doctor_response": "HIThanks for using healthcare magicIn cerebral palsy, patients usually have seizure due to underline brain dysfunction. In that case, it is very difficult to control the seizure. Normally in such condition, improvement depends upon drugs combination. May be your son need multiple drugs. Rest, you can discuss with your neurologist. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white patches in groin area and scrotum?\n\nHi, may I answer your health queries right now ?  Please type your query here...i have got small white patches in my groin area and scrotum,these patches are flat, dry and smells bad, when i try to rub and remove them, white powdery substance comes out, after which these patches becomes red and eventually it bleeds. please help. thankyou",
    "doctor_response": "Hello,It could be due to eczema, or psoriasis as well. I suggest you to a dermatological opinion for these lesions. It would be of great help for me if you have shared a picture of your lesions. You need to get tested for above mentioned problems after proper consultation with a dermatologist.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Sameen Bin Naeem, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed for PTB activity\n\nmy husband was diagnosed of PTB activity undetermined his Dr. from his pre-med told him to take 4 capsules of myrin p forte 30 min. before a meal everyday but after taking the capsules for almost 1 month we decided to check another dr. for radiologist and examined his x-rays told us that his ptb is stable and don t have to take treatment is there any possibilities that the 1 month of taking myrin p forte affects his body or triggered the PTB ?",
    "doctor_response": "Thanks for your question on HCM.I can understand your situation and problem.Any lung insult either tuberculosis or pneumonia or trauma after treatment show healing.And healing occur by any of the following mechanisms.1. Fibrosis.2. Calcification.3. Rarely complete resolution.Fibrosis and calcification are ore common and produce scar tissue which is visible on chest x ray.So your husband's previous x ray may showed old fibrotic lesion. In this scenario activity of lesion is determined by sputum examination for AFB. So for your current situation I advice you to consult pulmonologist and get done1. CT thorax2. Sputum examination for AFB3. Bronchoscopy and BAL (Bronchoalveolar lavage) analysis for TB.CT gives much better idea about fibrotic lesion than chest x ray.BAL is far superior than sputum in detecting AFB.If all are negative than no need to worry for tuberculosis. The lesions on chest x ray are just inactive scar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat hair loss?\n\nI am suffering from alopecia areata.Today I discovered my hair loss, there is a small tiny round patch at lower back of the head with shinny skin. At home my family member adviced me and applied ginger on the patch, is it okay?Please do something. Reccomed me what to do? I don t want it to spread.And say please how fast the hair will regrow.",
    "doctor_response": "Hello dear,The symptoms & case history mentioned in your post suggest that you might be having Androgenetic alopecia.Also known as Male pattern baldness, it usually follows a pattern of receding hairline & is related to genetic makeup and male sex hormones.Management includes:1. Minoxidil preparation to be applied directly to the scalp to stimulate the hair follicles.2. Finasteride preparations that interferes with the production of male hormone linked to baldness.But these medications have to be used regularly under the guidance of a Dermatologist...as hair loss tends to return on stoppage of these medications.So...it will be better to consult a Dermatologist & start treatment.Wishing you a Good Health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for restless leg syndrome\n\nHello, I am tring to find a solution for restless less syndrom. I am currently taking 75 mg twice a day and have just been started on Lorazapan 0.5 mg 3 times a eay, not sure why, I still have restless legs like crazy! Is there are solution that will really help with restless legs?",
    "doctor_response": "Hello Several prescription medications, most of which were developed to treat other diseases, are available to reduce the restlessness in your legs. These include,  Drugs like, ropinirole are approved by the Food and Drug Administration for the treatment of moderate to severe RLS.gabapentin, may work for some people with RLS.Narcotic medications can relieve mild to severe symptoms, but they may be addicting if used in high doses.The combination medicine oxycodone and acetaminophen .Some lifestyle modification are useful for restless leg syndrome like,Sleep better by sticking to a regular sleep schedule.\u00a0 Exercise\u00a0in moderation.\u00a0.Cut back on caffeine.\u00a0.Avoid alcohol and cigarettes.\u00a0 Consider dietary supplements.\u00a0Check with a doctor or nutritionist to find out if you\u2019re low on iron, vitamin B, folic acid, or magnesium. Deficiencies can bring on RLS.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a patch of bumpy rashes on my left breast. Is it breast cancer?\n\nHello doctor, I am a female, who weighs 158 lbs and 5.9 feet tall. I feel that my strength\u00a0is declining, and I have itchiness and hot sensation across my breasts, neck, and torso. I also had a bumpy rash patch surfaced on my left breast several days ago. This rash has not gone away, and it looks like the texture of the orange peel and is yellow and red. Severe fatigue is affecting my daily activities.\u00a0I am worried it might be inflammatory breast cancer. I also have a swelling and sensitivity in that breast area.",
    "doctor_response": "Hi. Revert with more information to an endocrinologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What precautions should be taken for skin psoriasis ?\n\nhi i have psoriasis of skin ...which increases when i go to cities with hot and humid conditions...now i have a job offer in such a city for 2 yrs.wt do i do?",
    "doctor_response": "Hi...dear Dr.Rohit..., Thanks for choosing HCM.., Just U follow below the  instructions carefully.., 1) Get some sun. Natural sunlight has been shown to sigificantly improve, or clear, psoriasis. Get regular daily doses, but keep them short and avoid the sun from 10 a.m. to 2 p.m., when the rays are strongest. 2) Add over-the-counter tar solutions, bath oil, oatmeal, Epsom salts and Dead Sea salts to your bath. All of these will help soften the skin. 3) Use moisturizers after bathing and periodically during the day. These may not clear the psoriasis, but will help reduce itching and retain moisture in the skin. 4) Try using aloe vera gel, jojoba oil, vitamin E oil or natural vegetable oils as moisturizers. They are a natural and relatively inexpensive way to moisturize the skin. 5)  Take flaxseed oil or evening primrose oil according to directions on label. They supply essential fatty acids which are important for the skin and preventing dryness. 6) Take natural beta-carotene, 25,000 IU per day. It helps protect skin tissue. 7) Take zinc, preferably in the form of zinc gluconate lozenges..., for maximum absorption. Do not exceed 50 mg per day 8) Try shark cartilage. Take 1 gm per 15 lbs of body weight. Divide it into 3 doses a day. Shark cartilage has been known to stop the spread of psoriasis, but you will need to give it 2 to 3 months to see results. 9) Take vitamins A (10,000 IU daily) and E (400-1200 IU daily). 10)  Take Vitamin C (2,000 to 5,000 mg a day) in divided doses. It is necessary for immune system function and for formation of collagen and skin tissue. 11) Brush scales lightly with a loofah, then apply an alcohol-free extract of the herb goldenseal..., This will help reduce inflammation and swelling. 12)  Keep a record of your outbreaks. Psoriasis typically flares up and then improves. Write down what you were doing, eating, or what was going on in your life at the time of a flare-up. Triggers to flare-ups include stress, tension, illness, sunburn, certain drugs and alcohol. 13)  Decrease or eliminate red meat and dairy products. They contain arachidonic acid, a substance that can cause inflammation and, in turn, make your psoriasis lesions swollen and red..., Ok..good luck...,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Numbness in feet and hands. Brain MRI had abnormal nervous response\n\nI have had numbness in feet and hands during 4 months, lot of labs exams and my doctor can not find antthing abnormal in the results, last exam i had was a brain mri, i wouls like to know based in these syntoms what could be the most probably diagnostc, also based in other exam he did with some electric shots he told me he detected somthing abnormal in my nervous responses , that is why i had the mri, but i do not have results for it yet",
    "doctor_response": "HIThank for asking to HCMIt may be everything okay it is just your worry for such nonspecific complain that you have experiencing it you have to neglect such feeling otherwise this may cause mental disturbances I would advise you to go for relaxation therapy this will definitely help you a lot keep your stress level very much low every thing will be alright have great life bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the foot pain and numbness be due to lyme disease?\n\nI have been having a lot pain in my right foot (big toe) area and at first it hurt to touch, can not wear a sock or shoe. My family DR has ruled out gout. but now the pain has moved a crossed my foot and now my foot goes numb to the touch and I also have numbness to my arms and lower neck. A friend asked me if I had been tested for lyme disease. could that be a possibility?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you are wondering if foot pain and numbness be due to lyme disease. Well the symptoms you mention in query can occur due to may reasons like achilles tendinitis , bone spurs , bunions , bursitis , corns and calluses , diabetic neuropathy , gout or plantar fasciitis . Lyme disease can cause joint pain , for that you can go  for Western blot test  and ELISA test . I would suggest you to consult podiatrist for proper diagnosis and treatment . Podiatrist may recommend supportive footwear such as sneakers , arch supports , metatarsal pads , shock absorbing shoe insoles and inserts and orthotics . For now give proper rest to your feet and put your feet in hot water tub with one spoon of salt daily at least for 15 minutes . You can also take ibuprofen or acetaminophen for pain . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat eczema rashes on the face and body despite using steroid cream?\n\nhi my son (11yrs) woke up Tuesday morning with an itchy red rash on his cheek. by the end of the day, the rash had spread slightly to his forehead, ear, neck, chest and inside elbow crease of one arm. the day before, he said he felt like he was coming down with a cold. about 6 monts ago, the same thing happened - brought him to pediatrician, was told it was most likely eczema, and they gave us a topical steroid cream. after a week, I brought him to dermatologist - said the same, but she gave us a 2.5% hydrocortisone cream (said the steroid is too strong for his face don t use it). anyway - so back to current day, i m assuming its a flare up of this eczema rash again. today, the rash is even worse, his cheek & one ear is swollen and hot. there are little patches of the rash on other parts of his body, stomach & legs in addition to the others I ve listed already. none of them are as bad as his face and ear, yet. I guess my question is, does this sound like eczema? can eczema cause swelling and be warm to the touch? I called the dermatologist, but of course its my luck they are closed until Tuesday for Labor Day holiday.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I am indeed sorry that you haven't been able to get urgent attention for your son. It is now over a month since you asked this question. If you are still interested in knowing what to do, I will offer a reply. Yes, this is eczema, and it should be treated with moisturizers, and if necessary, steroids applied topically. The child may also need an antihistaminic to reduce itching and the rash. This last medicine would need to be used orally (by mouth). Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can psychiatrist help in improving concentration and urge to skip studies?\n\nhello i am leonard.....i need help regarding my studies......i fell the syllabus as a mountain and try to pass time with t.v and sleep excessively....sometimes even though i try to say myself\"be it a mountain...lets go day by day..\" but after studying for an hour or so...i feel tired sometime...some days i have an irrestible desire to watch tv.....as days past i fail in the exams and just get further sad.....this is happening over the past two years....just thought i may feel better if i talk to a psychiatrist",
    "doctor_response": "Hi, thanks for asking. In my opinion you should see a psychiatrist as he will be able to assess and diagnose your condition and then be able to help. He will also be able to rule out attention deficit disorder for you. Also you may need cognitive behavioural therapy for your problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can anxiety and depression be treated?\n\nI m having some anxiety and depression from the past month. I recently broke up with my girlfriend. I always thought that she is the one and I still think that i lost her forever. Maybe this is not the only thing that keeps me worried. I am always worried about my family, because everyone has anger problems and anything can happen. I want to leave my family, stay alone, and i thought would marry my girlfriend after some years. I am stuck. I always feel like im in a box.",
    "doctor_response": "hi sirin my opinion, presently your entering into depressive episode. your separation with your girl friend was the main stressor for you at present. as your unable to cope up with that stress, your slowly entering into depression. Because of that, your having those feelings of being sad and lonely features. if you neglect it, slowly you enter into severe depression. So, i strongly recommend you to consult a psychiatrist. Mostly cognitive behavioral therapy is sufficient at this stage. If needed, anti-depressant medications can also be prescribed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rashes on leg\n\nI have a rash on my right front leg that was originally diagnosed as contact dermatitis . I have been to 4 different physicians and no one knows what it is. A C&S came out negative except regular Skin flora. I also have been to Loma Linda Univ hospital.The most definite answer I got was from a Dermatologist who said it was complex and gave me Clobinex that turned into chemical burn. The other was Fluocinonide which I can t use ,because it is exteremly painful.In the meantime my whole leg is hurting .Please,forgive mistakes.I m upset and this IS ruining all aspects of peaceful living .Ask me any questions.ThankI m sorry,but I do not have a credit card availoable until later tonight.I just discovered it",
    "doctor_response": "Hi Dear,Understanding your concern. As per your query you have symptoms of rashes on the leg which is very common due to hair follicle infection, sun poisoning and as dirt and moisture get trapped by your clothing and the friction that comes from sitting.Need not to worry. I would suggest you to keep this area clean and dry. You should apply warm compresses with soaked towel and apply vitamin C serum at night. If condition doesn't get better then consult dermatologist for proper examination. Doctor will examine physically along with blood test and sample for lab test. Doctor may prescribe immunosuppressants and may prescribe benzoyl peroxide ointment. Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe joint pain in the arms, shoulder and hips?\n\nHi. Lately (maybe for the last year or so), I have had had some joint pain. My wrists, elbow joints, shoulders, my neck, my knees, my ankles... Even my fingers. And in the last month, the pain has also made an appearance in my hips. In addition, the pain seems to be getting worse as time progresses. I d say from a 5 to a 7 from a month or 2 ago til now. Any idea what might be going on with me?",
    "doctor_response": "Hello,You may be developing some form of inflammatory arthritis like rheumatoid arthritis. You need to see a doctor for an evaluation and treatment.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking minocycline for acne. Medicine not available. Changed to vabramycine. Any effect by changing antibiotics?\n\nhi i was taking minocycline for acne for 25 days but after that i discovered that the medicine is finished and i didn t find it in pharmacies so i decided to continue with vebramycine so this can affect my case or no problem to shift between these antibiotic specially that they are under the same tree of tetracycline Thanks",
    "doctor_response": "Hi Shaheen, Welcome to Health Care Magic, For treatment of acne you can take any of Tetracycline, Doxycycline and minocycline antibiotic group. You can also switch from one to another of them but when it is unavoidable. So according to me you can change it. With regards. Dr. M Mostaque Mahmud, Dhaka, Bangladesh,(drmstq@yahoo.com)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart palpitations with dizziness?\n\nHello I'm 47 years old and I've been on a weight loss regimen for a year, I lost 60lbs from my highest weight of 300lbs. I've been walking on a daily basis for an 1 1/2 daily. I have just been cutting back on my food intake less bread and sugar foods. I do drink a veggie and fruit smoothie every morning. I'm eating much healthier.  I feel like I am taking care of myself more. My problem is that I have been experiencing dizziness and almost on a daily basis light headed. And I also feel heart palpitations. It scares me.",
    "doctor_response": "Hidear get your blood pressure, serum sodium and potassium levels monitored , all of them are responsible for maintaing bp to normal,stop dieting take regular food , eat high salt food and drink plenty of water, keep a record of you blood pressure every 2 nd day for 10 days if not relieved2d echo test would be done to rule out cardiac ejection fraction thankshowever you case is electrolyte disbalance",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain, front groin pain, heavy bleeding in lumps. What is the cure?\n\nI am Leena, My friend is 45 yrs old. She carried very heavy sacks of 50/ 20 kgs and had tremedous back pain and front groin pain and heavy bleeding (in lumps ). She has been getting periods also continously. Her pain si trenedous for the last 4 days. She gets fever and cannot eat anything. Is it an emergency? SHe did go to the Doctor , he gave her an injection but it did not work on her. Her pain is unbearable. Awaiting your quick reply.",
    "doctor_response": "Hello. Thanks for writing to us. The unbearable pain and a heavy bleeding with clots needs an immediate treatment. After carrying heavy loads, there could be a disc problem but the bleeding is more likely to be due to a hormonal problem. You can take her to ER. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of hysterectomy surgery?\n\nI just had hysterctomy surgery yesterday, I still have my ovaries. While I was in the hospital, I was on a morphine pump and now that I m home, my skin is red like a mild sunburn and a little warm to the touch. What could this be? Is it a normal side effect of the surgery?",
    "doctor_response": "Hello dearUnderstand your concern.Following are the side effects of the hysterectomy:It produce surgical menopause lead all the symptoms of menopause may occur like vaginal dryness, bone pain, mood swings, dryness of skin, hot flash, depressionDisturbance in sex life/loss of libidoBladder damage during operation also produce urinary incontinenceHope this may help youBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is there any permanent treatment for toothache related to broken decayed tooth?\n\nHello doctor, For the past two months, I have had on and off toothache. My gum sometimes hurt. There is a decay where I had broken a tooth and it has just chipped away over the years, is sore as well. I have been taking a lot of Ibuprofen. Is my life going to be in possible jeopardy?",
    "doctor_response": "Hi. If you are not allergic to following medicines, immediately start taking it. Tablet Augmentin 625 mg twice a day for five days, tablet Metronidazole 400 mg twice a day for five days, tablet Brufen 400 mg thrice a day for five days. This will cover your infection. After this, give me followup after three days if you are having improvement. Moreover, for a home remedy, you can put a clove in that place. It is very helpful in releasing toothache or put some clove oil on small cotton and roll it and put it on decayed part of the tooth. But ultimately you have to visit the dentist and get this broken tooth extracted.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have metastatic cancer of uterus. Is morphine taking away will to live?\n\nI believe a cancer patient going into a hospice and heavily using morphine is more likely to lose the will to live. I know of a 65 year old cancer patient with metastatic cancer of the uterus who told me she definitely wanted to live but was going to use hospice to be more comfortable in her quest for a mind-body immunotheraputic healing. Prior to the hospice she had started to use the mind-body approach to revitalize the immune system to heal the cancer. Now after starting the hospice she seems to have lost interest in following through with this approach. Could it be the \"lalaland\" effect of the morphine taking away her will to live? What are your thoughts along these lines.",
    "doctor_response": "Hi, Morphine is needed very often in treating the cancer pain and there are definite indication and definite way to prescribe this drug. Depression is a common problem in cancer patients. There are many causes but morphine probably has no role in depression. Proper counselling is necessary at this stage, specialist onco-psychiatrist opinion to be taken.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can any online doctor help me with the following results?\n\nhi i have had an ultrasound on my ankle and the conclusion was tenosynovitis peroneal tendon with full thickness tear anterior talofibular ligament associated with large joint effusion.I am not sure how bad this is are you able to give me some answers to what might happen next.",
    "doctor_response": "Hello, As this indicates that you have a joint instability and ligament is already torn. I will advise you to stabilize the ankle Frist so by which you won't be allowing the joint to become more unstable. Using crepe bandage or ankle brace is advised. Also, if left without stabilizing then the joint may undergo faster degenerative changes and lead to Osteoarthritis. So better to stabilize. Later you can take help of a Physiotherapist who can help you with ankle stabilization exercises since the ligament is torn and now muscles have to take up the role to stabilize the ankle joint. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp stabbing and random twinges of pain in lower abdomen?\n\nI have brief sharp stabbing pain and random twinges of pain on the right side lower part of my abdomen and I would like to know what the most likely causes are. They said there are no ovarian cysts on the right side what else could it be? The symptoms don t really fall under the stereotypical appendicitis category. Help?",
    "doctor_response": "Hi. Read and understood that you have pain in the right lower abdomen. They have ruled out ovarian cysts and you don't feel it to be classical appendicitis. The causes can be :Colitis meaning inflation of the large bowel. Typhlitis of cecum Lymph node mass Irritable bowel syndrome Right Ureteric stone or so Atypical appendicitis due to odd position. It looks that you have undergone Ultrasonography, it does not show many of the problems I mentioned, hence yes need of contrast enhanced CT scan of the whole abdomen. And also needed are proper investigations of blood, urine and stool as guided by a general surgeon after clinical evaluation. This way a proper diagnosis will be made and a curative treatment done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to treat recurrent ringworm infections?\n\nHi doctor, I had\u00a0ringworm infection and itching from many days.\u00a0When I used Terbinafine cream and tablet along with Cefadroxil tablet for 20 to 30 days,\u00a0the ringworm and itching totally disappeared. But after a month, it started automatically. What to do?",
    "doctor_response": "Hello. I can see your ringworm infection has reoccurred. There might be some sources from which you are acquiring the infection.There are few minor precautions which you need to take as follows. For more information consult a homeopathic physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "My mother in law with colon cancer. Could this be caused by liver failure ?\n\nMy mother in law has colon cance. It has spread to the kidneys and liver. She went to the cleveland clinic and they are trying to figure out chemos for her. My question is, her lower poart of her legs, feet and ankles are swelling. Could this be caused by liver failure ?",
    "doctor_response": "hello, sweiing is called oedema. It is due to fluid accumulation. Can be due to kidney, liver or heart disease. I would advise you to get a renal function test and a ultrasound of the abdomen. It wil help to know if the mets have migrated elsewhere. Also get a liverfunction test to know the status of her liver. I hope i have answered your query. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bruising in leg after being sting by a red wasp\n\nI was stung on my ankle by a red wasp 6 days ago and immediately I started to swell. Two days after the sting it was swollen so bad I thought it would pop. From day one I took benadryl and aleve. I finally went to ER and was given a t-shot and put on antibiotics. This is my third day on meds. Where the venom traveled in my ankle and up my leg looks bruised and is tender along with a deep itch. Is the bruising normal and wl it go away?",
    "doctor_response": "Hello, Thanks for writing to HCM.It is unfortunate that you got stung by red wasp. Also, from your description, it appears that you have initiated treatment partially for the local reaction you are getting. The following things can be done.1. Wash the sting area with mild soap and water to remove as much of the venom as possible. 2. Apply a cold pack to the wound site to reduce swelling and pain. 3. Keep the wound clean and dry to prevent infection. 4. Use hydrocortisone cream or calamine lotion on the site for itching5. Take Tablet.Cetrizine 10mg once a day for 5 days to control itch6. Take Tablet. Ibuprofen 400mg twice a day after food for 5 days.Continue with medications what you are taking. You should get better in about 3 to 5 days. Wish you good health and speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Took prednisone for asthma, now on augmentin for sinus infection. Painful bruising in thigh. Any side effect ?\n\nHello, I am concerned... Beginning in December, had a respitory infection, took amox. 3 times a day..got better. Then developed severe asthma . Got a breathing treatment, inahlers and prednisone . I just finished the prednisone for severe asthma. Then got a bad sinus infection . I am now taking augmentin . Yesterday I noticed random (6) bruising on my right thigh and it aches a bit. I m wondering if this is from the medication and should I be concerned. The asthma is semi controlled, the sinus infection is clear, except for soreness in my lower jaw bones.",
    "doctor_response": "Your symptoms are related to the throat congestion ans asthma. For asthma control use regular nebulization either with normal saline or in combination with bronchodilator such as salbutamol. Use nebulization till your symptoms are over once a day for 03 to 05 minutes. Also use a drug labelled as leukotriene receptor antagonist named as montelukast for astma as twice daily dose. Also take Brufen for burning in the jaws as it may be related to seasonal change and sinusitis. I hope I am sucessful in solving your query If u have further you can ask me Get well soon Take care Regards, Dr. Azhar Sattar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What would be the reason of swelling in gum after root canal?\n\ni just had a root canal on a lower right molar on monday and now my gum/ cheek is swollen. Not sure if its my salivary gland or re infection. Ive taken emycin, clindamycin and i am now on zithromax. Getting frustrated with my dentist because they dont seem to know what it may be??",
    "doctor_response": "thanks for your query, the pain in the gums and swelling over the cheek could be because of tooth infection leading to pus formation and spreading into tissue spaces. take some radiographs like IOPAR and OPG to rule out pathologies in the adjacent teeth and any defect in the root canal treated teeth. the antibiotics what you are taking is sufficient to bring down the infection...do saline gargling. consult a oral physician for opinion and needful.. i hope my answer will help you take care..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for swollen penis?\n\nHi, may I answer your health queries right now ?  Please type your query here...My bf was kicked in the testicals about 2 yrs ago iv benn wif him for a yr n a half he got kicked that hard his penis swell right up to about 3inches longer than wat it is originaly now wen we have sex he has to rely on tkin sex pills fm the internet wud this prevent me fm gettin pregant",
    "doctor_response": "Hello,Maybe trauma may can cause local testicular damage. Once you get it done ultrasound scrotum and semen analysis. Then check weather his penetration is adequate or not.If above things are normal means there's is no doubt to became pregnant. But excessive using of pills may not good for health please consult your physician he will examine and treat you accordingly.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have diarrhea, digestion issues, allergies. Scheduled allergy test. What can be done?\n\nI am trying to get some help from my doctors here in NW AR       They say I have a malabsobtion but not interested in going any farther with my diagnosis, saying I can take allergy tests on every vegetable and fruit to see if I'm allergic to it.   I have not taken allergy testing but have tried to entroduce each food so I can see if I'm affected.   So far I can tolerate tomatoes and potatoes and plain meat.   I can eat rice and can eat dill pickles.   Can't tolerate any of the fruits or any dairy products.      I'm on medicare and they don't want me to go out of state to be tested.    Is there anything else I can do,  I'm still having diarrhea constantly and cant trust my digestion to do anything?",
    "doctor_response": "inflammatorybowel diseases and gluten enteropathy should be ruled out.For gluten enteropathy,avoid wheat in the diet.Symptomatic treatment like bowel binding agents may be used for a short period.Foods that are intolerent,are avoided.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause small nodules on the knee cap?\n\nI keep finding bean sized up to peas sized hard nodules on my left knee cap and tendon area. It s only the left. They don t hurt. U can t see them, but I feel them. They don t really move but do seem a slight bit pliable in location. This started showing up after repairs to my patella from motorcycle accident a few years ago",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. These nodules could be lipomas in the subcutaneous tissues. To be on the safer side, I would like to remove one of the swelling and have a biopsy. If it does turn out to be a lipoma, then nothing further is required. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. 2. 5 year old suffering from stomach ache. Which medicine has to be given?\n\nHi doctor, My son is 2.5 years old. For a week, he is complaining of stomach pain. After farting he is fine. Our family doctor recommended one antibiotic for five days and a medicine to avoid vomiting. He had small vomits twice, but later it was fine. Now, after completing the course of medicine he again complaints the same. His diet is almost nothing and he is not ready to take any food. He just has few mL of milk. He does not have fever. His stool was watery, but it is normal now. Can you provide any recommendation on diet and medicine? Please give me a solution to the problem. Thank you.",
    "doctor_response": "Hi. I can understand your concerns. Complain of abdomen pain with vomiting suggests that your child probably has acute gastroenteritis or food poisoning. Since, antibiotic is already given and now there are no loose stools or vomiting, there is no need to give antibiotic again. For abdomen pain, you can give syrup Cyclopam (Dicyclomine hydrochloride and Paracetamol) 5 mL on SOS basis (as and when required) that is when abdomen pain occurs. Whenever a child becomes sick, there is decrease in his appetite which improves as child recovers. Now, you should give him all the foods that you were giving him earlier. If he is not eating then you can start Glucon-D in water thrice a day for one or two days. Start a multivitamin like syrup Bevon 5 mL once a day for 15 days. Keep patience. Child will eat properly now as he has recovered from illness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had unprotected sex, had bleeding. On alesse, missed pill. Why did it happen?\n\nI'm currently on alesse, today is Friday I missed taking the pill last Saturday and Sunday (first week of the pack, I start my packs on Mondays). I took two pills Monday and two Tuesday. I did bleed for a day or so. I've had unprotected sex multiple times during the week and twice where he finished in me. When is the earliest I can get a pregnancy test? And should I be worried even if I get a regular withdrawal bleeding?",
    "doctor_response": "Hellothanks for your query.The earliest you can take a pregnancy test is when you miss your normal period, the one you had before starting the current pack, count 30 days from then, and if you do not have your period by then, take a pregnancy test.even if you get a regular withdrawal bleed, pregnancy is not ruled out.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could discomfort tin elbows during pregnancy suggest?\n\nMy daughter is 23 weeks pregnant. Last night she experienced intense discomfort in her elbow joint, wrist, and armpit of one arm. It was so uncomfortable she couldn t sleep. No other symptoms but scratchy throat. Any idea what would cause this pain? Would a warm cloth help ease it for her if it happens again. The wrist & elbow pain are better, but the armpit discomfort continues.",
    "doctor_response": "Hi.Armpit discomfort could be due to a hormonal fluctuation resulting from pregnancy, as the lymph nodes leading to the breast lie in the armpit region. There is nothing much we can do about that and I am sure it will subside soon. And yes, you can use a warm pack or compress over the region.As for the scratchy throat, if she develops a fever along with that then please report to her doctor.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a red rash on the legs\n\nfrom one week i have suffaring from some kinds of rash in my legs its like some redish and pain around it I have taken wyeth (medicine) as droctor prescribed but its not clear and wghenever i used cold water for bath in morning this symtomps come back..(as my assumption) could you please help me!",
    "doctor_response": "Hello,Thank you for posting on HCM.The condition you have referred to is called Urticaria or hives. Its an allergic manifestation of skin, where an allergen leads to release of certain substances from your blood, leading to itchy skin rash and swelling over soft tissues. Its proper management requires thorough history, clinical and laboratory work-up.You may have to go for specific tests like patch test, food prick test, IgE antibody levels etc. As for treatment part, best would be the avoidance of allergen as far as possible. Try to eliminate possible triggering foods from diet. I would also advise you various anti-histaminics for long duration( atleast 3 months) with or without oral corticosteroids. For non- responding cases there are many other drugs like dapsone, cyclosporine, montelukast, omalizumab etc which can be used in certain selected cases. Hope this will help you in resolving your query.Thank you Dr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI shows degenerative changes in L5-S1, annular disc bulging. Painful. Treatment?\n\nhi, I m 35 yo male, I feel severe pain since the past one month & consulted my physician, taken MRI of LS spine states Degenerative changes in L5-S1 with central & left posterolateral protrusion of L5-S1 compressing thecal sac & narrowing left lateral recess & neural foramina. Also shows mild diffuse annular disc bulging of L4-L5, indicates bilateral neural foramina. Kindly advise me what is the remidy, which type of treatment will help me?",
    "doctor_response": "Dear friend, welcome to HCM. you have slipped discs in the lower spine. those probably are causing pressure on your nerves and hence the pain. pl. see a spine surgeon to evaluate if conservative treatment would help or surgery is must. nowa days minimally invasive spine surgeries can be safely and effectively done at good centres. Take care and pl. keep me posted on your progress.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever in a child?\n\nMy son was 4 years old and he was sick (fever) for the past 6 days. During the day time his temp. was normal, but in the evening after 6 pm the temp. was around 100 to 101. He given the blood and urine samples yet to receive the report. Can I know why he was having this kind of temp.",
    "doctor_response": "Thank you for asking query.First of all i would like to know some history.What is the weight of child?Is Fever associated with rigors?Any other complaints like cough,vomitting?There can be many causes for fever like infections-malaria,typhoid,denguebut if you tell detail history i will be able to conclude.Hope you find this helpful.Rate the above answer if you like it.Regards,Dr rushikesh kute",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could pain and semi-clear discharge secretion indicate, Ciprofloxacin offered little relief?\n\nHi, after a warm shower, there is a slight burning pain about an inch from the tip or head inside. At this time a small amount of semi clear discharge can be squeezed out. The pain in only a brief couple of secs. Just finished a 7day bout of cipfroflaxon. Not much help. Your opinion is welcomed.",
    "doctor_response": "Dear FriendWelcome to Health care magic. I am Dr Anshul Varshney , I will shortly try to help you with my opinion.In this case you should see if you had any unprotected sexual intercourse that is high risk.I would suggest you:1. Pus culture2. VDRL3. HIVIf this is infective then antibiotic like Augmentin would help.Based on the available details, this is my best advice for you. You should discuss with your doctor and share my opinion, I am sure he/she will agree to my opinion. If you wish to discuss the problem further , you may please  ask.Stay Healthy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in chest when pressure is applied?\n\nhello doctor, myself Darshan, persuing my final yr BE. from past three days am experiencing pain near my left chest. when i touch the left chest i can make out the pain persist and after lunch it pains a lott.! when it pains i cannot breathe properly.! i mean when i inhale it pricks.! please help.",
    "doctor_response": "Hello dear  Darshan , hiWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .*  This pain seems to be in relation with gastritis  with acid reflux and     manifestation  from  underlying  stress or  anxiety .Hope this  will help  to clear your doubt   .Wishing you fine recovery .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is headache a side-effect of Nevanac ophthalmic suspension?\n\nHello doctor, I am 37 years old. I have discomfort and mild pain in the right eye since last four days. The doctor has advised taking Nevanac ophthalmic suspension 0.1 suspension, and Maxmoist eye drops for dry eye. He has advised to take Nevanac one drop four times daily in both eyes, and Maxmoist eye drops only in right eye one drop four times a day. But after using Nevanac suspension I feel pain in my left eye which was not before. I have headache after using this suspension. Is it the side effects of Nevanac suspension? Should I discontinue Nevanac? I have myopia. My power is -3.75 in left eye and -2.75 in the right eye. I have myopia since 20 years.",
    "doctor_response": "Hello. No, Nevanac (Nepafenac) does not have such side effects. But, I suggest you reduce the frequency of Nevanac to twice daily after 15 days and then to once at bedtime after next 15 days. You said you are wearing -2.75 in the right and -3.75 in left. This is a spherical error but your prescription shows that along with spherical error you have a cylindrical error too. -0.50 at 60 degrees in right and -0.50 at 14 degrees in left. If that is not incorporated in your glasses please include it because not using cylindrical power along with spherical can cause a headache. If Nevanac does not work in next three to four days you can try Tobramycin plus Fluorometholone eye drop twice daily for seven days. Do not use it for more than seven days. Also, get yourself checked for any near vision error, that is presbyopia. For more information consult an eye care ophthalmologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Weight gain, excessive hunger. Taking Krimson. Side effect? Will weight loss help in conception?\n\nHi I am taking krimson 35 tablets as suggested by my gyanc. But I can feel a lot of hunger pangs and have put on a lot of weight in the last 2 months. Wanted to know if this is a side effect of the medicine? I am 5 2 and my weight is 62. I have been told to actually loose about 6 kgs to increase the chances of conception while this treatment is working on the opposite. Please help !",
    "doctor_response": "Weight loss helps by letting your hormones work in a better way rathe just being concentrated in the fat.krimson 35 doesn't make you gain much weight.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes foul smelling stools in infants?\n\ntoddler at daycare has really strong smelling foul stools that s hard to wipe off his bottom. It actually causes me to have dry heaves or vomit it s so horrible smelling. Any idea what is causing this? I can t stand changing his dirty diapers due to the immediate reaction I have upon smelling his feces.",
    "doctor_response": "Hi,I  can understand your concerns. Foul smelling stools in a child is most commonly due to stomach infection. in most cases, there are also chances of loose stools. I suggest you to get the child examined by doctor. Child will probably need antibiotic. I hope this will help you. Let me know if I can assist you further. Wishing your child good health.  Take care.Regards,Dr. Deepak Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and pain in my toe?\n\nI was bitten on my second toe after my big toe by what appeared to be a bed bug very early yesterday morning. Today my toe is swollen and painful and throbbing, especially around the cuticle. Is there anything I can do to ease the swelling and pain? I have my fooy elevated now but even that hurts from the pressure.",
    "doctor_response": "Thanks for asking in Healthcaremagic ForumIn Short: You have inflammation of your toe due to bite.Explanation: As you had bed bug bite, it is the inflammation caused due to bed bug bite. So you can take anti-inflammatory drugs for relief. It is also advisable to have antibiotics to prevent infection from bite.                 So, consult your doctor before taking antibiotics, as it is a prescription medication.For time being you can apply oint betadine locally.                 Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have smear semen when aroused?\n\nhi pls i want to know if its is normal or abnormal to have smear semen from my penis when i am aroused but without intercourse. it happens to me most of the times that when i think of having sex and could not, after shrinking in of my penis, semen is smeared. pls advice me if it is normal or not",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you are getting watery discharge from penis on arousal.Watery discharge that you get on arousal is a secretion of the Bulbourethral glans located in urethra which get stimulated on arousal and secrete a mucus secretion which acts as a lubricant to help in passage of a thick semen during ejaculation.Do not worry this is a normal phenomenon Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can hital hernia effect second pregnancy?\n\nhello sir, i have a sliding hital hernia and it s detected after delivery. some time my stomoch comes up that time i feel uneasy. when it comes up then,while talking i feld difficult and feels like something is streching at my throat.after detecting hital hernia sometime when i suddenly standup,my bone is twisted which is under the left site of chest.will u pl tell me is it because of hital hernia or any other reason?and my weight is also increasing,so which excersises should i do for reducing my weight. because of hital hernia there r restrictions on excersises so please suggest me excercises to reducing weight.we r planning for second baby but getting too scared what will happened...so pl suggest me for that...thanks",
    "doctor_response": "Hi.Don't worry. Hiatus hernia requires more of a religiously regimen which will include restrictions from certain foods and drinks, a dietary regimen, eating smaller meals more often, avoid overeating, drink plenty of water, etc.As for exercises, I would recommend only cardio exercises and choosing between all the cardio exercises, the ones you are most comfortable with. Write to me for an elaborate discussion using our paid service.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have pain in the right side jaw while having food. Why?\n\nHello doctor, My right side jaw is paining while having food. On consultation, I was advised for physiotherapy. What could be the reason for it?",
    "doctor_response": "Hello. There might be several issues expected, 1. As you mentioned if there is only jawline problem, then you should have physiotherapy and warm massage at TM joints (tempero mandibular) at the junction of the ear when you open your mouth, it can be felt quickly. Do warm massage for 10 days, twice a day this will relieve symptoms definitely if it is because of the joint. Try not to yawn or open your mouth big, do eat with a spoon, do not have rice with hand. These will relieve jaw pain. 2. If the symptoms do not get better with massage and exercise, and you are having pain in some tooth, then you might be having some infection in the tooth that needs root canal treatment or extraction. If you can provide me with OPG X-ray of your jaw, I can tell you the exact diagnosis and the treatment plan. Tell me about symptoms as well, do you feel more pain at night as compared to day time? Are you feeling hot and cold sensations? Tell me details so I could figure out the root cause of your pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain , abdominal cramps and fever?\n\ni had three test for sugar in last 18 month with last being done 4 months ago. Result for all of them was 4.8. I had another test a week ago. My result was 6.2. I had back pain, light fever, and abdominal crampings at the day of the test. How do you see this test result?",
    "doctor_response": "Dear patient Test done for you is level of glycosylated hemoglobin level which is indicator of long term sugar level in blood over previous 3 months. Constant high blood sugar levels leads to its deposition in red blood cells as glycosylated hemoglobin. So when test is done for it high level indicates that your blood sugar levels were constantly high and is sign of diabetes Mellitus. Please consult expert diabetiologist  nearby  you and get yourself examined.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevation in the blood pressure?\n\nHi, recently i have staryed noticing that some days my resting pulse stays around 105-115 for no reason. I have had ekg, 24hours holter, blood tests done and all came back normal. Its been happening every few days it goes and comes back sometimes whole day resting pulse stays at 105-115. 5 years ago i had an episode of tachycardia and i went to ER for that but all tests came back normal adrenal glands etc. What can be causing this?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Rapid heart rate is mostly due to heart diseases. But since your all heart related reports are normal, no need to worry for major heart diseases as a cause for tachycardia. Sometimes, stress, tension and anxiety can cause tachycardia. All these actually causes sympathetic over stimulation and this stimulates heart for fast beating. So better to consult psychiatrist and get done counselling sessions. You may need anxiolytic drugs too. Don't worry, you will be alright. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rapid heart rate?\n\nHello, I been challenged with increased heart rate for the past two weeks and don t exactly know what the symptoms are. Of course the common: I am under work stress, changing jobs, and moving, plus being a mother to two young children. But my heart rate increases in the evening, almost to an anxiety attack level.",
    "doctor_response": "DearWelcome to HCMWe understand your concernsI went through your details. I think you are being reasonable. That is a good sign. Your heart rate fluctuates mainly due to stress and related anxiety. You will be able to feel the heart over your chest skin. That is natural on a stressed body. I will not say there is nothing to worry. You need to worry about stress. Either you adjust with the stress creating situations and take it easy or avoid the stimulies. Please understand, prolonged stress could create many health problems. Please consult a physician and follow his advise. Exercise, proper dieting and happy life contributes to healthy life.If you still need my assistance in this regard, please use this link.  Please remember to describe the whole problem with full detail.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fragmented disc in the neck and lower back\n\nHi, I was wondering what I can do best for my fragmented disks. I have 3 defragmented disk s in my neck, and 4 in my lower back. The bottom disk in my back buldges and is pressing on my sciatic nerve. I have sever pain. I am taking Celebrex, Gabapentin, Vicodin, trasodone, and meloxocicam. But nothing is helping and my pain is so bad, I was wondering what you would suggest. I am seeing a Dr., but since I have hepatitis C, he is worried about what to give me. My sciatic nerve right now has been causing me alot of pain down the right side of my lower back, down through my buttock s, and down the middle of my leg, on the right side. I have had it do that on my left side and got to where I couldn t walk!",
    "doctor_response": "Thanks for your question dear you should have consult with neurosurgeon who is going to scape your from this plus if  avoid excess weightifting  and sternous exercise in this preroid thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a purple colored bump on the face of a child?\n\nMy 15-month-old has had a bump on his face for the past 8 months. I thought it was a pimple when it stated. However, it has never gone away and will get larger and smaller. It used to be red but now it seems purple has a hint of black. The pediatrician gave us acne cream but it does not work. We are seeing a dermatologist but they can t see us until Jan.",
    "doctor_response": "Hi...bumps over face could be a dermoid cyst. I do think a cream will work for a tissue swelling causing a bump. But skin conditions are best treated as after directly seeing them. I suggest you either upload an image here on this website or consult a dermatologist regarding this.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain, pain on standing up, do gardening for a living. Treatment?\n\nI have lower back pain following quite a lot of heavy lifting today. I find it difficult to move around, and particularly difficult to get up after sitting down. I am wearing my wife s support belt which helps a lot with movement once I am up. I want to know how to manage this problem, the do s and don ts, and because I have so many things that need to be done in the coming weeks, I need to plan ahead. I do gardening for a living, and also am about to begin decorating a house for re-letting. Thank you for any help and advice you can give.",
    "doctor_response": "Hi Cornerstone1, Back pain after lifting heavy weights is most likely due to a muscle or ligament tear / sprain. There is a possibility that there may be a disc prolapse also, but if you do not have any pain running down your thighs/ calfs or any numbness in any of your legs/ feet, the treatment remains the same in the initial period. Bed rest, heat therapy, light massage, pain medication for 2 - 3 days should relieve pain. Avoid bendin forwards, lifting heavy weights, sitting on floor, squatting. Gradual physiotherapy should be started as the pain settles down to train good posture and lifting practices. If the pain persists beyond three days/ pain running down the legs/ numbness or tingling sensation in the legs or feet, it would be wise to see your orthopedician/ spine surgeon. Get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for erectile dysfunction?\n\nhi sir am virat  26 years old unmarried sir before 3 months  i was watching a blue movie & sudenly my penis lost its hardness & from that time i started a desi medicine & i had it for three month that time i was fine but when i left the medicine same problem is persis so pls sir give me the right solution am too going to get marry after 3 months",
    "doctor_response": "Hello, Erectile dysfunction at your age should only be due to anxiety and stress or performance anxiety. Do you have any other problems like diabetics, hypertension, hypotension, thyroid dysfunction etc? If no, it has to be anxiety created out of excess porn videos or masturbation. I suggest sex therapy for you. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for frequent falls?\n\nHello  I never used this before but I must ask you a few questions. . I fell on the tile floor in my kitchen 2 days ago really hard  I'm in my mid 50's but pretty active however this is not the first fall.  is it necessary to run to the hospital.  I have taken ibupropin and ice it and keep it wrapped  I used a walker the first day and most of the 2nd  but I am able  to bare weight more now..What do you think hospital or not just wait and see?",
    "doctor_response": "good day!  Geriatric age with history of falls always need a visit to hospital to be evaluated for any injury. SO please go to hospital and get worked up. And avoid future falls and take serious measures for thatgood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to have unprotected sex the day after taking diane 35?\n\nIs it safe to have unprotected sex the day after you take diane 35 for 21 days?i was on my 4th days break of taking diane 35 and still no period yet.is it normal?when do i need to start taking diane 35 since my period didnt come on the 7th day break of taking diane 35?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. If you took all tablets in Diane 35 pack as per the schedule without missing pill or time, it will give protection during pill free period also. If you missed any pill during last seven days before intercourse, better to use additional contraception or emergency contraception after the act. Sometimes you may not get withdrawal bleeding as expected, in that case, check for pregnancy once, if test gives negative result, you can start new pack after 7 days break. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and stiffness in the shoulders?\n\nMy right shoulder bone is sticking out higher than my left shoulder bone and it is sore to the touch in my right shoulder is in constant pain and when I wake up in the morning sometimes as stiff as a board I can barely roll out of bed almost brings me to tears what could be the problem?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It sounds like you may have some arthritis in that shoulder. An exam by a physician and possibly an X-ray could help to clarify the situation. A dislocation is also a possibility. See a doctor soon. You need a diagnosis before a treatment can be suggested. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How serious is myopia in children?\n\nhi doctor my son 5 yrs and 3 months old complained that he cannot read faraway letters so we went for an opthalmologist and he confirmed myopia. his prescription is -1.5 in left eye and -4.5 and cylindrical power -2 in right eye. he prescribed glasses and patch for symptom of lazy eye. i wanted to know how worst is this and how to follow up",
    "doctor_response": "Hello, You are on the ball.  Your child complained and you took him to the eye doctor immediately! Many young children have myopia.  In fact, it is the most common vision defect in this age group. Normally both eyes line up together. In a lazy eye, one of the eyes deviates so the eyes do not line up together.  The patch makes a correction so that with time both eyes will line up normally. If you had not taken your child to the ophthalmologist and his lazy eye wasn't correct, your son would have vision loss. I should think the eye specialist would want to see your son back in 2 months for his first eye check since he got his glasses. You may wish to invest in a pair of eyeglasses whose frames bend and not break and whose lenses are scratch resistant. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Arnold Zedd, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I had a rift with my family. Please help me to divert myself.\n\nHi doctor, I did not sleep for the past few months. I did not have proper food. Even if I am hungry, I could not eat. I had been through a fight\u00a0with my family as well as my\u00a0fiance. I do not want to leave,\u00a0but I want to know how I can divert myself. Please help.",
    "doctor_response": "Hi. Thanks for the query. I hope this helps. Take care. Feel free to drop a query anytime. For further queries consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes redness and swelling behind the neck?\n\nI have a bug bite on the right back side of my neck. It is red and swollen. When I woke up this morning the skin on the right side of my face is hyper sensitive (only superficially), as well as down the right side of my back and my right breast feels a sensitive and maybe slightly swollen... and my right eye lid is a wee bit heavy",
    "doctor_response": "Dear sir /madam based on your description I think you are having a immune reaction to bug bite, I suggest taking some antihistamine and analgesic NSAID   and wait for swelling to come down",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the sperm analysis with tail defect 3% indicate?\n\nHi,I have tested semen testing in which I found1. morphology = 4million/mibut impression = MILD ASTHENOSPERMIA.Remarks: sperma appear normal in number & show mild loss of active mitilitdy.1. head defects: 15%2. mid field defects : 12%3. Tail defects: 03% Please suggest me what would be the remedial actions for these.I am very thankful for your suggestions",
    "doctor_response": "Hello Thank you for trusting HCM Normal sperm have an oval head with a long tail. Abnormal sperm have head or tail defects \u2014 such as a large or misshapen head or a crooked or double tail. These defects might affect the ability of the sperm to reach and penetrate an egg. However, having a large percentage of misshapen sperm isn't uncommon. In addition, morphology alone doesn't indicate if you are fertile or not. A typical semen analysis also assesses:Semen volumeTotal sperm numberSperm concentrationVitality (percent alive)Movement (motility)Coiling and bending of the tail are sometimes seen. Broken tails of less than half normal length should be categorized abnormal. Double, triple and quadruple tails are seen and are abnormal. Cytoplasmic droplets along the tail may indicate an immature sperm . if tail defect more decrease sperm motility so decrease fertilization capacity. Please consult your doctor further guidance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful swelling and tightness in the left lower leg and back?\n\nI have pAinful tightness and swelling in left lower leg in the back. I am unable to sleep or relax that leg. I am on crutches because of it. I also just had surgery on left foot, but the painful tightness started before the surgery. What should I do?",
    "doctor_response": "Hi, Most probably it is due to spine related problems like prolapsed disc. As a first line management you can take analgesics like Aceclofenac or Tramadol for pain relief. If symptoms persist better to consult an orthopedics and get an MRI scan done. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness and tingling sensation in the finger?\n\nThe finger of my right hand go numb and tingle. There is pain in my palm just below my thumb and in my wrist. The numbness and pain increase and decrease in intensity and always coordinated. I am losing strength in my hand. My hand is also swollen and I have trouble closing my hand completely. I have not been bitten by anything. The symptoms started about 5 days ago and have been getting worse. What are the possible causes?",
    "doctor_response": "Hi, I have gone through your medical history carefully and understood your concerns. The swollen hand associated with numbness and tingles in the finger could be due to arthritis or any local trauma. Get immediate consultation with orthopaedic specialist. Keep the hand raised. Take anti-inflammatory meds (e.g. ibuprofen, aspirin, etc.). Wish fast recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for chest pain and chest tightness?\n\nI am 28 years old and the last 2 nights I have woken up with chest pain/tightness. I took tums when I woke up in the middle of the night thinking maybe it was heartburn, but it didn t really help. I had some tingling in my arms when tossing and turning to fall back asleep. Today I have had pain in my shoulders.",
    "doctor_response": "Thanks for your question on HCM. In my opinion your symptoms are mostly related to stress and anxiety. But better to rule out cardiac cause first,  you have chest tightness and arm pain and numbness.So get done1. ECG2. 2D Echo. If both are normal than no need to worry much for cardiac  cause.  It is anxiety related only. So avoid stress and tension.  Be relax and calm. Consult psychiatrist and get done counselling sessions and discuss your problem s. Try to find out stressor in life and work its solution.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes increased bowel movements when the colon is stretched?\n\nmy 10 yr.old has build up in her stomach,they said her colon is stretched.shes been taking murilax 2 times a day since october or november.shes had bowel movements every day,several times a day,accept this week.she hasn t gone since monday,could this be serious?",
    "doctor_response": "Hi,Welcome to HcmFirst of all let me assure you that there is nothing to be alarmed about. Your child seems to be having loaded colon which needs to be emptied completely by giving laxatives. Once his gut is completely free of stools, then on he will have normal bowel habits and his diet also will improve. I would suggest you to consult a pediatric Gastroenterologist or even a pediatrician for the same. Hope I answered your query adequately. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red bites with pus in legs and buttock areas?\n\nAn 11 year old male has what appears to be red bites with some pus his legs and buttock areas. He was outside a couple of days ago (possible mosquito bites) & also used a public bathroom. He also sat in folding outdoor chair & the back of a truck. What could the bites be?",
    "doctor_response": "Mosquito bite won't have pus filled in and on buttock which is not exposed part it can't be mosquito bite....Most probably due to humidity and heat..but exactly we can say only after seeing the lesions",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes darker complexion in babies?\n\nHi doctors, i had some queries for my baby. Actually when my baby was born she was very fair.And now she has become very dark. When i consulted with child specialist he told me that it is because of dry skin, so he asked me to apply emoderm oinment all over the body and use pears soap for bath. he also told me to stop oil massage. After doing all this still my baby is getting dark day by day. Doctor is also telling me that it is fungul disease. Will you please help me out with this problem. My baby is 5 months old now",
    "doctor_response": "Although environmental factors like sunlight and UV rays have a role to play in determining the colour of an individual, genetics plays a very important role in this regard. The skin colour does not express itself properly at birth. So it is not unusual for a newborn to look fair. Even the present colour might not be the final colour of skin of your child. Although fungal infection is possible, it seems less likely.Oil does not get absorbed through the skin and hence your doctor has asked you to avoid it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen and painful lump\n\nI did a shot of meth- at first it didn't really hurt but I didn't get really high- 16 hrs later I was in shower and it swelled up and has been continuing to throb and hurt- I have been applying pressure and heat- are their any other home remedies that will speed up this healing process- I am a health care professional myself and it is hard to disguise this knot at work",
    "doctor_response": "Hi,from history it seems that there might be irritation due to injecting material and shot might be in subcutaneous tissue and not deep intra-muscular causing this bump and swelling.Apply ice pack 2-3 times a day for few days.Apply Thrombophob cream on the part.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes teeth pain, sore neck and headache?\n\nI am a 23 year old female, been having teeth pain for 3 days after eating an oreo cookie, pain is located on left side on both upper and bottom teeth hard to tell which ones.. woke up the second day having sore neck, mild headache, and constant toothache. I took some ibuprofen, didn't help.. gargled warm salt water.. didn't help.  I can't get to a dentist I don't have the funds, and don't really have enough to go get any other medicine. What else can I try to relieve at least the headaches and toothache so I can figure out how to get this all fixed. I can't sleep at night, I can't do much during the day because my head starts hurting and throbbing...",
    "doctor_response": "Thanks for your query, I have gone through your query. The pain in the tooth could be arising from an infected wisdom tooth. usually infected wisdom tooth produces this kind of pain in the head neck and temporal area. you need to take a radiograph of that tooth and get it treated by extracting or RCT. Meanwhile you can take a course of antibiotics like amoxicillin 500mg tid, metronidazole 400mg bid along with ibuprofen (if you are not allergic and sensitive to these drugs). do saline gargling. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for head pain and dizziness in a child?\n\nmy 4 year old little girl, has hit the back of her head. i cant see anything but she is complaining that it really hurts when she moves it (starts crying) and when she stands up she feels dizzy. she done it over an hr ago and its getting worse, can you please help me on what im ment to do",
    "doctor_response": "Hi, welcome to HCM. Your child has trauma to head 1 hour back and now she is feeling dizziness and crying a lot on moving the head, i suggest you to take the child to er, an immediate CT scan of head should be done. In case of head trauma, if loss of consciousness, ear or mouth bleed, vomiting, seizures or dizziness episodes occur then there are chances of intracranial bleed and an immediate CT scan should be done. I hope this will help you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "L5-S1 posterior central disc protrusion with moderate to severe spinal canal narrowing. Suggest me treatment except surgery\n\nI have low back pain since 2months The conclusion of my MRI report is L4-5 posterior central bilateral paracentral disc protrusion associated with annular tear and severe spinal canal stenosis and moderate bilateral neural foraminal narrowing. L5-S1 posterior central disc protrusion with moderate to severe spinal canal narrowing. Now i want to know other than surgury what all cures are possible for me?",
    "doctor_response": "Hi, Try physiotherapy, esp. lumbar traction & IFT for 15 days , if still you do not get relieved of pain, then surgery is the best treatment for you Take Care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any home remedy to get rid of codeine addiction ?\n\nI am a codeine addict from last 7 years. I want to leave it tried cold turkey two times for 9 &11 days. My problem is, I can not admitted in hospital due to some personal problem. Is there any home based treatment? Regards Girish Mishra",
    "doctor_response": "Dear It is basically your will that determines the success of treatment. Make up your mind and tapper off the dose in a short span of time to support your mind that you are successful. Amongst herbal medicines brahmi shankhpushpi based compounds as streswin work good and at bed time trifla is recommended.",
    "dialogue_context": ""
  },
  {
    "patient_message": "30 year old female, not having feelings of a women, but that of a man\n\nSir , Good morning!!!!!!! how r u? I am harisa, from Wayanad ,Kerala.Presently working in Dubai,Sir My Question is.i am 30 years old Female.But i dont have Any Feelings LIke a Women..my thoughts,all feelings as a men ..what i will do now..my marriage is almost fixed.but i feel very bad to my all cercumstances...really i am confused.please help me",
    "doctor_response": "welcome to health care magic!I have gone through your question carefully and from my clinical experience I can advice that you must see a psychiatrist. I can understand that it is a stressful situation but please donot take any wrong step/ decision which might harm you or your family. there are several cases like yours, with proper counselling, and may be along with medicines, one is able to decide for his/ her self in a confident way. The treatment will not force you to change your outlook to life but will help you in looking at the problem areas, and then make an intelligent decision for yourself.take care , Hope the reply is helpful for you.Dr. Manisha Gopal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will high levels of TSH affect conception?\n\nHello doctor,The following is the thyroid function report of my fiancee. She is 22 years old. The TSH is 4.42, T4 is 7.53, and T3 is 1.30. Please have a look. Since her\u00a0mother had a thyroid issue, I am worried that she could have it too. Do you think this could create any problem in the future? Will\u00a0she need any medication in the future? Please advise. It is urgent.",
    "doctor_response": "Hello. I just read your query. Hope you find my advice of some benefit. Good luck. For more information consult an endocrinologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful sores on the head?\n\nHi, may I answer your health queries right now ? Please type your query here... I have very painful sores on my head mainly at the bottom by neck but spreading more all over , feels similiar to boils in spots, crusty and scabby also. started out as one and is now about 10. what is it, what can i do for it? some parts even feels swollen. can you help?",
    "doctor_response": "Hi,thanks for the query to HCM.Dear,Based on the facts of your report,you seem to have staph Hidradenitis suppurativa with crusty and scabby boils,which started as one and now 10.Treat-Rule out diabetes by Fasting/and Post-meal  Blood Sugar studiesContact dermatologist and treat it with antibiotics / antipyretics/ and anti-inflammatory,with a long term followup.Hope this reply would help you to plan further treatment in your case.Good Day!!Dr.Savaskar,Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there something to be concerned about?\n\nwe have a founr year old that has asked if there was an earth quake today cause she said everything was shaking. we asked her to show us what she ment ans she shook her hand and said everything is shaking like this. it has happened three times today. is this something we should be concerned about?",
    "doctor_response": "Hi, Welcome to HCM. This should be a cause of concern as the child has described the symptoms well. It looks like that it was a episode of dizziness. You should do complete blood count of child. Blood pressure should be checked. Child should be given adequate liquid diet. If next time, this type of episode occur then you should report to hospital. I hope this will help you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Though my interest is good, I am not getting proper erection. Why?\n\nHi doctor, I am 54 years old. I am a hypertensive patient. Currently, I am taking Telma 20 mg, Metoprolol 25 mg in the morning and Roseday 5 mg at night. My weight is 105 kilograms. I am not getting proper erection nowadays. Though I have an interest in intercourse, I am unable to perform. Before a month, I had a burning sensation after sex which lasted for 30 minutes. I do not have complications like fever, abdomen pain, frequent urination, cloudy or bloody urine, and pain during urination. I consulted my GP, and he gave me a food supplement. Please advice.",
    "doctor_response": "Hi. I have gone through the attachment (attachment removed to protect patient identity). Your report shows that you have diabetes, deficiency of vitamin D3 and vitamin B12. Your hba1C (glycated hemoglobin) is in a higher range. Take care of these issues. Have a walk in the morning for at least 30 to 40 minutes every day. Avoid smoking and drinking if you have these habits. Take healthy food and adequate sleep. For erectile dysfunction, I recommend taking Sildenafil 50 mg almost 30 to 60 minutes before having sex. If there is premature ejaculation, you can take Fluoxetine 20 mg or Paroxetine 12.5 mg or Dapoxetine 30 mg one tablet one hour before sexual activity. Try master and Johnson technique for erectile dysfunction and try stop technique or squeeze technique for premature ejaculation if you have.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest precautions for cervical TB not spreading to child\n\nHello doctor I am 35 year old female having cervical tb have taken five months of treatment how can I make sure my five year old son does not catch it from me. Or how can I keep checking him so that at the earliest evidence I take him to paediatrician",
    "doctor_response": "Hi Dear Welcome to the HCM,Three weeks of proper anti tubercular treatment makes the person non infective to others.Baby to be considered as contact,to be investigated in terms of ESR. Mx TEST,CXR  etc to rule out the spread.Some symptoms to noted like Loss of appetite, no proper weight gain, dullness, irritability,swelling of the cervical or axillary lymphnodes, chronic pain in abdomen etc.Hope the query is answered,thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe back pain, pain during movement for last few months. Cure?\n\nSir My low back pain is before six month continue. Sir when I am sitting on chair that time I stand from chair I have some pain when I strat going , I am go forward left or right side, that time I am not going proper, after 20-25 step then I am going proper. Sir secondaly I am stand up from bed, I stand left or right side, I am not proper stand up.",
    "doctor_response": "Hello. Thanks for writing to us. From your description it seems that you are having a disc prolapse due to degenerative changes in the spine. An MRI scan of the back will help in proper diagnosis. Meanwhile you can start taking a mild pain killer along with a muscle relaxant for relief. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe pain in the lower back be treated?\n\nI discovered I have two stress fractures in my lower back. Today I had a MRI to confirm this. I am 78 and my doctor suggested medical cement. I have already had two lower back surgeries. I have lost about two inches in height. I am wondering if the cement will help with my height. I have been in severe pain. It hurts so bad getting out of bed. I have to hold on to the bed and walls to get downstairs. Will the cement help relieve the pain? I am unable to work around the house since this happened.",
    "doctor_response": "Hello,At which level you have got stress fractures in your back? Is at dorsal spine or lumbar spine? Medical cement you asked about is, we refer to as Vertebroplasty.This is effective measure to relieve pain and to maintain height of vertebra. You also had two back surgeries for which purpose?Please share details of surgeries and MRI report so I will be able to guide you through definitive treatment.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Jayesh Vaza",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yellowish discoloration and bad odor in feet?\n\nMy son is 2 years old.we were at the doctor last week and he had mild pneumonia. He has finished his antibiotics.He has been tested and his iron has been low, the last few months .Today I noticed his feet are slightly yellow and have a very strange smell to them.",
    "doctor_response": "Hello,Due to pneumonia, antibiotics, the iron level may decrease, and so you need to take iron tablets for your child. Also, I will suggest a healthy diet with soups, vegetables, fruits, and liquids to help him recover.About your other problem I can say that the slightly yellow may be due to iron decrease and anemia but for the strange smell, I will suggest taking in consideration a fungal infection.Of course is just an opportunity that you can take into consideration in this case. So, first do not let his feet wet, dry them well, use cotton socks and leather shoes as well.You can also try powder with antifungal which helps in this case with the problem and with the smell.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Elona Dashi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the cut on my thumb knuckle infected?\n\nI cut my thumb knuckle on an aluminum can last week. There was a lot of blood but then it healed quickly with not problems. Now there appears to be a lump underneath and the cut is gray in color and it hurts to bend my thumb. Is it possible it became infected? I had a tetanus shot in 2004. Thank you!",
    "doctor_response": "Hello,Welcome to HCM,As you cut your thumb knuckle with an aluminum can last week which was followed by lot of blood and it healed quickly without any problems. As there is a lump underneath the cut which is gray in color and it hurts when you try to bend your thumb and this may be due to underlying bleeding which has lead to your problem.I would suggest you to follow 1. Bending the thumb in the hot water2. Tab Lyzer D, Twice daily for 5 days.3. A course of antibiotic like Tab Augmentin, twice daily for 5 days.You can take these medicines by consulting your doctor.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump in the armpit indicate?\n\nHi, I have a large lump In my left armpit, (keep in mind I am a hypochondriac and I worry about severe illness) it\u2019s like a horizontal line across my armpit and it\u2019s very tender and sore. It\u2019s hard to move my arm. I also have a very slight sore throat, but nothing major. My shoulder on the side of the lump is also sore but nothing super major. And I also had the same sort of lump on my right armpit but it went away with short time. I am severally worried about what could be wrong. Thank you. Also I\u2019ve never had any sort of severe illness",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. * The severely painful lump in armpit suggests underlying inflammation in boil or else. * In our clinic, I recommend a primary management with oral antibiotics and anti inflammatory medications for certain period of time. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure hypertension effectively?\n\nMy husband has a left bundle branch block with a pulse rate of 55-60 much of the time.  Treating his hypertension has been a challenge as beta blockers slowed his pulse to the point he fainted. Was on Diovan HCT, now too expensive and is on Benicar HCT, also expensive.  Has only been on Benicar 2 weeks, BP is about 140/76. Do you have any suggestions we could discuss with his doctor.  We really need to find something that works that doesn't cost so much. Thanks",
    "doctor_response": "Hello,He can have tab Amlodipine 5 mg once a day which can be increased to 10 mg if needed. It's very cheap and cheaper than benicar.   Also, he should have healthy lifestyle like low fat, oily and low salt diet. Regular exercises will help. Hope this helps you and get back if you have any doubts.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of tendonitis?\n\nhi, i am a 15 year old girl and an athlete, i have had knee pain in my outer and lower knee for 3 to 4 years, i thought it was tedonitis and i thought it was growing pains and all this other things but al that is supposed to go away this hasn t. i wear a knee brace because if i don t my knee gets really tender and makes noises when i try to bend it and sometimes it becomes really hard to bend. what do i have?",
    "doctor_response": "In my opinion you have lateral meniscal tear i recommend an MRI scan to confirmFollowed by 3 Month physical therapy however if MRI show ACL tear then you should consult an orthopedic for surgical reconstruction Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a squeezing heart sensation?\n\nHi I wanted to ask I am a 33yr old female and have been experiencing a strange squeezing heart sensation should i be worried its lasted about 10 days so far and the last time i went to my aerobics class afterward i felt a strange pressure in my chest ?Can you advise?Had a cardiogram was normal but of course heart rate was normal at the time",
    "doctor_response": "At 33, as long as you have no major risk like diabetes, smoking or cocaine use, the chance of heart as a source of symptoms is low. Low is not zero. I usually will review symptoms of reflux (burning, sometimes meal related, often lasting longer than 30 minutes or occurring at rest) and musculoskeletal pain (positional and localized with a finger) and recommend a trial of over the counter heartburn aid. If the symptoms fail to improve, I will usually reassess and consider testing.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for thrush\n\nhello, i found out i had really bad thrush on tuesday and they gave me some stuff, but the itchy is still there and its really getting to me now. i took the pessary but read not to take it on my period but the man new i was and i dont thing it has worked, what should i do?",
    "doctor_response": "HI, thanks for using healthcare magicVaginal yeast infections can be itching and they are associated with a white- yellow discharge.There are oral tablets that can be used to treat this infection that would not depend on whether you were having your period or not.The main one is fluconazole 150mg. Only one dose of this medication is taken.This is the best option since you are currently menstruating.It should be available at your local pharmacy though you may need a prescription.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in left side of stomach for weeks?\n\nHi umm... i don't exactly know whats wrong with me... Well the left side of my stomach has been hurting for about three weeks now off and on, also my head begins to hurt and i feel dizzy as well as naseous. I just want to know what could be wrong with me.",
    "doctor_response": "Hi ! Good morning. I am Dr Shareef answering your query.If I were your doctor, I would advise you to avoid eating from outside if you do, specially against spicy, fried and fast food. I would also advise you for a liquid antacid gel, and a prokinetic agent along with a proton pump inhibitor, and go for a stool test for ova and cyst. In case all routine investigations coming to be normal, I would advise you for an ultrasound abdomen, and possibly an endoscopic evaluation of your upper gastro-intestinal tract by a gastro enterologist in your area. Further management would depend on the physical examination and investigation reports.I hope this information would help you in discussing with your family physician/treating doctor in planning your treatment. Thanks for using the health care magic forum for your query on health. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a swollen shin caused by trauma?\n\nHi sir, my lower right shin received a bad hit few weeks back. It became swollen, red and is numb. It hurts if you press the area and it feels a bit heavy when i stand. I have visited an orthopedist and followed his instructions. He told me to apply a warm wet cloth in on the area and keep it elevated. The shin cured a bit but a few days back it became worse than before. What is your advice?",
    "doctor_response": "Hello,I have studied your case and i think that you have a soft tissue injury with blood collection in this region. I would suggest you to continue with hot water fomentation and apply compression bandage. Also you can take NSAID like brufen for pain and swelling. Avoid standing for long time and when you are sleeping keep your leg is elevated over pillow.I hope this answer will be useful for you.Let me know if there is any other followup questions.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning penis post mastrubation?\n\nI am 22 male and have a problem from like 4 years now. well sometimes after mastrubation I feel burning sensation in my penis and then this sudden urge to pee, but the pee won t cone out, I will have to stay in bath for 10 to 20 mins. the process is long and quite painfully and annoying. I have sex regularly but it only happens after mastrubation. don t know who to ask for help, so asking here.I need answers, its kinda scary now.",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: There is nothing abnormal with you.Explanation: When the ejaculation is prolonged (the duration), burning sensation can occur after  ejaculation and feeling to urinate is also a normal feeling after this.                    But you cannot urinate suddenly after this because your passage to urinary bladder is cut off whenever you are excited to make way for semen.(Semen and urine have same passage after some distance, so one closes to make way for another and vice versa).                     Wait for some time as you did and urinate to prevent any Urinary tract infection. Enjoy, you do not have problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which is the best medicine available in India for treatment of acne?\n\nbest medicine available in india for treatment of acne???",
    "doctor_response": "there are many good medicines available. Go to a skin doctor. Let he decide what kind of acne you have got and accordingly he will give medicine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bloating,abdominal pain and dizziness?\n\nHi I had bloating nearly a month ago. Took antacids. My ultrasound is normal. Ct scan is also normal. Now I am having very dark stool which is greasy. And left upper quadrant abdominal pain. Which spreads to d left shoulder blade. I also feel dizziness and heaviness in mind. I am taking antibiotics and liv 52 surrup and probtex vitamin syrrup. What should. I do now?",
    "doctor_response": "Hello, Abdominal bloating with dark coloured stools and normal scans could be some Gastritis/ Duodenitis/ Or some duodenal ulcer , but since you have shoulder pain also first get an ECG done if it is normal, then go ahead with complete blood picture to see if there is any drop in heamoglobin(because of dark coloured stools), and please consult a Gastroenterologist to get examined and to get an upper GI endoscopy to evaluate the above mentioned. Hope I could help you.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long is the treatment for mild cardiomegaly?\n\nMy husband's chest x-ray was found to have a result of mild cardiomegaly and it worries us both. The doctor said it was due to prolonged high blood pressure. He can not continue with work with this kind of condition. How long can is the treatment for it?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.Yes, uncontrolled hypertension can cause strain on heart muscles and this in turn cause hypertrophy and cardiomegaly.So best treatment is strict control of blood pressure. He may need additional antihypertensive drug to control blood pressure. Along with antihypertensive drugs, he should follow these. Avoid salt in diet. Weight loss is beneficial if he is obese. Quit smoking and alcohol if he has these habits. Avoid stress and tension, be relax and calm. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wishing good health to your husband. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dry and itchy skin around nose after using face cleanser?\n\nI am 19, 5'2'', weigh 128, and I am not allergic to anything that I am aware of.About a month ago I bought Neutrogena Deep Clean Facial Cleanser and I had been using it about 4 times a week or so but when I read that it can take makeup off I started using twice a day for about a week now and today I noticed dry and itchy skin around my nose (but not on it) close to my mouth, on my upper lip, my chin and forehead. This has never happened to me before I am very worried, how long will it last, am I allergic to these products?",
    "doctor_response": "Its not an allergy. It happens because in these specific areas the skin has a tendency to become more dry after face wash. Dont use the face wash in these areas. Or even better considering the dry winter season use a soap free cleanser like cetaphil cleansing lotion",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Prescribed Ovacare, lupiHCG 2000, deviry. Ovulation egg growing proper. Reason for prescribing deviry?\n\ni am a 26years old married woman. i am trying to conceiving for my second child since one year.my period is regular i was consult a doctor she has prescribe to take T.MCBM-69 tablets,ovacare tablets,lupiHCG 2000 injection. she has done follicular study also.and she said my ovulation egg is growing proper and she has prescribe to take t. deviry 10mg tablets. i heard t. deviry tablets uses for menstruation problem, why she has given me.. please help me doctor.",
    "doctor_response": "welcome to HCM.it seems u r not ovulating.drugs prescribed will help in ovulation.unless u r pregnant, deviry is safe.as, at present u r non-pregnant,nothing to worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can treatment for chronic myeloid leukaemia be stopped once cured?\n\nHi, may I answer your health queries right now ?  Please type your query here...i am a 22years old girl,i suffer from chronic myeloid leukemia from 3 months,but my tests show a surprising improvment,is it possible to stop my treatment(glivec 400mg/day) later???",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You has chronic myeloid leukemia.  It is chronic leukemia so prognosis is good.  However you should not stop thd treatment without your doctor's advice.  You should complete the course of yoir chemotherapy. Consult your doctor and take treatment accordingly. You should go for regular blood count to monitor your chronic myeloid leukemia. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I getting pus filled pimples often?\n\nHello doctor, I am suffering from some allergic symptom on my foot. First this was like a pimple with forming pus. After it burst, and started itching and it started forming in that place also. What is this? What is the medicine for this?",
    "doctor_response": "Hi. With the information given and photos provided, I assume that you are most probably having eczema. Eczema commonly presents like these morphology associated with itching. Please apply Excel-G cream [Clobetasol with Gentamycin] twice daily for 10 days and Deslor Desloratadine tablet once before sleep for 10 days. If you do not find any improvement, kindly review back to me for further advice. Tinea Pedis Excel-G cream twice daily for 10 days or tablet Desloratidine once daily for 10 days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can an online doctor explain the meaning of the kidney reports ?\n\nI got father s report today, please tell me the meaning in simple words, there is a large mass of the superior/mid pole of the right kidney , measuring approximately 90mm in its maximum transverse dimension with extension into the perinephric space and the renal hilum. tumor extends and abuts the IVC, however, there is no convincing caval extension(T3a). few smalllymph nodes are also seen in the retroperitoneum at the level of renal axis which may indicate N1 nodal status. there is a focal lesion in the right liver lobe which is just under a cenrimeter in size, however, would require ultrasound correlation for further assesment ans small cyst or small metastatic focus would be difficult to exclude.",
    "doctor_response": "Hi Thanks for your query The report suggests that there might be a tumour or a cancer affecting the kidney and has spread into the area around the kidney. It does not appear to have spread directly into the veins or the blood vessels of the kidney. However it may be spreading to the lymph nodes. You need to consult a urologist ASAP Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower back pain\n\nHiyya,Am not sure if am in early labour, i've been getting lower back pain, cramps like period cramps and the other day i had abit of a dribble of clear fluid down my leg. Am unsure about whether i should contact the midwife or not. Many thanks, Jade",
    "doctor_response": "Dear patient What the duration of pregnancy?  If it's around nine months your pain is suggestive  of labour pains. Dribbling of clear fluids indicate rupture of amniotic  sac which may be due to contractions. This initiates labour contractions and pain. This needs to be taken with care and you need to consult expert obstetrician  nearby you and get yourself examined.  All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat restlessness?\n\nHello, I am a 28 year old female. I have been struggling with constanlty feeling restless. My body feels like a car engine that won t shut off. I m always tired. My heart feels like it races. I can be doing completely nothing but my body WON T relax and as a result it exhausts me. I feel like I process things slower than others and it takes longer for me to complete tasks than it did before. I even feel a physical pain from this restlessness. I am looking for help becuase I m exhausted and it physically hurts. Thanks. I",
    "doctor_response": "Hi,I can understand you distress. From what you have mentioned, it seems that you have symptoms of anxiety and depression. Getting tired, not able to relax, difficulty in concentration, anxiety with restlessness can all result from underlying depression.I would advise you to seek a psychiatric consultation. Treatment with selective serotonin reuptake inhibitors like sertraline would be helpful. In addition, benzodiazepines like clonazepam will decrease your restlessness initially and can be given for a short period of time. You should also start exercising daily as that will help you feel relaxed.Hope this information was helpful. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does glyclomet tablet has any side effects?\n\ndoctor told me to take glyclomet 850mg 3 per day. Is there any side effect from this. I am having PCOS. From past two days my throat become dry and from past one day feeling bitterness ( mouth bitterness). Could you please answer to my question. Thanks in advance.",
    "doctor_response": "Hello,Some of the side effects of Glycomet are:- Nausea.- Vomiting- Taste change- Abdominal pain- Loss of appetiteTake care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red small raised bumps in clusters on the legs of a child?\n\nhi, my toddler has red small raised bumps in clusters on her leg starting to spread to her other leg with a little spot and a tiny one on her belly now. No other symptoms that I know of or that she is displaying. What could this be? She also had bad eczema when she was a baby but has not had it since and it is raised like that but looks alot different.",
    "doctor_response": "Hi...I feel by what you quote he should be having a - Hand Foot Mouth disease. This is one viral illness among all other exanthemas which can cause fever followed by rash over palms and soles. It is a self-limiting disorder and itching can be really worrisome. I suggest you use any over the counter antihistamine if you have one with you now. You can use Hydroxyzine at 1-2mg/kg/dose (Maximum 10mg) every 6th to 8th hourly for 7 days. This can even cause some peeling of skin in the next 4-6 weeks and do not worry about it.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had ruptured back disk in childhood, since then on pain killers. Taking duragesic patch, hydromorphone\n\nMy name is Greg I am 44 and I ruptured a disck in my back when I was 13 or 14 I ve been om pain killers for over half of my life for the last ten years I ve been on disability and this really depresses me. When I was put on disability my doctor put me on 100mcg per hr duragesic patch and 8 mgs of hydromorphone every 4 to 6 hrs. Since then my insurance wouldn t pay for my scripts till I spent so much out of my own pocket and I could not afford them anymore so my dr. Put me on 100 mg MS Contin twice a day and needless to say it did not help any. I m so tired of being grumpy with my kids cause I m hurting so bad.most days I wished God would just call me home.is there any thing out there that is cheaper that will help me not to Be so missureable and Cary on a half way normal life with my kids so when they say hey Dad lets go fishing I can say yes Dad feels good enough to go fishing with you let s go? Please help me figure out a way so that I can enjoy my children please and thanks to any one who can",
    "doctor_response": "Welcome to Healthcare-MagicGreetings of the dayPresence of pain not responding to analgesics, worsening of pain in your case are valid indication for surgical intervention like discectomy. There is no point in suffering the pain. I suggest you to discuss this option with your treating physician.Take careRegardsDr T ShobhaMBBS MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for depression due to chronic pain caused by bilateral clubbed foot\n\nI have Bilateral clubbed foot on both feet with all three symptoms. I m 16 years old and suffer from severe depression as a result from the chronic pain. I still play tennis and other sports but every day actions are getting harder and harder. Are there any new, innovative, methods to fix this?",
    "doctor_response": "Hi, Could you please send pictures of your feet since club foot is a different condition and playing tennis is very strenuous by nature and difficult for a person with club feet. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe for epileptic children to go on fun rides?\n\nMy 9 year daughter has recently been diagnosed with epilepsy. She is on regular medication and has not had a seizure since. However, she is very keen for us to go to Universal Studios in Florida (particularly Harry Potter World ). Would the rides be safe for her to go on? I am worried in case they trigger a fit.",
    "doctor_response": "Hello. I just read through your question.As long as the seizures are controlled on the medication, there is nothing to be concerned about. She may go on the rides.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any side effects of taking Metpure XL 50?\n\nMy dad has been advised to take metpure xl 50. Before sleeping he took a tablet and seems he is unable to breath properly. He says he got cold. He had undergone angioplasty 4yrs ago and had to undergo eye operation now. Since his bp did not come to normal doc prescribed this tablet",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Metpure XL is having metoprolol. It is beta blocker. It blocks the beta receptor in the body. Beta receptors on airway are responsible for bronchodilation. So metoprolol blocks these receptors and cause bronchospasm. This is not seen in all patients but sensitive individuals tend to develop bronchospasm after metoprolol. So in my opinion, you should consult his doctor and change this metpure XL. Hope I have solved your query. Wishing good health to your father. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic back pain\n\nYes can you tell me how I can get treated for chronic pain now that the laws have changed? Also I ve been working on some of these issues this time around for a year now. Just found out results to an updated MRI I had a year ago after 3 drs seeing me. Nobody taking in consideration for my ddd on multiple levels of my back, plus 2 buldging discs in neck, carpal tunnel both hands , and broken (fractured ) foot due to the issues I ve been having with my back. Now all of a sudden I am not being prescribed anything that works for me at all. I feel like I m being discriminated against",
    "doctor_response": "Hello!Welcome on Healthcaremagic!I understand your concern and would recommend performing a lot of physiotherapy to help correct your posture and reinforce the back muscles. I would also recommend trying amytriptiline or gabapentine for the chronic back pain management. Hope you will find this answer helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to rectify deformed forehead after been punched multiple times?\n\nI got punched in the forehead multiple times and now the lump is big but there are some spots that are dipped in and now my forehead looks deformed (only I noticed)...as a kid I would get so mad that I would bang my head on the floor multiple times I m wondering if this incident will likely change my forehead in appearance because the brides and lumps look like their not going away even with an ice pack to help. Should I go see a doctor I really don t want to have a busted up forehead.",
    "doctor_response": "Hello, Corrective surgery in the form of cranioplasty may be required. Consult a plastic surgeon and he will direct you accordingly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "White discharge from nipples with white dots on the tip\n\nHi I'm a 31yr old male and I have what seems to be a white discharge from my nipples it's like the white discharge from a milk pimple (white) not like milk or puss and I notice it after I shower little white dots on the tip of my nipples and if I squeeze them it comes out its not continuous at all. And I'm 186cm tall 85kg healthy male. I think I would love to get some feed back on this please",
    "doctor_response": "HiWelcome.It might be due to mastitis. Culture and sensitivity of the discharge.Do not squeeze it, to avoid secondary infection.See physician for examination and further help.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe pain caused by knee replacement surgery\n\nMy left leg knee replacement took place hardly month and half back. Presently I am going thro lot of pain. I also also have my back disc L4 and L1 L2 damage. TIred of eating Oxycrocent and other pain killers. Hot water salt bath helps temp. Can U. Suggests to avoid severe pain I go thro my leg and back pain. Night can not sleep et sleep disturbed",
    "doctor_response": "Hi Thanks for your query and Welcome to Healthcare Magic. I am Dr Akshay from Fortis Hospital, New Delhi.You have mentioned that you had a knee replacement surgery around 6 weeks back and even after that you are having a lot of pain.Normally pain after a knee replacement surgery should start settling 6-8 weeks from the date of surgery and should be a bare minimum at 3 months , and there should be no pain from 6 month onwards.But some patients can have pain for a slightly prolonged periods of time. Anyways if there is only pain, but no other s/s of inflammation or infection like Skin redness, increasing swelling, local warmth etc , then it can be managed by :- Ice packs for few more days- Change in the medications you are taking , maybe a combination of Tramadol + Paracetamol can be given if it is routinely used by your Orthopaedic surgeon.- Physical therapy can be modified according to your pain tolerance as aggresive physical therapy can sometimes increase pain after knee replacement surgery.Also you can initially limit your ambulation and other activities as per your pain tolerance, or as guided by your physical therapist.As far as your spine problem goes, i can advise you in detail if i have a detailed information about your problem including neurological examination and relevant MRI images and report.Do not hesitate to contact me if you need any further assistance. Thanks & RegardsDr Akshay Kumar Saxena",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the suggested medicine to treat Follicular cyst?\n\nHi im trying to conceive...,then when i go to my ob..she said that i have follicular cyst at my right ovary...,& she prescribed this kind of medicine..in 3 consecutive months..,i take this drug twice a day..,in 10 days.every months...,should this medicine help me to get rid of that follicular csyt? And also should i conceived after taking this medicine? Thank you..",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.Follicular cyst should be treated with oral contraceptive pills. Oc pills helps in subsiding follicular cyst, but it should be monitored with follicular scan to see the response.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Acute liver failure, fall asleep for several days. Several drugs. Remedy?\n\nDx with Lupus;SLE. Have been on several different drugs. Cannot take Sulfa as caused Acute Liver Failure. Due to adverse reactions to these meds my Rheumatologist is nervous treating, unsure of what will happen; as I am too. T he fatigue is si severe that I have been reduced to unable to work as I can rarely get out of bed. When I go on errands, dr. appts., etc... I fall asleep suddenly  and cannot get up for several days. I am a R,N,, therefore I have tried everything I can thik of yet am afraid of Embrel and other meds of this sort as I caught HBV in 1980 and am afraid of all meds, which are most of them that warn not to take if you have ever had HBV. I feel I am only existin, not actually living. I live in Seabrook, Tx. I am desperate for help. I would go anywhere to get my life back...Eileen",
    "doctor_response": "Hello and welcome to HCM,The symptom of falling asleep and not able to get up for several days suggests hepatic encephalopathy.This is supported by the history given by you.Lactulose is the drug commonly used for hepatic encephalopathy.A number of drugs are metabolized by the liver so in case of liver failure a number of drugs are contraindicated.You need to consult a physician immediately for clinical examination, investigations ( liver function tests) and management.Treatment of hepatic encephalopathy (if present) is an urgency, so do not waster time.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and discomfort in elbow after a crunch sound?\n\n2 weeks ago I lifted a heavy object with my right arm. the arm was straight, not bent at the elbow. as I lifted i got severe pain in my forearm/elbow area and heard a louc crunch/tear. i have rested the arm and used anti inflams but am still in pain and discomfort particularly when lifting even a kettle. there has been no swelling or bruising",
    "doctor_response": "sudden onset of pain after lifting of heavy wight suggest tear or sprain of extensor muscles of fore arm. extensor muscles take origin from lateral part of elbow. sprain at this area is called as tennis elbow. it takes time to heal. but you should not be worried at all. it is a treatable condition. avoid screwing movements ,apply tennis elbow band(commercially easily available), icing and analgesic gel massage at tendor area  and mild analgesic such as ibuprofen will give relief in symptoms .  Hope this helps.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest risk for pregnancy with damaged eggs\n\nI have recently had a ct scan of my admomen/ kidneys, and the emergency room doctor warned me that there is a risk of damage to my eggs (increase risk in birth defects). Is this entirely true, and if so, what is the potential risk to future pregancy?",
    "doctor_response": "ct scan can cause injury to egg by inducing mutation, but any birth defects in baby can be detected by a anomaly scan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shortness of breath\n\nHi, I am a healthy but slightly overweight 41 year old, no problems and workout regularly, however today when I walk or do push ups I get short of breath and dizzy, it feels like I am having to suck the air in. I do have slight nasal allergy today but never been short of breath before.",
    "doctor_response": "Hi thanks for contacting HCM...Here first get your respiratory esmunation with auscultation....If rhonchi heard then bronchiolitis or COPD or asthma can lead dyspnea....Investigated with x ray and pulmonary function test....For lower respiratory infection antibiotic given....If dyspnea is by bronchoconstriction then bronchodilator might given....Avoid smoking....Keep exposure to environmental pollution less.....Get your blood pressure measurement....Here as you have dyspnea on exertion I would suggest to rule out cardiac cause like heart failure by.......ECG And 2D ECHO....If suspected pulmonary edema also has to be ruled out......Hope your concern solved.Take care....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe back ache\n\n50 year old female, 5'7, 160 pounds, prior history of breast cancer.  Also have spondylithelosis, broad based disc bulge at L4-L5, uncovering of the disc of l4 on l5, facet degenerative changes at l4-l5 and l5-s1, multilevel disc degeneration in lower lumbar levels and partial sacralization of l5.  I saw a neurosurgeon who looked at my MRI and said \"when youre ready for surgery we will do a spinal fusion\".  That scared me a lot and I never went back (this was in October 2010).  Now my back is worse than ever, hurts every day, spend the majority of my day sitting down and bending forward to try to relieve the pain.  I am also having trouble going number 2.  Cannot urge it along.  My neck is making rice krispie noises every time I move it.  Also, my spine is very recessed - you can hide a finger in it, it looks like it is caving in.  Help!",
    "doctor_response": "Hello,Thanks for your query.After going through your query I came to know that you probably are suffering from chronic lumbar disc prolapse. It is confirmed by MRI scan.There are two treatment options.First option is Rest in position of relief(generally lateral position with both knee bend),NUROKIND GOLD ONCE DAILY and analgesics (Diclofenac three times a day after meals is effective). Sometimes strong analgesic(such as ultracet three times a day after meals) is required. OMEPRAZOLE  before meals  prevent acidity caused by analgesics . This method needs patience as it take longer treatment times sometimes up to  6 months. Second option is go for surgical operation(Discectomy and fusion etc). You also has cervical spondylosis. For which addition of glucosamine and diacerine in treatment will be beneficial. You can discuss with your treating Doctor about it. I do hope that you have found something helpful and I will be glad to answer any further query. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have PCOS and trying to conceive. Is it safe to take Kalarchikai along with Letroz?\n\nHello doctor, I am 30 years old. I never had an irregular period from the age of 14, but in the past eight months I am trying to conceive and nothing happened. I have PCOS in the left ovary alone. My period is irregular and my gynecologist suggests to do a follicular study from day 12 provided with Letrozole 2.5 mg two tablets daily. My egg was grown good till day 14 and on day 17, I again got my period (on the same cycle). She informed to wait till the next cycle to have the follicular study again and informed to take Letroz 2.5mg. She increased the dose, three tablets per day. Now, my sister suggests to take kalarchikai with pepper and honey for 48 days. Is it safe to take kalarchikai while having Letroz medicine?",
    "doctor_response": "Hello. Taking Letrozole 2.5 mg for ovulation induction is a good choice and reportedly has been more efficient than Clomiphene. So please proceed with your treatment as prescribed by your gynecologist. Kalarchikai, commonly known as grey nicker has been suggested to be helpful in follicular growth stimulation in women with PCOS (polycystic ovary syndrome). The mechanism is still not fully understood, and it can cause irregular periods as well (possibly due to hormonal interactions). So I strongly recommend not taking any herbal element while on Letrozole to avoid unwanted results.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore neck and lump at the base of the skull?\n\ni woke up w very sore neck, sm pea size lump at base of skull, above neck, on the left side, nothing palpable on the right side.  Now, i have slightly sore right side of neck, and a new pea size lump there, have felt very fatigued sleeping 15 hours a day since monday.   Had a sore throat a week ago, it went away on its own.  I do have EBV, and DM.  not sure if i should wait and see what happens or go to dr.  i am 41 years old, 129 pounds, hx of dm ebv and cardiomyopathy...also have very bad headache for a few days, comes and goes",
    "doctor_response": "Dear,Thanks for the query to HCM. I studied your query and understood your health concerns.Remedy and cause-of your problem-In my opinion  your  lump and sore neck is due to the sore throat.Fatigue you have is of active infection with the bacteria and DM.I would ask you to consult ER surgeon.I suggest you following -Treatment  -a-Consult Er Surgeonb-Tab-Nsaidsc-If no relief I would advise FNAC biopsy and needful treatment by its excision with proper drugs.Revert to your doctor on this advise- who would help you.This would help you to resolve your query.Welcome for any further query in this regard.Write review ASAP,with strong recommendations for Me and HCM to benefit old and new patients.Have a good day.With Regards,Dr.Savaskar M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does blood get clumpy in vial after tests?\n\nI went to the lab for a blood test yesterday.  I have to do this regularly.  When my blood was being taken, it stop flowing into the vial and the person taking the blood test pulled out the needle.  Once she did that and looked at the vial, my blood lucked clumpy.  What could cause that?",
    "doctor_response": "Welcome to H.C.M. I am Dr Krishna Dubey.No need to worry because this is very common in lab. The vial content anti coagulant to prevent blood clotting. Sometimes it can be absent in vials because of manufacturer mistakes.Sometimes staff does not mix blood in vial because proper mixing is very important to prevent clotting.Thanx for query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause sharp pain in abdomen while coughing?\n\nHi ! ,, l am having problems with my upper left abdomin stomach muscles or cramps u can call it,, every time l cough l get this wicked sharp pain ,,in which also gives me breathing problems,, seems to be getting worst,,l am a 57 yr old ,type 2 diabetic .",
    "doctor_response": "HI.The sharp pain in the upper abdomen as described by you can be due to muscle sprain. But it is important to rule out the fracture of rib/s in the underlying the area of pain as you are having breathing problem. An X-ray for the ribs with a knowledge by the technician is required.As also an X-ray of the chest to rule out any pleuracy problem. Both are common, and can be easily produced as you have a diabetes too. I would advise such a patient to consult a Chest Physician for clinical examination and further management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could growing hard bump on inner thigh oozing blood suggest?\n\nHello, I do a fair amount of cycling, and I've had a hard bump on my inner thigh for a while. It is painful while riding and sometimes is painful and has a chafing feel during inactive moments. I assumed it was an ingrown hair and would go away, but it has not and has recently grown a little bit in size. Today, as I was taking a shower, I pinched the sore spot and a large amount of blood came out. There have been small amounts of blood coming out throughout the day after the initial rupture",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.This looks to be ingrown hair - boil as you have rightly suspected. You have ruptured it during the stage of cellulitis that is inflammatory stage only; so the bleeding throughout the time you mentioned.It would be wise to start an antibiotic and anti-inflammatory medicines under the guidance and prescription of a Doctor. Also get a sterile dressing and please do not fiddle it more. This may settle well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the swelling be due to the problem in the kidney?\n\nI am 58 years old. weight 75 kg, height is 1.68 m. i found my legs are swallen. Checked blood urine etc but nothing found. Some body says its from kidney. but ultrasono shows nothing. i am thinking of seeing a nephrologist. what is your suggestion. is it a problem of nephrology?",
    "doctor_response": "Hello and welcome  to HCM.As an Urologist, your urine, blood, scan reports, could've been sent.Now you should have your B.P. checked, and urine for micro albumin tested.Hope your blood creatinine has been done, with sugar,sodium,potassium and proteins.If microalbumin is high, 24hours urine proteins, must also be tested.If ECG is normal, cardiac cause can be ruled out.You can get my expert opinion, by sending the reports,as a direct question.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat myself as I start crying hysterically after developing celebrity crush?\n\nabout 8 months ago i developed a celebrity crush but it wasn t anything serious it was just fangirling if i saw his face but now its gradually got worse. If i see him i hyperventilate and start to cry uncontrollably and now i think about him everyday. my family think im going insane, am i?",
    "doctor_response": "it is a variant of obsession disease.I would suggest meeting a behavioral therapist as well as a psychiatrist.A psychiatrist will be able to suggest some medications for youThese medicines can have some side effects so it is best left for a psychiatrist to prescribe after reviewing you fullyI think actually you realize the futility of the obsession yourself. otherwise you wont have entered the query. Yes, everyone has a favorite celebrity, usually of the opposite sex, but one does not obsess over it.Best of luckDr Mittal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can the fatty liver be controlled through diet having the LFT results normal?\n\nMy doctor has prescribed udizia 300. LFT results are normal except for SGOT(AST), serum & SGPT(ALT), serum. results are 40 U/L for SGOT & 83 U/L for SGPT. My uncle & aunt has been diagnosed with liver cancer. and hence dr adviced  all the family members for LFT. can fatty liver be controlled by diet?",
    "doctor_response": "Hi & Welcome.Yes, fatty liver can be controlled through diet having the normal LFTs.I have gone through your query, I am of the opinion that the liver enzymes are slightly raised.With the following life style modifications the liver enzymes and thus fatty liver can be restored to their normal conditions;1. Refrain from alcohol or alcohol containing beverages2. Avoid taking fatty meals3. Take plenty of fruits, vegetables and eat home cooked foods4. Do regular exercise.5. Multivitamins rich in Vitamin E are effective in restoring the raised liver enzymes to their normal levels.Hope I could answer your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for loose motion in baby\n\nHi, My baby girl is 5 months old and having loose motions from last 4 days.Its not entirely watery but semi liquid 6-7 times a day.She is on bottle feeding and doesnt take breast feeding. Have given her Sporolac sachets, half sachets 3 times a day, still no effect.What to do?",
    "doctor_response": "Hi,You can try a different anti-diarrheal drug as imodium 3 times daily. You should also make sure the child is adequately hydrated with enough amounts of fluids to compensate for fluid loss in diarrhea.  You can also give oral rehydration solution 5 teaspoons for every pound of child's weight to avoid dehydration.  Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Salah Saad Shoman",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can cheek lumps with hardness, swelling and itching be treated?\n\nhi my name is megan, im 19. a couple days ago i woke up with a cluster of skin tone bumps on my lwft cheek, next to my nose. they didnt hurt or itch, then the next morning the surroundin area is hard and my whole cheek is swollen, and now it really itches, and hurts a little bit what is it?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have cheek lumps with hardness, swelling and itching which could be due to local reaction to something if you have applied during few days or may not have a specific reason. You can consider allergy testing to determine what would have caused this reaction so that it can be avoided. It could be Lipoma which  is over growth of fat cells in fibrous tissue under the skin. Exact cause of lipoma is not known but sometimes minor injury can act as a trigger factor. But as it is bothering you aesthetically ,you can get it removed by surgeon. Small incision under local anesthesia can serve the purpose. Hope your concern has been resolved,Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Ultrasound done. Uterus anteverted. Having regular periods. Planning for baby\n\nHi. I got an ultrasound done today. Reports say uterus anteverted and it measures 65*39*35mm. Rt ivaru measures 41*24*24 mm. Vol -12.4 no. Lt ivaru measures 35*26?16 mm. Vol. -7.6ml. Both ovaries show myltipke peripherally placed follicles with increased central echogenic stroma. I hv regular periods and married and planbing for a babyy. Kindly advise.",
    "doctor_response": "Hi, Thanks for your query, Your ultrasound findings are suggestive of PCO ( polycystic ovaries)   which may be associated wiyh irregular cycles and problems in ovulation. Problems in ovulation may be solved by some drug like clomiphene. So i will suggest you to try for pregnancy.And if you face difficulty you will need ovulation induction drugs.. Take care and best of luck.. Hope it helps you..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Colonoscopy showed slight diverticulitis and 2 non cancerous polyps. Suffer severe tightness around rib cage. Remedy?\n\nI am going to run this by you to see if you have any suggestions. My brother is a family physician and either he doesn't believe my mom or he just doesn't know what is causing this. She has also seen a gastroenterologist and her colonoscopy found slight diverticulitis and 2 non cancerous polyps that were removed and no problems found with the endoscopy other than she had a slight inflammation at the top of her stomach that the physician didn't seem too worried about. This is her symptoms... She complains of a severe tightness around her rib cage to the point where she has to take off her bra and has trouble breathing. She also gets bloated sometimes when this happens. I can't stand to see her in pain like this anymore. I did a search on the Internet, (yes, I know you guys hate armchair doctors.. Lol) and it seems a lot of people complain about this but have no answers. A bit on her background- she is 80 years old. She's a diabetic. We thought the metforman was causing the pain so they put her on lantus and humalog. I know diabetes can cause peripheral nerve damage, not sure if that can cause the tightening. She also has had her left kidney removed because the artery that carried the blood to it got clogged and it failed, so they removed it 12 years ago. She also had two stints put in her left and right illiacs to open them as well. She recently had an MRA, and they found two of the 3 main arteries to the bowels are become blocked, but the physician didn't seem to think this would cause tightening, but chronic diarrhea, which she does not have. This all started after she had the flu last January. She has not visited any foreign country recently, so I don't think it's a parasite. I read that maybe she should have a stool sample to check for parasites. Have you heard of this condition? Any of you? Any suggestions on what to try? I am at my wits end. She lays in her bed and moans when this happens and she's not a complainer so I know it's bad. Thanks for your time.",
    "doctor_response": "The picture that you have portrayed seems to be more in favour of a heart related problem than anything else. It is not explained by any of the problems that you have cited, namely, polyps in the colon, diverticulitis. She has a history of blockage in various arteries-kidney, small bowel, iliacs. So she probably has a tendency to excessive clotting. She may have had blockage in one of the arteries supplying the heart and suffered from a mild heart attack. In diabetics, the symptoms of a heart attack are suppressed and atypical.So, i would suggest that you immediately show her to a cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Soft, permanent pain on the left upper abdomen for 5 yrears\n\nhaving a soft, permanent pain on the left upper abdomen for four /five yrs, can touch and pin-point the location but doctors give no importance (male-41), constipation started which was unknown to me, body smell changes. what type of tests should i go for to understand the gravity of problem. i m also steadily loosing weight. amit mukherjee",
    "doctor_response": "Hi Welcome to HealthcareMagic Since the pain is from 3 to 4 yrs, an USG scanning of abdomen is necessary to find the cause.. take the opinion of surgeon..",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure frequent nausea ?\n\nhi my name is Amy and I have been having sudden nausea everyday at I can  have it up to 4 times a day when i stand up I get light headed and I get suddenly tired aswell i've been like this for 2 months i'm not pregnant I was getting lower abdomen (pelvic pains) but they have stopped after I had a hour  spotting I am on the depo injection please help me",
    "doctor_response": "Hi ! Good evening. I am Dr Shareef answering your query.Even though you are on a depo injection, I would advise you to get a serum HCG and an ultrasound done if need be on consultation with your family physician. In addition, I would also advise your for a routine blood test along with a liver function test. Further management apart from an anti emetic, would depend on the investigation reports and physical examination by a doctor in your area.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swelling in the rectum\n\nI am a 19 year old gay male. My partner and I engaged in intercourse earlier. Now my rectum is swelling. Kind of like 3 dime sized pockets around the entrance. There isn t much pain or discomfort. Only a slight burning. (friction) Just wondering if I m okay and what this is...",
    "doctor_response": "Hi thanks for contacting HCM...Here you need to get your anal area examination including proctoscopy also ...It might reveal proctitis / fissures/ piles ....According to cause treatment given ...In general meanwhile try to avoid straining at stool....Excess spicy food avoided...More water ....Ibuprofen taken for inflammation relief...Hot water sitz bath useful....Avoid constipation by taking stool softener....Avoid anal sex if practising ...With keeping my answer in mind consult surgeon for that....Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does \"liver is mildly enlarged in size with increased echogenicity\" mean?\n\nHi Doctor,  My report shows  - liver is mildly enlarged in size with increased echogenicity. what does this meanalso my husbands reports shows calcification in right lobe of liver? Calcified Granulomaalso left renal cortical cystPlease advise if there is any issue and also the remedy for it",
    "doctor_response": "Hi and welcome to HCM.It would be easier if you ve posted the  liver enzymes findings.It ma indicate alcoholic, viral, autoimmune or toxic liver damage. The most probable cause is  is fatty liver which can be found in healthy people, but usually is resulting from elevated blood lipids, overweight and elevated blood sugar. If ultrasounds didnt find anything and viral markers are negative then you have no reason to be concerned. YOu should treat it by changing dietary and lifestyle habits. Do exercise, avoid alcohol, smoking, fats, fast food and carbonated drinks. Eat more fruit and vegetables, boiled meat and follow some of hepatoprotective diets. Findings usually improves on such measures. If not, then some medicines can be prescribed, but I suggest to go step by step. If you dont have any symptoms then this is just slight and reversible liver damage.Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hole in heart\n\nHii,My cousin is having a hole in heart. Please find the summary of his check up. Doctors are advising for surgery. Which type of surgery is suiable for him? Key hole or open heart? Is it urgent to do the surgery now?SUMMARY Large secundum ASD seen in multiple views. Measures up to 2.4 cm from superior rim to inferior rim.The left ventricular size is normal.Left ventricular systolic function is normal.The right ventricle is mild to moderately dilated.The right ventricular systolic function is normal.The left atrial size is normal.The right atrium is mildly to moderately dilated.Mild atherosclerotic plaque(s) in the aortic arch.Mild atherosclerotic plaque(s) in the descending aorta.FINDINGS: LEFT VENTRICLE The left ventricular size is normal. Left ventricular systolic function is normal.RIGHT VENTRICLE The right ventricle is mild to moderately dilated. The right ventricular systolic function is normal. LEFT ATRIUM The left atrial size is normal.RIGHT ATRIUM The right atrium is mildly to moderately dilated. Large secundum ASD seen in multiple views. Measures up to 2.4 cm. A secundum type atrial septal defect is present. - AORTIC VALVE The aortic valve is trileaflet. No aortic regurgitation is present. - MITRAL VALVE The mitral valve is normal in structure and function. There is no mitral regurgitation noted. - TRICUSPID VALVE Structurally normal tricuspid valve. There is trace tricuspid regurgitation. - PULMONIC VALVE Structurally normal pulmonic valve. Trace pulmonic valvular regurgitation. - ARTERIES Mild atherosclerotic plaque(s) in the aortic arch. Mild atherosclerotic plaque(s) in the descending aorta. - VENOUS 3/4 pulmonary veins were visualized draining into the left atrium. -",
    "doctor_response": "Hi, He is having a condition called atrial septal defect( ASD). It is a congenital problem and might cause many problems in adulthood. Small ASDs will close by itself. But in this case, the size is quite large and hence surgical repair may be required. Consult a cardiac surgeon and he will direct you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain while urination?\n\nHi doc, i have this problem with my penis, which started 3days ago everytime i urinate it hurts like hell, sometimes it s affecting the way i poop, Im19 yrs old, and never been to intercourse i viewed lots of articles but no solutions yet for me. What should i do? What meds to drink? what diet routine should be implemented? Thank you Hoping you read this Steve moreno , Philippines",
    "doctor_response": "Hi,It seems that you might be having some infection in penile urethra giving rise this problem.Taking so much spicy or junk food do cause this type of pain.Go for one antibiotic like Ofloxacilin for 3-5 days.Take plenty of water and juices.Avoid fried, chillies and junk food.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for low pressure during ejaculation\n\nHi Dr. Rakesh, I use to masturbate from long time. I got married 2 years back. How ever I found that when I ejaculate it is not coming by pressure if I masturbate regularly. But I I masturbate after 4 to 5 days, my semen ejaculate by pressure . Please suggest me how can I increase my pressure of my ejaculation of my semen. I want to get my wife conceive for a child. Thanks a Lot !!!",
    "doctor_response": "HiThank you for asking HCM. I have gone through your query. It is usual to have less volume in ejaculation if you frequently masterbate. For increasing it you should take more water and proteinaceous food. You should have proper exercise also. Weight exercises will be helpful for increasing testosterone and there by increase in semen production also. Hope this may help you. Let me know if you have any further queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do these MRI test results of the spine indicate?\n\nc5-c6- left central and foraminal broad-based protrusion with endplate marginal osteophyte formation results in flattening of the left ventral cord. End plate marginal osteophyte abuts the exiting left c6 ventral nerve root. Left greater than right uncovertebral hypertrophy and facet arthrosis contribute to moderate left foraminal narrowing.What???",
    "doctor_response": "Hi i am Dr Ahmed Aly    thanks for using HealthcareMagic site ,I had gone through your question and understand your concerns ..  From your given report i think you have cervical radiating pain due to nerve compression . such nerve compression may show neuropathic pain towards your  right shoulder and even may reach your hands and fingers .    In mild cases such pain may subside simultaneously with relaxation and even without medication . you may avoid heavy lifting , over weighing , vigorous movements , bad sleeping or sitting postures . Physiotherapy sessions with a good chiropractor , hot massages , yoga and spinal straightening exercises are of good value in all cases .   For my patients i may suggest painkillers like advil tab when needed , hot gentle massaging with topical gels of anti-inflammatory , B12 vitamin supplement , muscle relaxants will be effective for most of cases . steroid tabs or injections may be prescribed if needed in more sever cases .    If pain persists i recommend you follow your MRI results with your neurologist for proper evaluation and management . Please click and consider a 5 star rating with some positive feedback if the information was helpful. Wish you good health,Any further clarifications feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the prognosis in a patient with a low ejection fraction?\n\nmy husband had a build of of fluid in his legs two yrs ago.he went to the doctor .they sent him on to the hospital because his enzyme level showing he was having a heart attack. six months before that he had several test on heart . his heart pumping function was only 20%. but when he went in hospital they told him he needed a pacemaker with defibillator. he had one put in and it put his pumping function at 40 % he is still there after 2 yrs what is the outcome of his prognosis and aslo he has applied for disability. he also has diabetes out of control high blood pressure and high cholesterol.he is only 52 yrs old now.thank you for any info",
    "doctor_response": "you have mentioned his ejection fraction is 40% which is not very bad. Although he has risk of deterioration still will be able to lead a comfortable life with medicine.regular medicine and proper follow up as advised should be done.low sugar and salt along fluid restriction, healthy lifestyle, regular exercises will help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the diet plan for increase the body ?\n\nsir my body is thin so i feel shame to meet the relatives and other people is this any disorder of mental health how this can be cured",
    "doctor_response": "Hi, This is not mental problem but you have got inferiority complex. You develop self confidence,having thin body is not bad at any angle.on the contrary fatty people might have jealousy by seeing you. So do not feel shame to meet the people. Take nourishing food with high fat,high carbohydrate and high protein. Take dry fruits,fresh fruits and green veges. Take B complex and multi vitamin supplements. ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for fatty liver and urinary problems?\n\ni have +1 bilirubin and urobilinogen in my urine and have fatty liver of average sgpt of 80 every test, what should i worry about? and how to lower my fatty liver? i have high concern now for my bilirubin and urobilinogen which is always negative on urine test, this is the first time i got that result. thanks",
    "doctor_response": "HelloFatty changes in liver is a reversible condition.Most commonly it is due to obesity and sedentary life. It may also be due to alcohol intake,hepatitis,metabolic disorder etc.Increased SGPT and urobilinogen in urine may indicate liver damage.It may be due to fatty liver.I suggest investigations like routine hemogram, Random blood sugar(RBS), Lipid profile, Renal function test(RFT),viral markers,ultrasound of abdomen to my patients.You should try to lose your weight as you are overweight.Fatty liver is a reversible condition and it can be reversed by diet and life style changes.You may need some medicines after full investigations.You should be active in your daily life.I also suggest tablet ursodeoxycholic acid 300 mg twice daily for three months to my patients.It helps in regeneration of liver cells.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of survival with metastasized cancer in brain?\n\nMy wife haws stage 3 non small cell cancer. She was treated with radiation and chemo and we were told she was in complete remission. 2 weeks later after a cat scan it was found the cancer has metastasized to her brain. What are her chances of surviving after radiation on this. Any thoughts? Where can I find more answers to my concerns? Thanks",
    "doctor_response": "HIThank for asking to HCMI really sorry for your wife's health issue, and appreciate your concern, even if it is metastatic phase and that does not catch the vital area, and your wife is asymptomatic then I would advise you to just forget it, because metastatic process not always be dangerous, this could halt at certain level without causing any clinical symptoms and that would be the starting of natural remission, lets hope for the good, take care of her, have good life.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for severe sinus infection?\n\nhi im a 20 yr old male this has bee goin on for a couple months i had sum bad sinus infections and colds i puked up blood after i drunk alot of monster energy drinks i went to the docotors here and they gave me a shot of promethazine and sum generic nexus for my throat she said i might have ruptured my stomach or throat lining then after that i had a cyst removed from behind my right ear i let it go to long it got infected bad about the size of a nickel or quarter or bigger marble they lanced it and squeezed all the poison out its healed up now and im not vertigo anymore i still fell like im caught in a dream and when i wake up i notice i grind my teeth while im sleepin i spit up yellowish brown mucus in the morningi do smoke cigs almost a pack a day  could u answr why i fell fatigued all day?",
    "doctor_response": "Hi thank you for choosing healthcare magic. the best treatment for sinus infection is azithromycin 10d for 3 days and steam inhalation and also if recurrent consult an ENT doctor to do endoscopy and sinus opening removal",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a dent on top left of forehead due to an injury?\n\nHi,I have a dent at the top left of my forehead where my hair line is!it was caused by someone throwing a bottle which left me with 7 stitches! This happened a few years ago but at the time the hospital never even gave me an x-Ray and just stitched me up.... This happened a few years ago, should I be worried?",
    "doctor_response": "Hi there, Sorry to hear about the bottle and the dent! The dent at this point could be due to either a defect in the skull (would have been there for years, since the injury). Or more likely due to loss of muscle and tendon tissue in that region (could be a slow progressive process)The best way to figure t out is to get some x-rays. If it is a soft tissue (tendon and muscle), then you need to go to a cosmetic surgeon who can see if anything can be done.I hope this helps!Vinay",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please suggest me the right way to get rid of snore and cough.\n\nHi doctor, From last few days, I have been facing cold. Cold is my common friend due to allergy. The friendship is almost 8 years old. I have been using tablet Levocetirizine when required. In this recent episode of cold attack, I am having irritating cough. It even wakes me up at night. At the time of sleep, some sort of snoring sound comes out from my chest. I can feel that it is due to cough. I am attaching the sound. The mucus is dense and pale yellow in color. Please suggest me the right way to get out of this.",
    "doctor_response": "Hi. I have thoroughly gone through your case and can well understand your genuine health concerns. I appreciate you for uploading the sound clip (attachment removed to protect patient identity) which is a really helpful move. You are having the typical symptoms of asthma and the sound clip showed that you have \"expiratory wheeze\". When the airways are narrowed due to some reason, it makes difficult for air to pass in and out of the lungs and creates such noises as you can hear in this sound clip. Cough is a part of acute exacerbation of the asthma attack. You need to have proper medicine for sometime to get rid of the situation. You need reliever medicines to give you ease right now and also some long term relief medicine named controller medicines. Keep a follow up for better outcome. 1. Pulmonary function tests. 2. Allergy test for asthma. 1. Combivent inhaler - combination of Albuterol and Ipratropium bromide. You use this when you feel shortness of breath or the sounds like you have right now with respiration. It means you will need it as needed. 2. Prednisone by mouth 20 mg twice daily for two weeks. 3. Azithromycin 400 mg once daily for 10 days. 4. Ebastine 10 mg twice daily for 10 days. 5. Ibuprofen twice daily for a week. 6. Cough syrup available over the counter.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does redness and itchiness in rectum following diarrhoea indicate?\n\nTwo weeks ago I had a bad case of diarrhea.  Unfortunately I did not wipe good enough and my rectal area began to itch.  I went to the bathroom, and wiped, to notice some fecal matter was still on my rectal area.  I cleaned it and washed it pretty throughly.  THen it became red and very itchy.  A few days later, it appeared to \"peel\" and I thought it was gone.  Then more redness came and the cycle started over.  What is this and how do I cure it?  I am thinking it may be a rectal yeast infection?",
    "doctor_response": "Hi,Due to having frequent passing stool and not cleaning local part properly might lead to some irritation and infection.Clean part with warm water and apply triple action cream.Keep local hygiene clean and dry.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for rapid heart rate and tiredness?\n\nHi i woke up a couple of weeks ago feeling unwell sickess and lack of energy, i was getting palpations also the n in the eveing my heart stared racing up to 130..they did a full blood count and a ecg and a xray everthing was fine they only thing was a top part of the heart going fast this went on for hours....i am a BIG worrier with my health and constantly think there is something wrong..i am due to see a cardo next month..i think my worry is making me worse",
    "doctor_response": "Hello,Brief answer: Palpitations get worse with anxiety. Sure need a cardiologist consultation. Simple rate control with medication would help.Explanation: My opinion is that palpitations have many causes: anemia, anxiety, caffeinated drinks, some diseases like heart failure, ischemia, etc.Normal EKG is a good thing but needs to be followed up if complaint persists may do a Holter that is simply a record to your heart beats. I suggest my people the following avoid anxiety, excess coffee, do some labs like CBC. Get a Holter and electrocardiogram. Give a low dose beta blocker if no contraindications. The information provided by you is not sufficient to provide a good opinion. If someone comes to me with this condition I would ask them about medical history. Conclusion: I suggest you check your GP and ask about rate control drugs and if they fit in your condition till your cardiology check.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mahmmad Gamal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tiredness and paleness to a 10 year old?\n\nHi I have a 10 year old daughter and she has been very pale this past 3 weeks,she also has been very tried and not in good form,I had her at her own gp 2 weeks ago for blood tests and one of her blood count came back high.She has to go back to get them redone.Could you help me with my query?",
    "doctor_response": "Hi,Thanks and welcome to healthcare magic.Pallor in 10 years old may be due to anemia.Anemia may be due to several causes, but most common cause is iron deficiency anemia.You not mentioned the specific blood cell whose count is increased.But as far as I know thrombocytes may increase in IDA.Hope this reply is O.K for you.Please feel free to ask further queries if any.Dr.M.V.Subrahmanyam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pneumonia be managed while suffering from COPD?\n\nMy sister, age 72, and living alone drove herself to an emergency room at 4:00 a.m. with temperature of 101+, chills and a little dizziness. They diagnosed her with pneumonia. She has COPD and uses inhalers and oral meds. I am concerned because she just told me she is extremely tired and has been under a lot of stress due to move from home of 45+ years, family concerns and loss of husband 2 years ago. She had hip replacement three months ago. I live an hour and a half away and am wondering if I should drive to her city and check on her. She does have a son and a neighbor friend looking in on her.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. She is already suffering from COPD (chronic obstructive Pulmonary disease). And pneumonia can be severe in already compromised lungs. So pneumonia in COPD patients should be treated promptly. And hence she needs hospital admission, Intravenous antibiotics, anti pyretic, Intravenous fluids and other supportive drugs. So better to admit her and start appropriate treatment. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of a spur breaking off?\n\nI have a large spur in my shoulder. I have been told that it can break off at anytime. What are the sign of the spur breaking off and what should I do? I have been dealing with this for about fifteen to twenty years. I also had cervical stenosis and had three vertebrates removed. I still have a lot of pain in both my shoulder and my neck. What should I do?",
    "doctor_response": "Hi you have a spur in your bone in the shoulder for last 15-20 yrs and it has nor broken yet. You also had surgery in your neck. In my opinion you can wait for the spur to break( it will be indicated by increased pain and severe restriction of movements + you may have local bruising). In case it breaks you can go for excision.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to play while suffering from a purple bruising after pulling a hamstring?\n\nHello, i pulled a hamstring about 10 days ago playing a soccer match, i rested  my leg for a week now and used cold therapy for 4 straight days with painkillers. The pain is gone and i can walk normally. I just noticed i have a purple bruise on the injury, not too big though. I have a league match tomorrow, is it safe to play as a sub?",
    "doctor_response": "In my opinion it is safe but you need few precautions 1- warm up for 10 min 2-use kinsiology tape on your hanestring to support it 3-make sure you do cooldown exerciseGood Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the numb soft lump formed on thigh after falling?\n\nI fell over on my side at skiing 4 weeks ago. At the time I felt a very sharp pain in my right thigh just below the buttocks and it swelled up and became black and blue with bruising for about 10 days. Since the swelling subsided I have had a soft lump in the location about 6cm roung and 1.5 - 2cm high that is very soft to touch and is quite numb. Do you think this could be a hernia?? The tingling goes down the outside of my leg half way to my knee. Regards Michael Conroy",
    "doctor_response": "Hello!Thank you for the query.This lump is rather not a hernia. As it was blue with bruising and has appeared after the injury, most likely this is a hematoma.It appears due to veins rupture (Caused by the injury). The blood cumulates in the soft tissues. If a hematoma is pretty large wont disappear by its own.I suggest you to consult general surgeon. The hematoma should be drained. In case of doubts, soft tissues ultrasound can be done.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does positive ANA mean that one has SLE?\n\nI have been diagnosed with SLE in October 2011. Since then, I am on a regular immunosuppressant medication with prednisone, HCQS, folitrax and folic acid. My ANA test and butterfly rash were considered as symptoms for the diagnosis. I did not have any complaint of joint or body pain. There were no other symptoms. But after having the prednisone, I was feeling more fatigued than usual. I recently read in an article that a positive ANA does not mean that one has SLE, although the butterfly rash was indeed a symptom. I wondering whether there is even a faint chance that I might not actually be suffering from SLE. Also, the year before that is from February 2010 to February 2011, I was taking a year-long course for homeopathic medicine to improve my immunity against my allergy to cold and dust. I had chronic cough too, which got cured with the homeopathic treatment. Please advise me appropriately.",
    "doctor_response": "Most of the time it is SLE. However it might be other autoimmune disorder in few cases. But butterfly rash is the symptom of SLE. There are many symptoms required for diagnisis. Total 4 out of 11 criteria is needed tk diagnosed as SLE.  Malar rash, butterfly rash, photosensitivity, hematologicak, neurologicak, renal, autoimmune etc are the criteria.  If you have doubt then go for anti ds dna and anti sm antibodies or immunofluorescence test.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a heart disease\n\nhello dcoctor , i am a recent heart patient and had astent put in, i am on ecosprin, 150 mg a day and get alot of gerd symptoms.please advise me what to do, sshould i reduce the dosage. the other medications i am on , are clopilet 75mg,starpress 25mg,and storvas 40mg. thank you",
    "doctor_response": "SYMPTOMS of gerd is due to aspirin....you can add some antacid in your diet.....try to have something before taking aspirin.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower abdominal pain?\n\nI have had abdominal pain, like a dull pain where my ovaries are located and my lower back for the past few days. My period is not due for at least another 10 days. I ve also been very emotional recently. Starting to tear up from minor things and unable to control my mood.",
    "doctor_response": "HI.Thanks for your query. The pain in lower abdomen along with lower back can be due to the following resons:Enteritis ColitisSalpingitisOvarian cyst or its torsionIBSYou have not mentioned any other symptoms either related to intestinal or bowel habits.Consult a Doctor to get examined and get ultrasonography done just to rule out some of the reasons known to cause problems as mentioned and get treated accordingly, May be for the emotional upset or so.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain and spasms in the back be treated?\n\n67 year old male. Slipped, fell down, slammed back against large machinery. 6 days ago. No broken bones, or kidney damage. Injury is on the right side, and when spasm hits, pain shoots almost all of the right side. Received muscle relaxer and pain pills, and ledocaine patches. No pain when I sit, but severe pain (with queasiness) when standing up, picking up stuff, bending. Pain pills help, but patch is useless and so is muscle relaxer. Pain and spasms reduce when I press againt the injury point (a bruise with slight decoloration) when I feel the spasm starting. ER doc gave no info on what to do if pain and spasms occur after meds run out (5 to 20 days) depending on if severity says the same. Advil and Aleve seem best for long term. Thank you.",
    "doctor_response": "Typically the pain from a muscle injury will improve over a few weeks.If it doesn't, MRI of the lumbar spine can be done to look for a deeper injury, to the bones of the spine, or the nerves to the spine.If your pain hasn't considerably improved over a few weeks, discussing with your primary care doctor is helpful to get further testing done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Liver tumor increasing in size, spreading. Quantiferon tb gold test positive. Diagnosed primary hepatocellular carcinoma, hcv. Advise?\n\nmy faher by MRI IN 2007 diagnosed primary hepatocellular carcinoma.no biopsy done,he has a HCV.all tumour marker -AFP,ALKALINE PHOSPHATASE,CEA,BILIRUBIN,ALL OTHER TEST are normal,exept sgot-126,sgpt-37,GGT-83,ESR-46.before 4 months all  lab almost normal,liver tumour increasing in size.now it spread in both adrenal glands & psoas as per MRI.weight reduced -5 kg,anorexia,diarrhoea,weakness start this is almost within 2-3 months.he is treated only with homeopathy,HCV VIRAL LOAD BY PCR -neg.I read in google some cases dx-hcc & then turned liver TB.he has a old lesion of pulmonary tb.now chest x-ray normal but QUANIFERON TB GOLD TEST-positive.this test does not diff. letant tb & active tb.  bl.culture neg.can you give us advised please.thanks.waiting for your answer.",
    "doctor_response": "Good morningYou need to urgently see oncologist and herpetologist(liver specialist).Your father has advanced cancer of the liver.The cancer has metastasis(spreading to other organs) sign of bad prognosis.He will also need counseling services by professional counselor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the treatment methods available for ringworm infection?\n\nHello doctor, I have ringworms on my face, nose, eyebrows, scalp, jock itch, white spots around the anus that hurt and itch. I get blood when I go to the bathroom, nails rip off easily, always feeling sleepy, swollen lymph nodes and itching all over the body. Please help.",
    "doctor_response": "Hi. For how long do you have this problem? This is not ringworm or fungal infection. There are multiple atrophic plaques over the face and arms from your picture. Have you applied anything over them? It looks like it is lupus erythematosus but confirming the diagnosis would be made on skin biopsy. You also have folliculitis over beard area with secondary infection over it. I will suggest you consult your nearby health facility. Skin biopsy. Lupus erythematosus, Tinea incognito, atrophic lichen planus, folliculitis. Take oral antibiotics for folliculitis, tablet Co-Amoxiclav 1 gm BD for one week, apply Fusidic acid ointment BD over the lesions. Maintain hygiene of body, wash with soap and water, avoid using Dettol and other irritants.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can keloid developed after ear piercing be cured with homeopathy?\n\nSir I have developed a keloid on the front if my left ear after a piercing . It's 4 years old now  . I went to a homeopathic doctor who said that he can help . But instead of reducing, the size of the keloid has increased 4 times in 3 years . Is there actually any solution in homeopathy?",
    "doctor_response": "Hello and welcome to HCM forum.Keloids basically are over enthusiastic healing of the skin after a taruma which can lead to a raised scar and it can keep on growing with or without medicines.It is a difficult and sometimes painful condition which can sometimes be managed by corticosteroids injections or radiotherapy .In Homeopathy cases have been managed  successfully when it controlled the further growth of the keloid and reduced the scar thickness significantly .You can get back at the following link with further details of your problems for a better understanding of the problem include how it started ,if any pain or sensation in the keloid ,how profusely and easily do you sweat, what body parts do you naturally sweat more ,any odour to the sweat ,what are your food cravings --e.g extra salt, sour , raw vegetables, meat ,eggs ,milk,pickles etc )Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hair fall in a child?\n\nI am 13 years old and most of my fringe has fallen out but i dont know why. It now looks like i have shaved it but i havnt. I have tried to let it grow out again and i left it for two months but it didnt grow back. Is it a serious illness and do i need to see a doctor?",
    "doctor_response": "hair fall in children is due to severe fungal infections, tenia captis. start using ketokonazole hair\u200bshampoo, and consult your dermatologist asap.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high systolic blood pressure?\n\nI am a 38 yo female and have tachycardia and had borderline high blood pressure then but now my BP is running about 190/85.The bottom number isnt bad but the top is so I was wondering what causes top number to be elevated and bottom number ok and is this as bad as bottom number being high?",
    "doctor_response": "Your BP is significantly very high.get your thyroid profile done.ECG and ECHO.Also take a reading of your BP for atleast two weeks, after that you may require medications to control BP",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for kidney failure\n\nHi, may I answer your health queries right now ?  Please type your query here...  Thank you for your help.  My Neice is in Malaysha and has been diagnosed to have both kidney failure and transplant is recommended possibly in India.  I have no clue how to proceed.",
    "doctor_response": "welcome to hcm ...there are many legal formalities for kidney transplant in india ...good institute are aiims delhi ...pgi Chandigarh or dmc ludhiana ...please visit any of these then you will be properly guided there ..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of impregnation after an unprotected sex?\n\nHi. I had unprotected sex with my gf. Her last period was 11 dec and she has irregular period. 2 weeks ago she spot a little for one day. However she said this has happened before. We're concern about how high the chance of pregnancy is because I didn't ejaculate.",
    "doctor_response": "Hello dearI understand your concernThere may be some chance of the pregnancy as you had unprotected sex and precum may enter into the vagina unknowingly before the ejaculation.Spotting could be due to hormonal imbalance, ovulation.Blood HCG test will help you to detect the pregnancy as period is irregular.I would suggest to go for blood HCG test 10-12 days after the sex.Or go for pregnancy test 8-10 days after delayed period.Menstrual irregularity could be due to hormonal imbalance, ovarian dysfunction, thyroid dysfunction, endometriosis.All should be rule out by consulting the gynecologist.Meanwhile avoid stress, take healthy diet, drink plenty of water and do regular exerciseHope this may help youContact HCM for further queryBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will suffering from PCOD lead to problems with conceiving?\n\nWhat is pcod problem in ladies..I would like to know what happens if that is there..will it make a problem during conceiving or sex what happens..I have no thyroid and my blood percentage is normal..I m not getting periods regularly.When i contacted doctor she told me we call it as pcod nothing more than that..",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and I understand your concern. PCOD is very complex disease, cause multiple cyst in ovary. It cause hormonal imbalance, menstrual irregularity and also cause difficulty in conceiving. But after proper treatment it is very treatable condition. I would suggest to consult the experienced gynecologist and undergo reproductive hormone analysis, USG scan and ovarian follicle study for better management. Doctor will give following advised for PCOD: Drugs like Progesterone pill in second half of period to regularize the period. Drugs like Krimson, Metformin can be useful. Avoid stress, take healthy diet in small frequent meal, take more fresh fruits and green leafy vegetables, do regular exercise and lose 10 to 12 % body weight if you are obese.Hope this may help you. Contact further if follow up needed.Best regards,Dr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can an abusive person suffering from bipolar hurt a child?\n\nI have a five year old daughter and she has to go to her dad's every other weekend, her dad has bipolar, he was very abusive to me, he drinks, and does not take his medication, should I be concern about her being there with him? could he hurt her? if so what should I do?",
    "doctor_response": "hiThanks for choosing healthcare magicAs u told that child's father does not take medication. In that case it is very risky to send her alone to meet her father. Bipolar patient could hurt anyone due to his mental illness. In that case u should go with her whenever she goes to meet her father and try to protect her in serious circumstance. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Nido be given to a child?\n\nHi my son will turn 1yr in 2 weeks. Just to be on the safe side can I give him nido? He drank similac advance this whole time besides food I eat. He doesn t have no complications I just want to know since family members have mentioned nido to me. I m a first time mom so I m new.",
    "doctor_response": "Yes NIDO is a good supplementary food for children. You can safely use the milk. Just follow the instruction given to prepare the milk,and stick to the instruction. But always encourage your child to eat from family pot as gradually this will become his diet and also giving him a balanced diet is more important than giving NIDO.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to concive. Have endometeris cysts. On Ovarl L and lupride injection. Any need of IUI?\n\nHi,I am trying to concive from last 3- 4 years, it was unexpalined infertility i.e stress & travelling and even low motility of hubby's sperm. last years it was detected endometeris cysts, so Laproscopy was done & lupride injection was been given. I got my periods after 5.5mths ...& next cycle again there was a cysts in left ovary 5.8 Then doc prescibed me Ovarl L for 2 mths & the cysts size reduced to 4.8 & then we may check if ovalation is happening nicely we may do IUI .. on saturday acordingly to the ultrasound report they performed IUI as all reports were good .. follicle 20mm & 22 mm ET 10.5 & Fuid was seen ... Hubbys report was also very good i.e 50 million & rapid Linear 90% . Next day doc again asked to come for ultrasound which showed the follicle was still ther 36 mm .. When I asked hime he told as the fluid was seen it indicates ovulation, After ovulating it may have sealed again in some cases or it had not ruptured also two opinions & also while doing IUI doc said it was very easy to do due to muscus etc.. I m confused what exactly had happened .  So wanted to know how are the chances of pregancy & what precaution to take after IUI ...Please help waiting",
    "doctor_response": "IT MAY HAPPEN THAT DUE TO ENDOMETRIOSIS A FEMALE MANY A TIMES MAY NOT GET CONCEIVED. ALSO, THEIR ARE GREAT CHANCES OF ABORTION EVEN AFTER CONCEPTION...IN SUCH CASES PRACTITIONERS OF MODERN MEDICINES ASK THE PATIENT TO GO FOR IUI BUT ... ALTHOUGH YOU MAY ALSO GO FURTHER AT TAKE HELP OF THE ASSISTED REPRODUCTION TECHNIQUES... IUI IS THE TECHNIQUE ONLY TO REDUCE THE SPERMATIC TRAVELLING DISTANCE...ALSO, YOU HAVEN'T MENTIONED YOUR DETAILS OVER HERE ABOUT YOUR AGE, WEIGHT HEIGHT OCCUPATION AND DETAILS RELATED TO MENSTRUAL HISTORY OR ANY PREGNANCY YOU HAD EARLIER ETC.. YOU MAY ALSO BE SUFFERING FROM A CONDITION CALLED \"PCOS\" IN WHICH VARIOUS CYSTS MAY BE SEEN AT THE OVARIES... THIS AGAIN HAS TO BE TREATED PRIOR WHICH MAY HAVE BEEN NEGLECTED BY YOUR GYNECOLOGIST EARLIER, DUE TO YOUR HUSBAND'S CONDITION...SUCH CONDITIONS ALTHOUGH MAY NOT BE HAVING AN ANSWER IN MODERN MEDICINE BUT DO HAVE BEST TREATMENTS IN AYURVEDA..THEIR ARE LOT OF THINGS BEEN ASSOCIATED AND TO MANY OF THEM WE HAVE ANSWERS TODAY ... DO KEEP PATIENCE AND WRITE IN WITH COMPLETE DETAILS ...",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a pregnancy after intercourse be prevented?\n\nHey doctor, while having sex with my gf, I wore two condoms and the outside condom(2nd one) got torn off. And I have a doubt that sperm did go inside. Doctor please tell me how to prevent her from getting pregnant. It s been almost 15 hours since that incident happened please suggest me something, what should I do to be on the safer side?",
    "doctor_response": "Hello dearI understand your concernThere is chance of the pregnancy as condom torn.For safer side, take unwanted 72 pill as early as possible with in 24 hour of sex to prevent the unwanted pregnancy.Avoid stress, take healthy diet and do regualr exercise.Hope this may help youContact HCM for further health queryBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could cough be the only symptom of asthma?\n\ni have cough .doctor say asthama, but never had a attack . i suspect its alergy . i got this thing suddenly while working in outdoor  in 2006 december. but still no cure . many time been  to doctor . they just do x-ray , blood text , and give costoreoid and inhaler. pls would like to know what is the solution .thanks",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your history and would like to make suggestions to you as follows:1. First of all, yes, cough can definitely be the only symptom of asthma, but not very commonly. Especially if your cough is improved with corticosteroid inhalers and worsened by stopping them, there is high chance that the cough be asthmatic.2. Also, allergic rhinitis and sinusitis due to allergies can also cause cough. So it is important to identify the cause of the cough.3. Asthma cannot be definitely diagnosed with x-ray or blood tests. I would suggest you spirometry with reversibility with bronchodilator testing, which can diagnose or rule out asthma.4. For allergic cough, I usually prescribe my patients a combination of monelukast and levocetirizine which improves allergic rhiniris, sinusitis as well as asthma.5. I would also suggest you regular breathing exercises and avoidance of dusts/smokes/air pollution.6. I would also suggest you allergy testing which will help you identifying the substances causing troubles to you and also how to avoid them.Hope above measures will be helpful to you.Should you have any other concern, please feel free to ask at HCM.Wish you the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain and shortness of breath\n\nHi i have feeling heaviness in my left arm and left side of the chest i have performed all the test.ECG,ECHI,ETT,LFT,UREA CREATNINE,CBC All are ok.but now a days i am feeling pain on my liver side and suddenly this pain transfer from liver to the right upper side of my arm. i have feeling shortness of breath as well since 1 month.Please advice",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. No need to worry for heart diseases for your symptoms because your ecg and 2d echo are normal. By your history and description, possibility of bronchitis is more. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (pulmonary function test). PFT will not only diagnose bronchitis but it will also tell you about severity of the disease. And treatment is based on severity only. You may need inhaled bronchodilator and inhaled corticosteroids (ICS) on the basis of PFT values. Don't worry, you will be alright.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for chronic dry cough\n\nI am a 54-year old woman and have had a chronic dry cough since Spring; everyday I get at least five bad coughing jags. Last fall I had a similar cough (though I seem to recall it as a wet cough) but my doctor concluded that the cough was attributable to post-nasal drip and it resolved during the winter. I m concerned that this has been carrying on every day for at least five months. No other major symptoms exist except perhaps tiredness and achiness. How might you proceed with diagnostic procedures?",
    "doctor_response": "Hi,Thank you for your query. I can understand your concerns.it seems that you are suffering from seasonal naso-bronchial allergy. Most common allergens for naso-bronchial allergy are dust and pollen. Do blood test for absolute  eosinophil count and serum IgE level.Try to avoid possible allergens. MonteluKast 10 mg orally and Fexofenadine 120 mg /Levocetrizine 5 mg daily orally may help.Consult your physician for review.Regards Dr. T.K. Biswas M.D.Mumbai",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the stomach. Liver test reports high. What to do?\n\nHi My Name is ashidra And I Have A Problem with my stomach it been and on and off problem it s been going on for about 9 mouths now I been to 3 different hospitals about 3 time in one day before they Caint find anything wrong but some doctors say when they run there test my liver is high I don t really know but I was wondering can you help me it s like really bad pain at the top of my stomach makes me Caint sit Still and also fells like my stomach is collapse ins its a really bad bad bad felling I just wonted to know can you help me please",
    "doctor_response": "Hi and welcome to HCM thanks for the query.Most common causes of such difficulties is gastritis and gallbaldder issue so these are first things to rule out by ct scan and gastrocopy. High lft may indicate liver or gallbladder disorder but the exact cause should still be found and the right treatment can be performed. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard lump on the scrotum with irritation and itchiness?\n\nHave a hard lump under the skin about an inch from my scrotum on the left leg. It appeared over night 4 days and didn t hurt until the last 48 hours. It hurts when I m walking around, and when I wake up in the morning. Sitting down now there is no pain, just itchy irritation. It just started showing signs of developing a white head like a pimple. Is this a boil or cyst and is this something I should go see a doctor about?",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.This is a boil and if it is more than 3 days and showing white head - this is on way of a rupture. IF possible get the help of a Surgeon to get this properly incised and drained.. This helps the best and the fastest recovery. Also get all blood tests done- including that of sugar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fatigue and abdominal pain while suffering from fatty liver?\n\nWhat diagnosis should I look for, symptoms are fatty and slightly enlarged liver, URQ pain, fatigue, abdominal pain when hungry and a little while after eating, just came off methotrexate after 6 mos. and am still on embrel? I am a 5'6\" 58 year female approx 200 lbs",
    "doctor_response": "Hello,Such kind of symptoms are common in any sort of liver disease. As you are on these drugs these may be the side effects also. Further investigation is needed.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. B.dinesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain in tailbone while suffering from diarrhea or constipation be treated?\n\nHello, For a number of weeks now I have been experiencing health issues related to pain in tailbone region and across lower back (sometimes it is there and sometimes it is not). Also, I have had changing bowel conditions that are obviously not normal for me... ranging from what seems like constipation (albeit I went several times per day but the effort was not norm, also sometimes it felt like I had to have a bowel movement and couldn t) to current loose stool and diarrhea. It feels like the issue (pain) is coming from the bowels. So, I have been to the doctor (GP x 4, ER x 3) numerous times over the past few weeks so I will share the process so as to give you an idea where we are at. At this point (as of today), after you review the details below, I am waiting to go to a GI specialist however my condition is such that I am starting to really worry that each day I delay further treatment I am causing more damage to my body (condition and generally feeling of good health deteriorating)\u2026 1)\u00a0\u00a0\u00a0\u00a0\u00a04 weeks ago I visit GP for what appeared to be dark urine and or cloudy (vs. normal). Blood tests clear (tested for being anemic along with several other items such as potassium etc.). All clear for blood test. 2)\u00a0\u00a0\u00a0\u00a0\u00a0Due to visit in item # 1 there were 3 urine tests. 1st came back with more blood red cells than normal (just barely over the 0-3 count considered normal as per GP discussion).Two additional tests (one each day for 2 consecutive days) all clear for red blood cells. Due to other visits to GP and ER in notes below I have had another 3 urine tests all clear (3 of the tests were just dips and 3 were sent for microscopic tests) 3)\u00a0\u00a0\u00a0\u00a0\u00a0Due to visit in item # 1 sent for ultrasound of abdominal and chest x-ray (checked all organs except bowel and pancreas). All clear on both tests. 4)\u00a0\u00a0\u00a0\u00a0\u00a0Urine issue cleared up without any treatment. Increased my fluid intake overall so this may be the corrective action. There was discussion with GP that I had kidney stones but none found. 5)\u00a0\u00a0\u00a0\u00a0\u00a0Pain started to build across back (kidney area, I suppose) over several days and became somewhat unbearable. Pain moved around back and sometimes was higher in back and very painful (different days = pain in different locations). Visited GP again and was given pain pills as it was stated that due to the tests done so far it would not be normal to investigate any further. I was sent to physio stating that ",
    "doctor_response": "Hello! Good day! I read your concerns thoroughly and will break down all your problems systematically--1. tailbone pain --anatomically, the rectum (lower colon), is directly sitting on the tailbone.  Any inflammation in that area can cause discomfort or pain in the lower back, especially the tailbone (sacrum).  However, there is also a possibility that it is a separate problem, since previously you have had lower back pains.  Lower back pains can be caused by several problems-- most common is musculo-skeletal strain, other causes are kidney stones, urinary tract infection, slipped disc, scoliosis, impinged nerve.  The best diagnostic to rule out spinal bone problems in your lower back is a plain Xray of the Lumbo-sacral area (AP-Lateral views), an MRI might follow if with problem noted in the Xray.  2.  For your rectal pain, since it was already documented on your CT scan that there is thickening in the area, a sigmoidoscopy or a colonoscopy will give us a direct visualization of the problem, a biopsy of the inflamed/thickened area might also be a good idea to know the cause-- whether infectious, inflammatory bowel, auto immune, or cancer.  3. Diarrhea/constipation/bloating -- this problem is probably caused by the thickening of your bowels.  The main diagnostic that can give us an idea of what is the underlying cause will be the sigmoidoscopy/colonoscopy.4.  Sluggishness might be a symptom of dehydration secondary to your diarrhea.  I suggest you take in a lot of fluids, especially after an loose stool episode, to replenish the losses.I hope I was able to answer your concerns.  Goodluck and may you get well soon!",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have Stomach and liver problems, please suggest\n\nDear Mam I am Kiruba Nagini from Trichy. I have the following complaints. Less appetite Bloating body irritation in eyes and soles pain in joints fatigue highly irritated mind less alertness  I am 115 kg in wt. I am diagnosed as hypothyroidic. Besides, I suspect  that I may have some problem in my liver functions. I read an article in The Hindu regarding fatty liver recently. many of the symptoms are matching my complaints. Can u suggest me which specialist i should consult with?",
    "doctor_response": "Hi, Even hypothyroid condition does cause such problems. Are you being treated for the Hypothyroid condition? Treatment is essential for recovery. Also for the right specialist, you should consult an Endocrinologist or a General Physician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Slipped disc, suggestion for strong backbone\n\nMy backbone disc slipped midly...so many times when i get up early morning or when i give more stress to my leg or back.. then i feel pain in any one side of my back. Can u suggest me what to do to make my backbone strong again ?",
    "doctor_response": "Hello. Thanks for writing to us. Slipped disc is an age related degenerative change of the spine and you can only stop the further regression of the changes. You cannot revert back the changes that have already taken place. For that, surgery is needed. Pain killers with muscle relaxants and an effective physiotherapy regimen will be helpful in decreasing the problem. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness on the lips, blurred vision with swollen lymph nodes on the neck?\n\nToday my lower lip started to go dumb, I stsrtedstarted having cold sweats, my vision started to blurr, I wanted to throwup and passout. The side of my neck seems to have inflamed lymph nodes and it is hard for me to swallow at times. It is freaking me out some. Please advise what is happening to me.",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.In my opinion you should having allergy.Its an acute attack of allergy on chronic. Means you have chronic allergy and on it you are receiving acute attack.Lymph node swelling is because of chronic allergy.I advice you to look out for the allergen. Because you can only found out the allergen. Keep the allergen away from you is the best treatment you have.Till the time you can take the cetrizine and low dose steroid under doctors guidance. It will inmediate clear your symptoms.I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it alright to take ovral l while having a gap of 2 days?\n\nHi, I am getting married and my doctor suggested to take ovral l to prevent from pregnancy. But I missed to take it in sequence for first 3 days. I took it randomly. Now when I know to take it in sequence there will be a gap of 2 days(sunday & monday) which I took randomly, shall I continue to take tablet of next day or should I take a gap for these two days?",
    "doctor_response": "HelloThanks for writing to us with your health concern.See you have used the pill randomly this month, so it would not provide any protection from pregnancy when taken this way.What you should do is this - finish the rest of the pack, without any more gaps.Use a backup method such as condoms for this month.Next month onwards, start a new pack, from the second day of your period.Take that pack religiously without any gaps.Take the pills at the same timing everyday.Also, you would have a period once you finish all the pills in the current pack.Remember that this pack that you are using will not protect against pregnancy.This is because it  has been inconsistently used, so the hormones will not be acting properly.If you decide to use these pills, take them correctly else side effects will be great.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should hemoglobin level be having undergone c-section?\n\nThe following day I had a c-section, I couldn't breathe and 48 hours, I was given a cat scan and I was diagnosed with pneumonia, both my lungs were almost completely full. The doctors tried to give me oxygen through an  oxygen mask and I kept screming that I couldn't breathe, which I then went into cardiac arrest and needed to be resesitated. They put a tube down my throat shortly after. The next thing I knew it was two and a half weeks later, I was in a medical coma. I almost died and missed Christmas with my three children, one being a newborn. Is it possible that I had pneumonia before my c-section, and if it is, would the blood work that I had at my pre-op detect something was wrong?My hemoglobin was at 70, does this mean something. I was given 4 pints of blood as well because I kept losing a lot of blood? Or did I get it from my c-section? Because of the cardiac arrest and the pneumonia, is it also possible that I am having severe panic attacs.",
    "doctor_response": "Hi i did review your concern, thank fully you came out of this and you deserver credit for that. Ideal hemoglobin level for you should be above 12 gm/dl according to WHO standards. If you are not able to maintain it there could be multiple reasons and you need to then get your self investigated by a hematologist. about the pneumonia i guess it is more likely due to anesthesia or operative procedure or delivery process.i hope this helps. wish you a healthy life ahead",
    "dialogue_context": ""
  },
  {
    "patient_message": "On implant. Light bleeding, emotional,back ache, headache, vomitting, constipation, painful sex. Advise?\n\nI'm on the implant, and I've been on it for about 2-3 months. I've had constant light bleeding since It was insterted. However for the last 3 weeks I have not been feeling well at all. I'm emotional, I have bad back aches, headaches, my hips hurt. I feel sick ALL the time. Sometimes I vomit quite a lot. And I've also had a few belly aches and constipation. Sex is also painful.",
    "doctor_response": "Hi,As per your symptoms, it looks like the implant may have created hormonal imbalance and breakthrough bleeding and this could be causing the distress that you have been experiencing. Your symptoms do not suggest a pregnancy as they are nonspecific. You could be suffering from a gastroenteric problem as well. Please see a physician and get advice. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for a concussiona and headache in a child\n\nMy son has a concussion- a really bad headache for 5 days.A friend said he could take 2 5mg. oxycontin for the pain. I gave him that and it didn t help.What will and is the oxy bad for him? He doesn t take anything usually. I thought the oxy would take the pain and would sleep well.But that has not helped. Thankyou",
    "doctor_response": "what is the age of the child??? and what are other symptoms associated with headache?? Is it associated with nausea and vomiting?? Is there any family history?? Morning or evening symptoms?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a circular rash beside my nose and medications did not help. Please suggest solution.\n\nHello doctor, I have a circular rash beside my nose and did not subside. I have tried antibiotics, face cream, and face wash. Nothing seems to work. It does not itch though, it burns when it is really hot.",
    "doctor_response": "Hi,  Welcome to icliniq.com. I went through your case. I need to know the following things before arriving at a final diagnosis. What is the total duration since it first appeared? Is it sensitive to touch? Does it burn in sunlight? Any similar lesion elsewhere in the body? Is it thick on pressing? I need a clear photo to see if the skin over it has any scale or you ever notice any scale over it? Any variation in size or always progressing and never became normal? Please reply to the questions. DLE (discoid lupus erythematosus), Tinea faciei, Facial granuloma, Hansen's, PMLE (Polymorphous light eruption).",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hematoma knot on inner thigh caused by an injury\n\nHello, 15 weeks ago I flipped my 4 wheeler over on me, broke my collar bone, tore my MCL and got a hemotoma about the size of a cantalope on my inner thigh (Dark Blue and purple) with an egg shape knot in the center. The bruise is only about 1 inch wide and 3 inches long now The knot is about quarter size. Will this ever go away?",
    "doctor_response": "Hello, Based on your description , you are suffering from heamtoma in your thigh secondary to soft tissue injury . Usually the hematoma removes over a period ranging from 2 to 6 weeks . During this period you have to observe the hematoma and maintain good hygiene so that it does not get infected. Usually with this it resolves on its own. Visit your doctor if there is increased pain or size. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Santosh S Jeevannavar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get pain during intercourse with white spot on the inner side of vulva. Please help.\n\nHello doctor, I am experiencing pain during sex during three separate sexual encounters over the last few months. No sex in between these encounters. Upon recent inspection a white spot was noticed on the inner portion of the vulva which seems to be the source of the pain. Outside of sexual intercourse, there is no major symptoms but may have slight discomfort. I have used Canesten topical ointment for 14 days and experienced some relief but did not resolve.",
    "doctor_response": "Hi. Image is not much clear. (attachment removed to protect patient identity).  But looks like some inflammatory changes. There must be vuvlovaginitis or Bartholin gland infection. If previously, there was no pain during sex and now pain is there then there should be some problems there. There may be skin infection or hair follicle infection. Paraurethral glands are there. UTI (urinary tract infection) also can give pain. There is one chance your partner may have some problem. Do urine routine and culture sensitivity report. Do one ultrasound scan of perineum to find out any cystic swelling. Keep the area clean. Drink more water. Change pads more frequently during menstruation. Can take tablet Doxycycline 100 mg for seven days, Azithromycin 1 gm one time for two days. This is empirical treatment. For diagnosis, we have to do some test and need to see clinically along with per speculum examination. Can take any antacid to prevent acidity. Avoid oily, spicy food. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can one create an active and fruitful life for oneself?\n\nI suffer from Abused child syndrome, Complex PTSD, and multiple anxiety disorders all stemming from growing up in extreme abuses and neglect, and then marrying 3 abusive men over the course of 24 years. I left my last abuser 13 years ago, and have broken through the codependent behaviors that cause women to re-victimize themselves. I am still single now- by choice. I have taken many steps forward in my life. But there is one problem I have not been able to concur... and it prevents me moving forward in my life. Because of the emotional and physical repercussions of 42 years of abuse, I am now disabled, and have been receiving SSDI since 2009. I also have a Home Health Aide that comes and helps me clean the house, shopping, paying bills, etc. When she is here I talk and interact with her,. But as soon as she leaves I go back into a state of near catatonia. My brain works wbut I can not get to the point of decision making, and action. Mostly I sit and stare. Or I write out plans of how I want my life to be, but can not actually do any of it. My Psychologists says its avoidance syndrome, and I have to be more responsible for my own behavior. But that isn t it. This is not laziness, When I am alson there is a Blankness in my mind when I try to make decisions about doing things in my home, and writing- which is my only way to earn income . I am very frustrated, and I can not take it any more. What is causing this, and how do I make it go away? Please help me. I deserve to have a life- I want an active life, I am intelligent, and very creative, The stories in my head are worth writing, and many would love them, If I can get to the point of being able to organize and achieve my goals on a daily basis. I am a wonderful, insightful person, if I could only live outside my own head, I would be able to realize my dreams, and drag myself out of this hole I live in. With only $700 a month to live on, you can see why I am so adamant on this issue.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  You are \"I am intelligent, and very creative, The stories in my head are worth writing, and many would love them, If I can get to the point of being able to organize and achieve my goals on a daily basis. I am a wonderful, insightful person.\" In spite of these confident words, you also are negative minded.You do not need treatment. You just need to look forward, not back. Talk to your best friend and friend will guide you. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My life is worse with stress and I cry all day. Please help.\n\nHello doctor,My life is getting worse day by day. I used to be a brilliant student, but nowadays I fail in my exams even if I study for the whole night. My father and brother are not getting a salary, so we have to spend money with care. My sister, who is very close to me, is getting married, so she is about to move. Everything is going down, and I cry all day and feel so bad that I cannot even express.",
    "doctor_response": "Hello. Because you are facing so many stressful events like father and brother not getting salaries and sister getting married, this condition is known as an adjustment disorder. If you are feeling persistently depressed for the last two weeks, feeling hopeless, then you might also be having depression. For this condition, you may take an antidepressant such as Escitalopram 10 mg one tablet at night. From Psychotherapy point of view, you have to learn specific coping strategies. 1. Since you are only 21 years old, it might not be possible for you to contribute much financially towards the family. 2. Lower down your expectation level, and do not take all the load on your shoulder. 3. Every problem has a solution, sit with your father and brother, and discuss options with them. Whether they can do some part-time jobs? 4. Great people see opportunities in adversities. Take this as a challenge and motivate yourself to do something in life. But do not try to control the present. Some things will be better with time. 5. Your sister getting married is not a problem, it is part and parcel of life. Accept it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for burning sensation and itching on penis\n\nhi i am 22 years old recently i got balanitis around a month ago and  it was cured.But yesterday my penis foreskin got very itchy n den early morning i saw it was red completely after dat i washed my glans with soap (mild one keto) n den i experienced my skin is getting removed so i forcibly removed whole of the skin and now currently i'm experiencing burning sensation,itching swollen on my penis tip n glans......",
    "doctor_response": "Thanks for contacting HCMI am sorry to hear that you recently had balanitis and now having additional burning redness and itching of your penis. From taking the antibiotics you were able to kill the bacteria that caused the balanitis but now the usual bacteria are gone and a fungal infection has now started. I recommend that you try nystatin or other topical antifungal. Keep the foreskin clean with mild soap and water. If it continues you may need to see a urologist for additional treatmentsHope I answered your question. Please contact us again with your medical questions or concerns",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sweating due to sports, irritation in buttocks, rash on skin. Treatment?\n\nHi doctor, I have a question. So i have started running every morning for sports coming up for school and I ve been sweating a lot. I ve noticed that I ve been very irritated in the butt crack region and I took a look and it seems almost raw? I thought it was a rash and I ve tried desitin, but I m not sure exactly how to treat it since I m unsure what it is.",
    "doctor_response": "Hello,Thanks for writing here.You are having perianal intertrigo.Sweating ,friction with clothes can irritate skin leading to intertrigo.Take regular bath after running.Use loose shorts while running.Keep area dry and clean.,you can use antifungal powder like candid at day time.At night you can apply a steroid antifungal cream like canddid b for 1 week.In case if there is no response it will be better to consult a dermatologist.Hope this will help you.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on breast along with tiredness and pain?\n\nhi I am 45 years old ! AND JUST FOUND A LUMP SIZE OF A PEA ON MY RIGHT SIDE BREAST UNDER THE NIPPE ! HAD A MAMAGRAM AND THEY CALLED ME BACK THE SAME DAY ASKING ME TO GO FOR AN ALTRASOUND ! I HAVE BEEN FEELING VERY TIERD THE PAST YEAR AND PAIN IN MY BREAST AND BAD MUSCLE ACHS WITH SHORTNESS OF BREATH 1 SHOULD I BE WORRIED ?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some benign breast lesion like fibroadenoma, fibroadenosis or some benign cyst.  You should go for ultrasound study and biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it normal to get clear whitish mucus from vagina?\n\nHello doctor, I am 24 years old. Since last few days, I have observed thick jelly like clear whitish mucus coming out from my vagina. It is very thick and dry. It is not like the regular stretchy moist discharge. There is no irritation or pain. I am not sexually active. There is no odor also. Since last five months, I am having scanty bleeding. My period that would normally last five days now lasts only for three days. I will visit a gynecologist in person in some days, but I just wanted to know whether this is of anything serious. Otherwise, I am very healthy. Thank you.",
    "doctor_response": "Hi. Revert back after the test to an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How should carotid arteries calcification, altered diastolic function, pericardial effusion be treated?\n\nHi Dr.My Aunty 70yrs old is having right side facial numbness and paralysis like symptoms.She is able to talk properly. But has been forgetting things and feeling weak. I performed an ultrasound study on and noted calcified plaque in both common carotid arteries and 2d echo study revealed altered diastolic function of LV and mild pericardial effusion. What can be done next?",
    "doctor_response": "Hello, It seems she has stroke leading to one-sided (right) facial weakness and limb paralysis (Ischaemic stroke). Calcified plaque in carotids indicates advanced atherosclerosis.LV diastolic dysfunction is age-related. Mild pericardial effusion needs exclusion of Hypothyroidism. Go for serum Free T3, Free T4 & TSH and serum lipid profile, Blood sugar fasting and post-prandial, BUN, serum creatinine, serum electrolytes, complete blood count, urinalysis as work-up for stroke. MRI brain(plain) needs to be done to delineate infarct. Treatment follows after workup is complete. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Tushar Kanti Biswas, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest diet plans for a premature boy of 4 years\n\nMy child was born premature, i.e. 28 weeks. Weight at the time of birth was 1.6 kgs. He is about to turn 4. His present weight is 14.5kgs. He catches cold very often (once every month or more) and is low on stamina. He finds it hard to digest high protein / fat rich foods. Please recommend a diet plan for my child for his proper growth.",
    "doctor_response": "Ideal weight for your child at 4 years should be 16.7 kg.Approximate daily protein intake should be 21 gm and calories 1350 kcal.Offer your child foods from all five major food groups (grains, fruits, vegetables, dairy, and protein) at every meal. You may not always be able to get him to eat the recommended amount from each group every day, but if you serve a variety of healthy food, he'll eventually get what he needs over the course of a week.Prefer home made food over formulas. Limit dairy products. Add fresh fruit juices etc. This will solve bloating, constipation and other digestive problems.For further queries regarding your baby's nutrition you may consult me at Healthcare Magic under section \"Ask Expert \" >>>\"Ask Pediatrician\".Dr. Khan Shoeb",
    "dialogue_context": ""
  },
  {
    "patient_message": "ME patient with continuous ear, chest infections, diarrhoea, night sweats, weakness. Should i see a haematologist?\n\nHi there I had been diagnosed with ME when I was 22(now 38), although I have been used to swollen glands/glandular fevers and tiredness throughout my life, recently this has become different and more intense. I am getting severe drenching night sweats at least twice a week, feeling very weak, and have swollen glands in my right side of the neck. My blood test results came back negative for TB,Malaria and the doctor has assured me that if i had Leukaemia it would have shown up. I have a family history of cancer with more than 15 cases in my direct family. My doctor wants me to see a Haematologist, but we waiting for 3 weeks to let the current antibiotics I am taking work out. Is this normal - to wait? I am getting concerned because I am not getting better. I have been struggling for the last 4 months with continues ear infections, chest infections, diarrhoea, extreme dizziness and swollen glands.",
    "doctor_response": "Hi and thanks for the query,I do buy the idea of your doctor for you to wait till the antibiotics go through. This shall give an opportunity for a keen follow up and detection of some subtle signs that might not have been detected from the very onset. It is however important to get the opinion of the hematologist and infectiologist. In depth evaluation to exclude properly leukemia or other tumoral process is compelling. Kind regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of prostate cancer in case of thick bones?\n\nIn an neck xray for an accident, the Dr. informed me that I have thickened bones and referred to me a few other Drs. to check out the possibility of prostate cancer. What is the relation and is this a huge concern? I am uninsured and can't afford the costly tests involved. Do you have any suggestions for me? Thank you",
    "doctor_response": "Hi,Thanks for writing in.Prostate cancer is a condition that spreads to bones. Cancers can affect bones in two ways, either there is breakdown or there is excessive calcium deposition. In breakdown the process is called lysis and in deposition of calcium it is called sclerosis. In prostate cancer, there can be sclerosis seen in the bones of the spine usually in the lower back region. However bones of upper spine can also have sclerosis.I would suggest you to first get a low cost insurance and then take tests for prostate cancer like ultrasound scan, serum PSA and free PSA values. If there is probability of cancer then further detailed tests are required. Please talk to your doctor to arrange for the tests keeping in mind your ability to pay upfront for the various tests.The tests must be completed within a month and you can also try and find out healthcare support groups or from your employer if your tests and any treatment can be funded by external resources. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can any online doctor give me some guidance about intercourse ?\n\nhello doctor ,i m 24 years old.I get married 2 years before but me and my husband not to have relotion before my studies are completed.Now we want to have relationship but are unable to have relation.We are unabe to have sex.So please suggest me some solution to our relationship and getting pregnant .",
    "doctor_response": "Hi Welcome to HealthcareMagic You have not mentioned the reason of not having relationship. To get pregnant u need to have sexual intercourse during the time of ovulation in your most fertile period. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pregnant, having asthma. Feeling dizzy, cramping, nausea, vomiting and shortness of breath. Is this normal?\n\nI just found out I m pregnant... I may be 3 to 5 weeks pregnant. Before I found out on the 8th of June I had drank quite a bit and stressed out a lot. Recently I ve been feeling dizzy, getting slight hot and cold flushes, mild cramping with some popping feelings here and there above my belly button and i get some nausea feeling with slight vomitting, also I want to know why my body is aching bad almost like a flew symptom but i know its not that i can still eat and hang out and I have asthma too and I already took my inhaler but it doesn t seem to be working because I have shortness of breath and must keep breathing deep. I just want to know what s going on and are the symptoms normal?",
    "doctor_response": "if you aree asthmatic that increases in pregnancy if not asthmatic you can get it by calcium,bcomplex vitamins and iron which are given during m pregnancy if not getting relief by inhaler u can add tab montelucast 10 mgm in bd dosages and get it checked for the reasons i wrote",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to remove the spots on my penis?\n\nHi doctor, I have several spots on my penis from my childhood. Sometimes, when I masturbate few times in a day it gets rip and start to hurt. As I am going to be married soon, I would like to get rid of these first.",
    "doctor_response": "Hi. Before giving you a solution, I would like to get answer for the following questions. Revert back with the answers to a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to recover from hair loss happened due to medication?\n\nHello!I had alopecia areata, I was taking betnosol 25mg for 15 years, now doctors stopped me taking this medicine, given betnosol forte 4 tablets for 2 days in a week. this, I feel very tired and very week and also my hair is receeding very fast.doctor has also advised me to take azoran 2 tablets daily.pls. advise, will i be able to recover my hair again.with regds,Rajesh",
    "doctor_response": "hello rajesh, i can understand the pain you are going through. 15 years is a very long time.alopecia areata is a very common disorder but most of the patients recover either on their own or with medicines within months. in few patients the disease is long standing. most of these patients have an associated disorder like hypothyroidism. these patients improve once i put them on thyroid medicines.i suggest you to get the following tests done:1. S.TSH2. S.free T33. S. free T44. antithyroglobulin antibodies5. anti TPO antibodiesthe twice weekly regimen of betnesol is the most accepted regimen for alopecia areata. tab azoran is also an immunosuppresant and will add to the effect. i would suggest you to also apply tacrolimus 0.1% lotion daily at effected areas.alopcia areata is an autoimmune disease and as with any other autoimmune disease the course cannot be predicted. we can give you the best advise available. hope this answer helps. get back to us for any further queries. thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How often should fortis inj be taken to increase bone density?\n\nhello doctor, my mom age is 68 yr old . her bone destiny is negative . dr has suggested go for fortis inj which help her to increase the her bone denisty .even he said dat inj should take for 1 years then u will get result. is fact that my mo need take dat medicine evrey month since i heard dat it should take for once in year only. please suggest me.",
    "doctor_response": "Hello,This injection is usually taken every month for up to 24 months.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly suggest some measures for my headache.\n\nHi doctor, I am a 34 year old male. I am suffering from headache for the last 14 years. In the past, the frequency of headache was less. But recently, it has increased to three to four headaches in a month. I was taking homeopathic medicine for my headache. Also, I took Saridon tablet during headache, which gives me immediate relief or reduces the intensity of headaches. I have noted some trigger points which triggers my headache that are sunlight, hot weather, strong smell or odor, hunger, etc. My mother also has migraine headache since long time. Please suggest me some treatment for my headache. Also, my headache starts with neck pain. As the intensity of headache increases, the neck pain gradually decreases. The headache was always one sided that is either left or right. The headache mostly starts in the afternoon and goes away in the next morning without taking any medicine. It starts with lower intensity and gradually increases and after reaching a peak point it starts reducing. Please help.",
    "doctor_response": "Hi. A few points to be considered for your headache are as follows. Revert back with the reports to a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of shingles?\n\nI am not sure if I have shingles. I have no rash but pain from the middle of my back and it goes around to the front of my chest like under my breast. kinda hurts to touch it or move my body. put a heating pad on the area last night. Sometimes just taking a breath makes it hurt.",
    "doctor_response": "Hi,Thanks for the question.The first symptom of shingles is often extreme sensitivity or pain in a broad band or one side of the body.The sensation can be itching, tingling,burning, constant aching, or a deep, shooting, or \"lightning bolt\" pain.Typically, one to three days after the pain starts, a rash with raised, red bumps and blisters erupts on the skin in the same distribution as the pain. They become pus-filled, then form scabs by about 10-12 days. In a few cases, only the pain is present without the rash or blisters.I hope you'll have a fair idea about the signs and symptoms of Shingles.I'd like to add that it is always better to see a doctor especially for skin conditions.Please feel free ask a follow up question.Thanks,Dr.Prabhas Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it an allergy to have macular degeneration, intense pain in eye and sore throat?\n\nI have macular degeneration, the dry kind and am having pain in one eye similar to pains and needles like a body part falling asleep. I think I m getting a cold and sore throat and think my eye is affected by the cold. I m a snow bird and don t have a retina specialist here in florida so I would like to know if the discomfort in my eye sounds serious. My vision seems fine but my eye is itchy so possibly it s just allergy related. What s your take on this. Many thanks. Joan",
    "doctor_response": "HIThis sounds like a simple sinus infection and nothing too serious.  See a walk-in clinic doctor for an exam to see if you need a course of antibiotics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can wisdom tooth cause the little pop and jaw pain?\n\nwhile i was eatting, when i opened my mouth there was a little pop. then when i closed my mouth and chewed down the front of my left jaw hurt, the part just right after my back teeth. And oh i still have my wisdom teeth in. What could it be or what should i do? Its hurts more when i bite down?",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. This pop which you felt might be of jaw joint called as Temporomandibular joint. It can be possible that because of some hard food or stress you might have felt clicking on the left joint.For relief from pain you should start with muscle relaxants twice daily at least for 1 week with hot fermentation over the joint.Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can taking high dose of Levodopa and Carbidopa cure Parkinson s disease?\n\nI have Parkinsin;s , I was diagnosed 7 years ago, My doctor okaced me in Carpadopa,leveladopa. In the first couple of months it helped my balance in walking. My Parkinson;s has increased but my body no longer responds to this med. He keep telling me to increase the dosage,,,,but more meds that do not work is not working for me! If I tell another doctor my problem...they say well you have to continue with these meds. so I that I may make sure it is not working. HELP! Do you kno of any meds that eould be affective for me?",
    "doctor_response": "Hello, First of all the maximum dose of Levodopa and Carbidopa is one tablet three times per day and this drug is not given alone. For example, the patient should start half a tablet every morning for one week and half a tablet of another drug such as Benztropine 2 mg or Biperiden 2 mg for three days then the dose of both drugs should increase gradually over 2 weeks until the proper response. So in your case you should adjust Levodopa/carbidopa to one tablet two times per day before breakfast and dinner and start Benztropine 2 mg half a tablet in the morning for 3 days then half a tablet before dinner for three days then one tablet before breakfast and half a tablet before dinner for three days then one tablet before breakfast and one tablet before dinner for ever, then add half a tablet of Levodopa/Carbidopa before lunch for one week. Finally, take one tablet of Levodopa/Carbidopa before lunch. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dr/Mustafa, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest ways to avoid pregnancy post unprotected intercourse\n\ntoday i had an intercourse with my husband but during intercourse condom slipped. some of his sperm in the condom and some was outside of my vagina. now we both are not sure that sperm was inside me or not. now what can i do? may i take a contraceptive pill? suppose sperm was not inside me and i take the contraceptive pill, will it cause any danger??",
    "doctor_response": "Hi,    I understand your concern.    1. If you suspect some semen had leaked in vagina and if you don't want to conceive you better take plan B contraceptive within 72 hours of contraceptive.      even if there is no conception , there will be no major complication except for delay in periods by 8-10 days.   2  A nother way to terminate preganancy are-      - medical termination of pregnancy istill 49 days of pregnancy.      - Surgical MTP ( vaginal )till 3 months of gestation,    * When gestational age of fetus exceeds 12 weeks two registered practitioners are needed to perform the abortion legally.      - Emcredil instillation - causes MTP till 5 months of gestation,     - Histerotomy ( Per abdominal operation ) for removing pregnancy  when other methods fail.   Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I having tender breasts and breathlessness after unprotected sex?\n\nHi doctor, I am 25 years old. I had unprotected intercourse with my fiance 20 days back. He withdrew before ejaculation, still, I took Unwanted 72 after three hours to prevent pregnancy meanwhile. Next day, I got a vaginal fungal infection for which I took Candid V6 for six days (symptoms are relieved now, still I get ocassional vaginal itching). Now after nine days, my breasts feel tender and areola portion is little swollen. I feel a little bit fatigued and breathless also. What can be this due to? Is this PMS? Are there any chances of pregnancy? Can antifungal tablet reduce the efficacy of the pill? What can be done meanwhile? I do not want to get pregnant at this time as we are not ready yet.",
    "doctor_response": "Hi. As your cycle length is 27 days, and you had unprotected intercourse on day 8 or 9 of your cycle and that was the most fertile period of your cycle. So, do not worry, wait till your next periods. If they occur in time, then no pregnancy but in your case, the chances of pregnancy are more. If pregnancy occurs, then after an ultasound, if it is in the uterus, then medicines are there for an abortion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes right-sided abdominal and back pain in a person with fibromyalgia and MS?\n\nHi my name is Cheri. I have MS and fibromyalgia, and kidding factor 5. I am having a horrible pain in my right side around my waist. Feels like it moves a bit up my back, back to the side, up towards the front and my ribs. It s not like an MS hug tho.",
    "doctor_response": "Hi, It can be a part of fibromyalgia complex. As the first line of management, you can try Tramadol or Gabapentin for pain relief. If symptoms persist better to consult a neurologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does cough due to inhaling wood dust last?\n\nhello, about 2 weeks ago I was doing some sanding on wood and mdf, i stupidly didnt wear a mask as I only expected to be doing it for 10-15 mins, anyway i have had a chesty cough for 2 weeks now, and each day will have several episodes of intense coughing fits, but I am unable to cough any phlegm up. how long should I expect this to last before my body is back to normal, or should I go to a GP to get myself checked out",
    "doctor_response": "HelloThank You for contacting HCM.Yes it could be due to wood dust. Without general care it takes alot of time to become healthy and on the other hand it prolongs the illness. I would suggest you following:> Firstly, always wear mask when doing such activity.> Avoid dust till you become healthy again.> Take Diphenhydramine + Dextromethorphan suspension for cough twice daily> Take hot water in a cup, add one table spoon salt in it. Perform gargles(mouth wash) with it after every 5 hrs till you find improvement.Report to hospital if:> Condition remain same 2-3 days after starting this treatment.> Any unusual symptom appears> Condition deteriorates.> There is difficulty in breathing.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have discomfort in the back after hearing a sound once\n\nA couple of days ago I bent over to pick up a screw and I heard a pop in my lower back, since then I have had a sore back and especially bending and getting up from a sitting position. Looking at the chart my guess is it is the 5th lumbar. Is I can do to make it better?",
    "doctor_response": "Hi..Sudden onset of back pain following bending looks like u might acute lumbosacral strain.sudden stretching of the back muscles when bending causes spasm of these back muscles leading to LS strain.things to do.strict Bed rest for 3-4 days.Take pain killer and a muscle relaxant( Acoclefenac/Diclofenac + Thiocolchicoside) twice a day.U can use any pain killer ointment, gel or spray. Donot bend, lift weight, squatting.Donot do any physiotherapy like back strengthening till pain persists.if pain persists then visit a doctor for x-rays, +/- MRI scan and further management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hurthle cell carcinoma as radiations dint work\n\nMy father was diagnosed with hurthle cell carcinoma last march with a 5 cm tumor on his thyroid. Which he had removed. He is 77 years old. He is still feeling really bad and he had radiation several months ago. What are his chances of beating this cancer?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. He has hurthal cell cancer and he has gone through surgery and radiotherapy.  If tumour is completely removed then chances of survival is high.  But he should go for regular follow up yo detect early recurrence of tumour.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on the frontal wall of vagina?\n\nHi I just found a lump on the frontal wall of my vagina. Its around the size of a quarter-machine bouncy ball and the top is bumpy & dips inwards. I can feel all the way around it and if there were more room, I think I could grab onto it like its protruding. Also its hard, but not painful. Is it my g spot swollen or something bad? I m very scared but its nearly 10 pm & I don t have insurance and cannot afford a doctor visit. Should I go to the emergency room?",
    "doctor_response": "not to worry much as this could be a Bartholin's cyst or any other benign cystic lesion!just get a gynecological examination all the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes throbbing or fluttering sensation in the thigh?\n\nI m experiencing a light throbbing or fluttering sensation in my right thigh. It s not painful just annoying, sometimes it s occurs a few times with in 20 minutes, and other times it may occur a couple of times within 5 minutes.. This started about three or four days ago.",
    "doctor_response": "Hello, This could be due to compression of a nerve or could be a referred symptom of the sacroiliac joint. I need to ask a few more questions to come to the conclusion. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Anuj Gupta, Spine Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have severe disc degeneration, spondylosis, chronic pain\n\nHi Back! I m currently considered disabled. I suffer from severe disc degeneration, spondylosis, chronic pain, two knee surgeries (on the right) and now the left one is giving out on me adding to the chronic pain. I can only stand for about two minutes total. The good new is, I can ride a bike!",
    "doctor_response": "your age please?Kindly describe you symptoms rather than 'disc degeneration,spondylosis' etc.This treatment is being suggested on bases of the information provided.would like to examine & investigate you in detail.Rule out Diabetes or any way, you may try---.  Dolokind Plus (Mankind) [Aceclofenac 100mg +Paracetamol 350mg] 1 tab.  OD & SOS. X 5days.--. Caldikind plus (Mankind) 1 other metabolic disorder. Any way it may be tried,tab OD x 10days.(You may need help of your local doctor to get these medicines.)--. Fomentation bed with soft bedding.--. Avoid painful with warm water. Avoid direct flow of AC or Cooler.--. Sleep on a hard acts & activities.-- .Do mild exercises for Back. neck & shoulders.   Knee & Legs.     --.(Take help of a physiotherapist or visit www.drncgupta.com). --. Use no pillow under the head.Do not ignore, let it not become beginning of a major problem.Do ask for a detailed treatment plan.If no relief in 2-3 days, contact me again. (phone.91 9810012688)Kindly make sure, there is no allergy to any of these medicines. (Contact family doctor, if needed).For  emergency treatment visit nearest hospital.-Hope I have answered your question, If you have any further question, I will be happy to help.-Kindly rate the question.-Wish you a quick recovery & good Health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for multiple ailments\n\nPossible ms? having what feels like to have more feeling in one of your hands than the other Having your feet and arms and hands feel numb or like they are falling asleep when you are using them Fatigue Moving slow like you are weighed down (moving through wet cement or mud) Pain- sharp/dull/itching/burning/tingling/ tearing Hiccups Completely forgetting to do tasks often Random bursts of laughter till I annoy myself and I have to nap it off even though I am not tired and I have had adequate sleep Motor skills are often difficult Tingling on one half of tounge Tingling(pins and needles) in hands and feet and face (full or top of bottom or one side or the other) Sore face(weak, fatigue) Hot or cold hands Head rushes or dizziness Slurred speech Numbness in extremities Wobbly gait and unable to walk straight Balance issues and running into things you know are there MS hug(crushing and you can even get a shallow breath, also with knifing sharp pains that are never dull normally occurs for three days and occurs a couple times for each of those days). Frequent urination Hand tremor Hard of hearing Heavy legs and arms (they feel like a ton each) Trouble speaking(lost for words or trying to speak and not being able to say it, being tongue tied ) Shooting pains Especially in the temples or lower jaw and elbows and wrists What feels to be carpal tunnel in my wrists but isn t since it goes away and comes back(pain) Being extremely tight everywhere (legs, back,arms.....) Stiff and rigid body(everywhere) and especially in wrists and fingers (so much in fingers) Muscle spasms in inner thighs, and outer and in butt, arm, neck especially Spasticity hands, and legs Having muscles seize with pain associated with it Eye pain like when I wake up in the morning Feeling tired after a sufficient rest Having fingers subconsciously be pulled down by an invisible ribbon and held tight and stiff till I had to wait to move them. And eventually had to loosen it with my other hand manually Dropping almost everything Uncontrollable emotions esp uncontrollable bouts of laughter Drinking slightly cold water and getting extreme goose bumps on only my right side of my body Thanks , Bridget",
    "doctor_response": "Here as you know you have explain all possible neuro symptoms which can be there with many of the neuro problems.I suggest to visit a neuro physician and go for proper evaluation and diagnosis first. And then plan for treatment with medication and physiotherapy management for pain , to improve balance, coordination and muscle strength.You can also consult a dietician for advice on food especially on anti inflammatory diet advice because most of neuro issues starts with inflammation in body.Also practice exercise advice at home as per physiotherapist suggestion. You can also use hot and cold pack at home for painful soft tissue for some more relief in pain.It will take time for you to become all right since you have multiple issues. And here I have given general guideline to follow up since I have not done any physical examination.But I am sure this will be helpful for you if you follow it step by step.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the mass around the C7 area be due to calcification of soft tissue?\n\nMy sister s C7 area looks like she has a mass growing around that area. You see it a lot in people who don t have the best posture. It looks like her head is going forward and not up with a hump behind her neck to shoulder area. Is this a calcification of soft tissue? Is there anything she could do to correct it?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. The problem you are discussing about your sister' neck, probably is a deformation of vertebral column, called kyphosis. I recommend your sister plain radiographs of the neck and a consult with a orthopedic surgeon to identify the pathology and to discuss about the treatment. Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medication for Dementia\n\nMy mother-in-law has in the last week stopped using Exelon patches due to insurance not covering it and she cannot afford it. She has been using them since September. What are the withdrawal symptoms? She is 84 years old and in moderately good health except for dementia. She has been dizzy some this week. Thanks for your help!",
    "doctor_response": "Hi, Welcome to HealthCareMagic.com I am Dr.J.Mariano Anto Bruno Mascarenhas. I have gone through your query with diligence and would like you to know that I am here to help you.Withdrawal symptoms can be slowness - that is probably what you describe as dizzy this weekHope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in HealthCareMagic at  Best Wishes for Speedy Recovery Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes throbbing pain in hand?\n\nHi Dr Samuel I have experience a bad pain on my hand for 2 days i couldn t sleep last night from the pain. This morning it was very difficult for me to even get dressed on my own and do my own hair I placed icy hot and the pain is more miled but i can still feel throbbing aches and pains here and there Do you possibly think it can be a bite? or can it be that I had been using an exercising muscle band and just pulled a muscle",
    "doctor_response": "Hello, I have studied your case with diligence.Possibility of bite is less.As per your symptoms I would like to keep differential diagnosis of rheumatoid arthritis, carpal tunnel syndrome and peripheral neuropathy.Rheumatoid arthritis may involve small joints and early morning stiffness in joints, doyou have such complain?When such patients come to our hospital I advise them blood test like RA factor, ACCP, ESR, complete blood count, HLA B27.Carpal tunnel may involve sensation and associated with hand swelling.I will advise to consult doctor and do clinical examination.Till time take analgesic and physiotherapy like ultrasound or tens.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will two abortions lead to any problem to my child when I conceive ?\n\nhi,I am 23yrs old igot married before 10 months iget conceived but i aboted through doctors prescribtion on doing MTS and when i get conceived 2nd time i have taken tablets after 50 days due to my studies, is ther is any pblm for the next baby plz explain me clearly and tell me health tips for the next time how to take care of myself is there any check up",
    "doctor_response": "Welcome to HCM. MTP pills are not good for uterus health due to changing in hormonal pattern. You can start oral contraceptive pill to avoid pregnancy. Consult gynecologist for better guidance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes death of intestines?\n\nin july 2009 i had a terrible stomachache that just kept getting worse. finally i went to hospital and was in there for two days when they found out that my bowels had flipped and part of my intestines had died. they did surgury and i have colostomy. they have ran lots of tests and checked me for hirschburns disease and said i didnt have it. now they want to do my take down without giving any reason why my bowels flipped in the first place and why my intestines died. im scared to have take down in fear that it will happen again. any suggestions?",
    "doctor_response": "Hi ! Good morning. I am Dr Shareef answering your query. Even though your treating surgeon might be the best possible person to explain you the reasons, I would presume that the non viability of the intestines could have been due to jeopardizing of the vascular supply of the intestines due to either a vascular cause or due to any kind of pressure over it. Now that they might have excluded any cause for a recurrence of the problem, you had been advised for a reconstruction of the intestines for a normal passage of your stool. For further information, as I already told you, your treating doctor would be the best person for a detailed explanation.I hope this information would help you in discussing with your treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life expectancy of a person with stage 4 lymphoma, regrowing cells and hot spots, out of control endocrine system?\n\nmy friend has stage 4 lymphoma she has already been through one round of aggressive chemo tumor got smaller and for a while say 6 months seemed to be staying the same now she has 28 hot spots and cells seem to be growing again just so I can prepare what is the best and worse scenario for life expectancy she is 45 and over weight partly because her endocrine system is so out of whack.",
    "doctor_response": "HiThanks for your query.In progressive lymphoma, one option is to give salvage chemo and if there is a response, to do high-dose chemo with autologous stem cell rescue. This can lead to long term control of 30-40%. She needs to be fit for all these. Otherwise it is all palliative care.Hope this helps.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair loss\n\nhello Doctor, Manjunath here from BLR, I am having hair fall now a days a lot and its getting thinner day by day... How can this be cured? Can the new hair be grown at fallen places?... I know this is a heridiatary problem.. so I want to know whether this can be just prevented or also can I get teh new hairs in the lost place?",
    "doctor_response": "Hi, As per your query, you have symptoms of hair loss which seems to be due to genetic factor, fungal infection, stress and hormonal changes. Need not to worry. I would suggest you consult dermatologist once for proper examination. The doctor may order skin patch test, blood test and physical examination. The doctor may prescribe you drug like finpecia at least for 3-4 months or antifungal treatment along with minoxidil spray. The doctor may also recommend hair transplant with HUE technique. Yes, hairs can be grown at fallen places. Take Indian gooseberry powder (half spoon) with water once a day and use almond oil for massage. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Harry Maheshwari, Dentist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is there any possibility to fill the cavity instead of RCT in permanent molar?\n\nHello doctor,My daughter has a cavity and was told by the dentist that she needs a root canal on her 6 years molars. Is there any option we could fill the cavity vs having a root canal? She is in a lot of pain.",
    "doctor_response": "Hello. Well, the condition of the tooth decides its treatment. If the dentist has suggested her root canal that means there is nothing that can save her tooth but only root canal. I suggest you go for that. Filling the tooth is only done when there is a small cavity and has not damaged the pulp of that tooth. For stopping pain temporarily, you can consult your dentist for medications. I can suggest Paracetamol or Ketorol-DT (Ketorolac) tablet in low concentration.  For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach ache?\n\nmy child of 6 years is having frequent tummy aches and passes stool which relieves the pain and the stool has some mucus and the food that she ate recently. She had fever yesterday but no fever today. We thought she is recovering but the aches are back again. can we give her anafortan? or what else? .",
    "doctor_response": "HiWelcome to the HCMIn my opinion your child is suffering from a bacterial or parasitic infestation of the gut.It seems to be more like an intestinal amoebiasis.It is usually caused by ingestion of unhygeinic food or water. To support the diagnosis you can go for a stool examination and immunological test for amoebiasis. For management you should give her the following:1. Keep her well hydrated by regular oral rehydration therapy such as lemonade, Buttermilk, ORS etc.2. Start her on Ofloxacin- ornidazole syrup to treat the infection.3. For fever, you can give her anafortan.4. Also give her 2 doses of albendazole at 15 days interval.For further questions, do contact us",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take Vytone for rash around the mouth?\n\nHi I currently have a horrible rash around my mouth.  My dr prescribed vytone cream with aloe and it made the rash seem worse-more red, swelling, itchy, and peeling.  Now i am using neosporin because i think maybe i have an infection.  Any thoughts?Amy",
    "doctor_response": "Thanks for using Health care Magic.Read your query.The red swelling ,itchy and peeling are common side effects of the vytone(You may be allergic to some of its ingredient). If the symptoms increases immediately refer back to your doctor.You can use Neosprin,but I would advise to take your doctors opinion and continue.Hope this was helpful.Thanks and warm regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from ITP and obesity, frequent fall in platelet count, given Wysolone and antacid. Permanent cure for ITP?<br><br>\n\nmy wife is 34 and with normal BP and weight is 120 kg ( obesity ) she has ITP and frequently her platelet count fall and come back on her own yesterday her drop went to 2 k shown it to Hematologist M B Agarwal and he has given wysolone and some condolent with antacid i am worried so writing to u is there any permanent cure for ITP my email id is YYYY@YYYY",
    "doctor_response": "Hi There is no permanent cure for ITP. But there are various drug options, best of which is steroids. If she is maintaining  platelet counts well and not bleeding much, regular followup with the haematologist is enough. Steroid dependent patients especially with significant bleeding may be considered for a surgery called splenectomy. However the decision is best taken by the treating doctor after discussing both the pros and cons. It is very important to loose as much weight as possible. All the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lump on the tongue, weight loss. Biopsy ruled out cancer. Sore throat and pain in the ear after biopsy. Worried\n\nI have a lump on side of tongue,Dr. did a biopsy,came back not cancer. It's size is 1mm. on outside but it is 2mm underneath.Very painful since biopsy,sore throat,pain sometimes shoots into right side ear,This is on left side of tongue,oral.It even hurts to touch right side head and hair.Had this for 1 1/2 months.Have lost 13 pounds due to being painful to eat, or drink.",
    "doctor_response": "Hi, There is nerve communication between ear and tongue. Ear ache may be associated with tongue lesion. You have not mentioned your age. Anyway, in my opinion you may review this slide. The symptoms you have mentioned probably due to secondary infection. Consult your doctor and try an antibiotic course after proper culture sensitivity and analgesic. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can lower back pain caused by a herniated disk affect the nervous system?\n\nSix years Ago I had surgery for a herniated disk between L1 $ L2. Four months later I had a second surgery on the same disk to correct the same problem. Since that time I have had chronic lower back pain. I have had x-rays, MRI s (Twice with no structure problems) and 17 physical sessions with out results. My question is can lower back pain affect the nervous system creating a nervous condition to the point where my whole body shakes?",
    "doctor_response": "Hi, Lower back pain may not affect the whole nervous system. At the most, it may affect the lower limbs or bladder and bowel function etc. If the whole body shivering present then it may be due to electrolyte imbalance or generalized weakness or anxiety or tremors due to parkinsonism or essential tremor etc. Until examination is done it is difficult to say what it is. Please continue physiotherapy, once again check for your lower back by MRI spine. If symptoms not improved please consult your neuro physician, he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Asthma, asthalene inhalers, Formonide-400 and combimist inhaler, ocid 20 mg, Omnacortil 2 tab 20mg, L-cin 500 mg, odimont 10mg, doxiflo 400 mg,\n\nHello,Doctor! I am 40 years old, and suffering from Asthma from past 4/5 years. I have been taking asthalene inhalers for 2 years and get instantly relief , i have tried homeopathy since began.but not satisfied. now I need inhalers almost every day twice, then I contacted a doctor and he says its converted in acute asthma, my doctor suggested me to take Formonide-400 and combimist inhaler twice a day for 90 days and some medicine : ocid 20 mg, Omnacortil 2 tab 20mg, L-cin 500 mg all OD for 8 days and odimont 10mg for 90 days OD , doxiflo 400 mg 90 days BD. Doctor please suggest me , is my asthma in very serious condition. or its normal , my ongoing medication is all right?",
    "doctor_response": "You seem to be suffering from chronic persistent asthma. You have not mentioned whether you are taking oral steroids-omnacortil in your case on a regular basis.Long term oral steroids have many side effects and should be avoided. You should take inhalers regularly. Take Seretide-500 or Forrmonide-400 twice a day, duolin/combimist 2 puffs 3 to 4 times a day. Technique of inhalation should be correct so that the medicine is not wasted. Nebulization with asthalin or budecort solution on SOS basis can be taken.Take Doxyphyllin 400 mgm BD amd Montair LC at night. You have to take an antiacid like Ocid or Pan 40.. You may take Bromhexin cough syrup or ambroxyl to loosen the sputum so that it comes out easily. Avoid dusty and smoky atmosphere and drastic changes in temperature. Avoid junk food and artificial flavours and colouring agents. Pranayam and deep breathing exercises and weight control will help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the treatment and diet for fatty liver?\n\ngood am i ask you about my brother the doctor told him he has a fatty liver so he take a godex ds ....but when he eat a meat  his stomach he feel very very sore,if you have a fatty liver your stomach his affected to all the food he eat...so he has and ultra sound and his doctor told him he eat only steam vegies, steam fish....and he eat a little bit of rice,,then he said ha has no energy.....so can you advice me what will i do to my brother...",
    "doctor_response": "Thank you for posting query.increase liver enzymes and diagnosis of alcoholic hepatitis.decrease weight if over weight.avoid oil altogether. Pure olive oil maybe used in very small amount(advice:- abstinence from \"Alcohol and drugs\" - LOW fat diet should be followed- NO red meat- vegetables should be ingested daily- Moreover, less activity should be carried out (no sports). - use lemon juice (lemonade) once in a day- walk 30 to 40 minutes everyday.- or swimming is alternative to walking- NO sports and NO jogging-\"recheck liver enzymes after 6 to 8 weeks\".if any further questions, feel free to ask.Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health.regards,Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing frequent night sweats after taking medicines\n\nhello... I have been diagnosed with depressive disorder, insomnia, severe anxiety, and borderline hypertension. My prescribed meds are clonazepam =, 2mg daily, trazadone, 200 mgs at night, and melatonin (supplement) at night.  Since increasing recently from 100 to 200 mgs of trazadone my night sweats seemingly have become more frequent. Not excessive, but enough for my nightclothes to be damp when I awaken in the middle of the night. Any thoughts?",
    "doctor_response": "HiThanks for using healthcare magicThat may be due to anxiety symptoms either due to depression or drug. At high dose, many patients with trazodone feel anxiety symptoms. You can decrease the dose of trazodone to 150mg and that increase the dose of clonazepam. Better to discuss this with your psychiatrist. You can also try JPMRThanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden red itchy rashes on the body and fever?\n\nMy daughter, 7 years old, woke with a red and raised rash that is itchy and the symptoms have lasted all day. It also appears worse than when she woke. She has an elevated temperature of 99.4. No other apparent symptoms. Should I be immediately concerned? What can I do to help her deal with the symptoms and get some rest?",
    "doctor_response": "Hi Thanks for using healthcare Magic.Raised itchy rash sounds more like an allergic rash (utricaria/hives).It can occur in viral illness aswel. She needs antihistamine to get rid of of the itching and doctor's review.Hope this helps.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can gestational diabetes be treated?\n\nHello doctor. Am pregnant with twins. My random blood sugar tested at 3 months of pregnancy was normal.It was around 101. At 27 weeks I got tested with gestational diabletes. My readings are a bit high. FBS is 108, after one hour it is 174 and 2 hour it is 163. Please suggest what does it mean. I was not having diabetes before pregnancy as clearly shown by random blood sugar. What effect it can have on my babies and will it come back to normal after pregnancy?",
    "doctor_response": "i can understand your concerns. these values shows that you are having gestational diabetes. and gestational diabetes is something that appears during pregnancy and goes away after pregnancy is over. baby can be large foe date and go into hypoglycenia just after birth. but effective management can prevent complications.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes uncontrollable chills and pain in the legs?\n\nI woke up last night the air conditioning was on high but that s normal I am in Vegas and it s 112 I was not out in the heat for any length of time but anyway I had these uncontrollable chills I used all blankets turned the air off used a what pak but kept shaking and was SO cold i was aching in the legs and my fingers were so cold it lasted until I feel asleep I have never had anything like that happen before should I be worried?",
    "doctor_response": "Hello, As this should be related to the vascular supply in the lower limbs a physician should be contacted for having a thorough examination of the body. As this kind of chills is common using the AC but there might even be the possibility of an underlying cause. Fixing up an appointment with a physician should help him to understand the complains better as what you mention here is too brief to come to a conclusion. Post a thorough examination you may be asked for some basic urine and blood routine. Medicines will be prescribed based on the provisional diagnosis. Rest assured. you should be fine soon. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in chest while taking deep breath with heart palpitations\n\nHi, I am a 29 yr old female with trouble breathing. Specifically, it is painful to take deep breaths, and its not satisfying when I do. I also experience heart palpitations occasionally, but went to a heart specialist and they determined I have no heart problems. I was prescribed Prilosec by my doctor and it helped for a while, but now the chest pain is back again. I am not sure at this point if this is a gastrointestinal issue, or a lung problem. What do you think?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, you are mostly having GERD (gastroesophageal reflux disease) related symptoms. You are improved with prilosec (pantoprazole). This also favours GERD more. GERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause symptoms of chest pain, palpitations, burping, belching, chest tightness etc. So follow these steps for better symptomatic relief in GERD. 1. Avoid stress and tension, be relax and calm. 2. Avoid hot and spicy food. Avoid junk food. Avoid large meals, instead take frequent small meals. 3. Take prilosec (pantoprazole) twice daily on empty stomach. 4. Go for walking after meals. 5. Quit smoking and Alcohol if you have these habits. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back, joint and widespread pain\n\ndiagnosed with fibromyalgia,rheumatoid started metformin(pre-diabetic)and no mens.cycle since age 21,after childbirth(now am 43) and have been getting injections and taking methotrexate,no relief from back,joint,widespread pain,pain management wants to do a rheuzotamy(I misspelled) im sure.is this safe and should I continue with injections?alot of widespread itching with a new pain medicine",
    "doctor_response": "Hi, You can take analgesics like tramadol or acetaminophen for pain relief. If symptoms persist, you can consult a neurologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for pain in stomach during bowel movements\n\nMy 27 month old daughter has black pepper/coffee ground looking flecks in her bowel movement. Doesn t eat pepper. Causes? She s average size and weight for her age group. She has had problems with pooping sometimes. But the poop was brown and mushy. @15 months, a swallow function and an Upper GI were done and I was told it was normal. She wasn t able to eat regular food without throwing it up minutes later. We used Zantac for babies for a couple weeks, then we used Maalox for the next month and the food problems ceased. Her stomach seems to hurt quite a bit, especially when she s going to have a bowel movement in the next few hours. Her temperature also gets low, hours(maybe 6-8) before she has a bowel movement.",
    "doctor_response": "It's a clear case of indigestion in children called 'mandagni' in Ayurveda. As you have seen yourself that upper GI showed normal.So the problem remains with functioning of digestive system and enzyme secret which is causing mushy stools etc.My recommendation is that non toxic, natural herbal treatment should be given to your child.BAEL fruits pulp (dried) plays an important role in such conditions. If you can get it - nice. Otherwise get online from South East Asian countries esp India. Himalaya herbal co. also has BAEL cap containing BAEL extract. It markets the same globally.Now your small child would not take Capsule. So open/ cut the capsule and pour into a bowel. Mix honey and let the child lick it. Do it twice or thrice.Alternatively if you get BAEL powder (also called Bilv powder) from India, give it at least 1/2 gm with honey twice or thrice a day.After giving for a week or two you may add little (250 mg approx) dry ginger powder also once a day to BAEL powder and if child accepts its taste, continue it for a week more.It will flare the natural enzyme secretions. It is astringent, antimicrobial, antiinflammatory, antispasmodic etc without any toxicity or side effects.BAEL is also called stone apple, wood apple.For any other query pl write direct question.Hope it is helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What caused a burning sensation in my lower leg?\n\ntoday I was sitting in a chair and something felt like it let go in my leg (below my knee in the front). It really burned and hurt. When I went to get up my foot hurts so bad I can t put any weight on it. What can it be? Do I need to go to the emergancy room?",
    "doctor_response": "Hello, It could be due to neuropathic causes like peripheral neuropathy. If symptoms persists better to consult a neurologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rapid heart beat and palpitations\n\nI was diagonosed with rapid heart beats and palputations. They put me on metoprolol and it has slowed my heart down and helped with my palputations. However I have started having massive pressure in both ears. I had it prior to the meds but it wont go away. It keeps me half the night and I also wake up gasping for air. Please help.",
    "doctor_response": "Dear Sir/ MadamThanks for your query.1. The metoprolol is not known to produce pressure in ears. Since it is working well for your palpitation, do not stop it without consulting your doctor.2. I would recommend you to see your ear specialist for the pressure in ear. This may be related to some local problem in ears or may have a neurological cause.Feel free to discuss further.SincerelySukhvinder",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling effect and tightness in the back?\n\ni have a pain in my back, under my shoulder blade it feels like. its not sharp pain but when i move my head forward i can feel the pain and then it is a sharp pain...i have tightening around that area and sometimes tingling and tightness that comes and goes in my arm",
    "doctor_response": "This is initial stage of cervical disc syndrome and if precautions are not taken, may lead to cervical disc prolapse too. CDS may, however be due to intervertebral disc space reduction due to any reason that restricts free movement of neck and exerting pressure on nerves emanating from cervical spine and going to arm. It may be due to osteophytes too but that's generally in later age. Symptoms are similar.Physiotherapy and herbal decoctions are the best bet. Otherwise pain killers will make you dependable on them and cause side effects. Pain killers will also render ineffective after some time.If interested, pl ask direct question to know more about cervical support, herbals and decoction etc to keep life happy by prevention of progress of intervertebral disc disease.All the best.rajeshchoda@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for back pain due to lifting heavy weight\n\nI am a 26 year old male with a lower back pain. I am overweight as well and was helping a school teacher move things around and sitting in the chairs and bending I have hurt my back. The pain seems to stay local to the lower back but, sometimes if I twinst or bend wrong I cant move and have a sharp jetting like pain.",
    "doctor_response": "Dear patient You have got muscle spasm due to lifting heavy weight.  Avoid forward bending and weight lifting for 3 days. Start  tab diclofenac plus thiocolchicoside combination twice a day for pain relief.  Do hot water fomentation locally at your back.  You will be fine within few days. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to expand chest?\n\ni am 25 year old Indian man 63kg weight and 168cm height and chest size 83cm and chest expansion is 2cm only, i have medical test for govt. technical job they need 84cm chest size with 5cm chest expansion, how can i get 1 cm more chest and 3 cm chest expansion in next 3 months",
    "doctor_response": "Hi,To increase chest expansion few inches more, go for deep breathing exercises daily with taking deep inspiration, then keep air inside for some time and then expel all air outside slowly.Use Respiretrometer for  breathing exercise.Go for inflating balloons frequently.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I loosing control on my legs?\n\nI had a heart attack in 2007 and have felt well since and on the usual medicines. Last week I lost the control in my right leg and it recovered . Two days later I lost control in both legs and fainted. I am awaiting blood tests and have had my blood pressure tested. The latter was excellent. Please comment.",
    "doctor_response": "Dear patient the history that you give here points to a classic embolic stroke known as TIA.YOU should go to the ER immediately and tell them to get you an MRI/CT head. Mri will be better but if it takes time a ct will also point to a tia.Excellent Blood pressure may rule out a haemorrhagic stroke but it does not rule out the possibility of an embolic stroke which is common in patients with a history of a previous heart attack.I suggest you review the medications with your doctor and consider adding clopidpgrel 300mg with the aspirin you probably are taking.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing deficiency with unilateral mild tongue swelling & pain\n\nI'm a 24 year old woman with history of B12 deficiency with unilateral mild tongue swelling and pain at the back L of the tongue (radiating to ipsi submandibular gland and ear) for 1 month.  Pain is constant and moderate to severe, I have trouble swallowing and speaking but haven't lost any weight, I do wake up from the pain at night.  Naproxen doesn't help at all.  I can't see any sores/ulcers.  Also have a strong family history of oral cancer but I believe my relatives all presented with non healing ulcers.  No dry mouth/fevers/chills.  Should I go to an ENT vs dentist?  Also anything I can do for pain relief in the interim.  Thanks",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. This swelling which is present at the left back side involving tongue can be because of an infected wisdom tooth which might be impacted in the bone and causing this swelling. Better you should visit a dentist and get complete examination with radiograph,  as it will help you to find out the problem.Till then you can start with diclomol sp as it will help you in reducing swelling as well as pain..Hope it will help you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for wheezing\n\nsirmy son is suffering from wheezing whenever we are in Chennai.  we reside in delhi. he does not getany problem when he is in delhi. but morning sneezing is always there. now he is suffering from wheezing.  can u pls suggest which specialist has to beconsulted for this",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. In my opinion you should consult pulmonologist and get done PFT ( pulmonary function test ) to rule out allergic bronchitis. Your son is wheezing only in chennai,  this means he is having allergic phenomenon due to atmosphere or allergen in chennai. So we need to rule out allergic bronchitis in his case.He may need antihistamine, anti allergic and inhaled bronchodilators , whenever he is in chennai. All these drugs will help him to avoid allergy and thus wheezing. So better to consult pulmonologist and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes Parkinson disease?\n\nHello Dr. Weil, My husband has Parkinson s disease which started 6 years ago, now but doing quite well, he only has a slight twitch in his lip and sometimes a weakness in his feet and his memory is not as sharp as it used to be. He also has prostate cancer, but in great remission for the last 3 years. Dr. told him he may be a borderline diabetic, he does not take any prescription for it, he just takes good care of his diet. Can he take your Juvenon pills, would they help him, especially with his memory? Thank you,",
    "doctor_response": "Hello,If this is the Parkinson disease then it may sometime affects the memory but it is not always moral support, self-confidence, practical and positive attitude plays bigger role as long as the memory and Parkinson disease is concerned you can discuss this with his physician.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Akhtarhusain",
    "dialogue_context": ""
  },
  {
    "patient_message": "How effective is Betnovate cream for tight foreskin?\n\nHi I am a 22 years old male, I have a tight foreskin (only a part of it retracts). I have been using betnovate cream for a week. Using the cream i have no side effects such as itching or redness. So should i continue using it ans Is it effective, How much time will it take to show some results?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I think, you may be having phimosis. Consult the surgeon for the perfect diagnosis. No drug including Betnovate cream is not effective to release phimosis. Only circumcision can remove the tight skin. That can be done under local anesthesia. Hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does my heart beats fast and harder?\n\nAbout a month ago I was diagnosed with Hyperthyroidism. The dr prescribed 40mg tapazole and 50mg toprol. I had about a months supply. After I'd finished the medicine I still have a steady rapid heart rate. My heart beats fast all the time and when Im physically active (running, walk fast etc) my heart not only beats fast but it beats harder. What's wrong with me?",
    "doctor_response": "hello,Thanks for using HCM.I have gone through your query.Basically Hyperthyroidism needs long duration treatment atleast for a year or two.You should not stop or finish medicnes in month.If your symptoms are still persistent with continuous medications you need to step up the dose.So restart medicines if you have stopped and increase dose if you are already taking regularyl,My best wishesDr.Rajesh Teli,MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have crystals in my sperm. Would black cherry juice help?\n\nI have crystals in my sperm.I do have gout and l do drink alcohol not on a regular basis.I do drink a fare amount of water to keep up my hydration levels.I am on Allopurinol on a daily basis.My question is would black cherry juice help with the crystals in my sperm.",
    "doctor_response": "HelloThanks for query.Crystals in the semen strongly suggests agglutination of sperms .Please get your semen analysis done to confirm the diagnosis and to know the details of your semen parameters like sperm count ,motility of sperms and morphology of sperms etc.Most of the time this indicates infection either in prostate or seminal vesicle .Take antibiotics like Doxicycline twice daily for 2 weeks and repeat your semen analysis .Taking Black Cherry juice will not resolve the issue.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burnt skin near penis and how to cure it?\n\ndear sir!  i am 22 years old male.. i have a problem near laps between penis.. the skin burned bothsides on the laps.. and when i rub on the testies and laps i will get some dust which smells bad..  am worried.. please let me know the reason for this..",
    "doctor_response": "Hello, You can apply over the counter silver containing antibiotics like silverex ointment. If there is any signs of infection, oral antibiotics also be required. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is that grayish color of gum a form of gingivitis?\n\nHi doctor, I have a grayish patch above my teeth. I have attached some pictures here. Initially, there was a pink spot just above the teeth, and then it turned gray. Under my upper lip, it is dark pink or red. Is this a form of gingivitis? In the morning, I am getting brown saliva. Also, I am getting brownish froth when I brush my teeth. Why?",
    "doctor_response": "Hi. I have seen the pictures (attachment removed to protect patient identity). For further information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can lobectomy cause itching on back?\n\nMy mother had a upper lobectomy four months ago.   She is recovering nicely.   All of the sudden she has a lot of itching on her back...could that be related to upper lobectomy?     She is on no new medications, hasn't changed any soaps or personal products or eaten anything different.",
    "doctor_response": "HiThanks for posting on HCMLobectomy may cause itching on back if itching is around the incision site.Itching with scaring or wound healing is a normal process and may not be a cause for concern.I will advise you just observe the itching site for any rashes.If rashes appear, it may mean a skin condition to investigate.If no rashes, just stay put as just a normal process.Hope my answer will help youBest regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause fever,lip sore in a child?\n\nHello my daughter had a fever a few days ago between 100.4 - 102 and then I noticed a sore on her lip like a cold sore and today I noticed her gums are a little swollen. I know she has 3 teeth coming in, could this be the reason for this? Also she has lost her appetite",
    "doctor_response": "HiWelcome to the HCMGum swelling can be due to the possibility of teeth eruption. So don't worry. In case she seems to be irritable and discomfortable, you can give her acetaminophen or ibuprofen syrup for pain relief.A slightly raised temperature (lower than 38 degrees C), but not a fever can be an associated symptom for which acetaminophen will be helpful.Your toddler may lose his appetite when he's teething. Chilled foods, such as a yoghurt or fruit purees, may soothe his gums and be more appealing. For further questions, do contact us.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes movable lump attached to cartilage in throat?\n\nHi there, I have a marble sized lump that is firm and movesHi there, I have a marble sized lump that is firm and moves up and down only when I swallow. It seems like it is attached to the cartilage in my throat on my right side. It is approximately 1-2 inches north of my adam's apple and to the right a little bit. My doctor recommened a sonagram. I am just worried. Does it sound like something serious. Thanks",
    "doctor_response": "Hi,Dear,Thanks for the query to HCM.I studied your problem in depth and I understood your concerns.Cause of the hard movable lump on top of throat-You seem to have-Lipoma / or a lymph node or / Thyroid Cyst.Your USG would resolve few issues .and Hence for further treatment I would advise you to Consult ER Surgeon who would treat it accordingly.This advise is based on the facts from the history you give and needs further clinical check.Hence I would advise you to check with ER Surgeon.So dont build up  wrong concepts and create more psychic complications in you which would increase risks and costs to you.Hope this would relieve your problem.Welcome for any more query in this regard to HCM.Write good resume and Click thanks if you feel satisfied with my advise.Have a Good Day.Dr.Savaskar M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why were the blockages in a vessel and the right coronary artery of my heart not cleared?\n\njust had a stent placed in the left side of my heart in a vessal that was 98% blocked but my right coranary artery that was 100% blocked was not touched because the risk was higher, don t understand why both blockages were not cleared, can you explain?",
    "doctor_response": "Hello. I understand your concerns.I can only assume the scenarios when a totally occluded (blocked) artery is not opened. In my experience, there are several reasons we do not open a 100% blocked artery. In cases of a remote myocardial infarction, which was caused by a totally blocked artery, there is no benefit of opening an artery which, after opening, would supply a damaged territory of the heart. In other cases, the left circumflex artery is the dominant artery (8% of people worldwide) and the right coronary artery is a small, non-important, artery. The risk would be higher if the artery is opened in these cases, then the benefit would be. Another reason is, if the other artery (the one that was 98% blocked) was stented in a state of an acute myocardial infarction caused by this artery, then the other artery is stented in a second time.These are the major reasons why an interventional cardiologist has doubts of opening a closed artery. I hope I was helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the abdomen?\n\nHi I am 33 years old,female,75 kgs,I have been suffering with terrible problems with my stomach for some time.I have a constant  pain in my abdomen and I get a sharp pain at the left shoulder blade as soon as I eat.If I eat anything,I feel really full really fast and bloated.I am also constipated.My lower abdomen aches when there is a any sudden jerky movement .I am not sure what it is.Please help.",
    "doctor_response": "HelloFirst of all I  want to tell you that there is a membrane between thorax ( chest ) and abdomen . When you eat something ( rather I will say overeat then stomach dilate and it presses the membrane ( diaphragm ) ,hence person feel pain in the shoulder joint on left side because the nerve supply of joint and diaphragm is one and same i.e phrenic nerve.Now main question you feel always bloated , fullness, pain on left side and constipated all the time . Try raising the head of your bed about 4 inches with blocks . It also might help to avoid eating or drinking for 2 hours before you lie down. To control stomach acid one should not drink drinks with caffeine in them or eat chocolates or greasy or oily foods , avoid alcohol. When you feel such type of pain take some antacid but if pain is severe , you may need drugs like pantaloc- D  once or twice in day.As you mentioned that pain develops immediately after eating , so avoid overeating as this is the root cause of bloating , pain , fullness in stomach.While for constipation take high fiber diet . Still constipation present take phenophthelin tablet one or two depending upon hardness of stool.Plenty of water also helps . At present in my opinion no need of any tests. Only these upper mentioned measures will help . Still no relief then consult a Gastro-enterologist and get his opinion.Hope this information will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes small brown spots on back?\n\nMy 8yearcold daughter overnight developed very small brown spots on her back ! About 3 to 4 small dots ! I am worried what are they ! First I thought they are brown sketch pen marks but they don t go with scrubbing ! She has no pain or itching ! Pls help !",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for allergy to fruits and nuts\n\nI have been allergic to fruits and nuts for over 20 years now. I am tired of not being able to eat them, with how beneficial they are and how yummy they are. I get what has been called herpes of the mouth and have gone into anifilactic shock after eating an entire bowl of strawberries. I get sores in my mouth that hurt and my throat closes up if I eat too much. What can I take so I CAN eat these things?",
    "doctor_response": "Hi,Food or Nuts allergy can be diagnosed only on the basis of detailed history taking and thoroughly clinical examination by an expert.Although there are laboratory allergic testing of food is being done nowadays but none of them is reliable clinically and also adds extra cost to the patient.The best way to cure allergy is to avoid contact of that particular allergen here in your case that particular fruit or Nut.However there are very good medicines like epinephrine,steroids, antihistamines, mast cell stabilizers are available in market to combat allergic symptoms.Consult dermatologist or allergic specialist for further advise.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure seizures permanently?\n\nMy daughter has taken Topamax for seizures. She quit taken the meds several months ago and her seizures are coming back more frequently then before. She said her insurance will not cover them anymore. What should I do ? She just had another seizure today.",
    "doctor_response": "welcome to HCM!From my clinical expeirnece I can tell you that your daughter should start the medicine as soon as possible. As you mentioned that her seizures are back with more intensity, and the nature is different now, so , you should preffrably  see a neurologist and take consultation before starting drugs. She should also get an MRI brain to rule out any organicity, get her liver function test and blood counts (prior to starting drugs). I know it is very difficult to take long term medication but it is really important for her to remain seizure free. Every seizure destroys some brain cells, and thereby making her prone to get more of them. Apart from drugs you should see that she dosent drive for some time now, operates machinery under supervision.Please try to cut expenses on other things and ask her to take medicine, she needs them. Donot stop the drugs without consulting the doctor.Hope the reply is usefulDr. Manisha Gopal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can cancer patient have sudden spurt of energy?\n\nMy Father has a tumor around his juggler vein that is growing very rapidly, his cancer has also spread to his lungs. we have been told that he could pass anytime...today he had a huge burst of emergy and said he hasnt felt this great in several days... do cancer patients usually have a spurt of energy before they pass?",
    "doctor_response": "Hi.I understand your concerns.If he is on a lot of medications, specifically pain medications, they can create a feeling of excitement and energy. This is likely decided by the doctor to reduce the pain and let him enjoy.Please confirm this with the doctor.I hope this helps you. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to stop bleeding, pain after operation on left kidney?\n\nmy name is jean and question is i had oppration on my left kindy they put in a steint inn to keep the tub open but i am bleeding now and in pain and i just went to the er last nigth and they can,t help me and i go back in august 1 0000 and do not now the time on that day.and what should i do",
    "doctor_response": "Hello,thanks for the query.Small amount of bleeding is quite common after renal surgery and nothing much to worry and it will stop by it own.Do a urine routine and basic blood investigation to check whether hemogalobin level is reduced or not.you can take mefenemic acid-tranexa combination for symptomatic relief. it will help in pain relief as well as stops bleeding.If symptoms are severe, better to consult your urologist and get evaluated.Wishing you good health.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Numbness in back side of head, tired eyes, sluggish, severe neck pain, pus filled sac on thigh. Any ideas?\n\nI woke up one morning to find the right back side of my head somewhat numb. I don't know what to make of it, but it is obviously concerning to me since i have never experienced something like that before. Then i noticed that i was sluggish, very tired, tired eyes. I took a nap and woke up with my neck hurting badly, that was probably from just poor positioning as i layed on top of layers of clothing and went to nap. Then this morning, out of the blue, i noticed what appeared to be like a pus or sac filled with liquid on the outside of my thigh. Any ideas doc?",
    "doctor_response": "Hi,Thank you for posting your query.Numbness on the back of the head is probably due to mechanical pressure over the nerves in the skin (in that region). There is no need to worry about it, as it improves in a few days at the most.Pus discharge from the thigh region is unrelated and is due to a local infection. You would need to take a course of antibiotics.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do the infertility reports mean?\n\nGood Morning Doctor, Please find the attached report for in detail explanation about my wife helath problem, we are trying for family planing but we are not successful since last 5 months , then we consultated to doctor , and we did some medical test and same report i am attaching for your reference. Please let me know the what is cause of this problem, does this affect for permanently for pregancy, realy we are worried a lot ,please help us on the aboce query, thanks in advance.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You have infertility problems. I need your your semen analysis and your infertility profile of your wife. In public forum question you can not upload the report. So either give me detail of reports or use premium service and ask to specialist in which you can upload the reports.Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer.Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can you conceive if you had intercourse just after period ?\n\nhi i saw my period on the 14th it ended on the 18th and i had unportected sex on the 21st of this month is it possible i may be pregnant",
    "doctor_response": "mostly safe. b'coz pregnancy depends upon ovulation. & ovulation takes place round about 14th day of regular cycle.plus minus 2.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest possible treatment for fibromyalgia\n\nI am living in Bangalore temporarily and have Fibromyalgia. I have been reading that the underlying cause can be due to an under active thyroid. I was doing better but recently began to feel much worse. I don t know what to do or who to see here in the city.",
    "doctor_response": "Hello, I hail from Bangalore. Fibromyalgia what it is must be known to you. Having a good hands-on physical examination can help understand the extent of the fibromyalgia involved in the muscular system. Since you didn't mention anything about which are is more painful it is difficult to put words on how to resolve the issue Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am 20 yrs old, suffering from irregular periods, Is that i would not get pregnant because of this ?\n\nHello, I AM 20 YEARS OLD I JUST GOT MARRIED IN MAY 7TH OF 2011. BUT I TEND TO SOMETIME GET IRREGULAR PERIODS. I HAVE BEEN GETTING MY PERIODS IRREGUARLY FOR QUITE SOME TIME ( EVEN BEFOR I GOT MARRIED). I CAN MISS MY PERIOD FOR 10 WHOLE DAYS AND NOW I THAT JUST HAPPENED AND MY PERIOD DID NOT COME SO I THOUGHT I WAS PREGNANT AND IM NOT. mY PERIOD JUST CAM TODAY WEN IT WAS SUPPOSED TO COME EXACTLY 13 DAYS AGO. wAT IS WRONG WITH MY BODY IM SO AFFRAID FOR MY HEALTH. wILL NI EVER BE ABLE TO HAVE CHILDREN?: (",
    "doctor_response": "hi welcome, your problem related to hormonal imbalance only. for this , to make the hormone into normal level instead of going for hormone tablets i prefer you to go for alternate treatment,being an ayurveda doctor our system have so many medicines to make it regular and also we have ayurveda gynaec wing also for the details and better treatment write to us christyjoseph1@gmail.com sunithapoly124@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be wrong having the lower back pain that subsides while resting?\n\nAbout a week ago i popped my back trying to wrap up a pallet at work . I was in a lot of pain in my lower back. I got some rest for a few days and I do feel better. know my back still hurts a little but not like it did on the day it happen .So my question is do u have any idea of whats wrong!",
    "doctor_response": "Hello. Thanks for writing to us. The back pain that subsides on resting is likely to be due to a muscular pain. It is most commonly related to a bad posture. Proper rest and improvisation of posture is needed to take care of the problem.I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal ,drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is BP 119/65 normal during pregnancy?\n\nHello im 33 yr old female 19 weeks pregnant and i just checked my blood pressure and heart rate and was wondering if you could tell me if they are what they are supposed to be.My heart rate was 85 beats per minute.And my Blood pressure was 119/65 are these normal?",
    "doctor_response": "Hi,Your blood pressure and heart rate are absolutely normal at this stage of pregnancy.Even in normal health your these parameters are normal.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes whiteheads on the face?\n\nI have tiny whiteheads on nose and face. From there went to scaly skin and then itchy red patches with it. Dermatologist gave cortocosteroid and called it dermatitis. Said not to use unlesss I had an outbreak. It cleared the rash up. 2 days later the whiteheads came back lots of them, specially on nose and face what is this?",
    "doctor_response": "HIWell come to HCMThis could be blocking of skin pores with the sebaceous material and this is happening due to poor hygienic care of skin, and this later may get infection and turns to dermatitis, take care for hygiene continue the medicines, if this is not added with antibiotic then try Tab Amoxicillin 500 mg three times in day take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pea sized, painless lump in armpit.   No redness or swelling.   Lymphoma?\n\nI am a 25 year old female.I have found a pea sized which is completely painless lump in my left armpit. It's right at the top of my armpit and feels hard and mobile. There is no redness or swelling, which concerns me as it leads me to think it isn't an infection. I do not currently have any form of viral infection and haven't had one recently. I noticed the lump about 2 weeks ago.There is no real history of cancer in my family, but I am concerned that this could be lymphoma. I did go an see my doctor about this and he said it did not feel sinister and he thinks I should allow 6 weeks for it to potentially go down. He advised me to come back in again and see him if it's still there. Although, I would like to trust my doctor, I really feel I should have some form of biopsy carried out. I have huge anxiety about this at the moment and feel like it's preventing me from enjoying my life in the mean time.Please can you advise?",
    "doctor_response": "Hellowelcome to health care magicMadam freely mobile lump may be a lipoma..it does not transform into cancerYour doubt that it would be a lymphoma but it is not mobile..If it is lymphoma then in routine blood test you may see the abnormality in the total number of White blood cells..you may feel fever also.Consult pathologist and have FNAC(fine needle aspiration cytology) of the lump present in the arm pit..it will clearly tell the diagnosis..and based on that consult surgeon and he will guide you how to remove the lump.Hope you got answer from meThank youDr.siddartha",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for soft tissue cancer in the legs\n\nDear Sir, My brother was detected with soft tissue cancer in his leg about 6 months back and CT scan done after 6 months has revealed nodules in his left and right lung..He was underhgoing treatment in Hinduja Hospital Mumbai can you please suggest the best doctors available in Apollo Cancer Hospital Teynampet",
    "doctor_response": "soft tissue cancer  but which type .it's a tell megive me historyin leg but where to legpain is present so which type of painwhere is worsewhich better",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause sharp pain under the lower ribcage on the left side?\n\nHi, I am having a quite sharp pain on my left side under my lowest rib. It s at the front. I had the same pain about 3 weeks ago and the nurse said it was a spastic bowel and gave me bowel relaxant, however I was not having issues with the bowel and the tablets do nothing. Eventually the pain went away on it s own.On both occasions I have been hormonal but not on my period, and the pain worsens when moving and sneezing, but not when coughing or going to the toilet.I would rather not go back to the hospital as last time they kept talking about ectopic pregnancies and other things, which us turned out not to be but it heightened my anxiety for days after, which is rather avoid",
    "doctor_response": "Hi, Firstly , sorry to hear about your symptoms. As the history is straight away highlighting the symptoms related to two things as the pain is present just below the rib over the left side. There are some few basic important points which are not mentioned here. I would like to ask you your age and also if you have any gastric issues. The pain area is more prone for two things. Either this will be related to acidity or it may be related to heart. Take this way, If it is related to gastric you can try some anti acidity medicine and it should be fine. In case, it's not this than the heart needs to get assessed first. Because many a times a misdiagnosed condition later becomes serious condition. So I would like to advice your get checked with a cardiologist. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower abdominal pains, fluid around gallbladder, lungs, heart, pericarditis. Had bone marrow transplant, aplastic anemia. Advice?\n\nWhen my brother was five he had Aplastic anemia and had get Chemotherapy and a bone marrow transplant. He is now 24 and after lower abdomen pains the doctors found out he had fluid around his gallbladder, lungs, and heart. On top of that the sack around his heart is inflamed, Pericarditis. Because of that his heart rate is high and blood pressure low. They drained the fluids. They ruled out many viral infections, bacterial infections, and cancers. It may or may not be connected to his past condition, but they still don\u2019t know. They tried to treat the heart sack with steroids but it looks like they are going to have to do open heart surgery to remove the heart sack. We are looking for another opinion if you have any thoughts?",
    "doctor_response": "Hi, as it is it is difficult to find the cause, if he has chacolate coloured sputum, it may be the amoebic hepatitis, migrated to the pericardium, and lungs. There could be possibility of tuberculosis or recurance of aplastic anemia, but openion of the treating doctor will be the final, because from here we cant give the final diagnosis.                                So i advise you to allow the doctor to do his work. In the mean while give him nourishing food to with stand the surgery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "New liver can be replaced during end stage of cirrhosis?\n\nMy husband of 15 years and I are separated, we have been for about 9 months. As a result his family will not allow me to have any information about his health which he is in the end stages of liver disease (cirrhosis). He has been in ICU since Sunday on dialysis because his kidneys cannot filter the toxins any longer and his blood pressure is really low. How long does someone like this typically have to live and is he still eligible for a new liver? He's been hospitalized 8 times this year alone....",
    "doctor_response": "Hi thanks for contacting health care magic...Your husband having end stage liver cirrhosis ....Because of that there is functional failure of kidney is there....So kidney failure is associated....So his condition is not good and prognosis is poor....Chance of multiorgan failure is high....Liver transplantation is ultimate final treatment for cirrhosis but here as kidney failure is also there it has to be decided whether to go for transplantation or not by surgeon....Meanwhile monitoring of  his blood pressure , pulse , tempreture etc .has to be done.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a swollen and painful lymph node behind the ear be treated?\n\nmy wife has a swollen lymph node behind her left ear and gets shooting pains on the side of her head, her md said to use heat and tylenol and it should go away, and call back in a week if it doesn t change as there may be an infection but she is afraid she has something much more serious like cancer. does his diagnosis sound accurate or should we seek another opinion?",
    "doctor_response": "hi sir...briefly the most probable cause of these manifestations is infection not tumour....swollen and shooting pain with it means that there is infection bacterial or viral ..the lymph node have an important role in the immunity so when there is infection lymph node get swollen and inflammed and pain.....mostly ear infection or throat infection will cause that ...lymph node trap the bacteria or the virus and that cause these symptoms.....she shouldnot think about cancer as simply in cancer there is no pain in the lymph node......hope that i helped you ....take care of your wife health....thanks for contacting us",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes drowsiness and nausea after taking Etohine mr and Gabantin?\n\ni had sever neckpain so doctor suggested for me to take etohine mr and gabantin forte both tablets one in the morning and at night,just i started taking from last night,but my pains has reduced ,iam feeling drowsyness and nausia, i dont know why its like that?so please i need your help?",
    "doctor_response": "Hello, Your symptoms seem to be related to side effects of the medications that you are using. Nausea and drowsiness are more commonly related to the use of Gabapentin. So, I suggest to drink liquids and use Ondasteron to treat the nausea. If the symptoms continue, I suggest consulting your doctor about an alternative medication. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can carrot juice daily with regular meal lead to jaundice?\n\ntwo glasses of carrot juice daily, along with regular meal, will cause any disadvantage?(consumed for nearly two months)I asked this question because in this website its given as it may lead to jaundice.Aged 17 years, height 5.1 ft, 42 kgs and no sickness,",
    "doctor_response": "Thank you for posting query.according to best of my knowledge, carrot juice is beneficial to combat jaundice rather causing it.its healthy.Carotenemia is NOT jaundice and NOT a disease. Its common in children and NOT adults.Increased ingestion of carrots may lead to Carotenemia, a yellowing of the skin caused by eating an excess of certain vegetables. In this condition, a yellowish skin maybe observed BUT it does \"NOT\" affect the eyes while jaundice (increased bilirubin) affects eyes also- sclera may become yellow in Janudice. if any further questions, feel free to ask.Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health.regards,Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is flight journey safe after an injury to the leg?\n\nI have a 14 year old son who was hit above his knee with a hockey puck without any padding. We went to emergency room and he has crutches, but nothing is broken. We are set to fly on Wednesday to for two hours. Will it hurt more in the air and is there a higher risk of blood clots?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.You can go on your journey as scheduled. Ask him to keep moving his feet and toes. There is a very small percentage of risk for DVT. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Santosh S Jeevannavar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does non itchy blotches in the legs suggest skin caner in patients with past hodgkins lymphoma?\n\nmy grandmother has red non itching and non hive formed blotches all over her legs, she has a history of non hodgkins lymphoma x20yrs but has been in remission ever since, she went to the doctor yesterday, he ran lab test that were normal but said he had never seen anything like it and it looked like someone threw scolding hot water on her legs, she has to wait a month to see a Derm but could this be cancer coming to the surface of her skin from the lymphoma?",
    "doctor_response": "HI THANKS FOR YOUR QUERY. THIS CONDITION IS VERY UNLIKELY TO  BE SKIN CANCER FROM NON HODGKINS LYMPHOMA S SHE HAS BEEN IN EXCELLENT REMISSION SINCE THE PAST 20YRS....THE BLOTCHES ON HER LEGS COULD BE DUE TO INFECTION,UNCONTROLLED DIABETES,NEUROPATHY,HOT WATER RELATED ETC....SO YOU TO CONSULT YOUR DERMATOLOGIST FOR EXPERT MANAGEMENT,;ALSO SUSPICION HAS TO BE HIGH FOR TUMOUR RECURRENCE.ALSO KEEP IN TOUCH WITH AN ONCOLOGIST.THANK YOU.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a possibility of persistent bilateral club foot in the fetus at 21 weeks be rectified?\n\nHi, I have just done the sonography in second trimester of pregnancy of my wife. the report impression are 1).A single live intrauterine gestation of 21 weeks and 5 days. 2). Both the fetal foot appears rotated/deviated, suggests possibility of persisitent bilateral club foot(true clubfoot) And they suggest follow up scan after 7 days please tell me what s the meaning of this report",
    "doctor_response": "Hi, Welcome to Healthcaremagic.com.   I had gone through your question I can understand your concern about your intrauterine fetus.    The said ULTRA SOUND report suggest that the fetus is normal except he has one abnormality which is club feet. (feet are backwardly rotated). It is not fully rotated but not placed normally forwards but deviated to inwards.    This problem can be treated after birth and is highly successful if treatment is started as soon as possible. Regards Dr Muzaffar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is surgery a must for my mother's severe shoulder pain?\n\nHi doctor, My hardworking mother, aged 62 years has a history of diabetes for the past 10 years and occasional shoulder pain for the past eight years. A month ago she lifted my son's heavy school bag and got severe shoulder pain, restricting it's movements. We got the MRI done last week. I have attached the reports. Can this problem be solved by giving adequate rest to the hand or physiotherapy? Or is surgery a must? If yes, what is the success rate of surgery in this case?",
    "doctor_response": "Hi. Based on the MRI report (attachment removed to protect patient identity), it is a full thickness tear of supraspinatus with retraction. For further queries consult an orthopaedician and traumatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a broken tooth be fixed in a child?\n\nMy son is 5 yrs old, he has silver caps on all his teeth well one fell out tonight while eating it looks almost like his tooth broke off its gross, there is barley anything there now. It also bled alittle, What will they do to fix this, will it require surgery that's what freaks me out.",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain if the crown has dislodged off and there is no tooth crown apparent in the mouth then it seems that the crown has dislodged due to breakage of the tooth due to secondary decay..If this is the case and the tooth is a milk tooth then the remaining tooth has to be removed and a space retainer will be placed so that the space that is left empty after removal of the tooth is not occupied by drifting of the adjacent teeth and the space for the permanent tooth that will erupt in this place in future will not get blocked..This is the best treatment for loss of milk tooth..You can also send me a picture of the broken tooth and the cap along with the picture of the area inside his mouth by asking me a direct question by clicking \"Ask me a question\" in my profile..I will evaluate it further and advise you more precisely how to proceed for the treatment..Hope this helps..Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes an elevation in the BP level despite taking Amlodipine?\n\n2 months of uncontrolled BP. (Family hx of HTN and have been on BP med since age 35 yrs) MD increased Alsace to 20 mg. in AM & PM. Went for stress test and BP too high to perform test. Started on 5 mg. Amlopodine yesterday. BP still high 173/88 this AM. Worried my partner will have a stroke before they figure out what is going on. When can one expect BP to be lowered to a relatively safe level and at one point would a follow up be needed? Has taken 2-4 weeks to see PCP and then cardiologist, so it is not easy to bet in to se a physician. Any advise or suggestions are appreciated. (We know the usual: low salt, exercise, lose weight, fruits & veggies, fish, no smoking, limited alcohol which is our lifestyle.)",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I would explain that it is necessary to wait some days in order to see the final effects of Amlodipine in your blood pressure values. You should know that every change in the anti-hypertensive therapy may take some days to improve your blood pressure values. So, if your blood pressure values do not drop in the next days, I would recommend increasing the dose of Amlodipine. In the meantime, I recommend reducing salt and caffeine intake and avoiding straining physical activity. Hope to have been helpful! Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does the lump, black spots on the head after a fall requires attention?\n\nmy son fell down and had lump on his head, i had no idea that his head are affected. i found some block spots on his head. now he's sleeping but then sometimes he used to cry. do i need to get him to the hospital now because of the block spot on his head?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. He has history of trauma.  So she may developed hematoma formation.  He should take anti inflammatory plus analgesic drug.  Apply ice massage.  No need to worry. Consult your doctor and start treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I having dizziness, blurry vision and headaches?\n\nI have dizziness, blurry vision in right eye pain in bones around my eye constant headaches that are getting worse and my left arm is weaker and I cannot flex the muscle anymore. What is happening? I've also started having short term memory loss and confusion sometimes",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern looking to the given history here I could say that as long as the question of vision of concern you need to see the ophthalmologist because the blur vision is not due to some systemic cause, for your other symptoms these are non specific and may not be having any pathological reason, hope this information helps you, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure cyst in the stomach?\n\nHi I am an East Indian, 52 year old, woman who is petite, with no gall bladder, Never smoked in my life and never drank. I feel like a syst type some thing inside my tummy above the navel blow the rib cage . No pain but pressure and somtimes it feels like a tight band around my chest.",
    "doctor_response": "hi.based from your description, it could possibly be a cyst, a fibroma or a lipoma. it is best if you consult with a doctor, preferably a general surgeon, for clinical evaluation. medical (proper antibiotic regimen) and surgical (possible excision of the lesion if indications are found) management will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for the elevated serum creatinine levels\n\nI AM 46. Height 5.3.Weight 63kg. I had some simple problems .ThereafterI take daily rozavel 5, losakind 25 and flutee(flouxetine) daily as per doctors advice for last one yr. i got checked as normal check up. serum creatinine has increased to 1.80. Please suggest me which medicine should i drop which causes most on serum creatinine.",
    "doctor_response": "Hello welcome to HCM. I have read your question and understand your concerns. Actually losakind tab can raise serum Creat temporarily. So my advice is ask your doctor whether he can stop it gradually. You just repeat your S. Creat every monthly and see how is the improvement. If creatinine is decreasing then don't restart losakind tablet. The interesting fact is that same medicine is drug of choice in already established kidney damage. So if report is not improving after stoppage of the medicine then restart losakind. Avoid any kind of pain killers. Drink plenty of waters. There are medicines which can prevent further kidney damage. Ask your doctor about them. Thank you. Have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes scrotal ulcer?\n\nhi, i found a scrotal ulcer and it is small and painless.  it has stung a little, thats why i noticed it.  i am afraid that it could be herpes, but it seems improbable.  are there other reasons why i might have something there.  something common?  Ken",
    "doctor_response": "HelloThanks for query .A sudden appearance of small ulcer over scrotal sac could be due to burst open boil or a sebaceous cyst and does not signify any major issue .Take antibiotic like Doxicycline and Diclofenac twice daily  with topical antibiotic ointment like Betadine for 5 days.Ensure to was your genital with warm water twice daily.It should heal up within a week . Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Paralyzed leg and arm post severe neck pain. MRI showed cervical spondylosis disorder. Is it a neurology or orthopedic issue?\n\nlast 8 days my father suffering neck pain , and for this pain his one left size arms and leg is paralised, but other organs are functioning properly. After MRI local doctor suggested this is a Cervical spondolisis disorder. Currently a Nero medicine doctor is giving his treatment. Please advice is this a neurology issue or orthopedic? Can a Nero medicine doctor will cure him, or we need to take him with an orthopedic doctors.",
    "doctor_response": "Hi welcome to HCMForum. cervical spondylos usually dont leed to paralysis. if it happens will be extensive. you have taken MRI it might be mri of spine. mri of the head only reveal the thrombosis if any. spondylosis causing parylysis needs manipulative treatment by orthopedic surgeon and physio therapist. If thrombosis is excluded treatment by mrthopedic surgeon is a must. if simultaneous thrombosis is present neurologists treatment alone will be suffecient. what ever the reason is, it is completely reversible. but one thing to remember is recovery depends 75% py. hypertension and cholesterol are to be checkd and monitered. As it will take long time for recovery patience of the patient",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are swelling of veins in leg related with hole in heart?\n\nSo I have had this really weird pain in my left leg its hard to explaine its almost like my veins are swollen it make it painful even to touch.I am 26,5'2 and 110lbs.I have been to drs for my migraines and been diagnosed with a hole in my heart are the pains and numbness linked",
    "doctor_response": "I read you question carefully and I understand your concern.If you mean related in the sense of the heart issue causing the leg issue or vice versa then no, they do not cause each other.The hole in the heart may have some significance in one scenario though, if you have a thrombosis of one of the veins in the foot. It would be a serious issue with or without the heart issue as it can release emboli in the circulation which may block lung vessels, a pulmonary embolism. In people with a hole in the heart, where some blood circulates from the right heart chambers directly to the left without passing into the lungs, the above mentioned clots may pass to the left side and besides the pulmonary embolism may also block vessels in other organs, such as the brain, cause a stroke.Of course it would be a theoretical issue if you had vein thrombosis, first that painful leg must be visited to determine whether there is a thrombosis or some other issue.I hope to have been of help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes foot numbness in child?\n\n3year olds feet ( most often just his left foot) falls asleep often. Doesn t seem painful but just annoying to him. Happening for about 5 months. Last night he said both of his feet weren t working right. He was standing at the time. Also he complained about left eye and mouth not working once. His eye was noticeably slanted down. He also has sensory processing disorder....mild and highly functioning and gifted. Tested at three and was gifted off the chart. What about feet?..",
    "doctor_response": "HI BASED ON YOUR COMPLAINTS, I CAN INFER THAT YOUR CHILD IS HAVING A NEUROLOGICAL PROBLEM- POSTERIOR OR DORSAL COLUMN DISORDER ASSOCIATED WITH SENSORY DEFICIT. PLEASE CONSULT A PEDIATRIC NEUROLOGIST IMMEDIATELY TO FIND OUT THE CAUSE OF IT. HOPE IT ANSWERS YOUR QUERY",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have pancreatitis, very painful. Given IV and morphine. What can be done?\n\nI have pancreatitis and have been treated from time to time for about ten years. I was treated at the emergency room last night. I was given three bags of IV and some morphene. The pain never stop. I told the doctor but he seem to be unsure about what to do. A lot more wasn't done but I was seen at a VA Hospital. I'm considering going to the Baptist hospital because the pain is still with me and I don't know what to do. Is there anything that I can do here at home?",
    "doctor_response": "there is nothing you can do as pancreatitis is a bad disease you only need intravenous antibiotics and pain killersyou can try tramadol /codeine tab if it works along with antispasmodic tab",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent pain in the chest?\n\nHi. I am 59 years old, and there is a family history of heart disease/cancer. For about the last 3 hours I have had this pain in my chest on the left side. It does not go away with activity. I have been to the ER a couple of times for the same feeling. Once they dismissed it as TMJ, and another time felt that this was all in my head as I am a recipient of mental health care. That said, I am afraid to say anything for fear I will not be taken seriously. So what do I do about the pain? How do I treat it?",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. Chest pain should never be overlooked and should always be evaluated. Chest pain has a lot of causes, common being due to heart disease, muscle pain or chostochondritis. To rule out the most important cause that is cardiac cause, you need to do at least a stress echo or TMT. If that is negative the cardiac cause is out and you can just take pain killers for the chest pain.Hope I have answered your query. Let me know if I can assist you further.Thanks,Dr. Sameer Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for mental health problem\n\nhi i am 23 and for some time now i have been having severe moods, sometimes for weeks on end i become extremely down and find myself lethargic and not wanted to do anything, and then it for no apparent reason goes to the opposite extreme where im chaotic and believe i can do anything.  these mood patterns are starting to affect my life in bad ways though and would just like some advice",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  Though the information you gave is not enough to make a correct diagnosis, I think that you have a health condition named bi-polar disorder. Please consult a clinical psychologist or psychiatrist to get proper diagnosis and proper treatment. You need psychiatric treatment. Please get on with it.If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for enlarged heart and shortness of breath\n\nI have an enlarged heart pretty much ignored by my current doctor.  I have shortness of breath  dizziness from going up stairs.  I did get medicine for High blood pressure 6 months ago, but I haven't got any better.  What should I do and is this dangerours",
    "doctor_response": "DEAR USER,THANKS FOR CONSULTING WITH HCMI UNDERSTAND YOUR CONCERN BUT YOU HAVE IVEN INCOMPLETE DATAENLARGED HEART COULD BE EITHER DILATION OF HEART OR HYPERTROPHY OR BOTH..  I WOULD SUGGEST YOU TO CONSULT A CARDIOLOGIST AND GO FOR A ECHOCARDIOGRPHYIF YOU COULD MESSAGE THE ECHO REPORTS AND IF YOU COULD MESSAGE THE TABLETS YOU ARE TAKING FOR HYPERTENSION AND THE LATEST BP I COULD HELP U HOPE I ANSWERED YOUR QUERY. YOU CAN MESSAGE ME FOR ANY FURTHER CONCERNS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could nausea, rib pain, facial pain and nasal congestion be related to allergies?\n\n55 y/o female.  Approx 6 months ago thought I was biting right cheek, and the dentist thought that was what it looked like.   The dentist has a watch on a lower tooth on the right side that may need a new filling.  Noticed right nasal congestion off and on.  I have a history of allergies and get allergy injections.   Past week started having a lot of increased saliva, facial pain and can feel the muscle or bump in front of ear.  Not seeing any noticeable facial swelling.  Also I've been having nausea, and some occasional right upper pain below the ribs.  My right side of my face and neck is a little sore.",
    "doctor_response": "HelloWelcome in H.C.M.I have gone through your query regarding recurrent nasal discharge and obstruction with soreness over right half of face and upper chest. You are a diagnose case of nasal allergy.According to your clinical history it appears as you are having chronic respiratory tract infection invlving both upper and lower respiratory tract. Probably you are having sinusitis with infection of resp system may be bacterial or viral.I would like to tell you to consult your ENT doctor for thorough examination and investigations for making diagnosis that may be accordingly manage.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump in middle of the nail?\n\nHi my name is Luke and I am having a problem with my index finger for a while now it s been almost over a year now. It s hard to explain but it has a lump in the middle of the nail. It hasn t been bothering me till now but all it is just a little soar. But I was wondering if I could send a pic of my finger so you could see it.",
    "doctor_response": "HI,Luke,Dear,Thanks for the query to HCM.1-I have studied your query in depth.2-DEar,IN my opinion, your nail lump in index finger of 1 yr duration is due to the resolved and infected hematoma-subungual, with the boney contusion-which has now proped up as- fibrosed sore lump in the middle of the index finger nail.T3-he soareness lately indicates inflammation -post-usage trauma and or chronic infection.4- A picture would have added a bit in planning its treatment.5-Hope this would solve your query to your satisfaction.6-Wellcome for more queries to me On HCM.7-Thnks once again for your inquisitive query.Have a Good Day..!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a possibility of dry pocket at the site of extraction of wisdom tooth?\n\nHello, I had my bottom left wisdom tooth removed yesterday morning around 9:00am (it is now the next day around 4pm). I am taking painkillers which relieves the pain for about 3-4 hours, then it comes back and I take more painkillers which relieve the pain for another 3-4 hours, and so on. I am very worried about getting dry socket as I have been reading about it online. Yesterday around 1pm which was about 4 hours after wisdom tooth removal, I took a tablet for the pain, and when I swallowed it I swallowed it quite vigorously and immediately felt an intense aching throbbing pain where the tooth was removed. After the painkillers kicked in the paid faded away and now I just feel moderate pain, nothing intense. But I am worried I dislodged the blood clot when I swallowed the tablet because of the pain I felt afterwards, do you think this could have caused dry socket? I have stitches in my mouth where the tooth was pulled out, I know that you can still get dry socket though, my question is that if I do develop dry socket will the pain start after the stitches dissolve or will the pain start 3-5 days after the procedure which is the usual time it takes? My dentist also told me that there will not be a hole exposed as she stitched it up, so to me that meant that when the stitches dissolve, the hole where my tooth was will be covered by my gums and the hole will not be exposed, is that correct? Thank you.",
    "doctor_response": "HiWith your query, since your socket is stiched there are no chances of blood getting dislodged soon. Any extracted impacted tooth pain lasts fir 3-4 days for some 7-10 days it depends on how much bone is covered on the tooth and how difficult it became to the dentist to remove it I mean time taken coz if mire bone had to removed then it takes time and it causes more pain and swelling so wait for week and then get it checked by your dentist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the cause of left-sided hand and leg numbness?\n\nHello doctor,Left side hand and leg numbness and tiredness. I am taking cardiac medications.",
    "doctor_response": "Hello. I have seen your health investigations (attachment removed to protect patient identity). There are different possibilities that may cause weakness of one side of the body as in your case. Your healthcare center has touched every possible cause to investigate the reason behind this weakness on one side of your body and there came out to be nothing like this. I have extensively reviewed your MRI reports and other blood work. There are some red flags that bother me and indicate that these may be the cause of your issue. These are metabolic disturbances. In simple words, if your car engine's mechanical parts are all fine but there is diesel instead of petrol, your car would not work. Our body is a complex machinery and it cannot run normally if there is no controlled and balanced environment inside the body. Harmony (homeostasis) and rhythm in different metabolic products inside the body is needed at all times in order for the body to work normally. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stinky pus from tongue, have done with front tooth removal, have a tooth denture. Any thoughts?\n\nRecently had my front tooth removed (root included) and currently have a tooth denture waiting for it to heal in preparation for implant. However, with my tongue I have squeezed out some pus and it really stinks...I am rinsing with warm salt water and am brushing flossing regularly...also have been continually taking nurofen gel caps for the pain & swelling...should I be worried about the stinky pus?? I m endeavouring to go to after hours doctor asap coz I just want this to all go smoothly for the coming implant...thoughts??",
    "doctor_response": "hello there....Its been how long you have your front teeth extracted???? presence of pus is indicative of infection...What was the reason for your teeth removal? Inspite of antibiotic coverage, if pus discharge  still persists, culture sensitive test needs to be performed ...It is evident that micro-oragnisms are resistant to the antibiotics used and change of antibiotic is mandatory... if sterilization procedures are not well maintained that would also lead to infection... Usage of denture is not ideal before implant placement...use it only when you go out in public...continuous usage of denture is not indicated as it would pre-dispose to bone loss... for implant success you need to have enough bone....In your present condition I would advice you to wait for atleast  3-4 months before the implant placement... Get yourself examined clinically for further management...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe back pain, odd noise in ear, headache. MRI normal, minor tear in back. Reason for pain?\n\nHi I am a 36year old woman, who has a good diet and walks regulary and i have been suffering from back pain on and off for the last 12 years which has got worse over the last 5 years. I am also suffering from intermittent pain and pins & needles in my face and head, and hands and arms. I also get a strange sensory symptom when I touch my left forearm I get an odd noise in my right ear, almost as if I can hear the touch. I also suffer from headaches (which I believe come from my back?) and tiredness, which leads to dizziness and general slowness in thinking etc. I had an MRI in 2009 of head and neck which I was told was clear, however when I was pregnant this year I was sent back to neurologist who had a look at it again and thought there might be a suspected syringomyelia . I had another MRI after I had my baby which has come back clear. I also had a scan on my lower back in 2009 which showed minor tear and wear. I have had blood taken tested for b12, thyroid ect which were normal. I have been told that they believe there is nothing causing these symptoms but have reluctantly been sent for more blood tests and I am due to get a nerve test. I feel I am being dismissed, although I feel that my symptoms are getting worse. I am worried that if I go back to my doctor I will be seen as a hypercondriact. Any advise would be appreciated.",
    "doctor_response": "start some back srengthning  exercises gradually . no harm in getting repeat MRI. how much is your r weight. any gynacology problem . ?",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I get rid of inferiority complex due to my lean structure ?\n\nsir i feel very shame to meet the people my body is thin so i feel shamenes which diseases is this in terms of medical science and cure of this diseases",
    "doctor_response": "Dear Do you think after putting on weight the shame will be reduced? You also need to differentiate wherethere it is shame or fear ? If it is shame it may be part of your personality. If it is fear it can be anxiety and you can control it by different methods.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes marble sized like knot after i was injected?\n\nYYYY@YYYY 2012 ,I had a pneumonia shot but as soon as ir was injected a marble size knot appeared with discomfort . Problems health seem to get worse worser. What could of happen. I no longer see doctors. That injection added more problems to problems I was haveing due to statins. I also had to stop all meds. My date of birth 9-26-54. Hart and blood preasure meds up to 26/27 stoped due to reactions. Doctors refusals of help durning and comeing off statins reason for being off all with no care now.",
    "doctor_response": "Provisional Diagnosis-Functional benign Adrenal adenoma? Under InvestigationHi,Dear thanks for the query to HCM.I studied your query in all the details put from you.I understood your health concerns.In my opinion,you need to check with ER Surgeon,as you seem to have post-Pneumonia shot-injection lump with discomfort.I would advise you to first control this problem and then consult with your cardiologist doctor for review of statin  and other treatment, as follows-Anti-inflammatory / antibiotic medicines / with Cold compresses would control this post-injection knot.Hope this would help you to plan treatment with your doctor.Hope this would help to relive the stress of your queries.Write excellent review after reading this reply,if you find it helpful to you,so that your comments and reviews would help in rating my services for more HCM patients.Welcome for any further query in this regard to HCM and to ME.Wishing you fast recovery.Dr.Savaskar M.N.Senior Surgical Consultant.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Burning sensation after waxing the upper lip. Reddish mark with numbness. Any remedy?\n\nHi, I waxed my upper lip a day ago and experienced a burning sensation that lasted a lot longer than usual. The burning sensation and reddness continued throughout all of yesterday and today as well. I know have a red mark that is smooth but feels numb on my upper lip. Are there any remedies I could use to heal my upper lip and bring it back to normal?",
    "doctor_response": "Hi Kim, Welcome and thanks for posting your query to HCM. Getting redness after waxing process is common problem but generally it remains for few hours only and for beyond two days. During waxing due to slight heat of the patch as well as due forceful plucking it causes redness or itching and bit pain for few hours but if the wax patch is slightly more hot or and the force applied is too harsh then can cause injury to superficial skin and deeper hair roots leading to inflammation of the area remaining for longer period of time. The very first thing you do is  to give cold compressions for multiple time a day, application of calamine lotion to soothen the skin, can take antihistaminic drugs to relieve the feeling of itching and burning and not to touch the area repeatedly. If the redness is very high or there are any sign of mild vesciculation or blistering then should apply mild topical steroid cream under medical guidance. Kindly avoid direct sunlight for at least 5-7 days after proper healing to prevent any pigmentation of the area. Be careful nest time when you are doing waxing of any area. With best health wishes, Dr Sanjay K Kanodia MD ( Dermatology and STD/ Venereology)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have fever, vomiting, infection in stomach. Prescribed zanocin, ondem liquid. What is going on?\n\nHi Doctor my nine month old daughter is having fever n is vomiting since three days.... vomits in huge quantity n motions in huge and sticky. Doesn't eat and doesn't have milk. I went to doctor in the  morning and he said that is bcoz of infection in stomach. Doctor priscribed below list of medicine1) Zanocin Liquid2) ORS  3) Ondem Liquid",
    "doctor_response": "HiYour doctor is correct.Your daughter has infection of stomach.Apart from the above mentioned medicines,please give her paracetamol for fever.She has to be given Econorm sachets also.Sometimes,simple zanocin may not work.Another medicine Ornidazole/Metronidazole should be addedIf she is not eating anything by mouth,please give fluids intravenously.Wish her speedy recoveryRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for continuous coughing\n\nContinous cough. Chest is clear but i still feel heavy. Cough is bad during evening. Thread like flem does come but not to the mouth, i can just feel it in my throat. This has been going on for a month. Anti alergy tablets, cough syrup, salt water goggling all has just shown very little improvement",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. By your history and description, possibility of bronchitis or lung infection is more in your case. It is due to inflammation and edema of airways. Your symptoms like cough (not improving with routine drugs), phlegm and heaviness in chest etc are seen in bronchitisbronchitis and lung infection. So better to consult pulmonologist and get done clinical examination of respiratory system, chest x ray and PFT (Pulmonary Function Test). Chest x ray is needed to rule out lung infection. PFT is needed to rule out bronchitis. You may need antibiotics, anti inflammatory, inhaled bronchodilators and inhaled corticosteroid (ICS). Don't worry, you will be alright. First diagnose yourself and then start appropriate treatment. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to use MTPILL for pregnancy termination ?\n\nDear Doctor,I am 26 years old and had been pregnant for 15 days upon consultation with the doctor for termination; the doctor gave me MTPILL to take 3 orally for the other different medicine dose to take vaginally (if not starting the bleeding). Is it safe?",
    "doctor_response": "hello user,yes its safe to take mtp pill after advice from a gynecologist..nothing to worry..thanks...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes loud quacking noises from an infant?\n\nMy 8 week old had an episode where he made this loud quacking noise turned red and started foaming and drooling from the mouth. After I pounded on his back his color came back but was lethargic and sleepy for a few seconds afterwards. What could have caused this? Reflux or seizure?",
    "doctor_response": "Hi...by what you quote I feel that it could be a seizure as 1st possibility and GER as second possibility. I suggest you take him to a pediatrician and get him evaluated.regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swelling and pain in cheek after having abscessed tooth\n\nWOULD YOU BE ABLE TO TELL ME WHY MY BROTHER'S LEFT CHEEK IS SWOLLEN AND PAINFUL AFTER HAVING AN ABSCESSED TOOTH #12 DRAINED THIS EVENING?  I JUST GAVE HIM HIS CLINDOMYCIN ABOUT AN HOUR AGO AND ONE MOTRIN ABOUT 10 MINUTES AGO.  WHAT CAN I DO TO HELP HIM WITH THE SWELLING?",
    "doctor_response": "Hi Dear,Welcome to HCM.UNDERSTANDING YOUR CONCERN.Brief answer - Facial Space InfectionDetailed answer - As per your query swelling and pain in cheek after having abscessed tooth drainage is because dental infection or pus formation started in tooth and from there it reached  pulp and from there it reached jaw bone. From jaw it is spreading into soft tissue such as muscle, skin and spreading out to facial spaces and growing there. I would suggest you to take antibiotics such as Ibuprofen/ Augmentin for this as it will prevent infection and pain and swelling will be subsided. Cold compress the cheek area. Visit dentist once again and get X-ray done to check if all the abscess has been drained completely or still pus is there. Get RCT done for infected tooth after complete drainage of pus. Do warm rinses after ever two hours. Continue brushing and flossing.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is consumption of alcohol advisable with liver condition?\n\nHi i was diagnosed as follows liver normal size and shape,smooth and edge sharp, appears echogenic, no focal liver masses or dilated ducts, both kidneys normal in size and shape,no ascites hydronephrosis or para aortic lympadenopathy,conclusion was fatty liver. Can i use any wine , whisky ,cider or beer. Please advice.",
    "doctor_response": "Hi, How are you?Fatty liver or \"steato-hepatitis\" is caused by deposition of fat droplets in the liver tissue (which appears as \"echogenic liver\" on ultrasound). The two main causes of fatty liver are Alcohol consumption (alcoholic Steatohepatits, ASH) and high caloric food intake coupled with sedentary life style (non-alcoholic Steato-hepatitis, NASH). ASH is the early stage of damage to the liver by alcohol and is completely reversible if the patient gives up drinking. NASH is much more commonly diagnosed nowadays owing to high caloric food intake and sedentary lifestyle of most people. Both ASH and NASH, if not controlled will ultimately progress to cirrhosis of the liver which could necessitate a liver transplant in the future.In your case, you seem to be in the very early stages of fatty liver disease (echogenic, but normal size liver with sharp edges). Given that alcohol and high calorie food intake are the main causes, I would advise you to follow a healthy life style. Although alcohol consumption in moderation should not be a problem (not everyday), I would suggest following a regular exercise regimen and limiting you caloric intake. I would also recommend getting your Liver function blood test done as a baseline. This should reverse the fatty changes in your liver.Hope this helped and hope you feel better. Please do not hesitate to contact me for further details -  rxsuresh@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Am I taking the right homeopathy medicine for PCOD?\n\nHello doctor, I am taking Testosterone 30 to reduce testosterone as I am a PCOD patient but the pharmacist told me that it increases testosterone. Please reply. I have taken contraceptives, Metformin and ayurveda treatment for the same. I am undergoing laser treatment for facial hair.",
    "doctor_response": "Hello. The root cause of PCOS (polycystic ovary syndrome) is a hormonal disturbance. In homeopathy, the medicine corrects the disturbance without any side effect. No need to panic and get confused about what is the best treatment for PCOS. Testosterone is used for hypogonadism and delayed puberty. For your problem, I suggest Natrum Muriaticum 1M 10 pills once for five days and Ova Tosta 6X daily one tablet three times. Report after a month. Revert after a month to a homeopathic physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Home pregnancy tests showed positive. Later it went away. Is there any way i am not pregnant after 3 positive tests and a missed period?\n\ni missed my period and have taken 3 at home pregnancy tests with all positive results. however, on each test the pregnancy line was really light. i went to the doctor today and did a urine test and they did their tests and said it showed positive right away and then it went away. this confused them so i had blood dawn but won't get results for a couple days. am i pregnant?  is there any way i am not pregnant after 3 positive (but light) tests and a missed period?",
    "doctor_response": "Hi, welcome to healthcare magic.If your cycles are regular most probably you are pregnant. Of course the blood test will confirm this. 2 days is a very long time for a blood test. Usually the result is available after few hours. Anyway, if the test is positive, start taking Folic acid supplement and have an ultrasound to confirm intrauterine pregnancy and exclude ectopic. If the test is negative you may wait for spontaneous menstruation or visit your doctor to prescribe you progesterone to induce menstruation.Good luck.Dr. Ahmed Bahaa.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for chest pain\n\ni used to smoke for  around 3-4 year.nw i have stopped smoking and sitting at home for aprrox 4 months & waiting for a job,there is a pain in on upper portion of my chest.it is squezzing,radiating pain sometimes that pain goes to lower side of chest.please help me out",
    "doctor_response": "Hello!Thank you for asking on HCM!I understand your concern, and would like to explain that when facing with such an important complain (chest pain), it is important to perform a comprehensive differential diagnosis, to exclude/confirm primarily major acute chest pain syndromes (acute coronary syndrome, acute aortic syndrome, acute pulmonary embolism).Serving such a purpose, a careful medical check up is necessary, starting from a physical exam, resting ECG, chest X ray study, cardiac enzymes, arterial blood gas analysis, etc.If enough suspicions are raised, other specific imagine studies may be performed, such as triple rule out chest angio CT. MRI, etc.In the case when all the above performed tests result normal, then a psychological component should be sought as a responsible contributor to your complains (which is also compatible to your \"waiting for a job\" status).So my advice is to run to your local ER service and discuss with the attending doctor about the above mentioned issues.Hope to have been helpful to you! Greetings! Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath,numbness and muscular pain?\n\nHello, I m a 28 yr old male and lately I ve been waking up with very strong back pains which I m sure is due to my wrong sleeping ways. I ve been suffering from muscle knots and pinched nerves since then. My question is, I m having shortness of breath from time to time and slight numbness in my arms and muscular pain in my middle back, is that related to the pinched nerves and muscle knots? Heart beats are always normal,and so is my blood pressure. Also I was a heavy smoker, I used to smoke 2 packs a day and I suddenly dropped to 5 cigarettes a day. Could the shortness of breath be part of withdrawal? Thank u in advance.",
    "doctor_response": "Hello,I have studied your case and I can assure you that shortness of breath is not due to withdrawal and you should not start cigarettes again as you have done right by decreasing it. I would suggest you to get chest x ray as chronic smoking may ave damaged your lungs.     other common cause of breathness can be due to anxiety. Nerve compression in the back never causes such symptoms.   I hope this answer will be useful for you.Let me know if there is any other followup questions.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the following urine test report suggest?\n\nHi Doctor, my niece is 5 and half years old. She was running temperature of 100. Doctor suggested to get an urine test done. Her report says this Leukocytes 0 to 1 Erythrocytes 00 Epithelial cells 2 to 4 Casts Not seen Crystals Not seen Oval fat bodies Not seen Please can you say if this is normal or no. Thank you!",
    "doctor_response": "The urine test report is normal, stay relaxed. The temperature could be due to a viral infection. A blood count could have been helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower middle back pain?\n\nHi, I have a prolapsed bladder and for about 2 weeks my urine has had a rubber smell and I have lower middle back pain sometimes so bad I cannot stand up straight . What could be going on ? I don't know. If this helps but I also have a prolapsed bowel and uterus as well.",
    "doctor_response": "Hi,It seems that due to having prolapsed bladder and uterus you got this problem.There might be having some infection in urinary tract might cause this problem as well.Consult gynaec and get examined.Meanwhile go for Pelvic floor exercise daily.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i see neurologist or orthopedist for neck pain and pain in head?\n\nsir...my back neck is pained sometimes heavily...that time my head is also pained..i cant slepp at that time...this problem occur from my 9th standard..now my age is 21...thir problem based on nero or bone...what shal i do now?i l see neurologist or ortholigist..please reply me..",
    "doctor_response": "Hi, Firstly, sorry to hear that this issue is lasting too long. Coming to the point. I think you need to get consulted with a neurologist for now as this is a long persisting issue. As per me, either the pain is due to the headache or any muscle groups in the cervical region getting tightened due to any unknown factor leading to trouble. A neurologist will be of choice to get answered the complaints. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in conceiving after treating an ectopic pregnancy?\n\nI had married 3 years back and after 1 year i got ectopic pregnancy and had an laproscopy surgery. I lost one side tube. After that i had 3 cycles IUI and after that also I am not get pregnancy. Both we checked and my husband had 60million count and my eggs also formed correctly. I had an fibroid 4cms in my utrus, Dear doctor what kind of treatment required for me to getting pregnancy.",
    "doctor_response": "Hello, in my opinion you need ovulation induction and in utero insemination which will increase the chances of conceptionIn case you have any questions in future you can contact me directly on",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can sitting for a long time cause hip pain?\n\nI have started job in which i have to sit for long time on a chair. Recently i have started pain in my hip and down area of that on left side. When i walk i feel clicking sound in that joint (where thigh meets the hip or abdoman) . Do i need to concern . I am also doing exercise on elliptical for 25 mins every other day. Please advise. Thanks",
    "doctor_response": "Hello, Prolonged sitting can cause compression of the nerves of hip and can cause pain. As a first line management, you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist better to consult an orthopedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes muscle spasms in lower back and nose bleeds in a child?\n\nHello I have concerns regarding my 6 yr old son. He was recently diagnosed with ADHD and receives Ritalin before school. I am in the middle of a custody battle and my ex husband is not cooperative with treatment and appointments. He has developed muscle spasms in lower back, facial ticks, nosebleeds and headaches. These all started before the medication and are becoming worse.",
    "doctor_response": "Hello, Looks like more complications to your Child. Check for any nose pricking by your child for nose bleeds as it is the commonest, in ADHD sometimes muscle spasms and facial tics can be seen and treated symptomatically. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Lingamurthy Itha, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest chances of pregnancy after being on birth control pills\n\nI have been on aviane-28 birth control pill for almost a year. I take it about the same time every day. I had unprotected sex yesterday, July 15, and he pulled put long before ejaculation. He also hadn t ejaculated in days before then and urinated many times since last ejaculation. My question is, what are the odds of me being pregnant if he didn t ejaculate anywhere near me, no sperm in his Pre-ejaculate, and I am on the pill?",
    "doctor_response": "Hi dear..if you are sure that he hasn't ejaculated inside than there are no chances plus you are taking pills regularly so it's also helps in prevention..still I advise if you miss your periods by 2 weeks do the UPT, blood hCG levels and USG to confirm..hope this will help youThanks and regardsDr.Sohil Takodara",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Praguard IUD cause constipation?\n\nCan Paraguard IUD cause constipation ? I have my second Paraguard IUD placed a year ago (the first one was displaced, so it had to be removed). After the placement of the second IUD I started experiencing bloating, constipation and my stools became hard and dry. Can this be related to the Paraguard?Thanks",
    "doctor_response": "no dis is not related to parguard....u can use laxativeorstool softner,hot water to ease constipation...paraguard may cause bleeding between periods,pain,discharge..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the days we should have intercourse after periods to conceive ?\n\nHi, Today is 9th day of my period and as we are planning for kids from which day till which are we supposed to be participate and is there any no of times that we should be participate Thanks",
    "doctor_response": "Hi, Thanks for query, Keep abstinence for 3 days and from 12th to 15 days of your period go for unprotected sex daily. Do not go for toilet for 2-3 hours after sex. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a person to panic and repeatedly check the things?\n\nhi i think i have ocd,i just read some info and there was a qwoute saying that a person had to keep cheacking things where of and that there number was 3 and that they had to do things to that number like washing things and that some time if they didnt do somthing with the number that somthing bad will happen but with me its like i turn my hair straghtners of and i no i have turned em off but i keep going back to make sure i do this about 5-9 times befor i can walk away then sometimes when i get so fed up i say to my self if u go back then they will be on and they will set a fire then i will leave my house and i will keep cheacking i locked my door then i get fed up and i say if i go back and cheack then my house will get broke into then i get far away and i think to my self did i leave the door open then i start panicing and i think say that my house will get broke into becasue i didnt lock the door and my way of trying to say it wont happen is for me to tap my head 4 times and i set my alam to get me up but i set it like 10 times so if i put it on 10.06 then i change it and say no it cant be on that number it has to be a number above or below that number rather 5 or 7",
    "doctor_response": "Helli,This looks like OCD. You should gofor treatment .Usually, we prefer fluvoxamine 50-100mg daily and may incresae upto 200mg if needed.Along with meds- therapy is required many times to have early ang good response. ERP is the therapy which is practiced in OCD patients mainly.Please consult with your doctor and you may start the drug.For therapy- you will have to find a psychiatrist or a psychologist or a therapist near your home for regular contact.Im sure with medicine you will feel a lot better.Wish you good health.Dr. Manisha GopalMD Psychiatry",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe belching while taking Naproxen, Hydrochlorothiazide and Amlodipine?\n\nlast 2 days I have had the most gas on my stomach causing me to burp the entire day and feels like the burp builds in my esophagus....no pain, no stomach ache, no heartburn, no regerts...yesterday I took to chewables from lady at work...WHAT CAN HELP....(aditl info if need....2 weeks ago..had really bad UTI ..given macrobid...and anzo type pill to calm bladder....also take naproxen at least 2 days per week for inflammation in foot due to heal spur and plantar fisciatis...and take hydrochlorozide for years and last 6 months started taking amolidopine for raised blood pressure..",
    "doctor_response": "Hello, Your burp is not related to your medication you are taking, it is not a common side effect of ant of those drugs you mentioned, but either way, you may take disflatyl tab to relieve you. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with OCD, advised CBT. What is it?\n\nHello doctor.Thanks a lot for your help.I consulted a psychologist last week and she said that am actually suffering from OCD and stated that it can be from moderate to severe OCD.I told her most of the things that troubles me and she stated that I must do CBT .What is it actually?She said its a kind of therapy but she won`t be able to do it just like that.I need to take medecines before starting to do the CBT as the medecines will make me feel more relaxed. And for that i need to consult a psychiatrist who will prescribe the medecines while she i.e. the psychologist will do the therapy.But will the therapy work?And y should i visit a psychiatrist?I thought psychologist and psychiatrist are mostly the same. Can`t the psychiatrist do the CBT?In that case,i won`t have to see 2 doctors and this will reduce the cost as i don`t want my parents to keep spending so much money on me.And also i feel the psychologist is a bit too young...maybe she has worked only 2-5 years and i feel she might be a bit unexperienced.Am not sure but i want a treatment with someone who is experienced and understand the problem really well. The psychologist seemed surprised at times when i was telling her my problems of repeated washing etc",
    "doctor_response": "Hello..... Thanks for your query. i understand your cost constraints and need for both type of therapies. To clarify, a combination of medication and psychotherapy works better in OCD, particularly moderate-severe OCD. Psychiatrists are trained medical professionals authorised to prescribe medication while clinical psychologist are not authorised to prescribe medication but undertake  psychotherapy. Only few psychiatrists would be well-trained in psychotherapy. If feasible, i would suggest you continue the current combination therapy. Regards Dr Sundar Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in testicles?\n\nhello doctor, i am 42 years old  male..in my scrotum,right side of the testicles  a small boll is (1 cm lenth  x 0.5 cm width)there,,,some times  its  giving  little  pain,,,also  when  i am going  long  drive  also  little pain has  come.. kindly  tell me the solutions..regards",
    "doctor_response": "Hi, It can be due to abscess. Share a picture for conformation. The local antibiotics can help you. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes delayed ejaculation and low hormonal levels ? How can these be treated ?\n\ntreatment of delayed ejaculation +tretment of low hormone+treatment of increase prolactine 30 yr-married from7 m-have rt&left varcocell i don or since 1 month -fsh1.4-lh 1.3-prolactine 14.1 test 2.60total -free 3.4-seperm no 6 million motility 13% -i done mri sella free wt 100kg help me",
    "doctor_response": "Hi Nashwa Ahmed. ASW. Thanks for your query and for using Health Care Magic. Based on the given details, you have following issues 1. Bilateral Varicocele 2. Low FSH and LH 3. Normal Sperm Count but very Low Motility 4. Normal Prolactin should be 5. Delayed Ejaculation Since you have done MRI sell and its normal, we can safely say there is no obvious pituitary abnormality. You will need a detailed evaluation to find out what is the cause of your hormonal abnormality. This will include repeat testing for hormones at a different time and correlating. You should also repeat semen analysis as the motility is low and it needs to to be reconfirmed. Bilateral Varicocele can be corrected only by surgery. If not even varicocele interferes with fertility. You should meet an Endocrinologist and an Andrologist for a detailed evaluation and follow up Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low diastolic blood pressure?\n\nHi - am a 56 year old male.  The low figure on my blood pressure seems high.  It varies between 130/93 (morning reading);  134/88 (6pm reading before meal).  The lower figure seems to be consistently higher.  Am fit and don't have salt, don't smoke, dont drink.  Please could you advise?",
    "doctor_response": "Hello!Thank you for asking on HCM!Regarding your concern, I would explain that these values of diastolic blood pressure may indicate the beginning of high blood pressure. I recommend you to closely monitor your blood pressure and perform some tests to exclude other possible causes of secondary high blood pressure: - a chest X ray study- complete blood count for anemia- kidney and liver function tests- thyroid hormone levels- fasting glucose- blood electrolytes- inflammation tests (PCR, ESR).You should discuss with your doctor on the above issues. For the moment there is no need to start anti-hypertensive therapy. I recommend continue on your healthy lifestyle. Hope you will find this answer helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for knee and leg pain while suffering from sprained ligaments\n\nI had a total knee replacement last July and was recovering very well...six months later, I was accidentally pushed down 1/2 flight of staris and my leg folded under my body when I felll. I went to my surgeon and he told me I had three sprained ligiments and that it would take a while to heal. In the meantime, it is now 5 months later; I ve lost a lot of range of motion, and I can t walk down steps except one at a time....bending the knee is very painful. I use wet heat, try to stretch as much as I can w/o pain meds, then ice it at least twice a day I am presently w/o medical coverage. Do you think there is any other thing wrong? My quads are extremely tight and I cannot go fully around on a stationery bike.",
    "doctor_response": "Hello, I have studied your case.  I think that this can be due to damaged to your knee imlant. I would recommend you to see a doctor and get  a  new x ray of the knee. If there is everything normal than you need help from a physiotherapist.if there is any change in implant direction than It will need some surgical correction. I hope this answer will be helpful to you. Let me know if there is any other followup questions. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I feeling bloated and having tender breast with little discharge?\n\nI took ellaone on 7 August at which time I was ovelating. I ve since experienced bloating, tender breast, little discharge (red and brown) today and no period. I felt like I m about to get my period since i took the pill but it didn t come. Please help me because I can t afford having a baby now.",
    "doctor_response": "Hello, There are little chances of pregnancy in your situation. The symptoms seem to be related to premenstrual syndrome. I suggest using anti inflammatory medications such as Acetaminophen to relieve the symptoms. You can also do a pregnancy test to exclude the pregnancy completely. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the abscess the reason for stiffness throughout the body?\n\nI have an appointment next week to see an endodontist.  I have an abscess where I had a root canal six years ago.  I am experiencing stiffness throughout my body, especially when getting out of bed or getting up from a sitting position.  Is this the poison from the abscess going through my body?Thanks,Carol",
    "doctor_response": "Hello.no abscess can't cause stiffness. but yes its infection can cause fever and symptoms like that. You should go to physician for the diagnosis. For abscess you should get prescription of antibiotics from your dentist. Hope this will help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itching in internal thighs, increases at night, light rashes, using Candid-B ointment. Does it cause cancer?\n\ni am suffering itching in my internal thighs from last 20 years..irritation is very severe at night times.morninig is alright..skin is also very clear...there will not be rings or rashes in large number except in some internal areas that too very light..i have used many medicines from many years bt cant find any use..i use candid-B ointment..i have a doubt that ...is it good to use these ointments for a long time..?i heard that it causes skin cancer if these ointments are applied for a long time...pls give me proper suggestion as how to overcome my problem",
    "doctor_response": "Hi, The history elicited by you does not give any clear clue. For irritation/itching, I suggest you to use oral antihistaminics. Candid-B cream does not cause skin cancer, but its long term use can lead to several side effects like skin atrophy, dyspigmnetation, telengiectasia, striae, dryness etc. You should stop using candid-B cream. Approach a dermatologist and initiate proper treatment. Regards, Dr. Ajit Singh Kulhari MD - Skin & VD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain, hurts to walk, negative home pregnancy test, delayed period. Help\n\nHey I am 18 years old and a female, for 3 weeks now I have had pains all over my stomach , it gradually seems to be getting worse. Hurts to walk and move, can t even sit down or lay doe without it hurting. I m starting to get worried. I last had a period 2 months ago, last sexual partner a month ago, I was supposed to come on period on the 18th, 3 weeks late and I m starting to get worried, I have taken a home pregnancy test and came through negative. Anyone out there who can help?! This pain is unbearable!",
    "doctor_response": "Hi ! I think the home pregnancy test is not a confirmatory test to exclude a pregnancy, specially if it is somewhere else than its normal position in the uterus. From the history of your symptoms two possibilities are coming to the mind :   1) A neglected Urinary tract infection or pelvic infection, which has spread and causing the symptoms of a peritonism. 2) A chronic ectopic pregnancy, which might have  partially ruptured and causing such pain leading to a diagnosis of peritonitis.I would suggest you to visit your gynaecologist at the earliest, who may advise you for a serum HCG test, and an ultrasound of the abdomen to arrive at a diagnosis to decide on further course of action.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest the best treatment and monitoring methods for the third trimester\n\nhi...i have to do a ultrasound scan third trimester. just advise me on, where to do my scanning....i need a well equipped and best scanning centres in malleswaram or rajaji nagar area..pls suggest me a best scan centre where they provide all the details aquirately",
    "doctor_response": "Hi.Around rajajinagar you can find Columbia Asia hospital at Brigade Gateway complex near Orion Mall.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does tissue damage take to cure?\n\nI walked into an Urgent Care for injection for allergy to ant bites. About 30 seconds after injection I started screaming in pain. They said they injected two inches to high, I was taken to car in wheelchair. Now five months later I am still in teribble pain and can barely walk! I was told I have Tissue damage? How long does this take to heal, what else could be wrong?  Thank you, Bonnie     Age 69, 5', 90 pounds",
    "doctor_response": "Hello, welcome to HCM. Ther could be injury of nerve branches, hence you had sever pain and difficulty in walking. It will come back to normal but it will take time. mobilise that limb oftenly. It will come back to normal.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cracking sound at the back of the neck?\n\nHi I seem to have a problem with the back of my neck, when turning my head from side to side my neck makes a cracking sound, it s not painful just the noise is really irraratating, when I massage my neck it clicks & it s as if cartilage is moving round, I m really worried please help.",
    "doctor_response": "Hello, As this sounds what you hear are the unlocking of the facet joints and not any cartilages. As there is no cartilages present. There seems to be a muscle weakness majorly the paraspinal muscles and the muscles of the back. When you massage there is soothing effect and the muscles become weak. Post which you tend to get this kind of unlocking sounds. Doing strengthening exercises for the neck and lower back should such sounds. In my clinical practice of 12 years most patients complain about such sounds but with spinal muscle strengthening, they don't get any sound later on. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a benign adenomatous polyp cause high PSA levels?\n\nCould a benign adenomatous polyp cause a high PSA? In 2009 my PSA WAS 3.6. In 2011 it was 7. In dec 2013 - 10.3 and June 2014 - 11.0. I had a prostate biopsy in Dec 2013 and it was negative. I just had a colonoscopy and had 4 polyps removed. They were benign. Any ideas if that could cause a high PSA level",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. Your PSA level is high. Benign polyp doesn't causes rise in PSA level.  You may have some other causes like chronic prostatitis or benign prostatic hyperplasia.  You should consult urologist.  If your PSA level goes on rising then you should go for repeat biopsy. You may have some occult carcinoma.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cure for Parkinson s disease?\n\nMy cousin, aged 39, is suffering from Parkinsons disease, for the past six years. This has restricted movement and control of his right hand and legs. Who would be the best doctor in India? He has become very depressive and also suffers pain in the limbs, neck and head. Is there a cure? What should we do?",
    "doctor_response": "Hello, Was your cousin's, diagnosed from Parkinson's disease by a neurologist. What are the symptoms - because rigidity and tremors are the two significant symptoms which are notable in Parkinson's disease. For having a diagnosis we need the help of the clinical examination under a neurologist and also some brain scan, blood test and urine test. Post which if he is diagnosed with Parkinson's disease then oral dopamine supplement will be given and the dosage will be monitored as per the clinical findings. Exercise will help to improve the motor control, improve strength, the flexibility of the joints etc. Exercise along with dopamine supplement has a good response in patients with Parkinson's disease. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recurring deep cracks in tongue, sensitive to spicy, salty foods. Unable to diagnose. Disapperaed when had pneumonia\n\nI have had a recurring problem with deep cracks in my tongue, and super-sensitivity to spicy and salty foods.  I have seen a dentist, a dental surgeon, the head of Baylor College School of Dentistry, my primary physician, and a gastroenterologist. etc. on and on.  No one has the faintest idea what it is.  It disappeared for six months when I was hospitalized with pneumonia and had antibiotics for about three months. It also affects the toothpaste I can use without burning.  I am 75 years old, have been in good health all my life.  Thank you.",
    "doctor_response": "Pl review with your doc.. Is it something like a geographic tongue? Need to check that. That disease causes burning srnsation to hot and spicy foods.. The pattern of cracks changes.. Usually associated with emotional stress. Needs no treatment as such.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any permanent effects in taking seizure drugs like Keppra?\n\nHi, I was wondering if there are any permanent effects from taking Keppra (anti-epileptic/seizure drug). I ve been on it for just over a year now and we only just cut my dosage in half a month ago, but I m still very irritable, easily frustrated, and not myself. I have had major memory problems since I started taking it--even when someone reminds me of something, I still won t remember it sometimes. Will this go away eventually? I ve read things other people have posted in forums, and some people say people they know who took Keppra never were the same and never got their normal mood and memory back. I just want to be me again. Thanks!",
    "doctor_response": "in general keepra has the least side effects between antiepileptic drugshowever its common for this medications to cause irritability and agressivnessif you really feel that these side effects are bad then you should change the medications under supervision of your doctor",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back and groin pain?\n\nI noticed some small blood stains on my undewear and when I urinated and wiped myself there was a small amount of fresh blood on the toilet paper. My urine appeared light yellow when I checked. My urethra feels a little bit irrititated. I have a nagging pain near my groin and lower back pain both on right side radiating down my leg which I  have had for over 6 months",
    "doctor_response": "Hello.Thanks for writing to HCMI have studied your case and history.From your symptoms there appears to be systemic disease which may be affecting renal system.There can be associated urinary tract infection.You may require good clinical examination from MD orthopaedic and urologist doctor.He may advise you to investigate like Ultrasonography pelvis and abdomen.If required MRI spine will help.Spinal nerve compression can lead to radicular leg pain.You need to consult your treating doctor for further investigation.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does my semen analysis regarding sperm count indicate?\n\nSEMEN ANALYSIS:VOLUME - 5.1mlCOLOUR - creamy whiteVISCOSITY - viscosPH - 7.5MOTILITY - active 0%, sluggish motile 0%, dead o%.TOTAL COUNT - 0.0x10^6mlSEMEN M/C/S - pus cell - nil, epithelia cell - 0-4phf, RBC - nil.CULTURE - yielded no bacteria growth after 48hrs incubation.",
    "doctor_response": "Hello, You are having a rare condition called azoospermia where no sperm cells are produced or the sperm cells are destroyed in the primitive state. Consult a urologist and get evaluated. A detailed evaluation is required to find out the exact cause. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes drop in WBC count from 3.7 to 2.9?\n\nMy white blood cell counts have dropped to 2.9 from 3.7 six months ago. I had a needle biopsy on Friday. I have an enlarged lymph gland/node in my back for 6/7 years with no changes until this last year. It grew from 4.3 cm to 6.2 cm. I have no outward symptoms, no weight loss, no loss of appetite, no chills, fevers or night sweats. Do you have any thought of what might be cause of drop in white count, other than Lymphoma? RBC 4.60; hgb 14.1;hct 43.1;plat 190 down from 212; gran# 1.4 ( I don t know what that is it is marked as low on lab report). Thank you",
    "doctor_response": "Hello and welcome to HCM,A needle biopsy is not responsible for fall in white blood cell count from 3.7 to 2.9.Both the values- 3.7 and 2.9 are on lower than the normal range, thus, the difference is not of much consequence.Low white blood cell count can occur in case of severe infection or bone marrow depression. A low granulocytes count is also a consequence of low white blood cell count.All other parameters- red blood cell count, hemoglobin, hematocrit and platelet counts are within normal limit.Thus, all other parameters are within normal limits.Consult your primary healthcare provider to find out the cause of low white blood cell count.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can rashes on legs be due to fibroids?\n\nHi doc. Was diagnosed with fibroids my only option is surgery but I don t have any insurance. Now I m having a lot of rashes on both legs! Please could this be a result from the fibroid? I can t sleep at nights so stress please help me. Thank you Sarah",
    "doctor_response": "hi i do not think the rashes on the legs can be due to fibriods but it can be due to drugs used to treat fibriods.they can be cured by atarax 25 mg at night ,broad spectrum antibiotic twice daily and application of  calamine lotion can cure the condition.if no response go for oral steriods like wysolone",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for heart murmur?\n\nI am 15, 195 pounds 6\"3 and I've been told I have a heart murmur but it never ended up being serious because now I can play football... I think I might have ppp... Although I am not shure I think my penis might just be irritated from me useing soap while masterbating daily.. It looks kindof like ppp but I am not shure because I am sicrumcized",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!Regarding your heart murmur, I would recommend consulting with a cardiologist for a careful physical exam and a cardiac ultrasound to examine your heart function and structure. I would also advise performing some blood lab tests (complete blood count for anemia, thyroid hormone levels for possible dysfunction, blood electrolytes) to exclude other possible metabolic causes that may cause a heart murmur. Regarding masturbation, I would not recommend soap as it can be irritating for the mucosa. There are a lot of lubrication  gels which you can buy in the pharmacy for this purpose. Hope you will find this answer helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful lump on the ear of a child\n\nI believe my 2 year old son has some type of allergic reaction to mosquito bites. Once bitten he gets these oversize lumps that takes days to go down and normally leaves dark committed scars in the area. I m concerned today bc he has a lump behind his right ear and I can t tell if it s from being bitten or the result of the ear infection and cold he was diagnosed with last week.",
    "doctor_response": "HI,Welcome to HCM with your query.Confirm the diagnosis before the Treatment Planning-By the facts of your query,In my opinion,you seem to have Post-auricular lymphadenitis from Ear infection after the Cold attack your baby-son got last week.Treatment-Antibiotics/anti-inflammatory treatment from your doctor, if responded would confirm the infective cause of it.Non response would need Second opinion from Ent Surgeon who would direct further treatment after proper examination and investigations,accordingly.But don't worry as it is not Cancerous and Could be treated by -Surgical Excision with Biospy,which would confirm further treatment line.Hope this would help you to plan treatment with your doctor.Will appreciate hitting thanks and writing review comments to benefit needy patient visitors at HCM like you.Good day.Dr.Savaskar M.N.Senior Surgical Specialist.M.S.Genl-CVTS.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness in throat, nasal blockage and heaviness in ear/head?\n\nhi! I m jai laungani from Spain, From one year i have much problem in my throat,nose and ear,dostor says dat its fungus ,I m taking treatement but no recovery,,My troat left side is very tight,left side nose is always blocked and left ear inside is too heavy and my head also too heavy...According to u what problem it should be..?wat i should u..plz tell me..",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you are having symptoms of tightness in throat, nasal blockage and heaviness in ear/head which could be due to sore throat , which can be caused by bacterial or viral infection. It could be due to Eustachian tube dysfunction which is leading to creation of negative pressure inside ears. Need not to worry.  I would suggest you to consult ENT specialist for proper examination . Doctor may order test like viral culture test , throat swab test and blood test to confirm the diagnosis and rule out causes like acid reflux. You should go for otoscopic examination of ear as well and start treatment after proper prescription. Doctor may prescribe antibacterial ( amoxicillin) or anti viral ( acyclovir ) depending upon the diagnosis along with decongestants . For now continue doing gargles and drink one spoon of honey mix with glass of lukewarm water .Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen & tender abdomen in patients with hysterectomy?\n\nI have had unexplained weight gain. My abdomen is swollen from right under my breasts down. Myvabdomen is tender when I press on it. I'm extremely fatigued and can't sleep. I'm also having tenderness in left breasts and I have had complete hysterectomy & don't take hormones. Please tell mevwhat could be wrong",
    "doctor_response": "The distension of the whole abdomen can be due to :-Ascitis, meaning collection of the fluid in the abdominal cavity. This can be easily confirmed by ultrasonography, and and can be tapped to send the fluid for analysis. Ultrasonography will also help to see all other organs. -Gaseous distension, which in turn can be due to intestinal obstruction and can be due to multiple factors. This can be diagnosed by X-ray of the abdomen in a standing position. This can cause pain in tenderness. A proper diagnosis will decide for the further treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for depression?\n\nHello iam 39 years old I have 3 kids very healthy beside that 10 years I was diagnose with deprassion I suffer from at for 3 years until they told me that it s biopoler , they gave me litium and celexa and after few week I got better, I took at for 3 years , and then I got preagnant with my baby , we stop the medication , I felt great now after so long everything came back iam feeling very bad , I went to my famliy doctor and he gave me the litium and the celexa again but it s not helping , iam very upset I went to the emergency room last week , I didn t sleep for weeks , they check my litium level and they say it s very low 0.5 my doctor say it s not make different and this not why I don t feel better do u think if the litium level low the deprassion can go away ? They had me now another medic ion the name is lamictal , I am very depressed and very worry , I don t know what should I do",
    "doctor_response": "HiThanks for using healthcare magicYou are chronic case of depression. In that case you have to take medicine regularly. If you are not pregnant, in that case you can again start with lithium and any antidepressant. Blood level of lithium should be between 0.6 to 1.1meq/dl. Below that level, it would not show any effect. You should consult a psychiatrist to optimized your dose, so that you could get better response. In case you need our help, you can connect us.RegardsDr. Abhishek KapoorPsychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the pain during the movement of hand be due to sterile abscess?\n\nI was told I have sterile abscess from vaccine. My arm has been aching for 5 weeks and although I have full range of motion it is painful 3-4 to lift my shoulder upper arm and gives me trouble mostly at night. Is this normal healing time or should I be re- evaluated. I am wondering if maybe a nerve has been irritated?",
    "doctor_response": "HIWell come to HCMAfter the vaccine shot pricking area becomes tender and swelling may be seen, the term that is being used sterile abscess may not be proper this could be indurated part, wait for some time this would come around soon, take care, have a nice day. (Analgesic can be tried)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain after alcohol consumption\n\nI have a pain in my chest centre, it feels heavy like sombody is pushing on my chest, I was drinking alcahol last night, quite a lot, I am over weight but I keep quite fit from walking, I only drink once a week, but it is normally quite a lot, and its the next day in the afternoon the pain starts, I am starting to get a bit worried can you help me please.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Alcohol causes acute gastritis. And this causes chest pain, tightness etc.So better to avoid alcohol in future. Take pantoprazole tablet on empty stomach twice daily. Avoid stress and tension, be relax and calm. Avoid hot and spicy food. Avoid junk food. Avoid large meals, instead take frequent small meals. You will mostly improve with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest me treatment for multiple cysts on the testicles and is it contagious?\n\nHey Doc, I have multiple cysts on my testicles which I have always had.  I have asked doctors before and they say they are not dangerous and removal would be a painful process.  I try popping them myself because they are embarressing but they always grow back.  How can I get rid of them? Secondly when I pop them, white stuff comes out (both liquid and string)  are they contagious if that white stuff(I assume puss) touches other parts of my skin is it more likely a cyst will grow?  thanks doc",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have multople Sebaceous Cysts on scrotum.The scrotal skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin.Normally they fade away without treatment however they need to be treated if increase in size or get infected.Please consult qualified General Surgeon for clinical evaluation and further treatment.If needed some of them which are bigger may need to get excised in Toto (Completely along with the sac)Sebaceous cyst is  not contagious.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have post pregnancy weight gain after stopping breast feeding. Gained weight along my waist, hips, breast. Alternative medicine?\n\nI am 31. I have gained weight after delivery. Initially in the 1st yr post delivery i had lost almost half my pregnancy weight gain but now once i have stopped breast feeding my kid i have regained almost 10 kgs of weight and am 85 kg now. My height is 5 feet and 7 inches. I have gained tremwndous fat along my waist, hips and breast. Also i try to diet but get cravings for food and cannot resist eating. I am a pure vegeterian. Pls let me know whether homeopathic or ayurvedic medications will help me reduce weight or not and if yes what medications should i take",
    "doctor_response": "Hello Riarmk,Yours is a constitutional tendency to become obese. This can be corrected by genetic and constitutional approach of Homoeopathy. Homoeopathy can also prevent the development of any said complications of obesity. Your increased appetite can be reduced with this treatment. What medicine you will be given is to be decided by the physician. He needs a lot of information before he can select a constitutional remedy for you.Therefore my advice is to approach an expert Homoeopath  at the. If not able to find one, then you can get back to me with the detailed case history. I think I can help you.With Best Wishes,Dr. C. J. Varghese,Homoeopath",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness, chest pain and nausea?\n\nHi Doctor,  I am a 25 year old mother. My husband and I live a healthy lifestyle. Go to the gym 3-4 times a week. For the past two days I've been feeling extremely weak. Dizziness, feeling cold, gas and today a little nauseous. I have no energy to do anything. All I want to do is rest. I have also had a little Sharp pain on the right side and middle of my chest. What can this be?",
    "doctor_response": "Hi welcome to HCM....Here according to history you can have viral gastritis like condition along with digestive problem...Along with doing Jim drink lots of water and fiber rich food like whole grain, wheat bran , carrot, spinach , apple etc....Fruits more ...Gastric condition can lead reffered chest pain....Take omeprazole for few days...Check your blood sugar level also along with blood pressure monitoring....These two factors can lead dizziness , so these two investigation done ...Sometime viral flu also can lead these symptoms...In which congestive symptoms also present ...like rhinitis , cough etc....Avoid gas forming foods like cabbage, cauliflower and onion..If chest pain increasing chest x ray and ECG done....Also investigate with CBC and CRP...Take healthy and balanced diet and avoid heavy exercise for few days....Consult physician with keeping this in mind.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should one be concerned about growth of baby during pregnancy?\n\nhello, my other half is getting concerned about growth of our baby during pregnancy. we have recently had our 20wk scan (19+6) and the measurements are showing things that are making her concerned. the scanner at the time did not seem concerned, and the computer system also showed no concerns, but having checked online she has found that people with very similar and in some cases not as severe readings, have been refered for further growth scans. our measurments were; femur length 29mm abdominal circ 148mm head circ 163mm tcd 19mm. anything to ease her mind would be appreciated. j",
    "doctor_response": "Hello, and I hope I can help you today. The absolute measurements of the femur length, abdominal circumference are used to calculate the approximate weight of the baby. That weight is then compared to the average weight of all fetuses at the same gestational age and expressed as a percentile. If your baby's measurement is not less than the 10th percentile, further survaillance is not necessary.However after 20 weeks your prenatal care provider will measure the size of her belly from visit to visit and if it does not increase over time they are likely to repeat the ultrasound. So I hope I was able to answer your question today and that this information is reassuring. Best wishes, Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there a hole at the top of wisdom tooth?\n\nHello doctor, On one of the molar bumps of a wisdom tooth, there is a fade to white with a hole at the top that is not discolored at all. It almost looks like an animated drawing of a volcano. What is this? Could it be a cavity and if so how can you tell whether it is or is not reversible?",
    "doctor_response": "Hi. I have gone through your question. I can understand your concern. It is mostly reversible (attachment removed to protect patient identity) and depends upon your oral higeine. We can arrest the carries at till this stage only on the smooth surface because the plaque does not get accumulated on it. For that fluoridated tooth paste is sufficient. In your case, we cannot arrest it only by using fluoride supplements because there is a shallow depression. So you have to get it filled. Make sure there must not be any high point after filling. So you need to visit a nearest dentist to get it filled, there is nothing to worry about. Your oral hygiene is good and I think this had happened because of the malocclusion of this cusp in relation with the upper one. It is getting too long and we have to manage time too.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible while on plan b birth control pill post sex?\n\nHello. I have a question if I could be pregnant or not. I had sex tonight and the condom broke. I checked my period chart and it says I ovulated 2 days ago. But my period is always irregular. I took plan b like an hour after the condom broke. I really want to know what the odds are of me being pregnant. Thank you.",
    "doctor_response": "Hello,Welcome to HCMThere are always chances of becoming pregnant if there is failure of contraception.If you have taken plan b,your chances of becoming pregnant has decreased.But still i would advice you to do urine pregnancy test after two weeks and confirm it.Hope you are satisfied with the answer.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can delayed periods with nausea imply pregnancy?\n\nHi, wanted to ask about the pregnancy..i've missed the periods my LMP was on 12/05/2010...have leg pains and headaches on and off...negetive preg. test done on 14/06/2010...same day consulted doctor...asked me to wait for 1 more week ...could i be really pregnant...also feel nauseas since morning...",
    "doctor_response": "Yes of course you could be pregnant.As rightly suggested 2 u repeat your test after 1 week to confirm or rule out your pregnancy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chipped my tooth, noticed a bump on the gum above the next tooth over. Could be a gum boil ?\n\nHi, I chipped my tooth last week and the next day I was looking at it and noticed a bump on the gum above the next tooth over. I thought it was a canker sore. I went to the dentist to have my tooth fixed and he x-rayed it and the surrounding teeth(including one with bump) he said nothing of the bump. My chipped tooth was fixed with no problem. Now I was online and my bump looks suspiciously like a gum boil but wouldn t my dentist have noticed if the tooth had died?",
    "doctor_response": "Hi, Thanks  for  posting  the  query, Bump  formation  can  be  because  of  several  reasons  ,  it  can  be  an  abscess  formation, ulceration ,  irritation  or  trauma  due  to  the  chipped  tooth, plague  and  calculus  accumulation deep into  the  gum  pockets. I would  advice  you  to  visit  Dentist  get  a  checkup  done  . Take  an  x-ray, Get  complete  mouth  scaling  and  polishing done . Drainage of  abscess  and  Curretage  is  the  treatment. Decayed  tooth  is  to  be  restored. Maintain  a  good  oral  hygiene . Apply  dologel ointment  on  the  affected area. Hope  this     helps  out. Regards....",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes diarrhea with vomiting in a child?\n\nHi, my daughter is 7 mons old. She has been having diarrhea for a couple of days now. Tonight it got worst and she threw up once. My husband has been around a dog that had parvo and just died. Can these two be linked? Is it possible my baby has parvo?",
    "doctor_response": "Hi.. I do not think that this is due the  Parvo virus.Usually they do not present like this.It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What makes one feel that the heart is being squeezed?\n\nHi. Sometimes my heart feels like it is getting squeezed, and the my chest tightens up and my left arm feels relly heavy. I do not have any burning sensation in my stomach, my stomach- as far as i know- has nothing to do with this. I would appreciate help soon because i am worried about this",
    "doctor_response": "Hello,Please let me know your age, if any risk factors for cardiac illness like obesity, smoking, family history, or hypertension. These symptoms are very much suggestive of heart disease and you should get yourself evaluated. Get Ecg, echo and tmt done if needed. You need to be started on medicine as early as possible. Also get lipid profile and sugars tested once. Till then you can have tab Sorbitrate whenever you have squeezing in chest.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does elevated bilirubin level in blood test report indicate?\n\nHello i have a direct serum bilirubin level of 3.76 & also vitamin d deficiency @ 14. prior to testing been suffering from occaissonal diarrahias & bloating/stomach aches. also have pain in joints & occasioanl sever headaches/ weakness / & skin rash every once in while. not sure what i'm suffering from & after surfing the web today, i strongly feel that i may have problem with gluten & possibly celiac condition ! could the vitamin D / stomach problems & gluten be related & do they have anything to do with high bilirubin level (maybe indication of malnourishment) ??? could you please guide me what to do !Many thanks for your help in advance!",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Your high bilirubin level is not due to malnourishment or vitamin D deficiency.You may have some liver problem like viral hepatitis or cholycystitis. You should go for complete liver function test including hepatitis test and ultrasound abdomen. It will give exact cause of your jaundice. then take treatment accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for torn stitches\n\ni had my oldest daughter nearly two years ago and i had stiches. Since then they healed quickly and i have had another daughter about 2 year ago and didn t need stiches. Just recently where the stiches were has torn and i m just wanting advice what i should do and is it something to worry about?",
    "doctor_response": "hi I understand your concern.from the history you have given I am of the opinion that the vaginal area has gone very sensitive.but tearing after two years is not at all related to your delivery coz healing of episiotomy site happens in 6 -8 weeks .you need to get it examined surely from your nearest gynaecologist.then the further decision on medication be taken",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat nephrotic syndrome and skin disease?\n\ni am a boy.i am 14 years old.i am suffering from neprotic syndrome since my 3 years old.now i take 24 prednisolone tablets daily.besides,i am suffering from many kind of diseases of skin such as acne,pimple mark,skin disease etc.how can i do now,please give me suggestion of nephrotic disease and skin disease.?????",
    "doctor_response": "these are probably related to steroids. but unfortunately you have to take that for control of nephrotic syndrome.you should consult a dermatologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Missed periods. Over weight. Pregnancy test negative. Alternate medicine for cycloreg\n\nHi i have missed my periods now its been like 45 days. i m 29 and married. I m over weight so have had this kind of situation before and i was in India than. My Doctor there had given me Cycloreg. Now i m in Dubai. Have done my pregnancy test with the kits you get. but was negative. Do you get cycloreg in Dubai? if not which tablet can i replace that with? Kindly Advise. Thanks",
    "doctor_response": "Hi, Welcome, Obesity is the firstmost cause of amenorrhoea,disturbed cycles and thereby resulting in infertility  and other chronic diseases also. So if the periods start with some or the other hormonal pills, u might face the recurrence of the same, so please be careful, as u are a young married lady. Being a homoeopathic practioner i would suggest u to go for homoeopathic treatment. You will have to be diagnosed for different hormone levels and also for thyroid profile(for hypothyroidism), then only the treatment will be started, which may take few months. Till that time start reducing the weight,by diet control, regular walk/exercise etc.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why the blood pressure drops during the day?\n\nsometimes my blood pressure is 103/63 after exercising, and my head feels fuzzy. I take 40mg of micardis for blood pressure. Even though my blood pressure is never high. It is usually around 120/70 in the morning, but drops during the day, I am a very active person",
    "doctor_response": "please stop micardis(telmisatan)  for 3 days and monitor  your blood pressure twice daily keep a record of it for 3daysif the blood pressure is less then 140/90then its of no problem stop all medications and  just follow life style modification like fast walking strenous exercise and low sallt diet as of now your dizziness lightheadiness can be because of the low bp due to medication",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why my nipples bleeds while I am running?\n\ni am 48 years old male i weigh 173 lbs ive lost 30lbs over the last 6 months when i run more than 3 miles my nipples slightly bleed i see no problems no soreness no issues i am on e few meds from my doctor other than this i feel great what do you think?",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Running and bleeding nipple has no connection.It may be possible that you may bleed because of the drugs you are taking. You can get the chest X ray done. This will help you diagnose any tumor or any other pathology.Once the pathology is diagnosed you can be treated as per the pathology. I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can flu, ear clogging and laryngitis during a pregnancy be treated?\n\nGood morning. I'm about 4-5 weeks pregnant. I just found out 2 days ago. I had the flu all last week. My ears have been clogged all this week and I cant hear! Now from the flu I have a cough, and can bearly speak (laryngitis). Is this all normal and can I take anything for my ears and voice?",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the presence of ear clogging,laryngitis,cough after the flu is seen commonly.It needs symptomatic treatment like decongestants,any cough syrups etc.Take lukewarm water for drinking.Flu is caused by a wide range of viruses.Flu sometimes might cause secondary bacterial infection where in you might need a course antibiotics.So I suggest you to consult doctor for physical examination to rule out any bacterial infection.Nothing to worry.It will subside mostly with symptomatic and supportive treatment.Hope this helps.Best regards...Dr...Srilatha",
    "dialogue_context": ""
  },
  {
    "patient_message": "Uvula size increased. Advised food allergy, taken steroid, painkiller injection. Size not coming to normal, help?\n\nhi ,my name is dinesh and i am 23 years oldone day i eat very spicy foodin knight my uvula got increased very largely and very thick later i consulted the doctor she told me this is of food allergy and gave me steroid,painkiller injection and some tablets(Trypsin,Bromelain & Rutoside Trihydrate Tablets(Enractin)) which also used for thyroid.later after few days my uvula pain is reduced and got \"thin\" but \"The length of its size is not coming to its normal\"What can i do now please help me",
    "doctor_response": "the allergy take 3-4 wk to come down even after medicinesuse antiallergic tab for sometimeadd antacid liquidapply tramsolone gel on uvula before meals it will bring it normal in next days or wk",
    "dialogue_context": ""
  },
  {
    "patient_message": "Took pill after having unprotected sex. Had sex again. Should I take another pill?\n\nme and my bf had unprotected sex yesterday and within 1 hour i taken an ipill but after 10 minutes we had sex again but only for 10 min. Can i need to take another ipill with 24 hours...plzz help me ! i didnt want to get pregnant ........ 2 days ago - 2 days left to answer. Additional Details i know i did wrong but it was mistakely done........so plzz plzz help me should i hv taken another i pill?? plzz tell me",
    "doctor_response": "good evening to you... after an unprotected sex, to prevent conception you need to take ipill as soon as possible...since you have already taken one..,there is no need to take again on the same day....secondly ipill is to be taken only in cases of emergency and not as a daily method of contraception....i would advise you to be a little more careful next time...every contraceptive does have failure rates...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sexually active, had taken depo shot. Nipples sore and itchy, sensation across abdomen. Could be pregnant ?\n\nHello Dr. ,I recently had a child 4-4-13 via c section, and the beginning of may 2013 I had gotten on the depo provera shot. I do not remember exactly what day it was that I had went an got the injection, except it was the 2nd week of may at the latest. I am due now for the next dosage and have not yet gone to get it. My husband and I have been sexually active with no protection and I started having weird symptoms showing up. The first week I had cramps and sore nipples, the 2nd week (this week) my nipples have become itchy and still sore, the cramps are still present and when I get up to quickly or move suddenly I have the same sensations shoot across my abdomen as round ligement pain. I noticed a few days ago I started having a thin white milky discharge and my cervix was moving up and down. One night it would be really low and a few night later it would be really high. The discharge has now turned into a thick milky lotion substance just like when I was pregnant. There is no odor nor color to it and it does not itch. I have began having miagrains this past week also and just an over whelming feeling of not gettin enough sleep along with very vivid dreams that are awaking me. Is it possible that I could be pregnant again, or could these just be symptoms of the depo shot wearing out of my system. Please help me!!",
    "doctor_response": "Hello,Above features are mostly due to side effect of depo shot. It is highly effective (99.7%) against unwanted pregnancy. To clear confusion, you may undergo one home pregnancy test.Milky white vaginal discharge is quite physiological. It may be due to extra dose of progesterone (depo shot) which also causes sore nipples. As it has no odor or color or itching, you have nothing to worry. Just maintain your genital hygiene.Take some medication for migraine after consultation with doctor. Take balanced diet and drink more water. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have loose motions and pain in the abdominal area for two days. Please help.\n\ni have very thin loose motions , and pain in abdominal area, since 2 days and feeling weakness, taken flaygel medicine today, please recommend any medicine and precautions and diet plz",
    "doctor_response": "Dear, Welcome to.icliniq.com With history of 2 days diarrhea with weakness seems that you are on dehydration side. 1st of all most important step for you is to keep yourself well hydrated and replace electrolytes.Use ORS.Mix in 1 litre water and take as maximum as you can. Avoid spices,fried,outside meals .Take liquid or soft food for 2,3 days At least and eat less. Add yogurt and Ispagul and banana in your diet. continue with flagyl 400mg three times a day.Take ciprofloxacin 250mg after breakfast and dinner for 3 days.Also Take Mebeverine 135mg before breakfast and dinner.Also take antibiotics like Enflor sachet once daily for 5 days. I hope you will be fine soon.In case issue persists after 3 days ,please let me know . Take care !Stay healthy",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are these white spots on my waist, hand and underarms ?\n\nhello sir i have white spots on my hand, waste and in under arms. tis occurs afer applying veet on my hand please tell me now what i do. sir i m 24 yr old. m a female heigh-5.5 weight-60kg. sir m in bangalore. mera tretment patna main chal rha a approx 1 yr se but now it grows slowly slowly. i go married last month. i can tell tis o my husband ell me main kya karu aur iska tretmen kaise karbau?",
    "doctor_response": "Hi ....dr user ., Thanks for choosing HCM., White spots due to veet called ...CHEMICAL LEUKODERMA.., It has very good treatment.., 1) Apply Clobetasol cream on white spots and exposure to.., Sun for 5 mts.., 2) Tab....Methoxasalen morning 2tabs at 9 AM and exposure Sun after .., 2 Hrs..(Apply above cream..,) 3) Tab Betamethasone 0.5 mg 2 times per week for 6 weeks .., will get very good result...ok...good luck.,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for calf pain and aches\n\nI am a 35 year old male - 5 8 190 lbs. I have been halving some pain in my upper calf and around my knee for a couple of months. I was running 4-6 miles three times a week and first noticed the pain during my last run. It has been sore ever since. Aches during the day a lot and increases if I squat or kneel. I assumed it was tendonitis or something but today i am feeling dizzy. should i be concerned?",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms seem to be related to an electrolyte problem.It involve abnormal levels of sodium, potassium, or calcium. Typical mild\u00a0symptoms\u00a0of an electrolyte disturbance include\u00a0dizziness\u00a0and muscles\u00a0cramps.I suggest to teke an electrolyte solution and rest.Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for hives on skin\n\niv been suffering from hives over 2 yrs. they say its because I have hoshimoto disease. but I believe theres something triggering them late at night when my body temp rises they seem to onset no food allerigies I had a biopsy and was told it was chronic urticara im miserable nothing seems to help them",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.Chronic urticaria can be treated with long term antihistamines such as Levocetrizine and Fexofenadine. In case of lack of response to antihistamines, you can use cyclosporine, autologous serum injection etc.But, do take care of underlying thyroid disease as thyroid disease is one of the causes of chronic urticaria. If hives occur even after normalizing thyroid function, you can go for drugs such as cyclosporine.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is ingestion of bleach harmful to a child?\n\nMy 4 year old son has dipped his toothbrush in a sink filled with aprox 50ml of bleach/500ml water and put it in his mouth, should I be concerned. He is not complaining or vomiting and currently not showing any signs of discomfort other than the bad taste?",
    "doctor_response": "HI usually bleach if ingested results in ulcers in the mouth with redness and pain .As your kid might have taken quantity which is little that to diluted one, he had less effects.SO,just rinse his mouth properly and give plenty of fluids for now,HOPE THIS ANSWERS YOUR QUERY AND READY TO HELP FUTHER",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heavy feeling on jaw?\n\nMy jaw feels heavy and i know my bite is off. It all started in september when i went to the dentist to get a filing. I had to come back to get 2 more filings done. After about two week i noticed my right side teeth touched before my left. I only had temporary filings done cause my insurance doesn't cover it . I told the dentist that my bite seemed off so he tried to fix it, but it's still bad. Now i have heaviness in my jaw and if i open it wide i hear a little clicking and popping. It's not painful just annoying. I also have been having the feeling for about 3 weeks that something was stuck on right side of throat, again it's not sore just annoying. My doctor gave me antibiotics and i seen a ENT but both couldn't give me an answer just told me to take the antibiotics and it should clear it up.",
    "doctor_response": "hello thanks for consulting at hcm..may be you have an high point in your filling resulting in premature contact on the right side and your bite is not in sync,,,also one more reason for premature contact could be long duration of mouth opening might have resulted in slight tmj dysfunction,, so you need to take rest for that joint, by using muscle relaxants and avoid eating hard food, avoid opening your mouth widely, give hot and cold fermentation to that joint,,you could grind the high point in your fillings if any,, if you have night grinding of teeth,,you may need night guard,, so you definitely need a consult with a dentist, if you have tmj clinic in the area visit them,, hope it helps,,take care,,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Missed taking nordette pill. Have spotting. Is this normal periods? Pregnancy chances?\n\ni took nordette for 2months and 1 day i missed my pill ...so a day after that...i have mild spotting for 10days..so i think this is menstrual period.from that day..im not taking the pill until now...and today i already miss my period for 4 days....it is normal if i have irregular cycle after stop taking nordette pill? or i have chance tp pregnant?",
    "doctor_response": "Hi,Welcome to healthcare magic. I have read your question.I would like to reply as below:1) This is unlikely to be pregnancy. There is delay in cycles sometimes.2) Please get serum beta hCG blood test if still in doubt to confirm pregnancy.If you have any further queries, let me know so that I can help you much better.Wish you good health.Dr. Soumya",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for calcified granuloma on brain\n\n19 yrs.5feet 6 inches.78kg.female. i have a calcified granuloma in the right part of my brain...causing minor seizures...like my left leg gos numb sometimes.i wanted to know if there is any other solution apart from taking medicines for it for 3 years.im taking carbamazepine extended release tablets",
    "doctor_response": "Hello, You need to tell me WHAT THE ORIGIN of that granuloma might be...have they biopsied the lesion?  Is it DEFINITELY and beyond a shadow of a doubt the GENERATOR of your seizures? There are ways to determine this with virtual precision and accuracy.  Are there ANY OTHER focal generators for your seizures (perhaps not even able to be SEEN by MRI or CT scan?)? If in fact, there is a single solitary focus or generator to your seizures THEN, yes the focus can theoretically be removed surgically.  However, that depends on a number of factors.  Typically EPILEPSY SURGEONS will not agree to operate on someone UNLESS their seizures cannot be controlled using medication. If you are under very good or near-perfect control. Then, surgery probably represents more RISK than benefit in terms of excising the lesion and if I were your neurologist I would NOT recommend surgery at this point. If, however, your seizures are uncontrolled and there has been a success at using multiple and varied medications and/or other approaches to bring them under control then, YES surgery is indicated and should be reasonably considered. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from asthma since childhood. Prescribed euphomin syrup, addicted to syrup, shivering. Suggestions?\n\nHi Doctor , I have asthma from child hood one of the doctor suggested me to use, Euphomin Syrup and i get better when i use it, but the problem is the syrup has caffeine, and i have a doubt i got addicted to this drug, my height is 5.7 weight: 60 and i do excerise every day. When ever i use this syrup my hands are shivering , i need your suggestion",
    "doctor_response": "Thanks for your query. My search on Euphomin syrup shows that it is a combination of many medicines including some natural ingredients. Shivering can be caused by caffeine, along with other ingredients of the syrup. Again, natural ingredients can have unknown side-effects too. There are other medicines that can take care of your condition and do not have the side-effects mentioned by you. My suggestion would be to discuss the options with a physician and get a new prescription. Hope I answered your query. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Concerned about contracting rabies. Had a dog scratch in the past. Anything can be done?\n\nI am from Kolkata(India), Now I am suffering from very much fear and anxity regarding rabies because once I had scratch by a dog aproxmatly 7-8 years back and was not vaccinated by myself. On that time I was not aware abaout that decease, but few days before I suddenly have noticed some article on internet that mentioned rabies can take effect by several years also. As soon as I notice this information from internet I started to feel very much fear and going to be crazy, some time I feel I would better to sucide before die with that pathetic decease. Please Please help me to get rid from that fear and kindly suggest would rabies realy take affect after 7 years if dog scratch. I am newly maried haiving younger brother, Mother and Father and I am the earning member of my family, Trust me Doctor I dont want to die now, I want to live with happy.  Please advice what should I do.",
    "doctor_response": "Hi Biplab, Thank you for your query on Healthcare Magic. Rabies will occur if that bitten dog infected with rabies virus at the time of bite. What about the dog? Is the dog is a pet or a street dog? If the dog is a pet animal and its health was normal even after 10 days of bite there are very less chances of transmitting rabies. Usually the incubation period for rabies is 20 to 180 days and most of disease usually present within this duration. But longer incubation like 7 years is noted but it is a rare phenomenon. Don't be panic and consult your Physician for your concern and get examined for your anxiety and apprehension. Hope I have answered your query, if you have any clarification please let me know. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for natural emissions due to excessive mastrubation\n\ni have stopped masturbating for over 5 years months and from time to time I suffer from nocturnal emissions, which I have come to know is completely natural. On other days however when i wake up i see dried up sperm on my underwear which was not there previously, what is the solution to this problem",
    "doctor_response": "Hello,I don't know why you stopped normal masturbation. How do you expect your continuously produced semen will be let out. If you need to stop masturbation, you need to have regular sex or master in yoga. Masturbation two to three times a week is normal.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. S.R.Raveendran",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high RBCs in urine in a child?\n\nMy daughter is 5 years 6 months old, she always have a high RBC in her urine. Her blood tests like C3, BUN and creatinine are normal. Also her Ultrasound is normal too.. Sometimes her RBC in urine is 10-15, 8-10, 7-8. What do you think is the problem?",
    "doctor_response": "dear parent,  here are the causes of haematuria in children and how to diagnose according to associated symptoms 1) if there is clots of blood in urine, this is extraglomerular cause2) if there is fever,  dysuria, abdominal pain, this is urinary tract infection 3) if this happen following a trauma to abdomen, then this is hydronephrosis4) if the child suffer from early morning puffiness,  weight gain, oliguria and dark colored urine, this suggest a glomerular cause 5) recent throat or skin infection suggest post infectious glomerulonephritis6) skin rash and arthritis may suggest henoch schonlein purpura",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes knee cap pain, swelling and difficulty in bending?\n\nThe knee cap on right knee hurts to touch and to bend my knee, knee is swollen and hurts worse to bend past 90 degree angle. I ran a half marathon on Sunday and it did not bother me until the last mile. No other prior issues. Any idea what could be damaged?",
    "doctor_response": "Hello, Just observe for a day or two. If not relieved, get in touch with an orthopaedician, for MRI and further management. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. TEJAS KILLEKAR",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Do you feel CMIA is better than ELISA?\n\nHi doctor, My CMIA on 177th day was nonreactive with an index of 1.4. My second CMIA on 181st day was also nonreactive with an index of 0.8. These two were done at different places. If you compare\u00a0ELISA and CMIA combo for HIV antibody testing, which is better?\u00a0What is the maximum window period of forming antibodies and what are the reasons behind the delay?\u00a0If you compare rapid card test with CMIA, which is more sensitive and reliable? Based on my reports, can I consider it conclusively negative?",
    "doctor_response": "Hi. Based on your query and attached reports (attachment removed to protect patient identity), my opinion is as follows: For further doubts consult a pathologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of knee pain?\n\nI am 28 years old, I did a bungee jump( Elastic rope jump) 100meters. After a week i had a small sensation of pain, later it increased. I cannot run , swim etc.. I can walk but not much. I get pain when I climb stairs. I took x rays, ecography no problem in bone and tendons, muscles. It hurts deep inside the knee. There is no much swelling seen. What therapy should i go for ?",
    "doctor_response": "Hello,Your symptoms seem to be related to the jump. The pain in the knee\u00a0is caused by overuse of your\u00a0knee joint, such as frequent\u00a0jumping\u00a0on hard surfaces. It's usually a sports-related injury, related to leg muscle contraction and the force of hitting the ground. I suggest to use anti inflammatory medications such as Acetaminophen to relieve the pain. I also suggest to rest, use ice compresses and elevate the legs.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can high protein levels indicate cancer in ANA patient?\n\nHello doctor, Positive ANA, weak positive Smith through childhood or teens. Monitored for lupus by pediatric rheumatologist but never really exhibited symptoms. I have abnormal beta 2 glycoprotein that puts me at risk for blood clots. Was told in high school to take Baby Aspirin every day. I am now 28. Recently had full lab tests done for the first time in many years. Platelet count: 402 (had physical labs done three years ago and it was 432), protein: 8.9, ABS lymphocytes: 3.2. I went back to look through all my labs from my teenage years from a rheumatologist. I saw and I never had high protein. Also, my platelets were usually normal so I think the elevated thing is more recent? But it has gone down from 423 three years ago. I show no active signs and lupus and never truly did. I was always just monitored. I have a copper IUD and occasionally take my Aspirin. When I take it often, I bruise super easily. Just concerned mainly about the protein level. I have read about leukemia and other blood cancers. I was fasting for more than 12 hours and drank no water (I hardly ever do). All other labs are normal in the metabolic panel and CBC with auto diff.",
    "doctor_response": "Hello. The elevated high total protein does not indicate malignancy only. It could be due to some temporary infective etiology as well. Your all other parameters do not indicate any blood cancer. If you have a history of positive beta 2 glycoproteins as mentioned in the above description then you have to repeat your beta 2 glycoprotein estimation again after 12 weeks. If two repeated tests for beta 2 glycoprotein are positive and any history of thrombosis, then anti-phospholipid lipid syndrome can be possible or else not. The positive Smith antigen points towards lupus. If asymptomatic, then no need for treatment and only monitoring can be done. However, you can repeat your Smith antibody estimation again to exclude the possibility of lupus. You can investigate with anti-ds DNA estimation as well to exclude SLE. If beta 2 glycoprotein result comes negative in the repeat test, then no need to take Aspirin. The occasional Aspirin ingestion has no value and not indicated. You can consult nearby hematologist for detailed evaluation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are shortness of breath and tightness in lungs signs of asthma?\n\nI have high normal blood pressure.  My pressure in my lh arm was 135/74 and in my rh arm 153/85 yesterday morning.  By noon I had shortness of breath and my lungs were tight I wheezed inhaling and exhaling.  Do I have asthma or a heart related issue?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Wheezing during inhalation and exhalation is commonly seen with asthma. Hypertension can not cause wheezing. So possibility of asthma related wheezing is more likely. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test).PFT will not only diagnose asthma but it will also tell you about severity of the disease and treatment is based on severity only. You will mostly improve with inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal cramps during pregnancy?\n\nHello i have just found out that i am pregnant 3 days ago. My period was due yesterday and today i have started experiencing some cramping in the lower left side of my stomach. Is this normal? Also I have been told that i should go and see my gp and have my proestogen levels checked, is this right? If so what test do they do? Thanks",
    "doctor_response": "Hi,You should get B-HCG levels in blood checked and repeated after 48 hours to see if there is a doubling in their levels.Pain on one side ,with a positive pregnancy, could mean ectopic pregnancy, which needs to be ruled out.Progesterone levels can tell if the pregnancy is viable or likely to fail, depending on their levels, with 25 micrograms taken as a cut off.Do see a Gynaecologist and get HCG checked.Hope this Helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be concerned for the black eye and swelling in the parietal bone?\n\nHello, I fell going down wide concrete steps four days ago on the ice, and i hit the back of my head pretty hard.  A knot came up on the left parietal bone just above the occipital bone, about the size of a golf ball.  I didnt get knocked out, but couldnt move for a few seconds.  Afterwards, I only experienced a mild - moderate headache. No other symptoms until day 3, a black eye.  My right eyelid is black and purple with some very slight swelling. Since I haven't had any other symptoms of concussion and feel pretty good, I haven't considered getting a CTscan.  But now wonder if this black eye is an indication that something could be wrong.  Could this indicate some damage??",
    "doctor_response": "Hi,Yes definitely there is an internal fracture. Black eye means an internal bleeding. This needs to be treated immediately. You need a CT to be done. Also visit a neurologist for the proper assessment and treatment till then apply cold and ice packs alternatively to reduce the pressure on eye, also if there is a swelling on the skull you can apply ice pack over that area to reduce the swelling.Hope this helps you and you recover soon. Let me know if I can assist you further.Regards,Jenis Bhalavat",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pinkish,itchy,patch of flaky dry skin on penis?\n\nHii doctors, im a 17 year old male,black, and i for about 1 1/2mnths now ive noticed a pinkish,itchy(occassionally) patch of flaky dry skin, almost like dandruff on my (brown) penis....latley ive put neo-sporin on in begiinning to fade n not too itchy. Any suggestion wat it could be",
    "doctor_response": "Hello Thanks for the query. Probably you have developed fungal infection. I treat such cases with a topical antifungal cream like clotrimazole to be applied twice daily for a month. You can try this.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need treatment for swollen foot and ankle after an accident\n\nA couple of weeks ago I jammed my 2 right toes against a dresser and since then my foot and ankle have swollen. I have been icing it and now my toes are much better, but there s still swelling on the foot and ankle. I m wondering if icing is the best thing to treat this injury.",
    "doctor_response": "Hello, It could be a contusion probably. Fracture is unlikely. As first-line management, you can apply ice packs for symptomatic relief. If symptoms persist better to consult an orthopedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does albimin trace in urine indicate kidney damage ?\n\nHi, I am 28 years unmarried female.My problem is frequent urinating.Need to go bathroom every 10mins for pee.Had urine test and the report was trace(albumin).i am worried if my kidney is damaged.please assist me. Thanks",
    "doctor_response": "Frequent urination, every 10 mins (unmarried female)- Is a symptom of may be urinary tract infection. If you do not have any other complaints and ur urine test, revealed only trace albumin. Then you need to consult a urologist. However kidney damage normally presents with decreased urination (or absent urination). In your case and your age it is highly unlikely that would have occurred.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a hard lip lump be treated?\n\nHi, I have a small black bump on the corner of my upper lip. I m not sure what it is, but I know for sure that it is not a pimple. The texture is really hard, like a small rock. It s been on my lip for a while now, but I m just recently getting annoyed with it. Is there any way that I can remove it myself, or should I have a doctor look at it?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  You may have some tumour like basal cell carcinoma or some benign lesion.  You should go for biopsy.  It will give you exact idea regarding cause. 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have brown patches on the back & neck. Spreading. Ruled out fungal infection. Cure for symptoms?\n\nI have brown patches on the back and the neck. They started spreading over my shoulders and to my stomach. They appear white after I take a shower but otherwise appear as brown patches when dry. I had this few years ago, back then I consulted a doctor and I was given medication. Now I have moved to a new country and I consulted a physician who ruled out fungal infection. Not sure what it is.",
    "doctor_response": "Hello,Welcome to healthcare magicFrom your description it looks like pityriasis versicolor. When you stretch the skin over the patch do you notice fine scales over the patch. That is a sign usually seen in pityriasis versicolor. It is caused by an yeast species. 4OOMG Fluconazole tablet single dose is a good treatment for Pityriasis versicolor. Local application of ketoconazole 2% cream twice a day will give additional benefit. You may get these prescribed by your doctor.Hope this helpedTake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the lump in the child's neck a cyst or node?\n\nMy 10 month old daughter has a lump in her neck that is about the size of a bb. You can not see it but can feel it floating in the neck area. It does not seem to bother her even when touching it. Is this possibly a cyst or lymph node? Is it possibly something serious to be concerned about?",
    "doctor_response": "Hello!You havent mentioned where exactly on neck is the swelling & if fever is there or not.If on either side of neck, more likely it is a lymph node.If in centre & in front of neck, it can be a congenital thyroglossal cyst.Clinical examination is necessary to know the diagnosis.Anyways, as u said the child is playful & it doesnt cause pain on touching, need not go to ER immediately but should get examined once.Hope this information is useful to you.Thanks. Rsgards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a pressure on the chest an indication to heart attack?\n\nHi, my friend is refussing to go to the hospital because he does not have insurance.  But he is having pain in his arms, hands and legs.  he also has pressure on the left area of his chest from time to time.  Could this be a heart attack?  I gave him medicine for his fever 101.8",
    "doctor_response": "Hello!Welcome on HCM!I passed carefully through your question and would explain that his symptoms are not related to any heart attack. So, relax and don't worry about it!He seems to have an infection, probably a viral infection. This is causing chest pain and muscular pain in his limbs. But, if the fever persists, he may need to take antibiotics. Performing some lab tests is necessary to investigate for a possible infection: - a chest X ray study- complete blood count, PCR, ESR for inflammation- kidney and liver function tests- an urine analysis. He may need to take antibiotics. Hope to have been helpful!Wishing good health, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "A uretic stent placed, removed after colon resection surgery, still bleeding while urinating. Is it normal ?\n\nMy father had a colon resection surgery on July 10 and we don't understand why the doctor placed a uretic stent; this was removed after the surgery and he still bleeding while he urinate; doctors stated that it is completely normal and the stent probably scratch either the kidneys or the bladder.  First question is why a stent was placed? and is it normal that he still bleeding until now very red?",
    "doctor_response": "Hi,Thanks for writing in.Research shows that ureteric injury is a feared complication in colorectal surgery, with a reported incidence of 0.2%\u20137.6%. This can be decreased by ureteric catheter placement that gives the surgeon the advantage of facilitating intraoperative ureter identification and assisting in immediate injury recognition and repair.Also this decision is controversial because of fear of ureteric damage during catheter insertion and postoperative urinary complications such as obstructive oliguria and urinary tract infection.I suppose there has been little injury to the urinary tract due to the stent placement in your father during surgery. It was an action keeping in mind the complication associated with the surgery. Further research done in 2012 shows that ureter stent placement is safe and justified in most cases. Unfortunately the stent has caused a little scratch in your father. The injury should heal soon.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pain in abdomen due to genital pressure a sign of appendicitis or gallbladder problem?\n\nHi I am a 27 year old female. I am experiencing pain in my abdomen on the left side that hurts worse with gentle pressure applied, I feel nauseous and not hungry, I also feel like my stomach is swollen. I feel really tired as well as general achiness along with a headache. I do not have pain on my right side but am worried I may be experiencing either a gallbladder problem or appendicitis. Any help would be greatly apprecited thank you for all your time and help.",
    "doctor_response": "Hi...appendix and gall blader are right sided organ and so cause pain on the right side...you may be having either gastritis or ovarian cyst or ureteric calculi...try a course of ppi for a few days...if pain goes down then it was gastritis and so continue ppi for a few weeks...else get a ultrasound abdomen for the cyst or calculi...if you are having uti it goes more in favour of calculiDr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is class 3 malocclusion an autosomal recessive trait?\n\nHello, I have a level 3 malocclusion underbite. Both my parents do not have this trait. My grandpa did, my grandma didn't. Is this a autosomal recessive trait with homozygous alleles? I am hoping so because I do not want my kids to have such a disorder",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. Actually according to different studies it has been proved that this class 3 malocclusion compared to class 1 and 2 is an autosomal recessive trait, as if it is present in the dominant gene it will transfer. But there is nothing to worry about it,  as now a days there are many new treatments which can resolve the problem. Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Valido the right medication for the low aperm count and motility\n\nhi doctor,I have low sperm count (10milion) and the motility is 50%. we are trying for a baby for 4.5 years. my wife's test reports are fine. I am taking valido prescribed by doctor and the improvement is very slow. is it the right medication? can I do anything to improve it faster?thanks",
    "doctor_response": "HelloThanks for query .Based on your statement you seem to have Oligoasthanozoospermia meaning there by that your sperm count and sperm motility is less than required for effective fertilization of female egg to result into pregnancy .Truly speaking there are no medications that have proved scientifically effective to increase these parameters .However following general measures will help you to increase the sperm count and sperm motility. 1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning.2) Take high protein diet rich in vegetables and fruits and Vitamin A,C,D,E.and Zinc3)Take anti oxidants like Almonds 5-6 everyday..4) Avoid alcohol and smoking.Dr.Patil..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump at tooth extraction site\n\nHi, I had my wisdom teeth removed almost 2 weeks ago, I now have a lump on the bottom right side back further on the gum from the extraction site. It's about the size of a large pea, it feels and looks like a blister. I told the nurse at the dentist office about it and she said its normal and would go away on its own. It doesn't seem to be going away.. It's not really painful just irratating. Any advise would be appreciated, thanks.",
    "doctor_response": "Thanks for your query, I have gone through your query.The lump at the site of extraction could be a socket granuloma or excess tissue that has formed in the extraction socket. Nothing to worry, usually it resolves by its own, if it is troubling you and irritating you, get it surgically removed under local anesthesia. Do saline gargling.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain radiating from leg to toes?\n\nI have a pain that starts on my left side in my syiacted that goes down my leg to my toes. I have had this pain since July 24th after I strain my lower back. I have seen my medical doctor and she prescribed gabapentin 100mg three times a day and I also take two ibuprofen every four hours. I also see a chiropractor three times a week for twenty minutes each visit. Nothing seems to help. I am still in a lot of pain I use ice packs and heat pad on and off to help relieve the pain. What can I do to get rid of this pain forever?",
    "doctor_response": "Hello and welcome...Most probably you have ..sciatica.. A condition in which the sciatic nerve is compressed and causes pain.sciatin nerve supply the lower legs and it start fram the spinal cord..You need assessment ..full general physical exami tion and CT of the back bone to dig the bug.Better see a neurosurgeon ..Get well soon See you in good healthBye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is alcohol consumption allowed for people diagnosed with duodenal ulcer ?\n\nyes thank you doctor sab, i have suffered active duodonal 3 cm ulcer before 30 months , for the diagnosis, i consumed omerprazole 2 months, antibiotic 15 days & avoid food , around 12 months i avoided the food like oily, hot & sour, drinks , but sometimes i want to drink al;cohol during party , is it ok or ..........",
    "doctor_response": "Hello and welcome to healthcare forum. Alcohol is a known causative factor for peptic ulcer. As you are a known case of peptic ulcer, whenever you consume alcohol you will have relapse of your symptoms. So, now it is up to you weather to have symptoms or not. Wishing good health for you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can infertility be treated?\n\nHi I am trying to get pregnant from 1 year. I took the fertility treatment also, after different trails doctor suggested to go for IUI and did the scanning on 2nd of my period. In the results they said one previous unruptured egg is there. So suggested to take the ovaral g for this month. Can I get clear explanation on this. Is this is reason why I am not getting pregnant?",
    "doctor_response": "Hello,This is no reason for Infertility.We need to get all the basic investigation done for you and your husband and then only we can know the exact reason for infertility and that can be treated accordingly.Knowing the exact reason is very important.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mandavi Rai",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cystic acne, hair loss and low testosterone?\n\nMy son is 21 and suffers from severe cystic acne, hair loss, muscle wasting, and low testosterone. He has high DHT which our family doctor says is why he is losing his hair. Low T is causing the muscle wasting. He is always very fatigued. What can I do to raise his testosterone levels and keep the testosterone from converting into DHT? Also, if I try and raise his levels, will his acne get worse? Why are his levels so low? We have had a liver and kidney function test which were both normal. Do you think he has a pituitary problem?",
    "doctor_response": "Thanks for asking in healthcaremagic forum    There are many causes for low testosterone. Acne can be treated by medication and local antibiotic creams. Please send details of investigations like levels of FSH, testosterone and other reports for further suggestion. Yes it can be due to pituitary also.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pressure with sweating and weakness?\n\nI am a heart patient had a stint year ago, lately I have had chest pressure , all over weakness, and one day sickening jaw ache. I have the pressure or just discomfort in my chest everyday and this week excessive sweating at work. Please help me my blood work is good and negative EKG once. Advice would be appreciated. This has been going on for at least a month.",
    "doctor_response": "The symptoms you describe are considered angina equivalent more importantly idle they occur with exertion .  I will strong suggest you to get a stress test done (treadmill test) , and depending on the test results proceed further ad you cardiologist will suggest.  Time being you can start on antianginal medication like nitroglycerin extend release or Nikoran dil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for torn my frenulum and pain\n\nI was having sex with my girlfriend and I felt a sharp pain I just brushed it off. After turning on the lights the bed was covered in blood. I believe I have torn my frendulum. It s been two days now and it s no longer bleeding however it is very sore and when I peel my foreskin back to look at it it hurts. What should I do?",
    "doctor_response": "HelloThanks for query.You have sustained injury to your frenulum during forceful and probably dry intercourse.Please get the wound cleaned everyday with anti microbial solution Betadine and apply topical antibiotic ointment like Neosporin twice daily..Take antibiotic Doxicycline along with anti inflammatory drug Diclofenac twice daily.Avoid sexual activities till it heals up completely.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of stage four liver cancer?\n\nI am having some problems with my taste and smell ,I don t have any. I s been two weeks since my last chemo treatment, I have had four treatments up until now. I have stage four liver cancer and I am taking promethazine for nausae,andgabapentin for nurothopy. Should I be concerned?",
    "doctor_response": "Hi,Thanks for writing in.Stage 4 cancer of liver is advanced disease. It might cause mild symptoms in some patients and others might have severe symptoms.Usually the condition might have a large mass or multiple masses in the liver causing a hard to palpate mass in the abdomen. The mass causes compression of vascular structure including the inferior vena cava and this might lead to blood clots in the vein goind to the heart. The veins of the kidneys might also show clots.Few people develop ascites and fluid collection in the abdomen and this is due to the inability of the liver to function normally. The side effects of chemotherapy medicines also have an influence and this might cause neuropathy and nausea with dizziness and pain. Please discuss pain relief with your doctor. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there pain in throat while eating or drinking?\n\nHello doctor, It pains a lot in my throat on right side whenever I eat or drink something. This happened after I recovered from a cough and fever. Please help.",
    "doctor_response": "Hello. It can be posterior pharyngitis or especially tonsillitis like infection. Your posterior pharynx examination has to be done. If congestion is more, then it is better to investigate with CBC (complete blood count), ASO (anti-streptolysin O titer) like further investigation. Your doctor might put you on antibiotic and decongestant course for five days. Drink lots of water. Avoid excess spicy foods. Vitamin C lozenges can be chewed frequently. Salt water gargle can be done with warm water three times a day. You can consult an otorhinolaryngologist for examination.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are fatigue, lower back pain and throwing up symptoms of pregnancy?\n\nMy friend had unprotected sex on the 3rd day of her period, and her boyfriend had released his sperm in her, well once she got off they had continued to have sex and he continued to release sperm in her, after that she had  been throwing up, fatigue, and lower back pains, my question is she pregnant and if so how far along?",
    "doctor_response": "Hello,No she is not pregnant if she had sex on the third day but if you want, do UPT. Most likely, it's negative. Do not worry take Ondansetron for now.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sheetal Agarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is diva-250 safe to use continuously for migraines?\n\nI have migrane for last 12 years. Last year my doctor advised me divaa-250 mg .For 1 year my migrane attacks reduced but this year around same time again I started migrane headache very frequently.My doctor started again divaa-250.I want to know is diva safe medicine.",
    "doctor_response": "Hello, There is risk of Pancreatitis,kidney dysfunction and bleeding disorders on long term use. Take Divaa 250 MG Tablet with or without food  but do not take in larger amounts than advised. Consult the doctor if you experience any undesirable effects. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. AJEET SINGH",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and severe nausea?\n\nDizziness, sometimes severe, nausea, sometimes severe. Very close to throwing up at times, but not actually doing it. Headache. No pain anywhere, and it comes and goes a couple times in a day. I v had this about a week. I am well hydrated. I v been diagnosed with vertigo years ago, but it went away years ago, and this is nothing like that was. I feel okay between episodes, but tired. I have been laying down and sleeping when it happens, and seem ok when I get back up. It s been hit and miss, meaning not everyday. I haven t changed my diet or products",
    "doctor_response": "Hello!Thank you for asking on HCM!I carefully read your question and would explain that your symptoms could be related to an inner ear disorder or an inflammatory disorder, causing the headache. Coming to this point, I would recommend consulting with an ENT specialist for a careful physical exam and labyrynthine tests to exclude possible inner ear disorder. Further tests to be done are: - a brain MRI - inflammation tests (complete blood count, PCR, sedimentation rate). Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be remedy for sperm ejaculation in dreams?\n\nAm getting problem of sperm ejaculation at dreams Am losing my sleep and activites how to over come this problem Daily it occuring and am getting of much pimples which hurt me much to touch and proper digestion is not taking place So please help me to cum out of sperm ejaculation",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Night dream ejaculation is a normal body activity and there is nothing to worry about. Semen is produced whenever you are sexually excited. Such produced semen should be thrown out of the body. If you do not masturbate or engage in sex for more than a week or so, body ejects the produced semen through night dream ejaculation or through urine. The loss of appetite, pimples and digestive problems are due to anxiety associated with the wrong knowledge. For sexological counseling visit  this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe pain on right side of waist going upwards\n\nmy granddaughter is having severe pain on her right side starting at her waist and going up.the doctor took an exray and it showed ablockage in her colon on the right side , he said it would probably take care of itself. her pain has gotten worse over the last few days. her urine also showed that there might be an infection, they are doing further testing on that. what can I do to help her pain ?",
    "doctor_response": "Thanks for keeping faith ..as your grand daughter has been diagnosed with obstruction of gut with pain with suspected urine infection, just relax things will be all right ...just give her liquid diets ....plenty of fluid. ..for urine infection u can start a antibiotic like levoflox and with a antispasmodic like meftal spas bd...It will really help. ..If  symptoms get worse u should consult your physcion. ...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain laying flat down, lower adominal pain, headaches and nausea. Reasons ?\n\nHi, Ive been having back pains laying flat down, and lower adominal pains, headaches almost everyday and a nauses feeling in my throat .. I had sex july 22, Started having bleeding which felt like my period, Auguest 4th, was very light, lasted about 3-4 days, In July i got my period around the 14th, I have no idea what s going on??Please help!",
    "doctor_response": "Magnetotherapy treatment;- For your back pain u can place south pole of med. power magnet for fifteen  on the pain place.and drink magnetic water  thrice a day and report.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatments for neck and hand pain\n\nIve been suffering with feet and hand pain after a mishap that jarred my neck forward left and right.Pain arriganated in my neck MRI showed nothing.walking and using my hands is very painful.what specialty Dr should i see?I had no signs of arthritis before the accident. At first it was mainly my left side.Neck pain at the base of my scull is on the right.Now the pain is in both hands and feet.",
    "doctor_response": "Hello,I have studied your case and I think you are having a whiplash sort of injury. In this there is pain in neck with rediculopathy. I would suggest you to show it to orthopaedic surgeon or a neurologist. Till then you should wear a soft cervical collar, take muscle relaxant, like Myoril or myospaz twice daily.I hope this answer will be useful for you. Let me know if there is any other followup questions.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does backache along with soreness in the breasts indicate?\n\nI have started pain in my back and also sore breast experiencing just after my menstrual periods.. at the start I hv regular discharge but 2 3 days before it stopped. Now it s dry down . But I hv normal discharge during intercourse .. does it sign of pregnancy ?",
    "doctor_response": "Hello,Yes, these can be early signs of pregnancy. Get urine pregnancy test or beta HCG test done. Also, consult a gynecologist.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mahaveer Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why sometime but most ofently thick,viscous blood comes in my mouth ?\n\nhi doctor,i just wnt to knw the cause tht why sometime but most ofently thick,viscous blood comes in my mouth",
    "doctor_response": "Hi,Snehlaji, Thanks for query, It seems that youmight have chronic infection or tartered teeth causing bleeding from gums. You should be rule out Pyorrhea. Consult dentist and get examined. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for excessive iron in blood?\n\nTonight I recieved a call from my friend who is native to Spain. She was told she has too much iron in her blood and they want to start removing blood from her, they also said she has a fatty liver, can you help me understand and pershaps explain things to her. I am in FL., she is in Texas. Thank you",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. She may have hemochromatosis.  She has excessive iron in her blood, which get deposited in various orhan of body and create the problem.  It affects the liver and pancreas mainly.  She should take iron chelators. And if needed go for phlebotomy. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cough in sleep\n\nHello doc, My daughter has been coughing from last thursday mostly at nights in her sleep for say half an hour to forty five minutes on and off and when she stops she sleeps for the rest of the night. The cough is not dry it has a little cold but she is not having the flu, she is 18 months old..will ambroxol help? or what is causing it? she weighs 26 pounds.",
    "doctor_response": "nocturnal cough could be due to post nasal drip. check whether she has sinusitis, nasal congestion or adenoids ( snoring problems). simple nasal decongestants/ cetrizine at night time can help",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause of red dots on arms and feet, and fever?\n\nHi my daughter recently had a fever, a couple of days after I noticed there were a few red dots on her arms and feet...I was just wondering if it was normal because now the blisters that were on her feet poped and it looks like it hurts...I don t know what to do",
    "doctor_response": "It may be viral fever with rashes. So pls consult doctor. Some time low platelet count can cause this type of lesion. So pls go and see patient to doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of bronchitis?\n\ni have what i beleive to be bronchitis with chest congestion,runny nose,and low grade fever and now have developed small red dots,they are all about the same  size and red in color they do not itch or burn and they are not raised. started a few on feet but are now gone and now they are on my legs",
    "doctor_response": "Hi. I can understand your concern. You will need a detailed physical examination so better consult a doctor at the earliest. You will need blood tests as well. It could be dengue or some viral fever.Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I undergo a blood transfusion or take an iron pill for low ferritin level?\n\nHi I recently been diagnosed as severely anaemic my ferritin level is at four and I was wondering what should I do them is taking iron pills enough or should I be getting a blood transfusion of some kind or shots or something?",
    "doctor_response": "Hello, So if you have symptoms of anaemia like breathlessness and severe fatigue, or if you are unable to take iron tablets,  transfusion is indicated. Otherwise, you can take iron tablets. Else, you can take injectable iron also. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Deepak Sundriyal, Oncologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will tamiflu suffice for sinus infection and strep?\n\nI m being treated for strep AND a sinus infection, AND taking Tamiflu in case the virus I have is a non-type-A flu. This morning I started struggling with an intense gag reflex or reflux, I can t tell which. It s gotten stronger all day. I haven t yet thrown up, but I m getting close. Should I be concerned?",
    "doctor_response": "Hi,Welcome to HCM.Tamiflu is Oseltamivir, an antiviral drug most effective against al most types of flu viruses, but it does not have any effect on bacteria like streptococci. You have been diagnosed with viral sinus infection and have been rightly treated for it. Streptococcal infection can be treated with antibiotics and not antivirals.Most effective being penicillins.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why my premature baby continues to pass watery stool?\n\nhi dr santosh my baby is 7 mnths old when he was dlvrd he is pre mature baby he cntnue passes the watery stool he is on breast feedn as wel as formula milk all 110 when in stop frmla milk but he is facing the same prblm then my doctr advice me tht give him cow & gate soya formula milk my baby redusing substances in +2 now he is 7 mnths im again test stool dr now reducing substances is +1 whts duration of reducing sbstnce bcz hi has only 7 kg weight",
    "doctor_response": "Hi Dear Welcome to the HCMContinuous weight gain according to the age and chart is best indicator for the well being of the child. It is also the best indicator the adequate fulfillment of the caloric supply to the baby means baby is getting sufficient  milk.Many times because of the gastrocolic reflex there is frequent motion with out any infection. Gradually with due course of times this frequency decreases and baby strarts passing normal stool.hope the query is answered.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for gliosis in the right temporal lobe\n\nThe white matter of brain shows gliosis surrounding area of encephalomalacia right temporal lobe. Mild gliosis is also seen posterioly in the right frontal lobe.several areas of high signal are present in the white matter of the brain suggesting probable small vessel vascular disease. These measure up yo 8mm",
    "doctor_response": "HelloThanks for writing to HCMGliosis with encephalomalacia in brain is an irreversible condition and it doesn't require any specific treatment.High signal intensities in white matter of brain may be related to ischemic changes resulting from involvement of small blood vessels,demyelination,gliosis etc.Ischemic changes resulting from blood vessels changes in diseases like hypertension,diabetes mellitus,dyslipidemia.So,you need monitoring of conditions that leads to ischemic changes like hypertension,altered lipid profile,diabetes mellitus so that further progression of disease can be halted.You need investigations like routine hemogram,RBS,LFT,RFT,Lipid profile,ultrasound of abdomen.Proper treatment depend upon findings.Hope i have answered your query.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure yeast infection with blood indicating phosphorus?\n\nI have a rash on both legs and on my belt line.One Dr. said Yeast infection and gave me triaderm 0.1% with no improvement I went back and the DR, gave me viaderm k c cream. the rash spread and got more pain full at the ER myblod sample indicated Phosphorus too high, should I be concerned? I am 81 yrs old",
    "doctor_response": "Hello,Welcome to HCM,As you are having symptoms of fungal infection, your doctor has  advised creams like Triderm cream is a triamcinolone acetonide which helps to  reduces the swelling, itching, and redness that can occur in these types of fungal infection.Viaderm KC is also having same drug i.e triamcinolone acetonide is a topical corticosteroid prescribed to treat a irritation, pain, and swelling associated with injuries.Side effects that may occur while using these creams like pain, burning, or irritation at the application site.The most common cause of elevated phosphorus levels in the blood is decreased kidney function. Rarely, it is due to excess intake of phosphorus or vitamin D, which increases absorption of phosphorus from the small intestine.As you are having increased phosphorus level you need to undergo renal function test to see other parameters.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I unable to conceive?\n\nHi, We are trying for a baby for last 1 yr. But as of now nothing positive. I had a history of endometriotic cyst. I had gone through an operation almost 9 yrs back. But last ultrasound in February showed everything is normal. I want to consult a gynaecologist in Bangalore. Could you please suggest a doctor.",
    "doctor_response": "Hi, Thanks for posting in HCM. I understand your concern. Trying to conceive for more than a year with reports indicating normal could be due to secondary infertility. Both male factor and female factor needs to be clinically evaluated along with the investigations to know what could be the cause for the delay in conceiving. You can consult Infertility specialist in this regard in any of the corporate hospitals or Infertility hospitals in Bangalore to get a proper check-up and management. Hope the information provided would be helpful. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does Oxetol and Frisium need to be taken for treatment of complex partial seizure?\n\nMyself from India and my wife (21 yrs) will suddenly blank out 2 or 3 times a day only during the time of periods(4-5 days during mensturation). After consulting with a neurologist, he said it as Complex Partial Seizuer(catamenial seizure) and prescribed Oxetol 150mg on morning and 300mg on evening. Also prescribed to have frisium 5mg during the time of periods. 1) How long she needs to take medicine? 2) Does it have any side effects? 3) Does it affect pregnancy? 4) Will it be cured completely? Thanks to HealthCareMagic.",
    "doctor_response": "HIThank for asking to HCMYou said it is \"black out\" while the doctor called it \"Catamenial seizure\" let me tell you something, the seizure means the epileptic attack which means tonic and colonic movement of limbs either upper or lower or all four together, frothing from mouth typical screaming of patient before attack (Aura phase ) passing of urine involuntarily, in severe attack tongue also get bite, is this kind of symptoms did you see ? if not then this is not \"catamanial seizures\" and if yes, then she has to be on drug for longer time of period may be till the menopause, I am still doubtful this may not be catamenial seizure, I would like to advise you to have second opinion, and important is watch the symptoms properly,, have good day wishing you a very good health of your wife.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mild cramping after prostop infection?\n\nHi, 2 months ago I got prostop infection.  For the last 6 weeks I have been sick and unable to keep food down.  I am also experiening mild cramping. I am also on 75mg HRT.  Went to my doctor today and he is running blod tests and asked if I was pregant, can I get pregant",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.As you are the lady at the age of pregnancy it should be ruled out.Infection requires antibiotic treatment. This antibiotics will affect the pregnancy. So if you are not pregnant than giving the drug to you is no longer a barrier to you.This infection should be treated with good antibiotics like ceftriaxone, anti acidity agent like pantoprazole,analgesics like mefenemic acid and lactic acid bacillus spore. This can cover infection pain, diarrhea etc in your infection.Please maintian good hygiene as it is important in treating the infection.Hand washing is the good tool to combat the infection you should adopt it.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it correct to use yamini pill without seeing any effect?\n\ni have used this yamini for last three months and discontinued to see the effect but found the same situation. again i consulted with the doctor and she reffered to use the same again for the three months.whether it is correct, or it may be harmfull also!!!!",
    "doctor_response": "yamini is a birth control pill to regularize your hormonal balance...ya u can use yamini...we need to know wat problems u had earlier?...dont worry...it wont harm u..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the suggested medication for pneumonia?\n\nI have been taking levoquen for pnemonia got pnemonia when I aspherated in egd test and acid went to lung, while I was in hospital heart went to 124 went to follow up and my family physician said give it till I over this cause it was 114 in his office, should it be ok to wait? weight- 177 height- 5 6.",
    "doctor_response": "Hello,Thank you for your contact to healthcare magic.I understand your health concern, if I am your doctor I suggest you that take the medication as your doctor has suggested you. You should think for doing culture and sensitivity from the sputum. Once you have report take treatment accordingly.I will be happy to answer all your future concern. Thank you,Dr Arun TankInfectious disease specialist.Wish you a best health at health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a patch on the inner side of my cheek. When will it heal?\n\nHi doctor, I am a 30 year old male, and I have a patch on the inner side of my cheek from the past two weeks. It might be caused due to cheek bite, as I have a tendency to bite my cheek while eating. I have no pain and bleeding. I consulted a local dentist, and he said it does not look abnormal and has prescribed medicines. I have a history of smoking for eight years, and I gave it up two years back, I need your valuable advice on how can this patch be healed. I will attach the screenshot of the patch inside my mouth. Is it oral cancer? The medicines prescribed are\u00a0SM fibro\u00a0and Kenacort gel,\u00a0and I\u00a0have not used these medicines regularly.\u00a0Thanks.",
    "doctor_response": "Hello. I have gone through the snapshot of the patch you have sent me (attachment removed to\u00a0protect patient identity). I have few questions before I diagnose the same. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the small lump on my wrist with radiating pain?\n\nI have a small pea sized lump at the bottom of my thumb near my wrist. On my right palm. It is sometimes tender to the touch. I discovered it when I started to get pain in my palm and it was uncomfatable every time I tied my shoes or used my hand. It radiated into my wrist. I started using ibuprofen and it helped to relieve some symptoms.",
    "doctor_response": "It can be ganglion which is basically a swelling from the joint or some lipoma which is fat containing swelling. The Painkillers are good option for it",
    "dialogue_context": ""
  },
  {
    "patient_message": "On implants and pills. Do they interact?\n\nHi there, I recently went to see my local doctor, but its not the doctor I usually see, as he retired and she s taken over.. I m not good with new doctors. I have been on the implant for almost two years now and my periods are how to put this a pain! So she has now put me on the pill as well as my implant! I had concerns as I have heard it could counteract each other.. But she didn t really seem to be bothered.. Can you help me put my mind to rest please..",
    "doctor_response": "Contraceptive implant is licensed for 3 yrs - have you started getting continuous bleeding / painful periods? Implant does not interact with hormonal pill which is normally given to stabilise the lining of womb so irregular bleeding with implanon stops. If bleeding still continues - other causes need ruling out - infection OR uterine pathology (USS for fibroids)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does redness on face followed by headache indicate?\n\nI often notice my face is red, minus around my eyes. It looks like I got a sunburn with sunglasses on. Most do the time I end up with a headache right after my face gets red. People have commented a few times to me about how red my face is. Any ideas on what is going on with me?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern and let me tell you that this could be nonspecific symptoms but some how the chances of sinusitis need to be ruled out, and for that you can get done the clinical examination, or else this can be managed with Tab Acetaminophen with Ibuprofen three times in day, hope this information helps you, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "No periods. Stopped contraceptive pills. Negative pregnancy tests. Bloating. Need advice\n\nHello. I have not had a period for three months. I stopped taking the contraceptive  pill 6 months ago, had irregular periods for 3 months and now they have stopped completely. Four pregnancy tests are negative. I feel mmore bloated than usual but no other symtoms. I have a doctors appointmeny booked in a weeks time but wanted some quick advice please as it is worrying me. Thank you very much.",
    "doctor_response": "Hi dear user, thanks for your query.As per your history, you had your periods 3 months back and you pregnancy test are negative. Bloating may be due to fluid retention. In my opinion, you should get a few investigations done(complete hemogram, serum beta HCG, blood glucose,thyroid profile and serum LH& FSH levels) and an ultrsound of uterus and adnexa to find out any cause of amenorrhoea. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will Miralex, diarrhoea, vomiting make the Evra patch less effective?\n\ndoes the patch still be effective when it got very wrinkles and water gets into the wrinkles edge when showering? Would Miralax make the Evra patch less effective? I heard that if we have diarrhea while on the pill it would flush out the pill, but since the patch goes straight to the bloodstream, then does it mean I m still protected if throwing up or have diarrhea? Can I place the patch on my thigh in the back (under the buttock) and front?",
    "doctor_response": "the patch should be placed on your lower abdomen, chest (not breast), arm, upper back, or buttocks.  the thigh is not one of the approved places, so it may not work.you are correct that since it is not absorbed in the digestive tract, that diarrhea and miralax will not change it's' effectiveness.as long as it is still sticking on your skin it will work, but if the water washes it off you should replace it.I hope this answers your question, please let me know if you have any more questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high level of potassium in the blood?\n\nMy family doctor called and told me that my blood work came back and that my potassium level was high and that she wants me to go to the hospital to have blood taken at the lab there cause she will get the test back faster. What can make my potassium high and what can i do to make it go low.",
    "doctor_response": "Hello, Thnx to contact us. If I am your treating doctor I would like to advice you that having high pottasium is termed as hyperkalemia. There are many causes of hyperkalemia like: drug, addisons disease. excessive intake, redistribution of electrolyte, diabetic ketoacidosis. Because of lack of history in your question I am not able to answer the exact cause of your disease. In treatment part you should not take pottasium sparing drug, avoid food rich in pottasium, use resins which absorbs the pottasium from circulation, in severe cases there is requirement of dialysis. If you have anything else to ask please contact me. Thanx. Dr. Arun Tank",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in right side of the jaw?\n\nThe right side of my jaw hurts.  I can open my mouth and close it without too much pain but on the right side when I try to close it I'm not able to have the back of my teeth touch.  Left side is fine.  What could cause this and it's been like this for about a week?",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concern..As per your complain pain in jaw along with difficulty in occluding the teeth can be due related to jaw joint also known as Temporomandibular joint..There can be dislocation of the mandible leading to disturbed occlusion [relation between upper and lower teeth] leading to difficulty in touching the teeth..I would suggest you to consult an Oral Physician and get evaluated and a thorough clinical evaluation can be diagnostic and treatment can be planned accordingly..The phyician can advise you occlusal splints, mouth guards and also muscle relaxants, painkillers and physiotherapy for improvement..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for dizziness & nausea caused by chlorine\n\nI inhaled chlorine gas while closing my pool. I inhaled into my lungs ang i believe also into my sinises. My symptoms are mild nausea and equlibrium problems. My head ie my sinus area is bothering me. A mild headache. The dizziness is my major symptom. This happenned two weeks ago and will not go away",
    "doctor_response": "thanks for asking your questionI completely understand your problemchlorine poisoning is life threatening.if you have symptoms like dizziness ,breathlessness, headache. you should consult a pulmonologist who can get a chest xray and other blood investigations to diagnose chlorine poisoning features. Respiratory symptoms include difficulty breathing and fluid in the lungs. Digestive system symptoms include burning in the mouth, swelling of the throat, throat pain, stomach pain, vomiting, and blood in the stool.so don't panic it seems like a mild poisoning.thanks/regardsfeel free to ask more questionsmay god bless you with good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes green colored stools in a 5 month old?\n\nhi my baby is 5months n 2weeks old.since last month she is passing green stool.im taking iron pills tardeforn n my baby doctor has suggested to give her iron sterology 2drops a days.im nt giving her any soilod only breastfeed.she pass stool in evry daiper in morning its colour is dark brown then whole day green colour wot i do?",
    "doctor_response": "Hi.... I have the baby is only exclusively breastfed and nath bottle fed, unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heaviness in arm and elevated bp?\n\nIt feels as thought the bottom half of my left arm is heavy. A few days ago my right arm and both legs felt the same way. Went to urgent care last night. My BP was slightly elevated . They think it was stress. I went through a battery of normal tests - walking, sensitivity, breathing, eyes, ears, mouth. I am overweight. 5 8 and 280, but have been actively working out. Used to be 290 or more.",
    "doctor_response": "Hello,This is could be cervical problems. Still we need to rule out the heart disease. You should get one treadmill test done. I would also advise for cervical spine x-ray ap/lat view and nerve conduction studies. After confirming the diagnosis, we would go for treatment.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with inflammatory disease and noticed a hard lump on arm and elbow\n\nI have an undiagnosed inflammatory disease = 8 months now My spine burns up to 5 or 6 days at a time, and I become too exhausted to know what I am doing. Now, I have a small, hard lump on my arm under the elbow = the burning of my back and spine just consumes almost every day of the week. I cannot see a rheumatologist for a month and a half.",
    "doctor_response": "Hi and welcome to HCm. Thanks for the query. Well you should do ultrasound and xray to verify what kind of lesion is this lump. it ca be related to your primary disease but also it can be something else. Most commonly we see ganglion cysts,bursitis or bone exsostosis. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can chemotherapy reduce the size of a ganglion near the carotid?\n\nMy husband was treated last year  for CA base tongue stage 4, his tongue is clear but he has now had 2 of 3 sessions of Al Saraff chemotherapy, the 3rd has been postponed as he needs to build himself up. The specialist advises there is no tumour in the lymph gland but he has a ganglion which currently makes surgery high risk due to its proximity to the carotid.He says this needs reduced before surgery is an option. Can chemoptherapy reduce this sufficiently?If it is not an option what would a treatment plan be?Also he has mucositis which impacts on his eating, how long does it last?MALE 67 years  8ST",
    "doctor_response": "3 cycles of chemotherapy needs to be given followed by pet scan.mucositis lasts for 1 week.RegardsDr DeI",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause a pimple inside the mouth with pus in it?\n\nI have an area on the lower rt side of my mouth that had a pus pocket,it would drain if I applied pressure to it-then it wouldn't drain anymore but it is very sore & my gums' color has changed. I don't have any teeth in the back where this going on at but I am worried about it. Medicaid will not pay for work because I am over 21 yrs old. Please any advice Doc? In pain in Ga.",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,     I have gone through your query, as you have mentioned that you have pus pocket, dont worry it is not pimple it is sinus opening from that pus drains , as you said you dont have discolored teeth , pus can be due to periodontal Abscess also ,      You should go to dentist and go for Intra Oral Periapical m Radiograph and it is is not due to Carious tooth then go for Scaling and Root planning and Currettage, if it is due Caries then it is Periapical Abscess go for Root canal treatment done ,      Do warm saline gargle two - three times a day      Hope this will help you.   Wish you good Health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. MRI shows 'intermediate signal intensity lesion in endometrial cavity. ' What is it?\n\nHello doctor,My mother aged 55 years got an MRI with an observation of 'intermediate signal intensity lesion noted in the endometrial cavity measuring 19x28x24, in the fundal body region with loss of endometrial interface. Tethering of sigmoid colon with distal ileal loops to the uterus in fundus region.'",
    "doctor_response": "Hello. With this report, there is a possibility of malignancy. Cancer of the uterus is more likely. Do CA 125 level, CT scan abdomen and pelvis, X-ray, sonography, PET scan and consult a gynecologist near you and also take an opinion from an oncosurgeon. Doctors will do other routine investigations also like LFT, RFT, hemogram, HIV, Au-Ag, blood group, 2D echo, ECG. All this is to be done and consultation along with clinical examination required for deciding further management of this if to directly go for surgery or not. In that case, the best option is chemotherapy or radiotherapy. But yes, you need to take steps on an urgent basis if the MRI report is like this and you suspect malignancy with some changes. I do not want to over exaggerate this but malignancy can grow way faster than you imagine. The final diagnosis will be after sending for biopsy or HPE (histopathological examination). I do not know why you have done the MRI and what complaints she has, but whatever it is, if this is what the report says, then the above things should be done as soon as possible. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Constant broodiness, difficulty in taking decisions. How can I fix this?\n\nhai. i m a student of age 22.actually maximum time i always stay in a unminded condion.i always feel that i m soo..deeply busy in me. some times when i see myself i can t believe that its me. don t know why.i can t able 2 take decision of mine.when some one saw me he thought that i m thinking. 4 that i feel soo... sad. can u help me",
    "doctor_response": "Hello, Thanks for choosing health care magic for posting your query. From the description that you have given, there could be various possibilities of what might be wrong with you. It could be any where between a personality disorder or a brief depressive episode. But it will be too early to comment on unless we know some more details from you. You need to visit a nearby psychiatrist who can guide you about your problems. Hope I have answered your query. I will be more than happy to help you if you need any further clarifications. In case if you want to discuss with me directly you can use the link:  Wish you a good health!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hay fever\n\nHi, a couple of weeks ago I had a really sore throat, like swallowing razor blades. I went on a course of antibiotics. Which took 10 days. But a few days after I cleaned my house and was sneezing all day, then I haven t stopped all week, So I figured it might be hay fever, even my voice is really deep but throat feels ok. But now my ear is blocked, I cant hear very well and it hurts when I burp or sneeze. I so need a doctor eh.cheers Jen",
    "doctor_response": "Hello,Welcome to HCM,Your history suggest of allergic manifestations.Your symptoms can be relieved by1. Corticosteroid nasal sprays and drops2. Nasal decongestants3. Eye drops4. Immunotherapy: It is a important mode of treatment. In this allergen responsible for your symptoms can be identified by Prick test. After identifying the allergen it will be easy for treatment. But this requires some time and should be done in different sittings. By advice for you is you undergo skin prick test and identify the allergen and then you can receive either Sub lingual Immunotherapy (SLIT) or Sub Cutaneous Immunotherapy (SCIT).Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for severe cold and stuffy nose\n\nI had a severe cold in early november,which apparently didn't go away entirely, and now Ive been coughing for the past three weeks. there's a tickling in my throat, I also have to constantly clear it for mucus that seems to be stuck there,and added to that now is the chest discomfort i feel because it seems like my nose has closed up  especially when lying down. I really need some help .",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have  severe cold and stuffy nose and chest discomfort which is due to upper respiratory tract infection which is leading to sinusitis as well. Need not to worry. I would suggest you to avoid intake of cold liquids. You should take green tea every morning. You should take antibiotic Ciprofloxacin and antihistamine Levocetrizine for 3-4 days. Avoid intake of excessive oily, fried and spicy food. You should do warm saline gargles on daily basis and take steam inhalation as well. Visit ENT specialist once if symptoms keeps on persisting and get blood tests and X-ray chest done and start treatment after proper diagnosis. Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes gagging in babies?\n\nHi, I was talking with my daughter-in-law today about my 3 week old grandson.  She said that there are times when he acts as if he is gagging (she said it's like he is dry heaving), and it is usually not when he is eating.  She said it just happens every once in a while.  I told her to tell her pediatrician at the baby's next appointment.  Is it something she should call about sooner?",
    "doctor_response": "Hi, its common in small babies and no need to worry if it is not associated withany difficulty in feeds/breathing.Just you can take avideo and show to your pediatrician on a routine visit",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have Spinal Stenosis, spurs, high BP and back pain. Mother had cancer. Related?\n\nI have ms fibro.. spinal stenosis ,spurs,frequent shingles ,high blood preasure last yr when never b4.. always great bp ... my momther just died recently of cancer ... im scared to go to dr.. another system not sure if related.. My back always hurts after I eat sooo i try to only eat near bedtime so i can lay down... Im scared of cancer.. please help me",
    "doctor_response": "Hi there, I understand losing your mother has been very traumatic for you. Rather than giving in to the feeling of hopelessness, try to visit cancer support groups or survivor meetings and volunteer in hospitals and try to help the people who need help. Small things like even giving directions and chatting people up can make a huge difference. I'm sure your experience will make you wise and sensitive and you can help plenty of people out there with your sensitivity.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the red line going up towards the calf post heel injury?\n\nMy boyfriend was out swimming in a creek and he hit his heel on a rock. It was only a baby gash nothing serious. That was about a week ago. It has since scabbed over and looks like a normal sore, but it has a squiggly red line going up towards his calf now. What does that mean?",
    "doctor_response": "Hello, The red line going up could be an inflamed lymph vessel or a vein. Maybe due to an infective process setting in. The exact cause can be determined only after clinical examination and investigations. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Nirmal Chander Gupta, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chronic sinusitis, high BP. Which decongestant can I safely use?\n\nI suffer with chronic sinus infections and also have high blood pressure ...most decongestants have a warning of not to use them if you have high blood pressure, so my question is what can i use instead of? I take avalide. Is there a decongestant that you can use? my doctor suggested Benadryl allergy tablets. I have used Advil Cold and Sinus before and it seems to work the best, but how safe it that? This whole situation causes alot of anxiety on my part as with this whole sinus thing I sometimes have a hard time breathing. Any suggestions?",
    "doctor_response": "please go with your doctor and please take benadry allergy tablet.and if you have severe anxiety,please take tab.alprazolam 0.25mg when you need..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any cure for low potassium levels and its symptoms?\n\nMy wife just had a very serious bout from low pottassium in hospital for 4 days.want to know what the long term effects from this can be.She still gets tire very easy and recently been having erratic heart beats.Could this be from her bout from low pottasium and is there a cure for this problem or a specialist that you could recommend,thanks",
    "doctor_response": "Hello and welcome to HCM,Low potassium results from various causes like vomiting, diarrhea, or any other cause of loos of fluids from body.First of all the cause for loss of potassium from body has to be found out.You need to consult your primary healthcare provider or your physician for clinical assessment and to find the cause of potassium loss from the body.Low potassium is known to have a deleterious effect on the heart thus, erratic heart beats that your wife is experiencing is probably due to low potassium levels.Correction of blood potassium levels will correct the potassium levels.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "I felt a strange feeling in my left arm, could this be serious ?\n\n1)When reaching the age of 74 years old, should one stop having a pap smear? 2) In July 09, i was on vacation and we were having dinner, i felt a strange feeling in my left arm.. not pain but numbness from my elbow to my upper arm, my shoulder. the next morning i had swollen ankles. i contacted my docotr in philadelphia pa i was visiting in maryland. the nurse returned my call and told me to get to the nearest hospital in doing so the doctor ordered an ekg and quickly admitted me to ccu unit. i was told that i did not have an attack that i had afibrillation. that my heart was beating so fast that it was about to be dangerous. i remained in the hospital for 7-8 days. i am now on walfarin daily. upon discharge from the hospital the swelling had subsided but the numbness remains in my left arm. i spoke with my doctor several times i have yet to recieve a satisfactory answer . my question is to you, could this be serious ? there is no pain but the numbness is still there and sometimes my arm feels veryheavy",
    "doctor_response": "Hi, the numbness may not be related to cardiac problem . Numbness limited to upper arm of one limb only may be due to some pressure effect or stretching of the arm for some prolonged time . please discuss with your doctor and get investigations that may help. x-ray cervical spine may be help full  to rule out cervical spondylosis or sponylitis. Hope you remain in good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat constant back pain?\n\nsir,I am having constant pain at my back. I had done test and Xray there is no sign of any problem Slowly this pain is transcending from back to neck. I cant sit and do any thing for more than 15 minutes, It seems as if somebody has put ah heavy weight on my back. This pain is basically on upper back and when i sit straight than again i feel the pain in my bones.",
    "doctor_response": "Hi thanks for choosing HCMin my opinion you are suffering from either muscle spam due to incorrect posture you may be assuming while working or PIVD prolapse inter vertebral disc diseasefirstly try with keeping a right posture and gaitand do some stretching exercises you can also take  tab diclofenac and tab chlorzoxazone for symptomatic relief If it doesn't relieve go for an MRI and consult your doctor hope this information will help you best of healthRegardsDr BR Hudda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes objective vertigo?\n\nI have severe objective vertigo. It only happens periodically and only when i wake up from sleeping. It's getting worse as i get older it seems. I'm a 22 year old female, when i get it the entire room is spinning. When the spinning finally stops I have to have my fiance carry me to the bathroom or crawl to the bathroom and I vomit until i feel like my feet are going to come through my mouth. Sometimes when I'm done spinning I feel exhausted and can't keep my eyes open and then when i wake back up the vertigo happens all over again. I've seen several doctors but nobody has the slightest clue what is going on. They all seem to think it has something to do with my ears but my ears check out fine everytime. Also the sick slightly dizzy feeling can last for up to a full day. Can you help?",
    "doctor_response": "Hello dear,The symptoms as mentioned in your post can be attributed to pathology in the Vestibular Apparatus in inner ear (it is associated with maintenance of body posture & balance) most probably Labyrinthitis or Benign Paroxysmal Positional Vertigo.Symptomatic relief can be obtained with intake of Vestibular sedatives like Betahistine or Cinnarizine preparations (to be taken only under the guidance of a Physician).If it still persists, then you need to consult your Physician/ ENT Specialist & get a complete clinical examination done.Investigations like estimation of blood pressure, blood sugar levels, serum electrolytes & vestibular function tests will be required to rule out any pathological cause for the symptoms.There is no need to worry, you will be fine.Till then, maintain adequate hydration & proper nutrition status and avoid stress.And also take precautions of getting up from bed slowly & avoid sudden head movements.Wishing you a Good Health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heat boils on penis and testicles?\n\ni am getting some heat boils from few days on my penis n testicals is it due to summer or is it due to my daily workout in da gym and never masturbating? ? i masturbated last about a month ago plzzz help me",
    "doctor_response": "Hello, As per your history, it may be due to heat boils. For that you can apply neosporin powder locally. Maintain proper hygiene. Avoid sweating. Avoid hot and humid environment. You may require antibiotics in case of fever. Take tablet acetaminophen for pain. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from Restless Body Syndrome, depression, sleeplessness, suicidal tendency. Suggestions?\n\nhi Doc. I am suffering with RLS from last 5 years and from last few days with Restless Body Syndrome . few days before I consulted with Physchiatrist regarding depression and sleep less night problem and wrote Zoltafreshand Nexito ls. I can now sleep now but started to suffer with Restless Body Syndrome. and still suffering with depression. I dont want to talk to anyone. I want to live alone and sometimes thought of sucide comes in my mind. I also sometimes get so depressed that I want to leave everything and to go to some holyplace without carrying anything...pls suggest.",
    "doctor_response": "Hello and welcome to Healthcare Magic. Thanks for your query. I understand that you are going through a difficult time. Anti-depressants usually take a few weeks to bring out their full therapeutic effect. In the initial few days, sometimes, side effects may be more prominent that the benefits. Most side effects are temporary and self-limiting. So, please be patient till your medication takes full effect. If your RLS is severe, then you can report this to your psychiatrist and discuss other treatment options. Wish you all the best. - Dr. Jonas Sundarakumar Consultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chronic liver disease, infections since childhood, addicted to snuff. Will snuff weaken the effectiveness of antibiotics?\n\nMy son was born with Bilary Atresia. He is now 22, and we were told that before he started school, probably by the time he was 2, he would need a liver transplant. When he was 13 days old, they did a surgery called a Kasai procedure to buy him time. He has been hospitalized over 50 times since birth with infections of the liver, but IV antibiotics both in and out of the hospital plus a lot of prayer has allowed his liver functions to return to almost normal. Now that he is older and wants to be out on his own, but still lives with us, we try to allowing him to make his own decisions about his health, but the compliant boy while he was growing up is no longer. The many thing that has me concerned is that he takes his health in a way that would suggest that nobody is going to tell him what to do even if it does mean what he does will damage the liver more. He is totally addicted to snuff. We used to have fun watching tv together. He and I love the same kind of humor. Now, he is doing his own IVs and he is on them now, but very jaundiced and the other liver functions are not coming down as quickly as they used to. He knows he s not allowed to have the snuff around us, so he spends most of his time in his room and I know he must dip it there. I can t read his mind, but being his mom, I feel sure he must be thinking that he might as well enjoy what he wants because he might not live a full life span and he knows where he is going when he dies. He has tried to quit. He said he was going to quit for Mother s Day. LIke any addict s promises, that didn t happen and he says he won t be comfortable going to an addictions meeting at our church...and he just loves our Pastor. My question is this. Even though I know that the snuff will ultimately make his liver worse, would you say that right now the snuff could be weakening the effectiveness of the antibiotics and that s why it s taking him so much longer to get better. When he was little, after a few doses of antibiotics we could see him becoming less jaundiced before he even left the hospital.",
    "doctor_response": "Hello. Welcome to hcm. Snuff is a tobacco taken by nose. It is just a alternative of smoking. Though effects to lung are not present,the tar wil be absorbed in the body causing varied effects. There is little research on effects of snuff on systems of our body,it cannot be positively ruled out that it causes decreased response to antibiotics. If liver transplant was done,then your might have normal life span and he needs to be motivated to make his life more meaningful. I advice you to make him stop this habit as precaution is better than finding a cure. You can try again for de addiction centres as many addicts once shying away from these centres, wil like it when they feel they are accepted by its members. All the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for child suffering from asthma\n\nhi doctor, my son is 6yrs old.and from birth he has problem of coughing. doctor is saying that he has asthma from two yrs he is taking inhaler seroflo and asthalin (during cough)but still the problem is not cure,every month he has tremendous cough.pls suggest me something",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Greetings from Chennai.By what you quote I feel what your kid could be having asthma. I have a few questions for you -Questions:1. How many days per month does your kid cough or feel breathless?2. How many nights per month does your kid's sleep get disturbed due to above symptoms?3. Does your kid feel breathless when running around or playing with other kids?4. Are the symptoms when there are seasonal changes?5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?6. Is the cough always associated with fever?7. Are you using a spacer for the metered dose inhaler?8. Has the technique of administration of metered dose inhaler through spacer been taught to you?You can approach me at the following link.Once the page opens there will be an option below my image as \u2013 ASK ME A QUESTION \u2013 click on it.Please find the link below -www.yyyyyyyyyyyyyy.cyy/yyyyyyyy/dr-yyyyyyyy-yyyyyyyyyy/000000yyyyyyyyy - Dr. yyyyyyyy",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for mitral valve regurgitation?\n\ni recently was diagnosed with mitral valve regurgitation from being evaluated during a stress test and echocardiagram at the same time.  The only symptom I have is when I am excited I urinate frequently and every once in awhile I have rapid heartbeat.  I am 62 years old and I am scared to do the next test where they speed up your heart with an injection and monitor my heart can you tell me something that will ease my mind",
    "doctor_response": "hi, the treatment of mitral regurgitation(MR) depends mainly on the symptoms of patient like breathlessness or easy fatiguability and on the 2 d echo. of 2 d echo reveals decrease in lvef , then surgery is indicated. however if the MR is mild to moderate then usually patients are followed on medical management with 2 d echo done every 6- 12 months for close follow up.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dyslexia and ADHD in a child\n\nI have a seven-year-old daughter already diagnosed with ADHD and learning disabilities, specifically dyslexia. She is on an IEP at school and we are at a point where we are considering medications as behavioral  I have a seven-year-old daughter already diagnosed with ADHD and learning disabilities, specifically dyslexia. She is on an IEP at school and we are at a point where we are considering medications as behavioral approaches have not done enough to help her in school. What type of physician beyond her regular pediatrician would you recommend we see  for further outside the school of valuation, assessment, and potential medication management. Our physician gave us the name of three potential doctors all with different fields.",
    "doctor_response": "Hello thanks for asking from Health Care Magic for your health related queriesI can understand your concern. She has been diagnosed with ADHD and have learning disabilities. She is already on behavioural management and IEP in school but there is no significant benefit. In such case you should consider consulting a psychiatrist preferably a child psychiatrist for her management. In ADHD medicines like Attenterol, Amphetamines or some times low dose antipsychotics as Risperidone etc can help to reduce her symptoms of abnormal behaviour and will help in focus. These medicines will reduce the symptoms of inattention and impulsivity which are main findings in ADHD. Visit a psychiatrist for details of the treatment. Thanks, I hope this helps you. Take careDr. Seikhoo Bishnoi,Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic back pain\n\nHlw Sir, iam sruthi, iam suffering from back pain since 6 months. i ll get pain when i sit or liying on bed for a long time. while walking for a long tym i feel pain on my left lower limb. doctor diagnosed as mild IVDP at L4-L5 level, by seeing the ct images. how can i get recovery from this.",
    "doctor_response": "**1. You can use over the counter [OTC] anti inflammatory drugs along with physiotherapy,stretching exercise. 2. Maintain straight back posture while standing or sitting. Avoid bending forward and lifting heavy weight. Sleep on hard mattress. gentle massage with rubefacient ointments.. Lumbosacral belt to support the spine and prevent bending.PS. If there is shooting pain it may require pelvic traction, epidural injections, myelography or surgery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cramps and numbness on the inner thighs during nights?\n\nAge 22 (turning 23). Weight = about 140 . Height 5 6. I noticed that I was getting uti symptoms so I just drank cranberry juice and it would temporarily go away. But this happened about a month ago. I just got on the pill 6 months ago and I stopped this month. I started feeling a slight cramp on my right inner thigh but I ignored it. I slowly started feeling this cramp more and I realized that I felt better as soon as I got under blankets and got warm. But a few days ago I started feeling the cramp spread and my legs go numb (I was on my period). I also felt a slight burn when I peed before my period, but it went away while on my period. This leg pain only happens at night time. I m not sure what is wrong with me. It takes me so long to get warm and my feet are always freezing. I m not on my period now but I did continue to feel the leg pain at night. I also feel some hip pain. I started taking vitamins and ampicilin. I m not sure if it is working ... I m scared. I started taking ampicilin because I finally told my mom about how I had felt a burning sensation when I peed after my period was finally over. I guess I had just been dealing with the burning feeling. It did go away tho in the last month and come back ... I would drink water with baking soda and so maybe it helped. But since it came back, I took ampicilin. I only took the medicine for a day and not for the next day...But then the NEXT day, I woke up and peed only to find LOTS of bubbles in my pee. I m starting to think maybe my leg pain is connected to my uti symptoms. I m not sure what to do...I took the medicine today and I don t have pain at the moment but I do feel my legs cold and my feet freezing. HELP please",
    "doctor_response": "Hello,Your symptoms seem to be related to muscle cramps. I suggest using muscle relaxant such as Baclofen three times a day. I also suggest magnesium supplements. Warm compresses can also be helpful. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to keep liver healthy?\n\nIS there a safe product that will help make sure my liver is healthy? I have IDC Breast cancer and have finished with Chemo and RADS and am taking exemestane anti estrogen meds for the next five or ten years. I have put on 30 pounds since being thrown into menopause which I was no way even near! All around my middle. I was healthy really active prior to this and now suffer from severe joint and bone pain from the meds. My liver test are normal but I can\u02bbt help think this is somewhat related..I look like a totally different person now. Perhaps its my liver?",
    "doctor_response": "hi.noted history of invasive ductal carcinoma of the breast s/p chemoradiation therapy. bone, lungs and liver are the most common site of distant metastasis from breast cancer, hence, the need for regular follow-up and surveillance screening after breast surgery. if you are experiencing any symptoms related to these organ systems, it is best if you do a follow-up consult with your medical oncologist or your general surgeon, for physical examination and clinical evaluation. diagnostics (such as bone scan, chest xray, ultrasound, etc.) and management will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the toe stung by a bee be a matter of concern?\n\nHi, I take 50mg ER metoprolol and was stung by a bee yesterday on my toe.  Do I need to be concerned of any side effects?  The toe is very swollen and hurts and itches, other than that, there don't seem to be any other effects right now.",
    "doctor_response": "Hi, Thanks for posting in HCM. I understand your concern. Ordinary bee stings that do not cause much of an allergic reaction. Multiple stings or an allergic reaction, on the other hand, can be a medical emergency that requires immediate treatment. In your case, kindly wash the area with soap and water, and apply cold compresses or ice pack.For pain, you need to take an over-the-counter painkiller like Ibuprofen.For itchiness, take an antihistamine like Levocetrizine. You can also apply a mixture of baking soda and water or calamine lotion on the lesion to reduce the swelling. Avoid scratching the sting area. This will worsen itching and swelling, and increase your risk of infection. Gradually, your symptoms should subside and you should be better. There are no side effects associated with bee sting and taking medication such as Metoprolol. Hope the information provided would be helpful. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can cyst and uterine line thickening get converted into endometrium hyperplasia and cancer?\n\nHi I'm a 27 200 pd female with diabetes and when I went to get an ultrasound with my obgyn she found I had a thick uterine lining of 16 mm and a cyst of 2 mm .. I have been spotting in between periods and irregular periods .. I read about endometrium hyperplasia and read it can be cancer too .. Should I be concerned?",
    "doctor_response": "Hi, yes endometrial hyperplasia can be one of the signs of endometrial cancer. But since you are in ur twenties, and  having irreular periods, get your pregnancy scan done and if need be there, get dilatation and curettage done to check for histopathology.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be the reason for abdominal pain and nausea?\n\nWent to dr two weeks ago for upper left abdomial pain and persistent nausea. She thought possible gastritis,gave me omeperazole and said come back in two weeks. Pain fluctuates in times and in level. I have no gallbladder or appendix. No fever just chills and light headedness. I am 29 female otherwise healthy...",
    "doctor_response": "Hi. I would take this as a case of gastroenteritis, because you have chills and light headedness too.A course of an antibiotic like cefixime should solve your problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medication for fever of about 95F & cough\n\nhi my daughter has fever 95 f and she has cough with sound and her nose is running .while coughing she has problem breathing feels as if she is gonna vomit.v consulted a doctor and he told us to give her brikanyl syrup ,montain kid tabblet and coscopin.plz help",
    "doctor_response": "HI 95f is not a fever.We consider as fever if above 99f ONLY.Continue the medications advised and give plenty of fluids,steam inhalation to your kid to relieve the symptoms and she will get better soon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the lower back with frequent urination?\n\nI have had right lower back pain since Friday. I went to the er on Sunday and they said I had passed a stone and that I was bruised from the stone that s why I was having pain. Yesterday pain seemed to go away but today it s worse then Sunday!! I have frequent uranation and my pee is cloudy.",
    "doctor_response": "Hi, welcome to health care magic. After going through your problem my opinion is that you are suffering frpm uti associated with renal stone. Take analgesics, antibiotics, increase water intake. Visit urologist and have an usg whole abdomen done. Hope your query get solved.welcome for further queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of vertigo?\n\nI am 42 years old. I have been experiencing vertigo for more than a year now. My main concern is that for the fast 4 months or so, when I stand up or even turn my head a certain way my eyes cross for several seconds and I see black spots. What could be causing this?",
    "doctor_response": "HIThanks for using healthcare magicI think, you have nystagmus and that could be the reason in your case. You should consult a ophthalmologist for proper eye check up. That would help to find out the cause. In case, you need any medication, you can try amitriptyline after physician or ophthalmologist consultation. If you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is swollen node under the chin a symptom of HIV?\n\nHello doctor,I had unprotected oral sex with a bar pickup girl six months ago. She sucked my cock for about 10 minutes without a condom. I had only this exposure. After that, I ejaculated outside in my bed. I did not ejaculate in her mouth. After this incident, I was a little tensed. I waited for 60 days and got tested. I am fine as of now. I tested negative at 60 days after exposure with CMIA method. I also tested negative for western blot at 60 days. I also tested not detected with HIV PCR RNA after 65 days. Off late, I am feeling an inconvenience under my chin. I have probably developed a swollen node under the chin. Is it a symptom of HIV? Is it any kind of infection? Do I need further testing? Am I am at risk?",
    "doctor_response": "Hello. I have noted your concern. Your tests are conclusive. Most of the HIV infected will have a positive test by three to four weeks. Since you have negative tests even after eight weeks, therefore it is reliable. There is no need for further tests. Moreover, oral sex is a low risk for HIV as compared to unprotected vaginal or anal sex. Swollen neck lymph nodes could be due to another cause - perhaps a sore throat. Regards. For more information consult an HIV AIDS specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is the PEP regimen given to me for condom breakage during sex correct?\n\nHello doctor,I was having sexual intercourse with a sex worker when the condom broke. I was distraught so I ran to a hospital and they started my first dose of PEP after 12 hours of exposure. The regimen given to me for 28 days is Lamuvidine plus Tenofovir and Lopinavir and Ritonavir. Is this regimen right? I talked to another doctor and he told this is basic PEP and not of much help. He also prescribed PEP.",
    "doctor_response": "Hi. As per my experience, the regimen you are taking is fine. The only drawback is that it may be causing some more side effects like nausea, vomiting, headache, weakness, etc, and hence it is more difficult to take the one your practitioner has advised. You can continue with the PEP (post-exposure prophylaxis) you are already taking and need not stop and start another one as discontinuing it may do more harm than good. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of bump on my forehead?\n\n1 month ago, I bumped my forehead against a door; I failed to put ice on it due to time constraints.   The bump (about the size of a pea to a chick pea, is not going down.  When I move the skin above the bump, the bump \"moves with it\", so it does not appear to be on the bone/skull; rather it appears to be within the skin.  Will the swelling go down if I apply ice to it now, even though it is 4 weeks later?  Could it be something like a subcutaneous cyst, etc.?",
    "doctor_response": "Hi,It seems that there might be hematoma formation due to injury and now hematoma is encapsulated producing localized lump formation.Apply ice pack 2-3 times a day for few days.Gradually it will be absorbed.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause and treatment for dyskinesia?\n\nwhat causes dyskinesia?  How is it treated can it be cured.  Are there other conditions that could have the same system or similar. I have been told many time my head is moving back an forth but I can not feel it moving I have absolutely no awareness of it happening. .   I can not understand how this is possible. I have worked with individuals who have moderate/severe disabilities and I guarantee you they most certainly are aware their body's motion.Thank you for taking you time to help me learn what I will be dealing with.",
    "doctor_response": "The cause of dyskinesia are multiple. Currently the most common cause of dyskinesia is use of certain kind of antipsychotics (typical like haloperidol). The other causer are disturbance of certain neurotransmitters in basal ganglia region of brain. They can occur in variety of neurological disorders like parkinson disease.he treatment of dyskinesia depends on the cause and once you know the cause it can be treated easily. If you are taking any antipsychotic than you need to talk to your doctor for changing/reducing the dose of used drug.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Left face, tooth severe pain, swelling, migraine. Amoxicillin given for tooth infection. Normal?\n\nI went in to get a root canal on number fifteen tooth two days ago but the dentist wasn't able to finish because he said I had an infection that continued to drain. He gave me some pain medication and amoxicillin. It's been two days and now the left side of my face is in severe pain. I  having very bad left temple migraine my left eye, ear, nostril, and throat feel blocked and I have severe pain in my tooth and all the teeth on my upper and lower mouth on lefty side. I have some external swelling but I feel a lot more swollen than I look. My heart also feels like its racing. Is this normal or did the infection get opened and spread. My dentist is closed due to the weekend but I spoke with them and they said if it gets any worse than go to the er and get hooked up to an Iv with antibiotics bc it's dangerous. What could happen if I don't. Am I in danger",
    "doctor_response": "your painkiller reacted sometimes pcm in painkiller causes thisi think stop all exceppt amoxycillincan take short course of steroius stary with 40 mg od to yaper in next 10 daysas your codition recomendsapply kenacort mouth gel over the swelling area tdscan take liquid antaid tdschange painkiller can takenaproxyn sos as there are less allergy with it",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do pregnancy symptoms and negative test results indicate?\n\nHello, so feb 18 i had unprotected sex 6 days later i got my period (my cycle is about 21-24 days long but very irregular). I had unprotected sex on feb 26 (day after my period), march 10, and 12. today is march 15 and i took a pregnancy test and it came out negative. I feel sick quite a bit, i feel rather bloated, my breasts have slightly enlarged, what i would really like to know is if you think i am pregnant",
    "doctor_response": "Hello, and I hope I can help you today.If you are having unprotected sex, there is always a possibility you can become pregnant.However, pregnancy symptoms can vary a lot between women, and even the stress of worrying about pregnancy can make your menstrual cycle irregular. And breast tenderness, feeling bloated and tired can all be premenstrual symptoms.The only way to be sure if you are pregnant is to wait for your period to come, and if it does not on time, take a pregnancy test.  It will not become positive until at least 3 weeks after conception.I hope I was able to adequately answer your question today and that this information was helpful. Best wishes, Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back discomfort post spinal bracing\n\nHi My fianc\u00e9 had spine surgery and they did all 6 or 7 at one time . I believe he has 6 plates between the bones .. he has. It been able to sleep due to the discomfort of the brace . The dr said he must wear it to sleep but I have been reading up on it and most people take it off when sleeping . What should we do?",
    "doctor_response": "Hi, In my opinion, if the surgery was successful, the brace could be taken off during sleep. However, this should be confirmed by the treating Doctor. You should discuss with him about the discomfort that the brace causes during the sleep. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can dentures be made to be fitted without any supporting teeth inside?\n\nMY TEETHS ARE IN VERY POOR STATE , MOST OF THEM HAS BEEN FALLEN AND SOME ARE ABOUT TO FALL . FRONT TEETH HAVE BEEN EXTRACTED AND REPLACED BY ARTIFICIAL TEETH . MY PROBLEM IS THAT THE TEETH WHICH ARE SUPPORTING TO THE DENTURE ARE ABOUT TO FALL . IS THERE ANY SYSTEM TO PREPARE A DENTURE WITHOUT ANY SUPPORTING TOOTH ? IS THERE ANY SYSTEM THAT SUCH DENTURE CAN BE REPLACED ON THE SAME DAY OF REMAINING TEEH EXTRACTION ?",
    "doctor_response": "Thanks for using Health Care magic.Read your query.Poor oral hygiene and improper maintenance along with any systemic conditions like diabetes will be the probable cause for the early loss of teeth.Periodontal disease causes bone to be lost there's so little support for the teeth that they have to be removed.Yes, dentures can be immediately placed following the extraction of the teeth.I would advice you to consult a good prosthodontist and have a immediate denture done.Maintain it well and get back your confidence.Hope this was useful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How should kidney failure with stones be treated now?\n\nhi my name is kimberly wallace and I was at roseville sutter hospital on (9-08 -2014 they said my right kidney shutdown and placed a nephrostimy tube in my right kidney also they stated that i have a 7mm kidney stone ive done all that I can do to find a dr. that would help me . my pcp has now told me that my only choice left is to go back to roseville to have it removed I dont want toxic shock agian what do i do? Please help",
    "doctor_response": "Hello Kimberly and welcome to HCM.Your question doesn't say anything about the Left kidney.A 7mm kidney stone is not a problem at all to cause any worry or lead to kidney failure.As an Urologist, i've treated so many patients over the years with much larger stones, with endoscopy only,lithotripsy or laser.Please send the report of your U/S scan,blood creatinine, urea, uric acid, sodium-Na,K-potassium,and anymore tests done.You can contact me by name for an expert opinion.Dr.Matthew Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have fibromyalgia, seizures. Taking Keppra for pain and hot flashes. Suggestion?\n\nI read the question and comments from NanCcan about having pain waves followed by hot flashes. I have the exact same thing since July of 2010. I have fibromyalgia and just recently have had 2 seizures. I am on Keppra which has reduced the pain waves but not all nor reduced the intensity of the pain. I get them all day and they wake me up at night. I can t get my doctor to believe me. I lost my commercial driving job due to the seizures so I now have no income or insurance and my doctor keeps telling SSD that I m not disabled so he is making it impossible to get assistance. anyway. does anyone have a diagnosis for these pain waves or a better medical term? Something I just realized I forgot to add is that I was on Depo-Provera shots for 11 (eleven) years and stopped in 2007 when I had a hysterectomy.",
    "doctor_response": "Hello. Thanks for writing to us. The pain waves that you are feeling are a part of fibromyalgia. If the pain waves are debilitating then you need to consult a pain specialist for the proper management.I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal ,drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for extensive tearing of the labrum\n\ni have been suffering from chronic hip pain for 2 years. 4 weeks ago I had an MRI of my left hip and the results were as follows: There is appreciated to be quite extensive tearing of the labrum extending from the anterior to posterior margin superolaterally, the tear anteriorly having quite a globular configuration. No paralabral cyst, no evidence of cam type deformity. I have since seen my Dr and he explained that this is unfortunately inoperable. My tears are from hyper-flexibility in the joint and cutting away the shredded labrum will leave only a fraction left which will cause more pain. I am thinking of getting a second opinion as his only suggestion was for PT to strengthen the pelvis muscles.",
    "doctor_response": "dear friendsurgery is the only alternative to the condition but if in the opinion of your surgeon it inoperable it must be, surgeons are very adventurous by nature and will attempt the impossible most of the time and succeed, and if even then if he/she feels conservative management is better then you must trust them very few say so,physiotherapy with proper pain management will give you fair amount of recovery in due course.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp stabbing pain the arm?\n\nI m 24 years old, 5 5 and weigh about 140. I don t smoke, drink occasionally and I workout 4 times a weak. So over all pretty good health. The past two days I have had a sometimes sharp but achy pain in my left arm. From my elbow down to the top of my hand. My arm will also feel like it s getting hot from the inside, similar to a burning sensation. I have been a little light headed but not enough that prevents me from standing or siting up. My concern is should I make an appoint for the doctor or go to the hospital or wait?",
    "doctor_response": "Hi, It seems that your pain is due to compression of nerve in your cervical spine, please get MRI of cervical spine done till than take over the counter painkillers, physiotherapy. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Jaideep Gaver, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is an ER visit advisable for a child with flu symptoms?\n\nMy 4 year old daughter has flu like symptoms; cough, runny nose, no energy, very tired, irritable, no fever, no appetite.. she has been sleeping on and off for the past four days and we have been giving her Tylenol and ibuprofen for the last four days. Would you recommend taking her to urgent care?",
    "doctor_response": "yes , i would infact suggest you to take your daughter to hospital immediately. Flu might have made your child dehydrated, also she needs to be checked for any other infection. hope this helps. regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could gap in radiotherapy effect cancer treatment?\n\nIf there is a gap during radio therapy due to machine not working, please suggest My mother is going through RT she got breast cancer stage 1 and going through RT, some times machine does not not works and three four days gap accures. please sugest is it problem I am not getting any response",
    "doctor_response": "Hi. Ideally radiation therapy (RT) should be completed within the stipulated time. Since RT MegaVoltage machines have sophisticated electronics, machine breakdowns do occur and are common world over. To overcome the detrimental effects of gaps during RT, different institutes follow different SOPs. Some are:1. Treat on closed day/ bank holidays to cover for gap.2. Give two exposures of RT per day with a gap of atleast 6 hours in a day.3. Increase the dose per exposure to compensate for the gaps.4. Shifting patient to a mirror machine in case of long breakdowns.Fortunately breast cancer has a slow doubling time and time to kick off (radiobiological terms which I will not be able to explain unless you have a sound knowledge of radiation biology) and so gaps are not as detrimental as in Head & Neck cancer or cancer of cervix. I will still suggest that you discuss with your oncologist regarding gap compensation strategies.I hope your question has been answered. If you have any further questions I will be happy to answer. Thankyou for choosing Healthcare Magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fainting and low BP?\n\nMy daughter is 23yrs old, she has been feeling like she is going to faint on and off for a couple of months. This seems to be getting worse. She has been for blood test but they came back clear, the doctor said that she has a viarl infection and low blood pressure could there be something else? If it is viral how long could it last?",
    "doctor_response": "hello, I have gone through your query.Thanks for using HCM.Usually viral infection is self limiting illness and lasts maximally upto a week.sometimes young girl may faint during menstruation due to heavy flow.if she is getting repeated spells of fainting then she should consult a physician to evaluation.My best wishes,Dr.Rajesh Teli,MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mood swings, restlessness and memory loss\n\nsir, Good morning. I have been taking psychiatric medicine (i.e Escitalopram oxalate , milnacipran, desvenlafaxine & some multivitamin( mentat, neurofit, vimintaforte)) for last 3 years . There is some improvement in my mental problem but not totally cured .Problems  like mood swing, feeligs of hopelessness, restlessmind , sevre concentration & memory problem still persists  and affecting  in my job. I m confused & waiting for your valuable advice. My age is 26 . Height-5 ft 6\", Wt-65 kg",
    "doctor_response": "Hello,You are on three antidperessant drugs along with three multivitamins...so many meds are usually not required.You havent mentioned the dosage of antidepressants here and presently you are not completely fine.Ideally, escitalopram can be taken upto 30mg and still if there is no response- better stop it and shift to another drug.Milnacepram is usually not given with other drugs..so, if you want to continue it better take it to appropriate dosage strength or stop it.Desvenalafaxine dosage can be upto 100mg- if it is less than this and still you have symptoms- then it should be increased or stopped. It is not useful beyond 100mg.There is no point in taking three meds for one purpose and that too in inadequate doses.One of the reasons behind your not getting well is so many drugs..With several drugs we dont come to know what is helping and what is not..this also increases mood swings.Get TSH and B12 levels as they are frequently disturbed in mood disorder patients and show good improvement when treated.I would have helped in drug changes if you had provided me the dosage you are taking.Discuss the above points with your doctor, get the recommended tests.Hope this will help you.Dr. Manisha GopalMD Neuropsychiatry",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes visible lump on forehead after a hit?\n\nmy 6 year old son fell off the monkey bars at the park a week ago hitting his forehead on a wooden cross beam, his forehead immediately came out in a very large lump, 3 days later 2 black eyes appeared after the swelling drained into his eyebrows and nose, now 6 days later he still has a lump on his forehead which is very painful for him, he will not let anyone near him to touch it, we took him to the hospital on the day this happened and the Dr said she didn t think his forehead was broken - he wasn t scanned or given an x-ray. I am still obviously worried about him, should the lump still be so visible after 6 days?",
    "doctor_response": "Hi,It seems that he might be having formation of big hematoma leading to swelling on forehead and black eyes.It will take some time for subsiding hematoma on forehead.Apply ice pack 2-3 times a day for few days.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can laser treatment cure marks left by cold sores on my lips?\n\nhello,  I get  cold sore at least 3 times a yr when I am super stress.  however, the skin on my lips and around my lips has gotten really dark making it very obvious.  I have seen a dermatologist and they gave me creams to blemish the skin but nothing has help.  I was wondering if laser can help.",
    "doctor_response": "Hello,Thanks for the query,Yes laser can be used to remove this pigmentation.NdYag LASER is best suited for this.Another option is use of chemical peels.Modality of treatment is decided based on the depth of pigmentation and the surface of skin.A photograph would have helped me in giving a closer diagnosis.Please meet a dermatologist for exact diagnosis.Let me know if you have any other doubt.you can ask a direct question to me on this forum, following the below link. you a good health.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does duromine and the pill react badly together?\n\nHi, I was on the pill and then went off it on tuesday (a week ago) i then had intercourse on sunday night and the condom split. I have taken the morning after pill and i am also on duromine. WIll there be any bad side effects? Are duromine and the morning after pill going to react badly? I am 19, 65kg and 170cm",
    "doctor_response": "Hi dear and thanks for your query.There are no data that duromine can decrease the effect of I-pill.Hence wait for bleeding .All the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough and shortness of breath\n\nMy son is 21 years old and autistic.  He has been taking prozac for 4 months.  He has been suffering from a cough for approximately 3 weeks.  The Dr. perscribed anti-biotics for 10 days and said if they did not solve the cough he has allergies. He finished his course of anit-biotics and then the symptoms got worse.  He has nearly passed out from wheezing and shortness of breath.  He says he cannot get the air out of his lungs.  He has wet coughs with clear or pink sputum. The episodes last for approximately 10 minutes once per every 1-2 days for the last week. They have occured twice while sleeping and 3 times while active, both in doors and out dooors.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, possibility of bronchitis is more in your son's case. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x ray to rule out lung infection. 3. PFT (Pulmonary Function Test) for the diagnosis of bronchitis. PFT will not only diagnose bronchitis but it will also tell you about severity of the disease and treatment is based on severity only. He will mostly need inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone). Don't worry, he will be alright with inhaled treatment. Hope I have solved your query. I will be happy to help you further. Wishing good health to your son. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Worried for tingling lump on hand\n\nMy friend accidentally stabbed me with a writing pen before, it bled a little, and I m not sure if ink got in. It s now came up in a small raised blue lump around the area (kinda like a bruise) and my hand (where she stabbed me) feels a bit tingly. Should I be worried?",
    "doctor_response": "hello! your lump could be due to blood pooling (hematoma) on the area where you got stabbed that is why there is also discoloration/bruising.  There are also a lot of nerve endings in the hand, and the swelling in the area could cause the tingling.  I suggest you just placed a warm compress around the area if the accident is more than 24hours already (an ice compress will help if it is less than 24hours).  You can also take over the counter anti inflammatory medications if you are not allergic to it.  If it persist despite of these tips, you need to set an appointment with a physician to thoroughly examine the lump.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain, had appendix removal, stomach making noise, urge to urinate, bladder fullness\n\ni have a problem my lower left abdomen hurts but i got my appendix remove in 2005 and also my stomach sometimes hurts an be making noise. and every time i go to the bathroom and have to urinate like the feeling like my bladder is full. but once i get to the bathroom is like 1 or 2 drops and the i be have lower abdomen pain and stomach pain",
    "doctor_response": "Hello Thanks for the query It looks like you are suffering from inflammation of the colon. Please approach a gastro enterologist for  quick examination and if required a colonoscopy. Please do not delay the matter any further. You might require treatment with anti biotics and pro biotics for a week along with antacids I hope I have answered your query Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can my symptoms be related to multiple sclerosis?\n\nHi doctor, I had an MRI with a\u00a0possible indication of MS. I want to know based on the following symptoms, what type of MS it could be? A few weeks back, I had blurry vision in one eye for 20 to 30 seconds. My bladder wall is thick, and I had frequent urination problem. I consulted a\u00a0urologist, and he said that I probably have a\u00a0chronic prostate infection.\u00a0Sexual arousal is bad from the last two months. I am sweating more, and I was diagnosed with hypertension three months back. I do not have walking or running problems. Last year, I felt fatigued for a month. I get small light headaches\u00a0occasionally during the day. There is no particular flare-up that I can indicate directly. I have a tingling sensation on my legs for 10 seconds. Could any of the above be MS related?",
    "doctor_response": "Hi. I read your query and understand your concerns. I hope this helps you.\u00a0Feel free to write back to me if you have more questions.\u00a0Thanks and regards. For more information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stiff neck and an itchy, blotchy rash on legs, cheeks and upper arms?\n\nMy daughter has a stiff neck and an itchy, blotchy rash on her legs, lower back, upper arms and cheeks.  These symptoms appeared over the weekend and have gotten progressively worse.  She does not have a fever, but had the chills briefly on Sunday.  She also did not get much sleep last night.",
    "doctor_response": "Hi,This is probably a viral rash. If she is otherwise fine and taking feeds as usual, you can give paracetamol three times a day (to relieve stiff neck, chills and fever if any) after food. Itching can be relieved with antihistamine like levocetirizine and calamine lotion to be applied over rash. I could not mention the dose of drugs, as weight and age not mentioned.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam TK, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to be drowsy on taking Pedilyte?\n\nhello my 14 month old has cold sweats and is clammy. He started feeling like that after I picked him up from daycare. he just laid around I gave him cranberry juice and water because I gave him pedilyte all this weekend because he had congestion. he is sleeping right now is this normal",
    "doctor_response": "Hello. I just read through your question.it is unlikely that the Pedialyte is making him drowsy. More likely is the possibility that he has a viral infection. Viral infections frequently make children drowsy. If it lasts more than 3 to 4 days, I recommend consulting with your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have early endometriosis. Trying to get pregnant. Under medication. Advise me.\n\nHello doctor,im nadeeka 33 years old ,my doctor said that i have early endometriosis,im trying to get pregnant  from last 10 months,got some tablet for increase my egg mature& injection for egg relase.but still yet i couldnt be a pregnanat.can you advise me there are any medicine for production of healthy & fertile egg?",
    "doctor_response": "Hi,Thanks for the query.You once discuss with your doctor that what is the cause for the failure of your attempts.After that you can go for required treatment.If needed you can increase the dose of ovulation induction. And can use hormonal supplementation tablets.If needed you can go for artificial reproductive techniques.For more details you can ask me through:  care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itchiness, increased sensitivity with spells of twitching pain under the penis head, skin is dark red in color. Cause?\n\n51 male, I have an itchy,,sometimes moreso, on underside of penis head, shiny red, to darker red thin skinned, kind of senceitive also, with spells of twiching pain ,not bad just know its there.",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have itching on under surface of glans penis and your foreskin is red and thick .Many a times itching of the genitals is a presenting symptom of Diabetes .Please get your blood sugar tests on empty stomach and 2 hours after lunch done to rule out diabetes .If you turn out to be diabetic you will need to take opal hypoglycemic drugs as per advise of a qualified Physician,In the mean while take anti fungal medication like Fluconozole and topical anti fungal jelly for local application .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can one help their spouse who is in severe depression?\n\nI am the spouse trying to learn how best to support my loved one. my wife is in a pretty severe depressed state and I just want to say and do the right things to best support her. She is feeling very guilty about how this affects me. How can I assure her she is worth whatever it takes.",
    "doctor_response": "Hi and thanks for questions.first off all talk to your wife that what happens to her and what r the symptoms for depression. second guilt is because of some action so try to find out that problem. if u r unable than consult psychiatrist for same. during this period u will give escitalopram along with clonazepam for relief.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stiffness on the  outer cover of the penis skin?\n\nmy age is 20 yrs..sir my problem is that my outer cover of penis does not go beyond its cap size..after that it is locked..means there is a type of joint which does not let it go completely down..i dont have any sort of pain and any other problem..i just want to know that how can i cure this problem and wheathr i should consult a doctor immediately or when required for sex..pls give me a detail solution..i would be highly grateful to u..",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It looks like you are having phymosis. To know the severity you will need a direct check up with urologist or surgeon. It can be corrected. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe vomiting in a child\n\nMy 11 month old vomiting whatever I feed him immediately after taking in. What to be done in this condition? How to find he is okay? After giving him porridge it stayed in for 15 mins and no vomit? So is it a sign that he is alright?what kind of food to be given?",
    "doctor_response": "For vomiting you have to give him syrup vomikind or syrup ondansetron 5 ml twice daily with some antibiotic like syrup symbiotic-p or syrup moxikind-cv 5 ml thrice daily to cover the infection if any present. Continue feeding along with breast milk and maintain the hydration of the child.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe back pain, MRI showed spinal infection due to RB, diagnosed with ITP post random bone marrow examination. Is it TB induced ITP?\n\nMy husband had backpain ,, when we did a MRI they suspected it to be Spinal infection due to TB and then we did some blood test and identified his platelets count low less then 1000 ,, so he was given heavy dose steriod and his platelets not coming up much ,, and then treated with IVIG again it seems didnt worked ,, in between they did his bone marrow examination and they told production is fine and found it as ITP,, now he is under Revolade tablets ,, and they did a biopsy and confirmed the spinal infection is for TB,,now his steriod intake is reduced from slowly and gradually from 60 mg to 10 mg now and also he is taking ATT medicine now for tuberclosis,,please guide us with whether it can be a TB induced ITP",
    "doctor_response": "Hi, It can be TB associated. ITP. This is rare and few cases are reported in international literature. This responds to anti tuberculous treatment. Go By your doctor's advice!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cancerous thyroid, sticky tumor removed through surgery, radiation prescribed in area. Cause of worry?\n\nmy sister went in for removal of her cancerous thyroid ,she also had a massive cancerous tumor called a sticky tumor removed,it took the operation 6 hrs. this operation took place 2 days ago. they are talking about radiation ,the area of the tumor was in the neck or severity of asticky tumor . thank you ,alittle concerned does it matter if ist ie sticky?????",
    "doctor_response": "Hi and welcome to Healthcare magic.Thank you for the query.It seems like your doctor consider that there is a need for adjuvant radiotherapy and this is usually done when there is spreaded tumor or suspicous of it or as a prevention in highly invasive tumors. So i suggest to go through this and not to worry beause you need to do everything to prevent tumor recurence.Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for bruised coccyx and pins and needles in fingers?\n\nI fell twice iceskating and landed both timed in rear bruising my coccyx this was over 2 weeks ago ANC it s not getting better and I have pins and needles in my fingers often? I feel like it s dropping down into my bum cheeks too? I have had X-ray it s not broken",
    "doctor_response": "Hi,Regarding your concern, I would explain that these symptoms could be related to a nerve damage. An x-ray study is not the most appropriate test to examine the spinal column. That is why I would recommend performing a nerve conduction study coupled with a lumbar spine CT scan. You should discuss with a neurologist on the above issues. Hope I have answered your query. Let me know if I can assist you further. Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a sore lump under the rib cage\n\nI have a very sore lump underneath the rib cage on the left side that is very painful. I think it is a boil but has not come to a head to burst it . Just a small amount of fluid come out. It is too tender/sore to apply to much pressure. What sure I do now. It s been this way for about a week now.",
    "doctor_response": "hi.based from your description, it could be a cyst (a sebaceous or a keratinous type). these lesions can occur anywhere in the body and have the tendency to recur. it is best if you consult with a doctor, preferably a general surgeon, for medical and physical examination. management (medical and surgical) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does missing a dose of Atenolol worsen tachycardia and paroxysmal hypertension symptoms?\n\nI take 25 mg atenolol b.i.d. along with 1 mg Xanax and 0.1 Clonidine. Obviously, my pulse hangs out around 50. I can t remember if I took the Atenolol this evening. I have tachycardia and paroxysmal hypertension so I m concerned about going without it, but also reducing my pulse too far in my sleep.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Regarding your concern, I would explain that a missed dose of Atenolol (considering the dose that you are taking) is not concerning. With your actual heart rate, I would not recommend taking any extra dose, because it may lead to bradycardia. Coming to this point, I would recommend waiting and see if your heart rhythm is going to raise. In such case, you can take the dose of Atenolol. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for an infected wound on the elbow\n\nhello I have an area of prurigo nod. that I was picking with a pointed tweezer.  The tweezer punctured me in the elbow very deeply  and in 10 hours, I had a raging infection.  I am on Keflex 500 mg BID x 10 days, and it is helping.   I am worried I will get the lesion deep into my elbow and doctors will not know how to treat it.   Can it be transfered by an instrument?  What should be done if the infection continues after 10 days.  Thank you.",
    "doctor_response": "hi sir, welcome to HCG, if ur wound is deep and infected, plz use iv antibiotics for better results, brucillin-tazo 4.5gms slow iv once a day for 5 days... and everyday dressing the wound... thank u, have a nice day..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood in urine and low hemoglobin level?\n\nA friend of mine is seeing blood while urinating, it s about 3 days now, sometimes the colour of the urine become dark red or something very light pink. And recently after a blood test of his, the haemoglobin drops to 8.5 and in urine test there were positive leukocytes like ++ found. And the rest of the results were normal like creatinine and LFT but protein were 5g in the test but no bacteria were found. So please tell what eaxtly is it.",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Presence of leukocytes indicates infection. 2. Urine culture will be more useful than microscopy confirmation of bacteria. Get urine culture and sensitivity done to identify appropriate antibiotic for treatment. 3. Blood in urine, wont cause so much anemia. Your friend was already anemic. Get a complete hemogram and based on it, appropriate treatment can be started. Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tiny red area on scrotum, small bump on it. Causes and treatment?\n\nHello, I am a 15 year old boy, thats in high school I did track and field last semester, but now ive stopped doing sports in the summer. I noticed this tiny red area on my scrotum , and theres a small bump on it. Also not too far from that is one really small bump you can barely see. I don t know what this is, and I have also never had sex.",
    "doctor_response": "Hi,It seems that you might be having dermatitis or fungal infection on the part.Wearing synthetic inner wear does cause this problem.Avoid perspiration,Apply anti-fungal talc on the part.Keep local hygiene clean, dry and airy.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain due to periodental disease and gingivitis\n\nhi. I have periodental disease and gingvitis. I got even root canal treatment, I think i got it from oral sex and bad hygiene. frequenly i have been taking antibiotics. still pain persisits though I have imaproved much. the teeth even started moving a bit. when I show to dentist he advices only good care and mouth wash etc. kindly help me and should i remove my teeth to relive my pain?",
    "doctor_response": "Thanks for your query, I have gone through your query.The pain is because of the periodontitis and mobile tooth, once the tooth start shaking it applies pressure over the nerve endings and cause pain. Nothing to be panic, consult a good periodontist and get the scaling and root planing done and if required bone grafting or splinting can be done to make the tooth stable. Meanwhile you can take a course of antibiotic like doxycycline 100mg Which is very effective in gum infection.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a tooth pain that would travel from my jaw to my ear?\n\nI went to my dentist today bc i have been getting really bad pains in my tooth. when i went to her she looked in my mouth w/o taken any x-rays and pulled my wisdom tooth out.. i had told her that it wasnt it and she didnt listen to me. i know i went last month and she filled a tooth for me that the one that she filled is the one that is killing me really bad it would go from my tooth to my jaw to my ear and it would give me really bad headaches and i have tried advil, advil pm and also i have tried hydrocodone/APAP-ES 750 its not help ing at all what do i do?",
    "doctor_response": "Thanks for your query, I have gone through your query.The pain can be because of the tooth infection. If the decay is involving the third layer that is pulp, where the nerves and blood vessels are present, if the filling has been done over that, then you will get pain. So consult a endodontist and get the tooth treated with root canal treatment.Nothing to be panic, Meanwhile you can take a course of antibiotics like amoxicillin 500mg and metronidazole 400mg tid for 5 days (if you are not allergic) and analgesics like diclofenac 50mg with serratiopeptidase. Do saline gargling. Once the pain comes down you can get the tooth treated.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Subutex contain any sugar?\n\nDoes subutex contain any sugar? I am presently 31 wks pregnant & taking a glucose tolerance test ( the 3-hr one)...am wondering if taking the subutex will affect that...I have taken my usual dose during the 3 hr test...any information would ve appreciated, thank you greatly",
    "doctor_response": "Hello,I have read and understood your query. Sunutex is a morphine derivative and has no interaction with sugar levels and doesn't produce any change in sugar levels  you can simply keep it going as per your doctor's advice.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe shoulder pain radiating towards neck\n\nI have been experiencing a pain in my left shoulder for about the past month. I do not remember doing anything to put it out. It radiates up into my neck and across my bone towards my neck. It does seem to be worse when I sit. Any clues? Thank you",
    "doctor_response": "Hi there.You could be having pinching of the nerve in the neck but to a slipped disc. Apply hot water bottle to the painful areas. Take pain killers and muscle relaxant combination for relief. Consult your Orthopaedic surgeon for a prost diagnosis with the aid of MRI cervical spine as necessary to determine the nerve pinching",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the surgery performed for a chin lump?\n\nhi i just went and the doctor tried to drain the blood out of a bump under my chin caused my a minor trauma accident however the blood has conjeled so nothing came out. they have asked me to wait a few days then go doctor to get referall for surgery ? what surgery would it be ? cheers",
    "doctor_response": "Hi,dear thanks for the query to my HCM virtual online clinic.My diagnosis--traumatic Clotted -Resolving Hematoma.Treatments -if the lump under chnd does not reduce on its own-Surgical excision and drain is requried to be done by a ER-Surgeon.Hope this would solve your query.Wellcome to my HCM clinic once again.Have a Good Day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cyst in brain,vomiting and headache\n\nI have been diagnosed with a cyst on my brain, the dr. said he didn t think it was cancerous. For six years now i have had headaches, I wear bifocals now, my hearing is not that great, i stay tired, i have memory and thinking problems, i sometimes have speech problems along with left side drawing in my face and arm. At times my sexual desires are very high for me, my emotions are all over sometimes with alot of pressure in my head. I have been getting sharp pains with instant vomiting. i fall to sleep easy. I didn t ask any questions because all i was interested in was none cancerous. should a cyst be giving me all these symptoms?",
    "doctor_response": "Hi,Thanks for writing in.A cyst in the brain, present for more than 6 years is a stable lesion. However, it is important to know the location of the cystic lesion to know the exact implications and to confirm if your symptoms are due the cyst or there is any other condition that is responsible for vomiting. As you report emotional changes and sexual desires being part of your complaints, it is important to know if there is any anxiety related stress or a similar condition largely causing the symptoms. Please detail us about the location and size of the cyst in your bain and any recent enlargement is size. Cysts in the posterior fossa and causing pressure effects on the brain stem including pons and medulla can lead to vomiting.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can degenerative disc disease cause muscle ache in the lower back?\n\nIn 2001 I had a spinal X-ray showing L3 degenerative disc disease. I recently last week had another x-ray and am waiting for the results. Could my condition of aching and muscle spasm be associated with continued disc degeneration in the L3 lumbar region ? YYYY@YYYY Thank you.",
    "doctor_response": "Hi, Disc degeneration is known cause for back pain due to weakened joint between vertebra and instability. Diagnosis degenerative changes leads to loss of disc height and as a result bond between two vertebra becomes weak. this leads to muscle spasm to prevent increased mobility between vertebra. X-ray will confirm diagnosis. Treatment is use of lumbo sacral belt and tablet Ultracet twice a day. Visit to orthopedic surgeon nearby your area for detailed clinical examination is recommended. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jayesh Vaza, Orthopaedic Surgeo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden abnormal pain below the belly button with slight hardness?\n\nhello - 6 am NZ TIME ; last night a sudden pain [ 6/10] ] developed 2 - 3 inches left of belly button and I could feel a slight hardness bulging under my palm when I lightly inspected it - way worse if I turned on my right side [ as if the weight of intestines was pulling on it ] bearable on left side and I slept - upon waking and moving it exacerbated the pain and made me get up - pain still there and the closest I can describe it to is a severe case of stitch no history of this type of pain - I am 62 - male ; never been in hospital or had anything major wrong etc this pain makes me think that; if it continues I may have to go to hospital thanks AL BROWN just attempted to pay - but no funds in acc - no online banking and it s Sunday morn - oh well I ll get through on pain relief and see what happens during the day thanks anyway AL",
    "doctor_response": "HI. Good to know that you have had never visited hospital.Such type of pain can be due to intestinal infection. Severe inflammation makes pain even on turning to one side. Watch for loose motions , fever , nausea or vomiting and consult a Doctor if necessary. If no other symptoms you can try OTC antispasmodic and wait.Please do not hesitate to see a Doctor if other symptoms develop as you may need a good clinical examination, investigations like ultrasonography and medical management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Addison's disease be passed on to next generations?\n\nHello doctor,Is Addison\u2019s disease hereditary? My mother died from complications relating to Addison\u2019s disease and over the last year or so I have been developing symptoms that could be consistent with it (hyperpigmentation, abdominal pain, dizziness).",
    "doctor_response": "Hello, Welcome to iclinq.com. Addison's disease (primary adrenal insufficiency) can be due to many causes. It is like when your adrenal glands are not producing the hormones they usually produce. While in the past, infections (particularly tuberculosis) were the most common cause for the destruction of adrenals, but now the most common cause worldwide is autoimmune destruction of the adrenals. As with other autoimmune diseases, there can be a hereditary component and associated with other autoimmune diseases. Weight loss, fatigue, postural hypotension (feeling dizzy when upright) and hyperpigmentation are the initial symptoms. Among those, you have a few. You should definitely get yourself screened for it, by undertaking a cosyntropin stimulation test. And if that is positive, you should get your plasma renin activity checked, along with serum aldosterone concentration. Also serum ACTH levels. Increased basal serum ACTH concentration, high renin, and low aldosterone will help in making the diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes puss filled boil and bad taste after teeth removal?\n\nI had a tooth removed months ago,in the last month a boil came on  the next tooth (upper left front.I broke it and there was puss and blood and behind my palate there was a heavy build up of something which drove me crazy,since then I took twenty pills for 10 days,the stuff behind the palate went and it seemed the swelling and puss was gone...now only days after finishing the pills I am back where I started,except now I also have a terrible taste in my mouth..help",
    "doctor_response": "hellooo...read thru ur query....according to symptoms explained by you it is an abscess..but origin of it can be diagnosed(whether it is tooth related or periodontal related) can be said based on clinical view and also on xray..since it is openening into palate..it can be infection of the root of upper lateral incisor..bad taste is related to the puss and exudate still oozing thru ur teeth..to stop it u have to remove the cause..for that u have to meet dentist get an xray and get the treatment done..if its periapical infection rootcanal treatment followed by crown..if periodontal have to undergo scaling etc..till then do salt water gargle..maintain good oral hygiene...meet the dentist soon...(y to suffer if u have solutions and experts to solve ur problem)..nothing to be worried be cool..hope ur benefitted something from this..have a healthy day!!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen, itchy,burning sensation after subsided symptoms of bee bite?\n\nI was stung by a bee one week ago. The symtoms seem to have subsided after two days. After that thigs have been getting worse. The site (middle finger on the right hand) is now more swollen and ichy, I also have a burning sensation on the finger. There are also a few hives on my finger. Some pain going up my hand. Could the site be infected?",
    "doctor_response": "Hi,It seems that there might be having some bacterial infection due to itching over the part.Take antihistamine like Benadryl or Cetrizine for itching.Apply triple action cream after cleaning.If infection is more, you might require one course of antibiotic medicine for 3 days.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore lump under the nipple?\n\nMy twenty eight year old son... who has been doing a very hard work out for about 3 weeks now was very sore across both of his pecs. He then played about 4 hard games of ping ball. He called me this morning and said he had discoverd a bump under his right nipple that was about the size of a quarter. He said it was sore when he pressed on it. I am a concerned Mom.",
    "doctor_response": "Hi,Welcome to HCM.By the query data,You seem to have Gynecomastia with mastodynia.This occurs due to the pubertal changes usually.But in your son's case who is 28 yrs old,the case is little late and hence needs to be worked for any hormonal abnormality of low testosterone levels.I would suggest Second Opinion with Surgeon and  its urgent treatment after investigating its cause.This would help you to plan treatment with your doctor.Hit thanks if convinced.Will appreciate Premium query for further enquiry.Dr.Savaskar,Senior SurgeonM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from bronchitis\n\nMy baby is 6 maths old had bronchitis from last 9 days , coughing really badly on high pitch and also throws up once a day after his feed and also green thick slimey and mucus poop....is this normal and how long this can last , when can I see him recovering",
    "doctor_response": "It is probably bronchiolitis that you are talking about. It is common in children between 6 months and 3 years of age. It generally continues for 5 or 7 days. I would suggest giving the child steam inhalation if nebulisation is not feasible. I would insist you to keep the child in follow up of a pediatrician rather than wait for spontaneous recovery though it is likely to occur in about 7 days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is surgery to repair collapsed lung advisable at the age of 93?\n\nhi.. my dad, 93y/o very physically active b4 he had cough/sob that seeked him admission 2 d hosp. on 9/14/14. right now, he s been treated 4pneumonia..he was in ICU 4close monitoring, 2r/o pneumothorax vs. atelectasis.. had chest tube inserted 2drain out excess air..chest tube still in since his admission. his Dr. advised him to have surgery to repair d collapsed lungs.m my questions are..1. how long can a chest tube stay in to drain d air out? 2. is it advisable to have surgery to repair his lungs at his age? 3. his pneumonia hasn t been r/o jst yet.. he s given Zithromax 500mg iv q24hrs..what is best to do, considering not much antibiotics to choose from in the PHILIPPINES on top of high costs.. ThNKS A LOT FOR D RESPONSE...",
    "doctor_response": "Thanks for your question on HCM.I can understand your situation and problem.Surgery is not at all advised at this age (93).Because lung surgery is considered as major surgery and heart lung bypass is needed during surgery. And chances of post operative complications are very high at this age. So I will not advice surgery for him because of his age.Better to keep icd and wait for resolution of pneumothorax.Better to get done sputum culture to identify organism. And also get done sensitivity report to guide the antibiotic therapy.Once infection is resolved, pneumothorax will definitely subside.So discuss all these with your doctor and plan accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why i am sensitive to some sort of tooth paste?\n\nI am a twenty-five year-old female who has always had a good dental history. I've had a few cavities filled here and there, but overall the most extensive \"procedures\" I've had done are braces and fillings. I bought some Colgate toothpaste a couple (few?) weeks ago and have been using it. I've always known I was sensitive to certain types of toothpaste (some make my mouth feel \"raw\"), but I also want to maintain good oral hygiene. Last weekend I felt like I had chemical burns in my mouth and the gum in-between my two front teeth was swollen. I started flossing and the area bled and some white tissue sloughed off. I never considered that it may be the toothpaste I was using, so I continued to brush 2X a day with said toothpaste and continued to floss. I realized day-before-yesterday that it may be my toothpaste and I stopped using it. I've since been brushing with baking soda. It seems as though it has improved some, but I keep getting a white tissue coating the \"damaged\" part of my gum. It feels fine as long as that white coating is there, but once I wipe it off it feels \"raw\" again. I've scheduled a dentist appointment for Saturday, but I'm wondering if anyone has any idea what this may be? Is that white tissue stuff the gum trying to heal itself (like a scab?) and when I pull it off I'm re-opening the wound? Help!",
    "doctor_response": "thanks for your query, you are sensitive to the tooth paste what you told its called lichenoid reaction or allergic stomatitis..so you can stop using that tooth paste..continue soda bi corb wash..and you can use topical steroids like triamcinolone acetonide 0.1% 4-5times daily...the lesions will heal in 3-5days... i think my answer will help you..take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heaviness in lower leg?\n\nI ve noticed the last day or so that my left lower leg feels like a bit heavy...and tingles a bit. I noticed that when I m walking it seems my step is heavier than my right...I can hear it, I thought I just wasn t picking my left foot up...walking a little lazy, but when I m trying to pull my toes up on my left foot my toes spread out a bit and I can t pull my toes up like I can with my right foot.....Very odd for me. I m 50 years old, weigh about 118 pounds, take good care of myself, I ve never had anything like this happen.",
    "doctor_response": "HiYou need to have a doctor evaluate this and get an MRI scan of your lumbar spine because it's likely your have a ruptured disc in your back that is pressing on a nerve root",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for acute pancreatitis?\n\nMy mother in law (54+) was detected to have liver cirrhosis four years ago when she was being operated gall stones. the operations could not be done. Six months ago she had an attack of acute pancreatitis. Doctors have advised removal of gallstones. Can it be done at CMC Vellore and if yes, whom should we contact.",
    "doctor_response": "It's a case of  pancreatitis induced by gall stones, fairly common in females.   It has to be operated, that's the only solution.. You can call them directly from their number given on  their website",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain and swelling in jaw\n\nI got punched in the jaw about three weeks ago and the swelling when down almost all the way about two weeks ago but i couldn't open my mouth all the way so I forcibly open my jaw a little with my hands and heard a tock tock noise where i got hit in the jaw sounded and felt like it got set right i could open my jaws more right after but the next morning  when i woke up the left side of my jaw and face was swollen more than before and about four days has past and swelling  went down a little bit left jaw still feel swollen hard and I'm  having trouble opening my jaw and mouth all the way again. What is going on?",
    "doctor_response": "Hello,      Its sad that you had to go through such a lot a trouble with your jaw. Any swelling after a hit needs to be taken seriously and there could be underlying problems in your jaw like a fracture. Please visit an Oral and Maxillofacial surgeon at the earliest to get proper treatment for your problem. Hope you get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My glans appears wrinkled and red. What could the issue be?\n\nHello doctor, I am a 29 year old male. I have abnormal appearing glans of the penis. The glans started to change several years ago becoming very wrinkled and have a redder appearance than before. The meatus started to change at about the same time. I have not had any sores on the head, but had friction bumps that would come and go after sex. I have previously had multiple partners, but have been with the same partner for four and a half years. I have previously had a full panel STD test and everything came back negative. I am seeking a dermatologist's opinion as to what the issue could be and the possible treatments for it.",
    "doctor_response": "Hi. I have gone through your reports (attachment removed to protect patient identity). As far as all your investigations regarding sexually transmitted diseases are normal and you are not having any other symptoms (except wrinkling), you need not worry about the appearance. Try to apply proper lubricant like petroleum jelly or vaseline two to three times a day and avoid rubbing or friction. Sometimes, it is a normal variant. Having pimples are folliculitis which appears in these areas and they eventually heal. So your main treatment is reassurance and have to follow-up after six months in order to see any other pathological change. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause a sudden loss of motor function in legs & arms?\n\n67 year old female has had a sudden (within last 6-9months) loss of motor function in legs and arms. Is in a permanent stoop, where she can't stand up straight. Hands jerk all of the time like someone that is nervous. At times can't remember how to sit or stand.  In order to stand has to rock multiple times to get out of a seated position.  When walking takes steps gate is about 3-6 inches.",
    "doctor_response": "In my opinion She has parkinsonism ,she should see a neurologist Also physical therapy can fix her in no time You Physical therapist should focus on spinning and twisting exercise (u need a professional ), which will act as brain memory of movements recaller Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stiffness in the knees?\n\nvery stiff left knee. Its not a ton of pain but feels like there is a band around parts of the knee. Pain/stiffness mainly in front but does occur in back too. About 70% of the time there is stiffness but it does loosen up a bit where I don t walk with a limp. Been occurring for over a week after a week long camping trip where I wasn t sleeping well in a tent but didn t have an injury incident. What is possibly occurring?",
    "doctor_response": "Hi, It can be an early sign of arthritis. As the first line of management, you can take analgesics like Aceclofenac or Tramadol for pain relief. If symptoms persist better to consult an orthopedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes short breathing and heavy chest with running nose and coughing?\n\nhi, i have  a respiratory problem that causes me short breathing and heavy chest and also i am unable to talk loudly when this problem occurs...it comes with a running nose and coughing and sneezing...i suspect it to be asthma but am not sure abt it ...plz guide me with the tests i should go for so that i can be sure about the nature of my disease..thank you",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Yes, by history and description, you are mostly having asthma. Asthma is allergic disease which causes rhinitis (sneezing and running nose) and bronchospasm (cough, wheezing, breathlessness). So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. PFT (Pulmonary Function Test). PFT will not only diagnose asthma but it will also tell you about severity of the disease and treatment of asthma is based on severity only. You will need inhaled bronchodilators and inhaled corticosteroid. Intranasal spray containing steroid is also useful in rhinitis. Oral combination of antihistamine and anti allergic drugs are also indicated in your case. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat chronic abdominal pain?\n\nI have a 2cm cyst on my right ovary and it is a functional cyst. With chronic abdominal pain I was waiting for it to go away, however I started developing others symptoms such as diahrrea, nausea (especially when eating), frequent urination and still the pain -- I also had a fever the other day. I am getting the cyst removed, is this a good choice or will it cause me infertility?",
    "doctor_response": "Hi.Thanks for your query and an elucidate history. First of all, remember 2 cm functional cyst does not need removal at all, most of the times it gets absorbed on its own. The additional symptoms of pain in a abdomen along with diarrhea, nausea, frequent urination all suggest that you may be suffering from a severe for m gastroenteritis and may be an associated Urinary tract infection. I would advise you the following:First of all send the samples for tests before starting any antibiotic so that we can have the best results and reports to help for the most proper treatment. Send urine for culture and sensitivity and routine tests of urine , blood and stool. Get started on a course of an appropriate antibiotic and metronidazole, probiotic. Take plenty of oral fluids, Change over to another antibiotic as per the reports. I hope this strategy should get you the cure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have asymptomatic AF and vascular dementia. Please advise.\n\nHello doctor, I have asymptomatic AF vascular dementia.",
    "doctor_response": "Hello. Please attach your ECGs. Revert with more information to a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stuffy nose in a child\n\nMy daughter is 2 years and a half and she has a stuffy nose. She is very cranky and don t know what to give her in order to help sleep. She is waking up every 20 minutes because of her stuffed nose. She has no fever and no cough and only sneezing. Thanks for helping.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.Cough and cold are viral 95% of the times in children. For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15mg/kg/dose (max ceiling dose 500mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.For cold you can use Cetrizine at 0.25mg/kg/dose every 12 hourly for 3 days.For nasal block, plain saline nasal drops will do, every 4-6th hourly to relive nasal congestion.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is the cut by the side of penis a herpes infection?\n\nHello doctor, I have cut by the side of my penis and I do not know where it came from. I found when there was a little pain there. I was wondering if this is herpes. I last got oral sex a few months ago.",
    "doctor_response": "Hello. This is not herpes. This is just irritation induced cuts (attachment removed to protect patient identity). You need to apply Abzorb (Clotrimazole) powder two times a day for a week. Keep the area dry. Also, please upload a clear picture of the same. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rashes with black spots in groin area?\n\nMy 18 year old son had a rash in his groin area which was spreading in spots,. He went to the dermatologist who said it was a fungal infections and prescribed a foam and a shampoo. It is now about a month later, and he says the rash is back, now ion the front of his right thigh and lower right back. On his thigh it a rash with dark black spots that look like dried up blisters and on hi lower back it looks like welts and they have muscle tension under the and itch a little. He said the black dots are little, and started as some small red bumps about the size of a silver dollar, those turned into the small dark bumps then the rash spread from there.",
    "doctor_response": "Hi,From history it seems that you might be having fungal infection and require proper treatment.Apply anti-fungal cream or lotion locally.Go for one course of anti-fungal medicine like Flucanozole 150 mg once in a week for four weeks. Keep local hygiene clean, dry and airy.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicine to improve sex life\n\nHi, may I answer your health queries right now ?  Please type your query here... SIR I AM 39 YEARS OLD AND I AM ABLE TO SEX WITH MY WIFE AS MY LING IS NIT IN A POSITION TO HAVE A SEX WITH MY WIFE SI I AM FEEL VERY SHAMFUL KINDLY ADVISE ANY MEDICINE TO ME TO IMPROVE MY SEX",
    "doctor_response": "Hi, You can go with aerobic exercise, mild weight lifting and take balanced diet to improve your sex life. You can also take tab Nanoleo once a night. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes neck strain?\n\nI have been experiencing giddiness and imbalance for past 01 days. I consulted my physiotherapist who said that I might have a neck strain and advised me to visit a general physician. He prescribed me vertin 16, Atorvastatin, stemetil, Aceclofenac. He also said that it might be due to neck strain caused either because of stress or neck strain. He told me visit him if the condition persist. But I did not feel like I have recoverd. Is there anything alarming about this?",
    "doctor_response": "Hello, I have studied your case.Due to compression of nerve root there can be giddiness and pain.I will advise you to MRI cervical spine or MRI brain for better diagnosis.It can be due to various causes like sudden jerk to spine, due to facet arthritis, degenerative, due to chronic systemic disease like diabetes or hypothyroidism.For these symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.I will advise to check your vit B12 and vit D3 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you are satisfied with answer do not hesitate to rate this answer at end of discussion. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication to manage pain due to wisdom tooth impaction\n\nHi, I don't know if you can help me, but I have all 4 of my wisdom teeth that are really playing me up, but my bottom right is killing me right now, I'm in so much pain I don't know what to do. I've taken 2x  co-codamol 30ml which perscribed from my doctors and I've taken ibuprofen and anadin. Nothing is taking this pain away. I'm getting all fours taken out in 4 weeks. What can I do to help ease the pain?",
    "doctor_response": "Thanks for your query, I have gone through your query.The pain in the jaw is because of the wisdom tooth, this pain will not go till you get it removed or extracted. Mean while you can take a course of antibiotics like amoxicillin 500mg and metronidazole 400mg tid for 5 days (if you are not allergic). Do saline gargling. i hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes oral thrush and burning sensation on the tongue?\n\nOver the past few days I've noticed my tongue has a layer of white over it. I started brushing my tongue more thoroughly, I already use mouth wash ever day and floss, but I still notice it in the very back. Now I see two red swollen bumps on either side of of the back of my tongue where I can't reach the white layer. When I swallow I can feel that the back of my tongue is scratchy and dry. I'm not a smoker and I never exceed the recommended drinks of alcohol per week (maybe once or twice a year at a wedding or special event if that). What could this be? Should I see a dentist or my MP?",
    "doctor_response": "Hi Dear, Understanding your concern. As per your query you have symptoms of oral thrush and burning sensation on the tongue which is actually a fungal infection which leads to formation of thick white layer in oral cavity and its surfaces and if remains constant it start giving white layers. I would suggest you to rinse oral cavity properly 2 times a day with hydrogen peroxide mouthwash. Avoid sharp, hot and spicy foods. Take Amphotericin B and maintain complete oral hygiene. You should visit oral pathologist once if symptoms keeps on persisting and start treatment after prescription. Go for biopsy of lesions if symptoms keeps on persisting. Avoid stress and take Probiotics like Yoghurt in diet. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain\n\n10 days back I started with a back pain went to GP he advised biolfnac..initially thought its a muscle pain applied moov at home..I m an active male in my 50s..Completed the week tab but still the pain remains...Then went to an orthopedic who gav me Vit D injection prescribed tab too to take for 8 wks..Prescription for pain was Hifenac P.for a week twice daily along with a antacid once daily before food..its been over 3 days..pain hsnt reduced and I hv been lying the whole day as sitting on sofa increases the pain..unable to go my regular walks also due to pain n discomfort on the back.Pleae advise how long it ll take the pain to go away so that I can resume my routine activities..Is it anything to worry about...Please advise",
    "doctor_response": "Hi Went through your post and understand your concern as back pain could be crippling sometimes, your orthopedician has done one thing which isn't good and can be dangerously harmful and that is vitamin D injection wkly as much I know each vit D injection contains 600000 units of vit D so you will be receiving a total of 4800000 lakh units daily requirement is 400 it can cause extremely high blood calcium levels and renal failure. I would suggest you don't take any further injections of vit D And you can start sustained release pregablin 75mg once bed time that will help for backache and discuss with your orthopedician regarding vit D so that he doesn't prescribe it to others.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are side effects of eptoin?\n\nSir, my husband has menerias desease and white matter hyper intencities in the brain. nov 10 first he had seizure from there he is taking eptoin 300 mg/day, epilive 1000mg/day, lobazyme 10/day pl. advise us what are the side effects of these mediciens. How long those are to be continued.",
    "doctor_response": "Hi, These medications all have numerous side effects that must be balanced against the potential good they are producing. All can cause fatigue, lethargy, slurred speech, and generalized weakness if doses are high or if interactions between medications also occur. There are also side effects having to do with stomach upset and burning sensations in the stomach. Another important side of these medications is imbalance or loss of balance while standing or walking. These medications must be continued according to the patient's doctor's instructions and often when the cause is not known as to why the first seizures occurred then, we require these medications to be used for a minimum of 2 years and ask the patient to keep a daily journal of any and all events that can be checked with the doctor at each visit. Sometimes, if the cause of the seizure is known such as bleed in the brain, traumatic brain injury, or penetrating projectile into the brain, or even something like tumor which must be taken out surgically--- then, medication may be life long. You must check with the doctor prescribing the medication to find out what they're thinking. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruised lump on the vein of the leg?\n\nHi, I was walking in the house, had a sudden massive itchy feeling on my leg. Then when I looked I had come up with a big bruised lump on a vein. Itch subsided immediately but lump hurts. Lessens when I elevate my leg and hurts lots when I put weight on it.",
    "doctor_response": "Hi, dearI have gone through your question.I can understand your concern. you may have some phlebitis or peripheral vascular disease. You need examination. Then you should take treatment accordingly. Hope I have answered your question. If you have any doubts then feel free to ask me. Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please assess my risk of being HIV-infected.\n\nHi doctor, Yesterday, I went to a massage parlor for B2B massage. Once the massage was done, the therapist gave me a hand-job and during the process, I also touched her vagina with my fingers. We did not had any vaginal or anal sex activity during this time. But my concern\u00a0is since I do not know about her HIV status, do you see any risks here of getting HIV-infected? Or is there any other infection which might affect me? Should I conduct any HIV medical test? If yes, please suggest.",
    "doctor_response": "Hello. I read your query and understood your concern. I hope I was able to address your concern. For more\u00a0information consult a cosmetologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can heart palpitations with body tremor be treated?\n\nHello, please help, my bro was hit today with a soccer ball, he says his body shakes a little randomly and his heart is beating like 110/120 at rest per minute. He has asthma and no history of heart disease. He is sleeping now. Anyone give me recommendations and answers FAST!",
    "doctor_response": "Hello. I have reviewed your query and here is my advice. He must be feeling the high heart rate because of the fear and anxiety associated with the pain when the ball hit him. You can talk to a physician asap.Hope I have answered your query. You can contact me for treatment options. Let me know if I can assist you further. Regards, Dr. K. V. Anand",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for painful lump on hairline\n\nI have a small bump at base of hairline, it hurt whenI pressed on it, it is still there, maybe a little smaller than it was and no longer hurts when I press on it. Now I have a new one a little higher and on the other side of the back of my head. Should I get it looked at.",
    "doctor_response": "hi.based from your description, these lesions might have started as folliculitis, then became infected, hence the lump or cystic formation. if these lesions are bothering you, it is best if you consult with a doctor, preferably a general surgeon, for clinical evaluation. diagnostics and management (medical and/or surgical - excision) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have persistent thoughts of having committed a sexual assault. Please help me.\n\nHello doctor,I was in a strip club. I had a stripper perform a lap dance. She allowed me to touch her private parts. But, she pushed my hand away when I tried to finger her and continued with the dance as if this was not a problem. I have talked with a number of mental health specialists who have told me it was not sexual assault. But, I feel like it was.",
    "doctor_response": "Hello. Feel free to ask your doubts with more details. Revert with more information to a sexologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does a meatotomy procedure cause infertility?\n\nHello, I underwent a meatoplasty or meatotomy (don t know for sure which) when I was 3 years old to enlarge my penis opening. I am now 27 years old and with my wife, we have being trying to conceive for 3 years. After two years of nothing happening we went to the gyn and there s nothing wrong with my wife and I m beginning to think it s my problem. Could a broader hole affect my chances of fecundation? Being that the stream doesn t flow directly in a single stream but rather spray all over? Is there something I could do? Thanks",
    "doctor_response": "Hello,Meatoplasty doesn't affect fertility. Infertility has many causes and causes can be from either wife or husband or both also.From your side have you done your semen analysis?Tests your wife has to undergo are:- Thyroid hormones- FSH, LH- USG abdomen- Patency of both tubes and manyMy suggestion is to please consult a fertility specialist for baby.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Siddartha",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for chest pain\n\nI am 26, 210 lbs and have history of anxiety.  I have taken anxiety medicine but I am experiencing more frequent chest pain. It is as if there is a cloud around my heart.  When I take a deep breath I feel like the air isn't getting into the left side of my chest.  It give me a tight feeling in my chest.  This has been going on for around 2 months now.",
    "doctor_response": "Hi I can understand your concern...Noted you have chest pain....You have history of anxiety .Let me know you excess stress can lead to panic attack and such symptoms can occur like chest pain and dyspnea by panic attack...So here try to avoid stress..Daily yoga and exercise is good remedy for it......Try to avoid situation that lead you in stress.Daily meet with friends and relatives to relieve stress.Behavioural therapy also useful in relieving anxiety....Get enough sleep....Take care....If still after relieving stress,  pain present then your physical examination done to investigate further....Take care....Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for rapid heart beat\n\nI'm turning sixteen in about 3 weeks, I weigh around 115 lbs and I've never had any problems with my heart before but a few nights ago I was laying in bed and my heart started to beat really fast and then then it felt as if my heart....jumped..? inside my chest. then it would beat slower. and the cycle would repeat itself for about 2 hours.. and its done it at least once everyday since. what's going on?",
    "doctor_response": "you may have suffer from herart rhythem irreguility. so better to consult a heart specialist. first need to do ecg and 2d echo. then u may have to undergone 24hour ecg monitering. if these investigations normal then u dont have to worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in the lower back\n\nsir i am 28 years old i suffering from low back pain only in left side from month  10 days back i will take  an MRI report says L4-L5 disk was extended and it compressed the nerves  , but i am  able to walk  some distance  if cotunious walking pain will come on  also standing countinueious  pain wii come leg  what s u r  suggestion  pls tell me doctor",
    "doctor_response": "Hi,Welcome to healthcare magic.After going through your query I think your You are suffering from lumbar disc prolapse.There are two treatment options.First option is Rest in position of relief(generally lateral position with both knee bend),NUROKIND GOLD ONCE DAILY and analgesics (Diclofenac three times a day after meals is effective). Sometimes strong analgesic(such as ultracet three times a day after meals) is required. OMEPRAZOLE  before meals  prevent acidity caused by analgesics . This method needs patience as it take longer treatment times sometimes up to  6 months.Second option is go for surgical operation(Discectomy). You can discuss with your treating surgeon.I think your query answered.Welcome to any follow up query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for uncomfortable knees after falling\n\ni was tripped and i fell and the initial impact was on my knees.. now my left knee feels like there is fluid or air in the cap and it feels like there are gaps in the bone. it also is kind of uncomfortable when i walk on my knees or try to put my weighton my left knee",
    "doctor_response": "Hello, As the first line management, you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist you can consult an orthopedician and plan for an MRI scan to rule out ligament or tendon injury. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can headaches associated with sinus infection be treated?\n\nHello doctor, I am a 29-year-old male and I have headaches with sinus infection symptoms. There is a scar inside my nose. The headaches are on one side of my head. It started about one week ago. I had this scar inside my nose about nine months ago. Also, the headache started about nine months ago too when I started sports. There was nothing until then. Please help.",
    "doctor_response": "Hello. The headaches due to sinus infection are most likely to be more severe in the morning and when you lean forward. Also, you will have tender bones of the face. So do you have any of these symptoms?  It is treated with a course of antibiotics for one month like Augmentin (Amoxicillin and Potassium Clavulanate) 1 g every 12 hours plus Paracetamol 1000 mg three times per day. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. If you suspect any complications or in order to classify the severity of the condition, a CT (computed tomography) of the paranasal sinuses is required. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it possible to have low blood pressure and symptoms of anemia after dengue?\n\nHi doctor, Female, 34 years old, 164 cm height, and 74 kg weight. Last month I suffered from dengue fever DHF NS1 antigen positive right lung pneumonia right lung pleval effusion, ascites, and type 1 respiratory failure, anemia and PV bleeding. Now after recovery, I consulted doctor, he carried out various test as found all normal except reticulate count 3.2, Hb 9.9, mean corpuscular vol 104.7 plus all ultrasound and X-ray are now normal. Coombs direct test is positive so doctor has told to consult hematologist regarding this and current prescription is Folic acid 5 mg only. My problem is only weakness and low blood pressure and symptoms of an anemic patient. Kindly guide what is the treatment for coombs test positive patient.",
    "doctor_response": "Hello. The positive direct coombs test is suggestive of some form of hemolytic anemia in which antibody bind to red blood cells. The DCT could be positive because of immune hemolytic anemia. Dengue infection is form of viral infection and it can cause immune hemolytic anemia for short time. So, your DCT might be positive. Drink lots of water and fruit juice. After full recovery from dengue, repeat DCT test after few days. The iron supplement can be prescribed. You can consult nearby hematologist for detailed evaluation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to improve health of ova in order to get pregnant\n\nI had two ectopic pregnancies during which both my fallopian tubes were removed. Subsequently I had two IVF failures too. My doctor concluded that the reason for this is having poor ova. Kindly advice me medication or diet to improve the health of my ova. I am 33 yrs old with no medical history.",
    "doctor_response": "Hi there, I have understood your concern. I will suggest you the best possible treatment options. 1 ) First of all do not panic. 2 ) please get blood levels of the following - FSH, LH, PROLACTIN, AMH on second day of the cycle. This will help to know about ovarian capacity to form eggs. 3 )  please get post menstrual hysteroscopy done to know about the uterine cavity and endometrium.- the lining of the womb. 4 )  Please seek prescription support from your treating doctor for getting Anti oxidants, Folic acid, Vitamin B 12 and Omega 3 supplements and DHEA .These are found to improve the quality of the egg. I hope this answer helps you. May God bless you with a bundle of joy. Thanks. Dr. Purushottam Neurgaonkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for red and itchy anus area\n\nHello, my daughter is 6. Yesterday she spent too long in a wet bathing suit. Last night she complained of a sore bum. The area around her anus is very red and irritated. She also said it hurt inside her anus. This morning she is saying it just hurts around her anus. It is still very red. I looked for worms last night, with a flash light, but didn t see any , and because of the long time in the swimsuit yesterday, I suspect it s a fungal infection. It s extremely itchy. What can I do to relieve her discomfort and to start to treat this? Is there anything over-the -counter I can get?",
    "doctor_response": "Hello. I just read through your question.For the redness and irritation, zinc oxide can be used 2-3 times per day. if you suspect fungal infection, you can use any over the counter anti fungal cream (ie: miconazole). if there is no improvement within 2-3 days, I recommend consulting with your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can low blood count cause seizures?\n\nI recently took a trip to the ER for my fifth seizure in 2 years. Because of there infrequencies, I have not gone to a neurologist Yet. The last trip though the Doctor contacted me afterwards and left a message saying I have a low platelet count, My question is could the low count be causing the seizures? I am an above average drinker, but was not in withdrawl during any of the incurrences.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I must disagree with your assessment that 5 seizures in 2 years somehow represents a lower frequency of episodes than would be considered a good use of either your time or the doctor's time in seeing you. Also, if you are an \"above average drinker\" then, SEIZURE ACTIVITY may actually be a SYMPTOM of WITHDRAWAL and should be considered. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could abdomen pain with pressure on vaginal area suggest?\n\nHi Been having pain in the back on the lower left side.radiates to the front lower abdomen. Also have been having some slight painful sensation followed by sensation of heat in vaginal area along with a feeling of pressure in the vagina. when bending down and pressing on the left abdomen with thighs firmly  felt severe pain/sharp pain sensations on the front left lower abdomen too What could this be from?",
    "doctor_response": "Hi.Thanks for your query. Read the history and understood the problems. You have a pain on lower left back, radiating to the front lower abdomen, pain and heat sensation and pressure  in the vaginal area, on bending down or pressing on the left abdomen. The post probable causes can be: Pelvic pathology - Ovarian cyst with or without torsion / Salpingitis, PID, Cystitis of urinary bladder, IBS / Enteritis of some nature. I would suggest you the following :Tests of blood, urine and stool.The best is to get the ultrasonography and then CT scan to confirm and plan for the treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it advisable to take Dopamine agonist after stopping Paliperidone for schizophrenia?\n\nHello doctor, Ropinirole to boost dopamine after Paliperidone treatment for schizophrenia? I am a 46-year-old male. I have been in hospital a couple of times recently, in their judgment I was quite unwell (paranoid about spooks after certain events), diagnosed with schizophrenia (though I am not sure, although I was extremely paranoid), and they put me on a CTO for injections of Paliperidone, which I have been on for the last 18 months or so. 100mg I believe for 6 to 12 months, then 75 mg for six months, and now on the lowest dose that it comes in and have been completely free of thoughts of spooks for nine months, so I am well. But I notice that I seem to be a little zombified due to the effects of the drug, and am worried about Dopamine impact (an important chemical), and frankly, I would like to try to help restore Dopamine to a healthier level. I am not sure that is going to happen naturally, so was wondering about a low dose of a Dopamine agonist like Ripinirole for perhaps a year or so, to get things moving in the right direction. Whether this would actually help restore dopamine function though I am not sure. Also, it can increase the chance of psychosis, hence the preference for low dosage. What I am after then is some brief comment on whether you would recommend this or not (at a glance), or something else. Any comment would be appreciated.",
    "doctor_response": "Hi. Taking Dopamine agonist to restore dopamine level in the brain after giving antipsychotics for schizophrenia is not a suitable choice because of relapse of psychotic symptoms or exacerbation of symptoms not only psychotic symptoms but mood symptoms, these side effects are called extrapyramidal symptoms which can be managed to give anticholinergic medications along with antipsychotics, better to visit your treating doctor to have healthy discussion on this.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Nausea in morning, vomiting yellow bile, had gallbladder removed, diarrhea. Taken Zophran\n\nI have been sick for over 2 years and no one can figure out why. My episodes come and go all the time. I get very nauseated in mornings and usually vomit but i only vomit yellow bile . I have had my gallbladder removed and still vomiting bile. I have diarrhea about 8 times a day and its just bile also. When an episode comes on i began to sweat so bad then i get awful chills. I usually require going to the ER and need an IV with zophran phenergan and protonics. I have had all kinds of test, scans, ive changed my diet 100 times nothing helps. It just comes out of nowhere and its frustrating",
    "doctor_response": "Dear Friend.Welcome to HCM. I am Dr Anshul Varshney.I have read your query in detail. I understand your concern.These signs and symptoms might be because of any of the following:1. Irritable bowel syndrome2. Inflammatory bowel disease3. Malabsorption syndromes4. HyperthyroidismReview with us with all of your reports.This is my best advice for you with the available details, if you have any further query, please ask us.Stay Healthy",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes passing out with flu like symptoms?\n\nYesterday after a workout at the gym I felt I was going to pass out, so I sat in a couch and did pass out for a few seconds. The rest of the day my body suffered flu like symptoms: slightly upset stomach, feeling like I needed to go to the bathroom and headaches; I also had a slight fever.",
    "doctor_response": "Hello,Your symptoms are typical for viral infection. It is necessary to rest for few days, use paracetamol and stay well hydrated. If the symptoms last for more than one week see your Doctor.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful and swollen gums\n\nTwo days ago I felt my gum swollen under one tooth \"gum\" I felt weak pain when press under the right part of my jaw.Next day I had fever, sore throat and the gum swollen in next parts that it begin in the first place and it was controlled using ibuprofen. For profilaxis, I took Augmentin 625 mg, spiramycin-metronidazol, ibuprofen. I used gargles and mouth washes of different types. Yet the next day larger area of my gum was affected and swollen with the difficulty of swallow. When I tried to brush my teeth, it was painful and it seems that the gum was sensitive and I saw blood.This occured to me for the first time. I am 31 years old.",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. It looks that your gums are infected , you have to get complete cleaning of your tooth and gums done, as without cleaning the infection will not go no medication can treat it permanently. So better you visit your dentist and get complete cleaning done.Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is giving formula milk to 5-month old safe?\n\nHI... I have a 5 months baby(boy).....I am a working women and till four months i was exclusively breast feeding.....now a days i feel my boy is not satisfied fully only with breast feeding....and i too feel my breast milk secretion is getting low.....i need my boy must be satisfied at the end of each feeding.....is it safe to go for any formula milk??? Is there any alternative??? If so pls suggest me a best formula milk.....i am also trying to increase my secretion by taking nutritious food....but still no use....pls suggest.",
    "doctor_response": "Thanks for the query.Breast milk is best milk. But if the milk output is low, You can try nan-1 formula.You need to take care while preparing the milk.Feed him  with wati spoon , try to avoid bottle feed.Hope i milk you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Inflamed liver, elevated bilrubin, yellowish brown urine, hepatitis A,B,C, bile duct blockage,gallstones, pancreatitis negative, advised bland diet. Curable?\n\nI have an inflammed liver , was tested for hepatitis A ,B,C also for bile duct blockage,gallstones and pancreatitis , all negative. I spent 3 days in the hospital as I turned yellow, brown urine and beige stools. My billirubin was 3 times higher than the norm. When I left the hospital my levels were down 60%. . I had a full liver panel test done, will have the results in a week when I have an app. with the gastroenteronogist. I am a moderate drinker, 58 years old,I had hepatitis A 29 years ago from redtide clams. I am a health nut, take lots of supplements, eat extremely well and walk an hour daily. I am concerend, is this curable ? What could it be ? My gastroenterologist wants me to stop all my supplements, eat small frequent bland meals and rest. I have been in be for 7days as my energy level are low. Thank you for any advice you can pass my way.",
    "doctor_response": "HELLO THANKS FOR POSTING YOUR QUERY AFTER GOING THROUGH DETAILS OF YOUR HISTORY AND INVESTIGATIONS IT SEEMS IT MAY BE ALCOHOL INDUCED HEPATITIS SINCE YOU ARE CHRONIC ALCOHOLIC.SO PLEASE STOP DRINKING NOW OTHERWISE THIS DISEASE WILL PROGRESS AND CAN CAUSE SEVERE LIVER DAMAGE WHICH MAY BE IRREVERSIBLE.CONSULT YOUR DOCTOR WITH ALL REPORTS INCLUDING LIVER FUNCTION TEST AND ULTRASONOGRAPHY OF ABDOMEN. I HOPE I HAVE ANSWERED YOUR QUERY.I WILL BE AVAILABLE FOR FURTHER QUERIES IF ANY. REGARDS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. l got a sore hard lump after the removal of wisdom tooth. Is it normal?\n\nHello doctor,I just got one side of my wisdom teeth removed both upper and lower six days ago, and I have another one scheduled after two days for the left side. The upper is 100 % fine, which they pulled. The lower they pulled the tooth without removing the root because it was too close to the nerve. I do have some stitching in this area currently on the lower cheek. Noticed a hard lump about 1 inch between my lower jawline and cheek area. Is this normal because of swelling or something else. Currently taking Amoxicillin 500 mg and Ibuprofen 600 mg. Please let me know what this hard lump is, also generally on the lower side where this lump is, remains sore.",
    "doctor_response": "Hello. The lump is mostly a hard swelling which forms postsurgical removal of the wisdom tooth or maybe even by swollen lymph nodes due to infection. It takes a week or two for the swelling to subside. Sometimes, if the root is still inside, the infection may be remaining there causing swelling. Get an X-ray done to find out the exact problem and stronger antibiotics like Augmentin (Amoxicillin and Clavulanic acid) along with a painkiller for a week. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having swollen lymph nodes and pain in my wisdom tooth?\n\nHi my left bottom wisdom tooth is coming through and painful but also my lymph nodes are swallen and soar I'm sure it's perconitus but I also have like a large patch on my cheek which looks like what I can only describe as acny like on my left cheek. , is this normal and can it be treat without a dentist",
    "doctor_response": "hiwelcome to HCMduring the eruption of wisdom tooth it sometime cause pain. if the tooth is infected then it may lead to enlarge lymphnode.  first get your OPG xray doneAbout patch, if its white in colour then depends weather its cheek bite, leukoplakia or candidiasis etc . which can also be confirm by seeing the patch.for both thing visit dentist. meanwhile for wisdom tooth do warm saline gargles and can get painkiller.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bump on elbow\n\nhi i am 17 years old. i just discovered a bump on my elbow. upon accidentally bursting it, i saw water coming out of it. 2 days later i found another one on my chin which also released water as soon it burst. it then dries and forms a bump with a scab on it. it wasn't like a pimple though. it secreted some clear liquid. please advice.",
    "doctor_response": "Hi,Dear,Good evening.Thanks for your query to Health Care Magic.I studied your query in-depth. In my opinion the bump at 2 sites-is-Molluscum Contagiousum-as-the elbow lesion spread to chin , and as it affects young adults also./ or could be-Pimples -common at your age.Treatment-a-Molluscum-Contagiosum-as it -Being Viral is-self limiting and could be treated by -Steroids/antihistaminics with supportive vitamins and lot of liquids.b-Pimples -need Antibiotics / NSAIDs/ and  hygine of the skin at site for to avoid spread.Hope this would clarify the worry you had.Would love to Wellcome your queries to HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tight abdominal muscles, had anxiety attack, took antidepressant. Solution?\n\ni have been having tightness in my abdominal muscles for the past 2 years.i had this problem after i had a anxiety attattack before 2 years,when i sleep i feel my abdominal muscles are tighter than normal.i took antideppressant for the past 2 years ,but no change at all,i dont feel anxiety but abdominals are feeling tighter i want to know,wats the correct solution",
    "doctor_response": "hello to you and thanks for your question.you need some myorelaxants for the abdominal muscle tightness. also see a doctor to make sure there's nothing severe inside.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hyperkalemia\n\nOur daughter has an elevated potassium (no number given), but she has felt tingling in her hands, has an irregular heart rhythm, and recently blacked out . Could this be Hyperkalemia? Only once when she broke her wrist (age 14) the physician pressed on the pressure point, after removing her cast. She passed out, and convulsed. Nothing since. No other related issues.",
    "doctor_response": "Hello, Hyperaemia is a dangerous problem especially if she has abnormal heart rhythm. If you can upload the value and the EKG, I would give my opinion? Does she have any kidney disease? She should see a doctor and have investigations and treatment. In the meantime she should keep off fruits and fruit juices which are rich in Potassium.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should Isosorbide be taken daily to manage chest pain?\n\nMy doctor has ordered isosorbide for me because I have occasional chest pain which goes through to my back. My blood pressure is also occasionally high, but not most of the time. It is usually about 128/70. I take a number of other meds and I really don t want to add any if I don t have to. I m always afraid of side effects. My cardiac cath showed blockage of 40%. Is it really necessary to take medicine every day? Why not the old nitro that worked quickly and only as needed?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. * As there is 40 % of blockage, there is definite need of antianginal drug on regular basis for better symptom free life. * I recommend to continue the same drug as directed by your    physician for best possible outcome. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic cough\n\nHi Doctor I am Ashwin aged 25 For the past 2 months i have been suffereing cough not sure wat cousgh it is i tried medicenes and in fact took up 5 bottles of syrup wen to 2 doctors 2ice each but still it is not cured added to this i started getting ulcerts becoz of medecines what shall i do",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.In my opinion, you should consult pulmonologist for your chronic cough (cough for more than 2 weeks).You will need chest x ray and PFT (Pulmonary Function Test).Chest x ray is needed to rule out lung infection like pneumonia or tuberculosis.PFT is must for the diagnosis of bronchitis.Yoi will need antibiotics, inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone) based on the reports.Don't worry, you will be alright. First diagnose android then start appropriate treatment.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe abdominal pain from unintentional weight loss?\n\nHi, my name is Crystal. I'm 33 yrs old. My problem has been going on for about a yr and a half. Started out with just loss of weight and appetite and frequent movements. But now has progresses. I have movements at least 9 times a day ( I have counted) and along w loss of weight and appetite I have started having severe abdominal pain, like someone tightening a knot in my stomach. This has just started but I see my symptoms getting worse and worse. I know something is wrong. What does it sound like to u?",
    "doctor_response": "Ms/Mr Crystal, you are right in assuming at least after 18 months of patient observation that some thing went wrong with your system. Now i need to tell you a thing- mind and body are like friends and as long as they balance each other things are healthy. But either one gets upset, other suffer. So is your case. So we need to do some tests like Endoscopy and biosy to know whether it is body affection like ulcerative colitis or crohn,s enteritis or specific infection or it is Irritable Bowel Syndrome where we don't any clue to your symptoms. Please be assured in any situation this is manageable. Hence do not delay now . Consult A Enterology Dept to fix problem.All the Best to you !!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the skin which is hanging from the wisdom tooth gap?\n\nI have a nodule of skin hanging over where my wisdom tooth was extracted. It's about 4mm by 2mm and fairly bothersome when I'm eating. Because its the weekend my dentist is closed so I don't know who else to ask. It's been there since the extraction and is slowly turning a dark red from the fleshy pink colour it used to be. Any guesses or suggestions as to what I'm dealing with?",
    "doctor_response": "Hello and welcome to HCM,A skin hanging from the site where wisdom tooth was extracted can be due to normal healing process.The extraction site is initially filled by blood.Slowly a hematoma is formed.Hematoma is collection of blood and slowly it undergoes organization to heal up and form a ridge of soft tissue.Infection of the extraction site needs to be controlled.In case there is pain or pus collection at the site, you need to see your dentist immediately.The skin that has grown over the extraction site is new to you so it is appearing troublesome.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the findings from the brain MRI report?\n\nDear Doctor;Could you please explain to me the following MRI brain results in plain understandable English please.Is this condition is a big health issue??I had a brain MRI before and found mild generalised atrophy ; are we talking about the same finding in this mri report.==========================================================Clinical notes: Chronic HeadachesFindings: Generalised prominence of venticular system greater than expected for pateints age and disproportionate to the degree of sulcal prominence. No interventicular obstructing lesion identified.Normal pitutary with no superior convexity to corpus callosum. Findings : However , raise a possibility for communication hydrocephalus. No mass diffusion restriction or extra -axial collection. Major intracranial flow voids are preserved.Comments : Generalised dilation of venticular system raises the possibility for communicating hydrocephalus. No other significant findings.Thank you very MuchWarm RegardsJay",
    "doctor_response": "Hi Mr Jay,Thank you for posting your query.I have noted the findings of your MRI brain. First of all, I would like to reassure you that the MRI findings are not of concern and there is no need to worry about it.Yes, these findings are suggestive of mild cerebral atrophy (similar to the findings of your previous MRI). In any case, what was the reason for doing the current MRI? This information is important to establish the significance of the MRI findings.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What course of treatment should be taken for bipolar disorder and depression?\n\nHello.,...I am seriously struggling, suicidal ideas, diagnosed with Bipolar 5 weeks ago, am taking Sodium Valpororate, psychologist just told me in a hospital my levels would be up in 3 days, my family do not believe this about me, my mother used to work in mental health, very difficult to talk to her, my dad does not understand.This pains me greatly. I am 45, single, no children,lived alone last decade, had C3\\C4 fusion,Central Asia_D syndrome. Extremely depressed.",
    "doctor_response": "Hello, Your psychiatrist is right to say that the level of medications will be achieved in few days. There is good possibility that you will feel better over the coming days. I understand that you have little social support from family members but I think help of friends can be asked at this time. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ashok Kumar, Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling of tongue stuck to mouth. Taking Prestiq for depression. Is that the problem?\n\nI have been noticing my tongue sweeps in the back of my mouth. It wakes me up at night because it feels like my tongue is stuck to my teeth it is so big. I am taking prestiq for depression . Is that the problem? Or is there something else. I ve also noticed my legs swelling during the day and I ve put on aboutn50 pounds in the last year.",
    "doctor_response": "Hello and welcome to HCM, As you are on the antidepressant drug Prestique which has many disadvantages , i suspect the symptoms of pedal edema , lethergy , hypertension ,weight gain are related to the use of drug. i suggest you to take such medicines only under medical supervision . You need to consult physician soon and get the information about safety of this drug use. To your knowledge i can add few disadvantages og this drug like bleeding disorders, hypertension, mania, seizures, wight gain , lethergy, dry mouth , drowsiness and so on. i hope this helps you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Painful ulcer on gums, taking becosules, cause. Can I use smile gel?\n\nHi, I am a 27 year old female. I developed an ulcer on the tongue last week which healed after applying smile gel. Now a small white circle has formed on my lower front gum and on the skin joining my lower front gum and lip. It is extremely painful. Will smile gel heal this as well? Also are canker sores or gums sores the same as mouth / tongue ulcers? I had started taking becosules a week before? Could the becosules have caused the tongue ulcer and gum sores, as I very rarely get them otherwise? Thank you for the help.",
    "doctor_response": "Hi,Neerajaji, Welcome to HCM, It seems that you might have apthous ulcer. Only smile gel is not enough. Go for antibiotic medicine and B.complex and lactobacillus sachets. Do salt water gargle frequently. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for heart ailments\n\nI am 32, 165lbs and I have barrots esophagus. I have these (what I call) episodes where for several days I feel like I am having a heart attack, pain under left breast, pressure, feel like I cannot breathe. I have had numerous tests done on my heart and they say it is fine. I do have tachycardia where my heart will sometimes race up to 128 or so, but have been on metoprolol for that for 1 1/2 years, but drs say it is nothing to worry about and that it is not related. When I have these episodes I can barely stand it. It feels like there is something so wrong with my body and I feel so bad, but I have no options. It will come on with no warning, whether I have cheated food wise or if I have been following the diet of no red sauce, no fried foods, no carbonation, no caffeine, nothing spicy. These episodes will last for days and I feel so miserable. Is there anything I can do? I am desperate! I am working out regularly to try to loose weight and have lost 15 pounds and I am on daily prescription prevacid.Thank you!",
    "doctor_response": "Hi,It mostly a acidity and reflux disease. You can add  tab Domperidone which is prokinetic drug preventing reflux of acid and damage to esophagus, to prevacid. Otherwise continue to avoid fatty, oily and high calorie diet. Have some walk after having food instead of taking rest. Have multiple small meals instead of heavy meals. Have regular sleep habits and avoid stress. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe abdominal pain\n\nMy daughter, age 23 is having severe abdominal pain. These stabbing pains are lasting about 5 minutes. She went to the doctor yesterday, before these symptoms started and was diagnosed with a probable uti and prescribed antibiotics. There are stomach bugs running around our town right now.",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query.If I were your family physician, I would have advised your daughter for a urine routine/microscopic and culture sensitivity test before starting the antibiotic. Also a routine blood test like a complete blood count and a stool test for ova and cyst would be worthwhile, and treated if positive. If all the reports are inclusive, I would not hesitate to get her examined by a gynaecologist along with an ultrasound of the abdomen to rule out any pelvic infection and pathology. Further management would depend on the findings of physical examination and results of related investigations.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and bleeding around the teeth removed area?\n\nI had all four wisdom teeth removed a week ago. On the top right side, some bone is exposed further up on the outer gums on the furthest back molar. It's painful and bleeds occasionally. Also, on my bottom left side, I think the stitches came out too early or something and gums opened up and turned black. I am also experiencing some pain on that side. I have been rinsing with warm salt water but I'm not noticing a difference.",
    "doctor_response": "Thanks for your query, I have gone through your query.The bleeding could be because of the opened up wound or secondary to any bony spicule causing trauma to the overlying gums. Consult a oral maxillofacial surgeon and get it smoothened and stitches placed. Do not gargle too much. Apply pressure with cotton dipped and sqeesed in saline and bite it and hold. it reduces the bleeding.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a bump on the head\n\nI had a bump on my scalp for about 6 months it got really sore and I finally busted it but know it's still leaking a reddish liquid. it's not painful after 2or 3 days it fill back up with the reddish liquid. How can I treat this without a doctors visit?",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. By your history and description, in my opinion, you are mostly having infected sebaceous cyst. Sebaceous cyst is common in hairy area. It is due to obstruction of the duct. So the sebum  accumulates in it and cause swelling. If you burst it, sebum will come out. Since the obstruction is there sebum will again fill up and cause recurrent swelling. Best treatment is surgical removal of sebaceous cyst. So consult surgeon and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy rash behind ears, neck and on hairline?\n\nI have ichty rash behind ears and on hair line and neck,so does my partner,they seem to clear up,then come back when stressed or hot,tried numerous creams,plus washing with plain soaps more often,changing bed covers,towels more frequently,my doctor said I m allegorical to something,but why did my partner have bad skin for years,then suddenly on the last year I ve got it,we have been together for 11years,his skin thing was meant to be something to do with his stress levels,what can it be.",
    "doctor_response": "hi there.1. your concern may be eithera. allergic contact dermatitis to hair dye.b.seborrhoeic dermatitis, a type of eczema secondary to candidial yeast infection.2. you can try sebowash shampoo weekly twice, wash your scalp with soft drinking water .3. apply lulifin lotion, once daily bed time for 30 consecutive days.4. avoid hair oil and pollution.5. stress will flare seborrhoeic dermatitis.this will help you probably.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bump on back of head\n\nMy son fell at an amusement park today about 4 hours ago and hit his head on the concrete curb. He was examined by paramedics and I have been watching him very closely. He seems to be acting normally. However, he has a bump on the back of the head. Is it normal for the bump to hurt? How long will it hurt? Can he take a nap?",
    "doctor_response": "From the scenario what you have said I think it must be an haematoma... Haematoma means  collection of blood..if your son didn't have any loss of consciousness or vomiting there nothing much to worry ..just give hot water compression for two days.Haematoma usually gets absorbed in 3 to 4 days. He can paracetamol for pain..he can sleep in one side so that u can avoid compression of haematoma which might cause pain for initial two days..I hope I have answered you queries... Get well soon... Have u good day...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does fibroid or cyst or T.B cause pain in the abdomen?\n\nI am 31 yrs old. I have pain in lower abdoman for last 2 yrs. and I was operated for appendix .A small cyst and fibroid is  found in utrus and I also have T.B in stomach. I want to know the reason of pain .Is this due to fibroid or cyst or T.B pls answer.",
    "doctor_response": "Hello, welcome to healthcare magic forum,It is the TB which causes pain in abdomen, where as fibroid and cyst are less painful, cyst when ruptures becomes painful.So it is 100% the TB which is causing pain abdomen, hope you are continuing your abdominal TB medication.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in head when laughing, coughing or bending over. Cause for concern?\n\nHi there I m 27 and in great health otherwise, but for the last few days I ve been having a pain in the right side of my head (feels deep..like in my brain or something). It happens when I laugh, cough , bend over etc. I m wondering if this is a cause for concern or what it could possible be from. Thanks! YYYY@YYYY",
    "doctor_response": "Hi, thanks for writing to HCM.Based on the description, I suspect that you could be having COUGH HEADACHE which usually results from increases intracranial pressure during coughing causing headache.The other possibility is a SINUS INFECTION, for which an xray of the PNS or a CT scan will establish the diagnosis. Based on the severity of involvement a course of an Antibiotic along with antiinflammatory agent or a surgical drainage may be indicated.So, a detailed clinical examination and appropriate investigations are needed for further management.Hope this information is helpful. Good day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Whenever I think of sex,my penis starts secreting a transparent fluid. Is this a normal condition or some disease?\n\nHello doctor, I am a\u00a020 year\u00a0old male. Whenever I think of sex, my penis starts secreting a transparent fluid which keeps on coming out from my penis until I masturbate. Also if I do not masturbate after the excitation, my penis starts paining. Is this a normal condition or some disease? After 1-2 hours of masturbating, there is a mild pain in my penis which persists for few minutes. Also tell me how to increase the sperm count. Please help me with this.",
    "doctor_response": "Hello. What you are experiencing is a normal process. Whenever men are excited, the secretions start discharging from penis. The fluid which discharges initially is the pre-ejaculatory fluid (pre-cum). When you masturbate, the seminal fluid is discharged. Slight pain after excitation and masturbation is also normal. It subsides in a day or two. This is mostly due to muscle fatigue. Sperm count can be increased by drugs like Fertisure-M taken once a day for at least 3-6 months. Revert back to a sexologist online for further follow up -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get vivid dreams in which my best friend is abandoning me. Please help.\n\nHello doctor, I do not have a health issue but lately, I keep having an intensely vivid dream that an old best friend from high school or college abandons me right when everything gets crazy and I have people trying to hurt me. It is always in the manner of my phone will not connect with him or something like that but last night it was just that he was there and disappeared when I needed help. I keep waking up in a cold sweat and feeling like my dream has actually happened.",
    "doctor_response": "Hi. Dream interpretation is not a reliable science branch yet. Many types of research have been done on dream interpretation but there are no conclusions yet as to what suggests what. Some researchers say dreams have no purpose or meaning and are nonsensical activities of the sleeping brain. Others say dreams are necessary for mental, emotional, and physical health. Studies have shown the importance of dreams to our health and well-being. In one study, researchers woke subjects just as they were drifting off into REM sleep. They found that those who were not allowed to dream experienced: Increased tension, anxiety, depression, difficulty concentrating, lack of coordination, weight gain, tendency to hallucinate. Nightmares, or bad dreams, are common in children and adults. Often nightmares are caused by: Stress, conflict, and fear, trauma, emotional problems, medication or drug use, illness. If you have a recurring nightmare, your subconscious may be trying to tell you something. Listen to it. If you cannot figure out why you are having bad dreams, and you continue to have them, I can help you figure out what is causing your nightmares and provide tips to put you at ease. In your case, you must be having an emotional issue with your friend and you are stressed due to that. Keep in mind that no matter how scary a nightmare is, it is not real and most likely will not happen to you in real life. Therefore, do not worry about any dreams at all. Worry may further stress you and may sometime make you be obsessive on those thoughts which may further develop into depression. Ignore those dreams. Engage in your day to day activities. Increase your physical activity level so that you sleep well and sound at night. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal for teeth staining after braces removal?\n\nwhat is normal teeth staining after braces removal. My 8 year old son just had his braces removed and underneath is pearly white. Is it normal for the rest of his teeth to look normal. Will this go away on it's own? Is there a way to get rid of the yellow?",
    "doctor_response": "helloo..read through ur query....staining after removal braces is due to mainly the composite residues used to stick the brackets....nothing to worry...it is usual just that u have to wait for sometime...u have to go dentist for scaling..after few scaling it will be normal...and at home he has to brush twice daily....nothing to worry at all..its just as usual....hope ur clear with my reply...have a healthy day!!!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment should one with irregular periods and pcod take to get pregnant ?\n\npcod irregular periods 37x31mm cyst in LT ovary on11july. 7x7mm inRTovary and 11x12mm inLT ovary on22 july. 11x12mm inRTovary and 8x9mm inLT ovary on27july. what does this mean? IS ovulation happen this time",
    "doctor_response": "Hello Thanks for your query. This study is known as follicular study ,it done to monitor the formation of follicle that must be more than 17-20mm in diameter ,before an injection is given for the release of ovum ,necessary for fertilization and pregnancy .As you don`t have dominant follicle ,so chances of pregnancy are poor. \u2018Hope I have answered your query, I will be available to answer your follow up queries, \u201cWish you Good Health and trouble free speedy recovery\u201d",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can degenerative discs in lower back be treated?\n\nI have degenerative discs in my lower back but they have been behaving. Friday nite i pushed a very heavy wheeled cart at work and developed lower back ache, which I thought were just the discs aggravated..BUT a couple hours later I was getting very bad spasm like pain in the tailbone area when I bent over or got up or down and even if I leaned forward to reach for something while sitting...doesnt feel like the normal back aches...I had a pylonodoial (sp?) cyst removed when I was 15...am 52 now...could it be another? There is no lump or irritation in the area but I cant even touch it without pain...thanks",
    "doctor_response": "with rest u wil get relief..take triphala guggulu tablet 1 thrice a day..avoid weight lifting.massage with mahanarayan oil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain, spinal pain on lifting something heavy, pain in bent condition\n\nAge: 29 Height: 180 cm Weight: 70 Kg Sex: Male It is about one month that I have experienced some pain in the bottom of my spine and its surrounding. Its pain have been appear when I lifting some heavy things at home for a cyclic period during a day in the bent condition. At first it was not very painful; however, day by day my problem and pain had grown. When I went gym and did exercise very slightly its pain was eliminated but after some hours it returned. Now its pain is very severe and I could not sit down easily and after sitting for more that one hour I have some problem to upright my position. It is essential to say that I have been going gym for about 7 years, I am a student of mechanical engineering and recently for a long time sit on the chair.",
    "doctor_response": "Hi From your complaints of pain in the lower back suggests you are having a intervertebral disc prolapse at your Lumbar spine. Do not lift heavy weights . Get a X-Ray Lumbar spine AP and Lateral view done and consult a Orthopaedic Surgeon soon. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shoulder, right thigh and hip pain\n\ni am 36 years male. i am suffering with shoulder pain along with sever pain in heels. also pain in right hip and in thighs and crotch on same side. Blood test shows ESR 106 pus cells in urine upto 30. Chest x ray is normal. I am on pain killers for the last one month.",
    "doctor_response": "hilooks like you are suffering from urinary tract infection with  severe body pains.take plenty of oral fluidsplease go ahead with your urine culture to know the  organism &  drug sensitivityESR :106 &  pus cells: 30 in urine indicates you are having the infection since long time.IT IS NOT ADVISABLE TO TAKE PAINKILLERS UNTIL THE CAUSE IS TREATED.all the besttake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Missed taking pill. Started bleeding between periods. What is going on?\n\nhi there i just have a question about bleeding between periods this is the second month that in the middle of my second week of pills i start to experince brown like discharge much like the begging of a period . last month it happend because i missed a couple pills i went to my doctor and he said it was totally normal to continue taking the pills wait for my period let that happen normallly and the begin my next month normally but now this month i have started my pills havent missed any at all and as of today im experinceing this brownish discharge. im not sure what is going on",
    "doctor_response": "Hi, Welcome to Health care magic forum.                      Some times it may happen with the pills. It may be the result of your missing the pills in the previous month you had bleeding, and it is repeated again this month, if i am right,it may stop next month, or there after.                       If it is not the cause, the other causes are the anemia, and infection.                        Take more of green leafy vegetables, pulses, sprouts,and protein rich foods to have a good cycles.                       Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have these occasional gas pains, what it could be ?\n\nI have these occasional gas pains that really hurt my abdominal area and makes it very hard to sleep... it doesn't happen that often but maybe once in 2 months, is this an ulcer ? if it isn't what is this ? i am 13 years old.",
    "doctor_response": "Hello. You would get a better help, if you could describe your symptoms in detail( duration, any variation with time, food, etc) and the location of the pain, etc.. Bloating is sensation of tightness around the abdomen area or increased in size( due to gas in the GI tract). Causes vary from consuming aerated drinks, alcohol, high fiber foods to many medical conditions. Ulcer presents as pain mostly in the gastric region( stomach area). Pain after talking food or pain reliving after taking food. Also may present burning sensation in the throat and neck in some cases. Get an examination done from doctor to confirm any diagnosis. Here are some tips to help you in the mean while. 1) Drink plenty of liquids ( Water, fresh fruits and vegetable juices). 2) Avoid high fiber diet. 3) Pro biotic supplements containing intestinal bacterial spores may assist with restoring intestinal bacterial populations. 4) Avoid spicy food, alcohol, smoke , etc. Follow me on twitter for daily tips, drarunprakashmd.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is Mometasone dangerous to use on Face to clear my acne pimples?\n\nHello doctor, I am seriously facing acne pimples problem. Sometimes they occur on my face when I masturbate. If I use Mometasone, it gives a good result. Is it okay to continue this?",
    "doctor_response": "Hello. Acne is a universal issue in the age group of 15 to 25 years due to hormonal changes in adolescents. However, there are multiple effective treatment options depending on the grade and severity of the problem. Mometasone is a topical steroid and is to be avoided strictly on the face and for acne as it can harm your skin in the long run. Acne is dependent on hormones hence excess masturbation may sometimes lead to an increase in the problem. I would advise you to stop Mometasone immediately and kindly upload appropriate images to help us assess your current grade of acne and treat you better. Regards. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruise and numbness on knee?\n\nI had a minor motorcycle wreck and the weight of the bike landed on my knee. It s bruised and sometimes feels crunchy when I move it- as though a tendon is shifting. Also it almost feels numb on the surface. Symptoms have persisted for five days after the wreck without getting much better. Any thoughts? The trauma caused no twisting/straining- only impact.",
    "doctor_response": "Hello, I have studied your case.As per your age and history there is possibility of soft tissue injury in knee.Most commonly meniscus injury occurs. As per your symptoms you need to do physiotherapy and knee exercises to improve range of motion .If pain persist then you may need to do MRI again to see for any functional defect.Small meniscus tear can be managed conservatively with physiotherapy with USG and TENS.Meniscus injury can be managed by arthroscopic repair,and same day you can go home.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the prognosis for Staph Aureus infection in a dialysis patient?\n\nMy dad caught a virus in his bloodstream staph aureus which is being treated with antibiotics, however he is a dialysis patient for 9 consecutive years with 2 kidney transplants in 20 years. His heart condition is weak functioning at 10 percent, what are his chances of survival and if not much how long does he have.",
    "doctor_response": "Hi, thanks for using healthcare magicStap aureus bacterial infection can have varied severity from mild to severe.The presence of reduced kidney and heart function would significantly affect his ability to respond appropriately to treatment but it is possible that he may recover.Unfortunately no doctor can absolutely accurately predict how long any patient would live but his doctors with daily knowledge of his blood tests and examination findings would be in a better position to determine his prognosis.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could sperm count 150 million in semen analysis suggest?\n\nSir I was married in july 2009, but I dont have any child I want children but what should I do, I had semen analysis test which shows: sperm count 150 millions, motility 70%, morphology 75%. do I need treatment? is morphology normal??please help me in these 2 questions",
    "doctor_response": "Hi, Yes. it is normal. You don't need any treatment.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had kidney infection. Stent placed and taking antibiotic. Noticed blood in urine. What's wrong?\n\nBack on 12 /6, I went to the ER. I had a kidney infection and a kidney stone , the place a stent and gave me anitbiotics. I had a 1.9 cm kidney Stoney remove on 12/27 by doing surgery. I just finish my last antibiotic and still have the stent.( being removed Monday). I still see blood in my urine, my right leg is numb (same side as kidney stone) and I feel drained, is the normal?",
    "doctor_response": "Hi Welcome to HCM. The blood can be related to stent related infection. The numbness may be due to leg position during the procedure. Tiredness will go off once you are completely clear off the infection . Stent removal and antibiotics are needed. Best regards DR GS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a painful swollen lump on the buttock cheek be treated?\n\nFollowing a THD procedure on 15 August 2014 I prolapsed 6 days after. The recovery has been painful since the first day but started to ease. Since Wednesday 5 August I noticed pain returning to the left hand side of my bum. It has got progressively worse and I now have an extremely painful swollen lump in my left butt cheek. The area is hot to touch appears to be red. There also appears to b swelling. There are no lumps on the outside of the cheek visually but to to touch, walk or do anything it is extremely painful. Any ideas",
    "doctor_response": "it is likely to be gluteal abscess ,you can confirm it by needle aspiration or ultrasonography and  you need to drain it as soon as possible by a surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Nephrotic syndrome\n\nON 20/4/12, WE NOTICED A LITTLE PUFFYNESS ON MY 3YRS 6 MONTHS DAUGHTER \u2018S FACE ALONGWITH LOW URINE OUTPUT. WE MISSTOOK IT FOR COLD SWELLING AS SHE WAS SUFFERING FROM COUGH & COLD AT THAT PARTICULAR TIME. ON 27/4/12 DOCTOR DIAGONIZED AT AS NEPHROTIC SYNDROME. AT THAT TIME HER BODY WEIGHT WAS 14.3KGS. SHE WAS HOSPITALIZED FROM THE SAME DAY & WAS GIVEN 11.5 ML OF STERIOD (OMNACORTILFORTE),5MG PER 5ML. IN HOSPITAL SHE SUFFERED FROM SEVERE ABDOMINAL PAIN AND NAUSEA. GRADUALLY FROM THE 9TH DAY(5/5/12),HER PROTEIN LEVEL STARTED REDUCING FROM 3+ TO 2+. FROM 10TH DAY ONWARDS URINE OUTPUT INCREASED AND ON 13TH DAY URINE HAD \u2013VE READING. FROM 27TH APRIL\u201912 TO 7/6/12, SHE WAS GIVEN FULL DOSE OF OMNACORTIL FORTE -11.5ML AND FROM 8TH JUNE\u201912, SHE STARTED HAVING 6.5 ML EVERY ALTERNATE DAY. AFTER RECEIVING IT FOR 2 DAYS I.E FROM 8TH TO 13TH JUNE\u201912, WE AGAIN NOTICED PRESENCE OF PROTEIN IN HER URINE. ON 15TH JUNE\u201912 , IT BECAME 3+ & FROM 27TH JUNE \u201912 ONWARDS DOCTOR PRESCRIBED 12ML OMNACORTIL FORTE DAILY & ADVICED US TO WAIT FOR 10 DAYS FOR REMISSION. AT THAT POINT OF TIME HER WEIGHT WAS 17.5 KGS. FROM 22ND JUNE \u201912 TO 3RD JULY\u201912-HER PROTEIN LEVEL FRUCTUALED FROM 4+ TO 3+ AND THEN TO 2+ & REMAIN CONSTANT 2+ FOR 4 CONSUCUTIVE DAYS. ON 4TH JULY, HER PROTEIN LEVEL AGAIN JUMPED TO 4+ AND HER WEIGHT WAS AROUND 18 KGS. SHE HAD SWELLING ON HER FACE AND HER ABDOMINAL DIRTH INCREASED . WE TOOK HER TO ANOTHER NEPHROLOGIST WHO INCREASEDE THE VOLUME OF MEDICINE FROM 12 ML TO 14ML & ASKED US TO OBSERVED HER FOR 5 DAYS. ON 7TH JULY\u201912 HER PROTIEN LEVEL IS TILL 4+ AND SHE HAS BEEN GIVEN LASISE 40MG TO INCREASE HER URINE OUTPUT AND ALSO ALDDOCTONE 25MG. TODAY HER BP IS 90/60. I HAVE FOLLOWING QUESTION IN MY MIND: 1)IS THE LINE OF TREATMENT OKAY OR DOES YOUR HOSPITAL HAS SOME OTHER REMEDY FOR HER. 2)DOES HER SYMPTOMS INDICATING STERIOD RESISTANCE. 3) IF SO, DO YOU HAVE THERAPY FOR THAT. REQUEST PLEASE GUIDE AND HELP US.",
    "doctor_response": "Hi, You are getting the correct treatment for nephrotic syndrome, it may sometimes take more time for the child to respond. In first episode, steroids are given usually for 12 weeks. If patient has subsequent episodes then treatment is changed. I advice you to continue same medicines and monitor daily weight, urine protein, blood pressure and swelling of eyelids. I hope this has helped you. Take care. Regards Dr Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is light periods be due to intake of leveonelle?\n\nI took leveonelle after unprotected sex within 12 hours.. than I had a period which was heavy and than the next one was very light. I have taken a pregnancy test which was negative. could I still be pregnant as the last one was very light or is this a common problem using leveonelle.",
    "doctor_response": "Hi, It's mighty unlikely for a pregnancy test, even over the counter, to misfire at 1 month or later. The only time is if the test was really Really badly done. On the other hand, starting a new hormonal therapy will most of the time cause a change in periods that takes at least 2-3 cycles to begin to stabilize. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Do ideal BBT raise during ovulation necessary to conceive?\n\nHi doctor, I was diagnosed with PCOS when I was 17 years old and from there on I was taking Diane 35 to regulate my periods. I was having three months gap between periods and sometimes was regular before treatment. Now I am 25 years old, married and trying to conceive. So I had stopped Diane 35 last month. Since then we tried naturally for a few months. But it did not work out. So we started with treatments. The doctor initially put me on Ovacare myo and other vitamin E tablets using which I got my periods on time. This continued for a month. Next she put me on Ovacare and Endothik and post 15 days, I was put on Duphaston. This too did not help to conceive. Next, my follicle study was done. I was checked on the 12th day where my follicle was not that matured and ET was just 7. I was called on 15th day which showed my follicle in the left ovary was 19 mm and ET was 10.2 mm. The doctor gave me an HCG trigger injection. I was asked to try in this period. So I and my husband had contact from 14th, 15th, 17th day and also 18th day. I was called on the 18th day which revealed that my follicle had ruptured and it was a fresh one since it has some fluid around it. So since it is confirmed ovulation, I expected my temperature to rise. I had not checked my BBT before but when I did it on 20th day, it showed a temperature of 36.1 celcius. This is way too less right? With HCG shot and ovulation confirmation, I taught it would rise. Is there some issue here? I am given Duphaston and Mbryo safe sachets to be taken. Please advise if this cycle too I do not have any chance?",
    "doctor_response": "Hello. The chance of pregnancy in the ovulatory cycle is around 25-30%. As ovulation was confirmed, you have some chance. Rise in basal body temperature is an unreliable predictor of ovulation, and once you had confirmed ovulation by a more reliable test (ultrasound), there was no need to check BBT. Your body temperature does not give any information regarding the quality of ovulation and there is no need to assign any significance to body temperature in your case. As I already told, you have around 25-30% chance in each ovulatory cycle and there is no reason to lose hope. Just get your husband's semen analysis done if not already done, as normal semen is equally important for pregnancy to happen.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How will the large clot in the leg break down?\n\nAfter a vaginal hysterectomy the patient developed a severe blood clot in the leg from ankle to hip and clots in the lungs.  She was then given Coumadin and Fragmin.  Before release from the hospital her lungs were clear but the large clot remained.  After 2 weeks on Fragmin the Coumadin Clinic advised that the INR was within the safe range the and Fragmin could be discontinued.  How will the large clot in the leg break down and be released from the body and is the patient still in danger?  She is 41 and has asthsma, but no other recognized defects.",
    "doctor_response": "Hello and welcome to HCM,The drugs prescribed- coumadin and fragmin act by dissolving the clots in body.These drugs are monitored by INR.Thus, these drugs would have acted by dissolving the blood clots.The effectiveness of these drugs is monitored by INR within range.There is nothing to worry.The clots formed as complication of surgery however, the clots will not form once the patient becomes ambulatory or mobile.Thanks and take careDR Shailja Puri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Crisanta LS can be taken along with contraceptive regularly?\n\nWhat are the side effects if crisanta ls is used on a daily basis and morning after pill is taken regularly in a month.i have been taking morning after pill regularly since a month.and using crisanta every day.periods have not occured yet.what can i do next.do i have to take a morning after pill after unprotected sex even while using crisanta? And what is the safe time for unprotected sex before and after periods?please advice.",
    "doctor_response": "HelloThanks for writing to us wiith your health concern.If you are using Crisanta regularly you do not need a morning after pill at all.Taking a morning after pill minimizes its efficacy and maximizes side effects.The reason for the irregular and delayed period is the regular intake of the morning after pill.It is just an emergency contraceptive to be used once in a while in case your regular contraception fails.If you are sincerely taking Crisanta, stop taking morning after pill.The safe period method is not reliable for preventing a pregnancy.However, ovulation occurs on day 14 in a 28 day cycle, so avoid intercourse to be on the safer side from day 10 to day 20.All the bestTake care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat left-sided lower back pain caused due to a sprain?\n\nWhile playing tug of war with my students , I think I pulled something in my back. I am having pain on my lower back side on the left. It hurts to sit and stand depending on the position. I m fine when I m still in bed but endure discomfort if I change positions. I can t bend or squat without some type of pain. I don t know if I pulled a muscle or something else",
    "doctor_response": "if no pain down legs, weakness in legs you might have developed lumbar muscle spasm. It will get relieved by rest, muscle relaxants.also do core strengthening exercise when you are comfortable so that you don't develop these problems later in life.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause of pin pricking pain in back?\n\nI have a sharp, pin prick-like sensation in the same location from time to time recently in the upper left part of my back. It s not constant but it is in the same spot. I had my wife look at it and she did not detect anything unusual about it. I thought it might be a splinter from something but I don t remember doing anything in the area of my back that would cause this type of pain. I was involved in a severe industrial accident where I ruptured the quadriceps tendon at the kneecap on both of my knees. I have painful neuropathy in my toes due to that. Any suggestions as to what s causing the single pin-prick in my back and what to do about it?",
    "doctor_response": "sharp pin prick sensation in back is commonly myofacial in origin. Take NSAIDS with muscle relaxant and hot water fomentation for up to 1 week. If not relieved visit your pain physician, he will examine you and probably a trigger point injection will cure you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes electric shock like short burst of pain from head?\n\nHi I am 60 years old and for the last 15 days have been experiencing electric shock like short burst of pain from my right side of the head going all the way down to my feet.  It only lasts for 15 seconds and disappears.  After that I feel tired and feel little drowsy.  After 30 mins, I become normal. This is very intermittent and happens to me for e.g. alternate or once in 2 or 3 days.",
    "doctor_response": "Hello!Welcome on Healthcaremagic!I would like to know if bending over triggers these episodes. Do you have neck pain or arm pain?If you do not have neck pain and these episodes are not related to bending over, I would recommend performing an EEG and a brain MRI to investigate for seizures. If you experience neck pain and these episodes are triggered by bending over, a cervical spine MRI study may be necessary to investigate for cervical myelopathy. Anyway, a careful neurological exam by a neurologist is necessary to differentiate these two disorders. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is nebulisation required for cough in a child?\n\nHi, My daughter is 6.5 months old & from last sunday she is suffering from cough & cold.The doctor gave us cold act drops & even after that she had some cough & runny nose.Now my pediatrician says she has wheezing & needs to nebulised with saline & duolin solution for 3-4 days in the night.We have not yet tried it,But from yesterday night her cough has come down & she is also feeding well.I feel she has started to recover,Should I go ahed with nebulisation or leave it.",
    "doctor_response": "Hi, Actually, nebulization is not advisable without oxygen source and you cannot give it at home. Rather metered dose inhalers are a better option. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe knee pain\n\nMy knees suddenly started to hurt at soccer practice. First, i felt the right one start hurting and then getting worse and then i felt the left one which was a different pain from the forst one. I walked around a little bit and each got worse. Still, they bothe hurt but the right one hurts when flexed or leg is very straight and it is a sharp pain under kneecap. What is all of this",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have  severe knee pain. Well there can be many reasons for symptoms you mention in query like injury , baker's cyst , fracture , ligament or meniscus injury . I would suggest you to take proper rest , do not walk o move your knee much , apply cold compresses for 48 hours after injury and then apply warm compresses and take ibuprofen or acetaminophen for pain . Consult orthopedic surgeon for proper examination . Doctor will order X-ray ,or CT scan to confirm the diagnosis . Doctor may give plaster along with anti inflammatory and muscle relaxant . Doctor may recommend surgery in severe injury . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause of sneezing a lot, runny nose?\n\nI have been bunged up for months, some days worse than others, sneeze alot, runny nose sometimes, ears ach and roof of mouth itches.....could I be elergect to my HRT tablets as I have never suffered with this before.  I have tried Loratadine 10mg tablets which helps a little but it always returns.  Thanks",
    "doctor_response": "hello,thanks for your query, sequence of sneezes followed by running nose with itching under eyes, roof of mouth, inside the ear are related to allergic rhinitis. u need to avoid sust, curd, cold drinks, ice creams, fridge water. keep ur surondings and car dust free, start avamys  (fluticasone) nasal sprey twice  daily for 1 month. visit an ent surgeon for farther evaluation(nasal polyp) and treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a few medium sized pimples on my penis for about a few days. What could it be?\n\nHello doctor, I have a few medium-sized pimples on my penis. It was only one pimple a few days ago but now it has grown to four. I have started drinking garlic water after watching few suggestions on youtube.",
    "doctor_response": "Hi,  Welcome to icliniq.com. According to your description, there are multiple things that could present as such. It could be molluscum contagiosum, genital warts, or herpes. Sometimes even physiologic changes such as pearly penile papules can also present like this. If you are sexually active it could be an STD (sexually transmitted disease) as well. Kindly revert to me with photos and sexual history so as to aid in diagnosis and treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes discomfort feeling in right testicle?\n\ni am having discomfort in my right testicle, it has been about a week since I have had a traumatic blow dealt to the my scrotal sack, and the pain/ discomfort has only coincidentally started a day after said trauma was caused. I am a 16 year old male at 145 lbs.",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: Check for any swelling/injury over thereExplanation: Swelling/injury/bleeding over there may cause you this feeling after trauma. So, check yourself for the above conditions. If nothing visible please visit your doctor for help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any diet and exercise to reverse the kidney condition?\n\nGood Evening, My question regards Kidney failure. Is there anything I can do to reverse the condition? Keep kidneys working longer with new diet or medication... I was told to wait and see what condition is in a couple of months b/c not sure what s triggering problem. Want to be pro-active & try to prevent damage if possible.",
    "doctor_response": "HelloThanks for query .You are suspected to have Chronic Paranchymal Kidney Disease (CPKD).However it needs to be confirmed .Please consult qualified Urologist for clinical examination and get following basic tests done to confirm the diagnosis.1) Urine routine and culture.2) Ultrasound scanning of abdomen and pelvis3) Renal function tests 4) Estimation of urinary excretion of protein in 24 hours sample of urine (Proteinuria).Please note that CPKD is a progressive and irreversible kidney disease and one needs to take treatment and dietary instructions  as per guidance of Nephrologist  to keep it under control,Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Am I having side effects from Cobese?\n\nloose motions frequently because i was having Cobese suddenly felt pain in side of anus and when sitting when i touched n saw its a longish swelling slightly soft , pain is less today than yesterday have stopped Cobese n now dont have loose motions swelling makes me scaredvplease help YYYY@YYYY",
    "doctor_response": "Hello, Cannot say in your particular case, but generally, not absorbing fat will cause diarrhea. cannot say what the growth is without seeing it and hemorrhoids ar equite common. They are more common if there is more bowl activity especially straining. They can be easily treated withen the first pop out. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does dental implant surgery hurt?\n\nHi doctor, My sister got one of her teeth decayed. Most of it falls off on its own. When we visited the doctor, he asked us to get an implant. She is terrified of hospitals and has an anxiety problem. What I want to ask is that whether doing implant procedure hurts?",
    "doctor_response": "Hi. I have gone through your query. What is the age of your sister? From your statement, I assume that most of the tooth structure of the same affected teeth fell on its own and the other teeth are good. To guide you better, I would like to see the image of the teeth. If the adjacent teeth are healthy, you can also go for a bridge, which is also a fixed prosthesis, but there should be teeth on both sides of the missing teeth, and the adjacent teeth will also be prepared and capped. As far as the implant is considered, there is nothing to worry. The procedure will be carried out under local anesthesia, so there will not be any pain in 99.99 % cases, though she might feel pressure and any pain or discomfort during or after the procedure which will be managed with medications for comforting the patient. It will take time for the implant to get attached to the bone and the following procedures to complete. But it has a reasonable success rate and your adjacent teeth will not be affected. Make sure that the doctor knows her medical history if she has any. Regarding anxiety, you can guide her positively at home. The doctor will also give early morning appointment if possible and manage her anxiety and if required (for severe anxiety), medicines will be given. Tell her that everything will be done with her consent and only if she is comfortable. We are there to help you. If anywhere she feels discomfort, she can tell the dentist, and he will stop the procedure or manage it. She can communicate about her anxiety and fears to the doctor anytime. If she wants, she can visit the dentist first for just communication. Accordingly, the treatment schedule can be planned. There is nothing to get scared. I would like to see the image to guide you further. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How is gallstone treated?\n\nI have been diagnosed by ultrasound finding a 3.6M gallstone.What are my options on this diagnosis? I am unable to pay for this query ??? if I had known this was to cost me, I would not have wasted your time. I will search further for genuine care from some doctor understanding the need for simple answers at no cost, Thank you for your info, and may GOD Bless....",
    "doctor_response": "Hi there,Thanks for posting in HCM.The only definitive treatment for gallstones is surgery.Gallbladder can be removed laparoscopically if the stones are causing symptoms.Other options like medications and lithotripsy are not very effective.I hope that answers your query.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with pancreatic cancer spread to lungs and other organs.  On chemo, prescribed liquid morphine.  Any suggestion to ease the pain?\n\nMy best friend has been diagnosed with pancreatic cancer which seems to have metastisied to his lungs and other organs.  He is having chemotherapy and has been prescribed liquid morphine.   Is there anything ese we can do to ease his pain?  He has deteriorated very fast in the last two weeks from being totaly mobile to us having to hold him up when he walks.   He seems to have accepted the inevitable but Iw ould dearly love to see him more comfortable. At what stage do we get him to a hospice?",
    "doctor_response": "Hello,I feel sorry for the plight of your friend.Basically there are two main treatments for severe pain resulting from pancreatic cancer with metastasis.First is narcotic analgesics which you are already giving in form of liquid morphine.2nd is coeliac plexus block by 50-100 alcohol solution or phenol and gives very good pain relief for 3-4 months time.As far as going to the hospital is concerned,only supportive treatment can be given.You should discuss about both ( pain management and admission in hospital ) with his treating doctor.Best of luckThanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain during stretching of mouth after rhinoplasty?\n\ni had rhinoplasty 3 months ago and recently i ve been experiencing some sharp pain when i smile. at first it was only on one nostril but now the pain has spread to the other one as well. is this normal? is this temporary? when should i be concerned? who should i see for this since my original surgeon is not nearby to consult?",
    "doctor_response": "Hello,Your symptoms could be related to a stretched muscle or a pinched nerve (trigeminal nerve). Coming to this point, I would recommend consulting with your surgeon for a physical exam.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain, acidity, hot waves. History of h pylo bacteria\n\nHi- I am having constant abdominal pain all day long and sudden hot waves throughout the day. I had h pylo bacteria and was treated early this year and was told its gone. But i always feel acidic in my stomach and last week of so having persistent abdominal pain. I maintain a very healthy lifestyle and work out and eat very healthy. My weight is also controlled.",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum. I would come up with these measures for this case of severe hyper acidity. As diagnosis is already evaluated so need not to worry.1 Try raising the head of your bed 4 inches above with blocks.,It also might help to avoid drinking or eating for 2  hours before you lie down.To help control stomach acid one should not drink alcohol or drinks with caffeine in them or eat chocolates or spicy or greasy foods.Also take some antacid but if symptoms are severe ( as in your case), then you may need drugs like proton pump inhibitors.2 Tension is the another reason for your problem , so avoid , if necessary consult a psychiatrist.So consult a physician and get his help. Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of multiple sclerosis?\n\nlooking for symptoms of MS, ESPECIALLY LIKE A POSITIVE MRI OF THE BRAIN SHOWING LESIONS SLIGHTLY ENLARGING YEAR AFTER YEAR...T2 FLAIR ALSO HAVE ENLARGED OPTIC NERVE BLURRY VISION SLURRED SPEECH AT TIMES, SEVERAL FALLS DO TO NUMBNESS WHILE STANDING UP? I WOULD LIKW UR OPINION",
    "doctor_response": "Hi,Thank you for your query. I can understand your concerns.Multiple sclerosis (MS)-Visual blurring occurs  from ON (Optic neuritis). ON is common at the onset of disease but uncommon during the later course of the disease.Visual symptoms are generally monocular but may be bilateral.Speech problem (slurred speech) & Ataxia (recurrent falls) may occur from cerebellar lesions.Brain-stem involvement can cause vertigo,vertebro-basilar insufficiency again contributing to recurrent falls.Brain-stem lesions can also cause paroxysmal symptoms  like dysarthria (speech problem).MRI brain in MS-characteristic abnormalities are found in >95% of patients although more than 90% of the lesions visualized by MRI are asymptomatic. Lesions larger than 6 mm located in the corpus callosum, periventricular white matter, brainstem, cerebellum, or spinal cord are particularly helpful diagnostically.Evidence for dissemination in space in the brain (lesions slightly enlarging year after year ) based on T2+ lesions in the  characteristic periventricular, juxtacortical, or infratentorial regions -suggest insidious neurologic progression  of MS [Primary progressive MS (PPMS)].T2-images inflammation and demyelination better. FLAIR( fluid attenuated inversion recovery) image-edema and gliosis appear hyper-intense.Regards Dr. T.K. Biswas M.D.Mumbai",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lump in thyroid area, painful. Gave up smoking cannabis. Is it a sign of cancer?\n\nfeels like internal lump in thyroid area, although no physical lump visible or felt. just feels like it above and below thyroid. can feel pain if thyroid or windpipe is pressed. feels like hunger is connected somehow. lump feels bigger if hungry and slightly relieved while eating.it started maybe a few months ago and prompted me to give up 10 a day cigarette habit a month ago (started smoking cigarettes in 2001). not had a cig and going well, i dont think ill have one ever again. however ive also smoked cannabis socially from 1997-2005 and as a 5 joints per day habit from 2005-present. (about half ounce per week.) i thought the condition would improve and i could continue smoking cannabis but a month on and no improvement has forced me to give up the joints too. it has been 4 days and ive not touched a joint.coughing up normal colour/looking phlegm but with black tar dots in it. less dots the later in the day. cough sounds hacking i think due to the area it feels like its in. i have to manipulate the position of my neck to feel the cough in the area (if that makes sense)i realise its probably the smoking that has brought this on i just want to know is it normal? is it something to be coughed up in time? how long it will last? is it serious? could it be cancer? can i smoke cannabis again!?#would really appreciate some feedback. thankyou thankyou thankyou",
    "doctor_response": "HELLO DEAR,YOUR LONG HISTORY OF SMOKING INDICATES THAT YOU ARE SUFFERING FROM CHRONIC BRONCHITIS.YOUR SPUTUM CONTAINS TAR WHICH IS DUE TO SMOKING.YOU DONOT SEEM TO HAVE ANY THING SERIOUS BUT TO RULE IT OUT CONSULT ENT SURGEON.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to withdraw from blood pressure medication?\n\nHere is my question: I have been on blood pressure medication for about 10 years. Mainly because I didn\u2019t know the effects of sleep apnea. This past January, i started to use a CPAP and working out on a daily bases. My BP is now 118/77. I would like to go off of the mess, but my PCP says no. What do you think? Is it safe to go off of them? I plan on slowly weaning myself off.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. No its not safe to withdraw from antihypertensive medication. Diet control,low salt diet,moderate proteins,low saturated fats, low sugar, daily 30 to 45 mints walk and stress free life and use of medication all that you need it. Regular check up of Blood pressure on both arms is needed. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest ways to get off masturbation, fear, difficulty to speak with low self esteem\n\nnamskar iam 33 years old living in chiplun maharashtra when i was 12 years old i keep sex relation with same age boy that effect from that time till now i am doing hastmaithun ,i cant speak properly words from words strat r i am very frieghtened whenever i drive car i very in tens so wht remedies on aboe cause",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. You must understand that the masturbation is normal and cannot harm your health if practiced moderately. At your age, Masturbation thrice or four times a week can be called moderate and cannot harm your health. But anxiety about the masturbation habit is different. That anxiety can harm your mental health. I do think that the pronunciation problem could somehow associated with your anxiety. Do consult a psychologist.If you require more of my help in this aspect, Please post a direct question to me in this URL.  Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tenseness, tussle in chest?\n\nHi.iam 20 year old man and i have allergy problem last 8 year.and last one week i have feeling like tenseness ,tussle in my chest. last friday i have done asthma test . the result was normal. now am taking homeopathy medicin.now i have feeling tenseness and tussel more.so what i have to do? is this going to asthma?",
    "doctor_response": "Hi,Would like to know more as follows-- Is there a wheezing sound from your chest.- Any symptom of breathlessness.If the answer is yes to above, spirometry/PFT done to confirm .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower abdominal pain on the left side during sex?\n\ni have lower abdominal pain on my left side. i experienced a sudden pain in about the same place a few weeks ago while me and my partner were having sex. we stopped immediately and it went away. theres no real tender spots when i push on the area either. ive just finished my menstrual cycle so i'm not too worried at the moment because i figure it has something to do with that but i've never experienced it before and i just want to know what sort of things i should be looking out for, like symptoms of something? thanks",
    "doctor_response": "Hi.Thanks for your query.The pan during sex can be the first alarm sign of pelvic inflammatory disease or tubo-ovarian problem like inflammation.I would suggest you to take an opinion of a Gynecologist and undergo minimum of ultrasonography to find and get treatment. Avoid sex till you are diagnosed and treated well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a hurting pop sound while swallowing water a serious medical concern?\n\nHi I was drinking water and when I swallowed all of a sudden there was a big pop in my chest between my breast bone my friend sitting away from me said WHAT WAS THAT ? It was that loud it hurt alittle buti didnt think to much of it later that nite I went to the bathroom and filled the toilet with bright red blood please can u tell me what happened or if i need to go on to the dr about this ?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. That loud sound while swallowing is mostly due to burping and belching office gas from the stomach. This is normal and can be seen in gastritis. But more important thing than this sound is blood in stool. This is known as dysentery and most common cause for this is intestinal infection. Other causes anal piles, anal fissures. Gastric ulcers etc. So better to consult gastroenterologist and get done 1. Upper GI scopy for gastritis and gastric ulcer 2. Anal and rectal examination for piles and fissures. Don't worry, with appropriate treatment, 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should stitches on foot be removed if swelling is there?\n\nYes I have 5 stitches on top of my right foot just below the 2 small toes from a deep cut caused by my bicycle handlebars it is numb and my toes are bruised and my foot is still swollen since it happened on the 24th of June 2014 I m supposed to get the stitches out tomorrow is it too early to have them removed",
    "doctor_response": "If there is swelling and bruises at local area where stitches are kept. As well if stitches are healed then you can go for removal. But if it is not healed and there is a fluid discharge from local area then it shows there is a infection over there.   I suggest to visit your doctor and get evaluated properly make sure there is no infection and then go for removal of stitches other wise more then the removal the first thing you need to do is start having anti biotics if there is infection over there. And wait for stitches removal( till the time it gets dry).You can also use hot and cold pack at painful, swollen local area but make sure the water should not touch the local area where it is paining or stitches are there for some more relief.Here with out physical examination it is difficult to guide you in detail so I have given you simple guideline. I am sure this will be useful for you. Do visit your doctor let him check and take decision.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have bleeding, back pain. Was on depo. Why is it happening?\n\nhi been on depo for about 12 yrs buti got off it for about 4 months but I just got back on it last month I never had problems with it till now ive been bleeding for 8 days some days its off in the morning come back on at night or vise versal but its on everday an it see like my back hurts or maybe I got gas I don't no .but why iam bleeding now an could something eles be going on .",
    "doctor_response": "Hi, you had depo for 12 years, and stopped for 4 months and started again one month back.so far you never had such experience, But now you are having bleeding since 8 days, and back pain.                     It could be due to the infection, or anemia. I advise you to consult a gynecologist for diagnosis and treatment. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Am I having symptoms of TB?\n\nHi! Im sick right now, ive been to my OB gyne last tuesday and she prescribe me a antibacterial and suposutory. Does it cause my fever right now? Im scared that this is a symptoms of TB coz i have a active cought it just came yeterday afternoon. And the mucus are lot! I feel weak and body aches.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Possibility of Urinary tract infection and vaginal infection is more in your case. But better to rule out tuberculosis because you have contact with active patient. So get done sputum examination for AFB (acid fast bacilli-bacteria causing tuberculosis) and chest x ray. If both are normal then no need to worry for tuberculosis. Drink plenty of fluids orally. Continue treatment you have prescribed. Keep proper hygiene of private parts. Avoid unprotected sex if you are sexually active. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can you compare two images of fundus and tell me if there is progression?\n\nHello doctor,I need comparison analysis of two fundus photos to check if they are/are not showing signs of progression. Patient is on Xalatan, Timolol, and Dortas.",
    "doctor_response": "Hello. From the photographs, there seems to be a very slight progression (attachment removed to protect patient identity). But to come to a conclusion based on fundus photographs alone would be incorrect. One of the most accurate ways to judge progression is field analysis done on Humphrey field analyzer. All the known patients with glaucoma need to get their intraocular pressure (IOP) checked every two weeks and their target IOP is maintained then. The fields should be done yearly at least. In conclusion, from the above pictures, there is a very slight increase in the cup-disc ratio but more information is needed to come to a conclusion. Please do get the latest fields done and send it to me. Revert with more information to an eye care ophthalmologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shingles infection\n\nI had a very bad case of shingles starting Dec 4th, I had the intercostal nerve blocks, (which have I believe worn off), they really were terribly painful with spasms.  I have had terrible pain, I have been trying to stretch the intercostal area with stretching exercises.  Today I have burning,  any suggestions.  I can not take Vicodin or Lyrica, bad reaction.",
    "doctor_response": "Shingles a viral disease characterized by a painful skin rash with blisters involving a localized area. It is caused by varicella zoster virus which remains inactivated in our body. Post \u2013 herpetic neuralgia is a complication of shingles. Vaccine is available for those who are more than 50 years old. Vaccination reduces the frequency of post \u2013 herpetic neuralgia.Advice 1.\u00a0\u00a0\u00a0\u00a0\u00a0You are more than 50 years you can take vaccine under medical supervision only2.\u00a0\u00a0\u00a0\u00a0\u00a0Amitriptyline 25 mg per oral at bed time daily for 15 daysThanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for bruise in the upper arm\n\ni have a brown beauty mark (mole) on the inside of my right upper arm.  I've had it forever but it appears to have a slight bruise around it that is definitely new.  Just wondering if this is common, and/or if i should have it checked out.  I do not have health insurance.",
    "doctor_response": "Thanks for your query at HCM!I am Infectious Disease Specialist! I went through your query!Moles are melanocytes of skin.Are you having pain?If you are noticing any change in colour, height, size or shape I suggest you must consult a dermatologist.You might require a tissue biopsy for microscopic examination.Happy to take more queries! You can also write a review for me. If you would like some more information, I will be happy to provide. You can take a follow-up query.Take care!Dr. Sheetal VermaInfectious Disease Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for coronary stenosis\n\nI am a 59 year old otherwise healthy non-smoking female. I have 20 % Stenosis of Right Coronary 20% left main artery and my cholesterol is 178. I had a mitral valve repair 10 years ago and continue on Warfarin for continuous A-flutter. I am on Digoxin and atenolol also. Echo s confirm no changes in the valve repair or heart function. My dr wants to treat the coronary stenosis with statins to keep cholesterol levels below 80. I don t want more meds. Do I need to go that route just yet? Thanks!",
    "doctor_response": "Hi,For coronary stenosis of 20%, there is no sense to treat it with stent at all. In this case stent and native vessel will have the same percentage of re stenosis and blockage. And in case of stent you should take extra medications.I would advise you to follow healthy lifestyle , to eat diet less in animal fat, rich in fish oil, eat more fresh fruits and vegetables, exercise much. And everything will be OK.Hope I could help youWishing you good healthIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning sensation inside foot with pain?\n\nfor the last several months my right foot is burning inside and hurts so bad. When I first noticed it was after New Years and I thought maybe I might of had too much fun and injured it. No way I ve had pulled muscles and such this is unlike anything I ve ever felt. Even right now sitting up on the couch with legs up I can feel the burning inside come and go. Its in between the top and bottom of foot on the inside and starts from mid toe up the side of my foot going half way up foot. some times I can do things without any pain and other times not and sometimes not moving at all it still burns often its like a sharp burn.",
    "doctor_response": "Hello, I have studied your case and reportsCanal stenosis leads to burning/numb sensation and pain in your back and leg. For these symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.I will advise to check your vit B12 and vit D3 level.Epidural steroid shot can help.Another possibility of plantar fasciitis..Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sudden pass out\n\nHi I ve literally just nearly passed out whilst cleaning my teeth! I have felt fine all day, so this sudden feeling is a little worrying. I now feel very sick and have a high pitched tone in my ear (comes and goes - again this has just come on tonight). I am currently lying quietly on my bed but I feel like I m on a ship and feeling sea sick what on earth could these sudden symptoms be? I also feel very hot",
    "doctor_response": "Your condition is most likely related to the inner ear. You should see an ENT doctor. Take antiemetics (Antivert, Phenergan, Reglan, Zofran) in the meanwhile. If the ENT doc can't find that there is something wrong with your inner ear, you will most likely be referred to a neurologist for further investigation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do medications for ac joint injury cause dry mouth and rash?\n\nI am on several medications for an ac joint injury, lately ive been getting severe dry mouth, drinking upto 6 litres a day of water and still thirsty, i now have a rash on both my fore arms, im exhausted all the time. is this just a medication thing? or should i be worried",
    "doctor_response": "Hello,Your symptoms seem to be related to side effects of the medication. The rash can be related to an allergic reaction. I suggest using antihistamines such as Cetirizine 10 mg daily. I also suggest to review with your doctor the medication due to the side effects.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for red bumps on stomach and legs of a child\n\nMy 2-year-old daughter has small red pumps on her lower stomach, tops of her legs and bottom. She also has 2 bumps on her face. They look like small pimples. I noticed a couple one to two days ago, but the majority have come up this afternoon, after awaking from her sleep. My daughter weighs 14 kg and has no other health issues",
    "doctor_response": "Hi,Welcome To Healthcare Magic.I can understand your concern regarding to your child\u2019s health.This type of pumps can occur because of an allergy of synthetic clothes or any type of food allergy. As you are saying that they occur on lower part of abdomen, so it might be because of an allergy of synthetic clothes.So, first of all wear her only cotton clothes and avoid synthetic materials.  Apply medicated powders like Lotril or Imidil 3 times in a day after a clean bath (If no allergy). Give liquid Levocet 5 ml, at night (if no allergy). If there will not occur any change after doing all these things within 3-4 days, then consult dermatologist.After doing all these things, I hope your child will get well sooner and please share your review about my answer on healthcare magic.Take Care,Thank You.From:- Dr. Nupur Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bacterial vaginitis\n\nHi, I am a 33 y/o female diagnosed with a bacterial vaginitis diagnosis from my obgyn. Antibiotic treatment in the form of flagyl and clindamycin tablets and creams do not work. They relieve the symptoms but as soon as the prescription runs out, returns. Just looking for another opinion. Any other things I can try? I am already taking a probiotic, wear cotton underwear and drink apple cider vinegar diluted with water. I ve also been told to douche 1x / month with vinegar and water, but I m waiting until the latest course of antibiotics runs out ( they are not working).",
    "doctor_response": "Hello,Welcome to HCM,Bacterial vaginosis is not caused by a single bacteria there will be overgrowth of various bacterias in the vagina. Normally, there are different types of harmless bacteria in the vagina. These bacteria help in the defense against harmful germs, whenever there is a change in the balance of the normal bacteria in the vagina,certain bacteria multiply produce the symptoms of bacterial vaginosis.Metronidazole vaginal cream placed inside the vagina can be used and it has the same ability of oral metronidazole to clear Bacterial vaginosis. It should be used for 5-7 days for effective treatment.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated blood sugar levels while on Colcrys?\n\nWhen taking Colorys 0.6 mg 3 tabs 3hrs apart, my blood sugar jumped to 428. I am type 2 on Victoza.. Normally stays between 100 and 200. Was also given an injection on Solvmeclrol an inflammatory.. I am also on Xarelto... is his normal.. Am I on the right Rex?",
    "doctor_response": "Hello,Colchicine (colorys) is not known as a common cause of impaired glycemic control.On the other hand, steroids which you had as anti-inflammatory do cause impaired glucose tolerance. Please visit your doctor and so he can adjust your doses to suit your glycemic control.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Muhammad Adnan Iqbal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is lower abdominal pain a side effect of unwanted 72 or should I visit a doctor ?\n\nHii..I am 25 yrs old, i had unprotected sex on 6th july and took unwanted 72 on the same day.before that my menstrual period started on 26th june for 5 days.but after taking the tablet next period started on 22nd july, which was not a normal period as the bleeding was only for 2 days and very less.The problem is that i am suffering from lower abdominal pain(on my left ovary ) since then..Please suggest me, how can i get rid of this pain? Do I need to visit a doctor?Will there be any issues with my future pregnancy?",
    "doctor_response": "Most of the symptoms of the contraceptives are temporary, and usually clear up within 24 hours or a couple of days at most.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for red pimple like rash that is multiplying\n\nMy 15 month old daughter has developed a pimply rash that won t go away. It started over a month ago with just what looked like one large pimple amidst what looked like a simple rash. I applied Diprogenta (Betaethasone dipropionate Gentamicin sulfate) and although the rash disappeared overnight, the pimple stayed for over a month. Its redness would wane and then come back with the rash, but would look better after I applied the cream so I always put it down to food allergies. I eventually took her to the doctor after about a month, and was given a local balm (no idea what s in it, but it smells like burnt hair) and Metonate (Betamethosone) cream. The doc said it was Scabies, that I should apply the balm twice in the afternoon & evening, and the cream twice in the morning & late morning every day - this was 3 days ago. Since then, the pimple has multiplied, and she now has several of these angry, red pimples, along with the rash. There seems to be no itching, only these red pimples that now seem to multiply on a daily basis. Help!!",
    "doctor_response": "Hi, But skin conditions are always best diagnosed and treated after seeing them directly. I request you to upload some images here so that we can guide you better. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for clumpy white discharge and yeast infection\n\nI have used metro gel and have clumpy white discharge and got a horrible yeast infection that I now have under control. How long will the discharge last ( it s the third day of discharge and 6th day off metrogel)? And is it safe to have sex if I still have discharge?",
    "doctor_response": "Hi,It seems that you might require one course of antibiotic and anti-fungal oral medicine course to control infection.Avoid sex till infection controlled as there is risk of spreading infection and giving infection to your partner as well.Keep local hygiene clean, dry and airy.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the following follicular study report suggest?\n\nHi I have undergone laproscopy .both the tubes were ok. Than doctor suggested for clofert for 5 days and continued the folliculr study.my cycle is of 32 to35 days.. On 20th day et was 11 mm Left O 21\u00d716 Pod mild fluid On 23rd day Et was 10 mm Left O 21\u00d716same as of earlier e thick walls likely corpus luteium Pod mild fluid On the same day doctor asked me to take susten 200 tablets night and morning for 10 day. But after 3days of having it get itching on veginal area and watery fluid is comming out now a days. My last period was on 8th jan. Please suggest are these positive symptoms of expectation or need to get checked.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Clofert is a medicine that is given to promote development of follicles to a mature state and ovulation to occur. It usually takes 3-6 months for the action to take place. Ovulation is expected to occur once the follicles (little fluid filled sacs within which eggs develop in the ovary), reach a size of 18 - 36 mm. In your report there is a suggestion that the follicle reached the size of 21 mm, which is good. Fluid in the Pouch of Douglas (Pod) is also suggestive that ovulation might have occurred. This usually results in release of fluids along with the egg from the follicle. That the corpus lute was seen and reported also supports that ovulation (egg release) occurred. The thickness of lining of the womb (et) usually increases under the influence of progesterone. It is expected to reach up to 16 mm towards the end of menstrual cycle. Having a sufficiently thick endometrium supports the seating or nidation of a fertilises egg and its growth as a healthy, viable pregnancy. Your doctor advised Susten, which is progesterone, to develop this thickness which was shown to be just under at 10-11 mm. An increased vaginal discharge - as long as there is no symptom of infection should be normal. Since you are reporting itching as well, it might be worth getting yourself checked with your doctor for infection.All in all the report is satisfactory. Wish you all the best for ongoing treatment. PS: Just wanted to remind you that it is important to have your partner investigated as well when undertaking investigation and treatment for infertility. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the treatment for lower back pain?\n\nHello doctor, There is pain near the lower back portion above the tailbone in the right side, little swelling too. There is no problem in walking but sometimes it pains too much on some jerk or stretch.",
    "doctor_response": "Hi. This seems like coccydynia, pain of coccyx bone or near to it. Did you have a fall on your tailbone a week back? Also, if you had lifted something heavy, this kind of pain may come to lower back and may get radiated to buttocks or lower. Do hot pack for 3 to 4 minutes and ice pack 1 to 2 minutes, at least two sessions in a day. If you have any local pain relief cream, please apply it locally. Those painkillers will not work for this pain. Let me know in five days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathlessness after stent placement for a blocked aortic valve?\n\nAorta is 80 % blocked .Another valve is 30 % blocked. Stint placed in 30% blockage. Mother is having difficulty breathing and has been intobated. O2 sat going into 80\u2019s T least once a day and she crashes. Why would Dr place stint first , instead of repairing aortic valve",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. After going through your medical details I understand your concern and I would like to tell you that blood supply is very important to heart muscles if you want your should be working in extreme physical stress during surgery. In absence of full detailed medical history of your case I can just tell you that there are many possibilities of why they didn't repair valve as it can be patient isn't fit for surgery, patient was having acute coronary syndrome etc. Kindly speak to your treating Cardiologist as he can tell you in detail about your specific query. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling sensation in the tongue and light headedness?\n\nMy husband had a heart catheterization on Tuesday 7/19. He needs to have his aortic valve replaced. Yesterday he complained of feeling lightheaded and weak, with some tingling sensation of the tongue (central). His blood pressure was a normal value, but low for him. Today he again is experiencing this tingling in the tongue, but is not lightheaded. Should I call the cardiologist?",
    "doctor_response": "Hello,This most probably occurs due to low blood pressure, and it occurs due to aortic valve disease. He is probably having aortic stenosis. The definitive treatment is definitely aortic valve replacement as early as possible. Till then he should avoid dehydration, avoid risky activities like driving, don't get up suddenly from sleeping or sitting position. Whenever he gets such episodes he should immediately lie down and rest for sometime And drinks some fluids.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could continual bleeding after Copper T insertion indicate?\n\nhi doctor i had my copper t inserted before one and half month after the copper t was inserted i had my periods within 3 days and still i have bleedind everyday and the bleedind is not heavy but i feel discomfartable and tensed with this problem kindly gave me a suggestion",
    "doctor_response": "Hello dearUnderstand your concernLight bleeding, spotting and irregular period are common after inserting Copper T for first 2-3 months. It is known side effect of copper T due to hormonal imbalance and foreign body reaction. After consulting the doctor you have to take following medicine to stop the bleeding:Tranexamic acid for 4-6 days to reduce the bleeding.Oral contraceptive pill and progesterone pill can be given for 2-3 week to reduce the bleeding.But after taking pill if bleeding will still continue and you feel uncomfortable then you have to remove the copper T and you have to use other modality of contraception like Contraceptive patch and nuvaring.Take healthy diet with iron supplements and maintain proper pelvic hygiene.Hope this may help youBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest better treatment for asthma\n\nI persistent asthma but my pulmonologist is treating me with simbacort. It doesn t seem to be working could it be because I have asthma and not Chronic Opstructive Pulmonary Disease? It scares me to take a med that is not supposed to be taken with asthma.",
    "doctor_response": "HI, thanks for using healthcare magicSymbicort is an inhalor that is used in asthma. It is one of the medications that can be used for this condition.It is a combination of budesonide and formoterol. Budesonide is a steroid and it reduces the inflammation that occurs in asthma.Formoterol is a long acting beta 2 agonist, this means that it helps to keep the airways open.If it is not working for your asthma, the dose may need adjusting or you may need to be reassessed for any triggers that may be affecting control ( eg GERD or sinusitis).I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do movable firm lumps on the hip bone require medical attention?\n\nI have two lumps right above my hip bone on either side of my spine. They are not visible and I can only really feel them when I bend over. One is slightly higher than the other. They are very movable and seem fairly soft but firm. They only hurt when I press directly on them and the pain is dull. Should I get them checked out?",
    "doctor_response": "HiWelcome.I have gone through your query.It is difficult to comment on it without examination, so I would either suggest you to see doctor for examination and for exact diagnosis or upload the pictures here, I'll go through them, and provide you with specific advice.Lump might be lipoma but need to examined to confirm.Hope this helps.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I go to the hospital if have UTI, fever 99-100 and not too bad pain as the doctor is suspecting kidney infection?\n\nI have a uti and I'm on antibiotics. My doctor said I possibly have a kidney infection. And that if I still had a fever to go to the hospital. My temperature has been between 99 and 100. But the pain isn't too bad if I stay in one place. Should I go to the hospital?",
    "doctor_response": "U need to be sure that infection has not damaged the kidney which can be seen on ultrasound scan of kidneys. If symptoms improving then wait else better to visit a doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the right lower abdomen and nausea?\n\nI am 27 years old female. I am having right lower abdominal pain for past 2 years. The pain goes away after taking a course of antibiotics but reoccurs after some time. In the beginning the frequency of reoccurance was after 4 to 6 months, but now its occuring again and again within 15 to 20 days. I have the following symptoms. C 1)fatigue, Feeling discomfort and tired always 2)nausea always. Sensation is more after few minutes of food intake 3)severe pain in lower right abdomen 4)feeling burning pain in all over the abdomenal area 5)Getting constipation for few days and then loose motion for few days Have done abdomincal scan and showed results as 1)Left renal stone 2)Minimal fluid in cul de sac Have done blood, urine and stool tests and reports showed these 1)Haemoglobin is low 2)ESR is high - 34 3)Showed pus cells in stool, occassional and stool is brown in color. 4)showed 1-2 leucocytes and 2-3 epithelial cells in urine Menstrual periods  regular(30-32",
    "doctor_response": "Hi ! Good morning. I am Dr Shareef answering your query.From your history, and ultrasound report of fluid in the cul de sac, I would suspect you to be having a PID (pelvic inflammatory disease) which might also be associated with a UTI (urinary tract infection), which had to be ruled out by a culture and sensitivity test. If I were your doctor, I after a general physical examination of yours would advise you to get yourself assessed by a gynaecologist of your area to rule this out specially if you are sexually active. Till then, I would advise you for a course of broad spectrum antibiotics along with an anti inflammtory and a proton pump inhibitor for a symptomatic relief.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "For which disease risdone forte is used?\n\nhi what is the disesase for which risdone forte is given? actually earlier i was taking wilpose,fostera,vitcure........ i used to hear voices........... but i was ok....... it stopped...... again it has reoccured.......... actually i changed my city from lucknow to kolkatta,india. does that affect my health?",
    "doctor_response": "Hello, Risperidone is used to treat certain mental/mood disorders (such as schizophrenia, bipolar disorder, irritability associated with autistic disorder). This medication can help you to think clearly and take part in everyday life. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. AJEET SINGH, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high levels of psa?\n\nMy husband just recently had a psa test done. he is a 42 year old black male. his results came back with a score of 36..5 We have been having sex everyday for the last month twice a day. With oral sex and penis manipulation. Will this cause levels this high. No other symptoms as well. Will repeat test on friday with orders of no ejaculations Concerned wife",
    "doctor_response": "Hi,Thanks for writing in.The PSA level is an indicator for possibility of prostate cancer. However, there are additional reasons for having an elevated PSA level, and some men who have prostate cancer do not have elevated PSA.It can be elevated in conditions like infection of the prostate. Repeating the test is necessary for your husband.Most men with an elevated PSA level turn out not to have prostate cancer; only about 25 percent of men who have a prostate biopsy due to an elevated PSA level actually have prostate cancer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dry cough\n\nHello Doctor                      In few days ago my wife is suffering from dry cough and doctor prescribed her Tus Q dx. But she is mentally confused and over sleeping I could not understand the problem whether the medicine is harmful to brain.ndiaBipin I",
    "doctor_response": "The syrup does cause some amount of drowsiness. But I am afraid that she may be overdosed. Kindly stop the syrup and consult your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could regular nebulisation for cough and cold lead to asthma?\n\nHello doctor, I have an eight yr old son who weighs 45 kg . He has no repiratory problems and no asthma . Neither is there any asthma history in both sides of family however his pediatrition only prescribes nebulization as treatment with different drugs the recent one being duolin for coughing which is making me very uncomfortable . My son gets cough and cold thrice or four times a year . Is this going to make him dependent on a nebulizer or maybe create asthma where there is non ?",
    "doctor_response": "Hi, occasional nebulisation will not lead to asthma in child. If there is wheezing episode in child then nebulisation should be given otherwise condition may become worse. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is valerian herb infused in a tea safe to be taken?\n\nI was about to drink some hot chamomile tea before going to bed - I noticed it has valerian added. I do not know anything about valerian ... is it safe, addictive, does it have side effects, am I better off just not using it? For that matter, is there anything I should be aware of regarding the chamomile?",
    "doctor_response": "Hello,1. Valerian [Tagar] is most commonly used for sleep disorders [insomnia] and also used to treat anxiety, stress, muscular cramps and spasms Valerian has an action similar to benzodiazepines by increasing the amount of chemical called GABA which helps regulate nerve cells and has a calming effect on anxiety. 2. common side effects include a headache, upset stomach, dry mouth, excitation, strange dreams and daytime drowsiness and since Valerian does have a drug interaction with anticonvulsants, benzodiazepines, so one should not take them if taking Valerian as single or in compound form. 3. Since chamomile contains anticoagulant compounds called coumarin, thus should not be used with Aspirin, platelet inhibitors, tricyclic antidepressants. Hope I have answered your query. Let me know if I can assist you further.Regards, \u00a0\u00a0\u00a0\u00a0\u00a0Dr. Munish Sood",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to stop panic attacks\n\nI am a man ,25 years old, 181 cm, 67 kg, -excuse my bad English please-. 2 months ago i bought a new car and at the same day i had a mild panic attack it was terrifing and i couldn t eat for two days I was worried that maybe i bought the wrong car , but my new car was fine and there is nothing wrong about it, after 1 weak I start to recover from that panic attack but then after two weeks from the first attack i got the second one and it was big, then after 4 days i got another one, to simple it I got the first attack then 2 weeks later i got the 2nd one, then 4 days later I got the 3rd . and then the panic stops for 1 month - but during that time I was confused and sometimes happy and sometimes worried, I think i was depressed- and 4 days ago i had a panic attack but it was light and not terrifing like the first 3 attacks. Does that mean I start to recover from the attacks or what? And I forgot to mention that i used Cipram 20 gram for one week then i stoped it because of its side affects it made me confused and sleepy and weak I hated that weak so much. I just need help. and I m single from Saudi",
    "doctor_response": "HiThanks for using healthcare magicI think, you need antidepressant like paroxetine with clonazepam. That would help you to control anxiety symptoms in better way. You need prescription for that. Better to consult your treating psychiatrist or physician for that. You can also try some relaxation exercise. That would keep you calm in tense moment. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of chronic HBV?\n\nsir,i want to know about hbsag levels i tested first time on 22nd december 2009 and the result was hbsag ............reactive (250)test performed by ecliathen on 29th march 2010 and the result was hbsag...............reactive (5471)then on 26th april 2010 and the result was hbsag........... reactive(569.2)then on 12th may 2010 and the result washbsag .......... reactive (125)then on 30th may 2010hbsag ......... reactive (26.27)then on 10th june 2010hbsag ......... reactive (8.16)and then recently 23th june 2010 and the result was hbsag ........... reactive (4.29)                                           sir, i want to know that am i going to resolve the infection or am i now a chronic hbv patient, and is this normal the slow decline in hbsag levels in the end. with regards                                                    MUHAMMAD IBRAHIM KHAN",
    "doctor_response": "hi.thanks for posting query.HepB can not be eradicated completely in patients infected with it.however, complications can be prevented with proper care and treatment.Treatment is advised if AST and ALT are > ULN and HBV DNA count on PCR is very high. Liver enzymes and HBsAg status and HBV DNA PCR maybe done regularly every 6 to 12 months,Visit hepatologist for proper interpretation of results.hope to answer concernregardsDr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anxiety and depression\n\nHello, I m 22, I feel like my life isn t where I want it to be. I m in college, but I feel stupid going. I fail most of the classes or I have to drop them because they consist of presentations. I can t even hold a simple conversation with my own mother. Ive isolated myself form everyone including my family. Im always in my room. Most of the time i feel like i don t belong in this world and i want to take my own life away. sometimes i also get urges to kill people. the thing with that is that i hate the site of blood. i don t know who i am. i feel like a failure i want to work for law enforcement , but im too fat to even do that. and im not smart enough to do anything else. i don t know what to do. i already over dosed and i had to go the hospital but i didn t tell them i over dosed and they just thought it was my body reacting to the medication. I feel so lost.",
    "doctor_response": "HIThanks for using healthcare magicI think, you are in depression and in that case, you need antidepressant with low dose benzodiazepine. These drugs would help you to come out of that phase. You can also try some relaxation exercise that would help you to come out of that phase. Better to consult a psychiatrist for proper treatment. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have blood pockets on the wound and the head with leaking fluid in a 5 year old?\n\nI have a friend who was in a car wreck when her son was 1 1/2 and his skull was crushed. He has had several surgeries since then, he is now 5 years old. Now, his head is profusely leaking fluid from his most recent surgery. It also gets blood pockets on the wound. Is this normal?",
    "doctor_response": "This is not good, because in this pockets bacterias can cause inflammation and wound will heal for a long time. They can put drainage in these wounds and wash these pockets with antibiotic, should apply 1%chloramphenicol 2 times a day. I think she receives general antibiotics for prophylaxis of infection - augmentin -250 mg 3 times after meal 7 days and visilac 1 capsule 1 time 14 days for prophylaxis of disbacteriosis. Give to her Vitamin C 500g 1 time 20 days ,it will also helpful in stopping of bleeding. Recovery soon Best regards Dr.Svetlana Shrivastva",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does delay in periods after unprotected sex indicate pregnancy?\n\nHi I had unprotected sex after 13th day of mylast period(that is I had my perids on 28th Jan  n I had an unprotected sex on 9th feb) I took I pill with 1 hour after dat...n also on next day...Im evn diagnosed as pcod n I used regesterone tab for getting periods til 26th feb but I didn't get my periods yet im worried...cn u llz let me knw wt r the chancesof getting ppregnant",
    "doctor_response": "Hallow Dear,Considering your periods to be of 28-30 days, 13th day after the period falls very much near the day of egg release (ovulation). (However, they may be irregular considering your PCOS). Hence, due to unprotected sex on that day, there should have been high risk of pregnancy otherwise. However, within one hour after the intercourse you have taken Ipill which is very effective post coital contraceptive pill. So you need not worry about the possibilities of pregnancy.Ipill contains high amount of Levonorgestrel which is a Progestational medicines. Therefore, after Ipill, there is possibility of the periods getting delayed by few days. You need not be worried about  delayed periods. You have been given Regesterone pill to be taken upto 26th February. After discontinuing these pills, you should get menses within 4-7 days. However, if you have been diagnosed as a case of PCOS, please do not neglect it. Report to your Gynaecologists for appropriate management of PCOS. PCOS can also cause irregularities in the menstrual cycles. I hope this helps you.Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes big belly in skinny child?\n\nhello my daughter is going on 2 years old she has a belly that my family likes to call a buda belly because it looks like budas belly does but we know it is not fact we think there might be something wrong with her because the rest of her is skinny even if her back was faced to you you would know that she had a big belly what can i do to help her her doctor tells me that she is fine but they have only pushed on her belly i do not understand why she is like this someone plz help me put some clirty on this",
    "doctor_response": "Big belly in skinny child occirs because of hypotonia of abdominal musclesExclude protein energy malnutritionIn case of huge ascites, same condition occurs",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a stomach \"virus\" with unusual stools be treated?\n\nMy 16 month old son has been sick with a stomach \"virus\" for the past few days. The last 4 diapers i've noticed small (1/2\") worm like peices in his stool. At first I thought it was related to bananas, but now there are large clumps of these reddish brown peices in his stool, thousands with each diaper change. What is the liklihood of him having a parasite?",
    "doctor_response": "Viral infection with rotavirus is a very common cause of diarrhoea in children. It generally resolves on its own. All you need to do is to prevent dehyration by the use of ORS.It is not clear whether the white pieces that you refer to are worms or undigested food matter. The latter is more probable. However, worms are quite common in children of this age as they have a tendency of putting anything in their moutn. In case you think that he could have worms could be present. Giving a single dose of albendazole 400 mg syrup (10 ml) and repeating it after 14 days should be helpful.I hope that helps. Feel free to revert back with further queries if any.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the diet plan after typhoid?\n\nHi Doctor, on May 29th, I have been diagnosed with typhoid. I have taken anti biotic till June 1, 6 doses. last two days i didn t get any fever, but feel tired. Still I am taking idli and rise kanji and bread and juices only. 1. What foods I can take from today? 2. Can I go out for few hours in this hot summer(~35C)? 3. which all are I need to avoid totally for next few weeks?Please advise. Thanks in Advance! Below is my report: Age:28 SEROLOGY MALARIAL PARASITE (BY QBC METHOD) : Negative WIDEL Salmonella typhi O : Positive 1:80 dilutions Salmonella typhi H : Positive 1:80 dilutions Salmonella paratyphi AH : Negative 1:20 dilutions Salmonella paratyphi BH : Negative 1:20 dilutions",
    "doctor_response": "Hello, Thank you for your contact to health care magic. I understand your concern. If I am your doctor I suggest you to take your complete treatment. Continue your diet with idli, do not eat heavily as ulcer caused by Salmonella typhi may perforate causing a complication. Do not go in summer. Take complete bed rest. Avoid stress as far as possible.I will be happy to answer your further concernYou can contact me. Dr Arun Tank. Infectious disease specialist. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can infection spread through shaving razor?\n\nI used a razor to shave a patient's dry chest and than accidently touched the razor with the hair pulling some of the hair off. Can I get Hiv/Hepc this way? I didint see any cuts initally but now 1 day later after i showered i see small nicks in fingertips. not sure from that contact or from myself aftr i shaved this am",
    "doctor_response": "HIWell come to HCMThere are certain condition for HIV infection that could spread from person to person, if some one is HIV positive and body sera (Blood product ) comes in    direct contact with blood of normal person and that is mostly happens, through, intercourse, blood transfusion, using same syringe, this is blood born disease, and without this is not possible, in your case if this not like this then just nothing to worry, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could small penis size be due to low testosterone levels?\n\nHi, my son is 10 yrs old. I have a quesion regarding his penis size. When he was born he had larger than avg testicle size (even now they are large) but his penis seems small in comparison. He is very tall for his age, 5ft 3inches and is a big kid (not fat just bigger and taller than avg kid his age). Should I be worried about him having lower testosterone levels? What should I be asking his pediatrician regarding this (without making him worry or feel weird about it). Thanks.",
    "doctor_response": "Dear, Welcome to HCMWe understand your concernsI went through your details. I do not think you have to worry about your child's penis size. Your child is 10 years. In the initial years, it is quite natural that the ratio between penis size and testicle size is non-comparable. Testicles size is always bigger. Upto the age of around 12 years, or till the child reaches fully puberty, the penis size will never be more than 3 inches, at the maximum. But after that, there could be a drastic growth in the length and the penis can grow upto 6 inches. Therefore, as of now, the penis size is reasonable. There is no significant symptoms to worry about testosterone levels. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Happy New Year. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had CGN, ultrasound showed bulky kidneys, taken Mycophenolate. How long should Azaron be continued?\n\nI am 44 years. I had CGN detected in March, 2009. During ultrasound, both kindeys were bulky, subsequently real biopsy . DetectedCGN. Adminstered Mycophenolate Mofetill for 2 years 750 mg bd, reduced to 100 mg & 500 mg, steroid 20 mg, reduced 10 mg & 5 mg., amlong, telma. Since March, 2011, Mycophenolate stopped and started Azoran 100mg OD, Ramipril 2.5, Metolar XR 25 mg od. Now BP 130/90/120/80, Creatine was 1.6. Now it comes down to 0.7/0.8. Pl confirm how long Azaron would continue. Pl help. THanks",
    "doctor_response": "Hi, Thanks for writing in I think your physician would be tapering off the Azaron very soon. However, it seems that some form of immunosuppressive treatment like cyclophosphamide or steroids or Azoran ( in very low doses) would be required to maintain this stage of remission. Please continue with the dietary changes and other medications like Amlong and Telma as suggested  by your physician. These would continue lifelong. Hope this helps Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the pain and swelling after an injury in spite of taking medication?\n\nHello , i had bruised lip i had s fight Saturday night and since then the first two days was no pain at all , but the last two days are painful(after the first 2 days ) even thou am taking ibuprofen and the pain is not going away , i have fears that it got infected , am seeing white spots surrounding  red/black bruise and even thou the upper outside lip is healing , its expanding in the inside , is it infected or shall i wait more ?",
    "doctor_response": "Hi,It seems that there might be having infection on bruised lip.In this case you might require one course of antibiotic for 3-5 days.In such case ibuprofen gives relief for some time.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How should Femilon be taken?\n\nI took Femilon for the first time. I didn't miss any of the days and have now taken all 21 tablets. But I feel I have not started it properly. I took my first tablet on the first day of the period. But I didn't check the day as in whether it was a tuesday, friday etc. Took the first Monday tablet and then continued all 21 tablets? What should I do now? Should I wait for my next period and start it properly? Thanks in advance",
    "doctor_response": "Hi,If you are using the 21-pill pack, please wait for 7 days after the last pill and continue using the next pack after seven days, i.e., after day 28. This may not necessarily conform to the days of the week mentioned on the strip. If, you have any difficulty calculating, you can start the pack from any nearest Sunday from your period and go on. This should fall within a couple of days of your period preferably. Remember to use additional protection during the first two cycles. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes skin rash?\n\nFour days ago I noticed a red area like a rash on my leg and in the middle of the biggest bump there is a black dot the size of a pin prick. Later in the day and over the past days what i think to be a rash as developed on my fore arms and elbows. What do you think this could be?",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms seem to be related to an allergic reaction. I suggest using antihistamines such as Loratadine 10 mg.I also suggest using Calamine lotion for local application. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible when the uterus is small?\n\ni am 27 years old and will complete 2 years of marriage in august. i am planning for a family since a year,but results are negative. my menses are irregular and have to take medicine fo most of the time to get menses. i go for a checkup and doctor says utreus is small. and today i go for checkup again same result. i am worried,i would like to know whether i will be able to conceive or not. please help me out",
    "doctor_response": "Hi, I have gone through your question and understand your concerns.Irregular periods can be due to hormonal disturbances like hypothyroidism, hyperprolactemia or polycystic ovarian disease. These three are also the commonest cause for infertility.I would suggest you to consult an infertility specialist to get properly examined, investigated including hormonal profile and ultrasound and get appropriate treatment.Hope you found the answer helpful.Wishing you good health.Dr Deepti Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shoulder-neck pain and memory loss after scania cell carcinoma?\n\nI m 38 year old female I have had stage 3 scaumia cell carsonoma in female areas had it removed in 2007&08 but I have this pain that has taken over my body in my right side in my rib cage I feel something growing now I have knots all over my body ,shoulder pain neck pain my esophagus has harden .chills sweats fatigue vision problems nausea vomiting weight loss right leg pain hip pain talebone pain speech problems memory loss legs and feet swelling feels like I m having weakness in my hands . My husband thinks I m crazy I know my body I don t feel right . Do I need to be worried ? One minute I m hot next I m cold just don t know what to think also my chin and lips are going numb am I crazy ?",
    "doctor_response": "The history of your cancer treatment is incomplete as I am not sure if you received chemotherapy and radiation as well.For all the symptoms you mentioned it will be difficult to give you a diagnosis as such.I would recommend that you consult your doctor so that he can properly examine you and do relevant investigations to ascertain the cause of all your symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life expectancy for metastatic bladder cancer?\n\nHi, may I answer your health queries right now ?  Please type your query here...hi my mum has just been diagnosed with cancer that started in her bladder and she had surgry 6 weeks ago and tumor was to big to remove so they bypassed it to bag outside her body.She had a scan on wednesday and tolled her she has cancer in her whole body.they did not give her an idea of about how long she has left to live and the pain is starting to get worse in her bones",
    "doctor_response": "HiThanks for posting.I understand your concern.I am sorry to know about your mom. This is an incurable condition but with chemo the average survival time is 1 year. it can be much more or even less depending on the response and tolerance. But still we can palliate her symptoms and give her some quality life.Hope this helps.Please get back if you need any more clarificationsRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes an irregular pulse rate in an infant?\n\nHi,I have noticed that my 16 month old has an irregular pulse rate,though only when he is lying flat asleep. He is otherwise very healthy.He is taking Amoxicillin for an ear infection.His pulse rate is slightly irregular missing a beat every 10 beats or so.When he is upright and awake his pulse is regular.Please could you advise on this.Thank you",
    "doctor_response": "Brief answer:Do a urgent ecg and echocardiography. Detailed answer:Your child has missed pulses during sleep. This is not related to ingestion of amoxycillin. This could be missed beats, you need to do an urgent ecg and echocardiography to rule out heart disease. Revert back with above reports. Wishing your child good health. Take care. Regards:Dr Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rashes on stomach arms and knee?\n\nI just had knee surgery my only known allergy is too amoxicillin and now I am broken out on both arms my knee tops of feet back and stomache in a rash that is extremely itchy and when scratched is extremely hot and welts up I have been taking benedryl and using calamine lotion for 3days now I m not sure what I m reacting too can you tell me what else I can do??",
    "doctor_response": "Hi, thanks for using healthcare magicBased on your response, if you have not been exposed to amoxicillin, you have another allergy.It may be one of the medications given or food consumed.The use of the benedryl and calamine is appropriate but if the allergy is not responding to this then you may need to use steroids. Though topical steroids would help to reduce the inflammation, based on the severity, you may need oral as well.It would be best to visit your doctorI hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is bronchoscopy necessary to remove nodule in left middle lobe?\n\npulmonologist suspects atypical form microbacterium by CT scan of chest. friend is on remicade, has RA, and unable to give sputum culture. No other symptoms. Friend never runs fevers. With RA, this person only gets chills. This person has had a RA positive test by blood. Pulmonologist recommends bronchoscopy, with cell washing, and may take a piece (biopsy). There was a 3 mm size nodule in left middle lobe.Question: What are possible outcomes if this person chooses not to have bronchoscopy? Can this person wait for a repeat scan later on, instead?",
    "doctor_response": "Thanks for your question on HCM.I want to ask you few questions1. Age of your friend2. Is he smoker3. What are his symptoms and since how long he is having this.If your friend is young, non smoker and not having any symptoms than I advice not to go for bronchoscopy at present. You can wait and get done repeat scan after 6 months. But if he is smoker, old age and symptomatic than , no harm in bronchoscopy and BAL analysis and biopsy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of bipolar disorder?\n\nHello, I m not sure if this is the right place to do this but I need some help with my boyfriend and what he s been going through lately. We think he might have Bi-Polar disorder but of course we can t be sure without a lot more work and help. I was just wondering, where should we go from here? He is uncomfortable speaking to his mother or sister about it and I am far away so there s not much I can do. Again, I m not sure if this is the right place and I m sorry if it isn t",
    "doctor_response": "in  my  opinion   symptoms  of  bipolar   disorderthey  can  present  with  symptoms   of  depression  during  a  certain  period  like  sadness,  lack  of  interest  in  activities,   fatiguabilitythoughts  or  acts  of  suicide,  poor  self  esteem,  poor  self  confidence with  regards  to  maniac  episode  it  is  more of  feeling  elated,  increased  activity,  decreased  need  for  sleep,  it  is  necessary   to  check  thyroid  levels  ,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain?\n\nMy son is 3 years old and woke up this morning that his stomach hurts.  He ate breakfast and then would complain again that his stomach hurts.  I asked him every time if he needed to throw up assuming he had the flu, he did not need to throw up.  He tried to distract himself throughout the morning he kept complaining until he was in excruciating pain.  I am now waiting to hear from the doctor at the hospital.  What do we do?",
    "doctor_response": "Hi.Thanks for your query.The boy is just 3 years old, the causes of pain in abdomen in this age-group are a bit different. Commonest are:Abdominal lymphadenopathy. AppendicitisWorms.Consult a Pediatric Surgeon for a clinical examination.go for the tests of blood, urine and stool. And an ultrasonography to confirm or to rule out the causes. A course of an antibiotic and anti-inflammatory medicines may help him.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hypertension\n\nI m dealing with a lot, I have had to take over the care of my 75 yr old mother whom has had a stroke plus broke her ankle. My daily life is a struggle. My blood pressure is high 147/103 pulse Is 89. I had to quit my job and give up everything and it bothers me that my sibblings 4 of them do not help me at all.",
    "doctor_response": "hi before starting you on any treatment regime I would like you record your blood pressure daily for a week and start excercsing.. after a week let's review the readings and plan for further management",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pounding in chest?\n\nI am 43 years old I have had pounding in my chest for several days and now today I am very tired and sick to my stomach I have hbp ans high cholesterol and have been taking meds for years this is really starting to worry me not sure what I should do.",
    "doctor_response": "hello, This pounding sensation is most probably related to gastritis and reflux disease. However, get one ecg done during this pounding sensation, to rule out heart problem.  Do you upper abdominal pain, nausea, bloating, burping, increase in pain on food, sour water feeling in throat or chest burning, if yes it further supports the diagnosis. You should avoid fatty, oily and high calorie diet. Have some walk after having food instead of taking rest. Have multiple small meals instead of heavy meals. Have regular sleep habits and avoid stress. Lots of green leafy vegetables, fruits. Avoid smoking and alcohol if any. You can get prescribed tab Pan DSR 40 mg beforebreakfast once a day for 2 weeks.   For your other problems, you should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. If bp is persistently more than 140/90 mmhg, thenmedicines needs to be hiked up for it. Regular exercises like brisk walking, jogging according your capacity atleast 30 min a day and 5 days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn't abdominal fat deposition or obesity. Get your lipid profile and sugars tested once.. For cholesterol, you should be started on medicine like rosuvastatin 10 mg bedtime, you can get it prescribed from local doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for abdominal tugs after using Mirena?\n\nHi, so I've had my mirena since dec. of last year. I've been feeling like tugs or something in my abdomen since January. I got my 2nd month chech up an it was still in place. The thing is I'm craving all the time and it's like nothing con tempts me? You believe this is a mirena side effect or something else?}",
    "doctor_response": "Hi. Mirena is a hormonal IUD releasing progesterone all time. It causes few months to adjust with Mirena in the form of abnormal bleeding, cramps or pain lower abdomen . However it will settle in few months. You can consult your dr. and get treatment for that. But get one urine routine ex. to rule out UTI and also PID (any pelvic infection).Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is heavy sensation in groin due to swollen lymph node a matter of concern?\n\nLast year I had an ultrasound and was told that I had 2 Epiymal (?) cysts on my right testicle. and it had caused a slightly swollen lymph node. I was told not to worry unless it caused pain. It has been over a year and while not painful, it does cause a heavy sensation ion my right side groin and a sense of tightness in my lower abdomen. Should I be concerned, I have no other health issues associated with this.",
    "doctor_response": "HelloThanks for query .You have sensation of heaviness in groin on Rt side and detected to have two small Epididymal Cysts.The Epididymal cyst is a benign cyst and does not require any active treatment unless it gives rise to pain or there is sudden increase in size of the cyst .Mild discomfort that you have can be managed with pain killers as and when necessary.Do not worry and just keep a close watch on the cysts as regards increase in size .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause purple coloring of testicles after fall?\n\nMy three year old fell off his bike while going very fast and must have crushed his groin. His testicles are very purple and red and the seedling is going down. He says they don t hurt. Anything I should watch for? Should I take him in? It was a few days ago.",
    "doctor_response": "Thanks for posting your query at HealthCareMagic. I am sorry that your son got injured. Let me mention that the scrotal area contains loose tissue where blood can come from the injury site (elsewhere) and accumulate. The blood gets degenerated eventually before getting absorbed and the colour gets converted into bluish, purplish, blackish etc. Do not worry about it if it is painless. It will resolve in around 7 days on its own. But approach a doctor if he says that it is painful.Hope that I have been able to answer your query. Feel free to revert back in case of further queries if any.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Unable to conceive, all tests normal, egg size vary. Not interested in IUI. Treatment?\n\nhi, i m riya i m pregnent from last three years but i didnt conceive, i go through all tests blood , harmons and tube test as well its all clear. my husbands (simens analysis) is also ok. but sometimes my egg size is large and some times its small. we consults many doctors they said that u now go for IUI but i am not interested to go for that. what u will suggest for me.",
    "doctor_response": "Hello thanks for your query. Please consult a proper infertility specialist for further treatment. As all your tests are normal, which you have mentioned, then IUI ( intra uterine insemination ) seems the best way for you. The major cause of infertility is unexplained infertility, in which no definite cause can be found. In such cases, sometimes, there might be some local or cervical factor, which can be overcome by IUI. As such, by wasting time without treatment, your age would increase and age related problems would arise. You should definitely try to go for IUI, if you have already spent three years trying to conceive naturally. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I conceive if I have PCOS and irregular periods?\n\ni have pcos problem.having irregular periods long time.doctor did harmone test nd told lh harmone inbalance.nw taking apcod nd gluformin tablets.in which i geting regular periods while using medicine first time.then again iregular periods.what can i do to get conceive",
    "doctor_response": "Hi,Welcome to HCM.Main problem in PCOS for conception is anovulation & simplest way to conceive is through ovulation induction medicines under guidance of infertility specialist(preferable)/gynecologist.Please maintain healthy lifestyle by having healthy diet (cut down fats & carbs) & daily exercise of at least 30 minutes. This will help in reducing severity of PCOS.Hope this helps.Wish you good health.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why did the usage of moisturex and lactic acid lead to darkening of skin?\n\nHello,I have recently started using a moisturizer called Moisturex containing urea and lactic acid. It seems immidiatley after applying  this cream my skin turn quite dark. I was wondering if this is a temporary reaction to lactic acid. Would this side effect subside with long-term use.Thank you",
    "doctor_response": "Hello and welcome to HCM,I read your query and understood your concern.It is unlikely that any of the contents of moisturex will cause skin darkening. But maybe since it is quite greasy it may give appearance of darkening. Apply a very little amount on your face. If still it doesnt help you may want to switch cream.Also since lactic acid is mild exfoliating apply sunscreen whenever you go out.Hope I helped",
    "dialogue_context": ""
  },
  {
    "patient_message": "Painful little swelling on right side of abdomen, fatigue, pulling feeling in right kidney.  Have diabetes, high cholesterol, hypothyroidism.  Suggest\n\nI have a little swelling on the right upper quadrant of my abdomen. It hurts sometimes and I can see it and feel it when I run my hand over it.  Also, I have been really tired lately and sometimes my right kidney hurts or feels like it is pulling.  It is also near my liver I think.  I have Type 2 diabetes and high cholesterol.  I also have hypothyroidism and no insurance.",
    "doctor_response": "Hi,From history it seems that you might be having enlarge liver giving rise to this feeling.Consult physician and get examined.Go for ultra sound of abdomen to know the condition of liver and kidney.Go for blood work for liver and kidney function.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can passive tobacco smoker have allergic headaches?\n\nI'm having headaches.Usually always start at night.I've been allergent to tobacco ...tobacco smoke my whole life..tested for allergies in college ..Had 2 big ones tobacco and house dust..My wife smokes..is it possible i'm getting these headaches from her sleeping in the same bed... I think so...is there something i can take or just sleep in another room",
    "doctor_response": "Thank you for asking!  As active smoking does the damage, so does the passive one too.As you are allergic to it. The headaches can be explained. You can ask your wife to compromise, make a smoke free zone. Or use of mouth freshners after smoking. Avoidance of tobacco from an unknown person is difficult. From a close relative or partner i don't think that should be a problem to the extent to consider a room change. Take simple acetaminophen for the headaches at night.Hope it helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will icing wrist after spraining it help?\n\nI believe I sprained my wrist yesterday in a basketball game. I have iced about 4 times between now and then for about 10-20 minutes each time. What is the best procedure(s) to follow to treat this? Some have suggested soaking in epsom salt...agree?",
    "doctor_response": "Hello,Salt is OK or ibuprofen gel. Anyway, it is also necessary immobilization. If the pain persists, consulting with an orthopedist for a physical exam is necessary.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in lower left abdomen, pulsing sensation. Had hysterectomy, poly removed, sample of womb lining taken\n\nHello, I had a hysteroscopy on Wednesday and had a polyp removed and a sample of a thickening womb lining taken. I have some light bleeding, bright red but  not concerning. Last night, I suddenly developed a pain in my lower left abdomen, pulsing in sensation.I have experienced this during the night. I am not in agony by any means but find this new pain very disconcerting. I have not needed any pain killers after the procedure at all. I am 52, a non smoker and in general good health.",
    "doctor_response": "Hello,It is common to have slight ache pain in the postoperative days. This is due to the healing process.The bleeding is are very little. No need to be concerned.I would advise my patients symptomatic treatment like analgesic and antispasmodic for pain.Wait and watch. If the symptoms worsen then consult your doctor and get evaluated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a bump on the gum?\n\nI have a bump on my gum, that only appeared after I nicked my gum with a hard tooth brush. It filled with blood for two days and would come out and fill right back up. But just right now puss came out of it, and then just a lot of blood. I have no pain whatsoever and I have very healthy teeth.",
    "doctor_response": "Hello, Thank you for consulting with HCM.Actually it looks that you have traumatized your gums with toothbrush and now an abscess has been formed.You have to visit a dentist as he will examine the lesion and clear the area with irrigation and scaling.Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes testicular pain?\n\nI'm  33 and recently started to have some pain on my right testical.  About 3 days.  It was sensitive for a day and the next it was fine.  today it is sensitive again.  I play racquetball and work out 5-6 days a week.  it is sensitive only on the upper part of the testical (right side one).  Is this a issue that I should get worried about and see a doctor or wait a couple of days?  Thank you",
    "doctor_response": "Hi, It can be due to injury, torsion testes and prostate infection. Anti inflammatory drugs can help you. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic renal failure\n\nHi, Iam suffering from CRF stage V, One Doctor advised for replacment, other Doctos for dialysis, Iam 53 Years Male. My Cerum Creatinine 5.35 mg/dl eGFR ( estimated by MDRD method ) 12 ml/min. K 5.72, Urea 89. Please suggest what should I do go fr replcement or dialysis. Best regards Banibrota",
    "doctor_response": "DEAR USERTHANKS FOR CONSULTING AT HCMRENAL REPLACEMENT THERAPY INCLUDES DIALYSIS AS WELL AS KIDNEY TRANSPLANT ATHOUGH STAGE 5 CKD CAN BE TREATED BY MAINTAINENCE DIALYSIS.. AMONG VARIOUS DIALYSIS OPTIONS AVAILABLE HEMODIALYSIS IS MOST PREFERRED.. I WOULD SUGGEST U GO FOR A KIDNEY TRANSPLANT IF YOU HAVE A COMPATIBLE DONOR AVAILABLE.. IF NOT CONTINUE IN MAINTAINENCE HEMODIALYSISHOPE I HAVE ANSWERED YOUR QUESTION.. YOU CAN MESSAGE ME FOR ANY FURTHER CONCERNS",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can whole body cysts causing scarring on removal be treated?\n\nI have these cysts all over my body. The number of them have increased over the years. Some you can see and I am becoming self conscious of them. I have been Tolstoy they are fatty cysts and that the scar from them being removed would be worse then just leaving them. What is your opinion? Is it something more I should be concerned with?",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query.From your history, it seems that you have got multiple lipomatosis, which are benign fatty deposits. These are firm lumps which are benign carrying practically very negligible risk unless when they press on any organ or nerve. Multiple excisional biopsy would also give rise to scars unless done very meticulously. Usually it would be left onto the patient whether they need surgery and  would be ready to accept the scars or if they want these lumps to stay like that with proper precautions.Thus you would be the best judge to decide on it.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and tenderness in lower abdomen?\n\nHi  my name is john, i am 48 years old. i got pain and tenderness in my lower left  abdomen, i also have constipation and boating, each time me and my wife    make love she always feel discomfort after  sex,  in her stomach also she blow a lot of wind  fart, am worried may be i have infection in my sperm",
    "doctor_response": "HI Welcome to H C M I am Dr B M GUPTA answering your questionPain at lower left abdomen may be due to-Constipation-Stone Diverticulitis For constipation -Tablet Dulcolax-For Gas-Tablet or liquid ant acids-For diagnosisUltrasoundFor infection in sperm-Urinalysis-Semen examination-Change your diet -Take plenty of water ,fresh fruits,exercise-Cut -alcohol,caffeine,spicy foodconsult Surgeon for prostatitisBEST OF LUCK",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a crack on which the root canal was performed?\n\nI had a root canal done about 20yrs ago. It seemingly has a crack in it as I have gone from Dentist to Endo to Peri specialist. It has really flared up about 3months ago. Lot of pain, have had a pocket next to the tooth. It is the lower back left ...back tooth. I have been on a antibiotic for about 10 days , still pain of course and still on antibiotic before they will extract the tooth in about 5 days.My question is , I am having pain in the upper left sinus area above my upper teeth. Can the pain radiate that way and also, I feel more tired than usual and seem a little depressed...does this have anything to do with an infected tooth? I am so hoping to feel a lot better after the oral surgeon gets this thing out. Can I get up the next day and go on with life as usual?",
    "doctor_response": "hellooo...read thru ur query....regarding the pain it can radiate to upper tooth also as these teeth are supplied by branches of same nerve...so infection can cause pain in upper tooth and sinus...nothing to worry in that...and while going to dentist see for any decay in upper tooth also as for a confirmation....hope ur benefitted by my reply...have a healthy day!!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever and headache after a dental procedure?\n\nMy daughter had a dental procedure done on Thursday that required the use of laughing gas. That same afternoon she stared to experience headaches and later that evening a fever. I called the dentist and they had her go back in saying that it could be the filling, so they fixed it. She continues to have fever and headaches, she is currently taking amoxillin as per the dentist. They told me she had an infection on one of her teeth, which is why they put her on the antibiotic. I am concerned she may have meningitis.",
    "doctor_response": "Hi..Thanks for the query..Fever and headache after a dental procedure when she already has infection in one of the tooth is due to infection only..When the infection is severe it can enter the blood from the site of infection causing bacteriemia and septicemia and it can cause infection and the most common presentation is fever..So as she is already been advised amoxicillin, probably the infection will subside and also fever..Add Acetaminophen to reduce fever and pain..In case if the symptoms does not get better in a week then you can consult an Emergency room and get her evaluated..Hope this helps..Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does lumps in jawline with tonsils & swollen lymphnode suggest lymphoma?\n\nI am a 25 yr old male and last year I noticed a lump right under my jawline and my doctor told me not to worry. I went to see a ENT who said my tonsils were only irritated on the surface but the tonsil as a whole looked fine. A year later I have noticed a new swollen lymphnode on the right side of neck and my right ear does not hurt but it feels swollen on the inside but no pain. I do not want to keep running to the doctor but if I have an infection or even lymphoma I would like to know.",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.It is good that you have already shown to the Doctors.Since you are yet bothered about it, the best way is to go for ultrasono guided FNAC- fine needle aspiration cytology. It is better to get this removed (excised) for 2 reasons.1> your get rid of the disease and 2> you get the histopathological diagnosis- makes you tension-free that it is not a cancer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Am I under the right treatment for cough?\n\nHi doctor, I am having cough\u00a0for two to three weeks now. It is mostly dry and frequent throughout the day. I am getting two to three\u00a0coughs at one time and then it continues. Currently, I am taking Piriton-CS, Pantocid and Montek-LC. I had bronchitis problem a few years back wherein I used to get frequent cough. Please help.",
    "doctor_response": "Hello. I had gone through all the details you have posted. For further information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could continuous bleeding after being fitted with Nova IUD indicate?\n\nhi.. had a nova t380 fitted 2 months ago, i started my period 12days ago and there's no sign of it slowing down. i am anemic taking 3 iron tablets a day. because i have been bleeding with the pill, injection and i had a nova in 4 2months b4 this 1 and was bleeding, got sent  4 a scan and it was in the wrong place! is all this bleeding normal?",
    "doctor_response": "Hi Hope this message finds u in good health.I have gone through ur msg and understand your concern.it may be due to some sort of hormonal imbalances or variations in the body,though there may be other reasons as wellNothing to worry about, You should eventually get back to normal.Take multi vitamin and calcium supplements Do consult a gynecologist if symptoms worsenGet back to me for any  FOLLOW UP QUERIES anytime.Regards,Dr Mahaveer Patil...(MBBS,MS,Mch)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cause for twitches\n\nHello,I am Shikha. I am facing twitches from 2 months which started from my lower lip. And now i fell intermittent twitches in my calf, foot, hip , hands. I am feeling uneasy and worried. I consulted a neurologist and got myself tested for thyroid, calcium and phosphorus and diabetes. My calcium was a bit lower to the normal range (only 2 points low). On his advise iam taking Calcium supplements and anxiety tables( Zapiz and ciplar).Please advice. Iam worried .Thanks in advance",
    "doctor_response": "Hello,I read carefully your query and understand your concern. Face twitches can be related to anxiety. Low calcium levels can also trigger this symptoms. So,I suggest to take the medications as prescribed by your doctor. I also suggest a healthy lifestyle, eating a healthy diet and sleeping well. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, heavy menstrual bleeing. Ultrasound shows fibroids, ovarian cysts. Treatment?\n\nHello- I have been suffering from heavy bleeding, severe cramping, irregular periods, and galactorhea(spell?) I had an ultrasound which reveals a heterogeneous foci in the midline uterus consistent with fibroids 2.2 X 1.7 X 1.9 cm, a Nabothian cyst in the cervical canal measuring 1.5 X 1.6 X 1.1 cm, and a left ovarian cyst with septations and echogenic nonvascular material 3.4 X 1.7 X 1.7cm. My husband and I want to conceive as we have established our careers and are ready for our first child. I am 40 years old. What is your recommended treatment for this?",
    "doctor_response": "Hi, Thanks for your query. I read your query and I understand your concerns. The chances of you conceiving naturally with all these problems are very less. You must vist an infertility specialist to get evaluated for galactorrhea and get treated. Though fibroid is small, ovarian cyst needs to be evaluated further and diagnosed as to type of cyst & necessity for removal. You may try with donor egg option. Either ways you need to consult an infertility specialist. I hope I answered your query. I will be available for any followup queries you have. Regards, Dr.Mahesh Koregol IVF & Infertility Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for typhoid fever\n\nHi, Doctor s, My mother is 56 years old from last 20 days she suffering form typhoid fever she take 10 days medicine and injection which is suggested by doctor but fever is continue 101 to 103 degree now doctor suggest for urine test for bicolai and xray of chest. The bicolai test is nil but chest xray sown mild cardiomegaly. She is suffering thyroid and BP problem from 3 years",
    "doctor_response": "Hello,Welcome to HCM,I have gone through your query in detail.Typhoid is a bacterial infection and stays in the body till treated completely in most individuals. It is important to know what antibiotics you are taking, its dosage and duration for which you been prescribed. Most likely, you are getting cured and for complete cure you must take medications as suggested by your doctor. The main precaution you must take at present is eat healthy home cooked food with less oil and no spices. This diet may be continued for about a month to allow proper recovery. Medications also must be taken for complete course and in typhoid it is often given for 14 days. You may take adequate amounts of water and fresh fruit juices. As typhoid leaves you very weak, taking rest for a while is advised. Typhoid recovery is not the same in every person who gets it. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Montair LC be taken regularly for allergic rhinitis?\n\nI am suffering from allergic rhinitis since 15 years and by taking montair LC tablet daily get me relief.can I take it regularly.is there any side effects if I continue taking it daily.pl advise is there any weight gain due to this as I gain weight .i am 47 yr old",
    "doctor_response": "Hello,Welcome to HCM,The drug is very effective in controlling the symptoms of the allergy. Every drug will have its side effects but the benefits over weigh the risk of the drugs.As you are having allergy for last 15 years, I would suggest you to undergo Skin prick test to know the allergen causing the symptoms.After identifying the allergen you can either avoid that allergen or you can take immunotherapy against that allergen.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for liver dysfunction\n\nI am 68 years old and over the past four to five years I have put on weight around my mid section. I am told that thios is due in part by liver slow down or dysfunction. Both my mother and my brother had complications regarding their liver prior to passing away. I ve heard that there are liver cleansing remedies available or that can be purchased but at a considerable cost. I am on a fixed income and personally was hoping to find a more natural way to cleanse my liver. Do you have any suggestions?",
    "doctor_response": "there are no liver cleansing medicines available in the first place. Secondly, your belly fat is due to food and physical inactivity. in fact liver is affected secondary to this and not a cause of this. my advice is to go for weight loss by diet control and exercise. control of diabetes if any. once this is done liver will become normal on its own",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I have increased pain and pressure in the tooth after undergoing root canal treatment?\n\nHi doctor, I did a root canal on the upper first molar tooth before three weeks. I had sensitivity towards cold and sweets for years. The tooth was slightly loose. So I did a root canal on it. The second sitting was done before a week. I started to have pressure on the tooth after two days. I consulted the dentist, and he told me that the seal has got broken. The doctor said to me that the tooth should be pain-free for a weekend to have a fixing over it. But, I had more pain than before doing a root canal. The pain was terrible. Now, I have pain, pressure and it hurts even for a light pressure on the tooth. I do not have sensitivity. Now, it has been two days, and still, I have pain over the tooth. Please help.",
    "doctor_response": "Hi. You have an infection still lingering in your tooth undergoing root canal treatment. It causes pain. Your dentist should place a calcium hydroxide dressing in the tooth, and it disinfects the canals. A course of antibiotics should be given. Also, the tooth should be trimmed to avoid contact with opposite jaw tooth. If the pain does not get better, get an X-ray done and upload it to me. So that, I can advise you appropriately.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the meaning of hepatic parenchymal disease?\n\nI had a liver scan it said MODERATELY INCREASED HEPATIC ECHOGENICITY AND COARSENED ECHOTEXTURE CONSISTENT WITH HEPATIC PARENCHYMAL DISEASE VERSUS FATTY INFILTRATION. What is HEPATIC PARENCHYMAL DISEASE? Treatment? Cant find alot of information on it and cant get ahold of my doctor.",
    "doctor_response": "Hello, The hepatic parenchyma disease could be in the form of fatty liver or chronic liver disease.I suggest you to investigate to guide you further. -SGPT -SGOT -Viral markers -PT You can revert back with reports to guide you further. You need life style modification and stoppage of alcohol initially. Then based on your reports will discuss further. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for nocturnal emmision\n\nHi I am Raj 26 years old I having the problem of sperm release in sleep from age of 18 now for 2 weeks I am having treatment for piles so please help me to cure sperm release it is very embarrassing at nights without my knowledge sperm releases......",
    "doctor_response": "Thanks for asking in healthcaremagic forum   The body has a mechanism to replace older sperms with new one if not ejaculated by any means. So, night fall is the natural mechanism of body and is not a disease to be treated.    Continue your treatment for piles and hope you understood it. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have irritation type of headache due to prolonged lying in quarantine period. Please help.\n\nHello doctor, I have a headache in my upper part of the head. I do not know if it is connected with my neck because I had stiff neck due to my sleeping position. Well I lay down to bed most of the time due to quarantine and after I had that stiff neck I had this. It is not actually a headache, I guess it is like irritation in my upper head. I do not know if it should be treated with a pain reliever. As it is not that severe I did not take it.",
    "doctor_response": "Hi, Welcome to iclinq.com. I understand your concern. I need to know more about your headache. How and when does it start? Is it unilateral or both sides? Is it intermittent or continuous or any diurnal variation? Any aggravating or relieving factors? Light or noise sensitivity? Does it associate with nausea, vomiting, or blurring of vision? Did you have a history of migraines or asthma? Any history of fever or sinusitis? You should always note the red flags of headache such as sudden onset of headache, the onset of headache after 50 years of age, increased frequency or severity of headache, new onset of headache with an underlying medical condition, headache with concomitant systemic illness (fever and weight loss), focal neurologic signs or symptoms, blurring of vision. In that case, you need urgent evaluation. If they are absent, you need not be worried. Some times neck muscle tension stiffness may lead to headaches, as in your case. Simple Paracetamol or muscle relaxant will be useful. Adjust your sleeping position, try not to use high pillows. Another most common cause of headache is migraine. Simple Paracetamol at the onset of the headache will be helpful. Also, avoid triggers that lead to a headache. You should have adequate sleep, avoid stress, and take meals on time. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are symptoms of Braun-Bayer syndrome similar to dementia?\n\nHi I need to inquire about a Braun disease on set 50 - 60 that is caused by lack of 1 or 2 proteins in the Braun it is very similar to like dementia of alzheimners lijevin that same category but it the systems vit has is more like a chgange deamor mnaybe like some people after axstrokevhgave hard time with their emotions my Dr had mentumed ITV mne I can t remember the name ofvit expect for it started 2 lowercase letters I thin like MV them there 3 Cap letters after that like somevkind acronym but I v Cantvrember what they are and I want the name so I can research it pleaze",
    "doctor_response": "Hi, It's difficult to key in exactly what you may be referring to except to say that a change in demeanour or emotion is sometimes referred to as emotional INCONTINENCE (EI) or pseudobulbar affect (PBA). This can occur after a stroke or appear almost like a stroke has occurred in a person who suddenly begins exhibiting changes in behaviour and emotion without a clear cause or precipitating factors. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Vaginal bleeding after urination. Have implanon, do not have periods. Abdominal bloating, knot in ribs, cramps. What is the problem?\n\nHi, I am 16 years old. In the last two days I ve started to bleed from my vagina after I pee. I have the Implanon in my arm, have not had a period in 5 months and also I am bloating a lot in the abdomenal region. I am getting a knotting sensation in my rib/ lung area and stomach. And slight cramps, but next to none in my stomach. Have you any idea what the problem could be?",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, such bleeding could be menses (irregular) and this is common phenomenon in this age, other abdominal symptoms are nothing to take anything with this, and neither this is to worry for anything,  hope this information helps, take care and have a good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a cut in brow bone\n\nI have a cut on my brow bone that is about one third of an inch in length and a centimeter in width. It makes me feel dizzy and have black outs. Today i walked a lot and I was wondering if it could affect me in any way, because I m afraid of going to sleep and just not waking up.",
    "doctor_response": "Hello, If the cut is superficial, we can manage by daily dressing only. You can try collage containing ointments like megaheal for best results. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes memory problems to a 68 year old?\n\nMy husband has retired 5 years ago, only 68 years old. Has been forgetting everything. He has forgotten to pick up our grandchildren. Does not appear to be bothered by things. He wouldn t get off the couch and had our 9 year old grandson answer the front door alone, a strange man was at the door, and he still did not get up? It seems as if his conscience has totally left him. I need some help.",
    "doctor_response": "HiThanks for choosing HCM, glad to answer your query.Forgetfulness in an elderly man are suggestive of dementia.Which could be due either age related senile dementia or Alzheimer's disease.Take him to a neurologist for proper evaluation and treatment.Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recommend treatment for Obsessive compulsive disorder\n\nHi, may I answer your health queries right now ?  Please type your query here...hi im so embarrassed and distressed about what i am about to ask right now i really need ur help i am 17 and i have OCD i have had it for 5 to 7 years now and for a very long time i have been picking and pulling hair off my vagina (labia) it looks really bad and not healthy now please tell me what should i do i am too embarrased to go to the doctor",
    "doctor_response": "hi, Don't shy away. Your doctor can understand you and your problem. We will help you to get rid of this.If you are having problem of picking hairs.. it is called trochotillomania and is seen among many girls of your age.It has definitive treatment with medicines and psychotherapy which will help you lead a happier life.So please visit your doctor and stay healthy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does coarsened echotexture and increased echogenicity in liver ultrasound indicate?\n\nHello doctor, I had discomfort recently in my right upper rear torso. I recently had an ultrasound and a CAT scan. The results covered a variety of body parts. But I am interested in speaking to a liver specialist regarding what the results said about my liver. I would like a doctor to explain to me what these results mean. My recent ultrasound showed: Measures 12 cm. Liver shows coarsened echotexture and increased echogenicity. No liver masses identified. CAT scan showed: Liver: Diffuse hepatic steatosis. Indeterminant subcapsular posterior right hepatic lobe 13 x 9 mm hypoattenuation segment 7.",
    "doctor_response": "Hi. I read your US reports and I can say that: 1. You have fatty liver disease (steatosis). 2. With regards to second ultrasound indeterminant subcapsular posterior right hepatic lobe, 13x9 mm hypoattenuation means that ultrasound cannot identify the reason. Often it is related with no fatty tissues at this part of the liver. Otherwise, if I were your treating doctor I would suggest doing MRI of liver to better evaluate the parenchyma of the liver.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does my semen analysis report indicate?\n\ni wnt to know is there any inaccuracy in my semen volume - 3.0 ml colour -greyish white ph- 8.0 liquification time- 30 min total count - 88 m\\cc progressive motility - 40 slugish -35 immotile-25 pus cell - 2-4 /hpf rbc - nill epethelial cell - nill abnormal forms - 40 normal forms - 60",
    "doctor_response": "Hi,thanks for writing..The report is ok.. But immotile sperms are 25,so I would suggest to take some antioxidsnts like vit E abd tablets like coq, to improve the motility.. Take lots of fruits and leafy vegetables.. Hope I have answered your query.. Good day..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What relieves the pain under the eye due to the lump?\n\nMy Son is 40 years old and has had horrible pains around is left eye and around his sinuses. It feels like a lump under his eye and next to his nose.  This has been going on for about 2 1/2 weeks.  He used to get the pain about twice a night. Now the pain comes about every 1 1/2 to 2 hours day and night.  He is taking anitbiotics that he got from the doctor, but are not helping. He is truly in terrible pain. It came on very suddenly and had not been sick.  Please hel[p, what could it be and what to do. thank you     Margot Grammer",
    "doctor_response": "Hi Margot Grammer.Thanks for elucidate history. A good clinical diagnosis along with investigations like CT scan of the area is mandatory. This can be due to a mass in the Sinuses like Cancer which has got infected. In such a condition the patient should be hospitalized and investigated and treated .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the heart area passing to the left arm?\n\nSir Myself Vijay Kumar From Jawahar Navodaya ViDyalaya Vill. Tewa Kaushambi (U.P.). My Wife Smt. Pallavi (age 21) Suffering from pain at the location of heart and pain is passing in the left arm. We need help and suggestion from you please.  YYYY@YYYY   Mobile No. 0000.",
    "doctor_response": "Hello Welcome to HCM.Chest pain passing to the left arm is typical of heart problem but in view of her young age the reason to suspect a heart ailment is very unlikely . Please ask her to take antacids tablet Pan 40 mg twice a day before food for two weeks. Also get her vitamin D and Vit B12 levels checked. If they are found to be low, then she should be started on supplements for vit D and vit b12.Also do and ECG to rule out any associated heart problem . If despite  all these measures she has still got these symptoms, please do a treadmill test which requires her to walk on a treadmill while her ECG is continuosly being monitored . This will show whether she has any blockages in the heart.Please do the above tests and revert back.Wishing her good health Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can bacterial infection and scar tissue of lungs be treated?\n\ni have been to doctors after doctors and then in hopkins county memorial and was admited for 6 day now i have a cathider in my left arm that leads to the main arterie in my heart the doctors are saying that i have a bactirial infection in my lungs along with scar tissue on my lungs as well as my white blood cells being low i believe there is something more please i think they are not telling me everything i need to know what is wrong please what is your professional oppenion what would you think they have ran every test first it was tb then it was cancer and now its supose to be a bactiral infection please help",
    "doctor_response": "Scar tissue of the lungs is not a disease. It is the tissue that can substitute normal lung tissue that suffered an inflammatory injury, as result of a severe infection for exemple. Some diseases are difficult to diagnosis and sometimes clinical symptoms, signs and tests findings may be inconclusive or misleading. A strong relationship of trust with your physicians is extremely important to overcome the challenges of your treatment and rehabiltation. Your physicians will not hide from you anything related to your condition if openly questioned about it. The anxiety in the presence of a condition that is not completly understood or that does not improve may sometimes leads us to look for opinions of many different specialists. However, this conduct can also cause prejudice as sometimes it is difficult to stabilish and follow a sequence to diagnosis and treatment. Talk to your attending physician, expose all your doubts and questions and if you feel assured that you are been well cared, continue your treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Spotting, cramps and dull pain while urinating. Unprotected sex. Implantation bleeding?\n\nhi. i had an incident where the condom ripped rigth at the end. 15 minutes later I ran to CVS and got plan b. I was supposed to have my period the day before sex but now i have horrible cramps , slight spotting, and dull pain when urinating. I have taken plan b before but never had these symptoms...so im afraid the blood was an implanation bleeding ... I dont know what to do",
    "doctor_response": "hiiiii.Chance of pregnancy is there,if intercourse is done around ovulation time in regular cycle.Pain and cramp during urinating may be associated with some sort of infection. Do a Urine test if persist for 2-3 days or more. Drink plenty of water and maintain personal hygiene.Spotting or slight bleeding may be due to hormonal imbalance or early implantation.Do a urine test for hcg after 1 wk of missed period or a USG lower abdomen to rule out something.See result and consult with doctor. Avoid stress and practice safe sex in future.Be well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pain and swelling around the elbows symptoms of a tennis elbow?\n\nHi, I have had elbow pain that radiates up to the outer portion of my shoulder and sometimes down to my wrist. The elbow is swollen and I have weakness in the shoulder and am unable to lift what I used to be able to. Also, I am unable to lift my arm from the side of my body up. I had a cortizone shot that worked for about 6 weeks and it gradually came back and is now worse then before. Does this sound like tennis elbow?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Tennis elbow predominantly presents with symptoms around the elbow only and doesn't affect the shoulder. If the entire limb is feeling painful and any tingling sensation along with neck pain can suggest a cervical disc disease. So, I would suggest you to take a cervical spine X-ray and consult with an orthopaedician to proceed further. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jayganesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in my lower abdomen?\n\nHello Im 18 weeks pregnant and I have a UTI I got antibiotics Thursday but today the pain is a 10 it stings when I pass water and its a cloudy white. I have cramping pains in my lower abdomen when passing water. Today so far Ive drunk 1.55l of water I feel hot as well. Can anyone help please",
    "doctor_response": "Hi,Thanks for writing here.Acording to your symptoms you may be suffering from Urinary Tract Infection.In it,there is lower abdominal pain,burning sensation while passing urine,fever,may also have turbid urine.So I will advice you to visit a gynaecologist or urologist soon.After assesing you,Doctor will prescribe antibiotics or if you have already visited one,take advice from him & continue medication.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in joints and tiredness?\n\nhi.can any one plz tell me its my little brother 12 years old only.but he looks older than his age. he was normal till age of 8 but suddenly he grown faster. now physically he is not fit. his shape of face also turned ugly a bit, his body had less mass and most important thing is that his bones are strong but his joints are not that good. he feels pain and gets tired soon. plz help",
    "doctor_response": "Hi,Welcome to HCM,I had gone through your question and understand your concerns.As per your details, abnormal growth with tiredness could be due to hormonal imbalance or some genetic syndromes. kindly visit a endocrinologist for proper evaluation and treatment.Hope, I have answered your query, all the best, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for wheezing problem\n\nHI, I have wheezing problem which is immense in the morning when i get up. Its fine if i take citrizine. Doctor advised me inhaler which i took for six months and have left now since I have put on a lot of weight. Please advise if its ok to continue taking citrizine everyday,",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Cetrizine is antihistamine drug. It is used for allergic condition. Since your wheezing is improved by taking cetrizine, possibility of allergic asthma related wheezing is more likely. Cetrizine is very old antihistamine drug. Now a days, newer antihistamine drugs (levocetrizine or fexofenadine) are available which are more effective and less toxic than cetrizine on longer use.So start levocetrizine or fexofenadine instead of cetrizine. These drugs are safe for long term use. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nausea and dizziness after an ankle sprain?\n\nI just twisted my ankle or sprained it, I m not sure. Immediately after I started feeling nauseous, very dizzy, and sweaty. Why do I feel this way? It comes in waves. I just want to know if it is serious and should go to a doctor. I m 20, female, 5 10 , 185 lbs. Thanks",
    "doctor_response": "Hello, Nausea and dizziness that you are having can be due to dehydration or due to the shock of the sprain. This can be due to gastritis also that gets aggravated during anxiety. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful lump on areola?\n\ni am 12-going-on-13, and just today i have noticed a terribly painful, small group-of-beads sort of looking lump in my areola right above the nipple, i read that it might be a cyst but im rly worried it might be cancerous, its not big and, its not in the rest of my breast, but im like freaked out that it could be cancer. i just finished my period if it helps, and i might have been eating a lot of fatty foods lately. did i mention it rly hurts.",
    "doctor_response": "welcome to Health care magic.1. Not to worry, Its less than a 1% chances to see in your age group.2.But the way you have explained symptoms looks like a ductal dilatation (Fical ductal ectasia )3.You have not mentioned if it is related to your periods or not - if yes then its some thing to do with cyclical.4.A simple way to detect and diagnose id Ultrasound breast ( no radiation) easy way to detect weather its cyst/mass/fat lobule. 5. after that one can decide for treatment accordingly.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can hairline crack on coccyx bone be treated?\n\nAfter I met with an accident before 3.5 months in my life first time, I instantly felt pain in my west. After 3-4 days in x-ray, it get cleared that i have a hair line crack in coccyx bone. I tried many medicines even ultra sound therapy for 11 days, but nothing helped me. Since 3.5 months I sit over a seat which is specifically made for this kind of pains. While sleeping in straight condition, I don t feel comfortable and it feels like swelling in tail bone area. As such it does not seems in outer part of the body but it may be inside. I take warm water healing at least once a day for 10 minutes, but till now didn t found any major improvement. I can t drive vehicle even. I am a software engineer so my job is to just sit for the whole day in front of the computer, but i try to move around every half n hour so i can get relief from the pain. How could I come over this soon?",
    "doctor_response": "Hi, Hairline fractures of the coccyx heals by themselves. Nothing much is required apart from usual precautions to prevent displacement. As you are already doing what is required to relieve pain, the possibility is that either your fracture got displaced or you are having a bursitis of the overlying bursa. You need to have an X-ray (coccyx lateral view) to rule out fracture displacement. If fracture is healed, the only possibility is bursitis which could be taken care of by local steroid injection. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Rohan Shanker Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I feel people are interfering in my life?\n\ni am really worried about my son he thinks people are watching him and keeps his curtains closed and a knife under the chair and his bed, he finds it hard to make friends and keep them including relationships, he thinks they are seeing someone else or are planning on how to leave him, he was diagnosed with tourettes when younger and has stopped taking meds approx 18mth ago every time i try to give him a solution to a problem he just puts another problem in front of it, he has a flat but is not coping with living on his own what can i do and were can i go",
    "doctor_response": "DearWe understand your concernsI went through your desciption. I suggest you not to worry too much. From the symptoms you provided, it seems that your son is troubled with schizophrenia with paranoid ideation.  Proper assessment is required to have proper diagnosis and treatment. Please consult a psychologist for psychometric assessment and advise on further treatment methodology. Psychiatric treatment also is necessary for such a condition. Consult a psychiatrist according to the advise given by your psychologist. Do not delay please. Delay may make cure difficult.   If you need more of my help in this regard, please post a direct query on this portal. I am happy to help you.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of herpes simplex?\n\nGirlfriend came over with herpes simplex virus 1. Cold sore on lower left part of lip. Had Abreva covers, swore by them. Put it on to cover up the coldsore and I made out with her. Later on it fell off so I didn t want to kiss her anymore, but could help but to kiss her on the cheek. When I did, a few times she brushed up against my cheek and neck with the cold sore. What are the chances I have herpes simplex virus, and if I did contract the virus from the interaction, how long until I know whether or not I have it? How long would it take for a cold sore to appear, or this infamous tingle I hear about, etc.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern.Herpes infection occurs only in a person having weak immune system. So if you have strong immune system than you never going to have herpes as such.Though she has bursted at neck and cheek blister you are exposed to the lips for surely but you mostly won't suffer with shingles.Please maintain good hygiene it can prevent future infection. You can take prophylactic acyclovir treatment under your doctors guidance.Please eat healthy diet like fruits, dry fruits and green leafy vegetable.I am Dr Arun Tank answering your concern.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in the forehead post a cataract surgery?\n\nHello i had cateract surgery replacing my lense, and an oil bubble removed from previous detached retina surgery, this past Friday, an air bubble was added also, i have numbness in my forehead which seems to ve getting worse. Any help u can give me woukd be great. Is this normal?",
    "doctor_response": "Hello! Welcome to 'Ask A Doctor service'! I understand your concerns and would recommend performing a brain CT scan or MRI. The cataract surgery does not seem to be related to the forehead numbness, but a brain MRI would help investigate for any possible infection. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for headache and painful swallowing\n\nI started having chills 2 days back accompanied by back of head headache and pain when swallowing. Now chills hv stopped but back of the head aches n swallowing is a problem. I also experience a burning sensation from the neck down to the waist! Help.",
    "doctor_response": "Thanks for posting your query to healthcare magic.you are suffering from upper respiratory tract infection .it is mostly viral in origin recover spsontaneously wihin 4 to 5days.you should take symptomatic and suportive treatment and maintain good nutrition and hygein.Do.  SALINEGURGLE 4 TIMES A DAY. Diclophenac potessium 50 mgto releive pain two times a day after meal.pentoprazole40mg oncein a day empty stomach to preventdruginduced gastritis.cetrizine 10mg with monteleucost5mgonce at bed time as anti allergic,( allergy to viral protein)multivitamin with zinc tablet .all med7cine should be take under xlinician super viaion and if you are allergic to any drug consult health carw setting .dfeel free to contact .regardsdr manish purohitinfectious dis specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest solution for hard lump on the back\n\nMy husband has a hard lump with a small hole on his back.  He's had this for decades now and generally I squeeze it a couple times a year (smelly creamy goop comes out)  but it seems to keep it in check.  I haven't squeezed it in a while and now it's HUGE, so red that it's purple, and it seems to have shifted off-center.  I'm really worried...how urgent is this?  He is getting it removed in 3 weeks, but we're really nervous until then.",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.This is a sebaceous cyst, which has gone into infection. Take a proper antibiotic and anti-inflammatory for 1 to 3 weeks and go for a surgery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does burning and stabbing chest pain indicate?\n\nI was just release from the hospital for chest pain on my right side. It s a burning. stabbing type of pain that went down my right arm. I went to ER they keep me overnight run all types of heart test which came back negative. Then they sent me home but I still dull right chest pain. What could be wrong?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.First of all no need to worry for heart or lung related chest pain because your all reports are normal.Sometimes musculoskeletal pain can be the cause.So avoid movements causing pain. Avoid heavyweight lifting and strenuous exercise. Avoid sudden jerky movements of chest.Apply warm water pad on affected areas. Take painkiller and muscle relaxant drugs like ibuprofen and thiocolchicoside. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cardiovascular disease\n\nI have  cardiovascular desease and this petogen have been prescribed to me. However my concerns are that I am gaining weight and even though I am on a diet I can't loose the extra weight. can this be the cause of my weight gain and is there something else you can reccomend for me?",
    "doctor_response": "Hi thanks for asking question.Noted you have not mentioned which cardiovascular disease present..You are taking petogen ..This petogen having side effect of weight gain..So you have weight gain because of this.To loose your weight,with calorie restriction , calories also has to be burnt.For that do mild to moderate exercise like running, jogging etc.Take low fat diet.Green leaf vegetables taken more.As you have cardiovascular disease take low salt diet.Avoid junk foods...It would be better if you provide detailed history regarding cardiovascular complain then we can help you further....I hope my suggestion will helpful to you...Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest a remedy for the blood in ears of a 2 month old\n\nhi, my son is 2 years and 2 months old. on Monday the 9th of May 2011, he took a cotton board and put it inside his ear, we heard him shooting an saw blood running out of his ears. It was late at night no doctors were available so we applied some Anti-biotic and pain medicine. The following day, the only ear specialist we had in the country was out of the town, so i took him to a child care center, this time the doctor said he could not see inside his ear as it is filled with blood,so a medicine to clear/clean the blood for 2 days. After 2 days, when i took him again, the doctor said there are some damages in his ear so he referred me to another ear specialist. The following day again, this other specialist is out of the country and will not return till Monday the 16th. So i had to take him to another Child Doctor again because my son was crying pain whole night. This Doctor after examining his ear he told me that his ear drum is burst, she gave me Metronidazole syrup and Dalacin 75mg, for the infection to cool down. I have an appointment with her again on Tuesday, If she is not satisfied with his ear again, she said she will send him a an ear specialist. Please advice",
    "doctor_response": "Hello,Eardrum reconstruction is not necessary in every case. Sometimes it heals by itself. But proper treatment is necessary otherwise hearing impairment can occur. Consult ENT specialist as soon as possible, until then starts Burfen syrup to overcome pain, send CBC to check infection.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Hina Javed",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can cholesterol level be reduced?\n\nHello doctor, I have cholesterol level 189 after one month diet control and with exercise before month my level was 194 and TG level was 218 and ldl 102 hdl 41 now after one moth exercise and diet control my cholesterol is 189 TG level is 224 LDL 113 and HDL 39, whether I am a cholesterol patient or not because instead of decrease in triglycerides level it increases and LDL also increases but the general cholesterol level decrease I am so worried. Kindly reply. I am male, 32 years.",
    "doctor_response": "Hi. You need to monitor definitely levels are elavated and changes in a month not to be considered please continue for next 6 months and do recheck reports you will get good results. I am not clear with diet pattern what you are following to plan a customized diet plan I need more details. Follow these tips. Do regular walk with 5 minutes slow 20 minutes speed and 5 minutes slow walk a complete cycle do it in a level road. Include lean meat in diet as it improves HDL. Avoid excess oily foods but oil is also essential not zero oil. Include fish almonds, walnuts as it has omega 3&6 fatty acids, increase fruits and vegetables in diet, divide your meals to 6-7 meal pattern, increase fluid intake, do meditate to manage stress.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for an infected lesion on the hand\n\nA 28 year old veteran, recently returned from a 6 month deployment In Iraq, visited his health care provider and presented an ~ 2 cm lesion on the back of his hand.  The lesion had a raised upper margin with pronounced redness and swelling. He complained of a low grade fever (37.380C) and general malaise.  The health care provider referred him to an infectious diseases specialist.  A tissue sample from the lesion site revealed no bacterial infection.  However, a euglenoid protest was observed on the specimen slide.",
    "doctor_response": "Hello there I am aware of your concernThe lesion needs to be explored and debridement done under LA or perhaps GA  covered and put under antibiotic coverhope that helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dog bite\n\nhi all,last wednesday(12/Feb/2014) stray dog bite me in indira nagar 80 feet road,bangalore.On the same day i took vero rab and tt injection in cmh. then i went to isolation hospital near vivekananda metro station they told me to come on 15/feb/2014.Unfortunaltely i cant able to go on tat day but i took 0.1ml+0.1ml injection in trichy on the same day. I took low cost immune globalin injection(rate rs1200 8ml) around my wound on 13/Feb/2014.But still i m feeling pain around my wound, please suggest me a good hospital in bangalore. i was scared about rabies , please.....",
    "doctor_response": "Greetings.Welcome to healthcaremagic.It was a good to hear that you had the important immune globulins which is where crucial to stop rabies in case of being bitten by a rabid dog. This would have neutralized the infection. As far as the vaccine is concerned , you have to have 5 injections in total. a day of delay usually doesn't cause much problem and the time that has passed is a good sign ,because the risk of rabies remains for a few days . If there was no problems related to the rabies then you are in the safe zone. And let me tell you here that pain around the wound is not linked to the rabies. It shows either the wound was very deep damaging the muscles , which will take some time to heal or the wound is infected by some other organisms also. Easily available antibiotic will be enough to take care of this problem. But for that you need to visit your clinician , who will examine the wound and refer to surgeon if the wound required some cleaning. I hope the answer was helpful. In case you need any further assistance, feel free to contact in writing. Regards, Dr Talal Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes illness, nausea, headache, dizziness after taking dosulepin?\n\nTaken one Dosulepin last night (was changed onto them from Amitriptyline by my GP for Fibromyalgia) and have felt ill since. Gone through a range of symptoms from nausea and headaches but now I am dizzy, fuzzy heady and my balance is affected, can still feel it lying down but it is much worse standing up",
    "doctor_response": "Hello,Your symptoms seem to be related to Dosuleptin. The symptoms usually go away as your body adjusts the medication. If the symptoms continue, you should consult your doctor for an alternative treatment.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I get rid of the rash causing discoloration of skin ?\n\nI have developed a rash form wearing a under wire bra to the gym . The friction and sweat has caused a rash that has discolored my skin . How do I get rid of this problem?",
    "doctor_response": "Hi...dear  Jennifer.., Thanks for choosing HCM.., Elastic under wire Bra will give this rash and discolouration.., It is called...IRRITANT DERMATITIS.., So follow., 1) Apply CALAMINE lotion morning times... 2) Betamethasone and Gentamycin cream night times,, 3) Tab..Levocetrizine daily night times//. 4) Tab..Betamethasone 1 mg daily morning times..., 5) Keep that area clean and dry...ok., thanQ",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get whitish pus at the end of my tail bone. What is it?\n\nHi doctor, I am a 20-year-old male. A few months ago I noticed a small lump on my skin directly on my tailbone. I picked it and it formed into a small dent. I did not think anything of it but for the past one week the same dent has become inflamed on the outer edge and extremely painful to touch. I struggle to get up when I sit down as it is painful. When I touch it after standing up it feels wet. I have just asked my partner to look at it (as I cannot see for myself) and I gently opened my cheeks. She told me that a thick white pus substance was coming out in large amounts. I felt again and when I looked at my hands a small amount of white pus was on my nail. Whenever I have an infection in a scab my pus usually turns out to be a yellowish-white or a yellow color so I am quite worried. This color is not normal for me. Please help.",
    "doctor_response": "Hi. From your description, you could be suffering from a pilonidal sinus or cyst. Color of pus, yellow or white is not of great concern. What can be concerning is a large amount of pus. Kindly try to quantify it, may be in drops or teaspoon measures. It is a disease of young men, mostly hairy and sedentary lifestyles. Professional Drivers also get it in higher proportions. Going to see a doctor at local surgery is a good decision. The best way for pain relief is surgery to drain it properly and clean it. It can require to be completely removed in some complicated cases. Wash the area with soap and water daily. Try to avoid sitting for long periods. In case you are worried about the possibility of cancer, it is extremely rare in a pilonidal sinus. This is a common problem and only a handful of cases have been reported in the world of some cancer developing in it; that also after years of inflammation and without treatment. But kindly confirm with your local doctor that it is in fact, pilonidal sinus and not anything else.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Light headed and a sore lower right abdomen. Getting head aches and diarrhea. Should I be worried about the findings?\n\nI feel really light headed and a sore lower right abdomen , i have been getting head aches and diahhrea. My appendix hurts when you press on it but its not swollen. I havent got a urine infection or kidney infection as ive been tested for them. I really think its appendicitis but my doctor told me it isnt because my appendix isnt swollen",
    "doctor_response": "Hi, Thanks for posting your query. With the available described details, there appears to high possibility of Acute gastroenteritis with malaise. Headache could be a prodromal symptom of viral infection. Although abdominal pain is present in right lower abdomen, yet there appears to be least possibility of appendicitis as diarrhea is not a feature of appendicitis. You should consult with internal medicine specialist/ gastroenterologist and should go for thorough check up. He should go for complete blood count, erythrocyte sedimentation rate, ultrasound imaging, and serum electrolytes, renal function test. You should take complete antibiotic therapy, antispasmodics, probiotics, antipyretics, if needed. You should maintain your hydration status by taking potassium rich liquids. Take soft diet along with yogurt and banana. Avoid milk and all milk related products. Take care, Dr. Mayank Bhargava",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stiff neck\n\ni have stiff neck, maybe from my degenerative discs,.... but most of the joints on my joints on my left side are hurting. Both wrists hurt and ankle joints , toe joints are stiff and the lefts, second toe hurts more than the other toes. the left side by my heart is painful when i lay down. earlier noticed that I couldn t get a deep breath and still feel that way. thank you for taking my question",
    "doctor_response": "Hi, I had gone through your question and understand your concernsWith such presentations in my clinic, I would first rule out Ankylosing spondylitis as It may cause generalized stiffness and limited chest expansion.Ankylosing spondylitis could be diagnosed by doing the following:-HLA B27- x- RAY PELVIS TO SEARCH FOR SACROILEITIS- MEASURING CHEST EPANSION.-X ray and MRI for cervical spine",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the permanent cure of jaundice?\n\nI m suffering from jaundice ,25 years old male , pure vegetarian, unmarried, this is my forth time suffering with this disease since birth. I want to know is it a step towards liver Damage badly however my bellirubin not excedded more than 2.0 thrice n 5.0 once at age of 18.",
    "doctor_response": "Hello,I can understand your concern, having jaundice from birth can be because of several reasons ( congenital causes, metabolic causes,  viral causes,  autoimmune causes ), if this is the case,  you should be consulting your doctor, and should be thoroughly investigated with all the tests and see what is the reason for this ( such as viral markers- Hepatitis B or Hepatitis C, serum copper, serum ceruloplasmin levels, ophthalmologist check up, autoimmune markers,  USG abdomen, complete liver functions tests including PT/PTT/INR and if everything is negative then liver bipsy) please kindly consult your Gastroenterologist and get evaluated.  Hope I could help you. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to gain muscles, suffering from cerebral palsy? Will Huperzine A help?\n\nHello i m a hs graduate planing to participate in a collegiate sport in the fall. I am plan on training a lot this summer to get prepared. The only problem is the muscle tone in my legs since I have cerebral palsy . One of my friends recommended that I take Huper zine AI read up on it and it seems like it would work. So what I would like to know is what would be the best way for me to gain muscle and at the same time reconnect the signals from my brain to my muscles",
    "doctor_response": "Hi Patw,It's a purified herbal medicine of chinese origin, I have real doubts of its efficacy for cerebral palsy but you can use it atleast it will provide you a morale boost.....Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i become pregnant at the age of 35?\n\nHi ,I am 35 yr Old lady , married from last 3 yrs. I want to conceive and when I consult with doc She has recommended few tests  and during one test two endometrial polyp17X6 mm and 9X5 mm  has been found . Which is removed by dianostic hysteroscopy.After this operation and  6 month I again consult with doc bcz I did not conceive . This time doc has recommended me for follicular monitoring  and again one polyp of 11x5 mm and 17X12 mm fibroids has been found during   follicular monitoring. after watching this report Doc has suggested to go for HSG just after period. Now I am afraid .. 1. ) Do I need to again go with hysteroscopy treatment.?2. ) As i am already 35 yrs OLD can I become pregnant or not ?Please resolve my query ..  :(:(",
    "doctor_response": "hi,since your age is 35 ,dont delay your treatment.do basic hormonal tests like FSH,LH,PROLACTIN.THYROID PROFILE,AMH.you have consult an infertility specialist and treat your polyp with polypectomy. after that you have to undergo follicular study for ovulation.it is the right time to start .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the effective HCG level in blood for HCG injection?\n\nMy wife is undergoing IVF treatment. Her embrayo transfer happend on 2nd Feb. Doctor prescribed Ovidac 5000(HCG injection) on 2nd, 6th, 9th and 12th. She did beta hcg test on 16th and result is >1500 mIU/ml. Doctor said that it could be multiple pregnencies and she did a scan on that day and nothing was seen. Doctor asked her to come on 23rd for another scan. >We are very much woried about the result. My questions are 1. What is the effect HCG level in blood for HCG injection, is it possible that 1500mIU/ml is because of effect of HCG injection she is taking? 2. what could be ther possibilities for higher HCG level? 3. Doctor places 3 embroys and if all of them are continuing then is it possible to terminate one of them and continue with other 2 by any medical procudure? We are very much woried, any help would be very much helpful .. >BEst Regards, -Anisen",
    "doctor_response": "Hi, I have gone through your question and understand your concerns. hCG levels at this stage should be around 120 mIU. High hCG levels in your wife can be due to hCG injections as hCG takes at least 14 days to get cleared from the body.Other causes of high hCG levels can be multiple pregnancy or molar pregnancy.These conditions can be ruled out in ultrasound which you can get done after 2-2 weeks as now it is too early to detect anything.Yes, if there is triplet pregnancy, then the multifetal pregnancy reduction to twin pregnancy can be done under ultrasound guidance by a fetal medicine specialist.Hope you found the answer helpful.Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can Rheumatic heart disease lead to weakening of leg muscles?\n\nI am Karen, 21y/o.. I am diagnosed with Rheumatic Heart Disease.. I experience difficulty in breathing, dizziness, fatigue, loss in weight and difficulty in walking, my leg muscles are in pain when i move it. Can you tell me how the leg muscles are affected with my sickness?",
    "doctor_response": "Dear Karen,If rheumatic heart disease is advanced in this case heart cannot deliver as much blood to the organs they need, which leads to such complaints. Also, sometimes there may be serum electrolyte imbalance (lack of potassium, sodium or calcium in the blood) which may lead to weakness and leg muscle pain.After the treatment you will feel.Hope I could help youWishing you good healthIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pregnancy happen after having non penetrative sex?\n\nthe other night me and my girlfriend were messing around which i truly regret. Her pants came off and mine was out. I never ejaculated, but there was a small amount of pre-ejaculation on the tip. I never touched her vagina with my penis and im pretty sure there i never touched it with my fingers but if i happend to have just a small amount on my hand when i put that inside of her, what are the chances of her being pregnant?",
    "doctor_response": "Hi, I think there is a little chance of pregnancy.  She can take some emergency contraceptive if possible.  If her periods get delayed, do a urine pregnancy test.  If positive consult a doctor if you don't want pregnancy.  If negative wait for your periods. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Would fractured L1 endplate cause adrenal insufficency with Addison s?\n\nno pituarity tumor found. Cortisol base was .30. Second base was .50 before given Cortisol IV then 3.1 after 30 minutes and 5.1 after 60 minutes. Multiple tests negative but Endo is saying Adrenal Insufficency with Addison s. Endo is suggesting multiple epidurals (back, neck, shoulder) may be the cause. Now on meds. I don t understand my at 62 this is just now being discovered. Could this be caused by an injury such as a fracture L1 endplate (Aug 2013)? Thanks",
    "doctor_response": "hi,thank you for providing the brief history of you.A thorough neuromuscular assessment is advised.As you have an L1 end plate fracture , this is totally ageing factor and called as a pathological fracture. Since you are 62, this kind of fracture is commonly addressed as pathological fracture. Also, the steroids are given for temporary pain relieving factors of which the side effects are totally unknown.But as you age and no exercises then chances for degenerative changes to occurs is possible and ageing is an added drawback for pathological fracturesI will recommend to undergo and MRI and post which undergoing physical therapy for stabilizing the spine is recommended via exercises.In my clinical practice I see abundant cases in geriatrics with unknown cause of fracture. they respond well to physical therapyregardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are nausea, breast tenderness and abdominal pain signs of pregnancy?\n\nHi im trying to get pregnant but I ve always had an irregular cycle but now i have pregnancy symptoms. Nausea, tender breast, craving, lower back pain, and stomach aches but the pregnancy test keep coming up negative. Do i need to go get a blood pregnancy did? r is this normal? HELP! Thanks",
    "doctor_response": "Early pregnancy symptoms are nausea, vomiting, dizzyness, somnolence, breast tenderness but are not specific and depend on personal social and cultural issues. Hypersensitive nipples is a far more sensitive symptom of pregnancy than the other ones and seldom described. Anyway, if there is a missed period along with suspicious symptoms you should perform a pregnancy test to confirm or rule out pregnancy. Abdominal pain is not a symptom of pregnancy but it is frequently reported during early pregnancy and it is related to the ovary that ovulated and is harbouring the progesterone producing Corpus Luteum that is nourishing the developing products of conception. Good Luck!",
    "dialogue_context": ""
  },
  {
    "patient_message": "How contagious is chicken pox?\n\nMy five yr old granddaughter has chicken pox and i cant remember if i had it or not. However, in our young days i remember my sister having it but i do remember not catching it from her. So therefore,this being so contagious i should have gotten it from her! so i must of been ill with the chicken pox when i was much younger to a point of not remembering.Is it possible to live with someone that has chicken pox and not catch from her?The Doc that saw my granddaughter was worried on my behalf cause I m 50 yr old n i told him that i never had the chicken pox that i remember of n so he wrote me a script for the vaccine.My other sister said we must of gotten it when we were small and we did not have all the symptoms of the Varicella..meaning no scare marks.Is that possible? haha 2 questions thanx for your time!!",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Chicken pox is very contagious infection and it can be catched to anybody who comes in close contact.It is possible that when you are young you might not be in a close contact so you haven't caught any infection from the sister.If you are in query you can test yourself for antibody titres in the blood for chicken pox virus. This test is costly and only few laboratory can conduct it.If you don't have enough titre than you are at risk and can develop the infection. In this case get vaccinated against chicken pox is better option because it can be life threatening condition at adult age.Please maintain good hygiene around you it will help you combat the infection same as vaccine.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please suggest few measures to reduce abnormality in cholesterol.\n\nHi doctor, I have undergone preventive blood test. There is abnormality in cholesterol level. I have enclosed the reports for your reference. Kindly advise what to do based on my reports. Thank you.",
    "doctor_response": "Hi. I have read through your query in detail. Based on your report (attachment removed to protect patient identity) these are my observations: Diabetes screening, chloride content, pancreatic amylase, iron levels, liver function test, thyroid function test, kidney function test and digestive enzyme lipase are all normal. Slight variation is observed in blood cells. Calcium content is slightly low. Cholesterol is in borderline and triglycerides are high. I would like to give you few suggestions:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Propecia beneficial in treating hair loss?\n\nHi Dr my name is noormohammadi am 25 years old and i have a hair loss problem from since last four years i did treatment of it but wen i do the treatment of mintop on my hed so i face a reaction on my face if i do the cource of PROPECIA 1mg so it will be benifit me?",
    "doctor_response": "Hi,You seem to have androgenetic alopecia. You applied minoxidil solution, but you get reaction on face. I think you may be sensitive to minoxidil. So, avoid to apply minoxidil. You may continue finesteride 1 mg daily along with biotin 10mg.You may apply mild steroid solution on scalp. Cleanse the scalp with ketoconazole shampoo.Have patience for the good result.Thanks.Dr.Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Was advised Verine for giddiness and vomiting after MRI for head and backbone came clear. What does it indicate?\n\nHai sir,iam mahender from hydrabad, iam suffering from gidding and vomting, one day admit in hospital in that hospital doctor chekaup in head MRI and backbone MRI,in that MRI Clear no problem.Doctor siad to me use verine 16 mg daily two tablets continue one week dont drive bike  and take rest.",
    "doctor_response": "Hi Mr Mahender,Thank you for posting your query.I am glad that your MRI of head and back were normal and there were no problems detected.As of now, the diagnosis seems to be peripheral vertigo (due to ear related problems) and vertin (betahistine) seems to be the correct drug. I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the shaft of penis in a 4 year old?\n\nMy 4 year old son had a bacterial infection in his pen is (uncircumcised) and was given hydro cortisol fucidin cream for a week. The redness and pain was gone after 4 days. But 3 days after that, the head of pen is is blue and painful when we touch the shaft even to wash.",
    "doctor_response": "HIWell come to HCMIf this was the bacterial infection then the medicine that was given to him would not help any more in my opinion he need to be treated with the trimethoprim and sulfamethoxazole encourage the child for drinking water, hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Ears feel clogged while in a closed room. Why?\n\nHello doctor, Why do our ears feel full or clogged when we are in a closed room? Are these because of air pressure and ambient noise?",
    "doctor_response": "Hello. Rather than a closed or open room, this is related to outside and inside ear pressure. There is an air cavity in our ear called a middle ear, and there is a membrane which separates this cavity from the external environment called a tympanic layer. So, there is air on either side of the tympanic membrane. So, when pressure on either side if high, then the membrane gets fixed and cannot move properly, giving the feeling of a clogged ear. And there is a connection between the middle ear cavity and our throat which equalizes pressure within the ear cavity and outside environment. So, whenever one gets an infection, then this tube blocked and there occurs a mismatch of pressure leading to clogged ear. And also swallowing movements opens this tube temporarily, which helps in equalizing the pressure leading to relief. Similar things occur when one travels in an airplane. So pressure changes are decisive in this. I hope this helps you and get back if you have any doubts.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain in chest with increased heart rate?\n\nI m a 53 yr. old male 6 2 , 250 lb. realitivly good health, on Blood Pressure medication. Last full physical in Jan 2011, my BP was fine, cholosterol was fine, Dr did a routine EKG and it all checked out. I have been weight lifting for 30 years and still do lift relativly heavy 4 nights a week. Casual cigarette smoker, non drinker. On May 5 went out to dinner with a group and got sick that evening (vomiting & diareaha) ~ blamed it on bad Mexican food although no one else got ill. since then, everytime I cut he grass, after about 15 minuites, I get chest pain high up in my pectorials and my left fore arm. I stop for 5 minuites and it goes away & I m fine. The cycle repeats for the 3 times it takes me to cut the grass. I will go to the gym in the evening and work out hard for 1 hr.(Bench press 250, squat 325, etc) without any problem. I tried to reproduce this on the stationary bike by hard pedeling getting my heart rate above 100 for 1/2 hr. I have no problem, can t reproduce the chest pain. After cutting he grass yesterday (same routine as before with the pain) going the gym last evening for hour with no problem, I woke up this morning with diarea. I m thinking of calling my Dr and setting up a stress test? or do I have a virus? or have I developed alergies to grass polen? Any advice? Thanx",
    "doctor_response": "Hi, Cardiac chest pain generally occurs after exertion or stress. It is never localised and occur diffusely over the whole chest. It decreases after rest. I do not think you have a cardiac chest pain. It looks like you could have been getting musculoskeletal pain at times which can be relieved after simple painkiller. I will still advise you to get the stress test done just to rule out any possible cardiac related thing. I will advise you for Stress Echo. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sameer Maheshwari, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I stop bad habbit of eating slate pencil?\n\nHi, I'm 27 year old. During my childhood I used to eat slate pencil a lot however  later on I stopped. But now I feel like eating again. Now that I'm also planning for pregnancy, would my slate eating habit make any bad effect on this and I'm also trying to avoid this craving during my pregnancy.",
    "doctor_response": "Hello and welcome to Healthcare Magic. Thanks for your query.I understand that you are distressed due to the symptoms that you have mentioned. Eating non-edible objects such as slate pencil is called Pica. There could be a number of causes for this symptom and one of the most common causes is anemia.So, I would advise you to have a proper medical evaluation, including a hemoglobin test, in order to establish the cause of your pica. Moreover, since you are planning for pregnancy, it is important to detect if you are anemic, so that appropriate treatment can be initiated at the earliest.Wish you all the best.Regards,Dr. Jonas SundarakumarConsultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have sweating, temperature while having secondary chest infection?\n\nHello Doc. I developed a secondary chest infection where I was sweating a lot at night with temperature. I feel very shaky as well. Is this normal? I ve had a cough and cold for a week and a half but the last two days have been having night sweats and temperature. Thanks for your help",
    "doctor_response": "Hello,Welcome to HCM,As you have developed the secondary infection of the chest might be of bacterial origin, which has lead to your symptoms.The chest infection caused by the bacteria can leads to infection of the lungs called pneumonia, as you are having the symptoms of high grade fever and the night sweating this may be due to the infection of the chest.I would suggest you to get X ray done, complete hemogram and sputum examination. The investigation report help us to make proper diagnosis and then we can proceed with the proper treatment.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having acute lower back pain. Feeling uncomfortable. on cypro 500 mg. Any alternate remedy?\n\nI am having acute lower back pain . I can t comfortable sit, stand, walk or lay. The pain is presently concentrated at the tip of my tail bone. I saw a doctor last week and I have been taking cypro 500 mg. I never received complete relief. Yesterday and into today the pain is more acute and sharp to breath taking. I am seeking your recommendation to address this issue Thanks Karen",
    "doctor_response": "HELLO Karen, Thanks for calling us, First of all tell me whether this Acute LBP develops after lifting any heavy objects or following any sudden jerk. I advise you for bed rest for some days and avoid forward bending. You should visit an orthopaedic surgeon for clinical examination of spine and if necessary X-ray spine will be done. Meanwhile You can take oral Muscle Relaxant & Pain killers. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for the blood and pus formation in ear after piercing\n\nMy 6 year old daughter had her ears pierced some months ago but she had an infection and the piercing had to be re done. Now 12 weeks have passed, and I changed the earrings to gold as it is for the best. But still one of the ears is still with blood and white pus coming out even though I clean it with surgical spirit almost every day. I do not know if it is best to remove the earring or not, and what I should do. Could it be an infection?",
    "doctor_response": "It is indeed due to a possible infection. Infection can be confirmed by increased pain, redness, swelling, heat, or tenderness around the piercing site or yellow-green pus-like discharge coming from the piercing site as in your case. By switching to gold, you have minimised the possible allergic reaction to metals. It would be reasonable to remove the ear-rings for the time being and also go for a course of oral antibiotics. Meanwhile, apply some antibiotic ointment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dizziness and loss of balance\n\nHi, im a 20 year old female. A couple od months ago i went to the hospital for feeling dizzy, off balance and especially feelibg foggy headed. The dizziness at firt was very extreme, and it lasted for 24 hours a day for a whole week. Two weeks later, it started again but it wasnt as bad as the first time. They did a.ct scan and a bunch od blood tests, they all came out negative but unfortunately it still continues... i work at a supermarket and the lights and noise seem to trigger it more! I am currently in univeraity and i find it very difficult concentrating! The foggy feeling ia always there, i cannot keep up a full converstion with somebody, i get distracted with my other thoughts, its like daydreaming which never ends. Its.really fruatrating!! Pls help!",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, if the investigations reports are normal then the reason behind the dizziness could be due to vestibular dysfunction, wax impaction in ear also need to be ruled out, viral infection may be the cause, and last but not least it could be functional in origin, it can be managed with \"Tab Bitahistine 8 mg\" three times in day,  hope this information helps, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to manage low testosterone and SHBG levels without affecting conception chances?\n\nhi doctor im a guy , 30 years old i did test for testosterone and shbg both are low from the scal shbg is 4,63 nmol/l  from  13 to 71 testosterone 5.12 nmol/l from 8.64 to 29  does that effect free testosterone and sperm counting... on the other hand the doctor told me to use hcg and nolvadex for 30 days also if i take testosterone replacement  im gonna get back mu sec drive but my wife cant get pregnent??!! cause the outside testosterone would shutdown my natural test??!! thanx",
    "doctor_response": "Higreetings. Your question is very relevant. outside testosterone will suppress the sperm production. NOWwe have to find out why your testosterone  is low.Is there any other hormonal problems or not.For  that we have to do your pituitary hormones level FSH AND LH along with prolactin.If they are low then supplementing with hcg will help.We should also check the female hormone Oestrogen if you are very obese, so that decreasing it will increase your natural testosterone. Before all this get your SEMEN ANALYSIS DONE.So either discuss this with an andrologist or an  infertility  specialist..hope my answer helps you. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for high level of micro albumin (456 ug/mg)?\n\nIam 27 years old weighing 92 kgs and my height 5'10''. My spot microalbumin result is 456 ug/mg of creatinine.. it is much higher than the reference value of 20 ug/mg of creatinine. pcr is 0.68. i have hypertension and hypothroidism(i was taking 100 mcg in the past which was reduced to 50mcg 6 months back). I have done 24 hrs creatinine clearnace test it is in the normal range and blood creatinine is normal as well.  I havent done 24hrs protien clearance yet. Kindly let me know your feedback on this",
    "doctor_response": "Hello, Thnx to contact us. I understand your concern. If I am your doctor I advice you that maintaining the best optimum blood pressure is the key treatment and preventive measures in your case. if your blood pressure is good maintained than microalbuminuria will reduce gradually. you can also start with early morning yoga, and exercise, it will help you in long ago. take high protein and low fat diet.I will be happy to answer more of your concerns, kindly know me,Wish you a very good health at health care magic. Dr. Arun Tank. Infectious Disease.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does baclofen and lidocaine gel help in relieving back pain?\n\nI presently am taking hydrocodone acet. for back pain (4 back ops) total knee replacement, poly preferheal neuropathy, now they want to stop these meds and give me Baclofen and lidocaine gel, can you tell me more about these please? they also want to stop my Gabapentin for the neuropathy.",
    "doctor_response": "baclofen and lidocaine medicine help you in relieving back pain. To prescibing medicine  I like to know about your patient profile, illness you have. gapapentin help you in relieving pain in peripheral neuropathy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for discomfort in the stomach and headache with fever\n\nYesterday I had loose motions 3 times and had body pain, so I didn't have anything except juice yesterday. Today I don't have body pain and loose motion but my stomach is not alright yet, also have headache and feeling little feverish. Yesterday I had Crocin and Entero Quonol",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. You have food or water infection leading to stomach upset,first try without medication.Use easily digestible food like plane curd rice or dhal rice...Take plenty of water to prevent dehydration. Drink warm water with salt and sugar.If it is not controlled by this,use TAB.SPOROLAC three times daily..If still persists consult a physician and take an antibiotic.Take paracetamol for fever and headache.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "One tooth pushing the other. Tooth moves when biting. Is it going to fall?\n\nHi my name is Oskar. My third cheek tooth on top of my cheek have an adult tooth that grows out very slowly. It got space but still makes my tooth front of it go little lose. I see the tooth move when biting. Is it going to fall? I have felt pain when moving fast or shaking my head. It hurts alot and I hope the tooth wont be lose so I have to drag it out.",
    "doctor_response": "Hello and welcome, Thanks for choosing HCM FORUM, During tooth eruption,it usually exerts force and moves the adjacent teeth. This usually occurs untill the tooth eruption has completed. In such cases,The shaking adjacent teeth becomes firm once the tooth erupts. If the mobility persists after tooth eruption,chance of periodontal infection is high. I would suggest you to get a radiological examination. Maintain good oral hygiene. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for asthma\n\nHELLO DOCTOR , MY SON IS SUFFERING FROM THE PROBLEM OF ADENOIDS & HAVE A 24 HRS FLOWING NOSE & COLD.I WANT TO KNOW THAT FOR HOW LONG COULD I GIVE THIS TABLET MONTEK LC TO MY SON .I HAVE BEEN GIVING THIS TABLET SINCE TWO MONTHS.& COULD THIS PROBLEM BE EVER CURED BY USING THIS TABLET. & EVEN SOME TIMES MY SON  FACES ASTHMATIC PROBLEMS ALSO .PLEASE SUGGEST ME",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your son's history and my suggestions for him are as follows:1. Montek-LC (Montelukast + Levocetirizine) is considered usually safe for long-term use in children. Common side effects are sedation, drowsiness, impaired concentration (due to levocetirizine) and nausea, stomach upset (due to montelukast). If your son is not experiencing these side effects, I would suggest it will be safe for him to use it for long time regularly.2 . Montek-LC, however, cannot cure allergies, it can only control the symptoms of allergies.3. As he has asthmatic problems also, I would suggest him to use salbutamol or levosalbutamol inhaler on as-and-when-needed basis for asthma symptoms.4. I would suggest him allergy testing, which will help him identify the substances he may be allergic to and also to know how to avoid them. Avoidance is the best strategy to prevent allergy symptoms.5. I would also suggest him a healthy diet rich in vitamins & minerals which will help improve his immunity.Hope above suggestions will be helpful to him.Should you have any further query, please feel free to ask at HCM.Wish him the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tremors, numb hand and severe depression?\n\nHello, I ve been experiencing some problems such as balance, tremors, confusion, 2 fingers numb on left hand, severe depression and anxiety, trouble swallowing, consentration. I was also hospitalized because of a nervous breakdown for over a month. I don t want to self diagnose, but I checked the Mayo clinic for what the symptons were for parkinsons and I was shocked at how many of my symptoms were listed. In 2012 I was in a tramatic automobile accident with a semi truck and trailer and that is when I noticed differences and changes in my body. I was diagnosed with having PTSD. So I thought the PTSD has been causing my problems. But now I m not sure! Is Parkinsons non-curable? I do have a doctors GP appointment, but they couldn t get me in for a whole month because I am a new patient. Should I be trying to get into a neurologist instead? I don t want to waste time waiting only to be referred to a specialist. What should I do? Thank you, Nancy",
    "doctor_response": "Hello!Welcome on HCM!I read carefully your question and understand your concern. You should know that your symptoms are not typical of Parkinson's Disease. Depression or PTSD could explain your symptoms. Anyway, it is true that a careful physical exam from a neurologist would help exclude other possible disorders like Parkinson or any brain injury. A brain MRI would also be necessary considering the fact that you have gone through a head trauma. For this reason, I agree with you on the fact that consulting with a neurologist would help exclude other possible causes of your symptoms. But if the neurological exam and brain MRI are normal, you should continue to follow up with your attending physician. Hope to have been helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Bravelle. How many follicles will end up mature?\n\nI am currently taking Bravelle and just finished my last injections of 225 iu yesterday. The size of my follicles yesterday morning were 15.5, 16, 17, and 19. I was also instructed to take the ovidrel shot today and an iui will be performed on Monday morning. My main question is about how many of those follicles would end up mature. Also, I am hearing conflicting ideas as to whether ovidrel releases the dominant follicle or if it releases all mature follicles. I am just trying to see how my chances might be this month. Thank you for you help.",
    "doctor_response": "Hi, All of these follicle can release mature eggs. Ovidrel will release all mature follicles(not just dominant one). As you are having good number of follicles, you have good chances for pregnancy, which depend on your husbands semen analysis, duration of infertility & patency of one/both tubes. If everything is fine, maximum chance of pregnancy is 25-30%. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe stomach ache, nausea and dizziness?\n\nI have been having horrible stomach pains have been to ER twice in the past month. My Dr cannot find why Here s my symptoms CT scan shows one gallstone on my left side I was told it s to big to pass. It have been there for over 7mths. Now. The next is my stomach I get the pain right above my belly button, I am Nassau I throw up, I feel faint",
    "doctor_response": "Thank you for posting your query.Needs evaluation. what is your age? male?female?are you anemic? how often do you pass stool? color of stool?if your anemic or black colored stool, visit a gastroenterologist asap and undergo endoscopy? if NOT anemic and normal bowel habits, then;undergo any test for H.pylori.?  do it either by stool antigen test OR by urea breath test. if it turns out to be positive then you need eradication therapy and visit your treating physician with all the results.until H.pylori test results are awaited, you may take \"Nexium 40mg\", once daily before breakfast. Avoid spicy food, oil rich food, smoking and alcohol. Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health.regards,Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any alternative medication for Myasthenia gravis, the current medication is not of much help?\n\nHello, my name is Veronica. My sister has been suffering from myasthenia gravis for approximately 18years. She is unable to get out of the house without help. Her quality of life is extremely poor. She has been taking the prescribed medication for this condition with no cure in sight. Are there any current research studies or alternative treatments for this depressing disease. My sisters name is Victoria. It breaks my heart see her live with this debilitating illness. I Would appreciate any information on a drug, herbs or therapy that works.THANKS",
    "doctor_response": "Hi, welcome to our site. I am Dr Saumya Mittal.Read your query. That is a very significant question and i appreciate your problem. I will try my best to answer your queryI think it would have been better if you had mentioned the medicines she is already on and the doses. sometimes, all it needs is increasing the doses of the medicines.Drup resistant myasthenia is not a very nice thing to have. assuming she is on most of the medicines, including steroids, you could plan for surgical option, namely thymectomy.and finally, if that does not help, you could think of IvIg or plasmapharesis. I am sorry, but to my knowledge, no herb will help victoriaI hope this helps you. Inform the reports mentioned above so i can be of help further. Best of luck.I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you.Please do understand that some details could be extracted from a detailed history and examination.Looking forward to your return query with the details asked so that I can help you further.(If the answer has helped you, please indicate this)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes jittery feelings in head with elevated BP?\n\nI have been experiencing quivery, trembling, jittery feelings in my head - no pain. Slightly elevated BP (138/96) when my BP is normally 124/74. had thyroid tests done and they all seem normal. Experiencing stress at work and death in the family but I normally cope very well. Not sure where to start to resolve this...any suggestions. Nikki",
    "doctor_response": "Hello, If symptoms persist, better to consult a neurologist and plan for an MRI brain to rule out possible intracranial (inside the brain) causes. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take Vitcofol and Cypon to improve hemoglobin count?\n\nHi my child is 8 months and 13 days old his weight is 7 kg height is 68.5 cm. Doctor has recommended vitcofol syrup 2.5ml twice a day and cypon syrup 1.5ml twice a day because he appears pale before doctor has advised him tonoferon 8 drops for 1 and a half month but he  didn't found any improvement in his pale appearance, so he changed his medicine and prescribed vitcofol anf cypon for 1 month. is this medication safe? What can be done to improve his hemoglobin? What diet should I give him to improve his iron level and reduce his paleness and to increase his weight?",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. He can continue with the medication. However, weaning should have to done as nutritional deficiencies is possible cause at present.2. Ragi malt, fish and red meat along with eggs can be crushed and given.3. Avoid any sort of infections, as infections can lead to further malnutrition and further complicate management of anemia.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever with coughing up phlegm\n\nhello, i've been sick for like 3 days now.....i have a fever and my body temp ranges from 37.6 to 38.5.....and i cough producing Phlegm..........what really scared me today...i was coughing and i spit put phlegm with red stains on it, so is that normal or is it serious??",
    "doctor_response": "Thanks for contacting HCMI am sorry to hear that you are ill with a fever a productive cough which is blood streaked. This sounds like you have either bronchitis or pneumonia. I recommend that you seek medical attention. You will need to be on an antibiotic and supervised by a doctor. The blood in the sputum is seen frequently from trauma of severe cough. Hope this answers your question. Please contact us again with your medical concerns and questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which is the best medication?\n\nHi Doc, what is the difference between Mintop & Mintop Forte? - this wrt Dr.Reddy s product I m asking here.. And also I need to know which is the best & better in results to use, like here it s available both in Foam & Solution, then what % to start-up with Minoxidil 2% or 5%",
    "doctor_response": "Hello, Mintop forte is a fortified preparation which has got better bioavailability. However, both are same in composition. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe back pain and strain in leg\n\nHi i am Satya from Bangalore . I have severe lower back pain and some time i even feel there some strain in my left leg . If i increase some pressure on my left leg then pain on my back increases .when i sit on bed or chair i feel more pain at back .   So please suggest what should i do ?",
    "doctor_response": "Hello,I had gone through the case and found that it might be sciatica or slip disc pain.So go for MRI of spine and take proper treatment and physiotherapy. Meanwhile take mild painkiller and avoid long time standing.Hope my answer will be effective for you. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for painful lump between rectum and right buttock cheek\n\nI have a lump a little bigger than the size of a golf ball between my rectum and my right buttcheek. It hurts to sit down or even stand for long periods of time. It hurts slightly when I have bowel movements. It is not on the surface you cannot feel it unless you push down on where it is located. What is this?? What should I do?",
    "doctor_response": "HiWelcome to hcmYou must be having perianal abscess that is pus in deep space near anus. You should see a surgeon for confirmation and drainage if required.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in the legs having tumor in the back?\n\nI have a tumor in my backand I have 3 disc bulge. I also have peripheral neuropathy. I went to the er and that s what they found. Now my legs can,t move and I,m in severe pain. They told me to see my doctor in a week but his on vacation. What can I do to help my self?",
    "doctor_response": "Thanks for your question on HCM. In my opinion you should consult spine surgeon.Your disc bulging is causing compression of nerves, coming out from disc space.And this compression, when severe ,can cause loss of power (paralysis) of lower limb and neuritic type of pain.So at present you can take painkiller but for permanent solution you need surgical procedure to reduce compression. Also start vitamin b 12 as it is helpful in nerve repair and its function. So consult spine surgeon and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects after wisdom tooth extraction?\n\nHello. My 20 y.o. daughter was diagnosed with mono mid July 2018. She was treated by family physician (with antibiotics) and rested for a few weeks and her bloodwork returned to normal in early September. Mid September she had all 4 of her impacted wisdom teeth extracted without incident and completed a course of prophylactic antibiotics. She is now away at school and has begun complaining of feeling bloated, decreased appetite and says she is puffy just under her left ribs. She recently had an URI as well but is over that. What should I suggest to her? What could be the cause?",
    "doctor_response": "Hi,Symptoms of your daughter seems to be due to post effects of medications taken for URI. It is not related to wisdom tooth extraction as such. You can drink mildly cold water after extraction. Eat soft food like mashed boiled potato or gelatin and eat it with other side of mouth. If symptoms keeps on persisting visit general physician once and get complete examination done and start treatment accordingly.Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat penile rashes?\n\nhi I am male 26....I masturbate almost every day but 3-4 days back I did it back to back twice and got little rashes.yesterday u have a look inside my meatus it got few purple spots.please tell what it is and can I apply moisturiser to get rid of it......do I need to worry.",
    "doctor_response": "HelloThanks for the query.Apply a mild steroid like cortisone for 5 days. Let me know if you have any other doubts. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intermittent leg cramps, blood vessel and skin tags?\n\nIntermittent lower Leg cramps, small blood vessel tags over the chest appearing over the last 48 hrs, new skin tags developing over the chest and breast, fatigue for the last 6 weeks, arms feel like they have been through a work out, a chronic cough for the last 7 weeks. Wife diet is fantastic, fruits vegetables, lean meats. 5 7 137 lbs normal exercise except for the last 6-7 weeks. yearly exam in April no issues.",
    "doctor_response": "Hi,Thanks  for  your query.After going through the description, I understand your concern regarding your symptoms. Most of the time,  leg cramps occur for no known reason, and they're usually harmless. In general, night leg cramps are likely to be related to muscle fatigueand nerve problems.Infact, till date there is no clear cut evidence for the cause of muscle cramps. But the most common cited theories include -- Altered neuromuscular control- Dehydration- Electrolyte depletion- Poor conditioning- Muscle fatigue- Doing a new activitySelf-care Activities that might help prevent night leg cramps include:\u2022 Drinking plenty of fluids to avoid dehydration\u2022 Stretching your leg muscles or riding a stationary bicycle for a few minutes before you go to bed\u2022 Massaging the cramped muscle with your hands or with ice\u2022 Walking or jiggling the leg\u2022 Taking a hot shower or warm bath\u2022 Foods such as bananas, potatoes, prune juice and dried fruit may be helpful in relieving muscle crampsI do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I have Tylenol after drinking beer?\n\nIs it safe to take 2 or so Tylenol PM 6 hours after drinking about 32oz of light beer? Immediately after drinking the beer I got an intense, throbbing, all-over headache (about 9pm) and I still can t sleep...the headache won t let up. What should I do?",
    "doctor_response": "Hi,It is not safe to take Tylenol PM after drinking beer. If Tylenol PM is taken after drinking beer it can cause serious side effects causing liver damage. You may experience fever, fever, chills, excessive tiredness or weakness, vomiting, abdominal pain and yellowish discoloration of the skin and eyes. It may also result in drowsiness, dizziness, and motor in-coordination which may result in falls and various injuries. You must go the emergency room of your nearby hospital.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could popped blood vessel in eyes and headache be due to allergy?\n\nmy sister in law is visiting from UK in USA and about 2 weeks after she got here her eyes have popped blood vessel  in her eyes.  The house where she is staying  there are several cats and a dog and i'm thinking maybe she has an allergic reaction.  she gets headaches as well which last about 2-3 days...this has happened now 3 times in the last 2 weeks",
    "doctor_response": "Well to you it might seems to be allergic but to me it appears to be something else, repeated attack of conjunctival congestion eye with continuous headahce may be due to some eye pathology like open or close angle glaucoma or even some cavernous sinus pathology. so you should meet an eye specialist and get your eye examined , eye pressure measured, retinoscopy and fundoscopy done, and certain test should be done to exclude glaucoma, if required CT scan or MRI can be done to exclude intracranial pathology. follow the preventive and treatment plan of your specialist there after. thanks and with regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest tretament for painful and stiff knee in infants\n\n3 year old female no medical history left leg over the last week is not straighning and she is walking with a limp and complaining in the morning that her knee is hurting. we tried to straighten the leg but it feels very tight compared to the other side and she shows signs of disscomfort when doing so. Also she is now walking on her tiptoe on that side due to it being bent slightly. any ideas and whats the next step???",
    "doctor_response": "hi it might be due to some local trauma because its an monoarticular involvement sometimes infection also might lead the same so some investigation need to exclude the infection and some imaginary views (uss abdomen)until the cause identify need some painkillers toolater on physiotherapy",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can kidney damage be prevented?\n\nMy daughter has diabetes, uses the insulin pump, also has high blood pressure, takes meds to control this, and her kidney is not functioning properly. My concern is her kidney. How can she prevent further damage to her kidney? I understand she was under certain meds her initial primary doctor (now resigned) had placed her on. Her kidney specialist has taken her off all the meds effecting her kidneys in attempt to reverse any kidney damage? Is there hope here? My questions,.. What happens next in what order if her kidney do not get better? Is there anything she can do now to reverse any kidney damages?",
    "doctor_response": "Hi,In your daughter case there is high possibility of CKD (chronic kidney disease).Chronic Kidney Disease (CKD) is due to persistent underlying disease like diabetes, uncontrolled high blood pressure.Staging of CKD is done by estimating glomerular filtration rate (GFR).For calculation of GFR following factors taken into consideration-1) Age and gender.2) Weight.3) Serum creatinine level.I want to know-1) Her age.2) Height & weight.3) Duration of diabetes.4) Any heart disease.5) Habits like smoking, alcohol.6) Her diabetes control (fasting, postprandial blood sugar level, HbA1c).7) Her blood pressure control for her blood pressure target is below or equal to 125/75.8) Lipid profile.9) Current kidney function test profile (serum creatinine, blood urea, electrolytes, calcium, phosphorus, uric acid, urinary protein level, ultrasonography of kidneys - size, shape, echo, cortico-medullary differentiation).10) Blood acid levels by doing - Arterial blood gas (ABG).11) 24 hours urine volume.12) Symptoms like breathing difficulties, puffiness of face, swelling over body. Treatment of CKD is to prevent or to slow the process of deterioration of kidney function.It requires-1) Diet with adequate vegetarian proteins.2) Control of Diabetes, blood pressure, cholesterol.3) Avoidance of nephrotoxic food and medicines like pain killers4) Water intake needs to restrict if there is tenancy to retain water.5) Low Potassium intake (avoid intake of fruit and fruit juices, coconut water) in case there is potassium retention in body.6) Maintain calcium, phosphorus, uric acid levels under control.7) Avoid smoking, alcohol. 8) Screening for complication on heart.9) Proper treatment of acute illness using medicines safe drugs for kidney, prevention of undue dehydration or over hydration.10) Avoidance of smoking, alcohol.She needs to have regular follow up with diabetologist and nephrologist and screening for other diabetic and hyepertensive complications like neuropathy, retinopathy.In her case worsening of kidney function may be indicated by- 1) Signs of water retention like breathing difficulties, puffiness of face, swelling over body, decreased urine volume.2) Symptoms like generalized weakness, nausea, vomiting, decreased apatite. 3) Recurrent episodes of hypoglycemia (low blood sugar) on insulin doses which are suitable for her earlier that is decreasing insulin requirement.It is usually not possible to revert kidney function to normal in CKD, but we can definitely halt or slows ",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed pancreatitis. Could stress be a cause? Treatment?\n\ni have just been diagnosed with acute pancreatitis and was wondering what to do to keep this from happening again. I was hospitalized for two days... I understand I need to modify my diet, but the only thing I can find is to stop drinking, but I havenever been a drinker!! do I need to take off work for a bit? could stress have anything to do with it? I do not like being down with pain and don't want to spend my life on demirol!!",
    "doctor_response": "Hi and tank you so much for this query.I am so soryy to hear about your recent diagnosis with pancreatitis. Stress is not a known cause of pancreatitis. However, alcohol, heavy fatty meals and smoking are the major risk factors for acute pancreatitis. Even without risk factors, you can still develop pancreatitis!I am happy you are considering modifying your taking. also, demirol and good fluid intake would help you recover soon. Unless it gets complicated, acute pancreatitis would not require that you stay on drugs all your life for pain control. Stay positive and hope for a complete healing from this. Rest would also be a great addition to recovering quick fro this.I hope this answers your query fully. I wish you well, a complete healing and thanks for using our services. Feel free to ask for clarifications if need be.Dr. Ditah, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could sharp chest pain with fever and cough suggest?\n\nI've been having these sharp pains in my chest for about a week. They come and go and started in just a spot on my chest but have streched over the spand of my chest in a little over a week. I have been sick for about 3 weeks and have been coughing a lot, but i don't know if that has anything to do with it.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. You are having chronic cough (cough for more than 2 weeks) and fever and now developed chest pain.So we should definitely rule out pneumonia in your case. So better to consult pulmonologist and get done clinical examination of respiratory system and chest x ray. Chest x ray is must for the diagnosis of pneumonia.You will need antibiotics, antihistamine, anti inflammatory and other supportive drugs. Drink plenty of fluids orally. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in taking a decision?\n\nHello doctor, im a lady of 26 yrs.our marriage is love cme arrange marg.from beginning itself we live separate frm his parent.bcoz my parent s wish is like that.we lived abt 8 months.on those days we fought amny times bcoz of his family.they called him at his leave days to do sme work for them.he immediately got started n went to his home to do his duty...but he didnt never mind abt me even i was not well...after sme days he fought with me for living as joint family.for that both r separated for 1 month.then i decided to accept his wish.his family is not gud.they dont hav gud name frm neighbour also..my husb has 2 sisters.there is a pblm for me.for 1 month me n motherinlaw had gud relationship.but his sis encourage her mother to fight with me.,,i told to my husb every actions against me did by his sis .but he didnt response.ill be quite for 3 months.,then one day they shouted at me as usual..just i asked y u always scold me...then everyone my husb his sis and his mother also came to men beat me alot....i cant tolerate..i informed to my parent..next day my parent came n took me to my mom s home.still they r not ready to convince my parent n also me.my husb not ready to live with me as separate..he need again joint family.but i feel so afraid of them..again ill go there they may be beat me n kill me...so now my parent asked me to get divorce from him.but i couldnt do it..i need to live with him as separate life frm his family..but he didnt accept...its nearly 4 months i came to my mom home..stillthey r not ready to call me..they need again joint family..what will do?my parent askde me to get divorce....i cant spk against my parent also...its very bad to me...kindly suggest me what will do in this?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Family problems for the newly wed people are very common. Almost Every newly wed faces the same problems as you are facing. Meeting a psychological counselor who is specialized in marriage counseling in your demo-graphical set up, should be of immense help.  Know yourself and understand others. This is key.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 the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest non surgical treatment for blocked follopian tubes\n\nhellow doc am sue from kenya have been married for four years but no kid  i was told that my follopian tubes are broked is there ant thing i can do apart from going for opparation is there any medicine i can take to to unbroke my follopian tube plz tell me",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.Your fallopian tubes should be blocked not broken!!!!Blocked fallopian tubes couldn't be reopened by medicines.Surgery should be done to recanalization of tubes.Hope i answered or question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the sharp pain on the right side of my chest?\n\nI fell on the ground wrestling around with my friends over the weekend. Now there is a sharp pain on the right side of my chest. It shoots down into my arm when I take a deep breath. I'm assuming this is like a pulled muscle or something but I'm no doctor. What are some quick diagnoses?",
    "doctor_response": "Hello,I am Dr. Selmani and read carefully your question.Some quick diagnoses for your problem are1. Rib fracture , since it is related with breathing. That problem will go way in 4 weeks as the fracture heal.2. Pulled muscle of the shoulder girdle.3. More rare cause may be an herniated cervical disc that may cause nerve compression/ impingement that radiates along the arm.If the pain does not resolve during the course of 3 or 4 weeks I would suggest you to go ahead with more investigation with examination and consultation.Meanwhile during this time you can take pain killers such as acetaminophen and ibuprofen.I wish you a quick recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please advice about colon cleansing.\n\nHello doctor,What is colon cleansing? Colon hydrotherapy has been advised, and how effective is the procedure? I have chronic constipation.",
    "doctor_response": "Hello. Colon hydrotherapy is used to wash out the content of large bowel by using water or other medication. As colon can normally expel waste colon cleansing is not needed. It can disrupt normal bowel flora. However, in the fecal impact, it can be used but only under medical supervision.  Causes for constipation is inadequate water intake, the insufficient fiber in the diet, resisting urge to have bowel movements. So drink at least three liters of water per day, eat fruits and vegetables, try warm water in the morning. Keep in mind that if you have severe pain, weight loss, blood in the stool, if constipation lasts for more than two weeks, then you immediately consult a gastroenterologist and get his opinion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain\n\nhi there my name mary I have been with h.pylori for years.i had triple tablet three time but nothing change,but I do have this symtoms upper abdomen sharp pains and bloated everytimes,iam on nexium tablet for seven months but not improving.is there anything to help me please.thanks",
    "doctor_response": "Hi.H Pylori is not the sole cause of upper abdominal pain. As the nexium is not helping you, we should go for finding other causes of pain in upper abdomen and bloating.I would suggest in such a patient the following:Investigations:*Routine blood investigations like Complete blood picture, blood sugar, urea, creatinine, liver function tests, thyroid function tests.*Urine -routine and microscopy*Stool: routine, microscopy, occult blood, culture and sensitivity.*Ultrasonography of abdomen,*Colonoscopy All these investigations should be within normal limits for one to say you have IBS.Further treatment will be easy and fruitful if we find the correct reason of your symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Doctor advised us to have intercourse only from day 11 to get pregnant. Why?\n\nHi doctor,I am trying to conceive my first baby, and I am on Clomid this month. My gynecologist has asked me not to have intercourse till day 11. From day 11, I can have intercourse every other day. Now the problem is that my husband is not satisfied with this decision. We would like to know the reason why we should not have intercourse till day 11. Can you explain?",
    "doctor_response": "Hi. I would not suggest that regimen of sex to get pregnant, let me explain.  For further information consult an infertility specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach ache after taking tetanus shot for dog bite. Serious?\n\ndog bite yesterday, 2 puncture wounds, made to soak in special soapy water for about an hour, x rays - no breaks, received tetanus shot, dressed wounds with Dr s office super neosporin , wrapped up, sent home. Question: Is this weird stomach ache (almost cramp-like/a little nausea ) feeling across my upper stomach area (feels to be in/near the area of the transverse colon ) a leftover from the tetanus shot, or something more serious? I go back in 2 days to have it looked at.",
    "doctor_response": "Hi The stomach ache is not related to tetanus shot. Please take Rabeprazole and antispasmodic Dicyclomine. It will come down. Nothing to worry Wish you good health and speedy recovery Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Nutramigen be flavored safely for ingestion?\n\nTrying to get my son (1 month) to take his formula. Nutramigen A+ (Hypoallergenic). He can t stand it, and wont eat it. He was a premie and required surgery to remove part of his bowel (small intestine, 13cm s). We need him to eat this as he isn t gaining weight, but he won t. What do we do? Is there a way to flavor it safely?",
    "doctor_response": "Hello, From my understanding neither the company that makes Nutramigen nor parents who are feeding this formula to their infants advise adding a sweetener or other substance to this formula. This is most important.  Your newborn's intestines are very fragile and it would be unsafe to add other ingredients. For example, adding sugar may cause different bacteria to grow in intestine and injure it further. You can ask his pediatrician about a different formula such as Alimentum which is also a broken down formula. Or perhaps a feeding tube could be passed through baby's nostril and down into his stomach to bypass his taste ability. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Arnold Zedd, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Kidney infection, weird twinges in bladder and uterus, lower back pain, fibroid in uterus. Bladder recovering from the infection?\n\nHi, I have just had a kidney infection. No fever now and it seems to have cleared. However, I am feeling very weird twinges in my bladder or uterus . Not really a pain, although I do have lower back pain. Is it just the bladder recovering from the infection? I do have a fibroid in my uterus,I am five years into menopause.",
    "doctor_response": "hi, urinary infections need to be treated. If it has gone to the kidneys, treatment lasts for at least two weeks. After that, you need to get your urine checked to confirm the infection has gone. I hope sonography and other tests have been done and are ok. In urine infection, sometimes you get bladder spasms  with sudden urge to pass urine, these go away once the infection is cured. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes leg aches,joint pains and numbness in face?\n\nMy vitamin levels from blood work all came back high two months ago they were all low I have been having trouble with my legs aching, joint pain for past two months and numbness in my face from my nose down on both sides can this be from vitamin? I am a gastric bypass patient.",
    "doctor_response": "Hi,I can understand your concern. Joint pains, fatigue and numbness could be due to deficiency of Vitamin D. Sometimes, tingling and numbness are the first symptoms to develop due to Vitamin D deficiency.According to the level of deficiency in your blood work, your physician may prescribe you medications that can elevate the level of Vitamin D.You can also do some changes in your diet and lifestyle that can increase level of this vitamin in your body. Have more sun exposure, especially early in the morning. Sunlight is the best source of Vitamin D. Sit in sunlight for 20 minutes in the morning. Do not wear clothes that cover you fully so that your skin gets chance to get sunlight exposure and can make Vitamin D. Include milk and other dairy products in your diet as source of Vitamin D. These changes along with medicines will help you a lot regarding your symptoms.I hope this information is useful to you. Thank you for choosing HealthcareMagic. Best,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What precautions should be taken for dog bite?\n\nHello doctor, I have been bitten by a dog which is regularly vaccinated. So, what precautions should I take? Can you please let me know the diet for food or something else, please.",
    "doctor_response": "Hello. I have reviewed your query and here is my advise. You have been bitten by a dog, so tetanus toxoid and rabies vaccine can be taken for that to prevent tetanus and rabies. But as you said if you are sure that dog is fully immunized with rabies then no need to take the vaccine. No dietary restriction needed. You can eat everything. If a wound is present because of the dog bite then it should be kept clean by a regular dressing. For more information consult a family physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should one do to get relieved from shortness of breath, cough after inhaling great amount of Bleach?\n\nMy husband has one lung and he inhaled a great amount of Bleach mixed with Lysol in the church bathroom and even though it was strong he continued to stay in the bathroom to clean it, and now he is in a lot of pain. Shortness of breath, coughing and burning. What should we do?",
    "doctor_response": "Hello,Welcome to HCM,As your husband as inhaled bleach in bathroom,it is a respiratory irritant. It releases Chlorine gas at the cell level. Chlorine gas is a direct cell toxin. It will cause coughing can cause chest pain and can cause fluid accumulation in the lungs. In very high concentration they can cause damage to the lung, but even then the lining of the lungs heals rapidly so there shouldn't be any long-term problems.The best at home action is getting fresh air. Try to ventilate your indoor living space as much as possible.If the symptoms are not improving after 24 hours of good ventilation, you need to take your husband to the doctor.Based on the Symptoms he will be treated as appropriate.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Discomfort in stomach, no pain. On fluid diet. Was on junk food. Could this be the reason?\n\nI am a 21 year old male.  About one week ago I began to feel discomfort just below my left rib cage and also near my left hip and lower back (left side).  I went to the doctors a few days ago and he pushed around my stomach looking for pain but was no pain besides the basic tickle pain you get when someone pokes you.  He told me to go on a clear fluid diet then move onto a full fluid one over the next few days.  It is day 4 since seeing him and i have been eating nothing but home made soup (cabbage and beans) also having 1-2 fruit smoothies a day and have biked for 30+ min each day,  Even today my stomach feels like its really busy.   I used to be a big junk food eater so that is why he put me on this diet.  He also says it may be a piece of poop trying to make its way through and so that is why he put me on fluids to help clean me out.  The discomfort has subsided a lot since the first few days before going to the doctors and even since then but i still feel discomfort from time to time.  I was just hoping on getting some feed back/ 2nd opinion on this.  perhaps what I may be able to take for the discomfort and how long pains may last?",
    "doctor_response": "hi, I think ur problem is acid peptic disease, because of ur eating habits, u need to undergo an upper GI endoscopy and may need treatment in the form of antacids",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could dizziness, chest pain with difficult breathing suggest?\n\nI'm a 17 year old female for the past year and a half I have been getting weak, dizzy, shaking, having chest pain and difficulty breathing, when the symptoms occur I have a rapid pulse and high blood pressure. I've been to 3 different doctors and they all tell me there is nothing wrong with me. I've never had any health issues before this please help.",
    "doctor_response": "Hi welcome to health care magic... You have not mentioned which investigation you have done and what was treatment given.... Your work up needed with.... -Auscultation-Blood pressure measurement-EKG-Echo if needed -CBC -Stress test etc.. According to cause further treatment can be guided.... Sometime stress can lead such presentation but as chest pain and dyspnea since long time above work up necessary... Take careAdvise : Consult pulmonologist or cardiologist for this",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be concerned for the high dosage of Tylenol given to the child?\n\nI gave my son who has a g6pd Tylonel Twice is this really dangoures !!! Anything I need to do please! And as long as blue one of the things I need to avoid dose that mean Green and purple too because both combination from Blue and green and yellow ? Thank you",
    "doctor_response": "Hi,Thank you for asking question on health care magic.The therapeutic dose of tyelenol is 15 mg/kg body weight per dose and can be given as frequently as every 4 hourly depending on the fever.If you give execess dose you may omit the next dose,nothing to worry.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for difficulty in emptying the bladder and left side bend of penis\n\nI have over masturbate about 4 year now a last one year i have urine problem My bladder doesn t empty full /in one day i go to bathroom about 10/13 times And my penis is curved bend left side and right testis is loose penis erection is low Plz give me perfect suggestion to cure from this problem Qadir 20year YYYY@YYYY",
    "doctor_response": "A slight bending of penis towards left side is normal. Incomplete emptying of bladder may be due to bladder neck narrowing or it may also be due to weak bladder muscles. Masturbation has nothing to do with all these problems. Consult a sexual disease specialist for your erectile dysfunction.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a small bulb of puss and blood in the mouth?\n\nI had my wisdom teeth removed 10 years ago but about 3 months ago I started get a little bulb of puss/blood where my upper left wisdom tooth use to reside. It will come and go and once I pop with my tongue it will be fine for a couple of days/week, then it will reappear. It does not hurt when it is there or when I pop it. Any ideas?",
    "doctor_response": "Hello DearThanks for your query, I will be most happy if I could help you out so no need to worry much.Gone through your query in detail.Most probably the lump of pus which you have noticed is an abscess. It may or may not be associated with pain. It may be due to few reasons-      - Decay and Infection in the tooth next to your wisdom tooth(i.e. presently         last tooth in that quadrant). I think this should be the cause of your         problem.      - It may be due to infection in any root residue of the wisdom tooth left at           the time of extraction.       - It may be due to any underlying infection in the jaw bone.(not a very        common cause)  \u2022 I will advice you to get an appointment with a dentist as early as possible so that actual diagnosis can be made on the basis of thorough clinical and radiological examination and start the needful treatment can be started.(Procedure+Medication).\u2022 Meanwhile I am advising few things that will provide some symptomatic relief.      - Do warm water saline gargle 4-5 times a day.      - Do not apply any type of pressure or hot packs on the affected side,            Instead you can use a cold pack.      - Try not to sleep from the affected side for few days.      - Apply topical gel like Metrogyl-Dg Forte or Rexidine-M gel (commonly chlorhexidine and metronidazole combination) thrice daily.Hope this will help you. If there is any more query or question regarding this in your mind, you are welcome to ask me any time.Take CareRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat chronic cough?\n\nI'm a 31 year old diabetic (5'9\" 180lbs.) who has had a chronic cough for about 13 years now.  Last for 11 straight months.  Normally get a break in Last September, early October.  I have lack energy and lose my breath quite often.  If I play a sport such as basketball or football with my friends.  Now most of my friends are my age, height, about 40-80lbs heavier and smoke (which I do not) and yet they can last longer than me.  I also experience a discomfort, not pain under my left lower rib (feels as if you were to hold your stomach in for too long.).  These syptoms have been for 5 or more years.  Newer ones include a headache which doesn't really act like a headach.  Forehead is a little warmer than usual and feeling some minor pressure, but light nor loud noises bother it.  Also, lately have had a loss of appetite, but that normally last for a month and then I can eat normal for a while until it returns.  Summer time is torture because temperature above 75 degrees cause me to sweat like a 400lb man.  Winters are great, and never wear a coat...and I work outside.  I've been told to exercise more, which I had at one point, 10 hours a week at a gym for 9 months and looked like I was in great shape, but symptoms never went away and always had trouble with cardio workouts.  At different times my lungs were x-rayed, had a ct scan, ultra-sound (contrast) on my I believe my kidneys.  I had blood in my urine, but it eventually was ruled from a calcium build-up.  Any ideas?  Or do I have to accept the answer that I'm diabetic and these things happen?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. You are having chronic cough and breathing difficulty which is improving for 1 particular month (September). So possibility of allergy related asthma or bronchitis is more. For the diagnosis of these diseases, PFT (pulmonary function test) is must. So in my opinion, you should definitely consult pulmonologist and get done 1. Clinical examination of respiratory system. 2. PFT. PFT will not only diagnose bronchitis or asthma but it will also tell you about severity of the disease. And treatment is based on severity only. You might need inhaled bronchodilator (formoterol or salmeterol) and inhaled corticosteroids (ICS) (budesonide or fluticasone). Don't worry, you will be alright. I don't think it is due to diabetes. Consult pulmonologist and discuss all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower abdominal pain?\n\nhelloI am having lower abdomen pain for last 2days,...I have taken paracetamol 3 doses already (as the nurses in medical centre suggest), and its reduced little bit. the pain is always there...but can feel only if i got some pressure in my lower abdomen,...today morning I feel that I have a bad stomach too.",
    "doctor_response": "HI.Paracetamol alone will not help for pain in abdomen. Since you have pain in the lower abdomen which increases on pressure, and now you have a bad stomach too; I would suggest you to consult a Doctor to get examined , investigated and get a prescription of a proper antibiotic , probiotic and supportive medicines. Get a course for 5 days. If you do not get a complete relief you may need further investigations like ultrasonography.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medical condition causes pain in the lower abdomen?\n\nI have a dull pain in right lower abdomen off and on since Thanksgiving. Had 2 CT scans, one for appendicitis and one of right side of abdomen, both clear. Went to GYN and had complete exam including pap and ultrasound. clear. Went back to GP and he is referring me to Gastroenterologist for RLQ (pain in right lower quadarant) Can't get in until 9/5... What are your thoughts?",
    "doctor_response": "Hi, Pain in right lower abdomen with normal reports of CT scan and Gynecological examination. Ultrasonography indicate towards a cause that can not be detected by these. Hence I would advise you the following in such a situation. Send the stool for lab tests for 3 days. Get the  Urine tests and blood tests. Intestinal pathology may not show on Ct scans and Ultrasonography hence also needs clinical examination to see for any colitis or so and get treated accordingly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. T Chandrakant, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swelling in elbow due to mosquito bite\n\nI got bit by a mosquito last night. The bit has now doubled in size like the size of a softball. It practically surrounds my elbow. And I can t be certain however I feel as though front my elbow yo to my hand ( left ) that it s either numb or tensed up...???",
    "doctor_response": "Hello,Welcome to HCM,Mosquito bite can also do infection and irritation with the sting they can produce allergic reaction along with the saliva.Because of which you are having these feeling.I would suggest you to take antibiiotics and anti allergic like fexofenadine 120 mg od.You can take Tab CPM in the night and apply anti allergic mixed with antibiotic cream locally 3 times a day. It will take at least 3 week to come to normal.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lung congestion\n\nHi, I've had pretty bad lung congestion for 5-6 weeks now.  I make a wheezing sound when breathing.  I my coughing a lot but producing very little.  At this point, my lungs actually hurt as if they're bruised or something.  I completed a Z pack 1 week ago with no change whatsover.  Generally, I'm a very healthy runner and have never experienced this before.  I usually don't have sinus or allergy issues but I do have acid reflux for which I take omeprazole.  Any ideas what in the world is happening?  or whay?  Causes?  Thanks!",
    "doctor_response": "Hi,Following causes has to be ruled out like:-tuberculosis if fever,  weight loss present -pneumonia -acute bronchitis 1. viral 2. allergic 3. bacterial Your work up done is as follows:-Auscultation-CBC-Chest x ray If x ray shows consolidation than sputum gram stain and AFB staining examination needed -sputum culture if needed. According to cause specific treatment is given. For congestion relief benadryl like decongestant drug prescribed Steam inhalation done three times a day If CBC shows eosinophila than Allegra M prescribed for that If bronchoconstriction severe then nebulization by salbutamol and budesonide respule prescribed.Keeping my answer in mind, consult pulmonologoist for examination. Hope your concern is solved. Happy to help you further.Regards,Dr. Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which medicines should I take for pericoronitis ?\n\ni m pretty sure i have pericoronitis, what antibiotics do i need to make this go away, or what are my next steps to recovery",
    "doctor_response": "hello and welcome to HCM forum, as you are aware that pericoronitis is inflammation of soft tissue that covers your erupting tooth, you should perform warm saline rinses 3-4 times a day. this will relief pain as well as resolve inflammation. you should visit your dentist, he might place a medicated pack over the soft tissue, it usually takes a week to completely resolve, but depends from case to case. your dentist will prescribe you antibiotics and anti-inflammatory medicine according to your condition, kindly keep doing rinses and keep that area clean off food debris. i wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How should fever, ear infection, loose motion with vomiting be treated?\n\nmy 1 yr daughter is having fever last two days with ear infection due to cold and she had loose motion during the 1st day nearly 5 times. we were prescribed with ZiFi 50(4ml M & N) , Nutrolin-B Syrup (2.5ml A & N ) and P125(1ml every 4hrs if fever exists . Next day her fever was oscillating between 102.6 and 99.4 and same day night she had vommitted twice and we took her to the dr. and she was asked to take additionaly Emigo(2.5ml Morning & Night), Ibugesic Plus(2.5ml A & N) and Mefanorm(if fever is continuing). Pls advise.",
    "doctor_response": "Hi..I feel with so many systems of the body involved and the fluctuating fever being there, it should be 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.Do not use Mefenamic acid. It is an NSAID. . It carries the risk of gastritis and renal problems in the long run. Please do not use Mefanorm. Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach problems\n\nHi, may I answer your health queries right now ?  Please type your query here...For the last couple of days I've been getting these weird feelings in my stomach. They're like these little pinching type feelings. They seem to happen all over my stomach and it's like almost like a stinging feeling and lasts for a second, if that. They don't hurt too much. It feels like an ant is biting me there or something. I've also been getting these little fluttery/twitchy feelings all over my stomach. I also sometimes get this pulsing feeling along with the stinging feeling. I've also had an occassional dull backache. I've also had this bloated feeling in my stomach",
    "doctor_response": "Hi.Thanks for your query.Your stomach problems of feeling of fluttering, like ants biting or sometimes stinging feeling along with bloating of the abdomen is suggestive that you may be suffering from intestinal infection in the sub-clinical form.I would advise you to get the stool tested for routine, microscopy, occult blood, mucus, culture and sensitivity.Blood for Widal for Typhoid, blood culture and routine CBC and sugar.Urine - routine and microscopy.Ultrasonography of the abdomen Get a 5 day course of an antibiotic, metronidazole, probiotic and you may be fine. Investigations and an opinion of a Gastroenterologist will be necessary only if the medicines fail to give you relief.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can brains of male and female be swapped?\n\nok I know this may  sound crazy of somewhat  but I was wondering if there was any way of putting a male brain into a female ---in other words swap brains with a male and female ---could this be done ---If this hasn't been done and you need someone to try this on then I will be willing to do so --cause I would like to be the first to try this ---",
    "doctor_response": "Hi,Thank you for your query.To the best of my knowledge it has not been successful in animal models. Researchers are still wondering if it can be done as this shall be a great achievement for future medical management of a lot of neurological conditions.I hope I have answered your query to your satisfaction.Wishing you all the best.Regards,Rajiv K Khandelwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What could be the reason for intermittent shoulder pain?\n\nHi doctor, I have intermittent shoulder pain, mostly in the areas where neck and shoulder meets and in the rotator cuff. This is for the last one year. I had neck pain, which subsided after some physiotherapy and still I have the shoulder pain issue. Earlier, I consulted a general physician and a physiotherapist, but not visited for a while.\u00a0I had a suspicion that my shoulder pain was significant and started bothering after I played volleyball briefly in last summer.\u00a0I am wondering whether I should visit an orthopedic surgeon and need an MRI.",
    "doctor_response": "Hi. Trapezitis. Revert back after a week to an orthopaedician and traumatologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. There is white fungal ring infection on forehead. Kindly suggest the ointment.\n\nHello doctor, There is white fungal ring infection on forehead of my daughter. Can you please suggest some oitnment?",
    "doctor_response": "Hi. I have gone through your case. In my opinion, I have two diagnosis of your daighter's lesion. It could be fungus or eczema patch. For this, please mix Hydrocortisone and Clotrimazole creams in equal amount and apply two times a day for 14 days. Also apply any baby lotion at night. Within 14 days, it should heal. If in case, it does not heal, then please see your local dermatologist to evaluate her for other conditions. My second diagnosis is leprosy. Please consult your local dermatologist if the lesion does not heal.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible despite taking Postinor 2 after unprotected intercourse?\n\nHi good evening Doctor ,I am 21years old on the 8th of July I had unprotected sex with my boyfriend I took Postinor 2 that evening.One week after on the 14th I started bleeding and I bled for a week,it looked like menstrual bleeding.My period is nine days late and I\u2019m scared I might be pregnant.The heavy vaginal bleeding I experienced for a week is that of my cycle.I don\u2019t want to be pregnant",
    "doctor_response": "Hi, If you have taken Postinor 2 as recommended then you shouldn't be pregnant. The first tablet of Postinor 2 should be taken exactly 12 hours of unprotected intercourse and not later than 72 hours. The second tablet should be taken 12 hours after the second tablet. If you have made some mistake in taking the medications then the risk of getting pregnant is there. Contact your gynecologist if you are not getting your periods or do a pregnancy test with the first midstream urine. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nupur K, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abscess on the face with pus discharge\n\nmy friend has a abcess on the side of his face for three days now it keeps swelling and is pink n purple colour it also has pus coming out it and he said it feels hot he has no immune system and won't go to the hospital even though he's in a lot of pain",
    "doctor_response": "Hi thanks for asking question in HCM.Noted your friend has abscess over side of face...He should consult surgeon.Here abscess has to be drained ....As he feel feverishness also antibiotic like amoxycillin needed.For fever take paracetamol...Abscess should cleaned daily...cleaning can be done by normal saline....After drainage apply antibiotic cream topically....As abscess present over face dettol or tincture not applied to prevent discolouration unless much indicated.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Test showed mild allergy to shrimp. Are canned food shrimp related?\n\nMy Dr. gave me an allergy test and she said it came back as having a mild allergy to shrimp not shelfish though. I haven t had shrimp in months and the reason I had her test me is I am suffering from rosacea . Other than that I have never felt sick when i have eaten shrimp. My question is are there any ingredients in canned foods that are shrimp related without listing shrimp as the ingredient I should be looking out for?",
    "doctor_response": "It is mendatory to write every ingredient on canned food if there is no shrimp on the ingredient list it means there is no shrimp you can have it",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest suitable toothpaste without peppermint\n\nI am an adult that doesn t care for peppermint, spearmint, or wintergreen flavors. Unfortunately, 98% of toothpaste are those flavors except for children s toothpastes. Is there anything out there for adults that isn t one of those flavors? I can t brush my teeth with cinnamon flavored toothpastes either. The flavor is way too strong. If there is an alternative, please PLEASE let me know. Thanks!",
    "doctor_response": "thanq for your querythere are few toothpastes which are not flavoured eg: look for colgate and pepsodent. there are bland ones in these two products. if your want fresh feeling after brushing with either of two toothpastes, use a mouthwash.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe cough\n\nhi i have a terrible tickly cough which keeps occuring every 1-2 months.I have just had my second baby and my pelvic floor is not in good shape therefore this cough is really annoying.can i do anything?I have been taking tickly cough medicine and sucking throat sweets but hasn't helped.",
    "doctor_response": "Hello dear , hiWelcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This is in relation with lower respiratory tract infection .*  Guidelines for better  recovery -  Gargles with salted lukewarm water with added peppermint oil 3 times    a  day .-   Basic lab tests  with  x-ray  chest  is  mandatory  for  precise line of    management .-   In  our clinic , we recommend  cephalosporin group of antibiotics , bronchodilator  medications  with  or  without  steroids  as  per  the     need  of  the  case .Hope this will help you for sure .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for slipped disc\n\nI have a slipped disc and in horrible pain , I can hardly move, I m 55 female 57 kilos and around 5ft 2, did this 3 weeks ago had some scans done and was prescribed panadeine forte along with brufin was coming good then today just started to go down hill again but will even more pain, only was told 2 panadeine forte per day but it s not doing anything to alleviate the pain, what can I do?",
    "doctor_response": "Acute onset disc prolapse may cause nerve compression  causing pain and neurological deficit. As per your narration it seems that you are having severe pain without any weakness or sensory loss. For treatment you need complete bed rest for 2-3 days and gradual resume of routine activities supplemented with pain killers and muscle relaxant. Later on back extension exercises helps in muscle strengthening and disc protrusion may revert. Unfortunately if pain persists for months then surgical options have to be considered based on Mri spine finding. Wishing good health and early recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can having unprotected sex followed by intake of i pill cause pregnancy?\n\nHello, really hope you can help me. My boyfriend and I were heavy petting on 7 June and although there was no proper penetration there was a little pre-ejaculation. We had both been drinking and my boyfriend said that there can t have been any sperm in it as he experienced slight pain. As a precaution I took the morning after pill around 11 hours after the incident. My last period started on 28 May. Is there any possibility I could be pregnant? Thanks very much for your help.",
    "doctor_response": "Hello, and I hope I can help you today.First of all, unless penetration occurred, there is no reason to suspect that you could be pregnant.  There is a small amount of sperm in pre-ejaculate, but unless you and your boyfriend had direct genital contact there is no way the sperm could have traveled up your reproductive tract because sperm die when they are exposed to air.  Furthermore, even if you did have intercourse, the morning after pill prevents pregnancy 90 percent of the time if taken within 72 hours.So I really do thing that you can be reassured that you are not at risk for pregnancy. I hope I was able to adequately answer your question today and that my advice was helpful.Best wishes,Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have chest and arm pain with fever and vomiting. What should I do?\n\nHello doctor, I am suffering from right side chest pain and right arm and also have fever and vomiting. What should I do? Is it symptoms of something big?",
    "doctor_response": "Hello. You have mentioned that you have diabetes. Patients with diabetes need not always be present with typical chest pain in case of any sudden cardiac event; symptoms like right sided pain, and persistent vomiting should not be taken lightly. And also you did not mention about history of any 1) cough, 2) abdominal pain, and 3) burning urination In addition to a coronary cardiac event, your symptoms also suggest the possibility of any lung infection as it can lead to fever chest pain and even vomitings sometimes.And as people with diabetes have a predisposition to infections, patients with fever and vomitings should be evaluated for urinary infection also if other symptoms are present. You need to get 1) ECG. 2) Chest X-ray. 3) Complete blood picture. 4) Complete urine examination is done. Without any delay and also chest and abdomen needs to be examined for any infection. You can contact me any further queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden chills and head spins?\n\nMy wife (41 yrs) used to get sudden chills and recently had a few incidents of spinning head for a couple of seconds. We got her tests done and had couple of factors out of range. Her ATG levels are 934 and AMA is 314. T3 and T4 are normal, however, TSH is 7.5. Lipids are normal. She has been prescribed Thyronorm 25mcg for 3 months. Is hypothyroidism curable? Also, she has a family history of heart problems. Does this add to her risk of developing heart problems even though presently her tests results are normal?",
    "doctor_response": "Hello.I am Dr Mittal.There are three parts to your query which you seem to want to know about- heart problems, thyroid and vertigo.I will try to answer them one by one.1. Ideally you need to be more specific about the exact heart problems that are present. If there is a family history of heart problems, where you are considering heart attacks, yes she may be at risk. However, if she takes good care of herself, she need not necessarily have a attack herself.2. Hypothroidism- well the blood levels certainly suggest mild hypothyroidism. It is not curable. But it is well controlled if she takes her medicines properly and regularly. The thyroid medicines are best taken on empty stomach in the morning. 3. Spinning of the head may be a positional vertigo. That is why she gets it temporarily, probably when she looks in one direction or bends her head in one direction. You will need to visit a neurologist to perform a Dix Hallpike maneuver. if the condition is confirmed, medicines can be initiated like betahistidine.I have tried to make it as simple as possible.Let us know with the results of the tests for further suggestions.Best of luck, Dr Mittal.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes clinical sepsis in baby right after birth?\n\nmy niece just delivered a baby and was found out that there was pus in my niece urinalysis while she was on labor ... her baby has been treated with antibiotics for clinical sepsis ... how does the pus affect her baby ... coz just this morning her baby had lumbar procedures and the fluid was turbid ... pls enlightened me about this thank u very much ...",
    "doctor_response": "this is a serious bacterial infection if lumbar puncture showing pus. newborn baby needs antibiotics for 21 days in many cases of meningitis and it may affect the neurobehavioural development of baby",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain , leg pain and high fever\n\nMy brother has kidney disease and take dialysis twice-weekly. In the past week he has fever running at a high temperature and extreme back pain and leg pains he cannot stand up or walk. he has been to the doctor the hospital they have done ultrasound on his kidneys nothing has shown, done x-rays on his back. He has extreme hiccups he has been hiccuping for four days nonstop. What could be the cause of ongoing hiccups. We are frightened.",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.As he has fever so I think he should be having infection. Needs culture and sensitivity of urine and x ray lumbar spine to know cause of backache. Hiccups can be due to increased urea level in blood. So blood urea should be measured. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How safe is taking Tylenol and Advil for high fever?\n\nmy 8 month old has been experiencing high fevers. We are getting them down with tylenol and advil alternatively. He has not been sleeping, only about 20 minutes and then cries. His fever now is 103, nose running and we cannot lay him down without screams. Should we take him in to hospital?",
    "doctor_response": "Hello,First I will suggest plenty of water, cold baths, help to slow down the temperature. Of course, tylenol and advil alternatively is a good choice in this case and helps a lot. About going to the doctor I will suggest If your child has more than 3-days with the high temperature you consult the doctor.Hope I have answered your query. Let me know if I can assist you further.Regards, \u00a0\u00a0\u00a0\u00a0\u00a0Dr. Elona Dashi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Burning sensation, throat feels blocked, vitamin B12 deficiency, acid reflux, stress, swollen tissue, have bad breath, tender gums. Help?\n\nI am a 34 yr old healthy female! In November 2012 I strated feeling the sensation that my throat was closing up and had a burning sensation.   I went to the doctor and was advised I had a vitamin b12 deficiency, immediately strated taking a supplement every two weeks and was put on a acid reflux medication.  This did not work and the problem continued I went to see a ear, nose and throat specialist who advised me I have swollen tissue due to acid reflux and stress and it should get better...I have had a scope and it has remained the same buy now I have in addition to the above I now have a white substance on the back of my tongue which bleeds and I have very tender gums where my wisdom teeth were plus very bad breathe? I use a mouth guard but that doesn't help, I also brush my teeth two times a day and floss with no bleeding.Please help meTanya",
    "doctor_response": "Hi, Thanks for asking the query, Bleeding gums, bad breath  occurs due to poor oral hygiene maintainenece resulting in plague and food debris accumulation, nutritional deficienecies, immunological disorders, faulty appliances, hormonal imbalance. I would suggest you to visit the Dentist and get a checkup done. Take an OPG radiograph which will give entire picture of gums, bone loss and wisdom tooth. Go for symptomatic treatment of complete mouth scaling and polishing. Take multivitamin tablets. Use chlorhexidine mouthwash regularly. Include vitaminC, vitB12 containing food in your diet like lemon, oranges. As you have mentioned you have GIT problems get a checkup done by a Gasteroenterologist. Also check your menstural cycle, blood sugar level to know whether you are diabetic or not. You might be having Pericoronitis around the wisdom tooth, Get checkup done and if needed get the tooth extracted. Maintain a good oral hygiene. Hope this helps out. Regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning lumps in neck after thyroidectomy due to thyroid cancer?\n\nIn 2008 I had thyroid cancer with 2 lumps and a thyroidectomy done with ablation using the I-131 radiation tx. About 6 months ago 3 more lumps showed up in the same location and the docs thought that the thyroid cancer had come back. So back to the docs I go and they did another I-131 ablation and uptake scan (no cancer that they could see) good thing, but now I still have these lumps on my neck and every so often they burn like anything. I am getting bad heartburn, and my neck does hurt due to when they took out one of the tumors it had taken up residence on my C3-5 and in to my esophagus. Because of that my neck bones have developed spondelyoisis (sp) (no spinal Fluid) till you get to my C 6-7. They said that i d probably have to have neck surgery to fix that, that requires sole-searching. I would like your professional opinion on what you think these 3-4 burning lumps could be. It doesn t feel like strep throat, or anything else I ve ever felt. Thank you for your time.",
    "doctor_response": "Hi, I gather from the history you are telling,that you continue to have burning lumps of the neck area,briefly you underwent complete treatment for thyroid cancer- surgery and radio ablation including addressing even the residual lump around cervical bone and oesophagus and otherwise you are normal since 2008 except cervical spondylosis which calls for surgical immobilization.        You should remember invading the normal body to provide a cure surgically or radiation is also beset with distorted topography and inflammatory responses of tissues left behind.These effects perhaps explain your agony with lumps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Dostinex be taken during pregnancy?\n\nHi I m 8 weeks pregnant had a boy 5 yr old n miscarriage in 2015 doc advised me folinext duvadilan 40 mg twice a day gestofit sr 200 mg once a day and dolinext g twice but after a week i dint like d taste of Dostinex ginger n doc changed it to perinorm cd I took it for a day or so but read it somewhere it is nt good I don t have nausea n vomitting feeling from d beginning so do I need to continue ny of dese Dostinex / perinorm.here doc says u have to eat but I m confused I have stopped it",
    "doctor_response": "Hello dear,welcome to Ask a doctor service. I reviewed your query and here is my advice. Metoclopramide (perinorm) should be avoided in pregnancy if possible. There are no reports that it cause birth defects on fetus if used first trimester of pregnancy. While dostinex is category B1 according to FDA and can give malformations in fetus ,sometimes medical abortions is needed if exposure happened due to big malformations. Consult your doctor better about it. Hope I have answered the question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are Azithral and Meftal the right medication for throat infection?\n\nHello My daughter is having viral and mild throat infection since yesterday. Last night she had taken Azitral 500, Meftal 500 and a cough syrup Today morning she has taken meftal500 with breakfast (6am) Right now (2pm) her temp is around 103 We have given one dose Calpol 650 She is 60 kilo age 13 years Kindly advise No body pain",
    "doctor_response": "Hi...by what you quote i feel that your kid might be having a viral sore throat or a streptococcal infection. I suggest you see your pediatrician and get a rapid streptococcal antigen test done. If it is positive then she will require antibiotics. if it is negative then it might be viral illness and doesn't require antibiotics at all.Do not use antibiotics like Azithromycin without proper evaluation.Meftal contains Mefenamic acid which is a NSAID. It carries the risk of gastritis and renal problems in the long run. Please do not use Meftal-P.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to increase chances of conception?\n\nhello , i m heena. i m trying to conceive . i m 23 yrs old and i have been married since 7 months. previously i got too much bleeding for many daus. which is now cured by my physician. now i want to plan my first baby.my doctor said to go through some checkups which are normal.my husband too got normal results.now what are the things which can help me to concieve...plzzzzzzzzz suggest.............",
    "doctor_response": "Hi,   Thanks for the query.    I understand your concern.     -start taking tab. Folic acid 5 mg &a capsule of vitamin E 200mg daily .. by both of you.    -have healthy diet..  daily exercises.. sound sleep.&happy positive mind &avoid illhealth.    -have unprotected sex for 6 days from +ve LHsurge test (which marks ovulation).     -Let the semen be retained in vagina for half hour (take pillow under waist if needed)     -test for pregnancy by htp after 8 days dealy in periods.     *In case there is nopositive responce with these in 6 months(which is rare in healthy couple.... you both wouldneed detailed investigations &consultation of sterility doctor.     Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "ADHD, emotional regulation, depression, anxiety. Vyvanse and Lexapro. Weight gain, extreme fatigue, stiffness. Recommendations?\n\nHi,As an adult I suffer from the common characteristics of moderate ADHD, as well emotional regulation/ depression/ anxiety combined. I recently lost my health ins and wasn't able to continue some othe meds I was taking but was concerned greatly with the Vyvance side effects so decided to stay on the Lexapro and drop down and off the ADHD med. I was experiencing migraines and irritability with the vyvance and now I look back and see how intense those side effects were but am torn because I am having such struggle with completing daily tasks and overall decrease in my career and home life.The most troubling is I have gained almost thirty pounds in just three months off the drug and haven't changed my activity level that much or diet with the exception of the extreme fatigue it is more difficult to excersize and even have more joint pain am stiffness.Any recommendations would be helpful. Thank you -Sarah",
    "doctor_response": "Hello  You have some symptoms of adult ADD and also symptoms of depression and anxiety. Vyvanse is a stimulant drug and it improves inattention and other symptoms of ADD. On the other side as it is a stimulant drug so it has side effects of headache, irritation, intense stimulation etc. Escitalopram (Lexapro) is a SSRI drug and it is used to control depression and anxiety symptoms. It is not commonly used in ADD symptoms. You have gained 30 pounds weight in three months after starting this medicine. Escitalopram is known to cause a little gain in weight but it not so significant. Most likely increase in weight in your case has happened because of improvement in symptoms and consequent increase in appetite. I would advise you to start exercising daily and also improve you activity levels, it will come under control. Thanks Dr. Seikhoo Bishnoi, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sore lump on areola\n\nI have a sore lump on my areola that is the size of a pea feels like a sore spot and when i squeezed it some white puss came out, is this normal what could it be? I recently gave birth 4 months ago, but gave up breast feeding about week two, could it have been a trapped milk duct or something?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  You have history of child birth and brrast feeding.  You have lump on areola with whitish material.  You may have abscess forming mastitis or galactocele most likely.  You should go for fine needle aspiration cytology. 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for erection problem in an elderly person\n\nI was treated for congested heart failure 18 months ago. I have resumed my normal routine in regard to my daily routine living.  I am a 71 yo white male. No other health issues. I was a widower at the time. Now I am seeing someone getting serious. Sex is bound to come up. I worry about my performance so to speak. I don't have a general Dr. I don't see my heat Dr again in 7 months. I  have seen so many commercials for this but I don't who to ask. Would it be alright to ask about getting something before I se him again in the end of January 2018. He is a 2 hour trip away so would like to know if I should call and either ask the nurse or wait for January, I don't want to do either if there is going to be a \" no\".  I didn't expect this type of person to come into my life at our age. She was the girl that away 50 years ago. Instantly felt the same now as if time stood still for us. Do you think I should ask my Dr about it because I may get a yes.",
    "doctor_response": "Hello,As per your history, probable cause is psychological. Common causes of erectile dysfunction are:-1) Psychological2) Stress3) Fatigue4) Diabetes5) Other chronic illness.6) Spinal cord injury.You can tablet sildenafil one hour before intercourse after consultation. Treatment mainly depends upon underlying conditions. Kindly follow with detailed history or consult with sex expert.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Shyam B. Kale",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I develop cancer even after quiiting tobacco?\n\nHi I used to chew 2 cans a week of any chew I could get in a can except straight...but I have finally quit and have been tobacco free for about 6 months and I just wanted to know if I can still get mouth cancer even though I have quit doing it? I get tiny red bumps on my cheeks that don't hurt or bleed and on the right side of my cheek it feels dry and I don't know why so I was just wondering if I could still develop cancer after quitting?",
    "doctor_response": "Hi,Thanks for writing in.Tobacco is a substance that contains cancer containing substances. Being so it  increases the risk of oral cancer in those who chew it regularly. The risk to get oral cancer reduces significantly after stopping tobacco chewing However if you have done chewing of tobacco for many years then you will still have an increased risk of having oral cancer as compared to the rest of the population.If there is any lump in mouth or a wound that is not healing then you must at once consult the ENT surgeon and then get necessary investigations done if required.The relative risk of oral cancer increases with the time duration of tobacco chewing. If you have done tobacco chewing for less than 5 years then the risk is less. Maximum risk is in people who have tobacco chewing for 20 years or more. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a person die from sarcoidosis?\n\nMy Brother just passed away about 2 weeks ago of a heart attack and had sarcoidosis. I was just wondering if this could of been part of his heart attack. He was getting them shrunk for about a year once a week. Just trying to wonder why. They said it could of been a Blood clot",
    "doctor_response": "Hello, I understand your concern and would explain that sarcoidosis is a chronic inflammatory disorder, which can lead to an increased cardiovascular risk. So, in my opinion, it is not the only cause of the myocardial infarction, but when coupled with other cardiovascular risks such as age, an unhealthy lifestyle, smoking, diabetes or hypertension, it can lead to an increased risk for a heart attack or stroke. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness in breath and severe pain in chest?\n\niam 52 years old ,85 kg weight 176cm height.i suffer cervical spondylosis in c5-c6.every day 1 have shortness in breathing  and severe pain in left chest near the heart  with pulse and burn in chest bones near the neck and stifness in shoulders some doctors dignosed my case(angina pictoris)although i have no problems in heart and  lungs.please help and advice. subhi siddiq-iraq",
    "doctor_response": "Hi Dear !! Thanks for your query to HCM.Read and Reviewed your query in context to your health issues.In the given scenario and history facts,You seem to suffer from-GERD induced Esophagitis-causing chest pain.This is so because lungs and heart are without any evidence on investigations.Chest bone near neck pains with burning.This is from the high acid contents from upper stomach regurgitating in to neck/ throat, causing  chest burning with ? angina like pains, in your case.Also other causes of recurrent chest burning behind chest bone needs to  be ruled by consults with Ent/ Physician/ Surgeon.Plan Suggested for your treatment-GERD causes need to be ruled out- with Consults from Ent Surgeon / Physician / Surgeon by appropriated tests with these doctors.EKG andholtzers nuclear stress testing would fix and rule out heart ailment involved in your chest pain.Anti-Acidity drugs-PPI with LES(lower esophageal Sphincter) regulator-like Domperidone would fix the chest pain behind neck.Liqu.Gaviscon-Alginic Acid-gel- 1 gm x 4 times a day x 2 weeks would control this chest pain-from esophagitis.So treating these causes is needed with proper drugs after proper tests, which would need Consults with team of doctors as -Cardiologist/  / ENT /GI specialist.Other cause of , need to be ruled out, by examination with team of ENT/Cardiologist doctors/ Physician/Surgeon Doctor and others if need be.Hope this reply would help you to resolve the health issues with help of doctors attending on you.If need be, update any health issue 24 x 7 by a direct question to ME, at following HCM link-Dear, Don't forget to close this query with YOUR pleasing feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at HCM services.If you want to update more details and ask more update queries ,You are most Welcome herewith !!Good Day!!Wishing Good Healthy Life in time to come!!Dr.Savaskar M.N.Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I suffer from recurrent tonsillitis and tonsil stones with pus. What to do?\n\nHello doctor, I have been suffering from recurring tonsillitis since I was a child. I was told at one point that if I was to be diagnosed with tonsillitis again, I would have to schedule to get my tonsils removed. However, I have had it quite a few times since. I also suffer from frequent tonsil stones accompanied by pus, or just pus all together. It is really been a bother as I am becoming older and I am tired of frequent emergency room visits ending in the same treatment. The pain and severe swelling have been going on for two days now. My right tonsil, however, always appears to be swollen. I also have mucous in my nose that is draining from the back. Nothing is coming from my nostrils themselves. I am taking over the counter Chloraseptic for the pain, but it is not working. Along with vitamin C packs and cough drops. I visited my previous doctors a few months ago, they gave me a shot of penicillins and two other shots that I cannot remember.",
    "doctor_response": "Hello. Your tonsils are definitely infected. You need a course of antibiotics, decongestants, pain killers and good gargles. Additionally, we need to have a look at your nose to rule out if there is any rhinitis or sinusitis that is triggering the tonsil infections repeatedly. I would suggest a Z Pak 500 mg for you take it for five days one tablet once daily. If that is not there get Claritin. Take Sudafed and Deslor (Desloratadine) once a day. Get Benzydamine gargles and mix it with water and gargle thrice. Take Tylenol (Acetaminophen) as per pain. Since you are saying you got thick post nasal drip I would suggest some mucolytic and nose drops as well take it for four days. Otrivin and Mycinex would do. Once the current infection subsides I would want you to get a nasal endoscopy and CT (computed tomography) scan of nose and PNS (paranasal sinus) to rule out sinonasal problems. Do revert back for further help and guidance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes epileptic seizures while on creatine supplements?\n\nIs there any link between epileptic seizures and taking creatine supplments? My son, who was diagnosed with epilepsy at 16 doesn t think so, but as a mother watching him take this supplement and documenting when he has had seizures my gut tells me they are related.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. No creatinine supplementation may won't cause seizures. Few studies and journals say's that creatinine supplementation may decrease the seizures frequency and creatinine also useful in maintain of cell membrane stability. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain with temperature?\n\nI suddenly developed diffuse lower abdominal pain x 5 hrs ago. + low grade temp. 100.2 and chills. Passing gas and last BM 2 hrs ago. Should I wait it out or seek medical attention. I ate breakfast around 10 eggs, wheat tortilla, avocado and tomatoes. Made a cake around 1pm and took a small taste of the batter.",
    "doctor_response": "Hi.Thanks for your query.Pain in abdomen with fever and BM= this is sure an infection in spite of what you have taken.You should not wait; you should seek medical attention. A clinical examination by a Doctor can know better than to wait and go into complications.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting after having soy milk?\n\nMy six month old son had a very raspy chest and vomited alot up to the age of 4 months when i changed him to a lactose free formula. I can always tell if he has had lactose because his chest will become raspy again but i have tried him on a little bit of soy milk in his cereal and he has reacted to that. Just confused as i thought soy didnt have lactose in it. The only ingredient i can see that he might have reacted to is calcium phosphate. Should i get him tested to find out the exact intolerance as he becomes very upset.",
    "doctor_response": "Hi, welcome to HCM. A 4 week baby with rapsy chest on taking lactose milk formula is definitely an allergic reaction. This could be cow milk allergy. The fact that it also appears on giving soya milk, has made us to think of some other allergen than lactose. Calcium phosphate usually don't cause allergic reaction. I advice you to change the brand of lactose free milk and if this problem still persists then get a complete blood count with esr levels and ige levels in blood. Further treatment will depend on above reports. Revert back with above reports and exact weight of child. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back and abdomen pain?\n\nhello I m 10 weeks pregnant... Yesterday i felt pain in my lower back and lower abdomen without any bleeding then had an Ultra sound scan done. The scan discovered a Substantial Peri sac collection (14mm depth) noted. What is the cause of this and how can it be treated?",
    "doctor_response": "Dear patient You have got collection in your peritoneal cavity that might be due to trauma  to your abdomen.  Your ultrasound  is not indicating about status of fetus.  You need to consult expert obstetrician around you and get yourself  examined. Since there is collection in abdomen your baby might be affected. Do not neglect this and take visit to your doctor asap. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for mental health problem\n\nI am very shaky, almost like anxiety in my chest , arms and legs. not in the morning hours, but after I get home from work. I am wondering if temazepam could be responsible for this. I take 30 mg each night. I have severe sleep apnea, I use a cpap machine, also, I have copd",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern if you have a history of sleep apnea then it not advisable to continue any medicine for anxiety and depression because this medicine could flair up the problem of apnea, it is better to control your thoughts and keep the stress level very low, hope this information helps you, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump under the penile skin?\n\nHello, I have found a small lump under the skin of my penis, positioned where the frenulum is. It causes no discomfort when urinating or during intercourse.I can move the lump around but it stays in this position all the time. I was also circumcised in my infancy.Serious?",
    "doctor_response": "Hi,Dear thanks for the query to HCM virtual clinic.I studied your query in full details updated from you.I understood your health concerns.I reviewed your data and In my opinion the You seem to have lump of the skin from the friction of the frenulum with bruise / or it could be from Viral Papilloma(HPV virus)/ or it could be just a loose skin-Sentinel Skin tag at the frenulum, which remained after Circumcision surgery in your childhood.As it is without any complaint,and noticed Now by YOU accidentally you should just neglect it.I would advise you to consult ER Surgeon on this for a Second Opinion, on this Sentinel Skin tag at the frenulum of the penis.If you could send the picture of it,I can help you out more.Hope this would help you out for the long run.If it worries You Plan the surgical corrective excision at the earliest.Hope this would resolve your query.Welcome for any further query in this regard to ME.I would love to help you out.Awaiting for any further query.Wish you fast recovery from this intriguing health problem.Have a Good Day.Dr.Savaskar M.N.M.S.Genl-CVTS -Senior Surgical Consultant",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does whitehead on nipple area of an infant means?\n\nI have a 4 month old baby girl with what appears to be an infection (looks like a whitehead for lack of a more precise description) in one nipple area.  There is no redness and she hasn't had any fever.  Do we need to do anything to address the issue?",
    "doctor_response": "As far as there are no symptoms you need not worry. but you have to keep the baby under observation, and if any symptoms like oozing of pus or any itching develops then you need to take her to a qualified dermatologist.till then keep the baby neat with daily baths and powdering.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can taking Nutrolin be safe for increased temperature and stomach discomfort?\n\nHello, My baby is facing a problem of stomach problem with increase temp specially in Palm & lower foot area. It might be because of hot climate. we have given him Nutrolin b syrup. Please let me know what could be problem and treatment. Thanks",
    "doctor_response": "Hi...it could be a viral illness. Please do not think it is fever unless you have checked the body temperature and the thermometer is showing more then 100 degrees Fahrenheit. Regarding Nutrolin-B, it is a pro-biotic and you need not give it unless the kid is having diarrhea.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best medicine for fatty liver?\n\nDear Dr.,My Dad gets his Sonography done 4 days back and his report is normal except the increased fatties on ' Liver'.So after that our family doctor (MBBS) suggested him 'HEPAMERZ' tablet twice in a day for 30 days.I need your help, whether he's given him the right medicine for increased fatty liver.",
    "doctor_response": "Hi, How are you?Fatty liver can be caused by excessive alcohol intake (Alcoholic steato hepatitis, ASH) or due to excessive fatty food intake and sedentary life style (Non-alcoholic steato hepatitis, NASH). ASH is usually the beginning stages of alcohol induced liver damage and is completely reversible if the patient refrains from alcohol. NASH is being much more commonly diagnosed currently owing to poor dietary habits and sedentary life styles of people. High caloric intake, high fatty food intake and poor exercise regimens lead to deposition of fat goblets in the liver tissue leading to fatty liver (which shows up as increased echo texture on USG). This is also completely reversible in the initial stages if caloric intake is limited and exercise regimens are adhered to. If left un-checked, patients usually become obese, diabetic and in final stages may lead to cirrhosis of the liver which will necessitate a liver transplant.I would suggest a healthy diet and exercise regimen. Although there is no time limit on when to get a repeat scan, I would suggest one, once your dad has succeeded in losing some weight.Hepamerz is supposed to be protective for the liver. It does no help in resolving the fatty liver but MAY protect the liver from undergoing further damage.Hope this helped and please do not hesitate to contact me for further details - rxsuresh@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Flagyl for gland infection after root canal. Healing time?\n\nI amon 500 mg Flagyl for an infected gland after a severe root canal .....tooth was ok however the root was soooo infected. I was on penicillin for a week, now this. It feels like it is healing, however I feel so sick this second day. How long will this last, as my body adjusts, or will I suffer for the 2 weeks I am on this antibiotic? Thanks",
    "doctor_response": "DEAR FRIEND. Thanks for sharing your concern. penicillin along with flagyl (metronidazole) is usually prescribed during root canal treatment,as it takes  care of both aerobic and anaerobic infections very well.this is very much required in cases of root canal treatment. In your case, if you are not finding comfortable using this combination then you can visit your dentist and another set of antibiotics can be prescribed for you,like augumentin or cephalosporins etc. Need not worry, you will be fine once your root canal treatment is completed. you will be problem free. There are no nerves left in the tooth, to cause you pain after root canal,so relax,it will get over. Meanwhile,if you wish, you can visit your dentist regarding the discomfort faced by with the present set of drugs and ask for a newer combination. Also do frequent warm saline rinses and maintain very good oral hygiene.this will help you in reducing oral infection. hope it helps .take care.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed a tiny hole popped up on my finger and on my penis\n\nI notice a tiny hole popped up on my finger surrounded by hard dry skin. No pain or irritation.  Now the same holes (looks like pinholes) just popped up on my penis. Two of them adjacent to eachother??? I'm going to see the doctor but just curious of what it is",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern, your given history is very unusual because if this is allergic condition then this should be generalized and not the local on just finger and penis, this could be non specific type of skin lesion and that would go away soon, still the clinical examination is the only way that can clear every thing, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is severe body pain rashes and throat infection related to chicken pox?\n\nhi actualy i got an oppurchunity to join in a leading mnc its on monday but yesterday i got a severe body pain and then lite throat infection and today morning i Consulted a doctor and i got some tretment now my body seems to be normal no temprature anything but some rashes appeared nearly a dozen yesterday i got two or three now its more than a dozen before two weeks one of my room mate got chicken pox he is not with us now we send him home once he infected is that a chiken pox can if it is like that then how can i join on monday because monday is my only option",
    "doctor_response": "Hello ,I understand your concern. I am Dr. Arun Tank, infectious disease specialist, answering your concern.Yes it is likely that your infection is because of chicken pox.I advice you should also not join the MNC right now. You can inform regarding your case to them. Also submitt the certificate of illness to them and inform them regarding your probable joining.Please take the cefixime and paracetamol under your doctors guidance. It will prevent secondary infection and it also prevent the fever to comme in action.Please maintain the cleanliness as it also helps in clearing the infection equally as a treatment do. You can  apply calamine lotion on the rash, it also helps relieves the condition.I will be happy to answer your further concern you can contact me here or you can contact me on bit.ly/DrArunWe wish you a best health at healthcare magic. Thank you,Dr. Arun Tank",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for indigestion, weight loss and tiredness\n\nI have an 18 year old son who has suffered for about 3 years with mild indigestion because he eats really fast and over the counter stuff has always worked. The last 2 to 3 weeks the over the counter stuff is not working and he has lost weight and is very tired. He also coughed up some blood 2 days ago. Any ideas?",
    "doctor_response": "HI Dear Welcome to the HCMHe needs to be detailed  investigated for some chronic disease to be done by the physician, Like Tuberculosis etc.Hope the query is answered.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden cold and stuffy nose in an infant?\n\nmy 1 month old infant suddenly develops cold like symptoms,stuffy nose,mucus production,it affects his sleep at night where he starts yelling like he is about to choke,his ped says it is not a cold becuase of the absence of mucus in his lungs and no fever. could it be rsv or is this normal for his age",
    "doctor_response": "nasal block is a common problem in infants.it causes discomfort in sleeping or feeding.you can try using saline nasal drops 1 drop in each nostril when the child has noisy breathingyou can also use nasal mucus aspirator.steam inhalations with a baby steamer are also very helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can induced asthma, dry cough with difficulty sleeping be treated?\n\nMy son, who has exercise induced asthma, has had a significant chronic dry cough for several weeks. I have taken him in and he was put on prendazone. It did not do any good. He has an inhaler which does not do any good. We are a very smoke free environment. I have bought him a new pillow reduce allergens as much as possible. We are very health conscious... He is having a hard time sleeping and is disruptive in school...",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your son's history and would like to know more about him as follows:a. what is his age? b. since when has he asthma and allergies? c. what are his nose symptoms? congestion? running nose? sneezing? d. any skin/eye symptoms? e. does he headache/facial heaviness/recurrent throat clearing? f. any regular inhalers? g.which inhalers have you used, what dose & frequency? h. did he have fever at onset? i. any investigations? allergy testing? etc etcAbove details would help me to know his problems better and therefore to make ore specific suggestions for him.At present, from your provided history, I would like to make suggestions for him as follows:1. If he has nose symptoms, I would prescribe him levocetirizine + montelukast for 7-14 days, depending upon response.2. I would also suggest him regular warm saline gargles which will help early recovery of his throat.3. If he has difficulty in sleeping due to nose congestion, regular steam inhalation will also help in addition to above treatment.4. If he has coughing associated with wheezing/breathing difficulty, I suggest my such patients to use rescue inhalers such as salbutamol or levoalbutamol.5. For better management of asthma, spirometry with post-bronchodilator reversibility testing and post-exercise testing as well as allergy testing for common air-borne allergens are useful. Spirometry will help to know his lung capacity, whether he requires regular inhalers and what type of inhalers. Allergy testing will help to identify the substances causing allergies to him as well as whether he could be benefited from allergen specific immunotherapy.6. As you are living in a smoke free environment, it is very appropriate for children having asthma.7. After recovery, regular physical exercise (including breathing exercise) as well as nutritious diet rich in vitamins & minerals will also help him to improve his lung capacity and immunity respectively.Hope above suggestions will be helpful to him.Should you have any further query, please feel free to ask at HCM.Wish your son a very good recovery and a very good health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get pregnant?\n\nHi, I went to see my gynecologist on Monday and injected me Fostimon because I am trying to conceive, I went to see him yesterday, wednesday and injected me Choriomon which he said to give me a high chance of getting pregnant cus I will be ovulating soon after giving me clomid . My husband is out of town and will be back on Friday. I want to know if this will really give me the high possibility of getting pregnant?",
    "doctor_response": "Hello, choriomon injection causes ovulation within 36hours and couple should have sex for consecutive 3days then there are very high chances of getting pregnant.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can my grandson continue playing sports with a hole in the heart?\n\nMy grandson who is 12 was just diagnosed with a hole in his heart and an enlarged right heart ventrical. He s very active in sports. He s seeing a pediatric cardiologist on 1/3/12. Should he be playing any of his sports right now? What do they do to correct this?",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!Regarding your concern, I would explain that straining physical activity is not recommended in this clinical situation, as it may lead to progression of the enlargement of the right ventricle. I would recommend avoiding sports up to the correction of this defect. It can usually be repaired with opened heart surgery or with endovascular treatment, which is mini-invasive. You should discuss with his doctor on the above issues. Hope to have been helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the lump on the back of my lower gum?\n\nYes, just resently  I knowest a lump on the back of my lower gum (Teeth) sort of sided ways.  I have an exceptionally small mouth and have never had one wisdon tooth.  I am in my fifties.  the lump is roundest and hard.  What the heck?  It's sort of tender if I touch it, but not unbareable.",
    "doctor_response": "thanks for your query, i have gone through your query, the lump could be because of an impacted tooth or infected gum....consult your oral physician and get a radiograph done to rule out impacted tooth and infection associated with it...take a course of antibiotic and analgesic.. do saline gargling.... i hope my answer will help you..take care..",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure mouth ulcers?\n\nI have been suffering from mouth ulcers from last two months. These ulcers start automatically any time day / night and become big (inside mouth any part, not on single place). I am not sure the reason about this, i taken some medicine suggested by my doctor, i visited to 5 doctor, ENT Specialist too, but nothing works, neither mouth paint, cleanothrush, Tees, etc. I am worried why these coming, even nowadays there is no problem of stool etc, i left smoking two months back and also not taking any other things (Alcohol, Tobacco etc). Please suggest what i need to do or to whom i need to consult, is it Oral CA, but i also found on internet Oral CA Ulcer come on side not every where.",
    "doctor_response": "Hello,Mouth sores that reoccur are often viral.  Stress can bring on an episode and repeat. Have your mouth sores been tested? Simple swab, biopsy, etc.? See a specialist such as an oral surgeon. Visit a dental school or a dentist with a greater interest in oral pathology.  You seem to still need more diagnosis. Systemic conditions are known to be associated with mouth sores such as HIV/Aids.  Testing is critical to determine normal ranges and overall health. Your genetic history and family illness history may offer clues. Are you compromised? There are auto immune disorders. Students stressed can have Mono. Travel lately? Unusual exposure or diet change? Keep asking many questions.A history of Measles can later appear as Shingles. Mouth sores can be included in Shingles. Virus exposure history helps diagnosis.Having an association with another carrier of a virus such as Herpes can cause repeat reactions.Changing routines, limiting exposure and getting rid of items that might carry a virus are all good actions. You seem to have tried many actions. One other consideration is an allergic reaction to your dental care products and make sure you have ruled this out. Try changing toothpaste or rinses. Flavorings and other ingredients  are known to cause reactions. Symptomatic treatment with pain medication, rinsing warm salt water, avoid irritants and time passing is the best advice for now. I try to provide questions to help you think  and you have the option to visit other doctors for continuing clinical evaluation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent back pain\n\nI am a 47 year old female , I hurt my back a year ago , off and on all year it hurt. but now for two weeks it has been nothing but pain, shooting , stabbing, when I cough it hurts. I had rectal surgery three years ago , I was constipated a week ago and I thought that is why my back hurt. it is hurting like it did after I got this surgery. ?",
    "doctor_response": "Hello. This isn't from your surgery or from constipation.  It sounds like it's a disc problem in your lower back and you need to ask your doctor for an MRI scan of the lumbar spine to check for that.  If that's the case, proper physical therapy can help with the pain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My ALP increased to 278 after stopping Udimarin Forte. Should I be worried?\n\nHello doctor, My 54-year-old father had been operated for gallbladder 14 years ago. Since then, his liver enzymes like SGPT and SGOT remain at 55 and recently his ALP was seen 140 and GGT at 79 which became normal after taking Udimarin Forte tablet. After stopping the medicine, the ALP again increased to 278. He takes Thyronorm 75 mcg for hypothyroidism and Cilacar 10 mg, a BP medicine. For triglycerides, he takes Rosumac F which got changed to E-Cod Plus. He also has a deficiency of vitamin D and takes Uprise-D3 once a week for that. He does not have any symptoms now but before sometimes he complained bitter taste in the mouth in the morning which went away after taking Liv.52 DS which he currently takes. He is a nondrinker and a nonsmoker. Is there anything to worry? Please help.",
    "doctor_response": "Hello. There is nothing to worry. Possibly, he has mild fatty liver because of which SGOT (serum glutamic oxaloacetic transaminase) and SGPT (serum glutamate-pyruvate transaminase) are mildly elevated. However, the ALP (alkaline phosphatase) is elevated in either obstruction of the bile duct or due to bone disease like vitamin D deficiency which he has.  I would still suggest an ultrasonogram of the abdomen to look for fatty liver and CBD (common bile duct) anatomy. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pins and needles in hands and legs, vertigo symptoms and increased heartbeat. Weaning off prednisone. Advice\n\nI have been experiencing vertigo-type symptoms for the past 5 weeks.  I also am having periods fast heart rate, and a pins-and-needles sensation in my arms, hands, legs, and feet.  I am getting incredibly frustrated because I have seen my primary, and ENT, and a neurologist.  I am not pregnant.  I had a MRI that came back negative for MS or any neurommas.  I have been on prednisone consistently for about a month now, and have been weening myself off.  Over the past 2 days, my symptoms seem to be getting worse (without the prednisone).  I don't know what else to do.",
    "doctor_response": "hi Constant dizziness lasting months is usually psychogenic, not vestibular. However, the physician must be clear on what a patient means by \"constant.\" Some patients who say they have constant dizziness for months actually mean that they have a constant susceptibility to frequent episodic dizziness; this can be a vestibular problem. Headache, photophobia, and sonophobia suggest migrainous vertigo. Most patients with migrainous vertigo will also experience visual aura in at least some of their attacks. Shortness of breath, palpitations,pins and needle feelings and sweating may suggest a panic attack, but true vertigo is often so terrifying that such symptoms are not uncommon with vestibular disease. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to cope with post-holiday depression?\n\nHello doctor, I am a 20 year old\u00a0female. I live in really good standards. But, I have been suffering from apathy and depression for four years and took five different medications namely Salipax, Cipralex, Cymbalta, Zoloft\u00a0and now Prozac, which seems to be working. The first time I experienced depression four years ago was when I traveled and had a really amazing time and cried a lot when it was time to go back home. I really cried like never before for two days before our traveling time and I slept and woke up with depression. I do not know why I was so terrified of going back home, I really do not. All I knew is that I wanted this amazing feeling to last. It was a religious place where I experienced peace. Now, I am out of town for the fifth time after that trip but, this one is different. I had this feeling again. I started crying really bad and want these moments to last and not go back home. How do I deal with it this time? I want my trip to give me energy for what is coming. I do not want it to happen again. Please tell me how to deal with these thoughts and feelings.",
    "doctor_response": "Hello. I can understand your concern. I hope this helps you. Thanks and take care. For more information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible for the ankle to hurt all of a sudden having a plate and screws inserted few years ago?\n\nI broke my right ankle almost 13 years (2001) ago and have a plate and six screws in it. I woke up yesterday 4/13/14 with some pain in that area. If i cross my right leg onto my left or put pressure on the area where the plate is, i have pain. I did not injure myself, twist it or fall. Is it possible it would start to hurt all of a sudden?",
    "doctor_response": "Hi You were operated 13 yrs back and plates and screws were inserted in your ankle. It is generally not likely to have pain after such a long time. It is possible that you might be wearing tight shoes or may have abraded your skin in the region of plate.It is also possible to have radiation pain from back. Take pain killers for a few days and if the pain does not go away then go for an x ray and orthopedic opinion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever and vomiting in a child?\n\nHI, had to take my 6 year old son to after hours clinic because fever went to 104.5. He has been running 103 the last few nights and threw up one of those nights. They tested his urine and said it was really high in ketones and noticed some protein. She said have him drink plenty of liquid as he must be dehydrated. He is 45 lbs. and is always sick. It used to be every other month, now he is sick every other week. HIs father was diagnosed with Diabetes at age 8 and has taken insulin shots ever since. We tested his white and red bloods cells and platlets and that came back fine. Last time his sugar was tested it was normal. We are just worried because of him being so sickly. Please help! Thank you.",
    "doctor_response": "Hi,But by what you say I feel that your son is having recurrent viral illness. This need not be attributed to the Type 1 Diabetes his father is having. I will explain you how a viral illness behaves so that you can be more confident. 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 to 7 days. So do not worry about duration if the kid is active.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in back after an injury?\n\nHello, Today I was playing a game of frisbee with friends. Me and a friend both went to catch the frisbee at the same time and did not see each other. I jumped in the air, he knocked out my legs and I landed flat on my upper back. The wind was knocked completely out of me and I could not breath for a few seconds. I also made a very harsh exhale sound as I was trying to breath that I could not control. I was able to get up and walk around. After I sat out for a while I was able to play again at a very limited level. I have put ice on my back, but I have a constant dull pain on my spin directly between my shoulder blades. It hurts to tilt my head up and down. It also hurts to lay down in bed. My question is, will this get better with ice and rest, or do I need to seek medical attention? Hoq=w serious is this?",
    "doctor_response": "Dear sports injuries in young are common and most are not severe. In your case injury of thoracic region of spine is present. As this region of spine is well stabilised by ribs the likelihood of vertebral collapse is very low. Moreover you have not developed any limb weakness or urinary complains or respiratory distress. To me it doesn't seem to be injury of concern . For treatment you can use local analgesics ointment some pain reliever and rest. You need to consult a doctor if severe pain, respiratory complains, limb weakness, bony prominence over spine appears.  Hope you recover early.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for back pain?\n\nI fell off my horse about 3 weeks ago. I landed on my back and am still in a lot of pain. Went to the Dr. They gave me vicodin and Motrin. Took X-ray but I haven't received the results. Assuming nothing is broken, just bruised. How long before the pain subsides?",
    "doctor_response": "You mst be having jst muscular pain in back. I suggest you to take ultracet tab myoril 4 mg and pantoff D twice a day. As well continue back physiotherapy wid hot fomentation n short wave diathermy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the possibility of pregnancy if we had sex during periods?\n\nHello doctor,I had sex with my partner during her menstrual cycle and she abruptly stopped bleeding few hours after intercourse. Though I did not use a condom and did not ejaculate inside but, to be on the safer side I convinced her to take an I-pill after 48 hours of intercourse. What is intriguing is that her period has not started yet and she is late by three days. What is the possibility of her getting pregnant in this scenario?",
    "doctor_response": "Hello. I understand your concern. Although sex during menstruation is not advisable due to hygienic purposes, it is considered a safe period during which pregnancy cannot happen. My advice would be to check using a preganacy test and practice safe sex (you can use condoms). For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling on lips\n\nI am 79 years old. I have what feels like a swollen lip inside my mouth.  It is not sore. When I rub my tounge over the area it feels rough like rigdes (not bumps) It seems to  be more noticeable with some foods, such as peanuts and lemonade.  This has been noticeable for more than a year.",
    "doctor_response": "Hi there!seems to me thatThank you for your question in HCM.is aIt seems to me that you might have an allergy to certain foods like peanuts and lemonade. You also might have had these allergies since sometime, but might have noticed it now. If possible, do try to undergo what is called the allergy test, wherein they will diagnose the allergen (food or chemical) to which you are allergic to. That can give you a general idea as to what foods/ items need to be avoided. For an acute episode of allergy, you can take an antihistamine, like Cetrizine 5 mg, which should stop the swelling in your lips.Hope this helps.Cheers!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes involuntary shaking of legs and hands when sad or happy?\n\nhi doctor, whenever there is a situation causing extreme happiness or extreme sadness around me , my hands, legs lips and eyes start shivering along with that the fingers of my hands are locked which get again in the normal position after few minutes . i have consulted a doctor who says that i am suffering from vitamin D deficiency or hypocalcaemia. earlier my serum calcium level was 5.9 but now it is 9.1 (normal) but my knees have also started paining while going up through a stairs. so my question to you is that this problem of locking of fingers of my hand is due to calcium deficiency or not. thank you",
    "doctor_response": "Well please check serum electrolytes apart from calcium level.If it is happening with all investigations being normal and mostly in emotionally arousing states then psycological factors are playing important role.A mental health professional can access you regarding this sensitivity or associated nervousness & address the issue.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes electric shock feeling in the arms?\n\nI have these electric shocks from my shoulder to my elbow but sometimes to as far as my end of my hand. They usually last less then a sec and I ve had them for about 2 months. I only feel it in my left arm. The 2nd time I ve ever had it, I remember laughing and holding something in my left hand, then it shot up my neck down to my hand making me to drop my item. As a child, I played piano and my left hand had always been weaker than my right hand. When I work out my arms, I more likely have one. What exactly is my problem and how can I solve it?",
    "doctor_response": "Hi, It can be due to neuropathic pain. Consult a neurologist and get evaluated, you have to go for a nerve conduction study for further assessment. Wishing you good health. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower abdominal pain, constipation, diarrhea, back pain, fever, headache, rash. Have fatty liver\n\nI have lower abdomen pain . I have constipation ....sometimes I have diarrhea ,pain in my back have fever headache Itch rash .. bloating gold dark burning urin . My urinalysis came back as Bacteria an Mucus.in my urin..allso my WBC said accasional RAC is Accasional Epithelial says Fue ... I have fatty liver.. my Blood test AST 63... My ALT was 147. I have a 7mm accessory spleen. Please tell me what s wrong with my body...",
    "doctor_response": "Hello ,Thanks for the query to H.C.M. Forum. After going through your query it seems that all these symptoms may be due to ,1  URINARY calculus and diagnosis can  be confirmed by ultrasound  of both kidneys with urine culture and sensitivity test . As you are complaining that golden brown color of urine is  passing so this may be due to renal stone or kidney infection. 2 Pain in the lower abdomen , back ache diarrhea , constipation all may be due to disorder in large intestine , so for this get in colonoscopy  of lower abdomen and consult a physician and get his opinion . As  A S T & A L T , values are not so high so non-specific need not to worry. Accessory spleen is so small size and may be congenital so no value. Consult a physician and get his opinion. Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recurring acne, have undergone various treatments but in vain. Effective remedy?\n\ni suffer acne problem for so long almost 3 years already , i undergo different solution to treat my acne such as facial treatment , dermatologist etc. but to no avail, its always appear again i dont know how to treat already i feel so disappointed and it lower my self esteem since my work is to interact with other people so embarassing especially if someone ask me what happen to my face ... im glad you give me an answer.. thanks",
    "doctor_response": "Hi...dear melds., Thanks for choosing HCM.., ACNE VULGARIS... it is infection of.., Pilosebacous unit caused by bacteria.., due to Hyperactivity of Hormones.., common in Ur age... Follow up is very important... Once again Use these drugs.. Umay get good result ok.., 1) Tab Isotretinoin..20 mg for 2 months.., give 2 months spacing again use same drug.., for another 2 months.., 2) Topically Clindamycin 1% cream night times.., 3) Morning use..SUNSCREEN LOTION.., 4) Tab..Azithromycin 250 mg daily for 5 days.., ok....good luck.,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes decline in voice quality after radiation therapy for vocal chord cancer?\n\ni had radiation therapy in july and august of this year for vocal chord cancer  6 weeks after com pletion my voice was almost back to normal   Since then it has been back downhill and sometimes it is almost impossible to speak    My throat doctor has checked me out and says everything is fine    no cancer and chords moving why would my voice get better and then steadily worse",
    "doctor_response": "HI THANKS FOR YOUR YOUR QUERY.THE ISSUE WHICH YOU ARE CURRENTLY EXPERIENCING IS SECONDARY EFFECTS DUE TO RADIATION THERAPY.RADIATION CAN DAMAGE THE NERVES SUPPLYING THE VOCAL CORDS AND OCCASIONALLY VOCAL CORDS TOO.THIS CAN IMPAIR THE QUALITY OF VOICE SERIOUSLY.AS YOUR DOCTOR HAS ASSURED YOU THAT NO NEW TUMOUR HAS DEVELOPED ,THERE IS VERY LESS FOR YOU TO WORRY ABOUT.IT WILL TAKE MONTHS FOR THE VOICE TO RECOVER DEPENDING ON THE QUANTITY AND QUALITY OF RADIATION USED.HAVE REGULAR PERIODIC EXAMINATIONS OF THE THROAT.STAY IN TOUCH WITH YOUR DOCTOR.YOUR VOICE MAY IMPROVE BUT MAY NOT REACH ORIGINAL QUALITY AND TIMBER.THANK YOU",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cancerous cells in the stomach lining\n\ni was diagnosed with gallbladder cancer 12 months ago. The gallbladder was surgically removed and the pathology was T1a stage. Now one year later a tumor was recently discovered in the lining of my stomach directly below where the gallbladder was. If the cancer gall bladder cancer has metastasized what stage would the cancer be at this point?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.At the time of diagnosing, the stage was T1 only. After a gap of 12 months, tumor might have recurred in that area.So, the tumour grade was upstaged. Now, the stage may be M1. My suggestion is please visit oncologist for management.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Siddartha",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be done to to overcome the indigestion / lump issue?\n\nI'm in the process of getting a tooth abscess completed, the temporary is in-place adn I go back in 5 days for the permanent. I'm taking antibiotics and ibrophen, but now I have a feeling like there is a lump in my throat and a little chest tightness. Seems as though I might have some indigestion, but never had these symptoms before. How can I help the indigestion / lump issue subside?",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,   I have gone through your query, as you have mentioned that you have abscess in your tooth for that you have to go through , Root canal treatment, if you have complete all your appointment of RCT now you are taking antibiotics ,may be you are allergic to that drug you are taking thats why you have indigestion and feeling of lump in throat ,   Dont worry you do Warm saline gargle two - three times a day   Consult your dentist for medicationHope this will help you.  Wishing you good health Regards   Dr. Priyanka tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pelvic pain while blowing the nose?\n\nHi, this morning when I woke I went to void. While voiding I blew my nose and had immediate sharp pelvic pain, when I wiped there was some bleeding, not bright red. I have had the nexxplanon since March and have yet to have a period, but I have had about a 25lb weight gain. Today when I voided there was an uncomfortable pain and once again there was blood. I also could feel a bulge on the bottom part of my vagina.",
    "doctor_response": "Hi! Good morning. I am Dr Shareef answering your query. If I were your doctor, I would advise you for a serum HCG test, and an ultrasound of abdomen to rule out an unsuspected pregnancy. I would also advise you for a gynaecological check up to rule out any pelvic pathology. Further management would depend on the reports.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain, appetite and digestion problems?\n\nToddler seems to have pain at night and is inconsolable. Has had eating issues, still on formula and not much in the way of solid food. Did swallow study (she aspirates, upper GI (showed reflux but otherwise everything normal), slow gastric emptying test (digesting food properly). had a scope (everything working normal), had celiac test at 6 months(no issues), allergy tests (showed nothing). She is showing signs of pain, waking up a few times in the night and will cry for up to an hour. Doctors can t seem to find any issues.",
    "doctor_response": "Hi...I feel it could as well be a worm infestation. Why don't you test her stool for parasites and eggs of them.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tiredness and delayed period when trying to conceive?\n\ni m a 26 years old women and an advocate. we are planning for a baby for last 2 months. but did not succeed. before trying for a baby i had normal period no sickness etc. but after planning i fill very tried before my menstrual period. last month my period was 7 days late before last month i had a regular period. m taking folvite as suggested by my doctor.",
    "doctor_response": "Hello,Thanks for writing to us. Followings are my comments:1) Pregnancy depends on proper timing of ovulation & unprotected sexual intercourse. Ovulation occurs approx 14 days before next due date in regular cycle. 2) Late period may be due to hormonal imbalance, mental stress, ovarian cyst, weight gain, irregular diet habit, thyroid disorder, pelvic infection etc.3) Above conditions should be ruled out and you need to take Progesterone pill (D16 to D25) to regularize cycle.4) Ovulation prediction kit should be used in this context to predict ovulation and you should prepare for that day for unprotected sexual intercourse. 5) You would need to do this for at least 6 months to 1 year to make sure that you have given the natural process a chance. 6) Vitamin E, Zinc and folic acid supplements are very much helpful in improving fertility and chance of pregnancy.If with the above procedure, you fail to conceive, then you may need some initial investigation to narrow down the possibilities. These include:1) Fresh semen analysis for husband2) Ultrasound pelvis to check reproductive organs grossly.3) Hystero salpingography (HSG)-for tubal patency test.4) Hormonal test-thyroid profile, LH/FSH, Oestrogen & progesterone level.5) For ovulation- Day 21 progesterone level assay or serial ultrasound on day 12-16 for follicle measurement.6) For cervical factor- Post coital test & anti sperm antibody test.7) Blood sugar (PPBS) etc.Hope, it will be helpful for your information. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why my teeth is getting loose and falling? Taking crestor, tiazac xc and metformin\n\nlv had 2 back teeth loosen and simply fall out,,lm on crestor,,tiazac xc  and metformin,,,my blood/sugar averages 5. to 6.5 and my blood pressure runs about 134/70,,l cant understand why why these teeth fell out,,,my next doctors visitwould be in the new year..",
    "doctor_response": "Hello, thank you for sharing your problem with us. As you have mentioned that you are taking these medication they does not cause any loosening of teeth, but you are diabetic this can lead to your problem of loosing of teeth.Actually since long time researches are going on which proves that diabetes is related to periodontitis (inflammation of tooth supporting structures) and when then is inflammation of gums there will be loosing of teeth. It will be much better that you visit your dentist and get cleaning of teeth done regularly, it will help you in maintenance of your oral hygiene.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for infertility in men?\n\nhi i m sam.28 years old.unmarried. my testical r smal in size.calcium oxalet comes out in my urin.my sperms are 40% activ.my body is being week.i use to b masterbution.my hairs are faling.my memore is being week.my girlfriend is not setusfied by my sex.",
    "doctor_response": "Hello,There are certain things you need to do to improve your sexual life. Take your daily vitamins like D, E and C along with regular exercise. Wear loose fitted boxers, avoid tights. If you still facing issues after doing all these measures then I suggest you to consult doctor for a possible sub clinical infections in your genitals. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Sameen Bin Naeem, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What precautions to take when flying with a three month old baby?\n\nHello doctor, I want to fly with my three-month-old infant. What are the precautions to be taken while flying? Should I carry any medications with me?",
    "doctor_response": "Hello. I have reviewed your query and can understand the sensitivity of the situation here. If your infant is on no medications right now, has no allergies, or disease, there is no need to worry about. No special precautions are needed in that case. I would recommend Acetaminophen (Tylenol) to be kept with you in case the baby needs it for any reason. Otherwise, nothing much is needed. The flight safety precautions can be obtained from the airline website and it would be better to get a bassinet for the baby. Hope it helps. Feel free to ask me more questions if you need further assistance. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes habit of picking lips?\n\nhi i have a question i am a 22 year old female and i have a BAD habibt which i always pick my lips for example hen they are dry i keep picking even if the blood comes down i can stop i been like this since i was like 12 yrs old  but the last 5 years its beeen so much worst that everyone notices me and always tell me to stop so my question  iis do i have a mental health problem or wat thats what people tell me.oh ya i can like pick for 2 hours too. thanks for your time",
    "doctor_response": "Hi dear. I had gone through your query. I understnd your concern. Lip picking or skin picking may indicate impulse control disorder.Or it may be part of obsession or OCD spectrum. Need detail evaluation by psychiatrist. It can be treated with psychological method called habit reversal and by drug therapy.SSRI can be useful in impulse control disorder. But before that consult psychiatrist and gget help. I hope I have answered your question. Still if you have a query then feel free to ask. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will frequent masturbation cause hair fall?\n\nhello i just want to ask that i masterbate every 4th day or some times after a month , does this effect in fertility , as am losing my hair for this , in my family there is no baldness symbol , doctor gace me , a medicine for hair , but sites say that this will effect my sex harmone ,,,,,, plz guide regarding masterbation and hair",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. 1. Take good nutritious diet full of green leafy vegetables and milk. 2. Frequent masturbation doesn't cause hairfall. 3. Take an iron supplement and vitamin B12 supplement once daily for 3 months. 4. Other treatment options are topical minoxidil and mesotherapy done by a dermato-surgeon. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the ill effects of smoking?\n\nhi i am 20 yrs. old...i smoke nearly about 3 yrs...and i started smoking weed,hash nearly about one year..In the beginning i think it is not bad...But right now i feel the side effects of smoking these things...i lose concentration..reaction times become slow...how i build up my concentrations and overcome these sideeffects?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Honestly speaking, smoking is the worst habit for humans. It affects all organs of the body especially lungs, heart, liver, kidney etc. It also hampers brain functions So in my opinion, you should enroll yourself in deaddiction center for smoking cessation. In deaddiction center, they provide counseling sessions, motivational speech and drugs to counter withdrawal symptoms. Don't worry, you will be alright with all these. Be positive and stay strong. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bruise and pain after an injury\n\nsteel beam hit underside of elbow and xray showed nothing although doctor couldnt turn my hand cause of the pain and bruising showed up 4 days later. This happened 5 weeks ago and my arm is really painful constantly and it looks like small bone is protruding at top of elbow",
    "doctor_response": "Hello, As of now, you can use analgesics/anti-inflammatory combination like aceclofenac/serratiopeptidase for symptomatic relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to travel after skull injury and bleeding in brain?\n\nmy friend has had a bad fall down a flight of 14 steps, he has a cracked skull and some bleeding on the brain, He was taken to hospital by ambulance, This happened 4 days ago, He was told that he can be discharged and can fly back to South Africa as soon as he wants to. He is still vomiting and confused, - is this safe",
    "doctor_response": "Traumatic brain injury.Needs observation till resolution of bleed or hematoma.Even discharged vomiting and confusion are not a good signs. To be decided whether really signs of intra cranial hypertension are still persisting secondary to hematoma or whether is resolving or expanding and to take a decision accordingly for a repeat ct brain.Traveling is very unsafe at this stage.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain, overweight. Have Neuropathy. What is wrong?\n\nI have Neuropathy real bad and am looking for Dr. Michael Brady in Topeka, KS.  I understand he is a doctor that is very good.  I also have lower back pain.....200 lbs over weight and am in very miserable condition.  Could you tell me anything about Dr. Brady?       Thank you.   My email address is:   YYYY@YYYY",
    "doctor_response": "Hello and Welcome to HCM, Thanks for writing to us. The symptoms that you are having are likely to be due to a nerve root compression at the level oflumbar spine. You need to get an MRI scan of the area done and consult a neurophysician for proper diagnosis and treatment. You can search on net about Dr. Brady. Hope this helps you. Wishing you good health... Regards. Dr Saurabh Gupta.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fluttering and anxiety\n\nI am a 34 year old female who has suffered with anxiety for about 14 years. I have recently be having panic attacks and have noticed my heart \"fluttering,\" which concerns me. I have no pain associated with the flutters, but I obviously have concerns that there is an underlying issue. Is this normal? Obviously when I have the flutters it automatically kicks in my anxiety. Please help.",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and i totally understand your concern. But you should not worry.These fluttering sensation have to do with some electrical issues in the heart. Some electrical impulses that generate in a part of the heart different from normal sinus rhythm cause a premature heart contraction that you feel like a fluttering or skipped beat, because its not a normal one. These electrical issues might be different to simple sinus tachycardia, meaning frequency above 100/beat/minute to extra-sistolic beats or other arrhythmia.The extra-sistolic beats generally are followed by a pause till the next normal heart contraction. A sinus tachycardia means regular normal rhythm with high frequency that gives you the sensation like fluttering. If the rhythm is fast and chaotic than we are dealing with an arrhythmia like fibrillation ectIf this fluttering are not frequent, in Young and normal heart, it is nothing to worry about.There are different factors that might cause this fluttering/skipped beats like emotional stress, excessive coffee consumption , coca-cola or energy drinks, so you have to avoid them. It is quite known in medicine that anxiety, stress disorders might cause rhythm problems so you have to menage them.Pathology like anemia or hyperthyroidism might be other causes. So, if I was your treating doctor i would say that you have nothing to worry if this happen once a wile, its normal and we will try to deal with your stress disorder.But if they begin to bother you and interfere in your live, and as you say they trigger your anxiety we can decide to do some examinations like a blood analyze, your thyroid hormones, an electrocardiogram, echo-cardiography and of course a holter rhythm monitoring to have a full view of your rhythm and the extra-sistolik beat frequencies if any.Only than we can decide what we should do and if it is necessary to treat them medically.Hope I was helpful. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for leg pain\n\nI suffer leg aches and pains at night when in bed. They are relieved once I get up, but disturb my sleep. I walk an average of 10 kilometers most days. I am 73 yrs. old and have had by-pass surgery 5 years ago although I never actually had a heart attack.",
    "doctor_response": "Hii ,  Welcome To HCM & Thanks For Asking Your Query Here I have gone through Your query and will try to provide information you need on it As you said You walk almost 10 Km A day and your age is 73 years it is very likely that muscles of your legs are getting fatigue walking is good exercise for your cardio vascular health but along with that you should take proper balance diet including essential vitamins and minerals specially calcium You may Take Anti inflammatory Drugs Like Diclofenac with Muscle Relaxant like Chlorzoxazone to relieve pain , but it will only give symptomatic relief in your age it common to have leg pain after walking this much so in my opinion you should consult with your doctor and have an health check up done including some investigation for vitamin deficiencies (specially Vit. D3 , Vit. B12 )and Also serum calcium and Bone Density check up Apart From this you can follow these instructions to sooth your legs at home after walking -- Elevate your legs while resting- Consider an Epsom salt bath. Soaking your legs in a warm Epsom salt bath  can significantly reduce pain and swelling-Do some leg stretching- As  you're walking long distances, maybe the stress in your legs is due to muscle strain. so stretching will help -Change your shoes if they are ill fitting - Massage your legs can help alsoi hope this helpThanks again & Get Well Soon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having dizzy spells and experiencing pins and needles in hands. With past history of appendicitis. What could the problem be?\n\nI'm a 25 year old female nurse, only past medical history of appendicitis! Recently I've been having dizzy spells, I feel at times for example I've stopped the car but its still moving, I've been also experiencing pins and needles in my hands on and off and had 1 near faint! I'm wondering what it could be? I hate visiting the dr as I feel a fraud going thank",
    "doctor_response": "Hello, and thanks for visiting Healthcare Magic! Two of the symptoms that you describe (the dizziness and the episode of almost fainting) could very likely be caused by the same problem.  The list of things that can cause a near-fainting episode (referred to by doctors as pre-syncope) is long.  Two of the most common are dehydration and arrythmias. Dehydration is caused most frequently either by not drinking enough, or by losing too much water.  This type of loss can occur from diarrhea, profuse sweating (as in exercising in hot weather), or other reasons.  There is no set amount of water that everyone needs on a daily basis.  You should drink when you feel thirsty, or if you notice that your urine is dark in color (it should always either be clear or a very pale yellow color). Arrhythmias occur when the heart does not beat in its normal rhythm.  Some arrythmias are benign, others can be more dangerous, and some can even be life threatening.  One of the first things a doctor will do for any patient that has fainted, or almost fainted, is an EKG.  This allows us to determine if the electrical activity in the heart is abnormal, as would be seen in an arrhythmia. I recommend that you make an appointment with a doctor to be examined for this problem.  The 'pins and needles' in your hands are likely unrelated, and it's difficult to say without asking you a great deal more questions what could be causing this. I hope I have given you some useful information, and wish you the best of health. Sincerely, Dr. Kinney",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause back and neck pain, fatigued eyes and nausea?\n\nRespected Doctor Sir, when i start to work at kitchen , by an hour slowly my back neck having pain and slowly my eyes were tired , if i continue my work in this state i had head ache by an hour i cant to do anything. slowly i feel vomiting sensation and severe pain. please Dr. tell me what is wrong with me.expecting your kind reply",
    "doctor_response": "Hi,Thanks for posting the query,  I would suggest you to get a complete blood examination done, take blood test for thyroid.Also visit to a Physician and get physical examination and evaluation done.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am 8 weeks pregnant and I am not able to see my baby on ultrasound. Why?\n\nHello doctor,I am 18 years old with 5'6\" in height and weight 134 kg. I am eight weeks pregnant. I have not had any bleeding or cramping. I do not believe the baby is in my tubes because I have not had any pain. Why my baby cannot be seen on the ultrasound?",
    "doctor_response": "Hello. The possibilities are, 1. Your periods previous to pregnancy was irregular, so what you count as eight weeks maybe less, need to wait and repeat scan after 7 to 10 days. 2. Pregnancy is not healthy. Only if the growth of the baby is normal, the rate of growth of the baby will be regular, and by eight weeks, you should be able to see the baby.You can confirm the health of the baby by checking the serum beta hCG, repeat it after 48 hours, and it should be doubled in 48 hours. For example, if today value is 100 IU/ml, it will be 200 days after and 400 after two more days. If the baby is not healthy, the rise will be less than that. So then repeat it till you can confirm no adequate growth.Only when the beta hCG value is 1500 mIU/mL can a baby be seen on the scan. Do not worry about tubal pregnancy, it will be seen as early as six weeks, and as you said, you would have symptoms much earlier. I hope I have clarified your query. Do write back if any more questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the hip while walking?\n\nHi I am having hip pain it s deep like in the socket , I did just have it while walking , cleaning or playing pickle ball, but now its all the time, aches like a toothache. I ve been taking Ibuprofen on a regular basis, it s not helping. I ve been stretching it, seems to make worse. Please advise Thanks Laura",
    "doctor_response": "dear sir/ madami would like to know the age group, and examine your hip for range of motion and tenderness,and have a radiograph of the hip for looking the contour of femoral head and for sclerosis.mostly it could be hip arthritis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with heart failure, pulmonary edima, what are my chances of survival ?\n\ndiagnosed with heart failure, pulmonary edima.I am 56 overweight ,what are my chances of survival, improvement? I have been suffering from shortness of breath for 3 years, which got slowly worse. It was always explained with a worsening of the asthma , and with being about 40-50kg overweight.X-rays showed nothing unusual. 10 days ago,I went to the hospital,in thailand, where I currently live,because shortness of breath worsened.My x-rays showed water on the lungs, an enlarged heart. after 2 days in hospital , my condition improved a lot and I was sent home, with lots of medicine and an appointment for 12 days later. the doctor was very pleased with my speedy recovery,said I had a good costituition.he said, that he can make me better within 6 month. My main problem is communication.Doctor speaks some english. I like the hospital. very caring,private hospital, 1st world standards or nearly.Doctor very dedicated and caring. I would like to live as long as possible, with an improvement in quality of life.I am motivated. Any info, opinions, suggestions welcome.I am financially independent. thanks",
    "doctor_response": "Overweight is a deep understatement.  You are morbidly obese by medical standards, and need to quickly and thoroughly educate yourself about correct diet, and resolve to take this excess weight off.  My guess is that if you had the capability to get to a normal weight the rest of these problems would disappear.  Best wishes in this endeavor, but do it as though your life depends on it, because it does.  The fact that you had a nice recovery means to me that you have not wrecked your body irreversibly and that you have the capability for a normal lifespan once you get the excess girth off.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Tinnitus worsening mom's anxiety. What might help her?\n\nHello doctor,My mother is in a care home and is experiencing very loud tinnitus. She is becoming very stressed and anxious as this has been going on for months. We have asked her GP to help but it does not seem that anything can be done. She has had her ears cleared but this has not helped either. She is 89, on beta blockers, and recently prescribed a water tablet in place of a blood pressure tablet that is known to cause tinnitus but the problem is still ongoing. My question is, would it be advisable to ask for something like Propranolol or similar to be prescribed as she is very distressed? Do you think this would help to keep her calm and perhaps help with tinnitus which I am sure is made worse by her anxious state? She is very deaf now and finds it difficult to wear her hearing aids as she has a perforated ear. Can you help as this is very distressing to see her in this state? Thank you.",
    "doctor_response": "Hello. Revert with more information to an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Now i am trying to conceive for the second time. Could you advise me on this ?\n\nDear Dr, I am 42 yrs old & married for 7 1/2 yrs.I got my first child thro IUI 2 1/2 yrs after marriage. Now i am trying for another My period is regular for 26 days.Pls advise",
    "doctor_response": "before you conceive, please have a detailed discussion with your gynac regarding mongol child. as the age advances risk of giving birth to a mongol child increases.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do people fix midline misalignment of teeth?\n\nHello doctor, Why do people fix midline misalignment of teeth (the middle of upper and lower teeth do not line up), apart from appearance as the factor? I had undergone treatment with wire braces and removed them off just yesterday.\u00a0I noticed that I have a little midline misalignment even after treatment.\u00a0When I bring my jaws together (while biting) the edge of my left lower central incisor touches between (the back) of the upper central incisors.\u00a0This makes me feel very uncomfortable. I have attached pictures for you to understand my issue.",
    "doctor_response": "Hello.\u00a0 I have viewed the pictures (attachment removed to protect patient identity). Revert back to an orthodontist online for further follow up -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can taking Duphaston cause abnormalities in the fetus?\n\nI am fourteen weeks pregnant and I was prescribed Duphaston tablets since the beginning of my pregnancy, mainly in view of a previous miscarriage. However I have never been tested for progesterone levels. Now I read on the internet that duphaston can cause abnormalities in the foetus. Is this true? If yes, how high is the risk of abnormalities?",
    "doctor_response": "Hello dear,i understand your concern.In my opinion duphaston is safe to be taken during pregnancy.It is indicated in case of previous history of miscarriage ,any spotting during the present pregnancy etc.So dont worry.It does not cause any harm to fetus or pregnancy .So relax.Avoid physical stress.Take healthy nutritional diet.Beat regards....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Major back pain even after lumbar discetomy, inflammation still seen in MRI. What to do ?\n\nI had a lumbar discetomy of L4-L5 11/12 and still have major back pain. My MRI suggest discitis so I have done 3 disc aspirations and blood work all showing negative. Referred to ohio state spine institute had 4th MRI X-rays and blood work. Still negative but with inflamation present on the MRI. I have yet to receive a diagnosis because the results are always negative for infection but still no progress. Please HELP! Don't know what to do",
    "doctor_response": "Hello. Thanks for writing to us. The persistent inflammation in the area of the disc can be relieved with the help of local steroid injections. The treatment is done according to the severity of the symptoms. Till then take mils anti inflammatory medicines for relief. I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL  Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for severe pain in the gums\n\nis there any real meds that can really help to dry singles pain in the gums.yes,inside the mouth. I do have          a wonderful P.A. but there's got to be something for this horrible pain. I'm taking hydrocodone7.5Ace325,morphineSR15mgTab,lidocaine viscous2%,pregabalin75 oral cap,acyclovir200mg cap.It's been 9wks suffering,I,m just now taking fluoxetine20mg.    I'm 64 female suffering 17 years. I am a Christian. Married 46yrs. to a wonderful spouse.",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain you are being given a combination of appropriate medications that includes antiviral medication, painkillers, numbing agents etc..Singles is caused by Herpres Zoster virus and at times it can invade the nerve and cause severe pain..But in case if the pain is still not relieved you should consult an Oral Surgeon and get evaluated and he can do further investigations like blood tests, oral swab culture and also an MRI Scan to rule out the exact cause of the problem and will be treated accordingly..You can be advised other neurotic painkillers like Carbamazipine, Gabapantin and injectable painkillers to relieve pain.Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do these glucose tolerance test and HbA1c levels indicate?\n\nHello doctor,I am 34 years old and 28 weeks pregnant. This is my second child. Last week I was asked to do a glucose tolerance test and hba1c. The values are 143 and 5.2 respective ly. Am I at high risk of developing gestational diabetes? I was asked to take 75 g and take the test after two hours. Couldn't meet my doctor as she is out of station.",
    "doctor_response": "Hello,These tests are done to rule out gestational diabetes in pregnancy. In your case, they are within the limit, so you don't need to worry. It's an important test to rule out diabetes in pregnancy. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mandavi Rai",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach/thighs pain while on medication for ear infection/bronchitis?\n\nHello I m a 26 year old female. I was diagnosed with a double ear infection and the start of bronchitis. I was given antibiotics and benzonatate for the cough. It s been about 5 days and I m still very weak. And for the last two days my stomach and my thighs hurt as if I ve been working out, which I haven t been. Is this common?",
    "doctor_response": "HelloYou mentioned that there is ears pain ( both 0 with bronchitis ( as diagnosed ).Doctor prescribed antibiotics and benzonatate . You are feeling weakness, stomach hurts, and pain thighs . May be due to these possibilities .Side effects of antibiotics causes stomach pain due to abdominal discomfort ( hyper acidity ) and feeling of weakness . When such symptoms appear I usually advise my patient to take antibiotics with pantaprazole-d for nausea ( stomach pain ).So consult your treating physician and get his opinion .Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful shin after an injury?\n\nToday i got hit by a softball in my shin. The pain is getting worse now. It hurts on my shin bone where i got hit but the pain spread to my ankle, foot, and thigh. There is also a small lump on the side of my shin where i got hit and when i move my foot or ankle there is a sharp pain that goes up my leg to my thigh and it feels like im loosing feeling in my foot a little or like my leg is getting really tight. It isnt bruised but it is swollen.",
    "doctor_response": "Thanks for your query. I have gone through your query.  The pain in the shi following trauma can be because if the inflammation. Nothing to be panic, you can take a course of anti inflammatory drugs like ibuprofen, paracetamol and serratiopeptidase combination (if you are not allergic). If the pain and swelling is not subsiding then consult an orthopedician and get it evaluated.I hope I have answered your query Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for right lower back pain\n\nHi, this is Atif Noor (male, age 31). I used to be a long distance runner. About 9 years ago, I got knee injury in my right knee while fast running. It was diagnosed as chondromalacia patella. I did rest for 3 years. Then gradually started jogging and now I do 40 minutes jogging 2-3 days a week. But for few months, I have developed a pain in right side of lower back (may be in pelvic bone). It doesn\u2019t occur while jogging but it does when getting into motion after a stationary position. How can I permanently heal it?",
    "doctor_response": "hithis pain may be positional with some straining of few muscle fibre.you may do light massage before starting with anti-inflammatory gel/muscle relaxant cream after hot fomentation alongwith taking some rest for 3 days,avoiding bending or lifting objects from ground.Take dolo tabs twice a day for 3 days also",
    "dialogue_context": ""
  },
  {
    "patient_message": "I GET UP THERE IS BLOOD IN MY SPIT BUT ONCE I AM UP MY SPIT IS CLEAR.\n\nAFTER I LAY DOWN FOR A WHILE WHEN I GET UP THERE IS BLOOD IN MY SPIT BUT ONCE IAM UP MY SPIT IS CLEAR I NORMALLY SEE IT IN THE MORNING.",
    "doctor_response": "Hi, It seems that blood is coming from your teeth or ulcer in the mouth or congested nose due to infection. You go for dental check up,ENT check up and x ray chest to rule out some pathology in the lungs.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I doubt I have squint eye. Is it hereditary?\n\nHello doctor, I doubt squint eye. Whether squint eye is hereditary, and is there any treatment for these?",
    "doctor_response": "Hello. Squint eyes are the eyes which are not appropriately aligned, each eye focus on a different object and send signals to the brain leading to confusion. Thus the child starts ignoring signs coming from squint eye (deviated eye) resulting in amblyopia or lazy eye. It has to be aggressively treated in childhood or else cannot be processed once development occurs. Treatment is surgical, in some minor cases, prism spectacles. The exact cause is not known either developmental or hereditary. The treatment has to be done as soon as possible.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes thumping of heart beat for few minutes?\n\nSometimes my heart beats really fast and I can feel it thumping in my chest.  It feels like my heart is pushing through the chest walls.  This normally happens about twice a day and usually occurs when I am sitting.  It lasts about 15 minutes and then goes back to my normal rate.  Can you tell me the cause of this?",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!Your symptoms could be related to anxiety. But, before coming to this conclusion, I would recommend consulting with your attending physician for a careful physical exam and some tests to exclude some other possible causes: - a resting ECG and a cardiac ultrasound- thyroid hormone levels for thyroid dysfunction- complete blood count for anemia- blood electrolytes for electrolyte imbalance- an ambulatory 24-48 hours ECG monitoring to examine your heart rhythm trends for a prolonged time and exclude possible cardiac arrhythmia. Hope to have been helpful!Wishing good health, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for type 2 diabetes\n\ni am 73 and a diabitic type 2 patient for over two decades.I am having diabetic neuropathy,experiencing burning sensation in the night under my feet.I have been asked to take nova 75.I am also taking meganeuron capsule as vitamin supplement.When I  take nova75 i feel slight giddiness in the morning ,which makes me getup from sleep late.My guestion is will these medecines help me to get over my problems or i have to change the drugs.",
    "doctor_response": "Thank you user for your query.Actually the drug nova 75 which you are taking contains pregabalin which is an anticonvulsant which is also being used in case of neuropathic pain occurring in patients of diabetes. The giddiness that you are complaining is one of the side effects of pregabalin, along with nausea, weight changes and dry mouth.Also get your blood sugar done as hypoglycemia also sometimes causes giddiness.Since how long you have been taking these medications?All I want to suggest is to try contacting the physician whose treatment you are taking. As he might discontinue the medication or change the treatment even.god bless",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pancreas filled with fluid during pregnancy?\n\nmy cousin is sick her age is 20 years old he is married and pregnantHas a bag of water in the pancreas which is 17.5 cm long with a 3-year please can you help me for giving medication because the doctors of algeria could not perform the surgery because there is a large responsibility baby for three months",
    "doctor_response": "Hi,Your cousin has a pancreatic cyst, it requires treatment if it is causing symptoms. Since she is sick, she may require removal either by Endoscopic(key hole )surgery or open surgery.This can be attempted in 2 trimester (4 to 6 months of pregnancy), as these months are relatively safer to carry out surgical procedure on pregnant women, with minimal harm to mother and baby.But if her condition worsens immediate surgery is essential, as life of mother cannot be compromised, due to pregnancy. We need to save the mother first always. Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking oxetol, topaz and lonazep for mood swings. Not able to stop medication. Weight gain with sleeplessness. Permanent cure?\n\nHai Doctor, My wife is not having sufficient sleep because of mood variation since 20 yrs, this may having yearly 2 or 3 times, having medicine oxetol xr 300, 2 daily + 1 topaz 50 + (solefresh 10& lonazep 2mg in the night) as per doctors advice, this continuing for 1 month when problem reduces she stopps the medicine, she is cannot handle the serious problems and anybody talks against her may leads to sleep problems and going to small disorders and over thinging etc- now she is too worry with weight gain because of medicine, Can you sujjest how can we get rid of the problems from our life permnantly,because we worried too much of this un balance occuring in our life, is there any solution, if she continue medicine long time is the problem solve...",
    "doctor_response": "Hi There, Thanks for asking. The medication you mentioned do not have much side effect, especially they are not in high dose. If she continues the medication and this is the first episode she is experiencing, her doctor can stop the medications after a year if she does not have any especial issue then. It is very interesting that if you control you emotional expression in the family, she will have a controlled mood. Actually, Low emotional expression can decrease the chance of worsening situation from 44% to 10% in the future and it has been shown in the studies. It means you may not only less be critical to her behaviors, but also less show strong emotions to everything she does. Have a good health!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have blister under the eye which is itchy. Have psoriasis and IBS. No medication till now. What could it be?\n\nI had a blister come up on my cheekbone under my right eye the other night, it was gone within 2 hours, tonight I have another one come up, same place but under left eye this time, twice the size. Entire cheek is very warm to touch and blister area is itchy. Am on no medication. No allergies. Do suffer from psoriasis and IBS though. It doesn't look like psoriasis, it looks like a water filled blister. It's already going down again. Just curious as to what it might be.",
    "doctor_response": "ibs and psoriasis are now taken as allewrgies and both are due to chronic irritation by one of food we take daily as allergy extends it effect other systemsnow is effecting the eyeget blood serm test for specific antibodies for milk wheat potato chana rice nuts egg and other food you take go fort elimimnation diet and every problem will be solved after 3 wks - 3 months of eliminationtill then if want can show to doctor and take sympatomatic rx",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take Vertin during pregnancy?\n\nI m 4 Month pregnant , I have been having problem of dizziness , weakness , headache.my problem of dizziness occurs mostly whenever I lied down on bed and turn left to r or r to l and sleep straight.i went to physician , he prescribed me vertin 8mg 3 times a day for 5 days.i just want to know is it safe to take vertin 8mg in pregnancy.",
    "doctor_response": "Hello dear,welcome to Ask a doctor service. I reviewed your query and here is advise.There are no adequate data from the use of betahistine in pregnant women.It means that there are no sufficient human studies for use in pregnancy of  vertin.Remember to mention to your doctor that you are pregnant and he will balance profits vs contraindications. Hope I have answered the question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever, diarrhea and food intolerance with lips chapping?\n\nMy 3 year 9 month old son has had fever (99-100 during the day, 100-102 at night) and diarrhea (but, he frequently has loose stools and has multiple food intolerances) for 5 days now.  His fever goes down in the day and his energy level is normal except he is a little more whiny than normal and he has very little appetite.  His sleep has been broken since the fever goes up at night.  I haven't given him any fever reducers. His lips are getting pretty chapped.  My nephew was diagnosed with type b infuenza on monday and we played with him over the weekend.  At first I was fairly certain we got sick from him, but I'm concerned about his lips starting to crack and the duration.  Is lip cracking normal for the flu and is ?",
    "doctor_response": "Hi.... cracking of lips is not a sign of haemophilous B influenza infection. You need not worry about it.By what you say I feel that your kid is going through a viral illness. I will explain you how a viral illness behaves, so that you can be more confident.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.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are my sinus issues and tonsil stones related?\n\nHello doctor, I have had sinus problems my whole life, getting sinus infections every year or sometimes twice a year, constantly having drainage in the back of my throat) and it was only annoying until a few days ago. Four days ago, I learned I had tonsil stones when I coughed up about 10 (no photos provided). I went to the doctor and she said it was because of a virus causing me to produce more mucus than normal. I was given a medicine and took it and the mucus amount went down a lot and I started feeling better and thought my tonsil stones were gone. However today, I coughed up two more. So,\u00a0I decided to see if there were any I did not find on my previous visit, so I could make sure there were none left. I ended up removing 22 tonsil stones (photos provided to prove I am not exaggerating). While removing one, my tonsil started bleeding. I am not even sure if they are all out since I got the majority of those from one side of my mouth and my throat has hurt after both times I have gotten them out. Anyway, my question is, is there a possibility my sinus issues are linked to my tonsil stones, and would an ENT help me remove them since I have so many? Is there a possibility I have tonsillitis?",
    "doctor_response": "Hello. I understand you want to know if your tonsil and sinus problems are related.  For more information consult an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anxiety and depression\n\nYes, today my daughter had an ultrasound on what was left of her thyroid. She s been going through unimaginable anxiety and depression, rapid heart rates that come and go, paranoia and psychosis. She is overwhelemed over everything. She had to resign from the job that she has worked at for the past 7 years due to confusion and memory loss. We believe that the bit that is left in from her surgery 6 years ago is still producing and has sent her into several thyroid storms. The tech that did the ultrasound told my daughter that there were pieces of her thyroid spread out all in her throat and that there was a huge scar tissue. She said that the piece could be regenerating itself. Please ease my mind as to what could possible be going wrong.",
    "doctor_response": "DearWe understand your concernsI went through your details. Please do not go with the opinion of technical people who took the radiology test. They are not trained in such minute physiology or anatomy of endocrinology. The doctor who did the surgery cannot leave such a mess and be sure about that. In any case, you are going to be sure about the result when you show the result to the capable endocrinologist. Therefore, wait for the consultation. Even though there is some problem, that can be corrected. If you still need my assistance in this regard, please use this link.  Please remember to describe the whole problem with full detail.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My butt hurts after anal sex. I am not even able to sit. Please help.\n\nHello doctor, I had anal sex and now my butt has been hurting\u00a0all day for six days now. And\u00a0every time\u00a0I have to poop or wipe it, it is very painful. It is very uncomfortable when I sit or lay on my butt.",
    "doctor_response": "Hello. There might be a small tear in the anal region, which is commonly called as an anal fissure. Even a small fissure can be really painful as it causes a spasm of the anal opening. It heals slowly, as it gets irritated repeatedly during the bowel movement. You might even notice blood on the toilet paper or in the stools. I suggest you get examined by a physician. Warm water sitz bath, which involves sitting in a tub warm of water, to soak the painful anal area, helps a lot in this condition. The other recommendation is to take a high fiber diet. Your physician, after an examination, can prescribe you analgesics and a stool softener. Hold off on more anal sex until you recover from the current problem. Hope your query is answered. Best wishes. For more information consult an HIV/AIDS specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can I have to ease needle pain during bartholomew cyst operation?\n\nI m going in hosp on 30th for op on bartholomew cyst have never been operated on before and am terrified if needles! is there anything i can have before hand to make it less painfull when they put the needle in to put me to sleep?? also i m worried that when i wake i will be in pain do they give you some kind of painkiller before you wake??",
    "doctor_response": "I understand your fear of needles and it sounds like you are afraid of the IV needle. Sometimes the staff can put on a local anesthetic prior to insertion of the needle. Most hospitals do not do this though. I can reassure you though the IV needle pain is minimal and will be over very quickly. Post surgery you will have pain but they will medicate you before you wake and give you medication after surgery. Hope I have answered your query. If you have any further questions I will be happy to help",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can aggravated bursa on the hip and lower back due to Haglund's heel be treated?\n\nI am suffering from a Haglands heel after knee replacement walking different, it is bothering my bursa on hip and lower back as I am not walking straight and am limping around , I am icing taking Alleve or pain pill when needed I dont see a foor Dr. Until the 24th of Sept . Do you have any help in meantime esp, tendon exercises , etc. dont want to do anything to make it worse I am not going the surgery route unless it gets so bad I cant walk at all Any help would be appreciated ...Thanks Betty",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. After reviewing your health history, I'm of the following opinion: 1. Since there is a history of knee replacement and now facing gait problem thus consult with an Orthopedic surgeon to exclude any hidden pathology of your symptoms like hip osteoarthritis, AVN [avascular necrosis], osteoporosis [check with DEXA which is a means of checking bone mineral density] as they may be the cause of bone loss causing pain and difficulty walking. PS. If everything comes out to be normal you might be advised to go for revision surgical procedure and you may have to take an opinion of a Neurologist since examination of gait [posture of the patient while walking] often gives a clue to a neurological disorder. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for  back  pain\n\nA year ago I had an urinary tract infection and along with that came lower left side back pain. After that was treated, the back pain remained but only barely and never bothered me. Now I am having severe back pain on left side but no urinary problems, no muscle strain either. Any ideas whats going on?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern looking to the history given here I could say that if this is chronic backache then the underlying cause need to be found out because treating the symptoms for a longer than enough time is not advisable and in my opinion the MRI test is advisable, mean while you can try, \"Tab Diclofenac 50 mg  once in day\" take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long viral fever in an infant last?\n\nDoc, My 12 month old son is having fever for last 5 days. Paediatric said he has viral fever, and we give him acetaminophen drops for every 6 hours. How long viral fever can go on? he is active , eating and drinking as usual. Anything else to be checked? Thanks Prabhu",
    "doctor_response": "Hello, Generally, it will settle by five to seven days. If fever last for more than one week, we have to rule out other causes and blood work up may be required. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in the upper chest region?\n\nI am having pain in upper chest on inspiration A week ago I hit a vessel in my lower left leg and lost a lot of blood (saturated three wash cloths,puddles on floor,finally stopped by knotting a towel around leg). As this happened at hs I went to bed and all seemed okay since.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Since you are having recent history of large amount of blood loss, anemia can be the cause for your left sided chest pain. Anemia causes tachycardia (rapid heart rate). This is due to strain on heart due to loss of blood. So better to get done hemoglobin estimation and if this is low then you may need supplements in the form of either oral tablets or blood transfusion, depending on your deficiency. If hemoglobin estimation is normal than no need to worry much. Your pain is mostly due to musculoskeletal pain. So take painkiller and muscle relaxant drugs. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it possible to conceive naturally with issues in left fallopian tube?\n\nHi doctor, Recently, I have gone for all relevant test for checking infertility. My AMH and thyroid report are both normal. My HSG report is showing issues about the left tube. I am attaching my report kindly review and let me know if I can conceive naturally or next what should I do?",
    "doctor_response": "Hello. The HSG (hysterosalpingogram) report (attachment removed to protect patient identity) shows that there is a left sided cornual block of the left fallopian tube but the right is patent, so pregnancy is possible, but that would depend on the ovarian side which ovulates. The chance would be high if the right ovary ovulates and not left. Though there is a possibility of an intraperitoneal transfer, but it is rare. So, the next best step shall be to opt for hysteroscopic tubal canalization and an opening of the block which shall increase your chances of conception.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red circle around each of the ankle bones?\n\nMy two year old cousin has a purple, now red circle around each of his outer ankle bones. It has been there for a long time (months). It was mild at sight. However, in the past week it (both) have become very red and larger. He doesnt complain and it doesnt seem to itch or irritate him. Is this something that signals a more serious conditon?",
    "doctor_response": "hi,as mentioned by you first need to know the age of your cousin. As sometime varicose veins might be there depending upon the age and other factors. usually in the beginning the varicose veins don't pain. but on a later stage it might give symptoms of painAlso at times, it is a skin color changes for which a dermatologist can help after the thorough examination of the skin.with the grace of God I wish your cousin a good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes irregularities in periods?\n\nI am 26 married girl. My period were bit irregular somtime were 10-15 days late and sometime normal. this time it 2 and month i have not periods. pregnancy is negative. Pelvis scan is normal. No thyroid problem tested. I took (gynec suggested) cyclenorm P and E for 3days and then promulat-n 3 tabs for 5 days still no results after 10 days also. I am worried and I want a baby also. please help.",
    "doctor_response": "Hi,I have gone through your query and understood your concern. If i were to treat you, I would ask for a complete hormone profile including FSH, LH, serum estrogen and progesterone, serum Prolactin, serum DHEAS, insulin levels, ovulation studies and analysis of your partner. A normal pelvic sonogram mostly rules out polycystic ovaries as the cause of your hormone disturbance. If you did not get your thyroid profile done, please get it now. After your hormone levels are known, any deficiencies can be suitably corrected. If your partner has any defects that need correction, this also can be done simultaneously, since you are anxious to conceive. Meanwhile, please try to maintain a healthy BMI with diet and exercise. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe pain in wrist after injury\n\nI have not fallen on to my wrist but I did drag a heavy mattress down some stairs by myself. A couple of days after I started to have a severe pain in my left wrist which is getting worse by each day (now day 4). I find it hard to get to sleep and it wakes me up constantly. I am taking 400mg ibuprofen 3 times a day and rest and ice packs (told to by doctor). should I really go for an xray?",
    "doctor_response": "Dear Sir/MadamI have gone through your query and read your symptoms.In my opinion, the type of stress you are telling will probably need an MRI to ascertain any occult fracture and ligament injury. but still primary X Ray after consultation with an Hand surgeon is a must. I hope that answers your query. If your want any more clarification, contact me back.Dr Narender Saini",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for body pain and weight gain post stomach ulcer treatment\n\n@ 2 yrs ago I had a stomach ulcer, no problems since. dr took me off all arthritis med. My severe pain arms, neck, back,legs & knees have made me sedentary. 15 to 20 lb weight gain..I can barely walk of lift my arms. I took one 800 Ibuprofen today & it helped with the imflammation....am I playint russian roulette?.....Thanks....",
    "doctor_response": "i would suggest you add pantoprazole 40mg along with every dose of ibuprofen you are taking as you have a significant history of stomach ulcers. the dosage can be upto a maximum of 3200mg/day but that will increase the risk of renal side effects. The lower the dose the the lesser the side effects. i suggest try to take  two400mg tablets, one morning and one evening. if pain doesnt subside then revert to 800mg tab once a day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why are there recurrent episodes of allergic cold?\n\nHello doctor, My son is 16 years old and gets an allergic cold bout at least once a month. His symptoms during that time are an excessive running nose, frequent sneezing bouts, and nasal irritation. Please suggest the appropriate remedy for curing his allergy from the root and also for immediate relief as he is studying. How do I detect the reason behind this allergy so to keep away from the cause?",
    "doctor_response": "Hi. Give him Allegra M (Montelukast and Fexofenadine) tablet for a week in the evenings. This medicine is better than others as it produces the least sleep. This will help him read well. Keep away from dust, smoke, fumes, perfumes, mud, pollution, direct air-conditioning, etc. After his exams are over, note down whenever he gets allergy and that way you may be able to find the offending agent. Allergy cannot be cured. It can only be prevented and kept under wraps. To detect the allergen one must do a skin prick allergy testing.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain and dizziness while breathing?\n\nIT HURTS TO BREATH WHEN THE AIR IS COLD OUTSIDE. I FEEL DIZZIE AND MY CHEST HURTS. I HAVE HAD A STRESS TEST THAT WAS NORMAL AND A CAT SCAN OF MY CHEST AND IT WAS NORMAL. WHEN THE WEATHER IS WARM OUTSIDE IT, I M OK. NEVER BEEN BOTHERED WITH THIS BEFORE. WHAT IS CAUSING THIS?",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. You are having cold induced bronchospasm. Cold air is causing bronchoconstriction in sensitive individuals. So on exposure to cold environment, cold air is going in the lungs, so this will stimulate constriction in the airways and you feel breathlessness. Once this exposure is not there, your airways will dilate and so you don't feel breathlessness. The treatment of this is avoidance of cold weather.  Or you can take short acting bronchodilators just before cold exposure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any chances of getting rabies by eating fruit bitten by fruit bat ?\n\ni suspect I had eaten an apple bitten by stray fruit bat due to ignorance yesterday ie., 4-1-2011. though I had chopped the bitten part and also washed fruit in water, what are the chances of my getting infected with rabies . I am in Sudan where there is literally no health care",
    "doctor_response": "Dear Friend, . Only Vampire bats can transmit rabies The chance of getting rabies by taking fruit bitten by bat after washing is practically nil Contact me for more information or guidance Wish you Good Reproductive & Sexual Health With Warm Regards, Dr. A CHAKRAVARTHY MBBS; MBA; (MHSc Reproductive & Sexual Medicine) Consultant, Sexual Medicine / Sexologist, TRIVANDRUM, KERALA Email: dr.a.chakravarthy@gmail.com +91 \u2013 944 77 050 77 / 94471 55 0 77 / 99 464 2  55 77 President, International Association of Sexual Medicine www.drchakravarthy.com / www.sexual-medicine.org",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can something else be used to sanitize the skin area?\n\nMy 8 year old neice is on weekly injection of methatrexate for rheumatoid arthraitis and eye infection involement.  She has developed an adversion to the smell of the alcohol wipe used to sanitize the injection site.  The smell of the alcohol gives her nausea  and a headache.  Can something else be used to sanitize the vile top and skin area--something with less odor?",
    "doctor_response": "Thank you for consulting in Healthcare,of cause you can use other antiseptics like as chlorhexidine.You shoud know wiping during approximately five seconds on average  cannot possibly provide complete sterility. I advise to nurses to clean at the first big area,then the skin prior to injection to reduce the risk of contamination from the patient\u2019s skin flora.Swabbing the injection site with a saturated 70% alcohol or other antiseptic swab for 30 seconds and allowing to dry for 30 seconds .Best regardsDr.Svetlana",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat abdominal pain after taking contraceptive?\n\ni had taken an emergency contraceptive pill twice a month. since then the side effects like abdomen pain was observed. its unable for me to bear the  pain. i hav been taking painkiller everyday since the pain has seen. it gives me relief then. should i continue? or may i get a better solution?thank you",
    "doctor_response": "Hi ! Good morning. I am Dr Shareef answering your query.All the precautions including birth control pills are not 100% fool proof in protection against a pregnancy. If I were your doctor, I would go for a serum HCG determination and an ultrasound abdomen to rule this out including any other pathology in the pelvic/abdominal organs. Considering that you are sexually active, I would also suggest you to get a urine test for routine/microscopic and culture sensitivity test and properly get assessed by a gynaecologist to rule out a PID (pelvic inflammatory disease).I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure lower back pain due to an injury?\n\nI am a professional bmx rider and I happen to fall on my bike during a riding session and hit my lower back really hard! I can walk and bend over and back. But it is swollen really bad and pains a lot I only got it tonight but should I worry about anything or see a doctor? Thanks in advance!",
    "doctor_response": "Yes,  I would  suggest you to take advice from a doctor. You will also need to get a x ray of your back to make sure that nothing has happened to your bones. At present if you want pain relief  than you can start taking muscles relaxant like myoril or myospaz.  Also try to use ice at your back local application  of diclofenec  ointment  will also be helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should bronchodilator be given to a child for cough and cold?\n\nNamaste, My 16 month old son is suffering from fever since 5 days, probably the fever is because of cough and cold, Our pediatrician had prescribed levolin syrup due to which my son started shivering and we took them to an emergency clinic. The doc there said its a side effect and that is fine just wanted to know whether its safe. and what would be an ideal dose? Is it really necessary to give this bronchodialater?",
    "doctor_response": "Hello dear,welcome to HCM.Broncho-dilators like salbutamol are very useful in a child with wheeze.It prevents hypoxia and respiratory distress.Shivering is a common side effect of these drugs-need not be worried-it will disappear after stopping the drug.The dose depends on the weight of the child-usually 0.1-0.4 mg/kg 2-3 times a day.If shivering is significant,after ruling out shivering from fever,we can reduce the dose or stop the drug after a chest examination.Your doctor will guide you in this.Hope this answer might help.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can redness and pain around the anus along with constipation in a child be treated?\n\nMy baby is doing hard stools. He is crying and not allowing me to clean up the area. The skin is red and while doing stools blood is coming . For loose motions his doctor has prescribed him Oflomac Oz, Merispas Suspension, Econorm, Zocon - 50 DT. Can this medicines should be given during hard stools also",
    "doctor_response": "Hello,my name is dr.Dorina Gurabardhi.I understand your concern.I think you should consult your doctor about econorm because it can be the cause of the constipation.Some advices that I can give to you are:\u00a0\u00a0\u00a0\u00a0\u00a0-To soften the stools and make them easier to pass, increase the amount of fluid and fiber your child gets each day. -Limit foods that can increase constipation, such as fatty foods that are low in fiber.-Make sure your toddler gets out to play for at least 30 to 60 minutes a day. Moving the body keeps the bowels moving, too.Hope my answer was helpful.If you have any other question Ill be glad to help.Regards,\u00a0\u00a0\u00a0\u00a0\u00a0dr.Dorina Gurabardhi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a sore red lump on forearm imply?\n\nHi thereI have a sore raised red lump on my forearm it s been there maybe a week or two, I ve had silulitus twice before this and had some flux picking left which I started taking, this evening the lump started pussing a brown and red fluid what could this be?",
    "doctor_response": "It may be due to cellulitis with underlying abscess secondary to boil or trauma.if there is a fluctuation in the swelling, it has to be drained surgically.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to find the root cause of extreme fatigue?\n\nHi doctor, I am a 31 year old male. I am managing an IT company. I have suffered from periods of extreme fatigue for the past one and a half year.\u00a0The first period of fatigue was one and a half year back and it lasted for around 18 days. Then I felt fine for the next five months. From then till today I have had one to two weeks of fatigue followed by one to two weeks of fine feeling.\u00a0During these fatigue periods, I sleep an average of one extra hour each night. I get very little work done. I do not have the energy to exercise (which I have always enjoyed). I have no physical or mental energy and brain fog. This is something I have never experienced before.\u00a0I have attached the blood test results. Abdominal ultrasound and chest x-ray are also done with normal results. My weight is normal and I eat a healthy varied diet. I supplement with fish oils. I do not work very much and I do not feel stressed. My blood pressure is normal. Physical examination was done at doctor\u2019s office. The two doctors I have seen cannot find any problem, but something is clearly wrong with me. What do you suggest me to do next to find the root cause?",
    "doctor_response": "Hi. Revert back with the answers for the above questions to a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for adult onset dystonia\n\nI suffer from Adult Onset Dystonia. Recently I had been examined by my Neurologist for recertification of My NYC parking permit for persons with disabilities. I was wondering what AFC meant? My Doctor wrote, AFC easy. I apologize, but I live on disability and a pension and it is the end of the month. I cant afford to pay anything today, but I need to send the documentation off ASAP and after the 1st of the month would be too late. However, I really would like to know what something means before I send it out. Can anybody help? I know Im asking for a lot, but I really cant wait until after the 1st and I cant afford to pay anything today, unless you can bill Medicare of Healthnet (Tricare)",
    "doctor_response": "Hi, Short forms can be crazy and often confusing. There is no specific medical term or condition, with an abbreviation AFC. So, in all likelihood, your doctor meant - A Followup Case (AFC) of dystonia. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sudhir Kumar, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful bowel movements and stomach cramps in a child?\n\nit hurts so much. it s like i m getting stabbed in the back of the ribs, and in the back of my neck. it feels like i m being impaled from the divot just under my breasts, strait through to my back, and there s a shooting pain from where the vertibre in my neck meets my shoulder to where it meets my skull. Other symptoms i have are horrible cramping in the pelvic area no matter what time in the month it is, cramping in the stomach similar to hunger pains, frequent headaches, and painful stools. i have odd aches in the joints all over my body. I m a 13 year old 135 pound girl. please help me. it hurts to the point of tears, and my mother ignores what i tell her about it, despite her being a nurse. Can you help tell me what s wrong",
    "doctor_response": "Hello dear,it seems you have cervical neuralgia due compression of nerve,that's why you have impaled pain.You should try to take Diclofenac potassium 1 tablet once a day for 5 days for pain relief. Painful stool and cramps can be caused by enterocolitis. Charcoal 3 tablets twice a day and nitrofurantoin 1 tablet trice a day for 7 days.In addition you can use flaxseed-boil 1tablespoon for 2 glasses of water,take 1/2glass 2 times before meal.Hope it helps.Wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and pressure in the chest?\n\nim 15, and 96 pounds. i went to the er last night for chest pain but was released after my ekg and x-ray.. not showing anything. this morning my docter called after looking at the results, and said something about a prolonged heartbeat or a lull? please explain... i have a appt tomm with a cardiologist... what should i expect. im really scared because i still feel pressure in my chest. thanks so much.",
    "doctor_response": "Hi,Probably it was decreased velocity it heart impuses. Whether it is dangerous depends on the degree. If it is first degree, it can be a normal finding in young people. Your doctorjust may want to have some extra examinations to be in the safe side. You should know, that such problems usually don't cause pain and most probably it is a muscle pain or costochondritis. If you have no previous syncope, don't worry, it shouldn't be serious.Take careCome back if you have any further questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain around the navel while having persistent cough?\n\nI am recovering from an almost 4 week bout of bronchitis, and still have the post viral cough. Now, when I cough, sneeze, or sit up from a reclined position it causes me a sharp pain just below my bellybutton. Could I have a hernia, pulled muscle, or something else?",
    "doctor_response": "Respected Sir, hi it`s segmental nerve pain else referred pain . not hernia if there is no obvious visible bulge over the abdominal wall & muscle pulling is not agreeable entity dear thanks regards take care, control your cough and you will be fine. see that you don`t have constipation by cough controlling tablets or syrups and you passes your bowels smoothly daily. bye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to get pregnant. Low sperm count. Have cramps, back pain, mild cramps, nausea. Could I be pregnant?\n\nmy husband and I has been trying to get pregnant for three years he has a low sperm count that has been our issue. But this past month my period was light. I begin to have cramps a week to two weeks before my period they still have not left me its been 3 weeks. I'm having off again on again nausea constant back pain and mild cramps. I took a tes 2 weeks ago it was neg. Could i be pregnant?",
    "doctor_response": "Hello,                                                                                                                                  1. Jump to a healthy, balanced diet rich in vegetables and whole grains.2. Regular physical activity.3. Try to reduce stress.4. If you are overweight, losing excess weight, maintain your weight.5 Do not smoke.Sperm Count Low Home Remedies1. Garlic is the most effective remedies to increase sperm count. Garlic contains selenium, which can increase the sperm count, the most important part of one.2. The Onion: Onion is a very good heart and blood thinners. Improve blood circulation, blood flow to the genitals, and increase sperm count over time.3. Celery: Celery also serves as an excellent home remedy to use, to increase sperm count. Celery contains androsterone, increase sperm count and sperm health. Celery is also beneficial to sexual dysfunction.4. Eggs: Eggs are a good source of selenium and other important nutrients. The eggs are very effective in the treatment of various diseases such as erectile dysfunction, loss of libido; reduce the level of egg, and so on. Testosterone improves blood circulation, increase the intensity.5 Water is one of the most inexpensive home remedies to increase sperm count. Water to maintain moisture, and keep the circulation flow. Water to nourish sperm; increase sperm count and sperm health.                                                               Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could chest x-ray with streaks on lung suggest?\n\nI have been running a low grade temp since about July... They have done numerous blood tests and etc. on me and everything comes back normal. I got something like a bad cold or something just before Christmas. The xray showed white streaks on my left lung which my doctor was very concerned. But I was told by the nurse today that my report was normal even though the doctor had not signed off on it..I have just finished my 4th antibiotic an still have a low grade temp and a bad cough. What else is there to do?",
    "doctor_response": "Hello dear , hiWelcome  to Healthcaremagic.comI have evaluated your query thoroughly .*  This is in relation with lung infection , inflammation or others .*  Recommended to take CT scan thorax with contrast for further  in depth    analysis of the issue .Hope this will clear your query .Wishing you fine recovery .Regards dear take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Did lower molor root canal. Reinfected, so had clindomycin. Motion sickness and nausea. Related to procedure or another issue?\n\nI just had root canal done for first time 3 weeks ago. Lower molar.  Reinfected before job finished. So back on clindomycin again and in to office to have it cleaned out again.  During procedure had ringin in ear for about 5 min. Woke up next day with motion sickness. Nausea and  1 bout of vomiting.  Hot and cold.  Related to procedure or separate issue.  Antibiotic?  Etc",
    "doctor_response": "Dear friend. Thanks for sharing your concern. your symptoms are not directly related to usage of clindamycin.still if you want you can just speak to your dentist regarding an alternative antibiotic. please check with your physician regarding your symptoms like nausea and vomiting. once your canal preparation is completed,antibiotic has very less role then. hope it helps. thanks. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest if my semen report is alright\n\nhi my name is farhan i am from pakistan..... i done my semen test last day..my semen analysis report this..Physical...Quantity 02ML...P.H 7.5 : AlkalineColour..Greyish White Viscocity: Less Viscous Consisteency: Liquefaction Complete After One Hour.MICROSCOPIC EXAMINATIONTotal Count 90 millon Per ml ( 40-200 million per ml ) normal RangeActive 50% / hpf ...Pus  Cells 4-6.Sluggish 10% /hpf RBC's NILDead 40% /hpf note oud Side Sample .....please tell me about this report i m perfect or not...",
    "doctor_response": "Hi welcome to the health care magic I had gone through your semen report Your sperm count is absolutely normal Dead sperm here is somewhat High...  But you can produce child as your active motile sperm is 50%.. As per who criteria active motile sperm should be atleast 32%... Avoid wearing tight underwear and hot shower avoided Avoid smoking if having habit and consume more fruits and vegetables For getting child do intercourse frequently at 12 to 18 day of menstrual cycle If your wife can't conceive then we will discuss further Take care Hope your concern solved",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful lump in ribs\n\nI am 28 years old and approximately 112 lbs. 4 feet 11 inches tall. The only medical history I really have is depression, 2 c-sections, and tonsil and adnoid removal. I found a hard lump on my ribs and I wouldn t say tender to the touch, but more painful to touch.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some soft tissue tumor like dermatofibroma or neurofibroma or some bone tumour.  Yousshould go for x ray local part first.  Then if needed go for biopsy of 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for allergies and asthma\n\nI'm 44, F, 200lbs., 5'7.  My medical history includes asthma, which is controlled, I have seasonal allergies, oesteoarthritis, ADD, migraines and some neck and back issues.  I've had recent bloodwork done and everything is fine there.  I take medications for asthma, ADD, acid reflux, muscle relaxers and a variety of pain medicine.  I'm having a few problems all of them about my nose and sinuses.  I moved from Ohio down to Alabama 6 months ago.  I'm getting ready to go back soon.  Right before I left I started having problems with my right sinus.  When it started, it was just at night but now it sometimes lasts on and off in the day as well.  It's as if it's swelling shut where I can't breathe out of it.  But there's nothing in it.  I'm not blowing out anything and there's nothing draining.  Another problem is that there seems to be scabbing in both nostrils at the openings and just up in a little way.  They're extremely sore.  Next is on the edge of nostril towards the tip of my nose, there's a \"knot\" or bump. It is really sore.  I thought it was a pimple at first or an ingrown hair.  Well the scabbing and the bump both went away eventually, but now they have come back again.  I don't know what is going on or what to do about it.  At least how to make any of it more comfortable until it goes away.  I plan on seeing a ENT when I get back to Ohio, but if you could help me out for now I'd really appreciate it.  Thank you",
    "doctor_response": "There is a potential inhalant allergen in your surroundings, which is the reason for recurrent nasal allergies.  Additionally start an anti histaminic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the early signs and symptoms of pregnancy?\n\nhi i kepp thinking i am pregnant and i hope i am not i should have used protection :( i get dark urine, i have missed a period and i get sore heads often what could this mean i also think that my stomach has swallen but it then goes back to normal size i am skinny but i think i have put the weight on to soon please help x",
    "doctor_response": "Hallow Dear,If you have missed your period, you have to consider the possibility of pregnancy first. The other symptoms are:1. Nausea & vomiting with food aversions2. Frequency of urination3. Breast symptoms which include engorgement, heaviness, tenderness, dark discolouration of nipples & areola, increase in the size of areola and colostrum discharge from the nipples. Of course all these symptoms take varied periods to appear. By all these symptoms, pregnancy cannot be confirmed. For confirmation, the best option for you is urine examination for pregnancy test. This test should be performed on overnight first urine sample 8-10 days after missed period. Done earlier, the chances of false negative tests exist. Alternatively you may go for Beta hCG test which is very specific and sensitive even on the day of missed period or even earlier. If you do not want this pregnancy, you may opt for medical termination of pregnancy. Mifepristone and Misoprostol are reliable and effective medicines which terminate pregnancy safely up to 9 weeks of gestation. These medicines have to be taken only by Gynaecologist's advice and prescription.Hope this helps you. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood in the stool?\n\nDear Sir/Madam, My Nephew who is 5 years old has been passing stool with drops of blood since the last 2-3 months. The Doctors here have failed to diagnose the cause and suggested for a Colonoscopy. Since he is just 5 years old,so we are worried. Under such prevailing conditions we are at a fix as to what to be done. Can you please suggest us the name of a good Pediatric Doctor/Surgeon in your Hospital who will be able to take care of the entire matter? Please respond fast. Regards, S.Chakraborty. Siliguri,West Bengal",
    "doctor_response": "Hello, As per your history, it may be due to hard stool or constipation. For that give him a soft diet. Keep him hydrated. He may require stool examination and complete hemogram after consultation. At present no need for active management required. Watch for symptoms like fever, abdominal pain, recurrent blood in stool then he may require detailed evaluation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for severe congestion and sneezing\n\nI have a 2 yr old nephew and we have taken him to the dr many times for severe congestion, sneezing, doesn't sleep at all at night or while taking a nap.  His dr gave him a nasal spray and an allergy medicine once a day.....any suggestions?  havenot slept in days...",
    "doctor_response": "Hi,Welcome to health care magic,Sneezing and severe congestion in 2 year child are mostly due to viral infections of pharynx,sinus,larynx, epiglottis or nasal cavity etc.Some times it could be due to bacterial infection also.He may have some routine blood counts and sputum examination if there is cough with sputum to rule out infective pathology of lungs.He will require antibiotics in syrup form (quinolones or macrolides) to prevent super infection and anti-inflammatory, antihistamines with other supportive treatment.You can give him nasal spray and allergic medications available over the counter for symptomatic relief.Need not to worry about his sleep as the symptoms will start subsiding,he will be able to take a good sleep.Consult your pediatrician for further advise.Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Delayed period, back pain, headaches, creamy white discharge, tenderness in breast, nausea. Had tubal ligation. Am I pregnant?\n\nIm36 have 3 kids 3yrs ago i had a tubal ligation,my last cycle was oct 27 i was sexual during that time period, my cycle has been gone for 5days,yet im having back pain,headaches,creamy white discharge with no burning or itching,breast tenderness,blurred vision,nausea ,cramps in my legs and pelvic area,is it still possible i could have gotten pregnant ?",
    "doctor_response": "Hi,      Though rarely, failure of tubal ligation( recanalization) is seen. ( failure rate being 2-10 per 1000 cases)      IN your case the symptoms you are suffering may be  due to irregularity of menses  due to hormonal imbalance  OR  pregnancy .      You can exclude pregnancy by blood HCG testing.      If the test is -ve, take Norethisterone 5mg pills, 1 twice aday for 3 days . it will be followed by withdrawal bleeding.      Please consult your doctor for detailed examination & advice as per need.      Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can a patient lead a normal life after heart valve replacement surgery?\n\nHi doctor, My father, who is 57 years old, was suggested to go for AVR (valve replacement). His weight is 74 kg. What are the procedures followed for valve replacement? Is there any consequence after the surgery? Can he lead a normal life after surgery? Which valve do we need to choose irrespective of cost? How many days does he need bed rest? My father has high BP, and always it ranges around 170/80.",
    "doctor_response": "Hi. Thanks for writing in to us. I have read through your query in detail. Please find my observations below. The valve replacement surgery is usually done using open heart surgery technique, and the surgeon connects the blood vessels to a heart-lung machine and then stops the heart. After this step, an incision is made into the aorta and using careful precision the aortic valve will get replaced. This operation is 98 percent successful. For people less than 65 years, the valve implanted is a mechanical valve, and this is because a mechanical valve will work for many years. In patients older than 65 years, a biological valve is used. He can lead a near normal healthy life. He has to follow up with his doctor regularly and be on medications for a long time. He will be in the hospital for a week and should not be on bed rest. Only thing is he must avoid physical exertion after surgery and take strict precautions for three months after surgery. The blood pressure will get controlled with medicines and doctors make it a point that operation is not risky due to that. Regular medication has to be taken and should get echocardiography as instructed by the surgeon and cardiologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does dilated cardiomyopathy lead to severe pain?\n\nI was recently diagnosed with dilated cardiomyopathy.  My EF is 35%.  I take 3.125 mg of Coreg twice per day.  Today, while sitting watching a video, my heart rate, which is usually in the 72 - 78 beats per minute range was up around 90 beats per minute.  I also had a single shooting pain down my left arm and a general feeling of numbness in the arm after that.  I had this happen once before and the shooting pain in my left arm was so strong it woke me out of a sound sleep.  Do you have any idea what might be causing the shooting pain and racing heart rate?  Is this something I should be going to the ER for?Thanks,Scott",
    "doctor_response": "The pain in cardiomyopathy could be due to coronary artery disease / angina. You should go in for more tests to know the exact cause and have treatment accordingly. Yes it could be serious.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes clival tumors?\n\nI have been diagnosed with clival mass - chordoma -- adjacent to the brainstem and about the size of a grape. I m being referred to one of the medical teaching schools for further evaluation. Can they biopsy this? IF it is benign, what is repercussion of not doing anything with it... or is that an option?",
    "doctor_response": "Hi,Thanks for writing in.The clivus is part of the bone in the inside of the skull. This is a small bone that has a pea sized area in front where the pituitary gland is found. The clivus is a bone located behind the pituitary,A chordoma is a tumor of bone origin and is regularly noted in relation to the clivus. It is part of a family of cancers called sarcoma, which include cancers of the bones, cartilage, muscles and other connective tissue.Chordomas are thought to arise from remnants of the embryonic notochord and might have cell origins since birth and start proliferating at a later age. They are usually slow growing and recur after treatment. Because of their proximity to critical structures biopsy is difficult and requires skilled approach. Often it is diagnosed on CT scan or MRI scan and treatment is given. Having it evaluated in a teaching school will give you more options of treatment and cure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Moderate micro vascular disease, simple and complex seizures. CAD, angioplasty done. Pain management?\n\nI have been diagnosed with moderate microvascular disease (per MRI ). I have had seizures for about 15 years, most are simple complex but I have had about 2 grand mals. I am tested normal for the seizure tests. I also have CAD and have had 4 stents and 1 angioplasty , but I still have chest pains. I am now referred to a psychitrist for the pain since there seems to be no reason for it. I am not assured that this will be the right thing to do. I am still worried about my health.",
    "doctor_response": "Dear those micro vascular desease is probably related with blood hypo perfusion due to chronic illness such as arterial hypertension, diabetes, dislipidemia etc.If the cardiologist says there are no new ischemic cardiac events you have nothing to be worried.Wish you all the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any connection between Zocor and fatty liver?\n\nI was on Zocor.  Had a blood test after a couple of years and found that my ALT ans AST were 125 and 150. Had an ultrasound of the liver and was diagnosed with Grade 2 fatty liver. Stopped Zocor. ALT and AST went to 24 and 31.  Had another ultrasound 9 months later. Still have fatty liver grade 2. Any connection here between Zocor and fatty liver? any suggestions?",
    "doctor_response": "Brief Answer:NORMAL liver enzymes with fatty liver.Detailed Answer:Hi.Thank you for posting your query at HCM.Zocor may have caused the deranged liver enzymes but NOT the fatty liver.advise:get following blood test:1. Viral serology - anti HAV, HBsAg (if not vaccinated against HBV), anti HCV2. \"lipid profile\"You may visit hepatologist. Get the blood tests done asap.further advice:- abstinence from \"Alcohol\" - LOW fat diet should be followed, AVOID junk food and beverages- decreased oil consumption (oily food)- NO red meat- green vegetables should be ingested daily- use lemon juice (lemonade) once in a day- reduce weight if overweight/obese-\"recheck liver enzymes after 6 to 8 weeks\" and/or ultrasound.Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good and sound health.any further questions are welcomed.regards,Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can unprotected sex and missed period leads to pregnancy as on I pill?\n\nmy last normal period came on 6th october. on 13th october i had unprotected sex but took i pill within 4 hours.on 21st october bleeding occurs which last for 3 days. now my period is delayed by 6 days which was due on 6th november....... i m worried please tell me that m pregnant or not",
    "doctor_response": "As u have taken i pil post sex..nothing to worry..and moreover u had sex on safe period....u can do urine pregnant test n check if u r still anxious...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with prostate cancer, had a surgery. Treatment of provenge? Radiation harmful?\n\nHello, My father was diagnosed with prostate cancer about 5-6 years ago and had surgery right away. He than moved back to Florida and has had his hormone treatments there. However, a month ago we were just informed that his cancer spread to his spine C7 and that is was a very large area affected. His Dr. recommended radiation and he finished his 19 round of treatment. My dad is not a complainer and has the most positive spirit ever, however I am aching inside because I do not feel his Dr. is being upfront with us and how serious my dad s condition is. When I was there with the Dr, last month he told me my father will be fine and would like to begin a new treatment of Provenge. We looked into the treatment and my father objected to the treatment after talking to his Radiation Dr. I am going to see my dad and his Dr, in three days when I arrrive in Florida, please help me with what I need to know and ask the Dr. I just want to make sure my dad gets all the possible options that he can. Thank you, A concerned Daughter, Maria Canzano",
    "doctor_response": "Hi, after surgery prostate bed radiation is indicated in high risk cases. it is not clear whether your father had received prostate radiation earlier or not. now to treat vertebral metastasis radiation has been given. injectable bisphosphonate is an option. your father should continue hormone treatment , but drugs may be changed. if metastasis to other organ chemotherapy is as option. consult  your oncologist. take care of your father",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a low grade running fever\n\nMy daughter has been running a low grade fever (between 101-103) for three days (since Tuesday afternoon). This morning, she has a temperature of 98.8. However, she woke up with a very sort jaw line only on the left side. Any chance these things are related. The only other symptom she has had this week is vomiting (for the first 24 hours). Last week, on Monday, I took her to the doctor and she was diagnosed with strep throat and put on Amoxicillan. Her 10th day would have been WEdnesday, but we stopped on Tuesday night since she was vomiting. She doesn t have any kind of rash on her body anywhere so I don t think it s Scarlet Fever. What do you think could be causing her jaw pain? I don t feel any swollen glands under her chin/neck area.",
    "doctor_response": "Hi.... the jaw pain your daughter is experiencing could be referred pain from the inflamed and enlarged tonsils or congested pharynx. I suggest you continue the antibiotic therapy for a total of 10 days which is the appropriate duration of treatment for streptococcal sore throat. The jaw pain can be managed with appropriate dose of Paracetamol, but if it is so severe as to restrict the movements of the jaw then it requires evaluation by physician.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My EKG reading shows sinus arrythmia. Kindly advise.\n\nHello doctor, I went to urgent care today because I had bad heart palpitations while taking a walk, along with some cuest discomfort. I have heart palpitations quite frequently but these felt different. They were a but thump behind my sternum, several times in a row. The EKG reading from urgent care says \u201csinus arryhtmia\u201d. I have had many EKGs done before but it has never said that. Is this of concern?",
    "doctor_response": "Hello. Your ECG is fine and sinus arrhythmia is normal phenomenon, where heart range varies with respiration. It may not be evident always or depends on sensitivity of machine, and also it is more pronounced, detectable when one is breathing heavily or rapidly. So it is not a matter of worry at all.  Next thing, were you also having palpitations when ECG was taken or subsided by that time? Because considering symptoms of palpitations and chest discomfort, its important to rule out possibility of cardiac arrhythmias like PSVT/ paroxysmal atrial fibrillation, which are intermittent and ECG would be absolutely normal at other time. So normal ECG does not rule out possibility of arrhythmia.  So you should either have holter monitoring (24 hour ECG monitoring, but it would detect arrhythmia only if it happened during this 24 hour period) or you can buy simple single lead ECG devices, which would help to monitor your rhythm whenever you are symptomatic. So, basically we need an ECG rhythm during symptoms so as to reliably rule out possibility of cardiac arrhythmia. In a nutshell, your ECG is fine and may need further steps. I would also like to know why are you eliquis, Prednisone. And thyroid problems may cause arrhythmia like atrial fibrillation, so TSH should be monitored.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can abdominal pain due to gallstones be treated?\n\nI started last Thursday with terrible pains in my stomach.... It has just gotten worse so I went to the ER Tuesday night. They gave morphone and it did not take the pain. They gave dialoted (can t spell) and did a CT scan and said I have gull stones. Can t eat anything. Have appt next Tuesday to see a surgeon but my pain is real bad today. Just ate soup and now throwing up. I just can t eat anything. My pain was so high Tuesday my blood pressure was 215/93. I just don t think i can wait until Tuesday next week to see a doctor and they have to wait for the surgery.",
    "doctor_response": "HelloGall bladder calculus pain is definitely a treatable condition.Definitive treatment of gall bladder calculus is surgical removal of gall bladder(Cholecystectomy).Till operation is planned,you can take analgesics and antibiotics.Gall bladder calculus are prone to infection and obstruction,so it is advised to remove it earliest.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should i do as my 2 year old swallowed a coin?\n\nMy almost 2 year old daughter swallowed a coin 2 weeks ago. I'm not sure if she passed it yet, but she has had diarrhea for almost 24 hours. First yellow and now black. Do you think this is from the coin? An infection? Should I take her to the hospital for an x-ray?",
    "doctor_response": "Welcome to HCM, I have gone through you query and understood your concerns, this is a very  common occurrence children this age put many things into their mouth in most cases when a child swallows a coin, it makes its way down to the colon and gets stuck in the stool and gets passed out, is very important to check the child stool within 3 days to see the foreign body, but you are not sure if your daughter removed it, I kindly suggest go to the doctor to a proper evaluation and avoid further complications  Please kindly rate if my advise has been helpful   Wishing you a good health   Dr Tania Portelles-Driggs",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes muscular spams in an agitated infant?\n\nIf a very healthy 9 month old baby with no history of neurological defect or deficiency has muscle spasms when tired, or overly aggrevated, can this be attributed to electrolyte imbalance? He is on an advanced schedule because he is trying to emulate and keep up with his 3 year old brother..",
    "doctor_response": "Yes muscle spasms can occur due to electrolyte disturbances but the most common reason is overuse, fatigue and dehydration.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hemangioma on tongue\n\nHi im 23yrs old female ..suffering with heamangioma on my tongue from birth..i have under gone plastic surgery twice @ 8yrs &  15yrs ..later 17yrs it spend on  corner of my lips bluish colour swelling is found n slightly lower gums of teeth front jaw..kindly give me a solution for it..thank you",
    "doctor_response": "Thanks for your query, I have gone through your query.The hemangioma can be treated by sclerosing agents and by surgery. Since you are telling it is recurring, you might have to get it treated again by surgery. Consult a good plastic surgeon and get it treated. Before that you need to get a CT angiography and MRI to see the extent of the lesion.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the dosage of i pill after intercourse?\n\ni had taken i pill after 30hrs .. mine was only a doubt that whether sperm has entered by mastebating.. no  real sex happened. my problem is tht i cant feel nothing special after having i pill. no common side effect... should i take another pill... pls help me plz",
    "doctor_response": "Hello,I can understand your concern. If a sexual intercourse has happened where there are chances of penis discharge or semen entering vagina, then only you can get pregnant. Chances of getting pregnant by masturbation are nil. To answer your question regarding i pill, not all women feel the side effects of i pill. Presence of adverse effects is not a sign of effectiveness of any medicine. So you do not need to repeat the pill.I hope this information helps. Thank you for choosing HealthcareMagic. Take care.Best,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes loose stool after drinking milk?\n\nHi, I just started my 1 year old on Whole Milk and she is having very loose stools - often yellowish /tan. This week she also had her 1 year old shots and is teething - I don t know if that can affect or not. Most people say that once on milk stool becomes harder. Hers was always loose - she was on a milk based formula but with the Added Rice because the formula seemed to run through her so quickly. Is this normal? Or could she be intolerant to milk? How do i know?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.What your kid is having is not a diarrhea and is only a gastro-colic reflux. It is quite common for babies of this age group to pass small amount of diarrhea or loose stools soon after feeds. This need not be treated as diarrhea and especially antibiotics are not indicated.When the baby takes milk , the stomach expands - then when it is contracting it sets off a wave form which moves down the intestines and when that wave reaches the lower down rectum, a small quantity of the stool is evacuated out. This is the basis for gastro-colic reflex. Do not worry. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What kind of treatment is recommended for malaria?\n\nHi, My aunt is suffering with malaria every after one month,when ever she is sick she is going to doctor, and the blood report is showing malaria positive, what should we do.instead of looking for local doctor planing to go to a specialist.which specialist we should consult for malaria treatment.",
    "doctor_response": "Hello,Suggestive of recurring malaria.Malaria is caused by four different species of parasites such as plasmodium falciparum, vivax, malariae, and ovale.Of these, plasmodium vivax and ovale are responsible for the relapsing attacks or recurrence because they can form dormant liver stages which can then re-enter the blood causing a relapse of malaria infection and a recurrence of symptoms. Your aunt needs to be examined by an infection diseases specialist who is an expert in the diagnosis and treatment of all kinds of infectious diseases including those caused by bacteria, viruses, fungi and parasites such as plasmodium.If your aunt has one of the relapsing kinds (P. vivax or P. ovale) then she needs to take a course of an additional drug called Pimaquine which kills the dormant liver forms of the malaria parasite and thus prevents future relapses.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mohammed Taher Ali",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for depression and severe anxiety\n\nI have depression and severe anxiety...I ve been on Wellbutrin 300xr for over a year...w/1mg xr xanax (1 per day) and 1mg reg xanax (1 per day) Stress in our life has gone up tremendously and my anxiety is out of control. I am afraid to ask my dr for a higher dosage or more doses in a day. How do I ask with out her thinking I m after more drugs ...I m looking for relief of anxiety and xanax is what helps me even as tabu as others find it. How do I ask her and how much more do you think I may need?",
    "doctor_response": "HiWelbutrin is bupropion and its  NDRI.Usually we do not prefer it for 1st line treatment for depression and anxiety.Xanax is good to handle anxiety.This kind of condition can be treated with SSRI like escitaloprm OR paroxetine.Now a days SSRI is the choice of drug for depression.So need to discuss with your doctor if you have still problem and symptoms.Besides thisDO meditation and exercise.Deep breathing.Proper and regular sleep.Take regular and healthy diet.Consult best psychiatrist nearby and discuss all this and get well soon.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can strep throat be treated?\n\nMonday I was diagnosed with Strep throat. Given an antibiotic. My symptoms have worsened. The uvula is swollen, white spots, laying on the back of my tongue and is raw. Swiping with a q-tip reveals some traces of blood. My throat is so sore that it is difficult to swallow. My glands are swollen and I have lots of white spots in the area of my tonsils, back of the roof of my mouth and even on my gums behind my molars. I have take the antibiotic 2x a day for 3 days. I am miserable, difficulty swallowing food as well as saliva. Warm salt water just sets my mouth on fire. Any suggestions?",
    "doctor_response": "Hi,   Thanks for asking.    All the symptoms you have suggest strepococcal  infection.    Penicillin or Amoxil are antibiotics of first choice . If you are allergic to penicilline, you can be given- Azithromycin,Cyclosporine,Clarithromycin,clindamycin... A prolonged therapy may be needed as per sevirity of infection by treating doctor.. it is advised to take full advised course with antibiotics & accompanying adjuvant medicines.    Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yeast infection around vaginal and anal area in a child?\n\nI am writing concerning my 6 year old daughter. She has battled an infection around the vaginal area and what looks like ulcers. She has been checked for every type of STD and bacterial infection and has seen 3 Doctor's and 1 Dermatologist. Their diagnosis was Erysipelas and the treatment was a strong antibiotic. Today, she was seen by a 4th Pediatrician and he tested her for bacteria that may be the cause of a fissure. He also said she has a yeast infection around the vaginal and anal area. He prescribed Diflucan 100 MG (2 tablets). She will see him again next week when the test results come back. Is this common for a 6 year old and should I start her on a stool softener in the mean time?",
    "doctor_response": "Hi,It seems that she might be having yeast infection with super added bacterial infection producing all these symptoms.Continue with all these medicines till full course.Important is to keep her local hygiene clean, dry and airy.After proper cleaning apply antibiotic or triple action cream.Wear cotton short and avoid more perspiration on local part.Give her proper instruction and training about keeping personal hygiene clean and healthy.Rule out worm infestation which again cause infection and irritation.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pelvic and lower back pain at night?\n\nI was awake all night with pelvic pain and lower back pain. I almost went to hospital at 3:30am but would feel stupid if it was just gas or something. I got a little relief laying on a heated bean-bag. I eventually had a smelly soft bowel movement and eventually started to feel better. This all happened the night before also, only less painful. Should I go to regent care or wait and see if it happens again tonight?",
    "doctor_response": "Hello, I have studied your case. Usually nerve compression cant be seen on x ray you may need MRI for this.There will be age related spondylitis but if there is any nerve compression then that may need specific treatment.I will advise you to do MRI spineTill time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Report shows sperm count as 102, motility during 1st hour rapid progressive at 10%. Symptoms of infertility?\n\nHi , I am attaching my semen analysis report , please suggest -Do I have infertile semen ? . Regarding Thickness , Motility & presence of (PUS Cell + Germ Cell ) please suggest -is it normal . I am 40 yrs old . lately married & truing for baby . Please give some good suggestion. SEMEN ANALYSIS SAMPLE INFORMATION TIME OF COLLECTION 2.25 p.m. TIME OF ANALYSIS 2.35 p.m. ABSTINENCE (IN DAYS) 5 Days PHYSICAL EXAMINATION COLOUR - Off white VOLUME 5.0 ml VISCOSITY Thick REACTION Alkaline pH 7.2-8.0 0 LIQUIFICATION TIME 25 20-30 minutes MICROSCOPICAL EXAMINATION SPERM AGGLUTINATION 1 2 - 3 scale SPERM COUNT 102 millions/ml MOTILITY 1ST HOUR MOTILTIY RAPID PROGRESSIVE 10 % SLOW PROGRESSIVE ---15 % NON PROGRESSIVE-- 25 % IMMOTILE --50 % 3rd HOUR MOTILITY RAPID PROGRESSIVE--- 05 % SLOW PROGRESSIVE ----10 % NON PROGRESSIVE 25 % IMMOTILE---- 60 % SPERM MORPHOLOGY NORMAL-- 80 % ABNORMAL ---20 % OTHER CELLS (per 100 sperms) ROUND CELLS (pus cells + germ cells) 2 - 5 /hpf EPITHELIAL CELLS OCCASIONAL RBCs---- OCCASIONAL FRUCTOSE TEST--- Present With Regards",
    "doctor_response": "Hello, welcome to HCM, Your semen analysis report shows Normal physical examination. Sperm count is within normal limit. Motility of the sperm is lower than required ( normal is >40% as per WHO 2009). Morphology of the sperm is within normal limit ( normal is > 04% as per WHO 2009). Among the other cells, round cells are mildly increased ( normal is occasional as per WHO 2009). Presence of fructose is also a normal feature. So, overall, the semen analysis report shows normal report except the motility and presence of pus cells. Consult with your treating doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had jaundice. Have high level of SGPT and SGOT. Is hepatitis F without liver transplantation chronic?\n\ndoctor i was being affected by jaundice(hepatitis E) before 1 and half years,due to water contamination and never undergone liver transplantation andall,and had alcohol after 6 months...when i went for LFT...my SGPT and SGOT level went high and Total billirubin too and caused jaundice again...and now it is normal doctor...can i consume alcohol again else after how many days can i have it????kindly dont mistake.....is hepatitis E without liver transplantation chronic????doctor?",
    "doctor_response": "Hello You Know that if any liver disease alcohol is strictly contraindicated. then why you want to drink it . you know very well last time you report also up going so keep away from alcohol if you live normal life and take proper food then no any problem It is particularly dangerous for pregnant women not you one more think hepatitis E vaccine developed by Chinese scientists only and approve by china only. you can take help of ayurveda also Dr Vinod",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lumps in armpit\n\nI have a grandson that has had a history as his father and grandfather has with lumps under their armpits from certain deodorants but recently my grandson, just turned 18 has developed lumps like ones under his pits on his chest.  He's had Mono but supposedly is over it. Can the lumps be caused by the mono?",
    "doctor_response": "Hi,Dear I went through your  query.1-By the facts placed by your query,I feel that this lump under the armpit appears to be due to the mono.2-This lump is not like the ones like his father and grand father-after de-0derants. and needs FNAC/ biopsy of the armpit lump. -It could be due to  even TB,but needs FNAC biopsy to to give any reasoning opinion on it.3-Plz check your  your ER- doctor for second opinion . 4-Hope this would solve your query,5-Thanks for your query to the Health Care magic. 6-You are wellcome for any further treatments if required.7-I would love to help you out of YOur  armpit lumps. .Thnks.Wellcome.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the spaghetti type growths on my tongue?\n\nI have three thin spegetti type growths on each side of the bottom of my tongue I did not notice them until the one on the right side started being sore... They look like a catfish or something..  I am worried. The are growing in complete symetry to each othe going down under tongue but on bottom of tongue",
    "doctor_response": "Hello,Some various shaped tissue attachments with symmetry may be your normal anatomy. Do you think there was any trauma to your right side such as biting your tongue or eating crusty bread? There are frenum attachments that secure your tongue in place. There should be an obvious center one under your tongue to compare with the areas you are concerned about. Symmetry is a good sign that this may not be a condition to be alarmed about. Monitor the area and see your dentist for further evaluation. Other conditions could include inflamed, calcified or blocked saliva ducts or blood vessels. An ulcerated area appearing could indicate a viral condition. Rule out an allergic reaction due to food, medication or habits. Consider a change in products used that may trigger a reaction. Rinse with warm salt water and take some anti-inflammatiey medication such as acetaminophen or ibuprofen. Avoid irritants such as spicy food, acidic drinks and food, smoking and alcohol. Keep well hydrated. Maintain good oral hygiene. Keep a proper diet and balanced vitamins.Provide additional details and I will be glad to comment further. Your medical and dental history would be helpful to know. Thank you for your inquiry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for stomach pain and greenish loose stools\n\nDr my baby s 3 months I m giving him nan pro 1 for past 5 days he s going dark greenish wit whire cold loose motion wat to do I dnt knw he a crying for stomach pain over night wat s remedy for my baby doctor pls reply for the greenish..can u suggest me a good product of milk I m giving only twice a day then full day my mother feed ly doctor pls reply",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is PEP effective after a risk exposure?\n\nHi doctor, Is PEP effective after a risk exposure?",
    "doctor_response": "Hi. It is not 100 % protective against HIV. But it significantly reduces the chances by over 80 %. Please mention about the mode of exposure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On IVF treatment, after E2 results advised Newmon, HUMOG injections. Is this treatment right ?\n\nHello sir i m 35 and my husband is 37 . We are taking IVF Treatment for a Baby. My periods came on 30/11/12 and my doc gave me one injection - Newmon R 225 IU + HUMOG HP 225 IU for 2nd to 6th Dec and second injection - Eutropin 4 IU on alternate day . Befroe presribibg these injection Doctor have taken Blood Report through Estradiol (E2) test. Result of E2 test is 18 pg/ml. Now looking to these high dose injection i m in confusion whether all procedure igs going in right way. Is there any problem with my testing thats why docotor are giving high dose of injection .Please help and guide. My email id is YYYY@YYYY",
    "doctor_response": "Hi, E2 level of 18pg/mL before starting hormone injections is normal value, Regarding the high dosage of injections, your doctor must have considered all factors & started the dose most suitable for you. Your treatment appears to be going in right direction. Don't worry. Wish you good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What caused severe pain in upper left side after being stabbed?\n\nI was stabbed in my upper left side just below my arm pit, the cut was so deep it was only a quarter inch away from my heart. About 2 days after I was sitting down and all of the sudden I got an intense, sharp pain in my heart/shoulder blade, basically my whole upper left side (not including arm), it was difficult to breathe. The pain was very, very intense at first then throughout the next 10 minutes or so the pain came and went. The doctor said I didn't hit any vital organs so Im wondering what it could be.",
    "doctor_response": "This may or may not be related to stab wound. 1. This could be an anginal pain if you are a smoker/ age > 35/ male/over weight.This could b secondary to stab wound that left your pleura ( lung covering) damaged. Now it is causing pleuritis and pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood in sputum when suffering from chest infection?\n\nI have a chest infection which is being treated with penicillin and steroids..I normally have low to normal blood pressure...I am a smoker and I have just coughed up blood streaked sputum..Is if likely my blood pressure is higher than normal because of the infection..I am aged 65 and have smoked since I was 7! I know I must quit now but is the blood a sign it is too late",
    "doctor_response": "blood comes in the sputum when the mucous membrane of bronchus or lung is opened due to infection / ulceration / irritation is there opening the small blood vessels under it!so it could be some infection, tuberculosis or even cancer!please ask for a sputum microscopic test in the early morning for confirmationall the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My newborn passes loose stool during or immediately after breastfeeding. Is this condition normal?\n\nHello doctor, My new born baby passes loose stools during breastfeeding or just after breastfeeding for the past three to four days. Sometimes it is very small amount. But he passes stool daily for about 10-15 times. Sometimes it is in the form of foam. Yesterday onwards, I am giving him probiotic. But still no improvement. He is suffering from blocked nose also. What to do for his condition?",
    "doctor_response": "Hello. Newborn babies may pass stools immediately after feeding. This is a normal reflex. If your baby is passing stools quite often and is feeding well, has got sleep after feed and passes enough urine, i.e., six to eight times in a day and gaining weight, then you need not worry. For the blocked nose, you may clean frequently or use saline drops. Probiotics are usually not of much help in this age group; breastfeeding is recommended. If the baby has a fever or poor feeding or a large number of stools or less urine or weight loss, anytime you feel baby is lethargic or looks sick, please consult your pediatrician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes ear infection and rashes on the face?\n\nHello, I am four weeks postpartum & breastfeeding. I have been experience extreme stiffness & tenderness in my upper neck / base of my skull. It is sometimes accompanied by a feeling of sore throats or ear infection however no infection is present. I am also getting flushes of heat, tingling & rash on & around my face & neck...Always in the evening. I have had a CT scan with normal results, blood work with normal results but feel so strange & sore any ideas of what I might be dealing with?",
    "doctor_response": "dearthanks for writing to hcmplease be calm and be assured that most of the symptoms described may be due to hormonal changes on account of the post partum  and nursing time.Gradually by six months most of the symptoms would be relieved,however for a chronic troublesome pain we need consultation.hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy after taking HCG injection?\n\nI am a 38 year old female, I have been taking Clomid 100 mg day 4-8. On u/s day 12 I hade two follicles, 22 mm and 23 mm. My endometrium was 13 mm. My doctor said to do the HCG shot the same night. I would like to know the chanses of getting pregnant. Thank you!",
    "doctor_response": "Hi, there is a good chance of getting pregnant.  In one cycle of ovulation induction and time intercourse, the chance is 7 to 10 percent even when everything is fine.  Take progesterone for next 2 weeks.  Discuss with your doctor regarding this.  Do a urine pregnancy test at home after that.  You can try like that for 3 cycles before going for IUI.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do these fluctuating BP readings indicate?\n\nB/P at hospital where I work was 182/102 then got a primary doc because just moved to muncie in. Went for visit the same day and I didn t feel like she took my b/p accurately. (Went too fast manually). The nurse got 142/84. The doctor put me on catapress 0.1mg . Took b/p at 2000 and now 182/100. Took first dose of catapress around 1600. Suppose to take Bid",
    "doctor_response": "Hi i do care for your condition. The blood pressure will fluctuate according to a persons current behaviour, whether calm agitated etc. But it will not vary to the extent that you have mentioned. I would advise to take at least 5 readings every 2 hours apart in a single day to confirm the correct blood pressure. And then taking medicines according to result will definitely help. Hope i have answered your question, if you have more feel free to ask. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does my vestibular test results suggest?\n\nI had vestibular battery test that came back abnormal. Interpretation: This is an abormal vestibular test battery dueto upbeat nystagmus throughout, reaching 7 d/s. This may suggest central localization of pathology. There is no evidence of peripheral vestibular abnormality. Clinical correlation is advised. I met with a neurologist and the Associate Diagnosis is Nystagmus. Ordering Comments: Abnormal ENG. Exam unremarkable except for mild dysdiadochokinesis bilaterally. Evaluate for brainstem/cerebellar lesion. I am having an MRI WWO contrast on Friday. She doesn t seem concerned at all, almost like I manipulated the test results. Is this possible? I used to be a heavy drinker for years but stopped about two months ago. I have been smoking pot and told her this. I know alcohol can effect the test, but what about cannibis? I didn t smoke right before either appointment. I ve been pretty sick for almost a year now and haven t been able to work. (pneumonia in October, C-Diff in the spring, continued nausea and now super constipated, loss of appetite and unintentional weight loss (dropped 4 sizes yet I look 9 months pregnant. Pelvic ultrasound and TVU was normal). I am also being treated for depression with Effexor XR, have RLS & PLMS (RLS for over 30 years), no longer have a thryoid (had the radio iodine about 13 years ago) and had a parathyroidectomy this past March. My husband thinks my physical is caused by my depression, which I know is possible. I also know it could be thryoid related (my TSH on 8.09.12 was 0.13) as well as brain lesions and even MS. My GI dr. feels it is neurological. My main question is could my two test results have in any way have been unintentionally manipulated by me to get the abnormal results? And is MS a real possibility? I can deal with anything...just not knowing and started to feel my husband is correct and that it is in my head. Thank you",
    "doctor_response": "Hello, The test shows nystagmus, an involuntary movement. It may be due to several causes, most commonly brain or ear related ones. Often may be born and benign. The test you've had says that it is not typical for ear disorder, the most likely origin would be the brain. It's unlikely you can manipulate it. Regarding the cause any type of lesion in the brainstem may cause it (MS but also stroke, inflammation, infection, tumors etc), the MRI should shed some light on that regard as it's the best test to visualize brain damage. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Olsi Taka, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are palpitations and shortness of breath a cause for concern?\n\nI'm a 20 year old female. I keep getting palpitations and shortness of breath. some of my friends have commented that i've been breathing quite quickly too. I was sent for an ecg about a year and a half ago for the same reason, but my gp said there was nothing to worry about. should i be worried now though?",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern.I will try to explain you something and give you my opinion.You should know that this palpitation are related to rhythm issue. There are some electrical impulses that generates from parts of the heart different from normal  sinus rhythm.They cause premature heart contaction that its not a normal one.It couse a fluttering sensation,palpitations,difficulty in breathing deeply, anxiety.This extra beats might be sporadic and difficult to catch.So, it might happen to have normal electrocardiogram and experience palpitation.This is nothing to worry about if it  happens once a wile.But, if it starts to bother you and interferes in your daily life than I would recommend you dome examinations to find a posible cause.Extra beats might happen because of stress, excessive coffee consumption or pathologys like anemia , hyperthyroidism , electrolyte imbalances ,ccardiovascular disease.So, I would recommend  a cardiac echo , a full blood analyze to exclude anemia , hyperthyroidism , electrolyte imbalances and a holter rhythm monitoring to see your rhythm tendency.Only after this we can better judge what we are dealling whith and how to treat it.Hope I was helpfull .Best regards , Dr.Ervina .",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to deal with chickenpox and its pain in kids?\n\nHello Doctor, My child has got chicken poxand this is 2nd day, per physician, giving regular paracetamol. He has develop a lump behind his one of the ear and is paining and he is crying. May please request to guide me for easy and do you think is this a matter of concern He is 7 years old.",
    "doctor_response": "Hi! there are anesthetic creams commercially available in the medicine shops; please ask your physician for a prescription and apply it on the painful areas or apply ice pack/cold compress SOS; Avoid heat and puncturing the vesicles...!regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the recovery time for fever in a child?\n\nMy daughter (5yrs old) was prescribed Azythromycin (300mg / 100mg per 5ml) last week Friday and we were instructed to start it on Saturday if her fever continued. We started on Saturday with a 1 1/2 tsp dose with continued 3/4 tsp doses. We are now on day three of taking the medication with no relief in her fever. I have been treating with OTC Children s Advil for the fever. I am wondering how long it should take for the fever to disappear? She was tested for the flu and this was negative. Are we dealing with a virus and I just have to let it run its course?",
    "doctor_response": "hi.regarding your query , of fever still persists after documentation of the temperature for three days it is better to do a blood total count just to make sure it is a viral infection or bacterial. if associated with any other symptoms like cough ,sore throat, vomiting , abdominal pain , symptomatic treatment would be apt with an antipyretic like paracetamol that should have been taken along with the antibiotic plus an antacid. do not worry. :) hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tarry stool and blood vomiting?\n\njust vomited a significant amount of blood, have a history of stomach problems and am now in pain in the solar plexis area {high stomach} with a burning sensation, have had tarry stools periodicaly should I seek emergency help or will this wait till Monday for my family doctor ?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You may have some gastro intestinal bleeding. You may have peptic ulcer or some other pathology. You should go for endoscopy. Consult your doctor and take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain around the heels and ankles?\n\nMy son had just gotton over cellulitis in his foot,but was still taken his course of antibiotics.Yesterday,he went to stand up and had the worst pain around the heel of foot and ankle area...would that be associated with that?...or possibly plantar fascitis (sure i spelled that wrong).",
    "doctor_response": "Hello,I am Dr. Selmani and I read your question carefullyThe plantar fasciitis has other signs different with what your son presents.Usually plantar fasciitis pain on the heal is in the mornings , when you do the first steps and you feel like walking on nails , then after some minutes it warms up and the pain goes away. Females have more plantar fasciitis then males and overweight and sports activities on concrete are related with plantar fasciitis.Your son's pain looks different from plantar fasciitis.I would like to know what is the age of your son and what antibiotic he is taking. If he is taking Ciproflaxacin ( or other drugs from this family) and is young age below 12 years old, the antibiotic may cause Achilles tendon rupture and pain behind the heel.Also other information that I do not know is , how much lasted the pain , seconds , minutes ?. Was the pain related with standing position in weight bearing or even in sitting position. Does he have fever.All this info would help to distinguish if it is a infection or inflammation.I think the cellulitis has left still some sort of inflammation around the foot and  ankle that needs to be evaluated from the orthopedic specialist.I wish quick recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for hair loss\n\nhi i am 25 years old and experiencing hair loss problem.. since last 2 months i am using products of arnica, sbl montana hair oil and arnica shampoo and taking arnica scalp tone tablet regularly and also using r89 drops on scalp, plz advice if i am going to the right direction??",
    "doctor_response": "Hi.As per your case history of hairfall.My treatment advice is \u2013 1. Take good nutritious diet full of green leafy vegetables and milk.2. Use a good herbal shampoo and coconut hair oil for regular use.3. Take an iron supplement once daily and vitamin b12 supplement once daily for 3 months.4. Other treatment options are topical minoxidil, oral finasteride and mesotherpy done by a dermatologist.Thanks.Dr.Harshit Bhachech.MBBS, DDVL.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is having perfect set of teeth possible due to having open bite?\n\nHi I am a 30 year old female who has an open bite which I am very self conscious when speaking to people and smiling is there any solution to this? as it's only my 2 front teeth which doesn't overlap with the bottom teeth. I am thinking of extracting my four front teeth and have partial dentures so that I can have a perfect is that advisable?",
    "doctor_response": "Hi! Welcome to Healthcaremagic.I read your query. Open bite can be due to jaw relation disturbance or occlusion disturbance.Extracting front four teeth wont provide a solution for this. You need to visit an orthodontist, who will study your jaws and teeth, take few x-rays and then decide the treatment.Usually teeth allignment is done using braces for 9-12 months varying from case to case. Extraction of one or more premolar may be required for making space. Then fixed braces will be attached to teeth exerting required force to move teeth in desired allignment.Now a days composite braces are available, which are esthetically better.Hope the answer helps you. Thank you!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to re attach an achilles tendon\n\nI have had Achilles surgery on 5/11/2017 and had a revision again on 10/30/2017 because the first one failed. I had a 3rd surgery on 4/05/2018 because of an infection I developed and now I am told there is nothing more they can do to reattach my Achilles tendon. Do you know if there may be any other options available to me for a successful reattachment?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. If the tendon is completely detached then only surgical repair can help. Hope I have answered your query. Let me know if I can assist you further. Regards, Regards, Dr. Praveen Tayal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hot and swollen ankle\n\nI had surger 7weeks ago on my ankle with a plate on the outside and two pins on the inside ankle. Six days ago I was given clearance to begin putting weight on it as I felt up to it, or it became painful or tiring. First two days didn t do much. Gradually I began doing more, but still had my scooter with me. My house has stairs and for the past three days I was able to slowly walk down and up one time a day to get to work and back. Yesterday I became very tired in the evening and noticed that my normal swelling that appears at the end of the day had not gone down by morning. I went to work yesterday, but didn t walk on it much, came home, elevated it, and iced it. Went to bed and it felt fine. Went to bed and have just woken up with a hot sensation. Got up to look and it feels hot, still swollen, and kind of red. The plate feels warm. I don t feel it as painful, but very uncomfortable. I haven t been taking my naproxen regularly, so I just took two to get it into my system and will take another in 8hours. Anything else I should do? An ice pack? So, I m searching before I call my doctor in the morning.",
    "doctor_response": "Hello I have read your query,As per your history there can be infection around surgical site.Or non union at fracture site.You may need to consult your treating doctor for clinical examination and further investigation.You may need blood investigation like CBC, ESR and PCR all non invasive.Improve your immunity by healthy diet execises, yoga, herbs.For early recovery drink plenty of water, eat easily digestible food, improve immunity, and take fruit juices and soups.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump and pain after wisdom teeth removal\n\nI had all four wisdom teeth removed 3 weeks ago. The healing process was incredibly fast and minimal pain for myself. Yesterday morning I woke up with a hard lump around my scarred tissue from the insicion. It progressivly became swollen all along the lower jaw line and the side of my inner cheek. I went back to the dentist who gave me a different antibiotic. My cheek has swollen incredibly, I have take 2 oxycodins, an IB profun and the Clydimiza. I was given the oxy's and the ib profun when I had my surgery, they halped but are not helping with this pain I have now.",
    "doctor_response": "Thanks for your query, I have gone through your query.The lump and swelling could be because of the residual infection in the extracted wisdom tooth or it can be from infection in the next tooth. Consult a oral maxillofacial surgeon and get a radiograph done to rule out any infection. If it is infection in the extracted tooth site, get it curretted. If it is from the next tooth get the tooth treated with RCT. You can take a course of antibiotics like amoxicillin 500mg and metronidazole 400mg tid for 5 days (if you are not allergic) which is more effective than any drugs.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for body pain and high fever\n\nHello, I am suffering from fever form Friday evening and had severe body pain and high fever during the night time . I consulted the doctor and he prescribed levocetirizine 500g, Formic-o 200 and Dolo 650. I was ok during the day time and had high fever throught out night and till now. Can you suggest me for a quick recovery?",
    "doctor_response": "As you have mentioned in your history it looks like of viral infection and it will take some time 5-7 days to recover. You have to take some antibiotics preferably cefadroxyl or cefixime after an expert opinion and continue the medicines as suggested by your doctor for fever and body-ache like dolo 650 or levocetirizine. Do cold sponging to reduce the temperature.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dental problem\n\nI have a question. I am currently receiving treatments from an orthodontists. I have an impacted front tooth that I want down. Initially, during the consultation, the doctor told me that in order for that tooth to come down, I would have to get braces and then a surgery to expose the impacted tooth and to chain it. He also said that because the tooth is in the front, he would put a temporary tooth in that place while he uses the chain to pull the tooth down. Well, I ve got the braces and I had the surgery. All I m waiting for is for the doctor to pull it down and to put a tooth in the front. Well, during my last appointment, he told me that he wasn t going to be able to pull it down because my surgery area wasn t completely. Now, the surgery area is healed, and I went to see him today. I was expecting to begin pulling my tooth into place. However, that was not the case. He told me that, now, in order for him to begin to pull down the tooth, he has to leave the open space, and I would have to go a few months without a tooth in the front. This is not what I agreed to initially and I do not want to walk around like that. Is there anything I can do about this?",
    "doctor_response": "Thanks for your query, I have gone through your query.The tooth cannot be replaced with a artificial tooth since in that place the impacted tooth has to be pulled down. By placing an artificial tooth, we cannot pull the impacted tooth into position. So ideally speaking, the impacted tooth should be exposed and then using braces it has to be repositioned. do not go for artificial tooth.I hope my answer will he lp you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for high Blood Pressure?\n\nmy blood pressure was 148/104 at the doctors office today  I can't get my blood pressure meds until tomorrow that she just prescribed which is metoprolol succinate not being able to take today is that real dangerous? and is that blood pressure real bad?",
    "doctor_response": "Hi There I understand your concern for your health and I would like to tell you that your Blood pressure is slightly high don't worry to much. No worries even if you start meds a day after. But do keep in mind that this level of blood pressure can very well be brought under control by good exercise and dietary schedule as well along with medicine. So it's advisable that you should go for daily brisk morning walks, reduces dietary salt intake, cut down your coffee intake, Stop smoking ( if you do ), avoid eating junk food. Follow this schedule regularly for 3 months and probably your Bp will be under control without meds.Wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the treatment to reduce CPK level?\n\nHello doctor, My husband is a 30-year-old. Last week, he went to the gym the first time after a year and did heavy biceps exercise with high repetitions. After two days, his arms were swollen, and he was not able to make his arms straight. Yesterday we consulted with a nephrologist, and he told to do tests for CPK and serum creatinine. The CPK level was 15850 which is very scary to us, and when the doctor saw reports, he said that it is a muscle breakdown but did not tell us to have an IV therapy and asked to drink lot and lot of water. We are quite worried about the kidney failure thing and wanted to know that is there really no need to admit in the hospital? Symptoms, 1. After a day of rough biceps exercise, arms were stiff and swelling, which has resolved 40 % by now. 2. Urine is clear, and the color is almost like water. The average urinate time is 10 to 15 seconds. 3. No other symptoms of pain other than both hands which have a dull ache. His report says, Yesterday CPK was 15850 and creatinine was .96. Today it was 15400 and Creatinine was .86 My question is, should we get IV, or it will it decrease over time? How is his kidney doing?",
    "doctor_response": "Hello. My opinion is that he should be admitted to the hospital. Good that he has enough urine output so far. But it can decrease any time, and kidney functions will start to drop. The best is to admit him for close intravenous hydration and daily monitoring of kidney functions and CPK (creatine phosphokinase). Also to guard against high potassium hazards. Rhabdomyolysis. CPK, kidney functions, electrolytes. Admission, IV hydration, close monitoring.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain, difficulty in movement, painful while breathing. History of UTI. Suggestions?\n\nHi, I have lower back pain on my right hand side. This is causing me problems with sitting standing sleeping. I had uti a while ago but I can't get rid of the pain. I get a ache all the time with a throbbing pain that comes and goes, if I sit down it hurts , I tend to find I get up from sitting down like an old person as I get stiff and can hardly move, warm baths don't seem to help. Sometimes in bed I found if very hard to sleep as I ache so much, I can no longer sleep on my front as its too painful, the best is on my back with my knees up. Even when I breathe in it hurts. I also feel cold and still pass water alot even though the last test was clear for uti.Any advice would be good.Thank you",
    "doctor_response": "Hi, You are having pain in the Lower back (throbbing in nature comes and goes) more on the right side, which does not allow you to sit, lye or stand. You are not able to sit erect and you have to sit like a old man bending your body. Even while in bed also the pain so much, that it disturbs your sleep. The pain does not allow you to sleep on your front as its too painful, the best is on your back with your knees up. Warm bath does not relieve you. You had once UTI which was treated and the recent investigations show NO UTI. Treatment: 1) A routine USG - to rule out any other cause other than spines. (kidney, ureter, bladder and appendix etc.,) 2) If USG is normal, straight away do MRI Lumbar spines with Lumbo Sacral joint. This will reveal any spinal pathology. 3) Routine blood test for WBC, DC, ESR, HB, MX, HIV, sugar, Urea and Creatinine, along with ECG, BP and Lipid profile if indicated. I think with this, the diagnosis will be very obvious. Treat the cause if any, You will be alright. Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does laser treatment for kidney stones cause low sperm count?\n\nDear Dr.Sree Bhushan,I would like to enquire about the side effects of LASER on kidney stones removal. This is regarding my husband he got the LASER done when he was in 20's for kidney stones and now his sperm count,motility of the sperm and the sperm concentration is low and we have been trying to have a baby since 4 years, recently we came to know that his sperm count is low and the doctors are advising us to go for IFV.Do you think is that because of LASER his sperm count is reduced? Kindly clear our doubt.",
    "doctor_response": "Good Day and thank you for being with Healthcare Magic!Laser treatment for kidney stones have not been associated with changes in sperm quality. I believe it is not associated. Your husband should get a scrotal ultrasound with doppler to rule out varicocoele. 50% of infertile men with decreased sperm count and poor sperm quality has varicocoele and 80% of the time sperm parameters improves with treatment. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at:   I would gladly help you.  Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain while laying down and pressing the chest?\n\nHi my name is sheilla and for the past 2 months I been having really bad chest pain when I wake up in the morning, when I lay down, when I m pressing down my chest. I m also having bad headaches were I would have to be in the dark because the light will bother plus I get the headaches in one side of my head and all over my forehead",
    "doctor_response": "Thanks for your question on HCM.In my opinion you are having muscular pain mostly.But as a rule in chest pain,we have to rule out cardiac cause first.So get done ECG to rule out cardiac cause.If ECG is normal then it is muscular cause only.So try to follow these steps for better symptomatic relief.1. Avoid heavy weight lifting and strenuous exercise.2. Avoid bad postures in sleep.3. Avoid movement causing pain.4. Take good painkiller and muscle relaxant.5. Apply warm water pad on affected site.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hi From last few months whenever i have to travel alone,nervousness, anxiety start drowning on me.I start thinking abt negative things.Due To This I Have Missed imp opportunity.I have a feeling of negative things during my travel .I have started felling like this few months ago.Can you please help me out Its urgent .....",
    "doctor_response": "Hello.welcome.This is probably loneliness and some insecurity which bothers you.No medical treatment is needed.Either you start traveling with a companion for sometime or you take reading material of your immense liking in your journey.I hope things will be normalized soon.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for epilepsy\n\nI am suffering from epillipsy from year 2000 until now I am eating frisium 15mg per day and oxetol 1200 per day.For longer time does it will effect from another disease like steroids,autoimmune disease,if yes then what should I do?Please reply me as soon as possible.",
    "doctor_response": "hellothank you for trusting HCMdear long term uses may be associated with few side-effects like hyponatremia, along with head ache dizziness,pain abdomen fast heart rate etc..if you develop above side effects please consult your doctor he will change alternate drug. I think I answered to your question if you have more questions feel free to ask.take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever,muscle pains and headache?\n\nI am 25 years old Male. I am currently taking in medications for my hypertension but now i am having fever 39.5 last night with headaches specifically at the back of my head (checked my BP its 117/77) , muscle aches, lower back pains, chills and also my eyes would hurt as well and there are times that my lower right body will hurt but only lasted a few seconds. My fever right now went down at 37 because i am drinking paracetamol however i still have the muscle pain and headaches... Please help me understand what im going through",
    "doctor_response": "As you are suffering from high grade fever with chills and body-ache it is pointing mostly towards Malaria so first of all I will advice you to do CBC with MP to rule out the diagnosis. If malaria is negative than it is viral fever nothing more than that. Treatment for the same is tab cefixime 200 mg or tab cefadroxyl 500 mg twice daily after meals with tab akilos-p or tab nimeson-p twice daily after meals for fever and body-ache with cap pantop-dsr or cap rabson-dsr twice daily empty stomach. You can do a course of chloroquine 250 mg base 4 tab stat than 2 tab after 6-8 hours than 2 tab stat once daily for next 2 consecutive days after meals preferably with milk. If feeling weak you can take some multivitamin like syrup zincovit or syrup multicherry 2 tsf twice daily.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does epidural numb the urge to pass stools?\n\nI had an Epedoral on Dec. 5th and have not had a normal bowel movement since.  I have taken stool softeners, prune juice, miralX.  I have no feeling of having to go to the bathroom.  Does this happen sometimes because I have had a series of three shots previously with good results.   Thank you",
    "doctor_response": "Hello!Welcome on Healthcaremagic!Your symptoms are not typical of any complications related to epidural shots. From the other hand, if there were any complications related to such procedure, you would also experience other complaints like urinary retention, numbness of the genital area or in the legs. So, there is nothing to worry about!I recommend consulting with a gastro-enterologist for your troubles with constipation.Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat grade 1 of fatty liver?\n\nhi doctor, i\"m 32 yrs old female height 5.3\" wt:61kgs. my gall bladder was removed 4 yrs back. a month back i experienced severe stomach pain and i wastested. doctor said that i have infection and i was prescribed rabium .  but even after a month's medicated the painin the right side of my lower abdomen is still perisisting and my stools arent regular,even after taking duphalc regularly. i was detected with a fatty liver grade I . I would like to know what my problem would be.",
    "doctor_response": "Hello  Fatty liver is a reversible stage.Fatty liver is a common problem among adults due to changing life style.It is due to excessive deposition of fat within the liver cells.You need few more investigations like routine hemogram RBS,Lipid profile,LFT.It is important to exclude altered lipid profile.You should increase your physical activity and avoid fried and fatty food.You should go for brisk walk regularly.You may need few medicines after full investigations.It can take 4-6 months for reversal of fatty liver.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause of muscle tensions, bloated abdomen and discomfort?\n\nHi doctor I am Brandon I am 18 and Ive been having bloating, discomfort in upper abdomen after eating small. Ive also been having muscle tensions in my body. I also have been getting a feeling like something is within my throat. Can you tell me what is going on?",
    "doctor_response": "Hello nothing to worry your symptoms sounds like you may have gastritis only.Avoid eating oily food and outside food.Sleep only after 2 hours of food.Sleep with your head end raised little.Good day!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for rashes in body with fever in children?\n\ni have a little girl with a slight fever and rash all over her body...it started yesterday with no fever.  it looked liked it was getting better this morning, but tonight it is back with a vengeance.  the dr. saw her yesterday and wasn't concerned at all, but it looks so awful and is very itchy.",
    "doctor_response": "I have gone through your query and it could be even a drug rash or a viral rash.I would recommend you to apply calamine lotion on the affected areas twice daily and give her antihistaminic likes syrup cyroheptadine for 4-5 days.This should resolve your problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower abdomen pain, nausea, fleshy clot came while urinating. What to do?\n\nHello,My roommate has been having pain in her, like lower abdominal area like right above her private area. I like around her pelvic area. She thought she might have a yeast infection because she has felt like discomfort. She's also felt nauseaous, Right now she went to the restroom and this fleshy clot like thing came out when she urinated. Its like white/pink with like little red dots. I don't know what to do, should we go to an urgent care or is there something we can do here? or is this normal?",
    "doctor_response": "Hi,From history it seems that she might have renal colic pain.As there is blood in urine there might be having UTI or stone problem.Go for routine urine check up and ultra sound abdomen to rule out renal stones.Consult your doctor and get examined.She should take plenty of water.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long will severe withdrawal symptoms like depression, mood swings, irritable last after being on vilazodone and stopping lustral?\n\ni felt terribly depressed recently and my gp altered my meds,she discontinued lustral200 MG s over a five day period but the withdrawal is dreadful, dizziness , electric shock type sensation in my chest and general fatigue.I am also tearful and extremely irritable angry,and withdrawn,I was on lustral for 11 years.for the most part I functioned very well,working etc,I am now on vilazodone 50mgs.should the withdrawal symptoms last much longer,thank you",
    "doctor_response": "Hi, Welcome to Health care magic forum.                       You are on lustral, for 11 years, and changed now, to vilazodone, experienciing deppressed. dizziness chest pain, fatigue, tearfull, angry, withdrawn etc.                       To stop such a drug, after prolonged period, it should be tapered gradually, and introduced the new drug, also gradually. With drawn the old drug, and start the full dose of the new drug.                       Take more of green leafy vegetables, pulses,sprouts, andprotein rich foods.                       Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this cat scan result indicate about liver size?\n\nMy son aged 21 was told he had an enlarged liver. On a cat scan it measured 22 cm long and 17 cm on the right midclavicular line. He is 6 1 and about 150 lbs. All his blood work came back normal. Could this be his normal size or could it be enlarged due to taking an antibiotic for acne?",
    "doctor_response": "Welcome to health care magic. 1.The report suggest the liver is enlarged in size for sure as normal ranges up to 14 to 16 cm.2.Antibiotic can cause the enlarged liver but not to this extent after a singe course of antibiotics.3.In this case i would recommend to get a LFT liver function test that will evaluate the possible cause.4.Enlarged liver is also seen in case of alcohol abuse with fatty changes - its better to avoid if there is excessive consumption.5.Finally an BIOPSY will be definitive if no cause identified.Good luck.Hope i have answered your query,any thing to ask ? do not hesitate to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will generic form of Prozac with wellbutrin help in anxiety and nervousness?\n\nI am on Wellbutrin 300MG. I still experience anxiety, nervousness and I get angry with people. MY doctor has now put me on the generic for Prozac 20mg to go along with it. Do you think this will help the anxiety, nervousness, and anger? Or is my Welbutrin dose just too high? Maybe I need an anxiety med with the Wellbutrin instead of another SSRI. What do you think?",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.Welbutrin and fluoxetine both act on anxiety in different ways and hence it is a nice way to augment each other. Only thing is that these medicines take time to help with and meanwhile the patient can be started on Clonazepam or propranolol to help her deal with anxiety symptomatically. 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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does vomiting and abdominal pain in a child mean?\n\nHiIm a stressed mom. My 4 yr old son  has been vomitting, abdominal pain. Diarrhea has stopped. Took him to doctor, he says that its my sons appendix. My husband is not believing the doctor because he thinks my son caught a bug from him the previous night. Help help",
    "doctor_response": "Hello. i just read through your question. Anytime a doctor encounters a patient with vomiting and abdominal pain, the diagnosis of appendicitis must be considered. The typical course would be a generalized abdominal pain that, over time, becomes most intense on the lower right side. From the time the symptoms begin until the time the appendix ruptures is approximately 36-48 hours. So it is important to make the diagnosis early. If symptoms have lasted longer than this, or the pain has not become most intense on the lower right side, appendicitis is unlikely and the most common diagnosis is a bug, as your husband stated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for productive cough after exposure to black mold\n\nMy son was recently exposed to someone who had PNA AND was exposed to a serious case of black mold for two days straight.  My ex takes him to the doctor and comes back with no antibiotics...He is couching non-stop and up green phelgm.  Should I still have a concern?",
    "doctor_response": "Hello dearWelcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This seems in relation with bronchitis .*  Suggestions for better recovery -  Allow plenty of liquids orally .-  Balanced nutritious diet to combat the infection .-  Deep breathing exercises , YOGA help great along with walking in fresh    air .-  Avoid exposure to mold / dust / pollens .-  Use  triple layer face mask liberally .-  In our clinic we recommend prophylactic antibiotic  for  cough along with    anti  allergic medications  and  cough  preparations .-  Inhalation of boiled water vapors with added tincture benzoin , blanket   covered over the head 3 times a day .-  Gargles  with  salted lukewarm water added peppermint oil 3 times a dayHope this will help you  for sure .Always  feel free to ask any further doubts .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Ehlers Danlos Syndrome and Osteopenia cause kidney stones?\n\nI have Ehlers Danlos Syndrome and Osteopenia. I've also suffered from kidney stones my entire adult life. After analysis I was told several times my kidney stones were caused by too much calcium in my diet. Obviously I can't be both getting too much calcium and not enough! I'm wondering if it might be just a calcium absorption problem? How might I fix this?",
    "doctor_response": "HiCalcium levels in the body is regulated at three different levels. Amount of absorbtion at the level of intestines, Excretion from the body at the level of kidneys and mobilisation of calcium stores from your bones and all three are dependent on hormone levels in your body. You could have excess mobilisation of calcium from your bones or inadequate deposit in to bones both causing osteopenia.On the other had one of the cause for formation of urinary stones may be excess excretion of calcium in the urine and this may be independent of what happen at bone level. Have you had 24 hour urine collection to check for increased calcium excretion in the urine or other abnormalities that makes you prone for stone formation. Dietrary advice for calcium is better guided by this result.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low pulse rate with stomach ache and dizziness\n\nHi, my boyfriend is experiencing a very low pulse rate (44) although he normally has a low pulse, about 50. He has been feeling faint and light headed for two days with a stomach ache, and has been sleeping and drinking fluids to combat this. Do you have any suggestions?",
    "doctor_response": "hello,      It's a matter of concern. First we need to find out a cause. Possible reason includes, thyroid problem, potassium abnormalities or sometimes problems in heart pacemaker called sinus node.      He should get one ecg and holter monitoring done. Also, thyroid and kidney function test are needed. If we are able find some treatable cause then it's fine, otherwise he may need pacemaker depending upon a cause.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tingling numbness hands, weakness, blackout\n\nSometimes when I have been sitting for a period of time and I get up and start walking, I start to get tingling and numbness in my hands and can feel weakness start to spread and I start to black out. I usually will grab onto something and try to stay conscious. The typical time this happens is when I have been sitting in my car in traffic for long periods of time, however, it has started happening during our Sunday service while I am sitting in the choir loft. We sit during the sermon and then stand up to sing an alter call hymn.",
    "doctor_response": "welcome to HCM!After reading the query I can say form my clinical experience that the symptoms suggest that (most possibly) you have orthostatic hypotension- in which their is a sudden fall in blood pressure when one stands after sitting for some time. I will advice that you should get your blood pressure checked- in sitting  and lying down position and see if there is fall of blood pressure ? also, you might be having some high blood pressure which is not treated or treated partially  and you need to revise the medicine.You should also get thyroid levels, sugar levels done, an ECG will also be helpful in ruling out other cardia cause.You seem to be otherwise healthy person as nothing more is mentioned, so, the above causes are most possibly involved. I think by getting the test will pin point the diagnosis and solve the problem.Hope the reply is usefulFeel free to ask more questionsDr. Manisha Gopal",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure rib pain after fracture?\n\nI fractured my ribs in the back side about 4 months ago in a motorcycle accident.... for the last few days it s like I have ONE rib giving me a lot of pain. Shouldn t this be healed? I also have a bump...almost like a part of the rib is poking through my back",
    "doctor_response": "Hello, As of now, you can use analgesics/anti-inflammatory combination like aceclofenac/serratiopeptidase for symptomatic relief. Nothing much to worry as the symptoms will settle once the stage of inflammation subsides. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a painful lump on the thigh be treated?\n\nI have had a a sizy lump getting larger by the day and extremely painful on my upper leg lower buttock region it has a dk. Black/blue blister looking top to it. It's very red and hot to the touch . It has very lil of clear liquid blood tinge. It's not getting better.",
    "doctor_response": "Respected User, hi I evaluated your query thoroughly.*Clinically it is Infected Sebaceous Cyst.*You can take temporarily analgesics for pain relief, but I strongly suggest   you to consult Consulting Surgeon as early as possible because many  cases are in need of definitely proper treatment & surgery at times. Thanks for using Health Care Magic & keeping trust in our medical services. Regards. Wishing you a fast and speedy recovery from the same. Bye Dear take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest complications with reactive hyperplasia\n\nhi sir .iam tak from india with 24year of age ,inin my neck and arm pit have swollen glands ,docter sggest tb skin test ,it was positive,then dr suggest fnafnac rsult was uncler and suggest reactive hyperplasia.sir wt was the real problem?any complications ? ihave no any otherproblems",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have reactive hyperplasia of lymphnode.  It us due to some infection in near area.  So its immune response by body. Reactive hyperplasia itself has no complications.  It will disappear after few days.  But possibility of tuberculosis can not ruled out.  You should investigate for tuberculosis also. Take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent hair loss\n\nhello sir,i am 25 year old having hair fall problem.i am using morr 12.5 % soln,taking tricho plus mens tablets since 4 months as prescribed by doctor.and also applying pronourise shampoo still no effect is observed. should i continue with this? or pls suggest some another treatment",
    "doctor_response": "hi there.1. you concern may be telogen effluvium along with androgenic alopecia.2. telogen effluvium is a visible hair loss , which is recoverable.3. you can try quilib men spray once daily during day time, gently massage enough quantity into the roots after head bath.4. you can continue other molecules which aid in protecting the remaining hair and making them thick.don't worry this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes random jolts in neck and around the chest?\n\nive been getting random \"jolts\" in the left side of my neck/ear and also in my chest around my heart. This has been going on for over a year and happens about 5 times a month. It jerks my whole head and I seem to llose control of my head very briefly.What could this be?",
    "doctor_response": "Hello!Thank you for asking on HCM!Your symptoms could be related to myoclonus. For this reason, I would recommend consulting with a neurologist and performing an EEG. Other tests to consider would be: complete blood count for anemia, thyroid hormone levels for thyroid dysfunction, blood electrolytes for electrolyte imbalance, calcium plasma levels and vitamin D plasma levels for possible deficiency. In the meantime, I would recommend treatment with clonazepam. You should discuss with your doctor on the above issues. Hope to have been helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe fever in a child\n\nHello Dr, my son has been having an on and off fever for 4 days, he was seen by his Pedia on Fri and given Tylenol for fever, today we went to emergent care for a fever of 105 and was given Motrin around 3:30pm and I accudentally given him another dose at 7:20pm is he gonna be okay?",
    "doctor_response": "Hi,Nothing to worry if dose of Motrim is given after 4 hours if fever is not responding with medicine.But important is to give plenty of water and liquids and keep him well hydrated as having more perspiration helps fever down.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is bowel incontinence normal having undergone spinal surgeries?\n\nMy sister recently had 2 operations within 8 weeks on her spine.  She is making a slow recovery at home but unfortunately  the operation has left her with bowel incontinancy.  When I spoke to her to ask if she had seen a specialist for her problem she told me that she hadnt and that when she was discharged from the spinal trauma unit in the hospital she wa told that her bowel problem was something that she would just have to live with. Unfortunately my sister lives 350 from me so it is not possible for me to talk to her doctor.   My question is...is this anormal side effect of that operation and is it something \"She will just have to live with!!\" Look forward to hearing from you. regards Margaret Hillier",
    "doctor_response": "Dear caring brotherFirst I would like to know what surgery has been performed and at which level of spine. Was surgery done to treat spinal trauma and whether MRI spine was done prior to surgery  and if done what was it's findings? If level of trauma was at dorsal or higher level then spinal cord injury itself leads to bowel and bladder incontinence. If bowel disturbance has occurred after surgery and not after trauma Then possibility of iatrogenic spinal cord trauma should be considered. If spinal cord has been damaged in any way either due to trauma or during surgery then bowel disturbance might be permanent. Kindly get an mri done if not done previously. .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever with chest congestion?\n\nMy 8 year old daughter has had a fever with an increasing phlegm like cough since last Tuesday. She has been to the doctor three times in the past week. She did take antibiotics for four days with no change and was told to discontinue them and at the end of her last doctor s visit today, the doctor said she did not see anything wrong with her but did order blood, chest, and urine test for her. The doctor stated she had a young patient last year who had a fever off and on for a month last year about the same time and they ended up saying he had Viral Fever. She has not said my daughter has this but she did share the story. Any insight would be great help or should I go to another doctor.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.Cough and cold are viral 95% of the times in children. For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15mg/kg/dose (max ceiling dose 500mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.For cold you can use Cetrizine at 0.25mg/kg/dose every 12 hourly for 3 days.For nasal block, plain saline nasal drops will do, every 4-6th hourly to relive nasal congestion.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with concussion. Done MRI. Showed small amount of hemosiderin of remote hemorrhage. Explain\n\nSure!  An MRI on 7-10-13 indicated \" ...persistent focal T2 signal hyperintensity within the left caudate nucleus and anterior limb of the internal capsule with corresponding susceptibility on the gradient sequence.  Findings suggest a small amount of hemosiderin of remote hemorrhage.  No evidence of acute hemorrhage....\"   I do not recall everything the neurologist explained.  I was rear-ended in early March and hit my head on the top left side and had a goose egg for a few days.  I have been diagnosed with a concussion and my symptoms are related to focus and memory and \"brain drain\".  Can you educate me on the MRI indication?  Thank you!I do not wish to sign up for any fee.  Sorry, and thank you.",
    "doctor_response": "HI Thank for choosing HCM, The Hemosiderin is not a indication of fresh bleeding, this is one reason for not to worry, second it is direct indication of deposition of some residual elements after dying the red blood cells in case of rupture blood vessels and bleeding from it, in later stage the phagocytosis will play the role, once  the phagocytosis start then the lesion will go away,  in short right now nothing to worry, but close observation will be needed, you will have to go for MRI periodically, and discus it with your neurologist, Have good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in hand during sleep?\n\nI have had numbness in my right hand for about a month or so. It comes and goes and usually comes when I am using that hand or the opposite when I am sleeping it goes so numb that it keeps me awake and is actually quite painful. I have seen my doctor and he thinks it is related to arthritis that I have but no other place that is irate by my arthritis is affected.",
    "doctor_response": "hithanks for writing to healthcare magic.you seem to suffer from carpal tunnel syndrome. its a condition in which a major nerve supplying the thumb,index middle and part of ring finger gets compressed at the wrist level.please do the following1. use wrist splints, especially while sleeping2. avoid bending your wrists too much3.avoid keeping your wrists under your head while sleeping4. give rest to to your wrists, avoid typing too much on your computer or     mobile phone.5. apply ice packs4-5 times a day6.use a mild analgesic like acetaaminophen it will take 3-4 weeks for complete recovery.hope i have answered your querythank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, high prolactin levels. Taken siphene, cabergoline. Suggestions?\n\nHi Dr. My age is 29 yrs and got married before 3 yrs. We are trying for baby for six months. I took siphene 100mg 2 times but concieved. After that I found another problem that high prolactin ie 36 and i took cabergoline for 7 weeks. Now my prolactine lavel goes normal. Still not concieved. pls suggest what should i do. Now i m worried?",
    "doctor_response": "Hello. Thanks for writing to us. An increase in prolactin levels are often associated with polycystic ovaries and a decreased potential for conception. You need to get your hormonal profile evaluated and start with ovulation induction regimen after consulting your gynecologist. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes left upper quadrant pain after exercising?\n\nIn line with the same question, my Left side is in pain (upper left quadrant). It pains so bad that I come home after workout and have to floss my gums and brush and then the pain subsides in 10-15 mins. Is it due to me drinking cool water during workout or is it due to infection or something else . Do I need to be worried about it ?",
    "doctor_response": "Thanks for your question on HCM. In my opinion it seems muscular pain only.But since it is left sided chest pain, we have to rule out cardiac and pulmonary causes first.So please get done1. ECG to rule out cardiac cause.2. Chest x ray to rule out pulmonary cause like chest infection.If both of the above are normal than it must be due to muscle pull only.So try to follow these.1. Avoid heavy weight lifting.2. Avoid strenuous exercise. 3. Take good painkillers and muscle relaxant. 4. Avoid bad postures in sleep.5. Wear chest belt for minimal mobilisation of affected part.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can low blood count cause breathlessness and lower abdominal pain, have history of rectal prolapse and hernia?\n\nYes, I feel out of breath when walking upstairs. I usually have no pens, but 6 mos ago I had same symptoms I went to an urgent care and they drew blood. 20 mins later they said my count was very low (maybe) internal bleeding. I left against des orders, told them I would go to the Dr next day or so. Never did and the prob went away. But it is back and I have achy front lower abdominal pain. Have rectal prolapse too. I'm only 54 but I've had 3 hydroxide/hernia operations. I'll quit talking!",
    "doctor_response": "HI, thanks for using healthcare magicShortness of breath can occur as a result of different conditions such as : (1) heart failure, (2)anemia, (3)angina,(4) lung conditions such as pneumonia, pulmonary embolism, pneumothoraxIf they said a count is low, they may be referring to your haemoglobin level, meaning that you are anemic.It would be best for you to visit your doctor for an assessment which would include physical examination and likely a repeat of blood tests.The source of the low blood count needs to be determined.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause accelerating fever in kids?\n\nMy grandson continually suffers from a high temperature (40C), seemingly it is every 3 or 4 days or so. Our daughter takes him to the hospital where they usually give him a drink of neurophen to bring down the temp, he has had 2 courses of antibiotics in the last 3 months. When he does not have a temp he is highly active and very strong. Everyone says it s normal for a child to get high temperatures, I understand that, but so often? Could it be because he is normally so very active that his temeature rises when he is tired?",
    "doctor_response": "Hello,It is not normal for a child to get frequent high temperatures (fever). Consult your doctor and ask for investigations like CBC, urine exam, Widal test, PS for MP, etc. Your doctor will decide further treatment based on investigation reports.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Khan Shoeb Mohammad Sher Mohammad",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to increase penis size?\n\nHello,my name is meher,age 28 from london.I am very upset about my penis cause its only 3.5\" when its strong & also very thin.Sex duration is also very low,4-5minutes.For that no girl want stay with me.I am very very upset.How can i increase my penis without any side effect.Plese give me proper advice.Its the question of my life.Thank you.",
    "doctor_response": "Hi, Many Research says the average length of a flaccid penis is 3.61 inches, while the average length of an erect penis is 5.16 inches. Few studies recommended flaccid penis length of less than 1.6 inches or an erect penis of less than 3 inches should be considered for treatment. Surgical ( liposuction around their pubic bone, Skin Graft) , Inflatable penile prosthetics are helpful if size less than 3inch. Share your penis size when flaccid  and erect. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Need second opinion on Celexa and Buspar for severe anxiety/panic attacks\n\nDear Doctor, I am a 24 year old female, was prescribed with\u00a0Celexa 20mg \u00a0once daily and\u00a0Buspar 5mg twice daily for severe anxiety/panic attacks. Both of these medicines are SSRIs though, and I read about it online that everyone/every source says never to take them at the same time due to risk of serotonin syndrome. Today, after taking the Buspar, I felt cold and shivered constantly. I could not get warm and I was very sleepy. Now I am scared to take the night time dose of Buspar and Celexa. I would like to have a second opinion on the safety of taking these medications together. If it is not safe, can I take only one instead? Which one would you recommend, the Buspar or the Celexa? Thank you in advance.",
    "doctor_response": "Hi. You are not on too high a dose of celexa or buspar. However serotonin syndrome is not always dose dependant. I feel just the chills and sedation are too general to be indicative of serotonin syndrome. You should have some level of muscle rigidity, high fever, muscular contractions (myoclonus) to suggest that. In my professional opinion I do not have much faith in Buspar.  Celexa is good enough as an antidepressant (SSRI) to eventually help you have a full remission of depression, anxiety and panic attacks. If I was your treating psychiatrist, I would have supplemented the celexa with clonazepam (Klonopin) on a as needed basis, between 0.5 and 1mg every 8 hours PRN anxiety. If you are feeling cold and shivering constantly you might need to see your PCP (Primary Care Physician) to urgently address if you have an active urinary tract infection and also have him check your thyroid function. In effect, I advise you to stop the Buspar for now. Hope it helps. Get back to a psychiatrist online for further help -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from dizziness, anxiety, nausea, hand weakness. MRI of brain shows venous angioma in frontal area of brain. Treatment?\n\nsir, i m 22 years of age and having neuro symtopes as 1. feeling of dizzyness and fear , anxiety . 2. sometimes vomitting and nausea 3.hands getting week i had done eeg and it says normal have done mri which says venous angiomia in the left frintal area of brain im little worried if its serious bcoz im a student. plz refer me some medicine.. if ayurvedic den it will b good",
    "doctor_response": "Dear NIrmalya, welcome to HCM. good that you sought timely help. hand weakness, vomitting are cerebral signs and are important if MRI shows a venous angioma. medicines are not of use. pl. consult a neurosurgeon urgently to see if any surgery is needed soon. if not you could take symptomatic treatment. it all depends on many factors of the angioma. It could bleed and get serious. so take neurosurgical opinion and act on it. pl. keep me posted on progress. good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I get intense kidney pain along with high fever ?\n\nI woke up two nights ago w/ shooting pains in my left kidney . Yesterday they pain was almost unbearable and wrapped around to the front also making me nauseous. Today the pain is just in my back again and getting worse as the day goes on but now I have numbness down the front of my legs. Usually when my kidneys hurt this bad I am running a high 104-105 fever . Now temp is normal.",
    "doctor_response": "Hi, Heaven, Thanks for query, Go for ultra sound and urine check up. As pain and fever is there it is more likely that infection causes renal colic. Consult urologist for further evaluation. ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for liquid-filled, painful lump on ear flap?\n\nI have a small soft lump (size of pea) on the top part of the pinna (Ear flap) it's seems liquid filled and soft and squishy to the touch! It is a little painful. I have recently had a tooth abscess on both left and right bottom wisdom teeth, if that helps at all! What could this be?",
    "doctor_response": "Hi,Thanks for writing to HCM.That could be a lipoma but better show it to a surgeon for a physical examination and its excision if needed.Its not related to your dental condition.Dr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can discomfort in walking in 38th week of pregnancy cause danger?\n\nim 38 weeks pregnant and 2 nights ago i woke up tried to get up and had bad pain in my mid to lower back but only on my right side i assumed that i slept wrong but now its making hard for me to walk around is this something that i should go to the hospital for or is there any thing i can do at home?",
    "doctor_response": "please don't panic if you take my opinion then I would suggest you that you need not worry these symptoms are quite common in 3rd trimester pregnancy ,also be careful as these might be features of early labour pain ,so I would advice you bed rest, an antispasmodic like drotaverine and and an abdominal ultrasound",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can hernia surgery causes large ejaculation?\n\nHi i had an upper hernia surgery 8 days ago through my navel My question is would it be ok to experiance an ejjaulation so soon after this type of suregry  could this cause damage to the stomach area since the mesh was put in to protect this area . I tend to have a large ejaculation when i do orgasim.",
    "doctor_response": "HelloThanks for query .You have undergone probably hernia repair with mesh for Umbilical hernia or Epigastric  hernia.You seem to have forceful ejaculation which may be due to abstinence for prolonged period .During ejaculation only the muscles in pelvic floor are involved and there is no involvement of muscles of the anterior abdominal wall so there is no danger at the site of surgery .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pregnant, suffering from running nose due to allergy. Safe to use Nasonex? Have sinus issues\n\nIs it safe to use Nasonex during pregnancy? I'm 24 weeks pregnant and suffering from runny nose- \"allergies\". Tired of blowing my nose every 20 minutes through-out the day. I have a sample of Nasonex that my Dr. gave to me before I got pregnant, haven't used it but curious to know If I can. Do you recommend anything else if I can't use Nasonex. I have bad sinus issues. Just wan't to stop sneezing and blowing my nose because it's giving me a headache - plus going through so much tissue.",
    "doctor_response": "Hi,Thanks for using Healthcaremagic,No it is not safe to use in pregnancy untill benefit outweigh the risks.Nasonex nasal spray contains the active ingredient mometasone, which is a type of medicine known as a corticosteroid (or steroid)This medicine is not recommended for use in pregnancy unless the potential benefit to the mother outweighs any risk to the developing baby. Seek medical advice from your doctor.Please consult your ENT Surgeon and alternative can be given for your relief.Hope this helps.Take careGood Luck.Dr.Akhilesh Dubey M.D",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain below my left breast\n\nHi Dr Grief, I have been having pain just below my left breast were my ribs are. I went to my doctor on Monday and had an ultrra sound on Thursday. I am having a mammagram on Wednesday, but I have not been able to sleep because the pain is worse when I am lying down. I have taken tylenol extra strength but it doesn t seem to help. I have acid reflux which is being treated with a daily tablet of rabeprazole so I stay away from anti inflammtories. This pain started just before Christmas and seems to be getting more intense and of course I am stressing out from lack of sleep and constant discomfort which doesn t help. I have been meditating but that only helps relieve the stress but not the pain. Any suggestions? Mary",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, possibility of stress and anxiety related chest pain is more. But better to first rule out heart related chest pain because left sided chest pain is commonly associated with heart diseases. So first get done ecg and 2d echo. If both these are normal then no need to worry for heart diseases. In my opinion, you should consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on it's. You will need anxiolytic drugs too. Counselling along with these drugs will help you in sleep as well as stress reduction. Apply warm water pad on affected areas. Avoid movements causing pain. Avoid bad postures in sleep. Avoid heavyweight lifting and strenuous exercise. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe pain in lumbar spine be treated?\n\nHello: Ive been in 2 car accidents. Since then I ve been in severe pain.Mri of the lumbar spine show L4/5 mild left paracentral posterior.Even though this is causing me sever chronic pain, the Neurologist doesnt think this should be a problem. I ve since then had a mri on my neck and cervical spine; which mri show L5/6 diffused disc bulgeeffaces the anterior subarachnoid space.facet joint hypertrophy greater on the left with moderate to marked left neural foraminal narrowing. at L4/5 posterior spondylosis greater pn the right with mild flattening of the right ventral cord. I ve see 2 Neurologist and one Neurosurgeon , Ive told them all im in severe pain constantly every day . ive tried several spinal injections which did not help only ending having to have a blood patch from a spinal headache. I m taking Lortabs 10 ; which one of the Neurologist prescribed and flexrell 10 muscle relaxers, they don t ease this pain because ove been on them for a while the doctor refuses to change any of these because he claims that it should relieve the pain which at first when I first start taking them I did get some relief and was able to hold my full time job. I ve also had decompress therapy for spine , nerve and back. which 13 out of 20 treatments that made me worse because when I come out of treatment I feel worse coming out than going in so, based on the medical stress of the pain, and medical debt, and the fact that I have no ease pain is chronic and severe medical debt that I can t no longer afford, In stop going. These Neurologist , and Neurosurgeon say that these findings of these 2 mri results can cause a little pain but they don t feel they are causing severe pain, but they are.based on the fact of me have been in two car accidents, my back back started from the first one and the second one increased the symptoms that I already had and added as well because from the first accident I did not have a problem with my neck , cervical spine but I do now test show diffuse disc at L5/6 and flattening and narrowing of space in other areas of L4/5. My question is , can these problems in different areas cause sever pain? everyone body is different,therefore things affect people different, What is your advice or opinion on what I should do. Now because of my sever pain I am unable to work.",
    "doctor_response": "DEAR FRIEND, I UNDERSTOOD YOUR CONCERNS, SEE AS PER YOUR MRI REPORT WE CAN ASSUME THAT THERE IS PROBLEM WITH YOU VERTEBRAL DISC AND NERVE COMPRESSION RIGHT? NOW WHAT IS SOLUTION? BY GIVING INJECTION IS NOT PERMANENT TREATMENT SO AS YOU SAID \"everyone body is different, therefore things affect people different\" SEE IN THIS TYPE OF CASE PAIN IS THE MAIN FACTOR WHICH TROUBLES YOU DUE TO IRRATION OF NERVE ROOTS. NO NEED TO WORRY, YOU NEED TO TAKE IFT AND TRACTION THERAPY FOR YOUR BACK IN PHYSIOTHERAPY CLINIC... IF ANY LOCALIZE PAIN IS PRESENT THEN TAKE ULTRASONIC THERAPY.... YOU NEED 15 days TO THIS THERAPY!! THEN ONLY START WITH VARIOUS EXERCISE... TILL THAT TIME WAIT FOR PAIN TO REDUCE....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for celiac artery blockage\n\nHi, I am a 33 year old female and I recently had an angiogram done in which showed my celiac artery was all the way blocked. This test was done due to constant abdominal pain, sternum pain, and weight loss. They will not do a bypass surgery given the risk and my age; therefore, can I live with a blocked celiac artery?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. No, you can not live longer with blocked celiac artery. You need to treat it first. If not going to treat you will develop bowel ischemia, obstruction, infection etc. And all these are life threatening complications. So you need to treat yourself as soon as possible. Removal of blocked segment of celiac artery and anastomosis with venous graft is treatment of choice for this. For this part of your calf vein is used. And success rate of this bypass graft is very high. So you should consult vascular surgeon and discuss all these. Don't worry, with proper treatment, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can a small anal fissure be healed by medicine?\n\nHello doctor,My father is suffering from a small anal fissure. Can it be healed by medicine?",
    "doctor_response": "Hello. The first thing to promote healing is stool should be soft. For that, he should eat high fiber diet like fruits apple, banana, oranges, green leafy vegetables like spinach, raw cucumber. Avoid smoking, refined food, fatty and oily food. He should have plenty of fluids and regular exercises. Also, syrup like Lactulose 15 to 30 ml bedtime to maintain your stool soft. Second, he should have Nitroglycerin gel two times a day. Also, sitz bath will be helpful, during a sitz bath, the anus is immersed in warm water for approximately 10 to 15 minutes two to three times daily. Sitz bath kits are available in most drugstores which contains Potassium permanganate. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce the swelling and pain of an amputated toe?\n\nHello.... My boyfriend has had an amputation of the big toe on the left foot. The first one was about 2 months ago.... He was out sof work almost four straight weeks. The doctor finally cut him lose and he went back to work when he went back to work , he worked like 3 or 4 days and he got all kinds of pain, swelling and discharge the pain was unbearable. So, we went back to hospital and they admitted and went back in for a 2nd surgery and more infected tissue was amputated as well. He has worked one week and now he has lots of pain but no high blood pressure, some swelling but no heat in/around where the stitches were . By the way he is not diabetic either. He is 56 years old and had ostiomalytis a few years back and the third toe on the right foot. He never had all this much trouble with the first amputation. My real ? IS right now is he is off from work and it is swollen like I said no fever or hotness no discharge...... Is there anything he can to get some of this swelling out.... he has an appointment tomorrow so he does not want to go today.... the wait time in this particular office is horrendous. And of course if any of the other symptoms are present or he gets worse I will get him to the ER. thank you if you could just give me an answer about the swelling.",
    "doctor_response": "hiosteomyelitis or bone infection is a very tiring thing for patient and doctor alike as it takes very long to control this infection.Repeated pus culture and sensitivity to anti biotics is required, and if some more dead tissue is produces has to be excised by surgey.Your doctor is best judge how much toes and forefoot he can save.Do not worry for amputations, though it is terrible, but nowadays prostheses are available for after care fitting, enquire with the surgeonif it will be possiblebest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have fever, loose motions. Had crocin. What can help stomach pain?\n\nMy son is 8 years and 23 kgs. He is having fever from yesterday. Local physician haven t given any medicine but Crocine. But after Crocine DS since fever was coming after every 4 hours, today we have given Meftal-P at 10 am. Fever came down that time. Again fever is up now and at 4:30 pm we have given Crocine DS at 102 fever. It is not fully down. Can we give Meftal-p again? What would be your suggestion? He had some stomach pain and had loose motion once in morning.",
    "doctor_response": "Hello You have to give only paracetamol and liquids to your son. Paracetamol is given in the dose of 15 mg per kg of weight in one dose. You can give this dose 4 times a day. Since your child is 23 kg,you have to give appox 350 mg four times a day. A syrup containing 250 mg per 5 ml can be given in a dose of 7 to 7.5 ml four times a day. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful hard lump on the back\n\nI have an itchy sore on my back that scabs over very quickly (4-6 hours) and the scab is very thick and feels like wood splinters. I m always tearing it off when I scratch the itch. There is a hard lump way under the skin. I ve had this for over six months now. what might it be?",
    "doctor_response": "hi.it is best if you consult with a doctor, preferably a general surgeon, for medical and physical examination. based from your description, it could be a cyst (a sebaceous or a keratinous type). these lesions can occur anywhere in the body and have the tendency to recur. medical (proper antibiotic regimen) and surgical (excision of the lesion) management will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lineator prescribed after checking the semen analysis report. Ho can I beat stress?\n\nFirst i check up my semen analysis sperm count is 14.6 milion/ml, % of motility active 70%, sluggish 10%, Immotive 20%. Then doctor take me for 03 month course of tab LINEATOR ,GOD SENT & AGIPREG(SACHET) each tab  night.(1 tab daily)IS THIS WRITE MEDICINE TO IMPROVE MY SEMEN ANALYSIS.AND ONE THING IAM 25 YEARS BUSINESS MAN WITH SO MANY TENSIONS SO PLEASE TEL ME WHAT TO DO FOR STRESS RELAXATION",
    "doctor_response": "Dear. Getting stresses cannot cure your problem. There are three steps in a negative situation. 1. Anger and denial 2. Distress (that causes anxiety and stress, which state you are now in) 3. Action to get out of the situation. Understand these steps and take action to get out of the situation. If you get stressed at 25, what will be your situation at 35, after marriage, with a lot of responsibilities? Meditation and yoga can definitely help you. Wish you good future.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of hair fall?\n\nHi, I have been loosing my hair for the past 3 months. Half of my hair is gone. I have also been on the pill for about 6 months. Loosing your hair I know is a side affect. I have heard though at the 5-6 mark that side affect may happen. BUT I have been dying my hair every month for the past 2 years. So i stopped dying my hair and I am still on the pill and taking vitamins for your hair. My hair has become weak and falls out a lot. Is it the pill or my hair dye? Should I go off the pill?",
    "doctor_response": "Hi, As per your query you have hair fall leading to alopecia problem which could be due to a side effect of medication as well as due to hair dye. Need not to worry. I would suggest you consult a dermatologist for proper examination. The doctor may order skin patch test, blood test and physical examination. The doctor may prescribe you drug like finpecia at least for 3-4 months or antifungal treatment along with minoxidil spray. Try on alternative medicine for a few days if symptoms start getting better. Start taking supplements like Vitamin A, Omega-3 and Vitamin E. Take Indian gooseberry powder with water and use almond oil. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Harry Maheshwari, Dentist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on leg?\n\nI am a 37 year old male.  Tonight I noticed a lump the back of my right leg just below the calf muscle.  It would best be described as a roll about half an inch tall from top to bottom and running across the back of my leg.  No pain.  I occasionally have a little swelling around my dress sock line, but this appears to be different.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some soft tissue tumor like lipoma, neurofibroma., dermatofibroma. or some benign cyst or ganglion cyst.  You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. 24 year old Male. How to perform Kegel exercise to improve my sexual life?\n\nHello doctor, I am 24 years old male. I weigh\u00a043 kg and I\u00a0have problem in having sex. How do I improve my sexual life?",
    "doctor_response": "Hi. I would like to ask you a few questions.\u00a0Since how long have you been suffering from this problem?\u00a0What kind of sex problem do you have, erection problem or premature ejaculation?\u00a0Do you have nightfall too? Is there any kind of stress in your life? Are you a smoker or non-smoker? Do have any kind or drug addiction Are\u00a0you\u00a0taking\u00a0any medicines? Well, it could be due to psychological reasons also.You are advised to:\u00a0 I also advise you to do\u00a0Kegel exercise\u00a0which will help you in getting intense and prolonged erection and prevent premature ejaculation(PE). The Kegel Exercise: Kegel Exercise\u00a0is meant to strengthen the pelvic floor muscles and treat premature ejaculation and impotency.\u00a0 You can do this exercise anywhere in sitting position either in a class room, office, or even in a public place and nobody will come to know that you are doing it.\u00a0 Before you start doing it, you must know the significance of this to the pelvic floor region. Around anus there are a group of muscles know as pubo-coccygeus muscles which control our urination and defecation process. We have to strengthen them by contracting and relaxing alternatively to achieve strong and intense erection of penis.\u00a0 The Procedure\u00a0:- By doing this, your pelvic floor muscles will become strong and will help you in attaining an intense erection for a longer duration.\u00a0You can strengthen these muscles and some other group of muscles also by doing this exercise, but in a different way: \u00a0 These two methods of contracting and relaxing pubo-coccygeus muscle will make them strong and will be helpful in improving your sex life. Follow up with the required details to a sexologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with dorso lumbar sacral spine stenosis multi level compression. Surgery not possible. Suggestions?\n\ni am kuldeep saxena 50 yrs old from agra india suffering with dorso lumber secral spine stnosis multy lavel comression right now medicines and exercises are adviced me by senior orthopadic surgon according to his opinion operation is not possible in case of multi lavel disc diorder or to clear compression iam regurly using motor bike 30 km in fieldj job i aM NOT FINENCILY SOUND TO BEAR EXPENCESIN REG. MEDICINE OR TO GO FOR OPERATION HELP ME SIR FOR CORROSPONDECE MY ADRESS ,KULDEEP KUMAR SAXENA M 44 VINAY NAGAR BODLA SHAHGANJ AGRA PIN 0000 [ U.P ] INDIA",
    "doctor_response": "Hi, Thank you for posting your query. You are suffering from multiple-level disc disease. This commonly causes back pain and pain in the legs. As your doctor has ruled out operation, the treatment would be along the following lines: 1. Physiotherapy- regular back extension exercises, Traction, IFT, Ultrasound, etc. 2. Medications such as gabapentin and pregabalin capsules. 3. If there is severe pain, you can go for epidural injections. Please discuss these options with your doctor. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Coughing, blood in ears, neck pain. History of asthma. Can coughing cause ear injury?\n\nI have asthma and had a coughing bout which lasted a good hour. I m coughing because I cannot stand the cigarette smoke/odor coming in thru my air-conditioning vents, but this is another issue with the landlords. However, shortly thereafter I used my nedi-pot and took a shower. Upon cleaning my ears, I had blood in my right ear showing at then end of the Q-tips. My right ear is hurting pretty bad now. Also, my neck on the right side where my cervical spine incision is hurting and pain radiating upward towards ear. I m not so sure how serious to take this. And could my coughing caused some injury to the ear and/or incision?",
    "doctor_response": "Hello. Coughing normally will not cause bleeding in ears. It can however cause problem to an extent if your eustachean tubes (connecting nose to middle ear) were blocked due to cold. From you history, there seems to be some injury or boil to your ear canal. Your hearing seems to be ok since you have not mentioned about any loss. Please get your ear examined. There is no need to suffer from a cough bout for 1 hour! Whenever your asthmatic airways trigger a cough bout, it is a good idea to take inhaled salbutamol 1-2 puffs and that should abort the cough bout. Bad prolonged cough bout can cause neck/ abdominal pain and can also cause fainting. -Dr. Tushar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe lower back pain and shoulder pain\n\nI woke up this morning with an acheing pain all down my back , lower back is the worse , up through my shoulders & neck. & my head feels really heavy. I go back in forth from having chills to being extremely hot. I went to work @4 & they had to send me home @ 5:40 because I couldn t stand because of the aching in my body.",
    "doctor_response": "Dear friend,thank you for your consultation.it seems that the pain in your lower back,neck all are bothering you very much.so first of all you should go for a complete investigation of the reason behind this pain.if it is caused by some bacterial or viral infection in the body causing muscular pain then a proper course of antibiotic and pain killer with some rest will help you to be cured.but if the pain is caused by local back muscle spasm caused by dislocation of disc between the vertbral bones then a week complete rest is needed.then home regimen of back muscle strengthening exercise like flexion exercise should be started.apart from that avoid bending forward and lifting heavy weight.I sincerely hope with following this advices you will get rid of this pain very soon.thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does semen come out of vagina after one hour of resting ?\n\nHello Sir, I am 31yrs old. After 2 yrs of marriage we have decided to have a baby. Since last 15 days we are trying for the same. The problem is that after ejaculation i lie down on my back for around an hour. When i get out if my bed some fluid comes out of my vagina. I am worried that if the semen does not enter how can I become pregnant?",
    "doctor_response": "Welcome to Healthcare MagicNothing to worry. Semen has sperm which will swim upwards into your cervix even if fluid leaks out. There will sometimes be leak of fluids from vagina which is normal, due to secretions inside vagina also. If you are trying for pregnancy, remember to have unprotected sex 14th, 15th, 16th days before your next period, which will increase your chances of getting pregnant.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to get pregnant after a vacuum abortion\n\nhello a yr ago i had a vacuum abortion ever since i haven't been able to conceive iv been trying everything and nothing is working, im not on the pill or anything and my partner has had a baby with another woman i feel as tho there is something wrong with me??",
    "doctor_response": "Hi, vacuum abortion generally doesn't affect pregnancy chances. So, get yourself evaluated for other things like a thyroid profile and prolactin levels and a ultrasound for your uterus and ovaries. If everything is fine, you can take some medicines like clomiphene for increasing the growth of your eggs. You can have contact every 2 to 3 days after your periods stop.  This will increase chances of your pregnancy.  Hope I have answered your question.  If you have any other query I will be happy to help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in my right feet?\n\nhi, my name is Nikhat i am 22 years old , i am having pain in my right feet since 2 months i am applying cream and doing massage but still there is a lot of pain and having swelling since 2 months plz advice. i have consulted a doctor but he advice for a complete blood test and gave me wysolone tablet plz advice.",
    "doctor_response": "Hello, If there is pain and swelling in the feet I will advise you to do hot water fermentation and post this elevation of the foot above the level of the heart in lying position. Doing ankle toe movements in this position will be beneficial. Also, use stocking for the leg which will help not to accumulate the metabolic waste. You can take medicine by name lasix if possible. It's a diuretic and your swelling will come down faster. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicine that can be taken with Fentanyl for anxiety\n\nI am on the Mylan 25 mgh Fentanyl patch for spinal mets pain. I have also been taking Tamoxifen for hormone treatment for breast cancer. I am very, very anxious from the Tamoxifen, so my onc prescribed 1 mg. Lorazepam for anxiety; however, I am afraid to take it since it also depresses respiration. Is there any other med for anxiety that I could take with Fentanyl? I am also anxious about the patch. It does take care of the pain, but I feel uncomfortable with it, knowing its potency.",
    "doctor_response": "HiI had gone through your query.I understand your concern about anxiety.Lorazepam is the safest anxiolytic for anxiety.It has very low dependance level.It can be taken up to 2 to 4 mg and with 1mg there are no complication like respiratory depression.So do not worry about it.You can take 1 mg of lorazepam for anxiety but take your treating doctors advise.Fentanyl is not used for anxiety and it wont help much in anxiety or psychological distress.Mild dose of SSRI like escitalopram or peroxetine will help in anxiety.Relaxation methods like yoga, deep breathing exercise, meditations and progressive muscle relaxation will help.Stress free activities and identify stress trigger events, try to modify it.Avoid smoking and alcohol.Take proper sleep and diet.I hope i have answered your query.Wish you very good health.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had chalazion, after sty on eye. Home remedies?\n\nI've had a Chalazion for about three weeks. It resulted after a sty formed on my left eye. It's not very large (smaller than a pea) and I just started adding heat to it. I'm starting a new job On Monday, and being that I can't take off right away I'm hoping it can be treated without surgery. Are there any home remedies that could help me?",
    "doctor_response": "Hello & thanks for your Q on HCM I recommend applying a warm compress to the cyst up to four times a day until the swelling reduces and finally disappears. Hold the warm compress on the affected area for 10 to 15 minutes at a time to soften the blockage and speed up the draining process. Always wash your hands well before applying the compress and use a fresh clean cloth. Never heat the water for a compress in a microwave as it can become too hot and burn the delicate skin of the eyelids. Instead of tap water, you could use normal saline solution. ( salt water). Other home remedies for eye cysts are Use of guava leaves as a compress. Warm these leaves and place them in a clean dry cloth. Place this cloth over the swelling and leave it on for a while to reduce pain and redness. Boil some acacia leaves in water. Remove the leaves and use this water to soak a towel or clean cloth. Place the warm compress over the eyelids to remove in order to get rid of the chalazion cyst naturally. Apply a mixture of rosewater and honey directly on the eye which has a soothing effect and helps the eye heal at a faster rate. Tea bag eye treatments are effective in treating an eye cyst-  the used teabag of chamomile tea should be chilled for a while and then applied to the affected eye for 5 to 10 minutes or so. Hope that it helpful & all the best for your new job",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach problems. Endoscopy done, stomach cancer diagnosed. Treatment?\n\nDear Doc, My father is 57 year old man and he is facing some stomach problem. We went to doctore and he did endoscopy and said that he has cancer . Again for our satisfaction we went to another doctor and he said that he don t have. I m confused. I have both endoscopy report with me. Please do suggest me Sir what should I do ? Thanking you!",
    "doctor_response": "Hi, Welcome to HCM, I am Dr. Das First of all without biopsy report it is difficult to stamp any lesion seen through endoscopy as a cancer. So, you have to do an endoscopy guided biopsy of that lesion theen weight for the histopathology reprt which will confirm whether it is a neoplasm or a ulcer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What to do for nose block and throat infection?\n\nHi doctor, I am 36 years old male. My weight is approximately 80 kg. My nose has been blocked and I am feeling tired. My throat is becoming sore. My chest is restless. What to do?",
    "doctor_response": "Hi. It seems that you are suffering from viral infection that could be the cause of your symptoms. I would suggest you to take I would also suggest you to take salt water gargling three to four times a day. Also try to have steam inhalation three to four times a day and drink plenty of fluids. For further information consult a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Asthmatic, clear lungs. Small rash which was treated, will scabies affect lungs?\n\nMY SON IS 7 YEARS OLD. WE GOT TREATED FOR SCABIES ...WITH PREME...CREAM NOT SURE IF WE HAVE IT ..PROTOCOL. MY SON HAD A SMALL RASH ...AND THE DERMAT GAVE HIM A SMALL CREAM FOR HIS BUTTUCKS. THE RASH ONLY LASTED ONE DAY...IT S GONE NOW.....HE SUFFERS FROM ASTHMA ... NOW HE IS COUGHHING...I TOOK HIM TO HIS PEDI AND HIS LUNGS ARE CLEAR...ONLY POST NASAL DRIP AND HAS GREEN MUCOUS....CAN SCABIES AFFECT HIS LUNGS",
    "doctor_response": "Definately no But your allergies are changing system It might have been allergic rash misdiagnosed with scabies because after some years the allergies start effecting another system like you asthma after some years can cause allergic rash.and if you treat that subsides and it shifts to other organ like nose and sinuses only give anti allergics fexofenadine 120mg od singular 10 mg bd syp ascoril 1/2 tsf tds and tossex 1/2 tsf n ight do for 10 days",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do with baby's bcg?\n\nMy baby is 3 months old, 15.8lbs. I accidentally pricked my baby's bcg because I stupidly thought it was a boil or an infected insect bite, so I tried to squeeze all the pus and blood inside. What would happen to my baby? Would the bcg be ineffective? What should I do?",
    "doctor_response": "Hi, BCG will not be ineffective. When a bcg vaccine is given, a papule develops at the site at 2-3 weeks, which gradually heals leaving a scar. You need not to do anything. Regards - Dr Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for severe pain in tail bone?\n\nI had a mylogram done a week ago today. Although i had no major headache, i have been experiencing severe nerve pain in my tailbone, since Sunday. It s stiff when i awake in the morning. Some days is worse then other. I have significant new edit damage in my L5 and S1 nerves. Can they be related?",
    "doctor_response": "Hello, As the history don't mention about any fall than the tail bone will have no fracture. Due to nerve root entrapment at the L5-S1 levels, there will be a weakness in the gluteus muscles. Due to which there will be excessive pressure over the coccyx. Leading to inflammation and pain. I will advise you to use piles pillow to avoid pressure over the coccyx bone/ tail bone. Post which I will advise for some icing. Along with this, core stability exercise, spinal muscle strengthening exercises, hip muscle strengthening exercises, lower limb Strengthening exercises. All of this will help to reduce pain and inflammation. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the symptoms of  bipolar and Schizophrenia in a person?\n\nHi, i have been suffering for years with different symptoms which i dont understand, i was hoping that u could help me, I have looked up on many sites for the symptoms and they all keep coming back saying either bipolar disoder or early signs of schizophrenia, im sorry i am unsure on how to spell that. I am too embarrest to go to my doctor and have alot of trouble expressing my feelings. If i list some of my symptoms could you help me?",
    "doctor_response": "Hi, thanks for the query; shame, guilt, stigma are the biggest hurdles in receiving proper treatment & care. Hence you must be courageous enough to come forward & enlist your problems/symptoms for getting help & proper treatment. Since you are extensively searching internet for your problems, answer a few more questions from my side also in addition to your queries you shall be posting to me.Are you into drugs like alcohol, marijuana, cocaine, heroin, MDMA?Do you Try to do 30 minutes/day physical exercise? or get a proper diet & 6-7 hrs uninterrupted night sleep on a daily basis? Consult your GP/Psychiatrist or get back to me for further assistance. Hope this helps; good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes night terrors while on Doxepin and Lamictal?\n\nMy Dr. prescribe Doxipen 50 mg x1 at bedtime for insomnia and biopolar depression and Lamictal 150 x2 per day which I thought caused sleeplessness. Why two biopolar meds and one antidepressant & sleep medication . I was also on Seriquil but I stopped taking this. I have starte having nite terors and dreamers that I woke up crying and not sleep well.",
    "doctor_response": "DearI need ur detail history to give u advise as per why urs medications were changed. it may be due to emergence of new symptoms some medication interfere with sleep wake schedule/REM sleep . So night terror occurs if they are too much debilitating,your treatment plan can be modifiedRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of nerve root impingement and canal stenosis?\n\nL3 loss of disc height annular disc bulge L4 both annular and dorsal disc bulge and a more prominent left latteral bulge L5 annular bulge plus posterior protrusion severe foraminal stenosis and osteophyte complex Shows signs of nerve root impingment and canal stenosis. Options please",
    "doctor_response": "Hi Hope this message finds you in good health.I have gone through your complaints and understand your concern.It means the leg nerve is compressed causing pain.physio,rest,analgesics,exercises should help.If unrelievedsurgery is the last option.Nothing to worry about.\u00a0\u00a0\u00a0\u00a0\u00a0I hope your question has been answered.If you have any follow-up queries,feel free to consult me anytime.Thanks,Take care,God bless.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pin sensation?\n\nI'm a 33 year old male, 6' (182 cm) tall, weighing in at about 185lbs.  I have been experiencing a strange sensation near my heart around mid morning for a few days.  It's not quite pins and needles, but it's none the less alarming.  My family never had heart issues for generations.I have weaned myself off coffee, and have been caffeine free for about 4 days.  I have recently increased my sleep, have a good diet, and am in good shape.I have been steadily increasing my exercise with weights for 15 months, recently increasing cardiovascular exercise to 20 minutes with a steady heart rate of about 150 beats per minute.What is the source of the chest pin sensation?",
    "doctor_response": "Hi,Dear,Thanks for your query to HCM.Dear I read your query and reviewed it with context to your query facts.Based on the facts of your query, you seem to suffer from-Obesity with Hypertension with Cardiac Angina(Stable) caused from Exercises.Treatment-8 Hrs sleep/ Reduce on your coffee strictly.Reduce on the Exercise load x for 6 weeks Reduce on your Diet by 40 per cent amount.x 6 weeksCheck for the Hyper-lipidemia and treat by statins if need be with Physician.Reduce on weight by 7-10 %.Take Betablockers-Tab Betaone-Xl-25 mg 1 OD to start with for to reduce the HypertensionTake diuretics to reduce on the high Bp medicines side effects.Tab Telsartan-20 mg to stat with.Keep Low on salts in diet.Hope this would help you to reduce worry with your problem.Take care and wish you to recover fast and Live healthy.Hope this reply would help you to plan further treatment with your family and specialist doctors there.Welcome for any further query in this regard.Good Day!!Dr.Savaskar M.N.Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rash and swelling on cheek?\n\nThank you. I woke up about 3 days ago with a bit of swelling under one eye and then within 24 hrs had a swollen nose, very red and a sunburned like rash, also swollen only on one side of check. I have been given a zpack and predestine, sp? and it is significantly better. I have been looking up lupus an am very concerned, could this be something else?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I will keep a possibility of shingles, considering the fact that the distribution of the rash is one sided. Shingles usually presents as red, swollen, painful and blistery rash on one side of the body. Though it affects chest and face commonly, it could affect almost any part of the body.. I suggest you to kindly consult a dermatologist in your region for confirmation of the diagnosis. Treatment of shingles would consist of oral antiviral like valacyclovir or acyclovir for a week. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes anxiety with irregular heart beats?\n\nHello, I am 28 year old male with severe anxiety..I feel an irregular heart beat just about every night. Like it skips a beat about every 5 beats...It scares the crap out of me..I am kind of a high strung person with a lot of energy. But for some reason I think something is wrong..it can t be normal to feel your heart beat like that. I was a fire fighter for a while and when I was under mild stress the emt s would do whats called pt...and check my vitals...just about everyone of them would look at me funny and ask was I ok? cause my heart beats really weired..It does not hurt but it really scares me and makes my heart rate go up? is there a need to rush to the emergency room in the middle of the night when I feel this?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Palpitations (audible heart beats) are a common feature of all anxiety disorder affected people. This happens as an obsession rather than the disorder itself. Many researches and researchers confirm that medicines alone cannot cure mental disorders. Life style changes, change in thinking pattern, relaxation etc are as essential as medicines. Psychotherapy can help you changing your lifestyle and thinking patterns. Yoga and meditation help you to streamline your metabolism and neurological balance. Please consult a psychologist for further information.If you require more of my help in this aspect, Please post a direct question to me in this URL.  Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a swollen ankle?\n\nI hit my ankle with an outside chair, it hit my ankle bone. I swelled badly, but I iced it. It is 2 weeks now and i have bruising on both sides of ankle, and the part I hit is sore to the touch. I am an avid walker, and am trying to do less, and ice after I walk. I have full range of motion, and can walk with no problem. What could I have done?",
    "doctor_response": "Hello, As this will be a bony hurt on the malleolus. Do hot water fermentation and use crepe bandage. This should help provide stability to the muscle and joint. Simple ankle stabilization exercises post this should help. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for skin darkening in an infant\n\nHello Doctor, My daughter is 9 month old now. She born fair and stayed fair till 2nd month. I started giving her oil massage with jhonson baby oil from her 2nd month. I noticed that her body turned light brown. By her 5th month her face and ears remain fair, but her rest of the body turned dark. So I stopped massaging her with oil from her 6th month. Just applying jhonson baby cream not the lotion daily after bath. Its been 3 months now I didn t applied oil. I noticed her body started turning light slowly but it is taking too long to become light/fair. I m feeling very guilty that i didn t noticed early that because of oil she is turning dark. What can i do to get her body fair back. How long it will take to get her actual color back. Her face and ears remained fair only her body turned dark. Please help.",
    "doctor_response": "Hi Thanks for writing to Healthcare magic.I would like yo know what is the colour tone of both parents?In case parents have a deeper tone the child too might have tone similar.I would suggest to use Seba med extra soft baby cream for body which will hydrate skin for a long time. It could help keep skin soft.Hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is CBD effective in the treatment of pain due to arthritis?\n\nI have arthritis and a back issue and was wondering if cbd might work and help with the pain. I have been reading reports on how it helped so many people with there pain. I am a 84 year man who is recovering from a bowel blockage in which they removed about 3 feet of my small intestine out and don t have a bag on. I had to have emergency surgery in November of 2017.",
    "doctor_response": "Hello, There is very little active ingredient in the CBD oil that is legally available. There is other cannabis edibles for which the pain effect is probably there, but difficult to evaluate. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for elevated ALT levels\n\nHello.. my brother is concerned about his liver enzymes being raised. All the other blood work came back in normal range besides his alt and the other one ast (maybe) he has been doing a vigorous work out for months now.. if it is just elevated from exercise, will it fix itself or will he need antibiotic or some other kind of medicine.. the ER didn't prescribe any to him",
    "doctor_response": "Hello! Thanks for putting your query in HCM. I am a Gastroenterologist. Increased liver enzymes  has many cause like Hepatitis B, C, Metabolic disorders, NAFLD, alcohol intake etc, hope all are negative. If not done then get them done. . There are few medicines which I found very useful in my patients are ursodeoxycholic acid and vitamin E. Continue exercise.I hope I have answered your query and this will help you . Wish you a good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I have problem in bending forward?\n\nHello doctor, I injured my lower back while squatting about one and a half month back. I have difficulty in bending backwards. A sharp pain was felt when I used to bend backward. But, no pain in forward bending or sideway bending. Neither any pain was felt on touching the region. So, I started physiotherapy and the situation is improving. Recently, when I was playing badminton again I felt the similar pain whenever I tried to bend backward. So, I consulted a doctor. He viewed my x-ray report and said there is no such problem in it. He advised me to stay away from sports for the next 10 days. But, the pain has worsened now. I feel pain in a different region that is just above the right hip. The pain is felt on touching that part and now I have even problem in bending forward. Even sitting increases the pain now. Standing and walking makes it better. As advised by the doctor I regularly do muscle strengthening and stretching exercises, but no improvement can be seen. Please help.",
    "doctor_response": "Hi. The x-ray is not very clear (attachment removed to protect patient identity), but your pain will surely reduce. So, do not worry. Instructions to reduce back pain: Facet pain - lumbar spine. Revert back after five days to an orthopaedician and traumatologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause for abdominal pain, loss of appetite, swelling, fatigue and sleeplessness after surgery?\n\nhi my daughter is 26 years old.  She recently had a tubal using filshy clips.  Every since she had the surgery, she has had abdominal pain,loss of appitite,swelling, fatique and sleeplessness. What could be wrong with her. She can not get her doctor to listen to her.",
    "doctor_response": "Hi. If the patient is suffering from the problems you told about, there has to be a problem. I would advise you to take her to another Doctor, get a clinical examination and investigations like x-ray chest, blood , urine and sonography to ascertain the cause, and treat accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bronchiectasis and microcephaly\n\nHi My Name is Vicki, I have twin boys aged 9, one of who has the following, Bronchiectasis - Which he has half a right lung left to function with, HE has NF1, lost of Cafe Lait, Two Cysts, one on his Brain and one on his mid to lower spine. He has high amounts of protein running through his spinal cord, he has lesions on his brain like MS, but not MS, he has a head circumfrace of 98% above. He has Macrocephaly, He has mild urinary problems now, he has serveer back pain now, he has fractured nerves to the base of his spine, he has a CSF Pressure of 28 under GA, he has short term memory loss as well. He is ok at the moment, but I know he is loaded, and all he wants is to find a cure to live. Sean gets very worn out now, and at times finds it hard to walk long distances. Sean is also drug free at the moment. Does anyone know what this all means for him, and is there any treatment he can have to secure him to have a beter and longer life. Thank you, We live in Auckland NZ, My Name is Vicki Adams",
    "doctor_response": "hi sry for the condition of ur son.the condition NF I is a congenital anomalies due to defrct tive chromosome 17q11.2 which results in defective gene NF I gene whitch is a tumor suppersor gene which activation produces neurofibromin protien.a s far as tratment is concerned there is no single best cure only symptomatic tretment for rest of the life",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes penile pain while urinating/touching?\n\n.My penis hurts extremely whenever i pee and my penis head has become very painful to touch. i was prescribed azithromycin but it seems to have only gotten worse, to the point that i have refused to pee anymore because it feels like someone is slicing my urethra with a razorblade when i try. plus my mouth and tongue has recently begun breaking out and becoming very sore. what could be wrong that the antibiotics couldnt help?",
    "doctor_response": "Hello,It may be due to urinary tract infection. For that you may require complete hemogram, urine analysis, ultrasound abdomen after urologist consultation. You may require antibiotics after consultation. For pain you can take tablet acetaminophen. You may require syp. Cital. Keep your self hydrated. Maintain proper hygiene.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of taking Fertility-M?\n\nSir, Whether Fertily-M is advisable when i have normal sperm count.My doctor has suggested me to take this medicine for three months even i am having normal sperm count, Whether there is any side effets for taking this medicines for 3 months. Our doctor has suggested Fertiliy-M for me for 3 monhs and for my wife fertily-M 100mg for 5 days immediately after period as she is having AMH .76 and trying to conceive since last one year. Please advise",
    "doctor_response": "I understand your concern. Fertyl M tablet contains 'Clomifene' as an active ingredient. It is used for the treatment of infertility in men as well as infertility in women. In men, it is known to improve the sperm count. The following are the possible side effects that may occur by intake of Fertyl M. 1. Breast Discomfort2. Flushing3. Vision Disturbances4. Nausea5. PancreatitisSeek medical attention promptly if you experience such side effects and if it becomes bothersome. Kindly take the medication as advised and do the necessary follow-up as suggested. Hope the information provided would be helpful. Let me know if I can assist you further.All the best. Regards,Dr. Ashakiran S",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does rash with scab and no itchiness indicate?\n\nHi, I recently had a rash on my lower back/upper buttocks that kind of appeared out of nowhere. At first it was real sensitive, like a cut almost, then it scabbed immediately. This is similar to another \"rash\" I had that scabbed, and it hasn't gone away. It's not bothersome anymore, but just kind of strange that the black scab hasn't gone away. In both instances, there was no itching and major scratching that preceded it. Any ideas what this might be?",
    "doctor_response": "Hi Dear ,Understanding your concern.As per your query your have rash with scab and no itchiness which can occur due to heat rash and related environmental factors. Need not to worry. I would suggest you to give cold compresses several times a day to prevent from swelling and itching and take over the counter antihistamine drug like benadryl. If symptoms still persist the consult dermatologist for proper examination and treatment . Doctor may perform skin test and challenge to find out the trigger factor . Doctor may prescribe other steroid cream ( mometasone) , anti inflammatory drug or drugs that can suppress immune system. Herbal tea and aloe vera gel are also very helpful. Stay in cool environment.Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent welts in a child?\n\nMy Grandson has been having welts. They don t last more than 30 - 45 minutes but are concerning. When he sits on the bath mat in the tub and then gets out he has welts. Then he fell off the couch and grazed my shoulder and had a welt on his face. My daughter said this has been going on for about a week and a friend told her he was dehydrated? Should we be concerned?",
    "doctor_response": "Hi,By what you say I feel that your grand child may be having cholinergic urticaria. I suggest you discuss this with his pediatrician.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any laser treatment to remove TB scar?\n\nHi... I have affected Tuberculosis at me 17 th age, treatment taken for 6 months, Doctor told me you are ok. But when i try to going to Singapore got rejected in medical exam reason is TB scar on lungs.. Can u advice me is there any laser treatment to remove the scar...  Pls help... to go Singapore.",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. Sorry to say but there is no treatment available for removal of lung scar because it is not active disease, it is just healed , inactive scar tissue.For your visa problem,  I advice you to consult pulmonologist and get done1. CT thorax2. Bronchoscopy and BAL (Bronchoalveolar lavage ) analysis. If both are negative for active tuberculosis, you can argue with visa authority that your lung scars are not due to active tuberculosis and hence you are not infectious.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Uterus cancer. Had hysterectomy. Bowel collapsed. Why bleeding now?\n\nhi, my mum had cancer of the uterous, had a hysterectomy with Professor Shepherd (the best) and was told that they got all of the tumour (it was a high grade one). That was in January. Her bowel then collapsed and she was in hospital for 2 weeks which was really worrying time, but her bowel starting to work again and she made a full recovery. She went for a scan today, which she told me was just routine. Turns out it wasn t as she now admits she has had some bleeding . She has been scanned and the scan is clear but Professor Shepherd has taken tissue of her vagina for tests. Of course I am now worried sick. My mother has told me that there sometimes can be bleeding following a hysterectomy and not to worry.. any thoughts to allay my fears..?",
    "doctor_response": "Your history is incomplete. you havent mentioned the treatment she received after surgery. Any radiation was given? since you sad it was high grade, she would definitely require radiotherapy after surgery. If she had radiotherapy, radiation changes can sometimes cause spotting. if no radiation has been done, it must be either granulation tissue bleeding (not cancer) of some local growth. Biopsy would give final answer. since treatment was given very recently, very unlikely cancer coming back. other causes might be the reason for bleed",
    "dialogue_context": ""
  },
  {
    "patient_message": "Semen analysis done. Diagnosed astheno-terato-zoospermia. Can it be treated?\n\nhi doctor,my age is 39 years, weight is 75 kgs, height is 5.8please note my semen analysis,sperm count 70 mil/mLmotility:total progressive 20% at one hour and 10% at 2 hoursimmotile 72% and 80%rapid progressive 00%morphology:normal forms 02%head defects 65%mid piece and neck defects 27%tail defects 07%multiple defects 33%diagnosed as astheno-terato-zoospermia.Is this condition treatable really?  Can me and my wife have a baby, my wife being diagnosed with hypothyroid (on thyroup 75 mcg) and PCOS, her HSG and other scans are normal?awaiting your reply in anticipation,Babu",
    "doctor_response": "Hi Babu,Thanks for your query. I read your query and I understand your concerns. Following is my reply:1) You have less normal forms and slow moving sperms. 2) I suggest you take anti oxidant medicines prescribed from your docotr and repeat the test after 3 months which might improve the success and get better count.3) Moreover your age is increasing. If you have been married for long, please go for IVF / ICSI method of treatment without wasting timeI hope I answered your query. Let me know if you have any followup queries.Regards,Dr. Mahesh KoregolIVF & Infertility Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to deal with an unusual behaviour of an adult?\n\nHello sir My brother is 29 years old and from last 2months he did some unusual behave at home ,he shuffled all house stuff and just now he did wrong massages to some people,some time he he cut his hair by his own ,actually he likes to stay alone don't talk much to family members and this problem is going on last 10 years and we didn't realize but now in 3 months 2times he did this kind of thing now we are planning to go to psychitatrist i just want to know after treatment if he'll get married will he able to mantain his married life because i read and people says that these psychotic drugs bring impotency we are very worried about him pls suggest us...thanks",
    "doctor_response": "Ur brother is having psychotic illness. And there will be chance to get cured with antipsychotic medicatiinYes there are some side effect of drugs but impotance is less commin among themIf u see benifit of drug is far better than its side effectAfter marraige u have to stick on medications because certain illness require maintaince thaerapyU can go for psychiatrist and he will guide u how long he will require treatments But without drugs he worsens day by day so u need to give support. Thank u",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and swelling in leg after undergoing back surgery?\n\nI have had 3back surgeries, most recent in January I m prone to have scar tissue I still have severe leg pain and now I have swelling in foot and leg pain is worse it forces me to stay off my feet I had ultra sound they ruled out blood clot I am waiting to have MRI in two weeks sometimes I feel like warm water is being poured over my leg real slowly from top to bottom I am worried about what s going on I m scared can you help",
    "doctor_response": "Hi, I am Dr.Bruno.  I have read your question and understand your concerns. Let me try to help you Question : What causes pain and swelling in leg after undergoing back surgery?Answer : The most common cause of Pain and Swelling in Leg after undergoing Back Surgery is a condition called as Deep Vein Thrombosis. Because your legs were immobile for long, the circulation in the veins of the leg had become sluggish and a thrombus (blood clot) has formed inside your veins A Vascular Surgeon will be able to cure this and make you alright  Hope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have 25.3 mm follicle on 14th day in my right ovary after treatment. Can I conceive ?\n\ni had problem of pcod bt after treatment on 12th day my follical is 20mm and after taking injection nw i hae 25.3mm follical on 14th day in right ovary and 9.5mm in left ovary ... is this positive sign of concieving i had pcod and nw after treatment nw i have follical of 20mm in right ovary on 12th day and after taking injectionnw on14h day i have 25.3mm follical in right ovary and 9.3mm in left ovry.... is this positive sign of concieving... what will be the exact date of ovalution ,....",
    "doctor_response": "Hi Welcome to Healthcaremagic Yes its a good sign to conceive. You need to confirm ovualtion( rupture of egg) by ultrasound. Once ovulation is confirmed you can have intercourse same day and very next day to improve your chances of conception. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Overweight with bone spur and disc bulge. Taking steroid injections. Stabbing pain in the neck, nausea, migraines. Damage to spinal cord?\n\nI am 35, 200 lb s, female with a bone spur in my neck and a bulging disk. One week ago I received steroid injections in my neck. That very night I felt a hot stabbing and shooting pain in my neck. It also went down the left side of my back, through my left shoulder and up into my head and behind my left eye causing me a migraine . I was up all night in severe pain, pain level same as labor. Now for a week I have been sick. Nausea, pain, migraines, cold and hot flashes, sweating, pain behind my left eye and dizziness. I am afraid that the doctor hit my spinal cord and is making me sick. What do you think?",
    "doctor_response": "Hello, Thanks for the query You may be having independent cervical spondylosis and migraine. You will benefit with medications like topiramate (this will help you loose weight also), amitriptiline along with regular exercise and diet and life style changes. You may consult a local neurologist for the help who will guide you through examination and investigations. Hope this clarifies Best wishes Dr Gopal K Dash  MD, DM, Post-doctoral fellowship (Epilepsy) Consultant Neurologist and Epilepsy specialist Narayana Hrudayalaya Hospital, Bangalore My Blog in the Web site:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lack of ambition in life with depressed feelings\n\nHELP..........I HAVE NEVER BEEN THIS LETHARGIC AND DOWN LOST MY MOM NEW YEARS DAY. ALSO HAD TO MOVE MY FATHER-IN-LAW IN HOUSE. BEEN TAKING CARE OF HIM AT HIS HOUSE HE NOW NEEDED DIALYSIS. ALOT OF OTHER THINGS I CANNOT FUNCTION.I AM SCARED TO EVEN LEAVE THE HOUSE,EMBARASSED,HATE MYSELF. FEEL LIKE A LOSER.NO ENERGY AMBITION ETC. I FEEL UGLY FAT AND DO NOT WANT TO CONFRONT ANYTHING...NEED HELP BAD STARTED CYMBALTA 30 MGS. GETTTING SHAKES SWEATS...AMOST 4 WEEKS HAVE MEDICAID....HELP  SHARI...",
    "doctor_response": "Hi,I can understand what you must be going through> with so much going on in your life, you really must be very stressed out. You definitely seem to be in a depressed state.Its good that you have already started treatment. In your case, since its already one month on cymbalta at 30 mg/day and still the symptoms are persisting, I feel that it is time to increase the dose further up. we can go upto 120 mg/day gradually depending on how you are responding to the medicine. If you don't show response to it, another drug like escitalopram or venlafaxine can be considered. You can discuss the options with your psychiatrist.Hope that I was able answer your query. Best wishes for a speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for limpoma\n\nI've been diagnosed with a mass in the posterior left side of my neck. MRI revealed a possible lipoma. I went to a general surgeon, who informed me that the mass appears to be in the muscle. This \"lipoma\" causes my neck to ache. With that in mind, I was wondering if a nerve may be entrapped and what surgical options might I have. Thank you.",
    "doctor_response": "Thanks for your question on HCM. Lipomas are benign soft tissue tumour s usually containing fat tissue only. So they are soft,  non tender and non itchy. And usually does not produce any symptoms.so no treatment is required. But when they produce symptoms or increasing in size than surgical removal is the only treatment. So consult general surgeon and get done surgical removal of lipoma.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling jittery and dizzy. Could it be due to depression or anxiety? Any relief?\n\nhi i feel jittery everytime i go out.. This is after i got dizzy and puked when i went out one time Seems like i cant get rid of that worry out of my head. What should i do? this is effecting my social status sometimes i dont go out anymore because im scared of getting dizzy.. I know its all in the head but its easy to say. When it slaps me i feel uneasy, my feet feels light and i feel like i need to rush somewhere or rush home. I calm myself with water sometimes and a menthol rub but it seems like its getting worse. Some people say it could be because im depressed or its anxiety .. what should i do?",
    "doctor_response": "Hello.... Thanks for your query. On going through your symptoms, it appears that you are suffering from social anxiety disorder which has adolescent onset. It is characterised by anxiety symptoms only ion social situations. Effective anti-anxiety medication are available in addition to psychotherapy (eg exposure & response prevention). Hence, i would suggest you undergo a thorough psychiatric evaluation so that appropriate management can be initiated. Regards Dr Sundar Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest therapy for neck & shoulder pain\n\nHello I am 2.5months post partum. I had an epidural and got a spinal headache from it however do to the sudden onset (within 1hr from epidural placement) my neck was aching and hurting, after the epidural was removed it got much worse. Then the next day a little better and so forth. I have been back to work for 3wks (lots of walking) and I have developed the neck and shoulder pain again, along with foggy headed, and a throbbing headache, and neck is sore and stuff, vision feels more blurry. No fever and I can turn my head from side to side.",
    "doctor_response": "Please do a mri brain if possible contrast enhanced.immediately consult a neuromedicine doctor.epidural may nit be cause for this headache",
    "dialogue_context": ""
  },
  {
    "patient_message": "How safe is taking Rocefin and Bentelan injection for chest infection?\n\ni have had a bad chest infection and my left lung is very tight and painfull when breathing but i am on rocefin and bentelan injections. do i need to go back to my doctor or is it normal that it hasn't resolved yet. i have been on these since sunday night.",
    "doctor_response": "Hello,According to history, don't worry you can take them safely as your doctor has prescribed. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Jnikolla",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful tingling sensation on knees?\n\nHello, I m a dancer and I do a lot of things where I land on my knee (just below it) fairly hard or I do things where I m on one knee. It was constantly bruised. Now, this part of my knee is extremely sensative. When I put pressure on it, I get a painful tingling sensation that lasts a while. I ve been experiencing this for the last several months. I can walk and function normally, I just can t bare weight on my knee or touch it. What is wrong?",
    "doctor_response": "I think you need to visit an orthopedic specialist as he will assist you in assessing your knee joint and the muscular strength. sometimes a dancer needs a proper guidance of exercise by a qualified physiotherapist and then to overcome the pain and aches for their best ever performances.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high blood pressure\n\ni have a pressure on heart from one month i have high blood pressure and short breath some time can i go for stress test . when stress test is recommended , i am from asia and doctors are not so good , so please recommend me should i go for stress test immediately .my Trig is 435",
    "doctor_response": "u need to have ECG, echocardiogram and stress test too . u need to have proper evaluation for shortness of breath and high Bp. and start Bp medicine immediately like lisinopril 10mg daily",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for recurring neuralgic pain in the arm and chest of a diabetic with seizures ?\n\nmy patient has pain in left arm and chest. It is neuralgic type as many ecg are within normal limits and she is a diabetic. I have started her on pregabalin 150 mg / day. and she is on carbamazepine for seizures 600 mg per day. Her pain continue to occur once a week. What can i do for her? Thanking you in anticipation for your reply, Dr. Ashish Subhash Kakaria. (MD Medicine, India)",
    "doctor_response": "Hi, I suggest to add anti anxiety drug as well and monitor the response after 15 days. Pregabalin and Carbamazepine both act in similar way you can replace it with anti anxiety. If the nature of the pain changes then it is better to refer to a Psychiatrist as well for counselling purposes. If the nature is the same, a trial and error pain medication should be applied. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and muscle pain while on Metoprolol for High BP?\n\nHello my name is Michelle .I was taking hydroclorizide 25mg. for my blood pressure for 2 yrs now. but it is not contolling my bp,last monday my dr. put me on amlodipine besylate 10mg. and metopropla tar,25mg.and told me to take it twice a day.itried but now im only taking the metro. at nite because it is way to stong for me. also.I have taken it for a week and am having side effects like very low energy sleepy all the time and dizziness ,muscle pain.I want to know if there is some other bp medicine with not so many side effects.I have a business to run and cannot be drugged up like this .barely can function.I dont have no heart disease or any other medical issues,thanks,m",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.You can take tab Amlodipine or Telmisartan. Both are safe and are better suited for active males. For Amlodipine 10 mg once or twice a day as per response and Telmisartan 40 mg once a day or two times as per response. Take any one of these two. Start morning or evening walk at a moderate pace at least for 30 minutes daily, reduce salt consumption one spoon at a single meal and avoid smoking and also fast fried foods. Hope I have answered your query. Let me know if I can assist you further.Regards, \u00a0\u00a0\u00a0\u00a0\u00a0Dr. Varinder Joshi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and tenderness in lower back after cervical fusion surgery?\n\nI am having lower back pain that is also causing discomfort in my legs. When I press on my lower spine it is very tender and sore to the touch. I have had (3) cervical fusions in the last 4 years on wonder if this could be related to my medical history with my surgeries. I know this isn t a normal feeling of pain and worry this could be serious?",
    "doctor_response": "Hello, I wouldn't jump to the conclusion that the pain represents anything SERIOUS based on the little information you've provided but the fact you've had several cervical fusions could mean you are prone to developing more than average osteoarthritic degenerative problems which would explain the back pain.  However, going for an evaluation with a doctor is always the best first step in solving such problems. It will likely be necessary to get an imaging study of the back but it is also very likely (based on probability) that your pain in the back and legs can be adequately managed using conservative means at this time such as PHYSICAL THERAPY, AQUATHERAPY, and APPROPRIATE MEDICATIONS. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for white and numbed finger due to blood vessel breakage\n\nBroke a blood vessel in left index finger at first joint (closest to hand) yesterday. While maneuvering grocery cart at market this afternoon, that finger became numb and white. I rubbed it and it normalized eventually. Now it s numb and white again. ???",
    "doctor_response": "If it hurts, apply ice. Take pain killers. Get an Xray of you can't lift weights or use that finger for regular work.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rapid heart beats?\n\nas of the past few days, i am experiencing rapid heart beat.  it was short at first but has increased in duration to about 10 minutes at a time.  when it occurs, i am not doing anything strenuous.  i am 36 and in relatively good health.  is this something i need to worry about?",
    "doctor_response": "Dear- thanks for using our system. Rapid heart beat can be secondary to multiples causes. It is important to find out if the heart rate is more thatn 100 per /min and if it is regular or irregular.The best way to find out is taking your pulse and having an electrocardiogram. Medical conditions as panic attack or anxiety, hyperthyroidism, caffeine intake , are some examples of rapid heart beat. You need to see your doctor for a checkup, electrocardiogram and 24 hr holter monitor trying to identify why type of arrythmia you have. Some valvular conditions as mitral valve prolapse can give you rapid heart beat too.I hope that my advise has been helpfulDR.Sara",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy after rupturing of egg on follicular scan?\n\nHi, I am 30 years old and have irregular periods. My Gnynea put me on some pills to get my periods and post which from the 2nd day of my periods on these pills called Siphene. Today i finished 7 sessions of follicular scan and the doc said that the egg has raptured. What does this mean and what my chances of getting pregnant?",
    "doctor_response": "Hi, thanks for writing..Yes, follicle has ruptured means ovulation has occured and you need to have intercoursae in and around this time to attain pregnancy.. If you dont get pregnant in this cycle, repeat the same for next 2 cycles.. In the post ovulatory period take duphaston for 10 days for luteal phase support.. The chance of pregnancy increases with this.. Hope I have answered your query.. good day..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever , cough and cold in a child\n\nhi sir my kid 8months babyboy nearly from 9days he got fever, cold n cough... i use somany times paracetamol in various companies bcz of i changed 2doctors 2day new doctor says me tht use MACBERRY XT halfcup 3times in day.. CEFPOM 3ml 2times in day... febrex plus 5ml every 5 hours and also he did injection then my baby fever 101 nearly... he comes to normal temp..",
    "doctor_response": "Hi,Thank you for asking question on health care magic.Paracetamol 15 mg/kg body weight every 4-6 hourly along with tepid sponging will bring down fever quickly.Local instillation of saline nasal drops as well as oral zinc drops will help reducing colds.Sinarest AF may be helpfulHope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the abdomen?\n\nDear doctor, I am 34 year female, married, have 2 sons aged 20 and 17. i work in a corporate office. some 12 years back i had a acute on my right abdomen and doctor doubted appendicitis but the pain went away. Then aftersome years the pain on the same abdomen occurs sometimes and goes, but slowly my montly period became heay lasting for 7 days and some kind of piece of blood comes, feel thirsty, no appetite, feel like eaten too much, gas formation, some whitesh discharge comes sometimes, back pain, some giddiness while geting up from chair/bed. The monthly period com on time. after the delivery of two sons tubotomy was done as both the delivery was ceaserean. Recently about 20 days back again i had a acute pain on the same abdomen with  feeling of something is struct inside, feeling like vomiting sometimes, overeating, thirsty, no appetite. This time one doctor after doing all the checks and ultrosound says tumor in ovary, need surgery and i referred to second doctor, who conducted all the test and check says not tumor but cyst in ovary, need not surgery. The pain is better but still there little. The pepsimer and malingness test is noram.no medicine given. advised to review after 6 months I am confuesed with two opinion. If doctor could give some advise on this and also your suggestion to diet and other means to control or reduce the pain.",
    "doctor_response": "Hi I am sorry to know about your illnessI can understand your concernat this point of time you need not to worryif you can upload your ultrasound reports I would be able to help you bettermeanwhile have plenty of fluids avoid fatty and fried foodPhysical exercise dailyhave tab pantoprazole 40 mg half an hour before breakfast to avoid hyperacidity and related abdominal symptomsHope this helps you you can ask for further query if anythanks for using health care magicwish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will having meth will make lupus worse in long run?\n\nPlease write yi have SLE lupus and im haveing really bad pain and i am seeing a pain and have been going to see different mrdical specalists for my medical conditions . however they dont feel i need a higher dose of medication and what there giving me is not helping . i have gotten so desprate for help that i started using meth to deal with the pain i dont plan to just keep doing drugs so im getting a second opinion . my question is even though meth helps with the pain is it going to make my lupus worse in the long run?our query here",
    "doctor_response": "Dear Madam,Generally it does not affect lupus activity but it is not advisable to take this drug for long time.Dr. Shruti",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in the hands with stiffness in the fingers?\n\nHi! My name is vida: My hands have been aching for over a month now. My middle and index fingers hurt real bad middle buckles on both hands hurt very bad all the time and fingers lock up if I m not constantly moving them!!! Very hurtful if I even try to make a fist! Went to emergency room and didn t get any help or referral. What kind of doctor do I need to make an appt with?",
    "doctor_response": "Hello,I read your question and understood your concern. I think you have trigger finger syndrome which is an inflammation of flexor tendon sheath caused by overuse (may be profession) and is manifested with locking of the fingers. In the beginning we treat it with medication and cortisone injection in the fingers, if no results found then we do a small surgery on the palm of the hand. I think you should see a hand surgeon, or if you do not have a hand surgeon then an orthopedic surgeon would take care of you for this problem.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Edvin Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump in the throat indicate?\n\nI have what feels like a lump in my throat when I swallow.  No Pain.  If I were to indicate where I feel the lump (externally, although the feeling is internal), it would be in the nook just above my clavicle off slightly to the right side.  As best I can tell, there is no swelling or palpable lump externally/on my neck.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.As per my surgical experience, this indicates possible enlargement of adenoid or tonsil giving the deep level of discomfort during swallowing.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "I was experiencing groin pain- I had massage therapy which\n\nI was experiencing groin pain- I had massage therapy  which  aggravated it - about  a week after, I had  diverticulitis -antibiotics -  that went away  but I still have groin pain - really only bothers me very early morning if it should try to turn over in bed. During the  day   there is some aggravation from time to time but not anywhere severe as morning.I have to sleep on one side only.  Any help would be appreciated - thank you    ps  Having a colonoscopy and stomach check June  12th",
    "doctor_response": "Hello,The pain in the groin prior to massage or after - it should be due to diverticulitis as you mention. If you can understand what is diverticulitis - that will explain the cause for your present problem.Diverticulitis is the formation of pouches (diverticula) within the bowel wall, typically occurs within the large intestine, or colon, although it can occasionally occur in the small intestine.cause: Raised intraluminal colonic pressures and lack of dietary fiber.Till colonoscopic confirmation Antibiotic can be taken, along with investigations like TC, DC, ESR, Hb, Mx, X-Ray Chest and USG abdomen.Most cases of simple, uncomplicated diverticulitis respond to conservative therapy with bowel rest and antibiotics. Surgery is not indicated for you why because,surgery is decided by the stage of the disease, the age of the patient and his or her general medical condition, as well as the severity and frequency of attacks or if the symptoms persisted after a first acute episode.I wish you a normal colonoscopic report.Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pale yellow colored stools in an infant?\n\nMy 8 month old baby has recently Been passing pale yellow coloured stools. She was unwell about 2 weeks ago as she was cutting a tooth. Her diet has stayed the same and is still breastfed as well as solids 3 times a day. Previous to her stools Chang colour they were brown. Thankyou",
    "doctor_response": "Hi . Thanks  for writing at Healthcare magic.I would suggest get a Stool RM test done.Did the baby have any fever, jaundice, or loose motions recently? Hoping to hear back from you. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes increase in TLC level?\n\n12 year old child who was diagnosed as a case of dengue on 5 th day of his illness CBC was performed count were as follows Hb, 6.2 RBC,3.4, Hct 22 TLC 2.3, Plat,70. After 36 hours his Hb unexpectedly rises from 6 to 13 Tlc from 2.3 to 4.0 and plat from 70 to 130. Rise of Hb is unexplainable please. Previos CBC was rechecked from 3 different analyzer and the result was found reproducible no change in any parameter",
    "doctor_response": "Normal total leukocyte count varies with the age of a person. It also has a diurnal cycle i.e. counts vary during a 24 hour day. Normally they range from 4000 to 10,000 per mcl in an adult. The counts may go up due to an increase in any component of the white cells i.e neutrophils, lymphocytes, monocytes , eosinophils or basophils . This can be judged by a differential leukocyte count. The range of RBC, TLC were decreased due infection and intoxication, then increased, because all cells ran from store to focus of infection to struggle with infection.     Best regards    Dr.Svetlana Shrivastva",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to manage the pain in the body and joints without metformin, Xanax?\n\nI am 47 with hypothyroid for 27 yrs.. Also metabolic syndrome and take metformin, Xanax for anxiety. Recently diagnosed with fybro and can t tolerate any of he meds for it... All over pain and joints. Terrible fatigue.. And leg pain. Rheumatologist ordered test that I am slowly getting results. Really want to know what they all mean.. ANA titer was high.. 320, ch50 was over 60 and drrvt was 30 flagged low. I am waiting on one more test result.. Are these looking at lupus? Or results from autoimmune from thyroid? The pain is unbearable at times. Worst during menses and when over exertion. Have a terrible time falling asleep and pain wakes me up every night. I m a mom of a little girl who was born with type 1 diabetes and she needs a mom who can function to care for her. Any help? Thanks",
    "doctor_response": "Trust your rheumatologist ,disclose all your detailed history of symptoms.After tests results final evaluation will be apparent if any auto immune process, rheumatoid or fibromyalgia issues.There are many medications for all above diseases processes and substitutes for Xanax.metformin is oral hypoglycemic and depending on blood sugar status can be modified in dosing or substituted plus other distic and supportive measures may be advised.physical therapy offers good respite from joint , muscles aches symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a baby be trained to breastfeed?\n\nHiiii...I have delivered a baby boy almost 15 days before.My problem is that I am not able to breast feed him till now...I am giving him supplement(NAN1).He is not able to latch..I had problem of flat nipples.But I have been extracting breast milk using syringe...Now my nipples have been almost corrected but still he does not suck.When he is in good mood he simply puts the nipple in mouth but does not suck.When he is hungry he starts crying loudly and does not even hold the nipple. Pls suggest how to train him to feed? Should I buy a breast pump? I have heard that if the baby does not suck the milk production stops even if we use a pump... Is it true? Pls suggest.........",
    "doctor_response": "Hi, No, the breast milk will continue as long as you suck it out. Put the mouth of your baby firmly close to the nipples and push him inward towards you. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Am i suitable for marriage and immigration with my HBV disease status?\n\nGood day Sir ,I was infected with HBV in 2007 and that time my virus load was 9.4*10^4 by pcr qnt,HBeAg -ve and ALT was 71.My hepatalogist started my treatment. I took adefovir for 1 year and enteavir for 2 year.HBV DNA by pcr become nagative and HBe Ab +ve and normal LFTs right after 2 year of infection.I stopped my treatment and after 8 month of stoppageHBV DNA was still -ve but HBsAg is reactive by eliza 3700 cutoff 1.Please ellaborate my disease status.Am I suitable to immigration to other countries and marriage? THANKS A BUNDLE",
    "doctor_response": "Thanks for your query at HCMI suggest it is good that your HBeAg is negative and in that case there is least chances of infectivity to others. But the matter of concern is HBsAg reactivity I suggest you get the test repeated. In some cases it takes time for HBs Antibodies to appear late.So don't worry just be in touch with follow up with your physicians. Avoid marriage/immigration for some more time if you can as if your HBsAg is positive for more than 6 months then you might be a carrier and have risk of chronic infection. Get your liver enzymes checked to confirm the same. Ready to take more queries if any.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of Bursitis?\n\nFor the past 3 weeks I have had excrutiating pain in the left hip/inner thigh. I am unable to walk without a cane & not very far with it without sharp unbearable pain. I went to ER, did X-rays & said Bursitis of the hip. Saw Ortho & scheduled for MRI. He saw no OA. What can I expect?",
    "doctor_response": "Hello, As due to bursitis there will be pain leading to weakness of the muscles of the hip. Taking anti inflammatory medications prescribed under the orthopedist should be helpful to reduce the pain and inflammation. Doing hot water fermentation and simple hip range of motion exercises should help achieve the muscle property to be maintained and get maximum output. Post the pain comes down and after the low-intensity exercise for 2-3 weeks strengthening exercises will be advised to restore the hip joint complete motion. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Fatigue in my vocal cord is refraining me from speaking and singing. Please help.\n\nHi doctor,  I had some vocal fatigue for a while and I have been resting my voice for pretty much one month now. I was not so sure if I should start speaking again or not. I am a bit afraid if it is going to affect my singing voice. Either way the first time I consult an ENT they said I had hemorrhagic patches on my anterior one-third of both of the vocal cords. I have been drinking a lot of water and also I took some proton pump inhibitors. I also have a phonatory gap but I do not think that is the problem here really. Anyway, I was just wondering how much time do you think I still have to keep resting.",
    "doctor_response": "Hello. I assume that these videos are one month prior to today's condition. (attachment removed to protect patient identity).  I see some amount of inter arytenoid pachydermia (suggestive of acid reflux and associated changes in the posterior part of vocal apparatus) and anterior phonatory gap. Although I cannot see the anterior one-third of the vocal cords that clearly, I understand that your ENT has found that those portions had some hemorrhages. He was right in advising you voice rest and proton pump inhibitors. Ideally, a week of absolute voice rest is sufficient. Followed by voice restriction, vocal hygiene, antiallergic treatment, nasal sprays (based on nasal symptoms), increased hydration, etc. Now considering you have taken a month of voice rest, I think it is sufficient. But do you have any symptoms whatsoever now? Any nasal symptoms or allergic symptoms? Any history of substance abuse? Do you suffer from diabetes or hypertension? In my practice in addition to antireflux (PPI tablets), antiallergics (antihistaminics like Fexofenadine, Allegra, Deslor, etc), hydration, voice rest, dietary and lifestyle changes. I add some voice therapy. Probably you should explore some vocal hygiene tips from a speech-language pathologist or voice therapist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having pressure in lower abdomen & sharp pain while sneezing\n\nHaving pressure in lower abdomen and sharp pain when sneezing along with frequent urination. Had a urine culture 2 weeks ago and it was negative. I did have urinary tract infection about 6 or 8 weeks ago however. My doctor says the results of the blood work says the infection is gone. What should I think at this point?",
    "doctor_response": "Hi. It looks the residual infection in the urinary bladder and the related structures or its aftereffects are still lingering on. Also have a review ultrasound and urine tests.. Take a long course of an antibiotic like Doxy if it suits you. I would also advise you to go for IVP-= intravenous pyelography to rule out obstruction/ stones or other affections of the urinary system .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bed wetting problem is medical or due to emotion of separation?\n\nMy brother is 45 yrs and is going through a nasty separation from wife he has confided that after long days of work or off he drinks more than 2 beers of a night he does not wake up until he had already wet. Bed is it medical or emotional that causes this",
    "doctor_response": "DearWe understand your concernsI went through your details. You are right. Bed wetting (enuresis) is possible due to emotional problems. In this case, enuresis could be due to the excess alcohol he consumes. Also note that excess alcohol causes extra sweat especially in the pelvic area and the sweat can be mistaken as urine. In any case, restrain your friend. I suggest psychological counseling.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can transverse myeltis cause mouth sores and stomach cramps?\n\nI recently developed a sore inside my mouth, between my lower lip and gums - tonight, my lower lip is also numb and tingly. I have transverse myeltis and have been having some severe stomach cramping and swelling - not sure if the two are related, but really becoming worrisome.",
    "doctor_response": "Hi,Thank you for posting your query.First of all, I would like to reassure you that the mouth sores are not connected or related to transverse myelitis.In transverse myelitis, there is viral infection of the spinal cord, leading to weakness of legs and arms.These mouth sores could be related to vitamin deficiency or bacterial infection. Please discuss this with your doctor.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to stop panic attacks, insomnia and fear of sudden death?\n\nhello i am 31 year old male i am at the moment on trt inject 1ml biweekly i also take hydoxyzin50mg 3 times a day and mirtazapine30 mg at bed time .i am a full fledged STONER i smoke about 7 grams a week of high grade buds. Now i have always smoked weed but i started to have major panic attacks and insomnia so the doctor gave me the other meds. my question is when do i go to the E R today my panic attacks would not stop i can not get the fear of sudden death out my mind because my sister had the same type of problem with panic attacks but it was her heart. she was obese. i am 6 4 280 please help YYYY@YYYY",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Please understand the fact that the fear of sudden death is worrying everyone of this world. Everyone fear death, worry about diseases and unhappy future happenings.Then, tell me, how are they living normally? How are they able to live peacefully? The answer is based on their attitude. Those who have the right attitude, has the right behavior. Bad habits and bad attitudes are always a boost to anxiety. Kill both of them and live happy.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to control high bp during 9th month of pregnancy\n\nhi doci m in my ninth month of pregnancy all during 8 mths of my pregnancy i had normal BP but all of sudden in my ninth mth my BP has shoot up to 140/100 as we dont have family history of high BP nor i m over weight nor do i have any  swollen on my legs or hands anywhere on my body still .....kindly help me and pls suggest me some remedies to control high B. i m on alphadopa medicine",
    "doctor_response": "Hello ...usually in pregnancy alpha methyl dopa ... labetolol and occasionally amlodepin is prescribed...it need to be monitored very carefully...so please visit Ur physician or cardiologist for medication as need to monitor closely take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does the broken cheek bone still stings when water touches it ?\n\nMy girlfriend got her cheek bone broken as result of an assault and it stings whenever water touches the skin. There is no broken skin or open wound. It has a lump underneath her skin on the bone I presume and her eye has started to turn bruised again",
    "doctor_response": "hiThe bruised area often stings to touch,temperature as underlying bone and soft tissues are inflamed.Do not worry it will settle in few days",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will masturbation cause weak handgrip?\n\nHello doctor, I am 26 years old. For the last 10 years, I am suffering from very weak hand grip strength. At the age of 16 it started and grip strength was negligible for like four years. Then I started working out with hand grippers and the condition has improved a lot. There is no pain or numbness but still, at times, I feel my gripping strength is very weak and when I perform exercise it improves for the time being as I can feel the blood rushing inside the hands. My query is that does masturbation has any link with this because I have noticed often that after performing the act the situation starts getting worse as in there is very less blood flow in hands and I feel very low gripping strength. I have no issue in lifting weights eg. bench press and there is no pain while doing any kind of lifts. Please guide me on my condition.",
    "doctor_response": "Hello. There is no link between masturbation and handgrip weakness. The cause of your hand grip weakness needs to evaluate further. You need an in-person neurologist consultation face to face because we need to examine your strength, reflexes, sensations of your hands. Is the weakness is more on the right or left? Do legs are involved or not? After a thorough physical examination only we can advise MRI (magnetic resonance imaging) cervical spine or nerve conduction study. But as a neurologist, I can definitely guide you that there is no link between masturbation and hand weakness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for pain in the knee due to a bump?\n\nI got ACL reconstruction surgery about 7 months ago and I have a small bump on my car incision and it gets bigger as I exercise but it is hard and it s not too painful but it does hurt a little bit when I touch it and I could feel it when I walk and run and it hurts when I bend my knee or straighten it out for like flexible hyperextended",
    "doctor_response": "hithank-you for providing the brief history of you.A thorough clinical scar exmaination is advised.As you have scar post ACL reconstruction you need to get the scar mobility back. As scar is a hard tissue applying a soft therapeutic ultrasound therapy massage with help loosen the scar tissue and dissolve it as well.In my clinical practice such scars are recommended to physical therapy and the scar dissolution is noticed.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes left sided chest pain with stomach discomfort?\n\nI'm an eighteen year old male and I have a constant pain from the left side of my chest, straight to the left side of my back. Every time I inhale or exhale or move for that matter, the pain almost triples. It's been almost a day since I've had this pain, and it's been increasing and getting stronger by the minute. My stomach has started to twist, because of it. I've been smoking cigarettes (and nothing else) for about six years and I'm an occasional drinker. My recent activity that might've caused this pain, was moving into my new home. But, the heaviest object I lifted without using a dolly, was a tool chest. I also know how to lift heavy objects without hurting myself in the long run. Earlier tonight, I tried to take a deep breathe and \"push it down\". After that attempt, my eyes started to water due to the excruciating pain. Please, help.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Stomach pain is mostly due to smoking related gastritis. So take pantoprazole tablet on empty stomach twice daily and quit smoking as soon as possible. For left sided chest pain, get done ecg and 2d echo to rule out heart diseases.If these are normal then get done chest x ray and PFT (Pulmonary Function Test).In any case smoking cessation should be done immediately. If all reports are normal then possibility of simple musculoskeletal pain is more likely.So apply warm water pad on affected areas. Avoid movements causing pain. Take simple painkiller like paracetamol or ibuprofen. Don't worry, you will be alright but please quit smoking. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes discomfort between knee and ankles after gall bladder surgery?\n\nI had gall bladder surgery on April 20th and I ve been having some discomfort in both my legs, not all the time, it comes and goes . sometimes it is in the front of my leg, shin area, then it may be in the back of my legs, almost like trying to have a camp. This is between my knee and ankles. do I need to call the surgeon",
    "doctor_response": "Hello, I have studied your case. Leg Muscle cramps can be reduced byMassaging the cramped muscle with your hands or oilDrinking plenty of fluids to avoid dehydrationStretching your leg muscles or riding a stationary cycle.Taking diet rich in calcium and potassium or oral supplements of the sameCheck your vit B12 and Vit D 3 levels.Till time, avoid lifting weights, You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.If no relief then you can consult your surgeon.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to insert Guaifenesin Tablets into vagina ?\n\nhello doctor . The doctor has prescribed my wife to insert guaifenesin tablet into vagina from day12 to day 18 for infertility problem. is this safe to insert this tablet into vagina.",
    "doctor_response": "Welcome to Healthcare Magic This tablet needs to be taken by mouth which will loosen the secretions of the thick cervical mucous. It makes the mucous less thick and allows sperm to penetrate this mucous better. You need to confirm as I am not aware of a vaginal tablet.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On medications for anxiety and stress, have pain on one side of the body, intense physical symptoms during severe stress. Remedial measure?\n\nI have very bad anxiety and stress in my life right now. I am currently on anti-anxiety meds. I have been having pain on my left side and I read that that can be related to stress and anxiety is this true. Also I went to the doctors last week because I was afraid it was related to my heart , he told me my heart was absolutely perfect not to worry. I should also tell you I am one to always get physical symptoms when my stress level gets out of control. Do you have any suggestions etc. Anything would be helpful.",
    "doctor_response": "Hi, From your description it appear that you have severe anxiety problem leading to somatic complaints. Anxiety may lead to pain complaints due to muscle spasm. Medicine are very effective, so better to continue existing treatment. As treatment for anxiety needed for long term along with monitoring of symptoms and investigation to rule out medical causes. So it is better to visit your psychiatrist regularly for assessment and treatment. I hope this information has been both informative and helpful for you. Wish you Good Health. Regards, Dr. Ashish Mittal www.99doctor.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is there treatment available in Ayurveda for 95 % artery block?\n\nHello doctor,My brother is 57 years old is diagnosed with 95 % blockage in one artery, and his doctor had suggested for a stent. Can Ayurveda treatment cure this?",
    "doctor_response": "Hello. 95 % blockage is more and can not be cured with the help of medication, whether Allopathic or Ayurvedic or any other medicine. Because if a complete blockage occurs, it might further lead to heart attack due to the hindrance of blood flow. Medicines are given to prevent further blockage because once the blockage occurs, there are chances that in other arteries blockage may occur. So it is better to go for stenting, and once he stabilized after all the treatment, then you can take ayurvedic medicine as a preventive measure to protect the heart from any further problem. I hope you are satisfied with my answer. For more queries, you can consult me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome the neural problem?\n\nMy Father , 64 yrs, has neuro problem.his  brain cells are shrinking day by day. We consult so many doctors till 2 yrs. all Alopathy doctors advised that My father has to take regular medicine  and there is no remedy to overcome this problem.Pl suggest and guide about  it.",
    "doctor_response": "Hi..From the details you have given,It is less likely to know about the actual diagnosis of your father,Because it is normal physiology that our brain's mass reduce as we become old....we can take the dicussion forward with the details as follows:              *what is your father's actual complaint              *whether any investigations has been done?              *Was he diagnosed with any clinical condition?              *What are the medicines he is taking?Take care....I wish your father,A good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bulging in the stomach after doing tummy tuck?\n\nI had a tummy tuck 10 weeks ago and sometimes have a bulge near my belly button, made woese after excerise, its ok of a morning but get sore as the day goes on, not painful but tender to press on sometimes. Is this still fluid or swelling or something I should be concerned about. Thanks",
    "doctor_response": "Hi.Thanks for your history. Tummy Tuck surgery is a good aesthetic surgery. The most probable cause can be as you have rightly thought is collection of fluid called as seroma. Another cause if possibly a development of hernia. The best way to get a diagnosis is to undergo high resolution ultrasonography- aspiration if seroma as a diagnosis and therapeutic procedure followed by tight bandage. Get operated it this is a hernia.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant pain in heart and having mitral valve stenosis?\n\nMy name is Melissa and I am 28 years old. I have 2 kids (3 and 1yrs old). I had rhuematic fever when i was young and had a mitral valve stenosis at 19years. My heart is constantly in pain but in a specific area. I feel a consistent pain under the rib cage and am not sure why. What could it be?",
    "doctor_response": "Hello Melissa!I would like to have some more information on your concern: - Is the pain triggered by deep breathing or body movements? This would indicate musculo-skeletal pain. - Is the pain triggered by straining physical activity? This type of pain could be related to a cardiac disorder. Anyway, considering your past medical history, I would recommend consulting with your attending physician and performing some tests to investigate for the possible causes underlying your symptoms: - a cardiac ultrasound to evaluate the mitral valve opening size and other possible valvular problems. - an exercise cardiac stress test - a resting ECG- a chest X ray study- complete blood count- PCR and ESR for possible inflammation. Meanwhile, I would recommend taking ibuprofen. If it helps relieve the pain, it would indicate a musculo-skeletal pain. Hope to have been helpful!Wishing good health, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pneumonia reoccur in a patient due to exposure to pneumonia again?\n\nMy mother was admitted to St. Jude s last Wednesday with pneumonia. She is 82 and also has COPD and Parkinson s. She was treated with antibiotics and released four days later. She is to continue with antibiotics treatment at her skilled nursing facility for another 7 days. The day after she returned to her skilled nursing facility, she was given a new roommate who has advanced pneumonia and in critical condition. A few days earlier, the doctor at the hospital said that my mother s pneumonia was negative and she was taken out of isolation. Is it dangerous for my mother, who seems to be recovering or has recovered from her pneumonia, to be placed in the same room as a patient with advanced pneumonia?",
    "doctor_response": "Hello,To be honest, there is a chance of cross infection from one person to another. However, this depends on so many factors and most of the infections, especially bacterial pneumonia, do not transmit easily. If more than one arm distance, the chance is very little and if not too close (like kissing etc.) the chance is further reduced. If two of them are already on antibiotics, as in your case, there is a chance but in the setting what u described, it is extremely unlikely. Hope I have answered your query. Let me know if I can assist you further.Regards, \u00a0\u00a0\u00a0\u00a0\u00a0Dr. Mahboob Ur Rahman",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking beyaz birth control, missed pills, restarted pack, spotting for one week. Treatment?\n\nHello. I was on Beyaz for a around 3 weeks and had un protected sex. I was also on azithromycin for 5 days. I did get my period on the time I was supposed too. I started my new pack of pills on time and everything was fine. Well on the 3rd week I messed up and skipped two pills. I had to restart a pack and now have been spotting for over a week. Help!",
    "doctor_response": "Hello, and I hope i can help you today.First of all, I want to tell you that the antibiotics you took in the first pack should not interfere with the birth control you took, and the fact that you got a normal period on time means you do not have to worry about pregnancy.Missing two or more pills in a row usually causes some breakthrough bleeding a few days after the missed pills, even if you make them up.  This is the bleeding you are experiencing now.  It most likely will stop eventually, but may continue until you finish this pack. You maximize the possibility of stopping the spotting by trying to take your pills at the same time every day.  A way you can help remember your daily pill is to take it at the same time as some routine activity you do every day, for example brushing your teeth, or having a morning coffee.  Carrying your pills in your purse all the time can also help if you do not consistently stay in the same place every night.I hope I was able to answer your question today and that this information was helpful.Best wishes,Dr. BrownYou should use a backup method of birth control for at least a week after your two missed pills (in case you ovulated then), but after that you can rely on the pill for contraception.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could cluster of small wart like non itchy spots be juvenile spring eruption?\n\nI took my child to gp because of a cluster of small wart type spots on her knee. He diagnosed juvenile spring eruption but after looking into this online , these cases present themselves with red itchy spots. My daughters spots are skin coloured and non itchy. Could it be anything else?",
    "doctor_response": "Hi,Thank you for asking question on health care magic.Non itchy cluster of small eruptions  specially over knees and elbows may be due to vitamin A deficiency.It is called xeroderma or toad's skin.Try AD caps as well as Vitamin A containing foods like fish ,liver, green,orange ,red and yellow fruits.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Uterine cancer treated. M spike para protein found in blood work. Could cancer cell enter blood stream during surgery?\n\nHad uterine cancer, stage 1, Grade 1.  Made it 3 years. At least I thought so. No futher treatment was needed after surgery other than 3 month check ups. Should blood work have been done during my gyn/oncol visits? Only had vaginal smears done. Now I have to see a hematologist because I had M spike para protein in blood work. 0.24. by my peronal care doctor. Could a cancer cell have entered my blood stream during the surgery? Thahk you for your time.",
    "doctor_response": "Hi, thanks for using healthcare magicThere is not likely any like between your procedure and the present results.Para protein is an abnormal protein found in the plasma aspect of the blood.It can be associated with benign causes or multiple myeloma. Multiple myeloma is a different cancer than uterine cancer.I wish you the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain with tingling. Difficulty in erection. Are these related or due to a pinched nerve?\n\nI have been experiencing very bad lower bavk pain and tingling indown my right lwg for thw past 4experiences weeks. During this time period I have had a difficult time gaining an erection . I am 30the and in failry good health and fairly active. Could the lack of erection be caused by back injury or even a pinched nerve?",
    "doctor_response": "Hi thanks for your question You\u2019re experiencing low back pain along with tingling sensation radiating along your right leg and lack of erection. These symptoms are suggestive of prolapsed intervertbral disc. The prolapsed disc can press on genital nerves leading to importance.( lack of erection) Consultation with a physician is encouraged to know wether you prolapsed disc or not You may need MRI spine to establish cause of your back pain and treatment accordingly. Hope this answers your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does the Oestrogen levels be abnormally high at the age of puberty and is diagnosed for autism?\n\nMy 10 year old son has autism and had blood work recently. His blood work revealed an abnormally high level of estrogen, I believe 195 and his testosterone was in the normal range. Is this what happens in puberty for boys? I couldn t really find anything that would say so for boys.",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.No. Such rise in estrogen levels is unlikely with boys at 10 years even if he is autistic. He will need a peroper abdominal scan to visualize his adrenals and also a CT scan brain to scan the pituitary gland.  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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tender, bleeding gums, white spots, pustules on roof of mouth, rotting front teeth. Cure?\n\nIm a 24 year old male... In the last week my gums have become very tender, bleeding , have spots that are white or grey... The roof of my mouth has had what feels like sacs that bleed out when i touch them. A couple of my front teeth have even began to get what looks like rotting toward the base. Once again, all these symptoms just showed up and have rapidly increased in the last week",
    "doctor_response": "Hello there..there are various reasons for that...please mention if you have elevated spots over your palate( roof of your mouth), is it fluid filled? or is it the just red patches?...do you have ulcerations all over your oral cavity or is it just the redness you are experiencing on your gums?all these questions will lead to diagnosis of your problem,,,,if they are fluid blisters the management differs...if it is just gum redness with bleed on stimulation the management differs...consult your dental surgeon for clinical examination and management...Clinical examination becomes very important for management of these kind of symptoms....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cortical cyst in right kidney. Taking homeopathic medication. History of high BP. Permanent remedy?\n\ni have a cortical cyst in right kidney measuring 4.9 x 3.7cm. my kidney size is 5.1 x 10.1cm. for the past two years. please advise me the treatment available in allopathy . also i have taken hoemo medicine. i couldnt get any result. is this serious problem what is the permanent remedy. please help. my age is 43yrs wt 78kgs no sugar and slight blood pressure only",
    "doctor_response": "Hello, Welcome to Healthcare Magic. I appreciate your efforts for medical consultation in so much distress. Well, you are unnecessorily worrying for the cortical cyst, if you don\u2019t have any symptoms associated with cyst then you don\u2019t have to  get anything for that\u2026\u2026\u2026..just get a yearly USG and nothing else\u2026. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swollen lymph nodes. Antibiotics ineffective. Done biopsy. Risk for cancer?\n\nmy daughter had a biopsy Friday on a lymph node under her right arm pit.  We have been battling swollen lymph nodes since October.  Antibiotics are not effective.  My question is, the dr said 4-5 of her lymph nodes were clustered together.  What exactly does this mean?  Does this present a risk for cancer?  Cancer runs ramped on both sides of the families.",
    "doctor_response": "Hi Lymphnodes are normally present in the neck,under armpit,groin etc. They are enlarged in many diseases like Tuberculosis,Cancer spreading to the lymphnodes,Lymphoma's,infections etc. It is routine to remove one lymphnode and send for histopathological examination. Let the biopsy report come. Lymphnodes will be attached to one another even in infections ,tuberculosis etc.It doesn't mean cancer. Nothing to worry. Hope it is a simple infection If you come back with biopsy report,i will clarify further Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe cramps in the hip and knee be treated?\n\nfor the past 3 weeks I have been experiencing cramps in my right hip and right knee,mostly at night. Seems to be most pronounced when I lay or turn onto my right side. It can wake me up. Now, for the past 3-4 days, it is also on my left. I have been treating it with 600 mg motrin during the day and 600mg motrin with 2 tylenol/benadryl at night. still hurts when I turn but I get 5-6 hours sleep before it returns.",
    "doctor_response": "Hello, As first line management, you can take analgesics like Paracetamol or Aceclofenac for pain relief. If symptoms persist, it is better to consult a physician and get evaluated. Detailed evaluation including an MRI scan is required for further assessment. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent kidney stones when diagnosed with Parkinson s disease\n\nI m 56 years old Male. I have Parkinson s since 2014.. since then I pass 100 kidney stones. 8mm 6mm 5mm 4mm 3mm 2mm 1mm. Had ct and ultrasound done.. dont eat food high in oxalate..I did for 3 years from 2011 to 2014 but no more. Doctors here don t seem to worried as long as I keep passing them. But it is painful. What should I do",
    "doctor_response": "Hi, Most small stones in patients with relatively mild hydronephrosis can be treated with observation and acetaminophen. More serious cases with intractable pain may require drainage with a stent or percutaneous nephrostomy. Treatment of nephrolithiasis involves emergency management of renal (ureteral) colic, including surgical interventions where indicated, and medical therapy for stone disease. In emergency settings where concern exists about possible renal failure, the focus of treatment should be on correcting dehydration, treating urinary infections, preventing scarring, identifying patients with a solitary functional kidney. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Iven Romic Rommstein, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shrinkage in the size of penis?\n\nWhat is causing my husband penis to shrink. It`s the shaft the skin on the shaft comes forward over the head of his penis on a dalily basis. He has NO interest in sex for the past 2 year i said if you don` t use it you will lose it thats what I think is happen. He says its a medical issues Please help.",
    "doctor_response": "Hello, Penis size usually does not shrink for normal people. Shrinkage may happen due to old age as part of general degeneration. Regarding the lack of interest in sex, you should talk to his sexologist in person. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful swelling on the heels bit by the spider?\n\nBitten by an insect on my heel which may have been male red back spider many months ago. Suffering from reoccurring painful swelling at the site which lasts for a week each time. What is this and what can I do. Doctor initial treatment was antibiotics ice and antihistamines. When will this stop.",
    "doctor_response": "HelloWelcome to HCM,Spider bites are actually rare occurrences and bites from most spiders cause local redness, irritation and pain that usually can be treated at home.These local reactions usually resolve without treatment over a period of 7-10 days.I would suggest you to followWash the site of the spider bite well with soap and water.Apply a cool compress or ice pack over the spider bite location.Over the counter pain relievers may be used to relieve symptoms.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathing difficulties and cold?\n\nhi doctor, my son is 12 year old and he feels often breathing is difficult...... he is prone to cold related problems easily. need ur advice on treatment, dos n don ts . regards , satishthemagician bangalore karnataka - india 0000 YYYY@YYYY",
    "doctor_response": "Hi SatishWelcome to the HCMThe breathing difficulty and easy susceptibility to coughs and colds can be a sign of childhood asthma. I would recommend you to take him for a pulmonary function test. In case it is suggestive of obstructive pulmonary disease, then he needs to be started on regular therapy. You may start with Budecort 200microgm twice daily. Visit a pediatrician for proper clinical examination and follow up.Hopefully this will help you. I would be happy to help you in any further questions.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can having a single kidney be congenital?\n\nMy husband has just found out he may have one kidney he s 49 years old and thought he had two, he also has arthritis since he was 17 years old is there conditions that could cause him to have one kidney later in life or is there just birth defects that creates him to only have one kidney",
    "doctor_response": "Hi, The chance of congenital absence of one kidney is more. So the problem might be since birth. Infection of kidney like chronic infection can lead damage of kidney and loss of its portion but total absence of one kidney could not be due to that. The surgical removal or congenital absence seems most likely. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump in testicles?\n\nHi. My husband found a lump inside of his ball sack awhile ago. He went to the doctors but it disappears when he lays down, like it goes back into his body so they just said that there was nothing but recently it has gotten bigger and is starting to worry us. Any idea what this might be?",
    "doctor_response": "Hello!Thank you for the query.Lump in the testis should not be ignored. It can be a cyst (hydrocele), inguinal hernia or even a cancer. The last one should be ruled out at first.Hernia can appear and disappear especially when changing position. It may also give pain in the groin while coughing or lifting heavy objects.I suggest you to consult a surgeon or urologist. Ultrasound should be done.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful lump on the forehead\n\nWas working outside this morning--painting a porch and garage door, then trimming bushes. Later I discovered a lump on my forehead, right side; it s larger than a quarter. My right ear is hot and itchy as well and I feel overly warm. Any ideas? Should I see my internist tomorrow? Thanks.",
    "doctor_response": "Hi,It seems that there might behaving local allergic reaction due to touching paint on the part producing lump with itching.As this appeared suddenly while painting indicates that this is an alergy reaction.Take Benadryl or Cetrizine for a day or two.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain and headache around eyes due to sinusitis\n\nI am 33 years old 1m60 around 70 kg  suffering from sinusitis with pain and headache around my eyes .Doctors here suggested cleaning surgery .I suffer from ulcerative colitis - on full remission now Taking Imuran and rafassal -5 Aminosalicylic acid Otherwise Ok Is surgery really nessecary? Thanks Any medicine that can help?",
    "doctor_response": "hi,   I understand your concern. Sinusitis is mostly secondary to common cold that is allergic in origin.Finding allergens, avoiding them/desnsatize them is as important as taking anti allergics & other medications for sinusitis,    - Vapor inhalation regularly to clear the sinuses in addition to medicines as per advise of an ENT surgeon,( anti allergic with decongestants/ antibiotics after testing sensitivity/ / anti inflammatory drugs/ nasal sprays as per need  should be given a fair trial , when there is no response/aggravation in symptoms/ frequent attacks ...due to blockage of sinus, surgery is the option.   Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having tooth infection, given pulmicort flexhaler, using inhaler. Safe to take medication?\n\nI have been given a pulmicort flexhaler (180mcg) from my allergist, I currently have a tooth infection, and am concerned about using the inhaler as given my health status at the time of the appointment with the allergist (tooth was not hurting) it did not occur to ask him about this matter.  Is it safe for me to take this medication with this infection?",
    "doctor_response": "Hello,It is very safe to take this inhaler along with not only this tooth infection but also with the antibiotics,you would be prescribed for tooth infection.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe backache and osteoporosis be treated?\n\nMy mom is almost 85 years old and has had past back surgery for bulging disks (2005), has spinal stenosis, arthritis, and osteoporosis. She has severe back pain--mostly on the right buttocks area. In the past, she has had epidurals which led to nerve damage in her leg and an infection from another such epidural. She uses a walker and can still walk short distances. I have asked her doctor to give her a prednisone shot every so often (which he has done), but the last visit he gave her an oral dose and she vomited (she does not tolerate a lot of oral meds), but is also on Eloquis blood thinner to avoid clots due to afib which is under control. Other than this, she is pretty healthy, has maintained her weight, and has a good appetite. Is there a possible option for her? I don t want her to undergo a major surgery, nor does she. Thank you.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You can take Tramadol and Paracetamol combination 2 times a day for five days take Omeprazole and Domperidone combination drug twice a day for five days. You apply local Diclofenac spray on the affected part you go for physiotherapy which is helpful for you. Apply hot water bag on affect ed site. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "History of stinging sensation under left ribcage with mass in right side. Increased size of mass. Sign of improper working of spleen?\n\nabout 10 years ago I felt a stinging sensation under my left rib cageresulting in a mass that sticks out more thatn the right side. \\sensation went away but mad=ss remained.  Didi not think about it for years but lately seems to be larger.  My DR said nothing to worry about but it seems strange to me.  My herbalist said my speen is not working properly.  Any blood test for this?  should I just ignore  this?fmilazzo",
    "doctor_response": "Hello,If the pain under your ribs concerns you then you need to investigate the cause of the pain.You may need1. X ray of the chest 2. Ultrasound sound(To rule out any Splenomegaly).3. Hemoglobin and Peripheral blood smear to rule out splenic dysfunction.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the lump on the lower jaw bone with severe pain due to the fracture?\n\ni was hit in the jaw the other day. i was unable to open my mouth for several days and although it still hurts, the pain severity has lessened. however, there is still a large lump on what feels like the bottom jawbone. could it be fractured and should i get an xray?",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,   I have gone through your query, as you have injury on lower jaw now you have lump on jaw bone dont worry yes it can be due to injury in periodontal ligament may be there is root fracture in tooth that cause Periapical pathology or hair line fracture of segment of mandibular bone .  For this you should consult dentist and go for oral examination and Investigations done OPG XRay . If there is periapical pathology then go for Root canal treatment or Apicectomy and if there is fracture of bone then you should go for splinting .Hope this will help you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pregnant. Bright green discharge refers to? Why did I have heart murmurs?\n\nHi i am 26+4 weeks pregnant with my 2nd child and have had problems from the start of pregnancy ie alot of cramping which has been bearabe and not to bad and bleeding, i am A Rhesus D negative and have already had 2 lots of Anti D in this pregnancy so far. I have been told my cervix is only 2.6mm and could poossibly have a premature labour . 2 weeks ago i went to gp with alot of discharge that was a very bright green. I had a swab and was diagnosed with Group B Strep , i was told to inform my midwife which i did and nothing come of it. My results show: Pus cells ++ Epithelial cells +++ B haemolytic Strept Group B +++ Yeasts and anaerobes not isolated A few days later i went to see my consultant regarding my heart murmur for a check up and he saw the results and sent a urine sample to be cultured and was also told i would need IV antibiotics when in labour, but no one can tell me what will happen if my labour is as quick as my first, i had no pain and then had a long intense cramp which lasted 10 mins i went to the hosp straight away and 13 mins later my first child was born, i received a call from midwife when the results were back saying i needed to go on antibiotics and was told to go on a 7 day course of amoxycillin which i have completed and my oddly green coloured discharge has just got worse, i called gp this morn and he said to see the practice nurse and speak to her. Since this morning i have had terrible pains on the right side of my bump quite low down and i really painful when sitting standing and also laying down. I cannot seem to get in touch with my midwife all day and am worrying as to go to the hospital not. I dont want to waste anyones time. What would you suggest as i am in alot of pain.",
    "doctor_response": "Hello. Thanks for writing to us. The infection you are having needs to be treated as it can further precipitate a preterm labor. The antibiotics will help you but these should be taken according to the culture sensitivity report. For pain, you can do a hot fomentation in the area and attend an ER for proper management. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in lungs area while breathing and talking?\n\nhad an xray, showed something on right lung but dont know what it is..then had ct scan yesterday they called today saying the radiologist sees something behind the 6th rib, but again, doesn't know what it is still?? so have a bone scan set up for this upcoming monday  , hopefully that will show what it is they are seeing and what's causing this severe pain when breathing, talking , walking, leaning forward or laying down etec* do u have any ideas?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description possibility of osteolytic lesion in 6th rib is more. Chest x ray and CT scan are usually fail in diagnosis of lytic bone lesions. So bone scan is needed for this. Most common cause for lytic bone lesion are 1. Primary bone tumour. 2. Metastatic bone tumour (primary from other organ and spread to bone). So get done bone scan and if needed Biopsy to confirm the diagnosis. If all these are normal then sometimes costochondritis can be the cause. So get done bone scan for diagnosis. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my son freezing cold to touch?\n\nmy son is freezing cold to touch, like he s been stood outside. He s two. On thursday he had an extremely high temp. Over new year he was in hospital after having convulsions. He still has the same cold. No D/V just freezing cold and wants to sleep all the time. He won t be touched, yet is a loving kid usually always wants hugs. What s up with him?",
    "doctor_response": "Hi, What you are describing seems to be hypothermia which is even more dangerous than high-grade fever. This signifies a significant bacterial infection and all the more so you are suggesting that he has been lethargic after a seizure. I suggest you take him to the nearest Emergency Room as soon as possible. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for itchy rashes during the night in diabetic males\n\nHi, my father is 79 years old and is experiencing severe, nightly itching and discomfort of his feet. He also cannot get them comfortable. Lotions and Benadryl provides temporary relief, but he can t sleep once the symptoms return. I m in NC and he s in MI, so can t see firsthand. He is also diabetic.Thanks",
    "doctor_response": "Hi, I have gone through your complaints and itching can occur due to senile pruritus or diabetes. I would recommend him to frequently apply a moisturizer lotion. Also take antihistaminic like tablet Cetirizine once or twice daily depending on the intensity of itching. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest suitable treatment for an infection in the gums\n\nmy granddaughter has not been well they have had her to the doctors she has not been drinking much they have giving her water in a syringe because she wont drink her mouth is sore she is 2 yrs old but her little gums started to bleed a little bit what should they do pleaseshold they wait and see how she goes  or is it life threatning",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.The health issues regarding your grand daughter is not been summarised properly,so a detailed symptoms would be required to judge what is the cause of the bleeding gums.It would be better if we would a picture on what treatment she is on ,then I could have helped you better.Cool teething aids could help if the bleeding is because of teething.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for irregular heartbeats\n\nMy name is William laguer, I m 22 years old. I woke up thi morning perfectly fine, when I bent over to pick my pant up I got the weirdest feeling coming from my heart like it started beating slow but really hard and I felt it at my throat, I ve been experimenting and also found out that if I stand up to quick I have the same feeling, if I raise my hands up and put them down quick I have the same feeling. I m worried with what s going on in there and want to know what it could be.",
    "doctor_response": "Hello!Welcome on HCM1I read carefully your question and understand your concern.Your symptoms may be related to orthostatic intolerance or just anxiety. What are your actual blood pressure values?I recommend consulting with your doctor for a careful physical exam and some tests: - a resting ECG- Head up Tilt test to exclude possible orthostatic intolerance- chest X ray study - blood lab tests (complete blood count, blood electrolytes). If all the above tests result normal, you should consider anxiety as the main cause of your symptomatology. Hope to have been helpful!Best wishes, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to control blood urea and allow urine secretion\n\nHi, this is balaji from Bangalore, India, a close relative of mine obese (weighting more than 115 Kilo grams) and in his early 70's is having a very high level of blood urea and oedema due to non-urine sectretion, he is not able lie on his back in a sleeping position, as he feels the fluid in his body gushing up, his body condition doesn't allow for dialysis either and effect of dialysis is unkown, he is left to deteriorate with blood urea levels increasing between 30 mg to 50 mg per day, it would be of real help if we get a suggestion on how to control his blood urea and allow for urine secretion... many thanks in advance",
    "doctor_response": "Hello, Consult a nephrologist and get evaluated. Peritoneal dialysis will be the only option left. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is child controlling stools?\n\nI have a son who is 6 years and he is impacted because he holds it in when he needs to poop, and refuses to sit on the toilet. We spoke to a pediatrician and they told us to give him Miralax twice a day and my mother-in-law says that she wanted a second opinion and that she thought the pediatrician should have done more for him. Do you think this is the case, or is what the pediatrician correct. Thanks",
    "doctor_response": "Dear, Welcome to HCMWe understand your concernsI went through your details. Children at this age are usually averse to pooping not because of lack of training or pain or something. This is because of their developmental period's peculiarity. Sigmund Freud explains it classically as phallic stage. The phallic stage is the third stage of psychosexual development, spanning the ages of three to six years, wherein the infant's libido (desire) centers upon his or her genitalia as the erogenous zone.In this case, the child is getting some sort of pleasure in withholding the stools. I know this do not last for days together. When the urge becomes uncontrollable, the child will evacuate it. This is part of the development and there is nothing to worry about it. Just keep advising and motivating your child against doing it frequently.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I give zanocin to a child for fever?\n\nmy son of 2 years is having fever from 3 days .first day of  fever doctor has given azitral 200 syrup. but 2nd day he got mucus stool pass  doctor sugested to give zanocin syrup, till today fever is there after giving zanocin for 2 days yet it is  to be given for other two days .",
    "doctor_response": "Hi....by what you quote I feel that your kid might be having a viral illness. But I don't see any reason why 2 antibiotics should be changed within few days. Actually antibiotics are not indicated in viral illnesses.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.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is hepatitis curable?\n\nhi.  \u00a0\u00a0\u00a0\u00a0\u00a0 what is HCV borderline result of anti HCV test?and how can it be cured. i recently tested for anti HVC test and the result came \"Border line\" what is this?and is it cureable?some other information about test is this.. cutoff value 1.00 patient value 2.28 CUTOFF VALUES: non reactive 5.0 PLZ TELL ME WHAT IS THIS AND HOW CAN I BE CURED",
    "doctor_response": "hi.thanks for posting query at HCM.the values of both tests suggest that you need further tests to confirm if you have HepC or not. Test required is  HCV RNA by RT-PCR.Yes, HCV can be treated. You should consult treating hepatologist. hope to answer your concernregardsdr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard lump in heel causing numbness and burning sensation?\n\nI have a large white lump on my heel and it has made my heel numb and bruised and had a pink center on the top of it, it s making me limp very badly. It feels like a rock is in my skin and it s constantly burning. I ve been told this could be a Plantars wart but it keeps swelling and getting less bearable to deal with... What could this be and how do I get rid of it?",
    "doctor_response": "HiWelcome to hcmThis can be a corn which has got infected or something got pricked like thorn or glass piece which is developing into abscess. You need to remove the causative factor (thorn or glass piece) and drain the pus or remove corn if it is the cause. For this you have to show it to your surgeon. Also antibiotics like amoxacillin with clavulonic acid 625 mg three times a day for 5 days and tab chymoral fort three times a day for 5 days will help. Tab brufen can reduce your pain. But most importent is its surgery.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed ulcer and soreness in tongue\n\nDear Dr. Matthew MintzI have a very sore tongue. It looks like blotches of raw tongue where it looks like the skin came off. It is constant and very painful with a large degree of burning. I also have little ulcers (white dots) which also are extremely sore. It hurts to eat anything with salt or something acidity. Lately it has become almost unbearable. Can you help?",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,   I have gone through your query, as you have mentioned that you have sore painful tongue , dont worry it can be due to Nutrional deficiency ,  or depapillation of papillae .   You do is take one capsule Vitamin B complex supplement, twice daily for 5 days.     You can apply ointment Mucopain or dologel twice daily for 5days .  If then you wont get relief then go to dentist for examination and if necessary investigations .  Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why did my blood pressure drop so low?\n\nMy blood pressure seemed to drop really low today, sweating, dizzy, blurred vision and tingling in hands and arms. Then felt the need to vomit and defecate. Once, I used the bathroom my period started. This is the first time this has happened. I am 42 yrs old with normal 28 day periods but this one is a few days later.",
    "doctor_response": "Hellokindly tell what was the exact reading of ur bp ???Kindly urgently get these tests done\u25cf COMPLETE HEMOGRAM\u25cf COMPLETE HORMONE PROFILE\u25cf BLOOD SUGAR F/PP\u25cf ECGsend me scanned copy of ur reports",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had rashes and redness on breasts. Done partial hysterectomy. No history of breast cancer. What may be wrong?\n\nI had a rash that came on over night on my upper right breast it was bright red it has been a week and has just about disappeared  I went to the doctor today for my blood work results on my hormones I had a partial hysterectomy 4 years ago. and when I showed her  the rash she examed me and it hurt when she touched she wants to see me again in two weeks I don't have any history of breast cancer in my family only colon cancer should I be concerned?",
    "doctor_response": "Hi rashness and redness cannot be sign of breast cancer .it think the rashes can be urticaria or tinea corporis.slight pain on touch only a sign of cancer.go for mammogram to rule out cancer.use atarax 25 mg at night.flucanazole weekly once and application of fintop ointment can cure the condition",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have Calculous cholecystitis cortical cyst in right kidney. Can it be cured without surgery?\n\nI was operated for gall bladder stone which was not removed in 2002. Since last 2 months due to pain on the mid back particularly right side I went for ultrasound on 21/02/2013 which says: Calculous cholecystitis cortical cyst.- right kidney . But both kidneys are normal in size and position. GB:mildly contracted with mildly thickened walls and echogenic shadow in lumen (12.2 mm). All other features like sugar , BP,Chest are normal. Can it be done without surgery? My present age is 71.",
    "doctor_response": "Hello welcome to HCM Renal cysts is a fluid collection in the kidney. The Majority of renal cysts are benign and can be monitored without any treatment. However some are malignant and have to be removed by surgery. simple renal cysts are found frequently in the elderly. Regarding your Gall bladder stone i would like to know why was it not removed during surgery 10  years ago and were you asymptomatic since last 10 years. Because patients with symptomatic gall stone disease should undergo elective surgery for cholecystectomy to avoid complications of Gall  stone disease.Adult patients with silent or incidental gallstones should be observed and managed expectantly, Oral bile acid dissolution: ursodeoxycholic acid.is given to patients who do not wish to undergo surgery. Stone clearance: 30 to 90 percent . Your Ultrasonography report suggest that you are having chronic cholecystitis and the treatment should be cholecystectomy., If surgery is to be avoided in patients unfit for surgery patient is advised to avoid dietary fats and large meals. Hope iI have answered al,l your queries. Wishing you Good Health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for typhoid fever\n\nMy daughter of 8 years has had typhoid fever for the last 14 days now. While her peak has reduced from 103.5 to 101.5 and the gap between the rise in fever has gone up from 4-6 hours to 6-8 hours, her fever has still not gone, despite giving her 10 ml X twice a day Zifi and once a day 5 ml. of Azithral for the last 5 days. Do advise future course of medical action and how long the fever might last. Also, how long might it take for her for full recovery and for her fever to come down to normal?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice. The drugs you are taking is correct. Sometimes typhoid may take 10 days to respond. You can wait if no complications like persistent vomiting, severe pain in abdomen are present. I hope this has helped you. Wishing your child good health. Take care.Regards,Dr. Deepak Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have light head and my heart is running fast\n\nI haven t ran for a long time and the past week I started running again. However, as I keep running and running, my heart starts to thump faster and faster and then it starts to feel like it s going to explode. I have no choice but to stop running and wait for it to stop every time. I remember before when I ran in grade 7 and 8 my heart didn t feel like it was going to explode, it felt different. Also, sometimes when I m running my stomach feels like it s burning and I just finished running today and I feel really really light-headed. Is this normal? Is this the result of not running for a long time or do I have heart problems or asthma? I don t have asthma... I think I m getting it though.",
    "doctor_response": "It is just from being a couch potato for all winter. Most of us are hard pressed to go running come spring.  I really think it will get better as you get back into shape. And when you finally get back to where you can run like you did in middle school, stay that way!!! Don't get like this again!!  You must run all year around, somewhere!! Find an indoor track or use the basketball court and just make laps around the perimeter as well as the old coaches trick of running up and down the bleachers.  Yeah!! it is harsh!! And I don't sound really friendly saying it! But when we do the winter couch potato we really are not doing ourselves any favors. It gets harder and harder the older you get, to get back in shape after laying off for several months.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe weight loss and fatigue while having cerebral palsy?\n\nI am concerned about my son-in-law. He is 40, has mild CP, and is a highly stressed college professor. He has for the last couple years been losing significant amounts of weight, without trying. And for several months he has been saying he has never been so tired and exhausted in his life. This does not seem right to me. We love him and want to keep him around and well!",
    "doctor_response": "Hello!I am glad to attend you on Healthcaremagic!His clinical situation seems to be complex and could be related to different possible causes: a metabolic disorder, malnutrition, depression, a malignancy, etc.. For this reason, I recommend consulting with his GP for some tests: - a chest X ray study- a resting ECG- a complete blood count- an abdominal ultrasound- kidney and liver function tests- fasting glucose- blood electrolytes- vitamin D and vitamin B12 levels- PSA  and CEA levels. You should discuss with his doctor on the above issues. Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for excessive crying\n\nI cry all the time about things that wouldnt normally upset someone enough to cry. I cry when someone gets upset at me, dissapointed in me, or even raises their voice at me. Im 16. I cry when i think of past events, when i get angry angry or frustrated, when i cant express myself well, when i cant say whats on my mind because im not sure where to start, and when i feel misunderstood. For example, i said something to my boyfriend and he took it the wrong way, i tried to explain it to him but i got choked up and just started crying and i couldnt stop. I try so hard not to cry but i just cant help it. i have been like this for as long as i can remember. One time when i was little, i had a necklace and i was flinging it around and i accidently hit him in the face with it. he told me to stop. i started uncontrolably crying. is there some kind of disorder where you excessively cry? im not depressed, ive very happy and content with my life. i just get so upset over the silliest things. what can i do about this?",
    "doctor_response": "hi, You appear to be emotionally oversensitive. This is a personality trait which could be seen in many persons. There I no need to treat it untill you are having intense discomfort or inability to function properly due to this problem.Usually you get good things to happen after crying, that might be carrying forward this for these many years.If you are strongly willing to charge this, you can control it. Introspecting yourself- try to answers the following questionsWhat all matters often triggers the cry?How long will it take after starting of the issue to crying?Infront of whom you can cry and whom you can't (won't) cry?What will others often do when you cry?Now try manipulating these factors and get control over your emotional expression.Often we feel that tears come immediately but if you recall properly it takes time.First you gets thought about certain issues.Different issues mingle up causing some emotional turmoil. Finally you start crying.So in the beginning start observing this pattern. Gradually you will be able to prolong these.There is no need to loose sensitivity but can increase the empathy by trying to understand others.Mediation and mindfulness will help you in this regard and they have scientifically accepted modes for handling ones' emotions.If this leads to more severe problems like feeling to harm yourself or punish yourself then contact a psychiatrist or psychologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of potential tuberculosis?\n\nHi ,I had tuberculosis 2 years back .I took the medicine for 9 months .Now my medical was done for residency in Middle east.They are going to take my blood test n my sputum test as my xray was not clear.My question is can my sputum test come positive by any chance",
    "doctor_response": "HiI had gone through your question and understand your concern. See , you had tuberculosis infection in past ,and because of that your x-ray is showing changes. Such x-ray changes remains even after tuberculosis has been cleared. Hence , if tuberculosis was completely treated back then , then there are NO chances that sputum test will come positive.I hope this information was of helpThankyou.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yellow stools with nausea and chest pain?\n\nI have yellow poop and I believe I been having gallbladder attacks after a meal high in fat I get nauseated after eating a meal and I instantly have to use the bathroom after I eat when having an attack I feel nauseous and constipated and I also get diarrhea and is like yellow water I also have chest pain and shortness of breath I ve lost 21 pounds and gained it all back I just want to know for sure if its my gall bladder",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  You have problems after high fatty diet. You may have some liver disease or gall bladder disease. You should go for complete liver function test and ultrasound abdomen.  It will give you exact diagnosis. Then you should take treatment accordingly. Till that avoid fatty food.  Take high protein diet. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I having a rash on stomach?\n\nHello doctor,I have a rash on the stomach. Not raised or itchy. I noticed after dehusking a coconut, but I am not allergic to eating coconut or drinking coconut products.",
    "doctor_response": "Hi. This is not an allergic reaction to any food (attachment removed to protect patient identity), looks rather a fungal infection (T.incognito). Use Clotrimazole cream (or newer ones) twice daily for six weeks. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for over thinking and getting hyperactive\n\nhello, sir, i am in gr8 difficulty, i had a problem that i keep on thinking on any absurd thing for many days, like if someone has said something wrong to me, i will keep on thinking over it for years, becoming hyperactive on it, it seems to me that it had happened jst now, i will feel anger and different feelings regarding to it.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. This type of attitude / over thinking happens when you have very little to do. That is your job / education is of a very easy nature. You get a lot of time to think and instead of thinking positive, you are habituated towards negative. No problem. This is not a mental disorder. Keeping yourself busy should solve the problem. Be passionate towards your job / studies. Involve yourself in games and other social activities. Keep yourself healthy and enjoy life.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness on the bottom and groin with back pain?\n\nHave had back pain for 2 weeks now. Was told that I had torn muscles in lower back but I m sure now I a slipped disc as getting no rest from the pain and getting numbness in my bottom and groin. I have pain killers and relax pill for the muscles, should I go back to the doctor to tell him about this numbness?",
    "doctor_response": "Hello, Pain numbness that radiatiates to lower back and groins is a sign of nerve root compression,you need to get an mri lumbar spine done. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Rohan Shanker Tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does metastatic deposits of mucin secreting carcinoma at right inguinal region mean?\n\nhi sir i have query about a biopsy lab report there is a impression (metastatic deposits of mucin secreting carcinoma/pseudomyxoma peritoneil ) at right inguinal region (measuring tissue 2.0*2.0*1.0cm) i need an explanation of disease and its treatment and whether it is curable or not?(age 74 male)",
    "doctor_response": "Hello sir,  it is a kind of epithelial tumor usually originates from appendix,here i have no idea whether you undergone appendectomy earlier.it is a very rare kind of tumor .As the tumor grows and occludes the lumen, mucus accumulates and the appendix ruptures. The peritoneum is then seeded with mucus-producing cells, which continue to proliferate and produce mucus. The progressive accumulation of copious amounts of mucinous fluid gradually fills the peritoneal cavity and then it leads to intestinal obstruction, which is fatal without treatment.there is two types of treatment,1.best suggested one is aggressive type; it includes cytoreduction and intraperitoneal chemotherapycytoreduction means removal of as much as cancerous growth .intraperitoneal chemotherapy means administration of heated intraperitoneal chemotherapy after surgery.the survival rate is 5 years in 70-80%.i hope this information is helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How safe is taking Ornidazol tablet for tooth infection?\n\nhello there.. i have been using ornidazol tablets for a dental infection for 3 days now. i d like to ask you, does ornidazol causes abnormal vaginal bleeding? (its not my period but  ive seen brown spots in the toilette and also on my lingerie yesterday and today)",
    "doctor_response": "Thanks for using Health Care magic.Read your query.It is not mentioned in your whether you are taking the ornidazole tablet with your dentist advice.Ornidazole is usually not the first line of treatment in dentistry ,unless it is a must for the dentist.Please consult the dentist if you are taking for dental infection.Abnormal vaginal bleeding is not the side effect of this medicine ,though it may cause nausea ,vomiting and abdominal discomfort.For vaginal bleeding or spotting ,please visit your gynecologist.Hope this satisfies your query.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can chinese herbs be taken for treating gall stones?\n\nwith an ER diagnosis of gallstones and biliary colic, is the only solution to have my gallbladder removed?  this was my 1st attack, and the pain lasted about 1-hour, followed by a 20 minute break in pain, and then another 30-40 minutes of  extreme pain from right below my breastbone ... radiating up into my chest, radiating right, and across my back.  by the time i got to the ER, the acute pain had subsided, but i did feel pain upon palpation by the doc.  this was one week ago, and i've had no further attacks.  i would love to consider chinese herbs as an alternative.  what are your thoughts?",
    "doctor_response": "**1. Gall stones due to under active thyroid [hypothyroidism] has shown to improve with Conservative line of treatment, but if due to other causes, medicines are not effective to that much extent. 2. women are probably at increased risk because estrogen stimulates the liver to remove more cholesterol from blood and divert it into the bile.3. if we look into the Anatomy of Gall bladder, one will come to know, why it is difficult to remove them with Medicines, and Surgery is the best Available Treatment.4. since the ingredients of Chinese herbs are not known thus for more information regarding Adverse effects of Chinese herbs, please go through: www.naturalstandard.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Rheumatoid Arthritis, headache, jaw pain, low BP and tinnitus\n\nWell, I was going to look at a combination of factors happening now. Lightheaded but bordering on a headache. Ringing in ears. Pain in left jaw. Low BP with high pulse. I have Rheumatoid Arthritis, so I chalked up jaw pain to that. Heavy stress right now, so easy to make it about that. Have appt with primary care on Tuesday, just wanted to check things out myself.",
    "doctor_response": "Hi, Let's straight come to the point as there are lot of things to treat for. For tinnitus - you need to do some basic exercise for reducing the ringing of years. this exercises I have tried over 12 years and many have got benefit from it. It slow process but good one. Try taking water in mouth and hold in the mouth and do cheek movement's. Try to do for as long as 1 minute. Jaw pain - for this the above one will help as there will be good amount of strength developing which will help ease the pain over the jaw as the ligament will get release of pressure. RA - in RA there is inflammation of the joints. Doing regular exercise and maintining the joint ROM and sufficient muscle strength is required to avoid pain. Most patients with RA have to undergo physiotherapy for improving the life style. also anti inflammatory medication will be provided by the Rheumatologist. Headache -  for this you need to mention that where exactly the pain is. because some are vascular, some are due to neck stiffness. Having a good physical examination should help assess the cause of headache and medication based on it. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in centre of rib cage\n\nHi Was wondering if you could advise me. I have been getting pains for a few months just in behind the centre of my rib cage, It feels a bit like some sort of cramp and is quite tender to touch. i went to the doctors a month or so ago and they gave me co-codamol 30/500. these did help although only masked the pain. It is giving me alot of worry as its been going on for a long time.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Central chest pain is commonly caused by GERD (gastroesophageal reflux disease) and costochondritis. But better to first rule out heart related chest pain. So get done ecg, 2d echo and stress test (trade mill test). If all these are normal then no need to worry for heart diseases. Do following things for better symptomatic relief in GERD and costochondritis. 1. Avoid movements causing pain. 2. Avoid bad postures in sleep. Avoid heavyweight lifting and strenuous exercise. 3. Apply warm water pad on affected areas. 4. Take pantoprazole tablet on empty stomach. 5. Avoid stress and tension, be relax and calm. Avoid hot and spicy food. Don't worry, you will be alright with all these but first rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can urine infection in a postpartum preeclampsia patient be treated?\n\nHello doctor, My 36-year-old wife has a urine infection. She was diagnosed with postpartum preeclampsia after two days of delivery of a female child. She had high blood pressure at the time of delivery but now it is normal. Her average blood pressure is 110/75. She had a severe urinary infection before the birth of the baby. The infection was not controlled after birth too and an antibiotic was given. As per urine culture report, blood tests, and the doctor's prescription, antibiotic and other medicines were given but the infection has not improved at all. What should be done?",
    "doctor_response": "Hello. I would suggest you to repeat urine culture and drug sensitivity to determine the bacteria causing infection and the antibiotic to which it is sensitive. Few bacteria which cause urinary infection in women develop resistance very easily and become difficult to treat. So I suggest you get another urine culture and sensitivity and discuss with her treating doctor a combination of antibiotics which can be more effective than a single drug. Also, carry out an ultrasound of the abdomen to rule out any abdominal source of infection. For more information consult a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Irregular period, gaining weight, symptoms of pregnant, negative pregnancy test. Pregnant?\n\nI have all the sings of being pregrant however my test came out negative and so did the blood work what can I do I have not got my period from july 14 I can even feel movment like butterfly feeling everything I eat I feel sick and that's if I don't throw up im tired all the time im craving and eat wired things and been eating oviles and hot peppers on everything and I only want coffee but when I drink I get sick and throw up ive been gaining weight and none of my cloths fit anymore what can I do to find out if I am or not",
    "doctor_response": "Welcome to HCM.Weight gain and irregular period suggest some thyroid problem(hypo)Go for cbc,rbs,s.b12,calcium,freet3,t4 and tsh,hormonal study.Start b12,calcium supplement.Go for exercise,yoga regularly.Go for protected sex in this condition if you don't want pregnant.Consult your physician for proper diagnosis and better medical management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes panic attacks while on Eliquis and Metoprolol?\n\nHi . I have been taking Eliquis and metoprolol for afib for 6 months now and suddenly started having very distressful panic attacks....Could these drugs be affecting me in this way? It s been a stressful time with illness in the family also...I never had these kinds of episodes in the past...",
    "doctor_response": "Hello,Your both drugs which do not cause any anxiety symptoms. You developed anxiety symptoms is mainly due to other cause or your physical weakness. So if you feel more anxiety than consult your doctor.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Gauttam Prajapati",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is tumor on the base of neck oozing?\n\nI have a tumor at the base of my neck..it moved to the side of my neck and is now formed a oozing pocket. When I went to the Doctor and had a hospital stay the test came back no cancer. I went to go get the oozing pocket taken care of an they told me it now may be cancer. I am getting to a cancer dr asap. if it is not cancer and the tumor is non cancerous why is it oozing",
    "doctor_response": "Thanks for your question on HCM. In my opinion you are having cervical abscess. Neck area (cervical collar) is full of lymphnodes. And these nodes can sometimes infected and become enlarged.If proper treatment was not started, the center of the node becomes necrotic and liquifies and produce pus like material. It is known as cervical abscess.It can be due to malignancy also.So best way to confirm is aspiration of fluid and get done cytology,  routine microscopy and culture and sensitivity. If cytology shows atypical cancerous cells than you are having malignancy. But if cytology is negative and culture grows bacteria that means this is infective abscess.So better to get done aspiration of fluid and its tests.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fractured finger caused by an accident\n\n7 weeks ago, crushed my thumb with enough forced it squeezed my nail out from the root in one complete piece. The thumb since showed a slight fracture but I feel there is some more serious damage as it remains quite enlarged, no joint movement and still is painful. I wear a finger split and wonder what could be the cause of the symptoms. The pad of my thumb has been rather hardened and a small bump is present",
    "doctor_response": "Hi, Now its 7 weeks since the injury and it seems that the thumb has begun stiff from the crush and also from the long immobilisation. A joint needs to move as early as possible after the pain and swelling has settled.The fracture is minor but what had happened now is that the main joint of the thumb  has become as though stuck with glue as a result of the splinting. The pain comes from the  contracted ligaments and tissues.This needs exercises to loosen the joint, immersion in warm water and salt for 15 mins twice a day and physical therapy with wax baths to relax the joint.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does an elevation in ejection fraction level signify?\n\nMy friend had a an attack while working, heart rate increased to 180/min, (atrial fib). B/p was very high 220/160, He passed out. taken to the hospital, diagnosis was cardiomyopathy. He thinks He did not have a heart attack. He states the Dr. never said the words Heart attack. Did He have a heart attack? this was 5 years ago, He is now doing well on medications, EF has increased from 20% to 47% .",
    "doctor_response": "It's hard to say whether or not he truly had a heart attack. Cardiomyopathy is a general term that can refer to many disease processes that weaken the contracting function of the heart (which can be measured by the ejection fraction). It can certainly be caused by a heart attack. The diagnosis of a heart attack can be made with either an electrocardiogram (ECG) or cardiac enzymes (blood tests). He can request this information from the hospital where he was treated. The improvement in EF is a good thing, it means that the pumping function of his heart has improved significantly, almost to a normal level.I hope this answers your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower abdominal pain\n\nHI, I seem to be having lower right side abdominal painwhich started last night. Its a bit like a menstruation pai, but a little more intense. Iawoke thismorning with thepain and lower back pain as well. I have sofar takena myprodol and the pain seemsto subsiding. This is the 1st time this is accuring, should I be worried?",
    "doctor_response": "thank you for sharing your complain,dear friend don't worry. pain may be of appendicitis or may be ureteric stone which may radiate to back or urethra. sonography and blood investigation with cbc will rule out the cause of abdominal pain.hope this answer will be helpful to you.for more queries plz don't hassitate to ask.get well soon dear frienddr.manu khimani",
    "dialogue_context": ""
  },
  {
    "patient_message": "High SGPT level. Gained weight after stopping gym. Any way to lower it to normal range?\n\nhi..i have a SGPT level of 70.0 and my doc consider it high..i don t drink nor smoke , i don t take any drugs like to lower cholesterol for i have a normal level on that test.. i am a gym fanatic but that was 7 months ago. Since i stop doing my regular work out, i gain almost 20 lbs from then.. My doc told me to shape up in a month, go back to the gym again as i used to ..then we will do a lab test again..is there any way i can lower it to normal range ? what food do i need to eat or not to put on my diet? tnx",
    "doctor_response": "Hi, Welcome to HCM If you have only mildly raised SGPT no other health issues, it is right way to repeat it after 3 to 4 week to see if it is normal or not. It is good to do regular exercises but not fanatic please do regular gym not very heavy one start from cardio exercises. As you have gained weight there may be some fatty liver which can cause SGPT rise there are many other causes of such rise but take care of diet also take less fats and avoid high calories in diet. which also depends on your age. You may take 3 to 4 month to lose weight but it is more important to maintain that . Take care. Remember pevention is better than cure. Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathing difficulty after doing exercise?\n\nI'm 53, 180lbs, moderately active, just started a new exercise program.  I have \"reactive airway\", so my difficulty breathing may be related, but twice now, after working out I've noticed that for several hours afterwards I have a hard time getting a good breath.  I don't feel overly taxed.  My heart is not racing.  I took my inhaler and it seems to alleviate the symptoms somewhat.  I'm concerned because of my age and weight that my heart may not be in great shape.  I had a stress test a few years back and it was \"great\".  Should I be concerned?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.Since you are having 'reactive airways', your current symptoms are mostly due to exercise induced bronchospasm.So continue taking inhaler as and when needed.Heart related disease is less likely. But since you are old, better to get done repeat stress test (trade mill test).If this is normal then no need to worry for heart diseases.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do I need to check with Dentist for my son ?\n\nMy son is already 7 year old, but still his teeth has not fallen. All his classmates have already got the permanent teeth. Do i need to check Dentist. Can thedentist remove this teeth if it does not fall?",
    "doctor_response": "Hi,Thanks for asking the query,It is not necessary that all the children shed their milk teeth at the same time individual variations can be seen, you can wait for some more time.You can consult to an Pedodontist and get the checkup done, take an OPG radiograph to look for the position of the permanent errupting teeth.There is no need to get the milk teeth removed as they will shed by themselves when the permanent teeth errupt.Hope this helps out,Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do when you hit the back of your head?\n\nhead I recently hit the back of my head off the handle of the bathroom door, at the time I didn t think anything of it. but I had a migrain the next day n iv had it since its been like 8-9 days now, I have high blood pressure n have a kidney problem called allports I get mugrains with the whole blood pressure being high but its never been for 8 days straight, it would be great for some guidance on what to do Rebecca hanks",
    "doctor_response": "hello and thank you for asking HCM, I understand your concern. Regarding to your symptoms, this migraine is connected with your high blood pressure and not with hitting the door. My suggestion is to visit your GP to test your blood pressure and make proper examination to get proper medication. High blood pressure can years be without symptoms, but after headache appears, it means that your body cannot compensate it any more and that you need medication. I hope this answer was helpful to you and I hope you will visit your GP as soon as you can.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain on right side, chest pain, lumps. Had kidney stones\n\nI am a male, 31yrs of age, and having pains on my right side starting from the lower back to the front of my right side, but not past the oblique area . I noticed the pain for about two weeks now, and it seemed to have happen around the same time I started having more pains in my chest from the lumps that I have been seen for. Not sure if the pain is coincidence. I have had several kidney stones when I was 18 due to my high calcium diet and hard tap water I used to drink. The pain is not the same. It doesn t not seem to be worse when I touch it, twist, or do any activities.",
    "doctor_response": "hello.your pain appears very typical of what is called a renal colic (due to kidney stones) your chest pain may have a different origin as i dont know what kind of lumps you have been investigated for. generalised pain and aches ,bony pain  along with calculi (stones) may be a part of calcium metabolism disorder as in hyperparathyroidism but you need thorough investigations to come to a diagnosis. get yourself eveluated for renal stones by a urosurgeon and investigated and if required he might ask for a physician opinion. otherwise kidney stones is a very common problem to have and recurrence and associated symptoms and signs need. thorough eveluation. all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat pain on left side of kidney and redness in penis?\n\nhello,my son who is 5 has had a couple of occasions over the last 2 months where he is getting pain in his kidney area.he is off school today as he has pain on his left side,to the point were he is crying in pain.. i am not sure if it is connected but he is also having problems with his penis in that it becomes very red and sore. he has seen our gp about the issues seperatly but i am now wondering if they could be related?? why would this keep happening? what should i ask our gp to be doing about it??",
    "doctor_response": "dear parent, you have not said what your GP says. if this problem is occurring again better see GP again. the child may need investigation s. both conditions may or may not be related. this can be said only after examining the child.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for small lumps on the mouth\n\nI have 2 lumps on each side of mouth. The lumps are pretty hard. The lumps are on the inside of my teeth on the jaw bone. They don t seem to be on the floor of my mouth or tongue. It s on the inside of my jawbone by tongue. I ve also been fighting an allergy infection or cold for last 10 days.",
    "doctor_response": "Hi,Thnks for the query.1-After going through your problem-Its my opinion that there are 2 hard lumps on the inner side of the jaw bones  besides the toungue.2-Mostly it appears as the-indurations cropped up after the food allergic reaction-as your story supports.3-I would advise you to consult your family doctor nearby , who would treat it by prescribed -anti-allegic drugs and anti-inflammatory drugs 4-Any thing else would be discovered and treated by your doctor-on the lines suggested or by the exact findings seen by him.5-Hence go to the nearby doctor and take urgent treament on the line advised.thnks.Wellcome-for  any more  queries to fix this matter.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a weak heart and shortness of breath?\n\nMy husband has had autonamic dysfunction for 20 years and recently his heat stopped twice.  Once at home the other in the hospital.  He is so tired and weak and sleeps a lot lately.  He also has shortness of breath.  His doctors said his heart is getting weaker.  All blood tests are normal.  What could be causing this?Thank-youB.Finley",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and  I understand your concern .I will try to explain you something and give you my opinion.Weakness can came from different reasons.They might be cardiac, metabolic,endocrinoligic causes esct.To cardiac problems I would mention heart function or rhythm problem.If a person has a low cardiac output, meaning an insufficient heart and if he is untreated he might feel week and have different in breathing deeply.Also, heart rhythm problem might couse weekness.Low heart rhythm, heart pauses or electrical system problem might be responsible for weeknes, fainting ect.Electolit imbalances,thyroid gland disfunction also might cause such symtoms.So, if I was the treating doctor I will recommend  some examination like a cardiac echo to evaluate heart function and walls , a full blood analyze to exclude electrolyte imbalances , anemia, hypothyroidism and a holter rhythm monitoring to see your rhythm tendency during day and night.After all this we can better judge how to treat the problem.Hope I was helpfull.Best regards , Dr.Ervina.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a problem in erection at the time of penetration. Kindly suggest me a remedy.\n\nHi doctor, I am 35 years old male. My weight is 88 kilograms. I have a problem in erection at the time of penetration. I have lost my erection. My vitamin D level is 7.49 ng/mL. My prolactin level is 9.5 ng/mL, and I have an HbA1c of 5.5 %. I have a random blood sugar of 99 mg/dL, and I have cholesterol of 262 mg/dL. My testosterone level is 191 ng/dL. I do not have a habit of smoking and drinking. Kindly suggest me a remedy.",
    "doctor_response": "Hi. Please explain whether your penis becomes fine and tighten during the morning when you wake up. If you are unable to attain a normal penile tightening in the morning, then I would suggest you approach a urologist soon. If you are having a problem with erection during intercourse, you can take tablet Tadasure 5 mg (Tadalafil). It should be taken before one hour of having sex. Take this tablet once a day. Try to spend time with your partner and communicate with each other. About the reports, other than a vitamin D, the remaining results are within the normal range. You can do exercise or brisk walking in the morning. Take tablet Vitamin D once a week for six weeks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in the base of neck?\n\nI m having pain in base of neck in front and around my collar bones. Especially the right side. Sometimes its so painful I cant lay on my side at night. I have gained quite of bit of weight in the last few months also. Im wondering if it could be from the weight? I also was wondering if the Lexapro I take for panic attacks could have any impact on my weight gain.",
    "doctor_response": "Thank you very much for contacting healthcare magic. You have problem of pain at neck region with history of weight gain also that may be because of thyroid gland problem. ..Check your t3 and t4 level first. ..Consent a physician for further diagnosis. Proper physical examination give exact idea. ..I hope my guidance is helpful to you. Take care.Thanks..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could hoarse voice after hip surgery be due to history of having heart failure and severe mitral valve prolapse?\n\nHello. My mother has both right and left side heart failure, a severe mitral valve prolapse. A light smoker for years. She had hip surgery a week ago. Her voice is very hoarse and I was wondering if this could be a symptom of her chronic heart failure? She also has COPD, and is now in a rehab facility. She does receive several breathing treatments a day, both at the rehab facility and when at home. Lots of meds. Thanks.",
    "doctor_response": "Thank you for your question.According to the details provided by you, your mother is suffering from heart failure with copd. And now she has an associated hoarseness of voice. Does she have cough at present? Or difficulty in swallowing? It would be prudent to visit an ENT specialist in order to check her throat and rule out any problems there. The use of an Endotracheal tube to help her to breathe during anaesthesia in surgery can also cause hoarseness of voice which can last upto 3 or 4 weeks. This too can be confirmed by an ENT specialist.  A chest Xray may also help to rule out any other causes.In certain situations, the nerve to her voice organ or the larynx may be pressed upon by something leading to hoarsness. Again an Xray may help wit this. One other situation you should bear in mind is that since she has heart failure, her heart is probable dilated or swollen. Sometimes ( though rarely) an enlarged heart may press upon her voice organ nerve leading to hoarseness of voice (this is called Ortner's syndrome).If I were your mothers physician I would get an ENT opinion as well as a chest Xray. Further investigations maybe needed according to the discretion of your physician.I hope this will help you to take a decision regarding further management for your mother. If you need further clarifications please do get back to me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart murmur pain?\n\nMy girlfriend has a heart murmur and has heart pains everynow and then she tells her parents and they do nothing and if she goes to the hospital all they tell her is that she has a heart murmur and another problem that they cannot find out what should she do ?",
    "doctor_response": "Hello,Brief answer: Probably heart valve problem.Detailed answer: Heart murmurs may be a result of different causes, from minor to severe conditions. This problem may be caused by conditions like: anemia, fever, or even uncontrolled blood pressure. More severe conditions include, congenital heart problems (present since birth) or heart valve problems like stenosis (not enough blood flow through the valve or regurgitation: a valve that doesn\u2019t close properly and leaks).Each of this condition causes a murmur. So, I would recommend her to do some lab test including a complete blood count, an erythrocyte sedimentation rate, and a lipidogram. Also, it is necessary to consult a cardiologist and to do an electrocardiogram and echocardiography to check if there is any presence of congenital heart problem or an abnormal heart valve that cause this murmurs. At the meantime, until she goes to see the cardiologist, I would recommend to stay calm, eat a healthy diet, to avoid stress and physical effort.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Genti Mulla",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this follicular study report indicate?\n\nHi Sir I am 26 yrs old.trying to conceive.Failure. Mine is a 33 day to 34 day cycle. Did follicular study on cd 10, left ovary 12mm and right ovary follicle size 13mm. on cd - 13, right ovary - 13*13 mm and left ovary  - 8*8 mm with endometrim - 7mm. on cd 17 - right ovary - 13mm*13mm and left ovary - 10 mm*mm with endometrim - 8 mm. Is it case of anavulation??I am really worries with this report??",
    "doctor_response": "Hi, I think your follicles are not growing normally.  So, you can take some medicines like clomiphene for the growth of your follicles and track your follicles growth by repeated ultrasound.  When follicles reach a size more than 17 to 18 mm, take injection for rupturing the follicles.  Be in contact with your husband every 2 to 3 days after your periods stop.  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.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Due for a laser treatment for dysplacia of the larynx. What is wrong?\n\nI am 55 years old and due to have a second laser treatment for Dysplacia of the Larynx , I am worried that this may return again, what are the chances of that happening? I m not a smoker and haven t had a cigarette for 15 years, I drink only Wine responsibly. My father and his father died of cancer of the throat , my father at 53 and my grandfather at 59, could this be hereditary?",
    "doctor_response": "Hi, if dysplastic lesion recur again and again. you should be cautious. it may turn into invasive carcinoma. anyway , you have mentioned it is larynx. larynx has many subsites. if your lesion is in vocal cord then also treatment for early lesion is laser. but fiberoptic  larygoscopy to look for the entire region is mandatory. cosult your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in back with normal urination?\n\nHave had intermittent pain in back (kidneys?) for a while especiallywhen sleeping on my back. Today the urine flow is clear and stings.Its the weekend...what can I do until I see a physician. I havesome Amoxxilian (sp?) should I take this until I can get to the doctornext week.",
    "doctor_response": "Dear friend your back pain can be because urinary tract infection or kidney infection.or can be muscular reason.to be on safe side you start taking plenty of water.also cant take a full course of an antibiotic like amoxycillin.the stinging sensation will go if the medicine reduces the infection.and as far as low back pain is concerned ,a back muscle strengthening exercise will help to reduce the pain.taking a few analgesic will be a good idea to reduce the pain.hopefully you will be free of pain during this week-end and can see a doctor in next week.till then my best wishes for you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen eyes in a child\n\nmy 4 yr old spent about 3 hr outside today then woke up from his nap with both eyes swollen. I have been giving him childrens Allegra Allergy that we got from the store for his runny nose and watery eyes the past week and it seemed to be helping him but this is the first time since it started that he spent any time outside. should I give him somthing else before I go to the doctor in the morning?",
    "doctor_response": "Hello. I just read through your question.I would not give him anything in addition to the Allegra. you can use warm compresses on the eyelids for as much as he will let you do it. This will help bring down more of the swelling. Then you can address the issue when you see his doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for esophoguas and stomach cancer?\n\nmy husband was just diagnosed with esphoguas & stomach cancer, don t know what stage yet, but has every symptom for the eshohagus, so I was trying to find out some info on both combined, don t know yet if it has spread to other places, lungs, kidneys etc, and before treatment what else to look for. my husband says he knows his body, and doesn t feel like he has to much longer, he felt this before being diagnosed.",
    "doctor_response": "Hi ! Good evening. I am Dr Shareef answering your query.Sorry to learn about the diagnosis of esophagus and stomach cancer in your husband. It is very difficult and may not be possible to advise treatment on such issue without seeing the patient personally, and without going through the investigation reports including that of the biopsy. However, one  can go for some proton pump inhibitor drugs, some probiotics, and some kind of antacid gel to relieve him symptomatically of his esophageal symptoms,and also get the head end of his bed elevated to aid in this. Further management has to be discussed with the treating doctor of your husband.I hope this information would help you in discussing with your family physician/treating doctor in further management of your husband's problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am facing depression and anxiety attacks after break up with my best friend. How to manage it?\n\nHello doctor, I recently had a bad break up with someone who was formally my best friend, and she feels like now we cannot even go back to where we were before as good friends. But we still talked for a while after it, but now we have not been talking, and I have been feeling depressed and having constant anxiety attacks after the past couple of weeks.",
    "doctor_response": "Hello. You are undergoing some adjustment problems. When we had a bad experience or event, then our body and mind take time to adjust to the new situation. It is common to have some emotional outburst and anxiety during this time. But if your friend does not want this relationship to continue, then it is best to break it rather than and being in talking terms. Communicating with her will increase your expectations, and you will have a desire to get her back in your life someday that will increase your confusion and trauma in the long run. So rather than confusing yourself, it is better to have a clear one-sided answer. Being friends with her will be more painful for you than her so move on.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does my semen not getting liquefaction?\n\nmy semen is not getting liquefaction.so what should i do to get liquefaction in time?.last year my semen analysis report said everything is normal eventhough i am a diabetic.this time lab people say that my semen is not getting liquefaction.so what is the problem?",
    "doctor_response": "DearWe understand your concernsI went through your details. Semen is a thick gel at the time of ejaculation and normally becomes liquid within 20 -30minutes after ejaculation. When semen is ejaculated, it is thick and gelatinous. This is to help it adhere to the cervix.  .The liquefaction is the process when the gel formed by proteins from the seminal vesicles is broken up and the semen becomes more liquid. The semen eventually liquefies to enable the sperm to swim better Liquefaction time is a measure of the time it takes for the semen to liquefy.Delayed liquefaction may indicate a problem with the prostate, the seminal vesicles, or the bulb urethral glands, which are also known as the male accessory glands. Therefore I suggest you to consult an urologist or infertility specialist for evaluation and for further treatment.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have frequent bronchitis and pneumonia. Triggered from flu. Feel tight chest. No coughing. Often have infections. Asthma?\n\nDear Physician,I have frequent bronchitis and pneumonia.  It seems that whenever i get the common cold/flu it becomes bronchitis/pneumonia and triggers periods (several weeks) of chest pain/tightness and breathlessness.  I am wondering if i may be slightly asthmatic and they are related.  I do not cough or wheeze. I have had these infections every 4-6 months for the past 4 years or so.  This why i am very concerned.  I am 27 and have a smoking history.  I plan to see a physician for chest x-ray.  For the moment i am wondering if this sounds like i may have asthma.  I do not have problems with physical activity at all.",
    "doctor_response": "HI there,Welcome to HCM.Flu leading to bronchitis and pneumonia and this causing breathlessnes and wheeze is not asthma. Asthma as such is usually allergic meaning it gets triggered when exposed to allergens, pollen, dust etc. This exposure causes swelling and increased secretions in the bronchi causing narrowing of the bronchi and wheeze. However Flu in an asthmatic can be severe when compared to others.Definitely smoking reduces the lung capacity making you vulnerable during any infection. I suggest you get a lab work up with a chest x ray to rule out any lung pathology. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is nor metrogyl right medication for diarrhea in a child?\n\nmy 2.8 year toddler has diarrhea for last 2 days (2 very watery and khakhi colored stools), she s not eating at all (just one biscuit a couple of apple slices etc) while she continues on her pedialyte formula, she s drinking enough water, yesterday the doc prescribed and we started her on nor metrogyl, is this ok and is there anything to worry about?",
    "doctor_response": "The symptoms that your child has are suggestive of stomach infection. Nor metrogyl is usually given in stomach infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had colonoscopy, small lession, pain in gut area, diarrhea. What should i do?\n\nhad a colonoscopy they found a small lession, going to watch it. but I have lost 42 lbs in 3 months and have severe pain in my gut area, then severe diarrhea . my doctors are now palying a guessing game with me. i am always tires and don t want to eat cause I don t want the diarrhea. when i lay down at night i can feel the pain also.",
    "doctor_response": "Hi, Your symptoms can not be explained by a small lesion on colonoscopy. If there is any suspicion a colonoscopy guided biopsy can be done from the lesion. Generally colonic small lesion does not produce much pain so there may be some other causes, consult your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could severe mood swings with stress and crying bouts indicate?\n\nHi, I'm a 28yr old stay at home mother of 3. Ages 7, 6 and 2. Feeling as though all life is throwing at me is getting too much. Finding myself moody and snappy, crying lots and so stressed. This has been the case for several years. but as life throws more uncontrollable things at me i am finding it harder to cope.  Find it a mission to WANT to get out of bed in the morn and am moody immediately. Dont want to feel like this anymore, my family deserve a happy mummy and wife.",
    "doctor_response": "Hello,Looks like depression is creeping up from several years and has now become significant. Please meet a psychiatrist and strat meds. This will help you a lot and make you good and full of life once again.For similar cases I have seen very good response with - sertraline 25-50mg,  initially and then can be increased upto 100-150mg after gap of two to three weeks by monitoring the response.There is usually a gap of a week or ten days before effect comes on mood, so dont loose heart and continue with meds. Im sure you wil definitely get better with medicine.Get thyroid test aand treat if there is any hypo or hyper thyroidism associated with depression.Good luck and have a speedy recovery.Dr. Manisha GopalMD Neuropsychiatry",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can aldinir syrup cause red stool in children ?\n\nMy son - 8 months old was advised to take ALDINIR (CEFDINIR Oral Suspension) for 5 days - dosage twice a day... Today he passed stools and it was Red/Maroon in color. Unable to reach the doctor. Is it due to Aldinir that the stool color appears red/maroon? Kindly advise.",
    "doctor_response": "Hello, Aldinir or other syrups can cause a change in stool color because of the certain coloring agents contained in the syrup. You can wait for spontaneous recovery and if abnormal color persists even after stopping the syrup, we have to rule out possible causes like gastroenteritis and indigestion. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which antibiotics must be used to prevent blood in urine ?\n\nmy husband had a case of strep throat that went to his kidneys about a month ago. we became concerned when his urine was red (i mean really red). we were sent to a urologist and at his follow-up last wednesday, there was still blood evident in his urine. he has a ct scan scheduled for this coming friday but on thursday, he started running a high fever once again. our gp diagnosed it as strep again and gave him a stronger antibiotic. by thursday night, his urine was once again very red. it is now saturday morning, his fever is lower but his urine is still very bloody. my question is this: should i take him to the er? i am concerned with his health and would love for someone to admit him to a hospital, run all tests necessary, iv his antibiotics if needed, and get to the bottom of this. am i being ridiculous?",
    "doctor_response": "Thanks for the query It is certain that he has an infection mostly of the upper urinary tract, he needs immediate admission and by your history maybe even blood transfusion, PLease dont delay it further, HAve a healthy living",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for raised creatinine levels in a diabetic patient\n\nMy husband, age 60 has diabetes, weighs 260 lbs, is around 5' 9'' -5' 10 and smokes (about 5 cigs or less a day NOW) but has been a smoker for many years).  he recently had blood work done and his microalbumin/creatinine ratio is 560 which we know is HIGH and means that protein from his kidneys is leaking into his urine.  He is on many meds for these.  He does HVAC work and is required to go onto roof tops in 90 degree weather daily.  I also want to mention that after seeing his M.D. he may have gout in his elbow.  (we are currently going to change doctors being that his current dr. prescribed meds for the gout without even sending him for bloodwork to check his uric acid and never looked at his current blood work from his endocrinoligist among other reasons).  Can you shed some light on how serious or not this may be and what he needs to do (besides conferring with a new MD which I'm sure he will have a complete physical).  Is it alright for him to have soft boiled eggs, (the whole egg and not just the whites).  I would appreciate any light you can shed on this matter.",
    "doctor_response": "diabetic patient with high micro albumin creatinine ratio suggests diabetic nephropathy. if serum creatinine is normal then ACE inhibitor can reduce the problem. regarding gout, check serum Uric acid level and if possible, joint fluid Uric acid level. if high, then treatment can be started. before taking whole egg, check lipid profile. if it is okay, then u can take it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the infection in the kidney curable?\n\nMy girlfriend had a UTI which spread to her kidney. She also had a kidney stone in her left kidney which when she passed it damaged the kidney causing the infection to spread to resulting in bkth kidneys becoming inflamed and Infected. Shes hospitalized with pain medication ans antibiotics. Im extremely worried about failure, sepsis or death. Will she be alright since shes getting treatment?",
    "doctor_response": "HelloThanks for query .Your girlfriend has landed in what is termed as Urosepsis and have been hospitalized .Since she is under care of specialist all the necessary tests like urine culture might have done and she may be treated with appropriate antibiotic as per culture report.Do not worry she will definitely come out of this crisis and get fully cured within 2 weeks .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and tingling sensation in the toes and foot after an injury?\n\nHello my name is Maria about a month ago I fell down a few stairs. I had swelling for the first two days and went away. but now I m getting this tingly feeling on my foot and toes. My ankle hurts when I point it out wards and when I point it towards me it pops",
    "doctor_response": "Hello, Thanks for writing to us, I have studied your case with diligence.I will advise you to use splint support for ankle and foot for 2 weeks.Physiotherapy like ultrasound and TENS will help in early healing of torn ligament.I will advise to do MRI ankle for soft tissue involvement if pain remains persistent.Till time you can continue physiotherapy and also use supportive splint or brace.You can start tab tendocare for early healing of ligament consulting your doctor.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does multivitamins and reducdyn take to reduce bilirubin in blood?\n\nhi doctor, i'm pharmacist eman, my age is 23. i'm suffering from jaundice for 2 months my bilirubin starts with 2.2 then 1.8 then 2.1 then 1.88, i go to a doctor and he gave me multivitamines and reducdyn tab, i wanna to know when will it reach the normal value? and what is the cause of this values?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You may have hepatitis. You should go for complete liver function test including ultrasound abdomen. Then you should take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes my son s recurring stomach ache with blood and mucus in stools?\n\nmy 4 1/2 yr old son has had stomach cramps intermittently all week, no fever, vomiting, etc. Had some loose stools, not real diarrhea. Today he had several bowel movements that were loose with lots of pink tinged brownish mucus, what could this mean? he is acting fine except gets some on and off cramps when he has to have a bowel movement.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Causes of recurring stomach ache and blood and mucus in stool are stomach infection, gastritis, outside food or water, unhygienic food or water, colitis. You can give him syrup cefixime, syrup, sinarest, syrup mefenamic acid as per his weight.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Shyam B. Kale",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it safe to continue homeopathic medicines for sebaceous granules on glans?\n\nHello doctor, The sebaceous granules are found on my glans. I am using some homeopathic medicines to remove it. Sometimes redness is found on the affected area. Is it safe to continue these medicines?",
    "doctor_response": "Hello. I have seen your attachments (attachment removed to protect patient identity). Yes, these are Fordyce spots or pearly penile papule and these are harmless and also non-transmissible. The mentioned medicines may be correct if someone has prescribed you by asking you some questions which is called case taking. Because in homeopathy there is some difference, there is no specific medicine for disease, they are specific for a set of symptoms which includes your disease and your basic nature, behavior, liking, disliking as well. If you are taking these medicines yourself then please do not take them, they may harm you in some other way. There is a good thing with these spots that they are harmless and does not transmit if they are not genital warts.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Due to personal problems, I have relationship issues with my mother. Please help.\n\nHello doctor, I love my family. However, there is a huge ideological difference between my mother and me. Our religious views are poles apart and I feel someone is smothering me with those ideologies because I tend to take full control of situations under me. (eg: vegetarian vs non-vegetarian, etc).I cannot seem to express myself clearly. I feel like I should be leaving home and live my life the way I want to. But I always end at the same level and I tend to forget. I feel this has been an ongoing issue in my life. I am going through a divorce and I started having trust issues with people. Please help me and guide me.",
    "doctor_response": "Hello. Your dilemma is quite common. It is perfectly normal to have ideological differences with family members, but we can continue to be close to our family. You made a very important comment that \"I cannot seem to express myself clearly.\" It is important to sit down with your mother and have an open talk about these issues which is grinding you down. Sometimes parents do not always realize their children are grown up adults and have a mind on their own. Being clear and explicit with your mother about topics to avoid will help to ease your tension. Is your mother trying to be supportive in her way? Going through a divorce can be a stressful experience for anyone. It can have an overall exhausting effect on your life but will gradually get better with time. I can understand your predicament. I think sometimes we have to accept that you cannot change an adult's personality but work around minimizing conflict. In this situation, it will help to just accept your mother as she is and learn to tolerate some amount of disagreement. Gradually develop better-coping strategies. Yoga and meditation can help. Look after yourself during this period. Eat healthily, sleep well, exercise regularly, talk to trusted family members and friends. Do not isolate yourself as it can worsen the situation. If you find it difficult to cope, you can consider professional counseling.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain after lifting heavy weights\n\nDear Dr. I have been sufffering from pain in the abdominal area which started 6 months ago after I lifted a heavy weight. First the pain was in the back (middle of the spinal code) and from next day it radiated through abdomin. I consulted diffrent doctors and taken anti-inflamatory and pain killing tablets. In the beginning the pain was severe and now it is tolerable but getting severe while i am sitting for long time. presently, I m taking Zerolol TH once in a day and get relief. Is this recommended for long term use? Could you please prescribe a suitable treatment to get complete relief from this pain.",
    "doctor_response": "Hi.Thanks for a proper history and query. You history is so specific that I can tell you that you most probably have a herniated disc in the spine compressing on the spinal cord, causing the local pain as well as the referred pain to the abdomen. The history of 6 months supports this. Zerodol should not be taken for such a long time as it may cause gastric ulcers and related GI disturbances. You should take Ranitidine along with Zerodol to avoid its complications. I would advise you to take an opinion of a Neuro-Surgeon (not the Neurologist) and go for MRI of the spine and get operated if indicated so.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will petogen contraception cause weight gain?\n\nI m on the petogen contraception for about 2.5years. I ve gained lots of weight and want to go onto the pill because i heard the pill doesn t make u gain weight. I ve been exercisin for a year and haven t been able to lose weight. Please direct me on What would work best.",
    "doctor_response": "Hello, The copper IUD (e.g. Paragard, Mona Lisa, T-safe) does not contain any hormones, so there is no direct way that it would affect weight. Copper IUD users still gain weight in long-term studies though, just like people who aren't using any contraception will gain weight with time and age. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. AJEET SINGH, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have cramping, continuous spotting after Mirena is inserted?\n\nHi so I got the mirena iud now for 3 weeks I bled for 3 days after insertion than got what I'm assuming to be my period for 5 days and I'm still spotting I been spotting for 2 weeks now I am also having a brusing like pain at the top of my vagina in the pubic hair area. Also I experienced so much pain and really heavy bleeding the first days following the insertion I felt cramping and I had never had cramping before NEVER except for my contraction when I was giving birth. Please help I just want to know of this is normal???????",
    "doctor_response": "HIThank for asking to HCMNo this is  not normal at all this may be something else and better to get it examine whether the UID placed properly or not, because the improper insertion of device may cause such symptoms so it is better to confirm it have  nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having fever and Hbsag +ve. Took homeo medicine but no effect. How to cure?\n\nhello I m Bappi Kumer Das , I have A poor Family, I m 27 years old unmarried. I have Any Bad Habit. I work A comuter Furm Post of Normal servent. I M not eating Smoke , Or Any oter Drug and more any bad habit, I m never go out to passed of any bad or good girls . Now Im Fever Hbsag+ve Possetive last three years. I took it some Homeo Doctor in our Bangladesh and They give me lot of medicine regular. by I have No Improve Now At this time. What are I do now",
    "doctor_response": "Hi Bappi kumar das, being HbsAg positive is not a diseased state but only informs you that you have been infected with Hepatitis B virus. If you are asymptomatic you do not need treatment so no need to take any medication, however you should continue to have a healthy lifestyle as you already have now, if at all in the future you have any symptoms of hepatitis then you need to visit your doctor and take treatment for the same. As of now you can be relax and not worry about it . In the future when you plan to marry make sure that your would be bride is vaccinated 2 months prior to any sexual contact as she may get infected by you. It is also advisable not to donate blood and to inform your health care provider of your HbSag positive status. Take care and live healthy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in back,neck,knee with severe headaches?\n\nHi doctor, i keep having these horrible back, neck, knee, feet pains that are causet by masterbation when ever i check people tell me its perfectly normal, and sometimes i just cant help it, what bothers me the most is the morning after i wake up, i get a suvere headache. Please write back, thank you, Sami.",
    "doctor_response": "hi sami..it is not normal getting these pains ..it seems you are so weak and lacking vitamins ..I recommend vitamin b12 and vitamin c .eat vegetables..fruits..and low fat proteins.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red warm painful lumps on the shin?\n\nI am a 28yo F and woke up with red lumps on my shin roughly 3 weeks ago. One below my left knee cap and 2 on the right near ankle. At first I thought they were welts from a bug bite but they dont itch. They appear red, tender, inflammed, painful when walking and feels hot. Only ice seem relieve the hot feeling. I was given Keflex 500mg QID for 10 days and applied triamcinolone prn. Its been 2 weeks since I completed the antiobiotics, the right side seemed to heal on its own, which now appears bruise-like brown color. The right side recently got inflammed again and now my ankle and foot is swollen. I ve been taking aleve to help stop the inflammation but no results. Researching online I ran across Erythemas Nodosum. Is it possible that I may have this? I am on Tri-nessa for 10 yrs, however, my red inflammation is about 4-5 inch in diameter on my ankle.",
    "doctor_response": "hello. you give the classical discription of a erythema nodosum. according to the history it is erythema nodosum. but confirmation of the diagnosis done by histology. there are lot of causes for that skin condition. in your case I think long term usage of hormonal contraceptives. e. odosum can disappear on their ownleagij  if recurrent eruption occurs I usually give an oral steroid. when we see erythema nodosum, we have to find the under lin cause.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a painful pea sized lump on the chest?\n\nI have  pea sized lump on my chest.  About a month ago, it was soft and pliable (painful to the touch).  It's now hard and has become slightly larger.  The tissue around it is soft and yet I can feel that this tissue is also beginning to harden.  I'm thinking about a trip to my PCP....",
    "doctor_response": "Hello there,Thanks for your post on HealthcareMagic.I carefully read your query and understand your point of concern.I think this is an infected sebaceous cyst. It occurs due to accumulation of sebum. It is usually painless but when get infected it become painful on touch and hard. It has a black point on its top.I think you should go to a general surgeon for excision of the cyst after confirm the diagnosis.Hope it will help you.Wish your good health.RegardsDr. Atiqul",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump under the armpit with pins and needles?\n\nhi,myself deepak 35 yrs,due to infection after burn a cyst has developed and gradually increasing under my armpit,due to this my ulnar nerve is uneasy,itching and pins,needles feeling is there and in hand also.what should i do.now it is around 1.5 cm in dia.",
    "doctor_response": "Hi ! Good evening. I am Dr Shareef answering your query.This could be an abnormal scar otherwise known as keloid, which is causing the problem. Even though it needs a physical examination to diagnose it with certainty, I would suggest you not to scratch it though it might itch to prevent its spread. For the present you may go for an anti inflammatory, and an anti allergic drug, and take an appointment either with a general surgeon or a plastic surgeon for further management.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat tiredness and sleepiness post heart by-pass surgery?\n\nMy husband is heart patient went twice heart by-pass surgery My husband is a heart patient & twice operated by-pass surgery & in oct got 2 stents in main art.now a days he is feeling sleepy all the time & lost interest in all the activities . What to do?",
    "doctor_response": "Hi,He needs some examinations to find out the cause of his tiredness to receive correct and effective treatment. I would advise you to monitor his blood pressure, heart rate and glucose for couple of days. If the data are normal, then he will need to have complete blood count and serum electrolytes to find out the cause. The further strategy will depend on results.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the red blood cell oxygenated or deoxygenated?\n\ntrace a red blood cell from the ascending aorta through a capillary bed in the left knee, and back through the heart and lungs to the ascending aorta.  at each step name the vessel the red cell is passing through and whether it oxygenated or deoxygenated",
    "doctor_response": "Hi,Thanks for asking.Based on your clinical history and query, my opinion is as follows:1. Except for pulmonary artery, all arteries will have RBC with oxygenated blood2. Except for pulmonary veins, all veins will have RBC with deoxygenated blood.3. Capillaries - oxygenated, veinules, - deoxygenatedHope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in chest, faster heartbeat with difficulty in maintaining erection?\n\nhello doctor, i am kibria from bangladesh, i am 37, 5'-4\" height, weight 78 kgs. I am having problem with my heart. it pains most of the time but not acute. it beats so hard when something wrong happens in front of me even when i sleep in the day time. the cot keeps moving with my heart beating, i can feel it. besides of that it hampers my sexual life, gaining an erection 70%-80% but maintaining that erection after 3-4 minutes becomes tough. my hair is growing white faster my elder brother has no white hair. if i am tensed i cant think much about anything. may i have a solution to these problems? please help me. thanking you kibria",
    "doctor_response": "Hello,Please get your electrocardiogram (ECG), ambulatory blood pressure, thyroid studies are done. Don\u2019t take street drugs for erectile dysfunction. They also cause these effects on the heart. Get your stress echo also done and revert back to me.Hope I have answered your query. Let me know if I can assist you further.Regards,     Dr. RS Gulati",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause on and off severe pain in lower stomach after periods?\n\nMy lower stomach is having severe pains. The pain is literally unbearable. I can't stand unless I'm hunched over. It's an off an off pain every 5 minutes and it hurts so bad that it makes me cry my eyes out. I got done with my period about 3 days ago. Is it possible that  I could be pregnant? Or is it something else?",
    "doctor_response": "Hi,Thanks for writing to HCM.That can be due to ureteric stone. You need to get an ultrasound of your abdomen and pelvis to look for the same and that will also help rule out any ovarian or uterine pathology.RegardsDr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes irregular heartbeat?\n\nI had a herpetic whitlow - sp? which caused lymphangitis, or red streaking up my hand and arm - about the same time, my heart started beating irregularly and I went on a 7 day course of Keflex. While on the Keflex, my heart was fine. The minute I went off the Keflex, the palpitations came back. I ve worn a heart monitor and was told that 2% of my heartbeats are extra but what I feel is that there is some sort of infection at play here even though my bloodwork has come back normal. Thoughts?",
    "doctor_response": "Hi, There are many causes of irregular heart beat. These irregular heart beats become especially significant when associated with syncope, loss of consciousness, vertigo, shortness of breath, chest pain, palpitations and fluctuations of your B.P. In any individual, even without history of other diseases and comorbidities; these abnormal or irregular heart beats be recorded on ECG rhythm and be exactly typed that what sort of rhythm it is. Most of the times in a healthy individual with no past medical history of note, only assurance is all that is needed after a mandatory baseline cardiac workup. My opinion is to have an outpatient visit at cardiology section. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Syed Hashim Ali Shah, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are nausea, dizziness and sinus headache normal after denture fitting?\n\nI had 10 teeth extracted and an immediate denture placed one week ago. Two days ago, I started having nausea and intermittent dizziness problems and a sinus headache. I went back to the oral surgeon today, he checked my mouth, said everything looks fine so I should feel much better in another week. Do other people have these problems?. I was given antibiotics to take for 4 days following the extraction. I am worried about an infection because I have had joint replacement surgery in the past",
    "doctor_response": "nausea,vomiting can be even due to antibiotics and pain killers. new denture takes time to adjust yet in can u have localised pain or swelling or redness its a sign of infection",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling under the armpit?\n\nHi, I noticed a few weeks ago I had swelling under my armpits - the right one is larger than the left it is like there is fluid under the skin and it is not painful at all. Thought it was caused because of the fact I have put on a little weight recently - but today while showering noticed it again so thought i shoudl check....",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You may have enlarged axillary lymphnode. It can be due to reactive hyperplasia, tuberculosis, lymphoma or metastatic carcinoma. Or you may have some benign cyst or abscess. You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the swelling in gums along with a bump on the chin?\n\nmy 7 year old grandchild has a right and left lower molar loose and the gums around them are very swollen, and I feel on the right side under her chin a little bump (swollen lymph node?) she is not complaining of pain and the gums are not reddish but very swollen. I m just concerned and hoping that it might not be pus heaping up and that that ball under her right chin away though from that teeth might be a collection of pus. I don t remember nor me nor any of my siblings having had these problems when changing milk teeth for the definitive ones. Thank you. Rita",
    "doctor_response": "helloo..rita..read thru ur query..accordingly i must say that in this case there is nothing to worry...swollen gums are due to the new tooth going to come out in some time and at this time the lymph nodes(swelling in the neck)will also get enlarged....and also it may not be genetically inherited...its just a usual case in many people..so nothing to worry as she is not having any pain..shez perfectly alright...if pain comes u may meet a pedodontist...be cool...hope for nice big teeth to errupt...hope my reply has given u some benefit..have a healthy day!!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pressure, breathlessness and lower back pain?\n\nMy 12.5 year old daughter just started having tremors in her arms, hands, trunk, weakness in her legs when standing. She had been complaining of chest pressure and difficulty taking deep breaths, as well as achy lower back. I had her take 2 ibuprofen, as well as a couple puffs on her inhaler about 40 minutes ago ( she has intermittent seasonal asthma). Her current pulse rate is 88.",
    "doctor_response": "Hi...sometimes the inhaler medication which is usually salbutamol and levosalbutamol can cause tremors like this. If the tremors have started after giving the inhaler you can be rest assured.... it is a common phenomena which will subside by itself in few minutes to hours. Regarding chest tightness it could have been wheezing which the child is expressing like this.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in the breast after open heart surgery?\n\ni had a heart attack, i had the widow maker with a colapsed artery. i had to have open heart surgery rite away. im 48 yrs old and a male. it has been almost 3 months since the procedure. anyway i just wanted to know if i will ever be like i was before, so full of energy. anymore im tired all the time my breast plate hurts still. i cant work for more than a 3 hour peroid before im out of gas. a little more info on me: im 6ft 2in and weight 200lbs. also maybe im a little bit mentle but im affaid to push to hard on myself past the 3 hours and make work happen, im a baker and do alot of heavy lifting.",
    "doctor_response": "Hi Welcome to HCM,I can understand your concerns.It could be simple muscular pain.Avoid stress and anxiety.If still symptoms persists get an ECG,Lipid profile , Serum electrolytes as a part of your routine checkup.Post your further queries if any,Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are cold flashes possible in males?\n\nUsually once a month for the last ten years, i will wake up in the morning and start shaking very badly.  I shake bad enough that I can hardly walk, and cannot keep sugar for my coffee on a spoon.  I am 57 years old, 5'11\", 195 lbs.  Are there such a thing as cold flashes like hot flashes in males?",
    "doctor_response": "Hello and thanks for your question.It's my first priority to help you.Flashes can be associated with andropause due to low testosterone levels.And you should check your serum testosterone levels.Even your blood pressure and blood sugar levels should be checked.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can an ear infection be treated?\n\nI have thrush and ear infection which I taken canesten solution 20mlthree times day and ciprofloxacin tablets 500mg one twice day ,I am now in to my4anf half days and things do not feel any diffirent still getting sharp pains so taken som pain killers to get some rest bit from the pains",
    "doctor_response": "Hi,For how long you have been taking this medicine?I suggest you to take T.Hifena D BD (twice daily after food) for symptomatic pain relief and I advise you to complete your antibiotic course. If still symptoms persist, I suggest you to consult an ENT surgeon for basic Otoscopic examination.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Indhu Priyadharshini",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and ringing in the ear?\n\nHey my sister is suffering from brain stroke which is connected with the heart too and other organs of the body.when she get brain attack at that time she find walls are getting closer and she get dizziness and some sound she listen which is irritating like some one continuously changing channels on television.and she also get some water coming on her throat which taste is different unexplainable she also some times feel like vomiting that seconds of brain stroke is very miserable pain where she talk all nonsense too",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I understand your concern, and would explain that it is important consulting with her attending physician for a physical exam and a brain MRI. Some blood lab tests (thyroid hormone levels, blood electrolytes, kidney and liver function tests) are necessary too. If all these tests result normal, I would recommend consulting with a psychiatrist, in order to exclude possible psychiatric disorder related to the stroke. Hope you will find this answer helpful! Best regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain, coldness and swelling in scaphoid after removing cast?\n\nhello , we have a patient who is 68 years old female , had a scaphoid fracture six month ago , but after he removal of the cast she felt pain , severe pain and still having it with swelling and felling coldness . What d o you think she have ? help ???",
    "doctor_response": "HiThere should be a check x-ray or MRI for any non union and additional soft tissue, tendon,ligament implications.Although after cast removal it's normal to get swelling but there shouldn't be tenderness at fracture site.there should be hot water fomentation and application of voltaren gel, thumb,finger, wrist exercises if union is complete.Advil tabs for a short course be taken.Consult treating doctor.support wrist in a brace for few days and use arm sling.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes flushing and fluctuations in the BP level despite taking Amlodipine?\n\nI m a 60 year old woman, and prescribed amlodipine 5 mg. I started taking it one and a half years ago for high BP. My readings were 130-145/85-95. Since I am otherwise very healthy, my dr recommended daily cardio exercise. I chose stationary bike and walk my dog twice a day (about 1.4 miles both walks). In March 2017 I got a Peloton bike, and love it. I bike hard and noticed my BP returning to normal (ten minutes after bike, 120/77 range). I monitor the BP periodically and highest reading now is 145/90 but that is getting rare. Mostly it is under 120, and lower number ranges 82 to 77 (lowest). I would like to get off the amlodipine and continue my exercise program. I am 5 5 , weigh 120, eat healthy, low salt, natural organic foods, very little alcohol (almost none except special occasions, and that is small), and I don t smoke or use drugs (including over the counter). But I am a little nervous to quit the amlodipine, being on it one and a half years now (Dec 2015-June 2017). The side affect which I get and don t like is flushing. It happens periodically through the day and night. Like I feel this hot flushing feeling and want to rip off my sweatshirt even though I was cold before. I never got the leg swelling, though I read a lot of people get that. I plan to see my dr this summer to discuss but curious for your feedback on discontinuing the amlodipine 5 mg. Thank you for any advice. Debbie",
    "doctor_response": "Hello,Firstly I would appreciate your efforts to keep blood pressure in control and doing all the right things which you are currently following. Please continue the same things.\u00a0Stopping amlodipine can increase your blood pressure since you are taking it for a long period. I would suggest you decrease the dose of amlodipine from 5 mg to 2.5 mg once a day. Monitor your blood pressure if blood pressure increases, then you need to continue the amlodipine 5 mg regularly.\u00a0If on taking amlodipine 2.5 mg blood pressure remains below 120/80, then you can withhold blood pressure medicine for a few days and monitor blood pressure regularly. If blood pressure increases then can restart amlodipine 2.5 mg.\u00a0Please do not stop blood pressure medicine suddenly as this is the common mistake done by the majority of patients after the blood pressure is in control. Currently, your blood pressure is normal range because of lifestyle changes and blood pressure medicines. Kindly note blood pressure reading is not sufficient to make a decision about the dose of blood pressure medicines.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Aparna Amritsagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for early ejacuation\n\nhello Doctor,I am 29 yrs old,height-5\".10 inch, wieght 105 kg. I am Having high blood pressure & daibaties past 5 years. I am taking bisocar HT 2.5 one time for Blood pressure & Daibend-m half tablet two time for Daibites. I am married & i have two Duaghters. I dont know wht to do i get ejaculates very fast while inter course. & Doesnt charge for second ejaculation. but when i takes viagra  tablets & go for inter course all happen correct. i get shy because of ejaculating fast before my wifes reach to orgamns",
    "doctor_response": "Hi, You may be having Premature Ejaculation, and drug works for you may be if we find the reason for your issue we can work on treatment, 1.\u00a0\u00a0\u00a0\u00a0\u00a0Stressful work \u2013 night duties, 24-hour jobs 2.\u00a0\u00a0\u00a0\u00a0\u00a0Diabetes, hypertension, thyroid issue has effect on Premature Ejaculation. Keeping your Blood sugar, blood pressure and thyroid hormones under control will help you 3.\u00a0\u00a0\u00a0\u00a0\u00a0On long term medication related to hypertension and anti-psychiatric medications 4.\u00a0\u00a0\u00a0\u00a0\u00a0Frequent masturbation/prone masturbation 5.\u00a0\u00a0\u00a0\u00a0\u00a0Excess porn 6.\u00a0\u00a0\u00a0\u00a0\u00a0Receiving less foreplay from partner or lack of knowledge regarding foreplay and female masturbation 7.\u00a0\u00a0\u00a0\u00a0\u00a0Having a affair giving you guilty feeling 8.\u00a0\u00a0\u00a0\u00a0\u00a0Lack of exercise, obesity Need to check FBS/PPBS to rule out Diabetes, Check your BP, Free T3, T4, TSH for ruling out thyroid issue. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a child to spit milk?\n\nhi, my daughter is 3 weeks old..and is constantly spitting out milk..she feeds fr 5-10 mins and falls off to sleep...it feels ike she is using me as a pacifier..the moment i put her down she starts crying...i m not sure how to help her as she seems to be in a lot of pain",
    "doctor_response": "Hello,         Your 3 week old daughter is spitting milk which is normal at this age. Make sure to burp her after each feed. Some babies sleep off while breast feeding without satisfying their hunger and that is the reason why she wakes up later crying. For this problem when she is breast feeding and becomes sleepy gently rub her ears or flick her soles, this should wake her up and she will finish her feed. She should breast feed for 15 - 20 minutes at one sitting.         Try this and also get her weight checked to see if she is gaining weight adequately.          Hope this helps.Regards,Preeti",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever in 12 month old\n\nfriday morning my 12mth old son awoke with a fever of 100.8. I gave med(children panadol) and water bath in order to get fever down.during the day no fever... but during the night into this morning fever came back.. 98 to 99. He s not eating food but will drink is milk(formula) an water... any suggestion as to cause.",
    "doctor_response": "Hi,I guess he is having only fever. If no other associated symptoms like cough, vomiting or loose stools, and he is active otherwise, nothing to worry. This may be a simple viral fever. Just give paracetamol every 6-8 hours, he will be fine in 3-4 days. If fever not getting down by 3 days, or develops other symptoms, we will need a consultation to look for the focus of infection and treatment accordingly.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam TK, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair fall\n\nI stay in mira road and i have a dandruf problem for which once i removed my full hair and still the things doesn't work and again I got dandruf and I think because of this i am getting a problem of hair fall. My family doesn't have any Hereditary problem of hair fall. Kindly suggest me what should i do to stop hair fall",
    "doctor_response": "Hi.As per your case history of hairfall.My treatment advice is \u2013 1. Take good nutritious diet full of green leafy vegetables and milk.2. Use a good herbal shampoo and coconut hair oil for regular use.3. Take an iron supplement once daily and vitamin b12 supplement once daily for 3 months.4. Other treatment options are topical minoxidil, oral finasteride and mesotherpy done by a dermatologist.Thanks.Dr.Harshit Bhachech.MBBS, DDVL.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for the food allergy for which cetirizine has caused thick mucus?\n\nHi was Having after food some allergy and feeling of sweelling and breathless due to which i went to doctor .he precribed cetrizine for Night 1tablet and predisolone 20mg 2days 15 for 2days 10for 2days 5for 2days.but i did nt use Those but took cetrizine 2tab for2days and felt good stoped.but as a result slowly i felt after few days mucous in Throat and chest but it became thick .later few months i started Having gastric with lot of acid .doctor preccribed somac.but still i feel lot of mucous thick when i eat food very discomfort .can i take predisolone now as he told to take.please advice.",
    "doctor_response": "Hello,Welcome to HCM,As you are having the symptoms of food allergy. As you were prescribed Tab Citrizine  and prednisolone and weaned off over the period of time, these drugs will helps to control the symptoms.These drugs  can only control the symptoms but it cannot cure condition.You need to avoid the food allergen which is responsible for all these symptoms, or you can choose immunotherapy. Either you can take subcutaneous immunotherapy or sublingual immunotherapy against the particular allergen.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should the hair on the chest be waxed before a TMT?\n\nis it necessary that hair on the chest be removed before going for tmt test. my husband aged about 40 got two different results . it was proved positive when tested with out hair removal.and after one week tested in another hospital after hair removal it has proved negative.he has no symptoms as such he had just gone for general health checkup",
    "doctor_response": "Hi,Chest hairs if excessive are generally shaved before going for TMT as presence of hair alters the TMT result due to conduction problem.So the test with hair removed is considered true & final.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing blood counts to drop?\n\nMy sister has a blood problem and the doctors are doing test on the veins in the stomach. They are saying they think the bleeding is coming from the tear in a vein in the stomach. Her blood count drops from 10 to 8 in thrtee months therefore she takes 2 pints of blood at that point. This has been going for nearly five years and getting worse. She is a diabetic and has had heart issues. Is is also tested every rwo weeks and sometimes needs a blood shot. Please advise. Looking forward to hearing from you",
    "doctor_response": "Hello and welcome to HCM,Blood loss from any site in the body leads to fall in hemoglobin or anemia.You have mentioned that there is a tear in vein in the stomach.Tear in the veins of stomach can occur due to sudden vomiting, retching or varices.You need to consult a gastroenterologist for management of the condition.Treatment of the cause of bleeding will improve the fall in hemoglobin.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes reddish rashes on knees,stomach and shoulders?\n\nMy Son is almost will be three in november, the past few days he has had a runny nose and a bad hack type of cough. He has been showing signs of a redish rash on parts of his body. Mainly behind his knees, stomach, side of his shoulders and slightly at times on his cheek area, and back. It is not sore nor itchy. The rash appears and disapears. I found out that my wife changed our laundry soap so we went back to what we use to use and rewashed all his clothes, (this was 2 days ago). Should we be worried or...???? Thanks.",
    "doctor_response": "Hi Dear,Understanding your concern. As per your query your son have symptoms of skin rashes on knees, stomach and shoulders which occurs due to contact dermatitis and allergic reaction of body. Need not to worry. I would suggest you to avoid application of any chemicals and apply topical antibacterial ointment such as mupirocin. Drink plenty of water daily and add fresh fruits and vegetables to your diet. Apply aloe vera gel and don't itch or prick rashes. If condition doesn't start getting better in few weeks then consult dermatologist once and get it examined completed.Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Clinical correlation is suggested for back pain\n\ni had an mri because of severe lower back pain. MRI says one part that concerns me and my orthopedic dr. referred me to hemotologist. The marrow signal is slightly mottled, as could be seen with reconversion in the setting of anemia or early infiltrative processes. Clinical correlation is suggested. Also had one month ago lab work done that showed WBC- 3.9/ RBC 3.87; Neutrophils 34/; Lymphocytes 55; Basophil 3; absolute neutrophil count 1.3. Then repeated 2 weeks later and was told the results were normal. Thank you",
    "doctor_response": "Hi, welcome to health care magic. after going through your queries my opinion is that you are suffering from hematological disorder. for which few investigation are of help such as ESR, CRP, CBC, Periferal blood film, bone marrow biopsy, electrophoresis. after confirmatory diagnosis treatment should be carried out.Hope your query get answered. welcome for further queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should Udimarin Forte and Evion be continued for the treatment of fatty liver?\n\nGood Morning Dr. , I am having fatty liver, SGOT: 39units/l, SGPT: 70units/l; Even after Fibroscan, the IRFI value has arrived to the range of 1.40 -to-1.64m/sec. The impression is Mild Hepatoc Fibrosis. I have visited Dr. who has prescribed me 1) Udimarin Forte (Ursodeoxycholic Acid 450mg) and Evion 400. Pls. suggest me if I should continue the medicine or suggest any medical guidance. Kind Regards-Jp Biswas; Email ID: YYYY@YYYY",
    "doctor_response": "Hello, Ursodeoxycholic acid will help in dissolving cholesterol in bile. Vitamin E helps as an antioxidant to fight in fatty liver. So both these medication is to be prescribed and helpful in fatty liver. You can continue with these medications. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be done after the kidney transplant failure?\n\nDear sir, i have done transplantation on march 14th 2011 two and a half months the kidney is good. due to various drugs changes CMV virus got attacked and i am back on dialysis. We are not in a position to come out of situation. day by day health is deteriorating.pl help us",
    "doctor_response": "HelloThanks for query .You have undergone renal transplant but unfortunately there is rejection of transplanted kidney due to CMV viral infection .In a given scenario the only option is to do Dialysis at frequent interval till you manage to get renal transplant again .To transplant a kidney again is the the only option to have a normal life.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for soreness and pain in the back\n\nGood morning, I have had a sore back for the past 2 weeks, I notice when I sit down it seems to be alright once I get up the pain returns. I am obese maybe that could be the problem? When I m lying in bed and turn over my stomach and back hurt. I m finding it really difficult at times. I have changed my diet and hoping this could make a change.",
    "doctor_response": "which aggravates after walking or straightening of spine (such as during lying on bed and turn over my stomach ) and relieved with bending forward,sitting or taking rest suggests lumbar canal stenosis .its a dynamic phenomenon in that neural canal diameter decreased due degenerative spine disease. obesity aggravates the problem. in initial stages analgesics such as ibuprofen ,weight reduction and flexion regime exercises (series of exercises in which abdominal muscles strengthens) gives some relief.For this you need expert's guidance by rehab specialist and physical therapist.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can oxyelite pro cause dizziness and spike in the heartbeats?\n\nI ve recently started taking Oxy Elite Pro. I dont always take as much as directed but still have noticed that sometimes, after stooping down or bending over, once I rise,I get a dizzy, confuesed euphoric feeling. I ve change my diet and started working out and lost over 60 lbs in the last 90 day or so days. I am happy with the results but am concerned about the side effects. I ve also noticed a periodic spike in my heartrate. So, Should I quit taking it?",
    "doctor_response": "Hi,Yes, it may cause these side effects. Oxyleite-Pro is an over the counter nutritional supplement claimed to be effective for weight loss, fat reduction, appetite suppression, and increased energy.  However it's efficacy has not been proved on any clinical studies for such claims.Because it contains an antidepressant fluoxetine and caffeine, it may cause nervousness, restlessness, increased heart beats, dizziness, fatigue, and stomach upset. It is also reported to cause irreversible liver damage and hence the Federal Drug Administration has already banned its use.I advise you to stop taking it and change your life style like do regular exercise, avoid fatty meals, fast and junk foods, alcohol intake, take plenty of oral fluids and fruits, eat a healthy balanced diet.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blackish sediment in the bottom of a child?\n\nMy 4 year old daughter, with developmental delay and hypotonia, has begun to have a blackish sediment in the bottom of the training toilet when she goes... I am concerned for her kidney health. Any thoughts or ideas of what this could be? We are going to her doctor tomorrow, and hope to get a cath UA done (since she is not toilet trained well enough to produce a clean catch).",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. I have gone through your question and understand  your concerns. I would recommend you to go for urine evaluation to rule out any pathological cause such as altered blood, hemolysis etc. This usually occurs secondary to certain drugs. Visit your pediatrician for clinical evaluation and definitive treatment.Hope I have answered your query. Let me know if I can assist you further.Take care.Regards,Dr. Archana Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Paternia and Fertile-M improve sperm count and motility?\n\nHi Doctor,We have been trying to conceive from the past 8 months but in vain.The tests resulted good for my wife but disappointed me with my sperm count being 11 million with 50% motility .On consulting the Urologist , I have been prescribed Paternia and Fertile M.Can I expect any betterment on using the above tablets.Can you please help me",
    "doctor_response": "Hai,Both the drug will help you in your problem.  as you got 50 % motility,chance are more to conceive with this profile.with the above drug kindly take almond,peanut,arrowroot,tuber vegetables,watermelon,dairy products,pomegranate,dates,fig will help in increase your semen and sperm  quality.thank youhope i answered your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bump on head even after 6 months of hitting?\n\nMy daughter hit the side of her head on the edge of a glass table six months ago. She cried immediately after and developed a goose egg in the spot. There is still a small, squishy bump in the spot she hit her head. It is much smaller and she has not shown any symptoms whatsoever of concussion. Why would she still have the bump on her head?",
    "doctor_response": "HIWell come to HCMIf this was a injury so the chances of some bony structure may be possible and this could be fracture part, the only best option to confirm this is x-ray study, better to get it done, although if this is asymptomatic then nothing can be done even if this turned some fracture, hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and dryness in mouth?\n\nHi, Taking Atorvostatin 20mg Since starting them I have had dizzyness and lightheadednessplus waking up in the middle of the night with really dry mouth feel weak in the arms too have been to A&E with whatI thought was a panic attack had all bloods done for heart issues but all clear.",
    "doctor_response": "Hello, Regarding your concern, I would explain that your symptoms could be related to Atorvastatin adverse effects. For this reason, I would recommend reducing the dose or switching to another drug. Hope I have answered your query. Let me know if I can assist you further. Wish you good health. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for the nausea and vomiting caused due to popping in shoulder?\n\nMy husband started feeling air in his left ear when he is breathing. It started early this morning when he turned over in bed onto his left shoulder. Something popped in his shoulder causing pain and the pain went up the left side of his neck to his ear. He immediately became nauseous and vomited green bile (horrible smelling). He is also experiencing more pain in his upper back.",
    "doctor_response": "First green vomit is normal , as you said bile second he does not need any treatment as this is due to sever painso he can take cataflam I.M if nausea persist then he can take 2 pills of primpranfinally poping in shoulder with sever pain requires an MRI scan or physical examination , i recommend he see an orthopedic doctor by the way air in his ear while breathing can be due to common cold ( nothing to worry about )",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for foot pops after injury\n\ni stepped badly on my left foot around 3 1/2 weeks ago. there were 2 distinct pops. i went to the dr. but he just told me to ice it all of the time and rest as much as possible. i have 2 active teenagers that rely on me. whats the least amount of time i can stay of this foot without causing futher damage",
    "doctor_response": "hello, first of all nothing to worry regarding your complaint and its a minor issue too. dont feel depressed regarding this. if im your treating doctor i would diagnose it as a ankle sprain and can be treated with bed rest for max of three to four days with using following medications which includes analgesics and serratiopeptidase combination. also ankle crepe bandage 6 inch size is mandatory for you to tie to make the swelling to subside and decrease the pain. though it aches but there is no such thing that progression of damage. ok nothing to worry. take car if you have any quiries you are always welcome to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What type of allergy am I suffering from as i get sneezing and cough during night ?\n\nHi , I am 23 years old , my height is 5.6 and weight is 65 kgs.I am working in a MNC.I am having breathing problem mainly during night hours. Till 12th standard i was living with my family in my home town. During that time m having so much sneezing and cough whenever i come in contact of dust. Then in my graduation time I use to stay in hostel only and there is so much greenary around my campus.There also have faced same problem but there is no dust/pollution in my surrounding. My family doctor said that some times in certain atmospheric conditions this happens. In last 6 month this problem has increased and at times medicines which i was taking before this are not at all working .Now m living in a place where 5-6 months in a year it rains, pollution is less , not much cold but humidity is there. Please suggest me solution for the same.",
    "doctor_response": "Hello, u seem to be suffering from an allergic tendency or say a mild form of asthma.prevention is better than cure in such cases but nowadays many medicines or respiratory pumps are available.kindly consult a chest physician for best treatment",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with breast lymph nodes and in under arms, throbbing pain. See an Oncologist?\n\nHi, my mother was diagnosed with breast cancer twenty years ago and had both breasts and lymph nodes under the arm removed. Over the past few months she has been having pain under her right armpit and upper breast area. The pain started out as being mild but over the last month has gotten worse to the point now that is an almost constant throbbing pain. It is painful to the point that she dreads dressing and putting on a bra. She has been without an oncologist the past few years but she is scheduling an appointment with a new oncologist tommorow. If you wouldn't mind giving any advice it would be greatly appreciated. Thanks",
    "doctor_response": "Dear Ma'am, Sorry to hear about your mother's problem. If the pain has developed recently (keeping the history of breast cancer in mind) it is better to get it evaluated by an oncologist to rule out a recurrence. This can be ruled out by doing an USG/MRI of that area. Once recurrence is ruled out, other causes of pain like neuropathy can be evaluated. Hoping for the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are side effects of missing betnesol tabs?\n\nI have been taking betnesol 5mg tablets along with other medicines for the last 45 days in connection with my treatment for CAD and COPD. But, unfortunately for the past 15 days I forgot to take betnesol tablet with my intake of other medicines. What shall I do now",
    "doctor_response": "Hello,I would suggest you to take tablet Betnesol 5mg as prescribed from this point. It is not required to make-up for missed dose, nor you will need to increase the current prescribed dose. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Ayesha Shareef, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for viral fever in a child\n\nMy son is 4 years Age, he had viral Fever for 3 days, and doctor is given calpol 250 mg (low Fever) / meftal p syrup (for High Fever), and due to high fever of 102.5 temp re- consulted the Doctor, advise to give monocef O 100 . After giving 3.5ml of Monocef o 100 one time, my son had loose stool, we stopped giving Monocef. Now no Fever, but loose green stool is not stopping, started giving ORS and nutrolin b syrup 5ml twice day, as per doctor.",
    "doctor_response": "Hello Sometimes antibiotics produces loose motion with greenish color . So get in blood for serum bilirubin level . While your son is having viral fever . Calpol is the best drug . Only calpol ( paracetamol ) 10 mg / kg body weight 3-4 times is sufficient . if high fever present , ice massage will suffix . ORS is another useful therapy .Usually viral fever remains for 7-10 days , so don't take tension.If fever persist >7 days then consult a paediatrician and get his opinion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the lump inside of my knee?\n\nI have a lump that has appeared on the inside of my knee overnight. It is the same colour as my natural skin and the size of half a golfball. it isn t sore but uncomfortable when I use my knee. It is hard and feel like bone but I know obviously that this is not what it is. Are you able to help?",
    "doctor_response": "Hi! thanks for your query on HCM!After going through your problem of the lump inside your knee, I must consider following possibilities as per ultrasound/needle biopsy reports in my clinic:1. a bursa or degenerative benign cystic lesion: 50% possibility2. a ganglion or benign myxoid cyst 20% possibility3. acute synovial collection or effusion due to arthritis or irritation: 20% possibility4. recent hematoma or some benign cyst 9% possibility5. malignancy 1% possibilityTherefore, it should be investigated properly and you must not neglect but get it to some doctor for imaging and needle biopsy if needed to relieve your concerns!regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any chances of pregnancy with insertion of fingers having precum into the vagina?\n\nMe and my gf were giving each other handjobs yesterday i either pre cumed or cumed it was semi dry and i it was moist when i lightly poked it i rinsed my fingertips with cold water rubbed my hands together and may have wiped my hands on my pants  i then without thinking fingered her clit and moved down a little til i felt wetness but i didnt go inside her cause her legs were closed she took plan b today 20 hours after and tonight she said she had a light period  but it was drops  ive heard of implantation bleeding and dont know if this could be it or a period please help me im way to young and not ready to father a child please tell me if shes pregnant or not",
    "doctor_response": "Hi,I have read your query.One thing you must know that, oozing pre-cum is involuntary, meaning a guy can\u2019t control when he secretes it. Pre-cum usually doesn\u2019t contain sperm. But some men\u2019s reproductive systems leak small amounts of sperm into their pre-cum. There\u2019s really no way for a guy to know if he\u2019s one of the guys who have sperm in his pre-cum or not.So it\u2019s unlikely but still possible to get pregnant from pre-cum. The most likely way to become pregnant is through unprotected vaginal intercourse.Since she had taken plan B and she had light periods, she may not get pregnant.So at last, remember that pre-cum isn\u2019t guaranteed to be sperm-free. Condoms are made to protect people from both STDs and unplanned pregnancies, so why not use them? After all, it\u2019s always better to be safe than sorry.I hope you have get your answer.Thanks.Dr.Singh.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having pain after the treatment of pancreatitis\n\nI have been given treatment for acute pancreatitis . Two months over,still iam having pain at the place.having constant pain if any movement or work that will increase the pain. im taking less diet without fat,oil,sugar and im getting normal excretion . what will be the duration period for recovery. All the medical reports connected with disease now normal. plz reply to my question in short time. when the pain will be reduced???",
    "doctor_response": "Hello Thanks for your query. Post pancreatitis ,even after treatment ,complication & residual symptoms & problems are common.It may take time to respond.Continue with the treatment. \u2018Hope I have answered your query, I will be available to answer your follow up queries, \u201cWish you Good Health and trouble free speedy recovery\u201d",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Once increased, will the creatinine levels decrease?\n\nHello doctor,I am a 70 year old male. I am a long-term diabetic patient. My weight is 69 kg. I am suffering from CKD for the past one year. About one year back, my creatinine was 3. Now it has gradually increased to 5.18. It is my doubt. Once increased, will the creatinine level decrease? 10 days back, it was 4.70 now 5.18. I am taking a diet without salt. There are no any symptom that is, leg swelling, breathing problem, etc. I am taking the following medicines: Evion LC 1-0-0, Ketoadd 2-0-2, Nodosis 1-0-1, Nefrosave Forte 1-0-0, Urimax D 0-0-1, Dytor 10 1-1-0 Inj. I want to avoid dialysis. Are the medicines fine? Please advise me.",
    "doctor_response": "Hello. Since your creatinine has gradually increased over a period of a year, it will not decrease. In acute settings, like some infection or diarrhea, creatinine will temporarily rise and then comes down. But, in your case, it is a progression of the disease itself. So, it is unlikely to come down significantly. Next thing, a slight increase in creatinine also occurs on initiation of diuretics (Dytor) medicine which will increase your urine output. If your Dytor is initiated recently then it might have caused a slight recent elevation in creatinine. This elevation does not occur due to damage to the kidney but has a different mechanism and there is no need to stop Dytor for it solely. Probably you are not having any symptoms since you are taking Dytor which will prevent edema or fluid accumulation in lungs. So, no shortness of breath. Your medicines are fine. Keep a check on the BP and it should be strictly under control (less than 130/85). Also, avoid unnecessary medicines like pain-killers, Ayurvedic medicines, etc. And, obviously, sugars should be under control. Hope this helps you and get back if you have any doubts. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can strep be the cause for abdominal pain and nose bleeding in child?\n\nmy 6 year old daughter has tested positive for strep twice now and is on her 2nd round of antibiotics, she has complained of severe abdominal pain and is now having nosebleeds. She had been complaining of the abdominal pain before this 2nd round of antibiotics, but now has the nosebleeds. At the start of this she had sudden onset of abd. pain, with fever , vomiting, grey skin color, heart rate was in the 160 s. We went to the ER for this and she was started on the 2nd antibiotic there through IV, and responded well to this. I am still confused over the abdominal pain and nosebleeds.",
    "doctor_response": "Hi.... Can you describe the complaints in details? Does the child have history of nose picking? Is there underlying coryza like symptoms? Nose bleed can most commonly be due to nose picking or can be a manifestation of underlying bleeding disorders. As it is associated with the abdominal pain and fever we should also think about infective etiologies like dengue where the patient has high grade fever, rash , epistaxis, abdo pain can be associated. Other possibility is that this nose bleeding may be different from abdominal pain. I think the child will need few investigation such as hemogram to look for platelet count and bleeding and clotting time. Also please let me know how is the abdominal pain and fever at present?",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat hair loss in a diabetic female?\n\nhai good evening madam / sir, i m jnn,mhi from kurnool and i m a diabetic patient and also having hair loss probelm my doctor suggeted  me to use the following tabs 1.  curzlvit, 2. minokem 2% lotion and 3.  ebexid tabs ( for reduce weight )   by using the 3rd tab can i reduce my weight?",
    "doctor_response": "HIWell come to HCMHair loss may not be due to diabetes but this could be due to something else and possibilities of fungal infection of scalp, thyroid dysfunction, some systemic disease need to be ruled out, what ever medicines give can be taken, but better try to reduce the weight with low calorie diet, exercise, rather than medicines, hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for boils under the armpit\n\ni am a mother of a two month old baby, lactating, and am suffering from boils in the area under the right arm pit next to the the right breast for the past three days. there is a cluster of boils whish is extremely painful, the same looks like caused by either the bra strap or red ant bites. Can u pls suggest any home remedy since the boils looks to be spreading.This is the first time  have boils for reasons still unknown...pls help...",
    "doctor_response": "HelloAs you mentioned that these boils are in the arm pit and for 3 days with pain .These type of boils ( frunculosis ) are usually due to bacterial infection ( usually streptococcal or staphylococcus are responsible ) .When such patient visit with this short duration of symptoms I advise them to take LEVOFLOXACIN 500 + AZITHROMYCIN500 ) in combination pack , one tablet after meal / day for 5-10 days .Also take pantaprazole-d with this tablet to avoid nausea and vomiting.Also take aceclofenac 200 mg c r twice in day for 5 days .Usually cold ice packing provide relief but not a cure . So for this you have to take tablets .Hope this will help you.Rest is also important .But if this lymphadenitis ( boils ) don't respond to this treatment after 5 days then consult a surgeon and get his opinion and all tests.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high BP\n\nPrior to a work related car accident, I was in perfect health. I, was wearing my police uniform, when struck by an imparied driver in 2009. Since that day, while specialists were trying to figure out why I was in pain and having flu like symptoms monthly for a week at a time, and extreme pain and unusual fatigue my orth surgeon sent me for a bon scan where the nurse dropped the needle and put a belt around my elbows without steralizing. The next morning I woke up with 4 golf ball size lymph nodes under each arm. I had surgery and was diagnosed with a staph infection, I had home care for over two months while nurses changed the wound dressings under both underarms until they healed. As i tried to go for rehab to get strong again, I continue to crash and suffer from extreme exhaustion and was eventually told I had Fibromyalgia. I went to the USA for a 1 year treatment plan at the fibro and fatigue centre in Marietta Georgia. During my IV Injectoin treatments it was detected that I was not suffering from high blood pressure at rest 169 over 116 with a pulse of 90 to 98 at rest. Since then my dr prescribed blood pressure medicine and I take it but blood pressure is still 157 over 110 and my pulse is 104 at rest. What does this mean?? The last time I went to a heart specialst they advised that my heart was somewhat enlarged and mentioned left ventrical hypertrophy a condition athletes get as it happens over time with the heart having to pump harder. Any suggestions. I have been advised that Fibromyalgia causes our blood to thicken and less oxygen and a number of different theories. I really want to find the best doctor in the world to help me. Thank You, Katherne 46 yrs always an athlete until this accident and the driver and passenger were impaired by drugs on a monday morning in June at 11am and this is still before the courts and I just want it to be over so that I can try fetal stem cell or something to save myself.",
    "doctor_response": "Hi welcome to HCM.I understand your query and concern.High blood pressure with Left ventricular hypertrophy should be evaluated for Dilated cardiomyopathy.Best treatment for elevated blood pressure is through drugs like beta blockers and Ace inhibitors.Before that adequate management and work up is needed.I advise you to have a baseline 2 dimensional echocardiography,ECG and lipid profile to assess the basic cardiac reserve of your heart.Restrict the intake of salt to less than 6g/day.Regular physical exercise in the form of brisk walk for 20 min a day for 5 days a week is pretty useful.Drugs like antihypertensives and antiarrhythmics will help.Reduce the intake of fatty and fried food.One pomegranate a day will help to keep your heart at good pace without clot formation. Stress management is most vital in your case.Fetal stem cell transplant needs some criterion to be fulfilled.So Consult a Cardiologist for further expert management.Post your further queries if any.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathlessness and fatigue?\n\nFor the past year and a half I have had night sweats and then since oct 2010 I have had breathlessness, fatigue, small lymph nodes,fevers,itching and when I drink alcohol my lymph nodes hurt. My consultant thinks these are from tb as I tested positive with the quanitferon test in June 2009. I have been on treatment for 5 weeks with no improvement and have developed a cough which is not there all the time. I have had a normal ct scan to check for lymphoma. Is this tb or could it be lymphoma.",
    "doctor_response": "Hello thanks for asking from HCM for your doubtsI can understand your concern. You are suffering from night sweats, breathlessness, fatigue, fevers, palpable lymph nodes, itching etc symptoms since last 5 years. You were positive with Quantiferon test in June 2009. These symptoms can be seen classically in tuberculosis especially in extra pulmonary tuberculosis. You also have developed cough which can be considered as a symptom. To confirm the diagnosis I will suggest you to visit a physician. Get your total blood work up along with ESR done. Raised ESR is one of common finding in TB. Also get your lymph node biopsy, chest X ray done. This will help to find out any granulomatous lesion of TB. Also get repeat Quantiferone test done. These tests will supplement the diagnosis. If everything comes negative then we can think of some other possibilities. Saroidiosis, Lymphoma could be other rare possibilities. Visit a physician for help. Thanks, Hope this helps. Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is there anything I can do to get out of insomnia?\n\nHi doctor, I have insomnia for a couple of weeks. These weeks are being the worst where I have sleepless nights. Last night, I took Trazadone 150 mg which was prescribed and slept. Then again after that, I went back to Trazadone 100 mg tonight along with Melatonin, but I did not get any sleep. Is there anything I can do tonight to get some sleep? How long does insomnia typically last? Am I at risk for anything fatal? Also, I am planning to go back to my GP later on.",
    "doctor_response": "Hi. First, we need to know the reason for insomnia. It is just insomnia, or it is due to depression or due to psychotic or due to a mood disorder. If there is any other underlying condition, then it is important to treat that condition.  You can also follow some nonpharmacological way to manage your sleep problem. For more information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes increase in liver enzymes after having three beers?\n\nGood evening, I had a blood test done recently and my liver enzymes were 5 times higher than normal. The night before the test I had three beers. Would this typically be enough to raise my liver enzymes to this level? I am 25 years old and have, at times, gone through months or years of binging. During these times I would have 5-6 craft beers per night. I have scheduled all kinds of tests; but, they wont happen for another two weeks. I can t stop thinking I may have created serious health problems for myself. Please, let me know what you can. Kind regards, Alex",
    "doctor_response": "Hello, Alex. First at all five times higher is not a dangerous situation so keep calm and with your conscience that you have created health problems to yourself I'd suggest to follow to a great decision: give up drinking, it's for your good and it's the first cure at all. I'd like to know which of your liver enzymes was the highest SGOT or SGPT, but never mind after giving up drinking, you can begin to take Legalon 140 mg three times a day and Vit E 100 mg, three times a day, while waiting for the other exams results.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to test numbness and swelling in the left leg and arms?\n\nI CAN HARDLY WALK AND MY LEFT LEG IS HEAVY. WHAT type of MRI SHOULD I HAVE? mY NEUROLOGIST ORDERED CERVICAL SPINE . IT HAS NOTHING TO DO WITH MY ARMS OR HANDS. IS THERE ANY INJECTION TO RELIEVE THE INFLAMMATION ,mY LEGS ARE KIND OF SWOLLEN. WHAT SHOULD I DO DOCTOR?",
    "doctor_response": "you can do cervical spine MRI with screening of whole spine.  if there is only lower limb involvement and symptoms of tingling lumbar spine MRI may be helpful, but anyway do whole spine screening with either MRI. Neurologist will have always look at cervical spine first.. but tell them you also want to get screening of whole spine also.  i also suggest vascular color Doppler of your leg to rool out any vascular pathology(narrowing of arteries)  like vascular claudication.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the cause of widespread muscle twitching and sweaty palms?\n\nHi doctor,I am 25 years old. What can be causing me to get widespread muscle twitching (twitches last about five seconds and go away and reoccur in a different muscle minutes or hours after)? Legs and hands get shaky, hands get sweaty, at night I feel like my legs are vibrating and my heart is pounding for no reason. I just noticed my hair is falling out too. I am also getting lots of anxiety, especially at night. I am in good health, I am a little overweight, not too much though. Should I get a blood test?",
    "doctor_response": "Hello. I have read through your question and would like to suggest that you should get a number of blood tests done. The following are the tests that I would suggest. All these tests are just to reach a proper diagnosis. It is necessary to know whether all these symptoms you are having are due to a pathological cause or physiological. You said that you have anxiety. Even anxiety alone can be a reason for your symptom complex. If all these tests come clear we may have to investigate the reason for your muscle twitchings. I hope I was able to help. If you have any further questions please feel free to contact. For more information consult a family physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain,itching and numbness on legs?\n\nI am having rerstless night with attacks of itching numbness an burning pain of both my legs. The curious thing is that it does not happen during the day,. but about half an hour from going to bed t night. Recent MRI indicates that arthritis might be the cause. I know arthritis pain what it is like because I have it in my both hands. The sensation in my legs is more a burning pain. Thanks if you can give me some advioce.",
    "doctor_response": "Hello,I have studied your case. I think you are having neurology problems in your body. it can be due to these reasons.1.Low serum B 12 estimation.2.Nerve compression in the spine.   I would recommend you to get your serum B 12 estimation and MRI of the spine. If there is low serum B 12 than you should start taking Pregabalin M one daily. Also take calcium and vitamin D 3 daily. I hope this answer will be useful for you. Let me know if there is any other followup questions.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "When will this sciatica related problem of slip disk cure?\n\nI have slip disk problem of L4,L5 and S1. I don't have pain in low back area. But I have sciatica pain in my right leg. It is improving but very slow. 3 months I am suffering . I am taking Short wave diathermy . It gives me relief.When will this this sciatica related problem of slip disk cure?",
    "doctor_response": "hi as you told sciatic pain in your leg and taking short wave yes it will help you surely but with this IFT is there that you can take and very helpful in relieving pain of sciatic and exercises for back strengthening slr and stretching that will also help you it will take time to cure but after correct treatment there is completely relief. wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having Liver cirrhossis. Diagnosed with varices. Pain in shoulder blade when swallowing. Caused by varices?\n\nI have liver cirrhosis from blood transfusions Inreceived in1977. I have already dealt with Class action over this I have never drank in my life-now ag 82. I have now been diagnosed with small varices and wonder how this will affect me--now I seem to hurt a little when I swallow and a pain goes through my shoulder bl.ade-- is this from the varices. I do see my specialist on Apr 4, but would like to know what is going on in the mean time",
    "doctor_response": "Hi and welcome to HCM. It shouldnt affect you until it bleeds or cause stomac stenosis. Varices are usual consequence of liver damage and when it appear it usually goes through stages(grades). It is evaluated by gastroscopy where we can see how is it serious and is there any danger of bleeding.  So doctors need to see is there any  progression in size of varices and does it need endoscopic treatment. It can cause symtpoms you ve mentioned unfortunately son consult your doctor about some method of varix removal. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for Ostosclerosis?\n\nHello, I was diagnosed with otosclerosis and am looking for the best and most experianced doctor in NYC, to consult me on the stapedectomy surgery and eventualy to perfom it. He should be with many years of practice and many surgeries performed. Thank you in advance!",
    "doctor_response": "Radiotherapy may cause your symptoms but you must exclude stomach, colon and hepatic disorders. First, ultrasound scan should ne done on abdomen. If there is stomach disorders, start take H2 blockers twice daily. If there is colonic type, carbon tablets taken in sever cases.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for avascular necrosis of hip?\n\nHello, I am a 51 year old female that weighs 130 lbs and is 4'10\" I have been diagnoised with avascular necrosis of the hip.. I as wanting to know why my right leg is getting shorter than my left and can it be fixed.. have an appointment the 1st with ortho doctor.. was just curious",
    "doctor_response": "Hi,As you are diagnosed with avascular necrosis of hip.As ball of your hip joint collapsed leading to shortening of effected limb.You will probably require total hip replacement ,after which both of your limb should be equal.I think this will be of help to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies to keep eosinophil count in check\n\nhi i am suffering from hi eisoniphil count and my doctor advised to take iv of Decaden and deryphillin when ever the situation is out control even he admimistered hydrocartosene when the case is severe.Please suggest some remedies to totally control the count.i am 5'8\" weight 65 kgs and asthmatic since 6 yrs old",
    "doctor_response": "HIWell come to HCMAbsolute eosinophilic count is matter here if this is high then underlying cause of this being treated, in your case looking to the history this could be allergic condition so why the eosinophil must have been gone high, in such condition steroid is given to control the symptoms, steroid could bring down the count at lower level but this could take some time, hope this information helps, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it advisable to remove Histrelin implant after four years in precocious puberty?\n\nHello doctor, I am a female. I was diagnosed seven years ago for central precocious puberty and was treated with three annual implants of Histrelin. The third implant still has not been removed after about four years. I have looked at procedure guidelines online that say that the implant must be removed after a year is up. Does it have to be removed? What will happen if it is not removed? Also, I am showing no signs of puberty except pubic hair and height. Is it possible that the Histrelin is holding my growth?",
    "doctor_response": "Hi. Yes, Histrelin implant should have been removed after one year. Please speak about this to your doctor. Histrelin implant is a synthetic analogue of gonadotropin-releasing hormone (GnRH) agonist. It works by decreasing the production of certain hormones, which reduces estrogen and testosterone levels in the body initially. Laboratory tests, including luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol, testosterone levels, or height and bone age may be performed to monitor your progress or to check for side-effects. I would suggest you to carry out all the hormonal profile that is FSH, LH, testosterone levels, thyroid levels, estradiol levels to see that they are in normal range. Periods are related to circulating estrogen levels.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. 2. 5 year old suffering from stomach ache. Which medicine has to be given?\n\nHi doctor, My son is 2.5 years old. For a week, he is complaining of stomach pain. After farting he is fine. Our family doctor recommended one antibiotic for five days and a medicine to avoid vomiting. He had small vomits twice, but later it was fine. Now, after completing the course of medicine he again complaints the same. His diet is almost nothing and he is not ready to take any food. He just has few mL of milk. He does not have fever. His stool was watery, but it is normal now. Can you provide any recommendation on diet and medicine? Please give me a solution to the problem. Thank you.",
    "doctor_response": "Hi. I can understand your concerns. Complain of abdomen pain with vomiting suggests that your child probably has acute gastroenteritis or food poisoning. Since, antibiotic is already given and now there are no loose stools or vomiting, there is no need to give antibiotic again. For abdomen pain, you can give syrup Cyclopam (Dicyclomine hydrochloride and Paracetamol) 5 mL on SOS basis (as and when required) that is when abdomen pain occurs. Whenever a child becomes sick, there is decrease in his appetite which improves as child recovers. Now, you should give him all the foods that you were giving him earlier. If he is not eating then you can start Glucon-D in water thrice a day for one or two days. Start a multivitamin like syrup Bevon 5 mL once a day for 15 days. Keep patience. Child will eat properly now as he has recovered from illness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had a knee surgery, torn madiskis. Now have lump on leg. Burn when rubbed. Did MRI. Cancer?\n\nHELLO.....I HAVE HAD KNEE SURGERY BOUT A YEAR AGO   TORN MADISKIS...IM NOW HAVING SOME BUMP/LUMP ON MY LEG  2 OR 3.AND MAYBE SOME NEW ONE  NOT SURE..AND THEY BURN WHEN I RUB THEM....IM WAITING  TO GET A MRI  WHAT COULD THESE BE....IM HOPING NOT CANCER.... PLEASE HELP ME    SORRY I DID NOT KNOW IT COST $ TO ASK ONE QUESTION AND I DONT HAVE ANY TO SPARE.....I JUST WANTED TO KNOW WHAT IT COULD BE AND IF IT COULD BE CANCER....I HAVE NEVER SMOKED  THANK YOU FOR YUR TIME  GOD BLESS",
    "doctor_response": "Hello, You have no cancer,Don't worry at all.Please contact your nearest Orthopedic surgeon for further treatment.But i can say surely it is not Cancer.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on clitoris\n\nHello I m 19 years old and just a day or two ago I notice a lump or something on my clitoris and I ve never had this happen to me before. Me and my bf had sex several times now but I don t think it s a disease or anything bcz we both been checked by doctors to make sure months before we had sex. We didn t use a condom which didn t help I m sure. It burns alil on my vagina but not bad. I ve been stressing out about this bump or lump or whatever it is. It feels hard from the inside though. Someone plz answer ASAP bcz I can t keep stressing about this :/",
    "doctor_response": "Hi,from history it seems that you might be having some infection in opening of urethra giving this problem.Apply antibiotic cream locally.Keep local hygiene proper.Take plenty of water.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for renal failure\n\nMy mother is diagnosed with CKD.She is a chronic diabetic patient with high blood pressure under control. She is on 40 units human mixtard (50/50) before breakfast+ 36 units subcutaneous (30/70) before dinner. She suffered from frequent UTIs since last one year and in the recent past she was admitted (sugar:560,serum creatinine:3.5) and administered high dosage of intravenous antibiotics.Thereafter when her sugar levels were under control and serum creatinine at 2.1, she was discharged and was suggested to take oral antibiotics to prevent recurrent infections. Thereafter her potassium levels started to increase (6.0) and with K bind, her potassium levels were lowered to 38. However,from past two weeks,her potassium increased from 3.8 to 4.4 and today it is at 5.3. Also, her serum creatinine last week was 2.2 and today is at 2.6.Treating doctor had advised her to take K bind and asked for a review after 2 days with reports.I would like to know with this background, is there a agressive traetment at this stage to stop further renal failure?",
    "doctor_response": "Hello and welcome to HCM.As an Urologist,i can understand your anxiety.Your mother has CKD and creatinine and potassium levels can fluctuate.Both need to be repeated alternate day or third day,depending on condition.There's no treatment to keep both levels in normal range all the time.You've not written her age.She has diabetic nephropathy as cause for CKD.Definitive treatment is a kidney transplant or maintainence dialysis later.If you've any doubts,send it as a direct question to me,with all reports.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I feeling sick even after three times of blood transfusion?\n\nHello doctor, I recently had my third blood transfusion a week back. However, it is a week later, and I still feel unwell. Is this normal or what should I do? I feel tired and weak with zero energy.",
    "doctor_response": "Hello. For severe anemia, you had given a blood transfusion. The clinical improvement depends upon hemoglobin value. Usually, if your weakness is due to anemia then with normalization of hemoglobin level, symptoms will improve. If no improvement, then other causes for weakness need to be searched like low vitamin D, low calcium, electrolyte dost urban, liver and kidney disease, etc.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pains after a little increased alcohol intake. Had enlarged liver, white cell count abnormal. Reason ?\n\nhi i was told two years ago by a doctor that i had a enlarged liver and to change my lifestyle. i was given no more information so thought it wasnt that serious. i cut down on my alchol intake but did carry on drinking. havnt felt great for a while now but after a few too many on sat have felt quite unwell, stomach pains, tiredness,confusion ect. was also told by my doctor a year ago that my white cell count was abnormal but the reason was unkown.",
    "doctor_response": "Hello, thanks for contacting HCM. If you were drinking at thetime you were told about enlarged liver , it is quite possiblethat may indicate Fatty Liver caused by alcohol. I am not surehow your liver tests were then or how they are now. If they areabnormal , you really have to take care of the problem.You mention about the white cell count being abnormal. Again ,I am not sure if it was high or very low.You need to stop drinking completely, eat a high protein diet ortake protein supplements along with B-Complex, Vit-C and Vit-E.Tiredness and confusion some times indicates advanced liver disease.You really need a full work up.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Depression, worried, convincing of being pregnant after taking microgynon 30. How to get relief?\n\nI ve been on microgynon 30 for over a year, around beginning of december 2010, never had any problems with it, was able to take pills back to back wouldn t have any issues what so ever. Since december 2011, i began to get all depressive , started worrying about everything, like worrying my boyfriend didn t love me, my friends didn t really like me, and also started convincing myself i was pregnant , even though i had all my periods on time, and they were normal (partly thing this was because some girl at college got pregnant for using no protection, auntie was pregnant, it was just always mentioned) so i got it in my head that i could be and got myself all worked up. I even managed to get things like sore breasts, pains in my stomach , tiredness, everything, but only when i think about it, anything i get wrong with me i am convinced is a symptom of pregnancy because i sat there looking up symptoms and scared myself big time. I ve always been quite an emotional person but i feel since december i have become worse and all i can think of is my pill. I take it at 7am everyday unless the odd day my alarm doesn t go off and i ll take it 8:30am latest, never miss any, i m VERY conscious about it, i ll always think i ve forgotten to take it when i haven t and panic. I m 17, nearly 18 and just want to be able to sort out this issue as it s genuinely effecting my life now, We don t always use condoms as in the leaflet it says you don t have to as long as you take the pills correctly and I am fully aware you aren t protected against sti s but me and my long term boyfriend are each clean.",
    "doctor_response": "Hello and welcome to Healthcare Magic. Thanks for your query. You need professional help to deal with your depressive symptoms and the false belief that you could be pregnant (which could be anxiety-related or sometimes, indicative of a delusion). I would advise you consult a psychiatrist for a detailed psychological assessment and further treatment. There are effective treatment options - in the form of medication or counselling / psychotherapy which will help you overcome your problems. Wish you all the best. - Dr. Jonas Sundarakumar Consultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes head pressure and dizziness?\n\nI ve been starting to occassionally have pressure in my head if I lay stomach first one my bed. It is relieved by standing back up. Today, it was bad enough to make me real dizzy, but again relieved by standing upright and then sitting in a chair for awhile.",
    "doctor_response": "Hello, As you mentioned about giddiness and headache. I would like to ask you a few things - are you diabetic, are you having any signs of hypertension,? if none of this then this could be related to vertigo and may have to get it examined by a neurologist, for medication and later a physiotherapist for vertigo exercise. In case you have pain in the neck then examining the neck and taking an MRI should help understand the soft tissue and management post that. As most people even have dizziness, headaches due to neck pathology. In my clinical experience of 12 years, a proper clinical examination and assessment have helped to figure out the diagnosis and treatment accordingly to help patients. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the significance of an elevated CA-19 tumor marker?\n\nHello doctor, I have a question regarding the significance of an elevated CA-19 tumor marker. I recently had one and that came back as 43 (per laboratory should have been under 34). I do not have cancer and I am wondering what else could cause this elevation? Please help.",
    "doctor_response": "Hi. CBC (complete blood count), LFT (liver function test) and USG (ultrasonography) of abdomen. Revert back after the tests to a medical gastroenterologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and darkening of legs?\n\nMy mother in law aged 90 has now developed swollen legs and which are turning black just around the ankle and a little higher. Some days they are a darker shade of purple and others they are turning black. She was diagnosed a liiitle earlier with Cirrhosis of the liver (non- alcohol related) and because of the swelling she has been put on a tsrong diuretic which has now been reduced stpped because it was making her urinate all the time and out of control. Her legs are painful as well. One leg is wrse that the other ? Can you tell me what this might be ?? No results have yet come in She is due to have a doppler test tomorrow, and she has already tested for a pulse in her which now has been identified by the doctor",
    "doctor_response": "Hello, Varicose vein is a possibility. You can go for a venous Doppler to confirm the diagnosis. Other causes like renal dysfunction and hypoalbuminemia must be ruled out. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to be pregnant while on birth control pills?\n\nmy last pill of diane 35 was last Dec. 23, 2013 then I had unprotected sex in the morning of Dec.26, 2013 then I take Charlize pill at the night of the same date. I'm afraid now, I still dont get my period. I tried to have a pregnancy test last January 04, 2013 but it's negative. Now, it's January 9 but still I don't get my period. Is there any possibility of me getting pregnant?? Pls help me. I need a very urgent  answer.",
    "doctor_response": "Hi,Welcome to HCM,If you had taken Diane 35 regularly every day, starting from Day one of your menstrual period, and you had unprotected sex on 26th December, there is no chance of pregnancy. There could be many other causes for not getting period. Sometimes if you are taking these hormonal tablets, randomly, without asking the Doctor, or not following the proper instruction, it may disturb your cycles. You may repeat your Pregnancy test tomorrow morning again with first morning sample. If it is negative just wait patiently for the period, but make sure to avoid intercourse or use proper protection. If you are continuing Charlize pills, continue it and you may see your period  within 10 days after you the last tablet. If you still have some doubt r getting impatient, you may see your Doctor.Hope you got your answer.Dr H Hamdani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lumps on the legs , shoulder and chest\n\nDear Resp Dr s. I have lumps all over my body leg, shoulder pr chest. The all are moveable or in side my skin. and i feel pain some time.i m worry about it. what is the treatment of lump? dr said its angio lepoma. but i ask him how would u know? he said 1 lump on your forhead it will gone. one more thing this lump are not growth mean size is not big. please tell me i m really thankful to you",
    "doctor_response": "Hi,Dear thanks for your query to my HCM Clinic.I studied your query indepth. In my opinion,its adiposa dolorosa, or dercums disease.Treatment-a-Surgeons opinion,b-Surgical Excision of painful lipoma.Hope this would resolve your query.Wellcome for next query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had LAVH/BSO/APP/LYMPH NODEr removal for cervical cancer. Having swelling in pubic area, lower abdomen. What can be done?\n\nHello Dr. Samuel, I had my LAVH/BSO/APP/LYMPH NODE Removal 10 days ago for cervical cancer. Now with swelling lower abd, pubic area and tenderness in left groin. No temp elevation, no drainage, pain scale 1-3. Problems with constipation. So long will the swelling last? Taking Colace, eating fruit, drinking water, sl walking, took enema 2 days ago, passing gas but not bm on my own\"",
    "doctor_response": "you may have developed a postoperative intra-abdominal collection which is a common problem after lymph node removal as the lymph keeps leaking for some days. This can easily be ruled out with an abdominal ultrasound. If found, such a collection can be drained under ultrasound guidance easily. That should relieve your symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the middle of my chest?\n\nHello doctors very recently i have had a pain in the middle of my chest, it feels like a very small lump but the pain occurs when i touch it, stretch and sometimes when i'm breathing, i'm a male 17 year old with no history of asthma etc. i weigh 73.4 kg and have a very active lifestyle but i dont believe this pain was created through me practising my sports as i noticed this when i just woke up one day",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. This is likely a musculoskeletal pain, and there is no need to worry much. Use diclofenac gel for local application and tab Diclofenac whenever needed with tab pantoprazole. If it doesn't resolve in a week then visit a local doctor for examination.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic nerve pain in neck\n\nI have cronic neck pain from fusion of4 and 5th cerfical disk over a year ago. I take alive250m and tizanidine pain doc. wants to do facet joint shots and burn out nerve connection if one is found. I need pain relieve now. I am getting weak and shaky and am becoming debilitated by the pain. I am a75 year old female and ilive by myself",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have chronic nerve pain in neck . Well there can be many reasons for symptoms you mention in query like injury , arthritis , osteoporosis , fibromyalgia spondylosis or meningitis . I would suggest you to consult orthopedic surgeon again for proper examination and treatment. Doctor may order CT scan , MRI or physical examination . Doctor may prescribe muscle relaxant , anti inflammatory along with nerve supplement . Doctor may recommend physical therapy and stretching exercises which will help alot . Doctor may also refer you to neurologist for nerve problem . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can persistent hair fall since childbirth be treated?\n\nHello doctor, My problem is about my hair fall. It passed10 months of my post delivery. And my hair fall started nearly from 6 months after delivery. It s very horrible day by day loosing so much of hair. Kindly suggest me with good medication. Thank you",
    "doctor_response": "Hello, You seem to have postpartum telogen effluvium which is hormonal due to a withdrawal of hair stimulating effect of estrogen on hair during pregnancy. This is usually self-limiting and recovers in 3-6 months. However, I suggest you take a well balanced nutritious diet along with an oral biotin supplement. Correction of any deficiency like serum iron and vitamin D, vitamin B12 would also help. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Kakkar S., Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is stiffness,pain and swelling in finger indication of an infection?\n\nHello. On April 3, I cut open my finger just slightly above my knuckle (left hand ring finger) with scissors. About a centimeter cut, maybe a 1/16 in or less deep. Bled a bit but was under control. Cleaned with water, wrapped with gauze and bacitracin, and a large bandaid to immobilize finger. Did that for about 3 days. Healed fairly quickly. However, the finger gets stiff and is painful. The knuckle is slightly swollen...sort of pillowy. Hurts when I press on it. A teeny bit reddish but not really. Poofy. Might it be infected?",
    "doctor_response": "Hi,Welcome To Healthcare Magic.I can understand your concern regarding your health.Though you are saying that healing is proper done but features like swelling, puffiness, redness are present because of infection that is improper healing from inside. So, it will be better to consult a doctor for proper dressing, injection Tetanus and medication. Till the time you will consult a doctor, you can take Tablet Vetory SP (if no allergy) 1 B.D. for 3-5 days and Tablet Pecef (if no allergy) 1 B.D., 200 mg for 5 days.After doing all these things, I hope you will get well sooner and please share your review about my answer on healthcare magic.Take Care,Thank You.From:- Dr. Prashant Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce height?\n\nHi, Doc! May I know if there are certain procedures to reduce my height? I think I can t stop growing and it worries me a lot coz I don t want to grow above 170cm but I m reaching approximately 185cm already. Do you have any idea what kind of procedures I can undergo?",
    "doctor_response": "hi,thank you for providing the brief history of you.As you may be into the growing stages like below the age of 18, the growth hormone is pretty active and is leading to increased in height. There are measures to suppress the activity of the growth hormone, but it is not recommended since this will lead to abnormal reactions in different systems of the body.Even, after this you want to stop the physiology of the growth hormone you can meet an endocrinologist and get helped.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes purple color near the stitched wound under kneecap?\n\nOver a week ago, I wrecked a dirt bike and when I hit the concrete it took out mostly everything right under my kneecap. No muscles or ligaments hurt. But the doctor pulled together both the sides and stitched it up. Now all around the wound, my skin turns purple at random times. What can be causing this?",
    "doctor_response": "the skin around the knee remains very loose. so it becomes easy to  collect blood under the skin usually after such injury. this is called bruise . it changes color as time passes from red to blue,purple ,green and finally becomes normal after 15-20 days. its a normal phenomenon . you should not be worried. icing, rest and if swelling is there anti inflammatory such as ibuprofen will help you .Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should I do for lump cyst on my sons upper?\n\nhi doctor my son just called me and is troubled with a wart like bump lump cyst on his upper that is flat while sleeping and becomes raised thruout the day ,it very annoying and impossible to keep from touching with tounge, lips ,ect. He is in a halfway treatment program and te NURSE on is calling it a cyst and wants to inject it with teroids. I am afraid for him and am thinking about everything from herpes mersa to oral cancer and ant him to see a specialist if they allow it. thankyou for your time",
    "doctor_response": "Hi, thanks for sharing your son's problem with HCM!Well, not to worry about this and if I were his family physician in this case, I would just think about a retention-type of cyst or in worse case a hemangioma/lymphangioma type of swelling!In fact, thee is some loose collection within its cavity and it is very prone to get infected. I would like to suggest to confirm the diagnosis first by FNAC test/ultra-sonography and accordingly go for treatment as suggested by your surgeon!The treatment could be just aspiration of its contents or excision or just wait and watch under conservative treatments!But never it is some serious condition!See you again with feedback and all the best...",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should I take lorazepam, bupropian hcl for anxiety and depression?\n\nHi,  My VA doctor has prescribed Lorazepam 1 mg tablets for me for over three years for anxiety.  He also is giving me Bupropian HCL 100 mg for depression.  Both are for Post Tramatic Stress from combat in Vietnam.  My question is should I be taking these drugs for so long, especially the Lorazepam?",
    "doctor_response": "hello thanks for choosing healthcare magic.comIn Post traumatic stress disorder duration of treatment is 6 to 9 months. rest depends upon the flashabacks and anxiety symptoms. if patients is asymptomatic, medicine could be stopped by 9 months. In presence of anxiety symptoms medicine would go for longer time. Lorazepam should be stopped or take on SOS basis to avoid dependence.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the sperm analysis report normal?\n\nSir/madam I am maried 3 years my total sperm count 50 million/ ml and total motile 25 million/mi, total nonmotile 25 milli/ ml, progressive motile 15 milli/ ml, sluggishly 10 milli/ mi, immobile 25 milli/ ml, total normal cells 15 milli/ ml, total abnormal cells 35 milli/ ml. What about my results good or not? Please help me.",
    "doctor_response": "Hi, It looks like you had a basic semen analysis done, and the results are suggestive of a reasonably normal sperm production.If you are unable to conceive in the next three months, I suggest you repeat a semen analysis at a good infertility centre where the quality of report is likely to be dramatically better than any average lab, as they also look at other criteria such as sperm morphology. the really good labs might even do tests like sperm DNA fragmentation, which however is quite expensive and might not be required in all patients.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of lump in left armpit?\n\nDearDr. Krueger,  On Oct 31st, my husband found a lump under his left armpit about the size of half of a tennis ball.  Our primary then referred us to a general surgeon who removed the lump on 11/8.  The surgeon moved up his post-op visit because he felt that based on what he saw that he would be referring us to an oncologist.  However, the pathology came back benign.  The pathology reoprt did mention granulomas so we were referred to an infectious disease specialist who has run numerous tests all of which have been unremarkable except the c-reactive which was a little high.  I believe it was 9.  They did notice some nodules on his lungs for which we were referred to a pulmonary specialist who assured us that they were normal.  However, he did suggest that my husband obtain a ct of the abdomen and pelvis as the did notice some enlargement of the spleen.  About a week ago my husbands left elbow became swollen similar to the look of the axillary. Although he has no history of more than a cold in his 44 years, his father had non-hodgkins and his mother had a brain tumor.  They had about a 5 acre farm in which pesticides were used and I feel concerned that this could be related. At the present time he has little or no complaints.  He awoke last night with what seemed like night sweats as he had to change his clothes.  Finally my question to you.  Could the pathology have been wrong and should we seek a consult with an oncologist? Thank you for your time. Terri",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  His lump can be due to tuberculosis,  other granulomatous disease like sarcoidosis or some lymphoma.  You should go for second opinion of that histopathological examination.  Review of histopathological slide gives you exact idea.  If still there is any doubts in diagnosis then IHC marker study will help you.  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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should only Cyclobenzaprine be used without Tramadol?\n\nI have ben taking Tramadol for awhile now.However had been out and just got new script.Took two at 5:26. I have severe vascular problems w/ severe muscle spasms in my legs.My Dr also just today called in a new pain med called Cyclobenzapr Tab 10mg.I realize I shouldn t take one now. Would it be safe to just use the new drug at night and no Tramadol,and only take the tramadol as needed during the day? I see the combination can cause seizures.Thank you. If it helps I am a 57 yo female.",
    "doctor_response": "hiTramadol is for pain and cyclobenzprine is for muscle spasms, both may be indicated in your case so doctor may have prescribed.There would be no siezures as you fear.But i may suggest you to try physical therapy,massage and fomentation also if put on both drug for earlier responsebest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for red color frequent urination in a child?\n\nhello! doc. my son is 24 months old and in mid of Oct 2010 we found that his urine was red with no pain, but frequent urination and that also in small amount, we had his first urine routine micro done and found out plenty of RBC with occasional WBC. our doc advised antibiotics and it reduced, but again the after few days the urine color was red and second test findings were 4-5 RBC and 5-10 WBC again doc advised a full course of antibiotics. well we were also advised to have his routine micro checked after 15 days or so. till date his urine is not red, but the frequency of urination is frequent and sometimes in very small amount. we had his urine test done exactly after 18 days after his second test i.e. today 18th Nov 2010, 10-15 RBC and 15-20 WBC were found. our doc advised abdomenal sonography to be done. according to our doc it could be a bladder stone or congenital disorder. well i am not so worried about the stone, but congenital disorder scares me. what you advise? please help... thanks a lot",
    "doctor_response": "Hi, Congenital disorder, he could mean IgA nephropathy. Everytime he gets a respiratory tract infection, the chance of hematuria is present. It has chronic course. The child needs yearly evaluation for kidney function tests, blood pressure and probably future kidney biopsy and regular follow up. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Prasanna Lakshmi, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes jaundiced skin to disappear ?\n\nI have experienced extreme fatigue on a fairly short-lived but regular basis for my entire life, and have often coped through impromptu napping, after which I would typically feel fine.  Many years ago, low blood sugar was thought to be the culprit.  Today, for the first time ever, I woke to find my skin jaundiced.  I was too tired to get up and look at the whites of my eyes in the mirror, and the jaundice has disappeared.  Any ideas?",
    "doctor_response": "Hi thanks for asking question...Noted you are complaining yellow skin and jaundice under suspicion...First for jaundice confirmation, do your serum bilirubin estimation with LFT profiles...If no jaundice then no need of worry.For your fatigue do your peripheral smear examination , serum ferritin and vit.b12 Level.Correct anemia with iron tablet and multivitamin tablet....If raised bilirubin then further work up done with consultation of doctor...Take care.Dr.parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible for hepatitis to recur after treatment?\n\ngood morning dok... i have test hbsag negative after i diagnosed hepatitis b from june 2009, that day until dec 2009 undergo treatment for 6 months the result is good.. hbsag got negative i develop immunity to to antiviral, i use for treatment.. is it possible that hepatitis might be back ?",
    "doctor_response": "Hi thanks for contacting healthcare magic....Noted you had HBSag positive....After six month it was negative means you had free from disease...You have developed protective antibody that gives protection for long duration esp.many years also sometimes....But still now onwards try to avoid HBSag infection.......You can do your anti HBS antibody  titre ....If it is more then 10 then it is protective.Happy to help further if have further query.Take care.Regards;Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedies for tonsillitis\n\nhi there,,,i would like to ask what are the home medicines of tonsilitis?i guess i got one..:(,,,but i felt not so bad,,just something lump when i swallowed,and bit pain, esp,after waking up in the morning,,,,i already gargled warm water with salt this morning, and crashed garlic and i garled the juices too with a bit water,,does it have connection in sleeping late at night? like 11pm or sometimes 12 mid,or 1 am,,i ma quite streeful has work at day and school at night,,,pls,advice me..tnxx.imz",
    "doctor_response": "HIWell come to HCMthere is no home remedy for tonsillitis if the condition is infective then this need to be treated with antibiotic and the best option would be Tab amoxicillin according to age or weight three times in day, hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any treatment to fill the gaps between front teeth ?\n\nHELLO DOCTOR , I AM AMIT, AGE 26 YEARS. I HAVE A BIG GAP BETWEEN MY FRONT UPPER TWO TEETHS. WHAT ARE THE TECNIQUE AND APPROX COST FOR FILLING THIS GAP? THANK YOU.",
    "doctor_response": "Hello, Thanks for writing to us. A diastema is a space or gap between two teeth. It appears most often between the two upper front teeth. However, gaps can occur between any two teeth. Sometimes, a diastema is part of a set of problems that require orthodontic treatment. If you want it done in one visit, then bonding is the way to go. Bonding is considered a permanent material, but that doesn't mean it will never need to be redone, it most likely will at some point. Orthodontics might be the best choice, but it takes longer and will be more expensive, people get braces, which move the teeth together. Often, no matter where the diastema is, you must wear a full set of braces \u2014 on both your upper and lower teeth. That's because moving any teeth affects your entire mouth. Wishing you good health... Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment for typhoid fever?\n\nhi a girlfriend of mine got typhoid fever in IBADAN - NIGERIA released from hospital after 5 days , she gets as drugs ATESUNATE, AMOXIN AND CYPROTEB  + BLOOD TONIC SHE IS BACK HOME NOW BUT FEELS ONLY 50% RECOVERED WHAT IS THE BEST MEDICAL CURE FOR HERE AND WHAT DO YOU ADVICE HER TO DO",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.The prescribed treatment is the combination of the malaria and typhoid.Actually the regimen provided is not the best for the typhoid fever.I suggest you to take the ceftriaxone as antibiotics in place of the Amoxycillin prescribed to you.You can take the injection of the above antibiotics under your doctors guidance.Please do not eat single large food at once instead you can eat small frequent diet. This will help prevent perforation in the intestine.High protein and carbohydrate diet is advised avoid spicy foods.You can also test yourself for the malaria and typhoid in the near by laboratory to get the exact diagnosis.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lumps like two spots on my tongue?\n\nhello , I am not feeling any pain or discomfort but about a week ago . I discovered two spots on my tongue ( on opposite sides but symetrical ) that are hard in the inside almost like lumps but inside the tongue not on the outter area . I think I remeber biting it but Im not sure",
    "doctor_response": "Hello,I have read you inquiry. Biting your tongue could cause a reaction that you describe. Warm salt water rinses, avoiding spicy and acidic foods, anti-inflammatory medication such as Tylenol or Motrin and continued daily home dental care will assist healing. Keep well hydrated and proper nutrition with balanced vitamins especially vitamin B.  Avoid irritants such as smoking and alcohol. you can apply a benzocaine numbing gel if sensitive. You can can have a remaining solid feeling for a longer period with no concern if you bit  the tongue rather hard. It takes time for inflammation to resolve.Observe the area. Look for ulceration and monitor appearance. If your condition worsens or causes an increase in pain, swelling or function, see your dentist for an evaluation. Monitor tongue for any other changes such as size, color, and coating.Other considerations:-inflamed papillae -growth, cyst, tumor-allergic reaction- rough , broken teeth or dental appliance-grinding teeth, likely at night-change in or stressful bite-infection: bacterial, fungal, virusThank you for consulting Heathcare Magic. I am glad to assist you further if you can provide additional details or have more questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the legs to shake during and after a run?\n\nI am on cross country and I have been for four years. I am in very good shape, do not have any health problems that I know of am not overweight don t drink alcohol or do drugs. During and after many of my runs My legs shake uncontrollably for a long time even after I do cool down. They shake in between each step I make and I have no idea why I shake so badly. I do not have anixety and this happens rain at 30 degrees with no jacket on or when it is 110 degrees. Most days I drink 2 liters a day before practice. I have been tested for anemia and I am not anemic. Why do I shake during my runs whether a hard run or not. I almost always shake when I do hills repeats even if the repeats arent fast but I also shake during flat practices. I also always do at least a mile warm Up and stretch. What is wrong with me?",
    "doctor_response": "Hello,It may be due to hypoglycemia and dehydration. For further assessment you may require complete hemogram, blood sugar levels, serum electrolytes after physician consultation. Further treatment mainly depends upon the underlying condition. Till then keep your self hydrated. Do regular blood pressure monitoring. Take balanced diet. Avoid strenuous activity Hope I have answered your query...Let me know if I can assist you further.Regards,Dr Shyam kaleFamily and general physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest an oral opiate for RSD patients\n\nHi Dr. Grief I have RSD and currently am taking a significant amount of opiods 30mg of Oxycontin, 10mg Oxycodone and Ketamine troches for breakthrough pain. My problem is sometimes I fall or the pain is not able to be controlled by these meds requiring an ER visit for morphine/dilaudid. My doctor will give me whatever but I am looking for an oral opiate I can take stronger than y current meds for emergency purposes only",
    "doctor_response": "hi,As mentioned by you that you have RSD I wish to help you in a natural way. To let you know that medicine are always present for providing the symptomatic relief. If taken for a longer time then there might be a chance of having other issues and may lead to future contra-indication of the pain killers.To go with the RSD, it can be helped and resolved with the natural form. Physical therapy can be of help as I have seen many cases who have had RSD and along with medication and physical therapy they all perform well now without pain of the RSD.Also, physical therapy is a long and painful process but I have seen 99% recovery in my cases. I hope the same from you.physical therapist can help you by Therapeutic ultrasound therapy and TENS therapy. later on providing the exercises for stretch relax of the muscle fibres will help reduce the pain. initially it will be a painful process but as practiced regularly will reduce the pain and regain the full functionality.if you have any more questions you can ask me and I will be happy to help you.With the grace of God I wish you a speedy recoveryRegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can cholestasis be diagnosed without taking bile salt levels?\n\nhad some blood tests done for my liver as have some red blotches on my chest appear since ive been pregnant.  At 32 weeks my ALT levels came back at 55, i had some more blood tests on saturday at they are not 111.  I have had a liver scan today, a consultants appointment tomorrow and more bloods on wednesday.  They have diagnosed me with Cholestasis.  Is this something that can be diagnosed without having the bile salt levels done?  I am now 35 weeks and want to push for an induction around 37 - 38 weeks.",
    "doctor_response": "hi.to answer your questions, yes, cholestasis can be diagnosed even without bile salt levels examined. ultrasound is a diagnostic tool with a high sensitivity for diagnosing hepaticopancreaticobiliary tree concerns.. additional diagnostics (such as ct-scan, blood exams) will be recommended as needed. if you're not experiencing any symptom related to it, an elective cholecystectomy (surgical removal of gallbladder) may be done after you give birth. you will be advised accordingly if you consult with a doctor, preferably a general surgeon, re your cholestasis. low fat diet is also advised for now.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat itchy rashes in legs?\n\nRash has appeared on both legs. Over the course of one month, there are time the rash appears to be getting and then there are time it appear to get worse. The affected area itches and is relieved by applying either benadryl or calamine lotion, but does not eliminate the itching or rash.",
    "doctor_response": "Hi Dear,Understanding your concern. As per your query you have symptoms of itchy rashes on legs which seems to be due to contact dermatitis, allergic reaction, and fungal infection. It could be due to heat rash.Need not to worry. I would suggest you to keep your skin clean and dry and you should apply only petroleum jelly and take antihistamine like benadryl twice a day. You should avoid touching or pricking your skin with any sharp object. If condition doesn't get well then consult dermatologist for proper examination. Doctor may order certain test like skin patch test , blood test , allergy test and take history to rule out the side effects of certain drug. Doctor may prescribe immunosuppressants along with anti inflammatory and corticosteroid ointment.  Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes body pain, ear pain and headache?\n\nI am a 30 year old female. Yesterday my entire body ached. Today I woke up and my entire body still aches. More so in my neck, shoulders and arms. I have a headache and my ears hurt a bit. My throat is also bothering me, it feels like its swollen. Any idea what these symptoms are from?",
    "doctor_response": "Hi, The symptoms you have mentioned are commonly seen in viral infection where body ache, headache and irritation in throat is present. As you said you initially had body ache and it has progressed to other symptoms of headache, throat irritation and these can further progress. I would suggest you to take paracetamol tablet for the pain till you visit your doctor. Your doctor needs to do your physical examination and as per your history he will advice you if there is need of any medicines and tests depending on your symptoms. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Manisha Auradkar, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower abdominal pain?\n\nI have a dull ache on the far lower right side of my abdomen since yesterday. I can feel it when I move about. Other than that it is not noticeable. I am not vomiting, or nauseous in anyway (I am rather hungry actually). I also do not have a fever. In fact, other than the dull ache, I am just fine. Should I go into critical care to make sure that it is not appendicitis pain?",
    "doctor_response": "Hi.Thanks for your query.The causes of the dull ache in the right lower abdomen can be :Appendicitis,ColitisRight ureteric problem with urinary tract problems. Lymph node mass and so on. I would advise you :Go to ER as you are rightly thinking as this will help to confirm the right diagnosis to get a correct line of treatment You will get :The physical examination, blood and urine work and Ultrasonography",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cramping and abdominal pain during pregnancy\n\nHi this is my second pregnancy, I feel like I am showing already but I am only 5 weeks along on paper. My last period was Jan 16th and was incredibly light. I have pretty normal pregnancy symptoms but I have noticed in addition that my stomach feels full and tight and I am very gassy. I have had constipation and some very light occasional cramps. Every now and then I will get a more noticable pain that is short lived in my lower abdomen. Passing gas and changing positions usually helps. My question is should I be concerned about the cramping or is it just gas. Also, is it safe to have intercourse at this time. My first OBGYN appointment is not until a month away. I am 5 2 and 33 as of right now (BD in a month). My first pregnancy was normal aside from a cesarean section.",
    "doctor_response": "Hello there, thanks for writing in. 1.  Feeling gassy with tight abdomen and constipation are quite common in pregnancy and can be attributed to loads of progesterone being produced in your body. It is not a concern as long as you can relate your cramps to bloated abdomen and if you feel relieved with passing gas. Do consume lot of fibre and fruits to help you feel better. Warm water helps in intestinal movements and helps constipation. I recommend you to pay close attention if its cramps or if it feels like twisting menstrual like pain in the lower abdomen. If its menstrual like and if you see any spotting or bleeding, then you need to see your doctor early, which I don't think is a likely scenario.2. As your pain can't be reasoned out yet, I suggest you to refrain from intercourse till you see your doctor. There is no harm in indulging in intercourse after first trimester unless its nor vigorous. Few physicians recommend to abstain in the last few weeks of pregnancy out of sheer caution that it may lead to preterm delivery as semen is known to contain prostaglandins which can set off labour.3. As you had very light bleeding (can happen when pregnant) and you are already showing, there is a slight possibility that your pregnancy may be a bit advanced which you will be able to know for sure by early trimester dating scan. It will be useful if you can reschedule your appointment a bit earlier.Hope this was helpful to you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is getting colon resection for carcinoid tumor ideal?\n\ndr. my sister just had a right colon resection for a carcinoid tumor i april 2011 at the time she had 2 spots on the liver that were biopsied.had a ct scan 6 monthes later and has 3 areas onthe liver.she then had an ostreotide test done and just got results = 1 of the lesions is positive for carcinoid it is 1cm.What is your best recommendation now? i would appreciate you advise,thank you.",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. But carcinoid tumours are very notorious in spread and recurrence. And liver metastases are very common.The treatment of isolated liver metastasis is surgical removal. It is known as metastesectomy.In this enblock resection of nodule with negative margin is done.So better to consult oncosurgeon first. And discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe abdominal pain?\n\nI WANT TO CONSULT A GASTROENTEROLOGIST FOR MY DAUGHTER -I AMFROM SION MUMBAI MY DAUGHTER WAS SUFFERING FROM SEVER ABDOMINAL PAIN RIGHT SIDE -SHE GOT ALL HER TESTS DONE, COLONOSCOPY, CT SCAN, BIOPSY -IT SHOWED ACUTE  ILEAL ULCER, THERE IS NO SIGNIFICANT IMPROVEMENT EVEN AFTER A MONTH",
    "doctor_response": "Hi. Thanks for your query.Read the history and understood the problem. ileal ulcer- what was the biopsy report?Was the report of Widal for typhoid positive.?Your not mentioning the Biopsy reports make it difficult to comment . The differential diagnosis is ::Tuberculosis of the small intestine TyphoidChron'sThe treatment will be as per the biopsy report and she will be fine",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the INR reading of 5.2 indicate?\n\nMy husband has been on warfarin for quite some time and his recent INR reading wa 5.0. He was told to skip a dosage and go have it read the next day and it was 5.2. He was told to get to the ER and have a checkup. We are going on vacation out of the country and I am concerned as to what could happen.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Your INR value is very high. It suggest very high prothrombin time. You have risk of bleeding.  You should stop warferrin and consult your physician urgently. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the medical protocol for brain bleed?\n\nwhat is the standard hospital protocol after an elderly person has a brain bleed?  My mom has been lying in the hospital for 8 hours without and food, water, iv's!!!!  they said that this was normal and she needed to be DRY because of the bleed in her brain?  does this sound right?",
    "doctor_response": "Hi, welcome to our site. I am Dr Saumya Mittal.Read your query. That is a very significant question and i appreciate your problem. I will try my best to answer your queryFirst and foremost my sympathies about your mother's condition.As for them keeping her \"dry\", i must explain to you that though that is not the standard protocol, that is entirely up to your doctor to decide. You must understand that bleeding in the brain is not an easy and safe problem. Maybe its a small bleed and possibly your mother seems active.But there is always, the possibility that she may develop seizures or become unconcious, or they may simply need to operate her.In any of these situations, if there is food in her stomach, the chances are high that her stomach comments may regurgitate and enter the lungs thereby making the situation even more complex- something called as aspiration.So I would suggest that you definitely go by the doctors orders.For better opinion I would need to see the MRI/CT that they have done. If possible, upload it and then maybe i can help you betterI hope this helps you. Inform the reports mentioned above so i can be of help further. Best of luck.I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you.Please do understand that some details could be extracted from a detailed history and examination.Looking forward to your return query with the details asked so that I can help you further.(If the answer has helped you, please indicate this)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a large lump in the armpit?\n\nI have a lump under my left arm pit. It started in 2009 and was the size of a pin head. I showed my dr and she said it was nothing to worry about. Now 5 years later it has grown to the size of large grape. It has not oozed any fluid and doesn t have a head on it. Recently I noticed it has a foul odor. It is skin color. It doesn t hurt to touch it. Can you help?",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You may have some axillary lymphnode enlargement due to reactive lymphoid hyperplasia or tuberculosis.  Or you may have lipoma or soft tissue lesion.  You should go for fine needle aspiration cytology.  Then you should take treatment according to your diagnosis. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mild fever while on Tylenol for cough?\n\nmy son is6 years old he is running a low grade fever and has a bad cough when he coughs some times he screams outlike he hurts. my son has cp and autism I took him to his doctor Monday he said it had to run its cours. what can I do to help him I m giving him honey for the cough and tyoln and motin for the fever and pain he is not wanting to eat",
    "doctor_response": "you can try combination of levodropiazine with chlorpheramine maleate syrup 5ml twice a day .Drink plenty of water",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe pain in the tongue due to mouth ulcers. Not able to eat. Need immediate cure\n\nHi i had severe pain in my tounge i was nt able to eat also i consulted a doctor nd they tld me that i had mouth ulsers nd they prescribed me with a gel nd few pills nd it healed withing 3 days. Nw recently 3 days back while havin lunch i bit my tongue nd it startex bleeding but at that time it was nt painin nd the followibg day i was nt able to speak or eat it hurts badly.even now itd the same. My mum is preparing delicious food for dinner and i so badly wanna eat but the pain is insane pls temme wat to do to take away the pain immediately?",
    "doctor_response": "Hi, Thanks for asking the query, Recurrent mouth ulcers occurs due to many reasons like immunlogic defects, vitamin & iron deficiencies, traumatic self inflicted bites , toothbrushing and dental trauma, hormonal imbalance, allergic factors. You have traumatised the tongue accidently while eating, dont worry apply Dologel oral ointment topically over the affected area, Take multivitamin tablets daily . Apply cortisone acetatae topically over the affected areas. Maintain a good oral hygiene, use saline water gargles, antiseptic mouthwash gargles. Avoid eating hot and spicy foods. Hope this helps out. Regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have cirrhosis, renal kidney problems with high BP. Feeling nauseous and belly pain with itchy hands. Suggest?\n\ni have cirrhosis and renal kindy problems along with high blood pressure chronic pancreatitis the last few days i have been feeling tired nauseous and pain in my upper belly and bad back pain also very depressed i haven't felt this way in about 9 months. my hands are itching my belly is bloated along with my angels. i know i have these problems but should i go to the er. i just don't know if they can help me with anything. i looked up the signs of kindy symptoms and i have 7 out of 12. IDN what i should do nor do i know what is making me feel so bad the last couple day's. i have medicaid will the hospital do more test then if i had no insurance because i have had a lot of test done in the past but a biopsy on my liver is what i really need and a MRI.",
    "doctor_response": "Hi, you have cirrhosis kidney problems, hypertension, pancreatitis, Now immediately what you should have is the relief from the pain, and discomfort.                           I to my patient with such symptoms prescribe omeprazole, domperidone, and antacid gel for pain rlief.                           The yoellow skin and itching of the hands suggest the increase in bilirubin. So you consult your doctor for decreasing the bilirubin. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cirrhosis of liver, swelling of legs, swelling in stomach. Had gallbladder removed 2 years ago. Suggestions?\n\nI' m 59, female, had gallbladder removed 2 summers ago. My liver started with hep c now I have cirhosis of the liver. My edema of , lately left me swelling of my legs and feet more obvious on my left and continues. I                had a home injury which is leading to a rotary cuff repair soon. Since my last visit  about July 31  I have been swollen even a distending stomach. I don' feel like eating much but I  try. Is there any comfort I should try before the clinic opens? Done.",
    "doctor_response": "Hello,Thanks for posting on HCM,There is not much you can do at home if you are having complications of cirrhosis (swelling of legs and abdomen/ascitis) besides avoiding to take in too much fluids (there is need to reduce fluid intake) and also reduce salt intake. These are potential sources of fluids and since you are suffering from body fluid retention, it is best you avoid taking more until medical intervention can be done. Taking care of your liver cirrhosis can prove to be tough and you will have to get through a lot of treatment sessions just for temporary relief. You will have to exercise patience and acceptance of your condition. If you are having poor urination, then you might also be having an associated kidney diseases. Hope you stay well until the clinics do open.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden feeling of stiffness in the body?\n\nMy mother , at 73 roller her eyes, hands stiff and stayed claw like. Her hand grabbed my hair and we could not pry her hand opened. She feel backwards, and was unconscious for 1 min. She woke, said she was fine and would not go to the hospital. She is now drinking alcohol and eating. I am concerned.",
    "doctor_response": "hi,thank you for mentioning brief history of your mother. since she instantly clenched her finger and grabbed your hand which was tough to release i am concerned with this.you should meet up a neurologist and get check once. It looks like a Epilectic effect for time being which was of short duration. in the mean time please avoid alcohol. As she is aged she needs a proper attention as falls are good for her. I wish you meet up a neurologist and get check once. there is no harm taking an expert's advice as saftey is the first thing we all should see.with the grace of God I wish your mom a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for facial paralytic stroke\n\nMy freind based in Bhopal has got facial paralytic stroke just 4 days back. He is a male with 35 yrs of age having background of hyepr-tension and suagr. Would you be able to suggest the stroke neurologist either in Bhopal or nearby city for consultancy and treatment??",
    "doctor_response": "Hello, Yes, in such case is a necessary evaluation by the Neurologist for this condition. If stroke is suspected, your friend may be accompanied at the ER also. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can loop be inserted immediately after birth of baby or should we wait?\n\nHi Dr, I have a 5yr old daughter and soon i will be giving birth to my second baby (boy) i never in my life taken prevention tablets or injection and i am scared to start now. my hubby and I have decide that this is our last baby and i want to insert a loop. Is it possible that they can insert it immediately after giving birth? Is it safer? should i wait a month or two after giving birth? Please advise. My e-mail add is:- YYYY@YYYY",
    "doctor_response": "Hi, inserting an intrauterine device after child birth is usually done around 6-8 weeks after birth. Because the uterus is back down to it`s normal size then. The doctors won`t insert it directly after birth - as the uterus still has to shrink back down to the normal size and any intrauterine device wouldn`t be \" held\" by the uterus. Most women won`t have sex during those 6-8 weeks - as you are still postpartum - having postpartum discharge which is first red and slowly turns a different color until it stops after about 6-8 weeks. You can usually talk to the doctor at your postnatal check up - or just after the birth so that the insertion can be organised for you ahead of time. Hope this has helped. kind regards, JR",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain even after taking antibiotics for bronchitis?\n\nI have been on two antibiotics for bronchitis recently.  I finished both courses and I still have pain in my lungs.  I had a chest x ray that came back clear.  I am a little worried because my mother died at at 42 from lung cancer.  The doctor prescribed two inhalers, but they don't help much.  The pain comes and goes.  I don't feel anxious or have any issues with anxiety.  I am concerned about exercising again.  Do you have any ideas of what it could be?  Maybe the infection is still lingering?",
    "doctor_response": "There is a large list of conditions causing chest pain. The causes may belong to any of the systems such a respiratory, cardiovascular, gastrointestinal, Musculo-skeletal. there for evaluation of reason for chest pain requires detailed assessment of symptoms, a through  examination and then relevant investigations. If some one has normal Chest x ray picture, its possible that infection is not so much an issue to cause recurrent chest pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stress\n\nMy son, 30 years old, B.E. in Computer Science, 2008 pass out.  During his college  days at Hostel in Bangalore something abnormal happened and since then he is behaving abonrmally.  Not talking to anyone, Not able to concentrate on the job.  He is not able to continue in any employment more than one or two months.  I request your goodself to help me to whom I should approach.  He is intillegent, leads normal life.  But his mind is always thinks something that we are not able to understand.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  From the description, your son might have come across some negative happening (type of shock) while at his hostel. That happening changed his thinking pattern and then he was habituated with the new habit. We need to understand what happened at the hostel. Then change his pattern of thoughts and habits. Programing or tuning his neural network is what the treatment is all about. A trained psychologist can do the treatment with the help of psychotherapy techniques.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I get tingly hands when I panic?\n\nHello DoctorI get tingly hands when i get paniced ~ example: someone darted in front of my car yesterday and i changed lanes so i could avoid the collision. my hads and forearms seemed to be filled with electricity. It immedialty stoped but it was a very strange feeling ~ what is that?.",
    "doctor_response": "hithanks for using healthcare magicTingling sensation is part of anxiety disorder. U have one episode then there is nothing to worry but in case u have repeated such kind of episode and these episode effecting ur work then it would better if u  consult a psychiatrist and get urself properly evaluated . Mean time u can do some relaxation exercise to stay calm.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could a painful lump on the wrist be?\n\nYesterday evening I realized that I have a lump that is extremely painful when touched, along with swelling and a very light blue bruise that is becoming more obvious on the top of wrist. It is right at what I believe is the distal radius end. It is on the same side as my thumb, but on the side of wrist that the forearm and elbow are. The lump is about buckle size and the bruise covers a wider area, and the swelling is noticeable but ends at the wrist area where a watch would lay. It's making my wrist look very thin in comparison to the swelling next to it! No memory of trauma, no falls, I did not hit it on anything. I have full movement with some pain, and stiffness due to the swelling and my thumb is slightly numb. If I palpitate the area it really hurts but if I leave it alone, the pain subsides to a small full ache. I did do a ton of push-ups yesterday and have been doing them quite frequently the past 2 weeks after years of not doing them. I did not experience pain doing them yesterday, it was several hours later when I found the \"injury.\" What could this be?",
    "doctor_response": "Hello!Thank you for the query.The most probable lump in such location is a ganglion. Its a kind of joint herniation which leads to a lump formation. Such lump is soft in touch, painful and filled with clear gel like fluid. It does not increase cancer risk. However as a pain is present, I suggest you to have it removed.Please consult a surgeon, have an ultrasound of it and consider surgery.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for aneurysm\n\nI'm a 22 year old female, to say I'm a bit of a hypochondriac/worry wart woud be an understatement..I have a friend who's just 24 yrs old who passed away two nights ago due to an aneurysm. I'm not worrying and it's causing me so much anxiety I'm losing sleep. I've been suffering from chronic headaches for 2 years, and I had an MRI about 4-6 months ago and it came back normal. My question is; how long does it take an aneurysm to form? I know I'm over analyzing and thinking way too much into it. But I'm losing sleep over it, and I'm really concerned.",
    "doctor_response": "Aneurysm are of multiple types.It may take days to weeks to form aneurysm.Please get your blood pressure checked along with a TEE",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden pain in left arm?\n\nHi. A friend of mine appeared to be fine, but suddenly could not move his left arm. After 5 or so mins he started to feel a bit better. It turns out he has been having a few bouts of this per year for many years. Sometimes the pain in his heart is great. What could this be ? Your help would be very appreciated.",
    "doctor_response": "Hello, It is necessary performing some tests to investigate for the possible causes underlying your complaints: - a resting ECG - a shoulder and neck X-ray study - complete blood count, PCR, ESR for inflammation. A brain MRI and an EEG may be needed in order to exclude partial seizures that may mimic this clinical situation. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes redness and itching on the forearm and constipation?\n\nI have constipation, pale yellow round rock-like stools, headache, hair loss, small found sores in the outer ear, upper shoulders l. Forearm. Starts with pain, redness goes to itching then blessing without signs of infection. Sores are round about 1/64th inch in diameter. Upper thigh pain & heaviness. P.C. doesn t know, I m to see a gastroenterologist. Also my gums & lips burn. Any help would be appreciated.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.For intestinal motility disorder with skin manifestations the reasons may range from gastroparesis, deficiency of trace elements, minerals, digestive enzymes, vitamin B12 or others, fungal involvement of skin, systemic hormonal imbalances including thyroid and others, and rare immune disorders.Case evaluation need thorough history, physical examination, and supportive data as per clinician choice to reach the root of the issue and decide the management plan accordingly.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Purva Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "My tummy feel heavy after taking antibiotic, are there any home remedies to cure this ?\n\nI`m on anitibiotics (ciprofloxacin) and as a result have my tummy feel heavy. the information on the drug mentions Epigastric distress as one of the side effects(and i guess that is why have this), how do i be relieved from this as i don`t like it when my tummy is heavy. please help, are there any home remedies?",
    "doctor_response": "Hi Welcome to Healthcare Magic Forum Once the course of this antibiotic is done, the sideeffects will fade away. You can take antacids along with this , cold milk, fresh yoghurt helps a lot. Also homeopathic remedies help with acidity, without other unwanted effects, so you can try them as well. Takecare For further enquires- dranshita.rathore@yahoo.co.in",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cause and remedy for difficulty in exhaling\n\nI have shortness of breath esp when active. I have 44 % lung function according to the Pulmonary test. I can inhale but have trouble exhaling. My ct shows nothing. What could this be? I have a wild bird and a chinchilla in my room could they be the cause?",
    "doctor_response": "Thanks for your question on HCM.Yes, birds and animals can be cause for this.As their feathers can cause allergy and irritation in the lung and cause this.In my opinion you should start treatment as your lung function is 44% , which is low for normal. So this low lung function is the cause for your symptoms. Start inhaled bronchodilators like long acting beta 2 agonist and corticosteroids.Antihistamines and anti inflammatory drugs.Better to consult pulmonologist for this.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Kidney pain after taking antibiotics for lung infection. Suggestions?\n\nI was just in hospital with sever lung infection. When I came home they put me on a strong antibiotic that I noticed was causing kidney pain. I quit the pills but the pain is still there. Not quite as sever but I can t put pants on that touch that area. any suggestions? FORGET IT ! I can got to ER or doctors in the AM without paying YOU! What a scam!!!!!!!",
    "doctor_response": "it seems to me some other cause is there.first kidney or ureteric stone is to be ruled out,for which ultrasound abdomen is to be done.second thing is associated kidney infection check urine culture,third is colitis check stool routine,fourth is crystaluria.test needed is urine routine,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the treatment procedures for ovarian cancer other than chemo?\n\nI am a 73 year old woman with a history of ovarian cancer stage 2 since 2004.  I underwent surgery and was told they got all the cancer, I underwent 7 cycles of chemo.  My cancer returned in 2007 and was again operated on for the cancer, they also removed my appenbdix and fixed a hernia.  I have been on different types of chemo since then the latest being the pill VP16.  I have had NED several times during this time, only for it to return again.  It is limited to the abdominal area, liver and kidney.  The organs are not affected, it seems the tumors are outside.  I am now at a point wher I don't feel I want to take any more chem, definetly not through my port, and I believe the VP16 is losing its power, as it seems to be active again, although slow growing.  So I would like to know about alternative methods and would be interested in knowing about Oxy or Oxy DHO.Can you make any suggestions.  I am on the following meds, Benicar HCT 40/25, Warfarin (for blood clots), Proprananol er, lexapro 30mg, macrobid 100mg, vicadin as needed, and vesicare 5mg",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Resistance to chemotherapy develops after 5-7 years of treatment. And you are experiencing the same thing. Your cancer is now inoperable. So better to consult oncologist and ask for palliative newer chemotherapy drugs which are not used in your case till now. You can start palliative treatment in the form of pain management and nutritional support. Consult psychiatrist for end of life issues. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does the cyst in the uterus lead to cancer?\n\ni m 42 years old and delayed for 2 mos. myob gyne askme to have a transvaginal ultrasound. here are the findings, cyst in left ovary about 2.1, no fluid in cul de sac, and thickened endometrium. is there a possibility that i m pregnant? or the cyst found is cancerous? or i mgoing to menopausal stage.",
    "doctor_response": "Thanks for your question on HCM. In my opinion you should not worry much about the cancer. And ovarian cyst looks benign mostly. Get done repeat ultrasound after 3 months and if cyst is same or decreasing in size than no need to worry about cancer.And about thickened endometrium,  I think it is due to menopause only. Your age is also approaching menopause,  and delayed menses with thickened endometrium,  all suggest menopause only.So no need to worry for malignancy.  You are mostly having starting of menopause.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach pain while suffering from liver cirrhosis\n\nhi my father is taking proxyvon.. since 2days... Because he ws suffering from Liver crirosis.. & his stomach was paining so we gave him proxyvon But he not fine.. He does all wired things... Since yesterday i hv stopped giving him this. Hope i hv done right.. Kindly advise",
    "doctor_response": "Hi,How are you? My name is Dr Suresh Raghavaiah. I am a liver transplant surgeon and I hope to answer your question today. By the history you have provided, I am worried that he might be suffering from hepatic encephalopathy which is a complication of liver cirrhosis. Encephalopthy can be precipitated by a lot of things (infections, medications, etc) but in most cases it is easily treatbale. In your Dad's case, it could very well been brought on by the proxyvon tablet, but infections have to be ruled out. Please let me know your geographical location so i can guide you to the nearest liver specialist. Hope this helps and hope your dad starts to feel better.Dr Suresh Raghavaiah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for excess rashes on body in children\n\nPlease help me. My son son have rash for last 3 days. This is the third night treating it Benadryl and Hydrocortisone. On the first day it appeared on his chest neck area. 2nd day it was all around his neck, arms, pits and groin area. Today I notice it in his umbelicus and now on the foreskin.",
    "doctor_response": "Hi, As you have not described the rash, it would be difficult for me to come to a final diagnosis, It could be an urticaria (hives) or eczema. Final diagnosis could be made only after proper examination by Dermatologist. So, do consult your Dermatologist for further management. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, IVF ended at week 20, chromosomal abnormality. How to improve egg quality?\n\nMy pregnancy from ivf has been ended at 20th week because of chromosomal abnormality. We do not have genetic problems. I had 16 eggs , 14 fertilized and I had 2 embrios transferred at blast stage. I am 40 and we did ivf because of sperm issues (morphology problems) . I am tring to conceive again, how can I improve my egg quality? Thanks..",
    "doctor_response": "Hi, You can take antioxidants & mitochondrial micronutrients (Your doctor will prescribe it) to improve egg quqlity. Apart from that you can opt for preimplantation genetic diagnosis to be sure that embryos being transferred don't have chromosomal anomaly. Wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bronchitis asthma, sudden attacks due to climatic change, breathing difficulty. Will asthalin inhaler help?\n\ni have bronchitis asthma from around 7 to 8 years. in between i had lots of trouble with it but then it was controlled by ayurvedic medication then i was relieved. but now sometimes because of climatic change or any incentive smell i get breathing trouble. am taking asthaline inhaler if any trouble.i have got ideopathic hypertension also last year. are there any medicine effects i need to face more? can i cure my asthma problem?",
    "doctor_response": "Hi, I do not have access to any of your reports. But from history, it seems to be a case of asthma. Asthalin alone will not help you. You should take  either formoterol-budesonide(200) 2 puffs twice daily or salmeterol-fluticasone(250) 2 puffs twice daily.The dose has to be adjusted according to your clinical symptoms. You may also take influenza vaccine as you gave history of frequent cough and colds. You did not mention which medicines are your taking for your hypertension. If ,you are taking betablockers, it may worsen your asthma control. Asthma can not be cured but it can definitely be kept under control if you take above prescribed inhalers daily.Hope, i answered your queries. Thanking You.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe abdominal pain, lightheadedness after stent removal?\n\nHi my name is Judy. I have had a kidney stone removed this past summer and had a stent for one week. When I had the stent removed I experienced a lot of pain in my abdomen. The pain is persistent, and now I am light headed all the time. I am scared, and have been to see the doctor to rule out diviticurlites (sp).",
    "doctor_response": "HI THANKS FOR POSTING YOUR QUERY ON HEALTH CARE MAGIC.GOING BY YOUR CLINICAL HISTORY,I WOULD LIKE TO TELL YOU THAT PAIN AND GIDDINESS IN YOUR CASE ARE PHYSIOLOGICAL AND THAT YOU NEED NOT EXCESSIVELY WORRY ABOUT IT.POST STENT REMOVAL,PAIN CA BE CAUSED BY STRETCHING OF SMOOTH MUSCLES OF RENAL TUBULES AND URETER.THIS IS ASSOCIATED WITH AUTONOMIC REFLEX FALL IN BLOOD PRESSURE CAUSING GIDDINESS.THESE SYMPTOMS SUBSIDE BY ITSELF,OVER TIME.IN CASE THEY DO NOT RESOLVE,TAB PROMETHAZINE AND TRAMADOL WILL HELP.TAKE GOOD AMOUNT OF WATER TO KEEP YOU HYDRATED.DIVERTICULITIS IS'NT RELATED TO YOUR CURRENT ISSUE.HENCE YOU NEED NOT BOTHER ABOUT IT.IN ANY CASE OF DISCOMFORT GET A NON CONTRAST CT SCAN OF YOUR ABDOMEN TO DETECT VARIOUS CAUSES PERTAINING TO CURRENT ISSUE.CONSULT EXPERT UROLOGIST FOR FURTHER HELP.THANK YOU.TAKE CARE.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in ovary when having kidney stones\n\nsir i had the kidney stone so i was under treatment but suddenly i felt pain in my right ovary. ultrasound revealed enlargement in right ovary.two days before i went to see gynecolgist and she gave me some medicines. last day my periods started and today i felt something white thin net like substance with blood,hardly visible.what is that sir ,do i have a bigger problem. plizzzz answer",
    "doctor_response": "Hi, The kidney stones and ovarian enlargement is not related. You can continue the medicines prescribed by your gynecologist and you can take analgesics like Mefenemic acid for pain relief. If symptoms are more severe, you can consult your gynecologist again. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce pain that radiates from hip to knee?\n\nI slipped on the tile floor and fell kneeling down on my left knee. I have a goose egg right under the knee. I can bend it but the pain is terrible when I do bend it. I also have pain in my left hip when I sit that radiates down toward the knee. I have taken advil and iced down the knee. What else can I do for relief?",
    "doctor_response": "Hello,Having some rest and avoiding walking is necessary in the next days. If the pain persists, I would recommend consulting with an orthopedist and performing an X-ray study of the hip joint and the knee. A knee MRI may be needed.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any side effects of taking Benforce and folic acid?\n\nhi doctor my name is shaila    i am 32  years  my weight is 52 kgs and my height is 5 feet.i got married 1 year 8 months back and had undergone 2 miscarriages now i am planning after 8 months doc suggested me to take benforce m and folic acid tablets daily .little tensed for i had undergone 2 miscarriages.",
    "doctor_response": "Hello Madam,understood your concernPlease do following test before planning pregnanacy  beacuse you had 2 Miscarriage1.S TSH2 RBSL/HBA1C3 VDRL4 Antiphospholipid antibidy assay5 HBsAg6 USG PELVIS 3D preferably to rule out any uterine abnormality If everything comes normal than continue FOLIC ACID , If HBA1C  abnormal than take BEnfoce otherwise NOgood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy scrotum pain\n\nMyhusband was cutting down a tree and lost cntrol of a large branch. It came down and hit him in the face, the force knocked him back and he fell on his butt hard. He is experience scrodum pain now, is that serious? My husband is 60, weighs 200 Lbs, high blood pressure.",
    "doctor_response": "HiGREETINGS Any traumatic scrotal pain has to be examined by a qualified doctor to rule out torsion or haematoma. Hence I suggest you to get it evaluated properly.At times it can be an acute emergency.Hope my answer helps you. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hives and body pain despite taking Prednisone\n\nI am 23 years old, female in generally good health. no allergies, no major surgeries I work as a certified nursing assistant in a care home. in Feb of this year I suddenly broke out in hives with fever and terrible body aches, swelling and soreness. had many, many blood tests, x-rays, etc. was placed on Prednisone and weaned off slowly, but once I got to 4 mg BOOM all the symptoms came back. there was never a definitive diagnosis, however the working diagnosis was human parvo virus. I have now been sent to a rheumatologist who had more blood tests done, but I am on 50 mg of Prednisone a day, so tests showed nothing, except continued inflammation. I am at my wits end",
    "doctor_response": "Dear Patient,in my career, resistant hives were related with parasites. This is particularly true if gastroenteric symptoms are coexisting. I recommend you to search intestinal parasites doing a direct microscopical observation of stools, then CBC is important to exclude high count of basophils (which are generally rare in normal CBC), total IgE, hepatic function. Then, I would perform an abdominal ultrasound and, if gastrointestinal symptoms are present, a colonoscopy and an EGDS. Let me know",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for mental health problem\n\nHi, I feel I have some problem with my speech. I feel it really difficult to phrase what I want to say I think I have lost the sense of words. This has started to happen after a small house hold accident. I slipped in bathroom and have lost recognition to any one or anything at all for whole night but slowly came out of it. Since then this lost of recognition is with me. it was frequent in earlier days but getting better now, all by itself. i some time lose sense of judgement or decision making or I am listening but actually I do not know what other person saying or forgot about something at all. I am absolutely normal but people could be thinking that I am talking weird, its embarrassing and I think I am making even more mistake and annoy people at my job. I am planning to all this for last 4 months because if I say to my doctor without planning they will say may be its nothing and I will miss important detail to tell them.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. I sincerely suggest that you are victim of your own negative thinking. If you are sure that you will not be able to convince others about your current problem, then possibly you are over doing. In psychiatry, we have clear cut symptoms and definitions to disorders related to mind. If you visit a psychiatrist / psychologist, they will be able to diagnose the problem you are in, just interviewing you. You don't even have to explain all these things. Just don't worry about what others will think about your problem, just approach a capable and reliable trained person and he will treat you well.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to remove abscess formed after tooth extraction?\n\nhi about three weeks ago I had a tooth extracted which was infected. the dentist believed it was connected with my sinus cavity.... I have bad teeth and am getting dentures. out of all the teeth being pulled this one developed an absess like bumb right above the socket on my gums its been hurting this whole time the doc put me on a heavy antibiotic but it isn't going away. my dentist cant get me in for a while, and hasn't looked at it what should I do. I have a history of severe  tooth infections resulting in hospitialization",
    "doctor_response": "Thanks for your query, i have gone through your query. the bump or growth at the site of extraction could be a socket granuloma. consult a oral maxillofacial surgeon and get a radiograph done to rule out any residual infection and oroantral fistula. if there is infection still you need to get it curretted irrigated with betadine and saline. if there is a socket granuloma, then it has to be removed surgically.i hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication to reduce severe vomiting during the 15th week of pregnancy\n\nHello doctor, im 15weeks pregnant, and still vomiting like 1st 3mnths. Can you please tell me whether Digene or Pan d is safe or not during pregnancy? Should I take these to control acidity, heart burn, vomiting? And im taking another pill named Doxinate suggested by my doctor. Bt now he told me to stop taking Doxinate. Is there any problem if i continue with Doxinate, cz it hlps me to control vomiting. Plz reply... I need you precious advice. XXXX",
    "doctor_response": "Hi,1. Digene and Pan-D are considered to be safe during pregnancy hence you may take these to control acidity and heartburn. Remember, Pan-D has to be taken on an empty stomach one hour before meals or snack.2. Doxinate is also considered to be safe during pregnancy hence it is prescribed to treat vomiting, there is no problem in continuing with Doxinate.3. I would recommend Doxinate with Vitamin-B6 or Meclizine or Promethazine if the vomiting is not controlled with Doxinate alone.Beside, other causes of severe vomiting should be detected and treated accordingly.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having a rash on the head of my penis?\n\nHello and thanks. I have what looks like a rash on the head of my penis and down a little on the foreskin . There has never been any pain or itchiness. What could that be? My girl did have a bladder sling put in and then had a snip of the tie off creating a sharp edge in her that will sometimes cut me. Any thoughts?",
    "doctor_response": "Hello!Thank you for the query.Its hard to give exact answer not being able to see it. Such rash usually indicates some kind of local infection. Usually fungal infection appears in this location but other type of infection are also possible.I suggest you to visit dermatologist. In case of fungal infection, antifungal agent will be necessary. If you have also burning while urinating, urine analysis should be done.In a meanwhile try to keep affected area clean and dry.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can squamous cell carcinoma be treated?\n\nHI, My mom was diagnosed with squamous cell carcinoma. It s been metastasized in lungs and liver but we can not find the place where it s spreading from. She currently resides in Russia but I have all her info and analyses here in NYC. Is it possible to consult an oncologist with all the biopsy, MRI s, etc. that I have from her? Thanks in advance.",
    "doctor_response": "Hi  Since squamous cell carcinoma has been detected which has spread to liver and lungs I would suggest you do a whole body pet scan and a biopsy from any space occupying lesion to find the primary source of cancer and then only treatment can be decided. RegardsDr De",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can we manage overactive bladder?\n\nHi doctor, I do not have a UTI. A test was done to check my kidney function and diabetes. I have the urge to urinate for the past one month. I urinate more in the morning, and it gets decreased during the day and at night time. I have muscle aches on the thighs, arms, and back. I have bloating and constipation for the past two months. I am taking Culturelle and Metamucil.",
    "doctor_response": "Hi. I have gone through the attachment (attachment removed to protect patient identity). If your tests have ruled out urinary infection, you may have an overactive bladder. Take a moderate amount of fluids throughout the day. Do not take a large amount of liquid at a time. Avoid taking tea, coffee, alcohol, and soft drinks if possible. Try holding your urine for five minutes longer than usual, and increase to 10 and then 15 minutes every week. For example, if you go for every 15 minutes, now try holding for 20 minutes. You can start a beta-adrenergic called Mirabegron if your doctor advises. Try to reduce weight. Avoiding constipation will help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can petogen injection have negative effects on an unborn child?\n\ndoes petogen injection have negative effects on an unborn child? i just realised that i am expecting 3weeks after i had my injection. my worry is will the baby be born normal and i took home pregnancy tests they both were negative so now i am confused",
    "doctor_response": "Petogen has effect for nine months give as bimonthly injections and if your pregnancy test is negative, why worry? Better confirm with gynae specialist once more. Yes, it may affect baby and so be sure you are not pregnant.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for severe chest pain?\n\nHello, My dad has been admitted to hospital because he was experiencing terrible pain in his chest and was feeling very uneasy. After a scan was done the doctors found out that he his aorta had strated leaking. Now the leaking aorta has formed a blood clot and has stopped the leak. He is unconcious right for the day he was admitted. It is now 3 days that he is unconcious and in the ICU. He had also gone through an angoplast a few years ago and also has pressure problem. He is about 75 years of age. Could you please suggest what is the best option or surgery taking into account all his medical problems and age that can be done for him. Also if surgery is done what are the chances of survival after surgery for a 75 year old man. Thank you for your help",
    "doctor_response": "Hello,Your father mostly having a ruptured aortic aneurysm. It is seen with uncontrolled hypertension in old age. It is a life-threatening complication. Surgical repair of an aneurysm is the only treatment option. But survival after surgery is very less. So considering his age and medical condition, I will not advise surgery because there is a risk of death during surgery.  Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Kaushal Bhavsar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to stop urine and semen leakage\n\nHad painful prostatitis and was treated with a heavy anti-biotic. 6 months later my prostate is normal with no pain but I still leak urine for 10-20 minutes after I urinate and leak semen after i ejaculate. I never had precum until a year ago and that's when the prostatitis started. After long erections without relief i still have a large amount of precum. How do i stop the urine/semen leakage?",
    "doctor_response": "Hello, To avoid semen leakage you can masturbate and take urine culture in order to retest for prostatitis. Gently massage your prostate to get relief. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i take a CT scan sooner to follow up chest infection and pneumonia?\n\nI have had a recent CT scan that shows I have 2 lung nodules , one 13mm and one 26 x 13mm with ground glass opacity. I recently had a severe chest infection and pneumomia. I have been advised to have a follow up CT scan in 3 months. Is this wise or should I follow up sooner?",
    "doctor_response": "thanks for asking your question I completely understand your issue actually physician has requested for a followup ct to see the nodules , if they grow in size in next three months or they r stable or regressing.followup ct scan to evaluate for lung nodules is a low dose ct after 3 months .if your problem increases and symptoms doesnt regress then u need to visit a pulmonologist and evaluate for the cause he may or may not order for a review ct scan.dont panic thanks / regardsfeel free to ask more questions may god bless you with good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful lumps on legs?\n\nI have a lump in the lateral segments of gastrocs in each leg. The lumps are painful when pressed and sends pain down to the foot on the lateral side. When the calves are pressed or squeezed the lower leg gets pins and needles. Are these symptoms of torn muscle? No pain when I run or stretch. Numb after running. There is mild swelling of the calves each evening and feet sometimes become numb.",
    "doctor_response": "How long you have noticed this lump and since when you started noting the pain in them are important for us and whether similar lumps you have noticed in any other part of your body since your childhood and what is present age of yours. These info are relevant . Please take pains to revert us or better see a GP of your locality to cone down the approach now.Thanks for the query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the multiple enlarged lymph nodes be due to inflammatory etiology?\n\nMy daughter 11yrs old has been diagnosed with supraclavicular lymphadenitis, ultrasound scan report says she s got hetergenous mass lesion measuring 2.7x1.4cm with internal necrotic areas & surrounding echogenic(inflamator) regions noted in left supraclavicular region...likely matted lymphnodes with suppuration / abscess. Multiple discrete enlarged lymphnodes in the neck on left side.....inflammatory etiology.....? tuberculosis Dr. suggests immediate admission and observation for next 48 hrs with further tests to determine cause and suggest treatment .... Your views please",
    "doctor_response": "Report is suggestive of Tuberculosis.Further tests and treatment is essential but she is active and eating well ,this can be done from clinic also.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can dry mouth and redness on the tongue while in Synthroid be treated?\n\nI have a thyroid that's on \"part time\" I've been on Synthroid (88mcg)and cytomel (5MCG) for about 6 years. I was feeling good and my recent blood work was in good shape. Fairly suddenly (2-3weeks) I find that I have a very dry mouth, especially at night and the edges of my tongue look red, rough and irritated. Also, at about this same time I have had digestive changes, more constipated than usual and bowel movements that are difficult to start and take the form of lots of small pebbles. Any suggestions? I do take a Centrum Silver and a prostate supplement, but I have been on them for 10 years.",
    "doctor_response": "Hi, Drugs used to treat thyroid problem, multivitamins and drugs to treat prostate disorders can cause allergic reactions involving tongue, oral mucosa. The tongue can inflame, look reddish and the patient can feel dryness. Thyroid drugs can also cause as you are taking now sweating which may lead to dehydration that can also contribute to dryness. Digestive changes can be seen when a patient takes drugs and most of the drugs have impacts on the gut. Your hormonal changes can also contribute to constipation. Diet may be a factor which is well aware as I tell you frequent non-vegetarian, lack of sufficient intake of fluids can cause it also. Habits like mouth breathing or snoring may be in your case due to some problem. I suggest you certain preventive measures so that you may be relieved from it: - Take fibrous foods, fruits and vegetables in the diet. - Take plenty of liquids and fruit drinks. - Reduce consumption of meat and meat-based products. If symptoms don't subside in a few days, then consult the dentist and physician. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Soheel Hussain Zargar, Dentist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a bulge below the navel region?\n\nI fell almost a year ago and landed on a bar across my lower abdomen the Drs told me i had a hematoma it was dtained twice we got over 500cc out. Now i still have a painful buldge beloe my bellybutton and still cannot put anything around that part of my waist because its painful. I jog and exercise 4-5 times a week and am very health concious but all the Drs keep saying is its fat. Ive never had a buldge before my fall",
    "doctor_response": "Very fact that you underwent drainage it could again be part of that trauma, hematoma. Do one thing, get a soft tissue scan on that particular area, it'll clear the doubts. We can then plan for treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause lump on penis?\n\ni hope u can help me my partner has found a lump on his private parts made an appointment at the doctors the doctor didnt even look at it and sent him to a clinic that he said would help they told him he had to go to a walk in centre that have now told him his doctor shouldnt of sent him but go to local hospital he rang them and has got to wait for an app its now 4 days of waiting and hes worried sick i just want to no why the delays when it could be very serious i dont know what else he can do to find out what the lump is",
    "doctor_response": "Hello, Without a physical examination of the penis, it would be impossible for anyone to provide you any diagnosis on this matter. The lump could be pimples, pearly penile papules, genital warts etc. For the time being, do not worry too much about it because it may not be anything serious. Wait for the doctor to inspect and then investigate. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lack of focus and concentration with a history of having anxiety?\n\nI have lost my drive and motivation to work even though I meet work obligations, I sleep excessively during the day, do not go to sleep until between 1 and 3 each night, have a history of anxiety and I attract men with personality disorders? What is wrong with me",
    "doctor_response": "Welcome to HealthcareMagicIt would be wise to tell a little bit more about it..Are you having these1.low mood2.easy fatigue3.unable to enjoy activities which were previously enjoyable4.loss of concentration (as u said is it regarding work or generally in any category)if yes then you might be in depression ..please elaborate a little since how long you feeling it.so we can help youRegardsDr Varun",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes redness and tenderness around belly button after gall bladder surgery?\n\nI had gall bladder surgery 5 weeks ago and they repaired a hernia at the same time.  However, I had the flu last week and was vomitting a lot so I think this strained my hernia.  I have redness around my belly button & it is very tender above it.  What do you think it is?",
    "doctor_response": "hi.it is best if you do a follow-up consult with your surgeon for physical examination and clinical evaluation regarding your concern. your post-operative wound might have developed an inflammation or a seroma formation. daily wound care and completion of antibiotic regimen is also recommended. other diagnostics and management will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes palpitation in chest?\n\nIm having an odd palpitation in my chest just to the mid right of my left rib it has been happening all day this is a first and im 22 yrs old. i dont know whether to be worried about this or not its not a severe palpitation its subtle but nerving, any input?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Most common cause for palpitations is stress and anxiety. But better to rule out arrhythmia (rhythm disturbances in heart) because this can also cause palpitations in young individuals. And if not treated promptly, arrhythmia can be life threatening. So consult doctor and get done ecg, 2d echo and Holter monitoring (24 hours continuous recording of ecg). If all these are normal then no need to worry for arrhythmia or other heart diseases. Sometimes undiagnosed and uncontrolled stress can also cause palpitations. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on it's solution. You may need anxiolytic drugs too. Don't worry, you will be alright. But first rule out arrhythmia. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cystic schwanomma and chronic neuropathic pain\n\nHi, I was treated for cystic schwanomma (benign) through surgery and have chronic neuropathic pain. I did a routine health check with the key results as follows: Hb is 11.6, ESR 45, Alkaline Phosphatase is 215 IU/mL and Hba1c is 6.4. Otherwise, LFT, Peripheral smear, Renal function test, s. electrolytes are normal. Ps provide ur opinion, thanks.",
    "doctor_response": "Hi, Welcome to HealthCareMagic.com  I am Dr.Bruno Mascarenhas, and I am happy to answer your queries. I have read your question with care and understand your concerns. Let me try to help you.  Your Hba1c is 6.4Your Chronic Neuropathic Pain is Probably due to Diabetes. To treat it you have to 1. Manage Diabetes Properly and Keep Blood Sugar under Control 2. Treat the Pain with Drugs like Pregabalin, GabapentinHope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.Best Wishes for Speedy Recovery Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are lumps in pubic area abnormal?\n\nHiI had an injury to my pubic area following a motorcycle accident in which the aceelerator handle struck the area hard. Its been 7 months from the accident and i still have a small lump on the right side of my pubic area above the penis where the handle hit me. It also feels like it might have spread to the left a bit but i might be just paranoid. Should i be worried??",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have history of trauma.  So there is chance of extravasation of blood.  It accumulated in that area and produce lump which is called hematoma formation.  If you have small lump then no need to worry it will absorbed by body.  If you have large lump then it should be drained.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe abdominal cramps at night?\n\nPlease help last night extremely bad cramps in my stomach then I had to rush to the bathroom. I'm have yellow dirhera that burns. It's more like yellow liquid now.  I had this all night long and now. I had my gal bladder removed in 2007. I also get this every once in a while for the past month. This time is worst.",
    "doctor_response": "Hi your symptoms may be rel;ated with  gastroeneteritis. You need to  take p[lenty of water, tasectan , hydramine. if  you dont  have improvement after a couple of  days you should  do fecal exams to rule out bowel infection. wishing you all the best DR.Klerida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have tingling sensation in my neck and back which reduce on stretching the neck. Why?\n\nHello doctor, About a week ago, I started to notice a fuzzy tingling sensation going down my neck and back when I look down at the floor. If I continue to stretch my head forward and back, I no longer get the sensation down my back and neck, but this sensation will come back after I have not looked down for a while. The closest thing I can find that matches my symptoms is the L\u2019Hermitte sign. I do not have any other symptoms, my vision is fine, I have no problems with balance or anything else associated with MS (as L\u2019Hermitte is typically found in MS sufferers) but this was the only disease I could find that fit my symptoms best. Nothing is painful it is just a weird sensation. I have had no accidents or traumas to my neck or anywhere, and I do not take part in any aggressive physical activity. I am otherwise active and healthy, BMI of 26.2. I am a 25-year-old male. Just to mention, I do have a bad back posture if this is contributing?",
    "doctor_response": "Hello,  Welcome to icliniq.com.  Your query will be addressed properly and you will be provided with best of the treatment, I assure you that.  Now Coming to your condition, your BMI (26.2) comes in preobese category which could be one of the cause of tingling sensation because weight puts more pressure on your spine and your bad posture may add up to your condition. Do you spent lots of time in front of screen like mobile or laptop? Given your medication history, are you taking it for asthma? Which other medications have you taken for it before? Is it under control?  I can prescribe you proper drugs and exercise, but I have a few questions about your condition that need to be asked. If you can join me for the follow up, or hotline chat, it will help me to analyze you properly and you will be fine with proper guidance. follow up with details.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Unable to conceive after missed abortion. Laproscopy, dye test scheduled. Will they cause tubal blockage?\n\nHi, I was not conceiving after i had a missed abortion on August 2010. Now the fertility specialist have recommended me to undergo a laproscopy and DYE test together. I m pretty confused if this will lead to any problems in the future like tube blocks. Further I would like to know if the period or the ovulation be early or delay after laproscopy ?Kindly help. Thank you.",
    "doctor_response": "Hello Nazreen. Thanks for the query. Laparoscopy with dye test is done for definitive diagnosis of patency of Fallopian tube. Dye test removes any debris like small mucus plug . Dye contains iodine which further increases the ciliary movements of the Fallopian tube and thus improves your chance of pregnancy. So i recommend you to go for laproscopic dye test. Your ovulation or periods will not change because of laproscopy. Regards and good luck. Dr Nilofer",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling lump in collar right under penis head after intercourse?\n\nI am a 57 year old male with a monogamous relationship with my wife of 20 years. I am circumsized. We have to use Astroglide for intercourse due to my wife's dryness after a hysterectomy. Lately I end up with an oblong lumpish swelling in the collar right under my penis head where my foreskin was removed. Could this be some latent std? Or possibly a reaction to astroglide on my part? I have extremely sensitive skin. Thank you",
    "doctor_response": "Hi ! Good evening. I am Dr Shareef answering your query. Even though chances of STD are remote because of your monogamous relationship with your wife, I being a doctor would advise you to under go tests for it after getting it physically examined by a dermatologist in your area to rule this out.The lumpish swelling could also be due to friction and the foreskin attachment with the penile shaft being pulled up causing a small hematoma in there. This could be said with certainity only after getting physically  examined by a doctor. If you are using astroglide for the first time, sensitivity to this reagent can not be excluded. Whatever it could be, I would advise you to get your self reviewed by your family physician/dermatologist to arrive at a particular diagnosis.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does providencia rettgeri have any natural remedies?\n\nI have been diagnosed w/Providencia rettgeri, my dr proscribed ciprofloxen, I also have high b/p are there any natural remedies?  I have been taking cranberry capsules and it is better 90 %.  I was using a catheter, must not have cleaned it well enough.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.No, it's not having any natural remedies.You should take the completed treatment to clear the infection. Antibiotics prescribed to you is ciprofloxacin, this is right and you should take it.Please do not substitute the therapy with other home remedies. This will otherwise makes the condition worse.If you are catheterised patient then there is nie way that you can escape from taking antibiotics.If you have used the dirty catheter than your infection arises from this situation..Now as you are free from the catheter, you should maintain good local hygiene with frequent cleaning and dressing. This will help in cleaning infection form the urinary tract.Please drink plenty of water it will help you flush the bacteria from the urinary tract. I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and cold in a child\n\nHello , My son is 8 years old.he is having cold from 7 days and fever from 6 days. Doctor has prescribed Relent syrup and Dolo for cold and fever reduction respectively. We had consulted to doctor after 4 days of beginning of cold and fever.The fever varies from 99 F to 101.8 F and still persists. What is needed toj be done?",
    "doctor_response": "Hello dear,welcome to HCM forum.You was given paracetamol and antihistamines.As the fever is persisting,we have to add antibiotics after examining the chest.I usually gives antibiotics like amoxicillin+clavulonate or azithromycin for 3 to 5 days.Your doctor will guide you.Meanwhile,continue present drugs.Hope you will find this answer useful.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Spot on pancreas. History of colon cancer, pancreatitis. Chances of survival?\n\nMy mom 79 had colon cancer that mestasised (?) to the liver she is a 6 year survivor of both....has had regular yearly check ups a little pancreaitis the last one being about 2 years ago. Went for her annual check up today and they discovered a spot on the top of her pancreas doing an endoscopy friday......I know pancreatic cancer is bad is there any chance of survival?",
    "doctor_response": "The life expectancy for stage 4 pancreatic cancer is very low and is worst among all forms of cancers. The median chances of survival for patients with stage 4 pancreatic cancer is about 3 to 5 months. The reason for the low life expectancy for stage 4 pancreatic cancer is that the cancer is not confined only to the pancreas. Prognosis of stage 4 pancreatic cancer is thus not very good. Unfortunately, the cancer does not show many symptoms in its early stages and is only diagnosed in advanced stages.Regards and take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can stress be the cause for rapid heart beats?\n\nHello Doctor. I write cause sometimes my heart starts to rapidly vibrate and beats at a bit more than 200 pulsations per minute ( I am sixteen years old) for no more than 5 minutes, then it returns to normality.It is impredictable to know when is gonna happen each time, no matter if I am doing exercise or just sitted. I am sedentary and a very nervious and stressed person. Could this be the causant of this problem?",
    "doctor_response": "stress can cause palpitations but what ever u r explaining doesn't look like a stress but a kind arrhythmia called as psvt. so you should see the cardiologist and get investigated. test like holter and electrophysiological studies will be done according to need. most of the times it's a treatable condition",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does red spots on tongue indicate herpes infection?\n\nI have these little red dots on the tip of my tongue. I ve had them before, this is the second time and last time it lasted a week or so. It doesn t hurt when I eat or anything but it stinks when I brush my teeth. Also, I ve had fever blisters since I was two years old. Could this be oral herpes on the tongue?",
    "doctor_response": "Hello, Welcome to HCM,The herpes simplex 1 is known to affect the area around the mouth and it will not affect the mucosa and it is confined to area between moth margin and the skin.The symptoms which you are giving are more in favor of aphthous ulcer which is red in color and painful and it is mainly due to deficiency of vitamins.The sharp teeth, spicy food and the drugs can lead to these symptoms. It can be prevented by avoiding these risks. I would suggest you to apply ulgel cream on the lesion and consuming daily vitamin B complex.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and shortness of breath?\n\nI'm experiencing dizziness, that come with feeling to faint, light headed, rubbery legs, sweat and shortness of breath where I gasp for air daily & pretty much at the same time for a wk now. No possibility of pregnancy, blood work was done about a month ago & all came back normal",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. By your history and description, we should first rule out heart and lung diseases. So first get done ecg and 2d echo.Then get done PFT (Pulmonary Function Test). If all these are normal then no need to worry for major heart and lung related diseases. Sometimes stress, anxiety can also cause similar symptoms. So better to consult psychiatrist and get done counseling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic drugs too. So avoid stress and tension, be relax and calm. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedies to prevent pregnancy after unprotected sex\n\nI want to stop myself from getting pregnant. My husband accidentally ejaculated inside me tonight it hasn't been 24 hrs after that. So any home remedies? Not sure if i would be able to reach a Doctor in 3 days since there is a curfew going on and i don't want to get pregnant since i'm in my middle year of Degree.",
    "doctor_response": ",          short answer: use post coital pills         detailed answer: first of all i would like to know what is your last menstrual period, you might have had sex in the safe period if so nothing to worry about. but if you had sex in the unsafe period then immediately after sex you have to wash your genital organs with water and soap as deep as possible. there are post coital pills available which will prevent you from being pregnant.hope this finds useful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life expectancy while suffering from cardiomyopathy?\n\nhello..my father was diagnosed with cardiomyopathy 7 years ago ..at that time he had an only 30% of his heart working..last week he went for new test..and the results were that he has only a 20 -25% working heart.  What can we do?? where can we go ?? what is his % of life???",
    "doctor_response": "HelloThanks for sharing your concern..I understand that he has been diagnosed with Cardiomyopathy. However it would have easier for me to talk about his prognosis (future health), if I had known his age, whether he had a heart attack before, what kind of therapy he is currently receiving, and any specific cause identified for the cardiomyopathy. These will have a strong bearing on how long he continues to live. I hope he is receiving the best possible medical therapy which will include drugs like ACE inhibitors/Angiotensin receptor blockers, beta blockers, aldosterone antagonists as these are known to prolong life in these patients. However the specific choice of drugs will depend on his history and other findings that are picked up by your treating physician. Besdies medication there are even device therapies like the implantable cardioverter defibrillator or the left ventricular assist device which have clearly shown to increase life span of the cardiomyopathy if the patient is fit to receive them. You can check with your cardiologist about this.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful lump under the skin after insect bite\n\ni was out visiting a park yesterday in raleigh nc.  something bit me on the neck.  no big deal, i didn't see it.  i feel it now.  None the less, it is burning, elongated, and painful.  I now have a knot the size of a small gum ball behind the ear on the side of the bite.  I have several sore lumps and sore surrounding tissue developing under the skin at my hair line on the same side and now i have noticed a painful lump forming under the skin near my jaw joint.  it is getting larger and causing a throbbing pain when i hold my head down.  i also have the burning sensation on the bite area and sore neck where the lumps are at the hair line.  what should i so?  I have been rubbing the bite area with alcohol swaps today.    The bite area is very sensitive to touch.",
    "doctor_response": "Dear, Lumps are lymph nodes of body which contain your infection and inflammation. i suggest you to use mupirocin local ointment, Ibugesic plus tablet and penicllin group antibiotics. for 5 days. good bye. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cluster of bumps inside the buttocks of a child?\n\nI have a 2 yr old that has a cluster of bumps on the inside of his butt cheeks. They were itching him last night so I put AD ointment on them. He has not scratched or complained about them today. They don t appear to filled with any fluid. Any ideas?",
    "doctor_response": "if this diper rash is of a small size , red and sometimes can give a small blood tinged diper it's usually a contact Dermatitis and A&d ointment will protect the skin and moisturize it and will do the trick .but if these rashes have white satellite like slits , it's usually a candidal skin infection due to increased humidity at this area and candizole  cream can treat them .if this rash is  red raised papules that are very tender to touch then it could be a staph infection and fuscidin cream will be appropriate  .I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hypertension and high BP\n\nHi i am 23years old! I have had problems with hypertension starting almost two years ago which was initally thought to have been caused by the pill, i was started on hypertensives which were stopped when my blood pressure was controlled. However since then i have continued to often get high blood pressure readings but they are inconsistent and recently have started to feel  a bit light headed. My only health history is a goitre, as i have a positive antibody i m not on thyroxine yet but get my blood tested every six months. What could be causing this? shuld i be concerned???",
    "doctor_response": "you are 23 and hypertensiveit can be a renal artery stenosis get a color doller done there is a condition called pheochromocytoma in young person ,its a tumor of kidney and cause high blood pressure in very young age blood levels of metanephrines and vinylmandelic acid and mri abdomen should be done to rule out the condition",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with cirrhosis of the liver. First diagnosed with Hepatitis C. What kind of doctor should I seek?\n\nHello, I have been diagnosed with cirrhosis of the liver.  I was first diagnosed with Hepatitis C 5 years ago.  My current doctor wanted to send me to a infectious disease doctor, however, I don't think an infectious disease doctor is the correct choice since I now have cirrhosis.  I read interferon treatment will not cure cirrhosis.  My doctor now wants me to see a Therapist.  What kind of doctor should I seek?",
    "doctor_response": "Hi, Thanks for using HCM.Better to consult a gastroenterologist, he will take care of cirrhosis and hepatitis infection both.Hope I answered your question. Feel free to ask me if you have any further queries.Wish you good health. Take care.RegardsDr. Vidya",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Negative thoughts affect my studies since I entered puberty. Please advise.\n\nHello doctor,I am a 17 year old girl. I am suffering from tension-like feeling about everything around me since I entered puberty. I have very very low power of decision making. All this has now affected my studies. Now, I am very worried about my studies. I do not know what to do. If I found my performance going low, then I have thoughts of suicide. I cannot achieve what I want due to my negative thoughts.",
    "doctor_response": "Hello. Firstly, you need to reduce thinking so much about all these issues. Most of the issues resolve with time and on their own. Your priority should be studies only. Just focus on one thing at a time.  Try to work hard and perform well. Once it improves, you will get some confidence and other things start improving. You should do some yoga and meditation in order to improve concentration and mental stability. Also, consult a psychologist for counseling sessions regarding your future action and dealing with negative thoughts. Hope this helps you and get back if you have any doubts. For more information consult a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in abdomen, weight loss. Diagnosed with fatty liver disease, EGD showed gastric ulcers. Any connections?\n\nI have Recently been diagnosed with fatty liver disease (about a month ago).  I do not drink nor take any medication. All my LFTs are normal so I was referred to GI doctor because the pain has not subsided and I have lost about 15 pounds in a month.  I had an  EGD done today at which point it was discovered I have gastric ulcers.  I am wondering what link, if any the two have to ech other.  Can one cause the other?",
    "doctor_response": "No it may not be related, cut down fatty food and oily food from your diet, if LFT is normal then no need to take medications, start morning walk to reduce fat and burn calories. for ulcers, if ulcers are proved to be benign and if H-PYLORI infection ruled out then take proton pump inhibitors  for 6 weeks. u may get one endoscopy repeated after finishing the course.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain behind knee and tender sensation in legs?\n\nhi about five years ago i had bilateral vein surgery. I now have very tender legs and when i press them in certain places they are very tender and it feels like a stinging sensation. Sometimes i get pain behind the knee and also accasional feeling that something is popping inside my lower legs any suggestions",
    "doctor_response": "Hello, Varicose vein surgery can cause minor damage or nerves of the lower limb and may cause these symptoms. Recurrence of varicose vein itself is another possibility. Consult a vascular surgeon and get evaluated. A venous Doppler can be done to make a diagnosis. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a lump on the right elbow?\n\nMy husband had right rotator cuff surgery in April. About mid July he developed a lump on the right elbow. It has continued to get larger, nearly the size of golf ball. There is no pain or redness. What is this and the cause of it and how to treat it?",
    "doctor_response": "Hi,Dear thanks for the query to HCM virtual clinic.I studied your query in full details updated from you.I understood your health concernsBased on your query data, In my opinion ,Dear You seem to suffer from Students Bursitis,or Olecranon bursitis.Other cause could be Gouty elbow with tophiUsually medical treatment with Motrin /antibiotics or no treatment is enough and goes on its own.For the gout elbow bursitis-allopurinol with probencid treatment with surgical treatment for the gouty elbow may be needed.In some cases Surgical excision of the Bursitis is needed and is very rarely needed.Team of GP and Physician  doctor and Orhto-Surgeon  would be needed to treat your health issue.Hope this reply would help you to evaluate your case and treat it with your doctors in time to come.Hope this would resolve your query and worry and Anxiety accompanied with it.Welcome for any further query in this regard to ME.I would love to help you out.Awaiting for any further query.Wish you fast recovery from this intriguing health problem.Have a Good Day.Dr.Savaskar M.N.M.S.Genl-CVTS -Senior Surgical Consultant",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can vitamin D deficiency cured with injections?\n\nHello doc. Lately I ve been diagnosed with vit d deficiency which was less than 8 and vitamin b12 was 220. My doctor has adviced me to get methyl cobal injections every alternate day for 5 days. I have already got 2 vit d injections and out of 5 vit b12injections, have got2 and have been told to get one vit d injection more after 3 weeks. The medications prescribed are clk2, flexispas8, and kyrab 10mg. But my discomfort and pain in hands and legs still persists. Can you tell me why, moreover my stomach has also got upset. What exactly is my condition and I am exposed to what all health issues. Is this can be cured or is a lifetime problem.",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. You are having both Vit B12 and Vit D deficiency. 2. You need to continue taking both Vit B12 and Vit D shots. Also sun exposure will be helpful for Vit D improvement. For vit B12, take diet rich in fish, egg, green leafy vegetables and pulses.3. It all can be cured. Continue the medication. These are not a life time problem. Diet and nutritional supplements are very important. Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for stomach pain\n\nI have had this pain in my stomach since Thursday morning. It feels like I have been kicked in my stomach and there is a lot of pressure also. I am eating/drinking just fine and using the restroom with no problems. I won't see my doctor until Monday morning. What can I do until then?",
    "doctor_response": "HI.Thanks for your query and an elucidate history.The feeling of the pain like being kicked in the stomach without any obvious nausea , drinking and eating being fine and no restroom problems, this can be due to :Enteritis, meaning inflammation of the small intestines or colon. Lymph node mass or some other inflammation going on in the abdomen. I would advise you the following. Get Physical examination of the abdomen by a Surgeon.Ultrasonography of the abdomen. Test of blood. urine and stool . All these thing will give a probable diagnosis which to be followed by a proper treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can an online doctor help understand the spine report and explain ?\n\nfinding L1-2 is normal there is a minimal disc bulge at L2-3, asymmetrically greater on the left. there is a minimal disc bulge at L3-4 asymmetrically greater on the left. there is a left subarticular-left paracentral anular tear with a small to moderate associated focal disc protrusion. The protrusion displaces and may mild compress the traversing left L5 nerve root . No significant thecal sac compression. There is mild facet arthropathy with mild left sided neuroforaminal stenosis . There is small moderate focal right paracentral-right disc extrusion at L5-S1,which displaces the traversing right S1 nerve root.Otherwise,there is a mild circumferential disc bulge with no spinal canal stenosis. IMPRESSION 1. There is a small to moderate focal right paracentral-right subarticular disc extrusion at L5-S1,which mildly displaces the traversing right S1 nerve root. 2. There is an annular tear with a mild to moderate left paracentral-left subarticular focal disc protrusion at L4-5,which displaces anday mildly compress the traversing left L 5 nerve root.",
    "doctor_response": "Hi, Thank you for posting your query. Your reports are suggestive of disc bulges in the lumbar region (lower back), causing compression of the nerves in that region. The initially treatment is with medications such as pregabalin and physiotherapy. Those who do not improve with above (about 10% of cases) may require surgery. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the right testicle?\n\nI have some dull pain in my right testicle but only when i sit down on a chair when it starts to hurt i usually just stand up and sit down again and that usually helps for awhile (pain is only about a 2). What could it be? There is no swelling that i have noticed, if i touch the testicle directly it s a bit tender but does not hurt.",
    "doctor_response": "HelloThanks for query.Pain in testicle could be mostly due to mild infection (Orchitis).Take  broad spectrum antibiotic like Doxicycline  along with anti inflammatory drug like Diclofenac twice daily.If problem persists consult qualified Urologist for clinical examination and get following basic tests done 1) Routine Urine test.2) Ultrasound Scanning of Scrotum. Further treatment  will depend upon the results of these tests and final diagnosis.Dr.patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hoarse voice while crying?\n\nMy 4-week old baby has just developed a hoarse voice to her cry without any other symptoms...although we seem to sense some-what of a stuffy nose. She is acting normal, eating well, and I breastfeed - it doesn t seem to bother her (she can breathe just fine). Any ideas what is causing the hoarseness?",
    "doctor_response": "Hi...hoarse cry during crying or agitation could be due to acute laryngotracheobronchitis or laryingitis. If the baby is comfortable and feeding well then you need not worry. But if she is having respiratory distress then I suggest you take her to the nearest emergency room immediately.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for aggressive behavior in case of OCD\n\nmy son is suffering from OCD problem for more than 15 years. He is 29 years old.has done study upto high school only and is not doing anything .For last many yrs he is on following medication: Pacitane -1 ----------OD Resperidone-1------BD Prodep-20------------OD However, we dont find much improvement / control over his repetitive behaviour and anger.He gets extremely furious over petty matters specially whenever his unending demands are declined and creates a lot of fuss in the family.He sometimes , while in extreme fit of anger, pretends to kill himself by holding a kitchen knife in his hand. Pl advise what to do.",
    "doctor_response": "The doses of medications which he is taking needs to be increased. Increase prodep to 40mg and resperidone to 2mg bd.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do tingling penis tip, lower back pain with black stools indicate?\n\nI have a tingling feeling in the penis area towards the tip. Also I have lower back pain on each side. There is no discharge or anything and I have no issues with urinating. Should I go to the ER? Plus my stool is black and I don t take any iron pills or anything.",
    "doctor_response": "Hello,Tingling sensation around tip of penis along with backache mostly occurs in kidney stones.So i would like to suggest you to go for sonography of abdomen and pelvis to rule out kidney stones.Black color stool occurs when there is bleeding in upper gastrointestinal track. Hope this helps you.Thanking you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for soren boil in gums\n\nI notice about week ago I had a sorenes on my upper left side of my gum. when looking future I notice that I had a boil on and   that it has some puss inside of It .   It doesn't hurt but it' there, and it look like it getting worst. beside going to my healthcare, is there anything that I can do on my own?",
    "doctor_response": "Accumulation of pus indicates chronicity of infection. Definitive treatment would be prophylactic antibiotics with relieving the area accumulated with pus.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes delayed ejaculation with no pleasure?\n\nLately whenever I masturbate my penis has had close to no feeling in it, when  I cum it just doesn't feel as good as it used to and it takes a lot longer to reach climax, it's been going on like this for about 2 weeks and I'm not sure why it just started happening all of a sudden. I know it's not anything relating to an STD.",
    "doctor_response": "Hello, You are practicing masturbation and it's pleasure giving procedure. I don't feel any problem in you regarding masturbation is concerned. The feeling of joy is achieved if you reach climax. You are achieving climax according to mentioned history. So don't worry about that. You are not having any specific problem. You can take help of sexologist regarding counseling if still not feeling joy in masturbation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful forearm post aortic valve replacement?\n\nMy husband had an aortic valve replacement and a bypass 4 weeks ago. He awoke from surgery unable to move his right hand and arm. He has gained some movement back but his forearm and hand are very painful and he is not close to having full function. We have been told that it is due to positioning during surgery and that he will regain use but I am concerned that this is something more serious and permanent.",
    "doctor_response": "Dear PatientAs i can get from your history there are chances that during procedure your limb would have been in such a position that it caused prolonged compression on one or more nerve. This is not uncommon because during the procedure the doctor is on life saving mode. The usual time of recovery in such cases is around 6 to 8 weeks.Continue with physio and let the normal course of recovery take place.Rest in peace and let things become normal.If things show no improvement at 6 to 8 weeks than you may need  consultation.Hope that helpsThanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated HCG level in blood after tubal ligation?\n\nhi dr,iam a nurse i had my tubal ligation with my second c/s 4 years back.now my beta hcg is high,150,  my LMP was on 30/01/2011 and i have lower abdominal pain, last month my period was late for 10 days,that time beta hcg was high123 ,but after period also betahcg  is not in tha normal leval what could be the reason?",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.TL operation never causes high beta HCG. It is likely to be some malignant condition. Some malignancy of the genital system can cause increase on the HCG level. Or you may be pregnant again that's causing increase in the HCG level.In both of this situation you can do USG abdomen. It will differentiate both this situation, and help in further management of the condition.I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for painful lump between vagina and anus\n\ni am 15 years old and am sexually active with one guy, I have a very painful lump between my vagina and anus, it was been there for a few days and has increased not only in size but also painfulness. I can t walk without it bothering me and I m in unbearable pain at moments depending on my sitting position. it s red and purple and whenever the slightest thing touches it, there s a very sharp pain for a long period of time. if there s anything to sooth the pain please let me know! thank you",
    "doctor_response": "Hi,It seems that there might be having forming abscess giving this trouble.This might be due to infection caused by some skin condition like dermatitis or ingrown hair.Go for one antibiotic medicine course for 5 days.Take NSAID medicine like Ibuprofen for pain and inflammation.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can laser be used to treat eye floaters and retinal tears?\n\nHello doctor, I am 29 years old. I have eye floaters in both my eyes. I am suffering from nearsightedness, and I have retinal tears. I consulted several doctors, but I did not get proper answers. The topic of eye floaters is not studied well in my country. My ophthalmologist says that I should do nothing and wait, just have a systematic evaluation of my eyes. I also consulted a laser eye surgeon. He offered me to get LASIK surgery at first, but he also did not give me definite and concise answers. The floaters almost poison my life. I am really close to a depression. My occupation is connected with computers, so I have to work on it for a long time every day. The last time, my eye floaters become more and more bothersome, and it seems to me that their number is gradually increasing. They are of different forms and sizes. I read a lot of information about the possible eye floaters treatment. To be honest, I am afraid of vitrectomy, as it is extremely risky. Laser treatment is more preferable, but I got to know that the patients of my age are not treatable by means of laser procedure. In this case, I have got some questions to ask. What should I do to stop the increasing of my eye floaters? Should I follow my ophthalmologist's advice and do nothing? Are there any successful cases of eye floaters treatment among the patients of my age by laser? Can I have a laser treatment of eye floaters when I become older or this type of eye floaters can never be treated by laser?",
    "doctor_response": "Hi. I have many patients like, and I have treated them also. Your age is no problem. For more information consult an eye care ophthalmologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does Revlimid stay in our system?\n\nHello...my mother is 81 with multiple myeloma and is on Revimed. 21 days on, 7 days off. she has side effects, diahriah (spelling?), constipation, etc. How long does Revlimed stay in system...is it possible that side affects will continue during week off meds?",
    "doctor_response": "The 7 day gap is given to allow the body to recover from the side effects of the drug and not to allow the drug to go out of the system. Diarhhoea is a common side effect of the drug and is normally not worrisome. If it is excessive you can try giving Tab loperamide at bedtime. Else, you might have to discontinue the drug in consultation with your oncologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intense pressure on one side of the neck?\n\nmy husband feels intense pressure when on one side of his neck he bends over.  he has high blood pressure but it is under control with medication.    he does not want to go to the emergency room and says he can wait until a week day to see his doctor.  Should I be more forceful in my request that he see someone today (Sunday)?",
    "doctor_response": "hello,I have gone though your query.Thanks for using HCM.if BP is under control and neck pressure is bearable then you may wait till week.You may ask him to avoid undue movement of neck and take analgesic like Aceclofenac 100 mg twice a day for relief,My best wishesDr.Rajesh Teli,MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for cough?\n\nI got the flu around december 10th and then bronchitis but it is not getting  better.  Sometimes i dont cough all day and now today i am coughing like crazy. Is it better to cough? There is nothing coming up when i cough. plus now i think i have a sinus infection...is this normal to be sick for this long...over a month? Also, when i go outside and come back in i cough even more.",
    "doctor_response": "HelloI appreciate your concernchronic cough for long duration warrants detail evaluation to find out the underlying cause which can be any of these infection or inflammation of the respiratory tractCOPDallergic reactionTuberculosisLung cancerIf I were your treating your doctor I would have advised you for a battery of tests after thorough clinical examination like blood for hemoglobin, CBC, ESR, Sputum microscopy and an X ray chestIn my opinion you should take anti allergic drugs like levocetirizine or fexofenadine for 7 to 10 daysTry to find out any trigger for cough and avoid itDeep breathing exercisesSteam inhalationcough lozenges during cough boutsIf it doesn't improve with this than you must visit your doctor for investigations to confirm the diagnosis and treatment accordinglyHope this answers your questionthanks for using our services please feel free to ask for more clarification, Wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in taking a deep breath?\n\nHi, may I answer your health queries I am 44 with controlled diabets, hypertension and moderate sleepm apnea. I have been having a hard time with taking a deep breath. I have no edema. I did a chest xray for pre-op and it showed minimal cardiomegaly. Should I be overly concerned?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. You should definitely rule out heart diseases for your breathing difficulty. You are having following risk factors for heart diseases. 1. Diabetes2. Hypertension3. Cardiomegaly on chest x raySo better to consult cardiologist and get done blood pressure monitoring, ecg, 2d echo and stress test (trade mill test).You may need coronary angiography if above reports are showing abnormality. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain and bloating during pregnancy?\n\ni got abortion before month of september 2014 then month of december i got intercourse with my partner then after a week i use pregnancy test and the result was two line but the second line was faded color. now I'm about 3 months  pregnant i guess. but I'm confused for having pain and bloating every evening....",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the faint line can be due to :-1)Due to early testing- Usually urine pregnancy test gives accurate results a week after missed period.But in cases of wrong dates or late conception the test can be weakly positive.Here the test need to be repeated after a week.2)Abnormal pregnancy due to hormonal insufficiency like progesterone insufficiency or any.I suggest you to repeat the test after a week.And also get an ultrasound done to know the status of pregnancy.Nothing to worry.Take folic acid supplements and progesterone insufficiency.Take healthy nutritional diet.Avoid physical strain and intercourse.Take good rest.Hope this helps.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for masturbation problem\n\nRespected Sir,                    I came across the suggestion for health through  WWW.WWWW.WW I am student of MCA persuing from Mumbai University.From last 8 yrs I had habit of shaking the penis which is now  I feel like addicted to it.Sir I daily do exercise for almost 1 and half hours.Could help me for the problem mention above.",
    "doctor_response": "Hello, Masturbation is not unhealthy if it is done in moderation like twice a week or so. If you are doing it more than that, it can be cleared with the help of behavior addiction. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing numbness on the upper right thigh after a bee sting\n\nhi i have a question.i was stung by a hornet or bee back on my upper right thigh back in aug 2011 and when i stand for long periods or do alot of walking for some reason indoors only that area becomes numb and i have a tinkling heat like sensation why is that?",
    "doctor_response": "Thanks for your query at HCM,I think it has nothing to do with the past bee bite. I would like to know your weight? I advice that you avoid standing for long time take intermittent rest. Get your blood sugar test for fasting and post prandial and HbA1C. Reduce weight if obese. Follow up with investigations or visit a local doctor.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for spina bifida\n\nHello I am a 39 year old woman with spina bifida and for the past month I been having a constant burning sensation at the top and back of my head that is numbing. I had issues with anxiety 6 months ago where I was on antidepressants but they didn t agree with me and was off them within 2-3 weeks and have never taken them ever before. The anxiety issues are gone but the numbing sensation is getting worse such to the point where it is hard to concentrate. What could it be?",
    "doctor_response": "Hello,Is your spina bifida is operated at your childhood or not? There is currently no cure for spina bifida, but surgery might help restore a senior's independence if his or her nerves are affected due to ageing. Most seniors with spina bifida may require surgery on the back to relieve pressure and alleviate the impulses moving up and down the spine.Probably because of anxiety you may got headache called tension headache. It may be due to stretching of nervs. Use tablet. alprazolam 0.25 mg at night time for five days. Use tablet pregabalin 75 mg once a day for five days. If symptoms not improved please consult with your neurosurgeon he will examine and treat you accordingly.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for sciatica & lumbar spine problem\n\nhi sir iam having a sciatica problem and lumber spine problem for this pain i had taken a electro homeopathy treatment in that doctor had given me a electric shock on my left leg main nerve for 3 times and the pain is gone for few days only after that it came again i had taken  lot of pills but no cure now my doctor suggest me duzella 30 mg so how much its useful for me pls suggest me some good medicine iam fearing tht any side affects will come because my marriage is thier in a month and iam having high uric acid 9.0",
    "doctor_response": "**1. since the symptoms again came back after taking conservative treatment, thus check with X-ray LS-spine, MRI for any nerve impingement or narrowing [which might be the cause of sciatics pain], thus consider orthopedic surgeon opinion.PS. if there is shooting pain along one leg, initially you may require pelvic traction, epidural injections, myelography studies.2. since you have been diagnosed with the said problem, thus in Ayurveda  we treat/manage the disease on the line of 'Gridhrasi' PS. Duzella [duloxetine] is an antidepressant/anti anxiety drug given to alleviate the symptoms, thus is not disease specific but is advised to alleviate moderate to mild stress]3. You can incorporate following prophylactic aspect also:. sleep on hard bed/mattress . wear heavy shoes and warm socks. massage of olive oil is beneficialPS. Acupuncture has been approved by the U.S. FDA as a treatment for back pain, and the National Institutes of Health has recognized acupuncture as effective in relieving back pain, including sciatica.. take 4 tsf holy basil juice         4 tsf ginger juice         4 tsf honey and drink for 1month.4. Prescription medicine which are worth trying is/are: maha rasnadi kwatha, bala arishta, Mahavishgarbh/mahanarayan/mahamash oil5. before advising for high uric acid level, one has to make sure whether it is due to increased production [hyperuricemia] or due to under excretion [gout] where renal function tests are advised, thus ask your doctor about relevant examination and investigations, make sure you avoid high protein diet, alcohol, and take plenty of fluids along with medicines prescribed [if any]",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does medicines duolin and flohale causes restlessness?\n\nMy granddaughter is 4 y 5 m and is being given duolin and flohale50 inhalers and montair 4mg tab for chest congestion and wheezing. Also, nasonex nasal spray in the mornings as she also grinds her teeth in the nights. Sometimes she is restless and has nightmares. Is it because of these medications?",
    "doctor_response": "Hi, Levosalbutamol in duolin that acts as a bronchodilator can cause tremors and reduced potassium levels in the blood. The dose of the drug can be reduced and the frequency of inhalation aerosol should be restricted to every 4 hours. Steroids in the above-mentioned drugs do not cause such side effects. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Saranya Ramadoss, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in my right hip area post laminectomy?\n\nOn November 3rd I had a L4 L5 S1 laminectomy (left side of spine), my back pain seems to be just about completely gone. Ever since a couple days ago I have had excruciating pain in my right hip area, so painful I can barely walk and put my clothes on. I called my surgeon and since it doesn\u2019t sound back related he is hesitant to get me in right away for a review\u2026 any ideas or should I just head to my local hospital\u2026 it a 10 out of 10 for pain\u2026",
    "doctor_response": "Hello,Looking at your details it looks that it about more then 4-5 months after laminectomy. As the compression was on left side so it does not looks to be due to disc related problem.In that case this can be due to sacroiliac dysfunction. You should do following to have relief in this:- Use a lumbosacral belt to prevent abnormal movements at back- Apply an analgesic ointment over affected area- Do warm water fomentation with water bag over affected area- Take a good analgesic like aspirin,ibuprofen or paracetamol Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mukesh Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will I transmit TB to my partner after completion of the TB medicine?\n\nHello doctor, I am having pulmonary TB and this is the third month since taking medicine. I had blood in sputum few times and sputum test showed negative but based on CT scan, the doctor suspected pulmonary TB. I was recommended medicine for six months. I am feeling better after taking medicine and no more cough or blood in sputum. There is a marriage plan in the family but I have doubts about recovering from this disease. These are some queries in this regard. Whether any other treatments are required after completing six months of medicine? If yes, mention details. What is the chance of transmitting TB to partner after completion of medicine? How long one should wait for marriage after completion of TB medicine? What kind of risks a TB patient carries even after completion of medicine? Whether I am still infectious to others after taking medicine?",
    "doctor_response": "Hi, Welcome to icliniq. com. I would need to know that have you got a repeat sputum test or chest X-ray after the treatment has started. I need to see that before I could answer your questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. After a fall, my daughter has got knee injury with difficulty in stretching. Can this be fracture?\n\nHello doctor, My daughter went ice skating last month and she fell a few times but she was able to stand up and skate again. The next day, saw bruises on her legs especially the knee area but that disappeared after a few days. She mentioned that she still feels some pain but she can walk, move around and jump with it so I thought it is fine. However, recently, I noticed that she cannot stretch it to its maximum. Although she can move around with it, she says there is still a pain when she stretches it too much. What do you think is the problem? It is not broken, right? We cannot have it x-rayed due to lockdown.",
    "doctor_response": "Hello. If she is able to walk putting her full weight, she might not have a major fracture. But I want to ask you a few more questions to come to a conclusion. Is there any swelling around the knee now? Is there any history of massaging it every time she fell? Is she able to straighten out her knee completely now? Probable causes here can be some joint fluid in her knee which is causing an inability to stretch completely. If she is limping now also, if she is complaining of pain with every step, we should think of any ligament injury. Or else if she does not have any pain on walking, do not worry she does not have any fracture.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach pain and vomiting in kids\n\nmy 3 year old son got sick tuesday afternoon with a stomach ache and nausea. he vomited a few times that day and was very cranky and crying a lot throughout the night. he had diarreah a couple times but non since wednesday morning. he has been getting tylenol every 4 hours for his fever which was 101 yesterday. he has been sleeping a lot. he woke up for about an hour this morning and is already back to sleep. he looks pale and seems very weak. he has barely ate anything since tuesday morning. i m worried that he s sleeping so much. he s normally very against napping in general.",
    "doctor_response": "vomiting , fever and diarrhoea suggests that he has gastroenteritis which is the infection of the intestine usually caused by a virus.  the pallor , weakness and sleepiness suggest he has moderate to severe dehydration and this must be treated with fluids . the treatment of gastroenteritis is fluids therapy like ORS but in your child's case you must rush him to the hospital because he will need intravenous  fluid because  he is intolerant to oral fluids . I suggest doing serum electrolytes also in the ER .I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this semen analysis report indicate?\n\nHi Doctor,I am 29 yrs old.I went for semen analysis,the parameters are count=58 million, immotility=41% .He also suggested me semen culture in that result was \"No pathogen isolated\" what is the meaning  of this.Am I suffering by infertility?Please guide me.",
    "doctor_response": "HelloThanks for query ,Since you have not posted complete report of your semen analysis It is difficult to comment regarding your fertility .The percentage of active grade one motile sperm is an important parameter that decides fertility of an individual .Your semen culture revealed no pathogen indicates there is no infection of semen .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for bleeding in gums?\n\nMy gums have started bleeding profusely over the last week or so, with no apparent cause. This can happen numerous times throughout the day and at night as I have woken with blood on my billow. This is totally out of character for me, I have never suffered any problems before. I have been on beta blockers for around 8 months and over the last two weeks have felt generally unwell and depressed. I have become very concerned about the heavy and random nature of the bleeding in my mouth.",
    "doctor_response": "Hi. Welcome to Healthcaremagic.I read your query. Gum bleeding indicates periodontal disease. But the amount of bleeding you mentioned can be a manifestation of some underlying disease too. I suggest you visit a dentist and get it checked.Get oral check up, blood test for anaemia, Von willebrand factor, clotting factors.Maintain good oral hygiene, proper diet. Use non alcoholic mouthwash. Get oral prophylaxis done regularly.You didnot mention about history of pregnancy. It can also lead to gum problems. Main treatment is to find underlying cause and treat it.Hope the answer helps. Thank you!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower back pain\n\nlast Tuesday i hurt my lower back while doing squats. its been hurting but the pain is isolated in my lower back it hasn t spread it sometimes hurts when i bend over but usually it just is really tight in my lower back which prevents me from bending over very far. it also hurts when i get up after sitting but it is very miniscule.",
    "doctor_response": "Dear- thanks for using our system and hope will my medical advise will be helpful. You probably have a pinched muscle from the exercise Sometimes,specially when you do an exercise and don't stretch well, you can have this problem. It might take few days to improve, try to avoid heavy exercise, use a heating pad, rest and take anti-inflammatory as ibuprofen for 72 hrs. If it does not get better, you might need to see your doctor for an x-ray and further evaluation.Dr.Sara",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for breast cancer\n\nI have been diagnosed with IDC breast cancer. So far I have been told that the ER and PR receptors are weakly positive (2% ER and 20% PR) and the HER2 is negative. I have also had an MRI which shows one suspicious lymph node which I will have an ultrasound/biopsy on next week. The mass in my left breast has measured at 3.2 CM. I have been told that the treatment should be 5 months of Chemo (ACT) and then surgery. I am wondering if I should be seeking a second opinion or if this course of treatment sounds correct. From discovery of the lump to now, it has only been a month so everything has been moving quite quickly.",
    "doctor_response": "Upfront chemo followed by surgery is one of the suggested therapy for early breast cancer. On chemotherapy the lump may decrease in size and later the surgery could be a breast conservation on rather than a radical mastectomy.. Hormon receptor status is weak . So hormone therapy may not be very useful.. You are ilon the right course... Continue with the same.. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "How much time does the fractured tibia take to recover?\n\ni broke my tibia and fibula 17 days ago and i have a short cast on my leg. the fibula broke up towards my knee and my tibia twisted and broke towards my ankle. my doctor said we basically only have to worry about the tibia on a count that the fibula was aligned and would be fine . i did not need surgery. was wondering on an estimated recovery time???",
    "doctor_response": "hi,thank you for providing a brief history of your illness. Usually Lower limb healing takes about 6-8 weeks depending upon your personal habits like drinking, smoking etc. please follow the surgeons guidelines and avoid putting any weight to the limb as the normal aligned healing is always good then malaligned heal. Hope you will understand this. Taking a help from a physical therapist post the healing if your surgeon recommends you will be beneffited further.with the grace of god i wish you a speedy recovery",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lump on shoulder\n\nI have had a small lump on my shoulder for ages and the other day it seemed to get a head. I squeezed it and loads of fatty white smelly stuff came out, this has gone on for about a week and now it seems to have gone down. I can't feel it moving under the skin as it used to, it is just a bit sore. Is it ok?",
    "doctor_response": "Welcome to healthcare magicI am Dr Fahim and I will help you with problem     I have gone through your question. To me it appears to be sebaceous cyst, which was present there for long time and now it got infected. If a patient with similar complaints walk into my clinic, I perform excision of the sebaceous cyst, leaving the wound open for repeated antiseptic dressing. Tab Co-amoxiclav 625mg 8hourly, tab paracetamol 500mg 8hourly are perscribed post-operatively for 5days.Patient usually respond to this treatment in 3-5days, while the wound is then closed with delayed sutures.I hope my answer will help you. Do rate it, if you like it.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Loss of erection while on bath salt. Is it because of dehydration or lack of nutrition?\n\nWhat causes you to lose your erection while being on bath salts? Is it dehydration or lack of food...both? Ive been up two days.n c weird thing was I was barely doing anything and I ejaculated like with no problems...well except I was only at about 50 percentile. Is there anything in the short term I can do to fix this and make it up to my sweetheart tonight?",
    "doctor_response": "yes dehyradation and inadequate rest can have stress and stress is bad for performance. kindly take rest,eat fruits,salads,drink water sufficient and enjoy to night with a relaxed mind.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recent advances in the management of G.B.SYNDROME..\n\nRESPECTED DR.Kindly let us know the recent advances in the management of G.B.SYNDROME.",
    "doctor_response": "No cure yet. Scientists are concentrating on finding new treatments and refining existing ones. Scientists are also looking at the workings of the immune system to find which cells are responsible for beginning and carrying out the attack on the nervous system. The fact that so many cases of Guillain-Barr\u00e9 begin after a viral or bacterial infection suggests that certain characteristics of some viruses and bacteria may activate the immune system inappropriately. Investigators are searching for those characteristics. Neurological scientists, immunologists, virologists, and pharmacologists are all working collaboratively to learn how to prevent this disorder and to make better therapies available when it strikes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and vomiting in a child\n\nHi my son is 20 month old at 2:00 am morning he had vomited and a fever of 100 ,101 degree As prescribed by the child Dr emeset for the vomiting and ibugesic plus for fever please suggest me fever is not getting down anything what he is taking coming out i hv tried curd as dr said milk will cum out in this situation What to do in this situation?",
    "doctor_response": "Hiwelcome to HealthCareMagicI understand your concern, for fever you can do tepid sponging to bring it down .For vomiting , if he vomited immediately  in 15-20 minuets you can try another dose , and do not give anything after that for 30 minutes or anti emetic injection can be taken after consulting treating doctor. Also important to note activity of baby , is baby active when fever is down , is he accepts feeds after vomiting is controlled , is he passing urine 4-6 hourly , if not he might need urgent consultation to rule out any serious illness and if required admission .Hope I answered your queryrevert if any other querythanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest Flexeril dosage for severe back pain\n\nI took flexoril , broke it in half and took approx. 5 mg, then took the remaining half 35 minutes later, and it didn t work. The night before I took the whole 10 mg pill and it worked fine. Can I take another one? It,s been about 6 hours, and I m having severe back pain. Thank you.",
    "doctor_response": "Hi, It is started from the dose of 5 mg per day then gradually dose should be titrated up. Please consult a physician for your complaints so that your treatment can be appropriately started. It is further advisable to take medicines under the guidance of a physician only. Hope that helps. If you have any further questions, I shall be glad to have you in follow-up. Regards, Dr. Ajay Panwar Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "On Mirena, took job busing tables. discomfort in pelvic area, spotting, cramping. Reasons ?\n\niv been  on the marina birth control for 8 months. my son is 11 months on the 23 of this month. im 17 and have been using only the 1 method of birth control. i recently got a job busing tables at the village inn (past month). the past week i have been having slight discomfort in my pelvic area and slight blood spotting. in the past 24 hours i have been having major cramping and my bleeding has picked up. please help",
    "doctor_response": "hi,there will be some changes from usual periods in first year after child birth due to hormonal changes, need not feel unsafe, look for next cycle , if that is also same, then see your gynecologist. take medications for symptom relief as use to take earlier, like dicyclomine or any analgesic. wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the possibilities of my girlfriend getting pregnant?\n\nSO my girlfriend and I were having some fun one night and we ended up grinding each other without having sex but my penis was touching her vagina. I couldn t remember if i had ejaculated or not when doing this because I didn t feel an orgasm but she was worried that I did. Even if I did ejaculate it would have been on the outside of her vagina. Is there still a possibility of her getting pregnant? Also her mom gave her these pills to take because she is going to mexico when her period is suppose to come. Im not sure what the pills are but she said they are some type of birth control? will this effect her and the possibility of getting pregnant?",
    "doctor_response": "Hi.The pills her mom gave her would have most probably been to delay her periods (e.g. norethisterone). I doubt she is pregnant, and for now there should be absolutely no issues in regards to her menstrual cycle.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes trouble in sleeping?\n\nmy 12 1/2 yr. old grandadughter  goes to bed at 9pm, sleeps only maybe 15 min, wakes and lays awake 2 to 3 hours, then sleeps again maybe 15 to 20 min. Doctor has ordered x-rays and EKG, I am very conserned. Am afraid she may be afraid to she could die after seeing her mothers boyfriend having bad seizures due to swelling in his brain from time to time, What should we do to help her?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  I think you should wait for the doctor's opinion before getting carried about. From the description you gave, the sleeplessness may be due to anxiety and the cause could be the that person's bad seizures due to swelling in his brain. Such a scenario, the anxiety, could be easily treated with counseling and psychotherapy. Nothing to worry.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Skin peeling from upper arm to waist, herniated disc at c4-c5, c7 diagnosed, epidural due. Is this related?\n\nI have recently been diagnosed with a herniated disc at c4-c5 and c7.  I am going in for an epidural next week to see if this will help with the pain and numbness in my neck, left arm and hand.  Recently (last 3 days) I have noticed that the skin is peeling from mid upper arm to my wrist... as if sunburned.  Is this related and what is causing it?",
    "doctor_response": "Hi,Based on details you have given you have L) cervical radiculopathy secondary to herniated discThere is no relation to  peeling of skin in upper limb ( you meant left side)and radiculopathy. Consult dermatologist for local examination",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rash under arms/groin when having fever and respiratory infection?\n\ni am 36 and have had a fever up to 103 for the past 4 days, doc said it was a upper respitory infection but i had a rash under my arms he said was from the fever.  he gave me a steroid for the rash and today it has came up in my groin area as well.  any answers???",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.This rash is surely because of the respiratory infection you have. If your respiratory infection is treated than there is no need to worry. Steroid will suffice to take care of your rash. Cetrizine can help cure the itching associated with the rash.You can continue the low dose steroid like prednisolone under your doctors guidance.Fever should be avoided, high fever should be immediately treated with the paracetamol.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to lower TSH and cholesterol levels\n\nmy wife is 52 yrs old.HER WEIGHT IS 75KG HIEGHT 160CMS. IN ROUTINE LFT test alkp 144(RANGE 42-98), sgot 42.6,sgpt 42.9.(RANGE 0-31) REST ARE O.K. SHE IS A THRYORID PATIENT. CURRENT TSH WAS 22.6 INSTEAD OF 5.5. CHLOROSTROL LEVEL 206. SUGGEST PRECAUTIONS AND REMEDIES.",
    "doctor_response": "hi.thanks for posting query at HCM.it looks like the patient is suffering from hypothyroidism.she immediately needs to visit treating physician and she maybe advised to take \"thyroxine hormone\" daily and \"-statin\" drug to lower cholesterol level. she may have a diet control management for increased cholesterol before taking the statin drug ( fat free diet and no red meat/no junk food / no beverages).TSH level should be monitored to adjust dose of thyroxine hormone ( tablets).hope to answer your concern.regardsDr Tayyab Malikdirect question link",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which medicine is applicable having Vancomycin and Teicoplanin sensitivity?\n\nMy query is that I am undergone a lung surgery and one point of surgical area outside got infected abd pus comes out of that. I did the pus culture and sensitivity. The result is pencillin, ampicilin, vancomycin, teicoplanin and gentamycin(high level) sensitive. Which medicine will be applicable for me at this time.",
    "doctor_response": "Dear Friend.Welcome to HCM. I am Dr Anshul Varshney.If Pus Culture and sensitivity is showing some growth and also, the organism is susceptible to the above mentioned antibiotics, any of them can be used, based on the organism grown.I personally prefer to use Vancomycin in such cases.Stay Healthy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are allergy on elbow and weakness symptoms of STD?\n\nHello dr. I m 21 yr old guy i had unprotected sex with hiv positive girl on 24 august 2013 nw m getting weak n i hv a allergy on my elbow ?? Tell m rly worried plz ans me nw dat girl is died she didnt told me she is positive later i knw dat aftr she died plz hlp me out",
    "doctor_response": "HIV infection can manifest initially with very different symptoms,even without symptoms.If you had unprotected sex was with a girl HIV positive, your doctor must request  measuring blood antibody against hiv and other additional test to rule out  HIV infection.I wish you good health. (If the answer has helped you, please indicate this)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to masturbate?\n\n+.i shake my penis regular",
    "doctor_response": "Dear user,Thanks for writing to healthcaremagic.I can understand your concern regarding safety/harmful effects of masturbation.Masturbation is a normal sexual activity. Masturbation is similar to sexual intercourse for penis. What penis does in vagina during sexual intercourse, same it does during masturbation in your folded palm! This is a natural activity and I would say a 'healthy' activity and does not either affect or deter sexual performance.If you feel pleasure and sexual satisfaction after masturbation, no need to be worried about. No need to control. No need to feel guilt.Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain on front tooth?\n\nHi DoctorWhat happens to my front tooth, it hurts badly when I drink hot water, or brush my teeth or even when I talk.  I had filling done on this tooth some months back.  The tooth hurts right up to below my nostril.Awaiting your answer and thanking you in advance.Best regardsCC",
    "doctor_response": "Thanks for using Health Care Magic. Read your query. Pain in the filled tooth could be due to irreversible pulpitis ( or decay involving the pulp).If left untreated can progress into an abscess. I would advice you to visit your endodontist and have a radiograph done.Removal of filling followed by root canal treatment and then refilling will solve the problem. For the pain ibuprofen can be taken if you are not allergic to any medicine. Hope this was helpful. Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in jaw and neck?\n\nI have bilateral jaw pain that goes from my ears to my chin, ear popping like I am at high altitude,as well as neck pain and have developed stomach and problems with my esophagas. I also feel like my voice is paralyzed and at times I am very tongue tied and my voice has changed drastically. Just not feeling like myself. Female, athletic, 51, non smoker, non drinker, Kris",
    "doctor_response": "Hi Dear,.Understanding your concern. As per your query you have pain in jaw and neck which is spreading to chin, ear and other areas which is mainly due to temporomandibular joint dislocation or it could be due to because of the neuralgia in relation trigeminal nerve. Nothing to be panic anything, consult dentist once and get it evaluated. Go for radiographs like OPG and TMJ views to confirm the diagnosis. Start taking anti inflammatory analgesics  for the joint dislocation. Do mouth stretching exercises. Do not eat hard substances and  do not open your jaw too wide. Do a luke warm hot and cold fermentation to suppress swelling and pain.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shortness of breath and headaches\n\nMy husband is 54 y/o. He has had symptoms of shortness of breath and headaches. We determined the source of his headaches were blood pressure related. He has since been put on Lisinipril 20 with a diuretic. He has problems staying hydrated due to his work. It is usual for him to have cramps at night in his legs but drinks alot of gator aid and water throughout the day. The last few nights his legs have cramped consistently resulting in no rest and he is using the bathroom constantly. He continues to have shortness of breath and at this time his bp was 102/73 and his heart rate is 119. He had a heart scan this morning which came back clear. He is re-hydrating today and the doctor has called in the same medication without a diuretic. He has shortness of breath and a headache. I have explained that these are symptoms of low blood pressure. Any thoughts about this.",
    "doctor_response": "Hi,Have you got him examined? If everything is fine from cardiology side then this could be related to lung or blood. Is his hemoglobin normal, have you got his chest x-ray done, does he have any wheezing, what are the factors which increases or decreases shortness of breath, does he smoke, have cough with sputum production, is is having to exposure to particulate matter at work, these are the multiple questions I want to ask. We need to rule out , his lungs as a cause of shortness of breath. So get his x ray and if needed CT scan done. Get back with the answers of the above questions and with exact reports if possible. Till then follow healthy lifestyle like exercises, yoga and avoid smoking if any. He should protect himself at work if there is any exposure.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does slight bump on pelvis with slight bleeding indicate?\n\nJust recently yesterday morning i noticed a slight bump on my penis close to my pelvis and was concerned that it was something serious. i first noticed it when it bled slightly, but after that it just remained a little swollen and had a small entrance mark resembling a cut. Up until now the swelling has gone down a little,  i wasnt sure if it was a bug bite or maybe something more serious, what are your thoughts on this?",
    "doctor_response": "Hi, it sounds strange.Did you suffer any trauma to the area or any sexual encounter in the recent past. These things could explain why it happened.Other than that it would be difficult for me to say, specially without examining you.You could observe it or better would be to show it to a Surgeon who can examine you and suggest accordingly.It is probably nothing serious but it would be better to be sure and get it out of your mind by seeing a Professional.Take care,Dr Rishi, New Delhi, India.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mild cerebral atrophy. Normal for myeliriation pattern, no focal parenchymal lesion. What does it mean?\n\nMild cerebral atrophy is seen with mild hypoplasa of bilateral u.uirot ite matter and prominent ventricular system. Myeliriation pattern is grossly normal for age. Brain parenchyma shows otherwise normal ML morphology and gray-white differentiation. There is no focal parenchymal lesion . l he midbrain , pons and medulla are normal",
    "doctor_response": "Hi, Thanks for using HCMIn my opinion this CT/MRI report is very much with in normal limits. Mild cerebral atrophy is a condition that causes some changes in the structure of the brain. Several conditions can cause a brain to atrophy, including diseases and ageing. hence this symptom is not a serious condition if it is mild, except that the patient might experience mild memory loss problems. cerebral atrophy is found in the majority of people as they age. It usually progresses with severity as a person gets older. what is more important than the presence of atrophy is whether the degree you have is appropriate for your age.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Started bleeding after periods. Taking insuling fasting sugar. Thick endometrium. Any problems in conceiving?\n\nhi, i am a 27 yr old lady.not conceived yet.i am trying these days.but this month after getting periods on my 14th day after periods i found bleeding and its a very irregular flow but i have this till today. i went to doctor and she asked me to take a insuling fasting sugar test. my endometrium is 16mm and thick. do i have any problems for conceiving?",
    "doctor_response": "Hi,Thanks for the query.At the time of ovulation some amount of spotting can be seen because of hormonal fluctuation.As you are having spotting for prolonged periods there could be some hormonal imbalance.Increased endometrial thickness is also suggesting that.So you once get evaluated for hormonal profile.Depending on that treatment can be taken.Once periods become regular you may not have any problem in conceiving.For more details you can ask me through:  care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain and feeling of lump in throat?\n\nMy daughter is 12 and has often complained of stomach pain over the last couple of years that doctors usually associate with ADHD.  She occasionally cries from the pain, which is bothersome because she typically has a VERY high tolerance for pain.  Yesterday she told me it feels like she has a lump in her throat when she swallows.  Could this be something serious, and how much should I push to get a definitive answer from her doctor?",
    "doctor_response": "HI.ADHD is a diagnosis by exclusion , meaning when all the tests are negative . I would advise your to take her to the  Pediatric Surgeon for clinical examination, proper history taking and investigations like ultrasonography, confirmatory CT scan to see for abdominal lymph nodes, appendicitis, problems related to ovaries as she is 12, or any other pathology.ENT opinion as she may have granular pharyngitis or lymphoid hyperplasia as a cause of feeling of a lump in the throat. The treatment required for both the problems will be the same and at the same time give her treatment for worms and a course of antibiotics and anti-inflammatory medicines. This should solve her problems. ADHD should be considered only if all the investigations and treatment have failed to show a cause.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had a kidney transplant, on Prograff, Cellcept. Could I smoke marijuana with this ?\n\ni recently had a kidney transplant on june 13 from my mother... i am taking 3.0 g of prograff in the am and 2.5 g in the pm. 750 mg of cellcept in the am and 500mg in the pm. i wanted to know though if i could smoke marijuana now that it has been 4 weeks since my transplant. i did have acute rejection and so i am taking prednisone 40mg in the am.",
    "doctor_response": "HIThank for choosing HCM,,NO you can not do that even if you do not have medical condition, then also it is harmful to you, either you are normal person or patient you need to keep your self away from narcotic drugs, have nice life without Dop.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it against FDA regulations to implant expired stent?\n\nHi, I recently had a scheduled angioplasy and two stents implanted. I had a followup visit this week with the cardiologist. He informed me that he implanted an expired stent. This is a Taxis drug illuding stent. Is this against FDA regulations to implant an expired stent in a patient? I believe there must be strict FDA regulations in doing so? Tom J",
    "doctor_response": "Hi, Using expired stent is against the law and illegal. There is a shelf life for every product in medicine beyond which its use is not recommended. You should have got the cover boxes of the stents and you can see it yourself whether they were expired at the time of placement. If they were expired, you can file a legal lawsuit on the doctor and hospital. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sameer Maheshwari, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to heal stomach infection?\n\nhi how are you ,  doctor  doctor last week i was suffering by acute pain  on stomach  after i took test of ultra sound, axray, endoscopy, and CT SCAN , reports are normal  but  after when i checked the level  of pancreas test i was  very high 700 and doctor admitted for 5 days and  now am okey   but i want to  know why this happen   and i was  sufferring by  small small  stomach infection from last month, and am alcohalic every  day  and i eat  non veg to much   i want change i have to give in my body",
    "doctor_response": "Thanks for your query at HCM!I am Infectious Disease Specialist! I went through your query!As you told you are alcoholic it could possibly be an mild episode of pancreatitis or gastritis which is quite serious condition. You must stop the intake of alcohol. If not you are having tendency to develop chronic pancreatitis which can be life threatening.Take healthy diet. Avoid spices and oily food.Happy to take more queries! You can also write a review for me. If you would like some more information, I will be happy to provide. You can take a follow-up query.Take care!Dr. Sheetal VermaInfectious Disease Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment options for chronic cough with mucus\n\nI have a chronic cough with excessive mucus and I have had this condition for over 2 years. Test shows my lungs are clear, sinuses are clear. Where can this mucus be coming from and what can I do to get relief from this cough? It is changed my life drastically. I don t cough when I am laying flat. It causes me to vomit quite often because I can t get all the mucus out. Any ideas?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.By your history and description, possibility of bronchitis is more likely. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test).PFT will not only diagnose bronchitis but it will also tell you about severity of the disease and treatment is based on severity only.You will need inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).Oral N acetyl cystine (NAC) twice a day is also helpful.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for soreness and numbness in leg caused by bruises\n\nI woke up with a sore leg from the hip down 2 days later I got several bruises all over that leg they are still black it s been over a week my leg is hurting more as time goes by and it get numb sometimes...... is this something I need to have checked",
    "doctor_response": "sometimes small injuries do not need attention. but since it's a week I wish to recommend you that it ll be good that you visit and close by orthopedic specialist and get yourself checked once.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stiff neck,headache and severe muscle pain?\n\nSpent seven days in hospital receiving iv antibiotics (zithrimycin, ceflex and another) for sepsis and pneumonia from aspirated bacterial enteritis. Released six days ago and had. Had been feeling better each day, but tonight not so good. Have EXTREMELY sore stiff neck that wasn t helped by lortab, headache and muscle aches. Suspected origin site of sepsis was small surgical incision on my face (removal of growth that was a cyst), and it is inflamed and crusty. Should I be concerned tonight?",
    "doctor_response": "dear madam , i would like to know do you still experience fever, since you had sepsis i would do some maneuvers for testing menigeal irritation, then decide what to be done, i would recommend visiting clinician again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any cure for minimal fluid in POD ?\n\nminimal fluid in pod noted due to check up through doctor how i can cure it",
    "doctor_response": "welcome to healthcare magic fluid in pod can be normal finding. normally also during ovulation when the egg is released some fluid comes in pod . so this should not be worried about. hope this is helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the rise in TLC levels even after kidney removal?\n\nMy father is 65 years old. He has been operated for staghorn stone (55mm) on 11 july. But his tlc and fever hasnot decreased and it goes up to 23000. On 2nd september Dr operated him and removed his kidney due to infection. After that his tlc come down to 11000. During this period has been injected high dose of sudopen. But again it incresing from last 3 days and now it is 13000.. what to do.. pls suggest.",
    "doctor_response": "HelloThanks for query .Your father has undergone surgery for stag-horn calculus and subsequently developed infection which was manifested by high grade fever and raised WBC count which were not controlled even by taking higher antibiotics for long period hence surgeon has to remove his Kidney (Nephrectomy) .Please get his routine urine test and urine culture done to find out the organisms causing this infection and antibiotics to which they are sensitive to so that he can be given appropriate antibiotics to contrl his infection and WBC count to come down to normal .Since the focus of infection (Infected Kidney)has been eliminated from his body and his WBC count is showing downward trend there is nothing to be worried about He will most likely be normal within  2 weeks .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sneezing every morning after waking with blood streaks, no relief with medicines. Advise?\n\ndoctor, I sneeze every morning as soon as i get up from my bed around 5-6 times with little bit of blood and .... and ofcourse at night time lillte bit. Now I started using Flomist nasel spray and I too used citizin for abt 15 days and it s not working either. Please advise me for the above... regards wangdi",
    "doctor_response": "Sneezinh for more then7days even haemoptysis Did ever been in contact with tuerculosis patient Investigation MONTOUX TEST AFB FOR SPUTUM do it for 3days TB IGM,IGG CHEST XRAY PA VIEW if u result coe positive then do RENAL FUNCTION TEST AND LIVER FUNCTION test as baseline  to adjust the dose nd check for side effect",
    "dialogue_context": ""
  },
  {
    "patient_message": "Am I having side effects from Oflacin and Ornidazole?\n\nI have been diagnosed with amoebasis. given oflacin and ornidazole tablet for 2times for 3 days. For 1 day everything was fine. 2nd day stomach pain and loose stools started. what could be the cause. Could this be side effect and can I stop taking medicines.",
    "doctor_response": "Hello, The symptoms seem to be related to side effect of Ornidazole. I suggest using an over the counter option such as Imodium for the diarrhea. I also suggest using daily probiotics and eating a healthy diet.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Dorina GurabardhiGeneral & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for tiredness\n\nTired, weak legs during the day with rls at night. Can t seem to get good night s sleep, but sleepy during the day. Two weeks ago after going to bed had jaw ache with some pressure around my chest like a belt tightening; didn t last long, maybe 2 minutes and was able to fall asleep afterwards. Also sometimes feel like I blank out for a split second. I have COPD and take Advair, Spiriva, Daliresp daily, along with Effexor for depression; Pravastatin for my cholestoral; and Anastrozole of which I have to take for about 4 more months for total of 5 years. I also have sleep apnea, but hate to use the cpap--so I don t. My current personal life is pretty stressful. I have a 19 yo daughter diagnosed schizo-effective and has a drug habit. Been out of work for 6 months and have lots of debt. Gee, I just noticed your last name! Seriously, I want to crawl in a hole and not come out.",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.Tiredness could be a manifestation of depression which will require regular treatment. The drugs meant for these are escitalopram, fluoxetine etc.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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tiredness, difficulty sleeping. Finished breast cancer treatment. Normal BP and cholesterol. Did she have brain attack?\n\nYou may e-mail me at YYYY@YYYY I have a friend who had what was diagnosed with a mild stroke , probably 6 weeks ago. She had been under a lot of stress at the time and is very very high energy. Now she gets tired easy and has dificulty sleeping some nights. She was just finishing a 5 yr treatment for her breast cancer and her family physician said that was the cause of her stroke. After 5 years??? She is 72 and has normal BP and Cholesterol levels, also normal wt. Oh she sometimes has some dizzyness. What if any is her recovery time supposed to be and do you think she definitely had a brain attack? Thank you!",
    "doctor_response": "the only way to know is if she had an MRI.  there are many causes for strokes including blood pressure, heart problems, and cholesterol in the neck.  only imaging will help you further",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should one be alarmed at the elevation of aso count?\n\nI was recently diagnosed w a severe case of streptococcus pyogenes on my face and in the hospital for five days 1/6/11. My ASO count on admittance was 1,428 and on a test 1/21/11 it was elevated to 1,747. I am currently on antibiotics Levaquin 750mg and clindamycin HCL 50 mg. Should I be alarmed that it is elevated and not going down? thanks, babs",
    "doctor_response": "Hello,The ASO titer just reflects the infection that you have with strep. It should go down once the infection is treated. Do not worry about it at present.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for headache and vomiting after dialysis\n\nI ask the nurse to only take out two liters on dialyses-one did the prior 3hr the last sesion  an outer nurse after i told her to take out only 2 lt water -she took out 4 liters and I got sick on the way home headache and vomiting-what to do to change this nurse -how  does not listen to me",
    "doctor_response": "Hi, Nausea and vomiting is quite common after dialysis and it is due to the complexity of procedure and use of fluids. You can take antiemetic drugs like Domeperidone for symptomatic relief. If the symptoms are severe, consult your nephrologist and get evaluated. Wishing you good health. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussai",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intermittent pressure in chest in eledery?\n\nmy question is regarding my grandmother of almost 90. she recently has stated to me that after sitting down from doing an activity. when she stands up she feels pressure in her chest. it doesn t seem to last too long but it has been occuring for a week now and i believe a bit more frequent when she spent the day outside of the house with family. any need for conern?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Yes, we should definitely rule out heart diseases in your grand mother's case. She is almost 90 years of age. So possibility of age related coronary artery disease (CAD) is high and this can cause similar symptoms. So better to consult cardiologist and get done 1. Ecg 2. 2d echo3. Stress test (trade mill test) 4. Coronary angiography (if required). She may need cardiac supportive drugs on the basis of these reports. If all these reports are normal then no need to worry for heart diseases. Hope I have solved your query. I will be happy to help you further. Wishing good health to your grandmother. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for blood noticed during cough\n\nwell ive been coughing up blood for past 3-5 months. I have been to doctors to have blood test and x-ray but they came back clear and the doctor says nothings wrong with me but its still going on and its got alot worse as the blood is dark red and its happend about 5times a day its alot of blood as well as well with the blood ive been feeling dizzy and weak. I have also got pain on left side of my stomach and back and im loseing my apitit to eat and been loseing weight.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understamding your concern. As per your query you have blood in sputum while coughing which is known as hemoptysis could be due to inflammation of any vessel in lungs, due to throat irritation because of acid reflux. Need not to worry about it. You should visit pulmonologist once and get CT scan chest done. You should go for bronchoscopy as well. You should start medication after proper diagnosis. Sputum test and smear culture should be done. Till then take antibiotic along with antiinflsmmatory drugs such as Levocetrizine . Avoid use of cold liquid substances. Avoid spicy, sharp and oily food. You should take steam inhalation. Take diet rich in multivitamins. You should gargle daily.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump in the forehead of a child?\n\nHi my son is 7 years old n has had a lump on his forehead for a couple of years it is as hard as his skull. Since having it he is randomly sick, he gets a fever and constant headaches. N he says he feels pressure in his head. His behaivour is very erratic. One minute hes fine n the next hes really angry or really hypo. The past couple of weeks he has had a headache n pressure every day. Were at a loss. Should i take him to the drs or do u think im overeacting. Thanks",
    "doctor_response": "HiThanks for writing to healthcare magic.Lumps can be a cyst, dermoid, post traumatic fibrous tissue, etcSend us some pictures if you could.If it is associated with headache, take him to your doctor to get him examined, scan or Xray may be required.Wishing your child speedy recoveryRegardsDr Arun",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itchy rashes above the ankle. Due to bug bites?\n\non my left leg just above my ankle area, I have a couple of small flat red places that sometimes itch . They are bright red at first, then later become brown and start to fade. I first thought they might be some strange bug bites from working outside this summer. But now that I am not outside anymore, I still get one or two.",
    "doctor_response": "HI there. Thanks for your query at HCM. As i am wont to say, dermatology is a 'visual' field. So it would be great if you could upload some good clear photographs of the rash onto this site using the 'upload data' icon on the right side of your screen. In the interim, your guess of an insect bite reaction seems fairly accurate & intelligible. The reason it does occur indoors is probably due to the presence or infestation of dust mites/fleas etc in our indoor surroundings including carpets/rugs/ blankets etc! There are two approaches you could take. First, visit a skin specialist (dermatologist) nearest you & get an opinion/skin biopsy & then move onto the treatment or simply apply a potent corticosteroid cream that you may get over the counter if you have a friendly neighbourhood pharmacist on hand & do remember to treat the fomites & spray the surroundings etc! But, do remember if you go with the cream, then no biopsy can be done for at least two weeks after stopping said cream. In any case if the cream & and a non sedative antihistamine (fexofenadine 180) does not work, then best visit the dermatologist. Cheers & Good LUck! Dr Praveen Rodrigues MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a skin infection on the calf\n\nCover up tattoo on calf. A week ago today noticed greenish clear pus bump on it. Washed as usual with antibacterial soap, but piece of tattoo and skin came off. Switched from store brand lotion to aquaphor earlier and put bactine on raw patch. Curious how to home treat this.",
    "doctor_response": "HelloThank You for contatcing HCM.You most probably are suffering from skin infection due to tattooing. If a patient with these symptoms come to my clinic then i would suggest the following:> Keep wound as clean as face.> Change dressing of the wound on daily basis till it becomes better.> Use polyfax plus ointment and rub over the wound.> Use acetaminophen for pain & fever (if occurs)You need to visit nearby hospital for further treatment & antibiotic cover if:> Wound does not start improving in 3-4 days> Wound gets worst> Any other unusual symptom appears. Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. If you do not have any clarifications, you can close the discussion and rate the answer.Wishing you good health!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rashes and strep of child\n\nMy 4 year old has a rash, it started on Thursday on his forearms, pediatrician said it looked like contact dermatitis, he also was diagnosed with strep, but the rash doesn't look like a strep rash. On amoxicillin for strep, on Friday, rash grew hot to touch and became very red and itchy, so I started benedryl.  Today he looks like he has a sunburn, only places unaffected are groin and ankles and feet.  Fever still come back, rash still warm to touch, seems the brightest on his cheeks.  Oh, he's non-verbal autistic as well so he can't describe any other symptoms to me.  There have been no changes to soap, detergent, environment, or foods in the last 3  weeks, and he is a fair skinned red head as well.",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms seem to be related to scarlet fever.Scarlet fever  is an illness that can happen in kids who also have\u00a0strep throat\u00a0or\u00a0strep\u00a0skin infections. The\u00a0strep\u00a0bacteria make a toxin that causes a bright red, bumpy\u00a0rash.I suggest to keep the area\u00a0dry\u00a0and clean, using unscented, gentle soap and warm water. Applying calamine lotion or hydrocortisone cream may help reduce and soothe the\u00a0rash. Gargling with warm salt water can soothe a\u00a0sore throat.Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "My toddler accidentally rubbed her eye with iodex and eye is puffy and swollen around the eye lids. What should I do?\n\nI HAVE BEEN ON THE DEPO SHOT BIRTH CONTROL FOR AROUND 3 YEARS NEVER HAD ANY BLEEDING BUT LATELY I HAVE HAD BEEN HAVING PREGANACY SIGNS SUCH AS SORE BREAST FEELING SICK FATIQUE DIZZINESS AND THEN TODAY I HAVE STARTED BLEEEDING BRIGHT RED BLOOD THIS IS NOT NORMAL AS I HAVE NOT BLEED ON THE DEPO IN 3 YEARS WHAT COULD THIS BE",
    "doctor_response": "When you are on Depoprovera injection, you will not get your periods regularly. Since you suspect to be pregnant get a urine pregnancy test done. Also get an ultrasound abdomen done. Bright red colour of the blood indicates withdrawal bleeding.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for swollen penin\n\nHi Doc the rim of penis is swollen. 2 weeks ago i went to my primary care doctor and he said everything looks alright. I had ct/gc and rpr done and is negative. for second opinion i went to a urologist and he prescribe me with clotrimazole-betahethasone cream.He said swelling should  minimize in 10 days. This is the 8th day and is no improvement. what should i do. By the way no sores and pain.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.I advice you should do culture and sensitivity from the affected area skin.This will guide us regarding the possible pathogen and it's sensitivity pattern.Applying cream as per the report will not only cures you but can also cures you properly.Clotrimazole and betamethasone cream is antifungal agent and can be used in fungal infections.If the infection is not the fungal one, we can't treat it with this cream.Please wash the affected area regualry. Maintain good local hygiene.Please start the treatment before the condition become worse.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have severe abdominal pain and lower back pain. Pap smear and urinalysis normal. Suggest?\n\nI am 49 years old and am waking up in the morning with severe abdominal cramps and lower back pain.  Approximately 30 minutes after I get out of bed, all the pain goes away for the rest of the day.  I have been to the gynecologist and my pap smear and urinalysis were normal.  Also, I had a sonogram to check my ovaries for any signs of cancer and that was normal.  The pain has been getting increasingly worse and wakes me up about 5:00 in the morning.",
    "doctor_response": "Hi, it appears to be the signs of hydronephrosis, due to subclinical urieral stone , or a stone in the kidney. The other cause being not passing urine while going to bed and it causes pressure over the kidney. Hypertension also can cause the pressure over the kidney.                          I advise you to consult a urologist for diagnosis and treatment.                          Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mouth ulcers and red gums?\n\nhello please help me,My five year old son has mouth olsers and red gums and he keeps sweating but feels cold, he hasnt eaten for days but he has been drinking fluids, whats wrong? Xwe did go to a farm last week and fed some animals but he did wash his hands afterwards",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM, I have gone through your query, as you have 5 year child have mouth ulces and red gums dont worry for ulcers you can apply ointment Gum paint twice daily for one week . For redish gum and gingivae you can advise him to do Luke warm saline gargle two - three times a day.  If wont get relief then consult dentist and go for oral examination .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling and fogging feeling in brain in mornings?\n\nHello, I m 26 I consider myself super healthy eat friuts and vegtables daily I exercise a good amount. I recently stopped smoking marajuana for a month and a half after I ve been smoking for 5 years. Here s my question, my brain especially in the morning feels like its tingling and foggy. Is my brain healing from all the weed? or should I be worried? I would really like not having to go to the Dr if I absoutly don t have to. .",
    "doctor_response": "Hello,Some symptoms of withdrawal after quitting marijuana are acceptable. I think you shouldn't worry about. You should see your Doctor if there is a worsening of the symptoms.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could you please suggest any medication for rash on groin in a 19yr old?\n\nHi Doctor,My 19 yr old son has a really bad rash on his groin,he has not been sexually active in a yr and a half,it may be a heat rash but red spots don't look like a heat rash.It is only around the groin area,can you suggest some type of cream to use??",
    "doctor_response": "Hello and welcome to healthcaremagicI would like to keep a possibility of fungal infection/Tinea cruris. In order to confirm my diagnosis, I would suggest a KOH scraping test.In case it is found out to be fungal in origin, I would have advised a topical antifungal cream e.g clotrimazole or miconazole cream twice daily to be applied locally.An OTC antihistamine e.g cetrizine 10mg once daily would help him symptomatically with the itch.regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from Parkinson's disease. Addicted to medication, over dosage. On syndopa plus, pramipex and zolfresh. Need help\n\nsir mi aunt is suffering with Parkinson disease since 6 years and now she is having D.B.S the main problem with her is highly edicted to medicines and she is consuming over dosage even though not required and always thinking about medicines and nothing else. now she is using syndopa plus 1/4th tablet for every 2 hrs in between 6.am-9.pm pramipex 0.5mg thrice a day,zolfresh 5mg at 9.am & 5mg at bed time,mitraz 15mg at bed time. i request you to suggest to control her over thinking about the medicines and ediction to medicines. thnak you....",
    "doctor_response": "I dont think that she is overdosing/addicted, though that is a possibility.The chance are more that she forgets the medicine she has already taken.Therefore as soon as she feels uncomfortable, she remembers again that she can take a pill and goes to take it.I think the best solution, and a little uncomfortable for you is to stop leaving her medication up to her. You can leave her medicines that she needs to take in a separate box. The morning and evening doses you can give to her yourself. In other words, you start medicating her.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes inter menstrual bleeding after taking I pill?\n\ndoctor i had unprotected sex and after 34 hrs i took 1 I PILL Tablet is there still any chances of getting pregnant. After taking that tablet after 3days i am getting bleeding is that my periods or symptoms. And doctor when to get pregnancy test after how many days",
    "doctor_response": "Hello,I have gone through your query and understood the concern. The emergency contraceptive pill provides ample protection when taken within the stipulated time interval after unprotected sexual intercourse, in any phase of the menstrual cycle. The pill, moreover, contains high hormone doses and this disrupts the hormone milieu thus causing menstrual disturbances. What you are seeing now is the withdrawal bleeding due to the pill effect. You can also expect your next natural period to get delayed by a week or two. If you become overdue by ten days, please get further help from an expert. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does renal cyst on USG KUB suggest?\n\nThere are several small echogenic non-shadowing foci within superficial renal parenchymal cortex. No echogenic focus in the renal sinus. No hydronephrosis. Right kidney measures 10.2 cm in length. There is an exophytic anechoic cyst protruding from the superior renal pole measuring 10x8x8 mm. Left kidney measures 10.1 cm length. No calculus, hydronephrosis or parenchymal abnormality. Normal appearance of the urinary bladder with normal bilateral ureteral jet. No bladder wall mass or calculus is seen. 16 cc post-void bladder residual. Impression: No renal calculus or hydronephrosis Few small nonspecific echogenic foci within renal cortex, possibly small cortical calcifications but not representing renal calculi 10 mm right renal cyst Small post-void bladder residual Can you please explain?",
    "doctor_response": "Hi,Thanks for writing in.The ultrasound scan report shows a 10  8 x 8 mm simple cyst in the right kidney upper pole. This is described as an exophytic cyst in superior pole. Such a small cyst can be ignored and requires no treatment. Cyst are thin walled fluid filled sac like structures and a few of them can be normal. Please do not worry for the cyst.For the cortical calcifications, these need to be followed up by doing serum electrolyte tests to know your calcium level. Any metabolic condition causing calcium deposition on the kidneys must be investigated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from asthma. Using ashthalin inhaler. Feeling conjusted and breathless. Suggest\n\nI am 25 yrs old girl. I m suffering from asthma from last 10 yrs...I am using ashthalin inhaler I use 5 to 6 puffs in  day.nd specially in night I take 1 puff and 1 puff when I get up in morning.at dat time I feel conjusted in my chest.or breathless.I have taken so many medicines.its has no use....due to dis my my weight is 58 kgs according to my height it must be b/w 45 to 49...my height is 5 .I am overweight. wht should I do to reduce my weight nd to control my asthma.plZz suggest me.I am vry tensed due to dis problem.",
    "doctor_response": "us anti allergics montair fx twice a day this is combination of montelucast and fexofenadine syp ascoril 1/2 tsf tds inhalers can be continued with this if you completely stop milk and diary produts nd eliminate from diet your wt will be reduced and asthma will be controlled with minimum medcines milk and diary are animal proteins and thet increases allergies",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hip pain\n\nIts my wife I m asking for she has pain on her hip she a little over weight and diebietic her hip hurts then her knee starts hurting she doesn t like taking pills unless the doctor tells or prescribed it.what can she do to help she losing weight but what else?",
    "doctor_response": "hi,thank you for providing the brief history.A thorough neuromuscular assessment and musculoskeletal assessment is advised.As has pain in the hip, she is diabetic and obese, I will advice you to undergo physical therapy as it will help her to reduce the pain, reduce the weight with exercise and reduce the blood glucose levels.Also, to understand that in diabetes the major issue with the high blood glucose level. With exercise the levels can be reduces.As the pain is in the high which travels up to the knee, it indicates the muscles are weaker and needs a strength.Weight is also an issue here which may tend to apply more pressure on the hip and knee joint. So reducing the same will help to avoid pain and aches.In my clinical practice I have seen diabetic patient with many much more complains. but they respond well to physical therapy and in about 3-4 weeks of time the symptoms are slowed down. Later the regularity is important to improve the overall health status.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling and numbness in hands and arms?\n\nI was never officially diagnosed with Atrial fibrillation but every day my hands and arms will go numb at least once or twice. They have the tingles feeling and takes a little bit before the tingling stops. I work every day and do not have any weakness in my arms. I am slightly overweight I am supposed to be around 280 and I weigh 340. It happens almost every morning and through out the day.",
    "doctor_response": "Hi, you may be suffering from carpal tunnel syndrome, and this is due to neural compression, your will be requiring a examination of your hand , consult a neurologist first. the surgery of this condition is performed by  Hand Surgeons.",
    "dialogue_context": ""
  },
  {
    "patient_message": "suggest treatment for difficulty in conceiving\n\nHi Doctor I am Sharan 25 years running. I am 3 years married. My problem is i am unable to get pregnant. Last Year i was pregnant but i had aborrtion in the month of 2.5 , after that i am unable to get pregnant. I have all tests like TORCH TEST (IGGM, IGM), Glucose test, Menstrual  blood test taht all ate normal. I a test i have PCOD problem for this problem doc, advised me TABLET BIGOMET SR 500 for 3 months i am taking this tablet and this is my last month for taking this tablet,  with this i am taking FOLIC ACID tablets also. please doctor advise me what should i do for get pregnant as soon as possible. Regards Sharan 0000",
    "doctor_response": "Hi . Continue to take  the two tablets your doctor has prescribed.You have not given some necessary information. You have not mentioned what is your BMI. If it is more than 25kg/m2, you need to reduce your weight. This is extremely important to improve your chances of getting pregnant. The very fact that you were pregnant last year means that your husbands semen analysis is acceptable and your Fallopian tubes are patent.Some women with PCOD do not ovulate regularly. Are your cycles regular.  Have  you done serum progesterone test.If you are not ovulating regularly you need to take medications like clomiphrene citrate to induce ovulation. This should be combined with folliculometry studies( ultrasound to monitor the growth of follicle in the ovary ) to confirm ovulation. This is the first step. Discuss with your doctor about this.  Keep me updated about the progress of your treatment. If you any queries write to me again. I will be happy to answer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in the mouth despite a normal CT scan?\n\nWhile having a cup of coffee my friend s right side of her mouth felt numb as if she were given novocane. She was taken to the ER. They did a CT scan and bloodworm & said results were negative & recommended an MRI. The same thing happened the next day",
    "doctor_response": "Hello!My name is Dr. Aida and I am glad to attend you on Healthcaremagic!Your friends symptoms are suggestive of TIA (transient ischemic attacks). For this reason, I would recommend consulting with his GP and performing some tests: -a Doppler ultrasound of the carotid and vertebral arteries- an ECG Holter monitoring to investigate for cardiac arrhythmia- a cardiac ultrasound- blood lipid profile- fasting glucose - kidney and liver function tests- a brain angio MRI or angio CT scan. You should discuss with your doctor on the above tests. Hope you will find this information helpful!Best regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can persistent abdominal pain be treated?\n\nhi sir...my name is muhib khan...before 4month s ihave suffering by lower abdominal pain...diagonosis report are urinari trac inection mild..octor pescribe me imipramine 25mg+aceclofenac 100mg+omiprazol..i take those drug..and my lowe abdominal pain back again...also pain to my scoturm....then my doctor pescribe cipoloxacine 500mg daily 1+0+1=7days....but my lower abdominal pain r continue...better to talk about this i take imipramine 25 mg only 11 days...bcs o that its may be reaction and my whole body were rashing.icching...but when i take off this medicine before 25 days...but this reaction are stiil now..and i have too much pain of my lower abdomine...i take now hydroxizine...10mg...bcs its help to me few hours to verry bad pain relief...i m a student...And i have very poor...what can i do sir? what medicine i take now?",
    "doctor_response": "Hi ! Good evening. I am Dr Shareef answering your query.Discomfort in the testis could be due to ignored repeated trivial trauma, which causes inflammation causing pain/discomfort in the same. Testis being an intra-abdominal organ embryo-logically, brings the nerve supply to it from above, and so the pain in the testis is frequently radiated/felt as a discomfort in the abdomen/pelvis area.  In your case your urinary tract infection might have spread to the testes giving rise to such pain in the testes.If I were your doctor, after a thorough physical examination I would advise you for the following:1) Support your testes with properly fitting under garments.2) Avoid standing for prolonged period, and avoid lifting heavy weight if you do.3) Advise you for a routine blood tests like a CBC, AEC, HbsAG, HIV test and a urine routine/microscopic examination followed by a culture and sensitivity report if need be and advise antibiotics as per the report.4) Avoid indulgence in any sexual activity if you are active sexually which would prevent further trivial trauma if any to the testes, apart from precipitating any kind of infection if present.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dry red skin on lip\n\nHello, i have a red sore on my lip its not a cold sore and has come up out of nowhere i have done nothing different in my lifestyle. its sort of red and dry and stings if i dont put vaseline on. do you know what it might be?",
    "doctor_response": "hi its known as chelities . its due to dryness may be internal or external. avoid wind ,sunlight exposure. do apply vaseline as many time u need . drink more water do not popped it",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can disinfected bottle with hydrogen peroxide cause tingling in lips?\n\nI recently disinfected plastic water bottles with hydrogen peroxide @ a store where you can purchase purified water. they had peroxide there to sanitize bottles you bring in. I rinsed the bottles out before I filled them with water. But there may have been some peroxide residue left, because the water tastes funny. My lips also tingle a bit after I have drank the water from the bottles. What are the dangers here for me. Should I discard the water Can I boil it instead. Is there a health risk?",
    "doctor_response": "Hello, Thank you for consulting with HCM.Actually hydrogen peroxide is used as a bleaching agent for tooth. But at that time proper precaution is taken for prevention of soft tissue , as it creates slight irritation to soft tissue.So in your case it can be possible that this chemical might have contacted your lips and a sensitivity has developed.But as it is in diluted form it will not cause any further damage.Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should Lupron depot be stopped altogether?\n\ni have pain in my left lower abdomen. on a scale of 1-10 it is a eight.and at times a 9/10. I feel and look bloutted amost all the time. I tire very easily..I had prostate surgery in 2010 for an aggressive type of cancer i had 28 tx of radiation. and did fairly well...I only got tired toward the end. Now I really don t want to eat the smell of food makes me sick. it causes back pain in my left side. I also take Lupron I have seen my doctor I have had blood in my stool and urine since I finished radiation therapy. I know that bone cancer is a possibility I did delay a shot by 2 months i thought about stopping jt all together. What do you think?\\",
    "doctor_response": "Dear GreetingsIt seems that there is a progression of the disease bony pain and bleediing manifestation are could be part of it.One should get the bone scan done to find out the cause of bone pain.Mri pelvis also recommendable to rule out the local recurrence.Se.PSALupron depot should not be stopped immediately as other therapies can be add on to the Lupron.Mri pelvis will also help t",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can controlling, obsessive with possessive type behavior be controlled?\n\nHi, may I answer your health queries right now ?  Please type your query here... I am controlling obsessive and posseive over my boyfriend. I make demands and I boss him about. Most of the time I don't know I'm even doing it till I take a step back and look at it from an outsiders point of view. I need help and I don't know where to go or who to turn to",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  I can assure you that you are not doing anything wrong. You are being possessive and authoritative towards your boyfriend because, you are in love with him Don't worry. all these behavior are part of every day life. Don't be amused. Just make sure that you think positive and right. slowly, when you understand the depth of love and life, you will stop behaving possessively. Called maturity.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could large gliosis on temporal lobe shown on CT scan of brain refer to epilepsy?\n\nHi, I have problems with my memory. I can not remember information that I read or listen to and I have difficulties forming sentences (speech). I had an old injury to my right eye nerve. I did a CT scan recently which showed a moderately large gliosis in the right temporal lobe. I did EEG and was normal. My neurologist suspects it is an epilepsy and gave me medications for that. However, I read online on the topic and found that the epilepsy symptoms do not happen in my case except the memory issue. I wonder what to do next.",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your details. Large gliosis in the temporal lobe seen in the CT suggests a past history of brain injury. It may lead to epilepsy, however, as you suggested, your symptoms are not suggestive of epilepsy. So, in my opinion, you do not require epilepsy medications.The cause of your memory loss needs to be investigated. Serum vitamin B12 level and thyroid profile may be done. I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat difficulty in breathing after having a stent placed on artery?\n\nafter having a stent placed in an artery and medication for another artery that was 30% blocked, I feel like I can't take a complete breath (not short of air) and I'm very tired all the time. No history of HTN or hyperlipidemia. I stopped smoking over a year ago",
    "doctor_response": "Hi,You should see your doctor for full evaluation as 30% blocked artery can't caused such symptoms, and the other artery is already treated with stent, which shouldn't cause any complaints.There are three possibilities1. You have problems with inserted stent, for exclusion you will need ECG and/or stress test2. Your complaints are caused by the medications  you take3. There is another problem, which is not related to the heart.So you need to see your doctor to find out the cause.Take careCome back if you have any further questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for painful, growing lump after fall\n\nHi 2 weeks ago i had a fall and developed a small lump well after bruise healed i felt small lump was still there but it wasn t painful well this pass Monday i felt sharp pain and yesterday out of nowhere the lump doubled in size and its hot and hurts bad i walk and i have a limp i cry of pain",
    "doctor_response": "kindly visit a close by physician and Get examined at the earliest. I would have recommended you to do icing. but since icing will change the physiological pattern and may misguide the physician it's better you meet them and get urself assessed as u haven't mentioned  where the lump is also. highly recommended to visit a physician and get checked.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is sore throat and headache with swelling in lymph nodes cause for concern?\n\nHi my 6, almost 7 year old son has had three nights in the last couple weeks where he has complained of a sore neck, a headache and has had swollen lymph nodes. Sunday night he had buzzing in his ears and the last two times he has had dizziness as well. I have also noticed his eyes when he is talking to me have very small pupils. Should I be concerned",
    "doctor_response": "hello, It seems you have devloped sinusitis. That is your sinuses around the nose also infected by bacteria inflamed and mucus produced has filled them but not draining them properly through nose. That condition shows similar symptoms. What you need to do is 1 Steam inhalation2 Loratadine3 Amoxicillin4 Small dose of steroid for 3 days5 Plenty of warm water to drink. 6 Rest for few days until symptoms reduceHope this helps. thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high blood pressure\n\nHi, I just came back from my emergency dept. because i wasnt feeling right, they took my vitals and my blood pressure read 178/98, they said it was a little high, and that was it.. is there anything i should do and is this really high?  I'm a 27 year old female and my mother just suffered a heart attack on thursday",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern. I will try to explain and give you my opinion.We talk about hypertension if we have mean values that exceeds 140/90 mmHg. It is normal to have higher blood pressure values after a physical or an emotional stress, so it is important to judge on mean day and night values.Hypertension is divided in two groups: essential or idiopathic hypertension without an identifiable cause and secondary hypertension, usually in young ages, meaning that is a secondary cause of it. This cause might be a renal disease, an endocrine problem, a cardiovascular pathology.As you explain, your mother had a heart attach before.This might have caused a little stress on you and this high values might be normal.The fact that it is a family history with cardiovascular problem should make us much alert with you even your young age.If I was your treating doctor i will recommend a full check up with blood test analyze, a electrocardioram, echo-cardiography and a pressure holter monitoring to check your mean values.Only after this we can be sure if is just a stressed period or something else.Hope I was helpful.Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for asthma and allergic rhinitis\n\nhello sir, my name is vivek thakur and i using seroflo 250 inhal;er for last one year continuosly one puff a day and i my asthma is under control. i am a smoker also. in my lifetime i have come across three asthma attacks having intervals of 1 year each. i am also having allergic rhinitis for which i don t take anything except antiallergic(levocetrizine). my question is continuos use of seroflo inhaler one puff a day is harmful for me in the long run? thanks vivek",
    "doctor_response": "HI, thanks for using healthcare magicIf you have asthma attacks only once yearly and there are no other asthma related symptoms such as night time or early morning cough, shortness of breath, chest pain, then you may not need daily use of the seroflo.You should go to your doctor for reassessment to see if your medication can be stepped down since you are in control.There are some persons who require the inhaler for the long run and it is beneficial since it ensures that the asthma is controlled.The risks of using it are less than the risks of uncontrolled asthma for most persons.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What do right bundle branch block and mild mitral regurgitation mean?\n\nHello doctor, My 18-year-old son got an ECG and blood tests last month as a requirement for medical screening. He jogs every night for 30 minutes. He looks healthy. We consulted our cardiologist early this month and he requested for 2D Echo and treadmill stress test. Unfortunately, we were scheduled for a consult but now we have lockdown for Covid-19. I hope you can help me understand the condition of my son. Thank you.",
    "doctor_response": "Hi. Could you upload his ECG (electrocardiogram) if it has been taken and also his echo and treadmill results?",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes round bulged tummy in a child?\n\nMy 10 year old daughter still has a tummy that I thought would slim down as she got older, but it hasn t. She has no complaints about pain or discomfort. She does t over eat or eat a lot of sweets and has a bowel movement at least once a day. She also exercises regularly. Her height and weight are normal for her age and has no significant medical history. Her tummy got my attention when I was tying her belt around her for her martial arts class. It hangs over the belt. Any ideas?",
    "doctor_response": "Hi,Very good question. I suggest two kinds of exams USG and X ray both of tummy. X ray will show us if there are lot's of gas that could explain why she have a normal life but with this round bulged tummy. USG will check abdominal mass. If everything goes good, so can be that her abdominal muscle are weak. But nothing of abdominal exercises until she complete the menarche phase.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sever back pain\n\nIm 18, 5'11, 150 lbs in pretty good physical condition and suffer chronic back pain since i was about 12. Ive tried smoking marijuana and it considerably helps my back pain. I told my doctor but she thinks im just a kid trying to get drugs out of her. Can i get a medical marijuana card for this. My back pain is sometime so severe i have to sit down or slouch over at work",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern if you have backache then first thing would be underlying cause of this, you are too young for certain disease so routine x-ray study is must and better to quit the narcotic stuff, for the symptomatic relief you can try Tab Diclofenac 50 mg once in day, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could itchy rashes on limbs with fever and sore throat indicate?\n\n3 year old has low grade temp and minor sore throat. She had an itchy red bump on the sole of her foot. We thought it was a mosquito bite. She now has a red pimply rash on arms, legs, palms of hands and soles of feet. Also, has a little on her face.",
    "doctor_response": "Hi Read ur question Ur baby had sore throat and rash  over palm , sole and on face. Mild garde fever with running nose and rash over hand foot and mouth is present in hand foot mouth disease It is a viral disease which is cure itself  It may not required any treatment Treatment is for local symptoms like running nose and for itchingFor this u have to give cetrizine suspension 2.5 ml  two times a day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for numbness in toes\n\nhi I have numbness which started from the big toe and I have not bothered to do any thing about it its been two weeks the likely cause could be I was workingstandiding mostly in same place for accessof 5 -7 hrs now i m not doing that but the sensation has only got worse would rest reverse the syptoms",
    "doctor_response": "hiDefinitely rest and fomentation, elevation of feet on a front stool while sitting may help.Just do mild toe and ankle exercises while sitting to restore circulationbest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How do you know when you are depressed and should see a doctor?\n\nHello doctor, How do you know when you are depressed and should see a doctor?",
    "doctor_response": "Hi. The cardinal symptoms of depression are following, and these should be present for at least for two weeks: If you have any of the above symptoms, then it indicates that you have some mood disorder. This is also important to remember that these symptoms may be present in other medical and psychiatric disorders as well. If your symptoms impair your functioning in any domain and causing distress to you or your family members, then it is time to see a doctor. In my view never to wait for more than two weeks for impairment in functioning to see a psychiatrist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can urine infection be correctly diagnosed?\n\nHi, My daughter is just 23 days old and we got CUE done for her as she was crying before passing urine. Doctor had shown us that PUS CELLS are ranging at 2-4/HPF and hence there is an infection. However, the next day we got Culture test done, which resulted in Negative. Hence, just wanted to cross-check with you if she had infection or not??",
    "doctor_response": "Hello, Pus cells are slightly elevated and it is not significant. As the culture is negative, urinary tract infection is unlikely. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Even after clearing my throat with ethanol, I get oral thrush with white dots. Why?\n\nHello doctor, I have non-allergic asthma diagnosed before six years. Currently, I am using a corticosteroid Foster inhaler two times a day with two inhalations each time. After the inhalations, I clear my throat with throat cleaning solution and also I use a sprayer with propolis and ethanol several times per day and yet despite that I got the oral thrush with white dots all over my throat. I thought that maybe it is just temporary and will disappear after a while but three weeks passed and it still stays the same. Do I need to buy some medication or do I need to just wait for it to disappear while still using the sprayer? Also, can this be related with my higher temperature which is varying in the interval 37.1 - 37.4?",
    "doctor_response": "Hi. Oral thrush that is oral candidiasis is a kind of yeast infection that in your case can be attributed to long term steroid use. This is a kind of untoward effect due to inhaled steroids. You need to clearly examine the entire oral mucosa with regard to the extent the creamy layer has spread. Coming to the treatment aspect, you need to apply Nystatin suspension on the affected area four times daily, which means the sequence should be food, gargle, apply medicine. Nystatin should be applied to the white areas inside of each cheek and/or on the tongue. Apply gently with your finger. Continue for 48 hours, after all of the white spots have disappeared. Also, get FBS (fasting blood sugar) done to screen for diabetes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the neck and back and breathlessness after having a pacemaker?\n\nI had a pacemaker put in last July but lately my hips, back and neck muscles ache and I get short of breath and dizzy when I get up. I am usually the energizer bunny, (ask my great grand-kids,) BUT NOW AM FEELING MY 76 YEARS all the time. went to water aerobics this morning, but doing housework and laundry now, took 2 ibuprofen but have to lay down for a few minutes. Aches don t stop and am walking with a noticeable limp!!!! JANICE.",
    "doctor_response": "Hello Janice!Welcome and thank you for asking on HCM!I passed carefully through your question and would explain that it is important performing a comprehensive differential diagnosis, between different possible causes that may lead to such clinical scenario: - heart failure- chronic anemia- an inflammatory disorder- vitamin D deficiency- orthostatic hypotension (especially considering the fact that getting up makes you feel dizzy). Are you taking any statins? They could also lead to muscle pain and fatigue. Coming to this point, I would recommend consulting with your attending physician for a careful physical exam and some tests: - a chest X ray study- a cardiac ultrasound and a resting ECG- complete blood count for anemia- blood electrolytes- liver and muscular enzymes (ALT, AST, LDH, CPK)- vitamin D levels- PCR, ESR for inflammation. A Head Up Tilt Test should be done in case of suspicions of possible orthostatic hypotension. If you are taking any statins, I would recommend stopping them for a short period of time. You should discuss with your doctor on the above issues. Hope you will find this answer helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from pain in the wisdom teeth & visible hole in the gum\n\nmy daughter has been having a problem with her wisdom teeth and has been to the dentist and won't be able to see her again until May 12th. She is in severe pain and now she has noticed a large one inch hole in her gum that is black in color. this doesn't sound right. Should she go to the emergency room?",
    "doctor_response": "hello thanks for the consult at hcm..she might be having a periapical r periodontal abscess due to which pus discharge mighe be thr which looks like puntured hole in the gums,,, either ways do salt water gargle thrice daily,,could also use betadine gargle,,she will need x-rays and antibiotics and analgesics..if pain persists she could visit the er for medicines,,hope it helps,,tc",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain, numbness in fingers. MRI shows foraminal extrusion. Will numbness go away?\n\nHi doctor, recently i had acute pain on my lower back radiating to my left leg and felling numbenss from left tight to teft leg fingers. The MRI RESULTS is L5-S1 disc show mild reduced height, moderate peripheral loss of hydration signals and medium sized posterior lefft paracentral -foraminal extrusion migrating inferiorly behind S1 superior end plate, encroaching into lefft lateral recess and neural foramen with severe compression of left S1 transversing nerve root .. IMPRESSION ---- L5-S1 disc left paracentral- foraminal extrusion compressing left S1 nerve root. i consulted a doctor who gave pain killers and ased for complete bed rest. now after one week of rest the pain has reduced considerably but there is still numness on my left leg fingers. will it go automattically? pls reply . thanks SHAJI",
    "doctor_response": "Hi, Welcome to HCM, I m Dr.Ganesh I read your report, it shows you have a moderate severity problem.L5-S1 disc left paracentral- foraminal extrusion  causes compression of  the nerve root of S1 which supplies the lower part of leg. Presently you have to take rest , gradually start physiotherapy according to your consultant. Modify the siiting and working posture. Your numbness will go automatically but gradually. Dont rely to much on pain killer tablet as it is not the solution. Exercise is must for you, never ingore it in your rest of life. You will have good quality of life Thanking you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a persistent cough with eye problems?\n\nI have had a persistent cough as well as eye problems. My first trip to the doctor I was told I had a sinus infection. I was treated with antibiotics. A week later after a chest xray I was thought to possibly have pneumonia. Another week passed and was diagnosed with allergies. Many medications later I am worse and not better. Thought that my bedroom had a musty smell. What should my next step be?",
    "doctor_response": "You can have sarcoidosis. It is a disease that commonly causes eye problems along with chest infections. Allergies can be sometimes be a part of sarcoidosis and may manifest as the same. Get a Chest xray and a spirometry test along with S. ACE levels and mantoux test. ALL these will help in getting a proper picture",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could eating raw rice lead to stones in the body?\n\ni used to eat raw rice when i was 14 years old and i tastes very good i was addicted and wen i was 19 i underwent surgery for gallbladder ,was it was for eating rice.my gallbladder has been removed ...but i still love to eat raw rice...will i have stones again??",
    "doctor_response": "HI.Thanks for your query .You will have no further stones. Raw rice does not cause stones but it has a tendency to change your blood sugars. Do check blood sugar regularly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible after tubal ligation?\n\nHi my name is Ariana,I had my tubes cut and burn after my second child who is now 3 years because I had to financial support from my ex. I met a wonderful man who I m now married to and regret having tubal ligation because he has not any children. I would love to at least have one baby by him. Please help me.",
    "doctor_response": "Hi, I think there are two options for you.  One is recanalization, but as your tubes were burnt , so chances of success is a little bit low. 2nd option is IVF.  The chance to get pregnant in one cycle of IVF is 40 to 50 percent.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for itchiness in the natal cleft\n\nI have chafing on my buttcrack, it is not my anus but by nearby crack... It is red, itchy & burns... It also seems to be producing clear fluid like water... It is always wet & I think it s hindering healing... Plus washing/ going to the bathroom etc doesn t help... Hard not to touch that region, throughout the day... Help!",
    "doctor_response": "Hi,From history it seems that you might be having some skin problem like dermatitis or yeast infection.Clean the part and apply triple action cream.Go for one course of antibiotic to control bacterial infection.Keep local part well cleaned, dry and airy.Wear cotton inner wears.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can angular cheilitis be treated?\n\nhello, i am on Accutane and have developed angular cheilitis. I have tried to apply hydrocortisone 1% on my lips twice and it burned like hell. I am wondering if this is a skin reaction from hydrocortisone or is this the healing process. It didn't moisturize my lips neither. I am wondering if i should continue using hydrocortisone? can i try using pander or an anti itch relieving cream (benzocaine 20%, resorcinol 3%) thank u!",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Angular Cheilitis can lead to dry and cracked corners of the mouth and can occur due to a number of common causes like iron deficiency anemia, fungal infection, ill fitting dentures, loss of teeth leads to folds of skin at the mouth corners, systemic diseases like Celiac disease etcetera.Treating the underlying problem that is causing the symptoms will help in its resolution. You can also apply a thick coat of Petroleum jelly over the corners to relieve the dryness and smoothen the area.Do cool compresses. A low potency steroid ointment along with antibiotic ointment can also be advised. But, if the hydrocortisone is causing problems then you should avoid using it. Take multivitamin tablet for 15 days. Consult your physician for prescription. Drink plenty of water. If it does not improve, consult a Physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pressure to urinate?\n\nLatey I feel like I have presure to urinate, right after I Urinate. I have no problems sleeping at night, but this accures more during a work day when I'm more active. I have been to the doctors and I have no prostate problems or UTI. When I sit I feel fine, Its mostly when I'm working. I do construction.This is becoming a problem and affecting my days.",
    "doctor_response": "Hello and welcome to HCM.During the daytime,if you happen to sweat more, increase your liquids intake.To check if your urinary flow rate is normal, there is a test called \"flowrate\".You should do that to ensure you're not having a low flow rate, suggestive of some block in the urinary passage.In males,flow rate is reduced due to a prostate gland enlargement most commonly.Other than a rectal examination to check the prostate gland enlargement, you should also get an Ultrasound examination.This will guide us regarding treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes appetite loss with loose motions and constipation?\n\nThree days ago my daughter began showing a decreased appetite and has had loose stools and constipation.  Last night she had a low grade temp of 100.5 and vomited.  She isn't complaining about being in pain but has said her stomach hurts from time to time.  I'm wondering if I need to call her pediatrician or if it could be viral and will run it's course.  Also, she has urinated once in the last 13 hours - the majority of those hours were over night - she is 3 and potty trained - when she woke up last night vomiting, she did not have to go the the bathroom.",
    "doctor_response": "Hi DEAR WELCOME TO THE HCM,Sir the child is having some stomach infection.Leading to poor appetite and GIT disturbance. Please encourage to take plenty of fluids.Some Git specific drugs like ofloxacin with proper doses will relieve the symptoms.Hope the query is answered.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have stage IV CLL but white cell count not high enough to start treatment. Why I am falling down with no reason?\n\nI have been told I have stage IV CLL but my white cell count isn t high enough to start treatment, so I am in a watch and wait period My question is I have fallen 3 times now, my legs just go out and I fall, no notice, no reason that I can tell do you have any idea what this might be?",
    "doctor_response": "HIThank for asking to HCM This could be TIA, you have not mentioned your age and gender this could have help a lot in giving you advise, telling about the age and gender is too much mandatory, better to go for CT brain have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Epilepsy Complex febrile fits. Issues with equilibrium, spinning, buzzing and dizziness. Suggest?\n\nepilepsy Complex febrile fits .... i can be in the middle of anything and i will suddenly get a horrible smell and burning in the bridge of my nose then seconds later my head starts spinning really fast,I know i must sit or lay down fast or fall over or buckle to the floor. My head feels full of deep gray of and noses, like seeing and hearing through a off the air TV station in my head. i feel like I m just in my head. i cant think right, even though i am conscious, my awareness is impaired and i have saver pain and buzzing, dizzines and spinning in my head and am not really aware of people around me or whats happening, it usually lasts for at least 10 to 20 mins. after the episode I m exhausted and so very tired and lightheaded and i cant walk for a while as my legs give way when i try to put any weight on them. I collapse in a heap, and feel like i could sleep forever, like a life time. i remember what has happened, but details of the event are confusing. i also can get the spinning in my head and the smell/burning in my nose a few times a day just on there own for about 2-10 seconds then nothing happens? I don t fill well for a week or more after this happens Ok my ?? is I had a spell 10 days ago a bad one. Now i seem to have a real problem with my equilibrium, head nose and spinning all the time now, I am almost bed bound. I also if i go up steps i see another spep thats not really there. very clumbsy. I hpe this is enough info. I am out of town and can not get in to see a neurologest tell March 8th.",
    "doctor_response": "Thanks for posting this question HCM Your symptoms could suggest possibility of complex partial seizure. The second set of symptoms may be related to medicine side effects. Sorry, i donot know your medications. Please at;east see a general physician nearby and get examined. They will help you and let you know if it is medicine side effects or somke thing else. Please get back to me in case of any further query in this regard Dr Gopal Krishna Dash Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for itching along with dryness and redness on hands\n\nit started when i noticed the acidic juice of a tomato caused my fingers to itch, started using gloves and it went away. well it is back and worse. it itches so badly that i can t help but scratch, the little blisters ooze and dry. skin is very dry and stays red all the time and has now spread to both hands (top and bottom) and both arms. sometimes when it itches, i will let hot water run over it, i guess it triggers the nerve receptors and it feels wonderful. any suggestions?",
    "doctor_response": "I suggest you need to avoid washing hands with soap as it will irritate skin more. Also use plenty of emollients ( moisturising creams) - this will help form a protective layer on skin.In case of redness & blisters - you seem to have a condition called - Pompholyx eczema - which needs treatment with topical steroid based creams - depending on the country you reside - you may be able to find some preparations available without script ( they will help you to some degree but they are weaker in strength).Hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Slipped, fell. MRI report shows L4-L5 diffuse disc bulge, herniation, facet hypertrophy. Complete cure possible?\n\nHi, Dr,: I slipped & fall 6 months ago. I just did MRI Sep. My MRI report shows my L4-5 there is a diffuse disc bulge with a small left paracentral/foraminal disc herniation with mild facet hypertrophy . This causes left-sided lateral recess stenosis with compression of the descending left side s1 nerve root . Can this problem completely heal?",
    "doctor_response": "Thank for the query. The first issue to be addressed is if the MRI findings are due to the fall or if that were already there before the fall. Facet hypertrophy may be constitutional or due to degeneration. Disk bulge and herniation may be caused by trauma, but it could be already there - did you ever had any sort of left sciatic pain? True disk herniation usually causes an inflammatory reaction that may lead to its resorption and cure. However, if their parent disk is already dessicated, they won\u00b4t resolve. Facet hypertrophy is a permanent condition due to its origin. Just a comment on your MRI report - it is unlikely that a L4-5 disk herniation might cause S1 nerve root compression. This is because, within the L5 lateral recess, resides the L5 root, not S1 (just a minor mistake) Best wishes,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dry nose and mouth after smoking marijuana. Any way to prevent runny nose?\n\ni found that smoking marijuana helps relieve my allergies. normally my nose keeps running / im sneezing after eating any kind of food, but my nose is completely dry for 2 hours after smoking. the nose is probably dry for the same reason that the mouth is dry (cotton mouth). is there any way to dry up my nose without having to smoke?",
    "doctor_response": "Hi, You seem to be suffering from allergic rhinitis. Smoking marijuana is definitely not the treatment for the same. You need to stop smoking marijuana first. You need to visit an ENT specialist and get yourself evaluated in detail. Medicines that may be of symptomatic relief are antihistaminic medicines and topical nasal sprays along with avoidance of all forms of dusts. Regards Dr. Gyanshankar Mishra MBBS MD DNB Consultant Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does rise in temperature and neck pain indicate meningitis?\n\nHi Doctor, My neice aged 6 is in Mumbai, India. She has the following symptoms over last three days. Temperature shooting up to 103and 104 and on giving paracetamol coming down to 98. She has pain in neck, as in all other fevers she does not like sunlight. No rash all over. We are scared for meningitis, though on initial diagnosis doctors have said it is viral flu. If u can answer please.",
    "doctor_response": "meningitis is characterized by neck stiffness which is inability to move your head in different directions..  if thats the case then you need to go the hospital immediately",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain and painful, swollen glands on groin. Urine test reveals puss and RBC. What could this be?\n\nHello I am a female age 33.My problem started with pain on my right side hip area and near the kidney area. I have swollen gland in my right side groin. The pain seems dull and stabbing. I went to aGP he gave me pain killers but it didn t help much. He said I am having a kidney infection. I was not aware of this because except for the back pain I didn t notice any symptoms. I had blood test, urine test and urine culture test. There was no bacterial growth and the urine report showed pus cells rate 10-12, red cells 1-2. My GP said if I drink 3lit of water a day it will clear. But its nearly 2 months now I still feel the pain in my kidney area and when I touch with my fingers on my back I can feel a little lump/gland (I don t know how to refer it) type thing only on the right side area of my kidney. Is it something serious or should I just ignore it? I feel I might sound like silly if I refer this to my doctor because when I asked if there is no need to take antibiotic he laughed and said water will clear the bacteria.",
    "doctor_response": "Hi,From history it seems that you might be having urinary tract infection.You may require one course of antibiotic as your problem is not solved after taking plenty of water.I hope with one antibiotic medicine course, you will be alright.Take Citralar liquid to clear infection faster.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a pimple near anus indicate?\n\nHi, My 3 year old has had a pimple like growth on his buttocks (by his anus) for over a month now. It is only one, on a small scar he has since he was weeks old (the area was once drained after a cyst there was found- they were unable to culture it). The tiny bump does not seem to be fluid filled or hard. It is not red or painful. At first I thought it was a cyst, I thought I saw a tiny black dot on it but it may be my imagination. It appears to have gotten a tiny bit bigger. Should I be worried about a bump that has not gone away?",
    "doctor_response": "Hi Dear Welcome to the HCM,It all appears to be left over skin tag after the excision of the cyst.Photograph of the lesion would have helped to explain you better.Hope the query is answered.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could swollen gums be a side effect of using Zyncet?Is it safe for 2 year olds?\n\nMy two year old has a bacterial infection in his tonsils and one of the medication prescribed was zyncet in addition to antibiotics.  Is Zyncet safe for a two year old? Also, his gums have recently become swollen after three days of use. Could this be a side effect of the drug? Kindly advise",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. You should be worried but not too much. The most common side effects of Cetirizine: drowsiness; dry mouth; stomach pain; tiredness; trouble sleeping.Seek doctor's attention right away if any of these side effects occur:Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); dark urine; fainting; fast or irregular heartbeat; mental or mood changes; persistent fatigue; seizures; severe dizziness; unusual bruising or bleeding; yellowing of eyes or skin.Sometimes allergy to antihistamines  occurs,if you saw swollen gums after zincet, then don't give,change medicine.Please let me know if you have further questions before meeting your primary care Doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "11 mm stone at the junction of kidney and ureter with some hydronephrosis, lower back stiffness, muscle twitching. Can it be solved ?\n\nI have a 11 mm stone at the junction of my kidney and ureter with some hydronephrosis . I don t know how long it has been there but I have been pain free concerning typical stone symptoms of pain in general I have lower back stiffness , muscle twitching, and tingling sensations in feet with a sense of just not feeling well which has persisted for approximately 5 months or so. Could this be due to the pathology described because of chemical imbalance Due to the certain amount of kidney failure and can it be resolved by elimination of stone?",
    "doctor_response": "Hi, the size of the stone and associated kidney nephrosis might warrant a more invasive a serious care. Tests to evaluate kidney function in this case are so vital. Serum creatinine levels, a complete serum electrolyte panel (Potassium and Calcium especially) and kidney ultrasounds are of great importance, Considering that the stone is clinically symptomatic with pain, is greater than 6mm in size and with an associated hydrnephrosis, considering removal of this stone is almost imperative and life saving. Left undone could be a serious threat to the affected kidney with a high risk of kidney failure. Removal of the stone could be through open surgery or endoscopy or another modern method, called Lithotripsy using Laser. The choice is always made by the urologist depending on the clinical eva;luation and financial readiness of the patient. Its reasonable to book urgently to meet a urologist. Thanks as I hope this helps, Best regards, Luchuo, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for painful arms during cancer in neck\n\ni had cancer that started on the base of my tongue last year, stage four, spread to nodes in neck. I had strong chemo and raditation. I continue with visits to dr. no return seen but....i am having alot of pain under one arm that radiates into the breast and sometimes have painful swelling under my jaw on the same side. It can be quite painful.",
    "doctor_response": "Hi,Thanks for writing in.There are many areas which require attention in your case as the following.1. It is possible that your cancer is still not completely treated. This requires follow up clinical examination and imaging to confirm any active disease. If confirmed then you might require another session of treatment with chemotherapy or radiation therapy.2. Another situation is that your immunity is less due to cancer and chemotherapy. This might cause secondary infection in the throat and neck region. This will usually be found with acute symptoms and local rise in temperature and skin changes. This requires specific treatment to minimize the infection and symptoms of discomfort.3. There might be side effects of chemotherapy and radiation therapy on the neck and throat region. This will slowly improve with time over weeks to months.Please have a follow up consultation with your doctor to know the exact cause of your symptoms and have it treated. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for congestion in the chest\n\ni started with a sore throat  31/2 weeks ago. then it went on to chest congestion. doctor put me on azithromycin. that didnt help. went back then i was put on moxifloxacin and prednisone now i finished those and still my chest feels very tight and i cant breathe in deep. cause it feels like its blocked and when i try to cough up phlegm nothing comes up. i'm tired and just feel awful what do i do next?",
    "doctor_response": "You should get your self investigated with Chest X ray, lung function testing  and sputum testing to find out nothings wrong in chest. Inhaled medicines(Inhalers or Nebulisations) are beneficial in some cases who have chest congestion and wheezing due to it. Hot water steam may provide some relief in symptoms",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a blister on the finger?\n\nI have a blister on the side of my pointer finger just past the first knuckle from working with landscape tools. I cut it open to relieve pressure like I have done a thousand times and have kept it clean. I sqeezed it to much due to the irritation and soreness I attributed to a slight infection. now my finger is slightly swollen and is red/pink around the blister and over the last day the pink color has ran up my arm all the way to my armpit and I have slight pain or tightness up to my elbow. I have clidamyacin antibiotic from a infected tooth and took some hoping to slow the infection if that s what it is. what is happening and what actions should I take",
    "doctor_response": "Hi thereit does sound like an infectionclindamycin sounds good too. You should take the same dosage as it was prescribed for tooth infection. Be very careful about this. If the pain and swelling doesn't settle 2 days after you started your antibiotics you must see a doctor very quickly because it might be that there is already pus underneath that needs drainage by a surgeon. Just check that your clindamycin hasn't expired yet.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Circular rash on pits of elbow, comes and goes. Relief with lotion. What is it?\n\nMy daughter, age 10, has a circularish rash in the pits of both her elbows. It has come and gone over the last 2 weeks. No itch or irritation associated with it. She has been using over the counter hand lotion on it and it does seem to help. My initial concern was ringworm but the color is uniform and the rash comes and goes. Any suggestions?",
    "doctor_response": "Hello, it may be an atopic dermatitis as ringworm is uncommon at elbows.she must apply a fluticasone ointment twice a day and lots of moistorisers throughout the day.take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am trying to conceive with high prolactin and low progestrone\n\nhi....high prolactin 30.16 n low progestrone level 5.52 on day 21st of cycle...i m trying to get pregnant from 1 year without any sucess",
    "doctor_response": "Hi there Hyperprolactenemia can cause infertility.You need to start meds for high prolactin first and then only try to concieve.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need treatment for cough & congestion\n\never since my gallbladder surgery about a month ago, I get a cough with a lot of thick white phlem. The cough is more from the phlem in the back of my throat and no difficulty breathing unless I get coughing a lot. Could this be the result of a very difficult intubation? It took 4 anesthesioligist.",
    "doctor_response": "hi,thank you for providing the brief history of you.a Thorough examination of the lungs and musculoskeletal assessment is advised.As post abdominal surgery this is the common symptom patients have. For which the steam inhalation and physical therapy is advised. Since post surgery breathing exercises helps improve the capacity of pure blood for optimum healing and strengthening of the abdominal muscles as well.in my clinical practice I have been working on cases with post gall bladder surgery. and breathing exercises work well on them and early recovery is attained.regardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes gum swelling with sores in the cheek?\n\nI went to the doctor the other day and she prescribed me amoxicillion, she said my throat was red and I was coming down with a cold. Well I did'nt get it fillied and the next day my gum is swelled badly where my wisdom tooth is. It hurts badly, It hurts to open my mouth and it feels like I got a sore on my check were my gum is swollen. Know My nose Is running could all this be from a cold or from the other wisdom tooth coming in???Help Please..Thanks(:",
    "doctor_response": "Hello,Your symptoms could be from either or both. Did your doctor diagnosis strep? You should start your amoxicillin and complete the prescription as directed. This will offer relief in both instances. Take anti-inflammatory medication such as acetaminophen or ibuprofen.  Benadryl, an antihistamine, helps control inflammation and reduce swelling as well. Rinse with warm salt water. You may have bitten your cheek with the swelling and sore spot. Keep hydrated. Avoid vitamin deficiencies and maintain good nutrition. Practice good oral hygiene.Schedule an exam with your dentist or oral surgeon to evaluate the wisdom tooth. You may need an extraction. Infections can spread and have serious consequences. Corticosteroids may be prescribed for a great amount of inflammation. A chlorhexdine gluconate rinse is often recommended and can help with healing sore spots. Avoid irritants such as smoking, alcohol, spicy and acidic foods.Thank you for your inquiry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does viagra help?\n\nHello when I was 17 my dad died so I decided to abuse steroids and my balls get so tight when I have a boner and not all of my penis gos in its effecting my sex life really bad does Viagra make my balls hang again Or will I need to see the doctor I am 20 years old now and I am to scared to see the doctor Stephen",
    "doctor_response": "HelloSildenafil citrate ( viagra ) is used fro erection of penis .However it is not clear in  your history , what do you want.As you mentioned that you are now 20 years old and erection is a common thing ,while when penis is erected naturally testicles ( balls ) become tight , so need not to worry.Still you think you have any problem without any hesitation consult a psychiatrist and get his opinion  as physical examination is very important.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does ECG taken for chest pain indicate?\n\nHello doctor, I went to the doctors with four bouts of chest pain. Lasted under a minute each time. The pain went into the left arm. The doctor ordered ECG. No breathlessness, unless exercising. Can you please review and provide feedback on a recent ECG?",
    "doctor_response": "Hi. Significant findings in ECG are: 1. Early repolarization in V5 and V6. This is a normal finding at your age. 2. Deep S wave in lead V3. This can suggest left ventricular hypertrophy (by Cornell voltage criteria). However, there are no other changes in ECG to suggest LVH and deep S wave can sometimes be seen normally in young people. You can get echocardiography to remove any doubt regarding LVH (left ventricular hypertrophy). Echocardiography.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated leukocytes counts?\n\nMy grandfather is 95 yr old and from few days he is facing alot of health complecations his leucocyte count is more than 12,000 he has sepsis n is on iv antibiotic, nebulisation is also done.he started eating but from yesterday even milk is coming out from nostril if amount is increased, he is not able to lie on bed though feeling sleepy.please help me I request.",
    "doctor_response": "Counts above 10,000 are considered raised. The most common cause for raised leukocyte counts is infection/ inflammation. In your case, sepsis- its a type of infection is responsible for raised leukocyte counts.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause constant severe pain in body diagnosed as problem with immunity?\n\nI am wondering what I should do. I am in tremendous pain. I have had it for more than 5 years, seen doctors from Ivy schools, had various work ups, ; The most I get diagnosed is a problem with immunity . It took more than 200 (mg or mcg, you should know)to night to help quell pain. Various places feel as if they are filled with jello globs making my skin nearly pop open. The fatigue with this is unbelievable. No cancer history in family. This does not fit profile of fibromyalgia. I have not been able to work . I need to work . Spirit is low & I feel I have nothing for a life or will improve in a meaningful way..",
    "doctor_response": "HIHOW CAN YOU TELL YOU ARE NOT SUFFERING FROM FIBROMYALGIA.WHAT PROFILE ARE YOU TELLING.ANYWAY I THINK FIBROMYLAGIA IS BEST OPTION AND PLEASE CONSULT A PHYSICIAN AND ALSO PSYCHIATRIST ALSO.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for a chesty cough in a child\n\nSon 9 yrs old has a chestu cough constantly whole day giving himcough mixture but doesn't eem to help ? Went to see local gp 2 days ago and says just to give honey but son does not like Chest is sore every tym he coughs .",
    "doctor_response": "HelloIt would be better for him to be evaluated by a pediatritian and to do a chest X Ray Dr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistant cough and stressed feeling?\n\nOk last year I wasn\u2019t allowed to drive for 6 months because I had some sort of episode where I was unresponsive for 20 mins . Was thought a seizure but no definite diagnosis. High blood pressure at its highest 210 over 110 had a angeogram but all ok loads of medication. I\u2019ve stopped all medicines since Christmas last year . Been ok but have now started feeling quite stressed and have now got nasty persistent cough . Should I get checked out again ?",
    "doctor_response": "Hello dear , hiWarm welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  Stressed feeling is in relation with BP fluctuation most likely .*  Cough has multiple reasons to be evaluated by physical examination with    your  doctor .Hope this will help you for sure .Wishing you fine recovery .Regards dear take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any treatment needed in 2 year kid if penis is small?\n\nHi doctor, When my son was born the doctors advised that he has micropenis and recommended us to check after one year. When we followed up after one year the doctor said it seems to be normal and not to worry. My son is now 2 years old and his organ looks very small. WHat is the treatment for this?",
    "doctor_response": "Hi....the treatment for micropenis has to be decided only after directly seeing it and measuring the actual shaft length without taking into account the fat pad surrounding it. I suggest you either upload an image on this website or take second opinion from another pediatric surgeon or pediatrician.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain on the left side?\n\nHello,I'm experiencing a very sharp pain on the left side of my abdomen. It started this morning when I sneezed. It felt like a knife going through my abdomen. It was like an explosion of pain! I felt ok afterward until 45 min ago when I lifted my 4-year-old daughter. Especially when I was putting her down, I felt that explosion again. I can now still feel the pain. It's sharp. The pain is in the same line with my belly button, 2\" to the left. Do you have any idea what could it be and should I visit a doctor?",
    "doctor_response": "Welcome to ' Ask a doctor ' service .I have reviewed your query and here is my suggestion .Yes , you should undergo visit to a local doctor as he will examine you to see if there is a abdominal muscle tear or hernia as your symptoms point to stress induced pain .If no such thing on examination , i will suggest ultrasound abdomen to rule out any abdomen pathology as urinary stone etc .Uptill doctor visit , avoid lifting any thing .I hope I have solved your query .Let me know if I can assist you further in this query .WITH REGARDS , DR VARINDER JOSHI.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes delayed sperm flow?\n\nHi I'm 28 male, my question is about sperm flow after the maturity age.I heared  sperm will be released automatically twice in a month normally for all males. I'm 28 now,but  still at this age I never had sperm flown automatically from my body. Is there any problem with my growth and should I need to consult the doctor about this.  Please advise",
    "doctor_response": "hithe automatic flow of sperms at night which is also known as wet dreams or night fall, it is a natural process of body to get rid of old sperms to make room for new sperms as the process of sperms formation is ever going in menmost of the men never had wet dreams in their life and it is quite common.the most common cause for not having wet dreams is masturbation or sexual intercourse which would remove sperms from body off and on and body does not need to make room for newer spermsin any case not having wet dreams has nothing to be worried about, if you still want to test your semen then i would recommend you to get semen analysis done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Painful lump near the base of top left molar.  History of extraction of wisdom tooth,  incapable of fully opening mouth.   Help\n\nI have a lump (about an inch to an inch and a half long) on the inside of my cheek near the base of my top left molars. I had my wisdom teeth extracted on may 30th and I'm still not capable of opening my mouth all the way. It actually seems to open less than it has for at least a week, and it is very painful! Please help!",
    "doctor_response": "Hithanks for the query,To rule out whether the lump is due to wisdom tooth or top left molar, you need a thorough clinical and radiographical examination.If it is because of wisdom tooth , then visit a dentist for irrigation of socket with betadine and ZOE dressing.And if its due to top left molar then treatment is root canal for it.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause a brown thread in the bowel movement?\n\nMy 9 yr old just had a bowel movement and there was what looked like a brown thread hanging out.  I had to pull to get it completely out.  It ended up being about 2 feet long.  I can't imagine him eating a piece of thread like that.  He did complain that he had heartburn last night and today.",
    "doctor_response": "HI it might be a worm- Tape worm, which is brown and so long.It is not a thread as described.Please get his stools examined along with Complete blood picture to rule out any Eosinophilia.Please start him on an antihelminthic drugs as prescribed by a child specialist nearby depending on his weight.Hope it answers your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for stomach cramps?\n\nHi,am having stomach cramps like someone who is on her periods but nothing, its so painful, its happened like this for the last three months, i was given femiplan injection on 21st sep 2012, please advise my email is  YYYY@YYYY  sorry cant afford to pay online at the moment please",
    "doctor_response": "Hello!Thank you for the query.Stomach cramps can indicate bowels obstruction. Especially when lasting for so long.Due to some intestine narrowing or lump, the stool can not get through the intestine what gives cramps. This cramps are the symptom of intestine trying to force the stool through the obstruction.So if your abdomen is also bloated, you have nausea, vomiting, constipation, diarrhea please visit your doctor as soon as possible.Abdominal X-ray should be done at first. If you are over 50, colonoscopy is necessary.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of chest pain?\n\nFor the past few months I have had on and off central chest pains and tightness which alters in how bad it is but a heaviness is always there. The past couple of days I have been experiencing pins and needles and shooting pains down my right arm from the shoulder to my finger tips at the same time as my chest pains getting worse. The chest pains are also becoming more frequent. Should I be concerned and are both connected?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. In my opinion, we should rule out cardiac cause first for your chest pain. So get done ecg and 2d echo. If both are normal then no need to worry for cardiac disease. Also get done chest x ray to rule out lung related causes. If all are normal than possibility of stress and anxiety related symptoms is more. So consult psychiatrist and get done counseling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic drugs too. So avoid stress and tension, be relax and calm. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes middle back pain and feeling spine is closer to skin?\n\nI have an ache in the middle of my back and it feels like my spine is closer to my skin when I lay down if that makes sence.. I m only 17 but I ve been sleeping on a sofa for a few days so I was wondering if that had something to do with it? It s quite uncomfortable",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your symptoms and would like to reassure you that they are not suggestive of any serious neurological illness.The pain is most likely related to muscular pain, which may have happened because of sleeping on the sofa.I would suggest you to avoid sleeping on sofa, and go for back extension exercises.For pain relief, you may apply diclofenac ointment.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the causing sharp stinging pain on left side of belly button?\n\nyesterday, I started having a very sharp stinging pain on my left side about three inches from my belly button. nothing really helps, but nothing really causes a trigger.  stretching may help but it may also hurt.  bending usually triggers but not always.  it is a very isolated spot.",
    "doctor_response": "Hi. IS there a bulge also on straining? Are there associated other complaints like loose motions , burning urination? If not this can very well be a hernia. It is better to show to a Surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain on the top of the head radiating to the sinuses?\n\nI have a kind of sharp pain on the top right side of my head, the pain kind of travels down the right side of my forehead, and travels down the right side of my sinus, and it also travels to the back right side of my head at the base of my neck, don t know what it is, but it throbs on the top of my head then the pain travels to those places, any idea what it could be?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Possible causes of unilateral headache with radiating to sinuses and neck may be migrainous headache or cluster headache or neuralgia or sinus headache or sagittal sinus thrombosis or intracranial bleeding etc. Until examination is done it is difficult to say what it is. Use tablet Naprosyn twice a day for five days. If symptoms not improved please consult your neurophysician he will examine and do MRI scan and treat you accordingly. Take care. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does irregular menstruation cause infertility?\n\nhi,i am 28 yrs old single girl, i have problem with irregular menstruation and i am worried about  is there will be any problem to conceive?also,i am having breast tenderness and pain before my periods. and i am always embarrassed about my small breast as i am 28yrs.so please provide me good suggestion accordingly.",
    "doctor_response": "Hi,Thanks for writing to HCM .Yes irregular cycles cause infertility.  So I suggest you following investigations to know the cause of irregular cycles and take treatment accordingly.-- thyroid profile, serum prolactin, ultrasound abdomen to rule out polycystic ovary disease (pcos).The pain  in breast during cycles is seen in some people. Don't worry for that. You can take primrose tablet after consulting your doctor and pain killer.Normally breast develop in proportionate to body . If you still feel your breasts are small compared to your body then for external appearance you can ware thick padded bra.For your sexual life, then you can go for breast enlargement surgery by a plastic surgeon. Hope I have been helpful .Regards Dr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "30 year old having polycystic ovary syndrome and IgA nephropathy. Had a cesarean delivery due to preclampsia. High protein in urine. Taking coversyl\n\nHello i am a 30 year old female with Polycystic ovarian syndrome and kidney disease which is called iga nephropathy .I have a healthy 11 month old delivered at 37 weeks via c-section due to preclampisa.I would love to get pregnant again but wonder if it is safe for my kidneys.I currently have high amounts of protein in my urine and i take coversyl to help control it.I have around 50-60% kidney function and creatinne level stays pretty much the same at around 100.I had to take clomid to conceive the first time and wonder if i will need it again.My cycle is very irregular and i haven t had a period since Feb except for the 9 days of light spotting i am experiencing now.",
    "doctor_response": "You need to quantify the proteinuria in your urine. If it is less than 1gm in 24 hours you can go ahead with the pregnancy as your creatinine is also with in reasonable range. But you should understand this comes at a slight increased risk of prematurity of baby, preeclampsia and  worsening of renal functions. You should also stop coversyl once you conceive and have a close follow up with the nephrologist through out your pregnancy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pricking sensation in left throat\n\nHi, I'm having a pricking sensation in my left throat region ( the sensation is similar to a fish bone or sharp object pricking) ... It is creating a constant irritation ... I'm not about its cause ... could you please recommend a remedy for it ... will be highly obliged ?",
    "doctor_response": "**1. Throat infection is/are commonly viral in origin, as such you should consult with medicine specialist or ENT surgeon for examination [to look for particular area] and evaluation. [regarding any foreign substance in the throat region] 2.  initially take complete antibiotic course [to prevent secondary bacterial infection along with decongestants and anti-inflammatory medicines. 3.. gargles three times in a day [gargle with warm spinach juice], voice rest, stop smoking. avoid sour, curd/ yogurt, cold drinks and oily food. . take multivitamin supplements. boil 2 spoons of 'yashtimadhu churan' in 4 cup water till 1 cup remains. filter it and add4 spoon honey to it and drink",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get pregnant with adenomyosis?\n\nhi any ob gyn on line? just want to know had endometrosis did the surgery last february  and they remove my right ovary and the doctor told me that i still getting the pain cos i have adinomyosis as while just want to find out i really want to have a baby im 35 years old cod tell me what to do?",
    "doctor_response": "Hi, I think you need some medical support for conceiving.  Take some medicines like clomiphene 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 cycles.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes body pain after viral infection?\n\ni am 20 yr old. i recently had a viral infection and eventually got severe pain in both the arms specially the shoulders, wrists and fingers, pain in ankles, knees and calf muscles of both the legs. At times, i also have numbness in my right hand and have cough as well. I also feel fatigue and have severe headache all the time. Its been a week  since the viral ended but there has been no improvement. What could be the reason for the pain?",
    "doctor_response": "this is myalgia and reactive arthritis. this usually occurs due to the toxins left over in the body by the viral. that acts against the body tissues. to get relieved of it faster eat citrus fruits, take vitamin C suppliments and drink a lot of water.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to overcome insecurity and negative feelings towards others\n\nHello Doctor,My brother is 23 yrs old and his behavior is a little different for the past one year. He is very suspicious of the people around him, and he doesn't seem to trust anyone. Not even my mom, dad or me. He constantly feels insecure about himself and he has a negative view of the world. He says that it's hard to survive in a world where people are always trying to put others down. He always thinks that everybody is acting weird around him while it's only him who misunderstands people. We asked him several times to come to a psychologist. But he refuses to go. Can you please tell me how to convince him to get him to a psychologist? Thanks!3",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  From the description given, I see a case of paranoid personality disorder / paranoid schizophrenia. Could be the outcome of possible negative thoughts and worthless feelings. You may need psychiatric intervention instead of psychologist help. Your brother may be hard to convince. But he will definitely be having some good friends, whom he listens. Find them and convince him through them, that he needs treatment.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I having anxiety and acidity after taking Tezlocbeta?\n\nHello doctor, All my reports are normal for high BP. Presently, I am taking Tezlocbeta 50 since last six months. After that, I am suffering from so many problems like acidity. Presently, I feel anxiety for the past one month. Before one month, my doctor prescribed me Esopam 10 mg. After taking one tablet, I feel bad. After this, I am suffering from anxiety. Right now, I am taking Etizolam 0.25 mg, please suggest me what do. In starting time my blood pressure was 135/95 to 140/105. My doctor prescribed me Olmetrac AM, after a few months my blood pressure came 110/70. Again he changed Tezloc beta 50, before taking Esopam 10 mg. I have a gastric problem.",
    "doctor_response": "Hi. I have read your health related query. Glad all your blood reports are normal. I understand your concern. Right now what is important is to manage your blood pressure, once the blood pressure is maintained with medication your symptoms may start to reduce gradually. You must continue the treatment as advised by your doctor. Meanwhile continue treatment for anxiety too. Apart from anxiety treatment, try some relaxation techniques like meditation, aromatherapy massage. Avoid stress or stressful situations.  Avoid too much coffee and tea and sugars. Try to go out for small mild walks. Try to drink at least nine glass of water and consume fresh fruit and whole grain in diet and take the low salt diet. Try to be around people who care for you, spending time with family and friends. Try to take a break from work if that is leading to anxiety or any situation that can be a potential cause for anxiety. Visit your doctor regularly to follow up with blood pressure management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment can be done for dry skin ?\n\ni have dry falky skin even after i apply baby oil or vaselin lotion after bathing plz suggest wt can i do?",
    "doctor_response": "stop using soap for bathing. use no soap cleanser like cetaphil. apply moistuirizer immediately after bath. like moyzen cream. apply at nite also.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment to get pregnant?\n\ni m having pcos.my age is 24.height 5'2''..weight 50 kg.my both ovaries has pcos.diagnosed when i was 18.i was on birth controls for many time.i stopped taking them 1 year back.now i got married and i wish to get pregnant soon.i had my periods on 23 oct 2011 normally without birthcontrols. after that hadn't got my periods yet.what should i do to get pregnant?",
    "doctor_response": "Hi,Welcome to Healthcare Magic.I am Dr Ramadevi Wani. I will be answering your concerns. It is good to know that you have normal BMI.  If your periods are  irregular, then there is a possibility that you are not ovulating regularly. So consult infertility specialist in your area and register for treatment. Do baseline hormone tests, insulin level and HSG for you and semen analysis for your husband. Based on the results further treatment can be planned. If you are found to have insulin resistance, you will be prescribed medicines( Glucophage).  This improves the possibility of ovulation too. You may also be prescribed medicines to initiate ovulation. You are still young. You have very good chances of conception. So do not worry.To increase your chances of conception maintain normal BMI, quit smoking (if you're a smoker) and have intercourse at least three times in a week.Take a tablet of folic acid daily.I hope this is helpful.If you have any further concerns do contact me through Healthcare Magic.Best wishes,Dr Rama",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I lead a normal life after taking medication for depression and anxiety ?\n\nHi i am takings medicine for for depression and anxitiey The Below tablets ,how it will take me to recover and back to my normal life Stablon 12.5 (Three times a Day) Mirtaz 15mg ( One at day) Quitipin 25mg Thrice a Day Lametac 100mg ( one at a Day)",
    "doctor_response": "Dear Sir The medication given if suitable for you usually alleviate depression and anxiety after about 3 to 4 week of medication. However it is unclear whether depression is uni-polar or bipolar which often determines dose, duration and rapidity of response to medications. These medication are proposed to normalized neuro-chemical imbalances of brain observed  in depression and anxiety disorder.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is dizziness and lightheadedness normal after lumbar puncture?\n\nMy daughter had a lumbar puncture done on Tuesday of this week. She is feeling very dizzy and light headed when she stands up. Is this normal? Is there anything she can do to help that feeling? She has had lumbar punctures before and sometimes has had to go in for a blood patch.",
    "doctor_response": "Hi,Thanks for writing in.Lumbar puncture involves placement of a needle in the space around the spinal cord to draw CSF which is the fluid occupying the space around the brain and spinal cord. Sometimes there is sudden decrease in pressure of the fluid after the test and this can cause dizziness and light headedness for a while. In most patients, this starts decreasing from the day following the lumbar puncture but in a few, the dizziness can last for a week to a month. This is especially felt when the patient stands up and there is change in position.Taking fluids and caffeine beverages can help many patients get back to normal. She needs to change from sitting to standing position slowly to avoid sudden change in posture.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with stage 4 cirrhosis, due for liver transplant. Any pain medication?\n\nI have been diagnosed with Stage 4 Cirrhosis and am awaiting until I can be placed on the liver transplant list ..My current GI Specialist doesn't believe in prescribing any pain medications. I have to go to the hospital every 2-3 weeks for my paracentesis. Please let me know if any Physician in NC prescribes pain management????",
    "doctor_response": "Hi and thanks for the query,Under these particular circumstances, pain medications must be selected carefully. It s advised to avoid Acetaminophen - paracetamol. A few morphines could be used but under keen supervision and follow up of your primary care physician. A detailed pain management plan has to be discussed between you, your transplant surgeon and follow up primary care physician.For now, low dose morphines are safe till you meet your transplant surgeon for a detailed pain management plan.Thanks and kind regards,Bain LE, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can sever lower back pain be treated?\n\nI have sever lower back pain...it feels like my lower back is dislocated from my pelvis...I know that this is not the case. It is mostly lower back and left buttocks area that is most painful. Every movement hurts. I do see a chiropracter regularly but it seems that thus is happening more frequently which means I am attending more chiro appts which is becoming very expensive.",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.With such presentations in my clinic, I will ask the patient to do MRI for lumbosacral spine .Simply buttock pain is mostly radicular pain from the back problem which will be assessed well by MRI.I advise you to wear lumbosacral belt and to recieve NSAID and pregabalin and to avoid heavy physical activities.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to clean vagina properly after sex?\n\nHello doctor, How to properly clean the vagina after period sex, to avoid any discomfort? Is it necessary to clean the vagina after engaging in period sex, if so, why? What is the best way to properly clean the vagina after engaging in period sex? Is there anything else hygiene-related you wish more young women to know about period sex?",
    "doctor_response": "Hello. If you are not planning pregnancy, after intercourse you can simply wipe with dry tissue paper or if you feel sticky wash with water and dry with a tissue paper. On a regular basis, frequent washing and the use of soap should be avoided, as it hampers natural bacteria. Once or twice in a day while bathing, cleaning is enough. Just use a tissue paper if you feel damp after urinating. Wear cotton underwear, and try changing them twice a day. Avoid any perfumes or talc over your perineum.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy without waiting after using Encare ?\n\nhi thank god finally, I am worried because we used encare but we didn t wait 10 minutes after inserting it what are my chances of being pregnant? We only waited like 3-5 minutes because I felt some liquid stuff coming out like it had dissolved already and I didn t want it to all come out before we even started.",
    "doctor_response": "Hallow Dear,Encare is a locally acting birth control which acts by deactivating the sperms. Its action is through the foam it forms and through the chemical reagents. Though a fair contraceptive method, it cannot be relied completely and hence it is advisable to use this method along with another protection like condom. It is advisable to wait at least for 10 minutes after insertion in lying down postion. This much time is advised for allowance of the dissolving the tablet and forming a foam. If you do not give sufficient time, it may not act and the chances of failure are there. Since you have performed the intercourse within 5 minutes of the insertion of the tablet, you cannot guarantee its success. In such case, you have following options:1. Support the birth control by additionally taking Plan B post coital emergency contraceptive pill within 72 hours of the intercourse.or2. Get intrauterine contraceptive device inserted within 5 days of the intercourse. This can give you further ongoing birth control for few years to come.You may find out the status of pregnancy by:1. Beta hCG test after 10 days of the intercourse. or2. Pregnancy test on overnight first morning urine sample after a week of missed period (if you miss it)You have an option of terminating unwanted pregnancy by medicines upto 9 weeks of pregnancy.I hope this helps you. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathing difficulties, dysphagia with symptoms of trying to vomit?\n\nHi my 14 month old daughter was fine when I put her in bed, and suddenly she has difficulty breathing what could be the problem, she is crying and struggling to vomit, is something stuck in her throat? Its 2am here I am thinking of rushing to the hospital. is there anything I can do before I do that? Thanks",
    "doctor_response": "Hello,Yes, rush to the hospital she probably had aspirated something, urgent chest x-ray need plus baby need oxygen support, further, will be managed accordingly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Hina Javed",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a swollen lump under the ear\n\nI have a swollen lump under my ear onto my neck like a swollen glad also it s al swollen from my ear down my cheek but under the skin it s sore wen I touch bt no ear ache etc I also have my eyebrows threaded 3 days ago and I have a realy sore swollen lump all red on it",
    "doctor_response": "Hi,Dear thanks for the query to HCM virtual clinic.I studied your  query in all the details you gave.Treatment-Cause of the lump under the ear is -Acute Parotitis.Don't be anxious.I would advise you to consult with ER primary doctor who would give anti-inflammatory and antibiotics drugs,which you take for 5 days time and it would reduce.If not relieved, consult a ER Surgeon, who would investigate and treat it according to  its cause.Welcome for any more query to HCM in this regard.Write Excellent review and hit thanks if this reply Helps you out.Have a Good Day.Dr.Savasakr M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why feeling pressure in chest while breathing along with dry mouth?\n\nI feel little pressure in my left side of my chest and fell when i breathe  is like i dont breathe right  and  sometime when i sleep i wake up and my mouth is dry   and i cant breathe true my nose  i vent to se a doktor the say  nothing is wrong  with my hart  what could be",
    "doctor_response": "thanks for asking your questionI completely understand your problemthese symptoms like pressre over chest and chest pain while breathing may occur in pleural effusion. nasal blockade can be due to sinusitis.for these symptoms you should visit a pulmonologist who can get a chest xray and a xray pns to accurately diagnose the condition.if each test comes normal then it might be due to anxiety.thanks/regardsfeel free to ask more questionsmay god bless you with good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of the yellow and orange stains in the teeth due to smoking?\n\nI have stained teeth, yello wnd orange stains due to smoking and chewing of plain pan masala, can you suggest any tablet for cleaning it. I have already gone through cleaning but it turns out to be same after 6 months. Please suggest any other option other than cleaning.",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.Good that you have undergone cleaning of the teeth, but have you stopped smoking and chewing pan masala ?Stains by chewing these are very tough stains and requires compulsory stopping of usage of these .I would advice you to first stop smoking and eating pan masala ,also they are not adviced for your general health.*Have your teeth cleaned and polished by the dentist with following the correct follow up instructions.*Proper brushing and flossing is necessary.*If the stains are persistent , then you can consult your dentist for bleaching of teeth and have it done .Hope this was helpful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why my wife is vomiting blood?\n\nHelllo MY wife is 30 years old...She had TB before our marriage and was under treatment and she even got Ok....but few days back she had complaint of pain in back of upper shoulder,no fever nothing..Dr.advised to do Xray and they told that it has been relapse n she was given medicine but now she is vomiting pure blood....no cough,no fever..",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, she is having hemoptysis (blood from the lungs). Since she is suffering from tuberculosis (relapse), hemoptysis is not a good sign. Hemoptysis is suggestive of drug resistance tuberculosis. Drug resistance tuberculosis is commonly seen with relapse cases. So better to consult pulmonologist and get done sputum AFB culture and sensitivity report. This will diagnose if drug resistance is there or not and sensitivity report will guide about effective anti tubercular drugs. So consult pulmonologist and discuss all these. Hope I have solved your query. I will be happy to help you further Wishing good health to your wife. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Lyrics and Lisfranc be taken together for disc prolapse?\n\nHi for disc prolapse, neuro opted no op, l5s1, discs attempting natural fusion. Nerve pain.no regular meds. Have been given lyrics after lisfranc type injury, along with duromine, need 20 kg off. Also have ultraset, altosec. Allergy to sulphonamides and flagyl, will altosec cause problems? Also usually take no meds just swim, but foot triggered nerve pain lumbar area. Can these meds be taken together? Regards Kat",
    "doctor_response": "Dear, For the pain of your disc take Tab Tramadol 100mg twice daily.do not take so many medications for this purpose,.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My teeth has turned yellow color, shall I need to undergo scaling ?\n\nMy teeth has turned yellow color. I went to a dental doctor. the doctor suggested that these stains will not go by simple brushing. I need to undergo scling. He has given appointment for scaling.",
    "doctor_response": "Hi Raksha, Scaling is a procedure for cleaning teeth which is followed by polishing to remove stains and any other deposits accumulated in time. Scaling as i am sure as your dentist would have mentioned needs to be done every 6 months. The external stains may go with scaling and polishing but this does not result in whitening. Whitening of teeth is an entirely different procedure in which teeth lighten by 3-4 shades from the normal colour or sometimes even more. this procedure is commonly referred to as bleaching. There are 2 types of whitening procedure. one is done in clinic called inoffice procedure and the other is done by the patient in the house called home whitening. If you desire whitening, please consult your dentist for the same. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nausea and fever?\n\nMy Husband has nausea, fever, achy hands, feet and extremely tired. Last year he had a bone infection in his foot from an open wound that started around a callous. He was on numerous antibiotics, had hyberbaric oxyen therapy, finally surgery on his foot. Right now he is telling me he feels like he did when the infection was at its worse. Recently other family members had the stomach flu which he already had, so I don't think thats what he has now. I want him to go to the doctors but, he doean't want to. What could it be?",
    "doctor_response": "Fever is a symptom of an underlying disease. There are many causes of fever such as malaria, typhoid, infectious mononucleosis, TB, Dengue etc. Advice 1.\u00a0\u00a0\u00a0\u00a0\u00a0Azithromycin 500 mg daily per oral for 3 days2.\u00a0\u00a0\u00a0\u00a0\u00a0Paracetamol 500 mg per oral if fever occurs3.\u00a0\u00a0\u00a0\u00a0\u00a0Domperidone 10 mg per oral when he feels nausea4.\u00a0\u00a0\u00a0\u00a0\u00a0Cold water sponging if fever is more than 100 degree Farenheight5.\u00a0\u00a0\u00a0\u00a0\u00a0Investigations \u2013 CBC, ESR, Widal test, blood smear for malaria parasite, and dengue NS1 antigenGo to hospital if fever does not come down with above measuresThanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swelling under arm. Ultrasound taking too long. Means something?\n\nHi. Iam 40 years old and attended the hospital for an ultrasound scan for a swelling under my right arm . The Radiographer told me to make an appointment to see my GP , to receive the results in ten days time. When I phoned the surgery , the receptionist said these things can take longer, and gave me 4 May to attend for the result. I am quite anxious, do these things usually take so long?",
    "doctor_response": "I am too late to post answer as I joined this forum recently. Hope you have got ultrasound done",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Zimig 250mg intake be repeated over days for treating ringworm infection?\n\nI have taken zimig250mg for one week but ring worm agin appear after few days then i take again one weak after few days it back again then doctor said to take one doze more ihave taken but after few dsys it appears in some extent ..what will i do can i repeat the same",
    "doctor_response": "Hi,Thanks for contacting Healthcaremagic.I have gone through your query,\"zimig\" is the brand name of antifungal medicine terbinafine.Zimig is very effective for ringworm infection,We prescribe once daily or twice daily dose according to the severity of the infection.As you are having recurrence,you can go for twice daily dose.Use a topical antifungal cream along with the oral medicine. Clotrimazole is a commonly used for local application.Try this after having a word with your doctor.Hope it will work.Wishing you all the best.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Advised Gabapentin after burning nerve pain on face, arms, hands, legs and feet, want relief from side effect. Solution ?\n\nHello!  I am a 50 year old woman with mild high blood pressure which is controlled with medication.  I have recently had a MRI with and without contrast of my brain.  This was ordered because I have been experiencing burning nerve pain on face, on arms, hands, legs and feet for five months (after a bout of shingles). I am currently taking 100 mg. of gabapentin twice a day for the nerve pain.  This does not completely control it, but I do not like the side effects so I am trying not to increase the dosage.    A previous MRI without contrast (for numbness and tingling in face two years ago) showed some possible white matter lesions in right frontal lobe. At the time, I was told that I was experiencing \"silent migraines\"...no pain, just numbness and tingling.   This most recent MRI showed \"slight progression minimal periventricular and moderate deep white matter disease since last MRI.  This is nonspecific and consistent with demyelinating process, vasculitis, or chronic small vessel ischemic change.\"  It also stated that \"two new adjacent white matter lesions at the right frontal lobe centrum semiovale measuring appr. 1mm.  The remainder of the white matter lesions appear relatively stable on the right.  There are two new foci of T2 prolongation at the posterior aspect of the left frontal lobe deep white matter at the junction of the centrum semiovale and corona radiate also measuring on the order of 1 to 2mm.\"Should I be worried?",
    "doctor_response": "Hi,Thank you for posting your query.The MRI brain findings are non-specific and minor, and there is no need to worry about them. As your doctor suggested, they are most likely related to migraine, and the other diagnostic possibilities such as vasculitis and demyelination are unlikely in your case.The pain and burning are not related to MRI findings. Gabapentin dose can be gradually increased based on the relief from burning and possible side effects. If you are unable to tolerate gabapentin, then, other options include pregabalin and carbamazepine.Best wishes,Dr Sudhir Kumar MD DM (Neurology)Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce over masturbation\n\nI am a 19 year old boy approaching 20. 1.83m talk. I have a great medical history. I have never been admitted to hospital or any other facility. The problem i have is over masturbation. I started to do it on the year 2002 now i find it hard to stop please help",
    "doctor_response": "HelloThanks for query .It is natural for a man to masturbate at the age of adolescence .It is one of the safest mode to fulfill desire of sexual satisfaction without getting in to physical intimacy with female .It has no side effect on body or any organ .However addiction to frequent masturbation does lead to sexual problems related to erection and ejaculation in later life .hence one has to restrict the frequency of masturbation .Please note that there is no medicine that can help to reduce frequency of masturbation , It requires self determination Try to reduce the frequency of masturbation by keeping  yourself busy in activities like sports ,reading ,social work etc so that you will not get free time to masturbate.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have PVC after starting Methadone. Will beta blockers help?\n\nHi doctor, I am a 35 year old male, and I am currently on Methadone for chronic pain. I currently have PVC, and my last EKG showed a long QT (over 500 ms). The doctor recommended that I take Magnesium and Potassium supplements as he believes that Methadone may be reducing my magnesium and potassium levels. It has been a week now since I have been following the regime and currently the PVC is nearly gone. I do not have the option of reducing the Methadone due to my injury. The doctor said he wanted me to get an opinion from a cardiologist if I may need a beta blocker or not. He wants to wait to see how the supplementation works out first. Is there any advice you can give me? I get an EKG done twice a year.",
    "doctor_response": "Hello. I have gone through your explanation in detail, and I understand your worries. Best regards. For further queries consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pressure while travelling to high altitudes?\n\nWhen traveling to low altitudes, less than 3,000 , i have experienced chest pressure that starts about 10 minutes at the resting elevation. The pressure is centralized across the breast area and feels like gas. I do get burps, but then I get a shallow breathing. Seems like it s hard to breathe normally. I have had like a dizziness that starts from my body and goes to my head and doesn t last long - a few seconds. Then the back of my neck becomes stiff and tight and somewhat sore. I took a tums and the pressure did subside a little, but went away completely, as did all other symptoms, after we went back to our normal elevation of about 800 . Any idea what could be the problem?",
    "doctor_response": "thanks for asking your questionI completely understand your problemas we go to high altitudes the atm pressure decreases and concentration of oxygen decreases and air becomes more denser so in order to escape from these symptoms of high altitude slow ascending and slow descending is followed that will acclimatize your body in due course of breaks in between climbing to high altitudes.thanks/regardsfeel free to ask more questionsmay god  bless you with good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can birth control pill usage cause irregular menstrual cycle?\n\nI was on a birth control pill for about a month. It was causing me to be very moody, and have awful cramps. So i stopped, but i stopped in the middle of a pack. There was 3 weeks of hormone pills, then one week of substitute pills. I ttook one month of pills had my period, I took one weak of hormone pills then stopped. I had a period about a week after I stopped. My period normally comes on the 1 of every month. I stopped last month, it is now december and the first has passed and then the date of my withdrawal bleed had passed. I have not had a period.Could the birth control have messed with my cycle that badly, or could i be pregnant?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As per your history, generally birth control pills do not cause irregular cycles, but still your date is missed then do urine pregnancy test and ultrasound abdomen and pelvis for confirmation after gynecologist consultation. There is chance of pregnancy even though you took birth control pills. Take care. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the procedure for IVF treatment with donor egg?\n\nI am a woman of 46 yrs. I want to come to your hospital for ivf with donor egg from you for having a baby. Pls. note that I have no period since 2008.What is the procedure ?  Me  & my husband  consulted some gynaecologists of our country and went through several tests including my husband's sperm test . They suggested ICSI for my husband since he has lower count of healthy sperm. Awaiting your prompt response in this regard. Thanking You. Regards ! K. Akhter I am a woman of 46 yrs. I want to come to your hospital for ivf with donor egg from you for having a baby. Pls. note that I have no period since 2008.What is the procedure ?  Me  & my husband  consulted some gynaecologists of our country and went through several tests including my husband's sperm test . They suggested ICSI for my husband since he has lower count of healthy sperm.",
    "doctor_response": "Hello, donor eggs can be availed on payment from professional egg donors and in case you have a relative who is ready give ger eggs can also be taken into considerationIn case you have any questions in future you can contact me directly on",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could lumps in arm pit & rib cage be?\n\ni have a lump under my right arm pit i have been keeping an eye on it but its getting bigger is about the size of and orange or apple, when i had my last d.o.t physical she notice a lump about the size of a dime on the left side of my rib cage. what could it be",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.Lump on right can be a sebaceous cyst and the one on the left side could be again a cyst .Get examined clinically by a Surgeon and get operated before they go into complication like infection .",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can antisocial and aggressive behaviour in a child be treated?\n\nI m concerned about my 15 year old grandson. He has agression, antisocial, verbally abusive, acting out and manipulation and lying. His parents got divorced when he was 9. His dad gave him gun shooting games so he didn t have to deal with him. Dad would not let his mom have custody until he was 11 and 2 1/2 years behind in school. The divorce was because his parents agrued a lot and his dad was never home and was verbally abusive to his mom. My grandson now treats his mom like his dad did. My grandsone has been seeing a psychologist for years and manipulates her or doesn t think she knows anything. My grandson can be as sweet as pie when he wants something and mean as shit if he doesn t get it.",
    "doctor_response": "Dear userWe understand your concernsI went through your details. The issue is definitely parental neglect and resultant behavioral disorder. Your grandchild may not be having any antisocial behavior pattern. Please tell me how is his general behavior with his teachers at school and his friends at school ? Is his behavior different from what at home and what at school ? Please let me know this fact and other details so that I can help you in dealing the issue.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How late will the next period be while taking birth control?\n\nI took plan b twice within a weeks time and had just started my birthcontrol about two weeks before that its been over a month and i still havent gotten my monthly period. I took a prego test and it says negative. How far can it throw off a persons cycle?",
    "doctor_response": "Hallow Dear, What I gather from your brief history is that after taking Plan B pills, you have started birth control pills before you got your menses following Plan B pills.In fact this is not the way to start birth control pills. They should have been started on the second day of the menses following Plan B pills. Anyway, you have started regular contraceptive pills; so you should get the menses within a weeks time after finishing this month's pack; provided it is 21 days pack. If it is 28 days pack, you will get the menses during the last 7 different coloured pills which do not contain hormones. However, considering the irregularity in starting the pills, if you do not get the periods within a weeks time after this pack, please report to your Gynaecologist. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Baby is chewing on his tongue. Can this be due to teething?\n\nHello doctor, My son is 4 months old and started chewing on his tongue. Is this due to teething?",
    "doctor_response": "Hello. Teething usually starts about six months of age, but at this time kids try to pet objects more often in the mouth because that is the way they try to learn about objects. It is very natural. But if your child is continually biting on the tongue and not occasionally, it could be something else. You can take a short video that would be more helpful. You can discuss with your doctor when you visit.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible when suffering from PCOS?\n\nI am currently cd 17 4 dpo, 2nd month ttc. On 2dpo I ended up in ER. During CT scan the Dr noted 1 cyst on right ovary and multiple ovarian follicles on my left ovary. Opk was positive on CD 12. I dtd multiple days leading up to ovulation day, that day and the day after. My question is, could I be pregnant even with the present follicles or are they still there because I perhaps didn t ovulate?",
    "doctor_response": "Hi,I guess your concern is about, is pregnancy is possible when suffering from PCOS. My answer is YES, you can. Let us discuss about PCOS (polycystic ovarian syndrome). In this case there is multiple cyst present in one or both ovaries. Patients usually have a number of complaints like irregular menses, acne, weight gain etc. That's why it is called syndrome. Out of this patients usually have irregular menses. Once menses is regular, there is high chances of getting pregnant.With the above information you can try out my suggestions:1. RELAX, KEEP PATIENCE. There is chances of getting pregnant with PCOS. DON'T WORRY.2. Try to do coitus during fertile period(it is from 10th-16th day of menses),during this period chances of getting pregnant is high.3. If you are in hurry then visit nearby infertility specialist. He/she can help you.I hope the above information is useful, informative and helpful for you. Let me know if I can assist you further. Regards,Dr. Sudha Rani Panagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lack of concentration and emotions\n\ni'm 19 yrs old M FROM VASHI,MUMBAI.from last 3-4 years i'm not able feel anything like happiness or sadness.concentration is effected,face difficulties to recollect things....not able think about my future...forgets frequently.i always feel heavyness in my right side of my head....everything in brain is blur.....nthing clear.pls help rly",
    "doctor_response": "Hi,Thanks for choosing Healthcaremagic.I have read your query carefully and understood that you are these symptoms since last 3-4 years characterized by alexithymia, memory diturbance, poor concentration and somatic symptoms in the form of heavyness in right side of head.I would like to let you know that symptoms you described suggest dysthymia. However, detailed assessment is needed to rule out chronic depression or vitamin deficiencies (especially B12 deficiency).I would advice you to visit a psychiatrist near you for proper evaluation and treatment.Hope I answered your query, let me know if you need any further information.RegardsDR. ASHUTOSH SINGH",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My BMI is 25. 4. Do I need to workout to reduce my belly fat?\n\nHello doctor, My weight is 65 kg, and my height is 1.6 m. Although my BMI 25.4 is in the margin of normalcy, I have got belly fats. So, I am working out from the past two weeks, and changes are quite unnoticeable. I was wondering, do I really need to lose my weight to lose belly fat or it can happen with the same BMI? Because my calorie intake depends on whether I have to maintain or lose weight. Even, I have decided to take up some supplements. But it has to be a mass gainer or a whey protein, I am quite unsure of it. So, I want to know whether I need to lose my weight or belly fat can be lost with the same weight and indeed keeping the same calorie intake, rather than reducing it from 2000 calories to 1480 calories? Please help.",
    "doctor_response": "Hello. According to WHO (World Health Organisation) a revised BMI (body mass index) for normal is 19-22. You need to work out and lose weight to reduce belly fat, as fat accumulated is of adipose tissue work out is necessary. You can take supplements of whey protein along with the same supplements. You can concentrate on both weight reduction, belly fat reduction, and improve muscle mass. In the market, there are supplements with soya or isolate soya. According to your age, you need to continue with 1800 kcal per day. Do not reduce the intake less than this. You can divide your meals into a 6-7 meal pattern. Increase the intake of fluid and fiber content and meditate to manage stress.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for herniated disc disease\n\nI have been suffering from a herniated disc for the past 3 years now.  3 months ago I suffered some excruciating pain from this condition.  The pain went away after about 24hrs but ever since then I have been walking with a slight limp, I have very little strength in my right calf and my lower leg swells up every day after walking for about an hour.",
    "doctor_response": "Hello, If This disc bulge is not compressing nerve root so conservative treatment may work.If symptoms persist then surgical decompression may help.Medication like methylcobalamine and pregabalin will reduce pain which can be started consulting your doctor.You can focus on spine extension exercises.Some exercises which can be done include- Spine extension exercises, Lying on your stomach flat lift leg 6 inches from ground, do it for other leg.Now lift both hand and leg simultaneously, 6 inch off the ground and stayPosition for around 10 breathes. Core stabilizing spine exercises will help.You may consult physiotherapist for guidance. He may start TENS, or ultrasound which is helpful in your case.If not relieved you can take epidural injection.Hope this helps. Wish you a speedy recovery.  If you find this answer helpful do not hesitate to rate this answer at end of discussion.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low pulse rate?\n\nHi, I recently had my blod presse tken and the reading was 113 over 60. My pulse rate was also measured at 47 bpm. I am a 40 yr old male in reasonabe shape and fitness.  I was told that whilst my blod presure reading was fine, my pulsae rate was too low. Should I be concerned and if so, what should I do about it ? Thank you...",
    "doctor_response": "Hi,Welcome.This is Dr Sameer.Low heart rate could be normal sinus Bradycardia or it could be more serious heart block. Sinus Bradycardia is very common in athletes. You need ECG for diagnosis.If it is not caught on ECG, than we put 24hr ECG monitoring called Holter Monitoring.Treatment will be as per the report of above investigation.Thanks & take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Taking duphaston, no results. Treatment to conceive?\n\nHI sir,sam here.i m trying to concieve for the last one year bt fail.i went to doctr she checked up then said all ok.bt next month i also got period.i went on third day she did u/S ND FOUND OV.ENDO.ON 12 TH DAY I WENT AGAIN THN SHE PRESCRIBED DUPHASTON I TOOK for 10 days and got periods again.i went for check up again there was  no ov endo bt small pco. SHE told me for mating on alternative days on 12th fay of ma periods.now my periods wete due on 2 of july.i went on same day for check.she did ultrsound there was nothing.then she prescibed duphatson for 5 days.kindly help me out what is all this.wl i b able to concieve.also my husband sperm count per ejuculation is 38 million.",
    "doctor_response": "Hi,Thanks for the query.You have to track your ovulation and have to plan intercourse around that period, which will increase the possibility of pregnancy.Refer: early pregnancy ultrasound may not detect the signs.So you continue the tablets as advice by your doctor and after one week go for repeat scan.Possibly this time ultrasound can detect the gestational sac.If you want quicker confirmation you can go for blood test for pregnancy now.Refer: more details you can ask me through:  care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen lymph node behind the ear with lump on the pectoral muscle?\n\nMy 16 year old son has a swollen lymph node behind his ear and recently noticed a lump in his pectoral muscle near the nipple. He also has said he has experienced fatigue during the last few weeks. He is active in baseball so it is difficult to assume if this is all related.",
    "doctor_response": "Hello ,I understand your concern. I am Dr. Arun Tank, infectious disease specialist, answering your concern.The most common cause of the swollen lymphnode in India is the tuberculosis.I also suspect the same in your child. For the confirmation of the diagnosis it is necessary that you should do FNAC and ZN staining from the material received.If the test is positive you should also do the TB testing by GeneXpert, It is also diagnose the common resistance pattern and can help you in treatment part.TB treatment have many side effects, please do not discontinue the treatment as it can create resistance pattern in the bacilli. Complete treatment only cures you but also prevents future relapse.I will be happy to answer your further concern you can contact me here or you can contact me on bit.ly/DrArunWe wish you a best health at healthcare magic. Thank you,Dr. Arun Tank",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should non vegetarian food be avoided after a dog bite?\n\nHi doctor,Last month a street dog bites my mother, and i had taken 5 doses of  injection . Any food control need to follow. My mother friends are telling to avoid non veg completely for 3 months.Is it necessary?.Please advice.Regards, Mamatha 0000  YYYY@YYYY",
    "doctor_response": "Hello,Welcome to HCM,Rabies is a disease which is transmitted by the dog, which is 100% fatal but it is 100% preventable by proper and adequate treatment. As your mother was bit by a street dog for which she has taken all the five doses of antirabies vaccine on days 0, 3, 7, 14 and 28.There is no diet restriction in dog bite,you can give her regular diet. If she is alcoholic or smoker they have to avoid that only because it will reduces the immunity. As such there is no diet restriction in dog bite victims.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low grade fever and fatigue?\n\nHi, I am 50 yr old female I had mono last February and I have the same symptoms again. Low fever daily constant fatigue. is it possible that it has just returned. The Dr. couldn t do anything for it the last time should I make another appointment to see him.",
    "doctor_response": "HIGreetings from Dr.Divakara.PThanks for posting your query.  Fever and fatigue can be caused by any infection . Infection most commonly happens due to Virus or bacteria. Even MONO is a viral infection.    Among viral and bacterial infection , most of the viral infections are self limiting , means there will get cured by itself in 2-4 days . So my advise it to wait for 2-3 days , you can take Tyelenol for fever , drink plenty of water and fruit juices .    If there is no improvement in your condition then you can consult your doctor as in that case you shall require certain test for the evaluation of the fever. Hope this information is useful to you. Any clarification feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for cellulitis?\n\nI was stung by a bee on Saturday then went to the doctor today and he said it looks like it was possibly infected and called it cellulitis he have me 5 days worth of antibiotics and to come back in if it doesn t get better or gets worse, when do I get concerned if it isn t getting better",
    "doctor_response": "Hi,welcome to healthcare magic forum.You can wait for 2-3 days to see whether it is coming down or not.If not,report to you doctor.If it is getting fine,you can stop after completing the course.Also,it is fine to have tetanus toxoid injection if you had not one recently.I hope you will find this information useful.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will it be safe to take Signoflam for pain in left foot?\n\ni had a viral fever 15 days fever . it lasted for 3 days. After that iam experiencing pain in left foot, ankle and knee. Dr has prescribed signoflam for 10 days and SOS. It s almost 10 days and without the tablet i feel the pain and how long should i continue this medicine?",
    "doctor_response": "Hello,Based on your description, your doctor has prescribed you tab signoflam for relieving pain and decreasing swelling of your foot. Usually along with this medication, you would have been advised to go slow for giving the joint rest and to heal the inflammation. Although the medication is safe, I would recommend you to take it only if the pain is severe as you have already taken it for 10 days now. I would also suggest you to take plain paracetamol instead And consult your doctor as per your scheduled visit.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Santosh S Jeevannavar, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tooth ache and infection in wisdom tooth\n\nI had a massive toothache the week of nov 11th so I went to the dentist so I was told that I had an infection in my right lower wisdom tooth and that it was on the nerve I was given antibodics and pain meds. So I was referred to oral surgery so when I went on Nov. 17th my neck was swollen and I could barely open my mouth the dentist numbed me up and pulled all four of my wisdom teeth out now the pain is manageable but on the right side where the infection was at still hurts my ear and my throat and I still can't barely open my mouth. What can I do about my throat cause  I finished all my medication and it feels better after I spit",
    "doctor_response": "Hello ,Thanks for consulting HCMRead your query as you have toothache and infection in wisdom tooth and undergone extraction of wisdom tooth pain and reduced mouth opening is seen in some patients after wisdom tooth extraction .I will suggest you to consult your dentist for follow up and follow post extraction instructions , maintain proper oral hygiene .Do warm saline gargle two - three times a day . Dont do gargle or rinse vigoursly.Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump near to vagina?\n\nI have two lumps next to the vagina. its under the skin but i can feel them. im thinking its a cyst but its on both sides in the same spot. they appeared a about a week ago, or atleast thats when i noticed they were there and they're not going away . what is it? and should i go to the doctors to get them removed??",
    "doctor_response": "They could be Bartholin cysts. If they are bothersome you should see a Gynecologist. Nothing to be scared of. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat pain and white discharge around gum post tongue piercing?\n\nHello, I just got my tongue priced about 3 days ago. A day ago i started to get pain on place where my gum and lip meet. I looked at it and there was a white type of discharge there. I tried to remove it and it was easy to remove, however, when i did so, i started bleeding. What is it? Is it a big problem?Please help me",
    "doctor_response": "Heloo pt-Once you find that the infection has set in, do not try to squeeze the discharge from the infected site. Mix sea salt in a cup of warm water and rinse your mouth with the solution at least three to four times in a day. Especially rinse and gargle the solution after every meal.The sea salt solution will also help to remove the crusts and other debris that has developed around the pierced area.You can also use an antibacterial mouth wash.If there is swelling of lymph nodes in the neck, you need to be careful and immediately seek the physician\u2019s advice.Use gentle tooth brush and take precautions that a food particle does not lodge inside the piercing area.Stop drinking alcohol and quit smoking as they prevent fast healing process.Yogurt helps a lot as it contains good bacterial flora. Eat it regularly twice in a day.For first few days you can chew or suck crushed ice as it helps to reduce inflammation and pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a fever and stomach ache?\n\nMy daughter has always had a hard time going to the bathroom.  It continues to be something we struggle with.  My younger daughter got a fever last week.  She had it a day then the fever went away.  This week my older daughter (with the stomache issues) got a fever.  I figured it was the same thing but her fever is still not going away (day 2).  She also mentioned she had a belly ache. I confirmed that she went to bathroom 2x yesterday.  Should I be worried about her appendix?  Should she be seen by a doctor at this point?  I always try to weigh the risks of going into the dr office since so many kids are sick I figure unless I'm sure I need to go then I hold up.  She is 8 yrs old, small for her age but also short.  About 50lbs and 50\" tall.",
    "doctor_response": "Hi.Thanks for your query and an elucidate history. The causes of pain in abdomen in 9 year old child with fever can be :-Tummy tonsils- meaning enlargement of the lymph nodes of the abdomen.-Appendicitis- by default this has to be ruled out in every case of pain in -abdomen of a child.-Worms.The best diagnosis is a high resolution ultrasonography. some blood, urine and stool tests.A therapeutic trial with a course of an antibiotic, metronidazole and probiotics under the guidance of a pediatrician / Surgeon always helps to solve the problem and to get a diagnosis.Also given is a dose of medicines active against worms in intestine.I hope a consultation with a Pediatric Surgeon, investigations and a course of an antibiotic and metronidazole should solve the problem.If this is indicative of appendicitis , please go for the surgery of appendectomy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have partial epilepsy. Taking Lemitor and Frisium. Want to get pregnant\n\nHi this is Radha, I am having partial epilepsy . In last 3 years I have 3 seizers. The one in 2010 was due to less sleep, actually I had to take a flight at 6 in morning and I got up at 4 in morning so had one. Second one was in 2011 June when i missed my medicine. Third one just in this month on 10th Dec 12.The reason was I took Azithol (to get rid of pimples from my face). I am currently taking 200 MG (Lemitor ) + Frisium 5 MG+ Epilex Syrup (5 ML)Need your advice as I am planning to go for pregnancy . Your advice will be really appreciated.",
    "doctor_response": "Hi Radha, It is important when you are planning on conceiving that a. You NEVER miss the medicine dose b. You AVOID the precipitating factors that you have already identified this is to ensure both the mother and fetus is safe during pregnancy and delivery c. You be prescribed Folic acid to prevent neural tube defects in the child d. You seek the advice of a Neurologist prior to conception who will see if the current medicines will need to be continued or alternate ones need to be prescribed. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching all over body after kidney stone removal surgery?\n\nI have a friend that had surgery to remove kidney stones that were too large to pass about a month ago.  Since the surgery she has been itching all over to the point of leaving bruises on her stomach, chest, legs, and arms.  She went to the PCP and they said it was a reaction and prescribed steroids but that didn't help.  Any ideas?",
    "doctor_response": "Hi, I would suggest that your friend stop all medication and see if things get better. Steroids are useful, but drugs like fexofenadine at 180mg once daily might relieve itching. You could also find out if there is any internal stent which has been placed, and often if this piece is removed, patients are relieved, especially if they are allergic to the substance of which the stents are removed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a PAP smear test necessary for virgins?\n\nmy daughter is 14 and she have an infection. I went with her to see the doctor. the doc ask her is she sexually active and she said no. the doctor still gave a blood test, pregnancy test and a pap smear.is it necessary for a pap test if you are a virgin.",
    "doctor_response": "Hello,PAP smear test is not indicated under the age of 21 irrespective of sexual activity. It is usually started around the age of 21 and continue till the age of 50 or 60.Hope this helps you.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lack of appetite while having acute pancreatitis?\n\nI am suffering from acute pancreatitis for several months now. I didnt realize I had it until I had lost too much weight to be hospitalized. I am 5 5 and 102 lbs. Having pain so eating is still difficult. I am 49 yr old female. I was wondering if Splenda is okay to use. I am learning what to eat.",
    "doctor_response": "HiYou can have splenda. But try to eat healthy food. Avoid alcohol and spicy food.Take pain killers for the pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for cervical lymph node swelling\n\nI am under Tbc treatment for about 8 months..during my 6th month i had cervical lymph node swelling and it was suspected to be a lymphoma..but after a sectional biopsy it was confirmed to be a healing Tbc in lymph node with absence of mycobacterium bacteria. Although the swelling was decreased considerably, it is showing an on and off symptom of increasing lymph node swelling at the same place.my lungs have almost proved to be clear in my last xray diagnosis. I am still under tbc treatment..does it mean that it is turning into a non resistant tbc..should i worry about it ?",
    "doctor_response": "HI, thanks for using healthcare magicLymph nodes are part of the immune system and respond to the presence of inflammation/infection in the area.It can take 4 to 6 weeks after an infection has resolved for a lymph node to decrease in size.This means that the node may decrease in size so you can monitor for now.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for end stage COPD\n\nI have late stage copd, past smoker, quit 16 yrs. ago. My parents and childhood Dr are now dead. My first pulmo dr told I had come into something more than cigs because of my scarring and other signs, I was then 44. I had numerous strept throat infs in grade school, until tonsillectomy when I was 14. Not too many yrs later, I began the usual, just peer pressure. I am the oldest child of 4, all or breathed 2nd hand, no one comes close to me. I am dying younger than my bio parents. Some thing has always seemed strange to me about Clorox! I asked my mothers older sisters, said no, yrs ago, forgot it! Asked my younger aunt just recently, she said yes . You got into it when your sis was a baby, you were a toddler not even quite 2 Sorry, got carried away, could this the original culprit?",
    "doctor_response": "Thanks for your question on HCM.Clorox may or may not be the culprit but smoking is definitely the cause for your COPD.Now the important thing is to start treatment rather than searching for cause. As COPD is irreversible and progressive disease. You need to start treatment to halt the progression. So consult pulmonologist and get done chest x ray and PFT (Pulmonary Function Test) to know the severity of the disease as treatment based on severity only.Treatment consist of following steps.1. Quit smoking.2. Start inhaled bronchodilators in the form of meter dose inhalers having long acting beta 2 agonist (LABA) and inhaled corticosteroids (ICS).3.Enroll in  Pulmonary rehabilitation programme where chest physiotherapy is available. 4. Vaccination with pulmonary vaccines like pneumococcal and influenza to prevent future lung infections.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower abdomen pain?\n\nhi, i have an aching sort of pain in my lower right abdomen (quite low down) and when i lift my leg up it hurts and when i'm holding a small amount of pee in it hurts as well, i've had the pain for about 2 days. I am also needing to pee more. There is no burning or anything like that",
    "doctor_response": "Hi ! Good afternoon. I am Dr Shareef answering your query.If I were your doctor, I would do a general physical examination of yours with special attention to the abdomen to rule out any possibility of appendicitis, which could also give rise to urinary symptoms in some of its positions. Therefore, I would go for some routine tests like a CBC, urine for routine/microscopic/culture and sensitivity test, and an ultrasound abdomen. Further management would depend on the results of clinical assessment and related investigations.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a swollen tonsil with a red spot be caused by a viral infection?\n\nHello. In the last couple days I have noticed my asthma worsening, and today my throat is a little sore. I also have a red spot on my right tonsil. The tonsil is swollen as well. I had a red spot like this on my throat earlier in the month as well. Do you think it s something viral, or should I see a doctor about it?",
    "doctor_response": "Hello,Welcome to HCM,Most common cause for tonsillitis is viral infection which is followed by bacterial causes. The virus can easily gains entry into the body which will be trapped by the tonsils, which is one of the important lymphoid organ and try to neutralize the virus there by produces the mediators of pain and fever, which will leads to congestion and increased body temperature.The triggering factor for the asthma should be identified, because the tonsillitis is secondary to asthma. The triggering factor may be a allergen like dust, mite , pollen and food.The prolong attack of asthma leads to recurrent attacks of dry cough which may leads to congestion of the tonsils and may produce the symptoms which you are having.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hump on back due to spinal cord kyphosis\n\nHi, I have some kind spinal disorder from birth. It may be spinal cord kyphosis. Actually only two verbetes are curved in spinal cord because of these hump on the back appeared. My parents notice when I was at the age of 7. Even we consult to many doctors but advice not to go for any kind of surgery. I am now 25 living normal life no pain nothing. But my appearance from back side is the issue. Any advices.",
    "doctor_response": "Hi there, thanks for your question. At your age cosmetic appearance is one of the indication for intervention apart from disability caused by pain. In spite of recent advances in modern spine surgery kyphosis correction surgeries definitely have higher risk than correction of deformity like scoliosis. So if you can manage with your cosmetic appearance and pain is negligible you can wait. In the other hand if you feel the appearance is disabling and you would rather get it corrected, surgery is advisable. Your doctors might have refused surgery due to smaller magnitude of deformity. Treatment varies on case by case basis. Hope this helps. All the best.Regards.. Dr.SBK",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swelling in legs and feet, was under treatment for transverse myelitis. How to treat this?\n\nHi - I am recovering from a diagnosis of trransverse myelitis -- I was in Mayo until 10/17,  I am now walking with a cane, working on my gait...  my question is about swelling in my legs and feet.  Especially my left foot, which is the less compromised one.  I just finished soaking my feet in comfrey leaves and warm water, I massage & elevate  them a lot, but nothing seems to help.  Any suggestions?  Linda",
    "doctor_response": "Hi.leg swelling can be due to many reasons..u have to rule any heart or kidney disease.are u diabetic or hypertensive? U may need CUE,urine micro albumin level and ECG,2D echo to rule our kidney and heart functioning.u can use stockings with ur doctor advice to relieve edema..cheers",
    "dialogue_context": ""
  },
  {
    "patient_message": "My husband went through heart surgery last summer and had three stents put in. The cardiologist put him on two different blood thinners and he is allergic to aspirin. The two thinners are Effient and Cilastizol. He is having a very bad reaction to the Cilastizol with diarrhea and was told to take only a quarter of the pill once in the morning and once at night. Is there another blood thinner that can be prescribed rather than the Cilastizol?",
    "doctor_response": "Hi, He can use Plavix tab, its a good medication with low side effects, effective in most cases with no allergic condition reported against it. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could red rashes in vagina be caused by masturbating using a certain lotion?\n\nhi i work for a online sex site. I have been masturbating alot with lotion lately,,,, now i have a red rash and it burns when i apply lotion now.....i know i am std free and i think its cause i do it so much with the lotion,,,besides stopping for a while what can i use to help healing process? thank you",
    "doctor_response": "Hi,I can understand your concern for the red rashes in vagina. You are correct in your observation that the rash is caused by masturbating using the lotion.I suggest you to stop any sexual sexual activity including physical sex as well as masturbation for atleast few weeks of time to give some rest to the affected vaginal area. It will help you in healing of the inflamed mucosal skin of the vaginal walls.Do not try to apply any kind of lotions or creams for healing and during masturbation too as it can cause secondary bacterial infection as well as multiple other problems.Simply take paracetamol tablets with antihistamine tablet and maintain good hygiene and can do warm compression for early healingAll the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it advisable to use Z-pack for fever, mucus filled coughs with runny nose?\n\nHi doctor, I am a 22-year-old male with ulcerative colitis since the age of 9. I woke up with a nasty fever, mucus filled coughs, and runny nose. I was curious how a Z-pack would affect me.",
    "doctor_response": "Hi. I can understand your concern. The possibility of respiratory tract infection is more likely. You should definitely take Z pack, no need to worry about this. Along with Z pack also, do warm water gargles and steam inhalation 4 to 5 times a day. If not improving in five days, get done chest X-ray. Please let me know if you have chest pain, breathlessness or wheezing.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for depression and panic attacks\n\nim currently on 40 mg prozac 1 daily clonazepam 1mg 3 times daily flexeril 10 mg 3 times daily and my inhaler im depressed still my anxiety seems worse every morning a panic attack and i do not want to be mobile it may be the flexeril or depression i was once taking phenterimine for 3 months on and off then 3 months again i changed drs. and got off of it during pregnancy and insurance reasons i asked my current dr now and he just doubled my Prozac i did not need anti depressants while taking phenterimine i was always happy and confident kind of in a bind i don t want to look like i am dr shopping as i hear",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Panic attacks always happen due to underlying anxiety. Therefore you must address the underlying anxiety first. Please understand anxiety and related problems. Once you understand your anxiety, you will be able to keep yourself away from panic creating situations. Therapy always starts with avoiding such situations along with coping techniques when forced to be in such situations. Start slowly, progress gradually, attain neatly.You should know that these problems are not mental diseases, but are mental disorders. Many researches and researchers confirm that medicines alone cannot cure mental disorders. Exercise, Life style changes, change in thinking pattern, relaxation etc are as essential as medicines. Psychotherapy can help you changing your lifestyle and thinking patterns. Yoga and meditation help you to streamline your metabolism and neurological balance. Please consult a psychologist for further information.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump on the knee cap?\n\nI have a hard lump or knot on the top of my knee cap for almost a year. It looks like the size of a rubber bouncy ball, doesn't hurt much, is hard and seems to be just under the skin. Any ideas what this may be? Should I see a ortho Dr or family practice dr?",
    "doctor_response": "Hello,That bump on your knee cup is suprapatellar bursitis, a collection of fluid in the bursa due to overuse or inflammation or friction kneeling down often, praying or profession position.I think you should go to the doctor to aspirate it with needle and put an elastic bandage. If you don't aspirate, there is a chance of infection.Wish you quick improvement.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Edvin Selamni",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. The foreskin covering the penis is very intact and not retracting during erection. What could it be?\n\nHello doctor, I am a 24-year-old male. I am afraid that I might be suffering from phimosis. My foreskin is too intact that it covers the whole penis, without retracting even during the time of erection. There is no problem while erection, masturbation or urinating. It is just that my foreskin is too intact that it covers my whole penis and I get to see no glans penis, as it is totally covered by my foreskin. My foreskin starts to retract from the middle of my penis. I am so afraid that this might affect my sex life. Please help.",
    "doctor_response": "Hello. You can try to retract foreskin daily during bathing, a little more every day. If this does not work or is painful, better get a circumcision done. This will ensure there is no problem during intercourse. It is a small surgery done by urologist or surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there chances of pregnancy at the age of 40 having AMH level of .26?\n\nMy daughter is 40 years old, has never been or tried to get pregnant. She now wants a child. She was told she has no chances to get pregnant due to AMH level of .26 as well as poor results in other hormones. Is this 100% correct or is there a very small chance? She is in very good health.",
    "doctor_response": "Hi. I fear that AMH levels which tell you about ovarian reserve are very low(less than 0.5).As the age of female increases AMH decreases and other hormones are also not showing good results.But don't loose hope. Consult a good IVF specialist and look for all other factors also. See if ovulation is really not taking place or  it is possible to do ovulation stimulation with drugs .You need a thorough work up for everything and still there is a hope if nothing works    by a donor egg. I think you should work on it. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can high fever in an 8-year-old child be treated?\n\nhi dr Andrew. My son is 8 years old and having very high fever temperature 39 -41 degree C. I have given him paracetamol syrup but the temperature do not drop at all. He also complains of stomach pain after taking the paracetamol syrup. Should I change to other types of medication? what can I do to help to lower the temperature?",
    "doctor_response": "Hi, Fever of a 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 every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. Apart from Paracetamol, you can try Ibuprofen at 8th hourly if fever is more than 101F. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain under the rib cage?\n\nI have severe pain under my left ribcage. I cannot take very much pain medicine because my stomach is sensitive. I am disabled with fibromyalgia, high blood pressure, and degenerative arthritis. What could this be? I ve recently had blood tests on my pancreas and liver and they were fine. What do you think?",
    "doctor_response": "Hi,Thanks  for  your query.Firstly the pain under the left side of the rib cage may be due to Gastritis(Inflammation of the stomach). I advise would be to avoid spicy and greasy food. Prescribe proton pump inhibitors like omeprazole. A gastroscopy will help in the diagnosis.Secondly it may be due to pancreatitis(Inflammation of pancreas). Stop smoking and alcohol if any. Blood tests like serum amylase and lipase will help in the diagnosis.Thirdly kidney stones. X ray of the KUB will help in the diagnosis. Antispasmodic for pain. Increased intake of water is advised. The size and site of the stone determines whether the treatment is medical or surgical.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pea sized lump on ball sack?\n\nhello, i have a small,pea sized lump at the top of my ball sack and near the thigh,it is red and somewhat tender to touch but i can squeeze around it and it feels like there is a tiny hard ball or knot on the inside of my sack, please reply with help and once again it is at the top of the sack and starting of my penis and it is also on the right side. i am 21 yrs old, is this normal and should i have a doctor check on this imediately or should i give it some time to heal on its own?? i just noticed the lump today and i dont think that it was there in the past",
    "doctor_response": "HelloIt could be a small lipoma or nodule of fat ,getting infected.Generally it should be all right after some time. You can wait for 2-3 days. If it worsens, get it checked by a doctorDR SAATIISH JHUNTRRAA",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for heart and throat infection\n\nDear Doc, My daughter is suffering from fever 104 F her head and face is hot but hands and feet are cold. I am giving her Pedadol 100mg and oxmapox 125 mg for her throat and chest infection. I cannot take her to a doctor as it will be to difficult. The fever is not coming down for last three hours please advice could I give her calpol syrup after every 4 hours.",
    "doctor_response": "Hi,There might be having viral or bacterial infection giving rise high temperature.But as antibiotic medicines are continue, nothing to worry.Give Calpol syrup round the clock to bring down the fever.But important is to give plenty of water and keep her well hydrated.If high fever continued then consult your doctor and go for investigations like complete blood checking and routine urine check up.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for lupus?\n\nI have physical signs of lupus, these were the only blood tests that showed anything mcv high, mchc high, plt high, anticardiolipin high, I have hypothyroidism (TSH normal) and b12 deficiency (take shots, b12 normal on this blood work). Are the positive results due to my b12? possibly lupus?",
    "doctor_response": "Good evening. Your MCV high can be attributed to B 12 defeciency. When you say physical signs, what does that mean. A Lot of conditions can mimic lupus. Among st your blood tests, i cant find ANA report which has the highest sensitivity for Lupus. High Anticardiolipin can point towards AntiPhospholipid Syndrome which can be a very close mimic of Lupus. If you could give us more details we will be able to help u out here with the exact diagnosis and the treatment options.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause a feeling of low pressure in the ear after a hit on the head?\n\nA friend of mine asked me to look this up for her. She hit her head on Sunday. On Monday, she began to feel pressure in her ears. She describes it as being similar to what one feels on an airplane. There is no hearing loss; she is not in pain. But she wonders whether she should see a physician. Thank you!",
    "doctor_response": "YES SHOULD AS THE AREA IN THE HEAD REPRESENTING EARS MAY HAVE HEART INFLAMED OR BRUISED TO CAUSE PRESSURE IN THE EARNEED TO SEE DOCTOR FOR CT SCAN HEAD ALONG WITH INTERNAL EARS AND LOBES OF BRAIN REPRESENTING EARS AND TREAT ACCORDING TO RESULTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a bump on the anal opening?\n\nhi my bb is a 13 months and ive notice he has like a bump on his asshole is that normal ? the pediatric said it was okay but i have been looking at it these past 2 ,3 months its been looking bigger is it normal ? the pediatric said its part of his body that thats how he has it . to me it dosent look normal",
    "doctor_response": "If it painful and bothersome to the baby it could be a abcess. But if its painless it could be any thing from a wart, hematoma,sebaceous cyst.. anything. You dont have to do anything just monitor it and dont handle it often. If it continues to grow after 6 months consult a pediatric surgeon... Lastly I dont think it is anything to worry of much.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the ill effects of an elevated ALT level?\n\nhello, I just received a elevated ALT level of 61.  I am 32 years old, healthy otherwise.  What could this mean?  How high is this?  I just had two babies, one is just 2 and second is 10 weeks.  Also just had a cardiac ablation done, but the test results were from the week before the procedure?  please help",
    "doctor_response": "Hi,Your liver enzymes value just mild High and not raised more than two times. Hence it is not much significant. Still do work up as follow for it.- USG abdomen- Serum bilirubin estimation - Measure your BMI- Serum cholesterol - Viral infection history should be ruled out If your weight high means BMI high than reduce weight Fruits taken more If fatty liver detected than life style modification done along with exercise. Repeat your test after two weeks. Drug and alcohol history should be ruled out. With keeping this in mind consult physician for examination.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I do not have dandruff but still losing hair. Why?\n\nHi doctor, I am a 38 year old woman and have been losing my hair for about six years. All tests came back negative. My GP prescribed a shampoo as she thought I had dandruff, but I have never had dandruff. I am taking Fexofenadine for urticaria and Naproxen for costochondritis. Also, I have a Mirena coil due to very heavy periods. I do have thyroid, diabetes and vitamin D issue. Any help would be great. Thank you.",
    "doctor_response": "Hello. With your descriptions it seems that you are suffering from female pattern hair loss. If you can send picture of your scalp it will be better to diagnose. You did not comment on test reports. Are you a diabetic? Are you suffering from hypothyroidism? Since you are having heavy periods you should go for serum ferritin level and hemoglobin level. If you have diffuse hair loss you can start 2% Minoxidil 1 mL local application daily and tablet Biotin (vitamin H or vitamin B7 supplement) once daily. To see visible response it will take two to three months. Female pattern hair loss. Chronic telogen effluvium. Female pattern hair loss. Follow up monthly to a dermatologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does phentermine affect baby in the womb?\n\nHi I just found out Im pregnant I am thinking Im probably 1 month or so and Im worried because for the past 3 months I have been taking phentermine and I received 2 laser hair removal treatments. Can you please let me know if this is dangerouse for the baby? I have stopped taking phentermine about 2 days ago when I found out.",
    "doctor_response": "Hello, and I hope I can help you today. Unfortunately, phentermine is a medication that is associated with an increased risk of birth defects with exposure in early pregnancy. It is considered a medication that is in pregnancy category X which means we absolutely tell women to avoid during pregnancy and recommend a woman not become pregnant while taking this medication.However, if the pregnancy is so early that a fetus is not yet developed, there is a possibility that the fetus will not be affected. The only thing that can be done at this point is to see an OB/GYN for the pregnancy and confirm the gestational age of the fetus. If the fetus was exposed the majority of the first trimester, there is a high risk of congenital abnormalities. Ultrasound scans can be performed later to screen for malformations, but these will not probably be visible until at least 15 weeks.Regarding laser hair removal, fortunately this does not have any effect on the developing pregnancy, though your skin becomes more sensitive when you're pregnant so I would avoid it.So in summary, I recommend you get evaluation by an OB/GYN as soon as you can. Then you will be able to find out the accurate dating for your pregnancy as well as the potential prognosis depending upon the amount of time that the fetus was exposed. In the meantime, stop drinking alcohol, begin taking prenatal vitamins, and keep a well-balanced diet, drink lots of water, and get an adequate amount of rest.Best wishes for the rest of the pregnancy and good luck,Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "How do I manage my varicose veins on scrotum?\n\nHave little like bumps which I assume are varicose veins on my scrotum amd today on eof them broke oen like a pimple and bleed profusely.  I called my family dr. and he told me to apply pressure to it for 10 mins  it did stop bleediig which was brigth red blood.  I asked about following up on it and he just said watch it-lol.  I have a few of ths on my scrotum but none have ever bleed.   Is this the normal process.  I am overweidgt but not extreme nad have a rather lg scrotum .  Can I excpet more of these to burts?",
    "doctor_response": "Hi,Dear,Thanks for your query to HCM.Dear I read facts of your query and reviewed it in context to your health issues submitted in your query.I understood your health concerns and feel Concerned about them.Based on the facts of your query the reply of your query is-Your current health issues seem to be due to -Long Standing and Advanced Varicose Veins of the Scrotum-which was not noticed / or was not cared unkwoingly.This needs to be verified with other causes of large Scrotum-which could be due to accompanied- Inguino-scrotal hernia/ or accompanied Filarial Scrotal enlargement.The Cause of this in your case needs to be investigated.Other causes need to be verified,as discussed above.For this you need to consult Surgeon and Urologist from Surgical Department.Remedy-Do's in your case-Check With Doctor-Rest-for few days-4-5 days- with head low would help you to strenghten the Varicose rupture site and would avoid recurrence in time to come.uYou need to Urgently plan Micro-Vascular Surgery for correcting the varicose veins in Varicocele which many need ELVT-endoscopic laser ablation of the engorged communicating vessels and Foam sclerotherapy to reduce the engorged mass,as your case is advanced Varicocele.Bleeding from the Scrotal Varicose Veins - is not a normal process, and indicates long standing Varicose veins with thinned out skin over it, with minimal trauma causing bleeding -as happened in your caseReduce on obesity by strict dieting plans from nutritionist and family Gp.Check Testosterone / LH/ FSH and thyroid and blood sugar levels,which could be low due to long standing Varicose Veins of the Scrotum-Varicocele and fix  if diabetes/hypothyroidism is  the cause  of obesity in your case.Get physical check with Urologist who do USG and Color doppler studies to asses the severity of Varicocele / with accompanied testes atrophy -if its there.There are many causes which need to be verified amongst the causes discussed above before planning specific surgical remedy in your case.High protein low Calories/low fat / high fiber diet to built up body muscle mass and loose obesity.Proper Gyming and walking exercises would help you a lot but under guidance of Physician-as to avoid more ruptures due to uncontrolled exercises,due to increased abdominal and venous pressure.Vit B12 and Folic Acid- to stabilize aid BMR rise and reduction of obesity.Thus You should consult Urologist and Physician.This would resolve the complaints of your's.Constant follow-up with local ",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in lactation?\n\nim a 27 yr old female mother of 2.the younger one 3 months.in my early pregnancy i  had issues with my lactation like clogged duct...i used lactare granules and other same sort of medicines for improving my lactation ...but i   faced a very bad situations like lack of milk and pain due to clogged ductmore over my breast size got increased very much.....this time i didnt go for any granules ...i ate 20 lactare cap after delivery (10 days)and stopped .now im feeling my body i snot producing enough milk after evening ,so thinking od eating lactare again..will it increase my breast size????...and some people says that lactare reduce boduy weight is it true????",
    "doctor_response": "Hallo Dear,The main  reason for lactation failure is faulty technique.  While breastfeeding, you should not give only nipple to the baby to suck. Baby's lips should rest around the areola and nipple with areole should enter baby's mouth. Thus  the baby roles the tongue under the nipple with pressure on areole.  This way baby gets milk without getting fatigued.    By sucking the nipples only, the milk flow is only by baby's suction and the baby gets fatigued. this leads to incomplete emptying of the breasts. Emptier the breasts, more the milk is formed. After baby is fed on one side, should be held vertically on mothers shoulders to burp so that the trapped air gets expelled and the baby drinks more milk. Your history suggests that you do not have problem in producing the milk. It seems the faulty technique of suckling is causing the problem. After feeding the baby, if any milk is left behind, it should be squeezed out to empty the breasts. The expressed milk may be preserved or you may drink it. Arrowroot powder helps more milk secretion, does not disfigure the breasts after breastfeeding and even takes care of falling hair also.  I hope this helps you in brestfeedin your baby",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on chest?\n\nHi, I have a brother who is currently incarcerated. When I went to visit him today, he told me about a lump on his chest. He also told me that the doctor there was giving him medication but was telling him the wrong name of the medicine. I was just wondering, aren't they suppose to do some type of exam on him to determine what it is before they just give him medication for it. The reason I ask this is because he told me that they said it was nothing that they could do. So I was wondering if they were suppose to diagnose him with something before just giving him medication?",
    "doctor_response": "Welcome to health care magic. 1.The history is bit inadequate, as you have not described the lump and its location on the chest, however i will try to explain you the possible causes.2.The most possible cause could be infective aetiology, hair follicular infection with collection within - which needs antibiotic in early un complicated condition, where late and complicated needs excision.3.Other possible cause will be lipomas which needs to monitored unless until symptomatic where excised.4.Finally bone lesions arise on the chest wall, and hernias. Which need to examine and do needful treatment.5.An ultrasund scan will help in the assessment of the nature of the lump, its source and extensions.6.Suggest to get examined and diagnosed and treated appropriately.7.Probably the doctor would have visually able to make out the type of lump he is dealing so started treatment. Good luck.Hope i have answered your query,any thing to ask do not hesitate to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can kidneys be attacked by lupus?\n\nI have all the signs of lupus sle but all tests have been negative except anticardiolipin igg was 1 point over normal so it said high also i have high creactive protein and sed rate for 6 years. I feel im having a flare of symptoms im getting a rash back on my legs and fingers also in my scalp i keep getting butterfly rash and hives from sunlight and now my urin smells like sulfur or ammonia and its brown like coke it feels like i need to still go but can t. Im drinking gatorade constantly and im swollen everywhere. My pcp said the last few times i was there my urine had protein and blood in it but the culture showed no infection. I have this every few weeks but no infection could the undiagnosed lupus be attacking my kidneys?",
    "doctor_response": "Good evening. Yes lupus can affect the kidneys. But i am not too sure why is it still undiagnosed if it present. Urine protein and blood are abnormal. But there can be many causes for the same presentation. I am not too sure if you have your ANA, ANCA levels, ENA Profile,complement and DsDNA levels done. Cause one needs to see into these causes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can FHLH disease be passed to the offspring?\n\nsir, i m from pakistan,want to know the way of getting blood sample for diagnose of a blood disease fhlh ....how should we confirm that wether a couple is a carrier of fhlh disease for their offspring?what is the process to send sample and what is its charges?",
    "doctor_response": "Hi, dearFHLH is a hereditary disease.  It can pass from couple to their offspring.  Genetic counseling and investigation is required.  For that cord blood is taken and genetic test is performed on that.  It can be done in any genetic laboratory. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Azithromycin be taken by an individual allergic to Macrobid and Bactrim?\n\nI am highly allergic to macrobid and also Bactrim.  I was just prescribed Azithromycin, reading it is a macrolide antibacterial drug, I am worried it is the same class, & too similar to the 2 I know I am highly allergic to(macrobid, and Bactrim)... Is this 'z-pack' ok for me to take??",
    "doctor_response": "HiDo not worry Z pack is another group of antibiotics.You can use it safelyI wish you a fast recovery Take careDr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bump near anus opening?\n\nI have a bump near the opening of my anus and normally I don t notice it unless it feels itchy, usually after going to the bathroom. I also have a bump on my cheek that doesn t itch, but hurts a little when I sit a certain way and looks a bit like a pimple.",
    "doctor_response": "Hi,It seems that you might be having some skin infection like dermatitis causing this type of lumps.Possibility of having fistula in ano should be ruled out.Consult surgeon and get examined.Avoid constipation.Keep local hygiene proper.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yellow and black stuff on teeth?\n\nhi i have been feeling some strange sensation on the back of my teeth , on the front bottom ones... i looked at them and i found out some yellow n blackish stuff on them which wont go away by brushing..  it feels very strange when i touch them with my tounge and a feeling of dryness and like something sucking my teeth ...",
    "doctor_response": "Thanks for your query, I have gone through your query.As far as the black and yellow stuff on your teeth is concerned, I have two possibilities.It can be secondary to the stains or deposits due to poor oral hygiene.The other cause could be because of the decayed tooth.Consult a oral physician and get it ruled out. If it is because of the deposits, then get your teeth cleaned and maintain oral hygiene. If it is secondary to decay, then get the teeth restored. I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes knot on right side of spine, headache, tension muscle aches?\n\nI am a 26 yo f, no significant health problems. I have a quarter sized hard, but not raised knot on the right side of my spine, where my neck and skull meet (hair line). It is hard and not moveable. I have had this knot since I was a teenager. I have a lot of headaches and tension muscle aches. What could this be?",
    "doctor_response": "Hello!Welcome on Healthcaremagic!The knot on this region could be related to a sebaceous cyst or a lipoma. In my opinion it is not related to the headaches. Anyway, I would recommend consulting with your GP for a careful physical exam and a tissue ultrasound, in order to clarify its nature. Hope you will find this answer helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red itching bumps on thighs, legs and feet?\n\nMy feet started itching really bad in the middle of the night. I assumed it was a mosquito bite BUT I have been getting red itchy patchy spots all over my thighs, legs, and feet. And they itch so bad I m having a hard time sitting still. How can I get these red bumps if no bugs are even biting me? I m in the sun right now and the bumps are just spreading even more.",
    "doctor_response": "Hello,This is Dr. Papaqako answering your question.Thank you for posting your question to HCM.From what you are describing, looks like you are having an allergy or skin hypersensitivity. Whatever you notice that is making it worse, stop the exposion. It should be something that is new for you like a new food, a drug you have been taking lately or even e new detergent or cream you are using. To help the itching, apply a steroid cream to the red bumps (hydrocotisone or betamethasone 1-2 day, thin layer, until it heals, not longer then 10 days.If those are getting worse, or not better, consider a visit to the allergy doctor, who will do a test and discover what is the element that is causing you that skin reaction. If you have fever, you should go to the doctor immediately.  Skin problems are complex, and need to be seen together with the other symptoms. Even though in your case, looks like a allergy ans I would not be worried for something contagious if you have not fever.Hope this helps.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for liver cirrhosis\n\nMy mother in law was told she had 30 days to live with cirrhosis. Two months later her amonia levels are normal and she has not had a paracentisis since then. Mentally she has declined- not wanting to take medication and thinks she has to pee all the time. Her communication has declined, she cries all the time and hits her nurses.",
    "doctor_response": "hi,Whatever symptoms you have described ,it looks like she is in encephalopathy ,for which she might be hospitalized for further management and check her blood parameters like renal function and electrolytes which are usually deranged and there are chances of getting infection too.If there is any abnormality better to correct to regain her conscious levels.And about pee ,that will be because of diuretics which your doctor might have prescribed.So starting with encephalopathy measures like adding duphalac syp 30 ml twice or thrice a day so that she should pass stools atleast 2 to 3 times per day if not consider to give her duphalac enema .Tab RIFAGUT 550 MG twice a day for atleast 15 days should be given as this is a intestinal antibiotic with no side effects.Avoid NSAIDS.Proper nutrition specially protein content is necessary as in cirrhosis there will be low protein.AVoid pantop injection as its not recommended in cirrhotics.Avoid oily band spicy foodHope this information helps youThank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tonic clonic seizures\n\nI have a 5 yr old daughter with tonic clonic seizures.Her teacher has been very explosive, screaming in her face, etc.Can this stress cause a seizure and where can these facts be cited? thank you.I need proof to have her removed from the classroom.",
    "doctor_response": "Hi, yes stress are provocative factors for seizures. Either the teacher should be counselled or your daughter should be removed from classroom.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can i stop the progression of CKD?\n\nMy name is rison and i am 47 years old. now my creatine level is 1.6  and all other lab reports normal. ultra sound scan my kidney size is 9.8*3.5and 9.9*4.1.    .  my bp is 130/90 and no diabatic background. sir, wht will be my life span in this stage of ckd ?  and can i stop the progression?",
    "doctor_response": "Hello, your kidney sizes are pretty much in normal range. S creatinine is borderline raised. You have not mentioned whether you have been diagnosed with having CKD or you are saying it yourself.If your all other lab reports are normal and this are the 2 reports i would say you are doing pretty well. You mentioned you dont have diabetes and have only hypertension.For now only thing for you to do is keep control on hypertension by taking medications properly. Avoid excess salt and oily diet.Exercise regularly. And i dont see any problem for you with atleast your kidney point of view.Just keep regular follow up with you doctor.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tiredness and vomiting in a child\n\nMy 6 year old Daughter started feeling very tired two days ago. Later that day she vomited twice. Since then she is very tired one minute and not the next. She has no fever nor any other symptoms that are clear other than going to sleep when she is normally very active. She has been drinking water fine.",
    "doctor_response": "Tiredness and increased sleepiness in such a scenario may be a sign of dehydration. If it is associated with reduced frequency of passage of urine, it confirms dehydration. In such a case you need to take the child to a doctor without delay. Meanwhile giving ORS (oral rehydration solution) should be helpful in replenishing the lost salts and water.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for back pain\n\nHi, I have had a backache on the right lower side of my back for a few days but for the past two nights I have felt sick and on both occasions have woke up at 4 am the same time each night to be sick after that I am fine. What is wrong with me ? Help!",
    "doctor_response": "Hi,Welcome to healthcare magic.After going through your query I think You are suffering from acute backache. Treatment of it is rest and analgesics . Diclofenac three times a day after meals is effective. Sometimes strong analgesic(such as ultracet three times a day after meals) is required. OMEPRAZOLE 20 MG before meals  prevent acidity caused by analgesics .Sometimes vitamin D deficiency is the cause so get your vitamin D checked .If it is low then vitamin D supplementation(Bon DK 60K weekly with milk) can be taken.To further investigate MRI of the region is advised. I think your query answered.Welcome to any follow up query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Full of problems due to work\n\nI am an IT guy with hectic schedule and no proper lifestyle.meaning..sometimes i wrk in shifts and end up eating and sleeping during the odd hours. have BP and take athenol tabs and its normal now. My parents have asthma and hence I am worried about that as well. Kindly help me. I need to loose weight.",
    "doctor_response": "Loosing weight is a tough job requiring a lot of patience and strictness. Get a complete health check done. Modify your lifestyle a little to have proper weel balanaced diet and sleep.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taken Metformin for PCOD. Trying to conceive. Done follicular study\n\nHi Doctor ,I am 28 years old and married and have plan to conceive. I reported PCOD 6 months back.Started taking  metformin since then.Last two cycle i also took fertile medication from 2 day of my periods to 6 th day.Today is my 11th day ,Undergone follicular study .it repoted that i got follicule but the size is 23x25.Please suggest me .",
    "doctor_response": "Hi This suggests that the follicle is getting matured to ovulate and the drugs are working. They may ovulate in a day or two. Follow your doctor's advice.Hope this helps.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any side effects for taking Naturogest after IVF treatment?\n\nHi, My sister, age 43 has had IVF 13 days back and was advised to take Gestone regularly after IVF. She started having some side effects like rashes and swelling on face and body. Hence was advised by the doctor to change medicine to Naturogest instead of Gestone. I hope it is safe to take Naturogest. Also i hope the Gestone side effect and Naturogest will not have any negative impact on the IVF results.. I am worried for my sister. Please respond.",
    "doctor_response": "Hi,Naturogest contains progesterone hormone similar to Gestone. The drug can be used in IVF treatment in case of allergy to Gestone. Do not worry.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Saranya Ramadoss, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does having HHT cause weakness in leg?\n\nHi, I have Dystonia and have had DBS which has controlled the symptoms. However I also have a problem with my right leg, and have fallen several times.The last fall was 10 days ago. My PCP thinks I may have Drop Foot and has referred me to a local neurologist. I also have a 15% shunt and am in the process of determining if I have HHT. Can HHT be a source of the leg problem? especially since I have been told I have White matter disease?",
    "doctor_response": "hi,neurology is a complicated system to understand and comment by just a mere of few words. You need to be more in providing your medical history in detail without any short forms. ofcourse muscles are controlled by the nerves and nerves are by brain. So white matter and grey matter makes an importance for the transmission of neural impulses. Meeting up a neurologist is always a good step. you can even meet a physical therapist for some exercises which are specific to brain training. And if your neurologist feels he will surely recommend you for physical therapy as with medicine it works well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am getting symptoms resembling tetanus due to long time Strychnine injection. Am I likely to recover?\n\nHello doctor, I have reason to think that I have been ingesting small amounts of Strychnine over a long period of time. Not enough to kill me. But enough to cause noticeable symptoms. The symptoms resemble tetanus. Extreme jaw muscle tension to the point that I have trouble chewing sometimes, paralyzing neck muscle tension and general stiffness through out all the muscles. Extreme irritability, anxiety and tremors. And extreme trouble breathing as well as dementia-like symptoms. My question is if I have been ingesting small amounts of Strychnine are there any tests that will show it? Will small amounts of Strychnine build up in my hair follicles? Will any signs of it remain in my blood? How long after ingestion will traces still be detectable? And what is the best method of determining whether or not it is, in fact, Strychnine that I have been ingesting? What kind of symptoms can I expect after long term exposure? Are the symptoms likely to continue after I am no longer exposed? And am I likely to recover?",
    "doctor_response": "Hello. What is your age? Since how long have you been ingesting Strychnine? In what form and amount? Though there are one such diagnostic tests available to detect Strychnine poisoning other than typical signs and symptoms like generalized effect of muscles, convulsions, etc. Chemical analysis can be done to reveal the poison.  Yes, continuos use of Strychnine can deposit in the body and can be detected many years after death as well, but not in hair follicles but in the spinal cord. Some amount of Strychnine also gets secreted in milk, saliva, sweat, etc. To know whether it is Strychnine apart from test typical signs and symptoms will conform it. Presence in the body and detection of the same would depend largely on the form of poison consumed. The presence of symptoms must be treated with certain drugs. Long term exposure will cause it to accumulate in the body. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does an irregular heartbeat mean?\n\nHello doctor, Just tonight I started having an irregular heartbeat. I have no other symptoms. I am not weak or dizzy or lightheaded. It has been going on and off for about five hours.",
    "doctor_response": "Hi. I understand your concerns. Your symptoms are most likely due to heart arrhythmia most likely AFib (atrial fibrillation), the most common arrhythmia which causes palpitations and may be completely asymptomatic. The other possible causes include SVT (supraventricular tachycardia) or other heart arrhythmias. Please provide me with more details in order to reach the appropriate diagnosis. Is it the first time you have this symptom? Do you have any health problem (thyroid or heart)? My advice is to perform ECG (electrocardiography) and send me the report. Measure your blood pressure. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat damage to the right knee ligament caused due to an injury?\n\nHi..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.",
    "doctor_response": "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 kneeIn 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 weightbearing. 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 stabilising your knee and reduce your symptoms. Some ligaments do eventually scar down and you will have less 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 stabilisation will lead to earlier rehabilitation and better function.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to stop coughing in 3 year old\n\nhi docmy 3yrs and 9mths old son have coughing problem from last 10 months..we visited doctors and gave him nebulizers and all the antibiotics...but it doesn't work...he is coughing usually in mornings and night.. don't know what to do...please help us",
    "doctor_response": "Hi thanks for contacting HCM...Your child needs detail examination and investigation ..Repeated viral or allergic infection can lead chronic cough....Auscultation of your baby done...If rhonchi heard it could be bronchiolitis or asthma like condition....Try to avoid exposure to dust, pollen , passive smoking etc....Healthy food given ...Give him turmeric powder one tsp added hot milk daily for drinking....Sputum examination or culture needed to rule out whooping cough by bordetella petusis....According to sensitivity report treatment given ....If needed chest x ray also done...For excess cough antitussive medication can be given...Consult pediatrician with keeping this in mind.Take care ...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy, related with stomach bloating and hardness?\n\nHello! I have been feeling extreme bloating for about 3 weeks now. My stomach is hard and but I can feel thing moving all the time. I cannot possibly be pregnant because both of my tubes have been removed. Although my boyfriend thinks I am. What else could it be?",
    "doctor_response": "Hallow Dear,Since your both the fallopian tubes have been removed, there is no chance of pregnancy. The bloating, hard abdomen and excessive movements in the abdomen you are feeling seem to be most likely due gaseous distension due to digestive problem. You may please chew Tums tablets, drink plain soda and if possible take some enzyme preparation. This will help controlling acidity, passing the gases and improving the digestion. I hope this helps you.Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lumps in the breast?\n\nOk here it goes.....3 days ago I found three lumps in my right breast.  Two are small, pea-size, then there is this huge lump(one each day).  The entire lower quadrant! It is warm to touch, the veins are prominent in my areola, my nipple is sticking further out not in which is good I think.  Went to a clinic today, and she gave me antibiotics to try.  So all is good but it is so excruciatingly painful, I'm starting to get pretty concerned.   Should I be?  I've searched and searched and all I can find similar is cancer or abcess?  Any suggestions?  I'm not pregnant, nor have I had children.",
    "doctor_response": "hi.based from your description, it could possibly be a cyst, a fibroma (fibrous tissue formation) or fibrocystic changes of the breast, which are all benign breast lesions. malignancy must also be ruled-out. it is best if you consult with a doctor, preferably a general surgeon, for clinical evaluation. diagnostics such as breast ultrasound and mammography may be recommended. management (medical and/or surgical) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the following follicular study indicate?\n\nHi, This is Sasirekha.  i am 27-year-old female, planning for kids.  Dr. suggested me to have follicular study on day 11, 13, and 15.  Report on day 11 as follows, Right follicle dominant measuring 5.0 mm Left follicle no dominant. E:E:  7.0 mm POD:  No free fluid. my query is 5.0 mm dominant right follicle  on day 11 is a problem or not. Does report indicate any problem, if so please explain. Thanking you.",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.1]As such comments can not be made from single day's report.2] Growth of follicles in any ovary should show that follicle grows 2 to 3 mm per day and around day 14 or 15 of the cycle i should rupture to release an egg. At the same time, E.T. _ endometrial thickness should go above 7.5 mm.3] This kind of report with little bit variation can be considered as normal.I hope my answer helps you.Thanks.Wish you great health.Dr Purushottam",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for calcified granuloma in right occipital region\n\nHi Sir, my brother has calcified granuloma in right occipital region.We found it almost 6 years ago He suffer from fits yearly once or twice from last 6 years. 1)May i know ,how can we know whether it is Active or inactive. 2)is it completely curable? 3)Can he eat Non Veg?",
    "doctor_response": "Hi,Thanks for writing in.Neuricysticercosis is infection of the brain by the dog tape worm. This occurs due to contamination of food and water. The neurocysticercus is an organism that occurs in 4 stages and the cystic stage is the one that causes most seizures. Since your has has the calcified stage, it is a healed stage and less likely to cause seizures.However the fact that he had a seizure since 6 years means that the granuloma might be causing sudden outbursts of electrical activity. Seizures happen due to sudden out bursts of electrical activity in the brain and that can happen due to the old calcified granuloma or any new granuloma.Since CT scan is already done then proceed with an electroencephalogram to study the focus of abnormal electrical activity in his brain. Once the tests are done, he can be treated with anti epileptic medications for months and also he might need a dose of anti helminthic should there be any active neurocysticercosis lesion.If there is brain swelling then measures are to be taken to reduce it. He must avoid driving, swimming, cooking over fire and working with heavy machinery requiring high degree of alertness till his doctor allows him. Also make a note of any seizure attacks he gets in the next few days. This might happen and must be told to the doctor to give proper dose of medicine.If it is fully calcified then the infection is inactive. Repeat scan might be required to know recent activity. A single granuloma can be cured and might take months to years. If no seizure for 5 years then it is understood to be cored. He can eat non veg that is cooked properly in pressure cooker. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pap test detect hpv infection?\n\nI'm 35 y/o, 5'2\" in height & weighing 55 kgs. During my annual check-up this June, the OB GYNE doctor notice that I have small genital warts on the labia minora. I was shocked because I and my husband have been no other partners. We were both virgins when we got married. The doctor said you can contract them thru infected linens? Now I have the result of my pap test & it says \" negative for intraepithelial lesion or malignancy\" \" shift in flora suggestive of bacterial vaginosis\". I have taken metronidazole for this and was already ok. But I would like to know if you could see using pap test if your really HPV infected? Why do the doctor told me that I really have warts while in the first place I have neg. pap result? Were they really warts. Can a doctor misdiagnose this? Could it be just vulvar vestibular papillomatosis? Is a histopathology can reveal if these are really warts?",
    "doctor_response": "Hello,The pap test does not look specifically for human papiloma virus (HPV). There are many strains of HPV and some of them cause warts and some do not. The strains of HPV that causes cervical cancer are not the same strains that cause warts. You can ask your doctor to do an HPV test to look specifically for all strains of HPV. You can also ask that the warts be biopsied and sent to pathology to make sure they are really warts. Warts are pretty distinctive but it is always possible that we could make a mistake if we are just looking at the lesion.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it a side effect that i got fever after taking niftran ?\n\none of the urologist advised me to take niftran 100mg as i had urine infection. but after consuming that tablet, i got high fever . is it side effect? should i continue or stop eating tat capsule.",
    "doctor_response": "Hello, welcome to HCM. Niftran is an antibiotic used for urinary tract infection. You need not worry about fever as it is one the few documented side effect of niftran. Apart from fever it is known to cause nausea, vomiting and rashes. You should continue taking it and also paracetamol tablet twice a day till fever is present. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is 0.50mg Xanax the right medicine for anxiety disorder?\n\nI took 0.50mg of Xanax at 9am this morning.  This has been prescribed for temporary relief of anxiety.  I will be drinking alcohol tonight (2-3 vodka drinks).  As the Xanax is fast acting and rapidly leaves the body, is this amount of time before I am able to drink alcohol?",
    "doctor_response": "hello user , xanax (alprazolam) is a benzodiazepine drug with half life of around 10-12 hours and due to its sedative actions the simultaneous use with alcohol should be avoided . however if a 0.5 mg dose is taken in the morning and small amount of alcohol is consumed in night , any serious interactions are unlikely , but you should discuss these issues with your prescribing psychiatrist for a better opinion . hope i answered your query - if satisfied please rate the answer",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am using Rotacap regularly for wheezing. Will it cause frequent canker sores?\n\nHi doctor, I am 26 years old man. Thrush or canker sore is there in the tongue, lip or mouth side. Not fever but body temperature is increasing feeling like hot. Tongue buds are burning for the past two days but thrush or canker sore is there for 15 days. When canker sore is healed, a new one (canker sore) will appear. I am taking Rotacaps.",
    "doctor_response": "Hi. I can understand your concern. I have gone through the history you have mentioned. These two can be the main possibilities for your problems. Vitamin B complex deficiency. This is most commonly seen folic acid, riboflavin, and niacin deficiency. So start multivitamin tablets containing these vitamins. Since you are using Rotacaps, if your technique is not proper, it can also lead to drug deposition in the mouth which can cause these symptoms. So always follow the Rotacap technique properly and wash your mouth after every rotacap use. Do let me know your Rotacap technique. I will be happy to help you further. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How do one confirm the presence of cancer in bladder?\n\ni had blood in my urine with my uti. two weeks after drugs i had just a little pink so i called dr and he put me on a three day dose. he was an on call dr over the phon nd he said it could be bladder cancer   he scared me so much i am almost sick  i will be seeing my dr on thrus. ithink his comment was way out of line   do you?  this is my firat uti.",
    "doctor_response": "Hi,Thanks for writing in.Cancer of the urinary bladder is evaluated in a step wise approach.First there may or may not be blood in the urine. This is evaluated by doing an ultrasound scan of urinary bladder as a basic investigation. If there is any cancerous area withing the urinary bladder then it requires a cystoscopy. This is an investigation by which the inner lumen of bladder is directly visualised with the help of a fine tube like endoscope. If any mass is confirmed then a biopsy is also done and the material sent for pathological analysis to the lab.The pathologist in the lab will confirm if there is cancer on the suspicious area or not.If a cancer is confirmed then further detailed examination like CT scan, MRI scan and PET scan might be required to know the stage of disease.As this is your first UTI, please do not get worried and take treatment for your UTI first. Get the ultrasound scan done to clear doubts of any mass in the urinary bladder. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Burning and constant feeling to urinate after gallstones removal surgery. Is this due to the surgery ?\n\nHi, my grandmother recently had gall stones removed. She had the surgery a week ago tomorrow and is still experiencing extreme amounts of pain. Additionally, she seems to be having symptoms similar to a urinary tract infection - burning and constant feeling to urinate. Is that a symptom involved with gall stones or the removal thereof? And to add more to all of it, she has been having diaherra for over 2 months. Her doctor precribed her medications for this which help when she remembers to take them, but it seems to be an ongoing issue for her - even more so after the surgery. I m worried that my grandmother may have some other issues going on that the doctors haven t found yet. Can you help shed some light on any of this? Thank you!",
    "doctor_response": "Hi and welcome to HCM.This is rarely caused by gallbaldder surgery unless there was baldder or ureter injury. but it would be reported. it is more possible uroinfection which is common in people that underwent any surgical procedure since their immune system is weakened few weeks after surgery. she should treat it by taking lot of fluids and antibiotic if necessary. diarrheas may be experienced after gallbaldder surgery but it shouldnt last for more than 2-3 months. if there is no improvement she may need gastroenterologist work up to rule out some bowel disorders.Thanks for the query. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could thickening of endometrium and polypoidal thickening affect the chances of successful IVF?\n\nDear Doctor, My ultrasound shows thickening of endometrium (day 10 the same is 10 mm). Also some polypoidal thickening. Can this be the reason for non implantation of embryo? Would this affect my chances of success in ivf? I have been trying to coceive naturally for last 5 years. Had conceived naturally once but suffered miscarriage. Would be really thankfull for your guidance.",
    "doctor_response": "HelloThanks for writing to us with your health concern.Proliferation and development of the endometrium ( lining of the uterus ) is normal during the cycle. 10 mm on day 10 is slightly on the higher side.However, polypoidal thickening is not normal.It can definitely impact the implantation of the embryo.However it is not a total contraindication for pregnancy.It would slightly reduce your chances of conceiving from the IVF procedure.Since you are yet to go for the process, dont worry about what you cannot change right now.If the endometrium is not favourable, your doctor certainly wont go ahead with the pickup and transfer.Just dont stress out and stop worrying.A slightly more than normal thickened endometrium might sometimes be favourable for implantation - you never know !JUst keep your fingers crossed.All the bestTake care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can leg pain, which aggravates while sitting or lying down, be treated?\n\nI have diabetes and lately I have pain in my leg that starts mostly when I sit .it lokks like pressure in the upper thigh but it also starts in my toes . I take aspirin 2of 325 mg that helps after 30 minutes , but I get this every day in the evening. or when I am in bed. I do  not have any symptoms during the when I am active. Do I have to live with this or is there some medication ?",
    "doctor_response": "Welcome to HCM,In view of the fact you have diabetes, you might be developing a form of \"neuropathy\" a painful condition of the nerves. Topical application of ointments containing Capsicum (red pepper) has given some of my patients relief. If overweight, lose the weight. Try not to sit too long. Use a sacral or ischial tuberosity support cushion to help alleviate the weight on joints as you sit.The doctor can properly evaluate you and if it is nerve pain, there are medications to help with that as well.Best Wishes to You, Kathryn Shattler, MS,RDN",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure pain in ribs and back?\n\n.My daughter complained tonight she felt funny and her ribs hurt.she has been feeling strange since thursday..However,tonight her back is hurting too.she has been cold but no fever.she is 16...Im wondering if she is getting sick?she hasnt slowed down any except for tonight.coughing strange a couple of times...",
    "doctor_response": "Hello, Our daughter is feeling associated symptoms of viral infection. These will go away within few days. Meanwhile, you may give her symptomatic treatment for her fever and cold. Keep her well hydrated. If she is having dry cough then she may do warm saline gargles. An analgesic anti-pyretic preparation like acetaminophen will help her. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mukesh Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sharp pain and swelling in upper abdomen\n\nHi, My wife and I were running and she had to stop because she started to experience a sharp pain in the mid-left of her upper abdomen. This has happened to her before without any physical activity. It causes her pain when she breathes. She also believes that her stomach is swollen. We are thinking of going to see a doctor today, but any helpful ideas you can give as to what is causing this would be appreciated. Thank you Nick",
    "doctor_response": "Gastroentrologist is the man whom you are suppose to visit. The symptoms provided here are very bleak as to what might have been the cause and what is the condition. Your wife will require a physical evaluation to be done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lumps on the neck\n\nI am 17, I have just recently noticed two lumps on my neck. since then ive been getting severe headaches and mood swings, sore redness around my eyes, as well as being generally tired and weak feeling. i had a full blood count test yesterday which came back normal. any ideas as to what this may be?",
    "doctor_response": "welcome to Health care magic.1.Considering your age, i would think of infective aetiology.2.The lumps could be lymph nodal enlargement.3.I would suggest an ultrasound scan to identify and find out the consistency (cystic/solid)and relationship to the adjeceg organs.4.After that an FNAC - fine needle aspiration biopsy.5.I think it could be tubercular/infective.6.Take possible appointment with your doctor and get examined - do not postpone till it get complicated.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can reddish discharge be due to yeast infection?\n\ni have a question.. i took my daughter to the doctors on wednesday for a yeast infection and the doctor said it was nothing to worry about and to just put diaper rash cream on it for a couple of days. but my worry is that she keeps having a a reddish discharge coming it out and is still complaining that it hurts. i am thinking about taking her in to get a second opinion.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of Potrate-MB6 and Zurig?\n\nIn my regular blodd check-up and ultrasound, i got to know that My uric acid is 8.4 and my sgpt is 65. There is a stone in my right kidney of 5mm. My doctor has advice me Potrate MB6 2 tbs twice a day and Zurig 80mg. Is the treatment is in right direction. What could be the side effects of above mentined medicine.",
    "doctor_response": "Hi thanks for posting in HCM I have understood your concern 1. you're uricacid levels are slightly on higher side2. renal stone may be because of high uricacid levels only3.potrateMB6 maintain the alkaline nature of urine and prevent the precipitation of urate in kidneysside effects are mostly gastric irritation and vomiting4.zuric reduces the production of uricacid and dose is correct for you. but the side effects of this drug is liver injury and your sgpt is slightly high , you need careful monitor of your LFT periodically.hope this helps you any further questions please let me thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is fungal infection related with, itchy sores on face and  eye swelling?\n\nHi, may I answer your health queries right now ?  Good morning I wonder if you can help. I have developed 2 sore really itchy red patches on my face.  One on right of chin and the other on eyelid.  No discharge just raised red - tried hydrocortisone and Dakacort - not working!!! Is it fungal do you think?  Eye has swollen lid and only half open - no pain and scalp is itchy.  BW Sarah",
    "doctor_response": "HI, thanks for using healthcare magicIt is possible that it is fungal infection. This can cause an itchy rash to occur. In most cases the rash has a round appearance and may be scaly as well.A topical antifungal would help though it can take 2 to 3 weeks sometimes for complete response.Eg of topical antifungals are ketoconazole, miconazole, econazoleI hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in arm with numbness in fingers?\n\nI have been having shooting pain down my left arm into my fingers and some tingling/ numbness in my pinky and ring finger sometimes my middle, this has been going on for a couple of days. I just checked my BP and at rest it is 150/100 with a pulse of 98. I am almost 30 years old and I do smoke. I am also on Norco for a neck injury from a car accident but the Norco does not help much with the pain in my arm. Should I be concerned?",
    "doctor_response": "Your narration seems to be related to cervical radiculopathy. Your neck injury and radiating pain and tingling in left C 7 distribution are linked. You need to consult neurologist for evaluating your cervical spine imaging. For treatment you can try neck collar, amitryptiline, pregabalin with methylcobalamin. Physiotherapy options should be discussed with physiotherapist. Hope you come out of your agony soon. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can be done for allergic rhinitis?\n\nHello doctor,I have allergic rhinitis. My eyes are itching, sneezing, I have runny nose, and hives. Kindly help.",
    "doctor_response": "Hello. I understand your concern. If possible kindly send photo of the wheals you are getting. Also, I would need to know how frequently you get them. Meanwhile, you can use the following medicine to help you with these symptoms. Levocetirizine 5mg, Montelukast 10 mg twice a day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatments for pain in the knee that radiates to the shin and back of the leg\n\nThe other day I landed on my feet and twisted my knee (I m a cheerleader) and it s felt stepperated and just wrong ever sense, I tumbled on it again tonight and when I got home I stepped on that leg and felt a snaping feeling in my knee and it made like a popping noise, iv never had a single body part swell before and it s got slight bruising oh and the pain radiates down my shin and back of my leg to my ankle",
    "doctor_response": "Hi,Thank you for providing the brief history of you.As the pain is radiating in nature, a thorough neuromuscular assessment is advised. This kind of pain occurs due to pinch of the nerve root in the lumbar spine and radiates down the leg depending upon the dermatome and myotome  regions.Also, with simple physical therapy, you should get maximum benefits. As per the research, majority of cases recover with physical therapy and have a better functional ability.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the left lower abdomen?\n\nam  27  years  old lady   , I  have  been  feeling  a pain  in  my  left  lower  abdomen   for  the  last  two  years ,  I gone  for  a   check  up  but  everything  went  well ,  a few  months  later  the  pain  come  back   and   I  went  to  another  test  where  I  have     done   an  ultra  sound  scanning     but they  did  get  anything  .  am  so  worried about  my  condition  because the  pain  is  still  there  please  I need  some  help",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.If all the tests are normal , means there is least chance of the problems which could have been detected by the tests you have undergone through. Your pain is:Left lower abdomen - 2 years- ultrasonography is normal- A good clinical examination by a Surgeon with proper physical examination can definitely get the diagnosis. I would think of colitis - this is not picked by any sonography. GO for colonoscopy/ take a course of an antibiotic, metronidazole and anti-spasmodic for a 5 days. If this helps , nothing to worry about. You may consult  a Gastroenterologist to have further clinical examination and investigations and prescription based treatment. Stress does increase such pains as also sort of an allergy to some foods and beverages. If you have noticed - please stop consuming them ./",
    "dialogue_context": ""
  },
  {
    "patient_message": "Late phase Sweet Syndrome and Ehlers-Danlos Syndrome, pain in pancreas and liver, infections. Orophyangeal tumour, headaches, dry cough. Tumour in throat, ovary and spine. Advise?\n\nI have late phase Sweet Syndrome and Ehlers-Danlos Syndrome .....i m having sever pain in my pancreas and liver region, but labs show nothing? i keep getting infection after infection and now losing my big toe nails and going through an ENT for a eval of a Orophrengeal tumor ......my voice is hoarse, throat hurts, headaches, persistent dry cough and swallowing neck spasms....I don t feel well and the doctors aren t moving fast enough for me...it s been a year, only steroids and nothing else......What else can I do? I m afraid it may be cancer.....I have had many tumors removed and have 3 now one throat, one ovarian, and one in my spine.",
    "doctor_response": "It is better to get whole body pet ct. It wl detect cancer anywhre in d body. N also do cytogenetics to see any genetic abnormality, that can be screened in d family",
    "dialogue_context": ""
  },
  {
    "patient_message": "What might the problem be unable to withstand the erection for a long time which started after the damage to lower lumbar in an accident?\n\nI am a 19 year old male, recently involved in a car crash, no serious damage just minor back  (lower lumbar) injury.. my sex life has not been the same since the accident, my mom says it is a pinched nerve because i cant seem to keep anerection long enough to finish, i can have an erection but it isnt full and if it goes away it is impossible to get another one.. i need some help with what it might be.. i know it could be ED but before the wreck i didnt have this problem",
    "doctor_response": "Hello,After injury, there may be a damage to your nerves in spinal cord.That's why you have erectile dysfunction.Spinal cord injury (SCI) has a significant impact on erectile dysfunction.Treatment modalities for individuals with SCI are similar to treatments for those without Spinal cord injuries.Stress and anxiety may add the fuel in the fire and thus consult a psychologist.Usual treatment options are1. Sildenafil (Viagra), Tadalafil (Cialis), Vardenafil (Levitra, Staxyn) These drugs enhance the effects of nitric oxide, a natural chemical your body produces that relaxes muscles in the penis. This increases blood flow and allows you to get an erection in response to sexual stimulation.2. Alprostadil self-injection into the base or side of your penis. Each injection generally produces an erection that lasts about an hour. 3. Penis pumps, surgery and implants- if medication did not works.further1. If you smoke, quit.2. Lose weight-Being overweight can cause or worsen erectile dysfunction.3. Exercise regularly - this educing stress, helping you lose weight and increasing blood flow.4. Avoid alcohol- Drinking too much or taking certain illegal drugs can worsen erectile dysfunction directly or by causing long-term health problems.5. Improve communication with your partner and consider couples or marriage counseling if you're having trouble working through problems on your own.Hope this helps.Please write back for further queries.Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Gall bladder cancer spread to other parts of body. Having loose motions during chemotherapy. How to reduce SGOT and SGPT levels?\n\nHello Sir, My mother aged 62 years was operated for Gall bladder surgery on August 25th and then she was detected with liver cirrhosis also.  After biopsy report it was known that she had gall bladder cancer.  After 2 months she was adviced for a PET-CT Scan in which it was detected that the cancer has spread to other parts of the abdomen like liver, pancreas etc.,  She was adviced for 3 cycles of Chemothereapy with medicine Gemcitabine and Dacotin and tomorrow she will be completing the course.  Whenever she was given chemo she suffers sever loose motions due to infection and she will be given lomotil and cifran CT for 5 days.  The problem is her blood test report for SGOT & SGPT reading shows 114 and 73 respectively which was done yesterday.  What could be the reason and any remedy to bring them to normal range?",
    "doctor_response": "Hi. Sorry to read this history. As the PET CT Scan shows spread of tumor to other parts, this will be a stage 4 and needs Chemotherapy. Cirrhosis and cancer have increased the values of SGOT SGPT. It is more important to look for treatment of cancer and go ahead with a detailed discussion and possible outcome . Measure the cause and effect, Pron and cons with your treating Medical Oncologist ( the Specialist who treats cancer with Medicines only ) before taking further steps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are there any new interventions for bronchiectasis to improve the quality of life?\n\nHello doctor, I am a 47-year-old male. I am a known case of bronchiectasis since childhood. Is there any new treatment? Or new interventions for the best quality of life?",
    "doctor_response": "Hi. I can understand your concern. Yes, a new pulmonary antioxidant is available. May I know his current medications? Is PFT (pulmonary function test) report done or not?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain and rapid heart rate in a child\n\nhi im a 13 year old boy and i have been having problems today first my heart was beating fast my chest was hurting i started to get dizzy and i went to my science teacher and she tried to check my pulse but she was having trouble then she looked at the lower part of my neck and saw a vain in my neck that was moving in and out so you could see it and my hart was beating real hard that my chest was moving my shirt and now i have pains in my chest were my heart was beating at what is that and what should i do",
    "doctor_response": "I think it's related to some heart pathology...u have to check ur B.P, pulse , a thorough cardiovascular examination...if there is any such history of previous episode...a ECG must be done den we can think of 2d echoanother possibility is of anxiety attack or panic attackbt in ur side it's more probably a heart disorder.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I have minor joint pain and back pain?\n\nHi doctor, About six weeks ago, I started having pain in my right index finger. It was mainly when I used my mouse. A few days after, both of my hands started hurting. It was mainly in my right-hand joints, but also in other parts of the hand too. I got scared that I got rheumatoid arthritis. I read all about the symptoms and went to an orthopedic doctor. The doctor examined my hands and said it was not rheumatoid. I have no redness or swelling or pain when the doctor examined me. And then a few days ago, I started having slight pain in my knees and I also had pain in my back. But, now pain in my hand is almost gone.",
    "doctor_response": "Hi. You do not have rheumatoid arthritis. There is only pain and swelling in the joints along with morning stiffness. If you have pain, you can take Tylenol (Paracetamol). But if there is swelling, fatigue or morning stiffness you can consult a rheumatologist for evaluation. For more information consult a rheumatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child with appendix out by keyhole surgery. Upper pain under rib cage. Why is he experiencing this?\n\nMy son recently had his appendix out by keyhole surgery ,after about three week s after has been complaining of upper pain under the rib cage on the right hand side . We have been back to the hospital twice having MRI s done also had the camera put down I am worried because it dose not seem to go away only ease of and come back ,he explains it as a stabbing pain",
    "doctor_response": "Hi Appendix is located in right lower part of abdomen.As it is removed by keyhole surgery,there will be no complications. As the pain is in the upper part of abdomen under rib cage,his Liver has to be tested.Go for Liver function tests and Ultrasound examination. Till then use skeletal muscle relaxant along with Rabeprazole. If you come back with above reports,i will clarify further Wish him speedy recovery Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which is the best inhaler to use for bronchitis asthma ?\n\nI am having bronchaties asthama. which is the best inhaler to be used.",
    "doctor_response": "hello Ramachandaran, Welcome to Health Care Magic, millions of people suffer from asthma due to different reasons.Inhaler is one of the most common releif. However,is still needed to be prescribed specifically as different patients have different symptoms and conditions. It will be good for you to visit a doctor and get a inhaler prescribed.he will even show you how to use a inhaler which is even more important. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vibrating sensation in groin area?\n\nJust researching as within the past few months I have been experiencing slight vibrations in my groin, like most people ive been reading about here, This increasing trend of this experience is caused I believe by the ever increasing amount of microwave antennas all over, I am an electrical engineer and I now how microwaves (even low amplitude) can cause this, but who is brave enough in our government and especially doctors to go against telecommunication corporations, We all know health care has nothing to do with health, Its about the business and pushing pharmaceuticals, so don t waste my time with your bunk",
    "doctor_response": "Hi there.You could be experiencing myokymia or involuntary muscular contractions. Eat a healthy diet with plenty of fresh fruits and vegetables. Keep well hydrated with 6-8 glasses of water daily. Get 6-8 hours of sound sleep. Stress, electrolyte imbalance can cause myokymia. Exercise regularly to stay fit. If the symptoms do not resolve, consult an Internist to look for possible electrolyte disturbances.Wishing you speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treated for tonsil infection and cured. Why is mouth red and sore? Cancer?\n\nHi I am aged 29, I dont drink and smoke , I maintained a healthy body till now,In Last month, I got Treatment for Tonsill Infection and got cured, I had stomach infection, which is also cured, and Now I have got small loose fleshy growth under my tongue as well as on the floor of my mouth, It is reddish in colour, My problem is its not paining, I am afraid it to be an Mouth Cancer , or It may be caused by any Viral Infection and Vitamin Deficiency, PLease kindly advise me on this part, Thanks in Advance.",
    "doctor_response": "Hi, Thanks for writing in. It is unlikely that the growth in your mouth is cancerous. It is likely to be a small mucous cyst, polyp or retention cyst. They do not occur due to a viral infection or vitamin deficiency. It occurs due to the blockage of a gland duct. If they are not causing any symptoms, they do not need to be treated. They can be removed or drained as is the case if they are causing discomfort. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am suffering from skin infection. Many bubble like structures formed on my legs due to which itching takes place.\n\nhello sir, my name is Hayatun. I am suffering from skin infection. I have already consulted with many doctors but their medicines has proved inefficient in curing my disease. Their were many bubble like structures formed on my legs due to which itching takes place.So please help me in this matter.",
    "doctor_response": "hi u have some blistering disease. its better if u  send some pics of u to my e mail. u need to understand that some disease can be controlled and not cured. apply good moisturizer cream take tab cetrizine at night for itching.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will I be able to conceive again after having AKT treatment?\n\nhello sir, I'm 27yr old female. 5 months back i had missed abortion due to the detection of TB infection in my uterus. from past 5 months i'm on my AKT treatment. Now i'm having AKT-2. I have a query, that will this treatment will affect my conceving issue. I planning to conceive again in February. will i be successfully conceive it ?",
    "doctor_response": "hello..thanks for trusting the healthcare magic doctors for ur health related queries.I guess ur concern is about..will u able to conceive after AKT treatment..right.my answer is..YES. there is chances of getting pregnancy after AKT.u have told that u r 27 yr old that means u came under reproductive age group( age 15-45yr came under this group). in that age group chances of getting pregnant is high. but u had diagnosed Tuberculosis of uterus which poses some difficulty in getting pregnant. but DON'T WORRY..everything have solution. ur next query is- this drugs will effect ur conceiving issue. my answer is-YES, they will effect ur conceiving issue. my advice is u have to postpone ur  planning for conceiving till the treatment is completed. this treatment will effects ur baby if u will take it during pregnancy. this AKT drugs for the treatment of tuberculosis. once tuberculosis cured completely, u can get pregnancy with ease.with above discussion u can try out my suggestions-1. RELAX KEEP PATIENCE, NOTHING TO WORRY. once tuberculosis cured,u will be pregnant soon.2. take AKT properly as advised. it helps to cure tuberculosis.3. if u r in hurry then visit nearby infertility specialist after completion of AKT treatment. he/she can help u. I hope the above information is useful, informative and helpful for u.regards- Dr sudha rani panagar.( i can understand ur tense-full situation. I pray the God that u will be blessed with a cute n healthy baby as early as..hopefully TWINS)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain and burning sensation in the urethra?\n\nI have lower left side back pain I have been treated for a UTI this past 2weeks. I haven t had a fever, just full bladder feeling, burning sensation in urethra and back pain. I had another culture today , but no infection. What might be causing my pain? I m going out of town this weekend and don t want to be ill",
    "doctor_response": "Dear patient Lower urinary tract infection can be associated with lower back pain and is usual finding. So do not worry. since you are being treated for UTI  back pain will be relieved in few days. if it's bothering you you can take tab ultracet twice a week for 3 days. Local application of dynapar gel will also help.  Drink plenty of water.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for hair loss\n\nI am 22 yrs old, And I am facing problem of Hair loss by 3yrs. last year I went to skin specialist she prescribed me biotin tablets & ketokonazole shampoo and told me the hair loss due to stress and not due to any skin prblem, but now also i am facing same problem . Please give some suggetions",
    "doctor_response": "hi, welcome to HCM,at this age hair problem is due to either telogen effluvium or androgenetic alopecia (Most commonl).Telogen effluvium is a form if hair loss that occurs in response to stress. Although persistent stress can cause hair thinning.Maintaining a balanced diet and avoiding stress can support healthy hair growth.as a treating dermatologist i am in favour of androgenetic alopecia.apply minoxidil 5% lotion daily.serum Capixyl to be applied once daily.tab biotin 10mg+ PABA - one tab daily.wash your hair with volumizing shampoo(X gain).hope this is helpful.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could being overweight cause problem in conceiving despite medication?\n\nHi I have been trying to get pregnant for the past 3 yrs.  I have 2 boys by c-section, and so I know I can get pregnant its just not happening.  I have taken 2 rounds of clomid with no sucess, I am over weight by 30lbs mostly mid section can this be why I am not pregnant.",
    "doctor_response": "Hello,Do serum TSH and serum prolactin then do HSG on day 8. Then do follicular study after taking Clomiphene from day 2 then after rupture do IUI.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sheetal Agarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes feeling of being superior and aggressive behaviour?\n\nsir,i am young boy .when I do some work,I fill i am the best in the world.after few time I lost my interest.when my parent angree with me,I understand that  understand that but don't full fill that problem.i also angree with my parent and i do any thing worng.actually what is my problem i don't understand.plz suggest me.",
    "doctor_response": "It is difficult to comment specifically about your problem from such small history. However I can guide you what may be there. First possibility is features of bipolar disorder.And symptoms you described may be part of manic or mixed episode.Second thing you may be in stress  either of your study or work which you may not able to cope up with.Third it may be due to some development issue during your growing period.Consult a psychiatrist with your parents so can reach proper diagnosis.And later on you van be treated with medicines and/or/ counseling.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I continue my treatment for Cymbalta as I am unable to get prescription for the same ?\n\nI recently moved to New Mexico from California and have not been able to reach my physician in California to obtain a refill Rx for Cymbalta. Both my pharmacy and I have left him numerous messages. I have not been able to establish myself with a physician here yet due to snafu s related to insurance, but I do have an appointment scheduled for April. The problem is, I am going through major Cymbalta withdrawl and can t get a prescription! I have taken this medication for many years. My medical group does have an urgent care clinic , but I was already told by phone that they would NOT give me a Rx for Cymbalta as that must be ordered by whatever doctor I establish myself with, but again, that is not until April. What about continuity of care issues? What the heck can I do? Any ideas?",
    "doctor_response": "Hi, Welcome to Healthcare Magic, \"Cymbalta\" is a \"S\" category medicine in most countries of the world, i.e. it can only be sold by a real Pharmacist upon production of Really real Prescription and the ins and out have to be submitted to FDA on daily basis, hence until you have proper prescription no one will sell you, i am sorry, but this is as things stand currently my advise would be to go get a proper prescription. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is lower abdomen pain normal after embryo transfer?\n\nI had my embryo transfer done yesterday and am having pain in lower right side of my abdomen .....is this ok? What should I do? Also some pangs in my lower back at times...I am taking progesterone suppositories and estradol piles...could it be because of that?.",
    "doctor_response": "Hi it is sometimes normal to have such pains after embryo transfer due to manipulation of the uterus. No need to worry about that. If you have severe pain then consult your doctor. It is not due to progesterone or estrogen tablets. Hope I have answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Headache, vomiting and drowsiness. Confirmed as brain fever. Blood reports are normal. Any suggestions?\n\nDear Doctor, My brother went sick 6 days ago. I visited Doctors for the first 3 days. They gave some medicines and provided glucose drips. However, they said that the blood reports are normal. During this time my brother was not intaking food properly, he was always sleeping. he said me that he is having severe headache and vomiting. Yesterday when we visited another clinic he was tested with typhoid. He was provided Glucose through IV. Due to sever headache the doctor made some test by taking blood from the spinal cord area. then he confirmed that my brother has brain fever. we are in gulf region right now I am planning to send my brother back to india. please advise",
    "doctor_response": "the inflamation of maningis or maningitis can most likely the cause in my opinionall the symptomps are of the same according to your statements he requires good coverage o antibiotics and care for this if  it is well and you should consult your doctor if the consdition is stable and your doctor can tell if he can be transfered safely to india or not this is what i think from the position",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lowering of BP while on Atacand?\n\nI had three stents put in 5/6 years ago.  I have never had high blood pressure or high cholesterol, but the Cardiologist that inserted my stents insists that I take Simvastatin, and Niacin for cholesterol and Atacand for blood pressure.  Lately, I have been getting light headed and my blood pressure (we have a home device) ranges from 110/60 to 135/78.  Without my Cardiologists permission I'm cutting my Atacand in half, but still feel light headed.  Advice (beyond, 'go see your Cardiologist?'",
    "doctor_response": "Hello,If you were not hypertensive before, then you can stop your Atacand and see if your symptoms improve. But by that time, you need to monitor your blood pressure daily for a week, and if it stays below 140/90 mmHg, then there's no need to start Atacand back. I would also like to advise you to check your serum electrolyte level as electrolyte imbalance due to medicines can also produce symptoms like these.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhanu Partap",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can phototherapy be a solution for plaque psoriasis?\n\nHi, I m 22 and have moderate to severe plaque psoriasis on my face, scalp and torso. I ve exhausted most topical creams and ointments, taken courses of steroids with no real results. Would phototherapy be my next course of action. Is thinking about biologics too radical?",
    "doctor_response": "Hello. Thank you for writing to usTopical treatment with ointments and lotions is usually combined with systemic treatment/ oral treatment for psoriasis involving > 20% body surface area.Phototherapy, though is a good choice for extensive body involvement with plaque psoriasis, however, certain body sites like scalp are resistant even to phototherapy.Apart from phototherapy Oral methotrexate is a well known treatment for plaque psoriasis and can be considered in a healthy young adult.Biologics like adalimumab, ustekinumab are not first line options in a young patient with limited involvement with plaque psoriasis.Scalp involvement responds well to topical steroids lotions with or without salicylic acid.Vitamin D anlogues e.g calcipotriol/ calcitriol lotions are also effective in scalp psoriasis.I suggest that you visit a dermatologist in your region.Your dermatologist will assess the severity of involvement and advice accordingly.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having jaw popping with catch. Why?\n\nHello doctor, I have a question about TMJ catching and popping. About ten days ago, my right jaw suddenly began catching and popping with a great deal of pain at the time of the pop. Since then, the pain when the pop occurs has diminished quite a bit, but the right side of the jaw still catches each time I close the mouth. It does not catch when opening. Also, when it catches, or pops, my lower teeth do a quick shift, then return to center. My question is, does the quick shift suggest a cause for the TMD I am experiencing?",
    "doctor_response": "Hello. I have gone through your query and understand your concern. This shift in your lower teeth could not be a cause for your TMD. Temporo Mandibular joint is the jaw joint between upper jaw and lower jaw and involves multiple and complex structures like a disc between two jaws, chewing muscles, and the joining bone structure. A complete TMJ and dental evaluation should be done to determine what is causing your jaw popping, swelling and clenching habit. Jaw clenching (Bruxism) is not a condition but one of the main symptoms of a TMJ disorder. TMD could be because of:  1. Tensed chewing muscles. 2. Disparity in the disc. 3.. Changes in jaw bone structure.  Other than TMJ issues,  4. Psycological stress. 5. Misaligned or attrited (worn-out) teeth. 6. Multiple dental treatments or multiple missing teeth. 7. Recent dental injury or infection. 8. Recent hospitalization. General health conditions or systemic diseases affecting bone like arthritis could also cause TMD. Visit a TMJ specialist to identify what has caused your jaw swelling. From your query and the details provided regarding the panaromic x-ray (OPG), the cause should probably be the change in your jaw bone structure due to the advancing age and long term medicines intake. It could also be from the psychological stress (if) from the recent hospitalization and surgery. This psychological stress or an underlying bone disparity could have triggered a subconscious level jaw clenching thereby causing a tension in your chewing muscles leading to a muscle swelling in your jaw.  Initially a muscle relaxant will be prescribed to bring down the tensed jaw muscles and the swelling. After which a complete TMJ evaluation and X-ray study will be done to pinpoint the cause. A splint similar to a night guard (called deprogrammer appliance) will probably be suggested as a diagnostic appliance to identify the cause and to protect the teeth from getting attrited during jaw clenching. Once the cause is determined, the treatment is targeted right at it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes raised bumps on top of the head?\n\n36 female 5 feet 125 pounds... have soft spots on the front top of head... wit a raised part in the center.... went to doc yesterday... had xray and labs... doc said they are bumps on the xray... im goin to have a cat scan done soon... what cud this b?",
    "doctor_response": "Hello,Most likely they are fat collections under the skin. In rare cases, the bone of the skull may be involved too. The CT scan will give the necessary information about the diagnosis.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for mild concussion?\n\nTwo days ago I may or may not have had a very mild concussion a few days ago. I fell hard on my back in Judo but did not hit my head. I felt slightly fuzzy after practice and that has continued, though decreasing. One of my pupils is refocusing slightly slower than the other and I have since felt slightly foggy and disconnected, with the fogginess getting better since a day or so after the incident. Recently I started feeling sinusy pressure between my eyes and having sensitivity to light and sound, with pressure directly at the top of the nose, and yesterday got a piercing headache on my eyebrow in my sinuses, which went away after sleep. I still have some sinus pressure which increases when I bend down or move a lot, but little to no pain. Are these two symptoms related and what would be your general advice. I have an appointment with my PCP on August 6th as a new patient (just got free health care).",
    "doctor_response": "Don't worry. Symptoms will subside of its own. But to be on safe side,  get your cat scan of brain done. Take tab paracetamol sos if any pain Hope my advice will help you.  Take care. Don't forget to rate me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "2 yr old started with Croup, advised liquid steroid, no fevers, sleeping all time. Worried ?\n\nMy two year old started with Croup on Sunday but had no fever, by Monday early day he wouldn t eat and barely drank anything. I took him back to the doctor on Teusday and they said it was a cold which was flaring up his Asthma and gave him a liquid steriod and told me to continue his breathing treatments every four hours. He doesn t have a fever but since yesterday afternoon all he is doing is sleeping all the time. Should I take him back to his doctor ?",
    "doctor_response": "Hi Its better to take him back to the doctor. It might because he din`t drink or eat anything- he must be tired and sleepy. If he has been prescribed some anti-histamines like Benadryl too- he must be drowsy because of that. Hope his breathing difficulty is better now. But its better to see your Doctor again, get him examined fully and do accordingly. Wish your son a speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Liver mets were found to be carcinoids. what next can be done ?\n\nI have liver mets, primary found in rectum was removed surgically. liver mets were found to be carcinoids. first treated with sandostatin 20mg/once a month. then larger 3 tumours were chemo embulised. since chromogranin kept on rising, sandostatin LAR was stopped and i have gone through 3 cycles of Lu177 PRRT in AIIMS. the tumours have increased 10% in last 9 months and chromogronin is 6 times normal values. it seems PRRT is not working. what next can be done? any latest development on this score . please advise",
    "doctor_response": "hello, there are various methods like radioablations, hepatic artery embolisation, resection of the tumor part of the liver ect. since you have high levels of the tumor marker it shows the persistence of the mets. rule out recurrence of primary elsewhere in the gi tract or in rectum by doing a scan a CT or  a MRI. however i would advise you to meet your physicain and put forth your query. this will help them to treat you better. for any further query pls contct us at HCM. i wish you good health. taake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this TORCH panel test report indicate?\n\nI am 27 yr old. I had two miscarriage, on dec 15 and dec 16, both around 10-12wk. One was incomplete abortion and another was missed abortion. Recently I have done TORCH panel test. Found that Rubella Ig G is 276 and CMV Ig G is 246. Now I am planning to conceive. Should I take any medication due to this raised titre? Can it affect my next pregnancy?",
    "doctor_response": "Hello,Thank you for trusting HCMPositive Rubella and CMV IgG is good. This means that you had been previously infected/vaccinated and is currently immune to these infections.No medications need to be taken before conceiving. Pregnancy will be safe.Hope this answers your questionPlease address further questions hereRegards,Dr.Lekshmi",
    "dialogue_context": ""
  },
  {
    "patient_message": "When is bone graft necessary?\n\ni m 62 year old. had done 3 implants previously which have failed in my lower jaw. right side of the lower jaw has bone height of 4 mm only. also other bone doesnot have a good height . my doc says 3 to 4 implants can be possible . should i go through a bone graft or should i put smaller implants ?",
    "doctor_response": "if the bone height is less..better to do bone graft..take proper pre investigation with xray and ct scan for determine bone thickness and heigh..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a toddler suffering with asthma\n\nhi doc,my 2yr old daughter is asthmatic,she s finding it so difficult 2 sleep,it s about 2am our local time(nigeria)i m so worried c os she s getting really weak a d moment.doc,pls,advice me on wat 2 do so can sleep comfortably.eager 2 hear 4rm u doc.",
    "doctor_response": "Hi, If she is having sever breathing difficulty and is weak/lethargic, kindly take her to emergency department immediately to avoid hypoxia. For temporary relief, give her 20mg prednisolone tab now and take inhaled salbutamol(MDI) that you might be having with you- 2puffs 5 minutes apart. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Muhammed Aslam TK",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain, feeling tired, hot. Feeling push in stomach. Pregnancy test negative. What does it mean?\n\nmy girlfriend is having stomach pain, always tired , gets hot , mad at me one moment and then in love with me the next , trips over every little thing. she says she feel something push in her stomach i think she is pregnant but we took a test a while back and was negative but basically these are all the symptoms..... what would you think it is??????",
    "doctor_response": "Thank you for asking on health care magic.If I was the treating doctor i will do the following:1. Look for other symptoms along with stomach pain like vomiting, diarrhea. If they are present will consider some infection. If there is only stomach pain, cramp like and no other symptoms, i will consider psychological causes.After ruling out any organic illness, the symptoms appear due to psychological causes likely anxiety. Anxiety can cause stomach pains, feeling of heat in the body, irritable mood and sometimes tiredness.I hope you find this helpful.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in the legs?\n\nMy Nephew aged 11 years is feeling severe pain in both legs and not able to move his legs at all, after seeing a orthopedic he was able to move but again after two days felt same excess pain but this time including waist also below waist he was not able to move at all. again saw ortho and and now is able to walk but still he is very weak, so plz suggest what may be cause and to which dept we should consult?",
    "doctor_response": "Hello, A detailed evaluation is required. Neuropathic and vascular causes have to be ruled out. MRI and nerve conduction study have to be done. Consult a neurologist and he will direct you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abnormal morphology, What should I do ?\n\nHi my name is gihan Im married i hve two sons 12and 7 and they are in verry good health I want to get pregnant again, my doctor sent my husband to do the sperm test, when we got the result we found out that he has an abnormal morphology sperm. What should i do?",
    "doctor_response": "hello  ghindec.. Welcome to HealthcareMagic forum.. plz clear the reports what kind of abnormal morphology structure found? dont worry there is 100% treatment in ayurveda but first we must know all details.. drbhagwanjindal@gmail.com thanks.. all the best for good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does shingles pain last?\n\nI got the shingles on the left side of my face eye and head. this started December 29 2013. There are no more blisters for a long time. The pain just won t go away. It is very strong in my eye lids and the eye brow above my right eye. I have been taking gabapentin 300mg and Hydroco/acetamin 7.5-325 mg tabs. How long can I expect to have this pain? I am tired of taking meds.",
    "doctor_response": "Hellothanks for using health care magicShingles is a viral infection that affect sensitive nerves of the body. Pain resulting after shingles is common especially in adults.Unfortunately, once someone develops shingles, the pain becomes more or less permanent.  Pain killers used have to be effective for neurological pains.Carbamazepine or amitriptylline are commonly used drugs to managed such pains.Talk with your doctor on the possibility of either of these drugs to relieve your pains.Hope this helpsDr Achuo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hematuria\n\nI m a 44 yr old female with no trauma to abdomen. RBC 100, hemoglobin 300 Ery. Strong history of kidney stones, but no regular symptoms (flank pain) of stones. The test were being run because I woke up with excessive amount of blood in urine. History of hysterectomy.",
    "doctor_response": "thanks for your query to hcm .hematuria indicate bleeding from urinary tract .  As you are having history of stone , it is possible to cause trauma by stone , leads to bllod in urine .you should consult a urosurgeon and undergone USG or Cystoscopic examination of urinary tract and take treatment .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes drop in blood count after prostate removal surgery?\n\nMy husband s blood count is 24 after 4 days for surgery for removal of prostate. He wants to go home but dr wants to keep him. Is there anything that can be done to raise the level. And if he was given transfusion today would he have to stay in the hospital?",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: Your report is incompleteExplanation: Blood count cannot be just 24, please send me complete report of your husband for proper suggestion. Stay in hospital depends upon the condition of the patient and that can only be done after physical examination. So, consult your doctor and trust him.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Meaning of the sputum report?\n\nim having cough for more than 2 weeks, i visited the doctor they have advised me tests, all the tests are normal, i just got my sputum report it says Few pus cells\u200e, \u200efew epithelial cells\u200e, \u200eplenty of gram positive cocoi in pairs \u200e& \u200eshort chains are seen... what does that mean please let me know",
    "doctor_response": "Thanks for your query at HCM!The report seems to be normal. There are commensal bacteria like Streptococcus viridans, Streptococcus mutans, Streptococcus salivarious, etc in our oral cavity which are gram positive cocci seen in pair/short/long chains.AS there are no pus cells no need to worry.You must have got culture of sputum also done for Group B Streptococcu, Pneumococcus, etc. Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cervical spine injury\n\ni have been diagnose with cervical spine injury specifically;compression fracture on c5 for five years ago.since then, i have been going through a difficult to have a deep breath,tight back,a small meal will bloat my stomach,difficult to urinate,bowel movement,chest pain and above all, difficult to sit still what is going on docs,",
    "doctor_response": "Hi,Thanks for writing in.A cervical injury causing compression of C 5 vertebra might cause significant pain and discomfort. It is important to get the affected vertebra stabilized and pressure on nerve roots decompressed. In a vertebra that is compressed, it can be stabilized by screws and plates. Please check with your doctor if your compression of C 5 vertebra requires surgical treatment.There are many nerves originating at various levels in the cervical spine and there might be irritation of nerves that requires attention.The bloating sensation, bowel discomfort, chest pain and inability to sit still might be treated with medication and this also needs to be evaluated by doing a MRI screening of whole spine. Each symptoms might be due to certain nerves getting irritated at different levels. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low white bloods cells and low platelets count?\n\nYes Dr. I have low white bloods cells and low platelets. I am under treatment with a hematologist and get 3 injections monthly of Neupoegen. Every test has been done, but I can t an answer to what it causing my blood disorders. Can you please give me some guidance or advice? Thank You, Diana Garcia 58 yr old *****I am sorry, I am also disabled live on limited SS income and Funding assistance for my medical treatment for the meds. I didn t realize there was a fee. I am sorry for your time, but thank you anyways! ***** I don t have the financial means to pay this, thank you for your consideration.",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. Low wbc and low platelet count may be due to many reasons.  Most common is viral infection.  If you don't find any cause then you should go for bone marrow examination.  It will clear all doubts and give some idea regarding cause.  Go for it and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pap smear result indicate severe inflammation abundant neutrophils. Is it dangerous?\n\nhi im 31 yrs old..its my 2nd time of papsmear..when i got the result its indicate that i have a severe inflammation abundant neutrophils..is it dangerous? im nervous my ob gyne is out u just got the result frm his assistant..plz help me..it may cause cancer or tumor..plz help me",
    "doctor_response": "Hi...relax...it wont cause any cancer...its just infection... take a course of antibiotic and you will be fine...Dr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have slight pain and irritation in throat which aggravates when I speak louder. Please help.\n\nHello doctor, I am a 55-year-old male. I am having a slight pain in the middle of my throat (Adam's apple), as if some small inflammation is there at the end of the tongue or neck for the past one week. I am not having any difficulty in speaking or eating but some kind of irritation prevails. I tried salt-water gargling twice or thrice a day and feel relief to some extent. It is to state here that about five days back, I was reciting slokas a little loudly for about one hour and I had the pain. I stopped reciting in loud and the pain came down. Yesterday, when I recited slokas a little loudly, my pain returned. No cold, no cough, no fever and no difficulty in breathing. My hearing is good. No reduction in appetite or in taste. I feel comfortable when I take warm liquids. I have (long) belching for at least five to six times after intake. Since lockdown is continued, I am unable to visit an ENT specialist now. Can you please assist me?",
    "doctor_response": "Hello. You might have caused some mild injury to the vocal cords while reciting the slokas loudly. You need to give your vocal cords rest by not talking or singing for a few days followed by restricted use of voice for the next week. You must not sing or speak loudly or in unnatural frequencies. You should not shout or whisper also. You will need medicines for stopping belching and acidity. Antiallergics and antacid syrup may help. If there is any nasal complaining please let us know as we would have to give some medicine for that too. Do revert back if you need details.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. After how many days of withdrawal bleeding does periods occur?\n\nHello doctor, I and my friend involved in physical intimacy a few days back and there was no ejeculation and penetration was only for 2 minutes. After that considering precum she took Unwanted 72 within 3 hours. She had bleeding after six days. She has regular cycle of 28 to 30 days and her last period was 30 days back. She did not have period till now. We performed urine pregnancy test at home. All are negative. Is it confirmed that she is not pregnant? If yes, how long ideally she should wait for period after bleeding? Is there any medicine required?",
    "doctor_response": "Hello. As she had a withdrawal bleed post Unwanted 72 intake and also the urine pregnancy test has been negative till date, so pregnancy is ruled out. However, the conclusive test for ruling out pregnancy remains serum beta hCG test which is a blood test. if hCG levels are less than 5 mlU, then she is surely not pregnant. Also, now she should be expecting her menses only after 10 more days as she had her bleed marking the start of her fresh cycle. Just get the serum beta hCG test done to get conclusive results. She can wait for her menses.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower left abdomen pain while standing\n\ni get pain in the lower left abdomen if stand for long time or strain myself, especially carry weights. i also get pain in the right lower abdomen while passing stool. i have piles for last 20 years.  I have to go to toilet 3-4 times a day.Nowadays whenever i eat outside especially non-veg, i 'll have to rush to toilet. sometimes i pass loose motions.what could be my problem?",
    "doctor_response": "HiThanks for writing in HCMI need further information regarding as u mentioned piles for 20 years have undergone any surgery for that or treated consevatively and also mention 1.)your age 2.)how long you are suffering with this problem 3.)any swelling or protrusion in right lower abdomen at the time of cough,sneeze 4.)do you have symptoms of nausea /vomiting  4.) factors aggravating your symptoms 5.)any chronic analgesic intake history/alcoholic 6.)are u under any cardiac or anti hypertensive medications 7).any sudden weight loss 8.)about your appetite 9.)do you have feeling of incomplete evacuation of stool 10.) any complaints of bleeding per rectum.my advise is to better avoid non-veg and oily foods and  to continue  diet rich in fibre content,green vegetables ,fruits.,my advise is to take ultrasound abdomen and pelvis and to consult general surgeon  i would be glad to provide answers to any further queries. Thanks for using HMC Have a good day! Regards Dr. V.KUMARAGURU general surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red patches near the molar and inside of the lips?\n\nHello, I felt a bit of soreness at the back of my mouth last night and this morning awoke to find a red patch on the back left side by my moller, it does not hurt to swallow but is tender when I touch my tongue to it, as well it looks like at the front of my mouth that I have bit the upper and lower insides of the right side of my lips, I have been told I grind my teeth so I am assuming this caused those issues, any help would be greatly appreciated",
    "doctor_response": "thanks for your query, i have gone through your query. the red patch could be a traumatic ulcer secondary to biting the cheek by your sharp teeth. you can take a topical anesthetic and analgesics like anabel gel 3-4times daily for 5 days. if the lesion doesnt heal in 5 days consult a oral physician. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and tenderness on the lower right side of the abdomen?\n\ni was released from a 3 day stay at hospital for a severe infection caused by an abscess on my intestine after being treated with antibiotics. Shouldnt the  abscess have been drained? I am still having pain and tenderness on the lower right side of my abdomen.",
    "doctor_response": "Get a repeat ultrasound abdomen done to know the status of abscess now after completing a 3 day course of antibiotic.I would advise you to get a surgeon opinion. Take an analgesic like tab diclomol twice daily which will relieve your pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes weight gain and difficulty in walking during pregnancy?\n\nI am in my 1st trimester in pregnancy (5th pregnancy). After giving birth to my youngest 18months ago, I developed a painful leg with swelling and was given clexane and a scan which turned out not to be a clot. I have just noticed it s hurting my leg to walk so have had a look and it s a big bruise looking vein, should I be concerned? I ve had previous DVT and about a stone overweight.",
    "doctor_response": "Hello, and I hope I can help you today.If you had a DVT before during pregnancy, you do have an increased risk of recurrence.  Women who have a history of DVT during pregnancy also should be on DVT prophylaxis to prevent clots if you don't already have one.  So you should see an OB or especially a perinatologist (high-risk specialist) who is comfortable prescribing Heparin (or similar medication) and you will need to begin preventative injections.However, DVT by definition is a deep vein thrombosis, which means the veins you can see are not DVT's.  If they become clotted, the treatment is warm compresses as much as possible, leg elevation and wearing support stockings.  So I do not think your symptoms now are due to DVT, however you do need to be on preventive medication for safety for the rest of the pregnancy.I hope this information was helpful and that I answered your question adequately.Best wishes for the rest of the pregnancy,Dr. BrownHowever,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I be pregnant with an ovarian cyst? Advise required\n\nDear Dr. Since last one year, i hav got a right ovarian cysy. now i am married. i wanted to know, is it safe for sex. my age is 33 years. i wanted for pregnant. what to do . pls. advise me.",
    "doctor_response": "Hello; Thanks for your query. Since you have had a right ovarian cyst for a year you need to repeat an ultrasound of the pelvis to see if the cyst is still there or disappeared. If you still have cyst then you need to consult a Gynaecologist in person and she will treat you for that. If you do not have pain now or even during intercourse then you can have sex safely. Better get examined by a Gynaecologist and she will do the needful for you and you can get pregnant after proper treatment. Take care. All the best. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Please suggest treatment for leg pain\n\nHi Doctor i am male suffering from leg pain can you please suggest some good treatment for the sameHi Doctor i am male suffering from leg pain can you please suggest some good treatment for the sameHi Doctor i am male suffering from leg pain can you please suggest some good treatment for the same",
    "doctor_response": "Hello, I will advise getting it examined once to rule out any neuropathy or other muscular pathology involved. Based on clinical examination the medication can be prescribed. For now, you can do hot water fermentation and take the help of a Physiotherapist close by who can help to reduce the pain with the help of the TENS therapy. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is angiogram required for episodes of chest pain?\n\nI'm a 45 year old male with mild-to-moderate restrictive lung issues (cause unknown). I've had a few episodes of chest pain radiating in left arm - went to the emerg once - they said there was something in ecg but enzymes were normal, so no heart attack. They referred me to a cardiologist who did stress test - was normal, nuclear scan - again normal but now he wants to do an angiogram. If all the tests are normal, should I still go through this test? As he explained there are some risks involved.",
    "doctor_response": "Hi,Usually when stress test is normal we don't go for further examinations, such as angiography. Rarely, there are cases, when suspicion remained, despite tests and the patient has additional risk factors, such as familly hystory of heart attacks, strokes, heavy smoker, very high cholesterol.In such cases we may order angiography to be in the safe side.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat hand pain and a knot in the back?\n\nFor a few weeks, I ve been getting a lot of pain in my hand, arm and a little on my upper back, where sometimes it feels like a painful knot in my back. Now, in the same are of my back, I noticed there s a big red mark that s been there for a couple days now & I m not sure what its from",
    "doctor_response": "Your age & sex please?It could be cervical spondylosis with fibrofasciatis.Sleep on a hard bed with soft bedding on it. use no pillow under he head .Do neck & shoulder exercises.take1.paracetamol 250mg BDX 5 days.2. Multivitamin 1 tab. OD X5 dayscontact me again ,if no relief in 2-3 days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to keep SGPT and SGOT levels under control\n\ni was sufering jandice since january 2013..bt nw i hv observed my sgpt & sgot is being increasing up to the limit..more over i hv follow that when i hav been taken ursocol/udlive/ursodil lik dis medicine then my sgpt & sgot lavel has been low level..if i do not take such of this medicine then my sgpt & sgot is being increased..plz sugest me. present sgpt & sgot is 80 & 50.",
    "doctor_response": "HelloIt is important to search for underlying cause of elevated SGPT and SGOT.Only taking udiliv/ursocol causes short term decline in SGPT.Elevated SGPT and SGOT may indicate liver injury.It may be due to many reasons like hepatitis,alcohol intake,altered lipid profile,medicines,auto immune causes etc.You may need few more investigations like routine hemogram,random blood sugar,lipid profile,viral markers,urine RE/ME,ultrasound of abdomen.You are rightly taking udiliv(ursodeoxycholic acid tablet).It helps in regeneration of liver cells.You may need to take few more medicines after complete investigations.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. A 89-year-old has a constant fear and frequently using toilets. Why?\n\nHello doctor, So we have a little problem with our grandmother, she is 89-years old. Lately, she is acting like crazy, and she is living in constant fear that she will mess up and she visit the toilet in like 10,15, 20 minutes. The morning is starting with toilet and last till she gets tired with that constant going to the bathroom and back to her room, then she goes on half an hour, hour so that continuous going in the toilet with no reason only because of the fear it is stressful and irritating also boring at some point. So the question is is that normal on her age, considering that she has sclerosis dementia, I think. She suffered two brain, and one heart attack should be adapt on her when she is like that and make deals with her because yelling and talking do not have any effect on her mind are focused only on the toilet and on that fear, and it is like a drug to her. It is crazy and funny on the other hand, but in that situation, it is stressful sometimes because it is like dealing with lunation or maniac.",
    "doctor_response": "Hello. I can understand your problem very well and as you have mentioned already here that your grandmother already had two cerebrovascular accident (CVA) or in your language brain attacks and one heart attack and she was diagnosed as sclerosis dementia. As the term suggested dementia it means memory losses, she is suffering from memory disturbances definitely and increase urinary frequency might be due to forgetfulness or it may be due to other neurological deficit which is affecting her bladder also. So first we have to be very, very clear that. Is it urinary incontinence or forgetfulness? So most of the time caregiver became frustrated of these type of symptoms and thinks of craziness or lunacy I believe these are not proper words for your grandmother here. Remember if you are so frustrated because of these symptoms how stressful these for her? In that case, the most important thing you need is a support to your grandmother. The first rule out the cause of increase urinary frequency by making investigations and then will proceed accordingly. So make it clear by consulting her with a good neurologist who can rule out the cause. So before arriving any conclusion, it is very premature for me to comment on current symptoms and treatment option. What I can suggest is environmental support by a caregiver.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can fracture be the reason for severe pain and bruise in the foot?\n\nI was coming down my garage steps and jumped down the last one, or so i thought, and it ended up being more than one and my heel landed really hard on the step and instant shooting pain in my foot began. I noticed immediate bruising around the middle of my foot and immediately after landing on my heel i could barely walk on it. Several hours have passed and the bruise is getting darker and Im in excruciating pain when i put pressure on it. Is it possible I broke the heel of my foot?",
    "doctor_response": "hi To rule out fracture go to ER and have  xrays taken and protective padding, pain and anti-inflammatory drugs needed, keep foot elevated and do icing if less than 12 hours or hot fomentation if more time elapsed.restrict all foot movements and weight bearing on foot till ER clears or does managementbest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dental abscess in a child\n\nHello Dr, my 14 month old daughter is teething a few teeth at once and gums look very red and irritated with a little blood. Her Pediatrician said it s viral gingivitis and said it s not known what causes it. Do you think it s because I didn t brush her teeth well enough?",
    "doctor_response": "Thanks for your query, I have gone through your query.While teething the gums usually will become inflammed and become red, can cause bleeding. Nothing to be panic, take a course of antibiotic like amoxicillin syrup. Do saline gargling or mouth wash. Consult a pediatric dental surgeon for further opinion and needful.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden stop of bottle milk and food stuck only to breast feed?\n\nHELLO I AM OM AGARWAL FROM SURAT (GUJ) INDIA. I HAVE A BABY OF ONE YEAR OLD. HER WEIGHT IS APPROX. 8KG AVERAGE DIET OF MY BABY IS 3-4 200(ML) EACH BOTTLE OF MILK AND EATING FOOD EVERYTHING WHICH WE TAKE,LIKE RICE OR DAL, WHEAT CHAPATI ETC.BUT FROM LAST ONE MONTH SHE IS NOT TAKING MILK OR FOOD BUT SHE IS FEEDING MILK FROM HER MOTHER. SHE IS CRYING VERY MUCH. SO PLEASE TELL ME WHAT TO DO",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.I take this opportunity to tell you certain scientific facts and relieve your distress - 1. An active is a well kid even if she/ he is not eating well. 2. Development of a kid is as important as or I would say even more important than growth alone.3. As the kids grow their interest in food decreases and interest in play activities increases so that they eat small quantity and run away to play. As parents we need to be more patient and feed than less quantity but more aliquots per day.4. This age rather than the quantity of the food I suggest you concentrate more on the number of times you feed her and also make whatever you feed her calorie dense by adding good amount of ghee to it.5. I suggest you not to use appetite stimulants on long run as they may cause drowsiness.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat red blotchy areas all over the body?\n\nMy 3 year old son has developed red, blotchy areas on his skin. It began on his cheeks and around his mouth, and I wondered if he d eaten something he was allergic to?? Within a few days, it had spread to his triceps, and forearms, upper thighs, and lower legs. The red areas are generally warm to the touch, but there is no raised bump or roughness, rather smooth skin. It doesn t itch or hurt. He has a history of eczema (fairly mild), but this is clearly something different. Otherwise he is a healthy kid.",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your son's history and would like to make suggestions for him as follows:1. From your provided history, I would first think of atopic dermatitis, though it should itch intensely, which is not the case with your son.2. I would also like to mention here that mild forms of atopic dermatitis may not always be due to food allergies. They can be caused by personal tendencies (genetic)/skin type (dry skin) could be reason.3. I usually suggest my such patients regular use of calamine lotion or moisturizing creams, especially immediately after bathing, which improves moisture content within the skin and hence help healing of skin.4. I also suggest my patients probiotics & vitamin D supplementation which helps to improve skin & immunity.5. If you suspect development of eczematous skin lesions due to some foods, I would suggest specific IgE levels for that particular food, which help to identify whether he is allergic to that particular food.Common foods causing allergies are animal milk, egg, peanut, wheat, soy, tree nuts, fish, sea foods, etc. If he is allergic to any food, avoidance is the best treatment option.6. As itching is not a major problem, I would suggest to get him examined by dermatologist, if not done previously, so he can think of alternative condition, if it is there.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish your son the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best medicine for meningitis?\n\nDear Dr, My son get menigitics 5 month ago,,, He can,t sit and walk,,he has also a problem with his attitude.. Please advise or guide me best medicans to treat him. His EEG and CT scant report was normal..... I am a poor man and can,t effort costly treatment.. Please help me and guide me.",
    "doctor_response": "Hi,Thank you for posting your query. It would be helpful, if you can upload the reports of your son.The treatment of meningitis depends on the cause. If it is TB, then, at least 18 months of TB medications are required. For other types of meningitis, shorter duration of treatment would be enough.I hope my answer helps. Please get back if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe neck pain\n\nHI I HAVE VERY BAD NECK PAIN  HANDS HURT BAD AN D MIRGRAINS AND OSTYPEROSIS AND SPONDISIS AND BAD BOND DINSITY AND NOW  HAD PAROTHYROID SERGURY.NOW SILAVIA GLAND BLEEDING AN STONES  two shoulder a knee sergury migrain since i was eight . granmother aunt cusin to alot.shot in belly hurt kidnry and have kidney diease....",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Causes of sever neck pain are:1. Injury2. Blunt trauma3. Sprain or strain4. Spondylosis5. Spine related problems6. Improper postureYou can take tab. aceclofenac. Apply diclofenac gel or cream. Apply ice locally. Do x-ray and MRI neck region. Use cervical collar. Consult your physician for prescription.Treatment mainly depends upon underlying conditions. Kindly follow with detailed history or consult with orthopedician. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Shyam B. Kale",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause facial hair and black spots?\n\nHi Doctor, I am a woman of color,i have alot of facial hair and i wax two to three times a month. I have black spots/ hackney spots that turn black and wont just go away, i have use aloe vera lotion and proactive but that wont help, what shall i do? thanks",
    "doctor_response": "to get rid of facial hair you will be needing 6 to 8 sessions of diode laser hair removal. and for dark sport and dark areas you can go for fractional co2 lasers for better results. without any medications",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vertigo at night?\n\nWhat do you think of only nighttime vertigo? My friend s husband shared only when he lays his head down on the pillow at night the room spins. She took his blood pressure and it is normal. No dizziness in the day only at night and it is really bad and scary. It passes with positioning after a while. Sorry I thought this was a free service. Not paying just forget was just trying to help a friend. Please take my email off your list.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.Changes in head position as you describe immediately resulting in a vertiginous feeling which then, calms down after about 30-60 seconds by keeping the bed still is the classic description of a condition known as BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV).  BTW, this is a free service when asking THESE questions.  The premium service does cost to ask questions..not this side of things.  Perhaps, your friend would like to contact us because this is an easy fix and does not represent anything considered dangerous or terminal.  Hope I have answered your query. Let me know if I can assist you further by contacting me at: www.bit.ly/drdariushsaghafi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can acute disseminated encephalomyelitis be treated through plasmapheresis ?\n\nI want your help and valuable suggestion for my father s treatment to make decision about treatment by plasmapheresis . Case History: On 26th Dec my father hospitalized after 2-3 vomiting , fever and motion at my native (Madhya Pradesh) in CHL-Medical center ( Hospital affiliated to CHL- Apollo Hospital Indore, MP). upto 4 days in hospital he was conscious & moving his left leg and hand on command. presently he is unconscious and only eyes are open. As per Doctor diagnosis for Acute Disseminated Encephalomyelitis (IVMP & IVIG ) as well as antibiotic treatment is on. I want to know about possibility of treatment through Plasmapheresis and approximately cost of the treatment.",
    "doctor_response": "Hello and welcome to Healthcaremagic. ADEM is a demyelinating disease oof central nervous system characterised by abrupt onset of neurological system preceded by infection. The goal of treatment in ADEM is to arrest the CNS inflammation as soon as possible. High dose corticosteroid are the first line of treatment,however plasmapheresis and iv immunoglobulin aree used in cases where there is contraindicaation or resistance to steroid or in cases of treatment failure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have Implanon in arm. Have excessive bleeding, irregular periods, lack of energy, cramping and depression. Advice?\n\nHi, I have the implanon in arm for 2 years and keep experiencing excessive bleeding. It starts, lasts for 3 weeks at a time now for atleast seven months. I might break one day to a week and then it is back. I had something different this past 2 months. I had 2 week period and stopped 6-3 and last tues I had some bleeding and stopped before morning. Then yesterday, I started back up and not only this, it has this dead bad smell to it and extreme flow and clotting. I have also severe cramping especially left side, severe sleeping, depressed, and lack of energy. Is all this usual for anyone on implanom?",
    "doctor_response": "Hi,Thanks for the query.Implanon can present with menstrual irregularities.And usually they will get corrected in few months.But as you had excessive bleeding with clots, pain abdomen etc. better to consult gynecologist once and get examined to rule out the possibilities like ectopic pregnancy.You may need one ultrasound.If no abnormality is noted, then the bleeding could be due to hormonal effect only and you can take additional dose of hormones to control the bleeding.For more details you can ask me through:  care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason of having stomach sickness with a family history of pancreatic cancer?\n\nI m asking for my mother who will be 88 in March. She complains often of having a sick stomach, feeling nauseous, no pain, doesn t throw up. She s in remarkably good health for her age. Two of her sisters had pancreas illnesses that lead to their deaths (late 70s), we re unsure if they had pancreatic cancer or just what the diagnosis was except that it involved the pancreas.",
    "doctor_response": "Hi. Regards for your Mother. I would advise you to undergo a simple test of ultrasonography to rule out whatever you have on mind . If USG is normal , nothing to worry and bother about. Nausea with sick stomach can have simple problems behind it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shaky hands and is it a cause for concern?\n\nHey i have some probleme in my hand , i think it could be a flapping tremor , my hand are shaking a litttle and it makes me under stress during a presentation my question is what should i do ? is there any danger ? Should i consult a doctor Thank you",
    "doctor_response": "Hello, The shaking of hands can be related to stress and anxiety or some neurological problem. Doing relaxation exercises and taking an anti-anxiety drug will help. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the constant chest pain along with high BP?\n\nThis is vengat. i am 31 yrs old . I am working in UAE for Piping Draftsman.I have left side cheast (Small)pain(70%) . Last year  i checked doctor,he told that u have BP.He take Scan And ecg. everyting is perfect.  Now i am doing exercise and diet. Now BP is Normal. But Cheast Pain Still I have.(last one Year I have  this problem) One time i walked by staircase until 12 th floor. Then I feel BP Rise. (My BP Rising Time-154/94) Noramlly i have (130/90) last 6 month I am Jogging for Half Hour(Continously-2.5 Km). Some times  only BP Increase. But Continously Chest Pain(Small Pain). I dont take any medicine for this Problem .Incase doctor advise Bp Tablet. Which Tablet Is better Ayruvedic or homeopathy or alobathy. Pls give solution(Next Month I will Go to India. So which doctor I want consult Ayruvedic or homeopathy or alobathy",
    "doctor_response": "Hello dear , HiWarm welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  Constant chest pain has to be evaluated with normal BP recordings .*  It is not advisable to consume BP tablet for just chest pain occasionally    without  BP  measurement  or  doctor  consultation .*  Best way is to consult  MD physician &  get  proper  line  of  diagnosis    and  management  to  cure  it .Hope this will help you for sure .Regards dear take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does panic attack cause sharp chest pain?\n\nHi doctor, I am 27 years old. I had sharp chest pain on the bus. I suddenly got off from the bus and rushed to a local doctor. My BP was 150/90 and heartbeat was 140 bpm. Then doctor checked ECG and he said it was due to the acidity that I got pain. I have gone through TMT also and got a negative result. Next day, I rushed to another hospital and the doctor did a series of tests. He also concluded the same thing. I was very anxious because it happened the first time in my life. I was worried that, whether I will have a heart attack in the next coming days and always kept thinking the same. The doctor suggested me to consult a psychiatrist. Psychiatrist termed it a panic attack. Nowadays, I am trying not to get anxious and not to worry about that. Currently, I am taking the acidity tablet twice weekly. But, I still get some sharp pain in the chest. I do not know the reason and it leads to negative thinking. So, I need your suggestion on this matter.",
    "doctor_response": "Hello. Please give me some more information regarding your illness, so that I can help you better. Did you feel suffocated in the bus, with a sort of air hunger (feel of insufficient oxygen)? Did you feel something is going to happen to you? Is there any family history of heart disease? How active are you? Do you exercise regularly? Your tests are essentially normal. Kindly answer these clarifications. After that, I will send you a detailed answer as to how you should tackle this problem. I am sure you would be fine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes one to get typhoid even after getting vaccinated?\n\nA few years ago I got the typhoid fever shot because I was going to be traveling to some poorer countries. 1 month after I had the shot, I went on vacation and became violently ill. The doctors told me it was typhoid fever. I was tested, and I responded positively to SALMONELLA O, TYPE Vi POSITIVE A with somatic(O) antigens. My question is, how do I know for sure that I did have Typhoid fever (and that the positive test wasn't the result of my earlier vaccination)? Wasn't my vaccination supposed to prevent the Typhoid? What are the chances someone can get Typhoid even though they were vaccinated? Does this mean I can get typhoid fever again (do I need to be vaccinated again?)",
    "doctor_response": "Hello,first of all, the vaccine does not confer 100% protection, so getting sick cannot be excluded.The diagnosis of typhoid fever is not based on a positive H and O because this test is considered obsolete. And the reason is that a patient may have other pathogens that cross-react and give positive results, so an overdiagnosis of typhoid fever would occur if we relied on this test only.The most accurate way to establish the diagnosis is by culturing the organism. Stool cultures is the most feasible strategy but bone marrow specimen can be used as well.The vaccine efficacy is not very well studied but it can be about 70%. It declines rapidly with time. Three years after vaccination it's supposed to be lower than 50%. If this was typhoid fever indeed then this acts as a booster for your immune system. So if you're going to travel again in the future then perhaps you should receive vaccination again, particularly if more than a couple of years have passed since the last vaccination.Kind Regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bleeding in right knee?\n\nI AM 67 YEARS OLD AND KEEP GETTING BLEEDING IN MY RIGHT KNEE. I HAD DVT 11 YRS AGO AND WAS PUT ON WARFARIN AND DRS KEPT ME ON THIS MEDICATION. AFTER THE 3RD BLEEDING KNEE, THEY TOOK ME OFF, WITHOUT REPLACING IT WITH ANY OTHER MEDS. AFTER 5 DAYS, I BECAME VERY ILL, FELT IF I WAS DYING. COULD THIS BE WITHDRAWAL?",
    "doctor_response": "Hello, It is a side effects of warfarin. Consult an orthopedic at the earliest and get evaluated. An ultrasound scan of the knee joint is required and if there is significant collection, it must be aspirated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for suicidal tendency\n\nIve always been suicidal June 6th 2011 my mother was murdered, June 29th i had spent all my money and saw and spoke with Christ, June 29th 2012 i had finished reading the bible once through, Ive send demons and angels since and I m loosing hope, i want to die every minute, one day I m going to loose.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. You are not a person who can loose. You are a courageous person who have the blessings of Jesus Christ. You are lucky enough to see and speak to Christ. Then why are worrying about your ability?He, Christ, decides our destiny. You are his lamb and he shall lead you to safety. To safety is already decided and that is the reason why he spoke to you in person. The problem with you is that you loose your hope very easily. You loose your confidence in Christ very easily. That is where you are wrong. Trust him, for he is your savior. Trust him, for he is your shepherd. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a swollen cheek in a child?\n\nMy 2 year woke up this morning with her left cheek swollen close to jaw line and ear and took her to doctors and they were saying could be lymph nodes or teeth coming in but she has nomfever and seemed fine once we got home but cheek is still swollen??",
    "doctor_response": "Hi...it could be teeth coming out.... Quite possible... No need to have fever definitely. Other option us that some sort of allergy or angioedema. If she's otherwise fine and her usual self, you can wait. Don't worry.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest OTC medication for crusty, itchy sore between toes\n\nHi I have what im sure is athletes foot but its in between my last two smaller toes. its crusty and I have seemed to develop a huge chunk out of it and its very sore and itchy and my feet have an awful smell to them. is there anything I can use to treat it without a prescription?",
    "doctor_response": "HelloThank you for contacting HCM.First and very important thing that you need to take care of is that you need to keep your foot DRY else it will not heal in any case. You can take Clotrimazole 1% & Hydrocortisone 1% cream and apply between your fingers. It will take 3-4 weeks to resolve but may prolong if you do not take care. For itching you can take cetrizine before going to bed.Get Well soon.Thank You",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for hairfall and dandruff\n\nHi i am sridevi my age is 22 5.5 height with 51 kg I have problem in hairfall and light dandruff I came here to chennai for the past three months my hair started falling from the second month is that due to water or dandruff or changing shampooor iron deficiency  plz suggest me a answer",
    "doctor_response": "Hello,Thank you for posting on HCM.It seems you are suffering from Seborrheic dermatitis,which secondarily leads to hairfall and thus its important to treat it first hand. I would recommend you a short course of oral antifungal drugs like ketoconazole/itraconazole and a lotion containing clotrimazole and betamethasone twice a day over scalp for few weeks. Use a medicated shampoo containing ketoconazole and salicyclic acid twice a week. Take antihistaminics as required for itching. Avoid excessive use of hair oil.As for the hairfall, start oral supplements containing biotin and other essential vitamins and minerals (Follihair new) once a day for atleast 3 months.Hope this will take care of your query.Thank youDr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for lower back pain?\n\nI know I have chronic lower back pain.  It's in the lower center of back my.  I have had numerous injections and nerve blocks, nothing works.  I cannot stand longer than 5 or 10 minutes without going into a terrible sweat and the chronic pain starts.  When I sit the pain goes away, however, I still have a numbing, throbbing pain that stays with me continually sitting.  I was referred to a Rheumatologist who told me my SED level was 79, he put me on meds that did not touch the pain and I'm even more miserable than I've ever been in my life.  The Rheumatologist has changed my meds at least 3 times and I still am getting no relief.  HELP.  Have I been diagnosed wrong.  What is wrong with me.  This pain came over a period of time and has gradually has increased.  Did I mention I have a small disc, but every doctor seems to think that the source of my back pain could not be related to that tiny disc.  What should I do.  I need relief.  I want to walk without being in pain and I'm young with a child.",
    "doctor_response": "dear friend your low back pain seems muscular pain.if all reports are normal then physiotherapy and exercise will help you a lot on long term basis. presently if you have severe pain then take muscle relaxant medicine like combination of aceclofenac+paracetamol+chlorzoxazon and consult physiotherapist.-exercise for low back pain- raise your leg sraight from hip joint without bending from knee after sleeping on back and then put down slowly. same exercise for another leg and then raise both leg simultaneously. sleep on abdomen and raise your head and chest backward. do all these exercise 40-50 times per day by increasing slowly daily.hope this answer will be helpful to you.for more queries plz don't hassitate to ask.get well soon dear frienddr.manu khimani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for itching and lump between testicles and anus\n\nI am 28 years of age and I have been itching a lot between my testicles and anus. It s been irritating to say the least. Now I ve noticed a lump has formed under the skin. I don t know what you would call this area. So I hope it s enough info for you to help.",
    "doctor_response": "Hi,From history it seems that there might be having some local infection like fungal infection or dermatitis causing itching.Due to itching there might be some irritation causing lump.Apply triple action cream.Keep local hygiene proper.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Red spots on body which turn brown, something bitting feeling  around the area. What it could it be?\n\nhi I got some red spots on my left arm around my wrist and towards my fingers and uo my arm n they started to turn dark then I got some on my other hand but more spread out n not as many it took a couple of days to turn brown, I noticed some on my back also....like on each kidney area ... around there. I notice I feel like a stingy feeling...like something is bitting me...not just necessarily on d actual spots but around the area. im very concerned. oh also some bigger spots actually were a bit bumpy. what could it be?? ive had it for about 2 wks or longer n don't go away and it started little by little.",
    "doctor_response": "HiThe spots if fluid-filled can be chicken pox. It does take a few weeks to get complete relief from the rash of chicken-pox. You may take symptomatic treatment for it.If they do not go away, the need evaluation by a dermatologist.Dr Vaishalee",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat swelling in lower limbs?\n\nI wrote to you a few minutes ago about swelling in my legs and then the computer lost it. Did it get there? Well it has been over six hours and since I have not heard anything and I have just kept them elevated as my nurse, family member instructed me to do, the swelling does seem to be less. So if I remain doing so, maybe, it will just go away. Thank you anyway. Goldie Seibert from Sharon, PA.",
    "doctor_response": "Dear patient Swelling is for what duration and  have you met with trauma?  Etiology  for swelling of both lower limbs may be 1. Dependent oedema due to gravity 2. Renal malfunction  with  fluid retention 3. Low protein  level due to liver malfunction 4. Cardiac failure with decreased output and hypertension .  So if you are not having any other associated  complain need not to worry. Keep both limbs elevated on two pillows and maintain fluid intake and output chart. If you are having low urine output , chest pain , alcoholic  please take visit to expert physician  and get yourself examined and investigated.  All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cause for lumps in rectum\n\nI have a small lump up inside my rectum. It seems to be protruding out through the outer part of the anus. More towards the cheek. It only hurts when I directly apply pressure. No blood , itching, as of yet. I m assuming after it has been there for a couple days it is more than likely a internal hemroid",
    "doctor_response": "Yes, you are right! this could well be an internal hemorrhoid. However, some other possibilities are also there like a rectal polyp, a mucosal tag, mucosal prolapse, lymphoid tissue etc...AS PER THE DESCRIPTION, IT IS LIKELY BENIGN AND nothing to worry much but still needs confirmation!Therefore see a surgeon for a rectal examination, colonoscopy if necessary and stool examination and to discuss about possible cure if needed!regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it ok to fly with having type 1 Chiari?",
    "doctor_response": "Thanks for the query The cabin in a plane is pressurised so that normal atmospheric pressures are maintained even at heights. IT is safe to travel by plane but make sure his vitals are stable before the flight Have a healthy living",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the lower back?\n\nI did something to my back this morning - I have pain in the lower right side and pressure on the front. I am thinking one of my disks is jacked up (precise medical term). I was just sitting down when my two year old sat on my lap and the pain started. I wasn't lifting and had just woke up about 10 minutes before that.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The pain in lower back can be due to back muscle strain or a disc problem. MRI scan will help in diagnosis. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest possible treatments for PTSD\n\nI m at Gulf War veteran it suffers from severe PTSD I have tried every medicine the book to try to fix this with severe nightmares everything I could possibly try During the day I can t even function I go behind on my bills I can t remember if I made appointments I feel truly on functional my mind races I cannot think right I am part of the VA system 100 disability with those doctors I m here to tell you those doctors just aren t right I have recently tried adderall and I also stopped taking every other medicine that the VA has put me on to try to solve this problem during the day I have a Rolodex in my head I can not pay my bills I cannot function as I said but when I try the Adderall I focused on my therapy now I do kind of therapy I m off 90 percent of my drug I have lost 60 pounds I feel great but when I request a script for adderall 30 milligrams 3 times a day WEA says no absolutely not here take some more of these medicines that put you in lala land is there any way to get online prescription from a doctor for the meds I live in Michigan in here the doctors will not give you a script for adderall unless they are 100 oz wrath D and in my case they want me to listen to the VA doctors is there a way I can get online prescription for adderall",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. PTSD is a mental disorder. Diseases needs medicines, not disorders. Many researches and researchers confirm that medicines alone cannot cure mental disorders. Life style changes, change in thinking pattern, relaxation etc are as essential as medicines. Psychotherapy can help you changing your lifestyle and thinking patterns. Yoga and meditation help you to streamline your metabolism and neurological balance. Please consult a psychologist for further information.If you require more of my help in this aspect, Please post a direct question to me in this URL.  Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdomen pains,back pains,headaches,body ache,naseu,dizzy, tired,weakness. What does this symptom indicate?\n\n15 year old female, experiencing multiple symptoms. should i be worried.? Hello, I am 15 year old female about two weeks ago I was feeling stomach sick and threw up about 5times,had a fever , felt weak,and had no aappetite. Since than I still felt weak and stomach sick and have a very little apetite. Today my throat started hurting bad,have abdomen pains,back pains,headaches,body ache,naseu,dizzy, tired,weakness. What do I have.? What is the treatment.? Should I be worried.?",
    "doctor_response": "Kindly check your blood for Liver Function Tests along with CBC/ESR and Urine Routine/Microscopic Have Rest Drink Boiled water Have Vital-Z or Enerzal powder with water Till then take Tab. Liv52 1 tab thrice a day Dr. Manish R. Rijhwani +91-9422571734 drmanish78@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling, pain and small red bump at the site of insect bite\n\nYesterday morning something bit me on the underside of my forearm near my wrist, over a vein. It hurt when it bit me but by the time I looked down, whatever it was, was gone. However, the location of the bite immediately swelled up and a rash spread from the site all the way around the side of my arm from elbow to wrist. The rash went away within a few hours but I have pain (a throbbing ache) that goes from my shoulder to my fingertips. Today the site is a small red bump with a blister type head on it. When I popped it, it turned into a crater with a dark dot in the middle. The area around the site and around my wrist area is hard as a rock and hot to the touch, with some swelling. Should I go get it checked out or is there a way to remove the venom from whatever bit me?",
    "doctor_response": "Hi,From history it seems that there might be having allergic reaction at the site due to poisonous bite.There is possibility of having thrombophlebitis giving rise swelling, pain and rashes.You might require medicine like antibiotic, anti-allergy and anti-inflammatory medicine to get cure.Consult your doctor and get examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat fatty liver and urinary infection?\n\nhi, just had an ultrasound and was diagnosed with grade 2 fatty liver changes,my urine analysis showed that i have an urinne infection which was causing me pain in my lower abdomen. after a few days the pain still persisted and then i did an ultra sound. i am a male of 33 years and weigh 98 kgs. please let me know what could be the cause and how do i improve on my situation",
    "doctor_response": "Hi I can understand your concern...Noted you have fatty liver and urinary tract infection....Take cefixime like suitable antibiotic for UTI.More fruit juice.Cranberry juice extract useful....Avoid excess spicy food.For fatty liver life style changes done.Low fat diet taken.Avoid alcohol.Regular exercise.Less oil in cooking.Refine food avoided.Udiliv 300 mg taken daily....Take care.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for mitral valve regurgitation?\n\nMy 98 year old mother was diagnosed with mitral valve regurgitation. She was placed on lasix and after 4 weeks became dehydrated as evidenced by an unexplained rash and itchiness on scalp and chest. Went to a dermatologist and the physician did not find any bug source, being that my mother resides in a nursing home. My mother s BUN rate was 90 but after being hospitalized for the past 2 days and hydrated with an IV is lowering now to 50. Her creatine level is normal as well as her glucose leves. Blood pressure is normal -146/72. They discovered a UTI for which the doctors are administering rocephin until they specify the exact bacterium. Results should be back today. She is on Celexa for mood elevation - which is questionable as to its efficacy (40mg daily for the past 2 years). A catscan yesterday revealed an enlarged liver which is pressing on the pancreas. They want to do an ercp scope to rule out gall stones - which she has no history of - what other tests should we run.",
    "doctor_response": "Hello, After going through your medical query I understand your concern and I would like to tell you that mitral valve regurgitation is treated with medicine as well as with surgery depending upon the severity of regurgitation and symptom symptoms of the patient. Kindly get and echocardiography did and consult a cardiologist for further management. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain\n\nHi i am a 33 yr old female, 5ft 10 in height and weigh 12 stone. I am generally of good health up until approx 3 years ago when i had an abnormal smear cin 3 but had it removed and since then have been fine. I have suffered for a long length of time with pain in my lower abdomen which Drs have put down to ovulation pains. I have recently had bloods taken for inflammation, blood count, liver function and these all came back normal except blood count which receiptionist stated came back as if i was suffering from mild viral infection and i have to go back in a months time for a check. I have been for an ultra sound today and my ovaries appeared fine however when scanning mu kidneys the lady took some time on the right side and i observed her measuring what looked like a white shadow and saw a few dark spots. She did not tell me anything re kidneys and stated that they would be in touch within a week. I am really worried now and thinking allsorts especially kidney cancer??? I do not spoke and never have, I have never had high blood pressure i am very active and have a good veggie diet with lots of proteins by only down side is i do drink a bit of wine.",
    "doctor_response": "Hi ! Good afternoon. I am Dr Shareef answering your query.Even though it is good to be concerned about one's own health, one should not become frightened or obsessive on cancer for a shadow seen on ultrasound. I would advise you to wait till the report arrives along with the result of a clinical assessment by your treating doctor. For the present just continue with your healthy dietary habits and active life style.I hope this information would help you in not worrying for a problem not yet confirmed. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be concerned about Rheumatoid arthritis knee replacement of my father?\n\nmy dad is 79 and is scheduled for rt knee replacement ,recent abi test normal as were concerned of circulation problem .his foot is cold to touch. his surgeon is in agreement to do knee replacement. I am concerned. should I be. I neglected to say he is type 2 diabetic.",
    "doctor_response": "It is risky to do a total knee replacement for a diabeticif you are afraid you can do doplar on his leg arteries  to make sure it is the right choice",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a painful lump on the arm be treated?\n\nseveral weeks ago a laundry basket full of wet towels fell on my upper inside bicept. immediately a large lump the size of an orange formed on my arm but no visible bruising. It is very sore and hurts all the way up to my shoulder causing constant pain. i thought it would go away by now. what do you think it is?",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. Well, this is probably posttraumatic hematoma or fibroma and this should pass spontaneously in several weeks.  Also, considering your description this may be some other  benign subcutaneous lesion such as lipoma, fibroma or atheroma and if there are no skin changes such as redness, pus discharge or pain and fever then you should not be worried since it can be easily surgically removed under local anesthesia. Then it there are doubts it can be sent to the patohistologic analysis. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat pain and tenderness in the lumbar area caused due to an injury?\n\nMY DAUGHTER 17, IS AN ATHLETE AND CHEERLEADER. SHE STUNTS SOME IN CHEER BUT DOESNT REMEMBER A SIGNIFICANT FALL WHERE SHE HURT HER TAILBONE. SHE IS VERY TENDER TO THE TOUCH ABOVE THE BUTT AND NEAR THE CRACK AREA AND IT FEELS WARM. IT HURTS TO SIT NORMAL. ICE HELPS SOME BUT IT DOESNT SEEM TO BE GETTING BETTER. SHE HAS A DR. APPT IN THE MORNING BUT I WAS JUST WONDERING YOUR THOUGHTS. THE WEBMD THING SAID ITS MOST LIKELY MUSCLE STRAIN.",
    "doctor_response": "Hello,Hard to tell without an exam. She needs an x-ray to make sure there is no fracture. It should be getting better it is a musculoskeletal strain. He may be better than ice.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Kathy Robinson",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain and indention in buttock\n\nI have an 1.5 diameter indention in my right buttock/hip from a cortisone shot several months ago. I am now having a considerable amount of pain in my hip. Mobility isnt as well either. My husband was going to massage my hip for me and the sorest spot is the middle of the invention. The pain is what bothers me most at this point. Advice?",
    "doctor_response": "Ice application for 7-10 min 2-3 times in a day at the painful region will help to reduce pain.Don't go for any massage therapy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How get normal sperm count?\n\nhi Doctori am 32 year old married man. i have nil sperm count( tested 2-3 times ). My FNAC reports shows no presence of required cells in both testis. my blood test reports shows FSH-32, LH-16 & testosterone level= 2.9. is it possible to get sperm count to normal level ? pl guide with regards Sam",
    "doctor_response": "it is very unlikely to get sperms to normal level when you dnt have cells necessary for sperm.production.. try to go for microscopic testicular biopy..it might be able to identify sperm in testicular tissues that can be used in an IVF cycle",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe cold and shortness of breath\n\nmy toddler is breathing very fast. He has had a cold and is now coughing. Last night he could not sleep properly because of his coughing and labored breathing. His chest and throat moves up and down really fast when he breathes. Should I take him to the hospital to check for asthma or pneumonia?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have severe cold and shortness of breath which could be due to severe upper respiratory track infection/lung infection and it could be sinusitis. I would suggest you to do warm saline gargles and betadine gargles alternatively , avoid eating spicy and heavy food. I would suggest you to consult ENT specialist for proper examination . Doctor may order throat swab test , viral culture test and blood test .Doctor may prescribe anti viral ( acyclovir ) along with anti inflammatory Levocetrizine. Drink plenty of fluids to rehydrate yourself. You should take cough expectorants as well.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I having forceful urination with itching and burning in penis, urethra and anus?\n\nHi doctor, I am 32 years old and suffering from forceful urination and urine direction is towards the left side. I do have itching, burning feeling in urethra, anus, and penis. I have been prescribed Afzoo, Kcit and Cranpac D. That does not seem to be working. I think my symptoms match with urethritis. Additionally, I have been facing this issue since the day. While I was urinating in the morning, I felt some sudden nerve movement.",
    "doctor_response": "Hi. Your symptoms suggest either prostatitis or urethritis. We also need to rule out stricture of the urethra. Please share your urine and ultrasound reports. Also get a uroflow test done. A urine culture should be sent if not done till now. What is the duration of symptoms? What is the frequency of urination? How is your flow? Is there any urgency or straining while passing urine? Is there any abdominal or back pain? Let me know all the above. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have space between teeth even after treatment with wire braces. What do I do?\n\nHello, About 5 years ago I had wire braces for my teeth. And to have the braces on, I had 4 teeth extracted because my teeth were overcrowded. As far as I know, a lot of orthodontists take out premolars to create space. But for some reason my orthodontist took out 2 premolars, 1 molar on my bottom left and 1 molar on my top left. I got my wisdom teeth removed on the bottom right. So, I have only first molar and partly seen third molar on my bottom left side. I was only 14 years at that time, so I really did not think much of it. This has caused many jaw problems for me. I have not chewed on my left side for the past five years. I heard jaw problems can make my face look weird, as of now I have not noticed anything. But I am worried that it might affect in the future. Is there any way I could put a second molar in the bottom left? I still have space where my bottom premolars were, could I move the molar with braces to fill in that space so that I will have space at the back to put on a an implant? I just really want to fix the problem. Please help.",
    "doctor_response": "Hi. Sometimes orthodontists do extract molars if there is very severe crowding of the teeth. In your case, as you said there was severe crowding. Now you have space present where the molars where previously present and hence you are unable to chew properly. Is your second molar on the left side tilted or upright? I assume that your second molar is upright. There are 3 treatment plans for you: For the best treatment option, attach\u00a0an intraoral photograph of the upper and lower jaw and consult an orthodontist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be concerned for the trembling of legs while sleeping?\n\nHello, recently my daughter has woken me up as I am lying on the couch with my feet at her end because after I fall asleep my legs tremble.  I am a runner and 6 days a week excersicer.  I do have a condition called Neurological Foramin Narrowing but continue exercising.  Every 2 months I get an epidural (cortisone) in my right lower lumbar.  Should I be concerned?  Thank you.",
    "doctor_response": "Consult a neurologist for re evaluation with MRI of lower back, to know whether for animal encroachment is enhance compared to before or needs surgical laminectomy to ease narrowing.Secondly, restless leg syndrome should also be ruled outNerve conduction studies shall helpMassage with oil before bed to relax muscles and lessen running,jogging,forward bending till it's approved by neurologistThanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest tightness and pressure with shortness of breath?\n\nThe feeling comes and goes, it is cross between tightness in the chest and feeling like something heavy is sitting on my chest. Along with this comes a cob webby feeling again in my chest and a little shortness of breath. what s wrong with me - had this off and on for a month now.",
    "doctor_response": "Thanks for your question on HCM.In my opinion you should consult cardiologist first and get done1. ECG2. 2d echo To rule out cardiac causes (congestive heart failure-CCF, coronary artery diseases -CAD).As your symptoms like chest heaviness, tightness and shortness of breath are seen commonly in cardiac causes.If all these cardiac investigations are normal than no need to worry much for Cardiac cause.You may have anxiety. As anxiety can cause similar symptoms. So avoid stress and tension.Be relax and calm. Consult psychiatrist and get done counselling sessions to identify stressors in your life. And Try to work out solution for the same. You may need anxiolytic drugs too.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pimples and blackheads, treatment ?\n\ni have pimple in my face dont know what to use i also have black heads in my face .please help me",
    "doctor_response": "Hi..dear Arishma..., Thanks for choosing HCM.., Pimples on face is common problem..., in Adolscents and young adults.., It is due to Hyperactivity of Hormones.., It is called....ACNE VULGARIS..., 1) Frequent washes with FASH BAR..., 2) Tab Isotretinoin 20 mg daily for 30 days..., 3) Clindamycin 1% aplly on face 2 times daily ...,, 4) Plenty of vegetables, fresh fruits..., ok..good luk...,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child has painful white spots with pain around the dental caps. Prescribed Tylenol\\codeine but no relief. Suggestions?\n\nOn Monday  my 5 yr daughter had caps put on her teeth. Since yesterday shes has been complaining of pain.  So last night I looked at them and they are swollen with white spots. I called the dentist and he said it sounded like ulcers and he just refilled her medicine from when she first had the procedure done. that just stops  the pain and makes her drowsy (Tylenol\\codeine) She only complains and cries when she has to eat or drink something so she barley eats... What can do to help her? I've tried salt water. But nothing seems to help ease the pain.",
    "doctor_response": "Hello and welcome to HCM,Appearance of painful swollen lesion with white spots after putting on the dental caps is suggestive of ulcers in the oral mucosa.Drowsiness may be due to codeine that your dentist has prescribed for the pain.Painkillers will relieve the pain for some time,  however an examination of the oral mucosa is required.The dental cap could be causing the problems.Re-fitting of the cap may be required to prevent the ulcers.In the mean time, you can apply local anesthetic eg lignocaine ointment to prevent the pain during eating food.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for erectile dysfunction despite taking Giyspot, Getgo and Jakjoy\n\nDear sir I have Ed since 12 months I visited my sexologist ,he did all the test and suggested me to take giyspot in the morning ,getgo 10 mg in the noon and jakjoy at night, for a month and he said that I will feel the difference at the first week itself , but I felt no difference even after taking medicine for the full month . I am not able to over. Come ED problem please suggest what is the next step I should do ?? Please help",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I understand your concerns and I will try to help you as much as I can.Erection problems can have many causes. These include:Physical problems, such as injury to nerves or loss ofblood supply to the penis . Other health problems, such as diabetes, high blood pressure, anxiety, anddepression.Side effects of certain medicines. Stress. Drinking too much alcohol or smoking. The exam, lab tests, and sometimes mental health tests can help find out the cause of the problem. Tretament is based on cause and include avoiding tobacco and drugs and limiting alcohol.Also, talking about the issue with your partner, doing sensual exercises, and getting counseling may be beneficial. Finding and then stopping medicines that may be causing the problem. In some cases you can take a different medicine that doesn't cause erection problems. Taking prescription medicine that can help you get erections. These include pills such as sildenafil (for example, Viagra), tadalafil (for example, Cialis). In most cases this is sufficient for treatment but you should just be patient and do necessary tests.I hope I have answered you query. If you have any further questions you can contact us in every time",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes  nausea and stomach pain in a patient with type 1 diabetes?\n\nI am nauseous when hungry, stomach pains when I eat anything.  I have type 2 diabetes, high blood pressure.  I also have low b12 (I am on my 3rd shot)  tired a lot of the time.  Also I have a elevated white blood count.  I have lost 23 lbs in 3 months.  I am scheduled for colonoscopy in 3 weeks but could use some relief now or at least a idea of what might be wrong.",
    "doctor_response": "Welcome to Healthcare magic. if you are having long standing diabetes like more than 10 years you are prone to get more side effects. given significant weight loss. you must get checked for gastroparesis where your stomach will not move properly leading to nausea. this occurs from the neuropathy from diabetes. you should strictly control your sugars to stop the progression of gastroparesis and neuropathy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anemia\n\nhi i have been diagnosed with anemia in september. i have currently been taking folic acid tablets for the last three months, i do not feel better at all and now im bruising more easily. i have had blood in my stools and feel so tired and sick most of the time.i just want to know what else can be done?",
    "doctor_response": "first of all you should get your blood test done called as \"coagulation profile\"sounds like your blood has got thinner than normal which is the cause of bleeding. this ultimately can lead to anemia. Also get FBC done to check your Hb levels, if its too low then you might need some blood transfusion. Also a proper workout should be done whats causing your blood to get thin. Are you taking any blood thinner medications?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly suggest ways to gain weight.\n\nHello doctor,I have a migraine problem but side by side I have a problem of weight loss too. I am married and have two children. Please suggest me how to gain weight.",
    "doctor_response": "Hello. Migraine is such a disorder with some symptoms like headache, nasal, eye, forehead pressure, etc., climate or weather change or allergic prone also. Any time often can be attacked. There fore I think no direct relation with weight. So you have taken both but in a separate way. For migraine, there are some specific treatment and related medicines available. For weight loss, you can gain weight gradually by a consistent effort. Check the following, 1) Blood loss excess with your menstruation may be low iron and folic acid, and RBC. 2) Take CHO carbohydrates like rice or roti little more enriched with protein like milk and milk products. Also, fish and chicken 50 gm at least daily. If non.vegetarian then go soya and soya products, pulses. 3) Plenty of green vegetables, greens, spinach, gourd family vegetable mainly. 4) Take three servings daily fruits like lemon, orange, guava, apple, grapes, watermelon, papaya, and cucumber at any time. Also, go for eight hours rest and deep sleep. And do not take the stress. A lot of things are there to add. You can properly make a diet chart, which will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment options for lymphedema of the legs\n\nI have been fighting lymphedema in my legs for the past several years. Are there any surgical treatments which show promise to either cure or at least manage this condition. I am on Lasics and use lymphodema pumps twice a day. I have had pressure socks and unaboots. Any ideas",
    "doctor_response": "Hi, Lymphedema is a difficult condition to cure. You can consult a vascular surgeon and plan for surgical options for complete recovery. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should Progress Gold milk be stopped due to loose motions?\n\nHi. I have a 1 year old son. I am still breastfeeding my baby but I still find it hard to find a better milk for him. He is not gaining weight very well. I tried Nan-HW and Gain but he does not like the taste. So, I tried Progress Gold and I was very happy that he liked it. From time to time, he wanted to drink milk. But unfortunately, there is an effect. He is passing just small amount of watery stool like 3x a day (no other signs and symptoms noted). He is doing fine and does things normally like he used to. No irritability noted. Is it a bad side effect? Should I stop giving her Progress Gold? I am just worried. Thanks.",
    "doctor_response": "hi...if child is liking and accepting adequate quantity of progress gold, you can continue. passing stool 3 times a day is not a problem. now you start adding vegetables, fruit juices and biscuits and rice one at a time once in a week.don't worry and follow above suggestion.if you are happy with my suggestion kindly rate me.regards - Dr.Surendra.H.S",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting in a baby?\n\nhi my 14 month old daughter has recently started vomiting with anything put in her mouth, even pureed food. she will also vomit as soon as I try to give her a bottle of milk. she is now refusing to be fed at all and has quite a severe tamtrum. please help.",
    "doctor_response": "Causes of vomiting in baby may be Gastroenteritis, Reflux Disease, Urinary Infections, Cow's Milk Allergy etc. Some uncommon but serious causes are Intestinal Obstruction Meningitis, Metabolic Diseases etc.You need to consult your pediatrian and ask for antiemetic medications along with investigations like USG abdomen, blood investigations etc to find exact cause.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is Mometasone dangerous to use on Face to clear my acne pimples?\n\nHello doctor, I am seriously facing acne pimples problem. Sometimes they occur on my face when I masturbate. If I use Mometasone, it gives a good result. Is it okay to continue this?",
    "doctor_response": "Hello. Acne is a universal issue in the age group of 15 to 25 years due to hormonal changes in adolescents. However, there are multiple effective treatment options depending on the grade and severity of the problem. Mometasone is a topical steroid and is to be avoided strictly on the face and for acne as it can harm your skin in the long run. Acne is dependent on hormones hence excess masturbation may sometimes lead to an increase in the problem. I would advise you to stop Mometasone immediately and kindly upload appropriate images to help us assess your current grade of acne and treat you better. Regards. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes an elevation in the SGPT level while having a mild fatty level condition?\n\nI have mild fatty liver as USG report says and recently I have found in LFT report my SGPT level is 111 U/L and SGPT 61U/L . I don t drink . Rather very rarely. I don t smoke. My age is 37. I m getting panicked with the raise of SGPT. My bilirubin level is very much normal.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The SGPT value of 111 is of no clinical significance and there is nothing to worry about in it. In case of liver diseases the values will be above two thousand. No treatment is required and you can repeat the enzymes after to weeks for reassurance. Better to stop alcohol consumption to prevent liver diseases in the future. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a cyst on the right breast?\n\nI'm a 17 year old girl, 5'0, around 110 pounds. I have a cyst of the skin on my right breast. I've been to my doctor, who prescribed me medication (Augmentin), but the lump just got bigger, more painful and red. After a sonogram, she told me to continue with the antibiotics and I'm scheduled to see her in two weeks. If the cyst persists, I'm told I have to get it removed. However, recently, the skin on and around it started to peel, and I think I may have broken the skin because it started to bleed, and what looked like pus and an pily substance came out as well. Most of it has stopped, although I put a bandage on it if it continues. Should I be worried or is this sommething that just happens?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some inflammatory cystic lesion in your breast or itvmay be abscess formation.  You should complete the course of antibiotics. If it doesn't respond to treatment then you should go for biopsy and 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have fibromyalgia, bulging discs. Have back pain. Did gastric bypass. Have malabsorption issues. Suggestions?\n\nI have been dealing with fibromyalgia for at least 12 years and am now having trouble with lower back pain due to bulging discs. My pain level with my fybro has greatly increased in the past 5 years. So much that along with the chronic back pain I finally agreed to pain management to be able to function as normally as possible before the pain became so severe and continuous. I am also a roux n y gastric bypass success going on 12 years. I do still have malabsorption issues and am not able to take time released medications and always have to take a double dose of antibiotics when needed. I have been dealing with pain management center who simply do not understand the complexity of my situation, don't really have time to care or just don't want to spend extra time to understand and listen.  I have attempted to work with them and explain that the current treatment just does not work. I am prescribed Norco 10/325 which helps take the edge off for a short period of time but I am never at a truly comfortable functioning pain level. I will soon have to provide a new provider as they are no longer accepting cash paying patients who do not have insurance. I do currently live in southeast Missouri and would appreciate any advice or recommendations at this point. I am very discouraged and running out of time and options. Your assistance would be greatly appreciated.",
    "doctor_response": "HIThank for asking to HCMI can understand your pain, but you do not have any option but to follow the treatment given by pain management, from this platform nothing much can be done only we can give you moral support, you had gone through such critical procedure, and then pain is more likely, the best way to rid out of this pain is bear it as hard as you can, once the pain intensity achieved the peak level then it start declining slowly, and this phase gives much relief from the pain else all the pain killing pills are too dangerous for your health, be brave man, have good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have chronic asthma with diabetes and high BP. How long can I live with the help of asthma breather?\n\nA friend of mine is 67 years old, she is obeise she has a asthma after walking few steps she has to take a asthma breather. She has high blood pressure and she is diabetic. Her lifestyle is sedentary and she has no control over food she eats whatever she wants. She takes medicines regularly though and she breaths oxygen from oxygen cylinder for one hour daily in the evening. Besides these she has a thyroid too. How long can we expect her to lead a life like this.",
    "doctor_response": "IN MY PRACTICE I HAVE SEN MANY PATIENTS LIKE THIS WHO HAVE MULTIPLE ORGAN DISEASES BUT CAUSE IS SAME THE BODY PROTEINS START SUDDENLY REACTING WITH FOOD PROTEINS WE TAKE DAILY AND THEY CAN CAUSE MULTI ORGAN SYSTEM PROBLEMS LIKE WE CAN GO ON CONTROLLIN AS COMPLICATIONS ARISE WITH SYMPTOM SPECIFIC MEDICINES BUT CANT CURE ITIN MY OPINION WHEAT OR MILK OR BOTH CAN REACT TO CAUSE THISI ADVISE YOU TO GET BLOOD SERUM TESTS FOR SPECIFIC ANTIBODIES FOR MILK WHEAT POTATO OR OTHER FOODS WITHDRAW THEM TO GET RESULTS WITH SAME MEDICINES YOUR MEDICINES QUANMTITY AND DISEASE WILL BE CONTROLLED MUCH BETTER   USE NON SPICY NON GREESY NON OILY FOODS USE PLENTY OF FLUIDS TO INCREASE PLATELETS WHICE ARE IMMUNITY BOOSTERS USE LOW PROTEIN HIH FIBER DIET AS THE PROTEIN INCREASES THE DISEASEDONT TAKE MEDICINES WHICH INCREASES ASTHMA LIKE  PARACETAMOL DISPRIN ASPIRIN DIETRY SUPPLIMENTS AND VITAMINS AND IBUPRUFEN AND STRONG ANTIBIOTICS THIS IS MY EXPERIENCE AND IT IS GIVING EXCELLENT RESULTS IN MY PATIENYS",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can an infected biopsy wound on the thigh be treated?\n\nI had a biopsy on my inner thigh 4 weeks ago ... think it may be infected ... could not get into the dermatologist who did the biopsy (confirmed hives) for him to check today. I have some Cipro 500 mg that I use for chronic UTI s ... should I start taking it just in case until I can see the Dr. on Monday?",
    "doctor_response": "Hi,It is inadvisable to start a course of antibiotics before confirming the presence of an infection. You could temporarily use an antibiotic ointment and a cold compress on it.Once you meet your dermatologist, he will see the wound site and may even take a swab if there is some pus before putting you on antibiotics so that the antibiotics can be tailored to the organism that is there.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Pranav Balakrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest if treatment is right for lymph node\n\nI have developed a lymph node on the right side of throat. It's not big and not visible from outside. It started with slight sensation at the same place and has swelled a little in a period of 2 months. Swelling can be seen by touching that area. Over this period of 2 months I had ferver 3 times. I have been prescribed1. Novomox 500 (2 mths back) - Fever2. Forenza 350 (1.5 months back) - Fever3.Montair - FX    (ENT specialist)    (1 month back) -Lymph node, Fever4. Moxif 400 (10 days back) - Lymph node, Fever5 FERY 120 (10 days back) - Lymph node, Fever6 Xaria (now)Can you suggest if my treatment is on right track or should I change doctor (presently ENT specialist). If yes, which specialist is better to consult?",
    "doctor_response": "Hi,it seems that there might be having chronic lymphadenitis in the neck giving this problem.This might be due to recurrent infection in surrounding area like throat, ears.Nothing to worry, you have selected proper specialist and remain in his regular follow ups.Rule out any chronic dentall problem like carious tooth or tarter-ed teeth.Keep oral hygiene proper.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a chronic dry cough and mild heartburn from the last five days. Please help.\n\nQuery regarding chronic cough almost dry not completely dry from last 5 days. Gets more persistent during sleep. No fever whatsoever. Took 1 tab of citrizine on day one thinking its allergic since no fever or stuffy/running nose. So ruled out allergy since then. No medication taken, just some otc antacid \"digene\". Mild heartburn. Twice at night coughing was so strong that I puked. Looks like GERD to me. Non smoker. Male. 25 years old. No history of any other illness. Height 167cm Weight 64 kg",
    "doctor_response": "Dear, Welcome to Icliniq. Thank you for providing a detailed history. I just want to clear one thing what do you mean by CHRONIC cough? The history you provided is of just five days so it is not chronic but you used word CHRONIC which means cough for months or years. So if it is just five days of cough then yes it is suggestive of some reflux episode which is leading to laryngeal irritation followed by cough and occasionally can lead to choking like sensation in sleep. I will like you to start the following medications and it will help out. 1. Cap.Deslansoprazole 30mg 1 cap twice daily before breakfast and before dinner for 2 weeks. 2. Syp. Rondec ( Dextromethorphan) 10ml three times daily for 10 Days. You need to avoid late time eating. Three should be a gap of at least 2 hours between dinner and going to bed. Avoid Smoking. Avoid Evening Coffee or tea. Thank you. Incase of any further query get back to me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure water filled blisters after an lung biopsy?\n\nHi..my mother underwent a lung biopsy two days back.I had opened up the wound yesterday and applied undiluted savlon only on around the wound area and not on the wound.Today I found water filled small blisters. I tried to burst few blisters and water came out. So I got scared and put some calo soft lotion on the surrounding area.. And covered it with dry gauze. I hope it's not serious.Please help..",
    "doctor_response": "Thanks for your question on HCM. In my opinion you should immediately consult treating doctor.Because your mother is having Surgical Site Infection (SSI).It is skin infection seen at the site of infection. It is mostly due to poor post operative wound care.Fluid containing blisters are suggestive of SSI only.So your mother needs thorough cleaning of wound and proper aseptic dressing. For all these consult treating doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dry,white,flaky appearance and itching in the groin?\n\nmy groin and scrotum ONLY on the left side have taken on a dry, white, flakey appearance and itches like nothing else. Some days it s not that bad, and other days I just can t seem to make it go away. Moisturing lotion does nothing, only anti itch cream helps, but only for a few hours. It s worse at night and after sex. Some times, I wake myself up scratching my groin. So to recap, the skin is discolored white, it s flakey, and it itches like crazy. It s only localized on the left side. What gives?? I want to see a GP, but I don t have health insurance yet. Any ideas?",
    "doctor_response": "helloI share your concernLooking at your detailed description it might be related to fungal infections or allergic reaction,I would advise you to use antifungal or antibacterial ointment like clotrimoxazole ointment to be applied at least thrice a daymaintain good hygiene, change your undergarments or wash it with antiseptic solutionIf you can write back to me with a photograph, your age and relevant medical history, so that I will be able to tell tou more precisely.waiting for your replyBest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes concentration deviation and empty feeling?\n\nI'm a 17 year old girl. I feel empty and tired all the time. I have at least one outburst every single day, when I feel fustrated, empty and angry. I've been low pretty much all the time for a month, I can't seem to shake these feeling off, I've tried relaxtion methods, the methods do help, but I can't return to my normal state, even when I forget about my sadness, after a while I realise I still feel empty, it's like it doesn't leave me. Also I seem to have trouble concentrating on my homework, it's difficult to study, I have to force myself, because now I'm concerned about my grades. I've lost interest in activities, I feel distant from people. I do have minor problems, but these problems on their own should not cause suicidal thoughts, or temptations on hurting myself. Am I just an over reactive teenager?",
    "doctor_response": "Hi,I read your query and can understand your distress with the symptoms that you are suffering with. From what you have mentioned, it is highly probable that you are suffering from depressive episode. I would recommend that you don't ignore your problems as teenage issues and discuss with your parents regarding seeking psychiatric consultation.You would need treatment with anti-depressants like escitalopram. The medications usually take few days to start showing its effect. So you will have to be patient about the response. Continue  doing the relaxation exercises regularly. That will help you.Hope this information was helpful. Wishing you speedy recovery. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring fever along with headache and stomachache?\n\nMy 9 year old son has had a reoccuring fever off and on every week and a half for the last month or so. The fever happens for a couple of days peaking around 105 along with headache and some stomach ache. He s fine in between these occurances. What could be causing this?",
    "doctor_response": "Hi,Having recurrent fever for long time requires some blood work to be carried out.Go for complete blood testing like TC,DC, platelet count, ESR, MPReport will give exact cause of having fever.After report your doctor will go for appropriate treatment.Give him light food.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a small lump in armpit indicates?\n\n22 year old female, 5'9\", 117 lbs. Found a pea sized lump under my left axilla this morning. It is tender to the touch, slighly red, and it hurts to raise my arm. How long should I let this persist before I see a doctor? What could it be indicative of? I have not changed deodorants for about a year now, no injury or trauma to the area, no allergies (seasonal or other), no recent illness.",
    "doctor_response": "Hi,From history it seems that there can be enlarged tender axillary lymph node or having ingrown hair follicle infection.Go for one antibiotic medicine like Amoxicilin for 3-5 days.Take Ibuprofen for pain as needed.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My son is having white spots on his legs,knee & back. is some other line of treatment that we can undergo ?\n\nSon aged 8 years is having white spots on his legs, knee, back my son aged 8 years is having white spots on his legs,knee,back, I have consulted skin specialists, they have diagnosed this disease as vitiligo. They have prescribed flutivate ointment & Tacrolimus ointment.But the effect is a bit slow.Pl. let me know how much time it takes for these spots to vanish or there is some other line of treatment that we can undergo.",
    "doctor_response": "hi; htere is limited treatment available for vitiligo as it is auto-immune disease ;it comes by itself please continue the treatment.keep him stress free & healthy ;he should improve evenif the effect is soww if it is positive continue the same. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hypertensive, stage 3 kidney disease, have Hashimoto. Feel tingling, shaking while sleeping. What to do ?\n\nI am a 67yr old adopted female.  I have hypertension & stage 3 Kidney Disease.  Diagnosed 2 years ago. I also have Hasimotos Thyroid Disease.  My thyroid & 2 tumors were removed in 1972. Since June 6 2012, during the night when I sleep I experience tremors, vibrations, pain?  They wake me up, & I experience tingling all over, pin pricks, shaking.  It only happens when I sleep at night.  On 3 occasions I've had to go to the ER.  I have been to an excellent Neurologist.  I  am taking Gapapentin at night, & I have had Sleep Studies, EEG, MRI's, (brain, spine) lab work etc.  Steroidal injections in my neck and face.  My bones feel week in my upper body.  No Parkinsons or MS diagnosed.  I'm really concerned, because I have 6 children & 24 grandchildren I want to hang around for a long time.  Do you have any suggestions?  I also see my hypertension & kidney doctor regularly & I have blood work ups done.  No one has any answers for me.  The Doctors just shrug their shoulders & I just deal with it.  Also my Parathyroid #'s are high.  I've seen an Endocrinologist for that.",
    "doctor_response": "hi,thanks for using health care magic.all the symptoms that u r suffering from are due to uremia, and use of steroid injection.this is y your parathyroid levels are high.take low protein diet,take adequate water.  consult u r nephrologist either for dialysis or renal transplantation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Unsteady on feet, having mini blackouts, ESKD, on dialysis. Need suggestion on medication?\n\nI am a nurse and have a patient who is unsteady on his feet and having miniblackouts. He has ESKD and has been on dialysis for 10 years. The medications I am concerned about are Lyrica 75 mg nocte, oxycontin 30mg nocte and cialis 5mg. I think the issue may be the lyrica as he sometimes takes double the dose at night. Any suggestions on how to manage this? He has quite severe peripheral neuropathy and chronic pain. tks",
    "doctor_response": "HIThank for asking to HCMI have gone through the history given here, I think your patient's main concern is blackout and unsteady on feet, If I would be doctor of your patient then I would reassess the case right from the beginning, I would stop all the medicine non of it would help the patient instead it may worsen the clinical condition, serum electrolyte has to be done in this case so we can manage the hydration, blood pressure should be under normal range, mean while I would put the patient on conservative line of treatment, vitamin supplements would be of great choice with good nursing care, such strategy gives good result, take care of your patient, any further question will be appreciated   bye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe pain in back and neck.   No use from muscle relaxants, microcid and vitamin d tablets.   Help\n\ndoc i m 32 years old and suffering from backpain and neckpain frm last 2 months.i visited many doctors and they gave  muscle relaxant bt of no use.few days back i went to ortho.my x-ray fr neck and spine was done.i asked him but he didnt tell me anything.he just gave me microcid and some vit D.its more than 4 days bt pain is still there.i am working woman but because of this pain i am not able to drive or even sit.[lz suggest",
    "doctor_response": "Hello,   Welcome at HCM.I have read details of your question.It looks that you are suffering from back pain since last 2 months.In case there are no other symptoms then please aslo check for following--If you are working for sedentary job for long hours then avoid that.This may lead to weakness in muscles of back & lead to back pain.-If you are working for long hours or frequently in abnormal position then avoid that.-Check for your habit for lifting heavy weights in abnormal position like with bending of back at ninety degree angle.-Check status of your bed .If this is too old or having slope in it then buy a fresh one.-Take the advice of a good physical therapist ,avoid too much analgesic.Hope this all will help you.With best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for tasteless tongue, neck pain, twitching eye and numbness in right side of face\n\nHey the past few days I've had a tasteless tounge I've had kneck pains my right eye has been twitching and up unittl I woke up this morning the right side of my face is not able to move you could say can't make any of the right side move I'm 19 and I need help?",
    "doctor_response": "Hello!Welcome on HCM!Your symptoms seem to be related to a peripheral facial nerve palsy or Bell's palsy. I recommend consulting with a neurologist for a physical exam. As your symptoms have started gradually (from a few days with taste changes) a brain MRI may be needed. Hope to have been helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dropping gums\n\nHi, may I answer your health queries right now ? Please type your query here...the other day when i woke up i went an looked at my teeth and i noticed that on my top left side of my mouth my gums dropped down all the way down to my bracket of my braces and i dont know what caused it and how to treat it...so can u help me out???",
    "doctor_response": "Hello,Thanks for consulting HCM, Read your query as you are undergoing orthodontic treatment now you have dropping gum see in this Orthodontic treatment oral hygiene is not maintained properly causing gum problem dont be worried so much I will suggest you to consult you dentist and go for oral prophylaxis and try to maintain proper oral hygiene , do warm saline rinses and do chlorhexidine mouthwash once daily .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for multiple ailments\n\nOn Tuesday my husband crame home from work with a dry cough.  About 9 pm I gave him Alka Seltzer Plus every 4 hours like it said to do.  Then on Wednesday I started him on equate for flu.  He has been bed ridden since Wednesday.  He has foamy diarrhea, and when he throws up it is  mucusy.  His joints aches severly, head feels like it is going to explode.  Couple of days ago severe cough and it felt like someone is stabbing him in the kidney, then it moved to him stomach (appendix).  But it only hurts when he coughs.  He had a fever of 102.1.  He sweat one time and then he is really cold.  He haas no sense of taste or smell.  He has only eaten about 5 handfuls of food since Tuesday and he has no strength.  He has been drinking alot of fluids, but it is never cold enough.  What can we do for him?",
    "doctor_response": "dear madam you must take him to the nearest ER and get him evaluated. its been a few days since he is not well and his symptoms are increasing to say the least.he need to be examined by a doctor and a proper diagnosis made.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can sitting for long hours at a computer cause chest pains and severe back pains ? What posture will help alleviate these pains ?\n\nAm 37yrs old,5ft 4inch tall,72kgm.a mother of 2 kids, ve bn having pains for sometime now @ d back of my right side which also affects my chest .ve bn working wt computer for about 15yrs now,I am responsible for processing of customers invoices.went to see doctor last month and ws told d pain is caused by d nature of work I do.",
    "doctor_response": "try out hot water fomentation twice a day. consult a physio try out these simple exercises. static back and static abs physio modalities will help you. back mobilisation by trained physio. follow these simple precautions: use a lumbar roll behind you lower back while sitting. avoid bending with your back rounded in order to pick up anything from ground.squat with ur knees and then pick up. while standing for long place one leg over a stool. when getting up from lying position turn on one side and then get up",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I deal with heart flutter and high BP?\n\nWent to my doctor today for a checkup. I had been experiencing heart flutters for the past few months. No shortness of breath, sweating, pain or cramping. Blood pressure turned out to be 190/90 and my pulse rate at rest was 41 which in itself is fairly normal for me. Never had high blood pressure before. He did an EKG and it showed a flutter while it was happening. The fluttering is constant.",
    "doctor_response": "HelloFluttering heart rate is indicative of rhythm disturbances and according to severity, type and quality it is being treated some time it may be temporary, underlying cause of it need to be found out with the high blood pressure, coronary artery disease need to be ruled out.Hope I answered your query, let me know for further assistance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes green stool in infant?\n\nHI DR I HAVE 6 MONTHS OLD BABY ,SHE IS PASSI;;;;;;NG GREEN COLOURED STOOL ,IAM FEEDING HER FORMULA MILK AP;TAMIL NO BREAST MILK ,NW I HAVE STARTED WITH RAGI AND BAN;ANA;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;",
    "doctor_response": "Thanks for asking but your question is not complete. Let me reassure that greenish stools are normal in children of this age. It occurs due to rapid transit of fecal matter through the large intestine and the bile does not get time to change to yellow colour pigment of stool. 6 months is the right time to start semi solids. You have done the right thing by starting ragi and banana. You can give any type of adult food in mashed form and low on spices. Introduce items one at a time.One possible reason for green stools is that your baby is getting too much foremilk and not enough hindmilk which often occurs when breast milk production comes down. The hindmilk provides most of the calories your baby needs, and makes him feel full. If breast milk is inadequate, no need to give formula milk; you can directly switch to semi solids.You can introduce:CEREALS & GRAINS: Rice-Barely-OatFRUITS: Apricots,Apples,Mangoes,Bananas  that you have mentioned Peas,Peaches,Pumpkin,Plums,Prunes.VEGETABLES: Sweet Potatoes,Acron/ButternutPeas,Green beans,Yellow squash.DAIRY: Plain whole milk yogurt.Hope that helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of welts on arms and legs?\n\nHi. I have welts on my arms and legs. I had a couple on my stomach too. After I scratch them is when I notice they are there. They just show up one by one randomly. I haven't done anything new. I use the same soap shampoo laundry detergent and haven't eaten anything that I am allergic too that I know of. They are so itchy so I can't stop scratching them. They start to scab a little. What's up with me?",
    "doctor_response": "HI, thanks for using healthcare magicUrticaria or hives refers to the formation of these welts on the skin. There are types of urticaria that can occur in response to the pressure on the skin or stroking the skin.This may the case for you.It is also possible that it may be related to a particular allergen.You may want to consider allergy tests to see if there is a particular allergen that is causing the reaction so that your exposure can be reduced.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will taking sovereign silver increase the immunity?\n\nMy sister is 54 and multiple medical problems, been wearing a morphine patch for at least 5 years... She says her back hurts??... Anyway now she has been diagnosed with mouth Thrush, and is spitting and vomiting up blood, really black she said, she is unable to eat also and in a lot of pain.  My question... would taking the Soverign Silver to build up her immune system? And doing away with any and all items that would feed the fungus candida? And also taking beef out of her diet .....this has to be in the esopoogus and stomach?  How bad do u think this is?",
    "doctor_response": "this is an advanced condition. she should be immidiately hospitalized and anifungal drugs should be started. diet is not a problem she can have anything she want. probably this is esophagal candidiasis. i dont thing without having a check up with a doctor she should go for any medicine like soverign silver.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of blurred vision and headache?\n\nHello Dr I am 27 year old man that has extreme fatigue weakness some blured vision on and off headaces on and off. I stay thristy alot Ive had som test ran and so far only thing that came back out of range was low testorone which was 243 also today I have had alot of sensitivity in my right nipple.",
    "doctor_response": "Hi,I understand your concern and would explain that your symptoms could be related to low testosterone levels. You should know that this hormone is necessary for a normal physical performance. I would recommend consulting with an endocrinologist on the above issue. Further tests may be needed to investigate for the cause and possible treatment options. I would also advice to closely monitor your blood pressure frequently during the day to exclude possible low blood pressure. Hope you will find this answer helpful. Let me know if I can assist you further.Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Infant has reduced activity in hand, brown patches on limbs. CT showed gliotic infarct. Possible cause and treatment?\n\nWhat is the clinical implication of CT finding of gliotic infarct involving parafacline right occipital lobe, left frontal lobe and right high parietal lobe with no evident abnormal idptomeningeal enhancement. She is 9 month old baby with reduced activity of left hand and brown patches on limbs . The possible cause and treatment if any? Thanks",
    "doctor_response": "Hi,Thank you for posting your query.The infarcts on the brain scan are old, probably they occurred in the intra-uterine period (before birth) and these findings can explain her hand weakness. As of now, she needs good physiotherapy and exercises. If her limbs are spastic (tight), then, Botox injections would also help.Brown patches need to be examined. If possible, please upload a photograph.In any case, the child would continue to improve as she grows.Best wishes,Dr Sudhir Kumar MD DM (Neurology)Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recommend treatment for chronic urticaria\n\nmy mother is suffering from chronic urticaria, and the doctors cant really predict what is she allergy of. Pass few years its worsening till she had throat tightening and breathing problem. What is the best treatment for this disease and who is d most experienced dermatologist in curing urticaria patients?",
    "doctor_response": "Hi,Having chronic urticaria is a problem to cure as there might be having multiple causative factors playing role.This can be due to internal allergy like worm infestation, some protozoal infection, diabetes, thyroid etc.External causes might be allergy to soap, detergent, perfume, duo, body wash, body lotion, clothes ,some foods, vegetables etc.By trial and error you have to find out the allergen causing this urticaria.Meanwhile you can give her Benadryl, Levo-cetrizine for few days.Go for one ati-worm medicine course.Rule out thyroid, diabetes.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Done semen analysis. Please explain\n\nin my semen analysis report following result is:- 1.GROSS EXAMINATION:- volume-1.5 ml color-Grey-White Reaction-Alkaline Viscosity-Normal Opacity-Normal 2.CHEMICAL EXAMINATION:- Fructose-Positive 3.MICROSCOPY:- sperm Count-90 million/cumm Motility(1 hr)-70 % Grading-15 % actively,40% moderately,15% sluggishly motile spermatozoa Pus Cells-1-2 Agglutination-Not seen 4.MORPHOLOGY:- Normal-90% Abnormal-10% Giant Heads-02% Pin Heads-02% Swollen Neck-02% Amorphous-04%",
    "doctor_response": "Hello, Welcome to HCM, I am Dr. Das. Firstly, the volume, color, reaction, viscosity, opacity all are within normal limit. Fructose positivity indicates a good prostatic function. Sperm count is within normal limit ( Normal is >20 million /ml as per WHO 1999). Now, motility. Though actively motile sperm is lower than normal ( normal is > 25% as per WHO 1999), but the total motile sperm is normal ( normal is >50% as per WHO1999). Morphology which is a most important point for fertility, is absolutely normal. Pus cells and others are within normal limit. So, overall, you have a normal semen analysis report. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of panic attack?\n\ni have chest pains and its hard to swallow went to emergency room last week and they said all results of blood work and x ray came back fine. i get lightheaded also they told me it could be panic attacks but worried because of chest pains and diffuculty swallowing.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Yes, possibility of panic attacks with anxiety disorder is more likely in your case. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You will need anxiolytic drugs too. Don't worry, you will be alright with all these. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for vertigo and dizziness\n\nHello..My question is concerning children at the age of 11. This boy was taken to Urgent Care because of being dizzy and vomiting. He was diagnosed as having Vertigo. Is this possible that a child of this age can have Vertigo. Thank you for your answer.",
    "doctor_response": "Hi there. Yes. Inner ear disorders can present with Vertigo and Nausea. Also certain brain disorders like infection, meningitis, tumors etc. He needs a thorough Neurologist checkup to rule out the conditions. Keep him well hydrated and we'll fed with healthy food. He may need CT Scan brain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the natural remedy for respiratory infection and fever ?\n\ni m 26/f, weighing 40kg, i can t take allopathy medicine .please suggest homeopathy hospital where i can be treated in delhi.i had water in my lungs & had fever since 10-15 days...",
    "doctor_response": "Hi The disease you are hinting at calls for very very regular treatment and never do the mistake of leaving allopathic medicines in between as this leads to resistence and then very few option are left while complications multiply. Medicines in all other pathies do exist but not worth taking a chance. You may wish or not this medicine is a must. No other option. dr_lakhanpaul@yahoo.co.in",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain, tailbone pain, buttocks pain, worse with cough. What is it?\n\nDuring last month pain in mid to lower back, tailbone, both hips esp. left near buttocks area, left mid femur; pain worsened with certain movements of left leg, certain sitting positions, and oddly enough pain in left rear pelvic/buttocks area worsens with cough and laughter. To my knowledge haven't experienced physical trauma.",
    "doctor_response": "Hi,From history it seems that there might be having muscle strain due to some unusual movement at back or lifting heavy weight and there is muscle spasm giving you this problem.Take analgesic with muscle relaxant medicines.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of getting pregnant after precum getting inside vagina?\n\nMy girlfriend and I had sex. She had been on the nuvaring for 7 days. We used a condom, but it broke and I withdrawled right away. I did not ejaculate, however we are worried about Precum. She took plan b 3 hours after just to be safe. What are the chances of her being pregnant?",
    "doctor_response": "Hello,Your girlfriend is currently on Nuvaring and she took Plan B 3 hrs after breaking condom. Here, chance of pregnancy is extremely RARE.She will get a withdrawal bleeding within 3 to 5 days and next cycle may be delayed for 1 to 2 weeks due to hormonal imbalance. However, she can undergo one home pregnancy test to clear doubt if her period is delayed more than 1 week.Good luck and practice safe sex in future.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for puffy foreskin on penis after having aggressive oral sex?\n\nHii doc i m 40 i had been oral with a girl for two years , she appeared to fine healthwise ,, now couple of days back i did aggressive sex with my wife. And now i notice my circumsized penis remaining forskin is puffy without any pain even while urinating and ejaculation no burning ,, i am wondering wht is it ,, could it be any std from that oral or aggressive sex gave me that puffyness and saggy skin",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have puffy foreskin after having aggressive sex with your wife.This is not STD as feared by you because oral sex never gives rise to STD .The puffiness of the foreskin is mostly due to friction during dry aggressive sexual encounter.You need to take broad spectrum antibiotic like Cefexine along with anti inflammatory drug like Diclofenac twice daily.along with topical antibiotic ointment like Neosporin twice daily.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bloating abdomen, back pain, ultrasound fine, no constipation\n\nHi, my lower abdomen is severely bloated for almost 3 weeks now. At first I thought it was PMS but its been over a week having finished. I am so bloated, that my clothes no longer fit me. I feel very uncomfortable, no bloating in other body parts...just my lower abdomen. Doctor thought it was maybe a cyst so she sent me for an ultrasound but turns out im fine but bloating is still there and now i have lower back pain. No constipation is present although I had an early period (about 5 days) when it is usually late . I feel a bit of pain, almost like a mild cramp coming from my hip area all the way down that comes and goes....I am 30.",
    "doctor_response": "hi, i have gone through your symptoms and i feel you need not worry.this is due to mild infection of instetine .please take Tab.pan-d orn tab pon empty stomch in morning,for 15 days,tab.MEFTAL Spas twice daily for 3 days, and probiotics(sporlac) for  15 days. if there is no improvement please attend your physician for further tests like endoscopy. bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain in forearm and wrist be treated?\n\nI ve been woken up by pain in right forearm for the past couple nights. It s not extremely crippling pain but it s enough to the potent where I can t ignore it and sleep through it until it s gone. I recently sprained this wrist and I m not sure if that has something to do with it.",
    "doctor_response": "Hello, Yes, you guessed it right. it is related to a wrist sprain. Due to injury at the wrist, there will be muscle wasting in the Forearm muscles which needs attention to regain the normal strengthening. As sprain in the wrist always makes the Forearm muscles weaker. Once done things should be fine. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for weakness,twitching and cramps in muscles of trunk and leg,and fast breathing and heart rate?\n\nHELLO, I HAVE CPK LEVELS THAT HAVE PEAKED AT 2900 AND CURRENTLY ARE AT 1585. I HAVE SEVERE MUSCLE WEAKNESS PARTICULARLY TRUNK AND LEG MUSCLES. I ALSO HAVE MUSCLE TWITCHING CONSTANTLY (LEGS TRUNK GLUTEALS ARMS) .ALSO THERE ARE SEVERE MUSCLE CRAMPING WHENEVER THE MUSCLES HAVE TO DO ANY TYPE OF HEAVY WORK RESULTING IN PAIN IN THAT PARTICULAR MUSCLE. WHENEVER I DO ANY TYPE OF MODERATE TO HEAVY EXERCISE SUCH AS SHOVELLING SNOW OR USING A CHAINSAW TO CUT FIREWOOD MY BREATHING AND HEART RATE INCREASE SUBSTANTIALLY AND I BECOME VERY WEAK. I HAVE BEEN EXPERIENCING THESE SYMPTOMS FOR 2 YEARS NOW. I HAVE BEEN TESTED FOR ALS, I HAVE HAD A MUSCLE BIOPSY(RIGHT THIGH) BOTH WITH NO ABNORMALATIES SEEN. THIS CONDITION?? IS STARTING TO BECOME DEBILITATING . the second character in my email address is the number 0",
    "doctor_response": "Serum CK levels, along with careful physical examination, may be used to monitor myositis Other muscle enzymes that may be elevated include the following:Lactic dehydrogenaseAspartate aminotransferaseAlanine aminotransferaseAldolase - In practice, usually only the CK and aldolase levels are determined. occasionally cpk levels may be normal because of patchy involvement. Although there's no cure for polymyositis, treatment can improve your muscle strength and function. The most commonly used medications to treat polymyositis include:, Corticosteroids, RituximabPhysical therapy. A physical therapist can show you exercises to maintain and improve your strength and flexibility and advise an appropriate level of activity.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to improve energy while having bipolar problem?\n\nhi doctor,i am a  47 year old male with severe bipolar,is there anything i can take to boost up my energy,no matter how much sleep i get i am still very tired and cannot do my daily routines,i am just wiped out all the time,is there anything i can take to help,thank you, steve",
    "doctor_response": "are you taking any medicines for bipolar disorder? sometimes they can cause reduced energy. if you feel low mood you can take antidepressants prescribed by psychiatrist to remove depressive phase. you can take multivitamins like rechamp gold to feel more energetic. some physical exercise will also improve your condition.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for anal itching\n\nHello. I have been having anal itching at night for the past week or so. It feels as though something is crawling into/around my anus. I sometimes notice trace amounts of blood on my toilet paper after wiping, but this hasn t increased in the past week. I got back from working with children in China six weeks ago. What might be the problem? Thanks for the help.",
    "doctor_response": "Hello,This is Dr. Klarida Papaqako answering your question.Anal itching is usually idiopathic, probably contact dermatitis.Other dermatologic disorders may be lichen planus, lichen sclerosus, psoriasis, seborrhea, infection - fungal (Candida), herpes, condylomata acuminata, pinworms, scabies or anorectal disease - fissures, fistula in ano, proctitis, prolapsing hemorrhoids, skin tags, sphincter dysfunction.Treatment is decided according the cause which need a doctor examination of the area.Meanwhile I would recommend:-- avoid any foods which appear to aggravate condition (for example, caffeine, spicy foods, citrus fruits)-- avoid perianal irritants (any creams or other care products that may be causing irritation, excessive cleansing with soaps, excessive rubbing with toilet paper or wash cloth)minimize moisture in perianal area (wisp of absorbent cotton in anal cleft may help keep area dry)--hydrocortisone 1% ointment, once-twice/day appears to reduce symptoms of itchiness.Hope this helps,Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat anal worms that cause pain / itching in a diabetic?\n\nHi, I m a 15 year old girl who has typr 1 diabetes (since I was 7). Recently I ve been experiencing really bad anal pain, it keeps itching-especially at night. Last nigt I found a white worm in my anal area. It s causing me to have restless nights. I don t want to go to my gp, a chemist nor my mum. Please help, thanks xx",
    "doctor_response": "Hello, Thnx to contact us. I understand your concern. If I am your doctor I advice you you should start with Albendazole tablet 400 mg. Since its anti helminthic drug all your drug will be killed in single dose. But if it is not getting cured in single dose I advice you to take the another one tablet. I will be happy to answer more of your concerns, kindly know me,Wish you a very good health at health care magic. Dr. Arun Tank. Infectious Disease.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have allergies. Ephedrine and sudafed. Is medication correct?\n\nI am cleaning out my medicine cabinet and I found these pills with the imprint of GFL 25. So far, I found they may be in the ephedrine category. I have allergies, so I am guessing they are probably comparable to sudafed or actifed. Could you confirm? I have thrown out the box for more room, so I am marking them with a marker what they are for. Thank you, Reina",
    "doctor_response": "Hi Reina, Thanks for using HCM.Since you don't have the cover / label of these drugs and these drugs are open, I advice not to use these drugs. They may be any drug, might have completed the expiry period. If you require any drugs then buy it from your drug outlets. Also I advice you not to store medicines for longer days as they require different storage conditions like temperature, light etc. So buy new required drugs.Hope this clarified your doubts.Wish you good health.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can fibroadenoma with cyst BI-RADS 2 to 3 lead to cancer?\n\nHello doctor, My mother aged 49 years old was diagnosed with a fibrocystic disease of breast seven years back and was subsequently operated. Since then, she has got a cyst in both breasts. Last year, she was got USG done, and the doctor found fibroadenoma along with cyst BI-RADS (2 to 3) in the left breast. The doctor asked her to review after 6 to 12 months. Recently, she discovered a lump in her left armpit which is small and can be felt only after touching. Is it anything serious? Also, please tell that does these diseases cause an increase in chances of breast cancer. She also has a fibroid in the uterus, and for that, the doctor prescribed Sevista 60 tablet twice a week, and he said that fibroadenoma would go after taking Sevista.",
    "doctor_response": "Hello. Based on the report (attachment removed to protect patient identity), fibrocystic disease of breast and fibroid uterus, both of them are due to hormones, mainly estrogen. When using Sevista (Ormeloxifene), the fibroid in the uterus will decrease. For breast condition, BI-RAD 2 to 3 means it is was a benign (it can regress) condition (not cancer). Treatment depends on menopause. If she has not attained menopause, then she has to use Sevista. If she has attained menopause, after some time, Sevista can be stopped. With menopause, the fibroid can disappear. Fibrocyst of the breast may persist, but malignancy is very rare. At present, no need to worry. Frequent six months or yearly once monitoring with ultrasound is enough. Further treatment depends on whether she had excessive bleeding (menstruation), her calcium levels, family history of breast or other cancer. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the lower back, diarrhea. Are these related?\n\nA few days ago I pulled my lower back at work, for the first day and a half it was pretty painful, sort of like when you wake up with a kink in your neck , that pain. The pain has now mainly gone away, I only really feel it in the mornings when I wake up. It s almost as if, once my lower back muscles are not in use they cramp up. Today though, and all last night, I have been experiencing frequent watery diarrhea . Just inquiring if the two are related and what I can do about it. Thanks.",
    "doctor_response": "well these 2 seem to be un related , early mornig stiffness or back ache is first sign of disc disease you need to see aneurospinal surgeon. Pain due to diarrhea doest last long and is generally in front side",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce hypertension blood pressure?\n\nMy mother age 51 yrs suffering from hypertension BP 190/90 mm hg She takes Losar 50, Stamlo 5, Metolar XR25, Dytor 10, Ecosprin 75 daily for the last 3 yrs. Inspite of taking so many medicines she suffers from muscle cramps, throbbing sensation, palpitation, talks on religious matters, maniacal, repetitevely talks on same matter I'd like to know if on holistic approach a single medicine can cover the whole symptology and gives her relief",
    "doctor_response": "Certainly one would check out simple blood tests to monitor potassium and magnesium and kidney function all of which are likely to be affected by HTN treatments.Weight loss will lower BP if someone loses about 10% of their weight. BUT it only lowers it one notch (lowering one or dropping ONE medicine not all of them). However, although these medicines are all good, AND if one has heart problems there are GOOD reasons to be ON ALL OF THEM, if there is JUST blood pressure as the only problem,generally we would go at a high dose of ONE before adding a SECOND and none of the medicines are at their highest doses.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could swelling in lower neck be related to FNAC report suggesting tuberculosis?\n\nI have noticed swelling on the right side of lower neck around 15-20 days back.  The FNAC report is strongly suggestive of Tuberculosis. Can you please let me know if I can start the treatment? I need to know when the treatment starts, how can I come to know that I am relieved from TB and when my nodes will heal? Also let me know the precautions to be taken and how can I start my treatment. Whether this is infectious? And what are the reasons for this disease.",
    "doctor_response": "Thanks for your query at HCM!According to me you are suffering from tubercular lymphadenitis infection. As your FNAC report also suggest the same. Absolutely it is high time you start the treatment with first line anti-tubercular drugs isoniazid, rifampicin, ethambutol and pyrazinamide with pryridoxine. You may get registered if centers for treatment if provided in your country like DOTS in India where you get free treatment. You might have to undertake repeated aspirations for swelling if it persists and send sample for ZN staining and culture for AFB and sensitivity test for the same. There are special tests like Hains which can be ordered at that time for genotypic testing from aspirate.Yes this is infectious you need to take precautions and follow hygiene practices. After 2 weeks post treatment you will become non-infective. The reasons for the disease is living with a person suffering with TB or you may have contracted it through coughing by infected people who commonly move in public places. Sometimes latent TB gets activated with declining immunity. It is curative, so don't worry. strictly adhere to treatment of long duration to avoid emergence of drugs resistant mutants which can complicate your case and life-threatening.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "High blood amylase level, low platelet count, severe stomach pain. Was treated for H.Pylori, stomach acid, amoeba. Treatment?\n\nYoung man 22 years old in Kenya has high blood amylase level 232, and low platelet count 120,000.  Has been experiencing what he considers severe stomach pain.  Only a few spoons of food and he can't eat more.  Mostly just drinking tea with milk (chai) at this point.  His stomach was checked out with a scope and everything was found normal.  He has been on a treatment for H. Pylori, before that high stomach acid, and before that for ameba.  However the pain and his condition seem to be getting worse.",
    "doctor_response": "dear welcome to HCM ....if the pain is not subsiding,then repeat S.Amylase ,as this rise may be due to acute pancreatitis ...also go for an abdominal U/S .....to exclude biliary diseases...treatment of acute pancreatitis is nothing per oral,i/v fluids,and antibiotics....consult a gastroentrologst if still not improve...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have recurrent fever, abnormal SGOT and SGPT count. History of IBS. Dengue?\n\nHi i have mild fever since last 2 months it is coming like 2 days it is there then relief for next 2 days then again it comes. I had a liver test having my SGOT = 55IU/L and SGPT = 68 IU/L, and i had platelets count = 1.1 lacs.i had fever along with fever. i had IBS also. Please suggest me some advise to control my SGOT and SGPT and platelets count. As i am worried that it may cause of Dengue.",
    "doctor_response": "Thanks for choosing HCM.You are advised to go for further investigations like cbc,qbc,urine,rbs,s.bilirubin,dengue igg/igm to reach the diagnosis.Only low platelet count suggests some viral fever.You can take paracetamol round the clock to subside the fever,cold sponging will be helpful during episodes of fever.Increase liquid intake is the remedy for any viral fever.Drink more water,lemon water,coconut water,fruit juices.Avoid spicy,oily food. Simple high fiber diet is ideal for  ibs. Take b12,vitamins,minerals to boost up your immunity.You will get recovery within 7 to 10 days after proper management under guidance of your physician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having pain in one particular teeth. What is wrong?\n\nThere is a pain in not any of my teeth but just one in particular. I just got checked a week ago & i was told my teeth are fine. No cavities. & i just got a palate expander about 5-6 days ago. I know it causes pain but no other teeth hurt but that one. It also kind of stung when i used toothpaste & mouthwash . Is there anything wrong with just that tooth?",
    "doctor_response": "dear friend. thanks for sharing your concern. The reason being that either your palate expander is causing impingement on that particular tooth or there could be gingival (GUM) recession and root exposure on that particular tooth. Do you have this problem in your anterior(front) teeth or posteriors(back tooth)?As the canines and premolars,have long roots and sometimes gets exposed due to gingival gum) recession. i would suggest you for a revisit to your dentist and get it examined for any tissue  impingement or recession of gums.further it can be managed hope this helps. thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Underwent bladder surgery before 20 years but could not control urine sometimes. Why?\n\nHello doctor, My brother having a problem. When he was 3 years old he underwent an operation in the bladder. I have attached all the summary for your reference. Now he is 25 years old, still, he cannot control the urine for sometimes. Could you please suggest what we can do for this? Please help.",
    "doctor_response": "Hi. I have read through your query in detail. Please find my observations below. Your brother was treated for a tethered cord with a lipoma in close proximity to the cord at the sacral region. It means that he had a fat-containing tumor in the lower end of the spinal cord. These are birth and developmental problems that cannot be completely treated. At 25 years of age, he can get another MRI (magnetic resonance imaging) scan of lower back done and discuss it with a neurosurgeon if there is any persisting area where there is pressure on the spinal cord or the nerves. Usually, if any pressure effect on the nerves or cord is present now then they can think of releasing the pressure and this might improve his symptoms. If his condition is not possible to be treated after discussing and doing an MRI scan then the only way is to pass urine at regular intervals and avoiding an over distended bladder.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe pain on the wrist with osteochrontitis\n\nwell i was gardening today using a shovel and now i have a shooting stabbing pain in my wrist every few seconds and its enough pain to make me stop and near enough cry and i cant put any weight on it i have osteochrontitis in my elbows, i dunno if it has gone to my wrist or not",
    "doctor_response": "HiI have gone through your question and I think at this moment you can use over the counter pain medication and rest your wrist. you could also use some ice on it. I am not sure whether you are talking about osteoarthritis or osteochondritis in your elbows. osteochondritis is a defined entity and doesn't usually affect more than one joint in the same person, Osteoarthritis however affects older people and can affect more than one joint at a time. I hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for heavy contractions,nausea,vomiting and hardness in stomach\n\nI am 36 Weeks and 2 days pregnant. Dialated at 2 and 60% effaced. I am having heavy contractions and cramping most of the day and it stops. Today has been consistant with contractions about 8mins apart...but now has slowed down. When it does slow down I get nausea or throw up. Can't sleep, everything is hard from my stomach to my breast. Is there something I should do?",
    "doctor_response": "HI,    I understand your concern.    From your symptoms you seem to be in labor.. as you are vomiting , you need IV/ IM injections to control your symptoms & also facilitate progress of delivery.     You should go to  ER.     Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal for 4 month old to wake inbetween at nights?\n\nHi, my self Narendra, My son 4.5 months old, he is quite growing good and does not cry or some thing in day time. But when it comes in night times, He normally sleeps for one or one and half hours and gets up and then his mother has to feed him milk and then he sleeps for one or one and half hours and that s how night goes. I am really not understanding why it is happening to him. Also when he gets up, he rolls himself on stomach and tries to sit and starts crying until unless him mom does not feed him milk. I just want some suggestions whether he is OK or any thing wrong that we are not able to understand that he is probably feeling or so. Even we went for his vaccines today and consulted doctor about the same and doctor says that it s OK and baby does not have any problem. But only question I heard that if baby does not take long sleep in night than it affects babies growth. Is that correct? Looking for some good response on this. --Narendra",
    "doctor_response": "DearWelcome to HCMWe understand your concernsI went through your details. The sleeping behavior your child shows is quite normal. Your doctor said this is normal. \"Sleeping through the night\"is not achieved by babies almost before 12 months. The sleep pattern you here is the ideal one for the child. Because the child is sleeping almost for around 15 hours day, because the child is taking liquid diet and therefore it digests fast and it needs replenishment etc the child often asks for food and then the sleep breaks. Nothing to worry about this.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should i take LIV 52 tablets?\n\nHi Doctor,I am 33 old male, recently i had abdomen pain , diagonise with the doctor he confirm its a food posion need to take few medicine. Also i have taken abdomen scan everything its normal, but liver shows fatty. doctor advice me to take liv 52 table.Kindly advice LIV 52 tablet should be continued and how long . Provide your advice regarding.",
    "doctor_response": "fatty liver is a finding that is very commonly found these daysyou may take liv 52alternatively, you can avoid it and maintain a good diet and exercise wellfor fatty liver avoid alcohol and drugs/medicinesudiliv 300 twice daily is a better option if you do want to take a tablet",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for redness on penis and testicle\n\nhi my 18 month old bay has very red testical and is red at the of his penis i have used all nppy creams but is not helping it is bank holiday and will not be able to get a doctors appointment till about tuesday should i take him to hospital thanks you nicola",
    "doctor_response": "Hi,When did the problem start? Is the testicles painful to touch? Any itching there? If not of sudden onset, there is no fever/discharge from penis/pain over testicle, we need not worry, this may suggest candidiasis(fungal infection). After confirming the diagnosis, this can be treated with anti-fungal creams like clotrimazole. In this case, you can wait for the appointment. Meanwhile, keep the area clean and dry. Frequent wetting exacerbates the condition.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam T. K., Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy if half of an ipill is taken after having unprotected sex?\n\nHi Sir,I am married and I had unprotected sex a week before. We are still not ready for child. I had my periods on 30th of last month. I took Ipill not a complete one but half of it. Are there any chances of me getting pregnant. I am really afraid as I did not take one complete Ipill also.",
    "doctor_response": "Hello and welcome,I completely understand your situation. Unfortunately half the I pill may not provide complete protection. Just check which day of the cycle it was. Days 10-20 are fertile [counting from day 1 of periods]. Rest of the days are not likely to be fertile so chances of getting pregnant are less if sexual contact occurs on other days.If it was on fertile days, the only option now is to wait for your periods. If they come, you are safe, if they are missed get a pregnancy test done after 7-10 days to rule out pregnancy. Hope this satisfies your query. Thanks for using HCM.\u00a0\u00a0\u00a0\u00a0\u00a0Feel free to ask any more questions that you may have. Dr Madhuri BagdeConsultant Obstetrician and Gynecologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take antibiotics for repeated cough and cold?\n\nHi, My son is 3 yrs old,he is suffering from troat infection, doctor gve him clavam bid dry dyrup.Is this work and i want to know is antibiotics are good for health.My son get suffered from cough n cold frequently n i have to give him antibiotic is it good for healt,his immune system is also weak.what to do",
    "doctor_response": "Hi....By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze. I have a few questions for you -Questions:1. How many days per month does she cough or feel breathless?2. How many nights per month does her sleep get disturbed due to above symptoms?3. Does she feel breathless when she runs around or plays with other kids?4. Are the symptoms when there are seasonal changes?5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?6. Is the cough always associated with fever?If your answer is yes for any of the above questions, your kid might be having viral associated wheezing or multi triggered wheezing and I suggest you meet a paediatric pulmonologist who is near your place. No point in using antibiotics every time. It will do more harm than good by increasing bacterial resistance.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for pimples on scrotum\n\nHello sir I have a white pimple like thing on my scrotum .I have 3 pimple of which one is large one .it is been there from almost 2 years .I don t face any problem because of the same.I though it will go by its own but they are stable in size and shape....sir pls give ur suggestion for I am very worried about the same.....is it any std? And is thr any home remedy....?....pls reply sir ...thank you...",
    "doctor_response": "HelloThanks for query .Based on your statement it seems that you have 3 lumps on your scrotal sac since 2 years .These are most likely to be Sebaceous Cysts The scrotal skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin.Normally they fade away without treatment however they need to be treated if increase in size or get infected.Start taking broad spectrum antibiotic like Cefixime along with anti inflammatory drug like Diclofenac twice daily for 10 days .If problem persists consult qualified General Surgeon for clinical evaluation and further treatment.You may need to get the bigger cyst excised in Toto under local anesthesia.Dr.Patil..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could redness of skin with spots on newborn s skin leading to death be significant of?\n\nMy baby died two days after birth. His body gets extremely red 6 hours after birth and converted into red spots. his weight was 5 lb. it was 3 weeks preterm birth due to lake of water. what should we care for next baby....and when should we plan for next baby!!!!!",
    "doctor_response": "Hi,Thank you for asking question on health care magic.The red colored spots may be due to capillary fragility because of preterm delivery.You may go for next pregnanacy whenever you wish.Be under supervision of a obstetrican right from conception till delivery.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for chicken pox and sore throat?\n\nHi doc...i am 28 years old, 60 kgs., and medium built..I have chicken pox for about 3 days..blisters are now coming out and it is itchy and painful..i also experience soar throat and loss of appetite.  what medication (medicine) shall i take for my fast recovery? what foods should i take and avoid? ty for immeasurable help...i'll wait for your reply.ASAP pls.",
    "doctor_response": "Hi,As you are a healthy young individual, I recommend that the chicken pox disease will cure on its own.I advise you to avoid any medication as this is a viral disease and will not be treated by antibiotics.You just need symptomatic treatment, avoid contact with other individuals who have had no history of the disease.In case the spread is rapid, you can try Tab. Acyclovir after consulting with a GP.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take amlong instead of stamlo for blood pressure?\n\nI was taking amlong 10 mg along with other drugs for high blood pressure.My pressure  was 80/120 then.my doctor for no reason deleated amlong and put me on stamlo 10, now my pressure reads as 100/170 and my feet get swelled up by evening.my doctor is away on holiday. is it alright for me to get back to amlong 10 instead of stamlo 10.please reply as i am due to go on a trip tomorrow. thanks Shyamali.",
    "doctor_response": "Hello, Thanks for using Healthcaremagic. i can understand your problem,but amlong and stamlo both contain the same drug AMLODEPINE just different manufacturers. the problem of swelling of legs by evening is due to hydrostatic edema wich is a common side effect of amlodepine. the edema increases by evening and decreases with rest or elevation of limb. kindly change AMLODEPINE to CILNIDEPINE 10 mg which does not have this side effect. other cause of edema like failing heart needs to be excluded before attributing the cause of edema to amlodepine. so you need to consult your doctor for clinical examination and if necessary 2Decho. hope this helps...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes growing sore on arms?\n\nmy 6 year old daughter had a sore appear 5 days ago on her arm that looked like a mosquito bite. however it started to get bigger. i showed a nurse who thought it was a spider bite so we covered it for a couple of days. i took off the dressing tonight and found it had tribpled in size and scabed, but smaller little blister like sores have appear around the original sight. A couple of them have oozed clear fluid from them. it has been suggested also it could be school sores but i have read that they have a yellow crust and that they ooze yellow fluid this is clear. can you help me.",
    "doctor_response": "Hi,It seems that there might be having some local allergic reaction due to insect bite producing blisters and now oozing.Clean local part with warm water and apply triple action cream for 2-3 days.Oozing blisters will healed up.If still infection persisted then she might require one course of anytibiotic medicine.Give her Benadryl or cetrizine syrup for 2-3 days.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Blackheads on nose, pus filled pimples on forehead. Cure?\n\nHello. My face usually in the January, I ve clear face. With blackheads on my nose and pimples on my forehead . But recently, in this two months, I ve a sudden breakout. When I woke up, my face popped up with a few reddish pimple that is beneath my skin. I m worried, and the breakout became worst. And now my face is filled with acne that s beneath my skin and cause reddish acne scare. There s only two or three box pitted scar. And the pus that comes out from it is yellowish liquid, and with some kind of smell. I m worried, please reply. Thank you. :)",
    "doctor_response": "Dear Mel. there is nothing to worry about. You have a n acne & excessive sebaceous discharge associated. There are different remedies from topical & systemic antibiotics use to more definitive systemic isotretinoin therapy. However, you do need to visit your local dermatologist to be assessed in person & the treatment will depepend on various factors including cost & side effects et al. There is no need to be worried & treatments nowadays are designed to get rid of your problem & one may resort to lasers too if so deemed necessary. Regds & keep the faith..all will be well soon.cheers",
    "dialogue_context": ""
  },
  {
    "patient_message": "What prognosis is recommended for this chest CT scan result for signs of TB?\n\nI have had a year long plague of pneumonia with reason not found . An opacity in chest right upper lobe was found . Two bronchoscopies and one needle biopsy yielded no results .. although my symptoms were fever , weight loss , shortness of breath and cough that doesn t stop .. TB tests were negative ..No specific bacteria or fungi found during this time. They diagnosed this to be lung abcess and finally docs suggested me augmentin for several months which did kill all the symptoms but the mass in my chest would not go away completely .. surgery was advised and they were going to do a lobectomy but ended up doing a wedge resection .. now after a month of healing from this I m still having same symptoms and a CT still shows a mass or opacity in the upper lobe (right) . Doctors are suggesting a full lobe removal but my point is I have been through this once with no results .. what are the chances that this is a misdiagnosis and I have TB .. should I take a second opinion and treat for TB ?",
    "doctor_response": "Hello and Welcome to 'Ask A Doctor' service. I have reviewed your query and here is my advice. Yes, you should definitely go for second opinion. Recurrent mass like lesion on upper lobe is mostly due to 1. Tuberculosis. 2. Lung cancer. So empirical anti tubercular drugs should be started first. No harm in taking TB treatment. If mass is improving then no need to worry for cancer. But if mass is persistent then possibility of cancer is more likely. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat cancer of 1.5cm in the liver?\n\nMy friend has just received results.  Has breast cancer, now  the cancer has developed in the hip and 1.5 cm in the liver.  Re. holistic medicne  they suggest a small caful of hydrogen peroxide each day.  As this would put oxygen in their blood it infers that it would slow down the growth.  Is it also true that cancer cannot live in an alkaline body?  I am not sure if you can answer these questions, as I know most Doctors may not believe in alternative therarpy. kind regards Kelly Appleby",
    "doctor_response": "Welcome to Healthcare Magic.....Your friend has advanced breast cancer with disease that has spread to the liver and bone...She requires chemotherapy...There  is no evidence currently for suggesting alternative therapy for treatment...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does sympathetic stimulation causes vasoconstriction if the liver is congested?\n\nHi, (22 male here) I took a B6 supplement for the first time (50mg) and afterwards experienced a tightness in the chest and after 12 hours, it's still somewhat there but subsided mostly. It's not painful but just quite tense/tight, is this common after taking b6. should I do anything about it immediately and is this likely to happen again if I took it another time?  Only thing I could find that I think fits is:'sympathetic stimulation causes vasoconstriction if the liver is congested'",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, the symptoms of tightness of the test is not because of the vitamin B6 neither it could be side effect of it, but it could be some else and most of the time it could be hyperacidity, what you have the information is not fit for this, if it is the hyperacidity then it can be given try with Tab Omeprazole 40 mg once in day ( Hyperacidity could be drug induced)  hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is slow rising HCG level during pregnancy a matter of concern?\n\nHi I had my LMP on 14/3/18. On 12/4/18 I had my first beta hcg test and the value came as 35.75. Again on 16/4/2018 I had my second beta test and the value came as 84.05. Again on 19/4/2018 I had my third beta hcg test and the value came as 245. 4th hcg test I had on 25/4/2018 and the value came as 715. Today again on 28/4/2018 I had my beta test and the value came as 946. The hcg is not doubling but rising slowly. Is it normal . Is thr any thing to worry. I had an ultrasound also. In scanning we saw a 3mm gestational Sac. The gestational age was 4 weeks to 5 weeks.",
    "doctor_response": "Hi there, I have understood your concern and I will suggest you the best possible treatment options.Please don't panic.There are many reasons for slow rise in blood beta HCG levels. Delayed conception is most common.I will suggest you to get USG done after 2 weeks to assess gestational age and viability of pregnancy. Instead of repeated beta HCG tests it's better to get USG done after 2 weeks.Please seek prescription support from your treating doctor for Tablet Natural micronized progesterone twice a day for 2 weeks.I hope this answer helps you.Thanks.Dr. Purushottam Neurgaonkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can collapsed lung cause lung cancer?\n\nCan a collapsed lung occur due to lung cancer?  They are saying that they think my grandfather has lung cancer, yet no tests have come back positive.  Today they told us that his left lung was collapsed, yet they aren't doing anything about it.  Is that normal?",
    "doctor_response": "HiYes it might be vbut for discovering it a chest CT and a Fibrobronchoscopy should be done. Regards Dr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could this white thick glob discharge be a mucus plug?\n\nI just used the restroom and passed a white glob it had no blood or anything it was completely white..i am 34 weeks and 3 days pregnant and was wondering if this was my mucus plug... also me and my boyfriend just had intercourse could it be sperm that came back out?",
    "doctor_response": "Hi,   I have gone through your query & understand your concern.   Mucus plug is thick mucus sealing cervix throughout pregnnacy & protecting it fro infection. Discharge of mucus plug indicates starting of opening of cervix. It may take few hours/ days or weeks when labor sets in after mucus plug discharge.    Usually when the delivery is in near future.. mucus plug is pinkish/ blood stained when discharged. AS you say, the semen along with sperms & vaginal mucus  can similate mucus plug.   So if there are no increased contraction/ pains.. you need not be scared & rush to your doctor. Continue your routine as usual/ special care for genital hygiene & avoid sex. You can inform your doctor about the incidence while your next pregnancy check up.   Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have skin allergy. Have red rashes, swelling in skin in hand. Itching. On montek LC for epilepsy. Suggestions?\n\nHi sir , i am having skin allergy , after taking any food i am getting red rashes and swelling in skin especially in hand it is itching too much , my doctor suggested me to take 'montek LC' tablet after taking that i feels normal , once i stopped problem getting started again and also i am taking medicine for epilepsy along with montek LC , please give me some suggestions on this problem sir .",
    "doctor_response": "Hi this clearly suggests that you are suffering from allergy. Since red rashes, itching and swelling is more in hands I advice you to wear full sleeve cotton dress and glouses to avoid any contact with allergen, daily wash your dress with hot water and sun dry them. Also the area you are staying should be dust free. With these you can continue montelukast 10 alone without LC every day and levocetrizine only when required(For symptoms). You can apply topical mometasone cream, this will help you in preventing the rashes to occur.Thhe permanent cure is to avoid allergen and if not possible get done skin prick test to find the allergen and then sensitization therapy/immunotherapy can be given.Hope this is more informative and helps you in management.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough\n\nI have got this really irritating persistent, tickly hacky cough and have extremely bad coughing bouts. with a slight whistle each time I cough. Feel slight tightness during coughing but ok when coughing has seized for a while. It does help when I have either hot water to drink or cold water However it is most persistent at night. More or less at the same time each night It isn t as bad during the day time However first thing in the morning I do cough up Phlegm but I have also a nasty taste in my mouth only when coughing first thing. Had wisdom teeth out in march time also. I have been a smoker in the past but now I am an ex smoker for at least two years now I was wondering if this could be simply clearing my lungs out?",
    "doctor_response": "HIWell come to HCMAllergic bronchitis may be likely cause of cough, if this is more than couple of weeks then this need to be investigated for underlying cause rather than allergy, and x-ray study of chest and routine blood test is advisable, till then following medicine can be tried 1) Tab Loratidine with pseudoephedrine three times in daytry some pure honey at bed time, stop smoking, hope this information helps, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes weak and white pubic hair?\n\nI need help but im too embarassed to go see a doctor in person.  I am 17, male, unknown on height around 6ft i think, i weight 113 and i dont know much about my medical history(sorry).  but i um have yellow/slightly white hair on and beside my scrotum/balls and i have tried to pull them out but they are for some reason weak and break into two.  I am afraid that i have an infection or fungus but as i said before im too embarassed to go see someone in person to talk to. please help me! give me some advice or treatments, something that i can get rid of it without going to the hospital and feeling embarassed to talk about this with my mom and dad in the room or to anyone else. p.s. sorry for the spelling and lack of medical history.",
    "doctor_response": "hellothank you for trusting HCMdear until examination done it is difficult to day what is the reason. it may be due to infection or vitiligo or White piedra or public lice etc..please consult your dermatologist he/she will examine and treat you accordingly. I think I answered to your question if you have more questions feel free to ask.take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have irritability, anger, and mood disorder inspite of having medications. Why?\n\nHello doctor, I am suffering from irritability, anger, and mood disorder. Now I am taking Qutan 25 once at night, but the improvement is not good. Please help.",
    "doctor_response": "Hello. I understand it must be difficult for you. But it would be helpful if you could elaborate more about your irritability and anger, i.e., since how long you have had this problem. Do you get irritated due to some reason or nothing at all? Why exactly would you say you have a mood disorder? Is your mood too low or too happy? How are your sleep and appetite been? Do you have any other medical illnesses along with this? You are taking Qutan 25 mg. Has it been prescribed for you or you have started on your own? With this dose of Qutan, you may sleep better and feel less anxious. But it is not sufficient for your irritability and anger. Please let me know the details of your problem to help you better.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had bleeding after tonsillectomy, got operated and wounds stitched. Had more bleeding which clotted. Suggest?\n\nHi, I'm in Day 13 of a post tonsillectomy.I bled both on the 2nd and the 4th day. Had an op to stop the bleeding and the wounds were stitched up. I've had a couple more bleedings which clotted and stopped after a while.1. If the scabs continue to come off, and a further op is needed to stop bleeding. Will my body still be able to manage being put to sleep again?2. Will there be any bleeding, when the stitched come out?",
    "doctor_response": "Hi,Once stitches are taken chance of having bleeding is less.to avoid spotting of blood do not gargle, avoid hard stuff eating and do not try to expel cough or mucous forcefully.At the time of removing stitches chance of bleeding is rare due to healing of wound.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause extreme mood swings?\n\nmy mood goes from low to high to low again in a single day. do i have a bipolar? I can be really happy and full of excitment and i can get these great ideas in my head then my mood changes and all the happy things i was thinking before dont seem possable and dont interest me anymore.",
    "doctor_response": "HiThanks for using healthcare magicMood swing is part of bipolar disorder, but on basis on only mood swing, psychiatrist can not diagnose bipolar. If you have another symptoms like sleep disturbance, increased psychomotor activity, grandiosity etc, than you can have bipolar disorder. Better to consult a psychiatrist and get your mental status done. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I sense an evil entity in my room?\n\nHi. I am 18 years old and recently I have had difficulty with sleeping. I have this problem for over a year now...It usually happens when I am about to fall asleep I get a feeling that there is something in my room that I can only describe as evil and wants to hurt me. Sometimes I am unable to move (this is not always the case) and have an intense feeling of fear. I have also heard this thing in my room whisper my name and sometimes whispering. I have also felt a pressure on my mattress and something touching me. This has also happened to me when i woke up from sleep. This has happenes to me before when I was around the age of twelve...I can t talk to it about anyone not even my own GP incase they tell me I think I m crazy or imagining things. I am now afraid to go to sleep and am also extremely tired during the day even when i do manage to get some sleep. Please help me. S.",
    "doctor_response": "Hi chemicalcheez, I am NOT starting out telling you that you are crazy.  Although I am not familiar with parapsychology, unexplained phenomenon occur daily.  So, I am not going to attempt to puzzle this out. I will state, there are certain medications (prescription and illegal) that can induce these symptoms.  Also, if our brain's chemistry is not balanced, you may experience these types of symptoms.  You are giving me descriptions of paranoia along with auditory and tactile hallucinations.  Have you attempted to change your sleep routine?  Have you attempted to sleep in a different location (both within your home and outside of your home)? Are you a very spiritual-based person?  Have you attempted to enlist help from your local clergy? No family physician should make you so uncomfortable that you cannot confide in him/her.  If you do not trust your own physician, see another.  I believe you could benefit from seeing a therapist in addition to a clergyman. I'm trying to address your problem from two points - medically and spiritually.  If this is a medical problem, the sooner you find out and begin the correct medications, the quicker the symptoms will abate.  If this is a spiritual situation, I hope you have a clergyman that is willing to help you.  Attempt to speak to a catholic priest. Be well, Dr. Kimberly",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is twinge in upper chest while being overweight be due to anxiety?\n\nHello...I am a 42year old female who is unfortunately about 25 pounds overweight....I do try to watch what I eat but fall off the wagon ever now and then. I used to exercise by running on my elliptical 5-6 days a week. I havent done that in some time since i had a herniated disc in my neck and was operated on last year. I did start back to the exercise about 3 days ago though. II have no history of heart trouble, no high blood pressure and my cholestrol runs borderline at times. At age 40, i was experiencing some anxiety and weird pain in my chest area so the doc sent me for a stress test.The cardiologist said mt heart looked fantastic and all was well. That pain turned out to be acid reflux. flash forward to present day...the last 5 days or so i have been feeling little twinges in my upper left chest area. Not painful but it scares me. I do not feel them when i ecercise and do not have shortness of breath or nausea/sweating. It seems to be mostly when i lie down at night. I am a major worrier and I am not sure if this is anxiety related or not. Of course wondering if your having a heart attack does little to sooth the anxiety. I currently take no medications but my multivitamin and fish oil. I did however just try a very low dose birth control pilll for the 2 months. I am no longer taking because the side effects were too much for me. I am not a smoker. I dont feel like I am having an emergency but thought maybe a call to the pcp is best. Advice?",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. I think your symptoms are mostly related to stress and anxiety. But since you are over weight , taking oral contraceptive pills , I think weneed to rule out cardiac cause first. So get done1. ECG2. 2D EchoTo rule out cardiac cause. If both of these are normal than no need to worry much for cardiac cause. It is mostly due to anxiety. So avoid stress and tension. Be relax and calm.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does these ultrasound of kidney indicate?\n\nHI i got a UTZ ultrasound i was wondering what is the findingshere is the impression: IMPRESSION:NORMAL SIZED KIDNEYS WITH MILD PELVIECTASIA IN THE RIGHT AND SUBCENTIMETERNON-OBSTRUCTING LITHIASIS IN THE LEFT.NORMAL SONOGRAPHIC STUDY OF THE URINARY BLADDER",
    "doctor_response": "HiThe ultrasound indicates that there may be a stone in your left kidney. The mild pelviectasia is a technical term for dilatation of the urine collecting system of your right kidney. However this needs to be further evaluated by CT scan without and with contrast of the kidneys and bladder.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathlessness while playing?\n\nwhen i play football, it seems like i can't breath very well. before i used to be everywhere in the game running from one side to the other, but after approximately 10 minutes, i have this feeling, i dunno, it is in my throat or lungs, there is something that doesn't let me breath very freely, why does that happen?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. You are having breathing difficulty on exertion (running). So we should definitely rule out asthma and bronchitis because both of these can cause similar kind of symptoms. So consult pulmonologist and get done 1. Clinical examination of respiratory system. 2. PFT (pulmonary function test). PFT is must for the diagnosis of these diseases. It will also tell you about severity of the disease and treatment is based on severity only. You Amy need inhaled bronchodilator and inhaled corticosteroids (ICS). Don't worry, you will be alright, but 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes popped up blood vessel on the penis head?\n\non the left side of penis, by the top I was hit and now there is a hard grissel like thing that came up . Less than a quarter inch wide about three quarters long around  rim on top .  It does not hurt, but just concered why it appeard. Looks like a blood vessal but no color. Can that hurt me?",
    "doctor_response": "Hi, If there is no pain or redness or increase in size no need to worry - share a picture for conformation, blood vessel appearing on penis is normal as long as it is not painful. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this bone scan test result while treating prostate cancer indicate?\n\nQuestion: Prostate Cancer diagnosed in 2005, Gleason 2, watch and wait until 2015 had orchiectomy followed by Casodex followed by Lupron. My problem is after moving three Physicians disagree. currently bone scan shows possible metastis in right shoulder and left groin but no change on bone scan after two years. Very confused.",
    "doctor_response": "Hello,You have prostate cancer. Bone scan is to check whether cancer is spread to the bone or not. Prostate cancer is known for bone metastasis.Please send me your bone scan report, so that I can help you further. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Hardik Sanghvi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Ponstan be taken for long duration for the abdominal pain?\n\nMy wife ( Age 50 ) has  severe severe abdominal pain and heaviness  in thighs / leg muscles, forehead becomes hot. These synmptoms start 3-4 days before start of the period and lasts till end of it. She also gets easily  irritated during the period. She is disgnosed for thyroid about one year back and on regulr medication Eythurox 50ug one daily.We contacted gynaec  2-3 times inlast 18 months and got ultrasound /other tests like pap smear etc and results were all ok.She takes Meftal spas or Ponstan Forte when the pain is unbearable but afraid to take these medicines  due to fear of ide effects.Can you please give further advice and also tell how long she can take meftal spas  or Ponstan safely ? Is Ponstan better that meftal SPAS ?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. These are called pre-menstrual / menstrual tensions, and this is very rare at the age of 50 years. To me it looks to be more of pre-menopausal changes wherein the patient's response to hormonal changes is severe. Rarely this can be due to increase in congestion in pelvic area, suggestive of pelvis inflammatory disease.I would suggest to have recheck of thyroid status , may be we need to modulate the dose of thyroid medicine which may help to improve the symptoms. Also to go for female hormone estimations on day one of pain.Another suggestion would be to reduce salt intake just before the anticipated days of pain and/ or to take diuretic to flush out extra salt. May be there is a need to add an anxiolytic medicine. HRT if  your Gynecologist feels so. Meftal Spas has an additional medicine of dicyclomin (antispamodic). Taking Ponstan forte for a long time is not going to have any problem as I suppose she takes these only during the pains.There are some rare problems of inflammation of the muscles of the uterus, not easily diagnosed. Even you can think of Hysterectomy as a permanent treatment for this problem.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. T Chandrakant",
    "dialogue_context": ""
  },
  {
    "patient_message": "History of seizure due to aspartame. Now have aura. Concerned about recurrent seizure\n\nI had seizures in my teens which was triggered by aspartame. Since I no longer investment aspartame (since16years old) I have had no seizures, I am now 43. For the past 2 days I have been experiencing the same kind of aura I had then before a seizure. Only it is happening all day long in periodic bursts of one second duration in clusters of 5 - 20 at a time. I am concerned about having a seizure as mine were quite severe. With my worst seizure I was on my stomach arched in a U shape for 15 min. Then covulsed for 20 min and did not regain consciousness till the next day. Could it be a return of my seizures?",
    "doctor_response": "Hello Welcome to HCM Any seizure in brain occurs due to abnormal and excessive electrical discharge in brain areas. When the electrical activity of brain is disturbed one may suffer aura. Individuals show confusion, lightheadedness, irritability. Your seizures were triggered by aspartame and for long time you didn't experience any seizure. I will advise you to visit your doctor and get EEG of brain done. It may detect abnormal electrical phenomenon happening if any. Second it may be due to some some anxiety, due to anxiety individual may have features mimicking aura. So go to your doctor for proper evaluation. Thanks Dr. Seikhoo Bishnoi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant sickness and cough in a child?\n\nMY SON IS TWO AND A HALF YEARS OLD FROM ABOUT 6 MONTHS HE STARTED GETTING A COLD ,EVERY MONTH HE GETS SICK AND COUGHS CONTINUOSLY ,WE HAVE TAKEN HIM FOR X-RAYS BUT THEY SAY EVERYTHING LOOKS FINE BUT HE STILL GETS SICK EVERY MONTH ,WHAT DO YOU THINK IS THE PROBLEM?",
    "doctor_response": "Hi,From history it seems that he might be having some atmospheric allergy causing this problem regularly.If he is weak, anemic or having low immunity does contribute this problem.He might require some blood work like TC, DC, ESR.Go for Montoux test to rule out primary complex.Consult pediatrician and discuss about this.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On hyponnid, metformin and parlodel after fertility blood investigations. Missed periods. Side effects of medications?\n\nmy GP put me on hyponnid, metformin and parlodel last month after a thorough fertility blood investigations on me and my hubby, i have missed my period this month which has never happened to me before...am sooo nervous not knowing if its a side effect of those drugs or something else...pls what is ur opinion, cos i need help and answers...thank u",
    "doctor_response": "Hello. Thanks for writing to us. The delay in your periods is likely to be due to the hormonal disturbance which you are already having for which you have been given the treatment. It seems that you have polycystic ovaries which are causing this delay and hormonal treatment will be the best for you. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes foot pain and swelling after walking?\n\nI had surgery for tarsal coalition about 11 years ago. But recently my foot is in a lot of pain. when i walk form maybe 10-15 minutes my foot become swollen and is in pain for the whole day. It has been getting worse since the past few years. Why is this happening?",
    "doctor_response": "Hello, It looks from your details that you may be having arthritis of foot. At present you should do following to have relief from this- -Consult to your doctor and get a x ray done. -Take a mild analgesic like acetaminophen for relief. -Check your shoes.Change them at every 6 month. Use comfortable well cushioned shoes. -Take some supplements like glucosamine sulphate,chondroitin preparation or collagen preparation. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mukesh Tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for disc protrusion at C3-C4 and degenerative arthritis\n\nI slipped on ice earlier this week and jerked my neck; I have been having terrible neck pain since then. I went to the ER and had a cat scan. The results said the following and I didn t know what this means or what kind of doctor I need to follow up with: CT Cervical Spine. No acute C-spine fracture appreciated. Paracentral disk protrusion c3/c4 with moderate central canal narrowing noted. Diffuse bulge C4/C5- this in conjunction with osteopathic ridging results in mild to moderate central canal narrowing. Degenerative arthritis. No subluxation. Straightening of C-spine, perhaps spasm. Do I need to see a doctor right away about this or can it wait?",
    "doctor_response": "Hi, Yes, you should consult a neurosurgeon straightway. You are suffering from cervical PIVD which is causing nerve symptoms due to the protrusion of disc. You may require surgery on the basis of your findings n need an urgent MRI for that. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sachin Chhabra, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My son has dark red urine. Is this a medical emergency?\n\nHello doctor,My son's appendix burst about four weeks ago. On the day they burst, his urine was a thick dark red color. His appendix was gangrenous and the infection had spread to all four quadrants of his abdomen. He had a catheter after surgery which became blocked with the thick urine so was removed. Last few days his urine has turned this dark red color again. Looks like blood but is not every time he wees. It happens about once a day. Is this a medical emergency? Is it related to the appendix or is it a different problem? What could it be?",
    "doctor_response": "Hello. Dark red colored urine means blood mixed with urine and is generally arising from the urinary tract. That means either from urinary bladder (common) ureter (less common) and kidney rarely but cannot be due to appendix unless it has locally affected the above-mentioned organs. Second is it an emergency? Yes, because losing blood is always an emergency and needs to be stopped as early as possible. Regards. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the treatment available for cancer?\n\nmy aunt has been diagnosed with cancer,she is 61 years of age and barely weighs 100,im trying to find out what kind it is for treatment options, but all ive been told is its called no-cell cancer,but my serches cant find that,im sure thats not the clinical name for it thou",
    "doctor_response": "The treatment of cancer depends on various factors like type of cancer, stage of the disease. physical fitness of the patient. Similarly survival also depends on same things. Hope that makes you clear.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for heart palpitation after weever fish sting\n\nhi there i got stung by a weaver fish last year on the hand and had a anthlatic reaction and ever since ive never been 100% right, and ive been getting alot of heart palpitations alot over the last yr which are getting worst, and this last 6 days ive been getting headaches and heart palpitaions and shortness of breath and neck ache and a sharp pain wat lasts a second or tw then goes n then cums bk on the left side near the arm pit",
    "doctor_response": "Hello, I understand your concern and would explain that your symptoms do not seem to be related to the heart. Anxiety may mimic this clinical situation. Anyway, before coming to this conclusion, I would recommend consulting with your attending physician for a careful physical exam, an ambulatory 24-48 hours ECG monitoring in order to exclude possible cardiac arrhythmia and some blood lab tests (complete blood count, PCR, ESR for inflammation, thyroid hormone levels for thyroid gland dysfunction, etc.). You should discuss with your doctor on the above tests. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for mental disorder?\n\nI have been trying to find answers to what is my health problem and what I can do for it for some time. Some of the descriptions for predicted sound like mine, except I do not suffer nightmares or memory flashbacks from the sudden unexpected trauma which was the onset of what I have suffered every single moment since. What I have had since is pain, pain so great that it is unbearable to live without preventing it at all times or being forced to take my life against my own will. This is without exaggeration. It sounds crazy and unheard of, which is the reason I can t face my doctor with the problem. Also, to the contrary of treating the pain with anything that slows me down, I have found that stimulants are more effective by far, during this horrible quest to survive. I know I m in a deathtrap , but I don t want to be dead. I m pretty sure my only hope is to find a way to be able to survive and live in a way that s monitored by a specialist, hoping this condition has been heard of by some doctor in this world. I know too much about what I struggle and strive everyday. I know there have been many where I had been, at the moment of tragedy, and most end up taking their lives because it is pain-driven, and they never live to see tomorrow - the future of the worst pain ever. Its beyond ptsd anxiety. Its more like living in fright, fright of the pain, what it has the power to do, and what will happen if it doesn t stay constantly prevented. I hope somebody knows what I m talking about. I can t be the only one on earth that is trying to live and survive at the same time, nor the only one who understands what I mean by this. I hope you can help me and if nothing else, point me in the right direction to research or maybe someone I could talk to that could better aid this very rare life situation. Thank you so much.",
    "doctor_response": "Hello,I suggest you not to worry much. You are talking about pain in your description and is not mentioning any type or location of the pain. That is well understood. These are called obsessive thoughts. Brain (mind) is made for its functions and it must think. Therefore you cannot stop it from thinking. But you definitely can control the way it thinks by diverting its attention to more demanding things. Creative thinking should help brain diverting. If you try to forcefully overcome obsessive thoughts, it will come back now and then and disturb you more vehemently. Psychotherapy techniques should suit your requirements. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. K. V. Anand",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe knee pain\n\nA few weeks back, i slipped on the ground two times continously and fell down on my knee and it got hurt and now my left knee and ankle is feeling heaviness and i am having difficulty in walking...i had taken medicines and even then there is no improvement... my age is 48 yrs old and weight is 60 kg... kindly advice .........",
    "doctor_response": "Hello,I have studied your case and I would recommend you to get x ray of the knee joint to confirm the diagnosis. If there is any fracture or any soft tissue injury than it can be confirmed with this only.Til you get the x ray done I would suggest you to avoid any massage of the knee. If there is fracture than you will need splinting of the knee joint. If there is only soft tissue injury than it can be deal with hot water fomentation, elastocrpe bandage and Ultracet tablet twice daily.I hope this answer will be helpful for you.Let me know if there is any other followup questions.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could small focus of white matter in frontal lobe be life threatening?\n\nHad numbness with almost a menthol sensation from my foot to my face on July 5th...all on my right side...included leg, outer torso, arm and half my face...lasted approx 5 hours. Have also had numbness/tingling around my eyes and nose over the last year...none of these symptoms caused blurred vision or slurred speech and was able to function normally. Had an MRI on July 21st...Here are the findings: There is a focus of the T2 bright signal demonstrated in the subcortical white matter of the left frontal lobe. This measures approx 4 mm in diameter. The findings are nonspecific, although in a 45 year old woman do include demyelinating and disc spinous processes such as multiple scierosis. EDEM, vasculitis, or Lyme disease can give similar appearance. Small vessel ischemic change is also possible. Diffusion weighted sequences are unremarkable without an acute process seen. The ventricles are normal in size and configuration. The orbit and paranasal sinuses are within normal limits. Impression: Solitary small focus of white matter change in the left frontal lobe of unknown clinical significance. My history...Had an Head MRI in 2010 due to family history of aneurysms...MRI was clear. Also was diagnosed with Lyme 5 years ago...suffered joint pain in right knee/left arm...took 30 days antibiotics...one year later had similar symptoms and antibodies were high(not sure it that is correct term) so went on another round of antibiotics. Have recently had similar joint pain, but very inconsistent and not frequent(3x for only a few minutes over the last month...comes on w/o any cause). current Meds...25 mg Adderall for ADD/125 mcg of synthroid for hypothyroidism and just added 81 mg of aspirin as a precaution incase I had a TIA. Hadn t heard from Neurologist until I called today...was told not life threatening and they would go over results at my follow up which is at the end of August. After hearing this I requested the MRI report...I am looking for some thoughts of what might be going on or what my next step should be. I do have a Great Aunt on my mother s side that had MS. Thank you!",
    "doctor_response": "HelloSmall hyperintense focus in deep white matter of brain may be due to ischemic changes resulting from involvement of small blood vessels(vasculitis),demyelination,post lyme infection,post traumatic etc.Ischemic changes resulting from blood vessels changes in diseases like hypertension,diabetes mellitus,dyslipidemia.So,you need monitoring of conditions that leads to ischemic changes like hypertension,altered lipid profile,diabetes mellitus so that further progression of disease can be halted.You need investigations like routine hemogram,RBS,LFT,RFT,Lipid profile,ultrasound of abdomen.Proper treatment depend upon findings.You also need follow up scan. Multiple sclerosis(MS) is associated with many findings,it need clinical correlation.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Doing ICSI transfer. Can standing and making food hurt pregnancy chances?\n\nHi im on day 4 after icsi transfer yesterday we had a family memeber come back from overseas i didnt carry anything just the standing and preparing food could i have hurt my chances of getting pregnant btw i already have 3 kids naturally but after my third which is 8 yrs we found out my husband has y chromosone deletion",
    "doctor_response": "Hi, Standing and preparing food will not hurt chances of getting pregnant after ICSI in any way. So don't worry, relax. Wish you good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cramping pain in the feet?\n\nhi can i ask you about pains i have been getting in the soles of my feet, mainly in my right foot. it is like a cramp when i rest or stand for a long time. i have had it for the last month and it is sore. i am quite young so i feel that i shouldn t be getting these pains. could you possible tell me what could be causing these cramp pains?",
    "doctor_response": "U should wear soft shoe.chek serum fbs ppbs.follow up with the reports.what is ur age.does the pain resolves with rest?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for knee pain\n\nHi,i am a lady aged 39 weighing 64 kgs and height is 5'4\" I was having pain in my knee and today when x ray report came....it is early stage osteophytesvseen in tibia and patellar regions,i hav a piercing pain in knee if i drive a car..pls advice for allophathic as well as alternative treatments available",
    "doctor_response": "The formation of osteophyte indicates an increased spur of bone that comes mostly in joints. This spur erodes the synovial membrane of the joint leading to inflammation that is responsible for pain. So first thing is to get rid of this inflammation and become pain free. Usually nutritional deficiencies lead to bony derangement leading to spur formation. In Ayurveda there is a procedure in panchkarma that cures it called janu vasti wherein medicated oil is kept over knee for half an hour daily. internally guggul, punarnava,haridra,ajmod based compounds are used to check pain and inflammation. Nutritional diet is a must.",
    "dialogue_context": ""
  },
  {
    "patient_message": "When should anti coagulant  medicines started after cervical spine surgery?\n\nif a patient is immoblie after cervical spine surgery for cerviclal spinal stenosis, when should anti coagulant or clot preventive meds be started.    While wating for emergency corrective surgery his condition , deteriorated tovery quickly  being bed ridden",
    "doctor_response": "Hi,Thank you for posting your query.I have noted the patient's condition.I agree that there is a risk of deep vein thrombosis (clotting of blood in leg veins) in this patient, as he is immobilised after surgery and due to weakness in the legs.Anti-coagulation can be started after 48-72 hours of surgery in most cases. However, the decision should be taken in consultation with the surgeon.The best anti-coagulant to use is low molecular weight heparin injection- enoxaparin 40 mg once daily subcutaneous route.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have constant bowel pains, and alternating diarrhea and constipation. Is it IBS?\n\nHi doctor, I have had a lot of constant bowel pains and alternating diarrhea and constipation. Quite often, I am noticing brown sesame seed kind of thing in feces. Is it a parasitic infection? Or is there a possibility for IBS?",
    "doctor_response": "Hi. Your symptoms of pain and alternating constipation and diarrhea definitely point towards IBS (irritable bowel syndrome). The natural method of reducing these symptoms is by avoiding spicy food, eating your meals on time, and drinking adequate amounts of fluids to keep yourself hydrated. It is also important to make a food routine, which means you should have meals that are familiar to your body. Avoid surprising your body with new varieties of food suddenly. There is a probiotic medicine capsule Vibact IBS (Lactobacillus plantarum) which can be taken once daily for a month. This has shown relief in some of my patients with similar complaints. As for the complaint regarding your stools, you have to undergo a complete stool examination at a diagnostic laboratory to figure out the nature of the particles in your stools. For further information consult a general practitioner online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to calculate date of conceiving?\n\nMy partner and I split for 6 months and I was seeing someone else during this time but we decided to get back together at the end of June (around the 28th June). I am now pregnant and my due date is the 6th April 2011. I believe i concieved in July with my current partner as we were having regular unprotected sex. When did i most likely concieve? I do not have regualr periods.",
    "doctor_response": "Hello dear,I understand your concern.In my opinion as you have irregular periods the conception date cannot be known .But the ultrasound might help in knowing the propable time of conception.The early ultrasound ie.,first trimester ultrasound is accurate.And overall the paternity test is confirmatory.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes small black spot on the gum?\n\nAbout 3 weeks ago I found a small odd shaped black dot on the top right side of my gum above my \"k9\". Days later it was gone. Today I noticed a small black dot on the top right side (same side as before), this time between the front and smaller tooth. I brush, floss, and use mouthwash daily, never had a cavity.  Any ideas as to what it is?",
    "doctor_response": "HiWith your query, your explanation is not clear I don't know what do you mean by K9. Anyways you are pretty sure about that you don't have any cavities and you have mentioned you are using mouthwash. Generally long term use of mouthwash results in staining of teeth. I would suggest you to visit Periodontist. As such not clear with the query",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get pregnant with a history of ectopic pregnancy?\n\nI Had ectopic pregnancy in right side two times.i lost my right side tube.i what to conceive.after marriage one miss carage.second time i had ectopic in the right side the doctor don laptroscopy. after six months again i conceived but unfortunately it was ectopic for second time in the right side tube.now i want to get pregnant.",
    "doctor_response": "Thank you for posting on HCMHaving had 2 ectopic pregnancies on same side, laparoscopic tube removal & 1 miscarriage you chances of natural conception will reduce unfortunately.Still one can't say for sure if & when will pregnancy happen - I suggest trying to remain calm, happy, good healthy diet & adequate exercise is very important.If natural pregnancy doesn't happen after trying for 12m ( depends again on your age ) - you must see specialist for further investigations.Hope this helps & all the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be done to have a good memory ?\n\nI was a distinction student through my academics. When I was doing post graduation, my father deceased and I had to take care of the family and went through many problems. For a year I did nothing and then I joined medical transcription and working for the last 6 years. The problem is that I do not remember many things that I read and watch. Even sometimes, I forget where I placed my mobile phone. These small small issues are bothering me a lot. Why is my memory so poor now? How can I be as I was before? Please advise.",
    "doctor_response": "First clarify if you are fogetting after you do the activities with absolute concentration or is it just that the activities you do habitually that you forget. With age and increase in reponsibilties people are mostly preoccupied by higher level activities because of which they fail to focus on simple things that is done habitually. Increased stress level further adds to the intensity of the problem. But in rare cases it may be some physiological disorder also. so first consult a clinical psycholgist to evaluvate your attention and concentration, stress levels and memeory quotient using standedized tests. then decide about what intervention should be done to overcome this problem Regs R.Manoj Clinical Psychologist rmanojcp@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are sweaty palms, armpits and buttocks due to SD?\n\nHello!  I have been experiencing sweaty palms, armpits, even buttocks!!  This has never ever happened to me!  Also,  I've found out that my blood related uncle has been gay for over 25+ years and is most likely sick..  I can only imagine the germs hes spreading!! He has the same sweaty palms symptoms as myself..  Did i catch an SD?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Excessive, uncontrollable sweating of the hands or palms, is called palmar hyperhidrosis. The first line-of-defense against sweaty palms is an antiperspirant. There are medical interventions available if you consult your doctor. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I having sharp stomach pains?\n\nHi, I'd just like to know what it means when you have a really sharp stomache pain. My stomache has been hurting a lot on the right side of the middle of my stomache. Also, my heart has been beating unusually fast and my breathing has been getting heavier. I can't eat or drink anything without feeling sick also.",
    "doctor_response": "HI.Since how long have you got these symptoms ?What are the other associated symptoms ?This looks to be serious as per your history you have provided. I would such a patient to go for a clinical check-up by a Doctor to find out whether this is something like typhoid or gastroenteritis.Or this is some inflammatory intestinal pathology like appendicitis which may need a surgery.Blood, urine, stool, Ultrasonography and if needed a CT Scan of abdomen, to find out that there is no other pathology in the chest like pleural infection or pneumonia is also necessary.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any treatment for small pimple on chest grown to big muscle bulge detected as celloid?\n\nhello sir, i am vikram from india,i had a small pimple like on my chest and now after 10years it has incresed to be a big muscle bulge on my chest,it does not pain but itches and i think its still growing,i had been to severel doctors they say its a celloid and cant be treated,is there any treatment for it...?",
    "doctor_response": "hi dear thanks for query on HCMit is a keloid.you need to visit a plastic surgeon.it is a difficult lump on treat.you need patience and time to treat it. minimum of 9 months.there are many treatment modalities, simple being a injection to site to intralesional excision. they may suggest pressure garment in addition.show at the earliest.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will garlic and fish oil help with controlling BP and heart rate?\n\nHi ihave a pt test tomorrow will garlic pills and fish oil be okay to take to help with blood pressure and heart rate Test is 3 minute step test 14 pushups and 14 situpsThey check blood pressure before first time I was on the high end and heart rate emidiatly after step testThanks",
    "doctor_response": "Dear- thanks for using HCM, garlic is good to control BP but does not help heart rate. Fish oil helps to lower the bad cholesterol or LDL, does not help the blood pressure. However, both are very good for the heart. If you have been training for this test, your body will respond to it.I hope that my advise has been helpful.Dr.Sara",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sinus infection and cough\n\ni had the flu/fever for 4 days, got better, then developed a sinus infection 2 days later. I went to my doctor and she prescribed me the 10 day antibiotic amoxicillin for my sinus infection. I have been taking it for 3 days now but the first day I was on it I got that wispy feeling in my throat that you get just before you get a cough. The next day I started lightly coughing. The next day I started a deeper cough and I could feel it may have traveled to my lungs. Today is slightly better but I still have congestion and a cough. Also throughout my entire 2 weeks so far of being sick, there has been a sore-like pain throughout my left arm, particularily my triceps brachi long head, flexor carpi ulnaris, and also the top of my rectus abdominis right under my diaphragm. What is wrong with me?",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain the wispy feeling in throat and coughing is due to irritation in throat that initiates bouts of vigorous coughing and due to coughing there can be pain in chest due to muscle stretching while coughing..It seems like you have an upper respiratory tract infection and all the symptoms are due to it and you need not to worry as body aches or muscle pain and cough and congestion are due to it..You should take an another course of antibiotics like Augmntin or azithromycin or levofloxacin, take tylenol for raised body temperature and body pain,take decongestants like Phenylephrine and do warm saline gargles, steam inhalations, saline nasal irrigation and suck throat lozenges..Drink plenty of warm fluids, do warm compresses on chest,take a soft diet and use a humidifier in your room..Take ample of rest..Hope this information helps..Thanks and regards.Dr. Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the ESR level of 60 suggest?\n\nHi, recently i got my chest xray and esr done...where my esr count is 60, i am 25 years old. i have been healthy until last couple of months where i have had cold, cough, sneezing, running nose, constant headache and congestion. have recently also started suffering from shortness of breath and wheezing. my doctor has to say everything is perfect and i need to keep my haemoglobin levels constant. even my sister is been going through the same problem since last month. i want to know how to keep the ESR level to its lowest and how do i get rid of cold, cough, sneezing, running nose, constant headache and congestion",
    "doctor_response": "Hi. I can understand your concern. You are mostly suffering from allergic rhinitis and asthma.Asthma is most common allergic disease which is not a curable disease but definitely controllable, by controlling the same you can lead a symptom free life. Usually presents with cough, wheezing, difficulty breathing and chest tightness. If not treated appropriately can be life threatening.So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of bronchitis. It will also tell you about severity of the disease.Allergic rhinitis is a due allergy to dust , pollens etc. Usually presents as running nose, excessive sneezing, blocked nose, headaches etc. It is ideally treated after consultation with a pulmonologist / allergist. Usually treated with intranasal steroids and anti leukotriens.Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can miralax be given to a child for abdominal pain?\n\nHi my daughter is 9 years old. she is 80 pounds and about 48 inches tall. She has been suffering for several months with stomach pain. It is a dull ache or sharp pain in the top part of her stomach. She also feels like she is going to throw up all the time. She even says she can feel it coming up her throat. We have took her to a doctor and they gave her a sonogram checking her for appendicitis. Her appendix was fine so they said she was probably constipated. We have given her Miralax and she does go to the restroom once or twice a day. Although even without the Miralax she never really had hard stools. They have always been watery or soft. So it makes me wonder if it is really constipation. She complains about it almost every day, and she just seems miserable. I don t know what to do because I feel if I take her back to the doctor they are just going to say it is constipation. Is there anything else it could be?",
    "doctor_response": "acute gastritis may be causing pain epigastrium . constipation means not passing stools for last 3 days and pass only hard stools.also evaluate for hypothyroidism by doing ft4 and tsh.test for blood sugar.there is no harm in giving albendazole single dose  along with beta blockers",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedy for lightening vagina color\n\nthe face of my vagina is kinda darkened, is there a home remedy for me to be able to make it lighter as well as my groin..well i am using Lactacyd a feminine wash yes it can make the inner part of the vagina look pinkish and clean but the outer is still darkened, is there a way?",
    "doctor_response": "Hi Genital areas wil be darkened in reproductive life due to hormonal influence.keeping the vagina dry and healthy is helpful.avoid cosmetic creams.apply creams containing clindamycin and salicylic acid.don't apply deep into your vaginal orfice.consult your gynecologist for further queries.Thankyou.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of gilbert syndrome?\n\nHello sir, recently I have diagnosed with 'Gilbert syndrome' due to deranged LFT (High level of Direct & Indirect Bilurubin) , I am little surprised because they have orally informed me for this disease & have not done any confirmed diagnosed test. now I am facing lot of fatigue & weakness in routine life. I would like to understand what is my actual problem & what will be the future complication for me in case if i will have Gilbert Syndrome.",
    "doctor_response": "Gilbert syndrome doe not need any treatment. You can get genetic studies done to confirm the diagnosis, but these are expensive and not essential to make a diagnosis. Your symptoms are probably not due to Gilberts syndrome.You won't have any problems in future because of Gilberts syndrome, The only complication is that people with Gilberts syndrome cane develop sever reactions to certain drugs which are used to treat cancer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "After treatment for cystic lesion mother experiencing toungue tingling and numbness. What could be the reason ?\n\nHer age is 48 yrs, weight is 83 Kgs.Sir my mom is having benign cystic lesion on her left hand side of the face . But my treatment and excerise it is almost covered 75%. Only she is having problem in her left tonque like tingling and numbness . We have started the treatment of neuro surgeons doctors also they told it will take time. Request you to answer does is recover or she will have problem life long. Please anwer on sales.pamglatt@acg-world.com Her age is 48 yrs, weight is 83 Kgs.Sir my mom is having benign cystic lesion on her left hand side of the face. But my treatment and excerise it is almost covered 75%. Only she is having problem in her left tonque like tingling and numbness. We have started the treatment of neuro surgeons doctors also they told it will take time. Request you to answer does is recover or she will have problem life long. Please anwer on sales.pamglatt@acg-world.com",
    "doctor_response": "Hi, Thanks for query, I ask one question the cystic lesion you mentioned,what neurophysician diagnosed? if it is in connection with nervous system then it is likely that there is some nerves are damaged causing symptoms in the tongue.this will take some more time to recover. But this problem is due to pressure on nerves due to lesion,after relieving of pressure she will have fast recovery. ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Has kidney disease and going for transplant. Found heart problem. Will this affect transplant?\n\nWe just went to Tampa general for my dads first meeting with the transplant team... It was devastating my dad never went to dr s when he was growing up and even older finally about 5-10 years ago he did and that s when they discovered kidney disease ....now the dr today tells us he may have a heart condition as well, the dr wants us to have a heart catheter with the dye injected in to see if there is blockage, but this could kill what s left of his function, if we have this done and they do find blockage would they refuse to transplant him?",
    "doctor_response": "Hi, As kidneys are already damaged and requiring replacement in the form of transplnat, it is unlikely that there will be further damage due to contrast agaent used during Coronary angiogram (CAG). He can definitely go for CAG and infact, once he is cleared from cardiac point of veiw , then only you should go for transplant as there will be difficulties if he needs any such procedure later during post transplant period",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does it mean to have thinning in lumbar as shown on X Ray?\n\nI had an x ray done and it said I have thinning in my lumbar especially on L4-5 and I think L3-4 and L5-S1 or something like that. What exactly does that mean? and what are the best ways to treat it? I m going to a doctor Wednesday but I m kind of nervous about what they will say. I am only 21 years old.",
    "doctor_response": "Thinning of vertebra may be loss in height of vertebra or more of translucency as compared to normal bone texture on x ray. wonder what your radiologist really implies. It is better to wait till your consulting doctor sees xray himself.It is no use pondering before that.Unfortunately this website doesn't allow posting of xray, or other reports scans ,otherwise things could be easier for us to give opinions on themYou can however, upload your xray after scanning and send me to my e mail suniliskumar5@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain around ribs in the morning\n\nfor about three weeks now early hours of the morning ache around back of ribs round to the front to the middle under sturnum want to stretch ribs out but as i breath back in under sturnum feels painful and feels like contractions really sore (the bit where it strains if you do crunches) once us and about for the day it goes away",
    "doctor_response": "This kind of symptoms may be due to muscle spasm.take pain killer tablet with muscle relaxant.also go for hot water fomentation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for BP 180 over 80\n\nHello.I am a 56 year old female, 5 ft 2 in, 145 lbs. Have asthma but generally good health, walk 2 miles a day. Take Alvesco, Zyrtec and Zantac. A doctor took my bp today and was told it was 180 over 80.  He was concerned. This was not my regular Dr. What should I do?",
    "doctor_response": "Hello,you mention that you have asthma and you take steroids and antihistamines drug to control it.Your blood pressure is 180/80 mmHg that is high.You have to control it.You have to start hypertension  drug under your doctor 's suggetion.You have to start regular exercise. Avoid fatty food and junk food.Control your asthma also it also affect over blood pressure. Use low fatty oil like sunflower  oil.Don't  Take too spicy and oily food.Regularly  mesure your blood pressure.Take  fress fruits and green vegetable. Use a  law salty food .it help you to control your blood pressure. I hope my answer helpful  to you.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ankle pain after ankle sprain\n\nI fell down the stairs maybe a week ago, I landed on one leg & it hurted my ankle so I had to limp to class. It stop hurting after a little bit but recently I have been practicing dancing & when I roll my ankle, it still kinda of hurts. Do you think I could have sprained it or hurt it?",
    "doctor_response": "HelloI appreciate your concernThis could be a residual effect of ankle sprain due to inadequate healing following injuryyou need not to worry please follow these guidelines1. Do Hot fomentation keep your both legs into a bucket filled with hot water for 10 minutes twice daily 2. Physiotherapy will definitely help you 3. Have a glass of milk daily and calcium with vitamin D supplements4. Take rest for few more days 1 to 2 weeksHope this helps you get well soonregards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for numbness and pain in the back\n\nhello, exactly a week ago i dove off my friends (low) diving board. i usually do it very well, however this time i believe my lower body flopped when i hit the water and it felt like someone punched me in the back... it still hurts, feels numb when i sit down, and hurts very bad when i try to correct my posture, lean forward or back... please help, i need to know if it is serious or not (age: 16, height: 5'7'', weight:117)",
    "doctor_response": "Hello,Thanks for your query.After going through your query I came to know that you probably are suffering from muscular pain or lumbar disc prolapse. It can be confirmed by MRI scan.For muscular pain rest and analgesics (Diclofenac three times a day after meals is effective) for 4-5 days will be beneficial. For disc prolapse there are two treatment options.First option is Rest in position of relief(generally lateral position with both knee bend),NUROKIND GOLD ONCE DAILY and analgesics (Diclofenac three times a day after meals is effective). Sometimes strong analgesic(such as ultracet three times a day after meals) is required. OMEPRAZOLE  before meals  prevent acidity caused by analgesics . This method needs patience as it take longer treatment times sometimes up to  6 months.Second option is go for surgical operation(Discectomy). You can discuss with your treating Doctor about it.I do hope that you have found something helpful and I will be glad to answer any further query. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Excruciating stomach pain, pins and needles in legs, painful. On birth control. Suggest?\n\nHello, I have been on my period for 9 days now. Usually it lasts up to 4, but I started to take the pill and this is my first period since. I have had the most excruciating stomach pains that occur every hour or so, and my lower back is in a lot of pain. I also keep having weird pins and needles running down my upper legs, sometimes it is painful to walk. I have also had blood clotting with my period which I think might be the cause for the stomach cramps . My doctor put me on the pill to help with my period pains and for birth control also, but I have never ever experienced period pains like this before.",
    "doctor_response": "Hello,You might been experiencing withdrawal bleeding due to OCP's.This might be the cause of abdominal pain.Pain, increase in flow and passage of clots may indicate any underlying pathology like infection, uterine and ovarian tumors.You may need a Baseline ultrasound for diagnosis.Do consult a Gynecologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is swimming safe while suffering from asthma?\n\nI am a 66 year old master swimmer, female in good shape with slight asthma problems, easily controlled, use my inhaler infrequently. What happens to your body, heart, lungs and BP when you sprint as fast as you can? I know your heart rate increases, does your BP go up? What signs would I have that I have pushed myself too hard? I can do repeats for awhile but I can t keep up with the kids. (40 year olds)",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Yes, swimming is safe only if your asthma is well controlled. Swimming is considered as aerobic exercise. Aerobic exercise causes tachycardia (rapid heart rate), slightly elevated blood pressure (not hypertension), tachypnea (rapid breathing) etc. So if your asthma is not controlled, you might face difficulty in breathing. You are not keeping up with young ones. This might be due to uncontrolled asthma. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT will tell you about severity of asthma and treatment is based on severity only. You will need regular inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone). Take your inhalers regularly to keep your asthma in control. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes liver enlargement?\n\nI had a ct scan showing my liver enlarged to 19cm. I am 37yr old female, weight is apx 175 lbs. Test results state hepatomegaly liver is homogenous without focal lesion. My blood work came back as having excellent cholesterol levels. I am having a decent amount of abdominal discomfort, nausea, etc. I don t understand what could be causing my liver to be enlarged if my blood-work is fine?",
    "doctor_response": "Hello,Welcome to Healthcare magic.It may be due to many reasons like alcoholic disease, fatty liver, hepatitis infections, heart failure, liver cancer, cirrhosis etc.Mainly due to alcohol, fat and hepatitis in general.Which causes jaundice, abdominal discomfort, weight loss, nausea, weakness, indigestion, fatigue etc.Please consult your surgeon for accurate diagnosis by ultrasonographyor or CT scan.Take treatment according cause found.Don't eat spicy and oily diet.Do regular exercise.Hope this will help you a lot.Thanks for contacting us.Have a healthy life ahead.Take care...Hope this will",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pressure with discomfort and panic?\n\ni am 47 years old have type 2 diabetes high blood pressure obeses in weight but under control via gp and cardiologist .now my problenm past 2 days sudden onset of squeezing mid chest lasting only 2 to 3 seconds.with no other symptoms other than panic.can u tell me should i be worried .the discomfort cames on at rest also.n.b i have a waist size of 44 inch",
    "doctor_response": "your concern is about chest pain which lasts for 2-3second only. if it's really only in seconds then chances of cardiac origin is less. however being a diabetic obese and hypotension patient cardiac ischemia can not be ruled out. better is to take chewable aspirin 300mg and get an ecg done. and further investigation if required as trademill stress test,echocardiography. and advise you to consult a cardiologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do i feel heart pulse in my abdomen ?\n\nHi, i m 16 years old. Lately, i had felt my pulse on my upper abdomen . It s really weird because i ve never noticed it before. Is there something wrong with me?",
    "doctor_response": "Welcome to Healthcare Magic Good Day Hi, The pulse you were feeling could be that of your abdominal aorta. It is usually well appreciated in thin individuals and quite well palpable after a meal or when in excitement.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from Proteus Mirabilis\n\nHi, My son has Proteus Mirabilis (more than100 000)in his urine. What can we use as natural remedie? to avoid antibios? Thnx Eva",
    "doctor_response": "hello eva..\u2018\u2019. consult ur doctor first n take his advice.. make him drink lots of water.. u can give him cantharis 200  one dose in the morning and second dose at night its a homeoapthic medicine so safe \u2018Wishing him Good Health\u2019. drvigsclinic@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of Psyllium Husk?\n\nI m having very sharp waves of pain in my upper abdomin that rolls upwards towards the chest. This happens everytime i eat something. Symptoms started when I took Psyllium Husk day before yesterday and that very night i ve had severe stomach pain. Bowel movements started today. But the pain is still there. Help",
    "doctor_response": "Hi, Psyllium (metamucil) is a bulk-forming laxative commonly used to treat constipation or bowel irregularity. Its common side effects include stomach cramping, nausea, vomiting and bloating sensation. A dose reduction of psyllium husk is recommended to over the stomach cramps along with adequate oral fluids intake however other causes of abdominal pain must be ruled out by your doctor.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why having hair loss even after treatment and is there any side effect of Fimax?\n\nHi doctor, i am 28 year old male, suffering from hair loss for last 5 years. i don't have any family history of hair fall and all family members has good hairs. untill 2 years back i took homeopathic treatment for hair fall, it slowed down my hair fall but didn't stopped it. Now my crown area has very less hairs. recently i consulted a dermatologist and he prescribed me Fimax 1mg and hairbless 5/4A lotion. i am worried that what side effects these medicines have and whether they will be helpfull and whether there result will last longer or just temporary till i take medicines",
    "doctor_response": "Hello. Thank you for writing to us at healthcaremagicYou seem to have androgenetic alopecia.Androgenetic alopecia mainly affects the front and crown part of the scalp. There is thinning as well as hair loss.This may also be accompanied by widening and deepening of angles of the anterior hair line as well as gradual recession of anterior hair line.Family history is positive in most in father, brother etc.Presence of family history in first degree relatives is not a prerequisite and it may be absent.History of baldness in uncles, nephews, cousins etc is also of significance.Minoxidil and Finasteride are approved treatments for androgenetic alopecia.The goal of treatment is to arrest Or slow down further progression.It is easier to maintain hair and slow down progression rather than regrow new hair.Therefore, treatment should be started early before alopecia has progressed to later stages.These are prescription medications and therefore I suggest that you visit a specialist for the needful.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swelling in throat and lump on throat after chewing tobacco. Is this allergic reaction?\n\nhi my question is about my twenty nine year old son. every time he chews tobacco his throat swells and now has a lump on right side of throat could he be allergic? we have had doctors give him meds for allergies and they work for the period he takes them then he chews again and the cycle contnues",
    "doctor_response": "this can be allergic or chronic inflamation as per my opinionthe chronic irritation and infection can cause lymph node swelling you must get check up for its cause and try to get rid of tobacoo in my view",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for burning sensation in legs\n\nI have been suffering with intense burning sensation in both legs for 3 or 4 years. Somedays my toes feel tight & swollen. I ve tried gabapentin and cymbalta, but they did not help. The only relief I get is when I go to bed. The discomfort calms down, but it never completely goes away. As soon as I get up in the morning the intense burning starts all over again & usually lasts all day everyday. I ve tried ice packs & cold towels. Lately I ve noticed this burning sensation has moved up into my left arm & left breast. Dose this sound like anything you can help me with? Thank you, Delores Adams",
    "doctor_response": "There can be two causes of this type of pain.One is nerve compression in the spine.Other can be poor B 12 level or smoking causing Burgers's disease. I would recommend you to get ultrasound of the leg to see if there is normal vessels. Also MRI of the spine to see if there is nerve compression in the back. According to that further management can be done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can multiple fractures in leg be treated?\n\nI had a road accident 3 months back, my right leg had multiple fractures, it was operated and a rod was inserted in it , now i am recovering from it , but during my last vist to doctor in medicity i was told that my ankle is in not good position and it has to be operated. is operation of ankle adviced, what should i do?",
    "doctor_response": "Hello, I think there may be a malunited fragment and a revision surgery is required. Repeat surgery will be a better option to prevent complications like arthritis and stiffness. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain, General & Family physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should I follow diet control while suffering from jaundice?\n\nHi i m partially recovered patient of jaundice. i had my last test on 19th december which shows my bilirubin 5. my jaundice was diagnosed on 28th november, from then i m on a very strict diet, no meat, no oil, no milk and no egg. for how long do i have to follow this diet?",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I canIt depends on type of jaundice. In most cases it should be followed for 6 months and alcohol should be avoided for longer.Medical management may involve treating infectious causes and stopping medication that could be contributing. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for constant stomach ache and bowel movements\n\nI've had a lingering, constant stomach ache for two weeks. It's not very painful, a 2 on a 1-10 scale. Sometimes it feels a little worse. No vomiting, but I've been having bowel movements more than 4 times a day. I'm not pregnant. I can't figure out what's wrong.",
    "doctor_response": "Hi,from history it seems that there might be having chronic gastro-intestinal infection giving this problem.Go for one course of ofloxacilin, tinidazole combination medicine for 3-5 days.Take antispasmodic medicine like Cyclopam or Meftal spas for pain if needed.Take light diet for few days.Take plenty of water.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for chesty cough\n\nI went swimming in the sea on Monday in a wetsuit in Cornwall for about 15 minutes only, and I have developed a very sudden chesty cough. Sounds like mucus, but not coming up, very noisy, very painful. Advice please? I have suffered with bronchitis and pneumonia in the past. I am 51 and female.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Sudden onset cough, mucus in chest, chest pain etc are commonly seen with pneumonia. And swimming in sea water can be a risk factor for pneumonia.. So better to consult pulmonologist and get done clinical examination of respiratory system and chest x ray. You may need need antibiotics, antihistamine and anti inflammatory drugs. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can vertigo, tinnitus, headaches and hand numbness be treated?\n\nI have been diagnosed with Lupus CNS. I am currently taking cellcept and prednisone. I was hospitalized last month and was given 1000mg of prednisone by IV for 3 days. This helped for awhile, but I am starting to have the same symptoms as before I went into the hospital. I have vertigo, ringing in my ears, headache, hands and feel go numb even when I m using them. I tend to fall if I m not careful. I have also blacked out a few times. I have consulted with my rheumatologist who suggests that I either wait and see if the cellcept is going to start working or start trying Cyclophosphamide (Cytoxan). I am afraid to take the Cytoxan as both of my parents died from cancer.",
    "doctor_response": "Hi, Thanks for the query. Co- morbidity be there or just modifiable adverse effects of medicines you take. If a person is ill , commonly dietary deficiency occurs, so you have to consult with your family physician for supplementation for vitamins and minerals wiz. Bit. B12 , biotin vit.B6 bit.B1  Vit.D etc.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is surgery only way to treat bladder cancer?\n\nWhat happens if we do not treat my 87 year old father's bladder cancer?  It is contained in the bladder. He has had 2 surgeries and is scheduled to stat 2nd round of flushes .   (he also has ahlzheimers at mid-level) If we don't do anything but keep him comfortable  - no more surgeries or flushes - what can we expect?  Is the pain manageable?  Thank you.",
    "doctor_response": "Hi,Thanks for writing in.If surgery is recommended for cancer of urinary bladder then it is contained withing the bladder and still in early stage. Any cancer if detected in the early stage can be treated better with surgery and usually this is a curative treatment. If surgeries have been done then treatment with flushing is important to wash out the cancer cells which were left over after surgery. This is a recommended treatment and followed in most cancer hospitals.If you choose not to proceed with recommended treatment then there is a probability that the cancer might return and cause more distress than the pain he is having during the treatment. In case of your father the pain is managable and this will help to cure the cancer. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for foreskin retraction issues\n\nAge 28, Height 5ft 7in, weight 70kgs, no previous medical history. Question relating to foreskin retraction. I first pulled me foresking back when I was 18 years old. I can pull it back anytime and there is no pain, but it does not easily move back and forth during sex or masturbation.  it is either in the on or off position.  Is this normal, what can be done to correct this?",
    "doctor_response": "Hello, There is nothing unhealthy about the condition unless you feel pain. You can use some lubricants to overcome this issue if you really need it. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child having rash on abdomen, flank area, buttocks, thighs. No scales, itching. What could it be?\n\nMy 6 year old daughter has a red rash on her abdomen, flank area, buttocks and thighs. It is simply red, with no postules and is not scaly. She says it does not itch and does not burn . I noticed it about a week ago before she went to bed and when I checked her the next morning it was not as red. Tonight she called me into the bathroom and she was about to get in the shower to show me again.",
    "doctor_response": "Hello,Thanks for the query,Asymptomatic rash is quiet common in children,It is usually viral in nature.However the rash of your daughter is persisting and typical.Another possibility is allergy to clothes.A photograph would have helped in diagnosis.Please meet a dermatologist for final diagnosis and treatmentLet me know if you have any other doubt.you can ask a direct question to me on this forum, following the below link.  you a good health.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for mood swings when on Quetiapine and Mitazapine\n\nI am taking quetiapine 25mg and mitazapine 15mg \u00b7\u00b7\u00b7My panic and insomnia is better but I have very irrational moods like losing my rag really quick and my limb are so heavy that walking up the stairs is such an effort \u00b7 I have 2 kids and can t get the energy to look after them :(",
    "doctor_response": "Hi dear . I  had  gone  through  your  query .Quitiapine  is anti psychotic and help as sedative .Mirtazapine  is anti  depressant  and it elevated  your sad mood.If you have mood variability  in spite  of these then need to add mood stabilizer.Mood stabilizer  like sodium  valporate  /  olanzapine  /  lithium  / lamotrigine  etc can help.Choice  of  medicines  depend  upon clinical  presentation .You  have  to  take  advise  from  your  treating  doctor  before  taking  this  medicines.If you have still  query  then  feel  free  to  ask .  Happy  to  help  you  further .Thank  you .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Chinese herbal medication advisable for allergies?\n\nI have a friend who is extremely allergic to most antibiotics she has taken. She has had a reaction so sever that she was admitted to the burn unit at a major hospital. They were concerned that she had SJS. She did not. She has just gone to an allergist to test for penicillin. She was very allergic to it as well. I know that Chinese herbal medicine, has many followers. How would she gain more valid medical information from a reliable source",
    "doctor_response": "**1.  avoid alcohol, caffeine, excess physical \u2013mental exertion, sun exposure, corrylium, smoking, errhine therapy, betel leaves, gruel, soup, day time sleeping, garlic, ginger, onion, spicy-heavy- junk food, mustard oil, pickles, .Take: mint, coriander, tomato, cumin, plenty of water, vitamins and mineral supplements, apple, banana,grapes,dates2. Prescription drugs available are: haridra khand, tablet Talekt, Purim, Arogyavardhini vati,Gandhak Rasayan, Shirish Avleha, ghritkumari, brahmi, ashwagandha, jatamansi, stresscom.PS. since the ingredients of Chinese herbs are not known/mentioned thus for more information regarding Adverse effects of Chinese herbs, please go through: www.naturalstandard.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Constant feeling of fatness, skipping food, wear layers of clothes to hide fat. eat only dinner. High BP, tired, ADHD and trouble sleeping. Physically semi active. Anorexia?\n\nI think i might be anorexic. I'm not sure if i'm being realistic with myself or not. I'm 5'6 inches tall and i weigh 155.3 pounds. I constantly think i am fat, talk myself out of eating almost everything i considering eating, I try to wear layers of clothing that hide my fat, i have high blood pressure most of the time, i fins myself tired alot, i also have ADHD and trouble sleeping. But i do eat dinner always, i try to skip lunch, but sometimes i don't because my hunger takes over. I never eat breakfast. I'm semi active. I play on a soccer team and play in my yard on some days for an hour. I need to know if i have it or not, or if there's anything to do about. I",
    "doctor_response": "hi there, usually the age and gender of the person is important in assessing the ideal weight of the person but considering that you may be a young female, your ideal weight should be between 115-155 pounds which I think is ok for you. You should not worry about being overweight but should consider to stay healthy. It is not a good trend to skip any meal. It is wiser to take small meals low in fat and carbohydrates but rich in vegetables and fruits. If at all you need to cut down on the food avoid having meals after 7PM.Pick up some regular exercise which involves doing cardio. Doing yoga will also help you curb some of the anxiety and stress associated with it. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and cramps in the calf muscles?\n\nhi dr! i am living in malaysia with my husband. actually the problem is with my husband. he is having painful calf muscles specifically and cramp like pain in his legs, consistently for a more than a year. he become tired and lethargic with an average or a bit more activity. he has pain his heels also but then he consulted the doctor and he suggested the cholestrol test which was quite high, he took medicine for it and the problem was solved, but now a days he is again feeling pain in heels at times. kindly suggest something",
    "doctor_response": "Hello I have studied your case,These symptoms are adverse effects of statins medication which doctor might have given to lower blood cholesterol levels..Continue your nutritional supplement.Take plenty of water, fluid intake will dilute toxins.Eat fresh fruit and juice and soup they have anti=oxidant.Physiotherapy with ultrasound and Tens will help you,Yes you can do exercises like swimming, riding stationary bicycle, but do not overexert yourself.Take potassium rich diet.Hot and cold fomentation to leg. You need to continue you medication for couple of month to see effects.Add tab methylcobalamine 1500 once day or Inj methylcobalamine1500 mcg once week for 6 weeks.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes urticarial rashes on the face and body of an infant?\n\nSeeing a 2 1/2 month old with uricarial appearing rach on face/trunk/extremities, not eczematous, since 6 wks of age. Thriving. Pedi switched formulas, now on Neocate with no change. Lesions are palpable, parents describe some appear to be a bruise.",
    "doctor_response": "Hello, I feel that this could be Atopic dermatitis or eczema. As urticaria is extremely uncommon in this age group. I suggest you upload an image here so that I can guide you better, please. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What measures should one take to increase sperm motility ?\n\nmy husband s sperm motility is 40% instead of the 50% WHO standard. What can we do to increase his sperm motility? He has a big stomach and is lazy about exercises though he has stayed off alcohol and quit smoking for over 10years. could this be the reason and honestly how can this be solved? We have been trying for almost a year.",
    "doctor_response": "Hi, welcome to H.C.M.Forum, you have to visit a fertility clinic for this purpose. 40% is not a big problem. fault may be in either of you, for that screening of both of you should be done.for stomach he should avoid fatty foods, junk foods, fleshy fruits. minimise the sleeping time, avoid afternoon sleep. he should eat proteine rich food , green leafy vegetables, juicy fruits and juices. thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain\n\nhello, i am a female 21  years old i have been having terrible back pain lately on the right side middle of my back. i hurts when i try to swallow food or drink any liquids. i haven't lift anything heavy at all. what could this be?? im so confused, and it hurts so bad",
    "doctor_response": "Hello, Thanks for your query.I suggest you to follow the below mentioned measures to reduce your back pain-- Usually 1-2 days of bed rest will calm severe back pain. Do not stay off your feet for longer, though.- Avoid lifting weights as it imparts more strain on your back- Change your daily activities so that you avoid movements that can cause further pain, especially bending forward and lifting as it will worsen the intervertebral disc problems. if you want to bend forwards, do it with your hips and knees flexed.- Use a lumbosacral back support to stabilize your spinal muscles and to provide support for your spinal column.- After the initial pain has subsided, remedial exercises to strengthen the spine are very important to restore normal spinal movements and muscle strength. The main aim of exercise is to encourage mobility, reduce muscle spasm, prevent further deterioration in the muscles and speed recovery.- You should maintain an optimum body weight to decrease the strain on your vertebral column causing more degeneration and arthritic changes.- At times, spinal steroid injections and Facet blocks will help in alleviating the lower back pain.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes repetition of same thought in mind?\n\nHi there. I just wanted to get an answer, I have the same thought reapeat over again all day and in the morning i get random songs playing in my head which slowly wear off to a word then that word repeats for few hours then goes away is this OCD I also have fear to touch things sometimes.",
    "doctor_response": "Hello,The symptoms point towards possibility of having OCD.Please see a psychiatrist in person, he will interview you in detail to pin point the diagnosis. Undetected and untreated this will persist and increase. Had i been treating you, i would have given you clomipramine 25-100mg daily at night along with therapy session for thought stopping and ERP.Both meds and therapy are essential for complete cure of this illness.Wish you good luck.Dr. Manisha GopalMD psychiatry",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for hematoma on the right side of the brain?\n\nRight now after doing ct scan,MRI and angiography i am diagnos having 10 by 10 cm hematoma at my right brain. Then my doctor said i need to do major operation at my right brain. But there s a risk that my left brain might be affected. Its not cleared to me right now what are the possible risk of my operation if ever i said yes to do the operation. And if i didnt want to do the operation what will happen to me? Please help me doing the right decision.",
    "doctor_response": "Surgical decision depends on size, site, duration of haematoma and cause of haematoma.  Please mention your age and vascular risk factors.  Also mention MRA  findings. If there is underlying AVM or aneurysm it must be operated. Considering right brain involvement,  which is a non dominant hemisphere neurodeficit will be minimalHope my advice will help you.  Take care. Don't forget to rate me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of pregVit?\n\nhi Dr. i want to know that my doctor prescribed me PREGVIT , it is instructed that i should take one tablet in morning with empty stomach and one in evening within 1 hr. of my meal. what can i do if after taking the morning tablet i feel nausea? and what is mean by evening meal ? thanx",
    "doctor_response": "Hi, Preg-Vit is and multivitamin and mineral supplement commonly prescribed during pregnancy and lactation. Its common side effects include vomiting, stomach upset, and diarrhea. The recommended dose of this medication is take 1 pink tablet in the morning and 1 blue/dark blue tablet at least 4 hours afterward or in the evening (within one hour after dinner). Since you are experiencing nausea following the morning dose. To prevent nausea with the morning dose, the pink tablet may be taken 2 hours after a meal/breakfast. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mohammed Taher Ali",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it must to take vitamins and mineral tablets when thalassemia patient has fever?\n\nMy Mother's Thalassemia problemsHello Doctors,I would like to check the abovementioned.My family are asian, Singaporean. My Mother is aged 75, many years ago, she was diagnosed that she has thalassemia, then doctor asked her not to intake 'iron'.My mother has Depression and Insomnia illness, and taking Valium 10mg, Lexotan 20mg on night.Lately, she often feel cold even in tropical hot weather like in Singapore. Beside, she often feel bodyache, headache and giddy.We brought her for detailed blood test check again, and the adnormal results are as followed:1) Haemoglobin - 10.70 g/dL (Low),2) Haematocrit - 34.30 % (Low),3) MCV - 69.30 fl (Low),4) MCH - 21.70 pg (Low),5) MCHC - 31.30 g/dl (Low),6) RDW - 15.40 % (High),This time, doctor said her thalassemia is worse then last time. Doctor prescribed her the following vitamins and minerals tabs:1) Folic Acid tab - 5mg, OD2) Calcium Carbonate 450mg & Vit D 200iu tab, OD3) Vit B1 - 100mg, B6 - 200mcg, B12 - 200mcg. ODHowever, after taken for a week, she claimed that bodyache and headache getting worst, and not able to sleep at all, and also the same often feel cold. As the doctor said her thalassemia is getting worst, no matter how she must intake the vitamins and minerals tab, even if she has flu and fever.I would like to check is it a must to take those vitamins and minerals tab if she feel heaty, having flu and fever?What could be any others alternative issue?Thank you and look forward to hearing from you the soonest.Best Regards,",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Your mother may have thallsemia minor. Multivitamines like folik acid and B12 and minerals are useful in thallasemia patients. Her bodyache and headache has no relation with these tablets. She may have some infection or flu. Continue with vitamins and take treatment for your flu.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is complete recovery possible post surgical removal of a cancerous tumor below the liver?\n\nSir my father undergone surgery due to malignancy Tumour in abdomen it is infected small intestine and some intestinal part is removed and tumour is not removed it is placed below the liver in which the blood is purified doctor said after complete recovery of his illness he is treated with another surgery sir Please tell me there is a chance for my father to lead a normal life again",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. If the surgery has clear margins like no cancer cells left then he will need 6 cycles of chemotherapy for cure of the patient at 21 days interval. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having frequent stools. Prescribed me with Lopamide, Dolopar. Reason for lower abdominal pain?\n\nHi Doc, I am 38 yrs old. Last week I developed fever with frequent stools(not watery but squashed stools)  around 15-20 times.  The doctor prescribed me with Lopamide, Dolopar and Recoup for hydration. The stools and fever stopped on the second day but the stomach pain persisted and I thought it was normal and after one or two days. But the lower abdominal pain persisted and in addition to that I developed urinary tract infection. A relative of mine suggested that may be I had bacterial infection and asked me to take Norflox. So I took norflox and the stomach pain reduced but I started developing allergic swellings all of a sudden around 4 to 5 inches in my thighs and it was also paining. The next day I went to the doctor and he prescribed cefixime, xyzol, flavomed and cyra. But this were things got worse. The allergic swelling grew in numbers all around my legs and thighs and it was more painful than itchy. I felt the pain when ever I stretched the legs and I felt like the skin was tight around those spots because of the swellings. So the next day Hydodoctor stopped cefixime  and flavomed but asked me to conitue the other 2 along with Methyl Prednisolone twice and he gave me Hydrocortisone injection.But there was very little relief and it started to get worse and the next day he stopped all the medicines except Methyl Perdisolone and gave me 8cc of Hydrocortisone injection and he started to suspect vasculities and auto immune . So he tested my serum creatinine, urea , sugar levels, CRP Levels and ANA. The tested revealed that  my sugar levels were normal but I had infection along with high CRP levels. So he sent me to a dermatologist. The dermatologist told me that I had chronic Urticarial Vasculities. I asked her if that was auto immune problem. She told me that she would tell me once the all the blood test are redone along with LFT, RFT, CBC and ANA.There are 2 other important things to note that I have had this urticaria problem from Jan 2013 when my wife was sick in the hospital with many serious problems and she died. She had Tuberclosis in the uterus (don't know if it spread to other parts- hydrosalphinx) , Veno Occlusion Diesease of liver, Auto Immune Hepatitis,Liver Failure , Ulcerative Collities and she got infected with CMV ,Pnuemonia Skeibella in the hospital. I was in the hospital for nearly 90 days that's when I got this allergic reactions. So afte",
    "doctor_response": "Hi, It is good to follow-up with your allergist, and rheumatologist. Furthermore, I would recommend to do the urine test again to exclude the relapse of infection and get proper treatment. Hope it helped!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are Shelcal and Haem-up advisable during pregnancy?\n\nHi doctor. My wife is a 20 weeks pregnant and our did not suggested any medicine for Calcium and iron. I want to start from side for Calcium is Shelcal And for iron Heam-up. Is it good to start or advise for the same. Thanks and Regards Mohd Kamal",
    "doctor_response": "Hello,Thanks for sharing your health concern with us. Firstly, I would like to know if there is any specific cause why your wife's obstetrician put off prescribing nutritional supplements. If proper diet is taken along with folates, supplements can be postponed for a while. If you wish to start supplements, please inform your doctor of the same because no self-medication is advisable. Shelcal can be used while it is better to choose a safer preparation than Haem-up. Allow plenty of fresh fruits, vegetables and rest. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "When will I get pregnant & how many cycle it take to get pregnant ?\n\nI had taken pelvis scan on 31st March (My Period is started that day). The report is Rt ovary is normal in size and appears polycystic. and Lt ovary shows a small cyst (3.46 * 2.78 cm). first 5 days i took clomid 50mg . daily i take vifolin .(3 months). after that i went to follicular study from 10 th. ovlation is not occur. than doctor prescribed injection choriomon 5000 i.u (two times 10th and 12th). ovlation was not occur. i took ovitrelle 250 MCG injection .Ovlation occured and i took duphastone 10mg for 10days. Again My period is started at May 1st. Than doctor prescribed FERTAB 50 mg For 5 days. (from may 10 th - i go for folicular study ). When will i get pregnant ? how many cycle it takes to get pregnant ?",
    "doctor_response": "Hiii banu, Good morning to healthcare magic. You are currently suffering from Primary Infertility due to Poly cystic ovary. You will get pregnant only if ovulation and sexual intercourse occur in correct timing. You have cystic ovary.So ovulation time alters and take time to be pregnant. So regularize your cycle and monitor your ovulation time regularly. Also you may do a fresh semen analysis for husband to detect any abnormality. Consult with your gynecologist and keep under treatment. All the best. For more suggestion,you may mail....soumenmmch@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing  rash that seems to be spreading?\n\nI have a rash that is seems to be spreading to my arms. I have taken Benedryl for 7 days and have just bought Eurax cream. I have been to the doctors and they have just told me that it is a allergy rash. Im worried because it keeps spreading.. please help me :(",
    "doctor_response": "HIWell come to HCMChances of hypersensitive reaction is very likely and this could be urticarial rash and in my opinion this need to be treated with Tab Levocetrizine 10 mg three times in day, even some time this comes around without the medicines, hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to increase the appetite?\n\nHelloI have 18 months old daughter, she refuses all kind foods(fruits, vegetables, pasta, rice....) .im worried about her growth. She is just 8 kilos. She born with 3.5 kilos. She is still on breast feed .is there any kind of syrup to increase her apatite.?Thank you.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.I take this opportunity to tell you certain scientific facts and relieve your distress - 1. An active is a well kid even if she/ he is not eating well. 2. Development of a kid is as important as or I would say even more important than growth alone.3. As the kids grow their interest in food decreases and interest in play activities increases so that they eat small quantity and run away to play. As parents we need to be more patient and feed than less quantity but more aliquots per day.4. This age rather than the quantity of the food I suggest you concentrate more on the number of times you feed her and also make whatever you feed her calorie dense by adding good amount of ghee to it.5. I suggest you not to use appetite stimulants on long run as they may cause drowsiness.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does colicaid help to pass stools in a baby?\n\nMy 2 months baby has been crying all night with SOME pain. His clothes are comfortable, he is not hurt. His mother tried to feed him last hour but he is not comfortable having milk. He didn t pass his stools too for 24 hours. We gave him colic pain 5 minutes back as suggested by Pediac. Let me know if I can check on something immediately, and will Colicaid help him pass stools?",
    "doctor_response": "Hi, yes colicaid drops helps in relieving pain abdomen in child. If child has not passed stools for some time, than also colicaid drops helps in overcoming stool problem in child. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does it mean when a person is in ICU with Staph infection that went into sepsis ?\n\nwhat does it mean when a person is in ICU and they have had a Staph infection that went into sepsis infection, it appears all is clearing up, pt getting blood tranfsions and has a blood clot in the artey in the neck ( i'm sure you know which one can't think of the name right now) still in ICU and now heart rate at rest is 185?.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. The scenario you are describing suggest poor prognosis. Staphylococcus infection in blood can lead to severe sepsis. And this causes hypotension, tachycardia, septic embolism etc. This emboli can cause blood clot in vessels. Tachycardia of 185 is very high. So over all his clinical picture is not good. It suggests that his infection is not controlled. So prognosis is very poor in his case. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need treatment for self harm disorder\n\nI have a quick question. Last year, I struggled with self-harm for a brief period, but stopped on my own never having sought help. Then, last weekend, I did it again. I don't plan on doing it again and feel I can stop on my own. Should I still seek help?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Though the question seems simple, there is supposed to be more to it. Every behavior has its reasons. If you behave in such a way that you harm yourself, even just once, why? I need an answer to the above question. Generally self harming behavior comes out of anger and frustration. Both these emotional outbursts can go out of hand. Then another question comes forth. What was your emotional state when you tried to harm you in both those occasions?Please, You can post a direct question to me in this website. Include every detail as much as you can. I shall prescribe some psychotherapy techniques to control your condition. I am sure that the techniques should be a success.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shape change of jaws?\n\nHi. I have concerns with the shape of my jaw, I recently grew a beard and while grooming I used to twist the hair at the ends, end of the jaw to get the hair into a shape, now i ve taken off the beard and my jaw looks flattened, and smaller, can this be the cause, or can extreme stress cause it?",
    "doctor_response": "Hello, The change in the jaw bone has nothing to do with the beard and the grooming. It's just that you may have noticed the jaw after a long time which may have made you felt the jaw is flattened and smaller. In fact, it will be much the same as it was before. Maybe some additional fat tissue deposition can occur at the muscles or else nothing more than that I feel. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to prevent staph infections coming back?\n\nHad UTI due to e coli, responded well to macro bid. Less than week later, after having pelvic exam and sex, have UTI due to staph sapro (50,000 cfu/ml). Finishing bactrim 7 days. Am 14 weeks pregnant. Otherwise, excellent health. Questions: what could have caused the staph infection? Do I need to be vigilant about regular urine tests to make sure doesn't come back? Why isn't bactrim indicated when pregnant?",
    "doctor_response": "Hi!Welcome to HCM!I appreciate your concern, nothing to worry.Following are the answers for the questions asked:1. You might have acquired the Staphylo infection during the pelvic examination since Staphylococci are normally found in the skin. If aseptic precautions are not undertaken then the chances of infection will be high.2. No need to have regular urine tests to detect the recurrence of infection.Maintain a good hygiene surrounding the private parts.3. Bactrim is the antibiotic found to be unsafe during pregnancy, hence not prescribed in your case.You are advised to take plenty of oral fluids, maintain good hygiene to prevent the possibility of UTI.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat pain just above the ankle?\n\nHi,I have daily pain just above the ankle in about the same spot I broke my fibula maybe 15 years ago. Had this pain for a year or so and seems to get worse with more activity. Worse in the evening and impacts ability to go to sleep. Usually have no pain when waking up in the morning. Could this be arthritis associated with the break and what can be done about it?Thanks.",
    "doctor_response": "Hello,I think you have got ankle posttraumatic arthritis. You should get ankle x-rays in 2 or 3 positions and confirm this diagnosis. The treatment is different depending on the stage of arthritis. In early stages the treatment is non-operative with medication, braces, and physical therapy. In advanced stages treatment is with surgery, ankle replacement, or fusion.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Edvin Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back and pelvic pain?\n\nHi doctor, iam 32 yrs old. Iam having left pelvic as well back pain,only left lower side ( both). Pain Is not stable...it s very mild, stays for a sec and the goes...but I feel even during movements in left side...have this problem for past 6 months...iam very much worried. FYI I had my second delivery inJan 2015 (VBAC)",
    "doctor_response": "Hi welcome to HCMI have gone thru your query and can understand your concern . Pelvic pain can be a sign that there is a problem with one of the organs in your pelvic area, such as the uterus, ovaries, fallopian tubes, cervix or vagina. It could also be a symptom of infection, or a problem with the urinary tract, lower intestines, rectum, muscle or bone .So there can be many  causes concerned with your problem .You might have to undergo a lot of medical tests to find the cause of the pain. The treatment will depend on the cause, how bad the pain is and how often it occurs.Another prominant cause of your pain also can be imbalance of (Vayu Tatv gas , in your body , which is  responsible your pains and inflammation .Proper regular physical activity , walk  ,meditation ,pranyam - deep breathing ,Yoga - back bending  exerises to relieve your back pain , to boost your blood circulation and detox your system under guidance of trained guide and balanced diet, including ,all essential nutrients as fiber ,vitamins,minrals and antioxidants  Ginger , Garlic , Amla , Aloe vera , nuts , Turmeric powder a spoon  in a cup of hot milk at bed time ,Cocconut water  ,all in natural form  help, eradicate Vayu Tatv ( gas) alley pains and inflammation and give resistance from diseases . Avoid food that is high in saturated or trans-fats like fried , fast foods , refined sugars and fine floor prducts , tea , coffee , alcohol , sleeplessness , dehyderation , constipation .worry ,stress all induce toxins in your body and cause you sufferings .It is advisale to consult your doctor before following any regimeHope this helps solves your query .Take care , All the best .Don't hesitate to get back if have any further queryv",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should Azulfidine be taken for edema in the knees?\n\nI ve been diagnosed with RA due to a pretty high RA factor but have no pain and, as yet, no joint deformity other than some osteo in my hands. I was originally diagnosed with CPPD, have recurring swelling in knees, a high nucleated cell count but now, after two years, no intracellular calcium crystals. Rheumatologist, a rather doddery one, wants me to start on Azulfadine after 5 months on meloxicam haven t helped keep fluid off knees. I m reluctant to take a heavy duty drug when I have no pain, no symmetrical joint derformity, no RA in xrays, and no pain. Do you think I ought to at least try Azulfadine?",
    "doctor_response": "Hi, It is used to treat rheumatoid arthritis. Also, used to treat ulcerative colitis etc. Many drugs are there for rheumatoid arthritis. These drugs are useful to treat the disease under control. Treatment depends upon the serum RA factor, anti-CCP levels. Please consult your rheumatologist he may advice right dosage of the drug. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of spots on gums?\n\nhello. i had redness around my gums which lead to severe pain later on. after a day or so i ended with some swelling on the outside of my face around my gum area. i have started taking anti biotics and brufeon with that i use a mouth wash. but i am still concerned because i have spot like things coming up on my gums. could you please advice me. will this get better or should i do something else.",
    "doctor_response": "Hello, Thank you for consulting with HCM.There can be two reasons for this gum and face swelling and spot. First it can be possible that the tooth might be infected  of that region, which has formed an abscess in the apex and a swelling with collection of pus. For this you have to go for root canal treatment of tooth as medications can not relieve it.Second it can be possible that there is an abscess of gums called as gingival abscess, for this also you have to visit a dentist.Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are multiple myeloma and plasma cell dyscrascia side effects of radiation therapy?\n\nmy husband had radiation therapy in 1986 while in the military for testicular cancer and discharged due to adverse affects from the radiation. In 2008 he started having medical issues turning out to be multiple myeloma, plasma cell dyscrascia. could the radiation therapy contributed to this",
    "doctor_response": "Well, it is difficult to say conclusively. radiation therapy is known to cause certain cancers like thyroid, breast or lymphoma. Even amongst these cancers, radiation induced cancers form a small percentage. Only rarely does radiotherapy for a previous cancer lead to multiple myeloma. So it is almost impossible to ascribe it to your previous radiation although it is definitely a possibility.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is missing few doses of Insulin harmful?\n\nI had to reduce the amount of Levemir that I take because I have to wait for the Low Income clinic to send me my prescription and I won't have any insulin until Wednesday afternoon. I need to know what will happen while I wait for my insulin. I used to be able to get it at the pharmacy in town but Humana never told me that they will only allow a certain number of times to refill and now my cost is $161.00 for it. It used to be $47.00. I was told to eat only things that had no or very low carbs, no sweets whatsoever and cut down more than half of my dose of insulin which I used twice a day.",
    "doctor_response": "Well come to HCMThank for asking I really appreciate your concern, if you are missing the dose of insulin no matter what is the cause for that you are not taking the medicine or insulin dose, then the level of glucose will go increasing in system the plasma glucose level will be too high some time it may cause the ketoacidosis, (Diabetic coma) but it takes few days and it may not happens at once or it is not the sudden onset of diabetic emergency, if it is not the type one diabetes then you can try oral hypoglycemic agent,  hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to get rid of extreme fear, suicidal thoughts, and fear of failure?\n\nHello doctor, I am a 38-year-old female. I have extreme fear, suicidal thoughts, and fear of failure. I am not able to concentrate on my daily activities. How to overcome all these situations? I had an aortic valve replaced through open heart surgery. I was under Nexito and Rivotril for two years after my open heart surgery.",
    "doctor_response": "Hello. Decrease in concentration, suicidal thought, fear of failure, and sleeplessness are features of a depressive episode. Why did you stop the medicines? Did you take the medications in the proper dose, and is there any episode similar to the illness has occurred previously? I think you should again start Nextio Fort (Escitalopram and Clonazepam) for the adequate duration, and if not improved, some second-generation antipsychotic can be added, or try cognitive behavior therapy. For sleep you can take help of sleep hygiene to wake up on fix time irrespective of sleeping hours. Avoid coffee or other stimulating agents, have a brisk walk, avoid food before three hours of sleep, and you can take a shower with lukewarm water.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can a corneal ulcer be treated without seeing a doctor?\n\nHello doctor, I am pretty sure I have a corneal ulcer. I have had them in the past although. It has been a little over 10 years since my last, I know the pain associated with getting one and I do have a history. However, I had never actually seen exactly what it looked like as my eye would be too red. This time though, I see an off white dot on my cornea near the iris. I am a contact lens wearer and I know not to sleep with my contacts. I have been slacking some lately. It feels like something is in my eye and sticking a thin needle down through it. The pain goes through the whole eyeball. It feels like deep in my brain. It hurts like hell and I could not sleep. The moment I was finally able to relax my eye from fluttering, a painful vibration would erupt through my eye. I am also extremely sensitive to light. I know I need a topical antibiotic to put in my eye and no contact use. Can it go away on its own without having to see a doctor and get the solution? Or can I just get an RX without having to do all of that? It is not super easy right now to do. I also do not have any of my medical files on this as it has been over 10 years and I am currently in the middle of a moving transition and cannot locate them easily.",
    "doctor_response": "Hello. From what you have mentioned, you seem to be having contact lens induced keratitis (corneal ulcer) or marginal keratitis. A corneal ulcer develops when there is a break in the corneal epithelium. Normally, tears play a major role in maintaining the integrity of the corneal epithelium. However, there are several risk factors associated with corneal ulcer formation among contact lens users like overnight wear, duration of wear, lens hygiene practice, dry eye, and smoking. Marginal keratitis is known to occur as a reaction to staphylococcus toxins, or coexist with blepharitis or rosacea. If so, please revert back to me. The symptoms mentioned by you point towards corneal ulcer. However, the diagnosis is made by a slit lamp examination, which is done by an ophthalmologist. Hence, an eye examination by an ophthalmologist is necessary for the diagnosis and treatment. Also, corneal scraping maybe done to detect the infective organism. The most common being pseudomonas, followed by acanthamoeba. Delay in diagnosis and treatment can lead to further complications. So please see an ophthalmologist at the earliest.  Further, you must stop using the contact lens (the one you have been using). You must take the contact lens along with the lens solution when you visit the ophthalmologist, as they will need microbiological testing as well. Conditions leading to extreme dryness of eyes like environmental dust and smoke have to be avoided. You can also use dark tinted goggles as you have intolerance to light. And please visit the ophthalmologist at the earliest. After the diagnosis is made, you will be started off with fortified antibiotic eyedrops and cycloplegics along with lubricant eye drops. For more information consult an eye care ophthalmologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump below clavicle?\n\nMy son is 17 years old. He is 6'3\" tall, weighs 165 pounds. He lifts weights regularly, and runs cross country. He had a cross-country meet yesterday. Today he has a very noticeable lump below his right clavical, about 2 inches to the right of his sternum. It does not bother him, unless I touch it or he coughs. We are going to physician tomorrow. The lump seems to be on the outside of the ribcage and not underneath. Any thoughts? He is an active athlete and also runs track and plays basketball for his school.",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query.Even though it might not be possible to diagnose the lesion without a personal physical examination, it might come out to be a simple hematoma, or some kind of swelling which could be confirmed by a FNAC (fine needle aspiration cytology) and other related investigations if any after the physical examination. Therefore, you could get a clear picture of the lesion only after you get it reviewed by the doctor with whom he has an appointment.Thanks for choosing health care magic to clear doubts on your health problems. I wish your son an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the sharp pain in abdomen be due to gall stones?\n\nI am 23 years old female. Few years ago, I accidentally descovered that I have a 9mm gallstone. Sometimes, when I am nervous or concern, I fell strong pain in the upper abdomen that increases rapidly.  When in pain, I drink linseed tea and the pain goes away in 30 min max.Doctors told me that I can live with it and didn't mention any other treatment than surgery. My diet is really healthy, and I have normal weight. Just to mention that my both grandmothers and my uncle (the brother of my father) had gallstones.I do regular checks- everything is normal and the stone does not increase.I want to keep my gallbladder since I don't fell pain often, actually it is very rare, max 10-15 times in few years. The problem is that I was told that the pregnancy with gallstones is hazard. I am not planing to get pregnant in near future,but I want to solve the problem with the stone, so I can have safe pregnancy in a few years from now.Can you please tell me your opinion about my problem.Thank you for your time and concern.Sincerely, Anita",
    "doctor_response": "Hello and thank you for asking HCM.I have read your report,and i understand your concerns.In most of the times,surgery is the only way of dealing with gallbladder stones. And yes,a pregnancy with a gallstone is hazard and might cause a lot of problems for the health of the mother (pancreatitis, infection of the gallbladder ect)Since you don't have serious symptoms (strong pain,vomiting,nausea, fever) and you don't want the surgery,there is another way of trying to get rid of the stone.Udiliv 300 (Ursodeoxycholic acid) is an oral prescription medicine used in the treatment of gallstones.It is also useful in preventing gall stone formation.It should be taken under medical supervision in terms of dosage and duration of intake after due consultation with a doctor.This product is safe to take if you are pregnant or planning to get pregnant.Also here are some advice to help your liver and body to not form any other stones:-don't use excessive amount of alcohol-avoid concentrated fats like oil, butter, margarine, fat on meat ect-vegetables, potato ,fresh fruits, rice,pasta ect-have  plenty of waterI suggest you check up with your physician or your gastroenterologyst for the prescripion of Ursobil. Your doctor will give the wright dose and the time that you need to take it.If you have any other question,feel free to contact me.Dr.Endri Katro",
    "dialogue_context": ""
  },
  {
    "patient_message": "Difficulty in impregnation, have azoospermia. Advised to go for sperm donation, adoption. Is opting for sperm donation advisable?\n\nHello Dr I have the problem for my husband. We are married 3 years. Still, the problem for baby. My husband sperm count is 0( Azoospermia ). so we are tried so many doctors. They are said to me, only for the two options 1. sperm donor 2. adoption. But i am totaly confused and i am mentally disturbed, Which is the best option i choose ? and , is there is any problem for sperm donor option in future? Tell me dr. Please",
    "doctor_response": "Hi Anitha Welcome to HealthcareMagic Azoospermia is not incurable. First of all azoospermia need to be evaluated whether it is due to block in tubes or there is no production of sperms at all. If azoospermia is due to block in tubes ( Obstructive ) then sperm can be collected from testis through a needle(PESA/TESA). Even when there is no block in tubes and sperms are absent there are chances of getting sperms with the above procedure. After getting the sperms IVF/ICSI can be done. when all these fail and you want to have your own baby , you have patience and finance is not a concern then you can even opt for Micro-TESE. Micro-TESE is new technique in which sperms are retrieved by a surgery and then surgery can be done.. Before all these your husband need to be evaluated thoroughly by a urologist and hormonal investigations to be done. If finance is a problem then you can directly go for donor IUI .There is no problem in future because donor's name is not revealed ,only his characteristics are known. Adoption is last option ofcourse. Wish you all the best for treatment . Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white chalky patches of urine?\n\nMy 5 yr old boy has missed the toilet when urinating a few times during the night this.month which i hadnt noticed until the next morning and when i noticed that the urine left white chalky droplets around the toilet. He has no complaints of pain or discomfort. No odor to urine.",
    "doctor_response": "Hello Sir/MadamI dont think your son has any major problem.turbid urine can be due to urinary infection but it is unlikely without any other symptom in children.You check his genitals for tight urinary orifice because it can lead to urinary infection.Also do a urine routine examination and microscopy so that any abnormalities can be detected.I'll be happy to clear any further doubts.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on the right side of my hard palate?\n\nI have a lump on the right side of my hard palatte I discovered this today. it was the first time I ever felt it yesterday I was with my gf and I gave her a hickey I was wondering if sucking on something really hard for long time can cause this? its not painful either",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some leukoplakia or some other lesion.  You should go for examination and then go for biopsy if needed. 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluctuating body temperature in fever with cough and headache?\n\nMy son is 21/2 years old, he had a fever for 3 days last week accompanied by a cough, and headache. Dr checked him out - said it was a virus, the fever cleared, but the cough has remained. My son has had a history of ear infections, so that is always my worry when he gets sick. I took him back to the doctor this past Monday - he was coughing a lot, but no fever, but hasn't been eating much. She said his lungs were clear, and that all looked ok and that his cough should resolve in a few days. Last night (Tuesday night) he came home from school with a low grade fever, still coughing and the fever has been fluctuating between 100.4 and 102. Can he have another virus?? Should i be worried?",
    "doctor_response": "welcome,take second opinion,doctor would examine physically & order for  blood test for hemogram,widal,culture,urinalysis,x-ray chest,ultrasound abdomen,he may refer to  E N T doctor for ear examination,sinus & ear infection are very common after viral infection.,he may put on antibiotics,anti allergic,take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for autoimmune disease in a child?\n\nHello, my daughter has suffered from many debilitating symptoms for about four years now. We are pretty sure that she has an autoimmune disease. In the past the has suffered from nausea pretty frequently with no rhyme or reason to what may be triggering it...presently over the past month she has suffered from more than her share of nausea. Yet, over the last 3 week she has been nauseous every day and has been throwing up a few times a week and sometimes a day. It seems that food is now triggering it. Any ideas as to why?",
    "doctor_response": "Hi... I have read through you question. Auto immune disease is unlikely to   produce the vomiting and nausea you have mentioned. the first thought which coming to my mind is a CYCLICAL VOMITING SYNDROME.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes neck pain and joint pain in all fingers?\n\ni have been suffering with joint pain in all my finger joints and my primary care and a rumetologist say my joints are fine. xray did not show anything. I also have 2 frozen shoulders, elbow and wrist pain. I had a neck injury that for some reason my doctor has never sent me for xrays or MRI. my neck hurts all the time, could all this be related?",
    "doctor_response": "Hello This all could be related ,please get your these tests done to know the exact diagnosis. HGM WITH ESR, CRP, THYROID PROFILE, URIC ACID, SERUM VITAMIN D, ANTICCP, ANA. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Jaideep Gaver",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reddish itchy bumps in the back of the neck, arms. Had scabies in the past. Recurrence?\n\nI have small, dense reddish bumps all over that itch , concentrated in folding areas. It started at the back of my neck and now it has spread to my back and arms (mostly on the underside). The neck bumps have now changed to a dry, scaly patch that itch a little less than the reddish bumps, as have some other areas which have started to die down . This has gone on for about 10 days. I was diagnosed with scabies about 5 months ago and my skin has been wreaking havoc since, I have been having some kind of a rash every 1.5 month. I am almost a hundred percent sure this is not a recurrent case of scabies as the itch is no where near its intensity when I had been diagnosed.",
    "doctor_response": "these are allergiesand the allergy can occur due to any substance at any age at any time as immunity decreasesit can be due to medicines taken for othr diseases like paracetamol ibuprufen paracetamol calcium iron multivitamins and diet supplimentsit can be foods pollens clothes oils shampoo cooking oil application oil hena dyes and other body application materialscan get diagnosed yourself by corelating the things or by teststill then you can take ebastine 10 mg od or bdapply calamine mixed with salysilic acid on affected areas",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness and tingling of foot in a diabetic patient?\n\nMy father is 52years old he is suffering from diabetes from last 1 month he realised fever in evening and pain behind ear during driving bike he feel pain in neck and many times numbness and tingling in foot during night he becomes very weak and also he feel cold in this hot weather doctor say his eosinophilic count increase and his tonsil become enlarged. Please suggest your opinion.",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your father's symptoms. These are suggestive of diabetic peripheral neuropathy (DPN). In DPN, the peripheral nerves (located in the skin) get affected. The common sites where nerves get affected are feet and hands.The common symptoms due to DPN are tingling, burning, numbness and pain in feet and hands.Nerve conduction studies may be done to confirm the diagnosis.Medications such as pregabalin or gabapentin capsules could help reduce the symptom severity.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting and nausea when had wisdom tooth removal?\n\nHi,Doctor,yesterday i had my wisdom tooth removed at about 2pm at vasavi dental hyderabad,Am aged 58.i had ice cream at 4pm.Night i had ragi soup and taken medicine prescribed by dentist.today  i had soup at about 10.30am.then i developed vomiting sensation and nausia at 12.30pm and vomitted.At 1.30pm i had idli mashed but i vomited that also iimmeadiately.i tried to contact my dentist.Am told that he will be at clinic after 5pm.Pl advise.",
    "doctor_response": "hello thanks for the consult at hcm,,Nausea and vomiting can occur as a result of swallowed blood, discomfort, anesthesia or pain medicines.  Post-operative nausea is usually self-limiting and sipping on flat cola or ginger ale often helps.  Soda crackers also may be used.  If nausea persists, stop taking the pain medicine..take anti nausea and anti emetic medicines, if it doesnt subside,,plz consult ur dentist ..hope t helps..tc",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long will the drug Mkat stay in body?\n\nMkat - how long does it stay in your blood/ urine? I am not a heavy drug user and I rarely dabble in drugs recreationally, however I tried some last Friday and I have a blood test this Friday and I d rather my doctor didnt have chance to judge me. I am 18, have the ideal weight for my height at 10 Stone and im pretty healthy.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You took M kat. It contains mephedrone. This drug is similar to amphetamine.  Its peak effect and level depends on route of drug delivery.  It cause rise in dopamine and serotonin level with peak effect within 40 minutes.  Its effect subside within 120 minutes.  So after that their level remains insignificant and doctor's can not detect. So your doctor can not judge whether you took drug or not after that. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have not had a fever for more than 15 years. Should I get tested?\n\nHello doctor,I have not had a fever for many years (around 15 years or more if I remember correctly). I read somewhere that I should get immunoglobulin checked because I have not got a fever for years. Will it be useful to do this test? If yes, then which ones should I get done as there are multiple tests for immunoglobulin-like G, M, and A? Please advice.",
    "doctor_response": "Hello. I really do not understand who has given you this information. If you did not get a fever since the last 15 years, is it not a good thing? Fever is a body's defense mechanism when you acquire any infection. Not getting fever means you have been taking good care of yourself and you are healthy. I do not think that you need to get any tests done. Please meet a local doctor or your family doctor and discuss your concerns with them personally. If you want to get some tests done, you can do a general full body health check. It will definitely tell you a lot about how you are doing health wise. Much more recommended considering the current stress at workplaces and personal lifestyle. Feel free to get back to me in case you have any other queries. For more information consult a general practitioner online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes delayed milestones in a 10 month old?\n\nmy 10 month old does not sit .His peadratrician says he is slihtly floppy and needs physiotherapy. will he be able to achieve all milestones with physiotherapy. at the ime of birth he had thyroid but treated completely and normal when tested after a week.",
    "doctor_response": "Hi....I understand your concern. But I need more information before reassuring you.Please answer the questions below -1. What is the exact date of birth?2. What was the birth weight?3. What is the current weight and length of the kid?4. Did the baby cry immediately after birth?5. Was the baby breast fed in the first 24 hours of life?6. When did the baby attain social smile?7. When did the baby roll over (at what age)?8. At what age did the baby sit without support?9. At what age did the baby stand without support?10. When did the baby start saying mama - dada?11. Did the baby get seizures any time?Please get back to me with answers so that I will be able to guide you better.You can approach me at the following link.Once the page opens there will be an option below my image as \u2013 ASK ME A QUESTION \u2013 click on it.Please find the link below -www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly look at my brain MRI and explain.\n\nHello doctor, I had an MRI of the brain and received the following finding: Questionable punctate area of altered signal gray-white matter interface left parietal lobe. What does that mean?",
    "doctor_response": "Hi.  Punctate areas could indicate many things like hemorrhage, chronic infarct, etc. Can you please mention a few things? What was the indication for MRI? In the report, they must have mentioned the area to be T2W hyperintense or hypointense, better if you can share a copy of the report. I will be glad to help. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Do you have any thoughts on promising drugs for dry AMD?\n\nHello doctor, I am 63 years old. I was diagnosed with dry intermediate AMD about five years back. The VA then was\u00a020/25 and now it is 20/60. I am currently on AREDS. I am a\u00a0non-smoker. I have an excellent health otherwise. The Amsler is normal. The recent OCT showed no fluid. Do you have any thoughts on promising drugs like Fenretinide, statins\u00a0or others\u00a0under trial or research?",
    "doctor_response": "Hi. For dry AMD (age-related macular degeneration), the recommendations mostly include AREDS2 (Age-related Eye Disease studies 2) formulation. The other recommendations are quitting smoking (in case of smokers), controlling hypertension, lipid level, diabetes and regular checking with an Amsler chart to pick early conversion of dry AMD into wet AMD. There are more treatment options available for wet AMD as it is a vision-threatening condition. There are options of intravitreal injections and lasers (PDT- photodynamic therapy). I would advise you to stick with the current therapy of AREDS and keep testing with Amsler. Keep in touch with your eye doctor about any new modality introduced for dry AMD. He will inform you. Dry AMD. AREDS and keep testing with Amsler. Stop smoking, control BP, blood sugar and lipid level. For further queries consult an eye care ophthalmologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness, nose bleeds and pressure in the head?\n\nMy friend had a car accident about a month ago where the airbag was deployed. Now she has dizzy spells, nose bleeds, pressure in her head, loss of speech, loss of movement. These episodes last anywhere from 15 mins to 45 mins. We went to er cat scan negative. Any ideas?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It is very reassuring that the CT scan comes out normal, it is sensitive in ruling out hemorrhages in the brain. To better rule out other brain damages or tumors an MRI would be more accurate so probably it would be advisable for her to have an MRI done as well. Another test to consider is EEG. This would examine her brain waves and rule out epileptic episodes. Sometimes epileptic episodes depending on the localization of the source might cause neurological symptoms while they happen (like speech problems or problems with movements). This is very important especially because her symptoms are episodic (in episodes 15-45 minutes).Hope I have answered your query. Let me know if I can assist you further. Kind regards, Antoneta Zotaj, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat diarrhea with hot and cold flashes and vomiting sensation in a child?\n\nMy 14 year old son has had mild diarrhea ever since we got back form South Africa this was about a month and a half ago first I thought it was a virus picked up at school and tested him with milk ferments it got slightly better but he still carried on with mild diarrhea since then I have taken him to see a doctor who felt his abdomen and advised me to have his stools examined the result was negative he says he occasionally feels as if he wants to vomit he is getting hot cold flashes and diarrhea has increased could you advise me what to do? Thank you",
    "doctor_response": "You can give domstal susp.1ml three times aday.&burping.small & frequent feedsentrtogermina one bottle two times aday  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with pain in left side, constant pain, kidney infection. What is going on?\n\nGood Morning, I have been suffering with a pain in my left side for the last few weeks its at its worse first thing in the morn , I find it very hard to bend down I am not in constant pain but hav grt difficulty if I sit down trying to get back up I did hav a kidney infection about five months ago and was wondering could this be another infection as the pain is more or less in the same place tho not as sever",
    "doctor_response": "Hi welcome to Health care magic forum.                            Thanks for calling H.C.M.Forum.                             You got pain on left side since few weeks. worst in the morning, hard to bend down, and to get up from sitting position.                             About five months ago you had a kidney infection.                             As you think it is not the kidney infection, and in that you dont find difficulty of movements, and will have a change in urine like frequency, urgency, and burning.                             It appears to be the inflamation of the bones and joints.                             You need to have neurotropic injections, anti inflamatories etc.                             I advise you to consult an orthopedic surgeon for diagnosis and treatment. you may need to have MRI,besides other routine tests for confirmation.                             Avoid taking more of potato, other tubers, tomato, egg, chicken, and sea foods.                             Wishing for a quick and complete recovery.                             Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for painful knees post cellulitis treatment\n\nMy husband had cellulitis in his knee and treated it with antibiotics. It has been gone for about 3 months now but he ca not lean on his knee at all and says that it feels like there is a lump under his knee cap? Is there something he can do to make it better? Does he need to go back to the doctor?",
    "doctor_response": "hiI think he may see a physiotherapist and do graded exercises for muscle buid uparound knee, do hot fomentation, apply local anti-inflammatory gels.it will be okaythanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Follicular scan done, shows multiple follicles on ovaries. Prescribed ovacare. Pregnancy chances?\n\nI have taken a follicular scan on 10 th day, it says right & left ovary Multiple Small Follicles & Endometrial Thickness 4.3 MM, (what is the meaning), whether i want to be in rest & should not do intercourse upto follicular scan get finish. Dr.Advised me to take Ovacare & asked to take the same scan on 13th day. whether is it possible to get pregnant this month.",
    "doctor_response": "Hello, At the moment a mature follicle has not formed in either of ovary.You should wait till middle of your cycle that is beyond 13- 14 th day to see if mature follicle forms.If scan detects mature follicle then there are good chances to get pregnant.So continue and repeat the scan. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in the feet?\n\nA month ago the side of my foot started to hurt and experience numbnes in a specific spot. When I laid down that foot the would hurt so much it kept me from. Sleeping. It would feel like stabbing or ripping of the flesh when trying to turn it in a certain way. Now a mn later the symptoms are still pretty simular but have spread I have a swollen ancle, pain everywhere in the foot, still numb in that one spot and it s not going away of getting better. I have SLE and bone spurs. Should I just chuck this up as nerve damage and wait to see my foot dr. In June or see my family Dr. Sooner",
    "doctor_response": "Hi, Numbness could be due to either compression in the lumbar spine or there is some peripheral nerve disorder. Kindly tell me your age and any co-morbidities like diabetes, hypertension, etc. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Anuj Gupta, Spine Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am scared if my ovulation will happen or not ?\n\nHi Its 4 years to my marriage and we are trying to conceive since last 4-5 months. I have thyroid 6.04 and taking Thyronorm since last 2 months ( I forgot to take thyronorm peals for 4-5 days between ) . I am scared if my ovulation will happen or not. Please help and confirm if I can be pregnant without any problem. My hsg and oethr scanns are normal.",
    "doctor_response": "forgetting thyronorm for 4-5 days don`t hinder conception. As your HSG & other scans are normal,you have bright chance to conceive.Consult gynecologist & get your ovulation studies by sonography.proper treatment will help you to conceive.Disclaimer",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need advice on Frenulum breve/Phimosis Foreskin issue\n\nPossible phismosis and short frenulum breve.The opening on my foreskin is to small for me to pull the skin back over the head of my penis more than a cenimeter. The frenulum is also to short to allow the skin the move much. I am 16, male, 5'10\", and 130 lbs.",
    "doctor_response": "HelloThanks for query Based on the facts that you have posted it seems that you have Phimosis .Consult qualified General surgeon for clinical assessment .The only best treatment option for Phimosis is to undergo Circumcision .This is a simple surgery done under local anaesthesia as a out  patient procedure and offers permanent cure and helps to have enjoyable sex for rest of the life.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible by penis tip touching vagina?\n\nI had a problem last week,  I was intoxicated, and a boy tried having sex with me, the tip of his penis touched my vagina but it didn't really go in, can I be pregnant, I'm supposed to be on my period, last night I received really bad cramps, but I haven't received my period this morning, whats wrong?",
    "doctor_response": "Hi, I think if you have not got your periods, do a urine pregnancy test. If negative wait for your periods.  If positive, consult a doctor if you don't want pregnancy.  Cramps can be a sign of menstruation.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes left sided cramps?\n\nhello my name is laura i was expriancing left side cramps last night while driving, this is going to sound crazy. and abusive, but i just wanted the cramping to stop. so i lightly punched my self.  I have what feel like a knot in my left side. and i feel like i have to puke .",
    "doctor_response": "Hello,I have studied your case and I think that you are having the lack of salt in the body. I would suggest you drink the glass of water with salt. It will improve your cramps immediately. Also in future avoid very cool temperature and take regular calcium and vitmainD.  Calcium should be 1000 mg daily and Vitamin D 60000 unit per week for six weeks. I hope these steps will be helpful for you. Let me know if there is any other follow-up questions.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes backache and pimples a week after IVF transfer procedure?\n\nHi doctor.. am actually on my 8days of my embroys ivf transfer..am afraid as am start having back pain and pimples.. i usually have pimples on my chin before i got my period.. can u please help me to know what is symtoms are? Should i wait for a negative answer... thank u",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Having back pain and pimples are not the indicative signs of negative result following IVF procedure. Some of them do experience back pain following IVF procedure. You need to take supportive measures like hot fomentation and local application of pain relief gel to overcome it. Pimples could happen as hormonal preparation like extra progesterone would be supplemented in the form of injection or tablets, as it is necessary to sustain and continue pregnancy following implantation. Pimples would gradually supply after few months as the dose of hormone preparation would decrease as the pregnancy progresses following a positive result. You can consult your doctor if the symptoms aggravates and becomes bothersome. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ashakiran. S.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mid back pain, bloated stomach, muscle spasms, gaining weight. Any ideas?\n\nFor the past month I have had mid back pain,distended bloated stomach, muscle spasms in stomach and gained 6 lbs. I'm 54 and have passed menopause . I also got a cold which is when it started a month ago. Back pain is very severe went to chiropractor twice so far.. Can u help? I also got a chest X-ray to make sure I didn't have pneumonia .",
    "doctor_response": "Welcome to HCM.bloating,pain is most likely due to excessive gas formation after indigestion.Take rebeprazole,pentoprazole/domperidone to subside it.Take nsaid/muscle relaxant to subside back pain but take it with some food,milk and continue above medicine .B12,calcium,d3,vitamin supplement will be helpful at this age.Apply nsaid gel locally.Start exercise,yoga regularly.Drink more water and fruit juices,vegetable soups,buttermilk.X-ray lumber region is necessary to ruler out cause of back pain.Also go for cbc,fbs,ppbs,urine,b12,calcium,thyroid profile.Consult your physician for better guidance and proper medical management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does negative rheumatoid factor regarding joint pain indicate?\n\nRespected doctor, my wife is suffering from joint pain for past some months. today we have taken a lab test. it shows RH FACTOR NEGATIVE,,URIC ACID 5.6 ASO ..POSITIVE could you please let me know what is ASO, does she need any surgery ? is it very harmful? expecting your valuable consult .thanking you sir",
    "doctor_response": "your tests suggest that she has seronegative arthritis.an aso titer in an adult does not have much value, it was not required to be done in the first place.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am i feeling exhausted and the shakes most of the day recently?\n\nhi Im a chef and have been over the last 8 years, I deal with a heavy work load, long hours and alot of stress, but this has never been a problem and I have thrived off this for years, but in recent I am really struggling to keep up and always feel exhausted and have the shakes for most of the day",
    "doctor_response": "Hello and welcome to Healthcare Magic. Thanks for your query.I understand that you are quite distressed by your recent problems. Feeling exhausted and having shakes could be due to a variety of causes. Psychological problems such as depression, anxiety, etc. could be possible causes. Medical problems like hypoglycemia, anemia, other nutritional deficiencies, etc. also have to be considered.So, the first step in management of this problem is to have a proper evaluation. Only if the correct cause is identified, then further treatment can be planned. So, I would advise you to consult a doctor in your place for a detailed evaluation and further treatment. Wish you all the best.Regards,Dr. Jonas SundarakumarConsultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling and numbness on the left side of the body?\n\nFor the past four years The left side of my body is tingling and gets numb. It seems circulatory but no doctor can give me an explanation. It seems tO be getting worse. What do you think it could be. Please, I'm desperate for an answer. This problem is starting to affect every aspect of my life. I'm only 21.",
    "doctor_response": "Good evening.  I am Dr. Saghafi and a neurologist.  I think the reason people aren't able to give you a satisfactory answer to your question is because what you may be expecting is something they can't do.  Numbness over 1/2 of your body in know way suggests a circulatory problem.  Therefore, you will not find a single doctor that can give you a good answer if you're expecting to hear that it's in the circulation somewhere...uh uh....What you really need to do is get to a doctor and then, TAKE THEIR ADVICE to be referred to a specialist who can perform studies and tests in order TO KNOW what's going on...guessing on a network like this doesn't do you much good since the information available is incomplete to make a diagnosis and there are literally hundreds (no joke) if not thousands of medical entities that can give a person numbness and tingling over a portion of the body.  So, hazarding a guess here young lady is definitely not to your benefit.  If you take my advice and get to your primary care physician who can decide what the best next step should be and then, bring back information in the way of test results, imaging studies of the head, etc. and upload them, I'd be happy to look at them and help you figure out what's going on if your doctor is stumped.You can look me up at by name (DARIUSH SAGHAFI, MD- Cleveland, Ohio, USA) at:   if you'd like a personal real time webcam consultation which can be done either through videocam (great if you'd like to get a virtual neurological examination done), instant live texting, or audio consultation you can find me on Wed.-Sat's 3a-6a (New York City Time Zone) and Sunday's 11p-3a at:www.healthtap.com/drsaghafiIf this answer has helped you gain a bit more insight (at least in why you SHOULDN'T use the internet to simply LOOK up symptoms) into your question would you consider giving a STAR RATING? That would be truly AWESOME of you and maybe we'll catch each other on the flip soon if you decide you wanna come back and see if I'm really this FUNNY in real life!  ROFLMBO!  Huh???-----  Cheers!  Be good....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My child's WBC count remains high even under antibiotics. What is wrong with him?\n\nHi doctor, My 4 year son is ill for past two weeks. Initially it was diagnosed as viral infection due to season change. He was given fever and cold medicine (Asthaline). Fever was mostly between 100-101 degree F. \u00a0He had occasional cough may be five times a day. He had the medicine for 5 days but there was no improvement. Then his doctor asked for a blood test. His WBC count was 23900 at that time. I have attached the entire report for your look.\u00a0Due to high WBC count, doctor suspected it as bacterial infection and prescribed him two antibiotics, Amoxycillin and Cephalosporin. In the next four days his fever got improved. But he had occasional low grade fever under 100 degree and he just wanted to lay down always. His activity has got subsided now. He is not interested in eating food. Only two small cups of orange juice a day and few bites of food. I took him to doctor again. He said antibiotics have not worked and asked for blood test and blood culture again. He also requested an x-ray suspecting pneumonia and a sonography of abdomen and pelvis.\u00a0X-ray showed prominent bronchovascular marking in both lower zones.\u00a0Sonography was normal. Liver, gall bladder, pancreas, spleen, kidneys and bowel loops were all normal. No mass or lesion or fluid or dilatation found.\u00a0Blood test again showed increased WBC of 31300.\u00a0Doctor said that he seems to have mucus in his bronchi and that seems to be the infection.\u00a0Doctor admitted him in the hospital, started giving him Linezolid and Cephalosporin along with Ipravent and Asthaline solutions, Pandotec (PPI).Today his blood culture report came as negative. No bacterial infection was shown.\u00a0Doctor asked for another blood report now and the results are appended. The WBC is still high with the value of\u00a029900. His doctor is again telling that he has both bacterial and viral infection.\u00a0We are very concerned. He is hardly eating anything and has already lost 2 kg of weight.\u00a0Before two weeks, he was absolutely fine and fit. He was physically very active.\u00a0What seems to be wrong with him now? Please help.",
    "doctor_response": "Hi. Your child has definitely got bacterial infection. From your attached reports (attachment removed to protect patient identity) the reasons are as follows. Contact with a person who has latent infection by coughing. Repeat x-ray chest, blood culture and CRP. 1. Atypical pneumonia. 2. Slowly resolving pneumonia. Continue full course of antibiotics. Cover mouth during sneezing. Revert back with the answers for the above questions to a paediatrician online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for knots on head post an injury\n\nThank you, the day before yesterday a cast iron lamp fall off a shelf and hit me with a force the pain is really bad, it did not bleed, I have several big knots on my head and it is like a very dark red and I have a dent in my head, so I am tired and today I have diarrhea. I am not sure what to do I can not touch my head the size is bigger than half of dollar",
    "doctor_response": "hi,thank you for the brief history of you.as you said you had a fall and also some knots over your scalp. You should see if you have any redness of the eye, bleeding from the nose or ear etc. Also as you have a direct impact on the scalp I will advice to meet a physician on a safer note for him to examine you. also you can take an MRI to see if any internal bleeding is there at a later stage if you have any abnormal symptoms.Swelling is a normal physiological process and it subsided in 48-72 hours or may be a little longer depending upon the age and other factors. As you said apart from this you don't have any symptom than you can wait for a while do some icing and things should be fine. If you find any abnormal symptoms you can visit the ER on a safer side.with the grace of God I wish you a speedy recovery",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is rabies vaccination required when scratched by a dog?\n\nHai Doctor,Today morning my pet dog scratched me with his nails but there was no blood only scratches on my hand.My dog is getting vaccinations regularly.Is injection is required for me to avoid any problems due to his scratches?Thanking you,Alex Jose",
    "doctor_response": "Hi Alex, Thank you for trusting healthcare magicI understand with your concern, in this case as long as your dog getting vaccinations regularly and the scratch received through claws or nails the chances of rabies are less, but not entirely ruled out (the dog might have licked his paws, infections can occur if the skin is broken and bacteria from the saliva of the dog that has bitten you, is passed into your bloodstream. Sometimes there might be no bleeding, so you need to make sure the skin is not broken.). As no skin was broken, you need not worry. Wash the scratch with an antiseptic and don't cover it. You might need a tetanus booster injection if the last shot was more than a year ago.I hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for bug bite infection\n\nive been recently getting these bug bites, and im not sure if theyre from mosquitos or not but they have never been this bad. They swell up and spread about 2 inches and feel very itchy and hot. I applied cortizone to the bites but it doesnt seem to be getting better",
    "doctor_response": "Hello,  Thankyou for your contact to health care magic. If I am your treating doctor I would like to tell that bug bite causes allergic reaction you can discuss  this chlorpheniramine maleate, prednislone, antibiotic powder neosporin with your treating doctor. Also do not forget to think about local hygiene of wound. If you want to ask me any thing else you can ask me. We wish you a best health at health care magic. Dr. Arun Tank: Infectious Disease Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat leg bruising in a 22 months old child?\n\nYes hi.. My name Tia my 22 month old has a real bad bruise on the back of her legs it comes and goes. A few months ago her iron dropped to a 6 but has since come back up to 11 like a month ago pls help what is going on . I do have her an appt in an hour. But this is really worring me",
    "doctor_response": "Hi...I have just read through your question. By what you quote I feel that your kid might be having a bleeding disorder. If I were your pediatrician I would suggest tests like CBC, PT, aPTT to rule out bleeding disorder.Regards - Dt. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe knee pain\n\ni had a knee pain since couple of year, i gets pain whenever i put pressure on my knees like while climbing staircases, sit upsi had a knee pain since couple of year, i gets pain whenever i put pressure on my knees like while climbing staircases, sit ups........................",
    "doctor_response": "Hello, As this pain is due to reduced joint space leading to compression over the internal structures of the knee joint and due to inflammation there is pain I will advise you to do exercises which helps improve the muscle Strength and improve the joint space. Exercises include - static quadriceps, static hamstring, straight leg raise and ankle toe movements. Also for improving the muscle and joint stability using a balance board training will be of help. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dark spot on lip. Should I see an oral surgeon?\n\nHi there. I brought my daughter to see her Dr about a dark spot on the lip that she s had for 7 months. It hasn t got any bigger but it s not going away either. He told me it wasn t anything to worry about but when I brought her to her dentist app today her hygenist almost seemed a little worried and said that they may refer her to an oral surgeon the next time she comes in if it s still there. Should I make an app for her now to see an oral surgeon? What could it be?",
    "doctor_response": "Hello In your question you haven't mentioned the age of your daughter as these spots disappear by them self in growing age( 10-16).Normally they are of not major concern.These spots are basically melanin pigments deposited in skin of lip.Wait for next 6-8 months and notice any change, if there and then see a skin specialist rather than an oral surgeon. Best Dr. Amit  k. Gaba",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for psoriasis\n\nMy cousin brother have been suffering with Psoriasis from childhood , and have undergone a lot of treatments in allopathy , homeopathy , naturopathy , But didnt get a relief . Can you suggest me the best hospitals of india dealing with dermatology , and also the Foreign hosptials dealing with dermatology ?",
    "doctor_response": "Hi,As you said your cousin brother suffers from psoriasis...I would like to say few things about psoriasis... . Psoriasis is a chronic relapsing and autoimmune disease. You may be having scaly plaques on various parts of the body,scaly lesions on the scalp. Exact cause is not known. Genetic tendency, autoimmunitity,stress,dry wheather...etc may be responsible for precipitation and exacerbation of psoriasis. You consult dermatologist for firm diagnosis and treatment.I usually recommend cap acitretin 10 mg twice a day along with methotraxate 15 mg weekly in three devided doses 12 hourly...for psoriasis.This may be taken for long time till good response. Blood tests may be done to monitor the treatment. For itching, you may take antihistamnics like levocetirizin...Avoid steroid ,as there may be severe flare up after stopping it.He  may apply mild steroid cream or calcipotriol oint on the lesions on the psoriatic lesions. He may apply moisturiser to improve the skin texture. He should avoid soap bath for few weeks..And he should be free of stress and worries as that might worsen psoriasis. He might get good result.I hope you got my answer.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take Relent along with vertin for tremors and disorientation feeling?\n\nSuffering from cervical prob gap C 4 n 5 n C 5 n 6. Heavy head especially behind the ear above neck n great discomfort. Audiometric test shows 20 to 25% hearing loss in left ear. ENT advice to see Neuro n do MRI Brain . B 12 is 420 n D3 is 25.Feeling tremors in the body n feeling disoriented. Can I take tab Relent alongwith vertin 16mg. What should be my next course of action",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, if the vertigo is due to vestibular dysfunction then you can take the vertin, and you can have both the medicine together, but in my opinion better to find out the cause of vertigo, once it is found then it has to be manage accordingly, you have not given the basic detail like age and gender  hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain on the face side after wisdom teeth removal\n\nHi. I had four wisdom teeth removed six days ago. Today I have not taken any pain meds( Tylenol with codeine) but I still feel pain around the entire left side of my face and lower right jaw. I figure the pain should he expected as there is still visible bruising. However I am concerned because todayvi have started to get waves of dizziness that come out of no where, I simply start to get clammy and feel like I am going to faint. Should I be concerned? FYI I am taking penicillin but have no history of allergy to it.",
    "doctor_response": "According to your description your pain looks more like that of a TMJ rather than the tooth retraction.  This may result after extraction as patient tend to limit the mouth opening and chewing after the extraction. This results into spasm of the muscles in and around the TMJ as they have discontinued their function. Warm water with salt gargles and heat packs from outside 4 times a day will help you to relieve the spasm. Moreover you can ask yor doctor to prescribe you skeletal muscle relaxants. With all these treatment you can now starr chewing the food  n let the joint muscles regain their function.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a person have blood in urine from jaw infection?\n\nMy friend had a root canal that failed & now an unknown pocket under her tooth that turned into an infection. It's been a few days but now she is nauseas & has blood in the urine. No pain like a bladder infection would give though. Why would she have the blood in urine from jaw infection?",
    "doctor_response": "hello thanks for consulting at hcm..it could be isolated finding blood in urine ad may not be related, u take consultation with ur dentist for the root canal, and a nephrologist if she continues to have blood in urine...hope it helps..tc",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have recurrent ulcers in the mouth, How to treat it ?\n\nI am a 45 year, with diabetes. I have recurrent ulcers in the mouth.. Can some one suggest what might be the cause ? How to treat it?",
    "doctor_response": "DEAR welcome to Hcm You should keep your Blood sugar level with in normal limit by Ahar vihar and Aushadhi [ diet , daily routine and medicine] try taking some Liver tonic in tab form at least for one month for local application irimedai tail this measures will bring recovery completely",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffer from sneezing and mucus formation. Sleeplessness. Need solution\n\nAm in Bangalore for the past one year but from the past one month i suffer from sneezing with mucus secretions in the mid night and early morning without any reason. This affects my sleep and the whole day becomes very tired because of lack of sleep and also at times i get body pains and all the time am feeling very tired. Please help me with a solution.",
    "doctor_response": "hi, you suffer from allergy it may be due to pollen or dust.  it looks like it may be from pollen since its only during few months of year. now to treat allergy you have to do it in a step wise manner first if your symptoms is for few months a year like 2-3 months then you start an antihistamine which you have to take daily at night. if your symptoms still persist then your start using steroid nasal spray, it has no side effect and it controls the allergy very well and you should start 2 weeks before your symptoms start. if this also does not cure you. then get yourself tested for allergy, it is called skin prick test you will know what you are allergic to, then if possible you can avoid the allergen or you can start treatment called immunotherpy. this is currently the best treatment available and your symptoms will easily reduce by 80-90 percent kindly visit your ent specialist he will guide you further. thank you dr.mukesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bad diet. Mentally unprepared for food. Why do I lose balance, faint or feel weak? Related?\n\nhello, i dont have any issues with losing weight, i like being a size 12 (10 stone ) and am this weight now. But i dont like eating, i dont feel hungry and i forget to eat, last year i ended up losing so much weight (down to around 7 and a half stone i think) i lost balance, fainted, had nose bleeds , i was weak and tired all the time and i think very depressed. i got like that without even realising it had anything to do with food and when i went to the doctors i was basically told its normal and im being silly! i really dont want to get like that again but forcing myself to eat is horrible! whats wrong with me? what can i do to help myself enjoy food like other people?",
    "doctor_response": "hi..may be you have excessive pre-occupation regarding weight-loss at the back of your mind which prevents you from taking food..it may lead to anorexia nervosa..so consult a psychiatrist now..also I don't whether you were dewormed or you were on any appetizer or any investigations done due to this..so please consult a gastro-enterologist to solve these issues..have a good health..thanks..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a leaking fallopian tube?\n\nHello,I recently went to the hospital for a GSH test I think that's the name of it, and it showed up That my Fallopian tube is leaking bad, what procedure happens next and is this why me and my partner are still to conceive a baby, If u could get back to me I would be grateful",
    "doctor_response": "hello....thanks for trusting the healthcare magic doctors for ur health related queries.I guess ur concern is about..treatment for leaking fallopian tubes...right.Firstly I want to inform you that..the procedure, u had go through is HSG(hysteroslapingography) not the GSH. it is done to know the patency of the both fallopian tubes. the infertility patient usually go through the procedure.in this procedure the dye injected inside the womb and x-ray films are taken. if there is dye leaking through the fallopian tubes inside the abdomen, proves that both fallopian tubes r patent, that means there is no blockage.I think u had HSG, n ur both fallopian tubes r leaking, that means u have no blockage. that means ur both fallopian tubes r patent. secondly i want to tell u that u r not required any type treatment for this, because ur fallopian tubes r normal.lastly want to say that...RELAX, DON'T WORRY. I have high chances of getting pregnancy. KEEP PATIENCE. with the above discussion u can try out my suggestions-1. RELAX, NOTHING TO WORRY.Just confirm the procedure. if u had HSG then nothing to worry.2. try to do coitus during fertile period(it is from 10th to 16th day of cycle during this period chances of getting pregnancy is high). so do coitus as more as possible during this period.3. if u r still worried or in hurry then visit nearby infertility specialist. he/she can help u.I hope the above information is useful, informative and helpful for u.regards-Dr sudha rani panagar(i can understand ur tense-full situation, but DON'T WORRY, u have normal result. I pray the God that u will be blessed with a cute n healthy baby..hopefully TWINS)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes  lower abdominal pain and pain in groin area?\n\ni have been having lower right abdominal pain for about 5 months,it goes away when i am laying down i have no pain at night at all,but soon as i wake up and start my day i have a dull pain that may start in my right side and i sometimes feel it in my groin area",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query.Possibly you have a developing inguinal hernia on the right side in its initial developing stage. The pain is due to pulling sensation of the peritoneum by the hernia which occurs whenever you stand erect and start your day and it goes off when you lie down due to release of the pressure exerted by the hernial contents. However, it could be diagnosed only by a clinical examination with related investigations, and for that I would advise you to fix an appointment with a general surgeon for further management. Till that, you could go for an anti inflammatory drug along with a proton pump inhibitor.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore and swollen vagina during pregnancy?\n\nhello i am currently pregnant and my vagina has been very sore and itchy. i ahve had this for a while but latly parts of my vagina have swollen up and gone very red. it has been that painful it has made me cry. i cannot wear any underwear as its very sore and rubs.",
    "doctor_response": "Hallow Dear, You seem to have vaginal infection which could be bacterial, fungal or trichomonal. These infections lead to vaginal itching and pain with discharge. Since during pregnancy the immunological response is poor, these infections are commonly observed. If you are having curdy discharge, it could be fungal infection. Trichomonal vaginal discharge is frothy greenish white while the bacterial discharge is mucoid or yellowish pus. Fungal infections can be treated with antifungal vaginal pessaries, Metronidazole can take care of trichomonal infection while for bacterial infections, antibiotics are needed. Both the partners should have the treatment simultaneously. Please report to your Obstetrician for proper diagnosis and appropriate treatment. During the treatment, please observe the following instructions: 1. Observe Sexual abstinence till you are completely cured. 2. Both the partners have to follow these instruction.3. Clean shave the private parts.4. Cut the nails short. 5. Use soft panty liners.6. Boil the underwear daily. Hope this helps you. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in neck\n\nI woke up yesterday with a pain in the meck the rotates into my right shoulder. I assumed I just slept wrong. However today it has worsened to where I can lift my arm above sholder height, the pain is much worse, my right hand is ice cold and tingling. Pinched nerve, maybe?",
    "doctor_response": "Hi,Thanks  for  your query.Neck pain that you are having are suggestive of degenerative -spondylottic changes of the cervical spine.X-ray of neck in lateral view or MRI will help in the diagnosis.Treatment includes 1. Use of cervical collar helps in immobilisation and brings relief. 2. Medical drugs like pain killers - acetaminophen/ibuprofen and muscle relaxants might be helpful.3. Cervical isometric exercises are beneficial to maintain the strength of the neck muscles. Neck and upper back stretching exercises, as well as light aerobic activities, also are recommended under the guidance of a physical therapist. 4. Hot fomentation helps in relieving acute symptoms.5. You can avoid using a pillow.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible despite taking a contraceptive pill?\n\nPls I had unprotected sex on Thursday morning, of which day before I was already having menstrual cramp.... I took postinor2 after the intercourse... From Thursday till today Monday or haven t seen my menses... But I have been having serious cramp and discharge.... What could be d problem doctor",
    "doctor_response": "dont worry, as u had postinor an emergency contraceptive on time,u wont get pregnant...the symptoms u r getting is due to hormonal imbalance...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will the infection from dog spread to human?\n\nMy husband s dog got infected with ear mites. was treated by 2 different veterinarians, was prescribed a cream to be applied in her ears and the fur around them, plus disinfectant soap to bathe her with. We are reasonably confident she is now free of the mites,but my husband is continuing with the treatment. The problem is that my husband is convinced he has them now on his body. He itches, specially at night. So he has been scrubbing his body with alcohol ( I do his back). I wonder if he really is infected with his dog s mites, or maybe is something else. His discomfort started soon after his dog was diagnosed. I do hope you will have some suggestion as to what to do or what kind of specialist he would need to consult. Thank you for whatever help you can give us. YYYY@YYYY",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.Yes, it can be possible to spread to Human.Some species of mites can spread to humans from dogs.So you must examine the area of itching very closely. If you find some burrow or mite attached to the skin, than your diagnosis can be confirmed.If the diagnosis is confitm you can use ivermectin tablet and gamma BHC solution under your doctors guidance.Till that time you can use cetrizine for itching. You can also apply calamine lotion for maintaining moisture.Maintenance of hygiene plays very important role in clearing the infections.I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest course of action for painful calculi\n\npersistent suspected small right lower pole calculus and 2 small calculi within the right renal pulvis the largest measuring 4mm...what should my next step be I am in terrible pain and nasty to boot..Have been carrying a heating pad around with me for 2 weeks..",
    "doctor_response": "Helloheating pad wont work but as the size of stones r very small they can be easily expelled by medicines n u dont need surgery for that",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is swelling in legs and feet with urine incontinence after being exposed to lye due to possible allergy?\n\nI have started making soap using lye with the Cold process method, meaning I mix the lye in water then combine with oils to make soap. I take great care with safety, goggles, gloves etc, but I have started to notice swelling in my legs and feet and sometime urine incontinence. I bought a respirator because I thought it might be some of the fragrance oils I use, but I made soap 2 days ago after a 2 week break with no fragrance and I got the swelling again. Could this be an allergy to Lye? Should I wear the respirator all the time and see if it occurs again? Please help, this is my new hobby after breast cancer and I do not want to give it up as I started it to make natural products for myself. Thank you very much.",
    "doctor_response": "Welcome to Healthcare-MagicGreetings of the day Its possibly allergy to the lye used for making soaps, i suggest you to avoid direct contact with the skin at the time of preparation. Also local application of coconut oil/olive oil could be helpful in preventing itWishing you a healthy lifeTake CareRegardsDr T ShobhaMBBS MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of having TB again?\n\nHello doctors.. my name is John Trice i wanted to ask regarding the fear that i am having.. i had a check up way back 2005 ... i was diagnosed that i have TB.. the mild one... years past.. i did not have follow up on that...   now i have a job requirement.. that is the medical exam.. im afraid if i will have that disease again.. could i have the disease back?",
    "doctor_response": "Hello,For tuberculosis once confirmed, the anti-tuberculosis drug should prescribe for six months. You had not taken any medicine so it might be still present or you might recover. For that, your chest x-ray and sputum acid-fast bacilli (AFB) test done primarily to rule out tuberculosis. Consult pulmonologoist for examination. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for masturbation addiction\n\nHi... I masturbate 2-3 times a day after I am back from office everyday. Is that over masturbation? I have experienced male pattern baldness, and a bit too loss in memory like (I am not good at remembering names, names of movies etc). WHom should I consult?",
    "doctor_response": "Hello, Try to engage in physical activities like outdoor sports and swimming. You can seek help from a psychologist also. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat fluid in ears?\n\nmy 24 month old grandson recently had an ear infection Friday he went for his follow-up and the Dr. said infection gone but he have water in his ear how do I remove the water. If the water remains in his ear will it eventually cause another infection?",
    "doctor_response": "Hello. I just read through your question. This is not uncommon. Sometimes fluid can remain in the ear after the infection is gone, and sometimes this can lead to another infection. In most cases, though, fluid in the ears resolves on it's own. You should follow up with your doctor in about one month to confirm this. If the fluid is still there, your doctor may want your grandson to be seen by an ENT. Until then, however, there is nothing to do.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for body pain and testicle pain?\n\nI am experiencing intense body pain and pain in my testicles. It started just over a day ago, I felt a sharp pain to the left of my scrotum which was followed by dull pain near my testicles. This has since escalated to almost full body pain and a sore throat in addition. Should I seek medical attention?",
    "doctor_response": "Hi, Yes, you need to visit doctor for examining your scrotum. Take Aceclofenac tablet for pain in testicle and body pain. Take antibiotic like Azithromycine for your sore throat. I suggest consult your surgeon for your scrotum condition. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Pramod Kokare, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could lung pain with body sore and pain have lasting results?\n\ni sprayed my shower stall ceiling to floor with triple concentrated bleach then covered the tub floor with a cleaner like comet. i added a little water and began scrubbing it. my eyes started tearing up severely, i wiped eyes, and went back to scrubbing, the smell was horrendously strong and my breathing was compromised. i took my head out of shower stall for a moment and again wiped eyes that i could hardly keep open by now. continued to scrub with face about 1 foot from the tub, with shower doors closed. it got to a point i could not keep eyes open and the tearing was pouring down my face. i couldn t breath, couldn t really stand up now, so crawled out of bathroom and shut the doors, in a short while. the tearing stopped but my thoat was tight and so very sore and burnig, i had wheezing when breathing. i began coughing and coughing for hours on end. i took benedryl and finally got some sleep, but now when i am awke, my lungs hurt when breathing, my whole body is sore and painful. is there a lasting results to what i did? thank you",
    "doctor_response": "thanks for your question in my opinion you should visit a Pulmonologist and get yourself evaluated as chemicals cause pneumonitis in early and delayed formPulmonologist may request for a chest X-ray to see if there is any urgent intervention required or notif these symptoms persist and chest X-ray has changes your Pulmonologist may prescribe you low dose of corticosteroids for a short period to counter the inflammatory process or he may add leukotreine inhibitors for the samethanksfeel free to ask more questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can hip soreness with back discomfort be treated?\n\nI lifted the heavy wood box felt a little twinge in my back and result left and side sore above right of hip and raidaiting discomfort across the mid lower back section, cant put on socks or sit comfoprtably on sofa only chair with support no reflief from nuromol paracetamol and nufrofen is it a time thing",
    "doctor_response": "Hello,Thank you for contacting me at \"Ask a Doctor\". I will try to answer your question to the best of my ability.This sounds like a simple back strain which is very common.  You may have strained some of the soft tissues in the low back such as the muscles or ligaments.  Usually, these will settle spontaneously in due course.  Ice will help with pain relief and sometimes applications of heat can help with stiffness.  Continue with simple over-the-counter pain medications for the moment.   If the symptoms persist, then I would suggest seeing your primary care physician.I do not think there is anything to worry about at this time, but certainly if your symptoms worsen, I would consult with your doctor or go to the emergency room.I hope this information is useful for you. Please do not hesitate to message us back if you have any further questions.Best wishes,Adrian Rawlinson MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can hernia affect fertility in men?\n\ndear sir, My husband is having hernia. we noticed it about 3 months before. now we can see it from outside. I want to know whether it will affect to the fertility or not. Any way we are going to have a surgery. PLs tell us about this fertility problem. Thank you.",
    "doctor_response": "Hello, The hernia is not related to infertility directly and it will not hamper the fertility of your husband. The hernia need to be operated to avoid strangulation, obstruction like complication. So don't worry about his infertility due to hernia. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and pain in the foot?\n\nI have experienced this twice and getting concerned, in the my bottom of my foot right below my second and third toe I have had swelling, and intense pain no matter if I sit or stand. But I can t stand nor walk hardly because of how bad the pain is. On a scale of 1-10 1 being lowest it would be off the scale.",
    "doctor_response": "Hi, There is nothing known common entity which fits into your symptoms. I would like to suggest you that get yourself properly examined to a orthopedic surgeon so that appropriate treatment can be given. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Anuj Gupta, Spine Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes jelly-like matter discharge from anus while on cancer remission?\n\nI m in remission now from uterine cancer. I was diagnosed a year ago and had a total hysterectomy. I had 25 treatments of radiation and finished in July. I m also in remission from breast cancer. Both stage 2. I m having clear jelly like discharge from my rectum and pain in my abdomen and lower pelvic. I also have cramping. What is the jelly from? I m having diarreha also.",
    "doctor_response": "hi. based on the description of your symptoms it appears to be radiation induced sides effect.  you need to modify your dietary habits plus anti motility agents such as loperamide. in most cases it is a manageable situation. if it is really affecting ones lifestyle than steroid enema can be used.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to heal liver damage?\n\nmy sister in law has been admitted to hospital they put a camera down and repaired a tear she has had a scan to look at the damage done to her liver but not been given the results yet she was shaking disoriented and dribbling when admitted it sounds really bad to me what doyou think",
    "doctor_response": "hi,if she has liver damage than most probably she has liver failure or cirrhosis.I would like to know more if she has used alcohol or she suffers from hepatitis B or C.Otherwise if she has has been disoriented from liver issues mos probably it has been related with liver encephalopathia.wish her fast recovery. Dr.Klerida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recurring nose bleed. Coughed blood. Allergic to pollen. Normal after nose bleed?\n\nHi, I had a recurring severe nose bleed for about a week. Lost a lot of blood.  Was examined by an ENT, who found a bleeding anterior artery in my right nostril, and it was cauterized. It stopped the bleeding, but obviously,  I couldn't blow my nose for a week. It's allergy season, and I'm very allergic to pollens. Started to wheeze. I've never wheezed before this. Yesterday I was able to gently blow my nose, and the wheezing stopped. This morning, I coughed up clotted blood. It wasn't much, but it alarmed me.  Is that a natural occurrence after such a large nose bleed? Is it just blood that went to my lungs from the nose? Should I ignore it and just wait and see. Otherwise, I feel fine, just congested from allergies.  Thank you.",
    "doctor_response": "Hi and welcome to HCM. Yes, this is normal for nose bleeding because usually some amount of blood comes into tho mouth so this isnt actually coughing. YOu should take antiallergic medicines in seasons of pollens. There is no specific prevention of nose bleeding but it usually stops spontaneously. If this persists you should check blood clotting factors and blood pressure to see is there any disorder. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for allergic reaction to dyes with irritation in eyes\n\nhello doc/s. my left eye is mucusing more than usual for teh oast few hrs. it's red, a bit runny- though not much as in pollen type runny eye- and not itching. a stray strand may have touched my eye in a flash while coloring roots this morning but the mucusing started before today, over the past 2 days when i got a fever/aches as in typical of a flu. i've flushed it with some cold water and optifree [i am not wearing contacts now though i did today but won't until this clears up] and applied a slightly warm compress too soothe the outside. any ideas for home remedies? i'm in my 40s, very healthy, wear contacts, veegetarian and female. thanks",
    "doctor_response": "With the information you provided, the best and safe thing is that Triphala water should be used to clean the eyes. Triphala is a combo of Haritaki, Vibheetak and Amla powders, commonly available in India. About two tsp of powder may be soaked in water (approx 200ml) overnight. In the morning, mash little bit, filter it and wash eyes with it. It may strain fabrics, wear accordingly. Do for one to two weeks. Avoid contact lense. Alternatively Triphala capsules of Himalya co. are also available but it would be costlier to take out suffucient powder for soaking.After washing put pure rose water drops in eyes. In the evening and at night put pure rose water drops in eyes after washing with normal water.Warm compress is okay. Continue it.Hope it helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having noticed a lump on the shin bone of about 2 inches\n\nRecently my doctor changed my bp medication by adding another one to the mix. after a couple of months I noticed that I was losing weight, and also found that my lips were becoming dryer than usual. As time went on, upon waking my lips were crusty and I had to apply chap stick frequently during the morning to lubricate them. Then my lips got redder than normal and eventually I had a rash on them. Understanding that it was likely an allergic reaction, I started eliminating things I thought may have been the problem. Finally, I was reduced to visiting my family physician who prescribed steroids to get rid of the rash. In the meantime, I took my daughter to see the same doctor for a sinus infection. Since I was there anyway, I told my doctor that at the same time my lips were getting better, so was the edema in my legs. He stated that with the elimination of inflammation I was able to eliminate the swelling as well. I had skinny ankles again and was not sure why the steroids had caused the change. My legs and ankles had been swelling each day to about twice normal size up to that point. They called me from his office the next week after my original visit to tell me that the results of blood tests taken at the previous visit showed that my TSH was low. Low thyroid, and I was losing weight, how could that be? I was also asked if there was something that I was routinely taking that would cause the allergic reaction I had experienced. As I was telling my husband about what they asked he remembered that he read on the paperwork that comes with my new bp medication that it could cause thyroid problems. Ok, so my next step was to ask the pharmacy for a copy of that information. Indeed all that symptoms I was having were likely caused by the new medication. Not good news at all in my opinion. I quit taking it immediately, and took the paper to my doctor. Now, for the question. I also am experiencing a lump on the inside of my left shin bone. this lump is about two inches in length and one inch wide. Is there any reason to believe that this has something to do with low TSH?",
    "doctor_response": "It appears to be case of Hyperthyroidism ( over active thyroid ).So get a complete thyroid profile. After that start anti thyroid drugs.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high blood pressure and anxiety\n\nI have been having heart spasms for 6 months and the pains last the whole day, I havent been treated...I been taking clopixol for 8 years for my biopolar and norflex for aches, the doctors say they are sideeffects, but my bloodpressure and anxiety is out of control, here the doctors are not specialized what do I do. thanx cecilia 34 yrs",
    "doctor_response": "Hi and thank you for asking!If you were my patients I would recommend to do as follows:- Reduce salt intake- quit smoking - Reduce alcohol - take camomile tea- Take anxyolitics Wish you health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for fatigue and dizziness after inhaling paint fumes\n\nHi, Early today (labor day) I painted my room with the doors and windows up with Valspar Ultra. After about 2 hours of painting I began to feel fatigued and became queasy. About an hour later I began to vomit in a quick succession about 4 times. Now I m feeling a bit better but I want to know if the paint fumes were enough to cause this reaction or, do you believe I ve ingested some and need to go to a hospital? Thanks~",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. Yes, paint fumes are the most likely cause in your case.Vomiting and dizziness are due to typical pungent smell of paint.This smell actually irritates nose and throat and cause vomiting. This also cause unwell feeling,  percieved as dizziness. Since you are now feeling better, no need to worry for this.  Just breath fresh air and drink plenty of fluids. Avoid hot and spicy food for 1 day.Don't worry, you will be alright. After 1-2 days, if you are still symptomatic then consult doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does taking the birth control pill late still offer protection?\n\nHi, I took my birth control pill 12 hours late once this week (I usually take it just before bed but this time took it when I first woke up), then I took it 10 hours late again a few days later. Am I still protected? I have been googling around and most accounts seem to say yes, I am still protected. Should I still get the morning after pill? I am on Ava 30.",
    "doctor_response": "Hi. Good to see your concerns about your health. As far as your question is concerned if you forget to take a pill on the specified time occasionally take the pill as early as you are able to recall. Even if you forget to take a pill on a day then take two pills togather on your specific time  and you will still be protected. So keeping in view the information  provided by you , it can be said that you are still protected. But you must confirm by visiting a gynaecologist two weeks later or wait for next periods whichever is earlier.Wishing you best of health.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is this semen analysis report normal?\n\nHi doctor I am 23 years old , 71 kg and 181 cm tall with mild  varococele, my semen analysis provided that i have 75% motile sperms , with 25% rapid progressive and 35% sluggish linear progressive and 25% immoritle , i am worried about abnormal forms as  I have 30% abnormal forms , 10 % abnormal head forms , 5 % mid-portion abnormalities and 15 % of tail abnormalities , also have 1-2 spermatogenic cells  , are these readings normal , below normal or what  , thaanks doctor",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. According to the guidelines your semen motility and morphology is absolutely normal.You need only 4% normal sperm to become a  father.So don't worry. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a red itchy patch beside my nipple?\n\nI have a red patch beside my nipple that has been here for about 2 weeks. It itches, and is red around the edges, and alight color inside. It s not puss or anything like that. I have another small spot right above that one and then another smaller one up a little futher. Not really sure what it is.",
    "doctor_response": "Hi, I have gone through your complaints and it could be eczematous rash. If I was your treating doctor, I would recommend you to apply topical steroid like cortisone cream on the affected areas twice daily and take antihistaminic like tablet Cetrizine once daily at bedtime. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i stop using Amway Nutrilite kids drink after getting rashes?\n\nDr Samuel, I had started using Amway Nutrilite Kids Drink-Mixed Fruits Flavor for my 47 month old daughter for the past twenty days. For the past 10 days, she has got red spots(rashes) over her body. As this is the only change she has in her regular diet, and does neither have the habit of taking any colored snacks (like chips etc) nor cold drinks, can I say that the product has got a side effect on her? Is it advisable to stop using the Amway Nutrilite Kids Drink immediately?",
    "doctor_response": "Hi, If you do not any drugs, it is advisable to stop Amway Nutrilite kids drink for few days and to look for resolution of lesions. But, if you are on any drugs, do visit your Dermatologist to confirm whether the rash is due to the drug or not. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for OCD of clearing the nose\n\nI am 30 years young Structural Engineer from Nepal. I'm having OCD since 9 years and having medicine of OCD since 9 years.But after getting medicine also my OCD doesn't give relief to me. I am taking Alprazolam 0.25mg twice a day,clomipramine 25mg-3 times a day, propanol-10mg twice a day.Also i have left fluoxetine-20 mg 8 month ago after consulting my Dr. because my sex ability reduces. My OCD is strange for me.My nose were runny since my childhood thus my friend and colleagues generally laugh at me due to my runny nose which i seriously take part at age of 21. From 21 years old i thought repeatedly that there is watery fall on my nose thus i check several times my nose with finger, my handkerchief, i takes lake large sound \"sukka\" so that i inhale water of nose inside. These are abnormal behavior. I take six years allergy vaccine which gave relief for my allergy too but this compulsive thought regularly hunted me up to these days.In earlier time i became nervous but these days i will fill uncomfortable when speaking with friends ,office staff etc. However positive thing is that i have not stop my regular work. i work in reputed company in Nepal, I complete my Master degree during this 9 years but i completely cannot forget this behavior. Can you treat me .",
    "doctor_response": "HIThanks for using healthcare magicIn OCD, patient needs both medication and behavioral therapy. If you are not getting improvement with medicine, that's mean, you needs both. Better to consult your psychiatrist for both and in case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for multiple glandular tumor\n\nMy brother has mulitible glandular disease turmor on his pituatory gland , adrenal gland both turmors were removed but he turmor on the pituitary gland has grown back in in stage 3 kidney disease because his potassium is spiking also he has a bad heart. I was told that his glandular condition is rare 30 cases in the world the doctors don t know what to do this is causing most of this problem how can this be treated please his other adrenal gland is not working right he is getting weaker in and out of the hosp",
    "doctor_response": "Sorry to say, but i am getting very little useful information out of the description you have provided. Probably you are talking about Poly glandular autoimmune disorder?It appears that he is not a good general condition!.I am left with more question than answers.Bad heart means?",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mycoplasma bacteria with mucous?\n\nhi the first x ray of my child suggested a right lobe mycoplasma bacteria , the xray after one week after hospitalisation suggest mucuos has spread to left does that suggest the concentration of mucuous has broken down and that he is improving, he has no fever and not so bad a cough. he is 9.",
    "doctor_response": "Dear i  can  understand  your  concern . I would  like to inform  you  that  you can't  say anything  about mycoplasma  on the basis is x -ray only.For diagnosing which bacteria is involved,  we need to do sputum examination  and blood tests . X ray can only tell if there is any area  of haziness  in  lung field   or not that is suggestive  of pneumonia  and many other diagnosis  .If your child has no fever or cough etc. Then there is no need to worry about that. You can only discuss  about your problems  with your physician . Specially  about infection  resolving  or not.Hope this  will  help you .  If  you  have  any  other  concerns  please  feel  free  to  message  me .  Thanks  for  contacting  HCM .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for heart palpitation\n\nI have been experiencing flutter like palpitations with my heart..The pollen has been really heavy lately and I was wondering if that could be part of it..I am a healthy female, 55 yrs old..it just seems like my heart wants to race, but the fluttering is very annoying...what could be causing this?",
    "doctor_response": "Hello, Since you are having symptoms of heart palpitations you should visit ER & get physically examined by a cardiologist. You may need to go through some regular investigations, CBC, Urinalysis, Lipid profile, ECG, Electrocardiography & stress test. Commonly palpitations are due to heart conditions like supraventricular tachycardia or atrial fibrillation. At times it may be an indication of some developing Coronary artery disease. Your treatment will depend upon the pathology detected. Avoid addictions if any, stay away from alcohol, smoking, caffeine, nicotine or energy drinks. Avoid anxiety & stress as they may trigger palpitations & worsen your symptoms. Sometimes dehydration can cause palpitations. Stay properly hydrated. Maintain the electrolyte balance of your body. Take adequate sleep, maintain healthy weight as per BMI. Avoid eating oily, greasy food. Take berries, fruits, veggies, whole grain. Avoid red meat. Hope I have answered your query. Let me know if I can assist you further. Thank you. Regards, Dr. Nupur K General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "what is diffuse annular bulging and posterior protrusion of L5/S1 inter vertebral disc?\n\nwhat is minimal retrolisthesis L5 over S1.what is diffuse annular bulging and posterior protrusion of L5/S1 inter vertebral disc causing compression on thecal sac and narrowing of neural canals on both sides left > rightWhat are the precautions  to be taken to avoid surgery?",
    "doctor_response": "Hi there, welcome to HCM.Thank you for your question. Regarding the first part of your question. RetroListhesis and disc bulge are radiological terms reported in an MRI which would require correlation with how your doing clinically.Retrolisthesis  describes the relative position of one bone over the other where one of the bones as slipped in relation to the other.Mild retrolisthesis is a normal variant at L5/S1 level and should not be a cause for Concern. Annulus is the outer envelop or covering of disc (which is the cushion between your bones). With degeneration of the disc's some times the material  bulges through its covering which presents as an annulus bulge. When the bulge goes backwards it can impinge on the nerves decreasing the space available for them which can also be termed as stenosis or narrowing of the space available for the nerves. If the bulge is not symmetrical it can affect one side more than the other as seen in your question (left more than right).These information is useful if the pain distribution matches the MRI, that is side of pain matching the side of narrowing seen in MRI. Conservative treatment with the combination of medications, physical therapy,exercises with strengthening of core muscles, spinal injections and life style modification should be tried before surgery is considered.Lifiting heavy weights, bending forwards and twisting movements have been associated with progression of back pain and should be avoided during exacerbations.  However, surgery will be absolutely Indicated if there is new onset weakness or numbness, loss of urine or motions control related to your spinal ailment.Unrelenting pain affecting your life style would be a relative Indication.Hope this answers your question. All the best With best regards DR . SBK",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recovering alcoholic. Done CBC. Interpretation?\n\nI am a recovering alcoholic with scary CBC numbers re: liver...can I hope for good news from latest CBC? First was done days after stopping drinking. It has been 115 days. Just took another and awaiting results. I am a 48-yr.-old mother of two with non-smoking/non-drinking/non-drugging lifestyle. Here are a few numbers: WBC was 3.5; RBC was 3.17; MCV was 114.0; MCH was 38.5; Platelet count was 80. My neutrophils# was 1.5; total protein was 5.9; serum albumin was 3.1; SGOT (AST) was 64; bilirubin total was 3.4 CH. I look forward to your reply.",
    "doctor_response": "Hi, thanks for writing in. Your reports are not as yet within limits of normalcy. You will require supportive nutritional and liver care to improve your hematological parameters. You need to consult a gastroenterologist for further advice. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why my toe is swollen and discoloured?\n\nI m a 53 year old female, 5 10 155 lbs in good health. Over the last 2 months my second toe on my right foot has been swollen, discolored and feels like there s a rubber band around it. I ve been to the doctor, had x-rays and blood work. There are no fractures and have ruled out gout. I ve been on antibiotics for the last 5 days but no changes. Any ideas of what to check for next?",
    "doctor_response": "Second toe swollen and painful could be infection or arthritis. Usually gout is seen commonly in great toe.Now as your x ray is normal and your blood investigation are normal.you will need repeat examinaion and screening as x ray may be negative in early phase of infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My close friends husband has liver cancer\n\nMy close friend's husband has liver cancer, colon cancer,kidney stones now his spleen is very enlarged and the doctors have sent him home to die and my friend hasn't been told as what to expect,time wise etc. and has asked me to see what I can find out for her. She just wants to be on top of things and can't quite get the answers from their doctor. Can you tell me anything that will help her she has taken care of him for so long and is trying to keep on top of things but is getting very worried as he's in a lot of pain and his stomach is very swollen and can't eat very much. He's on very strong pain meds.",
    "doctor_response": "Yes with those multiple cancers, there is very little hope for one to recover. So it is of concern for anyone. In cancer it is quite common to have difficulty in having foods and this worsens with progression. Give him supportive care as far as possible as that is what that can be done by anyone at this stage.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for kidney failure\n\nI am Avtar Singh from Srinagar, my wife has both kindenies failed as stated by Doctors of Sher-i-Kashmir Institute of Medical Sciences Srinagar (SKIMS) Hospital Srinagar. I don't have any doner. What help your hospital can provide as I am pety govt. employee who cannot afford the expenses of transplant?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. There are many trusts in which you can register for a cadaver transplant. But if you didnt get any donor then dialysis is the only option to give her some relief. Dont worry and please register in some organizations like jeevan dhan for cadavaric transplantation. Take care.Regards,Dr.Alekhya.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. If rubella IgG is positive, am I at the risk of TORCH infection?\n\nHi doctor, I am 4 months pregnant. I had a TORCH test before two years as I met with miscarriage. The TORCH results were rubella IgG positive 19.56, rubella IgM non-reactive, CMV IgG reactive (738.65) and CMV IgM antibody non-reactive. I want to know whether I am at the risk of TORCH infection? Am I TORCH positive?",
    "doctor_response": "Hi. I have gone through the query and images (attachment removed to protect patient identity).",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stress and depression\n\nGood morning Dr. David, I have a younger sister who got married 7 years back. has two kids, elder 3.5 yrs old and the second girl 1 month. There is no peace in their married life, my sister is a kind of short tempered, unwilling to accept her fault / forgive others. She is not having any friends from her school days, for her everybody on the planet is bad except her. if we try to correct her she cries, sometimes she bluffs whatever comes out of her mouth, using bad words, hurting someones feelings but when we ask her she will refuse saying she never told that. her husband has become helpless due to my sisters frequent misbehavior with her in-law. there is no communication between them at all. my sister blames them always. Dr. is this is related to any psychological problem? Please guide me, I lost my dad within 1.5 years of my sisters marriage, now my mom is under depression and I do not want to loose her as well. if I talk to my mom anything about this sister my mom also supports her. please advise me.....please.....",
    "doctor_response": "HiI  had  gone  through  your  query .I  understand  your  concern .Yes dear certain  features  that have you mentioned  suggest  psychological  problem.It may occur  in depression / anxiety  disorder or may occur in stress also.Sometime psychotic illness  may have such features  like decrease  communication .But difficult  to  say  with this  information .Detail psychological  evaluation  is necessary  to reach proper  diagnosis .It is treatable  and require  psychiatry  care.Psychological  and social support  is must.It can be treated  with  medicine  and psychotherapy .So consult psychiatrist  for further  assistance .Still  if  you  have  a  query  then  feel  free  to  ask .Happy  to  help  you  further . Thank  you . Take  care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will IVF succeed based on FSH and AMH levels?\n\nI'm Shambala age - 31, trying to conceive from last 6 years, Height is 5 inch weight is 54kg my FSH level is 12.30 and AMH level is 1.3, do I have some time in hand or need to go for IVF now? and what is success rate of IVF according to FSH and AMH level",
    "doctor_response": "Hi, I think you have a high FSH and low AMH level. These values indicate that you have less number of follicles in your ovaries.  So, you should not waste your follicles by timed intercourse and IUI. It's not that you can't conceive by them, but there is less chance of pregnancy with these. IVF has a better pregnancy rates of 40 to 50 percent while timed intercourse and IUI it is around 10 to 15 percent. So, IVF is a better option for you.  But if you want some time, you can try IUI for 3 months. Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump like feeling in the throat after coughing up blood?\n\nI m 14 weeks pregnant. I went to the hospital tonight as I puked and found my throats bleeding afterwards. It was sore and they told me it was nothing. Now it feels as if there is a lump on the right side of my throat and it s an uncomfortable feeling.",
    "doctor_response": "Hi,    Thanks for the query. I understand your concern.     The swelling on right side of throat can be inflamed tonsil....warm saline gargles / drinking warm water /avoiding sour, oily & cold things would help.Over the the counter pill of Ibuprofen 200 mg thrice after food can be taken for 2-3 days.     If there is no relief... you would need antibiotic.. to be advised after health check up. Please consult your family physician( inform him about your pregnancy )    Bleeding you had might be miner injury during brushing/ pregnancy gums inflammation,You can take Vitamin C with vitamin B complex preparation for such bleeding.   Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for focal dystenia\n\nHello Dr Muthane My daughter is having Focal Dystenia and she is having Pacitane(2mg) 5 tablets a day as advised by Dr Suresh Aroor.medicine worked for sometime and again she is having twitching.I am also not getting your appointment.Request you to help us",
    "doctor_response": "Hello, Focal dystonia is treated with Muscle relaxant like pacetane. Benzodiazepines may help to reduce muscle drive. Local injection of Botox may useful. Deep brain stimulation also may benefit. If symptoms not improved please consult your doctor he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Penchila Prasad Kandikattu , Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My teeth are turning brownish even after using Hexidine mouthwash. Please help.\n\nHello doctor, I have a problem with my teeth. I started using Hexidine mouthwash last month for whitening of teeth, but it is not helping me, and soon my teeth are becoming brownish at some places. What should I do to clean it?",
    "doctor_response": "Hi. Using Chlorhexidine mouthwash for more than 15 days in continuation causes brownish discoloration, that is the reason your teeth are becoming brownish. Now that you have developed chlorhexidine discoloration, I do not think scaling will be of any use. Instead, I would suggest you for either bleaching or veneering. Veneering is the solution for the type of stains that you have developed. Dental veneers are thin flakes of tooth-colored material, which are applied over the original teeth. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am suffering from suicidal tendency\n\ni m thinking about suicide lately..today i took an online depression test and it says i must consult a doctor soon..i ve been jobless for almost a year now,all my friends have moved on and are too busy.nothing seems to interest me anymore and i rarely talk to anyone",
    "doctor_response": "Hi, Research says that most of the suicide attempts are cries for help. Please talk to someone about how you feel.IT HELPS A LOT. OBVIOUSLY, TALKING TO A PSYCHIATRIST WOULD BE THE BEST THING. If you have someone amongst friends and family, who you can confide in, then talk to them take take their help as well. If you feel you can not talk to family or friends then talk to NGO help lines like samaritans etc. If you are in India befrienders run a help line (in selected cities only though (you can find the relevant number at  Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I remove this black spot at the sides of my lips ?\n\ni used a gel to remove pimples . it dried my skin and developed some kind of black spot at the sides of my lips.. how do i remove that?",
    "doctor_response": "Hi!, Welcome To HealthcareMagic forum, Is the black spot exactly at the place where you had applied the gel.If it is so then probably the gel was too strong or irritant to cause a irritant reaction and has lead to a post inflammatory pigmentation .In that case just wait for few days till it resolves on its own .If not then apply a mild steroid cream with antibiotic  cream for just 2 days over the spot .Also use a good sunscreen over the lesions in day time.Gradually the spot will go away. regards, Dr.chawda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes minimal fluid filled sac in testicle of a child?\n\nMy son had a suspected inguinal hernia last week. He had an ultra sound done. They called and said no masses in testicles but referred to urology at children s hospital due to a minimal fluid filled sac in the testicle. What could cause this and what could it be?",
    "doctor_response": "Some children have hydrceale along with inguinal hernia .hydroceale is liquid collection around testis in the scrotum.there is no specfic reason for this condition",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden numbness of whole left side body?\n\nMy 50 year old daughter - left side of her body had gone numb for about48 hrs and the hand and leg are not working. She has seed a neurologist previously for what thought to be an off and on type of MS. She went to the ER Tuesday afternoon and they did many test but did not have an answer (Posssible Cluster headache). She is supposed to see her Primary MD tomorrow and if he thinks it is necessary he will send her to the Neurologist Any ideas or questions",
    "doctor_response": "Dr. Hanif warmly welcomes you!Thanks for consulting at my virtual clinic. I have carefully worked through your case, and can well realize your health worries. Being your physician, I want to assure, I will take care all of your medical concerns.She needs a neurologist consultation for sure. He will see the degree of weakness or paraplegia  and will assess her physically to find out the cause of this weakness. Such conditions are slow healing and it will take some time too. MS patients are not always easy to diagnose. It also takes some time to diagnose even by a neurologist. So remain under supervision of neurologist for the whole treatment time.Hope I answered all of your questions. In future, if you need further, detailed and quick assistance on any health issue, feel free to click on 'Ask me a question' directly from my profile. Have a wonderful time ahead.Regards!DR. MUHAMMAD M. HANIFUSA",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bumps on palatolglossal arch, mouth sores and red spots\n\nI have bumps on my right palatolglossal arch and mouth sores as well as red spots in my mouth I'm 19 and don't smoke or drink and I'm pretty sure I don't have hpv or any stds. I have bumps on the back of my throat and feeling of breathing in really cold air in my chest sometimes during the day. What could this be?",
    "doctor_response": "Hello,You may have an oral infection such as strep throat or an oral  fungal infection. Prescription antibiotics can be used to treat these conditions. Other viral conditions are possible as well and often will heal with time. Are aggravated sinus or respiratory conditions causing irritation to the oral cavity? Do you have seasonal allergies or a postnasal drip condition?Take anti-inflammatory medication to reduce your discomfort. This includes Tylenol or Motrin. Stay well hydrated and drink plenty of water. Rinse with warm salt water. Maintain a proper diet with balanced vitamins. Make sure to include adequate amounts of vitamin B12. Schedule a visit with your dentist or doctor  for a clinical diagnosis and determination of medication needed to treat your condition.Thank you for your inquiry. I hope you feel better soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the solution for joint swelling in hands and pain in knees and hip?\n\nEver since I was a teenage, (59 now) I can not walk barefoot without causing extreme pain in my joints. It feels like every bone in both feet have no connection. The bones feel like they pop and crack. Within 10-15 feet my knees and especially my hips are in extreme pain. I have to sleep in socks because any kind of cold air causes awful pain. I have to keep my shoulders and elbows warm to prevent pain. I am now having a lot of joint swelling and pain in my hands,not just in the morning. Thanks for any insight",
    "doctor_response": "Hi,Get serum RA factor, serum uric acid, fasting blood sugar, ESR, CRP and send me the report.Till the have cap. rabiprazole empty stomach, tab. aceclofenac100mg+serratiopeptidase15mg thrice a day, cap.pregabalin75mg+ methylcobalamine750mcg at night.I hope it helps.Thanks,Dr.CHANDER MOHAN SINGH.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get mild left-sided chest pain with low Hb and vitamin B12 levels. Please help.\n\nHello doctor, I am a 39-year-old woman. I have mild pain in the left side of the chest (below the neck and above the breast) and then sensation in the upper back from four days. It comes and goes. Sometimes it goes to the right side of the chest also. I have done my ECG and blood test 6 months ago. ECG and blood sugar were normal. No hypertension but hemoglobin was 10 and Vitamin B 12 was below average. What can I do as in lockdown it is not possible to see the doctor as a person. Please help.",
    "doctor_response": "Hello. I would like to ask you some more questions, do you have symptoms of acid peptic disease or GERD? Or any burning sensation in the epigastric region, the center of your chest (heartburn). If you do, it could also present as chest pain so I will guide you accordingly. I would also like to rule out any muscular pain, for which I will encourage you to take a muscle relaxant and see if it helps. Take tablet Muscoril (Thiocholchicoside 4 mg) one tablet once a day when you experience pain and let me know in the follow up in a couple of days to see if it relieves the pain. Like you said your Vitamin B12 levels are below normal, it could also be neuropathic pain for which I will only advise vitamin B12 supplements (tablet Methycolbalmine once a day for three months) or B complex supplements. You can also improve these levels with diet. Take diet enriched with beef, liver, and chicken. Fish and shellfish such as trout, salmon, tuna fish, and clams. Fortified breakfast cereal. Low-fat milk, yogurt, cheese, and eggs. Since your Hb is also below the ideal levels, take iron-rich foods which are usually Vitamin B12 rich as well. So I will advise diet modification to incorporate these in your everyday routine or take supplements with iron and Vitamin B12 as well. Because anemia can also present with the said symptoms. Lastly, I will encourage you to reduce weight with exercise and changing your diet and switching to a low-fat diet with the addition of more fruits and vegetables to your diet. Try to start with atleast 30-40 minutes of cardio workout every day and work it up from there according to your stamina and you will see the visible change that you feel. You will feel more active and fresh. Try to bring your BMI (body mass index) as close to the normal range as you can. Because obesity itself can cause countless problems as well. I hope this helps. ECG (electrocardiography). Do not lift heavyweights. Take low fat, high fiber diet. After two days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest tests to confirm impotence\n\nHello, i m ankit ,24 i had undergone an operation in my penies when i was 2 months old. since then the size of my penies is very small and not very big at erection.my parents want me to marry but i m very nervous.can i hav sex and hav a child.and can i satisfy my wife and are there any chances of being impotent.please help.....thank you",
    "doctor_response": "Hello, You are worrying too much and that too unnecessarily. Length and size of penis is not a concern in marriage and child birth. A per son with even a two inch erect penis can satisfy women and can have babies. So don't worry about it. You are just 24. Focus on your career and education. Rest can be taken care of when the situation arises. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for chest pain\n\nwell to start things off plane I have asthma and endometriosis adhesions and MTHFR chromosomal abnormalityjust to name a few but I have been having problems problems with nasza chest pain and using the bathroomI am tired of going to the doctors and never rinsing any things out was just hoping you might B able to think of some thing that might help thank you for your time.",
    "doctor_response": "Hi. I can understand your concern. Possibility of asthma being uncontrolled is more in your case. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed 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 bronchodilators and inhaled corticosteroid (ICS)Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can someone get rid of weak sperm cells? My husband seem to be able to have kids, but he needs to try hard. And when I did, I happened to loss the baby. He tells me that was his first time of getting a girl pregnant and I have a 5 year old which is not his. Please help me, we need a baby.",
    "doctor_response": "hai. i advise you to go for a semen analysis to know about the functional part  of   the reproductive organs of your husband.semen analysis will reveal the problem behind your query.weak sperm in terms of motility/quality/ morphology should be ruled out and proper medication will solve the problem.with the proper analyzed semen report kindly consult an infertility specialist to fix your problem.thank youhope i answered your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rash on chest, spreading, itching. Breastfeeding. Using hydrocortosone cream. Suggest herbal remedies?\n\nAbout 5 days ago I noticed a tiny faint rash the size of a peanut on my chest. Over the last couple days that rash has spread over my chest and neck, and itches. I used a new rich moisturizer, which I have stopped using. I am breastfeeding so my medication options are limited. I used Hydrocortisone cream today which made it bright red for a moment, but i cant tell if that is working or not. What over the counter or herbal remedies will work?",
    "doctor_response": "Hi, it appears to be an infection, rather than allergy. or if due to allergy, it may be due to food you have started recently, or soap, spray, clothes, etc. I advise you to consult a dermatologist for diagnosis and treatment.                           I to my patient with such infection, prescrbes, levocitrizine, montelecast, and cifixime . Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Family planning, self injected nuristerate. How much is the minimum dosage?\n\nI self-injected nuristerate because I don't have time to go to the clinic, and when I do go, its so full, and family planning doesn't seem to be a big priority for the nurses.Anyway I got quite a bit in the syringe but there was still a little bit left in the ampule that I couldn't get to. Will that affect the effectiveness of the drug? How much is the minimum dosage. I've been on it for 9 months.",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum. Nuristerate is the progesterone hormone and uses as contraceptive medicine. Intrauterine contraception the normal dose if 38 mg into the uterine cavity efficacy can last up to one year.If  dose is not proper it will be effective ,but it depends upon the dose inserted. Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain due to moderate bulging disc L-2 through L-5\n\nquestion regards moderate bulging disc L-2 through L-5. Also denerative disc desease as evidenced via MRI with no contrast. Looking to help with pain management (other than drugs) such as exercise at this time. Am unable to have appointment with specialist until end of Oct- and do not think I can live like this until then.",
    "doctor_response": "Hello!Thank you for the question on HCM!I understand your concern.I would recommend a lumbar brace, and physiotherapy for the pain. You should avoid straining physical activity and staying in sitting position for a long time.It is not a matter of surgery. The non steroid antiinflammatories can help.If the pain still persist I would start Amytriptiline or gabapentine, but these medications ate given only under doctor prescription.Best wishes Dr. Abaz Quka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am getting cold and sneezes almost every day. How to get rid of this condition?\n\nHello doctor, I am facing too much cold (almost every day), whereas during my last four-year stay in the previous place, even for a single day, I never had a cold. All medicine like Avil, Sinarest, Citragin, etc. failed and almost all home remedies also. Please suggest to me which medicine will give me relief from many hundred sneezes, continuous nose leaking, severe eye irritation, headache, and laziness.",
    "doctor_response": "Hello. From the symptoms detailed, you have allergic rhinitis. Do you have a history of sinusitis? Sinus tenderness which can be elicited by applying pressure over your head, on cheek bones? Do you have congestion or blocked nose? Well the main cause of allergic rhinitis is the allergen that may be indoor, outdoor, occupational, pets, dust, smoke, incense sticks. Management includes,  1) Environmental control that is to identify and eliminate the allergen. This is the mainstay. Try to identify the trigger, avoid its exposure. 2) Pharmacotherapy, this includes T. Mont- L (Montelukast, Levocetirizine) evening 6:00 pm daily once. 3) Tablet Allegra 60 mg twice daily. 4) Intranasal Otrivin sprays if you have blocked nose only for five days. Intranasal corticosteroids, Beconase AQ or Flonase (Fluticasone) or Rhinocort, Nasacort (Triamcinolone) two to three times daily.  It may take a few days for the effect to start. Do steam inhalation with few drops of Nosikind plus dropped in the boiled water. As I have already suggested, you need to identify the allergen and get rid of that. Do continue home remedies. Do revert if your symptoms do not come down in three to five days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have a becker's nevus on my left upper arm. My parents had cancer\n\ni have a becker's nevus on my left upper arm. i want to cover it with a tattoo but both my parents died of cancer: father had pancreatic cancer and mother had breast cancer . will it be safe for me to get that patch tattooed? i have becker s nevus on my left upper arm. i want to get a tattoo made over it to cover it. but both my parents died of cancer:my father had pancreatic cancer and my mother had breast cancer. will it be safe for me to get a tattoo over the mark?",
    "doctor_response": "Hi! venu, I understand your need and dilemma.Lasers are costly and then in beckers the results are variable too.You are right in your way. I think to be doubly sure ,you can get a skin biopsy done and then go ahead with the tattoo.As such, tattoo  should not cause cancer.But your tattoo artist should be experienced too.By the way, where do you belong to. wish you good health, regards, Dr.chawda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pimples with white heads above the genitals?\n\ni have pimples with white heads right above my genitals. i noticed a few yesterday and by the end of the day there were a lot more. i have been married for 11 years and have been faithful. my wife has had a one time affair about a year and a half ago but she says she used protection. i have looked online and the pics of herpes and genital wort s dont look like what i have. mine look just like zits and arent on my genitals but all over right above them. i am trying Clearasil now that is supposed to show results in 4 hours but they still look the same. they do itch but not all the time and since i started using the Clearasil the itching has stopped all together. they arent anywhere else. what do you think it is...zits or something else.",
    "doctor_response": "Hi. It could be a mild Sreptococcal infection localized to the area. You should wash it regualrly and keep it dry. You could have a course of antibiotics if they are painful or discharging some pus like fluid or if there is redness around them. I would usually advice my patients Tab Augmentin for 5 to 7 days to clear the infection if thats what it is. However, to be sure one would need to look at it. So it would be in your best interest to have it checked up by your Doctor. Take care. Dr Rishi, New Delhi, India.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood in saliva with lightheadedness ?\n\nHi almost every day I have blood in my saliva when I wake up or even when I bend my head to pick something up.etc...and sometimes it just bleeds spontaniously..it has been going on for over 12 months now. I had antibiotics which improved the condition for about 3 weeks. I have been to the dentist and had my teeth cleaned...etc.. my doc. send me for a ENT but the specialists thought I do not need it done. It does worry me and also I don't have a cough or pain or anything. ..it does make me feel light headed.",
    "doctor_response": "Hi,Thanks for posting the query,     I would suggest you to get a blood examination done and get a checkup done by a Physician.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can gum injury be treated?\n\nHi, I was recently in a bicycling accident and damaged my three front teeth and gums above them. I went to the dentist a few days ago and he said my gums will heal and teeth will hopefully be fine. But just last night I noticed that my gum on my upper left tooth un attached itself from right to left in the middle. Will my gum reattach itself and heal buy itself? Or should I go see a dentist right away?",
    "doctor_response": "Hello,You must visit the dentist if the gum has detached itself and is attached at some point above the teeth as the dentist can excise that part of the loose tissue. But if a considerable part of the gum tissue is still attached and not hanging loose, then there is a possibility that it will heal. Because excising a part of gingiva can sometimes cause contraction the healing tissue and result in shortening of the gums and since it is the front teeth it doesn't look aesthetic. I suppose that's the reason the doctor must have waited to heal on its own. I would also like you to take soft food and not to traumatize the area while brushing. Fingers can be used for massaging the gums in that area or soft toothbrush can be used for brushing the teeth.Hope I have answered your query. Let me know if I can assist you further.Regards,      Dr. Shilpi Sharma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ear infection and cold\n\nI have a daughter that is a month shy of 27. Her white blood cell count is at 2.1 and has been low for 3 months now and she had what stated out as a ear infection and cold. I have been told to take her to a hematoligist and have a appointment for next monday. I am very worried should I be?",
    "doctor_response": "Hello  Dear I evaluated your concern in depth .@  This low WBC for 3 months are not normal , has to be evaluated for the     underlying pathology , not emergency but on planned basis .@  Till then take utmost care to prevent any type of infection & if occurred      immediate control of the same , as her immune system at present is        weak  due to low WBC count @  Gentle suggestions for your daughter to get fast recovery  # Ciprofloxacin ear drops in affected ear 2 drops every 6 hourly . # keep the ears  clean , dry . # apply cotton plus in ears when out of home # avoid exposure to dusty environment , pollen containing areas # in our clinic we recommend simple anti cold medications with systemic    antibiotics as per the need of the case . # avoid chilled beverages, biscuits , ice creams , chocolates , junk foods  # deep breathing exercises & YOGA support a lot  # diet balanced in all nutrients to combat against any invading pathogensHope this will help you definitely .Feel free to ask any further health related question in future anytime .Thanks for using health care magic .Regards dear .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is blood in urine of child with hernia a cause for concern?\n\nhi, my 3 year old daughter has a hernia ( stomach, since birth) she has complained of pain and i also noticed abit of blood in her urine. our dr said she could just have a stomach upset and didnt seem overly concerned about the blood?! is it something to be worried about?",
    "doctor_response": "Hello. I just read through your question.I'm a little concerned about blood in urine under any circumstances. It is worth having a urine sample sent to the lab for analysis. In most cases, it is nothing.  But it's good to do just to be sure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes large painful boil on scrotum?\n\nMy husband has had a very large and painful boil on his scrotum for about a week now. We went to the urgent care on Wednesday last week. They said it looked as though it was ready to pop, so they gave him anti-biotics and something for the pain. The next day it did pop, and some pus/blood came out. But now for the past 4 days, he has been draining consisitantly. So much that he has to wear a maxi pad in his boxer shorts to prevent his pants from getting wet. However, today, the blood and pus is thick and clotting. So much so that if he squeezes the boil, he literally has to pull the pus out like a string. It is very thick and long. The boil itself is still there, very large and hard. About 3 inches long. Is this actually a boil and will this improve or should we go back to the doctor. He is being stubborn today and wouldn t go to urgent care but I am very concerned.",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: Daily dressing with removal of pus is necessaryExplanation: A boil can cause swelling and pus formation which can burst open discharging pus. AS you are taking antibiotics, it is better to continue it for further 2-3 days and daily dressing by yourself or by medical personnel is necessary for removal of pus and for early healing.                   Do not shy away, visit a doctor again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for constant passage of gas and painful discomfort\n\nHi Doctor, I have a 45 days old baby girl who is on 70% breast feeding and Nan Pro 1 for the top feeds. She has been having irritation in the stomach and passes gas continuously through the day and night and as a result has not been able to sleep well. She gets utter discomfort at every passage of gas which happens almost every two mins. She passes stool once a day and it s not watery. She urinates normally. Her weight gain is also normal per the pediatrician. We tried simethicone drops but nothing is relieving her from discomfort. We try to burp every pre and post feed and has not helped.we massage regularly also to see if it relieves the discomfort.. It does not. We really need a solution / medicine which will resolve this constant pasage of gas and the painful grunting /discomfort the baby feels as a result. Please help.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.This is called evening colic and is quite common in this age group. This happens when the baby sucks at the breast very fast and in eagerness to drink milk will gulp in air too. Unless the air comes out like burping or flatus this discomfort will be there and next time check if the baby is sucking too fast and gulping in air too. You will be more convinced. Usually I don't advice any medicines for this as they give only temporary relief.The two best ways to relieve this distress is - 1. Do not put  the baby in lying position after feeding till the baby burps out the swallowed air.2. If  still crying - put the baby in prone position and keep patting the back gently so that the baby passes off the flatus and gets relieved.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are Levothyroxine and Citalopram blood thinner medication?\n\nWhich of the following medications are blood thinners: Levothyroxine Cialopram Minoxidil Hydrochlorohiazide Valsartan Januvia Oxybutynin Pravastatin Sodium Bysolic Pramipexole My husband is having surgery and needs to stop taking any blood thinners. Thank You XXXX",
    "doctor_response": "Hello, None of the medications you have mentioned is a blood thinner and he should not stop any of these without consulting the doctor. The medications you wrote are for thyroid problems, hypertension, high cholesterol, depression, muscle spasms (Parkinson), etc. I hope this answers your query. I remain at your disposal in case further medical assistance is needed. Regards, Dr. Antoneta Zotaj, General and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathlessness during sleeping?\n\nHi,sir am a 22 year old male.am working in a bpo night shift.I used to go to bed at 4.30 am daily.during in sleep i feel some one pressing my chest and also my back with a weight of four persons at same time,when i encounter this problem i cant breathe or move or lift my hands and leg and i also cant speak at that time.Is this a medical disorder or my friends advise me this might be a done by evil spirit please help me..",
    "doctor_response": "Hello dearWelcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This is in relation with psychosomatic manifestation of underlying stress , anxiety disorder .*  Recommendations at present -  Maintain hydration with plenty of liquids .-  Adequate sound sleep of 8 hrs .-  Avoid smoking , alcohol in any form .-  Regular walking in fresh air , exercises , YOGA .Hope this will help you a  lot .Welcome for further guidance .Regards dear .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is decolic injection given for abdominal pain?\n\nhi doctor, i want to know why doctors gives us decolic injection?from today i have a pain in my left lower abdomain.and it give me so much pain.then the doctor give me the decolic injection.withen 20 min. i fill better ,but again after 3 hr, i have steel pain.can u help me plz",
    "doctor_response": "Decolic injections are given for intestinal colic, dysmenorrhea may be for ureteric colic. It gives you immidiate relief. But it may not treat the cause of colic.In your case it seems to be either constipation or infection or may be ureteric colic. In fact if you are constipated your condition might deteriorate after the effect of drug passes of as it  may cause atonic constipation. You have not given any details of type of your pain. So go thouugh investigations as to why this is happening to you so that you can be treated accordingly. Till then have plenty of oral fluids and fiber rich diet. You can add laxatives at night if you are constipated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of sertraline?\n\ni have been on sertraline for 16 years and in the past 3 months i have been lowering my dose and now i have been off completly for about 2 weeks but i am having some side effects that are quite bothersome what can i do about them or should i go back on a low dose to keep them from happening?",
    "doctor_response": "HiThe side effects can be present even weeks after stopping the drug. Withdrawal symptoms have appeared in patients from one to three months of stopping the drug.Hence it can take between one to three months for the effects to reduce.Hope I have answered your query. Let me know if I can assist you further. RegardsDr.Saranya Ramadoss, General and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain & swelling of the outer thigh ?\n\nMy husband is having a lot of pain in his outer thigh I noticed it was swollen slightly. It's preventinghis ability to walk. He's been taking calcitriol 0.5 mcg. What can we do about the pain. His on call Dr. Said don't take it anymore ok that fine he won't but what about the pain? Can anyone help?",
    "doctor_response": "Hello,If pain and swelling is present on thigh which is not relieved with medication,suggest you to consult ortho doc and get an x-ray done",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does problem to hold sperm in vagina after sex prevent pregnancy?\n\ni leak after having sex with my husband. this didnt use to happen but i am concerned that this is keeping us from getting pregnant. we both have kids from previous relationships so i dont understand why its taking us so long. we have been trying for 3 yrs now",
    "doctor_response": "HI,   I understand your concern.   -  Leaking out of semen after sex is a natural thing. Retaing for few minutes suffices for getting conceived.. as even a drop of semen has millions of sperms. If you are worried of the leaking after sex..Don't get up immediately, try to sleep with a pillow under your back for half an hour after sex.   - You should try for checking semen analysis.. to confirm it to be normal.& take treatment if there is less number of sperms/ with poor motility.Also get your self checked for normality of ovulation.   Thanks,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for myalgia in neck & rib cage\n\nive been diagnosed with a couple of issues narrowing between c5 c6 disk in neck and myalgia also in between my shoulder blades the stabbing pain comes right around through rib cage to the front of ribs plus ive been having muscle spasms in upper back for years",
    "doctor_response": "Hello, As nothing is mentioned about taking any medicine and physiotherapy I will advise undergoing both as a combination therapy works better. Firstly will advise you to use the cervical soft collar to stabilize the neck muscles and spinal column to improve the intervertebral joint space. Post this static neck exercises, shoulder stabilization exercises, gentle kneading massage of the Trapezius muscles and inter-scapular muscle strengthening exercises will help to regain the muscle property, improve joint spaces and reduce the joint inflammation, muscle inflammation and pain levels. In my clinical practice of over 12 years, most patients with cervical spine pathology have responded well to a combination of drug therapy and physiotherapy. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for bad pain on inner right leg\n\nI have bad pain when I walk on my inner right leg it feels like in between my hip and leg for about 5 days and its not getting better I have to lie down on my right side or it will hurt and i can walk for no more than 30 sec. I have to walk with both knees bent if my right leg straighten out when i walk the pain will come very fast. I m taking inflammatory and T 3s and they don t work very well",
    "doctor_response": "hi,thank you for providing the brief history of you.a thorough neuromuscular assessment is neededas mentioned by your symptoms, it appears to me that you need a thorough neuromuscular assessment. As post which is the symptoms are connected to nerve related issues then an MRI of the lumbar spine will be performed to see the soft tissue status. As even you mentioned that the position you need to take for relieving the pain and your knees stays bend while walking. With medication and physical therapy combination there is a massive improvement in the health status. Also in my clinical practice dealing with such symptoms and post in detail neuromuscular assessment and MRI the precision of therapy is planned to get the optimum 99% results.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I suddenly experienced palpitation and felt dizzy. Is this manifestation of panic attack?\n\nHello doctor, I am 20 years old. At work, I had an episode of my heart started racing out of the blue. I could feel it pounding in my chest, and it made it feel like I was choking. I got very dizzy and thought I might faint, and started sweating. It only lasted about five minutes. I have issues with panic attacks, but this was an entirely new experience. Could it be another manifestation of panic, or might it be something more serious?",
    "doctor_response": "Hello. There are various reasons for having palpitations along with dizziness. The most important one is an abnormal heart rate or rhythm which starts suddenly and terminates abruptly. This could be detected by different monitors that you can carry with you, these devices can pick up the abnormal heart beats. Second of all is a thyroid disease, excessive thyroid hormones can cause stimulation of the sympathetic nervous system and you will feel hot, flushed with palpitations. Weight loss and diarrhea along with excessive appetite may also occur. Last but not least, is the most common type and is called vasovagal phenomena that happens when you suddenly change position from sitting to standing. Your body does not have enough time to compensate and you may feel having racing heart beats with dizziness. Panic attack is a diagnosis of exclusion and I would not jump to this conclusion as of now. I believe you experienced the last type I mentioned above (vasovagal), having said that if you have another episode, I would suggest seeing a cardiologist. Try cutting down on caffeine intake (including soda and other caffeinated beverages). Request your doctor to check your thyroid function test. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication to improve the sperm count\n\nHello Doctor, Recently i have tested my SEMEN and came to know that it is Just 14million per 1ML. Floating speed is just 10%. Will i be able to increase my SPERM count?  What tablets and steps to be taken to increase my SPERM count. Please Advise as i am looking for Kids. Thanks Suresh.",
    "doctor_response": "Hello, Medicines to increase the sperm count can only be given after clinical examination , other investigations other than semen analysis to know if the problem you have is treatable with medicines alone or it requires any surgery. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Fatima Clinic",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to heal allergy symptoms like swelling after consuming certain foods?\n\nsometimes after I eat certain foods, the skin around my knuckles in the middle of my fingers (all of them) swell up...not the bones themselves but the skin...it is painful to move them due to the skin being so tight and swollen. Please help as I can't find any answers....thanks.",
    "doctor_response": "Hi,From history it seems that you might be having some food allergy giving rise this problem.Try to find out the food likely to give allergy and avoid taking that food.By trial and error you will find the food cause allergy reaction.Take anti-histamine like Cetrizine or Benadryl as and when required.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on the outer area of the armpit?\n\nI am a 28yr old female and I have a lump on the outer area my left armpit, a little smaller than a marble, nowhere near the breast tissue. Its not at all painful. doesnt seem like a swollen gland or ingrown, it has been there about 10 days with no changes I have been getting laser hair removal on my armpits for 5 months now, do you think there is any relation?",
    "doctor_response": "Thanks for asking in healthcaremagic forum  That may be due to swollen lymph nodes because of the treatment you are undergoing.   So, please consult your treating doctor for examination and further management to rule out other causes of lump.   All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "CT scan suggesting appendicitis. Lesion and mass on the liver, kidney stones. Have vomiting after surgery, loss of appetite. Concerned\n\nI had a CT contrast study done late October. I had appendicitis . They found a lesion on my liver at that time. About 2 weeks after having my appendix out, I started feeling sick to my stomach and throwing up. My surgeon ordered an ultrasound . I was told today that they found 3 masses on my liver. 2 on the right side, and 1 on the left. My surgeon is out of town, so I wasn t able to ask any questions. Her medical tech gave me the info. I am still sick to my stomach, don t have much of an appetite , and have pain in my back. The ultrasound also showed I have kidney stones . I am going out of town on business and won t see my surgeon for 2 weeks. Is this something I should be extremely concerned about? Will flying affect anything? Thank you",
    "doctor_response": "if you can postpone your outing to seek help from gastroenterologist/Hepatic specialists it would be worth scince you are having symptoms due to liver disease,nevertheless if you have to wait for your treating surgeon,it is advisable to have bed rest for any kind of liver disease.Evaluation of liver mass by FNAC(fine needle aspiration biopsy),liver function tests,CBC (complete blood count) are few things which should be initiated right away.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stabbing pain under the rib cage in an athlete?\n\nHi, I m Adria. I m a runner, late teens, but lately, whenever I race a 5k, in the middle of it, I get a stabbing pain under the rib cage on my right side. I ve ensured it s not caused by dehydration, overhydration, or eating too much/too little, right before I run. It s different from breathing cramps, menstrual cramps, or stomach cramps. This hurts 10x worse. Any advice?",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .*  This is acute ligament or muscular cramp in relation with the over    exertion state .Wishing you fine recovery .Feel  free  to ask any further doubts .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "how to treat fever in a 9 years old child?\n\nMy 9 year old daughter has a temperature and glassy eyes for the last two days, she says she has a pain in her head and appetite isn't as good as normal, paracetamol is taking the temperature down but when it wears off it rises again, there are a lot of virus' going around at the moment so wondering could she possibly have one, she has a slight cough too, I think she could have a slight chest infection?!",
    "doctor_response": "Hi,It seems that she might be having viral infection giving this problem.Continue with paracetamol as and when needed.Give her some cough syrup for cough.If problem continued then she might require one course of antibiotic medicine like Amoxicilin or Azithromicin for 3-5 days.Avoid giving cold drinks and junk food.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What other injections besides immunoglobulin and rabibur are necessary after dog bite?\n\nMy son 1.75 yr old had been bitten by a domestic dog which is always chained in home since its birth say 3 months. It bit my son on head with deep cut in 4 places. within 6 hrs immuno globulin injected and stitched (because of deep open cut) and rabibur dose 4 given. Is there any other... we all are shock and untold sufferingss... but the dog is alive now (14 days till today)",
    "doctor_response": "Hello,Welcome to HCM,As your son was bit by a domestic dog over the head which has led to multiple lacerated wound. There was a bleeding from the sit of the bite for which yoyr doctor has advised a proper treatment.For any lacerated wound following the dog bite your daughter should receive both active and passive immunization. Active immunization with anti rabies vaccine should be taken on days 0,3,7,14 and 28.The wound can be sutured only after administration of rabies immunoglobulin to prevent bleeding from the site which was done as per the WHO guidelines.As your daughter has received all these medicine I can assure that your daughter is safe and protected.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can light period after unprotected sex indicate pregnancy?\n\nI was off my birth control for two weeks and my boyfriend and I had unprotected sex and I told Plan B two days after. A few days later we had unprotected sex again and I did not take Plan B, however I started to bleed three days later ans thought it was a light period, but my period wasn t suppose to come for another two weeks, The bleeding lasted for about 3 days. Could I be pregnant ?",
    "doctor_response": "HiWelcome.I have gone through your queryBased on the information provided but you, you are less likely to be pregnant.But pregnancy can not be diagnosed by symptoms.I wiggle recommend you to go for urine pregnancy test, after a week of missed period and using morning sample.Hope this helps.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there home remedies for hemorrhoids?\n\nI think I have a hemorroid and am worried about its state. Ive tried the whole home treatment therapy. Ive used prep. h and sitz bath 2-3 times daily. But as of yesterday a sickly yellow spot has appeared on what i can only describe as the head. And today a dark purple/black spot has appeared on the side of it. Should i continue my home therapy or is this a more serious matter that i need attended to? Also ive heard talk it could be an abcess is this possible?",
    "doctor_response": "**1. red/black mass coming out from anus could be possible prolapsed thrombosed piles, thus opinion of surgeon is required for examination and evaluation. [conservative or surgical treatment]2. wet dressing till swelling reduces, I won't prescribe any alternate remedies, till it has been checked by a surgeon. [to differentiate perianal abscess from prolapsed thrombosed piles or other forms of anal lesions]PS. till next appointment you may use OTC [over the counter] drugs like Ibuprofen, and a good antibiotic3. You can also incorporate following methods to alleviate the symptoms:. hot hip bath: sit in a tub of warm water for 10 minutes [2 times a day]. do not strain while passing stool,and use warm water or wet toilet paper but without perfume or alcohol(without soap) to clean your anus after each motion . avoid cold/tap/jet (western seat) water..  taking amla & aloe vera juice will help in cleansing the liver to speed up the metabolism.. In Ayurveda we hold Piles to be due to low digestive fire and since butter milk has digestive properties you can take it along with ingredients like asafoetida, coriander leaves, ginger, currey leaves and sea salt to enhance its digestion-aiding properties.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can hallucinations, headaches and irregular heartbeat be dealt with?\n\nHi! i think I might have drank too much coffee. I'm experiencing hallucinations, head ache, and irregular heartbeat. I can't also stop thinking about scary things. My head is soo  messed up! I can't even think straight. Help please! My class will start in 6 hours and I haven't gotten any sleep yet",
    "doctor_response": "HiThanks for using healthcare magicSometime, due to stimulant effect of coffee, patients feel such kind of symptoms. That would stay for few hours. Nothing to worry about that. In case, you feel too much problem, you can take low dose benzodiazepine, but that would not available over the counter.You have to consult a physician or psychiatrist for that.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "When should Gonadil be taken to get pregnant?\n\nhi I am 25year old with pcos and taking Regestrone to get my period. My doctor has prescribed me to take Gonadil and Apcod sachet as we want to plan our kids. My doubt is when should I start using Gonadil and Apcod sachet? Should I take them after i get my period or can I take it right away?",
    "doctor_response": "Hi, you can start taking gonadil and APCOD right away, but these medicines alone will not help in conceiving.  you have irregular periods.  So get yourself evaluated first.  Do a  thyroid profile and prolactin levels and a ultrasound for your uterus and ovaries.  If everything is fine, you can take some medicines like clomiphene for the growth of your follicles and track your follicles growth by repeated ultrasound.  When follicles reach a size more than 17 mm, take injection for rupturing the follicles.  Be in contact with your husband for next 2 to 3 days. 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. Hope I have answered your question.  If you have any other query I will be happy to help. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is stiffness in arm a side effect of Amlong A 50mg?\n\nhi , i want to know the side effects of Amlong A 50 mg , my father is 60 years old . in august 2011 he suffer from paralyses attack n little bit clot in brain , now he is recover from that but a lot of suffering from stiffness in left arm . his BP is now 130/90 . is it due to amlong ????",
    "doctor_response": "Hi, Amlong A is a medicine that is used as an antihypertensive (to lower the blood pressure). It usually does not any stiffness in the left arm. I feel first of all we should evaluate for some other reasons for stiffness. I hope there is no associated chest pain or reduce the power of the left arm. The stiffness may be part of frozen shoulder or compression of some nerve or inflammation of tendon. Sometimes it can be associated with some trauma. I think we need to do a detailed evaluation to decide the cause for the same. You can start some stretching exercises and take multivitamins. If symptoms persist then you need to do some investigations like vitamin B12 level, X-ray shoulder, ECG, nerve conduction studies. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Milinda Gupta, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Heavy head and tongue, neck pain, nausea, vertigo. Want expert opinion\n\nHi Dr Mintz I am Jasmine. I am about 38 years old and at present going through some health problem. For the last 2 weeks months I have a weird feeling. My head suddenly starts getting heavy and I feel my tongue is also getting heavy and feel it being pulled back. It all starts with slight pain that starts from the neck region. Before this my problem started with neck pain , heavy head with nausea and vertigo . After medication the vertigo part and nausea part is better but for the complaint that i have mentioned above. Request your expert opinion. Best regards",
    "doctor_response": "MAI I KNOW YOUR PROFESSION PLEASE?.BECAUSE MOST SOFTWARE COMPUTRER PERSONNEL HAVE H/O PROLONGED SITTING BEFORE THE COMPUTER WHICH LEAD TO STRAIN OVER THE PARASPINAL MUSCLES OF THE NECK LEADING TO WIERD FEELING.GET A X RAY CERVICAL SPINE DONE N GET CHECKED FOR CERVICAL SPONDYLOSIS.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the mid part of the brain?\n\nhi i have a severe pain in mid part of my brain from last 2 years i took lot of treatments and didi cityscan also but no result now i have got fed up now i want to die otherwise plz  help me to cure my headache i feel even my blood floow through this part like pulse",
    "doctor_response": "Thanks for  your question dear your headache according to history is migraine type so you better sleep well avoid coffee or tea and avoid watch TV in dark room  and you tab naproxen 250mg BD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could having a massage relieve throbbing pain in lower back with history of having back problems?\n\nI have a history of low back problems, but I have not thrown out my back for almost a year. Right now I have throbbing pain in the low back. It hurts to sit, stand or lie down except in certain positions. It also feels like I might throw up. I was thinking of going for a massage... is there anything else I can do?",
    "doctor_response": "Hello, I had gone through the case and found that you must go for MRI of back to find any other complication like slip disc or herniation . So after getting the correct diagnosis take treatment.Meanwhile take mild painkiller and apply muscle relaxant gel for local application.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes huge lump on lower back?\n\nHi, my boyfriend has a huge lump on his lower back. he gets back pain a lot from doing little things and when his back hurts the lump gets very hard. the lump is squishy when his back is ok. the bump is about 2 inches in diameter. i poked it with a sterilized pin last night and clear fluid was coming out and it smelled like feces but a little worse. i tried to drain it completely but wasn't able its still huge but he said he didn't feel as much pressure from it. any idea on what it might be? or what we can do about it?",
    "doctor_response": "Hi,Dear,Thanks for the query to HCM.I went through your query and understood your health concerns.In My opinion- that lump on back of your boy friend Infected Sebaceous Cyst / Or could be -Chronic boil -folliculitis- with sub- acute stage, which could be dealt by your family doctor.Treatment-a-Surgical Drainage from your ER doctor is needed,as you already pinned it and its still there,else it would complicate further with infection and abscess , which is worst and  painful.b-Antibiotics x 5 days form ER doctor.c-Dressings d-Tb NSAID to control pain and inflmation.This would recover in 5-7 days time.Hope this would solve your query. -Hope this would help to resolve your worrysome query on your next visit with your family GP doctor.Wellcome for further query to HCM in this regard.Wishing you fast recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain in the collar bone after the surgery?\n\ni had a surgary n the next day i woke up with sharp pain in at my collar bone. it has spread to the back of my shoulder to the bottom of my shoulder blade. then down the side of my rib cage n down to my shoulder. today it is down to my wrist. what is this?",
    "doctor_response": "Hello,I can understand your concern. It would have been helpful if you had mentioned what surgery you have been through and for what disorder. If you have had surgery in the head and neck region under general anesthesia, then you must been put on the wooden block under your shoulders and back to raise the surgical region and have better vision and accessibility for the surgeon. If that is the case, then due to being still on the wooden block for long time may make muscles stiff and you may feel pain in all the areas you have mentioned. The wrist pain may be experienced due to injection of IV anesthesia and medicines. If this is the case, then analgesics that you must have been prescribed after surgery and local application of Diclogesic Sodium gel (Volini) can help.If the condition is not what I have thought, then you should discuss the problem with your  surgeon for other possibilities.I hope this information helps you. Thank you for choosing HealthcareMagic. I wish you recover soon.Best,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could positive IgM and Strep B test but negative IgG indicate?\n\nIn march I got sick which looked like herpes got igm test postive and igg negative. went beck seven months later and igm postive igg negative I have been fine since March. strep b came back postive in March as well. If it's not herpes what could it be?",
    "doctor_response": "HI, thanks for using healthcare magicIgM and IgG are types of antibodies that are formed when the body reacts to the presence to a particular virus, bacteria, fungi.When the body picks up the infectious agent, it forms antibodies against it. The IgM antibodies are formed first then disappear and then the IgG antibodies are formed later.When checking whether a person had a particular infection in the past or has it at the moment or recently, the IgG and IgM can help.IgM means it is a recent infection, IgG means the infection was in the past.You had positive IgM antibodies, this means that you were positive for a present/recent infection of herpes.The negative IgG antibodies means that it wasn't a past infection, this infection recently happened.It is herpes according to these results.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting at night while having whole milk?\n\nMy daughter is a year and one month she recently like two months ago started drinkijg whole mill but recently at night she tends to wake up whine and throw up cottage cheese looking throw up and smells bad what is it? Should I take her to her doctor? Or switch milks or do organic or how many bottles is a baby her age suppose to consume on a regular basis or day?",
    "doctor_response": "Hi...at this age, the milk consumption should be around 300-400ml per day. By what you quote I feel that she is intolerant to cow's milk. Suggestions -1. Mother should go off the cow\u2019s milk products completely - including biscuits and chocolates and all products related to milk.2. Continue exclusive breast feeding and if it is not sufficient you can opt for Zerolac.3. Cow's milk protein intolerance in transient as it will go off as the kid grows up.4. Avoid all cow's milk products till the kid is 1 year age.5. Mother's milk is the best for good growth of the baby. Rather than stopping mother's milk, it is best for the mother to avoid all milk products and continue breast feeding.If you have any further queries you can approach me at the following link.You can approach me at the following link. Please find the link below.www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pounding in upper chest while bending down?\n\ni want to know why is it sometimes when bending down to wash my hands i feel in my upper chest pounding and it goes all the way to my throat and sometimes when i am lying down and i turn to the side i feel it too the thing is when I wald on treadmill for an hour an a half and i get down I don't feel that, I sometimes have the flu and I gough and feel some mucus and runny nose",
    "doctor_response": "Hi thanks for contacting HCM...Here according to your complaint you have some obssesion like thought ...It is some false neurological thought that chest has gone away from throat....Don't think about this....You are absolutely normal....Don't think about such abnormal thought...You have runny nose associated...For which symptomatic treatment done .Cetrizine can be given....Steam inhalation for blocked nose.If needed for blocked nose nasal spray can be used.Take care...Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for problem in mental health\n\nMy sister used to fell down while walking when she was 17 years old. She also started to forget things. she used to blame others like why you said this to me. After 7 or 8 months she was having seizuers. After that she went in coma and she came out of coma after almost 6 months with the help of brain specilist. Before that she did not had any brain specilist traetment because everyone was suggesting diffrent treatments. When she came out of coma she forgot every thing and she was like a kid(3 years old). Her hands were closed and she wasnt standing straight. With time she remembred some things like her dogs name but she doesnot now about toilet or bathroom. Some times she goes by herself.  Now its been one and a half year she is having same symptoms and doctor said her br.ain is not draining a water back and she need an operation. Could you please tell me more about this we are so worried and do not have enough money",
    "doctor_response": "Hello and welcome to Healthcare Magic. Thanks for your query.I understand that you are concerned about your sister's problems. From the description of her symptoms, this appears to be a serious neurological problem, but with the limited information that you have provided, it is not possible to pin-point a definite diagnosis. So, I would suggest that you take her to a neurologist for a detailed evaluation and an opinion on further management. You have mentioned that you have already seen a doctor and that she was advised surgery. If so, it is better to have surgery at the earliest in order to prevent further complications.Wish you all the best.Regards,Dr. Jonas SundarakumarConsultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for cirrhosis of lever?\n\nGood afternoon. One of my relative is coming from Bangladesh, who is suffering from cirrhosis of lever. He has already send his treatment details and the clinical report to me. Now he is asking for the cost of the treatment. Can I send the papers through e-mail which he sent to me to you for the advice. Kindly help me.",
    "doctor_response": "Hi,How are you? I am so sorry to hear about your relative's diagnosis. The treatment of cirrhosis depends on multiple factors including the cause of cirrhosis (alcohol, hepatitis, etc) the age of the patient, his physical fitness and if he is suffering from any symptoms due to the cirrhosis. If the patient does not have any symptoms or is only mildly symptomatic, then he will treated with medications only to control the symptoms and prevent any complications. But if his symptoms are severe or not being controlled with medications, then the best option will be to proceed with a liver transplantation.Please do let me know where your place of residence is so i can guide you to the nearest speciality center to get evaluated.Hope this helped and please do not hesitate to contact me for any further details - rxsuresh@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Unable to conceive. Had IUI. What can affect implantation?\n\nMy husband and i are both 32 and I had my first IUI on Saturday.  I ran competitively through college, and continued to log 30 to 45 miles per week until this past year when we were unable to conceive.  After the IUI Saturday, I did no activity Saturday and Sunday and walked Monday and Tuesday.  My doctor had said continue activity as normal, but I am skeptical about running.  Is to run?  I am trying to understand if exercise can adversely affect implantation.  Thanks!  Katie",
    "doctor_response": "Hello, Thanks for the query to H.C.M.Forum. Any rough activities may hinder the implantation . Once fertilization , fertilized ovum will implant on endometrium of uterus  . Any hard movement may interfere or dislodge the fertilized ovum , so please avoid rough activities  , just a precautionary measure. Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I experience chest pain while breathing?\n\nWhen I walk fast or jog my heart hurts.. Or if I push some1 it hurts.  If I take deep breaths while walking it hurts when I breath out very badly ! It feels like my heart is constricting when this happens.. And it doesn't hurt if I'm not doing anything...",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. You are having left sided chest pain on exertion (walking) which is relieved by resting.This is characteristic feature of cardiac chest pain. So consult cardiologist and get done blood pressure monitoring, ecg, 2d echo and stress test (trade mill test).You may need cardiac supportive drugs on the basis of these reports. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had dengue, weakness, delayed period, high AST, ALT, SGPT level. Can it be brought back to normal?\n\nI had dengue last month, 1st october 2013. till now my body is weak.1) how long will it take to fully recover?2) I run (road/ trials) 3-4 times a week - is it advisable for me to resume?3) last review - i had high AST/ SGOT + ALT/SGPT as per the liver function test. am put on medication now to improve the same. anything i can do to bring it back to normal?4) i have not gotten my menstrual cycle for month end october. anythign i should be concerned on?rgds,",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum.Serial wise answer .1 You will recover within next one month ( total recovery period 4-8 weeks).2 Yes you can start your sports activities ,just now gradually increase the speed .3 Liver function will also be normal within another one month .Take plenty  of fluid diet with minerals .Pomegranate juice ( fresh fruit juice , not tinned ).4 Menses delay is due to certain medication used in dengue . This is not a cause of concern & natural . Wait for 1-2 months and you will be fine and complete recovery.Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be the possible reason if IVF treatment failed twice ?\n\nMY SISTER in law is undergoing an IVF TREATMENT BUT IT HAS FAILED TWICE. WHAT CAN BE THE POSSIBLE REASONS/ AND ALSO HOW CAN THEY BE OVERCOME. SHE IS ALSO SUFFERING FROM HYPO THYROIDISM AND IS UNDER MEDICATION.",
    "doctor_response": "Hi: First try to find out the reason for IVF failure. Check her TFT and find the thyroid status. If required adjust your thyroid medication. Check her other hormones like prolactin LH and FSH. First her hormonal profile should be normal for any artificial reproduction.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swllen armpit area, sore around breast area, advised blood test and scan. Cancer?\n\nI have a swollen armpit area and I have been having pains almost pins and needles done my arm of and on. It also verys sore around my whole breast area and up into my collar bone area. My verys weird under my skin. I went and seen a doctor on Tues and she said that my lymhnodes are not swollen but it she is sending me for an unltrsound of that area plus having bloodwork done and a stress test. I m just quite upset and think that it might be cancer .",
    "doctor_response": "Hi!welcome to HCM!Your breast seems to be having infection rather than cancer.soreness in breast area is a symptom associated with mastitis or breast abscess .you must get an ultrasound and blood tests done.dont be upset relax ,let the USG and blood test results come.take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "stomach pain..\n\nive jst came off my period about a week, and i have been feeling sick on and off through day and night but i have been getting few pains in th bottom of my stmach could you tell me what it could be please?",
    "doctor_response": "Even during ovulation\u00a0 YOU can have such pains. Do check about it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in upper legs and upper arms?\n\nHi. I am 66 years old and am having increasing difficulty getting up from a sitting and kneeling position. When I try to I have intense pain in my upper legs and upper arms. I have Bi-polar disorder and have been on a dose of Lithium of 250mg twice a day. I walk my dog for up to an hour a day but am finding this increasingly difficult. The pain is getting steadily worse but is more noticeable now that it is winter. What should I do?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Without an exam, I can only give general information, but there can be disorders in the muscle from a variety of causes. obviously overworking them is the most common but people would know if they did that and not ask the question! Statin drugs commonly do this. I see this at least 1 or 2 times a year. Other medicines or autoimmune disease are a lot less common. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can aggressive behaviour in a child be managed?\n\nI am having difficulty reaching a 7 year old who is very intelligent, but very emotional when it comes to correcting or redirecting without severe emotional outbursts to the point of self harming. He is very controlling and has major melt downs with any kind of conficts. He has not been evaluated as of yet. I am trying to find ways to help this child learn to interact with others and to find ways to calm him down before he reaches the point of self harm.",
    "doctor_response": "Hi,I can advise some methods to control your aggressive behaviour...it is advisable to take lithium to control that behaviorI would advise you to discuss with your doctor regarding this",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "If the child has ventricular septal abnormality what is the surgery called?\n\nhi i am doing a project on vater syndrome would you be able to answer a few questions i have about the syndrome 1. i was wondering what type of ostomy would be used for a child diagnosed with no anus 2. what is a supra-public drains 3. if the child has ventricular septal abnormality what is the surgary called.",
    "doctor_response": "U have to go for ano/recto plasty for anal atresia.suprapubic drains are kept in initial post operative period for favour of drainage . for VSD we have to do patch closure of the defect.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for lower back pain?\n\nHi, I have been having some pain in my lower left side of my back. The pain has moved to the inside of my left leg and from my groin down to my knee and sometimes to my foot, I am feeling sharp pulling type pains. I am really concerned. What could this be?I am 39 and am 6-2 245",
    "doctor_response": "Hi,Welcome to healthcare magic. After going through your query I think your You are suffering from  lumbar disc prolapse with sciatic radiation. Treatment is rest in position of relief(generally lateral position with both knee bend),NUROKIND GOLD ONCE DAILY and analgesics (Diclofenac three times a day after meals is effective).It can be confirmed by MRI lumbosacral spine. I think your query answered.Welcome to any follow up query",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for severe back pain and constipation?\n\nHi, so....at around 10 AM today (eight hours ago), I noticed this pain in my lower back, on the left side, sort of above my hip a little, I don't know how to locate it more precisely. Around that time, I also kind of felt this feeling like there was something in my penis, as when I am desperately holding back urine, trying not to pee, But when I tried to pee, only little dribbles would come out. I sort of assumed that this was some kind of constipation problem, because I was trying to move my bowels too, without that much success, even though I had eaten a fair amount yesterday. But it didn't quite feel like constipation. As these last eight hours progressed, the pain in my lower back became increasingly intense (although it went away at times, particularly when  I was lying on my back or on my left side, or when I had walked around a little). At some point I got the idea that it was a kidney stone, so I started drinking water. I also took ibuprofen, and, about, two hours ago, Nyquil (I was thinking it might knock me out and make me sleep through this whole terrifying ordeal). I was trying to use the bathroom every five or ten minutes, but nothing was happening, other than some dribbles, and a few little bits of fecal matter, and some farting...but nothing really substantial. About an hour ago, I noticed that the pain had substantially decreased. I went to pee and a good healthy stream came out. My questions are as follows: i) how likely was it that what I had / have was a kidney stone?; ii) what should I do in terms of following up on this?; iii) how likely is it -- given that I still feel a kind of dull ache in that place in my back (but much less, and of a different kind, than before) -- that I am at least temporarily done with this ailment, whatever it was?",
    "doctor_response": "Hey..I'm pretty much sure that this isn't a case of kidney stone. But is surely a case of constipation....due to the increased abdominal pressure required to pass stools you get lower back ache. I advise you to take a laxative and consume high fibre food. Laxative to be taken- Macrogol granules --2 teaspoon in a glass of water at night. For lower back ache --Zerodol P tablet twice a day after food for 5  days and tablet Esogard twice a day before food for 5 days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and swelling on upper lips?\n\nMy 16 year old daughter noticed one of her front teeth felt a little loose about 12 days ago...we made a regular appointment for a check up next Thursday. This morning her upper lip was swollen and she has pain up to her nose above that tooth...no swollen gums? Should we just wait or call Monday morning or get her to a outpatient care facility?",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.In your query , you have not mentioned whether there is decay in the front tooth or is there any history of trauma in that area . Based on the description provided , it can be suggested that is a abscess formed in relation to the front tooth which may cause a slight mobility of the tooth.I would suggest you to give her apain killer like ibuprofen (if she is not allergic to any medicine), and take her to the outpatient facility and get it reveiwed .She will need a course of antibiotic on prescription and then the dentist can do the needful treatment . A radiograph will be needed in her case.Do warm saline gargling and do not apply hot bag externally.Hope this was useful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent rashes with dry skin?\n\nMy baby developed a rash on his cheeks at 4months. He has been given topical treatment since and it has not improved. It went away for a week when we went to a place with a more humid temperature then came back to the dry weather and it got came back and was even infected. Took antibiotics which cleared it up but after the 10th day of antibiotics is returned. Starts off as rosy cheeks, becomes red bumps, dry skin, cracks, yellow crust...just a few of the symptoms. Rash is nowhere else on the body. Could it be more than eczema?",
    "doctor_response": "Hello,Your kid concern may be atopic dermatitis by your description. It is a type of eczema. Start using good oat meal containing moistuirser thrice daily and use only baby soap for body wash.Also, use hydrocorticosone cream on affected areas. Meanwhile, report this to a dermatologist nearby you for physical examination. This will help her.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sandeep Golla",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I consult a Neurologist for the bulging discs of L1 and L5?\n\nI went to the ER this yesterday. I was diagnosed as having 3 bulging discs between L1 and L5. I was told to follow up with an Ortho doctor, but friends in the medical field suggest I see a neurologist. What is your opinion? Also, is that something that requires surgery?",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. Yes, please visit a neurologist, but first thing is what are your symptoms that you had not mentioned in the question because some bulging is normal as per ageing due to our day to day lifestyle. You require a life style modification and ergonomics advice on how to sit, stand, sleep,  and use mobiles and laptop. Kindly do contact us again with your symptoms in detail. And if you are experiencing leg pain, weakness, loss of strength then these are red flags signs for  you to visit a neurologist immediately.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Harsh Swarup",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My lax les is 38 cm with inflamed gastric folds and severe antral gastritis. What does it indicate?\n\nHello doctor, My lax les is 38 cm with inflamed gastric folds and severe antral gastritis. Presence of diverticulum and ulcer near the pyloric ring. I have constant nausea, bloating, and throat tightness.",
    "doctor_response": "Hello. Gastritis is an inflammation of stomach mucosa. It happens due to Helicobacter pylori a bacterial infection, smoking, alcohol and also certain medicines like Aspirin. Presence of diverticulum also causes gastritis. You are taking good medicines to your concern, continue them. You can add Panchsakar Churna 3 gm twice a day with warm water after meals and Arogyavardhini Vati 1tab twice a day after meals. Avoid spicy and fried junk foods, quit smoking and drinking if you have these habits. There may be need of surgical removal of diverticulum.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be done to get rid of anxiety & stress feeling?\n\nI am 17 and suffer from anxiety & stress and I have been prescribed 20mg of propranolol a day, ive been taking them for about a week, I still feel anxious around people even my friends, I start to feel dizzy & sick around people, what do you think I should do?",
    "doctor_response": "HIThanks for using healthcare magicIf you have continuous anxiety, in that case only propranolol would not help you. You need a antidepressant that would help to control the underline anxiety. You should consult a psychiatrist for it. You can also take low dose benzodiazepine on sos basis and can also do relaxation exercise.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Amtas advisable for high blood pressure?\n\nmy mother in law is suffering from high blood pressure which shoots up to 200/120 some times and she also had stroke due to this in last 8 years. somebody has suggested her to take Amtas* for controlling it. I was wondering whether it is a right option or it has some side effects presently she is taking Olmesartan H 40 mg",
    "doctor_response": "Olmisaetan and thiazide drugs (which is u r taking right now) are dieat choice of drugs for hypertension in patient with stroke. Amlodipine (Amtas) is second choice, which can be added if not controlled with olmisartan.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on right side of neck near jaw bone?\n\nHi I'm a 24 year old female and about a week ago I noticed a lump on the right side of my neck near my jaw bone it does not hurt just kinda bothersome my mom says it could be my thyroid because my hands and feet sweat alot and I'm tired more than often lately?? Just not sure if its an emergency or if it can wait cuz I have no insurance?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some enlarged lymphnode or thyroid enlargement. Lymphnode enlargement can be due to reactive hyperplasia, tuberculosis or lymphoma. Thyroid swelling can be due to colloid goiter or other cause. You should go for ultrasound study of neck.  Then if needed go for fine needle aspiration cytology of that lump.  It will give you exact diagnosis. Then you should take treatment accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tips for pain in spine and neck\n\nhii...m havin pain in my spinal frm neck to down spical cord.....neither m able to lying on bed properly nor able to sit nd stand.....m havin pain in my left shoulder nd headache continously from last 2 mnth......so wat shuld i do...culd u plzz zhelp me",
    "doctor_response": "Hello, Those symptoms suggest degenerative spine disease (spondylosis, etc.). In cases like yours, clinical evaluation by a spine Specialist and tests such as x-rays, MRI of the spine, and blood tests for inflammation levels, are necessary to achieve a correct diagnosis. Only after a correct diagnosis, the treatment possibilities are clear. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for boils in gums & tooth with headache\n\nI am a 24 year old female, 5 10 , 175 lb. I have a good medical history. I just had a baby 6 weeks ago. My problem is a boil on my gums. It is right below my wisdom tooth, with is only partially out of the gums. The whole left side of my face is swollen and is warm. I also have a headache. It hurts extremely bad, and I don t know if I will be able to get an appointment at the local dentists office tomorrow. What should I do in the mean time?",
    "doctor_response": "Thanks for your query, i have gone through your query. The boil on the gums could be a pericoronal abscess leading to cellulitis(pus formation). In this condition you might get pain, swelling and limited mouth opening. consult a oral physician and get a radiograph done to rule out the infection and amount of space available for the tooth to erupt. if no space is available then get the tooth removed. you can take a course of antibiotics like amoxicillin and analgesics. do saline gargling. i hope my answer will help you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes loss of appetite with nausea?\n\nim 36 wks pregnant im currently 3cm dialated i started having this real thick mucusy string like disharge comming out for 2 days now im having braxton hicks contractions all day with stomach tightness and now i have no appetite and i feel real nasauted is this normal",
    "doctor_response": "Hi,If you have passed a mucus plug and feel that intensity of contractions are increasing then it means that you going into labour, which is why you are getting all these symptoms.You should watch for watery discharge or bloody discharge as it could indicate that your membranes have ruptured and you have gone into labour, when you will need to go to your midwife /hospital immediately.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart pounding and belching?\n\nI ve been having lots of heart pounding, just sorta out of it feeling. Not pain, just pressure, comes an goes. I constantly feel jittery. Massive amounts of air belching up.. Some cold sensations, a hot flush feeling going through my body... It s all pretty much got me on edge...",
    "doctor_response": "Hi welcome to HCM.I understand your query and concern.Heart issues usually stem from anxiety related panic attacks.In all such cases its always safe to have organic heart lesions ruled out.I advise you to have a baseline 2 dimensional echocardiography,ECG and lipid profile to assess the basic cardiac reserve of your heart.Restrict the intake of salt to less than 6g/day.Regular physical exercise in the form of brisk walk for 20 min is helpful.Drugs like antihypertensives like atenlol and anxiolytics like alprazolam will help.Reduce the intake of fatty and fried food.Drink plenty of water to maintain adequate hydration like 3-4 liters of water a day. One pomegranate a day will help to keep your heart at good pace without clot formation.Stress management is extremely vital in your case. Practice yoga and meditation regularly.Consult a Cardiologist for further expert management.Post your further queries if any.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Procedure for artery blockage in old age?\n\nwhat procedure is recommended for a 79 year old patient with 75% blockage in Right carotid artery and 95% blockage in left carotid artery who also has congestive heart failure and irregular heartbeat? Yesterday during procedure it was discovered a stint was impossible to place because patient has a bovine arc in his heart area",
    "doctor_response": "Hello! Thank you for asking on HCM! Facing the actual clinical situation, a surgical carotid endarterectomy procedure would be the most appropriate choice. A  comprehensive preoperative evaluation should be performed (including cardiology consult, anesthesiology consult and vascular surgeon consult), to conclude about the potential risks and benefits derived by the proposed strategy.Hope to have been helpful to you. Greetings! Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is hepititis b deficiency dangerous?\n\nI am 26y old. In 2008, I terminated my Pregnancy at that time doctor told.I am with Hep B deficiency. Is that dangerous. What problems do we face because of that.And I have a Lower Back to left Foot pain through Hip. When I do work out My leg feels heavy.",
    "doctor_response": "Hi,How are you? I am sure your doctor meant your \"Hb\" is low meaning your \"hemoglobin\" is low. thisessentially means you have anaemia which is very easily treated with nutritional supplements. Being defecient in \"Hep B\" is definitely good as this means you do not have hepatitis B infection. I would advise you to get vaccinated with hepatitis B vaccine to protect yourself against future risk of acquiring hepatitis B infection.Hoipe this helped and have a great day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How will duphaston help in conception?\n\nHi Dr. My gynec asked me to take duphaston 10mg for 10 days from 7th aug to 16th aug.I am trying for my sec baby.I have pcos.My gynec said i lost 3 kg last time which means my cycst is going.I am getting 10 days delay in my periods from past 3 months.Because of this event dont know my ovulation time.Kindly let me know on this as well as how duphaston will support me for carrying. Thanks, Gmklmla",
    "doctor_response": "Hi,I understand your concern. Duphaston contain progesterone and it will help to become pregnant. It cause correction of hormonal imbalance, regularize period, make uterine environment favorable for implantation and support pregnancy. You can take Dupatson under advise of gynecologist and monitoring was done by USG scan and ovarian follicle study. You can also use birth control pill to regularize period. Once period become regular then drugs like Metformin, Cloniphene Citrate and HCG injection will help you to become pregnant.Hope this may help you. Contact further if follow up needed.Best regards,Dr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does unsuccessful IUIs suggest blocked tubes?\n\nMy husband was diagnosed with oligoasthenozoospermia and after 2 years of medication his sperm count and motility improved. Then we had IUI 3 times; his count was good for IUI and my follicles were also of good size at the time of IUI then what could be the possible reason that all 3 IUIs couldn t succeed? My dr didn t do any test to know ovulation time and did the IUIs without knowing it so could that be a reason of unsuccessful IUI as I had read on Internet that ovulation time is very important. Is it possible that my tubes are blocked?",
    "doctor_response": "it is quite possible your tubes could be blocked,also cheque your tsh level prolactin level ,and FSH and lh levels",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fainting spells and blurred vision?\n\nWhen standing for a long period of time I start to feel sluggish, get blur vision, get really hot inside my body,and I begin to get the fainting feeling. When I get like this I check my blood pressure and also my blood sugar and there levels are normal. What could it be if it is not my diabetes or blood pressure.....",
    "doctor_response": "Hello!Thank you for asking on HCM!Your symptoms seem to be caused by orthostatic hypotension. For this reason, I would recommend you to perform a Head Up tilt test coupled with some other blood lab tests: - complete blood count for anemia- thyroid hormone levels for thyroid dysfunction- blood electrolytes. Meanwhile, I recommend avoiding prolonged standing up position and take plenty of fluids. Hope to have been helpful!Wishing all the best, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have back, hip and leg pain. Hard to walk. Reason?\n\nHi. I have been having back problems now going on for the past two years. My back has been bad since November. I am doing physio with traction. I get a lot of pain now in my lower leg especially at night which keep me awake. Along with that I get pain on my right side in the hip area when I roll over and find it hard to walk when I get out of bed. What could be causing all this pain?",
    "doctor_response": "Hello. Thanks for writing to us. Since the pain is radiating to the leg , it s likely to be due to a disc herniation at the level of spine which is causing a compression of the nerve roots. It is best to get an MRI scan done for a proper diagnosis and further treatment. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Echogenic cortical nodule in the kidney. Is this angiomyolipoma which is stable. Should I be concerned about this?\n\nHello. I have just found out that I have a echogenic cortical nodule in the upper pole of the right kidney measuring 5 mm. They said, this may be angiomyolipoma and appears stable compared with September 2006. The remainder of the exam includin the liver, spleen , pancreas , gallbladder, left kidney, aorta and upper pelvis are remarkable. Stable angiomyolipoma in the upper pole of the right kidney. No significant findings elsewhere. What does all this mean?",
    "doctor_response": "Hi Thanks for your query Angiomyolipoma is often a benign tumour of the kidneys. If the size is only 5mm and there are no symptoms such as bleeding it can be left alone. However you need to repeat US every 1-2 years to monitor the size. Also it would be advisable to see a urologist Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high fever\n\nHi, may I answer your health queries right now ? Please type your query here...My 7 year old has a fever of 104.2. I gave him motrin 1/2 hour ago and will check the temp again in a few minutes. He started 2 nights ago with a fever around 102. He threw up that night. Yesterday he had 102 in morning and motrin took it down. Yesterday afternoon it was 102.2 and climbed to 102.9. After piggy backing motrin and tylenol, it went down to around 99 before he went to bed. He had 102 this morning. Overall, he s been lethargic, coughing a bit, but nothing too alarming about his behavior. His hands are cold and he says the light bothers his eyes. I know high fevers can be dangerous. Should I bring him to a walk in clinic? Or should I see if the motrin pulls it down and monitor him?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.If the child is having fever, vomiting, conjunctivitis and is lethargic for 3 days, and not relieved by paracetamol then you need to consult a pediatrician. Your doctor may ask for blood investigation and may add some antibiotics, antiemetics, etc., depending upon the investigation reports.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Khan Shoeb Mohammad Sher Mohammad",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it to be concerned about the mass near the heart?\n\nthere is a 1.3cm x 1.2cm low density nodule in the anterior mediastinum.the differential diagnosis include lymph ,small thymoma,or lesion.i have papillary carcinoma thyroid cancer with multiple tumors ranging at 1.3cm.i am having 1-131 cancer treatment done on jan,27,2012.i've had surgery done in 2010 of may,to remove my thyroid glands with a positive margin.i am concern about this mass near my heart.my name is marco camareno a cancer patient,a son,brother,husband,grandfather,friend but most of all a father with hope.i am only 36yrs old.",
    "doctor_response": "Hello!Thank you for the query.As you have a cancer history, such lump should be considered as a cancer recurrence. No doubt in that. And you should not wait with it. Please consult your oncologist or thoracic surgeon as soon as possible. The lump should be removed and tested for possible cancer.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pain in belly button and off to the right side of body and back indication of kidney stones?\n\nHi there my gp believes I may have kidney stones and is awaiting a ultra sound to confirm this over the last 4 to five days I have had pain around my belly button and off to the right side of my body and around to the middle of my back am I mistaking this pain for a possible appendicitis or are this more likely the kidney stone thing the pain in my lower front is like the feeling of having a bug and needing to pass a bowel motion.If this is kidney stones I long can I expect this discomfort/pain in my front/side/back to last",
    "doctor_response": "Hi ,  Kidney stone has symptom of pain which may be sharp / dull aching type at lumbar region on same side which may / maynot radiate to groin thigh testicle/ labia umbilicus mostly during early morning but may have any time associated with nausea vomiting. Someone there are no pain abdomen .  Pain of appendicitis occurs at rt iliac fossa or Mc burnis point or umbilicus may be gross of dull aching /cramping type mild to severe in intensity associated with nausea vomiting .    Pain abdomen needs to be examined clinically and accordingly investigated including  USG , X-Ray and later CT scan of whole abdomen.   So in my opinion wait for USG report and till then take plenty of fluids  , analgesic (NSAID), anti spasmodic , PPI (as your gp must hav prescribed ).Hope this ll help Thanks n regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Eumosone cream be used to treat eczema in a 3 month old baby?\n\nMy 3 month old daughter has eczema on her chest and below her chin. I have been using cetaphil lotion. Dr has prescribed eumosone cream to be used sparingly for 2 days by mixing with cetaphil lotion. Hope it will not cause harm as eumosone is a steroid. Have read some articles that usage of eumosone can cause side effects in babies like growth defects etc. Is it fine if I apply it sparingly with cetaphil so that the redness (eczema) would be reduced. Kindly advise. Thanks and Regards, ssg",
    "doctor_response": "HiThanks for writing to healthcare magic.Yes eumosome is steroid.But is used sparingly as per doctors advice it is safeEczema needs steroid ointments but supervisedUse plenty of cetaphilWishing your child speedy recoveryRegardsDr Arun",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does it take for pregnancy symptoms to begin?\n\nI am 16 years old and I'm afraid I might be pregnant. The last time I've had intercourse was two weeks ago and I can't wait until my next period because I only get my period every three months. I am not able to go to a free clinic. How long does it take for me to notice if I am pregnant or not?",
    "doctor_response": "Hi welcome to the health care magic You had history of unprotected sexual intercourse.... So pregnancy should be ruled out here... After three week of last LMP you can detect pregnancy by blood hcg estimation...  It is somewhat costly If you can wait then after five week of last LMP pregnancy can be detected by urine hcg card test which is not costly Choose any one of the above method. If urgent detection needed then serum hcg estimation done If hcg positive then for further confirmation USG can be done Take care Hope your concern solved Consult gynecologist for examination for your irregular delayed period",
    "dialogue_context": ""
  },
  {
    "patient_message": "CPK levels high and fluctuating. Started exhaustive hydration plan. Can he wrestle?\n\nmy son is a wrestler and cuts approximately 6-10 lbs every week to make weight. He was recently seen by a Dr. and blood tests were taken. his cpk levels were 777 about a week ago and then dropped to 277 with a weeks rest and back up to 300 after a couple of days rest, and then spiked to 1261 after going back to full strength wrestling and cutting weight. He feels fine, and shows no signs of any weakness. We have shut him down from wrestling completely and started an exhaustive hydration plan. What are the chances of him getting back into wrestling within the next 8-10 days",
    "doctor_response": "thank you. rapid weight loss is not feasible. regular physical exercise & control of diet is the mainstay of reduction of weight. CPK level may be raised due to vigorous physical exercise & it become normal after taking rest. so it is better for your son to reduce the weight gradually, not rapidly. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the low blood pressure in a brain cancer person a matter of concern?\n\na friend of has brain cancer. he had an mri with contrast on tuesday and i believe it has an allergic reaction. he has taken morphine and xanax. he has been totally out of it all night. his blood pressure is 92/55 and 92/61. i am not sure if that is too low and i should take him to the hospital. can you advise",
    "doctor_response": "Thanks for your question on HCM.Brain tumour are very notorious in presentation and also in response to treatment. They can rapidly grow in brain and compress the surrounding structures. They akso cause edema in the brain and cause high intracranial pressure (ICP) . Due to this blood supply of brain is hampered and patient looses consciousness and talks irrelevant. So your friend may had all above consequences. So immediately take him to the hospital.  He needs urgent MRI to rule out brain edema and compression. He may need operation too, to decrease iCP.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with fibromyalgia\n\nHello!I've been recently diagnosed with Fibromyalgia by a rheumatoid arthritis specialist. I recently retired and have been involved in physical fitness all my life. I am having a hard time accepting this diagnosis but have taken it upon myself to talk to a cognitive therapist, been to a chiropractor many times and have become an active yoga enthusiast. I don't enjoy the thought of trying various pain medications for fear of their side effects. I understand there is a blood test called FM/a which identifies markers produced by immune system blood cells with in people with fibro. Is this worth pursuing? My symptoms include pain in both upper thighs (t-bands), chronic stiffness in the neck and shoulder areas. Could this be related to some other underlying condition that hasn't been checked? I am having difficulty with this diagnosis since I have been quite active all my life (60 now).With Thanks",
    "doctor_response": "**1. Since diagnosis is made by a specialist, event then consider second opinion for available options and conservative management.PS. immune marker will help establish prognosis and available options of the disease, thus is worth pursuing.2. because there is no identifiable cause thus treatment is symptomatic, as a result both pharmacological and non pharmacological measures are used as adjuvant to get a good control of pain and extended symptom free period, such as:. Relaxation and stress management [stress is trigger response to fibromyalgia symptoms], thus yoga & Pranayama are helpful. Physiotherapy: wax massage, ultrasound/infra red technique to minimize pain.. Diet rich in omega 3 is considered helpful in alleviating fibromyalgia symptoms.. In Ayurveda we consider/manage the disease under 'Mans-Medo Gat Vaat', thus prescription medicines available are: chandraprabha vati, navak guggulu, trifla kwath,panchskar churan, navkarshik guggulu.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which of the two Lumnaskin and Meladerm is effective in getting rid of acne scars ?\n\nI m 15 years old and I have acne scars on my chest , back and the back of my arms. I m trying to find a skin product that can help lighten them and eventually get rid of them. I ve found two potential products: Lumnaskin and Meladerm.. I m just wondering which one is better and safer to use.",
    "doctor_response": "Both are similar creams They do not have steroids or hydroquinone. It makes them cosmeceuticals. May not be as effective as proper medical grade creams, but nevertheless they can be tried without the risk of any side effects as such. Use either of them for 3 months and see how the results are. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dry mouth after taking Duphaston?\n\nHi Doctor, I am 29 years old, I am trying to get pregnant and have a PCOS. I took some hormonal injections in order to increase my ova to become to normal size. I got only one within normal range is 18 and my doctor gave me HCG injection.Since 10 days and till now I have been taking taking duphaston. Yesterday and today I started feeling dryness in my mouth. Please can you tell me what this means? Am I pregnant or sick? Can you help please. Many thanks",
    "doctor_response": "Hallow Dear, So long as you are taking Duphaston pills, you will not get menses as these are progesterone pills. If it is 10 days after the last unprotected intercourse after the injection of hCG; please get Beta hCG test done. Values above 25 mIU/ml are diagnostic of pregnancy. Your follicle size of 18 mm was an ideal size for healthy egg. So pregnancy possibility is very high. If the test indicates that you are pregnant, you may continue Duphaston further with the advice of your Gynaecologist. In non-pregnant state, the levels are under 5 mIU/ml.  If the levels indicate that you are not pregnant, you may discontinue Duphaston and you will get withdrawal bleeding within 4-7 days. Do not go on the symptoms like dry mouth. Morning sickness starts appearing about a week after the missed period. I hope this resolves your dilemma. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for pain and tightness in the chest\n\nHi,I had done a surgery 3 weeks ago to remove left lobe thyroid because of nodules,I'm waiting for a biopsy result,on CT scan shows mild biapical pleural thickening/small bullous changes/moderate diffuse emphysematous/mild proximal bronchiectatic changes and I'm suffering from chest pain and tightness,and to much mucus can explain for me what can be those problems ,thanks",
    "doctor_response": "Hello,Your all symptoms are due to bronchitis and bronchiectasis. So better to consult a pulmonologist, and get done a clinical examination of the respiratory system and PFT (Pulmonary Function Test). PFT will not only diagnose bronchitis, but it will also tell you about the severity of the disease and treatment is based on severity only. You will mostly improve with inhaled bronchodilators (formoterol or salmeterol), an inhaled corticosteroid (ICS) (budesonide or fluticasone). Oral N acetylcysteine (NAC) is also beneficial. Don't worry, you will be alright with all these.  Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Kaushal Bhavsar",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of masturbation?\n\nHello,I have two question about masturbation:Q1- Is this bad : Sometimes I don't want to make a mess and take a shower either because im busy or I already took a shower so I start masturbating until my penis gets hard then I stop, I keep doing this then I stop.P.S. I stop masturbating when my penis is hard not when im about to ejaculate.Q2- Is this bad? I do it once a week:I start masturbating and when I feel that ejaculation is pretty close I stop. I keep doing this until I think that its time to ejaculate and I ejaculate.Are these two thing bad? Thanks,",
    "doctor_response": "HiThank you for asking HCMI have gone through your query.Too much masterbation is not good.Stimulating to the higher extent and stopping can have impact psycologically.It can gives you depression.You can deviate your mind to something else.Involving in games or exercises like jogging swimming etc gives you control over that.When your body is not using energy you will feel like masterbating more.Hope this may help you.Let me know if you have any further query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for paroxysmal nocturnal dyspnea while being treated for idiopathic pulmonary fibrosis\n\nYYYY@YYYY My husband has been diagnosed with IPF and is currently suffering through coughing attacks that he believes are related to PND. He has tried the over the counter allergy meds on advice from his pulmonary doctors but nothing seems to help. He has finally agreed to see a physician but I am not sure whether to schedule with an allergist or an EENT. He recently has suffered from dizzy spells and/or blurred vision that lasts only a few minutes when he turns his head and then turns back quickly which I thought could be related to his inner ear. He does not complain of pressure in his ears or sinuses. Do you have any suggestions about the medication for PND or to help his coughing subside? He constantly uses cough suppressants. Thank you for any advice you have.",
    "doctor_response": "Hello, As you explain the situation he should see a pulmonologist specialist at least and then he or she will decide if it is from PND and what to do further. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jnikolla, Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the uses of lupride injections in ivf?\n\nI am a 36 year old woman ( weight 72kg 147cm tall) undergoing ivf treatment using my own eggs and husbands sperms. I was asked to get 0.5mg of lupride injections for 23 days starting from day 17 of my yesmine( birth control pill) tabs.What I want to know is for what purpose lupride injections used for ?",
    "doctor_response": "Hi,Lupride is an injectable fertility drug that belongs to group of GnRH agonists.These drugs on administration prevent premature ovulation during the ovarian stimulation process.By using this drug,we can control when ovulation should occur, so that we can use drugs to mature eggs and thereafter mature, healthy eggs can release from ovary. It is like a controlled fertility where we can decide when ovulation can occur.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Saranya Ramadoss, General and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having pain on the right side of the abdomen area\n\nhello my right side hurts bad its not abdomen area its up more and it hurts so much more to lay down or take deep breaths but its the third day I've had it and this time the pain kept me awake i don't have insurance until next week btu i want to go now it hurts.",
    "doctor_response": "Hi ! Good monring. I am Dr Shaeef answering your query. A pain of the intensity you have described on the right side upper abdomen and under the ribs could be due some pathological process in the hepatobiliary system.If I were your doctor,after a clinical examination I would advise you for an ultrasound of abdomen to rule out a gallstone cholecystitis, or an inflammation in the liver. Further management would depend on the clinical findings, and reports of the investigations.As your pain is high in intensity, I would suggest you to go the ER of the nearest hospital to get assessed and proper immediate management of your pain. Any elective procedure could be done after you get through your insurance papers and depends on your doctor's advice as well.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do the blood test findings for Hydronephrosis indicate?\n\nDate 07/07/2011 Patient Id 0000 Emp. No. Report Date 07/07/2011 17:16 Name Mst. MALAY NEGI Age 8 Yrs Sex Ref. By Dr. C G H S Company CGHS CASH Test Name Value Unit Biological Ref Interval HAEMATOLOGY HAEMOGLOBIN (Hb) 11.8 g/dL 11.0 15.5 TOTAL LEUCOCYTE COUNT 6800 /cumm 5000 13000 DIFFERENTIAL LEUCOCYTE COUNT NEUTROPHIL 62 * % 40 60 LYMPHOCYTE 37 % 25 45 EOSINOPHIL 01 % 01 06 PERIPHERAL BLOOD PICTURE RED blood cells exhibit mild anisopoikilocytosis with occasional leptocytes & microcytes in picture. Hypochromasia observed with occasional pencil shaped cells. No codocytes or basophilic stippling seen. WHITE blood cells show no significant abnormality PLATELETS are adequate NO immature cells or hemoparasite seen. COMMENTS : MICROCYTIC HYPOCHROMIC ANEMIA . BIOCHEMISTRY SERUM UREA 105 * mg/dl 0 50 Tech:Urease/Cobas311 SERUM CREATININE 3.4 * mg/dl Tech: Jaffe/Cobas311 SERUM SODIUM 130 * mmol/L Tech:DISE/Vitros SERUM POTASSIUM 3.8 mmol/L Tech:DISE/Vitros SERUM CALCIUM 9.6 mg/dl Tech:OCPC/Cobas311 SERUM INORGANIC PHOSPHORUS 5.5 * mg/dl Tech:Molydate/Cobas311 SERUM ALBUMIN 3.5 * gm/dl Tech:BCG/Cobas 311 Sample Booking Time 13:10:29 TEST REPORT 07/07/2011 17:16 Name Mst. MALAY NEGI Age 8 Yrs Sex CLINICAL PATHOLOGY URINALYSIS URE PHYSICAL EXAMINATION COLOUR WATERY CLEAR VOLUME 35 mL URE CHEMICAL EXAMINATION SPECIFIC GRAVITY 1010 PH 6.0 NITRITE NEGATIVE PROTEIN ++ GLUCOSE NEGATIVE KETONE NEGATIVE UROBILINOGEN NEGATIVE BILIRUBIN NEGATIVE URE MICROSCOPY EXAMINATION PUS CELLS NIL /HPF EPITHELIAL CELLS NIL /HPF RBC's NIL /HPF CASTS NIL CRYSTALS NIL OTHERS NIL My child is suffering from Hydronephrosis since last year and his left kidney functioning 72% and right kidney 22 % by DMSA scan on August 2010 report.",
    "doctor_response": "hello, I have seen your child reports. the CBC is almost normal. Kidney function test suggestive of deranged kidney function and urine report suggestive of protein loss. as you already told about DMSA scan function that was low.these all report suggest kidney disease. in this age, you have to investigate for etiology. Do ANA, HbsAg, HCV, HIV. After then C3 level. then go for kidney biopsy. Once cause is found then treat according to that. meanwhile you have to watch for Urine output, Oral intake, swelling of body, serum potassium level and increasing pattern of urea and creatinine. if any thing go wrong and patient became breathless or swelled then go for dialysis.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for Transient Ischemic Attack?\n\nHello Dr. Taraknath My father is your patient. He recently visited you. He had previous TIA. He has been on clopidogrel and aspirin combination for the past 5 years. according to match trial iam giving the reference below this combination does not offer any benefit for secondary prevention of stroke and is associated with increased risk of bleeding. Can you please take a second look at his medication. Thank youLancet. 2004 Jul 24-30;364(9431):331-7. Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomised, double-blind, placebo-controlled trial. Diener HC, Bogousslavsky J, Brass LM, Cimminiello C, Csiba L, Kaste M, Leys D, Matias-Guiu J, Rupprecht HJ; MATCH investigators. SourceDepartment of Neurology, University of Essen, Hufelandstrasse 55, 45122 Essen, Germany. YYYY@YYYY",
    "doctor_response": "put him on Aspirin 150 mg alone along with Statin in low dose...like Atorvastatin 20 mg or Rosuvastatin 10 mg",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it to be concerned about breathlessness and dizziness?\n\n: I am a 33 yr old female...I have been having symptoms for months now including shortness of breath tachycardia episodes constant dizziness fainting nausea swollen lymph nodes nausea headaches and severe pain in my neck jaw and head only on the right side...these are made worse by smoking and eating...I have had my heart checked thuroughly by a cardiologist and it seems perfectly fine...my symptoms are not getting any better and now I am having insomnia nightsweats slurred speech and blurry vision...my bloodwork is normal and I have also been tested for hiv and mono both were negative...please help me I need answers I have no health insurance and am tired of making trips to the er to have them find nothing...what could this be ?????",
    "doctor_response": "If you have an pathological swollen lymph nodes then if a biopsy or fnac of them is done may give the diagnosis in your case. otherwise the rest of the symptoms can be just due to anxiety or stress even.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could i be pregnant if i had my period after intercourse ?\n\nhi .. i had unprotected sex today morn and my periods started in the evening ... r there any chances of me getting pregnant? do i need to take an ipill to avoid prenancy",
    "doctor_response": "If her periods are regular then there is almost nil chance of pregnancy.I suggest you use a more long term method of contraception.You have a variety of choices.See your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diabetic after kidney transplantation. Is fistula flap or plug safer?\n\nMy husband is a kidney transplant patient. Three years with the kidney and doing great. He is also diabetic taking 4 shots a day. He needs to decide between a fistula flap or plug. I have been reading about both and frankly they both scare me and there is no reason that the abcess will not come back. It is so hard to make a decision when the doctor is handing you a pen saying decide and sign. We need more information. He does not want to add incontinence to all his other issues.",
    "doctor_response": "hi you have lost one major organ d/t diabetes drug .you know bettr from me.i want to say to u that u could take help of homeopathy in other problem with your treatment. dr neeraj",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of Parkinson's disease?\n\nHi my husband has browny/ beige watery fluid on his pillow in the mornings about two or three times a month. It seems to be increasing in volume lately and last night was about a tablespoon ful. He was diagnosed with Parkinson's nearly four years ago.",
    "doctor_response": "Hi,Thank you for posting your query.The main symptoms of Parkinson's disease are motor: slowness of all movements, rigidity of arms and legs and tremors of hands and feet.Later on they may have falls and balancing issues.Some people with PD do have increased salivation, which could result in secretions on the pillow.Medications such as glycopyrolate and botox injections can help reduce the excess salivation.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the top of my head\n\nI have a pain on the top of my head, the pain will last for days and then it will go away. My head don t hurt, that area is tender in the top of my head. My main doctor suggested that I go to a Dermatologist, I am thinking that I need to go to a Neurologist first.",
    "doctor_response": "hello take  belladona 200 two doses ..its a homeoapthic medicine.. if the problem still persist .. consult a homeopath god bless",
    "dialogue_context": ""
  },
  {
    "patient_message": "How soon should a cancerous tissue on the nose be removed?\n\nI had a biopsy said it was positve, remove said size of half pea gravel, what is the next thing to do? The dr said go back in and cleand the tissues around the removed spot and check my mynose, do i need to all this now or wait to see if it comes back?",
    "doctor_response": "Hello,Any cancerous tissue must be excised immediately without delay, to save other body parts from involvement.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is large size of heart causing breathlessness and pain in chest?\n\nHi, I was born with a larger heart then normal. Now i tend to be out of breath quick and simple things make me lose my breath and it feels like my heart is beating a million times per minute. I also tend to get anxiety attacks a lot. I also at times get a very sharp pain on the left side of my chest. Is this something I should be worried about???",
    "doctor_response": "hi thereas per the details you have given yes buddy you have an heart issue and you Need to be on a regular follow up with your cardiologist. I wish you good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rib pain while taking deep breath?\n\ni woke up with rib pain when i take a deep breath it feels like they are being restricted i figured it was that i slept wrong and that it would go away but it has hurt all day, i have been experiencing what i think are muscle spasms in my rib cage and when i rub there muscles in certain places it causes it as well as it being random, they are sometimes often, sometimes i have to problem at all, i dont have broken ribs or any reason not to and i do not smoke cigarettes, it hurts to hiccup, to couch to take deep breaths.",
    "doctor_response": "Thanks for your question on HCM. By your history and description of pain, I think it is musculoskeletal pain only, mostly due to uncomfortable movement or posture. So try to follow these steps for better symptomatic relief in muscular pain. 1. Avoid heavy weight lifting and strenuous exercise. 2. Avoid bad postures in sleep. 3. Avoid movement s causing pain. 4. Take good painkiller and muscle relaxant. 5. Apply warm water pad on affected site. 6. Wear chest belt to avoid mobilisation of affected area. If not improving in 5 days than get done chest x ray to rule out internal damage.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for rashes in waist,top of leg and stomach from reaction to medicine\n\njust finished 2nd day of 6 day dose (4-4-3-3-2-1) prescribed for my swollen eyes (lids and under eyes) after gardening and trimming shrubs.  Started today with rash along waist and top of one leg and some of stomach. I've read that it can cause rashes.  Just wondering what you might suggest.... I was going to call pharmacist and dr tomorrow.  Thanks!",
    "doctor_response": "It was a short course of steroid given to you for suspected allergy. Add an anti-allergic like levocetrizine to get optimum response. If it does not subside ,consult a skin specialist for possible infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can fibroid cyst increase in size?\n\nMy husband has a hugh red spot on his left side of his lower torso about six to seven inches round with about a two inch purple spot in the middle.  He also has several lumps on his torso that the doctors have said are fybriod cysts.  We believe on has burst.  Can it get that big?",
    "doctor_response": "hi.yes, fibroid cyst can increase in size. some cysts can resolve spontaneously, some decrease in size. and some increase in size. when this happens, a consultation and a surgical excision might be needed.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing severe pain in hip after delivery?\n\nI have been having issues with my right hip since my first child was born...the pain is now excruciating to the point it hurts to walk...it almost feels like sometimes my hip is jammed and sometimes it is out of place...should i go to the ER or just go to an urgent care...and what could be causing this issue?",
    "doctor_response": "dear user. as you mentioned suffering pain from first delivery of child. this happens to 90% of womens. but not this severe pain.take accelofenac 250mg. shelcal d 250mg tavlets.and you need to go for lumbar traction with ultrasonic therapy to heal and reduce complete pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurrent UTI?\n\nI have been diagnosed yet again with another UTI with Klebsiella being the bug that is always found in my urine. The dr says it is not caught from my partner but every time I have sex with him I am back to the Drs again complaining of the same symptoms. Sometimes the urine samples show nothing but most of the time it does. Why is it that I no sooner get rid of the infection then have sex and the infection starts all over again. I m beginning to wonder if my partner is the cause of all of this. Never ever had this issue before with any other partner. I m in my 40 s and have been with my partner for 2 years and am completely monogamous (never have numerous partners). I m so over this please help me",
    "doctor_response": "Hello,Klebsiella is mostly and primarily found in not immunocompetent individuals, usually in hospital settings and cause the so-called hospital-acquired infections (HAI). They could cause opportunistic urinary tract infections, pneumonia and other respiratory infections, bacteremia, infection of surgical wounds, etcetera. In diabetics, people with chronic obstructive pulmonary disease, etcetera. Due to their particular structure, Klebsiella species are naturally resistant to penicillin-type antibiotics, some Aminoglycosides (Gentamicin, Kanamycin, Streptomycin, etcetera.). Often their treatment is possible only through the use of Carbapenems and Fluoroquinolones (Ciprofloxacin, Levofloxacin, etcetera.). Klebsiella is considered part of the normal flora in various parts of intestine and colon. Recent studies have reported that recurrent Klebsiella urinary tract infections are caused by persistent Klebsiella found in the urinary tract even after appropriate antibiotic treatment and all persons with recurrent infections were elderly and diabetics. Recurrent strains of Klebsiella also had increased adhesion and invasiveness compared to colonization strains (those causing infection for the first time) and this might explain their tendency to cause repeated infections. Now, it is known that frequent sexual intercourse is the strongest risk factor for recurrent urinary tract infections in healthy women, and it is why your disease comes back each time you have sex with your partner. The fact that the disease comes back after you have sex with your partner puts in high risk of future urinary tract infections. In your case the following measures could be of benefit: 1. Continuous antibiotic prophylaxis for six months, by using low doses of the antibiotic that is more effective in your case. You have to consult with your doctor about which antibiotic you will use and for how long.2. Post-coital therapy, by applying a single dose of the most effective antibiotic each time after having sex. You again have to consult with your doctor about the dose and type of antibiotic. 3. Apply the so-called post-coital voiding that is: urinating immediately after sex.4. You should maintain high genital hygiene as it could help as well. It is also important that you have a thorough evaluation by radiological examinations in order to rule out abnormalities of the urinary tract (anatomical or functional) that could boost infection recurrence. Lastly, Klebsiella is not transmitted sexu",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of hypotension?\n\nToday my grandfather woke up with hypotension, around 88/54.  He just had surgery to remove gall stones and a necrotic/gangrenous gall bladder.  He has congestive heart failure (CHF), and end-stage prostate cancer.  On line, it looks like maybe the hypotension could suggest renal failure or something else.  Any ideas?",
    "doctor_response": "it can be a minor heart problem as well as a kidney problem too.please take him to the local clinic or hospital and get his investigations done timely so that the side consequences of CHD and or renal problems can be managed",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be worried about the huge lump on the buttocks?\n\ni have a large lump about 3 inch wide and sticks out about 1  to 2 inches,its a constant pain.its situated above my right bum cheek but below the waist.i asked my own doctor about a year ago but he said nothing to worry about.i am 43,6.1 and slim so it is very noticeable.",
    "doctor_response": "Hi,This is likely to be a lipoma which is a fatty lump. This is not a serious problem. However, if it is in a position to cause discomfort for example with clothing, you may consider it worth having surgically removed. This would be a minor operation and would result in a permanent cure. Regards,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Taxim-O a tablet for typhoid?\n\nHi Sir, I went for blood test and I got Widal test as below, S.TYPHI O 1:160 (postive) S.TYPHI H 1:80(Negative) S. PARATYPHI :AH And BH are Negative Doctor told to take TAXIM-o 200 MG daily 2 tablets morning and night, TAXIM-O is for typhoid tablet ?? Is that fine, Please tel me, Thanks Regard s XXXX",
    "doctor_response": "Hi,Taxim-O Tablet is an antibiotic (third generation cephalosporin) commonly prescribed to treat infections caused by susceptible bacteria including typhoid. Continue to take it as prescribed by your doctor.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for two bulging discs and bone spur after heavy weight lifting?\n\nHi I am Al. I went to work 3 days after a car accident in 2008. I was assisting with an installation of a custom built in refrigerator when I notice a severe pain in my lower back. I was diagnosed with two bulging discs and now a bone spur as well. At the time of the original injury I suffered pain throughout my body. Nerves in my back, and neck felt like needles sticking when I sneezed. Upper thighs and legs were numb. My testes were very painful and lymph nodes in my hands , at my lower back, and near my groan area were swollen and paining. Pain shot from my left side of my lower back to the groan and testes. Since 2008 this subsided after about 10 months of little or no lifting. When I began to lift heavy items again the pain returned and now there are two masses in my scrotum area outside of my testes . This is one of the same areas where the pain was previously most intense. Many issues are now coming up including swelling in my left leg at the knee and a walnut size knot in the same area. What doctor should I see first and what tests should I have done?",
    "doctor_response": "Hello, Thanks for your query.I understand you have back pain . These symptoms are part of lumbar disc degeneration with PIVD where the nerves get compressed by the protruded disc. you must avoid any activity that aggravates the condition, like bending forward and lifting heavy objects, sitting long hours on computer, inappropriate sitting posture, etc.There are several treatment modalities with medicines, physiotherapy and with injections in the back called epidural injections and root/facet blocks.If you dont get better with these treatment ,I suggest you undergo surgery, by which the nerves are decompressed by removing the protruded disc (discectomy), which would significantly improve your symptomsI do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should oflin be continued?\n\nI had root canal done yesterday. the dentist prescribed oflin 200 mg twice a day for 5 days. I took one tablet yesterday and have been experiencing great discomfort with pain and lot of gas that I am unable to expel. should the antibiotic be continued?",
    "doctor_response": "Hi, i had gone through your problem. Basically oflin is an antibiotic which may also act upon the beneficial intestinal flora leading to some gas formation, diarrhea or abdominal discomfort. to get relief from this you can use lactobacillus spores sachets like bifilac or darolac etc along with the oflin. Otherwise you can consult your dentist if the symptoms persists. KINDLY NEVER DISCONTINUE ANY ANTIBIOTIC COURSE WITH OUT DOCTORS ADVICE. Hope this explanation would satisfy your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does small disc herniation L5, radiculopathy and diffuse disc buldge L4/5 mean?\n\nI have a 17 year old son that has never had any back injuries except in 2003 he had guillian barre syndrom. Here recently I have been noticing reports that he has small subligamentous disc herniation L4/S1, small disc herination L5, radicualopathy and diffuse disc buldge L4/5. What exactly does this mean and for his age?",
    "doctor_response": "Hello!Welcome to Ask a Doctor service!Regarding your concern, I would explain that these changes could be related to weight lifting or vitamin D deficiency. Is he obese or overweight? This could explain these MRI findings. I would also recommend checking vitamin D plasma levels and performing a lot of physical exercise, in order to help reinforce his back muscles. Hope to have been helpful!Wishing all the best, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a sharp shooting pain under the left breast?\n\nI had a pop under my left breast yesterday. Felt like a bone was sticking out at first. Excruciating pain with it. Tonight it happened again. It hurts badly when I turn, cough and breathe at times. The pain is also in my back between shoulder blades. Do you know what could be going on???",
    "doctor_response": "Hi,Welcome to healthcaremagic,I had gone through your question & understand your concerns about health.Your type of pain might be muscular pain.When I come across of this type of excruciating pain which hurts badly while cough, turn, and even breathe & pain also in back between shoulder blades, I suggest pain relief with muscle relaxant medicine like, Tab. Vetory MX (if no allergy of this type of medicine) twice in a day at twelve hourly for a 3 to 4 days.  Ice application is also helpful to relive in pain.I hope these answers of your question. If you have any more question or follow up questions, you can share on healthcaemagic , I would like to answer it.Have you good time for healthy & happy life.Take care.Please review your experience on healthcaremagic about my answer.Thank you.Dr.Prashant Shah.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath,rapid heart beat and pain and burning in heart?\n\nI have had shortness of breath, very rapid heart beat, followed by my heart feeling sore and then after the soreness there is extreme burning and pain in the heart area. This had been happening for 2 weeks. Starting very gradual but now it is happening several times a day. I am a 33 yr old female. I went to er 2 weeks ago at onset and they said anxiety. I went to my family dr. He had and echo done. Results were mild mitral valve reguritation. I also wore a holter monitor. I had periods of where my heart rate was up to 220. My dr. sent me to a cardiologist. He looked at my er report and tols me this was all anxiety. He did not even want to hear my symptoms or the progression of symptoms. Said shortness of breath could be allergies. Askes about weight gain but would not even talk to me about why I was reffered(mitral valve regurgitiation). I just want my life to go back to normal. Please help.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. No need to worry for heart diseases as your ecg, 2d echo, Holter monitoring and cardiologist consultation are normal. It is true that uncontrolled stress and anxiety can cause similar symptoms. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on it's solution. You may need anxiolytic drugs too. Don't worry, you will be alright. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high heart rate with blood pressure?\n\nI'm 27 and my blood pressure was 150 over 100 with a heart rate of 156.  I had just walked into the living room from another room, wasn't really stressed or excited.  My pulse has been getting higher and higher for months now.  (About a year ago, it was at 110 and before that it was 80-100 normally.)  My blood pressure is normally fairly low.  Is there something wrong with me?",
    "doctor_response": "HiHypertension ClassificationCategory\u00a0\u00a0\u00a0\u00a0\u00a0Blood Pressure, mm HgPrehypertension\u00a0\u00a0\u00a0\u00a0\u00a0SBP 120-139 or DBP 80-89Stage 1 HTN\u00a0\u00a0\u00a0\u00a0\u00a0SBP 140-159 or DBP 90-99Stage 2 HTN\u00a0\u00a0\u00a0\u00a0\u00a0SBP \u2265160 or DBP \u2265100DBP = diastolic blood pressure; SBP = systolic blood pressureSo siy at a ae of 27 blood pressure 150/100, is a awanig siren that some thing is wrongheart rate is also 160/mincause of severe htn at a age of 27 can be either due to renal artery stenosis o pheochrmocytomaadvicevinyl mandalic acidmetanephrinesmri abdomen2d echo to see cardiac hypertrophy advtab amlodipine 10mg once daily",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause change of color in urine and ejaculate?\n\nThe other day I noticed that my urine was dark orange...but I thought little of it as I had drank orange. Tea for a sore.throat I had developed. Also I noticed a slight orange hue in my ejacualte this morning..I have chills and a slight rash in my face.",
    "doctor_response": "DearWe understand your concernsI went through your details. Orange urine purely sifnifies lack of enough water. Slight orange tinge in your ejaculate is also normal due to dehydration unless the tinge is noticeable. Then it could be attributable to blood. Still don't worry. Consult a physician and you will be alright within 3 days.If you still need my assistance in this regard, please use this link.  Please remember to describe the whole problem with full detail.Hope this answers your query. Please feel free to post follow up queries. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Baby is having cold. Can it be cure automatically ?\n\nhi.My son is 1y 8months old.he is having cold.my doctor prescribed Asthalin and aleriod for this.we are giving daily 2 dose for 10 days.but cold is not cured.he is getting this cold once in 2 months and we are giving these same syrup.whether these medicines will have any major side effect. my wife is not eager to give medicines.her policy is that the cold will automatically go off. your suggestions pls",
    "doctor_response": "Hi Murali, If your child is having recurrent cold, he must be having either allergic problems or adenoid hypertrophy. You can try using saline nasal drops 2 drops 3times/day and give Syr. Actifed safely, these does not have side effects. Before that, please consult your ENT specialist and get a thorough examination done. Regards Dr. Naveen Kumar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if smoking heavily and gums are turned purplish black?\n\nHi. I have recently noticed my husband's gums are turning a purple colored black. Its not the whole gum, and it almost looks like you could wipe it off. His teeth are really good other than that. He is a heavy cigarette smoker, and a daily weed smoker. I am not sure how long they have been this way but I just noticed it tonight. He is white, black hair with brown eyes, darker completion. He is 28 yrs old, and has been smoking since the age of 13. Thank you.",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. Actually when gums are turning purple,it can be inflammation of gums. It occurs because of heavy smoking also, better you advise him to quit the habit and visit dentist to get complete oral prophylaxis done.As it will help him.Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to remove gallbladder stones\n\nSir I am taking udilive 300 on the advice of Doctor as a 17 mm stone is observed in my Gall bladder . Dr Specialist in Surgery has advised me take udilive 300 for 3 months. I have started . I have not observed any type of pain or other indication before the starting of Medicine and after that till date . I am fit in health in all respect . I am also taking Stanlip 145 for reducing Triglycerides on advise of the Doctor Medcine . I am 49 yes old my height is 5 feet & 6 inches. My weight is 65 kg. Kindly advice me whether Udilive is effective in disolving the stone or not . For how months the udilive is recomedable and can udilive take with other medcine like Stanlip. For any side effects please also advice.",
    "doctor_response": "Hello! Thanks for putting your query in HCM. I am a Gastroenterologist (DM). Tablet udiliv is not at all useful for dissolving gallstones. Only management of symptomatic gallstone is surgical that is removal of gallbladder.I hope I have answered your query and this will help you. If you have any further query  I will be happy to answer that too. Remain in touch and get-well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough and bronchitis\n\nHi - I was on two meds. for H/B one Losartan 50mg and amlopine 5mg. I also have a cough which is ongoing for years also have bronchitis this fall which has left me with a cough with mucus which is clear and so my M.D, told me to stop taking the losartan for 3 weeks to see if the cough goes away. It didn t. He went on vacation. I noticed my blood pressure going up and called and told his office that I am going back on the losartan as I started getting spots in front of my eyes and a headache. I have read on line that it is not a good idea to just stop any h/b med but gradually lower the dose over a period of time. I feel better taking my Losartan but have mixed feelings about continuing with this doctor for future treatment. What would you advise?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Yes, you are right. You should not stop any antihypertensive drug all of a sudden. You need to taper it down gradually. In my opinion, you should definitely consult another doctor because Losartan can not cause coughing, so no need to stop Losartan. For coughing, you should consult pulmonologist and get done a clinical examination of the respiratory system and PFT (Pulmonary Function Test). PFT will tell you about the severity of the disease and treatment is based on severity only. You will need inhaled bronchodilators (Formoterol or Salmeterol) and inhaled corticosteroid (ICS) (Budesonide or Fluticasone). Don't worry, you will be alright with all these. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Kaushal Bhavsar",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat rash with blisters on butt cheek ?\n\nhi...got a rash/blisters on my butt ...started about 3 days ago. I thought it was an insect bite at first but it has spread with blisters that pop easily...very itchy and uncomfortable...it is on both cheeks but more so on right where it started. Coincidentily? I have a cold sore on my lip..",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. According to me, it could be a Herpes Virus infection of skin. You need to take oral antiviral drug and treatment should be initiated as soon as possible. So, I request you to kindly consult your Dermatologist, as soon as possible. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Siva Subramanian",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does sharp pain in the lower back upon sneezing indicate?\n\nI have sharp pain in my lower back when I sneeze or cough. I m thinking it is my kidneys. I have no history of kidney stones, however I do have a diagnosis of interstitial cystitis. I get chronic UTIs. I do not have one now. Just the pain in my back/kidneys. It is both sides. What could be causing this.",
    "doctor_response": "Hi,I understands your question and I will try to help you. simply your back pain with sneezing is mostly due to myositis or muscle spasm of back muscles.. I suggest using muscle relaxant and hot fomentation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to control blood sugar\n\nI just got diagnosed with high sugar levels in my urine during a UTI visit with my urologist.  I have an appt. with my family doctor tomorrow but is bought an Accu-check-nano machine and just tested myself and it registered 254.  Is this what is causing my headache and can I do anything before I get into the doctor on Monday",
    "doctor_response": "Hi Thanks for contacting HCM.You have not mentioned about your age . Dont get stressed about ur sugarlevels . You need not to do anything in one night . Be relax and go to ur family physician . Tomorrow he will help u insorting out appropriate investigations and medications to control ur sugarlevels .Hope I have helped u .With regardsDr ponnarasu",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could swelling in ankles be indicative of?\n\nHi my ankle keeps swelling up and when the swelling goes down it is very painful to walk, the pain goes up my calf and along my toes and I have had a blood test for blood clots and that has came back negative my doctor isn't helping he said he doesn't have a clue wht it could be please help",
    "doctor_response": "Hi, If I were your treating Doctor for this case , I would come up with three possibilities, these include: First possibility is due to vascular problem like varicose veins or venous insufficiency or DVT and this can be excluded by doing duplex US for your lower limb and can be treated by raising your legs up , wearing elastic stocks and receiving veinotonics.second possibility  is due to elevated serum uric acid level and this can be excluded by doing blood level of serum uric acid and treated with urate lowering drug.Third possibility is due to systemic disease and this could be excluded by doing renal and liver function test and assessing cardiac function by doing ECHO cardiography.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes purple and yellow rashes on my legs?\n\nHi,i am a 20 year old female i am 5'2 127.lbs i have ashma and i have had bone corrective surgerys.i also have nerofibromatosis sorry dont kno if i spelled it righ. lol anyways lately i have been noticing in the mornings wen getting ready for my day that i have these purplish/yellow bruises all over both my legs.they start in my hip/thigh area and end just bellow my knees like almost my calf area. and i have done nothing to cause them. can you help me",
    "doctor_response": "Hi, I would recommend you to go for certain lab tests to find out its cause. I would recommend you to go for complete blood count and coagulation profile. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have severe pain due to pelvic inflammatory disease. Please help.\n\nHi doctor,I am 54 and passed by menopause. Recently, I had done my lower ultrasound due to heavy back pain, and ultrasound shows pelvic inflammatory disease. Suggest me what to do, pain is not bearable. I am already taking BP and cholesterol medicine on a regular basis. Kindly suggest.",
    "doctor_response": "Hi. You said severe lower abdominal pain and the ultrasound report came as pelvic infection disease. Are you having any white discharge per vagina or high color urine?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are anti-inflammatory pills advisable for a reddish bruise on the right bicep?\n\nHello, I have injuries my right bicep from getting punched many times on the same spot after playing a game with my friend. The bruising travels right around my arm as far down as my elbow which is a reddish pink color now. Where I was actually getting hit isn t brusied that much but the surrounding tissue and skin where there is more fat tissue seems to have take most of the damage. To me it looks almost like a blood cloth as I ve had one before in my leg. Was wondering could you give me advice for steps to take in the healing process. Would I need anti inflammatory tablets? Thanks,Peter",
    "doctor_response": "Hello,You have a bruise and soft tissue injury of the biceps area and elbow. Please take analgesics only if the pain is more as they have no role in the healing processes. To decrease edema and clotting I would suggest you take tablets containing enzymes like trypsin and bromelain. Tablet Phlogam or tablet Disperzyme. They are tablets MEABT to decrease the swelling. It will heal in about a week. Hope I have answered your query. Let me know if I can assist you further.Regards,       Dr. Santosh S Jeevannavar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to fly after brain surgery?\n\nMy brother had brain surgery a year ago in Brazil. He has not yet had the protective covering where they took part of his skull away. The drs. there say it is safe for him to fly back to the U.S. where we hope he will get faster treatment. Is flying safe for him?",
    "doctor_response": "Hello, Yes, he can travel. as its almost year there won't be any issue. but just before the travel gets a physical examination of the blood pressure and blood routine. Most cases can be shifted from one place to another without any kind of difficulty. In fact, it is good that the covering is not there as there will be no signs of high blood Pressure within the brain and he should be fine to fly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathing difficulty in a nasopharygeal carcinoma survivor?\n\nI am a 5 year survivor of nasopharygeal carcinoma. My worse side affect is the breathing issues that I am now having. I also have a deviated spectrum. The muscus is so bad and thick and I rinse with nasal rinse 7-8 times a day. Any suggestions to help with this, and when talking to others what is the medical turn used for this issue? Thanks for any suggestions!",
    "doctor_response": "thanks for your question I completely understand your question you may be suffering from upper / lower resp tract infection along with rhino sinusitis you need to consult a pulmonologist to evaluate the condition and to rule out other causes like mets.pulmonologist may start you on some broad spectrum antibiotics and nasal decongestants like cefexime and fexofenadinesteam inhalation three times ll help you can disscuss the above mentioned diagnosis and treatment with the pulmonologist who will guide u regarding the disease and prescribe you the treatment thanksfeel free to ask more questions may god bless you with good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could hydrocodone cause hives?\n\nMy husband keeps breaking out in hives that completly cover his body, his face and throat swells.  He has to go to the ER to get a cocktail shot to stop it. He was prescribed hydrocodone/acetamenophen after dental work. Could the pain med cause this?  Thanks for any help you can give me.",
    "doctor_response": "Hello, Thank you for consulting with HCM.Actually hives is a sign of allergic reaction to any drug. It will be relieved after taking anti-allergic medication.Hydrocodone is a drug which is contraindicated in alcohol users, so better you ask your husband that either to discontinue alcohol or to change the drug, as it can create further problems.Hope it will help you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for an enlarged lymph node in chest\n\nI recently went to the emergency room for Chest pain and I fainted briefly but after several heart test nothing found . They did find an enlarged lymph gland in my chest but no one seems concerned but me. What should I do and who do I see. My friend said this is what they found I. Her husband during a routine gallbladder surgery it turned out to be lymphoma. I am 69 years old",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. By your description I think you are having isolated mediastinal lymphnode.In old age (your age group) causes for this are1. Benign enlargement2. Infection3. Calcification due to old age4. Rarely malignancy (lymphoma) etc.So in my opinion you should not worry much. As single lymphnode is benign mostly.But better to get done repeat CT scan after 6-7 months.If lymphnode is decreasing or static than it is benign. And if increase in size than you need to consult pulmonologist and get done bronchoscopic ultrasound guided biopsy of the lymphnode.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to give Isomil to an infant?\n\nMy baby is 7 months old...he is totally on breastfeeding from birth...doctor told me to stop intake of milk products because of blood in his poop...but one month ago i changed the doctor he told it is infection...now after medicine he is fine and i am taking milk products onle he is straining while pooping...today i started isomil....is it safe?",
    "doctor_response": "Hi, Isomil is lactose-free formula milk, given in babies with lactose intolerance (with symptoms like gaseous distension, excessive crying in the evening). Blood in poop is due to infection only. If you breastfeeding from last 7 months with no symptoms, then it's less likely that its lactose intolerance in your baby. You need to give normal milk to the baby. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for anger issues,low self esteem and problem in working in public\n\nHi I have a 21 year old daughter who has suffered some trauma in her life at the age of 15, witnessing a murder on the grey hound bus out west. We have had her to many counsel sessions but doesn t want to stick to anything. She has quit college, doesn t work and has very deep anger issues and some times violent. She is also using pot several times a day. Has no self estem, thinks she s stupid can t spell and says she can t work in the public, I don t know what to do to help her get her life started",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.She will require intensive psychotherapy especially cognitive behavioral therapy, and systematic desensitization. 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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a red line in the butt cheeks?\n\nI had sex with a girl and noticed that she had a reas line between her butt checks, what is that? Is there something weong with her or something? I didn t ask her couse I tought that it probably was something bss or that she probably would be embarrassed.",
    "doctor_response": "Hello,Thank you for writing to HCM about your query,Brief Answer -those red lines most possibly could be stretch marks.Explained answer -No need to worry here, It could be stretch marks only nothing else.It would be allergy reaction caused by sweat from the activities.So, Don't be so worry about it.Still if you want then you may concern skin specialist for more clear instructions.Hope it will enough to getting idea on your question..Thanks & Regards,Dr. Gaurav Prajapati Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful bump at the top of butt?\n\nI have a bump at the top of my butt crack that hearts really bad. Last yr about this same time it started like this and I won't to the er and they said they don't know what it cud be. It's not staff. They lanced it and it got better. What do you think it is?",
    "doctor_response": "Hi,This is likely to be a pilonidal abscess. This is a cyst that has become infected. I suggest you keep the area clean and dry with regular baths. I recommend antibiotics to clear the infection. This is likely to solve the problem but if it persists, surgical removal may be necessary. Regards,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat severe hair loss?\n\nI am Aruna, 24 age. I am suffering from too much hail lose in 3 months.... and my hail round scalp on head..... like baldness..... I met a dermotology... he suggested me using Amexidil lotion..... I am using that lotion in 20 days. BT no result.... too much hair lose,and baldness increasing day by day... plz help me...... what was I do..... plz suggest me....",
    "doctor_response": "HIWell come to HCMI really appreciate your concern if this is male patron bald ness then you wont get good result but this can be prevented for time being with Minoxidil 5% the result of this may not be promising, hope this information helps, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for pain in the right calf\n\nApprox.3mo. ago I started to develop minor ache in my right calf only - not a charlie horse , but a ache. Now 3 mo. later I have severe pain in my rt. calf and the only thing that gives me some relief is a warm moist compress. I can t function - it seems to get worse when I sit - but it is also there standing. I was diag. like 4 mo. ago w/ crystalization in left knee and PT because they thought maybe the left leg was weak and more wgt. on right. Well I ve had the PT to strengthen the left leg and I lost weight - the pain seems to have increased. I need answers. PCP ordered alot of lab work - everything came back okay. What are we missing ?",
    "doctor_response": "Hello,The only thing I can notice at your scenario is the overuse of the right leg while having problems with the left leg. To me, you need rest, physiotherapy and magnesium and vitamin-B complex supplement.All the best. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Albana Sejdini, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility with all tests normal\n\nHi, may I answer your health queries right now ?  Please type your query here...hi me and my husband try for a baby abut 4 years now and we both was checked and we both can have children do u thing is time to do the treatment and if what treatment will be good for",
    "doctor_response": "Hellothanks for using health care magicDifficulty in conceiving requires a thorough multidisciplinary investigations and arrival at a diagnosis before accurate management could be given else, it will be try and error management with waist of time and money.You talk of tests being done, it will have been easier to comment had you listed the tests you both did.Also apart form possible illnesses, reduce sexual exposure, stress are all factors that can aggravate or predispose difficulty in conceiving.You need to do tests like hysterosalpingography, pelvic ultraosund, FSH and LH testing collected at appropriate time of cycle, high vaginal smear, chlamydia, etc and also, you need to do a temperature chart for a couple of months to fully understand your cycle.Treatment will be best once a diagnosis has been made.Best regards Dr Achuo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can B12 sublingual liquid help to treat hair loss?\n\nMy mother has hair loss(pattern is typical female alopecia), my hair loss is the same, both of use vegetarians - my grandmother, her grandmother etc etc were also vegetarian.  Would taking B12 sublingual liquid help as this is not in the vegetarian diet, or is it quite unlikely? my mothers sister is also vegetaian but has thick hair.",
    "doctor_response": "Hi, I would recommend you to go for vitamin B12 levels and then start with vitamin B12 supplements like the sublingual liquid. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can lower back injury pain be treated?\n\nHi. Just a week ago I injured my lower back. I finally went to the er Saturday because I could not handle the pain anymore. After some X-rays the doc says he believes I sprain a ligament. Well I'm just wondering when will the pain start to fade? And also tonight I felt a warm sensation in my whole lower back area, is that bad? Thank you for any answers.",
    "doctor_response": "if it is strain, just needs adequate rest with mild analgesics like Tab. Imol plus thrice daily and local application of sensor oint locally for three weeks should suffice. don't lift weights",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause lower abdominal pain and sharp pain in the vagina?\n\nI have lower abdominal pain feels like an dull ache. Sometimes hurts to my back hip and occasionally accompanied by sharp pains in the left side of my vagina. This pain seems to be way more prominent after I eat. I also get head aches mild nausea and really the best way I can describe it is that my head feels \"whirlybird\" not faint or unfocused if I could imagine what was going on inside my body it would be a small tornado? I dunno I hope that makes sense. I really don't know what to do! Some symptoms are similar to pregnancy but I have done a hundred urine tests and one blood test in the last 2 months and all are negative!",
    "doctor_response": "HI.We have to find the cause of the Abdominal pain. You doing 100 urine tests indicates that you may be suffering from Pseudocyesis, as you also say that you have symptoms like one gets after pregnant. I would advise CT scan of the abdomen to start with to rule out Tubal pregnancy, Gastrontestinal cancer, Tubo-ovarian Cancer or so.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough and body ache in kid\n\nHi - my son is 5 years old, he has been having cough for last 3 weeks, yesterday went to doctors office. They have given amoxycillin as he has pain in his body/ head ache & mucus. He is feeling restless, seems he is feeling heat in his legs. He has taken the medicine twice today.",
    "doctor_response": "Hi,Amoxicillin is an antibiotic which means that the doctor has found a bacterial infection. If the child suffers from body ache and headache you can give him acetaminophen or ibuprofen syrup every 8 hours to resolve the body ache and headache. If he is having cough with phelgm then you can use a cough expectorant as Mucinex . You can also use a cough suppressant as Dextromethorphan.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Salah Saad Shoman",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat borderline diabetes?\n\nI have a family doctor and he says I m borderline diabetic and I want to be proactive and make suggestions to my doctor what I should do since he isn t very forth coming with help. My Dad is on metformin and he says he takes that for his type II diabetes he s 87 I m 64. My dad also mentioned Gabapentin. I have read up on both and was thinking about talking to my doctor about it but as you know they want the money so they don t talk by phone just office visits so any help is appreciated.",
    "doctor_response": "Hello,Suppose normal range in a lab is 70 to 120, and a person with 120 or 122 or 118 will be labeled borderline. As with age, you may shift into the diabetic range. You have not mentioned your sugar level.I advise you to get your fasting sugar level that is 2 hours after meal sugar level plus HbA1c every 3 months. Normal FBS (Fasting blood sugar) level is below 140 and 2 hours after the meal is below 200 and HbA1c below 6.5.Avoid fast foods, restrict sweets, maintain adequate body weight, go for morning or evening walk at a moderate pace of 5 to 6 km per hour. Only one drug is effective for prediabetic, and it is Pioglitazone, Gabapentin is a drug for neuropathy.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Varinder Joshi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Undergone surgical tooth extraction. Have fluid filled overgrown tissue on healing gum. Could this be a Keloid?\n\nHey. I had a surgical tooth extraction about 3-4 weeks ago and there is a large, malleable seemingly fluid-filled pinkish reddish bloodblister-looking overgrown tissue on the healing gum.  I bit down on something and it must have perforated. It bled and bled. When I felt it after, it had gone down but the tissue was still there albeit smaller. Could this be a keloid on the healing gum?",
    "doctor_response": "HIThank for asking to HCMNo this is not keloid, this could be hypergranulation tissues and might turned into the small cyst, little surgical debridement may require in this case, it will be alright with this, you can have word with your dentist, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cough and switch in body temperature\n\nI am hot (to the point of sitting in front of a fan to cool off(. then I am cold. No fever but feel horrible. I had a cough which brought up green & grey matter. Now it is just clear but I still have the cough. This switch in body temperature is driving me crazy.",
    "doctor_response": "Thanks for sending query to hcm.you are suffering feom lower respiratpey tract infection. You should go for culture and sensitivity of sputum. Meanwhile you can take cough syrup containing ambroxole,  guaniphesin and terbutalin 2. Cetrizine 10mg with monteleucost5mg once at bedtime 3. Paracetamol 500mg for fever. 4. Antibiotic can be start imperically until sensitivity report come . You can start azithromycin 500mg once in a day. All medication should be taken under guidence of clinician and if you arw allergic to any drug dont take without consulting to clinician.Review me after culture report.Best wishes for good healh . Feel free to contact.RegardsDr manish puroit.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing a painless lump in my husband's testicles?\n\nmy husband who is 39 yrs old had swelling in his tesicles and pain in the back and scrotum now tat the swelling is come down and tere is no pain in it he hasdeveloped a painless lump in his testicle which has caused me worry please can u explain why this has happned and what are the side effects of removing testicles?",
    "doctor_response": "Hi,Dear Thanks for the query to HCM virtual Clinic.I studied your query with available details given in your query.I understood your health concerns.Cause of the painless testicle lump with back pain-Your query has swelling in testicle with pain in back and scrotum.This swelling has come down with a painless lump in the testicle.This story is bit confusing in your query and hence needs a Second opinion from ER Surgeon,as its very necessary to confirm the possibilities which arise from the query facts-as -this lump could be due to -a testicle swelling which has pain in back-indicating spread of the swelling to the lymphnodes in the abdomen.This lump lately has grown down -indicating a secondary hydrocele,which pushes it down by the increased weight, which got developed in to the swollen testicle-Such a lump could be Seminoma with spread in abdomen or in the mediastinum with low back pain with secondary hydrocele.-Or it could be due to the Spermatocele with pain in back due to the neural supply from abdomen,which later had Seminoma developed in such a testicle.So consult a ER Surgeon who would differentiate it by duplex imaging USG study after Clinical examinations..My clinical opinion on your query is-PET CT Scan with mediastinal/para-aortic node biopsies would confirm the duplex imaging USG studies of such a lump in your case.If not, Surgical Excision Biopsy with HPR would confirm  its cause as benign or malignant testicle tumors.Don't Self-treat or medicate in your case as the case may go in to further complications.Hope this reply would resolve your query and would help you to plan treatment with your doctor.Hope this would relieve of your health concerns.Welcome for any further query in this regard before final suggestions are given in your query.Wishing you fast recovery..Have a good day.Dr.Savaskar M.N.Senior Surgical Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the causes and treatment for puss filled bump\n\nI got the bottom of my belly button pierced in June. It was healed but just recently I noticed a hard bump under my skin right next to it. Yellow puss and some blood come out, is this an abscess and is there something I should do while I wait for my next doctors appointment?",
    "doctor_response": "Hi,welcome to healthcare magic forum.Your description points towards an abscess.It needs incision and drainage.Then only,antibiotics can act.If you have a delay for your appointment,you apply osmotic agents like magnesium sulfate paste,and start antibiotics and analgesics(i usually gives amoxycillin+cloxacillin to my patients),gently express out any pus,and keep the area clean.Hope you will find this information useful.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a large lump behind the ear\n\na few days ago I had a huge lump behind my ear &then it went away...now I have 2 huge lumps behind my (left)ear & they feel hard like bone. Ive also had a swollen glands for more than a week, lost my voice for a couple days and now I noticed the roof of my mouth is yellow. is that anything that will just go away?",
    "doctor_response": "Welcome to health care magic. 1.The history suggest the possibilities enlarged lymph nodes in the first place. 2.Lymph nodal enlargement can be seen after any infection / inflammation, can be localized or systemic.3.In this case you need to get treated the source of the infection. 4.Other possibilities are parotid,sub mandibular, or in fact a bony lesion - which needs to examine.   5.Ultrasound will give the information of the nature of the lump its source and extensions. I recommend to see your GP get examined and follow accordingly.Good luck.Hope i have answered your query,any thing to ask ? do not hesitate to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes viral fever and continuous sleeping after dog bite?\n\nMy 21 year old daughter was jogging a week ago and was bitten by a nieghborhod dog. the bit sight was checked out by an er doc and he stated it was superficial and healing fine. Thing is she has had a fever for a week straight now and the er doc sad it was just a viral infection let it run its course. she just sleep and sleeps. not like her she was very active prior to this.",
    "doctor_response": "Dr. Hanif warmly welcomes you!Thanks for consulting at my virtual clinic. I have carefully worked through your case, and can well realize your health worries. Being your physician, I want to assure, I will take care all of your medical concerns.Contact her primary care physician. To me it isn't looking like a viral one. If so, still she needs treatment. Give her Ibuprofen to relieve discomfort. Take a prescription for Ampicillin/Sulbactam from her physician to use empirically to keep her safe from getting secondarily infected by the bacteria.How is the dog? You specially need to follow the dog for any change in dog's habits of sleep, eating, aggressiveness, daily activities. If there is even a little difference in these, contact the disease control centre or her physician for suspected Rabies evaluation and treatment accordingly.Hope I answered all of your questions. In future, if you need further, detailed and quick assistance on any health issue, feel free to ask me a question by writing my name as a reference in the start of your question. I will get back to you right away. Have a wonderful time ahead.Regards!DR. MUHAMMAD HANIFUSA",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment other than dialysis can be given to a diabetic with depression for elevated creatinine levels ?\n\nmy father critinine 7.5 urea100 hg 9.1 my father also is depressive patient i can not transfer hem to hospital to make dialysis and his condition is become more worse with time now he can not go alone to w.c and his legs muscle almost disappears and he can not sleep without valinil tab and take (methyl dopa 500 tab-diletrol 25 tab)for hypertention and insulin for diabetic and his blood presure around 140/90 and blood suger 120 random i need you advice thanks",
    "doctor_response": "Based on the few numbers you've given, his diabetes seems relatively well controlled, but this is hard to say since I only have one random sugar to make that judgement. His blood pressure also is not very bad. However, he clearly has kidney failure and must get dialysis if he is to survive. Peritoneal dialysis may be an option for you. This kind of dialysis can be done at home. First he must have a catheter placed in the abdomen to use for the dialysis. I also assume the hg 9.1 is his hemoglobin, which is low. This is common with kidney failure. He may benefit from iron supplementation. He should already be seeing a kidney specialist. If not, please have him see one to discuss peritoneal dialysis at home, iron infusion (and ongoing supplements), as well as safe medications that can be used in kidney failure patients to treat depression. Fluoxetine may be a good option for him to help with the mood. However starting dialysis and eliminating toxins may also help improve the depression.  Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough with phlegm and shortness of breath\n\ni quit smoking a little over a month ago.  for a month now i have had the strong, uncontrollable cough with phlegm and i am always out of breath which makes me lightheaded.  i also have had some fevers here and there.  also my nose is stopped up a lot.  every time i blow my nost the back of my head and neck hurts so bad.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Since you were a smoker, we should rule out lung infection and bronchitis in your case. Both these diseases are common in smokers and cause similar symptoms like cough, expectoration, fever and breathlessness. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system. 2. Chest x ray 3. PFT (pulmonary function test). Chest x ray is needed to rule out lung infection. PFT is must for the diagnosis of bronchitis. You will mostly improve with antibiotics, inhaled bronchodilator, inhaled corticosteroids and other supportive drugs. Don't worry, you will be alright with all these. First diagnose and then start appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What ayurvedic medicines can help cure boils around my buttock area?\n\nHello doctor, I am a 32-year-old man. I have been suffering from recurrent boils and folliculitis on and around my butt area since two months. It comes and goes. Sometimes, it lasts for three days and sometimes seven days, but never more than that. This time I got one on my hipline and it lasted for around three weeks. Since then I got more on the other side which again lasted for around two to three weeks. The size of the first one was approximately 0.7 cm. At present, there are two on the left side and one on the right. Surprisingly, one day I was unable to sit properly because of pain and the next day there was no pain and this continued for some days and then I got relief for three to five days and suddenly felt pain the very next day. They occur almost at the same place. I suffer from tiny ones from time to time, but they vanish in three to five days and are never an issue. Also, I sit for a prolonged period of time all day long. I have heard that it happens because of that as well. Is it true? I do not want antibiotics. Can it be cured without them? How do I make sure if it is caused by bacteria or something else?",
    "doctor_response": "Hello. There are small boils around the anal area, recurrent formation and inflammation mostly occur in the anal fistula. But it needs physical examination to know the the exact diagnosis. Prolonged sitting, driving two-wheelers, chronic constipation as these are the causes of anal fistula. Inflammation, recurrent boils around the butt area may also be due to an allergic condition. We need more details about this and pictures of the affected areas to know better diagnosis and treatment. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the consequences of kidney infection in a child?\n\nMy son was diagnosed with grade 4 and grade 5 reflux while in utero. He is now 11 months. His right side looked like it was almost resolved according to a ultrasound 3 weeks ago. But two months ago a nucular scan showed blockage in left ureter. (Left kidney showed worsening hydronephrosis on ultrasound and voiding cystogram). Today he spiked a fever so I took him to er and he has a kidney infection. This is his first infection and I m wondering how much damage if any can the infection have on his kidneys?",
    "doctor_response": "Sorry to hear the news. As left ureter has a block which is resulting in worsening hydronephrosis, I think you will require a surgery to be done as early as possible because this obstruction will result in repeated kidney infection and ultimately gross kidney damage. However i need to know the degree of obstruction which you didnt mention... Till surgery could be done first the kidney infection has to be treated with iv antibiotics then he has to be kept on regular prophylactic antibiotics.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having pigmentation on face due to exposure to sunlight. Remedy?\n\nHello Dr, Greetings and happy New year. My wife is 28 yrs with one baby of 7 months. She had pigmented facial skin diffused stage only in forehead , mid nose and either side. Slight below the nose and not below the mouth. The pigment type is I fig of this site. WWW.WWWW.WW She is normal in health but at the age of 12 had TB. After DOTS, she was OK and lung is very well now after X ray as I know. She has not taken any oral drugs but some creams at the past. No allergy , no pain. But due to expose of sunlight, skin becomes dark. I am clinical psychologist and parasitologist. I am doing PhD in health science. No other physical and anatomical problem she had. Sometimes constipation only. Would you please give me proper suggestion. Thanking you,",
    "doctor_response": "hi..thanks for your query.. From the clinical picture described, I feel your wife has something called Melasma.also known as Chloasma faciei,is a dark skin discoloration. Although it can affect anyone, melasma is particularly common in women, especially pregnant women and those who are taking oral or patch contraceptives or hormone replacement therapy (HRT) medications.The symptoms of melasma are dark, irregular well demarcated hyper pigmented patches commonly found on the upper cheek, nose, upper lip and forehead. Melasma does not cause any other symptoms beyond the cosmetic discoloration.Treatments to hasten the fading of the discolored patches include: Topical depigmenting agents, such as hydroquinone Chemical peels. Laser treatment. It is extremely essential to use a broad spectrum sunscreen throughout the day , with repetitions every 3-4 hourly,not only when outside, but also  even indoor or while cooking. Hope this helps..Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Gudcef Plus safe to be taken with Riviflox for typhoid?\n\nHi, I am suffering from typhoid last four days and my age 42 yes and doctor prescribe me antibiotic Gudcef Plus (Cefpodoxime+Ofloxacin each 200mg) twice daily for five days and than Riviflox (Ofloxacin 200mg) daily for 15 days. Canu I take complete course or not? Please suggest me",
    "doctor_response": "Hello,Thanks for your query on HCM\"As\"per your clinical history is concerned if you have no complications then you can take it without any problem so complete it' course as per your treating doctors advise.If you have any complication then you can talk about [ceftriaxone injection].Do take following preventive measures when you go outside-1)Wash your hands thoroughly with hot, soapy water, especially before eating or preparing food and after using the toilet. Carry an alcohol-based hand sanitizer for times when water isn't available.2)Avoid drinking untreated water. Contaminated drinking water is a particular problem in areas where typhoid is endemic. For that reason, drink only bottled water. Carbonated bottled water is safer than uncarbonated bottled water is. Wipe the outside of all bottles and cans before you open them. Ask for drinks without ice. Use bottled water to brush your teeth, and try not to swallow water in the shower.3)Try to avoid raw fruits and vegetables. Because raw fruits may have been washed in unsafe water, so try to avoid fruits and vegetables that you can't peel.4)Choose hot foods. Avoid food that's stored or served at room temperature. Steaming hot foods are best. Try to avoid food from street vendors because it's more likely to be contaminated.Hope that helps and wish you a quick recovery soon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. As I faced two miscarriages, I had thrombophilia panel test. Is there anything suspicious?\n\nHi doctor, I am a 36-year-old female. I had two chemical pregnancies this year, and I am childless. Due to my age, I decided to investigate more. The thrombophilia panel test results recommended me to see a hematologist. I have positive results (heterozygous) for MTHFR C677T, PAI 4G by 5G, AGT M235T, factor XIII Val34Leu, and fibrinogen 455 G by A. Will I need special treatment for a future pregnancy? Please help me.",
    "doctor_response": "Hi. I have reviewed your case. It seems that you had two miscarriages. So, you have to know a little detail about your condition and to understand thrombophilia. The risk of abortion is none to minimal in normal pregnancy whereas intermediate and high in heterozygous and homozygous mutation respectively. In your case, as you have twice pregnancy failure, I have two recommendations. Try to do APLA test (antiphospholipid antibody workup) which is just the extension of thrombophilia work up. During future pregnancy, usually in your case, we need to give some medications which can maintain your blood flow, and it can prevent the micro clot formation in the placental blood vessels, and hence the chances of abortion will get decreased. These drugs are needed to be prescribed by your hematologist (low molecular weight Heparin and Warfarin). You can discuss with your hematologist regarding the test suggested and about the drugs that may help you in future pregnancies.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do disc bulges, stenosis and neural formaminal narrowing cause back pain?\n\ni have mild canal stenosis and mild right neural foramina narrowing at L4-5 secondary to right disc bulge and posterior element hypertrophy. l3/l4 diffuse disc bulge without spinal canal etc...same at l5/s1 and l4/l5 assymmetric right disc bulge with mild spinal canals stenosis and mild right neural foraminal narrowing.  Is this enough to be causing lower back pain",
    "doctor_response": "The MRI description you have given can cause lower back pain. The disc bulge and the posterior element hypertrophy can press on the nearest exiting nerve and cause pain and other symptoms like weakness and numbness along its distribution. If the pain gets severe I would suggest consulting a physician for initiation of pain medication and further management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath after physical exertion?\n\nHi, under exertion, running stairs, bicycling up a steep grade etc I experience shortness of breath to a point like hyperventilating. This will last for several minutes after I stop what I\u2019m doing. I am over weight and carry quite a bit of weight in my chest. I\u2019m a male 58 years old I have strength trained and lifted weights basically since high school. I used to suffer from lung congestion while taking  high blood pressure medication. I started taking singular and don\u2019t have the lung congestion but know deal with this problem. I\u2019m currently working hard at cardio exercise to reduce my weight Please what are your thoughts on this issue",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Since you are overweight and having hypertension, we should definitely rule out heart diseases for your breathlessness on exertion. So get done blood pressure monitoring, ECG, 2D echo and stress test. If all these are normal then no need to worry for heart diseases. We should also rule out bronchitis because of lung congestion. So get done PFT (Pulmonary Function Test). PFT will not only diagnose bronchitis but it will also tell you about severity of the disease and treatment is based on severity only. You may need long acting inhaled bronchodilators (formoterol or salmeterol).Don't worry, you will be alright with all these. First diagnose and then start appropriate treatment. Continue weight reduction efforts. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat foot pain?\n\nHello I do a lot of dancing and last week I injured my foot it feels like its the bone that connects my big to to my ankle and it grids when I put my fingers on it and I can feel it grinding when I walk it is painful but I can walk on my foot do I use ice pack or heat?",
    "doctor_response": "Hello, It could be a plantar fasciitis.As of now you can use analgesics/anti-inflammatory combination like aceclofenac/serratiopeptidase for symptomatic relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why not getting pregnant when having prolifen capsules and taking folinis injections?\n\nHi ! This is the second time im having prolifen capsules . Last month I had 2 times a day for 5 days and had a folinis injection on 13th day . Now my dr recommend to have prolifen 3 times a day and folinis injection on 7th day . Ive a 4 yr old daughter and had a d&c on 31st oct 2012 . Please let me know what can be the reason for not getting pregnant ? My cycle is of 31-33 days sometimes goes till 36. Thanx",
    "doctor_response": "Hello. Thanks for writing to us. You are taking the treatment for infertility for a second tine only. the success rate per cycle is not more than 20% even with best of medicines. Be patient and continue with the treatment.I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal ,drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the problem when there is sezuire, frequent sinus infection, pain above the ear and whose mom had alzheimers?\n\nI am dating a guy, age 55, 5 7 very athletic, trail runner, very good shape. Has a type of sezuire, it starts by rubbing his right eye, then stutters, lack of concintration, sometime just seems to be total out of it. will start a converstaion and stop and ask what he is talking about. Actually called and asked me what his phone number was. He has severe sinus infections frequently. The pain he gets in his head is also on the right side, above the ear. He had testing and refuses to tell me what is wrong. I am scared for him. Any help to what the problem is? He lost his mom and dad recently, both in there late 80 s. His mom had alzheimers and dementa,",
    "doctor_response": "HIThank for asking to HCMThis could not be seizure but more it look like hysteric attack and the most possible cause of this would be the shock and the stress level he is going through this will be fine with good moral support and little rest, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could swelling of fingers at night be a symptom of trigger finger?\n\nduring the night, my fingers seem to swell and in the morning a few of my fingers lock up. I researched this consition and the symptoms are similar to something called trigger finger . After movement, the locking eventually goes away, but returns if I rest my hand for a period of time. the locking fingers always feel somewhat swollen at all times. Is the locking caused by swelling? What is causing the swelling and how can I prevent it?",
    "doctor_response": "Hello,Your symptoms are suggestive of arthritis. For this reason, I recommend consulting with a rheumatologist for a physical exam and performing some tests : complete blood count, PCR, ESR, FR plasma levels, ANA and ANCA titer antibodies, blood electrolytes, uric acid plasma levels. You should discuss with your doctor on the above tests.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taken Curacne. Have mental disorder, hearing voices, have paranoia. Symptoms of which disease?\n\nhello doctor, Ive taked a medicament 6years ago, it was curacne wich causes me Mental disorder , at the start 3 first years and specialy first year ive been hearing voice i like had 2 brains one is normal and the other is paranoid and been living in hell, with my paranoia , then it comes the suicidial Ideas I couldn t talk to no one because i was suspicious of everything even my Self, the reason i Didnt commit suicide thought, its because of my Religion beliefs and that the one who suicide goes straight to hell, ok, after three years and after i started praying and letting out in my prayers I kinda felt better, the hallucation were kind of gone, and everything but the paranoia i m still stuck with paranoii suspicious about others motive (even thought there is no reason to) when i m in a cafe for exemple and went to the toilet i m afraid someone puts something in my cafe deadly or whatever, Its just not good, The point is after a years of research throught internet, I m pretty sure i had all the symptoms for Schizophrenic Paranoia but with time it got less and i was left when Paranoid Mentality disorder I heared that Atypical antipsychotics are good, but they are mostly not used for Paranoid mentality disorder Sorry for tapping too much, anyway and for orthographe faults, thanks in advance",
    "doctor_response": "Hello....... You require a thorough psychiatrist assessment and observation over a few follow up visits to ascertain the nature of psychotic disorder you suffer from. It could be schizophrenia or a persistent delusional disorder or even a personality disorder with a quasi-psychotic breakdown. Atypical anti-psychotics after careful assessment and discussion of side-effect profile might be beneficial in your case. Regards. Dr Sundar Gnanavel Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on the palm\n\nhi, i have a lump on my palm of hand with the last 2-3 wks, its on my left hand to the right down low , just to the inside of the fat part of the palm if thats a good description. it could be a vain but feels a bit lumpy, i must mention that my ankles swelled up considerably in the last month also, i went to doctor mention arthritis, he gave me a course of steroids which stopped both pain in ankles and hands temporarily, but both flared up again. im now taking joinace glucosamine and its helping my ankles, but my hand is the problem",
    "doctor_response": "Hi,Dear,Welcome to HCM. Based on the facts of your query,You seem to suffer from-Rheumatoid arthritis of the palmar bones/joints.Methotrexate /steroids/chloroquine/sulphasalzine are few drugs which-DMARDs-start remissions with NSAIDs-HOpe this reply would help you to plan further treatment with your doctors.Contact with a Followup Premium question to ME. Will appreciate your Hitting thanks and writing excellent review comments to help needy patients like you. Good Day!! Dr.Savaskar, Senior Surgical Specialist M.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does intake of orofer affect baby s complexion?\n\nI am sailaja. I am four months pregnant. Doctor prescribed me to take orofer xt(1 time daily) and calcimax500 (2 times daily). I have 13gms of haemoglobin. i am worried that taking in orofer xr would affect baby s complexion. Can you please guide if i am worrying unnecesarily or my worry makes some sense?",
    "doctor_response": "Hi,Orofer XT does not have any effect on infants complexion, it can stain it's teeth to dome extent. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Vasudha Jayant Athavale, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for asthma\n\nName: Rajani Santra Age:48 Medical History: Asthama Patient since 5 yrs.Repested Sir/Mam, i am suffering from asthama since 5 yrs. I am allergic to dust particles. I have to every best doctor/hospitals of India for my disease. Right now my condition so much sever that even by taking steriod also my asthama doesnot control and not even by inhaler... so suggest me",
    "doctor_response": "Hello Rajani Santra,There are many drugs for asthma & there are many types of inhalers also.From your history I can only suggest that you should be taking daily inhaled corticosteroids to control your asthma. As you have mentioned, if you are already taking it on daily basis, you will need to increase the dose after consulting your physician.I would advise you to consult an Allergist who can perform allergy tests & may advise allergen immunotherapy which will help you in a longer run.One more thing, please make Yoga & Pranayama your daily routine. It will help better control of your asthma & will reduce your daily requirement of corticosteroids.Hope my answer was useful.Wish you best of the health.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Incomplete root canal procedure causing tooth infection. Is tooth extraction the only way to get relief?\n\nHi doctor, I ve a tooth pains since last saturday. However i visied as dentist who told me that my tooth need to be removed as the root canal which was done 3 yrs back was incompelete bcoz of which i have infection in my tooth. Can yoy let me know if there is any aother resoultion apart from getting my tooth extracted.",
    "doctor_response": "Hi Dear siri15y By your history it looks like root canal treatment done for your tooth is incomplete or it is not done correctly. The options though for you is not only extraction. Before deciding on extraction an endodontist has to be consulted and opinion has to be taken whether root canal treatment can be re done. In that case the present filling what has been done will be removed and the root canals would be prepared again and new filling will be done. If retreatment cannot be done, which may be due to various reasons like perforated canal, fractured root, periodontal (gum) problem etc., then extraction has to be done. I recommend you to consult an good endodontist before going for extraction. Take care Wish you a speedy recovery and a great smile.Smile Dr.Avinash",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can bathroom mold cause bloody, mucus stained stools, fatigue and nausea?\n\nI have been having bloody mucus stools for the past 24 hours non stop with nausea, severe cramping, fatigue, weakness, and it seems like I can t fully empty my bowls. My bathroom has mold in it (it has for years) and I wondered if the two were somehow linked.",
    "doctor_response": "Hello, Thank you for your contact to health care magic. I understand your concern. If I am your doctor I suggest you that it can be possible with the mold only if exposure time is more or you have immunocompromised. But having mold in bathroom usually do not cause such a symptom because the exposure time in you is very small. I think there must be some other reason behind your symptoms.I will be happy to answer your further concernYou can contact me. Dr Arun Tank. Infectious disease specialist. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is \"follicle size of 18mm with endometrial thickness of 5.7mm\" a side effect of 'fertyl'?\n\nHi i am 30 years old. This cycle i took fertyl 50mg starting 3 day for 5 days. Follicle monitoring done on 11 january shows follicle of size 18mm but endometrial thickness is just 5.7mm. Is this the side effect of fertyl. Will progynova 2mg help solve the problem. Last menstruation period date was 3 january.",
    "doctor_response": "Hallow, Fertyl is clomiphene citrate. It is basically used for egg release (ovulation) where natural ovulation is a problem. It is in particular useful in Polycystic Ovarian Syndrome where the follicles are maturing to varied extent and still the ovulation failure is noted. Clomiphene citrate is also having antioestrogenic effect. So it may hamper  growth of endometrium. Hence, in women where Endometrial growth is low, gonadotropin hormones may be preferred for induction of ovulation. Endometrial thickness between 9 mm to 13 mm has proved to be most conducive for implantation of fertilized ovum or blastocyst. Ovulation occurring when endometrium is just 5.7 mm is likely to end in 'no pregnancy'.So long as the follicular size is concerned, it has been reported for many decades that the ova discharged from the follicles of size between 18 mm to 21 mm are the healthiest one and give maximum fertilization rate and continuation of pregnancy success rate. Progynova is a synthetic hormone replacement for oestrogen. It is used to build up the lining of the uterus in preparation for embryo transfer during a thaw cycle for women who do not ovulate regularly. Hence in your case, it might prove to be effective in building up the endometrium. However, you should not wait for the ovulation beyond the follicular size more than 21 mm. If it takes longer for the endometrium to grow, you may waste this cycle and start Progynova earlier in next cycle and have ovulation at proper follicular size. I hope this information is useful to you for further decisions. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intermittent pain in hands and feet?\n\nI have intermitted pain in my hand and foot left fingers and half of the hand and foot. Sometimes it is accompanied by an electric shock. I am 65 male.my uric acid is 3.0,vitamin D is 39.3,vitamin B12 is 624,hgb.AiC 6.5,sodium 138,potassium 4.5rheuatoid factor 10.2,WBC 3.0,RBC 4.86, Hemoglobin 13.3",
    "doctor_response": "Hello, I have studied your case.Due to compression of nerve root there is tingling numbness in your feet and fingers pain associated with it.I will advise you to MRI spine for better diagnosis.It can be due to various causes like sudden jerk to spine, due to facet arthritis, degenerative, due to chronic systemic disease like diabetes or hypothyroidism.For these symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.I will advise to check your vit B12 and vit D3 level.Another possibility of peripheral neuropathy.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you are satisfied with answer do not hesitate to rate this answer at end of discussion. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My son is 6 month old and has been taking Amoxicllin for 5 days now. He developed a diaper rash a few days ago and now I realized it s from the antibotic. I don t think it s an allergic reaction because it s only on his bum. What is the best diaper rash cream to use?",
    "doctor_response": "Thanks for consulting at Healthcare Magic.Antibiotics like amoxicillin can cause diarrhea. Diarrhea causes wetness in perineum resulting in diaper rash.Keep your baby clean and dry by changing his diaper frequently. That may mean getting him up at night for a diaper changeRinse his diaper area well at each diaper change. You may use Cetaphil Baby Diaper Relief Cream or Nappycare Cream etc.If no relief consult pediatrician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "White rash on hands, no bumps, not red, not itchy\n\nMy 12 year old daughter has white rash to both palms of hands . never turns red. never itchy. no bumps or hard area. looks like someone who has been in a pool or bath to long. it has been several months. we have only had a few days where it was gone. not painful but she is self conscious about it. her pediatrician is stumped. we have no insurance so cannot afford to go to derm.",
    "doctor_response": "Hi..dear damary.., Thanks for choosing HCM.., Acording to Ur complaint .., it could be.....KERATOLYSIS...,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anxiety and depression while on Cymbalta\n\nI have been taking 200 miligrams of zolotft(sertaline) for several months but my depression and anxiety attacks were still a problem. Phychitrast added 120 miligrams of cymbalta. This started on Feb. 14. On Sanday, Feb 25 I started to feel very tired and lethargic. I continue to have that same problem. I feel empty inside. I have had trouble with drug combinations before. What do yo think",
    "doctor_response": "As per my opinion you should try another anti depressants drug rather the combination of two drug. I would like to know about your profile and go through blood investigation then I will shift you other drug.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility?\n\nAoa,i'm 28 year's old woman.i'm married before 4 years, after marry 6 month i'll pregrant but after 2 month my abortion. us k baad ab tak asa kuch nae.hsg test report may hy left ovary cyst hy or right tube block hy.so recently i take laprotomy of ovarian cyst. atleast before 4months. and taken 2 lucrin injections. i taking myfol tablet one an alternate day. please kindly tell me how can i make pregrant? which medicine i can use? how much chance to my pregrancy? please what can i do ?",
    "doctor_response": "do not worry.you are not having severe  problem.tubal blockage is treatable. go for it.take tab clomid. other medicines you are taking will also help you.i wish you will be mother soon.take care.hope my answer helped you.do not forget to give ratings to the answer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What casues arm pain after a massage?\n\nI have just had a sports massage and the girl doing it massaged my arm as it has been hurting. When she did it in a certain spot it sent tingling shooting down my arm and into my thumb and forefinger. She said that it felt like there was a bubble or something under the skin. What could it be?",
    "doctor_response": "Hi, This question could be best answered by the girl who gave the message as medically there is no such term as bubble under the skin. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get pregnant?\n\nhello mamam asha from hyderabadits been 1 year we are marriedwe are planning for baby nowwe started planning for baby from last junepreviously we used condoms so i didnt face any problem but from the time intercourse was direct i was facing infections and all with which we were away fro each other for about one month..........from the time we had direct sex i am gradually putting on weight and having ma misperiodsi went had gone through lower abdomenall scan and uterus scan everyhing is normal........what is the problem with me?i visted doctor last month she gave me tabletas for getting periods i got my periods on november 16........the last period was on september 14she also gave me  folic acid tablets and ovacare am using them form nov 16 2011she gave me other10  tablets to stat from dec 1 (i.e 16 to 25 day) can u tell me whats the correct dates  to have sex  we cant have sex daily coz both of us are working thrice in a week is OK for us",
    "doctor_response": "Hi Mrs Asha,Welcome to Healthcare Magic.I am Dr Ramadevi Wani. I will be answering your concerns.I wish you had given me some more information like your age, BMI etc.Dear, among couples trying for pregnancy, 80% of them conceive in the first year and 90% by the end of second year. So don't be worried. You will conceive.It is extremely important that you maintain normal BMI. Otherwise it can interfere with ovulation.I hope the infection is cleared now. If not you and your husband both need to be investigated and treated.As you are  trying for pregnancy since more than a year, I suggest you consult doctor and do your baseline hormone tests and HSG for tubal patency and semen analysis for your husband. Based on the results of these tests  further treatment can be planned.Do continue to take tab folic acid daily.To increase your chances of conception maintain normal BMI, quit smoking (if you're a smoker) and have intercourse at least three times in a week. There is no need to calculate the ferility period. It unnecessarily causes stress. having sex 3-4 times in a week automatically takes care of the fertility period.I hope this is helpful.If you have any further concerns do contact me through Healthcare Magic.Best wishesDr Rama",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are hyperventilation and and chakra ?\n\nMy brother of age 14, suffering from chakra atleast 2 times in a day. We consult to the doctors and diagnose it also but the doctors reply was Hyperventilation . That this is happened due to mental pressure . Doctor also done the EEG , But that was also normal. Could you plz tell us is this The hyperventilation or any other problem like cabbage insect",
    "doctor_response": "Welcome to Healthcare Magic Good day Hyperventilation is fast and deep breathing which decreases carbondioxide in the blood thus making the person dizzy. Various causes include Anxiety disorder, fatigue, psychological causes. Better to discuss with a Psychiatrist to help in proper management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for dark patches on face who is 11 months old?\n\nHi my baby is 11 months old & she gets windy a lot, specially during the night time & suddenly from past 3 days she has stopped taking any solid food, also some dark patches on her face, specially near her nose & eyebrow area as well on her neck? What could be the cause of this? Please help..",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pain while coughing and sneezing?\n\nThis is for Dr Ratnakar Kini This is a follow up to my question- have been having it o about a month.  Seems to hurt more when I lay down.  Hurts more when I sneeze, cough or yawn.  I sometimes get coughing sells and I sometimes get hoarse.  I have reflux.  They did so many tess at the ER, but I do not know if they did a echocardiogram.",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. Chest pain on coughing and sneezing is characteristic feature of pleurisy ( inflammation of pleura ). Pleurisy can be seen in pneumonia, tuberculosis, pleural effusion etc.So get done chest x ray to rule out all these causes. If chest x ray is normal, then no need to worry much. Stress and anxiety can be the cause for your symptoms. Stress can worsen reflux disease.So control of anxiety is needed in your case. Consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may require anxiolytic drugs too. Don't worry, you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to add on to the intestine ? Has this ever been tried before ?\n\nMy dad has had multiple intestional surgery's. He now has an ileostomy bag very high up on the small intestine. He is fine when on an IV but when off the IV he is not able to absorb enough nutrients to keep him strong. Malnutruition then seems to set in 48 to 72 hours after the IV is moved. I was told he has had quite a bit of his small intestine removed so the stomer is very high up. Is it possible to add on to the intestine???? Has this ever been tried before???",
    "doctor_response": "Hi... I have heard of intestinal transplantation that has been done for patients with intestinal failure.. But the centres and the number of such procedures done have been limited due to the obvious reasons of availability of a donor.. I am not very sure of this option would be available to you, but this is definitely a possibility of treatment...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in leg\n\nI experience pain in my left leg while in bed. When I am active, I have little or no discomfort. Sitting can also cause pain. At times the outside of my left calf is on the verge of being numb. I sometimes have tingling in my left toes. Strangest of all is that it feels I have sticky paper on the sole of my left foot just below the toes.",
    "doctor_response": "Hi Hope this message finds you in good health.I have gone through your complaints and understand your concern.I generally see many cases like this at my clinic.i generally give them rest analgesics,exercises,physio etc.if it doesnt get better,i advice an mri done to find out the cause.U seem to have compressed a nerve in the back somewhere that might be causing radiating pain in those regions.Possibility of a lumbar disc prolapse or another disc should be kept in mind.I suggest you get an Xray as well as an MRI to find out the exact cause.Physiotherapy,analgesics,anti-inflammatory drugs should help.Avoid surgery as far as possible.If at all its needed,get it done endoscopically..Nothing to worry about.Do get back to me after ur mri reports are ready.\u00a0\u00a0\u00a0\u00a0\u00a0I hope your question has been answered.If you have any follow-up queries,feel free to consult me anytime.Thanks,Take care,God bless.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could there be a correlation between long showers and low IQ?\n\nis there a correlation between long showers and lower IQs and other health issues given the fact that trace amounts of various chemicals, including but not limited to: flouride, metallic deposits & arsenic, are not only in constant contact (making the trace amount factor multiply exponentially) with the skin for absorption but also vaporize and enter the lungs and brains",
    "doctor_response": "Hello,Up to date there is no relationship found between long showers and lower IQ. This is assessed by studies carried out for low IQ and its possible causes.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for itchy and swollen eyes due to an allergic reaction\n\nhello, For the past few months I've been experiencing an allergic reaction to an unknown source in my bedroom.  I've cleaned and cleaned, taken benedryl at night and eyedrops for allergies and finally am sleeping in the living room in hopes of escaping the allergen.  I wake up with swollen, itchy eyes and my eye lids are inflamed and the skin began flaking.  Since sleeping in the other room and using some cortizone my eyes have cleared up but I have noticed a small hard bump appear between my left temple and my eye. It is about the size of a pea but the hardness has seemed to spread to about dime or nickle size and is slightly painful to touch.  It feels like my temple is buised but there are no signs of bruising.  just this strange bump. I don't have insurance and cannot afford to go to the clinic to be sent away with a big bill and no answers. Can you help me?",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your history and would like to make following suggestions to you:1. Were I treating you, I would prescribe you montelukast and levocetirizine for at least 2 weeks.2. Should you have any of the following symptoms - swelling in throat, giddiness, suffocation, breathing difficulty, vomiting, abdomen pain, etc, please contact your doctor immediately.3. I would suggest you to observe your daily foods and correlate them with your symptoms.4. I would suggest you allergy testing to identify the substance which may be causing such reaction to you. Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bumps on penis\n\nmy brother is 11 years old and is a virgin (he is circumcised), he has two small painless ulcers on his penis that doesn't itch. we are from europe but have now been on vacation in a hot country for three weeks and the hygiene hasn't been good. what can this be? Thank you",
    "doctor_response": "HelloThanks for query ,Based on your statement I would say that your brother has developed infection of the glans penis (Ballanitis).He needs to take  broad spectrum antibiotic like Cefixime along with anti inflammatory drug like Diclofenac twice daily .along with topical antibiotic ointment like Neosporin twice daily.Ensure he washes his  genitals with warm water twice daily.I think this will work for him .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bleeding and spotting during pregnancy?\n\nim pregnant for 14 weeks now ,i start bleeding from 7 week of my pregnancy till now ,some time is heavy bleeding and some spotting and every time when i had heavy bleeding i went to hospital and they did ultrasound to me ,they said every think is fine and baby is fine and they didnt know the source of bleeding and my doctor said we dont know the cause of bleeding,im afraid from that bleeding ,can help me to understand my case",
    "doctor_response": "Hello dear,I understand your concern.It's good to know that you have all the reports normal.In my opinion there are various causes for bleeding during pregnancy like :-1)Thyroid abnormalities .2)Progesterone insufficiency.3)Abnormal pregnancy like miscarriage or ectopic pregnancy.4)Bleeding from cervix.etc.So as per your information all the above causes might have  been ruled out by physical examination and necessary investigations.Ultrasound helps to know the well being of fetus as it is normal you need not worry.Don't worry in some cases even though with the presence of bleeding everything will be normal and pregnancy continues till term and have good outcome.May be the bleeding might be from cervix.Anyways relax.Avoid physical stress and intercourse.Take prenatals and progesterone supplements.It might subside spontaneously.Take iron rich diet and iron supplements to combat anaemia caused due to bleeding.Hope this helps .Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Arousal, erection and itchiness in scrotum with pain, occasional ejaculation on holding girl's hand. How can I overcome this?\n\nHi doctor.. I am getting excited even when my girl friend just holds my hand and walks with me. i have no intention of having sex with her now. But when ever she is with me or even when she holds my hand and walks, my penis gets hardened and i have this itching sensation in my balls and an hour or so a pain in my balls and penis. Ijust have to leave from ther giving some excuse. I am truely in love with her. Initially i thought since this was the first time i touch a girl i feel so. BUt this happenes everytime i am with her. My penis leaks at times then. i browsed net is this called premature ejaculation?? I used to mastrubate before (say a year back )but now i dont do that. Has it some thing to do with it.?? I need ur help doc. Please help me overcome this. Is this curable.?? i just want to spend some time with her with our all these pain and problems.!!",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.No this may not be a premature ejaculation. Its normal for a boy to get stimulated leading to the some pain and seminal leakage. There is no need to worry. masturbation is also safe and there is no problem. This thing will settle down with time. You may even masturbate before meeting the girl which will reduce the stimulation and you will be comfortable. Team is the best healer in this case....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, or want to further details about your query, you can use the below mentioned link:bit.ly/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "26 year old addiction eraz ex correction fluid and there is a change in his behavior. Is this a physiological problem ?\n\nhi doc, my brother whose age 26 year. three years before he started smell Eraz-ex correction FLUID and this time he is totaly addicted. i feel so many changeg in his behaviour. he is always talking about money .he is not intrested to do any kind of job.when he is not take fluid he looking norml.his behaviour is aggresive. he drink alcohol bt in limit.doc he says always abnorml thing like Amerika president OBAMA won ellection with my support. he always coorelate him to any kind of TV news . he says that he handle all over world. plz tel me what we do? hi has mentel problem, depression or addiction i dont know.",
    "doctor_response": "Hello........ Thanks for your query. Erazex fluid contains toluene, an addicting substance. It is notorious for causing psychological changes as well as neurological deficits. Hence, i would advise you undergo an evaluation by an addiction specialist so that suitable anti-craving agents as well as psychotherapy (eg motivation enhancement to quit substance use) can be suggested. I would advise to do this on urgent basis. Regards Dr Sundar Addiction medicine specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rashes on hands torso. Swollen lips hands prescribed prednisone. Could this be an allergic reaction to cefdinir?\n\nI have a rash on hands inside and out.  Rash on my torso.  Swelling of hands and lips.  When my hands swell the  veins bulge and hurt.  I can breathe freely no swelling in the throat.  This has been on going since 11/11/13.  The walk in clinic Dr. presribed Prednisone.  Does not seem to help.  Could this just be an allergic reaction to Cedinifir? I had just finished a two week treatment.  No prior allergic reaction to any drugs.",
    "doctor_response": "HiIt could be a urticaria, allergic reaction to cefdinir. You should take a antihistamine drug like cetrizine 10mg once daily also for 5 days. prednisolone also you can continue for 5 or 7 days.Use calamine lotion for body.It will give you soothing effect.Hope this may help you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to relieve acute knee pain\n\nmy wife 69 years suffering from accute knee joint pain, unable to bend left leg. swelling on leg palm . when she rest no swelling but when she stand and work in kitche swelling increases. for many years she suffer this. 2 years back she fell on huting her knee since then knee joint pain . what is remedy. have done kerala ayurvedic treatment. but not much relief.",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.You may be suffering from osteoarthritis of knee joint as pain on walking and standing and not on rest and it is common in your age. You are likely to get benefitted by glucosamine and analgesic such as ibuprofen for pain relief. Your swelling can be related to your circulation and heart condition. You can get your your heart check up and take treatment accordingly. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the white strings hanging after a tooth extraction be due to dry socket?\n\nHi I just got a tooth pulled at 4 pm today and I didn't form a blood clot and all I see is 2 little white strings hanging out does that mean I have a dry socket he told me I will probably get that sense I didn't form a bloodclot I'm really worried please help",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. Please do not take tension,  as the blood clot which forms in the socket will not be visible to you and dry socket does not form in one day and even there is severe pain in dry socket. These strings can be of the gauge piece which dentist places after the extraction to stop excessive blood loss.But if you start with severe pain and swelling,  then you can think of that. Till then you should continue with the medications.Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes discomfort in loin when suffering from fatty liver?\n\nbefore i was diagnosed of a non-alcoholic fatty liver, and after 3 mon ths, it was lowered in my last lab test results, now i felt uncomfortable in my left loin (on anf off). what it could be? sometimes my left eye have qutie pain (but not really pain). thanks",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Loin discomfort is not directly related to liver diseases. It could be due to some renal stones which can cause similar symptoms. Get an ultrasound scan done to rule out stones. Inguinal hernias can also cause, loin discomfort. Look for any swelling pops up while coughing or straining. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a prolonged tooth infection cause liver damage?  The reason I ask is I have recently developed a band of red on the right side of my stomach that is hot to touch, but have no other symptoms other than an infected tooth (3 weeks infected, now taking amoxicillin).",
    "doctor_response": "Hello and thank you for asking HCM.I have read your symptoms and i understand your concerns.I don't think that the infection of your tooth damaged your liver. The liver can be damaged by an infection,but it need to be spread all over the body, (we call it sepsis) and the patient would be in serious conditions and have a lot of other symptoms,like low blood pressure, high fever,polipnea ect,this is not in your case.In your case, the red band in the right side of your stomach that is hot to touch, is probably skin rash that is caused by the varicella zoster virus or cellulitis or some other skin infection. Starting antiviral medicine right away can help your rash heal faster and be less painful and you can use ibuprofen for the pain (for varicella zoster,or antibiotics for cellulitis ex). I suggest you check up with your family doctor to see the red band that you describe,and if its from varicella zoster/cellulitis,he will give you the prescription with antivirals/antibiotics and some pain reviler. If you have any other question,feel free to contact me.Dr.Endri Katro",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump on the buttock\n\nHi, I have a lump right underneath the surface of my butt cheek and I was wondering what it is. I haven t fallen or done anything to cause one to be there, it just sort of appeared there and the spot where it is has slowly gotten more tender and painful to sit on. I can feel the lump when I touch it, but you can t tell there s anything there from looking at it. It is pretty small, maybe a bit wider than my index finger",
    "doctor_response": "Hi ! Good evening. I am Dr Shareef answering your query.Although it requires a clinical examination to opine on the lump, from the history it seems to be an infected lump, ranging from a simple abscess to a pilonidal abscess in the area. I would advise you to get it assessed by a general surgeon in your area for an appropriate management. Till then, you could go for an anti inflammatory drug along with a proton pump inhibitor for a symptomatic relief.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for painful ankle and knees\n\nHi I reacently started playing sports again and every time I run the area right above my ankle up to my knee feel as though they are ripping away from the bone but only in the back of my leg. I\u2019ve tried rolling them out, stretching better, hot water soaks and nothing seems to help! Should I be concerned?",
    "doctor_response": "Dear patient you may be having stress fracture of tibia. this occurs due to unaccustomed activity and overuse.You need to take rest. Diagnosis can be confirmed by mri of the leg. Rest for at least one month. Start tab diclofenac sodium 50 mg twice a day for pain relief. After complete pain relief you should start again with slow and progressive increase in workout.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Finished medicine course for kidney infection, have intense itching and rash. Cause?\n\nI have recently been treated for a idney infection that showed e. coli . I finished the antibiotics and I feel it is not completely gone as ow I have intense itching and a rash and I am still tired and a little weak. I am trying to get a hold of my doctor and repeat a urine sample as they said I may need intervenous antibiotics. Can you get intense itching from a kidney infection?",
    "doctor_response": "Hi welcome to HCM. It can be a side effect of the medicines. Stopping the medicines and anti-histamine medicines should help. Intravenous antibiotics are usually given when oral medicines are not effective or if there is fever. Weakness is due to the infection as such and you should recover soon after the infection is completely eradicated. Best regards DR GS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for flatulence and acid reflux in child\n\nhello my girls are preemies that are a little over two months old not corrected age and they are having issues with gas and reflux my daughter piper has had white hardish flecks in her poop what would that be from oh they are on neosure simalac",
    "doctor_response": "Hi,Thank you for asking question on health care magic.Premature children usually have gastro oesophagial reflux,Because of patency of cardiac sphinctor,regurgitation of feeds from stomach to esophagus.AS they grow old this will gradually subside.For normal babies it disappears by 6 months .for prematures it may continue up to one ear or even 18 months.Thickened feeds in propped up position will reduce the reflux.Perinorm drops may help.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could Endocet, Oxycodone and Acetaminophen cause heart attack or stroke?\n\nI ve taken 5 endocet pills at once, now these are the 5mg oxycodone with 325 mg of acetominophen....is it possible that it could cause a heart attack or stroke? I know you cannot exceed 4grams of acetomino[hen a day, but 5 endocet doens t contain that....now i don t have any history of heatr problems, but i am having a slight pain in my left side fo my chest but its more towards my shoudler really...I think I might just be having an anxiety attack but i just want to make sure thats itsnot a heart thing....can you let me know?",
    "doctor_response": "Hello ThereAfter going through your medical query I understand your concern and I would like to tell you that your current meds will not cause you heart attack but your lifestyle can( if it\u2019s sedentary).  It\u2019s recommended for you to get an ECG and an Echocardiography done and consult a physician with reports for further treatment.Hopefully this information will guide you properly.Kind Regards Dr Bhanu Partap",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for getting pregnant\n\nhello doctor,i had my period on 10/7/11.and follicular study on 12,14 days.active follices on left side 15*14,12*11.i have used susten200mgon my 15day but did not conceive?this month i had my period on 8/8/11.my doctor advised me to take clofert50mg(5 tab) on 3rd day of cycle.and advised me to take hucog5000iu injection on 10,12,14,16,18days of cycle and susten (15 tab)from my 15th day of cycle.will this medicines help me for getting pregnant this month please help me doctor...",
    "doctor_response": "Hello,Yes it will. You do serum TSH and serum prolactin and HSG on day 8 or day 9 of cycle. Then do serial follicular study until follicle size increases to 18 mm then follicle rupture occurs after taking Clomiphene with gonadotropins as per gynecologist then IUI for early results.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sheetal Agarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for multiple hip cysts while suffering from cervical spondylitis?\n\nI have had a bad fall 2 1/2 years ago have cervical spondylitis and herminated discs really painful shoulder and neck now found out ive got signs of small vessel ischaemic discease on the right side can this be caused by the trauma as mostly the damage is on the right side of my body I have also got multiple hip cysts on the right hip and ive as well got indention of the theca in my cervical level which hurts when I breath",
    "doctor_response": "Hello,Thanks for your query.After going through your query I came to know that you are suffering from cervical spondylitis and herniated discs.Now you are diagnosed with avascular necrosis(small vessel ischemic disease )of right hip.You want to know that can these all be due to trauma. In my view these are not related to trauma .Cervical spondylitis is a degenerative disease(aging),fall can be precipitating factor for herniated discs.Small vessel ischemic disease(avascular necrosis) is generally idiopathic(unknown cause). You can discuss with your treating Doctor about it.I do hope that you have found something helpful and I will be glad to answer any further query. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bluish lump on the arm with pain?\n\nOkay I have a lump it s not very big.. I looked at it an it s like bluish black! And I was squeezing it before I actually looked at it and it sticks out a bit.. And I kept like squeezing it but no puss or anything like that comes out just blood.. And it hurts when pressure is applied. It s squishy to and it s in my skin. Like when you like grab it in the skin. And you squeeze it sometimes it feels like when you pop a zit. But in my arm in the lump.",
    "doctor_response": "hi,dear friend,thanks for sharing your problemas you detailed here, you may have infected sebaceous cyst or developing abcess but it need more detail from you. abcess at developing stage causes imflammation and pain and after few days pus may form.so first you consult your family physician and start primary treatment.thank you for sharing queries.please share for any other queries.get well soon dear friend.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Earlier had high liver enzyme levels. Now have high ESR levels. Reason?\n\nI recently had some blood tests done and found I had a high enzyme level on my liver . The doctor put this down to heavy drinking over the festive period and asked me to book in for a secondary set of blood tests in order to confirm this and hopefully see the levels drop and asked me to stop drinking. I have now had my second set of blood tests results which indicate high ESR levels but they were ok in the first set of tests? Since my first set of tests I have gone back to the gym and lifting heavy weights as well as having a large volume of protein shakes in and between gym sessions. Could this be a reason for a high/abnormal ESR levels?",
    "doctor_response": "Hello, kevismename, I fully agree with your doctor that asked you to quit drinking and do the testing of your liver functions to see if you had caused any significant damage by binge drinking of alcohol.I am assuming that all the liver tests did come back to normal levels on your repeat tests. You mention that the ESR came back high. ESR is very non-specific, eventhough elevation may indicate some infection or inflammation somewhere , it can also be elevated after rigorous physical activities. (Muscle strain). Large quantity of protein shakes is not the cause of this. Make sure you also take a super B-Complex Vitamin daily. No binge drinking , remember ,liver damage can happen even if you only drink on weekends. I wish you well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How medication is recommended for depression, OCD and anxiety?\n\nHi I am chandra Shekhar rai age 33 I am taking medicines since last 12 yes for depression and ocd .some time I feel OK but in between I feels problem like laziness poor concentration anxiety continuous thinking irritation repeated thought of bad old days I feels weakness in doing my routine task lack in memory I lives many jobs in those days I m very much worries 4 future some times I want 2 die but never attempted some times I weep.I lay on the bed 4 long time I want 2 live alone I become less social due to my these problems . I feel 2 loose common sense some time I feel agrassive but some time very low I feel confused in doing any task some time I feel mind is not working properly heaviness in head some time I forget things most.please help me I will be grateful 2 u",
    "doctor_response": "Hello Mr. Chandra Shekhar, I am sorry that you have not been feeling up to your optimum for so many years. I am hoping that you are in regular touch with your treating professional to gain advice about your medication? I believe that besides medication for depression, stress, anxiety and OCD, you may benefit with an ongoing supportive counseling protocol.Sadness is a common emotion. It\u2019s a \u2018customary\u2019 reaction to loss, failure, rejection; all of which are inevitable in everyone\u2019s everyday routine existence. All such situations involve pain and the blues they cause are warranted. But staying sad for too long, letting the sorrow engulf you, and inability to snap out of it is not justifiable. That\u2019s the difference between sadness as a passing emotion; and depression as a disorder that needs attention. You cannot ignore your symptoms because they are affecting your life in totality now.Your continuous mental pain must be seriously influencing the quality of life and the you may actually feel that life is really not worth anything. But you need to move out of this mindset and look around to find things that interest you and give you reason to move on. Sleep, appetite, fatigue, laziness, stomachache, indigestion, diarrhea, and headache; even osteoporosis and cancers are linked to diminished immunity owing to depression and stress. The mind and body work in synch; to get the best outcome, both need to be nurtured and nourished else one or both of them give way and sanity get out of hand.I think you must seek professional help and consider psychotherapy (Cognitive Behavior Therapy-CBT, Rational Emotive Behavior Therapy- REBT). These are time tested to work, and require active participation from your side. Do reach out anytime for further help if needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal cramps, lower back pain, irregular periods, tubes tied. Treatment?\n\nhaving abdominal cramping..lower back pain ..if i had to describe it i would say feels like a contrcation and comes in waves..i am 48 period comes ang goes been irregular for about a year now and tubes are tied..",
    "doctor_response": "Hi Thanks for posting your query Your history is suggestive of painful periods and inflammation in the pelvis This is common when you are approaching menopause You should consult your Gynecologist for a proper hormonal assay and get an ultrasound to rule out any fibroid like lesion in the uterus Hope this helps Am available for any followup queries If there are no further doubts, do accept my reply and rate it Get Well Soon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is burning sensation on left side of tongue and thickness on cheek related to root canal ?\n\ni have burning sensation on the left side of my tongue and its been for a while.  i have thickness feeling on mylett cheek not sure what is this...my doctor said i have herpes (a year ago).  i have a 2 root canal in my upper front teeth. please advise... thanks-che",
    "doctor_response": "Hi,Thanks for asking the query,No not related.Get a checkup done once.At home take lukewarm saline rinses.Take multivitamin suplements.Maintain a good oral hygiene.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Fluconazole interfere with Flomax?\n\nI am currently taking flomax for urine retention issues. I also have a yeast infection in my groin area and my doctor is recommending i also take an oral fluconazole. I read that fluconazole can interact with flomax and that a reduced level may be required. But it didn t say if I need to reduce the flomax or reduce the fluconazole. What is the recommendation course of action here?",
    "doctor_response": "Hello, Fluconazole and Flomax do not have a known interaction. You can continue taking both medications the same. You should not be worried. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for breast , colon and lung cancer\n\nMy mother is 70yrs old.  She has had breast, colon and just diagnosed with lung cancer. She is diabetic. She has heart problems and kidney problems.  She is suppose to have surgery to have the cancer tumor taken off her lung.  They canceled it because she was anemic and dehydrated.  Now her legs from her knees up to her abdomen is swollen about 3 times their normal size.  All of these doctors do not seem to agree on anything.  No one really seems to know why she keeps swelling up.  Does anyone have any ideas?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Your mother has breast, colon and lung cancer. Moreover she also have problem with kidney. So her swelling can be due to kidney problem. Surgery should be avoided in these cases. Chemotherapy and radiotherapy can be used but it is just palliative treatment. It will not cure the disease. Prognosis is very poor and life expectancy is not good. Consult your doctor and plan accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Problem with projection of teeth, also I don't have four molars. If teeth is taken out then can dental implants be used there ?\n\nhello doctor , i am now 21 years old.i had done dental treatment done almost five years ago.i had a complicated problem.by birth my lower jaw was inside.When i went to treatment it was brought forward using twin blocks.Then braces was used to bring it back.It ended as okay.After one year settled teeth came forward.Then it was fixed using retainers.But the problem is there is still projection of teeth.It is not much visible from outside.I am not able to smile well or talk with confidence .I visited a dentist .He told me the only possibility is to take off four teeths .two from above and two from below and then put on braces.Is it possible. If teeth is taken out then can dental implants be used there.also i don t have four molars.Actually the teeth is still inside.i have asked about it to a doctor.he said it is better if it remains there since i dont have any pain or disturbance with it.will this make problem.Can you recommend any treatments.I am considering doing braces again.I am thinking of doing treatment after 2 years since I am doing my p.g.will that age be correct for treatment.",
    "doctor_response": "Hello friend. As per your symptoms you are having orthodontic relapse. After finishing the orthodontic treatment the teeth tend to move back to its original position, so a retainer is given to patient (removable or fixed) to hold the teeth in the new position. According to American standards it has to be given till the age of 22. At this age the growth of the body stops completely. Now that relapse has occurred in your case, you need to go again for orthodontic therapy that is fixed or removable depending on the severity. If minor correction has to be done better go for removable. If enough space is not there to align the teeth then to gain the space extraction of premolars (to gain more space) or proximal stripping (to gain less space) has to done. And yes, orthodontic treatment can definetely be done at this age. Its called Adult orthodontics. If you have photographs of your teeth plz send me to dentist@ravishah.co.in to recieve more advice.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is this throat cancer?\n\nI have dry mouth from taking WellbutrinXL. I have had sores in my mouth on the right side for the past 10 weeks. I have never smoked or drank alcohol. I had this in November too but 10 days of Keflex cleared it up. I took Keflex again 6 weeks ago and the condition improved but didn t go away. Is it throat cancer? I m a 60 year old female. (My father died at age 58 from toncil cancer but he smoked heavily) Thank you! Tricia",
    "doctor_response": "Hi,Tricia,wellbutrin is known to cause dry mouth  as you are aware.Multiple sores in mouth repeatably might be due to some nutritional deficiency.Keflex is an antibiotic which can help only in case of infection.It will not work in absence of infection.Please ge in tough with your doctor from regular vitamin supplementation which will take care of this current problem.From symptoms it does not seems to be cancer,but still after examination your doctor can throw more light on it.bye and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest possible medications to improve chances of conception\n\nHello Doctor.......... I have been married for 7 months and want to become pregnant but my problems are before marriage itself i had irregular periods . i did not take it so seriously to consult a doctor but now i really want to become a mother....... can i become pregnant????? plz help me .....",
    "doctor_response": "Hi,   Thanks for asking. I  understand your concern.   * The first line treatment is giving threee cycles of oral contraceptives.. which in turn correct menstrual cycle following the course.This most of the times helps in conception within few  months.  *In case there is no improvement &conception  you need more specific investigations &treatment. Please contact a gynecologist.    Plese don't worry.. your periods would be normal &ovulating soon... &you will conceive too!Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach problems and burning sensation after urination\n\nDear doctor, hi my doughter (8 years old) having porblem in stomack as well during urine time who suffering burn and lot of pain.consulted to the doctor as recommended for some test as blood and urine in which urine test shows positve result  will you please write me what can cause of this and what is the remedy?",
    "doctor_response": "Hi...By what is quote I put forth these possibilities - 1. Urinary tract infection.2. Calciuria or Oxaluria.3. Renal stones.4. Cystitis or inflammation of the urinary bladder.But I need to see the urinary report which you are quoting as I do not know what is positive in it.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red rashes with breathlessness?\n\nI am 13 and in the past 2 days I have gotten a red painless rash all over my arms and on my thighs. Today I was laying down and suddenly I found it difficult to breath. That lasted for about two hours. now i feel my heartbeat in my palms. What is wrong with me?!?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Red rashes on body, sudden onset breathing difficulty, palpitations etc are suggestive of allergic reaction more. So you will need antihistamine (levocetrizine or fexofenadine) and anti allergic (montelukast) drugs.Inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone) are needed for breathing difficulty.So consult doctor and discuss all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can bug bite be the cause of stomach pain?\n\nhi doctor i have this insect bite on the side of my hand and its been there for several days and doesnt seem to improve and still hurts alot. my question is that last night i woke up with sever stomach pains that felt like my stomach was swollen of full about to pop i was wondering if the bug bite could be the cause of if its something else?",
    "doctor_response": "if the site of bug bite is not improving in several days you should consult a physician as soon as possible because it can get infected as well as toxic substance of bug can cause necrosis.your stomach ache is also may be due to that bug bite because you may be suffering from stress induced gastritis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain due to missing of meals, gastritis, home remedy effective. How can it be treated?\n\nHi I m getting pains in my stomach iv had them now for few years but were very seasonal. The pains have now come often weekly or two weeks lasting few weeks and are painfully. Doctors say it can be gastritis and I need to eat properly. I do miss meals due to my job but even if I m slightly off schedule to eat my pains come and stay for days or weeks. These pains are not effecting my eating but can be painfully. The pain is usually all around my stomach and can be all over as well. It does come as high as my bottom half my chest and doctors put that down to acidity flaring up. The only way I feel relief is getting the stomach massaged by my mother who uses some old fashioned techniques the rice the gas and I must admit it does get better until the next time I miss a meal.",
    "doctor_response": "Hi! If the pain comes whenever you miss your meal, it is probably due to hyperacidity. However, to exclude other pathology giving rise to such severe pain , your family physician may advise you for an ultrasound abdomen. I would suggest you to have your meals in time and regularly to avoid such pains. For some time you may be advised to take some proton pump inhibitor and prokinetic drugs to reduce the acid. If it increases in severity, then your doctor may also advise you for a endoscopic evaluation of your upper gastro intestinal tract.Wishing you an early recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for extreme behaviour due to bipolar\n\nhi, i suffer from bipolar and am currently feeling very low with violent outbursts and self harming. I got diazepam from my doctor but they are not keeping me calm or helping with my anxiety. I have got a meeting with my psychiatrist on thursday, but have just cut my arm again and dont know what to do. It is not deep and does not require treatment, but I am scared of myself",
    "doctor_response": "Start taking mood stabilisers like divalproex sodium. Please discuss with your psychiatrist about your symptoms that whether or not you have symptoms of borderline personality disorder.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will a person with BP and diabetes able to withstand chemotherapy?\n\nMy name is swati from bangalore, My 68 year old mother has been diagnosed with tongue cancer last tuesday. Iam very worried about her. One oncologist says that the tumour is localised and he will do surgery for 1 and 1/2 hr and remove 30% of the affected are. another oncologis says that it is going to be 9 hour surgery and he eill remove 1/2 of tongue, reconstruct and then give her chemo. I am reading about chemo and radiation and i am so scared. Will my mother who has diabeties, hypertension will be able to withstand chemo/ radiation. Please advise",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. If your mother has tongue cancer then treatment of choice is surgical excision and reconstruction of tongue by plastic surgery followed by chemotherapy and radiotherapy.  If your mother has diabetes and hypertension then risk is high but if her general health is good then it is manageable.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Betaseron and Ampyra. GFR decreasing due to medications. Should I be concerned?\n\nI am 53 with MS. I am on Betaseron and Ampyra. My GFR in June of 2011 was 62.1, January 2012 was 55.4, May 2012 was 75, November 2012 was 58 and last week was 52. I started Betaseron in April of 2012 and Amprya June 28th 2012. Should I be concerned that my GFR is decreasing due to the medications and why is there such fluctuation?? MDW Mom",
    "doctor_response": "Hi Welcome to HCMBetaseron is an one of the effective treatment for MS, however decrease in GFR (decline in kidney function) has been reported in conditions such as hypertension, diabetes. If you experience dizziness, headaches, flashes of light please consult your primary physician for a consult. However, looks like your GFR was already lower before you started with the fore-mentioned drugs indicating that the drugs may not be the reason for your lower GFR. I will advice you to consult your doctor if your GFR decreases further. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever along with puffy eyes?\n\nMy 7 year old (good health, average height and weight) has had a fever of up to 103.6 for the past 5 days. no other symptoms, I have been treating the fever when it gets up to 101-102 otherwise letting the body do it s thing with plenty of fluids and rest. Went to dr today, they did lab work and determined its not bacterial, its a virus. Fever still, controlled with motrin and tylenol, and now he developed a welt under his left eye. Started as a pea size and grew to a quarter in an hr or so, it looked full of fluid. Now the welt (hive) has dissipated to puffiness around the eye. Should I be concerned about this new development and take him to ER or is it likely the virus and not something to worry about?",
    "doctor_response": "HI...I have just read through your query. What started as a viral illness might have been getting secondarily infected and the puffiness around a single eye and with fever cannot be just ruled out as allergy or welt. I feel she might be developing a peri-orbital cellulitis or soft tissue infection around the region. i suggest you get back to your pediatrician or nearest emergency room immediately as this will require antibiotic therapy.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning in penis at the junction of testicles?\n\nOk, my penis has had a slight burn going on for a few weeks now. It does not have any discharge, and when I pee the burning stops somewhat. It just has a pain kinda where my penis meets the sack area, but inside the penis itself. Also, I dint know if this has anything to do with it, but my left testacal feels like it's under pressure.",
    "doctor_response": "Hi, If you had unprotected sex - need to rule out sexually transmitted infection. If not, it can be due to urinary tract infection - doing a urine culture can help.  It can be due to renal calculi - doing a ultrasound pelvis can help diagnose it. Mild pain killer can help until diagnosis. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medication to hard painful lump inside the mouth\n\nHello,  I had my wisdom tooth removed 7 days agoo. I was really swollen but for the past two days its been a hard lump painful and spitting out yellow liquid that numbs my tongue   I went to a different dentist they said the lump is a concern and I should go back to my dentist.  I couldn't even get my mouth opened wide  enough to take a look. Why u happen to have any reasons this may be",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,    I have gone through your query as you have undergone wisdom tooth extraction dont worry after extraction of wisdom tooth it happens due to bacterial infection .  You do warm saline gargle two - three times a day  Take proper course of antibiotics as prescribed by your dentist  Consult your dentist again and go for Irrigation of socket . Hope this will help you.  Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ED\n\nHi doc i am a boy of 17 years old and i have had ED for a good year now and i have thought of all the possibilities, and one of the conclusions i have come to is can having a laptop on your lap everyday for a good while have an effect on erections? I can get an erection but it is not as strong as it should be and will become flacid in seconds.My problem is very embarrassing and its taking away my sexual youth.",
    "doctor_response": "Hello, The laptop usage and putting over thigh has no correlation with erectile dysfunction. Usually after a few seconds or minutes of erection if sexual stimuli decrease than erection lost. But if you feel erection is not proper in this few days than you have to consult a psychiatrist for detailed evaluation. The excess stress, obesity, spinal problem, prostatic problem, smoking etc some of the causes. If needed your doctor will suggest you investigate with doppler penile angiography as well. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in chest & under breast?\n\nI get these stabbing pains in my chests often. That seems to pass right through into my back. Breathing hurts, but I can breath. I know it's not gas since it's above my chest on my left side mostly. Rarely on the other side. Or sometimes right under my breasts. It's scary when I get it, especially when I'm driving, because I tend to ball up when it strikes. What could be causing this?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Since your chest discomfort is associated with specific position (driving position), possibility of muscular spasm and musculoskeletal pain is more for your symptoms. But better to first rule out heart related diseases because left sided chest discomfort is common in heart diseases. So first get done ecg and 2d echo. If both these are normal then no need to worry for heart diseases. Follow these steps for better symptomatic in muscle spasm. 1.  Avoid movements causing pain. 2. Sit with proper back support while driving. 3. Apply warm water pad on affected areas. 4. Avoid bad postures in sleep. 5. Avoid heavyweight lifting and strenuous exercise. Don't worry, you will be alright with all these. Hope I have solved your query. I willI be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the glucose and protein found in the urine?\n\ni went to the hospital for my normal check up today and they found glucose and protein in my urine and told me they cant wait a couple of weeks for another urine sample and have to go back thursday im just a bit worried now can you please tell me what they may be concenerd about",
    "doctor_response": "Hello, in a normal person's urine ideally tere should be no glucose or proteins. But as there is glucose and proteins in your urine it can show that you what we call as glycosuria and proteinuria. Glycosuria is seen in patients with diabetes mellitus. Proteinuria is seen in patients with nephrotic syndrome. They might have called you back to get repeat check of urine alongwith tests like diabetes check in form of fasting blood glucose and other renal parameters. So just follow up with the doctor and get it checked. Dont worry even if any thing is there diabetes and nephrotic syndrome is controllable with regular medications and proper following of instructions given by your doctor. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the discomfort in chest with 10% blockage?\n\nHi,  I have been having chest pain and discomfort, after further investigation I have a very slight !0% blockage in my heart.  Specialist says this isn't causing my discomfort.  However, it has been noted I have excess clasification on my chest for my age, have been told to see a bone or muscle spcialst, im so confused and fed up.  what could my problem be, I carn't get any answers",
    "doctor_response": "Hi thank you for asking in HCM.According to history the second step is to rule out lung problems and better to do:Chest X raySpirometryIf they come negative so your concerns go for a chostochondritis,or a myositis.CPK blood test for the last oneAnd then after having the results you should see a rheumatologist specialist for further work up.Thank youDr.JolandaPulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does these blood results for painful heel indicate?\n\ndear doctor i have pain in my right leg heel since from 8 months, right leg ankle and knee since from 3 years. basically pain was less but it was increasing now day by day i ve consulted to doctor got test which is as follows:- alkaline phosphate(alp)serum76.00 u/l calcium, serum 9.50mg/dl phosphorus, serum 3.50mg/dl vitamin d 25-hydroxy, serum 36.43 nmol/l vitamin b12;cyanocobalamin,serum 287.00pg/ml glucose fasting 101.00 mg/dl glucose (pp)115.00 mg/dl my doctor suggested to take tayo 60k tablets for 10 days (1 tablet a day). pls suggest",
    "doctor_response": "Hello!Some of the test results (related to Calcium metabolism) are a little above minimum.You can continue using Tayo tabs., but X-rays of heel, ankle and knee joint are recommended.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a surgery required for the bicuspid aortic valve?\n\nI recently discovered the my husband is having bicuspid aortic valve and the size of aorta is 4.0cm and the left atrium is of 3.9 cm and for left ventricla ESD=3.8CM,EF=65%,PW=1.1CM ,IVS=1.0CM, FS=36%.What to be done is this the severe one or do we require surgery please help.....the age is 32 years and weight is around 75.",
    "doctor_response": "Hi,If he has severe aortic stenosis or aortic regurgitation, then surgery is needed. Otherwise he needs only follow up and infection prophylaxis.Take careCome back if you have any further questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for persistent mouth ulcers\n\nMy wife has mouth ulcer since two years. She also tested bipsy  in safdarjing Hospital. She never take any pan masala or tobaco. she was treated in LNJP Hospital And safdarjing Hospital from 2009-sept2010. Now she was takin aurvedic medicine. please advice me what i do.",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain persisting mouth ulcer for 2 years can most probably be a malignant ulcer and as you have got a biopsy done the biopsy report needs to be understood along with clinical evaluation to rule out the exact cause of the ulcer and treatment has to be planned accordingly..As of now if there is pain she can gargle with numbing mouthwash like Lignocaine for relief..Take Ibuprofen for relieving pain and inflammation..Take a multivitamin and an antioxidant tablet daily..Gargle with 1:1 solution benadryl and milk of magnesia..Avoid hot and spicy food and suck ice..Hope this information helps.Thanks and regards.Dr. Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lack of appetite after taking Carvedilol while having AFib?\n\ni am having afib and erratic heart rhythums, shortness of breath, weakness in muscles, now im having trouble eating. how long do you go before going to er. last time they gave me a few carvediol and said there was nothing for them to do but they never stabilzed the heart rhythum.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Beta blockers intake may can cause decreased appetite. You have to rule out what is the cause for atrial fibrillation? Is it structural heart disease or vascular problem or electrolyte imbalance etc?? Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause pain in right upper arm?\n\nI have been having this pain in my right upper arm. Its around a mole that i have, ( not one that is above the skin though) It almost feels like having an iv and being injected with meds because i am having a burning sensation as well. I havent injuried my arm in anyway and havent done anything out of the ordinary activites. Should I make an appt with a dermatologist? Or my family doctor?",
    "doctor_response": "Hello,It could be related to local inflammation or a pinched nerve. For this reason, I would first recommend consulting with a dermatologist. If this does not help, the next step would be performing nerve conduction studies in order to exclude a possible pinched nerve. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain and pressure in head\n\nMy blood pressure is 170 over 100, consistently the past few days...i have pain towards my back (left side that comes and goes, mostly when i lay on it, have felt fatigue for over a week, change in breathing, hard to concentrate, pressure in head, arms feel week and tingly sensation to my bottom lip.I am a 43 year old otherwise healthy female.",
    "doctor_response": "Hello,  all the symptoms you describe are due to the blood pressure being  on higher side. The mentioned pressure range will not come back to normal with just diet and lifestyle modifications.  So along with the above,  you should consider starting medication for hypertension after proper evaluation. . A ace inhibitors /arb with chlorthalidone will be a good combination for you.  Regards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is best way of treatment for linear lucency?\n\nmy son has a 0.3cm linear lucency yet the doctor is sending him home with his foot unwrapped and telling me to force himn to walk on it we have an appointment on Thursday to see a foot specialist but im afraid it may be something serious what would you suggest would be the best thing to do ?",
    "doctor_response": "Hi there , it is not clear as to why you took your son for examination. I could be of help if you please post details of the reason for visit and where and how you found ;3 cm of linear lucency.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for hair loss?\n\nHi,I am Tanusree from Bangladesh.I have some problem at my scalp.Several time my scalp become hair less i.e may be alopecia (baldness).Some time i use a hormon injection,but now dr tell me it is harmful for lady.What can i do?am 26 th.And my marriage ceremony is near to door.",
    "doctor_response": "hi Tanusree.1. your concern may be telogen effluvium leading to pattern hair loss.2. you can try quilib women spray, roughly 5 sprays bed time all over the scalp.3. try neutriderm anti hair loss shampoo weekly twice, rinse with soft drinking water.4. try trichogro supplements daily one after breakfast.this will control your hair fall, then you can plan for making the existing hair thick with the help of minoxidil.plan for plate let rich plasma for hair growth along with the prescription.this may help you Tanusree",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am terrified that coronavirus will infect me through a paper cut on my thumb. Please help.\n\nHi. I am really scared about touching things in general because of the Coronavirus, but I also have a paper cut on my thumb and want to check if it is possible to contract it through it getting through my cut? That\u2019s not possible, right? I am so scared of touching anything. I\u2019m scared to get up or even make a cup of tea because I\u2019m so scared of touching anything. I feel stressed and exhausted and need help. I feel utterly terrified and can hardly think of anything other than germs. Any help would be appreciated. Thank you.",
    "doctor_response": "Well, there has been no evidence suggesting parentral transmission. Its entry into body has been largely suggested to occur through mucus membranes of nose, mouth and conjunctiva. In any case of a person happens to pick virus even if if doesn't enter through blood, it is likely to enter through mouth or nose or eyes. Luckily the virus is susceptible to even common disinfectants. So a thorough decontamination of the objects once followed by regular handwashing eliminates almost all the risk. Being cautious is good however being overly concerned isn't right at this point in time where you are already stressed. Just maintain proper hygiene there is nothing to worry",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in breathing after intake of certain foods?\n\nI cannot breathe at night if I ingest casein, peanut products, almonds, or soy products. I m wondering if this problem is related to non-alergic sensitivity to these foods or is it related to inflammatory response? How to overcome? I use a CPAP machine... I also use Triamsinalone corticosteroid possibly linked to glaucoma which I want to avoid using and I also use another nasal Spray... can t rememaber its name off-hand... --Bill--",
    "doctor_response": "You are an allergic person as you are using nasal spray i suppose.The difficulty in breathing that you describe after ingestion of certain food products can be due to your allergy and lead to an asthma attack sometimes.However you are on triamcinolone steroids that would be the treatment for any allergic disease but for an instant relief it wont help and hence you need to use an inhaler that provides instant relief.You can take ventorlin or asthalin nebulisations or inhalation sos",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for severe pain in the belly button & nausea\n\nMy 14 year old son has had deep pain behind his belly button and intermittent waves of nausea (about a 6 on a 1-10 scale) constantly for a week to the point that he can't run track.X-ray was done yesterday (1/14/11)and shows \"nothing\".Doc says to go to ER if he gets a fever or begins vomiting.Sounds like possible appendicitis according to the symptoms I've read online but hate watching him feel bad and have no course of treatment.  Can it be diagnosed (or ruled out) in any other way rather than waiting for it to get worse?  It hasn't worsened or improved in a week's time.",
    "doctor_response": "Hi,From history it seems that he might be having acute gastro-intestinal infection giving this problem.In my opinion he requires one course of Ofloxacilin, tinidazole combination medicine for 3 days.Give antispasmodic medicine like Meftal spas or Cyclopam for pain.Give him light diet.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medication can I take for abdominal tightness?\n\nMy lower abdomen is very tight, I am feeling like knife cutting. I have completed OZ (a kind of antibiotic ) and are being taken two tablets in day Normaxin RT, velgut and nexito plus for three years. Previously, just one week ago, I was on pantocid simple for the several months, often taking pan-D. OZ is frequently taken by me. but my lower abdomen problem for tightness is not solved. I have colonoscopy in 2004 and barium anema also as well as upper endsocpy in 2003 but nothing is there. Please advice me a appripriate medication to ease the problem. I feel great deal of discomfort and distress due to bloating and distension. Thankyou",
    "doctor_response": "Hi Probably your are suffering with chronic constipation,so you try to change your food habbits particularly in night. Pl try and tell me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can herniated disc cause dizziness?\n\nI had an mri done and have a bulging disc at l3-l4, a herniated disc at l4-l5. Lately I have had light headedness, and dizziness. Just started within the past 2 weeks. Happened about 5 times. Would this be related to the lower back issue or something else",
    "doctor_response": "HiThanks for posting your query.      No there is no relation between your lumbar disc problem and dizziness. There is something else which is causing this problem . Dizziness can be due to simple causes like low or high BP, low blood sugars, Thyroid problems, inner ear problems, anemia ..    Dizziness can also be due to serious problems like heart problems or brain problems.   I advise you to consult a physician for the evaluation of cause of giddiness. Any clarification feel free to ask.Happy to help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am not getting pregnant inspite of active sexual life. Why?\n\nHello doctor, I am 25 years old. I am newly married. I have irregular periods but not too late it occurs between 25 to 35 days. We are planning for a child but cannot get success. We have sex regularly. Now I have some doubts please clarify me in detail. I am over weight (pear-shaped). My height is 156 cm and weight is 68 kg. For my height and age, the ideal weight is only 50 kg. I am following a healthy diet by reducing the carbs and increasing the fiber and others. I am doing the walking and some low intensity exercise like squats but my relations compelled me to leave it as it will cause miscarriage. Whether my over weight cause any problem in my pregnancy? Does this irregular period affect pregnancy? I had a fungal infection in my vagina before marriage. I took tablets, I have more other problems that the black skin in that area. Sometimes I feel little itching during periods alone. Will the black mark disappear or not? Does it have any impact on pregnancy? Does heat-inducing foods and other home-based natural treatments for skin affect my pregnancy? I sometimes feel feverish during periods why is so? My hubby sometimes has to be out off station. He will be out for 25 days so after that we will have sex, but I feel some pain after two or three hours after intercourse but its mild. We have more foreplays after these 25 days and also we have tried some other position like doggy, cowboy, etc. earlier it was only a missionary position. Does it have any problem? Do I have to go to the gynecologist? Do traveling in car or jumping affects pregnancy? After intercourse, the sperms leak out of my vagina. My hubby feels like every thing ejaculated has leaked out. Is it usual or not even after doing in the tilted position it leaks out. What is the solution? The society makes us so confused all are giving advices. So we need proper guidance. Please help us.",
    "doctor_response": "Hi. Being overweight or obese definitely increases complications during pregnancy like abortion, low growth of baby, development of diabetes and hypertension. It is better to attempt weight reduction (if possible) before achieving pregnancy. Irregular periods, if it is between 25 and 35 days normally it does not affect the pregnancy, as such cycles are generally ovulatory. The black marks are less likely to be due to fungal infection. Those generally indicate insulin resistance in obese individuals. They may disappear slowly once you lose weight. Itching is not normal, need to check once with a gynecologist to rule out infection. Normally, foods are not known to affect the chance of pregnancy. Just do not take an overdose of nutritional supplements, as it may affect baby if you conceive. Slight rise in temperature normally occurs due to the hormonal effect and is considered normal. Slight pain after intercourse is no problem and needs no treatment. Traveling in a car or jumping does not affect pregnancy. Just do not try vigorous exercises in the first three months of pregnancy. Normally, semen leaks out after intercourse and there is nothing to worry, as what leaks out is generally plasma, sperms normally go into the uterus immediately after deposition in the vagina. Still, if you are worried, you can keep one or two pillows below your hip to keep the semen inside for the longer duration. Apart from those answers, we normally do some tests for women who are trying for pregnancy. Those are hemoglobin, random blood sugar, TSH (thyroid-stimulating hormone), Rubella IgG (to know immunity against rubella), HIV, HBsAG (surface antigen of hepatitis B virus). You can get those done if interested. These are to safeguard your baby. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes thumping sound in the chest with high BP and having a history of hypothyroidism?\n\nim 34, 270 lbs. i have hypothydosims. take 112 mcg of levo. in past 2 weeks my bp has been higher 138/88 or 90. my pulse is high 93. i feel a thump in my chest from time to time. sometimes feels like i swolled a big tennis ball and i just can't get it down. not sure what to think. i",
    "doctor_response": "Hi,I would advise you to check your thyroid hormones.Sometimes excessive intake of thyroid hormones can cause such symptoms.Hope I could help youWishing you good healthIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat low BP in congestive heart failure patients?\n\nNormally I am a high blood pressure Hpertension because of congestive heart failure left side I believe. Just recently checked it was at 50% ejection fracton ration. I actually havn't taken my meds I think for 2 days on accident. This morning I did take them. At work I got really clammy and light headed, Eventually I went to our BP machine and it was 92/58.  I feel really weak and walking is difficult, it is hard to put thoughts together, My question is should I wait and see if it balances out or is there something I should do to bring it up some? Or should I be going to the hospital?",
    "doctor_response": "hi,you have ot mentioned the medicines you are on kindly consult you cardiologist to lower the doses of hypertensives, ejection fraction 50% is not that bad .try lowering the doses of  anti hypertensives  and taper them to minimum posible doses , weekness is attributed to low blood pressuretake high ssalt diet for next two days. thank you and keep your body hydrated,go to hospital lower the doses",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have swelling and pain in elbow area after an accident. Why?\n\nHello doctor, I was involved in a car accident which my vehicle ran reverse on my left arm and got swelling and bruises all over my arm and now when I try to lay my arm down on something, there is a lot of pain in the elbow area and around the top of the elbow area and the doctor says there is nothing broken. I am just wondering what I should do. It is warm to the touch.",
    "doctor_response": "Hello. There must be crushing of the tissues and what is called internal degloving and a collection of blood called a hematoma and that causes the part to be swollen and warm to touch. As long as there is no fracture then you do not need a plaster but a sling to rest the arm is mandatory till the pain comes under control and the swelling reduces.  The sling will also enforce rest to the part and will help keep the forearm from swelling up. Ice the arm and elbow 20 minutes for five to six times a day. Elevate when in bed on two pillows. If no better in a week then re-visit a doctor for a review.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump in the legs\n\ngood day , Two weeks ago i found out a lump in the size of pea in the lower part of my leg in the area between my knee and foot on the side part , it is colorless and painless unless i push it , then it started to pain a little bit , it has an extension just a few centimeters , i was wondering what kind of lump ? iam not a person who does sport but iam not a fat person , a thin man , and recently i did a few jogging just for a few minutes , then i started to feel some pains in the bones of my legs between my knee and foot due to sudden running that my body was not used on and a while later i discovered this lump so what could this be ??? can it be a cancer but the area is not a common place for cancer i would be very appreciative to you sir if you could help me ? thank you",
    "doctor_response": "hello,thank you for consulting. swelling present only for 15 days and not before and it is a size of pea nut. dont worry.swelling of small duration will be inflammatory in origin its very difficult to tell the diagnosis without examining you but still it can be a lipoma or a bursa or a   chronic abscess.none of the condition is life threatening so dont worry.if it continue to hurt get it examined by surgeon.thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suspect brain tuberculoma or cysteriostisis. Now advised treatment for tuberculoma, then repeat MRI and review. Side effects ?\n\ni am 34 years old and is suspected to have brain tuberculoma? After MRI , doctor is not sure whether this is cysteriostisis or brain tuberculoma? He has suggested to take treatement for tuberculoma for time being and do a repeat MRI afte i hvae repeat MRI afyer 10 month then MRI report resolve edema but not reduce size Dr adv continew medicin for 8 month more but now i think take medicin more 2 or 3 month then repeat mri.it medicin will any side effect on my body",
    "doctor_response": "Hi, Thank you for posting your query. Sometimes, it is not possible to distinguish between tuberculoma (TB infection) and neurocysticercosis (tapeworm infection) on MRI brain. There are certain features such as size more than 2 cm, too much edema (swelling in brain), focal neurological deficits (such a weakness of arms or legs, etc), which may favour a diagnosis of tuberculoma. However, in many cases, we are forced to start treatment for either TB or tapeworm infection on empirical basis. Repeat scan after three months help us. If the size of lesion decreases, then good. If the size increases, then a biopsy (a small surgical procedure) of the brain lesion is done. TB medications are safe. However, liver function test and eye check up may be required to look for side effects. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes body chill when suffering from kidney disease?\n\nI have chronic kidney illness....not past stage one...recently went to the beach and began a fever. took Tylenol fever went away...had dinner and a glass of wine...sudden internal chill without fever. finally went away, but today after returning from the beach I have fever again...urine is cloudy....my renal doctor called me in a script for a bladder infection...question...could a bladder infection cause this chill or would it be my kidneys causing the problem",
    "doctor_response": "HelloThanks for query .Based on your symptoms you have UTI and it is insignificant whether it is kidney infection or bladder infection.Please get your routine urine test and urine culture done to find out the organisms causing this infection and antibiotics to which they are sensitive to.Please take broad spectrum antibiotics like Cefixime   along with urinary antiseptic like Nitrofurantoin twice daily and urine alkalizer thrice daily .Later on switch on to appropriate antibiotics as per culture report.Get the prescription of medicines from your family Physician.Ensure to drink more water .To keep your urine dilute .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please suggest homeopathy medicine for pain in kidney area without any stone detected.\n\nHello doctor, I was diagnosed with 10 mm stone in the left ureter four years back. I started to taking following medicine: Berberis Vulg Q 10 drops three times, Hapro Xpel drops 20 drops three times (composition: Berberis Vulg 10x, Sarsaparilla 10x, Terebinthinae OL, 8x Cantharis 8x, Lycopodium 12x, and Hydrangea Arb \u00d8). After medicine, I got relief but I got piles. Last month I did an ultrasound and no stone was detected. So, I stopped Berberis Vulg Q and continued diet without any restriction and I was taking 1 to 1.5-liters water daily now for the past five days. I have pain in the same region and I feel sometimes like vomit. Pain is manageable without any painkiller. Please suggest what should I do. Also is taking Cystone syrup safe with these homeopathy medicines?",
    "doctor_response": "Hello. According to your query, the stone was not there in ultrasound but only pain in the kidney area. The reason for pain may be the light gravel of stones which might be in the urinary bladder or urinary tract which is not visible in the ultrasound. Do the following: Diet should be restricted with avoidance of any cold drinks, hard substances, pulses, etc. Take three doses of LYCO 200 (Lycopodium) potency for three days. Dose to be taken: One dose every day early morning without eating anything. Take three doses for three days. Do not take anything like syrup or antibiotics in between. You can take a painkiller. Increase your water intake and drink lukewarm water one full glass before sleeping. I will continue the further treatment after three days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does shadow in lungs signify?\n\nMy partner was a heavy smoker until 2 years ago when he gave up. A month ago he coughed up a small amount of bloody mucus several times so the doctor sent him for a chest xray. The results showed \"a shadow\" on the lungs. Could this be cancer? He has to wait 2 weeks to have the xray repeated....a very long 2 weeks!",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your partner's situation and problem. He is having hemoptysis (blood in sputum). He is also having history of smoking. So following can cause shadow on chest x ray in his case. 1. Pneumonia 2. Tuberculosis 3. Lung cancer. So better to consult pulmonologist and get done clinical examination of respiratory system, sputum examination for AFB (acid fast bacilli-bacteria causing tuberculosis) and CT thorax with Contrast for the diagnosis of above diseases. Hope I have solved your query. I will be happy to help you further. Wishing good health to your partner. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can candidiasis be treated?\n\nMy sister, who lives very far from me, so I can t tell you a lot about her condition, tells me that she thinks she has Candida. My question is, is there any medications she can take to help rid her body of the yeast? I ve done a lot of research and found lists of food she shouldn t eat and one s she should. Based on my research, she has a very poor diet and eats all the things she shouldn t. She has had a life-time struggle with gut issues. She is get an injection, every 28 days, for her mood disorder. I can t find any information if these things worsen her gut issues.",
    "doctor_response": "Hello,Candida is a common yeast infection that can be treated with oral Fluconazole once and local Clotrimazole two percent cream three times per day for one week. In the case of systemic Candida infection, Intravenous antifungal will require.Hope I have answered your query. Let me know if I can assist you further.Regards,  Dr. Mahmoud Abouibrahim",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the pregnancy safe to continue despite taking Primolut N?\n\nHi sir i am 42 year old n my lmp was on dec 15 th... as i dint get my monthly periods i consulted a doctor and she advised me to take tablet primolut N twice daily for 10 days for three cycle.. and now because my menstrual cycle was still not regular i had a ultra sound scan and diagnosed as 15 week prgnant. and also my husband is a parkinsonism patient and he is on tablet SYNDOPA every 4 hours. Will it be safe to continue my pregnacy? now that it is already 15 weeks i dont feel like going for an mpt. what can i do ? please help.",
    "doctor_response": "Hi, Dr Purushottam Neurgaonkar here. I welcome you to HCM VIRTUAL CLINIC. I have gone through your question, and I think I have understood your concern. I will suggest you the best possible treatment options.1 )  First of all do not panic. 2 )  Tablet Primolut N is a progesterone group of drug. Though it has mild androgenic action,  it usually doesn't have serious effect on the baby.   Although it can lead to slight enlargement in female fetus. 3 )  I will suggest you to get counselled from fetal medicine expert.I hope this answer helps you. Thanks Dr Purushottam Neurgaonkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes warts on testicles in children?\n\nmy 5 years old grandson started out with a small growth on left testicle and now I noticed that it has gotten larger and more growth has start appearing on the rest of his testicles. Its red or blisted or anything its just look like moles or hanging warts",
    "doctor_response": "hi, this could be due to fungal infection or insect bite. In fungal infection there is a rash which spreads very fast and there is itching. In insect bite there is history of insect bite and rash is present. an examination by doctor should be done so that we may not miss any important finding. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stringy pus in an abscess on buttocks?\n\nEvening, I recently discovered an abscess on my butt check.  It burst about 3 days ago and now what I believe is pus is coming out from it.  I spoke to a doctor who recommended sitting a warm bath to flush it out.  but I was wondering how the pus should look.  It seems very stringy like fat tissue.  Is this correct",
    "doctor_response": "Hi, your history suggest more of staphylococcus abscess, highly muciod, hazy material, with or without blood tinged, suggestive of pus.the infected region region feels more like fat tissue.if i were your treating doctor, then i would advise 1) sitz's bath with warm water.2) antibiotics to fasten recovery i.e amoxicillin group will be effective.3) adequate hygiene, using antiseptic soap would help.Hope I have answered your question. If you have any further questions I will be happy to help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for the drainage from the sinus into the nose and throat?\n\nI have had a drainage from my sinus into my nose and throat for several years. I probably blow my nose 10 ot 15 times a day and have to clear my throat numerous times. The mucus is clear from the nose and light tan from my throat. Been to family doctor and ENT without any luck. One suggested allergy clinic but said it would run into the thousands!!!",
    "doctor_response": "Hello,Welcome to HCM.From your history, my impression is you are having what we call \"pot-nasal drip\". The most common cause of this symptoms is chronic rhinosinusitis, which may be due to allergies. I would suggest you 2 weeks of intranasal corticosteroid sprays along with a combination tablet of antihistamine & montelukast daily.Well, this will improve your symptoms currently.As you are having these symptoms for years, I would suggest you daily nasal irrigation/wash with normal saline spray & breathing exercises (or Pranayama) to recover faster.Please stay away from dusts, smokes & polluted areas. Wish you a faster recovery & best of the health.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a painful lump on the leg?\n\nhi i was laying in my bed when i felt a sharp pain in my leg i guessed because i was pressing my toe on my leg but I thought it shouldnt hurt that bad. So i sat up and looked at the area of my leg (upper ankle, lower calf). I was should to see a faint white discoloration on my leg it was very small a transparent but when I went to feel it there was some sort of lump beneath the skin. It extended on all sides a little past the discoloration. After looking at the bump I remembered a quick sharp pain maybe an hour or two before which I realized could have been some sort of bug bite. So I went online and looked at slide shows of many bug bites but none matched mine. It might be that the bite isnt apparent enough as many of the sites said it could take 4 to 5 hours for the bite to be truly visible. So I was wandering if you could help me. When I touch the lump I do feel pain but its not severe or really that bad. It hurts the worst when I press on the bone maybe less than a quarter inch away from it. That is what made me sit up and examine it in the first place. I dont want to go the ER if it isnt an emergency as Im supposed to be going on a trip tomorrow. If you could help in advance that would be great.",
    "doctor_response": "This one is a bursa or coud be some benign tumor like condition like neurofibroma! However it could be some abnormal growth too!Please go for an FNAC test to relieve your tension.All the best and regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the cyst removed from the back of scalp with yellow white appearance a tumor ?\n\nMy 27 year old son living in another state had a cauliflower shaped golf sized cyst removed from the back of his scalp yesterday.  He said it was yellow-white in appearance.  From the outside before surgery, it looked to be the size of a quarter, was raised, red, and very tender to the touch.  It had come on in a week's time.  Is this a cyst or a tumor -- any ideas?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  Cyst like structure with yellow-white color can be dermoid cyst, sebaceous cyst or some other mass. You should go for histopathological examination of that lump.  It will give you exact diagnosis. Then if needed you should take further treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes memory loss, confusion, stuttering and loss of appetite after an accident?\n\nI was in a car accident about a month ago where i was rear ended at a stop light by a speeding SUV. To make matters worse, this is the third accident in the last 14 months. I have 3 cervical disc bulges,1 cervical disc herniation, 1 thoracic disc herniation contacting the thoracic cord, and 4 lumbar disc herniations with one making contact with the S1 nerve roots. This most recent accident has me completely out of work. In addition to severe pain, i ve been having memory loss, confusion, occasional stuttering and I haven t had much of an appitite. When I do try to eat I hurt extremely bad throughout my adominal region (as if i ve over eaten) after a few bits. i ve already lost 10 pounds and 1.5 dress sizes. I am treating with a Chiro 4 days a week, I ve had a cervical and lumbar epidural, and will be meeting with an Ortho in the next couple of weeks. It seem like everyone is working on addressing my pain issuse, but seem to be neglecting everything else. Please advise what you think my non-pain related sysptoms may be. Thanks",
    "doctor_response": "hai.looks like ur into post traumatic stress tat too with such major problems. the problems what u have mentioned can be due to new intracerebral changes affecting the motor areas of the brain especially the speech,appetite,memory areaplease meet your neurologist to go ahead for a ct brainor mri brain to rule out any causeyou have more likely chance of suffering from a small stroke in these areas,due to your bedridden problems,stress,he can give you a solutiontake care.good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long is it safe to use Relibeta injection for multiple sclerosis?\n\nHello doctor,My fiance had been diagnosed with relapsing-remitting multiple sclerosis three months ago and she was advised for weekly Relibeta injection. Now, she is perfectly fine without any sign or symptoms. How long would it be safe to use Relibeta injection?",
    "doctor_response": "Hello. Relibeta (Interferon Beta - 1A) is a disease-modifying agent, used to prevent relapses. It can be used for many years. It is effective in preventing relapses. It is necessary to check periodically for complete blood count and liver enzymes. Kind regards. For more information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does anxiety, fear of illness causes tremors, shortness of breath and diarrhoea?\n\nFor the last couple of weeks my neck has felt swollen and stiff. I went to the doctor and he said my thyroid gland was slightly swollen and referred me to get my blood tests. After doing so, my results returned normal with no abnormalities. Yet I still that my thyroid gland is swollen. I've noticed minor irritation around my neck whenever I wear a collared shirt. I got anxious and started googling symptoms of hyperthyroidism. Ever since I've read the symptoms, I've been experiencing some of them (hand tremors, weakness, shortness of breath, and diarrhea). I even started googling possibilities of other diseases and am getting more anxious. I am constantly feeling my lymph nodes and am noticing that they are not swollen whatsoever. My question is: could it be possible that my anxiety/fear of illness is causing my body to have these symptoms?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Yes. It is possible that your anxiety/fear of illness is causing your body to have these symptoms. I mean it. You must have came across hypochondriasis and somatoform disorders when you searched across internet. You might be a victim of it.If you have a disease, it is the doctor's duty to find out and to prescribe medicines. Why are you assuming their roles? Are you a doctor? Ask this yourself and you will be alright.Come with all of your details through a premium question and I shall help you all the way to get out of this problem. We have effecive therapies exclusively for hypochondriasis and somatoform disorders.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest solution for allergy problem in body which rises in summer\n\nMy wife have allergy problem at her whole body. At the summer season when her body wets through sweating that time allergy rises, then now at this winter season when she feel cold that time allergy rises all over the body and also at eyes, may i know who might be the best doctor at Dhaka, Bangladesh for this treatment ? please suggest",
    "doctor_response": "He has chlinergic urticariaHydoxyzine 10mg bd would work for himAvoid stressful situation as well as allergens he is allergic to...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for nerve damage pain?\n\nI am dying from nerve damage pain in my left hand , its burning badly & there is some painfully patches on the back of my hand. I have AVM in the back of me left shoulder and I am taking Lyrica since March 2013 . I have tried all other medications nothing worked and the doctors are not helping me . I have little kids and im suffering every moment don t know what do where to go...please help meeeeee. thank you",
    "doctor_response": "Type of pain. Burning mostly means a nerve is having problems. This can be either a sick nerve or a nerve that has had an injury. Electrical, shooting would be others implying nerve source for pain.Lyrica isn't really the best. Amitryptiline is better. Of course if the pain is near the surface, lidocaine pathces can be used. also physical modalities like TENS units.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had unprotected sex. Taken ipill. Blood clots, excessive bleeding, abdominal pain. Taken Trenaxa. What is the indication?\n\ni had unprotected sex on 3 November but wasn t sure of conceiving so took an i pill on 5 November.after 5 days blood clotts came, but it was just one or two clots a day. But from yesterday excessive bleeding started with little bit of abdominal pain . So i took trenaxa 500mg yesterday night and i have two more doses to take.. But bleeding did not stop. Please help !! What is the indication? Will trenaxa help? Does ut have any side effect?",
    "doctor_response": "Hi thanks for your question. You have taken I pill 48 after unprotected sex and passed blood clots after 5 days. Now you\u2019re having excessive bleeding. Passing clots and excessive bleeding is normal after I pill use. Trenax is antifibrinnolytic that competitively inhibits the activation of plasminogen to plasmin and prevents the body from breaking down blood clots and thus decreases bleeding Thus trenaxa decreases the overall blood loss. It is used for different medical conditions, like: In hemophilic to prevent bleeding G. I hemorrhage, Treatment of heavy menstrual bleeding. Side effects are very few and include:  Nausea, headache, nervousness and vomiting Hope this answer your question",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe pigmentation, no improvement with melacare, depigmentation cream. Remedial options?\n\nGood morning sir, I am of 37 years old my mother was having seriour pigmentation problem now i am also facing the same for the past 3 years I have been using melacare cream but after some time it was not doing well Now I am using fab India depigmentation cream but not much improvement so please guide me with some remedial cream by which I can get rid of the pigmentation from my face.",
    "doctor_response": "hello kartika I know The dispigmentation on face is very causmatic problem for girls. but you tell me which area of  your face r more affected.had  you married/not married ?have you child /or no ?do you work in feld i:e more expoxure of sun/not ?what is  your menses ,s history.have you past history of joundice /any other liver trouble ?history of cold /coryza/blood loss ?how is your sleeping pattern ?becoz its cannot to  treat by only use of external med.than i tell you internal medicine . o.k thanx dr_neerajgupta@hotmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fungal infection in the vagina of a virgin\n\nHello.. I am 25years old. I am suffering from vagina fungal infection since 4years.I showed a doctor many times who prescribed me medicines and some ointments. It works but only for some days then again I am facing the same problem. I am a vergin and i never had sex. So why i am facing this problem? Please help me how can i cure it? Or what to do?",
    "doctor_response": "Hi, Thanks for posting in HCM. I understand your concern. Repeated yeast infection of vagina in a virgin could be due to poor genital hygiene. Kindly do the following to overcome the same.  1. Cleanse the area with mild antiseptic solution like Savlon twice daily. 2. Apply antifungal vaginal pessary or cream containing medication like fluconazole or miconazole. 3. Wear loose fitting undergarments preferably made of cotton. Maintain good personal hygiene. Gradually, you should be able to overcome the symptoms and be back to normal. Hope the information provided would be helpful. All the best. Regards, Dr.Ashakiran.S.,MBBS., MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for tenderness and swelling in knuckle\n\nHi, I was playing rugby and my hand was stood on. It instantly swelled up and then started to bruise now 4 days later the knuckle is still swollen. I have full movement of my hand pain free and it only feels tender if I put pressure on the swelling although it is itchy sometimes.",
    "doctor_response": "hi just do hot fomenation to knuckle by dipping in hot water, apply voltaren gel locally and take advil tabs after meals for 3 days. avoid movement of hand for 3 days, should settlebest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in the upper arm\n\nI am having pain in my upper arm. It feels like its coming from about half way between elbow and shoulder. sometimes quite sharp. Mainly at night it is worse. If I chang position and lay on my back it feels better. However still feel uncomfortable. feel it during day but not as bad. It does radiate somtimes, but seems centered in middle of upper arm. I have not had any recent injuries",
    "doctor_response": "Sir, Such pains usually originate from spine or local muscles. Since your pain also radiates it means that it is of spinal origin. You need screening of your cervical spine, a good examination and MRI are must.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in upper abdominal area?\n\nI have been having acute pain in my upper abdominal area. Recently I had scans which showed my left kidney was smaller than the right kidney and rotated. My doctor said this was quite normal and not to worry, however the pain that I get in this area is quite severe with nausea and sweating. What can you suggest!!",
    "doctor_response": "Hi.Thanks for your query.You have got a problem of pain in the abdomen with nausea and gets severe sometimes.IVP and ultrasonography is showing left kidney is smaller and rotated. This indicated that there is a problem.I would advise you the following:Rule out other causes like Gastritis by upper GI endoscopy.It is possible that the rotated kidney is causing intermittent blockage of the pelvis of the kidney . Consult a Urologist, it is possible that passing a double J stent might alleviate the pain and if so a definite surgery is indicated .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to experience abdominal pain after C-section?\n\nexperiencing pain inside abdomen 10 weeks after c-section. is this normal? ob/gyn told me abruptly last week that i would never be normal, they had to cut a lot of things to get the baby out and i would never be normal again :( she didn't even feel my stomach or check me. what do i do now?",
    "doctor_response": "Dear madam,I think you need to see a gynaecologist for your check up . A USG abdomen will  be required for the same .Dr. Shruti",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does my brain MRI report indicate?\n\nHello, I am a 29 year old female who had a brain MRI without contrast done. The results just arrived in the mail and I m not clear about them. Indication: Common migraine Technique: Multiplanar multi-sequential imaging performed through the brain parenchyma, without contrast. Findings: No evidence of acute intrcranial hemorrage, mass effect, midline shaft, or acute/subacute infarcation. The sulci and ventricles are normal in size for age. There are no extra-axail collections. There is a cavum interpostium noted which impresses upon the internal cerebral veins. The flow voids at the skull base are preserved. The orbits are normal. Mild mucoperiosteal thickening within the ethmoids and along the floor of the left maxillary sinus. Impression: 1. No evidence of acute/subacute infracation. 2. Note is made of a cavum velum interpostium, an anatomic variation. Would someone please help me and explain these results in a language that I can understand before worrying myself?",
    "doctor_response": "HelloMRI findings suggests almost normal findings except changes of mild chronic sinusitis in ethmoid and left maxillay sinus(sinuses are air containing spaces in facial bones).Chronic infection is indicated by mucosal thickening of sinuses.You may need treatment for sinusitis.Other wise findings are normal.Brain parenchyma appears normal.There is no e/o infarction,intracranial hemorrhage,collection etc.There is a cavum interpostium,which may be a normal anatomical variation and this findings usually doesn't require any treatment.Hope I have answered your query.RegardsDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can back pain be treated?\n\nHello, Experiencing severe back pain that seems to move around over past few days. From small of back (and down to kidney region) sometimes and up between shoulders at other times. Doctor has told me muscle spasms for which I am now taking muscle relaxers for (plus will do some physio in the coming days). The pills aleviate all pain except down at tailbone (the pain is quite bad). Pain focused on tailbone and left buttocks. I m also experiencing issues having bowel movements for several days now so I assume constipated (something I have had absolute minimal past experiences with). Background: prior to diagnosis of muscle spasms doctor has completed blood test, standard ultrasound of abdomin, KUB X-ray of abdomin and 3 urine tests. All came back good. Concern is, being I am only 34 (male) and in generally good shape (6 0 @ 180lbs) something serious is wrong as I have not experienced any injury to coincide with the pain. Any feedback appreciated.",
    "doctor_response": "to relieve pain, take intermittent rest(in occasion of extreme pain), take paracetamol 1 gm twice or thrice daily, give hot compression, and have some postural modifications. If pain relieves then start physiotherapy(Mckenzie exercises). Conveniently, consult an Orthopaedic surgeon and have X ray LS spine and MRi ls spine (if required) done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for lower respiratory chest infection?\n\nhi there i am just recovering from a lower respitatory chest infection. I finished my antiobiotics last week. I went to my gp thursday morning and felt fine for a check up. She took all my bloods then and said my chest was clear. At lunchtime a dreadful tiredness came over me and i have been sleeping alot since then. Is this all part of my sickness?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Yes, some degree of weakness is common after respiratory tract infection. Your weakness was worsen by blood reports. Many patients have tendency to feel more weakness when they give blood for reports. It is more of psychological. So don't worry. Drink plenty of fluids orally and keep yourself hydrated. Take multivitamin tablets. You will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lumpy spots on chest and back\n\nI have lots of little red lumpy spots on my back and chest most of them have whiteheads in but they are not itchy I normally get them from being out in the sun but never this bad am I allergic to the sun or is it something to do with the chlorine in the pool.",
    "doctor_response": "Thanks for your question on HCM. In my opinion, you are mostly having allergic skin lesions due to chlorinated water exposure. Possibility of sun related skin changes are less. As sun exposure causes blackening of skin. Chlorine is very well known skin allergen. And it is used as disinfectant in swimming pool water. So susceptible individuals, on exposure to chlorinated water can develop allergic skin lesions. So better to avoid swimming pool for few days. Start antihistamine and anti allergic drugs. Apply steroid containing cream on affected skin areas. Since all these drugs are prescribed medicines, you need to consult dermatologist for their prescription.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pus filled swollen jaw after removing the tooth. Blisters present. What to do?\n\nI had the left side of my bottom teeth removed for dentures today. I have a heart murmer and was given 4 lg. amoxil 1 hr. before. When I arrived at the dentist office this morning, my jaw was swollen so I knew there was infection somewhere. The dentist stated she saw pus when she pulled a few of the teeth. Now that I am home, the pain has become severe. I looked in my mouth and along the gum line, is filled with blister looking things filled with fluid. What should I do??",
    "doctor_response": "Dear friend. Thanks for sharing your concern. Do not worry if your dentist has examined thoroughly and suspects pus in your oral cavity then she must have drained them too.Any pus anywhere in oral cavity should be drained well before further treatment. Also you have already started with your antibiotic dosage due to heart murmur,so even if there is any infection and pus remaining, your sufficient dosage of antibiotic will help in this case. just take your medication properly in this case. Now the blister that you would have seen could be pitting edema(swelling after extraction which generally occurs). For pain relief you can consult your physician and take suitable analgesics for three to five days. I hope the symptoms should subside within five days, if not then you need to visit your dentist for follow up. meanwhile take all precautions and due care for post extraction healing. Take good nutritious and semisolid diet, and relax you will be fine soon. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will increased TSH level harm the baby's brain growth?\n\nHi doctor, I am 26 years old. My height is 5'1\" and weight is 52.4. I am 20 weeks pregnant now. I underwent a surgery for complete thyroidectomy and I am taking Thyroxin 100 mcg regularly. In my first trimester, the TSH level was 0.31 and the doctor advised me to continue the same dosage of medicine. But, in my recent serum test, total T4 level is 10.5 mcg/dL and TSH has shooted to 14.37 mIU/L.\u00a0The anomaly scan shows the baby is healthy with heartbeat of 153. But, I am worried about the TSH level which could harm the baby's brain growth. Doctor has prescribed 125 mcg of Thyronorm tablet for a month. Is it must to undergo an emergency thyroid check with an endocrinologist to avoid any complications?",
    "doctor_response": "Hi Revert back with the answers for the above questions to an endocrinologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Plan B cause stomach discomfort and bloating with back soreness?\n\nI have a question about plan b, I took it about 4-5 days ago. No major symptoms yet. Slight discomfort in the stomach and back soreness but there s a bloated weird fuzzy feeling in my stomach. I haven t gotten any other symptoms. Is this feeling because of the pill? No spotting or bleeding has happened. What stomach feelings are normal?",
    "doctor_response": "Hello dearUnderstand your concernYes plan B cause stomach discomfort, bloating and back pain as a side effects.Back pain are due to tiredness.Stomach discomfort and bloating due to high progesterone as it relax the smooth muscle of intestine.Bleeding is due to progesterone withdrawal and it will not occur in all cases.So do not worry all your symptoms are due to side effects of Plan B pill.It will disappear in few days.Just take analgesic and light diet, avoid spicy and fatty foods.But remember, Plan B also has some failure rate (5 % if took with in 24 hour and 10-15 percent if took between 48 hours)So if your period will be delayed by 10-12 days then go for urine pregnancy test to confirm the pregnancy. In pregnancy still you can terminate it up to 9 week by using abortion pill under the observation of gynecologist.Hope this may help youBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "i always get depression and sad for no reasons\n\ni always get depression . i am not able to get out of my past and its been 3 years. when ever i am alone i go in the depression and get sad for no reasons",
    "doctor_response": "hi, welcome to health magic, for depression there are so many medicines in homeopathy. depending upon the  constitution the medicine is selected,you can get a good result.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Using Petogen after delivery. Planning to conceive. Duration for petogen to get out of system?\n\nHi my name is Rhandzu i ve been using Petogen since i gave birth in 2010 February i was suppose to get another shot in December which i didn t because i m thinking of having another baby so my Question is how long will the petogen get out of my system,i haven t seen my periods since december it s only blood spots sometimes once in week. Thanks",
    "doctor_response": "Hello thanks for your query. After a year of using Petogen , almost 90 % women experience no periods. It takes atleast 3 - 4 months for return to fertility to occur after taking Petogen, but depending on various factors like age, weight etc, it might be as long as a year. please consult a fertility specialist if you have been trying for more than  a year. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be worried about infection if am having salty taste in mouth where the wisdom teeth were removed?\n\nHi I had my wisdom teeth removed about a week and a half ago, but there is a very small amount of a salty taste in my mouth where the holes are.  I have been irrigating with warm water and keeping good hygiene.  There is no discharge but just the taste.  Could the taste be blood? Or are the holes contaminated? Should I be worried about infection?",
    "doctor_response": "hi,thanks for your query.There are a number of signs that your wound may have become infected. If you suspect that you have an infection you should consult with your dentist is possible that you can have a discharge at the site of the infection .The discharge will be yellow or white in color and may start to seep out of your gums and into your mouth. This will normally taste salty and smell bad.A bad taste after wisdom teeth removal is most likely related to discharge entering your mouth. It will likely taste salty and can cause bad breath.The best way to avoid infection after wisdom teeth removal is to complete a prescription of antibiotics that is issued by the dentist.Avoid touching the site of the extraction with your tongue as this may spread the infection or introduce objects into the wound. visit your dentist.hope this is helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heel bursitis? How to treat it?\n\nI had pain on the inside of my heel which my podiatrist called bursitis. He gove me a shot of cortisone which made it worse because now I can barely walk I have so much pain all way up the back of my leg to my knee. I am 85 years old and don t know what to do about this pain. I have had 7 treatments with laser but am discouraged at this point. Can you give me some indication of what is causing this?",
    "doctor_response": "hi You have taken a cortisone injection for bursitis in your heel and now the pain has  increased and gone up to calf. In my opinion you had calcaneal bursitis where the tendo achilles ( Calf muscle tendon) is attached. It has probably ruptured and is causing your symptoms. I suggest you take pain killers , Crepe bandage on the leg and wait for some time so that acute swelling subsides. You will have difficulty in walking but pain will go away slowly. Other option is operative repair.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it suggestible to use Duraphat after my radiation treatment to tonsil?\n\nHi I am due to start radiation to my tonsil (which will impact on my jaw bone) and have been advised to use Duraphat during treatment to prevent decay and increase saliva. I have excellent teeth, no fillings and am 43. Whilst i don't mind using during treatment, I have been this is my toothpaste for life post treatment. I read the contra indications with the product and see i can no longer drink tap water, use salt and there are numerous risks with this product. Is it really essential to use it post treatment?ThanksValerie Dublin",
    "doctor_response": "Hi,Thanks for posting the query,  After radiation therapy there is decrease salivary secretion so the chances of caries formation increases.Duraphat is an anticaries agent and is given to prevent caries.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should Moxicip eye drops be used for an eye discharge with redness?\n\nHi My daughter is 6, has discharge from one eye since few hours, slight redness . The doctor advised me over the phone to apply moxicip eye drops (contains moxifloxacin hydrochloride Ph.Eur. equivalent to moxifloxacin.........0.5%w/v Aqueous vehicle........q.s.). What should I do?",
    "doctor_response": "Hi, I had gone through your question  and understand your concerns.Discharge from eye is indicative of conjunctivitis  for which your doctor has advised moxicip eye drops , redness indicates a component of allergic , it may be allergic conjunctivitis , better option will be do get examined by a doctor to know exact problem and act accordindly, meanwhile if you are using moxicip continue it and wash eyes with  water 3- 4 times .Hope this answers your question. If you have additional questions then please do not hesitate in writing to us.*Always check for history of allergy before taking any medicine.Take care .\u2022\u00a0\u00a0\u00a0\u00a0\u00a0DISCLAIMER: - All the information provided here is for information purpose only   , it is not a substitute for the advice of a physician after physical examination , it is not intended to replace your relationship with your doctor. This information in no way establishes a doctor-patient relationship. Before acting anything based on this information do consult your doctor. I  recommend that online users seek the advice of a physician who can perform an in-person physical examination",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lung infection due to TB\n\nHello Doctor, My brother is 32 and he was diagnosed with TB about a month back and Doctors say that it's in an advanced stage with more than 1/3 of 1 lung affected. He is also an epiliptic patient from his childhood and currently, he is on Carbamaprazine (1000 Mg).  He was immediately reccommended the standard TB drug regime - INH, Refampicin, Ethnambutol, and Pyrazinamide. After a week of intake of the drugs, he had epileptic attack and severe vomiting and was put only on drips as food intake was impossible. His lever was also seriously damaged with Serum beryllium greater than 1 from LFT. This could be becuase of \"interaction\" of the drugs. Then, doctors stopped INH, Refampicin (RCIN) and started another Regimen with Streptomycin and Ethnambutol and started introducing INH and then, Refampicin in an incremental way. But each time they tried to up the dose, lever was getting affected and also, due to interaction with Carbamaprazine, levels in blood were either increasing or decreasing. Recently, he also had a rupture in the rectum and there was a lot of blood in his stool. I do not see any improvement currently and need advice on a good Hospital in Bangalore (preferably) or Chennai or Hyderabad where the treatment can be done effectively. Thanks a lot!",
    "doctor_response": "HelloAfter going through your brother's history of illness I want to tell you somethings as . When such patient visit my clinic I at once start intravenous infusion with heavy doses of ranitidine ( in I/V infusion ) . Since your brother weight must be less than 50 kg start forecox( RIFAMPICIN 225 mg , isonizide 150 mg , ethambutol 400 mg , pyrazinamide 750 mg )   one tablet / day after 2-3 hours of meal .Add PANTACLOC_D once or twice in day .Carbamazepine can be given after 2 hour gap.Also add some LIVER enzyme in higher doses .No doubt your brother is weak in general condition but his condition is not so serious , once drugs will adjust his condition will improve. There are so many the best quality hospital in Chenai or banagalore , so consult a primary care physician and get his opinion , else consult a PULMONOLOGIST and get his opinion.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does abortions before marriage affect pregnancy after marriage ?\n\nSir /madam i had an 2 abortion before marriage , now we got a marriage and want a child ....... is earlier abortion effects my pregency ?",
    "doctor_response": "Hi , Welcome to Health care magic Forum. If the previous abortion were uneventful then there won't be any effects on future pregnancy. Try to avoid abortion in the future as it will affects your general health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent facial pain and pressure\n\nI have facial pain & pressure which I have endured for years but also have pressure in the sinus cavities in the back of my head& neck area. ENT has suggested balloon sinuplasty . D O has helped before with pressure in the back of my head. Which do you think w3ould be the best?",
    "doctor_response": "drugs can help controlling the acute infection, however if the sinusitis is recurrent, a surgery as advised is indicated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does recurring mastitis along with pain and tenderness in the armpit indicate?\n\nI am 31 with three children. My youngest is 7 years old. When they were babies i only breastfeed for a short time due to pain cracking and how painful it was. two years ago i was diagnosed with mastitis. took the meds and it seemed to go away for awhile. a few months ago i went to urgent care and was again diagnosed with mastitis and a heart murmur. they gave me oral meds but the infection came right back and now i have a white head on my nipple that leaks puss every now and then as well as the nipple seems to be a brighter red then the other which looks pink in color. i have tenderness and pain in my armpit.",
    "doctor_response": "dear mamI understand we have a painful breast with discharge.Rightly as we see it is mastitis,but i am afraid the infection has not reduced yet during the treatment.It can be linked to shallow breast feeding sometimes.Now in such cases we advise for blood test to ascertain raised total counts and ESR,more over let us go for injectable antibiotics with a bit aggressive treatment.Are we having fever?Plz do also consult your physician for the necessity of a pus culture in case of resistance.Mean while plz take good care of your diet and personal hygiene.Hope this helpsmost welcome for further queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Heaviness in breathing, asthma diagnosed, exacerbation dyspnea pleurisy. Steroids taken. PT for reversal cervical lordosis done. Advise?\n\nIm a 31 female with no previous breathing problems. I went to ER Diagnosis was Asthma w/ exacerbation dyspnea pleurisy. X-RAY clear blood work good. Gave steroid pack 6 day with treatments. Today last day & still have heaviness in breathing laying down & sitting up. Why is this happening to me know. Started when I started PT for reversal cervical lordosis.",
    "doctor_response": "THE ALLERGY CAN DEVELOP AT ANY ADE AT ANY TIME WITH ANY SUBSTANCESOME MEDICINES YOU TOOK OR LORDOSIS MAY HAVE CAUSED ALLERGIESYOU CAN TAKE ANTI ALLERGICS FOR 4 - 6 WKLIKE SINGULAR 10 MG TDSSYP ASTHALIN 1 TSF TDSSYP GELUSIL 1 TSF DSI THINK IF YOU DONT TAKE ANY PAINKILLER IT MAY  MAKE YOU COMFIRTABLE IN 3 WK TIME",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this case of lung analysis for Pneumonia indicate?\n\nAdmitted in Dubai hospital, during the course of visit to daughter . Emergency caseof pneumonia in ICU on ventilator from 7.1.2011. Findings with above ild to moderate left pleural empyema with small locule seen medially and pneumothorax, collapse consolidation in left upper lobe with pathy infiltrates and emphysematous changes in right lung. Now patient is off ventilator and out of ICU from 21.2.2011.Now requires repatriation to India,Pune, and further treatment to be continnedin Pune CGHS hospital, speciality hospital, patient being central govt. servant. Please help. URGENT PLEASE",
    "doctor_response": "Hello,As per your description, this patient needs a transfer in Air ambulance accompanied by trained nursing staff, doctors and with full equipment like oxygen, ventilator, Intravenous facilities et cetera.And there is always a risk of death during transfer. So, it is better to think about all this and then take a decision.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Kaushal Bhavsar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathing difficulty after eating rice?\n\nIn a few instances when I eat rice I suddenly can't breath.  It's like air (burp) wants to come up but won't.It's been at different restaurants and different rices (although some are okay) so am wondering if thereare some additives that I could have this reaction to.",
    "doctor_response": "Hi,Welcome to health care magic,The problem you mentioned could occur due allergic to food or obstructive pulmonary disease. It is the way our body to cause our diaphragm push against the stomach, when we fill our stomach with rice or certain food, it in turn pushes against our diaphragm making it hard to breathe.In normal people,means without any lung disease this could not occur because they have a better breathing capacity in their lungs.In my advice,i will suggest you to undergo routine blood count and chest X-ray to detect if there is any issue with lung parenchyma or not.So,consult chest physician to rule out whether it is just a allergy or due to some lung disease.Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in lower leg and foot?\n\nI am having lower leg pain front of leg and foot pain occasionally pain in hip but i have a bulged disk in my lower back ,but pain in leg constantly.Before i started having leg pain i was having cramps in my toes for about 3 months and my legs are weak,i can t walk but a little bit.I have trouble with my vitamin d getting low could it be my vitamin d low or coming from my back?",
    "doctor_response": "Hi,Thank you for providing the brief history of you.A thorough Neuromuscular assessment is advised followed by an MRI of lumbar spine.As you have a history of disc degenerative changes, a thorough assessment is required followed by an MRI to see the status of the disc. As, nerve carries dual functions - motor and sensory. So the pain and weakness are the two abnormal symptoms usually noticed with the degenerative disc disease as it pinch the nerve roots.I will advice to undergo physical therapy - therapeutic ultrasound therapy and TENS therapy to reduce pain. Also, core stability and spine muscle strengthening is required. Along with this, add on to the lower limb strengthening exercises which will help regain the confidence and strength in the lower limb muscles.In my clinical experience we receive patients with similar issues and we recommend physical therapy due to the success in the research. Majority respond well and regain the functions back.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest discomfort at night?\n\nevery night when I go to sleep, I feel discomfort in my upper left chest and under my armpit. I get anxious and it takes me at least 90 minutes before I fall asleep. When I awake...there is no pain...it only happens when I lay down for the night....never during the day",
    "doctor_response": "Hi thanks for contacting HCM....Noted you have chest pain while going for sleep....It take 90 minute for getting sleep means you have sleep induction problem....Because of that you are taking excess stress and yes this anxiety leading mild chest pain.....So be relax ....don't worry for sleep....Here are few advise for better sleep.Don't eat heavy while taking dinner....If feeling hungry snack can be taken...Daily regular exercise done...Coffe , alcohol etc avoided before sleep...Avoid late night party.Go for sleep before 12 at night....Try to avoid attending phone calls before sleep....If still no benefit then zolpidem drug can be taken....Take care...Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Most efficient and permanent way to remove body hair at home?\n\nI am a 54 year old male. I have always been very shy especially about my body hair and I want to know what is currently the best/most efficient and permanent way to remove body hair, preferably at home? I know that Professor Angela Christiano of Columbia University in New York was working on a hairless gene , and was in the process of developing a topical solution to stop hair growth, but there hasn t been any information/update that I can find.",
    "doctor_response": "hello.i am sorry, but i haven't heard of any topical solution to permanently stop hair growth, from recent literature.LP Nd.YAG or Diode LASERs would help you, though you would require multiple long sessions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for fast heart beat?\n\nHeart beatMy heart beats go from very slow to fast and pounding. I have many dx pvc's & pac's daily. Heart structure is normal. My heart pounds so hard it vibrates throughout my whole body...leaves me feeling exhausted. I used to run 2~3 miles a day.... What could this be?",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!I understand you concern, and would explain that your symptoms may be related to a cardiac arrhythmia. Anxiety and some metabolic disorders (like thyroid dysfunction, adrenal gland dysfunction, chronic anemia,etc.) could also mimic this clinical scenario. It is normal to have some PACs and PVCs during the day. But what is their frequency in your case?I would like to know more about your past medical history. Do you suffer from high blood pressure or diabetes?What tests have you performed to examine your cardiac function? As far as I understand a resting ECG and a cardiac ultrasound have been performed ( you mention PVCs, PACs and a structurally normal heart)You should consult with your GP for a careful physical exam, a chest x ray and some blood tests (besides resting ECG and cardiac ultrasound) :- complete blood count (for chronic anemia)- PCR, sedimentation rate (for chronic inflammation)- fasting glucose- thyroid hormone levels- cortisol plasma levels (adrenal gland function)- blood electrolytes, etc. An ambulatory 24-48 hours ECG monitoring is necessary to rule in/out a possible cardiac arrhythmia (if you have not performed it). If all the above tests result normal, the main cause of your symptomatology would be just anxiety. In such case, you should consult with a specialist of the field to help you manage your anxiety. Psychotherapy, Yoga, meditation and physical activity are helpful. You should avoid caffeine intake. Hope to have been helpful!Feel free to ask any other questions, whenever you need!Best regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have severe stomach pain. Please look into my reports and tell me the cause.\n\nHello doctor, I am a\u00a029 year old\u00a0male. I have a severe stomach\u00a0pain on the left side. I went to the\u00a0doctor and they did a USG of the whole abdomen. I am attaching the reports. Please help me.",
    "doctor_response": "Hello. I have gone through the reports (attachment removed to protect patient identity). For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rashes that itch and pain all over the body\n\ni have these white crystals thats come  out of my skin. it started out that it only realllty iched and was o9n my tummy, i have been dieagnoed with end stage live diease. cirroisius.  causes from hep c. no i d9ont drinik. thins is a very bad problem now,. it its all over myt bodsy and it iches and causes rashes and pain. people think i have lost my mind. most people dont get5 it. it is dribving me nuts. what can  i do",
    "doctor_response": "Hello, It is common for end stage liver disease to be associated with itchy skin due to deposits of bile products in the skin. We do usually recommend to take antihistamine meds to ease the itching. Apply aloe vera gel (or fresh aloe) on the itchy skin. Hope this helps. Dr.Albana Sejdini",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in chest and numbness in arms?\n\nIm 22 female  i have a bleeding ulcer .... lately i have been gettin weird sharp pains from my chest it feels like its coming from my heart and my heart feel like its beating weirdly sometime my arms get numb and i get light headed do i need to worry",
    "doctor_response": "this chest pain mostly due to GERD  and H. pulori infection. so take H pylori kit and then cap esmoprazole 40 OD for 1-1/2 month and also syp digicaine and syp sucralfate for 1 month . head end elevate during sleep.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does suspicious densities in the right upper lobe means?\n\nWhat should i do because i have suspicious densities on the right upper lobe. My company is asking me to get a fit to work. I had PTB way back 2010 and it was already cured but the doctor said it will leave a scar. I need the fit to work so i can work. What do i need to do?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Tuberculosis after treatment heals by either fibrosis or calcification. And both these produce permanent scar tissue on chest x ray. So for your query, I advice you to consult pulmonologist and get done 1. CT thorax 2. Bronchoscopy and BAL (bronchoalveolar lavage) analysis. CT thorax is much more informative then chest x ray in lung scar. Broncoscopy and BAL is more superior to rule out tuberculosis. If both these are negative for tuberculosis then you can argue with visa authority about not having active, infectious disease. Your right upper lobe densities are only old, healed, inactive lesions. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain\n\nOkay i have been experiencing extreme back pain and a stabbing pain on left side of belly. I have dizzy spells all the time to the point i have to go lay down immediately. I am so nauseous sometimes and i always feel bloated. Is this all linked together? should i go to the emergency room?",
    "doctor_response": "Hello,I had gone through the case and found that it might be due to constipation or renal stone.So go for ultrasound of lower abdomen to find the exact cause and take treatment according to that.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes muscles around disc to tighten?\n\n3months back I had spinal disc bulge or prolapse I found very hard to stand and do normal activities,but now iam able to do normal activities I think the bulge had decreased in size .But when I stand do the work the muscles surrounding the disc area are tightening, is it a sign that the disc bulge is healing or something else?Normal activies includestanding,sitting o.k but while bending it s stiffening my back .",
    "doctor_response": "hiu still dont seem to have recovered from disc problemstiffness occurs only if there is persistent problem insideget an mri done n let me know thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can firmer bed cause severe pain in lower back and hip while having spondylitis?\n\nI have scoliosis, diastematomyelia and spodilitis. I always have considerable amount of pain and on norspan and endep. Recently I replaced my bed with an extra firm one. Since than, especiallyin the last 3-4 days I have horrible pain in my lower back and burning, stabbing pain on mt left hip. I had sciatica kind of pain before I changed the bed but it is immense now. I just wander if it is beacuse of new firmer bed? Should I keep trying the new one or go back to old bed? Also, I used Celebrex for sciatica pain before, is it ok to use it while on norspan (10 mg) and endep (10 mg around bed time)? Thanks.",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.Your increase in pain seems to be due to change of bed. You can change to old bed and continue with drugs you are talking. You will be benefitted by back excercises. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for chest pain in the right side\n\nHi, my husband is on his way back from Asia, having spent the last week in Kuala Lumpur.  Since Friday, he has been experiencing chest pain on his right side.  He cannot take deep breaths, yawn, cough or laugh.  He says that the pain comes back right side deep under his rib cage and the top left back.  He had a massage on back to side (not sure what he means by that) and says that helped.  He had the massage within the last 24 hours.  He will be arriving home in about 2 1/2 hours and I am wondering whether to take him straight to the hospital considering he has had this pain for the last 48 hours.  He has been taking Voltaren every six hours.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Since his pain is improving with massage, possibility of musculoskeletal pain is more. So don't take him directly to the hospital. First follow these steps for better symptomatic relief in musculoskeletal pain. 1. Ask him to avoid movements causing pain. 2. Ask him too avoid heavyweight lifting and strenuous exercise. 3. Ask him to avoid bad postures in sleep. 4. Ask him to sit with proper back and chest support. 5. Apply warm water pad on affected areas. Don't worry, he will mostly recover with all these in 2-3 days. If not improving then consult doctor and get done x ray of spine. Hope I have solved your query. I will be happy to help you further. Wishing good health to your husband. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe pain in the lower back be treated?\n\nI\u2019m have really bad lower back pains and it\u2019s been 8 days now. It wasn\u2019t this bad in the beginning but the pain got worse and worse. I can\u2019t bend over, sit and sometimes stand or it hurts. I feel the pressure also on my right butt cheek down to my thigh. I\u2019m taking ibuprofen and muscle relaxants but is there any other way for this to heal faster? I need to get work done but I can\u2019t seem to do anything without it hurting.",
    "doctor_response": "hi sir/madam,Thanks for your question on Healthcare Magic.Let me advice you for your problem.Low back ache may be a pre-monitory (prodromal) symptom in fistula in ano, sciatica, gouty arthritis, hernia, emaciation disorder etc. Pain is confined to lower part of the spine (back bone) especially lumbar region or lumbo-sacral area (rarely sacro-iliac region also). If it is secondary, earlier history of fall or injury may be associated. Rarely, radiating pain may be complained by the patient towards lower limbs. But it is quite common in low back aches if the defect is in the discs between vertebrae (back bones). Often the movements of lumbo-sacral region like flexion and rotation are hampered either partially or completely.Low back pain may be found in mild form in case of anemia, sciatica, rheumatoid arthritis, hemorrhoids, urinary calculi, uterine disorders etc also.Line of treatment as per Ayurveda:-The general principles of treatment of vata dosha are adopted in case of katishoola (low back pain). It includes various measures to suit its varied clinical entities, stages and associated complaints.1. Snehana (oleation) \u2013 by sneha dhara (pouring oil), abhyanga (oil massage), avagaha (tub bath with oil or oleaginous medicaments), kati basti (retaining medicaments on the back) etc.2. Swedana (sudation) \u2013avagaha sweda  (sweating treatment with tub bath), pizichil (kayaseka), nadi sweda (sudation through a tubular device \u2013 local sudation), panda sweda (sudation through medicated paste or powder) etc.3. Mridu Samshodhana -mild purgation.4. Basti (medicated enema) like eranda basti, vaitarana basti, pippalyadianuvasana basti etc.Formulations indicated in Low back ache as per Ayurveda:-1. Dashamoola kwatha.2.Maharasnadi kashaya.3. Rasnaerandadi kashaya.4. Sahacharadi kashaya.5. Gandharvahastadi kashaya.6. Trayodashanga guggulu.And for local application these oils will help:-1. Ksheerabala tail.2. Mahanarayana tail.3. Dhanwantaram tail.4. Maha narayan tail.Avoid these for better results:-1.Bitter, astringent and pungent food2.Cold water3.Fear4.Exhaustion5.Standing6.Driving7.Cold food and beverages etc.Yoga is also very helpful in treating your back ache.Now for your backache do these yoga aasana:-1. Ardha Matsyendrasana(Sitting Spinal Twist).2.  Dhanurasana (Bow Pose).3. Marjariasana (Cat Stretch).4. Balasana(Child Pose).5. Halasana(Plow Pose).6. SUPTA MATSYENDRASANA(THE TWO KNEE SPINAL TWIST POSE).7.Adhomukha Shwanasana (Downward Facing Dog).8. Urdhva Mukha Svanasa",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat fatty lever with elevated level of Gama GT and SGPT?\n\nDear DoctorMy name is Danish, would appreciate if you could provide your expert opinion about my Liver condition. Around five years back I had LFT and came to know that my Gama GT and SGPT levels are high, my cholesterol level (triglycerides) remains high, sometimes above 300 which is control by taking medicine (lipiget 20mg), I have now reduce my weight and also my cholesterol level are under the limit but still liver level are high both SGPT/GAMA GT around 150 or some time above 250.I have consulted doctors but all they say is that it\u2019s fatty lever and will go slow with exercise. Need to know is this dangerous and what do I need to control it. Thank you",
    "doctor_response": "Hello!Thank you for the query.Such levels of liver enzymes are most likely caused by fatty liver indeed. They are not high, just slightly elevated so you have a time to help your liver to work fine.Fatty liver is reversible condition. But if not treated can turn into liver cirrhosis which is irreversible. Diet and lifestyle is the best way to maintain good liver condition. You should avoid fatty foods, spicy foods, fried foods, alcohol and medicines which are harmful to the liver (like popular painkillers). Physical activity is also very important.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is ketoconazole or miconazole effective for fungal infections?\n\nMy 7 yr old son has been diagnosed with a fungal infection. It s over 15% of his body and pretty angry. Doc prescribed ketoconazole for small patch on his face when we thought body was infected wounds from falling off his bike.Saw nurse yesterday and she said these are also fungal and prescribed miconazole 2%.Which should I be using please?",
    "doctor_response": "HI, thanks for using healthcare magicBoth of these are anti fungal creams and you can choose to use either one to treat his rash.It can sometimes take 2 to 3 weeks in some persons for improvement to be seen because fungal infections can respond slowly to treatment.It is important to use the cream consistently.If the extensive rash does not respond to topical treatment then he may need an oral antifungal.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do gallstones cause severe pain in lower back and right hip joint?\n\nHello I am awaiting to have my gallbladder removed due to pain and gallstones i had a severe attack last week and since the third day after I have severe pain in my lower back and right hip joint on all movement, could this be related to the gallstones? Helen",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query.  I understand your concerns and I will try to help you as much as I can.Yes, it is possible since it may be so called referred pain which radiates through abdominal nerves to distant parts of the body. Also, there may be pancreatitis if pain is felt mainly in the back. However, some additional disorders may be present as well so you should do gallbladder ultrasound first and then see if there are stones in it. If, not, you should see ortopedist and check for hip arthritis or ischialgia. Till that, have a nonsteroid painkillers , rest and have easier diet for few days.If pain worsens or fever occur, you should see a doctor in ER.I hope I have answered you query. If you have any further questions you can contact us in every time.Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedies for sore throat, headaches and cold\n\ni get water up my nose when washing my hair (i hang my head upside down under the tub faucet) & the last time this happened (few days after) I began sneezing coughing horrible headache and sore throat. I ended up getting medicine from my mom who is a nurse but I don't think she has anymore and  I think this is happening again I don't want to call off work to go to the doctors.. What low cost medicine could I take? or home remedies?",
    "doctor_response": "First of all try to follow NIDAANPARIVARJAN (in Sansrit language) that literally means avoidance of cause. When you know the cause of sneezing etc, do not try to repeat off and on.However proven home remedies are leaves of Holy basil, ginger pieces, one pepper black may be boiled in water for sometime and sip it when temp. comes down to warm. May mix it in 2 tsp honey. If anything of above is missing, go ahead with rest.Better take 1/4 to 1/2 tsp turmeric powder twice a day with it or with plain water.Steam inhalation may be taken at night.If you need more information and simple natural remedies for other problems, pl write direct question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Spots inside the cheeks and red spots at the back of mouth. Viral infection. What could it be?\n\nHello. Recently, I suffered what my GP diagnosed as a viral infection, however the roof of my mouth is a mixture of white and purple, and has not changed. This cannot be scraped off, by the way. I also have two spots, one on either side, inside my cheeks of my mouth. Each is pale white, with a red centre. I also have small red spots at the back of my mouth. I was wondering as to what this could possibly be? Thanks.",
    "doctor_response": "Hello,Thanks for sharing your query with us.As per your disrception the white and purple lesion on roof of mouth can be of ulcers. If it is caused by viral infection it will subsided along with the viral infection treatment.If it is not a viral origin,it can occur because of side effect of antibiotics or other medication you are taking so I would advice to complete with your medications dose and then again observe.If it would not heal then you can use mouthwash 2-3 times a day to keep your mouth clean.Take vitamin B capsules ( like Becasule) and apply topical anesthetic gel like lidocaine directly to the lesion if it is painful.Another spots you mentions on your cheeks bilaterally can be normal opening of salivary gland which is present opposite to molar tooth in  every individual and is normal. sometimes they can be seen in fever. but if it is painful then it could be ulcer.Red spots at the back of mouth can be normal if it is not painful and not sore or non bleeding.I hope information provided is helpful to you.kindly give us feedback.Take Care.Thank you!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have sudden urge to ejaculate while having sexual dreams?\n\nHi what are discharges really? Because i had a sexual dream then woke up brcause i had a sudden urge to ejuaculate/urinate, this was in the morning so im not sure whether it was a discharge or just normal urine? I had unprotected oral sex 5 weeks ago but both of us were virgins for sure, do you think it is normal for that to happen?",
    "doctor_response": "Hello, You had Wed dreams/nightfall also called as Nocturnal Emission is NORMAL It can be due to increased erotic stimulus mentally or physically or visually without sex or masturbation. Since you know the cause treating is easy. Reduce the frequent Erotic stimulus or masturbate/have sex. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness at blood withdrawal site?\n\nI had blood drawn one week ago; during the draw I felt pain and electric shock below the location of venipuncture (elbow). After blood collection, I noticed my forearm on the thumb side was completely numb. It is still numb - the area experiencing numbness is growing. The numb area appears slightly swollen, but no bruising evident. I am still experiencing shocks when I put arm down at side or attempt to pick something up (like a glass of water). I am also having a feeling like skin ripping or hair pilling in the area that appears slightly swollen (also the area that is the most numb). I went back to the doc; suggested taking NSAIDs. If not better by tomorrow, steroids. After a week should this still be getting worse? I already take Lyrica for other nerve issues related to posterior fossa decompression for arachnoid cyst/chiari malformation/syringomyelia. Quite frankly, I am surprised at the level of nerve pain I am feeling. What should I be doing?",
    "doctor_response": "Hello. I have been through your question and understand your concern.It seems obvious that you doubt aboit the procedure somehow affected on the nerve causing these symptoms.The doctor put you on NSAID and then on steroids because probably the surrounding inflammated tissues compressed the nerve, thus anti inflammatory drugs could reveal  the symptoms.It highly improbable that the procedure itself damaged directly the nerve.So, I recommend taking Lyrica again and schedule an electromyogramm and nerve conduction study.These would help a lot on better understanding the situation.Hope this helpsPlease feel free using MHC again",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the less invasive method to get over spinal stenosis?\n\nHi, I am an active, healthy 67 year old male in good shape but with a stenosis condition that I have been aware of for ten years. I have always successfully managed any pain with exercise (about an hour in the gym everyday) allowing me to ski, hike, and lift weights. Recently the inside of my right lower leg has gone numb and an MRI reveals that my stenosis has grown worse over the ten years. While all discs are in tact, the L4 and L5 are sliding with respect to each other, narrowing the spinal canal. What is the least invasive procedure that will allow me to continue with sports, hiking and weight lifting.",
    "doctor_response": "Hello, Steroid injection to the stenosis spinal canal is less invasive and emerging treatment modality. It can provide long lasting pain free interval. Consult a spine surgeon and he will direct you accordingly. Hope I have answered your query. Let me know if I can assist you further. Wishing you all the best. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bleeding upon stopping the cerazette. Sore breasts, headaches and fatigue. Pregnant?\n\nHi, about 3 weeks ago i ran out of my pill (On Cerazette) and after 4/5 days i started bleeding. But this was a different bleed to what i have had before, usually i am extremely heavy on my period, but i dont tend to get my period on this pill. this bleed was light and brown, using less than one pad a day. and continued for 4 days. ive had a bleed before from not taking my pill but that took 2 weeks to happen and was extremely heavy. I have extremely sore boobs which started within the last week, also having alot of headaches and i feel exhausted majority of the time. My discharge has been different as well being quite jelly, stretchy and clear (sorry tmi) and also felt sick at night but i think that may of been to do with something different. also done multiple pregnancy tests which say negative could i be pregnant? any help would be appreciated, thankyou x",
    "doctor_response": "hi,thanx for query.u had dischargeispite of that u can be pregnant.plz get doctors advice and get b hcg test done to confirm pregnancy.a full pelvic scan by agynaecologist and blood work up is required.it might be case of ectopic pregnancy too.plz get help byee.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stage four brain cancer, fainting, dehydration. Can brain cancer advance to stage four in one year?\n\nHI, my mom was diagnosed with stage 4 brain cancer in late June ... the 27th and passed away less than a week later on July 3rd ... how long does it take for brain cancer to reach stage 4 ... my mom was having episodes of passing out/blacking out 4 times in the previous year and the ER doctors kept telling us that she was just dehydrated ... a CT scan that was done in JUNE 2011 showed nothing ... is it really possible that the cancer could advance to stage 4 in less than a year??",
    "doctor_response": "Hi, brain tumours are sometimes aggressive and they can present with stage 4 disease within few months time. Black outs may or may not suggest any brain pathology though MRI brain is a good investigation when neurological symptoms are present and CT brain is normal. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. There is no urine build up during the day. Is there anything to worry?\n\nHello doctor, I have urination problem from six months. There is no urine build up during the day. But while taking bed rest in the day, I have started to urinate more frequently. There was no problem in the morning. I got a checkup done. The ultrasound, urine test, and blood test were normal. Now, I have no urine in the morning. A very small quantity of deep yellow colored (very concentrated) urine with no pressure in the morning. After two hours of taking tea and water, I urinate frequently. There is normal urination during the day. I am under deep stress and anxiety. Sometimes, I feel puffiness on my face and sometimes mild swelling on my legs after sitting for a long time in one place. There is no swelling in the legs while moving. I am sending my latest report. Please suggest me is there anything to worry. I am on Alfuzosin, Clonazepam, Alprax, and Sertraline.",
    "doctor_response": "Hello. Relax and do not worry. Your problem is not big. I have seen all the reports sent by you (attachment removed to protect patient identity). It is perfectly fine. Regarding urinary complaints, it looks like the side effect of Clonazepam and Sertraline tablets. These tablets cause decreased urine production and hence your symptoms. I suggest you maintain a bladder diary for three days. Also, drink water up to three liters a day. I suggest taking tablet Dytor (Torasemide) 10 mg at bedtime. This will improve your symptoms. For more information consult a urologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes plaque on teeth?\n\nWhen i wake of a morning my teeth and inside of my mouth are coated with plaque i am assuming. I floss and use a Sonicare toothbrush, go to the dentist every quarter and have no gum disease or cavities, I have porcelain fillings. What is causing this large amount of plaque? Does this mean my arteries could have plaque? My age is 67, 5 6 , weight 150. Good health. Take no prescriptions just vitamins.",
    "doctor_response": "Hi,Thanks for posting the query,     No this does not mean that your artries are ahving plague, i would like to tell you that plague is a sticky substance which is formed in our mouth due to food particles, saliva present in the mouth this substance gets tenaciously adherent to the tooth surface and fixed prosthesis, i would suggest you to brush your teeth at night before going to bed and get complete mouth scaling and polishing done once in every six months.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to prevent kidney damage if suffering from diabetes?\n\nhi my mom is 65 yrs old and has diabetes and blood pressure . he had 24 hr urine test and it showed 1+ albumin in it..other test such as cretinine was ok ...kindly let me know how can she prevent her further kidney damage by diet and lifestyle changes. from last 17 days she is on vegetable, beans and fruit diet and is not talking any meat, chicken, milk eggs. she is not taking protein. Thanks",
    "doctor_response": "Hellothe only way to delay kidney damage in her is to have a strict control on her blood glucose levels and bp",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is white jelly discharge with urine normal in a child?\n\nHi, My Son 5months 2 weeks old, uses Diaper all the Night, on the Morning Urine am finding White Jelly discharge along with his urine, He is not having any pain while urination. Only on the Morning Urination am finding this White Jelly discharge. Plz advise me, what i have to do.",
    "doctor_response": "over night urine can concentrate and form a jelly like substance in the nappy. if he is symptom free otherwise with a clear urine stream, need not worry",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the pain in lower left side back and tummy?\n\nhi i,m clare and i am suffering with some bad discomfort and pain in the lower part left side of my back going across the lower part of my tummy its sore to touch it hurts to walk, sit down or do anything but i am also weeing alot too and that is hurting also.",
    "doctor_response": "Hello Clare!I read carefully your query.The way you describe it seems to be an urinary infection and probably a kidney stone.Pain in your lower back,that hurts when you moves,with frequent urination and pain during fit perfectly with this diagnosis.To confirm this diagnosis you need to do an urinalysis and an abdominal ultrasound. I suggest to consult a physician and get examined.This infection is treated with antibiotics.meanwhile you should drink plenty of fluids.You can take Ibuprofen and Buscopan to relief your pain.Bath in warm water and warm compresses in your lower back can help.Hope my answer has helped.Take care.Dr.Rovena",
    "dialogue_context": ""
  },
  {
    "patient_message": "Arm tingling and numb,little spider veins showing up above bicep\n\nArm tingling and numb,,little spider veins showing up above bicep, below rotator cup I have lifted heavy weights all winter and noticed just at the top of my right arm bicep little bluish spider veins that are continuing to expand around the area. my right hand and arm keep tingling and losing feeling as if e somewhere. ust woke up this morning with right arm numb and and feels like that arm alone has just been through a workout like it feels puffed and is also a darker color as if there is no good amount of oxygen getting to the arm or the blood flow is being cut off by a pinched nerve. But why are these little bluish purple veins showing up just below my rotator cup at the top of my bicep and seeming to spread every day I look at it?",
    "doctor_response": "hi dont worry about vein as its normal. after some days of exercise or other work chance of change in size ,position of vein is there. normally they change its position . when u have good muscle mass ,they need more oxygen so more deoxygeneted blood in vein ,so they look like more prominent",
    "dialogue_context": ""
  },
  {
    "patient_message": "Gall bladder is partially distened & shows calculus. Red lobe of liver is shrunken, Hypertrophy of left and caudate lobe of liver. Suggestion?\n\ngall bladder is partially distened & shows calculus measuring 12 mms.Pericholecystic collection is noted.CBD is of normal caliber. Right lobe of liver is shrunken in size associated with hypertrophy of left and caudate lobes.liver shows lobulated borders.No evidence of of focal lesion or intraheptic bilary ductal dilation .Heptic vein radicals are normal .portien vein is mildly dilated & shows elevated velocities with hepatopetal flow.",
    "doctor_response": "Hi,Thank you for your query.I would like to know the following:1. Age and sex of the person whose report is mentioned.2. Complaints.3. Clinical findings.The report shows that the gall bladder has a stone and may be distended due to infection as there is fluid around the gall baldder. Since the right lobe is shrunken the left lobe has grown in size to compensate for the working. This all has to be corealated clinically with the examination and other investigation findings.I hope I have answered your query to your satisfaction.Wishing all the best.Regards,Rajiv K Khandelwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does mild microvascular disease in CAT scan indicate?\n\nThe report of a CAT scan says that I have mild microvascular disease. I am a type 1 diabetic and currently being treated for hypertension, psoriatic arthritis and cardiac issues. I had a heart attack in 1986 and two stents implanted. I have PMR (sed rate now down to 75). What does this diagnosis mean?",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. PMR stands for polymyalgia. Polymyalgia rheumatica is an inflammatory disorder that causes muscle pain and stiffness in various parts of the body. It most commonly affects the shoulders, neck, and arms. A blood test is usually done to help make the correct diagnosis. No blood test is 100% reliable for PMR. However, blood tests called the erythrocyte sedimentation rate (ESR) test and the C-reactive protein (CRP) test can detect if there is inflammation in your body from various diseases. ESR test results are measured in mm/hr, or millimeters per hour. The following are considered normal ESR test results: - Women under age 50 should have an ESR under 20 mm/hr. - Your ESR is 75 mm/hr highly indicative of an inflammatory condition like polymyalgia.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Rini",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a surgery like frenectomy necessary before placing dentures?\n\nI am not sure how to spell: tare-eye, but it is the area located at the bottom inside below your bottom front teeth. I was told by a Denrist I would need surgy to remove this st that theeth would fit properly. I was recently told with out having it removed my new denture's would always be painful. Yet I was not told any of this by another dentist that I had seen in Minnesota, not even that I needed this procedure.  I am scheduled in early November to begin the denture procedure and am now uneasy to do so.  Can you put any light on concerns here? Thank you, William Floodman",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concern...As per your complain it seems that you have a \"BONY TORI\" that occurs as a bony nodule like overgrowth over the jaw.Although it is harmless and painless but it can cause problems with proper placement and fitting of the denture..It will interfere with denture placement and disturb its proper fit and also if placed as it is, it will cause trauma to the mucosa over it and cause inflammation and ulceration..Therefore it is an appropriate advise to get the tori removed and then only you should get the denture placed..Hope this information helps..Thanks and regards..Dr.Honey Nandwani Arora..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for paining bump on anus\n\nI have had an anal fussier 2 years ago super painful. Present day I have the same pain but even more intens like a 8 or 9. Also a white bump started to develop right on the opening very tender. That bump poped the other day and I feel great there was a lot of white pus. The white spot is now a red blood spot. There still seemes to be some pus coming out every day. Am I ok?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  You had fissures in past. Right now you may have somp perianal abscess formation or fistula formation. You should go for examination.  Then go for surgery accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure cracked skin and blockage of sweat glands?\n\nSir,I am 39 yrs male and have two children aged 10 yrs female and 03 yrs male child. Female child is fit and fine by the grace of great almighty. Male child is suffering from severe skin decease. He is a harlequin baby. His skin is scaly and cracks regularly. However the pores of his nose have been opened and sweat drops are visible on the nose at the high temperature but skin of the entire body other than nose gets reddish then turns to yellow then cracks. His eyes, ears and other parts of the body have become normal but sweating glands are blocked so far. Resultant, the layer of entire skin is getting removed at the interval of six hours. As and when skin gets cracked, it gives a deep cut on particular spot which exposes the flesh behind the skin. His growth is normal and satisfactory and he is otherwise very active, talented, sharp minded, enthusiastic and perfect in all respect but this problem has kept doctors in chaotic state to give certainty of his future. However they are expecting six years to bring the child up to their assurance level. Whatever care advised is being provided at every level. He is kept in air-conditioned and sterilized room, his movements are restricted for infection prone zone and regular massage is being done to keep his skin soft. He is rare of the rarest in entire world and his survival is just a miracle. Your advise in this regard is required.",
    "doctor_response": "Hello,It's very unfortunate that your son has this rare disease. There is no cure for harlequin babies, but we can treat them by constant skincare with moisturizers (petrolatum) and preventing further infections.Oral isotretinoin may help in loosening the tightened skin. I'm really overwhelmed with the care that you are giving for your son to prevent infections. I would suggest you continue the same care and give him adequate fluids and nutrition. There are few reports of children with harlequin change who are surviving their adulthood. Hope your son's condition will get better.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Nirubhan Bharathy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cardiac stress test abnormal without operation\n\nMy husband is scheduled for a cardiac cath tomorrow morning because his nuclear stress test came back abnormal. He does not have angina. He has had a bit of loss of energy and endurance. Those were his only symptoms. We were told there is an 85% chance there is a 70% blockage in his RCA. I know once you have the stent, there is no turning back so I am hoping for clean arteries. We would like to have a conversation with the doctor before the procedure to make sure he doesn t decide to put in the stent if my husband could manage without it. What questions should we ask or how could we present it so he knows we trust his judgement, but really want to be conservative here? When is the Fractional Flow Reserve (FFR) indicated?",
    "doctor_response": "Hello. Thank you for your question and welcome to HCM. I read your query and understood your concerns.Allow me to start my answer with an analogy. Stent placement in a coronary artery is a remedy to the artery, as it is taking antibiotics when you have sore throat. If there is a blockage greater than 60%, then placing a stent is reasonable. There are no drugs or therapeutic remedies that would cause regression (\"growing down\") of the intracoronary atherosclerotic plaque. With the maximum of usage and dosage, they could stop it from building up, at best. Percutaneous coronary intervention (PCI: balloon + stent) is a safe and effective treatment of intracoronary plaques. It is accompanied with a great deal of symptom relief. With the right and proper care after the stent implantation, it should be successful. As about the fractional flow reserve, it is used by the operator when he has doubts whether to deploy a stent or not. In this term, I would only speculate if I gave you a precise answer, because I would had to see it myself. Summing up, my opinion and recommendation is that, if that plaque results over 70% in coronary angiogram, a stent should be implanted. At the end, the choice is always yours.I hope I was helpful. Take care and good luck!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower abdominal/chest/back pain while coughing?\n\nhi, I drunk alcohol and it burned my throat I think. My cough started in the morning until now 1 week already. I smoked a lot but I stopped because i had this dry cough and it didn't go away.I had chest pain and back pain because of cough. I had also pain when I coughed in my lower abdomen. pls advise me what to do.",
    "doctor_response": "Looking into your narrative the symptoms are quite suggestive of chest infection. For this you have to take some antibiotic after consultation with an expert preferably tab levoflox or tab linezolid with tab akilos-p or tab ultracet every 8-12 hours for pain and fever with tab rantac or tab famotid empty stomach. For dry cough you have to take syrup tusQ-dx or syrup grilinctus every 8-12 hours. Take tab cyclopam s.o.s if abdominal pain is there.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anterolisthesis\n\nI have just been diagnosed with grade 1 anterolisthesis of L4 over L5 Multilevel degenerative disk & facet joint changes, most remarkable at the L4-L5 and L4 S1 level I am 56 yr old female with history of high level of activity I have been in pain for long time What are my options to help this condition and deal with pain?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.Thetreatment options for spondylolysyhesis grade I are:1.Short period of rest or avoiding activities such as lifting and bending.2.Physical therapy ( when you are free from pain).3.Anti-inflammatory medications.(NSAID drugs)4.Epidural injection of steroids.5.Hyperextension braces of your lumbar column for short periods of time.( mainly during physical activity)If symptoms fail to improve with conservative treatment surgery may be an option. Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does gallbladder dysfunction cause constipation and warm sensation in the stomach?\n\nHi Doctor, a few weeks ago, I felt a flutter in my stomach after eating and immediately was short of breathe with Tachycardia, I didn t lose consciousness but couldn t catch my breathe and went pale. I went to my GP, had labs done, and everything came back in order and I was told it was nervous stomach from stress, I was prescribed Zantac. I have always suffered from constipation, but now after that episode, I get the same sensation in my stomach after I eat anything, I feel full, constipated, and like throwing up, and as if there was a ball in my stomach that feels warm. I also have the hard time breathing and my heart starts to race. Could this be a gallbladder symptom or something else? How can I have my GP give me a full check up to see if there s something wrong with my digestive tract? I m a 38 year old female and this is very scary. Thank you!",
    "doctor_response": "Hi, Yes, it may be caused by gallbladder dysfunction. I suggest to have echolecytsectomy. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Iven Romic Rommstein, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can stuffy nose and chesty cough be symptoms of hayfever?\n\nI have a constant stuffy nose, chesty cough that make's me heeve when i cough too hard, buzzing ear's and i feel as though my throat is closing up and i can't breath as good. I think it maybe my hayfever, or i have allergies? which i take tablets for. I don't go out that much, and i don't sleep until early hours in the morning.. could i have depression also? Lastnight, i woke up as though i had been holding my breath or something... it really scared me. Please help!",
    "doctor_response": "Hello,You have allergic bronchitis as well as stress-induced dyspnea as per history. For respiratory check-up the following workup needed. -Auscultation -Complete blood count (CBC) with absolute eosinophil count (AEC)-Chest x-ray -Spirometry if needed If CBC shows eosinophilia then montelukast plus fexofenadine tablet course prescribed for ten to fifteen days. For anxiety, fluoxetine course can prescribe and behavioral counseling useful. Consult pulmonologist for examination and discuss your case.Hope I have answered your query. Let me know if I can assist you further.Regards,    Dr. Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a chance that lice can live in clothes?\n\nI just found out I have lice. I am a babysitter the kids I sit for have lice. I packed last night to go away for a month. I m getting the head treatment now but what should I do with the clothes I packed and my suitcase? Can the lice live in there?",
    "doctor_response": "Hello Welcome to Health Care Magic.yes, lice can live in cloths. properly wash them and add disinfectant to clean them. and put them in direct sun light. Hope this information helps you.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful bump on the penile shaft\n\nI have a small bump near the bottom of my penile shaft. It is slightly darker than the rest of my skin and is firm but doesn t hurt or ooze anything. It doesn t seem to go away. About one 10 days ago I had some rough sexy and a long encounter of manual stimulation. Should I be worried about the bump.",
    "doctor_response": "HelloThanks for query .A small bump at the base of the penis is mostly due to staphylococcal infection of hair follicle (Boil ) in a stage of induration.You need to take broad spectrum antibiotic like Cefixime along with anti inflammatory drug like Diclofenac twice daily .Observe proper personal hygiene by washing your gemnitals with warm water twice daily .There is nothing to be worried about ,With this treatment it will get cured within a week .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a Cervical Cancer patient stay fit even after 10 years?\n\ncan a 58 year old women 164 cm high weighing 85 kilos have cervical cancer (which has also spread to the liver) for the last 10 years and still look fit and healthy, drink alcohol like it's going out of fashion and have heaps of energy for gardening cleaning etc?",
    "doctor_response": "Hi,Thanks for writing in.It is possible that the person in concern is under a strict treatment and follow up schedule. Cancer cervix is curable in the first stage of disease. However disease spread to liver makes it stage 4 cancer with difficult treatment. There are times when a person might have liver lesions which are identical to metastasis of cervix cancer. Therefore she might not have had stage 4 disease and the spread was misinterpreted. On the other hand it can also mean that she has well differentiated cancer which is responding to treatment.Drinking alcohol is not the same for every one. Some people suffer from ill effects of alcohol just by drinking a small amount while there are people who drink a lot and still show mild liver changes due to alcohol intake. Having energy and good fitness is a personal capacity. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruise that turned into a hard lump?\n\nYes please ,There is a four month old baby , We have seen a bruise from when the baby was a week old starting to turn into a semi hard lump still looking like a bruise but turning flat, oval shaped under the skin and it seems to be growing every month. What do we do as we have no specialist here?",
    "doctor_response": "HiWelcome to the HCMIt seems that your baby has cutaneous hemangioma. Hemangiomas are the most common tumors of infancy and usually are medically insignificant.The vast majority of infantile hemangiomas do not require any medical or surgical intervention. They gradually improve with age. In case, you feel that the hemangioma is leading to problems such as breathing problems, vision obstruction or significant disfigurement, then  you may consult a surgeon. Treatment options for clinically significant hemangiomas include the following:-Laser surgery-Surgical excision-MedicationHopefully this will help you. I would be happy to help you out in any future health related questions.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How the CAT scan during early pregnancy affects the fetus?\n\nI am seventeen years old. I had a Ct scan done. There is a possibility i may be pregnant. But if i am I concieved on the 17th of january, so I would be only two or three weeks pregnant. Is there a big percent chance that the CT SCan harmed or killed the unborn fetus?",
    "doctor_response": "yes. if u were only 2 to 3 week of having your last period and the pregnancy is confirmed . there is a mere chance of damage due to your xray exposure during ct. initial  2 months are very crucial for pregnancy becoz all the organs of baby are developed during this period . so if  u were  exposed to ct. u should go to your obstetrician for further management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes variation in blood pressure?\n\nI work home health & have a 58 ye old female patient with history of high BP & strokes. Lately her BP has bounced between 94/54 to 156/100 & every where in between. She can bounce 20 to 30 points in less than 15 minutes. Why is this happening & what kind of complications could this cause?",
    "doctor_response": "This problem occurs due autonomic disturbances which mean there is problem in nerve which controls your blood pressure and it can occur due diabetes , drugs especially antihypertensive drugs and simply due to aging.You should some precautions.Arising slowly, in stages, from supine to seated to standing.Avoiding straining, coughing, and walking in hot weatherMaintaining hydration and avoiding over-heating.Raising the head of the bed 10 to 20 degrees The use of custom-fitted elastic stockingsRegular exercise may help",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rash that itches between thigh and pelvic, spreading after rubbing with alcohol. Cancer history. Related ?\n\nWell I have a problem with a rash that itches me everyday.  It is in the middle between my thigh and pelvic.  I have had it for awhile I am 49 years old it started small.  Now it has spread I rub some alcohol on it and it soothe it for awhile then it flare up again I was also using cocoa butter stick after rubbing the alcohol.  Now I be loosing some of the skin as if it was a bump.  I am a cancer survivor.  I had breast cancer four years later lung cancer.  I've been cancer free for over eight years.  I am in menopause stages could this play a part.  Please help.",
    "doctor_response": "Hi,From history it seems that you might be having fungal infection on the part.Do not apply alcohol.Take oral anti-fungal tablet like Flucanozole 150 mg once in a week for 4 weeks.Apply anti-fungal cream locally.Keep local part clean, dry and airy.Avoid using synthetic inner wears.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility\n\nHi....I have a marriage of 3years. We both are fit and all our reports are positive. We are trying for baby since last one and half years. Every month follical study is done but still I'm not able to conceive. Our Dr told us for iui and we agreed. Last month she did but for no use and again this month she did iui. Today is my 16th day and still follical is not ruptured. What to do now?? I trust my Dr but I'm worried so thought of taking your advise.",
    "doctor_response": "Dear patient! Dont worry! As far as IUI is concerned, usually 3 attempts are required to get the desired results. So, you need not worry too much.As far as the rupture of follicle is concerned, kindly discuss the use of injectables(inj. Hcg) for the rupture of follicle with your doctor.Hope this lessens your anxiety and answers your question.Awaiting your precious feedback.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes canker sores in the mouth along with tongue and gums?\n\nEver since i started taking adderal (18 months) I have been getting canker sores in my mouth, on my tongue, inside cheeks, gums.  They are brutally painful. But I also have no teeth except for 4 on the bottom and they are rotten I am in the process of having dentures made. Also, I am on numerous medications, one being a high does of lyrica- please let me know what is attributing to these cankers",
    "doctor_response": "Dear Sir/ Madam,There are several reasons for canker sores in the mouth.It could be, Low immunity, Heavy medications, Local infections of oral cavity, Sharp tooth etc.There are usually very painful and sensitive. It leads to lot of saliva secretions in the mouth also.I suggest you to visit your dentist for this problem, he can guide you better.Otherwise an ointment by the name of metrogyl DG will help you.Regards,Dr. Vishal JainVitaldent",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it advisable to get dental extraction and implantation on second day of periods?\n\nHello doctor, I have the following on the second day of the menstrual cycle- a headache, lots of bleeding, abdomen pain, general weakness. Is it fine to have a dental implantation surgery during this time? It includes tooth extraction and implantation.",
    "doctor_response": "Hi. Yes, it is absolutely fine to have implantation surgery during your menstrual cycle. You can take Ibuprofen 400 mg four hours before surgery. You should have a proper meal at least an hour or two before your surgery so that you do not feel nausea during surgery or hungry right after surgery. Hopefully, everything will go smooth. Best of luck. Stay happy and blessed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to change reactive HBsAg result to non-reactive\n\nHi Doc! I m Jerald, 24, and my concern regards from my last test from a HBsAg reactive recently. Seven(7) years ago I undergone the same test and I m a non-reactive result. Do I have a chance to make it a non-reactive once again? Is there any ways(lifestyle changes) or medications that can resolve my issue? Thank you very much Sir and I appreciated your response toward my condition. God bless!",
    "doctor_response": "Hello,a positive HBsAg suggests hepatitis B. Unfortunately hepatitis B cannot be treated with anything else besides medications. The rest of hepatitis B indices are important for the diagnosis (acute versus chronic hepatitis) and the liver function tests may provide additional information. Anti-HBs, Anti-HBc IgM & IgG, HBeAg and Anti-HBe are useful tests to assess a patient's hepatitis B status. ALT, AST, ALP, gamma-GT, albumin and total protein and serum immunoglobulins are also important tests in hepatitis. Finally, depending on the results of the aforementioned tests, an HBV-DNA measurement may help in treatment decisions.You should consult your primary care physician for the first assessment. I hope I've answered your question.Please let me know if you need further assistance.Kind Regards,Dr Panagiotis Zografakis,Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it dangerous to conceive while on preventive medication?\n\nI am going to Kenya on honeymoon and am wanting to start trying for a baby, I am having vaccinations for Yellow fever and taking anti malaria tablets, the nurse said it was fine to start trying but I have read I should wait, is it ok to try or should I wait?",
    "doctor_response": "Hi there, ,Trying to get pregnant after taking yellow fever vaccine should pose no problems to you. But regarding the malaria prophylaxis, you should be cautious. A lot of factors play, Whether the area you are going to has high density of anopheles, chloroquine sensitive or resistant and how long do you plan to stay.You should keep in mind that no anti malaria tablets are 100% protective and you could still get malaria. Malaria can increase risk of miscarriage, and anti malarial medications may or may not have side effects on the pregnancy depending on which one you are using.I would advice you to avoid getting pregnant while on anti malarial medications.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain after falling down?\n\nHI MY NAME IS DEBBIE I FELL ON A WET FLR. AUG 8-10 HURTING MY RT HAND,LT , LT KNEE XAYS SAID I HAVE A VERY BAD  SPRAINS, I HAD HERNIA SURG 6-10-10 AND MY STOMACH HAS BEEN RELLY HURTTING THAT NIGHT OF THE FALL COLUD I HURT THE MESH IN ME OR THE HERNIA?",
    "doctor_response": "Hi Debbie.Thanks for your query. Read and understood your problem. On felling the muscles of the abdomen also go into sprain and spasm, stretching over the fibrous tissues around the hernia repair and the mesh. It is likely to get healed well provided you take proper treatment. The right hand and left knee will also heal well as there is no fracture on them.I would suggest you the following:Strict bed rest- this is the most sure shot way for early recovery.A course of an anti-inflammatory medicines like Ibuprofen in proper full dosages as per your body  weight and after full stomach.You will be fine soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will Glucose drips help in treating liver damage?\n\nmy daughter took 40 paracetamols she was taken to hospital and placed on a drip she had 2 glucose drips but when they done the blood test it revealed she had done serious damage to her liver so she is now on another drip of glucose will this help with the damage and if not is there anything she can do to repair her liver",
    "doctor_response": "Hi,I am sorry for the unfortunate situation. Paracetamol poisoning is the leading cause of acute liver failure in the United States, but in developing countries, it is rarely seen. Paracetamol poisoning can cause liver damage ranging from very mild elevation in the liver enzymes to total liver shut down (fulminant Liver failure). The extent of damage depends on the amount of paracetamol ingested and if the patient had any other liver disease before the poisoning. In mild cases, the treatment is continuous infusion of N-acetyl cystiene (? glucose drip) which helps in repairing the damage to the liver. In severe cases, the only available option would be an emergency liver transplant. Hope this helps and please do not hesitate to ask for clarifications. I hope your daughter a speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fungal infection in skin\n\nMy Father has fungal  infection  in left  leg  ,  we  have  consulted many  doctors  in  bhubaneswar .  due  to  infection  the skin  turns black and  thick . He is being  treated  for more  than 5 yrs .  Can  u suggest some  surgery so  that  the  skin  will  be  normal .",
    "doctor_response": "HiThank you for asking HCMI have gone through your query. A culture of skin scrappings should be done to rule out the causative agent/fungus. In case of suspicion of lichen planus a punched biopsy also should be done. A consultation with a dermatologist will be helpful to diagnose the condition properly and to treat it. If it is fungal infection then topical anti fungal agents along with oral tablets of anti fungals like terbinafine or fluconazole will be needed for long term to eradicate the infection. In case of lichen planus , moderately potent topical steroids will be helpful also. Hope this may help you.Let me know if anything not clear.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lightheadedness?\n\nHello, I have a question on a health issue. Last Dec 13, I fainted,went to hospital, was checked out for everything under the sun. Fainted for less the a minute. I have a slight heart mummur[had scarlet fever when I was 12 yrs.old.] When in hospital they checked for everything ekg,heart monitor,sugar, [had my thyroid killed with radiation last summer][it was 2 1/2 times the limit] that was in range when they did these test,.had tilt test.They said I was disgnose with having syncope.This had happened two more times in Jan. of this year. Same thing,went to hospital they did ct scans[ fell and split my head open] ,ent,hearing tested. I am now going to neurologist, he had me have a eeg and a mri, they came out fine, he has put me on a seizure medicine[Levetiracetam].Doing better but still have a few of lightheadedness. Just wondering if anyone of you would know what is wrong with me. My blood pressure has been with limits also. Just getting tired of not knowing what is causing this. Thank You.",
    "doctor_response": "Hello!Welcome on HCM!I read carefully your question and would explain that as all your tests have shown nothing abnormal, your symptoms could be related to vaso-vagal syncope or seizures. But as EEG has resulted normal, seizures are less likely. I would like to know more about these episodes: -Do you feel them coming? Are there any specific signs so you can predict them?- Do you remember how they occur?- Do you fall abruptly or try to hold on something to protect yourself from falling?- Do you regain conscience immediately or you feel dizzy and foggy for some hours later, after these episodes?All these characteristics can help differentiate between a seizure and a syncope. In case of syncope, levetiracetam would be unnecessary. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed NHL Diffuse large B cell lymphoma, 6 chemos completed, RCVP given, fever, hb is 7.6\n\nSir my father is a 77 yr old m diagnosed with NHL Diffuse large B cell lymphoma.He has completed his 6 chemos on 23rd sept 2013he was given RCVPRituximab'cyclophosphamidevincristineprednisolonepeggrafeel(filgrastim) was given after each chemofew days back he had fever of 101.3 and we bought him to hospalthough he has no inf detected after blood culturetoday his hb is 7.6yesterday it was 8and day before it was 8.2dr has said its side effect of chemo and will recoverpls suggest wat to dodr has not advised transfusion",
    "doctor_response": "As you are undergoing chemotherapy these drigs are very strong and have many side effects one them is bone marrow depression. These bone marrow a place where Red blood cells are produced. So many of the times patient feels fatigue, and weekness. So after completion of your chemotherapy the side effects of will be resolved. But bare in mind some times it destroys the bone marrows serioursly that can't regenerate. So my suggestion to start Haematinics and keep a watch on on your RBC count. You can talk to your physician regarding it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why are my tongue and roof of mouth swollen and tingly?\n\nMy tongue feel swollen and it tingles as though I have burnt it. The isdie of my lips and roof of mouth now tingles. Went to GP last Thurs who thought it was allergy and prescribed rx for this. It started to improve for two days but now back and getting worse. Had dental check up (26th March) all okay with my gums and this was prior to the problem I now have.",
    "doctor_response": "Hi,Thanks for posting the query,      I would suggest you to take tab cetrizine BD for three to five days, take lukewarm saline rinses and antiseptic mouthwash gargles, take multivitamin suplements, take plenty of fluids which are rich in vitamin C .Hope you find this as helpful,Regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am having pain after dental implantation.\n\nhi, I am 18 years old, 140 lbs. On monday I had the roots of my dental implants done, and it pains me to wear the retainer. everyday I try to put the retainer in hoping that it won t hurt and i ll be able to leave it on. But the pain hasn t faded and I m worried my teeth will shift. What should I do?",
    "doctor_response": "Hello, Its not a good sign to have pain after getting an implant in our jaw. The pain can occur for a day or two but if it is prolonged it could be a sign of infection. however in your case , you mentioned you wear reatiners- that is one of the possible cause of pain. you are not suppose to wear reatiners for atleast two weeks till the gums over the implant heal well. or if it is too important then your retainers must be lined by a \"soft tissue liners\" which will prevent any trauma to the underlying gums when you wear the retainer. its not a good idea to wear retainer in post surgical phase. avoid for two weeks and consult your dentist. let him do a clinical examination and take an x ray of the area. be cautious if you see \"pus\" coming out. thats a sign of infection. must go back to your dentist and talk. good luck. Dr. Manish Juneja Oral Implantologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes upper arm pain and very limited movement in arm?\n\nI have upper arm pain & very limited movement in my left arm. started about 3-4 months ago & thought it was a strain as this is what it felt like , now it has progressed to me having limited movement, I am wondering if you can tell me what this would be & how I can mange it.",
    "doctor_response": "This is symptoms of axillary or brachial plexus stenosis or cervical disc stenosis or inflammation. First, cervical x ray, nerve conduction test and CBC and fasting blood sugar should be done. Taking of vitamin B12 injection once every 3 days is effective now.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this MRI report indicate?\n\nHi I got a MRI the other day and got a copy of the results are you ready? Mild inflammation in the AC joint Interstitial undersurface tear of the mid to posterior suprasspinatus tendon It maesures less than 50% of the tendon thickness The NTERIOR AND THE REMAINer of the posterior supraspinatus tendon is intact Whats this mean?",
    "doctor_response": "hi,thank you for providing the brief details of the MRI scan.As mentioned in the scan, you need a thorough musculoskeletal assessment.As there appears to be a mild inflammation of the AC joint and a tear of the supraspinatus tendon, this report has to be related clinically. if clinical symptoms are found to be positive then the next course of action will be implemented. Like Medication for pain and physical therapy for improving the joint ROM and also strength.Also, the report indicated that, AC joint inflammation, Means there is a inflammation in the acromioclavicular joint - this joint is formed by the lateral part of the collar bone and acromion of the scapula (which is your upper back bone). The supraspinatus tendon is the tendon which arises from the supraspinatus muscle which allows the shoulder complex. usually cases with shoulder complex are well controlled with medication and physical therapy in my clinical experience, only a few needs surgery who has major damage of the joint.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Cilest, have breakthrough bleeding. What should I do?\n\nI have been taking the pill cilest since August without having any breaks and I am getting constant breakthrough bleeding every day and it isn't like fresh blood. I am now taking my 7 day break from it after all these months as I can't deal with this what seems like bleeding everyday and am on my fourth day yet still havnt had a proper period (however there is some reddish coloured blood instead of brown) what should I do? And can the way I have been taking the pill make me infertile?",
    "doctor_response": "HelloThanks for your quqery.You should switchover to another form of birth control instead of tolerating this kind of bleeding.Also, pills cannot render you infertile, so please dont worry.Please consult a gynecologist and choose a method that is better suited to your body.Have protected sex meanwhile.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can non penetrative sex cause pregnancy?\n\nHi, My name is Krystal and i am 13 years old. My boyfriend and i sometimes spend the night with each other and the last time i went over there i gave him a blow job and he \"touched\" me and im soo worried that i might be pregnant! could that possibly get me pregnant? PLEASE give me your advice!",
    "doctor_response": "Hello Krystal, I thank you for posting your query here and I'm definitely going to help you out.. Welcome to HCM.. Do not worry Krystal, this fear is common and I can say that you are safe! Don't worry.. I being a surgeon, we encounter so many such cases day in and day out. I read your question completely and have understood it well enough.. Please note these following things.. 1. You did not have Penetration. And there was no way he ejaculated into your vagina. In that scenario, there's absolutely no way you can end up in pregnancy. Never. 2. Blow job again will not lead to pregnancy.. So do not worry about it. Just chill out.. 3. Touching again won't cause pregnancy even if it's your vagina. Basically, the penis has to be unprotected, then go into vagina, ejaculate completely inside of the vagina and same time you should have ovulated. And then, there's chance of pregnancy. Your history is no where near to all these events. So do not worry.. 4. The scenario that you have told, I can say with certainty that you can not be pregnant. 100% sure of it.. 5. So suggest you to stop freaking out and be happy.. Hope this helps you Krystal, in case you need any further assistance, please let me know. Take care and God bless you..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can explain stabbing pain in lower abdomen with twitching sensation?\n\nfor about the past 2 weeks i heve been getting seriously bad stabbing pains in my lower stomache sometimes the last 15 seconds,sometimes 15mins ive tried lying on my back and front, walking around, bending over and streching to ease the pain but nothing works sometimes the pain is all over my lower stomache but sometimes i get shooting pains coming from a point between my left hip and my elly button i also get an occasional fluttery/twitching feeling here. since i have started getting these stabbing pains i have kept feeling like im going to be sick and getting headaches",
    "doctor_response": "Hi.Thanks for your query and an elucidate history. You have got recurrent sharp stabbing pains in the left abdomen between the naval and hip bone, this is most suggestive of the following :Impacted stone in the left ureter.Colitis with obstruction may be due to Cancer of the sigmoid. I would advise you the following:X-ray of the KUB region of the abdomenUltrasonography of the abdomen.Test of urine, blood and stool.If the stone is found, it needs to be removed.Get an opinion of the Urologist so that further treatment and investigations can be decided.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the pus filled spots on my leg in spit of taking antibiotics?\n\nI was started on Flucloxacillin after i was bitten on my leg and it looked infected. I stopped the antibiotics after five days and since then i have a further three puss filled spots on my leg that are itchy? is this further infection? do i need antibiotics?",
    "doctor_response": "Hi,You might not require further antibiotic but what is important is clean properly local part and apply triple action cream.Proper dressing is important for healing.Avoid itching as it might aggravate infection so take cetrizine or benadryl medicine for few days.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant pain in buttock, pins and needles in shoulder?\n\nI have a constant pain in my right buttock and the outside of my right calf. I have pins and needles in my right shoulder intermittently. the pain is not present when I run or walk. I am 69 and run and walk regularly over long distances 30 to 50 miles.",
    "doctor_response": "Hello, I have studied your case. There is possibility of transient ischemic episode leading to pins and needle on right side.You may need clinical examination to confirm neurological weakness, BP and other vital parameters. Another probability is due to compression of this nerve root there is pins and needle in shoulder.You may require MRI brain and spine.For these symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, you can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.I will advise to check your vit B12 and vit D3 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe backache be treated?\n\nHi I gave my partner 1 x 500mg and 2 x 30mg codeine phosphate at 10:45hrs for acute back pain. She also has prescribed diazepam tablets (2x 5mg 3x a day and 5ml of oramorph 4 x per day. Can I give her either of these in conjunction with what I gave her at 10:45 as she is still in pain? Chris",
    "doctor_response": "hiits a risk to give these medicines in conjunction as they have synergestic effects. overdose may cause sedation and dizziness and other similar side effects. consult a doctor thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do multiple lumps under the chin and mouth indicate?\n\nI found a lump the size of a pea under my chin towards the front in early september, about a week later found another on the floor of my mouth in the front. Now there is another one next to the one in my mouth. None have any pain associated with them. Should I be worried? What could it be?",
    "doctor_response": "not to worry much as this is benign condition like sebaceous cyst or lymph nodes skin tags / fibroepithelial polypif really worries you can go for an FNAC test for confirmationall the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for skin cancer\n\nHi,We leave in Langley, BC. My husband has been diagnosed with skin cancer. He is going to Glover Medical, Langley, BC. His doctor is Dr. Matthews, Ronald Bruce. He had a little procedure - a peace removed from top of his head and sent for a biopsy. Today he went there for the results and to have the stitches removed. The doctor (was dr. Sumani today) told him he needs another surgery in a month or two because it s not clean enough. I think my husband needs to be send to see a specialist (oncologist) and get the full blood test and furder treatment, not to wait one or two months for the next procedure from the walking clinik. I am looking for your opinion!",
    "doctor_response": "If the result of the biopsy does show skin cancer, then you should not wait at all for the second surgery, leave alone for a month. The cancer will increase several times in this period and may spread to other parts when it will be beyond cure. So, time is of essence. Immediately show him to a cancer surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower right back pain?\n\nI recently had severe pains in my right side which I thought was a kidney infection and the doctor put me on antibiotics, as the passion persisted the doctor referred me for an ultrasound, 2 hours after getting home from the ultrasound they called me to go straight back in for another as the doctor wanted to have a look at my gallbladder. At that ultrasound the doctor said everything looked alright except for my bial duct was enlarged which is unusual for my age and that it is usually caused by a stone which I have never had. Yesterday the doctor phone me to go in to get my test result, he informed me again about the bial duct and that there were also shadows on the liver. I now have to have blood tests and a CT scan and if they don t show up anything I have to see a specialist. Should I be worried and what could this mean. Donna",
    "doctor_response": "Bile duct dilatation is generally due to obstruction to the flow of bile, commonly due t gall stones, benign strictures due to pancreatitis, tumors.The cause is generally diagnosed by Blood test to check for live function, Ultrasound, CT scan.There is no need to worry as these are very common illnesses, and treatment is available for all the causes.Hope this answers your question, thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in breathing?\n\ni had a medical abortion about 2.5 weeks ago, and about 2 days after i took the 2nd pill i noticed it became difficult for me to breath. i am very short on breath and am very fatigued, its also hard to sleep and i do not feel well rested when i wake up. i went to my doctor and my oxygen levels were very low. i was 86 then after walking for about 40 seconds my level was 76. my doctor couldnt believe it so we did it again and i started at 77 and my level then dropped to 66 after walking for under a minute. i had a ct scan and he said it was normal also my lungs sounded clear. my blood work showed i am not anemic. any ideas as to what it could be? i m trying not to become anxious however its hard not to be. I am to the point where I am yawning just to get a full breath of air.",
    "doctor_response": "Hello,As per your history and description, we should definitely rule out pulmonary embolism (PE) for your symptoms.Pulmonary embolism is known complication of medical abortion pills. And your fall in oxygen saturation on walking also suggests PE.For the diagnosis of PE, you need special CT scan known as CT pulmonary angiography. So, meet your pulmonologist again and ask for CT pulmonary angiography.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Kaushal Bhavsar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shivering post a bike crash?\n\nim not pregnant how ever earlya today i was riding my motorbike in a old chalk quarry it is now abandond and has been for over 10-15 yrs  and it now looks like a lake were one of the stepdowns has filled with water i crashed my bike into it earlya today and woundered if you could help me understand wat i am feeling, wen i chrashed into it it was so cold that i oculd not get my breath even tho i was above water its like my lungs had frozen(posssibly shock of the cold like jumping into a ice pond like the sas do on training)  i then had to go in and out about another 5 times to drag the bike out  but im now having trouble breating its like my lungs are giving up but i dnt believe it to be this bad i got a pain in my throat i cant swallow andmy lungs kill every time i breathe in   i got water dripping out of my nose and keep going to be sick but the sickness is not from my stomach it is from my lungs and as far as i can remember i did not swallow any water can you shed some light onto why i am so cold and finding it hard to breathe (yes i am aware there was a risk of hyperthermia but once again i do not believe i have this either as i have been able to warm up abit but i am still shivvering) this happened at 5 pm british gmt  it is now 11:27 pm british gmt",
    "doctor_response": "Hello,Welcome to HCM.First of all thank you for sharing your concern with us .Breathing problem and shivering after an accident in cold weather can be due to following causes:1. cold 2. lung injury I would recommend to get a chest X ray done to rule out any possible injury in chest and discuss further with your Healthcare providers. If clinical examination and chest X ray is fine then such symptoms are due to cold and musculo-skeletal  injury which will resolve on it's own but first rule out any possible chest trauma as mentioned earlier .Best Regards,Dr.S.Tomar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get excess sleep with shortness of breath, and waist pain during exam period. Why?\n\nHello doctor, I am a 17-year-old male from India. At this time my exams are going on so I cannot visit any doctor. Kindly help me. I am feeling some health problem symptoms for about a week like excess sleep, short breath. When I lie down on the bed it get worse some times. I have a feeling of rubbing of knee bones while walking and also have waist pain. Yesterday, I took Modafinil 100 mg tablet as suggested by my friend. But my symptoms gone worse. I have trouble breathing lying down, throat pain and breathing trouble, high blood pressure, blood in stool, pain in backbone, excessive waist pain, muscle and joint pain. Today I got relief from some symptoms, but still, I am feeling breathing problem, back pain, rubbing of knee bones, sweating, tiredness, sleepiness, mind goes blank and black in front of eyes when I standup suddenly. Please help.",
    "doctor_response": "Hello. Well, from the information it appears you have an acute stress reaction. But I need more data before reaching that conclusion as you are experiencing breathing problems on lying down and blood in your stools. Did you experience similar symptoms in the past? Do you have any past medical history? Are you feeling stressed out due to exams? Breathlessness on lying down persists for how long and how is it relieved? Do you use any recreational drugs? And most important of all do not take any drugs like Modafinil without prescription it could be dangerous. Do you experience these symptoms during each exam? because it appears your symptoms are related to stress and anxiety of exams. Please tell everything, hide nothing it will be confidential.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump above the belly button?\n\nHello...I'm male, 39, 5'9, 170 lbs. I've had this lump for about 2 weeks. I can feel it from a couple inches above my belly button to...it feels like, just under the sternum. No real pain, as of yet, just pressure and feels tight. It's right directly in the center. Can you please tell me what this might be?",
    "doctor_response": "HI,Dear,Thanks for the query.1-I studied your query in depth.2-In my opinion ,The painless lump under the sternum and above the naval button ,may be-\" proped up non-strangulated perperitoneal fat\"- protruding through the defect in the central fascia between the 2 abdominal recti-as there is no pain in that central lump.3-It could be Lipoma herniating out of the fascial tissue between 2 recti.3-a-It could mimic the Umbilical hernia also and needs to be differrentiated.4-Hope this would solve your query to your satisfaction.5-Wellcome for more queries to me On HCM.6-Thnks once again for your inquisitive query.Have a Good Day..!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for belly button pain?\n\nTuesday I began to notice a pain in my belly button after helping a few friends move a safe. The pain increased as time went on and rolled into today. I played with a bigger dog about two hours ago and my pain shot through the roof. I went home and looked at my belly button region and noticed a clear/pinkish discharge coming from my belly button. The pain is only present when I stand. What could be the issue, any advice helps.",
    "doctor_response": "Hi and welcome. It looks like this is omphalitis which is infection of belly button and this is benign condition that usually passes on its own but sometimes antibiotics are neccesary. In every case keep this area clean and dry. Wish you good health.regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low semen volume?\n\nI am a 22 year old male and I have never had sex so I masturbate every day  and then all of a sudden I have noticed that  my cum  load isn't what it was before. I also noticed its taking me a lot longer then before to get hard. I was laid off from work and lately I have worried about a few bills and had stress and been a little sad but not quite depressed. I am curious if I should be worried about this  or if its just the stress about bills and being a little sad would be the issue?",
    "doctor_response": "Hello, Consult a urologist and get evaluated. Conditions affecting prostate and seminal vesicles must be ruled out. A semen analysis is required to check the count and motility. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain, General & Family physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain in my legs?\n\nyes I had a test done where they stuck needles into my legs to check them because I had weakness in them and every scine I have had that done, I get sharp pains in my left leg on the side feeling like needles .. at first I thought it could be a Charlie horse but it wasn t... could you in light me",
    "doctor_response": "Hello, I have studied your case. Usually nerve compression cant be seen on x ray you may need MRI for this. there will be age related spondylitis but if there is any nerve compression then that can lead to leg pain.I will advise you to do MRI spineTill time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with bells palsy with symptoms of blinking of eyes and dry eyes with history of paintball hit in the eye.  Is this serious?\n\nMy son was just diagnosed with Bells Palsy, he is 32 years old.  He says he blinks his eye a lot and puts eye drops in it so it does not dry out, and it will clear up by itself.  Several years ago he had a paintball hit his eye and was treated by a specialist.  He almost lose his vision but luckily did not.   I'm just wondering if he should contact the specialist and let him know what he was diagnosed with or am I worrying too much.  Also a friend told him he should do mouth exercises for the Bells Palsy, is that necessary?  Thanks",
    "doctor_response": "hiwith bellspalsy problem is that the nerve supplying face muscles becomes impotent for a while and those muscles are paralysed. this paralysis causes symptoms like inability to close eyelids fully, deviation of mouth, loss of wrinkles on one side etc. for eyes, drops are good and blinking helps. i would recommend taping the lids with a plaster tape every night before going to sleep, as putting drops during sleep hours is next to impossible. there is no relation to old injury and bells palsy now as bells palsy affects only eyelids. exercises wont help much. i would advice it to be left alone and he will be recovering or totally recovered in 8 months.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting while suffering from cough?\n\nHello , my son 23 months, for past 1 week he had cough and cold, for which I gave him cheicof and tusq-d but now for past 2 days he has loose motions , and started with econorme sachets and for cough tossex but every time I give cough medicine he vomits with the whole food out, pls help",
    "doctor_response": "Hello, Some time cough medicines will produce vomiting due to bitter taste. just mix the medicine with warm water and give. Otherwise, you can give 30 min before or after food. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Rajmohan, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a growing leg lump with pain be treated?\n\nI have a big red lump in between my bottom butt cheek and begging of back of the leg it s been 6 days I ve seen a doctor but they say it s a boil i think it s a cyst I ve been using antibiotics for 3 days now a pill and a cream I ve also been bathing in Epsom salt about 2 a day for 2 days and the pain is getting worst and it s getting bigger it s hard to lay down to sleep its hard to walk and I can t sit down any solutions",
    "doctor_response": "Hii appreciate your concern i can understand your problemin my opinion it might be a gluteal abscess if you are not getting any relief with antibiotics I would advise you to go for incision and drainage under cover of antibioticstake acetaminophen for pain relieftab pantoprattle to avoid hyperacidity Liquid paraffin for constipationmaintain a good hygiene by cleaning it very frequentlysitz bath Hope I have answered your questionthanks for using health care magic take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden pain in stomach of 3 year old at night?\n\nHi my 3 year old son has woken in the middle of the night screaming and crying. He keeps saying owwee and pointing to his stomach. He cant be distracted from the pain and my attempts to settle him have all failed. He stops crying and goes silent occasionally but this lasts no longer than 1 minute before he is screaning and crying again. This has been going on for over and hour now and i am beginning to get concerned.",
    "doctor_response": "Hi,It seems that he might be having intestinal colic giving frequent spasmodic pain.This can be due to some food difficult to digest.Give him Meftal spas or Coli-carmin syrup to get relief from pain.If problem persisted then in the morning consult your doctor.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is HIV antibody test conclusive at 53rd-day post-exposure?\n\nHi doctor, I got a complete panel and RNA PCR tests after 53 days of unprotected vaginal sex. The results were negative, except HSV-1 was reactive. So, I went to meet my doctor with the reports, who told me to get an HIV-1 and HIV-2 antibody fourth generation test. The results were negative again. But, I feel my body hot, burning, testicular pain, and I have red dots on my\u00a0tongue. Are my results conclusive? Please answer my question. I am very anxious.",
    "doctor_response": "Hi. Hope your query is answered, but if you have any other query, please do not hesitate to ask or call anytime.\u00a0Best wishes. Revert with more information to an HIV AIDS specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for asthma with severe headache\n\nhello doc,how are you?i am 47 years old woman.having asthama and sinustis.i have severe and continuos headache for past 5-6 years.i am using all the pain releives.my vision are also blurr.is this headache is related to sinus and asthama.please suggest me a better solution or remedy to overcome this.i willbe very grateful to you and thanks",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your query and would like to make suggestions for you as follows:1. Were I treating you, I would suggest you regular montelukast and levocetirizine. I would also suggest you to use salbutamol inhaler on as-and-when-needed basis for asthma symptoms.2. For sinusitis, I would suggest you regular steam inhalation which will also help.3. Sinusitis is a common cause of headache, but as you are having headache for last 5-6 years, I would suggest you to consult a physician to rule out other possible causes of headache. In general, I would suggest you to take paracetamol for headache.4. Please consult an Ophthalmologist for blurring vision as it is usually not related to asthma and allergies. 5. I would suggest you allergy testing which will help you identify the substances causing allergies to you as well as the measures to avoid them.6. I would also suggest you regular breathing exercises and a healthy diet rich in vitamins and minerals (adequate green leafy vegetables, fruits, sprouts, etc) which will improve your lung capacity and immunity in a long run.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain?\n\nhello..i have a bit pain in the middle right side of my stomach.So i did a Ultrasound of the whole abdomen and the finding are: bilateral mild nephromegaly with mild dilation of the pelvicalyceal system of the right kidney and mildly enlarged prostrate.",
    "doctor_response": "HI.Since the prostate is at the base of the urethra, the obstruction caused by an enlarged prostate can cause back-pressure to cause reflux of the urine from the urinary bladder to the ureters and up to the kidneys causing the changes you have seen in the ultrasonography. I would suggest such a patient the following. To get a consultation of an Urologist ( Surgeon ) for physical examination of the prostate by per-anal palpation by a finger to ascertain the size ,  consistency , tenderness and all relevant examination.PSA and all other blood tests including kidney function tests and sugar.Urine -routine, microscopy, culture and sensitivity tests. If Cancer is suspected a core-biopsy may be needed as also Orchidectomy. Prostatectomy as a treatment and as a specimen for biopsy. This should solve your problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low appetite in infants\n\nHi My baby Age is 1yr 2months.she is not eating well.before days when starting of first 2 teeth grows she eat solid foods but now she not eating solid food .we make it as semisolid more orless like a liquid we are giving now. please suggest it wt food to give.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.I take this opportunity to tell you certain scientific facts and relieve your distress - 1. An active is a well kid even if she/ he is not eating well. 2. Development of a kid is as important as or I would say even more important than growth alone.3. As the kids grow their interest in food decreases and interest in play activities increases so that they eat small quantity and run away to play. As parents we need to be more patient and feed than less quantity but more aliquots per day.4. This age rather than the quantity of the food I suggest you concentrate more on the number of times you feed her and also make whatever you feed her calorie dense by adding good amount of ghee to it.5. I suggest you not to use appetite stimulants on long run as they may cause drowsiness.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What could be the gray patches on the white of my eye?\n\nHello doctor, I am 19 years old male, and I want to know why there are gray patches on white of my eye though it does not irritate so far. I am curious to read a lot of stuff some article goes as far as cancer-related to this, need professional guidance as I am getting anxious.",
    "doctor_response": "Hello. Gray patch on the sclera might be due to some congenital pigmentation, freckles, or nevus. Mostly they are harmless and nothing to worry about. Rarely they are related to cancer, but at your age, cancer is not common. You need to observe these patches if you feel any change in color or size or any other symptom like pain or redness, then you should consult your eye doctor. So do not worry unless it starts behaving differently. You are most welcome for any queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower abdominal pain, buttock pain, menstrual changes. Caused by UTI or kidney stone?\n\nI have been experience lower left abdomen pain along with more severe lower left buttock pain and mentruation changes. Could it be caused by a UTI or even kidney stone? I have been treated for UTI s on an off for the past year. I am 2 yrs overdue for my pap smear . Am also experiencing a dark red throat, somewhat difficulty swallowing , and right ear bothering me a bit. I had a ivory lesion on my tonsil few weeks ago that eventually went away but still have red throat.",
    "doctor_response": "hello, you should go for complete blood test with ultrasound , urine test for confirmation.if this is UTI then take medicine for minimum 15 days with plenty of fluid, treatment for stones depend on size of renal stones if present.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause blood vomits and night sweats?\n\nAm 27yrr old a student,for the past 3wks of so i developed some sort of do i say vomiting blood or.fresh non clotted,no hx of trauma,i never take alcohol.but i have experinced  some sorts of night sweats for the 2wks.i suspected pulmonary tubeculosis but my worry is the amount of blood i produce.My ESR is 49mm/hr.what could be the diffrentials",
    "doctor_response": "Hi thanks for contacting health care magic...ESR is non specific measures ...It can be elevated in many inflammatory and infective condition as well in tumours.Your physical examination is necessary first...First it could be from tuberculosis e bronchitis or other respiratory pathology.Chest x ray can be done...If  suspected TB , sputum examination done for it....For it AKT given .And for bronchitis antibiotic given..Vomitted blood could be from liver pathology.So palpate liver and investigate with liver enzymes study and PT plus serum protein.If present then variceal bleeding also can be there.Gastritis sever or bleeding peptic ulcer also can lead bleeding .For above two condition endoscopy needed.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for renal disease while suffering from diabetes\n\nHi, I am 63 years male suffering from Diabetes, my fasting sugar is 154.6 with sugar absent in urine and PP is 244 with sugar prsent in urine (**). I am taking Glimmy1 one tablet before breakfast and Glycomet SR 500 one tablet after dinner. In my last pathlogy reports I have been identified with Bilateral Grade I Renal Disease. Please advise what should I do?",
    "doctor_response": "Hi, the renal problem is due to Diabetes. Please control your Blood sugar and blood pressure if you have, very strictly. And there are medicines to protect your kidneys. Please consult a kidney specialist--regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having low libido after taking medications for OCD. Kindly advise.\n\nHello doctor, I had a bad complaints of OCD 7 years ago, then I met with a Psychiatrist, he advised me Clonazepam 0.5 at night alongwith Escitalopram 10 mg in the morning. I felt a little comfort. But for getting more effectiveness I increased myself the dose of Clonazepam upto 2 mg for anxiety, panic attacks, etc. Now I am quite well using the above-mentioned medicines and I do not miss my dose (Escitalopam 10 and at night 2 mg Clonazepam). Now I am facing serious problems of sexual erection due to which my marriage life is disturbing because my libido is too much low. It is requested to kindly help me or advise me in the matter.",
    "doctor_response": "Hello. I am sorry to hear about your situation. I can imagine how hard it must be for you. I would put forward a few things you need to consider right now. First of all, Clonazepam at a dose of 2 mg if used for long duration can be addictive. This medication should be used only for initial few weeks or months to stabilize the anxiety symptoms. Escitalopram unfortunately can cause sexual side effects, what you can do is, if medication is working for you, ask your doctor to add something for sexual side effects or you can ask for changing the medication. Please do not worry as this is a common side-effect and only stays till the medication is going on and it gets normal after a few days of stopping the medication. Please do not stop medications suddenly, you need to taper them off and also take an alternative medicine otherwise your OCD symptoms can come back. You can start therapy. Cognitive behavioral therapy will help you with OCD symptoms and this will help you getting off of medications soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated liver enzymes and swelling in the abdomen?\n\nI am 75, male, in general good physical health although currently treated for bladder cancer and having chronic osteoarthritis. Recent blood tests show elevated liver enzymes and I do feel abdomen tenderness and swelling. Obviously, I have attempted diagnosis with my primary PA and urologist. Alcohol use and medications do not appear to be obvious factors and the condition is new. It dawned on me that within the last 18 mo or so I have started using a moderate dose of testosterone cream, fully under medical supervsion. Should I discontinue use? I can t recall any other major recent changes in medications. I am trying to deal with bladder chemo first befor getting into the emerging liver issues..what do you think?.",
    "doctor_response": "Hello, Our liver tests are only slightly elevated. In case of serious liver disease, these values are around 1000. The reason for your results can be a fatty liver which is present for sure if you are overweight. Please note that untreated fatty liver (which is a reversible condition) can lead to liver cirrhosis and liver insufficiency. To reverse fatty liver process, you need to change your diet and lifestyle. Fatty foods, spicy foods, fired foods, painkillers should be avoided. Otherwise, this process will slow going forward. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ivan R. Rommstein, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to wear braces without removing the tooth?\n\nHi, yes i have all my fully grown teeth but i seemed to have a baby tooth inside my gum. And my dentist said that before getting braces that I needed to get my fully grown adult tooth taken out . what happens if I decide not to get my tooth taken out and just get braces?",
    "doctor_response": "Hello.thank you for sharing your problem with healthcare magic. Generally over retained deciduous teeth need to be taken out.In your case its orthodontic problem .and sometimes due to lack of adequate space permanent teeth need to be taken out too .In that case you can't skip extraction and go with braces only. you can get better treatment from orthodontist than general dentist. You can consult for further queries. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes thick sperms?\n\nHello I was doing some research online... I have found a lot of different answers but my question is my boyfriend has clumpy sperm. Wondering the cause and if we can still have a baby? At this time we have had to luck, does this issue have anything to due with me not conceiving? We both have children with our previous relationship. I m 28 and he is 31. Thanks for any help Katie. Sorry",
    "doctor_response": "Hi,Thanks for writing in.If both of you have children from previous relationships then there should not be any worry regarding having children again. The clumpy semen you have noticed need not always be abnormal. It is important to get the semen tested in a laboratory to know the actual semen characteristics. Seeing it during ejaculation or sex as a clumpy material is not sufficient to comment about the sperm count and qualitative analysis. Since you both are still young adults, please do not worry for conception.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason to have lumps in finger and both feet?\n\nHi, my daughter have a lump on the side of her middle finger and lumps on the outer side of both feet and it appears to be getting bigger, within a month. I have notice them about 4 years ago but they were flat and hardly noticeable. But now, they are bigger and my daughter says that the lumps are starting to hurt on her feet and starting to feel uncomfortable wearing shoes. Is this serious? Thank you. Glenda, mother",
    "doctor_response": "there is nothing to worry much about these lumps!these are possibly benign tumor-like conditions like lipoma/neurofibroma or sebaceous cysts!just a simple FNAC test from any of the lumps could relieve your tensionall the best............",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pulsating pain in the knee having a history of GERD and Gastro paresis?\n\nI am a 44 yr old female with a history of gastroparesis, gerd, metabolic syndrome and pcps...i have had a pulsating on right side (inside) of left knee all day on and off..can see it pulse..doesn t hurt doesn t pulse with the pulse in my neck...doesn t feel like muscle twitching..seems to go away when i move...more noticeable when i am sitting standing or lying down..",
    "doctor_response": "In my opinion you have a popliteal aneurysm i recommend you do a doplar to be safe Please take it seriouslyGood Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can injury in forehead cause tripping and running into stuff in kids?\n\nmy grandson was dropped off by his paternal grandmother with a knot and scab on front forehead she said three days ago he fell on pavement but the child says mama dropped him ,but my concerns now is he is tripping over everything and running into stuff i have medical consent should i be worried he is also more frustrated than usual.",
    "doctor_response": "Hi,Welcome to Hcm,Your concern is understandable. Few more details like his age, how was he developmentally before the incident, how significant fall was it meaning from how high and what was the immediate situation after fall- did he loose his consciousness and have vomiting etc would actually help in arriving at a better conclusion. Having said that, we cannot neglect the possibility of internal brain injury with these symptoms which can present like abnormal symptoms in children. If I were your pediatrician , I would suggest you to get a Ct scan brain to be sure if there is any internal brain injury. Hope this helps your query. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My 4 years old son has red spot on his neck, back and ears\n\nMy 4 year old son woke up this morning with red spots on his back, neck, and ears. His ears are swollen and he says it doesn t itch. Any idea what this is or what we can do to make it go away?",
    "doctor_response": "These are allergic rash  called as URTICARIA.give anti allergic syrup like allagra syp and apply caladryl lotion after bath.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does elevated ESR cause any infections?\n\nHi doctor, I used to do CBC test before each time when I go for a travel and this time also, I did the same. Can anyone please tell me if these reports are fine? Or if I am suffering from any disease as some values are out of range. I am taking tablet Telday 40 mg in the evening for the blood pressure.",
    "doctor_response": "Hello. I went through your reports (attachment removed to protect patient identity) and everything is fine except ESR (erythrocyte sedimentation rate) which is slightly elevated, but it is acceptable to have it. Did you have a recent fever, or any other symptoms of infection like running nose, sore throat, excessive weakness? If yes, then, it can explain the elevated ESR. Even, it is acceptable to have this elevation. It is better if you get repeated after two to four weeks to confirm the static trend and not absolutely necessary. You can get it after you come back from the trip. For more information consult a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can intake of Tamiflu worsen asthma and cough-related issues?\n\nMy 12 yr old son has been having problems with his asthma.  We are following his yellow zone protocols and he just finished up with an oral steroid for 5 days.  He is still coughing a lot and his doctor recommended we up his maintance inhaler yesterday.  My daughter was diagnosed with influenza A so he was put on Tamiflu as a precautionary measure.  I just gave him the first dose at 7 and it seems like his cough/asthma issues have gotten worse since.  Could this be a reaction to the Tamiflu?  He has no other symptoms of a run",
    "doctor_response": "Cough is not a known side effect of taking Tamiflu.The cough could be due to the influenza. I would recommend an over the counter anti tussive like Dextrometharphan. Also water vapor inhalation might be helpful.Hope this answers your query. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe abdominal pain before/during my periods?\n\nhello doctor,i am 25 year old female. for almost 8 months i have been having frequent piercing pain on my lower left abdomen. it normally occurs when i am about to have my period or when i am having it. is it anything serious that i should be afraid off. i have checked with a surgeon and the pain keeps coming back now and then. what could possibly be wrong with me?",
    "doctor_response": "Hi,This seems that you might be having Dysmenorrhea giving this problem.This might be due to some hormonal disturbance.Consult Gynaec and get examined. In my opinion 3-4 courses of cyclical hormonal medicine will cure your problem.Meanwhile take antispasmodic medicine like Meftal spas or Cyclopam to get symptomatic relief from pain.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment should be taken after my sperm analysis report?\n\nHi I am 33 years old, I had a semen test wihcih shows 80 milliom/ml and motility of 20-30%, many sluggish and pin-headed and giant headed sperms are seen, Also scanning revealed mild varicocele on left testes. Should I undergo surgery or take any tablets to cure varicocele",
    "doctor_response": "Hello and .As an Urologist, let me assure you,a varicocele has no medical treatment.It can be treated only by a surgery, either laporoscopic, or open.Your semen analysis report suggests,below normal, live sperm count.The semen test report is incomplete, as morphology( shape and size ) of normal sperms is not reported.  Certain other details like,frucotse test, liquefaction time,presence of WBC's, etc, are not mentioned.You're advised to repeat the test, after 2-3 days abstinence, at a good lab.You can get my expert opinion, by sending the report, as a direct question.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should a child be taken to the ER while suffering from fever?\n\nmy 3 year old daughter has been running fever on and off today will be her 3 day she eating playing n using bathroom no problem its working me because it gets over a little over a 100 n then back down to 98 right now she is at 98.7 . should take her to the emergency room?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. What you say I feel that your daughter is going through a viral illness.I will explain you how a viral illness behaves so that you can be more confident.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 15mg/kg/dose (maximum ceiling dose of 500mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can i do for chest infection?\n\ni've got a chest infection for the second time in  2 months.i have blood cloths in my nose and feel pretty weak with a bad cough.I've not gone to the doctor and stayed away from antibiotics but feel i need some medication as my sympthons have been with me for 5 days.",
    "doctor_response": "Hi. I can understand your concern. It would be advisable for you to get a chest x ray done. You could be having pneumonia. So better consult a doctor at the earliest.Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure RBBB and heart palpitations?\n\nI have recently had chest pains and went to the hospital and they admitted me for observation and did ekgs and everything. They found that I have RBBB and Heart palpitation. I was wondering if this were serious and could it be corrected with medication?",
    "doctor_response": "Hi, Right Bundle branch block (RBBB ) may occur in subjects without structural heart disease and is most often benign.Right bundle branch block also occurs with heart disease, both congenital (e.g., atrial septal defect) and acquired (e.g., valvular, ischemic). As  you are symptomatic (chest pain & palpitation), 2D-echocardiography is indicated to determine the cause.RBBB cannot be corrected with any medication.Bundle branch blocks, however, may be intermittent. A bundle branch block may be rate-related; for example, it often occurs when the heart rate exceeds some critical value-hence self-limiting. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Tushar Kanti Biswas, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is Mometasone dangerous to use on Face to clear my acne pimples?\n\nHello doctor, I am seriously facing acne pimples problem. Sometimes they occur on my face when I masturbate. If I use Mometasone, it gives a good result. Is it okay to continue this?",
    "doctor_response": "Hello. Acne is a universal issue in the age group of 15 to 25 years due to hormonal changes in adolescents. However, there are multiple effective treatment options depending on the grade and severity of the problem. Mometasone is a topical steroid and is to be avoided strictly on the face and for acne as it can harm your skin in the long run. Acne is dependent on hormones hence excess masturbation may sometimes lead to an increase in the problem. I would advise you to stop Mometasone immediately and kindly upload appropriate images to help us assess your current grade of acne and treat you better. Regards. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for burning & painful lumps on throat\n\nThis evening I felt a pain in my throat when swallowing and then noticed a lump on the right side of my throat just above my collarbone about 1.5 in diameter. The pain seems to be a burning sensation and radiates to my right ear and through my right shoulder. It has been going on for about 6 hours. Not sure what to do but I don t usually go to the doctor for anything.",
    "doctor_response": "hi.based from your description, those lumps could be lymphadenopathies (inflamed lymph nodes) secondary to a recent or an ongoing infection (in your case, possibly an upper respiratory tract infection). if it is viral in etiology, it would subside in a weeks time. it is best if you consult with your doctor for clinical evaluation. management will be directed accordingly. hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain and shortness of breath\n\nHello, I am  27yr old female and weigh 62kg. I have never had any major health problems. Seven days ago I suddenly had some chest pains and difficulty in taking deep breaths. I am typically very healthy but over the past few weeks have felt very tired and as though my legs muscles in particular were aching all of the time. I saw my GP last week who did some tests and diagnosed me with asthma. However I did not find the 'salbutamol' pump very effective. In addition to this I often felt quite nauseous after using the inhaler so have not used it for the past two days- there has been no adverse affect to my breathing but I still generally feel unwell. Sometimes I just need to lie down as I feel so sick and exhausted- usually at night time. I had a full blood count last week and the results were all normal. I also have eczema and have had an on-going sore throat for a few months. I do not have swollen glands or a fever at all. Thanks in advance for any help! Folu",
    "doctor_response": "Hi thanks for contacting HCM....Noted you are diagnosed with asthma...For its confirmation pulmonary functional  test done....Auscultation will reveal rhonchi....Here if asthma confirmed salbutamol pump taken sos...If not effective we have to start formetrol plus budesonide low dose pump...of 200 mg once daily....Inhaler should taken with proper technique..So learn it from staff of hospital...For sore throat swab can taken for culture and appropriate antibiotic given...Regular follow up needed....Hope your concern solved.Take care...Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes extra heart beat?\n\nMy heart sometimes adds an extra beat.  I can feel it when it does and it makes my chest feel funny and makes me tired.  It comes and goes.  It just started doing it again a couple of weeks ago.  It hasn't done it for about a couple of years now all of a sudden its back.",
    "doctor_response": "Hello. Thank you for your question and welcome to HCM. I carefully read your query. This extra heart beat, with highest probability, is what we call extrasystole (a skipped heart beat). It is a premature heart beat that is generated from another area of the heart, not from the normal pacemaker of the heart. After this, there is a pause, as the heart \"resets\" and the next beat if more forceful and perceived from the individual experiencing it. This is called a palpitation. They can happen when you are tired, when you exerted vigorously, when you have had alcoholic beverages, and they can happen to anyone. In most of cases, they are totally benign. However, it is not a good sign if they happen often. Therefore, I would recommend you a 24-hour Holter rhythm monitor, to check how many times these phenomena happen throughout a day, and if they exceed the \"normal\" limit, proper treatment should be started. My opinion is that you should not hold back from everyday activity. I hope I was helpful with my answer. Wish you a good health. Best regards, Dr. Meriton",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is 'ensure' a safe drink to have while on chemotherapy for stomach cancer?\n\nIs ensure a safe drink to have while on both chemo and radiation for metastasized stomach cancer? I have read articles stating that ensure is filled with sugar, which can actually be counterproductive in cancer patients due to the fact that cancer feeds off of sugar.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. Yes, cancer cells grow faster in high sugar environment. So better to avoid excess sugar in diet. Since your protein powder is having excess sugar, better to avoid it. Better to start protein supplements with less sugar  or no sugar. Take multivitamin and antioxidants tablet. They will boost your immunity. You can also start high protein diet like milk, milk products, eggs etc. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On implanon birth control. What is the risk for pregnancy? Frequent urination, excessive hunger\n\nWell I am currently on implanon for birth control but I do know there is risk of pregnancy. I am almost 2months late for my cycle and I am increasingly hungry all the time, sleepy all day and urinating considerably a lot more then before . I took one test and it came back negative I am doing another in the morning to make sure but if I am not preganant then What could be causing these symptoms?",
    "doctor_response": "Hi thanks for your question. Relax your not pregnant, Irregular bleeding is side of effect of  implanon. After on year of use, in some patient it almost stops the bleeding which is normal and fertality returns after removal of implant. It is very effective contraceptive and failure chances are very very less.Polyphagia (increase hunger) and poylurea(increase thirst) are two classical symptoms of Diabetes,so get your blood sugar done to rule out or confirm diabetes,before going for further investigation for your symptoms.Hope this answers your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling and redness in leg after knee replacement\n\nI had a total knee replacement on June 12, 2014. Two weeks ago I was told that the scar was not healing properly and I was referred to a plastic surgeon. I have been treating the wound with Dakar Solution which worked fine for about 12 days but for the last four days my knee and lower leg has become swollen and red. What can I do?",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.You need to visit your operating surgeon and look and any infection It may be possible that your joint got infected. You may need antibiotics to control it. Analgesic such as ibuprofen are helpful in pain relief. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat tenderness on my right side of ribs?\n\ni have had a tenderness on my right side near bottom of ribs on and off for 2 yrs, had and ultrasound 2 yrs ago for Gallstones and all clear. Since October 2011 its been bothering me more and more with pain going round into my back and up between shoulder blades. Went to GP after awful night 10 days ago had vomited once and had slight diarohea. Sent to Casulty where Xrays of chest and abdomen were clear, then an ultrasound came back clear, followed by an endoscopy which showed Duodenitis, follwed by a CT scan which was clear. A biopy of the Duodenum was taken and am awaiting results. Am on Nexium 40 mg for 10 days now and whilst the tenderness and discomfort near the ribs in the abdomen is not too bad the pain in my back is very persistent between the shoulders down low. I think the Drs are thining Crohns but I dont really fit the profile IMO. I am very worried and wonder what should I be asking my Dr when i return on the 30th for Biopsy results. Have you any ideas or input that could help me to help my recovery....yours sincerely M",
    "doctor_response": "Hello sir,Needs proper history and clinical discussion, please consult on my personal app, its completely free.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe pain in the tailbone be treated?\n\nI fell yesterday and landed on my tailbone...........since then it I have had considerable pain in that area when I sit on any surface: soft cushion or hard chair. Leaning forward while sitting helps. It s Saturday and tomorrow is Easter Sunday. Question: Should I go to the Emergency Room for x-rays today or tomorrow?",
    "doctor_response": "Hello -Hopefully you have had xrays by now, to rule out an injury to your coccyx.  While it shouldn't have been an emergency, I hope you are feeling better by now.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in upper and lower teeth?\n\nI personally do not brush my teeth and I m a little concerned about my current teeth status. My left upper and lower teeth started to hurt yesterday and I was disturbed from sleep because of the pain. So I decided to brush my teeth but it sometimes bleed and I don t know what to do to improve my current status",
    "doctor_response": "Hello,I can understand your concern. Not brushing teeth can cause decay in teeth along with deteriorating health of gums by plaque and calculus (tartar) accumulation.As your sleep was disturbed, it is a typical symptom of development of acute irreversible pulpitis due to decay of a particular tooth that pains. It might be present in both upper and lower tooth or one tooth may cause referred pain in the other arch. When we sleep, blood supply in the head region increases causing shooting pain in the teeth that are affected by decay and pulpitis.I advise you to visit a dentist for clinical evaluation of your oral cavity. You may need to go for root canal treatment of the decayed tooth or extraction depending on the extent of the decay. You should also go for ultrasonic scaling at the dentist's which is mechanical cleaning of the plaque and calculus accumulated over the gum margins. It will give you relief in bleeding gums.In addition, you should start toothbrushing twice a day, use of mouthwash, floss and gum paint.I hope this information helps you. Thank you for choosing HealthcareMagic. I wish you feel better soon.Best,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the sharp pain below my ribcage?\n\nHi Im 44 years of age and in the last few days Ive noticed a sharp pain directly below my ribcage on the front left side. I had an ultrasound done on my gallbladder and pancreas and the doctors found a polyp on my gallbladder and a lesion in my pancreas. However after this I was sent to get a ct scan in which i was injected with a dye and nothing could be seen at all - the doctors said there must have been a glitch in the ultrasound - is this possible. Im worried about my pancreas as I m getting pain and wonder if I should go back for another ultrasound.",
    "doctor_response": "Hi, Welcome to Health care magic forum.                     As you describe, there is nothing wrong in the pancreas, as the pain is mainly on the right side.                       Your pain appears to be due to the peptic ulcer,due to irritant foods, anxiety or H.pylori infection.                       I advise you to consult a gastroenterologist for diagnosis and treatment.You may need to have gastroscopy,for diagnosis.                          Avoid taking spices, junk foods, and oily foods.                     Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for abdominal pain and bleeding after taking Unwanted72\n\nDear Sir, My gf took unwanted 72 after 30 hrs of protected sex, But for double protection she took unwanted 72, after 24 hrs of taking pill she have heavy pain in lower abdomen and bleeding too, and feeling irritation in urine, she has some bleeding after 36 hrs of pill and pain is also less. we had sex on 6th of the month and her period is due on 15th. Please suggest what to do and what medication to be taken to avoid this pain. and is there any serious problem to be checked by gyane. is there any serious problem in life ahead. needed medication advice plz.",
    "doctor_response": "Hello,Your pain may be because of severe uterine contractions.Your bleeding will also stop in due course of time, if it does not , please see a doctor.Please take ibuprofen and acetaminophen combination, after light meal.Light diet and plenty of oral fluid.If your urine irritation remains , get your urine tested for culture and sensitivity. While Waiting for report you can start a broad spectrum antibiotic course.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can anti-rabies injection be taken a week after dog bite?\n\nDear Doctor Sir/Madam, !!! MOST URGENT \\Dear Doctor Sir/Madam, !!! MOST URGENT Last monday night around 11 pm when i was driving my bike 3 street healthy dogs has follwed me to attack, but when I stopped my bike, my bike got skidded I fell down. one dog among them was tried to bite me, I had weared the pent, when I had observed the spot found no blood but some itchness for 5 minutes. But at that time I got confused that it was, because of my fell down or the biting of dog. I had forgetten by thinking it may be a scratch because of my fell down. I had discussed after 4 days because i was on an official tour when in my family, my family told I should have taken the injection of anti-rabbies for that. But today, is the almost 7th day. Please suggest, can I start the vaccination course of injection of anti-rabbies !",
    "doctor_response": "Hello,Welcome to HCM,Dogs are known reservoir of rabies virus and can transmit to human beings by biting. Rabies is 100% fatal but it is 100% preventable by proper and adequate treatment.As there is no bleeding from the bite site, according WHO categorization it is categorized into Cat II. So cat II bite should receive following treatment.1.Wash the wound thoroughly with soap and water.2.Active immunization with anti rabies vaccine on days 0,3,7,14 and 28.3.Inj TT, 0.5 ml, IM4.A course of Antibiotics like Tab Augmentin, twice daily for 5 days.As you have been given Inj TT and started anti rabies vaccine continue the same.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What has caused high SGOT level when not having drinking or smoking habit?\n\nMy nephew is 25year old.  He is not into the habit of drinking smoking then too his sgot level is 70.  Is it dangerous.  What can be done.  What are the food habits to be avoided and accepted.  and in how many months he should be testing again for re-check.  How does the level increase it is due to what reasons.  Please reply.  I am concerned.",
    "doctor_response": "Hi, thank you for posting.High SGOT(serum glutamic oxaloacetic transaminase) level is caused by many different causes. If someone has high SGOT level, this doesn't mean he/she has liver damage, because the high SGOT level causes are different.I think that he needs:1- Abdominal ultrasound, to exclude gall stone.2- Blood test(erythrocytes rate and hemoglobin level). 3- Heart ECG(electrocardiogram), to exclude heart damage.In rare causes high SGOT level is caused by muscle injury(that is caused by a disease).He should visit a gastroenterologist to determine the exact diagnosis.Regards.Dr. Behar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of lump o underarms ?\n\nHiii..I have a lump under my underarm lined up like in a row and a lump under my breast that's been there for about 2 months and it recently popped and now is oozin with blood and pus and a little meat....and now my left nipple has started to leak pus I'm 24 ????",
    "doctor_response": "You need to see surgeon and have these abscesses drained.also you must do breast ultrasound to check other breadt abscesses or lumps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain, chronic diarrhea, headache, fatigue,dizziness,nausea, Lump in neck, less WBC. Suggestion?\n\nI have been feeling Ill for a very long time now,severe stomach pain is the most serious ailment I have. I also have chronic diahrreah , constant headache , fatigue, dizziness and nausea. I have seen many doctors , GI specialists and gynocologists who keep telling me nothing seems remarkable, yet I know that  there is something wrong because I remember a time when I did feel well. I have stopped drinking alcohol because one doctor said that may have been the issue but still I have good and bad days . I have a hard lump in the front right side of my neck now for the past three days, and very bad lower abdominal pain as well. Last I went to the doctors, one of my liver enzymes was slightly elevated as was my white blood cell count. The doctor said it wasn't anything to really worry about though, but I have not gotten Bette",
    "doctor_response": "Hello, Thanks for writing to us, As per your history it looks that there is infection in your body .Another possibility of malignancy needs to be kept in mind.You may need complete check up like CBC LFT ,URINE EXAMINATIONColitis may also give similar symptoms you need to manage your diet .Holistic treatment with yoga and meditation has helped many patients.I hope that I have answered your query. Let me know if I can help you further.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure stomach and back pain after a bypass surgery for pancreatic cancer?\n\nhellow,i'm from Maldives, my father inlaw, is suffering from pancreatic cancer, we tried to remove his tumer four month back from one of the indian special hospital, but unfortunately, as his 71 years old, and his health conditions were not well, they were unable to remove it, so, they put a plastic temporary stent to, to reduce his jaundice level, which is better now and did a bypass surgery, some where near, to pass food, incase of spreading the cancer, after that we came back to our country, and for almost 3 months he was fine, other than stomach pain, and less eating, but it has been now more than a month which he is in a pretty serious condition, he has back pain, stomach pain, cannot sleep well, cannot eat, fever, hickups,stomach pain, and for most urin problems, which he cannot pass his urin well and now a urine bag has been connected, we removed it twice, but both the time also he was unable to pass. so1- what do you think his stage is.?2-what are the symtoms of the final stage?3-what do you think we should do? 4-how much time would he servive for.thankswaiting for a sooon reply",
    "doctor_response": "Hi,Thanks for writing in to us.1. It is clear from your description that during the first attempt the tumor was inoperable due to his general condition. In 3 months time, it is believed that the cancer has spread to nearby organs and therefore there might be stage 4 cancer.2. Jaundice is the first symptom noticed in most patients of cancer pancreas. He had the symptom for longer than 3 months. The later symptoms include severe pain in abdomen, indigestion and severe jaundice due to obstruction to biliary flow.3. Right now you should consult the oncologist and pain relief doctor and provide solutions to reduce his pain and discomfort. Nutrition should also be given and he should get adequate amount of fluids to avoid dehydration.4. Though advanced cancer has a survival up to 2 years, in case of cancer pancreas survival is difficult for more than 6 months. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low hemoglobin levels\n\nhi my wife is surfering from some kidney infection , and bioposy has been done and through primalary reports doctors suspect husshe has been given plasmaphersis 3 cycles followed by dialysis , still her hb count is not stablising and rbc also not stablising........hb is 6.5 , rbc 20.5 and platelets is 136000pls suggest me",
    "doctor_response": "She may need to take erythropoietin injections if her anemia is related to the kidney dysfunction. Do get a peripheral blood smear done. Consult your doctor for initiation of oral iron and vitamin tablets and work up before starting erythropoietin injections.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can epididymitis raise PSA level?\n\nCan Epididymitis raise your psa level.  Am 60 have had Epididymitis 2 times in the last 25 years.  Psa level went from 1.3 to 11 in 3 years.  Just tested and then discovered the Epididymitis-- had thought it was pain from riding long distances on a motorcycle.",
    "doctor_response": "Hi welcome to the health care magic PSA level more then 10 needs further evaluation Let me know you,  if associated prostate inflammation or BPH present then PSA can be high..... For epididymis rule out infective etiology like chlamydia,  gonorrhea by urine examination,  urine culture and serological testing as per need If needed antibiotic course can be prescribed for that For inflammation relief ibuprofen can be prescribed After epididymis resolves again check PSA and if still more than 10 then I will suggest you to consult surgeon  for per  rectal prostate palpation and sonography investigation for further prostate work  up Hope your concern solved",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the hard lump below my belly button after a hernia repair?\n\nI am 5 1/2 weeks post op from a Fleur-de-lis tummy tuck and major hernia repair. I noticed a hard lump almost directly underneath my belly button. Could this be scar tissue or possibly a hernia. I notice it mostly standing up not sitting. It usually doesn t hurt except when the evening comes and I m more swollen.",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.In my opinion it is herniation from the scar tissue.It is a type of hernia. I advice you should be checked by the doctor. Because there are many type of hernia, some times they cause acute pain requires emergency department visit.So if you got your self examined than such a event can be avoided.Ultimately a surgical correction is the only treatment I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a dog bite?\n\nmy dog bit my hand 2 days ago ... now my hand is swollen, feels warm to the touch (the back of it) and a small amount of puss is oozing from the initial bite wound ... I have some antibiotics left over from a previous injury that I am taking ... however my hand had quite a bit of swelling from yesterday to today ... the bite is inbetween my right index knuckle and the 'middle' finger knuckle, a little closer to the index finger knuckle ... I have been putting hydrogen peroxide on it since it was bitten also,..the first day the redness was about 1 1/2 inches in diameter .. the next day (now) the redness is all the way down to my right wrist and whereas my hand was only slightly swollen, I can see that it is swollen all across the back of my hand now ... however the redness is not as intense as it was yesterday, but the swelling has expanded ... given that I am taking antibiotics and still treating with hydrogen peroxide do I have anything to really worry about ... if so, when do I make the call to go see a regular physician ..?",
    "doctor_response": "Hello,Welcome to HCM,Rabies is 100% fatal but it is 100% preventable with proper and adequate treatment. As the dog which has bit  the bite is in between the right index knuckle and the middle finger knuckle, a little closer to the index finger knuckle.As the redness is all the way down to your right wrist and whereas your hand was only slightly swollen it suggest me that you are having cellulitis of the affected area, so i suggest you to take both the vaccine and the serum.Antirabies vaccine should be taken on days 0,3,7,14 and 28. The vaccine should be taken to the deltoid by intramuscular route.The antirabies serum or rabies immunoglobulin should be taken around the wound as early as possible.I would suggest you to follow aforementioned treatment as soon as possible by contacting your doctor.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of masturbation?\n\nhi i am sridhar. i am 22 years old. i have no problem. my friend has one habit which he is also 22 years old he is regularly wasting his sperm in a month 2 to 4 times. what is the side effect? could you please explain me. I need to recover my friend from this problem.",
    "doctor_response": "Hello Thanks for writing to HCMIt is good that you are so concerned about your friend.Masturbation is normally practiced by many persons but its obsession is bad.I don't think your friend is masturbating excessively.It can be taken as normal.There are no side effects associated with occasional masturbation.Hope i have answered your query.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had a minor blackout but no convulsion. Epilepsy ?\n\nI am 40 years of age , had a minor blackout (senselessness) for about ten(10) seconds at around 1A.M. inside toilet two years back but no convulsion. After two years that same thing happened at 2a.m. again for 10 to 15 seconds, again no convulsion. My query is am I a patient of Epilepsy? since my mother had a history of epilepsy 25 years back.she is taking Eptoin & Gardinal for last 45 years.",
    "doctor_response": "Dear friend, welcome to HCM. did you have these when urinating? if so, they are like micturition-syncope.the dizziness and passing out on urinating. since they are 10-15 sec only, I do not think they can be convulsions. if otherwise, pl. get evaluated to look for other causes like plain anemia, heart rhythm problems or brain problems. pl. consult a physician/ neurologist. I hope to have guided you in right direction. take care and keep me posted on your progress. good luck !",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for lumps on lower part of ear and neck\n\nI have two lumps one by the lower part of the ear and th other by lower neck also have a red bunch of bunch .I have two lumps one on the lower part of ear and the other at the end of neck also have a red raised numbs in the middle of both lumps.",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You may have some enlarged lymphnode or some benign cyst. You should go for biopsy of that lump.  Then you should take treatment accordingly. Thanks for using health care magic. Wish you a very good health. Don't forget to click thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I have leakage in my penis on doing jelqing?\n\nHello doctor, I am a 22 year old male. I have little penis (3 inches) and for increasing my penis size, I do stretching exercises like jelqing and on doing jelqing, I have leakage in my penis and I do masturbate 3 times a week and jelqing time duration is five days in a week and I also do exercise for my height means for increasing my body height. So will it affect the body? Is masturbation right or wrong? I have attached the reports you had requested for.",
    "doctor_response": "Hello. Your reports are normal (attachment removed to protect patient identity). So, no medicine will help. Height and penis size cannot be increased at your age. Masturbation is normal and not harmful. Be careful while doing jelqing. If you do it vigorously you may damage the penis. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of Licope Mkid after daily usage?\n\nHello Doctor, my son is about 6 yrs is suffering from allergic bronchitis. He was taking Licope Mkid from 3 to 5 yrs. But now as per Doctors prescription he is taking Romilast 5mg since last 2 months and also advised to take levolin 50mg inheler if necessary. My question is that, is there any side effects (both short term and long term) if taking it daily once in a day.",
    "doctor_response": "Hi, There are no side effects but the drug should be withdrawn gradually over 2 months period. I hope this has helped you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have lower back pain and spasms in leg. Is it sciatica?\n\nFor mthe past 2 mos I have been having pain in the lower back more to the left side and going down the outside of my leg. Now i am experiancing a spasm on the outer side of my leg and sometimes on my left side. I was thinking of siatica but don t know for sure. Thank You",
    "doctor_response": "Hi and thanks for the query,It is possible that it could sciatica. Sciatica usually originates from the back, is aggravated by stress, coughing or change in position. Bending often increases the pain. The pain generally radiates from the back and runs down till the calves and soles of your feet, at times touching the big toe. A simple clinical review, an X ray and at times spinal CT and MRI scans are useful, depending on the case to make a diagnosis. Kind regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intense pain in the neck and lower back along with chills?\n\nI have extreme pain mostly in my neck and lower back. Sweats and chills. Absolutely no energy. Headache that feels like a spinal headache. It hurts worse when I am up right but does not go completely away when I lay down. I can usually drink coffee but it now tastes horrible.",
    "doctor_response": "Take Advil tabs twice a day after meals.Do hot packs on neck and back.if pain severe,take tramadol 100 mg sos.Get your BP checked.consult a physician and a neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does lump on knee after recovering from scarlet fever indicate?\n\nMy 6 year old son is recovering from scarlet fever at the moment, when he bent his leg last night we noticed a lump pop up on the inside of the knee, whis is a little smaller than a table tennis ball but is hard, there is not one on the other leg. Can you please help?",
    "doctor_response": "Hello, i appreciate your concern. Scarlet fever does not cause any lumps anywhere in the body. From your description, the swelling behind his knee seems to be a Bakers cyst, which is a benign swelling that you do not have to worry about (even I have one behind my right knee). Unless it causes severe pain or difficulty walking, it does not require evaluation by an orthopedician. Contact one if he develops either of those.Hope this helps, do feel free to clarify any other doubts you may have.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for elbow lumps\n\nHi Q. Is i have two lumps size of sliver dollars to half dollar size oright and left elbows. If i stand up there just above the elbows. I ve noticed like smaller ones growing on bothe forearms. I also have to lumps on left and right knees just above the knee caps center. YYYY@YYYY",
    "doctor_response": "Hi, It could be a bursitis. Consult an orthopaedician and plan for an MRI scan. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for back pain?\n\nHello Doctor, I have an odd question. I was a U. S. Marine and while in the service I suffered an injury to my lower back. A very long story shortened, I would like to know why sleeping in my recliner alleviates most of the pain I feel compared to when I sleep in my bed. I have tried all kinds of mattresses from expensive to cheap and sleeping on a bed always kills my lower back upon wakening. Can you give me an explanation on why a recliner helps alleviate my back pain and if there could be any issues in the long run (other than a mad wife) lol. Thank you for your time. V/r, Jay",
    "doctor_response": "recliner usually are not ergonomically designed, they are mostly design specific raher than anatomical correct. staying in recliner for long time can casue back pain due to static wrong posture can put all the strain on your back muscle. the pain can be suppressed if you meet a good physical therpaist who works more on movement disorder or sply muscle rehabiliation also you can adjunt with dry needling to enhance the result. but to gain permanent change its better you start your ecercises and get ergonomically desigened recliner",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will taking Regestrone post unprotected sex prevent pregnancy?\n\nHello doctor, I and my fiancee had unprotected sex a month back. I had an orgasm before having but not during sex. She has PCOD so her periods are irregular. She went to the doctor and doctor suggested having Regestrone 5 mg three tablets for three days. She started taking it 13 days later and finished after three days. The day before yesterday, she got her periods. But she did not have blood clots and flow is very slow. Is there any chance of pregnancy?",
    "doctor_response": "Hi. How are you doing? As she has PCOD (polycystic ovarian disease), her ovulation date cannot be predicted. So there is always a chance of pregnancy. But as she had bleeding after having tablet Regestrone, pregnancy is not possible. Bleeding after having hormones will be thicker and lesser than normal, that is expected. Once the bleeding occurs, the inner lining of the uterus has fully been shed, so there is no chance of a possible pregnancy to get implanted on the post bleeding, thinned out uterine inner lining. So I do not see any chance of her being pregnant. But if you are still not satisfied or want a further confirmation, have her blood serum beta hCG tested. This can detect the smallest of pregnancy anywhere in the body.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is big red spot on white ball of eye in a child after hit on head concerning?\n\nMy 20month old daughter hit her left part of head and after an hour a fairly big red spot appeared on the white ball of her left eye.  It doesn't seem to be bothering her.  Is it something I need to worry about, and may it be due to the bump in her head?",
    "doctor_response": "Hi,It seems that there might be having subconjunctival hemorrhage due to hit on the left side of. head.Nothing to worry about this problem.Observe other CNS signs as she hit her head.For any CNS signs if present, then go to ER and get examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tremors in hands\n\ndo i have a problem my hands always shake i cant hold anything in my hands with out shaking really bad an its affecting me at work its been like this for 5 years an never really thought about it but it has gotten worse over time what should i do an what is it?",
    "doctor_response": "Hello dear,The symptoms as mentioned in your post can be attributed to:1. Entrapment of nerve fibers at the Cervico-thoracic region.2. Inadequate hydration status & electrolyte imbalance of the body, or3. Dietary deficiencies of certain nutrients like Iron, Calcium, Vitamin D, Vitamin B12, Folic acid, etc. which help in blood formation & nerve conduction.4. Any fluctuation in blood pressure or blood sugar level.Symptomatic relief can be obtained by intake of nervigenic agents (like Vitamin B6, Vitamin B12, Folic acid) as well as multivitamin & multimineral supplements including iron, calcium & Vitamin D needs to be added in your diet.Physiotherapy & postural exercise will also be helpful.If symptoms still persist, kindly consult a Neurologist & get a complete Neurological examination done.Certain investigations like complete blood count, serum electrolyte estimation, fresh estimation of blood pressure & blood sugar levels & nerve conduction studies will be helpful to rule out any pathological cause for the symptoms.X ray & MRI of Cervico-dorsal spine can also be carried out to detect any nerve entrapment.Wishing you a Good Health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility\n\nRespected sir, I have completed 5 years of marriage life. We did not try to get pregnant these years. Now we want to and trying for pregnancy for last six months. My wife cycle is accurate as 28 days although not succeeded. We have done all tests like sheman test as well as her tests too. All results are positive. Please help us out. Thank you.",
    "doctor_response": "Hello, you need ovulation induction and then follicular study to see the formation of egg in her body and also will guide for best days for intercouirseIn case you have any questions in future you can contact me directly on",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Which is the best mouthguard for teeth grinding and how to treat underbite?\n\nHi doctor, What is the best mouth guard used for teeth grinding? What is the cheapest way available to treat underbite?",
    "doctor_response": "Hi. Teeth grinding affects dental health. It is a cause of attrition. If stress is the cause for grinding the teeth, then do regular exercise, yoga, and meditation. Avoid drinks that contain caffeine. Avoid drinking alcohol and smoking, if you have the habit. Take a sufficient amount of water. The best night guard is fabricated by the dentist, after taking an impression. Your dentist fits the mouth guard to protect your teeth from grinding during sleep. There are many methods available for the correction of an underbite, which is cheap and best. Please see your dentist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for asthma and allergy\n\nHello doctor. I am working on a case study for my pathophysiology course and I am having trouble wording the reason why asthma patient s have a severe asthma attack have cold extremities, clammy skin and cyanotic. I know it is do to the blood being under oxygenated but my teacher is pretty tough and would like a more descriptive response. Can you help?",
    "doctor_response": "your answer of under oxygenated blood is right answer. but when allergen attacks on lung and bronchial tree get constricted, adrenaline released to combat stress like situation. this adrenaline will produced cold clammy skin by peripheral vascular spasm.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for knee pain\n\nmy knees hurt. they have hurt for a long time but recently they ve gotten worse. it s whe i am sitting or laying down. mmost time when im trying to realax or im in class. im not sure how to describe the pain it starts out small and then becomes unbarable",
    "doctor_response": "HiU seem to b having some sort of vitamin or calcium deficiency. U shud get an xray done or an mri done n let me know Otherwise everything should b fine n nothing to worry bout Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair loss\n\nhi, my age is 22. My height is 5.9 and my weight is 66. I have lost a lot of my hair from the front of my head in less than 6 months. In my family no one is bald. Now in the front only a little hair is left like v. Please suggest me what can i do to get my hair back. Currenty i have shaved my head. I am having e cap tablets it has vitamin e. Will this help",
    "doctor_response": "Hi!Welcome to Healthcaremagic. com.I have read your query in detail and do understand your concern.Excessive hair fall can be due to male pattern baldness, physical or mental stress, anaemia or nutritional deficiency or certain medical conditions like thyroid disorders, low serum ferritin etc. Take a nutritious and protein rich diet(pulses, milk products, eggs). Use of hair supplements containing biotin will be of help . Avoid routine application of gels or frequent blow drying of your hair. Use a sulfate free shampoo for your hair twice a week. A hair growth lotion or serum can be prescribed to you depending on the cause and severity of your hair fall. Minoxidil  lotion can be applied over the affected area twice daily. Biotin containing hair supplements can be taken for 3-6 months. Vitamin E is not much useful for hairHope this helps!Good luck!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had cancer in the tonsil. Did surgery with radiation. Now have developed salty, foul tasting in mouth. Lost ability to swallow. Juices burn.\n\nI had cancer of the right tonsil surgery with 6 weeks of 2x daily radiation four years ago.  I have developed progressively worse gooey, salty and foul tasting mucous in my mouth which nothing relieves.  Even after brushing my teeth multiple times the goo remains.  I have also lost the ability to swallow and subsist on liquids, basically tomato soup and chocolate pudding with an abundance of heavy cream.  I cannot tolerate any drinks other than plain water.  Juices and most flavors burn like acid.  \"Que Garne?\" or what to do in Nepali.",
    "doctor_response": "Hi, i to my patient with such symptoms prescribe lactic acid bacilli, antibiotic some times, and salt water gargling, injections of bcomplex can help to relieve the symptoms to some extent.                       I to my patient also advise to take fresh juice of palatable vegetables with out dilution or mixing any thing. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever and vomiting in a child?\n\ni am 12 years old am having fever from 4 to 5 days along with vometting my blood reports r showing normal ranges except the neutrophils have struck 84 %.wht could be the reason behind this .i also dont feel like having any thing be cause of  vometting",
    "doctor_response": "Hi.... keeping in mind your fever symptoms and vomiting I feel that you might be having a viral prodrome of gastroenteritis. You might start to have diarrhoea also. But you need not worry if your urine output is good and you are not feeling well and lethargic. If you feel that your tongue is dry or your eyeballs are sunken then these are signs of dehydration. Meanwhile I suggest that you take antiemetic medication as suggested by your pediatrician. These are prescription drugs.For fever you can take paracetamol in the appropriate dosage.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe hip pain\n\nHi Doctor, Have been through severe pain in my left hip over last 10 months. It erupts in a specific posture which is difficult to predetermine what will lead to pain. On thing is for sure, while turning around in the sleep, the pain gets excruciating and I generally get up with the pain. Also, I fell it during walk. However , if you ask me to stretch my legs in any position, there is no pain. Also, I don t feel any pain by pressing any point. - I have a decent flexibility as I ve been practicing yoga over last 2-3 yrs and have been leading a active lifestyle. Wt 78 kgs and ht 6 ft - MRI, hip X-ray , high frequency Ultrasound has been done and nothing has been found out so far. - ankylosing spondilytis, sciatica, piriformis syndrome, weak lower back muscles, buldge disc - all has been ruled out. Have been getting contradicting views . no idea on - should I do mild exercise or avoid it completely till the pain subsidies. - how should I deal with pain? - to long should o take pain killers and which one to take? - what might be the real problem and how will that be detected? End all - what should I do at how should I proceed further. Thanks for your time.",
    "doctor_response": "Kindly rule out diabetes ,vitaminD deiciency or any other metabolic disorder.Avoid pain producing actions & postures.fomantation will help.Take Multivitamin 1 tab OD paracetamol 250mg SOS.kindly keep me informed of your progress.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cough, inflated lungs and prominent bronchial calcification?\n\nmy mother had a chest xray becasue she had a very bad cough and it said that her lungs are mildly under inflated and again seen are prominent bronchial calcification and probable calcified lymph nodes at the inferior right hilum, what does that mean?",
    "doctor_response": "HelloYour mother X-ray findings suggests mildly under inflated lungs means less expanded lungs than expected.Normally chest X-ray(PA view) is take in full inspiration.Under expansion may be due to less inspiratory effort,restrictive lung disease etc.She need proper clinical correlation.PFT(Pulmonary function test)can be done if needed.There are also prominent bronchial calcification and probable calcified lymph nodes at the inferior right hilum,it may be due to many causes like healed infection,occupational disease etc.It is not an active lesion and mostly it doesn't require any treatment.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent fever\n\nMy father aged 55years is having fever for the past 2 weeks. the fever rises in the morning at around 4'o' clock in the morning but the temperature is normal during the day. he has had antibiotics and other medications but of no use. I, myself, being a medico consider it to be a viral fever bt the time related rising temperature is bothering me and the family doctor. The blood culture tests have been negative. He has been taking medicines for the auto immune disease. please help.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have persistent fever which is due to viral infection which is lowering down your immunity and making you prone for infection. I would suggest you to apply wet cold sheets on your head to lower down body temperature. Avoid hot, spicy and sharp food substances. You should take combination of antiviral drug along with anti-inflammatory drug. Take nimuslide along with paracetamol as well.Take diet rich in multivitamins and vitamin C. Your symptoms will resolve in 4-5 days. If symptoms keeps on persisting visit ENT specialist once and get some routine blood investigation done. Take diet rich in multivitamins. Drink plenty of water. Take hot milk rich in turmeric as it will booster immunity.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bulging disc\n\nHi. I am a man, 40 years old and healthy on no medication aside from some anti inflammatory tablets for lower back issue (bulging disc) I have had diahorrea on and off for last 4 days with excessive wind and nausea. My stomach is firm and constantly squelching particularly after eating. I feel drained and now a little concerned as I know my body and something doesn t quite feel right. I m trying to keep hydrated with water and fruit juices. I lack energy which is very out of character. Just wondering should I see doctor sooner rather than later? Many thanks, Mr Clarke",
    "doctor_response": "Hello Clarke, I have gone through your question and understand your concerns. Bulging disc is usual finding with increasing age on imaging of spine. Low back pain with radiculopathy or symptoms of canal stenosis are findings of concern. Sometimes pain killer or other medications for back pain may lead to diarrhoea. You must take enough liquid to keep you adequately hydrated. You can visit a doctor to be evaluated properly. For back pain and disc prolapse you may consult a neurologist. Hope you recover early. Wishing you good health Regards Dr Neeraj Kumar Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain, lump on back, tender to the touch. Previously done gymnastics. Worried about tumor or bone infection\n\nMy daughter is complaining that her back hurts badly. The pain is in the area of her right shoulder blade, and seems very tender to the touch. Slight touch to her skin and any amount of pressure is making her wince. It seems to be minorly swollen/lumpy but only on close inspection. It hurts her a little more when she hangs her arm straight down at her side. Nothing has reduced the pain - not ice, heat or advil . About 9 months ago, while doing gymnastics, was the first time she noticed any pain, but it quickly went away and I attributed it to gymnastics. She has since quit the sport but remains very active. She says that the pain has come back here and there, but the pain was only minor. The onset of this severe pain was 2 days ago - and while she is a very active child, I can t point to a specific reason that it would hurt. No fever, no loss of appetite , no bruising or bleeding. I am worried about a tumor or bone infection. Can you please offer advice?",
    "doctor_response": "Thanks for the query. Dont be panic. Most probably  it seems to be muscle sprain. Was there any injury to shoulder? Need to ask her? tumour or infection is relatively rare conditions to happen. I would suggest to get her examined by an orthopaedic doctor and  he may suggest Xrays and if needed MRI of the region. Also blood counts and ESR gives fair information if any thing wrong going on in the body. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes my 16 months old to be awake and crying all night?\n\nmy daughter is 16 months old. Every night she wakes up from her sleep crying and screaming. She cannot be consoled and at times we end up awake all night. She gets into such a state and is very distressed. what can I do? My cousin is epileptic and takes seizures in her sleep I am worried this is what is happening",
    "doctor_response": "Hello,What is her sleep routine? If she is sleeping in the day, then she will be awake at night. Check for any abdominal pain or ear infection.If the baby is having colic, give her colic drops and watch for it or if he plays so much in a day, then maybe, she is tired or having muscle pain. Try to give Panadol in that case.If she is wet in diapers, or it is too cold, or too hot, or she sleeps hungry, figure out among all these problems.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Hina Javed",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Positive pregnancy test. Lower back pain, abdominal cramping, bleeding. Reason?\n\nI had sex on the 6th of July, which was a Saturday. I felt funny later the next week and had a weird feeling. I decided to take a pregnancy test on Friday the 12th and was shocked it said positive!!!!!! I only had sex once in the past 4 months. I woke up this morning with a lot of lower back pain and bad cramping in my abdomen and had sort of gushing bleeding. Could I have REALLY only been a few days pregnant and now losing it?????",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.First of all, you need to undergo one TVS scan to estimate gestational age and rule out possible miscarriage.Following that, you need to consult with gynecologist. On the basis of scan report, next decision can be made. Take suggestive measures accordingly.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. S Patra",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for high TSH level?\n\nI just received my lab results from my medical doctor and I cannot get intouch with them and have an  immediate concern about my results and a major question.  My TSH level is 27.38 which is very high.  I am already on medication and have had my thyroid zapped twice with the radiation pill.  What does the 27.38 level suggest, other than my level being too high?  What are the immediate (like right now) ramifications?  What should I do immediately (like, right now)?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Your TSH level is too high. You are suffering from hypothyroidism.  You should take thyroxine tablet as per your doctor's advice to control your TSH. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for social anxiety disorder\n\nI love my own company so much l sometimes have to force myself to meet others.   I find people leave me totally depleted and I need serious time on my own to recover.   I enjoy the company of people - just in small doses and as long as I can leave and go home when I want to.     I am afraid that as I get older  I will so need to be alone that I run the risk of cutting people off from my life.   Why do I react to people in this fashion?   thank you.",
    "doctor_response": "DearWe understand your concernsI went through your details. The simple answer to your question is - you are a person who loves being alone. I don't see anything wrong in that. As long as your work is concerned you are able to perform whenever need arisen. Whether along with other people or alone, you did your job well. So you should not worry yourself on this aspect. The second question, do you want improve your social interaction ability? If yes, there are several personality development / self esteem / self confidence building workshops available. You may take any of them according to your need and convenience.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain with bleeding on lifting weights?\n\nWhenever I lift heavy items or dig in the garden I have very lower back pain and I start having a small period. I have endomitriosis and over the years this has happened from lifting a light suitcase. The digging and lifting i am doing now is heavy stuff. I am 42 what is normal work for a person who is 115 pounds and 5 2...?",
    "doctor_response": "hello.may be back pain is due to mechanical.you have said you do heavy lifting Works.take pain killers for oneweek and have rest.if not subside need other investigations..also need to consult for gynecologist for endrometrosis..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes weakness with history of angioplasty?\n\nhi, Its been a year since my dad had an angioplasty .Sometimes he would walk even half a kilometre without getting tired but most of the times he gets completely exhausted within 100 metres and can walk no further.There seems no reason why he is tired on some days and not on other days.He was a heavy smoker before heart attack.He is on medicines and diabetic.His all other levels are normal except HDL it is 35.I suspect he has developed more blockages....is it possible",
    "doctor_response": "Hiif stents are not succesful,they may detoriate cardiac functions , i would advice you to have a 2d echo as early as possible to rule out the cardiac function s, severe fatigue and in ability to do even normal work can indicate a problem with heart pumping 2d echo is must to diagnose the functioning of heartpre angioplasty echo should be comared by angiogram now to rule pout the detoriation of his cardiac function or possiblity of new blockages",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is my son put on Paroxetine in spite of having bad withdrawals previously?\n\nHello doctor, My 28 year old son is being treated for bipolar disorder and depression. He has been on and off antidepressants since he was 16 years old due to high anxiety issues. He just started with 50 mg Serquiler one to two tablets at night, 600 mg Gabapentin thrice a day, 20 mg Paxil once a day and Oxcarbazine\u00a0600 mg thrice a day. Is this too much? He was previously on 60 mg Paxil and had very hard withdrawal symptoms. Why is he still put on 20 mg?",
    "doctor_response": "Hello. Seroquel (Quetiapine) and Oxcarbazine (Oxcarbazepine) are indicated in bipolar disorder as both have mood stabilizing properties. Paxil (Paroxetine) and Gabapentine (Gabapentin) are used in anxiety or depression. As you mentioned that Paxil was used in the highest dose earlier with a difficult withdrawal, now your doctor may be using it for acute bipolar depression and wants to taper him off it as soon as the depressive symptoms clear. He will not have much of withdrawal symptoms as the dose is on the lower side. It is not uncommon to use two or more mood-stabilizing drugs in bipolar disorder when the person is not responding adequately to one drug. Also, in acute bipolar depression, antidepressants are used in combination with others drugs to treat it. For more information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can TB be spread with skin contact and breath?\n\nHi, Im a Police Officer. I arrested a male individual today well yesterday night, after I did the fingerprints 2 times! and speaking with this individual less that 1 feet away he told me he has Aids and TB. I know Aids is hard to get with just skin contact etc but my concern is the TB part, being that close and him breathing and speaking with me freaked me out a bit, should I see my doc ASAP?? I want to go to bed relaxed! :-)",
    "doctor_response": "Hello,Welcome to HCM,Pulmonary TB is a disease transmitted by droplet infection and droplet nuclei, as you arrested a male individual today and spoke to him at a distance of less that 1 feet.You are at a risk of acquiring this disease but all individuals can not develop the disease and it all depends on the immune status of the individual.Even though bacteria enters your throat it may not produce any disease in you but whenever there is suppression of the immunity you may develop the disease but chance of getting it is very very less.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing itchy rashes on the neck and back?\n\nI was outdoors for a long time yesterday and now have a rash on back of neck and on back that is quite itchy.  Not sure what caused it. Could be from some insect?  Not sure if could be shingles or maybe allergic to a nicklace I was wearing.  How to narrow it down and find out what it is.",
    "doctor_response": "Hello, Shingles present with severe pain and burning along with fluid-filled blisters in one dermatome of the body. You seem to be having either insect bite hypersensitivity reaction or allergic reaction. I would recommend you to apply cortisone cream on the affected areas twice daily along with antihistaminic like tablet chlorpheniramine maleate once or twice daily depending on the intensity of itching. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have white patches in the throat, but my strep test was negative. Please help.\n\nHi doctor, Two weeks ago, I developed white patches in the throat. I do not feel a sore throat, but there is slight discomfort, runny nose, and cough. I think it is due to cold. Also, I feel body pain for the past three days. I was tested for strep, and the rapid strep test was negative. The white patches looked like they started to go away, but now they are getting bigger again. Please help.",
    "doctor_response": "Hi. By looking at the history and symptoms, a few things come to my list of differential diagnosis. Before that, I would like to know a few things like whether it is associated with difficulty in swallowing, headache, neck stiffness, etc. As you mentioned you have already taken antibiotics, the streptococcal cause is less likely but cannot be ruled out completely even though titers are nil. It could be acute on chronic tonsillitis as you also have fever, throat discomfort and body ache. It can be a fungal infection as well especially if your asthmatic and on steroid inhalers. It could be infectious mononucleosis, a kind of viral infection associated with all your symptoms. The possibility is high if there are accompanying swellings in the neck. It usually spreads by kissing. The general mode of management for this would be to gargle salt water at least four to five times daily and drink cold fluids or have ice creams to ease throat pain. Avoid irritating, spicy foods and smoking if you are a smoker. You can take a combination of Ibuprofen and Paracetamol (Combiflam) thrice daily for five days along with antibiotics. For me, it looks more like chronic tonsillitis. The appropriate antibiotic would be Amoxicillin 500 mg thrice daily for five days. You can also take Rabeprazole 20 mg once daily for seven days in case you feel stomach discomfort because of these medications. If frequent recurrences of tonsillitis are happening, then it is better to go for surgical removal of tonsils. Your physician will help you with suitable antibiotics after ascertaining the diagnosis. Take care. For further information consult a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is smoking advised in the presence of a premature baby?\n\nHello Doc, I hv a premature baby who is now 3 months old since she was at 7 months. She has a pda and suffered from chronic lung disease. Can I smoke marijuana in her presence or wl this hv a negative effect on her condition as she struggled to get off oxygen. Thank you",
    "doctor_response": "Hello. I just read through your question.Smoking of any kind in the presence of a child, premature or otherwise, is definitely not recommended.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back pain?\n\nI have been having lower back pain more to the right side of my back, that varies from lower back to waist level. It sometimes moves around the right side to my lower right abdomen. I feel a bit bloated and draggy. Sometimes the pain is severe; sometimes a dull ache. What could be causing this?",
    "doctor_response": "Hi, thank you for posting.I have gone through your query and I understand your concerns.Your symptoms are caused by colonopathy. Another possibility is that you may suffer from a kidney disease.To relieve your symptoms you should follow these guidelines:1. Eliminate spicy foods and acidic foods from your diet.2. Do not drink alcoholic drinks, carbonated drinks, coffee and milk.3. Give up smoking(if you do smoke).4. Take proton pump inhibitor medications such as Omeprazole.But before starting the treatment you need an abdominal ultrasound, liver function test, complete blood count and urine test, in order to rule out a possible kidney disease.All the best.Dr. Behar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain while lying down after suffering from sinus, cold and cough?\n\nHello my name is norma i had like ainus and cold with cough. Last two nights ihave noticed when i lay dow to either rigjt aise or left side iit hurts i still have cough nut im worried it could be pneumonia does it  hurt spme times when i breath iy hurt s not always but yes it hurts whem on laying down on th right side or left side",
    "doctor_response": "hello norma, welcome to health care magic.the most likely cause of your pain is muscle spasm due to coughing. sometimes due to coughing,our intercoastal muscles(chest muscles) go into spasm.i would advice you to take a pain killer like diclofenac with pantoprazole and also a muscle relaxant like flexon mr.ideally it should resolve in 4 5 days, if it persists visit a nearby doctor and get a chest xray done.pneumonia symptoms are much worse, u will get fever,fatigue,anorexia, cough with sputum etc.pls visit a doctor if u are experiencing these symptomshope this solves your query.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does my mouth and teeth bleed at night?\n\ndoctor i have  problem started long ago in 2004.the problem is with mouth and the teeth bleed and this usually happens at night when am sleeping.i have been to the dentist and been given some mouth wash and antibiotics but it is getting worse now. what is the cause?",
    "doctor_response": "Hi! Welcome to Healthcaremagic.I read your query. Bleeding from gums can be due to several reasons main being Gum disease, Vitamin c deficiency, etc.I suggest you to maintain good oral hygiene. Brush twice a day, specially at night to avoid any food left sticking in gums. Use mouthwash with tannic acid.Floss everyday.Take good diet, lots of fluids, multivitamin supplements.Visit dentist regularly and get oral prophylaxis done every 6 months to a year as suggested.If bleeding persists longer, get blood test done for anemia, clotting factors and consult a physician.Hope the answer helps you. Thank you!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bump on the gums, became pimple after taking tylenol, pain subsided. What could this be?\n\nMy daughter had a bump on her gums above a tooth .It s her eye tooth, I think. She complained about it hurting a few times. I gave her tylenol and the pain subsided. This bump became like a pimple . I put warm compresses on it and got stuff out. Tried to get her to rinse with mouthwash but she wouldn t, so I used a q-tip and rubbed it onto the bump. It is now gone. But when that went away she complained to me that it hurts on the other side, in the same area as theother did. There was a bump, up high in the gumline. It has since gone down lower.She has complained about it hurting a couple times for a little while.With tylenol the pain goes away.I put warm compresses on it to try to get the bump to go away. It hasn t yet...She is not omplaining of any pain. It only hutr when I touch it.What could this be?",
    "doctor_response": "Hello there....What is the age of your daughter? if her tooth is decayed , the infection spreads to the lower part of the tooth and manifests in the form of swelling -abscess that has pus filled in it....that is the reason why when pressure is applied the swelling subsides...Hot compressions are not indicated in infections and any swellings for that matters... heat increases the blood flow and results in increased  swelling. Get her examined by your dental surgeon for further evaluation and management",
    "dialogue_context": ""
  },
  {
    "patient_message": "Baby has fever, gums are swollen, foul smelling. Is he teething? Is it gingivitis?\n\nhi my 19 month old boy started with a fever a week ago which subsided after 2 days then i noticed a foul smell coming from his mouth and i thought he may be teething ,i looked into his mouth and his gums all appeared swollen there were no signs of thrush , i started to brush his teeth and he started to bleed on contact with the brush, this has been going on for three days . i started antibiotics today thinking this may be gingivitis bc of the foul smell swollen gums and bleeding with brushing , on two occasions he has cried and his gums started to bleed during the crying episode .. is this gingivitis ? i have been using chlorhexidine spray and the swelling has settled a little along with the antibiotics, but because of the bleeding i just wanted to make sure i wasnt missing anything",
    "doctor_response": "Hello there, Thanks for your query. At the age of 19 months swollen gums are sign of eruption of deciduous/milk teeth,pain is because of pressure exerted by erupting teeth on the gums. Therefore there is no point to get worried. But during this period children more prone to infection,so maintain good oral and general hygiene. Fever may be because of viral infection,so do not give any medicine yourself, consult with a child specialist at the earliest and take a proper treatment. Hope this will be helpful. Take care. Dr.Gunjan Gupta",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes raised fluid filled bumps on face?\n\ni have raised bumps on my face (not on my limps and not anywhere else) that have water (fluid). Everywhere and they don t go away easily. There is no pain of any kind. My derm gave me medication for Herpez 1 but it is not helping at all. I have had a lot of stress with family death and I live with bacterial issues from breast implants...help. How do I fix my problem. My face is broken out all over check and nose area. thanks",
    "doctor_response": "Hi dear ,As you mention in query that you have been prescribed antiviral drug for fluid filled bumps on face and they are not working . It means the bumps are result of bacterial infection or body is showing reaction to certain medicine . I would suggest you to consult dermatologist again and your surgeon who placed implant to discuss the condition . Doctor may prescribe antibiotics like minocycline or clindamycin . Till the give cold compresses to the bumps , use mild soap to wash the face with cold water twice a day . Also apply azelaic acid containing cream which is very effective for pimples . Avoid excessive sun exposure , cover your facewhile unfer sun exposure .Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the reason for pain in both outer and inner vagina during intercourse?\n\nHello doctor, I am newly married. We had sex four to five times till now. Last time when we had sex, she started feeling pain in both outer and inner vagina. She feels like peeing, but actually, it is not. Kindly suggest for a better solution and any precautions that can be taken before intercourse.",
    "doctor_response": "Hi. From the available description, it appears that due to inexperience there is little effort for foreplay which is leading to less excitement and resultant problems. It is most important to devote more time for foreplay and excite her before attempting intercourse. It is also important to know each other's erotic body parts so there is proper excitement. For more information consult a sexologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sprained ankle with a bruise. Tingling in the face, bruises spreading on the body. Concerned about blood clots\n\nI am 29 years old. About 4 weeks ago I had a bruised left ankle which I thought was a sprined ankle-there was no visible bruise. Then it was gone. Three days later my left calf felt bruised but no visible bruis. Then it was gone. The next day I had a tingling feeling on the left side of my face. Almost like how it feels when a numbing shot is wearing off. I read up on some information and it sounded almost like shingles. But then two days later it was gone. A week later the area above my left breast was bruised but with no visible bruise as well. I stopped drinking caffeine because I thought it was a cyst. My mother has cysts in her breasts (seen by her yearly mammogram) and she said when she gets off her daily caffeine it gets better. Three days ago the area under my ribs on the right side felt bruised but had no visible bruise as well. Yesterday I had the tingling feeling under my nose. Now it's tingling on the left side of my face into my hair line and down my hair (occasionally). I'm sorry- these are a lot of symptoms, but I just don't understand what this could be. I stopped taking my birth control pill because I was afraid of blood clots, and am currently only taking synthroid. Thank you for your time and help!",
    "doctor_response": "Hi,You seem to be having a sensation of bruising without actually seeing any bruises. So what exactly is this sensation that you are feeling? Is it numbness or tingling or something else altogether? It might be a good idea to get yourself examined by your family physician. He/she will be able to determine if there is a problem in the circulation, or are there blood clots or whether it is something else altogether.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and a protrusion in the knee after injury?\n\nI fell hard on my left knee. It s quite swollen and looks like something is protruding on the left side of my knee. It s not black and blue but hurts like crazy and the swelling has only gone done a little in the past couple days. It hurts to bend all the way but I can straighten it. I do hear a clicking noise when I wailk but not all the time. What do you think it might be?",
    "doctor_response": "Hii,Thank you for asking a query.Sir your left knee might have swollen due accumulation of fluid within your knee joint which is called as knee effusion.The clicking sound that you are feeling may be because of some meniscal orligament tear in knee.Kindly consult an orthopaedician, You might require knee joint aspiration follwed by mri .Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in collar bone while stretching and breathing?\n\nI ve have been having server pain in my left collar bone for about 5 and a half. The pain feels like someone is stretching it and it s hot to the touch. The pain really gets intense when ever I raise my right arm above my head. It also sometimes hurts when I breathe.",
    "doctor_response": "Hello,You may be suffering from spasm of muscles that attached to collar bone in like pectoral groups. Trauma or thoracic outlet syndrome or tumour may present like this. Please get it done X-ray chest and consult with your orthopedician he will examine and treat you accordingly.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can anemia cause hearing loss?\n\nI was hospitalized and it was found that I am anemic my hemoglobin count went down to 5 was told it should be 12 or 13. I am a 56 year old female, I weigh 250 lbs and I am 5ft. 9 in. I now have hearing loss in one ear. I feel like this has something to do with the anemia. My doctor checked my ear for wax buildup but there was none.",
    "doctor_response": "Hi!First the facts 56 yrs, 250 lbs, 5ft. 9in (BMI -36.91-Obese),low Hb,unilateral deafness.Can anemia on its own cause deafness? Theoretically a low hemoglobin leads to impaired oxygen supply to all tissues including those involved in hearing and therefore could interfere physiologically with the latter. There have in fact been case reports where nerve deafness has been found to be associated with anemia due to iron deficiency as well as that due to Vit B12 deficiency. Your case certainly merits investigation from that point of view. Then, considering your rather high BMI (36.91) which puts in the obese category one would also have to look at the presence of the so called METABOLIC SYNDROME of which high blood sugar is a part. If you do have diabetes then hearing loss secondary to diabetes becomes another possibility. The message therefore islook at the hearing defect holistically - both from the point of view of local issues (fluid in the ear etc) as well as more distant causes like anemia, diabetes and so on. Do write in for more info. All the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes neck, testicle and left abdominal pain?\n\nI have a Colestrol 8.4 , I am having pain on my left side , it s vary day by day -- I had a pain on neck area goes to left hand , If I raise my hand on to my head I get relieve , today I am having pain on my lower waist area left side , sometimes on my testile left side -- I got one kidney by birth which works normal -- pls advise",
    "doctor_response": "Hi there.There may be infection around the testicle like epidydymitis or possibly tortion of the testis. You can take pain killer if the pain is much but I advise you to show to a Surgeon to rule out the same as they can be very dangerous and destroy the testis if not treated on time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a constant feeling that there is a hair at the back of my throat. Why?\n\nHello doctor, I suffer from a bad health anxiety. For the past few months, I feel like there is a hair at the back of my throat and it gets worse at night. My ear also pains and I can feel three pea-sized lumps on the right side of my neck. I got cold twice a couple of months back and I am taking Omeprazole from two days for acidity. I am a heavy drinker and smoke weed for a few years. I went to the doctors because of my throat issue, and he checked the back of my throat with a flashlight and did a swab, it all came back clear. I have been referred to an ENT, but I have to wait a few weeks. I just checked my throat and saw that my tonsil is swollen, and it feels like one side is numb. But I do not feel it when I swallow. I am so scared that I have tonsil cancer. Can you see the pictures and tell me if both my tonsils are\u00a0swollen?",
    "doctor_response": "Hi. After seeing the pictures (attachment removed to protect patient identity), I can tell you the following. You have pharyngitis, and your tonsils are inflamed. The foreign body sensation in the throat is due to a post-nasal drip. Do you have any nasal congestion? I suggest you get an x-ray of the paranasal sinuses done, and a throat swab for culture sensitivity, to see the cause of infection. And avoid smoking. Revert with more information to an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for severe elbow pain\n\nMY GIRLFRIEND IS 52 AND WAS WORKING IN THE KITCHEN BUT WITH NO DIRECT CAUSE CAME OUT OF THE KITCEN AND TO BED CRYING IN PAIN. THE TIP OF HER ELBOW SEEMS TO BE THE SOURCE. WHAT SHOULD SHE DO TO EASE THE PAIN? SHE TOOK 3 IBYPROFINS AND STILL SEEMS TO BE IN INTESE PAIN.",
    "doctor_response": "Hi, It could be minor contusion or inflammation. As a first line management, she can take analgesics/anti-inflammatory combination like Aceclofenac/Serratiopeptidase for symptomatic relief. Apply ice packs also. If symptoms persist better to consult an orthopedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes raised ESR?\n\nI've recently been for two full blood counts, both of which show raised ESR (55) and slightly low Folic Acid. I've also had a chest x-ray (results not back until next Friday) and have been prescribed Amoxicillin Capsules and Folic Acid Tablets. I'm always racked with aches and pains, but this is the first time my ESRs been raised. Needless to say I'm extremely frightened, as when you search the internet all the horrors appear (cancer, etc). How likely is it to be something really serious?",
    "doctor_response": "Welcome to H.C.M. I am Dr Krishna Dubey.There are lot of causes associated with Raised E.S.R like-   Infection,   Anemia,Pregnancy, Thyroid disease. Immune disorders like Rheumatoid arthritis etc.Your doctor started Amoxicillin so it suggests you have infection (a common cause of Incresed E.SR.). I advise you to complete the course of Amoxicillin and repeat E.S.R with complete blood count .This will completely resolve your query and help in further follow up.Thanx for query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can jaw soreness with teeth pain be treated?\n\nHi, I had my wisdom teeth removed 8 days ago. I finished my pain killers on day 4 and have been taking 3 ibuprofen daily since. During the days I have been experiencing tolerable pain, however, in the evening my jaw is very sore and my teeth hurt (like having braces tighten). Is this still normal after 8 days?",
    "doctor_response": "Thanks for your query, I have gone through your query.The soreness in the jaw could be because of the wisdom tooth removal. If the bone was cut during the removal of wisdom tooth there will this kind of pain, that last for 5-7days. The other possible cause of pulling kind of pain is the presence of sutures. Get the sutures removed after 7 days the pain will come down gradually. continue the course of antibiotics and analgesics. Do saline gargling.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for heart palpitations\n\nI have heart palpitations that feel like chest vobrations at night that continue for about a minute or two after waking and are followed by skipped heart beats for several hours afterwards.  The most noticable episodes occurr between 3 and 5 a.m. I an 74, male, exercise regularly, suspected of atherosclerosis.  Recently had a medical exam, ECG, Holter monitor which seemed to indicate no major abnormalities.",
    "doctor_response": "Hello and thank you for using HCM.I  carefully read your question and I understand your concern. I will try to explain you and give my opinion. You should know that this skipped beat has to do with a rhythm issue. There are some electrical impulses that generates from parts of the heart different from normal sinus rhythm.They cause premature heart contaction that its not a normal one followed by a pause and you might experience  a skipped beat, palpitations, difficulty in breathing deeply, anxiety.There are different causes of this rhythm issue like simple stress, coffee or energy drink consumption, patologyes like anemia, hyperthyroidism,electrolyte imbalances, ischemic heart disease ect.You mention that you have already done a holter rhythm monitoring and it doesn't reveal anything abnormal. This is a very good news.But you should know that this palpitation are sporadic episodes and it is difficult to catch them. If I was your treating doctor I would insist to find the cause and I would recommend a cardiac echo to evaluate heart function and valves, a full blood analyze to exclude anemia , hyperthyroidism and a strees test as you say you are suspected for atherosclerosis. It is essential to exclude ischemic heart disease. After all this we can better judge what we are dealling whith and if we should treat medicaly.Hope I was helpfull. Best regards, Dr.Ervina.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for increased sgpt levels after taking folic acid, liv 52?\n\nhi i am male 27 ido regular walk my weight is v much normal, one month back i got lft done in which my total bilibrium is 1.83 and sgpt was 27 so doctor recomends folic acid tablet and liv 52 ds.. thn yesterday i again got lft done in which total bilibrium is 1.24 but sgpt increased to 47... what shud i do..",
    "doctor_response": "hi, mild elevations of liver enzymes are common in many diseases. you need serial followup of enzymes and ultrasound abdomen. Folic acid do not cause bilirubin elevation and liv 52 is just a supportive drug. repeat the tests regularly, and if they are persistently high, then consult a physician or Gastroenterologist. Hope this helped.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Other than cochlear implant, is there any other way to treat hearing loss in a kid?\n\nHi doctor, My niece is 4 years old now. A year back we realized that she was not catching up how to speak and consulted an ENT doctor. Doctor performed few tests like BERA, OAE and hearing assessment. Then he confirmed that my niece is suffering from profound hearing loss. Doctor suggested hearing aids could help her in listening temporarily but advised cochlear implant as permanent solution. Though my niece grabbed very few words to speak with the help of hearing aids, she could not completely mingle with us. We still neither could digest the news nor can imagine that she wearing external devices for her entire life. Also that none of us or our ancestors had such problem. We consulted few more doctors for further confirmation and I browsed over the internet but everyone says cochlear implant is the only solution. We would like to take a final opinion from the doctors around the world before she goes under the surgery and hence drafting this. Can we have a hope that the problem could be different and doctor identifies the actual problem (if any) while operating the ear for cochlear implant? I figured out from few blogs that research is going on few devices which do not require wearing external device. Can you please let me know if they are available outside? If not, how many yet more years to pass to get those devices into the world and save many children with this problem? I have attached the BERA, OAE and hearing assessment reports for your reference. Please have a look at them and advice. Thank you very much for your valuable time and your help is definitely admirable and cannot be unnoticed.",
    "doctor_response": "Hi. Reports (attachment removed to protect patient identity) clearly explains about the problems. I clearly understand your concern and worries. CT and MRI scan for cochlear implant. 1. Speech therapy after cochlear implant, minimum three days in a week, only by speech language pathologist. 2. Regular mapping by an audiologist. For further information consult an audiologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting in infants after eating?\n\nhi ... My daughter is 1.3 year old ... she is not eating anything & even not drinking milk. Also when we try to give something ,, she behave like vomit coming out.... Also she is vomiting when eat some time . is this because of worm? .. if yes how to treat? Regards Askari",
    "doctor_response": "HiWelcome to the HCMIsolated vomiting episodes with aversion to eating in toddlers can be due to  viral gastroenteritis, gastritis, or worm infestation commonly. You may try following measures:1. Syp. Emeset or domperidone can be given for vomiting episodes.2. Tablet Junior Lanzol can be dissolved in water and offered to the child for associated gastritis.3. Give her rehydration therapy such as lemonade, Buttermilk, or ORS especially if she develops diarrhoea episodes.4. Keep trying for feeds.5. As it might be due to worm infestation, give her albendazole syrup. 200mg on 1st and 15th day at bedtime.This should be helpful.If still persistent vomiting, then do contact your pediatrician.For further questions, do contact us.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of severe hypertension?\n\nDear Dr. Koregol,I am a59 year old male.I have been treated for mild to severe hypertension for the past 15 years.For the first 10 years I was on concor[bisoprolol] adrenolytic and tritace[ramipril] ACE inhibitor.This worked very well for my BP and also my constantly elevated pulse of between 90 and 120[resting]However i developed severe post nasal drip ,constant coughing and very svere rashes, to the point of bruisig in the skin.My medicatio was then changed to atacand[candesartan]32mg a angiotensin2 receptor inhibitor and diuretic [thiazide] of 2.5 mg per day.My pulse is constantly elevated as is my Bp and i have not had a good night sleep in years because of the constant need to urinate every 2 hours.Please help",
    "doctor_response": "you cam consult your physician to restart concor as it can control bp,hr and some relief in anxiety also.Thiazide,Diuretic can be taken in morning or afternoon.... don't take it in night which will make you to urinate again n again which ll disturb your night sleep.All the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on the stomach?\n\nquestion I have a large lump in my tummy right at my belly button ... not sure if its a hernia or not but my feet are also swelling daily and not going down and I feel winded having to take walks. or anything and feel as my back is killing me with agonizing pain like I could cry is this all because this could be a side effect?",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You may have umbilical hernia or inguinal hernia.  Your description sounds that. You should go for examination of your swelling whether it is hernia or not.  If it is hernia then go for hernia repair surgery like meshplasty. If you don't have hernia then go for fine needle aspiration cytology. Then take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could a red, burning lump below the ankle be a cause of concern if suffering from Varicose veins?\n\nHi my name is Hayley & although I have always had aching legs with varicose veins etc they gave been especially sore over the past few weeks & just today I felt like a burning sensation & noticed like a red mark that feels kind of lumpy underneath near to my ankle that had got me kind of worried as unusual???",
    "doctor_response": "Hi, Welcome to Health care magic forum.                       It appears to be the deep vein thrombosis, usually been treated conservatively, the other causes may be the bacterial infection of the skin of the leg.                       I advise you to consult a surgeon for diagnosis and treatment. You may need to have a color doppler for diagnosis.                        Take more of green leafy vegetables, pulses,sprouts, andprotein rich foods to have resistance against such infections.                        Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for purplish bruising and pain on leg\n\nYes, I was healing my right foot from a blister on top near the 3 middles toes, since 12/2011, when I took a fall on my right leg on 2/4/2012 & had a big bump & bruise. Now I have internal bleeding going down towards my foot as indicated by purplish bruising & my skin is very tight & hurts. My primary said it is not infected & I finished my antibiotic (Levofloxicin) already for the blister part of it. He said to just elevate it & I didn t need compresses. It is hurting me & my skin is tight.....can t I use warm compresses to relieve it?",
    "doctor_response": "Hello, No, should not use warm compresses on the bruising part as it will make the bleeding worse. Should keep elevated as advised by your doctor. Apply heparin gel to disperse the blood (the bruising part). All the best. Dr.Albana Sejdini",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does upper respiratory infection, non stop cough requires attention?\n\nMy son had a rubber basketball and placed it on top of his lamp and forgot and turned the lamp on. In turn the lamp's light bulb melted the ball completely and fumes instantly filled his room as well as the whole house. He instantly started coughing and said he was nauseated. He was just diagnosed with an upper respritory infection today and is coughing non stop. Should we worry about the smell and fumes even though we opened all the windows?",
    "doctor_response": "Respected user , hi Thanks for using Healthcaremagic.comI have evaluated your query thoroughly .* This is allergic bronchitis  through  inhaled fumes .   Nothing to panic , but requires  definite  treatment  with physician in form    of  - proper antibiotics - decongestants - bronchodilators - steroids in    selected  cases with supportive management .* No further exposure is vital for fast recovery .Hope this clears your query .Welcome for further questions .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is OCD a psychological condition?\n\nHi, my aunt is 52 years old and for about the last 10 years , I have noticed that she constantly spits into a paper towel or tissue. She also rinses her mouth with water, and spits into a bottle frequently. I already knew that she has ocds with germs and washing her hands, but could this be OCD related? Also, she told me she does this for her health, and gets upset when asked too much about it. She does not have mouth or teeth issues. Could this be psychological, physiological? Thank you Paul",
    "doctor_response": "hi dear,definitely this symptoms are due to obsessive compulsive disorder and this is a psychological disorder and for that one should take medication. consult psychiatrist for detail history and treatment.also there are medication like SSRI or tricyclic antidepressant and also do behavior therapy which helps a lot.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having weakness, high fever and body pain. What is the reason?\n\nHello doctor,I am 57 years old male. I am facing weakness and high fever and body pain symptoms for a while now. Upon doing some routine tests with a local clinic, the test values are as below:RBC count- 5.48.Hemoglobin- 8.16.Hematocrit- 28.9.MCV- 52.71.MCH- 14.88.MCHC- 28.24.RC distribution width- 13.01.Total WBC- 3.18.Neutrophils- 29.1.Lymphocytes- 55.43.Eosiniphilis- 0.4.Monocytes- 13.66.Basophils- 1.4.Platelet - 405.MPV- 6.86.What do the above values signify? In addition to this, my iron is 18.22 and my TIBC is 300.72, ferritin is 213.00. Had colon surgery for colitis nine years back. Currently, I am taking Panadol, Ferroglobin.",
    "doctor_response": "Hello. Fever, weakness, and lymphocytosis in CBC are suggestive of viral infection. Symptomatic management is done with nonsteroid anti-inflammatory drug. Your physical examination should be done first that includes lymph nodes, spleen, liver palpation, auscultation, etc. Investigate with peripheral smear examination report as well. According to the physical examination, if needed, the doctor will suggest doing further investigation.  If a sore throat, abdominal pain or any other specific symptoms present then inform about that. After recovery from fever, iron tablets needed to recover from anemia. Provide peripheral smear examination report once done. Take care. Consult a physician for examination. For more information consult a hematologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain, fever, enervation, did not take prescribed Rabonik due to absence of nausea. Suggestion?\n\nI had pain in the abdomen with fever which went upto 101 for a day only.the doctor prescribed ORNOF BD for 5days,RABONIK DSR BD,CYCLOPAM SOS and COBADEX FORTE.he wants me to have Ornof for 2 more days. I did not have Rabonik at all but he said it is important to have it. But I am feeling very weak and drained out.you think I should have Rabonik.i did not take it as he said it will take care of nausea but I had no nausea.please suggest.",
    "doctor_response": "hi nishi, as your taking antibiotics that is ORNOF,it might irritate your stomach.eventhough you donot have nausea better to take Tab.Rabonik for few days as prescribed by your doctor. bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is aleve likely to abate swelling and pain in back after an injury?\n\nI slipped and fell on ice last week. I landed on my left side. i now have swelling in my back about half up and just out side the middle of my back on the right. I ve taken aleve, the pain is not unbearable but seems to be getting worse. How long should l let this go before I see my doctor?",
    "doctor_response": "Hello, you have not mentioned your age but if you are above 50 you should get your X ray as early as possible. Even a very trivial looking injury at back can cause fracture so do not take risk. if you are below 50, than few tips for you before you see your doctor. First take rest, avoid bending forward or sitting on chair fo long time. Apply ice over your back. I hope you are taking pain killers like brufen, diclofenenc with muscle relaxant like myospaz or myoril. If your pain persist beyond 7 more days, you should see doctor as well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Seen suffering with morning sneezes, no nose block. What could be the reason?\n\nHi, I am Sahana, I have been suffering with morning sneezing problem since 2-3 years. The symptom is early morning when I wake up before 7am anytime I start getting this sneezing and it goes non stop till almost 9am, But later like after 9am, I will be fine no nose block or any irritation. But this has become a daily routine and its very annoying. Please suggest",
    "doctor_response": "these are initial allergies which is due to irritation by some allergenyou can consult doctor to find out cause of allergiesmean time you can take anti allergic tab and apply neomycin h ointment in nose bd to control the symptomps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i eat yogurt and goat cheese while having gall bladder problems?\n\nI suspect gall bladder problems. No attack but bloating, gas, burping. Slight ache in upper right side under breast. Slight headache. I am also wondering about a diet of what to eat and what not to eat. Is yogurt and goat cheese in the lists? Thank you.",
    "doctor_response": "hi dear you are saying to have bloating, gas, burping and ache in right side abdomen, it seems to be related with gallbladder problems. But to be diagnosed exactly you should do abdominal ultrasound. With regards to your diet usullay we recommend to avoid fatty foods. Yogurt and goat cheese ore not listed as fatty foods, so yuo can use them. best regards dr.klerida",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the pain caused by paget s disease?\n\nI have been diagnosed with pagets disease and it is effecting the 7th rib on my right side. Ihave had one infusion (Bisphosphonate). I still continue to have pain in the same spot and it is uncomfortable. I also feel restricted in my breathing. Can you suggest anything for me?",
    "doctor_response": "Hello,The pain is related to local inflammation. I recommend taking gabapentin for the pain. This drug is an anti-epilepsy drug, used to treat chronic body or nerve pain. You should discuss with your doctor on the above treatment option.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain and fatigue after MRSA infection?\n\nIN 2008 I WAS DIAGNOSED WITH MRSA IN TNE GALLBLADDER. I SPENT A MONTH IN THE HOSPITAL, AS IT INFECTED MY ABDOMEN AS WELL. I HAVE LINGERING PAIN, FATIGUE AND SLEEPLESSNESS. IVE ALSO SUFFERED FROM CONTINUOS INFECTIONS OF THE DIGESTIVE TRACT. I WAS EXTREMLY HEALTHY PRIOR TO THE MRSA AND THE DRS. HAVE NO EXPLANATION FOR THE PAIN. COULD IT BE LONG TERM AFFECT OF MRSA OR ANTIBIOTIC TREATMENT? I M MOSTLY BED RIDDEN FROM THE PAIN AND WOULD LOVE TO HAVE MY LIFE BACK.",
    "doctor_response": "Thanks for your query at HCM!I understand your concern.Has your GB been removed?I think post surgery you might have developed adhesions which could cause pain.I don't think MRSA has any role in it now as you have no other systemic symptom.It is important to carefully follow your doctor's instructions about your diet. Avoid high-fat foods. Take bulking agents,  antispasmodic agents and proton pump inhibitors.You can get a follow up USG done.You can visit Local doctor/pain and palliative clinic for relief.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe itching & small red rashes on abdomen & then all over the body. Treatment ?\n\nDuring my first pregnancy (15 yrs ago) i had experienced severe itching & small red rashes on my abdomen & then all over the body except on my face.After the delivery the itching slowly disappeared. Almost after 13 yrs during winter i had same problem again that only abdomen and upper thighs. Our family doctor prescribed Clobetosol with Propisylic acid cream for local application, this worked out well ,so i continued using for subsequent winter period as i had the same problem . This year the same treatment is not at all working on me, instead the rashes are spreading towards my lower legs with severe itching. I want proper advise and treatment for this.",
    "doctor_response": "Your symptoms are suggestive of Acute Urticaria. This is usually caused by either intake of a new prescription drug like penicillin or an OTC drug like aspirin, systemic infection (either bacterial or viral), food additives, seafood or intestinal worms. The last is usually only of significance in children. Stress is also a major cause of an outbreak. Now about the drugs you are on - they are unlikely to be the culprit since you have been on them for so long. Many times it is not possible to find out the cause, however since most episodes of acute urticaria are self limited within 4-6 weeks of onset of symptoms, it is not imperative to do so. I would recommend taking Tablet Claritin 10 mg once or twice a day for 2 weeks + calamine lotion over the affected areas whenever symptoms occur and seeing whether they recur on stopping the medicine after 2 weeks. If they do then restart treatment for another four weeks and then stop and see. If they still recur then you will require some blood tests and will need to see a doctor in person. Please note that if you have any lip swelling or difficulty in breathing you should see doctor right away. Hope this information is useful, please feel free to ask if you have any queries. Please feel free to ask if you have any queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat chest pain?\n\ni was in a car accident 3 years ago,from that i started having pain in the chess very bad,like a long ice pick was being stabbed in me, hard time breathing,been to physical therapy for six months and do streches every day,but still every time i lay down or sit to long or move to fast i get that stabbing pain,it takes so much out of me,i need help talking to my docter about pain meds ,whenever i tell her about my pain she says no it cant be from the accident because it was over 3 years ago,but i know it is because thats when it started,my medical insurance wont pay her if she says it was from that i geusse because they didnt pay her before and she wanted me to pay for everything that was done and get reimbursed from car insurance,i also was diagnosed from a family docter 8 years ago with fibromyalgia ,please i;m in alot of pain and it makes thinking straight hard as well,i dont want to take pills at all because i have a hard time swallowing them i almost always choke,but i need real help",
    "doctor_response": "Hi, It could be due to nerve impingement. As of now you can use analgesics/anti inflammatory combination like Aceclofenac/Seratiopeptdase for symptomatic relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have shingles, constant headaches, fatigue, rashes. Taken amoxicillin. What else can be done?\n\nI have shingles and no health insurance. I still have some amoxicillan sitting in my fridge that hasn't expired.  Will it help with the shingles?  I've had shingles before so I'm sure the signs I have mean I have it. I  have a constant headache, fatigue and a small rash that is identical to the rash I had when I had shingles last time.",
    "doctor_response": "hi, Amoxicillin wouldn't work here, as it is antibacterial not antiviral drug & shingles is a viral disease. So, you have to go for acyclovir( 800mg 5 times a day for 5 days) or of famciclovir ( 3 times a day), start only within 3 days of symptoms, after 3 days no active treatment require. If pain still there need appropriate pain killer. Have plenty of fruit juices, water and vit c. I had many patients with similar illness and they respond very well with diet and pain killers. Fatigue will subside soon in 2-3 days on its own.Review after 5 days and in between if things wouldn't control or minimize.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Upper left abdomen pain from heart level. Not taking any medications.\n\nI get a sudden, sharp stinging pain upper left abdomen starting around heart level goes down my left side and sometimes part way across below my stomach. This has been happening for 3-4 months maybe, always feels about the same. It can happen when active or at rest, last several seconds then goes away. It feels to be below the surface a couple of inches, and can be described as ribbon-like pain, if that makes sense. It is pretty frightening and has me worried. It can happen at any time, and may occur a few times a week. There is no center chest pain or heaviness associated with it, and my breathing is not affected. I am 54 and in fairly good health, slim, walk a lot, smoked 20 years but quit 11 years ago. I am very active, but have been severely overworked for the past few years. I live in a rural area and the doctors do not seem to be very good around here, that is one reason I am putting off going. I had a kind-of phyical exam from one of them at age 50 and had no problems. I am not on any medication. Thanks.",
    "doctor_response": "Hi,Thanks for writing your query.After reading your post, it seems that you might be suffering from increase in acidity and gas formation in your stomach.You can take an antacid like Omeprazole 40 mg along with Domperidone 30 mg once a day before meals. Following precautions will be helpful :-1. Avoid spicy and oily foods.2. Do not miss a meal.3. Avoid smoking and alcohol.4. Avoid mental and emotional stress.5. Drink lots of water daily.If the problem persists, get yourself clinically examined and investigated.I hope this is helpful to you.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "May I take one vardenafil hcl 20 mg tab, while taking one penicillin vk 500mg ?\n\nmay i take one vardenafil hcl 20 mg tab, while taking one penicillin vk 500 mg tab four times a day ? Can I take one vardenafil hcl 20mg tab, while taking one penicillin vk 500 mg tablet four times a day ?",
    "doctor_response": "There is no reported interaction of vardenafil with penicillin so you can take it along with penicillin But you have not specifird your age or any pre existing illness if you are above 50 and or you are suffering from any heart related ailments you should avoid vardenafil; as it may cause sudden heart attack Dr. Manish R. Rijhwani +91-9422571734 drmanish78@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for weakness in the knee\n\nmy ldl level is 140, & to lower it i hav been prescribed rosuvas f 20, i hav had been taking rosuvas f10 for last one & a half years, but my knees hav gone weak i think, so i dont want to continue, pls advice, mylipid profile has gone back to normal now",
    "doctor_response": "Dear patient rosuvas is a drug of stating group and stains are known to cause initial muscle damage but it is temporary. since you are taking rosuvas for last one and half years and weakness has started now it is less likely because of statins. your cholesterol is now normal because you are on drugs. it may rise if you suddenly stop drugs. There are many reason  for knee weakness and one of them common in old age is muscle wasting because of knee osteoarthritis. You need to consult orthopaedic surgeon for detailed examination and diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest management for pancreatic cancer complicated by diabetes\n\nmy husband had pancreatic cancer surgery (Whipple Procedure) it was caught in stage I. He is diabetic and we are having a difficult time controlling his blood sugar, he is always hungry. Prior to this surgery, he had a large stroke which affective his ability to process information correctly.",
    "doctor_response": "Thanks for your question on HCM.I can understand you problem and worry.You can follow these steps for better control of diabetes in your husband.1. Diet modification. Avoid sugar in everything like milk, juice etc. Eat more and mor le green leafy vegetables.  Give him high fiber diet. High fibers can give you feeling of full stomach so further food intake can be avoided. Avoid large meals, instead give him frequent small meals. Avoid high calorie diet like oily, cheesy food.2. Regular aerobic exercise in the form of brisk walking,  jogging or trade mill. Go for walk after meals. This will increase metabolism and reduce post meal sugar spike.3. Take insulins regularly.  You can also give long acting insulin (24 hours action) to prevent day time fluctuations and provide glycemic control throughout the day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Morphine Sulfate safe to take for chronic pain?\n\nMy 92 year old mom , who weighs 78 lbs., has been taking oxycodone 7.5 -325 for 18 mos approx. She s living at our house, and is in hospice.The hospice nurse said she was changing her pain Medes, I m supposed to start her on morphine sulfate 30 mg in the morning, instead of the other Med. After reading all of the things sent with the prescription, I m afraid it might not be safe. Is this stuff e really safe for her to take?",
    "doctor_response": "Hello, Morphine is the drug of choice for uncontrollable pain. However, it is not safe for long-term use. She can also try other analgesics like tramadol for pain relief. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why did I feel suffocated during summer?\n\nI am just curious. Years ago, I felt suffocating slightly during the summer and always wondered what that was about. I felt like I had to take in full breaths - filling my lungs to the maximum - otherwise, I felt like I had not enough oxygen. It happened for about 1 or 2 weeks, twice in my life. I'm always a little worried that it could happen again... Thanks",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. It could have been anxiety attacks. If you had no other symptom like cough or chest pain. If you have any of these symptoms then get chest x ray and PFT done to rule out bronchitis. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for red and swollen spot on leg of a child\n\nHi, my name is Tina. My daughter is 2 years old. She has spot on her let that is swollen, red, feverish, hard and about the size of a half dollar. (The part that is hard is about the size of a qurater.) She limps when she walks. She doens t want us touching it. When pressure is applied a thick mucus comes out. A couple of days ago she was diagnosed with a virus. She had fever and vomiting and diarrea. (At the time we didn t think about the spot because it was small.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have epilepsy problem, taking Lamitor OD, face became expressionless. What should i do?\n\nI have epilepsy problem since 1998.I am 29 now.And nw my doctors are reducing my medicines.But my face is look totally dumb.I am taking Lamitor OD.And Its almost 2 and half year I have nt gone through attack. My face is almost expressionless.What should I do? Thank you",
    "doctor_response": "HiTo my patient I would have told that in epilepsy stone like face is known to occur .In addition i would have advisd my patient that if it is because of drugs It will become normal few weeks after stoppage of drugsDr Lal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could it be cancer if a bulge showed up around the lower spine during a Dexa scan?\n\nI had a dexa scan and my doctor called me today to tell me I need to have an X-ray of my lower spine because they saw something bulging but the bone around it looked fine. She told me not to worry because now I thinking cancer. She told me no but they need to see what it is just to be sure",
    "doctor_response": "\"bulging\" is not sign of cancer on Dexa filmthe sign of cancer in lower spine film is loss of pedicle of vetebral body Bulging from your Dexa scan mostly come from bone spur from degenerative of your spine.Don't worry It's normal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do we need to use glasses for cylindrical power in eyes of a child?\n\nI have twins kids; son and daughter. They are 4 years old. They have never complained about any problem with their eye and seeing anything. However since my wife has eye power -7.0 in both the eyes from the age of 9 years, therefore we thought to check up kids eyes with the doctor. The pediatric ophthalmologist from the L.V. Prasad Eye Institute, Hyderabad, India prescribed the cylindrical power for both my son and daughter. Son power is - 1.25 and -1.5. Daughter -1.50 and -1.75. The doctor prescribed the glasses for both of them. I am completely confused and worried. I have following questions to ask and I would highly appreciate any suggestion and advice for my queries: 1. Do we need to use glasses as per the doctor advice? 2. Is it possible that these powers will decrease and completely go away as the kids grow? 3. What are the precautions we should take? Any particular nutrition? 4. Is their any other form of treatment? Thanks",
    "doctor_response": "Hi, I am answering your questions :1. Yes, you need to wear them glasses as per doctor advice, because if they don't wear glasses then there number will increase and secondly, problem of headache can occur. 2. Since, the number is more, chances of them getting completely ok is remote but yes the number can decrease over a period of time if they continously wear glasses. 3. Precautions like watching less tv, and from a distance of atleast 8 feet. You need to give vitamin A rich foods like mango, carrot, cabbage, spinach, sweet potato, tomato, watermelon etc. I hope this has helped you. If you have any more questions, i will be happy to help. Regards Dr Deepak Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Seroflo inhaler be given to a child for cough and cold?\n\nHi, may I answer your health queries right now ? please type your query here...hi i have three year old child .he always treat cogh and cold .so doctor suggest seroflo inhaler for two times every day .it is good for health or bad .plese suggest me.......",
    "doctor_response": "Hello,By what you quote, I feel what your kid could be having viral associated wheeze or multi triggered wheeze.I have a few questions for you such as:1. How many days per month do your kid cough or feel breathless?2. How many nights per month do your kid's sleep get disturbed due to above symptoms?3. Does your kid feel breathless when running around or playing with other kids?4. Are the symptoms when there are seasonal changes?5. Is there any family history of asthma or any other sort of allergies like skin allergy et cetera?6. Is the cough always associated with fever?Please revert back to me with answers so that I can guide you better.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sumanth Amperayani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the use of calvepen and chloromycetin inspite of having chicken pox?\n\nI have chicken pox . The spots came out this morning I am 40 years old. My little boy got them Christmas morning. I have a v sore throat and covered in spots even in my eyelids. The secretary at the doctors said not to come to the surgery as I would infect people. Medicine was left at the Doctors front desk for me to be collected by a friend. It is called Calvepen 666mg and the other one is Chloromycetin. i would like to know what they are for. Is one of them an antihestimine for the itch. If not what should i take that I can take for the itch something I can take over the counter. How long do you think i should stay out of work roughly Thank You Aideen",
    "doctor_response": "HiThank you for asking HCMI have gone through your query.The medicines which are given for you are antibiotics Calvepen which is a penicillin and Chloromycetin a chloremphenicol. They are given usually for sore throat due to bacterial infection.If you having chickenpox sore throat is due to that and antibiotic will give no help.For chicken pox if it is beginning i give my patient antiviral drugs like acyclovir or famcyclovir. I also give them antihistamine like cetirizine for itching.For soothing over the counter calamine lotion can be applied or the green dye which if available in your pharmacy.Hope this may help you.Let me know if you have any further query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain below left ribs. Feeling warm, not fevered. Why is it?\n\nMy husband  is having severe pain in his stomach just below the ribs on the left side.  He feels aliitle bit warm but not fevered yet. It came on about 10 hours ago and the pain is getting worse.  It is really uncomfortable. He says he feels like he has been punched in the stomach.  This is about the 3rd time this has happened in the last 6 months.",
    "doctor_response": "Hi, Thanks for posting your query. Does he has acidic belching/ abdominal discomfort/ gargling sound in abdomen/ abdominal bloating after taking meals? Does he have retrosternal burning pain causing difficulty in swallowing? Does he has fever/ spasmodic abdominal pain? Is he alcoholic also? Does this pain increase on eating food? With the available describes symptoms, there could be possibility of peptic ulcer disease/ pancreatitis/ left lower chest pathology or splenic flexure pathology. He should consult with internal medicine specialist/ gastroenterologist and should go for thorough check up. He should also go for complete blood count, Ultrasound imaging abdomen, thyroid profile, blood sugar, x ray abdomen and serum electrolytes. Meanwhile, He should take proton pump inhibitors along with prokinetics for relief of your symptoms. He should also take tramadol for relief of your symptoms. Avoid oily and spicy food, tomatoes, citrus fruits, excessive tea & coffee, chocolates. Take soft diet along with yogurt. Take care, Dr. Mayank Bhargava",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in the legs post BP medication withdrawal?\n\nI have had pain in my right shoulder blade for 3 days it is a sharp pain and it is had to breath I when to the emergence hospital last Wednesday had head ache above my left eye pain in the middle of chest pressure numbness on left hand they keep me over night did a lot of test and said I did not have a heart attach ot stroke my potassium was 3 and my blood pressure was 87/53 low I have a follow up with Cardiologist not till 25th and my doctor on 21st they changed my blood pressure took out the water pill was 25mg and told me not to take BP med till my bp was 140 for a few day it has been low 90/46 the firt day home to two days ago 113/66. Haven t taken BP yet. I have swelling on my legs ankles and thights for three days today my hold body and face swelling. Should I try to get into my doctor sooner than 21st if I can. YYYY@YYYY",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I passed carefully through your question and would explain that the swelling is related to the stopping of the diuretics. For this reason, you should consult with your doctor and discuss on the possibility of starting again diuretics. Regarding the chest pain triggered by deep breathing, it seems to be musculoskeletal pain, not related to the heart. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My baby fell on the carpet from bed. What should i do?\n\nHi, I am just shocked and very scared. My baby fell from our bed this morning and I want to be sure she is ok.she fell on the carpet from bed, i found her lieing on her back. Picked her up immediately",
    "doctor_response": "She is 11 weeks, will be 12 weeks by this coming weekend",
    "dialogue_context": ""
  },
  {
    "patient_message": "Precaution for appendicitis and typhoid?\n\nHi, I have got acute appendicitis and typhoid (determined using scan and widal test). I'm on the antibiotics for 10 days (Taxim O and Metrogyl 400) . Now am feeling better. Is there a chance of appendicitis and typhoid come back  ? what precautions should I take?",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.In my opinion you should take the complete course of antibiotic.With complete course of antibiotics, both the disease never reappears.But if the treatment is left without completion then there is possibility of recurrence.In addition to the antibiotics please eat healthy diet like green vegetables, fruits and high protein diet.I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How will i practice a day routine for bowel movement to 4 year old?\n\nMy 4 year old poops every night at 11:00 pm and has done so every since she has been potty trained. The only problem is she is asleep, has to wear a pullup to bed and she poops while sleep. She gets embarrassed about it and I don t know how to get her on a day schedule. I ve tried every thing and she still goes at night. Help!",
    "doctor_response": "DearWelcome to HCMWe understand your concernsI went through your details. You know your child better and you will be the best person to make a plan which works. Usually this comes under toilet training. I am not saying this training is very easy. But for sure, it will work.Try this method. Please take your child exactly at 10.45 to toilet. Make her sit in the toilet till she poops. Mostly she will not do it. Continue doing it for a week and her habit will vanish. Even if she does it on the first time, it will not continue.Also try this method. Do not allow her to sleep before 11. Tell her, you will go to sleep only after you poop. Within two days she will learn to poop before going to bed, and that is a healthy practice and can be changed later.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can social anxiety be treated?\n\nGood evening. I m 21 and I ve always been a shy person, when I was younger I used to sweat a lot because of it and I could barely speak with anyone. As I got older I became more and more sociable, now I ve got friends, I m getting along with everyone at work and I m feeling quite good with myself. I ve never been depressed and I m a really happy person. The problem that I m facing is that whenever I talk to somebody, with anyone at all, my heart starts to rush and my face becomes red in just one second. I blush like I ve done some dumb thing and it s intense and very very red, anyone notices it. I ve tried to get it gone by going out as much as possible and I ve learned that when I get comfortable with someone, the blush and red face thing disappears (but it took 2 years to get comfortable with my boss for example). I m aware the problem might be associated with anxiety, but I ve never taken pills for it. I just want the blushing to go away, as that will make me less awkward and better in general.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. In my opinion it is important to go for cognitive behavioral  therapy relaxation therapy. Make  sure  thyroid  functions  are  normal. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for grade 1 fatty liver\n\nI have been graded as GRADE1 Fatty Liver (Age-32yrs,Total Cholesterol=205,Triglyceride-495) after Ultrasound scan. Please suggest whether this condition is highly dangerous.Kindly Suggest me the medication and Food habits,Please provide me the list of Foods to be taken.",
    "doctor_response": "Hi,Thanks for posting your query.I am Dr.R.K and I am pleased to assist you.Fatty liver as such is a harmless condition. There are many different causes for the development of fatty liver which includes alcohol intake, obesity, diabetes, high cholesterol etc.Treating the underlying condition/predisposing factor will resolve it.Medications like s adenosyl methionine will help to resolve it.You need to avoid fatty food and alcohol.If you are obese, you need to reduce weight.I hope that answers your question.Let me know if I can assist you further.Regards,Dr.R.K",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dizziness, cold sweat, sweating. Was it due to food or water?\n\nHi my name is David, this morning when I went to work I only had 3 hours of sleep, on my way I ate 3 pieces of wholemeal bread with nutella spread and a peeled apple. After 10 to 15 min, I reach the carpark upon leaving my car I felt dizzy, my head was spinning followed by cold sweat. I could not stand up I had to sit down afraid that I might faint. Shortly after that i went to the mens room and thats went I started to sweat like crazy....cold sweat. I thought something was wrong with my food I tried to put my finger down my throat I throw it all out but unsuccessful. After about 30 mins I did the same thing again and manage to throw out and almost cleared my stomach then I felt better. Was it my food or maybe the water I drank, thank you.",
    "doctor_response": "Dear Concerned., Thanks for writing to us. Basically to maintain the Biorhythm an individual needs to sleep for 06to 08 hours a day. Otherwise there will be definitely increase in blood pressure. The initial symptom of cold sweat and dizzyness could have been a result of sudden variation in BP as a result of lack of sleep.This is  physiological or normal phenomenon. You have not mentioned regarding whether you have passed urine when you went to rest room. sudden evacuation of bladder in such a situation will lead  to gushing of blood to the urinary bladder musculature depriving the brain from its blood supply for seconds as the urine passes out and the bladder musculature normals in thickness(In its maximum capacity the bladder would  balloon out to store urine upto 750 ml almost obliterating its own blood supply if you withhold passing urine).The sudden crazy unable to stand and you had to sit up was due to a Condition called Micturition Syncope. It is almost always Physiological or normal phenomenon. Now you may ask why the condition improved after you have thrown up the Gastric contents.You have relieved the Gastro intestinal System from the work load and the blood supply was restored to the Nervous system. Again Physiological and it was untimely food in all probability. I am giving you only the probability as I have only read the history and not examined you physically. In both cases ie.,the root cause seems to be due to sudden change in your Biorhythm/lack of sleep.It does not seem to be due to quality of Food or water Per Se but due to irregular sleep/eating  pattern.Kindly help yourself with normal sleep. In the event of non improvement kindly consult a locally available General Physician for a complete evaluation. Get well soon. Best Regards., Dr Lt Cdr ASN Bhushan.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurrent pain in the shoulder and elbow when I sneeze?\n\nI have a few things going on, back of right shoulder hurts off and on, elbow is very ache. When I cough or sneeze stabbing pain in back of elbow and the back muscle(trapezius area but closer to the spine), my right index finger and thumb were numb(like that fell asleep feeling) for a few months. I over excreted by self and thought I had injured the shoulder muscle a few months back. it has gotten much better but these things I mentioned are still occurring. I still have weakness in the right arm when reaching over myself(like scrubbing in the shower etc). my right wrist hurts sometimes and the two bones often feel wired and I crack them and it goes away. Any idea?",
    "doctor_response": "Hello, I have studied your case. .Due to compression of Cervical nerve root there can be tingling numbness in your arm and pain.For these symptoms analgesic and neurotropic medication like pregabalin and methylcobalamine can be started.Till time, avoid lifting weights.Continue your Physiotherapy like ultrasound and interferential therapy will give quick relief.I will advise to check your vit B12 and vit D3 level.Your Spondylitis will get aggravated due excessive travelling so better to avoid such travelling. If nerve compression becomes symptomatically severe then surgical decompression will give permanent relief.You can attach your MRI report or film so that I can help you better.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain in the center of chest?\n\ni ate some solid white tuna from a can and about 5-10mins later i got severe chest pains in the center of my chest. i could also feel it in my back. it wasnt constant, sorta came in waves and lasted about 45mins. everytime a wave came it hurt less and less. any idea what it was?",
    "doctor_response": "Hello, It could be a sea food allergy.It is better to avoid tuna and related foods.If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe lower back ache?\n\nmy mom is 40 yrs old,78 kg and 5.5feet was sufferin form fibrocytis since few months..but suddenly she started feelin severe lower back ache...one of the doctor's prescribed her to take zaltokin 80 tablets..but she is nt recoverin..please suggest somethng ??",
    "doctor_response": "Dear friend,not because of fibrocytis ,your mother is very much overweight if we considr her height and age.so ,continuation of that medicine can be considered but you have to keep in mind that excessive weight is putting pressure othe muscles that are attached to vertebral column and pelvic bone causing pain.losing some weight will really help her to alleviate this pain.my best wishes for her.thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medications can help Postpartum OCD induced anxiety attacks?\n\nI have been experiencing anxiety attacks EVERY morning thanks to postpartum OCD. I was prescribed Zoloft which made me have suicidal thoughts. The ER prescribed me Ativan after going in after a panic attack. That medication really helped me. I took it first thing in the morning as soon as the anxiety started and was able to live my day normally. Are there any other medications that DR's will actually prescribe that work like Ativan? Over time i've had, Effexor, Zoloft, Luvox, Geodon, Paxil, Abilify, Xanax ( too strong ) and Seroquel. Nothing has helped me except the Ativan. I need help :(",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Why should you talk about other medicines when you can overcome this so called postpartam OCD with other techniques such as psychotherapy and relaxation. These methods has proven track records. over and above, anxiety disorders are seldom cured with medications. Psychotherapy helps alter your lifestyle and relaxation techniques alter your metabolism which acts positively. For anxiety, you should learn to counter that situation instead of living with it. Take my word for it. And start the treatment I suggested, along with medicines for the time being. 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.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in the foot and shin pain?\n\nI was kicked extremely hard in the area of what I have read to be the fibula. I was kicked mid-shin and cannot walk without crying, but there is not bruising. There is a bump right where I was kicked, but it s been a while and still cannot walk or move much without pain. There is a lot of numbness in my foot. Do you think it s broken?",
    "doctor_response": "Hi,Thanks  for  your query.From description it seems to be soft tissue injury .Bump might be due to haematoma formation(collection of blood).You need an x-ray to rule out any bony injury. I suggest you to consult an orthopaedician nearby for a detailed examination. You may get the X-ray of the area affected under his/her guidance. Beside icing and elevating it, you can take anti-inflammatory drug like motrin to reduce pain and inflammation.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Twitching on top of forehead\n\nI have a throbbing or twitching right at the top of my forehead at the hairline just to the right of the center of my head my right eye also twitches they are not pain full just troubling",
    "doctor_response": "HI, welcome to healthcare magic. You are suffering from, Migrane. Follow these instructions--- 1- Steam inhalation three times a day. 2- Take tablet Vasograin 1 tab 2 times a day. 3- Cap omaz D( omeprazol with domperidon) once a day before breakfast. 4- Take plenty of water, take full sleep. 5- Tab clonafit 0.5 mg AT night. All for 15 days, it will definately help u. REGARDS, pm/.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in each foot?\n\nI ran a mini marathon 2 weeks ago and now each foot has a calas type sore on it and they are extremely painful when I walk.  What could it be and what do I do to make them go away.  This is my 3rd mini marathon in 3 years and this has never happened before.",
    "doctor_response": "dear friend don't worry. the pain may be musculo-ligamental type, that may occur due to sprain after much walking/running. it will subside in few days by its way. you can take analgesic like ibuprofen or if severe pain combination of aceclofenac + paracetamol + chlorzoxazon/serratiopeptidase for temporary relief. for severe symptoms got examined by your family doctor first.hope this answer will be helpful to you.for more queries plz don't hassitate to ask.get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering tuberculosis on right Fallopian tube. Tried IUI. Side effects of tuberculosis medication?\n\nsir my wife suffering tuberculosis on right fallopian tube since last 13 years in 1999 when we met the Doctor for infertility problem they find out the tuberculosis on right fallopian tube and they advised to take medicine for 09 months course mean while we do intercourse and got pregnant, immediately the doctor advised to stop the medicine and after 09 months we got a female baby in normal delivery, after that we try to get second baby but still it not possible, varies treatments are done including IUI in 5 times but not successes. now we wish to continue the tuberculous medicine for 03 months can we continue the medicine sir please advice. have any side effect to take this medicine",
    "doctor_response": "Hi thanks for your question. You have not mentioned before conception for how much time your wife had taken drugs for tuberculosis.Every medicine has side effect,and anti tuberculosis drugs are no exception.You want to know about the side effects of antituberculosis medicine,but you have not named what drugs she intend to take.There are different regeimns which are used for tuberculosis and each drug has different side effects.The current regeimn called DOT is safe and has minimum side effects. Hope this answers your question..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the effects of taking amlodipine and tamsulosin while having hypertension?\n\nhello My father is a 53 years old man that has HTN (140/90) for about 6 years and now he is using Amlodipine 5mg each day; also he has nephrolithiasis too and his prostate has enlarged and he has problem in urination and now for solving this problem he uses tamsulosin each day too; I want to know that is it taking both this 2 tablet dangerous for him and cause hypotension or not?",
    "doctor_response": "Hi,There is a little risk if hypotension while taking both medications Amlodipin and Tamsolusin, just monitor his blood pressure closer. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe back pain?\n\nHi i am 17 have a 2yr old dauaghter i didnt find out i was pregnant with her until i was 2 half months and i start birth control depo right before they released me in october of 09 then stoped in january of 11 and started the patch and then switch back to depo in april and was due for my second shot in june and missed it and had unprotectd sex i had some spotting and cramp then in july got my depo that same day and the lab lady droped my cup of urine so i took two pregnacy test came up positve and went back to the doctor and one negative urine and one negative blood test it is now its august and i still am spotting every time i go to bed brown or pink blood and cramps but no bleeding some times and constant peeing it feel like preasure on my bladder nasuea horribe back pain my lower are bloated in my lower adomen",
    "doctor_response": "For treatment of severe back pain you can take some pain killer like biozobid-plus or osteonac-th only when the pain is worse enough or disturbing your daily work along with some calcium supplements like shalcal-d or toscal-gem once daily. Take some multivitamins like metilda-af or neurobian-plus once daily. Do some exercises after an expert opinion of physiotherapist. I will also advice you to sleep on a plain surface.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump above the left eye indicate?\n\nCan. I get a blood clot from a fall &running into a wall? I hit my left eye it blacked the top of my eye pretty bad & also right above it i got a golf by size knot this happened on July 4 th the knot went down some its now about a nickle size what should i do & can that be a tumor? I thought the answer would be free I didnt know it cost. Is thier a free doctor on call just to answer that question?",
    "doctor_response": "Hello,As there is history of trauma, this condition is mostly hematoma formation around the eye.Ice application, antibiotics (as Cephalosporin group), anti-inflammatory drugs for varying duration resolves the issue. It is not a threat of cancer at all.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intermittent non-painful sinking sensation in chest near heart?\n\nI have an intermittent non-painful sinking sensation in my chest near my heart. I am a nurse.  this started yesterday. I am 53, nonsmoker, moderate drinker. 2 glasses wine per night. 5'5\", 120 lbs. I wear a combi-patch (estrogen), occasional ibuprofen use.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Disturbance in heart rhythm (arrhythmia) can cause similar kind of symptoms. So better to get done 1.  Ecg 2. 2d echo 3. Holter monitoring (24 hour continuous monitoring of ecg) to rule out arrhythmia. If all are normal then no need to worry for cardiac disease. Anxiety can also cause similar symptoms. So avoid stress and tension. Be relax and calm. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for fever & pain in the leg & neck\n\nhi doctor ,my wife is suffering from fever for last 1 months,some times she feels good and some times temp goes to high also she is having pain on leg and neck.today she did blood check from the result we comes to kw the ESR is high ie 80..so can you please advise me wat is the exactly we have to do for this..is der any other big problems...she is nw 26 years.. please give me sm suggections..",
    "doctor_response": "Thanks to HCM I can understand your wife concern don't worry the reports indicate high ERS value means there is inflammation in somewhere at joints here fever intermittently coming . for this we can use paracetamol 500 for 5 days but I would like to suggest just undergo  once aso titre,RA factor and x ray for cervical region and leg . ok from the finding if changes in report plz consult once the orthopaedician or HCM don't worry pain anf fever subside initially with paracetamol or aceclofecnac with paracetamol combination it may subside or plz confirm with investigations additionally written ok",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes visible veins near temples with stuffy nose?\n\nI just noticed my 5 year old daughter has noticeable veins near her temples. She has a stuffy nose. Could this be why? Or is this something to be worried about? She is 43 inches tall and about 42-43 lbs. She has reflux but is otherwise very healthy.",
    "doctor_response": "Hi.... is it common for fair skinned people for veins to be visible near the temple. This is because of the thin skin. There's nothing to worry about it, except when she has got severe headache similar to migraine. If this is not there please do not worry about the veins.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can weak erections and feeling of weakness after intercourse be treated?\n\nHi.can u please help?I don t know if I m I light place but I have problem about sex.i feel very weak after sex even next day.And I m not good in doing sex because I do just one not even I can have second around.Means olso I have a weak election.please if there is any thing u can do,please help",
    "doctor_response": "Hi, Sleepiness or tiredness after sex is normal but you are feeling it too much and that also even on the next day and your another problem is a weak erection. However, if you would have visited my clinic I would rule out any physical causes and would get your testosterone, thyroid and prolactin hormone levels checked. If that comes out to be normal then there may be psychological reasons also. You can take a good protein supplement and a multivitamin. Ayurvedic medicines like Tentex Forte can help but that had to be taken after consulting your doctor. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shantnu Sharma, Ayurveda Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am fearful of rejections. Please help me stay confident.\n\nHello doctor, I am very less socially active, a nervous beginner in conversations, and fearful of rejections. I have never achieved what I am capable of even being highly talented. I am not sure about my aim in life. All I want is to have control over my nerves and be self-confident in life no matter what the situation be. Can you help me?",
    "doctor_response": "Hello. You may have cluster C personality. First, learn to talk with yourself. Talk with yourself by looking into the mirror. Make eye contact with your eye in a mirror then start a conversation with friends by making eye to eye contact. Start with just a smile for a few days then start some conversation with just hello. Be confident. Do the exercise daily. If possible go for swimming and read good books. I suggest you read one book by the name \"How to win friends and influence inhuman people?\" by Dale Carnegie. You can get this book in many different languages. Never underestimate ownself. If you will not value yourself then no one else will value you. Develop some creative hobbies like reading, writing, and painting and accept your nature. You may be an introvert, but you are not antisocial. You like your personal space and you get tired easily with public contacts. So, cheer up. For more information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden weakness, darkened right eye and bad headache on right side?\n\nmy father was working when his right side of his body went very weak, right eye darkend and very bad headache on his right side of the head. what could this be? and yes he is in the hospital as i type this. still running tests to find out. but i am very worried.",
    "doctor_response": "Weakening of right side of body with headache can suggest stroke (may be hemorrhagic one). But darkening of right eye is not explained by that.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need treatment for blown disc on the back and the neck\n\nI have had both knees replaced, right hip replaced, left foot reconstructed, left reverse shoulder replaced, back surgery where a cage was put in, among other surgeries. I had a MRI done last week and found my back has four disk blown and my neck has two disks blown. The surgeon said they could fuse my back but there is only a 10% chance it will help. The disk in my neck is causing headaches. They are going to do injections in it soon. My right foot is deformed and have been told I need reconstruction surgery on it also. I know the feet can affect the back and the back affects the legs. At this point I am not sure which way to turn. Although I have a high pain tolerance I know I am facing some serious pain. I do not want to live the rest of my life in a drug induced stupor from pain meds. In fact I will NOT exsist like that. Please give me some input.",
    "doctor_response": "Hello, Sorry to hear about the list of injuries you faced. Coming to the point, you mentioned that MRI is suggestive of Lumbar and cervical disc degenerative changes. Let's discuss this first and then the rest. What my experience taught me over a period of 12 years with cases related to injuries like you and others I will give my suggestion. First foremost, buy a soft neck collar and start using it. This will stabilize the bones of the cervical region and also will act as s support to the muscular system to allow less compression over the nerve. The disc injuries are most times self healing, once the inflammation subsides you should not feel much pain. When using neck collar I will advice you to use on/off hot water fermentation so that the muscled which have undergone spasm will relax and the pain will come down slowly. Along with this. you have lumbar disc degenerative changes, so why don't you first take hot water fermentation so that the muscles of the lumbar region gets relaxed and make you at least stable. Post this use 3-4 pillows and try McKenzie maneuver in passive way. The details of McKenzie you can find over the net. This will help centralize the pain and once the pain is centralized you can use hot water bag to again soothen the nerve roots. Once nerve root is relaxed the pain travelling in its course will reduce automatically. Post which after 5-7 days of doing this you can focus on exercises but please continue the above advice as well. Exercise should focus on core stability, lower limb strengthening, upper limb strengthening and neck muscle strengthening. Slowly you will develop strength also and the inflammation on the nerve root will be reduced leading to the end result of improved lifestyle. If your pain symptoms are too high then a nerve block may be administered to the nerve root which may block the pain sensation for a couple of months. but if the muscles remain week still, it will again come back so doing the above mentioned exercise will be of help to avoid recurrence of pain symptoms. Coming to the surgical management, there is possibility of removal of the torn disc element and also fusing the spine but this may not make you get rid of the pain over all for long. The pain will be present through out the life and need exercise for the same. This option I do not recommend unless and until the motor functions are compromised. Also, very important is the diet, what you eat is to be focused. Having food which can digest faster without",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes walking difficulty after a surgery on hip?\n\nMy husband had suregery to close an open wound on his hip from a pressure sore; after the surgery 16 days ago, he is unable to walk; however, the days prior to that surgery, he was walking in the home, out of the home, and aboe to stand at stove and cook.",
    "doctor_response": "Hi, It is very unlikely that surgery for closure of pressure sore will cause an inability to walk or stand. There might be some other condition along with bed sore- perhaps some neurological disorder which in progressive I nature. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes gurgling in my left side of my chest?\n\nI have had gurgling my in my left side of my chest for 4 or 5 days now. Seems like every 4 or 5seconds there is a relase of air. I also seem to have a build up of gas which I can burb and feel beeter. sometime it helps the gurgling but most of the timeit doesn't. I have no pains.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. By your history and description, possibility of GERD (gastroesophageal reflux disease) is more. It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms of gaseous feeling in stomach (gurgling sound), burping etc. So better to follow these steps for symptomatic relief. 1. Avoid stress and tension. 2. Avoid hot and spicy food. Avoid junk food. Avoid large meals, instead take frequent small meals. 3. Start proton pump inhibitors and prokinetic drugs. 4. Go for walk after meals. 5. Keep 2-3 pillows under head in the bed. 6. Quit smoking and alcohol if you have these symptoms. Don't worry, you will be alright with all these. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure bruise and pain at the lower back?\n\nI am an active 29 year old female, 5'9\" and 135 pounds. I had taken a hiatus from running to heal from a couple herniated discs in my neck. Started back to running yesterday...one straight hour on the treadmill at a slow 4.5 pace. Once I finished, I had incredible bruise type pain in my lower back...not bone or muscle pain but as if my skin felt like it was ripping away from my spine. It feels like a bruise to the touch. Went back this morning to run again, and had the same thing (the pain is continuous...felt constantly but intensifies with every step in my run). Never experienced anything like this. Any ideas?",
    "doctor_response": "Hello, I have studied your case with diligence.As per your symptom and history there is possibility of acute muscle spasm in neck or there can be cervical disc compression.Due to compression of this nerve root there is pain associated with it.For these symptoms muscle relaxant with analgesic and neurotropic medication can be started consulting your treating doctor.Till time take rest and continue analgesic available over the counter take rest, and hot fomentation. Physiotherapy like ultrasound and interferential therapy will give quick relief.You may need to do MRI cervical spine if symptoms persist.I will advise to check your vit B12 and vit D3 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for headache and lower back pain.\n\ni have been tired for over a month im am always tiristy i have headaches that come and go my feet hurt my heals have cracks on them i poked my finger the other day and it seemed to bleed forever body aches lower back pain that comes and goes and as tired as i am i have trouble sleeping at night and get up every couple hours",
    "doctor_response": "Hello!Welcome on Healthcaremagic!Your symptoms could be related to a metabolic disorder, as well as a hormonal disorder. For this reason, I would recommend consulting with your GP for a careful physical exam and some tests: - complete blood count- thyroid hormone levels- blood electrolytes- PCR, sedimentation rate for inflammation- fasting glucose- a urine analysis. A brain MRI may be needed, in case of hormonal imbalance, in order to examine better the pituitary gland. Hope you will find this answer helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure a knot on the left lower abdomen?\n\nmy daughter has for years complained of a knot on her left lower abdomen. She is very uncomfortable at all times. Tests were done and all negative. MRI, cat scan , esophagoscopy , ultrasound, colonoscopy. What treatment do you recommend next. Would you recommend an exploratory surgery?",
    "doctor_response": "Hi. The reason of a knot on lower abdomen with all the investigations can be a hernia only, or an intermittent spam of the local muscles being felt and painful sometimes and not at other times. More than the investigations Clinical/ Physical Examination is the most important. So consult a General Surgeon who is well trained to find the rare cause of such symptoms which are not picked by any investigations.Colorectal Cancer could have been detected on all the investigations like CT scan and MRI already done. Colonoscopy to rule out such problems is highly recommended. MRI- Magnetic Resonance Imaging helps in the stationary organs and not in the moving organs like intestines.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat panic disorder?\n\nI have panic disorder. (1)I tend to panic while traveling in any vehicle especially planes. If I am driving or controlling the mode of transportation I have no fears. Especially at greater speeds.(2) I always want to see the different places but sometimes on doing so seeing unfamiliar races and areas I get too excited leading to constant swallowing, choking and panicking. I am not afraid of crowds or public speaking, I don t care about what people think of me one bit so having a panic attack with friends and family also tends to happen. It s like I retreat into myself and panic. Also no tragic incident led to the panic attacks. I was on a bus trying some deep breathing when all of a sudden I felt shortage of oxygen. I panicked and this was my first experience. After that I guess I shouldn t have dwelt on this episode for too long. Because then it led to general anxiety. Now I can feel anxious with any new and different thing. And traveling. How can I stop fearing a breathing issI have panic disorder. (1)I tend to panic while traveling in any vehicle especially planes. If I am driving or controlling the mode of transportation I have no fears. Especially at greater speeds.(2) I always want to see the different places but sometimes on doing so seeing unfamiliar races and areas I get too excited leading to constant swallowing, choking and panicking. I am not afraid of crowds or public speaking, I don t care about what people think of me one bit so having a panic attack with friends and family also tends to happen. It s like I retreat into myself and panic. Also no tragic incident led to the panic attacks. I was on a bus trying some deep breathing when all of a sudden I felt shortage of oxygen. I panicked and this was my first experience. After that I guess I shouldn t have dwelt on this episode for too long. Because then it led to general anxiety. Now I can feel anxious with any new and different thing. And traveling. How can I stop fearing a breathing issue. No asthma or thyroid. I have gone for all the check ups. Just not being able to keep my mind off breathing, burping, shortage of breath as a result, choking, and wanting to feel courageous instead of negative attitude towards lifeue. No asthma or thyroid. I have gone for all the check ups. Just not being able to keep my mind off breathing, burping, shortage of breath as a result, choking, and wanting to feel courageous instead of negative attitude towards life",
    "doctor_response": "Dear friend,I can understand the height of your suffering. But you have every chance of getting adjusted with any situation and lead a fruitful life.All the above episodes, symptoms and situations are generally called Anxiety issues.We are all social animals.The animal instinct of \"Fight or  in any situation is largely influenced by the interactions and past experiences we have with the environmental factors.We decide on either \"Fight\" or \"Flight\" based on our perception of the threatening factor and relating the past experiences almost to a certain extent. You may not be able to recall or bring back to memory some of the past experiences you had with regard to any situation or this situation in hand. We have some chemicals in the brain which regulate the animal instinct of FIGHT or FLIGHT. The irregularities in the secretion of these chemicals can be disturbing too.At present, it is my advice to avail the services of a Psychiatrist for some medications to bring back the equilibrium of the chemicals in the brain along with the services of a qualified Psychologist who can be able to patiently listen, interpret and render some therapy for a behavioural change.Good days ahead !Regards,Dr Rajesh Thottingal kalamRehabilitation PsychologistIndia",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are skin rashes a sign of HIV?\n\nI have skin rashes in my arms and back also I had pharengytis few weeks back and it got cured after consulting with doctor and taking medicine bt still my rashes r there and also have seen smegmas. My doctor said he dont think any serious illness I have. I asked him about HIV. But he said NO . I am still scared. Please suggest and help.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.Skin rashes can be a manifestation of HIV infection. If you are having doubt, please do visit voluntary testing center for HIV infection and get your HIV testing done.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to concieve with IVF treatment. Experiencing pregnancy symptoms. Pregnant?\n\nHi I am 34 and have been trying to concieve just over a year in that time I had a miscarriage so took a break as my cycles went a bit wonky, this cycle I decide to try soy isoflavones cycle days 2-6 a dose of 80mg day2/3 120mg 3/4 and 180mg day 5, I was fine taking them and got a positive opk day 12 (I have a normal 28/29 day cycle now) had positive for 4 days, day 14 I woke really Ill, I was feeling sick before I even got out of bed, that day I was sick, had really bad headache all day, couldn t have bright light on in the evening, stomach was bloated anything touching it felt uncomfortable, had low abdominal, back and hip pain, and maybe it was feeling Ill buy I was very emotional, I didn t eat much but forced a bit down but I can t remember moving my Bowles that day and urine was very dark, had very strong positive on opk, do you think I could of had ohss, I ve not really seen it with soy isoflavones more so with ivf treatment?",
    "doctor_response": "Symptoms are suggestive of ohss,but can't be confirmed until you get a sonography done a few blood tests done,I would advice you to meet your doctor and follow his advice. It might be just stress related also but get a check up done once. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling in the knuckle caused by hitting\n\nHi I had hit my drill on the knuckle of my index finger and now it is swollen hot to the touch painful and I am unable to bend it at this point I poked it with a sterile needle and only blood came out. I was thinkin puss would protrude from the area but only blood? Please help.",
    "doctor_response": "Hi,Thanks  for  your query.From description it seems to be soft tissue injury . Swelling might be due to haematoma formation(collection of blood).You need an x-ray to rule out any bony injury. I suggest you to consult an orthopaedician nearby for a detailed examination. You may get the X-ray of the area affected under his/her guidance. Beside icing and elevating it, you can take anti-inflammatory drug like motrin to reduce pain and inflammation.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. The girl used her spit for lubrication. Can I be HIV positive?\n\nHello doctor, My question is regarding a possible HIV exposure six weeks ago. The condom protected vaginal and oral although she did masturbate me without a condom and used spit for lubrication.\u00a0I took the fourth generation ELISA at four weeks and five weeks and both were negative. I was on a testosterone cycle and stopped two weeks prior to the meeting. I would like to know if my tests are conclusive. Would spit cause concern? Would my previous testosterone cycle have affected my tests? I would like to hear from you soon.",
    "doctor_response": "Hello. I am pleased to help you with your concern. For more information consult an\u00a0internal medicine physician\u00a0online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had a question about lab blood work. Is it normal for bilirubin levels to fluctuate within normal range? My last few labs were .8 then a .6 now back to .8. I quit drinking 4 years ago so pay close attention to liver tests. All are normal range but just worried somewhat as they fluctuate,",
    "doctor_response": "Fluctuation of serum bilirubin levels is quite common and need not to be worried as long as it is within normal range. Most commonly it appears to fluctuate due to change in the lab and kit.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have pain in ear after getting a slap on my ear. What damage could it caused?\n\nHello doctor, I have semi acute pain in my left ear due to someone slapped in my ear while ragging last year. I did not visit a doctor because I feel uncomfortable about discussing this issue. But nowadays I feel a sound that is like when water enters our ear. Now, I have feared of phonophobia. Please suggest.",
    "doctor_response": "Hi. You might have developed an eardrum hole i.e. perforation since the eardrum is a very delicate structure and cannot tolerate a high volume and high impact gush of air. In such a circumstance, you will definitely have symptoms such as ringing sensations, feeling of air coming out, irritation, unable to tolerate loud sounds, and even decreased hearing. There is nothing to worry as the eardrum heals on its own in four to six weeks provided you follow certain precautionary measures. Precautionary measures include not allowing water to enter the ear. Place sterile cotton in the outer ear and wear a shower cap as well while having a head bath. Cotton places have to be changed every six hours during the day. There is no medication as such required unless your ear has got infected and there is discharge. In such a situation, the healing process might take even more time or sometimes if adequate care and hygiene are not maintained, the hole or perforation might not heal at all and might require surgery to get it closed. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes brown spot on tongue in child?\n\nMy 13 m old daughter is in the hospital now with a brown spot on each side of her tongue. It looks almost burnt and seems to bother her. She is in for resp distress and a generic viral lung infection. She is on Xopenex, SoluMedrol and Rocephin. No one has seen them before. Any ideas?",
    "doctor_response": "Your baby is on steroids which can lead to fungal infections. Lesions over toungue are probably due to fungal infections.Treatment with candid oral paint and multivitamin syrup will resolve infection.For further queries regarding this disease or its medications you may consult me at Healthcare Magic under section \"Ask Expert \" >>>\"Ask Pediatrician\".Dr. Khan Shoeb",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain and bed wetting in a child?\n\nmy daughter sometimes wets the bed after saying her stomach is sore and her privates hurts. Does this sound like an infection? This unfortunately happens often which is hurting her self confidence about bed wetting at 5 years. I am more concerned she has a reoccuring infection?",
    "doctor_response": "Pain while urinating is a sign of urine infection.So before doing anything you shoud check Urine Full Report to see whether there infection or any other cause like urine stone which is unlikely.Do not treat with any antibiotics until you confirm the cause as is alter the whole picture.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can red spots on chest and severe cough be related?\n\nHello Doctor. Recently light red spots have shown up in the middle of my boyfriends chest. He does smoke recreational marijuana at least 1 gram a day but maintains a clean and healthy diet as well as very active. He tends to cough a lot which puts strain on his chest muscle and in black light the spots do show up as white. He feels tenderness when pressure is applied . He has been tested for T.B. and is confirmed false positive and has had chest X-rays and has been cleared.",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, this could be some skin lesion and may not be related with any of the chest disease neither this is related with narcotic drug smoking, better to keep this under observation for any changes, else this is nothing to worry,  hope this information helps, take care, and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a painful hard lump at left bottom cheek?\n\nHi I have had a hard lump just under my left bottom cheek for several years, it was dark brown in colour, firm to to touch but not painful. When i sat down on it however it was excruciating. In the last few years the pain has gone so i haven t worried about it anymore but today i noticed the skin there is softening and becoming concave. I can feel a dip if i run my fingers over it. Do you know what this could be?",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You may have some salivary gland lesion like tumour or infection.  Or may have lymphnode enlargement due to some reactive hyperplasia or tuberculosis.  You should go for fine needle aspiration cytology to diagnose the cause.  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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to reduce esr level\n\nHi doc! I had all my blood tests done. Sugar fasting, pp, cholesterol. Everything is just fine. My blood pressure is good by my ESR count was 46. I don t have any problem. I have hernia which is not giving me problem. My feet get swollen up by the evening as I keep sitting on a chair with my feet hanging for about four hours. What should I do to reduce my ESR level. Thanks",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. you have esr 46. Which is higher  than normal. There are many causes of high esr. Inflammation, tuberculosis, anemia,  autoimmune disease, paraprotienemia, malignancies and many more can leads to high esr. You should consult your physician and investigate for your high esr level. Then take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hives like rash on neck, arm, legs and torso. Shingles outbreak on forehead earlier. Is it recurrence ?\n\nI have a rash that looks like hives that I have had for over a week. Several spots on my neck, some on my arm and some on my leg, a few on my torso.  Today I have two white spots on my forehead where I had a shingles outbreak a few  months ago.  Do I have shingles again?  The rash is not painful, but very itchy",
    "doctor_response": "Hi,Thanks for posting your query to HCM.I can understand your concern for the Hives like rash on neck, arm, legs and torso.Shingles outbreak occurs only once in life time and never recurs again. As you had got it once so the possibility of same is unlikely. The present rash can be a part of simple urticaria only. I suggest you to apply medium potency steroid cream application because are best effective in these condition. I would have opted for either mometasone or Fluticasone or cortisone cream. Do not pinch, pop or scratch or een touch the area unnecessarily as it can cause aggravation of the rash. Wear cotton clothes and cotton inner garments which will give a soothing feeling to the skin. Stay away from extreme of environment such heat and humidity.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking vasograin, feeling pain in legs, headache and digestion problem with abnormal BP. Suggest?\n\nDear Sir, i am 40 year old (male) and taking 1/2 tablet daily of vasograin since 15 yers back,but i am feeling some pain in my legs and also my blood pressure is 100/150 mm of hg.is it safe to continue to take this type of tablet,and is headaches due to problem in digestive system.please guide me. thanks, suman saini",
    "doctor_response": "**1. since you are suffering from \"Syndrome\" of disease, so before opting for any Alternative system of Medicine, you first consult with a Cardiologist and/or Orthopedic Surgeon about your condition because:i. as you are taking vasograin (ergotamine) for last 15 years which is a potent vasoconstrictor, thus could be one cause of your high blood pressure.ii. since you might be taking B-blockers as prophylaxis for migraine as well as blood pressure, this also increases the risk of peripheral vasoconstriction (pain in legs) of extremities.iii. Vasograin due to ability to cause peripheral vasoconstriction (ischemia) also result in numbness and tingling of extremities",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for malignant melanoma\n\nI was recently diagnosed with malignant melanoma on my left callve. I am having surgery wednsday and the plastic surgeon might do a skin graft. If I have it done will they admit me into the hospital? My insurance does not cover the machine they want to give me.",
    "doctor_response": "Thanks for your question on HCM. For skin grafting hospital admission is must.And you have to take post operative chemotherapy to prevent local as well as distal spread. Skin grafting needs daily dressing and wound care for atleast 2 weeks.So 1 week hospitalisation is necessary and advised.So better to discuss these with your treating plastic surgeon before the procedure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the causes of schwann cell deterioration in the nerve cells ?\n\nwhat are the causes of schwann cell deterioration in the nerve cells?",
    "doctor_response": "Welcome to Healthcare Magic Good Day There are many causes. Vitamin B12 deficiency, infection, autoimmune disorders, trauma. Depending on the cause and extent of damage different nerves are affected. The disorders caused are Multiple sclerosis, SACD for examples.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child vomiting with stomach pain. Appendicitis?\n\nMy 9 year old boy has been vomiting with stomach pain for just over a day. Concerned it may be more than a stomach flu , perhaps appendicitis?... Temperature from normal to 99. He says pain is like an ache, cramp , not sharp or stabbing. He stopped vomiting, nothing today but he s also not eaten. A couple normal bowel movements. No stomach swelling. Doesn t hurt more on the right side, just everywhere. I, his dad, has IBS, so I m quite used to the pain that accompanies it. My ex wife is wondering if she should rush him to emergency.",
    "doctor_response": "Hello,  Thanks for the query to H.C.M. Forum. If I were your's son treating doctor I would  come up with these measures. 1 As overeating or hyper acidity may be the cause of such vomiting so take light diet and also plain as liquid , fluid , juice with banana . As vomiting already under control so need not worry and in my opinion no need to visit an E R . If vomiting reoccurs then  consult E R. 2 Rest is very important for this little boy 1-2 days . As due to vomiting certain essential minerals  deplete so child may feel pain all over body. Avoid fried food , junk food , spicy food , chocolates , drinks with caffeine in them . In my opinion antacid is necessary for 3-5 days . Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for cough along with plegm?\n\nHi, may I answer your health queries right now ?  Please type your query here... I cough and spit up plegm all day and night. Sometimes its so bad I start gagging and feel like I'm going to vomit, when it started today I did vomit, but it was not food it was a lot of little brown speckles of stuff. And it burned realy bad. Tired of the coughing and phlegm and need to sleep at night. Thank you",
    "doctor_response": "Hello dear user!I have gone through your query and understood your concerns!Thank you for sharing them on healthcaremagic.Have you fevers, pain in your shoulder blades or when you breathe?I would recommend you to go to your healthcare center and meed a doctor there. This severe cough with phlegm and brown secretions is suggestive either for a severe acute bronchitis or a pneumonia. Malign diseases of the lungs if you are over 50's and a smoker, have to be ruled out too.An auscultation of your lungs and a chest X-ray is needed in your case to determine the cause of your concerns.The cure is done accordingly the findings of examinations and must be done by a doctor for optimal effects.I hope this answer was helpful to you!Please kindly rate it as helpful and write a short review about your experience with me! I would appreciate that a lot.Thank you and best regards!DR ERIOL.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Skin allergy possibly due to sea food intake. How to prevent it?\n\nhave a good day sir/mam when i was young i had skin allergy . 2008 i encountered this skin allergy i dont know why. first i think its because i eat sea food but till now i have skin allergy even if i encountered little cold even if i stay in here in philippines. what should i do to prevent this skin allergy i read all the blogs and dont eat what they say but still i have this.  and thanks",
    "doctor_response": "you can say about allergis you cn get allergy tests for finding reason and and go for  specific sublingual treatment for allergies in the mean time you get your soap and creams changed to those types which donot contain almonds,coconut,walnut and groundnuts you can tale tab allegra 120 mgm daily which is available at international pattern you can take one tab daly for long time without any side effects",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why I am having skin rashes on my neck and under both breast after suffering from flu ?\n\nHi, every time I come down with a flu virus, I get a non itchy red splotchy rash on either side of my neck and under both breasts, which goes away after a couple of days-what is this from?? I cannot find an answer ANYWHERE. Please help",
    "doctor_response": "What you are suffering from is a viral exanthematous fever which is a common form of all viral infection, like measels,chicken pox,etc. Treatment is mostly symptomatic and there is not much to worry about",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling and numbness on face\n\nI started taking rowasa enemas and three days later I woke up with aslightly swollen face and there was a muscle on the right side of my face that was contracting every two seconds located on the smile line that comes down from the nose area. There was a little numblness at first like I used to feel when I had migraine headaches",
    "doctor_response": "withhold rowasa enemas.  treatment for numbness on face in migraine amitone 10 mg one tablet in night. tablet betacap 40 mg one tab in morning. and naxdom tablet for pain",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can an itchy hard lump in the scalp be treated?\n\nA tiny hard lump has developed under the skin at the top of my scalp. It does not hurt -- however my head itches like crazy -- so much so that lately i have been applying anti-itch lotion to it.  What kind of a doctor should I see.  I have moved and do not have a regular MD close by -- I am worried because I have a sister who developed squameouscell carcinoma in her mouth 10 years ago and it grew like crazy and she passed away from it. But, with all the itching, hopefully mine is something less serious.  I have also had a terrible fingernail problem for a year or so that I thought was just a dry skin condition, but now not sure.  Can you lead me in the right direction.  I am not one to worry about my health, however my roommate felt the lump earlier today and said I had better have a doctor see it.  Any advise is appreciated. Thanks.  Pat",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some dermoid cyst, skin adenexal tumor or some other lesion.  You should go for biopsy of that lump. It will give you exact diagnosis.  Then you should take treatment accordingly.  You should consult general surgeon first.  Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bulging nightmare causing severe nerve pain\n\nMy wife started suffering from what turned out to be, at least, a bulging disk at the base of her neck about six years ago. this eventually became visible (bulging out of her neck) and began causing severe nerve pain, mostly in her right arm and hand. ct scans show 2 herniated disks somewhere in the",
    "doctor_response": "Your post seems to be incomplete. Please give teh CT scan findings properly to be able to know what is wrong.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, prescribed duphaston and clomid. When to take these medicines?\n\nHi ..my husband n i are trying to have a child . I was perscribed by my gyno to take daphaston 10mg (2tablets per day for 10days) then to use clomid 50mg (2 tablet per day from 3rd cycle to 7cycle). Does that mean i have to use clomid at the 3rd day of using daphaston or 3rd day of my period?",
    "doctor_response": "you start the clomid on the third day of your period, not the third day of the duphaston. good luck!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lump in the throat, spitting blood. Chances of throat cancer? Have smoking habit\n\nHello, I have a lump like thing in my throat and I am quite sure that I do because its been like 2-4 months since I last felt this. Anyway, this morning when I woke up I cleared my throat and for the first time I spit out blood . I am not sure if it really is blood but it is red. My throat does not hurt its just the irritating lump inside. I tried to clear my throat again and then my spit is back to the way it was. Is this serious? a throat cancer? does it have something to do with my lungs? because I smoke a lot when I drink alcohol but when I don t, I only smoke for up to 2 or 3 sticks a day.",
    "doctor_response": "Dear Sir, Sorry to hear about your problems. The symptoms you are describing along with your history of smoking and alcohol consumption does raise a suspicion of cancer. It is best that you get yourself evaluated by a doctor without any delay. They would order an X-ray of the chest and a CT scan which would make things clear. Also a clinical examination by an ENT doctor to rule out anything in the back of your throat. Hope everything turns out to be normal.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can salt water gargling increase BP?\n\nyes please.  my wife is taking a blood pressure medication (which she has just started).  And she is battling sinusitis and is taking amoxacilin.  Add to that she gargled with salt water tonight.  her B.P is 181 /95 which is higher than it has been over the past few days under control with Linsinop/hctz ( with the amoxacilin but no gargling)..Question. Is it realistic that the Bp mighthave gone higher than normal because of the salt water gargle?",
    "doctor_response": "It is very unlikely. Single blood pressures should not prompt great concern. Decisions are best made from an average value from a two week span. Record her blood pressure on a schedule every day for two weeks. Use the average value to judge her control.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the medication for bee stung allergy?\n\nHi,i got stung by a bee a year ago and went into anafalactic shock i was talking to some people and they said that they heard about some hospitals that do treatments ones a week to make the bee allergy go away by putting the bee venim into your blood and so your bod dosn't fight to hard on he bee vinime so do you know any close hospitales hat do the treatment around st.louis?",
    "doctor_response": "HiI understand your concern and situation.But I would not suggest you to take any such therapies done as you have already suffered a shock and it can be dangerous. I advise you to take antihistamines if suffer from a bite. Get yourself avoided by such bites in future.Dr Sheetal Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent nausea having diagnosed with pancreatitis?\n\nHello I have had stomack pain for three years finally a doc came up with Chronic Pancritis ,after all the endoscopes I ve been threw ,but now I ve developed Nasusa for about 8 months now Doc has tried all kids of Nasusa meds nothing seems to be working oh I m not pragnat I m 60 years had historectomy years ago I hope you can help me",
    "doctor_response": "HIThanks for posting your query.        Chronic Pancreatitis can cause long term nausea sensation. I need to know whether any cause for Chronic Pancreatitis.     Also due to Chronic Pancreatitis there occurs abnormalities in the levels of calcium in blood which in term can lead to Nausea or vomiting. So my advise is to get Serum Calcium tests done and revert back .      If these things are normal then we need to evaluate other causes of nausea like problems in brain , motility disorders or endocrine problems . Hope this information was useful to you . Any clarifications feel free to ask .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for bad breath\n\nhey i have a black dot on the far inside of my mouth, like around the hinges, it is painfull and appeared recently, it started with my teeth bleeding when i'd brush my teeth now its both that and the pain, i even eat with the other side of my mouth. My breath is also stinking. I am currently using 3cp as an oral antiseptic with mouthwash but my breath is still bad.",
    "doctor_response": "Bad breath is a different issue while a black dot with bad breath, as u describe it to be, raises a bit of concern. Kindly get the dot examined at the earliest. As for the bad breath, try cleaning your tongue with a good brush, rinsing after every meal, brushing at night, and using Chlorhexidine mouthwash (0.2%- diluted at 1:1 solution).",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain radiating to back?\n\nhi I have had abdominal pains/discomfort for 2 months now plus a continual restless legs feeling within the abdomen and groin . The pain affects the left flank and lower back , but the worst is just above the belly button which is very tender. When this area is pressed with finger tip pressure it causes a very sharp pain that radiates to the back. I m waiting for an ultrasound in two weeks but it can t come soon enough",
    "doctor_response": "Hi.Thanks for your query. Read the history and understood the problems. You have pain and tenderness in the upper abdomen which on pressure causes pain in the back. This means you have some problems related to the Gastric Ulcer , Gastric cancer or panreatic problem such as pancreatitis or a Pseudo-cyst of the pancreas.The other symptoms may or may not be related to these problems.I would advise you the following:Do not wait for the appointment for the ultrasound which is 2 weeks away. Go to the ER , get a CT scan of the whole abdomen to find the reason, upper GI Endoscopy and get a final diagnosis.Start PPI, and get symptomatic treatment till you get the reports and go for the definitive treatment as per the reports and the clinical evaluation by a General Surgeon or a Gastroenterologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain after having liposuction?\n\nHi, may I answer your health queries right now ? Please type your query here... Hello , I had tummy and back, liposuction about 2 months ago, I have healed well bit my lower back hurts so much that I wonder why its taking too lo g for it to heal. Thanks",
    "doctor_response": "Hi there.There could be fat necrosis or death of some remaining fat tissue which can cause the pain. Also clots can cause the same. Take pain killers for relief. Apply hot bag/ Consult your Surgeon for a thorough examination and appropriate management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for loose motions in infants\n\nMy neice is 3.5 months old. she has loose motions from for 4 times today till . when ever still drinks milk she gets motion. She is fed with only mother's milk? Can some one suggest some home medicine as now we cannot reach doctors immediately this night.",
    "doctor_response": "**1. children at this age mostly get loose motion due to viral infection, and if he is passing watery loose motion, then the severity does not depend on the frequency but on the amount of fluid loss /day.2. If baby passes urine less than 5 times a day, is drowsy & refuses feed, along with dry tongue and high fever, consult your Doctor or Pediatrician immediately.3. In the mean time, prior to doctor appointment:. maintain good hydration: ORS [oral re hydration salt] is more important part of treatment, more important than drugs. Feed continuously, as much as the baby takes except when abdomen is distended or if vomiting, if it is not available the at home: take 200ml boiled & cooled water and add 1 tsp of sugar and a pinch of salt.. avoid fruit juice and wheat products. liquid diet or plenty of fluids are essential: electrolyte solution, coconut water, daal water.. Instruct the mother to clean the nipples before breast feeding.. after every motion clean and dry the buttocks, and apply talcum powder",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain, tightness, pain on bending backwards. Doing pilates, running a lot. Suggestions?\n\nHi! I am 15 female, and i m currently suffering some some lower back discomfort. I ve been doing pilates for 6 months and i do alot of running. First, my lower back started to feel really tight, then it started hurting when i bend back. I can no longer bend back as far as i could before. Is this something serious? Will my back get better in time? What should i do?",
    "doctor_response": "Hello. Thanks for writing to us. The pain that you are having in your lower back is likely to be due to a positional anomaly. Taking adequate rest, mild muscle relaxants, hot fomentation and pain killers are likely to help you. Avoid any heavy exercise till the pain subsides. I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL  Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes slight chest discomfort while having high BP?\n\nWent for my weekly wellness check up at my nutritionist today and my bpm was high they checked it three times before they would let me leave the office, all day I felt slight irritation pain above my heart, now left arm is cold, tight, tense tingly feeling like no circulation to my fingers is this due to high blood pressure or something more serious? No other symptoms",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. This may also be due to high blood pressure. But I will recommend that you should also be assessed by a chest X-ray and ECG. Keep your blood pressure under control. Also get cervical spine xray ap and lateral view to rule out cervical strain. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does positive for albumin from urine test indicate?\n\nHi doctor my daughter is 2 year and 4 month ols and she is having fever from last one week and pain in stomach done ultra sound,urine,blood,stool test on 3 rd day nothing came but on 6th day done urine test again and found albmin (+) what you advice to do?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.Albumin+ in a single specimen that too after 7 days of fever and medicines is not a cause of concern in itself  if other urine findings are normal. It can be repeated after 2 weeks once child recover from fever.She needs to be investigated to find the cause of fever .Hope this answers your question. If you have additional questions then please do not hesitate in writing to us.Wishing  your child speedy recovery.\u2022\u00a0\u00a0\u00a0\u00a0\u00a0DISCLAIMER: - All the information provided here is for information purpose only   , it is not a substitute for the advice of a physician after physical examination , it is not intended to replace your relationship with your doctor. This information in no way establishes a doctor-patient relationship. Before acting anything based on this information do consult your doctor. I  recommend that online users seek the advice of a physician who can perform an in-person physical examination",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes radiating pain around the knee?\n\nI went for an mri today because I was almost positive that I have a blood clot, it was extremely painfull ,still is. There was no blood clot , blood flowed ok. So what is it? It started a week ago. Horrible pain around the knee. Then the pain area moved to 3 or 4 inches above the knee to the inner thigh and the top of the thigh. Some times I feel it around my kidney area,like it is a muscle. With my knee getting most of the intense pain right now. I have no fever or any other symtoms except for being very hard to walk or move around. I am using a walker to get around with lots of pain. I am going to go to the emergency room if things don t gewt better. The thought of all that moving around is not welcome. What do you think?",
    "doctor_response": "Hi, It can be due to early-stage arthritis or ligament related problems. Consult an orthopedician and get evaluated. As of now, you can apply warm compresses and take analgesics like Tramadol for pain relief. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will the child be from the first intercourse or the second one?\n\nHi, may I answer your health queries right now ? if the first day of my peroid was on july 27th 2010 and i had sex on august 6th 2010, and then had sex with someone else on august 9th or 10th. which one is more likely to be the father of my expected child??Please type your query here...",
    "doctor_response": "Hello dear,I understand your concern.In my opinion incase if your cycles are regular the august 9 th or 10th comes under fertile period.So intercourse done around these days might have resulted in pregnancy.The accurate test can be paternity testing.Also ultrasound might help in knowing probable date of conception.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can swelling in the anus area be treated?\n\nHi doctor, I am facing swelling in anus area which is not getting shrunk even after trying some medicine and cream for piles.",
    "doctor_response": "Hello, Welcome to ilciniq.com. Good day. I have reviewed your history and picture that you have uploaded (attachment removed to protect patient identity). It seems to me a sentinal pile. They are not actually pile (hemorrhoids/ blood sac) but a anal fissure that has been present for so long and leading to bulging appearance resembling a pile.  Well having said that, the treatment you are on is majorily ayervedic but there are avaialble allopathic medicines which can be used instead. I would give you some treatment but I want that you should be examined in person by a local general surgeon, if any need of surgical removal of this. Otherwise at moment take following treatment.  1. Ispagol Husk 2 tsp/ daily with water irrespective of if you have soft stools or hard stools. Fibre has to do with many other things in your gut besides just stool softening effect.  2. Tablet Ciprofloaxcin 500 mg twice daily for 5 days.  3. Tablet Flagyl 400 mg thrice daily for 5 days (can cause some gut upset and mettalic taste in mouth but fairly low side effect profile).  4. Sitz bath. Put approximately 5 ml of dettol or any antiseptic and put in bath tub filled almost half with tapid water and at least try it 3 times a day.  5. Keep your area clean near your bottom.  6. Remove hairs.  7. Reduce weight. Increasing weight would impair your defecation (stooling) mechanism and that would abnormally high presure over your bottom. This worsens anal fissure in long term. Let me know in one week time if symptoms improve.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high BP and chills\n\nMy blood pressure has been high for about a week now, 165/92. I m getting chills today and after taking aspirin, I feel better. My blood pressure medication, Atenolol, 50mg has been changed to a different manufacturer. Could that be why it s not working? What should I do?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. After going through your medical details I understand your concern and I would like to tell you that you might require another anti-hypertensive drug to manage your blood pressure with or without Atenolol. Kindly consult a physician personally with your recorded blood pressure reading at different times so that he can prescribe the new drug. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fainting and slow processing speed post chemotherapy?\n\nChemo for 6 yrs. and radiation ( not sure how long on the radiation). Numerous test in past 6yrs. Family member is now having what I believe are symptoms that are related to the CNS: Lack thought process, falling; these sytoms are severe. She was initially dx. with colon cancer in 2008. Your input is appreciated. Thank You. Initially, she had a section of the colon removed.",
    "doctor_response": "Hi,Thanks for writing in.It is possible that the patient might have developed CNS manifestations due to the cancer itself or as consequence to chemotherapy or radiation therapy. Colon cancer is a challenging condition and more than half of patients might develop metastasis to liver and other organs even after treatment.Please get a brain scan done and rule out any process in the brain that might be causing her symptoms. Her blood count is also important to know if the chemotherapy has caused her anemia and that is why she is fainting and having stroke like symptoms. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent cough, upper back pain and breathlessness?\n\nHello. I have a dry persistent cough, some upper back pain and shortness of breath with a history of allergies, and lung cancer in my family. My Dr put me on antibiotics and steroids. I also got a chest xray. I am a 44 year old female. Should I be concerned that I could have lung cancer?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Don't think directly about lung cancer. Persistent cough, breathlessness and upper chest pain are commonly seen with bronchitis. Lung cancer can also show similar symptoms. But better to consult pulmonologist and get done clinical examination of respiratory system, chest x ray and PFT (Pulmonary Function Test).Chest x ray is needed to rule out lung cancer. If chest x ray is normal then no need to worry for lung cancer. PFT is must for the diagnosis of bronchitis. You may need inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).Don't worry, you will be alright with appropriate treatment.First diagnose and then start treatment. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Has ESWL for removing kidney stone. History of URS, diabetic. Reason for swelling face?\n\nMy mother just has ESWL for removing the kidney stone in her left kidney. Just to let you know that she has diabetic and has performed conventional surgery and URS two years ago for the same problem. Unlike those previous therapies, after ESWL my mom s face looks little bit swollen. Could you please let me know what is the possible cause of this?",
    "doctor_response": "Hello Thanks for your query.Your mother who gets Urinary stones repeatedly has recently undergone ESWL for Lt kidney stone.This is one of the known methods foe treating Kidney stone .As the stones get fragmented the bacteria present in nidus (Centre) of the stones are liberated and they enter in to general circulation causing infection of the kidney..This is the reason patients get swelling of the face However it is a temporary phenomenon .Please get her following Investigations done.. 1) Blood Urea 2) Serum Creatinine 3) Routine Urine examination. Please ensure that she drinks plenty of water.Things will settle in a week.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for getting pregnant\n\nHello mam, I am 26 year old and suffering form polysystic ovary.so i was taking ginnett 30 for three months.Now i have stopped it.But i do not want a child now.Will there be any problem for conceiveness after two years.Does stress has any role in hormonal imbalance.",
    "doctor_response": "Hi I don't think there will be any problem after 2 years. Medicines are available wh8ch can help you in getting pregnant.  Stress do have a role in hormonal imbalances.  Try to maintain a healthy life style with exercise and healthy diet. Avoid weight gain. Hope I have answered your question. If you have any other query I will be happy to help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am stressed and worried because my vagina lets out air almost like a fart. What to do?\n\nHi Doctor, I gave birth normally to a 3.2 kg baby boy however with a small cut that was stitched and healed. Its now coming to four months ever since I gave birth. My problem is that my vagina let's out air almost like a fart though not smelling. It could happen even during day time when I had just produced. But now only comes at night around 3:00AM. Am stressed, worried, and I don't really what to do. Am asking for help on what can really be done. Am tired of this situation in my life. Thank you doctor.",
    "doctor_response": "dear!! welcome to iclinq! saw your concern!! I can understand you completely... first of all make it clear that gas from vagina is ( queefing / vaginal fart) NOT a pathology!!!! it's because the roomy vagina holds air and during the rigorous act of coitus or ant bit strenuous work or excersises it passes out with a sound just similar to fart ( as it's from a hollow organ) as u had mentioned it's not associated with smell it's unlikely to be a fistula.....( rectovaginal fistula) .So just relax!!! nothing can be done to prevent it!! may be some positional changes.. avoid more of butt up in air positions both during work, excersises n sex... if you just understand that it's normal u would laugh it out!!!! regards & best wishes....hope you find it useful!! physiological, due to roomy vagina vaginal fart reassurance revert back, if any queries..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Xanax used for anxiety damages the brain and Ecstasy abuse?\n\nWell to stay on the topic of xanex, or any benzo to to help with my drug induced anxiety. I am afraid I have damaged my brain from heavy LSD and ecstasy abuse. What I can't wrap my head around is any time I tried a stimulant I had a normal reaction, but after a few times my anxiety would be so severe that I could walk out if my house and wouldn't recognize the environment. Where to go, I appeared as if I was mentally challenged. Now add 5 mg to using meth I could have a political debate with you. Otherwise I would hide in my room only hearing my heart pounding and whole body shaking, Lastly, I would forget anything I recently learned after a binge, till I downed boos +benzos. Any explanation? And working on healing my brain.",
    "doctor_response": "Hi,You seem to have developed an anxiety disorder which tends to persist even after you have given up Ecstasy and LSD. Both alcohol and benzodiazepines act on GABA receptors which have a role in anxiety and so make you feel better initially by cutting down anxiety. But when the blood levels fall, anxiety returns. The best treatment for you would be to start a SSRI antidepressant like Paxil or Zoloft or any similar medicine. It will cure the anxiety without the risk of becoming dependent again.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have a thick skin flap on the gum?\n\nmy 6yrold daughter has a thick skin flap on the gum where her 6 yrold molars are cutting through. Is this normal? Will it eventually tear away? It is protruding from the center of the soon to be molar. I thought it was food and tried to pull out of tooth until i noticed it felt like skin.",
    "doctor_response": "HiIn regard to your query,i assume you are talking about eruption of molars through the gums is what you mean thick skin flap nothing to worry wait for the molars to erupt and watch till then if problem persists consult your pedodontist for the needful.Hope i have answered your query and this helps you out.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is bleeding in gum symptom of pyria?\n\nhi, my gums are very weak its bleeds and even slight touch to my gums its bleeding and they are separated from my teeth and due to blooding its giving bloody test and bad breath and again due to lose gums my teeths are paining a lot so is it symtom of pyria",
    "doctor_response": "Hi! Welcome to Healthcaremagic.I read your query. Gum bleeding is the first sign of gum disease. However, detachment of gums from teeth occur at later stages of disease which may involve heavy bleeding, bad breath,pain, etc.I suggest you visit a Periodontist and get your gums checked. You will be required to go multiple times. You will be given oral prophylaxis and curettage if required.Usually with proper cleaning, medicine, maintainence of hygiene and nutrition, the gums start to re-attach with in 2-3 months. Else further treatment like flap surgery may be required.Along with treatment, you need to maintain good hygiene. Brushing twice daily with soft tooth brush, mouthwash, warm saline rinses, gum massage, proper diet, multivitamins. You may be prescribed antibiotics and anti inflammatories.Take lots of fluid, fruits, vegetables like spinach, carrot, lemon, etc.Hope the answer helps you. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could dark patches on the skeleton be?\n\nI had a bone scan to check to see if my prostate cancer had spread, but it showed negative. When I had an MRI scan however, there was dark patches showing on my skeleton in many places. I had to have a bone biopsy.  Have you any ideas of what it could be. I am a man of 64.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. In my opinion, possibility of metastatic bone lesions is high in your case. Prostate cancer is known to have metastasis in bones. It gives osteoblastic secondaries. PET scan can pick up lesions only when they are more than 2-3 cms. Small metastatic lesions can not be picked up by PET scan and hence you are having negative scan. In this case MRI is more sensitive because it can pick up lesions with size less than 1 cm. But biopsy and histopathological confirmation is needed for the diagnosis of bone metastases. So my suspicion is metastatic bone lesions and hence you need to get done biopsy for confirmation. Hope I have solved your. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain on left side of abdomen?\n\nLeft side hurts a lot more then my right most of the time. Right side hurts but it s worse on my left. Hurts bad in mornings daily to where I have trouble straightening up n standing. After being up n moving around then it s like a tight feeling that s achey. It doesn t feel like a pulled lower back though. It s more kinda closer to my ribs. I put pressure or rub on it during day just to have little different feeling. I m a 44yr old female. I ve taken ib800 and Epsom salt baths to try to ease pain but does work very long. I wish I knew what this could be.",
    "doctor_response": "HiThanks for your query. Noted your history of pain on the left side more than the right, is more in the morning and have trouble straightening up and standing in the morning. You are already taking Ibuprofen 800 and Epson salt bath. This is most probably due to disc problem in the back causing abdominal wall problem.I would advise you to consult an Orthopedic Surgeon for clinical evaluation, further investigations and treatment. Till then take a bed rest, do not lift weight , see that there is no constipation. I hope this answer helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does taking a pill after broken condom during sex cause pregnancy?\n\nHello doc hope so u ll hlp me out sir actually me n gf had sex a day before her periods cylce (i.e accordin to cycle 8th september is her date n v had sex on 7th september n condom tore off bt wit in 15hrs she took postpone 72 bt she din feel any diffrence yet so ll she get preg or nt doc plzz reply me asap ..?",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your query, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.1.First of all do not panic.2. As you might be aware that in a woman with regular cycles, day 10 to 20 of the cycle is the most fertile period of the cycle. And you had episode of sex act beyond this period, just before the expected date of cycle. SOyou were in almost the safe period. 3.The emergency contraceptive pill is 95% effective if taken within 72 hours of unprotected intercourse.As she  had taken it within stipulated time the chances of pregnancy are nil.The  pill causes hormonal imbalance leading to irregular bleeding spotting and the period might come early or late.4. Please get proper sex counseling done, so as to avoid unwanted pregnancy and to avoid unnecessary medications.I hope this answer was helpful to you!Thank you and best regards!Dr Purushottam S Neurgaonkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for mental health problem\n\nI turned sixteen years old about four weeks ago and I have been acting really strangely since then. I feel unhappy most of the time apart from random periods where I feel kind of hyper/over the top happy. I also seem to be losing my temper all the time over the smallest of things (and actually it has been like that for a while now) and getting so frustrated that I almost break down into tears, although nobody has noticed as I don t like crying in front of people. Even on my actual birthday when I should have been genuinely happy I just felt like I was faking it and felt oddly distant from what was going on. I really just wanted to be in my room and alone. I have also put on a bit of weight which is kind of good since I was diagnosed with Diabetes Type 1 in January and I was under six stones at height of five foot but now it is getting slightly too much - I have got a bit of a belly now and my Mum commented on it. I decided to ask this now since I haven t been sleeping well and I have been more irritable, not able to laugh even at stuff I would have found funny before as well as unable to concentrate on revising for my exams and I keep thinking about what would have happened if I died after my diagnosis instead, as I did come very close to death, and what would be the reaction of those I left behind. What is going on with me since I am usually quite a happy person and my friends have commented on me being much sadder and not keen on going out, will it go away?",
    "doctor_response": "Hello,Thanking you for writing to HCM,Definitely it will go away if you should make yourselves to go for change.Every mind should divert but its possible only when we try to help our mind to do that.You should have to try to keep your mind busy so that it cant think even for that behavior and also keep yourself with peoples.Because when you are alone its possible that your mind again think for that and it might not good thing at all.I will suggest here to keep yourself busy with persons you love and try to be easy and dont think to much.You should concern a good psychiatrist if problem still there and you cant divert your mind at your own they will defiantly help you for getting out of that.Hope you will get out of this soon.Take care.Thanks & Regards,Dr. Gaurav Prajapati",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can mood swings and depression after discontinuing Paxil and Wellbutrin be treated?\n\nDue to the loss of my prescription drug coverage, I cut back on some medications. I was taking 40 mg. of Paxil and 200 mg. of Wellbutrin daily. For almost 3 weeks, I ve been taking 20 mg. of Paxil, and 100 mg of Wellbutrin. I am very emotional, and find my self crying more...Also, two days ago I quit smoking, after 17 years of being a non-smoker, then, picking it up again after a trip to Ireland. So, after a 17 month relapse of cigarettes, and the doseage change, which one should I up? I feel the Wellbutrin may help with the smoking, but I would so appreciate any advice...",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As you rightly mentioned\u200b, Wellbutrin helps in deaddiction of smoking and also relieves you from depression, it's better you continue higher dose of Wellbutrin and cut down Paxil in a tapering way. Withdrawal symptoms are more severe with Paxil, so slow tapering off Paxil is very important to avoid withdrawal symptoms. It's better you consult psychiatrist and take a decision. Go for a morning walk daily, exercise for 2 to 3 days per week which helps you feel relaxed. Interact and enjoy with your friends, listen to music, go for a dance, have a healthy diet. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Proper medication for seizure?\n\nHello Doc,I have a query regarding myoclonic epilepsy which was diagnosed to me at the age of 26. I am 31 now, weight 95Kg, height 183cms good built. When this was first reported, the doc advised Valparin Chrono 200mg (4 tab/day) for 3 yrs,EEG and MRI normal. I took it for 6 months and discontinued, then again after 1 yr of first occurrence I had the seizure again. This time I took it seriously and started valparin course again and continued for 3 yrs. After 3 yrs of regular medicine (Sep 2012), I had the EEG done and it came normal so doc advised me to discontinue the medicine. However the issue is the problem has resurfaced in Sep 2013. This time I am in Bangalore and here the docs advised me to take Levepsy 500 twice a day. I just had another seizure out of the blue in Dec 2013 again even after taking the medicine. Need a second opinion from you that if any other scan or something is required. This time after few days have gone by I still feel a soft pain towards the left side of my body from head to toe. May be the after effects of the seizure, I am not sure. Kidnly advise if I need to undergo any other tests or scan and if this is curable through proper medicine course? Thank you!",
    "doctor_response": "unfortunately this type of seizure is longlasting but fortunately its easy to control on valparin or levepsy.since you were control on valparin I recommend you to continue on it.levepsy is a very good drug for seizure control but valparin is better for this type.since you got multiple attacks after stopping the drug its better to stay on this medication for your life",
    "dialogue_context": ""
  },
  {
    "patient_message": "To remove a ganglion cyst had an operation that increased cholesterol, have dizziness. Now?\n\nabout 6 weeks ago i had an operation on my left hand under general anesetic to remove a ganglion cyst after that i had a bad chest i had a blood test and my blood sugar level went up to 8.6. i recently had a fasting blood test and it went down to 5.8 and a blood test to test my liver it was up slightly and my colestrol was up abit as well. i have been feeling dizzy as well and have got tinitus and its driving me mad i am slight asmatic as well and i have got hayfever",
    "doctor_response": "Hi and welcome to HCM,thank you for your query.I dont think this is related to your previous surgery. these glucose finding are not something serious but it may require some medicines so consult your docto about it. Dizzyness and tinitus can be caused by various neurologic and heart diseases,you need more deatiled work up if it persists. Liver enzymes as well. As i said i would not related it to your ganglion cyst surgery.Wish you good health. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Difficulty in forgetting past, have low self confidence, get shortness of breath when emotional. Solution?\n\nmam i cannot able to forget my past negative things happen in my life...man made feelings so bad on myself...i want to forget that and also i used to think always wrong oly in myself eventhough others did wrong to me also very low self confidenet i want to die always thinking future oly iam always dreaming i should go to high but iam not starting to achieve that....one day i had breathing problems that day my relative one man did feel bad on me",
    "doctor_response": "Hi, Thanks for choosing HCM, you seem very depressed, everyone has a past...good or bad you need to go on with your life find out the purpose of your life its good you are trying to forget your past life sad incidents why do you think you are wrong all the time acc to me you are wrong only when you think low of yourself and lack self confidence what you are doing is good,dream big....be serious in fulfilling your wishes you said you are not starting to acheive your dreams...remember dear small steps make a big journey the problem behind you not starting to acheive is you have no clarity in what you want to do and how i will try to help you with it ... try these tips 1.put on paper what all are your dreams  , 2.divide them as big ,average and small 3.divide them into other kind also , a.practically possible(reality)  b.imaginations 4.take a big goal ,devise smaller steps to reach a goal and start working on it seriously 5.work about your goal daily ,however small thing you may do ,do it daily let me explain example:you want to cook for your self dream about what you want to cook,how tasty you want it to be now get your ingredients one by one veggies,onions ,oil,etc check for facilities you got like  a stove or electric cooker plan and learn how to cook practice well cook it you can do it this is a small example i want to give,dont think otherwise because you have not mentioned your gender age etc i have comeout with this so leave about cooking try to understand what i want to say start now think positive you dont need any outsiders help to lead your life happily alwaya be confident you have a purpose of your life , go ahead coming to your physical health ,it is quite common to get ill,and thats not your mistake no one can command you or illtreat  you just  because you have a health problem if you still have doubts go get a complete health scan done,take medication for your health problems, be health conscious take good diet mental health is equally important dear........ stay cool,relax,feel comfortable to live your life king size involve yourself in various activities do sternous exersice,it throws out all the bad stuff from your mind as well as your body try meditation perrform yoga it brings you confidence never try to hurt or harm yourself!!  your family loves you,they need you the most realize yourself,leave all imaginations behind  ,come out into reality read some inspirational books,watch such movies dont waste time,you have a lot to acheive if your ",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i take montec LC and doxilin for controlling asthma?\n\nGood Morning!  I am suffering from asthma and regularly taking Foracort 200 inhaler.  But now a days it is not controlled by it.  Should I take Montec LC and Doxilin? For how many days?  What are the breathing exercises you recommend for controlling asthma?   Thanks!",
    "doctor_response": "HI, thanks for using healthcare magicIt is possible that you are being exposed to a trigger that is causing the repeated asthmatic attacks.You can consider taking the montec Lc , this may be helpful.If it is possible to identify triggers and eliminate then, this would also decrease symptoms. In some persons control is affected by: post nasal drip , GERD, dust, viral infection, exercise.If you have symptoms of rhinosinusitis such as post nasal drip, treating this with the nasal sprays may help. The same for GERD, treatment would assistI hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "How effective is hydomorphine for pelvic pain?\n\nMy daughter has a series of health problems from cervical cancer, endometriosis so severe that it caused damage to her stomach, and bowels. She has had nearly fifteen surgeries to remove tumours and growths from her reproductive organs. She lives in constant pain. She was given hydomorphine contin however she can t seem to find relief on that dose most days. She is under hospital care regularly attending a pelvic pain clinic two to three times a week which only adds to her pain.. She has been on the same prescription of morphine for the past six years and at least every three months, especially on the third month, she loses the battle and runs out of her medication early. How do I help her with the withdrawals since I can t help her with her pain? I would also like to mention that my precious girl was really smart. She study hard and got three degrees from University, she had a really good job that paid well now she lives on a disability pension.",
    "doctor_response": "sorry to hear your daughters story. Morphine is supposed to be the most powerful pain relieving agent. if your duaghter is not having good relief, i feel she needs other medicines and combination of medications. She can be put on fentanyl patches and paracetamol can be added. else morphine can be given in combination with other drugs. Also if the pain is in a particular nerve distribution see if the nerve can be blocked for pain relief. Anything thing can be done, but pain needs to be relieved. seek the attention of right doctor for good management",
    "dialogue_context": ""
  },
  {
    "patient_message": "Undergone neuro surgery, skull placed in stomach for giving it required inputs. What should be next step?\n\nHi Samuel,i am gireesh kumar, i am here to let you know on my uncle's concern here who had undergone a neuro surgery where the skull appears to have been placed in the stomach for giving it the required inputs. He looks to be in coma and doesn't recognise nor talk anything. Could you please help me or suggest what the best thing i could do.",
    "doctor_response": "Hi Gireesh, Thank you for posting your query. I would like to know more details, to give a better answer. What is his primary diagnosis? For what problem, was the surgery done? What is the name of the surgery? In addition, if you have his CT or MRI brain reports, please upload them. Please get back if you require any additional information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could consistent inflammation in thumb with sharp, painful area be bone spur caused due to constant massage work?\n\nI m having consistent inflammation in my thumb, which has been sorely overused due to years of doing deep tissue massage work. There s an area that is hard, fairly sharp, and painful from the knuckle to the corner of the thumbnail, on the lateral side. Is an x-ray the only means to determine whether this is a bone spur?",
    "doctor_response": "HiYes, x-ray can be helpful .hot fomentations and application of volini ,may help.if severe pain, motrin tabsConsult a orthopedic doctor",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high fever in baby\n\nI have a 17.5 month old girl baby wt 9 kgs. She suffered from a severe stomach infection nearly 15 days back and was treated with Taxim O, enterogermina and calpol 120 (to be given if fever was higher then 100.5) for 7 days. Just 2 days after the above treatment she started having high fever 102-103.5 and we treated her at home with ibugesic plus, sinarest and probiotic. After 5 days her fever has not yet subsided. We went to doc today and he has prescribed another course of antibiotic azithral 100 4 ml twice daily and zedex. Is it okay to use antibiotics so close together. She also has cough cold and loose motions",
    "doctor_response": "Thanks for the query.I think you should go for blood investigation.Hope i helped you.Happy to help you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rapid heart rate while on Propranolol and Verapamil?\n\nI already take prpranolol at night and verapamil was added a month ago. My pulse has been up in the 90 s and 100 s all day. I just took chlorthalidine 25mg to see if that would help the overall blood pressure which was 147/82 pulse 98 at 2:00 and now 147/81 pulse 113. I am almost 71 and blood pressure has been a problem but not late",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Tachycardia usually responds to combination of propranolol(beta blocker) and verapamil(Non-dihydropyridine CCB).Go for serum Free T3,Free T4 & TSH to exclude hyperthyroidism and HB% to exclude  anemia as initial investigation for persistent tachycardia. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dizziness and slurring in speech, treated by many neurologist, no help. Any ideas ?\n\nHi Sir, This is AAAAA, Age:25 yrs old. Actually am suffering from dizziness and slurring in speech since 4.5 yrs, even i have been treated with so many neurologists till now but not yet cured with those medicines. Mostly am facing this kind of problem when i feel like vomiting , vertigo , slurred in speech and dizziness. Am fed up with this disease, even am not able to do my job in the office properly and people are thinking that i drunk wine so that am doing acting like that. So, kindly help me out with this bloody disease.",
    "doctor_response": "Dear I am sorry for the symptoms you are experiencing.Have you done any examination till now, such as brain CT scan or MRI?Any blood tests?It seems to be a cerebral problem but we can be more help if you send us any of these examination.Wish you all the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness with weak legs?\n\nHi I m 34 years old, I ve been smoking for 5 years. Lately after sitting for hours I ll stand up and get lightheaded, dizzy, my legs will buckle and get so weak that I ll have to sit where ever I m at. I ve scheduled a appointment with my primary doctor, but wanted to know if you ll could give me some insight on these concerns?",
    "doctor_response": "Hello,Dizziness on standing position may be due to:1. Decreased blood pressure on standing position (postural hypotension).2. BPPV.3. Muscle imbalance due to weakness.4. Stroke.5. Anemia. Until examination is done it is difficult to say what it is. Get it done blood pressure on standing position. ECG and hemoglobin status may help. Use tablet vertin 8mg thrice a day for five days. If symptoms not improved please consult with your physician he will examine and treat you accordingly.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for left side pain near the rib cage and purplespots on ankles\n\nI have left side pain near the rib cage. It feels tender with some pain.The lower left rib cage protudes more than the right lower rib cage. X-rays revealed no rib fractures.Tylenol medication does not help. I also have purple skin spots on the right foot in front of the ankle area.The physician assistant examed the purple spots and said it could be from crossing my ankles. I ve been avoiding crossing the ankles for 2 months. The purple spots have increased. I get shortness of breath when power walking. I had a physical 2 months ago. Also, the lab work (blood/urine) came back normal.",
    "doctor_response": "Hi,From the history what I suppose you have is Cryoglobulinemia disease from the group disease called vasculitis. Though this is a provisional diagnosis, I would like you to once again go for urine and blood test to verify any involvement of kidney and NY raise in WBC count respectively.Also to do a stress test as you feel breathlessness on power walking. Even though the test is very negative previously but there are chances that they are false negative. Hope this helps you in diagnosing your condition and apt treatment. Let me know if I can assist you further.Take care and hope for your quick recovery.Regards,Dr. Jenis Bhalavat",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of strep throat?\n\nI m a dentist. How can I tell if I have the flu and/or strep throat. Symptoms: Fatigue, severe soar throat, head ache, ear ache, slight cough, chills, difficulty swallowing and speaking, white patches in back of throat, no apparent exudate. No sneezing, no fever",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.As per your query, you have symptoms of strep throat which seems to be due to bacterial infection of upper respiratory tract leading to strep throat.Need not to worry. I would suggest you to start with warm saline gargles and betadine gargles 3 to 4 times a day. You should take ibuprofen or acetaminophen for relief from pain and swelling.You should consult ENT specialist once for proper diagnosis and rule out condition like viral infection. Doctor may prescribe antibiotics along with decongestants and anti-inflammatory medicines. Avoid hot, sharp, spicy food substances. Take throat lozenges.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a protrusion on knee indicate?\n\nSon has what Dr called a Genetic growth on right knee shows up as a spot on x-ray that is smaller than a dime and is in the front area in the smooth tissue of the cartilage what is this condition called? Dr is suggesting surgery but I cannot find any information online regarding this.  Is there any resources?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have bone overgrowth or cartilage overgrowth.  Its just extra bone like grpwtj and treatment of choice is surgical removal. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump under the chin?\n\nHi there. I m 15 years old. I recently found out that if I put my tongue on the roof of my mouth a LARGE lump comes out under my chin. It kind of feels like a muscle. And it only comes out when i put my tounge on the roof of my mouth. Should I be concerned about this?",
    "doctor_response": "Hi dear ,The symptoms you mention in query are probably due to a mucocele or mucous cyst . This occur when a duct of salivary gland duct get blocked due to injury or action like sucking . Treatment is based upon the severity of the mucous cyst. Sometimes cysts may not require treatment and will heal on their own over time. Superficial cysts often resolve spontaneously. If it doesn't go away in few days the consult oral surgeon for proper diagnosis and to rule out condition like tongue sore and herpes . There are treatment options like laser therapy , cryotherapy and intralesional corticosteroid injection . Maintain proper oral hygiene .Hope your concern has been resolved.Get Well Soon.Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dizziness and high blood pressure\n\nHello I ve been study in special effect make up for 3 days now but everyday during the class or after I feel so dizzy and my heart like high blood pressure I wanna know it because of the alcohol we use ? it s 99.9% I m from thailand , sorry for the english",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, dizzy feel could be vertigo if the symptoms long last then it may demands the medical attention but most of the time it may be due to vestibular dysfunction if the blood pressure is suspected then better to get it examine with doctor else without reading it can not be predicted,  hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need advice on allergy factor causing red bumps on skin.\n\nMy three daughters have been getting these red bumps all over there body even on there scalp. The complain several times a day because they itch so bad. Once they have itched them they start to get scabs there. I have took them to the Doctor and all they tell me is that they are allergic to something. I am just wanting to know what else this may be?",
    "doctor_response": "HelloThank You for contacting HCM.This could be allergy but i will be able to guide better if you let me know following questions:> Age of all children> Any such symptom in the past/ If yes, then how did it cure?> Do they feel itching between finger beds?> Do they have itch  particularly at night?In most cases allergy can be due to food, dust or pollens. In dermatological language it is called \"Urticaria\". At the same time this could also be scabies. Above mentioned questions help in differentiating both diseases.Hope this answers your question.Wishing them good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain on the upper right side of abdomen, hurts while eating. Causes ?\n\nim having a pain on the upper right side of what i think is my intestine or abdomen . It started hurting mostly when I eat. At this point (two days later) the pain is coming and going. I don t want to eat because it hurts but i feel really hungry. Almost feels like my food isnt going all the way down. I dont have insurance and dont know what to do",
    "doctor_response": "Hi, Thanks for query, The first possibility is of hyper acidity. It may be due to oesophagitis ,gastritis or enteritis. You should take antacid medicines . Take more milk. Avoid hot,spicy fried food. Take small frequent meals.Don't remain hungery or empty stomach. If this measures doesn't solve your problem consult your doctor. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes ammonia smell in urine and dry cough to a 2 year old\n\nMy son is 2 years old and 3 months, we are currently potty training and I recently (4 days ago) noticed that his urine smells VERY strong.. a strong ammonia smell. But not all the time he urinates.. Now two days later he suddenly developed a dry cough.",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.  Normally, urine that contains a lot of water has little to no odor. If your baby's urine becomes highly concentrated and very yellow \u2014 a high level of waste products with little water \u2014 urine odor may have a strong ammonia smell.Many foods and medications, such as lots of chocolate,peas,beans or certain vitamins, can affect the odor of urine. Sometimes, unusual urine odor may indicate a medical condition or disease, such as:-Urine tract infection-Dehydration-Diabetic ketoacidosis (high levels of blood acids called ketones)-Gastrointestinal dysbiosis, which lead to increase of uric acid and ketoacidosis -Maple syrup urine disease (rare genetic disease that causes difficulty breaking down certain amino acids)-Metabolic disorder If I were your treating Doctor for this case I would suggest:1. Keep your baby hydrated with plenty of water or ORS.2.Hypouricosuric diet-avoid products, enriched with uric acid(spinach,beets,radish,chocolate,peas).3.For better digestion I advise my patients to take Enzyme's syrup.4. Also take probiotics group of medicines like as Darolac, Visilac 1 capsule once a day for normal flora of intestine. Start on these changes and get back to me in 2 to 3 months. Wish you and your son good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Gall bladder will be removed at the end of this month and i am experiencing a strong metallic taste in my mouth\n\nHello. For the past month I have had a really strong metallic taste in my mouth ( I m not pregnant) ...there is a slight white film over my tongue and my taste buds are affected . I am due to have my gall bladder removed at the end of this month and have been having strong gallbladder symptoms this last week, and I have noticed since the gallbladder has been playing up , the metalic taste is getting stronger . Is there a link ? Thank u",
    "doctor_response": "Hi and welcome to HCM. There are plenty of possible causes and most of them are benign and usually subside spontaneously. usually this is caused by sinus or any respiraoty infections. Some drugs can cause it as well. Also, stomach issues,gastritis, gerd or gallbladder stones can cause it. I suggest to have easier diet, brush your tooth 2 a days and have antiacid mediciens. symptoms may improve after cholecystectomy too. Thanks for the query. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does aten 25 and prothiaden 75 cause infertility?\n\nI am 37 year old male just started aten 25 and prothiaden 75 since 4 month. It can be problem in infertility or restrict the chance of baby born through me. Can possibility to reduce the sperm in count with above drugs.",
    "doctor_response": "drugs you are taking are unlikely to effect fertility. you should consult the doctor to either reduce dose or stop medicine if feasible .Disclaimer",
    "dialogue_context": ""
  },
  {
    "patient_message": "What diet to follow with jaundice?\n\nmy father is 72 he developed a rash/ sores on his hands 6 weeks ago and 1 week ago developed jaundice he has an appointment in over a week for scans any dietry advice or general advice he has no sickness or pain at this stage he is fit and ideal weight",
    "doctor_response": "Hi, Rash and jaundice are generally due to hepatitis due to viral infections or some other secondary diseases in the abdomen.  The ideal diet for a jaundiced patient is low fat, high carbohydrate and proteins with branched chain amino acids. Limit spicy and baked items, see that he does not develop constipation. If he already has, put him on some laxative like lactulose which will really help a lot.All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take Asthalin?\n\nhi..i am 37 year old woman and have slightly thalesimia and thyroid which is in control.I got altitude problem as whenever i travel by air i feel breathless and doctor prescribed me asthalin,IS IT SAFE AND EFFECTIVE to take this inhaler,otherwise i dont have any breathing problem please guide....thx..",
    "doctor_response": "HI Thank for asking to HCMI really appreciate your concern, if you do have condition like asthma or asthma it self then the \"Asthalin\" is the right choice for you and it is safe for you no matter if you have Thalassemia, you can use this inhaler every where this is much better than the oral medication, hope this information helps you, take care and  have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach cancer\n\nmy wife,aged 38 is a Ca patient (stomach cancer). Even after 6 courses of Chemo therapy, she is sinking . Now CA is spreaded to the food pipe. she cant even consume liquid food . I heard about some sted pipe can be fitted in the affected food pipe      .....pls advice in detail",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.She has stomach cancer with spread in esophagus. It is stage 4 cancer. Surgery is not useful in this stage. So treatment options are chemotherapy and radiotherapy. But it will not cure the disease. It just works as palliative therapy. Despite of all treatment prognosis remains poor. Life expectancy is not good. Sorry to say but it is fact. She an have ryles tube for feeding. Only symptomatic treatment should be given.Consult your oncologist and plan accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause kidney area pain after a ureteroscopy?\n\nI have recently has a utereroscopy to remove kidney stones and even though the operation was 2 weeks ago the pain in my left kidney area has gradually got worse the last 8 hours so it s now like intense waves of stabbing pain and I ve noticed my last two lots of urine have had sizeable white jelly like mucus floating within it",
    "doctor_response": "helloThanks for your query.Yo have undergone endoscopic surgery of Ureteroscopy to remove stone in ureter 2 weeks ago and  now have sever pain in loin and passing mucus threads in urine ..This is mostly due to inflammation  of the ureter (Ureteritis).Consult operating Urologist and get routine urine test  and urine culture done ..Take broad spectrum antibiotics like Cefixime along with urinary antiseptic like Nitrofurantoin twice daily and urine alkaliser thrice daily.Later on switch on to appropriate antibiotics as per culture report.Get the prescription of medicines from your family Physician.Ensure to drink more water.To keep your urine dilute This will help to control dysuria.This will get resolved within a week.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach ache and green stool?\n\nhi I'm 31, female, very sore lower tummy, couldn't walk before but lying on my tummy and pressing it down seems to work and after going to the toilet and poo green faeces made it feel at ease, but it was really hard pooing and only one piece hard green poo came out. Still sore but now so as my virgina......not sure what to do...what would you suggest?",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.Green poo is suggestive of an infection of the intestines and a proper course of antibiotics will help to cure this; which will automatically help the pain in abdomen to subside. You can certainly undergo tests of blood , particularly for diabetes, urine and stool- stool culture and sensitivity too. This will help if the infection is resistant to routine antibacterial agents.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does having mono cause dizziness and breathing difficulty?\n\nHi, i'm 15 years old about 5'6 and 115 pounds. I've had mono for about 4 weeks and have been feeling better but I have recently been throwing up, getting really dizzy and having trouble breathing when I get up, it feels like someone is standing on my chest and I'm constantly out of breath, could this be linked to mono? If not, what else could it be",
    "doctor_response": "Hey Yes it could be due to mono.Get done chest X-Ray and PFT to rule out lung related problem like asthma.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatments for molar tooth infections\n\nMy 38 yr old daughters teeth are rotting out and she constanly has tooth infections in her molar.  Is this dangerous to her health?  She lives in Georgia, and doesn't have a job, and can't afford to have them pulled. Are there any resources out there with an Oral Surgeon to pull them even if she's poor.  They are making her sick.Thank you,Debra Smith",
    "doctor_response": "carious teeth are definitely a problem to a person's health. she will have difficulty during eating.she needs to either get it restored or extracted. try looking for some charitable areas for treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes distraction of thoughts while talking to people?\n\nhi , i am suffering from shizophernia and taking risdon 4 mg and pecitine 2 mg. but sometimes i have problems interacting with people and sleep problems. when i talk to people that things keeps on coming into my mind sometimes. also my family forces me to talk to people which i am uncomfortable with. i also feel financially insecure and i am in no position to work though i do housework but i feel my brother and his wife will throw me out of the house or will make such a situation that i myself leave the house . i am 44 years of age and not married, i live with my mother and doing spiritualism. can you suggest me some good medication so that i control my disease?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  Talking and interacting with people is treated as inherent therapy for schizophrenia affected people. Vocational therapy is also considered advantageous. Once you are sure that your schizophrenia is under control with these medicines, then why don;t you try for a job? Work with your psychiatrist for a better treatment / therapy plan.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 the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe abdominal pain while sneeezing\n\nHi I m Abby, in a teenager and yesterday I was stretching and my side of my belly started hurting really bad and know today it hurts to sneeze, cough or yawn. And walking hurts really bad on my side, whenever I stretch the side even a little it is very painful!! I hope someone can tell me what is going on",
    "doctor_response": "Hello, you might have got spasm in 1 of the muscles in your side abdominal muscles. Thats why any activity where the muscles is used up like coughing, sneezing, yawning will cause you pain. You will need to take analgesics,  medications to relieve the spasm and some hot fomentation to the muscles to ease the spasm.I hope i have helped you out. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent chest discomfort after playing tennis?\n\ni am 34 yr old male i exercise regularily  i m 6ft tall and weigh 95 kgs  i am a regular tennis player for last one year or so i am having frequent chest discomfort no pain . i got my tmt and echo done 3 times in last one year both are absolutely fine with my tmt results going better than 100% whay is this frequent chest discomfort",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. No need to worry for heart diseases as your 2d echo and TMT (trade mill test) are normal. In my opinion, you are mostly having musculoskeletal cause for your chest discomfort. Your chest discomfort is associated with exertion (playing tennis), so musculoskeletal cause is more likely. So follow these steps for better symptomatic relief in musculoskeletal discomfort. 1. Avoid awkward movements. 2. Sit with proper back and chest support. 3. Apply warm water pad on affected areas of chest. 4. Avoid heavyweight lifting and strenuous exercise. 5. Avoid bad postures in sleep. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Right upper abdominal pain, excessive ab workouts. Tests done. Could it be a muscle pull?\n\nI have had right upper abdominal pain for the last month. Some days are worse than others. I have been to the er two times and all tests have came back negative. I am scheduling a hida scan to check my gallbladder . Other than that, I do remember doing excess ab workouts the week this all started and my pain is mostly apparent crouching, crunching, and sitting.. Can this be a muscle issue?",
    "doctor_response": "Dear friend, welcome to HCM. yes. you are right. a muscle sprain / soft trauma can also cause pain there. an ultrasound would usually pick up a gallstone etc. if all tests are negatiuve, muscle sprain is likely. pl. try simple analgesics like acetaminophen and local pain gels to the muscle and see if it gets better. take care and keep me posted on your progress.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Switched to Sprintec from Lo Loestrin Fe. When will period start?\n\nIm switching from Lo Loestrin Fe to Sprintec 28.From what I have researched i have had \"withdrawal bleeding\" for 5 days. I took that last pill in my Lo Loestrin Fe today, and should start my actual period tomorrow. However, I have not yet. So should i start my new pack of Sprintec 28 tomorrow or wait  till i have started my actual period?",
    "doctor_response": "Thanks for using HCMYou can start taking tablet regularly, withdrawal bleeding should have started by this time, if not started yet get UPT done just for your satisfaction. Take tablets regularly. Have a good health.RegardsDr. Vidya",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can hemoglobin levels drop after a menstrual cycle?\n\nTwo weeks ago I had a hemoglobin level of 8.6 and I felt terrible. I started experiencing chest pain on top of a bunch of other symptoms and was told to go to the ER. At the ER, they gave me a blood transfusion with 3 units of blood. Four days after the transfusion, my hemoglobin was 16. Then I had my menstrual period which is extremely heavy for the first 3 days. After my period, my primary doctor did a complete blood count and my hemoglobin is now 11.8. I was shocked that my hemoglobin dropped from 16 to 11.8 after one menstrual cycle. Is that large of a drop normal after menstration?",
    "doctor_response": "Hello and welcome to HCM,Heavy menstrual cycles can lead to drop in hemoglobin or anemia.However, a single menstrual cycle cannot bring such a drastic change.Thus, you need to consult your primary healthcare provider for clinical assessment and complete hemogram.Besides hemoglobin, red cell counts, red cell indices and peripheral blood smear examination also need to be done to know the type of anemia.After knowing the type of anemia, appropriate treatment can be started.Most common cause of anemia due to blood loss is iron deficiency anemia.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for testicular shrinkage\n\nI am 20 year old boy and have been masturbating from 5years every time i masturbate my sperms are wasted. and now it has became my habit and I can not sleep without masturbatingnow from few month i am observing that my one  of the testis (balls near penis) is becoming small and converting into some  semisolid muscleI dont know what to do and soo worried by this problem and about my future married lifeplease give me solution of my problem",
    "doctor_response": "Hello, The problem you have requires clinical examination as well as investigations such as USG - scrotum to diagnose the problem. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Fatima Clinic",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is diabetics a reason for worry post foot injuries?\n\nHi, I have diabetes. 2 wks. ago I injured my left foot. I hit the top of my ankle on a metal step-stool while getting out of the car. I injured area immediately swelled.When I got home, I elevated my L. foot and leg, and placed ice on it. I repeated the next day.As of today, my three middle toes are black & blue at the base, my foot is b & b on all sides, and the bruising goes up my shin close to my knee.Quite painful. I can rotate my foot and walk on it. Except if I try to walk fast or maybe 50 ft. it hurts so bad I broke into tears. Do I need to be more concerned because of the diabetes?",
    "doctor_response": "Hello, You have soft tissue trauma left foot. In view of diabetes, the injury should be taken seriously as foot infection could turn grave and lead to complication like wet gangrene. You need to show a physician or a diabetologist. Blood sugar needs to be controlled with inj Insulin and suitable antibiotic coverage is to be given. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Tushar Kanti Biswas, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is there a problem with my son's personailty?\n\nHello doctor, My son is a college student. He is 21 now. He has depression from about three years and has been seeing a\u00a0psychiatrist for a while. He has been missing assignments and classes and got put on probation and withdrawal. And, he lies a lot. For instance, he signed a waiver to his college and I had access to his reports. He knew this, but he still lied to me about his grades. Sometimes, I feel it is not just depression but there might be some other problem with his personality. I want to know what we shall do as his parents. Shall we ask him to live with us so that we can watch him go to therapy periodically and have a healthier lifestyle? Shall we talk with him if we know he is lying?",
    "doctor_response": "Hello. Depression is now common in 2 % of the children and adolescents. Its cause is not specific, but a combination of multiple factors such as environmental, biological and psychological. Firstly, we have to look for any specific underlying causes for his depression. And then, we have to remove the underlying causes of depression. There are mainly two major ways to treat children's depression: If your child has symptoms of depression such as helplessness, guilt, hopelessness, irritability, loss of energy, sleep problems, etc. you should consult a pediatric psychologist for assessing the root of this problem. The causes could be hypothyroidism, drug abuse, bipolar disorder, etc. Please do the needful. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does taking Benadryl during pregnancy affect the baby?\n\nHi I'm 38 weeks pregnant and have a really bad cold. I was told by my doctor that I could take 1 to 2 benadryl every 6 hours. I was just wondering if it affects the baby at all. For example lowers the heart rate, puts them to sleep like it does us or anything like that? I just don't want it to hurt the baby on any way.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Benadryl syrup does not affect the baby. Baby at this stage will not get affected. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why my mother's head is reeling while lying down?\n\nmy mother is 60 yr now. She regularly takes medicine for blood pressure. Suddenly since yesterday night, while sleeping, she had a severe head-reeling problm...as if the bed is going up-side down...When she is sitting upright, its ok... but the moment she is lying down, she is having severe type of head-reeling",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern.You shoud not worry I'll try to explain you something and give you my opinion. A hypertensive crisis can give symtoms like headache,  blurred vision,  dizziness,  nausea. A person might experience a kind of head reeling but it is not related with head position.In my opinion this symptoms like head reeling, vertigo,  strongly related to head position or while lying down have to do with inner ear problem. In inner ear patologyes the patient experience this head reeling, like the house or bad comes over or up side down. They are strongly related with head movement  and position becouse in that moment the  inner ear takes imupses and controls our eculibre. So, my opinion is that your mother should consult an otorin and a neurologist doctor. There are some simple objective examinations to do and evaluate this problem.But you should not worry.If it is what I  suppose there are medications to control this symtoms.Hope I was helpful.Wish your mother  good health.Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could anyone tell me what this rash could be?\n\nI was wondering if any could offer any advice on what this rash could be.My son has had this rash now for almost three months. He is too embarrassed about the rash to go to the doctors, so i said id check online to see if anyone had any answers.. WWW.WWWW.WW hicago0000/img1.jpg WWW.WWWW.WW hicago0000/img2.jpgany help or advice would be greatly apprechiated",
    "doctor_response": "Hello,Thanks for the query.Images cannot be seen.You need to use the paid query facility for this.Definitely we will help you.you can ask a direct question to me on this forum, following the below link.  you a good health.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from chronic prostatis, no improvement with allopathic and homeopathic medicines. Is it curable?\n\ni am suffering from chronic prostatis since 2003 onwards, for which i would various medicines from both alopathy and homoepathy medicine but till today it could not be cured, hence i want to know whether it can really be cured or not. if it can be cured, what is the best remedy you suggest me. i am 57 year old retired banker",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have problem of Chronic  Prostatitis It is very notorious disease that does not respond to any antibiotics or medicines from any faculty of medicines.However I have been practising doing prostatic massage every day for 2-3 months in my patents and getting encouraging results.Please consult qualified health personnel to get prostate massage done .every day.This helps to discharge all the prostate secretions which is the prime source of getting infection.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it okay to have x-ray again?\n\nHi, I have a one year old son. He has had cough for 12 days. He took antibiotic but nothing changed. His doctor said that it might be a primary complex and needs to have x-ray to confirm. But my son had an x-ray 3 months ago. is it okay to have x-ray again? Thank you.",
    "doctor_response": "Hello. I just read through your question.Though we try to avoid doing xrays in any scenario, there are certain clinical scenarios where it is necessary. Often we can make a diagnosis based on history and physical exam, but sometimes we need the help of an xray to make a diagnosis. I agree",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are Prostap injections necessary to stop endometriosis?\n\nI have had endometriosis since 2010 after 2 laparoscopies and 6 months clomid nothing has happened some we were referred for IVF. They suggested ICSI due to my husbands low sperm count rang for treatment and have been told we can t start due to the endometriosis even though they knew this 2 months ago and have said I may have to have prostap injections to stop the endometriosis. Are these necessary? Can we refuse these? Will they enhance success rates?",
    "doctor_response": "No, it is unnecessary. For curing endometriosis, you could try herbal therapy \"fuyan pill\". It could eliminate all your symptoms of endemetriosis. What's more, it coudl repair your reproductive organs.Hope this could help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest a remedy to manage pain in neck, hip and knee\n\nI have defused c7 disc for past 7 years. I have been having more pain in the last year. I get what I call lock out feeling in my neck left are and past few months in my left hip and knee. I cannot take difene or other strong pain meds as the make me very ill and cause loss of memory. What would you recommend for me at this stage?",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. A diffuse C7 disc will lead to radiating or other type of neurological pain in your upper extremity especially in your forearm and fingers (index and ring finger). It will not cause any joint locking in neck, hip or knee. So, what I suggest is to check your calcium and uric acid levels and refrain from smoking and drinking as it exacerbates the condition Regular exercise like jogging or brisk walking, swimming, cycling will help you also you can start with neck exercise (remember to avoid neck bending form of exercise) like shoulder shrugging, static neck, active neck movements followed by mild resistance will help in preventing further disc problems. Hope you find this helpful. Let me know if I can assist you further.Regards,Dr. Jenis Bhalavat",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat severe pain blisters on the foot after a fracture?\n\nI dropped an 84 pound safe on my foot.... have been to ER, 3 X-rays determined no broken bones, just severe contusion. Today a blister has formed on top of my big toe where it bends & is very painful.... have punctured it to remove fluid.... is this normal? Just continue to remove fluid???",
    "doctor_response": "Hello,These are blisters filled with yellow fluid or reddish when are hemorrhagic blisters. This is from big swelling and contusion of soft tissue envelope. I would suggest you to keep the leg up above the heart level and do not cover these blisters as they need to dry up in the air. If the blisters show again, you can aspirate it with sterile syringe. You can take some broad spectrum antibiotics (Cefazolin) to prevent any infection. I think the situation will be back to normal in 2 or 3 weeks.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Valbona Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a high white blood cell count with large platelets mean?\n\nSince I was about 19 (I am 28 now) I have had high white blood cells counts without the presence of infection or sickness. I never followed up with it because I was never given a reason to be concerned (mia culpa). Recently though my new doctor has done 2 separate blood draws and again noticed the elevated white blood cell counts and on the second noticed large plaletes. I'm supposed to be seeing a hematologist soon but in the mean time I have been WebMding myself into a frenzy...any thoughts???",
    "doctor_response": "Hello, High WBC count can be elevated in any inflammation cause. It can be elevated in the physiological cause as well as by some drugs. It is important to know how much WBC elevation is present. So kindly attach your report so that I can check it. The large platelet is usually seen in case of pathology involving platelet destruction. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for restless and confused mind\n\nhello doctor my personal details are given below : NAME : JAIDEEP.J AGE : 23 EDUCATION : PURSUING MBA CITY : BANGALORE CONCERN : RESTLESS AND CONFUSED MIND. I dont have any neurological disorders, my concern is i cannot stop thinking about the next (future) event. as a result of this i fail in my duties. i have immense talent and all the people around me accept it but my mind is very restless , insecure and i dont know what will happen to me if this continues.. sometimes i want to quit this ( busy / rat race) world forever... what can i do ? is it possible for me to overcome this or is it too late n all over now .",
    "doctor_response": "Hello Jaideep,Such thoughts and racing mind is a common problem now a days as this is a competetive world. This does not mean that all is over now.I thnik if you are unable to control your mind and thoughts, you can take take tablet escitalopram 10mg once in morning daily. This will relax your mind.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the treatment available for pain in tooth while tapping?\n\nHello doctor, My upper right one tooth (front tooth) is painful to touch from the front. It is sturdy and does not move at all. It also is not painful to push from the inside out. It does not hurt to bite down at all. It simply hurts to tap the front of the tooth. Any ideas on what this could be?",
    "doctor_response": "Hi. Pain on tapping have two differential diagnosis. It could be a sensitive tooth. Enamel of tooth is weak that is why it is having greater amount of sensitivity on touch and pressure. If this is the case then veneering is done on the front surface of the tooth and this complain goes away in a week. The other reason could be there is some infection in the underlying tooth. Periapical, periodontal abscess or infections do not need caries or cavities to cause infection. They occur at root and bone part of tooth and usually occur silently. Once they start to aggravate, they cause such symptoms of pain on tapping only. Get X-ray done of the tooth in question, send me its picture and clinical picture of tooth also. If this is the case then root canal treatment is recommended. Give me its followup once you get radiograph done. Stay happy and blessed. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "When can rabies vaccination be given?\n\nMy 29 year old son is going to Haiti to work for a non-profit. At the last memeny, when he was getting trained in Chile he was told that he needed to get a prevent vaccination for rabies. He was given one shot in Chile last Thursday- Verorab k1141-3. Next Wednesday he is coming back to the USA and has to stay to complete the rabies shots before he goes to Haiti. Is it possible he can restart the 3 shot series if more than 7 days has passed, and is this safe?",
    "doctor_response": "HelloPre-exposure prophylaxis is occasionally given to persons at high risk ( including certain travelers to rabies endemic areas).A primary vaccine schedule is given on days 0, 7 and 21 or 28 .Irrespective of previously vaccinated or not , so in your son case he must take all three injection as mentioned .Previously one injection taken does not matter and no risk , because already 7 days passed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for chronic sinusitis with nausea and fever\n\nI am mustafa suffering from chronic sinusitis with severe associated symptoms like headache,nusea,fever,pressure in forehead portion,left sided nasal blockage,fatigue and im using some antibiotics along with steam,but there is no relief in any of the above symptoms.So kindly help me out with ur valuable suggestion with prescription.I will be highly obliged. Mustafa Syed Hyd",
    "doctor_response": "Dear Mustafa,                   Your nasal sinus may require cleaning. Your left side nasal blockage suggest that you are probably suffering from Deviated Nasal Septum also. Thus you should consult an ENT specialist personally, so that he can remove blockage if required & can prescribe you proper antibiotics on behalf of C & S report. Meanwhile you can take T. Sinarest  thrice daily & use Otrivin/Nasivion nasal decongestant drops s.o.s.With best wishes,-Dr.Chandra Shekhar Sharma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Has blood cancer. Tumors from stomach removed. Curable?\n\ni m abdul.my dad has blood cancer .Doctors removed tumours in his stomach after that they confirmed that it was cancer.For the past 3 months treatment is going on.By scanned his entire body they found some tumours in his stomach and neck .He is 50 now.His weight is 110,now he lost his weight up to 10 kg after treatment gets started.is it curable?",
    "doctor_response": "Dear makeitsimple, It is very difficult to answer your question without further details. There are several types of blood cancer, which have completely different treatments and outcome. Even if you say that your father has lymphoma, in order to inform you if it is curable, I need to know the subtype of lymphoma. Come back to me if you have any more details. Hope your father gets better.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies to overcome the problems due to transverse myelitis\n\nHi I was diagnosed with transverse myelitis in 2007 when I was only 17 years old I seem to have reocuring symtoms such as numbing in my arms and legs and esteemed fatigue the onset seems to come about most often when I have major changes in my life so you have any diet excersise regimends or suggestions in how to deal with these problems",
    "doctor_response": "Hi,Transverse myelitis is disabling conditions. it is important to know about what is the cause of transverse myelitis. sometimes it is due to inflammatory conditions, viral infection, etc. If no cause is found then it is called idiopathic  Transverse myelitis.  If it is idiopathic then it is usually doesn't recurs again. In your case, I hope it is Idiopathic transverse myelitis.Many times after recovery sensory symptoms such as pain and numbness and residual weakness persist. In that case, symptomatic medication such as pregabalin, muscle relaxant, and isometric exercise and physiotherapy will help you. If symptoms worsening or recurring after fever or stressful condition you should visit your family physician. It is important to rule out the recurrence of transverse myelitis and catch the disease early. The reconsidering cause of transverse myelitis is advisable.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mahendra Shivram Thakre, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does damaged thumb tendon take to heal?\n\nA sharp steak knife pieced to lower thumb quite deep, can not move upper thumb joint and feels numb.  How soon after the accident must I have a hand surgeon work on either repairing tendon, and nerve, and, after the surgery, how long does it take to heal completely, with therapy.",
    "doctor_response": "Hi, there!This is urgent situation! You have to go to emergency as soon as possible!Recovery after surgery is aprox. 6weeks (splint) and physiotherapy after all to restore range of motion.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Causes for weakness,light groin pain and  testicles pain after erection?\n\nGreeting, Here I am trying to mention everything for your consideration. Gender\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0:\u00a0\u00a0\u00a0\u00a0\u00a0Male Age\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0        :\u00a0\u00a0\u00a0\u00a0\u00a030 Years Married\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0        :\u00a0\u00a0\u00a0\u00a0\u00a0Never Height/weight/type\u00a0\u00a0\u00a0\u00a0\u00a0:\u00a0\u00a0\u00a0\u00a0\u00a05.65\u201d/74kg/Athletic Living on rent out of home and eating outside mostly since last 8 years. I used to stomach\u2019s warm from childhood. And always have digestion and constipation problem. As I was suffering from shivering & chilled ever in summer, one doctor gave me TB Treatment for 6 months from April 2012 to Aug 2012 as per his diagnosis. I attached his prescription Later on mostly doctors told me you should not. 3 months ago I had taken Vitamin D deficiency treatment. Reports & prescription attached here some points 26 Apr 2013 High Sensitivity C - REACTIVE PROTEIN (HSCRP) NEPHELOMETRY    0.22 mg/dl (0.20 - 0.38 -- High Risk) 25-OH VITAMIN D TOTAL \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0C.L.I.A \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a018.55\u00a0\u00a0\u00a0\u00a0\u00a0ng/ml ] (DEFICIENCY : <20 ng/ml) LIPOPROTEIN (A) \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0NEPHELOMETRY \u00a0\u00a0\u00a0\u00a0\u00a040.3 mg/dl  (Adults < 30.0 mg/dl) LYMPHOCYTE \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0PERCENTAGE \u00a0\u00a0\u00a0\u00a0\u00a045.8 % (M:20-40; F:20-40) PLATELET COUNT \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0121 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0X 10\u00b3 / \u03bcL \u00a0\u00a0\u00a0\u00a0\u00a0(150-400) PLATELET DISTRIBUTION WIDTH \u00a0\u00a0\u00a0\u00a0\u00a017.3 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0% \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0(10.00) MEAN PLATELET VOLUME \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a013.6 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0fL \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0(6.5-12.0) May 2013 Treatment 1.\u00a0\u00a0\u00a0\u00a0\u00a0INJ  ARACHITOL 6 L  (each 15 days) * 2 months 2.\u00a0\u00a0\u00a0\u00a0\u00a0TAYO 60K 1 tab (Each week) * 3 months 3.\u00a0\u00a0\u00a0\u00a0\u00a0ZENTEL 400 mg tab (once) Presently I am suffering for following issues; 1. Randomly suddenly I feel stomach pain especially in morning sometime other times too and after few minutes its normal or after toilet (latrine). [From years ago] 2.  I feel light pain lower right side underneath of stomach (groin) when bend toward toes. [Notice from year back] 3. After erection I have horrible pain in my testicles seems going to upper side on that time I have to take rest for \u00bd hrs to normal it. 4. These days weakness is major problem,I am noticing especially in morning, after urination, and when I gone through nightmare/masturbation (10-15 days interval), really feel I have no energy in my body. Sensation in thigh and pain in knee/joints Kindly help me out...",
    "doctor_response": "hellothis problem is not actually because of masterbation. we could be more helpful if you had written your age.However you should do your CBC,LFTs and urine R/E first. This will guide you to the problem if any there.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes body pains, high BP and fever?\n\nTwice now, I've woken up feeling clammy, achy and with,low body temperature. The first night, about 5 days ago, my temp was 96F, BP 128/83, pulse 80. Tonight it was 97F, 124/85, 65. I take benicar 20mg, aspirin 81mb, take testosteone 200mg every two weeks, and taking piroxicam 20mg daily for a bruiced tfcc. I take over the counter antihistamine (diphenhydramine 25mg) for ocasional allergies. Today I took the antihistamine. Could this be due to a drug interaction?",
    "doctor_response": "stop all the medicines.fever ,B P  normal. no medicine required.take paracetamol .it is safe.it is all due to viral.you would be all right with in a week.consult your family doctor.feedback.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does thick endometrium in the ultrasound report indicate?\n\nhi iam 27years ihad an ectopic pregnancy 2years back since then i have not concieved my left tube is good and i have pcos and ovulation problem now in this month i have no period for 15 days and negative SPT but in ultrasound it showed thick endometrium can ibe pregnant",
    "doctor_response": "HiGREETINGS You need to do a follicular study along with ovarian stimulation.Before that the patency of the other tube also has to be confirmed .Hope your husbands semen analysis is normal. I suggest you to consult an infertility specialist. Hope my answer helps you. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the bubble in the bellybutton that bleeds and smells?\n\nHello my name is brook I am 21 yrs old I am 5'8 and weigh 205 lbs I have like this bubble thing in my bellybutton it hurts bleed smells and its a yellow green color liquid coming out. I've went to the er and they said it was an infection but I've had it since I was 18 and it onlys bubbles up and does all that naSty stuff is when I get my monthly can u please help me?",
    "doctor_response": "Hello and thanks for your question. It sounds like you may have a small cyst around your navel that gets inflamed around the time of your period. The best thing to do is to clean around your navel every day with a q-tip and alcohol. Hopefully this will keep the area dry and avoid future infections. If it persists you may need to see a surgeon to have the cyst area removed. Thank you for using HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can be done for dislodged tooth filling with a lump in gums?\n\nHello doctor, I have a tooth filling that has come out, and woke with a white lump beneath it on gum, swollen lower face too on the other side of the site of lump. I had a dull, drumming pain during the night before. I rinsed with warm salt water this morning. Wondering if Flucloxacillin 500 mg which I was prescribed for a bad reaction to summer insect bites and too worried to take, would they help gum infection or abscess? Are four tablets a day all right? I have a dental phobia and will need to wait to be treated at my local hospital.",
    "doctor_response": "Hi. Your tooth is probably infected which has caused the white lump on your gums. The decay has gone inside the pulp, almost touching your nerve and there is infection beneath the root of your teeth which has caused this swelling. You will have to confirm the status of your teeth by taking an X-ray, to check how much the infection is affecting your tooth. I will not suggest you having Flucloxacillin 500 mg because it is not effective for dental infections. To suggest an antibiotic, I need to know the proper medical history of yours. At present, take an antibiotic and pain killer so the swelling subsides and meet a dentist as soon as possible for further treatment. Can I know if you have any allergies for any medicine, or any systemic diseases present? If so, I can prescribe the medicine for you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are visible veins in chest sign of pregnancy?\n\nOkay so pretty much my last period was June 5th and I inserted a nuvaring on June 23rd. A couple hours after it was in, I went to my boyfriend's house and we had sex and he -cough- \"finished\" inside me for the first time. So then a couple days ago I realised that my boobs were feeling weird and are sore and veiny. You know how easily you can see the veins on your wrists? Well it's like that on my chest and to my shoulders which is really not like them. I posted the question about my chest and someone mentioned pregnancy. Is that really the case? Could I be pregnant? If I'm overreacting please tell me, I'd rather hear that than \"yes, you could be pregnant.\" My nuvaring isn't due to come out for another two weeks. What do you guys think?",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the visible veins on chest might not suggest pregnancy.But any hormonal contraception needs additional protection with condom within first week of usage.We cannot definitely say there is risk of pregnancy.The first sign of pregnancy is missed period.Other signs are nausea,,vomitings,increased urination,sore breasts which start 2 weeks after missed period.When there is missed period I suggest you to go for a urine pregnancy test after a week of missed period for accurate results.As such nothing to worry and visible veins on chest is not a sign of pregnancy.Avoid stress.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a round purple bruise on the elbow in an osteoporosis patient?\n\nI noticed a perfectly round purple bruise on one elbow this morning, with slight bruising on the other one. I haven t fallen or knocked them. No pain, just a circular bruise. What might cause this? FYI, I am a 61 year old female with osteoporsis in my hips. Thanks,",
    "doctor_response": "Hello, The sudden appearance of a bruise without any history of injury in the area can happen due to a bleeding disorder or an autoimmune problem. You need to have a few blood investigations to find the cause. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does typhoid fever require to subside with Ofloxacin treatment ?\n\nHello Sir.. I am just passed mbbs and now working as medical officer in sub district hospital.. My sister s husband having fever since 2-3 days .. it reaches 102.5F .. cbs is normal with only thrombocytopenia 1,20,000 and malaria negative, dengue and lepto antigen negative and widal with o titre 1: 20 and H 1:40 at first week .. After taking my senior opinion I am started treatment with Magnazone inj. ( cefperazone and salbactam ) and now today with ofloxacin as signs and symtoms resemble typhoid .. But after 2 dose of inj. ofloxacin , his fever still comes and reaches to 102.3 F max.. I want to know how may days required to subside fever in typhoid with ofloxacin treatment ?",
    "doctor_response": "HelloWelcome to Health care magicNice to have a question from our community. Single ofloxacin treatment is not sufficient according to me. We are practicing some another regimen with very good results with very low relapse rate. Cefixime 200 mg 1 tab twice a day+Azithromycin 500 mg 1 tab for 5 days with pantoprazole 40 mg 1 tab twice a day. all for two weeks. You can also use combination of cefixime+ofloxacin for 14 days. Azithromycin is used for relapse prevention.Hope you will get it.Thanks for contacting.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pounding sensation in head due to occipital neuralgia?\n\nI have occipital neuralgia.  My pain is minimal but I have a serious pounding sensation in my head every night.  it moves from side to side - front to back.  sometimes I am unable to sleep.  when I do not get my sleep, my head feels as if it is disconnected from my body - I  I must lie in the bed for hours until I reconnect.",
    "doctor_response": "usually occsipital head ache is common in hypertension . check ur blood pr user first . if BP is abnormal u may need to take BP medications .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath, rapid heartbeat and sweating?\n\nHi, I'm an 18 year old girl. Recently I have been finding it harder to sing without getting out of breath. My heart pumps fast and i have a shortness of breathe even when I don't do anything. I think this may be worse when the weather is mild. I also sweat sometimes when im doing something as simple as putting on my make up. And sometimes when i straighten my hair i need to sit down for a second. My hands i shaking but ever ever so slightly.",
    "doctor_response": "Hello,Your symptoms are pointing to generalized anxiety disorder. It is something I come across in my everyday practice. These are some of the things you should do to help with your symptoms:1. Always try to get adequate sleep.2. Avoid smoking or drinking if you do as it will worsen your symptoms.3. Exercise frequently and eat a healthy diet.Take tablet Valerian extracts one to two hours for one to two weeks. It will help you sleep well and also help with your anxiety. If your symptoms persist after two to three weeks, seek consultation with a psychologist.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Isaac Gana",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can one hot bath after heart viral inflammation?\n\nI just had a viral inflammation of the heart. All was well afterwards and no damage occurred to the heart. I did have an angiogram as one of my tests. This was 48 hours ago. Is has healed well but wanted to know if a dip in a hot tub is a no no. Thanks Barry",
    "doctor_response": "Hi,It will not be harmful, you can safely have water bath, if wound is properly healthy and healed.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chronic cough with heart flutters?\n\nI have been coughing up mucus for a few days now and my throat is irritated and burning, talking makes me cough, and now my lungs are squeaking at the end of exhalation. Also, the last few weeks I have had many heart flutters that cause me to loose my breath, sometimes up to 10 in a row (in the space of a few minutes)",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. In my opinion, we should rule out heart and lung related diseases in your case. Heart diseases like arrhythmia or heart failure can cause similar symptoms. Lung diseases like bronchitis and lung infection cause similar symptoms. So better to consult doctor and get done 1. Blood pressure monitoring, ecg and 2d echo to rule out heart diseases. 2. Chest x ray and PFT (Pulmonary Function Test) to rule out lung diseases. On the basis of above tests, treatment should be given. You may require inhaled treatment or cardiac supportive drugs. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Progyluton help to get pregnant?\n\nHii my name is ansam , i have pco , my Gp doctor put me on clomid but i did nt respond ,my ovaries became overstimulated and made large folicles, she stopped clomid and put me on progyluton , glucophage and preconception multivitamines...will i get benefit from progyluton to be pregnat?? Thanks , regards",
    "doctor_response": "Hi, I think progyluton alone will not help. As you over responded to clomid, I think you should go for a natural cycle tracking of follicles.  In natural cycle, only one follicle grows. When follicles reach a size more than 17 to 18 mm, take injection for rupturing the follicles.  Be in contact with your husband for next 2 to 3 days.  Take progesterone for next 2 weeks.  Do a urine pregnancy test at home after that.  If follicles are growing naturally, you will not need clomid. If not, try with a low dose of clomid.  Discuss with your doctor.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I having severe pain in my esophagus while coughing?\n\nhaving severe pain in the esophagus area between my breasts when I cough...slowly calms down but when I cough again the pain in almost unbearable...don't know if this is a start of a cold...my husband has one.  I do have gerd and take dexilant daily but have never felt this before.  I am 58.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. Possibility of worsening of GERD (gastroesophageal reflux disease) is more in your case. GERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms of Central burning chest pain. Along with drugs, GERD needs following lifestyle modifications for better symptomatic relief. 1.  Avoid stress and tension. Avoid hot and spicy food. 2. Avoid large meals, instead take frequent small meals. 3. Go for walk after meals. Loose weight if you are obese. 4. Keep 2-3 pillows under head in the bed to prevent reflux. Avoid smoking and alcohol if you have these habits. You will mostly improve with all these. If not improving than get done chest x ray to rule out lung infection. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can overdose of contraception pill cause bleeding?\n\nHi doctor.I have some questions about my health.Which is i am sure that I had overdose on the emergency contraception pill.I have no idea if it is my normal period/ I'm pregnant/ overdose symptoms because my vaginal area is had been bleeding in a light flow about 2 weeks.",
    "doctor_response": "Hi,  You are welcome on this forum.This can be incomplete abortion or hormonal dysfunction .Better have TVS  and treatment accordingly.Along with You need  iron supplementation to prevent anaemia.Thanks for posting questions .Dr. Manisha Agarwal Obstetrician & Gyaenecologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen lipoma in the stomach\n\nI have lipoma on my stomach. And lately it has been swollen and it hurts. What can I do to bring the swelling down? Will a hot cloth or an ice pack help? The last time this happened a doctor told me it will go down on its own, but I was curious if I could do anything to help bring the swelling down?",
    "doctor_response": "Hi,Thanks for posting your query.I am Dr.R.K and I am pleased to assist you.The only definitive treatment for lipoma is surgery. It will not go down on its own.Having hot cloth or ice pack over it will not help.You need to consult a surgeon for removing the lipoma.I hope that answers your question.Regards,Dr.R.K",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain and stuffiness in throat?\n\nChest pains I woke up yesterday feeling like a pill was stuck in my throat. I had taken a pill the night before so I thought I hadn't drank enough water to get it down. at lunch, while eating soup, I had the worst chest pain with each bite that went down. right in the middle of my chest. felt like I had swallowed a burger whole and it was kind of on fire. same thing at dinner. the next day the lump in throat feeling is gone, but I still have the chest pain. also I feel like pain with a belch which I am doing some what often now, but not before. Taylor, female, 24 years old.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. By your history and description, possibility of acute gastritis is more. Pills often cause gastritis. And this causes acid reflux. So acid come up in the esophagus and cause central chest pain. Your belching, throat problem are also due to this reflux. So drink plenty of fluids orally. Take proton pump inhibitors (antacids). Avoid hot and spicy food. Avoid large meals, instead take frequent small meals. Don't worry, you will be alright in 1-2 days.Hope I have solved your query.I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from nasal stuffiness, swelling, sinus pain, mucus drainage. Taken montemac, allegra and nasal spray. Sufficient?\n\nHI , I have been suffering from nasal stuffiness(turbinates swelling) few doctors except 1st one have been prescribing diff medicines but it is not getting cured completely.1st doctor had suggested for surgery. Until now i had taken montemac fx ,montec lc ,deriphyllin along with teriod nasal sprays. Currently i have been prescribed with alaspan am, allegra and steriod nasal spray for 2 weeks. My sinus is paining currently with lot of mucus drainage and many a times sneezing",
    "doctor_response": "Hi there ~ Sometimes undergoing surgery completely relieves the condition as there is usually a small passage created by what is known as a deviated nasal septum (DNS) that causes you to have excessive sneezing, headaches, runny nose, mucus drainage, stuffiness, swelling etc.  However if you have gotten all kinds of imaging studies done including CT scan of the sinuses and your primary problem is allergies, I would suggest that you are probably on the right treatment for the condition.  Please consult with your allergist to confirm or take a second opinion. I hope this helps.  Take care and have a nice day !",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medication is suggested for hard lump on the middle of pectoral muscle?\n\nI have a hard lump on the middle of my left pectoral muscle. It s like a small pebble size, a huge spot. But can t pop it. It s not near my nipple but the very middle of my peck. What is this? I have taken steroids also so may be them but what do I do and will it go away, on its own?",
    "doctor_response": "Hi Hope this message finds u in good health.I have gone through ur msg and understand your concern.it may be simple cyst,or a lipoma or any soft tissue swelling. you should get a ultrasonography or an mri to see the extent of the lesion.aspiration of the contents and sending it for histopathology will give a clue towards the diagnosisGet back to me for any  FOLLOW UP QUERIES anytime.Regards,Dr Mahaveer Patil...(MBBS,MS,Mch)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child with high fever, pain on urination, abdominal pain. What should i do?\n\n6 year old male with high fever, pain on urination, lower right side abdominal pain. CT scan inconclusive for appendix. Urine culture showed no growth. Augmentin given for UTI. After almost 48 hours, still running high fever and pediatrician puzzled with no growth urine culture. Appointment made with pediatric nephrologist in two weeks. We are worried. He's had no history of UTI in the past. He has had intermittent low grade fever  with and without hives present over the last few weeks. No other symptoms. What could we be looking at?",
    "doctor_response": "Hi friend, Welcome to Health Care Magic Fever is generally due to infection. It is not always easy to pin point the cause. Augmentin is a good antibiotic - give another day or two / Some fevers settle down by fourth day only / if not, the child needs to be examined again...and the antibiotic changed.... Take care Wishing speedy recovery God bless Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause oddly tanned semen while having kidney stone and blood mass removal from bladder recently?\n\nI had two surgeries about 2 weeks ago...first for a kidney stone removal and then another surgery to remove a blood mass in my bladder. They may have had to cauterize some bleeding from my prostate. My semen is oddly tan or not clear. I also got an infection. I believe epidemistis and am on a two week course of CIPRO . Can you tell me what this is?",
    "doctor_response": "HelloThanks for query.Change in colour of the semen is mostly due to infection of the prostate which is common after the endoscopic surgery for removal after the mass in bladdr, .It will get cured with antibiotics taken for 4 weeks .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does generalized parenchymal volume loss with dilation of superficial sulci overlying both cerebral hemispheres suggest?\n\nI just had an mri, and it say\u2019s there is generalized parenchymal volume loss with dilation of superficial Sulci overlying both cerebal hemispheres; volume loss greater than expected for the patient\u2019s age and without lobar predominance. No hydrocephalus. I am 58 years old. Is this bad?",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Findings may suggest age related atrophy.These are expected findings with age. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold and chest infection\n\nHello My Uncle has scarring of the lungs and about 7 year ago he had a stent put in This has worked OK apart from chest infections occasionally cleared up by anti biotics.For about 3 months now he has had what some would describe as a cold but its not obviously lasting all this time. He is 86 years old slim build and no weight problem.He is about 5 8 tall Thank you",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, you should consult pulmonologist for your uncle. Scarred lungs can cause bronchitis and chronic lung infection like tuberculosis. And both of them can cause recurrent cough with expectoration. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. PFT (pulmonary function test) 3. CT thorax. He may need inhaled bronchodilator and inhaled corticosteroids (ICS) and anti tubercular drugs on the basis of reports. Don't worry, he will be alright. First diagnose the cause and then start appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wishing good health to your uncle. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is dengue recovered patient's thoughts and intelligence be affected?\n\nHi doctor online! Please let me know if the dengue recovered patient's thoughts and intelligence be affected? I have a colleague who had just recovered from the virus but she dramatically change her attitude ... from silent type to talkative.  Me and my co-workers are really wonder if it has something to do with her sickness?... Thanks a lot and more power - Tess",
    "doctor_response": "Hi,Welcome to HCM.Dengue presents with a combination of rash and fever and gets complicated when it presents as dengue hemorrhagic shock where patient has severe bleeding episodes, low platelet count and disseminated intravascular coagulation. There is no affect on the thoughts as such. Your colleague might just be happy that she has recovered from her illness.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back pain radiating down the legs?\n\nHi i am 35 years old man sufffering from lower back pain redating to lower legs since 3 years ...nearly every month there is one back pain atakc cause me to sleep in the bad 3 to 4 days last MRI report says \"  technique multi planar, multi sequential MRI of the lumbosacral spine. Thecal sac ends at T12/L1 level : lumber vertebral heights are preserved. L1/L2 no significant abnormality . L2/L3 : there is a sequestered disk that extends inferiorly and compresses on the thecal sac and nerve root at left lateral recess. L3/L4: there is a mild diffuse disk bulge. No significant central or foraminal stenosis. L4/L5 mild diffuse disk bulge with no significant central or foraminal stenosis. L5/S1 there is annular tear with a small central disk protrusion. No significant central or foraminal stenosis.\" I'm looking fowrard for your advice soon. ibrahim YYYY@YYYY",
    "doctor_response": "Hi,It seems that there might be having some disc lesion producing pinched nerve pressure giving Sciatica pain.Consult orthopedic surgeon and take his advise.Go for short way diathermy, lumbar traction.Do back extension exercises daily.Use hard bed for sleeping.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Renal transplant done. Persisting fever. Worried\n\nHi Samuel,The renal transplant has been done in Aug, 2011. It was going well till last month. However, suddenly fever started from this month May, 2013. Did all tests (Blood/ Urine, CT Scan, X-ray etc.), Every report is normal (-ve). Unable to get the exact reason of fever. From last 15 days, doctor giving Metacine/ Paracitamol for fever and asking for multiple tests. But no result so far.Please suggest. I am very much concerned.Regards,Ranjan",
    "doctor_response": "Hello!prolonged fever in a post transplant patient is not a good sign. because of the immuno compromised state, the patients are vulnerable to get infection, which are usually not easily detected and once detected then very hard to treat. I think you need more investigtion to rule out the disease and then to get proper treatment. Also, you have not mentioned about your urine output?thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for child suffering from runny nose and vomiting\n\nMy two year old grandson has been throwing up off and on for about a week now. When he does it is clear in color with white chunks and smells like poop. The first time was last Wednesday, then on Sunday and again today. after he does he says what happened why am I wet and I feel better. Other then the throwing up there is no fever, a runny nose and gets tired right before and after. Not sure what to do. The doctor says that I am the parent and if I feel like there is something wrong to take to the ER. Please advise",
    "doctor_response": "Running nose and cold can be treated with cetrizine probably the child is swallowing nasal secretion & mucus that is why white flakes and fouls melling pops lik is seen in vommiting citrezine can be given for 3 to 4 days ,it reduces throwing also",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and headache followed by seizure?\n\na few nights ago i got really light headed and dizzy following me collapsing and my friends said my eyes started moving as if i was about to have a seizure since then i have been having headaches located mostly on the back right side of my head. what could be causing this?",
    "doctor_response": "Hi, I am Dr.Bruno.  I have read your question with care and understand your concerns. Let me try to help you Question : What causes dizziness and headache followed by seizure?Answer : These are called post ictal effects. The dizziness and headache are because of electric and chemical changes in the brain Hope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffer from seasonal allergies, use sinex nasal spray. Allegra not working. Medication?\n\nI suffer from seasonal allergies,for years I used sinex nasal spray & my congestion would open up my nasal. I would get from my doctor a script for allegra before it went over the counter & he would give me singular but it seems that hardly anything works. Is there anything out there that would help me.Because when I can't breath thru my nose I start to panic. What should I do. I seem to be getting worse from nasal passages getting clogged up.",
    "doctor_response": "hello there! i can understand the agony you have. Change the medicine. start using Sudafed NAsal spray.Do you know your allergens, triggers and precipitating agents? try to avoid them.. use a surgical mask out side and indoor too if allergen is indoor.Sublingual immunotherpies are used for symptoms not controlled by decongestants. but they are not allowed in US yet. Approved in europe.Hope i was of some help. i will be here if you need any further, my profile has my contacts.RegardsDr Shafi Ullah KhanMy patient is My family",
    "dialogue_context": ""
  },
  {
    "patient_message": "What might be the reason for soreness in the cheek bone and swelling in the jaw?\n\nI have been having an issue with my cheek and possibly parotid gland. My cheek feels like it could have a canchor sore internally under the cheek bone. If I rub it slightly it aggravates it and then when I eat under my jaw swells up quite noticeably but goes down within the hour or so. I am on my 10th day of antibiotics and feel like the issue is still there. Any idea what it might be. It s been about 3 weeks",
    "doctor_response": "Hi, It can be due to stones or inflammation in your salivary gland also known as sialadenitis. You can consult a general surgeon and get evaluated. You have to take an ultrasound scan for further assessment. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for memory loss\n\nI WAS GOT DEPORTATION  FORM 2 YEARS AGO WHEN I WAS ON CANADA AND I DIDENT GOT ENY QUIRE NOW I FEEL LIKE I LOSE MY MIND AND I WAS BE SO ABSENT  I LOSE MY WIFE AND MY WORK EVRY THINK AND EVERY DAY I WEAKD UPLIKE NEW MAN WHAT SHOULD I DO I WAS GO 2 Psychiatrist FORGET UR WIFE AND UR LIFE AND FORGET CANADA I LOVE CANADA SO MUCH IT WAS THE FIRST TIME ON MY LVE I FEEL AIM HUMAN HERE IN CAIRO EGYPT AIM NOTHING SO I TACE SOME MIDETION AND AFTER THAT I FEEL EVRE DAY IAM NEW MAN LIKE NEW LIVE I HATE MY FAMILE MY DR EVREY THINK HERE EVEN TALK ARABIC I HAT THAT WHAT SHULD I DO AND MY FAMILY THEY ARE RESESS THEY DOESNT LKE AMRCAN OR CANDIAN PEAOPLE AND I HATE THAT I FEEL LIKE AIM BABY HERE I 31 YEARS OLD",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  From the given description it is very difficult to diagnose your problem. it does not seem like amnesia or memory related disorder. This could more be like some sort of anxiety disorder or depression. you need to work with your psychiatrist to have a proper diagnosis and treatment.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for breast cancer\n\nHi, my mother had breast cancer. A year and a half ago she had a successful lumpectomy. And the dr. advised she have radiation treatments to further make sure that it was good to clean up any possible bad cells that might still remain. 33 treatments of external radiation. Now a year later she hurt @ her breast bone and breast that was treated. she also spit up a lot of foaming softer flam. She visited her general PR actioner dr. He thought it could be poisoning from the radiation treatment ? Any suggestions would be appreciated. THANK YOU !!",
    "doctor_response": "hello  get a routine pet ct scan done to evaluate any possible avid shadows after post radiotherapy status and take plenty of multivitamins antioxidants and nutritious diet and possibly consult a medical oncologist for routine evaluation  and also try homeopathy for conventional relief along with other therapies ..iwish ur mother a speedy recovery regardsdr ankur prakash m.d",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with bronchitis, on nebulizer and Prednisone, bad lower back pain. Why ?\n\nI was diagnosed with bronchitis today. They have me a nebulizer treatment and a Rx for prednisone . Before I left that I gave me a shot of it to jump start it before I start the pills. Since late this afternoon, I have had bad lower back pain . The nurse said it could cause a charlie horse, but didn t mention back pain.",
    "doctor_response": "Hi Thanks for your query Look this first dose of steroid cannot cause low back pain. Long term use of high dose systemic prednisone can cause low back pain due to osteoporosis. I think in your case there is other cause of low back pain. So i advise you to go for atleast a digital x-ray of pelvis and lower lumbar vertebrae to exclude causes of low back pain. This low back pain may also be due to para-spinal muscle spasm. You may take analgesics with muscle relaxants for pain relief. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My mother is suffering from a mental disorder for 24 years. Can she recover?\n\nRespected sir/madam, My mother has been suffering from mental disorder since 24 years (from my birth) . My dad took her to the hospital and undergone treatment also but no use , after up to 2 years prescribed medicine also used . It had been 20 year of not using any medicine and treatment . Since my birth i hadn't my mother's love and care . Now I want to get her treatment . Her condition right now she is healthy , don't remember anyone ,quiet calm , sometimes do whatever we told. Is there any chance to recover ? Please give me some advice as I don't know what to do?",
    "doctor_response": "Hello , I am sorry to hear about your situation. I can imagine how hard it must be for you. In your query you have not mentioned the diagnosis so I can't suggest exactly what needs to be done but I will explain how it works .. The fact that you mentioned that she doesn't remember anyone could be a part of 1. Dementia for which you would require a neurologist , Medications can help to an extent . 2. Psychosis or Depression can have such reactions , you will require a Psychiatrist for this . A complete evaluation is required , the doctor might do a CT/ MRI depending on the symptoms and start treatment accordingly and yes Medications can help to an extent depending on severity of the issue. One way is to get her treated on OPD basis ie at home with followuos with doctor , or you can opt for residential treatment facilities which keep the patient in the facility and there is a holistic approach to treatment where doctor , nurses , therapist , etc works as a team in recovery . I would need more information about symptoms or need to talk to your mother to be able to understand exactly what she is going through . I hope this helps .. Feel free to contact me if you have any questions. take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get a popping and locking sensation in the jaw. What can be done about it?\n\nHello doctor, I usually get a popping and locking sensation in my left jaw which happens while eating and getting up in the morning. I also have a partially erupted wisdom tooth in that part. I read about TMJ on the internet and I am getting anxiety because of it. I am very afraid. Recently, the jaw got torn I think and I could not put my teeth together on the left side. It healed after five days of taking Zerodol-MR. I do not know what to do. Please advise as I am constantly thinking about it.",
    "doctor_response": "Hi. There is nothing to be afraid of. You seem to have recurrent disc displacement. The main cause can be the one you mentioned, your half-erupted tooth. I suggest you get it removed and make sure you eat from both the sides. The joint gets stressed if you eat from only one side and that causes lockjaw.If you have any cavity get it filled as soon as possible. Make sure during wide mouth opening to hold your jaw with your hand in front of the eye. Check TMJ exercises on the internet and do it in front of the mirror daily. You will get healed within months. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicine and dosage for kidney stone\n\nDear Sir i am a man 30 years old having small stone in my right kidney my Doctor proscribed me syrop. Portrate MB, i could not find it in the drug store would you please guide me the exact name of the medicine as well as the dosage? YYYY@YYYY",
    "doctor_response": "Hello and welcome to HCM.As an Urologist, i can suggest you take potassium magnesium citrate, which is available as tablets, syrup or sachets. Different companies market the same product in various names, like Stone-1 MB6,Alkaston MB6, etc, which are same as Potrate MB6.You should be able to get in most medical stores.Taking an alfa blocker like Alfuzosin with that, helps expel stone faster.If you send details to me as a direct question,i can give expert opinion.Drink 12-15 glasses liquids daily. Wish you good health.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce weight and conceive quickly?\n\nI am 22 yrs old female,Height 5.6 and my Weight is  61 kg. I am trying to conceive but I went through a pelvis Ultrasound which says iam having polycystic ovaries.please suggest me how i should reduce my weight and could conceive quickly.Married life 5months",
    "doctor_response": "Hi, thanks for writing..Reduce weight by diet control and exercise including aerobics. Avoid fatty, oily food. Take small amount of food at correct time.. Do you have regular periods? Irregular periods should first be treated. You can try for spontaneous conception for 1 year before taking any treatment..PCO can be an isolated finding in scan  without any symptoms. It doesnot require any treatment. Hope I have answered your query. Good day..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had flu like symptoms, developed into bronchitis, middle lobe pneumonia. Why do I have severe cough, back pain?\n\nI have been ill for nearly 8 weeks. It started out with flulike symptoms, developed into bronchitis in which I was treated with 10 days of levaquin and prednisone , turned into right middle lobe pneumonia which I was treated with zithromycin, tessalon pearles due to severe cough with pink sputum, and atrovent inhaler due to SOB. After I finished the zithromax my right middle lobe pneumonia resolved, my WBC s went back up to 14,000, Lymphocytes were 9 and sed rate was 63. My chest x-ray now shows that I have left side pneumonia. My physician ordered aCT scan of my chest today which shows I have a pericardial effusion. He wants me to go to the hospital tomorrow to have an echocardiogram. I currently am SOB, especially when I lay down at night, have had severe left sided pain under my breastbone radiating to my back, severe coughing episodes, and when I cough it tastes like amonia. The last Metabolic profile that I had done 2 days ago showed no abnormalities. Should I go to the ER or will I be OK to wait until tomorrow to have the echo. My symptoms seem to be getting progressively worse?",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for calling H.C.M.Forum. You had flu like symptoms , then right mid lobe pneumonia, then left side pneumonia,then pericardial effusion.Difficulty on lying down. It appears there is certainly a long way to travel, in the mean wile you should be cautious about the breathlessness , and you should have all the medicines necesory to have in hand for emergency. Being an on line doctor i cant be sure of what is going on, still i suspect tuberculosis or pericardium, which can be confirmed by examination of effusion fluid after the pericardiocentisis. Your question is do you have to go to ER or wait till morning. I advise you to go today only to be comfartable till tomorrow morning. Pericardiocentesis and use of  probable drugs will solve your problem to great extent. Wishing for a quick and complete recovery. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking fertility treatment, cycle of 25-35 days. When will ovulation happen? What are its symptoms?\n\nHI DOCTOR                 I'M 20 YRS OLD AND MARRIED. NOW I'M TAKING TREATMENT TO GET PREGNANT FROM THE LAST MONTH.MY MENSURAL CYCLE IS 25-35 DAYS CYCLE.I WANT TO KNOW WHEN THE OVULATION WILL HAPPENING IN MY BODY AND WHAT ARE THE SYMPTOMS FOR OVULATION ALSO I WANT TO KNOW WHAT ARE THE TIPS TO BE FOLLOWED DURING OVULATION LIKE(AVIODING ANY FOOD ITEMS,REDUCE TAKING MORE STAIN BY CARRYING WEIGHT ETC...).SOME DOCTORS SAYS AVOID INTERCOURSE AFTER 25 TH DAY FROM MENSURAL CYCLE BCOZ IT MAY AFFECT OUR EGG IF OVULATION IS COMPLETE WITH SUCCESSFULL LIKE THAT...IS THIS TRUE OR NOT...",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum. Let me explain when ovulation occurs as , Menses date  1 September ( bleeding starts ) now ovulation occurs any time 14 th September , 15 , ( in 95 % cases). When ovulation occurs there develops mild elevation of temperature ( 99-99.5 F ). Mild degree tenderness either on left or right side depending upon the site of ovulation . Release of ovum is not effected by intercourse at all , all these are myth. Release of ovum depends upon maturation of ovarian follicles and their ( its) burst . So deal according to your need , everything is scientifically proved. Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible with PCOS and multicystic follicles?\n\nHi mam.. i am 26 yrs old.. ttc for 1 year.. last april i was diagnose PcOs .. the impression was multicystic follicles with dominant follicles bilateral vs polycystic ovaries with dominant follicles bilateral... is their possible i get pregnant in this condition? I am taking metformin 1000mg for almost 4 mos. And folic acid 10mg.",
    "doctor_response": "Hello dearI understand your concernPCOS is very complex disease and difficult to manage.But pregnancy is possible once hormonal imbalance is corrected.I would suggest to consult the authorized gynecologist and take proper treatment.Following medicine will help you to become pregnant.Progesterone pill in the second half of the periodClomiphene citrate: it help to induce the period and maintain fertilityFSH analogue can be usefulIf medicine will not responds then surgical process like ovarian dreeling can be useful to resolves the cyst.Avoid stress, take healthy diet, drink plenty of water and do regular exerciseHope this may help youContact HCM for further health queryBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is hepatitis C curable?\n\nhello doctor,my mum has been diagnosed with hep c due to an incidental finding,we are doing her hcv genotype and RNA quantitative test.Her liver function test are still functioning normally and has no jaundice.What are her chances of recovery right now??She had a blood transfusion in 1989 following a hysterectomy.The doctor who examined heraid that left lobe is cirrhotic while the right lobe is enlarged.What are the treatment options and prognosis??Thanking you in advance",
    "doctor_response": "Hi,Thanks for posting your query.I am Dr.R.K and I am pleased to assist you.The outcome of the treatment depends on the genotype. Genotype 1 responds poorly to treatment whereas 2 and 3 respond better.The treatment is with Peg interferon and ribavirin. Now a new drug sofusbuvir is approved for treating hep C with good response.But your mom is already showing complications of Hep C in the form of cirrhosis. She has to undergo tests for complications of cirrhosis.Another  complication is liver cancer and tests are to be done for this also.I hope that answers your question.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for metastatic prostate cancer?\n\nHi, may I answer your health queries right now ?  Please type your query here... My husband has metastatic prostate cancer to the bones, he is  88yrs old, and is on chemo medication and 3monthly injections. this was discovered after being treated for severe arthritic pain in the neck and shoulders.what is his prognosis. Thank you. June",
    "doctor_response": "Hi,Thanks for writing in.The treatment for metastatic prostate cancer is by chemotherapy and radiation therapy.Surgery is not possible in a person who has metastatic prostate cancer. This is an advanced disease and cannot be cured completely.For symptomatic relief and to slow down the disease process, radiation therapy might reduce the pain from the cancer and chemotherapy will kill and control the cancer cells. Pain is also important to control and he is also having arthritis. He might require pain shots in the neck and pain relief for cancer symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do i do for re-fills prescribed by the psychiatrist?\n\nMy past Psychiatrist, Cynthia Evans, moved her location which is too far to travel. My family doctor, took over prescribing the medication she had me on. He did this for 4 years, now he is not giving me re-fills. I cannot stop this medication. What should I do?",
    "doctor_response": "HIThanks for using healthcare magicI think, in you case, you should consult another physician or psychiatrist for refill. If these drugs are important for you and you can not stop them, then try to find another doctor, who would able to prescribe these drugs. In case, you need our help, you would happy to help you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had bilateral mastectomy, hysterectomy. Altering diet enough instead of hormone blockers?\n\nJust had bilateral mastectomy because I had a tumor 1.2 in my rt breast and no positive nodes. The tumor was estrogen and proestroge.  Both of my breast had numerous cyst and drained for 28 years.  I kept up with mammograms, thank GOD.  I have had a hysterectomy about 12 years ago.  I have been researching hormone blockers and I don't want to use them.  If I change eating, add dim, iodine, D, B, exercise and loss weight will it be okay for me to not take the blockers.",
    "doctor_response": "Hi; Hormone manupulation therapy for breast cancer is proven treatment with multiple randomized trials which have shown survival benifit in patients whose tumor have hormone receptor. So you are strongly advised to take those medications. Regarding alternative food and diet,you can follow them but they are not substitute to hormonal therapy. Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes impertinent behavior in an adolescent?\n\nMy 18yr old son has become mote disrespectful toward family but mostly me (his mom) he has become parAnoid we now have to lock the doors and got himself a gun and concealed carry permit. He hates accused me of stealing money from him 6 different times but only mentioned it today. He says I m a lying,stealing bitch. Says I ve always been a bad on and all his problems are my fault. What is this?",
    "doctor_response": "Dearyour child need immediate attention May be early psychosis or mood disorder detailed evaluation and treatment is needed Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes foaming from mouth and nose while lying unresponsive?\n\nMy mom was found unresponsive on Thursday I m her bed 38 like foam was coming out of her mouth and nose her mouth was real stiff and looked real thick she was completely unresponsive she would gasp periodically but that s all she is still intubated and tnere not acting like they know much please help me",
    "doctor_response": "Hello dear friend,I really feel concerned and pray almighty for all the good ,he can do for you.It appears by the short history given by you that your mother had this acute event of unresponsiveness with frothing from mouth.Most likely causes in this setting can be-1)toxin-accidental intake of any poisonous substance2)Seizure- a fit or seizure is usually accompanied with a tonic contraction of limbs and neck with face along with frothing from mouth3)stroke-frothing is uncommon in stroke,but still in any case of acute or sudden unresponsiveness,a stroke is always a consideration.Important investigations in this case are a brain imaging-computerised tomographic(CT) scan or magnetic resonance imaging(MRI) scan,to detect a stroke or any other brain pathology.Electroencephalogram(EEG) to see brain cortex activity whether there are any ongoing non-convulsive seizures causing unresponsiveness.In case of poisoning,if suspected,measures like gastric lavage and diuresis may help(depends on the type of poison).Also,other investigations like cerebrospinal fluid analysis may help sometimes(to be decided by the treating physician)You need to discuss the possibilities with your treating physician and plan accordingly.I hope it helped a bit.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes changing mood?\n\nI think im crazy; i have these crazy mood swings several times a day, somtimes im really hyper and i piss everyonr off.other times i feel really sad and i hate myself!!!ive tried looking for help online but i keep getting told its nomal teenage drama; im 15",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. You are just 15. The description you gave is not enough to diagnose perfectly. If you require proper diagnosis, you need to provide more information.You should also know more about teen age. You are crossing an important mile stone. You will be confused among so many things about role identity, gender identity, family and peer identity, social identity etc. Over and above your parents could be treating you \"funnily\". These combined together, brings restlessness and other associated emotional problems in teen age. Also certain disappointments in lif events adds fuel to the problem. Understand that you are learning LIFE.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain post the breakage of ribs?\n\nMy friend broke 3 ribs 18 months ago at the age of 81. He was in severe pain and the ribs took a few months to heal but ever since the accident he has had upper back pain and can t sit in an upright chair for very long. He had swelling below his shoulder blade immediately after breaking his ribs but the doctor didn t seem to take an interest in it.",
    "doctor_response": "Hi ,Welcome to healthcare magic. You are right rib fracture generally heals in 2-3 months. But sometimes healed fracture  may remain painful for many months. Don't worry about swelling.It is callus formed in the process of healing of fractures. It will gradually reduce in size and may disappear. You can take analgesics(Diclofenac sodium 100mg slow release tablets) for pain relief.He is advised to check his  serum vitamin D level and if it is low then supplement this.I think this will be of use to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a density in liver on CAT scan?\n\nHello Dr. Grief, Pardon me, but really, Grief? No disrespect to your family name, it just kinda scares me, lol. Anyway, my son recently had a cat scan that shows a density in his liver. What does that mean? And what could it be? Sunday Blessings, Jo",
    "doctor_response": "Hello It is important to know more details about density.Decreased density may be due to many reasons like cyst,mass etc.Increased density may be hemangioma,hemorrhage,mass etc.Mixed density may be abscess.It is also important to know enhancement pattern.Treatment plan depend upon findings.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will taking nordette after 5 days of sex prevent me from getting pregnant ?\n\nI did it with my boyfreind last june 8--around 3:00 pm it was my first. We used the withdrawal method as it has lower chances of getting me pregnant ... although we used that method I am getting paranoid all of a sudden and took nordette last june 13-- around 9:15pm (4 pill first then after 12 hours another 4 pill, total of 8 all in all) Will it still be effective as i took the pill at 127 hours after our intercourse??? please help me with this im sooo worried and getting paranoid, i cant even sleep at night. please help. I wanted to make sure im safe...",
    "doctor_response": "Hi, Welcome to Healthcare magic forum, Withdrawl method is not so safe, since there are chances of sperms being in pre-cum, its advised to take contraceptive pill within 72 hours to be effective, since u have taken after 127 hours there are chances of not effective. Now the only way for u is to wait till ur due date, if u get ur periods then relax, if u dont then do a urine test to confirm pregnancy, if it shows positive meet a gynecologist before 40 days so that u can take pills for aborting. Hope I have answered ur question, Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could extreme pain in arms and legs be diagnosed as Epstein Barr virus?\n\ni suffer from extreme pain in both arms and legs. i was diagnosed as having Epstien-Barr virus with Parkinson like symptons. i dont believe that is what it is. i have been dealing with this for close to 10 years. i take pain meds but they dont kill the pain. at times i want to cut off my arms or legs because the pain is so severe. sometimes it feels like the bones are going to shoot out of my arms thru my fingertips. could this be bone cancer?",
    "doctor_response": "I understood your problem. you can go for physiotherapy treatment. in Physio treatment ,many pain modalities are available such as Tens,Ift, etc..active exercises for arms & legs.do some yoga & meditation for 15 to 20 minutes ,it reduces toxins from the body.you can join Art of living courses.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for weak erections with sperm leakage\n\nHai sir, as I was searching google got ur website,actually am having weak erections and from last 15 days am getting sperm leakege from urine pls help me out to get rid of this problem and tell me how to get good erction without falling my penis soon.",
    "doctor_response": "Hi,It is important to know if you were sexually active in recent times before your symptoms started. It is possible that you are having a urinary or urethral infection causing the symptoms and it is not sperm leaking but pus formation. I strongly suggest that you consult the urologist and get clinically examined for your problems. The loss of proper erection can also be due to the same problem if it is of recent onset and both the symptoms have developed together. If it is not an infection, then it is most likely due to stress related anxiety and the urologist will confirm it and suggest appropriate treatment. Both conditions are completely treatable and please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Has prostate cancer, PSA increased. On hormone therapy and radiation. Done blood test. What is wrong?\n\nThank you for being there.  We are beside ourselves.  My son-in law has prostrate cancer; 2009 he had a prostectomy, 2011 radiation, and now his PSA has doubled (1.3 > 2), Gleason of 9.  Before he has any more surgery, radiation, or hormone therapy - we'd like to rule out any fungal issues.  Is there a doctor any where in West Michigan that understands the antifungal issues that impact prostate cancer?  My son-in-law is active, healthy, wife and 3 beautiful children (13, 15, 17).  Could the last blood test have been \"wrong\"?",
    "doctor_response": "If the PSA is 2.there is nothing to worry., because the upper limit of normal(ULN) 4ng/ml, but you should repeat the PSA., then consult your oncologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is male to male sex safe?\n\nhi i am 23 years old male .i had sex with a 26 year old male.we had oral.i placed my penis between his legs and enjoyed sex.but nw we are planning to have sex without oral.is it safe.also whenever i feel a touch from other male i trying to sex with him is it bad",
    "doctor_response": "DearWe understand your concernsI went through your details. One aspect of society's emotional reaction to homosexuality is that it is \"different\" and unnatural. Understanding homosexuality is the key.These safer sex recommendations are agreed upon by public health officials for men who have sex with men to avoid sexually transmitted infections:1. Avoid contact with a partner's bodily fluids and with any visible genital lesions.2. Use condoms for anal and oral sex.3. Use a barrier (e.g., latex sheet, dental dam, cut-open condom) during anal\u2013oral sex.4. Cover sex toys that penetrate more than one person with a new condom for each person; consider using different toys for each person and use latex or vinyl gloves and lubricant for any sex that might cause bleeding.Be safe and enjoy.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe cold feeling in leg?\n\nhey (: teisted my ankle/like a week ago and it was swolen couldnt step on it so i rested/spared the food and now i can walk again but i still use crutches and i lean on the leg and there is no pain/today actually couple of hours ago i noticed leg is coldish/not crazy cold or anything but definitly coldish and i was siting a lot in front of a computer so im freaking out now and im under 10 blankets and trying to warm it up!is this normal?cause im freaking out here",
    "doctor_response": "Hi,A sprained ankle produces a good amount of swelling which should be treated with ice, pressure bandage and elevation . If this is not done the swelling will persist especially if you have been  immobile for quite a long time with your computer. This can cause slow blood circulation of the limb. Are you a diabetic? if so the blood flow to the feet will be usually sluggish.Take care of the swelling and do some stretching exercises of the ankle,toes and knee.If you still feel the limb is cold then you need to consult your doctor.Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does shoulder dislocation cause severe pain?\n\nMy daughter had a dislocated shoulder which her primary care doctor discovered and popped back in yesterday. she felt little pain before it was replaced as well as for the remainder of yesterday. however today she has a lot of pain which she is treating with Advil. The doctor felt she should not experience a lot of pain but did prescribe her prescription strength Advil. Is this day after pain to be expected? Thank you.",
    "doctor_response": "Hello, Shoulder dislocation can cause severe pain because the tendon and ligaments are injured. As a first line management, you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist consult an orthopaedic and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sore joints from neck to toes following a fall\n\nI fell down in livingroom after sliding on a toy truck, did the splits, right leg went back landed on knee while left leg out straigt, had a child on my left hip. I have went to chiropractor twice but I am sore from my neck to my toes, any suggestions or how long can I expect this? the fall was 10-02-11",
    "doctor_response": "Hello, Your complaints are not specific,if you are able to walk or not or able to bear weight on your affected limb,what about swelling or tenderness. As of now if there is no such significant complaints my advise is to do icing at sore points,and to give rest to the affected part in case of any of the significant complaints get s xray done of that part. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Rohan Shanker Tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for wheezing while sleeping\n\nI have gurgling, wheezing noises when I lie down to sleep, cannot clear it with coughing.  Do have pnemonia, was given antibiotics, albuterol inhaler and told other meds to take.  Have been sleeping last 2 nights sitting up due to the noise.  Any suggestions to get rid of the noise?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Breathing difficulty, wheezing during lying down (sleeping) are seen with bronchitis and heart failure. So better to consult doctor and get done blood pressure monitoring, ecg, 2d echo, chest x ray and PFT (Pulmonary Function Test). Ecg and 2d echo are needed for heart failure. Chest x ray and PFT are must for the diagnosis of bronchitis. Treatment is based on diagnosis. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heat, tremor, dizziness, syncope feelings, heart palpitations during a pregnancy?\n\nhello, i am 33 weeks pregnant and for the last 2 weeks i have been having these attacks where i get really hot and shaky and dizzy and feel like im going to pass out, but i never do pass out.  i can feel my heart start beating really fast when this happens.  the drs have said my sugar is good im not dehydrated.  they keep telling me im fine. what could this be?",
    "doctor_response": "Hi dear, I have gone through your question and understand your concerns.Pregnancy is associated with increased levels of progesterone hormone.It can cause decreased blood pressure, sudden dizziness and syncope.It is normal if your doctor has examined you and ruled out other causes of dizziness and syncope.I will suggest you to avoid standing for prolonged hours.Hope you found the answer helpful.Wishing you good health.RegardsDr Deepti Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for itchy skin in between buttocks and penis\n\nHi the seam between my balls and anus is extremely itchy and sore now I wasn't worried about it till it started  bleeding. I'm not gay so I don't think it could be a sti. But it's been like this for a week and it's to imbarrising to go see a doctor face to face. It's scaby red and a little bit inflamed what is it and what can I do about it?",
    "doctor_response": "Hello,You can have fungal infection rash over that area. You can apply topical steroid cream and clotrimazole like anti fungal cream over that. Wear loose cotton cloth. Don't wear tight cloths. Keep that area dry and moist free.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat bladder infection?\n\nI have had a bladder infection the past few days but it is now gone,before I had this I had thick discharge but didn't smell.im now worried as I have discharge with blood in it.im on the contraceptive pill and it hurts when I have sex.what could this be?",
    "doctor_response": "Dear I can understand  your  concern . I would  like  to  inform  you  that  urinary  tract or bladder infection  is very common  in female  and should  be treated  adequately . It may be because  of  some sexually  transmitted  disease  also. You need complete  work up with urine  analysis  and urine culture and get complete  course  of antibiotics  depending  upon  culture report . Till then drink plenty  of water and maintain  local hygiene  etc.Hope this  will  help you .  If  you  have  any  other  concerns  please  feel  free  to  message  me .  Thanks  for  contacting  HCM .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it due to seizure there is difficulty to concentrate?\n\nsir, my 11 yrs son is a delayed in all his activities after his birth. Now he can t read and write at his own. One episode of seizure occured in 2002 and given valporin three yrs and encorate tab three yrs. Please suggest how can we improve his study.....",
    "doctor_response": "Hello,Anti-seizure medications may contribute to cognitive delays. It is advisable to discuss with the Doctor for the possibility of stopping if he is using any of these. If no current drugs, then special training may be necessary.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of miscarriage?\n\nI am sexually active and take birth control pills. I chose to skip 2 periods just by taking the next pills in my case and skipped the sugar pills because I was traveling and did not want to have my period. I had my period at its regular time last month. I am due to have it again in a week. However, today i suddenly starting bleeding a lot at one time and some big clots came out. Am i pregnant? Did i miscarry? Or could it just be bleeding in between periods because I skipped two on purpose?",
    "doctor_response": "Hello, and I hope I can help you today.Is extremely unlikely to become pregnant on birth control pills, especially if you extend your cycle by taking the pills longer than necessary rather than missing any. Using birth control pills to suppress your menstrual cycle is medically safe and usually effective. However in some cases you can have what is called \"breakthrough\" bleeding where your period can sneak through at the wrong time even though your taking the pills correctly.There are birth control pills that are actually prescribed to make your period, only every three months; these brands basically are just three months of active pills in a row and then taking a placebo week every three months. The issue with suppressing your menstrual cycle with the pill, is that frequently it doesn't work until woman has been on three months cycling for six months to a year. Breakthrough bleeding is the most common side effect that women complain of when being on extended cycle oral contraceptives.So I really do not think you need to worry about having had conceived if you took all your active pills correctly. The best way to stop the bleeding at this point is to stop taking the pill for week... Which will reset your cycle and then you will be able to begin a new pack which will end this particular cycle.Suppressing your menstrual cycle also works best with pills that are the same dose all month long and are not particularly low-dose oral contraceptives. Depending upon your situation, if you decide that you may want to suppress your cycle to avoid menstruation, you might want to discuss the brand of pill you take with your gynecologist and possibly changed to one of the brands of pills that are designed for three months cycling.I hope I was able to adequately answer your question today, and that my advice was helpful.Best wishes, Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for vomiting and throat pain in a child\n\nMy friend drank 4 to 5 drops of harpic toilet cleaner and vomited a lot. She is experiencing pain in her throat and is refusing to visit a doctor.she has not taken a drop of water after drinking harpic toilet cleaner.what should we do now? What medicine should she take?",
    "doctor_response": "She should take charkol 1 tab for every her 10kg 5 days, if she is 20kg-therefore 2 tab. ORS 1 litr. For throat- almagel 10-15 ml 3 times for  1 hour before meal 10 days",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the advantages of taking ubiq during IUI?\n\nHi, I am married for 2 years and trying hard to conceive. Consulted a doctor and came to know that I had PCOD condition. I get my periods regularly, my tubles are patent. MY husbna'd count seems to be very good. We tried IUI for a more than 4 times and it landed up being a failure. I have been adviced to take Ubiq + by my Doctor along with Letroz 7.5. PLease let me know about the advantages of taking Ubiq + as far as my condition is concerned. Also, would like to know if I will be able to conceive or not, as it really puts me down evertime I get my period after trying so hard to conceive. Please suggest...",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.Ubiq contains clomiphene which stimulates ovaries and help in developing follicles, so in IUI intrauterine insemination follicles become helpful in fertilization.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in hip bone and difficulty in walking?\n\ni have had this lower back hip bone pain for long time .....seen the doctor but says its just a normal pain take tylenol.....but i really want to know if there is any other solution to this pain.....i cannot walk when i have this pain....it seems as if the hip is going to crack off...please help me",
    "doctor_response": "Hello, The pain in the hip joint can be due to bursitis, capsulitis or spondylotic changes. The exact cause can be detected after an MRI scan of the hip. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for numerous small foci present in the cerebral hemispheric white matter with irregular heart beats?\n\nI just had an MRI due to having migraines for a week - not like me.  I am 67 years old, but am diabetic from an acute case of pancreatitis, take high blood pressure pills and cholestral meds.  My blood work was good low blood pressure from meds.  My MRI said:\"Brain parenchyma:  Numerous small foci and some patchy confluent areas of hyperintense T2/FLAIR signal are present thout the cerebral hemispheric white matter with relative sparing of the temporal lobes and infratentorial brain panchenchyma in a pattern most consistent with chronic microvascular ischemia.  There has been significant interval increase in the number of these lesions since the previous examination (which was years ago when they increased my blood pressure meds).  The brain parenchyma is otherwise grossly unremarkable.  There is no abnormal parenchymal enhancement.  Hemorrhage:  There is no evidence of intraparenchymal or extra-axial hemorrhage.  Ventricles:  Ventricles, sulci and cisterns are normal for age without evident of mass effect or shift.  Herniation:  None.What is going on and what would be treatment of this?  My father died of a heart attack at 72 years of age, but my mother lived til she was 94.  Could this be a problem with my heart?  I have an irregular heart beat like both my parents.  I am a retired teacher, but still substitute often.  My brother (an opthemalogist) in his 50's just had open heart surgery to replace a valve.",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your symptoms and the MRI brain findings.These small foci of hyperintese lesions are due to ischemia (lack of blood flow to brain). The underlying risk factors for these lesions in your case are blood sugar, high BP and cholesterol. If your heart rhythm abnormality is due to atrial fibrillation, then, that could also be a risk factor.These lesions indicate a higher risk of stroke in you, which can lead to paralysis. So, I would advise you to be on aspirin tablets to prevent stroke in future.In addition, your risk factors as mentioned above should be kept under good control.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Successive failures in IVF, this time has a new symptom of back pain. Is this good?\n\nhi, my sister did the IVF since 6 days ago, and this is the 6th time i guess she did the IVF and she got a negative results, but this time she is facing a new pain, which is the back pain , and she is hoping that this would be a good symptom for pregnancy, my question is.. this may be a good symptom or a bad symptom after 6 days from the IVF? thank you",
    "doctor_response": "Hi, Back pain has nothing to do with positive or negative result of IVF. So its not a good or bad symptom. She can get herself treated for relief of backpain. Wish her good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain, nausea, fatigue and difficulty in sleeping?\n\nhi i have been having chest pain (tightness) some nausea off and on fatigue the feeling of butterflies in my stomach off and on my sleep habits have changed i have been having a hard time falling asleep or staying a sleep and I have been having paranoid thoughts that something real bad is going to happen what can this mean?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. You are mostly having stress and anxiety related GERD (gastroesophageal reflux disease). GERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause chest pain, tightness, pressure, burping, nausea etc. These symptoms are more common in night during sleep because of recumbent posture. So first we need to control your stress and anxiety. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic drugs too. S avoid stress and tension, be relax and calm. For GERD take proton pump inhibitors and prokinetic drugs. Avoid hot and spicy food. Keep 2 - 3 pillows under head in the bed to prevent reflux. Don't worry, you will be alright. Consult psychiatrist and discuss all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could Duodenum wall thickening with vomiting indicate Cancer?\n\nI had a ct scan and it is indicated that the duodenum wall is thickening. I know this is not common and a visit to a gastro doctor came with an answer of two distinct possibilities -- inflammation or tumor like a donut that is closing. I am not keeping any solid food down - no pain or nausea. Will have endo scope tomorrow with then a visit most likely to a surgical oncologist. Is it a high risk of cancer?",
    "doctor_response": "At this point it is difficult to be certain. Duodenal cancers generally present as a mass rather than just thickening. An endoscopy will definitely tell the presence of any overt cancer and also biopsy it for confirmation. If the endoscopy is normal, then you should take some antibiotics and anti-inflammatory drugs for 2 weeks and then repeat the scan. Another option is to get a PET scan done now. I would suggest the former.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion to increase sperm count and motility?\n\nhi i have been married for 4 years but not blissed with kid. we have checked with docters i am fine but my husand sperm count is very low. sperm count is 12million and 30% motality.he is taking ayurvedic medicine himalaya spemen for last 7 months but nothing frutiful result have been achieved. plz docter help me.",
    "doctor_response": "Hello and .As an Urologist,i assure you, sperm count has increased by timely treatmentBut all reports of tests done so far, must be available.   These include :1. Two semen tests reports, checked after 2 days abstinence.2. Blood male hormones tested like, FSH,LH,PRL,testosterone and sugar.3. Scrotal doppler scan, with a TRUS(trans rectal ultrasound scan).4. Medication tried so far, with duration of,  course of treatment.Once this information is available, i can give you give an expert opinion.You can send reports as a direct question to me. Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes calcium oxalate monohydrate stones?\n\nI am a 30 year old female and have had kidney stones for almost 10 years. I have calcium oxalate monohydrate stones. I currently have a 7 mm stone which has passed through the ureter and bladder and is now stuck in my urethra. I know it is uncommon for them to get stuck there, however this is not the first time this has happened to me.  I have been drinking more than 64 fluid ounces of water every day for the past month (ever since I felt this stone and was diagnosed with it) and have been taking flomax along with the magnesium supplements my urologist gave me. Would clitoral stimulation help to move the stone along the urethra? I am just exhausted and in so much pain, but refuse to take the pain medicine. Thanks for your help.",
    "doctor_response": "Hi, thank you for trusting HealthcareMagic.com!I'm Dr. Elton Halili, General & Family Physician.I read carefully your story. Now I'm giving details about your concern:- The main risk factor is hypercalciuria. Do you have members of your family which has same problem as you? Hypercalciuria means that serum cacium is normal but elevated urinary calcium.- Other factors can be primary or caused by excess ingestion of oxalate containing foods (eg, rhubarb, spinach, cocoa, nuts, pepper, tea) or by excess oxalate absorption due to various enteric diseases (eg, bacterial overgrowth syndromes, chronic pancreatic or biliary disease) or ileojejunal surgery. Other risk factors include taking high doses of vitamin C, a Ca-restricted diet (possibly because dietary Ca binds dietary oxalate)- Clitoral stimulation may be a good support, well it's known that body endorphines after stimulation are a good support for accepting the pain, but it doen't help to move the stone along urethra. you should take the painkiller for urinary colic.- If I was your doctor I would prescribe a thiazide diuretic to prevent calcium stones. If I was clear, please rate my answer as HELPFUL.Thanks again. Dr. Elton Halili",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for the burning sensation below the eye in child?\n\nHi, may I answer your health queries right now ? Please type your query here...My 12 year old daughter has a red burning sensation under her left eye and on her cheek. This happens on and off for her and symptoms go away. She has regular issues with stuffy nose and recently has acquired a cold complicating her stuffiness. Are these symptoms indicative of an sinus infection? Should she seek medical attention? Might she need antibiotics?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. By what you say, I feel that it could be an allergic dermatitis or an urticaria. I feel that she might require anti allergic medication. Give her Benadryl syrup and if not better, then approach your pediatrician or physician. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for liver ailment due to medication of RA\n\nHi, I have RA and it seems that all the meds they put me on cause my liver functions to elevate. They are now 3 times normal. I also have a fatty liver. When are the levels in a dangerous rage for liver damage. I am trying not to take the meds, but am suffering greatly. I know I cant live without my liver. Catch twenty two!!!",
    "doctor_response": "Hi thanks for asking question.Almost every drug in excess can affect liver.The only disease modifying drug or other necessary drug should be taken for rheumatoid arthritis with follow up monthly.You have fatty liver also.So because of that also liver enzymes could be high.Take more fruits and green leafy vegetables.Avoid fatty food in excess.In cooking use very less oil.Avoid bad fat that is butter, cheese, cookies ,chicken , pork meat avoided.Refined food avoided.If possible mild exercise good for you.Crushed garlic can be taken daily that is good herbal remedy ...Take care....Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair loss and thinning of hair\n\nHi,I am suffering from hair loss and thinning of hair. I am looking for a good dermatologist in Bangalore, who can help me to reduce the hair loss process and regrow my hair. I have a family history of hair loss, but I believe I can slow it down with medicines. I have been using Minoxidil 10% from past one year, I think its effectiveness has reduced with the passage of time. I would be grateful, if you can help me out. Am quite tensed, thanks",
    "doctor_response": "hello, i can understand your concernit would be very helpful if i could know your age and gender and see some pictures of your scalp.you may have telogen effluvium of female pattern hair lossor androgenic alopecia.hairfall may be due to lack of neutrients like iron or protiens in body, it may also be due to derranged thyroid levels. so to rule out telogen effluvium i would advice you to get your hb , serum ferritin  and thyroid levels tested.it may be genetic too.application of minoxidil and oral biotins once a day can really be helpful to you. minoxidil is slow method, it takes time to show results and you have to be compliant with its use, leavingg it abruptly can again result in hair loss. so be patient and keep using it.still if you dont find any results you can go for procedure like prp (plasma rich platelet) therapy, it could help you as results seen are very good.and you can consider hair transplant too.hope it would help.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen and painful vagina during pregnancy\n\nI have hemroids since pregnancy, for a total of 5 years. Within the past year they bleed every time I have bowl movement. It is very painful and I dread going #2. However, I know I can take care of this with surgery. Within the past week I am having vaginal pain in the back of my vagina. It feels dry, swollen, and extremely sensitive (like s bad bruise.) It hurts to wipe, even when I pee. The pressure can feel very uncomfortable too! My Vagina even hurts to sit and walk. I know I need to see a doctor a.s.a.p. but I am looking forgone advice on what could be causing the vaginal pain and discomfort.",
    "doctor_response": "Hi.It could be your bowels just applying pressure on the uterine walls because of the increased size of the uterus, the pressure falling on the bowels can cause some amount of counter pressure on the uterus. This could be causing the discomfort, but it is still best to visit your doctor and go about an abdominal scan to confirm/rule out the cause.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of taking Prolia?\n\nHello My 84 year old mum was given an injection of Prolia on the 18th November last . her face started itching badly 36 hours later especially along and slightly under her jaw-line. Anti-histamines have not helped She informed her GP of this itching 25th November and asked if it could be down to the Prolia but her GP dismissed the idea suggesting that it is something she is using i.e washing powder, skin products, food etc but Mum has not changed anything at all Mum also aske dabout being referred to a dermatologist or having blood tests or allergy tests carried out and all of these were again dismissed by her GP. The itching is no better. she took it upon herself to see another doctor who carries out allergy testing but as soon as he learned Mum had been given Prolia he told her that this was the cause of her itching and that a low dose of steroids would ease it for her. However it would take up to 5/6 months for the Prolia to leave her system. She is very distressed and getting very little sleep. Since Friday the itch has become more aggressive with splotchy red itchy pimples appearing on her forearms. She is now doubting the doctor s diagnosis that it is the Prolia causing the itch. because it is worse...is that normal...?. She started on 30mgs of Deltacortril this morning I would appreciate any opinion you have regarding this. Kind regards Catherine Foley",
    "doctor_response": "Hello and thanks for the query .Prolia or Denosumabis a  human  antibody used for the treatment of osteoporosis, treatment-induced bone loss, bone metastases, multiple myeloma, and  tumors of bone .Denosumab can cause skin problems such as dryness, peeling, redness, itching, small bumps/patches, or blisters. The most common documented side effects include infections of the urinary and respiratory tracts, cataracts, constipation,rashes and joint pain .It can also increase the severity of eczema",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a brown mucus like discharge in the periods?\n\nHi, I am 8 months postpartum, I got my first postpartum period on July 6, and then another period 2 weeks later, and then again 2 weeks after that. My CNM switched my birth control 2 weeks ago from the mini pill to regular birth control since I am no longer nursing. For the past month I have had brown mucus-like discharge. Not heavy, and not constant. Sometimes it will skip a day. What could this be due to?",
    "doctor_response": "Hi Hope this message finds u in good health.I have gone through ur msg and understand your concern.it may be due to some sort of hormonal imbalances or variations in the body,though there may be other reasons as wellNothing to worry about, You should eventually get back to normal.Take multi vitamin and calcium supplements Do consult a gynecologist if symptoms worsenGet back to me for any  FOLLOW UP QUERIES anytime.Regards,Dr Mahaveer Patil...(MBBS,MS,Mch)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes feeling of heartbeat in throat/chest while having first degree heart block?\n\nI was diagnosed by EKG with first degree heart block, but when I look at the symptoms, I think that I have many symptoms of second degree mobitz II heart block.  I have been having unexplained tiredness and episodes of unexplained light-headedness.  Also I get episodes of feeling my heart beating funn in my throat and chest.  It beats consistantly and then skips and then continues and skips again.",
    "doctor_response": "sir ...please see this ..in heart block when the compensatiory beat comes after blocked beat it is forceful and felt as heart beat or pulsation in throat ..donot assume by symptoms ..diagnosis  whether it is first degree or second degree is confirmed by ECG",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes weird sensation in testicles?\n\nHello I'm just enquiring I keep getting a weird sensation in my testicals it's been happening quite regular and has gotten worse over this week I am not sure wot it is an just wondering if you could tell anything.it keeps making me feel i nee to go to the toilet quite often",
    "doctor_response": "Hello I share your concern, i will try to help you out in best possible way.Looking at your description this could be may be due to trauma or infection like epididymorchitis.Another possibility is prostate problem or a Renal stoneI would like further information help you better relevant medical history like metabolic disease or hormonal disorderAny recent exposure to unprotected sex?You should ask your doctor for few investigations to confirm the diagnosis like Urine culture and sensitivity test and an ultrasound to see for prostate enlargementBlood for CBC and liver function test or urine test for culture and an ultrasound are advisable if it is a chronic issueMaintain good hygieneyou should wear scrotal supportUse condom during sex if you are sexually activeHope this answers your question please feel free to ask for more clarificationThanks and regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant vomiting and green mucus in eyes of an infant?\n\nmy son is 4 months old and for the past week he has been vomiting constantly at least 3 times a day the first day it was 10 times. the following day he had direah which cleared up after two days his stool is harder now but still very light yellowish color. he is only eating 2 oz at a time and still vomiting. not spit heavy heaves and it keeps up till hes totally empty. he moans like he is in pain not whimpers or crys or fussieness actuall moans and now as of yesterday he has green matter (mucus like) stuff comming out of his eyes. hes been to the doctor twice and hospital once he had his blood drawn and an x-ray so far. could you please give me some ideas of what this could be.",
    "doctor_response": "Hello, Conditions like infantile jaundice must be ruled out. Consult a pediatrician and get evaluated. Detailed evaluation is required to find out the exact cause. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can be done for a cyst associated with root canal treated tooth?\n\nHello doctor, I have the first upper molar root canal treated 15 years ago. It has undergone two root canals treatment but does it seem incomplete? I did a CBCT and it shows a cyst and sinusitis although I have not that much pain. I am 41 and the dentist told me that I have bone resorption at the upper left maxillary region and I also have been recently diagnosed with Hashimoto thyroiditis. Should I get the tooth extracted? Should I try again for a new third root canal? What about periodontitis which is at the beginning?",
    "doctor_response": "Hello. At first, I appreciate you because you have so much awareness of your oral health. The life span of normal root canal treated tooth is 5 to 6 years. If you have 15-year-old treated tooth, it means you are so health conscious and take care of your oral hygiene. My opinion is you should go for extraction along with cyst removal because third-time root canal of the same tooth is not a good idea. Periodontitis is nothing but an infection of gum tissue which is totally curable and depends upon your oral hygiene. Bone resorption is a kind of bone loss due to demineralization. There are many things which are responsible for that like age factor, some diseases, calcium level, gingivitis with periodontitis is also a cause of bone loss.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stone in spleen\n\nHi,Just a while ago, my wife has undergone ultrasound and she was told that there is a one centimeter length of stone in her spleen. Prior to hospitalization, she has been complaining of severe abdominal pains. Please advice on the best treatment of this problem. Thanks",
    "doctor_response": "Hi,I am so sorry to hear that your wife is in pain. I will confess that a stone in the spleen is not a diagnosis you hear every day. Unless it is a calcified spot in the spleen, which would be much more commoner, esp in the developing world. Normally if it just a calcified spot, it means the spleen had an infection and the body took care of it. So nothing more needs to be done. But if the \"stone\" is producing symptoms, then the treatment of choice would be to remove the spleen surgically. But I would make sure that there is no other reason in the abdomen to explain your wife's symptoms. We routinely remove the spleen nowadays laparoscopically so that the patient has minimal pain and has a faster recovery. But this will only be done by surgeons with advanced laparoscopic skills. Most of them would still do a traditional open splenectomy. Hope this helped and I hope your wife starts to feel better soon. Please do not hesitate to contact  me for any further details required - rxsuresh@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat increased creases on the forearms?\n\nhello my granddaughter is 7 months old and seems to have extra creases in her forearms and at her wrists is this something to be worried about she is regularly weighed and seems to be increasing at a steady rate and no one else seems to have picked up on it",
    "doctor_response": "Many thanks.A photograph will be more helpful.If there is no other problem then no need to worry at all.If there is any other physical findings then we can test genetic testing for any other association.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore lump in underarm with yellowish puss coming out?\n\ni have had a lump in my underarm for some years. several weeks ago i noticed it was very sore and there was yellowish puss coming out of it. this lasted @ 1 week. now the lump is very sore and my entire underarm is swollen and red and it is difficult for me to even lower my arm.",
    "doctor_response": "Hello!Thank you for the query.The lump which was present in your armpit for years is sebaceous cyst. Now it has gotten infected so the abscess has formatted. Arm swelling and pain indicates inflammation which is spreading. That is why I suggest you to do not wait any longer.Please visit a surgeon. The lump should be incised and pus drained.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why it is very hard to obtain and maintain erection?\n\nHello doctor,I have struggled with anxiety and depression my whole life and have finally gotten myself into a relationship. But at the moment, I have found it very hard to keep and obtain an erection. I have stopped masturbating, but still, I feel no desire to have sex or masturbate (and when I try to get erect the erections are rubbish). I have stopped watching porn and looking at soft porn, but it is hard. Kindly advice.",
    "doctor_response": "Hello, Welcome to the icliniq.com. The most common cause of erectile dysfunction is psychological. The anxiety and depression can affect your erection as brain control the erection. So you have to treat your anxiety by counseling and medication. Yoga and meditation are also beneficial. With six to eight month of medication intake, and by counseling, your depression can be treated. For that, you need to consult a psychiatrist for counseling. Moreover, you have to rule out hyperlipidemia, prostate problem, hypertension, spinal problem, etc., by history and physical examination. It is advisable to check your testosterone and prolactin as well. I hope I have answered your question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does blood in urine 1+ mean?\n\nHi doctor, In my routine urine test, blood in urine is 1+ and RBC 6-8. What does it mean? I have attached my routine urine test report for your reference. Please help.",
    "doctor_response": "Hello. I had gone through your report (attachment removed to protect patient identity). Revert back with the investigation reports to an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for coughing during night in kids\n\nhello doctor..... my children , son age 7 yrs and daughter age 3.5 yrs....both cough all night, have mucus...during the day they are fine....but when ever they have some fizzy drink , candy, ice cream...etc...we have a terrible night..........they take seretide evohaler and aeroline inhaler with a spacer once in the morning and once at night.........i ve given them myteka many times for a few weeks but i feel it doesnt make any difference.....am i doing the right thing ?...are they actually asthmatic ?.....or is there an easier treatment?...please help i am very worried now",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Greetings from Chennai.By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze. I have a few questions for you -Questions:1. How many days per month does she cough or feel breathless?2. How many nights per month does her sleep get disturbed due to above symptoms?3. Does she feel breathless when she runs around or plays with other kids?4. Are the symptoms when there are seasonal changes?5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?6. Is the cough always associated with fever?If your answer is yes for any of the above questions, your kid might be having viral associated wheezing or multi triggered wheezing and I suggest you meet a paediatric pulmonologist who is near your place.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can cervix cancer prevention injection help to prevent cancer?\n\ncervix cancer prevention injection hi there,i recently went in for an op to remove the first layer of abnormal cells on my cervix. im worried about this progressing into cancer in the future. is this a possibility and by what percentage? also, is it too late to take the cervix cancer prevention injection?thx",
    "doctor_response": "Hello dear, thanks for your question on HCM. Yes, cervical malignancy can be prevented by vaccine (injection).One of the risk factor for cervical malignancy is Human Pappiloma Virus (HPV) Infection.  So vaccine against this can gives you protection from HPV infection and thus cervical cancer. Along with vaccine you should1. Sexually active2. Avoid multiple sexual partnerEtc to prevent cervical cancer.Sono harm in HPV vaccine. You can take it at any time at any age.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Teeth pulled, cold sensation in left ear, popping sensation in right ear. Dental condition?\n\nA few weeks ago I had 3 teeth pulled on the upper left side, I think Im healing pretty well, however now I have been feeling like a cold sensation in my left ear it doesnt hurt just annoying. Also my right ear will all of a sudden start feeling like its poppng but its not popping just a sensation as if it is. Just wondering if maybe this had anything to do with my dental work or what?? Thank you",
    "doctor_response": "Hello Sheri, Thanks for writing your query. I read your problem,the detail given by you is not complete like 1.upper back teeth or front teeth has been removed? 2.Do you have any sort of infection now a days?etc....... Any ways i do not think that it is related to dental work,so i will suggest you please go to an ENT surgeon as soon as possible and get the clinical examination done. Nothing to get worried. Take Care Dr. Gunjan Gupta",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is leukoplakia a dangerous disease?\n\nhow dangerous is leukoplakia?  I have recently been examined by a resident ENT and she said I amfine, just watch for pain, redness or enlargement of the area. That was last week.  Now, I have a tacticalflashlight that shows things that ordinary flashlights do not.  In looking at the back of my mouth todayI notice that the tiny white spot has disappeared, but the area is bright pink but does not hurt, so do Ineed further examination at this time?",
    "doctor_response": "Hi...Welcome to healthcare magic. Leukoplakia is a precancerous lesion..You mentioned that there is red lesion present in back of mouth that may be because of erthroplakia or other..Consult a oral medicine specialist  for clinical examination and further investigation...Start a treatment as per reason behind it.. I hope this will help you. Get well soon.. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for proteinuria\n\nHello Doctor.,I am J.RADHALAKSHMI., from Coimbatore, South India, I have been diagnosed for protein discharge in urine +++., since 2012 . Creatin is 0.8, BP and sugar normal. What is your suggestion for my medication to take care of my kidney without any further damage.",
    "doctor_response": "hai,As protein in urine will be there in kidney related disease and other systemic abnormal conditions like (amyloidosis,systemic lupus erythmatous).ruling out  the cause for your protein in urine condition will be helpful in managing medication.certain condition will need only diet alteration will resolve or control the condition by taking less protein foods.thank youhope i answered your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the prognosis for a nodule on the thoracic cavity?\n\nI have received news today that a 2.5 cm nodule was found on the left T2 of my thoracic, my doctor has scheduled an US Thoracic. Just wanting to know my options. Before this I had a MRi brain which found 12 or more white matter in the postventricular region.",
    "doctor_response": "Hi there,It really depends on what the nodule is.  Some nodules turn out to be nothing more than scar tissue and others can be cancer. It's impossible to give a prognosis without knowing exactly what it is.  A biopsy will usually be able to tell what it is, and further options can be discussed at that time. I hope this answers your question. Please feel free to contact me if you have any further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bladder cancer\n\ni have been fighting bladder cancer for 10 years i have took BCG treatments (4 times once a week got sick waited 2months then 4 times once a week i got sick agin. but i have been cancer free for 1 year and 3 months will this be it as or do i have to take BCG again",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Treatment of bladder cancer depends on type of bladder cancer whether it is high grade or low grade transitional cell carcinoma or other type.  Stage of cancer is also important whether it is penetrated beyond superficial muscle or deep muscle etc. Treatment options are surgery with chemotherapy or radiotherapy or bcg.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in chest and the increasing size of muscle?\n\nhi, for about a couple of month i have been experiencing numbness from the left side of my chest and the muscle my left side is getting bigger and now it feels like numb getting far from the left side of my neck.. may i know what kind of symptoms is this? and what doctor to consult about my problem?.. thanks",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Possibility of musculoskeletal pain due to cervical spine pathology is more. But better to get done ecg first, to rule of cardiac diseases because left sided chest pain is common with heart diseases. If ecg is normal than no need to worry for heart diseases. Than Consult orthopedic doctor and get done x ray and MRI of cervical spine to rule out compression of nerve root. If this is also normal than get done vitamin b 12 level. If deficiency then you need supplements. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower abdominal pain ,lower back pain and bloating?\n\nI have just come home from a brief hospital stay where I was catherirized and have since been experiencing lower abdominal pain an lower back pain, i had a urinalysis that was negative but my stomach is bloated an the pain is constant, there is no fever but i am serioulsy uncomfortable.",
    "doctor_response": "we need to investigate for renal infection.I suggest consulting the treating doctor and running routine blood investigations will make picture clear.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Flat nails, diagnosed with platonychia due to low iron, taking medicines for reflux. Would low iron be due to reflux?\n\nI just came from a Doctors visit yesterday and a few of my nails are flat - about 4 total - with the rest of them being normal. He - the Doctor said that it appears to be what they call Platynychia which is commonly known for having low Iron. Moreover, I am being treated for reflux problem for over 2 years and the Heomtolgist I visited yesterday said that the low Iron was probably being caused from my reflux issue. Trying to obtain second opinion on this matter. Thanks for any confirmation on this matter.",
    "doctor_response": "Hello. Platonychia can be cause by low serum iron. If you are a female patient and you have heavy menstrual bleeding, that is a possible cause. I you are older than 50, you should have a colonoscopy to be sure you are not loosing blood in your stools. Reflux by itself is not a cause of low serum iron. However, some gastric problems which might cause reflux, as helicobacter pylori infection in your stomach, might be responsible for the low iron.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause bleeding from mouth, ears, nose and breast nipples, unable to diagnose without the right tools?\n\nHello I am concerned about a young lady age 23 years old. She lives in Africa and she is bleeding from her mouth, ears, nose and her breast nipples. Some of the doctors there are not sure of what is going on, and the others just don't have the equipment to figure out what it could be. What could I possibly tell them?",
    "doctor_response": "Hi, It will be sheer guessing to diagnose coagulopathy with too little information you provided because bleeding from multiple sites can be caused by a number of diseases. However, in my opinion, it could be a bleeding disorder related to structural or functional abnormality of platelets or a vasculitis disease.  simple and inexpensive tests like bleeding time, clotting time, platelet counts can throw some light into the diagnosis.     As some of them are highly reversible causes, it is suggested that a diagnosis be made early to save her life before anemia or internal bleeding takes toll. My wishes for her recovery are with her.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do skin start peeling off after impetigo gets healed?\n\nboth my sons age 17mos and 4yrs developed impetigo from school about a month ago..it has since healed..however, the places where they had it on their skin started peeling..now I have noticed some of their fingernails have turned yellowish and are very weak...is this normal?",
    "doctor_response": "Hi dear,I understand your concern. With such presentation in my clinic I will exclude anaemia, because lack of iron canc cause impetigo and weak nails,also I will consult dermatologist to exclude fungal infection .I suggest you- apply iodine or betadin to affected fingernails, it will  helpful in case of fungal infection. Don' t worry skin of child heals very well, because they have good blood circulation.Hope it is answer to your query.Wishing your baby good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sneezing,sore throat,runny nose and headache\n\nMy symptoms include. . Sneezing, sore throat, runny nose, headache, dizzy spells, skin crawling and aching, tingly face, spots with no pus just fluid on face, itchy pallet in mouth, geographical tongue out brake, hot/cold, cramp/pins needles in legs, fatigue",
    "doctor_response": "Do your symptoms occur at certain times of year, or after contact with animal hair or other things? headache on one side ?does your ear hurt? history of fever ? Do you have enlarged lymp node ? according to me it can be1. common cold 2. allergic rhinitis 3. migraines you can take the following test .IgE antibodies , serum calcium sinus X-ray ct scan .vit B 12 levels treatment,tab paracetamol , antihistamine , steam inhalation, gargles,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest risk with water retention in the liver in elderly\n\nmy grandmother 75  has suffering from liver problem she has large amount of water in liver. The problem has been from last few 5 months. Doctors of bgh has told that her situation is critical and have no good scope of treatment for this problem. Plz guide me its quite urgent.",
    "doctor_response": "Hi dear,The problem your mother is having is called ascitis,Ascites, is uasually a late manifestation of cirrhosis of the liver,pathophysiologic mechanisms of ascites include the role of inadequate renal prostaglandin production in the development of the hepatorenal syndrome and the possible role of nitric oxide in the pathogenesis of the renal complications of cirrhosis. The aim of medical therapy is to achieve a negative sodium balance and, consequently, fluid loss. Large-volume paracentesis is safe and effective in the management of tense ascites, but use of diuretic agents should be continued to prevent reaccumulation of ascites. Liver transplantation, transjugular intrahepatic portosystemic shunts, or LeVeen shunts should be considered in selected patients with persistent ascites.Please share her detailed reports and investigations for further  opinion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for cough\n\nMy Daughter has cold (running nose) and cough since last 5 days. When i visited doctor they suggested me to givem Toxim & Congestive for 3 days. But Cough is still there. I noticed that yesterday she vomitted and cud see but mucus in it. Let me know if Wikoryl would help reduce this cough",
    "doctor_response": "Hi thanks for contacting HCM...Here your child could have simple viral or allergic infection...Get her CBC done to rule out lymphocytosis or eosinophilia respectively.....The drug you have mentioned is decongestent containing antihistainc plus lead sedation by caffein...Here your child can have bronchitis or lower respiratory tract bronchiolitis infection...Symptomatically  management done...If cold climate then room humidifier can be used....If condition increasing and bacterial infection suspected antibiotic given...Meanwhile for cough expectorant ambroxol can be prescribed.....Consult doc with keeping this in mind and auscultation done for respiratory examination....Take care....Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mitro valve, have increased heart rate, high pulse rate, trembling, sweating, headache, shortness of breath, lots of stress. Not a panic attack. Is it due to stress?\n\nThe last few days my heart has raced. I thought it was anxiety bc I have a TON TON of stress. No heart disease except mitro Valve with my Mom. I took my pulse and it s been 100-106 and shaky sweating and headaches. A little out of breath. Can stress do that and should I see a doc ? It s not a panic attack bc I ve had those. Thank you",
    "doctor_response": "Hello and welcome to Healthcare Magic. Thanks for your query. Your symptoms could be anxiety-related. Anxiety can manifest itself with not only psychological symptoms, but with physical symptoms also. If you are having recurrent such symptoms or having difficulty managing your stress, then I would advise you consult a psychiatrist for a detailed psychological assessment and further treatment. There are effective treatment options - in the form of medication or counselling / psychotherapy which will help you overcome your problems. Wish you all the best. - Dr. Jonas Sundarakumar Consultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a great deal of pain due to L5-S1 disc hernia. How to get over it?\n\nHello doctor,I suffer from an L5-S1 disc hernia, with pressure on the S1 root. I also have a partial tear in the right hip labrum. My surgeon is not sure which one is the cause of leg pain which starts at the low back and ends at the back of my feet. I suffer from a great deal of pain and would really like to get it over with.",
    "doctor_response": "Hello. I understand your concerns. Disc herniation causes considerable pain that needs step-wise management. I suggest: For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Condom broke while having sex. Can I take an I-pill to prevent pregnancy?\n\nHello doctor, I had an I-pill nine months ago and I got my periods some two days later. Currently, three days before, while having an intercourse, my husband's condom broke. Can I take an I-pill now to avoid pregnancy? Can I take this now? Are there any side effects? I want to know about a daily contraception pill. Is it harmful? Of note, I had a medical abortion 10 months ago.",
    "doctor_response": "Hello. Yes, you have to take it as you do not have any other option. It will harm your body if you take it so frequently. Your hormonal milieu is disturbed. Regarding side effects, you may experience bloating, heaviness, and stomach upset. For regular contraceptive pill, you need to tell me your last regular period. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for difficulty in conceiving\n\nim havin sex a lot and my boyfriend ejaculates in me everytime...could i be pregnant..but my period comes on everytime.. we are tryin to have a baby.. but its a old saying and it says you cant get pregnant if you are tryin to ..is that true bc i really want a baby bad..and i dont know if somethin is wrong with my body or his but we need and help...please tell me something",
    "doctor_response": "HiGREETINGS Initially get his semen analysis and if it is normal you need to undergo an ultrasound scan and hormones analysis.Ultrasound scan to find out abnormalities of uterus and ovaries. Hence consult a gynaecologist. Hope my answer helps you. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for recurring fungal infection in toe nail\n\nhello doc, i'm suffering from a fungal infection in my toe nails. the nails are becoming thick and yellow day by day. I treated once and it was fruitful. but after almost 1 year, it is again recurring. i don't know what to do? should i follow the same treatment? since I've changed my place, so i can't visit the same doc again. should i visit dermatologist in my town? please advise. I'm 31yrs old, ht 5ft and wt 58 kg. thanks in advance. Debasree, Pune, India.",
    "doctor_response": "Thanks for posting you query to health care magic. fungal infection of nail take long time to cure as drug concentration in nail is very low and it very slowly kill fungus.if you didnt kill completely  disease  recure  so I suggest you to contact dermatologist and take complete treatment to get cure . hope you are satisfied with my answer .  feel free to communicate if any query . regards, Dr.Manish Purohit Infectious disease specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can it be possible to know through ultrasound whether it is ruptured after taking hucog ?\n\nAfter taking HUCOG on 13th day, Is it possible to know the whether the is ruptured through ultrasound on 16th day?",
    "doctor_response": "hello when the hcg injection is given follicles rupture usually after 36 hours. so any ultrasound done after that will show that the follicle is no longer seen ,also show presence of free fluid (which is normally present in the follicle) to collect in pelvis. so yes usg can tell us whether the follicle has ruptured. hope this is helpful",
    "dialogue_context": ""
  },
  {
    "patient_message": "Raking Errin birth control. Missed a pill. Will that make a difference?\n\nHi there,I began taking Errin birth control and am about halfway through my first pack. Yesterday morning I woke up late and realized that I didn't wake up to my alarm to take it. I took it as soon as I realized it just like the directions said to. This morning I woke up and took my regaular pill at the normal time and I then realized that I had woken up yesterday and took a pill but it was a Wednesday pill from two weeks from now. I had taken two pills in one day and now have a missing pill. What should I do?",
    "doctor_response": "Hi, thanks for the query.Taking two pills in a day will not affect the efficacy of pills and you will be equally protected. If you have  taken a missed pill within 3 hrs of due time, it will not change anything. But if it was after more than 3 hrs, then you should use backup method(condom) for next 48 hrs.As you have one less pill now, your pack will  end a day earlier. In my opinion you should start your next pack very next day.Hope this helps. For any further queries you can directly reach out to me on the following URL:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can hair fall with dandruff be cured?\n\ni am 24 yr old female with height of 5 foot noticing hairfall for the past 3yrs.please help as i have visible scalp.recently my doc suggested me to use hair 4 u solution,candid tv lotion and follderm tablets.i also have excessive dandruff.do i start taking what my doc has suggested? is my condition curable?",
    "doctor_response": "HelloWelcome to HCM.You can use the Hair 4u soln and tablets as advised. It must be done for a period of few months to show results.But firstly you need to keep a check on the dandruff and other possible causes of hairfall. Did you have any illness, new medication, hormonal problems prior to the hairfall? Are your periods regular?The candid TV lotion is aimed at the dandruff. Few things you must do for the dandruff - Wash your hair regularly. Don't allow it to get greasy.Don't apply oil to hair/scalp .-Be careful about sharing toiletries.-You may also try Arcolane shampoo if the Candid Tv suspension is very drying. Use it on alternate days for two weeks and then reduce to twice weekly and apply as advised.Since your skin is prone to oiliness and dandruff you will have to continue these anti dandruff shampoos atleast once a week.As for the hairfall, eat a nutritious diet along with the medication. Results will take 2-3  months and will also get better once dandruff is controlled.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat my 1 year old for watery loose motion?\n\nHi doctor...My 1 yr old has bn having watery loose motions since d day bfore yesterdayI ve bn givn hom norflox 50 mg  2 tyms a day..Bt to no avail .. I dunno wht to do cz here in kuwait thy dun gve meds fr loose motions except ors whch i m gvn hm occasionally.. Please advise",
    "doctor_response": "HelloIf loose stool is not mixed with blood and mucus,it is usually due to viral infection.Antibiotics are needed only if there is bacterial infection.Antibiotics when given adverently are harmful for the intestine as they kill the normal gut flora which are beneficial.The main aim of management in diarrhea is to prevent dehydration by giving plenty of fluids(ORS). Addition of probiotics and zinc helps in early recovery.Observe for frequency of urination,oral acceptance and behavior of the child and if you find any abnormality contact your physician.I won't get worried due to non availability of antibiotic as it is not needed.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will urinating just after sex cause problems during conception ?\n\nHi Doctor .. This is manjula. im 23 years old..weight 46,height 5.3. after having the sex..immediatly im going to bathroom for urion..is there any problem? we are planning for a baby.. so please clarify my doubt?",
    "doctor_response": "Hi Manjula,Welcome to HCM.Since you are trying for conception, it would be better that you do not getup immediately after intercourse, otherwise the semen will flow out and reduce the chances of pregnancy. Wait for at least 15 minutes after intercourse, lying on your back, before you leave bed. More over husband on top position for intercourse has better chances of conceiving.Wish you all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can loose motion due to teething be treated?\n\nHello Doctor, Our baby is 7 month old is having loose motion from last 4 days. we went to GP 4 days back and she said it is due to teething. now he excrete water type potty with bubbles around 5-6 times a day. could you please suggest some home remedy as we would be showing him back to doc on monday. Thanks in advance, Raja",
    "doctor_response": "HiThanks for writing to us.Usually this diarrhoea is viral.It may take even a week to settle.If your baby is active, playful and passing urine atleast 6 times daily, dont worry.JUst give ORS and zincWishing your child good healthRegardsDR Arun",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for frequent memory loss\n\nGood Evening Doctor, I am from Delhi , and is suffering from Hypothyroid and Anethesia already , recently doctor had conducted a MRi , and CT Scan due to the memory loss symptoms and sudden and frequent memory blackouts.I am been diagnosed with Alzheimer. Doctor want to know , is their a permanent cure for this as i am just 23 years old and even not married. My doctor advised me not to get married till my mental condition stablise.What do i do? Please advice",
    "doctor_response": "HiI admire you for positive outlook.If it has been already diagnose and you have Alzheimer then need to take treatment.I m wonder how it can be diagnose Alzheimer in just 23 year old???I guess it is some other condition in which memory loss occur in early ages need to get proper diagnosis so consult best neurologist near by.To be very frank there is no permanent cure of Alzheimer. you can reverse it you just stop progression of it.So do best consultation and diagnoses.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severely painful and burning lump in navel area post a C-section?\n\nI had a c section with my son almost 6 years ago and I had on and off pains and small lumps in and around the scar for a couple years after the surgery. For the past couple years I ve noticed the lump that normally isn t painful, that come up to the top of my belly where it is actually visible to see, it also moves around my belly. Tonight anytime I cough or move it hurts very bad, like a burning pain, nothing seems to help, it isn t moving any tonight..it s on the right side of my belly near my belly button. I touched it earlier and it hurt to push on..I have never heard of such a thing.",
    "doctor_response": "Hello hope the answer helps you.As you discuss had c/section 6 years back and earlier pain in  scar tissue is due to nerve sectioning in the abdominal wall as neuropathic that is transient and goes off with passage of time.Recently you noticed lump around scar increase or hurts with coughing that is increase inta abdominal pressure I guess you are having incisional hernia over scar site that is benign and treatable thing so no worries as far as rest of your body systems not having any trouble.Avoid constipation,plenty of water 12-14 glasses daily and high fibre diet along stop smoking if and take your time in the mean while to consult general surgeon for it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. After getting my hip adjusted, I get nerve pain in left leg and lower back. Why?\n\nHi doctor, I had my hips adjusted about a year ago and the trainer who did it yanked my right leg to align my hips. It felt good at that time but the next day I had nerve pain down my left leg and into my lower back on the right side. Every time I stretch my left hamstring or sit in an L shape I get a really sharp pain in my right lumbar spin area. It has not gotten any better and I have tried nerve flossing but that was making it worse. Any help would be greatly appreciated.",
    "doctor_response": "Hello. In my opinion, you might have your sacroiliac (SI) joint strained and the same is causing you pain in the back and the leg. You just need a good mobilization of the SI joint and lower spine. Along with some soft tissue work to relieve the pain and spasm. Nothing to worry. Once you start realigning the joint you will gradually feel better. You need to start strengthening your lower back and glute stability with hip control exercises. As of now, keep a lot of icing in the painful area frequently like once in two hours for 10 to 15 minutes. Gentle stretching of gluteus and hip flexor, gentle massage over gluteus muscles, and hip mobility program will help you to relax with lower leg symptoms. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can one exercise immediately after recovering from jaundice?\n\nI suffered from jaundice in mid of Sep 15 and my billrubin levels reached at 14 and sgot n sgpt @a 950...now I am recovered n currently billirubin level is at 1.2 with direct at .5 (sgot n sgpt At 1. When can I start workout. 2. Can I start drinking occasionally.",
    "doctor_response": "hi.noted history of elevated liver enzymes and bilirubin. did you undergo any type of procedure or surgery? if not, yes, you can return to your normal daily activities and function without reservation. a follow-up consult with your doctor is also best for clearance prior to doing so. hope this helps.good day!! ~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a fever and loose motions?\n\nSir,My nephew is suffering from sudden fever and low cold for last 7 days. Along with this he is having loose motion as well. Doctor advised to go for blood test and found that WBC had count 11000 and on next day it had count 14000. He is just 7 months old. Doctor is suspecting it as a case of septicemia. Please advise as we are very much worried about it.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Yes, it looks like septicemia.I advice you to do blood for culture and sensitivity.When there is septicemia bacteria can be isolated from the blood culture.With the help of sensitivity, we can give antibiotics to the patient.Patient can be treated effectively with it.For fever you can give paracetamol under your doctors guidance. This will bring the temperature down. Do not do overdosing.Maintian good hygiene around baby. This will effectively play good role in treating the infection.Give good breastfeeding and ORS to baby.This will maintain good hydration , and diarrhea can be cured rapidly.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes left-sided pain in the back?\n\nI have been having mid left back pain (it is sharp, not very constant, it gets worse when I take deep breaths in), cough, sore throat, runny nose, tight feeling in my chest, and a feeling like I am not getting enough air in my lungs. I am unsure if I should go to a doctor, or if it is not severe enough to need to seek urgent medical care.",
    "doctor_response": "Hi Hope this message finds you in good health.I have gone through your query in detail and understand your concern.Left back pain can be due to a slipped disc or fibromyositis of the back muscles due to a strain.Runny nose and sore throat may be causing shortness of breath and tightness in chest.I would suggest you to consult a physician and start on appropriate medicines.Deep breathing exercises will definitely help.Hope your query has been answeredNothing to worry about, You should eventually get back to normal.Get back to me for any  FOLLOW UP QUERIES anytime.Kind Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have pain in lateral and medial side of heel with flat foot. Please suggest solution.\n\nHello doctor, I have foot pain and I suffer from flat foot. Pain is mainly located at the lateral and medial side of the heel. Please suggest.",
    "doctor_response": "Hello. Flat foot is a very common condition and causes pain due to stretching of tendons, ligaments, and soft tissues of the feet. I guess an x-ray must have already been done for you. Just make sure that apart from the flat foot you do not have any other associated condition like abnormality of bone or abnormal bone growth. If you are overweight then you need to take care of it as excessive weight increases flat foot pain. Furthermore, if you have any other comorbid conditions such as diabetes or hypothyroidism, please control that as well. There are special shoes that are tailor-made according to your foot so that there is less strain while walking or running. Kindly get them. Also, visit a physiotherapist or a chiropractor who will teach you specific stretching exercises that you will have to keep doing regularly at your home to minimize pain and discomfort. When your pain is severe, take a painkiller of NSAID (non-steroidal anti-inflammatory drugs) group. I prefer tablet Aceclofenac 100 mg as it is known to cause less gastritis. It can be taken twice daily after food. In addition, taking a multivitamin and mineral pill will help in nerve health. I hope this helps. Developmental, congenital. X-ray foot AP, oblique, and lateral. Blood tests include complete blood count (CBC), blood sugars (fasting and post prandial), thyroid profile T3, T4, TSH (thyroid-stimulating hormone). Flat foot. Physiotherapy exercises and stretches. Custom made shoes. Painkillers as and when required. Avoid overweight, long running.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can peripheral neuropathy be treated while suffering from diabetes?\n\ni am trying to get my dr to prescribe decadron for me. i am diabetic and they are worried it may increase my sugar. i have taken the generic form many times over the years. i live in constant pain and when i get an injection i stop hurting. i recently had a nuerotransmitter put in my back and it doesnt seem to help all that much. i have nerve damage in my lower legs and feet. i have a hard time walking and the pain mamagement dr thinks this medication would make my nerve damage worse. what should i do.",
    "doctor_response": "Hello,The nerves are damaged by abnormally high sugar containing blood. So, abnormal sensations start in the limbs, and it is called Peripheral neuropathy.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mridul Das",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for psoriasis causing severe itching and sleepless nights ?\n\ni am 58 years old male working as senior executive in private company. I have been suffering from psoriasis for last 16 years. Both legs are affected with severe skin damages, itching, inflammation and burning. allopathic treatment taken on few occasions did not provide sustainable relief. i need to scratch the affected area very often to the point of bleeding and fluid discharge. not able to sleep due to skin inflammation. please suggest a treatment for relief. i have been applying coconut oil and taking atarax for some sleep in the night.",
    "doctor_response": "Hi...Rajendra.., Thanks for choosing HCM.., PSORIASIS....it is Papulo squamous inflammatory disorder with.., genetic predisposition..,So no cure , only controllable.., According to Ur history..U have Erthromatous type.., with Auspitz's sign...(Bleedin ocuurs while scratching.., Good treatment is available.., 1) Avoid non-veg, spicy and jenk foods., 2) Apply SORVATE-C ..it is Calcitriol with clobetasol.., on night times..,(Glenmark) Morning times use good Moisturizing cream...ELOVERA..( gracewell) 3) Tab...Mext 7.5 mg ..1 month pack for 3 months course..good respond.., Mext is Methotrexate.....Wallace company... If affordable...,ACITRITIN..,it is Acetretin...1 strip cost about..Rs...640 thanQ..,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat nervousness?\n\nhelli have a issue about nervousness. whenever i have to talk in front of crowds and and a huge audience, i get really nervous. my heart starts pounding more than usual, i forget my words, and my voice gets shaky. That is the reason i find it hard to share an experience through words to my group of friends. its really irritating because, i have so much to do related to communication with people. When preparing for situations like presentations and interviews, i know exactly how to answer them, but when the real test arrives, i shiver and in my head i go like, \"WHAT THE HELL IS HAPPENING TO ME? WHY IS IT HAPPENING? SOMEONE GET ME OUT OF HERE!\" This is a real stopping point at my career. It gets very difficult to gain my confidence to speak in front of an audience and EVEN friends.I really hate this. I have consulted some homeopatic doctors. None helped.it keeps coming back to haunt me.Please helpI dont want you u say , \"Face your fear! The one and only recipe.\"ust suggest me some diet, or some home remedies.Thanks",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. I sincerely opine that the problem you are facing now is of your own creation. First of all, your problem is not medical and therefore, mediines annot cure the problem. This is a sort of phobia, and is therefore a mental disorder. You are not alone. So many people are like you. There are no one step cure for your problem. Psychotherapy and consistant practice an only help you. If you are unable to do it today, be confident that you will be able too do it tomorrow. You will become mature to handle the situation when time comes. Don't worry about the minor setbacks. Try and try again with positive thinking.If you still need my help, please describe the whole problem in detail and post a direct question to me. I shall definitely help you with psychotherapy techniques to over come your problems.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is miliary tuberculosis in brain curable?\n\nMy wife was suffering from Miliary TB from october 2011 . she was in the medication from OCTOBER 2011 TO january 2013 but suddenly in june 2013 she has TB in Brain. she had seziures twice . now she is into medication.what should we do ???? is it fully cureable ???/if yes how we should cope with it ??",
    "doctor_response": "Hi, welcome to our site. I am Dr Saumya Mittal, MD.Read your query. That is a very significant question and i appreciate your problem. I will try my best to answer your queryMiliary TB is a form of tuberculosis that involves the entire body. All the systems of the body are affected in this condition. The lungs, heart, stomach and intestines, and even the bones can get involved in this condition. There is a possibility that the TB bacteria survived in her brain. The TB bacteria can form small focus of infection in the brain called tuberculoma. Or they can cause a generalized infection called TB meningitis. The most common manifestation of the meningitis is seizures and altered sensorium.The TB meningitis, may be treatable if the patient is not immunocompromised or if the other systems hold out. Besides the bacteria should be susceptible to the antibiotics given. yes, in a world full of antibiotic resistant bacteria, even TB bacteria are getting resistant to antibiotics and these are harder to kill.A suitable culture sensitivity may help diagnose the type of bacteria.If she gets effects of the medicine and starts getting better, chances are she will heal completely.Monitor her liver function testsI hope this helps you. Inform the reports mentioned above/if any other so I can be of help further. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you.Please do understand that some details could be extracted from a detailed history and examination.Please feel free to ask another query. I would be glad to help you. Looking forward to your return query with the details asked so that I can help you further. (If the answer has helped you, please indicate this)Best of luck.Dr Mittal.MBBS, MD (Internal Medicine), CC (Diabetes Mellitus), DNB (Neurology)Consultant Physician and DiabetologistJS HospitalEx Apollo Hospital, DelhiEx Kailash Hospital, Noida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white coloured skin on the site of injury?\n\nHi , my 1 yr old just returned from the er , he got 6 stitches on the fleshy lower part of the palm of the hand, under the thumb. My husband said the dry commented on how white the flap of skin was inside -what does that mean ? Why was it white inside ? They put him on cefovit antibiotics for 3 days",
    "doctor_response": "The skin has several layers. The pigment layer is not the lowermost layer of the skin. There are other layers as well as a layer of subcutaneous tissue which is made of fibrous tissue. This fibrous tissue looks white. If blood vessels are not ruptured, you can see this later if the upper layers of the skin are damaged or broken. Probably that is what you mean by 'white flap inside'. The skin that normally acts as a barrier to infection. In case of breach, it is preferrable to use some antibiotic so that some infective agent does not enter.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does intake of tamsulosin reduce PSA levels and mask prostate cancer?\n\nI had UTI in Sept/Oct and my PSA level shot up to 10.36. After the infection was cleared, the PSA reading showed 6.4. Last week (Dec. 3rd) it went up to 7.95. Today, my urologist has recommended TRUS study. He says that I have a large prostate but this is good. I am confused as to what does it mean. I am taking Tamsulosin 0.4 mg daily. Does this medicine reduce PSA levels and mask prostate cancer?",
    "doctor_response": "Hi and welcome to HCM,thank you for your query.Yes, it reduce psa levels so it may effect on diagnosis of prostate cancer but if you do frequent ultrasound check ups,you dont have to be worried. this is obviously just prostate hyperplasia and you should continue with tamsulosin.Wish you good health. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe headache,toothache and lump under tongue\n\nhi  my fried had a problem with his salvia ducks,he went to his doctor who gave him antibiotics theyndidnt help ,he has got a small lump under his tonuge and cannot open his mouth wide only slightly, he is getting terrible headaches and toothache he is terrifide of dentists ,his doctor wouldnt give him anotherstronger antibiotic, he thinks it might be an abcess could you enlighten me to what the cause may be",
    "doctor_response": "Hi Dear ,Welcome to HCM. Understanding your concern. As per your query severe headache, toothache and lump under tongue indicates that there is dental abscess formation due to infection extending from tooth to region below root apex leading to pus formation and lump. It can be swollen lymph node due to infection and blockage of salivary gland duct. I would suggest you to consult a dentist and get proper cleaning of the area done followed by irritation with hydrogen peroxide, betadine and saline. Take combination of Diclofenac and Ibuprofen. Chew on citrus substances. Use digital palpation method to allow salivary flow. Go for root canal treatment of concerned tooth to prevent further spread of infection.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump under the breast, headaches, weight gain and bruising\n\nI am exhausted all the time, sweating at night, found a marble size lump under my right breast. I have no gallbladder, and severe endometriosis. I smoke, but dont drink. Headaches all the time, weight gain, bruising a lot lately and morning nose bleeds....help",
    "doctor_response": "Hi,Dear thanks for the query to HCM.Treatment -for-a-the  lump of breast under neath-which mostly is fibroadenosis-Which needs Mammogram and FNAC Biopsy to rule out Cancerous element in it for your psychological relief.b-Headaches you have is due to the -the lifestyle -and smoking with high BP is the cause for it? for which you need to check up with your ER primary doctor.c-If you have? endometriosis which is not clear from your query-then this explains  high BP and nasal bleeding you have-as its very common association with endometriosis- and you should consult gynaec doctor who would treat it accordinglyd-Rash and bruising  needs treatment from gynaec doctor.These symptoms indicate-menopausal symptoms.For this you need to take hormonal supplements from your gynaec doctor.As your problems are multiple you need urgent care from Surgeon for the breast lump /Physician or Gynaec doctor- for the allied headache /weight gain / and bruising complaints -who would treat it accordingly.Hope this would help your worry to take proper steps for health.Wellcome again if you have any more query in this regard.Have a Good Day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What course of treatment should be done for depression, anxiety disorder and post traumatic stress disorder?\n\nI am a 70 year old female and have diagnoses of major depression, PTSD, generalized anxiety disorder illnesses, plus several physical illnesses. I was gradually removed from cymbalta, due to side effects, by the psychiatrist i am seeing. Gradually taking vibryd but became more ill while taking it. Stopped taking all vibryd, and then stopped lorazepam. I have been very ill, physically, since that time (some nausea,which is lessening); diarrhea after meals (not eating much or regularly, not hungry); not sleeping, but that is improving gradually, but have terrible rls, which I take med for, in early morning hours every night. I am wondering if I should see my family practice doctor, go see my psychiatrist, or who; or just tough it out. It has been 6 was from beginning of withdrawal from cymbalta. I am also very tired when I try to do a short time of Christmas shopping, going to see family, etc (5 hrs excursions). Thank you for any advice you can give me on how to proceed.",
    "doctor_response": "Hello, Giving benzodiazepines in the geriatric population should be avoided to the maximum. We can give a good dose of SSRI along with that 5 to 10 sessions of counseling works wonders. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Junaid Nabi, Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest a progesterone birth control bill that has no any side effects\n\nI was just curious, I am considering getting on the progesterone birth control bill again but Im concerned because the last time I was taking them I would have weird problems in the middle of night not being able to feel my upper body or it felt like I had no control for some time and I was awake when this happened. Can this be a bad side effect.",
    "doctor_response": "The symptoms that you describe are not known to be a side effect of progesterone birth control.  The most common side effects of these pills are irregular bleeding, bloating, acne, and a few others.  however, the vast majority of women who take progesterone birth control pills do not have any negative side effects.   I hope this was helpful to you.  Please let me know if you have any more questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I got pregnant outside marriage and feel ashamed. How can I deal with this?\n\nHello doctor, I am pregnant without being married. My boyfriend cheated me. I cannot contact him as he blocked me. I feel so ashamed to see my family. Until now, I never told them that I am pregnant. I want to die. I am mentally disturbed. What should I do now?",
    "doctor_response": "Hello. You do not need to die. Be bold and confident. Take a decision for your pregnancy/child. If you are not enough ready to take responsibility of your child, then go for medical abortion. You do not need to ask anyone for it. Take an appointment with your gynecologist. Talk to your close friend or any close family member. Do not be afraid to take help from a close one. It may be possible they may get angry at you but they will surely support you. Suicide is not a solution to your problem. Fight with your situation. Learn from this for your better future. Next time, use proper contraception or do not trust blindly. Every problem has a solution. We just have to work on it. Do not fear to talk. There is a beautiful life ahead to live. You have to talk and do. Take help from a gynecologist and meet her personally.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is surgery safe for miss formed shoulder bone?\n\nI was born with a miss formed sholder in fact a bone is missing and one bone if it continuse to grow it will come out of my neck also when i whent to childrens hospital in columbas they said that out of thousands people they help every day i was the first the docter said that after i have a couple grouth sperts that i would be able to have a 3 hour surgury so my right sholder would be corected and fixed by removeing part of the thy bone to fix it and im only 12 almost 13 should i go though with it im just so confusd",
    "doctor_response": "Dear Sir/MadamI have gone through your query and read your symptoms.In my opinion, you have no reason for your confusion, just go with the surgey, if proper care is taken surgery is quite safe these days, but do not forget to follow all instructions of the surgeon.I hope that answers your query. If you want any more clarification, contact me back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for elevated liver enzymes\n\nMY LIVER ENZYMES ARE HIGH . I HAVE BEEN TESTED FOR HEPATITIS A, B & C - ALL NEGATIVE. ULTRASOUND IS NORMAL. I DO NOT DRINK ALCOHOL. I DO NOT USE INTRAVENOUS DRUGS. HOWEVER, I GAINED 20 LBS WHEN I QUIT SMOKING 11 MOS AGO. MY GI IS DOING AN ENDOSCOPY TOMORROW MORNING - HE SAYS HE WANTS TO MAKE SURE THAT I DO NOT HAVE VERICOSE VEINS IN MY ESOPHAGUS. IS THAT THE NORMAL NEXT STEP TO FINDING OUT WHY MY ENZYMES ARE HIGH?",
    "doctor_response": "HI,When there is no signs of portal hypertension like spleenomegaly on ultrasound ,but i dont know exactly how much enzymes are elevated .But most likely you should not have esophageal varices.But you need to be evaluated for other condition like wilsons disease and other autoimmune condition if liver enzymes are significantly elevated.If they are mildly elevated just avoid oily and fatty food ,do regular exercise that will help you in reversing the enzymes.Hope this information helps youThank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Advised to take lonazep with qutan. Diagnosed  with  FTLD. Increased agitation  and  violence when reduced dosage? Continue medications?\n\nmy wife ( 56 yrs)has been  advised last  june (2012 ) to take lonazep  .5  and .25   in  a day  with  qutan  .25  and  .5  for  agitation  and sizures  . she  has  been  diagnosed  with  FTLD  with  some  psychiatric  manifestation . her  condition worsened  over  8/9  months  gradually  .. sphincter  control  completely  affected  with  incontinence  for  last  two  months  .  lonazep was  increased  to  2  mg  in  a day  and  now  reduced  again  to  1 mg  and  asked  to  reduce  further  by .125  every  fortnight .Her  agitation  and  violence  was  very  high  when we  started  reducing  lonazep .  Should we  continue  such  medication  for  a patient  who  is  rather suffering  from  dementia  than  any  other  type ?  PKM",
    "doctor_response": "hi Frontotemporal lobar degeneration (FTLD) is the name for a group of clinically, pathologically and genetically heterogeneous disorders associated with atrophy in the frontal lobe and temporal lobe of the brain, with sparing of the parietal and occipital lobes. In the over 65 age group, FTLD is probably the fourth most common cause of dementia after Alzheimer's disease, dementia with Lewy bodies and vascular dementia. In the below 65 age group, it is the second most common cause after Alzheimer's disease. In some patients the symptoms of FTLD and Alzheimer's may overlap so what your was surffering either of the two 1 fast withdrawal of lonzep ...with withdrawal symptoms with anger and more agitation   or 2 neuroleptic malignant syndrome from qutan more fast dementia means more urinary incontinence.....such medications are sometimes important and sometimes are totally useless....it just weighing of the benefits or side effects or medcinies that you have to decide.....what is better for her wit or with out medicine take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with chronic hepatitis C, have ascites, edema, jaundice, fatigue, itchy skin, loss of appetite, mental disturbance. Suggestive treatment?\n\nHi! my name is Nisar. I am 57 years old. I am suffering from hepatitus C since 26 feburary 2009. I am suffering from following symptoms: Fluid retention causing swelling of the belly ( ascites ), legs ( edema ), or whole body (anasarca) Persistent jaundice Fatigue Disturbances in sleeping Itchy skin Loss of appetite, weight loss , wasting Vomiting with blood in the vomit Mental disturbances such as confusion, lethargy, extreme sleepiness, or hallucinations ( hepatic encephalopathy ) please help me",
    "doctor_response": "It seems you have all the complications from cirrhosis due to your hepatitis C. You probably have had the virus for much longer than 2009. You should be seen at a transplant center for evaluation and consideration for liver transplantation, since you won't be a candidate for hepatitis C treatment with all these problems (the antiviral therapy could precipitate acute liver failure in your case). You need to be on diuretics (such as furosemide plus aldactone) for your fluid overload. You should be on lactulose or rifaximin for your encephalopathy. You should get an upper endoscopy to check if you have esophageal varices. You should get a liver ultrasound or CT scan to check for liver cancer. In conclusion please see a liver specialist as soon as possible!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. The sphere during eye exam has come to -2 from -3. 25. Kindly help.\n\nHello doctor, During my last eye exam, a couple days ago, my eye doctor stated I needed lab work drawn due to a drastic change in my eyes. The sphere was -3.25 bilateral two years back and now is -2.0 bilateral. What is the concern?",
    "doctor_response": "Hi. I understand that your eye power has changed quite a bit in two years. The change that we normally expect to see in you would be more on the minus side that is to say that your power must naturally progress to more on the minus side than becoming less. We see these changes occurring due to a process called nuclear sclerosis, which is part of the normal aging process of the lens inside your eye. Since the power has become lesser, this change cannot be simply ignored as due to aging and your doctor must be suspecting a cause for which he has asked for laboratory work. There are very few conditions which can cause such a change, to name a few progressive hypermetropia, retinal and choroid diseases.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in left testicle post vasectomy?\n\nI had a vasectomy performed 10 days ago, and am still having pain in my left testicle. The left is now hanging much higher than the other, and hurts to touch. I am also experiencing shooting pains in the testicle before and after ejaculation. What could be the issue?",
    "doctor_response": "Hi, It can be due to delayed healing. Make sure your blood sugar are normal and you had enough rest after procedure. Take mild painkillers - if the issue persist you can think of going for ultrasound scrotum. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does gliding, small, painful lump on distal forearm mean?\n\nHi, may I answer your health queries right now ? Please type your query here My husband has a small but very painful lump on his distal forarm ,approximately 2 inches from his wrist crease on the anterior aspect of his arm. The lump glides with movement. It appears to feel better with icing but I am not sure if he should see MD.",
    "doctor_response": "Hi,Dear,Thanks for your query to HCM.Studied your query in full depth of its details.Reviewed it in context of your health concerns.Based On the facts,Your husband seem to suffer from-Ganglion Cyst of the Wrist bone-joint on anterior aspect-or Swelling arising from synovial sheath s of the wrist tendons.CT study would rule out the possibility of -Bursitis of the wrist,which is also a gliding painful swelling,but would not be discrete in appearence.Hope this reply would satisfy you and would help you to plan further treatment with your doctor there.Welcome any further query in this regard,which would be replied in next session.Good Day!!Dr.Savaskar M.N.Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat  benign cyst in the right lobe of my liver?\n\nI am a 37 yr old man. After a recent abdominal/pelvis MRI with contrast I was told that I had a 5mm benign cyst in the right lobe of my liver. How can they be sure it is benign, simply via MRI Imaging? I had one CT of the Abdomen/Pelvis 2 years prior and another 5 years prior. Neither of these CTs showed this cyst. Why did it suddenly show up now and can I be sure its not metastatic cancer?",
    "doctor_response": "Hi, How are you?I am sorry to hear about your diagnosis, but I would not worry about it.Cysts in the liver are a fairly frequent finding on scans of the abdomen. Most often these cysts tend to be \"simple cysts\" and do not cause any trouble what so ever to the patient. That is one of the reason why they can grow upto 25 cms without the patient being aware of it. Some of the other causes for cysts in the liver include certain heriditary diseases (where there will also be cysts in the kidneys) and infections (Amoebiasis). Rarely malignancies can also appear as a cyst. But in all of these conditions, the patients will usually have symptoms from the disease. The current imaging techniques (CT and MRI scans) are very good at diagnosing the nature of the cyst without the need for biopsying the cyst. In your case, it appears to be a simple cyst (based on what you have written). Although mostly asymptomatic, simple cysts can also produce symptoms when 1) they enlarge to a big size 2) when there is bleeding into the cyst or 3) when they develop an infection in the cyst. In your case, none of these symptoms exist. Since the cyst is small, I would recommend a followup scan at a later date to see if the cyst is enlarging.Hope this helps and hope you start to fell better soon. please do not hesitate to contact me for further details - rxsuresh@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is fever and dry cough symptom of typhoid?\n\nmy husband had high fever appx 103-104. he had a blood test and the reports are:                                                        Samonella Typhi \"O\" - 1:80                                                                                                                                                      Samonella Typhi \"H\" -1:80                                                                                                                                                                  Samonella Para Typhi- \":AH\" - Negative                                                                                                                                       Samonella Para Typhi \"BH\" - negative  on doctor's advise he taken tab monocef -o         1-0-1 now he does not have fever but little of dry cough. can typhiod may repeat again? And what is best diet can I give him to recover",
    "doctor_response": "Dear Friend.Welcome To HCM.I am Dr Anshul Varshney. I have read your query in detail.I understand your concern.Only rising titres of Widal are significant.I would suggest you to take the antibiotics as advisedThese days viral infections are on hike. So, it can be that also.Diet normal can be given.There is no restrictions.This is my best advise for you based on available details.Reply with answers of these questions preferably in point wise manner.Stay Healthy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can taking hydrochlorothiazide lead to swelling of ankles?\n\nHello DR. GRIEF: MY ANKLES ARE SWELLING. IT NEVER HAPPENED BEFOR I STARTED A TEMP JOB, WHERE I SIT DOWN FOR MOST OF THE DAY. I DON T EAT ALOT OF SALT, HOWEVER, I DO TAKE A WATERPILL EVERYDAY, AND I VE BEEN TAKING IT FOR ABOUT 5 YEARS. IT S HYDROCHLOROTHIAZIDE 25 MG. WHY IS THIS HAPPENING?",
    "doctor_response": "Hi, Thanks for your question. After going through your question, I can understand your concern. For better opinion I want to know- Your age and gender. - why are you taking water pill. - Is there any diabetes, heart disease, Blood pressure or cholesterol problem. - Habits like smoking, alcohol. - Associated symptoms like fever, change in color of skin over feet, breathing difficulties. There may be following causes for swelling in your case - - Prolonged sitting. But other causes related to heart, Kidney, Liver disease need to be ruled out. Following investigation may help in diagnosis - - ECG, 2DEcho. - Complete Blood Count. - Renal function test. - Liver function test. - Urine examination including urinary protein. Depending upon clinical examination and above test results appreciate management can be planned. Hope this helps you, if so do vote as helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for behavioral problems\n\nA MILED MEANTAL RETIRED BOY AGE 28 YEARS OLD, ALSO FATHER OF 4 MONTHS  BOY CHILD. HE IS VERY MUCH ADICTED WITH PAN PARAG AND ZARDA (RAJNI GANDHA & TULSI ZARDA). HE EAT 10 - 15 PACAKETS IN A DAY.  IF HE NOT FGET IT HE BEAHAVED VERY  RUDELY. BITES EVERYBODY, AND STOLEN MONEY  ALSO FOR BUYING PAN MASALA. SO MANY BEHAVIOURIAL PROBLEM ARRISES  FOR THIS ADDICTION. PLEASE ADVISE US HOW TO CONTROL ? FATHER  RAJ KUMAR AGARWAL (KOLKATA) CONTACT NO. 033 0000  (0000)",
    "doctor_response": "Hi,Thanks for writingGiven the fact that the person has mild mental retardation (I believe this has been diagnosed formally), behaviors can be hard to modify. However, a professional advise in this regard from a psychiatrist might help. He might derive benefit from behavior modification strategies.Hope that helps,Dr A Rao",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does pain in testicle require long term treatment?\n\nsir, fifteen dayes back i felt pain above right testicle. on ultrasound found.my prostate is 24grms and post void urine is 140cc.feeling burning sensation in urinary passage. my age is 64years.whether i have to go for long treatment or for a short period.height-5ft-6inch,weight-79kg,diabetic-but controled by diet.",
    "doctor_response": "Hi thanks for contacting HCM..Here you are having high post voidal residual urine...Here according to report it could be prostate enlargement with infection....You have to consult surgeon for per rectal prostate palpation and subsequent investigation.Urine also should be examined which will mostly will show presence of pus cells ...For infection antibiotic given with more fruit juice and more water.....After controlling infection if prostatic enlargement there biopsy or PSA done to reveal nature of prostatmegaly...Then accordingly treated like with that of tamsulosin or prazocin...Consult surgeon for proper examination and treatment .Take care ....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for paranoia\n\ni am a nineteen year old female, around 5 ft 4 and about nine or ten stone. i am constantly paranoid that everybody around me dislikes me. I think they all think bad things of me and i am always anxious that i have done something wrong or something to upset somebody. I used to be a very outgoing person but now i find it difficult to strike up a conversation with somebody. I worry that people dont like me, and all these thoughts upset me greatly. I feel like a shell of somebody i used to be. Around a year ago i was a regular user of the drug mkat, and now i really worry that this is a long term side effect. At the time i was using the drug i was suicidal and constantly upset; a common short term effect of a heavy user. I have no physical health problems and in a physical respect i have a clean bill of health. I feel that my anxiety/paranoia is gettin worse and that i cannot handle it by simply thinking of other things. It is always in the back of my mind. It is intensified not when i am drunk but the next day, i have crippling anxiety that i did something wrong that i cannot remember or that i said something to make the people around me think little of me. What do i do now? What is wrong with me? Do i need to go and see my gp?",
    "doctor_response": "Dear User,Thanks for using health care magic.From the available description it appears that you are either suffering with OCD or developing depression. These are the symptoms of psychiatric disorder that need treatment as soon as possible. As you have the functional impairment due to above described symptoms they are indicative of disorder.I think you need to see your GP or preferably a psychiatrist after obtaining a referral from your GP. He will ask more details about your problem and may prescribe medication or psychotherapy for treatment.'Hope I have answered your query. If you have any further questions I will be happy to help\".Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I have bloating, minor abdominal and lower back pain after routine colonoscopy ?\n\nHad a routine colonoscopy 6 days ago. Have had bloated, full feeling since, with minor pain in abdomen, lower back, feeling pressure - especially when I urinate, with feeling of needing to use bathroom. Have had several small bowel movements, but don t get relief of the feeling of needing to go. Last couple of days pain increasing some - now pressure and some pain in rectum and uncomfortable when I sit down. lower back pain increasing today.",
    "doctor_response": "hi..welcome to hcmSymptoms are common for 2-3 days post procedure because of the intervention.So do not worry.Use analgesic and stool softeners and take soft,liquid diet.thankyou",
    "dialogue_context": ""
  },
  {
    "patient_message": "When does growth spurt end normally for boys? I have been craving for foods more than i usually do. I will be 18 this year and obviously i m done with puberty. I was wondering that does my craving for foods mean i am experiencing puberty again or it s just because i like to eat?The last time i grew was when i was 16, i find it hard to believe that i just grew an inch because i started swimming regularly for months and i only ended up growing am inch, which is dissappointing.Does it mean i can still grow?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Growth is a natural process. Muscles has nothing to do with increase in height. When your bones increase in length, height increases. Muscles provide support to bones and posture to the whole body. Growth is noted even up to the age of 25, but usually between 20 to 22. Growth spurt can start anytime between 15 to 20, but the duration is not at all calculated. Duration could be from one year to 3 or 4 years. Enjoy with whatever you have. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need treatment for pus filled wound in leg\n\ni had a wound on my leg and i could see pus coming out of it some times. I just wanted to know what type of food can cause pusI have avoided all the food item ( which am aware of ) which causes pus, but could still see pus. I remember eating sweet corn, does it causes pus?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern looking to the history given here I could say that the pus formation is taking place duet to the infection the bacteria are the cause behind this and not the food, if it is pus in the wound then this need to be drained and anti- biotic is must, you eat any thing you like, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Not feeling comfortable watching sexual things. Suggest?\n\nWhenever I watch or see any sexual things I do not feel comfortable and do sexual thing on night and this kind acts going on continious three to four days approxe or sometimes without  any sexual things remembering it works automatically Plz help me how can I control this .... due to this my health is going down day by day",
    "doctor_response": "Hi there ~ I understand your concern.  You seem to have a common anxiety problem which is called OCD or obsessive compulsive disorder or a personality issue related to the same.  I recommend that you see a doctor as soon as you can.  I hope a psychiatrist can adequately help you with your condition using medications.  Also your condition is treated with psychotherapy as well, who can counsel you out of this problem.  I hope this helps. Take care and have a lovely day!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for endometrial thickening\n\nHi, i am trying to conceive for the past 6 months, but i was not able to do so due to endometrium. The size of endometrium is rise upto 7.4 till my 14 days of my cycle. Also my doctor advice me to take all the medication. So any change to get conceive in that size.Regard,Nita",
    "doctor_response": "Hi I think you can take some medicines like oestrogen to increase the endometrial thickness.  Once your follicle reach a size more than 13 to 14 mm, you can start taking retro. Talk to your doctor regarding this. Hope it helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pains, frequent urination and tiredness?\n\nHello Doc, I am having chest pains and always feel tired for the past few days. I also turn to urinate a lot of the time. My mum is diabetic and my uncle as well died . I dont know why I feel tired after waking up in the morning and also with chest pains. Thanks, Wiliam",
    "doctor_response": "Dear-thanks for using our service, I understand your concern and will help you with my medical advise.First of all, you might have an urinary track infection and will be helpful to have a sample of your urine for culture and sensitivity. It is advisable too a complete physical exam including a blood count and blood sugar. You need to drink plenty of water to avoid dehydration which can make you feel tired . The family history is very important too.Chest pain could be gas or inflammation in the costal space but it is recommendable to have an electrocardiogram too.I hope that my advise has been helpfulDr.Sara",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for improving sperm count\n\nHi doc, i have a challange with sperm count as low as 10% but volumes of about 2.5ml, pH 9, motility 40% and most with large heads. I ve tried several drugs but no improvement and now am trying Tamarind powder. Can you help in suggesting ways to improve my sperm count.",
    "doctor_response": "Hello, The cause for less sperm count should be ruled out first and than treatment done accordingly. I suggest you investigate with ultrasonography testes, serum FSH and LH estimation, serum prolactin estimation and serum testosterone estimation for primary workup. You need to stop smoking if having habit of it. Hey Forte, multivitamin tablets and clomiphene are some of the tablets used for improving sperm count. You can Consult good andrologist or urologist for detailed evaluation. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest diet to gain energy\n\nRespected sir. i am doing hand practice(masturbation) from last 3 years so that is the reason i became lazy and my body health as well as my penis health became very weak.sir please suggest me any medicine or natural fruits or natural food which is benefical for me in this period.Thanks",
    "doctor_response": "Good Day and thank you for being with Healthcare Magic! I would suggest regular diet and exercise 2-3 x / week. Vitamin C and citrus fruits would help a lot because it contains plenty of anti oxidants. The anti oxidants would help repair the body. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at:   I would gladly help you.  Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes auditory hallucinations?\n\nHey.  Every couple months I get this voice in my head, it's my own voice, but it speeds up and isn't controlled by me every couple months.  These things only happen every couple months, and only last for about 10 minutes at a time, but this voice makes me feel weird, insecure, and in my head I feel like a could jump off a building.  I just feel like I am going to actually start screaming.  Luckily I have always been able to contain this thing, but if I am in public it gets really hard to control, even though I am talking like my normal self to people, I feel like I am going to just start jumping around like a lunatic and start yelling or something haha.  What is wrong with me",
    "doctor_response": "Hi.I had gone through your query. I understand your concern. Hallucinations has two types. 1. Visual 2. Auditary. Auditary hallucination specially commanding or threatened may indicate psychopathology. It can be a part of Psychosis or organic brain disorder.but it is must to evaluate it about its content/duration/frequency etc. Evaluation about others associated symptoms are also necessary to reach conclusion. It can be treated with medicine like anti psychotics.before that you have to consult psychiatrist and get help. Still if you have a query then feel free to ask. Happy to help you. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are solid lumps under skin of arms and legs a cause for concern?\n\nHello,I have several solid lumps under my skin about the size of a large peanut.  They are in my arms, legs and most disturbingly in my penis.  I am anxious as they have been there for several years - although the size/shape has not changed during that time.  Do I need to worry?",
    "doctor_response": "HI.You are already worried.The best way is to go for an FNAC= fine needle aspiration cytology and/ or excision biopsy to get a correct diagnosis.You can choose the one which is most unsighty or causing a problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abnormal liver function tests?\n\nI found, through routine bloodwork, that I have very elevated liver function tests. Bilirubin, AST and ALT are all very high. Currently, I am waiting for an appointment with a liver specialist on Dec. 13. In the meantime, I am very worried that I can t get the levels down. From Nov. 10 to Nov 22, the bilirubin climbed from 3.2 to 5.9. I was also looking jaundiced. AST went from 79 to 265 and ALT from105 to 407. Alkaline Phosphate is also high. On Nov it was 211. On Nov. 22 it was 214. After 2 weeks of drinking lemon juice and apple cider and eating apples plus drinking more water, there has been a very slight lowering. My bilirubin on Dec. 1 is down to 5.2, but my primary doctor said it is still dangerously high. I do not want to go back to the GI doc in our neighborhood. I have had an ultrasound and an MRI/MRCP. The MRCP shows two large gallstones, but they are not blocking the bile duct. Is spite of this, the GI doc wants to to an ERCP and I refuse to have that done except by an expert in the field. Also, I don t think he can see anything with the scope that the MRCP didn t see. Are there any other foods I can eat to lower the levels further while I wait to see the specialist? I can t exercise as I have too little energy. I have constant nausea and itching and am tired all day.",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.SGOT and SGPT  are sensitive indicators of liver damage or injury from different types of diseases or conditions, and collectively they are termed liver tests or liver blood tests. So the next step is to look for certain liver damage and most common casue is fatty liver disease. It should be confirmed by ultrasound. Other causes are viral hepatitis,cirrhosis, medications, alcohol intake or autoimmune diseases. To verify exact cause, US, bilirubin levels and tumor markers should be additionaly done Then appropriate treatment can be started.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. HPV is revealed from my abnormal pap test. What should I do as a preventive measure?\n\nHello doctor, My gynecologist told me that I had an abnormality in my pap test, and I have HPV. Eventually, she will need to look at my cervix to make sure what strain it is. The information she gave me was very bland. All she told me was that if I have sex just use a condom, which I always do. But I wanted to know, what can I do physically and sexually with what I have?",
    "doctor_response": "Hello. May I know what was the abnormality detected on your pap smear? As per your gynecologist, if you have got HPV (human papillomavirus) infection (high-risk HPV strains), that is responsible for the development of cervical cancer, you need to be further evaluated. So your gynecologist would be having a look at your cervix through a magnified camera that can pick up certain changes on the cervix, and can hint on the development of any precancerous changes. If present it can be tackled at an early stage before actual cancer sets it. So cervical cancer screening methods can detect changes almost five years before the actual development of cancer, so it is advisable you get regular pap smears as advised by your gynecologist and be under her follow. It would have been helpful if you could share the reports of pap smear and HPV testing with me so that I could guide you better. The reason your gynecologist asked to use condoms is that HPV infection is usually acquired through sexual contact. So to prevent repeated infection and also to prevent other sexually transmitted infections, which can further aid in acquiring HPV infection can be prevented by using condoms regularly. Regular pap and HPV testing. Avoid smoking and multiple sexual partners.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back and chest pains, throat blockage with tightness and rhinitis?\n\nI have a really achey back and strong pains in my chest, i feel like i have a blocked throat0 it feels really tight, and i have a blocked and runny nose. On top of that, i feel really sick, im worried to eat anything because i just feel like i'll throw it up. Any ideas on what this could be and anything i could take to help?",
    "doctor_response": "It s pratishyaya and shool in Ayurveda and in modern words called Catarrh.Simply decoction of holy basil leaves and Giloy ( tinospora cordifolia) twice or thrice will set it right in few days. No side effects at all.For catarrh only anti allergic is given with analgesics which has symptomatic and temporary relief only.Hope it guides you well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Undergone 2 cycles of IUI, treatment going on. Reason for infertility - cystic and bulky ovaries?\n\nhi i m 26 yrs old and have completed 6 years for marriage...........................have done a lot of medications ....................in 6 years...................also done 2 cycles of IUI ......................now also my treatment is going on.........................my follicular study is going on..........................today is my 12th day And the size of my Right Ovary is 18*20 & left Ovary is 16*16 & today my doctor will be giving me one injection to rupture the egg.................so that he can do my 3rd cycle of IUI..........................when the egg should get Rupture?????.............one more thing that my both the ovaries r cystic & bulky so m i having the problem of infertility b coz of cystic & bulky ovary or some other reason.....................pl.suggest me something",
    "doctor_response": "the eggs should get ruptured usually on the 14th day of menstrual cycle. yes polycystic ovaries will lead to infertility. dont worry continue with your treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will exercise affect the pregnancy in the future?\n\nhi my name is claine elizabeth i am a 17 yr old girl in texas and for the past three months i have been bulimic and exercising and i am 103 pounds an djust don t feel thin enough. When i am older will my being bulimic effect the chances of me getting pregant",
    "doctor_response": "Hi,   Thanks for asking.  Overweight is one  of the cause  of PCOD.. which disturbs  ovulation , leads to irregular periods . Ovulation is essential for pregnancy..    So yes, overweight can be  a hurdle in pregnancy.    You should therefore continue  with your efforts  &weight to ideal level & have regular menstrual cycle ( prevent chances of PCOD .. menstrual irregularity ) & have normal  chances of conception.    Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low WBC count and fatigue?\n\nHi My son is sixteen and has struggled with his health since I care to remember,he is tall when hes exerted or under preasure he burns out,his wbc count is low he is always cold has no energy and isnt a typical teenager it pains me to see him like this",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. He may have some viral fever. Body pain and fatigue is common in viral fever. You should go for complete blood count and peripherals smear examination. Check your platelets count regularly.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fatty liver\n\ni am having fatty liver grade 3 , since 5 months, shall i go for any tests now, i want to know which tests , how time to recover, is it reducing to grade 2 or reducing to normal, how the treatment doctors not advising any thing, is it depending on reason or general treatment",
    "doctor_response": "Grade 3 fatty liver is a matter of concern . I advise you to get a Liver biopsy done and revert back with the report .    If you are taking alcohol Stop it . Get your Lipid Profile tested and if it high you need to start medication for high cholesterol .   Daily do aerobic exercise for 20 minutes at least .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bad headaches with nausea and stomach cramps. What is it?\n\nHi, I am 16. I weigh 150 pounds and am 5 4! today i came home from school and i have a bad headache , nausea , my stomach is hurting pretty bad and i am dizzy and shaky and really tired! I have trouble with my stomach all the time so the stomach thing is normal for me but not everything else because i have been tested for many things for my stomach problems since i was 13 and they have found nothing! But i am just looking to see if i can find out something without having to go to the doctor!",
    "doctor_response": "Hi ! I would like to know your dietary and bowel habits.If you eat frequently from outside, and that too some junk food kind of thing, then that may be the reason for your stomach problem. Many kinds of parasitic and bacterial infection may arise for those who eat frequently from outside. Apart from this, some people react to a particular component , e.g., glutten which is found more frequently in junk foods from outside. This glutten enteropathy  may cause all the symptoms of yours. Such eating habits can also be a reason for your being overweight if any other hormonal causes are excluded. Try to add more roughage and liquids in your diet. Get investigated for parasitic, bacterial infections and also for glutten sensitivity. Till that you can take a proton pump inhibitor drug along with an anti spasmodic drug.Wishing you an early recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for urinary incontinence in a child\n\nHi Doctor, I have a question for u that my younger sister she is about in 5 class. she has a problem of doing urine on bed we try to control by making her routine to do urine at night but we are faild to control this now i wanna ask u for a best way how control this problem kindly help me for this kind act. I shall be very thankful to you for this kind act.I wait for your answer plzzzzzzzzzzzzzzz help me. thanks",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. I have few questions for you -1. Has your sister stopped bed wetting at certain age and again started having it?2. If so at what age she stopped and when did it start?If she had never stopped bed wetting form birth...you can try some behavioural changes which I can elaborate after proper history and interaction with you, but the effect will not be immediate, but it will be permanent.If its a recurrence after attaining night time control, I suggest you see your paediatrician to rule out pathological causes like urinary infections or Voiding dysfunction (In which the ultrasound abdomen will pick up thickened bladder wall).Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tightness in carotid arteries on both sides\n\nI have printmetal angina i am on cardizem 180 bid and asa and diastolic for htn, i have tightness in my carotids both sides of my nect up to my jaw line my pressure is good should i be worried i took everything in cluding lorazempan for relaxation of smooth muscles which helped for two hours.  my pressure is 117/70 i feel like my carotid arteries are beeing squeezed on both sides of my neck..",
    "doctor_response": "If symptomatic inform of stroke....then definitely need treatment for carotid stenosis...critical stenosis also need to be treated...ur case is more complex and need strategic planning and treatment",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Jakafi advisable for polycythemia vera?\n\nI was diagnosed with p vera back last Aug. I was wanting to see some pictures of a spleen that has p vera. I had been given a pill to take (can t spell it) which did not help at all. Now I am taking JAKAFI 10 mil. Some days I feel pretty good but then other days I hurt pretty bad. I am just wanting to see what my spleen could possibly look like and what my options are.",
    "doctor_response": "Hi, Jakafi has a very good track record in many patients to control the runaway red blood cell counts in PCV.  Stay well hydrated and stay in close touch with your doctors who will be monitoring your progress in order to tweak treatments and decide upon next moves. Here's a link you may find helpful which gives a diagrammatic representation of what a spleen may look like in PCV.  There's nothing really different about how spleens \"look\" in PCV except they are engorged, larger, and heavier due to the increased hematocrit and volume of red cells that need to be processed. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high fever with running nose and lump over face?\n\nI am suffering extreme hayfever symptoms, runny nose sneezing etc. I started getting small lumps under the skin on and around my chin, culminating today with a large walnut size lump on my temple. They do not itch. Whilst I have had hayfever for many years, never lumps!Thanks Jan Moon",
    "doctor_response": "HI.This means now you have a severe symptoms and this indicates the need for an additional steroid. Newer Steroid in the form of deflazacort are better , safer , cause less side effects and you can take short courses of say a fw days to a few weeks in reducing doses. This is important as the lumps are indicative of the pending complication like angio-edema, which is dangerous if it occurs in mouth , tongue ans such places. Consult a Doctor fast to get a prescription and the first shot ASAP",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stressful job environment. Plan a job shift but low on confidence. How to deal with this?\n\nHello:I am going through some major changes at this point.  The recession in our economy was stressful for 2 years in a row.  Then I managed to land a job in a place where the upper level manager is an emotional abuser.  I sensed it from the moment that I had an interview with him as if he did not want me to work there.  I reported directly to this other supervisor who did some questionable things like always being critical of my one co worker.  He eventually fell ill and had a long term medical leave.  I started to stress out as soon as he was gone.  Then I learned of many different individuals that had come and gone within this particular group within a short frame of time.  My supervisor eventually quit without another job lined up just like a few other individuals.  Then I started getting blind sided by this upper level manager because we had no manager in between.  I feel numb,  still a bit bitter by his put downs because it was like I was his punching bag on an emotional level.  I feel frozen about finding another job but I don't want to make the mistake of landing in another rough environment like the one that I had come from.  He was borderline stalking me even while I ended up in the hospital.I was just invited to 1 week of free endless fitness training courses for kickboxing.  I managed to get through one short term temporary work assignment since then and I managed to get some sleep each night without waking up from bad nightmares where this man was physically attacking some woman that I was unsure who it was.I don't want my fear to show up during my job interviews.  What can I do to feel better and get into another poorly managed company?  I am getting interviews,  however,  it's like I knew through strong intuition that something was wrong and I dismissed it because I felt that I had to take the position during tough economic times.  This stressful job ended up landing me in the hospital.",
    "doctor_response": "hello there, there seems to be a problem in confidence and overall fear of the unknown. this is surely an anxiety problem. diversion is one of the best way to overcome this. however, in your case you tend to gi back to your worries. the past job could have caused you to go down in this type of situation and getting another job should do the trick. follow your instinct on seeking another type of work or envirenment. it is just like hiiting two birds with one stone. having a new job will recover your confidence and self integrity. and having a new job would let you forget your previous bad job experience. put this in your mind and you will face the interview with enthusiasm. just set your mind to make good in this interview and that you badly need this job so that you will appear focused and firm on getting this new job. it is all in your will actually. you can do it. you will surely feel better after this interview. feel free to give us feedback after this. thank you dr. eric",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hands to fall asleep while sleeping?\n\nI have to questions, One when I sleep my hands fall asleep mostly i realize it in the morning when I m waking up because it s a little uncomfortable almost painful. About two years ago it was the joints in my hands and I went to a doctor and they told me it wasn t arthritis( it stopped when I was pregnant and started up again now a few months after giving birth) but now it s my whole hand. I don t know what i can be",
    "doctor_response": "Hello,Your symptoms seem to be related to a pinched nerve (carpal tunnel syndrome). For this reason,  I would recommend consulting with a neurologist and performing nerve conduction studies.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness?\n\nMy father in-law is 65 and had a stroke about 2 years ago. He is currently on high blood pressure medication but tonight he got dizzy and fell.  He was disorientated and we had to help him walk to his room. This is the second time that this has happend in the last 6 months but the first time that he fell. Should we be worried and what actions should we take to prevent this from happening again?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.It seems that he is suffering from Postural hypotension a known side effect of many antihypertensive.Please ask your father in law not to stand up abruptly, but sit before standing up from lying down and visit his general physician, so a substitute antihypertensive can be recommended.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Muhammad Adnan Iqbal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I conceive after terminating pregnancy and having semi brom and folic acid?\n\nHi ! i m 37 yrs old n trying for baby having unprotected one year sex. Till not concive. last yr i terminate 5 month pregnancy having trisomy foetus. now Dr prescribe semi brom and folic acid tablet. now i m worry about my pregnancy. i concive or not at this stage.pls give advice.",
    "doctor_response": "As your age is more than thirty five so less ovarian reserve.. So less chance of getting pregnant.. And there are more chances of anomalies in baby",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for drop in oxygen level?\n\nMy oxygen level dropped from 98 to 94 and I am concerned. I was diagnosed with AFib in 2011, but otherwise I am a very healthy, active 68 year old who drinks 1-2 glasses of wine/day, eats a very healthy diet and does aerobic ex. 3/week plus Pilates 1/week. Why did it go down? I do feel that I am not able to work out as hard as I used to a few years ago. My Doc said my lungs sound clear and my heart beat strong, but doesn't know why the drop.",
    "doctor_response": "Hi,Welcome to Health care magic forum.                        At this age, people will have a some atherosclerosis, and some alviolar closure and a degree of anemia.                        I advise you to consult a chest physician for diagnosis and treatment.                         Take more of green leafy vegetables,pulses,sprouts,and protein rich foods to have blood,general health and resistance against infections.                        Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with vertigo, repeated dizziness and vomiting. Any tests to prove it ?\n\nI have already been diagnosed with vertigo and presently on 100mg of neurotin.  I thought I was in remission from the dizzies and vomiting, but the dizzies have returned so severely that I can't walk across a parking lot or to my car without assistance.  This is causing me a lot of grief since I am  I am a Senior Fitness Exercise Teacher, and I now I have to teach from the chair.  I can't stand the sympathy or asking for help.  Any answers.  I have already had all the tests to prove vertigo..",
    "doctor_response": "Hi,Thank you for posting your query.Based on your description, the most likely cause of your symptoms could be BPPV-benign paroxysmal positional vertigo. An evaluation by a neuro-otologist would help in confirming the diagnosis and planning the treatment. Tests may include audiometry, electronystagmography (ENG) and vestibular function tests.Treatment consists of medications such as piracetam, vitamin B12 and betahistine tablets. In addition, vestibular adaptation exercises are also helpful.I hope it helps.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What should I do for severe pain with bad breath and taste after wisdom tooth extraction?\n\nHello doctor, I got one of my wisdom teeth taken out a week back. My stitches came out and now there is a big hole where the tooth was extracted. My dentist gave me nothing, not cleaning tools at all. I am just freaking out because their office is closed. What should I do about the giant hole? It hurts a lot. My breathe stinks and taste is bad as well.",
    "doctor_response": "Hello. If it hurts a lot, it means that you have a dry socket condition, where the blood clot gets dislodged from the wound causing infection. You need to start taking antibiotics like Augmentin 625 mg and a painkiller. Also, use warm salt water gargling three times a day. Do not touch the area. And wait it out till you can see a dentist nearby. In such condition it takes time for full healing of the area, thus you have to be patient, get the wound cleaned and debrided by your dentist as soon as possible.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes compulsive lying disorder?\n\nMy friend makes up stories all the time. He has even gone so far as to lie and claim to have gotten one woman pregnant then started saying that he wants to drug her and make her have a miscarriage. The problem is he has never even been alone with this woman. She knows him but not in a sexual sense.",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.This could be due to personality issues. That will require intensive psycho dynamic psychotherapy. Still the prognosis is not good. 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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to remove painful lump in the groin area\n\nI have a large painful lump on the top right side of my cliorus, its very painful and hurts when I walk. I also have swolen lymph gland both sides of my groin, which is very tender, I discovered this this morning and lump had grown since. I'm very worried. And in pain. Any help would be great. I aso suffer with cystitus and pain when urinating.",
    "doctor_response": "HI. This is definitely an infected lump near clitoris and has caused the secondary lymph node enlargement in groin. You have to consult a Gynecologist to have a direct examination of the part , the possibility of STD and have a proper treatment that will have effect even on the cystitis and burning micturition. Please undergo all the tests your Gynecologist would advise and take a proper care for future as long treatment may be necessary for complete cure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for weird dreams,night sweats and nausea\n\nHi my brother is having the same symptoms as a previous article listed :-Please advise ...Thank youI am occasionally afflicted by a strange condition that seems to be linked to my memory and my stomach. Every now and then, I get a flood of memories, usually from dreams I've had recently. the images and events I am remembering seem to make no sense, but are accompanied by a strong sense that remembering them is important, and that doing so makes sense, like a missing piece of a puzzle that has been replaced. Very shortly after this, I am overcome with nausea, developing a sort of tingling burning sensation in my stomach and breaking out in a sweat. This lasts no more than a minute at the most, but once the nausea has past, both the memories and the feeling of 'making sense' pass. This doesn't happen to me often, maybe once every six months or so, and usually happens three or four times a day, but it's very odd. Anyone have any ideas?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  Researches confirm Dreams come during pre-deepsleep period. If you do not exercise / work hard, there is a possibility that you never have deep sleep and then you have wild dreams. Secondly you must understand that you should not obsess the subject of dreams. If you do that you become anxious and the result could again be lack of sleep as well as nausea. Exercising / working hard to get deep sleep is the solution.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How will taking birth control pills help in IVF?\n\nHello doctor, My husband and I recently underwent an IVF cycle and it failed. Originally, my husband has a problem with 1% morphology. But, now I a have poor ovarian reserve. I am 39 years old and my AMH was .24. However, my FSH was 5.5 last time. AMH was not repeated. I was stimulated with the maximum dosages and only produced three eggs which all produced embryo's (I do not know the quality, only that one had progressed normally by day 3). We did a day 3 transfer. On the second day after the transfer, I had what I can only describe as scab-like discharge about the size of a tear. One the sixth day, I finally left the house and started to resume so level of normal activity (no heavy lifting) and that afternoon I had a very bright red urine flow like a small amount of blood pass when I used the bathroom. I thought that it might have been implantation bleeding, but clearly not. I want to try IVF again, but I am afraid of the same results. In doing research, I found a book that suggests many environmental factors such as BPA and phthalates can play a part in egg quality, quantity and affect the sperm as well. The book suggests waiting three to four months prior to beginning IVF to get the full effect of supplements recommended as well as let the harmful chemicals leave your body. My questions are given my numbers, in your opinion, will my number of eggs change drastically while waiting or should I be normal? Should I retest my AMH before making this decision? Also, is there any way for me to preserve my eggs (not menstruate) until the month before the IVF procedure. My thought was to take birth control pills for three months (and not take the sugar pills). Is this safe? Can it be done? What are the repercussion? Finally, Based on our numbers, would you recommend that we use donor eggs instead of trying another cycle? This time around will have to be the last as we do not have any money after this one. It is critical that we make the right decision.",
    "doctor_response": "Hi. Looking at your case history, (attachment removed to protect patient identity) it would better to go for donor eggs. Ovarian reserve decreases with age and retesting for AMH (anti-mullerian) is not going to affect the outcome (increase ovarian reserve), so no point in retesting AMH. By taking OC (oral contraceptive) pills continuously, you cannot halt a decrease in ovarian reserve (loss of eggs). Menses is just an indicator of loss, actually a woman loses 400-600 eggs per month irrespective of whether she gets menses or not. What you see on ultrasound is just loss of dominant follicle, the loss of those 600 follicles cannot be seen, it can be perceived indirectly by decrease in AMH, increased requirements of hormone injections during IVF (in vitro fertilization), reduced number of eggs retrieved and low pregnancy rate. One more effect of advanced age would be increased risk of Down's syndrome in the baby if you try with your own eggs. So considering your advanced age, low AMH, poor response to stimulation, low number of embryos formed in the last cycle and increased risk of Down's syndrome with own eggs I would suggest to go for donor eggs.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for skin rashes\n\nI have a rash on my back.It starts in the middle of my back,actually there is two patchy areas over my lung area and the rash has spread up my back to my shoulder area.It has also been accompanied by a cold,runny nose and stuffed up,cough, head ache,sore throat and that's about it as far as any symptoms.The rash is a little itchy but not bad.I have had it for 3 days now and no one else in the house has it.The rash looks like little red bumps,I did take some allergy medicine and I thought it was helping but it has not.",
    "doctor_response": "Hi,It seems that probably you may be having viral rash or allergic dermatitis. Kindly consult dermatologist for firm diagnosis. For systemic symptoms, consult physician. He might give symptomatic treatment to relieve cough, cold and fever. Blood tests may be done to rule out other pyre tic conditions. For skin rash, your dermatologist might give antihistaminics to relieve itch. If he feels for allergy, might give steroid in tappering dose. Local application of mild steroid cream may be helpful. I hope you got my answer.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dizziness,loss of balance and slurred speech\n\nyes i wakeup in the mornings with slurred speech i am dizzy sometimes i have trouble with one eye being red i very fatigued. I have trouble walking getting to my job no balance cant stand more than five minutes and i looking around where to sit cant even do the grocery shopping anymore cant walk the store.",
    "doctor_response": "Hello and thanks for using HCM.I have read your query and understand your concerns.Your condition sounds serious, it has to do with diseases of your nervous system (probably ALS or Amiotrophic lateral sclerosis, MS or multiple sclerosis and muscular dystrophies).There is need for you to consult a Neurologist and discuss your concerns, test needed also to properly diagnose your condition.Hope this helps. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How bad does it hurt to get liquid drained from knee?\n\nHow bad does it hurt to get liquid drained for your knee. I was sliding in softball and I slid wrong and now my leg is all bruised up and I have this pocket of fluid. The doctor I went to said that we will give it time to see if it will go down but my dad says it would be better to just get it drained now. I am scared to get it drained I am not good with big needles and shots! How bad will it hurt?",
    "doctor_response": "helloAfter trauma to knee often there is fluid collection into the joint and it usually subsides with adequate rest and icing in initial stage and later with hot fomentation and application of compression bandage and anti-inflammatory medicines. If it doesnt then , a fine needle aspiration or draining may be done. it is a simple procedure just a seconds prick and job is done, so nothing to worry.follow your doctors advicethanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe anxiety and depression\n\nI am having severe pins and needles all over my body constantly. My doctors say it s all anxiety as I suffer from Depression and anxiety. I also was I. Benzos and came off of them. And I have a history of psychological trauma and intense stress for the last twenty years. How do I tell what is causing this quicky. I am at the end of my rope",
    "doctor_response": "DearWe understand your concernsI went through your details. I can understand. I say, you are suffering from anxiety and stress for the last 20 years. Still you refuse to learn. Learn the stress and trauma as part of your life and never try to get rid of it. This could be the correct approach to it. The more you try to get rid of it, the more it comes and troubles you. Understand, be aware and learn about anxiety, stress and mental trauma. Accept it as part of your life. Always. Such a change in thought style should provide you with immense inner peace. I am sure about it. My whole of the treatment methodology is revolving around acceptance of them. I have definite results and cure to justify the procedure. Try this methodology as you have already ran out of options. Take care.If you require more of my help in this aspect, please use this URL.  sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump in neck while singing?\n\nI was just standing in front of my bathroom mirror singing while fixing my hair and noticed a lump slowly appear on the left side of my neck. I felt around for it and I can not feel anything there--no lymph nodes or pea-sized knots. Nothing. When I stop singing it goes away. Could this just be a vein popping up? Health history: I am an almost 32-year-old female. I am overweight, but otherwise I am in good health. I had some bloodwork done in February for insurance purposes, and it all came back normal. I have never had any health issues other than seasonal allergies. (I live in South Georgia--allergy capital of the world. ha)",
    "doctor_response": "it could be a thyroid colloid cyst or a laryngocele or mucocele - all are benign conditions and not to worry!USG can diagnose it accuratelyplz consult an ENT specialistall the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes liver movement feelings constantly?\n\nHello, For some time now and with time, its getting to be on a constant basis. My right side such as where my Liver is located is constantly moving like a baby would move inside..And, Im not pregnant. I am 54 years old and have had 5 natural births..Im going in for an ultrasound this thrursday and would like to have an idea on what to expect.",
    "doctor_response": "Hello! Thanks for putting your query in HCM. I am a Gastroenterologist (DM). It may be only gas or peristaltic movement of intestine.I hope I have answered your query and this will help you. If you have any further query  I will be happy to answer that too. Remain in touch and get-well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do these hcg values indicate?\n\nHi I had polysestic ovary so I took medicine to produce a good egg. 23rd April I took my first bool test and the result was positive with 77hcg. Then I took the second blood test 25th April and hcg was only 89. Now I have lower back pain. Am I still pregnant or not?",
    "doctor_response": "HAI WELCOME TO HCM you could wait for one week to do hcg.some time the value will increase after some time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting after having food?\n\nMy 19 month old son vomited during dinner last night. He was ravenous and ate quite a bit (turkey hot dog, six tortellini, some blueberries, and string beans). He threw up EVERYTHING. He was acting fine five minutes later and wanted more. Does he have a bug or did he overeat?",
    "doctor_response": "hi, the chances of overeating are more because there are no symptoms like fever, pain abdomen, regurgitation of food. Also, after vomiting the child becomes normal this also indicates that this was due to overeating. However, you should keep a watch of symptoms like vomiting, pain abdomen, loose stools and representation of food. in some cases, The Other symptoms comes at a later stage. Avoid eating food from outside, outside Food is low in immunity and also results in acute gastritis. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can we do for conceive ?\n\nsir, I have got married since 1 and 1/2 year before. but we are still sterlite.what can we do for conceivning a baby. Sandeep",
    "doctor_response": "Hi,Sandeep,Deepak, Thanks for query, You require to go for physical examination and some investigations, your's and your wife's investigations are required. Consult gynaec and seek his advice. I am sure you will get angel baby, Best of luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is accidental swallowing of a hard plastic paper in an 8-month-old a cause for concern?\n\nMy 8 months old daughter might have swallowed a piece of hard plastic paper, it\u2019s crescent moon shape, from kinder egg. It\u2019s been two days, she\u2019s been ok . . breathing, eating, pooping ok but I\u2019m still worried. Should I stopped worrying? I\u2019ve also been checking her poop n I haven\u2019t seen any of the plastic paper. Will it get excrete with the poop? And if I don\u2019t see it in 3-5 days, should I be worried? But again I\u2019m not sure if she swallowed it, I noticed the piece was missing when I took it from her, but I wasn\u2019t sure if it was there to begin with!",
    "doctor_response": "Hello, Depending upon the size and shape of the object you can wait for 7 to 10 days and if it has not come out till then I suggest that you approach a pediatric gastroenterologist, please. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in breathing and pressure in the neck?\n\nhello doc my name is Liza from Leyte, I am 33 yrs. old, married and have one child my height is 5'1\" weights 64kg. I have a non toxic goiter as what doctor said it to me after she got the result of my biopsy then she gave me medicine to take. My question is I'm having trouble of difficulty of breathing, nervousness, feeling pressure on the neck. Somebody told me that there is a best medicine about this and she recommended me to take herbal medicines, is it okay if i will go for it what she says? I am seeking for your advice, Please help. I am looking forward for your soonest reply. thanks.",
    "doctor_response": "Hi Dear  Liza!! Thanks for your query to HCM.Read and reviewed your query and health concerns. You seem to suffer from Thyroid Goiter, compressing tracheal air passage,which leads to breathing difficulty.This usually happens in very large goiters.In this scenario-You have hyperactive and hyperplastic thyroid follicles with increased sizes and number,in attempt to produce more thryoxine-to cope with increased needs in your age.Don't belive on home remedies as the condition is complex in your case and would need supervised treatment with-Thyroxine and iodine -Tab-to supplement increased needs in your case, which would shrink the goiters fast in calculated way-which could be fixed with USG study, accompanied with TSH/T3/T4 and Iodine levels in your case.This requires treatment under cover of Physician or Surgeon expert in treating in such Goiter problems in your case.Hence You should not go for herbal remedies,as your case is complex and needs more precise investigations and meticulous follow up under cover of Specialist Doctors / or Endocrinologist-in your case.There are varieties of goiter and causes for it,which may cause tracheal compression-like plunging goiter.Depending on the cause and urgency treatment needs to be planned in such cases, under guidance of team of Surgeon / and Endocrinologist, who would plan rightful treatment in your case.Hope this reply would help you to resolve the health issues with help of doctors attending on you.If need be, update any health issue 24 x 7 by a direct question to ME, at following HCM link-Dear, if satisfied,Don't forget to close this query with YOUR pleasing feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at HCM services.If you want to update more details and ask more update queries ,You are most Welcome herewith !!Good Day!!Wishing Good Healthy Life in time to come!!Dr.Savaskar M.N.Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is bone affected by cancer in Adeno Carcinoma stage 3?\n\nHello Doctor, My mother is affected by Adeno carcinoma of endocervix stage IIB. In her CT scan Report they have given one statement \"VISUALISED BONES SHOW EVIDENCE OF SEVERE DEGERATIVE CHANGES\" is this state ment means the cancer affected in bones also? Dr. pls clarify my doubt Regards, Rama",
    "doctor_response": "Hi , with regards to your mother, the changes in the X rays, could be due to 2 scenarios. 1. if your mother is above 45 years (which is my guess), these changes could be due to osteoporosis related changes. 2. In case of advanced cancer, the release of cytokines by the body, as a reaction to cancer, could cause degenerative changes in the bones. the treatment in both cases - is Vitamin D & calcium supplements (To strengthen the bones) and supportive medications like alendronate which can prevent bone loss and deterioration. In cases where the cancer directly involves the bones (in form of metastases) there would be seen as separate lesions and not as degenerative changes. You can consult the treating oncologist, and he will do the needful. Hope this helps. Dr Deepak Anvekar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heaviness in my chest and numbness in my arms?\n\nI believe it's stress or anxiety, but just wanted to be sure. I've been married for 13 years and I'm a stay at home homeschooling mother of 3 (7, 3 and 1 year old) in my mid thirties. For the last couple of weeks on and off, I've been feeling a real heaviness in my chest as if something were sitting on it and a swelling in my throat with some harder breathing. Yesterday my arms went numb for a while. Today my chest has felt the heaviest and I have not been able to get it to settle and my left arm is numb. I have some stresses that have been going on in my life (who doesn't) but nothing huge. I'm overall healthy and not a drinker or a smoker/or drugs and not over weight. (5 foot 119 lbs.) Is it ok to wait and just let this pass or should I just get checked out. Thank you!",
    "doctor_response": "Hello dear , hiWelcome to Healthcaremagic.comI  have evaluated your query thoroughly .*  There are different  possibilities for this condition as    -  low hemoglobin levels  -  deficiency of vitamins , minerals , trace     elements  -  stress  -  anxiety  -  over  exertion  -  inadequate  rest      -  cardiac  issues  -  others  .*  Needs  primary  work  up with physician  for  x-ray  chest , EKG and    basic  laboratory  tests  .Hope this will help you .Wishing  you fine  recovery .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medicine should I take to avoid damage due to a heart attack?\n\ni am travelling to nepla and far from doctors, i am on Ramapril 10mg, but wanted to know if and emergency occured a stroke or heart attack what should i take with me that i could use to help prevent further damage if i experienced this...i have spoken  with my doctor here in uk biut would like a second opinion, thank you, i was told something about Asparin? and some other tPA drugs by my doctor here in uk",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.The best drug you can keep with you is asprin which you can take regularly too in low dose.Another drug you should keep with you is any sublingual nitrate which will help you in pain and acute myocardial infarction. Hope I have answered your query. Let me know if I can assist you further.Regards, \u00a0\u00a0\u00a0\u00a0\u00a0Dr. Muhammad Adnan Iqbal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling on the face after taking Zithromax and Prednisone?\n\nI am taking zithromax and prednisone as I just had a tooth extracted and a bone graph yesterday. I started the medication today. I noticed my face has become swollen and hot.  I also am feeling tightness in my throat and short of breath. I took a benadryl about 30 minutes ago but no relief. Should I go to ED?",
    "doctor_response": "Hi..Thanks for the query..Your symptoms are clearly pointing towards allergic reaction..It can be due to either of the drugs that you are taking..You should immediately stop taking these medications as the symptoms seems pretty severe and consult an Emergency room immediately to avoid My serious complications.You can be advised intravenous antihistamines to relieve the symptoms..Also get a blood test done to narrow down the medication that caused the reaction..Hope this helps..Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes extreme sleepiness with high fever?\n\nmy child has had fever for the past 3 days with temp as high as 40.4...after giving ibuprofen it does go down to 37 and go up back to 39+.What worries me is he has been mostly sleeping the past 24 hours...only waking up for about 5-10 minutes and then sleeping again.He is 3 years old.He just take sips of water in between and ate very little.",
    "doctor_response": "Hi...the possibilities include - 1. Viral Illness2. Acute CNS infection or meningitis.I will tell you how a viral illness behaves - 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.But, excessive sleepiness cannot be ignored. I suggest you take him to the nearest emergency room.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and nausea?\n\nFor the past month to month and a half I get severe dizzy spells, I'm nauseous , I go pale my Bp goes up along with my pulse and my eyes do this fluttery thing. They put me on a holter monitor and blood pressure monitor which came back normal. What do you think it could be?",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!I understand your concern and would explain that your symptoms may be related to an inner ear disorder. A partial epileptic seizure can not be excluded, based on your symptomatology. So I recommend consulting with the ENT specialist and perform a careful physical examination and labyrinthine tests. If the above tests result normal, an EEG would be the next examination to be done. This would exclude possible partial seizures, which could mimic this clinical scenario. Hope to have been helpful!Best regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the elevated potassium values be due to blood pressure medicines?\n\nI had been taking lisonpril for my blood pressure, but was getting high levels of potassium and they took me off that med and put me on Norvasc, but my blood pressure has not gone down, was sick with emtreme sinusitis at the time but am still getting elevated readings of potassium, can this be from med or should I start looking for another reason.",
    "doctor_response": "Hi. I have gone through your question and understand your concerns.Lisinopril is ACE i group of medicine and hyperkalemia is known side effect of ACEi. It depends that when did you left taking lisinopril ,if its yesterday than its very early to say that its due to some other cause , but having hyperkalemia is very dangerous thing to have so i suggest you to consult your physician to get potassium levels under normal range. There are many causes of hyperkalemia so i suggest you to consult your physician so he/she should look for any treatable cause. Depending on the clinical findings and the results of the laboratory work, the following may be indicated:Glucose level - In patients with known or suspected diabetes mellitusDigoxin level - If the patient is on a digitalis medicationArterial or venous blood gas - If acidosis is suspectedUrinalysis - If signs of renal insufficiency without an already known cause are present (to look for evidence of glomerulonephritis)Serum cortisol and aldosterone levels - To check for mineralocorticoid deficiency when other causes are eliminatedSerum uric acid and phosphorus tests - For tumor lysis syndromeSerum creatinine phosphokinase (CPK) and calcium measurements - For rhabdomyolysisUrine myoglobin test - For crush injury or rhabdomyolysis; suspect if urinalysis reveals blood in the urine but no red blood cells are seen on urine microscopy.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate to ask. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are stomach pain and urge to vomit side effects of i pill?\n\nhi i am mansi . i am 18 and had sex wid my bf.. after having sex i had takken ipill on the same day. but after taking ipill i am not feeling well . i had a sensation of vomitting nd sickness or pain in my stomach.. do i get pregnant ? or is these are just the side effects ?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It can be both.More chances of IPill side effects because you have taken immediately after sex. Frequent IPill usage should be avoided. You can wait for 24 hrs and if no relief consult a gynaecologist. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can AKT 3 be started for cavity and lung tv?\n\nHI i have a cavity and lung tv( active) . i have started taking my medication before 1 month( each film coated tablet contains rifampicin bp 150mg,isoniazid bp 75mg and ethambutol hcl bp 275mg and i am olso taking a separate drug called ethambutol ip 800mg. now coz i coudn't find those drugs except ethambutol ip 800mg,i am planing to start AKT-3( ethambutol hydrochloride ip 800mg,isoniazid ip 800 and rifampicin ip 450mg. my question is....am i going to have a problem in the process of treatment",
    "doctor_response": "The dosages for TB depend on your weight. You should not exceed the doses you are prescribed because this can cause severe side effects that can be fatal, especially because the treatment of TB requires many months of treatment. It is also not advisable to take only 1 medication because this can cause your bacteria to become resistant and this can make it harder to treat your infection in the future. There are various regimens that can be used to treat tuberculosis. The CDC lists some of their recommendations here:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does masturbation cause any loss of strength and muscle?\n\nsir i am working on fitness bodybuilding n i workout 4 times a week and i dont masturbate i even tried to avoid it 45 days continuously n i did because i think if i masturbate i will lost my strength n muscle please guide me n brief me with satisfying detail? thank you",
    "doctor_response": "Thanks for asking in healthcaremagic forum Masturbation is harmless if done only when excited and within limits.So, it cannot cause any weakness or loss of strength as you think.  You can enjoy yourself and no need to withhold it un-necessarily.  All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are chances of getting abdominal cancer with family history of abdominal cancer?\n\nwhat are the chances of myself getting abdominal cancer if my mother and grandmother died of cancer in the abdomen. They were both 65. I am 5 ft. 123lbs.I exercise3-4 times a week. Dietary wise,I eat much healthier than either of them. I fortunately quit smoking after about 13 years on and off. I smoked anywhere from 3 cigarettes to 10 on averqage.",
    "doctor_response": "Hi,Thanks for writing in.Abdominal cancer is a non specific entity or diagnosis. It is important to know the exact cancer or group of cancer that have occurred in your family members. Since you have changes over to adapting a healthy lifestyle including food habits and exercises as described, your general health condition appears to be good. Also you have quit smoking and that is a positive development in reducing the chance of throat and lung cancer.Cancers can happen due to particular activation of cancer genes, some cancers might start after infection of viruses like HPV virus causing carcinoma cervix and hepatitis B causing liver cancer. There are patients who also get cancer due to exposure to harmful substances in the environment.In your case, it will help to know the exact type of cancer your mother and grandmother had and then get tested for the gene marker of that cancer. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dryness and cuts on labia majora\n\nhello,I had some irritation and  itching of the labia majora during my period ,i moisturized and the condition improved however after my period my husband and i had intercourse and overnight there was severe burning itching,inflammation and vaginal discharge. Since i have had yeast infections before I applied miconazole nitrate cream externally and went to my ob/gyn.She did a pap smear and gave me a supossitory and a one dosage of antibiotics.Now the inflammation is all gone and the itching has reduced drastically,however the labia majora is very dry and i have small cuts that are extremely painful along with some itching.I am still applying the micanazole cream externally how do make the dryness and cuts on the labia majora go away? please help.",
    "doctor_response": "Hello and welcome to healthcaremagicPainful cuts on the labia majora along with pain, does bring in a possibility of herpes genitalis, which needs to be ruled out by physical examination. Moreover since the itching and vaginal discharge has subsided on treatment given for yeast infection, however, the cuts and pain has persisted, which goes in favor of another possibility other than that of yeast infection, i.e herpes genitalis.I would suggest that you seek another appointment with your gynecologist or a dermatologist, regarding confirmation of diagnosis.Herpes usually presents as discrete, well defined, erosions/cuts with pain and burning sensation.Treatment of a confirmed herpes infection is by oral antivirals like acyclovir or famciclovir or valacyclovir.Hope this helpsRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat water blister and pain post circumcision?\n\nHi i have been circumcised 6 days ago and have been recovering ever since. Followed all the cleaning instructions and 3 days back started developping what i assume to be a water blister just under the gland (head). Also, the frenulum was cut and now i get a burning sensation when i touch that very specific area. Only there, does it burn. Nowhere else, including the blister, do i get pain with touch nor any pain while urinating. I consulted an urologist which suggested that it is possibly an allergic reaction to the medication i was taking ( was using a perscribed oftalmic cream, a desinfectant (betadine) and a pain med. That said, would just like a second opinion on the matter",
    "doctor_response": "HelloThanks for query.You have developed blister and pain on under surface of glans penis post surgery of circumcision .It is normal and natural to have this because of tissue reaction to the suture material being used to stitch the cut edges of skin.This will go away once the suture material gets absorbed .Take antibiotic like Doxicycline and anti inflammatory medication like Diclofenac twice daily and topical antibiotic ointment like Neosporine for local application over operated area.Ensure to wash your genitals with warm water and Betadine once daily .Ensure to avoid sexual encounters till it heals up completely. Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will taking Flotral be safe for prostrate enlargement?\n\nI get up frequently to urinate. I have prostate enlargement. Tried a couple of medicines in the past but effective. I was prescribed Flotral. Two queries:a) Is Flotral safe in the long run as I have been advised that this is a long term solution?b) If Flotral does not work, should I go for surgery?BR, RS",
    "doctor_response": "This can be taken fora long time. For monitouring PSA test can bedone iF level goes up then biopsy can be done special technique in rectal route  Other medication or radiation therapy can be given if requerred.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chronic pain on the left side below the hip?\n\nI have chronic pain on my left side just below the hip. I cannot lay on that side nor even if I shift to the right side the pain is there. I have been x-rayed and it seems to be normal. Motion (200mg) helped for awhile but no longer. Need to get some sleep",
    "doctor_response": "Here if your x ray is clear then it can be just a bursitis or soft tissue inflammation. I suggest to do MRI for further evaluation. And as per report consult orthopedic as well physiotherapist.Here orthopedic will guide for conservative and medical management for minor issues. And physiotherapy treatment will help you with soft tissue healing and reducing inflammation. With this the pain should come down. You can also use hot and cold pack to have some more relief. If there is no major relief, after following physio and doing all conservative treatment also it is not reducing then orthopedic can also help by giving intra articular injection of steroid for pain relief. And later the conservative steps has to be followed as it is.I am sure you will get result if you follow all above steps. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can one relieve from rash?\n\nfI had a dual chamber Medtronic pacemaker installed last Thursday. I have now developed a rash that covers my abdomin and has moved to my back. It is not itchy but can a person develop and allergy to a pacemaker? What is recommended to relieve the rash?",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms seem to be related to an allergic reaction. Everything can cause an allergy. I suggest using antihistamines such as Cetirizine 10 mg daily.If the symptoms continue, I suggest to consult with your doctor for further evaluation and specific treatment. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low RBC and HTC?\n\nA friend has been diagnosed with Possible Leukemia. He has had blood marrow test, several blood test and hemotologist could not pinpoint exactly what kind he had. Referred him to M.D. Anderson in Houston, but seems now they don t think he should come there. This has been going on for six weeks and symptoms getting worse. During this six weeks he has received four units of blood. He has low RBC, HGB, HCT MCHC AND PLT. No real diagnosis and no treatment.",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. He has received four units of blood to treat low RBC count or low hematocrit.2. Bone marrow biopsy will help in identifying the cause of pancytopenia, which he presently has.3. Bone marrow biopsy with flow cytometry will confirm the possible leukemia. If more details are available, I can help you more.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to get pregnant for 3 months. Had gall bladder removed, using cipralex. is this possibly the reason?\n\nHi, we are trying to get pregnant again.  We have a 17 month old little boy, and my wife was pregnant in the beginning of the year but sadly miscarried in March.  We were told that the first four months after the miscarriage is a time when she would be the most fertile. After three months of trying and miscalculating the days of ovulation I'm beginning to wonder. I use Cipralex and recently had my gallbladder removed. I also excercise ( I run twice a day 30 minutes). Is that possibly the reason?",
    "doctor_response": "Hello,Thanks for posting your query.There are only 15-20 % chances of conception in one cycle.So do not worry & have intercourse on 10,12,14,16 & 18th days of cycle to get conception.Cipralex & cholecystectomy are having no role in conception.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Nausea, sweating, feeling hot, light headed, stomach discomfort. What is going on?\n\nI just was singing in my vocal class at ECU, I m in musical theatre. I don t usually eat in the morning, so I didn t today. I was just now signing with the group and I started feeling slight nausea that started to persist. I started getting really hot and sweating all over my torso, arms, and head. I felt light headed and possibly like I was going to throw up. I say down for a moment. After only a few minutes I was basically fine. I m in another class now and feel a little light headed and something somewhat in my stomach . What s going on right now?",
    "doctor_response": "Hi, Thanks for writing to health care magic. Never miss your breakfast. You should cultivate  a habit of having some thing in the morning. You already take a fast of around 12 hrs when you do not eat any thing overnight and going on work with out having any thing is going to cause problems. Prolonged fasting can be responsible for gastritis which could be responsible for various problems you are facing like nausea etc. What is your age? Did you ever have your blood sugar or blood pressure checked up? Please reply in detail so that we can help you better. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a painful lump near the sternum indicate?\n\nI have a large k not where my clavicle and sternum connect, which is very painful to touch. Also have pain that extends out to my shoulder and up my neck. Had x rays which were clear. They put me in a sling this is week 2 and no answers? :-( I have had bursitis several times but never like this. I also have RA . 17 years now I m 49 but again nothing like this. Any suggestions?",
    "doctor_response": "Hello,The possible issue here seems to be inflammation involving sternoclavicular joint with referred pain to shoulder.I strongly recommend undertaking an MRI evaluation for the same.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for whiplash\n\nwe were just in a car accident and we suffer from a pretty bad whiplash we were given novalgin from sanofi aventis and it doesnt seem to be strong enough to take the pain away! we were told that 3 a day should be enoungh but I would like to know if we can take more",
    "doctor_response": "Hello, As there was an accident there is always a chance of Whiplash Injury. This injury occurs due to sudden thrust to the head and leading to an impression of damage to the spinal cord at the cervical region. I will advise the first foremost thing to do is taking up an MRI. because that will provide more light to the injury by revealing the internal structures of the cervical spine and spinal cord. Its good that you have not developed any major injury. because in whiplash injury things can go otherwise. Thank god that you are all fine and there is only pain. Once MRI is done you will be able to notice the extent of soft tissue involved in whiplash injury. Based on the soft tissue injury, painkillers along with physical therapy will be advised. As with physical therapy like Ultrasound therapy and TENS therapy the pain will reduce and muscle spasm will be reduced too leading to less pain. Any muscles which have gone wasting during the resting phase may need to regain some strength. Please use the cervical collar for time being to avoid more compression of the soft tissue. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can the viral infection with chronic asthma be reduced?\n\nI have a viral infection in my kings with chronic asthma I m on cephalexin three times a day and roxithromycin 1twice a day with a nagging cough can t lay down and get any sleep can you tell me what else can I do to get back to being healty I have had it for about 2weeks how long does it take to go away",
    "doctor_response": "Hello,Welcome to HCM,Most of the viral infections are self limiting, it will come down by itself. Only thing is you have to increase the immunity of the body.As you are taking two groups of antibiotics it will treat secondary bacterial infection following the viral infection.Antibiotics acts on all group of bacteria not on virus.Any viral infection affecting the respiratory tract requires 7-10 days for the recovery. you are already in the recover phase.Hope your query is answered.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Detected nail infection when removed acrylic coatings on nail. Diagnosed Smouldering myeloma. Any connection?\n\nHi I have been diagnosed with Smouldering Myeloma and recently have started havin gproblems iwth my nails. I have had acrylic coatings on my nails for several years without an issue but when I last went for infills the nail technician removed the coatings and told me to seek medical assitance as I have a nail infection. However from researching the internet the nails do not look like typlical infections and I am wondering if there is a connection to the SM or if my SM is deteriorating to MM (not due antoher check till July).",
    "doctor_response": "hello, myeloma is a malignant clonal proliferation of B-lymphocytes. infections in general are particularly common. nail infections are not particularly a common presentation. probably you could be suffering a much simpler fungal nail infestation. please contact a dermatologist for proper examination and also keep your appointment in july okay.take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do i need to take anti depressant for high blood pressure when on lisinopril?\n\nI have just recently started having high blood pressure...I think it is due to stress.  They doctors have put me on blood pressure medicine Lisinopril 10mg once a day... I have been on this for 10 days...blood pressure is still high during periods of the day....they told me due to anxiety I need to start on anti depressant...Zoloft.....Do I really need to take both?",
    "doctor_response": "Hi, thank you for posting.The causes of high blood pressure are different and one of those is stress. So you have to take antidepressant, but I would recommend Prozac 20mg 1 pill a day instead Zoloft. However contact your doctor.You have to take both of medicines.Take Care.Dr. Behar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can I manage blackening around the mouth?\n\nHello doctor, I have blackening around my mouth since two months and it is not fading. I went to Dermatologist, she prescribed me a deepwhite cream. But it is not working. What should I do? Please help me.",
    "doctor_response": "Hi. Keep applying that cream plus start taking tablet Folic acid twice a day for 10 days, then make it once a day for next two weeks. Cranking around lip corners occur due to deficiency of Multivitamins, Folic acid and winter season can also be a reason. As far as home remedy is concerned, put olive oil on finger and put it around your lips so that soreness is reduced. Do it before sleeping for a week. And above all start drinking water, like 1 litre per day mandatory.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tiredness after eating, excessive sleep during day time causing depression. Suggested antidepressants. Help?\n\nHi I find I am always tired especially after eating, I can sleep anytime during the day. I am regularly active at night during my sleep even to the point of sexual intimacy with my wife but with no recollection of anything happening. This tiredness leaves me to be unmotivated and sometimes depressed. I went to my GP and he prescribed me Anti depressants. This was about a moth ago, I have not taken the tablets as I feel these are just a cover to the real issue, I think I was prescribed these as I had a real hard break up with my ex wife and needed them at that time which was 6 years ago. I do intend to go back to my G.P. I hope this is enough info for you. Kind Regards Trevor",
    "doctor_response": "Hi Trevor, thanks for asking the question. Sleep sex without recollection in the next day is a parasomnic behavior which may also be seen with sleepwalking and talking during sleep. It can be triggered and intensified by sleep deprivation, stress or drinking alcohol or using illicit drugs. It happens during NREM, stages 3 and 4 of sleep so a medication which restricts these periods like clonazepam could be useful for such a condition. Some cases are related to epileptic discharge so it would be useful if your doctor evaluates you for that aspect as well. I wish you can get rid of it soon because its management is easy and its impact on your life is great.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can right-sided chest pain caused due to excessive cough be treated?\n\nMy daughter is taking migraine treatment intravenously - today one drug was long word starting with H and shortened to HDE? It made her feel heavy in the chest so the doctor said to quit that drug and not use again? What drug might it be?",
    "doctor_response": "Hello, According to history, you should be more specific because there are a lot of drugs starting with H. Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Jnikolla",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for stomach discomfort\n\nMy husband is complaining of stomach discomfort over the past few days. Feels like he needs to poop but then a little poop may or may not come out. If he bends over or binds up his stomach then hurts more. Standing or stretching abdomin out feels better. Not killer pain like gallstones, nagging pain that makes him feel like he needs to go. When bladder fills up the pain increases. No problems urinating. Did have gas and had clear, runny, sticky, type discharge...no blood. He is starting to drink lots of water with lemon and peppermint oil (doTERRA). To help flush things out. Is the discharge some sort of warning sign for something serious or just mucus build up due to constipation?",
    "doctor_response": "HIWell come to HCMI really appreciate your concern and I could say that this could be intestinal infection and protozoa would be likely and this can be treated with Tab Metronidazole 400 mg twice in day for five days, hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is nebulisation with Duolin repsules safe for infants during wheezing?\n\nMy son is 17 months old. When ever he have cold or viral attack, he is having wheezing also. My doctor prescribed nebulisation with Duolin repsules (1.2 ml duolin + 2 ml saline) 3 times a day and no other medicines. Is it safe to give this whenever wheezing comes? Thanks",
    "doctor_response": "Hi dear,I understand your concerns, but nebulization is always better then other ways for treatment. Duolin is safe,it just works in lungs. It is helpful for inflammation and spasmus of bronchi. It will not give general side effects, because it will dilatate bronhi and sputum will come out. Don' t do nebulization more then 4 times.Baby will recovery quicklier.  Wish your baby a good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can diarrhea be treated in a toddler?\n\nMy baby is 3 months old and am breastfeeding and formula feeding bcoz my milk is not sufficient for my baby ..Earlier i was feeding him Nan pro 1 but now i changed to lactogen1...After changing the formula my baby is passing loose stools 4-5 times and he is passing loose greenish watery amd smelly stools.plz advise me..",
    "doctor_response": "Hi, Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting. You need not worry. I do not think this is due to Lactogen 1. As there is no dehydration - you need not worry. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I see a fan-type rotating thing when I close my eyes. Is this normal?\n\nHello doctor,Sometimes, if I take a nap or close my eyes, I see a fan-type rotating thing in my eyes which goes in one minute. If I close my eyes, I can see that. It is a black-colored fan-like thing rotating. Is this normal? I am myopic and my retina was tested last year.",
    "doctor_response": "Hi. From what you have mentioned, you may have experienced a certain physiological entity called \"phosphene\". This is nothing to worry about. I suggest that you see an ophthalmologist in case you have the following: For more information consult an eye care ophthalmologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cream should I use to remove the black mark on my chin ?\n\ni hv a black mark on ma chin. please sugeest me somethin to remove tat. i tried many medicines and creams .but no result",
    "doctor_response": "Hi..dear user., Thanks for choosing HCM., You mentioned only black mark...But not duration, symptomatology, So If it is long duration..(by birth)..Epidermal Naevi.. short duration with itch...you can remove by..., RF.cautery.. or LASER THERAPY... ok..first evaluate..the lesion consult good dermatologist.. do accordingly....,bye good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to deal with puss from hysterectomy scar?\n\nI have a 26 year old section and hysterectomy scar which has never been a problem.  Just now I noticed some pus coming out of one area and it is all red around the area but not sore or uncomfortable.  Should I go to a doctor or leave it a while to see if it clears up?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern looking to the history given here I could say that this could be infection such infection is common event seen in the post operative cases in my opinion you need to see the surgeon and do not try to treat the condition by other mean, hope this information helps you, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for infertility problem\n\nMy height is 1.62, Blood group O+, I am 48 years. Have two abortions. Have no child. Have not seen menstral period since February, 2010. My husband has low sperm problem. Can you help us in place of advice.",
    "doctor_response": "Hello....im afraid,u seems to be approaching MENOPAUSE i.ea condition when a female's monthly menstural cycle stops naturally n ovaries stops producing ovum (eggs with which male sperm fertilizes resulting in pregnancy) but plz dont get disheartened as modern technologies can still help u in having a baby....(1) 1st of all kindly get these tests done from a good lab and tell me the reports of these tests - (a) complete hormonal profile including LH , FSH , ESTRADIOL , THYROID PROFILE (b) TORCH PROFILE (c) ULTRASOUND OF UTERUS AND OVARIES (d) SEMEN ANALYSIS OF UR HUSBAND.....tell me the reports as soon as possible so that i can guide u further....regards.....Dr Rahul Rathee",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure skin rashes and frequent urination with chicken pox?\n\nHi I'm 15 around 56kg and 169 cm male. I currently have a bad case of chickenpox at the moment and have these dark red scabs all over my face. Will they turn into scars and if so are they permanent? My mouth and throat is infect as well as under and on my foreskin. Will urinating frequently affect my genital area? As urinating is so painful at the moment",
    "doctor_response": "Hello,Welcome to HCM,It is highly communicable 1-2 days before the appearance of rash and 4-5 days thereafter. After which virus tends to die out and looses the capacity to transmit disease to normal individuals. The  scabbing usually begins 4-7 days after the rash and completed by 30 days. During the scabbing period you are sterile and will not transmit disease to others.This is a disease which will affect all parts of the body from head to toe including the genitals.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomitings, body ache, tiredness and itching after eating cashews?\n\nI believe I may have had an allergic reaction to cashews.  Approximately 12 hours after eating a rather large quantitly of cashews, I became very nausiated and then vomited several hours later.  The next day I had major body aches and was extremely tired and slept alot and stayed in bed.  In the days that followed I have developed an extreme itching, all over my chest, stomach and back, with no rash, I have been itching off and on now for about 3 days......Any suggestions?????",
    "doctor_response": "Hi,based on the history, You have allergy to cashew nut, it is moderate to severe. some times it can be life threatening. Dont neglect in future. consult doctor immediately you can confirm your allergy by allergy testingtreament - 1. avoidance",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can chronic backache be treated?\n\nI have had cronic low back pain . I was told I have a herniated disc L 4-5 and degenerative disc disease. It gone into spasms several times where it left me immobilized with pain and had to be hospitalized. I take alot of advil and aleve. I ve worked in the dental field chairside for 45yrs. I would like to try chiropractic but afraid it might put it into spasm or make it worse. Your thoughts?",
    "doctor_response": "Hello,Thank you for using healthcare magic.I read your question and understood your concern.I think you should try the physiotherapy procedures , masage, water aerobics , muscle relaxant medication , but not chiropractics. If these does not work you should consider cortisone injections in the spine every 6 months for pain reliev and see how it goes. If this fails then the next step is surgery.Dr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lumps on the bottom of the throat?\n\nI have a swallen throat. It's not sore. It is painfull it hurts to swallow and yawn and even just turning or touching my neck. It is towards the bottem part of my throat and feels like a lump or something might be stuck but there isn't anything stuck. Please help",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have granular pharyngitis. You should take c course of antibiotics like azithromycin.  You should also take antihistaminics and saline warer gargles. You will get benefit. Consult your doctor and start treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to prevent in infection due to needle pricking\n\nHi .. I work for the Commonwealth games in Glasgow .. I do house keeping and I used my hands to pick up rubbish from a bin that was in a athletics room!, I had noticed little green and white tubes and empty rapers .. I ain t a 100% sure if I had accidentally prick myself with a needle or not but am 8 weeks pregnant and quite scared that it was a needle or not!, what should I do .. Thanks",
    "doctor_response": "HelloThank You for contatcing HCM.Whenever you encounter such thing then always wash hand with antiseptic solution immediately. Chances of infection are less if there is a small prick like you had. You need to keep extra precaution now. Always use hand gloves while picking trash. Also do inform your gynecology doctor about this on your next visit.Report to hospital immediately if:> Any unusual symptom appears.> You observe any change in skin color at the site of injury.Hope I have answered your query. If you have any further questions I will be happy to help. If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health & healthy baby!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What relieves pain due to medicines after the placement of stents?\n\nMy husband is on statins due to placement of 4 stents.  He is in so much pain from the meds that he is unable to do almost everything.  He simply has no life.  He just stopped the Crestor and has felt absolutely  GREAT for the first time in a year.  What can he take?  Statins are OUT!",
    "doctor_response": "Hi,Statins are important class of drug for heart patient but since he is having intolerable side effects, various options other than stopping is to try alternate daily dosing of the statin. If that doesn't help then it is to be switched over to other one like Pravastatin. Also thyroid, cpk level and vit D levels should be done.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain and difficulty in breathing?\n\nhi i try to lay down to sleep i  my hearts starts paining and i stop breathing or cant take air inside i am smoker i did have heart palpations before but it seems this only when i laydown on bed i become normal once i get back up fast i also have lower back pain but i doubt its my kidneys or something seriouse since i checked recently",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Since you are active smoker, we should definitely rule out heart and lung diseases for your symptoms. So consult cardiologist and get done ecg, 2d echo and stress test (trade mill test) to rule out heart diseases.Get done chest x ray and PFT (Pulmonary Function Test) to rule out lung diseases.If all these are normal then no need to worry for major heart and lung diseases. Sometimes stress and anxiety can also cause similar symptoms. So avoid stress and tension, be relax and calm. And please quit smoking as soon as possible because it is not a good habit. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could it be if having mid back pain, loss of apetite and high BP?\n\nI am having mid back pain (radiating burning sensation) similar to a gall bladder attack (had my out about 5 years ago).  Loss of appetite.  My creatinine is 76.  Creatinine clearance >60.  I spent a night in emerg and they did ekg, chest xrays, blood work.  Blood pressure was 171/126.  They have order a CT exam on the thorax.  I do not know what they might be looking for.  I do not understand creatinine levels (is mine normal).",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern and from the history given here I could say that the creatinine value can not be 76 it is great mistake you did in reading or understanding this may be 0.76 and not 76, if this is 0.76 then it is normal and no need to worry, looking your clinical history you might be advised for investigations, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is drinking risky after open heart surgery?\n\nMy boyfriend is 20 years old and recently had open-heart surgery. He has a mechanical valve and has to take blood thinners. He has been drinking excessively (more than the recommended 2 drinks maximum) and I want to know if/how it can affect his condition if he continues to drink heavily.",
    "doctor_response": "DEAR USER,THANKS FOR CONSULTING WITH HCMI UNDERSTAND YOUR CONCERN ABOUT YOUR BOY FRIEND DRINKING MOREYES ITS ALWAYS DANGEROUS TO DRINK HEAVILYIT CAN CAUSE SEIZURES, CONFUSION, UNCONSCIOUSNESS IN SHORT TERM AND IN LONG TERM CAN AFFECT HIS HEART CONDITION CAN CAUSE LIVER DISASEYOU CAN TAKE HIM TODRUG  DEADDICTION CONSULTANT SO THAT HE CAN HELP YOUHOPE I ANSWERED YOUR QUERY. YOU CAN MESSAGE ME FOR ANY FURTHER CONCERNS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe pain in the lower back, unable to bend my neck. While urinating noticed blood\n\nHi for the last few days ive been having severe pains at the bottom of my back mainly when sat down or my knees are lifted slightly i cant bring my chin down to my chest as it causes the bottom of my back to pull tight feels like im being stabbed also whilst pooing ive noticed a lot of blood more than what i get when in on my period in only 20 should this be happening or do i need to go doctors\\hospital",
    "doctor_response": "Hello,This is probably due to vertebral disc problem. We doctor call it Intervertebral disc prolapse. This is causing severe back pain and muscle spasm.I this situation I would advise my patient undergo an MRI of the spine to rule out this condition.Rest and analgesic for pain.Physiotherapy and traction for muscle strengthening.Consult with your doctor and discuss with him. He will help in evaluation and treatment of the back pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could on and off red cheeks like tiny broken capillaries in a child be heart related?\n\nMy 20 month old daughter has intermittent red cheeks especially if she has been crying, exercising or is unwell with a cold for example. I put regualar cream on them because her skin is sometimes dry, but it looks more like tiny broken cappillaries just under her skin.Could this be heart related? She is otherwise strong and healthy.",
    "doctor_response": "it's is normal.. in children, due to sensitive skin, which crying or sick.. flushing occur.. it's not related to heart disease.consult a pediatrician if there is poor weight gain or frequently cold or cough..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a faint positive line in the pregnancy test indicate?\n\nSoo it goes like this, I call my girlfriend last week (tuesday) and before she came I masturbated and then we were sitting in our sofa then suddenly I felt my lust surge up again then I go to our restroom and then I felt like there s a semen in my body I think it s the last drop when I masturbated earlier on, I touched it and go back and after a couple of minutes I fingered here. And after that day she puked with blood and then we thought that maybe she s pregnant so everyday I ask how she felt and said she still feels normal nothing unusual then week after (yesterday) she tried using pregnancy test and the pregnancy test shows Negative and she didn t look further cause she was in hurry and after that (today) she saw a faint line in pregnancy test after a day so now we re in panic don t know what to do does that mean she s pregnant? and I got that pregnancy test in a pharmacy online",
    "doctor_response": "Hello, A faint line in pregnancy test most likely means pregnancy. To be sure you can repeat again the pregnancy tests. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Olgeta Xhufka, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do liver enzyme levels normalize while drinking wine?\n\nJust had my bloodwork done and my liver enzymes were high. I have started having a glass of wine in the evenings. I just read that this will make your enzyme count go up. I m suppose to go back to have my bloodwork done again in one month. How long does it take wine to get out of your body and allow the enzymes to go down?",
    "doctor_response": "Hi welcome to HCM...Let me know you duration of your wine drinking  ....It is not like merely in few days liver affected...The dose of drinking is also important...20 gm per day safe limit for drinking....After one month you can repeat liver enzymes.....Try to avoid taking less fatty and non veg food for few days.....Refined food and sugar avoided.....Fruits taken more...Alcohol induce fatty liver means steatosis is reversible.....Take care....Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for white spots on tongue of a child\n\nmy 16 month old this week has been diagnosed with tonsilitis again and is on anticbiotics which he is due to finish tomorrow. He has stopped having a fever now however he is still very cranky and Iv now noticed that he has small white spots on his tongue. In addition to this his gums are bleeding a lot when we try and brush his teeth (this has never happened before). He has been sick a few times this week but has eaten very little, Iv tried to keep his mouth clean but for obvious reasons he doesn t want me in his mouth with a toothbrush (he only drinks water and lactose free milk from a cup with a straw). in addition to this he now has inflamed white guns underneath his two top front teeth, this patch has got bigger in the last few days. we always clean his teeth",
    "doctor_response": "Hi,From history it seems that he might be having oral thrush giving this problem.This might be due to antibiotics as well as not cleaning his mouth properly after feeding.Give him Lactobacillus sachets or B.complex drops after consulting your doctor.Apply Gention violet  locally after taking advice from your doctor.Make a habit of cleaning his mouth and tongue with clean handkerchief keeping on finger tip after every feeding.Having soreness in the mouth and tongue he does not take more by mouth.Ok and take care.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How are pimples and black spots treated ? Which doctors should I consult ?\n\nHi Doctor , I m pooja 23 years old need one suggesstion because of some pimples i have got a black marks on my face may i know any solution for this problem? Also i would like to visit the Clinic and Consult one of the doctor for the same please suggest me on the address Regards, Pooja",
    "doctor_response": "Welcome to Healthcare Magic These marks can be removed by many methods. Hydroquinone skin bleach creams, microderm abrasions, laser therapy are good. Regarding the pimples, probably acne needs to be treated first. Avoid sun exposure. Use Sunscreen SPF25. Avoid junk, oily, fatty, fried food, pickles. Avoid cosmetics application on the face. Eat plenty of fresh fruits and green leafy vegetables. Drink plenty of water. Consult Dermatologist in your area Hospital for proper management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What problems could i face during pregnancy without a gall bladder?\n\ni m 34 years of age, on 7th march,2014 i underwent gallstone surgery , but before the surgery , the doctor said that there is a hernia in my naval area which he diagnosed after asking me to cough. He said that he will Stich it during the gall stone surgery. I have A son of 6 yrs age who was born by C_SECTION , And  we r planning for a second baby also .  So the doctor postponed my hernia problem for now , since it may create some problem during pregnancy. sir my queries are 1)   how much time should i take before conceiving?2) what type of problem can i face  during pregnancy due to lack of gall bladder and hernia in my naval area?",
    "doctor_response": "hi,i dont think you will have any problem during pregnancy you might get bouts of hyperacidity on and off but you can manage that with anti acids.i dont think there is any connection of your hernia and surgery to conceive another baby.i would suggest get reviewed by a gynecologist before conceivinghope to have answered your querythanking you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the early signs and symptoms of pregnancy?\n\nI just started the neuvaring this month, but before starting it me and my boyfriend had unprotected sex. I did use plan B the next morning but I took out the ring a week ago and I still havent started my period... I am also have some pregnancy symptoms. What do you think?",
    "doctor_response": "Hi dear, I have gone through your question and understand your concerns.Delay in the periods can be due to pregnancy or due to the effect of the emergency contraceptive pill you have taken, as it is known to delay the next expected periods by 2-3 weeks.I suggest you to get a urine pregnancy test done, if negative then you can safely wait for the periods for another2-3 weeks.Hope you found the answer helpful.Wishing you good health.Dr Deepti Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and nausea while on antibiotics for tooth abscess?\n\nHi, I went to the dentist last week as I have a tooth abcess under a crown.My dentist drained the abcess and gave me antibiotics to take if I felt it necessary. My head has felt heavy for some time now and this morning I woke up feeling very dizzy and slightly nauseas ,do you think I should take the antibiotics? regards P.Whale",
    "doctor_response": "Thanks for your query, I have gone through your query.The dizziness and nausea could be because of the antibiotics what you are aking for abscess. You have to take a antacid and anti emetics like Tablet rantac 150mg and tab perinorm. The abscessed tooth can be treated with RCT or extraction.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hepatitis hepatomegaly, stent inserted in kidney. Curable?\n\nmy father is suffering from hepatitis hepatomegaly with grade I. His age is 80 and also few day a stunt was inserted in kidney for stone & pus . Is it curable or not. but now my is in sleepy mood only , he is not able to sit also. he is admitted in Manipal mangalore. how can we know wat exactly happened to my father . whether it is curable or not.",
    "doctor_response": "Hi...your father is having pyonephritis with stone and a compromised liver...kidney infection is curable but we dont know how much damage has already occurred to it due to infection...if the other one is normal then there wont be much problem... but at his age it is very unlikely...all you can do now is pray...you are in very capable hands...have trust in them...Dr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Microgestin, brown discharge, negative pregnancy test, missed periods. Should I take another test?\n\nSo I have been on microgestin fe 1/20 for about 9 months. For the past two months I have not gotten my period and have only had brown discharge . I m usually pretty good about getting them for at least 2 days even if it s just spotting. I ve had migraines and such symptoms. I had taken a pregnancy test the first month I missed it and it was negative. Should i take another test?",
    "doctor_response": "Hi,It is possible that the endometrial preparation has become inadequate and hence you have had only some spotting. If you have never missed the any of the pills, pregnancy is very unlikely. In the current scenario, you should see a specialist for a complete clinical assessment and get a trans-vaginal sonogram along with a blood test for pregnancy. Urine pregnancy test is of not much use in the current situation. Your migraines may not be related to pregnancy; they may be pill-related. Hope you find this information useful. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the prognosis for patient with stage 4 melanoma, rapid weight loss, large and bloody tumor on trunk?\n\nA young man age 25 was just diagnosed with stage 4 melanoma. The tumor was ver large and bloody and on trunk. Hes had this thing for like 4 yeats but just started getting worse. Then last month he lost nearly 20 lbs in one month. Whats a fair prognosis? How long would he have to live?",
    "doctor_response": "Hi, Welcome to Health care magic forum.                      The survival rate of 5 years is considered to be 15 to 20 %, means 20 patients among 100 patients survive 5 years. Out look is better if the lesion is in the distant part, and in the lymph nodes than in organs. And if lactose dehydroginase is normal.                      Besides giving treatment give him fresh juices of palatable vegetables, to have an un explained little recovery.                         Wishing him good health. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain , heart burn and high blood pressure\n\nI have a family history of heart attacks. My father died from a sudden massive heart attack at the age of 51. His mother, father, 2 brothers and a sister also. I am 43 yrs old and have been experiencing chest pains mainly on the left side and heart burn (acid reflux). Just wondering if this could be warning signs? I also have high blood pressure in which I take medication. It was high (150/104) but since is slowly coming down. An hour later it was140/98. Is this a major concern that I need to go to the emergency room?",
    "doctor_response": "It is very important to take care of this situation. You have multiples risk factors for coronary artery disease, including : older than 40 years old,family history,hypertension. I don't know your sex , but if you are male with high cholesterol and diabetes, that will increase the risk factors. You need a complete cardiac workup with an electrocardiogram,echocardiogram and stress test to have a better view of your medical situation. You should go to the emergency room if have chest pain, do not wait. In addition to this,your blood pressure is high.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Dexolac administration 5-6 times daily with breastfeeding for baby advisable?\n\nhi, sir, i want to know regarding my nephew now he is one month and 25 days old..my sis give him dexolac infant feeding formula ratio is one teaspoon add in 30 ml of water. ...5 to 6 times a day... also give him breast feeding... is it right or can u correct the anything....thanx",
    "doctor_response": "Hello, Why are you giving Dexolac for a 1-month-old? Please don't do that.completely unadvisable. Continue exclusive breastfeeding with vit D supplementation Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Prasanna Lakshmi, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Continuous sneezing, eye redness, itching, allergy to dust, fumes, cold weather. Permanent cure?\n\nhelo, actually I am having continous sneezing , then my eyes turn red , and itching of eyes after sneezing. this problem is from last 4-5 years. atmosfhere change, dust , perfumes , and regularly in winters. what is the best medicine I can take. I usually take Citrazine during this and i got relief for about a day or two.",
    "doctor_response": "hello and welcome to HCM! your symptoms indicate that you might be suffering from allergic rhinitis or perennial rhinitis cetirizine an antihistamine 10mg orally once daily, is quite effective in immediate relief of symptoms but this is often temporary. you can add to this, intranasal corticosteroid like mometasone furoate (nasonex)(200mcg once daily per nostril). there may be a delay in its onset of action and you have to use it continuously for at-least 2 weeks before an effect can be documented. side effects of the drug are limited and are usually due to incorrect usage. also you can add to this, montelukast 10mg (montair)daily at bed time. keep in mind that the two drugs i have mentioned are to be used as a prophylactic treatment. montilukast has no role in treatment of acute attack. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tiny red bumps on hands, pain when something pressed on it. Is it an allergy?\n\nI have tiny red bumps on both hands. They are on either side of the knuckle closest to the palm, on the pointer fingers, inside area (like where your thumb could reach). They are not hard and do not itch . I have gotten them 4-5 times in the last year and they go away eventually. Allergy meds don t seem to help get rid of them. My actual knuckles are not swollen or hurting either. If you saw them, it would look like ant bites. They only hurt when something is pressed against them...like writing, or driving. Any ideas?",
    "doctor_response": "It is pamphigus light form of allergy avoid using mustard,coconut,groundnut,soyabean oil for cooking and application on skin keep skin dry use petroleum jelly and mometasone locally for 3 months",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I experience very severe pain. Is it due to diverticulitis?\n\nHi doctor, I have been prescribed Mirtazapine 15 mg for reducing my depression associated with my condition. In most of my adult life, I suffered from IBS symptoms. I rarely drink alcohol. I eat fish and seafood. But no other meat is taken in my diet now. In the past five years, my problems have markedly increased. Around four years back, I underwent a colonoscopy and was diagnosed with diverticulitis. They advised me to avoid taking nuts and seeds in my diet. Around two years ago, my situation again became worse and I have been prescribed with several courses of antibiotics. At the end of last year, I had an episode of diarrhea which lasted for a week. I was prescribed several courses of antibiotics with limited success. I still experience pain somewhat different from diverticulitis and bouts of diarrhea. I was referred to a gastroenterologist. I underwent gastroscopy and colonoscopy after consulting him. I have attached the report for your review. One of the recommendations given by the doctor is to see a Nutritionist, who first put me on the FODMAP diet. This had a small benefit regarding pain reduction. This time, the Nutritionist recommended me to increase fiber in my diet to improve gut motility and function. So, I introduced some oats into my breakfast. After few weeks, I saw Nutritionist, who recommended me to increase more of fiber in my diet and finally advised me to go on with RPAH diet. I am not feeling confident about taking this strict diet. I would really appreciate if you could review my current treatment plan and provide advice or recommendations. I had a very severe pain several nights back and my partner was so worried and called an ambulance. The severe pain finally receded after several loose bowel movements. All of this made me feel depressed.",
    "doctor_response": "Hi. I have gone through your attachment (attachment removed to protect patient identity). They are related to IBS (irritable bowel syndrome) Mixed type. IBS is of three types:1. Diarrhea-predominant.2. Constipation-predominant.3. Mixed variety. IBS is treated as follows: 1. Proton pump inhibitor like Pantoprazole and Rabeprazole, which will help in neutralizing any acid present in the stomach. 2. Avoid fat and pepper in diet and take soft diet. 3. You can take smooth muscle relaxant like Mebeverine SR 200 mg twice daily for stomach pain. 4. A combination of Chlordiazepoxide and Clidinium bromide is also beneficial. 5. Mirtazapine, as you have been taking, also help in controlling symptoms of IBS. 6. If you feel constipated, you can take Syrup Lactulose in the night. I hope this will help you. Revert if you have further queries. For more information consult a medical gastroenterologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for linear fibrosis?\n\nI recently had an xray... The radiologist reading is i have a Linear Fibrosis in my left upper lung. My xray is for my medical examination as a requirement for my visa application in Saudi Arabia. It was the first time of me to hear that im having that in my xray and im unaware of it.. Please help me with my question.. Is it possible that that linear fibrosis will disappear in my xray in any means??? IS there any way that it will disappear in my xray. THe dr said that it was already healed and it doesnt have any medicines.. Is that true?? I m living a heathy lifestyle now.sleep early and drink juice and milk instead of sodas, then take vit C 2x a day and some multivitamins.. Does it help????",
    "doctor_response": "Hello, The linear fibrosis in lung can be there due to- -Pollution -Some medicines like used for cancer ,high blood pressure,etc. -Old infection -Rheumatoid disease -Connective tissue diseases In your case it does not loks to be serious.There are some medicines like pirfenidone,nintedenib which are used in severe type of cases.In your case you should do following to have relief- -Eat healthy. -Exercises daily .This help to improve your lung capacity -Take vaccination for respiratory infections. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mukesh Tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I having period just after the follicle rupture?\n\nI M 26 YEARS OLD from LAST THREE  YEARS WE R PLANNIng for pragnency but we r not getting success i contact gynec  she did ovulation study result was folical was not formed then after my periods from the third day she gave me zaronil (letrozole tablet u.s.) one tablet a day for five days ihave thyroid problem i m taking thyronorm 12.5 mg from last 6 month my height is 155cm and weight is 77kg.after this treatment on the 11th day folical was not formed then she started Bigomet sr 1000mg one tablet a day then 14th day folical formed but not ruptured  normaly she gave one injection for that after it ruptured according to her advice i keep relation with my husband but now on 8th aug i got period again why these happend? now again from 3rd day she gave me zaronil 2 tablet aday  for 5 day,bigomet sr1000mg 1tblet perday for 30 days and ovacare (meyer cellage) twice aday for 30 days i want to ask is this treatment is proper?any of these tablet is having side effect?what are the chances of my pragnency?what should i do according to you? my husband's sperm report is normal plz reply me",
    "doctor_response": "Hi , hello how are you doing ?I don't find the treatment is addressing the problem. Your follicles are not responding to the normal hormonal cycles in body , as they are resistant.You main problem is Overweight , which until addressed  will not give you right eggs & even if pregnant will put you at risk of early pregnancy bleeding & abortions.Just delay pregnancy for few months. Your weight has to be Weight(in Kgs)= Height (in cms)-100Expected weight is 55-59 kgs.Once you reduce weight to normal range, you won't need any medicine to get periods or to get pregnant & pregnancy will be healthy. To reduce weight -NO FASTING, No junk food/ fast foods/ red meat, reduce snacks in between mealsHave low calories food, high proteinsRegular exercise, aerobics , yoga, brisk walkingtry to reduce 2-4 kgs / month. Don't hurry on weight reduction, it will be difficult to maintain. As soon as you reduce at least 5 kgs , you will see changes, you will ovulate on timeThese medicines will do wonders only after correction. Now it's not that effective. It has no significant side effects.Do check Thyroid profile & Serum Prolactin - can cause anovulationHope I have clarified your queries, do write back if any morequeriesAll the bestDr.Balakrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long after stopping Effexor XR does blood pressure normalize?\n\nhi, i just started my first day without effexor XR. My blood pressure has been high and my doctor thought it might be related to the pills., I have been on it for 9 months and feel great except for some muscle twitching and high blood pressure. How long after stopping should I expect my blood pressure to go down if hypertension is due the the medication?",
    "doctor_response": "Usually a week or two. it is dose related and affects above 100 mg doses. if ur controlled by effexor u should not stop medication may take some antihypertensive medication.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for throbbing pain in finger post an injury\n\nI cut my finger - at the top - about a week ago...it was starting to get better but in the last two days it s been throbbing and hurts pretty bad... I have been using peroxide, antibiotic cream and today I used an Epsom salt soak...still no relief...when should I go to the doctor?",
    "doctor_response": "Thanks for your query. I have gone through your query.The throbbing pain in the area of injury can be because of the unhealed wound. Nothing to be panic, consult a general physician and get it evaluated. If it is infected, you need to take a course of antibiotics like amoxicillin and metronidazole (if you are not allergic). If the wound is not healed, it might require a suturing after debridement. Mean while you can take an analgesic like diclofenac(if you are not allergic) for the pain.I hope i have answered your query. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of broken wrist?\n\nI tripped and fell over a suitcase about a week ago and my left wrist (about 4 inches from the bone that sticks out) and my hand (from the middle of my hand)turned purple (still ugly looking). It hurts some (dull ache) and swelled a little and is still slightly swollen. About two days ago my wrist started aching and just burns. I can move my fingers, grasp but hurts a little. Was wondering if this is a sign of a broken wrist or a bad brusing.",
    "doctor_response": "Hello,Based on your description of your complaints you seem to have suffered an injury to your wrist and forearm. The fact that you can move your wrist and hand with minimum pain indicates that your bones may have not suffered any fracture, however the best way to confirm this is to get an X-RAY done if it is easily accessible. In the meantime, you can keep you injured arm elevated over a sling and take paracetamol for pain relief and see how it goes for a few days. If the pain increases or swelling increases best is to get an X-ray and rule out bony injury.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Santosh S. Jeevannavar, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can allergic reactions to peroxide causing blisters be treated?\n\nMy daughter has a highly allergic reaction to peroxide. Her skin severely  blisters . She discovered this when she had her eyebrows tinted and they blistered for approximately 3 weeks. She has no reaction to household bleach. What could have caused this?",
    "doctor_response": "hello,thanks for your query, for 3weeks blisters, in my opinion you need to antihistamines, antibiotics,if necessary steroid cream after consulting an ent surgeon.hope i have answered your query. all the best. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can you please suggest medicines for PCOS?\n\nHello doctor,I am a 28 year old female. I am diagnosed with PCOS. I have irregular periods since seven months, excess unwanted facial and body hair, hair loss from the scalp and weight gain. Can I take homeopathy medicine for PCOS and its symptoms? If yes, then what medicine do I need to take? I want weight loss medicine also. Can you please suggest medicines?",
    "doctor_response": "Hello. I understand your concerns. Also, you should know that PCOS (polycystic ovarian syndrome) cannot be cured completely. Medications and homeopathy control the symptoms only and increase the chance of fertility if required. I suggest: 1. Oral contraceptive pills such as Gynera (Gestodene and Ethinylestradiol) once daily for 21 days, then seven days off and repeated every month. 2. Metformin 500 mg twice after lunch. 3. Spironolactone 50 mg once before sleeping as antiandrogenic. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. 4. Please send me a copy of your sonography report as well as any performed lab tests such as fasting blood sugar, and postprandial glucose level. 5. Send me a photo of the acne or facial hair as it may require laser removal. 6. Follow-up is required. Important note: If you desire to be pregnant, seek medical advice as some of these medications must be changed. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in body?\n\nHi, I m a 43 year old female experiencing achiness in my body. My muscles feel weak and my hands are noticeably shaking and I feel my body shaking as well. I get about 7 hours of sleep each night but I do know I don t drink enough water. My mother has Mytonic Dystrophy and Fibromyalgia and my sister has MS. Should I be worried about this? I kinda feel run down but if I get to sleep in I don\u2019t feel any better. Any suggestions? Thanks, Christina",
    "doctor_response": "Here you have family history of muscular dystrophy,  fibromylgia and MS.  So yes you need to be careful.  This all condition are genetically derived once it's there in family history. But triggering points will be too much of physical stress,  mental stress, improper sleep,  improper lifestyle as well food habits. So I suggest you need to get checked properly if you also have feeling of generalize body weakness.  For all this kind of my patients I strongly recommend the antioxidant supplement like vitamin c and vitamin e,  along with omega 3. Because all this together helps to heal your body from inside as well also helps for prevention of it with its natural anti degenerative and anti inflammatory effect. As of now you can take rest properly but still if you are feeling weak then consult your doctor.  Early prevention is better then cure.  Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes gait and girdle weakness?\n\ncomplaint history Gait- Unable to stand Tone nutrition normal Proximal girdle weakness motor evaluation right lower limb- hip-flexion/extension-grade-4 knee-flexion/extension-grade-4 ankle-flexion/extension-grade-4 palntars downwards bilateral knee jerk brisk bilateral knee jerk brisk After MRI & XRAYS Report (Dorsal spinal cord compression) (Pre and paravertebral Abscess) (Cord Edema) HPE REPORT- EVIDENCE OF TUBERCULOUS OSTEOMYLITIS (OPERATION NOTES) UNDEER ALL ASEPTIC PRECAUTIONS PAINTING & DRAPPING DONE. D6 TO L1 LEVELS MARKED & CHECKED UNDER C-ARM. MIDLINE EXPOSURE INCISION TAKEN & EXPOSUR DONE. D9 & D10 LEVEL DECOMPRESSED. D6 TO L1 PEDICLES MARKED & PREPARED. PEDICLES SCREWS PIT ON PEDICLES AT EACH LEVEL D TO D8 & D11 TO L1 ON LEFT SIDE & AT D6 , D8, D11, L1 ON RIGHT SIDE. RODS PLACED WITH TRANSVERSE CONNECTOR & SECURED. CLOSURE DONE IN LAYERS OVER NEGATIVE SUCTION DRAIN. DRESSING DONE.)",
    "doctor_response": "Hello,It looks from your details that you may be suffering from potts spine or TB of spine.Your notes show that you are operated for same. If you are in recovery phase then you should wait for 3-6 months for your recovery. It takes time to recovery from such lesions.Meanwhile your doctor will put you on anti tubercular medicines & physiotherapy.This will help you in your gradual recovery. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mukesh Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does your endocrine system assist your reaction in the below mentioned situation?\n\nHi, I am taking psychology and I've stumbled upon a question. Let's say you are driving down the highway when your tire blows, immediately you swerve several times and end up on the side of the road. Explain how the endocrine system assisted your reaction.",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.There is a boost of norepinephrine. It produces an alarm reaction and improves your reaction time.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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can infertility be treated?\n\nHi Doctor... I tasted my peak fertility time on 10th February, 2017. We did the intercourse several times. But my period has not been started yet. Today is 28th of February, 2017. I did the blood test on 23rd of February, 2017 and also tasted the pregnancy with the taster. Both of them were negative. On 24th February my gynecologist prescribed me Primolut 10mg per day for 5 days. I am taking them now. But I am very worried about my period. I don t have a baby yet but on 2015 I had a miscarriage of 7 weeks. Is there any chance to be pregnant now? I am so worried about my health. Please let me know your answer. Thanks -Adi",
    "doctor_response": "Hello,Don't be so worried. We need to find out first what is the cause of infertility then it can be treated accordingly. The test will have a basic investigation of you and your husband and the best plan can be made for you. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mandavi Rai",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it advised not to drink alcohol during amoebic cysts treatment?\n\nHi -- My doc prescribed a dose of Flagentyl one time -- followed by another dose one week later, in order to treat amoebic cysts. Is it advised NOT to drink any alcohol for the entire week between doses, or is it OK to have a glass or two of wine daily?",
    "doctor_response": "Hi,Yes, it is not safe to drink alcohol during treatment for amebiasis. Flagentyl is commonly prescribed in the treatment of amebiasis.  It is effective against the trophozoite forms of entameba histolytica but not against the cyst forms. For the treatment of amoebic cysts you are advised to take diloxanide furoate or iodoquinol. Taking alcohol drinks of alcohol containing syrups while on flagentyl may cause a condition called 'disulfiram like reaction' which is characterized by unpleasant side effects such as fast heartbeats, headache, warmth or redness under your skin, tingly feeling, nausea, and vomiting. Hence, avoid drinking alcohol while you are taking flagentyl and for at least 3 days after you stop taking it.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it dangerous to feel bruise on upper spine?\n\nWell,I started noticing a very touchy bruised feeling in my upper spine today.I have not done anything to cause it that I know of?I install floor covering for a living so I get banged up a lot,but usually there is something I did to. Cause it.I wonder is it something else?its sorta scary.I wonder will it be even worse tomorrow???hope not.should I put my heating pad on it tonight?",
    "doctor_response": "Hello!Thank you for your question on HCM! I appreciate your concern.  I think that your symptoms may be caused by a possible trauma, which you have not noticed, while working. A skin infection may also be possible. I would recommend you to consult with your GP for a physical evaluation. A blood routine test to exclude any possible infection should be done. Hope to have been helpful!Greetings! Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain radiating to right leg\n\nhi my name is aida vera i m 50 years old with lots of health issues, had to go by ambulance to the ER cause of my pain on my back and all they did was give me a shot of morfin and send me home that was this morning and i m worst the pain is running down my right leg and i m very depress could you please tell me what should i do",
    "doctor_response": "Hello,I had gone through the case and found that there might be many cause of pain.1- Lumbar spondylitis with pressing of sciatica nerve2- Osteoporosis with sciatica 3- Muscle spasm with nerve pull4- Vitamin D and calcium deficiency.5- slip discSo I will advise to go for blood test and X-ray of lumbo-sacral region to get the diagnosis.Meanwhile take mild painkiller with hot water compressing massage.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with DM-2, hypertension, have depression inspite of taking medicines. What is the remedy?\n\nsir, i am suffering from major depressive disorder since 1999 and taken antidepressants given by psychiatrists during last twelve years. at present i am taking medicines for D M TYPE-2, HYPERTENSION AND ANTIDEPRESSANTS such as 1-MIRTAZ-45 MG AT NIGHT. 2-LONAZEP IMG TAB - 1 TAB AT MORNING AND 1TAB AT NIGHT. 3-NEXITO 10MG 1TAB AT NIGHT. 4-VENLA-XR-150MG 1 CAP AT NIGHT. 5-PAXIDEP CR-25MG 1 TAB AT NIGHT. 6-PRAMIPEX 0.5MG TAB 1 TAB TWICE DAILY. but i am not well despite of taking all medicines and feeling depressed. sir, you are requested to resheduled and optimised the medicines and advised me for better medicines that i can lead a cheerful life. thanks, yours ever, k g agarwal, 45yrs, male, wt -95kg, businessman.",
    "doctor_response": "hi, its not known whether you are following prescriptions of multiple psychiatrists at one go because 4 anti-depressants ( mirtazapine, escitalopram, venlafaxine, paroxetine ) are not really a good cocktail..one or two anti-depressants at optimum doses should be tried first, followed by some augmenting agents..please re-schedule by visiting your psychiatrist and follow only one advice..your thyroid status needs to be checked..thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please check the image and tell me what I can do about my kid's eye infection.\n\nHello doctor, My three-year-old daughter got some infection in her eyes since yesterday and trying to rub her eye. There is some discharge also coming from the corner of the eyes. Picture is attached.",
    "doctor_response": "Hello. I have seen the picture (attachment removed to protect patient identity). It appears to be a case of conjunctivitis with associated nasolacrimal duct infection. All this for seven days. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. You have to perform nasolacrimal duct massage with your thumb and index finger of right hand place them over the portion where the nasal skin is meeting eyes, that is, corner of one's eye and gently push down. Please maintain good hygiene of your as well as patient's hand. Do wash your hands before and after instilling drops and massage. Get well soon. For more information consult an eye care ophthalmologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure the condition of abdominal migraines?\n\nwe were told our child may have abdominal migraines- both of this parents have regular migraines( headaches) and strong family history of headache migraines on both maternal and paternal sides.  One family member ( adult) has abdominal migraines.  Our child has what appears to be very strong episodes of nausea that can last for as long as six hours but usually around 1 to two hours.  nausea is in waves.  He gets extremely pale and says his cheeks feel numb and then sometimes his hands and arms do as well.. this can last as long as nausea sometimes.. I thought the tingling sensations might be panic related ( panics when the nausea is very bad) but GI doc said tingling should not last that long with panic.  He also has dark circles often with these and more recently has complained of back bothering him when he has these episodes.  He has had stomach cramping for two months now as well as the nausea but nausea is getting more severe... he had upper and lower scoping done and has been recently diagnosed with acid reflux for which he is taking 40 mg of prilosec in capsule form ( capsules poured out).  He has also been prescribed ondansetron for nausea ( which does not always seem real effective) also just started him on amitriptyline ( 10mg) just started last night.  had been hesitant to start him on the amitriptyline as the GI specialist said that with as severe and as long-lived as the nausea seemed, he wondered if it was maybe abdominal migraines and that the nausea would not be that long lasting with reflux alone.   So, my thought was if it was abdominal migraines, I wanted to monitor what he had eaten the days the nausea has been really bad.  The common thread I found for each day was caffeine and he loves iced  tea.  He has had six episodes of severe nausea, tingling etc in the last two weeks..... all lasting at least an hour if not more... He also urinates a lot and when he has these episodes and sometimes says he feels dizzy.  My main question is, if he continues to take the amitriptyline, is it then going to be difficult to diagnose him with abdominal migraines ( GI doc said if it is abdominal migraine, that is the med a Neurologist would prescribe).  Can reflux cause abdominal migraines or make them worse?    Looking back over the last couple months when this first started... he has been pale a lot ( looks sick)... we were pediatrician several times and were not to see specialist until next week but w",
    "doctor_response": "With such presentations in my clinic, I would prescribe Domperidon 1 tablet 3 times after 15 min before meals . It is gold standard for acid reflux.Kindly follow Pevzner's diet 1, don't give him ice or other tea, it will increase acidity, avoid chocolate and cheese, it can cause migrains also.Begin to take flax seeds(boil 1 tbs in 2 glasses of water,take 1/2 glass before meal twice a day). Give him yoghurts,probiotics(Visilac), it will decrease nausea and increase appetite. For headache  migraines you can use 1 tablet of Diclofenac and 1 tablet of Domperidone.  Hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in arms and head after injury\n\n2 days ago I was roller skating and fell on my back hard on cement. I can t extend my arms out, it hurts to My head, and bend or reach for something. I have to stay on otc pain meds just so it won t hurt to breath. There is a bulge and bruising. How long Can I wait out this pain before I know it might be some thing more serious that requires a Dr. And if I go do I go to a chiropractor or urgent care",
    "doctor_response": "Im sorry to hear about your recent fall and injury. For starters, I definitely do not recommend going to a chiropractor or a urgent care. My main concern is that you fell onto the back of your head and also that you are unable to lift your arms. This could be due to multiple causes : rotator cuff injury or tear, cervical disc bulge, subdural hematoma, or even a epidural hematoma. You should definitely make an appointment to see your primary care physician or even just go to your nearest ER for evaluation. If you start having symptoms of nausea, vision changes, lethargy or somnolence than this is even more concerning and you need to go to the ER immediately. I hope you feel better soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have a knot on my shin and mildly painful caused by an injury\n\nHi I dropped a skillet, hit my shin. Immediately, within seconds  I had a knot on my shin and mildly painful. I am on blood thinners due to a clotting issues. I am pretty confident I just busted a blood vessel, but what should I watch for or when should I be alarmed?",
    "doctor_response": "HiAfter going through the query ,my advice would be compression bandage,ice fomentation and limb elevation this will help.But you should watch for increasing size of the swelling and discoloration.Take care and wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excessive noise while breathing in a 5 month old child?\n\nsir, my baby (5months) has not well.when she breath kurrrrrrrrrrr.....kurrrrrrr.......sound was producing. we can feel like some cough is make this sound from the chest.i consulted one peadiatrician and he Rx cefixime potassium clavulanate oral suspension . now the course was completed and no progrees was found.she has no other problems",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. The sound you are describing is mostly seen with lower respiratory tract infection or asthma.Infection causes collection of secretions and they can make such noises. Asthma causes bronchospasm and this spasm can make this kind of noises. Since she is not improving with antibiotics, possibility of asthma is more. So better to consult another pediatrician and get done clinical examination of respiratory system for wheezing and bronchospasm. She will need inhaled treatment in the form of inhaled bronchodilator and inhaled corticosteroids (ICS). Don't worry, she will be alright with appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wishing good health to your daughter. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is there any medical procedure to heal acne, pits and scars?\n\nHello doctor, I am 21 years old with acne prone skin. I have lots of acne scars and pits from popping pimples when younger. I tried benzoyl peroxide and did not work. What medical procedure can stop pimples and heal the pits and scars? I am suffering from this for the past six to seven years.",
    "doctor_response": "Hello. Chronic acne with resultant scarring is an indication for treatment with oral Isotretinoin besides topical antiacne preparations like Benzoyl peroxide or Clindamycin. For scarring, there are cosmetic procedures like laser resurfacing or dermabrasion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest diet plans for typhoid fever of 12 year old\n\nmy son 12 and half years has been diagnosed typhoid fever, he has 100 fever and light abdominal pain and light headache since twelve days, kindly let me know the seriousness of the disease and he is taking ofloxin 400 BD & CEPODEM 200mg BD. tell me the diet for him pls ans my query.....Why d fever not going????",
    "doctor_response": "Please let me know how long is he on medication now? Typhoid fever usually takes 5-6 days to subside after starting medication. Diet of your child should be light food containing soups, also give food every 3-4 hours, because the child will have less appetite, and due to pain in stomach as mentioned by you will not take big meal at a time. The medication itself can cause pain in stomach as side effect, see to it that they are administered after some food and not empty stomach",
    "dialogue_context": ""
  },
  {
    "patient_message": "Skin discoloration like pinpricks from toes to ankles, freckles. What could this be?s\n\nMy husband has some skin discoloration that looks like pinpricks of brown running from the top of his toes to his ankles, on both feet. We at first thought they were freckles, because of the pigment color, but they have been spreading. My husband is 22 years old, in good health, so we are unsure on how we should proceed. What could this be?",
    "doctor_response": "these can be due to drugs used for other ailments even if off and on .ike paracetamo ibuprufen calcium vitamins and diet supplimentscan be soaps shampoo oils cooking oils or body application materials need to investigate on these lines and treat the cause",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can elevated ca125,abdominal swelling and fibroid tumor be symptoms of ovarian cancer?\n\ni have the symptoms of ovarian cancer i had a ca125 test done and it came out a little elevated at 43, my pap, uterus, and ovaries look normal on a sonogram but i do have a fibroid tumor i'm waiting for results of a ct scan of the abdomen and pelvis with and without contrast can i still have ovarian cancer what really concerns me is that my abdomen swells up alot i've even had people ask me if im pregnant that doesnt bother me what bothers me is that i don't know whats going on",
    "doctor_response": "Thanks for query.CA125 is not specific for epithelial ovarian cancer and is elevated in other benign and malignant conditions, including menstruation; endometriosis; pelvic inflammation; liver, renal, and lung disease.It is also elevated in 6% of women who do not have epithelial ovarian cancer.so there is no reason to worry based on ca125 levels. the thing you should be  concerned more is ascitis(fluid in abdomen).we may get a hint of diagnosis after CT report.but final diagnosis in such scenario is generally made by staging laprotomy.discuss with you gynaecologists.regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does siphene 50 and diane help in getting pregnant ?\n\nHI , i had pcos issue and my doctor had asked me to take diane for 2 mths and then cme on my second day of my periods in the second month, when i visted the doctor she gave me siphene 50 mg tablets and asked me to take it for 5 days starting from second day of my period, and then come on my 10th day for a scan to check which egg is producing and stuff, but i have a doubt as to whether i can have intercourse during this 10 day period before going for a scan or not, and also let me know if this tablets could help me in concieveing",
    "doctor_response": "Hi, As you are having PCOS, hyperinsulineamia along with irregular periods will be there. If insulin sensitizers like Diane are used it will control the condition and improve fertility. Siphene is brand name clomifene tablets which will help in inducing ovulation. You can have inter course in first ten days. But if you maintain abstinence two days before your ovulation, the sperm count will be good and chances of conceiving will be more. Means in regular 28 days cycle the ovulation will occur around 14th. So, maintain abstinence on 10th and 11th day. From 12th to 16th day you be together, at-least on alternate days. After your doctor examines you she will suggest according to the condition of the ovum when to plan intercourse to increase the chance of pregnancy. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i withdraw Qutan slowly without any adverse effects?\n\nHi doctor, i have been taking qutan 100 mg for past two years due to problem \"borderline anxiety depression syndrome\" which was stated in my psychological evaluation, now i feel 100% fit, but will it be possible for me to stayfit in near future without this drug.",
    "doctor_response": "hii understand your concern.it is good that now you are feeling good. withdrawal of drug is depend upon many factors like duration of illness/duration of drug therapy/risk factors/family history/time to improvement.It is advisable that best will judge by your treating psychiatrist because he knows everything about it.Yes it can  possible to reduce dose gradually but take your psychiatrist opinion for better outcome.still have query then feel free to ask.Thank you.wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes increased heart rate?\n\nI am a 29 female. My heart rate speeds up then returns to normal. I have what seems to be heart spasms. Also they come more often and last longer now. Yesterday for an hour. WIth this comes my heart pumps very hard and is visibly noticable. It feels as though like I have 2 seperate heart beats sometimes. It is so loud sometimes that it makes my ears hurt. Headaches are also in the picture.",
    "doctor_response": "Do you have any chest pain or breathlessness?Thyroid problem?Get your ECG,Echo and thyroid profile done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this semen analysis report indicate?\n\nGood day. .Dear doctor, I have secondary infertility for 2 years until now..I did semen analysis two times with almost the same result:Viscosity: normalPh: 8.0Motility: 40%Motility grade: 2Viability: Count: 40 mi/mlWbc: 15/hpfMorphology: 75% abnormalPlease give your opinion about this case.Thank you.",
    "doctor_response": "hello...semen report  suggests infection due to WBCs..so semen culture and sensitivity to choose the right antibioticAlso abnormal morphology n motility is grade 2:so antioxidants to be added CoQ, L carnitineany heat exposure .at work/elsewhere,.smoking, alcohol consumption also affects semen quality",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a permanent cure for lumbar spondylysis?\n\nif there is a permanant cure for lumbar spondylysis?? If a patient is not willing to undergo surgery,can she spend his lifetime without any pain by taking medicines and ample rest.. The patient in reference is suffering from L5 S1 grade 2 lumbar spondylysis since  2011 till date",
    "doctor_response": "Hello!Thanks for query. Nerve root block is an alternative for surgery in lumbar spondylosis is not the permanent cure.Repeated injections may b needed.Hope this answers your query.Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the modes of transmission of hepatitis C?\n\nIs there anyway hepatitis C can be transmitted by touching where a patient with hep c touched, sitting in the same seat, etc? I was told once we don t know where some people get it and I worry that I can get it from shaking hands, touching things they ve touched, etc.",
    "doctor_response": "Hello dear,Transmission route for the hepatitis are as follows1. Via blood transfusion or Receipt of Blood Products2. By using same needle for injecting drug3. Sexual transmissionSo not to worry.It does not transmitted by touching to hepatitis C patient.Hope this may help you.Take care.have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to remove food stuck between teeth after teeth removal?\n\nHello. I've had 3 wisdom teeth removed 3 days ago, and while I was eating jello this morning, I thought I had some jello stuck near the place of extraction (bottom right). I didn't want to move it because I was afraid, but upon looking at it in the mirror, it's a black/pinkish lump attached to my gum, and it appears to be the size of a tooth. It's soft and jelly like. It doesn't bother me, and it doesn't give me pain. I'm just wondering what could it be?",
    "doctor_response": "Hello,  Thanks for consulting HCM,  Read your query, as you have undergone extraction 3 days ago there is blood clot formation on extraction socket which you feel like pinkish lump , dont be worried so much if you have food stuck between lump and teeth you do saline rinses it will be removed and disturb the clot .  If you feel pain or food stuck wont removed consult your dentist and go for examination of socket and removal of food debris . Follow all post operative instruction given by your dentist , take proper course of antibiotics .Hope it will help you.  Wishing you good health.Regards,  Dr. Priyanka tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for large, bruised bump on forehead\n\nhi i banged ma head 1 week ago got a large bum on my forehead called doctor after bump advised to use cold compress meaning bag of frozen peas and be watched for 24 hours,now a week old i still have lump on forehead maybe smaller with bruising ALL over left side above eye which is yellowish green now but have 2 black eyes beneath my eyes is this normal i have been to the doctor twice and got tolld a goose egglump is goo cause it out not in and the forhead is a strong bone but today my left inner arm is tingling meaning cold/freezing doctor said is fine meybe just nerve damage from fall it will clear i hope you can help xxx",
    "doctor_response": "HI THANKS FOR POSTING YOUR QUERY ON HEALTH CARE MAGIC.GOING BY YOUR CLINICAL HISTORY IT SEEMS PRUDENT THAT A INTERNAL HEMORRAGHE SECONDARY TO HEAD INJURY HAS TO BE RULED OUT.INJURY TO FRONTAL HEAD HAS RESULTED IN A CONTUSION ON THE FOREHEAD WHICH HAS RESULTED IN SEEPAGE OF BLOOD INTO THE SOFT TISSUES AROUND THE EYE.THIS IS REFERRED TO AS \" PERIORBITAL ECCYMOSIS\" OR 'BLACK EYE'.IN ALL SUCH CASES UNDERLYING BONE INJURY LIKE FRACTURE HAS TO BE RULED OUT.THIS REQUIRES AN URGENT PLAIN CT(COMPACT TOMOGRAPHY) OF THE HEAD HAS TO BE CARRIED OUT.THIS CAN DETECT INTERNAL BLEED QUITE EFFECTIVELY.TREATMENT INCLUDES SURGICAL DRAINAGE OF BLOOD THROUGH BURR HOLE.YOU ARE CURRENTLY RECEIVING A RIGHT TREATMENT,BUT EXCLUDE BRAIN INJURY.CONSULT A NEUROSURGEON.THANK YOU.TAKE CARE.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and pressure on the left side of the chest?\n\nMy daughter is 15 and is having left chest pain which continues around into her back and feels a little pressure on her chest . I have had her to Dr and heart doctor who say it s not her heart . But this continues to hurt her . Could you tell me what this might be.",
    "doctor_response": "Thanks for your question on HCM. Since your daughter's cardiac work up is normal, no need to worry much about heart diseases.I think it is muscular pain mostly.So try to follow these for better symptomatic relief. 1. Avoid heavy weight lifting and strenuous exercise. 2. Avoid bad postures in sleep. 3. Take good painkiller and muscle relaxant. 4. Apply warm water pad on affected site. 5. Wear chest belt to avoid mobilisation of affected area. 6. If weight is more than try for weight loss.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and limp while walking after ankle got hurt?\n\ni tripped over a steel post about 3 inches off the ground. in hitting my left leg just above the ankle. had to rub it for few minutes before i could walk. the next day i could hardly walk, took ibuprofen & treated it like a sprang ankle. now one week later it is still swollen & i walk with a limp. is their more i could do?",
    "doctor_response": "Hi, it seems you have hurt quite hard, as even after one week, you are having pain and swelling.Two things are required,1 X Ray ankle AP and Lat views,2 Apply crepe bandage , continue your medication, and keep limb elevated.if these resolve, be happy.If persist consult your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Upper right abdominal pain radiating to back soon after eating food. Ultrasound normal. Suggestions?\n\ni get pain in the upper right abdomen which at time moves to the back...i did ultrasound of abdomen and pelvis ..but everything seems to be normal. doctor has now suggested me to have nor metrogyl tablets for 5 days...the pain is subsided a bit..but not completely. i feel pain soon after eating food. what is the next step to be done by me",
    "doctor_response": "welcome to hcm,as u have rt upper abd pain no fever & jaundice & usg abdomen normal then u most likely to have peptic ulcer diasease (gastric ulcer)as pain ancreases after taking meal.u should stop taking mirch/masala/alcohol/ciggarette etc,take tab pantop-d 40mg 1 tab 2 times a day 1/2 hr before meal erverything will be all right.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have chiari malformation 1, right side weakness after brain stem stroke. Take Lopressor. Losing balance. Why ?\n\nI am 62 years old and have chiari malformation 1.  I had a brain stem stroke 20 years ago with right side weakness that has not gone away.  Lopressor has been prescribed for fast palpitations while at rest.  I can't balance myself with the weakness and this drug.  It doesn't stop the heart from fluttering. Maybe the Chiari and brain tonsils finally caused problems with my heart that drugs can't correct.  Would that be possible?",
    "doctor_response": "Hi, you are 62 years, had stroke 20 years ago, and now your body has changed a lot, including the harmones. There could be ischemia of the brain, anemia, anxiety, etc.                       I advise you to consult a neurologist for diagnosis and treatment.                       Take green leafy vegetables, pulses, sprouts, and proteine rich foods. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have mild prostate enlargement. Prescribed Veltam. Have abdominal pain. Reason?\n\nI am a 56 year old male recently diagonsed with Milld Prostate Enlargement. The PSA was 1.9 and prostate weighed 33 g. I have been prescribed Veltam 0.4. I am sometime experiencing abdominal pain . what could be the reason ? I am on this medicine since last one month. This is apart from my regular medication for blood pressure and cholesterol .",
    "doctor_response": "Hello Thank you for getting in touch with us. As I see, you have been diagnosed with mild prostate enlargement. It should also be noted that your PSA levels are normal at the moment. Veltam is a commonly used drug in the elderly population with prostate problems and is highly effective in them. Regular use of this medicine leads to significant improvement in the condition of the patient. Abdominal pain is mostly not associated with Veltam and you need to get it examined to find out the real cause. You should try to keep your BP and cholesterol in control and exercise on a regular basis. Hope this helped Regards Dr. Gagandeep Dhillon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medication is suggested for foot neuropathy?\n\nHello, I have foot neuropathy in both feet..I was told I need to be treated with lasers and UV light..I also have an AV malformation on the bottom of my left foot.. Would it be a problem to go through treatment since it will increase collateral circulation of the feet?",
    "doctor_response": "Hello, AV malformation does not cause any problems with your treatment. You can try drugs like gabapentin which is very effective for neuropathic pain. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yellow discoloration on the skin of a hepatitis C patient?\n\nMy son was diagnosed with Hep C appx 20 yrs ago, he had the treatment and his liver was OK and has remained so. But I notice,, and other members of the family also, that he is turning yellow. He gors to the Dr. but tells me he just had blood work and dr said everything OK. Blood work was 2 mos ago. What do you reccommend?",
    "doctor_response": "Hi welcome to the health care magic You are telling that it seems to be yellow eyes in your son... As he is having hepatitis c infection for yellow eye jaundice or hemolysis should be ruled out... For which following investigation can be done.... -Serum bilirubin estimation -Peripheral smear blood examination and CBC with reticulocyte count -Serum LDH If these reports are normal then no worry regarding jaundice Let us provide reports done in past for giving more comment Hope your concern solved Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Constant dull pain in the abdomen, feeling of lump on pressing, difficulty in bowel movements causing rise in BP, had abdominal surgeries. Reason?\n\nI have a constant dull pain on the lower right side of my abdomen . When I lay down and press in firmly I do feel a small hard lump. My bowels often feel like they are strangled, some sort of stricture happens and I am unable to have a BM and my blood pressure goes up. What is going on? I have had four abdomenal surgeries in the past.",
    "doctor_response": "Hi, . Lower right quadrant abdominal pain are associated with a few medical condition. The most common one being appendicitis / appendicular mass. Other possibilities are mesentric lymphadenitis, inguinal hernia, muscular ache and so on. The abdominal pain and lump in right lower abdomen concerns me. Since you been exposed to 4 previous abdominal surgeries, there are chances that what you could have be related to those surgeries. A detailed abdominal examination, ultrasound examination and or CT/MRI scans of abdomen is warranted to confirm the diagnosis. I suggest you to report to your gastroenterologist. Hope this helps. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Would you recommend birth control pills for my acne?\n\nHello doctor,I am a 33 year old female. As a teenager, I got acne on my face and back. In my 20's it mostly went away. I would get a pimple here and there on my face, but nothing too bad. My back cleared up completely. Now in my 30's, the acne has started to come back worse. I get breakouts on my face, chest, and back. I have tried courses of antibiotics like Minocycline and Doxycycline, but they never cleared up entirely. My doctor checked my hormone levels, but there was nothing abnormal. He also got me checked for PCOS, but there was nothing abnormal there either. Would you recommend trying birth control or should I go straight for Accutane?",
    "doctor_response": "Hello. Please attach some good quality pictures of the affected area. Revert with more information to a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which specialist should one consult for a mouth cancer?\n\nMy Husband just recently had a biopsy done from under his tougne and the results came back as superficial cancer., The biopsy was done by a DMD Doctor, we now need to find a doctor that can help with a cure for this, we have been waiting for a referral from the DMD and he has not returned our calls., so my question is what kind of Doctor do I need to look for here in Columbia,SC. To get started on a treatment for this?, I appreciate your help in this.",
    "doctor_response": "Hello,Based on your husband biopsy report it is confirmed malignancy. You need to consult surgical oncologist for further management and it depends upon the clinical staging.For a superficial cancer and without nodes, there will be a simple excision. If nodes are palpable, then surgeon will plan for radical treatment.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Siddartha",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is asthalin ideal for a child suffering from asthma?\n\nHi Doctor, my kid i suffering from wheezing problem sometimes...she is bit allergic...recently doctor suggested to use Asthalin inhaler 200 m doses and seroflo inhaler 125 m doses...she is 5.5 years old....can you please give more details about this",
    "doctor_response": "Hi,I had gone through your query and understand your concern.These medicines are prescribed by the doctor thinking of probable asthma.Asthalin inhaler acts as a reliever where as seroflo inhaler acts  as controller as well as reliever of attacks.If I were the treating physician,I would first look for triggers(cold,dut,exercise etc),personal history of atopy ,family history of atopic diseases (asthma,eczema,hay fever etc),sleep disturbance and other typical symptoms of asthma like cough,breathlessness,chest tightness .I would then perform objective test if possible to confirm the diagnosis of asthma and exclude other diseases like bronchitis,brochiolitis etc. If asthma is suspected,then I would start treatment according to step care management guideline of asthma.Seroflo inhaler is a combination of salmeterol and fluticasone.Salmeterol is a long acting drug which is not preferred as first line management.So my suggestion is :please consult with a respiratory medicine specialist to confirm the diagnosis and get proper step care management.Hope this helps you.Wish your kid good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for ALT-2.5 times higher and HBV DNA viral load-655000?\n\nHi Doctor, I have been diagnosed with Hepatitis B since 2000. On December 2013 my ALT test results are 2.5 times higher than the normal value. Also HBV DNA viral load is 655000 iu/ml. My doctor recommended that I should start treatment. Is the right time to start treatment now?",
    "doctor_response": "hi, Guidelines (EASLD and AASLD) say that if liver enzymes are elevated twice the normal, treatment is recommended. your viral load is high, and it is perfect time to start the treatment.  There are very good drugs for hepatitis B but the response will be best before liver gets irreversibly damaged. So,proceed with the treatment. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden mood swing?\n\nHi Dr.i had a Q:it was around 4 am i was awake with my friends talking and having fun, i was talking for few min then i felt somthing went wrong with me  like i felt i was high something went wrong with me , i new what i was doing but i though im not normol , i dont know whats wrong with me doctor please help what should i do ?Ali",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. I sincerely opine that the problem you are facing now is of your own creation. You tol that you are woke up and enjoying with yur friends at  4 AM. It is quite natural that you were feeling sleepy, and were tired. The euphoria and the resultant excitement added to your tired ness. There could be some influence of substances, if you consumed some substances. Tired and sleep deprived body is bound to give you warning signs, and that was what you experienced. Don't worry. If you still need my help, please describe the whole problem in detail and post a direct question to me. I shall definitely help you with psychotherapy techniques to over come your problems.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Teeth have become cold sensitive, getting electrical sensations. Causes ?\n\nHi. As of the last few weeks, I ve been having a problem with my teeth becoming very cold sensitive. This is becoming worse everyday. At first it was just the teeth. Now I have electrical sensations in my teeth and my gums - left and right, upper and lower. ALL my teeth are effected. I have not noticed any kind of changes with my teeth or my gums at all before or during this whole time frame. I can push on my teeth, push on my gums, or bite down hard - and no pain. So it does not appear to be a dental problem. It seems to me the nerves in my gums leading to my teeth have suddenly become over active. What could have caused this? By the way I am a 47-year-old white male.",
    "doctor_response": "Hello and welcome to hcm, Sensitivity of teeth may be due to-Regressive changes like attrition,abrasion or erosion of teeth. Periapical infection of teeth. Exposed tooth portion has to be restored with tooth-coloured filling material. Use soft-bristled toothbrush and clean your teeth in back-forth,up-down motion. Avoid intake of carbonated drinks,citrus fruits. Avoid tooth grinding habits. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can chronic cough and pneumonia be treated?\n\nYes I ve been treated with 2 different types of antibiotics for neumonia but I can t get rid of the cough, tried claritin for allergies and tessalon pearls but nothing is helping plus I feel like flems are stuck in my chest and I can t get rid of them what do I do?",
    "doctor_response": "dear userabout your complain of pneumonia with cough you should follow simple steps you should see your doctor for clinical examination and discuss with him to do chest x ray and blood culture to confirm diagnosisif diagnosis confirmed you should do antibiotic sensitivity test to detect most sensitive antibiotic with good resultpneumonia has resistance to antibiotic so tests should be performed some times we choose to give pencillin plus aminoglycosides as gentamycin because it will give great results with pneumoniadrink alot of fluids will help and avoid severe effort and try to have cough sedatives to help and you can take tylenol if there is feveryou neednot to be worry and just follow thathope that helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of my yeast infection?\n\nHey, I am currently a 21 year old student studying for Registerd Nurse. About three months ago I had sex and then soon afterwards I received a yeast infection. I went to the doctor and they gave me meds. Here three months later and this yeast infection is back and my groin is sore. Can you give me any advice?",
    "doctor_response": "Hello,Welcome to HCM,The history and symptoms suggests me that you are having fungal infection and these infection are more in the genitals as these are the normal comensals of the genitals.As you are getting these infections frequently I would suggest you to follow1.Keep the area clean and dry2.Apply antifungal cream over the affected area3.Take Flucanazole tablet 4.Oral antihistamines to reduce the itching.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am getting dark complexion after using of cosmelite\n\nHi I am a dark skinned asian femail, i was using cosmelite which gave me a good complexion however is started getting pimples becoz of that..hence i stopped cosmelite..now i have becum more darker..wat shud i do? shus i continue to use cosmelie is it a good cream for any skin type?",
    "doctor_response": "Hi ! gayu, Welcome To HealthcareMagic forum, You should never use cosmelite for long time.If you use it for a week or two it would give you good complexion ,but on long run its going to spoil your face. It is a combination of three things (steroid,tretinoin & hydroquinone).Its the steroid component which leads to all the side effects.I am sure if it was prescribed by a dermatologist he would have told you not to use it for long. If used for long it can cause pimples,rosacea(redness) ,fine lines on face ,capillary out breaks  etc.The moment you stop using this cream ,it leads to itching & burning sensation with redness.pimples is a major side effect. If you continue to use this cream its going to cause all the above problems.So stop this cream asap. Once you leave  this cream you are going to get with-drawl effects of this cream as described above( they are same as you use it for long). It takes along to get over it .There are creams like tacrolimus or pimecrolimus which would help you recover from this.In case of pimples I prefer oral retinoids if pimples are sever.And always use a sunscreen while going out. You can mail me if you have any further queries. regards, Dr.chawda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Headache from 4 years\n\nhello doctor  4days back i got a severe headache even my head doesn t move smoothly means its almost structed,if i bent down i m feeling like the head weight increses as welll as pain also this will be continues for 2days after that i consult a doctor and he will give some medicines after using the medicines the headacqe is not much as previous one but im suffering little bit now ..give any suggestions",
    "doctor_response": "I hope your blood pressure in normal. Even if it normal, do get it measured regualarly, another common reason in this season could be cough and cold. The way headache you are having sinus headache is more likely. Take medicines as advised and take steam inhalation twice in a day, avoid cold drinks and fried foods, hot soups etc. is better. Wear ear plugs when you go out in cold and sweater etc.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can the pregnancy date be calculated?\n\ni have taken MTPill 200mg one tablet yesterday evening at 1730hr ie 19 Jun 2010 and will be taking four tablets of Micronised Progesterone Tablet, 100mg each tomorow ie 21 Jun 2010. My last mensuration cycle started on 06 and finished on 10 May 2010. I have done Strip test and ultrasound done from doctor for pregnancy confirmation. Please advice as to how many days I am pregnant and also is it right that I have not felt anything till now after taking MTPill medicine.",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.If you have regular cycles, with MAY 06 as your first day of last menstrual periods, by JUNE 21 your pregnancy will be 6 weeks and 4 days duration.Also, I usually suggest dose of MTPill as follows- tab MIFEGEST 200 mg followed by tab MISOPROSTOL 800 mcg after 48 hours. Please get it done under medical supervision, as per the laws of the land where you are living.There is no role of Micronized progesterone tablets in pregnancy termination.I hope my answer helps you.Thanks.Wish you great health.Dr Purushottam",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will ciplox help treat pain in lower abdomen?\n\nHi, I have been having on and off side pain on the lower right hand side of my stomach.Showed the doctor - got the ultrasound done -- nothing just(mild fatty liver).Urine test showed 4-6 hpf pus.Took ciplox tz for 5 days but i still have that pain.I have noticed it pains when i bend .What could I be suffering with.",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.Good that you took the right course. But the pain on bending can not be explained by urinary tract infection. It is possible that there is is an internal problem like peritonitis or some problem with the abdominal wall musculature. A clinical examination by a Surgeon can exactly pin -point the problem .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach ache around the navel?\n\nHi. A few years ago I had a surgery which led to another surgery because I had a bowl obstruction, I was 16 1/2 when it happened I am now 22 and I ve been experiencing some severe stomach pains, it started tonight and has been going on for the past 3 hrs? It s in the middle of my stomach and around my belly button? I m not sure what s going on ? The pains come and go like every few minutes. Please help me. What could it be?",
    "doctor_response": "Welcome to ' Ask a doctor ' service .I have read your query and here is my answer .As you had previous history of surgeries , and as per your symptoms there is doubt of adhesions leading to small bowel obstruction .Please visit emergency as you need urgent xray abdomen in standing position .Also needed is ultrasound abdomen .Go for lab tests as TLC DLC ESR and stool examination as it may be gut infection also .I hope I have solved your query .Let mw know if I can assist you further in this query .With regards dr varinder joshi .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could chronic low blood pressure with a systolic and diastolic being close together indicate? I am frequently light-headed, blood work is extremely good, but I have had blood in my urine present with 3 doctor visits. I am to have CTs done and a cystoscopy. I do have history of some flank pain, cloudy urine, mild hearing loss and just starting to realize I have had ringing in my ears occasionally over the last couple decades. Could my blood pressure be hypertension? Beginning to worry and become scared.",
    "doctor_response": "Hi, I understand your concern and I'll try to help you. Hypertension is a very common disease and is related to genetic factors and lifestyle that people have. Hypertension has no cure and patients need to change the lifestyle and often using medications to lower blood pressure throughout life.Your question is a bit confusing and I understand that you have hypertension for at least two decades, is a loss of blood in the urine (hematuria), flank pain, and ringing in the ears and is systolic pressure and very close diastolic. I will address each of these problems.The loss of blood in the urine and flank pain may be related to a disease that leads to the formation of stones in the urinary tract, known as nephrolithiasis. This disease is one of the most common cause of blood in the urine, as well as urinary infections. There are diseases that can cause increased blood pressure and hematuria secondary to kidney inflammation known as nephritis. To identify the cause of the loss of blood in the urine, it is important that your doctor search for the presence of these stones with tomography urinary tract and a cystoscopy, and seek signs of inflammation in the kidneys with specific blood tests.The ringing in the ears is usually related to poorly controlled hypertension or the vestibular system of the inner ear diseases. The vestibular system is one of the responsible for the body balance and when it is compromised can cause dizziness, feeling stuffy ear and tinnitus, being known as Meniere disease.Finally, when the systolic and diastolic are very close, the first thing to do is check if the devices and pressure measurement technique are correct. If these pressures are even close, it is important to search for signs of heart failure with loss of contractility of the heart muscle. This research can be done initially with an echocardiogram.It is important to look for a strict control of blood pressure levels to reduce the risk of complications secondary to poorly controlled hypertension as cerebral infarction, myocardial infarction, heart failure, kidney failure and blindness. To achieve this control is necessary to seek healthy lifestyle with proper nutrition, regular exercise, weight loss, sleep apnea control, in addition to the rigorous use of antihypertensive medications.Hope I have answered your question. If you have any further questions I will be happy to help you. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can high blood pressure be treated?\n\nI am 60 year old female that flew in from London 6 weeks ago to look after my mother who is in hospital since 29 April. I\u2019m experiencing high blood pressure for several weeks and 2 days ago I had a wavy vision in my peripheral view in my left eye, then I woke yesterday with a pain in my left temple behind my eye, I took ibuprofen and used ice pack, which helped alleviate it, but it has persisted during the night again and it keeps waking me up,. My ears are ringing and my BO is 150/110 with 50 beats at 5:15am. I usually have low blood pressure and suffer from vertigo BPV..... I am trying to rest but can\u2019t sleep and frightened if I can have a stroke. I have no medical coverage here if I go to A& E , but afraid to fly home in this condition.... what should. Do?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I passed carefully through your question and would explain that your symptoms are not typical of a stroke. But, it is important to exclude possible temporal arteritis which can mimic this clinical situation. For this reason, I recommend consulting with your GP for a physical exam and some tests: - a resting ECG - complete blood count, PCR, ESR for inflammation - blood electrolytes for any possible imbalances - thyroid hormone levels for thyroid gland dysfunction - a brain MRI study. You should discuss with your doctor on the above tests. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is itching in my foot and arm related to Chikungunya?\n\nHello sir: I had Chikungunya 15 months ago and now I am experiencing Raynaud phenomenon type symptoms and joint pains especially in the wrists, fingers, digits and also frequency I get swollen up my arm and foot having severe itching......please let me know what to do, is this effect of Chikungunya and what measures to take to avoid completely Thanking you",
    "doctor_response": "Thanks for asking at Healthcare Magic. I read your question and I understand your concern. Yes these symptoms can be chikungunya virus infection as it has three forms acute that resolve in7-21 days, subacute 3-5 days, chronic takes months to years and sometimes there is relapse of Rhumatological symptoms months or years later. However you have also to do workup for other rhumatological diseases like SLE, RA etc.. through ANA, Anti CCP and ESR or CRP. As there is no treatment for chikungunya virus. Take NSAIDs like Advil, Topical steroids like beclomethasone propionate and anti allergic like cetrizine. Keep your body warm but away from heat and cold. Take plenty of water. Hope it helps best. Don't forget to rate this answer and close the discussion at Healthcare magic. RegardsDr Ejaz",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes slime like substance on tongue and white colour on the edges of the tongue?\n\nMy mother is in the late stages of dementia she has for the last three weeks had a slime like substance on her tongue,it is also a white colour on the edges. Her lips also were swollen and very sore it really does look horrific .What do you think it could be?",
    "doctor_response": "HiIt could be anything.May be a part of drug therapy or nutritional deficiency.It would better to consult your treating doctors and get advise.Do symptomatic treatment like Vitamin b complex and folic acid.If it is swallowen then apply chlorihexidine gel over it.But if there is difficulty in eating then consult a doctor.It is difficult to give advise without examine it properly.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Positional vertigo, elevated sgpt, prescribed donasure. Dietary precautions?\n\nhi, i am gouri AAAAAAA AAAAAAA 70 years old i am suffering from positional vertigo and sgpt in blood is 57 , how to eat in daily routine, my doctor is prescribed the medicine donasure 5 mg one tab daily in night",
    "doctor_response": "Hi, Welcome to Health care magic forum.                        The causes of positional vertigo may be the infection, or ischemia  of the internal ear, or may be ischemia of the brain. The other causes may be the hypertension, or hypo or hyperglycemia.                          I advise you to consult a physician for diagnosis and treatment.                           I usually prescribe to my patient with such symptoms cinnerzine, and ranitidine.                         Take more of green leafy vegetables, pulses, sprouts, and protein rich foods to have good health and resistance against infections.                         Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does stents, affect breathing patterns in elders?\n\nhi dr.gopi.my mom who is 76yrs old who had 2 stents fixed at wock then in oct 09... but she has been complaining of chest pain when she bends... andhas breathless when she walks.kindly let me know whether stents effect the breathing pattern. and why she has pain in the stent area when she bends.thank u very and awaiting ur valuable reply.ara eurekha",
    "doctor_response": "Hello, Regarding your concern, I would explain that stents are not related to her symptomatology. Gastro-esophageal reflux, a lung disorder or heart failure could be the causes underlying her complaints. For this reason, I would recommend consulting with her attending physician for a physical exam and some tests: - a chest X-ray study and pulmonary function tests - a cardiac ultrasound and NT pro BNP levels for heart failure - kidney and liver function tests. A fibrogastroscopy may be needed if all the above tests result normal. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause fatigue and heavy chest ?\n\nFor the past 3 weeks I feel like someone is pushing on my chest. I have felf fatique for the past few months and sometimes I feel like I loose my balance. I quit smoking 6 weeks ago. I have not been excersizing for 4 months. Also, the past week I have been waking up with red bugers in my nose. Any connection to all these strange symptoms. ? am a 58 aged female.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.Your symptoms are more suggestive of post Menopausal syndrome.But better to rule out heart diseases first.So get done ecg, 2d echo and stress test.If all these are normal then no need to worry for heart diseases.Consult gynecologist and start hormone replacement therapy (HRT).Avoid stress and tension, be relax and calm.Don't worry, you will be alright.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How safe is taking Lisinopril from Cardizem?\n\nI recently switched from Cardizem CD (300) to Lisinopril 40 MG due to my insurance company raising the rate for prescription 400% This was done by my doctor after I told him about the increase. Inhave been having BP readings in the n150/104 range consistently for two weeks. Is there a significant change in the two types of medication to cause this? My readings on Cardizem were usually in the 130/80 range.",
    "doctor_response": "Hi,Actually it is a little bit risky to switch abruptly from Cardizem to Lisinopril. The main side effect can be sudden increase in heart rate abd arrhythmias. Of course increase in blood pressure also can occur. As they are different they can act differently in individual patients despite the fact that both are given in high doses. If you didn't have palpitations you may wait another week, if your blood pressure remains high, I would advise you to see your doctor to revise your treatmentHope I could help youWishing you good healthIn case of further questions don't hesitate to ask.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the lower back after a hip injury?\n\nA year ago I injured my right hip and lower back from a 15mph fall off a longboard. I did not seek a doctor and over time felt better. I am now experiencing lower back pain after physical activity, which has never happened before. I usually notice it when I lay down at the end of the day and I get a sudden rush of pain in my lumbar section of the spine. If I slowly turn on my side and lay in a curled position the pain will eventually recede. This has been happening for several months and has not improved.",
    "doctor_response": "HiThere must be neglected soft tissue injury if lower back presenting now.Do hot packs, avoid forward bending,wear lumbo sacral brace in daytime, apply muscle inflammatory gel like vitaran gel twice after fomentation.Seek orthopedic doctors consultation",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pre-ejaculation. Unani treatment in vain. Can I have a solution?\n\nsir jab my apnay wife k saath sex karnay ki kooshish karta ho tho mera penis intercourse kay pahalay he leak ho jatha hai please solve my problem aur maine doctor treatment leya kuch bhi solve nahe huwa . aur unani treatement lay kar bhi dekha kuch faida nahi huwa . sir please help me . sir meri age 37 yrs hai aur mera 2 yrs ka beta bhi hai pahalay tho aisa problem nahe tha aba 1yr say a problem ho raha hai please & please solve my problem & give me a solution to my question .",
    "doctor_response": "Dear There is premature ejaculation in your case. In majority of cases this is a psychological problem. Once you accept it and start thinking of it for quite some time it will keep on creating problem for you. The best thing to overcome this is to forget that you have any problem and lead a normal life with proper diet and regular exercise. Don't attach much importance to it for a quick relief. Amongst medicines the first thing is to treat psychogenic part and for that you will have to take Cap. strescom and to increase your power and time have tab. shila pravang.If you believe my advice firmly your problem will be solved once for ever.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have constant tickle in my throat for 6 days\n\nI cant stop this tickle in my throat and i cough untill im sick I ve had this constant tickle in my throat for 6 days and i cant seem to stop it even when i cough until iam sick what is it i cant sleep and feel really ill tonight?",
    "doctor_response": "Hi, thanks for query, It seems that you have got pharyngitis,viral or bacterial. Due to irritation in the throat you get cough reflex and having coughing. do salt water gargling, If you have bodyache,lethargy,fever you go for antibiotc course and cough syrup. Avoid fried and spicy food,smoking. ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I feel like something is stuck in my throat associated with acidity. Kindly advice.\n\nHello doctor, I feel like something is stuck in my throat from two months, and I also have the problem of food coming in the mouth sometimes, and acidity. When I went to the doctor, he recommended Pantoprazole after which I had little relief, but not so much. Please prescribe me something better.",
    "doctor_response": "Hello. Have you been back to your doctor after he recommended Pantoprazole? I think that you need to have an upper endoscopy to look at your esophagus and what is causing this problem. It sounds like you may have a Zenker's diverticulum. This is an outpouching of the lining of the esophagus. There are treatment options for this, but you have to Consult a gastroenterologist who may be able to fix the problem through the endoscopy. I hope this information is helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump in vagina\n\nI am very scared about a lump I have found just in the entrance of the vagina. It is about as big as a pea and I have not been sexually active for about a year. It is not painful but I have probably made it tender where I was trying feel about the area for more.",
    "doctor_response": "Hi, dear I have gone through your question. I can understand your concern. You may have some benign cyst like batholine cyst or other cyst.  This type of cysts are common in that area.  You should consult gynecologist and go for examination.  Surgical excision is the treatment of choice. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruised feeling near right groin?\n\nA couple of days ago I noticed a severely bruised feeling area near my right groin area (from looking at diagrams possibly the inguinal node ages). No bruising exists but the area is very tender to the touch and an ache has begun to radiate down the leg to the knee area. Also during this time, I have been feeling slightly ill, running a low grade fever of around 100 and experiencing chills and night sweats. I live in a rural area and am wondering if this is something I should seek medical attention for or just give it a few days to pass. Thanks.",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: Any infection in lower limbs can cause inguinal lymph node swelling with pain.Explanation: Please look if you have any infection/problem below waist. Any infection below waist can cause inguinal lymph node swelling. So, you can take antibiotics for this.                  But it is better you visit a doctor and get examined yourself for proper diagnosis and treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long cerebral palsy and bilateral femoral takes to get cured?\n\nMy son has cerebral palsy and recently had bilateral femoral, tibia and fibula osteotomies about 3 weeks ago. How long does it normally take to start seeing results. He is 23 yrs old and in good health. I am afraid he is getting depressed because he is not able to left his legs and still not able to bare any weight.",
    "doctor_response": "Hi,Thanks for writing in.Cerebral palsy is a chronic lifelong condition that can be improved by providing good rehabilitation services. The femoral, tibial and fibular osteotomies will take at least 6 months to heal and then the results can be seen. It is a surgical procedure and in bones such procedures requires the patient to be in recommended rehabilitation for proper healing. After about 6 weeks of the surgery the bone ends which were cut will form a soft callus and at 3 months the callus becomes more mature. After six months and after taking guidance from the doctors and rehabilitation experts he can start bearing weights as per his recovery. Please do not be in a hurry as this can cause damage to the healing areas and lead to complications. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does my urine test indicate ?\n\nWhat does the presence of bacteria of the degree in microscopic exam. I am a male 75 years old.under tratment for prostatitis with urimax D.The microscopic exam. of urine shows presence of bacteris of degree++ .and presence of Ammonium urate crystals. Do they have any clinical significance?",
    "doctor_response": "hi,thanks for query.Presence of bacteria means there is some infection or sample contamination.please talk to your doctor,you may need further help and antibiotics after examination.Please also discuss with your doctor about blood sugar check up. wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for suddenly waking up from sleep with coughing followed by choking of saliva\n\nHi, Regards. My son is 6 years old and radiologically diagnosed as mild enlarged Adenoid. Problem is that when he sleeps, suddenly he wakes up from sleep with coughing followed by sign of choking of saliva in his throat for a while. It is happening almost every night for last 2 weeks.I am very much worried about the problem. Please advice.Imrose Mohit from Dhaka,Bangladesh.",
    "doctor_response": "Hello,I can understand your concern. Adenoids are lymphoid tissues that all fetuses have but as soon as the children grow, the tissue shrinks, decreases in size and disappears. If it persists like it has in your son, it causes problems like sleep apnea, breathing problems, snoring, breathing from mouth, teeth development abnormalities etc. In such case, where adenoids are not disappeared on their own, a small surgical procedure is performed by ENT surgeon to remove them and manage all the associated problems. Thus, I would recommend you to visit an ENT specialist and go for further investigations and discussing procedures for management regarding enlarged adenoids.I hope this information helps you. Thank you for choosing HCM. I wish your son feels better soon.Best,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Belly button has foul smell, yellow mucus, lower back and abdominal pain, hips pain, headaches. What is it?\n\nHi I seen nasty smelly odor come from my belly button then it gets green yellow color then really crudsty so I clean I always check and sure there smell back it drains fluid so I just thought it go away well as not scenes then I been have lower back pain lower tummy pain button is beat red smells now today I go to rest room and the belly button is bleeding I had to look 2 times and it really smell bad bad before bleed I been feeling a lot of pain on both sides my hips in and out down the sides of my legs not sure this mean any thing plus a lot of head acks just not feeling my self please help thanks much Erica",
    "doctor_response": "Hello and welcome to HCM,The presence of smelly odour, green-yellow crusty discharge, bleeding from the belly button suggests that there is infection and injury to the belly button.The belly button needs to be curettaged for removal of crusts and application of an antibiotic ointment.However, you need to consult a surgeon for clinical examination of the belly button.In case there is pus discharge, the pus culture needs to be done.This investigation will isolate the micro-organism causing the infection.The pain on both sides of hips and legs can be due to a number of causes.It could be due to trauma, musculoskeletal pain etc.Headache can also be due to number of causes.Consult your doctor for clinical examination and thus further management.thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain without surgery\n\ni am 47 andd have medicare as prim and medicaid as 2nd. i am gettin on suboxene by a surgeoun mon and taking self off of opitates for back been on for over 10 yrs. have had non evasive back surgerys did not help and on july 8th took a bad fall and its worse. want to get surgery which i was against after detoxed on the opiates. but, concerned after surgery how will be treated with pain as wouldnt want any opiates. maybe temp only iv of it then off. ALOT OF BAD SURGEONS MY COUSIN HAD A HORRIBLE BACK SURGERY OVER 2 YRS AGO AND NEEDS AGAIN. AND SHE WAS IN THE HOPITAL 3 WEEKS OF BAD BAD PAIN MISERABLE. ANYONE HAVE ANY SUGGESTIIONS? THANK YOU MUCH I VERY MUCH APPREICATE IT. YYYY@YYYY",
    "doctor_response": "Hello,Did you write this while having high!!All spinal surgeries do not have equally beneficial outcomes. It depends on a lot of parameters.As for conservative therapy, physio plus baclofen and some neuroprotective agents might help,There is also option of steroid injection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I know the cough of my baby is coming from throat or from chest?\n\nmy child is taking cepodem 7th dose administered today. Also crocin ds and asthalin expectorant going on. But fever returns at 99.8. Cough sometimes loose sometimes dry persists. Nose when blown - transparent mucous comes out. How to know if cough is frm throat or chest",
    "doctor_response": "HI children with cough from lower tract will have associated difficulty in breathing, increased respiration and look dull/irritable.Hope it answers your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden dizziness,sweating and palpitations?\n\nI start to get dizzy and then start sweating and my heart starts to pound pretty hard, not faster or slower just harder, or so it feels, and all that only happens for about 30 seconds. I only get it now and then but it seems to be happening more often every day, and it happens randomly at different times. what could this be?",
    "doctor_response": "Hello,  This can be a cardiac arrhythmia like psvt or atrial fibrillation, in which heart rate suddenly goes up and also suddenly decreases. Blood pressure falls during these episodes and one has dizziness, fainting, blackouts, sometimes syncope. Usually ecg is normal as it is usually done in between the episodes. ECG done during episodes will show abnormality. You will need 24 hour holter monitoring. So visit nearby cardiologist for these investigation.Also, hemoglobin and thyroid test should be done. ln order to abort such episodes you should try to cough hard.Is there any stress or anxiety associated. Till the time your evaluation is complete, you can ask your local doctor for tab ciplar LA 20 mg once a day. If none of the above is successful then last option is of electrophysiological studies which is invasive test which can diagnose and treat the arrhythmia permanently in most of the cases.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stabbing pain on the right side of the back?\n\nMy mother is experiencing stabbing pain on her right side. It is radiating from her back, she says it feels like someone is pinching her side really hard and than it goes away again.This has been happening off and on since Thursday afternoon. She isn t sick to her stomach.",
    "doctor_response": "Hi,  In my opinion this kind of severe pain in (R) side of abdomen could be due to Gall bladder disease , or kidney stones and may be due to muscular problems. I suggest urgent ultrasound whole abdomen and blood counts ASAP. Give her pain killer injections. Best would be a visit to Emergency of a nearby hospital.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain, shortness of breath and heart murmur?\n\nMy husband has a heart murmur . It has been checked 9 years ago and everything was fine .  Now he tells me he has been having pain in the chest  pectoral muscles . He has also said he has shortness of breath upon exertion. No pain. he is also congested. I am looking for a goo heart doctor in the Trinity, Clearwater Tampa area to follow up?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Yes, you should definitely take him to cardiologist. Possibility of congestive heart failure (CHF) is more likely because of chest congestion, chest pain and breathlessness.So get done ecg, 2d echo and stress test (trade mill test).He may need diuretics and other cardiac supportive drugs. Don't worry, he will be alright. Hope I have solved your query. I will be happy to help you further. Wishing good health to your husband. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes throat discomfort while having severe cough?\n\nI ve had a terrible cough for about a week now early on I had a bit of a fever but didn t last long maybe a day or 2 but i haven t had any other symptoms since just this awful cough. I have lost my voice now and when I cough it has this awful smell like i guess how an infection smells i really don t know how to describe it and i m coughing up what feels like pieces of my lung which i m sure that s not what it is ( i hope not anyways haha) but it s just pieces of something. I assume it s phlegm or something i m really not sure i just know it hurts and smells and it s miserable. What could this be?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.By your history and description, we should definitely rule out lung infection (pneumonia) for your symptoms. Pneumonia causes infected sputum production. This infected sputum is discolored, smells and tastes bad. So the thing which is coming out from the lung is mostly infected sputum. So better to consult a pulmonologist and get done a clinical examination of the respiratory system and chest x-ray. If the chest x-ray is showing consolidation patch then it is pneumonia for sure. You may need antibiotics, mucolytic and expectorant drug. Hope I have answered your query. Let me know if I can assist you further.Regards, \u00a0\u00a0\u00a0\u00a0\u00a0Dr. Kaushal Bhavsar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have problem with my nervous system from childhood\n\nI have problem with my nervous system . from childhood my hands, legs and neck start shivering when i got excited or when i am in hurry. Even when i sit alone, i feel shivering in my hand but its with low pace. Can you please suggest me is there and cure to this problem",
    "doctor_response": "Dear This problem is related to your anxiety or your hyperactivity. So for this you should give all details of the complain and we can guide you in a better way for future. Contact us on www.spandanhomeocure.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high protein level in urine of 3 year old?\n\nMy 3 year old son has leakage in protein first detected January 2011. He was given prednisolone 25 mg initially and then 30 Mg. After 3 months of treatment protein level is still +++ Please suggest if he is unresponsive of the medicine and what should we look for next",
    "doctor_response": "hi! looks like your child has a nephrotic syndrome. if you have given treatment for 3 months and still protein is +++ it could be a steroid resistant type. you have to start her on alternative medicine along with low dose prednisone. you also have to get a kidney biopsy done to know the actual disease. please take care to avoid urinary and chest infection as these are very common in these children. regularly visit your doctor. don't skip medicine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rashes, welts after using qvar inhaler, recurring condition. Allergic reaction?\n\nTrying to help friend. Ever heard of Qvar? Her son developed rash ( hives looking) after taking this. @ 8pm Took him to doc who said it is just viral rash. Vanished by a.m. but has recurred x 1. I think it might be Qvar inhaler - 2 puffs BID. Can that cause whelps? Allergic rx? I am looking at cell phone pic of the rash.",
    "doctor_response": "The histry suggests it to allergic to inhaler may patients are allergic to inhalers you can change the salt of inhaler after consultatin may be serofo or foracort which suit",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are muscle cramps and twitching sensation on the legs caused by pinched nerves?\n\nI have leg muscle twitching and cramping. This happened a few years ago, went away, and is back. It seems to be worse when I lie for a long time (I can go to bed fine and wake up twitching or cramping) or when I walk for long periods of time (my lower back gets tight with these symptoms). Could this be related to pinched nerves?",
    "doctor_response": "Hi, It might be due to nerve impingement. Consult an orthopedician and plan for an MRI scan. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ILD\n\nDear Sir, I am Md. Ariful Huq from Dhaka, Bangladesh. I am Manager Audit in Noman Group of Industries, Dhaka Bangladesh.  My father is M.A. Jamal, he is a Ex. Businessman. He is suffered in ILD. Now father is very sick. Here in Bangladesh I visit famous and various Doctor. But they are can\u2019t treatment care my father properly, because I saw my father time to time fall in weakness. Its very painfull for me that I can\u2019t make proper treatment for my father in Bangladesh. So I want to very good and proper treatment in India if its possible. Plz take my prayer and advice me what to do? Please Reply me, I am waiting for your reply and advice. Thanking you, Arif",
    "doctor_response": "Respected Arif , hiWarm welcome to  Healthcaremagic.comI have gone through your query in depth .*  This condition requires precise management  with  further  depth     evaluation  .*  Can surely come to India , we are providing best medical tourism      treatment  for  these types of conditions .    Can  consult  in private  through  the  same  website  or  can  have      further  assistance  via  email  at  bhagyeshvpatel@yahoo.comWishing him fine health ahead .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a circumcision wound be cured?\n\nI had an adult circumscision on Tuesday to correct balanitis / phimosis. The dressing was removed when I showered the following day. Its obviously uncomfortable with the exposed penis rubbing against any clothing. I had an RRP in 1991 and have to use pads for mild income=ntinence so opted to Dougcatheterised after the circumscision. Now, there is an opaque sticky discharge from the wound which I can was away but I m concerned this is an onset of infection. Or is it to be expected? Many thanks",
    "doctor_response": "Hi, But this is probably pus discharge due to a bacterial infection. Please refer to your doctor for a prescription of a systemic antibiotic along with a topical antibiotic cream applied three times daily. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is frequent masturbation harmful?\n\nhello ,, sir i has a bad habit of masturbat.. approx i masturbat 3-4 times in a week and this cause my health very thin .. also i have a problem of nigthfall this is 2-3 times in a week !!! I wan't to stop this and also want' to stop my bad habit of masturbation what can i do ,,sir pls help me !!!! I can't share this problem with my father !!!",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You are having excess masturbation habit. It is safe practice and pleasure giving but excess masturbation can lead fatigue and if your health affected you should decrease frequency. Yoga, meditation will be beneficial. Adopt healthy life style. Make short and long term goals. Focus in study and try to full fill goals. Try to avoid remain alone in room and avoid porn video and magazine. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I discontinue serequel and wellbutrin Prozac for anxiety and depression?\n\nI am currently taking serequel.wellbutrin Prozac and Xanax. I want to stop taking them. I feel more anxious and sad and I have no desire to do anything outside work. I had an episode of anxienty and the depression in 2008.i have been on several different prescriptions and have been on the above for about 9 months. I have good insurance but the office they referred to me last year is very inconstant with the staff everytime I go there is someone diferent I find it hard to communicate my personal feelings with just anyone. should I quit the meds all at once or ween myself off?",
    "doctor_response": "HiThanks for using healthcare magicYou are four different drugs. In that case, if you try to stop them abruptly, your anxiety and depressive symptoms would increase. You  should stop them gradually one by one. You did not mention the dose. Even these drug is on high doses, then gradually taper them off. In case you need further help, you can consult us.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat rashes in the wrist area?\n\nI ve just recently (over the last 2 days) noticed rash-like areas appearing on both hands. They are on the same place on both hands; below the lowest thumb joint and above the wrist. If you hold your hands out in front of you palm down the 2 rash-like areas will be facing each other. By appearance, they almost look like something between poison oak and athletes foot. Overall the area is red, with tiny, hard bumps. I haven t been working in the yard, so my exposure to any poison oak/ivy has been non-existant. No itching, no oozing. I just need to know how to treat.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The rash can be due to allergy, contact dermatitis or scabies. Wash your hands with warm water and do not use harsh chemical soap. Take non-sedating antihistamine (Levocetirizine), depending upon the severity of the rash. It can be contagious so be careful. Use Ascabiol emulsion, put it locally on the areas where you have the rash, leave it there for some time and then wash it off. The rash should go away if it is scabies, else repeat the same after few days. Take care of your hygiene and laundry. Do not scratch, take care. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nupur K.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for sharp pains in chest\n\nok im am now 18 yrs old and ive been smoking pot often. but i slowed down a lot and only been smokin like once or twice a week, jus depends on how much i want it. but anyways i have been experiencing sharp pains in my chest every now and then , but then it will go away after like 3-4 days after being \"high\". but it usually only happens right after i get done smoking & comes like every other 4 mins (maybe longer break then that) . & i aslo have high bp if that helps u, its at about 140/68. can u please help me!!! i havent been to get checked out yet because im a little scared to find out.",
    "doctor_response": "hello,welcome to healthcare magic.As you are smoking, your bp will shoot high and may be around 180 and 90 that cause sharp pain in chest.Smoking increase nicotine level in your blood and nicotine will make Nadu alert . it leads to high blood pressure and increase in heart rate.Otherwise 140 and 68 blood pressure is normal.Find alternative way to quit smoking.have a better health.regards Dr Nirav.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe headaches and bump after a neck injury?\n\nMy daughter (8) was jumping on a trampoline and injured her neck - diagnosised by dr with strain. Shea was doing repeat flips and landing on her neck. She has full range of motion but has been having severe headaches and a bump developed. We had a dr. check her out and he perscribed rest and motrin for a couple days and to check in after two days but I am worried",
    "doctor_response": "Hi.... in such a case what you need to know are the danger signs of head injury. I will suggest you the red flag signs or danger signs of head injury so that you can be on the look out and if these are not there you can be rest assured. Danger signs include -  continuous vomiting, loss of consciousness, seizures, double vision, bleeding from the ear nose, weakness of any part of the body. If these are not there you need not worry about your kid.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Naturogest effective in follicular treatment ?\n\nHi, I m on 17th day and two follicles in the right ovary both follicles have ruptured today and there were no dominant follicles in left ovary. Our doctor has suggested to take Naturogest 200mg capsules for 10days from now. What is the purpose of Naturogest 200 ? What are the chances of both eggs getting fertilized and getting implanted. Many thanks in advance. Awaiting eagerly for your responses.",
    "doctor_response": "Hi Naturogest is micronised progesterone which supports the pregnancy in its initial stages,helps in better implantation of the embryo.so no harm in taking it.chances of both eggs getting implanted depend on whether both of them get fertilised by the sperm and also get implanted..that is the normal incidence of twin pregnancy 1 in 80. hope this helps. regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pins and needles on head with hissing sound and severe pressure?\n\nHello Doctor - I DIDNT KNOW YOU NEEDED A CREDIT CARD TO GET AN ANSWER - - CAN I GET AN ANSWER WITHOUT PAYING ? Yes, thank you for answering my question: I have pins and needles sensation constantly on top of the head from the back of the head base of neck - facial pressure pains - so bad that at night - from a scale of 1 to 10 - I m at 15 ! the pins and needles sometimes stay right on top of the head the hissing gets louder and around the eyes there is a goggle pressure feeling - feels like tiny hammers pricking stabbing sensation - I think it starts from the back of the neck top part where the neck bone meets the head bone - sometimes I hear a breaking (like dry wood or the sound that the shifting of the left /right of a car - what do you think it is Doctor?",
    "doctor_response": "Hi, I have gone through your question and understand your concerns. In my opinion, most probable cause of your symptoms may be occipital neuralgia, a condition where occipital or upper and back neck nerves are pinched or compressed along their way.Another possibility of your symptoms may be high blood pressure.You need to discuss with your primary care Doctor above mentioned possibilities and tests needed in order to have a correct diagnosis.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes feeling of head spinning, eyes shaking and dizziness?\n\nHey, everyone once in a while like once everday 1or 2 days my head would feel as if its spinning, a sudden oncome of dizziness would hit me and my eyes would feel as if there shaking. It would last from 5 minutes to almost 2 hours. What's the cause of this ? By the way I'm a thirteen year old",
    "doctor_response": "well , it may be a manifestation of seizures, diabetes, worm infestation,  Evaluation by ent specialist is a must.child needs to be evaluated thoroghly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the early signs and symptoms of pregnancy?\n\nHi, I had intercourse on December 25th and the following morning I had morning after pill. That month my period was a bit earlier and lighter. I know that can be the pills side effect. but this month I had my period on Feb 2nd and ended on Feb 3rd. I had intercourse on Feb 4th morning. I know it is not much possible to get pregnant right after the period. Around these days must be my ovulation time but I am showing unusual signs ( normally I have these signs just 1 week to period not 2 weeks earlier) swollen sensitive breasts, nausea, vomitting, very tired all the time yawning, chills and hot flushes esp during sleep time in bed and these are still going on. Few days ago I had a strange pressuring pain at the end of my tailbone and lasted for almost 2 days.So these are caused any infection, just ovulation, still the Mornign after pill or pregnancy or something else? thank you",
    "doctor_response": "The best way to answer your question is performing a pregnancy test. I would suggest using a contraceptive on a regular basis",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does muscle infection after DPT be a cause for concern?\n\nhi doctor, my daughter is 4 years old and her weight is 12 kgs. 4 days back she took DPT vaccine in thigh from that she is unable to bend his left leg doctor suggest to take scanning and x ray and blood test and he said that she got muscle infection in the place of injection and he gave some antibiotics to use..is it ok? any thing we need to do",
    "doctor_response": "good question. infection secondary to injection is extremely rare and simple redness and muscle ache after injection are more common than people realize. Yes, it should be okay to use the antibioticscheers.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Prescribed Fertomid and Duphaston. Purpose of taking duphaston. Chances of conceiving with these medicines?\n\nHi Dr, I have been prescribed Fertomid and Duphaston by my Gynae . The Duphaston is to be taken 1tablet twice a day for 7 days and then repeated and the Fertomid to take 1 tablet once a day as directed which would be on day 4 of my cycle to day 9 as advised by my Gynae. My question is when do i start taking the Duphaston and what is it used for? I have been told to repeat this for three months and can i conceive after taking these medicines for one month and not have to repeat?",
    "doctor_response": "Hi Darren, Duphaston is the trade name for Dydrogesterone, which is progesterone without estrogen.It is orally active and works directly on estrogen primed uterus. (Progesterone and Estrogen are both female hormones. Estrogens are dominantly secreted before ovulation and Progesterone are secreted after ovulation.).  Duphaston usually supports pregnancy and is given in pregnant women if there is any threat of abortion (such as if the patient has had bleeding in the first trimester). It is also given in case of irregular periods as a progesterone challenge. If everything else is fine, most the times, periods normalize and ovulation occurs. That being said, there are several ways how Duphaston is conducive to pregnancy occurrence and continuation and there could be several reasons why you have been advised the medicine. We would need more details around your gynecological, obstetrical and medical history and history of present complaints to advise further. Hence, it may be best for you to confirm the days with your infertility specialist. Additional information: Fertomid and Clomid are trade names for clomiphene which is a drug used for fertility treatment. It induces ovulation. There are chances that you conceive in the first month of treatment but it wouldn't be a surprise if you may need to repeat. Hope that helps. Take care and all the best with your treatment!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for rashes\n\nHi I have a rash on my belt line on my right side. It itches so bad sometimes that I can t ignore it and when I itch it. I only make it irritated and red and grows. What could this be. I ve tries Benadryl anti itch and tanactin cream and spray and no improvements",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I have gone through your complaints and it seems to be an eczematous rash. I would recommend you to apply a topical steroid like Clobetasol Propionate cream on the affected areas twice daily and take antihistaminic like tablet Cetrizine twice daily. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest generic antianginal drugs\n\nI have two different pills that are supposed to be the generic for Procardia XL - I would like to know if both these bills are generice for Procardia XL - one pill has the letter G and the number 30 underneath it. The other pill is KU260. Originally, I was taking the generic pill Nifedical XL - but these two substitutes look different. They are 30MG.",
    "doctor_response": "All the drugs you mentioned are extended release formulation of nifedipine 30 mg,  you can use these drugs interchangeably.  However I will recommend that you chose one and take it forever  as the drug release and other properties are slightly different in different preparation s and so it will help your doctor to stabilise the drug dosage to maintain plateau blood pressure",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling and tenderness in ankle\n\nI got hit In the inner ankle a couple hours a go by a softball. My sister was pitching and I was catching. My ankle swelled up immediately and had a huge red spot. Now I can walk without much pain, but if I stand on it and put a lot of pressure on it then it hurts. My ankle is also very sensitive to the touch and is still swollen and bruised/super red. What could be wrong? Should I see a doctor?",
    "doctor_response": "hiHope this msg finds u in good health. i have gone through your complaints and under stand your concern. u seem to have strained some sort of ligament in ur ankle that might be causing pain and inflammation. doesn't seem to b a bony  injury though. take rest ice packs analgesics and anti inflammatory tablets.  crepe bandageif it worsens then get an xray done to find out whats wrong. nothing to worry about. Hope your question has been answered. if u have any follow up queries, feel free to consult me anytime thanks Take care god bless.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I need a second opinion for the medicines I take for bipolar I and ADHD.\n\nHello doctor, I have a query about the medication prescribed to me, and I need a second opinion. My diagnoses are bipolar 1 and ADHD. I take daily, 1. Lithium 1600 mg. 2. Lamotrigine 300 mg. 3. Amisulpride 400 mg. 4. Haloperidol 4 mg. 5. Sertraline 200 mg. 6. Pregabalin 400 mg. 7. Propranolol 80 mg. 8. Lisdexamfetamine 60 mg. 9. Procyclidine 15 mg. 10. Diazepam 10 mg (PRN). Is that too much medication? Do some of these counteract with each other?",
    "doctor_response": "Hello. The rule of thumb in psychiatry is to prescribe medicine for an adequate duration and adequate dose, before considering it ineffective or plan to change. If your doctor has previously tried one medication for proper dose and duration now, he can add another drug, so it depends on how you are responding to medicine? So it might be possible that if you did not respond to one medicine your doctor keeps adding medicine to your prescription. If you are not in a depression or not a rapid cycler, Sertraline can be tapered down. If you are in remission, Lamotrigine can be slowly stopped. I found no counteracting drug. Antidepressants can be given with mood stabilizers in bipolar disorder (depression episode).",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am on anti-tubercular drugs for TB lymphadenitis. Do I need surgery?\n\nHi doctor, I have enlarged lymph node on the neck. FNAC says granulomatous lymphadenitis consistent with Koch's (AFB Stain: negative). In ultrasound it is hypoechoic lesion of approximately 29*34 mm abutting the left submandibular gland but appear separate from it. Simillar lesion of approx. 14*23 mm is seen adjacent to this mass. I have been taking Rifampicin + Isoniazid + Rifampicin + Ethambutol + Pyrazinamide for 22 days and I have also consulted another doctor who says that it needs surgery and asked for digital x-ray of chest. I also gained weight. Please suggest me, should I go for surgery? Currently I am on Forecox 150, Mycobutol 400, Benadon 20 mg, and Neurobion.",
    "doctor_response": "Hi. I can understand your concern. According to your statement, you have been suffering from TB lymphadenitis and taking 4FDC (antitubercular drugs) for the last 22 days. Your query is whether surgery is needed for your lymph node or not. Antitubercular medications are enough for curing TB lymphadenitis. Surgery is needed in rare cases. Surgery can be done for diagnostic purposes or therapeutic purposes. Sometimes Fine needle aspiration or biopsy of the lymph node are needed for proper diagnosis of TB lymphadenitis is known as surgery for diagnostic purposes. If TB regimens for 6months or 7months or 9months are failed to subside the lymph node, then surgery is an option. Again during TB treatment if there is any change in size, shape or presence of discharging sinuses or turn into malignancy, then surgical drainage or removal of lymph node may be needed. Otherwise, antitubercular medications are enough to treat TB lymphadenitis. Your physician has advised you to do a CXR (chest x-ray) for the detection of chest involvement. You should undergo CXR. Again Prednisolone 40 mg/day for six weeks followed by gradual tapering over the next four weeks along with your current TB regimens are enough to cure your TB lymphadenitis without any surgery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling,redness and blue veins to pop out in legs?\n\nwhy would my feet,ankels and mid calf swell? my right foot, ankel and mid calf are really bad can t move foot and hard to walk? and another thing is I have purple veins really bad and knots on the side of foot? but the reddness is the thing I m really worried about? it only happens when I have been working:(",
    "doctor_response": "Hello, The swelling and redness in the calf need medical attention. This can be related to deep venous thrombosis or varicose veins. Proper examination and investigations are needed for diagnosis. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take providac and albendazole for weakness that occurs due to liver issues?\n\nHi Doctor , I've been having liver issues from the last 3 weeks. I do not feel like eating anything . At the same time , when i push myself to eat something or the other food , I feel like vomiting . However , Vomiting does not happen. I feel very week from inside. and after eating anything , I feel like my stoamch has become very heavy. In the morning , I atleat go to washroom twice and i am not able to eat anything specially in the morning time. Also i have contacted doctor for the same reason and he has given me medicines like providac, secnidazole tablets, Wintil , Albendazole tablets Please advice to whether i should take this medicines. Also please let me know if this medicinies can put any affect on my sexual life.",
    "doctor_response": "Hi,Thanks for writing in.Providac is a medicine which produces lactic acid bacilli and restores normal bacteria in the bowel. It will prevent diarrhea and indigestion. This can be taken every day and there is no problem from it.Albendazole is a medicine to kill worms and clear them from the body. It should be taken in a single dose after dinner and repeated after 15 days. This will help in treating any parasitic worms in your intestines.It will not affect sexual life.Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe pain in abdomen, right neck and shoulder. Have endometriosis. Causes ?\n\ni have endometriosis and have sever pains in the abdomen right neck n shoulder and chest like neddles crushing causeing me pain when i breath and talk. my son as to raise me out of bed to sit up because it pains so bad .what is causing this even when i have no period i have to take ibruphen buit the pain is worse during the period.",
    "doctor_response": "hello dear, i have gone through your complaints and i feel you have some problem realted to your lowerchest or right upper abodmen.so please go for chest x-ray PA view and abdomen scan. if this is normal we have to think of musculo skeletal problems .so please contact your physician with these reports take care bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had unprotected sex on the dates when periods were due. Took emergency contraceptive pill. Pregnancy possible? Need birth control advice\n\nHey! I had sex with my girlfriend on 23rd & 24th March, she had her dates of Menstrual Cycle, but it delayed as last month it was on 22nd Feb.  We had sex both the days, and once I inserted without precaution (condom) but sperm didn't released, and also it was not completely inserted into her vagina, it was just on the opening of the hole.But my penis was quite wet with the fluid.Now we are thinking Is there any chances to get pregnant?? That we don't want to happen. She took a contraceptive pill (Unwanted 72) today i.e. 26th March, as it says it has to be taken within 72 hours of Intercourse. Please tell me What can we do to avoid pregnancy? And also till when periods can start again? And if there is any chance to get pregnant what steps could we take to avoid that?Reply please..",
    "doctor_response": "Hi, Thanks for query. you should consult gynae for urine test,blood test and USG to rule out pregnancy. chances of pregnancy in your case is minimal because you have not ejaculated inside,but initial secretion also content sperm.she had EC pills also.but ovulation time is not confirm so chances of pregnancy always there.(no contraceptive give 100% protection). she had pills near her expected period so chances of delayed period is there,so don't worry period can be delayed for a month also. take care. GOOD LUCK.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood thinning?\n\nGot a blood test the other day and the person doing it said my blood is thin and asked if I take blood thinners. I DO NOT. I do take lipitor and lotrel. I also had 4 beers the night before. Last drink was done about 12 hrs before blood test. Can anything I wrote contribute to blood thinning?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You should go for prothrombin time with INR.  If it is raised then you should go for complete coagulation profile. You may have some coagulation disorder.  Search for the cause and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Liver Metastasys\n\nHello Doctor, my mother has been detected Stage IV Gall Bladder carcinoma with multiple Liver metastasis. Surgical Gastroentrologist advised surgery is not possible and Chemotheraphy in this stage will not good and advised not to do anything. In pain he suggsted pain killer to use. Please advise me is there any way or treatment left in which my mother will survive. Is Chemotheraphy is effective in this stage? What I should do? Please advise",
    "doctor_response": "Hi chakranil! Welcome to healthcaremagic.com.Your mother is indeed in thenvery advanced stages of cancer where doing something dramatically will harm her more than cure her.You can visit cancer centres with palliative pain relief facility wherein the pain is relieved and she can have atleast be pain free .Please find such centres near your place.It will help/Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are tightness and back pain related to blood clots in lungs?\n\nFor over a Month now the middle of my back on the right side will just get tight all of a sudden and feel like a tens unit going off,I can just be standing and it will start hurting in the center right side of my Back and travel downwards,no matter what I am doing it has come on all day every day for over a month,I had chest xrays last nov when I had a bloodclot in my left lung so i dont think its my lung",
    "doctor_response": "Thanks for your question on HCM. Yes, this can be due to blood clot in lung.This condition is known as Pulmonary embolism ( PE ). And if not treated properly , can lead to pulmonary infarction.And this infarcted area can cause pleuritic type of chest pain and tightness.So better to consult pulmonologist and get done1. CT pulmonary angiography2. V-Q (Ventilation Perfusion ) scan. These will be helpful in rule out pulmonary infarction.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if having fluid build up in neck, ringing in ears after spinal fusion following a car accident?\n\nhello my name is Bill and 2 n half years ago I was in a car accident and suffered from multiple injuries, I now have a plate that fused my C6-C7 together and I have been getting a lot of fluid build up in my neck which causes a numbness feeling and brings back most of my concussion symptoms, is there anything that would help keep the fluid away? and also I have had ringing in my ears since the accident is there anything that can be done about that?",
    "doctor_response": "Hi,Thank you for posting your query.It is good to note that you have done reasonably well after suffering from multiple injuries.For your current symptoms, the best treatment option is physiotherapy. In this, neck extension exercises are very useful. Taking vitamin B 12 supplements and pregabalin capsules would also help.Please consult an ENT surgeon for evaluation of tinnitus-ringing sensation in the ears. There are \"tinnitus maskers\" available in the market, which could suppress these symptoms.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the electric shock sensations I feel in my upper back?\n\nkeep getting these electric shock sensations in my upper back more to the left side, sometimes it can be really painful and it literally jerks my entire body when it happens. When it happens it happens so randomly. It might not happen for weeks and sometimes it happen multiple times a day for days. It doesn t matter if I m waking, standing, laying ect.. it just comes out of nowhere. I haven t always had it, it only started roughly about ago. The only thing I can put it down to is after a I moved I hurt my back and ever since I ve been getting the electric shock sensations. I haven t really worried about seeing a doctor because it goes away but always comes back.",
    "doctor_response": "Dear friend,thanks for your consultation.it seems that the upper back pain is really bothering you and it is really painfull and electric shock like .as far as you have given your trauma history ,you have hurt your back.from my clinical experienece I am telling you that you might either have injured your lower back muscle or vertebral bone of that region.an injured muscle or a group of muscles always give rise to this kind of pain.also see there is a sponge like thing in between our vertebral bones.it is called vertebral disc.if you have injured this disc or the disc is displaced then the nerve in between two vertebrae is getting irritated causing pain.so to know for sure you should go for a X-Ray and MRI of that region to know if there is any structural problem in that region like fracture of any vertebra  or dispalced disc or any muscle tear.my best wishes for you .thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes varicocele?\n\nI am a 44 year old male. 5'10\".  225 lbs.  I just had a semen analysis yesterday.  During my physical with the doctor, he said I had varicocele.  My semen analysis came back with the following abnormal observations:  Semen motility 33.3%; total motile sperm in ejaculation 37.01%; Norma Sperm (Krugr Strict Morphology) 1%.  abnormal sperm 99% (amorphous head 71, coiled tail 12 tapered/pyriform head: 10).  I understand that the varicocele may be the cause of the defective sperm, but may be corrected by surgery.  Can you please advise if this is correct.",
    "doctor_response": "HelloThanks for query .Your physical examination has revealed Varicocele and semen analysis has revealed Terratozoospermia .At the out set I would like to state that it has been in established by extensive research in the field of reproductive science that  Varicocele does not cause Terratospermia (Abnormality in sperm morphology).As regards possibility of improving Terratospermia and sperm count after surgery of Varicocelectomy it is established fact that it helps to improve these parameters only in 30 % of the patients.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Celexa for anxiety. Family history of schizophrenia. Hearing scratching noise\n\nI am on Celexa for anxiety. I have schizophrenia in my immediate family as well as depression anxiety and bipolar mood swings. A couple days ago I went to see someone about getting a divorce. My husband was very abusive and I have been diagnosed with PTSD. Since seeing her, my head feels like its rushing or expanding periodically. Last night I started hearing this scratching noise. I thought it was in my fan but realized when I went into the other room that it was actually in my head. I am really stressed right now and this is worrying me greatly. Am I going crazy?",
    "doctor_response": "Hi there, thanks for asking. You have a careful observation. The most probable thing is that the symptom you mentioned could be tinnitus happened as a side effect of the medication you are using (Celexa). Tinnitus could be intensified with with stress and anxiety. There are some ways to decrease or eliminate it such as avoiding caffeine, not adding salt to your food, not using so much canned food and decreasing the stress level. Tinnitus may also be sensitive to red wine and old cheese (some people report it). It is very good that you are paying attention to the possibility of other mental illnesses as you have in your family. I suggest that you notice to the factors mentioned and also with managing your stress level see if it is controlled. You can ask your doctor to check your blood pressure since it could also contribute to tinnitus. I wish you the best health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is yoga and what are the benefits of doing it regularly?\n\nHello doctor, What are the benefits of doing regular yoga? Ideally would like the quotes to focus on mental health and physical health.",
    "doctor_response": "Hello.  Yoga is very popular nowadays to maintain physical and mental health. Yoga means addiction. It is an addiction to different body organs in such a way it helps to remove the attention of mind from their subjects and concentrate on the particular points. Yoga is not only asana and pranayama. However, it contains Yama, Niyama, Asana, Pranayama, Pratyahara, Dharana, Dhyana, and Samadhan. These eight are collectively known as Astanga yoga. Yoga helps to coordinate our routine life, regulates body metabolism, relaxes the mind and improves mental health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bowel incontinence\n\nI have a 5 year old grandson that has had difficulty with constipation for many years since age 2. Now for the last 1 or more he has been defication on his pants, not telling any one. It is now a problem in school. What would cause this type of behavior and what can be done.",
    "doctor_response": "Hi....this is called encopresis. Usually in constipated kids the hard stools will be in the rectum and they tend to control it, as they fear the pain while it comes out. So when it gets accumulated, the normal motion above it tend s to come out in the sides and soils the under garments. This is called encopresis.  Nothing to worry. Once constipation is treated, this gets better.Suggestions:1. 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.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest possible medication for pneumonia\n\nwe took my 6 yr. old grandson to the hospital sunday morning. he was diagnosed with pheinoma. they also took exrays of his chest and stomache area. they found an enlarged spleen. we are waitin to hear from doctors what our next step is.rob.  YYYY@YYYY",
    "doctor_response": "Pneumonia is an infection of the lungs that is caused due to certain bacteria, or less commonly, viruses. The treatment could require antibiotics, the choice of which depends upon the suspected causative agent. The splenic enlargement could be a sign of certain infections but it is hard to comment on this from such little details. If you post a premium question with the relevant details surely I would try to help you out and indicate the exact choice of medications based on the details you provide.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How quick does tumor in lung grow?\n\nmy friend had l luno[]\\----- my friend has a lg tumer at the top of hr lubg which se feels is groing at njght whike she is laying in bed,  is it going ti grow to q point that she cant breathe.  how long does this take,  she has has it 6mos now tumer at right side top half if hr er lunggrowing toward vocal chords  thanks",
    "doctor_response": "Respected user , HiThanks for using Healthcaremagic.comI have gone through your query thoroughly .*  The tumor in the lung progress depend  upon the type , pathogenicity ,    host  factors  , associated  co morbid  conditions , type  of  treatment ,    food , abuse substances  use and so many parameters .Hope this will help you .Regards dear take  care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Depending too much on others, able to take personal decisions. Dependent personality disorder?\n\nAn adult feels unable to survive on her own and depends too much on other adults for protection and help for practical things (still hasn't fully grown up although way past adolescence) .  But she has confidence in her own intelligence and has no trouble forming opinions on issues and values, nor making personal decisions, nor disagreeing with others' views.  Can she sti;ll have Dependent Personality Disorder?.",
    "doctor_response": "Hi, you know she is confident about her intelegence, can form openions on issues, and values, can make personal desicions, can disagree with others views. Means she is doing all these things by her own, and you have observed.                                 It seems she is quite normal, and might be going for advise for self confidence, some times.                                  On line i may not be in a position to judge, if so it might be a obsesive compulsive neurosis. She want to hear her openion from some one who is besides. In this case if you observe the same position several times, you can consult a psychologist for diagnosis and treatment. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure pain in right knee and joints?\n\nI m 25years old my weight is 60 n height 5.5 . I m suffering from right kness pain not a joint pain from 4years..it ws started in October bt still continue. ..during my period Time its pain badly ..no injury n nothin evn now I m facing problem in my periods.plz help me ...one more some new pain is starting in my left leg foot datz is near my little finger kindly help me",
    "doctor_response": "hi,Thank you for providing the brief history of you.A thorough neuromuscular assessment is advised.As by your history, that you have pain since 4 years, have you ever consulted the ortho for the same. As sometimes, due to the wear and tear of the joints, the pain can arise oftenly. Also, during the period time, there is hormonal changes which leads to weakness in the overall bodily functions, by which there is a tendency to induce more weight on the one side of the body. As for which you can consult your personal gynec who can help you understand the situation of hormonal changes better in detail.Also, if you are unsure of any injury in the past or present, then getting a musculoskeletal assessment is advised. Post which if the ortho feels an MRI or x-ray will be advised, if not then you may be referred to a physical therapist. By learning the exercises for strengthening the knee joint and also the overall body conditioning, you can have enough strength to balance the body weight. Also, since you mentioned you have pain in the little finger, you may need to undergo an urine analysis for uric acid levels. with simple medication, the levels can be brought back to control.In my clinical practice, female of your age complaints of bodily pain and also particular joint pain during period. By a proper musculoskeletal assessment and guided physical therapy their symptoms can be controlled.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes palpitations, dizziness, anxiety, fatigue and nausea?\n\nHi, I am 27 ,female, diagnosed with Mitral Valve Prolapse (3 mm) but No Mitral regurgitation. I am experiencing Tachycardia, palpitations, dizziness, anxiety, fatigue, nausea and SWELLING over FEET and ANKLES. I know all the symtoms are matching with MVP except Swelling. Is swelling conecerned with mild MVP?",
    "doctor_response": "Hello!Thank you for asking on HCM!I understand your concern and would explain that swelling is not typically associated to mitral valve prolapse. But it may be related to a low cardiac function or other disorders such as:- kidney impairment- liver impairment- long periods of standing up and lack of physical activity - venous insufficiency in the inferior limbs- some drugs (calcium channel blockers, etc.) could also be the cause. I recommend consulting with your GP for a careful physical examination and some tests: - a resting ECG and cardiac ultrasound to examine the cardiac function- a Doppler ultrasound of the inferior limbs - some blood lab tests (complete blood count, kidney and liver function tests, PCR, sedimentation rate, blood electrolytes, blood osmolarity, etc.)You should discuss with your doctor on the above issues. Hope to have been helpful!Best wishes!Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for kidney stone\n\nHi doctor,i m 24 year old,and i have a kidney problem.before 6 month there was extreme a pain in kidney.and i found 1 cm stone by ultrasound.after the treatment,i break the stone by homeopathic medicine.But recently 3 day ago,i feel pain again,please suggest me,this pain is very difficult.",
    "doctor_response": "hai,thanks for consulting HCM.As  you got a history of kidney stone kindly repeat  an ultrasound to rule the cause and whether any new   kidney stone develpoed.visit a  Emergency  departement/nephrologist to treat the pain depends upon the severity.kindly  rule out the cause  for kidney stone formation. poor intake of  water ,excess amount of oxalate,uric acid containing foods which causes stone. ruling out which type of stone(oxalate,urate,phosphate)  developing and avoiding those source of food  may be helpful in restricting stone formation.lifestyle management and proper  diet will help you in keep away from developing kidney stone.Thank youhope i answered your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe forearm pain and hand pain\n\nHi Dr. Rynne, About a couple hours ago, I noticed that my right hand was not as strong as it normally is. And a few minutes ago I tried snapping my finger and realized that it caused a slight pain in the tendons about a quarter to midway down my forearm, and also felt the same pain when I shook my father s hand. When I woke up this morning I was fine, but this happened after I was moving some heavy furniture. Could it be possible that I have strained/pulled a tendon?",
    "doctor_response": "Hello, I have studied your case.Due to compression of this nerve root there can be hand weakness.I will advise you to MRI cervical spine for better diagnosis.It can be due to various causes like sudden jerk to spine, due to facet arthritis, degenerative.For these symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.I will advise to check your vit B12 and vit D3 level.Local injection may help if pain remains persistent.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you are satisfied with answer do not hesitate to rate this answer at end of discussion. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why i didn't get pregnant?\n\ni have been married from 10 months, i had a miscarrige in aug 2011....since then i had irregular periods till december 2011..from jan 2012 i am having normal periods...we were not trying for baby from den on but now i want to get pregnant and tried last month..but i couldn't conceive...what might be the reason?",
    "doctor_response": "Hi there, I have understood your concern. I will suggest you the best possible treatment options. 1 ) First of all do not panic. Sorry to hear about your previous pregnancy loss. 2 ) If you have history of regular cycles then day 10 to 20 of the cycle is the most fertile period of cycle. If you have unprotected sex act in the fertile period of cycle , then you stand chance to get pregnant. Usually, if couple is following this advice then chances of getting pregnant are once in sex calendar months. 3 ) Secondly, I will suggest to start use of Folic acid, Vitamin B 12 and Omega 3 supplements at least 3 months before you plan to get pregnant. This helps to prevent many problems during pregnancy and delivery. Please remain happy. Be positive. Try to meditate regularly. May God bless you with a bundle of joy. I hope this answer helps you. Thanks. Dr. Purushottam Neurgaonkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for CKD?\n\nDear Sir,I am from Dhaka, Bangladesh. Age 45years. I am a patient of CKD and my doctor is asking to do kidney Biopsy for further treatment. Would you please advise me as per following info what I need to do exactly and if I need to do biopsy of kidney then who will be the best Doctor at CMC vellore and how would I can get an appointment asap ?Urine examine report shows :Albumin : +++Pus cell : Numerous 24hrs. Creatinine Clerance Rate (CCR) : 35.0 ml/min/1.73m224hrs. Urine Protein : 6.7 gms/24hrs.24hrs total urine volume : 2.5 Liters/24hrsHematological Test shows:ESR : 105mm.1st hr.Biochemical Analysis report shows:Plasma Glucose (Fasting) : 8.4 mmol/LS. Urea : 16.4 mmol/LS.Creatinine : 261umol/LHB A1C : 6.8%S.Triglyceride : 786mg/dlSonographic Findings on KUB :Kidneys : Both kidneys are normal in size, shape and position withh ill-defined cortex, medulla. Cortical echogeniicity of both kidneys are increased. size of right kidney is 10.2 X 4.2 cm and the Left kidney is 10.9 X 4.2 cm. There is no calculus or any sign of ureteric obstruction in the pelvicalyceal system of both kidneys.Ureters : Ureters are not dilated.Urinary Bladder : well filled and uniform and normal in contour. There is no evidence of stone or growth.  comment : Increased echogenicity of cortex and medulla.",
    "doctor_response": "my dear friend,your report says that you are having diabetes and dyslipidemia (lipid disorders).Hence there is possibility that you are having diabetes related kidney disease.In most of the CKDs kidney size decreases, diabetes is an exception to this rule.Same is your report.Look, for diabetic kidney disease, renal biopsy is not at all recommended now a days, unless any other type of renal disease is suspected in a diabetic patient.You are prone to have urinary tract infection because of diabetes.So the first thing you must do is to do a culture sensitivity of your urine and if it comes positive then take antibiotic as per the report(after consultation with a reliable doctor because for your renal problem dose adjustment is necessary).Urinary tract infection is a very common cause to de-compensate the stable status of diabetic kidney disease.In the mean while have an eye check up-FUNDOSCOPY to rule out diabetic retinopathy.Have your blood sugar,pressure and lipid tightly controlled.There are some drugs(ACE inhibitors or ARBs) that can be used to limit your renal problem but they are to be used with caution and monitoring (serum creatinine and potassium).Consult a nephrologist or good internist for detailed follow up.You can get them in your country or if you wish you can come to India.Good luck.By the way,your problem is very common among plentiful diabetic patients so don't panic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for hard lump behind ears\n\nHello, I just noticed a hard lump behind my right ear (on the temporal bone, I guess). It doesnt hurts, and seems to be under the bone.. I dont know if I m just scared, but I guess Im feeling headaches lately, and I also feel something weird on that ear when I swalow. Hope you can help me, Thanks.",
    "doctor_response": "Hi,From history it seems that you might be having enlarges post auricular lymph node giving this lump.There might be having some irritation or impacted wax in right ear causing this enlarged lymph node.Consult your doctor and get examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to relieve pain in rib\n\nI hurt my rib last Saturday. It still hurts. I have iced it and taken OTC meds, but it doesn t seem to help. I feel the doctors can t do much for a fractured or bruised rib, but my cousin says I should go. I am pretty sure they are going to tell me to continue what I was doing. I probably slowed down the healing due to I was helping my office move to another office last week (this was after my injury)",
    "doctor_response": "thank you for your query....as because you still have not recovered, you should do the following go for an XRAY chest AP viewcomplete bed rest for 3-4 daystake ibuprofen 400 tabs twice daily after food, omeprazole 20 tabs once daily before foodu can continue cold compressvisit a doctor with the reports..you should have not risked the movements you did with your injury and that might have caused some delay in healing as u fear....do as advised and it will help your healing process...hope that was helpful....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cough with mucus, rumbling sound from chest, vomiting, ear congestion. Using alvesco. Cure?\n\nI have been sick since december 23 with a cough that has become significantly rough. I have been putting it off because all it seemed was a cough i now am coughing up alot of mucas and have a rumble in my chest when i cough. I am coughing to the point where i get sick and throw up. I also have been having some congestion in my ears my hearing seems muffled. I have now developed a full out cold ( sneezing , sore throat ext) ive seen a doctor twice, once i was told it would just go away, second time i was given an inhalent aerosol called alvesco but it docent seem to be helping at all :(",
    "doctor_response": "THYESE ARE A;LL ALLERGIES YOU SHIFT TO SAFE ANTIALLERGICS TAKE MONTAIR FX TWICE A DAY TAKE SYP TOSSEX 1 TSF BD SYP ASCORIL 1 TSF BDAPPLY NEOSPORIN H EYE OINTMENT IN NOSE BD SEA WATER 2 DROPS IN EACH NOSE AT NIGHT YOU CAN CONTINUE FOR 4 WEEK OR LONG OR YOU REQUIRE OFF AND ON BUT GET ALLERGY TEST FROM ALLERGEOLOGIST TO FIND THE CAUSEN OF ALLERGY AND ITS CURE",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of feeling light headed ?\n\nI sometimes get a weird feeling in my head. I call it being light headed, but I read about light headedness and my feeling doesn t fit. It is like sinus pressure because it is in the sinuses as well as the top of my head. It doesn t happen all the time, but is annoying when it does.",
    "doctor_response": "Hello, Sinusitis may cause you to feel lightheaded, so, since you feel sinuses pressure, you should get an evaluation for this possibility. X-rays films of the sinuses and an evaluation by an ENT Doctor are necessary for this purpose. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having a lump on my head and dizziness?\n\nHi, I am a 33 year old male and I have since a couple of days noticed a lump in the front centre of my head / scalp. I do feel a little dizzy / tired and it s uncomfortable to touch. I don t recall hitting my head in the past few days but 3 weeks ago I did cut my head close to where the bump is from a minor blow. I didn t seek medical assistance before as it didn t seem that serious. Do you think the 2 things are related or could it be something unrelated and more serious?",
    "doctor_response": "hi! i think the two things are associated and it is nothing but a hematoma or old-blood filled sac!as you are having dizziness, you should go for a CT scan of the brain to exclude any major injuries.apply ice/cold compress on it and review the report with us or any local doctor.all the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tearing muscle like pain in arm?\n\nfor several months now, I have been having pain in my arm whenever I reach for something, it feels like a tearing muscle. just recently when I was tested for PAD, they found that the pressure in my right arm, was only 76 as compared to 107 in my left, could the two be related. everyday things, such as tucking in a shirt in the back, or trying to brush my hair in the back cause severe pain",
    "doctor_response": "hi,Thanks for providing the brief history of yousince you mentioned you already tested for PAD and the pressure was varying from arm to arm. I do not think this should be the case.May be you have tightness of the muscles which is not allowing it to happen.Try doing some stretches for upper limb and do some hot water fermentation. If its just a tightness it will surely come down.Suppose in case if it is not coming down then you should try meeting an ortho and get self assessed once atleast. May be certain times, due to the tightness of the muscles, there might be some nerve entrapement and also most of the people have trapezitis too. You can get treated for that as well and the pain can be taken down.You can even visit a physical therapist who might help you with the case of you after doing a thorough assessment.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have kidney stone. Is it curable by medicine?\n\nHi Doc, a CT Scan have shown 1.2cm of stone in my right ureter , pls. suggest if it can dissolve thru medicine",
    "doctor_response": "Berberis Vulgaris-Q homeopathic mother tincture helps to dissolve kidney stones. But I am doubtful whether it will work for a 12 mm stone or not. Drink 20 to 25 drops in warm water 3 to 4 times a day. Also drink lemonade soda daily. Ayurveda has dissolved stones up to 18 mm. Contact Dr.M.S.Zambre, BAMS-AMA, Shree Gajanan Clinic, Near Datta Mandir, Dhayari,, Pune \u2013 411041, Phone: 09423533301",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a suggested medication for abdominal migraines?\n\nI am a 34 year old female, with episodes of chronic migraine headaches which present themselves with an onset of what seems to be an epileptic seizure in my abdominals. The stomach involuntarily contracts for a period of 30 to 45 seconds, subsides for a few minutes, and then occurs again until vomiting results. The following day or two I have symptoms of a migraine headaches, vomiting for 12 ro 24 hours, followed by nausea, sensitivity to light and sound, and in one instance I had an episode where I could not speak or write. My doctor thinks I have abnormal migraines, however, the symptoms occur three days prior to my menses- and when I am under a great deal of stress. I have been experiencing these abdominal migraines or abdominal epileptic seizures- which ever they are called- for a period of 23 years approximately every cycle. They get worse if I eat dairy, yellow cheese, meat, wheat, sugar, onions, and too much chocolate, or smell chemicals, diesel fuel, or bleach. I have received an endoscopy which came back normal, I was tested for Celiacs disease, and that came back normal. I feel frustrated because I cannot get a definitive answer about this condition. I just want an answer about this condition which with my current insurance, I cannot get the tests necessary to diagnose whatever I have. I would be happy to volunteer for a medical study for Abdominal Epilepsy or Migraines if it could lead to a diagnosis. I think this could help me to lead a more normal life, and possibly treatment for this condition. What is your advice for me, considering this has effected every aspect of my life, family, career and health.",
    "doctor_response": "Hello, If one comes to me with such complaints as yours I suggest to take the following Ayurvedic medicines. 1. Arogyavardini Rasa 1 tablet with warm water three times a day before food. 2. Kamadugha Rasa with Mukta (Preferably of Shree Doothpapeshwar Limited) 1 tablet with warm water three times a day before food. 3. Drakshadi Kashayam 3tsp (15ml) with 3tsp (15ml) of water three times a day after food. 4. Shirashula vajrari Rasa 1 tablet with Drakshadi Kashaya (Item no.3) three times after food. I would also like to suggest for a considerable dietary regimen as below: 1. Avoid use of caffeine, Bakery, Fermented, oil fried and cocoa products. 2. Increase intake of fruits especially Orange, grapes, fully ripe banana and Musambi. 3. Preferably pure vegetarian diet with lots of fibres and those belonging to cucurbitaceae like ash gourd, bitter gourd, ridged gourd, etc. I suggest it for a period of one month and then revive the condition. Now as this is a prescription Ayurvedic medicine and requires regular monitoring I suggest you to take the advice of a local Ayurvedic Physician for proper management. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Mahesh T S, Ayurveda Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can hypersecretion of ADH, due to pituitary tumor, affect blood pressure?\n\nMr. Grimaldi was previously diagnosed as having a posterior pituitary tumor that causes hypersecretion of ADH. He comes to the clinic regularly to have his blood pressure checked. Would you expect his blood pressure to be chronically elevated or depressed? Why?",
    "doctor_response": "Hi thanks for asking question.According to your question you want to know effect of ADH on blood pressure.ADH is called vasopressin.It has property of water retention in tubules and constriction of blood vessels with increase arterial resistance.So obviously it will raise blood pressure along with other symptoms like headache,vommiting and in severe case convulsion.So if he is suffering from ADH secreting tumour then blood pressure will rise.I hope i have solve your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How should testes and penis pain caused by stones passing be treated?\n\nhi this is moin from saudia arabia i have a stone in my left kidney and their size is 13mm and as per doctors prescriptions i have been operated stone through LITHOTRIPSY but after making first session of lithotripsy i have been passed much blood and now some pieces of stones are removing and passing through urine but i feel much pain in my testies and penis throughout the day. For this reason i visited doctors clinic two times  but he give me painkiller injuction and said untill all stone pieces removed u have to face pain and he give me antipiotic tablet named CIPROFLAXACINE. I m taking these antibiotic tablets since four days but having no effect plz guide me.",
    "doctor_response": "Hi,Thanks for writing in.The pain in testis is referred pain and due to presence of smaller stone fragments in urinary tract. The penis pain can be due to actual stone fragments or referred pain. The antibiotic ciprofloxacin is a good one and will treat any infection resulting from lithotripsy and passage of stone.  You may please drink lots of water and visit washroom frequently so that your urinary system is flushed regularly and the chances of stone fragments being left behind are less.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for the bleeding from anus?\n\nI have been bleeding a little when I go to the bathroom out my anus. And the crack area has been burning I went to look today anmean have a red ring around the anus and down the whole crack is red n purple any idea what it might be or if it's seriouse?",
    "doctor_response": "HIWell come to HCMI really appreciate your concern.Discussion:- Looking to the history given here chances of fissure is very likely, constipation need to be relieved for further damage, and in case of profuse bleeding fissure should be treated surgically but in minimal or less bleeding no specific treatment required.Medication:- Local application of hemostatic agent can be tired, with \"Povidone Iodine\" cream.Advise:- Have more fiber diet, drink more water, try sits bath.Comments:- In differential diagnosis infection, plies, and other lesion need to be ruled out and for that clinical examination is must.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I having chest pain after inhaling Grout?\n\nHello doctor, Two days ago, I inhaled Grout for quite sometime, the following morning I woke up feeling very painful on the chest on the back, when I moved my body parts I could feel a sharp pain on the chest and also the back and I felt the same when breathing in. Pease help me.",
    "doctor_response": "Hello.  Grout is mixture of cement and sand used as concrete in filling the cracks on the walls. It is possible that you may be allergic to cement following which you started feeling pain in your chest and other body parts. Another possibility is development of pneumothorax. That means because of lifting of heavy weight, some air leaked around the lungs. After air is collected in large amounts, you start feeling pain in chest and other body parts. To confirm this, you should do a chest X-ray. It will definitely give us the cause of your chest pain. For time being, painkiller medicines will help to alleviate pain but after X-ray, definite treatment can be given.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excessive sweating and bad body odor in child?\n\nMy son, who is eight tends to be very sweaty and have terrible body oder on a regular basis. He is very active, but do I need to be concerned for early puberty. This has been going on for some time. I read that the aporcien glands become active at puberty. This has been well over a year I make him wear deoderent.",
    "doctor_response": "HIThere are several possibilities here--Liver and/or kidney problems, so he needs blood work for thatAbnormal skin bacteria, so he needs to have a doctor check on that, too",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is purpose of taking albothyl suppos medicine?\n\nI was prescribed albothyl suppos to use every other day for 3 doses after what the gyn told me that my Pap was normal. I am 60, and had 2 days of unprovoked vag bleeding about 4 wks ago, that was the reason for that visit. Please tell me what is the use of this med and what is it? thank you.",
    "doctor_response": "Hello,Albothyl vaginal suppository is used for local treatment of inflammation or infection and tissue damage of vagina and cervix due to which you had bleeding.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Prabhash Verma, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain and frequent urination?\n\nhello, ive been having bad abdominal pain so i went to the er & they said i sasnt pregnant  no infections but the cramps have gotten worse i have frequent urination & i woje up today with a sore throat?!? i just wanna feel better & know whats wrong with me",
    "doctor_response": "Hi. This can be flu with varied symptoms.Go for the tests of blood and urine and stool if necessary. Visit ER again to get your dose of medicines. You may need a course of antibiotics and supportive medicines. Some diagnosis may take long to make. They are not evident on day 1 or 2 .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain\n\nim having severe pains in lower back it's been bothering me for some time now, it gets worse when I try to do laundry or anything that requires bending. Left side is swollen with a little bubble. I've had this pain for a long time. Just need to know if it's serious and that I need to go to the doctor",
    "doctor_response": "thank you for your question....kindly answer the floowoing questions so that it becomes easier for me to understand your problem better...how old are you?since when are you experiencing this pain?where exactly is it located?the swelling is hard or soft?is there any history of external injury to that area??anyways you should visit a doctor take restavoid bending or strenuous jobhave some painkiller for now do an XRAY/ MRI lumbosacral spinekindly contact me with the reports so that further management can be planned....hope this was helpful...regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Histroy of typhoid and jaundice. Slightly high bilirubin levels, SGPT alt on border line. On restricted food diet. Advice\n\nHello, My husband was diagnosed with Typhoid about 7 months back and within a week of Typhoid, he had Jaundice as well. Typhoid was long gone but his Bilrubin levels are slightly on the higher side - Total 1.2 and Direct 0.2. Aso, SGPT Alt is 40 which is in the border line. Even after no oil, less fat diet for 3 months and lest oil and less fat for the last 4 months the levels are not completely normal. Is there something which we need to do.Thanks in advance.",
    "doctor_response": "Hello, Blood reports of your husband are almost within normal range . In some patients it takes time to come below upper range. Is your husband vaccinated for Hepatitis B or not .If you are worried you can go for tests related to hepatitis B and Hepatitis C . Hepatitis B australia antigen Anti HBs Antibody, Hbe antigen and antibody and Anti HCV antibody  to rule out these cause for jaundice.You can consult gastroenterologist for your worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will low level of Lymphocytes and neutrophils cause tiredness?\n\nHi I have been feeling very tired/weak for over a year and blood tests keep coming back low level lymphocytes and neutrophils. My dr. ordered a test for blood film,full blood count, glucose random - gps only, U&E, liver profile, bone profile and thyroid function. All have come back normal what does this mean - am I clear, my dr. has been mentioning bone marrow and possible leukaemia is this now not the case?",
    "doctor_response": "Hello, Thnx to contact us. If I am your treating doctor I advice you that having a low lymphocyte and neutrophil dosent make you tired, there must be some thing else. I advice you to do a early morning exercise. That will raise your energy capacity as well as counts also. If you have anything else to ask, kindly contact me Dr. Arun Tank",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can breathing problem be treated permanently ?\n\nHello Doctor My Husband has suffer due to breath problem any time suddenly his breath has been stop an if he take one capsule in pump that time he get relax is it any forever solution? please let me know",
    "doctor_response": "Hi, Substances that cause breathing problem are known as triggers. Avoidance of triggers is the No. 1 way to control allergies and asthma. An accurate diagnosis is important before you can treat and prevent breathing problems. Each of us is different. The specific medication and treatment program that works for a family member or friend may not be the correct one for your problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain after stillbirth due to uterus rupture?\n\nDear Doctor, I got C-Section on 9th May 2011. I delivered a dead baby due to uterus rupture. I remained hospitallized for 9 days. I got discharged with the prescription medication of 5 days antibiotic and multivitamins for 2 months. I took medicine regularly. 2 Months passed, but I am still suffering from abdominal pain. According to latest ultrasound report of pelvic screening, a cyst have been seen in the lower abdominal section. I would like to get your wise opinion at this stage as I am still with pain.",
    "doctor_response": "The pain can be due to post-operative adhesions or the cyst you mentioned might be getting twisted. Confirm with CT scan. A diagnostic Laparoscopy is the best answer as you can see everything inside and get treated accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be causing pain and swelling in the heels and lower legs?\n\nMy heel is in a great deal of pain when I walk & stretch it out. I naturally thought it was my plantars facitis, but my foot into my ankle & lower leg is swollen. What could this be? My heart doctor told me a year or so ago i had veinous reflux. Could this be that?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It could be due to a condition known as plantar fasciitis. As of now you can take analgesics like ibuprofen or diclofenac for pain. If you are obese, you have to lose extra weight as obesity can worsen the symptoms. If the pain persist, better to consult an orthopaedic and get evaluated, steroid injections may be required in severe cases. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the procedure to cure bilateral leg pain?\n\ni had a percutaneous disekomy(stryker) on L3/4 because of posterior disc bulging deforming thecal sac without compromise of neural or foramina. i have radicular L3/4 leg bilateral pain, shin, knee, quads. it is 6 weeks later, pain is same. what procedure do i look for next? thanks",
    "doctor_response": "Hello, I will advise you to take the help of a Physiotherapist who can help with therapeutic ultrasound therapy for reducing inflammation and TENS therapy to reduce pain. Post which exercises to help improve the stability of the spinal column and strength for allowing muscles to hold the spine stable to avoid nerve entrapment. Usually, most cases are receiving guided physiotherapy and are helped better. Research studies show that physiotherapy plays an important role in helping in such conditions. Exercise includes - core stability, spinal muscle strengthening, hip muscle strengthening, and lower limb strengthening exercises. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swelling in ankle\n\nHi my fiancee was edging the lawn today and a rock flew back and hit his ankle pretty hard on the right inside where the circle is. His ankle is swelling but doesnt look discolored too bad or out of place. We have no insurance and no extra money. Please help with any suggedtions",
    "doctor_response": "Hello dear,The symptoms as mentioned in your post are due to the impact as well as accumulation of fluid & blood (Hematoma).Symptomatic relief is obtained by analgesics preparations (like Diclofenac + Serratiopeptidase), ice compression & adequate rest.If it still persists or there are any other associated symptoms like fever, loss of sensation, restriction of movements, discolouration of foot, etc...then it will be better to consult your Doctor.An X ray of the ankle joint will be needed to rule out any bone fracture or soft tissue injury.Till then, maintain adequate hydration & nutrition status.There is no need to worry, you will be fine.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pleural effusion\n\nmy mother is diagnosed with left pleural effusion and she undergone pericardiactomy 2 months before for pericardial effusion.Doctors diagnosed that she has tuberculosis but the result is negative for TB.still doctors suspection is TB.Now she is in Anti TB medications.Now she is diagnosed with pleural effusion.How pleural effusion can be treated.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your mother's situation and problem. With anti tubercular drugs, tubercular pleural effusion is mostly treated. Since she is still having pleural effusion despite of treatment, possibility of multi drug resistant tuberculosis (MDR) or malignant pleural effusion is more. So better to consult pulmonologist and get done 1. CT thorax with Contrast 2. Pleural fluid AFB culture and sensitivity.3. Pleural fluid cytology. 4. Pleural biopsy to rule out MDR tb and malignancy. So better to first diagnose her and than start appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes enlarged kidney?\n\nHi, may I answer your health queries right now ?  Please type your query here...i have a enlargerd kidney had mri then ct ivu and said ii might need a stent,they looked at results but not sure what is wrong so i have to have general op so they can have a closer look ,as i have had cervical cancer",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. If you have previous history of cervical cancer then there are chances that the enlarged cervix has obstructed the ureter which led to the back pressure on kidney leading to its enlargement. If CT scan and MRI are non conclusive then the only option left is to go for exploratory laparotomy in which the surgeon will look into the abdomen and see whats wrong there. But if I were your treating doctor i have have first done laproscopic exploration in which i would have just made 3 holes in the abdominal cavity and put a scope in the abdomen to see whats wrong as this is the minimal invasive option available for you. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Depression, taken cipralex 5 mg and oleanz 5 mg, alternate for these medicine\n\nHi my wife is on cipralex 5 mg and oleanz 5 mg once in night daily from past 7 years.. does she have to continue taking these medicines rest of her life? Also for a brief period her dose was reduced to 2.5 mg and she again went to depression again. so we reverted back to 5mg. will these medication be taken all her life any other alternate?",
    "doctor_response": "Hi and welcome to Healthcare Magic. Thanks for your question... The duration of treatment for depression usually depends on the number and severity of the episodes and whether there have been any relapses after stopping medication. If the initial episode has been severe or prolonged or if she has had more than 2 episodes or if she has a strong family history of depression, then she may have to take medication for a longer duration. It is also important to see if she has any predisposing factors for a recurrent depression like underlying thyroid abnormalities, certain vitamin deficiencies, etc. and treat them appropriately. In your wife's situation, since you have mentioned that there has been a clear relapse of symptoms on reducing the dosage of mediaction, I think that  it is advisable to continue medication for a longer duration. 5mg of Cipralex is the minimum effective dosage of that medication for depression, and it is a relatively safe drug with minimal side effects. However, you can discuss with your psychiatrist if she needs to be continued on Oleanz (which is an anti-psychotic medication and is given only when there are 'psychotic' symptoms (delusions, hallucinations, etc.), in addition to the depressive symptoms. Please feel free to clarify any more doubts that you may have. All the best. -Dr. Jonas Sundarakumar Consultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat neck stiffness?\n\nSo Wednesday I started to get a stiff neck and it got worse. by Friday I had ear ache and a head ache now Sunday I also have popping and cracking in my nose and my balance is off. When I bend or turn I am dizzy and feel sick. Please help I don t want to be like this for Christmas !!",
    "doctor_response": "Hi i am Dr Ahmed Aly    thanks for using HealthcareMagic site ,I had gone through your question and understand your concerns ..    You may avoid bad sleeping postures ,vigorous movements and try spinal straightening exercises .   For my patients i may recommend NSAIDs or painkillers like advil tabs when needed , hot gentle massages with topical gels of anti-inflammatory , B12 vitamin supplements and muscle relaxants will be effective for most of cases .   If pain persist i recommend MRI for proper evaluation and management and follow up with her physician .   Please click and consider a 5 star rating with some positive feedback if the information was helpful. Wish you good health,Any further clarifications feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pain in the knee be due to ligament tare?\n\nLast night, I was walking and my left knee twisted and popped. Afterwards, there was an extreme amount of pain and it hurt to walk. Today, I haven t noticed any swelling but it still hurt for most the day. I took some pain relievers and the pain has gone down, but I am unsure of whether the pain will return. Is it possible that I tore a ligament or could it just be a muscle strain? I have hurt my other knee before, and it was a torn ligament.",
    "doctor_response": "Hi, Definitely. The pain in your name can be due to ligament tear. To know the exact status, get an MRI done, X-Ray in this case will be absolutely normal. Apply ice pack, use knee cap and take over the counter painkillers. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jaideep Gaver, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of e-coli?\n\nMy son has had extensive graphs on his head, as a result of a chronic staph infection -- now I'm told that part of the graph died because he has e-coli.  What causes this . . . he's not been allowed to get up and has been receiving nourishment by a feeding tube.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.E.coli is the bacteria present as a commensal flora of the skin, and mucus membrane of the body.Its infection can occur when the body situation is not favourable. In your condition it is the chronic bedridden state that has compromised the immunity status of yours.In my advice you should take the sensitivity report of the e coli done. Taking the drug according to the report can cure you on good time and also cures you with minimal antibiotic use.Please maintain good local hygiene this can be done by proper cleaning and dressing of the affected part.You can do good dressing with the use of betadine, savlon and  polysporin ointment.Please give high protein, low fat and high carbohydrate diet. Avoid more oily and spicy food.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with scalp psoriasis, cured with treatment. How long should the medicines be taken?\n\nSir, I am 42 yrs male, was diagnosed for scalp psoriasis since last 2-3 month (appx.) on my back head. Dr advised Scalp lotion & Lotion of Coal tar, Sycalic Acid. Also advised orally Omega Acid tab & Vitamin A capsule daily & Oncotrex 10 on weekly. The scalp psoriasis got almost cured after medication of 15 days medicine & 2 dose of Oncotrex 10. Should these be continued & for how long. I am also having diabitise diagnosed last 2 years back. My Doctor says Psoriasis will spread with every change of weather. Please advise.",
    "doctor_response": "Hi , Thanks for writing in. The condition you are suffering is Psoriasis . It is a genetic condition. It can be kept under controlled with treatment. Can re occur with stress or infection. Treatment you are given is correct continue it for atleast 2 months.You can stop applying lotions on scalp.Only continue with oral medication. Also supportive oral tablets containing omega 6 FA  and multivitamis can be helpful. It can come back in winter season.Do not allow scalp to be dry. Hope this helps. Regards DrSudarshan MD Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason behind burning,pain between shoulder blades,skin sensitivity on chest,internal itching for a patient with multiple myeloma and diabetes?\n\nIs there such a thing as Shingles without a rash? My husband has all the symptoms (burning, stabbing pain between shoulder blades, skin sensitivity on chest and under arms, internal itching) but he has no rash! What can this be? He also has multiple myeloma and diabetes.",
    "doctor_response": "Initially pain can appear in Shingles and latter rash can occur. pain is high. Just itching is rare both can occur together. if no rash then it is not shingles. He needs to be checked for other conditions, fungal infections commonly cause itch, also parasitic infestations, both need to be excluded",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is having baby around child with strep infection safe?\n\nI have grandchildren coming this weekend.  We have a 3 1/2 month old baby in one family and a seven year old from another family that had strep this week but has been on antibiotics since Monday, 4 days.  Is it okay to have the baby around the older child?",
    "doctor_response": "Hello. I just read through your question. The seven year old who has strep is not contagious as long as he has been on antibiotics for more than 24 hours and has not had fever for more than 24 hours. It seems from the information you've given that this is the case. So I have no concerns about the baby.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the effects of giving overdose of Cypon drops to a baby?\n\nHi dr. My wife by mistake gave 2 ml of cyphon drops to our 3 month baby instead of 2 drops prescribed by the doctor. So what we want to do now. He slept for 4 hrs after giving that. And now he wake up and feeded by her. He seems to be ok now . Wether we want to take him hospital now. ..?",
    "doctor_response": "hi sir,thank you for asking us your query.cypon drops contains cyproheptadine (2mg/5ml) which causes depression of brain(excessive sleepiness and breathing difficulties) in children.though these have not seen in your kid,its always better to saw a pediatric emergency doctor at the earliest for general check up and admission for observation for hald a day / under day care and if regards,dr sowmya",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe back pain\n\nim a 37 yr old m with severe back pain, went to neuro surgeon appt today and my bp was 175/125 , i was told the bulging disk wasnt bad enough for surgery beteween t9-10 , im on pain and blood pressure meds and neither are working, i went to the hospital this bad the other day and they gave me steroids and a morphine shot that didnt work, im still in psychotic pain,i dont know what to do",
    "doctor_response": "Hello,I had gone through the case and found that you need to do yoga exercise, deep breathing and meditation.It will help in reducing the blood pressure and pain.Also go for physiotherapy if pain is unbearable.Take calcium and Vitamin D3.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Leg Nerve problem\n\nhi this is srinivasulu, 26 i have a problem in the leg nerve that was expanding  can u tell me what is the problem  there is no pain but it was exapnding from past 7 years that was gone increasing and it spread up to 15 centi meters send me the details with images for conformation",
    "doctor_response": "OKIE THINK ITS NOT A NERVE WHICH HAS BEEN EXPANDING IN YOUR CASE BCOZ OF ITS LONGSTANDING HISTORY MORESO IF UR OCCUPATION ASKS U FOR PROLONGED STANDING IT MUST BE A VEIN, A VEIN IN D LOWER LIMBS USUALLY SWELL UP AND DEY R BLUE IN COLOR, NON PUSATILE, NO PAIN WITH LOCAL CHANGES... MAY B ASSOCIATEDWITH ITCHING.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take I pill along with promult N?\n\nif i am consuming promult N for delaying my periods as im gng on a trip. But wanted to check if i can consume I pill in case required along with promult N as I do not want to conceive at this point of time. My age is 28 and height 5.4. I dnt have any medical problems",
    "doctor_response": "HelloThanks for writing to us with your health concern.Well, as such you can consume I pill alongwith Primolut N, but taken together, they will mess up your cycle.Your next period would be totally unpredictable.Also, it is best to use pills as they would serve both purposes - contraception and regulating your period as you wish.Take caer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having noticed cramps & pain in lower leg\n\nhi i am 16 weeks pregnant and i am feeling sick all the time im always tired and havent been able to eat i eat very little today i have had allot of lower legg cramps back aches and just aches and pains just feel sick can you help me also thier is no bleedingthank you",
    "doctor_response": "Hello Thank you for using healthcare magic I read your question and understand your concern Based on what you describe it looks like you have vitamin deficiency and mineral deficiency so I advice you to take some magnesium vitamins from the mouth. It should go away pretty quickly . I wish you a quick recovery .Dr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be concerned for CT scan after mohs surgery?\n\nI just had Mohs surgery to remove a sebaceous skin cancer from an area next to my ear.  I've been told I need to have a CT scan from my head to my pelvic region to check if it has metastized.  Also, amammogram and colonoscopy.  This area was very small and taken by a dermatologist.  Should I be alarmed?",
    "doctor_response": "As long as surgery was done with a good resection margin, and histologically the resection margins were adequate and free without invasion of vessels you need not worry and you can according to me withhold other investigations.Dr. J. Ticku",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is my baby passing greenish loose motion?\n\nHello doctor, My 5 months 15 days old baby is having loose motion from yesterday and he has passed 8 to 9 times greenish motion. Please sugest me what I can do.",
    "doctor_response": "Hi. Do not worry about the color of the stool as long as it is not red and does not contain blood. Please give syrup Zincolife 2.5 ml once a day for 14 days. Also, give ORS solution (prepare solution as advised in the instructions given) as 10 ml/kg with the passage of each loose stool to keep the baby hydrated. It will take atleast 4 days for loose motions to be controlled after starting these medicines.  Watch for signs of dehydration like lethargy, refusal to feed, poor skin turgor, dry oral mucosa. If these signs are present it is indicative of dehydration. In such cases and also, if the child is passing blood in stools, it is advisable to admit the child to the nearest hospital after evaluation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause few white, flaky spots on the wound cured area on buttocks?\n\nI recently had a major wound on my left buttocks from surgery to remove necrotizing bacteria. The wound has been closed for a few days now but yesterday I noticed a few white, flaky spots on the area where the last bit of the wound had closed. The area is very hard. Today there was a larger amount of the white flaky stuff but it doesn't flake off like dry skin or dandruff, it is still very hard and almost feels like a scab. Should I be concerned about it?",
    "doctor_response": "hello dear,i will going to solve your problem.after removal of necrotising infection infection from your skin the wound is closed secondarity. but have you said that it do have white spots, which are actually slough of wound.the slough is made of dead bacteria, white blood cells and other dead cells. and for healthy wound the slought should be removed.when wound heals, it heals by fibrosis. fibrosis causes hardening of wound. so please dont afraid of hardening.hope i solved your problem but in case you have more queries and can ask me again. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I get rid off from sore lower buttocks?\n\nThe back of my right thigh from lower buttocks to almost halfway to my knee is extremely sore to the touch, almost like I have a fever but only in that centralized area. Ibuprofen and heat eases pain, but doesn't make it go away. Been 3 weeks now constant. What could this be?",
    "doctor_response": "Hello,Welcome HCMBrief..It could be staphylococcus infectionDetail..From your history it seems that you have got staphylococcal bacterial skin infection.For that you have to get promptly pencillin antibiotics course for 7 days at least to eradicate the infection ,otherwise it can spread to bones and other parts of body.My suggestion get checked by Physician and discuss further.Regards,Dr.Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a painful hematoma on the forehead be treated?\n\nHello. I had a boat tubing accident 6 weeks ago with my sons head met my forehead. A large hematoma and severe bruising for me for 3-4 weeks including a concussion. I did not go to ER...no XRays. 6 weeks out hematoma smaller but still is penatrating and seems to hurt much more now....without CS or X-rays what are the sysmptoms of a fractured supraorbital and how long should I give the hematoma to dissolve?",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Without xray or CT, fracture cannot be commented in skull region. The hematoma usually resolves in 4-8 weeks depending upon the side and location. You can take pain killer for few days for pain. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the best medicine for seasonal bronchitis?\n\nI have seasonal bronchitis which comes yearly once or twice in the rainy or cold season. I use ampicillin based tablets ....can you suggest me the best medicine. Symptoms: Running nose sometimes or blocked nose sometimes, severe cough, sometimes body pains (may be due to severe continuous cough) but someitmes occasional cough comes. SLight fever so I use sinarest tablet.",
    "doctor_response": "Hi thanks for asking question.Mostly according to history you have allergic or seasonal rhinitis with respiratory involvement.Continue using antihistamine drug for that.Meanwhile take more fruits and more water.Green leafy vegetable are helpful.Avoid smoking strictly as it can aggravate condition.Take healthy nutritional diet.Steam inhalation will be helpful in relieving congestion.If condition still severe then leukotrien antagonist drug can be added like montelukast.Meanwhile if suffer from blocked nose for immediate relief short term azelastine can be taken as nasal inhaler.I hope my suggestion will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is drowsiness 5-6 hours after taking paracetamol drops for fever normal?\n\nMy baby who is newborn and 3 days old had developed low grade fever so I gave him 0.5 ml (50mg) of paracetamol drops. He slept for 5-6 hrs and after got up now but still little drowsy. I am worried about overdosage and regarding liver and kidney adverse effects. Plz advise. He already has physiological jaundice",
    "doctor_response": "Hello,No, it is not an overdose, a baby is maybe lethargic due to jaundice, and this amount will not cause toxicity unless you gave it only once.Next time, have a dropper and only give off 3 to 4 drops of Panadol, not Paracetamol drug. Paracetamol is not safe for babies.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Hina Javed",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have constant minor chest and neck pain. Is it due to smoking?\n\nHello doctor, I am a smoker and have been smoking for 20 years. I can feel the stress of smoke while I breathe normally. But now I have constant minor chest ache probably in the lungs. I also have been facing a problem of pain in the neck and lower pain. This increases in the night when I am lying down. Can you suggest medicine to cure my lung conditions? I am prepared to give up smoking.",
    "doctor_response": "Hello. First of all congrats on the resolve to quit smoking. Half the job is done. Now please walk the talk. The other half. Whatever damage has been done will gradually reverse back. Also, start on some breathing exercises and yoga and good healthy eating habits. Now coming to your problem, since you have have been smoking for 20 years, we must rule out any neoplasm in the respiratory pathways. For the same a chest x-ray PA (posteroanterior) view is essential. I would also suggest some blood investigations namely, complete blood count inclusive of but not restricted to ESR (erythrocyte sedimentation rate), TLC (total leukocyte count), DLC (differential leukocyte count), RBS(random blood sugar), Hb (hemoglobin), etc. Do you produce cough or sputum or blood in sputum? If so we need to take a sputum sample for AFB (tuberculous bacilli). Neck pain can be simple muscle ache or sprain. The pointers to this sort of pain are aggravation at certain positions. Relief with hot fomentation can also be pointing to such sprains. As a temporary treatment plan I am suggesting the following: 1. Steam inhalation with Karvol plus capsules in the water (similar to Vicks inhalant capsules). 2. Paracetamol 650 mg for pain relief. It can be taken twice to thrice a day depending on the pain. 3. Multivitamin tablets, to my patients I usually prescribe Supradyn tablets or Supradyn activ tablets. 4. Good nutritious food comprising plenty of green leafy vegetables and adequate amounts of proteins and energy. 5. Diclofenac gel like Voveran or Myolaxin may be applied after hot fomentation of the neck to relieve any spasm. Also with regards to your height and weight, as per what you have given, the weight is quite high. It should be brought down by 25 kg to have a healthy BMI (body mass index). If you require help regarding the same you may contact me. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Missed birth control, spotting, periods. Normal symptoms?\n\nHi, I missed one of my birth control pills but carried on taking them the day after i missed it and have been now for nearly 21 days (I have three left to take) so that i can come on my period. About 2 weeks ago i spotted once and now it seems i am on my period. Is this normal? I have missed a pill in the past and this has never happened.",
    "doctor_response": "Hi,If you made up for the missed pill by taking two on the next day, you are amply protected. If not, you are at risk and the cause of the spotting you had can be attributed to a breakthrough. This could also be the reason for the early onset of the period. I would suggest in the current scenario, an estimation of the serum beta-hCG titre as a home pregnancy test may not be of much value so soon. Also, see a specialist for a proper appraisal of the situation and further management. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should I take for severe allergies to dust and pet dander?\n\nwhat can i do??growing up i had no allergies, now i have SEVERE allergies when it comes to dust and pet dander. i have tried everything to supress these symptoms, i have tried nose sprays, pills, and none of them are effective to my allergies...do i have to suffer or is there something out there for SEVERE allergies?",
    "doctor_response": "Hi,At the time of acute phase you will have to use nose sprays ,anti histaminic tablets,what I suggest,you is do desensitization.. At many pulmonary medicine physician this is available,they find out the most common allergen your sensitized with and they desensitize you,it will help you fighting allergyHope this information helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "CT scan conclusion says \"degenerative disease of spine with lamellated calculus in gallbladder\" . What problems can it cause?\n\nMy riends father's ct scan show septal thickening of  medial basal segment of right lower lobe  with ground glass opacities found due to adjoining vertebral osteophytes and conclusion says degenerative disease of spine with lamellated calculus in gallbladder so can u please tell wat is  degeneration n wat problems can it cause",
    "doctor_response": "Hello Thanks for writing to HCM Degenerative disease of spine are changes in the spine due to aging. It is in the form of osteophytes, disc prolapse etc. Aging causes chronic stress to structures so there are some changes in the spine. Mostly it doesn't causes any problem. If at all it is causing problems, treatment is available in the form of physiotherapy, surgery etc. Besides this, there is septal thickening in medial basal segment of right lower lobe of lung along with ground glass opacities in parenchyma of lungs. There is also Gall bladder calculus. Get well soon. Take Care Dr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump on the lower back?\n\nHello. I found a lump on the left side of my lower back about 2.5 months ago. It is the size of a dime and is not visible and can only be felt when pressure is applied to the skin. It hasn't grown or changed and is painless to the touch. However, I do have back and leg pain. I am a 22 yr old female. I don't smoke or drink and am relatively healthy. No history of cancer in my family.",
    "doctor_response": "Respected user, hi I evaluated your query thoroughly .* According to the narration, it is most likely to be Lipoma ( accumulation of   subcutaneous fat ) which can give rise to local discomfort but not leg pain   which seems to be separate entity than this .Hope this clears your query .Welcome for any further assistance .Thanks for using Healthcaremagic.com & giving me an opportunity to assistWishing you happy healthy life ahead.Regards dear take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful testicles\n\nhave been told I have complex hydrocele and varicocele right testicle and atrrophic calcified left side. Am experiencing pain when touched or any thing pushes again right side (pants. etc.) orologist recommends seeing another physician, says he suspects a hernia",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Yes, your description is supporting the fact of hydrocele and hernia combination.In my advice you should visit the surgeon nearby. Surgeon can examine such things and put a diagnosis at the end of the tests conducted. If the diagnosis is as suggests by you than you should be operated as early as possible. Operation can clear the thing of pain and other issues.Please avoid any injury to the balls otherwise infection occurs and can cause complication in further management.Right side is also to be operated for calcification in sac.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for diarrhea in a child\n\nHi,my 13 months baby is having a diarrhoea for more than a week. doctor suggest to change his normal formula milk to the special infant formula milk for diarrhoea.but his condition is remain the same. his stools is sticky,sometimes it is watery ad smells like spoiled egg. he also lose his appetite. he doesnt want to have any meals and for a time being,i just feed him with milk n biscuits. he has a bad mouth smells and restless sleep at night too..is he having a infantile diarrhea or what is the problem actually? thanx.",
    "doctor_response": "Hello, If your baby does not have fever or vomiting, he is at the right age for 'toddler's diarrhea'. The best way to determine if this is a problem or not is to check his weight. If he is losing weight, then he needs more evaluation.  If he is not losing weight, then you could adjust his diet and give it some time. Normal toddlers diarrhea often takes a few weeks to resolve on it's own. While you are waiting, I would not change his milk, but I'd make sure he is not getting fruit juice (the sorbitol and fructose can be hard to digest) and is getting some fatty foods to see if that slows down his stooling. Often at this age, a baby's appetite will go up and down. Again, if his weight is OK, then I would follow his lead about his appetite. Don't force him to eat if he isn't hungry. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Lisa Baker, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes reddish orange stool in infants?\n\nMy daughter is 3 years old and just had a diaper that had red-ish orange stool. She has been drinking different flavors of red kool-aid for about 2 days and I was wondering if that would cause this or if I need to get her to a doctor to get checked out to see if it s blood.",
    "doctor_response": "Thank you for your query. I understand your concern, she has normal bowel movement.Color of stool depends from pigments, flavours in the food. I suggest--Avoid following up food-Observe some days,i think it will be normal-If baby has diarrhea then she has frequent stool. Just don't worry. Take care  Wishing your baby and you good health. Dr.Svetlana Shrivastva",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Althea. Missed pill for one day. Is it safe to have intercourse?\n\nthis is my second month of taking Althea, on May 17 i took my first pill at 10PM. my 2nd pill is supposedly on May 18th but i was only able to take it on May 19th (2AM).... it also happens on the 3rd pill which am about to take May 19th, but i was only able to do so on May 20th 5am... but the following pills until now is on time... is it still safe for me to continue..and have contact with my partner?",
    "doctor_response": "Ya you can continue having the pills but resort to safe sex . in a sense use  condom.  and wait till the next cycle.  But for future if you missa pill one day you can take 2 pills together the next day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I get pregnant if I have PCOD and ovarian cysts ?\n\nmy age is 20....im having irregular periods...what should i do?3years back doctor had told me i have pco...they had given me krimson 35 tablets for 6cycles...it was regular thn but again its irregular now...plz tell me wat should i do?will i have chance to get pregnant when i get married?acc to the pelvic scan they did my ovary count it was 27.8*40.7m cyst ovary-31m*23.8 e.t-11.5m........plz help me what should i do now.....wil i be able to concieve?",
    "doctor_response": "hi tejaswini; Don't worry you will be able to concieve in future.PCO is a common & you have been treated ;it can relapse & again be treated.As for irregular periods till you are unmarried irregular periods are common because of hormonal problems .After marriage there will be change (irregularity will reduce or go away ).Presently don't worry consult a Gynaeccoogist if you still feel worried . thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting and low white blood platelet?\n\nmy grandson has been vomiting for like a couple for a months now. anything that he eats and drinks he vomits it. The day care start giving him cold formula. He has a fever on in off. And by the way he has a low white blood plate. I am worried that this is more than just a virus.",
    "doctor_response": "Thanks for the query.It looks like viral infection.Low white cell count is normal in viral illness.Also you need to check the urine for pus cells.For fever give paracetamol and for vomiting give ondensetron after consulting a doctor.It needs detailed investigations by the examinig doctor.Hope i helped you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recurring back pain. Height didn't grow as expected. Any remedy?\n\nIm 18 years old, on and off my back has been hurting since i was 16. My back will feel fine sometimes but then the pain would come back again randomly. I was told around the age of 14 that by the time i turn 18 years old, i would be 5 10 but now i m 5 6. I try streyching but it seems like it never helps. i used to be much taller than my younger brother but now he s 2 inches shorter than me and is catching up. I used to be taller than most of the people i knew in middle school but now im shorter than most of them (guys). Can you please help me with this situation?",
    "doctor_response": "get x ray of spine and see an orthopedist.an endocrinologist may help you know the cause of height problems if any",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What causes joint pain with stiffness?\n\nHello doctor, My height is 169 cm and weight is 95 kg. I am 50 years old, male. For the past three months, I am experiencing stiff fingers joint and pain in the outer ridge of the foot in the morning when I get up. Fingers become fine after some time but pain stays in the foot. This is coming on and off and frequency is increasing now. My work involves mostly working on computer and sitting job. Please advice future course of action and if any diagnosis is suggested? What it could be?",
    "doctor_response": "Hi. Well for fingers, it could be osteoarthritis because at your age this is something which is most common and it also has morning stiffness. In your foot, it is plantar fascitis. So for treatment, you have to do finger gripping exercises. For that, you can buy a smiley ball and do exercises 15 minutes twice a day. Along with that take tablet Cartigen Forte 1 tablet twice a day for three months.  For foot, get ultrasonic therapy done from any nearby physiotherapy center. Do plantar fascia stretching exercises. Hot fomentation. Hopefully, it will get better in 4 to 6 weeks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for peripheral ring enhancing lesion in LT\n\nhi! doctor i am 27 years old( female), height is about 5ft 6 inch and weight 58. I was was normal befor nearly 2 years but suddenly i got faint n found that i am patience of neurocysticercosis according to doctor and doctor said to take medicine for 2 years and refer me medicine zeptal CR300mg but i got rashes from that medicine n doctor refer me another medicin valprol CR500mg. It been nearly 2 years after that no promblem but whenever i put tight sandal my foot used to hurt right as peripheral ring enhancing lesion noted in LT. parietal convexity at parafalx region with market perifocal oedema... plz help me out?",
    "doctor_response": "Hello,Neurocysticercosis is a parasitic disease.The symptomatic treatment of this consist of anti epileptic medicines for seizure, corticosteroids and anti-parasitic medicines depending upon presentation of patients. The present pain in foot due to tight sandals may not be due to your neurocysticercosis. If it is burning or radiating then this can be due to neurocysticercosis. At present for relief you may have tylenol or ibuprofen.You should also avoid wearing tight sandals. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mukesh Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nausea followed by dizziness?\n\nMy husband had a fainting spell this morning. He said he was nauseous then room spun around and then he fainted. He has been under a great deal of stress and has had only a few hours of sleep for sometime. He heats very healthy no fast foods etc. he is committed to bed at normal hours ensuring at least 7-8 hrs. Could this he happened due to the extreme stress load and lack of proper sleep?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Is he hypertension?? How old is he?? Since when he is suffering from?? nausea and dizziness may be due to hypotension or TIA or anemia or myocardial infarction etc. Until examination is done it is difficult to say what it is. Please let him take to hospital and get it done, ECG, CT brain , hemoglobin, electrolyte and treated accordingly. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Am I having side effects from Cortisone injections?\n\nDear sir Recently I discovered that I have ependymoma,and my neurological doctor described me 5 cortisone injections but after the third one I have a sever left kedny pain just when I lay down and in the same time I had herpes over my penis since 10 years ago but It was treated but now I saw it again with great amount over the penis again. So please inform me if it is because the cortisne injection.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Recurrence of herpes over the penis shaft is because of cortisone injection.Pain in abdomen may be because of the cortisone injection. But it is required to be investigated.Cortisone is the steroid which causes immunosuppression. Initially it cures the infections like herpes but later grows with much higher intensity.So in my advice if the cortisone injection is not necessary to take than you can avoid it or you can take it for short period of time and than you can avoid taking it. Alternatively you can keep some time gap inbetween the drug taking.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can COPD be treated with symptomatic control?\n\nmy mother has been suffering from COPD. Past two years she's been getting worse. She's on nebulization and oxygen therapy the year through but her dependance on antibiotics and steroids is increasing. Is there any long term treatment that can make the episodes lesser",
    "doctor_response": "COPD is generally a progressive disease. She has to take her medicines regularly esp the inhalers. She should also be given chest physiotherapy which helps in removing secretions from the lung and in breathing. If she continues to be symptomatic she can be put on NIV like BiPAP",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pressure and pain in upper and lower jaw, neck and upper abdomen?\n\nI have pressure and pain in my upper and lower jaw, neck and upper abdomen. Also some light headedness and numbness in fingers of right hand. I get out of breath easily and sharp pain in my jaw after climbing stairs or doing housework. It all started in the last 6 months. What should I do ?",
    "doctor_response": "Hello and welcome.Thanks for sharing your concern.your symptoms are not restricted to teeth only.It could be serious problem related to heart and its circulation.There could be raised blood pressure or nervous compression causing such symptoms.This is not to worry you but to caution you from any serious problems.Therefore please visit your physician for your current symptoms.If you find any localized problem like bleeding or soreness in your gums or decay in teeth then you can see your dentist else not  required.Please see your dentist soon.Thanks.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain or tenderness in the elbow?\n\nFor approximately 4-6 weeks I have been having pain/tenderness in my left inner arm from my elbow to my underarm when I reach, esp. overhead. Recently, the pain has extended to include below the elbow. I can no longer straighten my arm all the way when I reach overhead. This is different than past experience w/ tendonitis (elbow bone itself is not tender to touch). When I reach, there is a distinct pulling sensation. At times I can see what seems to be a ligament of some kind stand out a bit and with my other hand I can follow the line from  my armpit to my elbow and into my  forearm (tender to touch). I can relate no specific injury to this. I am a package handler at FedEx but have no pain what-so-ever when I work. I am a 56-y-o female in good physical condition; I build stone walls and do manual labor in the summer and am accustomed to sore muscles, joints, aches and pains. This is different. Was an athlete in my youth; no fam Hx of heart disease. Thanks for your help.",
    "doctor_response": "In my opinion you have neuropathy caused by viral infection it will heal within 3 weeks (happens with cold and wind )i recomment vit b 12 supplementsGood Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the reason for having frequent throat infection?\n\nHi doctor, My partner gets throat infection for every 15 days. As soon as he gets the infection, he also gets running nose. As it progresses, there is ear pain, chest congestion, and chest pain. He is not taking antibiotics or any other medicines for this problem. Please suggest.",
    "doctor_response": "Hi. Collect the running fluids and do sugar estimation. Remember that the test has to be done soon after collecting the liquid. Otherwise, it will not be accurate. Next, get a sinus CT scan done to rule out the causative reason for having recurrent throat infections. Please send a picture of the throat to see whether there is any tonsillar hypertrophy. Meanwhile, start taking Septillin tablets to improve immunity. When there is no throat infection, give him amla (gooseberry) to eat. He can also have an allergy to pollens. So, he can develop an allergy. It can manifest as throat irritation, runny nose, and itching. You can do some tests to check allergy and follow some precautions to stay away from allergy. Revert me with more details so that I can guide you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could sharp back pain with bladder fullness suggest?\n\nI am 26 years old, I am experiencing upper left quadrant pain that puretrudes into my back it is a constant sharp pain. I have difficulty emptying my bladder completely.  Ill empty then about 5-10 min later i have to go again, The pain began about 24 hours ago and still wont go away, I have tried tylonel and the heating pad, i don't eat spicy or greasy foods, i tend to eat very small meals, or twice a day atleast. This pain is so uncomfortable!",
    "doctor_response": "Hi,From history it seems that there might be having urinary tract infection giving this problem.Youmight require one course of antibiotic like Ofloxacilin for 5-7 days.Take antispasmodic like Meftal spas or Cyclopam for pain.Take plenty of water.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is psychiatric evaluation required for paranoia after having bath salts?\n\nHi, I got hold of some bath salts yesterday and I took 500mg of the stuff, I am feeling really tingly, unfocused, anxious, depressed, disorientated and really nervous, also very paranoid. I took this about 3pm on Saturday - almost 34 hours ago and I am not used to this feeling at all. Although I do have anxiety and get medication for this (klonopin) and the doctor also prescribes me mood stabilizers for my depression. My utmost concern is that how long will this paranoia, nervousness, anxiety, hardly read and the tingly feeling last for.?I called in sick at work tomorrow and maybe more, depending how long this will last. I did take the white rush bath salts, thinking that it was an energy booster as I work long hours and this is the first time I took this evil stuff. I am now at the stage where I feel total paranoid and thinking that I can hear things.and almost see things too (maybe delusions)... My height is - 5 11 , my weight is - 235 pounds and I am pretty much heavy set. I am also 38 years old too, do you think I should call a psychiatrist or an on call doctor. Or just wait until this feeling has passed and this stuff is out of my body? Thank you for any input you could share with me.",
    "doctor_response": "Hello, Welcome to Health Care MagicThanks for asking from HCMBath Salts are recreational drugs that are used as drug of abuse by youngsters. These drug can cause acute restlessness, low mood, fear, hallucinations, suspiciousness and paranoid ideation. In some persons acute psychosis get precipitated. Acute psychosis is treated by anti- psychotic drugs but in some it may get complicated to chronic or to schizophrenia. As per my opinion if symptoms are persistent then consult a psychiatrist for treatment.Second generation antipsychotic drugs like Risperidone, Olanzapine etc can be used. The medicine will also decrease anxiety and stabilise mood.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persisting vomiting?\n\nHello my name is Katherine I have a 19 month old boy who has been throwing up in the middle of the night or mid morning for the past 3-4 days now. He doesn t seem to act sick, runs around like his normal self. Has a little appetite but seems fine. I m not sure whats wrong with him but I just want to make sure that he is fine and doesn t have anything serious going on.",
    "doctor_response": "Hello,You should take an antiemetic for your child in the doses depends on how much your child weighs. You should consume liquids and food. If it lasts more than two to three others day, or you see that your child dehydrated go visit a doctor. You can use Tresol giving it one tablespoon every hour to substitute the liquids lost with vomit. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Emilda Belortaja",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of persistent cough after herpes infection?\n\nmy father is having persistent cough. It is more acute in winters. He is 78 years age. this has happened after herpes infection about 2-3 years back. He is taking otc cough medicines but are not effective. He goes for morning walk in morning at 4:30 A.M. Please suggest any medication.",
    "doctor_response": "You would need to know the cause of the cough before taking any medications. Cough can be caused by a variety of mechanisms, and the treatment may vary depending on the mechanism. I don't see any connection between the herpes infection and this cough. Cough can result from lung disease, including damage from smoking, inflammatory conditions, pneumonia, bronchitis, asthma. It can also be related to post nasal drainage from sinus problems or allergies, from acid reflux from the stomach, irritation of the vocal cords/throat, or many other possibilities. It would be best that he see a doctor and get evaluated for these conditions so that a more specific treatment can be prescribed. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Heart beats hard but slow. Having murmer during teenage. History of heart problems. Am i over thinking?\n\nMy heart will all of a sudden beat really  hard but slow then go back to normal. I was told as a teenager (now 23) that i have a murmer. My grandmother had to have surgery to put in a new valve in her heart; heart conditions run in my family. I just wonder if it is something i should be concerned about. I have been really stressed lately. The only thing is that is doesn't do it all the time just randomly. So if I go to the doctor are they going to find this? And am I over thinking it? I know the heart is nothing to take lightly, so should I ask my doc?",
    "doctor_response": "Hi,Thanks for writing in.You need to have an appointment with a cardiologist and explain your history in detail and get basic investigations like ECG and echocardiography done.Doctors use echocardiography to evaluate the seriousness of heart murmurs. Murmurs are extra sounds, heard by the doctor through the stethoscope, that are produced as blood flows through an opening changed by disease or birth defect. Echocardiography records these blood flow measurements and converts them into pressure gradients, the difference in pressure between one side of the opening (at a valve, for example) and the other side, thus telling the doctor how severe the damage is. With the help of this test, the physician can determine how leaky or narrowed the valve is and identify which patients might benefit from medicines or corrective surgery.So you need not get worried because medicines are there for minor heart problems and if necessary it can be cured by surgery.Hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for excessive hair loss\n\nDear Sir/Madam, I have been suffering excessive hair loss for the past 3 weeks now particularly while shampooing or applying oil. I have very thick hair but prematurely gray so I dye it regularly. I live in London where it has been very cold for the past 3 weeks. Can you please advise me? Thanks",
    "doctor_response": "Hi.As per your case history of hairfall.My treatment advice is \u2013 1. Take good nutritious diet full of green leafy vegetables and milk.2. Use a good herbal shampoo and coconut hair oil for regular use.3. Take an iron supplement once daily and vitamin b12 supplement once daily for 3 months.4. Other treatment options are topical minoxidil, oral finasteride and mesotherpy done by a dermatologist.Thanks.Dr.Harshit Bhachech.MBBS, DDVL.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have a pimples in may face, how to get rid of it ?\n\nI have a pimples in may face !! what product to remove my pimples plzzz help me.",
    "doctor_response": "Hi! marynoordevera, Welcome to HealthcareMagic forum, Use a good antiacne face wash and apply creams like clindamycin topically and adaferrin at night over the pimples .If sever you can take oral antibiotics like azithromycin .Avoid using any moisturizers on face .Drink plenty of water and a good sleep in night is a must. take care, Dr.chawda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have history of kidney stones, having sharp pain with movement in left kidney area. Reason?\n\nHi, My name is Lucy. I m a 23 yr old female. I have a history of kidney stones but this feels nothing like anything i ve experienced with them before. Around 10am I started having sharp pain with movement in my left kidney area. Then all of a sudden a had a major movement feeling in the same spot. At the exact moment that happened I felt like my stomach dropped to my feet . Should I go to an emergency room?",
    "doctor_response": "Hello Lucy ..Thanks for your questions.I understand your concern and It seems that you are likely to have sharp pain because of restriction or passage of calculi from kidney down ureter .Its quite emergency to go to ER and get scanned for KUB .Drink plenty of water NSAIDS will not releive pain therefore its mandatory to go to ER and get treated.Hope this information is useful.Take Care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for PTSD and bipolar disorder\n\nMy husband has been diagnosed with PTSD and Bipolar 1 5+ years ago. About 2 weeks agohe was in a manic episode and went to the Dr. He changed his meds from citalopram to latuda, lexapro and busbar. He has been on it for 2 weeks and is now saying mean things to people, saying he doesn t care about people s feelings or how it effects them, He is saying he is not happy in his life and is now going to the bar. He was a non drinker for many years and has started drinking in the last month. He is secluding himself and is telling us his Dr is saying he should. I will consult his dr, but are the meds not working?",
    "doctor_response": "new molecule lurasidone has come in the market...you can try that.... you have to start with 40mgs half tablet for 4 days and then one tablet",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will using nail cutter which is used by a cancer/HIV patient makes trouble?\n\nmyself a eng student.i used my friend`s nailcutter.she is a nurse& she has doubt that she had used the same nailcutter for some cancer or hiv/aids patient some one month back in the hospital.Sir can you  please give me a answer, is it a thing to take tension.",
    "doctor_response": "hi thanks for asking on HCM, there i no need to worry dear cause cancer cant be transmitted like this and if the patient had been infected with HIV  even then if the nail cutter was not exposed to his/her blood or secretions there is no need to worry take care..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can excessive masturbation cause symptoms of anemia?\n\nHi, i am 21 years of age and above 5 ft tall. I happen to masturbate very often eventhough its not everyday. I masturbate about 3 to 5 times a day when i do so. Recently i am really weak, lack concentration, dizzz and very tired even after long periods of rest. I want to know if excessive masturbation can lead to anemia since i am feeling the symptoms of it",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.Masturbation has no side effects as you have mentioned. You can do it, even it has no anemia as a effect. Anemia occurs when you are bleeding as you are not bleeding in masturbation it won't cause you anemia.Even you can saturate desire by masturbating, so it has advantage on other side.I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can one relieve pain from a herniated disk?\n\nHi, I was diagnosed with a herniated disk a few months ago. I can t remember the exact disk, but it was L something. I was prescribed medication for pain management, had a spinal epidural and did many physical therapy sessions. I m very active (crosssfit and jogging), which I stopped for several weeks. I recently resumed without any real issues making sure my core was always engaged. However, this morning while doing a lift my back popped and I felt a poof inside the lower back. I dropped the weight ut instantly got light headed and passed out for a few moments. My coach turned me on my back and elevated my legs. I ve been feeling agonizing pain in my lower back and can only walk bent. I ve been lying on a heating pad on/off throughout the day, however the pain is almost crippling upon getting out of bed to use the bathroom. My residence has stairs and I cannot go up/down. My doctor is out of town, do I need to go to the ER or wait until her return on Monday?",
    "doctor_response": "Hello, The herniation may have progressed, so, you should not wait for your Doctor. I think an evaluation in the ER for the treatment of acute pain and the actual neurological situation is necessary. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will progynova decrease chance of conception by IUI?\n\nHi. I have an IUI due this month. Have been recommended by my gynae to take 1 tab of Progynova starting 9th day of my cycle. I have rcvd a packet of 28 tab and I m wondering if this can decrease my chances of conceiving through IUI this cycle since this seems to be a contraceptive? Please advice. Thanks in advance!! Regards.",
    "doctor_response": "Hi,I read your query and I understand your concerns.Following is my reply:1) These medicines contain estradiol.2) They are to increase the endometrial thickness.3) It does help if your endometrial thickness is less.Let me know if you have anymore questions.Regards,Dr. Mahesh Koregol",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dry and itchy skin in case of pityriasis rosea?\n\nHi there, here is my general info: I am a 22year old female. 1.65cm, about 54kg, have low blood pressure, anaemia, hay fever/dust allergy. Have a weakish immune system- always getting sick. I had pityriasis rosea and the rash stopped about 1 or 2 months ago. I was on Texa 10 tablets to help relieve the itching etc ( which was quite severe). Problem now is that my skin is REALLY dry and feels prickly, itchy and uncomfortable unless I moisturise- every day! Maybe even twice a day. Is this normal and will it go away? (Also it has left white spots/scars on my skin.)",
    "doctor_response": "Hello,Welcome to healthcare magic,It is normal for skin to be dry after a rash subsides. But usually by 2 months dryness due to rash should subside. Other possibility is your anemia. Anemia is associated with dryness of skin. And most of the patients having hay fever/dust allergy have associated skin dryness, we call Ichthyosis. I will advise you to continue moisturizing your skin daily. Treat your anemia with iron supplements and iron rich food. Avoid taking bath in very hot water, use very less soap, a soap free cleanser will be ideal. Moisturize immediately after bath. Food rich in omega 3 fatty acids are good for dry skin eg: Cod liver oil, flax seed etc.White spots post pityriasis rosea will slowly fade away completely.Hope this helped,Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the risk of swallowing hair conditioner?\n\nMy 9 month old may have swallowed hair conditioner. She spit up a couple time before I found the small foil thing they put over the top of it. I don t know what it came from other than the little conditioners that come with store bought hair color or if it was accidentally dropped on the floor. What do I look for incase she did swallow anything?",
    "doctor_response": "hi, nothing to worry about it will go out from her potty area. its very little pungent in taste and is mostly harmless. so dont worry just give water and fluids to drink.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does painful lump on top of spine with neck stiffness indicate?\n\nI have just noticed a hard like painful, marble sized lump at the base of my neck on left side at the top of my spine. My neck is very stiff and feels like a muscle pulling down into my shoulder. The lump moves when I touch it, and feels like a marble. What could this be? Any idea?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You may have occipital lymphnode enlargement. or you may have some soft tissue tumour like lipoma or neurofibroma. You should go for fine needle aspiration cytology or biopsy. It will give you exact diagnosis then you should take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had an echocardiogram. Increased pulse and body pain. Due to anxiety?\n\nI am 20 years old now. My birthday is Oct.16th and I am 14 in a half weeks pregnant. I have always suffered from Anxiety/ panic disorder since I was at least 7 years old. I have the worst symptoms of anxiety. Increased pulse , body achiness, breathlessness, but I had an echocardiogram done about 5 or 6 months ago and it came out NORMAL. But, I was wondering...Why am I feeling these symptoms so bad now that I am pregnant? I was taking zoloft and xanax 3 in a half months ago, but stopped because of the pregnancy. My Doc said that I had classic Anxiety also.",
    "doctor_response": "hi psychoactive medications have some adverse effect on fetus especially in 1st trimester of pregnancy when there is organogenesis..As you are in 2nd trimester u can take some drug which are safest in lowest possible dose after consulting a psychiatrist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should a rabies vaccination be taken for dog's scratch?\n\nlast december 2009 my 11 year old cousin was bitten by our dog,  she got all the anti rabies vaccines needed ( 4 shots of verurob + 1 shot of anti rabies serum + anti tetanus toxoid) though our dog was updated to her anti rabies shots and she just got her shot again last december 29, 2010. just this night (july 10) my cousin was bitten again by our dog on her lower lip, its a small scratch. does she need to be vaccinated again of the 4 shots verurob? thanx!",
    "doctor_response": "HIThanks for posting your query.      A minor scratch on the skin would not require a repeat vaccine but since it is on the lip I would recommend a repeat Rabies vaccination.    However for repeat vaccination only 2 dose is enough , the second dose to be taken 3 days after the first dose.    All said and done since it is your pet dog which has been vaccinated , there is no need for re vaccination. However if you opt not to get vaccinated make sure your dog is under observation for 10 days and if in this period the dog dies she has to get vaccinated. Hope this information was useful. Any clarifications feel free to ask . Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold , cough and sneezing in a child\n\nSir, my daughter is 4.5 yrs and she has problem of pollution allergy.so after consulting Dr I am giving her montair syrup and now rumilast for the last 1.5 yes.is it safe to use for such long? As I stop using the medicine she suffers from cold, cough and sneezing..plz help",
    "doctor_response": "Hi,Welcome to Hcm,Your child seems to be troubled with reactive airway disease and the medications prescribed are very much needed and its unfortunate child needs it for so long. But its not unsafe to use it for so long. Having said that, for your child to be so sensitive for so long there should be some trigger factor in your home or in the area that child is coming in contact with. You need to identify that and get it off from his life, then things should fall in place. Keep away from pollen, dust, smoke, cold etc triggers . wet mopping of home floor. Dusting and drying in sun of blankets etc are a few helpful tips. Take care. Wish your child a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment when the hepatitis is not active in the body?\n\nwhat is the treatment when the hepatitis is not active in the body. My staff is having the virus, one has been treated and given drugs but the other person was not given any drug as the doctor said the virus is inactive. does this have any effect on his health status. what drug can make the inactive virus die totally",
    "doctor_response": "Hi thanks for asking questions.You have not mentioned result of Viral marker test.You can have HBSag positive carrier ..It will mostly remain clinically silent with only few symptoms.If hepatitis is in active stage then drug useful.For inactive hepatitis drug not given..Following life style measures taken like....More fruits.Green leafy veg.Avoid alcohol if habit.Refined food and fat avoided.Avoid trans fat like cheese, burger, meat , junk food etc.Regular exerciseCumin seed with water taken daily.Use good oil in diet like sunflower oil.Take care.With detail report we can give you more guidence.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having weakness in legs, breathlessness on climbing stairs, anaemic, low vitamin d. Asthma symptoms?\n\nHello I ve been having leg weakness and shortness if breath climbing upstairs ... I m ok goin down ... I also notice my legs hurt or are weak when on a treadmill goin up a hill... Please help! Growing up I had asthma but it went away n my 20,s. it s inheritary . Also I know I m borderline anemia n my vitamin d is alway extremely low when I go to Dr",
    "doctor_response": "It is Wheat allergy Go for IGg test and Blood serum test for wheat speciic antibodies get other foods tested as precaution go for slit therapy after results",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevation in BP which is not controlled by medications?\n\nMy mom lives in corpus christi and needs to find a heart specialist. Her blood pressure is high and the GP that she see s can t seem to bring it down. Can you refer her to a doctor that either speaks spanish or has someone in the office to transalate to her.",
    "doctor_response": "Hello, The aim of this site is to guide patients through the diagnosis and treatment options. We can not prescribe medications or refer patients to specific clinics. Coming to this point, I would like to know more about her current therapy, in order to suggest possible changes that may help improve her situation. Then, you can discuss these treatment options with her GP. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for Autnomic Dysreflexia?\n\nI am a quadripglic c5 c6 level.  I am having proplems with autonomic dysreflxa  blood pressure 331/250 . I am on Xanax and methadone . and  have an impacked accending Collin. what to do er or gun store, the dr. think I am drug addic but I know better. I have been in a wheelchair since 1972.donald lapara at 985 265 4426,",
    "doctor_response": "Proper treatment of autonomic dysreflexia involves administration of anti-hypertensives along with immediate determination and removal of the triggering stimuli. Often, sitting the patient up and dangling legs over the bedside can reduce blood pressures below dangerous levels and provide partial symptom relief. Tight clothing and stockings should be removed. Straight Catheterization of the bladder every 4 to 6 hrs, or relief of a blocked urinary catheter tube may resolve the problem. The rectum should be cleared of stool impaction, using anaesthetic lubricating jelly. If the noxious precipitating trigger cannot be identified, drug treatment is needed to decrease elevating intracranial pressure until further studies can identify the cause.Drug treatment includes the rapidly acting vasodilators, including sublingual nitrates or oral clonidine. Ganglionic blockers are also used to control sympathetic nervous system outflow. Topical nitropaste is a convenient and safe treatment\u2014an inch or two can be applied to the chest wall, and wiped off when blood pressures begin to normalize. Autonomic dysreflexia is abolished temporarily by spinal or general anaesthesia.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I always have sneezing and running nose when I am inside a house ?\n\ni always have like a flu when iam home running nose and congested what could it be iam 31yrs and the problem is when get into some houses i get like a flu no temperature but sneezing and running nose or even if drink something cold what could it be",
    "doctor_response": "allergic rhinitis. you should avoid  environment and food that causes this type of allergic symptoms. and  if attack of allergic rhinitis occur than u have to take full allopathy  rx.",
    "dialogue_context": ""
  },
  {
    "patient_message": "History of miscarriage. Irregular periods. Unable to conceive\n\nhi, i have taken yamini ls for 1 and half year to stop pregnancy after birth of my first child. i got a miscarries prior to birth of my first child. the cause was thoyroid and herpis virus. after taking 6 month ocuvir the pregnancy was concieved. my periods were irregular by 5 days up each month. after first child we tried for pregnancy. since then one and half year has elasped. we are facing a grief period. please advise.",
    "doctor_response": "Hi,Thanks for your query. I read your query and I understand your concerns. Following is my reply:1) Get Semen analysis of your husband to know sperm parameters.2) Please get basic tests for your self as follows: On day 2 of cycle get FSH, LH, AMH. Get Follicular scan for antral follicle count.Get HSG ( Hysterosalpingogram ) to test patency of fallopian tubes.I hope I answered your query. I will be available for any follow up query you have.Regards,Dr. Mahesh KoregolIVF & Infertility Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest diet to improve immunity after chickenpox infection\n\nAbout diet after Chickenpox and scars after chickenpoxIam 34 yrs aged and on march 4th i got infected by chickenpox .its very severe after 5days i consulted doctor and he prescribed Acyclovir 800 ,p750,betonin syrup ,vegam 500(some thing like that), it get cured on 20th March.after that iam eating normally i have eaten Bananas ,eggs,fish(Non veg and veg) items in april. I keep on hearing many people saying that diet should be maintained post chicken pox .They say like don't eat Egg, chicken,Banana,Fish and many more items now by eating all these in future you will suffer with many health disorders like body pains leg bone pains,sugar,Bp etc.,.So please let me know what to eat and what not. And what care i have to take to cure my scars on my face like holes .at starting i didn't recognise it as chickenpox and itched the pimples so i got holes on my face. So please tell me .thank you sir.",
    "doctor_response": "Hi, Thanks for posting in HCM. I understand your concern. What medications have been prescribed would help you to recover from infection. Infection itself would confer natural immunity. However, to recover from the illness and to gain good immunity, you need to take protein rich diet. Kindly take protein supplement powder like Proteinex twice daily with milk. Include in your diet pulses and legumes. Eating groundnuts, almonds and other dry fruits will provide good amount of proteins. Also, eating fruits like apple, banana and guava would help you to provide essential vitamins and minerals. With intake of these foods, you can gain good immunity. Hope the information provided would be helpful. All the best. Regards, Dr.Ashakiran.S. MBBS., MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Fragmin effective in the treatment of factor V Leiden thrombophilia?\n\nHi I have factor 5 lieden and for many years I have been prescribed a clexane injection before I fly which was advised by the heamotologist after Getting a blood clot in my lung . Today i tryed to order my injection from the doctor as usual only to be told the health authority will not allow them to prescribe it any more! So they have given me Fragmin instead which is half the strength dose which the specialist advised and involves a lot more injections. I was also told that it was not covered by the NHS and had to pay \u00a334.00 privately. In the pharmacy I could see clexane on the shelf so it s obviously available to some . I m confused , can you put my mind to rest that Fragmin is as effective ?. Thankyou Sally",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Yes, it is useful in factor five Leiden mutations dosage may vary boy usual dosage is 150-200 Iu/mg once a day. As a prophylaxis dosage may be 100-150 Iu/kg life long treatment may required. Also check for injection site hematoma, thrombocytopenia or major hemorrhage etc. If symptoms not improved please consult your doctor, he will examine and treat you accordingly. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do after taking overdose of cramffic plus after chemo?\n\nhi my father took an overdoze of cramffic plus (around 6 teaspoons between afternoon and night) and that is causing loose motions and only dark green stools are coming with bad stink.Please suggest. He took his first chemo(Gem + Cisplatin) last week and was having a lot of constipation.",
    "doctor_response": "Stop cramffic temporarily. Feed him bulk forming foods for a day and lots of fluids.A not so raw banana will help.Start on cramffic with your docotr recommended dose after his bowel movements normalise.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pneumonia in a baby?\n\nMy baby has pneumonia, and he s been coughing and choking very hard, he can t catch is breath, it sounds like he s drowning. He s also breathing very heavily like he s having a hard time breathing. I ve already given him his steroid medicine and he just had a breathing treatment. What should I do?",
    "doctor_response": "Thanks for consulting at Healthcare Magic.You need to consult pediatrician as soon as possible. Your baby is in respiratory distress and needs urgent clinical evaluation and treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can calculi in kidney be treated ?\n\nhi doctor i was a patient of calculi in kidney size 5 mm in middle pole and 6mm in lower pole what can i do for that problem please help me?",
    "doctor_response": "HI, Keep waiting if pain is not severe and frequent.Review every 6 months by ultrasound.Take plenty of fluid. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have severe foot pain. Kindly review my X-ray.\n\nHello doctor, Foot pain started 18 months ago after running. It has persisted, but the severity of pain depends on how active I am. Most recently, the pain has become more severe. Please review my X-ray.",
    "doctor_response": "Hello. Please send me the full X-ray which you have sent (attachment removed to protect patient identity). I would like to see the whole joint, like of talocalcaneal joint.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is Cymbalta prescribed for?\n\nyes, how much of a pain killer is cymbalta? My pain management Dr. put me on cymbalta and no pain meds my concerns are withdrawal from my pain meds and will the cymbalta be sufficient in place of pain meds. i understood he was goimg to change my pain meds to oxcodine but he didn t. what happens to me now?",
    "doctor_response": "Hi, Cymbalta is a mediocre antidepressant that also has effects on stress hormones. Increased stress hormone levels at the level of spine and probably brain, block or take attention away from pain. So, everything is the same but the feelings are damped down. It doesn't actually lower pain and generally, it is not enough by itself. This is more likely to work well the more the pain is due to nerves and spine nerve or spinal pain and less if it is due to a non-nervous tissue cause. So, a lumbar disk hitting nerves or spine will lower pain some with Cymbalta but there is enough direct trauma that it won't work completely. On the other hand, a disorder in which the nerves are the whole source of the pain such as shingles or fibromyalgia might be really helped by just the Cymbalta. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for back pain?\n\nHi sir good morning, my self Vamsi krishna from Nellore Andhra Pradesh, and I'm suffering from back pain since 3 years and I've shown to Dr sunandha Kumar reddy in tirupati about my healthy injured he said some exercises apart from that over not recovered so please help me to recover my health",
    "doctor_response": "Hi, Thanks for writing your query. After reading your post, I would like to advise that you should get a MRI of Lumbosacral spine done. Physiotherapy will be helpful. Hot fomentation and application of pain relieving gel will help. You can take painkiller like Ibuprofen twice daily after meals along with serratipeptidase and muscle relaxant like Chloroxazone and an antacid like Omeprazole 40mg once a day before meals. Clinical examination by an Orthopedic surgeon will help in planning further management. I hope this is helpful to you. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes uncontrollable muscle movements and headaches?\n\nI have high blood pressure, really bad headaches which have sent me to the er, tingling in the arms uncontrollable muscle movements and bad muscle cramps really bad night sweats and hot flashes during the day. I m on depression and anxiety meds and bp meds. Lately my headaches have gotten worse ( everyday) and I m starting to become really scatter brained and my muscle movements are getting worse I don t know what s going on",
    "doctor_response": "Thank you for asking Healthcare majic. My name is Dr Ehsan Ullah & I have gone through your query.As you are having Generalised anxiety disorder with depression the above mentioned problems are due to bio-chemical changes in brain i.e. decreased level of GABA and inc level of Serotonin...    tab.escitalopram 20mg once a day    tab. bupropion 150mg once a day     cognitive behavior therapy you will feel better with above mentioned drugs and therapy class within 21 days and enjoy life as others do.Hope this may help you. Let me know if anything not clear. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling of fear on seeing new person, driving, fan movements. No relief with treatment. Cause and remedy?\n\nhi i am S.K.NAG from bhubaneswar,i am always feel affraid to see building,new peson ,whn drive bike,when i sleep at room ,to fan movement, when i going on lift ,when i see showroom.i am suffering this since last 1 year,i am consult doctor but i am not ok til now. plase give me information about the problem what can i do .",
    "doctor_response": "Dear Cocerned., Thanks for writing to us. The condition you are describing is a simple mood disorder termed as \"Phobic Neurosis\". The treatment involves finding out the root cause of Phobia by Pschoanalysis and treating the same by constantly speaking to you or invoving you in Psychotherapy by a qualified Psycho therapist/Psychiatrist.It is a long term treatment. In addition Oral Anxiolytics or Tablets are also prescribed for this as adjuvant therapy. Consult a Psychiatrist pls. Thanks, Regards., Dr Lt Cdr ASN Bhushan.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What precautions are to be taken after getting a stent?\n\nMy husband (age 60, 2 generation paternal cardiac history, regular medical care including ekg s, but not medicated for high blood pressure or cholesterol) suffered a 90% blockage in his Left Anterior Descending Artery and blockage in the diagonal. The cardiologist says he probably had a 40% blockage and an unstable plaque event brought on a sudden major blockage. Excellent care avoided the big one but he suffered a procedural heart attack when the diagonal collapsed as a stent was put in place in the LAD. 1. Please clarify how the diagonal may have been lost. 2.Could one regain that 10% lost function? 3. What could be ongoing consequences? 4. Is his risk of another event now elevated? Thank you very much.",
    "doctor_response": "Hello Welcome to HCM. The diagonal is a branch arising from the LAD. They may be single or multiple. It is a common complication during angioplasty of the LAD that the diagonal origin gets pinched off and the vessel shuts down. This causes lack of blood supply to the area supplied by the artery leading to heart muscle damage and a minor heart attack. The intensity depends on the diameter of the diagonal which varies from person to person. In some people its very small and its closing off doesn't cause a problem . It can be moderate or large sized also. Since heart muscle is damaged with the diagonal shutting off some amount of the hearts pumping function is lost. Usually since the diagonal supplies only a small portion of heart muscle, it does not lead to much drop in pumping function and in most of the cases the normal lv pumping function is achieved in about three months. It happens with about 10-15 % of patients undergoing an LAD angioplasty and does not have significant consequences. Also it does not raise the probabilities of further adverse events. Hope I have answered your query satisfactorily. Wishing you good health Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does chemotherapy session continue for stage IV cancer?\n\nHi, my step dad is 76, he was diagnosed last year with stage 4 cancer, tumor in the pancreas, in the lung, spots on the liver, and surgery  at the same time for cancer in the hip, putting a steal rod in, followed by radiation. They were going to do radiation on the brain, after the hip, but decided not to on the brain. He has a non currible cancer, treatable, but fast spreading, he just found out today he has 3, 3cm tumors on the lung, 1 effecting his esaughagus, which is causing him to have trouble swallowing and breathing. He will recieve a double wammy of chemo on Tues. When would a Dr. stop chemo? My dad would never tell the drs if the chemo made him sick, thats why he is getting strong doses. He has been sick everyday in the last year.",
    "doctor_response": "Hi,Thanks for writing in.Pancreas cancer is a challenging condition and survival depends on the stage of detection. In most patients having stage 4 cancer the survival can be extended up to 2 years with recommended treatment and supportive care. Your father has a stage 4 disease and therefore requires chemotherapy to extend his survival.Since the cancer has involved the pancreas and also seen in esophagus, liver and lungs, unfortunately he might be in the final stage of disease. The fight against cancer is till the end and if his general condition permits then his chemotherapy can continue till he is able to withstand the treatment. His pain relief also requires attention and he must be allowed sufficient pain relief medicines and live in comfort. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a feeling like rib cage is pinching the abdomen?\n\nI have clicking under left lower rib cage with either palpation of left upper quadrant or when slouched over. It occassionally almost feels like my rib cage is pinching my abdomen. No pain except for o ccassional moderate pain after eating. Ive been extra tored recently but attribute that to having an 8 month old.",
    "doctor_response": "mostly hiatal hernia with or without gastritis.an upper GI endoscopy can confirm that ..do you have reflux disorder ?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My HIV test reports came nonreactive. Still, is there any chance for HIV infection?\n\nHi doctor, I had a partner. I have not done sex with her. But I have kissed her. I do not have any symptoms till 80 days. But my fear and anxiety got increased. So after ten days, I did a tridot test. It came nonreactive. After ten days, I had a problem of having frequent urination and itching. So I consulted a doctor. He asked me to do a urine test, and the results came normal (with pus cells of three to six). Again, after ten days, I did a card test for HIV, VDRL for syphilis and HBsAg. All the results came nonreactive. After a few days, I got sores inside my lips. So I was planning to take IgG test for HSV. Is tridot test taken for HIV is reliable? Is there any chance to get gonorrhea and chlamydia after 100 days? Is IgG test is reliable after four months? Please advise.",
    "doctor_response": "Hi. Tridot test for HIV is reliable. There is something called window period in HIV. It usually ranges from two to three months where the test for HIV will be negative. In such cases, the test has to be repeated. Since you have done the test after three months, this test should be conclusive. VDRL (venereal disease research laboratory test) and HBsAg test (hepatitis B surface antigen test) are reliable. If they are negative, it means that you do not have an infection. Gonorrhea symptoms will start within two to five days of contact, and chlamydia comes within 10 to 14 days of contact. The chances of having gonorrhea and chlamydia after three months are minimal. For Herpes, you have to take both IgG and IgM antibodies test. IgG antibody indicates past infection, and IgM antibodies indicate present infection. If you have blisters, then IgM will be positive. If IgG alone is positive, it suggests about the past infection. I explain about pus cells also. Pus cells are polymorphonuclear leukocytes and neutrophils. There should be more than ten pus cells in the urine per high power field for the urine test to be positive. Having three to six pus cells are not of much significance. It should be more than 10 to be worried.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for loss of concentration\n\nMy boyfriend has a problem with concentration every 6ish weeks. He has periods of about 3 days where every so often he goes hot, can t think properly and can only perform basic actions which lasts about 10 minutes. He s had it for at least 3 years but wont go anywhere about it. I m sure its not normal. thankyou",
    "doctor_response": "earWe understand your concernsI went through your details. I suggest you not to worry much. From the given symptoms it is very difficult to diagnose any problems. But I can assure you that there is no such mental disorders which has symptoms as you mentioned here. Please consult a psychiatrist / psychologist if you want to know more. If you require more of my help in this aspect, Please post a direct question to me in this URL.  Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does DMSO help cure back pain?\n\nDMSO was recommended to me by a delivery person last week stating that it took away all her arthritis pain like magic.  I ordered and received it just now and there are no instructions for use.   It's an 8 ounce bottle of liquid DMSO.  I have horrific back pain and don't use how to use it.  Rub it on, drink it, ???",
    "doctor_response": "Hello,I would say no to use this product. It has been used before but has many side effects and it should not even call a drug. I think not to drink for sure. Regarding rubbing the skin, since you have bought it now and did spend the money can try once, as the effects on the skin are not so big if you drink it.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Edvin Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does my baby urinates in her jammies?\n\nHi, may I answer your health queries right now ? Please type your query here... for two days now,my 2.10 months old baby girl, pees on her jammies.she would tell me she wants to pee but before i could even take off her jammies, she would already pee",
    "doctor_response": "Hi, It is usual for children of this age to have such accidents, regular taking her to the toilet might solve the issue, like after meal or after drinking water, before going to bed and early morning. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. SHEHLA USMAN, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "When can Advil be taken for muscle soreness if having a clot near ovary?\n\nI went into the emergency room for pain last week, about 2.5 months post hysterectomy, and they did a catscan which found a clot near my ovary. They didn t seem concerned, and said I had a contusion from a hit I received in the abdomen. Some of the reading I have done says they will give anti-coagulants and antibiotics, but they sent me home and said no advil, because that can make the clot worse. I feel like I need the advil for the muscle soreness. How long do I need to wait to start taking it again? Should I worry about the clot?",
    "doctor_response": "Nothing much to worry about clot it will resolve after some time. ..u can take advil after consulting your doctor",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain in front of stomach, loud stomach noises. Had full period last week. Any ideas?\n\nHello, I am having very bad stomach pains; it\u2019s not at my sides where my ovaries are but right across the front of my stomach, and im making very loud stomach noises? I cant keep food down this past 3 days ? i want to see if its just a bug or should i go get checked at my Gp? I hda my full period last week and all felt normal. i keep drinking plenty of water",
    "doctor_response": "hi there, looks like you are suffering from a case of gastroentritis. It could be bacterial, amoebic or some times even viral. You will need to get your stool examination done to know the cause and get treatment accordingly. In the meanwhile you could try taking antispasmodics and plenty of fluids and some antiemetics like ondem.Usually the non-specific diarhoeas subside on its own in 2-3 days but as your symptoms are continuing you should visit a GP to get to the root of the cause. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes experiencing random electric shock feeling pain in my left knee?\n\nI have been experiencing random electri shock feeling pain in my left knee. It lasts about 10-20 seconds and it doesn t happen every day. It happened last night when I was sleeping and it woke me up. It happens when I sit, stand, walk, sleep, etc. Nothing seems to trigger it. I do notice that if I push on the spot that feels the pain, it does feel a little tender afterwards. But otherwise, I have no pain afterwards. I want to know what kind of doctor I should see.",
    "doctor_response": "Hello.I think you are facing with the problem of the joint.Specially since you have tenderness in the joint.I think you should therefore meet an orthopedician.Best of luck.Dr Mittal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant stomach pain?\n\nI have an smaylese level of 174 and lipase of 134. Have stomach pains some days snd no vomiting.all imaging tests so far are normal have had eus 2 ct scans snd MRI all are normal.what do you think might be going on ? This has been going on for almost one year. Is this chronic pancreatitis? Some months my lipase levels are normal but my amylase is always elevated to about 170. Please advise",
    "doctor_response": "Yes this pain can be due to Chronic Pancreatitis or may be due to dysfunction of the sphincter of Oddi . The best confirmatory test is MRCP and ERCP with visualization of the pancreatic duct. The Sphincterotomy at ERCP can be diagnostic as well as therapeutic .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Moody, sleeps a lot, poor in study, behaves abnormal\n\ndear sir, my brother is suffering from strange disease .his behaviou is abnormal.he does the work as told by us or drives vehicle.but he sometimes have differnt mood .he thinks one of our relative is creating problem in his path.he dislikes him and abuses him.he sleeps a lot.doesnt earn.he is poor in studies hence didnt get job anywhere.he is now thinking guilty for not studuing in childhood.his age is now 30.he is not social or doent have any friend.he feels guilty that due to negligence in studies in childhood he is facing this day.",
    "doctor_response": "hi welcome to healthcaremagic take him to a psychiatrist and he requires a psychological rehabilitation at the earliest hoping to find your brother get back into mainstream regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the sugar level to increase suddenly?\n\nmy siste she is went to mayo at lacrosse wi she has blood sugar of 106 to me that s borderline diabetis she is 46 yrs old. they have no follow up for her or for her to do blood sugar tests. what is wrong with this picture? also she had leuks in urine high plus sugar high. no follow up ???? what should she do? she has history high blood pressure which was 145/95 and they choose to do nothing. she has history of thyroid disease also. no follow up????? I am sister and rn and what should we do. she feels because she is on badgercare through Wisconsin that they don t care. I agree",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Get HbA1c tested to evaluate for diabetes mellitis, if normal, follow-up after three months with test again.2. For urinary tract infection, get urine culture and sensitivity and start appropriate treatment with prescription from your doctor.3. Blood pressure is mildly elevated. Weight reduction, low salt diet and moderate exercise will help you. Followup blood pressure evaluation, every 15 days, until its less than 140/90.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain\n\nHello! 17 years ago I was in an accident and my lower back was completely fused(mid waist down). Three months ago I was on vaca and did a underwater back flip. Nothing that hurt. Just messing around with my sister. Since then the indentation has greatly increased in my back and I have experienced a great deal of more pain. Before this, back pain would come and go every other month for a day or so, nothing big and it was nothing that I could not deal with. Since the vaca I have had back pain almost every day. Should I be seen or is this simply a pulled muscle?!!",
    "doctor_response": "Hello, I have studied your case. Yes it can be pulled muscle also but there can be nerve compression also.Due to compression of this nerve root there can be pain in your back.I will advise you to do MRI spineFor these symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.I will advise to check your vit B12 and vit D3 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is sweating, lightheadedness and nausea symptoms of virus infection?\n\nI thought that I had a virus for the past few days, but it is not getting much better.I am having unusually high blood sugar numbers and cannot get them down below 200. I am having profuse sweating, light headedness, pain in my upper abdominal area, nausea. I don t know whether to go in to the er or give it a few more days to see if it is just a virus.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You may have some viral infection. You should go for complete blood count and malarial parasite test. You should also control your sugar level. Control your diabetes first. And take treatment of your viral infection according to your complete blood count report.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a lump in vaginal area with itching, soreness and discharge. Please help.\n\nHello doctor, I am a 33-year-old female. I am concerned about a lump on my genital area and I am very worried it is a wart. I have had this problem on and off for about eight months now. I also have vaginal itching, soreness, and discharge. I visited a sexual health clinic and they said it was not herpes, but I am still suffering with the symptoms and the lump seems to have grown. Please help.",
    "doctor_response": "Hi. Please provide me dome details. Do the blisters appear first then this type lump? Is it painful? Does every time you get only one such lump or multiple also? Do you have any fever? Have you noticed small blistering anytime? It will help me figure out your problem. For time being it is difficult to conclude it as a wart, but if you give the above information then it will be easy to conclude. Serum IgM and IgG for HSV (herpes simplex virus) 1 and 2, if possible serology for HPV (human papillomavirus). Follow up with details.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Unable to impregnate girlfriend. Does not use drugs, does not masturbate. Causes for infertility?\n\nhi doc my name is XXXXX i have a question. I was married for a year and a half and never got my wife pregnant. after we got divorced she got pregnant by a guy who does drugs. so i then tried with my girlfriend who wanted a kid didnt get her pregnant. i dont do drugs and dont masturbate and i was wondering why i cant get a girl pregnant",
    "doctor_response": "Hi thanks for your question. The cause of infertality  (unable to get pregnant or make your girl friend pregnant,) lies both with male and female.Since some other guy made your  X gril friend pregnant ,it means cause lies with you . Consult nearby physician and get yourself investigated for infertality . You may need your seman analysis along with many more tests. Hope this answers your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach ache with microscopic hematuria?\n\nMy eight year old grandaughter has had a stomach ache for 7 days now, for the first five days she rated the pain as 8/5 on scale of 1-10. Took her to emergency and the non visible blood in her urine is 6. CAT scan and xrays and blood tests show everything is okay. She looks sick, eyes sunk and skinny. should parents pursue answers?",
    "doctor_response": "Get urine culture done and where exactly the location of pain? get urine nitrites, RBC casts and pus cells as well her BP to be checked. rule our AGN UTI and she is dehydrated with lack of appetite and fluids are neded.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the optimal height for men?\n\nI am 17 years old,1.81m tall, and 62kg. I have a question about the relavation of skeletal system's organs.I have heard that a man's height should be equal to the lenght of his opened arms, the lenght of my opened arms is 6'4\" but my height is 5'11\". I wanted to know does this mean that my height is going to grow to that lenght?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.There is no Ideal weight or height to be specific. Instead you can ask this like \" what is the ideal weight for my height or a person of my height or vice versa\" . Body mass index (BMI) is used to point ideal weight zone for certain given height. It indicates your physical health if your are overweight or underweight. You can check the same here at BMI Calculator .Try to maintain yourself in this zone. Everyone is different & unique and there are billions of people like us on this earth. Some are shorts & some are long depending upon genetics. So whatever you have got its unique, natural and best.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of potential pregnancy?\n\nI had unprotected sex on new years eve while on the 2nd last day of my period... is it possible that I am pregnant? Should I take plan B? I usually only am on my period for 5 days, and this time it was no different, and usually i get my period the same time of the month every month, but not exactly the same amount of days apart all the time.",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the 2 nd last day of period is safe period and there is no need of plan B.Relax .And wait for the period.There is no chance of pregnancy if intercourse is done during or 1 week on either side of periods.So avoid stress.And check for the period.Even the stress causes hormonal balance leading to delayed period.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in wrist?\n\nI have pain in my wrist. I cannot bend my right wrist forward as far as I can my left. I have been tested for arthritis and only have a little. I had testing for carpal tunnel about 3 years ago and it was negative. It is affecting my everything from my writing to opening doors and many other things.",
    "doctor_response": "Hello, As of now, you can use analgesics/anti-inflammatory combination like aceclofenac/serratiopeptidase for symptomatic relief. If symptoms persist better to consult an orthopedic and get evaluated to rule out possible causes like carpal tunnel syndrome. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest ayurvedic treatment for diabetes\n\nI am a diabetic patient for the last 8 months. I want to take ayurvedic medicine instead of allopathy medicine. I dont want to take allopathy medicine because if one takes it, it is to be taken for a life long time. What medicine I can take. My sugar level is FBS 249.",
    "doctor_response": "Hai,I appreciate your concern. Diabetes is not a disease,it is a disorder.. more clearly it is  not like  taking medicine for some period will cure the disease.what ever system of medication for diabetes you should take treatment  or manage for life long. As your fasting blood sugar is moderately high. as per Ayurveda system of medicine diet,yoga and medication combined together will help you in maintaining  diabetes.As per your Body mass index you should schedule your diet.Foods having high glycemic index should be reduced and eat more  leafy vegetables in your food.Add millet group of foods (ragi,bajra,)in your daily intake.you can split your daily intake into 5 to 6 times without altering daily total intake.(minimal intake at one serve.)wheat and wheat products and fruits like guava,orange,papaya,can be added. comparing to  physical exercise, yoga will give refreshment to the physical and mental health. certain yoga posture  will help in inducing pancreas to secret insulin. (hormone much needed in glucose control.) herbal like,amla,turmric,neem,guducci (tinospora cordifoila,) etc many herbal composition available in market will control blood sugar level. medication  like nisaamalaki,setebid. Above advise will help you in controlling diabetes.however i advise you to consult Ayurvedic specialist to go for  a proper investigation and medication.wish you a healthy life.thank youHope i answered your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat multiple CVA stroke?\n\nhi i am tapas ghosh from india.my father is suffereing multple CVA stroke in last 1.5 yrs.He had weakness in rights legs and hands,speech,facial distortation.he is taking multiple medicines everyday.but stroke is happening with these medicine. he is 54 .",
    "doctor_response": "Hi, If your father is aged 54 then, he would be considered \"YOUNG\" in the sense that his strokes may have underlying causes that promote or cause the formation and release of blood clots. This means that it is possible that the medications he's taking are not really the best type for his type of stroke he's experiencing. Your father should undergo what we refer to as a \"stroke in the young\" workup which involves a number of blood tests that are a bit specialized and not usually obtained during routine followup visits. I would recommend finding a neurologist who is specialized in stroke and if possible stroke in young patients such as your father so he can be thoroughly and rapidly worked up to discover either a CAUSE for these strokes or to get on a reasonable regimen of either anticoagulant,  antiplatelets, or perhaps some type of Antilipid/cholesterol set of medications. Your father would also likely benefit from tests such as electrocardiogram (12 lead) along with a 30-day EVENT MONITOR as well as an echocardiogram study with bubble study and then, in addition, a transesophageal electrocardiogram (TEE) to check for the presence of blood clots in the left atrial chamber of the heart. This is not an uncommon presentation and concern in the face of the number of strokes your father is having despite being on medication. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure headache and increase self confidence level?\n\nDear sir recently i hav complited my MBA bt still looking for gud job.nd my problem is that i m thinkig very much negative before doing any works....never think positive...nd always take tenson though i never want to take.bt due to some family issues i am not abble to overcome my problems.i always think that everyone is talking against me and i react it very badly nd also be upset all the time nd everytime get emotional ....alwyz suffering form headache. sir please give me some suggestion so that i can handle all this kind of problem. daizy",
    "doctor_response": "hi dear,as you described that you always have negative thoughts in your mind like every one is talking against you and than you react badly with every one. but this kind of behavior affects your relationship and work up to what extent?whether anyone of your family member thinks that you are suspicious?any other features associated like easy irritability, hearing of voice, not able to concentrate, felling low, loss of interest, sleep and appetite disturbance etc..consult psychiatrist for detail history and mental status examination.not to worry much all will be good.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain and frequent bowel movements?\n\nDear Doctor, My son is about 4 year old and complaining of stomach pain since yesterday night. he has also frequently passing motion and has passed motion 5-6 times during the day. The motion seems to be normal (no loose motion). After Passing motion he feels good. could you please advice us how to go about it.",
    "doctor_response": "This is just a viral infection of the gastro-intestinal tract. Stay with him, give him plenty of water with electrolytes, rest, and light, easy to digest food. For the pain, you will need to give him paracetamol syrup, 5-6 ml per dose, up to 3-4 times per day as needed by him.Dr. Taher",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain?\n\nI am a 54 year old city bus driver, I started ex periencing back pain last wednesday,just a light uncomfortable pain located about the mid back or around the rib cage area, by friday the pain was so severe that i had a hard time walking & talking, the pain was taking my breath away. to better describe the pain, i experienced a lower back sprain back about 15 years or so. the pain is very similar extending all the way to the front at times, i sure would like to know what the problem is. i do have some excess weight with a pretty good bellie",
    "doctor_response": "Hi, thanks for posting your concern in the HCM. Back pain occurs due to numerous reasons. For a midback pain, radiating to the front, any spinal pathlogy should be ruled out including spondylosis, PIVD, tuberculosis etc. Alongwith that any pathology involving the liver, pancreas, kidney and lung or mediastinum or git should be ruled out. You should consult your local doctor immediately.  Routine examination of blood and urine, imaging of the spine, Ultrasound scan of the abdomen, Xray chest, amylase, lipase, liver function test may be necessary depending upon the clinical findings. For symptomatic relief from pain you can take Paracetamol tablet 500 mg SOS ( at least 6 hr interval) until you visit your local doctor. Good oral hydration should also be maintained.  For any other query please write back to us. Regards. Dr. Kaushik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the treatment for mood swings and obsession?\n\nHello doctor, One of my relatives is facing some psychological problems for quite some time and she is under treatment as well. She has the following symptoms:  Mood swings. Everything available she wants to eat even though she is not hungry. Every time if anyone goes to washroom she also goes even without any feeling of nature's call. Sometimes she displays an obsession with her husband and daughter. She otherwise remains normal in front of strangers but in presence of her husband and daughter she shows obsessive behavior and becomes furious over petty issues as well.  She is undergoing treatment but not much improvement is seen. Following is the list of medication: Procyclidine, Clobazam, Risdon LS, Amisulpride, and Theophylline.",
    "doctor_response": "Hello. Her symptoms suggest some psychotic behavior but this should be evaluated in detail. Mood swings with episodes of irritation, anger outbursts could be part of some mood disorder. She eats a lot, she goes to the washroom without any need and this might be due to abnormal behavior resulted due to some psychosis. What kind of obsession she has? Please describe in details. Does she show behaviors like overspending, not listening to others, feelings that only she is right and others are wrong, argumentativeness, reduced sleep, over religious behavior, etc? These behaviors are seen in mood disorders. If she has symptoms like hearing voices which other cannot hear, suspiciousness, ideas that others are talking bad for her, etc? Her symptoms and medicines given to her suggest some psychosis. Though more evaluation is needed.  For more information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for abnormal behavior?\n\ndear sir, i m 34 years old. My husband is 30. I love my husband. He also. But i didn't feel that my family life is good. He has no liability. He does'nt have any job. or not a business. I had marries in 2005. I have a very cute son AUM. My husband does'nt give me 5,000/- Rs.He quarrels with me in little things like if I had late, I had tell my feelings for my in laws. He forces me to go my in laws house when I don't want to go. He insults my parents in every way. He beats me also. If my parents give any things to my son, he quarrels with me. When we go to my in laws house he behaved like a king, he has no worries for me & my son. I can't adjust my in laws. He was pampered by their parents and sisters. He is not sincere about his career, his wife ,or his little cute son. He becomes a boss in each and every discussion. He does'nt want to understand my feelings. He wants kathputli as a wife.My family background is educated as well as not his. His background is so poor. Our marriage is love marriage with concern our parents. My parents advised me for not get married. V had not live together last 2 months. His behaviour is very normal to others, but it is very very good. I think that he has a spilt personality. In short I m afraid of him. I can't share my feelings with him. I don't want to take divorce, and he also does'nt want. But v can't live together. What i have to do sir? Please help me.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  You are talking about a problem which is found almost in every family. That is where you should understand its commonness. You should understand that you, your husband and your children are family. Every other person is a third-person. leave them, don;t worry about them. love your husband and children, and they shall love and respect you. Visit a family counselor with your husband.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be concerned about bleeding while brushing a week after jaw re-alignment?\n\nHi mate,A week ago I had screws and bands put into my jaw to re-align a break.Today, while spitting out toothpaste after a brush, I noticed that there was a significant amount of blood in the toothpaste. Would this be anything to be concerned about?",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. As you are mentioning that you noticed bleeding after a surgery, while brushing,  then you should visit your dentist again,  ad this bleeding can be an indication of infection in the wound,  or it can just be a bleeding of gum infection. You should visit your dentist and get it examined properly as then you will be confirmed. Hope it will help you. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hip pain that radiates towards thigh and knee\n\nI have been having hip pain that runs to my thighs and then to my knees. The pain is so intense that it wakes me up at night. I have been having this pain for about three months now and have not gone to the doctor thinking maybe I have a pulled muscle or something. What can it be?",
    "doctor_response": "hi,thank-you for providing the brief history of you.A thorough musculoskeletal assessment is advised.As you have a pain which is radiating in nature it can be due to pinched nerve in the lumbar spine. when the nerve root is pinched in the lumbar spine the pain follows the course of the nerve and radiates down towards the lower limb.Also, taking an MRI will be helpful to understand the disc degenerative changes in the lumbar spine.Followed by which with physical therapy like therapeutic ultrasound therapy and TENS therapy the pain will be reduced. also later stages exercises will be implemented to strengthen the spinal muscles and also to stabilize the lumbar spine.In my clinical practice, we follow evidence based practice and most cases recover well.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Irregular periods, diagnosed hypothyroidism. Home remedies?\n\nmy marriage time 1yr and 6 month after marriage i have regular period but after 8 month i have irregular period i m consulting doctor and he told me this is by harmonal change but again i tast thyroid i have thyroid hypothyroid . and other taste are normal my husband and my . we want to plan for baby so what can i do for any treatment of any home made treatment on that . my husband job is touring so relation is not regular my problem last date is 17 th august what is ovulation period.pls reply",
    "doctor_response": "Hello, Thanks for approching. some Guidelines which you can follow for your Hypothyroid. Take adequate quantities of milk,water  in your diet. Increase intake of brown rice, barley, Bengal gram, moong dal,bran. Avoid heavy and sour foods. Avoid soya and soya products. Some Home Remedies: Mix equal quantities of long pepper (Pipali), black pepper and dry ginger powder. Consume half teaspoon twice a day with lukewarm water. Chew Licorice (mulethi) and Black Pepper in a 2:1 ratio three times a day. This will help in maintaining your TSH levels.But if they are elevated,then better go for any Homeopathic/Ayurvedic/Allopathic medication. take care, Dr. Tanju Khurana",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump on the knuckle\n\nI injured my hand and had to get stitches across my middle knuckle. It s been a month and the cut has healed but I still have a lump on the knuckle, furthermore, I still have pain while moving it. How long will it take for the lump to go away? Also, what can I do to get a full range of motion back in my hands?",
    "doctor_response": "Welcome to HCMHi I am Dr Fahim and I will help with your QueryI have gone through your question. I need to illicit some more information.- Was there any bone fractures of metacarpal (Hand Bones)?- How deep was the wound?- Was there involvement of any tendon or associated structures?- What are the overall range of movement of  your hand?- Does the lump moves with flexion and extension of the fingers?It appears that the lump is a part of the healing process. If it moves with finger movement than it may be associated with tendons, which will require a look by your treating surgeon. Pain will go will time, start some physiotherapy like holding a tennis ball in hand and pressing it. Hope this will help you with your problem. If problem persists do come back to us with answers to above questions. Wishing you rapid recovery.I hope this will help you. Do rate my answer if like it.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having noticed bruise with intense itching at the foot\n\nhello, I am a fit fifty year old female and seem to bruise spontaneously . I get an intense itch and then a swelling and large bruise in a matter of minutes. Yesterdays was on the outside of my foot at the base of my baby toe. Just wondering what may cause this. It has happened over the last several years on a few occasions on my fingers but never on my foot.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.It is a allergy of some kind. This will increase with each exposure.The best treatment for this condition is the prevention of exposure. If you prevent the allergen it will never causes such a allergic swelling.For prevention purpose you can use gloves, emollients, vaselline etc. This will make a layer over the skin and can help prevent exposure of allergen.If by mistake you receive allergy than you can apply steroidal cream. Betnovate cream can be help ful. Please consult doctor before you apply the cream. I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recurred pigmentation on face after stopping Melacare. Advised clearway cream. Help with permanent cure\n\nHello Doctor, I am suffering from Facial pigmenation problem (due to hormone imbalance) for the last 2 years. As per the Dermotologist, used Melacare for a month at night times with Suncross sunscreen during the day time for every 3 hours, pigmentation vanisheed completely, but when I stopped Melacare, pigmentation patches became worst than before. Dermotologist advised to go for 6 Glycolic peels + 2 TCA peels to be continued with Banatan cream in the night and Sunscreen during the day. Till now, underwent 3 Glycolic peels for about 35% concentration, after every peel have PIH problem, its looking very dark, worst than then pigmentation. I was asked to use Clearway cream by the Doctor, on the new patches for 2 weeks and then again to continue with peels. I am really confused now and lost hope to continue this treatment. I feel very low to go out and face people or meet office friends as everybody questions about marks on my face. I am requesting your best advise and medicine to treat this pigmentation, with permanent cure is really appreciated.",
    "doctor_response": "Hello, Thanks for writing to healthcare magic.You are having melasma.It is somewhat resistant to treatment.It is a common cosmetic problem in females and it will subside as age advances.Treatment which you are reciving is correct and continue with that.Only thing I want to add is get your thyroid checked.Also if you are taking any birth control pills stop that.I hope this will solve your problem ,to some extent.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does chlamydia affect fertility?\n\nI had routine blood tests for infertility and it came back as borderline for chlamydia antibodies. The report said it was indicative of a past or current infection. I need to do a urine test to confirm. Is it possible that I had chlamydia without realising it and it resolved itself without treatment? If so, will that still impact my fertility? Both my tubal patency test and pelvic ultrasound came back normal.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Nice to know that your tests are normal. You ought to get treated well for chlamydia, no worries its just borderline and can get treated. Yes, Chlamydia infection does interfere with the fertility of both men & women. So get rid of it at the earliest. In women it can cause Pelvic inflammatory disease (PID), infertility, blockade of Bartholins gland affecting vaginal lubrication, cervicitis, ectopic pregnancy. In males it may cause epididymitis & affect fertility. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart beat feeling with cardiac ablation?\n\nwhy can I hear my heart beat all night long and during the day if not busy. I had a cardiac ablation 3 months ago for pvc's and three weeks later i eas in bigeminy again. I am now taking rhyrhmol 225mg sr which has me in rhythm and my blood pressure usually runs on the low side.",
    "doctor_response": "welcome to hcm ..please note that bigeminy and pvc etc give rise to abnormal heart beats and forceful heart contractions ..these are felt by some personsif rhythm is in control the low bp is due to drug effect if you are troubled by low bp as you feel dizziness or lightheadedness as you stand from sitting position then you should consult your doctor he may adjust dose of drug",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Mucolite and Atarax vaccine safe to be given for cough?\n\nHi my daughter is 3 months old, she has been having cold since birth. Now she has started coughing and sneezing too, I feel she has blocked nose too for which doc has recommended nasal drops. At night I can hear weezing sound while she is asleep. Recently my pediatric checked her and told that she doesn t have cough but still she is coughing . She also suggested 8 drops of Atarax drops twice a day for 3 days and Mucolite drops thrice a day for 3 days. I just want to confirm if the drops are safe for my child. Also I have asthma problem since my childhood.",
    "doctor_response": "Hi, Thanks for your question. As per your child history and family history concerned your child might be having allergic rhinitis or asthma (as per father history). As the child is 3 months old just with symptoms (cough, wheeze, sneezing) what you tell we can not finalise the diagnosis as the patient need to be examined thoroughly.As of now mucolite and atarax drops can be given.I hope I was able to address your query. If you have any further questions, please do not hesitate to write to me. Wishing you all the best. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest fluttering during pregnancy?\n\nI am 24 weeks pregnent and for the last few days i have had this butterfly feeling in my chest, I get short of breath, it lasts for a couple of mins then goes away, comes back.....what can be causing this? and is it ok for my pregnency?",
    "doctor_response": "Hello, and I hope I can help you today. The fluttering you occasionally feel I nyor chest is called heart palpitations, which are occasional irregular heartbeats. They can be caused by pregnancy itself, but thyroid disease, anemia and other heart problems should also be ruled out. I recommend you tell your prenatal care provider about your symptoms, and they will likely refer you to get an EKG to check your heart rhythm. If it is abnormal,you may need to see a cardiologist for an evaluation. The good news about this is that none of these problems have any affect on the baby, but it is important you have a medical evaluation of your symptoms to make sure your heart is healthy. I hope I was able to adequate answer your question today and that my advice was helpful.  Best wishes,Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lots of pimples on face and chest area, skin peeling left huge dark spots, burning. Solution ?\n\nhello doctor, i m 17 year old female and i am suffering from lots of pimples on my face and on my chest area....i have done skin peeling and my pimples are almost gone but it left huge dark spots on my face and also a burning sensation.....now what to do and is there any kind of cream or medicine that i can apply on my face to reduce those spots and pimples?? please help.",
    "doctor_response": "Hi, it seems that a salicylic acid peel has been done on your face. the burning sensation is due to the peels ,you need to apply a noncomedogenic moistoriser on a regular basis due burning has subsided after which you can start a kojic acid or hydro quinone cream to reduce pigmentation. use a sunscreen daily.take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Liquids when drank felt in ear too, ear canal swollen sometimes, history of allergies and TMJ\n\nHello Why is it when I drink water or any other fluid I can feel the water in my ear afterwards? I can put my finger in my ear and feel it is wet?? I also feel like my ear canal is swollen not all the time but it seems like a lot. I do suffer from tmj and have a mouthgard at night but when I place my fingers in my ears I can her the loud noise from my jaw :-( I do also suffer from allrergies I am allergic to dogs and dust mites and take allergie meds and nothing seems to help. I always have a runny nose and swollen air way. I have been to 3 different ent docotors and they see nothing no infection of any kind and say my ears look good. So why the swollen feeling and the water feeling in my ears is it the tmj from my jaw?",
    "doctor_response": "as you have history of allergies in the long term allergy involves the organs like sinuses in your case you can confirm by getting xray pns done and treat accordinglyin sinuses there is postnasal drip which blocks eustachian tubes and causes problems of ear and joint tmj written by youtake doxycycline 100 mg bd for 5 days to clear sinuses fasttab fexofenadine 120 mg bdtab cpm 1 tab nightantaids to prevent gerd dueto pns of sinusesapply neomycin h ointment in nose bdsea water 2 drops at night in each nosewhich will clear ears and jawtake minimum 3 wk and condsult doctor or further management",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can appetite loss in an infant be treated?\n\nHi, My nine months child is not eating at all. Recently she had malaria and took medicine. After that, she can eat anything. I gave her multivitamine, sh is finishing a bottle of it but nothing has changed. What can I do to increase her appetit? Cause she lost 2kg in two weeks.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. First and most important step you have to take is to stop bottle feeding. Milk has low iron, it decreases appetite, second be patience, make sure while feeding there is no distraction, don't use gazet to make the child eat. Try to feeding a playful manner and with family. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Vikas Bhalla",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is HSG test ? how much time it will take to perform ? any caution before the test ?",
    "doctor_response": "Hello.Welcome to HCM.This is known as hysterosalpingiography.It is done to see the patency of Fallopian tubes.It is a small procedure.don't worry.good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for neck pain after the surgery?\n\nI had neck fusion on 3,4,5 disc about 12 years and had no problems but 3 weeks ago I had to have the disc 6 done and they took the hardwear out that was on the 3-5. My neck is hurting more and more all the time. all the muscles are very sore and I m having shooting pain up into my skull. When I try to turn my head it almost feels like it gets out of place.I never had this kind of pain on my other surgery.",
    "doctor_response": "hi,thank-you for providing the brief history of you.As you had neck surgery 12 years back which was not troubling till date until you had the next Surgery of the neck. Ofcourse this will lead to pain as in 12 years of time there will be a lot of degenerative changes and also the wear and tear of the joint.You need to wait for sometime for the bodys protective mechanism to complete it's course of inflammation and the pain will come down.If you had a Surgery recently I feel the surgeon must have provided pain killers which will take a little time to control the pain. Also using quick icing should provide an additional workout for reducing the pain along with drug therapy.This is the common complain we receive in our clinical practice. We recommend to undergo physical therapy like ultrasound therapy to reduce the inflammation and TENS if possible for the trapezious muscle to reduce the spasm. Quick icing is ofcourse a choice we prefer to add the help.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tender lump in socket after removing the wisdom tooth?\n\nI got my wisdom teeth removed a month ago. I ended up getting dry socket and an infection so the doctor gave me more medication. I started to heal and even flushed out the sockets. Not I have a lump along my jawline that is tender to the touch. Is it possible that food got stuck in the socket?",
    "doctor_response": "Thanks for your query, I have gone through your query.The lump over the jaw line can be because of the infection of the bone that is garres osteomyelitis. Nothing to be panic, complete the course  of antibiotics particularly amoxicillin and metronidazole combination. keep the socket area clean by rinsing with saline. If it is not reducing in a week, consult a oral physician and take a occlusal radiograph to confirm the diagnosis.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pimples\n\nsir, my name is alina.. n i am 18yrs old..n i am breaking out like hell.. :( I had crystal clear face till i ws 15yrs old.. as i turned 16 i started getting pimples.. n now it s like worse than ever.. i consulted a dermo last year in october.. n she suggested me to undergo chemical peelings.. i had 4 sittings of salicylic acid peeling.. n 1 sitting of gycolic acid peeling.. bt none worked! n lately am under another doctor s treatment.. n taking the following medicines~ isotroin 20 althrocyn 250mg rejuglow facewash crixan gel- ranbaxy melaglow cream But am not at all satisfied with what i see in the mirror :( iv been diagnosed with polycystic ovarian syndrome.. & depression.. iv been eating mirnite meltas 30mg for the last 8months.. I am breaking out like never before.. n every pimple leaves an ungly scars.. am really depressed.. Help me! Thanks.",
    "doctor_response": "Hi Alina ,Acne is a common problem experienced by teenagers...although it does leave behind scars....most of these are treatable. Stress can increase acne and since you have polycystic ovarian disease there are two factors that are leading to your breakouts...First of all relax cause treatment is not out of reach and isotretinoin with azithromycin is a good combination. isotretinoin initially causes increase in acne so it is combined with azithromycin...it takes about a month to show results and believe me it does work wonders. Don't loose heart, stop binge eating(fried food, ice cream, butter, chocolates), relax, exercise and most of all do not fiddle or touch the acne as that can leave deeper scars. Get treated for polycystic ovarian syndrome.(gynaecologist)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could negative result in HPT after home insemination indicate?\n\nOkay so i did a home insemination on feb 24-2014 i have irregular periods but before even inseminating i did an ovulation test and it said i was ovulating i was suppose to get my period on the 7th and i havent gotten it yet ive taken 4 pregnancy test and they came put negative.. What should i do?",
    "doctor_response": "Hi,Thanks for the query. If the insemination was done around the period of ovulation, there is possibility of pregnancy. But the success of achieving pregnancy due to insemination depends on many factors. Urine pregnancy test kit may not detects early pregnancy sometimes. So, better to wait for one week. If you do not periods even after one week, repeat the urine pregnancy test. Possibly by that time it can detect the pregnancy accurately. If the test again shows negative result, the possibility of pregnancy is less. Then you can consult gynecologist once and take tablets to induce withdrawal bleeding. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had allergies to corn pollen, ragweed and dust mites. What would cause hive to surface below eye?\n\nWhat would cause a hive to surface right below one eye??  Nothing else seems to be affected. I've had pretty serious attacks the past couple of years where both eyes are so seriously affected that they swell.   I've been diagnosed the past year with allergies to: dogs, corn pollen, ragweed, dust mites, and a chemical called thimerosal. I've tried to be cautious of what I'm coming in contact with and although, this attack isn't as bad as what it has been in the past, since I've  tried being careful I'm wondering if there is something else I should be doing.  It seems I am most often affected in August and December/January.",
    "doctor_response": "these are allergiesas these allergies cant be avioded as they are in airyou should go for immunotherapy as these are not fully avoidableand you can use anti allergic tab nd ointment on the area for controling it",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain and body aches\n\nmy age is 31yrs. suffring from backpain(cervical,lumber, thoracic level) from last 3yrs bodyaches increases in morning hours just after awaken from sleep then gradually decreases now from last 2yrs.small joints of hands and foots are effected my RBS, ESR, C REACTIVE PROTEIN,URIC ACID ,R-FACTOR,ASO TITRE level is normal,all the radiological findings are normal there is no history of injury plz. give me treatment. waiting for your valueable opinion",
    "doctor_response": "Hi, Though your symptoms point towards the diagnosis of arthritis, since most of the tests done to rule out arthritis are normal, it points towards the diagnosis of postural aches and pain. Also, there are high chances that back pain is because of bad posture while small joint involvement is a part of initial stages of arthritis. You need to get an arthritic profile done that includes tests for specific arthritis along with X-rays and MRI of back. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Rohan Shanker Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the effects of miscarriage on the mental health of a woman ? How are these effects treated ?\n\nhello, i recently suffered a missed miscarraige and since this i have been evoiding going t the doctors because just the thought of it make me think of the bad news that they gave me ... i am always cleaning stuff up, i hate mess. i also hate the idea of going out and about and if i do i try to evoid ppl with young children, i feel that they are rubbing it in my face . i evoid going out to see my mates. when im with my mates i feel bad because im forgeting about my baby, but i aint forgetting as my baby is always on my mind ... i cant sleep properly and if and when i do sleep i dont want to get out of bed in the morning. i just want to be a normal teenager again ... i have no support from my partner as he blamed me and as of this we are no longer together ... the family that i do have contact with, they just think im doing alright and that im okey ... my friends are amazing about it all but im too scared to make them as unhappy as i am if i speak to them about it. please can somebody help, i just want to no y i feel this way and wots rong with me xx kerry x",
    "doctor_response": "hello,you have been through a stressful situation.you are undergoing a phase of low moods called depression.however you know about it and you can combat it well as this is the right time.do not worry about going to the doctor. bad time has passed off. take help from doctors about your further plans. get yourself evaluated as to why you had the abortion.try to focus on positive things. try to relax by doing yoga etc.try taking support from friends and family when they offer.plan ahead for life.and most important of all remember to never loose hope as life always provides chances for us to be happy.i hope i am able to help you.i case of further doubt contct us at health care magic",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rapid heart rate and metallic taste in the mouth\n\nI am a 67 year old woman, under alot of stress for a couple of years especially because my husband and partner of 37 years died a year and a half ago, and have been taking a natural thyroid medication for a year and a half. My heart has been racing, I ve been advised by my Osteopath and Naturopath to reduce my Naturthroid (sp?) from 1+1/4 grains to 3/4 grains or even as low as 1/2 grain. I began reducing the dosage 4 days ago. Until today, when my heart started racing somewhat again, I felt better BUT.........here s my question.......last night I made some organic popcorn with brewer s yeast and some butter. It tasted bitter. I thought the brewer s yeast had gone bad. This morning I made a small mushroom and spinach omelet with swiss cheese and it tasted very bitter. I everything I ve tasted tastes bitter. My Osteopath on the phone said not to worry, that it wasn t important. But I m very weirded out. I ve been very healthy most of my life and having my heart race and now having a bitter almost metallic taste in my mounth is scary. Question.....What s going on the cause the bitter taste in my mouth",
    "doctor_response": "Hi,Regarding you racing heart, it suggest probably thyroid dose is heart causing this racing. So you get your TSH levels done, it will give the exact idea of thyroid status. Regarding your second problem, I think this can be related to herbal medicine so you have to discuss with your herbal doctor for this. Do you have any bloating, burping, nausea, upper abdominal pain. If yes suggest gastritis and acidity problem.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does it mean by Inferior Wall Ischemic Changes in an ECG report?\n\nHi This Irfan MY ECG has yielded evidence of Inferior Wall Ischemic Changes (T Wave Inversion in III,aVF). My BP was also slightly high 150/90 and after 15 minutes it was recorded at 146/82. My blood sugar (non-fasting) was at 59.What exactly does it point to? Off late, I haven't been able to have good sleep, lots of stress due to peculiar family circumstances.Please help.Thanks",
    "doctor_response": "Hello irfan. Thanks for posting at HCM. Your ECG says inferior wall ischemic changes which means that the lower part of the heart is struggling with its blood supply. It is possible that you have sustained a heart attack already. Since your sugars are low I suppose you are on medications for diabetes. Diabetics do not have symptoms of chest pain during a heart attack. You should definitely get checked up at the earliest. You have to see a cardiologist (heart specialist). You have to get a 2D echo done which will confirm the ECF findings if you really had a heart attack. If 2 d echo shows inferior wall changes then next step is an angiography which is an invasive procedure done through a small prick on your hand or leg. It will show whether your heart arteries have blockages and their severity. You may be advised angioplasty or bypass surgery or medical management on basis of angiography findings. This is important and you should get evaluated at the earliest. Please revert back with 2 d echo findings and also if you have any queries. Don't take this lightly. Your fasting sugars are also low so you also have to monitor your sugars closelyWishing you good health. and skip respective dose if sugars are lower than 100. Also you have to see your diabetologist for medication optimization. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Consistent allergies, dermatitis, perennial rhinitis, ear problem causing vibration of every word uttered. Effective remedy?\n\nHello sir I have been affected from allergies for six years. I have dermatitis or eczema ,preninial rhinitis and a associated ear problem in my right ear. I have loudness confirmation problem i.e. i am not able to judge and maintain loudness while speaking cause every time i speak i hear a sound of vibration with every word. For words like m and n there is similar vibration. Sometimes during day the vibration gets louder to me than my voice and hence i cannot judge how loud i might be speaking and that makes speaking ,talking and reading very difficult. I have feeling of strain in my voice and i think i can t make good output of voice or sound but my friends say that I sound fine. I can t hear to my own sound in a noisy place and i just could feel vibration sounding very deep while i could hear others speaking normally while i can t do so. Also i have to put extra effort or pressure to sound audible to others. Every time i speak my ear adds extra sound to my voice that only i can hear. it vibrates in a same way as cars glass vibrates with the audio system. + I have dermatitis and rhinitis dermatitis was more prominent in previous years but now its mild but it has not gone while rhinitis is persistent, It started from dermatitis/eczema in the year 2006 and it went off and came back with treatments but did not left ,three and half years ago i started showing symptoms of rhinitis with this ear problem which i misunderstood to be cold . I have taken countless of medicines in this regard but they have not worked. sir please suggest me the way out",
    "doctor_response": "THE ALLERGIES ARE AFFECTING YOUR DIFFERENT ORGANS LIKE SKIN SINUSES AND NOSE YOU HAVE POST NASAL DRIP DU TO SINUSITIS WHICH BLOCKKS THE EARS MOSTLY THESE TYPE OF SYMPTOMS ARE SEEN IN FOOD ALLERGIES MOSTLYMILK STOP ALL MILK AND DIARY PRODUCTS NO USE OF MUSTARD COCONUT WALNUT GROUND NUT ALMONDS SOYA OIL USE OLIVE FOR APPLICATION AND COOKING TAKE ALLEGA 120 MG BD SYP PIRITON 1/2 TSF NIGHT SYP GELUSIL 1 TSF TDS APPLY NEOSPORIN H EYE OINTMENT IN NOSE BD SEA WATER DROPS 2 DROPS AT NIGHT EACH NOSE GET BLOOD SERUM TEST FOR MILK WHEAT POTATO RICE CHANA EGGS NUT SPECIFIC ANTIBODIES GO FOR ELIMINATION DIET ACCORDINGLY YOU WILL BE FINE APPLY ANTIALLERGIC OINTMENT ON SKIN",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain\n\nage 54History of right side upper ab pain. Previous gallbladder removed in 2008. Dealing with Gallbladder like pain since 2007 and after the gallbladder was removed.  Pain has gotten worse in last 15 months, syncope and continued pain, diahrrea and vomiting.  Many e.r. visits with no answers many tests.Current issue:  right side ab pain wakes me up, keeps me awake, lightheaded constantly and has gotten worse.  Today I have been falling against walls and on furniture, cannot walk unassisted most of day. Now right side of head aches not like a migrane, ear aches now and feeling pain in right side neck and shoulder.All recent heart tests, ekg, echocardio gram and heart scan show heart in good condition no worries.  it is 330 should I go to e.r.",
    "doctor_response": "Yes , go to ER to get a symptomatic treatment and CT scan of he brain and MRI of the neck spine. It is possibly related to neurological in origin as surgery has not helped you. May be Gabaentin helps you. Discuss this possibility with your problem and get a reference to a Neurologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have numbness in head, blurred vision, breathlessness. Had cysts removed from head. What to do?\n\nHi, I have had a numbness in the front/top of my head (trouble remembering what words to use I.e I know there is a word, but cannot remember and have to try hard to remember) blurred vision, a cough with breathing difficulty, tingling in my body/arms. 37 years of age, male.  In the past I had 5 small cysts removed from head, but all were benign.  Thanks",
    "doctor_response": "Hi, Thank you for posting your query. Based on your symptoms, it is possible that there is a problem in the language area of the brain, which is located in the left frontal/temporal lobes of brain in right-handed people. If you have an MRI/CT scan of brain report with you, please upload it for us to understand your problem better to give a better response. Please get back if you require any additional information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any serious consequences for regular masturbation?\n\nHi, I have a problem with masturbation. I just cant seem to stop and every time I see a picture of a nice looking girl i would masturbate to the picture. If you can could you give me advices on how to stop as well as notifying me of what are the serious consequences to masturbation?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  You have not given your age here. Masturbation is not at all unhealthy. Men and women starts masturbating around their puberty. That is a natural process and even animals masturbate, for that matter. In adolescent period, masturbation once daily is normal. When you get older, the frequency lessens mainly because you have so many other things to do like studying or job. Between 20 and 30, masturbation once or twice in a week is normal. The main problem could be wrong knowledge about masturbation and anxiety arising out of it. Restrain yourself from such wrong information.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will acupuncture treatment be beneficial in treating CKD?\n\ndear sir / i suffered CKD 4/5 . creatinine 6.1 i taken homeopathy treatment past 3 months. last week i remove my back pain thru acupunture. i decide to take acu treatment for my problem. please tell me it is possible? if possible, wht is the duration for cure. mailid  YYYY@YYYY",
    "doctor_response": "HI Welcome to HCMI have gone thru your query  . It is nice to know that you have been benefitted by treatment from occupuncture .Acupuncture can stimulate your meridians and remove the block, improving kidney's self-cure and promoting kidney functions.Acupuncture can help chronic kidney disease patients relieve and cure some symptoms like back pain, headaches, muscle pain, allergies and other immune system dysfunctions, digestive problems fatigue, insomnia, asthma, depression, high blood pressure, diarrhea, irregularities in the heartbeat, vision and hearing problems, rheumatism, circulatory problems, etc.  very rare cases, more serious complications can occur if the acupuncture needles pierce the kidney, lungs or another organ.Acupuncture is considered to be very safe. In 1996, the U.S. Food and Drug Administration began classifying acupuncture needles as medical instruments, and it now requires that acupuncturists use only sterile, disposable needles. Also, acupuncturists will swab the acupuncture areas first with an antiseptic, so there is very little risk of infection. It's very important to visit a licensed practitioner, however, because poorly sterilized needles can transmit infectious diseases. Time taken in curing depends on the stage and receptivity of the patient  So in my opinion You can go for acu teatment safely and get full benefit of this therapy .Hope it helps to solve  your query . All the best Take careDon't hesitate to get back if any further query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hard lump on armpit\n\nhi, i have a lump in my armpit.. i would say about 1cm wide. it is a hard lump and used to have white pus come out when i squeezed it but now its just a clear gel-like liquid. ive had it for about 3months maybe longer and there is no pain at all. i think it started as an ingrowing hair. how can i get rid of it?",
    "doctor_response": "hi.what deodorant are you currently using? avoid high aluminum content deodorant and do not shave or pluck hair from your armpit for now. it might be a case of hidradenitis suppurativa, an abscess on your underarm. it is best if you sought consult w a general surgeon to assess the lesion if it needs drainage or just antibiotic treatment.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pregnancy symptoms despite negative pregnancy test?\n\nhi, I have been having pregnancy symptoms. but every test is negative. my last period was suppose to be January 25, 2014 but it came on January 28, 2014 . It was a really light flow and didn t have the normal clots in it. I didn t cramp and it last for 5 days off and on I wore a pantiliner the whole time. I took a test three days after it stopped and it was still negative. but this week I have had sore tender tender breast and my periods not due until February 24 my husband said the inside of my lady part has a bluish look to it and that my breast are enlarged and darker. I had this belt I wore three months ago and I can not wear it any longer because my hips have spread for some reason. I have been to a health department and they think since me and my husband want a baby and a pregnancy that we are both thinking every symptom is pregnancy. but how do you explain the bluish vulva? I really need answers on what I should do.",
    "doctor_response": "Dear Madam,I do empathise your concern. However, the first cardinal symptom of pregnancy is missing a period (though occasionally some women may get menses in first couple of months of pregnancy). You had periods, however, somewhat lighter. This should be taken into consideration. The other symptoms follow about one or two weeks later. They are:* Nausea and vomiting with pica: You do not seem to have them.* Frequency of urination which you do not seem to have.* Breast changes: - Engorgement and tenderness which you are having- Dark discolouration of the nipples and areola: This also you have noticed. Along with this, the size of areola also increases. Are there any tubercles under the areola? They will go more in favour of pregnancy. - Secretions from the nipples: They will be strongly supporting the pregnancy. We do not diagnose the pregnancy only on the symptoms; they have to be supported by confirmatory evidences like pregnancy test and/or clinical findings. However, your pregnancy test is negative. Madam, I feel you have carried out this test rather too early. These tests may report false negative in the first week after missed period. Hence, repeat the test after about 4 days; however, going for Beta hCG test would be more reliable. This is highly specific and sensitive test. The levels of hCG > 25 will confirm the pregnancy. If this test also reveals that you are not pregnant, you have to accept the diagnosis and attribute the symptoms to some other cause like increase in weight or so. Let the bluish discolouration of vagina be confirmed by Gynaecologist instead of a lay person like your husband. I hope this has given you a valid clue to resolve your dilemma.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe back pain\n\nI am currently on blood thinners as I have a history of blood clots. I have had a back ache on my left side for over two months now, while camping a month I tripped over one of our dogs on a down hill slope, I slammed my forehead which went back and I heard a pop in my neck. since then I have had head aches every morning, night and in between. they are from mile to moderate with terrible cramping in my neck. I have since developed cramping in the joints of the left side of my body, which includes fingers, arm, elbows, shoulder, neck, etc. last night at work I got light headed, with a headache, weakness, and felt as if I was to pass out. Again, I still have the left pain/back ache for the last two plus months. could this be related to my blood clots, or something else? And when I fell and snapped my neck a month ago could this have made things worse? i can t even spell it but it is authritis in the spine where the cushion has disappeared and it is bone on bone.",
    "doctor_response": "hiYou must undergo thorough check up by an orthopedician .A few x rays? MRI spine may be needed.You may be requiring anti-inflammatory medicine like naproxen and certain precautions for neck and spine which may   be decided after diagnosis by orthopedic doctorArthritis is due to degennerative changes in joints commonly which should be diagnosed early to enable doctors to control them early and prevent disabilities for futureBest Wishes,Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to check blood pressure with Sphygmomanometer?\n\nHello, I am trying to take my mother s blood pressure but I am confused as to how to accurately read the sphygmomanometer gauge. I see the gauge beginning to twitch at around 118mmHg, but I dont hear the first pulse sound until 92mmHg. This seems low. Can you please clear up which I should pay attention to?",
    "doctor_response": "if u r checking with stethoscope then the systolic bp is marked by first click sounddont go by oscillations 92 is low plz consult ur physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy after taking Duphaston?\n\nHi doctor, i am trying to concieve since last 2years . all my reports are noram. I get my periods only for 02 days. now doctor has me to take glucopage 750xr regularly twice a day and duphaston from day 16 for 10days. is it is possible to be pregnant with duphaston",
    "doctor_response": "Hi,yes it may regularize your cycle and you may get pregnant.please hit thanks.Good luck.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need treatment for hallucinations\n\nMy mother has parkinsons is 89 years of age and has been taking quetiapine 25mg for quite a few years now atbedtime. It has become difficult giving medication and so there have been times when she wont take it. Sometimes, when I read the side effects list, I think it might be better she does not take it. I will be seeing the specialist later in the month. Apparently this is to help with halucinations. Eleonore",
    "doctor_response": "HiThanks for using healthcare magicIn your mother case, quetiapine is the best medicine. Other antipsychotic like risperidone or haloperidol etc can not be given, due to side effects. Quetiapine would not effect on parkinson's symptoms, but help to control underline psychotic symptoms. In case, you need any further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red dot above lips?\n\nMy 3 yr old son has a small red flat dot above his lip. It has no drainage or swelling, and has remained the same size (like a pinprick). It doesn t go away. I have tried OTC cortisone and neosporin. If I put vasoline, it looks better but doesn t completely go away. It is a perfect circle and flat. He recently went through a round of antibiotics for an infection and the dot remained. It doesn t hurt him but my pedi and I don t know what it is. He has no significant medical history. I am looking for a pedi-dermatologist in my area. My pedi doesn t believe it s anything to be concerned about. My son does have sensitive skin and a hx of eczema - last bout was 2 yrs ago. He tends to wipe his and rub his mouth a lot.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe lower back pain\n\nI have lower back pain that has been happening on and off for about a two months. Recently it hasn t gone away and now my hands are not only going numb at different times in the day and night but the numbness has now turned to burning and my hand that is numb and painful is colder than the other hand ]",
    "doctor_response": "Hello, I have studied your case.I will advise you to MRI whole spine for better diagnosis.It can be due to various causes like sudden jerk to spine, due to facet arthritis, degenerative, due to chronic systemic disease like diabetes or hypothyroidism.For these symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.I will advise to check your vit B12 and vit D3 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you are satisfied with answer do not hesitate to rate this answer at end of discussion. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for frequent seizures that starts with leg pain\n\nHi, My daughter (age 25)is having frequent episodes of heavy sleep/minor seizure like episodes which can last up to two minutes at a time during the day. They are often accompanied beforehand as a cold leg pain which moves up her spinal cord to the head just before she enters these sleeping phases. They are more likely to happen during the afternoon/evening, but not in the morning. At other times she appears normal. Tests so far have ruled out a heart or blood pressure, or ear and nose problem, and many blood tests have not found anything. She has yet to see a Neurologist.Can you possibly advise what the problem may be as we are (and our own GPs) are running out of ideas.",
    "doctor_response": "HelloI am Dr Mittal.I have read your query.I think I can help you.The symptoms of your daughter are quite suggestive of 2 possibilities. I would feel that she has either a Complex partial seizure with secondary generalization. Another possibility is restless leg syndrome.Considering the information given in the query, I am more inclined to the former.Now this is quite a specific information that the symptoms start in the leg and gradually progress up the body. It seems to indicate the involvement of what is known as the homunculus, or representation of the body in the brain.I therefore feel that a MRI of the brain, and an EEG would help her significantly in getting to the diagnosis. A video EEG would be more helpful than a plain EEG.In case it does turn out to be seizure disorder, good medicines are now available for seizures.However, since the medicines do have side effects, I would not suggest tsarting them till a complete evaluation by a neurologist and the completion of the above tests.I have tried my best to make it as simple as possible.Please feel free to contact us for more information.Best of luck,Dr Mittal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe back pain and disc degeneration\n\nBack pain with disc degeneration accompanied by changes in my TSH levels, fatigue, stomach pain as well as anemia even though I ve had a hysterectomy. My doctor has ordered an ESR, CRP and CBC. It feels like all I do is go to specialist without answers. Suggestions? Test results are present for my MRI, just the intent to do the tests and that there is degeneration in L4 and L5. Been doing PT for over a year. Help?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Regarding your concern, I would explain that physiotherapy can help improve the chronic back pain. But, these tests will help exclude possible inflammation, which may need to be treated with antiinflammatory drugs. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant soft/yellow stool in a child after taking antibiotics?\n\nHi, my son is 2 years old and recently started throwing up and with high fever and diareah the doc gave him a strong antibiotic shot 6 days ago and also prescrived him 2 antibiotics and 2 other medicines since he started taking them his stool has bin soft and yellow and constant like every 30 minutes, but today is his last day on the antibiotics and his stool is coming out almost black and watery and smells like nothing what should I do? Is there anything wrong with him??",
    "doctor_response": "Hi.... I understand your concern. By what you say I feel that this is an antibiotic associated diarrhoea. You need to use Probiotics. I suggest that you use saccharomyces boulardii as this is specific for antibiotic associated diarrhoea. But this is a prescription drug and you will need a doctor's prescription for this.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain after bronchitis\n\nI am 60 yr old female.  When I was 14 had ruptured appendix resulting in parignitis and ended up having a rib removed due to infection I guess.  Recently I had bronchitis and now after 2 months still not well.  Have pain in my chest that runs up my back and has some burning sensation.  Was sure I had pneumonia but a chest xray shows clear lungs.  It is painful and not in my head.  Dr. has prescribed inhaler like I have asthma.  What should I do and what could I have.  Should I just see a chest specialist?",
    "doctor_response": "Hi welcome to HCM....You are complaining chest pain and diagnosed as bronchitis ....Your chest x ray clear , no fever , so no issue regarding pneumonia. ....Your pulmonary function test by spirometry has to be done along with auscultation of your chest .....Spirometry help in assessing severity of lung disease ...and according to management ....If bronchoconstriction more than bronchodilator can be given ....If inflammatory swelling more than short term steroid course also can be given ...Steam inhalation useful two times a day ...Avoid smoking exposure. ...,Consult pulmonologist for your examination..Take care .....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for cough & congestion in the chest\n\nMy daughter will be 4 months old on the 2 of December. I have noticed for the past 3 days that she is fussy. She has a cough that sounds like her congestion is moving to her upper respiratory system and she s sneezing more than usual. Her eyes have become watery and red rimmed. She s sleeping more than usual and not really into playtime. What do you think she has? A common cold? Or is something else?",
    "doctor_response": "Hello, Cough and cold are viral 95% of the times in children. For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15mg/kg/dose (max ceiling dose 500mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. For cold, you can use Cetrizine at 0.25mg/kg/dose every 12 hourly for 3 days. For nasal block, plain saline nasal drops will do, every 4-6th hourly to relieve nasal congestion. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility problems\n\nHello, My husband and I have been trying to get pregnant for two years, but without success. Two months ago I had hysteroscopy and laparascopy which ended successfully. But the other problem is that my husband is diagnosed with olygoasthenoteratozoospermia. My question is whether to try few more months to get pregnant spontaneously or we should not waste time with this diagnose and start immediately with insemination or even ICSI? Thank you, Katerina",
    "doctor_response": "HelloWelcome here.I can understand your concerns.Oligoasthenozoospermia means sperm count, morphology and motility, all are low.As you have tried for natural conception since last two years, i would suggest you to go for ICSI or IUI. The problem in your husband's semen analysis wont allow for a natural conception.Consult an infertility specialist nearest to you for further management.Hope this helps.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause burping and pain in rib area?\n\nHello, I been having this problem for the last two months. No one can tell me what the problen is. I have been burping, pain on right side under rib going around to the back. No problem with gallbladder been test.(no h ployid). white blood count is high. now getting unbearable to sleep at night. Gasterolgist whats me to see a infectious disease doctor what does this mean?",
    "doctor_response": "Hi, I am sorry for the situation you are in. 1. Burping problems you are having might be related to possible acid reflux or dyspeptic syndrome. Changes in your diet and lifestyle regimen are highly recommended together with starting PPIs in the morning and antacids after each meal. 2. Pain on right side under rib cage going around to the back while gallbladder is clear but with high blood count, then, it might be due to:- colitis - pancreas problems (pancreatic function test advised together with abdominal ultrasound and ct-scan)- urinary tract infection (kidney function test, urine analysis advised)If nothing will be detected, then, spine issues to rule out by MRI. All the best!Dr.Albana",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to withdraw Depakene slowly without any side effects?\n\ni have a child 7 years old he has absence seizure from 3 month he takes keppra 100mg/ml 4.3ml twice a day he was for 45 days without convulsion and later it begin to appear the doctor prescribed 6.3ml twice a day but useless after that he takes with keppra depakin chrono 500mg 1 tablet morning and 1/2 tablet evening he was only 1 week without convulsion and later with stronger with blue lips for 50 seconds and it was daily or twice a day we make calcium analysis it is 3.4 low and ammonia 65 heigh can i withdrawal depakin and use other drug",
    "doctor_response": "HelloWelcome here.I can understand your concerns.Depakene can cause raised ammonia levels. You must withdraw it.Serum calcium levels must be corrected as this can be a contributory factor for seizures.Other anti-epileptics can be considered like eptoin or tegrital.Please consult your pediatrician before changing the dose/drug.Hope this helps.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why there is pain in upper abdomen and sudden weight loss with all the blood tests normal?\n\nHi, We are dealing with something of a medical mystery.  The patient is 54 year old male.  Has upper left abdominal pain for 4 months with 25 pound weight loss.  Pain is chronic and localized.  Unrelated to food intake or body position.  No diarrhea, vomiting, nausea, reflux, or other GI changes.  Negative Upper and Lower endoscopies, negative H pylori; negative EUS; negative MRI of pancreas.  Negative Pill camera swallow.  Normal bloodwork including liver and pancreatic enzymes with exception of borderline high sugar. Imaging all negative (CT, MRI, Ultrasound of celiac artery).  Pain presented in days following a throwing injury that pulled oblique muscle on same side.  Muscular pull healed within days.  Negative Carnett's sign. MRI of Thoracic spine negative. Trial of Celebrex ineffective.  Any guesses?",
    "doctor_response": "The pain can be due to fibrosis of the muscles after healing. On exploration they appear pale and hard to touch. Or can have a small hernia trapping the omental fat which is easily missed on USG and MRI unless specifically scanned for. The weight loss may not be explained by this. It can be due to high sugar, particularly the postprandial . OGTT (oral glucose tolerance test)  and other investigations for blood sugar may help. May be the patient has a fear-factor or phobia causing this much weight loss.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain. Test shows albumin in urine. Significance and remedy?\n\na woman aged 5 having 5 children. Te last one born after getting tubectomised but got pregnant and delivered a healthy female baby. Recently due to persistent backache she went the gynecologist she suggested CUE beside Blood etc. Sha got +++ ALBUMIN IN URINE. Doctor prescribed some antibiotic and tested after one month and the result is the same i.e. Albumin+++. What is the significance and the remedy ? please suggest",
    "doctor_response": "albumin in urine is an abnormal finding and she must undergo complete renal function test,urine culture for bacterial count-urinary tract infection is a common cause",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy lump at the opening of the anus?\n\nHi. I felt a pea sized lump in the opening of my anus today. When i touched it, i didn t felt any pain at all. Should i be worried with this? Days before i found out about this lump my anus is itchy. Can you help me know what this? Thank you very much! I highly appreciate your help.",
    "doctor_response": "Hi,It seems that there might be having some local skin infection like dermatitis producing itchy lump.This can be due to worm infestation or having inner piles.Apply triple action cream.If require go for one course of worms after consulting your doctor.Keep local hygiene clean, dry.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can typhoid be treated?\n\nPlease write your question heremy daughter 7yr old had widal test positive in may.after 15 day medication with cefixime ofloxacin for 15 days agaiin widal was done which came out negative on 3june.from last 2 week she had intermittent fever varying from 99-101. With no abdominal discomfort.on reporting to Dr. She again tested positive for widal..antibiotics not started yet.please suggest proper line of treatment",
    "doctor_response": "she should be put on iv antibiotics..because it could be relapse of enteric fever ..may be due to prior incomplete course of antibiotics..better see a physician so that other possibilities of fever could alos be ruled out..",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can elevated BP along with migraine be treated?\n\nmy BP is 162/94, pulse 130. I have hypertension. Yes i take my medication daily and at the same time. I just took 2 clonidines and an amlodipine. I also take losarten and hydrochlorithiazide. I didn't take those two yet. I've had a migraine all day.",
    "doctor_response": "Hi, You can consult your cardiologist/physician and adjust the dosage of anti hypertensives. As of now avoid excess salt in the diet. You can consult a neurologist in case of migraine. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause of upper abdominal pain?\n\nI had pain in the center of the upper abdomen on and off for 3 days.  It felt like contractions and lasted 5-10 seconds each time.  A few days later I had an abdominal sonogram which shows hepatic parenchyma that is homogeneous, no evidence of intrahepatic biliary ductal dilation, no hepatic mass seen, the right lobe of the liver measure 18.1 cm, no ascites, gallbladder is normal in apprearacne and no gallstones or sonographic evidence of cholecystitis, the common bile duct measures 8.9 mm, the pancreas has a normal sonographic appearance and the abdominal aorta is normal in caliber. It was recommended to have an MRI/MRCP to evaluate.  Do you have any thoughts abou this?  Thank you.",
    "doctor_response": "Hi! Good afternoon. I am Dr Shareef answering your query.Everything in the ultrasound seems to be ok excepting for the size of the CBD, which is slightly more than the normal upper limit. However, there is no evidence of any stone or obstruction in the CBD. If I were your doctor, I would have advised you for a liver function test, serum amylase and serum lipase estimation more so if you consume alcohol, to rule out any chances of a pancreatitis. In case this is inconclusive, then I would like to go for an MRCP. Till then I would advise you for a proton pump inhibitor with an anti spasmodic drug and would go for a definitive opinion and management after the reports of the investigations arrive.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.]Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can milk,cheese and yogurt cause tan coloured stool in 18 months old?\n\nI have an 18 month old who for the passed week or 2 has been producing tan coloured stools. He may have a few bowel movements a day. Is this common. He drinks close to 400ml of milk per day and loves cheese and yoghurts. Could this be an isssue? I noticed he is cutting his eye teeth.",
    "doctor_response": "Hi dear, I understand your concern, you should be worried, but not too much. Color of her stool can depend from her food consumted daily and from amount bile secreted by liver.Her stool is normal, if you are confused, then perform stool analysis and check how he digested food.Wishing your baby good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tender foot with pain\n\nHi. I ve had Aaron feet for a couple weeks now. The very back part of my ankle on my left foot is tender to tit is also warm to the touch. I ve had trouble walking due to the pain. Im not sure what to do. I have tried ice packs with no luck. Thanks , Kelly",
    "doctor_response": "hi,thank you for providing the brief history of you.As you had Aaron feet and the pain is leading to difficulty in walking i will advice you to undergo physical therapy as it will help recduce pain and inflammation by Therapeutic ultrasound therapy and TENS therapy. Exercise on later stages will help improve the muscle strength and regain normal functions.in my clinical practice most cases respond well to physical therapy.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for low RBC count\n\nHi I have had menstrual cycle problems in the past however with diet and exercise advised by a gynacologist my periods became normal with a 24-25 day cycle.. Recently.. I got my periods 10 days earlier.. And it was quite worrying.. I have travelled to a country that s very hot and normally I stay in the uk which is cold so I m assuming maybe it was the heat.. I got my blood tests done hormonal blood tests to check if everything is okay.. My RBC is very low",
    "doctor_response": "Hi welcome to HCM Dear , Most women will probably suffer Early Menstrual Periods at some point in their lifetime due to psychological and physical  reasons . Stress and disease is the main reason . There is nothing to get panicked . Worrying will not help . You must get proper treatment by your gyne . Keep in mind that in most cases a combination of psychological and physical treatments is the best option to manage Early Menstrual Periods and related symptoms as low RBC count .   Best Remedy for low RBC is to strengthen your immune system by rectifying your fauly food habits and deraileled life style .In fact,Your body is always fighting something -- an infection, a toxin, an allergen, a food or the stress response -- and somehow it redirects its hostile attack on your joints, your brain, your thyroid, your gut, your skin,your kidneys or sometimes your whole body .It weakens your immune system. You have fewer white blood cells in circulation to fight off germs. This leaves you susceptible to infections.Your immune system is your defense against invaders .But when the immune system becomes weak, by frequent sufferings , disease cells can grow out of control , the disease overpowers . The only remedy is suggested to strengthen your immune system  to include essential nutrients in your diet --FIBER RICH , LOW SALT - LOW FAT DIET ,fruit ,green veges ginger , garlic to balance Air factor-- Vayu Dosh -- in our body , vitamins and minerals in natural form -, coconut water , , nuts , almonds , and supplements full of antioxidants as Aloe vera juice + Amla juice 2 spoons , Lemon juice with water and a pinch of salt and black pepper gives immidiate relief . Fish oil and flax seeds for Omega 3 and Turmeric powder + Almond oil is very important for our sound mental and physical health and strengthen immune response naturally and will take care of your  RBC problem .Avoid fried fast foods , sugar ,tea ,coffee , alcohol , smoking ,stress ,worry, anger ,Constipation .Proper regular walk , Adopt proper for blood circulation. exercise ,yoga  , Kapalbhatti pranayam -deep breathing ,Anulom Vilom , Bhramari are help ful for soothing nerves & relieving your stress inducing sleep and eliminating toxins from our body and help the natural hormones work,. Meditation also helps sooth the mind helps in detoxifying and strengthening the immune system to enhance resistance from diseases and pave way for healthy disease free life . It is important to seek medical attention  and get tho",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a feel of lump inside throat,heart palpitations and panic attack ?\n\ni have been having some strange symptoms the last few weeks. feeling of lump or frog in my throught , odd chest pains liht twinges near left shoulder, pressure in head and ear on right side. a few heart palpitations, and an odd feeling of anxiety for no reason almost like a panic attack, these symptoms come and go \\",
    "doctor_response": "Hello, Regarding your concern, I would explain that your symptoms could be related to anxiety. Nevertheless, I would recommend consulting with your attending physician for a physical exam and some tests in order to investigate for other possible causes: - a resting ECG - complete blood count for anemia - blood electrolytes for possible imbalance - thyroid hormone levels for possible thyroid gland dysfunction. You should discuss with your doctor on the above tests. If all the above tests result normal, you should consider anxiety as the main cause of your complaints. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having bile duct cancer. Food and care suggestions?\n\nMy adopted son who is 44 has just been diagonst with bile duct cancer, tumor is in bile duct &also on outside of duct, Rob is to be operated on in 10days, I want to know what are best food choices, I want to know how to help him. He has wife and 2 small boys 9 & 7, he is the best husband , father, son & friend. I won't give up on getting him better, So any advice you can give me will be appreciated. We live in Melbourne Australia,ThanksClaire",
    "doctor_response": "Dear Your adopted son already having been diagnosed as bile duct cancer, surgery will be the best option if found feasible by your Onco surgeon. This has to be followed if necessary by local radiation therapy and systemic chemotherapy. If surgery does not leave any residual disease then only systemic adjuant chemotherapy may be considered. The clear understanding will be there when we have post surgical and pathological details. Surgery is the best option. if the disease is completely resected out he may need adjuant systemic chemotherapy. If residual disease was left  after surgery ne may need external radiotherapy as wel. Post surgical and histopathological details will give understanding about the further course of action. Following  the advice of your treating doctor will be the best help to your son. Non fatty foods and palatable liquid diets may be suitable for him. I wish your son best of luck and quick recovery. Dr. J. Ticku",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes spasms with cough, phlegm and breathlessness?\n\nI keep getting weird spasm like feelings on left side, thought it was my heart skipping or stopping, sometimes scares me badly. I notice everytime I get a spasm I feel like the urge to clear throat or cough and feel phlegm down deep in left side. I get spasms bad and really out of breath when climbing hills, or stairs even small ones. Only 37 and feel 65. Is this anything I should worry about?",
    "doctor_response": "Hello You should consult your doctor for doing a chest X Ray amd a Spirometry test for lung function. Regards Dr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should a course of antibiotics be repeated for black spot in gums between two teeth?\n\nHi,I have some black spot in the gums between two teeth. it been there for a month. looks like an infection.I took a course of oflaxacin +orinidazole, for 5 days and one of the black spots disappeared. but there is still one more- should I repeat the dosage of antibiotics?you should tell the money thing first !",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM, I have gone through your query, as you hqve black spot on gum yes it can be due to infection in gum or due to infection in tooth at periapical region . For this you should consult dentist and go for investigations IOPAxray if you have periapical infection then go for Root canal treatment and if have infection in Gums then go for Scaling and currettage . Go for treatment , if you dont want treatment this time then go for antibiotics course.Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen lymph node\n\nI have swollen lymph node left side neck on and off for 5 yrs. always starts with really bad sore throat. Only left side swells up but have trouble swallowing when it does. Have hashimtos thyroid but they did ultrasound of thyroid & said this is clearly lymph node in neck not thyroid related. Had Lyme & babesiosis from tick bite in past. Had toxoplasmosis from cat rescue work. Treated for all of those.",
    "doctor_response": "hI! thanks for writing to HCM!Well, it seems that the lymph node is the active witness to all your illness! Therefore, it just acts as a guard to the insults and ideally If I were your treating Doctor for this case of neck lymph node, I would clearly tell that removing the lymph node, as that is the only cure for this, would not cure your disease! Therefore, first try to prevent/cure the aggravating conditions for this and rule out if any serious disease is with itself! these are called reactive lymph nodes or tonsils and warm saline gargle is necessary when enlarged suddenly and have to treat the specific neck/throat/thyroid inflammation....I suggest you to go for an FNAC to rule out any significant pathology before consulting a surgeon for its removal! Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high ESR levels?\n\nhi my name is ritu. am i ving troubles with my esr levels are very high. its 90 at present, sometimes um ving pain in my back,under knees, heels,arms pain like i ve got swelling inside.i am eating very less still my body is like a stone ,not weight loose.",
    "doctor_response": "there are various causes of high ESR. main causes are chronic infections like TB, cancers and connective tissue disorders. this is very nonspecific test. it is not diagnostic but it can help in making diagnosis and to check whether treatment is working or notDr Alok",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. The left side of TMJ is getting inflamed and is pushing on the inside of my ear. What to do?\n\nI have TMJ disorder and I was wondering if there was anything I could do about the left side TMJ getting inflamed besides just letting it be and relax, as it is pushing on the inside of my ear. I can feel/hear it making a crackling wet noise when I push my jaw forward, or a painful pushing feeling inside my ear when I clench my teeth. It started yesterday and is better now that I've slept and it's relaxed, but it's still bothering me and the crackling/pushing is still there.",
    "doctor_response": "Hi! For a TMJ dysfunction you can consider the following advice Spasm in the muscles around the joint can be the reason for this probable dysfunction. It will take around 4 weeks for the muscle to get back to normal but chiefly depends on how much precautionary measures (mentioned above) you have followed. I hope I have answered your query.  If there is anything that I can help, please do le me know. Get well soon! Warm regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest birth control pills that also helps in treating acne\n\nI need help with choosing a birth control pill? I m unsure of which brand to take. I ve looked up levlen and alesse because they apparently help with acne. But the mixed reviews have confused me. I need one that mainly prevents pregnancy, and to help with acne.",
    "doctor_response": "Hello user,you can use ortho tricyclen to reduce acne and it will give good contraception as well.thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from sneezing and blocked nose. Suggest some effective medicine\n\nHello doctor, I am Ashok, Age 34, Male. i have been suffering from allergy sneezing and nose blocking for the past 6 months. i took both english and homoeopathy medicines but i get relief only for shorter time..now this time i am suffering from nose block for more than 15 days and also have running nose and cold..finding difficult to sleep and even day time unable to manage...started feeling ear and teeth pain too..pls suggest",
    "doctor_response": "Hello Ashok. Thanks for your question. Your suffering from recurrent blocked nose,cold and many more symptoms. The commonest cause of these symptoms other than allergy is deviated nasal septum(DNS) You can use nasal decongestant,antihistiminics for relief of your symptoms but I would suggest you to consult an ENTsurgeon who will evaualvate you for DNS. Hope this answers your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Got second IVF transfer done. Got terrible abdominal pain, vomitting, pink and brown discharge. Good symptom?\n\nHI, I am 40 years old, I got my second IVF transfer on 6/10/2013, on day 5, my HCG was 13 and at night I got a terrible lower abdominal pain, and vomited a lot, when I went to the restroom I notice a pink spot when I wipe, them turn brown and I noticed all the time, yesterday stop and today get back again but this time is dark pink, I called my Dr. and he told me to continue with the same medication, I just wander is there is a good or bad symptom, tomorrow is my next blood work, There is something else that I can do?",
    "doctor_response": "Hi,Thank you for choosing Healthcaremagic. Its difficult to predict the outcome of this time IVF, you can just wait as advised by your doctor. Kindly dont get tensed, just leave it to GOD. Meanwhile you can continue taking natural progesterone injection or tablets/ HCG and pray for almighty. I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow-ups. If you like my answers kindly rate it, and write a review as well. Please do not forget to accept it.Thank you,Wish you good health.Regards,Dr ArifYou can consult me again directly through my profile",
    "dialogue_context": ""
  },
  {
    "patient_message": "Improper functioning of kidneys. Neuro stimulator implanted. History of herniated discs. Causes for symptoms?\n\nI got a call from my Dr yesterday and My kidneys are not functioning like they should. I also was in a car accident over a year ago and have two heniated disks at T-11 and T-12, and S-2 to S-3. The t-11 disk is the largest one and could it be affecting my kidneys? I have pain all the time and had a nero stimulator implanted in August and take pain pills too. I jsut need some answers, for this is wooring me to death..",
    "doctor_response": "Hi Welcome to HCM and thanks for your query. I understand your worry and anxiety. Disc prolapses are not known to cause kidney damage. regards DR GS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for failed lumbar fusion\n\nI had a 360 2 level lumbar fusion on 12/20/13 and it failed to fuse and caused the next level go herniate. I had revision lamiocentomy triple fusion on 9/30/14 and in major pain and know that I probably have permanent nerve damage from both surgeries. I am only 37 and my Dr says that I am too young to be disabled. I know a triple fusion is rare and can t get a honest answer on what my future will be as disabled or try to work again and further damage my spine. What should I do?",
    "doctor_response": "Hello, I would definitely NOT submit to any further surgeries.  At this point, the best possible approach or treatment for the back would be back exercise therapy to strength back and core muscles of the abdominal. This will stabilize the spinal column more forcefully and help reduce to my pain as well as further spinal column deterioration. But, I would definitely avoid more surgery at all cost. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure numbness in the right thumb region?\n\nHi I am a 51 yr old female veteran of US army no medications whatsoever Two days ago and ever since I have felt numbness in my right thumb back of hand I feel weakness when holding a heavy plate or mug of coffee I am a smoker about ten per day Kindly offer topics of research. Many thanks",
    "doctor_response": "Numbness in thumb is usually due to the decrease of blood supply in this area. There are many reasons for this like carpal tunnel syndrome, peripheral nerve disorder, arthritis, in diabetis also this problem occurs etc. Due to smoking also your nerves get weak and this problem occurs. So in such I would recommend you to consult some neuro physio who can diagnose it and can give you the exact reason for numbness.  In the meantime to get relief from this let me recommend you some home treatment:1. Take a warm water in a small tub or bucket. Place your hand in it for 5 - 10 minutes and then using other thumb massage your affected area. As it will increase the blood flow of the numb area and give your relief.2. After taking above hot fermentation perform some exercises like: Elevate your hand and then make a fist and open it, use use spongy (smily) ball press it tightly as much as you can and then release, you can also do finger counting exercise with thumb, and tie a rubber band over thumb and then stretch it by doing flexion, abduction movements.3. Once done with the exercise relax yourself by keeping your hand in elevation position for 10-15 minutes.Please take some precautions:1. Avoid drinking and smoking as much as you can.2. Avoid excess eating, specially citrus fruits, fat products like ghee butter etc., diary products for time being, junk food, fry food etc3. You can have healthy food items like bananas and leafy, green vegetables etc.4. Nowadays in winter do not keep your hand open, try to wear glooves and keep them warm.5. Keep your arm elevated to increase blood supply.6. If there is very much numbness you can have hot cold pack by checking if it is not more hot or cold from other hand. Apply in the ratio of 2:1.7. If require then only take medicine.Please follow the above treatment you will get a relief.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low blood count\n\nI am 28 years old female , married with one kid of 6 years age. i have low  blood count 7. I am having cough , not feeling well to eat anything. i visited one chest specialist suggested some IRON injections FerriKind S - 100. I have taken one still  .... felling the same. (Still 4 more injections I need to take )",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern you have not given the exact blood report because you said the low count but this is wont clear the thing in practical it required complete test report then and then I would come to know the exact clinicopathological condition if the hemoglobin level is okay then no need to take iron therapy, no need to become too much conscious, just take it easy, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Marijuana affect spinal Fusion recovery?\n\nHello thanks for your help. Does Marijuana affect a Spinal Fusion recovery? I've recently had a tlif spinal fusion at L5 s1, and I understand THC should help with chronic pain.  My question is if I use cannabis    what affects will it have on my fusion and Does the process of smoking marijuana result in the same problems/issues for the spinal patient that come from smoking tobacco?Thank you SL",
    "doctor_response": "Hi,Thank you for posting your query.There has been no research done/available about the link between smoking marijuana/cannabis and recovery after spinal fusion.However, as a medical practitioner, I would advise you to avoid smoking marijuana/cannabis.For nerve-related pain, you could take medications such as pregabalin or gabapentin capsules, to get good relief from neuropathic pain.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to deal with short temperateness,sudden swearing,irrational and spiteful activities?\n\nI have a son in his forties who has always had a \"short fuse\".     He can go from OK to suddenly swearing, acting irrational and spiteful.    He has tried drugs for depression over the years - to no avail.   We are desperate as it is tearing his family apart.    Please help",
    "doctor_response": "HiThanks for using healthcare magicI think, he also needs cognitive behavioral therapy. For that, you should consult a psychologist for proper therapy. It would help to clear cognitive distortions. he can also try anger management and relaxation technique that would help to control anger. In case, he needs medications, he can consult a psychiatrist and can consult us.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in abdomen, thin, difficult stools, frequently passing gas. Suggest\n\nfor 3 days now i have bad tummy pain passing small thin like stools and passing load smelly wind about 5 to 10 min apart feel like i have a ballon in my back passage but passing stool is very hard work i press my fingers near my back passage and push then up on the shin near and really strain to push my stools out which comes with alot of wind please help",
    "doctor_response": "Suggest you to see a surgical gastroenterologist to examine you and give you a solution. As your back passage needs to be examined and if necessary even a sigmoidoscopy/colonoscopy may be advisable. Also please take plenty of fluids and a high fibre diet in the meantime. Also use of a laxative may be warranted in your situation. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can yeast infection in navel cause holes on shirt worn?\n\nHi....I have a question about my navel....I do not seem to have any infection but all my shirts have tiny holes in them in that area....could I have a yeast excretion or something caustic coming from my navel.....I. Can t believe lot of my sweaters have like 6 tiny little holes in the front and my jeans are not low cut so they cover my navel but it sure is strange....",
    "doctor_response": "Hello, Thnx to contact us. I understand your concern. If I am your doctor I advice you that infection from any of the organisms wont cause a problem as described by you. So you forget about that infection with some organisms is causing such a infection. There might be some other reason and you have to look for it.I will be happy to answer more of your concerns, kindly know me,Wish you a very good health at health care magic. Dr. Arun Tank. Infectious Disease.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling and pain in hand?\n\nI first noticed a pain in between my thumb and pointer finger webbing about 1 1/2 weeks ago. It started out feeling like I was being poked by a Small pin and then it looked bruised. I now am still experiencing pain and occasional tingleing, but no bruising anymore. Do I need to go see someone?",
    "doctor_response": "hi,why don't you try doing some upper limb and neck exercises. as it will make the muscle stronger in your upper limb and neck region and will avoid all the tingling present. in case if the symptoms persists in future you can undergo an MRI of the neck which may be of input for the cause if any is present. 90% of the times with simple exercise the symptoms can be avoided and the best health can be achieved.",
    "dialogue_context": ""
  },
  {
    "patient_message": "2 months old developed severe chest congestion, Dr prescribed budecort. How to prevent such attacks ?\n\nMy daughter is 2 months old and developed severe chest congestion.She was coughing in the night 4/5 bouts of cough at frequent intervals. Doctor prescribed Budecort 100 4 times a day fro 3 days . My questions Can chest congestion not clear up on it s own? I tried steam inhalation as well but the mucous was deep inside and there was never any nasal discharge . How do i prevent such situations in the future ? Will children outgrown the need for such nebulizers and treatment.If yes by when?",
    "doctor_response": "YOUR HISTORY SUGGESTS THAT YOU CHILD IS ALLERGIC PLEASE DONT TRY TO GIVE OTHER MILK ONLY GIVE MOTHER MILK IF YOU CAN STOP ALL MILK AND DIARY PRODUCTS TILL YOU LECTATE NORMALLY I DONT GIVE INHALERS STEAM IS HARMFUL FOR THESE PATIENTS WHAT YOU DO IS START SYP ALLEGRA 1/2 TSF BD TAB MONTELUCAST 4 MGM CHEWABLE,DISPERSIBLE 1/2 TAB LET TWICE ADAY APPLY NEOSPORIN H EYE OINTMENT IN NOSE TWUICE A DAY PUT SEA WATER IN THE FORM OF DROPS INSTEAD OF SALINE WATER 1 DROP TWAICE A DAY DO FOR 3 WEEK AND THAT SOLVES PROBLEM YOU CAN DO OFF AND ON IN FUTURE BUT PRECAUTIONS ARE BEST AS I ADVISED IF YOU HAVE ANY PROBLEM YOU CAN ASK FOR IT AGAIN",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Vigantol and Tavanik cause any drug reaction in a prostatitis patient?\n\nHello doctor, I am being treated for chronic prostatitis rebounce. It is now the third day I am taking Tavanik (Levofloxacin) 500 mg a day. I am taking it the same time each day among other medications. One of them is Vigantol 1000 I.E. My doctor told me to take Tavanik at least one hour after and before other medications. I think I have errored and might have taken Vigantol soon after Tavanik. Any problem with that?",
    "doctor_response": "Hi. I have gone through your query, your doctor had suggested you take Levofloxacin before any other medication as the absorption will be better. Usually, we instruct patients to wait for an hour at least so that the drug can be absorbed. Unless you took both the medication together, even if you had spaced them by 30 minutes you should be fine. There is nothing to be concerned. But I would suggest you space the medication properly from now, because in chronic prostatitis, the more the drug is absorbed, better is its action.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bump on area where wisdom tooth was removed?\n\nhi i had my wisdom teeth pulled out five years ago. i recently went for a dental check up and the dentist said i have an abnormality on my bottom right side where my wisdom tooth was removed,like a bump he said.so he referred me to a specialist..i have no pain and the bump is not visible when i see inside my mouth..what could this be?",
    "doctor_response": "Thanks for your query, I have gone through your query.The bump over the wisdom tooth region could be a flabby soft tissue or irritational fibroma secondary to irritation from the opposing tooth. Nothing to worry, if it becomes symptomatic then get it surgically removed. It can also occur secondary to any root pieces left while removing the wisdom tooth. get a radiograph done to rule out this condition.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in stomach, tender feeling in stomach. Taking previcid and gas x. What could be this?\n\nHi Samuel,   not sure what is going on but for the last year I have had stomach issues.   Went to the dr. and he told me to try previcid which I used for a while.   Helped a little.   If I push in where my stomach is located it feels tender.   This last week I was in so much pain I had to lay down for a couple of hours at a time.   Was actually sick to my stomach because of it.  Took a previcid and a gas x  plus 2 tums.   Felt better after a hour but still have a tender stomach.",
    "doctor_response": "Hi thanks for your question.Most probably you are suffering from gastritis that is inflammation of the stomach. Gastritis is due to increased acid output and commonest cause for increased acid output is cigarette smoking, excessive tea, coffee and spicy food. Second common cause of gastritis is infection of stomach by  a bacteria called as H Pylori. I would suggest you to consult a physician who may able to perform upper G I endoscopy on you. You may also need ultra sound abdomen to rule out gall stone as cause of stomach pain. You can continue with previcid and additionally you can take proton pump blocker like pentoprazole.Hope this answers your question .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the medication for ulcers on the scrotum?\n\nhello....i had a shallow small ulcer on my scrotum (right side) with irritation and redness in the right groin....after shaving the hair in these tow places the irrintation was relived the next day....but the ulcer still....it has barning sensation....what can I do?",
    "doctor_response": "Hello Thank you for trusting Since when your having this problem?? Possibility of scrotal dermatitis, herpes simplex, chancroid, drug or soap allergy and rarely bechets syndrome. Please consult your doctor he /she  will examine and treat you accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible that clomid delayed my cycle?\n\nHello, i am 26 years old and trying to conceive.. my cycles are regular 29 days.. according to clear blue i ovulated on day 14.. but 2 months ago my doctor prescribed me clomid 50 mg 2 pills a day for 5 days.. my period turned to black or just darker.. it lasts 5 days.. which is normal.. but i had hot flashes during night and i started my ovulation test clear blue on 1 febrary and so far itis always negative i am now on day 20.. knowing that i usually ovulate is it possible that clomid delayed my cycle? or i ovulated earlier? does it happen? awaiting your reply best regards, Sana",
    "doctor_response": "HiClomid is an ovulation induction drug. Most women will ovulate 7 to 10 days after they take their last Clomid pill.Clomid can cause a false positive in Ovulation Predictor Kits if taken too soon after finishing the prescription. According to most of the manufacturers you should wait at least 3 days before using the kit.Hope I have answered your query. Let me know if I can assist you further. RegardsDr.Saranya Ramadoss, General and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest natural remedy for hair loss\n\nHi Doc ,  i have problem with my hair , i am 23 yrs old and im loosin my hairs all the time , i have some hair roots pain sometime , and i dont know what to do to stop it , im wondering if there is anything i can do naturaly so i can have my hair again",
    "doctor_response": "It's wonderful that you are thinking along natural lines. I can't say , without asking more questions, as to why your hair roots pain. Is there any swelling or infection at the site of hair roots visible? Any boils, any exudate? Just to assess in case any infection is there. Any dandruff? Any excessive use of chemicals, styling creams, frequent change of shampoos, any harsh procedures on hair.Any of these should be controlled to minimum limits or not to be done. High protein diet and vit c will help a lot.HCM is there to help you. First if all stop using soap and shampoo on hair for sometime. Use Fuller's earth ( called multani mitti in South Asia) to wash hair. Let dry. Rinse with plain water. Let hair dry. If you get Neeli Bhringyadi Hair Oil ( Ayurveda) somehow you can get a lot of benefits. It's not very common. Second priority is Amla oil ( hair oil prepared with Indian gooseberry), 3rd priority is Almond oil, 4th priority is any vegetable oil/ coconut oil/ Himalya's anti hair fall oil.When hair are dried, massage hair roots/ hair gently with fingers for long periods. Then do hot fomentation by covering head with towel dipped in hot water and squeezed. Be careful while dipping and squeezing towel in HOT water. Let it cool naturally.Rinse hair after 2-3 hrs or after overnight, with plain water. If can't tolerate the odour of oils, may use mild herbal shampoo from Himalya (anti hair fall) preferably. Also use gentle protein conditioner. All the above may be done at least once a week. Initially weak hair may fall in excess, which otherwise would also fall, but do not worry.Orally embic powder should be taken but its not so palatable. May take Amla capsule thrice a day to give strength to hair roots.Hope it helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does presence of papillary micro carcinoma  in thyroid indicate cancer?\n\nI just had a right thyroid lobectomy.  I had to have surgery because all tests were inconclusive for a 1cm nodule I had.  Final pathology confirmed the nodule was benign, but they found a small spot of incidental papillary microcarcinoma in the lobe they removed.  They are treating this like it is nothing.  Do I say that I had/have cancer or not when people ask.  I am so confused!",
    "doctor_response": "hi.yes, a papillary microcarcinoma is a cancer. but since it is a microcarcinoma, a right thyroid lobectomy surgery is sufficient to remove it. it is recommended that you follow-up with your surgeon and have surveillance testing accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white, fishy smell from under the skin of my penis?\n\ni am a male 16 year old. i have old discharge down my penis, i was masturbating and i wasn't ready for it and closed the skin when it came out of my penis and it has been months since this last happened and now and then some white, fishy smell comes from under the skin up my penis and i was wondering how to clean or get rid of it",
    "doctor_response": "Hello, The fishy smell is not from the old semen. Your old semen must have been removed by your body itself. Check your foreskin underneath part. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cyst in right ovary\n\nHi Doctor, I have been scheduled to start Ovulation Induction by IVF clinic.  But each month something comes up and we cant start.  Last month I could not start because they saw a cyst on the right ovary and they said lets wait for it to burst.  Today is my day 3 of my new cycle and the cyst is still there.  They have recomended I take Microgynon 30 for a month and see if this will help.  I am 45 and time is running out.  Have they done the correct thing by putting me on the pill?",
    "doctor_response": "Hi,You have rightly said that since you are 45 years of age , no time should be wasted.It seems like a clear benign cyst since they have advised you Microgynon.If I were your doctor I would aspirate the cyst through vaginal route under ultrasound guidance, check your baseline estradiol and if okay, I would start IVF treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tinnitus while having depression?\n\nMy wife diagnosed with depression. She tells me some times she will be sleeping, the phone rings waking her up. Now awake she tries to go bake to sleep but she says her brain keeps hearing the ringing. She has told me this before but with music or people talking. it's not voices in her head. it's seems like audio flashbacks. Any ideas",
    "doctor_response": "Dear userWe understand your concernsI went through your details. There are evidences that tinnitus can cause stress and stress can cause tinnitus. So many other studies prove that extreme stress could lead to depression. Though not studied enough and concluded, because of the above relation, it can be said that depression could cause tinnitus. But tinnitus is never a problem except it could be a little anxiety provoking in the beginning. There are no treatment and the patient will adjust to tinnitus himself in due course. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for runny nose and sneezing due to allergies\n\nI've had a stuffy/runny nose for close to ten years now. Not allergies. I sneeze constantly. It worsens in the way I move my head up or down. It cleared up during both pregnancies, The only thing that has helped temporarily which was perscribed to me a long time ago was to use a baby nipple on an inhaler and snort it in my nose. I need releieft help!",
    "doctor_response": "HelloAs you mentioned that you are having stuffy nose and sneezing continuously but  NO ALLERGY. Symptoms worsen with movement of head.You got temporary relief with inhaler . All these symptoms may be due to , these reasons , these include.1 Rhinitis :Inflammation of nasal lining membrane as this produces these sign and symptoms . Nasal itchingWatery rhinorrheaNasal obstructionSneezingpost nasal drainage Headache impaired smell morning cough ( in few cases ).When such type of patient visit my clinic I advise them to take monteleukast+ fexofenadine tablet one or two in day according to severity of symptoms . Ephedrine +saline spray in nostril also provide instant relief ( few patient feel palpitation ) .2 NASAL septum deviation . Nasal examination is important . Optional in patient with/mild intermittent symptoms.preferably performed by endoscopy .Nasal exam may reveal the following:--Swollen nasal turbinates ---Nasal crease--Rhinorrhea w/ clear , cloudy or colored discharge mouth breathing.In my opinion consult an E  N  T specialist and get his opinion.Hope this information will be helpful for you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does taking diclofenac cause heart attack?\n\nhi, i have been taking diclofenac for some years now,( i have problems with my knees), but now the surgery have stopped them and given me another anti infammatory, they say that diclofenac causses heart attacks, is this true ? as i found them really effective for my pain, thanks david dodsworth.",
    "doctor_response": "Hi,It has been recommended that patients with serious underlying heart conditions, such as heart failure, heart disease, circulatory problems or a previous heart attack or stroke should avoid diclofenac. This is because there has been shown to be a slight increase in heart attacks and strokes in patients who take diclofenac.There are a number of alternative non-steroidal anti-inflammatory drugs that may be considered in place of diclofenac for pain relief. Regards,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does drug addiction cause schizophrenia?\n\nIf a person who seemed to be normal in their youth but then was a drug addict who used crack for 25 years be a victim of paranoid schizophrenia? I have a room mate who thinks he is autistic, but there is no medical history on him due to him being adopted and nothing known about his biological parents. He has paranoia like I have never seen in anybody, and although I do not see him as becoming violent towards me, I am still concerned. I mean 25 years of constantly using crack seems like it can trigger schizophrenia. Can you help?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. People who abuse drugs sometimes develop symptoms that closely resemble the symptoms of schizophrenia, and in some cases, drug abuse may actually set the stage for the onset of the disorder. In people who already have schizophrenia, drug use/abuse can worsen the illness\u2019s effects in several different ways. Talk to psychiatrist for a clear picture. Hope I have answered your query. Let me know if I can assist you further. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the treatment for chronic bronchitis with fever, horrrible cough and shortness of breathe?\n\nHello doctor, I get sick every two-three months. My doctor diagnosed me with chronic bronchitis about a year ago. I get the same symptoms every time the illness flairs up again. The symptoms consist of a snotty nose, fever, shaking, weak, shortness of breath and a persistent horrible cough. I also throw up some of the things I eat and foam when I drink things. I have an inhaler that I plug into the wall and inhale the Albuterol vapor that the machine produces. I would just like to know what else I can do to treat this painful illness?",
    "doctor_response": "Hello. In many cases of chronic bronchitis, acute symptoms appear due to infection. So, I would advise in such a scenario to get a hemogram with ESR (erythrocyte sedimentation rate) and chest x-ray done. If the chest x-ray and these blood investigations show no sign of infection then, you would be treated for bronchitis. Treatment constitutes antiallergic drugs like Levocetirizine and Montelukast and in severe cases inhalers containing like Salbutamol and steroid inhaler like Budenoside. In case of severe spasm and coughing, a steroid like Prednisolone can be used for a short course, after being sure that there is no active infection or pneumonia. If you do not have a severe cough or respiratory distress, and your chest if found clear on examination, then a cough syrup containing Salbutamol, Levocetirizine, Dextromethorphan will help you greatly. Benzonatate pearls are helpful in an allergic cough only, as they just anesthetize the throat and reduce the allergic cough response. But in cases of severe chest congestion, they are not useful. Also, do steam inhalation for symptomatic relief. I would advise you to see your doctor and get investigated. Share my opinion with him, I am sure he would agree to it and would prescribe you accordingly. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had surgery for deviated septum, concha bullosa , enlarged turbinates, and chronic sinusitis. Breathing issues occured. Allergic reactions, no improvement with zyrtec. Concerned, advice?\n\nI has surgery to correct a deviated septum , concha bullosa , enlarged turbinates, and chronic sinusitis a month ago. Before surgery I had recurring bouts of sinusitis lasting from a few weeks to a few months. Since surgery breathing though my nose has never been better. No complaints except that its still a bit crusty in there. My problem is I still have cold symptoms - clearing my throat a lot, nasal sounding voice, coughing, sneezing , and watery eyes occasionally. My ENT says that is not a normal reaction to the surgery and suspected allergies which he prescribed Zyrtec for but didn t work. I see him again in 2 days. I m getting concerned. Any ideas about what the problem might be and how to be healthy?",
    "doctor_response": "SEPTUM DOES NOT CAUSE MAJOR PROBLEM SO AFTER SURGERY MANY CASES ARE UNSUCCESSFUL YOUR SYMPTOMPS ARE OF ALLERGIES GET ANTI ALLERGIC FEXOFENADINE 120 MG OD APPLY NEOSPORIN H EYE OINTMENT IN NOSE BD PUT SEA WATER DROPS IN EACH  NOSTRI BD GET ALLERGY TESTS DONE AND GO FOR DESENSITISATION THERAPY FOR PERMANENT CURE",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy after non penetrative sex?\n\nHey The other day me and my girlfriend were rubbing each others private areas above the clothes, like little bit of fun. I then went toilet and noticied I was erected and also had pre-cum on my boxers. I only touched my penis with my right hand, and afterwards I washed my hands. After awhile of doing other things such as buying food, eating food and also hugging my girlfriend. Me and my girlfriend then started fooling around again, and I started to rub her vagina with my left hand. We've never had sex and she is still a virgin, but she is worried that she is pregnant, is this possible?",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.1] Please do not panic.2] there are almost no chances of getting pregnant without penetrative sex, and without spillage of semen in and around vagina.3] Please wait till her expected date of periods and do urine test for pregnancy , if she crosses the dates.4] The chances are that she is not pregnant.5] I will suggest to get proper sex counseling done. Use of condom will protect not only from unwanted pregnancy but also from STDs.I hope my answer helps you.Thanks.Wish you great health.Dr Purushottam",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause a bald spot on a 6-year-old child s head?\n\nHello! I have a 6 year old daughter who is very active year long with dance and swimming. I do her hair every single day and today she had a bald spot about the size of a quarter missing right at the top of her head. I\u2019m worries and nervous. She did NOT have this yesterday. It\u2019s too big to miss. What\u2019s going on? Should i take her in to get checked?",
    "doctor_response": "Hello, I have gone through your complaints and it seems to be alopecia areata. It is an immune mediated disease of the hair follicles. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why my right hand shoulder is dislocated and thin after a polio attack at the age of 50 years?\n\nI was attacked polio in the right hand shoulder a the age of four. Now I am 50 years old. Now though I can write , eat with my right hand, but my right hand shoulder has been dislocated and I find  the Shoulder area has become thin to a greater extent. I also feel pain some times. How I should be treated ? Where I should go for immediate medical treatment ? Is there any possibility for the Polio again ?",
    "doctor_response": "madam if you had polio attack in right upperlimb in childhood shoulder girdle muscles and upperlimb muscles will be wasted, and that is cause of thinness which you noticed now.all dislocations are emergencies, dislocation of shoulder means shoulder joint ball( humerus head ) has come out of socket ( glenoid). it will be very painful and probably you will not be in a position to write. neglected dislocations are seen.  where exactly do you feel the pain madam/sir,once polio is affected it means your neurons have already been damaged. and it is the reason for wasting, there is no possibility for polio again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will wisdom tooth erupt at the age of 13?\n\nHello doctor, Does every wisdom teeth start growing partially erupt or do I percent have something wrong with me? My gum is half on my wisdom teeth (which is now starting to grow) are a bit swollen but the teeth does not look slanted or impacted so far, it hurts a little though. I just wanna know if wisdom teeth always grow half erupted and then slowly fully erupted? I cannot chew very hard or a lot because it will hurt, there is nothing wrong with my gum it is just on the top of the teeth and swollen but besides that looking normal. The teeth are on the right-hand side bottom of my mouth and I brush my left-hand side of my mouth a lot more than the right so it could be an infection, I am 13, my wisdom teeth probably should not be growing yet, my wisdom teeth on the bottom left side is also half erupted but does not hurt at all. I do not know if it is swollen. I am using numbing cream as of now.",
    "doctor_response": "Hello. Most third molars or wisdom teeth grow half erupted or becomes impacted in most populations. Sometimes, normally erupting teeth can cause pain and swelling. This could probably be your second molar tooth. We will have three molars on each side. The age of eruption of wisdom tooth is 17 to 21 years whereas second molars erupt between 12 to 13 years. This pain and gum swelling could mostly be due to its eruption. This is quite normal. You can do warm saline mouth rinses thrice daily to manage pain or can continue the same numbing cream to relieve the discomfort. The gums over the erupting tooth will generally be loosely attached, hence they attract food. Food particles get trapped between the loose gums and the tooth thereby causing gum swelling. Do rinse your mouth after every meal to remove food deposits. This should settle in a couple of days. But if the swelling and pain are not coming down in two to three days, you should visit the dentist and get the swelling examined. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is meaning of nonspecific foci of white matter and hyperintensity in periventricular region?\n\nI m a 42 year old female, I have chronic back pain in which I have had 6 nerve blocks, one epidural type and a S1L5 or something like that, none of this helped at all. My lower back right side radiating down my right leg into my foot both too and underneath sometimes with pins and needles, I am due to have Spinal Cord Simulater inserted but am a bit unsure about this.any information on this would be great but I have developed another problim this is happening a few time a day and started about 2 weeks ago I have very bad pain in my left leg and hip which when it gets bad makes my breathless with pain on till I sit down, I have had a brain scan recently which came back ok mostly except the following- Nonspecific Foci of white matter, hyperintensity in the periventricular region which in the appropriate clinical context could be due to early Demyelination?? What does all this mean??",
    "doctor_response": "Hi, I am Dr.Bruno and Let me answer your query.Based on what You have said, I would suggest that you first concentrate on your low back pain radiating to your right leg and foot. This is most likely due to compression of the nerve roots. This needs to be addressed immediately The Non Specific Foci of White Matter Hyper intensity in Peri Ventricular Region can be addressed patiently If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in the hand after taking MDMA?\n\nhello, i took some mdma yesterday and today have experienced some swelling in my hand, red skin, bumps on my four-head and swollen lips. i was wondering if i might be allergic and whether these side effects will subside with time or whether i should seek treatment.",
    "doctor_response": "Hi, Puffy hand syndrome is the end result of lymphatic obstruction. Repeated injections of drugs in or outside the veins destroy the lymphatics. Buprenorphine may play an important role in the puffy hand sign. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ajeet Singh, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the case of Multivessel disease for total surgical revascularization  emergency?\n\nCardiology: 54 yrs old, x heavey smoker, parkinsonism on carbidopa with NSTEMI anterior T inversion. LAD: tight 80% ostial and 90% mid segment lesions LCX: tight 80% OM 1 lesion Ramus: non critical 50% proximal lesion RCA: totally occluded from proximal segment with ante and retrograde flow from LCA. RCA is graftable distally Conclusion: Multivessel disease for total surgical revascularization Excellent systolic functoin Please advise on the intervention and the urgency of the situation",
    "doctor_response": "the report suggestive of tripple vessel disease.the treatment is off course CABG(surgical revascularization).no doubts in treatment option.but urgency depends on your symptoms.. if you were already on antiplatlets and stations and u developed NSTEMI then u should go for surgery early..if this NSTEMI is recent and you were not on drugs then treatment will depend on your functional status..if u can do your all household activities without chest pain and heaviness and you started your medicine then you can wait ..but this is your choice. nothing is absolute",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes delay in periods after having contraceptives?\n\nhi can i had my delivery last august 28, and i had my first period last sept. 27 i take althea last october 4 and i did a contact october 5 the next day i take the pills and i had just finished 1 pack that was this october 25, then i start drinking again last sunday in just wondering i didnt have my period since now can you help me thanks",
    "doctor_response": "Hi,I understand your concerns.Following is my reply:1) This delay is due to variation in hormones.Let me know if you need anymore help.Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Invisalign retainer has caused me jaw problem after stop wearing them. Why?\n\nHello doctor, I think I have had an adverse reaction to Invisalign retainers over the past few years. I think they have caused me jaw issues (chronic facial tension radiating to all areas in my face and associated with droopy eyelids and jaw clicking and aberrant jaw positions, etc., and I can move this tension around with purposeful movements of facial muscles and pressure sensitivity on the face-tension is trapped, worsened, altered by glasses, pressure, and prescription and eye movements). I believe this began when I stopped wearing them 24/7 and particularly when I switched to wearing them every other night. I have noticed that my jaw is asymmetrical and perhaps small particularly on the RHS (may be a link to why I was initially getting tension symptoms on the RHS) so maybe Invisalign causes issues, stretches, small and asymmetric jaws excessively, or I have some random unexplained predisposition to my jaw getting confused by regularly changing bites or something (still think the latter may have something to do with the former). I just wanted to inform you of this as I have been told these symptoms are unique, functional and although Invisalign is known to sometimes cause TMJ problems it is not heard of causing issues like this. I am open to suggestions. Thanks.",
    "doctor_response": "Hello. The symptoms described by you are rarely caused by Invisalign, it may cause TMJ (temporomandibular joint) problems in some people but for a shorter duration as it is not permanent. Actually allergy means that you have redness in the area and if you wear for some time it cause some reactions in the local area and may also in the body. Do you have something like that? The symptoms are mostly related to TMJ, the reason may be that you can not bite on your teeth and you are now biting on Invisalign, and this can increase your bite where it normally was. The best in my opinion will be to consult your orthodontist if you can pause your treatment. Stop wearing Invisalign, rest your jaw for as long as you can like do not eat hard or crunchy or sticky food. Soft diet, no prolong talking, do not open wide too much especially yawning. Also, use over the counter pain killer for relief. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to have ampicolix for infected graze when trying to conceive?\n\nI ve been trying to concieve and have been prescribed a 7 day course of ampicolix for an infected graze on my foot whilst on vacation. I m mid cycle and 3 days into the course of antibiotics (the cut is wellimproved and swelling on foot has resolved) is this medicine considered safe at the stage of fertilisation should conception occur. I note that there are unproven concerns around cardiovascular effects to the fetus with use of cloxacillin in 1st trimester",
    "doctor_response": "Hi, Okay, the first issue is that an untreated infection is far riskier than an antibiotic. Then there are some antibiotics we know are bad and ones which are far less likely to be bad. the difference is how much they interact with our stuff rather than the germs stuff. Tetracycline not only somewhat has the same effect on us (but less) than with the germ BUT it also binds to bone/teeth. It's bad. Quinolones have very little interaction with the particular thing that the germ has BUT it is toxic to tendons probably a bit bad. Pencillan / Amoxicillan etc. hit starch coverings around most bacteria that we don't have. They are generally pretty safe. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can high cholesterol be controlled?\n\nGood morning Doc, hope you can help? My doctor told me that I have inherited high cholecterol from family. Recent result shown my cholesterol mmol/L 7.2 and HDL-cholesterol mmol/L 3.1 and LDL-cholesterol mmol/L 3.8, total/HDL ratio 2.3. My doctor wanting to put me on cholesterol tablet and I'm not keen, I'm 5.3 inches weight 50kg, exercise 7 days a week, walk 1.3ohrs from monday to friday, saturday I run for 2 hrs and 2hrs gym workout on sunday. I take muesli and fruits for breakfast, lunch chicken salad without dressing and small portion of rice at dinner or grill fish someday for dinner. Do you think I should change my diet to get my cholesterol down and how. As it is my diet is so control and the only think is I will have to cut my coffee in the morning. I only have a cup of coffee and 2 cups of teas a day with low fat milk and the drink 3 ltr of water every day. Can you help? Nora Thanx",
    "doctor_response": "Hi NoraI have read the details provided by you and I would like to tell you that Familial hypercholesterolemia usually require some cholesterol lowering drugs during the initial part of the treatment to bring down the levels. You are on a good exercise and diet schedule so need not change that. Along with that I would like to start the cholesterol lowering meds as advised by your doctor. Take them for minimum of 3 months after that check your cholesterol levels again. Hopefully this strategy will help you and once they are low u can stop the medicine and continue with your healthy lifestyle routine. wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why are Zinnat and Fasigyn prescribed during infertility treatment?\n\nMe and wife are under infertility treatment currently. In one of the visit, doctor prescribed these two medicines Zinnat 250 MG Fasigyn 500MG. When i tried to claim to insurance company, they mentioned these medicines are not related to infertility treatment. I am wondering why doctor has prescribed these medicines.",
    "doctor_response": "Hello,These are not related to infertility definitely but your doctor must have given this for some type of infection he or she must be suspecting and then maybe they want to proceed for infertility treatment.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mandavi Rai",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever,cold,cold sweats and discomfort in stomach?\n\nmy husband just had fever (could also be flu because his body was aching), had colds and around 3 days after he was having cold sweats and unexplainable discomfort in his stomach. he was taking bioflu and sinutab during the time he had fever. what could be wrong with him?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. He may have some viral infection or upper respiratory tract infection. He should go for complete blood count. If it is infection then he should complete the course of antibiotics.  Viral fever goes by itself.  Just take plenty of water and symptomatic treatment.  No need to worry. Just be relaxed.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medication for pain & lump at the back of the neck\n\nHello there I woke up this morning with this weird lump on the back of my neck right below my hair line it doesnt hurt to touch but its really hard to the touch its causing pain when I move all the way down my shoulder and such and the lump keeps getting bigger and bigger should I be worried?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some enlarged lymphnode due to infection.  Mostly it is due to reactive hyperplasia.  However less likely it can be due to tuberculosis or lymphoma.  You should take a course of antibiotics. Mostly it will decrease in size. If it doesn't respond to treatment then biopsy diagnosis is advisable.Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain at hip joint, knee and ankle?\n\nmy husband has been experiencing odd symptons...pain and fatigue at hip joint, knee and ankle...swelling in hand, rapid weight gain and bleeding from ear...he is 9 yrs recovered from massive heart attack and continues to work at high energy pace...really slowing down, the last few weeks and feeling weak",
    "doctor_response": "Hi, This condition calls for complete medical check up especially in relation to kidney and heart functions. any derangement could lead to these symptoms. 9 yrs is a long time. Even without symptoms he should undergo complete check up. Hope I have answered your query. Let me know if I can assist you further. Thank you. Regards, Dr. Gopal Goel Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bleeding from the gums?\n\nHim, mayy  I answerg yuourm hse alth quberliees eridght now ?  Please type your query here...Well every morning my teeth bleed alot especially when I smile!  Even when I barely touch my gums and I also wake up with my gums bleeding...what does this mean?",
    "doctor_response": "Thanks for your query, I have gone through your query.The bleeding in the oral cavity could be because of the gum infection secondary to the deposits below the gum.The other possible causes of bleeding can be because of any cuts in the oral cavity or pulp polyp or any bleeding disorders like idiopathic thrombocytopenic purpura. Consult a oral physician and get these things ruled out. Get a complete blood investigation along with INR to rule out the bleeding disorders.If any gum infection then get your teeth cleaned and use topical gum astringents like strontium chloride (stolin) gum paint.if pulp polyp is there then get it root canal treated.If bleeding disorder is there then consult a general physician.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does my MRI suggest?\n\ncan you please explaing what is meany by following MRI reportMRI suggests disc at L4-L5 , L5-S1 causing thecal sac & nerve root compression & Disc bulge at L3-L4whether surgery is compulsory ?what are the precautions to be taken for avoid escalation of the above problemwhether it can be cured by physiotherapy",
    "doctor_response": "Hi, Thanks for posting in HCM. I understand your concern.Its age related complication and also due to over weight .you didnt mention either of them,, surgery is needed only when you have symptoms like parethesia of your limbs,difficulty while you sit and stand,and if you are passing urine and stool with out your consiousness. some time if  you have associated bone degeneration you will  have disc problem. precautions can be taken if over weight -- reduce your weightif you age is if your age is >45 its hormone related bone issues in female and male age related and surely its treatable with regular physiotherapyHope the information provided would be helpful. All the best. Regards,Dr.sameena",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chest infection, fever, sore throat, mitral valve incompetence. Taking avapro, symbicort. Cure for allergy?\n\nI have just tried to send my query and not sure where it has gone so I am trying again. I have a chest infection after a couple of days of fever with sore throat.Dr prescribed Tricef xl200 and although I have taken Keflex and Dicloxacillin previously but not together. I am somewhat sensitive to meds so always cautious. I am allergic to sulphas. I also have Mitral Valve Incompetence. Take Avapro 150 (Ibersartan) for hypertension and Symbicort 100 for asthma.",
    "doctor_response": "Hello, Cefixime (Tricef) is probably a better choice given the MVI you have and does not cause a problem in sulfa allergic patients. Viral infections are quite common now with change in weather and if you develop high grade fever with rash, please do get yourself checked thoroughly with a complete blood count, LFTs and infectious disease screen. I hope you have continued on the antimalarial prophylaxis. Let me know if you have any other queries. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication to improve the chances of conception.\n\nHi , I have a question . I just stop taking the depo shot my last due date for the shot was April first but I didn't get the shot . I'm not on Birth control pills I started them April third , me and my boyfriend is trying to have a baby . How long will it take for me to concieve ?",
    "doctor_response": "Hi there, I have understood your concern. I will suggest you the best possible treatment options. Usually, after the last depo shot of contraceptive, it's effect lasts for 3 months.  As you have opted for not taking the depo injection, you will be free from its contraceptive effects. Usually, fertility returns within 3 to 4 weeks .If you have history of regular cycles then you can start expecting toget pregnant from your current cycle.  As you might be aware that in a woman with regular cycles day 10 to 20 of the cycleis the most fertile periodof cycle. If you have unprotected sex act in the fertile period, then You Stand chance to get pregnant. I will suggest you to start with Folic acid, Vitamin B 12 and Omega 3 supplements at least 3 months before you plan to get pregnant.  This helps to prevent many problems during pregnancy and delivery. I hope this answer helps you. Thanks. Dr . Purushottam Neurgaonkar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for severe fever in child?\n\nMy daughter is 3 years old. We are from Nepal but have been living in Australia for last one year. She has been getting high fever which gets up to 40 C every 15 to 21 days. It was more severe in winter months here, she has had lots of check ups but nothing has been diagnosed. Many times she has had tonisilitis during fever. Now she is in fever but this time her tonsils are not swollen. Fever started from Wednesday 12 January and it is still high. I took her to GP yesterday and was told to wait before medication is given. She has been on penicillian for treating tonsilitis for last every fever. This may be viral fever so we are waiting. How long viral fever can be and what should be done if fever gets very high?",
    "doctor_response": "Hi, By what you say I feel that this could be a recurrent viral illness. I will explain you how a viral illness behaves so that you can be more confident. 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  every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for community acquired pneumonia\n\nI am a family doctor in an outpatient family medicine setting, and the question was raised reguarding treatment for community acquired pneumonia. If reoccurance of infection occurs, after treatment with z pack within 90 days how  should patient be treated. Would it be safe to treat again with levaquin as an outpatient?",
    "doctor_response": "HelloIt depends on the age, commodities, immunity status and the cause why the pneumonia is come back again.RegardsDr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "More acne breakout after various cosmetic techniques. Should I first treat acne?\n\ni am using isotretinion for three months, i had microdermabrasion in the second month, and in the 3rd month i had derma rollar,,,but my skin is getting worse day by day,,,,their are more acne breakouts on my neck ,,,these are cystic acne ,,,,,my acne course is of six months,,,,my two sessions of derma rollar has left,,,,so my question is should i control my acne first and complete the medication of sixth months,,,,and then i should go for further procedures like derma rollar etccc ???????? my name is rania ali.....age 25.....height 5-1........weight 55 kg",
    "doctor_response": "Hello Raina. Yes, it is best to control acne first and then go for other procedures. Also isotretinoin delays healing of skin, so it is best advised to treat acne foremost. Hope this helps Dr. R.P. Gupta",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a sore neck lump with an enlarged spleen?\n\nMy 15 year old daughter just found a small lump on the right side of her neck just below her ear. Last week she went to the emergency room due to excessive vomiting and dehydration. They ran several tests to rule out Mono and Appendicitis. Those two test came back negative, however, a reading of the CT scan of her ABD (w/out contrast) showed a slightly enlarged spleen. Her WBC was a little over 17,000. She seems fine otherwise. The lump is sore when it is pressed on.",
    "doctor_response": "Hello, The possibilities could be - 1. Suppurative lymphadenitis 2. Kikuchi's disease 3. Lymph node TB I suggest you discuss these possibilities with her pediatrician and get her evaluated, please. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had varicocele surgery and taking Carnisure 500 tablets. How long it will take to increase sperm count ?\n\nDear Doctor, I am 36 years old, 75kg, no child. after consult the doctor i did varicocele surgery in last week and now taking Carnisure 500 tablets daily. Before my sperm count was lessthan one million. It is right way to increase my sperm count and how long?",
    "doctor_response": "Hello;faisal;welcome to HealthcareMagicYes this is the correct method to treat male infertility which in your case was due to varicocele so please continue the treatment till the doctor advises to do so.Once the problem of varicocele is solved your sperm count will definitely improve and if your wifes cycle is normal and all reports are normal then try to do intercourse every alternate day from 10th day of start of menses till the 21st day to increase your chances and Insha-Allah your wife will get pregnant.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for encephalopathy\n\nRE: DENGUE ENCEPHALITIS W/ PSYCHOSIS (1 MONTH SINCE CONFIRMATION)Hi,I am Amanda Gordon Paragas, mother of 3 boys, whom recently contracted Dengue.  All four of us were confined last October 7-14 at St. Lukes, Fort Bonifacio, Philippines.   My eldest, who is about to turn 11 this November 18, Harry Paragas was diagnosed through a spinal tap to have Dengue Encephalitis.  Last October 31, I had to rush him back to the hospital as he was starting to exhibit signs of psychosis (parang sinasaniban).   It has been more than a month since we have been confirmed to have dengue.  We are now currently confined at the St. Lukes Hospital in Fort Bonifacio rm 651.I would like to ask for your assistance in finding other cases similar to ours to help resolve my my son's encephalopathy and get him back to normal.Please find attached the medical abstract of my son for your reference.Please, please, please, maawa po kayo.  You may contact me or my husband Eric anytime at 632-0000, 632-0000, +63-0000, +0000 or  YYYY@YYYY God bless you,Amanda G. Paragas",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your son's symptoms and can understand your concern, as he is unwell.Dengue encephalitis is uncommon, however, it occurs in most countries. Unfortunately, there is no specific treatment for cure of dengue encephalitis. Most of the treatment is supportive and symptomatic.If the child has seizures, we use anti-epileptic medications.If the patient has psychosis, as in your son's case, we use anti-psychotic medications, such as quetiapine or olanzapine.The good news is that most people recover over time, more so, the recovery is very good in children. I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could blood in sperms suggest?\n\nHi, may I answer your health queries right now ?  Please type your query here... hello, i have had blood in my sperm for about 4 days now... what could it be or what should i do...  i am 25 years old, 150 pounds and have never had any problems with anything",
    "doctor_response": "Hi, If you had unprotected sex - need to rule out sexually transmitted infection. If not it can be due to rough masturbation, urinary tract infection, prostate infection, bleeding disorder, doing a urine complete / sperm complete can help you. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Tramadol be given for pain in ribs?\n\nHi, I have a pain under my right rib. A little history: I was in a motorcycle accident 6 months ago and hurt my left ribs and back. The doc has been giving me Tramadol. My question; can the tramadol cause liver swelling, the pain is like a pinch inside under my rib. Thank You",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Yes, tramadol is given in pain in ribs. Tramadol is centrally acting painkiller (acts on brain).It is safe for liver and kidney so tramadol can not cause liver enlargement. Your current pain is mostly due to injury in the past. You can take tramadol for these kind of pains. Also apply warm water pad on affected areas of chest. Avoid movements causing pain. Avoid heavyweight lifting and strenuous exercise. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a white patch on the hip area in a child?\n\nHi, my 3.5 months old daughter has developed a white patch on her upper thigh/hip area, I ve seen her ped. for that, but she seemed not convinced it s a patch, she thinks it s from the skin folds - but anyhow she recommended that I check with a ped. neuro (since I voiced my concerns that I ve also noticed my daughter won t sleep at all these days except screaming and having these seizure like movements!) my question is: what this white patch could be? rather than a physical illness related to seizures?",
    "doctor_response": "Hello, White patches on babies are not unusual.  The cause can depend on a lot of things.  When you look at the patch is it white because it is scaly or white because there is a loss of pigment? Most often, it's pityriasis alba, a fancy medical term for a white spot!  Most likely on the cheeks, but I've seen them everywhere.  Also, friction can cause an area of whiteness in comparison to other skin. Sometimes it's a birthmark that has enlarged and become noticeable as the baby grows.  But there are some more concerning white spots. Much less likely, but possible, is a depigmented white spot called an \"ash leaf\" spot because it is irregular, mostly oval and shaggy-edged. This can be indicative of a very very rare disease called Tuberous sclerosis.  This can be related to seizures, so I'm glad you're already scheduled to see a Neurologist.  So while you're there, ask them to take a look at the white patch so they can tell you if it is just normal or not. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Lisa Baker",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will having a fever of 102 effect colonoscopy?\n\nI have a colonoscopy scheduled for this coming Tuesday. I began running a fever yesterday and currently it s 102. I just took a tepid bath, but it s still 102. What can I take that won t interfere with the colonoscopy prep? I know I can t take Metformin the morning of, but don t know if Ibuprophen is permitted or something else. Thank you.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You should go for complete blood count to search the cause of fever. If it is due to malaria or typhoid then colonoscopy should be postponed. If it is of simple fever then you can take paracetamol to control fever. No any oral tablets should be taken in the morning of colonoscopy day.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Old age, had a fall, hallucinating, in cardiac care, had depression. Get memory back?\n\nHello. My mom age 85 is in the hospital due to a fall. Thank God nothing is broken however she doesn t recognize most of us and talks to our deceased loved ones. She actually gets upset when we don t acknowledge that they are there. She has been off of all pain meds for three days so that was ruled out. This afternoon her heart rate jumped from 150 down to 50. She is now in the cardiac care unit of the hospital that she was taken to. She seems to be failing. She is a diabetic, controlled b/p and basically a healthy person. She suffers from depression since my dad passed 10 yrs ago. Do you think there is a chance of her getting her memory back? Thank you.",
    "doctor_response": "These hallucinations are likely to be precipitated by  acute   stressful situation. Mostly this happens due to underlying age related brain degeneration, although this can also be unmasking of subclinical dementia. Its is possible she recovers her memory back , if she is not having dementia , this will get clear only with passing time, meanwhile we need to make sure that her general health improves and she recovers from other treatable medical problems. Dr Kapil Agarwal Consultant neurologist GURGAON",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes uneasiness inspite of using Encorate for epilepsy?\n\nDear SIr My brother is taking the medicines for eplipsy from 1993 Last week he suffered from long epsiode of eplipsy & doctor given the Encorate Chrono 300mg After 2 days againg he is feeling uneasy His MRI,EEG all reports are normal Kindly suggest",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, if this is the Grand mal epilepsy then it responds well to treatment once the patient is on proper medication then convulsion stops then it seldom comes back, if patient is having seizure then either the diagnosis is not correct or medicine is not correct, I would advise you to discuss this with doctor or go for second opinion hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does itching last in obstructive jaundice?\n\nhi..i have been suffering from jaundice for 2 weeks..my bilirubin level last week was 14..this week  it went upto 23.6..doc told me it was an obstructive jaundice..which is also  causing severe itching in whole body..i have had obstruction removed through ERCP..but my itching is not gone yet?how much time will it take to go away?",
    "doctor_response": "Hi,Thanks for asking.Based on your clinical history and query, my opinion is as follows:1. Itching is due to increased bile acids in the body, which is deposited in skin. This is due to obstructive jaundice.2. Once the obstruction cause is removed, it will come down and it should reduce within a week.3. You can additionally take bile acid chelating agents.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to check for broken bones after getting hit in shoulder?\n\nmy son was playing 7 on 7 football, No pads just a helmet. He was hit in the coloarbone/shoulder. I think he is bruised pretty good, However What should I look for it it s broken? He can breath w/ no issues, a little tingle at the spot that got hit, No other systems he has shown.",
    "doctor_response": "Hi, As what I understand from the history it appears to me as there is no fracture but on a safer note taking an x-ray should be good. if there is a fracture there will be acute pain and unbearable symptoms by breathing. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does fever, headache and generalized body pain indicate?\n\nHi doctor, I am having fever, headache and generalized body pain since yesterday. I consulted a physician. He prescribed me medicines and advised for a blood test. My blood test report is attached here for your reference. Still headache and fever is high sometimes. Kindly give your opinion.",
    "doctor_response": "Hello. I have checked your blood reports (attachments removed to protect patient identity). For further information consult a family physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there weakness and back pain after delivery?\n\nHi doctor, A few days back my wife felt weakness and back pain and today she felt too much pain in backbone while sitting and while laying down. This pain started after delivery. She cannot move fast. This time she is in pain and I am very upset about what to do. She is a child's mother so please help.",
    "doctor_response": "Hello. From her young age and recent childbirth, she might have suffered from a slipped disc in her back. Does she have any leg pain? Please note that if she suffers from any urine or bowel disturbance then she will need to see a specialist straight away. My recommendation for your wife is to rest, avoid lifting and have strong painkillers followed by physiotherapy. If symptoms persist then she will need to have MRI scan. For more information consult an orthopeadician and traumatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for asthma?\n\nHello doctor . I have like an asthma attack ,I have in my cabinet ,prednisone 10 mg,and Hydroxyz Hcl 25 mg, which one do you recommend me to take , usually I have this asthma under control , and I do not take any medicine but the excess of pollen I got very sick ,is like I need some air. Thank you for your help.Marinela",
    "doctor_response": "Hi, thank you for posting.I have gone through your query and I understand your concerns.In these cases I recommend Prednisone treatment. This medicine has better effects and minimized side effects.You should contact your allergist to discuss about the dosage, because it is your treating doctor the one who determines the dosage.Take Care.Dr. Behar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching and swollen toes?\n\nA few days ago, one of my toes started itching, then swelled up and turned red at the tip. Then, 3 days ago, I developed a hives like rash covering pretty much my whole body. Today, I have blisters on the affected toe and also smaller ones in the area around it. Went to the doctor and she had me get a blood test for uric acid (testing for gout, I guess). The uric acid test is in normal range - 6.1. The toe is not painful, but itches like there is no tomorrow. I am a 60-yo male, and active - I do water aerobics and walk 2+ miles. Also have been hiking recently. Any ideas?",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.You can discuss with your doctor about it. I think you should exclude any cold exposure, diabetes and circulation disturbance. It can be something like cold allergy and circulation disturbances. You can get it clinical examination by general surgeon for better understanding. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the loose stools with grains be due to parasite attack in restaurant?\n\n63yr old woman, typical American diet, usually have good stools, but have had very soft stools since July of 2013, around the time I ate soup & appetizer at a chain restaurant here in Phx, AZ area. Stools come out very urgently , are very soft, and grainy , and come out in short, narrow sections, about 2 to 3inches each. I seem to be more gassy than usual. Could I have contracted a parasite at the restaurant? Thank you.",
    "doctor_response": "Hi,From history it seems that you might be having gastro-intestinal infection either bacterial or amoebic.you might require one course of ofloxacilin, tinidazole combination course for 3 days.Take light diet like curd, rice, buttermilk.Take plenty of water.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Oxycodone reduce abdominal pain due to cancer?\n\nHello there, I was wondering if you could answer this question for me. A friend of mine has a sister whom has terminal cancer and don t know how much longer she will last. Apparently she had a puck inserted into her abdomen for pain and the medication is dilaudid, not quite sure of the spelling on that. My friend, her brother said that she was still having pain so he said that he gave her his prescription of 15mg oxycodone (percocet}, so I guess I m asking if that is the wrong thing to do and can this harm her? I was under the assumption that this was a free of charge, one time question. I assume that I won t see an answer to my question, however, I will alert her family and they can speak to her doctor, as I don t want any harm to come to her, after all she is enduring to begin with.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. In routine case this drug is harmful.  But patient has terminal stage of cancer.  It is very very painful condition. Symptomatic treatment should be given to releive pain. It is justifiable in terminal stage illness. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of dark spots after recovering from flu?\n\nI had an aleergice reaction to just for men.  Swelling, rash, some strange clear discharge which hardened then peeled away.  Got flue type symptoms also.  Flue went away and the swelling has stopped but I notice a dark spot where the dye was under my beard.  Will this go away on its own eventually?  Should I see a doctor at some point?",
    "doctor_response": "HI, thanks for using healthcare magicYes, the dark area would eventually fade.It is due to the inflammatory allergy response and the chemicals that are released during this process.It can sometimes take weeks , however for improvement to occur. The use of cocoa butter, vitamin E creams may sometimes help.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for getting pregnant\n\nHi Doctor, Im 31years & have been trying to consive for the past 2 years. I went to my doc today for a scan (day 15) to find out if im fit for an iui. My right ovary showed a dominant follicle of 1.3 x 1.2cm while the left showed a follicle / cyst with echoes of 1.9 x 1.7cm. My doctor said that bcoz of the cyst the iui can not be done. Im a bit worried now, is this something serious?",
    "doctor_response": "My opinion is that those may just be functional cysts....You should however approach you doctor and discuss with him as there are other ways to help increase your chance of conception. I hope I have answered you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hip pain with lower leg muscle coordination?\n\nHi I am under a neurologist and have problems walking with coordination and muscle stabilizing in my legs, I trip on the floor and up the stairs and cannot walk more then a few meters without my legs feeling dead. I have a constant ache in my lower back central hip area and if I enter s dark room I almost fall over. Heat massively effects my balance and the feeling in my legs any idea please?",
    "doctor_response": "Hello,Your symptoms may appear like neuro claudication or peripheral vascular disease. Until examination is done it is difficult to say what it is. Get a colour Doppler of both lower limbs with MRI of hip joint which may give a clue. Please consult with your physician, he will examine and treat you accordingly.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the reasons of having pain in back and lower ribs which is prominent while lying down?\n\nhi,I have a pain in my back, right side lower ribs and more prominent when lying down in bed and turning from one side to the other. feels like a bruising pain. I am 65 and very healthy for my age.This pain has been going on for about 6 weeks.Thanks,Niko",
    "doctor_response": "Hello, I have studied your case. Due to compression of this nerve root there is pain in your back.I will advise you to do MRI spine.There is possibility of rib contusion or chostochondritis.For these symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.I will advise to check your vit B12 and vit D3 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty getting an erection?\n\nHi I m a 20 year old male, I ve always had no problems when it comes to being able to achieve good quality erections until just yesterday my girlfriend of almost 2 years gave me an intense handjob using lotion,after which the tip of my penis was slighty irritated and had a burning sensation, and ever since then I can sometimes get an erection but only for a short period of time or it s not a quality one. We have now unsuccessfully attempted intercourse 5 times. Please help thankyou",
    "doctor_response": "Thanks for asking in healthcaremagic forumIN short: Give rest to your penisExplanation: AS you told that you dint have any problem till now. You may have over used your friend in a short period of time. So, I would like to suggest you to give rest for 3-4 days. If you are able to get proper erections after that, you dont have any problem.                  Otherwise visit a doctor and get yourself examined for proper diagnosis and treatment for your problem.                   Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for gallstones and sludge?\n\nhi, I m 27 male and having pain in my abdomen, it s 5th consecutive day of pain as well as constipation is on it s hike, doc in my locale asked for ultrasound in which I received echogenic sludge is seen in gall bladder lumen. I was prescribed Domstal, Zinetac, Drotin-M and Merizyme syp. none is helping please guide me what to do..",
    "doctor_response": "Hello Definitive treatment of gall bladder calculus with sludge is surgical removal of gall bladder.Now a days,operation is done laproscopically.Recovery is fast by this method.It is not wise to keep gall bladder calculus for long time.It is prone to get obstruction and infection.It may also be cancerous if kept for long time.You are rightly prescribed symptomatic treatment but you should go for definitive treatment.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can medicinal marijuana be taken for liver problem?\n\nCan I get THC free medicinal marijuana, AKA CBD Marijuana, to help my liver? I was born with a weak liver, yellow eyes, and it was called jungis or something like that. The doctor also said my P.H (i think that is what it is called) was to high. I also have weird implant type things on my testicles, and sometimes they feel tender. I was told they were sperm clogs but who knows. Is this dangerous?",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.There is no some strong scientific support for marijuana as a liver treatment remedy but some studies show that it might be?beneficial in slowing the progression of liver fibrosis and the neurological decline associated with hepatic encephalopathy, in addition to the attenuation of the adverse hemodynamic consequences of cirrhosis. YOur testicle issue however should not be related to liver and this may indicate STD or epididiimitis so you should do std testing and testicle ultrasound.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What food items should i eat in case of high SGPT levels?\n\nHi <br><br>My SGPT is high after a sever Viral Fever. I was admitted in the Hospital for Two days. After a week i felt like So weak and i checked my SGPT level. It has gone up to 63. Can you Please help me out on what are the Foods should and shouldn't i eat.",
    "doctor_response": "Hi thanks for contacting healthcare magic...Here you have to rest liver by taking less fried and fatty food...Avoid alcohol...Try to be away from non veg food esp meat....Pizza , cheese , baked pestry etc....not taken.Refined food avoidedUse very less oil in diet....Sunflower or canola like good oil used.Take one tsp crushed carom and cumin seed mixture with water daily....Sugar cane juice good....Hope you will recover soon.For further query you can contact healthcare magic.....Take care......Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bumps on sides of frenulum and frequent urge to urinate?\n\nHi i am 18, i have had sex with 13 girls but i havent had a problem till recently when i noticed that i have these weird small messy clusters of bumps on both sides of my frenulum. My have recently also developed an increase in the urge to urinate also there is a strong cent then usual from my penis. It does burn sometimes when i urinate.",
    "doctor_response": "Hi thanks for contacting HCM..Let me know you by unprotected sexual intercourse you can have sexually transmitted illness.....STD....Sex always be done with wearing condom to prevent this....Now according to history it seems you can have herpes or human papilloma virus infection.....For that physical examination necessary ..You can post photo and it can help you to guide further.....You should counsult dermatologosit in your city for this ....And yes obviously try to avoid multisexual relation and focus on study at such an young age ....Take care ...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, medical reports normal, regular periods. Treatment?\n\nDear Sir/Madam, Me (30 yrs) and my wife (27 yrs) are married from past 2 years and are planning to have baby now. We have been trying from past 2 months, however she isn t conceiving. We have a clean medical record and are healthy. I am also taking care of her cycles and her possible ovulation days. She is having regular mensurattion cycles at an interval of 28 days from past 8 months. We have not used any artificial contracepative aid as well. We do not take any kind of drugs including alcohol. We wish to understand if we should be doing something additionally (which we might not have been doing) or should we both undergo some tests. Kindly Advice.",
    "doctor_response": "hi, infertility can be called only when pregnancy does not occur  after 1year of unprotected intercourse. so you need not worry. If you are sure that her cycles are regular, then you consult gynecologist and once go for semen analysis which will rule out any problem in male factor. if that is normal then your wife can have physical examination and one ultrasound, and depending on the results future treatment can be planned. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is HCG diet safe while having lupus?\n\nA close friend who does need to lose weight is utilizing the hcg diet, which I find disturbing because she has lupus. Granted she barely listens to doctors orders as she insists her 3-4x a week of drinking several beers is fine. What can the consequences be of this rapid weight loss plan with lupus?",
    "doctor_response": "it is definitely not recommended to go in for rapid weight loss, if a person has lupus, there are cases when autoimmune problems have been activated or worsened with these kind of diets.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes large black sticky stool after having neocate?\n\nMy paedeatrician prescribed Neocate as he suspected an allergy to her current formula. She has been on it for 2 days and just passed her first bowel motion. It was large, black and sticky. It was the same as her first bowel movements as a newborn. Is this normal?",
    "doctor_response": "Many thanks.I want to ask more questions from you.When did your baby pass first black sticky  stool ,either within 12 hours of age or after 24 hours  of age?Is your baby passing daily stool or not?first black stool is called muconium,it is very sticky.it is normal thing.if he pass delayed muconium and he is constipated then needs further evaluation and management to exclude Hirschprungs disease.if he passed muconium with white plug in front of then we called muconium plug which some time associated with Cystic fibrosis.I will advised you don't use any medication or different formula at this age without proper diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated liver enzymes with normal cholesterol?\n\nHi Doc, I am 45 yr old female, recently diagnosed with elevated liver enzymes. I have been taking 1 mg Klonopin 3x a day for 5 yrs.  I have my menstral cycle approxamately 3-4 times a year. My sugar cholesteral and hormones are okay. I am 5'2\" and weigh 170lbs . What is going on?",
    "doctor_response": "hi.noted history of elevated liver enzymes. causes of such could be inflammatory/infective (i.e. hepatitis) or obstructive (gallstones, tumor/lesions) in origin. it is best if you consult with a doctor, preferably a gastroenterologist or a general surgeon, for clinical evaluation and physical examination. diagnostics (such as ultrasound, ct-scan, etc.) and management (medical and/or surgical if indications are found) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rashes, on neck, breasts and back with yellow liquid. Why do they happen?\n\nHello,I seem to be getting a particular kind of rash quite frequently nowadays. It occurred last year in the summer for the first time. Now again, I have red dots which quickly multiply only on my chest (area under my neck and above breasts), nowhere else. Happened again 3 weeks ago, in a week they disappeared, my skin was ok for 5 days and they are back again. I was thinking if it could be heat connected but I have always lived in a hot country and this never appeared before. I live in England now and it is just not that hot. I had an appearance in the winter too but maybe once. SO I have no idea what it could be. The rash does not itch at all. In a day or two after the spots appear (they come out as flat red dots), then you can see like whitish/yellowish liquid inside of them. Takes ages to heal and then appear again. I can not wear suitable for the season clothes now as it looks disgusting and I hide it which makes it worse. If it is \"sweat rash\", why doesn't it ever itch at all? Plus, I don't really sweat, I always even wear less clothes than anyone else I am so so confused. Please, help. Thank you so much!",
    "doctor_response": "Hi ,thanks for writing to health care magic.Rash is suggestive of  fungal infection.It can occur in case you have dandruff.Use antifungal shampoo for dandruff.Keep area dry and clean.You can use antifungal powder at day time over affected area.Use loose cotton clothes.At night you can apply antifungal cream like miconazole.I hope this will solve your problem.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dizziness, black out, legs wobbling, palpitation. Is it due to leak valve? How to fix it?\n\nI was told i have leak in valve wat will need to be done to fix it? Also wen i get up i get relly dizzy at times having to hd on to something! Month ago i was scrunched down for bout half hr aa i waa dtanding felt dizImess coming then a loud buzz in my head i had a black out but it was alll white! I than wobbling my legs and arms wer useless( people around me said seemed like a seizure) i also couldnt speak during this but i heard everything!! I am wondering id these can be related to valve leak! I do also regularly have palpitation aor skip beata? Thank you! And mo i havnt been able to see a dr simce i was tol of the leak! To gwculvergeorge@ WWW.WWWW.WW ( im nora and im 44",
    "doctor_response": "Hi,Thank you for posting your query.Your symptoms require investigations to confirm the diagnosis. Regarding a valve leak, you would need to see a cardiologist and undergo an echocardiogram to confirm the diagnosis.In addition, you should also see a neurologist, and undergo an EEG and MRI brain to confirm or exclude a seizure or any other internal brain problem.I hope it helps. Please get back if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the red streak from foot to knee be due to the bite of water moccasin?\n\nI was bitten in the foot yesterday by a water moccasin. I do not think it actually got my foot. I had on rubber boots and i have to holes thru my boot and sock but I don t see any sign of a bite mark on my foot. I now have a red streak going from my foot about where it bit up to my knee. Can anyone please help me maybe figure out what could cause this?",
    "doctor_response": "Hello. It is difficult to say what that red streak is. But water moccasin is a venomous snake. You would have other envenomation signs also. You can't have a bite marks like that in a viper without other signs of envenomation. If you have any simptoms of allergy please consult your GP.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abnormal behavior in condition like ADHD?\n\nmy 11 y.o. grandson/son is pulling out his hair and has a very noticeable bald spot. He is also hyper sexual --he has erections most of his waking hours and likes to call attention to it. We have had him since he was 2 and he is being treated for ADHD; anxiety; ODD; PTSD; neglect, etc. The pulling out of hair is new and I m at a loss.",
    "doctor_response": "DearWe understand your concernsI went through your details. The conditions you are mentioning here are purely of chronic mental disorder. The child is showing very complicated mental health pattern which may need prolonged psychiatric treatment and care giving. Trichotillomania is an impulse disorder characterized by the compulsive urge to pull out one's hair, leading to noticeable hair loss and balding, distress. He is also showing attention seeking disorder. Multiple mental disorders are present and only a psychiatrist will be able to judge and diagnose and treat. Please do not beat the bush and work constantly with the psychiatrist.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cough\n\nHi My son is 10 and active he has a cough in the mornings and at times during the day he coughs intermittently. He sweats profusely when exercising hisnface goes bright red and hair sticks to his head. he is also like this at night and I need to change his pillow etc. He is not overweight.",
    "doctor_response": "hi, welcome to this forum. Cough only in morning for a long time he is usually due to allergic cough. You can start cough syrup like chericof 5 ml 3 times a day, if there is no improvement in 24 hours then get child examined by doctor. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is valium considered a good option for dental procedures such as teeth extraction?\n\nHello. My name is Robert. I'm going for a dental procedure to have teeth extracted. My dentist is going to be using a combination of nitric oxide gas and valium for my anxiety because I have a fear of dentists. How good is Valium for dental procedures and will it hurt me to use it in combination with nitric oxide as she suggests? Thanks for your help.",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern if you really have phobia then this is the only option can be tried and this is quite safe, nothing to worry about this, take care bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could dehydration elevate SGPT/SGOT levels in blood?\n\nI was sick and got dehydrated. Lost 6.5 lbs in 2 and a half days. Tues , wed , and thur. before dr. appt. Went to dr on Fri. could not get blood for test because of dehydration.  went back on Mon for blood test. My sgpt (168) and sgot (89) were both elevated. could this be from dehydration. I am also diabetic and take diovan ( recent additon to meds) glipizide and onglyza.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. SGOT and SGPT are liver enzymes. Their level increase in any kind of liver damage.  It may be due to viral infection, drugs, toxin or alcohol.  You should go for complete liver function test and ultrasound abdomen.  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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for getting pregnant\n\nhi doctor,i'm 30 years old,married for 4 years and have 28 months old girl,6 months ago,i removed the loop to get another baby,but no chance,the doctor gave me choriomon shot on my 11th day,and told me 2 have sex the night before it and in the 12 and 13th day..i missed the night before it but now i had it on 12 morning and still 13..when exactly does my ova erupts?is it best in morning or night?",
    "doctor_response": "Hi actually the ova erupts about 34 to 36 hours after the injection. So if you had contact on the day of injection and a day after it is enough because sperms can fertilise ova for 72 hours. There is no effect of the time like morning or night on the rupture. So don't worry you have got a good chance of pregnancy. hope I have answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a knot on the testicle?\n\ni have a small knot on top of my right testicle the size of a B.B. an its kind of sore to the touch but i dont have one on the left one is this something to worry a bout also ive noticed it for a bout two months an its not getting bigger is this normal",
    "doctor_response": "Hi, Lumps and swellings in the testicles are a relatively common symptom in boys and men, and can have a number of different causes. The vast majority of testicular lumps and swellings are caused by benign (non-cancerous) conditions that may not need treatment. Some of the main causes are: varicoceles, hydroceles \u2013 swellings caused by a build-up of fluid around the testicle, epididymal cysts and inguinal hernias. Some more serious issues such as tumors and carcinomas are less common but should be considered if there is pain and rapid growth of it. In every case, it would be good to do ultrasound of testicles by urologist and this will show us what type of issue this is. If this is benign then there is no need for urgent treatment unless there is pain and inflammation. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Iven Romic Rommstein",
    "dialogue_context": ""
  },
  {
    "patient_message": "Was diagnosed with jaundice, bilirubin count, SGPT abnormal. On the same diet. Worry?\n\nI am ratul sarkar(23). I was diagnosed jaundice in Aug 12. My billirubine count was 7.2 and sgpt 1700. Now I am fit as per my doc.. but still I am taking the same diet as Aug. I am not taking any medicine now and my last report was billirubine: 0.8 (Nov) and sgpt: 35. So when from I take normal diet as I used to take?",
    "doctor_response": "Hello, ra21dip, I hope your doctor checked you for the three major Hepatitis viruses, Type-A ,B ,& C. If your liver tests came back to normal within 4-6 weeks and you are feeling perfectly fine, most likely you had Type-A hepatitis. This does not lead to a chronic liver disease. If you had acute Type-B or Type-C Hepatitis , some of those cases go into a chronic phase. In such cases the liver enzymes stay abnormal or elevated for more than 6 months. You were probably told to stay away from fatty or fried foods during your jaundice. Now that all your tests are normal, you can eat more normal foods. If you drink alcohol, I would advice you to stay away from it for at least six months. You should take a good Super B-Complex Vitamin daily along with Vit-C 1000 mg. a day. High protein diet is good. Keep your weight under control and do regular excercises three times a week. You should stay healthy for a ripe old age ! I wish you well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "40 years old, trying to conceive, unsuccessful. Due to fallopian tube blockage?\n\nI am 40 years old. I have tried to have a baby for the last year and no luck. I asked my Doctor could my tubes be blocked and also asked if I could have the test to show if it is or not. He did not act concerned at all and totally ignored my question. He went on to say everything looked good and I should go ahead and get started because time was running out. I could not believe what I was hearing . I feel comfortable with my Doctor but hes not listening to me. Time is running out do you think I should insist on having the test or locate another Doctor?",
    "doctor_response": "hi ,thanks for choosing hcm taking your age into consideration your doctor should act fast,without wasting much time you may need hormonal medication assisting your pregnancy did you get all the hormonal assays done? thyroid,fsh,lh levels etc do not waste time get hsg done ,which gives information regarding tubal blockage so if he is not listening to you better to go for a second opinion to another doctor for best result both you and your husband need to undergo  certain tests all the best dont panic feel frank to contact me for further queries thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump on the wrist of a 2 year old?\n\nmy grand daughter, 2years 3 months old, has small bulge in her right arm just down to her wrist. When we consulted with the doctors, they said this could be due to MHE and asked us to wait for some time prior to an operation...Doctor would you be pleased to guide us in this critical stage...what should we do now ...",
    "doctor_response": "It's rare disease have genetic connections.it's not urgent to do surgery,u can do surgery if it's painful,causing discomfort or for cosmetic.but it has high chanses of recurrence and have to monitor for malignancy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I had a partial circumcision 43 days back, why has the swelling not gone down yet?\n\nHi doctor, I am a 43 year old male, and I had a partial circumcision 43 days ago. The swelling has not yet come done. The doctor told me to wait, but it is not getting better. Any idea what is the problem? I do not have any other medical problem.",
    "doctor_response": "Hi. Revert with more information to a urologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for slight pain in chest,left arm and headache\n\nMy blood pressure is higher than normal and I have a slight pain in my chest, my left arm has had a little numbness.  I have NOT have any headaches, swelling, trouble breathing or sweating,  everything feels right.  I also am thinking about heartburn because the feeling in my chest in annoying not painful.  I started taking Omega 3 and Garlic supplements along with a multivitamin.  I am trying to get potassium in my diet and exercising on a eliptical.  What could the problem be?",
    "doctor_response": "what is your age.does ur family member has any heart problemsdo u get chest pain while walking or with exertion if yes then u need to do some testsor else nothing to worry",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red bumps on elbow and knee?\n\nMy daughter is 9 years old and having red bumps on elbow and knees for more than a month now. Can it be psoriosis ? The blood test shows she is having mild eosenophila. None of mine or my wifes family ever had any history of psoriosis. Please advise. If it is psoriosis is it curable ?",
    "doctor_response": "Hi,Thanks for writing to Healthcare magic.Its difficult to comment on this query, I would request for an accompanying photograph with good resolution of the mentioned rash. else better still have a skin specialist opinion.Awaiting your answer.Thanks. If you have any more queries I am happy to answer them. Else please rate this answer and close the discussion",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain and pus discharge in the toe after walking bare foot?\n\nHi I am inquiring on behalf of my brother, who was camping just after Thanksgiving in the woods of central Pennsylvania. He was barefoot for a few moments, got his sock covered feet soaked in dirty brown ground water. He was in an area of high wildlife traffic. He was awakened by a sudden, sharp pain in his toe, and said it felt like being stuck with a hot needle. He thought it was a spider bite. Now, the toe is rotting and exuding copious amounts of puss. (ruined two pairs of shoes) Two doctors have tried and failed at diagnosing, and I suspect a parasitic infection. I want to show you a picture.(?)",
    "doctor_response": "Hello,I read your message carefully and understood your medical issue.If you can send me a picture of his toe it would be great. Also, mention to me if your brother has ever had some other associated symptoms local near the toe or systemic like fever or whatever.Usual causes are paronychia (infection of the tissue surrounding the nail) and onychia (infection of the nail itself). When the causative agent is fungal the progression of these two conditions is more chronic. When it appears suddenly it is caused by bacteria (staph. aureus is the most common).Parasites are unlikely to cause this type of infection.Anyway, my suggestion is that your brother must send a pus sample to the bacteriological lab to discover the exact cause. The result will discover the proper antibiotic that can work with that infection.These types of nail infections happen after a little trauma of the nail or the tissue around that that next becomes inflamed. Sent photos if they are available.I'll be here to help you further. Dr.Albana",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy after missing pills?\n\nSo I ve been taking birth control for years. On march 30 I had my period until April 3. I started my new pack on Sunday April 4. On Friday April 9th my boyfriend and I had sex. I missed my pill yesterday April 12,13 and 14 since I lost my birth control. Could I b pregnant since sperm could still be in me? According to an ovulation calendar, I think this is the time I would be. I found my BC and started to take it again..Please help me!",
    "doctor_response": "Hallow Dear, Birth control by contraceptive pills is governed by the continuous action of the pills taken throughout the cycle. Hence regularity in the consumption of pills is prerequisite for their success. However, missing a single pill or so does not take away the protection against the pregnancy. Missing up to 3 pills in a cycle is permissible according to WHO guidelines. When you miss pills like this, the ovulation calendar gets disturbed and you cannot rely on fertility window.  Since you have missed three pills, there are good chances that you may conceive during this cycle. Wait for up to a weeks after finishing the pack of the pills if it is 21 pills pack, otherwise till you finish complete pack if it is 28 pills pack. By that time if you do not get menses, go for the tests for confirmation of pregnancy. Pregnancy test on urine is to be performed on overnight first morning urine sample 8-10 days after missed period. Done earlier, these tests may give false negative results. Alternatively you may opt for Beta hCG test which gives reliable results even few days before missed period. If you are pregnant, you may opt for Medical Termination of Pregnancy which is very safe and effective up to 9 weeks of gestation. I hope this helps you. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat swollen and sore elbow?\n\nI fell friday afternoon, landed on my elbow, it turned dark green was swollen and sore. But I could move it fine. Its a lil less green today but still swollen and very sore, I can t touch it, because of the pain. Should I get it xray d for give it a few more day s?",
    "doctor_response": "Hello, As per your history, it may be due to blunt trauma. For pain you can take tablet acetaminophen. Apply diclofenac gel or ointment locally. Heating pads will also help. For further assessment you may require X Ray of that affected elbow after orthopedician consultation. In case of fracture you may require surgical intervention after consultation. Restrict your movements Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat coccyx pain after being diagnosed for oedema around coccyx?\n\nI had an MRI that showed soft tissue thickening and oedema around the tip of the coccyx. Also found serpiginous fluid signal mass lying in front of the rectom but separate to it, measuring 7cm across. It is thought to represent a hydrosalpinx. I have been suffering coccyx pain for the last six months. Can you please tell me what the treatment is for the results found on the MRI today. I am a 51 year old female.",
    "doctor_response": "Hello, The edema and pain around coccyx can be due to inflammation or a local injury. Proper rest, pain killers, hot compress and local steroid injections can help in the healing. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can gums darkening and teeth bleeding be treated?\n\nHi my gums have started to get darker on top and bottom last few mths my teeth last few weeks have bled abit while brushin i did get a tooth out at the top bk of my mouth bout 2 yr ago i was left with a hole in my gum now im getting worried incase there somethin wrong im usin cordisol mouth wash can u help me in any way as what mite be wrong im only 31",
    "doctor_response": "Bleeding gums are initial signs of gingivitis (Inflammation of the gums). In your case It could be due calculus deposits around the teeth(Tartar). You should see a dentist and get a scaling done. There is no local remedy or medication available over the counter.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness along with numbness in hand?\n\nTied fullness in head off balance dizziness anxiety don t feel well if in hot weather numbness down right hand side little finger numb now and again aches in joints feel so tied all the time sleep well try to excercisebut hard because feel so tied and ache been over the last two years am trying stay positive but draining not having energy frustrating have beautiful family who are very supportive just like your opinion on what you may think I m 48 no smoker non drinker healthy eater don t eat red meat",
    "doctor_response": "Hi,Thanks for writing in.The cause for your dizziness and numbness can be due to compromised blood supply or nerve pinching in the cervical spine.Dizziness is a non specific symptoms and at your age, the supply to brain requires evaluation. It is possible that there are occasions when the blood supply to your brain might be less and this can be due to the flow dynamics through the carotid and vertebral arteries or if it is only experienced when you raised your arms then there can be a cervical rib causing momentary compression of blood vessels in the neck. The numbness can happen due to the cervical rib as well. Numbness in the hands is an important symptom and a concern that requires detailed clinical evaluation and imaging investigations.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My Internist prescribed Fosamax 6 months ago for osteoarthritis. I am uncomfortable taking a medication that can cause jaw and femur breakage or other damage. What is the safest way to increase bone strength besides proper calcium and vitamin D intake and exercise?",
    "doctor_response": "Hello, To increase the bone strength, calcium and vitamin D3 along with a regular exercise is a must. You also need a proper multivitamin and multimineral supplement for this. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cramps in the arms?\n\nHI , I VE BEEN SUFFERING FROM THESE CRAMPS IN MY ARMS. IT BOTHERS ME MOST WHEN I M SLEEPING AND WHEN I M DRIVING . THE PAIN-NUMBNESS RADIATES FROM MY FINGER TIPS TO MY ELBOW, MOSTLY. I HAVEN T BEEN ABLE TO SEE A DR. YET BUT I WANT TO KNOW IF THERE IS ANYTHING I CAN DO TO HELP ALLEVIATE THIS IN THE MEANTIME . THANKS.",
    "doctor_response": "Hi, As of now, you can take analgesics like Acetaminophen or Diclofenac for pain relief. If symptoms persist better to consult an orthopedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest an effective alternative for Lamotrigine\n\nDr., I am taking Androgel for low testosterone; one gel packet/day, and lamotrigine for very irratible, angry mood swings ( first 50 mg/day, and now 100mg/day. I was told by my psychiatrist that this interaction could neutralize the effect of the lamotrigine. I know if I take Andogel 1 every 2 days, it may make tired possibly still effect the lamotrigine. I am causing havoc in my house; yelling at my wife for no reason, getting upset at myself for no reason. This is not my character! I can t take it anymore. Recommendations?",
    "doctor_response": "in  my  opinion it  is  important   to   probably   start  on    sodium  valproate instead  of  lamotrigine also  adequate sleep  not  having  night  outsmoderate  exercise  ,  water  intake  is  useful",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My D-dimer is 1. 28 ug/ml. Should I continue to pursue the D-dimer?\n\nHello doctor,I got blood work for recurrent chest pain. All was normal but my D-dimer was 1.28 ug/ml (normal below 0.50). Chest CT with contrast normal, doppler u/s both legs normal, abdomen/pelvic CT, as well as abdominal ultrasound normal. The doctor says do not worry about D-dimer but it was normal range a year ago. I had a hysterectomy, endometriosis excision or fallopian tubes removed five months ago and it resulted in an abscess and sepsis. I was hospitalized for a week but recovered. I have Hashimoto's but no treatment because my TSH is in a normal range. Should I continue to pursue the D-dimer? Currently, I am taking Lexapro 10 mg daily.",
    "doctor_response": "Hello. I think we should retest D-dimer may be after few weeks, three to four weeks. This is to see the trend and confirm the elevated levels. The usual causes for elevation include DVT (deep vein thrombosis), pulmonary embolism, infection, stroke, trauma and rarely some cancerous conditions. Also, D-dimer rises with age. But, all your investigations are negative so ruling out the major and important causes for elevated D-dimer.  I guess at this moment, you are totally asymptomatic, right? No fever or any evidence of infection, etc. The elevation from previous infection five months back should have settled by this time. You have undergone all possible test to rule out the causes for elevated D-dimer so I think there is no need to worry about it at this moment. So overall, I think, we should repeat the test after three to four weeks. Also, see if you have any symptoms or let me know if suffered from recent infection or trauma. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty to balance on standing when having low BP?\n\nHi My father age 65 yrs has been diagonised of MSA similar to parkinson his legs only shake and not his hands he also has a low BP the major problem he is facing is that he is not having a proper balance while standing he goes back and falls down and does not know if he is falling whenever he tries to get up he sits down not able to stand uphe is on syndopa cr 250 mg roliten and lonazep he also has a prosterate problem one of the doctor has advise him to take vertin 8mg for 5 days and to have a collar around his neck also have told him to takerablet 20mg,mecgla tablet..i have also checked with the ENT he ADVISED THER IS NOTING FROM HIS END HE CAN DO SO Pls advice iam going in the right track of treatment and the can i go ahead with the tablets as iam not sure why do we ahve take these tablests will it really help him regarding the falling back plspls pls,pls advise my email address is",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!I carefully passed through your question and would explain that MSA is a progressive degenerative disorder of the central nervous system. It causes orthostatic hypotension, causing a decrease in blood pressure when standing up. This contributes to chronic fatigue and difficulty in the body balance. From the other hand it also affects the cerebellum, which is the posterior part of our brain, which is the main region of our brain to help maintain our body balance. So unsteady gait is another feature of this disorder. Unfortunately there is no cure to this disorder and no treatment is possible for these symptoms. Patients are not able to walk in the later stage of the disease. I recommend discussing with his doctor on these issues. Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for multi-drug-resistant tuberculosis?\n\nHi, may I answer your health queries right now ? Please type your query here...i have mdr tb in bone. I am taking kanamycin inj,cyclosorene,ethanamide,q-mas,pyzianamide,n capreomycin,n linezolide. I have ulcerative colitis also,n fr tht i am taking rowasa pellets 1gm twice daily. Now,i am getting nausea,loss of appetite,gas n etc. Any advice,plz.",
    "doctor_response": "Hello, For multidrug-resistant tuberculosis, the antibiotics are given according to the culture sensitivity report. The medicines you are getting will help you but it can be associated with many side effects. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for recurring yeast infection\n\nI have a reocurring yeast infection even though I take the prescribed meds, it comes back right afterwards, so the meds are not effective. I had a total hysterectomy (including removal of ovaries).I am not on any HRT. What can I used to get rid of this infection once and for all?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You have repeated yeast infection. You should take antifungal antibiotic treatment. You should also go for blood sugar examination. Because it is common in diabetes. Consult your doctor and take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rash on bump of kid?\n\nHi Doctor,My son has had a rash on his bum, and we have been on holiday and came back last week and when changeing is napy he had diareha, however he had a rash wile chageing his napy the other night and couldn't sit on it.Could you give me any advice please doctor?",
    "doctor_response": "Hi,It seems to be eczematous in nature. I would recommend you to apply topical steroid like cortisone cream on the affected areas twice daily along with frequent and regular application of a most cream on the entire buttocks 2-3 times daily. Also keep the area dry and clean. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Water in lung, nothing found in test, taking tuberculosis drugs\n\nhello! my name is ben. my friend recently felt sick and when she checked the doctor, He found that she had Water in her Lungs. the doctor first sucked the water then begun a series of tests..but nothing was found.. she is currently taking tuberculosis drugs but I am afraid that the drugs have started to affect other organs. let me give the lists of the drugs she is taking and you will tell me what I should do.",
    "doctor_response": "Welcome to HCM!I have gown through your question carefully and from my clinical experince I can say that most common cause of fluid in pleural space, if nothing else is found, is considered to be because of tuberculosis. So, in a way the doctors are doing the appropriate thing by giving her anti TB treatment. It is advisable to start the treatment early in such cases, prolonging it may lead to sticking/ fibrosis in pleural space/ lung. You are right that these drugs give side effect to other organs but when we looks at the risk -benefit ratio of treatment with drug side effects , we decide the line of management. This risk -  benefit ratio goes infavor of treatment. Now about the test report, many times on is not able to get to a clear cut pathogen in such cases, as it is difficult to cultivate them in laboratory, also a long time is required some times.  but still the consensus says that if the fluid study dosent come out with any bacterial, viral, malignanat cause, it is treated for TB. In almost all such cases the medicine is successful in curing the patient.Hope this answer helps you trust your doctor. give your friend a good, healthy diet, regular walks when she is able to, breathing exercises and get scheduled tests done to check any adverse effect taking place. Please do. it worry about many side effects as anti TB drugs are sometimes given even to newborn / infants and toddlers and they too are able to make it safely. More one can see after one has a detailed list of medicine and the blood test reports of the patient ( which is not mentioned here).Please feel free to ask more questions.Dr. Manisha Gopal.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. There is a cavity on my tooth which pains if tongue touches it. Please help.\n\nHello doctor,There is a cavity on my left molar tooth and it pains a lot even when the tongue touches it.",
    "doctor_response": "Hi. You need to visit a dentist as soon as possible. If it is not treated soon, you may either need a root canal treatment or extraction of the tooth. For the meantime, I suggest taking the following medicine: Consult your specialist doctor, discuss with him or her and start taking the medicine with their consent. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "DMSA test findings said Right kidney appears normal, Cortical uptake is good, loss of cortical volume. What is the cause?\n\nDMSA test findings:Right kidney appears normal in placement. Cortical uptake is good. A peripheral wedge shaped defect is seen at the interpolar region with loss of cortical volume. Tracer distribution in rest of the kidney is homogenous.What is the meaning of this?What is the cause for this & what is the right treatment ?",
    "doctor_response": "Good Day!The peripheral wedge shaped defect at the lower part of your kidney simply means that there is scar formation on your right kidney at the lower part. The most common cause of this is infection of the kidney or pyelonephritis. Unfortunately there is no treatment to repair the scar in your kidney. The restnof your right kidney still has adequate function proven by good cortical uptake. Drink plenty of fluids to prevent infections in the kidney. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at:   I would gladly help you.  Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for sharp pain in the lower abdomen?\n\nDear DoctorMy wife had frequent pricking pain in her left lower abdomen. Ultrasound scan revealed normal appearance of uterus except for mass measuring 2.8 x2.3 cm in anterior part with the doctor's comment that it could possibly be myoma. Is there permanent cure in Siddha? If yes, we would like to come to Chennai (we are at Bangalore) for treatment.",
    "doctor_response": "Hi.Myoma possibly can not cause such pains as you have described. This can be due to colitis or other causes which are not picked up on ultrasonography anytime. IT is better to consult a gastroenterologist , to get a clinical examination and investigations : Blood- complete blood picture, kidney functions tests, blood sugar fasting and post-lunch, Urine- routine,microscopy, culture and sensitivity ( before start of antibiotic)Ultrasonography of abdomen.Get a treatment with an antibiotic, anti-spasmodics and supportive therapy. Frankly speaking we as Allopaths , we do not know anything about Siddha therapy. With todays newer machines , this much myoma can easily be removed laparoscopically.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rhinoplasty done few days back, nose tip seems to be off center. Reason?\n\nHi can you help me please, I have rhinoplasty 2 days ago, my nose was completly fine before it just I had a big rounded tip and wanted to change it to pointy tip, after my surgery my nose is tilted to one side.. I know its too soon to get results but my nose tip seem off center and thats depresses me.. would you know what is it off center now while it was OK before surgery? thanks",
    "doctor_response": "Hi....user., Don't depress., It will take time to get complete resolution., So...observe 3 weeks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in the jaw due to misalignment of teeth\n\nOn Wednesday I went in to my dentist for a simple teeth cleaning.  He talked me into getting some of my teeth sealed to prevent cavities.  Well after getting my teeth sealed, my teeth did not line up correctly and it was causing me a lot of pain in my jaw.  I went back to the dentist yesterday morning and he ground some of the sealer off, but all last night and this morning my jaw is still killing my and now my dentist won't be back in the office until Tuesday.  I took prescription strength Ibuprofen and it didn't phase the pain.  What do I do?  Is there any way to remove the sealer?",
    "doctor_response": "Thank you for your query,The symptoms you have mentioned are suggestive of over filling of sealants.The best method to relieve pain is to take analgesics and grind the sealant so that normal occlusion can be achieved.I have my reservations about removing the sealant by you, as it is usually light cured and difficult to remove.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am stressed due to marriage talks and financial debt. What can be done?\n\nHello doctor, My father has debt. I am upset severely by that and I am 26 years now, all are asking marriage questions. Believe me my ambition is to get into the politics or to do social service, the relatives laugh if I tell this. And I do not want to get into relationship. I hate marriage and commitments. Because of all this I feel like dying and stressed out so much. Kindly help.",
    "doctor_response": "Hi. I can see that you are under a lot of stress. To start with the debt, I do not know the financial details and your social economic position so cannot comment on how you can come out of it but to start with you have to understand that this is your reality. Instead of getting upset about it try to sit and practically think of what you can possibly do to start with to help your father in this situation. Getting married does not mean that you cannot help your father or you have to abandon the responsibilities you feel you have regarding your family. As a female I can understand your feelings, it does happen in many cases that after marriage the in-laws expect the female to just look after their family and not have involvement in her own family, but times have changed now. Even I am a female and I do support my family even after marriage as much as I want. The good things to do would be to communicate with your potential partner about how you expect your life to be. Be clear with your partner that after marriage you will be taking care of your own family and not abandon them. The relatives and society are just chatter. Do not get bothered with that. Getting married is not a bad thing, everybody needs someone in their life as a partner. Make sure you find the right partner and you will realise that it is a good thing. Regarding social service, I can see that you are altruist tech and you strive for higher good, it is a very good thing, but remember whenever you will try to do something which is not normal for the people around you, they are going to laugh. It is your choice whether you listen to it and get stressed or you ignore it and do what you want. To work in politics or to do social work you do not need to postpone or ignore marriage. You can start small, do as much as you can in your position and then increase with time. If you are not able to handle the stress I would suggest you to talk to a counselor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a wound on knee turning green indicate infection?\n\nI've had a wound on my knee from falling on a sidewalk and skinned it badly. I didn't go to a doctor because I figured I didn't need one and it was going to be fine. Its day 3 with this wound and its starting to turn green. I'm not really concerned, I'd just like to know if it's infected, it's normal and stuff like that. Whenever it gets wet or when it rubs against my leggings it comes off when it's really close and it feels kind of like vaseline and bleeds a bit. It's on my lower knee and is about 3 cm wide and 1 cm tall. I've also felt a little pain in my entire left leg, and also want to know what that's all about. Advice on what i should do to treat it and if that green stuff is bad or not? Thanks.",
    "doctor_response": "dear, If I would be at your place first thing I would do is show my wound to a doctor nearby. the green coloured thing oozing out of your wound is pus, which means infection. infections need to be taken care of properly as it will otherwise either heal late & may lead to increase in the pain & other co-morbidities. you should first & foremost clean the wound with dettol/savlon & put some topical antibiotics & start an antibiotic course which your doctor will prescribe.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful lump on the anus\n\nI have had a pea sized growth on my anus for a couple of months that i can remember, it is soft and not painful at all. I had it looked at during a routine exam and the doctor had thought it was a hemorrhoid, how long do they usually last? should i be concerned?",
    "doctor_response": "hi.hemorrhoids are permanent unless you have it removed. although if there are no indications for removal, conservative and non-surgical management may be opted. if you observe the following symptoms, pain, bleeding, swelling or thrombosis of hemorrhoids, it is best if you consult with a doctor, preferably a general surgeon for possible surgical management.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can masturbation affect penis length?\n\nhello im 21 years of age and i been seeing sudden changes in my penis. it is getting smaller , probrably due to my low self-estem and that i masturbate very often . before it used to be 6\" in lenght now i it IS 3\" in lenght and 5\" when erect please i dont know whats going on and i dont like it please can you help",
    "doctor_response": "Thanks for writing to Healthcaremagic.I have gone through your question and understood your query regarding size of your penis and perceived effect of masturbation on penis size.Masturbation is akin to sexual intercourse. What penis does in vagina during sexual intercourse, same it does during masturbation in your folded palm. If sexual intercourse does not reduces penis size, than how masturbation can do? Obviously NO.It is myth that masturbation causes impotency or reduce penis size.In fact, penis size or circumference has no effect on sexual satisfaction of either partner by penis vaginal containment. Only lower vagina (outer 1 and half inch only) has nerve fibers. Inner vagina is largely insensitive and lacks nerve fibers.If you want to arouse the partner during vaginal containment, you should focus only on outer vagina. For this erect penis size more than 2 inches is more than enough!Nothing is going wrong with you.Relax and wish you good sex life ahead.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of red bump after nose piercing?\n\nHi Doc, I had my nose pierced 3 weeks ago, and a bump, red in color has come out of the piercing, like an extra piece of flesh around the piercing. I do not want to remove the stud and also dont want surgery. Im really scared, Doc. Pls help. It forms a scab every day and then seems to bulge out fresh again the next minute. PLS HELP DEAR DOC",
    "doctor_response": "Hi..Can understand your concern...As per your complain red bump after nose piercing occurs as a result of trauma to the surrounding soft tissues when the needle or the sharp thing that knocks through the tissues to create a hole in the nose..The injury causes inflammation of the tissues leading to pain,lump formation and increased temperature in that area..It can lead to formation of a scar tissue in that area treatment should be done for prevention and relief..Apply warm saline packs over the area.. Dip a sterile cotton in luke warm saline water and apply over the area and keep for a few seconds.. Do for 3 to 4 times a day..In case of pain you can apply a steroid based cream for relief..Over the counter anti inflammatory painkiller like Ibuprofen can help in reducing inflammation and pain..Do not try to change the nose pin or ring till the inflammation subsides..At times if the swelling begins to get a white centre and softens there may be infection leading to abscess formation..In that case antibiotic oral intake and antiseptic ointment application has to be done..Hope this information helps..If you find the answer helpful please write a positive review and click on find this answer helpful as a token of appreciation..Thanks and regards..Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in midriff, dizziness, shaky hands, low blood pressure, vomiting\n\nMy husband has been unwell since November2012 His symptoms include a dull ache/pain in the midriff area, dizziness , shaky hands, low blood pressure at times, occasional vomiting ,amongst other little things. He has had all relevant blood tests,scans,ecgs and a gastroscopy? Not sure on the spelling there. All have come back clear of anything nasty ie cancer. He is referred back to his GP this week.after all this time and visits to hospitals and doctors everyoneseemsperplexed. Any ideas please? Thank you",
    "doctor_response": "thank you. i am extremely sorry for your husbands condition. no diagnosis has established though thorough inv. has done. so it need to be think in different way. abd. pain,occasional vomiting,dizziness & low blood pressure may be a manifestation of endocrine problem(addison's disease). some endocrine inv. is needed like cortisol level & short synacthin test. you also consult a endocrinologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could abdominal pain, painful hips and limbs with fatigue indicate?\n\nMy almost 5 year old daughter has been complaining of a tummy ache, legs hurting, hip area hurting and now her elbow area hurts. She also seems very tired. There has not been any fever along with it. What do you think is going on with her? A few months ago a couple doctors diagnosed her with Kawasaki s disease, would that have anything to do with it?",
    "doctor_response": "Hi, this can occur in calcium deficiency or rheumatoid arthritis. Get child examined by a rheumatologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain in the gums after tooth extraction be treated?\n\nhad wisdom teeth pulled 3 weeks ago.  had dry socket in both lower holes.  still having alot of pain in lower left and yellow pus coming out.  been \"sick\" with cold/flu like symptoms for 2 days also.  is there something that I can do at home, or should I go back to oral surgeon?",
    "doctor_response": "Hi Dear,As per your query pain in the gums after tooth extraction seems to be due to presence of remaining infection and infected tooth sockets. I would suggest you to consult dentist once and get thorough examination done and do warm saline gargles. Apply numbing gel over the sore area for relief from pain. Avoid eating from that side. Avoid spicy, sour and acidic foods. Take proper course of antibiotics along with anti inflammatory medications. Go for quadrant cleaning.Hope your concern has been resolved.Get Well Soon.Best Wishes,Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does an irregular menstrual cycle make you less fertile?\n\nHave been taking qlaira for a year now, no more periods -can this really be safe? Concerned about my future fertility. Also, have been getting constant headaches for a week now, GP says it could be progesterone based, can that happen after all this time?",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.You are having amenorrhoea since 1 year, so i would advise to investigate with ovulation profile, thyroid profile, histosalpingography HSG to rule out any pathology.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for allergic reaction towards food and medicine\n\nmy wife aged 55 could not digest number of food items like bread,milk,eggs,iron,citrous food,milk products,due to which she has developed anemia & her homoglobin level has come down to 9.5 .she is aiiergic to asprine,sulfa drugs,chick peas,grapes,pineapplesshe is also having anger complaints&increased pus cells,e p cells,ESR.she was on citrizine,livo ctrizene for last 20 years&now doctors have given her allegra in the morning (empty stomach)levo citrizene at night,Acilock in the daytime IE AFTER LUNCH.wHAT SHOULD I DO? PL GUIDE ME.iAM WRITING FROM INDIA(J&K)STATE.",
    "doctor_response": "Hi, its not that one cannot digest the food which is to be taken routinely in our life.yours haemoglobin is 9.5 which considered as mild to moderate anemia but severe that one would require urgent treatment. Even HB of 10 % is also considered as a normal in Indian Ladies. Now what treatment u r taking is good but u need to see physician as u said about increased pus cells,ep cells and elevated ESR, this all suggests some sort of infective component but don't bother u go to a physician first .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does IgG : positive and IgM : Negative from report suggest?\n\nsir,for last 10 days suferring from fever.First 3 days 104 F then after taking 3 injections of amikacin temp. goes 96, but again within a day it goes to 103 and still its there.Along with I have jaundice but not severe.My ELISA koch report is postive IgG +VE and IgM -ve.What I have to do do ?",
    "doctor_response": "Hi thanks for contacting HCM..Noted you have IG G antibody positive which is form in chronic infection.While in case of acute infection  antibody is IG  M..So here your koch ELISA positive...Means you here having tuberculosis .Sputum examination and chest x ray needed.Your treatment for tuberculosis started after consulting doc with AKT for 6 or 8 month duration under observation...Hope your concern solved.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe nerve pain in the leg\n\nI am struggling with nerves pain in my left leg from spinal guard to foot.... i am now under psychotherapist treatment. Psychotherapist advised me to inject nuru kind injection.Can I go for it? I am 29 years old... taking this will I get better??? should cause any side affect for me in future or my generation due to this injection. Please advice",
    "doctor_response": "Severe pain in left leg from spinal chord is something that needs more investigation. It could be intervertebral disc pressure on nerve which is compressed and causing pain and radiation to the leg. Your doctor would have suggested to get your IVD x ray or Ultra sonography. If that is healthy only then we can think in the direction of psychotherapy. On the basis of given information, I do not agree with your current psychotherapist treatment.Hope it helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sinus surgery cancelled yesterday due to high t4. Can you explain this ?\n\nhi. i m 33. i ve asthma , ibs, samters triad. i was suppose to go for sinus surgery today but it was cancelled yesterday due to high t4. i also have an overactive thyroid. The hospital told me there would be complications. Can you explain this to me please?",
    "doctor_response": "This entire problem can be cured permanently without any operation and it is true. For more details plz mail me on \"bharat80_shah@yahoo.com\" so that I will give you details of certified Nutritionist (doctor) who will give you solution after checking your all reports. I am engineer and working in pharmaceutical company as Manager. My intension behind this write up is to give me self satisfaction by providing and helping people to get permanent cure from such life style diseases.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I continue taking Fluticasone Nasal Spray for sputum in my throat?\n\nHello doctor, I have sputum always in my\u00a0throat. I have this problem for the past six months. For the first two\u00a0months, the sputum was in the larynx, and it was very less, but later on, the sputum began to go back\u00a0to the throat. I\u00a0recently consulted an ENT doctor and underwent a CT scan and a chest X-ray. I was diagnosed with small nasal polyps in the\u00a0right maxillary sinus. The doctor prescribed me Floresp Nasal Spray. I used it for one month, and this resolved nearly 80 % of the symptoms, but I feel there is still thin mucus in the throat like a thick, sticky saliva. I used Largy M too for a short course of 10 days. Recently, I developed an urge to cough to clear the sputum in the throat. Should I\u00a0still continue with the spray? Can I\u00a0continue for longer periods?\u00a0How long will it take for a complete recovery?\u00a0What foods should I avoid? Should the urge to cough, which I get, be ignored since it is just to clear the throat?",
    "doctor_response": "Hello. Do revert back for any support which you deem is necessary. I will be happy to help you. For more information consult an ENT Otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pregnancy be successful quickly?\n\nI'm afraid to go to a hospital maybe because i have a phobia. so try to get advice via   internet. I'm 25 years old, married.I and my husband want to a have  baby next year when He came home. I want to prepare my self. How can I get pregnant fast? what vitamins should I take?",
    "doctor_response": "Hello,Thank You for the query at HealthcareMagicChances of getting pregnant is maximum ,if you engage in sexual activity around the time of ovulation. Ovulation is around the 14th day of menstrual cycle (If you have regular 28 day menstrual cycle). The days are calculated from the first day of menstrual bleeding last month.If you try 2-3 days before and after ovulation, chances of getting pregnant is maximum.Here are few things to help ensure a healthy pregnancy-Start taking folic acid 400 mg tablets daily and multivitamin tablets containing Iron,calcium and DHA (Docosahexaenoic acid)-Eat healthy and exercise regularly-Stop smoking and avoid alcohol while pregnant-Talk to your doctor regarding any medical conditions or medications you are on currentlyHope I was able to help youPlease address any more concernsRegards,Dr.Lekshmi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fatigue in a person with hypoglycemia\n\nI was on night shift for two weeks and this is my first week back on day shift I have felt dizzy and so tired and at every meal I get sick have thrown up once. I had three days to catch up on my sleep and everyday I feel more and more tired. I have hypoglycemia but I haven t gotten that checked in about 5 years.",
    "doctor_response": "Hi there... See first of all how can u see its hypoglycemia without even doing a sugar test... Hypoglycemia is said wen blood sugar is less thAn 55mg/dl with symptoms like sweating palpitation tremors or sometimes if severe may lead to unconsciousness or convulsions.. But usually it occurs in diabetic patients on medications.. I think ur symptoms are mainly due to distubed sleep cycle.. Though get ur blood sugar and hemoglobin level checked.. Take care..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes delayed periods, stomach cramps, pain in upper abdomen while trying to concieve?\n\ni have been trying for a baby and had sex around ovulation. i come on my period a day late but my period is not the same as usual. it was really heavy for 24 hours and then stopped for 12 hours then there is only a small amount of blood there now. also i have really bad stomach cramps and stabbing pains at the top part of my stomach just before where my rib cage meets. i normally have a 7 day cycle and i never have any types of pains normally. could this be something to worry about?",
    "doctor_response": "Hello ,You are having regular periods .Upto +/- 7days is considered regular periods.But if you feel the amount of blood is heavy / with severe cramps(previously absent)/ dark maroon or brown color/ with brownish discharge - kindly rule out either an infection around uterus (PID) or endometriosis. You have to consult a gynecologist . If infection, you & your partner have to take medicines for it. These problems can be corrected & will not affect your pregnancy prospects.All the bestDr.Balakrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat high BP?\n\nHi, i was diagnosed with High BP in 2006. 160/110; went on medication for 8 months. Then deliberately stopped taking drugs with the alterative of natural remedy and lifestyle changes. Just came back for general check up and my BP reads averagely 160/104. I have been without medication for more than 3 years. Except time to time casual headaches and  palpitation (currently) , I have not been feeling that bad. How come, if my BP has been so high for so long?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can I can understand your. In my opinion, you should take antihypertensive drug along with lifestyle changes. Your Intermittent symptoms of headache and palpitations are suggestive of high blood pressure. So you are having this high blood pressure since starting. No harm in taking antihypertensive drug regularly. Continue other natural remedy and lifestyle modifications along with antihypertensive drug to control your blood pressure. Don't worry, take your antihypertensive drug regularly and you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to conceive despite normal test results?\n\ni m 29 years old  lady,married.but my married life is going on two years but i have no baby.i want a healthy nice baby.i check a gyno Dr  and test my blood reprt.ultra sonography, and my husband s cimen test all the report are ok .now what i do pls suggest me.",
    "doctor_response": "HIWell come to HCMJust keep trying and nothing to worry and hurry, when all the test are normal then why to worry even if the test are not normal then also this is nothing to worry because pregnancy is nature's great gift many have this gift even with the abnormal reports, hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My symptoms include dry cough, headache, body pain and nausea. Please help me.\n\nHi doctor,The problem started out with a dry cough. The next day, I had achy bones and\u00a0headache.\u00a0It seemed like it was going away and came back the day after when I woke up feeling like throwing up. My eyes, chest and upper back aches with a feeling of nausea. Please help me. I am scared.",
    "doctor_response": "Hello. I have gone through your query, and I can understand your concerns. The symptoms you have described suggest that you have a viral fever along with inflammation of throat (pharyngitis). There is no need to worry as it can be cured completely with treatment. Please consult a physician, discuss with him or her and get the following things done with consent. If symptoms persist despite, then blood investigations and throat swab may be needed. Do warm saline gargling or gargling with a numbing mouthwash. Use expectorant cough syrups. Drink plenty of water and have a healthy diet. For further information consult a family physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen lump above tooth\n\ni had a white swollen lump above my tooth that was filled with liquid ithink. i get these every once in a while usually above the same tooth. it errupted now and is all deflated. these past few days that same tooth has been feeling wiggly as well, like its getting loose",
    "doctor_response": "HiThanks for your query with HCM,It would have better if you had mentioned your age since you say it is erupting and whether the tooth is having any decay? Coming to lump it could be either periapical or periodontal abscessI would suggest you to visit your dentist for the best treatment don't delay if you want to save the toooth though it depends on the condition.Hope my answer would be helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing difficulty in breathing?\n\nmy breathing isn t right I have to force out my breath and is kinda fast, I can feel my heart beating hard almost in my throat like I have run a mile or so every once in a while I have pain in the back of my left arm , my left thiegh has a spot the size of a baseball that is stinging.and the toes on my left foot is tingling like they are asleep",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. In my opinion, we should first rule out bronchitis in your case because you are having breathing difficulty. So get done PFT (Pulmonary Function Test). If this is normal then no need to worry for bronchitis. Get done ecg and 2d echo to rule out cardiac cause because of tachycardia (high pulse rate) and left arm pain. If all are normal then you are mostly having anxiety related symptoms. So consult psychiatrist and get done counseling sessions, try to identify stressor in your life and start working on its solution. You may need anxiolytic drugs too. So avoid stress and tension. Be relax and calm. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My sister has pain in the legs from thigh to knee. Please help.\n\nHello doctor, The problem is with my second elder sister who is unmarried and aged 62 years. She was a school teacher and has retired from service. She is 160 cms in height and weighs 60 kg. She falls under the category lean to good health except for a bulging tummy. Main problems are, 1. Pain in both the legs with more pain in the right leg from thigh to the knee. 2. Sometimes a feeling of being pushed from behind when standing. a. Apart from these, she is also suffering from, When lying down to sleep or sitting for some time, 1. Feeling as if the veins inside the legs are getting loose with pricking pain on both feet. 2. Biting pain on both feet even when one foot is pressed with another foot 3. Sometimes a feeling of scratching with a sharp instrument. 4. Pain in toes and nails. 5. Pain in the bottom of the feet 6. Burning sensation in feet, especially when the saree edge touches the feet. 7. Feeling of standing on a carpet while standing on the ground without slippers. 8. Tips of the toes are getting rough even though creams are applied. 9. The sudden jerk of hand enough to break sleep. 10. Pain in the legs are spreading from the feet upwards towards the knee. b. While standing 1. Need for placing hands on nearby objects like a wall, chair, table to get better support. 2. Pain just on the right side of the right knee (the place where the knees fold) and a feeling as if the bone will break c. When walking 1. A feeling of getting pushed from the back 2. Unable to walk at a stretch for even half a kilometer 3. The feeling of forceful dragging of legs 4. Feeling of breathlessness d. Hands are unable to work with both sides together (e.g., holding utensils with both hands for placing them on a gas oven, holding the utensil with one hand while stirring the contents with the other) even though there is no problem when working with one hand alone. She has some relief when washing legs with cold water I am attaching herewith copies of all the doctor's prescriptions, the test reports including latest scan and MRI report of the spine, the medicines she has taken for your kind perusal, please. Please go through the details and kindly advise us what to do and what medications to take to make the pain bearable, if not eradicate the same.",
    "doctor_response": "Hello. Went through your queries and the files attached (attachment removed to protect patient identity). This clinical scenario is possible in two cases. 1) Compression of the spinal cord at the cervical level or lumbar level or both. 2) Peripheral neuropathy is affecting all four limbs. She has been extensively investigated. Treatment for peripheral neuropathy has been tried in the form of pregabalin, gabapentin, nor tryptiline, etc. which do not seem to have afforded any improvement to her. So I suggest we may try a course of the following medications for a week. Kindly consult your doctor to discuss the suggestion and take the treatment with consent. 1) Tablet Medrol 4 mg 1-0-1 after food (Methylprednisolone). 2) Tablet Pan 40 1-0-1 before food (Pantoprazole). 3). Tablet Phlogam 1-1-1 before food (Trypsin, Bromelain, Rutoside). 4). Tablet Nurokind LC 1-0-1 after food (Vitamin B12, Levocarnitine). 5). Tablet Nervijen-NP 1-0-1 after food (Nortryptiline, Pregabalin). 6). Tablet Alsody 1-0-1 after food (Alpha lipoic acid, Superoxide dismutase). Cervical stenosis, lumbar stenosis or peripheral neuropathy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for white spot on gum ripped area\n\nHad a bottom molar tooth extracted about a week ago, hole healing well bbut gum was ripped in the process. i thought that was healing too but I now have a tiny white spot on the side where the gum ripped. My mouth is still sore but not painful. What is the spot? do I have an infection/absess? what should I do, it s a bank hol. weekend.",
    "doctor_response": "HiWith your query, since you got extracted recently  it could be healing tag of gingival tissue nothing to worry about until it bothers you.Wait for sometime and if there are any symptoms please consult your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does my semen analysis require me to consider treatment?\n\nI am 42-year old man. Today I got my Semen Analysis test report. The fin8.dings of the report are: Volume: 02 ml Colour: Grey white Consistency: Thin pH: 8.0 Normal: 60 per cent Abnormal: 40 per cent Active: 70 per cent Sluggish: 10 per cent Non-Motile: 20 per cent Sperm count: 90mil./ml WBCs: 01-02 HPF. Would you please tell me about the report whether it is normal or I need to concsult a doctor for treatment. Regards.",
    "doctor_response": "Hi,Welcome to HCM.Your semen analysis report is absolutely normal & no need to worry for that.Wish you good health.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling sensation on arms and face?\n\nTwice in the past week i have experienced a tingly sensation, over my whole face and down both arms.This would start slightly in the face and would progress in strength and work it s way down my arms. This affects the skin only. My skin would turn red like a sunburn and last about 20-30 min then go away.",
    "doctor_response": "Hi,Thanks for writing in.The nerves to the neck and face originate from the brain and spinal cord in the cervical spine. The cervical spine is made up of 7 small bones aligned on top of each other. There are spongy discs between these small bones which give it a cushioning effect and help in forward backward and turning movements. There is a possibility that your discs at particular levels have been degenerating for some time. Since it has been happening over the past week, it is important to rule out any nerve irritation or a condition that has developed recently. The tingling sensation is more frequent when there is pinching of the nerves in the region. Doing a MRI scan of the region including brain and cervical spine might be required. This will be decided after once a your neurological clinical examination is complete. Treatment depends on clinical and imaging findings.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat an excess mass of gum tissues?\n\nI have just had a piece of tissue removed from upper gum due to bad fitting dentures a large mass of excess tissue has grown,  dentist wants to biopsy it before going ahead and removing it all. He put in some stiches and said they would dissolve. I am worried because of language barrier, I am in Taiwan. I am healthy 50yrs old woman. any help would be great.  Thanks",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.Excess tissue growth with ill fitting denture as you have described is usually harmless referred as epulis fissuratum. This is usually cause by chronic tissue irritation by a ill fitting dentures and its response to the soft tissue.Biopsy is usually done to rule out any other lesions including neoplasma.I would suggests you to go ahead with surgical removal of the tissue.After the healing get a new denture done with proper fitting and proper maintenance of the denture.Hope this was useful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of pain in hand ?\n\nTripped and fell with my hands outstretched a month ago and still fell a dull pain in right hand, middle very bottom of my right palm. Sometimes feel a sharp pain when picking up a bag or something. My whole hands aches, had it x rayed and it showed nothing.",
    "doctor_response": "Hello, As there was no fracture this is just a bony injury and have made the muscles weak now. Doing exercises for the hand muscles is advised along with strengthening the forearm and arm muscles too. This should help remove the pain and get optimum results. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lupus?\n\nIm a 56yr female just been diagnosed with mild pulmonary hypertension. I also have systemic lupus and fibromyalgia. Im a non smoker, but like a couple a glasses of red a week, and have a healthy diet. What lifestyle changes should I be looking at?and travelling with lupus is a problem but can be done, what about travelling with ph?",
    "doctor_response": "There is not much you could do, however you could avoid direct sun exposure, try eating a balanced diet, mantain your weight, exercise regularly.during travel be active and avoid sitting still for long periods of time , in order to prevent thrombosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful lump on the elbow\n\nI have a pea size lump that moves around near my elbow. The lump doesnt give me pain but if I put any pressure on my elbow it hurts a lot. The pain in the elbow is getting worse over the last couple of days. I only notice this issue they last two weeks.",
    "doctor_response": "Hi,The lump near your elbow appears to be boil/ furuncle / or infective origin ,which resolves on its own in 2 weeks time.I would advise following treatment under cover of your PCP doctor-Antibiotics /Anti-inflammatory drugs x for 5 days time.Cold compresses x 2-3 days time.Hope this would resolve your query.Welcome for any further query in this regard to HCM.Write good review and hit thanks if this reply is helpful to you.Have a Good Day.Dr.Savaskar M.N.Senior Surgical Consultant.M.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is required diet for a pregnant lady with Urticaria and Angioderma?\n\nHi Doc I just suffered a bout of Urticaria and Angioderma for the first time.I am 6-7 weeks pregnant my rashes are gone since 2 days and today is the 3rd day. WHat all foods can I eat I am still on antihistamine tabs. I had brinjal, strawberry milk, pickle, & 6-7 cashews which were main causes of the outbreak says my Doctor. Please tell me what foods can I start taking. Can I eat Upma? Lentils in little quantity? Can i start eating tomato and Potato. I am fed up of having curds n rice all these days and have lost 2 and half kilos in 4 days. Please help URGENT!!!!!!!!",
    "doctor_response": "dearfood for urticaria patient is,avoid lime / lemon, tomatoes, orange, curd,pickle,sauces, chutneys, any tinned food, vegetable with seeds,avoid any perfume with strong odour, extreme change in climate.if you have cough or cold take care of thatavoid stress.dr. Mira Butani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from ulcerative colitis, what caused stomach aches and sore shoulders muscles?\n\nHi .. my son has Ulcerative Colitis and is taking the medicine Humira. He has been complaining of stomach pains and sore muscles in his shoulders and tonight he said that his stools are black. What is the cause of this and what should we do about the situation.",
    "doctor_response": "HiIn ulcerative colitis, often there's some blood loss which presents as black stools.A stool test for blood can rule this out.I may suggest taking pantaprazole 40 mg once a day empty stomach also and dritaverine tabs if cramps in intestines or abdomen is there.Consult your treating physician alsoThanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is ectopic pregnancy related to ovarian cyst?\n\nhi im 34year old woman and last year Dec 2012 I had an ectopic preganancy of unknown location at11 weeks. I have been trying to conceive since April 2013 and with no luck. my doctor thinks I may have an ovarian cyst on my left ovary and I am waiting to do for a scan. I just would like to know if these 2 incidents are related to each other or has the treatment I received interfered with me trying to conceive (methotrexate injection) or is this possible my bodies way of telling me that a pregnancy is just not meant to be. I also have a 12 year old son and I am in good health. I work with children with disabilities and I am terrified that if I continue to try and get pregnant I may have a child with a disability",
    "doctor_response": "New born child to have disability can not be linked to previous tubal pregnancy Reason of tubal pregnancy can be investigated.I do not think  ovarian cyst can be relatedtoit.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take Duphaston and susten vt during pregnancy and with white discharge?\n\nHi, I am 7+ weeks pregnant. My doctor has advised me to take Duphaston 10mg 4 tablets in a day and susten vt 200mg twice a day via viagina.. I had slight bleeding at 5 week. Doctor has advised me to take them till 12 or 13 week of preganancy. is it safe to take these pills during preganancy? I am also having viaginal itching and white discharge because of susten vt.",
    "doctor_response": "Hi,Yes, these medicines are considered to be safe during pregnancy. Based on the history you seem to have features suggestive of suspected miscarriage for which your doctor has advised the medicines. Duphaston and Susten-VT are synthetic forms of female hormones progesterone which are useful in supporting and maintaining an early pregnancy and also to prevent miscarriage and preterm delivery. Ask your doctor for the treatment of vaginal itching or white discharge which could be due to fungal infection.Hope I have answered your query. Let me know if I can assist you further. Take care.Regards,Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest solution for severe depression, panic attacks, anxiety with bloating and stool leakage\n\ni have severe depression that also accompanies alot of panic attacks and constant anxiety, its utterly crippling. I suffer from bloating and nausea whenever i eat and i also suffer from humiliating de humanizing stool leakage i guess and it never seems to get any better. i know it takes time when your working on it but really how long or is it something totally different",
    "doctor_response": "Hi To my patient I would have advised Drug by generic name Fluxatintn  bd with Clonazepam bd see the response to come for a week and if no relief  i would have advised to personally consult a psychistristDr LalPsychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in abdomen under ribs, nausea, fullness, little oily urine. Gallbladder issue?\n\nI've been having what I think is gallbladder issues the last two weeks. Pain In upper right abdominal area right under ribs. Nausea vomiting fatigue....fullness after just a few bites, worse at night. I'm having an egd and hidascan done tomorrow. I've noticed my urien looks a little oily. It's all clear for the most part...a normal light yellow almost nonexistent color. But it looks oily. Could this be gallbladder related too? I'm 31 white female. Just incase that matters.",
    "doctor_response": "Hi, thanks for writing in. You need to undergo a few  tests which are an ultrsound examination of the abdomen, Liver function test and a complete blood count.If the ultrasound confirms the presence of stones then you need to undergo cholecystectomy. If there are'nt any stones then assessment of liver function tests and complete blood count will help in determining whether there is liver dysfunction or infection. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any chances of getting pregnant on combination of Clomid and the cinnamon/honey ?\n\nI'm 25 years old and trying to conceive for 2 years now I've been taking raw honey an cinnamon and I'm starting on my first dose of clomid. My question with the combination of the drug clomid and the cinnamon/honey help me with chances of getting pregnant/concieve.",
    "doctor_response": "HelloThanks for writing to us with your health concern.please upload all your tests done so far.With 3 years of primary subfertility, you should consult an Infertility specialist.Get your husband's semen analysis tested.Next get your basic hormonal levels done - TSH, LH, FSH, AMH, Prolactin, OGTT, DHEAS, Free testosterone, Lipid profile.ALso, go for a cycle of follicular monitoring.This involves tracking the growth of the egg follice in the ovary by serial ultrasound scan done throughout the cycle.If ovulation is fine, then you can go for 3 - 6 cycles of follicular monitoring alongwith natural trying for conception around ovulatory days to maximize chances of pregnancy.If ovulation is a problem, you might need help of ovulation inducing agents like Clomiphene citrate / gonadotropins to help ovulation.If 3 - 6 cycles of stimulation also fail, then you should go for a laparoscopy to check if your fallopian tubes are open.ALternatively, you can undergo laparoscopy directly too.As a last resort, there is always IVF ( in vitro fertilization ) which will help you.Maintain ideal weight.In response to clomiphene, almost 50 % of women ovulate and more than 20 % achieve a successful pregnancy.Cinnamon and honey has no scientific evidence, just eat healthy.Take daily folic acid supplements.All the bestTake care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful knot on lower part of right side of head?\n\nI recently came to the ER because I had what I thought was a crook in my neck. They gave me muscle relaxers and pain meds because the swelling in my shoulders were noticeable and he said since it s soft tissue no X-ray was needed. Well I went home and the muscle relaxers helped my shoulders but I now have a knot on my lower part on my head on the right side and it aches from time to time but hurts when I turn to the right. What could it be? Should I go back to the ER? I have been lightheaded and weak, just want to lay down and that s far from the schedule and lifestyle habit I keep. I m always on the go and full of energy.",
    "doctor_response": "Hello, it is a common dysfunction in the muscle most the people have it due to the erratic lifestyle. we use a lot of electronic gadgets like phone, iPads , laptops or TV. we generally tend to forget that we are not in the right posture, which causes imbalance in your cervical and lumbar muscles, which in turn cause pain, numbness or any other symptom. if you can correct your posture in all your activities it can get rid of such problems. would like to advise you meet a Physical therapist who can solve your problems and get back to your healthy and active lifestyle.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I take Sysron-N to delay my periods for a week, without disturbing the overall cycle?\n\nDear Doctor, I want to delay my periods for a week. Earlier my periods have been very sporadic. Just wanted to know whether, is there any way which can help in delaying the periods by a week without disturbing the overall cycle?",
    "doctor_response": "Hi. From your question, I understand that you want to delay your next menstrual cycle by a week. I need to know answers to a few questions before telling you the name of the drug. Your answers for the above questions will help me treat you better.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes wheezing, fatigue and dysgeusia after exertion?\n\nmy son was at an event tonight. they were running around and he became winded quickly. he then would make a wheezing noise. it seemed to stop once he caught his breath. he said it tasted like he had blood in his mouth when he was wheezing, but that he didnt think there way actual blood. what happened to him?",
    "doctor_response": "Hi,Thank you for asking question on health care magic.Most probably your son is suffering from exercise induced asthma.He needs specialist consultation .Better consult pediatrician.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes liver and spleen enlargement?\n\nMy daughter (8.5 years) is suffering from fever in USG and her liver and spleen is mild enlarged, but maleria parasite test and widal test are negative and in liver function SGPT are 65.  Kindly suggest why the liver and spleen is enlarge and medicines for remove fever.",
    "doctor_response": "Hi,There are many causes of liver enlargement and treatment depends on exact cause.  If this is caused by diet, obesity and diabetes then dietary and lifestyle changes will be beneficial in every case. Alcohol and viral hepatitis are most common causes and in this case medical evaluation is required. Also if there is infectious disease or biliary duct disorders then you need to do some tests to rule out more serious issues which require specific medical treatment.I hope I have answered you query. If you have any further questions you can contact us in every time.Kindly regards,Dr. Ivan R. Rommstein",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a red rash on the trunk and back of the neck of a 16 month old?\n\nMy 16 mt old grandchild is exhibiting a fiery red rash on trunk and back of neck with some raised welt like lesions that are very transiet. He doesn t seem to be feeling very well - possibly a low grade fever. Question an allergy bur concerned because of West Nile season etc",
    "doctor_response": "Hello, I appreciate your concern. What you are describing seems to be a form of allergy, called urticarial lesions which are raised and welt-like. A viral infection (in view of the fever) is the most likely cause. others could be an allergic reaction to a new food or piece of clothing/bedding (as it is confined only to the shirt area) The rash with West Nile virus will be smaller spots and bumps, which appear after the fever settles, so you need not be concerned.  I would suggest an anti-histamine to help with the rash and itching, it is important that you measure the temperature and give paracetamol if temp crosses 100 F. Hope he feels better soon!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my fiance having pains in his left side of his chest?\n\nMy fianc\u00e9 and me are laying in bed and he's getting really sharp pains in his left side of his chest. Than it's shooting down the left side and back up. Everytime it does it, he says it's making him have to pee and it hurts to pee. What is it and what do we do?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your fiance 's situation and problem. By his history and description, possibility of left sided renal colic (stone)  is more. But better to first rule out cardiac cause because left sided sharp chest pain is mostly due to heart diseases. So get done ecg. If ecg is normal, than no need to worry for heart diseases. Renal stone causes similar kind of sharp, stabbing pain in front as well as back. So get done ultrasound examination of abdomen to rule out left renal stone. If this is also normal than he is mostly having musculoskeletal pain. So painkiller and muscle relaxant drugs are beneficial. Apply warm water pad on affected site. Avoid movements causing pain. Don't worry, he will be alright. But first rule out cardiac diseases and renal colic. Hope I have solved your query. Wishing good health to your fiance. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bruises on brain and blood between brain and skull\n\nMy husband suffered a severe concusssion from looks to me like someone stomping on his face. He doesn t remember the incident, just waking up in a ditch. Surgeons at the hospital said he is lucky to be alive. The last CAT scan he had, he told me, revealed bruises on his brain and blood between the brain and skull. There is fluid in his head. Its only been three days. He left the hospital on his accord against medical advice. Im very worried. He says he is a little out of it. A little dizzy and having a hard time gaining his bearings. Im going to take him to another hospital for a second cat scan. Any advice?",
    "doctor_response": "Brusies in brain and blood between brain and skull are most likely contusions and Subdural/Extradural Hemorrhage. Requirement of surgery depend on extent of blood collection and if any pressure effect. if it is not that much, medical management is required only. For advising further I need to see the NCCT Head images and its report.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could vaginal bacterial infection be the reason for not getting pregnant?\n\nI have been taking clomid for 12 months as I have pcos. I had a laposcopy 6 months ago and they didn't find anything else wrong. I ovulate with clomid 50mg. My husbands sperm tests are fine. However , I found out today that I have a vaginal bacterial infection, could this be why I haven't conceived yet? Thanks",
    "doctor_response": "Welcome to HCM!It is good to hear that you husband has good sperm tests. It is better that you have proper treatment of the vaginal bacterial infection which many be a one cause that you are not conceiving the baby, but a gyn.specialist can examine you and advise you properly.Need not worry just have proper consultation.Take Care.Dr.minhas",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain after jabbing needle in the arm for blood test?\n\nI had a blood test taken 3days ago and it was the most painful blood test is ever had, I had a sharp needle pain in lower to where the blood was taken and a sharp shooting pain. I told the lady that took my blood but she insisted it didn t hurt :/ annoyed me. Now my arm feels numb and slightly tingly and I keep getting horrible twitches when I move my arm. ? Please help me ?",
    "doctor_response": "this is very unusual, obviously. The type of pain and 'shooting' imply a nerve is hit. THere are not major nerves in that area but certainly everywhere there are SOME nerves. With neuropathic pain:1) short run any nerve pill such as a lidocaine patch (you need ONE, cut into 2 cm squares, apply one 2x2 daily), anti-seizure med, or amitryptiline are likely to work at quite low cost2) long term minor nerves usually grow back ok.cannot say in your particular case.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the left side of the lower back?\n\nMy girlfriend has been getting back pain for a few days. It suddenly came while she was bathing. She mentions that it's on the left side of her lower back. It didn't get better after seeking treatment from a principal physiotherapist. She went to the doctor to get it checked and was asked to visit a gynae. Any idea what might be the problem?",
    "doctor_response": "HelloLeft sided lower back pain may be due to many reasons like musculoskeletal causes,pelvic pathology,genitourinary calculus etc.History suggests that pain may be due to muscular spasm.She need proper clinical examination and routine investigations.Investigations include routine hemogram,,renal function test,urine RE/ME,ultrasound of abdomen,X-ray L/S spine (AP /lateral).Ultrasound of abdomen is important in diagnosis and treatment.Proper treatment depend upon findings.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure the condition of elevated monocytes & swollen lymph nodes?\n\nhi i recently went to the doctor and have been waiting on my test results for almost a week now and just nervous. One thing they did tell me is that i have elevated monocytes, swollen lymph nodes and possibly anemic. I forgot to show the dr the red rash on my back and today is seems worse and I am just really worried. should i go back to the dr?",
    "doctor_response": "Hi XXXXThanks for your query at HCM!I am Dr. Sheetal Verma an Infectious Disease Specialist answering to your query! I went through your query and understand your concern.You are probably suffering from infectious mononucleosis which is a contagious illness caused by the Epstein-Barr virus that can affect the liver, lymph nodes, and oral cavity. No need to go back to doctor. Wait for test results. While the severity and length of illness varies, most people diagnosed with mononucleosis will be able to return to their normal daily routines within two to three weeks.Hope I have answered your question. If you would like some more information I will be happy to provide. You can also write a review for me. Wish you good healthTake care!  Wish you best of Health.Dr. Sheetal VermaInfectious Disease Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fingers went numb, couldn't read. History of migraines. Is this recurring migraine or seizure ?\n\nI had a migraine 11 years ago, I was unable to speak, and when I tried I made no sense at all. The headache was very painful and made me sick. Fast forward to 3 days ago...I was reading to my daughter and my fingers went numb on both hands. I thought it was weird, but kept going, then my words weren't making any sense. I couldn't read the words, but i could speak to my child normally. My husband took me to the ER, they did a CAT scan and said I either had a migraine or a seizure. The CAT scan didn't show anything unusual. Is it common to have these episodes so few and far between?",
    "doctor_response": "Hi, as it is felt, there was no head ache this time, but there is numbness of hands, no fault in the C.T.scan so it may be the seizure, a symptom of the epilepsy.                       So i advise you to consult a neurologist for diagnosis and treatment. You may have to get the E.E.G. for confirmation. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can I manage pain in ribs with breathing difficulty after a fall?\n\nHello doctor, I slipped, fell and landed on my side four days ago and have been in a lot of pain since around my ribs on the left side. The pain has not lessened, sometimes feels worse. It hurts when I breathe so I have to take shallow breaths. I know that X-rays will not do much and I realize that not much can really be done at all. So my question is what can I do to help the healing process or if there is anything I should not be doing. I have been going to work and avoiding heavy lifting. I cannot really afford to take more than a few days off. Would it slow the process of healing if I continue to go to work but avoid heavy lifting and any strenuous activity?",
    "doctor_response": "Hi. I have thoroughly gone through your case and can well understand your genuine health concern. Severe pain on the ribs and breathing difficulty after a fall indicates some injury to the ribs. Even a minor fracture of the ribs can cause severe pain and breathing difficulty. Sometimes, severe muscular spasm following a fall can also cause such symptoms. So you need a proper physical examination. As you mentioned that you fell on the left side and having severe pain and breathing difficulty also, I suggest you get an X-ray done and consult an orthopedician. It is true that X-ray will not help much but you can get it done to make sure that there is no rib fracture. For minor rib fracture, only conservative management should be done. You need to take rest, avoid excessive spine movements, avoid sleeping on left side, avoid lifting heavy weights. In my opinion, you should take rest and avoid working for a few days. I would suggest you take some oral anti-inflammatory drug in combination with muscle relaxant drug twice daily for about five days. You can also apply some analgesic cream or ointment twice daily. Also, hot water bag over the painful area for 20 minutes thrice daily for pain relief. Rib fracture or muscular spasm. X-ray thoracic spine- AP and lateral.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am on Insulin for diabetes. Could I get treated with oral drugs?\n\nHello doctor,I had been diagnosed as a person with diabetes before 10 years. Now I am taking Amaryl MV 2 bd dosage. Still, my rbs is around 250 to 270. What I need to do? Is there any possibility that I can avoid insulin therapy and by oral therapy only I can be treated? And now I think I am facing problems with neuropathy also. Pain in the palm and numbness in the feet even some sexual issues also. Please suggest to me what kind of treatment I should follow.",
    "doctor_response": "Hello. You are facing complications of diabetes, to control sugar you can take Glimipride 3 mg before breakfast and Sitagliptin Metformin 50/500 mg twice daily after breakfast and dinner. Avoid junk food, fatty meals, and deep-fried items along with sugary drinks. Brisk walk for 25 minutes for five days a week. Avoid anxieties try to relax. Eat Short meals instead of three meals, I mean divide your daily meal into small portions. Complications due to uncontrolled diabetes. 1. HbA1c,  2. Lipid profile. 3. Serum creatinine. 4. Urine analysis. 5. Fasting blood sugar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are fever, fatigue and nausea symptoms of shingles?\n\nI have shingles, the rash is improving and the pain is almost all gone. Today I have a fever of 101.3 and malaise, fatigue and low grade nausea. I stopped the neurontin yesterday in case that was making me feel bad. Is a fever and feeling this way normal with shingles?",
    "doctor_response": "HelloThanks for contacting HCM.You are in the recovery phase of Shingles and now you have high fever, body ache and fatiguability.Shingles is a viral infection  that brings immunity down and one is prone for infections.Possibly it is a secondary infection that has caused fever.Don't worry.Take plenty of Oral fluids, go for sponging and get an opinion from a Doctor in person.Incase i have a similar patient in my Outpatient Department, i will do a Basic blood count and if it suggest a bacterial infection, i will start a broad spectrum antibiotic and anti pyretics.Hope this helps!!!Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for an open hole in bottom molar?\n\nI have a open hole behind my back  bottom molar ( freaked me out when I saw it!). I have not had any widsom teeth removed. It does not seem to be one there. But the one on top has come in. I'm thinking it is from  the top tooth puncturing it. Any other thoughts? It's very painful when I eat.",
    "doctor_response": "Hello and welcome to HCM forum,I would like to inform you that from the details which ypu have posted with your query make it quite clear tha the upper wisdom is over erupting because the lower wisdom molar is absent.It is a normal physiological process for a tooth to over erupt in absence of its opposing tooth.I would like to advise you to see your dentist soon as the upper wisdom tooth will have to be removed in order to relief all the pain and associated symptoms.U til you see your dentist, you can perform warm saline rinses and take a pain killer every 8 hrs after meals, but do not overdose yourself as painkiller is not the treatment.I hope I answered your query,I wish you good health,Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for abdominal pain\n\nHi, My lower abdomen is always hurting and feels sore. When i press slightly on to it, i get pain there that stays for a while. I have learnt that my pain is triggered when i touch it, though i always avoid doing so. But i experience pain even when i am walking or relaxing, i feel something like a cyst irritating me near my belly button.",
    "doctor_response": "Hi.Thanks for your query and an elucidate history. Good history is to be supplemented by few investigations like Ultrasonography and an examination by a Surgeon. This can be due to :Ovarian cyst as you have correctly suspected.SalpingitisPID- Pelvis Inflammatory DiseaseSevere enteritis Appendicitis and so on. Get blood, urine and stool checked; ultrasonography will help in getting a proper diagnosis.This will help a proper treatment .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does diffuse soft tissue swelling mean?\n\nI have pain on the inside of my left ankle and had an x-ray taken. These aer the results can someone please explain what this mains to me. 1. Diffuse soft tissue swelling. 2. Corticated calcific density adjacent to the tip of the medial malleolus-question old avulsion fracture fragment versus accessory ossification center. 3. Calcaneal spurring",
    "doctor_response": "Hello, Here is description of your report in easy words- 1.There is swelling of your skin and underneath covering at your joint. 2.The bone which covers inner upper aspect of ankle is known as medial malleolus.It is having extra bone formation or bone like structure  which can be either a old fracture or a extra bone. 3.The heel bone is having protruding extra bone which is known as Heel spur. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mukesh Tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Am I having depression?\n\nI have Irritable Bowel Syndrome and I think it could be stress related cause every time I get worried,stressed,angry or sad I get really painful cramps and I find it really hard to deal with my emotions. I'm always angry and sad and when I am happy my happiness doesn't last for long. Could it be depression ?",
    "doctor_response": "yes,there is a big chance you have chronic depression.That is better then any acute condition,And treatment can really help and you will be fine.Take lexapro 10 mg once a day for a few months ,you will feel better after 2 weeks.Have bright lights in your house ,this will also help.As for The bowel syndrome you can control it by avoiding coffee,spices,alcohol and fat in food or milk.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning sensation on the tip of penis and frequent urination?\n\nBurning sensation on the tip of my penis and frequent urination1.tab flagentyl(secnidazole) 4 at once.2.tab sparfloxacin 200 mg twice daily for 10days.3.cap fluconazole 50mg twice daily for 10days.I have taken the above drugs but I still feels a burning sensation in my penis",
    "doctor_response": "HelloI appreciate yourconcernLooking at your description I would advise you followingGet few tests done like Urine culture and sensitivity test and blood sugar fasting and postprandial This can be related to passage of concentrated urine so have plenty of fluids dailyI would like further information.to help you better likeYour age and relevant medical history like diabetes or kidney disease If it doesn't improve with all these measures please consult a urologist for further examination and investigations like Ultrasound Maintain good hygieneHope this answers your questionWish you good healthregards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful hip bones and a cold lower back and bottom?\n\nHello, I have extremely painful hip bones and a cold lower back and bottom even at night. Serious difficulties moving from sitting position to standing but once up can walk for miles. I take iboprufan to ease the pain during the day and panadol night tablets to help me sleep. I welcome your suggestions to ease my problem. Thankyou, Wendy",
    "doctor_response": "hi you have pain in hip bones and cold lower back even at night. Walking is pain free once you get up .Change of posture is painful. I would diagnose it as sacroilitis , and treat you with pain killers , local heat and back physiotherapy program.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does fatty liver and minimal pelvicalyceal system prominence in kidney mean?\n\nmy ultrasound report shows fatty liver changes, intraluminal echoes noted in urinary bladder , minimal pelvicalyceal system prominence in left kidney what does this mean?",
    "doctor_response": "Hi,  Fatty liver means small globules of fat deposited in the liver. Most commonly it is because of alcohol consumption. It could also be because of high fat diet for long duration. Fullness in pelvicalyceal system means mild swelling or dilatation of kidney. It Could be because of obstruction by stone or some congenital narrowing. It can also be a normal variant.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this follicular study report indicate?\n\nHi, I m undergoing follical study. Last time period cycle was not happened. Dr given medicine sysron NCR 10mg to get menses. After menses went for follicular study..On 9th day both left and right ovary readings are MSF and endometrial thickness 11mm..What does this indicates? Is it leads to pcos?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.On day 9, your either one of the follicle should be increased in size but all follicle of the same size definitely indicates that eggs are not growing in size. In our best cycle, you should go for ovulation induction and the medicines can help eggs to grow in size. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. MANDAVI RAI",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Metadoxine in case of abnormal cholesterol levels and fatty liver?\n\nI 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",
    "doctor_response": "Hi thanks for asking question in HCM.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 life style.....You will get benefit by above measures...Take care....Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bulging vein on neck?\n\nMy 4 year old daughter has a bulging vein on the left side of her neck and when she cries or yells it is huge and bulges like it is about to bust..it seems to me to appear to be getting larger but it doesnt seem to bother her any...just being a super worried mom?",
    "doctor_response": "Hi Thanks for writing to Healthcare magicIt would be more informative if I could see a photo or a vedio. From your description I can only infer it as a superficial vein which is distending on increased blood pressure , that is while crying, or shouting even squatting might cause same. If she has no weight loss, no extra swellings noted, growth is fine, and no other obvious symptoms, You need not worry.. In case there is any other query I would be more than happy to answer, else rate the answer and close the discussion. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from anxiety. Please help.\n\nHi doctor, I am suffering from anxiety. Please help.",
    "doctor_response": "Hi. Your description of symptoms is concise and specific, which makes it easy to diagnose your condition. Mental illnesses are broadly classified into neurosis and psychosis. In neurosis, a person does not lose contact with reality and understands that he has a mental issue known as insight into illness. The person is concerned about it and actively seeks help, just like you. All anxiety disorders fall under neurosis. Conversely, in psychosis, a patient losses contact with reality for example false perception like voices talking or false belief like a delusion that people are planning to kill him. These patients refuse to believe that they have a mental problem and they resist any sort of treatment. Schizophrenia is a classic example of psychosis. Patients of neurosis do not convert into psychosis. Anxiety remains as anxiety no matter how severe or chronic it is. So, be assured that you are not going to become schizophrenic, lose your mind or land in a mental hospital. Anxiety disorder has multiple presentations like generalized anxiety disorder, panic disorder, obsessive compulsive disorder, social anxiety disorder, etc. Depersonalization also occurs in anxiety disorder. Frequently, these conditions coexist in varying severities at different points of time. Your description suggests that at a certain level, you realize that your fear is irrational, but you still cannot get it out of your mind. This is likely to be an obsessive thought. The characteristics of an obsessive thought are :- Despite this, you are unable to kick it out of your mind or prevent thinking about it. There is a proven helpful way of dealing with an obsessive thought. Try a deep breathing technique like the 4-7-8 technique (relaxed breathing) which you can find on the internet and use it whenever you feel more anxious. Lastly, if you feel the need of taking medicine to deal with it, you should choose an antianxiety drug like Clomipramine or Fluvoxamine which has proven efficacy against obsessive symptoms as well. For further information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain when chewing on right side, have braces. Pain caused by tooth or hard palate?\n\nHi, I have been having this pain when I chew foods on the right side of my mouth. I think that there is something in my hard palate, is that possible? Or is the tooth that makes the pain? I tried to press that area on my hard palate, as hard as I pressed it, the more pain occurs even at the molars that are near to it. Btw, I have braces but I don't think that's the reason for the occurrence of the pain.",
    "doctor_response": "Hi, The pain might be due to periodontitis due to food accumulation in that region since its difficult to clean the area with braces on. Get it deep cleaning done with dentist and use some good mouth washes and do not use toothpick to clean...Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a sleeping aid I can take while on morphine to help me sleep?\n\nI am a 67 year old male. I have stage 4 cancer. I went to the dr 2 weeks ago when I had a loud and painful pop in my shoulder. Xrays were negative and I go to see about an MRI on wed. I am currently taking Morphine for the pain in my shoulder but it is not working well. I also cant sleep at all due to the pain. Is there a sleeping aid I can take while on morphine to help me sleep",
    "doctor_response": "Greetings. It seems your pain is not well controlled and it is the cause of you not getting sleep. The dose of morphine can be increased as per your requirement. If it does not work then other narcotic drugs like buprenorphine or fentanyl in the form of patch can be applied. There are multiple option for pain control and you can discuss these options with your pain physician. i will advise you to increase the dose of morphine or try these patch formulations rather than adding a sleep inducer drug as it will be of little help.regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a neck pain?\n\nHey i just got out of the shower. I was drying myself, i turned my head ever so slightly to the right to dry my arm pit. I then hear this loud crack on the left side of my neck. I now cant move my neck at all because of the pain. What do i do? The pain is more to the left side of my neck.",
    "doctor_response": "Hey, it sounds like you strained your neck.  You'll probably be just fine...but there's going to be a little pain.  I'd get some ice on the most painful part of the neck.  If your neck remains stiff and immobile over the next couple of hours you may wish to see a doctor to be examined and potentially get a prescription for some form of acute treatment.  Please rate this a 5 STAR ENCOUNTER and write me at: www.YYY.YY/YYYYYYYYYY with more questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My tailbone slammed into cement floor after a fall. Is it curable by a chiropractor?\n\nHello doctor, After a fall slammed tailbone into cement floor. I cannot walk having much trouble during walking. Can a chiropractor help, correct and fix this?",
    "doctor_response": "Hello. First of all, an X-ray is a must. As the impact was on the cement floor, there might be a possibility of bone injury. Post-X-ray, we can say the possible next treatment plan. Usually with rest for the initial time and using piles pillow will allow the less compression over the injured area. Post which the exercise to strengthen the hip muscles are advised to regain the muscle strength. Please take an X-ray and share the report. X-ray to be taken is PA pelvic bones or PA coccyx.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for the mitral valve prolapse?\n\nI m 29 and live a very active life style. I was diagnosed with mitro valve prolapse at the age of 18 and then with cardiac induced rhino conjustivitis at 23. I m now on high blood pressure medication and I like to take B12 because it helps with hangovers on the weekend and makes me feel awake in the morning without drinking coffee. Lately when I run a begin to have a sharp pain in the center of my chest on the left side. I can t tell if it s my heart or lungs. Leaning forward causes an immediate sharp pain in the same area and short shallow breaths help to stop the pain from occuring when I inhale. I m 6 5, 200 lbs and perform a first class physical fitness test (PFT) (3 miles in 25 mins, 19 pull ups, 100 crunches in under a min) in the Marines. What gives? Should I be considering a new profession?",
    "doctor_response": "Hi ThereMitral valve prolapse is basically an incompetency of the valve leading to regurgitation which if left unattended can finally lead to physical disabilty due to breathlessness.Blood pressure control in your case is important as it help in controlling the progression of Mitral Regurgitation(Valve Leakage). also sternous physical activities (which in your job profile is bound to happen i guess) should be avoided as it increases the incompetency of the valve leading to inadequate cardiac output and finally dizziness or syncope.Mild form of Exercise daily, meditation, and avoidance of smoking, alcohol, caffeine may prevent symptoms.Surgical repair or replacement of the mitral valve is indicated for patients with exertional dyspnea, an ejection fraction below 50%, and a left ventricular end-systolic dimension approaching 45 mm. And lastly regarding a job change you need to discuss with your treating cardiologist for your options.I wish you good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility\n\nHiDoctor.....I am 28 yrs old and m married for 5 yrs now and live in the netherlands......its been more than 2 yr i have been trying to get pregnant.....have gone thru all kinds of tests related to infertility in Holland and all our test are positive and everything is fine with me and my husband...am not allergic to any medicines till now... i lead a normaly life...i took a second opinion from my doctor is india and she suggested me to take some medicines for superovulation as i get my regular periods and mostly ovulate on the 18th day from my period .......she prescribed Letroz - 5mg  or Naturagest and lupigest - 300. is it ok to take these medicines? do they have any side effects? As i am in a colder country am a bit over weight (though my doctor said its fine) and am not able to reduce my weight inspite of being on proper diet and cycling, will this medicine have any effect in ganning weight? Normally when am in India I easily reduce weight and also am able to maintain it as I sweat a lot. please do advise me as I really dont want to miss out on any option cause of which i can get pregnant as its more than 2 years of trying and its sometimes depressing inspite of evrything being ok with me and my husband. Please help :)",
    "doctor_response": "Hi, I have one through your problem. When all the tests of the couple are normal and still they are unable to conceive naturally, then the condition is known as unexplained infertility. It is responsible for approximately 30-40% cases of infertility. In such cases, the stepwise treatment protocol is followed, the next step is taken when the previous one fails:1. ovulation induction drugs (clomiphene, letrozol)2. Intrauterine insemination (IUI)3. In- vitro fertilization (IVF)Letroz is an ovulation induction drug, while naturagest and lupigest are progesterones to make uterine environment more conducive for pregnancy.These are hormones which do cause increase in weight and very minor side effects. I would suggest you to go for IUI if you have failed to conceive after 5-6 cycles of the above drugs.Hope you found this answer helpful. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could a puss-filled lump after mole removal indicate?\n\nHello! I had a mole under my right ear, which was removed with the electro cautering device 2 months ago, biopsy went out ok, not malign. and in the scar place in the lower part i had like a small lump with a little bit of puss. The area was hurting, so i squeeze gently and a little bit of puss came out and some blood, it doesn`t feel at pain anymore. I applied a little bit of betadine on it. I hope it`s nothing bad , can you answer me please, thanks so much.",
    "doctor_response": "Hi. Thanks for the query. As per your question, I believe you contacted an infection of that region following the procedure. As the pain has come down , it must have healed. If there is persistent pain and pus, better take a course of antibiotics and painkillers. If not, just relax. You ll be fine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes large lump in the middle of the neck with headaches and tiredness?\n\nMy daughter has a large lump in the middle of her neck right over her larinex. Her primary care doctor took her blood and told her that her SED rate is elevated. her ear is bothering her as well as getting headaches and she is always very tired. any ideas?",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You have lump in neck with high sediment rate. So most probably you have tuberculosis.  You should go for fine needle aspiration cytology to diagnose tuberculosis.  Then take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can the diet followed result in sharp pain in bowels and abdomen?\n\nWhen I cough or push to poo I get a bad sharp pain in/on my butt... sometimes I feel it in ny lower abdomen.  For about a year I have had this pain. Sometimes I could be sitting or standing and get the pain. I have had x rays and ultra sounds and they never saw anything...of course these were for different reasons but im sure they wouldbhave found something considering the areas they checked. Is it my diet?Should I see a doctor?",
    "doctor_response": "Hi...you may be having an anal fissure...see a surgeon for physical examination to arrive at a diagnosis...also take laxative if you are passing hard stools...Dr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is swelling of lymph nodes near thighs,a matter of concern?\n\nHi I fell last week off a stool. I fell on top of the stool and fell back. I heavily bruised the inner parts of my thighs with heavy bruising. Now the bruising has gone down I am now left with swollen lumps on the inner parts of my thigh. Should I be worried as the lumps hurts?",
    "doctor_response": "Hi. The lumps are lymphnodes in the groin that are helping to clear the bruising and eliminate dead tissue of infection. They will be painful as they are swollen, but they should get smaller as you heal. My opinion is just have a doctor examine and see if you are not developing abscesses as that may be a cause for concern. Hope that answers your question. Get well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for vitamin d resistant rickets\n\nhi doctor my nephew diagnosed as vitamin d resistant rickets his calcium level is 8.2 age is 17 months alkaline phosphate is above 3000and phosphate is only 2.8 is there any treatment for him he still nit start to walk or stand his milestones are delayed",
    "doctor_response": "Hello, He will require Calcitriol or 1,25 dihydroxy cholecalciferol and not simple vitamin D Supplements. Please discuss this drug with his pediatrician. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rib pain and swelling?\n\nHello, A few weeks ago I noticed a bloating feeling in my Oblique/Pelvic area (where a muscular V would be) on my left side. A few weeks later I noticed swelling and something protruding out of that same area. Alarmed, I went for a colonoscopy and endoscopy... Nothing out of the ordinary there except a few ulcers (I m only 19 but I m waiting on the test results). Now, Ive noticed that there s mild pain (3 or 4 out of a 10) and all of a sudden my Ribs on that same side are now also sticking out more! If I suck in all the air and stick my chest out it is very noticeable and on the bottom where the Ribcage ends, that same left side is extended down lower (feels like an extra few ribs or something of that nature) now I m just trying to figure out where to go from here. Again I m only 19 (Male), I DID break my ribs in football about 2 years ago so I m not sure if that s how it heals or whatever that process might be, but I m sure I would have noticed before now. I do drink socially, never smoked or did drugs and I ve always been an athlete, but since around June I just feel like the wheels are falling off on the inside of me. If ANYBODY can give me some insight it would be greatly appreciated, Thanks.",
    "doctor_response": "Hello Thanks for writing to us, I have studied your case with diligence.As per your history there is possibility of rib contusion or costochondritis.Rib contusion is visible on X ray/ CT scan. I will advise to consult to orthopaedic surgeon.Medication like muscle relaxant and analgesic will reduce pain along with it use rib support belt.You may consult physiotherapist for pain management. He may start TENS, or ultrasound which is helpful in your case.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you find this answer helpful do not forget to give rating at end of discussion.Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Proton Therapy cure prostate cancer?\n\nWHAT IS YOUR OPINION OF PROTON THERAPY FOR PROSTATE CANCER. MY BIOPSY REVEALED 5 SPECIMANS WITH CANCER CELLS OUT OF 12 TAKEN. THE MOST CONCENTRATED SPECIMAN WAS 80%. THE OTHER 4 WERE 5%. THE AGGRESIVENESS OF THE CANCER WAS LOW TO AVERAGE. I AM CURRENTLY TAKING HORMONE THERAPY WHICH TOOK MY PSA LEVEL FROM 10 TO 0.5. THANK YOU",
    "doctor_response": "Brief Answer yes proton therapy can cure prostate cancerDetailed answerhelloGreetingsthanks for placing your query om HMC, i read your Question. i think  i would be able to help youproton therapy also known as bloodless surgery, it has a surgical precision does not  affect  vital organs and healthy tissue in close vicinity.there are very less chances of recurrence.it has proven in various studies that its better than the traditional radiation therapy ( photon therapy)if you can afford it nothing could be a better alternative of proton therapy.Hope I have answered your question. If you have any further questions I will be happy to helpwish you good healthRegardsDr BR Hudda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with toxic liver, headaches, blurred vision. Taken medication. Test shows antigen serodia positive. Meaning?\n\nMy name is Mr Stanley  i was diagnosed with a toxic liver in the year 2010 when i was feeling much tired and pains all over my body even when i am less busy doing anything..I took some medications then..Now we are in the year 2013 I still went for a test and the result shows HBs Antigen(SERODIA)=Positive....But Anti-HBs Antibody(Serodia) = negative..In that case i am having much headache now and at times blurred vision..what do i do?",
    "doctor_response": "Hi and welcome to HCM.It would be easier if you ve posted other hepatitis b markers but it means that you are infected by hepatitis probbaly and the antibodies dodnt develop yet so it may indicate acute hepatitis b infection. blurred vision isnt usualy sign of such infections and it is seen inly in late liver damage,so it should be evaluated ny ophtalmologist or neurologist. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach aches and poops are not solid. Taking protein and creatinine. Is that it?\n\nHi, I am a 20 year old college student and have been having stomach aches and not pooping solids, it also looks like small BBs . I have been having side aches and expanding stomaching once I consume food. What could these symptoms be? I am also an athlete and take protein and creatine , I have been been told creatine can lead to kidney stones . What do you think it could be?",
    "doctor_response": "Your symptoms are suggestive of a condition called irritable bowel syndrome (IBS), however excessive proteins and other dietary supplements can also cause these symptoms.Are you taking any drugs to improve stamina or muscles too ?Why not stop all the food additives and high protein diet for a week and see if it helps.If that doesnot help then you will need a trial of some medicines called gastrointestinal sedatives and are used to mamage IBS .You can take these under guidance of a gastoenterologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Legs going numb after sitting for a while. History of broken vertebrae in an accident. Could this be related to spinal nerve damage?\n\nAfter sitting on the toilet the other day, my husband (60 y/o) stood up, legs went numb, and he fell backwards and broke the toilet tank in several pieces. He was in a minor car accident a few wks ago and either fractured or broke a vertebrae in the top of his spine (medical team is undecided). He has never had this problem before the accident. However, after showering yesterday, he almost fell out of the tub but caught himself with the soap dish handle. Could these falls be related to a nerve in the damaged spine area?",
    "doctor_response": "HiThank you for asking HCMI have gone through your query.Your problem is most likely due to nerve impingement from crack in vertebrae or disc prolapse. An MRI will be needed to rule out the condition.Most cases can be managed conservatively by physiotherapy  exercises muscle relaxants and analgesics.I usually give NSAID like aceclofenac and muscle relaxant like thiocolchicoside for a short term,neurotropic drugs and neurovitamins and send for physiotherapy.If no improvement or there is serious injury found in MRI then a surgical option can be taken.It is better to consult an Orthopedician and rule out.Hope this may help you.Let me know if you have any further query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please suggest some medicine for testicular pain?\n\nHi doctor, I feel pain on my right testicle when I touch it. I have consulted a doctor and he asked me to do some tests. I have all the reports and I am attaching those here. Please give some medication.",
    "doctor_response": "Hello, Welcome back to icliniq.com. I have seen all your reports (attachment removed to protect patient identity). All reports are normal except you have two small stones in kidney but nothing to worry about stones. Regarding testis pain, you should avoid wearing tight jeans and clothes. Use proper undergarments which give support to testes. Testes should not be hanging without any support.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What would be the result of CBC and PBS tests in a patient with pityriasis rosea?\n\nHello doctor, I recently had my blood tested and it turned out that I have WBC at 16000. I have no fever, a cold or a cough. Although I have rashes and I suspect this is pityriasis rosea. My doctor is not aware of my suspicion. Now he wanted me to undergo CBC and peripheral blood smear. If I really have pityriasis rosea what would probably be the result of my CBC and PBS? I am 22, female, 5'1\", 48 kg.",
    "doctor_response": "Hello. Pityriasis rosea is a form of viral skin infection. Your total WBC count can be high because of that and in your CBC, high lymphocytes can be a possibility but it is not the rule. For your rash, Levocetirizine 5 mg OD like an oral antihistaminic drug can be prescribed. If needed, topical steroid also can be prescribed. I suggest you consult a dermatologist for examination. Repeat your CBC with peripheral smear examination report after a week. For more information consult a hematologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the condition of acute appendicitis?\n\nHi. I am a 53 y/o female. I had bladder suspension surgery, using ligaments to attach to my pubic bone. I never felt right after surgery. 2 days later I was in severe pain and went to the ER. I was told i had acute appendicites and had to have an appendectomy. my wbc when from 7 to 17 and i was not having any symptoms of any appendicix or any symptoms before my bladder surgery. I was told that it was just bad luck by my surgeon. Have you ever heard of anything like this before?",
    "doctor_response": "helloAppendicitis  is a chance coincidence to develop in this period and is possible even had you not undergone bladder surgery,it is absolutely unrelated to bladder surgery.Appendix is a small organ situated at the junction of small  bowel and caecum ,a part of large bowel, and gets inflammed due to many other reasons,bladder is in lower abdomen.Sometimes, if abnormal position of appendix congenitally is present in the pelvis, then chances for  its infection may happen very rarely in suspension surgery of urinary bladder.The pelvic position of appendix is hardly less than even 1% of cases, if I am not mistaken. So have faith in your treating surgeonbest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly advice diet for a TB patient under DOTS treatment.\n\nHello doctor, My father is 48 years old. He is suffering from pleural effusion and TB for the last two months. DOTS treatment is going on. I want to know what foods should he take and what should he avoid?",
    "doctor_response": "Hello. Good your father is under treatment, continue without any break, that is the most important thing. Diet also plays a vital role in TB treatment. Consume fruits, and vegetables like orange, mango, sweet pumpkin, carrots, guava, amla, tomato, nuts, and seeds are an excellent source of Vitamin A, C and E. Protein-rich foods, and foods rich in B complex Vitamins should be taken. Ask him to have a boiled egg daily. He needs more protein because they aspirate effusion fluid from the chest, that is rich in protein. So there will be protein loss. To compensate add more protein-rich food.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can hair loss be treated?\n\n(1)Is there any way to treat hairfall....I mean i am lossing a lot of hair from the top of head,even when i shampoo my hair once in 3 days..My hair is oily, age is 19, male.....(2)Also Can i use shampoo daily??...Even when i apply shampoo to my head, i get hair on my hands...(3)Also is there a way to regrow hair using oil or something like that...",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.Loss of up to 100 hairs per day is normal. Anything above that is abnormal and in such cases the cause of hair loss should be identified and treated.You can apply shampoo regularly and it does not cause your hair loss. As I told, few hairs coming in hand while shampooing is completely normal and it is a part of hair cycle.For regrow hair, you can apply Hair serum daily.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Siva Subramanian.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had appendix removed. Have lower stomach pain and back pain, difficult BM. Help?\n\nHI i had my appendix removed about 9 months ago and i ve went back 3 other times because of the same symptoms and pain they relieved it. But now i am getting pain in my lower stomach and back at the same time erratically at times and its starting to last longer and hurt even more especially if i try to walk.Then sometimes after i make a bowel movement i fall to the ground because i get to weak to walk.and not to mention every time i eat i feel like im bout to throw up and i don t even eat that much .....whats wrong?",
    "doctor_response": "Hi. I am very sorry for the pain you are experiencing even after Appendicectomy surgery. It may be Irritable Bowel Syndrome .Please take a Pre and Probiotic capsule and a Proton pump inhibitor like Rabeprazole with Domperidone. But,you have to take Ultrasound abdomen and X ray abdomen to rule out Sub acute Intestinal obstruction,Urinary tract pathology and any pelvic lesion. Hope you will be alright with above treatment. Wish you speedy recovery",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will i get pregnant after taking Fertigyn injection?\n\nI tried for a child last 1 year bur could not succeed. All the reports are normal. My doctor advised me to take an injection Fertigyn 10000 mg. on my ovulation date for conceiving child. Is that injection helping me for conceiving? I heard that by taking this injection, chance of conceiving twins or more is increased .Is that true? Pls help me or advice should I take this injection or not.",
    "doctor_response": "Hi, How are you doing ?Just by taking Inj. Fertigyn you cannot get twins or get pregnant. Fertigyn is hormone LH , which is released from brain. This hormone will only confirm ovulation , only if the follicle of right size is available. Twins can occur if stimulated by Tablets like Clomiphene ( Clomid or CCQ or Siphene ) & follow up stimulation with HMG hormone injectionsThese hormones have no abnormal side effects, so it is safe to take it. Just go through the checklist of investigations, if you have missed any do get it doneHusband- Semen analysis at least 2-  done 4 weeks apart preferably in an infertility center ( examination done by andrologist), Blood sugarsWife - Blood Sugars, Thyroid profile Ultrasound scans to evaluate Uterus , Ovaries & adnexa          Confirm tubal patency- most important- Tube is the connection           between uterus & ovaries( the bridge where sperm meets the egg &           forms a baby) this is size of hair follicle & cannot be seen on scans.           So check with HSG( Xray with dye), or SSG ( Scan with dye) or            LaparoscopyIf all this done & found normal , nothing can stop a pregnancy with God's willHope I have cleared your query, do write back if any more queriesAll the bestDr.Balakrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am getting depression due to taking of exercise\n\nWhenever I work out, I get depressed anywhere from 2-4 hours after exercising. It is mostly physical--uncontrollable crying and suicidal thoughts without any negative thoughts about myself. If I exercise consistently over the course of a week or more, my depression becomes more permanent and more psychological. I ve tried many forms of therapy and while they may help with the psychological aspects, they do not help with the crying and suicidal thoughts that come after exercising. I ve been on Wellbutrin (no other antidepressant works for me) for a year and a half and it helps my exercise-induced depression about half the time. None of my psychologists or psychiatrists have heard of this situation or know what would cause it other than a major chemical problem, and a majority of them have recommended some type of brain scan but I can t afford it because I don t have health insurance. Does anybody have any idea what this might be or what might help?",
    "doctor_response": "Hang out with your friends that work out And don't work out 2-4 hours, that causes massive damage to your body I'm a retired marine and we never work out for that much, your body needs time to repair itself",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause symptoms like very less frequent poop, gassy and fussy poop in an infant?\n\nMy baby is 5 weeks old, i bottle feed and breast feed, he poops yellow. he used to poop after every feeding, now he hardly poops once a day and gets very gassy and fussy,  poop kinda smells. Although he still poops a darker yellow, it is very watery and with mucus, is that normal",
    "doctor_response": "Hi...this is completely normal in a kid of this age who is both breast and bottle fed. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. his happens when the baby sucks at the breast very fast and in eagerness to drink milk will gulp in air too. Unless the air comes out like burping or flatus this discomfort will be there and next time check if she is sucking too fast and gulping in air too. You will be more convinced. Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes throbbing pain in the neck?\n\nI am 5'4'' tall and weigh 260lbs. I have htn, diabetes, and hyperlipidemia. I sometimes have a throbbing pain in my neck near the base of my skull. It feels a lot like my pulse but it is painful. I can sometimes feel the same feelimg in my lower back on each side in the area where my kidneys are. It is not a constant pain, but comes and goes at times. I also take HCTZ for swelling in my ankles. When I take this medicine and I urinate a lot it seems to help with the throbbing pain in my neck. Could this be a result of CHF or fluid retention?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Yes, this type of throbbing pain can be due to congestive heart failure, fluid retention and aortic aneurysm. Your symptoms are improving with diuretics, so possibility of fluid retention and heart failure is more. Hypertension can cause aortic aneurysm. You are having throbbing sensation near kidneys and neck. So we're should also rule out aortic aneurysm. So better to consult doctor and get done 1. Ecg, 2d echo to rule out heart failure. 2. CT abdominal angiography for aortic aneurysm. If all these reports are normal then no need to worry much. Sometimes, stress and anxiety can also cause throbbing type of sensations. So avoid stress and tension, be relax and calm. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the total sperm count 65.60-160.milliun/ml suggest?\n\nmy sperm analysis report is normal or not volume :2.0ml color. :pearly white reaction. :alkaline total sperm count: 65. 60-160. milliun/ml motility . motile. :70% . non motile: 20% . . sluggish. :10% morphology. . . normal :90% . abnormal . :10% . pus cell . :4-6 . /hpf",
    "doctor_response": "HelloThanks for query.Based on the report that you have posted I would say that your semen analysis report is within normal range compared to WHO standards as for as count,motility and morphology is concerned.However presence of 4-6 pus cells suggest infection of either Seminal Vesicle or Prostate.You need to take antibiotic like Doxicycline twice daily for one month.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause urine smell like poop for 8 month old?\n\nMy 8 month old son s pee smells like poop. Sometimes it even smells like the meat he ate the night before for dinner. Why would it smell so bad? He nurses about 6 times a day and we started giving him a small amount of water every day (about a tablespoon). He has plenty of wet diapers during the day, but they stink!",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.She can have some metabolic problems. You perform urine test. If everything is normal, then give urine for chromatography to exclude some generic disease. Wish you and baby good health.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Svetlana Shrivastva",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back and neck pain?\n\nI 14 years old and have back and neck pain and serious discomfort. I am not sure what it is. I have seen a chiropractior and only gotten massages. They made it worse. Please help me figure out what this pain and discomfort is. I also get tinglyness in my arms and legs sometimes.",
    "doctor_response": "Hi,Thanks  for  your query.Back and neck pain is a quite COMMON problem. Back muscle strain is one of the MOST common causes of acute to severe back pain. Lifting a heavy object, twisting, or a sudden movement can cause muscles or ligaments stretch or develop microscopic tears.TREATMENT: Some general guidelines can help you to reduce back pain. These are as follows:1) Take adequate bed REST with maintaining posture. Individuals who do not regularly exercise to build strength and flexibility are more likely to experience recurrent or prolonged back pain. 2) Alternate Hot water bottle or Ice pack can help to relieve most types of back pain by reducing inflammation.3) Non-Steroid Anti-Inflammatory Drugs (NSAIDs) are quite useful to reduce inflammation and back pain. You need proper prescription from your doctor. Taking muscle relaxants will also help.4) Exercise for Back and neck Pain : It is a key element of almost any back and neck pain treatment plan. You may contact with Physiotherapist regarding this. I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI showing a fracture in sacrum below lumbar spine. Was on epidural during the fall. Back and leg pain, loss of sensation after child birth\n\nmy name is Amber, i gave birth in September and the epidural was left in my back for over 24 hours. i found it the next day. while epidural was n my back the nurses dropped me on the floor coming back from bathroom. about 4 days later a spinal tap was done also. i now have a MRI showing a fracture in my sacrum below my lumbar spine .. since delivery i have had back pain and leg pain. i have lots of pain in my knee as well, it is very hard to bend or straighten my legs and have loss of sensation in legs also..",
    "doctor_response": "Hi Thanks for asking the question. Back pain can occur after delivery due to laxity in the muscles and ligament. And it usually gets relieved by 3 months with toning up the muscles. But ur history of fall and a spinal tap points to something different. Does ur MRI states only fracture or anything else also. Fracture can be due to fall or rarely a stress fracture of sacrum. The exact localisation is important to tell the cause and plan treatment accordingly. I would recommend u to see your doctor(spine Surgeon) who will examine you, see ur scans; and will then be able to advise u appropriately. Arrange for an appointment at the earliest. U can contact me in case u need any further details. Bye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling of salt in right side of tongue, bad smell from mouth. What could be the problem?\n\nI have a feeling of salt while gulping and a feeling of blisters on the edge of my right side of my tongue .This has been for over a month now.I get a very bad smell from my mouth which irritates me further.I had checked with a dentist to which he said its not a dental problem and also i drink over 3 litres of water a day.I need to know the reason to which such a problem can occur.",
    "doctor_response": "Hello there... There are various reasons for that...Please mention your age? ...Since you have already got yourself examined from a dental surgeon the other reason could be from the upper respiratory tract...Salty discharge could happen if you have upper respiratory tract infections.Post nasal discharge that runs down through your nasopharynx would taste salty...and  you would appreciate it more when you lie in the supine position .. Person with chronic sinusitis would also have bad breadth from their mouth... If the dental examination has ruled out  your problem visit an ENT for further evaluation or visit a Oral and Maxillofacial Surgeon for further management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "White coating on the back of the tongue, painful bumps. Nystatin prescribed for yeast infection. Suggestions?\n\nHi, My query is about an oral yeast infection which is like a white coating on the back of my tongue , also the tip of my tongue is quiet painful with small bumps. My GP has given me Nystatin tablets and Daktarin oral gel which I have been using for 2 weeks with only a slight improvement, but the condition appears to be very stubborn. I also have developed a slimy feeling in my mouth causing me to spit out saliva that is slimy. I would value your opinion. Thank you. Kind Regards Maxine Inglis",
    "doctor_response": "dear friend. thanks for sharing your concern. you have developed oral candidiasis. that is fungal infection of candida albicans. are you on steroids,or taking prolonged antibiotic? xerostomia and poor oral hygiene conditions predispose to oral candidiasis. for this i would recommend, rx tab fluconazole 150 mg once daily. topical application of nystatin is also helpful. take plenty of fluids,keep yourself hydrated. maintain very good oral hygiene. i hope this helps. thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Using cremalax. Have blood sugar, high bp, thyroid preoblems. Any harm on prolonged use?\n\ni am using Cremalax (Sodium picosulphate) 10 mg tablets for the last four months, to relieve the acute difficulty in evacuating morrning stool. Does the prolong use of this medicine have any side effects. I am also suffering from High B.P.' Blood sugar and thyroid problems, but they are under control after medication. Kindly advice.",
    "doctor_response": "it is not advisable to take these medicines long term as they increase your dependance on them and gradually they may stop working all together or you may have to increase the dose of the medicine in order to get the desired result. i suggest it would be better to take natural supplements like isabgol and high fiber flax seeds.take plenty of water and fiber rich foods like salads and raw vegetables.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with loss of corticomedullary differentiation in both kidneys and bilateral renal parenchymal disease. History of high BP and Hellp syndrome. Explain\n\nGoodday, I am a 48 year old black female who has been diagnosed with loss of corticomeullry diferentiation in both kidneys and Bilateral renal parenchymal disease.  I have high blodd pressure for the past 10years and in 2002 i had HELLP sydrome.  Can you explain to me whath this diagnosis mean and if the HELLP sydrome may have a contributed to this present condition?  NB  I had temporary loss of kidney function with the Hellp sydrome.",
    "doctor_response": "Hello!Well, the overall scenario that you have stated, clearly shows that you have a renal failure but i cannot comment upon the stage of it (as no details of urea and creatinin is given). HELLP has contributed to your condition and also your high blood pressure history. i suggest you to get a proper review with a nep0hrologist.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for throbbing pain in the face?\n\ni just had a temporary crown put on a few hours ago. this was done on a molar that had deep decay and now I have a throbbing pain in that area, the pain has moved to the entire left side of face. The pain is fairly intense, and motrin doesn t seem to be helping.",
    "doctor_response": "Hi there.I think you have an abscess or injection of the area of the tooth. This can cause swinging temperature, sweating, chills and rigors. Kindly consult your Dentist to get it ruled out as it is an emergency.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could distortion of kidney shown on CT scan be the cause of diarrhea?\n\nI have had diarrhea for 8 weeks, lost about 30 pounds. Started with prep for colonostomy. Had colonostomy, endoscopy, chest x-ray, CT scan of chest, CT scan of abdomen and pelvis, numerous blood, urine and stool tests, all negative except for a distortion of one kidney. 63 year old female smoker.",
    "doctor_response": "Hi,Thanks for writing to HCM.No, kidney distortion does not causes diarrhea... its due to the bowel infection following your scopies....take a course of antibiotics like metronidazole and preprobiotics... you will be fine...Dr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing allergic rashes on palms, neck and ears?\n\nlooking for information after I visited my doctor today about a (probable) allergic rash, mostly on my torso but some on my neck and ears. She gave me a kenalog shot and a round of prednisone. I have had this before, about 5 years ago, and the same treatment. What is different about this time around is that I also have soar, red blotches on my palms. When I visited the doctor, these were the most painful and after several hours since the injection, they are still painful (like bruises) but less red. It is also the most itchy. What is causing the reactions on my palms? Is it related to the other rash which I had before or something different?",
    "doctor_response": "these are allergies and prednisone decrease it not cureyou can start reacting to any protein at any timemay be soaps oils cooking oils application oils 'hena dyes body application powders creams shampoosometime food and pollenyou can control by application of anti allergic ointments and tabs but get correlation with history or get tests to find the cause for preventing future allergies",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for aphasia along with moderate headache\n\nhave had auras in the past with no real headaches(mild to moderate at best) over the last 25+years. # days ago I had the same type of episode (for three days in a row) and found myself having aphasia during this. My husband confirms the aphasia because he said to me what are you saying when I was speaking. I was aware of the wrong words that were coming out but could not correct them. This lasted about 30 minutes or so. Is there anything more I should be doing, or just watch and wait?",
    "doctor_response": "Hi,We should say that this time is different, there is a.new symptom confirmed from your husband too:  sensorial aphasia.Differential diagnosis iin this cases is wide.You should take in consideration to visit your doctor bcs it is needed clinical examination, laboratory and radiological examination.To have the right treatment and follow up.Feel free for any other information",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for sharp chest pain and breathing difficulty?\n\nI am a 27 year old male and I have been experiencing sharp chest pains and difficulty breathing for about 2 weeks now. I am a smoker, 5'10 and 197lbs. It feels like the pain is in two different spots, between my breasts and in my right armpit. Coughing feels like I'm having a heart attack and most recently, I have seen changes in my stool color to a bright yellow. I have decreased the amount of cigarettes I smoke down to one a day since this started but have seen no improvement in the pain or labored breathing. Please help. Thank you.",
    "doctor_response": "Respected user , hiThanks for using Healthcaremagic.comI have evaluated your query thoroughly .* This is due to underlying bronchitis induced bronchospasm .* Treatment  include  many  parameters -  Clinical  evaluation  with  x-ray chest , laboratory data and certain case     need  pulmonary  function  test  .-  Deep breathing  exercises  , regular walking  in fresh  air , YOGA help -  Molecules as  bronchodilators , decongestants  are  to be decided  by    clinician  after  thorough  check  up -  Till   then  can  take  tab. tylenol ( 500 ) mg morning and evening after     meals .-   Quit smoking totally ( not one per day also )Hope this clears your query .Welcome for any  further   questions .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for pocket of fluid found during MRI after post op laminoplasty?\n\nMy husband is 6 weeks post op laminoplasty and MRI this evening found a pocket of fluid. How is this resolved? We won't hear from neuro surgeon for a couple of days. Waiting time for full report and etc but radiologist said they found a pocket of fluid.",
    "doctor_response": "hihow is your husband health  and the site of operation.If everything like no fever ,not much of pain at operation site then the most likely cause for this pocket is haematoma i.e. is collection of blood,which in most case get resolved of its own.i hope your query is answered.take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vaginal bleeding after urinating?\n\nMy 5 yr old daughter has light vaginal bleeding after urinating. No burning or other discharge or signs of infection. No pain or physical abuse. She had surgery on 01-13-15 for an umbilical hernia. Is this normal and when and should I be most concerned",
    "doctor_response": "Hi...By what you quote as there is painless or effortless bleeding - so I would like to consider the possibilities of - 1. Cystitis  - inflammation of the urinary baldder2. Renal colic - stones in the urinary tract.3. I feel this is unrelated to the surgery she underwent.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does masturbation cause any harmful effects?\n\ni am 16 it means and i love the feeling when sperm comes out of me but i hate to do it but even then i am not able to stop myself.this is my growing age period so i want to know taking sperm out regularly effect our body growth or our height stops increasing?",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, masturbation is physiological and natural instinct and this may not cause any harm if being done in proper way and in limit, hope this information helps, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stopped birth control pill, irregular period. Trying to conceive. Negative ovulation test. What's wrong?\n\nHi. I have been on the pill for many years. Last year August I stopped the pill as my husband and I have decided to have a baby. I have been having irregular short periods after stopping the pill. 2 weeks ago I visited my gynae as i was 1week late for my period. he advised that I was not ovulating. He prescribes Fertomid for me to take on day 5 of my period. I had started my period that night that I had visited the gynae. On Saturday was day 11, I had did a ovulation test and it was negative. Today day 13 I had tested again for ovulation and negative again. Is there something wrong with me?",
    "doctor_response": "Hello Thank you for your query. Sometimes, return to ovulation after stopping birth control pills ( particularly since you have been using it for years ) might take upto a few months. Hormonal tests can confirm if this is so. Also, you might be suffering from PCOS ( polycystic ovarian syndrome ), in which case the hormonal imbalance is caused by multiple small follicles in the ovaries, none of which ovulate, resulting in irregular cycles and anovulation. Thyroid hormone disorder, anxiety, stress, rapid fluctuations in weight etc also might cause such a picture. You need detailed hormonal evaluation, ultrasound, biochemical tests to confirm the diagnosis. Consult an infertility specialist / endocrinologist for the same. Also, since you are having irregular cycles, you might be having delayed ovulation/ no ovulation. It is better to undergo follicular monitoring instead of repeated ovulation tests. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had convulsions, brain infarction, mild paralysis, on antiseizure medications, giving thiosinaminum, had grand mal. Advice?\n\nHi Doctor, my brother had a motor vehicle accident in 2003, he had convulsions on the same day. He had 2 infarcts in his brain . He has mild paralysis on his left side with a drag to his left leg. In 2004, he had convulsions and was put on antiseizure medications Gardenal and Sodium valporate. it was increased in 2005 as he had an other attack. After that he has had no problems. The drag in his left leg has increased lately and he has been undergoing accupuncture and PT. The physiotherapist gave him thiosinaminum 4x last week. Yesterday night he had a grand mal. Please advise",
    "doctor_response": "Hi, You need to take your brother to a neurologist and have a regular follow up. I hope he has not missed any of his medications. He might require another CT of his head. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On chemotherapy for lymphoma. Having clear bowel movements with mucus. Severe stomach cramps. Need to go to emergency?\n\nMy mom is currently undergoing chemotherapy for lymphoma . She just had her last chemo 4 days ago and the next day she started having clear mucusy bowel movements. They are VERY frequent, more than 10 a day and all are clear and mucusy. Today she started complaining about stomach cramps as well as the BM s. Should I take her to the ER to be seen or wait until tommorow so she may be able to see her doctor?",
    "doctor_response": "Hi, certain chemotherapy has Gastrointestinal tract irritant action.Your symptoms suggest this condition, generally subsides on probiotic treatment within few days. But there is a problem. Many a time chemotherapy patients suffer from a disease called neutropenic colitis which needs hospitalisation. So do a complete blood count and stool for routine test and occult blood and consult with your oncologist.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes coughing sputum with blood?\n\nHello, from last 2 days i am caughing (medium), but today i found some blood mix with spit(like air boobles),what could be the reason?. It only happens once, after that i drink lots of water i can feel remaining blood i drunk with water, but i'm feel ok now cough was reduced, almost gone",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Blood in sputum is known as hemoptysis. In your case possibility of friction bleeding due to coughing is more. Other causes for hemoptysis are pneumonia, tuberculosis, bronchiectesis, bronchitis and lung cancer. So better to get done chest x ray to rule out all these lung related causes. If chest x ray is normal than no need to worry much. You are mostly having friction bleeding due to coughing. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat fall mediated injury?\n\nHi. I fell in a hotel bathroom last night (about 2a.m.) I lost my balance and fell against the door frame , then hit the floor. My left arm and leg are badly grazed and bruised. I didn`t think I bumped my head but I vomited about half an hour after the fall. I also started feeling dizzy. It has now been almost 18 hours and I`m falling asleep every few minutes and feeling nauseous from time to time. As I wasn`t knocked out and am back home with my family around me, am I ok to carry on with their support if they call for medical help if I get worse? Many thanks",
    "doctor_response": "hi,thank you for providing the brief history of you.As you had a fall in bathroom post which you had bruises, vomiting, nausea etc you need a thorough clinical Neurological examination.As many a times due to fall there will be a internal bleeding in the brain leading to such symptoms. Getting a Neurological examination will be on a positive side and will be beneficial to avoid any further symptoms.In my clinical practice most cases are Neurologically assessed and MRI of Brain is performed to see the possible soft tissue Injury.Many a times they respond well with simple symptomatic medication.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is premature ejaculation related to small penis size?\n\nHello doctor, I am suffering from premature ejaculation and also my partner complains that I have a small penis. Is this related to premature ejaculation? Also, I have a small pimple on the tip of the penis. Kindly request you to advise me on the same.",
    "doctor_response": "Hello. Small penis is not at all related to PME (premature ejaculation). What is the timing, as you mentioned that you are suffering from PME? Then only, I will be able to suggest a treatment. Small pimples over the tip of penis is normal. Also, send details like color, consistency of these pimples, are they painful or causing itching. Kindly answer all these questions, so I will be able to help you better. Revert with more information to a general practitioner online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is total sperm count of 36 millions/ml normal?\n\nMicroscopic examination:Volume  : 2.5 mlColour    :opaque whiteReaction  : alkalineViscosity  : normalPus cells     :10-12/hpfRed blood cells: 2-3/hpfMotility :Active    : 50%Sluggish :10%Dead       :40%MorphologyNormal forms  :70%Abnormal forms :30%Total count :36 millions/mlisit enough to be father",
    "doctor_response": "HelloThanks for your query,based on the facts and report of your semen examination that you have posted it appears that you have Oligospermia meaning there by that your sperm count is low compared to WHO standards.The presence of 10-12 pus cells suggest infection of either prostate or seminal vesicle ,You need to take broad spectrum antibiotics for 6-8 weeks Repeat semen analysis after 2 months .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for coughing up phlegm & fever\n\nHello! A little over a month ago I got sick and was coughing aching fever got to 103... My cough is continuing but it s not real bad but I m coughing up phelm.. About a week ago I started hurting on my right rib it s very sore and tender I can t hardly turn over in the bed!!!",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. Your symptoms like cough, phlegm, high grade fever and pleuritic chest pain etc are suggesting possibility of lower respiratory tract infection (LRTI - pneumonia) is more. So better to consult pulmonologist and get done clinical examination of respiratory system, chest x ray. Chest x ray is needed for the diagnosis of pneumonia. You may need antibiotics, antihistamines and anti inflammatory drugs. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes disturbed sleep and crying in a child?\n\nHi, my baby is 15 weeks old , weighs 6.4kg and he won t sleep! He has been diagnosed with mild reflux and is on 0.5mg nexiam 2x a day.During the day he will cry and scream when I try put him to sleep and at night he falls asleep for a few minutes and then wakes up! I m at the end of what I can handle! Normal docs say he is a picture of health but his sleep problems aren t making sense then! Should I take him to go and see a neurologost? Help",
    "doctor_response": "Hi,A 15 weeks old baby who is not sleeping well most probably is not getting enough nutrition. The sign of having a sufficient breast fed or bottle is that the child sleeps 2 hours after feeding. There is no need to go to a neurologist. Also the reflux is normal in newborns up till 3 months of age.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Salah Saad Shoman",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cold to touch body, loss of appetiete, crankiness and lethargy in a child with autism indicate?\n\nMy 5 yr old son, with autism, feels cold to the touch, he seems to have a bit of a stomach issue, no vomiting, just loss of appetite and cranky and lethargic , is eating a few things, temp was 97 just concerned - he is non verbal non receptive, so hard to get good answers ;(",
    "doctor_response": "HiWelcome to the HCMI completely understand your concerns but don't worry. The most common reason for such symptoms in this age group is self limiting viral infection. They usually improve over a period of few days with symptomatic management.Also, the temperature of 97 degrees Fahrenheit is perfectly normal. I would suggest you to start him on a probiotic such as enterogermina twice daily along with antacids such as Ranitidine or lansoprazole.Hopefully this will boost up his appetite. Offer him regular feeds and oral fluids to prevent dehydration and lethargy.You may use acetaminophen or ibuprofen in case of fever episodes if they occurs.Hopefully this will help you. I would be happy to help you in any further questions.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat abnormal fetal growth?\n\nHi doctor... I am 28 years old and am 8 months pregnant.. today my doc told me that growth of fetus is not proper . My baby is very small and she also said that she may admit me if the condition doesn t improve... I wanna know about the risks of improper growth of my baby ..And wat treatment my doc will provide I got admitted... Am worried.. pls reply",
    "doctor_response": "As your fetus growth is small your doctor needs to acess your fetal movements,fetal heart monitoring and for biophysical profile .and growhth of fetus through serial ultrasound...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Uneven skin color throughout the body. What to use to get rid of it ?\n\nHello doctor i am AAAA, suffering from skin disease,i do not have any even complextion through out my body,some part is black and some part is fair,even the same with my face and my forehead is too black compared to my face,could u please suggest me what to use to get rid of this, because am loosing my confidence to do anything with this kind of skin problem.",
    "doctor_response": "Dear Concerned., Thanks for writing to us. As I have not personally examined you ,I can only presume probabilities or Differential Diagnosis. 1) Hypermelanosis due to UV rays/Sun tan. As the name suggests that you are an Indian, are brown skinned. brown skin tans on exposed parts  of the body to sun and therefore on covering the exposed parts to sun screening creams which protect the skin from UV rays, the original complexion returns. 2) Hypermelanosis also responds to Vitamin C 500 to 1000 mg per day 3) Very high Insulin levels as in Insulin resistance /obesity /occult malignancy leads to a condition called Acanthsis Nigricans which leads to thick hyper pigmented velvetty skin. On removal of the causative factor , the skin returns to normal . Kindly consult a dermatologist for a prescription medicine. A Skin biopsy establishes definitive diagnosis. Wishing you a quick recovery, Regards, Dr Lt Cdr ASN Bhushan.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can swelling in the temple and locked jaw be treated?\n\nI was in a fight n I was hit n my temple with a lock my jaw was swollen n hard to open after n my temple was swollen I took a cat scan xray n I dnt have no fractures it dne been 3months later n I still have a lump on my temple but I dnt have any pain n my jaw doesn't hurt no mo either whn I open my mouth wht can I do to get the lump gone from my temple is the lump gone evenually go away its a lump like its still swoll",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.A lump on the temple can be due to hematoma formation. Hematoma is a harmless tumor like mass formed due to spillage of blood from ruptured blood vessels leading to accumulation of blood into the soft tissues forming a lump.At times, the hematoma gets localized and encapsulated and forms a firm hard lump that can take a long time, say a few months to resolve, but it generally tends to resolve itself.In your's case also, the lump seems to be due to a firm hematoma and you need not to worry as it will resolve gradually.You should do alternate warm and cool compresses over the lump. Apply Heparin gel as it helps in faster disintegration of the hematoma.In case if it worsens, consult a General Surgeon and get evaluated.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be  worried about enlarged heart?\n\nhi i recently had to have a echo done on my heart because it was enlarged should i be worried? i stay tired all of the time also but they put me on vitiam d to take because it was low. also suppose to be getting a surgery done soon for a colonocoptcy and the part where they go down your throat also in same day is that a bad procedure and are you out im kinsda scared",
    "doctor_response": "Hello!Thank you for contacting on HCM!Regarding your concern, I would explain that an enlarged heart (ventricle(s)); that is a dilated cardiomyopathy, may be a final natural conclusion of several pathological processes involving the heart (valvular, ischemic, myocardial, infectious, etc. disorders).When dealing with the evaluation of a dilated cardiomyopathy, the two main issues to consider are: (1) severity of cardiac function impairment in terms of abnormal LV ejection fraction lowering, and adverse ventricular myocardial remodelling, and (2) persistence of etiological  factort and its triggered pathological processes.The main goasl to achieve in a dilated cardiomyopathy are:(a) To completely relieve (if possible) the etiological triggering factor, (b) Impede as much as possible pathological myocardial remodeling, thus stopping further dilation,(c) Preventing potential cardiac and systemic complications derived by dilated cardiomyopathy (clinical signs and symptoms of heart failure, like congestion, excess fatigue, several arrhythmias, etc).Facing your actual condition, you need to discuss with your cardiologist about possible triggering factors of actual cardiopathy (in order to avoid them)., and to implement an ongoing therapy as you demonstrate heart failure symptomatology (fatigue, etc).Regarding the interventional digestive procedure, I would explain that though you have a dilated cardiomyopathy, there are no contraindications for colonoscopy, as far as you have implemented an appropriate management strategy for heart failure.These diagnostic procedures ar performed through a light sedation, which is not harmful for the heart.So I recommend to discuss with your cardiologist about the above mentioned issues. Hope to have been helpful! Greetings! Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for the painful lump on the injection area\n\nI injected 3 ml. Of testosterone enanthate and 1.5 mil. Of deca un my right butt cheek. A day later it is hard and painful to walk or sit on. Not red or hot, but very painful. A large hard lump has developed. Will it absorb into my body ? How long might it hurt. Do I ice it or apply heat?",
    "doctor_response": "Hi..Can understand your concern..As per your complain a painful lump at the site of injection can occur due to inflammatory reaction due to irritation caused by the injection medicine leading to formation of a hard lump as a result of inflammatory process..It can also be due to infection caused at the site of injection and the body's defence mechanism tries to wall off or confine the infection and there is formation of a small abscess which can appear as a hard painful lump..In case if it has occurred due to inflammation it will gradually resolve itself.You can apply a steroid based ointment over it for reducing inflammation and pain..You can take over the counter painkiller like advil or motrin which will reduce inflammation and provide pain relief..Cold compresses can also be helpful..In case of abscess formation antibiotic therapy and painkillers can provide relief..I would suggest you to consult a physician and get evaluated  to rule out the exact cause of the lump formation and get treated accordingly..Hope your query is solved..If you find the answer helpful please write a positive review and click on find this answer helpful as a token of appreciation..Thanks and regards..Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the lump below my breast?\n\nI sometimes when I am exercising, especially touching toes or sit-ups, I feel something pull and it feels like a lump that pops out just below my breast but it's in my very upper chest area. I can feel it and I can put it  back in but it's still sore for a bit afterwards. I can't feel anythng normally but only if I stretch funny or am doing exercises. Any ideas?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have small breast lump.  It can be due to some benign cyst, proliferative breast lesion like fibroadenoma or fibroadenosis, breast cancer or other lump.  You should go for mammography and biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in testicle?\n\nyesterday afternoon I noticed that my left testicle was tender to the touch, like I sat wrong or something.  Slowly it swelled up a little bit and the whole left side of became tender.  I could still walk okay.  Later during the night, the tenderness subsided a bit....but my scrotum area became very itchy...I itched it on and off for awhile and then noticed that the swelling of the testicle subsided but now my penis shaft had swelled up under the head like it filled up with something.  Now I am sore around the scrotum area and the underside of the shaft is still swollen but seems to be shrinking.  I have had epidymitis about a year in a half ago and a a vasectomy about 12 years ago.  Your thoughts?",
    "doctor_response": "Hello, It is likely some infection that is causing soreness and itching.  Maintain hygiene. Use emolient cream. Do not use excessive soaps. penis swelling needs to be taken seriously. It may be infection or rarely serious diseases like paraphimosis or fracture. They need urgent medical intervention. please see doctor urgently. For swelling in the scrotum, it may be result of previous epididymitis or result of vasectomy. i will advise do Ultrasound of scrotum. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Sujoy Dasgupta",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough and throat irritation in a child\n\nHello My daughter has had a cough for 3 weeks now. It started with a sinus infection. That seems to have gone away. The cough caused by tickle in the throat keeps her coughing all day and sometimes in the middle of the night. She had a prescription of antibiotics, and flonase. The antibiotics have been done for a week now. She uses and albuterol inhaler as needed and takes a claritin 24 hr allergy daily. She takes a benadryl at night. SHe won t stop coughing, 3 in a row, every other minute\u2026all day. Sometimes worse. She says tickle in her base of throat. She takes Delsum, but it doesn t seem to affect her. This happened 2 years ago, and they were looking into allergies, then antibiotics, then back to allergies before it kind of just went away. Well, here we go again, how do we stop this dry raspy constant cough. She is 11 and 100 lbs. She takes focalin xr 20 mg for adhd during the school week. Thanks!",
    "doctor_response": "Hi thank you for choosing healthcare magic.For some it takes some time for the postviral inflammation to come down during which period they have continous dry irritating cough which don't respond much to medications. And you are using all the medications for cough already, but remember that there is no effective cough medicine and cough supressants are not recommended usually. Apart from her regular medications try to make her take plently of warm fluids which tend to reduce her throat irritation. Hope this has helped you and wish a speedy recovery for your child.Feel free to contact if you have any further queries.Kindly vote as it does make a difference,Good luck,   Dr J Sravanthi, Peadiatrician and Neonatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Skin allergy,don't want medicines.\n\nI have skin allergy since I was a kid. This is caused by food and other allergens....I also consulted dermatologists but after sometime, they prescribed ointments and also anti-allergy tablets . . However, I don t want to be dependent on those meds. Because when I stop taking them, they recur after a week...What should I do?",
    "doctor_response": "welcome to hcm- if u have allergy to some antigen 2 way otf treatment either u avoid allergen to contact with u otherwise u hav to take antiallergic that is safe.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to differentiate between symptoms for heart disease and gastritis?\n\nhi dr. i would like to know why with heart diseases  shows the same symptoms as gastric problems like heart burn , vomiting , gas and so os . how we can differentiate between these?this is for my father who had undergone angioplasty . he turned 66 , 157cm , 63kg weight",
    "doctor_response": "Hi ! I had gone through your question and I understand your concern .Yes sometimes heart dissease it can be exsperienced like gastritis symptoms , nause , vomiting heartburn we call them atipical presentation of heart dissease ( in the rather case we will think angina pectoris)Sometimes there are not to may specific think to distinguish but when the hurtburn is from the stomach ( reflux) it dissapear when we give antacid to the patient ( ranitidine ), the patient have regurgitansion also .Pain from peptic ulcer worse 3 hour after eating . In  Heart problem the pain is most of the case tightness \", \"heaviness \" or pressure   \"sharp\" chest pain that can spread to the neck and the left arm .last 20-30 minWhen the pain start after physical  exscercise  it is from the heart. If your father have episodes with hypertension and the pain come should consider from heart. .Other cardiovascular  symptoms : hypotension, bradicardia) slow heart rate ), sometimes hypertension, tachycardia  ( fast heart rate ).When you suspect call the hospital that will do an ECG to confirm the diagnosis.Hope these help you !Thank you for using HCM",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the greenish yellow pus formation at the head of the penis be Herpes?\n\nWell on my penile head, the rim around the head just before my shaft has what looks like a pimple forming it has greenish yellow pus with a black dot in the middle of it. It dosent hurt or itch and its fairly tiny about .5 cm around im wondering if its a herpes breakout?",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.You can differentiates the herpes from the others by the presence of the pain.If you are having burning pain at the tip than it is herpes. If its not burning pain or pain is absent you can count it as a non herpes or other infection.I advice you should do Grams staining from the discharge. It gives us idea of what it is. If it's bacterial infection Grams staining will say about the infection. If it's viral than nothing will be seen on the Grams staining.Treatment taken as per the report will be great in curing the infections.But as per your description it won't look like the viral infections like herpes but it looks like some bacterial infection.Please avoid intercourse during the period. If sexually active both the partner should take the treatment.Please maintian good local hygiene. You can do that by frequent cleaning.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy of high blood pressure ?\n\nhi ,I am 59 yrs old and I have high blood pressure. I am currently taking Metoprolol , losartan and atorvastatin. My pressure continues to be elevated and I don t know why. I take my meds everyday and I am happy most of the time. I don t know what else to do.",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You are taking metoprolol and losarton for your hypertension.  You should consult your physician and check the blood pressure.  If it is still high with these drug then you need to adjust the dosage of your drug. Take it according to your doctor's advice. And continue with your atorvastatin for cholesterol. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat calcified granuloma in right lobe of liver?\n\nI got a sonography done on 2nd june, 2014 which showed calcified granuloma in right lobe of liver, but rest everything showed normal. Do I have to worry as my urologist stated that I am absolutely fine and normal. Just wanted to ask whether I have to worry because of calcified granuloma in right lobe of liver. Thanks in advance.",
    "doctor_response": "Hello You are rightly advised by your doctor.You are perfectly fine.Calcified granuloma in liver are healed stage of infection and calcification indicate that there is no activity in the lesion.Calcified granuloma in liver may be due to healed abscess etc.Infection naturally heals by calcification and fibrosis.Mostly it doesn't require any treatment.Get well soon.Take careDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I conceive as I am having PCOD, irregular periods and taking duphaston and standox ?\n\npcod, overweight ,irregular periods marriged for 8 months. previous month i have 9mm follicle on 12 thday duphaston and ebexid for 15 days. preg test were neg. after16 days .periods come i.e on11th july 2011.` doctor tested tvs+hpe, pcr . UT _ A/v 64x32. et -6mm.lt overy cyst 37x31.she gave standox for 5 days and ornida for one d . is this med helpful for my pcod +in ovulation+preg? any other med you recommed which help in ovulation and regulate my periods? is 16 days delay of period effect on my ovulation. she didnot give any med for pcod or periods",
    "doctor_response": "Hi, PCOD is problem with ovulation.The ovulation can be induced by clomiphine &certain injections if needed.your doctor will prescribe at proper time. Please get your thyroid testing done./also try to reduce weight. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for tingling in foot and leg with pressure in head\n\nI have been experiencing a feeling of pressure in my sinus and/or head but no drainage or blowing out any gunk. Things smell and taste really odd and I also get constant tingling in my left leg and foot like my pants are cutting off circulation, but they are not.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have tingling in foot and leg with pressure in head. Well the symptoms you mention in query can occur due to may reasons like disc problem , deficiency of vitamin B 12 , compressed fracture in spine and sciatica , diabetic neuropathy , gout . I would suggest you to consult orthopedic surgeon  who may recommend supportive footwear such as sneakers , arch supports  , prescribe nerve supplement and recommend physical therapy . For now give proper rest to your feet and put your feet in hot water tub with one spoon of salt daily at least for 15 minutes . You can also take ibuprofen or acetaminophen for pain . Doctor may also recommend surgery in case of disc problem . For head pressure consult neurologist to rule out acoustic neuroma , tumor , sinusitis or tumor . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this scan report of spine indicate?\n\nI have denenerative disc disease ot lower two levels particularly at L4-5 where there is a grade 1 spondylolisthesis. Advanced osteoarthritis is evident on the apophyseal joints at this level with a left sided pars defect. What does this mean and how do you treat this I am in a lot of pain",
    "doctor_response": "I read your question carefully and I understand your concern.That reports means that there is chronic damage to the joints and the cushioning discs which are found between your vertebrae. Some changes of this kind happen to all of us over the years, the older you are the most likely to be found. In some people these changes can be more pronounced due to genetic factors, trauma, heavy physical work etc.As for what needs to be done, for the moment only physical therapy and over the counter antiinflammatory painkillers like Ibuprofen are recommended. Physical therapy with time will reinforce your spinal muscles, strengthening your core and better supporting the spine giving its inflammation a chance to gradually subside. If such measures are not enough at times local injections of steroids and anesthetics may also be tried as a next step.I hope to have been of help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for trouble with speech and coordination\n\nI was run over by a golf cart in August, had a slight concussion, whiplash, and my left leg was run over by two wheels and was hyperextended and had deep tissue damage. Now I am worried because I have had muscle spasms in my arms, mostly my right, and now am losing strength and coordination with that hand. Also am having trouble with speech, seems an effort to get the words out and they slur sometime. I am trying to get into see a neurologist, should I be scared?",
    "doctor_response": "Hi welcome to HCM  I have gone thru your query  regarding trouble with speech and coordination .Dear ,All your symptoms  of suffering are outcome of your accident .The brain is a soft organ that is surrounded by spinal fluid and protected by a hard skull. Normally, the fluid around the brain acts like a cushion that keeps the brain from banging into the skull. But if the head or body is hit hard, the brain can crash into the skull and be injured. A concussion occurs when the brain is shaken inside the skull, causing changes to the brain's chemistry and energy supply. Whiplash injury\" describes damage to both the bone structures and soft tissuesand is typically not a life threatening injury, but it can lead to a prolonged period of partial disability .You should not worry about it . I would like to suggest you to see a neurologist for proper advice  .And for your info , you will have to work for speech and coordination of muscles Little exercise from head to toe  by rotating  neck , fingers , fist , arms  legs and feet ,thumbs etc . Yoga , Pranayam - Deep Breathing  , Anulom Vilom  , Bhraamari , Clapping and laughing aloud &  Meditation will certainly help you unwind your innerself and strengthen your  psyque and will help accelerate your recovery  to become normal . keep on doing effort to get the words out , pracice wiil make you perfect. Massage  with olive oil ,of your legs ,arms  ,whole body as a matter of fact will give your strength to your body sooth your mind & soul and detoxifying and strengthening the immune system to enhance resistance from diseases and pave way for healthy diseaseTake a spoon of Turmeric powder + a spoon of Almond oil  in a cup of hot milk at bed time ,Shila jit ,a herb  with warm   water or hot  milk .Aloe vera juice 30 ml + amla juice 2 spoons .All help in recovering .,Balanced  Deit containing all essential nutrients - Fiber , protiens , Vitamin D,C, minerals , fish & fish oil ,Nuts ,  lot of water all will help strengthen your immunity and help fast recovery and to achieve  over all  sound health ,Make sure to get sound sleep and keep at bay constipation , worry , mental stress , anger . Hope this helps solves your query .Take care .All the best Don't hesitate to come with further query if you have any .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hearing soft fizzing/popping after cough & difficulty in swallowing\n\nI'm hearing a soft fizzing/popping after I cough. Other symptoms: frequent violent coughing- each fit clears everything out but next fit follows soon after. Throat very raw- makes swallowing difficult- some streaks of blood occasionally in mucus- believe this is from minor injury to throat from violent coughing",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. You are having difficulty in swallowing and fits of violent coughing. These are seen commonly with obstructive esophageal pathology. So first consult gastroenterologist and get done upper GI scopy to rule out obstructive lesion. If this is normal then consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test) to rule out bronchitis. You may need inhaled bronchodilators and inhaled corticosteroid (ICS). Don't worry, you will be alright. But 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe depression and anxiety be treated?\n\nI am 80 yrs. old and have severe depression for 5 months. I have tremors (anxiety,panic attacks) for hours on end during the day. This has been going on for weeks. Med. 20mg Prozac since Dec 17, 2017 Bed time 150 mg Seroquel, 15 mg. Remeron and Xanax .05. Xanax prn during the day but nothing has helped Sleep is fair. Losartan 100 mg, and Hydyrochlorothiazide 25 mg for blood pressure. Synthroid 150mcg. Thyroid test is normal. My psyschiatrist has not been able to come up with any other answers",
    "doctor_response": "hii suggest you try non pharmacological treatments for depression in conjunction.CBT(cognitive behavior therapy) and yoga would bring in additional relief.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat male/female hormonal imbalance with agitation and tremor in a 59 years old male while on onezol, fluox, simvastatin, clonazepan, propranolol, bendrofluazide, aripiprazole and seroque?\n\nHello, My family is becoming more concerned with my brother who is having a number of drugs to treat his present problem. He lives alone, has always been a bachelor and is now 59. Earlier 2013 he became increasingly upset about his neighbours who he overheard, were plotting to get him. He has had periods like this and given the vicinity where he lives, some goings-on are very plausible. However, this time was more extreme and he became very perturbed and called the police (not the first time). He has been on hormonal drugs for a long time to balance his male/female imbalance and the doctors usually monitor this if my brother has concerns. He was admitted to a psychiatric ward for tests then put on this concoction of drugs to help him - please forgive my spelling: onezol, fluox, simvastatin, clonazepan, propranolol, bendrofluazide, aripiprazole and seroquel. He has always had a tremor but now can barely carry things, has extreme difficulty using his eftpos card, cannot lift a cup to his lips etc.... He is suffering from night sweats, waking in a pool of wetness, he is unable to remember what day or time it is and this in itself is leading to confusion, missing appointments and the inability to take his medication at the appropriate times. What would you recommend?",
    "doctor_response": "HiThanks for using healthcare magicI think, he has on overdose of antipsychotic that why he has excessive tremor and sedation.Due to sedation, he has drooling of saliva at night. Seroquel leads to excessive sedation, either dose of seroquel  should be less or clonazepam can be stopped. For tremor, dose of propranolol should be increased or get him investigated for drug induced parkinson.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are steroids sufficient to treat chest infection, pneumonia and asthma with disorientation?\n\nHi. I ve come to a dead end with my doctor and would really appreciate some help. Let me give you some background: I am asthmatic, but please don t let that occupy your thoughts too much. In 2006 I had Pneumonia and was admitted to Leeds GI for a week. In 2008 I seperated from my wife and moved into a small flat. I wasn t aware for 12 months that there was a wall of mould behind the chest of draws! I had and continue to have a Chest Infection every 2 months since! My main symptoms are the obvious taste and colour of the infection when it comes up. Also a tightness of my chest, making breathing hard, and leading to coughing and choking, now until dizzy, getting a buzzing sentation and disorientation. My doctor goes in circles unsure what the problem is and why the reoccurance of the chest infections. I have had chest xrays (usually by the time they are booked, the infection is gone and xray clear), and have seen a specialist who jumped to the same conclusion of mismanaging my inhalers. This is not the case. The nurse is happy with my meds and how I use them, and how I up the dosage when I have a chest infection. But because the doctor is at a loss, I only get amoxicillen and steroids (the latter are bad for me long term). All I do is go in circles, The chest infections take two courses of antibiotics, and still they do not make me completely better. The infections remain underlying, and the next cold I catch ultimately turns into the next chest infection. This has been my life for over 6 years now, and only since the initial Phenmonia. As a child I had a very weak chest. My mother would walk me to nursery only for me to get there and need to go home as my chest was so tight. I grew out of this with the help of inhalers, and my asthma wasn t much of a problem growing up. These chest infections have only become so frequent since the Phemonia in 2006. I am now at a stage where I feel desperate for someone with fresh eyes and an open mind to look into this, and not just make the wrong assumptions that I don t eat well enough, or know how to take my inhalers... I am 33 (DOB 25/07/80) and know in my heart that if this is allowed to continue without adequate treatment, I face an early death when my chest is older and even weaker. I don t think I can add much more; only that I do take my inhalers correctly, and to make you aware that ALWAYS when I have a chest infection and",
    "doctor_response": "It looks like you have pulmonary aspergillosis.you need to get following tests done:Bronchoscopy and transbronchial biopsyCBC with peripheral eosinophil countChest x-rayCT scan - chestSerum aspergillus antibodiesSerum IgG and IgE antibodiesSputum stain and culture for fungusBack to TopTreatmentAllergic aspergillosis is treated with steroids such as prednisone. The antifungal antibiotic itraconazole can also be helpful. Continue with ur usual treatment for asthma.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get palpitations often. Should I take Disprin for prophylaxis?\n\nHello doctor,I am a 62 year old female. I get palpitations quite often. My blood pressure remains 130/90 with Telma 20 mg and Nebicard 2.5 mg. Also, some friends told me to take Disprin 2.8 mg for prophylaxis. Please advise if I need to take Dispirin or anything else.",
    "doctor_response": "Hello. Your blood pressure is fairly controlled. Continue both the medicines. Please do an ECG when you are getting palpitations. Take Calcium and Vitamin D3 tablets and Meconeuron OD (Methylcobalamin) once a day for three months. Get serum vitamin D3 and serum vitamin B12 tests if it is not done. For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do red and white rashes on under arm bicep indicate?\n\nHello, my daughter is 6 yrs old I have noticed spots on the underside of her arm under bicep, some are white there are some spots also on the side of her body. there is a rash surrounding a small group of them, the rash is red and slightly bumpy do you know what it could be?",
    "doctor_response": "HiThanks for writing to us. Kindly send some pictures if possible. Based on the history you have given us it looks more like a fungal infection. Antifungal ointments like clotrimazole is what I usually give to such patients. Wishing your child speedy recovery. Regards Dr Arun",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i use candid V3 when i have an infection after intercourse?\n\nHi, I am vaishali Acharya age 38 got married in May 2013. have infection problem after intercourse alternate week. and one of my fly doc suggested me to take candid V3 tablet for 3 days and intewash cream. Could you guide me is it useful for me to use whenever i get this injection.",
    "doctor_response": "Hello,Welcome to HCM,There are so many infections which is related to genitals in a sexually active females.If you are getting these infections you need to have physical examination and laboratory investigations to find out the pathogens causing these symptoms.Candid V3 vaginal tablets can be used to treat candida vaginal infection, if you are having candid infections it will helps to control the infection but other conditions like chlymadia, trichomonas, herpes genitals and bacterial vaginosis can also present with these symptoms, which can not be cured by Candid V3.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of adult bed wetting?\n\ni am 22 years female.I wet the bed very often.i have tried out everything like avoiding fluid intake at night,holding urine for longer time , waking up periodically at night but nothing worked.It is very embarrasing.Please help me out in this n tell me a permanent cure for this.",
    "doctor_response": "Hi,I can completely understand your concern with your symptoms. Wetting the bed can be due to psychological as well as organic causes. I am not sure if you have undergone any investigations for the same. If not, you should consults an urologist and investigations like ultrasonogram KUB (Kidney, ureter, bladder), urine culture, uroflowmetry, etc can be carried out to rule out any structural defect in the urinary tract.If you have undergone all these tests and no structural effect has been found, treatment wit medications like Imipramine taken at the night time will help. The dose ranges from 25 mg to 250 mg/day. You should consult a psychiatrist for the same. In addition, it will be useful to continue with the behavioral measures that you've  tried earlier like avoiding fluids in evening, waking up periodically, etc.Hope that the information was helpful. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for lipoma in the corpus callosum?\n\nMy son was diagnosed with a lipoma in the corpus callosum five years ago.  He's almost twenty now.  I think in the back of his mind he worries about it.  Would it be wise to have this rechecked or is there anything I can do or say to relieve his anxiety?",
    "doctor_response": "Hello and welcome to HCM,Lipoma is a benign lesion, grows very slowly and does not metastasis to distant site.The lesion is not dangerous but its site is very sensitive.Compression of adjoining brain tissue can lead to neurological disturbance.However, development of any complication or not depends on the location of the lesion.A contrast CT of the brain will be re-assuring for your son and you so it is advisable to consult a neurologist for clinical assessment and contrast CT of the brain to determine the site of lesion and its relation with adjoining structures.Thanks and take careDr Shailja Puri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can speed and type of sperm cause ectopic and toxemia pregnancy?\n\nMy wife suffered first from an ectopic pregnancy, and carried naturally in pregnancy the third suffered from toxemic pregnancy causing bleeding lungs of the fetus as Ayesh seven days after birth and died after this incident took twice and aborted the third month is there a reason for the display of the problems women and whether the type of and speed of sperm a man in connection with this topic Sincerely",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Well in my opinion type and speed of sperms as nothing to do with all the aforementioned conditions in fact sperms has nothing to do with any such situation. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning sensation between chin and lower lip?\n\nHi, i am 22 years old. In the middle of the day i found burning sensation in the area between my chin and lower lip.next day i found red rash over there.when ever i touch over there i feel like my skin is burning. can i use dermovate for that. please suggest me..",
    "doctor_response": "Hi. What u r trying to say is termed as a paresthesia in medical field.if u are having skin rash too then u need to see dermatologist urgently.See common causes are sun burn,heat burn,neuropathy,diabetes etc..If problem persists then first contact your dermatologist and then physician if required",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful and swollen labia minora?\n\nHi I am a 29yrs old female, I have a 4 months old baby. No relavant medical history. Present complain: I have noticed yesterday a marble sized swallow on my right labia minor ( on the inside) red, quite painfull and seems to increase in size. What to you advise me to do about it! Thank you",
    "doctor_response": "Hello,I read carefully your query and understand your concern. Your symptoms seem to be related to Bartholini cyst.I suggest soaking in a few inches of warm water either in a tub or sitz bath, four times a day for a few days may resolve even an infected Bartholin cyst.Taking over-the-counter painkillers such as Tylenol may help with discomfort.If the symptoms continue, I suggest to take a cycle of antibiotics. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore throat followed by swollen gums and red tongue?\n\nPlease help me. 5 days ago.the inside.of my mouth got a sore spot. The next day it got bigger and the left side of my throat started hurting. Then the next day my gums got really swollen and my whole throat started hurting. So I went to the doc. And I was tested for strptheoat. It was positive. I got 875 mil of amoxcillin 2 times a day .The doc. Told me he didn t know why my gums and tongue.were swollen and red. So he said to call my dentist. I did that and the dentist just ordered me an oral rinse. I ve been taking my med and doing what my dentist said but.my gums aren t any better and now my tongue has a sore.on it. I had dental ex rays and dental work done on my teeth the last few months so my dentist knows all about my teeth. What could be wrong. It hurts so bad to brush.my teeth and to floss..help!!",
    "doctor_response": "Hello,  Read your query,  as you have swollen gums and red tongue this can be due to some reasons like oral hygiene is not so good , Nutritional deficiency, Vitamin B , C deficiency,  deposition of food debris at subgingival areas of gums , Viral infection , Hormonal influences,intake of Gum irritant (tobacco containing products) . For this you should consult dentist and go for oral examination and go for Oral prophylaxis , You can apply ointment Gum paint on sore and swollen gums , and take Vitamin B , C supplements by consulting with your doctor , take green leafy vegetables in diet , avoid taking hot and spicy food . Hope this will help you. Regards,  Dr. Priyanka tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taken Plan B after unprotected sex. Abdominal cramps, nausea, itching, continuous bleeding. What do I do?\n\nhello, i had unprotected sex and i took plan B the next morning. then i had really bad abdominal cramps and nausea etc which i read was normal\u2026.but now i have severeee itching and its creating a lot of discomfort and i started bleeding the same day i took the pill and its been more then 7 days even tho the bleeding is light now\u2026its not going away\u2026i thought it was my period\u2026but i dont know...what do i do?",
    "doctor_response": "Hello,It is true that withdrawal bleeding is often seen after taking the emergency pill, but, itching is not a side effect. You are perhaps having some vaginitis which needs to be treated, your partner also may need treatment. Since the bleeding is decreasing in intensity, you may wait for it to subside on its own. If it does not do so in a couple of days, you need to get expert help in person. If you are due for your period, it is possible that you have had a menstrual period also set in. Please see a specialist for further help. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there an alternative procedure for dialysis?\n\nhallo, my mother has kedney failureas well diabeties and recentle she got sick and the docter advised to under go dialysis,this is her first time. would you please advise me if there is any other treatment rather than dialysis? is it complasory?if dialysis done when it shold be repeted? 1 dialysis tratment works for minimum 6months?",
    "doctor_response": "HelloThanks for query .Based on the facts that you have posted It seems that your mother has landed in Chronic Renal Failure (CRF) and your Dr has advised her to undergo Dialysis .Kidneys are the organs that are involved in maintaining fluid and electrolyte balance and throw away end products of protein metabolism (Urea and Creatinine )through urine .Kidney failure results in accumulating these end products which are poisons to our body These products have to be expelled out by means of using artificial kidney which is achieved by Dialysis .Dialysis expels these products in urine and  lowers levels these products in blood and help to carry on normal bod functions .Since production of these products is a continuous process it is mandatory to undergo Dialysis fat frequent intervals Generally it has to be done every week or two (Not every six months)which depends upon the level of Urea and Creatinine in blood .There is no alternative to Dialysis Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for macrocephaly\n\nmy grandson 9 mnths has macrocephaly but also cp signs. can that be so? most cps have regular head size. nobody seems to be able to give dx. he has high pocketed pallet left side weakness , and shorter than right side. difficulty eating and low weight.",
    "doctor_response": "Hi, I am Dr.Bruno.  I have read your question and understand your concerns. Let me try to help you Question : Suggest treatment for macrocephalyAnswer : If the macrocephaly is associated with a Hydrocephalous, then CSF Diversion Procedures are needed Have you done a CT Brain. Can you share that Image to Us Hope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for PTSD\n\nhi,my nameis nansy,I had PTSD from 1992 from war in Croatia...I came in Canada because I am born here and I am going see my doctor for this problem 10 years now. My doctor give to me valium 5mg five times on day and Zoloft 2 times on day 50mg,but don't helping me.I  need take shawer  5-6 times on day because I have problem with sweat and problem with sleeping.Can you give me advise.",
    "doctor_response": "HiFor PTSD, there are two treatment protocol. One is psychological treatment, which include talking therapy , hypnotherapy, and other non medicine treatment.Second is pharmacological treatment, which include medicinesI think you need both, see a psychologist to guide youHope this will help",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain and stiffness in knees\n\nHi I am a male 57 years old, had severe knee pain and swelling in knees, lost 14 lbs in two weeks, after 6 vials of blood the only thing my family physician sould find was an elevated sed level, he made an appointment with a Rheumetologist for me in September, I was taking Simvastatin for 3 years and he had started me on Azor which I took in combination for about 2 weeks and that is when all the knee issues started, he then changed my high blood pressure medication to one that has a diuretic in it and that took the knee swelling down considerably however i now have stiffness in both knees and find it very difficult to get through the day , i have not taken any more simvastatin and am taking 1800 mg motrin a day to try to relieve it.",
    "doctor_response": "Hi, It can be an early sign of arthritis. As a first line management you can take analgesics like Paracetamol or Aceclofenac for pain relief. If symptoms persists better to consult an orthopedics and plan for an MRI scan. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe pain in the ribcage after a back injury be treated?\n\nI have a fracture in my back that has not bothered me for a couple years and this morning when I got up it hurt all the way around to my ribs. I can t lean to the left at all. The pain has gotten worse. My rib is hurting on the side and the front. It is very painful.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The pain in the rib cage is a muscular pain and oral muscle relaxants and rest can help. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes brown discharge during periods?\n\nHi I am on boirth control but have missed a few pills and have had unprotected sex, he did ejaculate in me. I have had brown spotting for about three weeks now, this has never happened to me and ive been on the pill for about 6 years now. I was supposed to start my period yesterday and it never came and took a preg test about ten days before my missed period, reading negative of course. What could this mean?",
    "doctor_response": "Hello and I hope I can help you today. It is not unusual for you to start to bleed if you miss more than two pills in a month. This bleeding generally will stop when your actual period is due. As long as you are not pregnant you can start a new pack when this one finishes. Breakthrough bleeding can become a problem if you take your pill at irregular times. Try to set an alarm or email reminder every day for yourself to take your pill. I hope I was adequately able to answer your question today and that my advice was helpful. Best wishes, Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be concerned for the fluid under the skin caused due to a head injury?\n\nHi my 5 year old daughter fell from approx 4/5 feet straight onto her head today, she instantly screamed had large graze on her cheek and within seconds a lump approx the size of tennis ball appeared! Luckily a doctor lives next door and he checked her over, her eyes and ears, and told us to ice the swell for approx 15mins then leave and swelling will go down just to be wiery of sickness but she seems ok The swelling has gone down some what but there seems to be fluid under the skin where she bumped. Is this anything to worry about? Thanks.",
    "doctor_response": "Hi, your daughter fell down  from height and had head injury in the form of soft tissue hematoma.Mostly these hematomas subside with ice application and conservative treatment.After ice application hematoma dissolve and some fluid remains there  as dissolved blood.It is matter of no concern.But skull xray should be done to r/o skull fracture.If there is skull fracure then neurosurgeon should be consulted .Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest side effects of ingested salve by 14 months\n\nMy 14 month old just ingested a pencil eraser size amount of draw out salve--main ingredients are green soap, ichthsmmol, sulfated tallow sodium salt, white petrolatum--he did gag slightly, I immediately rinsed his mouth with water and saw no coloring in the water he spit out. He is acting normal. Should I look for any symptoms and what would those be?",
    "doctor_response": "Hello. I just read through your question. This is a very common occurrence in this age group. Fortunately, there is nothing toxic contained in the eraser. As long as he is breathing comfortably, we are reassured that the eraser is not in his lungs. It will most likely pass through him and come out in a bowel movement. I don't expect any symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does masturbation affect fertility?\n\nhi ,i m doing masturbation since 15 year old age ......in middle i suffer from nightfall and weakness but i consults the doctor now i m normal but my present age is 24 year and i have less beard like a girls.or infirtility......i worried plz give guidence.... thanks",
    "doctor_response": "HelloMasturbation is not related to fertility.It is also not related to weakness.Night fall is a common phenomenon and it is not concerning.You should try to get rid of masturbation because its obsession is bad.You should avoid provocative literature and videos.Try to concentrate in your job.If you find any problem in coping the situation then you may consult psychologist also.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Under stress. Numbness in body. What is the meaning of this?\n\nHi,I have been going throw very bad situation and stress prusser of lots of issues in my life at the last few months and all of that happened while I was just starting my life with my husband I mean I married 3months ago Two days ago I had a fight with my husband and I was very angry I was crying badly then I was breathing very hardly and then suddenly I started feel numb all over my body especially my hands my fingers were sticking strongly and I couldn t releas them Today I cried because I was feeling stress then I felt suddenly numb in my face the part from my chin my cheeks and bellow my eyes I feel now so worried of what is happening with me Pls doctors tell me what is happening to me and what I should do to avoid the Worst",
    "doctor_response": "Hello........ Thanks for query. Relax. What you are reporting is a normal phenomenon. Hyperventilation is related to transient imbalance in the body's acid-base balance. This either results in numbing or pins & needles sensation. However, considering your social and inter-personal situation an evaluation of your coping skills, personality profile as well evaluation for an underlying mood/anxiety disorder is required. Hence, you require a consultation with a psychiatrist in this regard. Regards Dr Sundar Gnanavel Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling on feet?\n\nMy feet are really swollen. I take a water pill. Mostly in the summer I have really hard time with them. Usually I can get them to come down by putting my feet up, what I mean is I sit or lay ,which I am doing now, with my feet above my heart. However this time it just is not working. I would what I should do. They are really swollen.",
    "doctor_response": "Hi, the first thing we need to know is why you have this, there can be many causes of swelling in the feets, so take care, and go to your GP and get it examined, once your GP finds the cause treatment can be done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to bring down blood pressure\n\nI have high blood pressure but have not taken meds on a regular basis.  Took Hyzaar? yesterday - bp was 163/90. Tonight (1 am) after being upset my blood pressure was  189/112 (pulse 90) so I took 2 Hyzaar pills, a potassium pill and drank lots of water and calmed down.  Two hours later my bp was 204/118 (pulse 91).  I walked briskly inside for 5 minutes then decided I should ask before walking more.  30 minutes later is shows 174/94 (pulse 86).  My gym opens in 1/2 hour - should I go walk or what should I do?   Thank you!",
    "doctor_response": "Hello there I feel you should not go to the gym at allFirst get your bp corrected  on a regular pill and only then attend the gymhope that helped",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is there something as sexual compatibility with a partner?\n\nHello doctor, When it comes to physical intimacy, my partner enjoys having sex with me. I am a male. For me, it seems blunt. In spite of the erection, my penis seems less sensitive and there is very little excitement. Is there something like sexual compatibility? That is, is one only compatible with certain women? I also do not enjoy much when it comes to touching her. She is the first person with whom I had sex with. Or, does it take some time for my body to get adjusted to her? Other than this, she is a great person and we have wonderful chemistry.",
    "doctor_response": "Hello. Yes, it sometimes happens this way. You get an erection and can do intercourse because you are (probably) excited at the prospect of having sexual interaction with this woman, who you seem to have good chemistry with. But, you also probably did not realize at that time that she is not the right sexual mate for you, though a great intellectual companion. Although your body responded through erection and other bodily reactions, your mind remained cold and unresponsive because the sex appeal is missing or you just see her as an intellectual companion but not as a soulmate. This happens, and maybe a reason why there was very little sexual excitement during intercourse or upon touching her. That way, your guess that one is compatible with only certain type(s) of women is valid. What does this lead to? At least two possibilities are there. It depends on how you see the situation and how you mend yourself. For more information consult a sexologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Was admitted with suspected viral meningitis. Having nausea, vomiting, dizziness, swollen foot, rashes. Suggestions\n\nHi I am a 32yr old female who was admitted to hospital a week ago with suspected viral meningitis. i had a mri scan and a lumbar puncture all tests came back clear. Since returning home 5 days ago I have been experiencing nausea and vomiting constant dizziness dull head ache and today I have developed a rash on my Arms and legs and my right foot is swollen. Feeling really fed up now with no diagnosis :(",
    "doctor_response": "Hi, Thank you for posting your query. I can understand your frustration, however, I can assure you that you would improve soon. In cases of viral meningitis, MRI brain and CSF findings are often normal. Moreover, symptoms such as headache, dizziness, fatigue, etc may last for upto a few weeks. My only concern is the rash. In viral meningitis, skin rash may occur at onset. However, you should exclude any possibility of drug-induced rash in consultation with your doctor. I hope it helps. Please get back if you require any additional information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes positive in hair follicle test in a kid?\n\nmy fifteen month old grandson came up positive with a hair folicle test, we were told coiuld only go back maybe 60 days. what kind of exposure would have to happen for this to happen. It was apparently high amount. parents claim they never smoked in same room as him.",
    "doctor_response": "Hi,Welcome to HCMIn hair follicle test,Cocaine, Marijuana, Opiates (Codeine, Morphine & 6-Monacteyl Morphine), Methamphetamine (Methamphetamine/Amphetamine & Ecstasy), and Phencyclidine (PCP). These five drug classes are mandated for testing by the Federal Government.Environmental contaminants are the big problem for hair testing. Microscopic amounts of smoke and powders cling to the hair shaft and wind up as a trace amount on a false-positive hair test. To make matters worse, contaminants cling to dark, coarse hair much more readily-making African-Americans, Latinos and Asians significantly more susceptible to a false-positive result. According to one report, people with dark hair are 10 to 50 times more likely to test positive for drug use from a hair-follicle drug test.So in my opinion, if your grandson is not exposed to any of the drugs, then it might be just a false positive report due to contamination.For further questions, do contact us.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure seizures?\n\nHi,Apparently had seizures from being in a car accident.. I usually get an auras and kinda loss of sight.. they got worse since being taken off Klonopin in september. Around new years I had an episode where it seemed like I may have laid down and sat back up, all seemed strange. Idk if it s a stupid question. Since, my eyes seem like they twitching and I kinda get tingly. Was that a seizure and since it s been almost two months, as well as almost five since last seizure is it worth telling my Dr. I ve been on tegretol and vimpat since September..",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your symptoms. They indeed look like seizures and need to be evaluated to find out the type of seizures and the underlying cause.It is possible that the seizures are related to the head injury. An MRI brain and EEG would be helpful in confirming the diagnosis.Good anti epileptic medications at a proper dose would prevent recurrence of seizures.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can an initial level of sperm count cause delay in pregnancy?\n\nhi doctor i married before 10 months we r not using any precotin from start but still my wife is not become pregnetas per my seaman analysis i have on initial level of sperm count it may be a reason , please guide me.and tell me the proper medical solution",
    "doctor_response": "I am really sorry for your health condition.. Hi and welcome to HCM.. Thank you for posting your query.. I read your question completely and have understood it well.. I being a surgeon, we encounter so many such cases. You say, you have initial level of sperm Count, that means? Anyway, I will guide you what to do.. Generally, we term infertility only after 1 year of unprotected sex between couple. So Cheer up, you still have few more months.. Sperm counts lesser than 48 million per ejaculation as per recent guidelines are called oligopermia. That doesn't mean that, a male with 30 million sperm cannot have children, definitely not. And hence I need the exact sperm count of yours per ejaculation. Well, I will still try to solve your issue. 1.  If your counts are more than the number I've mentioned then you need not worry Do these things A.  Be positive, positive attitude gives good results B.  Make sure, your female partner is normal. C.  Have sexual intercourse, around the time of ovulation D.  You can use, Tablet Carnisure 500mg twice a day for 2 to 3 months. It helps. 2. If your counts are below the normal. If it's more than 20 million, then you still have pretty good chance. Lesser than 20 million, you need to go ahead with artificial insemination techniques. Hope I have cleared your doubts, in case you need any further assistance let me know.. Take care and God bless.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can masturbation cause frequent urination and burning in bladder?\n\nHi doc i m 19 years old. Last time I masturbated I had some urination problems and after that pain and burning in bladder after 2hrs. frequent urination and stress and pain in bladder and testicles. Can masturbation can lead to such problem. What I should do for relief",
    "doctor_response": "Thanks for asking in healthcaremagic forum Masturbation is harmless and cannot cause these symptoms. These above mentioned symptoms are suggestive of urinary tract infection.    So, I would like to suggest you to go for urine examination and a course of antibiotics with plenty of fluids for relief.    All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is life expectancy of person with COPD?\n\nMy Father is in ICU, he had a pulmonary embolism. He is on a breathing machine due to respritory failure, his heart is only working at 20% he has COPD and blood in his stool. What are his chances for survival. And what will his quality of life be if he survives?",
    "doctor_response": "Hello, What I can say is, it's sorry to hear about your father. but to be very much honest it is really difficult for anyone to provide a judgment that what are his survival rates with the short history you have provided. Also, we need to see the SpO2 levels, PI, ECG, Blood pressure, etc. Well, I am sure there will some kindness by Almighty to help him ease towards either side. Once he is out I think you can ask for a good pulmonary physical therapist so he gets the ease of the problems. In my 12 years of clinical practice, I have seen asthma cases with asthmatic attacks too. but over a period of 6 months of physical therapy most cope well. Please pray for good and the ease of the father. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness and pain in wrist,thumb and arms?\n\nI believe I might have microscopic polyangitis. My wrist, thumb, and arm is numb, yet painful. I have lost strength in the same area, and also am experiencing pain. I have red sliver looking specs under my nails on the same hand... Any advice or ideas about this info",
    "doctor_response": "Hello, It could be due to peripheral neuropathy. Consult a neurologist and get evaluated. Detailed evaluation is required including nerve conduction study. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mirena coil not removed due to the infection. How long to wait?\n\nHi I have the mirena a coil fitted for the past five years due to be replaced in June been at the hospital Monday got told it Was a womb infection Put on two lots of antibiotics Went back to gp who said was not caused through the coil as had water infection previous was advised to leave coil in and wait and see if infection clears before removal pain has eased how long will it be before i am completely better",
    "doctor_response": "Hi,Thank you for choosing Healthcaremagic. Once the course of antibiotics is over you can get this Mirena removed. And kindly make sure the whole infection is cleared before the new Mirena is inserted.I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow-ups. If you like my answers kindly rate it, and write a review as well. Please do not forget to accept it.Thank you,Wish you good health.Regards,Dr ArifYou can consult me again directly through my profile",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes piercing pains on upper chest and traces of blood in stool?\n\nI woke up early this morning with piercing pains on the right side of my upper chest to the right of my sternum and underneath my rib cage. The pain is worst when lying down and breathing deeply, though has been there all day. I can feel slight vibrations whilst breathing in. Over the last week, I have felt slight pains in the same area but barely noticeable until today. I m not sure if it s linked but my stool has traces of blood in it too, and my visits to the toilet have either had symptoms of diarrhoea, when blood has been sprayed, or being hard and black. Thanks",
    "doctor_response": "Thanks for your question on HCM.I advice you to get done chest x ray first to rule out lung infection as cause for your right sided chest discomfort. If x ray is normal than you may have gastric ulcer related disease. In this due ulcer pain in chest is felt, it is burning like sensation. And ulcer causes slow continuous bleeding from the vessel and this blood appear in the stool as black colored. Blood is actually changed its color due to gastric acid and turns black. So black colored stool is suggestive of gastric bleed.So better to consult gastroenterologist and discuss all these. You may need upper GI scopy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe fatigue and weakness in leg\n\nI ache all over and have a weakness in my legs when I walk. It feels like they are going to buckle on me sometimes when I walk. This is a new condition over the last couple of weeks. Advil helps, but the conditions comes back when I don t take it. I am on no other medicine",
    "doctor_response": "hi,thank you for providing the brief history of you.As you feel that there is no motor control that it could be a nerve trapping in its course. As the nerve has the dual functions of motor control and sensory . So any entrapment of the nerve will lead to such Buckling of the knee while gait cycle.Also, performing exercises under physical therapy should provide you better control of legs. Working out behind the core and the lower limbs should provide maximum control.Also, in my clinical practice such patients are common and with physical therapy they respond well.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having severe lower backache, migraine, tiredness, strong smell in urine. Kidney infection?\n\nHi my name is Kaela. I m having severe lower back pain , migraines, and I m constantly tired. I am also a day late on my period. However I can t tell if I have a kidney infection or if its my period. For the past couple days I had pain all across my lower back. This morning it was predominately on my left side and now it s spread out again. Do you think this could be a kidney infection and should I go in? I also noticed today that my urine smelt strong and it was cloudy. I have been drinking a lot of water the past 3 days.",
    "doctor_response": "Hi Thanks for the query. If you have a cloudy foul smelling urine it could well be an infection. It's best to obtain urine analysis and culture to confirm the diagnosis and see a physician who will guide the appropriate therapy. If the back pain persists an ultrasound may help. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pericoronitis has symptoms like swollen wisdom teeth along with foul taste?\n\nDear Sir,The gum around my wisdom tooth has gotten infected and swollen. I suspect it is pericoronitis. I had a similar problem around 2 years ago. I cannot open my mouth fully and the gum is painful when I touch it. There is foul taste in my mouth and I think some pus too.",
    "doctor_response": "HiWelcome to HCMYes all these are the symptoms of peritonitis.  You should get IOPA or OPG x ray done and visit dentist to get know whether it has yo be extracted or safe. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from headaches and loud whistle sound in ears. Kindly advice.\n\nHello doctor,I am a 33-year-old male with 5.8\" height and 72 kg weight. Symptoms are frequent pain starts at the forehead, following complete headache, loud whistle sound in ears, lower listening when the headache is high, and nausea. This is for the past three months, and now, frequency has increased. I am currently under, taking Disprine or Nicip plus.",
    "doctor_response": "Hello. The headache you are experiencing could be due to possible, 1. Sinusitis (starting at the forehead) to rule it out you should get an X-ray of sinuses. 2. Bad teeth, get them checked by your dentist. 3. Eye problems, get checked by an eye specialist. 4. For high blood pressure do monitor your blood pressure, record the results for reference, if elevated, should see cardiologist, spondyloarthrosis of the neck area, an x-ray of vertebral spine neck area should run to check it out. 5. Disprine or Nicip plus (Nimesulide) is anti-inflammatory and analgesic drug. As I do not have any of your lab reports, I believe you have been diagnosed with spondyloarthrosis of the neck. Take Betahistine for ear problems, and multivitamin B. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure frequent urination and pain in scrotum region after excess drinking?\n\nHi doc.I have a male friend who recently been on a drinking bender for nearly 3 weeks straight. A couple of days ago he feels like he needs to urinate every 5 minutes and when he does it's like peeing razor blades . His balls are also very painfull like they have been rubbed raw but they aren't.  He thinks he has an STD and did a test. They also gave him at the time antibiotics for urinary tract infection. Do guys get that?",
    "doctor_response": "Hi, It can be due to alcohol. Rule out for STD panel of test. If it is negative, you can take urine culture and start respective antibiotics.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the chest and back. Scan reports normal. Severe weight loss. Need help\n\nAM AT THE END OF THE ROAD-SUFFERING EXCRUCIATING PAINONTHE LEFT SIDE THE CHEST AND AROUND THE DIAPHRAGM AND IN THE MIDDLE OF THE BACK LEFT SIDE IOF SPINE FLUID/FOOD DOES NOT SEEM TO MOVE SMOOTHLY DOWN THE GULLET ALL COLLECTS IN UPPER CHEST CAVITY AIR /FLUID FEELS TO COLLECT HAVE HAD EVERY OSCOPY,SCANS ETC AND NOTHING IS SHOWING UP---G.P S CONSULTANTS NOW TEND TO TELL ME IT S ALL IN THE MIND ONLY JUST SUVIVING, WEIGHT LOSS WEAKNESS AND SHEER DESPERATION NO QUALITY OF LIFE AND NO EFFECTIVE PAIN CONTROL--PLEASE CAN YOU HELP IN ANY WAY",
    "doctor_response": "Hello. Thanks for writing to us. The pain in the left side of the chest that you have described can be due to a cardiac cause or a lung related cause. A muscle pain is less likely to be so severe in nature. If all the scans have come normal then you need to consult a neurologist for proper treatment. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can ADHD and OCD in a teenager be treated?\n\nI have a 15 yr old grandson, diagnosed with adhd. He takes 4-5 showers a day. Eats like he is starving, wolfs down the food so fast he surely cant taste it. Slams all doors rather than just closing them. Is this normal for a 15 yr old with his adhd?",
    "doctor_response": "Hello,He needs a complete evaluation and needs to start on methylphenidate along with fluoxetine. Hope I have answered your query. Let me know if I can assist you further.Regards,  Dr. Soujanya",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could headache and anger be due to blood pressure?\n\nHi, may I answer your health queries right now ?  I was so cool and polite in home, but nowadays i am getting angry in every incidents in my home, though i have lot of pressure in my work i was not like this before. I have BP for last few years, now i am 35 yrs old. Is this because of BP, I have a light headache like hang over nowadays. I not a frequent drinker, please advice.",
    "doctor_response": "Hello,First, you must watch your blood pressure, is it under control or what? The blood pressure can cause headache and disturbance in the sleep pattern, which at last leads to change in the mood.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dalia Nayel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for acute tonsillitis and tooth disease\n\nI have had an abscessed tooth, after popping the bubble on my gum, white pussy stuff came out, I popped it and spit it out, careful not to swallow any but the next morning my lymph nodes were swollen, my tonsils are swollen, including my tongue and lower palette on the left side. I went to the ER and they diagnosed me with acute tonsillitis and tooth disease. They prescribed me antibiotics and told me to take Tylenol ad use throat spray. I have also been using orajel. I went to sleep 4 hours ago and when I woke up I noticed a tiny amount of blood in my saliva. When I looked under my tongue my palette is extremely swollen, all the way to the top of my teeth on the left side. Around my teeth is all white and past that it looks like bruised and bloody sot of. WHAT DO I DO!?",
    "doctor_response": "With you query,I really dont understand what do you mean by ER and coming to your problem you might have had an Posterior tooth infection with deep dental dental caries which resulted in periapical abscess or dento-alveolar abscess through which the infection would have spread over to the posterior tooth areas resulting inflammation and infection of the mentioned areas like tonsils and palate.Generally, when there is a tooth infection one will have swollen lymph nodes or palpable lymph nodes which are first defense system for locally infected areas.Hence, i request you to visit an endodontist or oral surgeon along with ENT Specialist opinion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe back pain, nausea and headaches. Frequent bowel movements. What is causing this?\n\nHi, I constantly have really bad back pain its the bottom of my back and also going up the right side. I like I was to vomit a lot and get a lot of headaches and for the past month and a half I've going to the bathroom a lot not urinating but passing stools. Everytime I eat I have to immeditley go to the bathroom to pass stools. Can you give me any help of what could be the matter?RegardsEmily",
    "doctor_response": "Hello. Thanks for writing to us. The symptoms that you have described are likely to be due to an irritable bowel. The pain in the back could be due to a bad posture, poor nutrition, stress or indigestion. You need to get yourself physically examined to find out the cause. I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL  Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should i take fefol-z and foliglo to treat hair loss?\n\nhi, i am 23 yr old female.. i have lot of hairloss problem.. when i went for test i got a very low ferritin level- 21 ng/ml and iron serum - 38..the doctor told me it AGA..doctor prescribed me to take fefol z and foliglo.. i have been taking these medicines for three months, but it doesnt seem to help my hairloss problem.. nearly i am loosing 150 strands a day.. plz help me with the solution and also for how many months i should continue to take those capsules???",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Fefol (iron supplement) and foliglo (biotin supplement) are not specific remedies for Androgenetic alopecia. They are not expected to help much in your case. I usually  suggest my patients to use minoxidil solution and take oral finasteride for Androgenetic alopecia. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for swollen lymph nodes above the elbow\n\nMy gf in philippines has has a swollen lymp about 2 inches above her left elbow has reddened now she cant lift her arm she says has other lumps it is about 2 inches long and inch wide is reasonably soft to touch like fluid and has been there intermittant for 6 to 12 months only this few weeks has got red and now reallly painful",
    "doctor_response": "Thanks for your query at HCMYour patient is suffering from lymphadenopathy which is due to infections, inflammations or cancers. But as it is soft in consistency it can be infective in origin either viral or bacterial. You need to treat the underlying cause rather than swelling. I suggest get basic hematological test, ESR done. Undertake USG FNAC and examine for cytology, ZN stain (Tuberculosis) and gram stain/culture & sensitivity for bacterial infections. You can take analgesics for pain. Follow up with investigations to start appropriate treatment.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "How should aorta tear, liver damage with low blood pressure be treated?\n\nMy father has a tear in his aorta with the liver damaging... WWW.WWWW.WW say he is to weak to have op...hes 63 they are just keeping his blood pressure low...wot are the survival chances for him doing this...should they operate even if hes not been eating and weak...?",
    "doctor_response": "Hi,If this is aortic rupture then the only chance for him would be surgical procedure. Unfortunately, if surgery cane be performed, death is inevitable.I hope I have answered you query. If you have any further questions you can contact us in every time. Wish you a good health.Kindly regards,Dr. Ivan R. Rommstein",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning sensation after urinating and sex?\n\nI am a male and have burning sensation after urinating and sex.  I also have a small bit of discomfort on my lower abdominal and dont have a noticable discharge, but do feel like i am constantly wet.  I have test negative for STD's ( particular Chlymedia and Ghonoria). My symptons had started in February, shortly after i had unprotected sex. I had consulted 2 docters that had both indicated that i might be just an irrative bowl and blood test do show that i dont have any infection (red and white blood cell counting). I can def feel that something is not right and dont know how to re-explain it to determine to cause for my concern or for what other possible infection i can test for.  What else can cause the indicate symptones and for what other diseases can i ask to be tested for?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The most common cause for burning and itching or pain after sex or urination is lower urinary tract infection which includes prostatitis,urethritis or cystitis, i would recommend you to get your urine complete examination done and see if it shows any infection but in most of the cases the burning is due to urethritis which would not show any infection on urine complete. I would start you on antibiotic from quinolone group like levofloxacin for one day along with cranberry extract juice to reduce the burning. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of abdomen pain ?\n\ndear sirmy age is 28. last night continues pain in my left abdomen site. my ultrasound test is normal however pus cells=02-04 and rbcs =01-02. doctor prescribe these medicine tab esoprime 40 mg, nebrolfort, tevoflox 500g and nospa.can i continue these medicine?",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.Certainly , please continue these all medicines in a proper doses as must have prescribed and continue for 5 to 7 days minimum. By this time go for blood / urine culture and sensitivity tests. This may help in further management, if need may arise.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain, headache, weight gain, dizziness, nausea. Had cyst and gallbladder removal\n\nhi i had endioM Cysts ans tumors removed the galbladder as well last year. a lower back pain started at first once a month and now more frequently daily... also have constant headaches and gained a lot of weight. my back was sore only when i lie down but now its constant on the right hand side, severe when i sleep.. very stiff and then the stabbing headache comes. ive been to dozens of doctors no-one knows whats going on. i also feel dizzy as well as nauseas. your professional advice will be appreciated. Tershia",
    "doctor_response": "just do back exercises,try to cut on weight with diet ,exercise.For headaches,get your Blood pressure, eye vision,and ears checked with specialists-your general physician may prescribe anti-migraine medicine if all other things turn out normal.Take it easy, you have had too many surgeries for good only and worrying shall make you feel more morbid.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is 187 blood sugar normal for 8 year old girl?\n\nyes is 187 blood sugar level normal for my who has not been diasgnoised w/ diabetes she is tired all the time and not really eating and urinates quiet often.  My mom plus ex-inlaw mom has been diabetic since age of 12 and 16 so is there a chance my daughter coul become a diabetic.  my dauhter is 8 years old",
    "doctor_response": "Hello dear,I understand your concern. You should be worried, but not too much.Your daughter really has high level of sugar.Normal sugar is 70-100.You can discuss it with your treating doctor.I suggest your girl to go on Pevzner's diet 11, phythotherapy-radjma and radjma peels water,methi,papaya,Earth apple.Also consult endocrinologist.Hope it helpsWish you and your daughter good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for diarrhea and vomiting in a child\n\nMy daughter 10 year old has nausea , vomiting , mild fever. I took her to the doc in the morning and she said it is only gastrities and put her on zintec and periset. After some time, she started having loose stools. Now it is watery and nothing stays in the body. Is there any medicine I can give for diarrhoea. What kind of food will stay.. she vomits also.",
    "doctor_response": "Symptoms related to any diarrheal illness are often associated with any infection to the gastrointestinal tract, such as high grade fever, loose motion and abdominal pain.Electral or ORS (oral rehydration solution) needs to be given as the mainstay of treatment. If the amount of ORS taken in is greater than the amount lost, dehydration will not occur. It would help in replenishing the lost salts and water. She should be well hydrated with electrolytes, along with symptomatic treatment like NSAID (acetaminophen) for fever, anti secretary drug like racecodotril to reduce the frequency of motion and also to prevent dehydration will help her. Continue Zintac and the other medicines. Give some antiemetic like ondansetron 30 mins before food. It will help in retention of the food and prevent vomiting. Any food except for milk, can be given. Curd or yogurt can however be given. No specifications about food that will stay. Just use the antiemetic and things would be fine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in the left foot?\n\nI m experiencing left foot numbness. Left side of my foot and last 3 toes. I ve have 3 back surgeries but that was in 2006. I ve always had some numbness in that foot and leg but never this bad. This has been going on for about 3 months and seems to be worse at night.",
    "doctor_response": "Hi, The symptoms is suggestive of L5 nerve root or sciatic nerve involvement. Get a nerve conduction study too. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Neeraj Kumar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why would i need a scan for the pain in right side?\n\nI have kidney stones and had them blasted a few weeks ago. I have a stent in and keep getting UTIS. I had a blood test done and my LFTS were high and I have been sent for a scan. I have right flank pain why would I need a scan as scared stiff at min as I don t know why I am having one. It s not to do with the kidney stones tho",
    "doctor_response": "Hi, dear Ihave gone through your question. I can understand your concern.  You have history of kidney stones and treatment.  You also have frequent uti. Now you have flank pain and high liver function test.  You should go for complete liver function test, kidney function test and ultrasound abdomen. You may also have some liver disease. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness and tingling on tongue?\n\nI think I am experiencing parasthesia. I got my wisdom teeth out yesterday (all 4) and now I had numbness in the left side of the tongue and a burning/tingling sensation in the tip of my tongue. I was wondering if I could get an mri or some sort of test to fully determine the severity of the damage",
    "doctor_response": "Hello!Welcome to Healthcaremagic. I read your query. Since you got all 4 wisdom teeth extracted and having parasthesia, your symptoms correlate with Trigeminal nerve injury. A minor prick during injection can also lead to this. Mostly the symptoms are short lived ranging from few days to weeks. I suggest you to avoid taking too hot or cold things to avoid tongue injury because of loss of sensation. Take Multivitamins for 7 days if your Dentist did not prescribe already. In case the symptoms persists for more than a week, Please consult an Oral surgeon for further treatment. Hope this answer helps. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause low bp sometimes?\n\nMy blood pressure this morning is 103 over 62 what does that mean? I'm 63 years old, male, 240 lbs, 35 inch waist,  6'3\", big bone frame. I feel great with no side effects. No headaches, no weakness, no dizzies, heart not pounding, no vision problems except a few threads in both eyes, no chest pains, etc Most of time blood pressure is around 115 to 125 over 75 to 80, but why does it drop around 100 over 60 sometimes.",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!I would explain that these seem to be just normal blood pressure flunctuations during the day. You should know that our blood pressure usually depends of the physical and emotional activity, the time of the day, the food we eat, etc. So there are different factors contributing on it. It may be low after urinating and it may be higher after drinking water. Usually during the night and in the morning, when lying down, it is lower, because of the lack of physical activity. But as long as you have no symptoms, everything is OK. There is nothing to worry about. Hope to have been of help!Greetings!Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Could you suggest medicine for chest congestion and nasal block?\n\nHi\u00a0doctor, I am 32 years old. I am having problems of chest congestion from the last two to three months. Prescribed Allegra was quite soothing by the doctor. I was relieved for at least a month, and the problem has been declining since then. There was nothing concerning with the x-ray report, and CBC reports as well. Nose block has started from last few weeks and ache on one side of the head one day or the other. Mild chest congestion has also re-started with a\u00a0little bit of wheeze sound. Could you please recommend something?",
    "doctor_response": "Hello. I have seen all your reports (attachment removed to protect patient identity). For further information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for drowsiness when on Effexor regimen\n\nRecently began effexor regimen: dx-depression. Having difficulty with drowsiness, low nrg--etc. Am 66- year-old male, otherwise decent health. Effexor replaced long time (3 years Adderall 20 mgx3 after sudden onset of atypical seizure disorder, where during episodes, I retained consciousness and complete memory of episode i ned",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.Armodafinil is a good drug to decrease drowsiness. It has to be started in the dose of 50mg.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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have stage IV fallopian cancer. Done chemotherapy. Scan shows vaginal cuff, rectal wall. What could this mean?\n\nI have been battling stage IV Fallopian cancer for 2 1/2 yrs.  The cancer recurred 7 months after initial 18 weeks of chemo.  I have been undergoing various chemo treatments ever since ( 15 months).  My most recent scan showed nodes in the vaginal cuff, anterior rectal wall had enhanced from 4 mm to 6 mm.  Hot spots still showing on colon, as well. What could this mean?",
    "doctor_response": "Hi and welcome to HCM. thanks for the query. These findings are nonspecific and usually this is just infalmmatory reaction of lymph nodes,  but it can sometimes indicate new recurence of malignant disease so furthe tests are required. You should do PET CT SCAN to see is there some metastases and then new chemoth or radioth can be started or surgery can be considered. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "32 year old with pain in the head. MRI showing small spot on the posterior part of the brain. What is it?\n\nHi I am 32 y.o female and I have been having this pain on the left side of my head for about 3 mos severe at times. I have been in the ER about 3 time and to family doctor numerous times. I had a mri and a small spot was found on the posterior part of the left side of my brain but no one seems very concerned and will give me any answers. I ve been trying many different pain killers and nothing is working and I was wondering what this spot could be?",
    "doctor_response": "Hi, Thank you for posting your query. The most common cause for repeated headaches in your case could be migraine. Small white spots are common in migraine too. However, other conditions such as old blood clot, old brain injury, demyelination, infection, etc may also look similar on MRI brain. I would request you to upload a pdf copy of the MRI report so that I can give you a better answer. Please get back if you require any additional information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a hand growth with a lump on irritation?\n\nI have this thing on my hand where when I scratch it or if it gets scratched like by a paper cut, or just by someone else after a little while a bump comes on that spot and leaves after a couple of minutes. What is that and What can I do to prevent it?",
    "doctor_response": "Hi.Thanks for your query.Noted your history of getting bumps on the hand on scratching, or by a paper cut and it disappears after a couple of minutes. The probable reasons are:Exaggerated response of the body to a stimulus and this looks physiological as the bumps disappear within few minutes.Another reasons can be very sensitive histamine response of the body which the body takes care of immediately.Another possibility is that there was exposure to some allergens in the past which have caused this sort of hypersensitive response. I would advise you to undergo the tests of blood, urine and stool.Get a clinical evaluation, examination and investigations as may be decided by your Doctor.Special tests may be needed. Get a course of an antihistamine, steroids, dewormin and as may be suggested by your Doctor. Avoid any such things that can cause this phenomenon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in the navel post skin tag removal\n\nHi, I have a skin tag inside my belly button and my doctor used frozen liquid to remove, but my belly button hurts and its red and the skin tag has not dried out yet, it will be a week in two days. I am taking antibiotic for a stomach infection, will that take care of the redness or infection, if there is one. Thanks, L.L.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Pain could be due to skin tag removal which will subside over time.Antibiotics will prevent any infection.You can take analgesics for pain relief. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What precautions should be taken for conception in mid thirties?\n\nDear Doctor,I am arunjit banerjee from kolkata...i am 34+ and my wife is 34 also. We are planning for her pregnancy by next year May.. We are a little worried as age is slightly on the wrong side as she came to know from her relatives...if that is so what is the precautions that we should take ...and how can we possibly take precautions against risks...thank you",
    "doctor_response": "Hi, I think you should go for a first trimester screening which consists of some blood tests.  Also do a nuchal translucency scan between 11 to 14 weeks. These can rule out any congenital abnormality in the child. Due to increased age, chances of congenital abnormality increases in the baby. So, also do a second trimester screening and a level 2 scan at 18 to 20 weeks. Check sugar levels and blood pressure at regular intervals during pregnancy.  Hope I have answered your question.Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high fever at night\n\nGood day, my grandson has a fever now for 3 days without other symptoms, he was sneezing and did complain about sore legs, but after day 1 he said he did not have any more pains. his fever is usually high at night time. So what I can see is a bit of a runny nose, clear. he is a little flushed in the face, but nothing more.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Well, depending on your description it looks like a viral infection. You can use paracetamol or ibuprofen in case he has a high temperature. About a runny nose, you can use an aerosol with NaCl which helps in these cases. Of course a healthy diet, plenty water, and fruits helps a lot. I am sure the symptoms will go away in few days.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Elona Dashi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can my wife avoid passing on her eye infection to our child?\n\nHello doctor, My wife is having a red eye. We are thinking that it is spreading to the other eye too. We visited an ophthalmologist and she said that it is viral conjunctivitis. She has prescribed Gatifloxacin eye drops four to five times a day and Moxicip ointment at night. This was three days back. How can we prevent the spread of this infection to my 4-year old daughter? My wife takes care of her at home.",
    "doctor_response": "Hello. Here are a few tips to avoid transmitting eye infections to those around you: I know some of the steps are hard, but one has to follow them. For more information consult an ophthalmologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "My 9 months baby has a Urinary tract infection\n\nMy 9 months baby boy (DOB:27 April 2010) had following problems in the same sequence 1. Very first time a drop of pus was observed flowing thru his penis(24th November 2010). 2. Routine report showed 20-22 /hpf pus cells and protein trace. 3. Culture report showed 1,10,000 colony count with organism E Coli 4. Was treated with norflox ( oral antibiotic) for 10 days 1/2 tablet twice a day 100 mg and tests were repeated 5. Routine report showed occasional pus cells. 6. Culture report showed 80,000 colony count with organism E Coli 7. MCUG report shows trabeculated bladder with dilated posterior urethra and a bladder diverticulum with Grade II reflux on right kidney . 8. Ultrasound report said Bladder shows slightly thickened and irregular walls May be seen in infection ADV: follow up A small suspicious diverticulum in the right posterior wall. 9. A urine catheter was then put on to him with IV antibiotics( Meropenem ) for 2 weeks. 10. Pediatric Surgeon said MCU is suspicious of PU valves. 11. As per suggestion of a Pediatric Surgeon he underwent thru a PU ( Posterior Urethral valves ) fulguration thru cystoscopy on 11th Jan. 12. He is kept on Magnex IV antibiotic for 6 post operative days along with the urinary catheter. 13. After a week catheter was removed. He was given Taxim-o oral antibiotic twice a day. 14. After one week of oral antibiotic unfortunately he again shows multiple pus cells in his urine report and again the same organism E-coli can be seen. 15. He is now again on 14 day IV antibiotic. 16. Pediatric surgeon now suggests that we need to do ureteral reimplant surgery. 17. Took a second opinion from another pediatric surgeon and he said that ureteral reimplant is not necessary and we should see that the infection is eradicated completely. 18. As of now he has fever about 100-101 and is been controlled by paracetamol/ibuprofen. If fever doesn t go down he is suggested to have an urine cather again to release the urine bladder pressure.",
    "doctor_response": "I agree with most of the treatment given. Child surely needed cystoscopy with valve fulguration. The further treatment would be to keep the child on supressive dose of antibiotics after the present infection is irradicated. He may not need ureteric re-implantation as this is a secondary reflux.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do you suggest for back pain considering i masturbate twice a day?\n\nsir please tell elp me out this problem me if i can masturbate twice in a day & iam in age of 30+ so and also iam unmarried so help me out of ths problem that if i had low back pain problem last 10 years is only due to mastrbration or some other factors because i did masturbrate of 10years when i was sudied in school",
    "doctor_response": "HIThank for asking to HCMThis is real myth that masturbate cause the bad backache, your backache could be because of muscular pain due to more stress, and mental tension, keep the stress level low and try the following medicines,1) Tab Ibuprofen 400 mg three times in day2) Tab Chlorzoxazone  three times in day no need to worry about this your back pain will get alright soon, take care and have good time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I have brown discharge before getting periods?\n\nHi doctor, I have a brown discharge, and my dates came. What is that brown discharge?",
    "doctor_response": "Hi. If you are getting brown discharge regularly before getting periods, it is harmless. This is a normal phenomenon, which occurs due to hormonal changes. Similar hormone changes may occur during early pregnancy, and one may get such brown discharge, but there will be no periods. I guess there is no possibility of pregnancy in you and there is no history of sexual contacts. So there is nothing to get worried. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes feeling of restlessness and lightheadedness along with numb toe?\n\nFor the past few days I have been feeling restless and mildly depressed. Before that I have had numb toes (right foot) and still have a cough from a cold I had a few weeks ago. In the past two days I ve been feeling light headed and as if I weigh an immense amount less than usual when I weigh the same. I am eating healthy but I am a smoker. Female, 19.",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!Regarding your concern, I would explain that your symptoms could be related to inflammation or chronic anemia. That is why, I would recommend consulting with your attending physician for a careful physical exam and some tests: - complete blood count for anemia- kidney and liver function tests- blood electrolytes for possible imbalance- fasting glucose- PCR, ESR for inflammation. I would also advice checking your blood pressure. Low blood pressure could be the cause of your troubles. Meanwhile, it is important to have some rest for a couple of days and take plenty of water to stay hydrated. Hope to have been helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does liver enzymes be 450 272 suggest?\n\nyes, my liver enzymes were quite high 450 272. had ultrasound told had gallstone which ruled out liver issue. Then had MRI which shows lesion in bile duct area. Now scheduled for a Endoscopic Retrograde Cholangiopancreatographyll and Endoscopic Ultrasound. never drank, never smoke, no meds. whats wrong with me",
    "doctor_response": "Hi,Thanks for your question.After going through your question, there is possibility of cholangitis which caused rise in liver enzymes.Liver synthesizes bile which is drained through small intrahepatic channels to right and left hepatic ducts which join to form common hepatic duct, which is joined by cystic duct (duct from gall bladder) and form common bile duct.Any obstruction to common bile duct causes back pressure and leakage of bile in liver tissue which leads to hepatitis (Inflammation of liver) which causes raised liver enzymes.ERCP (Endoscopic Retrograde Cholangiopancreatography) is a endoscopic invasive procedure by which we can determine type of lesion in bile duct and if required can relieve obstruction by putting stent in common bile duct thereby maintain bile flow and relieve back pressure and bile leakage and revert changes of hepatitis.Endoscopic ultrasound is a less procedure help in knowing the nature of lesion but we cannot intervene if required.Hope I have answered your question.Do vote as helpul if found helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for high bp\n\ni have a grandson who's bp is 140/80 lying down-147/80 sitting up-and 166/83 when holding his breath like he is scared..the doctor said it was due to his diabeties..so what is he expected to do..put him on med to protect his kidneys and heart..wht does all of this mean for his health in the future?",
    "doctor_response": "as your grand son is a diabetic patient ,his blood pressure should be less than 130/80. otherwise he will be risk for chronic kidney disease / heart disease/ strokes in future.so needs to start drugs for his blood presssure reduction and protection of kidneys . he may need further investigations such as urine micro albumin urea and serum creatinin. so consult a specialized general physician for further investigations and management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bumps in palm?\n\nStarted off with 3 tiny bumps in my right palm. Then, it started to peel, and the peeling surface gained more tiny bumps. I can see tiny grey dots within the bumps. Then those bumps start to peel, and this cycle doesn t seem to end. What could this be? I ve had eczema before but it was just peeling (no bumps). I m using betamethasone valerate but it is not getting better. What do I do?",
    "doctor_response": "Hello and welcome to HCM,Formation of bumps and peeling off of the skin can be due to eczema itself.The steroid that you are taking is appropriate for the eczema and the current symptoms will also respond to the steroids, however, consultation with your treating skin specialist is required for further management.Thanks and take careDr Shailja Puri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for injury after wisdom tooth removal\n\nI had my wisdom teeth removed Thursday. It's Sunday earlier this morning my teeth on one side were hurting more than the others and when I brushed them it felt like they had popped. I pulled the toothbrush out and spit in the sink and it was bloody and nasty. I took a cotton swab with warm salt water over the back upper part of my mouth it had green looking slime the first time the second time it got darker and looked like a brownish color then eventually started being just blood. I went out to dinner tonight and ate some boneless wings. I came home and brushed then used gauze when I took the gauze out my top stitch came out too and now my mouth is bleeding like crazy. What should I do?",
    "doctor_response": "Hello,Thanks for consulting HCMRead your query as you have injury after extraction of wisdom tooth dont be worried so much for this I will suggest you to consult oral surgeon for examination of socket .Inmeantime you take a cotton swab and compress the extraction socket and put small cotton gauze on socket . Consult your dentist for examination .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for vitamin D deficiency\n\nMy daughter is 14 years old. She is 5'7\" and weighs approx. 190 lbs. She has had a vitamin deficiency the last year of Vit. D and Iron and has been taking supplements and a multivitamin off and on. Around August she presented with high blood pressure of 140/100 and it has maintained pretty much that pressure since. I could not get her pediatrician to do anything about it. I have taken her to a general practitioner last week and she put her on a low dose beta blocker, metaprolol. I started her on that on Friday. After taking the meds I notice her B/P sometimes goes up.. hasn't went down at all. Just now it was 130/110. I am not sure what to do.",
    "doctor_response": "Hi welcome to HCm I have gone thru your query  regarding vitamin D deficiency  of your 14 years old daughter and her High BP  and also over weight , which is indeed a matter of great concern .  Dear,  you have not mentioned , whether  she had been prescribed to take Vit. D and Iron , supplements and a multivitamin or had been taking on your own ? In fact,faulty life style and food habits weaken our immune system .   Gulping on medicines  or supplement don't help  unless we  modify  our life style and food habits  . If the detox process is hindered, toxins will build up in your body eventually causing acidity and toxemia. These are the root causes of  nearly all diseases , requires  modification  in our life style and food habits . Inclusion of balanced diet including all essential  nutrients-- fiber fruit ,green veges , lemon juice with water and salt and pepper before meals , ginger ,garlic , Aloe vera 30 ml , Amla , coconut water  , Turmeric powder a level spoon + almond oil a Tspoon with hot milk ,at bed time, with required work out ---- , regular exercise , yoga , pranayam - Deep Breathing Anulom vilom , Bhramari , Onkar Nad , Kapalbhati  , all  help weight loss & alley BP , problem .----Avoid processed foods carbs , sugar , fried ,fast foods , Tea , coffee ,alcohol and smoking , stress and Constipation all will produce biochemical and metabolic conditions in your body that will decrease your immunity, so avoiding is definitely the first step in the right direction to detoxing the body, boosting the immune system .All are the pillers of our strong immune system responsible for healthy disease free life . Vitamin D recmended dose is  for Children 1 - 18 years: 600 IU Sun rays are a rich source of vitamin D .Always remember, In case of any problems , please see your doctor /  professionalHope this helps solves your query .Take care .All the best .Get well soonDon't hesitate to come back in case of any further query .",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have 2 white patches on my tongue and inside cheek.Is it Leukoplakia or Lichen Planus ?\n\nDear Sir, I m from Bangladesh. I used to smoke. But I ve left smoking since 1.5 years. I have 2 white patches on my tongue and inside cheek since last 2 years which are not harden and also not raised. One dentist told me that it is lichen planus and another dentist told me that it is Leukoplakia . I did biopsy 16 months ago which said squamous hyperplastic chronic inflamatory cell found but no malignancy was found. I took konalog in orabse (Triamcinolone Acetonide), Vitamin A (5X50000 = total 250000 IU), Flukonazole. After taking this white patch inside my cheek went out for 2 months. After 2 months it appears again. I ve changed my dentist who extracted one wisdom tooth and giving me same treatment. Now the patch inside cheek has disappeared by 80% by the 5 days while the dose of Vitamin-A was going on. But after completing 5 Vitamin-A capsules, rest 20% of patch is not going away since 1 month. I m too much worried about this. Can you please give me a permanent solution for this problem? Thanks Hasan",
    "doctor_response": "Hi, Smoking and tobacco can result in various precancerous lesions and oral cancer. The lesion should be identified properly by a Specialist in Oral Medicine and Radiology. Meet such a specialist and if required another biopsy would be required to confirm the lesion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a recurring sore lump on my elbow with itchiness?\n\nThanks...I had an experience about 3 years ago when my outer right elbow started to itch suddenly and intensely....At the same time I noticed a swelling like tennis elbow around it....It finally went away, but the swelling has stayed...One Dr. thought the swelling was bursitis....But at that time the itching wasn t present...Every once in a while I get the itching and it is intense and usually accompanied by a sore.......The sore is in the center of a red spot which is in the middle of the swollen lump....It comes and goes....I have it now.",
    "doctor_response": "Yes it's tennis elbow and needs rest As it's chronic of long standing duration you may need an Inj. Kenacort mixed with local anaesthetic drug, so see an orthopaedic surgeon and get relief,   needs injection and you should recover in a week",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed pressure in bladder and frequent urination\n\nHi there. A few weeks ago I had pressure in the bladder, which made me feel like i needed to urinate frequently. It wasn't a UTI and seemed to pass on it's own. (this seems to happen monthly? Is it an ovulation symptom?) Anyway, i've since been burping A LOT, especially after I eat. I've just been very gassy in general, with occasional severe stomach cramps, just below the ribcage. I've now also got blood in my stool (bright red blood. I thought i'd started my period). Any advice? I will go to the doctor, but I have high anxiety and wondered if I was being a hypochondriac.",
    "doctor_response": "HiWelcome There are few possibilities that you need to discuss with your consultant.1. Gastroenteritis -- stool examination 2. Piles -- physical examination 3. UTI.-- urine analysis Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Oily skin, lots of pimples on forehead and both cheeks, some pain and leave scars. Suggestions ?\n\nhello sir...my name is AAAAA. i am from bangladesh. sir, i have oily skin and have lots of pimples on my forhead and both cheeks. some pimples do pain and leave scars. i cant use any make up, cream,even sunscreen. whenever i used sunscreen my normal face color became darker. now sir, would you suggest me how to handle with my skin.",
    "doctor_response": "hello habiba, You can start using a Toner[branded]twice daily after washing your face with a mild cleanser [cetaphil] or Spongysal face wash to reduce oiliness.You can use a noncomedogenic sunscreen thrice daily.Also use Brevoxyl cream topically by night and report to me after a month.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intense abdominal pain?\n\nI am experiencing intense lower abdominal pain. It started with a sharp pain on my left side while I was exercising. The pain quickly switched to my entire lower abdomin and worsens when I move; however, moving around does not bother it. I am not experiencing any other symptoms, but it has been hurting for two hours now. Do I need to go to the ER? Thank you for your time.",
    "doctor_response": "hithanks for askingsurely if the pain is not subsiding then you should go to ER and do some relevant investigations like full blood count and ultrasound abdomen and pelvis.......i would suggest to take 1) antispasmodic medication like tab no-spa forte2) muscle relaxant like tizanidine3) and pain killer like panadol",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy red spots all over the legs along with earache and tonsillitis?\n\nHi there Doc...I wonder if you can please assist me... I started getting ill last week first it looked like a cold or something in my eye then I started getting ear ace and now sitting with tonsillitis and I have been getting red dots on my legs and feet... can measles start on you legs and feet? I have spots all over my legs and feet very itchy or can it just be a rash?",
    "doctor_response": "Hello dear. Thank you for using HCM. I read your query and understand your concern. I looks you are suffering from a viral infection , Hand-foot-and-mouth disease  a mild, contagious viral infection common in young children is characterized by sores in the mouth and a rash on the hands and feet. Hand-foot-and-mouth disease is most commonly caused by a coxsackievirus.There's no specific treatment for hand-foot-and-mouth disease. Frequent hand-washing and avoiding close contact with people who are infected with hand-foot-and-mouth disease may help reduce your risk  of infection. Measles rush comes from head to feet and goes away from feet to head. so is not it. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will I be in trouble if I hang out with a friend having TB?\n\nHello doctor, My friend said he got a TB test a long time ago and it came out positive and he never went back and I had a positive test done also but I have taken pills for nine months because I caught it right away. That is why I was able to go on pills. They never gave me a shot so I will not get it again. Does me being around him mean I get it again? He is not sick but he seems like he has got a bit of a cold. Am I in trouble for hanging out with him or should I go and ask for a shot?",
    "doctor_response": "Hi. As a matter of fact, TB is a communicable disease and you first got it because of your friend. You have completed nine months course. But, after that, did you check for tuberculosis like whether it is actually cured or just treated? If not, you have to check it through a sputum smear or chest X-ray. About your friend, he needs a doctor consult because it may manifest as a more severe disease if not treated now. Please ask your friend to consult a doctor as early as possible. Abt your present situation, you need to rule out whether you will get a secondary infection or aggravation of the primary disease. For more information consult a general practitioner online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest permanent treatment for fungal infection in foot\n\ni am 21/femle .i have fungus infection(madurella foot) surgery also over.but my bad luck(6 months duration ) again the same promblem is raised .doctors sugested again need the surgery .there no final solution.but onething not affected bone plz   doctor tell solution my problem",
    "doctor_response": "HiThank you for writing to Health care MagicI reviewed your history.Fungal infections usually run a long course and require treatment for long time.The specific treatment is by the use of anti-fungal drugs.Do consult your doctor for examination and treatment accordingly.Hope this is helpful to you. Do write to me for further questions and I will be happy to help.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the pain of my left hand?\n\nOn my left hand, right below my thumb (palm side) down to my wrist hurts like I cant even describe. It s a very slow moving, coming-andgoing sort of pain. Sometimes I wont feel it for a fw minutes but then it ll come back with a huge wave of pain. Feels a little tight under the thumb. Help is greately appreciated, anything I can do to help the pain. I don t usually use sites like these but I need some advice on the pain, it s unmanagable.",
    "doctor_response": "Hi,Pain at thumb to wrist seems to be carpal tunnel syndrome where median nerve gets impinged at wrist level. I will suggest you to do hot and cold therapy (do take a bowl of lukewarm water and another of cold water, dip your hand in hot water for three mins then dip in cold water for one mins. Do it 7-10 times). And do wrist active exercises, finger stretching, don't lift anything heavy and avoid overhead activities.Hope you find the answer useful. Let me know if I can assist you further.Regards,Dr. Harsh Swarup",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes discharge of thick pieces of lumps?\n\nHi I m 25 years old, on fen 2014 I started to get a weird feeling in my head and I would feel for a split second des oriented some days It really annoyed me and gets in the way of my daily routines, fees weeks later I would get sharp pains in my heart every once in a wile but that didn t stop me from smoking(not cigg :)) I went to the doc they have me a blood test results came clear nothing wrong with me, which has been bothering me. I still feel te same and now I have been getting tonsillitis every month and I thought since I won t be getting treatment to start my own so I ve been eating a lot of raw garlic and now I can t seem to poop food feels like it s stuck. Sorry for the messy elaboration but there s just so much crap. The head thing I don t always feel it but my heart till aches every once in a while even when I quit smoking for a month I would get pain sometimes and got an crazy it came out clear. Now what and one more thing, I have been exposed to a yeast infection 2years ago I thought te girl had clap so I asked the doc to give me treatment for clap don t know if that could have anything to do with it. When I discharge now I get thick pieces or lumps of ya.. What could this be it s really destroying my life I need to get a solution been going to docs and they took another blood test and said its clear!! Help please and thank you",
    "doctor_response": "Hello, It can be due to urethritis.  You can send for culture and sensitivity of the discharge to make a diagnosis. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest diet to follow for person in stage IV prostate cancer\n\nMy dad has been diagnosed with Ca prostate stage IV and His liver has also been infected.He is a diabetic and has undergone the first session of Chemotherapy last week.Kindly suggest a suitable diet for him. He is 75 years old and is otherwise quite active",
    "doctor_response": "Hi,Thanks for writing in.A sample diet for your father who is stage 4 cancer patient is given belowEarly MorningA cup of tea (sugarless) with 2 plain biscuits like Marie or Thin arrowroot or RuskBreakfast2 parathas with curd (no sugar) or 2 plain rotis with egg/ paneer or 2 idlis with chutney/sambhar or 1 bowl of upma or oatsMid morningSoup or a whole fruit (apple or guava)LunchSalad with rotis (2 to 3) or rice (1 bowl) with dal/ sambhar and a cup of vegetable. Occasionally you can add some light fires in lunch. Non veg can also be added (2 pieces) or an eggAfternoonTea/ juice/ milk (sugarless) with 2 biscuitsDinnerSame as in lunch with slight variation. Dinner should be lighter than lunch",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child on medication for seizures but neurologist saying that isn't seizure activity. What is it?\n\nMy son started having seizures age 6, he was placed on 2 different meds that worked well for 2 years (no seizures) Then they started back, but not as severe as before. Now he can stay on his feet, he makes a humming noise, goes sort of limp, his head drops, and his arms hang and sway side to side, lasts between 20-45 seconds. This has been happening more and more often and his Neurologist is telling me that this isn't seizure activity. What is going on here?",
    "doctor_response": "Hi,Thank you for posting your query.I have noted the symptoms of your son. To me, they sound like seizures. If your neurologist feels that they are not seizures, then, what is his diagnosis?The diagnosis can be clarified by doing an EEG, especially a prolonged video EEG. If he has these abnormal movements and the cause is seizure, then, the corresponding EEG would be abnormal. If they are not due to seizures, then, the EEG would be normal.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does the delayed periods mean pregnancy?\n\nHi am a girl of 24 years.am using   pertogyn, then i discovered that I had discharge, went to doctor she gave me pills(flegyl) after be on periods immidiatly for 5 days. Then after I hade an unprotected sex then I suppose to go to my next appointment on the18/05/2015 I didn't do that continuing doing sex.so now since then I don't go to my period.Does that mean am pregnant?",
    "doctor_response": "HI,   A normally menstruating lady in fertile age.. having un protected sex & getting delayed periods.. the first diagnosis is pregnancy. Yes, you have possibility of pregnancy. But there are many other factors which cause delay in periods like- Hormonal imbalance due to psychological stress/ illness & medication/ thyroid or ovarian problems.    The pregnancy can be confirmed by  blood HCG test ( as urine test may have false result due to infection you had )/ USG scan of pelvis ( after 5 weeks )   Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain after it was hit by a shoulder?\n\n14 years old. Girl. 5'7. about 130 pounds. I was playing basketball today and a girl's shoulder hit me right in the middle of the chest where there was like all bone, straight down the middle. Right after that it felt the worse, it was really painful to breathe. I thought it was going to go away a while after that, but it hasn't it still hurts when I breathe, in and out. Should i see a doctor? And what are the possible things that could happen if i don't see a doctor?",
    "doctor_response": "Hi I can understand your concern....It is good that you are serious about health and want to know detail about blunt trauma...See you can have rib fracture if trauma sufficient enough....Chest x ray useful for it ...Analgesic needed.If needed compression bandage applied...Rest done....If inflammation associated then brufen needed.Now if trauma severe enough pulmonary contusion can be there ...Also chance of hemothorax or pneumothorax if injury severe enough....They might interfere ventilation ...Although you have less chance of severe problem to be safe just consult pulmonologist for examination....Take care ....Do rest ....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Medicine to cure redness and swelling after insect bite\n\nMy grandson (3) has an apparent inspect bite on his hand. Happened yesterday. Today it is swollen, red and is going into his wrist and starting to go up arm. No fever. Does not seem to bother him. Bothers his Mom. She gave him Cetrizine and is not working. We did a Baking soda paste. What else can we do? We think it may be a wasp sting.",
    "doctor_response": "hellothank you for contacting HCMin bee sting allergic reaction occurs in body which causes swelling, redness and pain. mainstay of treatment is antihitamines and analgesics. antibiotics are given if discharge starts to sppear from that site. i would recommend you to take:1. syp T-Day(levocitrizine) 1 t-spoon two times a day for 3 days2. syp calpol 1 t-spoon after every 6 hrs for 3 days3. polyfax plus ointment .. apply on the site 3 times a dayapart from medicine do the following:> do not unnecessarily touch the are.> wash hands before touching> place cold pack on the area. it will give soothing effect.visit nearby hospital if:condition starts to aggravatecondition does not improve in 2-3 dayschild becomes lethargicchild refuses oral feedany unusual sign appears.hope he will be well soon.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reddish circular rings in the groin, buttocks and hips. Working with the radioactive chemicals. Concerned\n\nyesi have aquired smaller red circular spottish rings around my groin, buttox, and on my hip bones. this all started after i started a new job that deals with radioactive oil field waste. cancerous chemicals etc. plsase help me figure out what this is.",
    "doctor_response": "Dear Austin, Hello, welcome to Healthcare Magic. You are having fungal infection of the above mentioned areas known as Tinea cruris. You should take oral and topical treatment of antifungals for around 2-3weeks period under advice of your doctor. This problem aroused because of your occupation which I suppose is having exposure to heat and humidity. Both of these things increases the propensity of fungus to grow. So you should  maintain proper hygiene with twice daily bath, wearing loose cotton clothes, changing your undergarments and general garments two times a day and maintaining a dry environment to prevent growth of fungus which will prevent recurrent/ further infection. With best health wishes, Dr Sanjay K Kanodia",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lumps in the neck\n\nI have a lump on the back of my neck on the right side, that seems to have got bigger since I went to the chiropractor two weeks ago.  He cracked my neck and since then I have been having more neck pain and wake up in the middle of the night with numb hands.  What to do now?",
    "doctor_response": "Hi,Dear,1-it appears that the lump in neck on right side,went painful , 2 wks after it was cracked from the chiropractor,Adv-to do NOW-is as follows-2-I would advise you to consult a surgeon immediately -as the cracking has complicated the lump , mostly by the infecting germs, which hence needs to be treated properly.3-Nothing to worry , if you attend to surgical expertise in your area.Thnks-HOpe I replied your query to the point.Any more query-is wellcomed to releive your problem.Thnks.Wellcome.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for attention deficit hyperactivity disorder\n\nHello. I am a 64 year old female and I have ADHD. I was taking Straterra and Adderal. I am getting worse. Less organized, eating at odd hours because I am ravenous in the early hours like 1 or 2 am. I talked to my doctor and she increased the dose but it is not working. Please tell me if there are other medications because she only prescribs those two.",
    "doctor_response": "Dear userWe understand your concernsI went through your details. There has been only one study in the medical literature about treating ADHD in the elderly. Published in 2008, it showed that ritalin-sr/99754?iL=true\" >methylphenidate (Ritalin and its ilk) was effective in treating a 67-year-old woman. I would suggest you work with your psychiatrist for a cure. You can always tell him that the symptoms are worsening. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have brown discharge post-sex while taking birth control pills?\n\nIm 17 i weigh 125lbs, & right now im on birth control. & well my question is ...after having sex with my partner, i dont know if its his sperm or my cum that comes in a pinkish, orangish, Brownish color... Were worried,& we want to know what can we do, help?!",
    "doctor_response": "Thank you for the question and thank you for visiting our site.When you have intercourse, there is 'bumping' of the cervix.  The cervix is very prone to small amounts of bleeding.  This blood, after intercourse, can makes its way out as a brownish discharge.  Given the strong association of this discharge with intercourse, I believe that my answer is the most likely.  It is never wrong to consider a visit with an OB/GYN to perform an exam and confirm that everything is otherwise normal and that there is no concern regarding infection.I hope that this helps and good luck!Dr. Tim",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does my symptoms point towards autoimmune disease?\n\nHello doctor,Based on the following, do I have an autoimmune disease:An overall feeling of sickness.Irregular heartbeat sometimes.Swollen and painful joints.Swollen legs, ankles, fingers, and toes.Headaches sometimes.Shortness of breath.Psoriasis arthritis.Visual problems, burning, itching, very dry, red eyes, and light sensitive.Feeling lightheaded.Behavior and mood changes, irritability.Chronic Dry mouth.Sinusitis.Unexplained weight loss.Night Sweats.The test findings are as follows:14 mm left kidney stone found four months back (removed via urethroplasty) and 2 mm stone in right kidney.11.5 mm left kidney stone found 20 days back.4 cm gallstone calcified 4.0 x 3.1 x 3.0 found four months back.8 mm calcified benign granuloma spleen and small hiatal hernia in CT scan four years back.Interosseous hemangioma in T11 vertebral CT scan 20 days back.C-reaction 2.56 this month.Vitamin B12 268 and erythrocyte sedimentation 26 this month.",
    "doctor_response": "Hello. I went through your post. Things which favor the diagnosis of autoimmune disease in your case are as follows: You need to be investigated for UCTD (undifferentiated connective tissue disease), RA (rheumatoid arthritis), Sjogren's syndrome.  The tests you need to do are ANA (anti-nuclear antibody), dsDNA (double-stranded DNA), CBC (complete blood count), anti-Ro/La (for lupus erythematosus), RF (rheumatoid factor), anti-CCP (cyclic citrullinated peptide), urine examination. Once reports are available will help in confirming the diagnosis.  For more information consult a rheumatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold and chest congestion\n\nmy daughter is 3.5 yrs ,and suffers very often from severe cold and chest congestion what is the best treatment ? I tried giving her alopathic medicines since the age of 5 months which has weakened her liver ,then tried ayurvedic for 2 yrs ,now the child specialist has given montek lc kid does it have side effects?",
    "doctor_response": "Hello.Thank you for asking at HCM.From your history it seems your daughter has allergic respiratory disease. However, I would definitely like to know for what condition she has been taking medicines since 5 months of age and how it was concluded that her liver is weak.Personally I agree with your child specialist and would recommend Montek LC kid for her allergy symptoms.Montek LC kid contains two drugs within - montelukast and levocetirizine. Both are considered usually safe for long term use in children. Sometimes child may complaint of sedation due to levocetirizine component. If you notice any behavior change or dizziness, please consult your pediatrician but they are rarely seen in practice. However, it is important to identify what she is allergic to. So I would suggest you to consult an Allergist who will suggest her allergy testing and then will advise you appropriate measures to avoid the allergens.As general measures, I would suggest her to avoid dusts, smoke & air pollution as much as possible.Hope this will help you.Wish your daughter the best of the health.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes premature ejaculation?\n\n\"me and my boyfriend use to have phone sex...he wished to do sex with me....during that he told me that he want more sex..while masturbating it takes more than half hour to ejaculate the sperm...one day as we planned ready to have sex,i gave him oral sex,then within 5 minutes he ejaculated sperm,the other day same thing happened,when i asked about this to him he told that the hot inside my mouth is the reason.... pls tell me that is that my problem???i frequently have hot body temperature...is that normal???pls tell me...\"",
    "doctor_response": "HelloThanks for query .Based on the fact that you have posted your boyfriend ejaculates within 5 minutes when you give him fellatio (Oral sex) where as takes long time when he masturbates .Ejaculation is a point of climax of sexual stimulation and is due to contraction of Bulbospongiosus and Pubococcygeus muscles of penis which get triggered  by stimulation of glans penis .This stimulation of glans penis being more in oral sex is the reason for early ejaculation than in masturbation .It has no relation with the temperature inside of your mouth .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for muscle pain and fever\n\nMyalgia. muscle pain, fever, light sensitivity, night sweats for 14 weeks.  14 year old male. Tested neg for flu, strep,mono,EBV.  CbC norm, liver enzyme elevated, meseteric adenitis,chest xray norm. Muscle pain is bad enough that he can't climb stairs.",
    "doctor_response": "HiThanks for your query at HCM.I understand your concern and situation.I would suggest you to get evaluation done by physicians to rule out immunological infections. You might require biopsy and tests to establish the cause.Hope I answered your queryDr Sheetal Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dry mouth and excessive saliva after putting medicated filling in molar?\n\nI had a medicated filling put in a molar Wednesday. Since then, I have had burning in my throat and a medicated taste back there. It also feels like there is a ball of phlem. I have had the sensation of extreme dry mouth, yet I have had excessive saliva. Is this from the medicated filling, a chemical burn from the numbing agent, or just coincidental throat infection?",
    "doctor_response": "Hi,Thanks for posting the query,       I would suggest you to take lukewarm saline rinses 3-4 times a day to give a soothing effect also take mutivitamin suplements for 30 days.You will be fine.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Bhui amla useful in treating hepatitis B? How can I get livomyn and nircocil?\n\ni had thatbhui amla is proving it's effcacy in  hepatitis B and  liv 52 hb or sy. livomyn should be given along with nirocil for better resultsplease how can i get this drugs and how is the cost of the drugs and how long can i take this drugs then i will get  well.please how can i get the website of this company and their phone number so i can contact them,i wish to hear back from youregards Davis",
    "doctor_response": "hello,,nirocil,bhui amla,liv 52 are all supposed to be ayurvedic herbal hepato protective aith multiple advantages..but do not heal hepatitis b (which is a viral disease)which you can get in any ayurvedic pharmacies..along with these drugs you should follow drs treatment and advice,stay healthy,healthy life style,absolutely no alcohol.avod hepatotoxic drugs,control sugar levels and bp,avoid obesity,,take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does a person feel pain when dying with catastrophic cva?\n\nMy mom died of a catastrophic cva. It happened on Friday am. Was unconscious. Was intubated. Removed after a few hours per her wishes in proxy. Remained unconscious but breathing on her own until Monday am when she died. Dr said she didn t feel anything but her legs were moving had slight gag reflex when extubated. Was she in any pain & why did she not fie immediately but died 3 days later? Could she have felt any pain during this?",
    "doctor_response": "Hi,Thanks for writing in to us.Sorry to hear about the loss of your mother. The brain is an important organ and a stroke can cause deficient blood supply or leakage of blood in to the brain as the case might be. The end result is decreased functioning of brain and this continues till the brain cannot sustain itself. Coming to pain being felt, the brain by itself cannot feel pain but if there was some leakage of blood in to the brain coverings then irritation of nerve endings might happen. This does not happen in every patient and when it happens, there is restlessness in the patient. If your mom did not show any signs of restlessness then there was no pain that she possibly had. The brain was supporting itself and in 3 days there was deterioration of the other organ functions leading to her demise. May her soul rest in peace.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does reddish brown discharge from penis while having urethral stricture indicate?\n\nHi, I m 22 years old. I have a urethral stricture. During the day I notice that many a times a cloudy reddish browny liquid is continuously being discharge from my penis. I was just wondering if this is because of the urethral stricture which I have or this is something else. Thank you",
    "doctor_response": "HelloThanks for query .You are known to have urethral stricture and getting reddish brown discharge from penis .There is always a inflammation of urethra proximal to stricture .This inflamed urethra secretes serous fluid which is passed out through urethral opening .You need to consult qualified Urologist and get appropriate treatment for urethral stricture.(Either Optical Internal Urethrotomy VIU  or open surgeryUrothroplasty ) Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Am I having cancer?\n\nI am 28 yrs old and have smoked for 12 years. I have recently felt pressure or a tightness on my neck with no pain... Just the tightness. Upon feeling my neck, I found a peanut shaped lump on the front lower left side just underneath my Adam s apple. Again, there is no pain and it is not attached to my skin. it moves up and down with my throat when i swallow as if it is attached to mu throat. i have no allergies and have no fever or cough. Is this cancer?",
    "doctor_response": "Get a thyroid scan done for ruling out throglossal cyst and throid nodule. ( ultrasound scan).Lymphnodes enlarged in cancer usually do not move with swalloing .Quit smoking as soon as possible.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to give Rantac for cold and cough?\n\nHi, may I answer your health queries right now ?  Please type your query here...my 2 1/2 year old son is always getting cold and cough last 2 days back he vomitted i gave him once vomikind and twice rantac mps suspension plse suggest me it was right to give rantac at this age?",
    "doctor_response": "Welcome to HealthcareMagic yes ranitidine is safe for baby above 2 years .in addition to this you must have given syrup levocetrizine 2.5 mg two times for cold .Steam inhalation is of additional value .If you have any further query then you can come back to HealthcareMagic or get in touch with me at drvarinderjoshi@gmail.com .With regards dr varinder joshi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does bilirubin-0.27,SGOT-138 and SGPT-166 in LFT suggest?\n\ndear sir my LFT test shows following abnormalities... Bilirubin Total: 0.27mg/dl (0-1.2) Conjugated (D bilirubin): 0.09 mg/dl (0.0-0.25) unConjugated(ID Bilirubin):0.18mg/dl (0.0-0.70) Total Protein: 8.12 gm/dl (6.6-8.3) Albumin : 4.22 gm/dl (3.4-4.8) globulin 3.9H (2.3-3.5) A/G ratio: 1.082H SGOT: 138.0H (0-32) SGPT: 166.0H(0-33) Alkaline Phosphate: 212.0 H (35-104) Gamma GT: 97.0H (6-42)",
    "doctor_response": "There is mild derangement of LFT but it needs some clinical correlation plus ultrasound abdomen report to confirmly comment on the condition but as aguess it seems mild hepatic dysfunction cause to find out",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause coughing up brown mucous?\n\nHello Dr. Grief, I quit smoking almost 1 year ago exactly and have been consistently been coughing up brown mucuous and a sticky, jelly-like substance. I previously smoked cigarettes for about 10 years, on and off, with a few month breaks here and there. My question is: when will I have gotten all the bad stuff out of my lungs? V/r Alex",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. Smokers are at great risk of lung infection,  because of poor defence system damaged by cigarette smoke.So chronic bacterial infection in lung is common in smokers. Green  mucus is seen in pseudomonas infection. And smokers are at increased risk of pseudomonas infection. So in your case we need to rule out this first. So get done1. Chest x ray2. Sputum culture and sensitivity. Chest x ray is needed to rule out infection. Sputum culture is needed to isolate the causative organism, sensitivity is needed to guide antibiotic therapy. So consult pulmonologist and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the pain in lower abdomen be due to pelvic infection?\n\nHi, may I answer your health queries right now ?  Please type your query here... hi well i had problems with mt stomache really bad pains and i went doctors and they thourt could of been pelvic infection but results were clear.. pains stoped and now they have started again but when i drink after a few but it really hurts",
    "doctor_response": "The most probable causes are : Appendicitis, lymph node enlargement ( tummy tonsils), meckel's diverticulitis, and so on. A proper history, clinical examination, investigations as per these findings alone can lead to a proper diagnosis . This is most important to lead to a proper management/ treatment.Blood- complete blood picture, kidney functions tests, blood sugar fasting and post-lunch, Urine- routine,microscopy, culture and sensitivity ( before start of antibiotic)Ultrasonography of abdomen.Ct scan of the abdomen and if required Diagnostic Laparoscopy are the best options for diagnosis and treatment",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blister in gum after tooth extraction?\n\nI had a tooth extracted three weeks ago.  All was well until yesterday when I noticed some sort of blister forming in the hole.  At first I was excited, as I thought I was almost done with the healing process.  But today the blister has grown in size and protrudes out of the hole and past my gum line.  What is this and should I be worried about it or is that normal?",
    "doctor_response": "Hello and welcome.Thanks for sharing your concern.From the history posted here it appears that there is infection developed in the socket.do you have pain too?It requires an immediate follow up within two days,so that a suitable antibiotics can be started upon clinical evaluation.Meanwhile please do warm saline rinses and see your dentist to the earliest.Thanks.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am unable to fall asleep. Taking ETIZOLA 0. 5 for every night. Please advice me.\n\nDear Doctor, My problem is that, I am unable to fall asleep and it persists for more than a year now. Now started taking ETIZOLA 0.5 for every night. Slight headache is also felt whenever I fail to sleep. I am a male, 38 years old, teetotaller (never drinks alcohol).",
    "doctor_response": "Hi, Chronic insomnia in a middle aged man who is a teetotaller is not very common. (Read expert advice for getting a good night's sleep) One leading cause of insomnia, or inability to fall asleep (Initial Insomnia) is Major Depression. If you experience periods of increased worrying, decreased energy, lack of interest and motivation, anxiety, irritability, sadness with or without crying spells, increased forgetfulness -- you might have a case of depression, which is easily evaluated and treated and is the best way to address your chronic insomnia rather than just taking sleep aides. You might want to see a psychiatrist in person or book for an online therapy at icliniq.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for cough in a child?\n\nMy 1 year old son has an extremely bad cough, it is starting to make him sick. we cannot get to the doctor because of the adverse weather condition but my 3 year old daughter has an antobitic for tonsilitis called calvapen. could i give him a small dose of this till we can get to a doctor",
    "doctor_response": "Hi, Cough and cold are viral 95% of the times in children. For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15mg/kg/dose (max ceiling dose 500mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. For cold, you can use Cetrizine at 0.25mg/kg/dose every 12 hourly for 3 days. For nasal block, plain saline nasal drops will do, every 4-6th hourly to relieve nasal congestion. Do not use antibiotic as the cough is usually suggestive of viral illness and antibiotics are not indicated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for concentration problems?\n\nI have a very poor attention span, i cant concentrate on a tv show, or even when someone is talking to me my concentration lasts a stupidly small time. I was considering asking my GP if he could prescribe me ritalin. I am not sure whether i would need any further testing or anything before hand. I do not want the drug for any form of recreational useage and in fact i would actully prefer one that increases concentraion without those side effects. I am not a fan of drugs that can have uses other than what i need them for eg when i have asked for sleeping pills or painkillers before i have specified i do not want opiates, benzo's etc.I was wondering if you think it would be a good idea to ask my dr for them, or if there is an alternitive to them that you think would be betterAdditional info, i am 21, male. I was been diagnosed with bpd a few years ago. I am not on any medication. I used to drink alcohol too much but i cut down a few months ago to a fraction of the amount i used to drink. Smoker - around 10/15 per day that i roll myself from tobacco.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. You are suppose to refer to concentration and attention as two. Attention span for any adult is maximum 30 minutes. Sometimes, a person can be attentive to an interesting thing for more than 30 minutes, such as movies or games. Concentration is attention plus understanding. For this too, span of below 30 minutes. If you are able to make your studies interesting and based on variable principle, your concentration level can be increased. Concentration comes only when you are interested in what you do. So please be passionate towards what you are doing or do only those things which you are interested in. It is also possible to improve your concentration level with the help of yoga, meditation and breathing exercises.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "When to start new pack of birth control pills if period is delayed?\n\nHello, I currently started using birth control and I m 2 days away from my last hormone pill w/ 7 days of none active pills. I have looked up & asked around when to start my new pack. I have been told to not stop keep going, wait until the first day of my period to start the new pack, if period doesn t start in 2-3 of my last hormone pill still start the new pack. I just need to know the answer to my question please. Thank you for your help and support.",
    "doctor_response": "Hello dearUnderstand your concernYou have to start the new pack from the first day of your menstrual cycle. If period will delay by 7 daya then  you have to find the cause of the delayed period. But once you are on regular pill, period will become regular.You have to take 21 tablet daily on sane time (at bed time) regularly. After finishing this you have to take 7 inactive tablet. During the this 7 days or after finishing 7 tablet, period will come.So if period will delay then you have to wait for period to come.If you started the pills without the period come then period may be delayed till you do not stop the taking pill.Hope this may help youBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could the loose skin in mouth which causes irritation after teeth extraction be?\n\nHello. I am a 15 year old male, and I had three of my teeth removed yesterday morning. At one of the extraction sites, there is loose skin. It keeps getting in the way of my tongue. I rinsed my mouth yesterday night, and some pieces of the loose skin fell out of my mouth. However, I do not know what to do with the rest of the loose skin. It is very irritating. Should I pull it out gently, or wait for it to come out by itself? Or is there anything else I should do?",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,   I have gone through your query,  as you have undergone extraction of tooth now, you feel loose skin dont worry it is unhealed socket .  Take proper course of antibiotics prescribed by your dentist,  and wait for 15 days atleast for healing of socket.   Do warm saline gargle two - three times a day. After one week of you wont get relief then go and consult your dentist for oral examination .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Urge for bowel movement, only have anal leakage after it, frequent urination also. Reasons ?\n\nI feel like I need to have a bowel movement many times a day, mostly after lunch and this feeling gets stronger after dinner. However, all that comes out is gas and some anal leakage. I also feel that it puts pressure on my bladder and I have to pee often. I am an extremely healthy eater and avid runner/gym rat! The amount of gas that I have is severe and sometimes uncontrollable! Please help!",
    "doctor_response": "Hi Welcome to HCM It might be possible that you have got intestinal infection which is causing abdominal bloating and constipation. It is recommended that have a stool complete analysis and you can use lactolose for relieving constipation. Thanks Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My periods are not regular after my abortion. What should I do?\n\nHello doctor, I had abortion, D and C, two months ago. After that, I got my regular cycle on the next month, and it was normal. Last month starting there was a one-day spotting, which again started on the mid of the month and lasted for four days. And after some days I had periods with a dark brown colored discharge but not of that adequate amount, but it lasted for six days like a regular period. But I had contact last month after which only the next spotting kind of discharge came as I told. I had progesterone from this month for four days to regularize my cycles. But I have not got my cycle till today. It is more than six days now. I usually used to get my period on the 5th day after progesterone. But this time I did not get my period till now. I do not want to be pregnant now. What should I do?",
    "doctor_response": "Hello. If there is a history of sexual intercourse after abortion, then I would suggest you do a blood test and serum beta hCG (human chorionic gonadotropin) after 10 days of intercourse. Also, I would advise you to do one pelvic ultrasound and serum beta hCG to rule out any retained product of conception. If everything is fine, then you can take OCP (oral contraceptive pills) for three cycles to regularize your periods. Please do a pelvic ultrasound and serum beta hCG and send me the report.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the next intervention after physical therapy?\n\nHi I injured my upper back at work last week. First I five days later I was given flexeril and ultram for pain five days later I was given an x-ray which was good, Now I have started physical therapy, what is the next logical intervention for this? Please advise",
    "doctor_response": "It depends upon your recovery. Since it is post injury, there are high chances that you will do good with physiotherapy. Depending upon improvement, next course will be decided",
    "dialogue_context": ""
  },
  {
    "patient_message": "Specific Polysacchride Antibody Deficiency, Common Variable Immune Deficiency, not on antibiotic, no immunity for staph and step, Cipro\n\nI suffer from Specific Polysacchride Antibody Deficency and Common Variable Immune Deficency. I take weekly subcutaneous infustions to bolster my immune system . I have not been an antibiotic in four years, both to treat infections and for profolactic reasons. Cultures have shown psydeumonisis, Strep , and Staph. I have NO immunity to Staph and Strep. While in MX last week on vacation I spat out a large mucous ball that was greyish in color with black striations (sp) throughout it. It is not the first time I ve seen this and have consistently reported this to my ENT. I am currentlty on 750 mg Cipro daily for profolactic reasons.",
    "doctor_response": "hi, being someone with feeble immunity, you are liable for bacterial and fungal infections. the ball you spat could be fungal! Get yourself tested for any fungal hyphae in sputum, and if positive, you need prophylactic antifungals.  Prevention is always better than cure and treating fungal infections in an immuno compromised patient is a difficult task. you may request your doctor for this.All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes muscle spasms on the back?\n\nmy mother has been having muscle spasm in her back and shes been to the er twice last night she was given a shot for the pain right in the area but it now has wore out and still hurting ....the doctor had told her that the shot should have lasted a couple of days",
    "doctor_response": "thanks for your question ,just give her skeletal muscle relaxant(tizanidine 4 mg) once before sleep and meloxicam 15 mg once daily after meal.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could lumps on butt cheeks suggest?\n\nOften when I wake up in the morning I have several lumps in my butt cheeks and sometimes along my spine. They give a dull ache, but not much real pain. After I m up and about they disappear. They always in the same place when I get them, but they can t be found during the day. Any ideas?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some hemorrhoid ( piles ).  Whenever you get constipated lumps apper near anal canal due to pressure. You should go for per rectal examination.  If it is due to piles then you should take soft diet.  Avoid oily and spicy food.  Take high fiber diet and plenty of water.  Hot water bath is also helpful.If medical treatment is not working then surgery is the permenent treatment. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for a bad cough\n\nallergy symptoms started monday and has progressed to extreme coughing with green mucus.  ENT doc gave me prednisone and musonix cough suppressent/expectorant.  I have been up ALL night wtih the worst coughing of my life.  What else can i do.  He would not give me an antibiotic.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. By your history and description, we should should definitely rule out lung infection (pneumonia) in your case because your are having excessive coughing with green mucus expectoration.So better to consult pulmonologist and get done clinical examination of respiratory system and chest x ray. If chest x ray is showing pneumonia then you should definitely start higher antibiotics like amoxicillin clavulinic acid or levofloxacin. Drink plenty of fluids orally and keep yourself hydrated. Do warm water gargles 5-6 times a day. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could white lesions in cheek & tongue suggest?\n\nHi, i have white lesion on my 2 cheeks. From one side it's small, from the other it's bigger. It's been so white, but now they became lighter, but i think my cheek inside became little bet swallen and 2 days ago i find out very small lesion on my toungue. I had been on urgent care and they give me some medication from trush, but it's didn't help and my dentist thinking it's not a trush........what it's can be?",
    "doctor_response": "It could be leokoplakia or more precisely if its filled with liquid , it could be leokodeamaApply tretinoin .025% ( retino a cream) and have an antioxidant and vitamin a chewable tablets daily.If it burns on application discontinue it",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the chance of getting pregnant with fertigyn injection?\n\nhello i am now 28 yrs old. its now 1-1/2 years after my marriage. we are trying for a child. in february i had a miscarriage after that my periods are irregular and i consulted a doctor after 4 months..and the diagnosis was PCOD. i am taking obimet for the last 3 months..now my periods are regular..my LMP was september 19. today my doctor gave me fertigyn 5000 injection. she told me that one follicle is growing nicely in my left ovary and endometrium is normal. what is the purpose of this injection..how much is my chance of getting pregnant with this injection?",
    "doctor_response": "Hi, the injection given to you is to make your follicles rupture and release the egg. It definitely increases the chance of pregnancy.  Be in contact with your husband for next 2 to 3 days after injection. The actual chance of pregnancy is 7 to 10 percent.  Hope I have answered your question.  If you have any other query I will be happy to help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dry mouth and tingling sensation in the arms?\n\nHi ..  I feel fine just wondering if anything is going on.  This is what I am noticing.Drinking a ton of water  ( More than I already do )Dry mouth at night and in the morning when I wake up.Urinating a lot probably because of all the water I drink.Sometimes when I reach for things I get a little tingling in my arms.I have been losing weight the last 6 weeks but not dieting.I am going to be 60 years old. relatively healthy. eat good and healthy food.",
    "doctor_response": "Hello,If you have dry mouth, and excessive urination in the night and morning only and not throughout the day, then it can be probably due to mouth breathing at night that can cause dry mouth. But in case if the dry mouth and excessive urination present during the day also, and there is also tingling sensation in arms, then it can be due to high blood sugar levels also.So my suggestion is to consult an oral physician or a general physician and get evaluated so that a clinical examination and fasting and postprandial blood sugar levels and HbA1c should be done to rule out the exact cause of the symptoms. For dry mouth, you should chew sugar-free chewing gums and gargle with Biotene mouthwash.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the small red spot under the radiated breast that opens up?\n\nI had breast cancer in 2005 - lumpectomy and 31 radiation treatments. Have a small red spot under the radiated breast that sometimes opens up but does not leak fluid - just sore.  Sometimes it disappears and then comes back.  Should I worry that this might be another cancer?",
    "doctor_response": "Hi,Thanks for writing in.It is always better to get a sore area in the breast clinically evaluated. Most are benign conditions but a recurrence must always be ruled out if you had previous breast cancer and took treatment for it. Radiation causes changes below the skin and this might manifest as a sore. It is not essential for an infection to be discharging in the early stages.Though it appears to be a post lumpectomy and radiation change that has taken place,  it is suggested that you consult your doctor and get ultrasound scan done to screen for any suspicious activity in your breast. Also please feel your axilla for any lymph node swelling and bring it to the notice of your doctors. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does high concentration of urea and creatinine indicate?\n\nhi doctor i take asthalin since 3 months and i have to copy with new problems like tachycardia , sever cough synosis , and sever stress they take many sample (blood sample ) and they discovered i have a high concentration of urea and ceratinine so i am so afraid of any disease s in my kidney",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.These markers are signs of kidney damage. If just slightly elevated, it should not be problematic and may be treated with dietary changes.However, this may be is caused by urinary infection including kidneys infection or urinary stones so you should do urine analysis, urinoculture and kidneys ultrasound to rule these out which are most common causes. You should drink raspberry tea and plenty of water till you do tests. You should reduce salt in your diet as well, alcohol and carbonated drinks. In most cases this is self limiting but sometimes antibiotics are required and more invasive tests such as cystoscopy or pyelography or CT scan. Less common causes include tumors, glomerulonephritis and metabolic diseases.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to confirm pregnancy?\n\nSo I had my period last month on the 8th of Oct. It s now November 22nd. So it s prety late. On November 13th, I woke up and as I was getting dressed a sharp pain came over the right side of my lower abdomen (where ovaries are located). It was a sudden pain like non other. I felt really bloated like a needed to fart, but I couldn t fart and trying to take a dump was painful. It hurt to put the slightest pressure on my lower abdomen. When I tried to walk I felt like my inner right thigh was tingling. I felt like it was more than just gas. I was to the point of tears. A couple hours later I tried to eat but got kinda nauseous and couldn t eat much. One the 20th I took two pregnancy tests both came back negative. Since then I ve been having symptoms of PMS such as irritability, mild cramps in my right pelvis region, headaches, tender boobs and cramping after orgasms. The thing is all of these are signs of early pregnancy as well. Is it a cyst or am I pregnant?",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.With negative pregnancy tests, you can be having these symptoms that suggest premenstrual Syndrome (PMS).I will suggest Tab B LONG F one at night for 3 months.I will suggest indulging in a healthy diet and regular exercise regime.Include plenty of fruits, salads, vegetables in the diet. Have adequate water intake , say 8 \u2013 10 glasses per day. Avoid deep fried foods, bakery products, and refined sugars.I hope my answer helps you.Thanks.Wish you great health.Dr Purushottam",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Ebast-M tablet the right medicine for nose allergy?\n\nHi doctor,Namaste.my son is suffuring from nose allergy.he is 16 years old.i consulted to doctor and he suggested that Ebast-M tablet to take 6 months.Is it correct or wrong?i will asking with u that please suggest me.any side or advrse effect from this tablet for taking long period to children ?",
    "doctor_response": "Hi,E-bast-M is monetelaucast, it is very good for respiratory tract allergy.There is no harm giving for long time.There is no major side effect and comparatively safe medicine.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What medicine should I take for yeast infection?\n\nHi doctor, I have two small sores on my penis head, probably yeast infection. What medicine should I take? I have tried using Cloben G for the same. But, I did not get relief. Please give some advice.",
    "doctor_response": "Hi. Revert back with the answers to the above questions to a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mono infection, no fatigue, swollen throat, on antibiotics, monospot positive, WBC low\n\nmy doctor says i have mono. but im not tired at all, and my throat has been really swollen for a week now. they gave me antibiotics and theyre helping alot, i feel better already and i ve been taking them for only 2 days. they gave me a monospot and it came back positive. They said my white blood cell count was low.. im worried its not mono.",
    "doctor_response": "Hi there, Thanks for your query. The severity of symptoms depend on the body's immunity status and virility of the infecting virus. Hence, your symptoms are minimal. Further, the diagnosis of mono has been confirmed. As such, mono tends to cause a transient lowering of white blood cell count, which reverts back to normal once the infection is cured. So, I don't feel that there is any reason to be worried. If you find my response helpful and informative, do not forget an \u201cexcellent\u201d (5-star rating)  to my answer, to ENCOURAGE ALL doctors- engaged in social service- to render sound advice to the FREE queries. Take care Dr. Rakesh Karanwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause bumps on the tongue while suffering from toothache?\n\nI have bumps on the back of my tongue.They dont hurt or anything just found them there..I have been having tooth pain..Plus i have bumps on the front of my tongue but i burnt my tongue bad last night so i know where there from..Plus my newph has strep..but i dont have tongsu anymore.But has not ran a high temp but my toaht does burn but just random times not when im eating or sleeping..",
    "doctor_response": "Hi, Bumps at the back of the tongue if not painful or annoying then they are not due to any pathology and can be most probably due to a normal anatomic structure that is Circumvallate papillae. Circumvallate papillae are large papillae present at the back one-third of the tongue and are present in typical V shape. They are raised and large and can at times be misunderstood to be due to some pathology. So you need not worry as I do not think there is anything pathological. However, a clinical exam can further confirm so please click pictures and send it to me so that I can advise you more precisely. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Honey Arora, Dentist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling in testicles and sensitiveness in penis?\n\nhello doctor i want to know what is my problem i am from six months the same situation even i saw lot of dermatologue and they said nothing my penis is sensitive.. i have burn and the sulcus is colour purple and i feel tiggling on my testicules..i did std nothing.. the tiggling is from outside.. it is connect to the head of the penis when it is burning the tiggling begin .. i do not what to do seen it doctors said nothing ..",
    "doctor_response": "Hi, It's NOT STD. Try to distract yourself from this. Often anxiety can create such problems. Maintain hygiene. At the most, you can apply local anesthetic jelly in the penis. It can help. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Sujoy Dasgupta, OB & GYN Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i meet a dentist for tooth pain and swollen gum?\n\nI woke up this morning with pain behind my last tooth on the bottom right and it hurts to chew food but not to sallow. The gum behind my last tooth is cearly more swollen than the gum on the opposite side of my mouth. Should i go see a dentist, by the way im 35 weeks pregnant.",
    "doctor_response": "Hello,The type of pain in the tooth you are mentioning with swollen gums it means that there is an infection in the tooth you should visit your dentist for the treatment of infection because without that the pain will not be relieved.If you are 35 weeks pregnant then right now initial treatments can be done but with precautions.Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the findings in ultrasound of shoulder without surgery?\n\nas USG Rt Shoulder report, Sir I am near complete to complete full thickness teaar of supraspinatus tendon with atrophic muscle bellly. Fluid distension of bicipital groove, SA_SD bursa and supcoracoid recess. Suspicious small tear in cranial fibers of subscapularis tendon. Degenerative cortical irregularity of humerous. please let me know I should go for surgery. As I am cardiac patient I want to avoid surgery. What should iI do please. J.K.Arora",
    "doctor_response": "hi,thank-you for providing the brief history of you.As your ultrasound reports suggest you have a rotator cuff injury and the pain level should be high as per the reports.Also, there is some degenerative changes in the muscles and bones around the shoulder joint as this is a common thing to happen as ageing progresses.I will advice you to undergo physical therapy and regain the full ROM of the shoulder joint and also the Strengthening of the muscles of the rotator cuff by which the next plan can be decided.In my clinical practice I have seen rotator cuff injuries and with atleast 2 muscles complete torn. But keeping into consideration the age of the patient we dealt only with physical therapy and regained the full shoulder functionality. Ofcourse surgery is avoided for her and maintenance of the shoulder mobility is what the plan .i will be happy to help you further if you can give me more details about your case and can be taken further from here to avoid surgery.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for weakness and numbness in the left arm, face and tongue\n\nHello, my wife has been dealing with left leg pain and weakness for the past 15 years. Recently my wife developed left arm, face and tongue weakness and numbness. She was diagnosed with a 5mm Chiari malformation and was given steroids to relieve migraines. After seeing a neurosurgeon she was told she was ineligible for surgery and has been told that she may be making up the symptoms in her head. We don t believe that, basically her left leg, arm and now face experiences pain and weakness and we have no idea why. She was tested for MS but with no lesions and multiple side symptoms that was rules out. Any advice you can provide would be appreciated.",
    "doctor_response": "Hello!Thank you for asking on Healthcaremagic!I read carefully your question and understand your concern. Coming to this point, I would recommend performing a cervico-thoracic spine MRI study to exclude possible syringomyelia, which could cause her symptoms. This is a common complication of Chiary Malformation. Anyway, it would not explain the numbness in her face or tongue. Another option would be starting an antidepressant, especially considering the fact tha she suffered from migraines. These drugs can help improve both the migraine and her symptoms. Hope you will find this answer helfpul!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have thyroid nodes. On acid reflux medicines. Why am I choking? Cancer?\n\nToday I saw a throat specialist, I have a a couple thyroid Nodes, one was dominant but only 1.5cm in size, had a biopsy and was told non cancerous but I am continuing to feel like I am choking, I am on acid reflux medicine and today he doubled the dosage, he did a probe and said my left side of thyroid is swollen...is it possible this is just acid reflux doing this? He also said, often the biopsies are non conclusive and he would continue to monitor it and ultra sound yearly with only a 5% chance of cancer, he will not touch it for now.......should I trust it s just acid reflux causing my burning and choking feeling?",
    "doctor_response": "depends on functioning of thyroid if biopsy is negetive you get your blood tests for T3,T4 AND TSH AND IF FUNCTION IS NORMAL NO NEED TO WORRY THE SWELLING IS DUE TO IODINE DEFICIENCY I HAVE TRETED MANY PATIENTS LIKE THIS YOU STRAT WITH COLLOISAL IODINE SYP 2 TSF ONCE A DAY FOR 3 MONTHS BUT TAKE DECISION ONLY AFTER GETTING REPORTS OF TFT",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is asthma related with bleeding of nose with fever ?\n\nMy son is 4 and had his first nose bleed this morning and then has had 4 more throughout the day coming from both sides... He has asthma and has had several cases of bronchitis and Phemonia so generally I wouldn t be worried but since he gets sick so easy is this something I should take him to his pediatrician for? I am assuming it might be dry air but they have all happened at different places today!",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your son's history and would like to make suggestions for him as follows:1. It is possible to have nose bleed due to rhinitis or dry air exposure, especially due to heavy pricking nose. But in general, nose bleeds have no relation with asthma.2. If bleeds are minor, moisturizing inner surface of nose by using frequent saline drops would help. Also, putting ice over nose bridge may help during bleeding.3. If bleeds are major and not stopping, in that case I would suggest you to take him to pediatrician and get him examined.4. Please make sure his nails are trimmed so that he cannot injure inner nose membrane subconsciously while itching.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish your son the best of the health and recovery ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain, dizziness, shortness of breath and nausea in elderly?\n\nI am 57 years old in good health with the exception of having high blood pressure. I work out on an eleptical every other day. a week Ago I Was Doing 6 miles On my eleptical and had Chest pain dizzness shortness of breath and naseau. Took my BP and pulse BP had dropped to 90 over 50 and pulse was 42. As the night went on BP came back up but pulse did not. The next morning I began having more severe chest pains went to ER did cat scan exray echo cardio gram stress test and heart cath. Was diagnosed with bigeminy arithmia. The constant tightness in my chest has not gone away nor has my headache lightheadedness was also put on acid refux med just in case and was taken off of hctz med and given potassium supplements although was in normal range. I constantly want to sleep now which is definitely not like me and wonder if this bigeminy is the reason I feel this way and if I am just going to have to get used to feeling like this or is there something I can do to ease these symptoms",
    "doctor_response": "First of all I need to know exact reports of your Echo,stress test and cath.I presume that they should be normal,otherwise you would have been advised further intervention .I view your problem with 2 diff angle1.chest pain which must be non cardiac in origin either acid reflux or muscular.over and above this you are anxious .so you should take bedtime lorazepam 1 mg at bedtime for few days.this will take care of your chest pain.2.low heart rate and bigeminy .looking at your daily exercise schedule  you may have athletic heart with high vagal tone which is infact good for heart.Bigeminy should be benign however you may get holter monitoring done to know its frequency and any need for electro physiological work up.My best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hands and feet are ice cold. Have depression and ejaculation on seeing a girl. Suggestions?\n\nHi, I had my blood test done recently the blood sugay level was 104. My hands and feet are ice cold almost all the time. I feel depressed all the time. My hands and head tremble and I am only 28. I started masturbating at the age of 15 and now whenever I see a girl my semen just comes out within seconds. I have worse condition of PE. Please suggest whet shall I do to get rid of these conditions. Thanks",
    "doctor_response": "Hello  Your sugar levels are in normal range, there is nothing to worry. You have mentioned your hands and feet are cold most of the time. You are feeling low. Tremors are also present. First of all just to reassure you, Masturbation is a healthy practice. It has nothing to do with your symptomatology. Every adult male or female after attaining puberty masturbate. So it has nothing to do with your depressive symptoms. But continuous thinking about masturbation and beliefs about its effects are producing stress in you. It has increased the anxiety in you. Due to this you are feeling low and you are having tremors. You have mentioned that on seeing girls your semen just comes out. It is most likely not semen, it may be precum, which is lubricating fluid secreted on getting erection. I will advise you to divert your attention by reading good books, exercise daily, practice yoga daily. If problem increases visit a Psychiatrist for episodic control of anxiety. Medicines like Fluoxetine Paroxetine will not only cover depression, but will also help to delay ejeculation. Thanks Dr. Seikhoo Bishnoi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is flucon recommended for recurring red spot under foreskin?\n\nhello last month i was suffering from red spot on and under foreskin so doctor suggested me flucon 150mgfor 5 days  after that the spots vanished i was perfectly alright ,but again few days back same problem occured so shall i continue the same course or shall i see an urologist",
    "doctor_response": "Good day and thank you for being with healthcare magic!!! I recommend seeing the urologist again for follow up since he has seen the lesions before and repeating the same regimen might not work again and may cause some antibiotic resistance already making it a bit more harder to treat. I hope I have answered your question satisfactorily and please consider a 5 Star rating for my answer. Thank\u200b you very much.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes obsessive nature in women?\n\nHi there! My mum is very obsessive when it comes to cleaning and being very judgemental. Everyday she is moaning about cleaning whether I have done this or not, even at about 6:30 every morning she is constantly asking me to do something which has cleaning involved she will even finish work earlier just so she can do extra cleaning or preparing food. She was raised in a very strict home with parents who are strict, my mother is a bit like my grandmother who believes the women should do all the cleaning and cooking while men just do nothing. However this cleaning disorder has been having a huge effect on me as she thinks I have not been doing enough every day and therefore she is constantly having arguements with me. I have tried not to be at home so often because of this and when I am she never asks me how have I been or how my day has been the first thing is an arguement about cleaning yet again. At home I try my best to help by washing dishes, moping, hoovering, cleaning the garden, maintaing a clean bedroom, dusting and etc... What more could I do? I am to the point where I can t deal with this anymore and I am only 19, my mother doesn t spend any time with me even though I ask to go to the cinema or come out for dinner with me (my treat)... but chooses to clean. Since starting my new job at a Bank I haven t been able to do as much cleaning as I could before, but I still help and because I am finding it quite difficult I have brought up the subject of getting a cleaner and I would pay, however I got laughed at. My dad who isn t together with my mum said that she went to his house and started inspecting it to see if his cleaner had done a good job. I know my mum so well that if I was to get a cleaner to come home she would just do it herself again as she does the same to me after I cleaned the day after or 2 she will go back to cleaning the same spot again. My step dad has not even bothered saying anything as in my view I think he enjoys that she does all the work... and says we do not need a cleaner, but basically my main question is do you think she has a disorder? I have even offered kindly to pay for therapy and she declined saying she does not need it. Not to mention my mum has been on anti depresants before and now I am having to suffer with her cleaning habit and on going arguements with me. Help please?????!!!!",
    "doctor_response": "DearWe understand your concernsI went through your details. I understand your emotions. In my opinion naming a disorder for your mothers behavior or obsession is quite easy. It can be called OCD. But is there any requirement to name it? Who is not obsessed? Everyone are with something of other. As long as the obsessions go out of hand and become a behavioral hazard, better not to address it. Your mother is doing well and finding her own satisfaction level with her current behavior. Let her enjoy. You can pacify her when she gets enraged. Please understand. Starting a psychiatric treatment for OCD may cripple her self confidence and self esteem. She does a good job, enjoys it, and never negative about it and is satisfied. What else do you want? Put her in trouble of psychiatric treatment? I shall oppose. Do according to your conscience. God bless you. If you require more of my services, please post a direct query with every Possible details.Hope this answers your query. Avilable for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant headache while having high blood pressure?\n\nHi I am having headahe since last  3 -4 days. never had for 3 -4 days continously. i am healthy - aged 36. also had cold couple of days ago but now feeling better. my BP used to be normal but yesterday electronic machine showing 150 - 90,,,but rechecked later with normal machine it was 130 - 70",
    "doctor_response": "Hello,Your BP (Blood pressure) is not high. Headache was because of cold. One high reading is not sufficient to label high BP.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. RS Gulati",
    "dialogue_context": ""
  },
  {
    "patient_message": "What's causing abdominal pain with less appetite and slight body tremors when all blood tests, appendix and cat scan normal?\n\nI have some abdominal pain, it's been there for 2 weeks now. I have been checked to make sure it is not something like an infection or appendix etc, but along with it I am not really eating much and I keep getting these slight body tremors. I notice them if I am sitting or trying to go to sleep. I have had 2 urine tests and blood work done and all came back good and 3 months ago I had a cat scan on my brain which came back good...sometimes I feel a. It weak and shaky but most of all I am scared of what could be causing this and I think my anxiety might be taking over! What could it be?",
    "doctor_response": "Welcome to HCM.Abdominal pain with less appetite indicates indigestion also called dyspepsia.Weak and shaky feeling might be due to anxiety and multi vitamin deficiency.Dyspepsia also occurs due to stress,anxiety.Try to avoid stress,anxiety.Drink more water and liquids.Take simple,high fiber diet.Start b12,folic acid with lactic acid bacillus.Cyproheptidine will be helpful to improve your appetite.Consult your family physician for further guidance and medications.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from fatty liver, left renal caluli. Back and stomach pain. Treatment required?\n\nHi sir, This is chitanya kumar research scholar from India. My mother K. Mary suffers with 4mm caluli in middle calyx of left kedney and Ub- partially filled.The doctor openion written as Fatty liver & Left Renal Caluli. Now she is suffers with back & stomach pain. Hence I request you sir please guide me which kind of treatment is required for her. what are the necessary actions have to be taken.......Please mail me back with all details. I am awaiting here for your positive response. My e-mail : YYYY@YYYY . Thanking you, yours faithfully K.Chitanya Kumar.",
    "doctor_response": "Hi friend, Welcome to Health Care Magic Fatty liver may be due to overweight or Dyslipidemia. Lipid profile and Liver function tests should be done. The kidney stone is small.  She must drink plenty of fluids - 4 to 6 litres a day.  Alkalising the urine may also help.  Repeat he scan after 3 to 4 months for follow up - by Urologist.... Take care Wishing speedy recovery God bless Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cyst in ovary\n\nI am 22 yrs old before a yr i had acyst in my right ovary after taking a course of medicine it was cleared but now i am having some tiny little lumps inside vagina which sumtimes has itching i daily have a dettol bath and use dettol soap previously these lumps came and after mensuration it dissappears but now a dayz it bcums less in numbers but they dont go permanently my doctor told me to take M2 tone fr 6 mnths so dat i can hav clear mensuration but now if i take take dat tonic i hav lot of pain while periods is dis very serious problem?plz tell me dr.",
    "doctor_response": "Hi,Thanks for the query to HCM.-I studied your query in depth and understood your concerns.-Cause of the cyst in  is--In your case it is due mostly because of -the acne of the labia majora of vagina.and would go with time.-Remedy--Treat by ocp to regulate your menstrual  cycle.-Gynaec opinion and antibiotics for x 5 day time would resolve these lumps.This would help you to plan treatment with your doctor.Don't worry and things will settleHope this would resolve your query.Welcome further for any query in this regard.Wishing you a fast recovery.Don't forget to Write a good review ASAP.Have a Good Day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for swollen cyst on the eyebrow?\n\nhai this is laxman ,male ,22years i have a cystic swelling on my right eyebrow ,it is effected from 4days and it is growing day by day from 2days i used paracetomol ,amoxycillin and TT injection to prevent septic what is the cure for my problem please give me the details",
    "doctor_response": "Hi,As this is of recent origin, there might be having ingrown hair follicle infection.As you are taking antibiotic, within a day or two it will be alright.If it remains same as before, there is possibility of having infected sebaceous cyst.Then consult your doctor and get examined.If cyst is there, it is to be removed with excision with sac.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen legs with fluid retention post heart attack\n\nA relative is type one diabetic. He had a mild heart attack 3 weeks ago followed by a massive heart attack 2 days later. The attack has left him with only 20% heart function. His legs are extremely swolen with fluid and because of this, cannot have surgery. He cannot lay down as fluid gets into his lungs. He has been re-admitted to hospital but doctors have not told us very much. He is 58 years old, not overweight and normally very active. He does not smoke and drinks only socially. Help?",
    "doctor_response": "Hello,I would like to tell you that swelled up legs and fluid retention is because of his decreased heart functioning. And the possibilities of having heart failure are very much likely.It is advisable for you to decrease the amount of oral fluids and consult with the treating cardiologist personally for physical and diagnostic evaluation. He may require dose modification or admission to ICU/CCU.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhanu Partap",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in buttocks and instability of leg after hip cupping?\n\nMy bottoms hurts yet I don t exercise and on the skinny side, my legs don t hurt but I m very unstable on my feet. One more thing, I m seeing double of everything. Any help would be appreciated And I m 35. Thank you.my name is crystal, one last thing, I ve been hip cupping since all this pain has started. Thanx again!",
    "doctor_response": "Hi Crystalbeing unstable on your feet and seeing double of everything is very concerning and calls for a thorough medical examination to determine the cause of these symptoms which can be related to brain or brainstem problems. your bottoms pain can be alleviated with some over the counter pain medication but you need to see a doctor for your other symptoms",
    "dialogue_context": ""
  },
  {
    "patient_message": "Asthma with chest infection. Given antibiotics, steroids, nebulizer. Still drowsy, nauseous, dry retching. Reason?\n\nMy 87 year old mum has just had an exacerbation of her asthma with a chest infection needing antibiotics, steroids, nebulisers etc and a stay in hospital. She was coming right but after 3 days of improvement now is excessively drowsy, nauseous and has epidodes of dry retching. We  think she is constipated also but What would be making her so drowsy?",
    "doctor_response": "Hi, Most probably the drugs she has taken to fight asthma attacks and chest infection. You can check what type of drugs she is taking for asthma, if there is any anti-hystaminic, that could cause drowsiness. Talk to her doctor to see if can change drug or lower the dose.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest heaviness\n\nmy father is 60 year old and he had a heart bye pass surgery last year and after that he again had angiyoplastic before 4 months, he is suffering for chest heaviness from last six months and all the reports are ok, he feels like lots of weight put on his chest and also lost hope for treatment and wants to die.  plz help us and suggest some treatment so we can same him...",
    "doctor_response": "Hi,Thanks for writing to Health Care Magic, I am Dr Asad Riaz, I have closely read your question and I understand your concerns, I will hereby guide you regarding your health related problem.chest heaviness may indicate some prob like stenosis going on again Bcs ur father ageing history of IHD with CABG n angioplasty , if he was my patient I would like to do proper exam n history that is this heaviness really symptom or he is just feeling Bcs of fear that he already had symptoms of IHD n will do X-ray to make sure it's not pulmonary after it will do ECG n ETT to see its not ischemia again or angio to see whether some artery is blocking or either stent is going to block Bcs it can be .. I would like to make sure that no serious damage is occurred n do echo too to see is there enough ability of heart to pump blood n optimise Tx n advice him for life style changes like not smoke if he is , not eat fatty food etc ..deprsion is comin in ch diseases Bcs of lmultiple drug needed for life long n still function is not improving well enough for which need to counsel about disease n symptomsI hope this answered your question, if you have more feel free to ask.Regards.Dr.Asad Riaz.General and Family Physician..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for stomach issues in child after formula feed\n\nYes hello my daughter is 6 weeks old . I haven t been able to breastfeed although I still try to at least once a day.i do however mostly formula feed For the last three days she has been spitting up a lot and having what looks to me like reflux and just looks very uncomfortable. I would like to know if there is anything I can do to help her. Thanks.",
    "doctor_response": "Hello. I just read through your question. If she is experiencing reflux and the reflux is causing her discomfort, one suggestion is to \"thicken the feeds\". This can be don't by adding half a teaspoon of rice cream to every 2 ounces of formula. This will often help. However, it is recommended yo discuss any possible remedy with your doctor before trying anything.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of dark spot caused by insects bites ?\n\nhow to get rid of dark spot caused by insects bites?And also want to ask what is the symptoms of Hives? Hello! I am Diana Carle 24 years old...I just wanna ask how to treat or remove dark spots on my skin caused by insects bites...I believed that the insects bit me are fleas from our dog...And I m kinda confious coz I m the only one who always got bit by the insects...At first it s itchy and it looks red then turning to dark spots...Mostly I got bit on my feet, legs and on my waist... And also wanna know what is the symptoms of hives?My skin is really sensitive..When I m outside and if its so windy or hot and if I wear tights clothes my skin get itchy and turns red...Ands it easily to get scar coz I can t help my sefl for scratching... I hope you can help me regarding this things...",
    "doctor_response": "Hi, Diana, You have got scars of insect bite. Take some antihisamines and marks are infected due to itching go for antibiotic course. Apply some moisturizing cream or triple action cream. you can apply Vaseline too. ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking treatment for Infertility, Suggested Siephen and gmh75 injection. Possibility to conceive?\n\nhello,doctor i m going through treatment of infertility since last 8 months..my doctor suggest siephen 100 last month..ovulutuon is ok and also rupture...m doc said everything is normal this month...but still can t conceive...and in progestoren report it was 6.7..so they said quality is not good...from this month i m takin siephen 100 and gmh 75 injection ...how s the possibility to conceive,,,pls reply",
    "doctor_response": "Hi, Thanks for your query. I read your query and understand your concerns. Following is my reply: siphene and gmh helps to grow follicles. please keep having regular follicle growth scans as you are doing. If still cant conceive, go for IUI as next step of treatment. I hope I answered your query. I will be available for any follow up queries you have. Regards, Dr.Mahesh Koregol IVF & Infertility Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pregnancy still happen during menstruation period?\n\nI am on my period and yesterday I had sex.  It is about the 4th or 5th day of my period.  It is a normal flow period.  He used a condom and waited for me to finish.  After I was done he got out of me still with the condom on, he was not near cumming.  Anyway he never came.  Is there any chance I'm pregnant or no?",
    "doctor_response": "Hello dear,I understand your concern.In my opinion there is no chance of pregnancy in your case.Usually there is scope for pregnancy when the semen is ejaculated inside or around the vagina during the fertile period.Roughly a week before and after the periods and period days come under safe period which means there is no chance of pregnancy even with unprotected sex.This is applicable only in case of regular cycles as the period can be predicted.So there is no chance of pregnancy in your case as it was done during the period.So relax.Avoid stress.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I got a wisdom tooth extracted five days back, why is it still bleeding?\n\nHi doctor, I had a wisdom tooth removed five days back. It was bleeding heavily until two days ago, but now the bleeding has mostly gone. But, it bleeds when I brush my teeth. Is there anything to do other than to put padded pressure on the void of the tooth?",
    "doctor_response": "Hi. I read your query and can understand your concern. Hope it helps. Regards. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will allergic treatment cause fatigue and weakness?\n\nHello doctor, I am facing constant tiredness, fatigue, lack of energy and weakness. I had left the non-vegetarian diet for a year or two. But now I am consuming it. I have recently treated for allergies and had a phase of amoebiasis. I had to consume outside food for about two months recently due to relocation. Please suggest something. I have done a urine and blood test yesterday. There was a lot of over exertion due to relocation for the past two months.",
    "doctor_response": "Hello. I have seen your reports. (attachment removed to protect patient identity).  Your urine and blood report are normal except for the presence of ketone bodies in urine which is usually absent in urine. The reason for that usually are diabetes ketoacidosis, starvation ketoacidosis, etc. Check your random blood sugar level to rule out diabetes. The increased metabolic activity also can also lead to the appearance of ketone bodies in urine. So check hyperthyroidism also by serum TSH (thyroid-stimulation hormone) estimation which also can lead to weakness. For weakness, anemia and liver doses has been ruled out here through reports. Check for serum urea and creatinine to rule out kidney disease. If you are drinking alcohol then provide history about that. And finally, you can check serum sodium, potassium and calcium levels as well. If all these are normal then over exertion due to the relocation can be the possibility for your tiredness. For amoebiasis, get treated by Metronidazole. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Difficulty swallowing, muscle twitches, weakness, clean EMG. Scared\n\nI have had some difficulty with swallowing at times I feel as if I can t seem to swallow its like it is stuck in miss stream......then I panic...I have had muscle twitches no weakness for almost a year 2 clean EMGs and nerve conduction test...only in legs and upper limbs my neuro assures me it s not ALS... Scared and feeling like I am going crazy.",
    "doctor_response": "Hi, Thank you for posting your query. First of all, I would like to reassure you that your symptoms are not suggestive of ALS- amyotrophic lateral sclerosis. ALS is a progressive disease. In your case, there seems to be no progression of illness. Moreover, EMG (electromyography) test is diagnostic in ALS. In your case, EMG is normal. This rules out the possibility of ALS. So, there is no need to worry. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "is there any side effect of thyronorm?\n\nI m diagnosed to have hashimoto s throiditis..i m 19 nw... i take thyronorm 100mcg on advice of a doctor.... but i m havin loose stools for the past one month on and off.... my weight is 46kg..... is the does high for me??? whether it is the side effect of thyronorm???",
    "doctor_response": "Hi,If used in optimal dose thyronorm is well tolerated by most of our patients. However, it may cause nervousness, tremors, heat tolerance, increased heart beats, sweating, diarrhea, and weight loss. Consult your treating doctor for a possible dose adjustment so as to have TSH level in the range of 0.3 to 3 mIU/L.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in upper jaw\n\nHi doc For about a week now I have been suffering from upper jaw pain radiating below the ear. It appears sensitive when I open mu mouth even wider. The pain is only on my right side and I have not experienced any swelling thus far. What could be causing it and which treatment may help. I m 8 weeks pregnant.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It might be due to TMJ (temporomandibular joint) dysfunction. As of now, you can take analgesics like Paracetamol (it\u2019s safe in pregnancy) and avoid excessive opening of mouth. If symptoms persist, consult an dental surgeon. Wishing you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of consuming Livolin Forte in the short & long term ?\n\nI am 53 yrs male non-alcoholic. Height 164 cm & weight 84 kg. Total cholestrol 5.1 mmol/l with zocor medication. Recently my blood chemistry (liver function test) revealed that my SGOT/AST & SGPT/ALT readings of 132v & 232v respectively. My doctor explained that I am having fatty liver . He then prescibed me to take Livolin Forte capsules twice (morning & at night) daily. Can doctor explain to me more about the readings of my liver function test (SGOT/AST & SGPT/ALT) whether very alarming or not ? What are the side effects of consuming Livolin Forte in the short & long term? Thank you. Hamzah Nassir.",
    "doctor_response": "Hi Welcome to HealthCareMagic Forum The normal level of SGOT - 35to70 and SGPT - 15 to 40 range.. your liver enzymes is moderately elevated..  since the liver enzymes are high if you are Alcoholic then you must stop immediately, because it will lead to further damage.. the tablets given to you contains of liver protective agents and vitamins.. there wont be side effects...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with spinal stenosis & could endometrosis cause sciatica?\n\nI have a l4-5 bulging disk. I have been diagnosed with spinal stenosis. I had two spinal epidurals. The first one worked and the second one did not. The second one caused vaginal bleeding. I had an ultrasound and everything was clear. I had cramps and bad sciatica with the bleeding. I am a breast cancer survivor and was on tomaxifen. Could endometrosis cause sciatica? My periods have been Been severe since my completion of tomaxifen. My ob/yn says my bleeding issues are a result of perimenopause and my vagianl ultrasound have been clear. I Am I crazy for trying to link the two problems?",
    "doctor_response": "Hi, Let me clarify that there is no connection between your endometriosis and sciatica. two are a completely different entity. However, I do not have your MRI scan but if you do not have relief from epidural you definitely need surgery for sciatica and please, continue the treatment advised by your gynecologist. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jaideep Gaver, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a tooth infection be treated?\n\nI had a tooth infection and was prescribed augmentin I have been taking it and started getting symptoms of a yeast infection, I took one day treatment miconazole but it didn't relieve the symptoms so I now have purchased 3 day treatment but at 4% I used it last night but when I used it it seem to make it worse the symptoms do feel a little bit better is this normal",
    "doctor_response": "Hi. Thanks for the query Augmentin is an antibiotic and many a times taking antibiotics can cause yeast overgrowth due to reduced resistance to infection as the antibiotics can kill the good bacteria along with the bad ones. This can cause overgrowth of opportunistic organisms like yeast. So it is better to get a prescription of anti-fungal medications after getting a proper prescription from the Physician. You should also eat more of probiotics like Yogurt and garlic. Hope this helps Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is there blood after brushing and gargling at mornings?\n\nHi,I am having a problem from the past few days, that when I burshing my teeth in the morning and then gargling a small amount of blood comes out. But it shows only in the morning.I usually smokes a 3-4 cigrattes day. Please help me out to confirm which medical test I used to go for. Any precautions I have to follow.Thanks",
    "doctor_response": "Hello,  Read your query,  as you have blood after brushing and gargling at morning dont worry this is bleeding from gums is seen in patients with deposition of food debris and calculus at subgingival areas of gums , leads to condition  gingivitis and periodontitis inflammation of gingival and periodontal fibres , as you have smoking habit also this also causes gingival fibres and periodontal fibres inflammed.  For this you should consult dentist and go for oral examination and Scaling and root planning , in meantime you should do warm saline gargle two - three times a day,  Do chlorhexidine mouthwash , maintain proper oral hygiene by Brushing twice daily.  Hope this will help you. Regards, Dr. Priyanka tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can having gallbladder stones impact cholesterol reading?\n\ni have had a cholestral reading of 9.4 and been prescribed statins......i eat a ver healthy diet so it may be linked to family. Hovever before i take the statins i was wondering if never having had my gall bladder removed ( i have stones) could be misguiding the diagnosis?",
    "doctor_response": "Hi,Increase in cholesterol level is among one of the factors responsible for formation of stone in gall bladder, its not mandatory that all gall bladder stones are made up of cholesterol. Keep taking statins in dose as advised by the cardiologist. Follow life style modification and repeat your lipid profile after 3 months.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Rini",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on left side of lower abdomen?\n\nThere's a still lump in the left side of my lower abdomen sort of by my hipbone, above/to the left of my uterus. The lump doesn't extend past my adominal wall, so it's not visible, but I can easily feel it and it's different from my right side. The same stiffness/mass/whatever it is can be felt in my upper vaginal wall.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  You an feel mass inside left lower abdomen.  You may have enlarged spleen or ovarian or uterine mass. You should go for ultrasound abdomen. 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red spot in the pubic region with unprotected sex?\n\nI had unprotected sex and have since found a red spot in my pubic region, it has a white almost scab like ring around it. It doesnt itch or hurt and there is no symptoms anywhere on my penis or gentinals. Im quite concered however i was told it could just be an ingorwing hair. Should i be worried?",
    "doctor_response": "it could be herpes or std infectionI would get it checked out.Please rate 5 Stars! I strive to provide the best answers to your questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to have normal pregnancy after having tubal pregnancy history?\n\nI am 30 years old and have only been pregnant once it was a tubal pregancy about 4yrs ago I had pid at 19 and had it taken care of.. nd no problems since ..I hv a normal period and would lk to know is it possible for me to hv a normal pregnancy I so want to mk a family and I'm only getting older..what do I need to do please help me",
    "doctor_response": "hi,you can have a normal pregnancy.the tubal pregnancy would have occurred because of previous history of pid.but in all likelihood your other tube must be patent so you should have no difficulty in conceiving.just keep one thing in mind that as soon as you conceive you must get an ultrasound done to confirm the site of pregnancy to rule out an extra uterine pregnancy.all the best take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have been detected with a tuberculosis lump. How long it will take to dissolve?\n\nHi doctor, How long should I take treatment to dissolve a tuberculosis lump? I have been detected this lump two years back. I showed it to the doctor where I was asked to take RHE-FD for two months which got extended to three months and stopped but the lump was not completely dissolved. Then again I got another lump near neck a year back and I again started the medication, which is still continuing. Within which I got the third lump and was operated and after culture test all the reports were normal. I was about to stop the medicines but the first lump now has become little big and now the doctor has asked me to have R-Cinex 450 for three months and stop RHE-FD. The lab tests performed were FNAC, histopathology, culture TB MGIT & identification. I just want to know that is this the symptom of a serious issue? Please suggest me a good suggestion as I am now fed up with it and want to get out of it.",
    "doctor_response": "Hi. Any anti-tuberculosis regimen has to be taken for a minimum of six months for pulmonary tuberculosis and nine months for extrapulmonary tuberculosis. Your tuberculosis appears to be extrapulmonary. There is no indication to stop treatment after three months even if tests are negative. I would advise you to visit a good pulmonologist and get yourself checked for drug resistance and restart anti TB treatment. Tb is completely curable if proper and complete treatment is taken. So, do not worry. For more information consult a pathologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a bony outgrowth from femoral shaft in a child\n\nhi doctor , my son age is 12he develop some lump in his left thigh while going through a x ray we found bone enlargement report says\"medical aspect of distal femoral shaft shows a bony outgrowth with short peduncle\".knee joint is normalplz give me suggestions regarding this'",
    "doctor_response": "Hi...by what you quote it looks like a neoplasm. It can be either benign or malignant. It requires a bone scan to ascertain or a bone biopsy to ascertain the same. I suggest you consult your kid's orthopedic surgeon for the same.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sensitive teeth, throbbing pain. Due to reduced enamel?\n\nI've just started getting sensitive teeth (front top & bottom), assuming it was related to cavities I made a dentist appointment, however he said I've been looking after my teeth and they were all ok. He said the ache would be caused by reduced enamel & to use sensodyne, however this has made it worse and when I go for a run the throbbing pain after is awful..... What is causing this?",
    "doctor_response": "Hello and welcome,The sensitivity may be due to -bone lossperiodontal pocket,gingival recession and regressive changes like cervical abrasion and erosion.I would advice you to brush your teeth using soft bristled toothbrush in back-forth and up-down motion.Avoid vigorous brushing methods.Get your teeth cleaned.Bone loss has to be corrected by bone grafting methods.Exposed dentin as well as root portion of tooth has to be corrected using tooth-coloured filling materials.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for bulging disc causing pain and cramps in the leg?\n\nHi, I have a bulding disc in L5 - S1 that causes pain, cramps and charlie horses in my leg. There are lots of nights i can not sleep because of the pain. I have tried injections and NSAID s with little or no results I am scared because you hear stories of poeple having this type of surgery and are paralyzed. My back feels swollen in my L5-S1 area and my kidney hurts too. What would you do doctor.",
    "doctor_response": "Hello,I will suggest you to go for surgery but when once a careful review of your MRI spine and other blood tests and a physical examination along with a detailed history has proven it to be disc problem. Being a mechanical injury, it is not possible to fix it with medicines only. Every surgery has its complications just like crossing roads has it's own.  But it doesn't mean you will never cross a road. The benefit of getting a surgery done is far more and chances of getting paralyzed is very very low in a specialized unit of surgery.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Muhammad Faisal Bacha, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cold pain in butt cheek?\n\nhello, every now and then i get this really cold pain that is from my right butt cheek to the inner thigh thru my leg and down into the bottom of my foot. it hurts without touching it and its worse when i walk or i come in contact with cold materials. what is going on?",
    "doctor_response": "It seems that u may have peripheral vascular disease..if u r a smoker ,stop smoking.Dont stop walking due to pain,walk intermitttently.Another possibility is u may have aome spine problem which is compressing nerve root and causing pain..so get xray LS spine done.And most important mention ur age,sex  and type of work u r doing.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does persistent low grade fever and headache in children need medical attention?\n\nI have a 4 year old daughter. Yesterday she complained of a headache. Last night she was running low grade fever. This morning she complained again and was running a fever of 101.3. I gave her some ibuprofin, which helped for a couple of hours then she was running a 101.5 fever. In less than 4.5 hours she is running fever again and still saying her head hurts. No other symptoms. Should I take her to the doctor? She is 4, weighs 34 lbs and is a healthy child.",
    "doctor_response": "Hi,Fever usually takes 2 to 3 days to subside. You will need to give her acetaminophen in alternation with ibuprofen. This will help the headache too. This is most probably a viral infection and will subside within 3 days. If the fever does not subside after 3 days this means it might be bacterial and that requires an antibiotic.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Salah Saad Shoman",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will Osteo Biplex work for hip pain?\n\nI want to start running on the treadmill, but experience pain in one of my hips from time to time. Would a product like Osteo Biplex work? I want to start running on the treadmill, but experience pain in one of my hips from time to time. Would a product like Osteo Biplex work?",
    "doctor_response": "HelloCan try but should start training based on how much your body can tolerate.Start with slow velocity, and then gradually increase the speed to the point you can tolerate.All the best.Dr.Albana Sejdini",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are chances of getting MRSA infection from children?\n\nHi there I'm a nanny of 4 and they have had mrsa going back and forth between 4 family members for about 6 months now.  The mother has been down-playing the illness so I didn't know that it was so severe until I just started researching it today.  Currently 2 family members have it.  I haven't seen any symptoms in myself but I'm wondering if I should quit before even going another day so save myself from getting it...or if I'm just over reacting?",
    "doctor_response": "Hello,Welcome to Health Care Magic.Thanks for writing.I am Dr.Nitasha Khan. I have read you question completely, i understand your concern and will try to help you in best way possible.wel to get mrsa you need to have source like wht is the source of their infection how did thy get sick find that out and also you can get sick only if you dnt take care as long as you dnt have any cntact with the patient like you dnt touch thm have their food you wil be fine I hope this answered your question.If you have more queries I am happy to answer.Otherwise rate and close the discussionRegards.Dr.Nitasha Khan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should a home pregnancy test be done for delayed periods?\n\nRecently diagnosed with HPV.  Two weeks late with my period.  I am 54 years old.  My nipples are tender and I need to check if I am pregnant.   Seeing my OB later this week to discuss the HPV diagnoses, should I take a pregnancy test at home prior to seeing the doctor?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Yes, you can do pregnancy test at home, there are many kits available these days, collect the first morning midstream urine for the best results. It is always better to do it in a laboratory for accurate results. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nupur K.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for swelling and pain noticed on leg\n\nHi- I slipped on a wet wood floor. I have a bad leg which caused instability. Looks like I blew a vein on my foot. swelled to about a quarter size. Hurts. But have elevated and iced. I assume it will take a few days to heal and I am not at risk. I have other medical issues.",
    "doctor_response": "hi,as you provided the mechanism of injury and also for swelling you been putting legs elevated and icing also. I will advice to futher add on simple ankle toe movements as it will help improve the hemodynamics of the vascular system and the swelling will come down. you can take an x-ray on a safer side or else you can wait for 72 hours to observe the swelling. Post that if the swelling still persists i will advice you can I take a scan and Doppler the vascular system to rule out the possible causes. with the grace of God I wish you a speedy recoveryregards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal distension while suffering from fatty liver\n\nI am suffering from liver problem since last 3 years and my main problem now is my tummy which is day by day coming out and giving sabby look to my body. My doctor has prescribed me UDILIV 300, SUPERIA L and Gelusil syp with LACTIFIBER for 2 months. Can you please suggest me better medicine which will cure me early as I am having Fatty Liver.",
    "doctor_response": "HelloFatty liver is due to deposition of fat within liver cells.It is a reversible condition.Fatty liver may be due to many causes like obesity,sedentary life,hepatitis,altered lipid profile,metabolic disorder etc.Thyroid hormone level should be estimated in your case.You may need few more investigations like routine hemogram,liver function test,lipid profile,thyroid profile,urine RE/ME.Try to reduce your weight if BMI is high.Avoid alcohol if you take it.Go for brisk walk regularly and take lot of fibers in your food.Avoid saturated fat and fried food.You have been prescribed right medicines,you should take it continuously.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Burning sensation on the tip of penis after urinating.Treatment?\n\nhi doctor my problem is this every now and then after i urinate about 10 mins after i do i get a slight burning pain in the tip of my penis it makes me feel like i want to pee again once ive pee'd again it tends to go away and i might not have any pain after i pee for days after but then it will come back every now and then i noticed tonight that the area around my japs eye is a bit red as well its more annoying than anything. the last time i had sex i wore a condom which didnt split and havent had sex in about a year prior to that",
    "doctor_response": "Hello, It may be infection or diabetes. Check blood sugar. Check urine for culture. Try Kegel exercise to have better control of urination. The pain may also be because of stone. So, you should do kidney ultrasound. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Sujoy Dasgupta",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does pain in right side of lower abdomen indicate appendicitis?\n\nI have been having a slight pain on the right side of my lower abdomen approximately 6 inches right of navel and have been constipated for 3 days. The pass 4 months Ive been drinking alot more do to a break up but have stopped and now im scared i may have appendicitis or something cause from drinking. I have been on web md all day. please help!!!!!!!",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.Web MD will confuse you more as there is no interaction with the Doctors. The cause of mild pain on consuming so much alcohol on the lower side of abdomen can be due to Colitis or typhilitis or appendicitis. I would advise you the following:Tests of blood, urine and stool. Physical examination by a Surgical Gastroenterologist.CT scan and colonoscopy will help in the proper diagnosis and for planning the management ...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Undergone two miscarriages and D&C, scared of getting pregnant. Precautions for future healthy pregnancy?\n\nhi doc, i had my twice miscarriage and had undergone d and c operation last february7,2012 AND January 5,2013.. first miscarriage is due to oblated ovum and the second one was due to no heart beat. i am so traumatize and scared that it might happen again if i try to get pregnant. i already have 5 kids but still want to have one. what will i do to have a future healthy pregnancy?",
    "doctor_response": "Hello,Having 5 kids with previous 2 miscarriage are always great risk for next pregnancy. Multipara women are always associated with recurrent miscarriage.Plan next pregnancy with some initial investigations like USG lower abdomen, Test for chromosomal abnormality, TORCH profile, Thyroid profile, PPBS and Progesterone level. Also take Folic acid & Vit-E supplements for at least 3 months in preconception period. Consult with your gynecologist.Try to avoid following things (preferably in the 1st trimester):1) Any type of sexual activity/intercourse2) Long journey/stepping uneven surface/heavy work3) High heel shoe (risk of fall on ground with miscarriage)4) Unprescribed/unsafe medication to avoid defective organogenesis.Be well and wish for successful motherhood once again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should Pradaxa be continued to treat blood thinning?\n\nI am on pradaxa - the new blood thinner.  I was diagnosed with erosive gastritis a year ago and spit up bloody sputum every morning when I awake.  It gathers in my mouth when I sleep, and shows only in am.  It seems to be minor.  The pradaxa keeps me from having angina.  I feel that I need to take it.  What should I do?",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Bloody sputum usually signifies, problems with oral hygiene.2. Meet a dentist for evaluation of gums, teeth or any ulcers.3. Pradaxa, if it causes gastritis, and bleeding, it would have showed in stools, as dark colored stools. 4. Presently Pradaxa is not causing any erosive gastritis. Causes of bloody sputum appears to be in mouth. ENT and dentist evaluation will identify cause. Need to look for tumor too.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a painless lump in the nipple of the right breast of a male due to an underlying medical condition?\n\nI am a male who has a painless lump in my breast just to the left of my nipple on my right breast it doesn t cause any pain, but when I touch it its sensitive and sore on and no visible signs as it is a flat lump under the skin what do you think it could be ?",
    "doctor_response": "Hello, I have gone through your question and I understand your concerns but this is probably due to a lipoma formation or a lymph node reaction. However, I would recommend that you get a mammogram to exclude tumour formation. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest a good formula food for an infant\n\nHi I have a 9 month old baby and i get help with formula from WIC they only give me 7 cans of formula and sometimes i end up running out of formula like a week before i get issued out again. Are there any other formula related things i can give my child like Nido? My baby drinks Enfamil A.R.",
    "doctor_response": "Let me emphasize on the fact that breast milk is the best feed for a baby upto 6 months of age. Beyond that, the baby needs a mashed version of adult diet low on spices. Milk becomes an optional component at this age if other sources of nutrients are included in diet. Nido, Enfamil or similar products may be given but I would prefer home made semi solids made from boiling rice and pulses along with vegetables and giving it after mashing it. Most of these would be more nutritive than the available formula and so I would not speak in favour of formula foods.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the cause for increased bilirubin level?\n\nHi doctor, Recently, I had increased bilirubin level around 1.6 mg/dL. But now it is decreased to 1.2 mg/dL which is at the boundary level. Can I do an exercise like skipping, running?",
    "doctor_response": "Hi. Coming to the serum bilirubin, it is a breakdown product of hemoglobin. Any increase in bilirubin level is needed to be assessed for liver enzymes and HBsAg (hepatitis B virus surface antigen), to rule out the cause. Bilirubin can increase due to: So, to confirm the problem, we need to do full liver function tests. Yes, you can do exercise at this level of bilirubin. Normal bilirubin is total bilirubin ranging from 0.1 to 1.2 mg/dL with direct being less than 15 % of the total bilirubin. For more information consult a family physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with diffuse parenchymal liver disease. Possibility of liver damage due to heavy drinking and obesity. What could be wrong with my liver? what should I do for proper diagnosis?\n\nHi. I was diagnosed with Diffuse Parenchymal Liver Disease after an ultrasound recently, but my liver is of normal size and is not enlarged in any way. My doctor and I ruled out hepatitis after hep profile, and he said that it was likely old damage from my heavy drinking days or damage based on my obesity and that it was not impeding the regular functions of my liver (based on blood tests). He also said the problem would go away if I continued to lose weight. However, a nutritionist who was supposed to help me construct a program to lose weight turned me away for my own health because of the diffuse parenchymal liver disease, so now I am worried. Could it be something more? What could be wrong with my liver and what steps should I take to diagnose it properly?",
    "doctor_response": "Hepatitis or \u2018inflammation of the liver\u2019 is caused by several factors like drugs, alcohol, toxins and inherited diseases. However, usually by hepatitis, we mean viral hepatitis or hepatitis caused by viruses A, B, C, D, E and G. In India viruses A, B, and C are common causes of hepatitis. Most of the complications that arise from liver diseases can be treated in early stages through dietary changes and medication. However, when these treatment options become ineffective, liver transplant becomes the only available solution.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am i having discharge from urethra?\n\nI noticed what appeared to be a single pimple on the side of my penis.  It was rather hard and of course freaking out... I popped it.  Today as I went to urinate, I noticed a discharge from the urethra.  I am not sure if either of these have anything in common, but would like someone's opinion on what it can be...",
    "doctor_response": "DearWe understand your concernsI went through your details. The discharge you had from your urethra, may not be having anything to do with the popped pimple like eruption. The discharge is simply your semen itself which is escaping through your urine. This is a natural procedure and happens many times. You just noticed now. Don;t be alarmed and don't relate it with any other health conditions. Take care.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful lumps on the mouth\n\nHello Doctor. My name is steve and i recently got canker sores in my mouth. but when i started to see if they are cured or not in a couple of days, i found 2 circular lumps inside of the LIPS. the right lump is big in size than the left one. Now, its 10 days and the size of left lump is slightly decreased and size of the right lump is same. I used to smoke 20+ cigarettes from the past 3 years, but i recently stopped before 1 month. Also, i got these canker sores and lumps only after i stopped smoking",
    "doctor_response": "Hi..Can understand your concern..As per your complain and explanation of the symptoms it seems that you have   Mucocele which is a false cyst and is formed due to trauma to the inside of lips leading to injury to minor salivary glands or their ducts leading to spillage of saliva into the soft tissues and formation of lump..Trauma can be caused due to lip biting, or any other trauma..There can be formation of multiple mucoceles also..I would suggest you to consult an oral pathologist and get evaluated and in case if it is a mucocele, many a times it gets healed by itself but in case of large mucoceles and long standing cases surgical removal has to be done..In case of long standing mucoceles which are small in size laser ablation can be done..You can do concentrated salt water rinses as it also helps in shrinkage of thelumps.. Hope this information helps..If you find the answer helpful kindly write a positive review and click on found this answer helpful as a token of appreciation..Thanks and regards..Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can coughing, breathlessness, swollen feet and vomiting be treated?\n\nbeen coughing for 3-4 days. have shortness of breath, swollen feet, when lie down breathing becomes tougher, heavy snoring, wake up in the middle of the night to cough and catch breath, on 4th day vomited, if breathe out the lungs sound like a heavy smoker of many years..",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, we should definitely rule out heart (congestive cardiac failure) and lung (acute bronchitis) related diseases. So better to consult doctor and get done ecg, 2d echo, chest x ray and PFT (Pulmonary Function Test). Ecg and 2d echo are needed for heart failure. Chest x ray and PFT are needed for bronchitis. You may need antibiotic, diuretics, bronchodilators and other supportive drugs on the basis of diagnosis. Don't worry, you will be alright with appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause painful hips after taking trigger point injections for lower back pain? Taking Neurotin and Perocet\n\nHi! I had trigger point injections done Thursday of this week at my Pain Management doctors appointment to help with low back pain. I suffer from fibromyalgia and my question is, I m having more pain in my right hip down into my butt area since receiving the injections. This pain was not there before the injections, I m not quite sure what to do about this? But, I can t sit and I m very uncomfortable. I do take Percocet 4 times a day and Neurotin 300 mg 5 times a day. Any advice will be great, should I place a call into my pain doc this weekend? I have tried a heating pad on it but no relief. Thanks!",
    "doctor_response": "Hi there. Your symptoms correlate to either local infection at the injection site OR irritation of the Sciatic nerve .Heating the area will make things worse.  Apply ice packs over the area 4 to 5 times daily. Take an anti inflammatory like diclofenac. Antibiotic like cefuroxime will take care of any infection .Take pregablin to suppress any nerve irritation. If all these remedies do not relieve the symptoms then kindly consult your pain specialist. I hope my advice has helpedGood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will intake of Concerta instead of Adderal and Paxil reduce depression in a teenager?\n\nA friend of mine at work says her teenage dautghter is on Adderal and an antidepressant.( Paxil) The daughter is still depressed. The mother wonders if Adderal is resulting in depression. She asked about Concerta. I heard that Concerta often is not effective. The daughter will be going to counseling The daughter gets good grades and does not want to stop the Adderal. As any teen she resists mother s suggestion to get involved in other social activities. Any suggestions on how to encourage socialization and any thoghts about medication?",
    "doctor_response": "Hi,Welcome to Health care magic forum.                It appears that she needs social allignment. She should be made to mingle in the community. She should have a group of friends. Should be taken to the functions, and allowed to go to out stations.                  Encourage her to take more of green leafy vegetables, pulses, sprouts, and protein rich foods,to have good health resistance against the infections.                Depend only on doctors for the drugs.                 Never talk about her health before her.                        Wishing for a quick and complete recovery. thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower abdominal pain and nausea in children?\n\nYes. My son is 10. He has been sick for 7 months. He complains of pain in his lower abdomen (colon area). He has nausea but not really throwing up. They have him on amitriptyline(anit depressant) to help dnumb the muscles & nerves. But all his blood work & tests came back good. But they did not run a colonoscopy. Is it possible for him to have colon problems and it not show up in blood work. My mom has crohns since she was small. Her Gi dr says colon trouble can be silent & my sons drs could be missing it. Without a colonoscopy they cant rule it out. Is this possible?",
    "doctor_response": "Dear Parent,Your child's long lasting lower abdomen (10 months) pain is a cause of concern. Given a family history of Chrohs disease it is pertinent that Crohn's disease is ruled out in your child. The most definitive test for Crohn's disease is to take a small sample of tissue from his colon( biopsy) during colonoscopy  and study it under a microscope. It is surely possible that your child can have Crohn's disease with  a normal blood work up. I suggest that you consult a gastroenterologist as soon as possible who can help diagnose your child's condition and initiate appropriate treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest an alternate syrup to Niftrans\n\nMy son age 2years has been operated for VUR(reflux Grade IV as per MCU) in the right ureter.He is under Septrans (prophylactic) till September 2011, again he suffered from fever due to UTI and doctor prescribed 3ml niftrans(syrup strength 25mg/5ml) as prophylactic. Sometimes he used to vomit after consuming Niftrans.Is it the effect of Niftrans.Please advise other alternative of Niftrans in syrup form as tablet of such low strength is not available.",
    "doctor_response": "Hi...your pediatrician is very much right in suggesting this syrup. This is Nitrofurantoiin and the answer to your question is yes - Nitrofurantoin can cause vomiting. If you want me to suggest an alternate medicine to Nitrofurantoin, I need to see the urine culture and sensitivity of the kid. I will be glad to suggest you an alternative medicine after seeing the report if you can upload it here.You can approach me at the following link. Please find the link below - www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does the dog bitten place need a surgery?\n\nmy friend has a dog bite about 4 weeks old below the knee it ocurred when he was in crete. The dog punctured a vein and he had a rabies jab. He is being seen 2x a week at his health centre in isle of white. His wound now smells necrotic and he is back on penicillin again. How likely is it that he will get better without radical surgery? I appreciate this is an impossible question but I am concerned that he will need to have his leg amputated",
    "doctor_response": "Hello, sad to hear about your friends problem, If I am your treatment giving doctor I would like to tell you that such necrotic leg requires a surgery there is no way that you can save it. But you can give it a try add metronidazole drug in your regimen some times in bite wound there is probability anaerobic infection. It will help you in treating the wound. If you want to ask something you can ask me. Thank you Dr. Arin Tank. Infectious Disease Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could anxiety cause slow heart beat and dizziness?\n\nI have been having symptoms of a slow heart beat .some times I wake up dizzy feeling my heart beat beating slow .I have seen my pulse on a finger oximeter. I have a reading of 42 sometimes 50 I have been taking atenolol for 8 years 50 mg for heart pelps. i have been to the emergency room had a ecg xray blood test all normal could anxiety be causing this ?",
    "doctor_response": "Hi, thanks for the question. I can understand what you must be going through. Anxiety is a condition where person has increased heartbeats, increased pulse, sweating, tremors, restlessness, feeling that something bad is going to happen or he/she is going to die etc. All these symptoms are due to increased autonomous nervous system activity. As I have already explained that in anxiety states there is increased heart beats and palpitations. Anxiety states don't lead to reduced heart beats. In your case the reduction in heart rate may be due to Atenolol. Atenolol is known to reduce the heart rate. Also feeling of dizziness after getting up may be due to a condition called as postural hypotension wherein there is reduction in blood pressure when person gets up from sleeping position. This again is caused by Atenolol.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had back surgery. Have degenerative disc disease, spinostinosis. What can help the pain?\n\nI had back surgery in may 2012. Wondering if there is harm in having a pain patch and taking an oral narcotic? Cause I have been taking pain pill now for about 5yrs, and they do not phase my pain. I have degenerative disk disease, spinostinosis, and thinning of my spine. Have to see my doctor tomorrow, and just need to know how to go about talking to him about still staying in constant pain. I do not have a daily activity life-style. Have any suggestions?",
    "doctor_response": "Hi Thank for choosing HCM, You are taking pain killing pill since 5 years, now you wont get much relief from this pill you will have to either increase the dose or take potent narcotic pain killing pill, in my opinion if you can hold your self in state of pain and let the threshold of pain comes (Top level of intensity of pain ) then it will decline slowly it self, it is difficult but try it, meditation is also a good, you can try this too, discus it with your doctor ask him for alternative remedy for pain, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause a bruise on the lower right abdomen between naval and hip bone?\n\nI have a light bruise on my lower right abdomen, centered diagonally between my navel and hip bone. It feels sore to the touch and may have a small lump. Looks as though my veins are connected to the bruise and there is also a small red pin prick type of sore. What could this be?",
    "doctor_response": "In my opinion this is inguinal hernia i recommend you see an internal medicide doctor before it does any complications or increase",
    "dialogue_context": ""
  },
  {
    "patient_message": "How is Hepatitis C transmitted?\n\nI have bedbugs in my apartment. I was hospitalized with cellulitis Oct 2.. I thought it was spider bites. Turns out if is bedbugs. I think I got them from a neighbor here in my building. She has hepetitis C and because I am so sick she would come visit me and we would hang out in my bed and chat and watch tv..etc. I know without much doubt they came from her. I am worried that the hep C could be transfered to me if the same bug bit us both. Worried. Also, I cannot get my complex to help me. I have been saving live bugs in a pill bottle. Do you think if I went to ER with my evidence they would document it for me and help me? I have them in my vagina and have no idea what to do. deb",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Insect bites are known to transfer hepatitis C.2. If worried, you can get a serological test or an antigen test done for hepatitis C3. Not to worry, live bugs are not necessary. Other infections can be transmitted through bed bugs and secondary infection is also possible. Discuss with your doctor.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is working out in gym safe with incomplete right bundle branch block?\n\nHi, may I answer your health queries right now ?  Please type your query here... I am 23 year old suffering from Incomplete right bundle brunch.Can i join jim or can lift heavy instruments. i am internally felling too sick.I need tips to protect myself",
    "doctor_response": "Hi ThereAfter going through your query I understand your concernI would like to tell you that RBBB ( Right bundle branch block ) is normal in some significant no of adult males. You can live your life normally.You can do your gym but it's advisable not to overt exert yourself whenever you feel tired stop there right away and rest.Hopefully this will answer your query.Kind RegardsDr Navneet Mahajan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden loss of consciousness with abnormal heart beat?\n\nHi, I collapsed while setting off for a jog (I was only about 5 houses away from my house/on the same street) when my heart thudded and my legs went from underneath me and I collapsed to the floor. The next thing I knew I was on the ground. Is this just caused by hyperventillation or is more significant? I've also had extrasystolies",
    "doctor_response": "Hello,Here we need to evaluate for the cause. Do you have any other disease like any chest pain, or history of heart attack. Although hyperventilation is can cause these symptoms we still need to evaluate the cause. For this you'll need one holter monitoring. If its showing some abnormalities then further test will be guided accordingly. Also, are you taking any drug at present.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "What caused a sore lump in my abdomen?\n\nI have a sore lump, almost feels like a muscle strain in my abdomen, Its about 2 inches in diameter starts in the top of my belly button and goes above it about center. I did some strenuous activities over the weekend and I don't know if I did something bad. Please help.",
    "doctor_response": "Welcome to Health care magic.It could be umbilical hernia, as you describe (some strenuous activities) which can only happens in the hernia when the bowel in the herniated content with peristalsis will feels like that.The pain could be due to the strangulation of the herniated content.Suggest you to see your GP as soon as you can and get it examined and ask for an ultrasound - helps to evaluate the nature of the lesion, its source and extensions and any associated pathologies. Further it cane treated accordingly.Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring stomach pain?\n\nHi doctor I keep getting pain in my stomach it swoops from left to right iv been in and out of hospital but no one needs to know what's wrong I'm also going for a wee alot I have the coil inane I don't have a temp and it comes and goes  please email back to  YYYY@YYYY",
    "doctor_response": "Hi.The pain in abdomen from left to right and repeated visits to the hospital indicate you have to undergo proper clinical examination by a General / Gastro Surgeon and undergo following investigations. Blood- complete blood picture, kidney functions tests, blood sugar fasting and post-lunch, Urine- routine,microscopy, culture and sensitivity ( before start of antibiotic)Ultrasonography of abdomen.Enteroclysis to decide whether you have intestinal Obstruction.Undergo surgery to get the problem corrected.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes medial knee pain?\n\nI have knee medial knee pain. Movement to is not restricted. If I use my fingers to try to find where it is tender I find nothing when my leg is extended when bent and I feel the centre of my knee on the inside it feels tender. I cannot be specific when the injury occurred it seemed to come on gradually. I played tennis on Tuesday. All ok. Then Friday a one hour coaching session all ok. Saturday morning a little stiff but no pain. Played 2 hours Saturday morning. Sunday morning a little stiff slight pain. Stiffness went, but if I moved quickly I got pain. I was playing a tournament. Sunday evening stiffness and pain but not severe but two sharp twinges. Today about the same and a couple of sharp twinges. I have for a few years been unable to use a stationary exercise bike because I quickly get the same pain that stops as soon as I stop pedalling. I do not get the pain riding a road bike or running. There is no swelling or heat. Any ideas?",
    "doctor_response": "Hi,Thanks  for  your query.your pain is due to Arthritis. When bone is not able to take weight due to arthritis than it has to be shared by muscles. It causes pain in thigh and calf muscles.Also some time it can be due to nerve compression. You can judge your self. If your pain increases on walking and relieved with rest, it is suggestive of nerve related pain.Arthritis pain is present even when you are taking rest.I will suggest you following.Hot water fomentation. Volitran ointment Tablet Pregabalin M one daily at night time .Calcium and vitmin D3 daily. Tablet Tramadol one daily.Please consult your doctor before taking those medicines.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for low sperm count\n\nHi, may I answer your health queries right now ?  Please type your query here..hello my naqme is james i am 31 years old first my sperm count was 3.2millions/ml  so the Dr.give me some tablet productiv-m to increase my sperm after a week i went to the Dr. to check my sperm count (mill/ejaculate)9*106 that is wnat shown in my report what else should i do to insrease my sperm count what diat i should use to incrrease pls help me",
    "doctor_response": "Hello,There are certain non medical measures which can improve your counts like daily exercise, take vitamin supplements of D, E and C, avoid smoking and other addictions, wear loose boxers not tights.  If all these measures fail to improve your counts then I suggest you to visit your doctor for testing for sub clinical infections and hormonal imbalance. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Sameen Bin Naeem, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes small painless lump in my vagina?\n\nI had an abortion 2 weeks ago, I have took the pregnancy test to make sure the procedure was successful which came back negative. I thought it would as all the blood passed after 1 week. I examined myself today and inside my vagina on the wall is a very small hard pea size lump. It has never been there before. Should I be concerned and how do I get rid of it?",
    "doctor_response": "It is possibly a benign cyst could be Bartholin's cyst or a minor hematoma related to trauma relating to the procedure!wait for few days and if it persists then get a physical examination not to worry much!all the best.............",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My dad had repeated subdural hemorrhages. Is it due to a wrong diagnosis?\n\nHello doctor, My 70 year old father had undergone left frontal and parietal, right frontal burr hole craniostomy with an evacuation of subdural hemorrhage under LA and sedation last month. Before the\u00a0operation, his right side was not working and the problem was resolved after the operation and the doctor discharged him on the 1st of this month with the following medication at discharge: Tablet Levipil 500 mg: one tablet thrice daily to continue. Tablet\u00a0Cetil 500 mg: one tablet twice daily for five days. Tablet PCM 1 g: one tablet thrice daily for five days. Tablet Pantocid 40 mg: one tablet daily before breakfast for 10 days. Tablet Amlodac 5 mg: one tablet once daily at 8 AM to continue. Tablet Shine 10 mg: one tablet once daily at bedtime for one month. Tablet Solitral: one tablet once daily at bedtime for three months. But, during the checkup (after CT scan study), the\u00a0doctor advised a\u00a0burr hole again as he mentioned in the prescription: Residual Chr. SDH Bh FTP commonly, that is, mess effect'. Then the doctor again told me that he may need a\u00a0third burr hole as well as the problem may sometimes happen. May I know is this due to diagnosis problem or something else? My concern is that it is difficult to go for the same operation again and again. Is there any solution for the hemorrhage problem. If I opted for the burr hole surgery at some good quality hospital with sophisticated facilities, will the problem will be solved completely? Is the recurrence of SDH due to a\u00a0wrong diagnosis?",
    "doctor_response": "Hello. If you are still in doubt, you can consult a neurosurgeon locally or on icliniq. For more information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for itching foreskin of penis\n\nsome days ago (4-5 days) I ve been getting this itch on my foreskin. I didn t really pay much attention to it until when I was showering I notice a little red dot(it s gone now) on the corner of under the penis so I thought I ve been bite by an insect or something so I let days past thinking that the itch will go away but now my foreskin is red and it let s go some kind of white liquid. It s not painfully but it s disturbing. Please any suggestions of what it is caused I m starting to get worried.",
    "doctor_response": "HelloThanks for query.Itching of the foreskin with discharge is mostly due to fungal infection of foreskin (Muco Cutaneous Genital Candidiasis).Get your blood sugar levels tested to rule out Diabetes.Take anti fungal medication like Fluconazole twice daily orally along with topical anti fungal jelly for local application.Ensure to wash your genitals with warm water twice daily.This should get cured within a week.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and swelling in gums near upper molar teeth?\n\nMy gum in between my upper molars (the last two molars) hurt sooo bad it's always painful and throbbing. As if the gums is squeezed in between. It is so painful and I think it's swollen because everytime I try to put floss, the floss doesnt even completely insert because the gums will start to throb so bad. Please help???",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concern...As per your complain it seems that there is loclized deeper infection in the gums in  that area leading to swelling and pain in gums as well as there may also be pocket formation that is loss of attachment of the gums from the bones due to infection leading to space [pocket ] formation which further flourishes bacteria and causes deepening of the infection..Nothing to worry consult a dentist and get evaluated and he can take an x ray along with clinical evaluation to confirm the diagnosis and in case of gum infection deep scaling and curettage followed by antibiotics and painkillers will relieve..He/she will also check for cavities in any of the molar on the wall that lies in contact with the wall of the other tooth and such cavities at times are visible only in x ray and not clinically and infcection in tooth can also cause infection in the gums and cause swelling and pain in gums and it can be treated by treating the tooth and filling it with a dental filling material followed by scaling  and  antibiotics and painkillers..Hope this information helps..Thanks and regards..Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is BP rise related to intake of packed chicken?\n\nWhen ever my husband is taking chicken from the next day he is having high BP for 2 days . This we have observed for more than 6 times. We usually get packed chicken and cook it home .Is there any relation with packed chicken and high BP ?  In my husbands family high BP patients are there.",
    "doctor_response": "Hello...The only association i can think of between the packed chicken and rising blood pressure is the salt content of the chickenMost packaged and ready to eat meals have a high degree of preservatives, salt being one of them.A high salt intake directly correlates with hypertension.Is your husbands blood pressure normal at other times and is he currently on any medications for the same? Because if it is always on the higher side then ideally he needs to be evaluated and may need a change in his medication for the same.Hope this helps.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes diarrhea after a head injury in a child?\n\nMy baby fell off the couch yesterday. He did not throw up. But today he had a lot of diarrhea like so much it just leaked all out his diaper. But other than than he s acting like his self. Last night he woke up fussy and crying, I have him some Tylenol and he eventually went back to sleep. He is 19 months",
    "doctor_response": "Diarrhoea is not associated with any type of head injury. Its completely different finding in your child. Syrup Tylenol is itself known to cause Gastrointestinal disturbances. Right now, make sure the child is well hydrated. Give him frequent feeds and ORS solution for every loose stool he does. Also give him Syrup Zinc 5 ml once daily for next 14 days. keep the diaper area clean and wash frequently with lukeworm water. Dont try to wipe it off after loose stool as rashes will develop in that area.Thanks and regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of recurrence of cervical cancer?\n\nHi there, I had treatment for cervical cancer 8 years ago in the form of chemo and radiotherapy.  At that time surgery wasn't an option so therefore i still have my uterus intact.  Is it possible for cervical cancer to come back after this period of time and if so what would the sypmptoms be and  what are your chances of success again.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Yes, possibility of cervical cancer recurrence is there, irrespective of surgery in the past. Means even if you had hysterectomy, recurrence can be there. Since you didn't undergo hysterectomy, chances of recurrence are higher in you. Symptoms of recurrence are foul smelling vaginal discharge, lower abdominal pain, bleeding per vagina, weight loss, anorexia, low grade fever etc. And regarding future treatment, you need to first get done staging of the cervical cancer. If it is localised cancer than surgical removal with post opera chemotherapy and radiotherapy are options. If it is metastatic cancer than palliative treatment in the form of chemotherapy, radiotherapy, nutritional support and pain management are the options. So if you have any of the above mentioned symptoms than consult oncologist, get done staging and star appropriate treatment. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for penile infection?\n\nHi, may I answer your health queries right now ?  Please type your query here...hello i am 19 yr old and i have penile infection (like ulcers,burns n pus)i have seen a doctor and he gave me forcan 150 tablets and clotrin cream.I had done urine routine test and it says 25-30 pus cells. I notice these burns after  when i masturbate but i am not sure...please help me and tell me what i am suffering from. done",
    "doctor_response": "Hello, You have been prescribed oral Fluconazole tablet and Clotrimazole cream.  Both are anti-fungal medicine. You have been suffering from fungal infection of penis head according to your doctor opinion. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stretching exercises for tight foreskin not helping. Penis bending on erection and painful. Total circumcision required?\n\nHi. I ve had a tight foreskin for about a year which suddenly appeared and have tried stretching exercises without success. My penis is now bending upwards when erect and is painful. Is this because I need a total circumcision and will my penis straighten afterwards? Thanks",
    "doctor_response": "Good Day and thank you for being with Healthcare Magic! You may have a condition called phimosis which is a tight opening in the foreskin. Phimosis may limit your erection and this is usually an indication to do a circumcision. Also with phimosis there is a tendency for the smegma to accumulate leading to infection and may brought about penile cancer. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at:   I would gladly help you.  Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could lump on shin be due to a blood clot after falling?\n\nI slipped and fell at a store about a month ago and smashed my shin against my shopping cart.  It immediately made this like blood blister on the shin, swelled a little.  A month later I have this noticeably hard but tender lump on my shin that seems a little swollen.  Could this be a blood clot?",
    "doctor_response": "Hello!Thank you for the query.Yes, this might be a blood clot. Especially if you have any varicose veins in this area. Injury is a very common factor of veins thrombosis. If you do smoke or take some hormonal pills (like contraceptives), the risk of thrombosis is higher. Such lump can be also caused by blood accumulation under the skin (in soft tissues). This is not related to the veins thrombosis.I suggest you to consult a surgeon with this issue.In case of doubts, ultrasound should be done.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for lumps in the chest\n\nI have a red lump on my chest about 1cm by 1cm big.  I tried to pop it today and it just bled but is still huge.  I also have a lesion near it that has been pussing for about a week I have had that befote and had surgrry to try to fix it but it has returned I havr however never had the larger lump .",
    "doctor_response": "Hello!Thank you for the query.From your description it sounds like you have a sebaceous cyst which has gotten infected. Due to infection, puss appears and starts giving pain. If it lasts long enough, the lump starts to leak.I suggest you to consult a surgeon with this lump. It needs to be incised and removed. To make sure it wont recur, it needs to be removed with the capsule. Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low grade fever with left sided rib-cage pain?\n\nI have a 11yo daughter with low grade fever complaining of left side pain under rib cage.  i am treating for potential constipation with magnesium citrate - no bowel has been been produced since first dose.  Is there any other condition I should consider before seeking medical treatment?",
    "doctor_response": "Hi Dear Welcome to the HCM,Probably some viral infection may be the cause of fever and chest pain. This may be taken care with some paracetamol with doses Of 15 mg per kg 4 to 6 hourly basis.Constipation to be take care .Hope the query is answered.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for reoccurring chest pain\n\nAbout a year ago I went to the dr. for reoccuring chest pain.  I had it frequently and I thought it may be gallbladder.  I went to the dr. several times. They did several test. EKG, chest xray, and gallbladder ultrasound.  All of which came back fine.  The doctor decided it was probably a pulled muscle in my chest.  It seemed to go away for several months and now it's back.  I was sick several weeks ago and had a really bad cough.  I coughed one time and it felt like it pulled a muscle in my chest and ever since then it started back up. I coughed again yesterday and it pulled again.  Now tonight I have it really bad. It feels like the pain goes in front of my heart and then a pain in my shoulder blade.  Do you think it is only a pulled muscle. Sometimes it is very sharp and sometimes it's not too bad. Thanks, Lindsey",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, possibility of musculoskeletal pain is more likely but better to rule out cardiac chest pain first. So get done ecg and 2d echo. If both are normal then no need to worry for heart diseases. Apply warm water pad on affected areas. Avoid movements causing pain. Avoid heavyweight lifting and strenuous exercise. Take simple painkiller like paracetamol or ibuprofen. Don't worry, you will be alright with all these but first rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How often should one take Vomikind to treat vomiting during pregnancy?\n\nHi.I m currently in 14week of my pregnancy but still i have vomitings and doctor has suggested for vomkind twice a day. I am taking this since my second month of my pregnancy. Coz if i dont take it i will have continuous vomitings and even water doesnt stay. Plz suggesr",
    "doctor_response": "Hi, I think you can continue vomikind 2 times per day.  It will not have any side effects.  Just check your TSH levels because sometimes thyroid problem can lead to excess vomiting in pregnancy.Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is a gold dental crown made up of?\n\nI don't want to tell the entire struggle I'm having with  my gold crowns . They made one for me and it developed a hole after 5 months. the temp crowns they used busted every 2 days.  Now they are making me  a new gold crown.  the temp crown appears to be burning my gums and my tongue.  What did they make it out of? I've never had such trouble with temp. crowns",
    "doctor_response": "Hello and Welcome to 'Ask A Doctor' service. I have reviewed your query and here is my advice. Well there can be a number  of materials  tgat can be used for making  temporary crown  so you should once check with your Dentist to know about the material  that they are using. Also there is a possibility  that the crown  is impinging over tge gums and have sharp edges that are irritating  the gums and tongue.. So once you should get a clinical examination done by your Dentist. For now you can gargle with specialised mouthwash like Magic mouthwash. Take soft and bland foods. Do cool water rinses Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is fatigue, loss of memory, imbalance and uncontrolled urination at the age of 54 normal for a female?\n\nHi, I m 54, female. I have been struggling with fatigue, forgetfulness, losing my balance, falling, and not being able to get to the bathroom in time (bm). I thought this was just part of aging. I am on prozac and lamotrogine. Is this normal for my age?",
    "doctor_response": "you describing a symptom of a disease called normal pressure hydrocephalusyou need some imaging like ct brain to confirm thatif that is the diagnosis the pt need surgery to releive the symptoms",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. There is a white spot near the penis. Is this something I should be worried about?\n\nHello doctor,I have a question.",
    "doctor_response": "Hi. I saw the picture (attachment removed to protect patient identity). There is redness. It looks like folliculitis as per the picture. I cannot really comment on what is going on unless you mention symptoms. Please elaborate your skin problem. Do you have itching? How long has it been there? For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does laser treatment affect conceiving ?\n\nHi All! Kindly help me providing information : Is any side effect of Unwanted hair Removal of FACE by Laser Treatment. Can it create any problem If she is going to conceive a child. Please suggest better Treatment : LASER or anything else .",
    "doctor_response": "hello, it may cause itching, redness, and swelling ,hypo or hyper pigmentation around the treatment area.it can be reduced by treatment with an appropriate laser type .sometime allergy may occur.but it will not cause problem in conceiving the child. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause PTB of undetermined activity at the age of 46?\n\nHi I am 46 yrs.old and I have problema with my chest X-Ray it shows like this IMPRESSION: PTB of undetermined activity, right from my Apico result. I am very surprising with this result cause every time I renew to work every 6mos. I always take an X-ray result for almost 15 yrs.all is clear but only now I got this result why?",
    "doctor_response": "Hello, * Pulmonary tuberculosis of undetermined activity can be shown up in an individual without symptoms, particularly when the person is exposed to the pathogen and it has remained dormant due to the precise immune system of the body to keep it inactive. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Bhagyesh V. Patel, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathlessness , cough and back pain?\n\nHi doc , I want to ask a question about my health is I got cough , running nose cant breath sometimes happens when I sneeze feel heavy in the right chest n wheezing sounds comes for more than 2 week now n I need to travel about 100 km n this days m having back pain Pls help the cough is not going only . Many nights are spoiled due to bad cough n breathlessness !",
    "doctor_response": "There seems to be a chest infection. consult a physician for auscultation of lungs , to know the details of wheeze ,sign of ronchi,crepts, an x ray chest if these are present.Take levocetrizine 5mg once a day, steam inhalation and acetaminphen 500mg tabs thrice a day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i use ban a tan cream for dark skin? Does it have any side effects?\n\nacn ban a tan cream be used for dark skin..........?   if yes...............how long should it be used ?   what are the side effects of ban a tan cream ?",
    "doctor_response": "Hi ban a tan can be used only for pathological conditions like melasma.post inflammatory hyperpigmentation etc.but not for fairness of skin.it should be used only for short time.u can use b glow cream .botanica or boxylak cream for improving complexion.the main side effects of ban a tan are xerosis of skin.irritation and sunburn like reaction",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in nostrils & teeth?\n\nMy nostrils feels numb and now my two front teeth feel numb as well.  No injury or trauma besides the fact I grind my teeth.  I also have a bit of pressure in my eyebrows and some numbness in my cheek.  I have previously had a head and neck MRI which was normal along with blood work done.  Please advise",
    "doctor_response": "HiThanks for your query with health care magic, i think you have an periapical cysts or abscess which are causing pressure on the nose leading to numbness snsation.It is great if you can visit your dentist and ENT specialist as well",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does heavy dark red discharge from vagina after embryo transfer indicate?\n\nhi doctor. im 31 with secondary sub fertility.both my fallopian tubes were blocked. ovum pick-up was on 05/02/14 did my embryo transfer (2 embryos) on 07/02/14. started to hv pink spotting on 17/02/14 progressed to brownish then heavy dark red on 19/02/14. my beta hcg check will be on 22/02/14. what does this bleeding means?is the any hope to be pregnant??",
    "doctor_response": "Thanks for consulting at HCM health forum. Although it seems to be an old question but it is in line waiting for a response and it's my pleasure to help answer it.This type of bleeding is normal and is due to the manipulation during the surgical procedure. It is also obvious from the change of color of blood with passage of time.Yes there are always some chances of pregnancy and this kind of bleed is usually seen in many patients.Let's see the beta hCG levels. Hope for the best.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from thyroid problem. I have been suffering from erectile dysfunction. I have fear of not performing.\n\nHello doctor, I am suffering from a thyroid problem. My TSH level is on the higher side. At present, I am taking 50 mg Thyroxine. For the last 4 or 5 months, I have been suffering from erectile dysfunction. Please give me a proper solution.",
    "doctor_response": "Hi. Unfortunately, the information provided at this stage is very limited, and it is difficult to interpret and make conclusions.I request you to post the following details: At this stage, I would like to inform you that thyroid is mostly not responsible for erectile dysfunction, and we need to explore additional reasons for same. I am not sure about your age, but if you are above 50 years, you are requested to get the following blood reports if not acquired already. Erectile dysfunction is a complex disorder and needs a thorough evaluation for treatment. I look forward to seeing more details.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is the base of my penis swollen and sensitive?\n\nI had what appeared to be a small spot on the base of penis 2 days ago, it popped during the night and bled a very small amount, it did seem like a zit that i just to get when i was a teenager on my face however it was very very tender. Now just above the base of my penis on my right side is swollen and is sensitive to touch and causes discomfort. I have a bit of a cold and my joints have been aching. Could it be just connected to the cold or could it be an STD?",
    "doctor_response": "Hello, This could be due to vigorous sexual intercourse which tends to injure the smaller tissues like glans, frenulum, and foreskin of the penis. You can take short course oral anti-inflammatories with antiallergic drugs available over the counter and apply antiseptic cream with mild steroids (Betnovate-N) which will reduce swelling, redness, and inflammation. You have taken Tab.doxy and force which are antibacterial and antifungal drugs which would be effective if there will be respective infections. Avoid sexual activity for 1-2 days and then observe for the disappearance of swelling and pain. You will start improving within 2 to 3 days of this oral and topical drugs. To avoid future recurrence, use lubricants like KY jelly or Vaseline during sexual activity. If the swelling and pain do not subside or there is the appearance of discharge or any other similar symptom, you need to consult your GP (if surgeon or dermatologist appointment is not feasible) for proper clinical assessment and treatment. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Iven Romic Rommstein, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a round large rash on the shoulder while on Duromine?\n\nI have been taking duromin for about 1 week. I have felt well and no side effects that I know off. I have found a round rash on the top of my shoulder quit large , I have scratched it and it has not spread. Ive never had a rash like this before , its as big as a 10c piece. Could this be a side effect from Duromin.",
    "doctor_response": "Hi,Yes this could be drug induced but it more seems to be ring worm infection (Fungal infection) and I would suggest to try Miconazole gel first, if this fails to responds then anti-histamine along with steroid can be tried orally and best drug of choice would be Tab Levocetirizine 10 mg three times in day and Tab Dexamethasone 10 mg three times in day for at least three days, if still the lesion is there then it needs to be clinically examined.Hope this information helps. Let me know if I can assist you further.Regards,Dr. Akhtarhusain Shaikh",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in getting pregnant?\n\nWe are trying for a baby but my wife is not able to conceive. The fluid comes out everytime after the intercourse.Can you tell why is it so?My wife says that she does not feel that my penis is inside her vagina but according to me half of my penis is inside her. What can you say about this?",
    "doctor_response": "Hi,I read your query and I understand your concerns.Following is my reply:1) As long as you have ejaculated inside vagina, pregnancy should occur.2) Please get your semen analysis done.Let me know if you have anymore questions.Regards,Dr. Mahesh Koregol",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have bad breath and acid reflux. Taken nasal spray, probiotic zinc. Help\n\nI have suffered with bad breath for years I tired everything OTC and if it was on the internet had a good dental exam had a ENT appt yesterday he said everything was good and I was one of those and ordered nasal spray.I have acid reflux so I stopped most everything red meat sugar dairy for months took every probiotic zinc etc grape seed extract 3days cleanser nothing has helped now I need to could it be something you can help me with.Lost",
    "doctor_response": "Hello,Thanks for writing to us.Bad breath can be due to -poor oral hygiene/GERD/systemic diseases like dibetes,hypertension.Please do visit a dentist and get thorough scaling done.Maintain oral hygiene well.Get complete physical examination done.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am O+ve and fiance is B-ve. What problems are we going to face?\n\nHi doctor, My blood group is O positive. I am going to marry a girl whose blood group is B negative. What type of problems are we going to face? I need your help.",
    "doctor_response": "Hello. With proper precautions, you will not get any problems. Your wife has to receive anti D at the proper time during pregnancy. Otherwise, the baby may have hemolytic disease soon after birth. There will be no other problem. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mouth ulcers, pus bags on front teeth and high WBCs?\n\nI had a tooth extracted which became infected, antibiotic taken, another tooth infected and was removed within same month. Now I have lost weight, have ulcer on my tongue and pus bags on front teeth, white blood count high and admitted to hospital for bone marrow test suspect leukiemia.. Could this be cellulitis instead?",
    "doctor_response": "It could be cellulitis. But you need to post your blood test levels. Kindly post ESR count if evaluated. Also mention your current medical ailments if any and age.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy rash all over body? Suggest treatment\n\nitchy rash yes hi my name is Shannon and I have had an itchy rash now for maybe a month or so. the rash is little bumps but they itch like crazy! I have them on my back my sides my legs my chest and my pubic area palms of my hands and in between my fingers! its not a normal rash though! its just one little bump here and there! and they just appear out of nowhere and start to itch! Please help",
    "doctor_response": "Hello and welcome to healthcaremagicI would keep a possibility of scabies, which clinically presents as itchy rashes on the abdomen, thighs, arms and extremities. The itching is specially troublesome at night in scabies.Treatment is single whole body overnight(8 hours)application of a 5% permethrin cream, from neck downwards with special attention to the finger webs, toe webs, folds of the groin and axilla etc.An OTC antihistamine once daily e.g cetrizine can be taken for symptomatic itch relief.regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest alternative medication for psoriasis\n\nGreetings to Dr. Rohit. I am Elizabeth Lee, from Malaysia. I have been suffering from psoriasis since I was 23 years old. Now, I am 34 years old. My psoriasis have been ups and down. But then its still manageable. But things turn differently, after my delivery of my baby since January 2010. My psoriasis have flared up so much that it covers 85% of my body, especially both my legs. I have seen many doctors, and even skins specialists. But then my psoriasis has not settled or remained the same severe. I had used 707 Oil, from India, by an Aryuvedic practitioner. And taken some oral Aryuvedic pills , Dermaflex, from India. But then my psoriasis has not improved. Now, after 4 months after my delivery, my skin has noit gotten any better, even though I have applied medication given by skin specialist. Any alternative medication?? Please help.",
    "doctor_response": "Thank you for writing to HCM.Psoriasis is really kashtsadhya to asadhya classification disease. You are advised to undergo Panchkarma at some good ayurveda hospital near you. Till that time please take following for some relief. Kakmachi - The juice of the leaves of the kakmachi can be applied locally on the affected regions.Garlic- Take 2-3 cloves everyday with Khadirarishta10 ml+ Manjishthadi kvath10 ml+ 20 ml water.Jasmine- The flowers of the jasmine have good effects in the treatment of psoriasis. The flowers are crushed, made into a paste and are mixed withwith neem oil and applied on affected part.Kaishore Guggul- 2 pills thrice a day with lukewarm waterwater(1 glass at least)Neem- Neem cap 1, Haridra cap 1 both twice a day with khadirarishta n manjishthadi kV.Taruni kusumakar powder 1 tsp at nightnightNote: Kakmachi and jasmine may be used separately for sustained effect. However it can be used simultaneously too but I would prefer separate though its time consuming.Its a vat kaf disease hence treatment is along those lunes involving charm and rakt.Food: Simple and light.If you feel satisfied may ask any query",
    "dialogue_context": ""
  },
  {
    "patient_message": "CT scan shows frontal lobe shrinkage. Family history of neuro problems. What are the risks?\n\nI have had my results from ct scan and says I got frontal lobe shrinkage and is there any family history of any nuero problems I told my gp now but my nan had suffered for 15 years with what I believe to be Tia s and my cousin had either Tia s or a couple of stokes in his late to mid 30 s do I need to go back and tell my gp this",
    "doctor_response": "DearSorry for the result of your CT scan but the symptoms of your relatives are vascular disease and they are not related with what your CT shows.You have nothing to worry.RegardsDr Eris",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cold sore spread in face and arm\n\ni recently caught a coldsore from my partner and it has spread to my faced and arm i have to go to wofrk every day and i haver been using makeup but also using anti bacterial cream and teabags but its getting better than all of a sudden gets worse do i have to take time off work to let it heal up its getting me really down",
    "doctor_response": "HI, thanks for using healthcare magicCold sores are due to the herpes simplex virus.Because it is due to a virus, it would not be affected or treated by an antibacterial cream (this treats bacterial only not viruses).You would need an anti viral cream such as zovirax.Abreva is also thought to help with cold sores though it is not an antiviral cream.If it is not healing well, you may need to see your doctor about oral treatment.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having upper body shakes. Taking pms clonazepam. What could be causing this?\n\nI am having upper body shakes and was prescribed pms clonazepam and the shakes have stopped. just wondering what causes body shakes? the doc on call at the hospital did not know and called a neurlogist and she said try these pills? and maybe its dystonia ..............I had been under some stress and a week before the shakes was dizzy and walking to the right or should i say staggering......they first thought it was innner ear infection , my blood work was fine, ekg fine and ct scan fine...........",
    "doctor_response": "Hello. Thanks for writing to us. The shakes which have subsided on taking clonazepam are likely to be due to anxiety. Remaining tension free and doing some relaxation exercises like deep breathing and yoga will be helpful in prevention of recurrences. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have dizziness, thirsty, head and neck hurts. Several test taken, all fine. Cure for symptoms?\n\nI have for the past year been asking my dr for help with dizziness. Recently as  a month ago it changed to a lightheadedness it has not gone a way. My doctor say its from stress yet does no further testing yet I am at the point of can function or do a thing I lay down I get lightheaded thirsty feels like a fever head hurts neck hurts off and on. I can't do nothing plan nothing or go no where's my dr to me is blowing me off my heart has been hurting off and  on I don't believe it's aniety any longer I think it's heart brain getting lack of oxogine . All the test come back wonderful but they refuse to do anything when I run to the office during one of these attacks. How do I get my dr to realize its more then just stress it's debilitateing . Can anixty last for a month none stop for three weeks. If so if not treated cant that cause problems and my dr ignoring me like I'm a hypocongeract",
    "doctor_response": "DearWe understand your concernsAs all the test results came wonderfully positive, there is nothing to worry about your physical health.But mental health is equally important.Your stress and anxiety level needs to be watched.Write down all the activities you do every day. Write down when the dizziness comes and when it goes.Try some relaxation techniques such as meditation.Do regular exercises which makes you sweat.Practice time management techniques.Learn to be happy always.For further advice consult a psychologist.Wish you speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a deterioration in the heart rate?\n\nI have been working out on the eliptical for a while now and during my last two workouts my heart rate is only 84 and I am doing the same workout I normally do and it is usually 160 - 170.  I changed machines and it still shows in the low 80's. Should I be worried?",
    "doctor_response": "HelloIf this decrease in heart rate has happened all of a sudden then it needs to be evaluated with the help of an ECG. As development of some kind of av block can also slower down the rate. Kindly consult your doctor and get an ECG done.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the recommended options for AV fistula placement?\n\nHello doctor, This query is for my father in law aged. He is 58 years old and is diabetic and currently under medication for BP also. He has a history of two major heart attacks. In the last five years, he did not have any major heart issues. Recently due to extensive amount of medications taken for a long time, he started showing signs of high amount of creatinine (currently 6.9). We did a few dialyses. Now doctors have advised doing an AV fistula on his left hand. His left hand is partially amputated from a previous septic shock treatment about four years back. His right hand is fine but an AV fistula there might terribly limit his movements and self-care. We wanted a medical opinion about where the fistula can be placed or can it be near to chest area as an alternate option?",
    "doctor_response": "Hi. There are three main types of AVF (arteriovenous fistula). The radiocephalic fistula is a forearm fistula created by anastomosing the side of a radial artery to the end of a cephalic vein. It is also referred to as the Brescia-Cimino fistula. The brachiocephalic fistula is an upper arm fistula created by connecting the side of a brachial artery to the end of a cephalic vein or slightly central to the level of the elbow. Finally, the brachial artery\u2013to\u2013transposed basilic vein (BTB) fistula is another upper arm fistula. This fistula is created by anastomosing the side of a brachial artery to the end of a basilic vein that has been transposed laterally and elevated superficially to make it amenable to dialysis cannulation. Other sites could be leg also. I advise you to discuss it with your doctor. The patient requires dialysis for sure or you can put a central line and replace it every 15 to 20 days. But AV fistula is the best option.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the future problem of having loose ligamental joints?\n\nHi doctor, I am 23 years old, and my height is 5'11\". Please look at my legs. I can walk, run and sit. I have loose ligamental joints (collateral ligaments) from childhood, and I have small patella. What is the problem of having loose ligamental\u00a0joints in future? Is there any problem with small patella? I cannot stand for more than 30 minutes. I feel uneasy to stand, and around knee cap sometimes I get burning sensation for a short duration. Is there any surgery to correct loose ligament joints?",
    "doctor_response": "Hello. I have gone through your history and the images provided here (attachment removed to protect patient identity). For further information consult an orthopaedician and traumatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause scaly spots on gum?\n\nI just recently checked my gums (at the top of my mouth) with my tongue. This seems to be the only part of my mouth that has this, but there are dry scaly spots on my gums. I'm 16 and I smoke... I know I shouldn't, but yeah. I just seriously need to know if this is the start of Oral Cancer... Thanks",
    "doctor_response": "thanks for your query, the scaly spots on the gums could be desquamative gingivitis or frictional keratosis or leukoplakia. nothing to worry consult your oral physician to rule out these things and stop smoking. prevention is better than cure. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes orange foot soles?\n\nMy son will be 13 this month, has Aspergers, Central Sleep Apnoe (treated with a CPAP), Multiple Epiphisaere Displasia (recently returned home to the States after 33+ years in Germany, where he was born and raised until now so not used to the medical terms in english, yet, sorry) and we are changing our diet over to strictly organic after both of us running into all kinds of troubles with the food here... anyway, my question is why does he now have very orange foot soles? (No, we do not eat many carrots)",
    "doctor_response": "Hi dear,With such presentation in my clinic, I recommend :- nose and throat culture for flora and sensitivity to antibiotics;- Drop Nasoclear every day and Sodium sulfacyl(Albucid)2 drops 3 times;-Resolve Sualin 1 tablet 3 times;- Zincovit 5 ml for 1 month.- Kuka syrup 1/2 teaspoon 3 timesWhen blood and urine analysises will normal,then go on adenoectomy for removing of adenoids, because it is just cause of his diseases, there are lots of patogenic flora.Hope I answered your question. If you have more questions then don't hesitate to write us.Wish your baby good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is citrobacter diversus ?\n\nI was trying to find out what is citrobacter divers us I was told I had this when i was six months pregnant and still been having problem with my kidney",
    "doctor_response": "These are bacteria that can be found almost everywhere in soil, water, wastewater, etc. It can also be found in the human intestines. They are rarely the source of any illnesses, except for infections of the urinary tract and infant meningitis, hospital acquired infections and sepsis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat separation anxiety?\n\nmy daughter (2 1/2yrs) shows sever separation anxiety . she is very reluctant to go to school and engage in social activities. what can i do to minimize this anxiety problem.",
    "doctor_response": "Hello. Thanks for writing to us. This is a normal and expected response of all the children whenever they go to school for the first time. It is best that you accompany her to the school for a few days till she mixes up well with her new friends. This transition will take place in 10-15 days and then gradually she will get herself adjusted to the new routine. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the lower abdomen which sharpens while standing up?\n\nHave been having pains on the right lower side of my stomach, since Thursday night around 8:30pm, it\u2019s now Saturday.... pains have not worsen but are still there, but these pains do become more sharp if I stand up or move a certain way, I have experienced a bit of nausea, but without vomiting",
    "doctor_response": "Hello,Thanks for your query on HCM\"As\"per your clinical history is concerned please follow like this -1)Do a clinical exam by your treating Doctor and do investigations like [CBC, Urine Re/ME and Ultrasound]to confirm.2)Do take treatment as per your clinical findings only.Do take few lifestyle modifications after recovery-1)Try to avoid strenuous activity at first for 15 days.2)Try to support your abdomen when you cough. Place a pillow over your abdomen and apply pressure before you cough, laugh or move to help reduce pain.3)Get up and move when you're ready. Start slowly and increase your activity as you feel up to it. Start with short walks.4)Try to sleep when tired. As your body heals, you may find you feel sleepier than usual. Take it easy and rest when you need to.Hope that helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Metoprolol cause low appetite and heartburn?\n\nHello, I am currently on Sucralfate and Protonix for gastric problems, but they have been no help. I cannot even tell I am taking any medication and symptoms are worse than ever. My Dr has not yet ordered any blood work or an upper GI and I ve seen him 3 times for this problem. My stomach is so distended, I look like I am pregnant and I cannot even wear some of my clothes anymore. I have little appetite, severe heartburn and a burning pain in the center of my stomach that comes and goes. This has gone on for about a month now. I belch all throughout the day, even on an empty stomach. I find that I feel better with nothing on my stomach. I have been on Metoprolol for a few years also. Could this have contributed to my problems? I was fine one day and I had all these symptoms the next. Could there be something else wrong? Bowel movements seem normal and I do not ever consume caffeine, alcohol or soft drinks of any kind. I do not smoke.",
    "doctor_response": "Hi, Let me tell you that symptoms described by you suggests that you have suffering from GERD.You need upper GI Endoscopy.For treatment Intake antacid tablets regular basis.Proton pump inhibitors drugsavoid lying down after eatingavoid wearing tight clothingYes metoprolol side effects low appetite and chest pain.Hope I have answered your query. Let me know if I can assist you further.\u00a0Take care\u00a0Regards,\u00a0Dr. Arup Majumdar (General physician and House physician)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause pain in chest?\n\nBeen having left side chest pain off and on for 3-4 months sometimes will last for hour or so other times just for 5-10 minutes. I had heart Cath 2 1/2 years ago with no blockage at all and all my labs are better now than they were then. Sometimes the pains are really bad and sometimes mild. Please any thoughts would be appreciated. Thanks",
    "doctor_response": "Thanls for your question on HCM. In my opinion you should get done cardiac work up again as its been 2.5 years since your angiography is normal.So please get done ECGTMT (Trade mill test)2D ECHOTo rule out cardiac causes.If any abnormalities found than coronary angiography should be repeated.So consult cardiologist and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome the typhoid fever?\n\nmy brother is suffering from typhoid fever please tell me how to get rid of it or please tell me the precautions which i should take for him its from last 15 days. Even he was admitted in hospital for 10 days, Day before yesterday only he got discharged please help me doctor i ll really be thankful for it .......",
    "doctor_response": "As long as the typhoid fever is concern, this can be best bring down with a tab acetaminophen but this can only be given when body temperature goes to 100\u00b0F (37.7\u00b0C) or more.This is not a contagious disease, so no need to take any precaution. Taking care of overall hygiene is the best way to prevent the infection.Hope this information helps.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain and numbness after spinal surgeries\n\nHi dr ,Samuel I m sherry I m 46 I had two spinal back surgeries, the first one the screws were not place right an was causing seriousness pain , that was 2009 .then An had been told it was scare tissue that was was the reason , then 13 months later a doctor finally ordered a milo c- t scan an indicated that was why I was in so much pain. Diferent sugereon operate rated on me 2 n.d surgery back fusion an removed all hard ware an gave me postieror back surgery at second level. Then pain return an is spreding further up my spine so sevear in legs hips , an pelvic it feels like hot burning knifes twisting in my spine , a lot troubles walking siting numbness ,weakness, need help",
    "doctor_response": "hi,thank you for providing the brief history of you. since you have undergone two surgeries it is sad to hear that. at the moment you need to try physical therapy and take help from there. as it is non invasive and safer. it will be time consuming and slow but it will also work on your body and help you ease of symptoms. I have seen failed back surgeries and have put them on medicine and physical therapy. things worked out well. I expect the same from you. what requires is the patience and motivation. with the grace of God you will be out of this situation soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Contracted klebsiela, having fatigue, diarrhea, stomach bloating, glassy eyes. On chemotherapy for uterine cancer. Treatment?\n\nMy 77 year old mother with recurrent uterine cancer has contracted klebsiela,she had just completed her first chemo treatment. The doctors act as if they have it under control but we are on day 12 of her admission and she is still exhausted ,sometimes confused hasngreen diarrhea and her stomach appears to be distended. Her eyes are also buggy and glassy",
    "doctor_response": "Hi welcome to HCMForum. Your mother is already old enough. The capacity to bear the chemo therapy will be less. there may be secondary infection of klebsiella. Dont worry as she is inpatient doctors will take care of her. Besides i advise some diet restrictions for her as to take more of curd and bland foods. avoid taking spices chillies oily foods junk foods and sour fruits. i hope my reply satirfied you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a decrease in the BP level despite taking Aspirin for high BP?\n\nLast week, I had a very small stroke...blood pressure went up as I was frightened at the numbness on my right side. 2 days in hospital , mri showed a small spot. immediately handed meds for cholesterol and High blood pressure and baby aspirin. my BP has always been spot on and today and range in the 120 s. I am hesitant to take the High BP meds. CHolesteral is pretty good too. I am frightened to take it and risk going to low and pass out. Help",
    "doctor_response": "Hello Welcome to Ask a Doctor service I have reviewed your query and here is my advice.If you are already on antihypertensive medicine then you need to continue it, if you are having some doubt then you can discuss this with your physician but do not stop the medication, again if you are in hospital or prescribed the medicine after the stroke then it is advisable to keep continue the prescribe drugs.Hope I have answered your query, let me know for further assistance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the high WBC count be the cause for ulcer?\n\nMonths ago I was diagnosed with  2 ulcers that the Dr. said were almost bleeding. My Primary care physican ran routine blood work to check my cholesterol and the results show my WBC to be 3.3 Could this have anything to do with my ulcers? Should I tell my gastro. Dr.",
    "doctor_response": "Hi thanks for posting on HCM increase wbc count show sign of acute infection increase count of white cells in your body which are defensive system of body but it's not a specific test to include or exclude your ulcer if you see other symptoms please concern your physician for it. But specificaly about your question it's shows a sign of of infection need further to be evaluated.ThanksRegardsDr Jawad Alam",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lumps on legs?\n\nHi, I m getting worry about my lumps on my legs. there are two lumps on my right leg and one lump on the left leg near the ankle. On the right leg, The first lump is soft and small, while the other one is hard and a bit bigger. When I touch the lumps, it wont hurt. but when I walked I can feel a little bit pain. Is this cancerous? Please help! I dont know what to do!! :| Thank you",
    "doctor_response": "Welcome to health care magic. 1.The lumps at the joint areas pain less with mild discomfort - features suggest ganglions.2.Ganglions are general arising from the tendons, ligaments, at the joint space.3.These lumps are general asymptomatic, if causing any discomfort - a small incision and drainage is recommended.4.As an investigative process - an ultrasound need to be done - that will help to evaluate the nature of the lesion, source and extensions. ( MRI - is the best)5.These lumps are generally monitored, in case of discomfort action might be necessary.6.Suggest to see your GP, get examined and request for a scan and further evaluation.Good luck.Hope i have answered your query,any thing to ask ? do not hesitate to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling of scrotum and enlarged testis?\n\nhi please solve my query,following are the details. problem : left sided scrotal swelling,left testis and epididymis enlarged,tender,left chord structures tender,thickened. i was admitted for injections (5days} n was treated with 4antibiotics and analgesics (ceftriaxone,amikacin,metrogyl} while i was admitted.got discharged since 2days,now on tablets levofloxacin 5oo,metrogyl4oo,emanzen d,pantoprazole.Query: what could be the reason for this to happen,does smoking,alcohol,masturbation(or night fall} have any effects on the medicines,can i do it if i am still under medication. my doctor is unavailable now so all my doubts are unclear.plz help...",
    "doctor_response": "Hellowelcome to health care magic, I share your concern.Looking at your description it seems to be acute epididymoorchitis, inflammation of testis or epididymis.Here I would like further information to guide you better your age and complete medical historyis there any history of injury to testis?any recent exposure to unprotected sex?have you ordered any investigation like colour Doppler or blood test, please uplaod the reportsI would advise you to complete the course of Medicine as your doctor has advised you wear scrotal support Have plenty of fluids and take rest until it improves completely.waiting for your reply Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Adderall and Lexapro contraindicated if taken together?\n\nIs it safe to start taking adderall and lexapro together? I also have klonipin for emergencies and have been taking small doses of to let me sleep at night. but I am getting this burning feeling in my stomach which is giving me anxiety should I be worried?",
    "doctor_response": "Hello Overall if adderall and lexapro (escitalopram) are taken together then there is no significant interaction. These drugs can be used together but both drugs have common side effects like GIT upset or burning sensation in upper abdomen which result in significant distress to individual taking these medicines. You can consult your doctor again for any dose adjustments of drugs. Alternately medicines like Proton pump inhibitors as omeprazole can be taken with these medicines. These medicines will help to decrease the gastric side effects.Hope this helps you. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for the ankle pain caused due to the working condition?\n\nHi I am stood most of their day in my job I ve suddenly started to get ankle pain in my left ankle , when I m home I rest it , I try to get up after the rest and I can t put pressure on my ankle I have not injured it at all I have scholl gel pads in my shoes to see if they will help but they haven t through the night my ankle aches , then I get up for work and once again can t put pressure on it , it eventually wears off so I can hobble about , but then it all starts again once I ve finished work can u help ?",
    "doctor_response": "Hi, welcome to HCM, you need to strengthen your calf muscles. Wear weight bands on calves and exercise. Every night--10mts ice fomentation, followed by 10mts heat, followed by pain balm. Strap your ankles during working hours. Try to move about intermittently. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My mother-in-law does not miss a chance to taunt me. I feel depressed. Please help.\n\nHello doctor, I am married for almost two years and have a baby. Before my marriage, my mother-in-law who is actually the aunt of my husband (my husband is adopted by her) had to face some problems with my parental family. Now, after my marriage, her behavior with me is really horrible. She never misses a chance to tease me without any reason. She even teases my husband if she sees us smiling together. I feel I have become a mental patient although I am a well-educated lady. If I ask my husband to talk to her, he refuses. I feel helpless. Sometimes, I want to commit suicide. I am totally depressed. Please guide me to overcome my feelings.",
    "doctor_response": "Hello. From your account, it seems that you are having adjustment issues with your mother-in-law. This adjustment issue might have progressed into a depressive episode. That is why you might be having suicidal ideas. Hence, I would suggest you seek a thorough psychiatric opinion as well as psychotherapies in order to develop coping skills so that you can cope up well with such kind of issues in the future as well. For more information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the report regarding kidney transplant indicate?\n\nMy brother is undergoing dialysis and need kidney transplant. He is 37 years and his wife aged 36 tests are going on for kidney compatibility. HLA report show no common antigen at HLA class I and II loci and GFR is 75. Please let me know if transplant will be successful with these reports. all other reports are ok",
    "doctor_response": "HelloThanks for query .Your brother is a victim of Chronic Renal Paranchymal disease (CRF ) and needs Renal Transplant .His wife is being investigated for compatibility for transplant and her HLA I and II tests have been detected not have common antigen .HLA I ad II testing are highly specific test to determine the outcome of renal transplant and risk of rejection of transplanted kidney in  recipient after surgery.Since your brothers wife and brother have no common antigen and her GFR being 75 the chances of success are very high and can go ahead with surgery.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What precautions should be taken after brachycardia diagnosis?\n\nmy husband got up yeserday and felt like the room was spinning around him - I measured his blood pressure, his pulse was very low he has felt very weak ever since We saw a doctor who diagnosed brachycardia Do you have advice as what he should/should not do we live in a remote locaation where medical help is hardly available",
    "doctor_response": "hellobradycardia can be life threatening and since he is symptomatic, living in remote areas is totally not advisable. but if he is diagnosed brqdycardia ehy arent you treating it.. you must treat the cause. like if there is a conduction block then a pacemaker can be put. or if no cause is found again a pacemaker can be put.. the pacemaker will maintain his cardiac rhythm and he will be symptom free. pacemakers usually work for along time. their service and checking is free and regular for lifelong. it would be very beneficial for him. in that case u can live at remote areas also.. but again first the cauee must be treated. if cause is not found and pt continues to be symptomatic a pacemaker has to be put. anothrr option is to do a holter monitoring which records EKG continuously to determine how many episodes of bradycardia he has everyday. and then treat accordingly. thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can taking Lovenox shots be safe for factor V leiden?\n\nHi I was recently diagnosed with factor five lieden. due to getting four superficial blood clos in a month I have gotten them a lot. and have vein surgery in the past. and was supposed to get it again but I found out that I am pregnant. ten weeks now. and was advised to take lovenox shots I was wondering how safe this is for the baby.",
    "doctor_response": "Hello,Lovenox is considered safe during pregnancy. Women prone to thrombosis may experience various problems during the pregnancy. Sometimes the baby may stop growing. Lovenox treatment may prevent that. So using it, if your doctor said you should, is essential. I hope I've helped!If you'd like further clarifications, please let me know.Kind Regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for sickness in the stomach\n\nhi, this morning while standing in line to get lunch my stomach starting hurting all of the sudden then starting seeing black spots all around me, felt like i was gonna pass out, i ran to the bathroom and ended up vomiting. I ve been weak ever since and can barely walk, and my stomach hasn t stopped hurting. i can feel everything spinning around me even when laying down, also been shaky all day. should i be concerned? should i head to the ER?",
    "doctor_response": "Hi! Good afternoon. I am Dr Shareef answering your query.Yes, if I were your family physician, I would definitely advise you to report to the ER of your nearest hospital where a physical examination along with the related investigations could be done to rule out any kind of intra abdominal pathology requiring urgent treatment. Till that you might go for an anti emetic and an antispasmodic for a symptomatic relief only.I hope this helps in solving your problem. In case of any doubt please do not hesitate to ask again. Thanks for using healthcaremagic portal for your health related queries. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have excessive thirst and frequent urination. Are these due to my medications?\n\nHello doctor,I have been on Lithium for bipolar disorder for over 20 years. From a blood test two years ago, I noticed that my GFR was below 40. So, I gradually started switching from Lithium to Epilim to avoid further damage to my kidneys. But now, I experience excessive thirst and I wake up at night to pee and drink more. I have transparent urine with bubbles, and I also feel quite tired. I would like to know what are your suggestions for these issues. Please find attached my blood and urine results chronologically ordered from the last two years. At the end of this month, I will do a kidney scan but, I have not seen a nephrologist until now.",
    "doctor_response": "Hello. I have seen your detailed reports (attachment removed to protect patient identity). Revert with the above reports. We can decide the further steps based on that. For more information consult a nephrologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is topirol 50mg and tryptomer 25mg proper medication for headache and ear ache?\n\nA friend of mine is treated with topirol 50mg and tryptomer 25mg for the past 9 months. she feels drowsy, uneasy. doctor has given this for her headache and earache also doctor told her it is for treating the excess blood flow to the brain.....can u explain",
    "doctor_response": "Hello!Welcome on Healthcaremagic!Based on your friend history of headache and this therapy, I would explain that your friend may suffer from migraines. This therapy is specific for the prevention and chronic management of migraine attacks. The increased drowsiness could be related to Tryptomer adverse effects. For this reason, I would recommend discussing with his doctor on the possibility of stopping gradually Tryptomer and switching to Prozac or Sertraline. Besides, I would recommend increasing the dose of Topirol up to 100mg daily if tolerated. Hope you will find this answer helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could a lump in the scalp cause mood swings\n\nthere was a link to an already asked question about lump that doesnt show up when i look for it here. My daughter has one that moves around under the scalp on the left side of of her head that is sometimes soft and sometimes hard variably about the size of a nickel to quarter. It is sometimes sensitive to touch but not majorly painful. There have been some moodswings more strong that usual lately, but she is 15 so could just be hormonal.",
    "doctor_response": "Hi.This may be a lipoma or a sebaceous cyst and the best way is to get this excised for two reasons. One you get the disease out of the body and secondly you get he histopathological diagnosis. The mood swings are related to the hormonal changes and not the swelling.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dull ache in middle of chest?\n\nI took a percocet for back pain last night.  Within 15 minutes, I began wheezing, and anxiety or \"an impending fear of doom\" kicked in increasing my heart rate.  I needed to take deep breaths to get enough oxygen into my system.  This morning, I continue to have a dull ache in the middle of my chest but with no other symptoms of anxiety.  And i am not on percocet today.  Thoughts?",
    "doctor_response": "Hello dearWelcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This is in relation with side effect of percocet , which will take 48 hrs . to    settle down .Hope this clears your query .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having pain in abdominal area, back. Feel dizzy, stabbing pains. Hurts to breathe. Stomach swells. Treatment?\n\nHello I've been in pain in my abdominal area ,under the beast area down sometimes pains in the back ,dizzy light headed, stabbing pains in the right chest area , hurts to breath , eat , on sunday I could hardly walk ,I can't function as a human being this has been gone on for sometime now ,I'm exhausted, my daughter is getting married in july I told my husband im praying to be living by then, My stool is tiny lil pieces & sometimes hard as  rocks, Its hard to breath sometimes ,my stomach swells I've been to hospitals & they aren't helping me, I'm begging someone to give me an answer I can't take it anymore I don't have any energy I'm constantly in pain anyone their who can help",
    "doctor_response": "Hi welcome to Health care magic forum.                           Thanks for calling H.C.M.Forum.                           You had pain in the abdomen, under the breast, some times down,and back, dizzy, light headed, stabing pain in chest area, hurts to breath and eat, stool is lil, or hard. Some times it is hard to breath, stomach swells, you doubt whether you can live till your daughters marriage in july.                            First of all every morning you say that you have no ill health at all. practice yoga, meditation, reading books of your choice, hearing music, and if interested you can do internal or external, gardening.                           Avoid taking spices, junk foods, and oily foods, take more of curd, bland foods, like bread.                            I admit that it is gastritis, which is bothering, the rest are apprehension. so i advise you to consult a physician for diagnosis and treatment. you may need to have gastroscopy besides other routine tests for confirmation.                           Wishing for a quick and complete recovery.                           Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What precautions should be taken with intestine having CEA test result rising?\n\nI had part of my colon removed due to cancer just about a year ago and the doctors said they removed all the cancer and it had not gone out the intestine but the Mayo clinic where I had the surgery said to have this cea test every 3 months. Last test was 2.8 slowly been going up and I am worried.  What are the next steps to take?",
    "doctor_response": "Hi,Thanks for writing in.Colon cancer is treated completely by surgery if detected in early stage. However, CEA is to be done regularly to know the progressive increase and possibility of a recurrence of the tumor. Colon cancer might cause liver spread and this also has to be looked for by doing an ultrasound scan and CT scan if required.It is important to discuss the rise on CEA with your doctor and then proceed with doing an ultrasound scan or CT scan and if there is a strong suspicion then a PET CT scan might be necessary. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Boniva generic recommended when suffering from scoliosis of neck and back??\n\nI am taking a Boniva generic once a month 150 mg tablet.  I am experiencing pain below my hip bones on both sides but a little more on my left side.  I have scoliosis in my neck , back and lower back.  I exercise 3 times a week in a gym and walk 2 miles every day.  I am 55 and weigh 105 and am 5ft. and 1 inch tall.  I do lunges and squats as part of my exercise routine. I'm wondering if it's the exercise or the pills that are causing the problem?",
    "doctor_response": "HIWell come to HCMScoliosis is the congenital disease of the spines which is not in normal straight position but goes in to three dimensional deformity that means it shape changed which looks like \"S\" or \"a\" shapes in imaging study, this may not be congenital some time but may be idiopathic and this again sub-divided in different class, late onset may not be harmful, (Initially) but in late life this could cause cardio-pulmonary disability some this could be self limiting and does not need any treatment, complication of this are very rare, scoliosis may be genetically related, physiotherapy self care is must, in severe case surgical intervention is the option, medicine has got no role here, hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can sore throat along with cough and laryngitis be treated?\n\nI have had a very sore throat with coughing and laryngitis. Coughing is so severe my ribs hurt. Cough is a wet cough and sometime has caused spitting up any liquids I ve just drank. Should I go into see a Dr.? Or is she just going to tell me I have a bad cough? I ve had no fever or upset stomach.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.You have symptoms of a sore throat along with a cough and laryngitis which are pointing towards upper respiratory tract infection which is leading to inflammation of vocal cards and giving your symptoms. I would suggest you to - Avoid hot, sharp, spicy food and avoid cold beverages. - Take throat lozenges. - Take proper rest and keep your head high while sleeping. - Take steam inhalation along with vaporizers. - Start doing warm saline gargles. - Drink one spoon of honey mix with a glass of lukewarm water. If symptoms keep on persisting, consult ENT specialist for proper examination. The doctor may order a throat swab test and blood test to confirm the diagnosis and rule out causes. The doctor may prescribe antibacterial medication like Amoxicillin or antiviral Acyclovir depending upon the diagnosis along with anti-inflammatory medications. Hope I have answered your query. Let me know if I can assist you further.Regards, \u00a0\u00a0\u00a0\u00a0\u00a0Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yeast infection in a child?\n\nMy grandson is 2 and about 3 weeks ago he developed a yeast infection in his diaper area the next day he broke out in a red rash all over his body and now the skin on his trunk(back, sides and stomach) is rough and flaking off. The tips of his fingers and the soles of his feet are peeling really bad. There wasn t any fever at all. The skin on his face is also red and flaking as well as his scalp. We have taken him to the doctor and they don t know what it is.",
    "doctor_response": "Hello, my name is Dr.Dorina Gurabardhi. I understand your concern. Some advices that I can give to you are:-Use antifungal creams or medicines.-preventing diaper rash may be done by applying barrier creams like zinc oxide (A+D Ointment, Desitin, Diaparene) or petroleum jelly (Vaseline, Aquaphor) to the diaper area after bathing.-Frequent diaper changes with the superabsorbent disposable diapers create an environment that does not let yeast thrive- Air exposure is also helpful.Hope my answer was helpful, if you have any other questions I'll be glad to help, thanks!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard lump at the lymph node?\n\nI have what i thought was just an infected hair follicle to my axilla area.  When i am sick it gets inflammed and occasionally drains a very foul smelling drainage.  i have had this on and off for the past 6yrs but now i have a hard lump at my lymph node.  I was wondering what this could be called i have seen folliculitis info on the web but i know there is another name for it when it is chronic and foul smelling but i can't remember the specific name of it.  please help",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have enlarged axillary lymphnode.  It can be due to reactive lymphnode hyperplasia, tuberculosis or lymphoma. 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please check my mom's reports and tell me if she is taking the right dose of Thyroxin.\n\nHello doctor, My 48 year old mother is suffering from hypothyroidism from the last three years. The first test for thyroid was TSH, and the result was 15.18. The doctor started Thyroxin tablets of 50 mcg two tablets per day. After that, many times the tests have been done and the dose was increased. Now, she takes five tablets per day. Her recent test results are attached. Please tell me what should we do? What is the\u00a0dose of Thyroxin tablets according to these reports? Her additional problems include depression,\u00a0swelling on face, and temperature.",
    "doctor_response": "Hello. I just read your query and went through the reports (attachment removed to protect patient identity). Hope you find my advice beneficial. Good luck. For more information consult an endocrinologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and numbness in the legs?\n\nI have numbness in my legs when I sit or lie down. Have had back checked, EMG of lets, and vascular check. All negative. The doctor doing the EMG said thyroid could do this. I do take armour thyroid and have for about 6 yrs. Blood tests are ok. Could I be taking too much thyroid. Never really had a lot of symptoms except being cold.",
    "doctor_response": "Hello,Leg numbness can be due to loss of potassium. You can follow the below treatment guidelines:- Drinking plenty of fluids to avoid dehydration- Stretching your leg muscles or riding a stationary cycle- Taking diet rich in calcium and potassium or oral supplements of the same- Check your vitamin B12 and Vitamin D3 levels.Till time, avoid lifting weights, you can consult physiotherapist for help. Physiotherapy like ultrasound and interferential therapy will give quick relief.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Vaibhav Gandhi",
    "dialogue_context": ""
  },
  {
    "patient_message": "T10 paralysis, wheelchair bound, rapid heart beat, dizziness, blurred vision, chest pressure\n\nI am a 38year old male with T10 Paralysis . I have been in a wheelchair for the past 20 years in relatively good health until last year. Since that time seems i have been battling one health issue after the next. Most recently in December I had what seem to me to be a very mild stroke , I had pain and weekness in my left side, heart racing, blurry vision . I was told by the emergency room dotors it was not a stroke, but even now seems like I stil suffer wth the same type of symptons. I currently have a racing heart, dizziness , I am shakey, blurry vision and chest pressure. I have spent so much time in the ER and at my doctors office, but I just want to know the underlying root cause or even where to go next so I can cure the illness rather then the symptons.",
    "doctor_response": "Regtarding your paralysis for twenty yrs, there nis so far no clear breakthrough. one ray of hope is to  have stem cell implantation though a team of gyneacologist and neurologist. once this is done with physiotherapy in due course of time you may get sensation and possibly power in the limb. Regarding your recent pain in the chest with racing of heart you are not suffering from stroke. exclude  anaemia, and dyspepsia with belching. consult your physician to know the exat cause.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can tooth removal be the reason for infection causing slight pain and swelling in the jaw.\n\nmy daughter had her 4 wisdom teeth removed 22 days ago.  Her follow up appointment went well.  Yesterday, she noticed that she has a bump on her lower jaw in the region that one of her wisdom teeth was removed.  It is painful to the tough, but hard and she has some slight swelling, but not really that noticeable.  Is this a possible infection?",
    "doctor_response": "hi thanks for your query. during tooth extraction the bone that supports the tooth is compressed to allow proper healing and to adapt bony margins.the bump what you have been explaining might be hard and sharp bone.this is because extraction to wisdom tooth is done surgically by cutting bone if necessary.if the site is infected your daughter must take a complete course of antibiotic and pain killers along with intermittant worm saline gargles. visit your dentist check the site clinically and and also get an radiograph done if necessary.hope this is helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for RSV\n\nMy 13 mo old daughter was diagnosed with RSV about 4 weeks ago. After 2 weeks she was not getting better (coughing, mucus, fever, vomit) so they took a chest xray and said she had walking pneumonia. They put her on an antibiotic, and an abutural inhaler. After another week she was sounding better, and her cold was gone, but she continues to vomit, at least once a day, always immediately following a meal, or after her evening bottle. She is also uncomfortable and irritable. The dr now says she has post infectious gastritis, and put her on Prilosec. She has been on for 3 days, but now the vomit looks like big (some 2 ) chunks of cottage cheese. I m assuming this is from her stomach acid and her milk from her bottles. Are we doing eveything, or the right thing?",
    "doctor_response": "RSV is a virus that frequently affects children between 6 months to 3 years of age. The treatment is with nebulisation which basically breaks the water and medicines into fine particles and delivers it deep inside the lungs. Steam inhalation at home could give her some relief if nebulisation cannot be given at home. Also give some antiallergic like cetirizine syrup. It should reduce the irritation in her throat which is the likely cause of her vomiting. You may also give some antiemetic like ondansetron half an hour before feeds. You may continue Prilosec. Otherwise you are doing the right thing.Our stomach contains acids that are meant for digestive purpose. The milk is supposed to get curdled when it comes in contact with this acid and this is normal. So, the chunks looking like cottage cheese, are not abnormal if she is vomiting out.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to remove kidney stone\n\nmy son age 22years is having 5mm stone in lower pole of ieft kidney. he has gone through 3 days hydro therapy in a hospital where 15 glucose bottles were injected to him.but the stone did not came out. he is suffering badly from pain. doctor has advised him to take plenty of water and take pain killer? can you suggest suitable medicines by which this can be cured?",
    "doctor_response": "Hi5 mm stone in lower part of the kidney usually does not cause pain unless it drops into the ureter- the tube draining urine from kidney to bladder. I presume the diagnosis is based on a CT scan of the kidneys and bladder and not based on ultrasound alone. If not then I would advice you to get a CT scan of kidneys and bladder. Ultrasound is not good for diagnosing stones in the ureter.If the stone in ureter is confirmed on CT scan and if your son is still in pain then the only treatment is do to surgery to remove the stone. If the stone in ureter is small then he can be treated by a combination of pain killers called NSAID(diclofenac, ibuprofen, Naproxen etc) and tamsulosin.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am a diabetic and sweat excessively while eating. Why?\n\nHello doctor, Why am I sweating without a reason all the time especially when eating? Does that mean I need B12 as I already take pills but do not get any better? Will I get better or B12 is just to prevent from getting worse for the polyneuritis?",
    "doctor_response": "Hello. I understand your concern. Sweating while eating is a phenomenon called gustatory sweating. It is a common symptom that occurs due to a neuronal trigger. It is very common in people with diabetes. With your medication listed, I can see that you are under treatment for diabetes. I understand that sweating can be a very annoying and embarrassing symptom. You are already taking B12 supplements for helping neuropathic symptoms. A better control of your blood sugar levels may help you to get relieved to some extent. If you are overweight, reduce your weight to see an improvement in symptoms. Try eating slowly and avoid spicy food. Other than this, there are other modes of treatment like anti-muscarinic injections, but I recommend that you try natural remedies first, because these injections have their side effects.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does contraceptive cause bleeding while sex?\n\nHello,I just began taking birth control pills on last Sunday after having a pap smear. Since then I have had sex 3 times. The first time was normal. The last two times I bled during intercourse. Could this have anything to do with the birth control?",
    "doctor_response": "Hi, I have gone through your question. Birth control pills do not lead to bleeding or spotting after the intercourse( post coital bleeding) . Local lesions in cervix or vagina including cervical cancer are the causes of post coital bleeding. Since you had your pap smear, cervical neoplasia will be ruled out.I would further suggest you to consult an OBGYN specialist to get properly examined, investigated and treated accordingly.Hope you found the answer helpful.Wishing you good health.Dr Deepti Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffered from panic attacks, prescribed Paxil, gained weight. Side effects of medicine? Reason?\n\nI have suffered from panic attacks for 35 years. Finally my Doctor prescribed Paxil . I asked if there were any side-effects - he said no. After 6 months I gained at least 20 pounds - (I hardly ate anything)! Within 1 month I discontinued the Meds - only 10 mg and lost the weight. After 7 years I still suffer from crazy dreams. Please - what is going on. I appreciate your assistance. P.S. I am back to my normal weight, thankfully after going off the Meds.. No more INSANE drugs for me. Thank you for your consideration",
    "doctor_response": "Hello Paroxetine is a SSRI drug and it is a good drug for anxiety and panic attacks. It is commonly used in a lot of anxiety disorders. It has a little sedation and weight gain as side effect. But the side effects are reversible. If you are afraid to gain weight I would advise you to consult your psychiatrist again for anxiety and panic attacks. Other drugs of SSRI group like Fluoxetine, Escitalopram dont cause gain in weight and infact cause loss of weight. So consult your psychiatrist again and remember these are not Insane drugs, the drugs help to improve living, there are not the drugs for insane.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Nordette usage within 12 hours prevent pregnancy?\n\nhi doctor. i used Nordette as emergercy contraceptive Levonorgestrel 0.15 mg + ethinyl estradiol 30 ug... i drunk 4pcs within 120 hrs of unprotected sex, and drunk again 4pcs after 12hrs of 1st dosage. what are the signs (without using a pregnancy test kit) that the drug was effective? thank you",
    "doctor_response": "Hello,I have gone through the query and understood your concern. Nordette is often used as an emergency contraception and is shown to be effective in the dose as mentioned. You can see withdrawal bleeding 3-7 days after use of the medication. This is suggestive of the efficacy of the drug and protection from pregnancy. Your next natural period may get delayed by a week. Please see your health care provider for further help if you become overdue by ten days. You may need to get a sonogram of the pelvis and a blood test for pregnancy at that stage to help plan further management. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will i get pregnant from pre-ejaculatory secretion?\n\nHello, my boyfriend and I have protected sex and the other day he put the condom on inside out, but he didn t put it on all the way. he flipped it over and put it on the right way and I am worried that I could get pregnant from the pre-ejaculation that could have been on it. but before he put it on the right way, he wiped it off on his pants to make sure. I m not sure if I am ovulating or not though",
    "doctor_response": "Hello dearI understand your concernChance of pregnancy is nil if you did sex during safe period of cycleChance of pregnancy is less if you did sex during fertile period of cycle (10th to 18th days of cycle considered as fertile phase in regular cycle of 28 to 30 days).As condom was wiped then very less amount of precum in it.But pregnancy is also depend on the amount of precum attached on condom.If you had sex in fertile phase then for safer side take I pill to prevent pregnancy.If period will delay by more than 7 days form expected period date then go for urine pregnancy test to confirm pregnancy.Avoid stress, take healthy diet, drink plenty of water, do regular exercise.Hope this may help youContact further if follow up neededBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for difficulty in writing and learning\n\nhi, i am feeling difficulty in writing & learning from last 3 to four years, even i face a problem in doing same signature, discountinued words, spelling confusion ets, my age is 31 years, weight is 60kg, hight is 5 .4 , have read some articals on disgraphia, so pls advise how do i come out from this.",
    "doctor_response": "Hello, Possible causes like dyslexia or learning disorders must be ruled out. Consult a neuro behavioural specialist and he will direct you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can sinusitis occur due to wisdom tooth appearance ?\n\nHi, my wisdom teeth are coming through and causing a lot of tension in my jaw. I'm wondering if this is causing the constant headaches/migraines I've been having recently. And also, if my wisdom teeth are responsible for my sinusitis like symptoms and pressure in my ears. Thanks.",
    "doctor_response": "thanks for your query, i have gone through your query. the pain could be because of the wisdom tooth. it produces radiating pain to the temporal area, head region, neck and some time it might aggravate migraine. consult your oral physician and take radiograph and check the status of the tooth and get it removed if it not in proper position. you can take a course of antibiotics and analgesics. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is difficulty in breathing and mid chest pain indicative of heart blockage?\n\nhi..my age is 26yrs..hght - 5\"9' wght - 67kg.. for a month i have been suffering from breathing problem and also have a pain in mid-chest..my BP is 150/100..a kolkata based cardiologist has asked me to get admitted in nursinghome as he is doubting a 2nd degree of hrt blockage..and told me that i might need to go through angioplasty.. i wonder whether only in 26yrs of age someone can hv such problem?? should i go for another doc's opinion??",
    "doctor_response": "golden rule of medical science is that there is NO RULE.for you first question can it be at a age of 26 yearsyes specially ifyou have  a strong family history of cardiac diseasesyou are a smokeryou have a sendantry life styleand many other factorsas your cardiologiost says you have a second degree heart block plus your presenting symptom is chest pain an angiography can be done to find out any blockage in heartthought it is more advisable  to initially get your serum electrolyte level checkedand get a 2d echocardiography done.stress thallium is a test with as high as97% senitivity ,angiography is a invasive test ...so it would be better to go for a non invasive test like stress thallium earlier ...and if its positive then go for a angiography",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am 26 weeks pregnant and I ate sunflower seeds which is suspected for listeria. What to do?\n\nHello doctor, I am 26 weeks pregnant, and recently I ate sunflower seeds that have since been recalled for listeria. I became ill the next day with vomiting, weakness, fatigue, muscle aches, chills. It was not until 10 days, later that I heard about the recall and made a connection. My gynecologist is concerned, but has no experience with listeria so she is not confident about how to proceed. She had a sonogram to verify the baby is fine at this point. She also ordered a blood culture. However, I have read that blood culture is not necessarily accurate. While my symptoms are gone, I fear that it can stay in my system for 70 days and could affect the baby at any point during that time without me knowing. My doctor is under the impression that any preventive treatment would require an inpatient stay with IVS and may have risk for the baby. Therefore, she does not want to proceed unless the blood culture is positive. Is there anything further I can do as a precaution?",
    "doctor_response": "Hello. Well contracting symptoms, immediately the next day following contaminated food is extremely rare. The incubation period to get symptoms of illness following the ingestion of food is 48 hours to 70 hours. Listeriosis is a self-limiting illness unless the patient is at high risk as in immunocompromised persons as it is an opportunistic infection. Pregnancy particularly third trimester is definitely a risk, but other more common causes like viral illness and other causes are to be ruled out. As in your case, your illness vanished without any intervention, it would have been a viral illness or a self-limiting illness. The only recommended investigation to rule out listeriosis is culture with enrichment media. Other serological tests are there but are unreliable. The good thing here is that you and your baby are completely fine. Your concern is apt but you need to await for the result as treating without confirmation a pregnant lady who is not symptomatic is of no use. Do not eat frozen foods, hot dogs and all these stuffs. Stay positive and do let me know the results.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Parkinson's disease, trembling in left hand, arm and leg, heaviness in legs. Taking medication. Cure?\n\nwhat remedy can you recommend to combat Parkinson Disease . My main symptoms are trembling in the left hand , arm and leg with a general weakness and heaviness in both legs. From last July I have been taking Arg. Nit. 30 and Gel. 30. One month ago I started taking Kali. Brom. 30. I am 72 yrs old and have been sick for more than one year.",
    "doctor_response": "Hi,  Before starting treatment in Parkinson thorough general physical examination is necessary. There is also need to look for drug interactions, medical and psychological  morbidities which is common in Parkinson. There is also need to rule out conditions which appears similar to Parkinson disease. I hope this information has been both informative and helpful for you. Wish you Good Health. Regards, Dr. Ashish Mittal www.99doctor.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any chance of pregnancy?\n\nHello Doctor , I am 47 years old , I tried twice to IVF with my own eggs . Three eggs each time , and after retrieval of eggs , doctors did not make the transfer , because the eggs were not good enough. Is there any chance in my age to get pregnant?",
    "doctor_response": "Hi, you can go for donor eggs- IVF. It will increase the success rates. Your age is high so your eggs quality is not good. Hope I have answered your question.  if you have any other query I will be happy to help.Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do I require medical attention for hurting my feet?\n\nhello i am Sarah 15 today I stook  something unsafe in my boot and  when i wanted to get it out i could not so i puled it out and blood came out with it and  later this day when i went to the bath blood came out and it hurt as hell do i have to go to doctor? and if i have to what would happen  ?please help me thank you",
    "doctor_response": "Hello,Welcome to HCM,As you got hurted and injured your foot because of something which stuck in your shoe and lead to your symptoms. As there was a bleeding following the injury itmay be a sharp object which  has damaged your foot. I would suggest you to follow1. Clean the wound with the antiseptics2. Take TT injection if you have not taken inlast 5 years.3. Keep it dry and clean4. You may require a course of antibiotics. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does hard bumps in tongue suggest?\n\ni have a tiny bump thats kida hard and moves from side to side when i touch and is only sore when i poke it. its under my tongue on the bottom jaw bone under my front bottom teeth. should i worry about cancer? im f 29, 147lbs, smokr but not extrememly heavy and have pretty much quit as of recently.",
    "doctor_response": "HiWith your query, it would have good if you had mentioned about your fronth teeth status its k with your explanation it looks like an periapical abscess or some fubromas. Whatsoever please visit your dentist.  It cannot be a cancer don worry but CONSUMPTION OF NICOTINE IR ALOCOHOL IN SNY FIRM MAY LEAD TO CAUSE CANCER.Hope this helps you",
    "dialogue_context": ""
  },
  {
    "patient_message": "How far the foreskin of a normal penis could be retracted?\n\nHi Dr. matthew MintzI am 29 year old , a virgin guy and needs to know how far the foreskin of a normal penis could be retracted .Is it ok , if it goes  behind the head (coronal ridge)of my penis (without any pain)and the frenulum is at the bottom although it won't go any furthur(i.e. only just behind the coronal ridge).I need to understand would my sexual life be okay.(would be great if you send some pics/link of normal retracted penis)",
    "doctor_response": "Hi and thank you so much for this query.The foreskin can only be retracted as far back as the frenulum. This is entirely normal and would not in any way interfere with your sexual life. Feel happy and comfortable about this.As you get sexually active, please always consider to use protection during intercourse so as prevent STDs like gonorrhea, HIV/AIDS, syphilis, Chlamydia, etc.I hope you find this helpful. I wish you well Feel free to ask for clarifications if need be.Dr. Ditah, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes palpitations with 104 heart rate?\n\nI am a 33 year old female.  I was diagnosed with a slight heart murmur when I was 6 years old.  I often get palpitations where it feels like my heart is going to jump out of chest.  Tonight I have a resting heart rate of 104.  I am very aware of my heart beating (if that makes sense).  Is this ok?",
    "doctor_response": "Hello!Thank you for asking on HCM!Regarding your concern, I would explain that your symptoms may be related to a cardiac arrhythmia. Your past medical history for a heart murmur is concerning about a possible structural cardiac cause of elevated heart rate. I recommend consulting with the cardiologist for a careful physical examination, a resting ECG and cardiac ultrasound. An ambulatory 24-48 hours ECG monitoring is necessary to examine your heart rhythm trends during the day. Some blood lab tests (complete blood count, blood electrolytes, thyroid hormone levels) are needed to exclude other secondary causes of elevated heart rate. Hope to have been helpful!Best regards!Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe weakness in the left hand?\n\nMy husband woke up Saturday morning with his left hand swollen and painful but by evening the swelling and pain was gone but now he has severe weakness in his same arm. He usually does 75 push ups every morning for years and lifts 20 lb weights before starting his day. Now he has tried every morning an he can t even do 4 push ups and cannot lift more than 5 lbs. He has no pain in his arm just muscle weakness. He is 65 yrs old. He is not concerned like I am.",
    "doctor_response": "Hello, I have studied your case. Due to compression of cervical nerve root there can be tingling numbness in your hand and pain.  I will advise you to MRI cervical spine for better diagnosis.You can take neurotropic like pregabalin consulting your doctor.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.I will advise you vitamin B12 supplement.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to improve the quality of eggs in a PCOS person?\n\nhello Dr, our 2nd and 3rd IVF cycle got failed..our 1st one was succesful but i wasnt able to carried out to the term due to IC. so we tried IVF again but both cycles got failed because of poor quality of eggs(i have PCOS)... what should i do now? is there any way to improve the quality ..pls suggest",
    "doctor_response": "Hello, in PCOD the quality of eggs can only be improved with the help of metformin and regular exercise onlyIn case you have any questions in future you can contact me directly on",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is severe backache a matter of concern?\n\nI am in very good health for a 79 year old. I exercise every day except Sunday, for over 10 years. This includes using my inversion bed or table, to help with nerve problem in legs. The last 3 months have had a lot of back aches, that seemed to move around. Ten days ago had blood work ( it was all within the normal range) and Urinalysis done with Leuk Est (75leu/ul) Abnormal - Blood (50ery/ul) abnormal - WBC 10-25,l abnormal - RBC 5-10 abnormal. Have been taking Septra-ds every 12 hours for the last 10 days, I am having less sharp pains across the middle of my back but still side aches. I have cut back on exercise thinking perhaps a strain from a muscle pull??? Still walking 2 miles and upper body exercise with 3# weights, also some stretching on inversion bed. (not nearly as much as I normally do.) Do I need to be concerned, or put up with doctors , you are getting older and back aches do occur and very common for your age. Should I insists for more checking or just put up with the back aches??Perhaps I should say I probably am 10 pounds to heavy, and trying to loose weight. I take Methyldopa 250 mg 4x a day, and several over the counter supplements. Not sure what to do now with the problem not solved in my mind. ugh",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Lower back pain is quite COMMON among middle aged individuals. Back muscle strain is one of the MOST common causes of acute to severe lower back pain. Lifting a heavy object, twisting, or a sudden movement can cause muscles or ligaments stretch or develop microscopic tears. Some other underlying causes like Sciatica, Spondylitis, Lumbar herniated disc, Degenerative disc disease, Isthmic spondylolisthesis etc should be ruled out through clinical examination and radiological investigation (like X- ray, CT scan, Myelogram, MRI etc). Kindly, consult with Orthopedic surgeon regarding this for proper management of the case. TREATMENT: Some general guidelines can help you to reduce lower back pain. These are as follows: 1) Take adequate bed REST with maintaining posture. Individuals who do not regularly exercise to build strength and flexibility are more likely to experience recurrent or prolonged lower back pain. 2) Alternate Hot water bottle or Ice pack can help to relieve most types of low back pain by reducing inflammation. 3) Non-Steroid Anti-Inflammatory Drugs (NSAIDs) are quite useful to reduce inflammation and back pain. You need proper prescription from your doctor. 4) Exercise for Lower Back Pain : It is a key element of almost any lower back pain treatment plan. You may contact with Physiotherapist regarding this. It includes 3 components: aerobic conditioning, stretching, and strengthening. The exercises are done through a controlled, progressive program to build more strong and flexible spine. 5) Epidural Steroid Injections - deliver steroids directly into the painful area of the lower back to reduce inflammation. It doesn't heal the components of the back, but often provide enough pain relief to allow patients to move, exercise and heal. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the light bleeding an implantation bleeding or due to pregnancy?\n\nHi I had sex on May 3. We used a condom and I am on birth control but I don t always take it the same time everyday. I got my period on May 24. Well my period this month was light but I still was able to use a tampon. It was mostly brown with some red mixed in. It was heavy enough that I would need a tampon sometimes but other times there was nothing at all. I took a test before I got my period and it was neg. I took another one today on May 29 and it was neg. I am feeling dizzy today and nauseous with fatigue. Could I be pregnant ? Is this implantation bleeding?",
    "doctor_response": "Hallow Dear, I gather from your history that you has sex about 21 days before the menses. It is very unlikely that sex on this day would lead to pregnancy. Moreover, you are on regular birth control pills though the timing everyday may be variable. However, the bleeding during the so called period was brownish and scanty. So the possibility of pregnancy has to be assessed. Seven days after (?) missed period, pregnancy test gives reliable result. Though the first test you performed was too early to be reliable, the second test was after five days. It is also negative. So the chances of pregnancy are practically nil. Still I  would request you to perform pregnancy test on overnight sample of first morning urine sample afterv4 days again. If this is also negative, you are not pregnant. You may go for ultrasonography to rule out blighted ovum in aborting process. Mostly this appears to be less bleeding due to hormonal imbalance. If you are taking progesterone dominant pills, they can cause such a low bleeding. If you do not get regular bleeding after one week, please report to the Gynaecologist.Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for bee sting?\n\nI recently got stung by a bee, just yesterday. I thought I hadn't suffered any allergic reaction but now I notice that my throat seems bigger and my tongue is a little swollen. Originally after I recieved the sting, I became really light headed but didn't think too much of it. Have I suffered a mild allergic reaction?",
    "doctor_response": "Bee sting may cause mild allergic reaction to severe anaphylaxis in some cases. The symptoms described by you are not due to major allergic reactions and likely to subside by a day. In case of increasing symptoms you may have to take antihistaminic medication. If there is pain analgesic like NSAIDs will help. In severe anaphylactic cases there may be a need of administration of adrenaline. As anaphylaxis reactions mostly occur within first 2-3 hrs of sting bite there is a very minimum chance of developing such serious condition in your case. Mild analgesic with antihistamines will help you to get a prompt recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause pain in the legs after a long drive?\n\nI experience pain in my legs which occurs on a long drive. Its not seeming to come from my back or down my leg nerve as in sciatica but more in what feels like the muscles or veins or ?? I m not sure. Its quite widespread around the legs and happens in both legs. If I stop and walk a little bit this eases it. Or if I manage to move my leg (more easily done with the one not operating the pedals), particularly if I bend the knee up towards my body for a while, it can stop for a while. It can at times get quite extreme and concerning. I am usually ok for an hour but if I do a long drive it comes on.",
    "doctor_response": "Hi, It\u2019s quite common and is due to muscular spasm and sprain. You can take analgesics like acetaminophen or tramadol for pain management and you will be fine. If the symptoms are severe you can go for a Doppler scan to rule out DVT. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling in lymph glands\n\nMy 13 month old daughter has been getting teeth and has had a fever on and off for about 4 days. Yesterday I noticed her lymph glands were terribly swollen and she was having a hard time swollowing. She also had a small white sore on her tongue. I took her to urgent care and was told she was teething. They said her nose, ears, and throat were all clear. Today I attempted to brush her teeth and blood went everywhere from her gums and she screamed. As much as I can see, her gums look very red and swollen. They look like they might be infected.. They look painful. Any help would be appreciated. Thanks.",
    "doctor_response": "hello ,Thank you for posting your query with healthcaremagic,First of all, I would like to appreciate you for taking your daughter to urgent care in order to make sure, things are under normal circumstances,Also, I would like you to know that during teething period it is quite common for kids to have fever, swollen/red gums, if you could offer you daughter cold teething toys(keep it in fridge for sometime) in order for her to chew on it which will sooth her gums down.Also, giving your daughter tylenol for fever will help her a lot. If she has any known allergies, kindly see the pediatrician before giving her tylenol.But if you feel, there is an infection in her gums, I will advise you to see pediatrician again , because kids are prone to infections when their immunity goes down ,as they are not eating well during teething period.Bleeding from gums while trying to brush , could be because they are sore/swollen right now.   Don't worry, kids do go through this phase which is temporary,I wish your daughter healthy day,If you have any more questions feel free to right us back.thank youwith warm regards,Dr. Anshika Taneja",
    "dialogue_context": ""
  },
  {
    "patient_message": "What creates an element of doubt in the mind regarding pregnancy?\n\nhi i m mehnaz, there always a question in mind that can i become pregnant after marraige or not ,i m so confused,somebody told me that i should consult a gyny, i am so insecure about this,plz help me i think its something psychy thinking ,is there is som good solution to get rid of this,plz and plz answer me",
    "doctor_response": "hiits quite common to have anxieties of future.first thing why you are thinking this.if you are getting your periods regularly definitely you can become pregnant.if your periods are irregular consult the Dr to know cause of irregular periods like thyroid problems, polycystic ovaries, severe anemias . its also important to know your general status.dont worry there are so much advances in medicine which helps you depending upon your problem.if everything is fine with your periods and only this thought bothers you, meet the Dr  for councilling. get rid of that thought from you now.Thank youRegardsDR Vasundhara",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to reduce swelling in scrotum after hernia surgery\n\nHad hernia surgery on monday, put in mesh, right side only. Today feeling very good, very little pain, mostly from sitting to standing or vice-versa. The question is about the swelling around the scrotum. the right scrotum is swollen, 3 times bigger than left, a little bruising, but no pain. A little swelling on penis also. My surgeon says its normal, but put me on a antibiotic, cephalexin. I'm 51 yrs. old, 180lbs. Take prevacid, toprol, flomax, daily vitamin. Taking x-strength tylenol for soreness. thank you",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. If the surgeon operated on you is telling that it is normal ,then it could be. He has direct access to you than online doctors. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yeast infection along with itching in the vaginal area?\n\nyes my doctor has me on fluconazole 200mg  for a yeast infection for a couple weeks and still iching in vaginal area and went back to him and put me on the same drug 1 pill a week for 7 week and metonidazole vaginal gel and still having eritation in vaginal era and had my sugar check and it was ok do you know what the problem is",
    "doctor_response": "Hello,Thank You for the query at HealthcareMagicSince your doctor have recommended to continue fluconanazole and metronidazole, the probability is that infection has not cleared completely and causing itching. Once the infection clears up completely.itching will subside.Other possibilities of vaginal itching are chemical irritants like condoms. lotions. scented wipes. douches ,laundry detergents. allergy to fabrics etc. and lichen sclerosus (chronic condition that causes thin, white patches of skin). These conditions are treated by discontinuing the irritant factor and use of steroid creams to relieve itching.I recommend that you continue the medications as prescribed and If itching persist after a week, follow up with your doctor to discuss about other possibilities causing your symptom.Meanwhile there are few things you can try to help alleviate itching-wear light cotton panties-Keep the genital area clean and dry-Wash with gentle soap and water.-Avoid using douches, creams ,moisturizers etc- Wipe from front to back after using toilet-Use a condom to prevent sexually transmitted infectionsHope I was able to answer your questionPlease feel free to address any more concernsRegards,Dr.Lekshmi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in stomach?\n\nHi, my friend had been complaining of abdominal and chest pains including sharp pains occasionally. The doctor recommended an endoscopy where she was told there was swelling in her stomach and a biopsy was done. Is it normal to have swelling due to an ulcer or is it likely that its cancerous in nature?",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query.Performing a biopsy does not necessarily mean that the ulcer would be cancerous. We have to wait for the report to have any confirmation. The ulcers or swelling could also be some kind of benign lesion. Till the reports come in, I would advise your friend to have a proton pump inhibitor drug for a symptomatic relief.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is hypo-echoic liver with mild fatter pancreatic infiltration?\n\ncomplete loss of apatite , cannot eat , constant pain in epi-gastric , umbilical region and right illiac, pain increase with intake of food . Stool formation is loose and sticky . Ultrasound report says , hypo-echoic liver , mild fatter infiltration of pancreas . blood report states no band stabs , neutrophill 50 , eosinophill 10 total bilrubin 1.60 conjugated 0.5 indurect 1.2 sgpt 25.0 sgot 32.0 stool test bacteria 4+ motile bacillus",
    "doctor_response": "NamastheWelcome to Healthcare-MagicGreetings of the dayPossibility of Gastritis should be considered.Would suggest you to consult a Surgeon for further assessment, if possible Endoscopy can be required for the same.In case you need any further assistance, will be glad to assist you.Wishing you happy and healthy lifeTake CareBest RegardsDr T Shobha Deepak",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does AST 82 and ALT 87 mean serious liver damage?\n\nJust had blood work done and my AST is 82 and my ALT is 87. I m a 46 y.o. male and I ve been a heavy drinker for several years. I have, however, just started treatment for my drinking and am committed to significantly reducing my drinking to just a few drinks a week. My question is; do these levels indicate serious damage to the liver, or will the levels improve with significant reduction in my drinking?",
    "doctor_response": "Thanks for posting your question on HCM!I appreciate your concern towards the elevated levels of liver enzymes AST AND ALT.In absence of the other abnormal parameters, the elevated enzymes alone indicate some sort of liver injury apparently caused by alcohol.These enzymes will return back to normal once you stop taking alcohol or alcohol containing beverages.In addition to causing liver damage, alcohol is found to be harmful to almost all the organs of the body.So, please take care.Regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause poor weight gain with VP shunt?\n\nMy daughter has congenital hydrocephalus with VP shunt at 3 days old, now 25 years old but is only 85 pounds height 5feet 2inch . Is this the shunt .she lives with her dad and he says she eats well ,but I m concerned.Forget it you want money I have( SAFELOCK )you should state you want money in advance and not after you ask a question.",
    "doctor_response": "VP shunt is not related with body weight at all. You need to consult your physician for poor weight gain",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath with reduction of saliva?\n\nMy mother is 79 years old - has been perfectly healthy her whole life except for mild thyroid disease and B thalssemia carrier. Six months ago she developed shortness of breath with and without exercise and a reduction of saliva secondary to it and then lately pressure from tip of tongue, tip of nose and forehead with blurry eyes. Everything from chest xrays, echo, CT scan, and blood tests are all normal! She has been cleared from Sjogren s, pulmonary emboli, cardiac issues, hypertension ... all clear! any suggestions?",
    "doctor_response": "The symptoms mentioned seems to be not pointing to any specific illness, and if she has undergone check ups for the diseases mentioned above and all are clear then I am afraid you may have to wait for something new developing that may further help to reach a diagnosis",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What causes dull chest pain?\n\nHello doctor, I am having chest pains that are dull feeling in random parts of chest at random times throughout the day and night. Been having them for 2 weeks now. I have a newborn child, 9 months, and I do not sleep alot because he does not either. That has been going on for 9 months, the lack of sleep. I am 34 years old with no health issues and no family history of heart disease or issues. My doctor did an ECG and said it was normal with an abnormality. I went to a cardiologist and he did an ECG and said it was normal but scheduled me for a echocardiogram and stress test to rule out anything. Am I just having anxiety, which is what everyone keeps telling me, or could it very well be heart related? I am scared. Thank you for your assistance.",
    "doctor_response": "Hello. I passed carefully through your medical history and would like to explain that your ECG seems to be within normal ranges. Nothing to worry or panic about. The lack of sleep has played a role in exacerbating your clinical symptomatology. Anyways it is rationale to follow your doctor advise and pass through the recommended tests cardiac ultrasound and stress test.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Cimzia cause low hemoglobin?\n\nHI, I AM SO SCARED. RECENTLY STARTED HAVING LOW WHITE BLOOD CELLS, LOW HEMOGLOBIN, LOW RED CELLS, LOW PLT. IN LAST THREE WEEKS HAVE HAD TO HAVE 4 PINTS BLOOD AND NEUPOGEN SHOTS TO RAISE MY WBC. AFTER THE NEUPOGEN SHOT MY COUNT GOES UP FOR ABOUT A DAY AND STARTS DROPPING AGAIN. THEY ARE SAYING THIS COULD BE CAUSED BY CIMZIA THAT I WAS ON FOR IBD AND ANKYLOSING SPONDYLITIS. MY LAST DOSE OF THIS WAS APRIL 17. COULD THE MEDICATION STILL BE CAUSING THIS? I KNOW IT CAN SUPRESS BONE MARROW BUT HOW LONG CAN THIS TAKE TO GET COMPLETLY OUT OF MY SYSTEM? THE DR S HAVE SAID THEY ARE JUST AS CONFUSED AS I AM AND ARE STILL DOING BLOOD WORK AND I WILL HAVE TO HAVE THE BONE MARROW ASPIRATE REPEATED IN 3 WEEKS AS FIRST TEST SHOWED ABNORMAL CELLS. CAN A MED CAUSE SUCH SEVERE BONE MARROW SUPRESSION? THANK YOU",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Cimzia can affect marrow by causing bone marrow suppression rarely. The effects usually would last for shorter period of maximum of 10-15 days and improve after that.2. At present Cimzia does not appear to be the cause. 3. You need to get a bone marrow biopsy to identify the possible cause. Vit B12 supplementation along with iron and folic acid is essential. More details necessary for further opinion.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does dull pain in the center of chest indicate?\n\nRecently I have been experiencing a dull pain in the center of my chest. I had attributed this to stress. Today I experienced it much harsher and it seems to be effecting my jaw, almost like this pain is causing an odd tingling sensation in my jaw, more specifically near the bottom of my front teeth. I was wondering if there was anything I should be concerned about.",
    "doctor_response": "HelloYour symptoms may be due to many reasons like cardiopulmonary causes,acidity,musculoskeletal causes etc.Firstly it is important to exclude angina and it is important to know your age.You may need clinical correlation and few investigations.You may need routine hemogram,random blood sugar,liver and renal function test,lipid profile,chest X-ray (PA view),upper GI endoscopy,ECHO,TMT,ultrasound of abdomen.Further investigations may be advised after evaluation.Proper treatment depend upon findings.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can insomnia due to nasal blockage in a 2-year-old be treated?\n\nMy son is 2 yr old.he has problem in sleeping.every night after 3 hours he wake up and find difficult to sleep.he change his position again nd again.he wants to sleep but due to nasal blockage he cant.i use nasal saline but no effect comes.it takes 2 to 3 hours in opening his nose.i have observed he never sleep more than 3 to 4 hours peacefully.when he again sleeps after 3 hours (very hard time me every night) ,he sleep only 2 to 3 hours after changing his posture.what to do?i think his nasal skin gets irritated so he might feel difficulty.what is your opinion?",
    "doctor_response": "can apply paediatric otrivin nasal drop. consult neonatologist for examination and advise on treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I get relief from a torn rotator cuff?\n\n67 yr old female, fell and tore right rotator cuff in May, have had extensive physical therapy, gone to surgeon, inoperable to repair, only possibility is replacement of ball and socket . Currently receiving cortisone shots in shoulder that are helping but bicep swells and have a lot of pain, already on percocet for extensive arthritis thru out whole body but this is stabbing pain. Put lidocaine ointment and ace bandage to relieve some of pain but there is now bruising showing in the upper arm where the pain is. Yes I do regular house hold duties as I have recently retired but when the pain is sharp, I have to stop. Over the counter ibuprofen 200 mg but need to know is there something else I can take. Thank you.",
    "doctor_response": "Hello, The symptoms seem to be related to torn rotator cuff. I see through the query that you have already used pain reliever. I suggest to use ice compresses to relieve the pain and rest. Continue using anti inflammatory medications such as Ibuprofen 400 mg three times a day. If the symptoms continue I suggest to consult an orthopedist for further evaluation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it safe to take both Adderall and Propranolol?\n\nHi doctor, Is it safe to take both Adderall and Propranolol? I have ADHD and I am taking Adderall. I have been asked to speak about my career, but I get paralyzing stage fear every time I speak in front of a crowd. A psychiatrist prescribed me Propranolol, but this does not seem like a safe combination. It is a kind of like how beta blockers are avoided when people have used cocaine. I spent a year after college as a research assistant in an emergency department. Please help.",
    "doctor_response": "Hi. We are here to help you. The fear and uncomfortable feel of standing and speaking in front of crowd is due to anxiety only, which can be an independent entity or can be associated with ADHD (attention deficit hyperactivity disorder) itself. Propranolol is going to reduce anxiety, but yes it should be avoided if you have been using cocaine or have any respiratory issue associated. In my opinion the best drug for you would be SSRI (selective serotonin reuptake inhibitor) like Paroxetine which will not interact with Adderall (Amphetamine) or even with your cocaine issue. Revert back with the answers to a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe itching on the hands?\n\nI occasionally have a break out of severe itching on my hands, so bad that I end up rubbing them so hard that I get popeye swelled hands. I know it s a severe allergic reaction but I don t know from what. I do suffer from hay fever, grass, ragweed and pollen. Can you help me? Trex...",
    "doctor_response": "Hello,You need to get some blood tests done. Kindly meet your doctor and discuss this. You need to get complete blood count to see if there is eosinophilia in blood. Generally, people with hay fever have this. In that case, you will need to take tablet Banocide Forte or Hetrazan or DEC 3 times a day for 15 days. Severe itching can be reduced by taking tablet CPM or Avil or Cetrizine.You need to find out which substances cause allergy to you and thus avoid it.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sanjay Kini",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for soreness in cheeks & jawline\n\nyesterday i used crest pro health mouthwash and started getting a tingling feeling in my mouth. when i woke up this morning my cheeks have been sore and when i eat i feeling a tingling sensation around my jawline. is there a way for me to relieve this?",
    "doctor_response": "Hello,  Read your query, as you have soreness in cheek and jaw this tingling sensation can be due to infection in jaw due to inflammation in gingiva or in inflammation in periodontal ligament due to deposition of food debris , not maintained proper oral hygiene,  use of tobacco containing product , or improper brushing or flossing technique. For this you can do luke warm saline gargle two - three times a day, avoid gum irritants that is tobacco containing product if you are taking, gently mas sage your gum with pulp of your finger in circular motion, you can apply ointment gum paint like stolin and take Vitamin B and C suoplements by consulting with your doctor.  Consult dentist and go for oral examination and oral prophylaxis. Hope this will help you.  Regards, Dr. Priyanka tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Report says breast nodules are fibroadenoma, but I am terrified. Please help me.\n\nHi doctor, They found two solid nodules around .09 cm on my left breast, one of which was suspicious finding BIRAD 4. On the ultrasonography, it looks black inside, wider than tall. Please help me out. I am terrified. The report said although it could be a fibroadenoma, it is still suspicious.",
    "doctor_response": "Hello. I have gone through the ultrasound report of the breast (attachment removed to protect patient identity) which is showing two suspicious solid nodules. Now, it is highly recommended to take a biopsy from both the solid nodules to confirm the diagnosis. Biopsy report will clear all the doubts and will show whether it is fibroadenoma or any other benign lesion or malignancy. The major risk factors for developing breast cancer are: In case you have any family history of breast cancer then you must go for genetic counseling. If you have any further questions revert to me. For more information consult a medical oncologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness and popping sound at the back of the neck?\n\nHello, yes, I have a popping sound in the back of the left side of my neck. Came on without any traumatic event. it s only when I turn my head to the left. I also notice it when I work out doing weights now my left back side of the neck tightens up and then it will pop. So there is a bit of my I can feel in the muscles. Nothing serious but it is a nuisance. What is the issue here? Is there non intrusive surgery? Will stretching help...as I am wondering if this is from the muscles causing the tightness which is causing the popping? thanks so much.",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. It seems your muscles of your back side of neck has gone into shortening. This may occur due to wrong posture in your day to  day life and sleeping in wrong position. Due to shortening of muscles bones have to adjust there alignment within the joint to receive the muscle of tightness and maintain the optimal length of muscles. Apply hot pack twice daily and do gentle neck movements and neck isometrics exercises. Do care about your neck posture and sleep straight on  butterfly pillow. And do gentle stretching exercises for neck and shoulder muscles it will help you. Follow it for one week and get back to us for neck and shoulder exercises regime once you stops feeling the sound as it might also be the initial stages of cervical spondylitis and following exercise regime and ergonomic regime will keep things under check.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Harsh Swarup",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes muscle pain , back pain and headache?\n\nI have a 20 year history of positive ANA, ( I am 43, female) diffuse speckled pattern, (used myself as a negative control which did not work out so well.) I have had mono articular attacks over the years but never any conclusive results. I just experienced a flu like episode leading to the most sever bone pain in my pelvic girdle and muscle pain in my buttocks, thighs, calves, and shoulders I have ever experienced. My PCP is concerned of PMR as I have also had significant changes in vision over the last 4-6 months, constant headaches, and now sudden increase in LFT s of AST 299 and ALT 499 when completely normal in January. I have significant family history of aggressive cancers and wish to decide if a PET CT is now my next best test. My only element that is not coinciding with PMR is an ESR of only 2. What would you recommend as the next step in treatment and to ascertain if the PMR symptoms are primary or actually secondary to an undiagnosed cancer?",
    "doctor_response": "Hello, I have studied your case.  Yes I will advise you to do PET CT SCAN You may need further investigation to rule out malignancy.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is vaccination needed again after being scratched by cat for second time?\n\nHi Doc.,Im Cris. I was scrathced by a cat in my legs last June and completed my vaccinne until the month of July..This month of september i was scrathced again by a different cat, on my shoilder bcoz it jmped on me.DO I NEED TO TAKE ANOTHER SET OF VACCINE???",
    "doctor_response": "Hello,Welcome to HCM,Cat is a known reservoir of rabies virus and can transmit rabies by biting. Rabies is a 100% fatal disease but 100% preventable by proper and adequate treatment.As you were bit by a cat previously for which you have taken complete shots of anti rabies vaccine. As you were scratched by the cat once again, according to WHO categories you will be categorized into Re-Exposures.Re_exposure should receive two shots of anti rabies vaccine on days 0 and 3.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the difference between Iron Ferrous Sulfate and Bisglycinate drugs?\n\nmy daughter is anemic and has been taking iron supplement, iron biscglycinate 50 mg 2 x day. what is difference between iron ferrous sulfate and biscgycinate. does this dosage sound correct? how much elemental iron does this have in a 50 mg dose of biscgycinate?",
    "doctor_response": "Hi I did review your concern.Both iron sulfate and bisglycinate have different amounts of elemental iron and that relates with toxicity and abdominal side effects as well as amount of response that occurs. Higher the elemental iron, higher the toxicity but higher the response.So a balance is required. Iron bisglycinate 50 mg bid is a right dose to start with and the best way to measure response is to get a reticulocyte count at 1week after response. it should rise in response to iron therapy. Also iron bisglycinate has 20% w/w elemental iron in it just like ferrous sulfate. It has more bioavailability and known to cause less Gastrointestinal disturbances as compared to ferrous sulfate.I hope this helpsWish you all the best Thank you for choosing healthcaremagic",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes choking feeling, fatigue and muscle weakness?\n\nFor the past 8 months i have had the feeling of someone constantly choking me, fatigue and muscle weakness. Also i have had strenuous hair loss. Is it possible i could have some type of hormone imbalance being a 22 year old male, i feel i am too young for that to happen.",
    "doctor_response": "Hello,The symptoms seem to be related to many medical conditions. One of the common causes can be anemia. Other possible causes can be hypothyroidism. I suggest to do a complete blood count and thyroid hormone levels. Meanwhile, I suggest to take a multivitamin supplement and eat a healthy diet.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long do symptoms of stomach flu last?\n\nHow long does the stomach flu last ?   My daughter is going on day 4 , she feels like she needs to throw up but she hasn't.   And  we went to urgent Care yesterday, the Dr said she is almost over it.   But. She is just laying around.  Not sure what to do for her.   She is 5.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It seems your kid is having viral diarrhea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting, you need not worry. I suggest you use zinc supplements (Z&D drops once daily for 14 days) and ORS , as hydration is very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron (as prescribed by your pediatrician). Regarding diet - Avoid fruit juices as they might aggravate diarrhea. You can give zinc supplements & ORS apart from normal vegetarian porridge & soups. Best regards Dr Sumanth Amperayani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is syphene tablet good for normal periods ?\n\nI went to doctor for a general chk up for getting mild cramps during ovulation ,we haven t planned for baby yet and I told her I will plan for a baby soon so she advised me if ur anxious to get pregnant take siphen and duphaston , my periods are regular and nothing serious medically. Can i take those tablets .?",
    "doctor_response": "Hi Welcome to Healthcaremagic Tablets prescribed by your doctor will increase your chances to conceive. Siphene is ovulation induction drug and other one is to give progesterone support. If it has been prescribed by your doctor then there is no harm because she knows your health condition well . Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can OCD with irrational fears be treated?\n\nSir I am Gaurav from Lucknow Sir I am sufferring from ocd I have following sysmptoms 1)Used to wash hands excessively when I was youn 10-12 yrs 2)fear of God(In 2003 when we were doin some puja) 3)Fear of exam(in 2008 I was having my final sem MCA exam a strange feeling came to my mind If I throw my roll no then would be debared from exam) 4)What happen If I slap someone in public Sir I dont know why these thoughts came to me I am mentally sound also sir I am very very shy and soft spoken,and also have feeling of fear of getting into new environment..thats why I am unable to get job.pls help me",
    "doctor_response": "In my opinion your problem is easily treatable by drugslije fluoxetine,fluvoxamine, chlomiprine. Visit a lical psychiatrist or kgmc lucknow.So dont worry.  Hope my suggestions helpful and thankful to you. Take care. Don't forget to give ratings.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can an online doctor explain the cranial MRI with gadolinium & dwi report ?\n\nHi my wife undergone cranial mri with gadolinium&dwi,and cranial mra and the impression is this:1.interval evolution of the subacute ischemic infarct in the left medial thalamus and cerebral peduncles.2.chronic lacunar infarcts,right medial thalamus.3.the above lesions sre compatible with artery of percheron infarcts.4.atherosclerotic vessel disease with suggestive proximal cavernous right ica&right a1stenoses.5.if the demonstration of the artery of percheron is warranted,DSA is recommended...what does this means?does my wife has the cance to recover?how does this multiple stroke be treated?",
    "doctor_response": "Hi,Thank you for posting your query.Your wife's MRI brain report shows features of multiple infarcts in the brain (blood clots due to lack of blood flow).Treatment would consist of physiotherapy, speech therapy, etc. medications such as aspirin would help in preventing further strokes. Underlying risk factors such as sugar, BP, cholesterol, etc should be checked and treated too.Best wishes,Dr Sudhir Kumar MD DM (Neurology)Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to find the ovulation period in a person with irregular periods?\n\nHello, I had a miscarriage in April 2012. I am having trouble becoming pregnant. My last four cycles have been irregular and having trouble trying to figure out when i'm ovulating. I also wonder what would the method be since my partner works out of state and we only have sex approximately every 4-6 weks.",
    "doctor_response": "you are in a difficult position, because with irregular periods it is difficult to predict the day of ovulation, and you don't have sex often.  you can use an ovulation predictor kit to help you, but I would suggest that you speak with your doctor.  your actor will be able to prescribe you medications that will make your ovulation more regular and predictable so that you can time our sex better and make it easier to get pregnant.  I wish you the best of luck!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a hard lump in stomach after getting bruised?\n\nHello. A week ago I tripped landing hard on my lower righthand side of my stomach onto the corner of my footboard of my bed. Now the bruising has started to fade but Ive noticed a hard lump about 3 inches long right under the injured area. What could that be and should I go see my doctor?",
    "doctor_response": "Hi. Of course yes. Visit a Doctor. The lump is most probably a hematoma, but the resultant local weakness and herniation should be ruled out by a clinical examination and ultrasonography.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring bacterial vaginosis?\n\nHi I have been having problems down there for a while now and at first I was afraid that mayb I have contracted some kind of std but I've been tested multiple times and every time tests come back negative. They told me I had BV and put me on meds for it but it Keeps coming back. The worst part is the pain in my lower right abdomen and the odor in the discharge. I'm starting to get very self conscious and concerned for my long term health. Does anyone have any idea what could be going on w me? Thnx",
    "doctor_response": "Hi and thank you so much for this query.I am so sorry to hear about this recurrent infections. If you feel better after the treatments that are being prescribed, then I think they have made the right diagnosis and treatment decision. However, if you never get better, a different diagnosis needs to be looked into. Possible contributing factors to Bacterial vaginosis is poor hygiene, use of poorly maintained public rest rooms, etc. I will also suggest you see an OBGYN for more insight about this. I hope this helps. I wish you well. Thank you so much for using our services and feel free to ask for more information and clarification if need be.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does sharp pain along with swelling in the foot indicate?\n\nI started with pain in my left foot and once in a while a sharp pain in my left leg then after a couple of months the pain is in both feet and my ankles started swelling, the swelling goes away by the next morning. but pain in feet are bad, hurts to walk and is not in the heel it can be on the top bottom in toes not always in same place. I have been in remission from sacroiditis for over 5 years. could this be a sign of my sacroiditis coming back, it was in my eyes at the time. I have been to a foot doctor, I don t think it plantifiactitis",
    "doctor_response": "Hi, It may be due to minor contusion to ligament injury. As of now, you can take analgesics/anti inflammatory combination like Diclofenac/Serratiopeptidase for symptomatic relief. If symptoms persist, better to consult an orthopedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for folliculitis on penis\n\nHello, I was recently diagnosed as having folliculitis and it is showing up on my penis area. Sexual activity irritates it and therefore is becoming difficult. I am taking oral antibiotics and topical treatment but nothing is working. How can I treat this?",
    "doctor_response": "HIWelcome .Do not worry. Consult your Doctor again,he may change the antibiotic .Keep the area clean & apply antiseptic several times.It may take one week to recover.Thanks for query .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for cold and bronchiolitis\n\nI have a 6 months old baby boy and seems to get a cold all the time, since December to now march, he has suffered from 4 colds and also had bronchiolitis , he gets congested and suffers with a snotty nose which means he doesn t settle well through the nights, he has also never slept through the night due to these colds reoccurring. I use saline nose drops, a vaporiser and a humidifier to help him be more comfortable through the night but still nothing helps. My mother-in-law suffers with her heart, has a very low to nothing of a immune system and has M.E. so I am also concerned that maybe her problems have been passed down to her grandson?",
    "doctor_response": "Hello! Welcome to HealthcareMagic! Have you taken you're child to a pediatrician? If no, better take expert opinion. Children may recover fast but can deteriorate too. As far as grandmother is concerned, has her physician told you she has contagious infection? Two months is quite a long period to treat the child on your own, as it may lead to many problems. Hope that clarifies your doubts. Regards, Dr. Ratna Mulay, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. l got a sore hard lump after the removal of wisdom tooth. Is it normal?\n\nHello doctor,I just got one side of my wisdom teeth removed both upper and lower six days ago, and I have another one scheduled after two days for the left side. The upper is 100 % fine, which they pulled. The lower they pulled the tooth without removing the root because it was too close to the nerve. I do have some stitching in this area currently on the lower cheek. Noticed a hard lump about 1 inch between my lower jawline and cheek area. Is this normal because of swelling or something else. Currently taking Amoxicillin 500 mg and Ibuprofen 600 mg. Please let me know what this hard lump is, also generally on the lower side where this lump is, remains sore.",
    "doctor_response": "Hello. The lump is mostly a hard swelling which forms postsurgical removal of the wisdom tooth or maybe even by swollen lymph nodes due to infection. It takes a week or two for the swelling to subside. Sometimes, if the root is still inside, the infection may be remaining there causing swelling. Get an X-ray done to find out the exact problem and stronger antibiotics like Augmentin (Amoxicillin and Clavulanic acid) along with a painkiller for a week. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a lump in the neck?\n\nPitting edema in right leg, lump on right side of neck that s been there for about 10 years and is now sensitive to touch, tire easily, frequent urination, irregular menstruation cycle, frequent headaches, eye twitching, unexplained chest pain that leads to difficulty breathing, can you please help me find out what is going on in my body? I m a 35 year old mother of 5 children and I worry because my doctor made a comment that he doesn t want to be the one to tell my children I died because he didn t listen but he doesn t seem to be understanding that something is not right. Please help!",
    "doctor_response": "Hi,Welcome to HCM.Based on the facts you seem to suffer from-multiple ailments suggestive of Hormonal Imbalances with? diabetes/hypothyroidism/cardiomyopathy.I would suggest you to have A second opinion from Physician and endo-crinologist to work out the causes for all your syndromic illness.Theses specialist would work out the treatment for the multiple complaints you have.Now doubt at 35 its a cause for worry.But I think you never have been treated with specialist doctors,which you need to be,since long back.Don't worry till then and act fast to investigate it fast on the lines suggested as above.Hope this would resolve your anxiety and would help you to plan further treatment with your doctors.Will appreciate your Hitting  thanks and writing  excellent review comments to help needy patients like you. Good Day!!Dr.Savaskar,Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the hard,purple bump on my butt?\n\nThere is a bruise like mark on my butt cheek, basically on the crack line. It's been there for over a year and  from time to time it hurts. You can feel a little bump if you touch it and it's very visible. Purple. It feels tougher than the rest of my butt. Help!",
    "doctor_response": "Hi,This may be a pilonidal sinus. I suggest you see your doctor for assessment. This is not a serious problem but can be helped by surgical removal to prevent any infection developing. Regards,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a cyst on the forehead indicate?\n\nHello, I have a cyst on my forehead and I really need it away. I have watched videos on removing them and have all sterilised equipment, I have stitches for after it to close the wound. I don t have numbing for it but I figure I can take the pain to get rid of it. I am just wondering the location of it (above the eye brow) is safe to make a small insicion and force the puss out and the sack of course. Going through the NHS is taking too long, it s an eye sore and a great dent to my confidence. I want to go through with it and I am accepting the risks, I just want to make sure I m not going to hit something major, I am probably going to go through with this so trying to talk me out of it isn t the best idea, I just want to get advice on the best way to go about it or something I need to watch for etc?",
    "doctor_response": "Respected user , HiThanks  for  using  Healthcaremagic.comI have evaluated your query thoroughly .*  This cyst may be simple sebaceous cyst or dermoid cyst of the scalp .*  There are potential chances of bleeding as per the location is highly     vascular along with other possibilities  by  this  venture , I  strongly     oppose  not  to  venchure on your  own  for  its  removal  ;  only     qualified  Surgeon  will  do  it  in the best possible way .Hope this clears your query .Welcome for further  doubts .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cortical cyst in kidney\n\nMy father has recently been operated to remove right kidney because of suspected renal carcinoma and the tumor size was very big. Now he is detected with cortical cyst measuring 14 x 13 mm on the left kidney. Is there any thing to press the panic button?",
    "doctor_response": "Good Day and thank you for being with Healthcare Magic! Simple Renal cortical cysts are benign conditions and doesn't warrant any treatment or intervention. The cyst of your father is very small and would not transform into a cancer 99% of the time. I would suggest having him drink 1.5-2 liters of water and avoid pain medications. If he has hypertension or diabetes then he should ensure they are well controlled to take care of his remaining kidney. FFUp with ultrasound to monitor the cyst is advised together with biannual urinalysis and serum creatinine determination.   I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at:   I would gladly help you.  Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain?\n\nHello I am 25 yrs old and i have chest pain at the end of the sternum n exactly opposite of the sternum on the back. the pain sometimes radiates towards left shoulder and hand. have done all the essential blood tests, ECG and  xray too. Everything is normal. I am prone to hyper acidity but m anxious bout whether my pain is due to acidity or any heart related problem.",
    "doctor_response": "Hi thanks for contacting HCM...According to history, heart problem ruled out first ....Your ECG normal so no need for worry ...Still for confirmation about rule out ischemic coronary artery disease you can investigate with echocardiography.If it is normal cause is acidity and excess stress...Try to avoid taking stress...For acidity take omeprazole capsule 20 mg before meal on empty stomach ....Lots of fluid taken....Avoid excess spicy food , smoking etc that aggravate acidity .Consult physician for it .Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do the MRI findings of a cyst on the knee indicate?\n\nhello. I have a cyst behind my left knee a year ago. It did not bother me. Just 2 weeks ago, I experienced some pain on the left knee, and at the same time I noticed another cyst like thing just above the first cyst. Mri done today, says the following:- In the popliteal fossa, a multiseptated cyst closely related to the midial gastrocnemius is noted extending inferiorly and laterally to the uppoer calf. Maximum diameter of this cyst is about 8cm x 1.7cm x 5cm. Superficial to part of this cyst, mild increased signal is seen in the subcutaneous tissue. The ACL, PCL, MCL and LCL all show normal signals and morphology. Quadriceps and patellar tendons as well as the patellar reticula are all intact. The lateral and medial menisci do not demonstrate any tears. A small suprapatellar knee effusion is noted. Osteophytic spurs seen in the superior and inferior poles of the patella. Conculsion: Solitary multiseptated cyst in the popliteal fossa and upper calf, consistent with Bakers cyst, possible with minimal leakage. What do you advise I do as a follow up? thank you very much",
    "doctor_response": "HiThe cyst may or may not be bursitis.since painful,it may be inflamed.Treatment is anti inflammatory medicines like advil twice a day..and your surgeon may consider excising it as it's fairly large and communicating into joint or extending..it may lead to infection also, so better to remove surgically",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dry skin\n\nHi I have dry skin and redish bloches on forehead, very dry after washing in morning and I moisturise the skin after with a dry skin cream. Also I have whitish patches forming on the top of the head with one in particular in the centre raised and throbs sometimes, also the penis skin gets dry and flaky and itchy sometimes  can you advise",
    "doctor_response": "Hi,You said you suffer from dry skin..xerosis. There may be discomfort  due to dryness of skin. Itchy sensation or burning would be there. Soap might exacerbate the disease, so avoid to apply soap at bath. You consult dermatologist for firm diagnosis and treatment. Investigations may be done to rule out internal diseases like DM,thyroid dysfunction,renal diseases, blood diseases or other diseases.Moisturising cream or lotion may be applied. Mild steroid cream may be applied if you have itching. You may take antihistaminics,vitamin A and vitamin E orally to have improvement. I hope this would be helpful in treatment.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lumbar MRI showed a disk bulge and herniation. History of TLIF spinal fusion. What does it sound like?\n\nHello good evening. My name is Robert. I have a previous history of TLIF spinal fusion L5-S1 in 2011. I was involved in an auto accident in 6/11/13 while at work. I was struck from behind by a Frito Lay delivery truck and a sedan. I went to the ER, and was referred for Neuro Surgery. Neuro surgeon referred me to a neurologist who conducted EMG / NCV which indicated Chornic Bilateral Radiuclaphty.  I requested Lumbar MRI which reported small central disk bulge at L5-S1 area, and Cervical MRI which indicated C4-C5 of a small subligamentous disk hernation at left ventral touching cord. I have felt moderate to severe pain for almost 5 months. I am scheduled to see a Neuro Surgeon in 2 weeks. I had previous bad experience with pain management, and I am wondering if I should reconsider having surgery again for the back and most likely neck. Any feedback is greatly appreciated. I do have a workers comp & third party attorney working on case recently.Thanks",
    "doctor_response": "hello Mr Robert , you mentioned that EMG/NCV studies indicated chronic bilateral radiculopathy.Is this report for upper or lower limbs?If it is for lower limbs , with ur previous history of TLIF fusion for L5-S1 and present MRI showing small central disc bulge at the same region you neednot worry for this as it is already a pre existing problem.Do you have such a severe neck pain n radicular pain in both hands incapacitating ur daily activities now ?Do u have any difficulty in gripping things with hands or do u have any difficulty in combing ur hair or buttoning n unbuttoning of shirt?If u dont have any of the above mentioned,small subligamentous disc herniation at C4-C5 region,I always advise you conservative treatment in the form of wearing a hard cervical collar when u r at work ,analgesics like tab aceclofenac 100mg twice daily after food,one tablet pantaprazole 40mg on empty stomach in the morning half an hour before breakfast, a pregabalin tablet 75 mg per day and physiotherapy (IFT) n one week of bed rest is advisable.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How do you stop a old woman with alzheimer's disease ?\n\nHello, I would like to know how do you stop a 57 yaer old woman with alzheimer's disease from trembling on her left side ( face , mouth, hand, leg and foot) could this be a sign of something else or side effect she also has anxiety? When she lays down it kind of calms down but when she walks, talks, and eats, its worse.",
    "doctor_response": "Hi nicole, Tremors she is having is also called as intention tremors which appears on action, which may be due to stress, medications, alcohol, drug abuse, stress, cerebeller disease. consult neurologist for further treatment and evaluation Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Ultrasound report shows mild diffuse wall thickening of gallbladder, tiny,  echogenic focu present with reverberation artifact.   Explain\n\nMy sister's ultrasound report states the following for gall bladder. \"Normal size, shape and position, showing mild diffuse wall thickening. Multiple tiny echogenic non-mobile focu are present within its wall with comet tail reverberation artifact.\" What are the possibilities of gall bladder stone and does this require removal by surgery? Please advice",
    "doctor_response": "Hi ! You have not mentioned the reason for doing an ultrasound for your sister. Did she have any abdominal pain, or belching or any hyper-acidity. Immaterial of whether she had these symptoms, the ultrasound report could mean that she has got multiple stones, which could become impacted anywhere in the biliary tract and cause more problem. I would suggest you see a gastrointestinal surgeon/general surgeon, who may clinically examine your sister, and may also advise for a gall bladder removal surgery, which is done well by the minimally invasive surgery.I wish your sister an early recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Unable to conceive. Taking injections to increase follicle size. Scan shows ruptured follicle. Did ovulation occur?\n\nHi.. I m trying to conceive from past 6 months. My doc is giving me injections to increase my follicle size. I had my follicle scan on cd 12 and the size was 16. I had one more scan on cd 14 and the report said the follicle had ruptured but the size of the follicle was 14. What does this mean? Did I ovulate on cd 14 or I did not? Can the follicle still have a size even if it ruptures? My email id is YYYY@YYYY .",
    "doctor_response": "HELLO, Well,the follicle might have ruptured evidenced by free fluid in the pouch of douglas.Clinically ,many times you feel a dull aching pain on lower abdomen during follicular rupture.The follicle of 14 mm might be a new follicle that has come up.Even the follicle ruptures , sometimes you can measure it , but the margins are irregular.the third possibility might be human error. I think I have answered your query.good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pimples, black spots on face. Prescribed clyndamycin and benzyl peroxide lotion. Can I use?\n\nHi my skin is oily.. i used cinthol for many years.. But recently i changed to Dove. I get lot of pimples and black spots in my face..It happen last year also when i use one new cream at that time a dermatologist suggested clyndamycin and benzyl peroxide lotion and dermadew soap. my face become soft and clear.. shall i use the same lotion and soap now.. and am using Lactocalamine lotion now.",
    "doctor_response": "Hello, Thanks for writing your query to us.You can continue clindamycin, benzyl peroxide lotion & dermadew soap. Continue with lactocalamine lotion daily.Avoid touching your face frequently.Use daily suncreen.Have good night sleep.Avoid stress & exertion.Have healthy nutritious diet. Drink plenty of fluids.Avoid dehydration.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause fever and rashes on an infant s body?\n\nI have a 17 month old grandson who has what seemed to be a minor cold for the last 2 weeks. He threw up a couple of times in the last 2 days, (mostly bile and water), and had a temperature of slightly more than 100. He went to the pediatrician with a heartrate of about 200. He is now in the hospital where he has had bloodwork that came back normal except for a couple bands high in his wbc count. His hr is now about 140 but when he s upset it spikes to 180. Chest xray appears a normal heart and lungs, but they are saying his lungs may have borderline pneumonia? He also has presented with a rash. Any ideas?",
    "doctor_response": "Your child is suffering from the ill-effects of a lung infection which may have occurred initially as a virus, but got complicated into a bacterial one about the time he had to be put in a hospital. All the symptoms and signs and the investigation results prove that the infection is a rather serious one, so he should be on a path to recovery if the antibiotics they are using on him are working well. The rash could be part of the manifestations of the germs that gave him the infection, or it could be due to the antibiotic that is currently being given to him.Hope this helps!Dr. Taher",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tiredness, weight gain and right-sided discomfort in the rib cage?\n\nI have been very tired the last couple months, I experienced weight gain, I get these discomforts on the right side of my rib cage. For the last week I have been waking up with a headache. A few months ago I was having a lot of debilitating muscle spams on back on the same side as where I keep having discomfort. What is going on with me?",
    "doctor_response": "Hello there I have read through your question and would like to tell you that sudden weight gain can be a sign of Hypothyroidism. I would advise you to get a thyroid profile done . Regarding the right sided discomfort and occasional pain , it can be a sign of cholecystitis. An USG abdomen will help to diagnose it. I hope that answers your question . If you have any further questions please feel free to write. Thank you for choosing healthcare magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Temporary brown spots on upper thigh, like pigmentation spots spot on throat. Cure for symptoms?\n\nHi,I have light brown spots on my upper inner thighs. They are coming and going, but recently I feel like I have more spots. I have them in both sides and they are not itching and they are painless.I'm a healthy, normal woman sizes woman.The spots are different sized, and like I said they have been coming and going. At first I just thought that it was some pigmentation spots, but now I'm getting worried and I don't want them to spread more.I also saw on spot in my throat, a really small one but the same type.Thank you.",
    "doctor_response": "the symptoms which you have mention is cleared that it is a fungal infection but it not proper to justify and treat your symptoms without watching it.so for this kindly upload the picture of your effected area.... then it will be treated or suggested .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment can be done for neck and back pain ?\n\ni am suffering form back and neck pain since couple of weeks , had pins and needles and totally blackout today. hi , i am suffering form back and neck pain since couple of weeks , today when i was doing my exercises for my neck pain , i suddenly blackout and felt pins and needles in my body. I also felt weak at that moment. Would really appreciate if you could please advise me , what is happening and if there is something to worry about . I am also a heart patient.",
    "doctor_response": "Hello, Thanks for posting your query. One thing is you check out if you are over exercising. Black out also occurs if more heat is generated when your over exercise. You can also try with pain killers and give rest to your muscles along with hot compresses. If you do not find relief then I suggest you to consult a physician. Hope I have answered your query. Wishing you good health. Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can past failed IVF history permit pgd ivf in india?\n\ni am 35 yr old female,i am stimulated 3 times for pgd ivf in bangkok but 1 st chance (jan 2011)didnt got enough eggs to proceed for pgd2 nd chance (april 2011)we got 3 embryos but all abnormal3 rd chance ( june 2011)we got 1 ET done but faileddoes above history give us sufficient reason for pgd ivf in india",
    "doctor_response": "yeah you can go in india mainly gujarat. lots of fertility center who can solve your problem. good and low cost facilities including surrogacy. so dont worry all the best i  wish you will become mother soon. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for body odor during dieting\n\nEvery time I start dieting ( really staying with it) I start noticing this odor coming from my forearms and hand. Not the sweaty arm pits, it actually seems like it is emitting from my skin. I have tried antibacterial soaps and etc. Is there a home remedy other than H2O2, vinegar or acohol",
    "doctor_response": "hello,,you can try having bath 2-3 times a day.dont use tight dresses.dont use synthetic clothes.try cotton dresses and be in healthy surroundings",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness/tingling in feet while blowing nose?\n\nEarlier I blew my nose and my feet went sorta numb and felt tingly? But they are fine now. I always feel pressure on my chest too. I am an anxious person who doesn't handle stress well. I am not a very good eater either. Is this normal, piched nerve, or could it be serious like pressure on the brain?",
    "doctor_response": "HI, thanks for using healthcare magicIf you had to blow your nose consistently or blew hard then the increase in pressure would have cause the symptoms that you are experiencing.It is not likely that it is due to any serious condition especially if it is persistent.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the right hand after an injury?\n\nI fell off my bike 5 days ago. I injured my right wrist (no bruising) and my right foot (bruising and large lump on upper top foot close to ankle). I could walk right after the injury, and now I can lift things with my right hand (couldn t for a day or so). Should I have gone to the doctor, or, since pain is a little better every day, or could I have injured myself in a way that needs more than pain reliever and ice?",
    "doctor_response": "base on your description you are most likely suffering from soft injury of wrist and ankle. if the pain persists or swelling increases or difficulty in doing daily activities then it should be worried.i would recommend continuiung ice fomentation giving rest to part and analgesics for a week. if afer a week if there is no change then it is to be worried.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for influenza infection\n\nI am wondering just recovered from a week long battle with the flu and now I have some real persistent legand but soreness that one would usually associate with that of after workout soreness. What could this be and can I do attempt to help or stop it.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Influenza is viral infection. No antibiotics works again it. It will clear by itself. Symptomatic treatment should be taken. Antibiotics should be given to prevent secondary bacterial infection. paracetamol can be taken for fever. Consult your doctor and take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I took I-pill after unprotected sex on the 7th day of my periods. Any chance of getting pregnant?\n\nHello doctor, I had unprotected sex on the seventh day of my periods, and I have five days bleeding. I took an I-pill on the 58th hour. I had bleeding on the seventh day after taking the\u00a0pill.\u00a0But, I\u00a0am 10 days late for my periods, from the last month's date. I am worried. Please help. Is there any chance of pregnancy?",
    "doctor_response": "Hi. Sexual contact on the seventh day of periods will not make you pregnant, as they are the safe period. You should not have taken I-pill. I-pills are meant for emergency contraception and not for routine use. These are hormonal medicines and can disturb and disrupt your cycles, and can cause abnormal bleeding. I think that is why your periods are late. But still, you can get beta hCG done to rule out pregnancy. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I use Kojivit gel to get fair skin?\n\nHi doctor, I am a 22 year old female. I have a dusky skin that is brown skin. I want to become fair. Can I use Kojivit gel? Or any other dermoatology cream can I use? My hands are also brown in color and full of tan. Do you suggest any creams to get fair? I want to become fair as my marriage is going to get fixed by next year. Please suggest me some creams, so that it should not show any side effects. Also, how long I should use it? If I use anything, then will it have any effect in case of pregnancy, etc? Please help me. Thanks in advance.",
    "doctor_response": "Hi. One's skin color has 2 components. First one is genetic, which cannot be changed. Every skin color is beautiful in its own way and we should learn to love our skin color and augment it and not hide or lighten it. The second component is acquired, which is due to the influence of environment, sunlight, hormones, aging, etc. We can only target the acquired component of fair skin color while attempting lightening procedures. I suggest you antioxidant capsules like capsule Antoxid HC (Beta-carotene) and apply sunscreen lotion Lashield gel at 8 AM and 12 PM. Also, you can apply Glyaha koj lotion (Hydroquinone) at night time. Start with an alternate night application initialy as it may irritate your skin a bit and after a week or so, shift to daily night application. Consult your specialist doctor, discuss with him or her and take the treatment with consent. You can go for chemical peeling or microdermabrasion from your dermatologist which will help in exfoliating and give you a clearer skin tone. All these treatments are free of side effects. You may use them for three months. For further information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heartbeat to miss during periods?\n\nI have skipped heartbeats mostly in the middle of my cycle and a week before I m due. Have had all the tests and have been told I m fine, but when it happens it scares me. I am also on iron tablets, as my iron count drops due to my periods being heavy. Still worry about my skipped beats, I feel I need reassurance I m ok all the time.",
    "doctor_response": "Hello, it has missed beats relation to ur period oeniron tablet or iron level. How do u know u have missed heartbeats ? Any symptoms? Ecg? Revert back. I hope I helped u. All d best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can fluff of cotton cause throat infection and phlegm in chest?\n\nHi Doctor,I am belonging from textile sector, during my job i have to work in the fluffy atmosphere during my job hours about 8-9 hours. The fluff of cotton is around everywhere in the mill its a weaving unit. I am facing throat infection & feeling phelgm stores in my chest.Thanks,Danyal Siddiqui",
    "doctor_response": "Hi thanks for contacting HCM...Noted you have exposure to cotton..So here you could gave cotton induce occupational lung problem...It could be pneumoconiosis...Called bysinosis like problem...Chest x ray and pulmonary function test useful...Just now for throat infection you can take antibiotic and antiinflammatory drugs.More water....Here regular follow up needed.Take care.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "My sister has unusual behavior. What could be the reason?\n\nAsalaamaleikum, I want to talk 2 u about my sister, she is facing a very big problem of blaming others every now and then. For sometime She will sit quietly, and then starts crying, and she starts sayimg that everyone is against her people are creating problems to trouble her. We had consulted a doctor but its a month she is fine for few days and agin she is the same. Please can u give some advice to us, it will be a great help.",
    "doctor_response": "She might be needing psychiatric help. Get her evaluated by a psychologist or a psychiatrist. They wil put hr on some treatment and counsel her, and might refer for behavior training and therapy too which wil help her to come out of the problem that she is facing.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is having sex with partner having throat cancer risky?\n\nMy partner suffered with throat cancer 3 years ago and was successfully treated. However 5 months ago he was diagnosed with oesaphagus cancer, which was removed and replaced, and now he has had his larynx removed which has led to the discovery of further cancer cells, - he may have 2 months or 2 years life expectancy.  If we are intimate, am I at risk ?",
    "doctor_response": "hi and welcome to hcm.No, there is no any risk for cancer transmition. only infective disease may be transmitted sexually. Wish oyu good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for premature ventricular contractions\n\nI have PVC s and IC. My doctor prescribed Mybertiq. Only one pill caused a severe migraine and a large increase of PVC s. I stopped the drug and I m still having an increase number of PVC s. When should I expect the number to go back to my normal amount?",
    "doctor_response": "Hello, I am Dr Mody and I would be addressing your concern.  You must have been started on mybertiq for incontinence.  However it's an anti cholinergic drug,  which is known to increase heart rate, pvc 's blood pressure and may precipitate headache.  There would be two alternative 1) discuss with your doctor about taking an alternative drug,  as mybertiq is not the best option for you. 2) if no other medication,  consider taking small dose of beta blocker,  propranolol.  Which will take care of both the extra pvc and offer prophylaxis against migraine ,  and will be an ideal medication for you.  Regards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes spinning sensation followed by vomiting?\n\nHello! Well,for two days now, I wake up and the room is spinning. After blinking, it disappears. But today, I woke up two times and the room is spinning. Again, after blinking, it disappears. But somehow, I feel lightheaded and ready to throw up. I make sure that I sleep well but for many days now, I ve been constantly on bed and just playing with my phone, surfing the net, fb, etc. What s wrong with me? Also, I slept with hair wet for two days. I m a fat woman with 5 6 height and 78 kg weight.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Yes you need proper sleep 7-8 hours per day and don't use phone while lying on bed. Also you should eat healthy take fruits & vegetables in your daily diet. Also get your eyesight checked and don't tie your hairs when they are wet. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Uroosa Najam",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in chest and left arm after removing statins?\n\nI have coronary heart disease for many years and have been on statins all that time. Recently my PCP took me off the statins, and now after three months I am having chest, left arm pain. Can being off the statins be enough time for the cholesterol deposits to increase enough to cause this pain?",
    "doctor_response": "your pain is not because you stopped statins.but it's definitely an important symptom for you to visit your cardiologist and get a check up done.get a ECG done and see if there are any new changes in that as compare to previous one.you might need to go for a TMT as well. Don't ignore your symptoms,specially when already have coronary artery disease.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can I do for toothache?\n\nI have been having toothaches recently, and I was a international start abroad in Kenya. When I ha returned home I felt like the weather in England was really disturbing me so I started getting problems with my jaw like it felt like it was going to fall off. As this continued I started experiment pain in my tunisile where it feels swollen and like my head is going to explode. It really hurts I went to the local GP and have me strong pain killers. They do not work on me effectively and I fe so much pain that I hve a very hard time getting any sleep at all. Please assita",
    "doctor_response": "hi From the symptoms you have told here, pain in jaw , head and swelling in tonsils, it appears to be a case of tonsilitis. but to be sure of that, you have to go for dental checkup. but if its tonsillitis, just painkillers will not help. you have to take antibiotics ( amoxycillin 500mg three times a day) along with painkillers. also try warm saline gargles. take as much warm liquid as you can. symptoms usually subside within 2 weeks after starting antibiotics. wishing you good health with best regards Dr Ankit",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is kidney problems associated with loss of appetite & frequent urination ?\n\nHello. My daughter is in a nursing home after recovering from sepsis last spring. Lately, she has had mental confusion, fatigue, loss of appetite and low body temperature (95-96). and urination every 2 hours at night  She is in stage 4 kidney disease. Are these symptoms cause for concern regarding her kidneys/ Thank you",
    "doctor_response": "Frequent urine is due to kidney disease but it had no relationship with dicrease of appetite, its due to gastric upset , usage of appetite stimulents can help u",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent vomiting and elevated monocytes and platelets?\n\nMy 19 month old daughter has had intermittent emesis for over 4 weeks without any other symptoms. 4 days ago, she quit eating, drinking, urinating, and had more persistent emesis. Her monocytes and platelets are elevated. Any possible diagnosisyou can think of?",
    "doctor_response": "Seems to have caught cough and cold but you have not reported any fever. If you can get piper longum herb, it may be boiled in milk or water and given 1tsp TDS. Holy basil leaves may also be boiled along with it.Piper longum may also be given by grinding as powder and approx 125 mg - one pinch may be given in honey. If you can grind seeds of cardamomum that may also be added. Or boil with piper longum, holy basil etc. Vomiting may not stop immediately. Give it thrice a day for few days.Hope this primary measure will help you without any toxicity, without any side effects. May be slow in action.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is Mometasone dangerous to use on Face to clear my acne pimples?\n\nHello doctor, I am seriously facing acne pimples problem. Sometimes they occur on my face when I masturbate. If I use Mometasone, it gives a good result. Is it okay to continue this?",
    "doctor_response": "Hello. Acne is a universal issue in the age group of 15 to 25 years due to hormonal changes in adolescents. However, there are multiple effective treatment options depending on the grade and severity of the problem. Mometasone is a topical steroid and is to be avoided strictly on the face and for acne as it can harm your skin in the long run. Acne is dependent on hormones hence excess masturbation may sometimes lead to an increase in the problem. I would advise you to stop Mometasone immediately and kindly upload appropriate images to help us assess your current grade of acne and treat you better. Regards. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I use Kojivit gel to get fair skin?\n\nHi doctor, I am a 22 year old female. I have a dusky skin that is brown skin. I want to become fair. Can I use Kojivit gel? Or any other dermoatology cream can I use? My hands are also brown in color and full of tan. Do you suggest any creams to get fair? I want to become fair as my marriage is going to get fixed by next year. Please suggest me some creams, so that it should not show any side effects. Also, how long I should use it? If I use anything, then will it have any effect in case of pregnancy, etc? Please help me. Thanks in advance.",
    "doctor_response": "Hi. One's skin color has 2 components. First one is genetic, which cannot be changed. Every skin color is beautiful in its own way and we should learn to love our skin color and augment it and not hide or lighten it. The second component is acquired, which is due to the influence of environment, sunlight, hormones, aging, etc. We can only target the acquired component of fair skin color while attempting lightening procedures. I suggest you antioxidant capsules like capsule Antoxid HC (Beta-carotene) and apply sunscreen lotion Lashield gel at 8 AM and 12 PM. Also, you can apply Glyaha koj lotion (Hydroquinone) at night time. Start with an alternate night application initialy as it may irritate your skin a bit and after a week or so, shift to daily night application. Consult your specialist doctor, discuss with him or her and take the treatment with consent. You can go for chemical peeling or microdermabrasion from your dermatologist which will help in exfoliating and give you a clearer skin tone. All these treatments are free of side effects. You may use them for three months. For further information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the painless bump on shaft of penis?\n\nHi doctor,I have a bump on the shaft of my penis. It is not painful and it is the same color as my skin. The bump is only visible when I pull back the foreskin. However, there is a small cut visible when the skin is more extended. It is like the bump is covering the small lesion. There is also another lesion nearby, also visible when the skin gets more extended. This time, no bump, but it is like the skin is covering the cut as well. Do you know what it could be, and what should I do?I have been taking Fucidin, as I thought it was the same issue as I had before, but it seems different this time.",
    "doctor_response": "Hello. I have seen images sent by you (attachment removed to protect patient identity). Yes, there is a bump on the penile shaft. It appears because of repeated small trauma may be during masturbation or sexual intercourse. At present I want you to apply Mupirocin topical ointment twice daily for two weeks. It will heal. Avoid masturbation or sexual intercourse.  For more information consult a urologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the causes of pain in right testicle sack area?\n\nI am 74 year old male. 6 foot ,200 lbs. Very active.Run 25 miles a week plus weights and machines. Last week developed a very painful area on right testicle sack. No discoloration, swelling or lumps. Only hurts when touched or roll over in bed. Doesn't hurt when not touched.",
    "doctor_response": "Hello, ,The pain in the testicular region is may be due to1.Epididymitis2.Prostatitis3.Orchitis4.Varicocele5.Hydrocele6.SpermatoceleThese are some of the conditions which leads to your symptoms. You requires physical examination to find out the cause for your symptoms.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for senseless patient after accident?\n\nMy father had a accident 2 months ago.He is in hospital.he had a brain operation and till today he is senseless.What should we do?Today his condition is very serious.yesterday night his heart was blocked 3 times.We are not a rich person.We are not getting what should we do now?",
    "doctor_response": "i am very sorry to hear that.really sorry for his condition.your next step should depend upon some factors like is he in Intensive Care Unit (survival only with life support) ? or he is just unconscious but is alive without life support? but anyway GCS below 3 or unconscious for such a long period is really not a very good sign.but if you believe in God and fate then you may already know that we all will die one day.have your faith and plese try to understand that regaining consciousness or death is largely dependent on fate at this stage apart from the doctors utmost tries.but i would really suggest if is in ICU now which is really costly for you then put your trust on God and let him go.beacuse at this stage regaining consciousness is really unlikely.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for the proteinuria?\n\nHello, I am 36.  At the age of 20 I was diagnosed with proteinuria but the kidney biopsy could not conclude fsgs.  Since then I have been fine.  At that time the Dr told me to take blood pressure pills.  I smoke at least 10 cig. a day of marijuana does this help to lower my blood pressure? thank you",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Marijuana doesn\u2019t help but can worsen your disease condition. You can consult a physician and start on anti-hypertensives. ACE inhibitors land ARB sile Captopril and Losartan are the better options for you. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of spine curving?\n\nSpecial needs Rett Girl has pain for 40 mins or more after eating (crying screaming).. once she belches four or five times it is like turning a light switch on. Also Rett Girls tend to swallow lots of air. Was wondering if could also be a sign of the spine curving.",
    "doctor_response": "Hello, A very nice study looked at a variety of Rett children and specific risk factors that seemed to be tied to the development and severity of scoliosis which is the most common orthopedic anomaly seen in this condition. Of the variety of parameters, they looked at, belching to relieve trapped gastric air after meals were not included although they did have several items categorized as \"feeding problems\" You can look up the article to see all the risk factors they did mention and measure. With your daughter's belching as being so apparently associated with feeding I'm certain that had any of their study girls had that type of issue they would've looked at it in the context of their study. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "When is pregnancy possible after the first normal periods?\n\nI am 22 year old female, I have been using Nur isterate since from June 2011 till April 2014. I am healthy and have never had complications with my health, however I have experienced my first normal periods early this month, before they were a bit irregular. I want to find out how soon can I fall pregnant",
    "doctor_response": "Hi, How are you doing ?Nur Istrate is Depot Progestrone. This is a medication which stays for long even if you stop the injection. I mean you may have periods , but ovulation may not occurBut don't worry , as you already had periods,it means your hormone level is wearing off. Just wait for few months & regularly try for pregnancy if you want to. But if the cycles are irregular of no periods at all, have a course of Combined Oral contraceptive pill ( 21 pills packet) from the first day of periods & get your periods. This will regularise your hormone levels. Hope I have clarified your query, do write back if any more queriesAll the bestDr.Balakrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed cut on skin below the frenulum after protected sex. Is there any risk of STD?\n\nHello doc ..i had a sex with a sex worker i used my condom ..but during sex i feel.somthing streching my penis skin .i was quite painful ..i ejaculated inside the condom .and aftter removing it i saw .a small cut on the skin  below the frenulum of my  penis the area was totally red ..and that perticular area was streching during the intercourse ..i was quite worried .is there any chance of getting STD",
    "doctor_response": "Thanks for query.you need not sorry much about it as it would naturally heal in few weeks .as you used barrier (condom) no chance of STD as such but you are at risk if you have unprotected sex withcontacts of std.try to avoid such things.regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment available for scars and black marks\n\ni have pimples and scar in my face .. what are the treatment available for scars and black marks .. how much money i have to pay for this treatment .. want details",
    "doctor_response": "HI  WELCOME TO HEALTHCAREMAGIC Laser Surgical removal of the scar is very effective and sage. Consult Dermatologist experienced in cosmetic procedures. Regards, Dr. Jagdish",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to get pregnant\n\nHi doctor..i m shrabanti bose..age 24...i want to get pregnant from 4 months past..but i have failed..my doctor suggest to take siphene 100 from day 2..and sustaine 300 from day 20...regulary ossuer tab..tii i dont get pregnancy...and my periodic blood volume very low...what can i do?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. I would recommend a hormonal course to first help regularize your menstrual cycle before the initiation of medications like siphene. The process of correcting infertility can be a little lengthy at times, but it is safer for both the mother and child when it is done right, and not in a haste.Hope I have answered your query. Let me know if I can assist you further.Best wishes,Dr. Shoaib Khan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ejaculating the semen\n\nI am a 25 year old male. I have good erections anytime I need. Not a problem. But I am not able to ejaculate the semen. I always have some uneasiness in the left testicle. I guess it is the semen build up. The only time I could ejaculate semen is during Wet Dreams/Nocturnal Emission. Will this affect the chances of becoming a father. By the way, I am not married. I have not had sex. Is there a serious problem.",
    "doctor_response": "HelloConsistency and volume of seven depends upon number of factors like How frequently you ejaculate?Nutritional statussecretions of prostate and seminal vesiclesHygiene In my opinion you need not to worry,this is not a serious problemIf it gets even thinner or lumpy than it could be urethral discharge You should consult your doctor for seven analysis or urine culture to rule out the possibility of UTIHave plenty of fluids maintain good hygieneMultivitamin and food supplements to boost your heath and vitalityHope you will find my response informative and helpful please feel free to ask for follow up questions, I will gladly answer you Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be done to bring down the sudden swelling in hands and feet?\n\nI have high blood pressure and am currently on medication. I suddenly had my hands and feet swell up and I can t figure out why. I have made no changes to activity or diet. I did drive for 8 hours yesterday with no real break and that s not normal for me. I noticed the swelling when I got out of the car. But it hasn t gone down or got worse. What s it from and what can I do?",
    "doctor_response": "Dear Sir/MadamI have gone through your query and read your symptoms.In my opinion, you yourself describe the cause of your swelling, patient with high BP tend to have fluid collection in the dependent parts on long sitting, which seems to be true in your case also, now what you need to do is1 Rest with limbs elevated2 Do not walk for long or sit for long, this can increase your symptoms.3 Get your BP under control by consulting a physician and following the drugs and exercises he prescribes.I hope that answers your query. If you want any more clarification, contact me back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child having elevated ALT, liver enlarged, sugar level low, vomiting yellow fluid, urine smells. Cure?\n\nMy 8 year old son has had elevated ALT for the last 5 years. His pedi also said his liver is enlarged, they are trying to get us an appointment with a GI doctor. We have been to many specialists. My sons blood sugar used to plummet in the mornings to under 60. He would then puke a horrible highlighter yellow fluid. We ve had a diagnosis of Ketotic Hypoglycemia , which he should have outgrown. His blood sugar is no longer lowering. But he is still vomiting the highlighter yellow fluid approximately every 6 to 8 days. He gets very pale, with black under his eyes and his usually rosey lips turn grey. He then vomits and his color returns. His urine also smells very strong.",
    "doctor_response": "Hi and welcome to HCM.first the exact cause of liver damage should be found. in his age the first thing to think of is congenital liver disorders such as gilberts. secind,it may indicate any kind onf systemic infection and thirdly it can be certain blood disorder if associated with anemia. He needs extensive work up to evaluate his blood sugar.it may suggest pancreatic disease or beginning of type 1 diabetes.Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for severe cough in a child?\n\nMy son is 19 months almost, he has a terrible cough which he is being sick on at least 3 times a day. However, now he is just being sick, not on a cough. he was sick in his sleep the other night which really worries me. I have been to the drs several times but they just say it will pass, i am very concerned there is an underlying problem",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Greetings from Chennai.By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze. I have a few questions for you -Questions:1. How many days per month does your kid cough or feel breathless?2. How many nights per month does your kid's sleep get disturbed due to above symptoms?3. Does your kid feel breathless when running around or playing with other kids?4. Are the symptoms when there are seasonal changes?5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?6. Is the cough always associated with fever?Please revert back to me with answers so that I can guide you better.You can approach me at the following link.Once the page opens there will be an option below my image as \u2013 ASK ME A QUESTION \u2013 click on it.Please find the link below -www.yyyyyyyyyyyyy.com/doctors/dr-syyyyyy-ayyyyyy/000000Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of red spots on grind and penis?\n\nI HAVE RED SPOTS/BUMPS ON MY GRIND AND PENIS THEIR IS ONLY ABOUT 4 OF THEM THEY COME AND GO THEIR LIKE SPOTS YOU GET ON YOUR FACE CAN YOU TELL ME HOW TO GET RED OF THEM COS ME GIRL FRIEND IS HAVEN A BABY AND DONT WANT TO HAVE SEX COS SHE MITE GET THEM?",
    "doctor_response": "hiI can understand your concern for your symptoms, if you had unprotected sex , need to think of Sexually transmitted infection .if not it can be balanitis fungal infection - if there is itching I Hope I have answered your query. If you have further doubts , I would be happy to help you. Happy day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does taking Abilify and Cymbalta together improve mental health fast?\n\nI just started Abilify this week, actually today is day 5. I take 2mg and also take Cymbalta. I am very surprised that I feel so much better already and I have so much energy! I concerned since it has worked so fast and the changes are so drastic. Is this situation unusual? Thanks for your advice.I ve chosen not to continue...thank you anyway.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Cymbalta may increases the effect of Abilify. Do not increase further dosage without consulting your psychiatrist as it increases the chances of side effect caused by Abilify as well. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any chances of getting heaart attack acquiring diabetics ?\n\nafter cranyopharengyoma surgery, is there any chances of getting heaart attack & acquiring diabetis",
    "doctor_response": "Any stressful event can cause such cardiac episodes but it cannot be said exclusively to cranionpharygioma, but nevertheless it is a major surgery so you should take the necessity care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can dengue be treated?\n\nHi Sir, my sister is having high fever about 102-103 and report says NS-1 ANTIGEN DENGUE positive and TYPHIDOT Igm- WEAKLY POSITIVE,also platelet count is 1.05Lakh/cmm, and pcv count is less that is 31.3. Please suggest what to do ,what king of food she should prefer ,any medicine you can suggest ,it will be great help of you . Thanks Vikash",
    "doctor_response": "Hi thank you for querry.As it diagnose a dengue fever and weak postive for typhiod fever its better to first treat dengue fever.incourage oral fluid intake like canned and fresh juices along with plenty of water for fever only paracetamol is given.CBC with platelet count and pcv on daily basis to see the improvemnent.Hope the answer will help you.wish her a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to be pregnant after menopause?\n\nHi, I was concerned about my mom, me and her think she is pregnant. she is 52 and the doc has already told her that she is going thru menopause. I have researched about being pregnant during menopause and I have found it is possible but unlikely. Also my mom does have the symptoms of getting pregnant. she has experienced a lot over some time and her belly is big and firm and she has a lot of sharp pains. In the lower region of her abdomen and lots of back pains too. I\u2019m so confused.",
    "doctor_response": "Hello, and I hope I can help you today. If your mother no longer menstruates she is not capable of pregnancy at age 52. At all. Short of in vitro fertilization or women who have had a recent pregnancy (within 2 years) 52 year olds do not get spontaneously pregnant. In a woman of your mother's age, symptoms normally associated with pregnancy can actually be signs of real medical problems. Increasing size of the abdomen with pain can be a sign of cancer, both of the ovaries and the GI tract. Large tumors and fluid in the abdomen can also make an older woman look pregnant. Fluid in the abdomen can also be caused by liver disease So I seriously encourage both you and your mother to abandon the thought of her actually being pregnant (which is really not possible) and make sure she is evaluated for her enlarging abdomen by a regular medical doctor. She should at least have a ultrasound or CT scan of her abdomen to make sure nothing dangerous is going on. I hope I was able to adequately answer your question today and that my advice was helpful. Beat wishes to you and your mom,Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat pain while crossing legs or ankles?\n\nI have very uncomfortable pain when crossing my legs or ankles. Even if I cross my legs at the calf the muscle is sore and I must uncross after a minute or so. I am on Warfarin, Simvastatin, Spiractin & Prexum - could this be a si effect? I am a 68 year old male.Many thanksJohn ThompsonDurban South Africa",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.With such presentations in my clinic, I would first reassure you as this is only crampy muscular pain in thigh muscles. I advise you to avoid leg crossing for long period and to recieve muscle relaxant and NSAID.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can bilirubin increase with days in child?\n\nAt 18 days old my daughter had bilirubin level - 335. Is it possible, that she had higher level (f.e. 400) at day 10? 335 level: can it go down by itself or only some treatment could help? Which level is dangerous or the brain cells? She eats well, gains weight well. Just not too much active (may be it is her personality). She is 2 months old, her level is still high: 146. Is it dangerous?",
    "doctor_response": "Hello,        Your daughter had jaundice in the newborn period and her bilirubin is still high at 2 months of age. This is definitely not normal and she needs to be evaluated in detail for the cause of persistent jaundice. There are many causes of persistent jaundice and it is difficult to ascertain the cause based on the history you have provided. I advice you to take your child to a paediatrician for a detailed check up, as some of the conditions causing jaundice at this age need urgent treatment.         Wishing you good luck.Regards,Preeti",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Can you explain my semen analysis report?\n\nDr, I'm 40 year old, my semen analysis report is  quantity:- 2ml. Colour:- whitish. Consistency:- viscid. Reaction:- alkaline. Actively motile:- 65 -75%. Puscell:-present:- 3 - 5 / HPF. Morphology:- 60 - 70 % normal forms. Total count of spermatozoa :- 68 million / ml of semen.please can u tell me this report ok for fritility. Another question:- I have 3 children , I was in abroad 6 years.my is was not with me. After 6 years I come back to my family . Last two month we are trying to another baby but my wife had start period (bleding) please tell is there any problem me or my wife. My wife is 36 year old.",
    "doctor_response": "Hello,Your semen analysis report is absolutely normal with good counts and normal motility and normal morphology.few pus cells are normal to be found.As far as difficulty in conceiving is concerned,it is too early to comment on this,since you are with her gor past 2 months only.Moreover there are various things essential for conception to take place,which means...Sex on ovulation days.Proper ovulation of your wifeHer tubes should be open.Moreover as the age advances in female,ovarian reserve dwindles.It becomes really problematic for a female to get pregnant after 35 years.However two months are too early.Wait for six months and try doing sex multiple times around ovulation days and if you still dont find any success,you may consult a fertility expert.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cervical spine with mild diffuse posterior bulge C4-5\n\nWhat is the treatment of chiari 1 malformation, mild hyderocephalus and degenerative change - cervical spine with mild diffuse posterior bulge C4-5",
    "doctor_response": "what is the treatment of chiari 1 malformation, mild hyderocephalus and degenerative change - cervical spine with mild diffuse posterior bulge C4-5 disc indenting the thecal sac and lateral recess",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. 2. 5 year old suffering from stomach ache. Which medicine has to be given?\n\nHi doctor, My son is 2.5 years old. For a week, he is complaining of stomach pain. After farting he is fine. Our family doctor recommended one antibiotic for five days and a medicine to avoid vomiting. He had small vomits twice, but later it was fine. Now, after completing the course of medicine he again complaints the same. His diet is almost nothing and he is not ready to take any food. He just has few mL of milk. He does not have fever. His stool was watery, but it is normal now. Can you provide any recommendation on diet and medicine? Please give me a solution to the problem. Thank you.",
    "doctor_response": "Hi. I can understand your concerns. Complain of abdomen pain with vomiting suggests that your child probably has acute gastroenteritis or food poisoning. Since, antibiotic is already given and now there are no loose stools or vomiting, there is no need to give antibiotic again. For abdomen pain, you can give syrup Cyclopam (Dicyclomine hydrochloride and Paracetamol) 5 mL on SOS basis (as and when required) that is when abdomen pain occurs. Whenever a child becomes sick, there is decrease in his appetite which improves as child recovers. Now, you should give him all the foods that you were giving him earlier. If he is not eating then you can start Glucon-D in water thrice a day for one or two days. Start a multivitamin like syrup Bevon 5 mL once a day for 15 days. Keep patience. Child will eat properly now as he has recovered from illness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause drowsiness?\n\ni am 30 years old height 1.55 weight 70 kgs i dose off for a few minutes excessively during daytime. it doesnt matter where i am in church, sitting talking to people. this has been happening since i was a child and now its becoming embarassing. i cant visit anymore",
    "doctor_response": "Hi, You have features of excessive daytime sleepiness. Most likely it is a part of sleep disorder. The common causes are narcolepsy and obstructive sleep apnea. A sleep study would confirm the diagnosis. Hope I have answered your query. Let me know if I can assist you further. Take care. Regards, Dr. Sudhir Kumar, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment to get pregnant?\n\ni miscarried a year ago last july, i was about 4 and a half weeks and since then i feel like im producing milk everytime after i eat. i get sore breasts after i eat. ive been trying to get pregnant but no baby yet. whats wrong?? last time i breast fed was 5 years ago.",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic.I have gone through your query. I think I have understood your concern, I will try to suggest you the best possible treatment options.If you have problem in getting pregnant and you have breast secretions , I will suggest to get Blood prolactin levels done. High levels cause breast secretions and also cause problem in getting pregnancy.Start with B 12, FOLIC acid,  B LONG at least 3 months before you try to get pregnant. In case of high Prolactin levels, you need to take Tab Cabergolin 0.5 mg once a week for 4 weeks and repeat the test.I hope my answer helps you.Thanks.Wish you good health.With regardsDr Purushottam",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can distended stomach cause restlessness?\n\nI have my stomach distented too much. It is fool of gas and discharge is very foor. This causes restlessness, pain in the stomach etc. I am a patient of parkinsons disease and taking syndopa plus 3tablets and syndopa CR daily. Please advise the action you want to take. Lajja Khare.",
    "doctor_response": "Hi.Thanks for your query.Distended stomach can cause lots of restlessness, difficult in breathing and pain in the abdomen.Plan of action as you asked for is ::-Continue Syndopa Plus and Syndopa CR as before as this is a must for the control pf Parkinsonism.-Get an X-ray of the abdomen in standing position. This will help to see which part is distended to plan a treatment and further investigations accordingly. -Barium meal and follow through to see the interior of the stomach and intestines.-Upper GI Endoscopy to see for ulcer / cancer / duodenal stricture.-CT scan of the abdomen.-Tests of blood- particularly for Diabetes and Hypothyroidism which can cause this problem.--Treatment plan. Start with prokinetic like Domperidone.Find the cause and treat according to the reports.Reduce the stress and anxiety as these are one of the most important causes of your problem.Avoid foods and beverages which cause gases and increase the problems.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful lump on the neck with a history of breast cancer?\n\nHi my name is kathleen I have found a pea size hard unmobile lump on the left side of neck and its also round. Been having alot of neck pain along with headaches its about two fingers above collor bone some times if i press on the lump it gets alittle pain full it seems like its near the musel. I had breast cancer a year ago called her 2 new they said that my cancer can come back with in a year or two and it can go to the lungs liver or kindeys. iam 53 years old should i be concerd?",
    "doctor_response": "welcome to Health care magic.1.Yes you need to be concern with the lumps on the neck ( as they are lymph nodal enlargement generally after confirmed breast Ca)2.Get an Ultrasound Breast and neck done - an FNAC of the Lymph node can be done for confirmation.3.An immediate action can be taken by oncologist - like mastectomy and lymph nodal removal. Which will give a better life.4.Do not ignore - take actin as soon as possible.5.A triple phase CT chest and abdomen pelvis to stage your breast cancer can be done by your doctor and treat accordingly.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a fractured rib?\n\nI am reluctant to going to the hospital; however, it is obvious my discomfort is only increasing.  What I thought thought may have been a \"fractured rib\"  now includes severe stabbing pain posterior and anterior at what I think is the 9th or 10th rib on my left side.  Also, most pain is present when I am laying flat.  Is an ER visit in my future?",
    "doctor_response": "Without any trauma it is unlikely a fractured rib .Stabbing pain over posterior and anterior aspect at the lower aspect of thorax or a upper abdominal region could be pancreatitis ( inflammation of pancreas) or a gastritis/ duodenal ulcer.It is advisable to go the hospital to rule out the above causes and if it is a fractured rib then the treatment is rest.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is locked-in syndrome treatable?\n\nHello doctor, I am a locked-in syndrome patient. MRI report indicates marked hydrocephalus, diffuse cerebral and cerebellar atrophy, attenuated blood flow in the cerebral vasculature, and hypoxic encephalopathy. I cannot move or do anything but I react to pain. Please help.",
    "doctor_response": "Hello. These MRI (magnetic resonance imaging) findings are indicative of chronic severe changes in the brain. Unfortunately, the clinical condition of locked-in syndrome is very serious and the prognosis is really reserved. In most of the cases, patients with this syndrome do not improve and die from complications of cardiac arrest, pneumonia, decubitus, pulmonary embolism, etc. I would just recommend discussing with a surgeon about the hydrocephalus. If it is acute, a shunt may help. For more information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to improve the white blood cell count?\n\nHi, I went to the doctor around June last year and he discovered my white blood cell count (neutrophils low and lymphs low) was low around 2.8. He said we would test it again in 6 months to see. In 6 months it went down to 2.3 and a week later 1.8. My total protein is also elevated (gamma globlin). I don't believe I have any other symptoms besides that. Recently I have had pain in my right bottocks and hip and a burning sensation   on my shoulder blades which I sometimes get from stress. I am a little nervous and have a hematologist appointment scheduled, but I am wondering what it could be.  Also last year I had an allergic reaction to penicillin and could possibly be allergic to other things.",
    "doctor_response": "Hello,Welcome and thanks for your query.There are several causes for decreased white blood cell count . It is likely to be either an autoimmune destruction or a defect in the formation of the WBCs like in myelodysplastic syndrome. A condition called aleukemic leukemia is alo possible but less likely. It is important that you have a bone marrow biopsy done and also investigated for autoimmune diseases like SLE.Do get back to me if you have further queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes foot pain in a diabetic patient?\n\nHx Diabetes.Gradual onset R plantar foot pain 3-4 metatarsal space pain.Feels like I have a rock in my foot.Also dorsal pain same foot and area.Can recreate when I squeeze foot laterally or apply pressure.Hx mild neuropathy also No Hx trauma.Minimal swelling @site.No fever,chills.Foot not warm or red",
    "doctor_response": "first you need to control blood sugar  take Ayurvedic medicinetab BGR 34 2 bd for diabetestab mahayogaraj gugglu for neuropathic pain.  it will solve your problem",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for restricted movement in the left shoulder\n\nI can t get my hands above my head. My shoulder are stuck. I had surgery on my left shoulder and fell a week after breaking my arm. Now I have blown my right shoulder. I m now waiting for surgery.I I really wish I could get my left shoulder to work ,at least.",
    "doctor_response": "Hi, This is something known as periarthritis shoulder. You need to regularly do shoulder range of motion exercises. It will take time to recover but the results are very good. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Anuj Gupta, Spine Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am being tested for many ailments including Celiac disease. My liver enzymes are elevated for no apparent reasons\n\nHello, I have recently seen a gastroenterologist who is conducting blood work. My symptoms seem to be worsening. I am being tested for many ailments including Celiac disease. My liver enzymes are elevated for no apparent reason (I don t drink, never traveled abroad), and other symptoms include bruising, brain fog , loss of energy and fatigue, tenderness in the stomach or liver area, and this very strange buzzing sensation in my abdomen. I also occasionally get a heartburn feeling, almost like an ulcer (but tests have shown negative for ulcer). I had an liver ultrasound in Feb. and everything was normal. Other liver functions also appeared normal according to liver blood tests. Any ideas? Thank you so much for any possible diagnosis. I have always been a very healthy person, so all of this is very disturbing. I have been worried about this since my general physical exam in Jan. when the liver enzymes were discovered to be rather high (approx. 140). I am 45 years old, 108 lbs, 5 4. THANKS! The resident who worked with the gastroenterologist was puzzled because I do not fit the profile of someone who would have an irritated liver. L.",
    "doctor_response": "i some way dont agree with dr rakhi and also agree with her. let me tell u something, raised enzymes are a very vague term for any medical professional. there are numerous reasons, like obesity ( which i dont think you are), diabetes, drug induced rise. there are causes as dr rakhi suggested but then there are many rare causes that all have to be ruled out and properly attended here is the list of few ( but reading all would drive you crazy) best would be seeing a good liver experts ( hepatologist ) and also hematologist Certain prescription medications, including statin drugs used to control cholesterol Drinking alcohol Heart failure Hepatitis A Hepatitis B Hepatitis C Nonalcoholic fatty liver disease Obesity Over-the-counter pain medications, including acetaminophen (Tylenol, others) Other causes of elevated liver enzymes may include: Alcoholic hepatitis (liver inflammation caused by drinking alcohol) Autoimmune hepatitis (liver inflammation caused by an autoimmune disorder) Celiac disease (small intestine damage caused by gluten) Cirrhosis (liver scarring) Cytomegalovirus (CMV) infection Dermatomyositis (inflammatory disease that causes muscle weakness and skin rash) Epstein-Barr virus Gallbladder inflammation (cholecystitis) Heart attack Hemochromatosis (too much iron stored in your body) Hypothyroidism (underactive thyroid) Liver cancer Mononucleosis Muscular dystrophy (inherited disease that causes progressive muscle weakness) Pancreatitis (pancreas inflammation) Polymyositis (inflammatory disease that causes muscle weakness) Toxic hepatitis (liver inflammation caused by drugs or toxins) Wilson's disease (too much copper stored in your body)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicine for seasonal allergies\n\nI am a 22 year cadavar kidney transplant patient. This kidney is still functioning very well.  I live in Chattanooga, Tennessee and have been suffering with seasonal allergies.  Would a consultation with an allergist or immunologist be recommended and could he/she provide some relief?",
    "doctor_response": "HiWith you query, definitely they will help you with the treatment coz in kidney diseases one cannot take all the drugs which may interact with drugs. Kindly visit either of you mentioned doctors. Hope thus helps you and avoid the allergens that result in discomfort.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to stop prolonged menstrual bleeding?\n\nHi doctor, I am suffering from prolonged menstrual bleeding. The bleeding did not stop for the past one month. I have PCOD and I am overweight. How to stop the bleeding? Please help.",
    "doctor_response": "Hello. PCOD. Menorrhagia. Hb, TSH, PRL, FBS, fasting insulin and hormonal profile (LH, FSH and estradiol). Cyclical OCP after bleeding controlled. Revert back after a month to an obstetrician and gynaecologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a lump on the foreskin be treated?\n\nI did something stupid and don t really know why. I injected fish oil...not much,less then a capsule into my foreskin. Thinking nothing of it being just skin. And now its a hard lump and I can t retract the skin. What should I do..very worried. I did it 5 days ago...the hard lump appeared 2 days ago.",
    "doctor_response": "Hello dearWarm welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This indicates inflammation of the foreskin in form of balanitis or para phimosis .*  Immediately consult your general surgeon dear without any type of delayHope this will help you .Regards dear .",
    "dialogue_context": ""
  },
  {
    "patient_message": "33 yrs old and still not pregnant. Please advice.\n\ni had periods for two days full bleeding third day morning to evening no bleeding evening slightly bleeding and fourth day onwards no periods and i am now 33 years old and not pregnatn still",
    "doctor_response": "Hi Rajini, Welcome to Healthcare magic forum, Since u got ur periods its confirmed that ur not pregnant. Hope I have answered ur question, Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat pain and swelling of thumb as i slipped and fell down?\n\nI slipped & fell on the ice outside my house last night. My left palm, at the base of the thumb bruised immediately. A few minutes later it started to swell. Ice & tylenol helped the swelling, but it's still a little swollen & bruised. It felt ok when I woke up, but the longer I was up the more it's beginning to throb, like a dull stabbing pain. It is tender to the touch at the bruised area & around it, at the base of my thumb in the palm area. Should I go get it x-rayed, or is it likely just a sprain?",
    "doctor_response": "Hi..I read your question and got your concern.Get an xray of your hand.. and consult with an orthopaedic surgeon to rule out any possibility of fracture or dislocation.If xray is normal,then oral paracetamol will subside the pain and swelling within a week.Wish you good health.I will be happy to help you further if you have any question.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Radiating pain from back to stomach. Nauseated. Using Tylex. Suggestion?\n\nHi my name is Lisa , I am a 28 yr old female. I have been feeling nausea for a little over 2 weeks now but suddenly today I began having pain in my back which is worst on my left side but pain travels to my stomach this pain is like a dull pain but is very painful at times. It hasn't left at all today just kind of eased a bit with tylex. Could you please give me some advice. Thanks",
    "doctor_response": "Hi,From history it seems that you might be having acid reflux or gastritis giving rise to this problem.Take Omiprazole type of tablet daily for few days.Take antispasmodic tablet like Dicyclomine for pain.Take light diet.Avoid fried, chillies and junk food.If there is no improvement then go for ultra sound abdomen to have more precise view about your problem.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treating Hep C with triple therapy peg-interferon alpha 2b. Is there a chance that new born of hep C infected also has it ?\n\nHi, I have Hep C. I am treating it with the triple therapy peg-interferon alpha 2b, ribavirin and Victrelis. I have had four undetectable blood tests come back, and only 7 weeks left of treatment! That's very exciting news for me, now I am so worried about my 13 year old son. Should I get him tested for the virus. What is the percentage of children born to a mother with hep c actually getting it and the virus becoming chronic? Please help, I am really in need of a correct answer. Thank you.",
    "doctor_response": "Hi Thank for choosing HCM, I really understand your worry, as matter of fact you should go for testing of your son, as the chances  of infection of hepatits virus from mother to son is more likely, I said more likely but not always, it is all depend the immune system of mother if she has good immune system then the chances of infection is minimal, so it is better to test your son,, take care of your family , Have good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Infection in pancreas and liver after removal of gallbladder, unable to eat.  Suggested surgery for pancrea removal.  Quality of life without pancreas?\n\nYes, my sister recently had her gall bladder removed and developed infection affecting her pancreas and liver...still in the hospital and cannot eat...feeding her intervienously....to weak for surgery right now so they are sending her to a rehab hospital which will be followed by surgery on her pancreas....not sure if they plan on removing all or part of the pancreas...liver is somewhat involved now but now sure to what degree...family is concerned obviously and is ofterntimes confused by what the array of doctors are telling us....the question is can a person live without a pancreas and what will be the quality of life?",
    "doctor_response": "Hi and welcome to Healthcare magic.Thank you for the query.Yes,it is possible to live without pancreas because its function can be replaced by certain drugs. She ll need to take enzymes and insuline till the rest of her life,but quality of life is not very affected. She just need to be patient and be aware that musch serious consequances may happen if pancreatitis progresses,even the worst thing.Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dry itchy patches on legs\n\nI have circular dry patches on my legs. They are very dry and itchy. Some are as big as a nickel. I've been having these patches on my legs for 3 years now. They don't itch all the time but every so often I get the urge to itch them. Each place that the patches are seemed to be the same areas where a mosquito has bitten me. What could this be and how can I treat it?",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, if this is the chronic dermatological condition then this need to be rule out for the psoriasis and for that you need to see the dermatologist there you may be in need of some investigations, till then this can be tried with \"Terbinafine cream\" because this could be associated with some fungal infection, hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Vigan Forte advisable for hair loss with PCOD?\n\nI am 24 yrs, weight - 45.5 kg and height is 5'3 and m suffering from poly cystic ovarian disease (PCOD)from past 4 yrs....I have pimples on my face and suffering from hair loss problem now from past 1 yrs....now i have very less hair on my head...my doctor has suggested me Vighan Forte and mintop solution....is it safe as m suffering from PCOD",
    "doctor_response": "Hello. Thanks for writing to us at healthcaremagicHair loss in PCOD has a hormonal origin. There is an excess of male hormones that are circulating that normally should'nt..These male hormones are responsible for miniaturization and hair loss predominantly from the top of the scalp in females (Female pattern Androgenetic Aopecia) similar to that what is commonly seen in males.Treatment of PCOD is specifically aimed at normalizing the hormonal imbalance with monthly hormonal pills(combination of estrogen and a progestational agent). Once the hormonal balance is normalized the excess male hormones which were acting, no longer do and therefore hair fall is arrested and even reversed.The tablet which you mention contains biotin. Biotin is an added advantage as it promotes hair growth. It also promotes utilization of proteins by hair but it is not specific therapy for hair fall in PCOD.Minoxidil too is not specific to PCOD, it is a non-specific hair growth promoter but it has an added advantage when it is co-administered with specific therapy for PCOD.However, both biotin and minoxidil are absolutely safe to be used in PCODRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have mucor infection in respiratory system. Feeling weak, shortness of breath and body pain. Taking steroids for asthma\n\nI have a mucor infection(some say its aspergillious) in my respiratory system. I am feeling very weak ,short of breath,confusion, and body pain. Many dr.s disagree about treatment. they are doing nothing while I keep failing. I have been on high does steroids for years for asthma. What should I do?",
    "doctor_response": "Hello,Welcome to HCM,If mucor is infecting you, it will produce symptoms like dyspnea (difficulty breathing), nausea, vomiting, persistent cough and coughing blood.If you are having these symptoms it should be confirmed by swabs of tissue or discharge  and biopsy of the involved organ.If it is confirmed to be mucormycosis it can be treated by amphotericin B therapy.Regarding your asthma, you need to identify the triggering factor and try to avoid those triggering factors.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant pain in foot, big toe, heel and ankle?\n\nI have constant pain in my left foot. Strangely the pain shifts every day; sometimes on the outside edge, then at the base of the big toe, then above the heel, then on the outside ankle, then the inside ankle etc. Also, every morning when I awake, my feet are the same size however after arising, my left foot swells throughout the day. This repeats every day. This condition happened after one of my chronic gout attacks. Any ideas?",
    "doctor_response": "Hello I have studied your case, suggest sequelae of chronic  gouty arthritis with possible osteomyelitis..In gout there is accumulation of uric acid crystals in joint mainly foot. This leads to swelling and redness in foot.I will advise to do blood inv like complete blood count ,uric acid level, and foot scan.Till time take analgesic and neurotropic like methylcobalamin.for gout  you may need medicine accordingly and diet restriction.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with colon TB. Is it contagious? Enlarged liver, lymph nodes in abdomen. Diet to follow?\n\nI have been diagnosed with colon tb, im 29 yeras old female. firstly i want to know if it is contagious or not? my medical tests shows mildly enlarged liver and lymph nodes in upper abdomen . I do night shifts, should i leave my job beacuse it will effect on the timings of prescribed medication. what kind of diet should benefit me? please advice. ur reply is awaited.",
    "doctor_response": "hi. abdominal TB is not usually contagious. u should get a chest x-ray and sputum examination done to rule out active pulmonary TB, or consult a chest & TB physician. enlarged lymphnodes  are common in TB. there is a risk of perforation of gut from ulcers in small intestine. so u should avoid constipation and at the same time the diet should not be very high in fiber that will create high intra-luminal pressure in gut.  so as to if u have deranged liver function tests the diet should be low in fat and protein.  i do't think job will affect the timing of medication. u can take medication while on duty also. but the treatment should be regular for at least 6 months. the disease causes weakness in body, so have high energy diet and avoid hard work till recovery. get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes allergy?\n\nHi dr,my 3yr old kid got nail scratch by a dog.we gave rabivax for two days.we did not completed thecourse.but she got allergy due to insectbite which is lasting for Two months inspire of giving medicines.is this because not  completing the injection course?",
    "doctor_response": "Hello.Thank you for asking at HCM.Insect bite allergy and incomplete course of rabivax has no relation.Sometimes an insect bite causes a large reaction, which takes time to heal, in between it may be get infected, and repeated scratching it will not allow it to heal.So please do not correlate it with incomplete course of vaccination.Hope this will be helpful to you.Wish your daughter the best of the health.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for electrical feelings in head and loss of smell\n\nI have already been diagnosed with peripheral neuropathy. I take Lyrica and oxycodone , xanax and trazadone. Lately for the past 2 mos. I have been falling and have had electrical feelings in my head but they do not hurt . The electrical feelings started 3-4 months ago and now are every hour and I cannot work. I can hardly stand to type at the computer or think. I have a metallic taste in my mouth and things do not smell the same. Also I have no appetite.",
    "doctor_response": "Hello!Welcome on HCM!Regarding your concern, I would explain that your symptoms seem to be related to trigeminal neuralgia. But, considering the loss of smell, I would recommend performing a brain MRI. Some other tests are needed to exclude for the causes of peripheral neurophathy (which could also explain the lack of smell): - complete blood count for anemia- iron levels for iron deficiency- vitamin B12 levels- thyroid hormone levels - fasting glucose and HbA1C for diabetesHope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for prostatomegaly gr-II?\n\nthe ultrasound reports that I've prostatomegaly gr-II with calcification +.The X-Ray and the urine is normal.. The frequency of my short toilet going has slightly increased though not severe. I dont feel pain  and there don't seem to be any kind of infection. At present I'm consulting general surgeon. So far, I've not got a date with him to show the reports. What line of treatment should I go Sir.",
    "doctor_response": "If the symptoms are not severe and no recurrent infection conservative treatment is recommended.  Tab tamsulosin or its congener with a combination of dutasteride is recommended once at night dosage.  However I will recommend you to get for once your PSA (prostate specific antigen) done,  though the probability of it coming abnormal is lessRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to treat my dark upper arms?\n\nHi doctor, I am a 26 year old female. My\u00a0upper arms\u00a0are so\u00a0dark and\u00a0I also have some\u00a0small sand like bums. I\u00a0noticed this since I was 15 years old. As my skin is quite fair, it looks obvious. Please suggest me some advice.",
    "doctor_response": "Hello,\u00a0 Welcome to icliniq.com. Revert back with clear photos to a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does a bout of chikungunia aggravate filaria?\n\nHi Doctor, my mother is suffering from filaria (in one leg) for about 6 years now. She was taking tablets & injections for it. One year back she got chikunguniya and as a result stopped taking any medication for filaria....will it have worsened her filariasis? she now often gets nerve-knots in her legs..",
    "doctor_response": "Hello Your mother got Chickenguniya , while she stopped the treatment for fliariasis .Chickenguniya is a viral disease while filariasis is caused by worms .One year back your mother stopped the treatment .Usually , according to this history your mother is having lymphatic filariasis.As you mentioned that there is nerve -knots ,These are blockage of lymphatic system , hence if treatment is stopped naturally symptoms will flare up , so take treatment as this is acurable disease.Consult your physician and take treatment .",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the sharp pain in the abdomen accompanied with tiresome and fatigue?\n\nHello... I'm having a sharp pulling pain kind of electric transmission at lower left side of my stomache accompanied by left chest pain. This pain has been there for very long period of time. I have seek many doctors to rule out the cause yet my problem was not solved. The pain get more intense day by day. I feel extreme tired, fatigue and always release gas. Please advise me. Thanks",
    "doctor_response": "Hello dear,The symptoms as mentioned in your post is attributed to accumulation of gas secondary to increased acid production in the stomach.Symptomatic relief can be obtained with intake of Pantoprazole preparation (to be taken twice a day before meals) & antacid gel (to be taken after meals).They prevent formation of excess acid in the stomach & provide symptomatic relief.And it is also needed that you take certain precautions regarding your diet & lifestyle, such as:1. Take soft, plain, non-spicy foods2. Drink lots of water to maintain adequate hydration3. Avoid fast foods & gas producing food products like cabbage, etc.4. Avoid smoking & alcohol.5. Keep away stress, think positive.There is no need to worry, you will be fine.Wishing a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Intense scalp itching with swelling post using hair lightener. Reactions continue even after taking Benedryl. Suggestion?\n\nHello, I am in my 60 s and have been lightening my hair via a stylist since I was about 16 years old. In the last few years I seem to be reacting negatively to the lightener. After about an hour I notice an aggressive itching on my scalp and later I can tell that my scalp is swollen. I have been using benodryl but am a little worried about continued reactions. Can you give me additional insight. Sincerely, Marcia Kellen",
    "doctor_response": "you take fexofenadine safe medicine take 120 mgm once a day or twice a day as required start piriton 1/2 tsf once a day with warm water you apply flucort lotion on the scalp at night and wash with ketakonazole shampoo in the morning do it twice a week",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest an effective alternative for Insulin\n\nHi, My mom has a new prescription for Actos. She had taken it years ago. She has been on insulin for a few 20 years give or take. How long should she wait to start the Actos after stopping the Insulin. She is getting older and feels insulin is too hard on her system. She would try another insulin but we're not sure what kind that would be. Actos with Metaformin is going to the diabetic routine along with the usual heart, blood pressure etc.",
    "doctor_response": "you need to add some Ayurvedic medicine along with regular vyayama.   tab BGR 34 2bdvyayama (exercise) 30 min morning 30min evening regularly .  gradually insulin dose will decrease.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes delays in menstruation?\n\nI have copper t fitted for last 5 years..I was having my periods regularly but now copper t is due for removing as 5 years is completed..and this time i had my periods delayed by 4 days..am i pregnant or is this because of any harmonal imbalance factor?",
    "doctor_response": "Hello dear,i understand your concern.In my opinion it can be either due to pregnancy or hormonal imbalance.It can be confirmed by doing a urine pregnancy test a week after missed period as the urine pregnancy test gives accurate results a week after missed period.So relax and wait for the spontaneous onset of period.If no period do a urine pregnancy test.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can birth control injections affect fertility?\n\nim a 20 year old female who has been on the birth control shot for 2 years. my last shot was November 2009. i was due back for my shot Feburary 2010 but im trying to get pregnant, but it seems like i cant. did the shot mess up my fertility, or do i need to be off the shot longer?",
    "doctor_response": "Hello, after a shot it can take around 6-9 months for ovulation to resume In case you have any questions in future you can contact me directly on",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can anxiety be treated?\n\nWhat medication that is not in the benzo family could provide me the benefits clonopin does. My doctor won t prescribe benzos. I have taken buspar for two years for anxiety and I think it is part of why I can t seem to get well. We tried hydroxazine but it made me worse",
    "doctor_response": "Hi,You can try with ESCITALOPRAM as it has anti anxiety properties which can help youI think benzodiazepines are always better to regulate your sleepSo discuss with your doctor regarding thisThank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fast heart bit with fatigue and sweating?\n\nyesterday  all of a sudden i felt like my heart is beating fast and i was feeling fatigue and sweating.....i went to doctor ,he  said it was because of svt  they gave me treatment and prescribed metpure-xl 25.this i have to take life long .why this happened to me.is it risky?",
    "doctor_response": "hello, Thanks for using HCM.I have gone through your query.If your symptoms are due to condition called SVT you need to take medication for long time.I would like to see your ECG at the time of palpitation .There is procedure called RFA (Radiofrequency Ablation) for Extra pathway in heart which may elimnate need for permanent medication.However i can guide you only after examining your ECG, My best wishes Dr.Rajesh Teli,MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will bowel cancer have an effect on pregnancy?\n\nHi in 2001, I was admitted to hospital as emergency and was found to have bowel cancer. I had a subtotal colectomy for Dukes B adenocarcinoma. Since then, I have regular check up, endoscopy every 3 years, which have been normal. The thing that is worrying me is that I have just found out I am 3 weeks pregnant at the age of 45. I am concerned whether carrying a baby for 9 months would have an effect on my baby s health and also mine. I would be grateful for your advice. Joanne",
    "doctor_response": "Hi,Since you have recovered and going for regular check up, the bowel cancer will not have much effect. But what could have more effect is your age. At 45 years of age, the chances of pregnancy complication are much more.There is  an increased chance of miscarriage, down syndrome in baby, congenital defects, hypertension in pregnancy, diabetes in pregnancy, preterm labour to name a few.Also, if you do end up with a Caesarean, it might be a high risk surgery, as you have had previous surgery for colon cancer and adhesion are to be expected intra abdominally. This could make post operative recovery longer and difficult.Please see a gynecologist who will carry out all basic checks to see your fitness for this pregnancies and exact dating of the pregnancy.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could knots on back of neck with headache suggest?\n\nI have a knot in the back of my neck..right next to my spine on the right side. It has been there for a while now and i always assumed it was just a knot . it hasn t changed in size. but recently its causing headaches and hurts to tilt my head back. I can only feel the knot if i put my chin to my chest. Is this something i need to have looked at?",
    "doctor_response": "Hi, happy to help you on your health concern!In the present case of nape of neck swelling or lump, if I were your consulting physician, I would just say you, 'nothing to worry!'As per your description, it is benign harmless lesion like skin tag or common papilloma or some neurofibroma!Take caution not to get injured there as this might invite infection.If you are still worried, please get an FNAC test for confirmation and revert back to us.Hope you got your answer. Please feel free to write to us if any more queries.Wishing you the best health!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause hard black stools in infants?\n\nHave 2 month old straining to poop and seems to be painful, had been 3 days since last poop, finally pooped today and was black, thick pasty like is this something to worry about. He is bottlefed, simulac sensitive formula. He get gas in his tummy very easy.",
    "doctor_response": "Kindly avoid bottle feeding mam..because bottle feeding leads to constipation..along with Similac kindly give breast feeding also please..also days once passing motion is normal upto 6 months..give feeding through spoon and paladai. .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes discharge of pus and blood from the navel?\n\nTwo weeks ago my son s bellybutton had discharge in the form of pus mixed with a bit of blood. We went to the doctor who cauterized it and it bled older, faint colored blood and no more pus. It bled very little each day...one discharge per day, for example. It s been like that for one week now, very little, blood with a faint, older tinge.We began treating with antibiotic over the counter drops and the bleeding has subsided substantially to now a faint, older tinged color of blood. No pus, no swelling, no fever, no loss of appetite and normal behaviour.I am curious if it s a subacious cyst and what else can we do.",
    "doctor_response": "Hello, How old is your son? Is he a small baby. According to thae symptoms you are telling it seems like your baby has had an umbilical granuloma or mild infection. Cauterization will mainly help in umbilcal granuloma. Using topical antibiotic cream will fasten the healing of the wound.  You have to keep the bellybutton dry to facilitate fast healing. But dont dry vigorously after washing. Because it would irritate or break the scab again. So you have to fan it well to dry.  Hope this helps. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cramps and spotting. Trying for pregnancy. Have thyroid problem. Any help?\n\nHi I have been trying for a baby and tested yesterday, the 28 th day of my cycle, it came back not pregnent but I keep getting a bit of blood hardly anything for the past 3 days and stomach cramps as if I am going to start my period for the past week my monthly cycles are a bit irregular as I have thyroid problems e.g last month it was 26 days the month before it was 34 days. I'm I defiantly not pregnent. Thanks",
    "doctor_response": "Hi,Thanks for the query.As your bleeding started there is less possibility for pregnancy.But if you think that the bleeding is abnormal for you and as sometimes urine pregnancy test kit may not detect early pregnancy, go for blood test for pregnancy or repeat urine test after one week.You have to keep your thyroid levels within control to get regular menstrual cycles and for fertility.For more details you can ask me through:  care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I get pregnant while suffering from PCOD?\n\nHi Doc,i am married for 5 months now and recently got diagnosed with Bilateral Polycystic Ovaries.i had irregular periods in the past.In the ultra sound report:My uterus is in normal size measure approx 59.0 X 35.8 X 45.5 mmThe endometrial thickness is 12.9 mm,hyperechoicBoth ovaries are bulky.The right ovary measure 41.5 X 33.5 X 20.5 mm and 14.9 cc vol.The left ovary measures 36.6 X 32.8 X 21.4 mm and 13.4 cc vol.i am metformin 500 twice daily.will i ever become pregnant?",
    "doctor_response": "Hello,Thank You for trusting HealthcareMagicChances of conceiving with appropriate management of Polycystic Ovarian syndrome (PCOS) is high.Maintaining a healthy weight by eating healthy add regular exercising is very important.Continue metformin as prescribe, as metformin regulates the insulin level and promote ovulation.There are also other medications like clomiphene,HCG injections and other treatments available if metformin alone is ineffective.Hope I was able to help youPlease address further questionsRegards,Dr.Lekshmi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in the lower rectum\n\nHello.  I have been with pain in my lower rectum for the last three weeks.  I thought it was caused by antibiotics I was taking for a tooth infection, as I don\u2019t usually have any rectum problems. Nothing like this anyway. About 8 days ago, while sleeping, the pain in my rectum was extreme.  It was waking me up every 10 to 15 minutes.  Sharp stubbing pain. The next day I got a fever (100).  I visited the doctor and it was determine that I had a combination of issues: a) an external hemorrhoid and b) a virus was developing, perhaps the flu.  As soon as I got home the sickness of whatever I had took hold.  I had the chills, fever, and diarrhea.  The first two lasted for a day.  The diarrhea I still have it. It has been 8 days and I still have the diarrhea and the lower rectal pains.  It\u2019s not diarrhea all the time; occasionally I have solid or loose stools.  I\u2019m going to the bathroom very often, an average of 4 to 8 times per day. When I have to go I get a sense of urgency.  The defecation is relatively small and is either diarrhea, soft stools, or very thin solid stools. The hemorrhoid is still there, if that is what it is.  I\u2019m using creams and it is not going away. What do you think I\u2019m going through?  I had stomach virus before and the diarrhea only lasted me couple days.  Thanks.",
    "doctor_response": "HiI would suggest to replenish your salts and electrolytes which you are loosing through stools.use copious amount of ORS.For external haemorhhoid simple evacuation of the haematoma(blood)inside is adequate.If these are internal haemorrhoid which are coming out on defecation,then surgical treatments are needed such asInjection of sclerosant ie almond oilBandingStapled haemorrhoidectomyOr open haemorrhoidectomyThanx",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frozen feeling on the legs after a c-section?\n\nI had a c section four and a half months ago after six weeks i was getting a frozen feeling on my right leg and now its on my left leg ive had a full spinal mri and they found a bit ofswelling but the docs said thatsho not bea problem and now they want me to have a head scan. Can you help or advice me. Thanks",
    "doctor_response": "Hi, It could be due to peripheral neuropathy (postpartum). Calcium, vitamin and methylcobalamin in adequate dose should help. Neurologist opinion will be worthwhile. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nirmal Chander Gupta, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes haphephobia?\n\n-I seem to hate most people. Even people who would call me their friends.-I have this weird thing of touching things.. like if I touched one side of a table, I would want to touch the other side to like balance things out. This also happens in how objects are placed. I know it's weird.-I have really uncomfortable, panicky feelings quite a lot. Sometimes it's for no particular reason. -I get nervous and lack confidence when in a classroom with loads of people. You can probably guess.. I don't really like most of them so maybe that's why. -I crack my knuckles and play around with my hair too much. -In class it feels like I can't speak very loud.. like I'm too quiet but with friends at break/lunch, I'm loud.-I feel like I have these illnesses like, migraines, brain tumours, diabetes making me feel like I'm gonna die. -I feel really lonely a lot.. like I have no one to talk to. Does this all lead up to anything?",
    "doctor_response": "HiThanks for using healthcare magicI think, you have social phobia and haphephobia. In that case, you need both pharmaco-therapy and psychotherapy. In medicine, you can try antidepressant like paroxetine or benzodiazepine. In psychotherapy, you can try some relaxation exercise or exposure therapy. Better to consult a psychiatrist for proper management. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of persisting pain in the left side of the abdomen after going through several treatments ?\n\ni am suffering from lewr left abdominal pain for long time, many treatments taken but no relif my name Hanuman age- 30 years. i am suffering from abdominal pain at left lower side for a long time. some times pain in legs also. many treatments taken from different places but no one solve my pain. for which i so weak.",
    "doctor_response": "Hi hanuman,thanks for query.Just visit a surgeon in your nearby and go for some tests like blood counts,ultrasound,urine examination and other test as per his advise.Either you have some infection in your intestine or some disturbance related to urinary tract.Do not worry you will be fine.bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe cough in an gitelmans syndrome and tietze syndrome patient\n\nOkay so i have gitelmans syndrome and tietze syndrome and ive had a really bad cough for the last 3 days i have to use my inhaler more frequently because the coughing is causing my asthma to flair up and im having this really bad pain in the middle lower part of my chest it feels like its spreading it just hurt and im wondering if i should go to the er or not?",
    "doctor_response": "thanks for asking your questionchest pain can be due to inflammatory costochondritis that is teitz syndrome and increased cough is a part of flaring up of asthmayou need to consult a Pulmonologist for both the diseases who can start you on certain medications to relieve your symptomsin my patients I usually start them on inhaled steroids and long acting beta 2 agonists for asthma as per international recommendations for asthma regarding teitz syndrome I prefer to control symptoms by prescribing some analgesics , non steroidal anti inflammatory drugs and if needed local injectionsthanksfeel free to ask more questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Sore breasts, sweats, hot flashes, brown discharge. Tubal reversive surgery done. Explain situation?\n\nHi I am 30 years old 4 months ago I had tubal reversal surgery and my husband and I have been trying to conceive every since. I have been charting my cycle which is every 29 days and I ovulated on April 4. At this time I experienced sore nipples/breast  which is normal for me except this time the soreness continued. I began to get sweats and hot flashes. On April 13, I noticed a pink spot while using restroom just the one time which would have been 7 days before my expected period. I also developed very mild cramping. 3 days later April 16th I began to spot regularly it was light pink and brown off and on for 1 day. The next day the flow picked up but wasn't enough to fill a pad. April 18 thru April 21 The bleeding turned moderate brown in color with some clots and I began to cramp badly. This was odd for me because My periods are usually very heavy and usually only 5 days long with the last day being light. On April 22nd I stopped bleeding all together thinking I just had a weird period but on April 23 the spotting came back but was light pink/brown and continued until April 25th with mild cramping. Also My breast/nipples are now heavy full and more sore. I have also developed lower backpain, pimples and I am fatigued all of the time. I took a pregnancy test which came back negative and I have never had these issues before what could it be? I am so afraid because I fear an ectopic and I only have one fallopian tube after reversal surgery. Any help would be appreciated.",
    "doctor_response": "Hello. Thanks for writing to us. The pain in the lower back that you ahve could be related to uterine contraction, poor posture, Vitamin D 3 deficiency, etc. Few blood tests and direct examination will help in proper diagnosis.I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL  Regards, Dr. Praveen Tayaldrtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest natural remedy for depression, anxiety, sleep apnea and migraines\n\nI am a 51 yr. old woman. I have a medical history of anxiety, asthma-copd,hgh.bld.press.,sleep apnea,migraines,acid reflux,bells palsy-hemi facial spasms,and t. dyskinesia. I have tried cogentin, valium,topomax,primidone,and neurontin for the tremors. They were not tolerated very well. I had been on numerous depression meds when this developed 2 yrs. ago. I take lorazepam,enalapril,singulair,symbicort,and abuterol on a regular basis. I would like to know of any vitamin-mineral or natural product that might help with the symptoms of this disorder. Look what prescription meds. have already done. Please TRY and figure out something. My family does not understand this disorder and is considering putting me in a nursing home.......CAN YOU HELP!!!!!!!",
    "doctor_response": "Hi dearI understand your concern. Vitamin or minerals can help but they only boost your energy level but not help to recover from depression. L methyl folate and methylcobalamine can help in depression.Both have a good review in treatment. It is effective only when give with ani depressant. Anti depressant like sertraline / escitalopram will help along with L methyl folate.Thyroid function is also necessary . Do it if you have not done yet. Suppliments of thyroxine also beneficial. Do take advise from your treating doctor. Consult psychiatrist and get help. Still if you have a query then feel free to ask. Thank you. Get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On IUI treatment, have period like cramps, unsure of ovulation. Advice?\n\nI would just like to remind you that i am on Fertility Treatment IUI . Cycle Day 2-5 Femara. Day 5,7,9 - Menopur ( 2 each) Day 10 - U/s, 2 follicles sized 22 mm and 16 mm rest all less than 10mm. - Doctor said HCG Trigger at 9 Pm. Day 12 - IUI at 2:30 Pm Day 19 (7dpiui) - Checked Progesterone .(Doctor told this might help us to know if i ovulated) Day 21 (9dpiui) - Got result and its showing 17.10ng/mL. Day 24 (12dpiui) - today Doctor we are not sure if v ovulated and i have cramps like periods are nearing",
    "doctor_response": "Hi, One cycle of superovulation with IUI doesn't give 100% pregnancy rate. Also with the follicle size you described, after injection of hCG, there is very rare chance of ovulation failure. Also menstrual like cramps doesn't indicate failure of treatment (Not being pregnant). Pregnancy is still a possibility. You can just wait for 2-3 more days & if you don't have periods, you can do pregnancy test.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to stop hallucinating that baby is an alien\n\nhi i am suffering with depression diagnosed by a psychologist, it first started 6 years ago after i had my youngest child, i felt perfectly fine until i had a fear something bad was going to happen to my eldest child while at her dads that thought then quickly turned from being afraid something would happen to her to me thinking and feeling like i wanted to harm her, as the days went on i tried to ignore these thoughts and urges until one night i was feeding my youngest child who was about 1 month old at the time when i suddenly thought your an alien sent here to hurt us this really freaked me out and i felt so guilty, it got so bad i went to see a psychologist who diagnosed me as having ocd, he put me on fluoxetine 20mg per day which in time worked well and ive lived the past 6 years happy and content and able to push any silly or unwanted thoughts out of my mind easily, however in january this year i decided to stop taking the fluoxetine 20mg per day as i felt in control, i felt fine for the first four weeks after stopping them but around the fifth week i hit rock bottom, the thought that i wanted to hurt my youngest child suddenly came into my head whilst having a cuddle with him and since then i keep imagining hes an alien again even though i know this sort of thing does not happen in real life it feels very real to me and im having terrible trouble convincing myself that he is just my little boy whom i love dearly and have a very close bond with, my doctor has now put me on 40mg per day of fluoxetine and for the last few days i have been takin diazepam and sleeping tablets, i just want this nightmare to stop only it feels so real please help",
    "doctor_response": "You need 60 mg fluoxetine, fluvoxamine clomiprine and tab risperidone for 6 months atleast. Aftr that tapper the doses. And go side by side counselling and group therapy. You will be fine after six months. and no need of treatment afterwords. Talk to your doctor as i suggested. Hope my suggestion helped you and gave you some relief in such difficult situation. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Delayed periods. Lower abdominal pain. Pregnancy test negative. Histroy of PCO. Help\n\nhi, i am 27 year old, have been diagnosed with pcod, had done one course of femilon contraceptives before three months, after that for two months i got my periods at 30 days exactly. this time it has been 1 month and 14 days, had three negative pregnancy tests, have mild and frequent lower abdominal pain since last 15 days. i am desperately trying to get pregnant. but last month was a failure and this month is all confusing with three negative pregnancy tests.. please help me out with a way....thank you.",
    "doctor_response": "Hi, Thanks for your query. Irregular periods means anovulatory cycle, that is because of PCOD. You should consult a gynecologist and took treatment for PCOS. For pregnancy cycle should be regular and ovulatory. Get your urine, blood test and the USG has done to rule out pregnancy. GOOD LUCK. Don't worry. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is overdose of Calpol dangerous for an infant?\n\nMy son is 6 months and 3 weeks old. I accidentally gave him 10mls of calpol instead of the 5mls that it says is recommended on the box for his age, as I have lost the measuring syringe and used a teaspoon. So I gave him two teaspoons thinking that they amount to 5mls but have since found out that two teaspoons I'd 10mls! He is a very good weight, over a stone in weight. Should I be worried as I am panicking now! Thanks.",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your history and would like to make suggestions for your son as follows:1. Although an overdose, I would think an approximate double dose of paracetamol (Calpol) would not cause any serious consequences. Of course, grave consequences can occur after a very large dose of paracetamol.2. Please observe your son for any symptoms like nausea, vomiting, abdominal pain, lethargy, uneasiness, etc. Should any of above symptom appear, please consult a doctor and get him examined by him/her.3. In pediatrics, doses of drugs are based on weight of the child, not on age of the child. So in future, please do not give any drug without consulting a doctor. Dosing of a drug based on labels on the medicine can be harmful.Hope above suggestions will be helpful to you.Wish your son a safe outcome and a good health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome masturbation addiction?\n\nHello am a guy of age 25 and my problem is that i had masturbate lots of time from my childhood.even i was addict of this..so now a days i feel that my memory is very weak & even my physical stamina also very weak .so how can i recover all this things??",
    "doctor_response": "HelloIt is good that you are trying to get rid of masturbation addiction.You should avoid provocative literature and videos.You should try to be calm and try to engage yourself in your job.You may also need psychological counselling.Masturbation doesn't lead to memory weakness and weakening of physical stamina.This is a myth.You should take healthy and nutritious diet.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the ribs?\n\nI fell into my nightstand a week ago Friday. This injury bruised the front of my right side. It s located right below my rib cage, above my hip bone. Under the skin there s a hard lump, when I try to rub it out it really hurts or if I bend over the wrong way and it pinches there s a burning pain the runs through it. I m concerned if it s a blood clot that needs to be treated by a Doctor or if it s just the healing process of the bruise?",
    "doctor_response": "Hello dearWarm welcome to Healthcaremagic.comI have evaluated your concern in depth .*  The cause of pain in the ribs may be    -  hematoma underneath stretching  the  skin     -  irritation of the nerve endings  through  inflammation     -  rib  fracture     -  costochondritis     -  ligament  sprain or strain *  Hematoma  is  self  limiting  condition , local care with ice pack      application 4 - 5 times a day take well care of it .-  If  there is more pain or fever , redness over the area then consult a    Doctor .-  Do  not  rub  it  at  all .Hope this will help you .Welcome for further guidance .Regards dear .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain, burning sensation and abdominal bloating?\n\nwhat is my problem ????the symptoms are chest pain are intermittent along with a burning sensation,  abdominal bloating and frequent belching, while lifting something heavy or bending the pain worse, the chest pain located deep in the center of the chest ,most of the attacks occurred in the evening and also after a big meal also the blood pressure 140/75 with medication and difficulty swallowing, difficulty sleeping and coughing.",
    "doctor_response": "Thanks for your question on Health Care Magic. Your symptoms are classical of GERD (gastroesophageal reflux disease).GERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause symptoms of Central chest pain, burning, belching, bloating (gaseous distention) etc. So follow these steps for better symptomatic relief. 1. Avoid stress and tension. 2. Avoid hot and spicy food. Avoid junk food. 3. Avoid large meals, instead take frequent small meals. 4. Start proton pump inhibitors and prokinetic drugs. 5. Quit smoking and alcohol if you have these habits. 6. Loose weight if you are obese. Don't worry, you will be alright. All these will also help in hypertension. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest natural ways to treat high BP\n\nI am 61 year old female. Just recently, I saw my doctor and my blood pressure was high. I have never had a problem with that. She just blew it off as nothing, but went to the dentist and they said it was high. Should I seek treatment? I don t really want to be on medication, but what can be done otherwise?",
    "doctor_response": "Hi, How much is your blood pressure? If it is elevated (120-129). But in case of stage 2 or stage 3, it may need treatment with antihypertensive drugs. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for constant vomiting in child\n\nI have a 5 yr old daughter who threw up first thing this morning, before eating, this afternoon, after eating, and this evening before bedtime, after eating. She is not showing any signs of discomfort, has no fever, and is not complaining of pain. Just doesn t like throwing up .",
    "doctor_response": "i suggest syp emeset 5 ml twice a day. after givin this syrup give a gap of 1 hr and then give her some juice like apple and some water along with t.junior lanzol 15 dt once a day for 7 days . syp emeset for 2 days",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it safe to use Daktacort cream on genital region?\n\nHello doctor,I have had a fungal infection on my penis for a month or so now. I saw my GP and was prescribed Daktarin cream, and the symptoms decreased significantly. However, I recently run out, and I experienced dry skin again. I was prescribed Daktacort cream this time, however, it says not to be used on genital region. Is it safe to use? Also, as I am only experiencing mild dry skin now, would butter be suitable to use as a moisturizer?",
    "doctor_response": "Hi. Daktacort is a combination cream. It has Hydrocortisone along with anti-fungal. It can be used safely for up to two weeks, not beyond that. Hydrocortisone is low potent topical corticosteroids, it can be used on the face as well as genitalia under the supervision of a dermatologist. It is so mild that it is FDA approved for treating dermatitis in children. In fungal infection, it is wise to avoid combination creams, as fungus starts developing resistance to antifungal. Hydrocortisone can be used for winter (dry) dermatitis, along with good moisturizer which has ceramide content in it, only for two weeks. Moisturizer can be mixed with Hydrocortisone or Hydrocortisone to be used at night. The moisturizer to be used in the morning. After two weeks continue to use moisturizer. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling in the gums\n\nAll 4 of my wisdom teeth are almost fully out now, except for a small flap of gum over my bottom right one. They seem to fit in my mouth just fine with my other teeth, but for the past week I've been sick with what I assumed to be Strep or the flu. For the past few days I've noticed that the right side of my face is swollen and my gums around that bottom right wisdom tooth is swollen, inflamed, and VERY painful when I swallow/drink/eat/talk. I can also taste what I assume to be is pus coming off of it. Tonight it seems worse, I feel feverish, dizzy, and also kind of like the right corner of my mouth and lips are numb. I don't have insurance, so I don't want to go to the ER unless it's really necessary. What should I do?",
    "doctor_response": "Thanks for your query. I have gone through your query. The swelling over the face and pain is because of the infection over the gums of wisdom tooth. And its spread to involve tissue spaces called space infection.Nothing to be panic, consult a oral maxillofacial surgeon and get the infected flap removed(aperculectomy) if sufficient space is available in the jaw for the wisdom tooth, if not the tooth has to be removed.Meanwhile you can takea course of antibiotics like amoxicillin 500mg TID and metronidazole 400mg BID for5 days(if you are not allergic).Regarding your insurance, you can get the tootb treated in a educational dental institute, wherd the treatment will be done with nominal price. But get the tooth treated as early as possible to prevent further complications.i hope my answer will help you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of getting pregnant after taking dronis 30?\n\nlast night i and my wife had unprotected sex and even i discharge sperm on her penis.....but before we had sex she had taking dronis 30..... so is there any chance of pregnancy and more the dronis course is of 21 days after that any risk of getting pregnant, if she stop taking the pills after 21 days and get a cycle?",
    "doctor_response": "hello i understand your concern. Dronis 30 is a oral contraceptive pill. oral contraceptive pill is prescribed as a 21 day cycle starting from 5th day of menstruation. so cycle course is 21 days. continue with regular daily for 21 days, then you are protected from pregnancy. if you stop the drug on 21st day, then also you are protected from pregnancy because it leads to withdrawal bleeding. so no need to worry about pregnancy and continue with the drug as prescribed. hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have hard bumps under my tongue along the jaw bone . What could this be?\n\ni have hard bumps under my tongue along the jaw bone . What could this be? They seem to be getting bigger. I can feel them in my mouth. Its annoying, but not painful. Female 24 years old",
    "doctor_response": "hello, most probably it must be your bone's growth. to determine what's the abnormality you should have a clear history of that lump and consult a dentist soon. he will decide the tests required to find out the problem and start treating it accordingly. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Body twitches, terrible taste in mouth, short term memory. Muscle in intestine is under stress. Spreads?\n\nI was a patient at Mayo Clinic untill last week,  they could not determine what is wrong with me. They ruled out Parkinsons, ALS, and epilepsy.  I have had MRI Brain shows one mass they assume is from a trauma, rest of spine is fine. All nerve and every test they could run showed normal. Now the process has turned to treating symptomatically, and when I lay down to take a nap (chronic fatigue)  my body is beginning to quiver and twitch much more. Occasionally my entire body will make sudden twitch,,feels something like a sneeze building. I have a terrible taste in my mouth when things are going to start. I have intense loss of balance, short term memory as well. Blood tests were ran as well with elevated voltage gate potassium, ferratin, Kreatineine w/e gfr. Determined was not restless leg syndrome through sleep study. It started with intense intestinal pain, gastroenterologist determined the small muscles in my intestines were under stress and cramping causing the pain. Prescribed Hyoscamine that works very well. It seems to be spreading through my body. Any ideas??",
    "doctor_response": "i suggest you to consult allergeologist to get blood serum tests for specific antibodies for food proteins like milk wheat potato and other foodas suddenly food proteins start reacting with body proteins to cause these types of thingsi advice to withdraw those food proteins which can be helpful to you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for kidney stone\n\nHi doctor i am in bad pain .I had a kidney stone . But when i had sex tuesday after that i m getting bowel disturbance . I do not pee properly and get an unusual pain in my abdomen please help me out with this immediately as i cant tell my parents about it",
    "doctor_response": "HelloThanks for query,You are known to have kidney stone and now getting severe pain and urinary problems since couple of days .Hiding all these facts from your parents is not going to solve your problem .Please let all the facts known to your parents and consult qualified Urologist for evaluation and get following basic test done to confirm the size of the stone ,site of the stone and its effects on kidney function etc 1) Routine urine test and culture 2) Ultrasound Scanning of abdomen Further treatment will be decided upon the results of these test and final diagnosis.In the mean while you can take antibiotics and pain killers.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause inflammation and hardness around areola?\n\nI'm a 36 year old male and wanted to find information about what could cause inflamation and hardness around my left areola. It has been this way for about two months now and I first noticed it about a week after getting a typhoid fever vaccination.",
    "doctor_response": "Hi, It can be due to hormonal imbalance, infection and carcinoma. You can rule out biopsy for cancer. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have oxycodone, moraphine. Under medication. What should to done?\n\nyes please, my husband has been in the military for 18 years urine sample always came out clean never had any problems with any kind of drug usage, now he has steroid shot in his neck about 1 time per month, he is on gabapention, lisinopril, hydrocodone, and nortriptyline, we get a letter on Friday certified that my pain management doctor can no longer treat him due to his last urine test showed positive for oxycodone, and moraphine, we have neither of those but did not show positive for the hydrocodone that they prescribed for him, My question is how could something show up like that and what should we do?",
    "doctor_response": "Hi,Based on the information it seems like a \"FALSE POSITIVE\" test for CODINE/ MORPHINE.There are two different possibilities if the information provided is 100% correct.1) There are cases where a patient had eaten to many donuts with \"POPPY SEED\" which has as same content as codine/ morphine in very trace amount but eating a lot will turn the table around and make their urine positive for such drugs.2)URINE sample may have accidentally changed with some one else.Hope it helps.Dr. JAY PATEL.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can degenerative disc disease be managed?\n\nI have degenerative disc disease narrowing of the spine and possible sciatica, my doctor only put me on ibuprofen 800mg 3x a day that is not cutting it I am in a lot of pain now I can hardly walk is their other medications besides a narcotic that can help me with this",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. To manage such disease, if normal painkillers don't work, then dose should be increased or other strong pain killers should be started. Besides that you will need muscle relaxants like Tizanidine or Orphenadrine, etc. and drugs for neuropathic pain like Pregabalin, Gabapentin, etc. These will help with your pain for sure. Also take vitamin B12 and do some exercise as well. Don't let yourself ridden to the bed. As the above drugs will be available on prescription,  so talk to your doctor about that. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Imran Zeb",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is exfoliative erythroderma?\n\nMy father has been diagnosed recently with exfoliative erythroderma, they put him on an immune suppressant i'm not quite understanding the reasoning for this...also, treatment options seem to be far and few between do you have any knowledge on this particular disease/disorder...? He is 47 years of age and has been suffering from this for around 4 years now. He is so cold all the time. I just want to find him help",
    "doctor_response": "exfoliative erythroderma is an immune reaction in which the skin gets red and falls off. The skin falling off acts as a severe burn and is a serious condition and a reason to immunosuppress. Etiologies are often unknown, but fall into two groups: one is purely an immune reaction and can be to a known thing someone is allergic to (drug reaction. skin exposure). In these cases, with removal of the allergen, the condition gets better. Mostly the allergen isn't so clear or its autoimmune (psoriasis). The other group are cancers (generally blood cell cancers) that invade the skin and cause inflammation. Skin biopsy would be the first stage. Then removal of allergen, or treating the cancer; mostly, giving immunosuppressants is all that can be done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a way to shave pubic hair without getting acne ?\n\nhi, I am 16 and I was wondering a few thing.  First, my penis cures to the left is that a problem?  Second, I get an erection when I wear boxer shorts how can I stop that?  Third, is there a way that I can shave my pubic hair without getting acne where I shaved? And finally, my left breast is bigger than my right, how can I fix that?",
    "doctor_response": "HIThank for asking to HCMYour all the issues are not the problem in fact, curve penis is not the disease, this is absolutely normal, stop wearing the boxer pant if you are facing erection, acne can not happens due to the shaving the hair, you just forget all these things and take it easy, hope this information helps you, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fibroadenoma symptoms\n\nare there any drugs cause fibroadenoma ?",
    "doctor_response": "Hello. . Fibroadenoma is very unlikey to be caused by drugs. But it can be a very very rare side effect. Dr. Rakhi Tayal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Should I be concerned about serotonin syndrome if I take Trazodone?\n\nHello doctor, I weaned off of 40 mg of Paroxetine very slowly but my sleep was impacted and as of two months, I have been suffering from extreme insomnia. I have gone back to medication and I am currently on 20 mg of Paroxetine and 10 mg of Fluoxetine, but my insomnia has continued. I was prescribed Ativan (0.5 mg) for sleep, and it sometimes helps, but not always. Even if I take a bit more (I have taken up to .75 total), it does not always help me sleep. My psychiatrist prescribed Trazodone (she suggested I start at 25 mg and if I feel no effect, to take another 25 mg/ go up to 50 mg in one night (but I am concerned about serotonin syndrome from taking another medication that messes with Serotonin). Can you advise if I should be concerned about serotonin syndrome if I take the 25 (or 50) mg of Trazodone? Additionally, should I be concerned about anything else in terms of taking these three medications together?",
    "doctor_response": "Hello. Serotonin syndrome is an acute emergency case, rarely seen in common practice. At least not when you have already been taking 40 mg of Paroxetine for years. Also, Trazodone is a safer and better sleep-inducing agent when it comes to being used for sleep. As per my knowledge, in fact, these two drugs are given together in depression/ anxiety with insomnia. Yes, Fluoxetine is an SSRI (selective serotonin reuptake inhibitor) known to cause sleep disturbances. So, be careful with it and avoid taking it in the evening or at night at all. Let me know if I can help you more. For more information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling in the spine, numbness, tremors down the arms and legs after an accident\n\n40 yo Female, motorcycle wreck, cervicle swelling and pain, lower L skull fracture and L ankle fracture and ligament tear. X-ray shows no breaks in spine however major swelling from C3-C6, and numbness, tingling, and tremors down both arms, legs and loss of feeling in finger tips. Unsure of where to go from here",
    "doctor_response": "hi,thank you for providing the brief history.As due to the accident there will be a whiplash pressure applied to the cervical spine. Due to which there will be a swelling and spasm of the neck muscles. Also the mechanism of injury was high jerk so there is a soft tissue Injury. X-ray can reveal only the bony areas but for soft tissue taking an MRI of the cervical spine and also a thorough clinical examination is advised. Initially a spine surgeon should interfere for clinical examination and the MRI report needs to be performed. Tremor, weakness, pain numbrness etc are a part of the nerve so needs a thorough care and attention. Stabilizing the cervical spine initially with a hard collar and taking complete rest is advised. As the medication can be helpful for reducing the inflammation and pain. Since cervical spine is the important area of the spinal column a thorough care has to be taken. I will advice to use a hard neck collar and meet up a spine surgeon along with MRI of the spine since it is a RTA.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can frequent bacterial infection in vagina be treated?\n\nHello doctor, I was not having periods on my own. They use to be so uncontrollable and the doctor kept saying wait 10 years and I took myself off all medications that she gave me and went two years without any. I am 27 and I am back to having regular menstruation every month. They not on the same day but they come for 5 days out of the month and are like 27 days apart. But my other problem is bacteria keep coming back why and why have I not got pregnant yet? What would be my next step?",
    "doctor_response": "Hi. First of all, birth control pills itself help in controlling your PCOS with added lifestyle modifications like a balanced diet and physical exercise. So keep up the good effort but now you need to stop the pills. Check if you are ovulating regularly or not with the urine ovulation kits available in the market. If you are still not, you may need some fertility boosting medicines. Secondly, you need to do the following to prevent the BV to recur: 1. Avoid any kind of vaginal douches. These wash away the good bacteria as well, clean with normal water while taking the bath. 2. Have probiotics for two weeks to grow back the vaginal flora. 3. Use cotton panties and avoid using tampons. Use pads preferably.  4. Avoid oral sex from the male partner. 5. Need to use Metronidazole vaginal pessary for a week to clear the BV. I hope these measures help you out well. Do start using Folic acid supplements.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to prevent tapeworm infection?\n\nHello doctor, I have severe Crohn's disease, which is not under control. I ate a piece of medium rare steak with tapeworm in it, and I am terrified that I may have got tapeworm infection. I have tried puking, but not much came out as my body does not process things completely before passing it on. Is there anything I can do to keep myself from getting tapeworm infection?",
    "doctor_response": "Hi. Revert with more information to a medical gastroenterologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for breathing difficulty and numbness in arm\n\nHello, Had 2 types of antibiotics for fluid on the lungs. I'm waiting for test results after a pleural effusion of 950mls on the same side (right side) as I had breast cancer, stge 2, 10 years ago. Chemo, Radio, Mastectomy & Oestrogen blocking drugs for the last 10 years followed - I was discharged from Oncology Sep 2010. The effusion hasn't helped me feel better, I thought it would give me a reprieve as I am waiting to get back to my 30min jogs and generally very good health.  My right arm, from elbow to wrist on the underside went numb Sat 4th, the effusion was Mon 6th June. I had Osteopathic treatment to try to clear the numbness, no joy. Why don't I feel a little easier with breathing and could the arm numbing be linked ? Age 50, 5'9\"tall & 63kgs weight",
    "doctor_response": "Hello dear , HiWarm welcome to Healthcaremagic.comI have evaluated your concern in depth .*  Breathing difficulty has to be addressed with x-ray and laboratory data    in terms of necessary bronchodilators , antibiotics  &  other supportive     care  .*  Numbness in arm is in relation with neuropathic issue  from various      reasons  need  nerve conduction velocity with or without  MRI  for      further  management  and  guidelines .*  Present  suggestions  for  primary  relief -  Deep breathing exercises , YOGA .-  Light exercises involving shoulder rotations .Hope this will help you for sure .Always  feel  free  to  ask  further  doubts .Regards dear take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Planning for a baby. Irregular period, brown discharge. Taken meftal spas. Help?\n\nHi doc, we are married for 2 years now and now planning a baby. my periods were due around the 4th of march and did not happen till date jan. but i had been facing been in the lower belly for many times in these days. In fact i checked for the pregnancy test but it was negative. but yesterday evening the periods started which was much lesser than regular. i took meftal spas for relieving myself from pain. it was later followed by a strange material outflow for once. this was a mix of thick brown blood and some white substance...kind of the layering substance which i couldn t understand. kindly suggest.",
    "doctor_response": "Hi, Thanks for query. As you say your period are not regular,chances of pregnancy are also uncertain because your ovulation time is not fixed. Pregnancy test sometime be false negative,but may be you are pregnant. May be meftal spas cause contraction and may be that white material is early sign of pregnancy. but don't worry,whatever happened is happen,go to some gynae,get USG done. Took treatment for your irregular periods Everything will be fine. good luck take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fatigue,dizziness,pain in shoulders and neck and blackness in under eyes?\n\nSince 2 weeks I feel something strange in my body! I feel like my body is down , I don\u2019t have energy to do anything , from time to time I feel dizzy  and if I have an internal fever, I have pain in my shoulders and neck and my under my eyes become black\u2026 Can you tell me what these symptoms are?",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.You do not have any infection. You are suffering from the severe weakness.I suggest you to start doing exercise. Regular early morning exercise of half an hour will cure all your problem. If. You are having a 15 more minutes than doing yoga for morning period also improves your cognition.There is no terminology like you are having internal fever. Please eat antioxidant reach foods like fruits green leafy vegetables etc. It is also a good tool for good healthy life.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood in the stool of a child?\n\nmy daughter is nearly 4 years old and had bright red blood in her stool today. the blood was also spotted in the toilet, and was clearly noticeable on the toilet paper (after wiping). it was more than just a few specs. one her preschool teachers informed me of this when i picked her up late this afternoon. i of course called our pediatrician, and without hesitation, she suggested we take her to the ER. my husband is there with our daughter right now. i haven t heard anything (yet) and would appreciate any insight/advice you could lend in the meantime!",
    "doctor_response": "Hello,The most common reason for blood in the stool in a child at this age is a hard stool. It may have only been 1 or 2 times. This is all that is needed. Often some added fiber or a laxative for a short amount of time is enough to alleviate the problem.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Eric Goldstein",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back pain, left leg pain and excessive sweating?\n\nI am a 38 yr old femake, 5'5\" about 160 lb. I have been suffering with horrible lower back pain in the L4, L5 region. I have had multiple steriodial injections that have not worked. I also suffer from left leg pain down to my foot and sharp pains that radiate up my back. As strange as it sounds, since all this began I have suffered with horrible sweating. Not just annoying sweating but change my clothing, sheets and pillows at night sweating. I am at a lose of what to do. I can't seem to find any relief and the doctors can't seem to help me either. What are your thoughts?",
    "doctor_response": "Hi,Welcome to healthcare magic.After going through your query I think  You are suffering from chronic backache. Reasons of back pain can be weak muscles and bone and disc prolapse and.Treatment of back pain  is exercises, neurotropics such as mecobalamine once DAILY and analgesics (DICLOFENAC  SLOW RELEASE TABLETS)  . Sometimes vitamin D deficiency is the cause so get your vitamin D checked .If it is low then vitamin D supplementation( weekly with milk) can be taken.Eat milk, fruits and green leafy vegetables daily.To further investigate MRI of the region is advised.You can discuss with your treating surgeon. I think your query answer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of potential pregnancy?\n\nI had protected sex on day 14 of my menstrual cycle. We used a condom and it didn t break or leak. I m not late yet but I m starting to show other early symptoms of pregnancy. Is there something else that causes similar symptoms or should I be worried?",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic.I have gone through your query. I think I have understood your concern, I will try to suggest you the best possible treatment options.1] If you have taken proper precautions , then please do not worry.2] Please wait patiently till your expected date of menses.3] If at all you miss the periods, then get morning's first sample of urine checked.4] Even if you get pregnant and do not wish to continue the pregnancy; you can opt for termination with medicines safely till 9 weeks of pregnancy.5] For your information-Common symptoms of pregnancy are\u2014Missed periodsGiddinessNauseaVomitingLoss of appetiteSleepinessFrequent urinationFatigueHeaviness in breast.You may have any of these symptoms.I hope my answer helps you.Thanks.Wish you good health.With regardsDr Purushottam",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cream and face wash for blemishes and brown mask on face\n\nhello Dr. I am suman 26 years old. i do have blemishes on my nose. and light brown colour mask on my face. I am really fed up of using cosmetic on my face. i want you to help me in this. i think my desire of having spot free face will be a nightmare for me. what cream i should use what face wash wash .... please help",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain if the skin tone has darkened and it is not exactly what you have naturally since birth then it is pigmentation of skin and can be improved gradually to some extent although may or may not completely resolve..You can use facewash containing Salicylic acid and Glycolic acid like Melaglow or AHA glow atleast 2 to 3 times a day.Apply creams containing Kojic Acid, Glycolic acid and arbutin..Taking Vitamin C supplements and applying Vitamin E gel at night will help..You should always apply sunscreen lotion when exposed to sun..Scrub your face twice a week using a gentle scrub..Drink plenty of water and take a nutritious diet..You can also go for Photofacial and chemical peeling by dermatologist..Hope this information helps..Thanks and regards.Dr. Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for burning and dryness in mouth and lips\n\nafter a long bout with a sinus/allergy infection in dec 2013, I took nystatin 2x and dyfilucan 1x, and probiotics. White tougue and yeast in and on my mouth every morning. worked on diet with naturalpathy and ate much yougurt, very little sugar and very little wine (3x a wk) started chewing on my lip and inner cheeks of mouth as a habit - continually now- mouth and tougnue burn every afternoon til bed time and mouth and lips are always dry with funny taste. Now what? Jamie",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.In my opinion you have allergy and superimposed fungal infections.You can find the allergen responsible for allergy. Stop exposing your self to such a antigen is the permanent solution.You can take cetrizine for more allergy related problems. If you have much burning and pain you can use local anaesthetic cream which we can apply on mucosa.Avoid spicy and hot foods. More of the foods like butter cheese helps you prevent from burning.I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be worried about high WBC count?\n\nHi there i have a 7 month old liitle girl, i just went to the doctore cause i cant get immune to rubella he said it might be something else wrong in my body , my results from the blood test came in and it said my white blood cells are high and to have another blood test in a month to see if there gone back to normal . He said not to worry , should i worry?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You have high wbc count. There are many cause for high wbc count. But in routine practice most common cause is infection. Don't worry about that. You don't have any serious disease. Just go for repeat blood test. If your wbc count remains persistentely high then you should go for further investigations. Right now no need to worry.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recovering from radiation for metastatic prostrate cancer. Difficulty in urination, swelling above the clavicle. Side effect of radiation?\n\nMy husband is recovering from radiation treatment for metastatic prostate cancer . He is having difficulty urinating and despite numerous amounts of stool softeners, laxatives, and high fiber is not having bowel movements without the help of an enema. Yesterday, he woke up with swelling above his right clavicle . The lump is about the size of 1/2 a grapefruit. I m worried about the lump. Is it a normal side-effect? Or should I take him to the doctor?",
    "doctor_response": "Dear Ma'am, Sorry to hear about your husband's problem. The urinary and bowel problems are due to the metastasis of the tumor. For the bowel problems he will need to continue the stool softeners and laxatives. The swelling over the clavicle can be another bony metastasis from the cancer and it is better you get it evaluated by the doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does HCG diet affect Implanon birth control?\n\nI have had the implanon for a yr & just started the hcg diet. I started some spotting 2night & didn't know if I should be worried? I have not had a period while on the implanon & my husband & I are not ready 2 have kids. Should I be worried? Can the hcg diet nul my implanon birth control?",
    "doctor_response": "first get pregnancy test.consult your doctor to go for-change in family planing method like copper t. Even your husband can use condom. hcg diet has nothing to do with pregnancy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taken Uniferon, Ribazol, Liv 52 for hepatitis C. Weakness, dizziness. Suggestion?\n\nI am from Pakistan having problem of Hepatitis C, First it got Uniferon + ribazol for about 9 months but result finally was detected. In the meantime, I was using Liv 52  one tablet daily and feeling good.  But doctor suggested to go for PEGASYS + RIBAZOLE 400MG, but after 13 injections result obtained was not 2 log, so again doctor ask me to stop treat and go on Liv 52 1+1.   But If I take 2 tables daily I feel further weakness and dizzy. Because of this reason I unable to do my office work properly.Whereas doctor and Live52 advisor ask this is a very good supplement but your said complain probably because of any other reason. Now suggest me what to do, my age is 47",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum.Since , you have full treatment of  hepatitis C ,but ,what about the report at present ? Also mention the reports of liver  enzymes such as S G O T,  S G P T. bilirubin, c p k , Amylase ( pancreas). Liv 52 are commonly used drugs in Hepatitis . In my opinion it never causes any weakness. So your age is at present 47 years and this age is prone to many diseases. Consult a physician and get in blood for  C B C, E S R , sugar , lipid profiles. Routine blood pressure is also important. Hope  I have answered your question. If further any question I will help. Get well soon. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes congestion, cough and running nose?\n\nMy 5 yr old son had a sinus infection a few weeks ago that returned Friday night. He has coughing, clear drainage, runny nose and fever off and on. About an hour ago I discovered a rash on his lower back. I had been giving him the decongestant from his last dr visit. Should we go to the ER?",
    "doctor_response": "Thanks for consulting in HealthcareMagic . Causes -supercooling, drafts, viral, bacterial infections, allergy, bad immunity. Try to keep your child hydrated with plenty of water, ginger,lemon and turmeric powder tea.It seems he has allergy on his back , thats why give antihistamine/Benadryl/, from cough you give ambroxol 30mg 1/2 tab 2 times, from fever -antipiretic syrup or adol 250mg-1 suppositorium per rectum.Wash nose with saline solution 4 times in a day, drop otrivin 2 drops 2 times , it works 12 hour. Give zincovit-multivitamin 1 teaspoon 1 time 1month and tulsi juice1 teaspoon daily 1 month for increasing immunity. Cut onion, put 1/2 glass of water and leave near child, he will respirate fitoncides, which will kill viruses, you can drop this solution in his nose and give to drink. In addition he should rince his gurgle with soda, salt water or chlorhexidine with water and take sualin 1 tab 4 times for resolution.From home remedy procedures you can put mustard on soles in socks and do steam inhalation 1 teaspoon of soda for 2 glasses of waterBest regardsDr. Svetlana",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this Tc-99m MIBI stress test report indicate?\n\nHello Sir/madame, I belong to pakistan last week my father doctor recommend the test of Tc-99m mibi strees and the result of this test is mild reversible myocardial ischaemia involving anteroseptal wall can anyone tell us that what is the problem? My father has a diabetes/ and blood pressure patient. Plz tell what we will do???",
    "doctor_response": "HelloWelcome to Ask a Doctor serviceI have reviewed your query and here is my advice. The test result indicative of some area in the heart having less blood supply or no blood supply and it happening due to the cardiac artery disease, condition further needed some cardiac evaluation like angiography, CT angiography and others, to know the lesion in the artery Hope I have answered your query, let me know for further assistance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Critically serious. Details of the best nephrologist in India, Ahmadabad needed\n\nTo obtain an opinion or to refer a critically serious patient, I want details of the best Nephrologist of Ahmedabad,  best of India and best in the world. Their name, mobile and e-mail address pl.Thanking you, With Warmest Regards! D.A.Shah ( G.A.S.) Resident Additional Collector &Additional District Magistrate Collector Office, Patan, Gujarat, IndiaGovernment of Gujarat,  Cell-+91-0000, +91-0000",
    "doctor_response": "Dear Mr Shah, there are very good nephrologists at Ahmedabad.. Dr Javed vakil, Dr Ketan Darji and Dr Manthan kansara. They visit almost all hospitals of new Ahmedabad like sterling, SAL etc. Good luck and health wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How many Valium tabs should I take before root canal?\n\nLast time I had a crown at my dentist and took 2 5mg tabs of valium . Did not even feel relaxed at all. Have a root canal tomorrow. How may can I take and hoe long does it take to work I am 250 lb female. I usually do nitrous but they have none. I want to feel like I dont care but not totally messed up. If I try 15mg 1 hr before and I get there and I need another one how long will it take to work?",
    "doctor_response": "Hi, Thanks  for  posting  the  query, Valium is used  to  treat  anxiety  disorders, musle  spasms  ,  siezures. Take  valium  exactly  as  prescribed  by  your  doctor  do not  take  larger  or  smaller  amounts for  longer then  recommended. Call  the  doctor at  once  if  you  feel  that  the  medicine  is  not  working or  if  you  think  you  need  to  use  more  dose  than  usual. Generally for  relief  of  symptoms  of  anxiety  the  recommended  dose is 2-10mg  , 2-4  times daily. I  would  suggest  you  to  concern  a  doctor  before taking  the  drug. Hope this  helps  out. Regards.....",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low level of aspartate transaminase in blood?\n\nto be specific my blood test showed critically low level of aspartate transaminase level is 4iu/l ref range 16-56.  my Alanine range is 13 (10-75).  I go to the VA and am inbetween appts at the moment just curious as to whether i should bother my doctor about this or what it could possibly mean that i can correct.",
    "doctor_response": "Hi welcome to health care magic You have not mentioned your complaints If liver enzymes high than it suggest hepatocytes injury Here for low liver enzymes no need for much worry Better to do other work up regarding your complaints if having Take care Hope this will help",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat citrobacter koseri infection?\n\nI have been operated at my Achilles' tendone and after the 2nd operation they found an infection, after laboratory test turned out to be citrobacter koseri. what does that mean? will this be a permanent damage? can I ever recover completely from it and from the tendon operation?",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.Yes you can surely come out of infection, there is no point of worry in it.Citrobacter koserii is the bacteria of enterobactericiae group which has treatment with the same antibiotics as do E.coli have.With the culture report you must have sensitivity report also.Taking treatment according to sensitivity report can cure you earlier and rapidly.Please take treatment under doctors guidance, take complete treatment and maintain utmost hygiene . I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do to cleanse the liver. Will it get cured of its own?\n\nAlso come this April 2013 we will be waiting 5 years we were told that 5 years is just about the usual time if you do not get a new liver which my husband has not all the doctors tell us that my husband is much sicker than his meld score reflects. My husband is only 61 and I am tempted to try herbs and other things if that might help along with cleansing of the liver. What do you think ?",
    "doctor_response": "Hello, The Model for End-Stage Liver Disease (MELD) system was implemented on February 27, 2002 to prioritize patients waiting for a liver transplant. MELD is a numerical scale used for adult liver transplant candidates. If the doctors say that your husband is much more sicker than the actual MELD score,then it is very serious. There is no herbal medicine with proven scientific evidence,which can cure a end stage liver disease.There is no point opting for herbal medicine as that may deteriorate the condition even more.There is no way by which liver can be cleansed. You must try to get the liver transplant done as early as possible,as that is the only scientific and proven way,which can cure your husband. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for on and off acidity with abdominal pain?\n\nMy wife (aged 41yrs., wt. 58kgs.) is having pain in the right side of the abdomen and having acidity off and on, lot of gas formation as well. Her sleep is also not sound and she feels heavy at the head after coming out of bed. Myself away from her and join her once in 2-months. My son (aged 17yrs.) staying with her. What could be the problem and possible solution for the same? Regards, Deb",
    "doctor_response": "Hi,This could be due to gastritis or gall bladder stone or gall bladder infection.Ask her to get an ultrasound abdomen and show it to a physician for a physical examination. Till then she can take a ppi like omeprazole for her acidity, preferably with a levosulpride combination. But for the prescription she needs to see a local doctor.Dr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling numbness radiating throughout the right leg till the toes?\n\nA friend of mine called with symptoms down his right leg, numbness and tingling down to his toes. He also feels pressure with neck flexion while long sitting on the floor. He does feel as though he is febrile. Also having symptoms that are vague when urinating.",
    "doctor_response": "Dear patient your symptoms are suggestive of nerve root compression si at spinal level with radicular pain in the affected area in the leg. Diagnosis can be confirmed by mri of the lumbo sacral spine with screening of whole spine.  please get it done from radiology centre nearby you.  Meanwhile start tab pregalin x 75 mg one at bedtime.  You need to consult spine surgeon with report.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I treat skin dryness ?\n\ni m a boy if 19 years old suffering from dried skin .Have realised that it usually comes during the winter time.I got burnt all of my body this brought about the dry skin ..Can you please help me out ..",
    "doctor_response": "Dear Richard, partial and full skin burn will definatly destroy the sweat and sebum producing glands. to our come from this problem, you have to nourish your skin with topical emollients and moisturizers. fews things you have to follow - 1. always apply emollients just after bath so the water will retain in your skin. 2. frequent application 3. Use sunscreens before outgoing (apply 1/2 an hr before) 4. Use full clothing You will definatly our come from this get well soon  :)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is general herpes related to itching?\n\nAbout a month ago, my arms began itching terribly and only ice packs help reduce the itch...I also have MS & take Gabapentin for nerve pain (pins & needles type) so this med helps the itch.  Today I have an outbreak of genital herpes....can it be related to the itching?",
    "doctor_response": "HI, thanks for using healthcare magicIt is not likely that the herpes outbreak is related to the history of itching.This is not a known symptom that occurs prior to an acute attack.Itching may be due to allergies (most common cause), side effect of medication, liver disease, infection, kidney disease in some cases, thyroid disease.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to control blood sugar and sore throat\n\nhusband blood sugar shot up to 300, not usual. was lower 100's a while. was coming down with sore throat so think spiked. Saw online to bring down with water, exercise and eat eggs. just realized egg rotten. he has no smell so didnt know. Now vomiting. gave suppository for nausea.  is this all i can do. doesnt take insulin.  count 276 now.",
    "doctor_response": "HI, thanks for using healthcare magicDuring an infection, the blood sugar would increase due to the stress response of the body but it should not elevate these levels.This may indicate that he has underlying diabetes and he may need investigations to determine if he is a diabetic.The medication for nausea should help to control his vomiting and nausea.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump above hip bone and belly button pain?\n\nYesterday I had intense pain in my belly button region and wouldn t go away(thought it might have been gas). Now today above my hip bone on my right side, I feel a hard lump like spot and when I press on it, it is tender. Not excruciating pain or anything just tender. No fever as of now but I am experiencing a sore throat. Any ideas what it might be?",
    "doctor_response": "Hi, thanks for writing to HCM.If I were your treating Doctor for this case of lower abdominal lump, I would come up with three possibilities, these include: 1.\u00a0\u00a0\u00a0\u00a0\u00a0lymph nodes due to some infective condition like viral fever, tuberculosis, lymphoma or chronic throat / neck infection or even malignant diseases in elderly people!2.\u00a0\u00a0\u00a0\u00a0\u00a0The second possibility is of an abscess like parietal abscess !\u00a0\u00a0\u00a0\u00a0\u00a03.\u00a0\u00a0\u00a0\u00a0\u00a0The last possibility is of kind of femoral hernia or sebaceous cyst or some other cysts like mesothelial cyst or lymphatic cysts! I suggest you to go for an FNAC and ultrasound of the lump for confirmation and to relieve your concerns!Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could nausea be due to laryngitis?\n\nMy girlfriend and I are worried that she is pregnant. About 2 weeks ago and i was only in her for a second. I know i didnt cum in her. But recently she has been feeling really nauseous. She went to the doctor and he diagnosed her with laryngitis. But the doctor did not know about this instance. So i'm curious if she could be pregnant or if it is just a symptom for the Laryngitis.",
    "doctor_response": "Your question is very specific...Nausea is a non specific symptom of many underlying physiological(like pregnancy) or pathological condition.Usually laryngitis only does not cause nausea .Laryngitis may coexist with other condition causing nausea.Thanking you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy spreading lumps under the ear?\n\nHi, I'm 16 years old and I've never been found to be allergic to anything and my skin isn't extremely sensitive, just normal. But, just today I noticed some rash like bumpy areas that itch right under my ears that is spreading along my jawline. I haven't done anything abnormal/eaten anything that I wouldn't normally eat so I can't figure out what triggered it or what it is. Help please!",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your history and would like to make suggestions for you as follows:1. There are many causes of such itching and rash. Common causes are exposure to sunlight, sweating over that area, exposure irritant from air, exposure to shampoo/soap, etc.2. For treatment purpose, I would suggest you to use an antihistamine like cetirizine or levocetirizine which will control itching.3. I would also suggest you to apply a lotion such as calamine lotion over the itchy area.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my blood pressure increased?\n\nBlood pressure is 123/86 with a pulse of 109. 53 year old male. 74 kilos and live in warm part of Costa Rica. I m taking Ramipril, Hydrovhlorothiazide, amlodipne, cipralax and oxi-dine for knee pain. I am on a good diet and try to exercise daily.. I sleep more often now then before and have stopped smoking 11 days ago.mi was taking zyBan. But decided to stay off it. I have been suffering by hypertension for two years now and still find the need to monitor my pressure as it has increased to 150/110 without reason.. Await your reply",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Your blood pressure is too high. You should immediately consult your doctor and take treatment for that. Life threatening events like myocardial infarction or stroke can occur with this blood pressure. We can not find all the cause of blood pressure.  Genetics, life style, stress and many other factors are there. You need to set the dosage of your antihypertensive medicine. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore throat, stuffy noise and cough?\n\nHi ive been currently sick, probably from allergies. Symptoms were sorethroat, stuffy noise and occational coughin. Question i am interested in, durring the late phases of being sick ive noticed my eyes crusting up and i can barely open them when i wake up, sometimes happends alittle durring the day also. Curious",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern.  You may have some allergic problem.  So you have allergic rhinitis leads to cough cold and sore throat.  You should take anti histaminic drugs and antibiotics according to your doctor's advice. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for heart ailment\n\nMy CABG done in sept. 2010. I am fit at present. Size of heart is normal. Pump rate is improves from 45% to 47% and no bad habits. I am vegetrian. In the morning I am doing exerxie and walk atleast 45 minutes. What are the chances of smooth life. If any problem arise in future what are the chances of second by pass if heart size is normal and pumping remains the same. Ashok Jain",
    "doctor_response": "Hiashok dont worry post by pass you should undergoe a test called stress THALLIUM every year , if stress thallium is good that means all the grafts  are patent, these days life expectency post by pass is more then 25 year.just follow all the medicationsget a  stress thallium done every year , if grafts are ok nothing to worry about.do exercise 45 minutes a dayuse unsaturated fatsavoid too much oil.Second by pass also have very good prognosis , less then 5% patient  die after that , most of them havee aperfect prognosis , dont worry just get a stress thallium dione every year",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for fever & loss of appetite\n\nMy 80 yo mother was hospitalized for pancreatitis over Christmas.  It was caused by a endoscopic ultrasound guided bx of a pancreatic cyst.  The cyst appeared to be benign.  She was treated with 3 GM of ampicillin IV every 8 hours for 2-3 days after she spiked a 101 temp. Since coming home her tongue and gums have turned sore and bright red.  She had a fever of 101.6 on Thurs.  Her tongue and gums are very slowly getting better (she is eating yogurt and taking probioticsbut she runs a low grade fever every morning and continues to have malaise and poor appetite but no pain.  What could this be?",
    "doctor_response": "hello therei would like to check her throat for tonsils and do some basic blood tests on her..might help..hope you agree",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for Urticaria.\n\ni have been suffering from urticaria since 15 days, the rashes appear suddenly without any trigger. a itch occurs all of a sudden and it swells and becomes a red rash. please advise the best medicine to take for permanent relief. I am 28 yrs old and currently in London.",
    "doctor_response": "Hello and welcome to healthcaremagicI would keep a possibility of Acute Urticaria. It presents as itching and skin welts/swellings, which can be distributed all over the body.Urticaria OR hives can occur due to various causes like(to name a few):--Infections(bacterial , viral, fungal) --Drugs(Pain killers/ antibiotics etc) --Certain foods and food additives/preservatives --Physical Urticaria: Cold temperature, Heat, Pressure(Prolonged Standing, Sitting), Dermaographism etc. --Cholinergic Urticaria: in response to strong emotions, exercise, spicy food etc --Autoimmune disorders like SLE, RA etc. --A few cases have no underlying cause and are known as idiopathic urticaria. I would advice you to get few basic lab tests like Hemogram, stool for ova/cyst, Urine routine, Chest X-Ray.An oral antihistamine like Fexofenadine (Allegra 180 mg tab) OR Loratadine (Alaspan 10mg tablet) once or twice daily for a week would be suitable. They are non-sedating and wont affect your alertness level. If I was your treating doctor I would have also given you a shot of injectable antihistamines like Avil(pheniramine) and Injectable efcorlin (hydrocortisone) for rapid relief. A topical soothing lotion like calamine would help you symptomatically. take care regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is dental pain after root canal treatment a cause for concern?\n\nI had my first meeting of root canal on 16 march...and now I feel lot of pain....My dentist called me on 18 for next meeting of root canal but did not perform it and said that it will take more time to heal...she has now asked me to come on 21...But I am constantly having this pulsating pain...Should I consult another dentist in between the treatment?",
    "doctor_response": "Hi, Many a time in the first meeting or first sitting of root canal if the canals are not completely extirpated or cleaned, then in that case due to infectious tissue present there is pain and pressure. So the root canals need to be re-cleaned and a course of antibiotics should be advised. For now, take 3 days course of antibiotics and painkillers as it will help in reducing both infection and pain and help in easing the treatment also and better outcomes of root canal treatment. In case if there is no improvement or after the re-cleaning also there is nothing better then consult an Endodontist and get rechecked. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Honey Arora, Dentist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe hip pain\n\nI had my hip replaced 7 yrs ago, now I m having hip pain that starts in my hip sometimes the pain encircles my entire thigh high up then it travels down the outside of my whole leg, the pain is very uncomfortable and is relieved by sitting down or laying down, having to take more and more pain medication to get the initial results, I don t like to take drugs cause I don t like that dopy sleepy feeling so sometimes I will take extra strength Tylenol then go back to the pain pills. I will never get hooked on pain meds as I hate the dopey feeling it gives me but it helps the pain some what. My e-mail address is YYYY@YYYY .",
    "doctor_response": "Hi! i have understood your query , the pain which is coming to your thigh and radiating to your leg , might be because of previous hip problem as well as some new problem which you might have developed over seven years of time , may be lumbar spondylosis with some nerve entrapment at lower level.to differentiate get an x-ray of your back done. kindly visit your doctor for clinical examination. In the mean while take hot fomentation at home and rest.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain after an injury to chest?\n\ni have pain in my chest for last 2, 3 years?3 years before when i was doing an exercise then by mistake a dumble was touched to my chest hardly. After that time i feel the pain some times but during some previous months i m feeling a continuous pain.Is anything serious with me?What kind of test you advise to me?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. No need to worry much for your chest pain. In my opinion, you are mostly having pleuritic pain due to previous blunt chest trauma. But better to get done chest x ray at present to rule out internal lung pathology. If chest x ray is normal then no need to worry for major illness. Any warm water pad on affected areas. Avoid movements causing pain. Take painkiller like ibuprofen. Avoid bad postures in sleep. Avoid heavyweight lifting and strenuous exercise. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness on toes?\n\nMy toes on my right foot are numb. I can move them but they tingle and I can not really feel them. this happened after some acting dance classes, like two days later. My foot went to sleep but then my toes would not wake up. How bad it is fluxuates- eating seems to effect it sometimes, and walking allot. I also have dark urin in the morning and Ive had cancer twice. Sometimes I think it has finally gone away only to flair up again. I am not a diabetic. I weigh 120 pounds and I eat healthy & I am gulten intollerant.",
    "doctor_response": "Hi, This can be caused by 2 things per say, though there can be innumerable causes for the same.1. Peripheral neuropathy2. Nerve root compression in your lower back.If you are not having diabetes, the chances of neuropathy are less but it can still happen specially with vit B 12 deficiency which your anti cancer drugs can cause. For other condition, you might be having pain in lower back for that matter. Any disc herniation, nerve root edema or compression can cause foot/toe drop. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Rajesh Hingwe, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I have pain in the left side of my chest that goes to my jaw in the middle of the night?\n\nThis has happened about 3 times, not consistant. While I am sleeping I get woken up in the middle of the night by a pain in the left side of my chest that goes to my jaw. No other symptoms. I had an EKG at the drs. office Monday and the results came back fine. It happened again last night about 2a.m. It usually goes away in a 5 mins, and then I don t get it again. What is causing this and what should I do?",
    "doctor_response": "Hi. Thank you for your question and welcome to HCM. I carefully read your concern.Well, initially, your age would help a lot. Anyway, I will try to be thorough in my answer. My opinion is that you should not be restricted only on EKG, and further investigations should be undertaken. Angina, the chest heaviness in the midden part of it, that comes from a coronary artery atherosclerotic plaque of various severity, usually starts as episodes arising on physical effort. Although, we cannot exclude the cases that it arises even at rest. Therefore, I would recommend you to go on with an echocardiogram and a cardiac stress test, for further evaluation and confirming or excluding the coronary artery origin of this concern. I hope I was helpful. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for bed wetting in children\n\nHi, my son is 7 years old and he s still wetting himself only at night. I ve tried to minimize drinking water..etc 2 hours b4 he goes to sleep, we made some urine analysis and complete blood picture and seems everything fine, next step the doctor gave him MINIRIN 650 mcg he took it for one month but no use....what else can i do??",
    "doctor_response": "Hi, I have few questions for you -1. Has your son stopped bed wetting at a certain age and again started having it2. If so at what age he stopped and when did it start. If he had never stopped bed wetting form birth...you can try some behavioural changes which I can elaborate after proper history and interaction with you, but the effect will not be immediate, but it will be permanent. If its a recurrence after attaining nighttime control, I suggest you see your paediatrician to rule out pathological causes like urinary infections or Voiding dysfunction. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat severe rashes and scaly skin in inner thigh?\n\nHello Dr Prasad I am an Indian resident and I am 22 years old. Have been developing inner thigh rashes since the last one month. Tried applying Itch guard but that helped in no way. In fact, it has become worse. The skin has become scaly and has developed a reddish brown colour. Scratching results in whithering of white scales from the skin. A little of these rashes have spread from the inner thigh are to the sides of the bladder as well. The skin sometimes burns but mostly gives an itching sensation.Please provide me a medication prescription or suggestions of how to treat this severe problem.",
    "doctor_response": "Hello,Thank you for posting on HCM.It seems you are suffering from Tinea cruris and corporis, a kind of fungal infection.I would suggest you to consult your dermatologist for proper management of the condition.I usually recommend proper course of oral anti-fungal drugs like Fluconazole or Itraconazole along with anti-fungal cream like luliconazole for local application at bedtime. You can additionally use antifungal dusting powder containing sertaconazole during day time and a soap containing ketoconazole for rinsing of affected areas. Take oral antihistaminics for itching as required.Maintain hygiene over those areas and avoid wearing tight undergarments.Hope your queries are resolved and wish you best of health.Kindly spare some time to rate my answer and drop your valuable review at the following link:  you require any further assistance in future, you can reach me directly through the above mentioned link.Thank youDr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I have erectile dysfunction, and premature ejaculation?\n\nHello doctor, I have a lack of interest in sex, erectile dysfunction, premature ejaculation, depression, and low BP.",
    "doctor_response": "Hello. Please provide me more details. What kind of symptoms do you have? Have you taken any treatment so far? Any history of hypertension or diabetes? Any history of smoking or an excess alcohol intake?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does mouth/ear pain, sinus issues and dizziness indicate sinus or ear infection?\n\nMy dad is 62 years old and has been experiencing mouth pain, ear pain, dizziness, nausea, and is having sinus issues. Does it sound like he has an ear infection or sinus infection? I m concerned because he is so dizzy and cannot do much of anything now. He is such an active person normally.",
    "doctor_response": "Hello, Thnx to contact us. I understand your concern. If I am your treating doctor I advice you that yes from the symptoms you mentioned it seems to be a sinus infection or sinusitis. It affects head, ear, face pains. You can take a antibioitcs for him cefixime 200 mg three times a day under your doctors guidance. I will be happy to answer more of your concerns, kindly know me,Wish you a very good health at health care magic. Dr. Arun Tank. Infectious Disease.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for recurrent fever in kid\n\nMy 3-year old daughter has been having recurrent fevers about every 2-3 weeks for about a year now. These fevers last about 3-4 days ranging from 101-104. She has had blood tests, urine tests, x-rays, cystogram, ultrasounds and there is still no answer...",
    "doctor_response": "Hello, If such a similar case comes to my opd I would suggest  as all reports seems to b normal there is nothing to worry. Some kids may have less immunity and can catch disease's quite easily. Maybe this can be due to the weather change. as its reducing and being under control in 3-4 days there is nothing to be worried off. hope she will soon develop immunity and it happens less. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Jilu Joseph, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat back pain?\n\nHello and thank you for your time. I ve been having some minor to severe back pains for a while now, from what I believe originally stemmed from a pinched nerve in my upper neck. A few weeks later, however, my once isolated back pain has spread to more or less my entire upper body. I ve had multiple chiropractic visits and massages in this time, but my condition has only worsened. The latest development seems to be a seizing up of the chest that s made it difficult for me to breathe and swallow. I can very clearly feel it as food goes down my throat, and breathing has been labored throughout the day. There is no comfortable standing, sitting, or lying position, and I am often kept awake at night by my inability to find comfort. To ease the pain I have taken aspirin and ibuprofin, sometimes at the same time. What are your thoughts on this matter? Thank you again for your time.",
    "doctor_response": "You must consult a neurologist again.There may be disease of spinal cord or muscular disease itself myasthenia gravis may be another cause. All these have to be sorted out by a neurologist.CT scan of spine and brain may also be needed.treatment rests on accurate diagnosis",
    "dialogue_context": ""
  },
  {
    "patient_message": "How is H.pylori infection transmitted?\n\nI am taking four meds. for a positive blood test for H . pylori can i give to dogs or cats or my bird? how can i protect my husband and grand kids from me giving it to them? How do you spread it to other? Any good web sites I can help myself with? Thank you, R",
    "doctor_response": "Hello and thank you for your question. We do not really understand why some people get this infection and other do not. It is transmittable through saliva. I do not think your animals can get it but you can protect your family by good good hand washing, dish washing and not exposing them to saliva or other body fluids until you are treated. The Mayo Clinic has very good information about this infection. Here is a link: health to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain in the hip joints after a long walk be treated?\n\nI am a 68 year old male. I walked 4 miles today as exercise. I do this 2 or more times a week. My hip began paining, not the pelvis, more like the joint, a couple of hours after my walk. Now, when I take a step, the left hip joint hurts, making me limp. What have I done and how do I fix it? Thanks",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Even though you regularly exercise, it is still possible that you may have sustained an injury to the hip joint. It is possible that it may be limited to the muscles surrounding the joint but it would be difficult to know with imaging eg x ray. In addition to assessment by imaging, physical examination would also be important. Rest to avoid aggravating the area, would be helpful as well. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for white matter brain lesions mentioned on MRI?\n\nHi I had an mri twice now and it shows white matter brain lesions. I had a lumbar puncture and tested negative for MS, Lupus, and lymes. I have been diagnosed with fibromyalgia, should I continue to push for a diagnosis for the lesions? Is it something that I should be concerned about? I do have a history of migraines, but the lesions are larger than is typically found in migraine patients per the report.",
    "doctor_response": "Hello!Welcome on Healthcaremagic!I would like to directly review your brain MRI report for a more professional opinion. As far as the lumbar puncture has excluded such disorders, I would just recommend follow up with a brain MRI every 12 months. Do you have any family history for CADASIL or stroke in young age (considering the fact that you suffer from migraines)?You should discuss with your doctor on the above issues. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I resume physical activities having suffered heart attacks?\n\nI have recently had a hear attack and 2 stents.  How long before I can resume normal lifting activity (children, garbage etc.) and exercise program.  I am only 42 with no history of heart disease or other heart related issues.  My family is scared and treating me with kid gloves.  I am not happy with my current doctor although he seems nice enough.  He has me on a recordable heart monitor now but has not given me any feedback from it.",
    "doctor_response": "Hello,   Daily household activities are allowed after 12-24 hours of femoral route procedure and in a week time period you can resume work. It's a minor procedure. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does a burnt plastic in the microwave cause any harm to a small baby?\n\nMy husband accidentally burned some plastic in the microwave this evening. We don t know what type of plastic was burned, but the smell permeated our small house. We opened a window and turned on a fan to air out the kitchen. We have a 3-year-old and an 18-month-old. How likely is it that either child was harmed by inhaling these plastic fumes? Thank you.",
    "doctor_response": "it shu;d not have any effect as per ypur history you can yourself see if the children are breathing normally no cough no iritatio on skin or other extra symptomps it means n efect if there was some effect childrem shuold have symptomp like itcing iritation snezing coughing etc",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does chewing sponge indicate any deficiency in a child?\n\nHi doctor, My daughter, who is 11 years old, is found to chew sponge. She will not swallow but used to chew it. Could it be due to any deficiency? Otherwise, she is normal and healthy. Please help.",
    "doctor_response": "Hi. 11 year old child chewing sponge could be due to two possible reasons which are as follows. This could be a habitual thing. It has been noticed in some children that they have a habit of chewing things, lip-smacking, making noisy sounds during breathing, etc. For these habitual things,proper counseling is needed. One should not be angry with the child as this will lead to an increase in the related habit. The second cause could be pica. In pica, there is iron deficiency anemia and the child usually eats wall surface, whitewash, sponges, etc. In pica, children usually have anemia or low hemoglobin in simpler words. I suggest you do a complete blood count to look for anemia. I recommend you to give her a deworming drug like tablet Bandy plus (Albendazole) single dose at night time and advice complete blood count with proper counseling.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pelvic floor tension myalgia\n\nHelp! Please... I have been diagnosed by Mayo with pelvic floor tension myalgia, IBS, and IC... these have proven to ge totally disabiling 2 or 3 days every week. I ve tried so many medications, accupuncture, ice packs, high-fiber, gluten-free, whatever, whenever... Nothing is helping. Any suggestions?",
    "doctor_response": "For pelvic floor tension mylgia along with IBS, you have tried with medication, fiber rich diet and hot and cold pack also. I suggest you should take physiotherapy treatment along with this. There are specific treatment available along with exercise therapy which can help you a lot with IBS and pelvic floor tension mylgia. It will be more effective again when you do a combine treatment along with medication, diet management, and use of hot and cold pack. I also suggest to improve your lifestyle and food habits in terms of timing and add more colors by adding more fruits and vegitables in your diet, add omega 3 along with fibre in diet. do regular morning and evening exercises as guided by physiotherapist. As well take proper medication as directed by your doctor.Mylgia  is basically pain in muscle due to over strain so I also suggest to practice meditation and try to control your body's natural normal functioning along with that with power of meditation and body healing.Here I have given you general guideline butbi am sure this will definitely help you if you follow properly. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes suffocation and cough while sleeping?\n\nMore and more often I m waking up at night gasping for air like I m suffocating and coughing and wheezing a lot, it eventually goes away but takes a while but only if I remain upright, I have to sleep sitting up a bit or it s worse but I m left for a while with a tired heavy feeling in my chest, what could this be, oh and sometime my heart feels like it s beating fast",
    "doctor_response": "Thanks for your question on HCM. I want to ask you few questions first.1. Are you obese?2. Are you having diabetes, hypertension and ischemic heart disease?3. Are you having morning headache, sleepiness, tiredness?4. Are you smokerNight time gasping spells, suffocation, cough seen in 1. Obstructive sleep apneoa (OSA)2. Cardiac causes3. COPD (chronic obstructive pulmonary diseases).So better to consult sleep specialist and get done sleep study (polysomnography). This will help in diagnosis of above mentioned cause. Treatment of all are totally different. So you need to diagnose first.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in child to form a sentence?\n\nhello, i am prabha.my daughter is 3 yrs 6 months old.she speaks most of the words but does not form sentences.she forcefully speaks a sentence of just two to three words. her all other activities r quite normal.she is very active.she goes to a play school. i want to know whether this is too late for her to pick up or it is common. pls reply.",
    "doctor_response": "Hello, If a similar patient comes to my OPD I would suggest that by this age this growth is quite normal, nothing to worry. She will slowly pick up and start creating a sentence of 4-5 words by 4 years. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Jilu Joseph, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will intake of ccq 100 along with folic acid and m2 tone syrup help in conceiving?\n\nactually my marriage was got 2 years I was trying for conceive from past year but not yet so I consult one gynacologist in my town she prefer to take ccq 100 for 5 days from the 3rd day of my periods and along with that folic acid and m2 tone syrup is this preferable for conceive soon",
    "doctor_response": "Hi, Ccq and m2 tone will help you in conceiving. Ccq helps in the growth of your follicles. M2 tone is multivitamin which improves the Fertility. Track your follicles growth by repeated ultrasound and when your follicles is more than 17 mm, take injection for rupturing the follicles.  Be in contact with your husband for next 2 to 3 days.  Take progesterone for next 2 weeks.  Do a urine pregnancy test after that. Hope I have answered your question.  If you have any other query I will be happy to help. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "On homeopathic treatment for skin lichen planus, have blackish skin on inner thighs that seems to be increasing. Remedy?\n\nhi .. i m 25 yrs old unmarried girl .. i have been suffering from skin lichen planus since i was 14yrs old ..from past 2 yrs i have switched to homeopathy treatment from allopathy(steroids) ..its improvin no doubt ..but i have blackish dark skin both the inner thigh ..which is increasin day by day ..it itches some time .. how i can i remove blackish dark skin ??",
    "doctor_response": "Hiwelcome to HCMThe lichen planus is very well curable by constituional homeopathic treatment. The sign of improvement of lichen planus starts after treatment with homeopathy. As you were on steroid so it will take a time to put its full curative effects. But as you are telling you are getting improvement that shows the treatment is on right tract. when the rash tends to heal that leave a  blue-black or brownish discoloration that persists for a long time. But that is also a vital symptom for a homeopath. So consult your homeopath and narrate the new symptoms you have received then he is the best person to decide wheather the potency of the existing medicines will be changed or medicines will be changed or to give gap in betwen two medicine that totally depends upon the treating doctor. So nothing to be worried just consult your homeopath and keep continuing the treatment. Yes you can apply Echinacea ointment in those patchy area but consult your homeopath before using. thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get pregnant at 40 + age ?\n\nHello, i'm a 41year old woman. i would still want to to babies, i hope there's no problem about that I m a 41year old lady, i want to make babies even though i have an 11year old daughter. i menstrate normally, but considering my age, i hope there s no problem. At the moment, i m using folic Acid, vitamin E, B-complex, Pregnant care for conception, Evening Primrose and Vitamin C.",
    "doctor_response": "Hello. Thanks for choosing HealthcareMagic forum. If you are having your regular periods then you can conceive. But it is better to start ovulation inducing drugs like clomiphene under the guidance of a gynaecologist in order to conceive early.Your will be a high risk pregnancy and needs care. Dr. Rakhi Tayal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain and bloating in the lower stomach?\n\nI HAVE BEEN UNDER DOCTOR FOR YEARS WITH MY STOMACH I HAVE LOWER LEFT SIDE PAIN SWELLING BLOATING VERY PAINFUL WHEN SWELLING CAUSES PAIN UNDER LEFT RIB ALWAYS CONSITPATED UNTIL DOCTOR PUT ME ON ORLISTAT BUT NOT LOSING WEIGHT EVEN THOU I DONT EAT ALOT THEY HAVE QUERYED IBS DIVERTICULITUS NO DIAGONOSIS",
    "doctor_response": "HiThanks for your query.Your history is typical of :The lower left swelling, pain, bloating, swelling causing pain under the left rib cage. This is suggestive of sigmoid volvulus...Get a simple X-ray of the abdomen in lying down position and standing position when you have symptoms. A simple surgery will cure your problem,.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Infertility due to PCOS. What time gap is required for another IVF from the D&C date?\n\nHi,I am suffering from infertility due to PCOS problem. I have 4 failed IUI and have one IVF which was successful but have a miscarriage on the 8 week 4 days of my pregnancy. I am currently 34 years old and my husband is 35 years and his semen analysis is ok. He has no problem. My question is what time gap is required for another IVF from the  D&C date ? what chamces lie for comnception and will the miscarriage chances reduces in 2nd cycle?",
    "doctor_response": "Hi there ~I understand your concerns.  PCOS is a very common cause of infertility in females.  I also think that another IVF from the D&C date that you have would be helpful to conceive.  I believe that you should consult a gynecologist who is well versed with these conditions and can help with your infertility problem.I hope this helped and I wish you the very best.  Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cold,hair fall,nose bleed and sore throat?\n\nHello, I was wondering if there is any connection between some symptoms I have been experiencing lately.  I am 17, five foot eight, and 190 pounds.  Well, I have been noticably more tired and cold.  I have also experience a difference in my hair. It has become more coarse, and a lot more falls out.  Also just tonight, I got a nose bleed for no reason, and that has never happened before. Also the nose bleed went into my throat and I was spitting out blood. I'm scared... Thanks for the help.",
    "doctor_response": "Hi,Thank you for your query. I can understand your concerns.Your BMI (weight in kg/height in meter squared) is 29.13 i.e overweight. Your other symptoms like feeling cold and tired and coarse hair with undue hair falls suggest hypothyroidism. Excessive dryness of nasal mucous membrane might have caused nose bleeding. You go for thyroid function test like serum free T3,free T4 & TSH level.Regards Dr. T.K. Biswas M.D.Mumbai",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are pain, swelling, numbness and tingling sensation in the hands symptoms of tendinitis?\n\nI have had tendonitis before and gotten 2 rounds of steroids in my wrists, which helped for over a year. Now I have grabbing pains and tingling in both arms and swelling in my hands that can last an hour. The pain happens when I sleep and wakes me up because it is so bad. The numbness and tingling happen any time throughout the day. Is this also tendinitis, or could it be something else?",
    "doctor_response": "Hello, Consult an orthopaedic and get evaluated. An MRI scan is required to rule out neurological causes. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I feel my gum a little raised?\n\nA few days ago i had started to feel an itch on the right hand side of my jawline. It is still present 3 days later and is now slightly swollen. Inside my mouth on that side i noticed in the gum under my tooth a small raise and if i look in the mouth it almost looks like a tooth coming through or a small bit of white peeking through",
    "doctor_response": "Hi! Welcome to Healthcaremagic.I read your query. You have not mentioned your age and exact region of swelling. Is that wisdom tooth area you are talking about where you feel a tooth appearing? If thats so, then this swelling is associated with erruption and temporary. Do warm saline rinse, betadine gargles, maintain hygiene. You can get an x-ray done to check if tooth is straight or impacted. In case of impaction, you may need an extraction.However if swelling is not in that area, then this is pus due to dental infection. Check for any cavity in nearby tooth. That affected tooth will need Root canal treatment. Ask dentist for antibiotic and painkiller prescription. Do warm saline gargles. Maintain oral hygiene.Hope the answer helps you. Thank you!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for irregular menstrual cycle with heavy bleeding and menorrhagia\n\nhello doctor i would like to ask about my daughter who is 11 yrs old and diagnosed cong. hypothyroidism since the age of 5 months at pgi chd. her eltroxin was contd since then and titrated to 75 micr. gms. at present, no other medicine is given, her problem is earely menarche at the age of 11 yrs, her cycle is 2--3 months/ 8 --10 days at present she is under cycle and menorragia, 6( 6 th day is going with heavy bleed. what shoul I do.pl. reply earely thanks.",
    "doctor_response": "Hi, Hypothyroidism by itself can cause heavy bleeding like this.I suggest you get her evaluated for appropriate control of Hypothyroidism.If that is normal - I suggest you get her evaluated by a gynecologist. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can gallbladder stones be treated?\n\nI am 30 years old, with 70Kg weight. I am diagnosed with multiple gallstones recently varying in size from 3mm-8mm. I consulted with few doctors some of them suggested to remove the gallbladder. One doctor suggested to have udiliv 300 for couple of months then test further. I am having low fat diet and not having any major problem right now except acidity. Please suggest if udiliv will be helpful or I should go for removal of gallbladder. Also suggest me what all I should avoid to eat in this situation.",
    "doctor_response": "hi.noted history of gallstones and several consultations. udiliv and diet modification are just temporary measures of controlling symptoms of gallstones. eventually, symptoms will recur.  definitive management is still cholecystectomy or surgical removal of the gallbladder. it can be done laparoscopically (goldstandard) or thru open technique. it is best if you consult with a general surgeon for clinical evaluation, physical examination and discussion of surgical plans.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for a liver disorder\n\ni am on udiliv 300mg for faulty liver disorders - any better mediciene to protect the liver. i had lost 7kgs of weight in 4 months but last 3 months my weight is constant. i have suddenly started looking 10 yrs older than my age 43 and doctor says less of oxygen in body.",
    "doctor_response": "Hi,Liver rejenuvators  and antioxidants a re a good option.Take one capsule of sylimarin daily.It is 16 times more potent in liver problems as compared to  other anti oxidants.Alternative ayurvedic therapy with LIV52 capsules  twice daily can be taken along with it(herbal supplement).Take a multi vitamin capsule daily,Ginko biloba 50mg should be taken once daily,Start following a regular exercise schedule and eat a good and healthy low fat diet,Take 2 cups of fruits daily(cheap and locally available seasonal fruits).Eat  green leafy vegetablesavoid too much dairy and meat,Walk 30 minutes a day,Involve in activities like swimming or cycling,Things will start getting better in 2-3 months.Medicines is not a substotute to healthy life style.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having little annoyance below belly button. Is it an indication of beginning of hernia?\n\nI am nervous, because I was lifting a heavy desk last weekend and I think I might have done something to my body. The last 7 days or so I have been feeling a very light annoyance by my lower belly section. It is below my belly button, over to the left, and 2 inches down. I don't feel anything coming out, but maybe it is too early to notice any lumps or bumps. Was wondering if it is a hernia starting.",
    "doctor_response": "Hi. The site you mentioned is very unusual site for hernia occurrence. This can just a spasm of the muscle causing little distress. Ye t the only thing which confirm is wither by physical examination by a surgeon  and/ or high resolution sonography.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant pain in the lower back?\n\nHello, Last night at bedtime my lower back made it very hard for me to fall asleep. No matter which position I put myself in I was so uncomfortable and my lower back hurt pretty bad. This morning is the same. Hurts with movement, hurts with sitting. Goes up my back. Not sharp or dull or shooting. Constant pain that doesn t go away no matter what I do. I have no fever, no loss of appetitie, no numbness or tingling, nothing like that. The only thing I can think of that I did yesterday was move a potted planter. Didn t hurt at the time I did it and didn t hurt until right before I went to bed. This morning it hurt around the side and into my front on the left side. Right now it s my entire lower back and all the way across. Question is should I be seen? Wait it out? Should I be worried about my kidneys? No previous concerns with my kidneys to date. Thank you! Heather",
    "doctor_response": "hello there.lower back in your case can be due to spine .In my opinion you should get your x- ray lower back done to look for any slip disc or herniation .thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Seeking a neurosurgeon to answer my question. Is it possible to have trigeminal neuralgia like symptoms with supraclinoid aneurysm? Symptoms include constant dull ache in face like a tooth ache (dentists have confirmed zero issues with teeth - and physician has recommended CT as he believes it to be TN). No burning sensation.  Dull ache is accompanies by ocean wave that ends with a stab. Then it repeats itself or does not. Thank you.",
    "doctor_response": "hi trigeminal is not related to any supraclinoid aneurysm kindly take some opiod drug u have pain is there it will subsided by itself",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why there is swelling on my elbow?\n\nI ended up getting a pain in my elbow that had swelling and was warm to the touch.  I am currently icing it, taking ibroprufen, and using compression.  After 3 days, the pain definitely has gone down, but the swelling has seemed to increase slightly.  Any ideas of what it could be?",
    "doctor_response": "hello,The swelling and pain on the elbow suggest olecranon bursitis(inflammation of olecranon Bursa present in the back of elbow).The causes are repeated trauma(even if it's mild)on the elbow, exerting over pressure on elbow as in while writing,sepsis, arthritis and repeated elbow movements.You need an X-ray to confirm the diagnosis and a blood test to confirm the cause(in case of sepsis)As a part of treatment you are doing it right(RICE),and depending upon the blood test you need to take appropriate antibiotics,so,it would be good if you visit a physician for the prescription.Post treatment you need to protect you elbow from repeated trauma to prevent reoccurrence.Hope this helps youthank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic pain with history of cervical stenosis\n\nHave cervical stenosis at c5,6,7 lower lumbar stenosis c3,4 osetharthis grade 3 in knees my medication help very little have not had a,body scan in 3years for narrowing of spinal cord. Just feel am getting pushed from pillar to post, docs now say I have fibromyalgia. The pain is really get me down",
    "doctor_response": "Hi,Decompression surgery is the best option for you. But before all that, I suggest you see a spine surgeon and seek his opinion with all your scans too. After a thorough physical examination, if the cause of the pain seems to originate from the nerve compression, it probably is not fibromyalgia. The best thing is to get a repeat MRI scan after consulting with your spine surgeon. Hope this answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a small cystic structure adjacent to the left kidney a complication during pregnancy?\n\nHello doctor, i m sathish..i just want to clarify my doubt..my wife ultrasound report indicates the below msg she is also worry about this msg..pls tell us about baby s health. IMPRESSION: 1.Single live fetus of 21+ to 22+ weeks in utero 2.Small Cystic structure adjacent to the left kidney -? Significant Suggested fetal echo and follow up scan",
    "doctor_response": "Hi, I think you should go for a feral echo and a level 2 scan also. It will tell you in detail about the baby. Don't jump to any conclusion before that. It can be a normal finding also like some ovarian cyst or urachal cyst also. So, wait for the scan. Hope it helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What causes lump on tonsil?\n\nHello doctor, Lump on tonsil for the past three years. Full left ear feeling. Been to ENT twice.",
    "doctor_response": "Hello.  It looks like a mucocele or cyst (attachment removed to protect patient identity). Do you have any throat complaints? Throat pain? Do you smoke?",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the red cut on penis?\n\nMy husband has something that looks similar to a cut but that isnt a cut on his penis he says it is also red. It gets worse after intercourse. He has been tested for std's when he joined the military and he didnt have anything. Does anyone know what it may be?",
    "doctor_response": "Hello, These kind of cut marks or red rash marks are common in penis head mainly because the penis head is a delicate portion. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having endometriosis, why do have a swollen painful lump on my belly button?\n\nI am 16 years old and have endometriosis. However, after my last ruptured cyst, I have had a swollen lump in my stomach near my belly button. It is very sensitive and painful when pressed against. It comes and goes. I just had a very sharp stinging feeling in my stomach. Very strange. I don't know what this is.",
    "doctor_response": "Hello and thanks, The symptoms may be due to many reasons.The first is endometrioma as it comes and goes and you have history of endometriosis. It is rare but possible. Check to see if its appearance has any relation to menstruation. Other possibilities are a hernia, lipoma, hemangioma and so on. They are all soft and may be painful. Hernia is a prolapse of abdominal contents mostly intestine or omentum from a small defect or hole in the abdomen coverings. Lipomas and hemangiomas are non cancerous tumors of different tissues. So you need an examination as description cannot pin point the diagnosis. You may also need an ultrasound. So get examined and evaluated for final diagnosis and treatment. Hope this satisfies your query. Thanks for using HCM.\u00a0\u00a0\u00a0\u00a0\u00a0Feel free to ask any more questions that you may have. Dr Madhuri BagdeConsultant Obstetrician and Gynecologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are persistent knee and neck pain signs of abnormal liver function?\n\nThanks. Just got blood tests back with elevated AST and ALT scores. ALT 102 and AST 126. My doctor is confused. Suggested I have an alcohol problem and I do not drink but maybe once a month. Just beer and usually only one at a time. These levels are elevated from my last physical 3 years ago, when they were in the normal range. I have had some strange knee pain and tight neck pain in the past 2 months that I have never had before. Persistent for the past 2 months or so. I am a male 52 year old, former pro soccer player. Thoughts?",
    "doctor_response": "Hi thanks for asking question.Here you have elevated ALT and AST,suggestive of liver disease like hepatitis.Here possibility of chronic hepatitis or carrier of HBSag has to be ruled out.For that viral markers are useful.If HBSag positive more then 06 month then chances of carrier is present.If hepatitis is present viral markers will be elevated.If still cause for hepatitis unknown then liver biopsy can be taken according to patient's examination.Second here neck pain and knee pain may be because of some bone condition like osteoporosis or arthritis related changes.You should check your vitamin D and calcium level , if they are low calcium and vitamin D supplement needed.Take regular milk.If you are obese weight has to be reduced.Regular light exercise helpful in arthritis related change.Knee x ray can be taken to search for pathology.I hope you will understand my concern.Wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes wheezing while suffering from bronchitis and asthma?\n\nI have had what I thought was Bronchitis and I have asthma. I've taken a z pack a steroid pack on ad air and pro air and still have significant coughing wheezing and today my cough sounded very croup like. I think I have pneumonia. What are your thoughts?",
    "doctor_response": "HelloYou should do a spirometry test and a chest x ray for detecting if there is a pneumonia or not.RegardsDr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for high blood pressure\n\nHi, I have been suffering for 7 months with a whole range of symptoms and I seem to be getting nowhere with my doctors. After being ill for about 5 months I had an anxiety attack while driving on the motorway and now the doctors always revert back to anxiety as the root to my problems.even though I was ill for 5 months prior to the anxiety attack. I have been diagnosed with high blood pressure and Im on my 4th brand of BP tablets and beta blockers. I admitted myself into A and E on numerous occasions with chest pains, light headedness and abdominal bloating and diarrhoea but after an ECG, blood pressure and blood tests they say it s probably a reaction to the BP medication. I have been on an ECG monitor for 5hrs in the hospital, had a 24hr portable ECG fitted, loads of blood tests, 24hr urine sample, cardio scan (the one with the jelly) and liver scan (because I drunk heavily for years but now have cut down dramatically). All tests have come back as OK but I m still suffering. My wife has been diagnosed with Helicobacter Pylori which, after extensive research on the internet, it s not certain whether or not it is contagious so I m being sent for a breath test on Wednesday and a 24 hr BP test on Friday. My symptoms are: Chest pain (front and back), chest tightness, palpitations (periodically), stomach pain, excessive gas (both ends), stomach swelling with an aching feeling in the stomach and sides, periods of diarrhoea (the last bout lasted 30 days), chronic fatigue, occasional blurred vision which lasts a full day, skin blotching on the arms, I can only lie on my back when sleeping\u2026if I lie on my side I get weird sensations in my chest which makes me jump, I sometimes have trouble sleeping, movement of air from stomach to anus (rumbling), when driving I start feeling nauseous and get tight chested (it seems to be the car vibrations which causes it), I sometimes feel light headed (while sitting or laying down) and feels like Im going to faint, pressure in my temples and tingling sensations in my arms and legs. Can you please help?",
    "doctor_response": "Hello, I passed carefully through your question and would explain that your symptoms could be related to indigestion or irritable bowel syndrome. Helicobacter pylori cannot be excluded either. For this reason, I agree with your doctor on the breath test. I would also recommend trying an antiacid and avoid spicy food. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I have pain in my hand and finger joints?\n\nHello doctor, I am a 69 year old male. I have suffered from many types of infections several times in my life from systemic candida infection, valley fever, fungus infections and so on. I also have RA, have experienced Reynauld's several times, I also have SLE and have tested positive for MCTD. I also have male boobs, wide hips and all around feminine shape. Three years ago, I had a mild myocardial infarction, veins are unobstructed, heart in good shape. I was on meds for about three years, to date no further coronary occurrences, no signs of heart problems. I am down to just aspirin and no additional meds. Currently, I have severe pain in my hand and finger joints and also, in the joints of my big toe on both feet. Recently, I came down with some sort of cold that has turned into bronchitis with a pain on my right side. My doctor has put me on a five-day antibiotic plan again. I had a late start into puberty, started shaving at the age of 25, had small testicles. I worked out with weights for years and was never able to \"muscle up\". I have small bones, long fingers, long legs, short torso. I have never been tested for Klinefelter's syndrome but have been suggested by several doctors that I may have been born with this condition XXY but they seem to be reluctant to test for it. Is it possible that I am not being treated for the right cause of my illnesses? I am not sure what to do at this point, help.",
    "doctor_response": "Hello. Repeated infections with different organisms including fungal infection indicate severe immune deficiency which could be due to the steroid therapy you take for MCTD (mixed connective tissue disease) or due to other condition like diabetes. So, please tell me the following: The other possibility is immunodeficiency due to the autoimmune disease you have. Please provide me with your CBC (complete blood count) lab report. I also suggest that you perform karyotyping in order to diagnose Klinefelter's.Wish you all well being. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes large black bruises on the back of the legs?\n\nOver the past few months I have had  large black bruises on the back of my legs without having done anything to get the bruise. Sometimes the hurt other times they don't and the range in size. The largest one I had was about the size of grapefruit. Also, I have had sharp pains in my abdominal region. What could this be?",
    "doctor_response": "Hi, you should investigate for that. Check your platelets count and coagulation profile once and also consult dermatologist once hope from this you will mostly find the cause for that.  Then take treatment accordingly. Thanks for using health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a pinched nerve cause numbness/heaviness in left arm and chest pain?\n\nI have been to the doctor and they did an EKG and lung Xray.  All good there.  The reason they did these tests were because I have numbness/heaviness in my left arm/hand and tight chest pains near my heart.  I am now taking Prednisone but it's still there.  Any ideas?  Would it most likely be a pinched nerve?  Should I worry about a blood disease?  I am a healthy 32 year old woman.  5'10\", 160 lbs.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. First of all, no need to worry for major heart or lung related diseases because your reports are normal. It is unlikely for pinched nerve to cause chest pain and arm pain together. In my opinion, at your age of 32 years, we should rule out vitamin B12 deficiency as a cause for this kind of pain. So get done vitamin B12 level and if deficiency then you will need supplements. If this is normal then stress and anxiety are likely cause for your symptoms. Undiagnosed, uncontrolled stress and anxiety can also cause similar symptoms. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on it's solution. You may need anxiolytic drugs too. Don't worry, you will be alright. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Prescribed Divaa, Oleanz, ativan for aggressiveness. Kidneys affected leading to chronic state. Is it possible?\n\nI admitted my mother a week ago, due to aggressiveness and the doctor suggested three pills 1) Divaa Tab 500mg 2) oleanz tab 10 mg and 3) ativan tab 2mg. within a day she was normal , but next day the doctor told us there is slight effect on kidney . and it may lead to chronic state , is it possible? because my mother hasn t reported any problem regarding kidney, or urine passing . i admitted her in a private hospital in ranchi (jharkhand).",
    "doctor_response": "HIThanks for the query.The medications which you have mentioned do not cause kidney failure.Does your mother have Diabetes or high blood pressure? We also need to review if she has taken any other medications.She needs to see a nephrologist who can examine her and do further tests to determine if she has kidney problems and if so what is the cause and further appropriate management.Hope this helpsGood luck,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with hyperthyroidism & noticed dizziness & shortness of breath\n\nhi over 7 years ago i was diagnosed with hyperthyroidism.  it cleared up using neomarcazole (carbimazole).  ive recently had a baby and just over the past few days i have had a lot of heart palpitations and feeling dizzy and short of breath.  could this be my thyroid again should i get a blood test.",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. Irregular heartbeat, dizziness an shortness of breath can be complications of Graves' disease. I suggest:- to check TTH,T3,T4;ECG;- getting diet with proper amount of calories, calcium, and sodium;- taking vitamin D and calcium supplements during  treatment-Shelcal 1 tablet daily;-Ashwagandha 1 capsule daily for 1 month.Please let me know if you have further questions before meeting your primary care Doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to increase sperm count\n\nI am 38 years now. 5years back I had 10mil dead sperm in my semen. now nil count. I got varicocele problem. We have tried ICCI one but failed. Pls sugest me some remedy to improve my semen quality. may be alopathy, homeopathy, sidha , unani og herbal.",
    "doctor_response": "HelloThanks for the query.Take iron and zinc supplement and good nutritious diet. Let me know if you have any other doubts. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can migraine be treated in a 7 weeks pregnant 33-year-old?\n\nI\u2019m 33 years old and I\u2019m 7 weeks pregnant and have been getting migraines since I was about 9 years old. I usually take Tylenol 3\u2019s or Maxalt when I get one but haven\u2019t taken anything since I\u2019ve been pregnant. I\u2019ve had a migraine now for two days and I don\u2019t know how much longer I can take the pain. I\u2019ve been in bed, under the blankets with ice packs. I\u2019ve also been vomiting. Is there anything I can take that won\u2019t be harmful to my baby? I don\u2019t have my first Obgyn appointment until the end of the week..",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You can take Tramadol and Paracetamol combination 2 times a day for five days. You can take Pantoprazole and Domperidone combination drug twice a day for five days. Don't eat commercial products and unhygienic things eat home made rice and khichdi, don't eat spicy food fried chicken, do yoga and pranayam in the morning do exercise in the morning do meditation in the morning. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes left sided chest pain?\n\nIve been having terrible chest pain on my left side that goes down to my arm. Started last night went to the ER and doctors said my ekg was fine breathing pressure etc. Im still in a lot of pain especially when i exhale and my arm feels a little numb. Im also 6 months pregnant",
    "doctor_response": "Once your EKG is normal, cardiac component is more or less ruled out. Get 2decho done for heart , to get clear idea of heart status. Left sided pain may be muscular or at times due to nerve compression at neck region. Mostly it seems to be non cardiac origin.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should we do MRI scan for Kidney pain and renal failure?\n\nHi ...my husband was diagnosed with anterior renal failure...he had kidney pain, fever chills and high creatinne levels at the time, but with due course of time and with some antibiotics the creatinine levels came back to normal on their own.....the ultrasound showed no abnormalities.....should we get an mri done? The doctors have diagnosed the reason yet...they r suspecting t was some vciral infection...?..",
    "doctor_response": "Hello There is no need of MRI(Abdomen) in your husband's case.MRI is mainly required in  assessment of soft tissue pathology.Your husband had acute renal failure and that too is resolved now.Many causes can cause acute renal failure and it is good that it is reversed.Ultrasound findings are also normal.It might be due to some viral infection.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any side effects of taking Axepta 10mg?\n\ni veve 5 years old son, who is autistic (mild to moderate) . of late he become very hyper- active. doctor suggested me to give him AXEPTA10mg to come down his hp. i m not sure whether it is a phase,or will eventually come down.. not very comfortable with medication.. because of its side affects",
    "doctor_response": "Hello, When it comes to medication in children, the aim should be to use drugs as less as possible. It may be a phase that may regress with time, so, I think that you can use AXEPTA occasionally when it is really necessary to control hyperactiveness. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bugs inside body\n\nhello,  i have a friend of the family that has an issue with bugs inside their body.  Mostly coming from inside her eyes and anus.  They are small specs, that you can not see with the regular eye.  Do you have any ideas what could be the cause and how to cure?",
    "doctor_response": "Hello,Welcome to Health Care Magic. I have gone through your query and I understand your concern. In order to be more helpful for your friends case, I would need more details, like for example the symptoms your friend is suffering from. As a first impression from the details you are giving, I would suspect for a loa loa filariasis, but, I cannot give any diagnosis or treatment without other details. I would recommend that your friend visits his/her local infectionist, in order to have a clear diagnosis. After that I could help you with an option of treatment. If the disease I mentioned above is diagnosed, it could be treated with the drug diethylcarbamazine (DEC), and when appropriate, surgical methods may be employed to remove adult worms from the conjunct.Hope I answered to your question. Take care.Kind Regards,Dr. Ina Zaimi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the likes of canesten oral with a capsule and lotion be beneficial for white lesion on tongue?\n\nMy son has a white lesion on his tongue which the dentist has recommended should be seen by a doctor. He is travelling so we are arranging for this to be done in a couple of weeks There is a suggestion that it could be fungal. Could the likes of canesten oral with a capsual and lotion applied be beneficial.",
    "doctor_response": "Dear user,Thanks for using healthcare magic.I had gone through your query and understand your concerns.Sure canesten oral and cream is effective in fungal infection,canesten capsule containing fluconazole and cream containing clotrimazole both are antifungal action,fluconazole treat main infection and clotrimazole relive the symptoms,so don't worry it will be definitely beneficial.wish your son get well soon, 'Hope I have answered your query. If you have any further questions I will be happy to help\". Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe stomach pain?\n\nMy stomach has this horrible pain every 30 minutes... it started last night where it was real bad. Right now, its not as painful, but if i move, then it feels kind of like, if you hit your head on something and (not the touch feeling) but the feeling of \"its a knot\" ... i dont know if i am making any sence.....",
    "doctor_response": "welcome to Health care magic.1.All above symptoms are seen in the acute gastroenteritis, after any food products caused infection.2.Take an anti spasmodic drug which is available on counter should help you to feel better.3.If the symptoms still persists, you need to get an appointment.4.If you are my patient, i would have start with examination and an ultrasound abdomen to narrow down the diagnosis.Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any chance of pregnancy after having protected sex?\n\nHi, Gopal here from mumbai.I had oral sex with my girl friend,after that my girlfriend dint get her period still nw(it was 20 days late).While sex  was using protection and I just touch my gental to her vagina not more than that.Is their any chance my girl friend to be pragnant?Please suggest me.",
    "doctor_response": "Hello,Thanks for asking at Healthcaremagic.I have gone through your query and I can understand your concerns.Pregnancy is almost impossible in your case.Amenorrhea(absence of periods) could be due to some other reasons probably due to some hormonal imbalance.You can do a UPT(urine pregnancy test) for your own reassurance.Thanks.Dr.Shana",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain around the elbow?\n\nHi. My mother has what appears like a bruise on her arm near the elbow. It has grown in size over the past two weeks and she is complaining of pain around the elbow. Is it something to be concerned about? She is 82 and takes 75mg of aspirin due to a previous heart condition.",
    "doctor_response": "hi,thank you for providing the brief history of your mother. A thorough musculoskeletal assessment is advised.As your mother is 82, this burise will be related to pressure sore. Which is common in most patients. Also, the pain is the protective mechanism to indicate that the brusie is present and pressure on that area should be avoided. Also the muscles will be weak.I recommend to undergo a simple physical therapy like ultrasound therapy to reduce the pain . Also, if your mother is not diabetic than qucik icing should help reduce the bruising. Physical therapy will help get strength and functional ability of your mother. Post which she might not develop such things as in.In my Clinical practice I see geriatrics alot and by the help of physical therapy they respond well in strength and functional ability as well.regardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain due to fatty liver and antral gastritis\n\ni am rajat gaba 31yrs male having accute pain in stomach. after undergoing endoscopy&ultrasound fatty liver and antral gastritis has been diagonised.i am taking leusuride, folic,zenteel,pylokit,vizylac but still continuing with the pain.pls suggest if iam rightly treated and guide how to overcome the pain iam taking drotin ps for  pain",
    "doctor_response": "Thank you for posting your query.Needs evaluation.Did you undergo any test for H.pylori.? if not, then do it either by stool antigen test OR by urea breath test. if it turns out to be positive then you need eradication therapy and visit your treating physician with all the results.until H.pylori test results are awaited, you may take \"Nexium 40mg\", once daily before breakfast. Avoid spicy food, smoking and alcohol. Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health.regards,Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain with stomach bloating and pain?\n\nHi Dr. , one month ago I went through radical hysterectomy/whenteims hysterectomy for cervix cancer IB,I am 50, 60 kg, now still feel little bit pain at my abdomen and I feel uncomfortable after eat,drink, stand quite long as my tummy become blotted heavy as if pulled downward and increase the pain. Is this because of the position of my organ in abdomen or the wound of the operation not healed yet?",
    "doctor_response": "Hi,Thanks for writing in.Healing after a hysterectomy might take time. Please take care of yourself during the recovery period and avoid staying hungry for long duration. Take smaller meals at short intervals like 3 to 4 hours. This will prevent the symptoms of gastritis from occurring and also you will not feel bloating frequently.Maintain a regular intake of fluids and water. This will also enable smooth bowel movements. Please avoid stress on your abdominal muscles and do not lift any weights. Complete healing might take 3 months and until then please do not do heavy physical activity at home. You should not lift more than 5 kg weight. These symptoms are temporary and will improve quickly. if there is pain at operation site then consult doctor. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain and labored breathing\n\nIm 15 and I ve had a tight chest and bad heart pains for the past month or so. it feels like i have a 100 pound weight on my chest ALL THE TIME which goes from the side of my armpit to the top of my stomache. I cant sleep well and i feel like even when i take enormously large deep breaths i still dont get enough oxygen. every time i sit down and get up i have to take a deep breath and i get light headed and lose all the sight in my eyes for about 3 seconds. the losing sight in my eyes scares me alot. I also check my heart beat all the time and it seems like it spikes and slows down randomly. ive never had an anxiety attack before but last night and the night before i think i did because i could hardly breath. i tell my parents about it but they wont think anything of it. There both paramedics and i think they THINK they know everything there is about health but im sure they dont. ive had child hood asthma but i pretty much dont have it anymore but i still keep a inhaler, ive thought the chest pains might be some asthma or bronchitis but i use it and i feel no relief whatsoever. my parents dont even listen to what i have to say, i start to talk about it and they just say i complain about being sick all the time. im getting tired of them doing this and im thinking about calling 911 just to show them how serious i am about this. please get back if you think you know what might be wrong. Also you should deffinetly know that i took alot of speed about 2 weeks ago and it has deffinetly gotten worse, i took 3 and a half 20mg adderall rx pills and i think i might have had a overdose. ive also had extreme dry mouth and have developed a sore throat yesterday.",
    "doctor_response": "Respected user, hi I evaluated your long narrated query .* All symptoms you suffer is from ADDERALL only .* Have you told about its consumption to your parents or using without their   knowledge ?* Recommendation highly for you :   Disclose use of Adderall to your parents if not till now , you will require   intensive deaddiction treatment to cure all the ailments .Hope this helps you.Welcome for any further assistance.Thanks for using Healthcaremagic.com & giving me an opportunity to assist you.Wishing you fine recovery from the same.Regards dear take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from spinal tuberculosis since 18 months\n\nsir my mother is suffering from spinal tuberculosis since 18 months now she is better then previous but now she has severe pain in lower limb and feet.sir tell me why it is",
    "doctor_response": "As tuberculosis of spine causes compression of vertebrae,which in turn compress nerves leading to pain in the area supplied by the nerve.So start lumbar traction to prevent compression of nerves   & to get relief from pain after consultation with your doctor.Disclaimer",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain on the left side?\n\nHi,I am having chest pain located only on my left side that gets worse when I inhale or exhale. I also am experiencing back pain in the same area that gets worse when I inhale or move my body and back to the right. I have tried looking up symptoms but am unsure what could be causing it.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Possibility of musculoskeletal pain is more likely. But better to rule out heart diseases first because your pain is more on left side of chest. So get done ecg, 2d echo and stress test (trade mill test).If all these are normal then no need to worry for heart diseases. Do following things for better symptomatic relief in musculoskeletal pain. 1. Avoid heavyweight lifting and strenuous exercise. 2. Avoid movements causing pain. Avoid sudden jerky movements of back and chest.3. Apply warm water pad on affected areas of chest.4. Take simple painkiller and muscle relaxant drugs like ibuprofen and thiocolchicoside.Don't worry, you will be alright with all these. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hard spot on jawline of child\n\nMy daughter, who is 8 yrs. old, has a hard spot on her jawline. We noticed it about a month ago, it was small in size and just a little different then the other side. So, we took her to her pediatrician, and we started the process of finding out what was wrong. They did an ultrasound and it didn t show anything, so we have a CT scan scheduled for next week. Only, today it seems to have doubled in size and seems much harder. What should we do? We feel like we can t wait till next Friday for the scan.",
    "doctor_response": "Hi...there is a condition called, Caffey's disesase. This fits into the diagnosis. This type of hard jaw swelling will be a intermittent ans can get aggravated with fever. Oral NSAIDs are the only treatment as of now. Nothing to worry. it can be self limiting too. The other possibility is a hardened lymph node. This too can be inconsequential.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Anxiety, depression, tingling sensation in face, lack of focus. Taking xanax. Treatment?\n\nI ve been suffering with anxiety for 18 months, which has lead to some depression . I am taking pregablin and xanax and have just started to feel quite odd in the past hour - lack of mind focus and I now have tingling in one side of my face - much like when coming round from a dental anaesthetic. Is this most likely a nervous problem? Thank you",
    "doctor_response": "Hello and welcome to Healthcare Magic. Thanks for your query. Your symptoms are likely to be anxiety-related, and don't seem to be typical of specific medical problem. Now, it is important to understand that anxiety can manifest itself with not only psychological symptoms, but with physical symptoms also. If you are having recurrent such symptoms or having difficulty managing your anxiety / depression, then I would advise you review with psychiatrist for further treatment. There are other effective medication like SSRI antidepressants which can help you with both your anxiety as well as depressive symptoms. In addition, there effective psychological therapies like CBT (Cognitive Behaviour Therapy) which can help you deal with your problems. Trying relaxation techniques, like deep breathing, and engaging in regular physical exercise can also be benefial in controlling your symptoms. Wish you all the best. - Dr. Jonas Sundarakumar Consultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the chances of pregnancy after taking an Ocp late?\n\nHi doctor, I have been on birth control continuously for three years. About a month ago, I took a pill late instead of in the morning. My boyfriend has not ejaculated in me. But,\u00a0I noticed that I have gained weight.\u00a0What are the chances of me being pregnant\u00a0after taking a pill late? I do not have periods since I take the pills continuously.",
    "doctor_response": "Hello. This is a common mistake that you have faced. However, a single late pill intake is in no way could turn you fertile as well as pregnant. Even if you miss a single pill, the chance of pregnancy is very remote. Now, continuous pill intake could be the reason for absence of cycle. We advice this sort of continuous pill intake only if you have endometriosis, a disease produces painful menses. However, you need to take pills with a gap of 7 days pill free period or have to be on inert pills for 7 days. Then only, you will have cycles. For further doubts consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is haemoglobin 9.7, high platelets and clot behind knee serious?\n\nHi, I was diagnosed with a clot behind my (R) knee. I had bloods taken , all came back good except for my haemaglobin 97 & high platelets. I am on Clexane 80mg & 5mg warfrin daily. Have my first INR on Tue. I have got my self so worked up that i might have some cancer.My doctor said yes it was a bit high but didnt seem to worried.Please try & set my mind at ease.",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. Your hemoglobin is low. You should go for peripherals smear examination and search the cause and need treatment of that.  You should continue your warfferin according to your doctor's advice. Your INR should remain in higher side. It will prevent further clotting.  Take regular treatment.  Don't worry about cancer.  Its not there.Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe chest pain\n\ni expirienced a very sharp pain to the center of my chest while asleep that woke me up it was like a lighting bolt that la sted what seemed a second my pulse was racing and irragularly irragular with some rebutting beats no regular s troke or heart attack symthomes present except but sanxiety some dizzenss after aprox 6hours pulse normal but some fatigue remaims",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. Your symptoms are mostly due to anxiety. But better to rule out cardiac cause first because of chest pain and irregular heart beats. So get done1. Ecg2. 2d echo 3. Holter monitoring ( 24 hour continuous recording of ECG )If all are normal then no need to worry for cardiac cause. Anxiety appears more in your case. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. Avoid stress and tension. Be relax and calm. You may need anxiolytic drugs too. Don't worry, you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing my daughter s sticky eyes?\n\nMy daughter is 3 years old. Every morning she could not able to open her eyes due to stickyness. We have showed to many doctors. Some of them says that its an allergy and will last for 2 to 3 years. Some are givign some eye drops but no use. If we take her out in a quite airy wheather, her eyes get red. I would like to have your valuable suggestion on this.",
    "doctor_response": "Hi,Is she having any atopic manifestations like eczema or wheezing? Any chronic itching or stuffiness of nose? Are the eyes itchy and watering through out the day, apart from morning hours? Also, any seasonal variations for the same complaints?Conditions to be ruled out are allergic conjunctivitis or obstruction of naso-lacrymal ducts and chronic blepharitis. If the there are purulent discharge along with stickiness, taking an eye swab in the morning for examination can detect any organisms colonised, which then can be cleared with proper antibiotics. Kindly discuss once again with ophthalmologist. Sticking to one doctor during successive visits will help directing a proper workup.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam T. K., Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a large lump in the right armpit indicate?\n\nHi I have a large lump in my right armpit, I can ony feel it when I raise my arm or tough the back of my head it gets bigger. I m right handed and the lump is bigger on the right compared to my left. I have two - one in each armpit both in the same place. It feel like its part of my back or shoulder muscle. It s hard and only hurts after I ve touched it for a little while an sometimes gets bigger the more I touch. They ve been there for a year since I started weight training and not sure if its anything serious or part of my muscle? I ve recently had a blood test and failed slightly on one of the parts - the infection part but only by 0.4. Quite worried but I m perfectly healthy I play tennis a least 3 times a week just my armpit aches where the lump is the day after.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You may have some enlarged axillary lymph nodes. It may be due to reactive hyperplasia, tuberculosis or lymphoma. You should go for fine needle aspiration cytology or biopsy. It will give you exact diagnosis. then you should take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does intake of Biscolax Suppository during pregnancy affect child?\n\nHi, I m 8 weeks pregnant and have been constipated for a while now. It was so bad that I decided to use a Biscolax Suppository and it did help. but now I m worried that it might effect my baby. I only used it once...Is it possible to effect my unborn baby?? Please help!!!",
    "doctor_response": "Hello dear,I understand your concern.In my opinion usage of biscolax suppository once might not cause any problem.Suppositary has local effect and absorption into blood is less.You need not worry.The fetus is safe.And constipation is routinely seen in pregnancy.It needs to be counteracted by taking high fibre diet ,adequate fluids upto 3 litres per day and if needed laxatives.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "CT scan shows calcium in brain. Have dystonia. Headache, memory loss, tingling face. Treatment?\n\nHi ive just been told that my ct scan shows quite a bit of calcium in front left lobe of my brain & that i need an mri now to see in more detail. I suffer from dystonia to which affects my neck shoulders arms hands. I have been getting a lot of headaches lately with some memory loss & lso tingling in my face they dont think at moment that theres any tumors behind the deposits but just wondering what treatment i could expect",
    "doctor_response": "Hello, Thanks for the query, I understand your problem Let me tell you that If the CT scan shows calcium in the brain, you continue to do MRI as advised by your doctor. There e is a possibility that you may be having parathyroid problem and the whole symptoms that you have could be related to disorder of calcium metabolism and it is treatable and you will improve. Patients with dystonia generally require neurological evaluation and exact classification of dystonia so that treatment becomes easy. Medications that are used to treat are Tetrabenazine, clonazepam, trihexyphenidyl, botulinum toxin etc. Which medicine is to be used will depend upon the classification of dystonia. Please consult a local neurologist who will guide you through clinical evaluation and investigations and treatment Best wishes Dr Gopal K Dash  MD, DM, Post-doctoral fellowship (Epilepsy) Consultant Neurologist and Epilepsy specialist Nrayana Hrudayalaya Hospital, Bangalore My Blog in the Web site:",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat swollen gums and odor?\n\nI got hit I'm my mouth my gums on the right side were swollen but it went down a little bit,first my gums were just  purple now they are purple and white and has a funky odor even after I brush my teeth and rinse with salt water...what could this be???",
    "doctor_response": "HelloWelcome to HCMThis swollen gum and purple colour must be traumatic.  You continue with warm saline gargles and can apply gum paint 3 to 4 times a day. You should also visit your dentist for local treatment. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility because of PCOS\n\nim 22 n 1 year married but i cant concieve bcz my gynae says i have a PCOS n i have irregular periods before my marriage. im taking DIANE 35 and GLUCOPHAGE 1500 MG daily n last month i take clomid 50mg but now on thiz month same problem i had irregular period. my dr. recomment again diane 35.. kindly tell me what can i do??",
    "doctor_response": "HelloIf I were your treating doctor for this infertility case ( not getting pregnant ) and also having PCOD ( Poly Cystic Ovarian Syndrome or Disease) I would come up with these measures , these include.1 Clomid or clomiphene or clomifene 50 mg daily for 5 days starting on the 5th day of menstrual cycle or at any time if there is amenoorhea ( or wait for menses date in spite of irregular date and count 1st day of bleeding as day one ) .Now get in folliclular study on 14-15 day for ovulation . Keep watch over size of dominant follicle and its release date ( it must attain 19-20 mm ) . Sex on these days on regular basis from 13th to 15th days.If ovulation does not occur, a 2nd course of 100 mg for 5 days may be used as commencing as early as 30 days after the previous therapy. Further treatment may not be recommended if pregnancy has not occurred after a total 6 treatment cycles . Glucophage 1500 mg you can take but in my opinion diane 35 ( cyproterone +ethinylestradiole ) tablet don't use it.2 Also get in SEMEN analysis of your husband .Hope these measures will be helpful for you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lump under knee\n\nI fell over and landed on my knee on a concrete floor, It hurts a little to bend my leg, I have a little lump under my knee. I cannot kneel down otherwise it really hurts by pressure being on it. The bruise itself feels tight, is that normal? Any idea what I ve done?",
    "doctor_response": "Hi.Thanks for your query.Noted your history of fall on the knee and development of a lump under the knee. This may get resolved if it is a hematoma.But since you have also difficulty in bending the knee, I would advise you to consult an Orthopedic Surgeon to rule out any internal injury like cartilage rupture or ligament tear and have an MRI for further evaluation and treatment accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which treatment is suggested for diverging squint eye?\n\ndoctor,               is there any treatment in ayurveda to cure squint at the age of 30.i ve gota diverging squint in my right eye .i underwent  laser treatment at the age of 21 and 4 yrs laer i had typhoidand my health was weak and i regained it. in 2013 eyes were effected with corneal conjunctivitis and then after i noticed my right eye is diverging with a squint.i feel really reluctant tocome forward... i consulted opthalmolagist and they recomended surgury.bt im scared about its sidesffects.is there any treatment to cure squint other than surgery please helpdoctor.....with the right advice                     thank you",
    "doctor_response": "Hi,I have gone through your query.Divergent squint is due problem of the muscle of eye ball. Muscle helps in movement of eye ball and if they become weak or lax, it causes squint. I am afraid to tell you that there is no medical treatment available in allopathy, homeopathy or ayurveda. The only option remains is surgery and don't be afraid of its complications. Muscle will be fixed by operation and it is done.Let me know if you have any further questions.You can contact me on my page  you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes delay in having beards and mustache?\n\nHi I am 16 years old. I am an african-american male and I dont see and beard or mustache on my face as yet .I am so angry and jealous because most of my friends have side burns and I want to know if its safe for me to take pilll that will boot mt TLevels.",
    "doctor_response": "Hi, Find out your HORMONAL levels. Also get a physical examination to rule out other causes. Is your testis normal? Don't take any testosterone supplements without supervision. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr B. Radhakrishnan. Nair, OBGYN",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a painful lump on the buttocks?\n\nI noticed a hard knot like lump close to the top of my buttcrack the other day, it is completely painful to sit or to touch anywhere near it. I know notice it has spread to the other side of my buttcrack. The side it was originally on is really hard now and doesnt hurt as much and the other side is the same as the other side was with a knot and is very painful to touch and sit on. These lumps are under the skin too. It is starting ti hurt just laying on my stomach or on my side even now. Please what do I do???",
    "doctor_response": "Hi,From history it seems that you might be having some in grown hair follicle infection and induration and swelling is formed.Go for one course of antibiotics medicine to prevent abscess formation.Keep local hygiene proper.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat for the pain and bruise in toenail?\n\nHi I bruised my right big toenail 5 weeks ago and the last few nights when in bed I ve had immense pain on one side of the toenail. This just happens when I m lying down in bed and for a while after I get up. It looks like the toenail is curbing into my toe, like its constricting my toe",
    "doctor_response": "Hello, I will advise to do hot water fermentation and do gentle massage over the outer aspect of the nails and the toe muscles. Due to abnormal tissue growth, the pain can occur while providing the compression over the soft tissues nearby. Hot water fermentation will help the tissues to relax and gentle massage will help the spasm to reduce. In case the nail is growing and not relieving the pain then removal of it will be advised. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a disoriented feeling after experiencing an electric shock?\n\nMy 49 yr old husband accidentally shocked himself while fixing a piece of machinery 220 a/c a week and a half ago. He seemed to be fine so he didn t go to the doctor. Now he has been having symptoms of his left chest back the ring him even along the front of his shoulder. He has been under a lot of stress lately but otherwise healthy. This strange nagging feeling has been going on about 2-3 days. Should I take him to the doctors?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I think an evaluation of your husband's primary care Doctor and chest x-rays are necessary to understand better your husband's condition. If he felt after the electric shock, fractured ribs, for example, may cause such symptoms. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could swollen neck with fluid blisters suggest?\n\nHello. I am a 19 year old female, with some mysterious infection on my neck.  it is red, slightly swollen, has what appear to be blisters with white fluid. It is painful and was initially itchy.  Initially it looked like a insect bite with two brown marks.  It was about 1cm by 1cm and has grown to about 2.5cm by 3cm. It started a week ago. I was put on 3 antibiotics (bactrim, which i started thurs of last week) (valtrex last friday) these two im taking two times a day. (the third is cleocin 4 times daily) the infection is still spreading despite the antibiotics. I have not missed a dose. I went to three doctors and they are all cluless. i can upload a picture if needed any idea what it might be?",
    "doctor_response": "Hi, Thanks for posting in HCM. After going through your description, it appears that you have a local inflammatory reaction due to insect bite. This has not responded to the antibiotics which was administered. Kindly take the following medications and it should respond to these. 1. Tablet.Ciprofloxacin 500mg twice a day for 5 days. 2. Tablet. Ibuprofen + Paracetamol twice a day after food for 5 days. Keep the wound site clean, dry and free from infection. In case it doesn't subside, you need to get the following tests done and managed accordingly. 1. Random blood glucose to rule out diabetes mellitus. 2. Pus culture and sensitivity to know the organism and the antibiotics it is sensitive to. Hope the information provided would be helpful. All the best and wish you speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedy to extend a painful ring finger after hurting it\n\nI have an inch-sized cut on the back of my hand (right over the knuckle below the ring finger).  While I can ball up my hand into a fist slowly with minimal pain, I can't seem to fully extend my ring finger.  It's like it's just lazily laying there.  Is there anything I can do at home?  (can't afford a trip to the ER)",
    "doctor_response": "HelloThank You for contacting HCM.It will take some time to heal. As the healing process will progress, movement will become possible. Meanwhile i would suggest you following things:> Keep wound clean.> Apply polyfax plus ointment thrice a day> Wash hands before and after applying.> Take acetaminophen for painHope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had surgery for kidney stones. Getting severe pain. Any suggestions as to what is causing this?\n\nI ve had kidney stones three times in six years. All stones were 2mm or smaller and caused severe pain . I use the va and had the surgery two of the three times. The last surgery was jul 2011. Starting march I started getting severe pain again. I am told its probably not the stones that hurt cause 2 mm stones don t hurt. What else could it be? Every time I have had pain I ve had small stones. Surgery relieves the pain for awhile but i still have never passed a stone. They stay in my kindness. Any suggestions as to what is causing this?",
    "doctor_response": "hi, kidney stones are a recurrent problem. if you have a kidney stone, chances of your having another stone in next 8-10 years is around 50%. so cause of your repeated pain attacks may be that you are forming new stones which while passing down the kidney tubes cause you pain. Surgery does not prevent new stone formation. Each episode has to be treated as a separate disease, some will require medicines only, some will require surgery. go see your urologist for further evaluation and treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting after eating food?\n\nhi my son was sick about month ago was vomiting for almost a week and it kinda went away then it started 3 days ago again as soon he eats it comes out if it is flu how long does vomiting stays and took him to doctor yesterday and found out that in 2012 when i brought him in for same reason they did stool test but just told me yesterday that hi has parasite so just wondering is it a flu ,parasite or something other then those two",
    "doctor_response": "Hi....mentioning age would have been even more helpful. But one thing parasites/ worm infestation doesn't present with vomiting.This could as well be a prodrome or starting stage of a viral Diarrhea too. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes skin rash with nausea and dizziness?\n\nMy 13 year old son has been itchy with a hives style rash foe a week now.   He keeps getting pyrexias fri night 39.4 and today 38.4. He is nauseated and has a headache he has also been complaining of dizziness and abdominal cramps.  He has been I'll since returning from Germany after a school trip",
    "doctor_response": "Hi,The rash may viral in origin most probably,as he suffers from fever,pain in abdomen and emesis. Consult the Dermatologist and pediatrician at a time tobget perfect diagnosis. After thorough examination and investigations,they would treat properly...okHope this helps.Dr.Ilyas Patel, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does follicles in the ovaries affect pregnancy?\n\ni am a 28 year old female. I have been trying to conceive for two years now but failed. I took a scan test and was told that my ovaries have few follicles. What does that mean and what are my chances of conceiving? I was also told that i have a fibroid but it is growing outwards from the uterus. My husband took a sperm analysis test and he is very fine. I am supposed to take an HSG test on saturday but i am asthmatic. How dangerous is the iodine used in the test to my health and how can i minimize the side effects? Thank you so much. Maria",
    "doctor_response": "If you are not allergic to iodine , there should no be any danger. in addition the doctor who is going to do the test , should be able to decide if any medication needs to be given or needed in your case.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes less intake of food and vomiting in an infant after having rotavirus dose?\n\nHi Sir, By baby is about to 6 months. He already taken 1st does of rotavirus. From last 3-4days, he is not having enough neither from bottles nor from his Mom..not even sleeping enough. Now from last day he is vomiting frequently, please suggest. Is it Stomach infection? BuMotinorm is enough for this or should i go with injection?",
    "doctor_response": "Thank you for posting your question.Before answering your question I would like to inform you that  6 months is not a correct age for the first dose of rota virus vaccination. The course should have been completed by now. It is not ideally supposed to be given this late.Now coming to the symptoms, vomiting and decreased feeding are very non specific symptoms and could occur in a variety of conditions. In order to clearly determine the cause of such symptoms, their association with other symptoms like fever, diarrhea, cold, cough etc. should be studied.It is less likely(though not impossible) that the symptoms may be due to rota viral vaccine. There is a higher probability that it could be due to some viral infection of the gut or any other infection causing the child to refuse for feed. If there is associated cold, then nose block should be ruled out as it can also cause decreased feeding and it should be managed by applying nasal saline drops. Also reflex vomiting should be ruled out if there is associated cough. Here the baby will vomiting right after a bout of cough. Vomiting may be managed by antiemetic drug like moti norm. Make sure to keep the head end of the child elevated while asleep and keep the child well hydrated by frequent feeding. If the complained of decreased feeding continues or additional symptoms arise, a medical consultation should be taken.If you have any more doubts regarding this case, do reply back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for sinus issues with hair fall and dandruff\n\nam 38 years old i had sinus problem,so i cant drink liquid item,it mean drinking only boiled water.so i cant eat butter milk,fruits,wn i ate buttermilk or fruits immidiately headche and cough coming.i had so much dandruff my head all hair falling,so wt can i do.my son have esnophylia problem.he have cough.cold",
    "doctor_response": "Hi Dear,Understanding your concern. As per your query you have symptoms of hair fall and dandruff which is mainly due to fungal infection, improper cleanliness and stress leading to telogen effluvium. Sinus issues could be due to upper respiratory tract infection.Need not to worry. I would suggest you to consult dermatologist for proper examination. Doctor may order skin patch test, blood test and physical examination and may prescribe finpecia at least for 3-4 months along with antifungal medications. Take Indian gooseberry powder (half spoon) with water once a day and use almond oil for hair massage. Avoid use of hard cosmetic products, gels, sprays and shampoo's. Do nasal saline rinses for sinus issues and avoid intake of outside food. Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to get pregnant without penetration?\n\nHi, I was wearign underwear and my boyfriend was wearing his underpants and slacks. We were grinding and making out for 3-4 hours. There was no penetration. He said he did not come but I saw something wet. I am in my ovulation phase. Is it possible for me to get pregnant?",
    "doctor_response": "Hello,Thanks for writing to us.There is NO chance of pregnancy WITHOUT actual penetration or proper ejaculation. It was a complete dry sex.Sexual excitement make you some wet feeling. However, you CAN'T be pregnant as there was no sexual intercourse.Don't be worried much. Practice safe sex in future. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to check for abdominal injury?\n\nHijust wanted to ask a question about my 5 yr old son, he was playing in the garden with a broom (running) he was trying to help tidy up, and the broom hit a step and bashed in to his belly right where his belly button is he has some discomfort and has a red mark there can this cause any damage as i know the belly is a delicate area.thanks Emma",
    "doctor_response": "Welcoma to HCMHello, the pain and redness may be due to the direct impact of the broom ,since the location is belly button there may not be much damage to the organs ,you need to visit a peadriation who may examine your child and ask for abdominal ultrasound where you can rule out the internal damage and advice some antispasmodicsAdvice1.Some rest is advised2.light digestible food should be given3.watch for increase in pain, redness in the area,coughing blood ,blood in stools  you have to rush your child to emergency room Thank you Dr.Krupa",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes discomfort in lungs?\n\nI was wondering why I have discomfort in my lungs?  It is a dull achy pain and I tend to have an annoying cough.  I had a really bad allergic reaction years ago that affected my lungs for 9 months.  Do you think that could've damaged my lungs?  I am a healthy fit woman of 51 yrs old.",
    "doctor_response": "thanks for your questioni completely understand your questiondull achy pain in chest /lungs can be due to variety of diseases like pleural effusion, pneumonia etcin your case it seems like old healed infecton ,as you said you had some lung infection few yrs backthat old infection can cause fibrosis in due course of time amd that might be causing the pain.you need to consult a pulmonlogist who can request for a chest xray and rule out other causes ans mentioned above and lead to a certain diagnosisthanksfeel free to ask more questionsmay god bless you with good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if ibuprofen is taken by mistake when having asthma?\n\ni am a 22 year old, 5,6 and wiegh around 14 and half stone i am asthmatic and been advised not to take ibuprofen and without realising i have taken ibuprofen this morning and now suffering with tight chest pains. i have taken my reliever and preventer inhalers what else can i do??",
    "doctor_response": "hello, thanks for your query, with one brufen  u may have slight wheeze and cough. after 4-6hours its action reduces, ur inhaler  is sufficient for that obsarbed dose of brufen. hope i have answered your query. all d best. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take clarithromycin for chest congestion, cold and asthma?\n\nHello, i have had head and chest congestion for about two weeks plus. It had started to clear up last Sunday but then i got very hoarse and lost my voice. My dr. Prescribed clarithromycin last week but i was hestiant to take it because i should be ovulating and my husband and i are trying to get pregnant. To complicate matters i have bad asthma esp. When i have a chest cold so the Dr. Wanted me to take a few days worth of a small dosage of prednisone since it wasn clearing up. I have not taken either yet and found mysrlf usung my inha ler 3x today after being in the cold weather. I also am coughing up some congestion. How do you think i should proceed. My husband and i were hoping to try one more time this cycle.",
    "doctor_response": "Hi,If there is severe infection, it is not advisable to go for pregnancy.So before trying for conception, get your lower respiratory tract infection cleared with antibiotics and other medicines.After you become alright, try for conception.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood blisters after tooth extraction?\n\nI have stage 4 liver failure. i had a tooth extracted on thursday and that same evening a blood blister looking thing appeared on extraction site, now i have three of them, they look like blood filled sacks kind of black looking. should i seek medical attention, one of them bleeds a bit, then stops.",
    "doctor_response": "Hi Dear,Welcome to HCM.Undeestanding your concern. As per your query you have blood filled blisters at extraction site which is normal after every extraction for first 2-3 days. As you have stage 4 liver disease your immunity is highly compromised, i would suggest you to maintain proper oral hygiene. Follow all post operative instructions such as do warm saline gargles, do not suck or swish any liquid forcefully , do not eat hard food and avoid any kind of vigorous exercise . Eat very soft food. Drink cold water and have ice cream for rapid healing for 48 hours . Take combination of ibuprofen and diclofenac . Visit dentist once if symptoms keeps on exaggerating or if bleeding does not stop . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat extreme fatigue and short of breathe?\n\nHi I'm a 29 yr old woman and since this afternoon have been feeling short or breath wheezy and extremely fatigued I just checked my bpm and it says 114 should I be worried and go to a hospital now or will I be fine to wait to tomorrow to go see a doctor?",
    "doctor_response": "HiThanks for using healthcare magicNothing to worry in your case. Your vitals are normal and that fatigue, shortness of breath may be due to underline anxiety. In that case, you can take low dose benzodiazepine on sos basis. You can also do relaxation exercise that would keep you calm and relax.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have a growth on my gums that is spreading and my left side of my jaw bone is very tender. That also spreads towards the center of my chin. I feel no other pain though. My left jaw is very tender and I do have a growth on my gums. I feel no other pain except for the tenderness along the jaw and under the chin. What might I be dealing with?",
    "doctor_response": "Hello There. Welcome to healthcare magic forum.. It might be some kind of infection..You need a course of antibiotics which would help you to relive the symptoms.If the growth doesn't subside with antibiotics u need a biopsy to rule any other serious condition such as cancer..So consult a surgeon!!' Hope this helps. Take care..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does excessive usage of asthalin cause shortness of breath?\n\nI am having anxiety / shortness of breath and chronic  asthma.  I am using two puffs of Combihale twice a day and if required I take Synasma - 400 mg per day and Montek LC.  Only medicine that is effective is Montek LC and since it causes drowsiness at high dosage, I resort to asthalin quite often.   I would like to know if my shortness of breath may be the cause of excessive asthalin usage.  If so, how may I manage both shortness of breath and anxiety.Age: 37",
    "doctor_response": "Hi,I had gone through your query and understand your concern.No,this is unlikely to cause shortness of breath in asthma patient due to excessive asthalin use since asthalin acts by dilating airways and thereby relieves breathlessness.Rather excessive use of asthalin indicates that your asthma is not under good control.For asthma management,Physicians follow step care management.If I were the treating physician,I would check the diagnosis,inhaler technique,triggers and drug compliance first.If every thing is found alright,then I would think for stepping up like increasing the dose of steroid inhaler if required and other drugs according to asthma management guideline and clinical judgement.So my opinion is :Please consult with a respiratory medicine specialist to confirm the steps of asthma control and get treated accordingly.This is how you could manage shortness of breath and anxiety as well.Hope this answers your query.Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the lump on the stomach that has started leaking fluid?\n\nHi i had a lump on my stomach like on the skin for about a week and a half but just in the past week or so it started leaking fluid and now it seems to appear to have a hole where the lump used to be i have been taking tyenlo extra strength like crazy since this has started and i put bandaids where the hole is and been cleaning the area when it leaks. Is it good or bad if it leaks fluid? and what is it to begin with this thing on my stomach skin?",
    "doctor_response": "Hi,Dear,Welcome with your query to HCM.Studied your query in full depth of its details.Reviewed it in context of your health concerns.Based On the facts,Dear, you need to consult Surgeon for the burst our boil on the stomach.USG would fix the cause of the leaking lump in the stomach.This reply would help you to plan further treatment soon with your treating doctors.Best of Luck and early recovery.Welcome any further query in this regard,which would be replied in next session.Good Day!!Dr.Savaskar M.N.Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and tightness in jaw and chest?\n\nMy husband is 43 years old and had Right Shoulder Arthroscopic Aeromioplasty this past Monday. He was prescribed Oxycodine, Hydrocodine and a Nerve Block Ball with Catheter. He woke up from a nap Tuesday night at 8:00PM, clinching the center of his chest, and with severe jaw pain, which he had felt the jaw pain earlier in the day. I rushed him to the ER and Chest Xrays, blood work and EKG all came back normal. Today is Friday, the catheter was removed yesterday and he is taking the Hydrocodine for pain as needed, however the chest and jaw tightness are still there. He really feels the chest tightness when he lays on his left side, or twists his body to the side, or takes a deep breath (He's a smoker, by the way). We have an appointment set up with a cardiologist for next Thursday, but would like to have these questions answered so we don't spend the weekend worrying.  We are wondering if this pain could be due to the Hydrocodine, or perhaps a muscle in his chest could be pulled due to the stress on his body, causing the additional pain to the jaw, or perhaps even an infection of some sort.  The last thing I want to think is perhaps there is a clot or embolism, but is it possible?  We've been told to take him back to the ER if the pain worsens, I can have him there in minutes.  Thank you for your time.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Yes, possibility of pulmonary embolism is high in his case. Risk factors in his case are 1. Recent surgery 2. Active smoker 3. Chest pain and Chest tightness, recurrent and not relieving. So possibility of pulmonary embolism is more. He needs CT Pulmonary angiography to rule out this. If CT Pulmonary angiography is normal then no need to worry for Pulmonary embolism. His pain can be due to musculoskeletal cause. Don't worry, he will be alright. But better to first rule out Pulmonary embolism. Hope I have solved your query. I will be happy to help you further. Wishing good health to your husband. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stage 4 colon cancer\n\nhello doctor my FIL has been detected colon cancer stage 4 now they provided stent for smooth motion going he is taking chenotherphy and tablets also if small kids has close contact whether any injection to 2 month baby will get by these medicine they are taking (chemo theraphy tablets )",
    "doctor_response": "Thanks for your question on HCM. In my opinion no treatment required for kids who are in contact with your FIL. Since colon cancer is not contagious and it is not spreading by skin contact,  no treatment required for contact persons including kids.And stage 4 colon cancer is inoperableand palliative treatment is the only thing we can do.Palliative treatment consists of1. Nutritional support in the form of multivitamins,  proteins,calorie and carbohydrate supplement. 2. Palliative chemotherapy to reduce pain and tumour size.3. Painkiller etc.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for mental health problem\n\nHi sir, I am from Bangladesh. My younger brother age of 14 has a seizure disorder since 5 years old. He has also mental problem. When he becomes ill he cannot control himself, he cannot tolerate her mother so he beats her mother recklessly. At that time he doesn't remain human being any more, he become very angry. He says you are all disturbing me, so he beats everybody. These are become stable for 15 days or one month, then he become normal. Every year for at least one time he becomes ill. He is taking currently-1. Epilim Chrono-200mg (2+0+2) 2. Lonagep-0.5mg (0.5+0+1) 3. Foloson (1+0+1) 4. Halopid (0+0+1) 5. Cyclid (0+0+1) For last two days he is taking Opsonil-100mg & Angquil-15mg twice a day.What is your suggestion sir/mam ? your kindness may help us.We are really in a big trouble sir.-Ferdous Bangladesh",
    "doctor_response": "Hi dear,patients who have seizure history they are normally some what high tempered than others.  is there any others symptoms other than irritability?is ther any symptoms like suspiciousnes, high talk , talkativeness, etc..consult psychiatrist for behavior disturbance.,medication to control seizure also control behavior problembut detail history is necessary to treatment.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the antiepileptics available for managing seizures in autistic patient?\n\nHello doctor, I have an autistic and hyperactive person in my family, who is around 19 years of age. He has been having epileptic seizures for more than a year now. The medication he has been prescribed by the doctors right now is Tegretol (Tegral). However, we think it has may have side effects. I want to ask are there any other appropriate alternate options of medication available for such seizures.",
    "doctor_response": "Hello. You are absolutely right that there may be side effects of prescribed medicine. There are many more alternative anti-epileptic medicines available. But every medicine has possibility of its own side effects. Consideration to change to alternative medicine is done if some side effect of medicine develop in a patient or that medicine is not effective.",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI showing disc herniation. Neck pain, headaches and numbness in the arm. Took injections in the muscles. What is the further treatment?\n\nHi, my recent MRI has shown that I have a disc herniation in C5-c6 for about 4 mm. I have been having having neck pain , headaches , back of the head pressures, numbness in my left arm and hand and now for the last few days, dizziness . My Orthopedic doctor gave me some trigger point injections in the muscle about 3 weeks ago, so my neck doesn t hurt as mush, but I still have the headaches, head pressures, and diziness. They said surgery is not a good idea for me. what do you suggest I should do ?",
    "doctor_response": "Wear cervical collar and also do isometric neck exercises.If pain radiation is still there,your doc. must re evaluate for discectomy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having reocurring allergy patch at bottom of back. Cure?\n\nHi, I have a reocurring allergy patch that comes up on the bottom of my back every now and then. It 1st came up about a year ago and has come up about 4 times since. It is extremely itchy and lumpy. It seems to weep slightly as it develops tiny scabs but I m not sure if this is due to the scratching . It always comes back in the same place and probably lasts about 2 to 4 weeks. It is around the same size as 2, 2penny coins (uk).",
    "doctor_response": "Hello,Thanks for the query to H.C.M. Forum.You have mentioned only allergy patch from one year and 4 times in a year. This is not a complete history.Please mention,  Age,Sex,Previous history of allergy ( as bronchial asthma)Family history,Diabetes, fever,any other  member of family infected or  not. Report of blood tests as about eiosinophilia or not. So please mention about  above things.Good luck. Dr, HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. From yesterday, I have fever, headache, and cold. Please help.\n\nHello doctor, I have fever, headache, and cold from yesterday night. I took Paracetamol. Please help.",
    "doctor_response": "Hi. You are most probably suffering from common cold and flu. The headache is due to sinusitis. I suggest you try taking the following: For more information consult a general practitioner online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can gum lumps be treated?\n\ni have two puny bumps on my gums, the doctor said theyd go away in a bit but they havent and my dentist said theyre just minor warts. im scared that they might be genital warts and whats worse, i just started a relationship and im scared of infecting her. help please?!",
    "doctor_response": "helloo..read thru ur query and accordingly i feel that in my opinion it can be a papilloma(cant reach final diagnosis without seeing the clinical presentation)..and genital warts wiil come on genital area..so dont worry about infecting her with this oral lesion..but in my opinion i will tel u to go for a second opinion to an oralsurgeon and get it treated based on clinical presentation...(why to simply live scared if u have measures to solve it)..so cheerup and go for a second opinion...hope ur benefitted something from this reply.have a healthy day!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Has urinal problems, operated, painful kidney. What is the reason?\n\nDear sir, please we need to clarify few health trips pls explain me our child has 6years old and he has been urinal problem came and operation did 7month old child and after long today he fell down and he has getting pain from his kidney . pls guide us what could be resone and where we can refer . we are waiting for your reply as soon as posible",
    "doctor_response": "Hi Welcome to HCM. It is better to go to the emergency department of the nearby hospital to assess the nature and extent of injury. Pls do not delay. Regards DR GS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard lumps on jaw?\n\nI have a bone hard lump growing on my right side of my jaw where it opens and closes. It is very sensitive it hurts when I chew and when I open my mouth it s growing at a pretty rapid pace it s about two inches long n two inches wide right now what could it be",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You may have some salivary gland tumour or siledenitis.  You should go for fine needle aspiration cytology of that lump.  It will give idea regarding your lesion.  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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from asthma and headache. Looking for permanent cure\n\nHello doctor,this is kiddy from Ooty,Tamil Nadu,India. I have a problem which i would like to express it to you.iIam suffering from asthma and headaches daily,also even if i sleep ten hours a day if feel very tired but not fresh.For asthma i take inhalers and for headaches i take medicine but there is no relief for me.So suggest me some tips to keep in control of asthma,headaches and tiredness or to permanently have a cure out of these problems",
    "doctor_response": "Hello, Asthma results in poor ventilation resulting in decreased oxygenation to the whole body and this is perhaps the cause of your headaches. Anyway, you should also exclude other reasons for your headaches like sinus problems, refractive errors etc. It is because of the asthma that you feel tired even after rest. Since you stay in a cool place at high altitude where the atmospheric oxygen concentration is lower, you can use a nebulizer for better relief. Also, steroid inhalers are needed to prevent attacks as they reduce the need for bronchodilators which usually have unpleasant side effects. Permanent cure for asthma is not possible but you can keep the symptoms at bay by avoiding triggering factors and taking anti-histamines whenever needed. You can try yoga and pranayama when when there are no attacks. Please consult a pulmonologist for further advice. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for fever,body aches and stomach bloating\n\nmy wife has a 101.9 fever with body aches (back, arms and legs) and she isn't hungry (has not eaten in 24 hours).  She just came home from Japan and Indonesia, so she is jet lagged too, having slept from yesterday at 3pm until now, only getting up for bathroom and water. Her stomach \"feels like a rock\".  Sore throat is minor if at all",
    "doctor_response": "Hi Dear ,Welcome to HCM.Understanding your concern. As per your query your wife is having fever, body aches and stomach bloating which seems to be due to impaired kidney function, due to electrolyte imbalance and it could be due to viral infection. Need not to worry. Weakness in body could be due to increased potassium level in body. You should visit general physician once and take resin therapy to lower down your potassium levels. Get your lab values monitored after every 15 days. Take proper rest and take Ibuprofen in case of fever. Take diet rich in multivitamins and drink plenty of fluids.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the dangers of ectasia?\n\nHello doctor, What do the following mean?  Diffuse ectasia at proximal and mid section of LAD. LCX continuing as Om1. Long course of PLV and extending to inferolateral walls of the left ventricle. (super dominant RCA).",
    "doctor_response": "Hello. The LAD vessel, that is left anterior descending artery is showing ectasia which means it is slightly enlarged in caliber, but there are no blockages. Also, other things which are mentioned is description of the vessel, the way they are supplying the heart but there are no blockages or any abnormalities. According to it, right-sided vessel is giving long branches and supplying a large part of the heart, but there are no abnormalities. So overall, other than the enlargement of the vessel, there is no abnormality and it is not a cause for his chest pain. Does he smoke? If yes, he should quit it gradually. The report does not appear worrisome. For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to deal with smeared dark stool problem in child?\n\nMy kid is oozing stool for second week. It all started 2 weeks ago he cought flu like symptoms and at thet same time he start oozing stool. At first i thought that it is going to go away on its own, but now i am starting to worry about it. He is having normal stools ones in 2-3 days. I have to change his panties up to 3 times a day becouse of smiared dark stool. is this someting to be worried about?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron (as prescribed by your paediatrician).Regarding diet - You can use cerelac...any flavour will do. Avoid fruit juices as they might aggravate diarrhea. You can give zinc supplements & ORS apart from normal vegetarian porridges & soups.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible after anal intercourse?\n\nHi so im virgin we had anal sex and he ejaculated on my pubic area and after 1 minute i wiped from pubic area to down suddenly I realized that i shouldn\u2019t touch my vagina but it was too late . Im so scared that i will be pregnant . And it was right after my period ends .",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.According to your question, the possibility of pregnancy is less. - There was no vaginal intercourse and ejaculation.- In the case of regular periods, the possibility of ovulation just after completion of periods is less and so pregnancy possibly is also less.- But as you touched the vagina during wiping and if you are having irregular periods, we can not completely rule out the possibility of ovulation and pregnancy. In that case, if you miss your next periods better to go for a urine pregnancy test once.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sree Gouri SR",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough and cold\n\nmy son is 11 months old and he frequently suffers from cough and cold.Recently he has been prescribed with LEVOSALBUTAMOL INHALER(two puffs 4times a day when there is cough / wheezing.hOW FAR IS THE USE OF SUCH INHALERS SAFE FOR A BABY OF this age?Does it contains steroids.. Are there any other option of treatment without the usage of steroids...",
    "doctor_response": "Many thanks for writting.there is not really evidence based medicine for salbutamol but it helps sometimes.you can give normal saline nebulizer for cough and cold, which is quite safe.normal saline nasal drops can be used for the same purposes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How effective and safe is topiramate 25mg?\n\nMy neurologist put me on topiramate 25mg 2 tabs bid. I have head tremors from a car accident.  I have been on this medication for almost a year, but my head is still shaking.  Evidently this med is not working.  I'm researching Inderal.  Thinking about talking to her about that med.  What do you think?",
    "doctor_response": "Hi,Thank you for posting your query.Topiramate is a safe and effective drug for treating tremors (however, it is more commonly used for treating migraine and epilepsy).Inderal (Propranolol) is more effective than topiramate for treating tremors. So, in my opinion, it would be a good idea for you to switch from topiramate to inderal.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the suggestion for blister in mouth?\n\nhello doctor, i have a blister in my left side mouth for past 3-4 days. Initially i thought it ll get okay on its own, but the pain has increased. i used Betadine mouth wash, but it hasn t helped me. Is it ok/safe to use BORO-G (Borax Glycerine) in my mouh in my 12th week of pregnancy? Please help... thank you, aparna",
    "doctor_response": "Thanks for your query, i have gone through your query. the blisters could be because of the herpes virus infection or it can be because of the burn secondary to consumption of hot things. nothing to worry, you can take topical anesthetic and analgesics like anabel gel. consult a oral physician and get an opinion to rule out the above said conditions. do saline gargling. i hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could fluttering sensation in abdomen suggest?\n\nI occasionally get a fluttering feeling in my lower abdomen.  It mimics the feeling of early fetal movement, even the location is similar. However, I am not pregnant. I am not having any other digestive issues. Just wondering what this might be? thank you",
    "doctor_response": "Hi.Thanks for your query.Since you have mentioned this as a typical fetal movements and in the same position, that you are so much certain of, and since you do not have any digestive issues as you have specifically mentioned, this can be taken as a case of Pseudocyesis.In Pseudocyesis the re is no actual pregnancy but the patient gets all the signs and symptoms of being pregnant. I would advise you the following:Get an ultrasonography and standing X-ray of the abdomen and a urinary pregnancy test.Consult the Gynecologist.And be assured if all the tests are normal. Nothing specific treatment is needed as this is self-limiting and passes off most of the time the moment you have next periods. Assurance is the biggest treatment at the  moment. If something is found during the course of investigations or the tests, the treatment can be guided as per the cause.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high fever in babies\n\nmy son avik das is very high fever.but no cold.presnt started medicine taxim-o 4ml,ibugesicplus 3.5ml,catalyd8drop.but no responce this fever.and vometing.my son age 9months.two days runing fever.this medicine is correct?why full clear this fever?7.25kgweight.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query your son have symptoms of high fever which could be due to viral infection. Need not to worry. I would suggest you to start with paracetamol every 4 hourly. Maintain hydration of child well. Avoid giving large meals to child and give him small but frequent meals. Visit pediatrician once and get it examined. You should go for blood tests as well and start treatment after proper examination. You should give child proper rest. Avoid giving any outside food. Give curd in diet. Start giving oral rehydration fluids sip by sip to maintain the hydration.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could red lumps on spine suggest?\n\nMy 14 year old daughter has 3 quarter sized red lumps on her spine and another lump slightly larger on her shoulder.She says they itch.She has had the lumps on her spine for 2 weeks, the other appeared today. I thought it was a reaction to soap or clothing but now I am concerned.",
    "doctor_response": "Hi,Dear thanks for the query to HCM virtual clinic.I studied your query in full details updated from you.I understood your health concerns.Based on your query data, In my opinion ,Dear Your daughter  seem to suffer from bed bugs as all the red lumps are on spine and on on the shoulder.Itching confirms the insectbite she had,which is causing these spine lumps.History of similar lump 2 weeks back on the spine,is suggestive of bedbug or insect bites and need to be treated accordingly.Hope this reply would help you to evaluate your case and treat it with your doctors in time to come.Hope this would resolve your query and worry and Anxiety accompanied with it.Welcome for any further query in this regard to ME.I would love to help you out.Awaiting for any further query.Wish you fast recovery from this intriguing health problem.Have a Good Day.Dr.Savaskar M.N.M.S.Genl-CVTS -Senior Surgical Consultant",
    "dialogue_context": ""
  },
  {
    "patient_message": "How do i correct an electrolyte imbalance?\n\nhi my name is jennifer i am a nursing student doing a case study on an elderly pt who was given two extra doses of Lactulose she is experiencing symptoms which lead me to assume she is experiencing electrolyte imbalance i am monitoring her i&o, labs, vitals and administering fluids intravenously i was wondering if there was anything else i should be doing for this patient i appreciate your help",
    "doctor_response": "Hello jenniferya as lactulose causes diarrhoea if given in excess which will lead to loss of water n salts from the body..u shud get these tests done\u25cf SERUM SODIUM/POTASSIUM\u25cf SERUM CALCIUM/PHOSPHATES\u25cf RENAL FUNCTION TESTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain from the navel to the pubic region?\n\nMy son age 10 years complained for abdominal pain starting from naval area proceeding to pubic region and settling to right side.  I rushed to emergency due to fear of appendics and he went through various examinations which include CBC, Urine DR,  X -Ray abdomen,  & ultra sound lower abdomen.  All test were found OK except TLC level was a little higher then normal.  CBC was again performed after 15 days which showed further increase in TLC.  Doctor checked him clinically and declared no appendics and diagnosed that pain is due to constipation.  Now even after 20 days that pain is there it appears n disappears on unspecified intervals.  There might be no pain for 2 or 3 days but again he will feel pain on right side without any reason.  He is still having constipation and passes hard stool only once in morning. Please help be what is reason of the pain and what should in do to get him relief.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It could be a urinary tract issue. Another probably cause is a Meckels diverticulum, considering the clinical course and raised WBC. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could inflammation in the liver be a matter of concern?\n\nI recently had my gallbladder removed due to gall stones that were discovered during an ER visit for severe upper right quadrant pain. My liver enzymes were slightly elevated at the time of my surgery so my Dr. conducted a liver biopsy during my surgery. It later showed that I have some inflamation, I am wondering how concerned I should be...he repeated the labs and I haven't heard anything...?",
    "doctor_response": "1) You might have inflammation in liver which may occur due to many reasons2) To quantify severity of inflammation, liver function test is must3) Generally treatment for hepatitis is medication only and in most cases it resolve with medical support.4) In your case, liver function test might come elevated also due to episode of cholecystis (inflammation in gall bladder and surrounding area).",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the effects on Xanex bar on child?\n\nI think my 20 month old daughter got a hold of a little less than half of My 2mg xanex bar. I had left it on the counter & it was not there when I came back. I tried to induce vomiting by sticking my finger down her throat & she only threw up a lil white foam. I also swabbed inside her mouth with a wet wash rag & have been making her drink milk & keeping an eye on her. What should I do?",
    "doctor_response": "HelloThank You for contacting HCM.Take her to ER, doctor will pass nasogastric tube and lavage her stomach. It will wash the medicine present in the stomach(which is not been absorbed so far). Keep her close. If there is altered state of consciousness then visit hospital.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hydrosalpinx and cyst on left ovary\n\nhi there i am a 21 year old female and had an ultra sound and transvaginal ultrasound just over a week ago and have been diagnosed with hydrosalpinx in the right fallopian tube and have a 2cm cyst on my left ovary. i suffer with pain everyday with this mainly on the right side but in the last week the left side is just as tender. i had an emergency pregnancy test which came back negative. my mother had severe endemitriosis and i know that it is hereditary. i am concerned that if i dont have something done soon my chances of having fertility problems will escalate. my breasts have been very tender in the last week also. i also have an IUD, i had it put in September 2012. what kind of doctor or specialist should i be seeing for treatment?",
    "doctor_response": "Herbal medicine is one of the most popular alternative treatment for hydrosalpinx. Some herbal formulas are highly powerful in removing the blockage and adhesions, and even make fallopian tubes function well. Fuyan Pill produced by Dr. Lee Xiaoping, has been patented as a treatment for multiple gynecological conditions, which works on hydrosalpinx and can cure it after three to four months medication.What's more, this pill is also effective on curing endometriosis. And small cyst could also eliminated by it.You could have a try first. And since it it made from natural herbs, you could eat it without worries. It could repair you reprodutive organs at the same time.Hope this is helpful for you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I bled after I-pill, but missed period on due date. Am I pregnant?\n\nHi doctor, My periods got ended on the 12th of last month and I had protected sex on 15th. As I noticed some semen on me, I took an I-pill on the same day. Then, I got periods after 8 days of I-pill, which lasted for five days as usual. But, the period was not like the way I usually get. There was no heavy flow or continuous flow of blood. The color of the blood was brown. My actual due date is 7th of this month and I missed it now. I am worried whether I am pregnant. Please help me with this issue.",
    "doctor_response": "Hello. First of all relax. You are not pregnant. Your periods came early because of I-pill medicine (emergency contraceptive pill). Sometimes, it can make periods come early and sometimes, it can delay. In your case, it made your periods early. But, I want to caution you that you should not use I-pill medicine in daily routine as it is a very strong medicine and have side effects also. In your case, you did not even need to take I-pill because your periods finished on 12th and you had sex on 15th. You cannot become pregnant if you do sex in the first 10 days of your periods. For further information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is good somatic and cardiac activities, placenta anterior grade 2 andadequate amniotic fluid volume at 23 weeks normal?\n\nMy ultrasound result is single intrauterine pregnancy,in cephalic presentation,23 wks by composite aging (BPD,HC,AC,FL),with good somatic and cardiac activities.placenta anterior grade 2.adequate amniotic fluid volume.long and closed cervix with t-shaped configuration.what does it mean?",
    "doctor_response": "Hi, Your USG report is absolutely fine. You need not worry about baby's growth. Baby's physical growth is normal. Placenta, which supplies nutrients to the baby, is working fine. Fluid around the baby is adequate. The opening of the womb is closed at present as expected. Please have a regular follow up with your treating doctor. Opt for a healthy diet and regular exercise regime. Supplements of iron, calcium, omega-3, multivitamin, multimineral and protein are advisable. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Purushottam Neurgaonkar, OBGYN",
    "dialogue_context": ""
  },
  {
    "patient_message": "Body pain, salty taste in mouth. Taking amoxicillin for cold and cough, nasal spray, no relief. Cure for symptoms?\n\nI have recently been on a short course of amoxicillin 500mg 3 x day for 5 days for a very bad cough , cold, infection. The course has stopped but I am left still feeling full of aches and pains but the worse thing is that I cannot taste anything other than a salty taste in my mouth and salty mucus . I went to my doctors last week who prescribed some nasal spray for allergies!? Its not working anyhow, whats wrong with me please?",
    "doctor_response": "ALLERGIES DONT RESPOND TO ANTIBIOTICS YOU NEED ANTIALLERGICS tAKE METROGYL 20 MG BD FOR 7 DAYS TAKE MONTAIR FX BD SYP VENTROLIN 1/2 TSF BD SYP TOSSEX 1/2 TSF NIGHT TAKE ANTIALLERGICS FOR 3 WK METROGYL FOR 7 DAYS ADD ANTACID SYP FOR  TDS TO END TASTE YOU DESCRIBED",
    "dialogue_context": ""
  },
  {
    "patient_message": "Inhaled potpourri polish. Allergic reaction leading to extreme pain due to coughing. Pain coming and going. Reason?\n\nI inhaled Mr muscle potpourri polish about a month,during that night I coughed so much and so hard. Being caused by pain I felt when woke up in the middle of the night,the pain was so extreme causing me to cough,at the clinic its an allergic reaction ,during the next few days the pain went down,but now I have realised it comes and goes,what could be happening Doctor?",
    "doctor_response": "you might be suffering from previus allergies whch get worsoned after inhalation of polish it takes 6 - 8 weeks before the symptomps go after exposure to particular allergen take zinetac 150 mgm before meals in morning take montelucast 10 mgm twice a day syp tossex(cpm+codeine)1/2 tsf twice take 4 glasses of warm water in the early morning and before sleep wit for 3 weeks and get medicines for 3 weeks if no subside go for allergy checkup",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will applying heparin and benzyl nicotinate help in treating bump on head?\n\nMy forehead banged against a glass door. There was no cut or injury, except a bump which has been there for a quite a while, reduced in size but refuses to go. Will applying ointment of heparin &benzyl nicotinate help? I am 53 years, ft ins tall and weigh 84 kgs and menopausal.",
    "doctor_response": "Hi,It seems that there might be having formation of hematoma and now it becomes localized and encapsulated.You can apply heparin, benzyl nicotinate cream.Apply ice pack 2-3 times a day for few days as well.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I feeling pain in my fractured arm?\n\nmy arm was fractured abt 3 years ago .. today in the gym, i lifted more than usual weight and i started to feel the pain in the same arm .. the pain is less but similar to the pain when i fractured my arm ... will i be able to workout ever again .. i am scared ...",
    "doctor_response": "Hello, If you are having old fracture at arm and feeling pain then you should be cautious. If lifting of weight is causing pain then I will advise you to have a X-ray of affected part to know the reason behind pain. This can be due to incomplete union or stress fracture. Till then you should avoid bearing weight on affected arm. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mukesh Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cam I take nexium for hiatal hernia as shown on endoscopy?\n\nhad a upper endoscopy done with diagnois of hiatal hernia. Had a severe attack yesterday of stomach pain like being punched in my stomach.  Unrelenting! Taste of rotten eggs when burping. Lasted for about 12 hours. Took another nexium (I'm on 1 40mg day). Eased the pain so I could breath and finally sleep. Regurgitated bile later. This morning pain is tolerable but in upper gut and under rib cage.",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.Yes, you can continue nexium and also add domperidone, antacid gel , soft bland and frequent feeds, not lying down immediately after food, no gas forming beverages.Continue the treatment , repeat endoscopy after 3 weeks.Surgery for hiatal hernia is it is large and causing symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long can one take Sangobion capsule with normal haemoglobin count?\n\nHi... I want to ask for how long can someone take sangobion capsule being a female aged between 23 to 24 with previous hb count as 8 and current hb count as 12. I have been taking one capsule daily for 2 years. Should i stop using it or continue taking for the maintenance of my healthy hb???",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Since your hb has come to normal you can stop the tablet. And maintain good healthy diet. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain while urination, whitish substance in the urine, cloudy urine. Tried cipro and diflucan. Undergoing peritoneal dialysis. Any suggestions?\n\nI have pain while urinating especially towards the end of urinating. Sometimes there s the feeling of urgency. Also, when I urinate, there is a whitish sediment that settles to the bottom when I urinate in a cup. The toilet water often looks cloudy. No blood in urine . I often urinate at the first feeling to prevent any infection. I ve had several urine lab test as well as culture. The culture is clear. I ve been on three different does of Cipro as well as three different doses of Diflucan . I am a Peritoneal Dialysis patient. I ve inquired with the Pharmacist whether difulcan gets dialysed out immediately. He checked his book and he said not really. I also drink 6-8 oz of Cranberry Juice and take 2 cranberry pills per day. I try to drink a lot of water -- no soda . This has been going on for about 6 months. I had a cystoscopy and he found no blockage or anything strange in my bladder. However, he excreted a lot of the sediment using saline solution. I would like your thoughts in the matter. Is there anything you know about the my Urologist hasn t tried yet?",
    "doctor_response": "I will start from the beginning.You have ackd & are on CAPD.Capd presumably is OK although it would have been better had you mentioned details about that too.The symptom you are experiencing is 'Stranguary' & the cause for this & whitish substance appears to be Graveluria.Commonest cause of this condition is stone forming substances like oxalates,uric acid,phosphorus,calcium.This does not suggest infection therefore you may stop antibiotics.You may also stop cranberry tabs & reduce the quantity of cranberry juice to 150-200ml daily.Please mention all the details about your drugs,diet & CAPD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in left side below the ribs\n\nMy 10 year old daughter is complaining of pain in her left side just below her ribs. She says it hurts every time she breathes out. She says laying on her stomach makes it not hurt. This happened one other time a last week and lasted for about three hours. She is not crying but walks hunched over because it hurts.",
    "doctor_response": "DearWelcome to HCMWe understand your concernsI went through your details. The possible causes of the pain below the ribs could be acidity, stretch or strain or simple apprehension and anxiety. You do mention that the same symptom was present before so days and it went away after three hours. First of all motivate her that this is nothing. Then apply some mild pain killer gels and convince her that with this treatment the pain should vanish. Encourage her to divert her attention towards more entertaining and creative tasks. Inspite of all this, if the pain persist, consult a doctor.If you still need my assistance in this regard, please use this link.  Please remember to describe the whole problem with full detail.Hope this answers your query. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can glioblastoma or the therapy for it cause liver problems?\n\nI have a friend fighting a glioblastoma x 2 years. Has now been told he has cirrhosis and hepatitis C. Receiving Avastin therapy.  Are these liver problems from therapy or were they underlying all the time and if so, shouldn't all of this been checked before going through 2 major brain surgeries and all the chem and radiation?",
    "doctor_response": "First, he has hepatitis C. So the hepatitis C may have cause the liver problems, not necessarily the globlastoma or the chemotherapy can be blamed for the liver issues. The infection is a strong risk factor for liver failure too. As for the surgery, usually a check up is always performed before a big surgery. Chances are that his levels were normal then. In that case, a doctor cannot always predict if the failure will result in times to come.Besides, we have to take into account what is the most dangerous condition for the patient. Some hard decisions are usually taken according to what will benefit the patient most. Usually this is done in consultation with the family of the patient",
    "dialogue_context": ""
  },
  {
    "patient_message": "How treatment should I take to get rid of black spots on the face ?\n\nhi, my name is shilpa i have black spot on my face last 2 yrs plzzzz tell me.how can i remove them",
    "doctor_response": "Welcome to Healthcare Magic The black spot on face can arise due to one of many possible causes. You need to eat fresh green leafy vegetables in diet. Drink lot of water. Avoid sun exposure. Consult a Dermatologist who will suggest skin whitening ointment containing hydroquinone which is very good in lightening the dark areas. Also there are other options like laser removal which will be suggested if needed by Dermatologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lymph nodes swelling two years after diagnosed with renal cancer and had partial nephrectomy. Mesenteric nodes removed in kidney showed PTGC. Any thoughts?\n\nI have had clear cell stage one renal cancer, and partial nephrectomy. Following this, had hives and was diagnosed with carcinoid. Now two years later, lymph nodes swelling bigger and having left external iliac biopsied. I am 57. Biggest is 2 plus cm. Some are in inguinal and some mesenteric. Mesenteric nodes removed in kidney surgery showed PTGC. Any thoughts?",
    "doctor_response": "Hi and thanks for your question.Metastasis(spread) of renal cancer to other organs must have taken place.you need to urgently see an oncologist for further evaluation and management.hope i answered your question,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could a large lump in skull (base) indicate?\n\nI have noticed a large bone like lump on the back left hand side of my skull just above the base of skull it was not there earlier and have not bumped or banged it. It is not painful to touch and I have no headache at the moment but I do suffer from severe headaches and migraines sometes for days at a time.",
    "doctor_response": "Hi,I read carefully your question and would explain that there are different causes that may lead to this symptoms: a bone tumor, vitamin D deficiency, an intracranial lesion (like meningioma). Coming to this point, I would recommend consulting with a neurologist for a physical check up and some tests: - a brain CT scan- blood electrolytes- PCR, sedimentation rate for inflammation. If all these tests result normal, there is nothing to worry aboutHope I have answered your query. Let me know if I can assist you further. Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is sciatica hereditary?\n\nHi! I am 31 yrs old. I m having sciatica nerve problem since a long time. In my right leg one nerve is pulling from the toe. Now only I found that it is sciatica problem. My mother is also having the same problem. Can it be a heridity problem. pls suggest me a doctor from chennai or Trichy.",
    "doctor_response": "Dear user, thank you for your question, no sciatica is not hereditary, usually it happens due to common similar reasons between people, it happens because of sciatic nerve impingement. losing weight if over wieght might help reduce the symptoms. Sadly i am not from chennai or Trichy and i cant refer you to any doctor there. hope this answered your questions please rate as 5 if you find it helpful. Best regards, Dr. Nazzal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can be done to cure ulcerative colitis with bleeding before every stool and anemia?\n\nHello doctor, I have ulcerative colitis for more than two months. I pass more than seven stools a day (loose stools). Constant bleeding before every stool from the rectum. Fever, rapid heartbeat, and anemia. And have a fungal infection, taking medicine too.",
    "doctor_response": "Hello. For ulcerative colitis, an anti-inflammatory drug like Sulfasalazine group of drugs can be started. (In a severe case, Steroid can be prescribed for a short duration). Immunosuppressive drugs prescribed if needed. Anti-diarrheal medication also can be prescribed to decrease diarrhea frequency. Your anemia is because of constant bleeding in the stool. For that, Iron medication like Ferrous Ascorbate can be started. All these medications are taken regularly and even if still no improvement then surgical management can be done. Consult gastroenterologist for examination and accordingly get prescription. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does an inflamed and hard lump under the right nipple indicate?\n\nThank you. I am male, 73, no history of cancer....generally good health, active good weight.  Traveling in Mexico I have in the last two days developed, first a very painful inflamed hard lump under right nipple.  5 days later a hard small (like a wart) lump under right knee?  Taking aspirin, antidepressants, Flomax and limpitor for years and no sideeffects.  Idea?  Thanks.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. * So far as symptoms narrated here, the lump under nipple seems to be inflamed soft tissue lesion as sebaceous cyst or else. * I would like to have a photo picture of the same in follow up   conversation for further management guidelines. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a purple rash on the ear of a toddler be treated?\n\nHii my three year old toddler has a purple ish bruise on the top and back of his right ear I\u2019ve no idea what happened and he doesn\u2019t seem at all bothered by it what would you advise me to do if anything?",
    "doctor_response": "Hi, Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically. Please revert back to me with images so that I can guide you better. You can approach me at the following link. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the NeilMed nasal rinse cause high blood pressure?\n\nhi I have Sinitus and before using the NeilMed nasual rinse I had a perfect blood pressure. Now when I visit the doctor on the last vist my blood pressure was high could the NeilMed nasual wash be the reason. I have never has high blood pressure before.",
    "doctor_response": "Hi and thanks for this query.I am so sorry to hear about this increased blood pressure that you have reported. A single increased blood pressure is no reason to freak out. Follow up and get more measurements to see if this is a permanent increase or not. if it were just a one time increase,it needs no further attention. It is unlikely for this product to cause increased blood pressure.I hope this helps. I wish you well. Thank you so much for using our services and do feel free to ask for more information and clarifications if need be.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is DHT that is produced from testosterone responsible for hair loss?\n\nhello sir, my age is 21, weight 61 and height is 5.7 I am experiencing reduction in front hair lines my hair and studied that the DHT which is produced from Testosterone is directly responsible for hair loss.Please tell me that is this correct or false and please tell me way to control DHT so that I can prevent my hair ... Thanks.",
    "doctor_response": "Hello,Welcome to healthcare magic.Dihydrotestosterone (DHT)is a derivative of testosterone which acts on the receptors on the hair and skin. In genetically programmed individuals who have a hereditary pattern of hair, this is responsible for mediating the receding hair line which manifests as varying degrees of baldness. This is called as androgenetic alopecia as it is androgen mediated.The US-FDA approved treatment for androgenetic alopecia is Finasteride which inhibits the action of this DHT. This has to be prescribed by your dermatologist and is not an over the counter drug.The other drug which seems to be beneficial is Saw palmetto. This can be used topically as well as orally and is a component of many hair loss preparations.Hope this answers your query.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will i be able to conceive again?\n\nHI Dr i got missed abortion last year October i.e 2013 till now am trying to get pregnant but nothing happen. i get something moving in my uterus yet i receive period monthly. iam 39 years. Dr do you think i can get pregnant again Iam so desperate\\",
    "doctor_response": "Hi.The first and most important step is to check on your hormone profile, ultrasound of your abdomen and pelvis and meet an obstetrician. Gettung pregnant and conception is no joke, and if you can get pregnant once, I am sure with the right guidance you can conceive and go through with a healthy pregnancy for sure, but not on your own, with a doctors supervision.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower abdominal pain and back ache\n\nHi, may I answer your health queries right now ?  Please type your query here...am 29 years,5'7 ft and 66kgs, i have a history of lower abdominal pain,back ache,heavy monthly periods, frequent UTI's. i was diagnonised with diffuse adenomyosis and was prescribed with lupride injection. What does this mean and is their an alternative prescription?",
    "doctor_response": "Hi.Thanks for your query and an elucidate history. The Diffuse adenomyosis is a condition in which al the muscles of the uterus are diseased to have inflammatory and causes too much pain and associated symptoms. If the medical treatment fails to resolve this, the only option is ''Hysterectomy''.There can be associated PID- Pelvis Inflammatory Disease. You can certainly take a course of antibiotic, metronidazoe and anti-fungal tablets and the same dose and course to be taken by your husband. This may help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pimple like bumps on the right side of body?\n\nMy baby has 3 little bumps that look like pimples or blister and they feel sort of hard. smaller than a pencil eraser. He has one by the outer corner of his eye, one on his shoulder, and one on his leg, all on the right side of his body. What could this be?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore lump in armpit and neck?\n\nHi I have a small hard lump in my left arm pit which is sometimes a bit sore and sometimes not. I went to the doctors and was told that it was an insect bite and that it would go away, it did start to go away but now it seems to have flared up again. I also have a sharp pain in the upper left side of my back (which sometimes moves to my chest). It is most painful when I m laying down. I had the back pain for about a week and the lump in my arm pitt for about 2/3 weeks. Just today I have noticed that there is a very small lump forming in my neck (on the right side just under my jawline) which is a bit sore to touch. Are any of these things related?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have axillary and cervical lymphnode enlargement.  It may be due to reactive hyperplasia, tuberculosis or lymphoma.  You should take a course of antibiotics. If it doesn't respond to treatment then you should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent cold, high fever and nosebleeds in an anemic child?\n\nMy 5 year old grandson is anemic (currently on iron tablets), frequently gets chest colds since the time he was born, will run a high fever and get nosebleeds. He also has red puffiness under his eyes. He is a good weight, ~ 47 lbs, and has high energy but he is continually very pale What type of blood work would you recommend. I had to ask the doctor to do the lab work last time for anemia - for some reason she was hesitant to do so but the results were low iron. Thank you.",
    "doctor_response": "Hello, If your baby has very frequent cold, cough, red eyes, it could be due to allergic rhinitis. I advise you to go for allergy screening. Anemia in this age group is usually due to nutritional deficiency as iron or vitamin B12 or folic acid. Get blood test - CBC, iron profile, serum vitamins B12 level, folic acid level and review with reports, further course and treatment will depend on reports.Hope I have answered your query. Let me know if I can assist you further.Regards,      Dr. Sachin Kumar Agarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring tooth infection and swollen lymph nodes?\n\nI have been being treated for a infection in my tooth for 2 years, followed by a root canal then a surgery after the root canal didnt work.  I have taken antiobiotics on and off for 2 years and the problem goes away afer abou 2 rounds then comes back.  I have sinus pressure on that same side.  After having the dental surgery I still have the same problem and dentist said the tooth healed correctly and the bone grew back like it should.  They have referred me to  a head, nose and throat dr.  my glads tend to swell on that same side.  what could this be.  i have been told that my sinuses are very deep",
    "doctor_response": "Hello:)Welcome to HCM. You did not mention your age.Frequent antibiotic usage is not recommended.You did not mention what your ENT specialist concluded.Sinusitis can frequently show up as toothache.I  recommend you to get treated for sinusitis first.This should ideally reduce this radiating pain to the jaw. Also rule out infection in other teeth.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of swelling and numbness in upper left chest?\n\nMy boyfriend has swelling in his upper left chest-puffy like fluid and numbness or tingling in his left arm.  He also has shortness of breath frequently.  He was recently seen at a Patient First and they told him he may have COPD.  He has had the shortness of breath for quite some time.  He has an appointment with a pulmonary doctor August 5th but they would not see him before that.  What do you think?",
    "doctor_response": "Hello!Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Regarding your concern,  I would explain that your boyfriend symptoms are suggestive of subcutaneous emphysema,  probably related to copd. For this reason,  I would recommend consulting with a pulmonologist as soon as possible and performing a chest X-ray study and pulmonary function tests. A chest CT scan may be needed. Hope you will find this answer helpful!Kind regards, Dr.Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. A mentally retarded woman has ACS. Kindly explain her ECG.\n\nHello doctor, I try to help a mentally limited woman of 36 with ACS complaint from which the ECG is not clear. I have a photo of her ECG. It seems inferior wall ischemia or NSTEMI. I try to get her examined but difficult to explain to her. Please can you help in reading the ECG?",
    "doctor_response": "Hi. I have gone through the attachment. (attachment removed to protect patient identity). Yes, definitely there are ischemic changes in the inferior wall as well as lateral wall, suggestive of ischemia, if possible do give her an antiplatelet agent like Aspirin and Clopidogrel after consulting the local physician, better still take her to a cardiologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes reoccurring oral thrush?\n\nI have been having reoccuring oral thrush for 9 months now. I go on the drugs for 2 weeks then it comes back. This cycle just keeps going on and on. I take Advair disk in the morning for asthma. I have been drinking Vodka on a daily basis (8-12 oz) in the evening. Do you think the Vodka is driving the thrush? I have been on the Advair 8 years with no problem until now. I have been drinking for the last 1 1/2 yrs. I just stoped drinking completely 4 days ago with no side effects. Do you think the thrush may now clear up on it's own?",
    "doctor_response": "HiWelcome to HCM!I appreciate your concern towards the recurring oral thrush.Since you have been using Advair diskus which contains a steroid (Fluticasone) in addition to a bronchodilator which is useful form your bronchial asthma.However it is because of the steroid you are getting the recurrent oral thrush (fungal infection). Steroids are known to suppress the immunity of a person vulnerable to get fungal infection if used in the form of inhaler.Alcohol consumption (Vodka) is associated with bad oral hygiene which promotes the growth of the fungus.So, maintain your oral hygiene, do frequent saline water gargle after every use of inhaler if oral thrush does not subside then you may have to take Nystatin solution for the fungal infection.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the difference between migraine and sinus infection?\n\nHello, how can I tell the difference between a migraine and sinus infection? I have a long history of recurrent sinus infections every 2 months. I have been on migraine medication for 3 years and have not found anyone that really help the pain. ER doctors give me Migraine cocktail, but topomax, Elavil and Neurontin does not seem to work. Please help Miranda",
    "doctor_response": "Hi I did review your concern.Sometimes it becomes difficult to differentiate between headache due to migraine and headache due to sinus infection.The important clinical differentiating point is that headache due to sinusitis generally also has concomitant pain when pressed over the sinuses. You can check that yourself by pressing on both sides close to your nose and above your eyes for sinus tenderness.Another evaluation is sinusitis is CT scan of paranasal sinuses.Also if ELAVIL and neurontin are not working it is more likely for sinus headache than migraine.I would recommend you consult a ENT doctor and get your self evaluated for sinus infection and management of sinus drainage.I hope this helps.Wish you all the best.Thank you for choosing healthcaremagic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Slow urination with burning sense\n\nDr I had my TURP 2 years before . Now about a week urine stream is thin and have burning sensation . Daily i am urinating 9 times.",
    "doctor_response": "hi,welcome to HealthcareMagic forum.as per your symptom there is chance of infection.it may be due to retention of urine because of stricture,complication of surgery,although usually rare.you should visit to urologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is recovery period after crown preparation before air travel is advised?\n\nGood evening... I am currently experiencing a very sore jaw from dental work... the preparation for new crowns on No19 & No20... lower left... permanent crowns to be installed tomorrow... and a vacation upcoming... involving air travel.  Please advise as to the appropriate time line for recovery... before air travel.  Thank you.",
    "doctor_response": "thanks for your query, i have gone through your query. you can go ahead with the crowns for your teeth. it will not interfere with you air travel. make sure that the teeth are root canal treated before capping. because in future if the teeth get infected again we have to repeat the crown. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any treatment for fibromuscular dysplasia of internal carotid artery?\n\nI was diagnosed with fibromuscular dysplasia of the right internal carotid artery at the base of my skull. I was told 17 years ago the technology did not exist to do a bypass on the artery. Is the technology there now and do I need to have it rechecked? I have been on warfarin ever since to keep the blood as thin as possible.",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your symptoms and treatment received so far.I think you are on correct treatment and warfarin should be continued for long to prevent any brain stroke.You could see your neurologist for review. I do not think that a bypass surgery is needed, as you are doing so well on medical treatment.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Painful wisdom tooth, irritating, wobbling, found a lump. What is wrong with it?\n\nI have my wisdom tooth for 8 years now. But 10 days ago I felt some pain there, well not really pain,just annoying feeling that you get when a tooth falls out as it does in your childhood. So I felt the tooth with my finger and I felt that it was wobbling. My question is can a wisdom tooth fall out on It's own? So started to play around with my tooth hoping to make it more loose to fall out. But now my gums around the tooth is starting to get more painful. So I felt my gums to see where the pain is coming from and I could feel a very sore lump high above the wisdom tooth. What is this lump,should I have this lump when my wisdom tooth has been erupted for a while? Or is it because my wisdom tooth has come out abit and wobbling?",
    "doctor_response": "Hello, Thanks for posting your query. The lump overlying inflammed pericoronal flap is due to the inflammation surrounding erupting wisdom teeth. Frequent warm saline and betadine gargle will relieve pain and infection. clinical and x-ray examination of the inflammed area will help to decide the treatment. Tooth has to be either extracted or flap overlying tooth has to be removed to enhance tooth eruption,depending on the space available for tooth eruption. Take complete course of antibiotics-analgesics as per dentist's prescription. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever\n\nHi, my 2.5 year old is running a temperature of 102. We gave him crocin before 5 hours and now the fever is high again. Should i continue giving crocin? the pediatrician said that it will take 2-3 days to feel better and that we should continue giving medicine.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.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.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for viral pericarditis with Cardiomyopathy HF?\n\nI have been diagnosed with viral pericarditis with. Cardiomyopathy HF with 20% EF. Hosp now for decompensation took ten pounds and 4 liters off. Is this still an  acute issue now? What is the prognoss my ECG says multifunction PVCs then QTc alarm every once approx an hour.",
    "doctor_response": "hello there I understand your concernElectrolyte disbalance is always an issue in decongestion therapy which precipitates VPCs which need to be stabilised with correction of electrolytes It is not an acute issue now but care has to be taken regarding your fluid intake and output in future for a recurrence not to occurHope that helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lymphadenopathy symptoms\n\nLymphadenopathy: 2cm-firm, mobile (right inferior cervical) lab work was normal no other lymph nodes emlarged did not decrease in size with antibiotic. Do i need excision ?",
    "doctor_response": "Well, you need not go for excision straightway. I would recommend FNAC (Fine Needle Aspiration Cytology) which is a non-invasive investigation. If FNAC report is negative or equivocal, it may be even repeated. If FNAC fails to establish the diagnosis, then excision biopsy may be considered. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is neutropenia?\n\nHello doctor, I recently had my blood test and the results came back that I had mild neutropenia. It has got me a little concerned since this has been present on my last two blood tests with the lymphocyte count being significantly higher, but still within the normal upper limits. I have had no infections, fever, night sweats, aches, no splenomegaly and no history of anything. I currently take Propecia 1.25 mg for hair loss. My first blood test five months back was this way neutrophils 42.8 % and absolute neutrophils 2.1, lymphocytes 45.6 % and absolute\u00a0lymphocytes 2.2.\u00a0My newest blood test as of this week reads neutrophils 30% and absolute neutrophils 1.2, lymphocytes 59% and absolute lymphocytes 2.3.\u00a0I will upload my most recent laboratory work. If more information is needed then I can get the previous one.\u00a0Thank you.",
    "doctor_response": "Hi. Based on your query, my opinion is as follows: Low grade viral infections increasing lymphocytes. The normal lymphocyte count is 20% to 40% and here is 59%. 1. Improve nutrition to fight the low grade infections. 2. Maintain good hydration. Repeat test after three months and get back to a hematologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lost weight after partial splenectomy due to cancer. What can be done to gain weight ?\n\nHi there.My friend is 68 years old and two months ago he underwent a partial splenectomy because of cancer.We both live in North Thailand hours away from the hospital and doctor who preformed the surgery and there is no home help available along with the fact that when a patient is admitted to hospital it is not the nurses that tend to them but family members because the lack of help.He has lost so much weight and has only left the bed to go to the toilet with the help of a friend.He was considering traveling back to the UK for post op treatment and care but he is unfit to fly and now the doctor who performed the surgery wont clear him for travel nor chemotherapy.He cannot eat solids either so my question is this .I want him to begin to gain weight and I thought that a  high calorie diet is required such as whole milk and some milkshakes with fruit along with V8 drinks might help to give him what he needs but I'm fearful that this could be dangerous.We are pretty limited here for certain foods but if your suggestion can help me decide and work to get him on his feet again I would be very grateful for he has no one else and I work full time as a teacher.Yours sincerely AAAAA",
    "doctor_response": "Hi, it appears that if the patient is not on supports like oxygen, E.C.G.monitoring, stomach tube, and if he can walk with support usually the flight people may not have any objection, to carry him, any how enquire directly.                             You can give him proteine suppliments with milk, and juices of vegetables, for immediate energy. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which are the brain problems which may cause syncope?\n\nI have a friend who is a 59 year old male. He is diabetic but it is very controlled with metformin. He has been having blackouts and grey outs for months... at one time, we thought it was due to his sugars... as he recently lost (on purpose) 65 pounds. His primary ordered a CT scan of the brain. My friend received a call that the radiologist (not his doctor) wants to see him next week. Trying to support my friend, but not sure how to... to say he is freaked out is an understatement. Any thoughts on possible conditions? Good or bad... just would help to understand some possibilities that I can research so that when the diag comes... I know how to help him.",
    "doctor_response": "I welcome your concern about your friend.  As narrated by you the likely cause of these presyncopal and syncopal episodes may be autonomic dysfunction due to diabetes. Some elderly people may get such symptoms due to cervical spondylosis. But your main concern is the call by radiologist. As far as I know CT is not a good modality to evaluate for this. The remote possibility of some intraventricular SOL or posterior fossa mass may cause this postural symptoms. Another possibility is that his CT may have detected some other lesion not related to present complaints. But for know be assured, first diagnosis is the likely one. May your friend be healthy and you happy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat allergy mediated cough and chest tightness?\n\ni am allergic to cold and dust. nowadays i am suffering with breathing difficulty. firstly i will get cough then chest tightness following dyspnea.  that time i feel like somebody is tightly holding my throat . are these symptoms are  asthmatic ? kindly give me some solution for this",
    "doctor_response": "you are having allergy asthma is also allergic in almost 90% casesat present you can use short course of steroidswith tab montelucast 10 mg bdbronchodilator syp bd and anti allergic syp at night   after the episode is over get for allergy tests to find out allergensavoid avoidable allergens and treat dusts and others by sublingual immunotherapy as this is the latest known permanent treatment according to international research",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump on the left side of the neck indicate?\n\nHello, I am a 19 year old male and have had a lump on the left side on my neck right beside my Adam\u2019s apple for around 6 or so years. I have been troubling with constant sore throats and swollen tonsils and glands for about 4 months. Recently the lump started to hurt me on and off and swelled up a couple of times. I had an ultrasound on my neck about a week ago to see if it was a thyroid nodule but the doctor couldn\u2019t see any nodules and didn\u2019t know what the lump was. Could you try inform me on what it could be please?",
    "doctor_response": "Hello,The possible reason for such a lump is a cyst or lymph node in the absence of thyroid issue. I would strongly recommend consulting in follow up with the ultrasound report.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could vitamin D3 have caused elevation in liver enzymes?\n\nI am 61 years old and was diagnosed with Multiple Myeloma in December 2010.  I am currently on \"maintenance\" IV chemo of .9 Velcade and 4 mg Decadron IV weekly.  I also receive a monthly IV dose of Zometa.  I take Acyclovir 400 mg p.o. bid daily, EC Baby ASA daily and a multivitamin tablet daily.  Labs are checked weekly and had been normal until last week when I had an elevation of AST and ALT.  Bilirubin was normal.  The only difference from the week before was that on doctor advice I started taking Vitamin D3 2000 units daily.  I stopped taking that when I got the blood work results last Thursday.  I also noted that when I started taking the Vitamin D3 I did not feel well - more aches and pains and just didn't feel \"right\".  I attributed that to the Vitamin D3.  Could the Vitamin D3 have caused the elevation in the liver enzymes?",
    "doctor_response": "Hi.thank you posting your query at HCM.noted your history and medications prescribed.to the best of my knowledge, VitD3 supplements do NOT cause a rise in liver enzymes ( effect the liver).i advice you to visit treating physician to prescribe some blood test to rule out causes of hepatitis. ( viral causes, alcohol are most common causes for hepatitis). Certain medications may inure liver but NOT vit D supplement.if common causes are ruled out, then maybe the chemotherapeutic drug maybe causing the elevated liver enzymes. if the values are more than two times the upper limit, treating physician may change dose or the drug.Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .hope to answer your concern.wish you good health.regards,Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will PTB be transferred to the people i get along with everyday?\n\nI was diagnosed to have PTB minimal.. will you please help me.. I have never felt any symptoms before? My brother and my grandmother was diagnosed with the same result but they were cured already. I never stayed with them during their medication thats why i was shocked recently.. help me please thnx. Will this be transferred to the people i get along with everyday?Especially my partner?",
    "doctor_response": "Hi, I had gone through your question. I understand your concern. TB transmits mainly by air-born droplets when an infected person coughs. When someone breathes in these droplets which contain TB bacteria, they get infected. Not everyone who inhales bacteria develop disease. Whether someone develops TB disease depends on that person's immunity. Regarding if you can transfer disease to your contacts, depends on presence of TB bacteria in your spit. This is checked by testing 3 samples of sputum on consecutive days, looking for TB bacteria (generally called Acid Fast Bacilli). If your chest X-ray shows cavities (empty spaces in lungs), chances for presence of bacteria is more.   Anyway, more important is for you to start Anti TB medications at the earliest. Usually this is a 6 months course. Once you start treatment, by 2 weeks most of the patients become non-infective. Hope I have answered your queries. Thanks for using HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent blackouts, seizures, headache and stomachache?\n\nMy seven year old caucasion daughter has been passing out for the past year. She sometimes has seizure like symptoms (shaking and trembling of arms and legs) but not always. She often has a headache and stomach ache prior to blacking out. Sometimes she vomits before or after these episodes. Currently she has had a head ache, stomach ache and bloodshot eyes. She has had six blackouts in the past 16 months. She has had two EEGs, two EKGs, an MRI, a CAT, a heart echo, and blood tests. All have come out fine.",
    "doctor_response": "Hello, Have her doctors considered abdominal migraine as a cause? It is most common in kids from 5- 9 years old. Just like headache migraines, it leads to 'attacks' of 24-72 hours, with abdominal pain, vomiting and sometimes other neurologic signs. Please check with your Pediatric Neurologist. Just like regular migraines, we don't know the exact cause or mechanism.  Some people feel it is stress, others do not. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Lisa Baker, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart palpitations with headaches?\n\nHi, may I answer your health queries right now ?  Please type your query here...I am having heart palpitations all day even when resting..not \"attacks\" like for a few minutes but they come like heavy beats then stop then do it again randomly throughout the day. I am having daily horrible headaches even when I wake up. Pain in my ribcage that wraps around front to back and other random symptoms like leg pain and bruising.  I had bloodwork done and it was normal. i know something is wrong, I know my body. What could be going on? Im scared.",
    "doctor_response": "Hello!Welcome on HCM!Your symptoms could be related to different possible causes: chronic inflammation, cardiac arrhythmia, thyroid dysfunction, electrolyte imbalance, vitamin D deficiency, etc.. Anxiety can also mimic this clinical situation. For this reason, I would recommend consulting with your attending physician for a careful physical exam and some tests:  - a cardiac ultrasound to examine your heart function and structure- an ambulatory 24-48 hours ECG monitoring to exclude possible cardiac arrhythmia- complete blood count for anemia- thyroid hormone levels for possible dysfunction- blood electrolytes - Vitamin D plasma levels- PCR and ESR for inflammation. You should discuss with your doctor on the above tests. Meanwhile, I recommend you to closely monitor your blood pressure. Blood pressure fluctuations can trigger headaches. Hope you will find this answer helpful!Wishing good health, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for blood in urine after being treated for kidney stones?\n\nhi I am a 71yr old woman I have had kidney stones in 2011 I had them blasted now I have had my usual chec up blood found in urine again I have had ultra sound done and been through the tunnel found no stones but blood still in urine I am very concerned as I just lost my sister in august with bladder cancer last year previous to that a year earlier my brother died of kidney cancer , should I b e concerned of the same happening ton me .",
    "doctor_response": "Hello!Thank you for the query.Blood in the urine can be the first symptom of bladder cancer indeed. Especially if no sign of infection. But most probable reason of it are stones. Please note that stones can recur. And even if no evidence of stones in the ultrasound, some small stones can be present. I suggest you to consult urologist in that matter. Cystoscopy to rule out cancer should be done.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Unable to remember names. Prescribed pexep cr 37.5 mg. What is this medicine meant for?\n\nSir,my dad is not been able to remember names of people which irritates him.throughout the day.our doc has adviced to give pexcep Cr 37.5 mg so can he start taking this dose without starting with 12.5 or 25 mg plz guide me as soon as possible& can U also give me every single detail of these medicines& what they are meant for",
    "doctor_response": "Hi, Thanks for using healthcare magic. I have gone through your available history. Pexep Cr contains paroxetine which is anti depressant medicine with anti anxiety property. does your dad have any symptoms of depression like sadness of mood or decreased interest in surrounding pleasurable activities or somatic  unexplained complains??? You should consult qualified psychiatrist for detailed evaluation and treatment. He may have early dementia. So your doctor may rule out that. Doctor may also advise to go for blood investigations like vitamin B12 deficiency , thyroid dysfunction or diabetes etc. Treatment will be directed as per cause. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could taking MMR vaccination while conceiving affect the fetus?\n\nI am wondering what the results would be if I received an MMR and got pregnant? I am also wondering, I have to get the MMR for my job and I am also taking Metformin to stimulate ovulation. Do I have to stop taking this medication or do I just need to use a form of birth control for 4 weeks?",
    "doctor_response": "Hi,It is not safe to take MMR vaccine while becoming pregnant. As per the Center for Disease Control and Prevention, measles, mumps, rubella (MMR) vaccine, should be given a month or more before pregnancy because of the safety concerns. It can also be safe for you to take MMR right after giving birth, even while you are breastfeeding. If you need to get vaccinated for MMR avoid becoming pregnant until one month after receiving the MMR vaccine. So, in view of the above you may need to take birth control pills for at least one month after taking MMR. Metformin is safe during pregnancy hence it can be taken as prescribed by your doctor.Hope these answer your queries. Let me know if I can assist you further.Regards,Dr. Mohammed Taher Ali",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could left anterior hemiblock suggest?\n\nHello, I just found out through an EKG that I have a left anterior hemiblock. I m not sure exactly if that s serious or not. I was told though that I have a normal heart rate. The only problem is that I have this left anterior hemiblock. I m 18 by the way, I m about 5 11 and I weigh 140. Does having this left anterior hemiblock affect me in any way? Is it dangerous or serious in any way?",
    "doctor_response": "Hello There After going through your medical query I understand your concern and I would like to tell you that generally it is normal and don\u2019t cause any complications but better to get a Echocardiography done and consult a cardiologist personally for proper management.Hopefully this information will guide you properly.Kind Regards Dr Bhanu Partap",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling of electric shock in knee. Reason?\n\nHi ty for talking to me, I have had this shock feeling going on with my left knee now for a couple of months I have no ideal why, but its like a electric shock for a few seconds, then it goes away, it comes at no notice, & its so shocking I can't help but cry when I get them",
    "doctor_response": "Hi, Thanks for using HCM.Feeling like electric shock may be due to nerve involvement. I hope you are not taking any drug and no other disease/disorder. You can do regular proper exercise and avoid any unusual posture or pressure on that knee. Get done one EEG and EKG one to rule out any other cause. Consult your doctor once for examination and management.Hope I answered your question. Feel free to ask me if you have any further queries. Wish you good health. Take care.RegardsDr. Lohit",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for complete cure of cold of 4 year old\n\nmy 4 year old boy suffer from cold cough since one year after her typhhed vaccine doctor prescribed her medicine albutamol syrup kids pred antibiotic etc.when he uses medicine he cure but after ashort dureation relapse sneezing cough and cold.how he complet cure and what precaution should itake .",
    "doctor_response": "Hi,Thanks and welcome to healthcare magic.Recurrent cold occurs due to viral infection.It is difficult to promise complete cure.Antihistamine syrups usually give relief.I prefer Ebastine syrup to be given twice daily.Zn-20 5 ml daily for 14 days prevents recurrent cold.Steam inhalation gives immediate relief .Keep the baby warm and avoid cool atmosphere .Avoid cool drinks and ice creams.Hope this reply is OK for you.Please feel free to ask further queries if any.Dr.M.V.Subrahmanyam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes erectile dysfunction at the age of 30?\n\nI've always felt that I was healthy sexual wise. But, over the past 2 years or so, I've come across a situation 3 times when I was about to have sex and couldn't maintain a erection. I've noticed that this has happen in the midst of me waking up in the middle of the night to have sex like around 3am. Is there something I can do about this? And I'm 30 years old by the way.",
    "doctor_response": "Hi, It can be due to stress full night work, improper or excess fatty food. If your issue persists, you can think of investigation for hormones. Regular exercise and proper diet can help you. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will inlay sole helpful in correcting in toeing problem?\n\nGood afternoon Doc. My name is Andrea. I have a daughter age 7+. She has intoeing problem. We visited an ortho and he has recommended a specially made inlay sole to be put in her shoes. Its supposedly suppose to help her feet get corrected. Its not cheap either. Will this really work? Thank you. Andrea Gomez",
    "doctor_response": "Hello, As most foot correction cases need to be helped with the insoles as they help to avoid the abnormal transfer of the weight to the joints and leading to the abnormal anatomical position of the bones. If the orthopedist has advised for the same I will recommend undergoing the same. Also along with this doing hot water fermentation and feet muscle strengthening exercises is advised to activate the muscle groups which aren't activated and leading to abnormal weight transfer to different angles. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Irregular periods, tender breasts, variable pregnancy test results, spotting. Pregnant?\n\nHi We are trying to concieve been trying since last september, we both got tested 2 months agao and habbys sperm is good and blood tests say I am ovulating, have irregular cycles ranging from 27 to the longest one 41 which was last months, I actualy thought I was pregnant last month but all the tests i took came out negative and eventually i got my period on day 41 following tow 30 day cycles. this time I am on day 32 and my breasts have been tender for the past two weeks, I tested on day 28 and it was positive ( urine home test) then tested again on day 30 , one test was faintly positive and the other test i took was so faint i wasnt able to judge if it was apositive line or not.. i have just noticed some spotting today and have a doctors appointment for thursday, is it possible to be pregnant and bleed? ..my last menstraution ws actually three days long instead of my usual 4 days and spotting on the 5th day",
    "doctor_response": "Welcome to HCM.Mild spotting may occur even in pregnancy during cycle date.There is chances of pregnancy because urine test is mild positive.Ideal is after 7th day for missing cycle for urine pregnancy test.Wait  and do it again after 7th day.If pregnancy is positive and still spotting is there than you have to start hormone therapy under guidance of your doctor.Consult your gynecologist for further medical management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Arachnoid cyst in the posterior fossa of the brain. Oily discharge from the naval with pain, fever. Swelling in the brain\n\nI have many health problems. An Arachniod cyst in the posterior fossa of my brain. For a few years I have had an oily discharge from my navel which caused some pain,A burning sensation and very itchy. It would become red and irritated. It came and went. Have not had that problem for some time now. Doctors I saw could not tell me why. A couple said cancer but noticed no other signs of it.. Also my navel developed a crust. For the past year there has been the same smell behind my left ear. As of late; my right ear. They seem to become somewhat feverish, a burning sensation and also the itching. And then a swelling in my ears as well. At times it is difficult to hear properly. I have been told that the cyst in my brain causes swelling. In my lower brain, the back of my throat ,my ears and such. There is so much more. With what I hav told you, Can you possibly give me any indication as to what is happening to me? If you need more history I can provide of course. Thankyou.",
    "doctor_response": "Hi An arachnoid cyst is not likely to cause such symptoms. You may need a new MRI of the brain to see if there is something else going on. As far as your ear and navel problems are concerned, to will need to consult an ENT surgeon and a general surgeon. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yellowish color loose motion in an infant?\n\nHi , my son is  7  months old now, 2 months before he got diarrhea , that problem is under control now but he is suffering from loose motion since then, slightly yellow color & 4 to 5 times a day, he is not having any teeth till now, plz suggest somenthing",
    "doctor_response": "Hi...what your kid is going through is a viral diarrhoea. Usually it is a self limiting condition. Unless the kid is lethargic with sunken eye balls or has very low urine output or has blood in the motion or has green bilious vomiting you need not worry.I suggest you use zinc supplements and ORS for dehydration.  If any of the above red flag signs develop I suggest you rush to the nearest emergency room immediately.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I feel dizzy and light-headed when I stand up?\n\nDear doctor, I am a 54 year old male. I do not smoke or drink. I do regular exercises. For the last seven years, I was suffering from sudden sleep disturbance with following symptoms:  Breathlessness. Palpitation. Chest congestion.  I underwent the following tests: ECG, chest X-ray, echocardiography, exercise stress test, pulmonary function test, VIDAS PL, MRI scan of brain and sleep apnea test. All the above tests were normal. At last, I was diagnosed as having acid reflux symptoms and accordingly on doctor's advise I took proton pump inhibitors for about four months (Topacid 40 mg, Nexapro 40 mg, and Perinorm CD). The medication is discontinued and with the change of lifestyle (like light dinner, breathing exercise, etc.) I was able to control the symptoms effectively. But, occasionally I was experiencing irregular heart rhythms and on a medical Specialist's advise I took Prolol TR 40 mg for two months and after a satisfactory result, the specialist advised me to discontinue the medicine. Now, the present episodes (as described below) compelled me to seek opinion and advice. Occasionally, I am feeling dizziness, breathing difficulty on a lighter side, blurriness on the eyes, chest congestion, etc.These symptoms are quite evident when I bent my head while doing exercise (not always). Last week, while doing a breathing exercise on a sitting posture and when suddenly changed the posture by getting up, I almost fainted, but recovered instantaneously. But afterward, I felt weakness in the legs and arms, cold, breathlessness, etc. I play badminton for one to two hours daily without any problem. My B-12 and hemoglobin levels are satisfactory and BP is normal in the range 85 to 130 Hg for the last five years without medication. There is no history of diabetes or cholesterol.",
    "doctor_response": "Hello. I have gone through your details and I have the following inputs: First of all, you have gone through a lot of tests which were not needed in your case, but since everything is normal, that is reassuring. Your symptoms can be related to a few problems as I understand. The first one is, of course, GERD (gastroesophageal reflux disease) for which you have taken treatment. The problem with your treatment was - Perinorm is a medicine which is not used these days due to its side effects called as extrapyramidal symptoms. It causes dizziness and imbalance in some people. So, your present symptoms might be an after effect of that medicine. You should continue PPI (proton pump inhibitors) because once you have GERD, it would never get normal and the medicine should be continued for very long. You have mentioned that you have irregular heartbeats. This is a serious and complicated issue if this really is seen. You might be \"feeling\" this but if we can see this in our tests then this should be immediately treated. How to catch this? A normal ECG will not tell irregularities if it is sub-clinical or if it is occasional like in your case. We have to study the ECG (electrocardiogram) patterns of one full day continuously to find this out. So, go for a test called as Holter study to find if you have dysrhythmias of any kind and once treated, your symptoms will vanish. You have mentioned that you feel dizzy and faint when you stand up and then recover. This is a typical symptom of orthostatic hypotension which means, your BP falls as soon as you stand up and then the heart recovers it in seconds. This is a common problem and we need to find the cause for this. It can be age-related or organ related, or it can be due to a blockage in carotid arteries, etc. It is difficult to pinpoint the cause till we examine you and then the tests are done according to what we find. I would suggest that you take a print of these points to a cardiologist in your area and tell him to look for all this. You will surely hit the correct diagnosis and get treated easily. None of the above problems are tough to treat. Hope that was helpful. For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pulsating feeling in outer calf muscle?\n\nIt started when I began using the treadmill (fast walking). My right calf - on the outter side above the ankle flutters. It sometimes feels like it is bubbling or pulsing. What does that mean? It doesn t hurt but feels very odd. Now it happens when I just walk.....",
    "doctor_response": "Hi, Mostly it is nothing to worry about, this can be either muscle contractions, spasms, or arterial or venous pulse due to blood and circulation activation. Hope I have answered your query. Let me know if I can assist you further. Regards, Ayman Darrag, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any problem for taking higher dosage of Refzil-o?\n\nHello Doctor, My Son 6 and half year old. he his prescribed to give Refzil-o 250 mg, but I din't noticed that  i got 125mg from the medical shop. So inspite of giving 5ml I gave him 8ml. I couldn't able to contact doctor. Can you give me a suggestion.",
    "doctor_response": "Hi...it you have got a medicine at half strength of what your doctor has prescribed then you have been right. You can double the dose of 125mg strength when the kid has been prescribed a 250mg strength basically by the pediatrician.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the chronic lethargy in a child?\n\nMy 5 year old daughter says shes sooo tired all the time. her legs are tired. shes too tired to eat dinner sometimes. shes tired at school. its been going on for over 3 months now. and im starting to get worried because it seems worse now than it did 3 months ago. what could this all mean??",
    "doctor_response": "Thanks for consulting at Healthcare Magic.It is not uncommon for children to feel tired occasionally. However prolonged tiredness extending whole day needs clinical evaluation. Tiredness in kids might be due to Anemia low hemoglobin), lack of sleep, chronic allergy or asthma, heart diseases, type 1 diabetes, chronic infections etc. Most common cause is anemiaConsult your doctor. He will do detailed clinical examination and may ask some investigations like CBC,BSL etc. to confirm exact diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in lower back out of norm?\n\nI have lower back pain that seems to have come from no where. I don t think i should have done anything to have caused my pain. It feels stiff and i can feel a little bulge where the majority of my pain consists but touching it doesn t hurt ,only the area. Icyhot patches seem to calm the pain but it wont take away my stiffness. This has already happened 3x and i think it has past and it comes back out of no where.",
    "doctor_response": "I have understood your concern, as you mentioned your pain is recurrent in nature and this indicate that your muscles are weak not enough to provide proper strengthen to spinal segments and main thing is your siting and laying posture may give rise to chronic long term recurrent pain. you need to correct the posture. bulge may due disc impingement at spinal level. patches may give you pain relief but temporary. so my suggestion is to relive pain and stiffness at spinal vertebral level, you have to take physiotherapy treatment in form of IFT modalities and ultrasound treatment for localized tenderness is very useful. only physical therapy can cure problems permanently, need to take strengthening exercises with physical therapist learn many exercises which helps to give stability at spinal column. I hope you have satisfied with the answer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes allergic skin rash?\n\n2-3 weeks ago i started to break out randomly in hives. at first i thought i was getting eaten up by something or bitten but they keep appearing all over me. They look like quarter to nickle sized welts and itch like crazy. My boyfriend and I live together and he is unaffected so that is what makes me think they are hives. How do i treat them and should i be worried about it being something more serious?",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your history and would like to make suggestions for you as follows:1. There are many possible causes for hives such as bacterial/viral/parasitic infections, some drugs, allergies, physical conditions (temperature, sunlight, etc), thyroid disorders, immune conditions, etc etc.Hence, I would like to know many more details about your health, habits, nature of hives, response to drugs, any other medical conditions, etc.2. For symptom relief, I would suggest you to use antihistamines such as levocetirizine or cetirizine or hydroxyzine.3. Regular application of calamine lotion or moisturizer will help to improve dry skin and reduce itching.4. Please do not scratch the itchy areas as scratching aggravates itching.5. To identify possible cause, apart from detailed information, I usually suggest my patients investigations like complete blood counts, ESR, CRP, urine examination, stool examination, etc. I usually suggest investigations if my patients do not improve with regular antihistamines even after 6 weeks.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to prevent cancer?\n\nMy 1st pap was abn high risk HPV, biopsy was taken bengin, 2nd pap 6 months later still ACUS HPV positive 16,18 types detected. I was told no action needed until re-test 6 months.  Unfortunately I did not have a pap for over 5 years so at this point I am not sure how long this has been. At this point is there any treatment or surgery to prevent changes or cancer",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You have HPV 16 and 18 positive. So there is high risk of cervical cancer. You had 2 pap test negative and no test since 5 years. You should go for Pap smear test first. If it is still negative then no need to worry. just go for follow up pap test at every 6 months. If you Pap test shows any high grade squamous intra epithelial lesion or carcinoma then you should go hysterectomy accordingly. Consult  your doctor go for pap test and take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatments for blocked arteries with ejection fraction of 52%\n\nmy husband had heart attack 5 days ago ,had angioplasty immediately.He has 2 more furring up in arteries  Drs have said better to leave them alone but he is worried that he may have a sudden heart ttack as his heart was damaged during the heart attack.His ejection fraction is 52 %.Please advise",
    "doctor_response": "welcome to hcm ..please see the decision to intervene is taken by cardilogist as per angiography pictures ..if he is asking to ignore then let it be ..you just take proper medicines ..aspirin tablet and cholesterol drugs ..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will tylenol3 reduce the earache and a swollen lymph node?\n\nI had an affected tooth under a bridge that was extracted yesterday. Two days before I started with an earache and a swollen lymph node. The dentist gave me an antibiotic and tylenol3 and said the swelling should go away in a few days What do you think?",
    "doctor_response": "Hello,Thanks for writing to us,I would like to inform you that from the information that you have provided here states that swollen lymph nodes and pain was from an infected tooth which is now pulled out by your dentist.As the causative factor is now no longer present therefore a course of antibiotics for a week and tylenol 3 if you have pain will resolve all the symptoms.I will advise you to continue with your dentists prescription and see him after a week.Also you can perform warm saline rinses , or apply ice packs to reduce swelling.I hope i answered your query.I wish you good health.Thank youTake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Take medicine for high BP. Have high creatine levels. How to lower the level?\n\nAt age 72, a female who rides a bike 15-20+ miles 3-4 times a week with well developed muscles and was shocked when my cardiologist phoned, after seeing him for my annual checkup, and told me that my creatine levels were high and I needed to have an MRI done of my kidneys. What can I do to lower the level of creatine in my blood. I do have several cardio issues and have taken meds for hypertension since I was 50. I think I am unusually healthy and active; we eat no processed foods and limit red meat.",
    "doctor_response": "Wer you checking yr blood pressure regularlyYou cannot do anything to lower to creatBut you need to avoid drugs like diclofenac and other medications which r excreayed thr kidney and which can increase creat.Regardimg high preesures take goodantihypertenaives.Take nephrologist advice",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest tightness and numbness in arms when walking?\n\nI'm a 62 yr. old male, 5'9, 186lb's. No medical problems or history. Was diadnosed at a long time ago w/ Scheuermans disease ? not sure if I spelled it ok. My question is ; when I walk at times my chest tightens and both my arms go numb my whole upper torso sot of goes numb and I have to stop and get back to normal and I am ok. What causes this ?",
    "doctor_response": "Hi and thank you for choosing HCM to post your question.I read carefully your question and my opinion is as follows:The characteristics of your pain,(tightness sensation,localization in chest,radiates on arms,precipitation by efforts ,relieved by rest) ,your age,make me think about angina pectoris.It is usually due to atherosclerotic heart disease but may also occur as a result of severe myocardial hypertrophy,severe aortic stenosis,or in response to increased metabolic demands as in hyperthyroidism,marked anemia,If I was your treating doctor i would order as first diagnostic tools:ECG,Exercise ECG to look for evidence of ischemia  during pain or stress testing.I hope my opinion is helpful to you.Wish you good health.Kind RegardsDr Dushi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain on lower stomach, bloating, felt like pulled muscle. Remedy?\n\nI have this pain on lower right side of stomach,like above the beltline or kinda like under the stomach to the right. Sometimes it doesn't hurt as much,but some days I have to lay down and cry. When it first happened 3 weeks ago I thought I pulled a muscle since I got up kinda fast. Also my stomach has just gotten bigger and I haven't been eating as much.",
    "doctor_response": "Hello,The symptoms are consistent with Acute gastritis.(Inflammation of the stomach).You may take proton pump inhibitor like omeprazole. This will reduce the gastric acid secretion and improve your symptoms.Avoid fatty and spicy foods, caffeinated and carbonated drinks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long will it take for the wheezing to go in a child?\n\nmy daughter has wheezing problem she is 8 months old and i am giving her nebulization when it is severe, or else i apply vicks on the chest and throat and as the day progresses it goes off but every morning she has this problem. How long will this lasts?",
    "doctor_response": "Early morning cough is a sign of asthma.since she is only months old she cannot be branded as asthmatic.as per current guidelines she falls into transient Wheezer category.she may he treated with drugs like montelukast and sos nebulization.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the specific health issues that occur during periods?\n\nHello doctor, 1. What are some health issues that can crop up during the period? Please explain why this might occur, and if there is anything to prevent it? 2. What specific health issues might be more common during the period? How to keep healthier during this time of the month?",
    "doctor_response": "Hello. Usually, periods are associated with abdominal pain, nausea, vomiting, body pains, headaches, irritability, lack of concentration, mood swings, susceptibility to allergies, cold. All these symptoms are because of the hormonal changes. Yoga, lifestyle modifications, deep breathing exercises, plenty of oral fluids, fiber-rich diet, Multivitamin supplements will help you get relief from the symptoms. Avoid smoking, alcohol, caffeine intake, junk, and spicy foods.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is 83% oxygen levels a cause for concern?\n\nWe have been on vacation and my 3year old daughter developed a cough and a fever. We just got home this evening and as soon as we walked in the door I tested her oxygen with our %SpO2 (pulse oxcimeter, my 9 year old has really bad asthma) level. It ranged around 89-91%. She is sleeping now in our recliner while I am on the couch constantly watching her oxygen level fall. It has been sitting at 83 for a while. Should I wake her up and take her to the ER or just take her to our doctor first thing in the morning??? It is 3:09am here currently, what should I do??? Tracie",
    "doctor_response": "Thank you for the question Tracie.Your concern for the younger one is understandable.Her O2 level while she was awake was normal, and now also it is within normal range. Quite possibly this is because of shallow breathing during sleep.It is advisable to keep a watch and if the fluctuation is not going down you may wait, If she is comfortable then take it easy.If it keeps declining then take her to ER.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe leg pain\n\nHii doctor this is ilaa I am 29 years old and I have been suffering from leg pain, joint sprain. I do gyminng also but not able to do every day because of pain in my legs..I had vitamin D deficiency when I got it checked level was 7..it s been two years. That time I took treatment and got ok..but now I think I am getting this problem again.i want to know good protein powder for my health and nutrition not for weight gain nd ..plz suggest",
    "doctor_response": "Hi welcome to HCM,I have gone thru your query and can understand your concern . Dear,Illa  for your info , the patients ,who come to me for similarr problems , are advised ,till recovery , not to induldge in gyms or any vigorous workout which can further damage the joint and an xray is advised to ascertain the depth of ijury ,so that proper treatment is given .All I have to suggest you is ,to get yourself checked  again , to get treatment as before  . You may have vitamin D deficiency . And for your info , I don't believe in prescribing much of the supplements, until and unless very essential .They work only if your immune system is strong .Finally , Best way to keep fit is to boost your immunity by modifying your   lifestyle  and  food habits . Do Proper regular physical activity , walk ,yoga ,pranayam - deep breathing  to boost your blood circulation and detox  your system under  guidance of  trained   guide and  balanced  diet, including  ,all essential  nutrients as fiber ,vitamins,minrals and antioxidants  in natural form all help gain resistance from dseases .Meanwhile ,take Turm\u00e9ric powder , an antioxidant and antibiotic ,a level spoon with a cup of hot milk in b/f  and at bedtime , gives relief from pain and inflammation .Apply an analgesic  ointment on the painfull part and wrap crepe bandage ,for instant relief  . 30 minutes sun bath is very good source of vit D ,Lemon juice with warm water ,a pinch of salt and black pepper is an effective antioxidant and energiser .Avoid food that is high in saturated or trans-fats like fried , fast foods , refined sugars and fine floor prducts , tea , coffee , alcohol , sleeplessness , dehyderation , constipation .worry ,stress all induce toxins in your body .It is advisable to consult your doctor before following any regimeHope this helps solves your query .Take care , All the best .Don't hesitate to get back if have any further query",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a skin cut on the penis be treated?\n\nAbout 2-3 days ago during sex my frenulum ripped and there was a lot of blood but not a lot of pain. I am uncircumcised and so far the cut has a scab on the upper part of the cut and i think it\u2019s healing but besides that the inside of my foreskin that\u2019s usually on the outside when I pull the skin back Is swollen do I put ice on it or leave it for it to go down also what do I do about the cut can I just clean it and let it heal overtime.",
    "doctor_response": "Hi, I have gone through your question and I understand your concerns but please apply warm compresses on the wound along with an antibiotic ointment three times daily to fasten healing and prevent infection. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of bed wetting?\n\nmy boyfriend is wetting the bed at 17 years old . he s a very deep sleeper and smokes weed. I wake up every morning to wet covers and sometimes even my clothes are wet. he seems to wake up in the night and change so he knows he s doing it . I don t want to say anything to him because I don t want to embarrass him :( help",
    "doctor_response": "thanks for your querythe problem of bed-wetting may be cause of weed he smokes. try to convince him to leave that habit gradually and advise him to pass urine before going to bed. please share this issue with him so that he realises and quits weed.if this doesnt workout there are drugs for bed-wetting. consult nearby dctor and get the treatmentthank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bump on shoulder after falling and suggest treatment?\n\nhi, i fell on my shoulder about 4 months ago, i thought i broke it but i was still able to move my arm... i waited a few days and it got better. i waited longer and it went away but left a bump on my shoulder (like a bone) it doesn t hurt when i move it around but it kills when i try to lift up weights. what can it be? do i need surgery?",
    "doctor_response": "Hello,The symptoms seem to be related to a separated shoulder. The\u00a0shoulder\u00a0blade  actually moves downward from the weight of the arm. This creates a\u00a0bump\u00a0or bulge above the\u00a0shoulder. The injury can range from a mild sprain without a\u00a0bump\u00a0to a complete disruption with a very large\u00a0bump. I suggest to do an X-ray of the shoulder and see an orthopedist for further evaluation.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can sacroiliitis be cured?\n\nI had a bone marrow biopsy for megaloblastic anemia in september 2017. The site got infected and I couldn t move. After a month recd antibiotics for infection. Now on sulfasalazine 1000 mg day and night.MRI and x ray diagnosis bilateral sacroilitis. Will it affect other joints and is it curable. Anemia is now cured. Will this medicine make me prone to infections as it is immunosuppressive. Please help. When I take medicine there is no pain but after stopping for 12-15 days it starts paining.",
    "doctor_response": "Hi, You are suffering from ankylosing spondylitis. Bilateral sacroilitis is sign of this disease. It is one type of chronic inflammatory arthritis affecting large joints. It may spread to involve both hip joints and knee joints. Progress of disease varies in different patients. In long standing disease hip and spine joints may get fused. Please visit rheumatologist for detailed examination. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes inconsistent feeling despite treating hydrocephaly with a brain stent?\n\nHi my father had a shunt placed in his brain for hydrocephaly on Feb 10th and showed immediate improvement like a switched had been turned on and continued to improve in gait, incontinence, clearness, etc. He continued to improve until February 27th when like a switch going off he immediately went into decline. We went to his Dr and he increased shunt flow which had not effect at all and has declined rapidly since. The doctor felt there was no chance that there was a blockage in the shunt but other people we know with a shunt who had experienced the same symptoms tell us that it is possibly a blockage as was with theirs. What do you think?",
    "doctor_response": "Hi, your father had normal pressure hydrocephalus for which VP shunt was done .He showed initial improvement followed by decline.This could be due to blocked shunt  , dementia due to NPH or  some other cause .He requires proper evaluation  and repeat CT head should be done  to know whether shunt is functioning well or not .Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does the right side of my chest hurt when I bend over or apply pressure?\n\nHi, I am experiencing pain in my chest on the right side below the breast area. Right now the pain only occurs when I m lifting my leg and reaching with my arms, trying to put on socks or shoes, which causes some pressure in that area. The pain last, probably less than a minute but is pretty strong.",
    "doctor_response": "HellAs you explain the situation this might from the ribs probably an osteochondritis.Try painkillers for up to two weeks such as Ibrufen orally.RegardsDr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for cold and cough in a child?\n\nDear Dr. My son is 2.8 years old and he gets Cold and Cough very frequently and ofcourse sometimes fever as well. I came to know one of my friend to give Montek Tablets. Kindly let me know if this ok to give him with zero side effects and how many days this needs to be given. Thanks & regards, Mahboob",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Greetings from Chennai.By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze. I have a few questions for you -Questions:1. How many days per month does he cough or feel breathless?2. How many nights per month does his sleep get disturbed due to above symptoms?3. Does he feel breathless when he runs around or plays with other kids?4. Are the symptoms when there are seasonal changes?5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?6. Is the cough always associated with fever?Please get back to me with answers so that I can guide you better.You can approach me at the following link.Once the page opens there will be an option below my image as \u2013 ASK ME A QUESTION \u2013 click on it.Please find the link below -www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cracking sound in bones?\n\nI m 20 years old and my bones see always cracking for instance when i stand up when i move a certain way sitting down an even if i turn sometimes when walking my knees or hip will pop it doesn t hurt or cause discomfort but it is loud an alot more than i think is normal",
    "doctor_response": "Hello,The cracking sound is actually ligaments snapping over bones at the joints.In moderation, it is not a problem, but if it is persistent, it can cause joint problems later in life. Stretching exercises should help to reduce this.All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does chronic myelogenous leukemia cause internal bleeding?\n\nMy husband has been diagnosed with CML.  He is on gleevec and it is working well, however, when he had submitted a stool sample (before being diagnosed) it came back with blood in it.  He is going for a colonoscopy and upper GI test.   My question - does CML cause internal bleeding, and does being on gleevec help or hurt this?Thank you,Susan",
    "doctor_response": "You have not mentioned whether your husband was in chronic phase or accelerated  phase at diagnosis.Chronic phase CML is unlikely to be associated with bleeding from gastrointestinal tract (GIT). Colonoscopy is the right way to proceed to look for a pathology in colon or rectum causing the bleed.Accelerated phase CML can be associated with bleeding from GIT and in that case Gleevec is likely to stop the bleed by improving blood cell counts.Please discuss it with your oncologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does below MRI report indicate? What are the treatments required?\n\nSir,Iam suffering from shoulder neck pain for a pretty long time.Recently i am having pain in the right side of of brain above head followed by pain in the eye.MRI {P+C) report says Tiny T2 hyper intensefoci in bilateral frontoparietal subcortical white matter suggestive of ischemic foci.sir,what does this mean .any treatment required and if so what is your advice?",
    "doctor_response": "Hello!Thank you for asking on HCM!I carefully read your question and would explain that your MRI report indicates the presence of small strokes in both fronto-parietal lobes. These findings can be related to different disorders: - migraine - small vessel disease- an inflammatory disorder, etc.. That is why, I would recommend consulting with a neurologist for a careful physical check up and some tests: - a cardiac ultrasound - an ECG Holter monitoring to exclude possible cardiac arrhythmia- a Doppler ultrasound of the cervical arteries to investigate for possible narrowing- blood lipid profile- PCR and sedimentation rate for inflammatio- complete blood count for anemia- fasting glucose for diabetes. Meanwhile, I would recommend taking aspirin 80-100mg daily. Hope to have been helpful!Greetings, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does spotting and cramps indicate pregnancy?\n\nHi, I was intimate with a guy just over a week ago, he was wearing a condom and I am on the combined pill, He didn t enter me but he was around that area and I m not sure if he came, we were interrupted I just got paranoid. A few days later I forgot to take my combined pill and have spotted since twice and have been having bad cramps. I took a pregnancy test a week after the incident, and it was negative, but I know tests dont really work a until about 4 days BEFORE the next period and I had mine before the intimacy. Is there any chance at all I could be pregnant..",
    "doctor_response": "Hello dear,I can understand your concern.In my opinion the chances of pregnancy are rare because you both were protected ie.,he was using condom and you were on combined pill.Moreover true intercourse did not occur as he did not enter into the vagina.So there are rare chances of pregnancy.And missing the pill a few days later might not effect this intercourse.If you had any unprotected sex during the missed pill time then it might pose risk for pregnancy.I suggest you to do a urine pregnancy test a week after missed period for accurate results but not before the expected period.So relax.Avoid stress and check for the period.Best regards...gynecologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for decayed or broken teeth\n\nHi Doc, My name is Nitin. I am a 27 year old male. I have some serious problems with my teeth and I need some advice, I have only 14 teeth in my lower jaw and 13 in the upper one. Almost all these teeth are either broken or decayed. Could you please give me a suggestion of what can be done to get back my smile?",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. As you are mentioning that many of your teeth are missing and now the rest are decaued or broken, it looks that you might be having a defect in enamel of dentin of the tooth, these are the component of tooth structure. In this case just treating the decayed teeth is not the solution, you have to get an OPG done of your jaw, which will show the cause of this,  then get the rest teeth restored with topical flouride application on the teeth and then at the end get a full mouth rehabilitation, means get crowns on the remaining teeth.Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for arthritis foot pain\n\nmy husband has been told that he has arthritis in his foot joint. His shoulder and back have been hurting also. now he has a knot on his finger. he can t sleep with out taking a bunch of pain meds. sometimes that doesnt even help. he can t get into an arthritis dr. until july 22. don t know what to do for him. he s in constant pain. it seems like it keeps spreading. don t like him taking so much pain medication. don t know where to start.",
    "doctor_response": "Hello, I have studied your case with diligence.There is possibility of polyarthritis.Rheumatoid arthritis may involve small joints and early morning stiffness in joints, does she have such complain?Ankylosing spondylitis typically involve spine and hips with other large joint also. There is reduced chest function in this disease. Stiffness in spine is increased does she have such stiffness in spine? NSAIDs, DMARDs (disease-modifying anti-rheumatic drugs) are sometimes prescribed in more severe cases. These include methotrexate and sulfasalazine.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "what can cause stomach aches and bad odor in abdominal area ?\n\nwell lately my daughter has belly aches and today she told me she had notice a bad smell down there.",
    "doctor_response": "Hi,Kauffmanb, Thanks for query, She might have some infection in her genital tract. Go for vaginal swab test and ultra sound. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How To Overcome Sex Addiction?\n\nhello sir i am 15 and i am sex addict from 2 year and i want to overcome this addiction how can i do that and also this addiction causes pimples on my face tell me solution for that shell i eat fruits",
    "doctor_response": "hi mujtaba , can you be more specific as to the meaning of being a \"sex addict\" . as for the need for food and sports and other activities that give us pleasure ; the need and drive for sex also varies a lot between humans.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a hard lump on the sternum\n\nI have a hard lump about 3 inches in length and about 1 1/2 inches wide on my sternum, but also finding little round lumps on other parts of my body. Didn t show on my xray and have had swollen lymph nodes for years. My birth mother had non hodgkins lymphoma can it be hereditary.",
    "doctor_response": "hi.i advise you to consult with a physician for complete medical history and physical examination. based from your description alone, one could not say if it's lymphoma right away, unless there's a tissue diagnosis/biopsy done. diagnostic evaluation and management will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause irregular heart beats to 72 year old?\n\nI just had very very heart beat in my chest lasted approx 15 minutes - it has calmed down but now I'm scared.PS I am 72 years of age - I was bending to put something in the oven = I put my feet up very high now I just have a pain in my left shoulder - I do have neck problems.",
    "doctor_response": "Hello!Thank you for asking on HCM!Your symptoms could be related to a cardiac arrhythmia. I recommend going to the ER for a careful physical exam and some tests: - a resting ECG- a chest X ray study- some blood lab tests (complete blood count, cardiac enzymes, blood electrolytes). Hope to have been helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is moving around while having bad balance and numb feet after stroke at the age of 82 yrs advisable?\n\nI am 82 year old male, active all my life until 4 years ago had a minor stroke left side weekness, my balance is bad, my feet are numb and tingling. I do very little to no exercise since my stroke. my hands and feet seem cold most of the time. My wife says it is circulation and I need to get my body moving. can you help",
    "doctor_response": "Hi, You should do vigorous exercises for left side weakness because no exercise would increase spasticity and contractures.You should take antiplatelets , low fat diet ,active and passive exercises and regular follow up with neurologist. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic obstructive pulmonary disease\n\nHI! My sister n law is on life support. She has COPD and has in the past taken pills, some subscribed and others that people gave and sold her. She is not breathing on her own and is on life support. She has had surgery to have a trake put in. She is now at a rehabilitation center but still on life support. What are her chances fro survival? She is stable that is good sign, right? prayers welcome in Commerce, Georgia...",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. COPD patient on life support with tracheostomy in situ is not a good sign as far as survival is concerned. COPD patients have dramatically reduced lung volumes. So functions of lungs are drastically compromised. This is the reason for need of life support system. Life support itself has many complications like infection, barotrauma etc on long run. So by keeping all these in mind, survival rate for your sister is very very low. Hope I have solved your query. Wishing good health to your sister. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen and bruised legs\n\nA bad fall several days ago left both legs severely bruised (one more than the other). Now experiencing burning sensations where the bruises are in addition to rather bad swelling of both legs. Been to the walk-in. They gave generic vicodin and told me to ice them 3x/day and try to stay off my feet. But the swelling hasn t gone down at all.",
    "doctor_response": "hi,thank you for providing a brief history of you. as you mentioned all proper guidance have been given to you with perfection. For swelling I will recommend you to just keep the legs on the pillow while you are lying down. in that position you can do simple ankle toe movements as long as you can do and as long as you can repeat in the day. icing will also help to heal the wound and reduce pain as well.with the grace of God I wish you a speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lump in left knee\n\nsmall lump behind left knee. Believe it s been there for 7 months post schleratherapy. Will it go away on its own or do I need it drained? Could it be a bloodclot. It feels somewhat close to the surface by adjacent to a tendon so it bothers me since I can always feel it.",
    "doctor_response": "Hi, If the lump has occurred after a Sclerothrapy then it is most likely a thrombosed varicosity. A vein which was sclerosed has a clot in it which is the desired effect. Did you use any kind of Compression after the therapy. You should use compression to decrease the swelling. If it is not red and painful then it does not require drainage. You should use compression in the form of Crepe bandage or Class II Compression stockings. It should get resolved with that. Otherwise, you can see your Surgeon who can have a look at it. Do not worry.It would be alright.Take care, Dr Rishi, New Delhi, India.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is enterococcus faecalis transmitted through sexual intercourse?\n\nMy 70 year old male friend who is diabetic has had a few UTIs which they are now treating a second time with Cipro.  He was told it is enterococcus faecalis.  He has had the same partner for 3 years. He is asking:  Is this transmittable through intercourse or oral sex?  What is best antibiotic for this bacteria? Thank you.",
    "doctor_response": "Hi, Enterococci are most commonly transmitted due to poor hygiene. Since it is naturally present in the gastrointestinal tract, E. faecalis is found in fecal matter. Improper cleaning of items containing fecal matter, or not washing hands after restroom use, can increase the risk of bacterial transmission. Everyday objects such as telephones, doorknobs, towels, and soaps can also contain E. faecalis. The bacteria can spread throughout hospitals if healthcare workers do not wash their hands between patients. If not thoroughly cleaned, catheters or dialysis ports can also transmit infection. Enterococci are eradicated with a combination of certain cell wall\u2013active drugs (e.g., penicillin, ampicillin, amoxicillin, piperacillin, vancomycin) plus an aminoglycoside (e.g., gentamicin, streptomycin) is used to achieve the bactericidal activity. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. AJEET SINGH, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is on a guy's mind when he gets very possessive about me?\n\nHi, I am Rose. I have a close friend. He is younger to me and was calling me as his sister in the beginning. But ..as days go, he started becoming very possessive. Now, I have a doubt whether he still considers me as his sister. Now, I dont know what should I do. I want to know what is in his mind.",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.Relationship issues are very complex and its not possible to understand what is going on in ones mind unless one speaks it out. If you feel so then you can take him to a psychologist or a psychiatrist who can discuss these issues with him.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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can emboli form as a result of chemotherapy?\n\nHi doctor, The patient has stage 3 rectal cancer. He had brachytherapy radiation last summer. Through surgery, they removed the rectum, surrounding mesorectal fat and involved lymph nodes. Pathology declared radiation to be a complete response and no cancer found. FOLFOX chemo has begun before 14 months for every two weeks to prevent metastatic cancer. Patient also has an aneurysm in his ascending aorta of 5.3 cm which was initially found on a CT scan due to the cancer. Plan is for repair of the aorta. A chest CT scan with contrast was conducted last week in order to follow the growth of the aneurysm that left the following impression.\u00a0Multiple bilateral pulmonary emboli involving the left lower lobar pulmonary artery, multiple bilateral segmental and subsegmental pulmonary arteries.\u00a0Patient has no history of emboli. Multiple scans prior to surgery did not reveal such, so these seem to be the result of either the surgery or the chemotherapy itself or a combination.\u00a0Patient has since been put on 1 mL injections of Lovenox, morning and night. He has infusion of FOLFOX scheduled for this week. This will be round 11 of 12 in total. Patient has two upcoming surgeries planned for this summer. The ileostomy reversal and the repair of his 5.3 cm thoracic ascending aorta.\u00a0We were hoping to hear the recommendations in regards to proceeding with the infusion as a result of the most recent finding. Will further infusions slow the reabsorption of the emboli and thus delay necessary surgeries?\u00a0Thank you for your help, expertise and insight.",
    "doctor_response": "Hi. Based on your query, my opinion is as follows: Chemotherapy and bed rest. Can continue chemotherapy along with Lovenox. 1. Continuing Lovenox is essential. Watching for any bleeding is necessary. 2. Regularly evaluate respiratory function along with patients PTT (partial thromboplastin time) and APTT (activated partial thromboplastin time) or INR (international normalized ratio) to avoid risk of bleeding due to anticoagulant therapy. For further information consult a hematologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure aggressiveness and anger?\n\nHi I have a friend that no longer is my friend she got mad at me about something but won t talk to me about it. I think she may have a medical problem or mental problem. We do private care and a company is in there to. She has the family convinced she is the only one that does any thing. She is always saying something is missing and some one is steeling. She aims it at me. She isn t there at same time others are there to put blame. She is always moving something or rearranging something. For instance last Wednesday I noticed that the dish rags and towels were awful low just thought they were in laundry but they weren t . I never called her or family. But she has made a big deal out of it and it s been aimed at me. One minute she is talking to me like we are still best of friends then the next day she has flipped on me. Her additude as totally changed. I feel like she is trying to get me fired but hasn t gotten that close to family yet. It seems like if you tell family about something going on with their parents they call her and ask her about it and if it not happening with her they do nothing about it. I can not be the only person stuff happens with. She has them Bufflowed. I am very worried that there may be something medical going on. I was trying to make this short but that didn t happen sorry. Can you help me with what I have given you.",
    "doctor_response": "HIthanks for using healthcare magicThe way, i have described her symptoms, it looks like she has underline psychosis and she needs psychiatrist help. Better to take her to a psychiatrist for proper evaluation and management. Medication in her case depends upon diagnosis that will be done by psychiatrist .Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a leg wound with pain and pus be treated?\n\nHello, I have a wound on my leg that is in its 3rd week and still shows no sign of healing. Two days ago the area around the wound started to hurt more and have some puss in it. Now today I woke up and I can barely walk due to the pain in my thighs and calf in both legs. What would be teh cause of this and should I go to the ER after work tonight?",
    "doctor_response": "Hello,I have studied your case. It would be better if you go and see emergency. Non healing of the wound can be due to following reasons.1.Diabetes2.Infection3.Varricose veins or neuropathic ulcer4.Smoker and alcoholics   So you need to find out the cause why you are having this problem and than you can get treatment accordingly. I hope this answer will be useful for you.Let me know if there is any other followup questions.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could red bumps on back with puss suggest?\n\nHi there I have a bump on my back which isn't red or sore or anything but keeps filling with almost solid White pus. Every time I squeeze it, loads of the pus (which has a very cheesy smell to it!) will come out and it will flatten. You can still feel a slight bump there though and within 6 weeks it refills again. It's not painful at all but it is annoying!",
    "doctor_response": "Hi,Looking to the history, draining white cheesy material with refilling again indicates that there might be having infected Sebaceous cyst giving this problem.Consult surgeon and get examined.It might require excision of cyst with complete removal of sac.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "4 years old diagnosed with myoclonic seizures. Reason for puking?\n\nMy 4 yr old was just diagnosed with myoclonic seizures. Last week he puked for two days and wouldn t eat for the following three days. Then finally the next day he acted as if he was starving and cried to get something to eat. When he ate he wanted more. If I gave him something he didn t like he would cry and scream at me. Even hit me a couple of times. Is this due to the medicine or some virus?",
    "doctor_response": "hi brittanyclodfelter , I Have read your Question, Myoclonic seizures is a case where generally doctors prescribe a medicine known as sodium valproate  (since you have not mentioned the drug prescribed , Iam assuming it could be sodium valproate), The medicine is suitable for everyone and it could show a few side effects like , diarrhea, vomiting, aggression and behvioural changes as you mentioned above, but sometimes empty stomach , the constant vomiting could also be the reason for irritation as you stated. My suggestion is to consult your Physician or neurologist  immediately for the further advice. Wishing your son  a good health, Dr.G.Gayatri Devi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pericarditis\n\nHi, may I answer your health queries right now ? Please type your query here... \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0my boyfriend is 22 and has had paricarditis and now he always hurts in the chest and ribs his hands sweet aloot and is week and tired alot there are times in hips that hurt",
    "doctor_response": "Hello There After going through your medical query I understand your concern and I would like to tell you that for pericarditis your boyfriend needs to consult a cardiologist because he requires A set of antibiotics and some basic cardiac evaluation.Hopefully this information will guide you properly.Kind Regards Dr Bhanu Partap",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cyst in kidney\n\nhi my mother is suffering from CKD. She has been found tested for KFT and kidney clearence test was to be 12.7%, S,creatinine is 4.6, Blood urea is 89.6. She has been diagonised with two cysts in one kidney and has got partial loss of CMD in another kidney. she is now taking medicines.please tell me about recovery of kidney for proper functioning using medicines? what are the chances ?",
    "doctor_response": "HelloThanks for query .Based on the facts that you have stated your mother has Chronic Paranchymal Kidney Disease and she has been detected to have two cysts in her kidney .The cysts that she has are congenital in origin and does not need any active treatment .As regards her CKD .It is a progressive and  irreversible disease .Consult qualified Nephrologist for proper control of Serum creatinine levels and has to be under his guidance to maintain kidney function at optimum levels of serum creatinine .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Shaking legs while sitting, walking when tensed, unable to sit for long duration. ADHD?\n\nI am 22 yr old male. I study in college and have always been good in studies. I can t stop shaking my legs while I am sitting. I don t feel comfortable sitting for long duration and I start walking especially when I get tense and don t seem to have a lot of control on it. Also I find my attention wandering off unless I am working on something that requires urgent attention. I have started to think I might have ADHD , I had these symptoms for years but i never thought they could point to a condition. Is it possible I have it? If I do, do I need to do something about it.",
    "doctor_response": "Hi, Welcome to HealthcareMagic Forum Considering your age and nature of symptoms, I would consider possibility of anxiety disorder first in your case. Common symptoms of anxiety which may or may not be present in your case: nervousness, restlessness, mild irritability, excessive worry regarding own health, tremor, muscle spasm, heaviness in body, easy fatigability, headache, sleep disturbance, palpitation and dry mouth. Out of them you mentioned restlessness, tremors and poor concentration. These symptoms increases during stress. As you have symptoms for years then possibility of ADHD need to be ruled out too by examination by psychiatrist. Till you meet psychiatrist, following simple measures will help you: -Healthy diet: Milk and fruits in diet. -Daily morning walk -Breathing exercise, yoga and meditation (which you can learn from some expert in person) Wish you Good Health and all the best. Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I want to buy some medial device to prevent snoring during sleep. Please help.\n\nHello doctor, I want to buy some equipment or medial device to prevent snoring during sleep. It should be safe and be able to buy online, preferably FDA approved.",
    "doctor_response": "Hello. Snoring while sleeping is usually associated with sleep apnea syndrome. Sleep apnea is a sleep disorder in which pauses occur in breathing during sleep. Symptoms usually occur due to obstruction of the airway.For the treatment of snoring, we have to treat the sleep apnea first. Few such devices which I would suggest are: Before purchasing them, do consult a sleep medicine specialist in person for clinical examination.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for recurrent vaginal yeast infection before menstruation resumes\n\nHi I keep having reoccurring yeast well at lease that s what my doctor said. I m tired of going to the doctor. It happens every month around the time my period is dew, it s itchy the discharge is white and clumpy and I urinate a lot each time I go to the doctor I get medication it disappears until my next cycle",
    "doctor_response": "HI, thanks for using healthcare magicThere are some women who do have yeast infections before or just after each period due to changes that occur in the vagina at this time.You can try to reduce the other risk factors such as tight or occlusive clothing, rule out diabetes or other causes of decreased immune system.In some women the use of probiotics help to decrease the frequency of these infections, it may work for you.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. l got a sore hard lump after the removal of wisdom tooth. Is it normal?\n\nHello doctor,I just got one side of my wisdom teeth removed both upper and lower six days ago, and I have another one scheduled after two days for the left side. The upper is 100 % fine, which they pulled. The lower they pulled the tooth without removing the root because it was too close to the nerve. I do have some stitching in this area currently on the lower cheek. Noticed a hard lump about 1 inch between my lower jawline and cheek area. Is this normal because of swelling or something else. Currently taking Amoxicillin 500 mg and Ibuprofen 600 mg. Please let me know what this hard lump is, also generally on the lower side where this lump is, remains sore.",
    "doctor_response": "Hello. The lump is mostly a hard swelling which forms postsurgical removal of the wisdom tooth or maybe even by swollen lymph nodes due to infection. It takes a week or two for the swelling to subside. Sometimes, if the root is still inside, the infection may be remaining there causing swelling. Get an X-ray done to find out the exact problem and stronger antibiotics like Augmentin (Amoxicillin and Clavulanic acid) along with a painkiller for a week. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am a male suffering from infertility. Please advise.\n\nHi doctor, I am a 30-year-old male suffering from infertility. Recent semen analysis test shows no sperm found in semen, FSH- 0.08, LH- 0.02. Total test 3460.80 results. What should I do?",
    "doctor_response": "Hi. You are suffering from azoospermia. Pre and post-testicular azoospermia are frequently correctible, while testicular azoospermia is usually permanent. Go for serum prolactin level, a testicular biopsy may be required to find out the exact cause so I would advise you to consult local urosurgeon as physical examination is also required.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of sexual anhedonia?\n\nMy name is rohan I m 21 .single. weight is 55 kg and height is 5'10...never had a sexual vaginal or oral inter course....masturbating from 1year and 9 months.earlier I first saw porn when Internet broadband connection was taken at my home on jan 2012 aftr few mnths I first masturbated.i was so amused by the feeling of orgasm that I started doing it daily.sometimes more than 1 time.while watching porn.i got porn addicted. and during watching porn I use to masturbate.times went on.after 3 months the frequency decreased.2 times a week.in may.but during October starting.i got a huge depression in my personal life.so when ever I feel depress I masturbate to feel relief this continued till october this year when I realised its no longer that mental pleasure I used to have its just all physically rubbing of penis to ejaculate.no orgasm.as I got used to it I keep doing it. not enjoying the act anymore.earlier I used to HAVE ORGASM EVERY TIME I EJACULATE ......not having pleasure of orgasm anymore.very worried. plz help.will I be able to enjoy a normal sex life with partner.i read its called. Sexual anhedonia. but plz note I just use to ejaculate only once.even if its still erect.because earlier I used to have orgasm every single time I ejaculate.i also having wet dreams from past fee months.in the begining of my porn masturbation stage in 2012 jan I sometimes used to rub nd stroke my penis hard and give vigorous strokes...plzzz I m very depressed by the thought that I destroyed my sex life because of bad habbit of over and vigorous masturbation.THINGS CAUSE ME DEPRESSION AND MASTURBATION BECAME A WAY TO ESCAPE.I WAS NOT HAVING ANY PRIOR INFORMATION ABOUT IT.ITS TECHNIQUE AND SIDE EFFECT.MY QUESTIONS ARE IS MASTURBATION PRACTISED BY HARD STROKING OF PENIS HARMFUL.MY PENIS FORESKIN BECAME DULL IS IT CURABLE.?HOW I CAN END MY SEXANHEDONIA?WILL I EVER HAVE A NORMAL SEX ?LIFE WITH PARTNER.?had I made a permanent damage.?how can i make bring my penis sensation back?yesterday i watched porn but my penis not having proper erecting and porn was like another video of songs or movie.just a very little arousal.PLZ I M VERY WORRIED SIR..HELP ME PLZ.plz give ur persnal email id I feel suicidal coz of earlier drpression and now this sex thing.also tell me cn masturbation cause me weak body.?can I recover my sex power lost in masturbation and damage caused to penis.",
    "doctor_response": "Hi Rohan,I read you problem in detail and can understand what you are going through. Lets start with some basic facts. Masturbation is a normal physiological process and masturbating on a daily basis doesn't lead to any physical, mental or sexual weakness. However, from what you have mentioned, it seems that you are suffering from depression and that is leading to you having a lot of negative thoughts. Your feeling of sexual anhedonia can very well be part of depression. Your  situation is highly amenable to treatment. What i would recommend is that you should immediately consult a local psychiatrist. You need to be started on some anti-depressants together with regular supportive therapy sessions.  Wishing you speedy recovery. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lack of concentration\n\nsir  ,my  name is santhosh kumar     and i am in staying in  dharmapuri  my querry is   i  am  not  able to control  my mind in a  concentrate manner   i.e any  time  some  songs  and  bad words  are  running  through  my  mind  and  even  i  felt  that  the  suicide  is  better  options  to  me  .",
    "doctor_response": "Dear User,Thanks for using health care magic.Presence of suicidal ideation along with lack of concentration is very common in persons with problem of depression which is a common psychiatric problem worldwide. You meet a psychiatrist with more details so he can make a diagnosis and prescribe some treatment for you. I hope there is psychiatrist in your district, if none is there you can visit nearby cities like Madurai, Tritchy etc.'Hope I have answered your query. If you have any further questions I will be happy to help\".Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does a BP reading of 136/90 need medical attention?\n\nI am 91 years young - female - and thought I was in excellent health. I take no meds. What Today I visited my primary doc and the blood pressure reading was 136 over 90. A shock. I know I need regular exercise (too much sitting reading/computer). Is this reading significant of hypertension? What to do to return to my recent normal reading of 140 over 75? I weigh 135, height 5 . - Thank you.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I am astonished with your health at your age (91 years old). I hope all ladies of your age should have the same health status. Having a reading of blood pressure (bp) 136 over 90 is not that significant. I would suggest to monitor your bp for at least 1 week, and record the results, so you can show to your caring doctor. After analyzing the results, we can determine the treatment strategy. We usually do not make a diagnosis of hypertension based on only one measure. Your weight is excellent in propotion to height (5) for your age. Of course, making some physical training can help keeping fit together with a healthy diet. Hope this helps. Let me know if you have any other concern.",
    "dialogue_context": ""
  },
  {
    "patient_message": "HCT test result high, CRP, BUn high. Can high HCT give a false ESR ?\n\nHello.....I just received some test results back today. The HCT test is HIGH 45.2 - HGB is 15.1. I also have a CRP at 1.4 HIGH and BUN at 18.... Creatinine 0.9. The ESR is 8. I have read where a HIGH HCT can give a false ESR Rate. I have a Postive ANA 1:320. Back in 1996 I was diagnosed with Lupus....then he said Undifferenciated Connective Tissue Disease and Systemic Fibromyalgia. I am in horrible pain and in a flare. I just broke out with sores in my nose again which my doctor never sees. I went to my Dermatologist on Tuesday. He thinks I have Impetigo . I also have Granuloma Annule. Something is going on and they can t figure it out. Could I have Lupus? I have a lot of the same Symptoms. But, my doctor says he has never seen anyone have Lupus without a High SED RATE. I have read a High HCT and interfere with the SED Rate. Thank You For Your Assistance! AAAAA",
    "doctor_response": "Hi It could definitely be lupus. The esr may be false, that is true, and many times it does not correlate with the disease activity of lupus.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Indoor, outdoor and food allergic reactions. Biting sensation in body\n\nHi Doctor, My grandmother has been experiencing indoor/outdoor/food allergic reactions for a while now. At first it was indoor and outdoor, then it spread to her sense of smell, and now she is allergic to all foods and the smells of cooking, paper, etc. She experiences these biting sensations throughout her body(skin) and into her digestive tract( stomach ). She describes it like someone s poking her with a knife.",
    "doctor_response": "THESE ARE FOOD ALLERGIES TYPICALLY IN FOOD ALLERGIES THE STARTING SYMPTOMPS ARE ONLY IN PARTICULARS TIME AND POSITION BUT AFTER SOME TIME OF DISEASE EVERYTHING SEEMS TO REACT THIS MOSTLY HAPPEN IN FOOD MILK OR WHEAT GET SERUM TEST FOR MILK AND WHEAT SPECIFIC ANTIBODIES ELIMINATE FOOD FROM DIET ALL YOUR SYMPTOMPS WILL GO AWAY WITH MINIMUM MEDICINES",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is my sperm count normal?\n\nRespected madam, I want to ask some question abt fertility. right now my sperm count is 14 mil/ml and motility is on grade 3. (forward progressive), so plz. tell me such sperm count is good make pregnant. My age is 29 yrs. My name is suresh shinde (0000)",
    "doctor_response": "Hello, Your sperm count is slight low. However at such borderline count also pregnancy is possible as motility not get affected. So you can try for conception by doing intercourse midway in your partners menstrual cycle. If not able to to conception after six month to one year than assisted reproductive technique beneficial. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning sensation on the end of the right shoulder near spine?\n\nFor the past six weeks I have been feeling a burning sensation on the end of my right shoulder near my spine, and the skin feels numb to the touch and itchy. Keep stretching it out but does not help. I am a builder, and I have started bodybuilding over the past 7 months. I am use to getting pain between shoulder blades from exesive work and repetitive movements, but this is a different pain. I feel it more when I am rested.",
    "doctor_response": "you need to figure out what exercise you perform and what is the dosage for it. the pattern of exercise performed may need a modification. pain in the iterscapular region and shoulder blades are close to trapezitis. you need to undergo a pain management for the release of muscle fiber . Myofascial release should help. mean time the burning sensation needs to be assessed by checking with the specialist. it may be a muscle inflammation or may be high uric acid or lactic acid or may be a nerve entrapment. kindly take a close visit to the specialist for accurate diagnosis and treatment plan.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to differentiate between a scar on the lung and TB?\n\nMy husband had an accident in 1980 which left him with a scar on his lung.  He has no applied for a work visa in Dubai and has been told that this scar indicates he had tb (which he has not had)  he is going tomorrow for his SIXTH test for TB - the other 5 tests were negative.  Is this normal practice?",
    "doctor_response": "HelloI understand your worry.I think that he is doing PPD test and sputum smear for tb bacillus.If PPD test is postive and sputum smear is negative no problem he is not contagious.Maybe he should take a preventive medication for 6 months than.In order to be sure for the scar in the lungs he might do a chest CT with contrast to evaluate better the lesion in the left lung.If sputum smear is positive he is contagious and should be under treatment for tb disease from a specialist.Thank youDr.JolandaPulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in stretching hand straight?\n\nHi my name is Vincent, i don t know what happened but my left hand cannot go straight and it goes max like (0degrees straight) About 30 degrees and 95 degrees if u know what i mean, and it hurts so much hard to sleep when i move and hurts. Is it broken or something? (MY ELBOW)",
    "doctor_response": "Hello,Your symptoms could be related to a pinched nerve or local joint inflammation. For this reason, I recommend consulting with your attending physician for a physical exam, a joint X-ray study and inflammation tests (complete blood count, PCR, ESR). Performing nerve conduction studies may be needed.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the diagnosis for dizziness, tightness in chest and pain in sternum?\n\nYesterday I went to the ER with dizziness, tightness in my chest, tenderness in my chest cavity, pain shooting from the sternum straight through to my back and shortness of breath. My BP was 144/ 110 and pulse was over 92. I had an EKG that showed no abnormality. My blood work showed an elevation in the white cells and a chest x-ray was ordered-again, normal...the doctor decided to order a CT scan of my chest using dye. The results were normal. He palpated my sides and chest area trying to feel lumps, I kept jumping in pain. No lumps found. I have been suffering with neurological symptoms that mimic Multiple Sclerosis and had all of the tests done. Every test keeps coming back normal. I am puzzled as are the doctors who treated me. Is there another way to diagnose me? Should I keep seeking opinions or get a genetic test done?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concernconcern. No need to worry for heart diseases as your ecg is normal. You are having chest pain and tenderness (pain on pressing), so possibility of musculoskeletal pain is more. Your chest tightness and dizziness are due to stress and anxiety. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on it's solution. You may need anxiolytic drugs too. Avoid stress and tension, be relax and calm. Apply warm water pad on affected areas. Avoid movements causing pain. Avoid bad postures in sleep. Avoid heavyweight lifting and strenuous exercise. Take painkiller like ibuprofen. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in the hands?\n\nHi my name is Allen, 51 yr old male. I unfortunately inquired influenza a 2 month s ago. Every since they have experienced several things, low back back pain intense, fatigue, bone-joint pain,numbness in both hands, and a severe pain under left shoulder blade that massaging dosent help, sometimes goes into the neck. Now, right hand is numb as we speak. Feels like I m somebody s bad joke. Can you give me insight? Thank you Allen, God bless you. .",
    "doctor_response": "Hi, Consult an orthopedician and get evaluated. You may be having neuropathic symptoms and it is rare with influenza. A detailed evaluation is required to make a diagnosis. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes urinary and bowel incontinence in a child?\n\nI have an almost 5 year old girl who since last Saturday just doesn t seem quite right all the time. Last Saturday she refused to go to the bathroom when we asked her to and she ended up going 12 hours in between bathroom trips. She also said she was tired. On Thursday, she peed her pants on the way home from a errand. She then went home and told me she wasn t hungry for lunch and that she wanted to take a nap. She went to sleep and peed her pants again. By the way, daddy was gone Wed & Thurs. nights on work. On Friday, she peed and pooped her pants during her nap. She peed her pants again on Friday night. On Saturday morning she got up and started to poop her pants. I had her sit on the stool on both Friday night and Sat. morning. She did end up having a rather large bowel movement on her own in the potty on Sat. Now it s Sunday night and she peed her pants on the way home from church with her grandparents. She came straight inside and said she was tired and that she was ready for bed, but that was because she had peed her pants again. Do you think this could be a UTI? Diabetes? She says there is no pain anywhere.",
    "doctor_response": "it could be uti but her stool incontinence does not support that diagnosis. its definitely not diabetes.in your case treatment can be behavioural  therapy and good bowel habits and syr lactulose 10 ml at night and high fiber diet. Good family support is a must.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any risk of pregnancy?\n\nIam taking gracial ( combined  oral contraceptive) and started my next pack one day late  as i took my first pill from the current pack on the 8th pill free break day instead of the 7th and had intercourse after taking the pill on the 8th .took the forgotten 7th day pill on the 9th day (two pills that day) . Will starting the subsequent pack one day late increase the risk of pregnancy or am I protected as long as I took the forgotten pill?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As per your history, as you have taken two tablets on next day of missed tablet, so you are protected and continue as advised. Still for next 4 to 5 days you can use extra protection like condoms etc after consultation. Take care. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lack of concentration, mental pressure, difficulty to resleep after getting up at night for urination.  Sign of depression?\n\nI am not able to focus & concentrate over my work since last 6-8 months.  Mind is always wandering over different thoughts. Mental pressure is increasing with the increase in held up work. Even when I wake up for urination during night, mind starts wandering and it takes 15-30 minutes for resleeping. Do these symptoms suggests any sign of depression. Do I need to consult a psyciatric Dr.",
    "doctor_response": "HIYes of course this is sign of mental disturbances and in other words can be said to a depression and anxiety, it is still in your hand you can handle it with your own, try to control your thoughts bring back your decision power back, you need to counsel your self the best way for this is go for meditation,yoga , this will help you a lot will skip the psychiatrist visit nothing to loose in trying this, have good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the prognosis of having two spinal canal stenosis and severe facet arthritis considering currently being very active?\n\nI have two spinal can stenosis at the L4 L5 , severe facet arthritis and one disc is now sitting on a nerve. I am allergic to aspirin and NSAIDs and use Tynalol extra strength. I am 63, swim 2 km a day, participate in Tai Chi and am considering Nordic Pole walking. I was a teacher and now am on LTD. I am just wondering about this in the long term.",
    "doctor_response": "Hi, Welcome to Health care magic forum.                 You have stenosis, atL4,L5and severe fact arthritis, and the disc is pressing on the nerve.                   You are aged 63, and swim 2 Km, a day, participate, in Yai Chi, and considering Nordic pole walk. Your health and the ambition to do some thing made you to do all these.                   Take more of green leafy vegetables, pulses, sprouts, and protein rich foods, to make you run for ever.                      Avoid taking potato,other tubers, tomato, egg, chicken, and sea foods to avoid as far as possible, when there is any type of pain.                   Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy after discontinuing birth control pill?\n\nHi, I am 41 years old and went off the pill 8/15/15. My period has not been regular and now I am on 40 days of not having it. As I wish I were pregnant, my test at home says negative. I have an appointment with my OB on Wednesday. Outside of perimenopause which can be the case, is their anything else she should look into?",
    "doctor_response": "Hello, and I hope I can help you today. There are a few potential causes of irregular periods when women come off the pill. The first is that your natural cycle may be irregular, and you may still ovulate, and the irregular cycles are just due to discontinuation of the pill. In that case, you will usually resume regular cycles by 6 months off the pill if you previously had regular periods. The second possibility is that certain medical conditions, such as thyroid dysfunction or an excess of a hormone called Prolactin, can cause irregular periods. Your doctor should test for these conditions as part of your evaluation. Lastly, there is also perimenopause, which can be tested via blood hormone levels.So I recommend you see a GYN doctor for an evaluation... because there are multiple possibilities for why you are having long cycles. I hope I was able to adequately answer your question today and that my advice was helpful. Best wishes,Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are vomiting, diarrhea, weakness and headaches symptoms of H1N1?\n\nMy family and I have all been experiencing vomiting, diahrea and weakness today. My wife and I also have headaches, and I have a hard time going up the stairs in my home without losing my breath. Does this sound like h1n1? My wide just took my mother in-law to emerg because of the same symptome plus irregular heartbeat. She passed out on the toilet and is also very dizzy.",
    "doctor_response": "what you are experiencing is probably food poisoning as every one is involved. may be the food you had yesterday was spoiled. H1N1 will be presenting as fever and berating difficulty and viral fever like symptom tiredness, head ache.main issue with food poisoning is dehydration due to fluid loss in case of vomiting and diarrhea which will give rise to the above complaint like tachycardia and week ness.drink plenty of fluids like water and butter milk, take antibiotic tablet ciprofloxacin TZ trice a day for 5 days. for vomiting can take ondensetron 4 mg tablet twice a day.watch for signs of dehydration like dry mouth and tongue fatigue and low blood pressure and increased heart rate. then you may need intra venous fluid.take care. any doubt feel free to contact me any time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are causes & treatment for pain in male genitals?\n\nMy husband (28) is feeling a needle pricking kind of sensation in his a**hole from last 2 weeks? He tried keeping it clean and dry , applying talc powders but it doesn't seem to get better. Can you tell me what this is and how can it be treated orally ?",
    "doctor_response": "HelloI appreciate your concern for your husband.Needle pricking kind of sensation in anus might be caused be fissure in Ano, hemorrhoids or infected anal gland and perianal abscess.In my opinion he should apply anaesthetic ointment like lignocaine for symptomatic relief.Ask him to avoid constipation by taking laxative or stool softeners like liquid paraffin.Ask him to avoid fatty fried and junk food, advise him to take lots of fresh fruits, vegetables and dietary fibers in his diet.No smoking and alcohol for time being until it heals completely, if he is into it than.Sitz bath or hot water bath will definitely help him.Hope this answers your question, please do let me know if you have any more queries, I will happily answer you.Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pulling sensation on left side. Histroy of bilateral laproscopic inguinal hernia repair. Suggest\n\nI had a bilateral laproscopic inguinal hernia repair about 8 months ago. I'm still feeling an uncomfortable pulling sensation on my left side. It feels a lot like it did before the surgery....I've gone back to the surgeon twice and he seems to think that everything is fine. Any idea about what could be going on? Also it's worse after I exercise",
    "doctor_response": "Hi ! Your operation was done 8 months ago for bilateral inguinal hernia. Now you are feeling the same old sensation on the left side only. Have you noticed any type of swelling on your inguinal area just as you had before the surgery. If it so, then it could be a recurrence of the hernia on the left side. But due to improvement in the surgical techniques laparoscopically, this is a remote possibility even though possible. The other possibility is entrapment of nerve or adhesion of the mesh with any other abdominal viscera, or fibrosis at the site of surgery. If there is no swelling, and not any major problem, you can wait for some more time, and see if the problem subsides of its own. Otherwise you will have to get yourself reviewed by the operating surgeon. Wishing you an early recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and purple color on finger?\n\nHi, I recently had swelling in my finger and thought it was an ingrown nail. It became worse so I went to am EMO (I am not at home and have no doctor in the area) and they tried to drain it. It became worse so I went to the ER the next day (yesterday) where he told me it was herpetic whitlow and prescribed me something for it. I have taken two doses today, but am nervous about my finger. It continues to swell and is now purple. I have some slight swelling on my hand as well.",
    "doctor_response": "Hello,I have studied your case. I think you need to see a skin specialist. These type of swelling is mostly due to following causes.1.Bacterial infection 2.Fungal infection  A skin physcian can examine your swelling and confirm the diagnosis. If there is bacterial infection than after drainage of abscess you will need antibiotics for six to ten days.If it is fungal infection than this may need treatment for longer time may be three months.If you can send me images of the finger, I can help you in diagnosis.Let me know if there is any other followup questions.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in the right leg long after a back injury?\n\nHi! When I was like 5 years old I fell down de stairs, it was a small staircase, only a few steps, but I hurt my lower back. The pain was so strong I couldn\u2019t even breathe for a few seconds. I had an X-ray the same day and they said something\u2019s swollen and I would probably feel pain for the next couple of days, gave me some pain killers and said that should be it. So I don\u2019t remember much after that. But as I grew older I noticed that sometimes my right leg goes numb. It never was really bad or something, but a year and a half ago I started working somewhere that requires me to stand 8 to 11 hours a day and I can\u2019t move much. Since I started this kind of routine, I noticed that the pain is worse every day and that my leg goes numb really often, to the point where it almost hurts. I was thinking about seeing my GP and then I\u2019ll go from there. Do you have any advice or something that can help me figure out what this is? Thank you!",
    "doctor_response": "Hello, It is due to neuropathic causes secondary to spine related problems. Consult a neurologist and plan for an MRI scan. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause a numbness and tingling sensation in left hand that moves on till eyes?\n\nMy sister is 52 and has numbness and tingling in her left hand and a twitch that comes and goes in her left eye. Went to ER and they kept her overnight to check heart, arteries, blood, etc. and all was fine. Any suggestions on what could be causing this? Thanks!",
    "doctor_response": "Hi your sister has tingling in her left hand and twitching in her (L) eye.In my opinion the tingling in her hand could be caused by 1. Carpal tunnel syndrome  where there is pressure on median nerve in wrist .2. Cervical spine where there could be pressure on one of the nerves. I would suggest that you get 1. X ray cervical spine 2. NCV both upper limbs and S Vit B12. Occasional twitch in the eye in common and there is nothing much to worry about it. In the meantime I suggest that you start taking Gabapentin , Vit B 12 supplementation .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tiredness and body pain?\n\nI have been very tired the last 4 days, for the last two days I have had an increase in my pain in my neck, shoulders, and wrists. I have also had sensitivity to all my teeth. I have been taking my muscle relaxers, and anti- inflamatories, resting, and doing my stretches and physical therapy. My husband theorized that maybe I have some kind of sinus infection that is causing all the jaw and muscle aches",
    "doctor_response": "Hello, Maybe you have tensed muscles due to anxiety. Try taking orphenadrine citrate combined with acetaminophen. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Rana Ahsan Javed, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am suffering from secondary infertility after having the tube test\n\nafter successfully tube test and egg formulation i am facing secondary infertility .After sperm count test my husband count is on border line but he done two months course to imorove count .We do not understand the problem .kindly guide us.Age of my husband me 35 years .I have nine years old girl.",
    "doctor_response": "hi,thanks for query.What I understand by secondary infertility means you already had one child and having difficulty in getting another.In medical terms this is known as secondary infertility.Once you are pregnant the major causes of infertility are ruled out.This time the cause could be some hormonal imbalance,bad semen quality,some uterine problem etc.Please discuss this with your doctor and get your thyroid checked.He will suggest some investigation to see for ovulation and other things.If everything is normal you can still conceive with low sperm count with the help of assisted techniques. wishing you all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could severe discomfort, like sitting on hard lump, after fall indicate?\n\nA little over 2 weeks I fell off a ladder and landed unto the sprinkler tip off a water hose and patio with my lower back.  The pain is not as excruciating, but I  still have a lot of discomfort especially sitting or when I get up.  I feel like I am sitting on a hard lump or bone.",
    "doctor_response": "Hello,I had gone through the case and found that it might be pelvic bone affected.Go for MRI of lumbosacral and pelvic area.After that take proper treatment.Meanwhile take mild painkiller and do massage with ice.Hope my answer will be effective for you. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I use Moxikind tablets for teeth infection?\n\ni have teeth infection and there is a swalling on the upper Jaw,for which doctor suggest antibiotic tab moxikind cv 625 three tab per day for 5 days . please suggest it is correct anbiotic for this treat ment and i have aiready taking MAHASEF L Tab antibiotic for two days @ 2 tablet per dayas suggested by another docter,I am not able to decide whether I stop MAHASEF by taking MOXIKIND CV 625 or continue for MAHASEF for another 3 Days?",
    "doctor_response": "Hi,Thanks for posting the query,    I would suggest you to take medicines prescribed by the Dentist to you if you are taking moxikind then stick to it, also take tab ketorol DT and ibugesic plus along with it, antibiotics and analgesics will give  a temporaray relief i would suggest you to go for  a complete root canal treatment of the tooth.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain on the left-sided back after leg shortening?\n\nI have a history of bilateral hip displasia at birth. I have been having a problem in the last year and a half of my left leg shortening. Normally I have gone to a chiropractor and he s been able to realign it and it stays for a while(weeks to a month). This past Wednesday it shortened about an inch but after being realigned it goes right back short in a matter of hours. It never really hurt before but now I have excruciating sharp pain just to the left of my tailbone when it shortens. Is this sciatica or should I see an orthopedic dr for the hip?",
    "doctor_response": "Hi. With a history of dysplasia and recurrent possible hip dislocations, you need to see an orthopaedic surgeon. There are new technologies that an orthopod can use to improve stability of the hip joints. Hope that answers your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of Concerta?\n\nMy sons Dr took him off Concerta 54 for the summer and wanted to see if he could manage without it. In the meantime since June my son has gained 30lbs and his grades have gone from B s & C s to F s. We brought him to the Dr today and they put him back on Concerta 54 which is the same dose he took before. Will there be any side effects should they have started him back on the same dose? My son is 12 years old 5 and 172lbs will the weight start coming off now that he s back on this medication?",
    "doctor_response": "aggression, restlessness, hallucinations, sore throat, and headache are some of the side-effects of concerta.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy if we had intercourse on egg eruption date?\n\nMy wife LMP date is on 10th Jan. She had two eggs on her left ovary. one raptured on 21st and other on 22nd. we have intercourse from 16th to 23rd Jan(once in a day). Will she get pregnent?. Is their any symptoms to find weather she is conceived or not.",
    "doctor_response": "Hi,Thanks for writing to HCM.The chances of pregnancy is more around 50 to 60 % in your case as the timing of intercourse was correct.But there are many more factors which decide fertilisation and implantation like poor sperm penetration or implantation probelm or hostility.I wish your wife conceive soon. The confirmation of diagnosis is by either serum b-Hcg or urine b-Hcg presence. It will be positive after 14days of fertilisation. The symptoms which can suggest pregnancy are weakness, vomiting or sensation of vomiting, mood variations etc but not so specific.Hope I have been helpful.RegardsDr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes protruding collar bone near the throat and tingling in that area?\n\nIn the last 2 months I ve developed a protruding collar bone near my throat on the right side. It s like a hard knob at the tip. It is no longer smooth/flat like the left side. I also have continuous tingling in my neck from under my ear to my collar bone, always feels cold. I do have DDD and had a 3-level corpectomy with titanium cage surgery about 10 year ago. This knob and tingling is really bothering me now through the day. What could be causing this change?",
    "doctor_response": "That protrusion could well be a infection of stern I claviculae joint. So consult your doctor and get investigated. Only than can a treatment plan be made",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for the puffiness in the lips and cheeks caused due to an abscess in gums?\n\n... tried to treat what appeared to be an abscess on the upper gums with raw garlic.It was probably left there too long and now the soft tissue under the upper lip in grossly inflamed.Also the lip and cheeks were puffy, but the lip is not as much now:  in 3rd day.Are antibiotics needed?",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,    I have gone through your query, as you have inflamed gums and lips dont worry it can be due to periodontal problem there can be formation of Periodontal Abscess   You do is warm saline gargle two - three times a day  Do chlorhexidine mouthwash twice daily  Consult dentist and go for Scaling and currettage .  Hope this will help you.  Wishing you good health.Regards   Dr. Priyanka tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is flattened T wave something to be worried about?\n\nHello doctor, Recently, I have done some cardiac tests like ECG, 2D echo, TMT and serum electrolytes at my regular consultant. Four months ago, I got blood pressure 140/100. So, my regular consultant suggested I use Telvas CT 40 tablet (only half tablet at morning) daily. Recently, I got gastric problem. So, I went to my regular consultant and he suggested I use Pantop IT 40 mg and I went after 10 days for review and I have done the cardiac tests as mentioned earlier. My actual problem is when the ECG was done, the diagnosis report mentioned flattened T wave (I, V4, V6). Previously, I have done ECG last year but the diagnosis shows normal ECG. Now, it changed. Because of this, my doctor suggested me to do other tests like 2D echo, serum electrolytes, and TMT. Finally, he told me that all the reports are normal. There is nothing to worry but still, I am worried about my reports. Can you please check the reports and suggest me? I smoke one cigarette every day and drink 180 ml of brandy every week.",
    "doctor_response": "Hello. Yes, there are changes in the ECG (attachment removed to protect patient identity). But, your evaluation is normal including echo and treadmill test. Now, the changes in the ECG are likely due to high BP and not any blockages. I guess you do not have any symptoms like chest pain or chest heaviness on exertion or during the treadmill test. So I do not think there is anything to worry about now. Is your blood pressure well controlled? You have to check your BP frequently, thrice a day at least for a week so as to know the pattern of BP. Have a low salt diet. It is important that gradually you quit smoking because smoking is much harmful than alcohol and alcohol occasionally is acceptable but not smoking. Hope this helps you and get back if you have any doubts. For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure chest pain and breathing difficulty?\n\nMy husband age 57, has been complaining that his left side of chest is tight and almost fights back when he inhales, his lower left rib hurts to the touch, he was in a car accident in March and a rib was out. He has been to a chiropractor. He is yawning a lot to get air, and very fatigued.",
    "doctor_response": "Thanks for your question on HCM .In my opinion your husband is having musculoskeletal cause mostly due to past accident.But it is better to rule out Cardiac cause first. So get done ECG to rule out cardiac cause.If ECG is normal, than no need to worry much for cardiac Cause.Chest trauma can cause1. Rib fracture2. Pneumothorax3. Pulmonary contusion4. Muscular injury.And all can cause chest pain, soreness on touch and breathlessness. So get done chest x ray to rule out all these.If chest x ray is normal, than it is musculoskeletal Pain mostly. Avoid strenuous exercise, heavyweight lifting and movements causing pain. Take good pain killer and muscle relaxant. Apply warm water pad on affected site.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I have abdominal cramping and diarrhea, itching of hands and feet and redness of upper trunk after eating food?\n\nHi I've had several bouts, on different occasions, where approximately an hour after eating, different types of food, I have sudden abdominal cramping and diarrhoea, itching of hands (sometimes feet) and also redness of upper trunk.  I have had allergy testing, which showed I'm not allergic to anything.Please does anyone have any idea.Thanks",
    "doctor_response": "HI. This is definitely an allergy to a particular food that you only can notice and stop that food forever. Any allergy testing can not diagnose all types of allergens. You already know you are allergic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could white lines in chest be?\n\nMy 7 yr old son is adopted from Guatemala. We have recently noticed a faint white line in the middle of his chest from just below his nipples almost all the way to his belly button. Is this normal? Anything to worry about? Any indicator of any kind of health problem?",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. This white line can be normal finding, but better to get done following tests. 1. CBC (complete blood count). 2. Vitamin b 12 level 3. Calcium and vitamin d3 level. 4. Thyroid function test. Anemia, vitamin b12 deficiency, low calcium and vitamin d3 and hypothyroidism can cause similar skin changes. So get done above mentioned tests. If all are normal then no need to worry much. This line will gradually go away with time. And if any of the test is low then your child needs supplements.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dark reddish seminal fluid?\n\nMy husband is 53 and for the first time last night we noticed that his seminal fluid was a dark reddish/brown. We are making him an appointment with the Urologist, but wanted to know if that's the correct medical field for this? And how urgent is it that he be seen?",
    "doctor_response": "Hello, Seeing blood in the semen can make a man anxious. Fortunately, it doesn't always signal a major medical problem. For men younger than 40 with no related symptoms and no risk factors for underlying medical conditions, blood in semen often disappears on its own. But for men 40 and over, chances are higher that blood in the semen needs evaluation and treatment. Blood in the semen is known as hematospermia. Prostate biopsy is the most common cause of blood in the semen. Blood in the semen can be caused by tumors, infections, anatomical abnormalities, stones, or inflammation in many sites throughout the genitourinary system. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can foot surgery cause pus and pain?\n\nJust recently, I had surgery on my foot back in june. the wound on my foot has healed up nicely. For a couple of weeks now my big toe has been swollen and paining. this past week it has been pussing. I cant seem to figure out the reason why this is happening and cant find a cure. Do you have any suggestions?",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms seem to be related to a toe infection.I suggest to use Hydrogen Peroxide to clean the toe. I also suggest using an antibiotic cream for local application such as Neosporin cream.I suggest to cover it with a sterile bandage.If the symptoms does not improve you should see a surgeon.Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can PTB in the right upper lobe be treated?\n\nHi..I wanna ask, I had my xray last year and recent year the result/impression was ptb right upper lobe..I had my sputum test and it s negative. I don t cough nor have fever.I just have a skinny bod.I don t know what to do now.it restrict me to have a job.it s really a hindrance to my employment.please I do need an advice. Tnx ;)",
    "doctor_response": "Hello,In the radiological report, you have diagnosed tuberculosis. But sputum is negative. Hence you can investigate with a more confirmatory test like sputum culture and Genexpert study.Hope I have answered your query. Let me know if I can assist you further.Regards,\u00a0\u00a0Dr. Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes colds with breathing discomfort in a baby?\n\ni have 9 months old baby.. i gave him 1 ml carbocisteine and 1 ml cefalexin for 1 week now but nothing has change ..he have colds now and i use saline to make him comfortable to breath at night.. and in the morning it kinda watery.. what should i do now.. do i need to continue the medicine hes taking or i need to change it? please give me an advice.. thank you and God Bless",
    "doctor_response": "Hi,Welcome To Healthcare Magic.I can understand your worry regarding to your child\u2019s health.As he is having cold, give liquid Fabrex Plus (if no allergy) drops, 6 drops, 3 times in a day, at the interval of 7-8 hours for 3-5 days. Also give liquid Levocet M (if no allergy) 2.5 ml, daily at night for 5 days.Apply Nasivion (mini) (if no allergy) nasal spray, twice in a day, at the interval of 12 hours. After doing all these, if your baby will not feel better, then consult a pediatrician.After doing all these things, I hope your child will get well sooner and please share your review about my answer on healthcare magic.Take Care,Thank You.From:- Dr. Nupur Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should I do to increase my chances of conceiving?\n\nHi Doctor, I would like to know my options towards conceiving. I do not have regular mensies and my last pap smear which was about 2 years ago came out ok. I had a miscarriage about 3 years ago. What should I do to increase my chances if conceiving and if any, what lifestyle changes do need to put in effect?",
    "doctor_response": "Hi,I read your query and I understand your concerns.Following is my reply:1) You have to loose weight and attain healthy weight.2) Have balanced diet and exercise regularlyLet me know if you have anymore questions.Regards,Dr. Mahesh Koregol",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Which ayurvedic medicine can give a long time relief from asthma?\n\nHello doctor, Thank you for giving us the first query free. I am 26 years old male suffering from asthma for the past 14 to 15 years. So, I feel shame for myself when I use an inhaler. I am not able to go on tour especially in winter because I do not want to share my worst condition in front of my known people. I do not need any sympathy faces. Sometimes, I do not feel shortness of breath but wheezing irritates me, and I am unable to focus on work. When people leave me alone, then I take inhaler. When I take a bath in winter, I feel shortness of breath. Right now I am taking Bresol (Himalaya tablet) two times a day for past two months with lukewarm water. This winter I am drinking lukewarm water every time. But the problem is still there. When I go to sleep, I feel wheezing and the same when I wake up. A pharmacist said to use Septilin (syrup) with Bresol and take Bresol thrice a day and Septilin twice, and nobody told me how long I have to take this. I know asthma is not curable. Please give me some good advice and names of medicines (ayurvedic) for long time relief. And also advise regarding Bresol and Septilin (especially how long I have to take this).",
    "doctor_response": "Hello. Regarding the continuation of medicines, you may have to use the multivitamin tablet, Septilin (Tinospora) and Bresol (Turmeric, Vasaka, and Vaividang) for a long time till your allergic condition persists. These medicines are for helping your body develop good immunity against the respiratory problems. These medicines act slightly different than inhalers. Although, I would like to tell you that inhalers are scientific. Ayurvedic medicines may not help to get respite from an acute problem. Asthma is a manifestation of hypersensitivity. It is wise to find the cause of the hypersensitivity. We call the same allergy. Rhinitis asthma is different manifestations of allergy. Allergy is present in the genes, and we may not be able to cure allergy entirely. Allergen avoidance forms the mainstay of the treatment and management of allergy. You should be carefully noting down which areas and circumstances lead to the symptoms in you. Like going to gardens, smoking, pollution, dust, particular smells and fragrances, fumes, effluents, climate, etc. You should also note when the symptoms are more and when they are less. Whether there are any seasonal or diurnal variations. Once you have a detailed diary regarding this, you will be able to make some reasonable conclusions regarding when you have to be careful. Next method of finding out the allergen is allergy testing. The two methods available are skin prick testing and blood immunoCAP method. Both methods are easy and fast, but skin prick testing is more accurate. Once we find out the allergens causing the problem for you, we can give you specific advice on how to avoid these allergens and stay safe. The treatment of Septilin and Bresol that you are taking are to help your body stay healthy, improve immunity, provide all nutrients and micronutrient for the body to deal with offending agents. But these are not the definitive cure for the problem. Hence, it is not possible to say clearly till what time you will have to take the medicines. Additionally, if you get an asthma attack during the course of these medicines, you may still need inhalers or nebulization or medicines on an SOS basis. Do share with us your prescriptions and investigations reports so that we can help you better. Hope to see you healthy soon. For more information consult an allergy specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can infection be contracted from unsterilized makeup brushes?\n\nHi doctor,I want a professional and honest answer. I suffer from anxiety and OCD. Yesterday, I was dealing with patients post them having cosmetic injectables. There was pinpoint blood from the needle insertion points. I am thinking the worst case scenario and not saying this happened, but my mind is playing with me - what would happen if I then applied makeup to that person with a brush and double dipped into the color without sterilizing, then used the brush again on another person and so on? Could that contract an infectious disease? I am worried sick.",
    "doctor_response": "Hello. Our main concern here is regarding the transmission of HIV (human immunodeficiency virus), hepatitis B and C. Now, in the scenario you are explaining, it is less likely for any virus or infectious disease to transmit to other, but small risk of transmission remains. There are two reasons. Considering you are applying makeup on intact skin, so in that case, it is unlikely for any infection to transmit. Secondly, if you are applying it on the skin where you have given injections, then a small possible risk is there, but risk is further reduced by the deactivation of viruses by colors. So overall, there is a minute risk may be less than 0.1 percent, which is really small. So, I think you should stop worrying about it and use a separate container from next time. Hope this clears your doubt and get back if you have any doubts. For more information consult a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat breathing problem due to cold in a toddler?\n\nhi doctor, i am premalatha from velachery. I have a 16month old baby girl. she is suffering from nose block from last 3 weeks. this started as part of her cold this time. her doctor gave her treatment for cold, but later after a week she was unable to breath well and no sleep in the night. The doctor tested again and gave nasal drops and another medicine. but there is no improvement, doctor says it may take time to get cleared. i could see little buldge on her nose walls. i showed it to doctor but they say no to worry. how can i be without worrying when my kid is not sleeping well from last 2 weeks. please advice.",
    "doctor_response": "Hi.... greetings from Chennai. I am a consultant Pediatrician at Kanchi Kamakoti CHILDS trust hospital in Chennai. I understand your concern. By what you say I feel that your kid has got sleep disordered breathing or upper airway resistance syndrome.I would like to have a look at the kid. If you can come to Kanchi Kamakoti CHILDS trust hospital, Nungambakkam Chennai and request to see me (Dr. Sumanth.A), I would examine the child and do the needful.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair loss\n\nHi sir my name is Raghu i am 23 year old i am suffering from hair loss before from 4 year now i am bald i was consult many doctors but no use but doctor has suggested mintop forte i am using before from 1 weak but i did not visible eny improvement please tell me solution and what i do for hair regrowth",
    "doctor_response": "Hello Mr Raghu. Welcome to HCMFirst thing to consider is if you have a family history of hair loss, if there is male baldness in the family. In this case you will be more prone to similar problems. And medical treatment may not help you much.Other causes to consider are hormonal(thyroid etc), any lifestyle or residence change, stress, any history of recent illness like typhoid, any chemical procedures, etc.Also do note if you have hair loss anywhere else in the body.These causes need to be considered and treated as they affect hair growth.For now you may continue Mintop solution to scalp as advised, along with hair supplements daily like Follihair. This needs to be continued at least for 2-3 months. Improvement will not be visible within a week.Since you have been on treatment since a long time, with not much improvement,do consult a dermatologist, to assess your type of hair loss and to give you treatment based on the results. They may also suggest some routine blood tests if required. if medical methods do not work well for you,certain new surgical procedures can be considered such as PRP.hair transplant etc, as will be advised by your consulting doctor after observation, if they feel that it will be a good option for you.Also get a good nutritious diet, avoid stress, smoking, get good rest.Hope this guides you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe left arm pain?\n\nHi, with no warning or obvious reason, my continuous pain has begun in my lower left arm. It started a few hours ago with just a stiffness in my wrist, but has continued to the rest of my forearm and slightly to my fingers... What could this be? I am a 21 year old female.",
    "doctor_response": "Hello, As this sounds to be due to nerve root entrapment at the cervical or the wrist level. Getting it examined will be of help. Either it can be cervical Radiculopathy or carpal tunnel? But need an assessment to claim one. Also, doing hot water fermentation to the neck, posture correction, static neck exercise, shoulder stabilization exercises should help reduce the symptoms. Kneading massage over the Trapezius muscle will be useful. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dry, itchy lips on using lipstick, swelling, redness in arms, legs. History of chronic allergies. Treatment?\n\nhi this is regarding my allergy problem it has been 1 year by now i cannot use lipstick as whenever i use (whatever brand)it my lips goes dry and itchy........ so i have been using lip balm from past 8-9 months to make it moist. and when it start itchy on my skin may be on upper eyes arms legs , redness appears and it get marks all around (like swollen bruises) please suggest me to get rid out of it regards",
    "doctor_response": "Hello Mona, You may have developed a Type IV hypersensitivity (delayed sensitivity) to chemicals often found in cheap lipsticks but also in expensive ones and patch tests (through a Dermatologist) will help in determining which chemicals you have become allergic to. Patch tests involve a series of chemicals (in tiny amounts) applied to the back and secured with a tape and remains in contact with skin for 48-72 hrs and then read by a skin specialist. Any redness or blisters around the chemical confirms the allergy. Hope this was helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for upper back pain , cough and shortness of breath\n\nHi. I have a cough on and off every year. I do smoke around 20 cigarettes a day but latley ive reduced the numbers as my phlegm tastes like chlorine. Ive also been sufferening shortages of breath and have pains in my upper back sometimes. Why is this?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Since you are smoker, possibility of bronchitis is more in your case. Bronchitis can cause similar symptoms like cough, chest pain, back pain, expectoration, difficulty in breathing etc. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x ray 3. PFT (Pulmonary Function Test). Chest x ray is needed to rule other lung diseases. PFT is must for the diagnosis of bronchitis. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. Smoking cessation should be done first. Inhaled bronchodilators and inhaled corticosteroid (ICS) are mainstay of treatment. So possibility of chronic bronchitis is more in your case. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for psychiatric problems\n\nsir my mother is 50, 5.4\",50kgs...and she is undergoing a psychiatric problem(as we have assumed it to be)..she is a patient of hypertension...very short tempered and that worsen our problem...she has a different world going round her mind...can you suggest me what steps i can take to cure her..any treatment",
    "doctor_response": "If you feel she had had some psychiatric problem, just take her to psychiatrist with current medicines going on for hypertension and other medical records..As there are more than 300 diagnosis in psychiatry, from such small comments I cant tell you specifically about treatment.But as you mentioned, she has different world going around she might have psychotic features and schizophrenia. however she is hypertensive , we also need to rule out any brain damage through MRI. So without waiting go to doctor soon because earlier the treatment started better the result.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for breathing difficulty while sleeping\n\nHi 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.",
    "doctor_response": "Thanks for your question on Healthcare Magic. 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. PFT (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 salmeterol) and inhaled corticosteroids (ICS)(budesonide or fluticasone). Oral combination of antihistamine (levocetrizine or fexofenadine)  and anti allergic (montelukast) drugs are also useful. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can patch birth control cause tumor in muscles of arm?\n\nHi I have they believe a fatty tumor on or under my arm, I went an got a MRI an it showed the tumor to be bigger then I thought an it starts under the skin an goes around the muscle an ends up under the muscle to the bone now within the the 6 months I had fell outside but one time that stands out is that when I did fall I was holding on to my truck door an ended up slipping under the truck but the arm save me from going under in the meantime I tore a few muscles so my arm is really been hurting that s why I ended up going to my dr. Now sent me to another an I have a app. In a few days, my question is this tumors has been there at least 6 yrs that s when I found it so I am sure it s been there longer I used to take the patch birth control an where the tumor was is where I used to put the patch each time, do you think it could of caused the tumor? Thanks for your time Kathy",
    "doctor_response": "HiIt may not be due to patch birth control.I may suggest to consult orthopaedic doctor.An FNAC biopsy should be done for assessment of nature of growth.if it's been there for long time and not growing, likely to be benign...but it should be confirmed on FNAC biopsy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the growth in a different area after the removal of cancer growth?\n\n2yrs ago or so had cancer growth removed from my chin--seems to have returned in slightly different area--still on the chin, should i get this ck'd out even tho my oncologist advised me if it would make me feel better to do so--he did not indicate it looked canxerous nor offer to have biospy done??",
    "doctor_response": "hello thanks for consulting at hcm..i advise u take an second opinion  with oncologist and for an biopsy of that region and a consult with a oral pathologist..better to be preventive na..hope it helps,,tc",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medicine should be taken for stomach pain and lose motions ?\n\nhi since from two days iam suffering from stomach pain and xterday with motions ,i dont know wats happening in my stomach,please can anyone suggest me any medicine as iam not able to bare this stomach pain.. thank u",
    "doctor_response": "Hi Rajesh, . Did you have food Outside recently or do you have vomiting? You are having gastroenteritis which is the infection of Gastro Intestinal Tract. Kindly get yourself examined by a Doctor at the earliest as you need antibiotics and anti diarrheals. No medication can be prescribed without proper physical examination. Take Plenty of fluids and get adequate rest. Do not eat outside and always eat home cooked fresh fruits. Wish you Good Health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly suggest the management for sweaty palms.\n\nHello doctor, I am suffering from sweaty palms. It is very difficult for me to work in an office or shake hands during business meetings.Please kindly suggest a remedy.",
    "doctor_response": "Hello Welcome to icliniq.com. 1. Your condition is called palmoplantar hyperhidrosis (sweat glands of palms and soles secrete inappropriately large quantities of sweat). 2. Apply the lotion I am prescribing you below. 3. Another more long-lasting and more effective treatment is Botox injections given in the palmar skin only. The effect lasts for six months. Palmar hyperhidrosis. 1. Aldry or Nosweat lotion apply once at night for four weeks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Recofast right medication for an infant for cough and runny nose with phelgm?\n\nHi Doctor SantoshMy daughter is 1 year old and she has cough and running nose with lot of flem. I gave her t-minic (3.5ml, 3 times for 3 days) and Ambrolite S (same quantity) but hasnt subsided. SO my Doctor told me to stop t-minic and give Recofast (3ml 3 times). Is this fine.",
    "doctor_response": "Hi,Thanks and welcome to HCM.your doctor gave the right medicine and continue recofast or t-minic as advised by him.Steam inhalation and local instillation of saline nasal drops will hasten the recovery.Hope this answer serves your purpose .please feel free to ask further queries if any.Dr.M.V.Subrahmanyam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to achieve conception when suffering from Polycystic ovarian syndrome (PCOS) and high TSH?\n\nhi sir,I'm gunajit roy,for your information my wife is suffering from PCOS & TSH.TSH is slightly high & for that taking medicine regularly.Dr. had given lots of medicine from last 1&1/2 years. and again we are trying to conceive from last 10 months but not getting result. & today also Dr. has given lupi hmg75 inj & goodova tab.Sir, pl suggest what to do!!",
    "doctor_response": "Hello Mr. Roy,I can advise you better if you can furnish me the details of the investigations and the medication received so far. PCOD is the most common hormonal disorder that is observed during the reproductive age-group and responds very well to treatment. Only, it needs a lot of pre-treatment assessment and a systematic approach to treatment. Initiation of treatment without proper prior investigation leads often to failure. Maintenance of a normal BMI helps a lot in addition to regular exercise and a healthy diet. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat blood clots in both legs?\n\nMy wife is having problem of blood clotting in both legs. When blood clots, there is seen red spots on legs and after some days, it disappears automatically. She is not getting any permanent relief from treatment done so far.Please advise us suitably.",
    "doctor_response": "Hi,Thanks for asking.Based on your clinical history and query, my opinion is as follows:1. Require more details for exact evaluation.2. Are they red spots or reddish nodules. Red spots, if superficial, mild indicate petichiae. As they are disappearing, it could probably by due to a hemorrhagic disorder. Further evaluation is necessary.3. If you give me further details, regarding the age, onset, type and the treatment taken, I can be more helpful.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do dark marks on back of neck that burn indicate?\n\nHi. I noticed dark marks on the back of my neck. At first I thought is was a rash or bruise from scrubbing my neck during the shower but now I am a bit concerned because it also burns while resting on a pillow. It looks kind of ashy and dry but smooth to the touch. Is this a cancer related issue?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.It may be Acanthosis Nigricans. Consult the dermatologist for the perfect diagnosis and proper treatment. Apply salicylic acid ointment at night and Alovera + Vitamin E cream in morning. Avoid rubbing the skin.Take cap vitamin E, cap vitamin A and tab vitamin C daily for long time.Have internal systemic check-up done by physician to rule out internal cause.I hope I have answered your query. Let me know if you have any further questions. Regards,Dr. Ilyas Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for severe pain due to kidney infection\n\n...i visited the er last night, was dianosed with severe kidney infection, prescribed antibiotics and dilaudid 4 mg every 3 hrs..it has been twenty four hours and i am still in agony over the pain, it stops for a minute when i take my meds but then becomes unbearable.  should i revisit the er?",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can. You should take tramadol or perocet for example if this is caused by kdoney stones.. You should drink raspberry tea and plenty of water. You should reduce salt in your diet as well, alcohol and carbonated drinks. In most cases this is self limiting but sometimes antibiotics are required 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.DR. Ivan Rommstein",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bony,hard protrusion above the shoulder\n\nHi Dr. Praveen Thank you for the generous offer to follow through with my right shoulder problem. It was 30.6.2014. It has not changed and there still is a raised, bony feeling bump on the end of my right shoulder top. Very pronounced. I feels as if it definitely does not belong. The pain is subliminal and only when I have not used the shoulder for some time. It feels bony, hard and full. I do not know whether I should wait a little longer for an improvement or seek specialist attention. I have full movement without hindrance, BUT there is that bony, hard protrusion above the shoulder. I have not dared to use full strength on that shoulder and dare not use my bicycle on hills. I feel that there is not full strength but I have not tested it. Thank you for your help and generous attention. Affectionately Peter Kurz",
    "doctor_response": "Here it can be related with frozen shoulder or shoulder joint soft tissue damage, as well you also have mention about protrusion over the shoulder joint. I want to know this protrusion is recently started or its there from birth as well is it present even when your hand is down resting and there is no movement in shoulder joint. Or it comes only while moving your hand up with shoulder movement. If it is there from birth and even at resting position then its normal but if it comes only while moving hand up along with shoulder then its biomechanics of joint which is affected and so that you are feeling it as shoulder protrusion. Here one more symptoms you have given is bone tightness at shoulder. It can be due to less movement also. So the surrounding soft tissues have become tight.I suggest to visit ortho or physio doctor get it examine properly if needed they may ask for MRI scan. And based on diagnosis if there is mild to moderate issue that will get over with physio treatment and exercises suggestion. If there is major damage to soft tissue or joint capsule then you may need surgical correction and then again physiotherapy treatment for further healing and rehabilitation.You can also use hot and cold pack over your shoulder painful area for further pain relief.I am sure you will recover soon if you follow all above given steps.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cure for itching and little red dots with skin rashes all over my body?\n\nHi my name is connie I been having a skin rash severe ras on my body for tha past 4 months it iches alot its like little red dots and they swel up it goes away not compleatly but then it comes back. My lips are starting to dry very much they flake alot .....Hot water seems to calm itch but not for long At first I thaugt it was an alergic reaction but no alergy pill seem to work",
    "doctor_response": "HiFrom the description,  it looks like yet have developed an eczematous skin disease.Since you have it from a long time now,  I think that you need a thorough assessment by a dermatologist to look for the cause of the same. Sometimes various blood tests are also required to look for the cause of the same.Anti allergy drugs usually help in such disorders but they have to be given for long and continued pensiod of time and sometimes even short courses of oral steroids have to be given along.You should keep your skin well hydrated by application of good moisturizers and body oils atleast twice a day.Dr Geetika Paul",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain near waist and faster heart beats and unable to walk in the morning?\n\nHill good morning doc I m recently stay in Kuwait I m married my husband always complain about he s back closer to he s waist right side is hurt and he s pump and he s two foot ,during early in the morning he can t walk while he step on the floor is hurt ist atritis doc or kedney",
    "doctor_response": "Dear friend I understood your concern, see your husband may be obese a little. So weight of his body may shifts in.wrong pattern so pain may develop. He needs to do exercise daily with out fail. And reason of foot or heel pain when gets up in morning will be same. Over weight so first needs to decrease weight. Then do everyday yoga pranayama to make body relax and muscle strong.go to physiotherapy doctor he will guide you more. I hope you satisfied with my answer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could headache, sore throat and uncontrollable chills be meningitis?\n\nI have had a massive headache for a couple of days and started to get a sore throat. Last night, I started getting chills which turned into being freezing to the point of shivering uncontrollably. I just took my temperature and it was 104.6 degrees. I m exhausted, yet I ve been sleeping on and off all day. I had traveled to the Boston area for a week and got back last friday and have had the headache and accredited it to jet lag. Is my temperature at a dangerous level. Should I go to the emergency room. I have been taking NyqQuil and Excedrin but they do not seem to be helping. I feel horrible. Is it possible that I have Meningitis?",
    "doctor_response": "Fever is indicative of infection. If associated with chills and rigors it could be malaria or urinary tract infection and needs to be investigated. Although meningitis is also a possibility, there is no need to jump to conclusions without having associated symptoms or investigations pointing to it. Sore throat, headachhe and fevers are commonly associated with common cold which is basically a viral infection. Viral infections are associated with high rise of temperature and if not controlled properly and promptly, it could lead to brain damage. 104\u00b0F is definitely a very high temperature and there is reason to be concerned. You may try Meftal P (mefenamic acid) which is more effective in controlling temperature.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for skin rash\n\nHi a couple months ago I noticed an inch rash between my legs and I started treating the rash since it started to get larger. After the creams the rash started becoming brown and started to fade. is this an enczema? Im worried that it might be an std.",
    "doctor_response": "Hi, If the rash is becoming brown and started to fade, now you are having post inflammatory hyperpigmentation. Yes, the rash could be an eczema or a tinea infection. It would be difficult to tell the accurate diagnosis without proper description of rash. For accurate diagnosis, I recommend you to visit your Dermatologist. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Atorlip-F a substitute for Storfib tablet?\n\nHi, I have an urgent question. My Mother suffered from stoke on 23rd march and was in ICU for 3 days with all heart and arteries reporting fine. Doctors used Asprin and some other medicines to cure her and she is fine now. The question is : Her prescription says a storfib tablet at bed time and the pack of medicines has atorlip f. Are these substitutes.",
    "doctor_response": "Helloyes both are same medicine. Just check strength of the contents. Both contains Atorvastatin and Fenofibrate. Dosage must be mentioned on the back side of strip. Usually comes in 10/145 strength. Hope this helps you and get back if you have any doubts.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes partial complex seizures?\n\nMy son, 9 years old has had 43 partial complex seizures (well controlled with Trileptal and Keppra). He has not experienced a seizure in 2 years. He also has Trigeminy. One cardiologist suggested prolonged QT syndrome but 2 others said that was not true",
    "doctor_response": "Hi.... I suggest you upload the ECG and EEG reports of the kid in this website and get back to us. Long QT syndrome is to be diagnosed only on the basis of ECG only. But usually it will be associated with loss of consciousness.Kindly upload the ECG with report and get back to us.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe backache?\n\nAfter going to the bathroom and wiping, my back pain is so intense I cannot walk sometimes. I have come to the conclusion that I think its the way I wipe after a bowel movement. I lean to the left put my weight on my left butt cheek and raise my right leg on the ball of my foot as I wipe. Immediately I feel a pinching burning crushing spasm. When im finished i stand & its just crazy intense. But even more crazy, no matter what essential oil, herbal tea, herbal rub, yoga position, self massage, you name it, that I do, I cannot locate it!! At first I thought it was in my thoracic region, then lumbar, then....well....HELP!! PLEASE",
    "doctor_response": "Hello,For your information, only medication will not help attain normal health unless you change your life style and food habits.To alleviate the problem, by increasing flexibility and muscle strength, yoga back bending postures, pranayam, regular physical activity - under trained guide, meditation and rest.A balanced diet including all essential nutrients - vitamin D, minerals, Calcium, antioxidants and sufficient hydration is suggested to the patients in our clinic to help relieve the back pain. No front bending in any circumstances.Hot pack and Til oil massage on your back before bed time gives you relief from pain. In case your pain remain constant, your problem can be most likely due to urinary stones. So, it is better to rule out that by doing ultrasound examination.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Suchda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe lower back pain?\n\nMy daughter 12 years old and her lower back has been hurting. she went to the doctor a while ago and they told her to rest it healed they said it was a pulled muscle. But now she says it hurts even more. I dont know what it is or is it seroius. She said it hurts alot when she runs or does certian things.",
    "doctor_response": "HELLO, PLZ GET HER U/S ABDOMEN PELVIS , URINE  R/E, CBC , DONE TO SCREEN FOR ANY ANOMALY LET ME KNOW THEN, GIVE TAB BUSCOPAN PLUS FOR NOW. KINDLY DESCRIBE WHETHER THESE PAINS HAVE BEEN CHRONIC OR EPISODIC, THANX",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could creamy yellow discharge be side effects of monistat?\n\nHi, I recently b was on anti biotics, and wasnt eating my yogart. Well I got a yeast infection and treated it with monistate one day, its been a couple days since and today I noticed a creamy yellow discharge and wondering if its just the after effects of the monistat?",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The yellow discharge is more likely to be related ot the yeast infection.I suggest to continue using monistat cream for local application.I also suggest uising Fluconazole 150 mg one tablet a day for three days.I recommend to maintain a good hygiene.Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for scratch mark caused by a stray dog\n\nhi doctor, i am from delhi, india, my son who is 11 years old was chased by a stray dog yesterday and clawed, though there is no blood marks on the spot but he has got redness in the area which is very minimal. Please let me know if we need anti rabies vaccination for this, please note again he was not bitten but clawed.",
    "doctor_response": "Hello,Welcome to HCM,Dogs are known reservoir of rabies virus and can transmit to human beings by biting. Rabies is 100% fatal but it is 100% preventable by proper and adequate treatment.As there was no bleeding from the bite site, according WHO categorization it is categorized into Cat II. So cat II bite should receive following treatment.1.Wash the wound thoroughly with soap and water.2.Active immunization with anti rabies vaccine on days 0,3,7,14 and 28.3.Inj TT, 0.5 ml, IM4.A course of Antibiotics like Tab Augmentin, twice daily for 5 days.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sperm analysis: Total count-97 mil/cc,pus cells- 2/3 HPF and reaction -alkaline\n\nDear Doctor:I am 36 years old, Male, highest is 170 C.M, weight 80 Kg, I am a smoker, I smoke a packet of cigarette per dayBelow  is my semen Analysis, would you comment on it .PHYSICAL EXAMINATION Volume\u00a0\u00a0\u00a0\u00a0\u00a02.5Reaction\u00a0\u00a0\u00a0\u00a0\u00a0AlkalineViscosity\u00a0\u00a0\u00a0\u00a0\u00a0VISCOUSLiquefaction Time\u00a0\u00a0\u00a0\u00a0\u00a030 MinsMICROSCOPICAL EXAMINATIN P us CELLS\u00a0\u00a0\u00a0\u00a0\u00a02 \u2013 3 / HPFR B C s\u00a0\u00a0\u00a0\u00a0\u00a0Nil  / HPFEpithelial Cells\u00a0\u00a0\u00a0\u00a0\u00a0Nil / HPFSpermatogenic  Cells\u00a0\u00a0\u00a0\u00a0\u00a02 \u2013 3 / PHFMOTILTYProgressive\u00a0\u00a0\u00a0\u00a0\u00a065 %Non Progressive\u00a0\u00a0\u00a0\u00a0\u00a020 %Non Motile\u00a0\u00a0\u00a0\u00a0\u00a015 %MORPHOLOGYNormal\u00a0\u00a0\u00a0\u00a0\u00a060 %Abnormal\u00a0\u00a0\u00a0\u00a0\u00a040 %TOTAL SEPRM COUNT\u00a0\u00a0\u00a0\u00a0\u00a097  Mill/CC",
    "doctor_response": "HiGREETINGS Your semen analysis report is normal. One report won't be sufficient to finalise .Smoking can affect sperm morphology. Hope my answer helps you. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "On birth control, taken folic acid, provera and fertomid, no result\n\nHI, I WAS ON BIH CONTROLL FOR 11 YEARS AND WAS ADVISE BY MY GYNE TO USE FOLIC ACID , PROVERA AND FERTOMID USING IT FOR 3 MONTHS NOW STILL NOTHING YET.PLEASE ADVISE",
    "doctor_response": "Hi,\u00a0\u00a0\u00a0\u00a0\u00a0Thank you for choosing Healthcaremagic. If you are anxious to conceive you need further evaluation for the same, to get pregnant you need to have normal ovulation, patent fallopian tubes and normal semen analysis , kindly get evaluated for the same.Please ask if you have more questions. If you are satisfied, please make sure that your LIKE my answer so that I receive points, also kindly rate and review my answers. Good luck!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for arachnoid cyst?\n\nmy husband age 37 male He had a C.T scan and M.R.I in which reports shows that he is having atypical arachnoid cyst/posterior fossa epidermoid cyst.and here nuero surgeon adviced surgery can help out,i am very much confussed what to do,because brain surgery is a serious matter,i need your help please advice me what to do? Here i am giving the detail of M.R.I and C.T scan----- M.R.I axial-T1,T2,T1(post gad) Coronal-T2,T1(post gad) sagital-T2 flair,T1(post gad) Oservations----- midline  heterogeneous posterior fossa cystic lesion descending up to CVJ with rim enhancement with heterogeneity within,measuring approx 41.5*27.5*18.0mm. Opinion-- Posterior fossa Epidermoid cyst /Atypical Arachnoid cyst.",
    "doctor_response": "If your surgeon feels that this is an epidermoid cyst, it is large enough to consider surgery to remove it, as these cysts can enlarge over time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Want to find out the right way of counting the exact day of my pregnancy?\n\nHi there just a quick question regarding conception , I had my last period on the 14th of December 2012, I went for a dating Scan yesterday which dated me 13 weeks exactly, which puts me a week ahead? If I count back 13 weeks ago is that when I conceived or do i count back 11 weeks to find out conception? Does this just mean I could of conceived a week early?",
    "doctor_response": "Hi, Thanks for writing in. During the first trimester a discrepancy between dates & scan of up to one week is considered acceptable. Time of conception is usually two weeks after the first day of your last period if you have regular 28 days cycle. I suggest you should not stress out much by these medical details & concentrate more on your diet & wellness. Wish you best of luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does tooth decay cause body temperature and sweating?\n\nI have lower body temperature and sweating , went to doctor he checked my urine, my blood pressure, heart beat, and lungs said all were fine, I think I have a tooth infected from smell in mouth, dr said I was fine and said to come back if problems arise example: blue lips",
    "doctor_response": "Hi Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concern. Decreased body temperature is common after sweating & this might be symptom of excessive sweating  & doesn't denote any problem. Tooth decay doesn't cause  decreased body temperature and sweating. You should visit a dentist for treatment of dental decay, if you have them to prevent any dental complications.            Decreased body temperature and sweating is commonly due to systemic conditions like low blood sugar, excessive sweating, low blood pressure, etc. so you should visit  physician, if problem persists  & blood tests may required for diagnosis.In meantime you could take acetaminophen & drink ample amount of water.Don't worry you would be fineHoping your query is solved.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore and bruise shoulders with difficulty in movement?\n\nOh backwards down the stairs two days after the fall my right shoulder is very sore there was a bruise in my range of motion doesn\u2019t exceed shoulder height what could possibly be wrong? This happened after I fell from my stairs onto my back bruising my shoulder",
    "doctor_response": "Hello, I have studied your case.It can be rotator cuff injury to shoulder muscle which may need MRI for confirmation.Medication like methylcobalamine with muscle relaxant and analgesic will reduce pain, you can take them consulting your treating doctor.You may consult physiotherapist for further guidance. He may start TENS ,or ultrasound which is helpful in your case.You may need to take rest for early healing.Also check your vit B12 and vit D3 in your blood.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take careRegards Dr Vaibhav",
    "dialogue_context": ""
  },
  {
    "patient_message": "Getting itchy bumps. Have allergy. Applying moisturizing cream. How to get cure?\n\nI am a 29 year old female and I have a lot of allergies-dust, dogs, cats, fresh cut grass. It s winter and I ve been getting random itchy bumps that stay itchy for days. I do use moisturizing cream which does help some, but it s very frustrating. This year I have already got lots of these bumps. I m the only one in the house that gets them and we have had our place Che Jed for bugs-nothing. These bumps appear at any time during th day.",
    "doctor_response": "Hello, Thank you for writing to us at Healthcare Magic. You seem to be getting cold-induced urticaria, that does only partially respond to creams, as it removes the scratching component. Physical urticaria is when you get more lumps after scratching the skin and therefore you must avoid doing this. House dust mite allergy gets worse in the winter, especially in the western part of the world (due to central heating etc) and once daily long-acting allegra 180mg plus nasonex nasal spray is recommended for the entire winter. The long-acting antihistamine will also help with the skin condition, and occasionally you may have to resort to sedative antihistamines like hydroxyzine 25/50mg (sometimes 75mg) at night to control the difficult urticaria. Hope this helps. Best Wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for loose motions in a child\n\nhi, my 2.5 year old has fever ranging between 37-39 fluctuating with cold and cough since past 4 days nowdoc prescribed amoxylyn and panadol, how fever has come under control and returns again every 6-8 hours wich is imild but then today he passed out watery motion twice in 4 hours.",
    "doctor_response": "Hi Dear,Understanding your concern. As per your query your child have symptoms of loose motions which seems to be due to viral infection of body leading to acute gastroenteritis and electrolyte imbalance in body. Need not to worry. Give him banana on daily basis and light food. Avoid giving any sharp and spicy food. Drink plenty of fluids to rehydrate him. Visit general physician once and get it examined. You should take antiemetic like domperidone and ranitidine for gastritis. You should go for blood tests as well and start treatment after proper examination. You should start treatment with combination of fluoroquinolones and ornidazole or albendazole depending upon the diagnosis . You should give Ibuprofen to your son along with proton pump inhibitors as well.Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for difficulty in walking and slurred speech\n\nmy father is with MDR TB since jan 14 having medicines tericox, m-cin, protomid, microzide, monopas, efficin 0.75 gm, liveril forte, rabemac dsr & 18 june 14 he suffered like slurred speech, frequently 1-2 mins gap body shiverring. for this he is having Atorva 80, clopitab-1 50 now he is not able to walk as well",
    "doctor_response": "Hi, Welcome to HealthCareMagic.com I am Dr.J.Mariano Anto Bruno Mascarenhas. I have gone through your query with diligence and would like you to know that I am here to help you.Can you please specify what exactly is your question I see no question hereIf you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in HealthCareMagic at  Best Wishes for Speedy Recovery Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there chances of pregnancy after having sex on the first day of periods ?\n\nsir, you will get pregnant if you have sex on the first day of your period?",
    "doctor_response": "Hi Welcome to HealthcareMagic No there is no chance of pregnancy if you have sexual intercourse on first day of menstrual period. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a heavy cold & chest infection\n\nHi, may I answer your health queries right now ?  Please type your query here...i had a heavy cold which went on my chest and i had antibiotics for a week, the cough wont go away and the phlem keeps rumbling up and down my tubes in chest, tried all things from chemist",
    "doctor_response": "Thank you for contacting HCMFirst big mistake you made is taking medications from chemist that too without prescription.Now coming to your problem, you haven't given detailed history like are you suffering or suffered from fever, breathlessness, noisy and fast breathing if your answer is no to above symptoms then not to worry.most probably you are suffering from post viral fever bronchitis which will subside gradually without any medications.Mean time do the following things1.Wash your hand for 4-5 times a day.2.Steam inhalation for 4-5 times a day.If your symptoms not subsided within 3 weeks or you developed any new symptoms like shortness of breath, fever, fast noisy breathing then you must have to consult your near by physician.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had infertile spasms. Why has platelet count reduced? How to control fit?\n\nHi Dr. My daughter is 11years old and she had inferntile spasams when she was at 6 months. She was given valparin for more than 9 years she was started with 2.5ml twice day and increase up to 10 ml twice a day her fits was controlled and recently her platelet count has come down to 0000. We took blood report in May in that her platelet was 0000. Her weight is 40 kgs. I want to know her dose is correct and why her Platelate count is dropping. Please advice me.",
    "doctor_response": "Platelet count may be affected by Valparin Dose of valparin varies, usually 20-40 mg/kg/day There can be other causes of low platelet that need a pediatric hematology or neurology consultation on urgent basis Sometimes, this can be a laboratory error. Test can be repeated",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes middle of rib cage pain and pain that radiates to shoulder blades?\n\nI have had my gallbladder taken out at the end of Feb 2015. I still have pains, burning pain in the middle of my rib cage in the front and sharp pain that goes into my shoulder blades. I have runny diarehhea, gas, burping. My Dr put me on a prevacite Acid pill and Radidine for ulcers. What do you think it could be?",
    "doctor_response": "Hi thank you for posting your query in HCM.. I had gone through your question. I understand your concerns. Usually pain under ribs occur due to indigestion of food, especially fatty foods, due to straining of the muscles. After gall bladder removal, there is likely chance of developing infection in the liver, this can also cause pain under ribs that can radiate to the shoulder blades.I would  advise you to continue the medication and avoid fatty foods intake.drink plenty of water.  Hope i have answered your question. If you have any further questions i will be happy to help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My period has been late by 13 days. What could be the reason?\n\nHello doctor, I am a 24 year old female.\u00a0My period has been late by 13 days.\u00a0I am sexually active.\u00a0I took a home pregnancy test but that was negative. My period has been fairly regular in the past with them happening 4 days prior or after my date.\u00a0I have taken emergency morning after pill in the past (thrice in the last 4 months). What could be the reason?\u00a0Is there a possibility that I could still be pregnant after a negative test, though I have not had any other symptoms of pregnancy nor am I having any sought of discomfort?",
    "doctor_response": "Hello. The striking point in your history is that you have taken morning after pill thrice in the last 4 months. It has to be understood that the most common side effect of an emergency contraceptive pill is delaying the next 2-3 menstrual cycles.  As your pregnancy test is negative even after 13 days post period, it clearly indicates that you are not pregnant . Hence, the delay in periods is likely to be due to ipill side effect. Or another possible reason for the delay could be stress induced hormonal imbalance during this menstrual cycle. Stress including emotional, psychological, physical or social disturbances, all have a bearing on the reproductive hormones and can easily delay your menses, once pregnancy is ruled out.  It is suggested that you can wait for another week to allow your menses to resume naturally , if not then you may opt for a withdrawal bleed with progesterone pills to resume your menses.  As pregnancy test is negative, you can rest assured and wait for another week safely. For further queries, consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on the left side of my jaw?\n\nJust noticed a lump in on the left side of my jaw where the jaws meet.  It is small, not painful.  I was diagnosed with whooping cough and pneumonia on 1/6/12 and placed on antibotics.  I still have a cough and cold like symptoms.  Is this something I should get checked?",
    "doctor_response": "yes u get checked.it probably a lymphnode enlargement may be due to some oral cavity infection or parotid gland enlargement or irregular,inadequate antibiotics taken past ,u should undergo investigation  fnac to rule out",
    "dialogue_context": ""
  },
  {
    "patient_message": "What kind of pacemaker should be placed if heart is weak?\n\nhello sir my dad's is of 47 year old his heart is weak by doing all medical precautions and tests one of a doctore recommended him to have a operation of having pacemaker so could i know wat type of pace maker he would have and what is the price of dat pacemaker?",
    "doctor_response": "Hello!Thank you for asking on HCM!Regarding your concern, I would like to explain that pacemaker implantation is required when something wrong is going with heart stimulating impulses generation or their conduction through special underlying cardiac conductance system as well.There are several cardiac disorders which deserve such a therapy, in order to supply inadequate cardiac impulses, avoid consequent daily physical performance limitations, and furthermore treat life-threatening conditions.Each cardiac disorder needs a certain pacing (and hence pacemaker type) regimen, one-chamber, dual-chamber, etc, and different pacing regimens, like AAI, VVI(R), DDD(R),etc.It is important to identify the exact primary cardiac disorder, to optimally define the appropriate pacemaker device.So, if you could supply a resting ECG, or an ambulatory 24 to 48 hours ECG recording (if the disorder is transient), it would be possible to clarify this issue.Regarding pacemaker costs, it depends on health insurance policies, available and applied to your living area, county, state, etc. and to certain individuals. There are no strict rules. Privately costs in my region, differ from type of pacemaker, and medical center (approximately 2500 - 4500 euro).Hope to have been helpful to you! Greetings! Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is surgery necessary for gall stones and helicobacter pylori?\n\nHi. I was diagnosed through an ultrasound of multiple gallstones, the biggest measures 16mm, associated with thickened wall denoting calculus cholecyctitis.  In my stool test, i am positive for helicobacter pylori. The doctor said i need to undergo surgery. I'm not sure if the surgy is for that h pylori or for that gallstones. What are the risks of the operation? And what is the consequences if i delay the surgical operation. Thanks a lot.",
    "doctor_response": "Hello! Thanks for putting your query in HCM. I am a Gastroenterologist. Surgery was advised for gallstone and cholecystitis that is cholecystectomy that is removal of gallbladderRisks of operation are less l;ike bile duct injury, sepsis, and any risk of operation done under anaethesiaThe consequences of delaying the surgery can be recurrent cholecystitis, empyema of gallbladder that is infection of gallbladderI hope I have answered your query and this will help you . Wish you a good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i take medication during pregnancy?\n\nHi,I currently take 2.5mg of ramipril daily as I have moderate heart valve regurgitation and will one day have to undergo heart valve surgery. I also take 10mg  of propranolol twice a day to prevent migraines, though my cardiologist said this has benefits for my heart too. I'm looking to start a family, and have been told that I will need to 'wean off' ramipril before getting pregnant. Do you know how long it will take to wean off 2.5mg of ramipril? Also, can I still take propranolol during pregnancy? I know there is a lot of risk involved; my partner and are continuously discussing the pros / cons! I weigh 9 stones, I', 5\"7 and I'm 25yrs old. Thank you.",
    "doctor_response": "It's not safe to take Ramipril in pregnancy. it causes decreased fluid in womb and kidney problem in the unborn child. Propranolol on the other hand is safe. Talk to your doctor and change your medication before attempting conception",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mildly elevated liver enzymes, sharp pains in groin area, dull ache below rib cage, frequent urination. Any ideas?\n\nI recently had blood work come back with very mildly elevated liver enzymes . I m scheduled for an ultrasound on Dec 18 but last Saturday I went to the ER with periodic sharp pain above the right groin area. I was concerned about appendix issue but I was released and since then I haven t had an episode as bad but still the odd pain. Also for the last month I have had a dull ache below the ribcage on the right side. I ve also noticed a lot of lower back fatigue on the right side and frequent urination . No fever or loss of appetite/nausea. No jaundice . Regular bowel movements, although there is sometimes some constipation. Any ideas as to what I might be experiencing?",
    "doctor_response": "Hi andrew ! You are saying frequent urination, go for diabetic test. If pain in groin area did you think it may be hernia.  if both are not true as diagnose. Then eat healthy and consult the doctor. Bye be healthy. Bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it effective to use pacemaker to control heart rate?\n\nMy 83 year old dementia ridden aunt broke her hip had surgery, was medically cleared. She is on multiple bp medications. At home she was only on Lisinopril 20mg daily and synthyroid. Now her heart rate is occasionally in the 55 with no symptoms of syncope, sob or dizziness, now the cardiologist says she needs a pacemaker. Isnt this excessive.",
    "doctor_response": "a heart rate of 55 / mins without any other symptoms may Not need a pacemaker , you should first do an echocardiogram to figure out the function of the heart , if normal , there is no need for a pacemaker but only follow up .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Psychoneuralmuscular clonus in teenager. Anxiety  medicines offering no relief. What is an appropriate treatment?\n\nmy granddaughter has been dx'ed with psychoneuralmuscular clonus she has been taking an antiantiety medsand still not getting any better. She hurts because of all the mms. contra. Yesterday she had to crawl because shecouldn't stand up .She goes to a psychologist & a physch. doctor but they don't seem to be in communication withone another. She has had an Brain Scan. & electrodes placed oher head & they say its psychosomatic. She's only14. Her life has been turned upside down,she now is unable to go to school. She has a 17 yr. old sister in giftedclass.She is also in gifts classes. There is also a brother who is 8 & autistic. & going to special needs class. She says she doesn't know where this is coming from. It started the beginning of the summer ater an operation on her thumbnail, due to a skate board accident. She is on Prozac &  now and an enchanter,which I don't know the name of.Mydaughter has insurance but every time she goes to the doctor its 75. dollars, . They wanr her to take my granddaughter to the doctors at least 3 times a wk. which cannot happen. We are @ our wits end. Can you offer some advice......",
    "doctor_response": "Does not look like Psychosomatic Only anti anxity drug will not help. Please get the opinion of a Neurologist as well It will not be proper to suggest drug without detailed examination",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on labia?\n\nI've had these bumps on my labia for a week now I started putting neosporin on them yesterday because my mom said it looked like razor burn it hurts to sit walk and when my pee touches it I don't know what they are. It even hurts to put in a tampon because the swelling is that close to there on my labia. Please help",
    "doctor_response": "HI.You need to take a regular antibiotic and anti-inflammatory medicines for 5 days. This can be a an abscess or just a cellullitis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for erectile dysfunction and infertility\n\ngood morning Doctor, my name is Arun. my marriage was on 2011 we dont have a kid yet. i am suffering a problem while having sex. i am loosing the strengh of my pains before ejakulation that why i am feeling that i can drop the semen deep inside. is this a cause for infrtinity. please advies..",
    "doctor_response": "DearWe understand your concernsI went through your details. The details given here are not clear. You are unable to keep your penis erect till the end of your sexual act? That is hardly possible. Ejaculation takes place when your penis is fully erected and is suppose to be vibrating with fullness. I think you are being unnecessarily anxious about the condition here. Don't worry. I suggest you to post a more detailed query here so that I can help you. Take care. If you still need my assistance in this regard, please use this link.  Please remember to describe the whole problem with full detail.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I feel stressed due to broken relationship. How to get rid of it?\n\nHello doctor, I stress and overthink a lot, and after my breakup and I am facing this for a year. I am hardly able to concentrate I am always involved in thinking about my past. The guy always tries to defame me and speak rubbish about me, I being an introvert I am unable to talk to a lot of people and he takes advantage.",
    "doctor_response": "Hello. 1. It is common to feel stressed following a break-up in any relationship. Usually one gets better with time, but you are reporting the ongoing stressful situation. It will get better with support. 2. Have you spoken about your difficult situation with any family member or friends? Try to open up and have an honest discussion with a trusted person who can understand and support you. 3. It does not help that the ex-guy is trying to defame you. Try to ignore him and see whether his actions die off. Block his contacts. Try to stay off social media for some time until everything calms down. If he continues to harass you, try to warn him formally. Take help from family and friends instead of handling it alone. 4. Try not to worry about the current stressful situation. You will come out of it as a wiser person. Try to stay positive. Focus on long term goals. Try to exercise regularly to help you to relax. Distract yourself by listening to your favorite music, watching TV, movies, etc. 5. If you are continuing to feel emotionally distressed, you can consult your doctor for further assessment and support. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe vomiting and low grade fever\n\ni am 23,female,65kg and 5'3'' height.one and half month back i had severe vomiting lasting one week.and since then  i have been experiencing low grade fever and throat pain.i had two boyfriends and was sexually active with them.but both didn't have any other sexual partner.they both are perfectly healthy presently. could my ailment be something serious?",
    "doctor_response": "Hello You are having low grade fever with  throat pain . Before this ,you were also having vomiting for one week.Sexually active with healthy boy friends .Such typical symptoms may be due to these possibilities , these include:1 Chronic septic pharyngitis ,as you are having low grade fever with throat pain so you may have pharyngitis . Diagnosis can be confirmed by physical examination by an ENT specialist.2 Typhoid fever , the next possibility may be of typhoid fever. Diagnosis can be confirmed by Widal as well serology test for enteric fever .3 Chronic tonsillitis as this one most prominent cause of throat pain as well as low grade fever.In my opinion get in blood examination for VDRL ( sexually transmitted disease ) as well as physical examination by an ENT ,  so consult an ENT and get his opinion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a splinter under a fingernail in a diabetic?\n\nmy daughter is 25 years old and a juvenile diabetic. she has a splinter under her finger nail. it has been 3days and now there is small amount of drainage at the finger nail. Her doctor s office is closed till tommorow and wondering what we can do in the interim.",
    "doctor_response": "Hello,If it looks infected at all (redness, swelling, pus) or if she has a fever then she needs to be seen today so I would take her to ED or to an urgent care. If there are no signs of infection she can wait to be seen tomorrow. There is nothing to do in the meantime.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard spot on one side of the prostate?\n\nHi, may I answer your health queries right now ? I am 55 yrs old and am having a prostate biopsy in 2 wks, as my PSA was elevated (was 1.1 14 months ago, was 5.6 in Dec 10, then to 2.8 on 2/1/2011, after being on antibiotics for 6 wks. Urologist says there is a hard spot on one side of my prostate. I have not been feeling well overall for a couple months ie.,symptoms such as bowels not normal (constipated, now very thin movements, some diarhea, some swelling in legs, Latest symtom this morning my temperature was 95.5 when I woke up. I drank a cup of tea, went to 98.1, and is still at 98.1 a few hours later. Is low body temperature a sign that I do in fact have cancer? If so, soes it mean the cancer is aggressive? Should I wait 2 weeks for the prostate biospsy or try to have it sooner? (Dr s office said that s when the next time is available)? If body temperature goes down again, should I go to ER?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You have hard spot in prostate. you may have benign prostatic hyperplasia or it can be prostate cancer. but your symptoms are not due to cancer so don't worry about that. If your PSA level is very high then you should go for urgent biopsy. If it is borderline high then no urgency is there. Consult your doctor and go for biopsy on schedule. Then you should take treatment accordingly.Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer.Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suddenly having soreness in the middle back. Hard time standing, sneezing, deep breathing. What could it be?\n\nHi: I woke up around 5am this morning and all was well. I went back to sleep until 730 and when I woke my middle back was extremely sore. I have a hard time standing straight up and I was unable to sneeze . I can walk around for a bout a minute, but when I try to take a deep breath it gets real sore again. I ve never had any symptoms or back pain in this area before.",
    "doctor_response": "Hello and welcome The problem can be due to muscular spasm. Try Ice and hot fermentation and take complete rest till he pain subsides. Apply local anti-inflammatory gel at the site. Take analgesic and and anti-inflammatory drug to reduce pain. Use hard bed to sleep. If pain persist for more than 2 days feel free to consult your doctor and get your X-ray done. Best Wishes and get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do pain in the knees while kneeling down and numbness in the feet need medical attention?\n\nHello, I feel down a couple of steep steps while traveling in China 2 weeks ago and landed on my knee. I have no pain other than when I kneel down on it. It is excruciating! There is also some numbness on the outer part of my knee cap. Do you think it will heal on it s own or should I see a dr?",
    "doctor_response": "Hello, This type of injury is quite common. It usually heals up in due course of time, if you don't have other associated  diseases like diabetes, hypertension or any other metabolic disorder. You may take an occasional tab of paracetamol & multivitamin. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Nirmal Chander Gupta, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed a painful lump on the arm pit\n\nMy 9 yr old daughter has a lump/knot in her arm pit that I just noticed tonight.  It is apparently painful to the touch.  She is a swimmer so I wondered if it could be a sore or pulled muscle but now am more wondering if this could be a swollen lymph node?  I have not noticed any infection or illness & she has not seemed to feel bad.  It is larger than a quarter size.  How concerned should I be?  Should I make an appt with her pediatrician right away or just watch it??",
    "doctor_response": "Hi and thank you so much for this query.I a so sorry to hear about this swollen lump in your daughters armpit. Chances are high that this could most likely represent and abscess. There is no need to rush to the doctors right now. Monitor it over the coming days and if it should fail to regress, then you may want to seek for medical consultation. If it is a minor abscess it could regress or even pop open all by itself. Try tylenol and Ibuprofen to relief her of the pains associated with this.I hope this helps. I wish her well. Feel free to request for more information if need be.Dr. Ditah, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the ribs, headache and vomiting. Gall bladder removed. Is it normal after surgery?\n\nYellow Stools, Under Right Rib Pain, i had my gallbladder remove a year ago and now i have this problem, is not all the time, i think is when i eat to greasy food. I have a little esophagus hernia, gastritis and reflux and usually when i have the symptoms above i usually vomit like acid fluid and get a headache. At the ER the took an X ray of the area and found nothing. Still want to know if this is normal after the gallbladder surgery and it is go away?",
    "doctor_response": "Hi and welcome to HCM. Thank you for your query.It can be normal as a part of postcholecystectomy syndrome which is sometimes found after such surgeries. SOmetime more than a year should pass till your digestion stabilize again.  YOu should have more frequent but smaller meals and avoid alcohol, fats and smoking. ALso follow some of the hepatoprotective diets and check frequently your liver enzymes. This can also be gastritis so it doesnt need to be related to gallbladder removal. WIsh you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing voimitings in an infant after taking food?\n\nMy 6 month old started vomiting all of her food a couple weeks ago. We had started some solid foods and had been doing rice cereal with milk a couple weeks prior to that. She started to lose weight, and had started to get dehydrated. Our pediatrician assumed GERD was the cause at first so prescribed some Axid. Things got worse. We ended up taking her to a after hours urgent care for kids. She is now in the hospital and has been there almost a week. Has had many tests done. They can t get her to keep down the contrast when trying to do an upper GI. She is now on a feeding tube with breast milk at 30mL an hour. She has been keeping a lot of it down, but after being on it almost 12 hours last night and 6 hours today she has had some vomit again and they stopped feeding her now. We are waiting on further orders from doctors and are growing increasingly concerned. What questions should I be asking the GI specialist? And what key things might I be missing to helping the doctors diagnose her?",
    "doctor_response": "With this minimum information all i advice is to wait for the endoscope report. other causes for vomiting should be ruled out if endoscopy is normal- like CNS causes or any metabolic disorders, thank you ,regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for painful lump in pubic area\n\nHi, I am 32 weeks pregnant and have had significant pubic pain for the last couple of weeks that I attributed to pubic symphysis diastasis.  In the past 2 days the pain has gotten significantly worse and is now excruciatingly tender to palpation on the left side.  Tonight I noticed a hard lump on the left side of my mons pubis that is incredibly painful.  I have not had any other systemic symptoms, vomiting, fever etc.  Any ideas?",
    "doctor_response": "Hi.Thanks for your query.The pain in this area with a swelling on one side can be due to an abscess or symphysis diastasis as you rightly thought about.The only way to get a proper diagnosis is by clinical examination by an Orthopedic Surgeon, and/ or MRI ( MRI is safe in pregnancy).The treatment will depend upon the diagnosis.IF an abscess - needs a nice course of pregnancy-safe antibiotics and anti-inflammatory medicines.If diastsis- anti-inflammatory may be sufficient.Gynecologist's opinion about an early caeserian section can also be sought if the problem is severe.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a non healing open ishiorectal abscess\n\nHello I had a surgery for ishiorectal abscess, it was drained on the 15th Nov 2011 and was discharged the next day, the surgeons told me that it would take 6 weeks for the open wound to heal, it was left open for the body to heal inside out. The wound is still open with pus and some blood discharging every day. I clean it every day followed by a stiz in salt water. I had a MRI scan on the 28th Dec, the report of which was discussed on 24 Jan with the surgeons. I was told that I would have to undergo another surgery which could either be Lay Open or Seton surgery depending on the depth of the tunnel formed.The MRI scan final report say the following: \"There is a rather to the well-defined inter sphincteric tract running from the lower anterior sphincter at 12 o'clock down to perimeum. The track measures 3 cm in length. There is no extension of the tract above the level of the dentate line and there is no evidence of horseshoe formation or braching. The maximum width the tract is 6 mm. There is no other significant finding elsewhere on the images of the perinium.\"",
    "doctor_response": "ah, that's what I thought. There's been a connection from the infection/inflammation connecting the anus and the outside skin. Treatment would be to surgically remove the entire abnormal connection, and patch everything else and watch the healing closely to make sure things close up the way they should.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can foniasophobia be treated?\n\nDear sir,my name is Ajitendra from katihar (Bihar), my cousin brother who was very good in study and he done b.tech in patna.Now he has changed he thinks all the time ,he thinks that some body is planning to kill him...at home he dosnt talk to any one.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Foniasophobia is the fear of murderers or serial killers, or of being murdered. This fear is usually triggered after hearing news that somebody got murdered or of hearing a person on a killing spree, or more rarely encountering people who killed other people. Our first duty is to enquire regarding the life events which occurred in the past related to murder or encountering people who killed others and after that giving him reassurance regarding his safety repeatedly make him feel better. What is his lifestyle is being significantly affected it's better consulting a psychiatrist and explaining him the whole condition so that he will either advice for cognitive behaviour therapy or low dose antidepressants which make him feel better and come out of phobia. Advise him for morning walk daily and exercising for 2 to 3 days per week which also makes you feel better. If is not recovering on antidepressants then low dose antipsychotics as augmenting agents also helps him cover quickly. Giving the diet rich in Omega 3 fatty acids also helps him feel better. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Achampet Vikas",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes diarrhea during teething?\n\nMy sixteen month old had yellow diarrhea now for about 2 weeks...he went to whole milk and then I went back to just straight formula for 6 days to see if it cleared up a little it didn t just wasn t as yellow but was still pooping 4 to 5 times a day still...3 molars are coming in at once I know they say that doesn t cause it but my other two kids def had diarrhea when teething....is it a stomach infection, teething, lactose problem...no fever, seems happy during the day was never a good sleeper so still wakes 3 or 4 times a night...was wondering if I should go to the doctor tomorrow??",
    "doctor_response": "Thanks for your query, I have gone through your query.The diarrhea can be secondary to the eruption of the teeth called teething disorder. During teething there will be itching over the gums and you will be feeling like biting over the gums. So kids usually put there fingers inside the mouth and start massaging that area. In this process contaminated fingers result in infection and cause diarrhea. Nothing to be panic, its a self limiting condition. If it does not stop in 5 days, consult a oral physician. I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. From the photo, please confirm if my son has ringworm infection.\n\nHi doctor,mI believe that my 6 year old son has ringworm infection. It started out small and then within a few days has gotten larger. I have attached the photo for your reference.",
    "doctor_response": "Hello. I just read your query and saw your attachment (attachment removed to protect patient identity). Yes, you are right. It does appear to be a ringworm infection of the scalp called as tinea capitis. For further information consult a family physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back pain and urinary incontenence?\n\nHi I been having really bad pain in lower back an down hip an leg haven problems standing r walking on left leg some numbness an now today I can t hold my urine I can t really tell I have to go really bad then all if a sudden I do an cant make it to the bathroom in time I also been having electrical shock down my arm same side an lost feeling in the tip of my index finger",
    "doctor_response": "Hello,The fact that you have urinary incontinence is very concerning. It may mean that something in your spinal cord is damaged that is causing the back pain and incontinence. You need to see a doctor as soon as possible for an exam and some testing.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain\n\nI have had back pain on both sides at my waistline, that raps around each side for the past couple of days. Breathing deep causes the pain to increase. Aspirin and the heating pad help a little, and the pain is different than an aching back caused by overuse. The pain feels internal, if that makes sense. Just wondering how long I should wait before seeing doctor.",
    "doctor_response": "Hi,Your pain might probably be from a pinched nerve. When you take a deep breath the abdominal pressure increases causing increased compression of the nerves, which in turn causes the pain. If the pain is not relieved by taking over-the-counter meds or if it is increasing in severity or if you experience new symptoms like pain going to your thighs and down the leg along with numbness, you should see a spine specialist. There is no exact time frame that can be foretold as the symptoms are subjective to change. It always helps to get a baseline MRI and follow it up if the symptoms change for the worse. Hope this answers your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in the pelvis\n\nhi, im 37+2 weeks pregnant with my second child , i was in hospital for couple of days few weeks ago when they thoght i was in slow labour , when i went up on thursday there they said the pain in between my legs and back was to do with my pelvis . the doctor said the babies weight is 7lb3oz , can i request to be induced now as i really can not stick the pain anymore and im not sleeping as its worse when i lie down and therefore im ratty with my son , which isnt fair",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the pelvic pain might be muscular pain.Some non specific pain appear in pregnancy which subside spontaneously.Take panadol for pain.Induction of labour is indicated when:-1) Pregnancy passing out EDD with no natural  onset of labour pains.2)Termination of pregnancy for any reason at term.Before induction the bishops score is taken into consideration where different parameters like cervical consistency, position,dilation,length etc are taken.If the score is less the success of induction will be less.So I suggest you to consult doctor and get examination done for the evaluation of bishop score.If the score is good induction can be tried.So relax.Hope this helps.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe dizziness, nausea and headache after waking?\n\nHi. I woke was awoken this morning at 6am to the room spinning faster than anything I\u2019ve every experienced. My eyes were rolling around as I couldn\u2019t gain focus. It made me very sweaty and I felt a little nauseous, unsure if this was because I was worried as I didn\u2019t know what was happening to me. I\u2019ve never had anything like this before. I managed to go back to sleep for a little while after I\u2019d calmed down and during that sleep I remember rolling over and the dizzy sensation came back briefly but not as bad. Now I\u2019m up, my head feels very funny and I have a headache. What could this be please? I\u2019m so worried!! Thankyou!",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I think you may developed acute episode of vertigo it may be due to BPPV or Acute vestibular neurinitis or labyrinthitis or TIA or hypotension etc..Until examination is done it is difficult to say what it is. Please check your blood pressure, check blood sugar, check cardiac status with ECG.Use tablet vertin 16 mg thrice a day for five days. If symptoms not improved please consult your neurophysician/ENT specialist he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe bronchial inflammation?\n\nMy daughter has had asthma type symptoms for an extended period of time. It s been a year, it s getting worse and dr says they need to do more tests. She needs her inhaler every day, throughout the day. Dr has ruled out asthma and says her bronchial are very inflamed and damaged from prolonged inflammation. Both of my parents had collagen diseases and her dr is testing her for this now too. I don t understand the lack of diagnosis. Does it sound significant of anything you know?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Routine bronchoscopy and lung function tests would help in your case . Collagen disorders definitely need testing to rule out similar issues. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have severe itching and redness in the groin area. Please suggest a solution.\n\nHi doctor, I am a 26 year old male. I have severe itching and redness in the groin area. I have used over-the-counter creams, besides, I have also used some home remedies over the affected area. The skin is flaky. Please suggest a solution.",
    "doctor_response": "Hi. I have gone through your query, and I have noted your concern. Regards. Revert with an image to a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes aggressive and temperamental behavior in a child?\n\nhi my daughter has been showing some really dab signs lately she started having issues at age 3 when she showed signs of hurting animals and openly admits she did it she is now 12 and shows a lot of anger towards people she is a compulsive lier and imagine things and then almost makes her self belive them in fact she does believe them she is always ceating problems with my partners going out of her way to stuff things up she has been to a doctor and they said she does not have add but there is serously and issue can you tell me more",
    "doctor_response": "these are symptoms of aggresive and antisocial behaviour. these are due to genetic and enviromental factors. u should go for a chromosomal analysis of ur baby. extra x chromosome in genome may lead to difficulty like thease. frontal lobe lesion in brain may also cause this. so u should seek help from pediatric neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe back pain after straining. Reason?\n\nI am a home health aide and yesterday I lifted my client that ways the same as me. The first lift I felt bad pain in my lower to middle back and it sounded and felt like tiny bubbles popping or like rice crispies crunching. I ve had horrible back pain all day yesterday, all night and now my lower up to middle back is killing me! Horrible sharp pain. Now I also feel like I have to pee a lot but I go and it s just a very small amount. What could ve happen when I lifted my client and felt crunching in my lower to middle back in the center right on spine??? I m in so much pain!!!",
    "doctor_response": "Hello and Welcome to HCM, Thanks for writing to us. The symptoms you have described are more likely to be symptoms of muscles strain. To get relief from the pain and for quick healing: 1. Do hot fomatation at the site. 2. Apply local anti-inflammatory gel 2-3 times a day. 3. Take anti-inflammatory drugs like Ibuprofen to reduce pain and local swelling or inflammation. 4. Do not lift weight or try to do exercise that involve painful muscles. Give proper time for the injury to heal. Hope this helps you. Wishing you good health... Regards. Dr Saurabh Gupta. Orthopaedic Surgeon. (H1N1)2009",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cervical radiculopathy and neck pain\n\nI FELL BACK IN FEBRUARY AND WAS DIAGNOSED WITH C6 AND C7 CERVICAL RADICULOPATHY. I VE BEEN OK SINCE, UNTIL NOW. I M CURRENTLY HAVING NECK PAIN THAT GOES ACROSS MY SHOULDER AND INTO MY RIGHT ARM. THE PAIN TENDS TO INCREASE WHEN I INHALE. COULD THIS BE FROM MY FALL?",
    "doctor_response": "You may use a cervical collar for support of neck, do isometric neck exercises under a physiotherapist. take dolo-neurobion One tab BD for 10 days. Do hot fomentation also",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for vomiting\n\nmy son is now 3.5 yrs old having weight 18kg.Now a days he started vomiting while giving breakfast.I used to give him medicine recommended by doctor ones in 3 months for tapeworms in stomach but i didnt give him any medicine for the same for last 4 months.what medicine shall i give him to eat well and keep healthy and energetic through out",
    "doctor_response": "Hi, give your child a tablet of Albendazole 400mg single tablet. Also give him an antacid in form of Tablet Lanzol junior 15 mg once daily empty stomach for 3 days. Syrup Ondem 5 ml SOS should take care of vomiting. Give him a lot of fluids. Keep a healthy diet and avoid excessive oily food for sometime. Also give him a multivitamin syrup for 15-20 days like Syp A to Z.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain after exercising, high ESR, done stomach scan. Should I continue walking?\n\nhi......iam priyanka 24 years .......from my young age i was not doing any kind of physical work i was just hooked to reading........and now from past 1 year am slowly working a bit....am doing tread mill walking ....i do it just for 30 mins......for 1 month i did only upto 5.8 speed.....after 1 month i walked at 6 speed for just 10 mins and then slowed down.......now my problem is am getting abdominal pain .....like when i walk my abdomen is aching like its gripping effect and when am sleeping and jus twist my abdomen its like my abdomen muscle is aching and also my thighs are aching........also my hips and back are aching......even when i jus cough my stomach ie abdomen aches.. i have done all test stomach scanning ,x ray,blood tests and all...my ESR range is 75 and every other tests are normal...........please tell me whether shud i continue walking r stop it........thank you all...",
    "doctor_response": "Hello, priyankka Dayanandan, I am reallybglad that you have gotten into work outs! In the long run,  this will be very beneficial to you and makes you healthy and strong and leads to long life. The symtoms that you are experiencing are very typical for someone who has been inactive for a long time. What I suggest is that you do your workouts three times a week resting in between.TKe some nice warm tub baths if you can after your workout. Elevation of ESR is from activity. I would not worry about that. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for behavioral changes and anger disorder in a child\n\nOur 11 year old has always had these uncontrollably yelling screaming appasodes that last one hour, she must always be right, controlling, she kicks and punches, she only like certain things, she doesn t like new people or things unless its her normal likeings same as clothes only like certain ones, she talks loud over everyone and right in your face remind you she s always been like this we just got custody and mom says this is just who Carissa is to me we have major concerns can you help me figure out what wrong so we can correct this for her and everyone else",
    "doctor_response": "DearWe understand your concernsI went through your details. I can understand your emotions. You should know that child rearing is an act. A child aged 11 is going through a developmental period where he needs maximum attention and appreciation. If do not get these two, he will fight for it until he gets it. But if you learn to ignore his activities in tune with the given scenario, he slowly succumbs to the pressure. I am not suggesting that you doing everything wrong. You should introspect. Definitely there is something wrong in your behavior towards the child. Behavioral disorder of the child is another view point here i must not overlook. To determine or diagnose the child's behavioral disorder, I will need more information about her behavior. Or you may consult a nearby psychologist for assessment of her behavior.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i give Taxim-O drops for white acne for a 1 month old baby ?\n\nTaxim-O drops for white acne for a 1 month old baby Hi, My baby is 25 days old, 3.2 kg and no medical history and he has developed red acne which is all over his face and neck. Also, on his head he has just started developing white acne. My doctor has given him Cefixime Oral suspension Taxim-O drops for the white acne. Is it safe to take that drops for him?",
    "doctor_response": "HI, Thanks for query, There is no adverse effects known to Cefeixine in infants. As it is prescribed by a doctor you can give. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes light headed and increased body temperature while using BP medicines?\n\nI am taking medicine for high blood pressure and one of the side effects is feeling light headed when I stand up.  But sometimes my body feels very hot to me but when some one touches my forehead and face feel normal but by neck seems very hot. So I am trying to figure out if it is from my blood pressure medicine or if it is something else that is causing me to feel like I am burning up when just my neck feels hot. Any ideas or suggetions would be appreciated. I am 51, 5'6\" about 240 lbs and working on losing weight. I am taking two types of medicine for high blood pressure and medicine for high triglycerides",
    "doctor_response": "Hi,Your light headedness can certainly be due to bp medicine, and sometimes even got may be due to low bp, but this will be temporary feeling. I would advise you should check your temperature and confirm it whether it is really rising or its just psychological. Also, you need to monitor blood pressure three times a day for a week, if readings are below 110 then we need to decrease the dose of BP med. Also avoid sudden getting up from sitting or sleeping position. If you have severe symptoms, then you can take ORS whenever needed.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need advice on bleeding from ear.\n\nmy 3 year old put a sharp object in his ear on tuesday and now its thursday morning and he woke up with alot of blood on his pillow from his ear. I did take him to the doctor and he prescribed an ear drop mamed neo/polym/hc. so why is the ear still bleeding? please help",
    "doctor_response": "Hi,It seems that there might be having sharp injury in the ear due to sharp cutting object leading to bleeding from the ear.Apply cotton plug tightly in the ear after putting ear drops.This will lead to blocking of bleeding point and bleeding will stop.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have a blockage in my vas deference, Is it possible to clear the block ?\n\nhai, I am 32 yrs old male. Now I found to have a blockage in my vas deferens. Is it possible to clear the block ?",
    "doctor_response": "HI well come to H.C.M. You should consult Uro-surgen and  looking to report he will explain you kind of surgery if required for that. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dry heave, back pan. Kidney stones or pregnant?\n\ni think that i may either have kidney stones or may be pregnant . about a week after my last menstration i started to dry heave and a week after that i noticed i had back pain where my kidneys would but only on my right side and the pain radiated to the side this has been going on for 3 days now should i go to my regular health care physician or go to my gynecologist?",
    "doctor_response": "Hello, You can differentiate between two conditions. If you are pregnant, then there should be history of missed period ,at least one period missed. You will start to have naucea, breast tenderness, fatigue. Here in this case, after one week of last period you can not decide on whether you are pregnant or not; as ovulation itself occurs on 12-14 days of starting previous cycle. So as you are having back pain radiating to sides, you can refer to general physician. After doing USG diagnosis can be made. Take care. Best regards, Dr. Neelam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can seizure re-occur while on Coreg, HCTZ and Naproxen for high BP?\n\nBP readings today, 159/103 76 pulse 11am 163/101 75 3:30 pm 150/97 68 4:30 pm 144/94. 76 6:00 pm 167/112 76 9:00 pm Current medications: coreg 6.25 mg bid Hctz 12.5 mg qd Naproxen 500 mg qd Atorvastatin 20 mg qd,Sertraline100 mg qd Trazodone 50 mg qd I had my first seizure one month ago.I m worried about having another one or worse.Please advise",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. If you're worried that a high blood pressure will precipitate a seizure, then please don't. Seizure control is individualized, so you'd better stick to your neurologist's advice regarding the treatment measures that have to be taken. I have to notice though that you're not taking drugs for seizure control or you haven't mentioned them. Regarding your blood pressure, it is possible that your blood pressure is not under good control although random high readings may occur in every patient. Be warned though that naproxen makes blood pressure control difficult. Pain control on the other hand is important both for patient comfort and to avoid blood pressure elevations due to pain. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Panagiotis Zografakis",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are severe heart arrhythmias along with severe headaches a life threatening condition?\n\nHaving severe heart arrhythmias for last few wks. gotten much worse today, am feeling wk. and little worried. Have history of such but it normally goes away. I have a hospital nearby but I have no insurance & not much $ and fear I ll be turned away or die while waiting in E.R. No pain in chest, arm or jaw. Get a very bad headache in back of head when these spells come on. Not sure what to do or if its life threatening-",
    "doctor_response": "Hello Welcome to Ask doctor serviceI have reviewed your query, and here is my advice.Without EKG tracing it is difficult to say anything about the arrhythmia more over it is the medical emergency that demands the immediate medical attention, the symptom that you stated here weak and worried is not indicate the arrhythmia, but it could be due to anxiety and depression, if you want to confirm the arrhythmia then you need to get done the EKG, if this is found there then you have to get in hospital for proper treatment, type of arrhythmia matters here.Hope I have answered your query, let me know for further assistance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "hi, My wife is 7 weeks pregnant and has severe vomiting sensation and feels feverish/cold. Doctor has prescribed Doxinate 3 times a day. By using Doxinate, vomiting sensation still persists doctor asked to use Emeset 4 in case of emergency. She felt better for 2 days when she took Emeset in evening for last 2 days. She feels better after taking Emeset-4 in evening and again feels same vomiting/feverish from next day afternoon. Is it safe to take Emeset-4 everyday during pregnancy? Why Doxinate is not at all helping her to control vomiting?",
    "doctor_response": "Hi.It is fine to take it once daily, but avoid using it more often. What you can do is to take 1 emeset per day, and if the sensation still persists, try doxinate. It should be fine to use one tablet a day sir, as this is only temporary and should subside soon.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for a swollen gum?\n\nIm11+ 4 days pregnant, I got swollen gum on one side and very sore and now got a sore thriat and hurts to turn my neck had it for 3 3 days, I also woke up feeling faint and aivk is all this related or is my dizzi ess and feeling sick coz im pregnant,as it passed after few hours",
    "doctor_response": "Hello, Thanks for your query.As you may be aware viral infections do not respond to antibiotics. After the viral infection like flu many people get these kinds of problems including a feeling of severe fatigue. This will improve over 10-15 days. Take some fresh fruits, juices, cold milk and some bland food. For pain you can take paracetamol tablets. You will improve soon. Do not worry the best thing you can do is to visit a dentistI do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to conceive after a failed IUI treatment?\n\nHi drMe and wife trying for baby 2years and 7months married After one year try we met gync Dr they start some basic investigation and found left tube Block after start one iui failed 2nd iui successful but unfortunately that was tubal pregnancy ruptured after 2months so dr opt and removed left tube and pregnancy 4 month after that we did 2iui but faildNow what take next step for pregnancy? We r so confused  old help some suggestions Thanks",
    "doctor_response": "Hi I think you can go for 2 more cycles of IUI. If it doesn't work, you can go for IVF. BIG had higher success rate than IUI. The chance of pregnancy in one cycle of IUI is 10 to 15 percent only. In IVF, it is 40 to 50 percent. Hope it helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could the lung shadow be?\n\nhi my 3yr old daughter has been ill for some time now she has had a persistant cough since october 2010 and has been ill since january2011 with high temperature, cold and the cough shes so worn out and has lost weight, a xray shown a small shadow on her right lung now im really worried as i have to wait to be refered to a specialist with her and not sure how long that will take, i just feel shes being dosed up with medicine constantly but with no affect, shes been yet again perscribed another antibiotic as from yesterday but am now struggling to get them in her as there makin her feel sick and i think shes had enough of takin them, please help",
    "doctor_response": "Your child should thoroughly investigated to rule out for Tuberculosis as persistent cough ,loss of weight.Please do sputum AFB and Mantoux test.Other cause would be pneumonia.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe pains in the abdomen\n\nHi there.  Every month I have really bad stabbing pains in my abdomin. It is really crippling me.  I am 36.  I get my monthly period but seems not to be around that time.  After, my ovaries and lower abdomin are really sore and tender for a few days.  What could be wrong with me?",
    "doctor_response": "This can be due to Painful Ovulation also called as Mittelschmerz Syndrome. Get an ultrasonography and Gynecologist's opinion during pain cycle and she may confirm and start medicines to stop ovulation for 3 month period. The other reason may be Endometriosis of so. Diagnostic Laparoscopy during pain can give a better diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on the under side of the penis shaft?\n\na lump found on the bottom side of shaft of penis, young age still basically a virgin. larger lump, bigger then average pimple. researched some STD s, do not seem to feel any symptoms or differences in body. quite embarrassed and do not see ingrown hair",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  You may habe folliculitis or skin infection or dome other lump.  You need examination.  Consult your general surgeon and go for examination. or send me the image do that I can help you further. 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high temperature and tonsillitis in a child\n\nHi. i have a 5 1/2 year old boy - often gets croup, tonsillitus with high temperature. Has been given antibiotics and steroids to fix. Has been very unwell, and is now a lot better but very thin and pale. Any suggestions on what i can give him to maybe stop him picking up every virus out there?",
    "doctor_response": "Hi...by what you quote I feel that your kid might be having a viral sore throat or a streptococcal infection. I suggest you see your pediatrician and get a rapid streptococcal antigen test done. If it is positive then the kid will require antibiotics. If it is negative then it might be viral illness and doesn't require antibiotics at all.Cough and cold are viral 95% of the times in children. For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15mg/kg/dose (max ceiling dose 500mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.Warm saline gargles will be soothing and will give a lot of relief if the kid can do that.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for bump and squishy feeling on top of foot\n\nI had foot surgery in May, two extra bones removed, and tendon work done. On the top of my foot there has been a little bump. I thought it may be a pimple and I picked at it, and it itches. It is not a bite because it has been there a while. Now the top of my foot feels squishy, and you can push it in and it will stay sunken in in that spot, but it does swell back up. Should I be concerned?",
    "doctor_response": "Hi,Thanks  for  your query.Well, without a clinical evaluation it would be difficult to determine the cause of the lump. Possibilities that may need to be considered include enlarged bursa, lipomas, cysts, growths from underlying connective tissue etc.I would suggest getting this evaluated by an orthopedician for an accurate diagnosis and appropriate management. You may get the X-ray of the area affected and FNAC (fine needle aspiration cytology) of lump under his/her guidance.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful lump on foot\n\nHi there, I am wanting some advice. For the past couple of months I have had a lump on the heel of my foot, Its quite painful and I want walk or touch that part of my foot, its like i have a marble on the inside of my foot, any ideas on what thing could be?",
    "doctor_response": "Hi,Dear,Welcome to HCM. Based on the facts of your query,You seem to suffer from-Tendoachilles Subtendinous Bursitis./Retro-Calcaneal Bursitis / or could be from -Sever's Disease of-Calcaneal Apophysitis.USG and X-ray of the ankle would fix the diagnosis.Treatment -Would be Motrin/ Steroids Intralesional/ Hot fomentation / Rest/ infrared heat locally would help.HOpe this reply would help you to plan further treatment with your doctors.Contact with a Followup Premium question to ME. Will appreciate your Hitting thanks and writing excellent review comments to help needy patients like you. Good Day!! Dr.Savaskar, Senior Surgical Specialist M.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for extremely swollen legs and ankles\n\nMY FEMALE NEIGHBOR AT THE PLAZA HOTEL NAMED SALLY CAMPANELLO HAS EXTREMELY SWOLLEN LEGS AND ANKLES.....SHE IS AGE 82. WHAT IS THE CURE......HOW CAN I GET HER MEDICAL ATTENTION? IN SAN DIEGO AT 1037 4TH AVE. SAN DIEGO, C.A. 92101......ROOM 226...... SHE NEEDS PERSONAL CARE.....AT A SENIOR ASSISTED LIVING APARTMENT......OR A BETTER LIVING ARRANGEMENT. FROM DAWN SCHEUERELL RM. 304. THEY DON T ASK HER FOR ......WHERE SHE WOULD PREFER TO LIVE.....AND WHO SHE SHOULD BE FRIENDS WITH FOR NORMAL MENTAL HEALTH? THE INFORMATIION SHOULD BE READILY AVAILABLE ......AT THE LOCAL LIBRARY....WHERE I AM TYPING THIS LETTER FROM. I CAN T AFFORD TO HAVE A HEALTH PROBLEM....OR TO BE LIED TO BY ILLEGAL EMPLOYEES.....WHO HIRED THE EMPLOYEES??/ IT SHOULD BE ILLEGAL TO REQUEST A FEE????",
    "doctor_response": "Hi,Thanks  for  your query.There are numerous causes and conditions that produce swelling in the ankles. A few important causes are chronic venous insufficiency, Heart related issues, kidneydisorders, liver problems, water retention etc.A thorough and detailed evaluation along with a few investigations are needed to establish the correct diagnosis.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bad stomach pains and nausea, took a bottle of naproxen. Harmful ?\n\nHi, my 11 year old daughter was having really bad stomach pains and nausea , and she got into a bottle of naproxen . I believe it was 500mg... I m not sure. It was my Husband s, we are on vacation so he had some in a baggie. She watched me get a few tylenol out of a different bag for myself before, and probably thought it was the same thing. She is about 4 5, and weighs 105lb. Will she be ok? She s sleeping right now, should we just watch her?",
    "doctor_response": "Hello, Stomach aches and nausea on vacation may be due to many reasons. It may be due to improper diet. Sudden change in diet schedule etc. Naproxen is an pain killer and antiinflammatory drug. If your child's pain is like cramps she may need a anti-spasmodic drugs like dicyclomine or buscopan, if it is of burning sensation she may need a pantaprazole etc. Her pain is not associated with any vomiting and diarrhea, so probably she would be fine with the pain killer. Ask her to get plenty of fluids. If the pain is still presistent get her to a physician. Bye",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can infertility be treated?\n\ndr. i  am ptiti i am married since 8 years . i am 33yrs old.i am taking treatment from past two years. when i did my first HSG test it was showing my left fallopian tube blockage. and i was taking treatment according. now recently  did my HSG . now result positive came my . tube s r good enough and my period 4th day she given 3 HUMOG 150 injection for every alternative day and. now advised me to take goodova100mg for 10 day. plz tell me whether my treatment is going correctly or not",
    "doctor_response": "hello user,yes,your treatment is correct..you can do serum Tsh and serum prolactin.You should do follicular study after taking goodova 100mg to know exact time of ovulation..and keep relationship around ovulation or iui for early results..thanks..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful red lump on middle of chest?\n\nI am26yr old male I have a red lump on the middle of my chest to the left a little it started out as a smaller lump with no color and now it is about the size of a silve dollar and red it is painfull to take a deep breath very painfull to cough and especially to sneeze what could this be? please help",
    "doctor_response": "Hello!Thank you for the query.This sounds like sebaceous cyst which has gotten infected. Your symptoms indicate that there is a pus accumulated inside this lump. You need to consult a surgeon, otherwise your symptoms wont go away. The lump needs to be incised and pus drained.Please do not wait with it as it is a source of infection.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pimples around penis head?\n\nHi i am a 41 year old man, married with 3 three kids. I am 72kg of weight and 1,7 in height and I have never experienced any sexual infections or decease apart from what I am about to ask. My problem is at the age of 30 I developed pimples around my penis head and it has since been there till today. I believe its first appearance came about as a result of not washing immediately after intercourse but it later vanished after constant washing with potessium pemanganate. Now what seems to be a problem is that every time i use a condom I see the small pimples around the head of my penis again even if i immediately wash after intercourse. Some friend said its penis infection.Now I want to know if it can be cured without me circumcising?",
    "doctor_response": "HelloThanks for query .Based on he facts that you have posted the pimples that you develop on glans penis after protected sex are mostly due to allergic reaction to chemical in condoms that are being used as lubricants .You need to either change the condom to non lubricated condom or practice unprotected sex with other method of contraception like your wife taking oral contraceptive pills or IUCD.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for elevated neutrophil count in blood\n\nMy brother is 6 feet tall, 270 lbs, 35 years old and does not drink nor smoke. He has had lower stomach pain that moves around his lower right belly area. Blood work showed his neutrophils are very elevated. He has H pylori. Took antibiotics for 2weeks. However, his pain still remains. He has random bouts of diarrhea. His neutrophils remain very high. Doctor has not given a reason nor scheduled any further appointments. Any advice?",
    "doctor_response": "Hello,Thank you for your contact to healthcare magic.I understand your health concern, if I am your doctor I suggest you that high neutrophil count is associated with some kind of infection as you mentioned in your case probably is because of H. pylori infection. H. pylori infection required long duration of treatment. So do not expect short treatment and result. Take the treatment and wait for good result that is what all is necessary in your case.I will be happy to answer all your future concern. Thank you,Dr Arun TankInfectious disease specialist.Wish you a best health at health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe pain around the wrist and the small finger be treated?\n\nProblem with right wrist on pinky side surround ulnar bone that protrudes some from the wrist. Mostly dull pain on and off for the past two years, occasionally will have much sharper pains with things like driving or using a mouse. Have tried both resting and strengthening it. X-ray showed nothing wrong. MRI results below are very vague. Doctor told me he didn\u2019t know what to do with those results except maybe rest more. I would like to go back into training and exercising, weightlifting, body weight stuff, tennis, softball, etc. What is the best way to do this?MRI impression: 1. Possible partial tearing of the volar meniscal homolog at its triquetral attachment, evidenced by irregular interstitial contrast signal and contrast extending into the mid carpal joint at the triquetral-hamate articulation. 2. Suspected sprain versus low-grade, partial thickness tear of the volar radioulnar ligament, with slight dorsal translation of the distal ulna with respect to the radius. 3. The triangle or fibrocartilage articulate disc, scapholunate ligament, and lunotriquetral ligament remain intact. 4. No acute fracture or high grade/full thickness cartilaginous injury. 5. Suspected small synovial/ganglion cyst emanating along the volar margin of the radioscaphoid fossa, of questional clinical significance.",
    "doctor_response": "Hi, The pain in wrist and small finger can be related to tendonitis or fasciitis. Proper rest and pain killers with regular physiotherapy can help you. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Calcified granuloma in right upper lobe. Non calcified nodules in left upper, right middle, right upper lobes. Indications?\n\ni recvd medical report today ..says there is a 2mm calcified granulom in left upper lobe. there is 3mm non-calcified nodule in the left upper lobe. there is a 4mm non-calcified nodule in right middle lobe there are two non-calcified nodule in the right upper lobe measuring 5 and 7 mm. in a nutshell what does this mean to me? thanks.",
    "doctor_response": "Hi,Calcified granuloma indicates healed granuloma. These calcified granuloma are present in left upper lobe of lung .Most common cause for this is old tuberculosis of lungNon calcified nodule are present in R) upper lobe and middle lobule.You require sputum analysis for AFB to rule out reactivation of TB.Consult chest physician for further plan and treatment",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid the fibromyalgia, depression and chronic pain?\n\ni have been diagnosed with fibromyalgia, depression and chronic pain. i am on cymbalta 60mg once aday, soma 3x day, percocet 7.5/325 every 4-6 hours,gabapentin 300mg 3x a day. i am still in constant pain always at a 8 pain rate, depression is worse, cannot sleep for more than 2-3 hours at a time.any suggestions on any other type of meds that could help, or should we up any of the meds i already take? i have Doctors appointment on monday and would like to go to Doctor with suggestions so i can get some relief. having a second opinion may really help in my treatment. Thank you! terri",
    "doctor_response": "Those are not different diagnoses. Just thought you should know. Depression produces body sensations. Mostly that is what fibromyalgia is. Cymbalta is a crap anti-depressant and a crap nerve pain pill. The main thing is that the good anti-depressants do nothing on pain and the good nerve pain medicines do nothing for pain.There is about a 1 month time period needed for the cymbalta to work.So, treeating depression is helpful.Alternatively learning to have a very high pain context is helpful. Very large amounts of exercise have proven benefitial n fibromyalgia.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the risks involved in doing push ups in case of a child?\n\nHi, my son is a very fit; he s been doing gymnastics for years. He wants to raise money for a children s charity to celebrate his 11th birthday and has come up with a plan to do 1100 push-ups in 2 hours. Seems a lot to me, but then I m not as fit as him!. He comfortably does 250 per day in training. The plan is that he ll do them in sets of 10 (at about 1 per second), then rest for the remainder of the minute, etc. Are there any health implications?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Yes, there can be complications like muscle spasm. Also, the age of the child is 11 years which is not suitable for such heavy exercise. It is not advisable to do 1000 pushups at the same time.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Purva Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fever, nausea and swollen jaw. Had removed wisdom tooth. Need to get checked?\n\nMy son had his wisdom teeth out 3 1/2 weeks ago. All was fine at the post-op follow up on Wed last week. He played in a handball tournament this weekend. Now his right side of jaw is swollen again and is painful.  Ice and Advil are helping.He also has a fever and nausea, but I think he may have got the flu from one of his team mates.Just wondering if I should take him to doctor or ride it out.",
    "doctor_response": "Hello,Your son had a tooth extraction.Following which he has pain, swelling at the site of extraction and it is associated with fever.It is unlikely to be flu because he has swelling and pain in the extraction site.May be that the wound may not have healed inside or hematoma(collection of blood) may have formed or abscess may have formed.Revisit the dentrist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can wearing partials in lower gums be avoided until the gums heal?\n\nHi my name is Bill. I just had 9 teeth pulled on Wednesday the 13th. I am now wearing partials both upper and lower. The uppers are fine, but the lowers are very uncomterble and I hate wearing them. My dentist has tried to adjust them, but I am still in pain. Can I just not wear them untill mu lower gums heal?",
    "doctor_response": "Thanks for your query, I have gone through your query.The wearing of partial denture can be avoided till the wound get healed completely.Since the extracted site will be open and it will be in a healing stage, there will be pain when it comes in contact with the denture. Do not wear denture till the wound heals. You can use topical aneshetic like lignocaine gel and topical analgesic like choline salicylate. Do saline gargling.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for black gum lining around the teeth ?\n\nHi. I'm a black male 24 years old. My gum located around my lower teeth is normal. A pink color. But just around the lower teeth, if you look at it further down a black color on the begging of the gum is seen. I wonder why this is? I'm around 177 pounds, nonsmoker, occasional drinker.",
    "doctor_response": "Hi,Thanks for asking the query,This could be due to pigmentation or plague and calculus deposition.I would suggest you to get the checkup done.Also go for complete mouth scaling and polishing.Maintain a good oral hygiene.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ankle pain with a history of broken ankle\n\nMy wife broke her ankle badly 3 1/2 years ago. Thirteen screws and two plates to repair. It has been fine until last night. The plates began hurting in her sleep. Pain of 6 on a scale of 10. It was ok while she went to the gym this morning. Then began hurting again an hour later. Pain was 7 on a scale of 10 then. Now it is tender, but not hurting. She says she can specifically feel the plates. Any input?",
    "doctor_response": "hi,thank you for providing the brief history.As the Injury was almost three and a half year ago, by this time the bone must have healed. So most of the times when such reaction occurs the choice is to remove the screws and plates.As due to the screws and plates there will be a lot of biomechanical changes in the gait and may lead to pain and aches to the adjacent muscles and fascia.On a longer run, it is advised to remove the plate and screws. Also, avoiding gymming equipment is of choice , since due to impact of the feet on the hard surface of the gym may lead to rise of the Newton's third law of reaction - equal and opposite reaction. So the harder the feet hits the floor of the equipment the harder it hurts the screws and plates.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump under the penis?\n\nDear Doctor, My son is 1.5 years old and he also has cyst/lump in left side of penis under the skin. We showed it a pediatrician and he suggested circumcision. Is this really recommended solution? Doctor also said that at this young age the baby s skin is very tight and hence he cannot remove the cyst manually (without surgical intervention). So my question shall I go for circumcision of my son? Is it safe? How long will the pain remain after procedure? Please advise. Thanks gopal",
    "doctor_response": "after 1 year penis skin can be circumcised without any complication about that cyst we have to incise it by doing circumcision.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back pain, abdominal pain and leg pain?\n\nI have extreme low back pain that never stops along with pain in my abdomen & back of my legs. I have just been diagnosed with a 1.7 by 1.5 cm posterior fundal intramural fibroid. Could this be causing my symptoms? I am 43,130lbs,5'6\". They say this pain is Fibromyalgia but I don't really have any of the other sx's related to that dx. I also have several Hemangiomas, one desribed as being 2.4 cm in size & \"almost entirely replacing the vertabral body\". There is also mention of some mild Arthropathy, minimal buldging & mild stenosis?",
    "doctor_response": "Hi.Thanks for your query and coherent history.The uterine fibroid can not cause such symptoms as you have. It is small enough.The pain in abdomen, back and abdomen looks to be due to combination of all the problems you have noted. There are hemangiomas, arthropathy, bulgind of the disc together with the canal stenosis can cause all these symptoms. Every problem contributes in a smaller way to have this collective effect.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Would sciatic nerve issue be the reason for numbness and tingling of fingers?\n\nI am having numbness and tingling of fingers and toes periodically throughout the day. I also have a siatic nerve issue on the right side hip that runs down the right leg. Would this be causing the issue in my fingers or could it be something else? I am a 50 yr old female who also is going thru menoupausle symptoms. I work with my hands a lot with my job stocking grocery shelves",
    "doctor_response": "Hello dear,Considering the case history of Sciatic nerve issue, the symptoms can be attributed to para-spinal spasm and entrapment of nerve fibers at the lower spinal region.Other causes can be:1. Inadequate hydration status & electrolyte imbalance of the body.2. Dietary deficiencies of certain nutrients like Iron, Calcium, Vitamin D, Vitamin B12, Folic acid, etc. which help in blood formation & nerve conduction.3. Peripheral neuropathy caused due to any fluctuation in blood pressure or blood sugar level.4. Hormonal changes- as you are going through menopauseSymptomatic relief can be obtained by intake of nervigenic agents (like Vitamin B6, Vitamin B12, Folic acid) as well as multivitamin & multimineral supplements including iron, calcium & Vitamin D needs to be added in your diet.Physiotherapy & postural exercise will also be helpful.If symptoms still persist, kindly consult a Neurologist & get a complete Neurological examination done.Certain investigations like complete blood count, serum electrolyte estimation, fresh estimation of blood pressure & blood sugar levels & nerve conduction studies will be helpful to rule out any pathological cause for the symptoms.X ray & MRI of lumbosacral spine can also be carried out to detect any nerve entrapment.Wishing you a Good Health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "what causes my daughter s dizziness and headache?\n\nMy 10 year old daughter has been getting dizzy for the a last couple days accompanied by a headache, she started with a fever last night and has a sore throat. I ve almost ruled the fever and sore throat down to strep throat but I am very worried about her getting dizzy",
    "doctor_response": "Hi, Looks like your daughter is having upper respiratory tract infection, probable rhinosinusitis with pharyngitis. I would advise you to keep your daughter well hydrated and give paracetamol for headache and fever. Warm water or saline gurgling will help for sore throat. If any worsening of symptoms, I would suggest you get an opinion from ENT surgeon too. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nirubhan Bharathy, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a back injury?\n\nI am 66 yrs old.  I fell last week off a step stool.  I fell about 4 feet.  I hit on my back.  I was on meds.  I did not miss the step.  It was like I thought I was on the  floor.  I just stepped backwards.  I have put ice here  and there on my tail none area.  The pain increases on a daily basis.  What I   have Google it appears it is my  tailbone.  Im on  Narco already for other problems.  I bought a pillow  yestersday.  It is oval with the  center cut out.  I can't hardly stand sitting on it.  No pain standing, or  driving.  Can't stand sitting or bending forward while sitting down.  Help!",
    "doctor_response": "Hello,Regarding your history, it may be a lumbar or sacroiliac fracture. First of all you should have a X ray and after that a consultation with the orthopedic surgeon. Best,Anisa",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a painful lump on the forehead?\n\nMy 17mth old fell yesterday and bumped his forehead which resulted in a hugh lump, I kept an eye on him and he was fine, this morning the lump had reduced but he fell again and now the lump is back and has spread further along his forehead he seems ok but just want some advice, should I take him to hospital since he has bumped it twice???",
    "doctor_response": "Hi,Dear,Thanks for the  query to My HCM Clinic.I studied your query  in details and understood your health concerns.-Treatment and Cause of your babies forehead lump -a-Mostly it is-a repeat Boney Contusion.b-Keep a watch for 24 hrs or c-if vomitting or dizziness sets in -ER Surgeon needs to be consulted who would treat that post-trauma head lump accordingly.-I would suggest to show it to your family doctor who would send him to ER Surgeon if need be.This advise would help you to plan treatment with your doctor.Hope this resolves your query.Wellcome for further query in this regard. Have a Good Day...!!With Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am using Mirena and have been spotting every day. Is this normal?\n\nHi doctor,I had a Mirena IUD inserted before 18 months. I used to spot for a day or so in every few months. But, for the last two weeks, I have been spotting every day. Is this normal?",
    "doctor_response": "Hi. It is one of the complications of LNG-IUD (Levonorgestrel-releasing intrauterine device) or Mirena. The Levonorgestrel being released by the IUD makes the inner lining of the uterus or the endometrium so thin that it will just give way. Let me give you a few facts. By 50 or 52 every lady reaches menopause. After this age, there is no significant healthy follicle in the ovary, and so the estrogen level is extremely low. It will not allow the inner lining of the uterus to increase. To add on to this, the progesterone or LNG makes the lining even thinner, and it will spontaneously tear causing fresh spots every day or intermittently. I wonder what the indication was to have Mirena at age of 54 years. I hope they had ruled out any surprises by taking PAP smear or liquid base cytology, the ultrasound scan of the pelvis and necessary blood tests. If all the above mentioned tests were normal, then spotting is due to hormone deficiency. Reconsider whether the IUD has to be continued. Once removed you may enter menopause and will not have periods anymore. Otherwise, meet your gynecologist, and you will be started on the hormone estrogen cyclically to improve the thickness and bleeding, so the spotting will not occur. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain and dysphagia post treatment for H.pylori infection?\n\nI was diagnosed with H. pylori by RUT. I completed my 14 day course of triple antibiotic therapy on Dec 22. I am on an antireflux capsule now for total of 6 weeks out of which I have completed 3 weeks. I dont have any pain in chest but I still have the sensation of food being stuck up in the lowe end of of the throat. The EGD showed hiatus hernia but on 2nd opinion with another docotor i was told that there is no hiatus hernia only the opening has been a bit enlarged. What do the symptoms after the treatment suggest",
    "doctor_response": "HiThanks for posting on HCMSorry to reply to your query late.Hope you are ok by now.Will still like to reply your query if it may still help you.Any of the 2 diagnosis from both Doctor could be correct.However, unless i examine you i may not know with certainty what could be the problem.Being treated for H pylori may not stop your symptoms immeidately.Healing is progressive and this is why you had to go on an anti-reflux/anti-secretory for some weeks again after your antibiotherapy.If i were your treating Doctor, i will would have treated as follows:-Antibiotherapy for 14 days-Anti-secretory like omeprazole for 21 to 28 days-Antacid like maalox-Counseling on home measure to prevent gastitis/GERDIf symptoms do not improve, i send you to a Gastrologist for examination and a fibroscopy or endoscopy.If you are still struggling with your symptoms, i will advise you see a Gastrologist for evaluation and better management.Hope this will helpBest regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in abdomen after having sex. Feeling gassy. Did not ejaculate inside. Cause of pain?\n\nI had sex with my boyfriend a little over a week ago and ever since then I have had some pain in my abdomen and my side, I also started my period about 4 or 5 days after( I have irregular periods so I never know when they may come) anyways the pain has lessened. I have felt slightly gassy. I haven t had any change in eating or such. I feel active and all, just curious as to what might be wrong. It was my first time and I didn t bleed during or after, he didn t ejaculate inside of me or even before hand . Not sure how long I should wait for the pain to go away or what. Any answers would be greatly appreciated!",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for calling H.C.M.F. As you describe you had sex for the first time and you had pain in abdomen and side. lasted for few days. It is due to 1st experience you had pain, it is optional, as you had pain it is suggestive of having tear. Of course it may be cured by its own but it is better to have treatment by a doctor. Simply by a non invasive treatment it will you will be fine. Though no pain it is wise to have treatment for complete healing. Wishing for complete recovery. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain, chest pain, bleeding. headaches. Done heart ultrasound. Am I okay?\n\ni am a 19 year old female. i have back pains that are almost constant, chest pains that come and go typically the left side of my chest though sometimes (rarely) the right side as well, nose bleeds that occur everyone once in a while (months ago for two weeks i had one almost every day though they stopped when in an accident i was hit in the face with a metal bar causing 1 where a large clot of blood came out), headaches that will last for hours have been occurring for the last several days. the chest pains have been slowly getting worse, though i can go on normally; that pain only last for a few secondary to several minutes. i have been to two doctors about the chest pains, the first doctor gave me a heart ultrasound but never called to give me results, the second doctor possibly a year or two later used a machine on me (sticking wires all over my body with stickers); this doctor told me there was some irregularities but that she thought it was just the machine messing up. what are the possible things that are wrong with me?",
    "doctor_response": "If you can consult a General Physician in an hospital,that would be proper. My advise would be that you get X rays of spine, chest and complete blood count in private if affordable and take these to a physician- at-least provide baseline test reports so that the doc. builts up some clinical picture in his mind and either investigate further or provide treatment with some probable diagnosis. Even on this forum paid services of physician can be availed  but i would advise you to note down your history of illness in chronological order, meaning by from when you were completely okay. What was your first symptom and what brought it on, how could it be relieved, what medications were given(if you have Docs. prescriptions on record.What aggravates your symptoms. Is thee any family history of illness of similar kind or any other disease.Is your diet normal, what is your weight,height.What is your menstrual cycle normal or prolonged.Do you get breathlessness on exertion. please provide few clues so that docs. may work on you is there delay in healing of wounds, or prolonged bleeding after cuts or injury? etc",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can masturbation cause health problems in future? How to overcome this habit?\n\nhi sir i am loosing sperm wantedly thrice in a week ..is it cause   any health problem to me...? am doing this action at the age of 19 years old ...now my age is about 25 years will it leads any dangerous to me ....even i have healthy body after doing this also ..only the problem is am lean....please give me the solution to overcome this habbit",
    "doctor_response": "Hi,Masturbation is a habit and not the disease. Nothing bad happens after the masturbation. Then, why should you worry? Take it easy.Just relax after the  event. Still, if you want to quit masturbation, you consult psychiatrist.  Psychotherapy and  anxiolytic  medicine may be given to you by your doctor.I hope. You got my answer.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the effects of adderall on blood pressure and heart rate?\n\nI just recently started taking Adderall for ADD and was curious about blood pressure and heart rate while one. Do most people s bp and hr go up? My average is pretty normal, usually around the 100s/70s or 80s with a hr of about 85-90, which is kind of high, but it s always been that way. I just checked and my bp was 93/67 with a bp of 107. Is that ok?",
    "doctor_response": "Hi, i have gone through your question and understand your concerns. Yes Adderall can cause palpitations, increase in blood pressure. But it commonly cause anxiety issues. Your blood pressure is ok but pulse rate is bit high. You should exercise daily and eat healthy diet. I suggest you can use Xtended release tablets comes with name of Adderall XR this will have less side effects.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate to ask . I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is weight gain normal post dialysis?\n\ni know a friend who gets dialysis. His weight before dialysis was 114.7 pounds. After dialysis it was 116.8 lbs. He does not understand with how much weight is considered normal to gain or loose after dialysis. Please explain. When does he need to contact his kidney doctor when it comes to weight gain or loss?",
    "doctor_response": "Hello, Possible causes like fluid over load must be ruled out. Dialysis per day does not cause weight gain. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain, General & Family physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen lump under my armpit\n\nI have a swollen lump under my armpit it is so sore and effecting the muscles around my arm and a tingly sensation I have had constant headache for 2 weeks and pain in my neck no pain relief wil work and also my legs ate bruising for no reason all on my legs feel so run down",
    "doctor_response": "HI. If this is 2 weeks , the abscess in the armpit must have been matured to be operated - incision and drainage done. This only can relive your symptoms.A proper antibiotic cover and anti-inflammatory medicines will supplement an early recovery. Get this done , it looks you are already late.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I consult the doctor for the indentation on the arm with large bruise?\n\nI fell off my skateboard and hit my right forearm on the edge of the sidewalk. I don t have any pain right now but there is a large bruise and the part that was hit is slightly indented. Should this be something to worry about or will it go away on it s own?",
    "doctor_response": "Hi you have a bruise on your right forearm after a fall but no pain. You are worried about one indentation over the bruise. In my opinion , any swelling can have indentation so you need to keep a watch on it . Do cold compresses regularly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Semen analysis report. How many mil are good sperms out of the 392 mil?\n\nHi, please help me understand my husband s semen analysis results. Volume 4ml, sperm count 392 mil, motility 40% normal, 60% abnormal, morphology 60% normal, 40% abnormal. How many mil are good sperms out of the 392 mil?",
    "doctor_response": "Good Day and Thank You for being with healthcare magic!Your husband's sperm parameters are within the acceptable limits set by the W.H.O.. He has a very good number of sperm cells with a 40% normal motility and 60% normal morphology.I don't see any problem and good luck in conceiving.Regards,Dr Manuel See IVUrology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can prostate cancer in gleason stage 4 be completely treated?\n\nmy father is having a prostate cancer'it is gleasons grade-4.In specimen report-r(lobe)-6cores,l lobe-6cores,macroscopy-right-seven pieces of grey white tissue all ranges in size for 1 to 1.8cms.all embedded.left-6 linear pieces of white soft tissue ranges from size1 to 1.6cms.all embedded.is this  cancer can be compeletly cured.wht will we do?age-72,height.158,weight-60",
    "doctor_response": "Gleasons 4 is low riskthe patient\u2019s overall life expectancy (as determined by age and comorbidities) and overall health status determines which of the following treatment options is suitable.Standard treatments for clinically localized prostate cancer include:Active surveillanceWatchful waitingRadical prostatectomyRadiation therapyHormone therapyFor further clarification meet your oncologist.And yes it can be cured.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome nervousness, body shivering, anxiety and vomitings?\n\nTook Dexona and Ciplactin tablets for 1 year around 8 years back but still facing some issues Nervounsness , Body shivering , Anxiety, Vomiting kind of symptons sometimes for small small issues like giving presentation or attending interviews , going outside etc.. Please help me how can I overcome from these diseases. I already stopped taking these tablets 8 yrs back but not bale to get rid from its symptons after stopping these medicines.",
    "doctor_response": "Dear User,Thanks for using health care magic.From the available description it appears that you are suffering from some anxiety disorder which was initiated with use of steroids like dexona. What ever the cause of your anxiety symptoms but currently it seem to me that they should be considered separate and treated in appropriate way. There are medicine available and if you are not comfortable taking medicines than you can contact a psychologit or psychiatrist for counselling or psychotherapy. Please be assure that you can be treated with minimal or no side effects.'Hope I have answered your query. If you have any further questions I will be happy to help\".Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the belly button after sneezing. Reason?\n\nYes hi last night i ws sitting watching a movie and suddenly i sneezed! i do have allergies, but with it came a sharp burning pain on my right lower side of the bely button, that went away gradually over a couple of minutes! i got the pain again when i tried to get up to go to bed and again this morning to get out of bed. No other symptoms NOT tender, hot, warm or rock hard ABD, just a dull slight pain right next to RL belly button. Thank you. SK, SN BHC",
    "doctor_response": "thank you. this is a musculoskeletal pain,not involving the internal organ. the pain was created due to sudden stretching of the abd. muscle & it occured due to sudden forceful sneezing. it will be OK within 2-3 days. do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for persistent fever in a child\n\nhi, my 7 yrs old son is having fever since morning and the fever now is not responding to the aceto-250 and i went to the doctor saying my son has 103 fever inspite of medicine given 90 min before and dr prescribed meftal-p, can I use meftal-p for viral for 2 days",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.Meftal -P can be  used in addition to paracetamol in prescribed doses.Most viral fever take 3-5 days to resolve. Better option will be to use one antipyretics   and use tepid sponging to bring down fever if it occurs despite antipyretics .Hope this answers your question. If you have additional questions then please do not hesitate in writing to us.*Always check for history of allergy before taking any medicine.Wishing  your son good health.\u2022\u00a0\u00a0\u00a0\u00a0\u00a0DISCLAIMER: - All the information provided here is for information purpose only   , it is not a substitute for the advice of a physician after physical examination , it is not intended to replace your relationship with your doctor. This information in no way establishes a doctor-patient relationship. Before acting anything based on this information do consult your doctor. I  recommend that online users seek the advice of a physician who can perform an in-person physical examination",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it good to take blood pressure medicines with diuretic drugs?\n\nMy wife took one of my bloodpressure meds with a diuretic. She has a bloodpressure of 110/74..She has dizziness just going to the bathroom and back to bed..and she breathesa llittle quicker than I think she should be. She also seems a little pale in the face at times. What should we do..she took it at about 10 yesterday and I hope this pill will soon be out of her system.",
    "doctor_response": "hi, her blood pressure is quite ok. she is probably developing postural hypotension due to the diuretic induced volume loss, which is making her dizzy while standing. I suggest you to stop the diuretic and consult your doctor for this. hope this helped.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have hep-c, pain in right side, getting worse. What to do?\n\nI have hep-c. I have had pain in my right side for over a year now. Up until last week i could tolerate it. Finally, I had to go to the e.r.. After running blood work the doctor told me that the tests showed everything to be normal. however, the pain is still there and seems to be getting worse. I have lost work and sleep but i cant afford to miss anymore work. i do not have a primary care doctor at this time. I wont be able to afford one until I get some more work done. What am I going to do?",
    "doctor_response": "Hi, The pain in the right hypo chondrium , signifies duodinal ulcer, gall bladder infection, or gallstones, or hiatus hernia. Can be confirmed by the M.R.I. abdomen.                     So i advise you to consult a gastroenterologist for diagnosis and treatment. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be concerned for having allergic bronchitis and mantoux positive with swelling in arm?\n\nHi, I have allergic rhinitis problem for almost 7 years now. Recent past months I have been suffering with frequent cold cough with expectoration. When my problem is severe, I have expectoration with continous cough and unable to breath. I could hear wheeze. Recently I did Mantoux test which came out to be positive. I took an CXR which is normal. I consulted a GP and he told that I have Allergic bronchitis and not to worry about Mantoux +ve.There is no weight loss or fever. I was prescribed inhaler and antihistamie for 6 wks. Do I have to worry about this positive.I did mantoux test 6 days back and still there is slight swelling in my arm. How long will it take to get cured?",
    "doctor_response": "Hi. Your GP has very well said and advised you a proper thing. Forget about mantoux positive if all other blood work, clinical examination and history and other blood tests are normal. Only positive mantoux has no value. The swelling of Mantoux heals on its own if you do not disturb it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nausea and cold sensation in the chest during pregnancy?\n\nI am 8 months pregnant, i work in an airport currently but i do work inside, i smell a lot of the fuels from the planes but i have noticed i've been experiencing nausea in the morning when i am there but i have a cold/menthol like feeling in my lungs and chest now , what could this be? I am worried for the baby if this is effecting her.",
    "doctor_response": "Thank you for the question and I am happy to help.I think that you should be concerned about the exposure to fumes given that you are now having symptoms.  While the chance of harm to the fetus is very small, this should be discussed with your doctor.  More importantly, this is seeming to affect you at this point.  Nausea in the morning could simply be related to reflux from the stomach.  I hope that this helps and good luck.Dr. Tim",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for uncontrolled hypertension\n\ni am having serious issues controling my bp. i take 10mg amlodopine,40mg lisinopril, 100mg antenolol and 2.5 mg bendrofluazide daily , i had it checked and it was 162/108. i do all the normal things to help but nothings working now, i cycle 2-3 miles 5 days a week , eat well and try to sleep plenty, and at 32 i am getting a bit fed up of this.any ides?",
    "doctor_response": "Hi,You will first evaluation for cause of blood pressure. You should undergo test like kidney function test, renal artery doppler, Sr cortisol and 24 hr Urinary Metanephrines. Also get lipid profile and sugars tested. I think you should be started on tablets like Prazosin or Clonidine which are highly effective in controlling BP. So request your doctor for these and to reduce dose other medicine like Atenolol and other. Also have healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. Regular exercises like brisk walking, jogging according your capacity at least 30 min a day and 5 days a week. Eat lots of green leafy vegetables, fruits, fish once or twice a week, and avoid meat. Avoid smoking and alcohol if any. There shouldn't be abdominal fat deposition or obesity.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could sharp, radiating pain in spine with history of tinnitus indicate?\n\nHello, Over the last several months,I have developed pulsatile tinnitus in my left ear.I should mention that I have had occasional stabbing pain in same ear.Several years ago,an abnormal group of blood vessels was found in the same area during a cat scan,but I was told it was nothing to worry about.Recently,I ve developed sharp pain in my neck that radiates down my neck,shoulder and left upper chest.This pain is all on left side and is intermittent.Ive gone to an ENT and was very disappointed with the Doctor.Im currently looking for another.Any suggestions or info would be greatly appreciated. Thank you in advance..",
    "doctor_response": "Hi i did review your concern. What you are experiencing as a radiating pain down your neck and shoulders and chest is what can be called as Lhermitte's sign and it is seen when nerves get irritated. It can occur in multiple disorders and is not very specific. Along with tinnitus i would recommend you get a MRI of your brain and neck done to rule out any potentially harmful condition. Also consult another ENT doctor and get your ears checked by audiometry if there is any hearing loss that you may be developing.I hope this helps.Let me know if you have any more questions or concerns.Wish you healthy and happy life ahead.",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI report shows straightened lordosis with disc bulge at C5-6 level. Indications?\n\nHello,This was my MRI result can you explain what it means?FINDINGS: No cerebellar tonsillar ectopia.  No foci signal alteration of cord \u00a0\u00a0\u00a0\u00a0\u00a0 on T2 weighted images and no enhancing intraspinal lesions. \u00a0\u00a0\u00a0\u00a0\u00a0  Soft tissue prominence in nasopharynx measures 11 mm in AP diameter.  No acute \u00a0\u00a0\u00a0\u00a0\u00a0 vertebral body compression fracture or prevertebral edema.   Straightened  \u00a0\u00a0\u00a0\u00a0\u00a0 lordosis. \u00a0\u00a0\u00a0\u00a0\u00a0  C2-3: Unremarkable. \u00a0\u00a0\u00a0\u00a0\u00a0  C3-4: No focal disc herniation, cord compression or high grade foraminal  \u00a0\u00a0\u00a0\u00a0\u00a0 narrowing. \u00a0\u00a0\u00a0\u00a0\u00a0  C4-5: No focal disc herniation, cord compression or high grade foraminal  \u00a0\u00a0\u00a0\u00a0\u00a0 narrowing. \u00a0\u00a0\u00a0\u00a0\u00a0  C5-6: Disc bulge without cord compression or high grade foraminal narrowing. \u00a0\u00a0\u00a0\u00a0\u00a0  C6-7: No focal disc herniation or high grade foraminal narrowing. \u00a0\u00a0\u00a0\u00a0\u00a0  C7-T1: No focal disc herniation, cord compression or high grade foraminal  \u00a0\u00a0\u00a0\u00a0\u00a0 narrowing. \u00a0\u00a0\u00a0\u00a0\u00a0 Enlarged lobes of the thyroid gland with 5 mm low intensity focus in the right \u00a0\u00a0\u00a0\u00a0\u00a0 lobe. \u00a0\u00a0\u00a0\u00a0\u00a0  IMPRESSION:  \u00a0\u00a0\u00a0\u00a0\u00a0  No cord signal changes and no cord compression.   No enhancing intraspinal  \u00a0\u00a0\u00a0\u00a0\u00a0 lesions. \u00a0\u00a0\u00a0\u00a0\u00a0  Straightened lordosis with disc bulge at C5-6 level.",
    "doctor_response": "HelloThanks for writing to HCMYour report suggests that there is intervertebral disc bulge at C5-6 level without cord compression or foramen narrowing.There is also straightening of cervical spine with loss of lordosis.It may be due to spasm of muscles.At other levels, findings are within normal limit.Beside this, thyroid gland has enlarged lobes with 5 mm low intensity focus in right lobe.There is Soft tissue prominence in nasopharynx measures 11 mm in AP diameter. It may be due to many reasons.Hope you have understand the terms. Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Low pyruvic acid. On levocarnitine treatment. Headache, fatigue and burning sensation in the eyes. Advice?\n\nHi, I had low Pyruvic Acid and the ratio to Lactic Acid was bad, but my Carnitine was good yet my doctor gave me levocarnitine treatment, how would this address the problem? I read that low levels of Pyruvate can give a form of anemia because the cells break too fast so the organs dont get good oxygen. I have been suffering from energy fatigue and strong headaches that seem to be from bad metabolism of something, its like a burning sensation in the eyes and frontal area, could the carnitine help with this? Thanks.",
    "doctor_response": "Levocarnitine is used to prevent and treat a lack of carnitine. It is used to prevent and treat this condition in patients with kidney disease on dialysis. It is given to people whose body cannot properly use carnitine from their diet. Lack of carnitine can lead to liver, heart, and muscle problems. Your doctor may treat lack of carnitine by prescribing levocarnitine for you. Pyruvic acid levels alone have little clinical utility. Abnormal concentrations of pyruvic acid, and lactate-to-pyruvate (L:P) ratios, are not diagnostic for a particular disorder but must be interpreted  clinical presentation(symptoms) A low L:P ratio is observed in inherited disorders . Your Doc.who has examined you is the best judge as per your clinical symptoms",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent mood swings, sleeplessness and headaches?\n\nI don t know where to begin, it feels so overwhelming to be talking to someone about what I m going through. I know I need to make an appointment with a doctor, but fear and lack of finances hold me back. I experience extreme lows in regards to my mood and often find myself crying over the least little thing. On the flip side of that coin, so to speak, it seems to take nothing to set off my temper. At the end of the day I cannot seem to be able to rest and sleep, and yet when I am in bed I want nothing more than to stay there. Sleep is a most elusive thing and I find myself tired quite often. The thought of being around people, especially groups of any size, sends my mind buzzing and my heart racing. I am experiencing more often pain across my lower back, sometimes it is nothing more than a twinge and other times is sharp and breath stealing. I suffer from acute prolonged pain in my right arm where I broke when I was a child. My appetite leaves much to be desired, usually eating once a day, and not very well when I do. I have headaches that last for days that make me have a sick feeling in my stomach and even more sensitive to light than normal. I have to force myself to take Tylenol for any reason. I do not do drugs or drink and am feeling at the end of my rope. Any help would be greatly appreciated.",
    "doctor_response": "My friend, you just have described every typical symptoms of a person suffering from depression. Depression is a syndrome that occurs mainly due to decrease in serotonin level in brain, which is a neurotransmitter. It results in decreased energy, increased fatigability, lack of interest, decrease urge for social interaction. The person finds no pleasure in any activities that he used to enjoy much previously. Sleep may increase/decrease, there is serious lack in self confidence, guilty feeling. Most of the time the person feels hopeless, helpless and worthless. Depression however is curable. There are numerous drugs available that balances the serotonin level. Alongside, therapy with an experienced psychologist always adds to the effect. I'll suggest you to immediately get in contact with a psychiatrist near you. Get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for numbness and tingling in left side? Does irregularity in the vessels of brain cause any problem?\n\nhi I recently have been having what I have are episodes where I get  numb and tingling on my left side my doctor has run all kinds of blood work and I recently had a ct scan and mri of my brain the mri showed som irregularity in the vessels of my brain and no stroke I didn't ask my doctor if these could be tias(or would the mri have showed this) I was diagnosed with neuropathy(mild and I'm not diabetic)10 years ago my doctor says this is a normal sign of aging (the swelling of the vessels) do you agree",
    "doctor_response": "Hi,Thank you for posting your query.Based on your symptoms, the most likely diagnosis is TIAs, wherein the blood supply to a part of brain is reduced for a short while. CT and MRI scan may be normal in TIAs.You should start aspirin to prevent the recurrence of TIAs or brain stroke in future.In addition, risk factors such as high BP, sugar or cholesterol should be controlled.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Head overheating, cannot focus, hypersensitivity, tingling feet\n\nmy head over heats and my recall is shocking it feels like my mind and body cant rest cant focas on one thing, i dont make sence, and hypersensative to my saroundings. its like im out of spirit no energy heard burning eyes burning a bit ifeel heavy and it bothers me alot . its like imsick or im having a seaser or like something is bloked. like my bodys vibration,, musaull spasems feet tinging ,, when im like this i like to be on my own and quiet so my head doesnt tingle and presure on my head , some friends think i think to muck but my mind is total blanks , but when im doing things like typing or reading my body comes down, but i need silence, i cant focus on a lot of things at wonce like sounds people around me, i cant explane it ,, its like in paralysed or some thing , and when im like that i get upset because im like that ,, i still no and remember every thing, but nothing comes out right,,,, it feels like some thing is breaking down and it upsets me and thats when my sweat stinks alot /////",
    "doctor_response": "Hello, The vast number of symptoms that you are experiencing are likely to be due to anxiety spectrum disorder. The lack of concentration, hyper-reactivity to environment, excessive sweating, feeling heavy are all symptoms of anxiety. You need to consult a psychiatrist who can evaluate you and start you on medications. Good medications are available for anxiety and he should be able to help you significantly. Also get thyroid function tests because sometimes problems of thyroid can present like this. good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for the shooting pain in the stomach near the ribs?\n\nI had shooting pain on left abdomen just nearby ribs for about 2 minutes.The pain was unbearable and i couldn t find a proper position to sit or sleep during these 2 minutes.Afterwards the pain relaxed and i slept for the whole day i felt a slight pain in the same area.The next day again same happened with unbearable pain for 3 minutes.Again the pain relaxed but this time pain the was getting more intense by body movements.whenever i walked or moved my body the pain was more intense.i consulted a physician who treated me normally by giving a pain killer an anti inflammatory drug.But for safety sake he got me sonographed which revealed 3 stones in left kidney of 3-5mm size.The doctor said it is normal drink plenty of water they will pass out.I took the medicines and after 5 days i was fine no pain at all.it has been now more than 45 days i have no complaints. Kindly suugest should i take kidney stone medicines and how will the stones pass out.",
    "doctor_response": "HI. Your Doctor was absolutely right . The best therapy for small kidney stones is to drink plenty of oral fluids. This helps in diluting the urine so not allowing enlargement of stone and forceful kidney flush-out can force the stones flow down with force of excessive urination. If you are talking about herbal medicines for stones , you can definitely take them if suits you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chest injury. Difficulty breathing, back pain, lump on back. What should I do?\n\nHi, Today when i was playing soccer, the soccer ball hit hard into my chest. At first it felt a bit hard to breath, but after a few breaths it was fine. Although in about 10 minutes, every time i took a breath there was a sharp pain in my back. I've come home still having this harp pain in my back, and now realize that there is a lump on my back. What should i do?",
    "doctor_response": "Hello dear friend, thanks for writing to HCMI am Dr vaibhav Gandhi, I am orthopedic surgeon I have studied your case.you should take Xray chest to see for any fracturehair line fracture can lead to pain without swellingyou will have to use rib belt to support chest and ribthere can be rib contusion leading to pain which will aggrivate on deep breathing coughing ,sneezing Here are my suggestions to you:give rest do hot and cold fomentationTake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Shall I skip my tablet as BP has lowered?\n\nHello Dr. I m 36 weeks 2 days pregnant and taking Alphadopa to control high blood pressure which was around 130/90 when I started taking it a month back, I m taking Alphadopa thrice in a day, suddenly now I see Blood pressure around 98/68. Shall I skip my tablet for now ?",
    "doctor_response": "Hello,I think you should consult with your doctor first. It's good that your BP has lowered, but it is because of the medication. If you stop it without consulting with your doctor, then, I'm afraid we cannot tell what might happen with you BP. Better consult with your caring doctor first. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Albana Sejdini, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do I need to take rest for long time as suffering from para cardiac pneumonia?\n\nHi Doctor,I am diagonised with right para cardiac pneumonitis and on leave from past 15 days and taking antibiotic injections and nebulization.I am planning to get back to work from tomorrow, can I? or do I need to take rest for few more days.My cough is come down.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. 15 days rest, post pneumonia is enough and you can resume your work now. You already said that the cough is gone down, this suggests recovery. Also note following things which favour recovery. 1. Absence of fever 2. Improving appetite 3. Absence of cough with expectoration. 4. No chest pain. So if you are having above mentioned things then you are definitely improving from pneumonia and so can join your work. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful lump in neck at the site of injection?\n\nI had a procedure today where they were supposed to give me an injection in my neck to basically burn the nerve endings. I ended up with a golf ball size lump in my neck and the pain is worse. They did an ultrasound and it is fine. What could this be?",
    "doctor_response": "Hi,Dear,Thanks for your query to HCM virtual Clinic.I studied your query in all the details put forth by you.I understood your health concerns.More information is needed like-Was the compression bandage given for that lump or not?or the injection is left without any compression bandage?Cause of painful lump in neck post-Chemical denervation-Still from the data given from you,following causes need to be ruled out-Moslty your lumps seems to be-  either a  venous hematoma/ or arterial hematoma , post injection,due to the accidental blind puncture of the perineural vessels in the neck.-ORa effused injection material in perineural tissue, which is causing pain due to tissue irritation from the ablative chemical use for neck nerve chemical denrvation.(Phenol or Alchohol).Still I would suggest you to take Second opinion from ER Surgeon as I don't have any first hand clinical information or a pohotograph of this lump.To confirm other causes I would hence suggest you to consult ER Surgeon or PCP doctor.But you need to be worried as it would complicate into infective and  other problem associated with it.And act fast on the above suggestions,which helps you to plan treatment with your ER Surgeon. Hope this would resolve your query with full satisfaction.Welcome for any further query in this regard to ME by direct question at HCM.Write excellent review and hit thanks, to narrate your experience ,which would improve my rating for many other visitor's to HCM.Wishing you fast recovery.Have a good day.Dr.Savaskar M.N.Senior Surgical Consultant.M.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be this bluey-black spot shaped vein on operated lower back area ?\n\nI have had an operation on my lower back (right side) about 5 years ago to remove an extremely painful collection of veins. The slightest touch would give me extreme pain and even sleeping in certain positions was difficult. I noticed a small bluey-black spot shaped vein on the edge of the scar today and poking it sends pain across quite a large area of my lower back. It s nowhere near as bad as it used to be but the pain is unusual and very noticeable especially when I stretch or put pressure on the area. I m 19 years old, male, I don t smoke or drink, I consider myself very fit and healthy, and noone in my family to my knowledge has had a similar problem. I want to know as much as I can about this problem, and if it s likely that I ll need surgery again. edit: I tried taking a picture of what it looks like now, it s not very noticeable: just looks like a small bruise on the bottom tip of the scar.",
    "doctor_response": "You probably have a Glomus tumor which is very sensitive to touch and is known to cause Chronic back pain. It can be removed by Surgery. It appears that the surgeon did not remove all of the previously present Glomus tumor. Kindly visit your Doctor to help you get rid of this problem once and for all.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach pain and vomiting\n\nMy 9 yr old daughter experienced what we believe to be stomach flu  3 weeks ago, it started with stomach pain then vomiting/ dry heaving for 12 hrs then she felt better. But te stomach pain as stayed settling in her belly button area, a couple days it hurt, during the last couple weeks  and she cryed, but the other das she said it only hurt when presure is applies. All urine / blood est are normal. Tonight after eating a salad, she said that she has to take a deep breath to get a breath and she had one other episode of this breathing issue last spring. Any ideas, I feel helpless, as she has a high tolerance in pain she seems like it is just an annoyance to others but I know she is serious as she does not tell us things thinking it I'll go away and only mentions when it doesn't. She is a trooper but I am concerned.",
    "doctor_response": "Hi,Welcome to health care magic,Abdominal pain and vomiting could be due to acute gastroenteritis,viral gastroenteritis,diverticulitis etc.She must undergo routine blood count,electrolytes with clinical examination of abdomen or ultrasound of abdomen.You might require antibiotics(quinolones or cephalosporins or antiprotozoals etc.) with antiemetic, antispasmodics and antiinflammatories with prebiotics and probiotics.There might be great need of fluid and electrolyte balance in body.You must consult pediatrician for immediate treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy rash along the inside of legs?\n\nhi i seem to have a rash that resides along the inside of my legs like jock itch, bu im not sure if thats what it is. its dry and itches but i have used some cortizone cream and its not as itchy anymore. however today it feels like there is a rash along my butt crack that itches as well",
    "doctor_response": "Hello,Thank you for posting on HCM.It seems you are suffering from Tinea cruris, a kind of fungal infection.I would suggest you to consult your dermatologist for proper management of the condition.I usually recommend proper course of oral anti-fungal drugs like Fluconazole or Itraconazole along with anti-fungal cream like luliconazole for local application at bedtime. You can additionally use antifungal dusting powder containing sertaconazole during day time and a soap containing ketoconazole for rinsing of affected areas. Take oral antihistaminics for itching as required.Maintain hygiene over those areas and avoid wearing tight undergarments.Hope your queries are resolved and wish you best of health.Kindly spare some time to rate my answer and drop your valuable review at the following link:  you require any further assistance in future, you can reach me directly through the above mentioned link.Thank youDr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is this semen analysis result normal?\n\nHi Doctor, Today my test reprt  recived for Semen Analysis. Kindly suggest me i may saffer for me. Dept\u00a0\u00a0\u00a0\u00a0\u00a0Specimen\u00a0\u00a0\u00a0\u00a0\u00a0Parameter\u00a0\u00a0\u00a0\u00a0\u00a0Observed Value\u00a0\u00a0\u00a0\u00a0\u00a0Unit\u00a0\u00a0\u00a0\u00a0\u00a0Reference Semen Analysis CP\u00a0\u00a0\u00a0\u00a0\u00a0Semen\u00a0\u00a0\u00a0\u00a0\u00a0COLOUR\u00a0\u00a0\u00a0\u00a0\u00a0OPAQUE GREY\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0- CP\u00a0\u00a0\u00a0\u00a0\u00a0Semen\u00a0\u00a0\u00a0\u00a0\u00a0LIQUIFICATION TIME\u00a0\u00a0\u00a0\u00a0\u00a020 minutes\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0- CP\u00a0\u00a0\u00a0\u00a0\u00a0Semen\u00a0\u00a0\u00a0\u00a0\u00a0VOLUME\u00a0\u00a0\u00a0\u00a0\u00a05.5\u00a0\u00a0\u00a0\u00a0\u00a0ml\u00a0\u00a0\u00a0\u00a0\u00a0- CP\u00a0\u00a0\u00a0\u00a0\u00a0Semen\u00a0\u00a0\u00a0\u00a0\u00a0VISCOSITY\u00a0\u00a0\u00a0\u00a0\u00a0NORMAL\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0- CP\u00a0\u00a0\u00a0\u00a0\u00a0Semen\u00a0\u00a0\u00a0\u00a0\u00a0TOTAL SPERM COUNT\u00a0\u00a0\u00a0\u00a0\u00a0128.5\u00a0\u00a0\u00a0\u00a0\u00a0millions/ml\u00a0\u00a0\u00a0\u00a0\u00a060 - 150 CP\u00a0\u00a0\u00a0\u00a0\u00a0Semen\u00a0\u00a0\u00a0\u00a0\u00a0ACTIVELY MOTILE SPERMS\u00a0\u00a0\u00a0\u00a0\u00a010\u00a0\u00a0\u00a0\u00a0\u00a0%\u00a0\u00a0\u00a0\u00a0\u00a0- CP\u00a0\u00a0\u00a0\u00a0\u00a0Semen\u00a0\u00a0\u00a0\u00a0\u00a0SLUGGISHLY MOTILE SPERMS\u00a0\u00a0\u00a0\u00a0\u00a010\u00a0\u00a0\u00a0\u00a0\u00a0%\u00a0\u00a0\u00a0\u00a0\u00a0- CP\u00a0\u00a0\u00a0\u00a0\u00a0Semen\u00a0\u00a0\u00a0\u00a0\u00a0IMMOBILE SPREMS\u00a0\u00a0\u00a0\u00a0\u00a080\u00a0\u00a0\u00a0\u00a0\u00a0%\u00a0\u00a0\u00a0\u00a0\u00a0- CP\u00a0\u00a0\u00a0\u00a0\u00a0Semen\u00a0\u00a0\u00a0\u00a0\u00a0PUS CELLS\u00a0\u00a0\u00a0\u00a0\u00a01 - 2 cells / hpf\u00a0\u00a0\u00a0\u00a0\u00a0CELLS/HPF\u00a0\u00a0\u00a0\u00a0\u00a0- CP\u00a0\u00a0\u00a0\u00a0\u00a0Semen\u00a0\u00a0\u00a0\u00a0\u00a0RBC CELLS\u00a0\u00a0\u00a0\u00a0\u00a0Nil \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0- CP\u00a0\u00a0\u00a0\u00a0\u00a0Semen\u00a0\u00a0\u00a0\u00a0\u00a0NORMAL FORMS\u00a0\u00a0\u00a0\u00a0\u00a088\u00a0\u00a0\u00a0\u00a0\u00a0%\u00a0\u00a0\u00a0\u00a0\u00a0- CP\u00a0\u00a0\u00a0\u00a0\u00a0Semen\u00a0\u00a0\u00a0\u00a0\u00a0PIN HEADER FORMS\u00a0\u00a0\u00a0\u00a0\u00a05\u00a0\u00a0\u00a0\u00a0\u00a0%\u00a0\u00a0\u00a0\u00a0\u00a0- CP\u00a0\u00a0\u00a0\u00a0\u00a0Semen\u00a0\u00a0\u00a0\u00a0\u00a0TAILLESS FORMS\u00a0\u00a0\u00a0\u00a0\u00a05\u00a0\u00a0\u00a0\u00a0\u00a0%\u00a0\u00a0\u00a0\u00a0\u00a0- CP\u00a0\u00a0\u00a0\u00a0\u00a0Semen\u00a0\u00a0\u00a0\u00a0\u00a0GAINT HEADED FORMS \u00a0\u00a0\u00a0\u00a0\u00a02\u00a0\u00a0\u00a0\u00a0\u00a0%\u00a0\u00a0\u00a0\u00a0\u00a0- CP\u00a0\u00a0\u00a0\u00a0\u00a0Semen\u00a0\u00a0\u00a0\u00a0\u00a0ANALYSIS OF SPERMATOZOA\u00a0\u00a0\u00a0\u00a0\u00a0-",
    "doctor_response": "HelloColor opaque ( grey opalescent normal ,but in your case normal )Liquefaction time normal semen liquefies within an hour ( 20 minute , normal )Volume 5.5 m l ( normal )Viscosity normal Total sperm count 128.5 million normal Motility ABNORMAL (  see below ?)Pus cells , RBCs normal Morphology ABNORMAL ( see below?)Multi-institutional studies suggests normal FERTILITY is associated with sperm counts of >48 million ( normal in your case )with  a motility of >63 % ( while in  your case it is 10 % i.e. very low) with 12% exhibiting morphology(normal in your case ).Since in your case only MOTILITY is low ,so consult an INFERTILITY specialist and get his opinion.Good luck .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does delayed menstruation with light discharge indicate pregnancy?\n\nafter sexual intercourse about a month and a half ago I was expecting my period and it came about a week late and it was lighter and shorter than usual. My period was supposed to have came around the beginning of the month and still hasnt came. Could I be pregnant?",
    "doctor_response": "Yes,There is good chance that you are pregnant.Please do a blood HCG levels. Sometimes when a period is missed and there is just light bleeding it could be that the pregnancy is implanted on the tubes instead of the womb.Thus, it is very important to rule out pregnancy and also to identify the location of pregnancy if positive.Do a Blood test for hcg and if levels indicate pregnancy, repeat it after 48 hours. See a gynecologist if you develop any pain abdomen,loss of consciousness, giddiness, or bleeding.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for left sided body pain and swollen knee\n\nHello Two nights ago I feel down carpet stairs landed sitting in left leg. So naturally yesterday that knee is swollen and painful to put full weight on . Woke up today whole left side of body hurts could that be the brushing a couple days later? Will ipurphen be ok to take",
    "doctor_response": "I understand your concernyou got trauma to your left lower limb and knee especiallythis knee swelling may be a simple concern or need further evaluation according to pain and limitation of your movement it may be some ligament sprain or meniscal injury, yes it may get bruise after few days according to nature of your trauma and yes you can take this drug and see.if you not get benefit you should consult your doctor and may need further evaluation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I have electrical sensation in my right shoulder and arm?\n\nI am an avid runner. I have noticed at times while running at a comfortable pace a tinge almost electrical sensation along the front of my right shoulder and down my my right arm. It happens and that s it. What could be going on? Is it my heart? A pinched nerve of some-kind?",
    "doctor_response": "Hello,Your symptoms are suggestive of a pinched nerve. Another possible cause to consider, would be a bulging disc in the cervical vertebral column. For this reason, I recommend performing a cervical spine MRI study and nerve conduction studies. Anyway, nothing serious seems to be going on!Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for rashes in arms and thighs along with vomiting while having flu\n\nHi I have had the flu for around four days it caused me to get pretty sick but today is the fourth day and I m finally starting to feel like myself but earlier this morning when I got out if the shower I noticed I have kinda like a rash on my arms and torso and a tiny bit in my thighs is this what happens when having the flu I also was vomiting from this flu could that have something to do with it? Thanks for your help",
    "doctor_response": "Hi, I have gone through your complaints and rash is very common after a viral infection. Most likely you had a viral rash. It will take few days to disappear. You can apply Calamine lotion on the affected areas twice daily for few days. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower abdominal pain and bleeding after accident?\n\nMy daughter was in an car accident 2 days ago, and now she is having lower abdominal pains and when she eats her stomach hurts and now she has started bleeding but her period is not due for another 2 weeks. She never had cramps. Should i take her back to emergency",
    "doctor_response": "You have to report to emergency at earliest. To rule out blunt injury abdomen. Get a ultrasound abdomen and pelvis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause tingling sensation and swollen gums after wisdom teeth removal?\n\nhello, Dr.Chakraborty,My daughter had 4 wisdom teeth taken out on Monday of this week.  However, she is still feeling tingling and a little swollen and really concerned about this.  She went back to the dentist today and checked her out and told her to give it time.  HOWEVER, we are worried.  Please your thoughts",
    "doctor_response": "Hello,Thanks for consulting HCMRead your query as you have  tingling sensation and swollen gums after wisdom teeth removal dont be worried so much sewlling in gums is seen for one week after wisdom teeth extraction .  Follow post operative instructions and take proper course of antibiotic prescribed by your dentist .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible with history of two abortions, irregular periods and thyroid problem?\n\nI had two time abortion beause of no heartbeat .After that there is irregular menstrual period and i am gained lots of weight.nowadays i am taking eletroxin 50 because of my thyroid problem and i take rubella vaccination also.Now i am 28yr  in this lots of problem pregnancy is possible?",
    "doctor_response": "As you are just twenty eight pregnancy is possible.. Thyroid wud get treated with estrogen.. And start taking folic acid before getting pregnant",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for heart throbbing pain in chest\n\nMy daughter s chest hurts it feels like a throbbing pain in her left side. She says its kind of hard to breathe too and having trouble breathing. Her palms are also sweating. It is still hurting , the pain is like a sharp pain closer to the side rather then the middle. Just 10-15 minutes ago she was drinking soda (crush). Could it be because of that or something else?",
    "doctor_response": "Thanks for your question on HCM. I can understand your daughter 's situation and problem. In my opinion, we should first rule out cardiac cause for her left sided chest pain. So get done ecg, if ecg is normal then no need to worry for cardiac cause. She might be having stress related gastritis which is worsened by soda. Sweating in Palm also suggest stress and anxiety. So ask her to avoid stress and tension, be relax and calm. She may need anxiolytic drugs too. For gastritis, proton pump inhibitors are good drug. Don't worry, she will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Broken up with long time partner, difficulty in getting over feelings, extremely emotional. Suggestions?\n\ni recently had a breakup..and its really difficult for me to move on...coz we had a good long 6 year relationship...and everything i do reminds me of him....though i have changed my city,and m trying to keep myself busy. we are now just friends..and he calls me sometimes....but i m unable to remove my feelings for him... what should i do....???",
    "doctor_response": "may i ask why did you break up? why the continued friendship. Has he moved onto another relationship? how is this effecting you medically? any sleep or eating disturbances? how is your energy? you say you have tried to move on , what efforts have you made to do so apart from moving cities? I cannot tell you what to do without knowing more detail, and even then I cannot tell you how to continue with life. I will only be able to advise you on your options",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for friction on foreskin and penis head\n\nDear Dr. I have had a friction burn on my foreskin and head of my penis for several years now. It has been a huge burden in my life and affected my relationships. As well as just confidence in general when coming to itimacy with the opposite sex. I m wondering is there any topical treatment, procedure, etc that could rid me of these unsightly burns. Any help would be greatfully appreciated!",
    "doctor_response": "Thanks for asking in healthcaremagic forum   I appreciate your concern. Dryness can cause this. If I were your treating doctor I would have advised you some lubricant while performing interourse to avoid dryness  which inturn prevent friction erosions. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is bite plates with braces proper ailment for bruxism?\n\nHi, I have bruxism and have elected to do conventional braces for another issue.  My dentist today says they have tried night guards with braces but have not had any luck.  She would like to do bite plates with the braces.  Do you have any opinions regarding this.Carla",
    "doctor_response": "Hi! Welcome to Healthcaremagic.I read your query. Bruxism can be due to stess, anxiety or local oral factors like abnormal bite, missing or malalligned teeth etc.Since you are already getting orthodontic treatment with braces, bite plate will help in correction of deep bite if you have. Also it prevents direct trauma to TMJ by distributing grinding force on teeth.In addition to this, avoid stress. Do calming exerciss, meditation. Drink lots of water and avoid alcohol, caffeine, chocolate.Relax your oral muscles by exercise. Put a warm cloth in front of your earlobe for 5 min. This also relaxes oral muscles. Avoid chewing gums and intentional clenching.Hope the answer helps. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from degenerative disc disease, bulging discs in neck, pain from base of skull to shoulder. Back surgery, epidurals done. Treatment?\n\nI have degenerative disc diese in my lower back and a buldging disc in my neck , with constant pain in those areas sometimes pain shots up and down my left side from the base of my skull spreading down my left shoulder to my hip and down to my toes. I have had one back surgery in 2008, as well as, several epidurals. But, nothing seems to help. I take pain medication but that does help either. What should I do?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern looking to the history given here I could say that if this is degenerative disc disease then the over all case management is depends upon the severity of the disease most of the cases well responds to conservative line of treatment in my opinion you better discus this with the orthopedic doctor, hope this information helps you, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can an online doctor tell me the chances of pregnancy based on the symptoms ?\n\nFor FET I took lupride injection from second day of my period to 12 days. And after 12 days I started progynova 2 mg tables three times for first 5 days and four times for the next five day but that 3rd days I start bleeding then doctor suggested to cancell the FET. My last mensus date is June 28. But July month mensus is yet not come. If I am pregnant or not... Pls answer my question",
    "doctor_response": "Thanks for the query There are reasonable chances ghat you are pregnant since u have not got your periods yet. I suggest you take a urine pregnancy test today and then again after one week Have a healthy living",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the best possible treatments other than ALT test for hepatitis ?\n\nhi there,I am patient of hepatitis C and I got hepatitis C 5 years beforeafter every three months  I go for ALT test and my doctor told me its pretty goodand I don't need treatment of hepatitis CI just needs to know is that correct or I still need treatment",
    "doctor_response": "HiFrom your medical data you are diagnosed with non reactive hepatitis C.I am glad to know that your liver panel are normal and it means that you don't need treatment.But to perform exact diagnosis if your hepatitis C is reactive or not  in our  clinic practice we use HCV-RNA  level test.Please discuss them with your treating doctor. wishing you all the bestDr.Klerida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the purpose of siphene medicine ?\n\nHello doctor iam 39 yrs old male. Myself and my wife undergoing infertility treatment . for me Siphene 25mg tablet is given by my doctor. but while seeing in net i understood that this tablet is for women to get multiple ovalations. but it is given to me. can i know for what purpose it is given to me. thanx Ram kumar.K India YYYY@YYYY",
    "doctor_response": "Hi Mr Ram Welcome to HealthcareMagic Siphene is clomiphene citrate used in treatment of infertility... It can be used for both men and women when there is hormonal imbalance leading to infertility. In males it improves semen parameters ( count, motility and morphology). Dont worry about the treatment given to you. trust your doctor. If you have doubts regarding treatment you can always clarify with your treating doctor. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest methods to prevent effects of oxyelite pro\n\nHello I started taking Oxy Elite Pro on the Feb 25. I took it for five days and then I had to go to the emergency room because it felt like i was having a heart attack mind you i am only 27 year old female. Every since then I quit taking the product,but I am still feel it in my body, and it is causing me to have panic attacks how can i flush it out my system how long does it take and should i be worried.",
    "doctor_response": "Hello, After going through your medical query I understand your concern and I would like to tell you that most likely Oxylite pro ingredients caused you Severe gastritis which was the cause of chest pain. So stop taking Oxylite and take antacids like Pantocid-DSR twice a day for around 10 days. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does high fever with chilling relate to typhoid?\n\nHello, My son is having High degree fever with chilling (103 degree) every 4 hrs. Doctor has given him monocef-o 100. He said that since it is beginning so Vidal test would be negative, but lets start the medicin clinically. Today he vomited after taking medicine.. He is 5.5 yrs old and he is in fever since wednesday night. Is the medicin ok or you can suggest us any test that can confirm that he is suffering from typhoid.",
    "doctor_response": "HIWell come to HCMChilling and fever are the main manifestation of any infective disease, if typhoid being suspected then the given medicine is okay, in early phase of disease the Widal titer does not show any precipitation, but rapid slide test gives the clue for this, more over routine blood test would be much helpful and this need to be done, hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to relieve back pain due to disc compression against spinal cord\n\nHi, may I answer your health queries right now ?  Please type your query here...my husband had an mri scan and it revealed the c6 and c7 disks compressing against his spinal cord....he has had pain that has been progressing over a year now.his pain is continueous and its a dull pain all the time he also has had black outs and now in the last few days vomitting and severe headaches...we are waiting to see a consultant but could you shed any light on this for me?",
    "doctor_response": "Hellowelcome to hcmwell the pain in back is due to the MUSCLE SPASM in the involved area n this pain can be releived by taking analgesic medicines n doing physiotherapy....the other symptoms u have mentioned r not related to the back problem n u can visit a physician who will do certain tests n clinical evaluation to find out the cause of these other symptomsregardsdr rahul",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does \"mild cortical brain involution seen..\"mean?\n\ncan you explain \"mild cortical brain involution seen in the form of widening of the cortical sulci, especially in the parietal regions\" there is periventricular white matter ischemic change, there is no evidence of intracranial haemorrhage or space occupying lesion or significant mass effect. my 81 year old mother's CT head scan .",
    "doctor_response": "Hi, mild cortical brain involution is due  to age related brain atrophy.With age ,  Our brain shrinks , Sulci and gyri become more prominent,  Ventricles become dilated and there is peri ventricular ischemia. So in short these are normal changes normal for 81 yrs of age. nothing to worry. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My neck is stiff and some movements cause neck spasm. Which position should I sleep in night?\n\nHello doctor,I have a stiff neck, and some movements cause my neck to spasm and feel like something is being pinched. Which position should I sleep in tonight?",
    "doctor_response": "Hello. This appears like a muscle spasm. Doing hot water fermentation and gentle kneading massage should release the neck spasm and make it comfortable to lye down flat without the pillow. With the help of gravity, the stiffness will reduce in the overnight, and you should be fine. Incase if the stiffness is same, please do let us know so we can suggest the other methods.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe bouts of vertigo with burning and watery eyes, difficulty in sleeping and concentrating, exhaustion. Suggestion?\n\nDr, I keep getting severe bouts of vertigo during which my eyes begin to burn and water; i find difficuty in speaking. Two years back my neurologist prescribed Vertin 24 thrice a day. I took it for 2 months and then stopped. I also feel very exhausted and not able to concentrate on anything for a long time. Kindly suggest what I shoul do.",
    "doctor_response": "Symptoms of vertigo associated with such predominant somatic symptoms points toawrad psychogenic vertigo. Try tab pexep CR plus and if vertigo is troublesome then add tab vertin. Hope my answer will help you.  Take care.  Don't forget to rate me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this semen analysis for fertility indicate?\n\nHi i'm 36 yrs  married  and having problem with my semen.after semen analysis my report shows Pus cell 5-8 hpf,Mortality 75%, Count 80million/cc, Ph 8.5,Volume 3ml,color whitish opaque,Contaminants only grown.am i able to make pregnant my wife? i had ciprofloxacilin 750 twice a day for 3 days and 500 mg twice a day for next 7 days",
    "doctor_response": "HiWelcome to healthcaremagic.I have gone through your question.As far as your semen analysis is concern its normal except pus cells and ph.Pus cells suggest infection and you are already on ciprofloxacin for 10 days. So i would suggest let the treatment complete and repeat semen analysis. You can definately make your wife pregnant.Hope i answered or question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "When can i conceive after coming off Depo injection?\n\nHi im 22 we have two daughters who r 4 and 2 and want another baby but are struggling to concieve after coming off the depo injection in june was on it for nine months how long will the injection take to come out my body so we can concieve also cant find my most fertile time because i nleed on n off throughout every month please help",
    "doctor_response": "Hi, I think it takes around 6 months to 1 year to get your ovaries back to normal after stopping depo injection.  So, I think you can take some medicines like clomiphene for the growth of your follicles and track your follicles growth by repeated ultrasound.  When follicles reach a size more than 17 to 18 mm, take injection for rupturing the follicles.  Be in contact with your husband for next 2 weeks. Do a urine pregnancy test at home after that.  You can try like that for 3 to 6 months.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for rapid heart beat?\n\nMY DOC CLAIMS THI HBP HAS NOTHING TO DO W/INCREASE IN SINTHROID, YET THAT IS EXACTLY WHEN I FELT MY HEART FIRST RACING W/HBP. WILL IT DECREASE WHEN I GET ENOUGH SINTHROID IN MY SYSTEM TO GET THE TSH HIGH ENOUGH? I AM FEMALE, 5\"4\" 124 LBS HAD HALF THYROIDECHTOMY FOR NODULE WHICH WAS BENIGN",
    "doctor_response": "Hi,Taking excess thyroxine than what is needed is a very frequent cause of tachycardia & palpitations.You need to again check your thyroid level & discuss with your endocrinologist to change the dose of thyroxine, if required.Also get your ECG taken at the time of palpitations for its diagnosis.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for movable lump\n\npea size about 20 years ago, it was then moveable, now getting to the size of a ping pong ball  when surrounding skin is stretched, had mentioned it to my doctor some years ago and was informed nothing to worry about, but it now seems to be getting bigger quicker but no soreness or pain.age 56 weight 11 st height 5'5\"",
    "doctor_response": "welcome to Health care magic.1.First thing you have not mentioned the location of the lump, where you are feeling?2.If its not causing any pain and slow growing its lipoma - no need any intervention unless causing discomfort and cosmetic reasons.3.If its tenderness and pain with fever - then its abscess which needs urgent medical attention.4.An ultrasound scan help to find out the constancy of the lump and adjacent structures involvement.5. Try to get an appointment and evaluate.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the white colored substance after hair fall?\n\nHello doctor,I have severe hair fall. And when the hair falls, I can see a white color substance at the root of the hair. Can I know what is that? Is it dandruff?",
    "doctor_response": "Hello.  I have noted your concerns, and this most likely seems to be due to telogen effluvium or hair fall. In this condition, three is loss of scalp hairs in their entire length from all areas of the scalp. The whitish bulb-like substance that you see at the root of the strands is a shrunken hair root which is in good health active and thicker but shrinks when the hairs are falling. There are several ways in which patients of this condition are helped. These are 1. Do not brush the hairs when they are wet. 2. Avoid massaging and use of harsh chemicals. 3. Biotin, a vitamin taken orally helps in the majority of patients. 4. Correct your anemia and dietary habits. Finally, have patience as that this disorder takes several weeks or months to clear up. In general, it responds well to measures.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medicine to take for anxiety and depression in pregnancy?\n\nsir i was taking medicine feliz s and collonotril from last 1.5 year but now as iknew i m pregnant istop the medicine im 3 months pregnant but the anxiety and depression repeat again. what should i do i m very much worried how i can comeup with this thing",
    "doctor_response": "Hi,I read your query and can understand your concern regarding your symptoms and also regarding effects of drugs on your pregnancy.Feliz s (escitalopram) is an anti-depressant and clonotril (Clonazepam) is  benzodiazepine. In your case, since you are having depressive and anxiety symptoms again, it will be advisable to start treatment again. Treatment can be of two types: with medications and with psycho-therapeutic methodsIn case your symptoms are mild, option of treatment with psychotherapy like cognitive behavior therapy can be considered if there is a trained therapist in your locality. Alternatively, treatment with escitalopram can be considered. Escitalopram is relatively safe even in pregnancy. The highest risk is usually in the 1st three months which in your case is over. Benzodiazepines should usually be avoided throughout pregnancy. So medicines can be started. You can discuss regarding this with your psychiatrist.In any case, treatment is necessary as depression during pregnancy can cause effects on the unborn baby too.Hope I was able to answer your query.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest juice to drink for an infant\n\nwhat juice is best to give a one year old?  How much should they drink thru the day?  Also we are giving organic whole milk - how much should she have thru the day.  One more question - she has bronchitis and is on antibiotics what is the best drink to give?",
    "doctor_response": "HiWelcome to the HCMYou may give any fruit juice but prefer citrus fruit juices as they are rich in vitamin C which helps in respiratory infections. Fruits are better than juices as they also give fibres which help in peristalsis. 1-2 glass of juice is enough for a day. Excess juice may lead to loose poops. 2-3 glasses of milk and 4-5 bowls of complementary feeds are recommended at this age.Hopefully it will be of help.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling feeling in fingers after blood donation?\n\nI tried to donate platelets today, but they were unable to get my blood flowing enough to gather them. While trying to get the needle in the vain they moved the needle around a lot. I now have a tingling feeling in my fingers, that wont go away. Should I be concerned?",
    "doctor_response": "Hello. I have been through your question and understand your concern.While taking blood from your vein they might have caused some tissue injury which may have somehow compressed some nerve passing by. This is very unusual and uncommon but still possible. This should go away in a couple of days.In case it persists, you should do a EMG to be sure there is no nerve compression.Hope this helps. Please feel free using MHC for further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diet and medication to control sgpt level\n\nhello sir hope you fine sir have do my liver test thank GOD all are ok but my sgpt level is also hight like 80 i use the multimotion and food control so i go to 37 so after one month i check again so its increse 72 so i m very woried about this so please guide me what i do and which food i use and which medican i use so please help me and reply me my id is YYYY@YYYY i m waiting of your reply",
    "doctor_response": "Dear Friend.Welcome to HCM.It can be due to alcohol consumption , in case you don't do, I would suggest you following:1. Viral Markers2. Ultrasound Abdomen3. Complete LFTStay Healthy",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does my lipid profile results indicate?\n\nI had a recent lipid profile with results as follows HDL 86 LDL 234 Triglycerides 70, my doctor was very upset with these since the LDL numbers have risen since my menopause 8 months ago. I am not overweight, exercise regularly, eat quite healthy(take flaxseed powder 2tbs. daily, along with liposomal vit. c and salmon oil, eat plenty of veggies and fresh orange juice daily... She wants me on medication. I do not think medication is an option until she is willing to test for LDL type a or type b to see if I am truly at risk for heart disease. Where can I get this test?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You LDL cholesterol level is high but there may be some problems in HDL. HDL level of 86 is very unusual.  Ypu should repeat your complete lipid profile test after a month.  Till that take low fat diet with high amount of polyunsaturated fatty acids. No need to start medication now.  Later on if needed you can start drugs like atorvastatin or pravastatin.  But right now you don't required medication.  Just go for repeat testing. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "17 year old with itchy rash on the hand, fluid filled blisters on the wrist. Fungal infection?\n\nhi, i m an 17 year old female and i have an itchy rash that appeared on the top of my hand out of no where a few days ago. it started out as a cluster on my wrist with one or two sporadic tiny fluid filled bumps towards the center of my hand. fast forward 3 days later and my hand now looks like it s been covered with a blanked of a toads skin. this isn t the first time it s happened though, i ve had it twice on my face and one time before on both of my hands and all of those came along for the first time when i moved from california to new jersey and then back again. my 18th birthday is in about two weeks so i don t know if it s stressed induced or some sort of fungus? i need some answers because i just can t have this going on for 3 months and then disappearing again.",
    "doctor_response": "Hi there. Thanks for writing in to HCM & for a detailed history & clinical features which does make our task of helping you out that much easier! From all that you have stated, No it does not appear to be a fungal infection to me. It appears more to be an 'allergic' phenomenon & most likely a 'photoallergic reaction' & /or more specifically a 'phyto-photodermatitis' & it may be related to the plants in your region. Please trying applying a topical betamethasone-fusidic acid cream locally to the area & taking an antihistamine. This should help relieve your symptoms. Ideally, go across to a dermatologist & do some 'patch' or 'prick' tests depending on what the suspicion is on (allergen i meant) & this may help give you a clearer picture for closure & one can avoid implicated allergens. Trust this was clear advice & gives you a clear action plan. Good Luck! Dr Praveen Rodrigues MD Dermatologist, Cosmetologist, Venereologist Bangalore, India",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Even though investigations are normal, I am getting chest pain. Please help.\n\nHi doctor, For the last two years I have been suffering from severe chest pain. The exact location is behind the breast and the pain radiates to the left hand. I have done enough of evaluation like TMT, 2D echo, lipid profile, MRI thoracic area, MRI cervical, CT chest with contrast and other blood test. None of these reports are positive or identified any issue or problem. I have visited cardiologist, neurologist, psychiatrist and general medicine doctors. Everyone tried to give me some painkiller and that works for a week. And then the pain will be back after a week or so. Over last three months the pain is so severe and I am rushing to the nearby hospital. They used to take an ECG and give me three to five injections through IV to control the pain.\u00a0I am sick and tired in finding the root cause and also very depressed because of this pain. I am unable to bear it most of the time. Please help me out in directing a right specialist or doctor to visit who can get me some relief from this pain. As I am unable to concentrate, my professional and personal life is on stake because of the pain. I am looking forward for your quick response.",
    "doctor_response": "Hi. We are here to help you. Revert back with the endoscopy report to a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why there is blueness around mouth and eyes of my 7 years old?\n\nMy 7yo girl has been having mild sore throats and headaches recently, and now she is constantly blue around the mouth and eyes. Her temp seems low, so I ve been having her run and play or sit by the fire. Should I be concerned? She has no known health issues besides sesory disorders. Thanks!",
    "doctor_response": "Hi, It's better to get her checked by General Physician. I want to know if she is getting this blue colour change after playing or running. You should be concerned if it is occurring after running or playing and consult a doctor immediately. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Yasam Lavanya, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of a bruised heart?\n\nWhat are the symptoms of a brusied heart? I was riding a quad two days ago and wrecked. It threw me a good 20 feet and the bike landed on my left side. At first I had short and shallow breathing. I'm a little sore now but notice my heart is beating irreegular and louded than norrmal. Should I be concerned?",
    "doctor_response": "Hi There After going through the details provided by you it doesn't look like a Heart problem, nothing much to be concerned but as you have sustained an injury I would like to suggest you to get an chest X-ray done and an echocardiography to make sure that trauma has not affected the heart anyway.Wish you good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can mild tricuspid regurgitation in a child be treated?\n\nMy son 14 years age has mild TR in echocardiogram, now in chest x ray PA view doctor reported heart is not enlarged, mild prominence of right heart border, some hilar congestion and mild pulmonary vascularity, lungs are clear, no inflamation, no solid mass. He suggested ecocardiography which we already had, his serum Ig E level is high 686. In fact boy has off and on cough problems, sore throat with fever.When he was an infant doctors asked for heart check up, which later I did mild TR little PASP 35 mm Hg with no other defect RBBB in ECG. My boy has got good height say 68 inches but I am worried about his health.Kindly guide me. Thanks and best regards. Rehan Adil",
    "doctor_response": "HelloWelcome to Ask a Doctor Service I have reviewed your query and here is my advice.The findings are not suggestive of any disease of illness, and what ever the  cough symptom he has that could be due to some allergic condition or may be nonspecific if this is the allergic condition then it is self limiting and no need to worry about this Mild TR has nothing to do with the symptoms he has, you can discuss this with his doctor Hope I have answered your query, let me know for further assistance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is bluky liver a symptom of jaundice?\n\nsir , i am umamaheswara rao. last year i got my total checked. every thing was normal. in the findings of the scanning. they wrote that BULKY LIVER, doctor did not suggest any thing. i used to go for walking 30 minutes daily with 140 steps per minute. i am neither a smoker nor an alchoholic. for the last 4 months i find my stomach is looking heavy. blood tests were done. belrubin is 1.4, SGOT SGPT are 54,48 more than normal. doctors telling that, jaundice is just entering. sir , is there any relation with bulky liver. my appetite is good. my i am taking live 52, and b complex tablets.",
    "doctor_response": "Hi,Thanks for your question.After going through your question, I can understand your concern.Bulky liver may be the feature of jaundice, though other conditions may also associated with bulky liver, even normal obese person may have bulky liver.There might be following causes  in your case for bulky liver and marginally elevated Liver enzymes (SGOT, SGPT):- NASH (Non Alcoholic Steato Hepatitis): It usually present in obese person due to insulin resistance.- Or Developing Jaundice.- It just a incidental finding.I would like to advise you-1) Follow your daily walking.2) Keep your weight under control.3) Avoid fatty, spicy food. Avoid high calorie food if you are obese.4) Can use Live 52 & B complexes as currently using.Watch for symptoms like yellowish discoloration of eyes & skin (urine will be yellow due to B complex use), increase in abdominal pain, nausea, vomiting if these symptoms appear repeat Liver function test immediately and consult your doctor for further evaluation.Otherwise repeat LFT after 2 to 3 weeks.If there is deterioration of LFTs there is need for further evaluation.Hope this helps you, if so do vote as helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Effect of polycystic ovaries on fertility\n\nHello Sir, My scan for ABDOMINO-PELVIC-ULTRASONOGRAPHY has shown that i have mildly enlarged bilateral ovaries with few randomly arranged follicles - ? polycystic ovaries and sugg :hormonal correlation. I am too much worried about the infertility ...can you please advise on this?",
    "doctor_response": "Dear there is not need to worry.this can be effectively treated and once treated you can have positive chance of getting pregnant.Please get in tough with your gynecologist and he will help you.bye and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Came off sprintec birth control pills, trying to conceive. Any side effects ?\n\nI took a weeks worth or less of the sprintec birth control realize that i didnt want to take them any more for the simple fact i am trying to conceive and produce my bundle of joy. I am wanting to know the side affects i may have and also what will my body go through or will have to go through after not taking this medicine.?",
    "doctor_response": "Hi,Thanks for the query. As you took the contraceptive pills only for few weeks, there may not be any major change in the hormonal levels. But better to avoid the pregnancy in the month when you took the pills. Contraceptive pills can lead to irregularity in ovulation and menstrual cycles sometimes. Usually these will become regularize soon by their own. So better to wait one to two months for regularization of the cycles. Once your cycles become regularized, track your ovulation either with kit or with follicular study. And plan unprotected intercourse around that period. This will increase the possibility of pregnancy. Start taking folic acid supplementation from nowonwards. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the small lumps at the back of neck?\n\nI have had a tension headache for two days, I used a heating pad on the back of my neck. It's gone now. But I noticed two small lumps right below my hairline on the back of my neck on the right side. I also have one on the left side below my hairline. Should I be worried?",
    "doctor_response": "Hi,Do not be worried. These are most likely to be sebaceous cysts which are harmless. They do not need any treatment if they remain small. Regards,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe fatigue while suffering from essential thrombocythemia?\n\nI am 66.jUST DIAGNOSED WITH ET.DR AT UAB in Alabama told me AVERAGE life expectancy is 4 years.That seems a little pessimistic from what i read.Any thoughts?I am very active and dont smoke.I do Crossfit 3 times per week.Also i have felt somewhat fatigued .Is that from et or hydroxy treatment.Thanks Bobby Boone",
    "doctor_response": "Dear Bobby, I don't know with which reference your doctor is telling such low life expectancy. Most of the ET patients have near normal lifespan. Only those who have thrombosis or transformation of ET to acute leukemia have reduced survival. This is the reference:  Please continue your daily physical activities without any restriction. I feel your fatigue is more psychological. If your hemoglobin level is more than 10gm/dL, then there is no need to worry about fatigue. Please get your blood tested for hemoglobin level. Hope I have answered your question. If you have any further questions I will be happy to help. With regards, Dr. Girish Kamat",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for mild back pain\n\nI am 45 years old and female. I rarely get sick. I recently visited my doctor, a resident, at the local university hospital. My first visit was due to a small, pea-sized growth on my right clavicle/sternum joint. I had a follow-up visit a month later to check the size. Although the size had not changed, below the clavicle was noticeably swollen. The entire clavicle, and the rib below the clavicle, protrudes more than the left side. An x-ray was ordered and the radiographer mentioned the right side seemed to protrude on the image. I went back today for the follow-up, saw different doctors, explained my symptoms, answered the same questions again, and then again after a team of three other doctors entered the exam room. They will be referring me to an orthopedic specialist in order to determine if this growth is a ganglion cyst. I have no pain or discomfort at all in the joint or bone, I have had a sporadic low fever several on and off the past month, 3 upper body skin rashes, several incidents of burning/itching palms over the past 9 months, no swollen lymph nodes. Sometimes, mild, dull pain in my upper right side back. I don t drink or smoke. I run about 4/3 times per week. I try to eat healthy and rarely eat red meat. If I am fatigued, it sometimes gets better with exercise. Any suggestions as to my next step or second opinion?",
    "doctor_response": "Hi,Thanks for your query. After going through your query I came to know that you has small growth of pea size on my right sternoclavicular joint .You have no symptoms at joint level so no need to much worry.Your doctors suspected this growth is a ganglion cyst. This cyst are not harmful so no need to worry much. But you have sporadic fever off and on in this month ,I think possibility of lymph node enlargement.So I will prefer a  excisional biopsy of swelling which may provide a direct diagnosis You can discuss with your treating Doctor about it. I do hope that you have found something helpful. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a way to walk without the help of the left quad muscle?\n\nI have RSD and nerve damage to my left quad muscle after knee surgery.  it's been 3 years now, and it's still \"dead\" and I can't walk correctly.  Tried electrical stimulation, etc.  Nothing gets this quad to \"fire\".  Will I ever be able to walk again without having a functioning quad?",
    "doctor_response": "Hello, If there is loss of power of quadriceps muscle since last 3 years then there is only one option and that is surgery. Such cases also happen in polio patients. In that case, the hamstring muscles which are at back of our thigh are transferred anteriorly. Although this does not help in gaining complete normal movement, it is very helpful in doing routine tasks. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mukesh Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to smoke after tooth extraction?\n\nI had my 4 wisdom teeth extracted Friday it is now the next Thursday I didn t have any problems until Tuesday night I woke up with bleeding and on Wednesday they put packing. And a stitch in the one that was bleeding could I smoke a cigarette without chance of getting a dry socket",
    "doctor_response": "Thanks for your query, I have gone through your query.As far as the bleeding is concerned, it occurs secondary to negative pressure created by smoking nothing to be panic, do not smoke for 3-5 days till the wound heals and the clot gets stabilized in the socket. If you still smoke, there are chances of you getting the socket infected or dry socket.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do shortness of birth and dizziness post alcohol consumption indicate TIA?\n\nI had a stoke in the past last weekend I had a couple of drinks then, suddenly I felt off , I went outside to get fresh air and it was if I was bombed , but not really drunk I could no longer stand and my husband had to help me walk then suddenly I felt like I was going to vomit we got home and I went to sleep immediately no signs of hangover the next day, just extremely tired and not myself could I have had a TIA",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The fact that you had some drinks makes this confusing.  Defining a TIA or not is best done with an immediate MRI of the brain with diffusion/perfusion tensor imaging performed as soon after the event as possible but in any case not more than 24 hrs.  So based upon BEST information available from your description of things I'd say that the likelihood of your having had a TIA is very very small. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes inability to conceive inspite of normal test results?\n\nHello Dr. Im 28 yrs for today, married for 2 yrs 4 mths. Im trying to conveice but not working out. From day one we havnt used any precaution. i hve got my utrus and my husband sperms count test done. the result is normal. Please sugguest me how to go about please.",
    "doctor_response": "Hi , Welcome to HealthcareMagic. I suggest you to start on ovulation inducing drugs like clomephine . This will help multiple follicles to mature and rupture . With this you have to undergo follicular study done.  I suggest you to discuss this with your doctor.  Hope I have answered your query. RegardsDr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can tract infection harm IUD ?\n\nHi,My name is Lonesha. I've or should I say I assume I have a tract infection because of the frequent bathroom runs,foul smell,and discharge but my question is Ive had it for over a week with no treatment and I just got my IUD a little over a moth ago,could this infection mess up anything with IUD?",
    "doctor_response": "HI, thanks for using healthcare magicIUD function would not be affected by the infections but IUD are associated with an increased risk of developing infection.Urinary tract infections can present with some or all of the following symptoms: frequency of urination, change in the odour or colour of urine, urgency, discomfort on urination, abdominal pain, fever, vomiting, loss of appetite.You need to consider visiting your doctor for an assessment and treatment which includes antibiotics.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in chest and cough?\n\ni m somking since i was 17 years old. now i m 23, i m expereincing cough...n a little sound while exhalling from past 3-4 months, also having pain in chest when i press my chest with hand..i am scared..please tell me are these symptoms of lung cancer???",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Yes, this can be symptoms of lung cancer. Since you are active smoker, your symptoms can be due to 1. Bronchitis 2. Lung infection (pneumonia) 3. Lung cancer. So consult pulmonologist and get done clinical examination of respiratory system, chest x ray and PFT (Pulmonary Function Test). Quit smoking as soon as possible. Treatment is based on diagnosis. So consult pulmonologist, diagnose yourself and start appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does surgical removal of tooth cause problems in eyesight, ears and brain?\n\nI am Mrs Charlotte Pinto age 30years, height 5.4 \", weight 45 kgs. Does surgical removal of wisdom tooth and the molar next to it due to decay, effect the eyesight, ears, or brain as such? what are the side effects. Since this removal dr . suggest will have stiches after removal.",
    "doctor_response": "Hello,  Read your query, as you are asking about side effects of removal of wisdom tooth there is no side effect on your eye , ear and brain dont be worried in surgical extraction of tooth stiches are given to have proper healing of extraction wound .   Follow all post extraction extraction , maintain proper oral hygiene,  take proper course of medication prescribed by your dentist.  Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain, green and foul smelling feces, family history of colon cancer, history of opiate addiction. What should I do?\n\nI have been addicted to opiates for over 2 years now (following a full term pregnancy that ended with complications, I lost my son yet retained the placenta and was rushed into an emergency d&c ) I felt like I needed to add that medical history, that emotional trauma has been too much to handle without the self medicating. I now suffer from severe abdominal pain , and a wide variety of inconsistant bowel charictaristics. I just passed lime green, slimey, very fowl smelling feces. Recently, I have seen clay colored, black tar like, marblely, hard to pass, blood mixed inside, white mucous, well, you get the idea. Colon cancer runs in my family. The pain is becoming more than I can medicate away on my own, I do not know what is wrong with me or what I should do but I fear that if I do not seek help soon I will have autopsy results instead of a treatment plan. Please help me. Thank you for listening. -H.M.L",
    "doctor_response": "Hello! Your symptoms associated together are significant for acute pancreatic inflammation. And morphine intake doesn't help as morphine can sometimes cause this disease. Your symptoms may be also caused by severe constipations caused by morphine as well. It can also make your gallbladder overfilled as it caused gallbladder muscle spasmed. I suggest you to have abdomen ultrasound and blood tests, liver enzymes tests and pancreatic enzymes test as well. You cannot get rid of acute pancreatitis by yourself as it is very urgent state and needs immediate medical attention. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I take medicines for BP with readings 164/90?\n\nI am 64 years old weighs 100kgs 5ft 11inchs my pressure readings yesterday was 180/100 I was taking ATEN-25 for some time  but, I had stopped taking the tablets for the past 3months. as I ran out of stock as I can't find the drug in the UAE I visted a doctor in the UAE and he precribed COVERSLY 5mg But I did not take it thinking the change in drug would effect me. This morning my readings are 164/90 should I continue taking the tablets for BP What should I do?",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern. I will try to explain you something and give you my opinion. You should know that we talk about hypertension if we have mean value that exceeds 140 / 90 mmHg.A person might have high value during emotional and physical strees so its mandatory to judge on mean values during day and night. Hypertension is divided into two groups. Essential hypertension is a chronic disease, whithout an identified cause and it should be treated all live long. Secondary hypertension is common in younger ages and it means that it has a secondary couse of it.This might be a renal disease, an endocrine problem or a cardiovascular anomaly. So, if your doctor has previously prescribed you blood pressure medication than they probably has diagnosed you whith esencial hypertension meaning that you should treat it live long. In this moment, as you have been whithout treatment for a long time, if I was your treating doctor I would recommend some examination like a cardiac echo to evaluate heart function and walls,  a full blood analyze to chek renal function, electrolyte and a preassure holter monitoring  to evaluate your values during day and night. After all this we can better judge what is the most adapt drug for you now, atenolol or another class, because treating your blood pressure is mandatory.Hope I was helpfull. Best regards, Dr.Ervina.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Asthalin and Omnacortil safe for cough and congestion?\n\nMy son is two and half year old. His weight is 17 kg. He has cold and cough, and also feel uneasy to breath. When consult pediatrician they suggest to give Asthalin & Omnacortil syrups. But he not able to sleep properly bcoz of cough. Can you suggest is it fine to have this syrup to continue?",
    "doctor_response": "Hi...by what you quote it seems like that your son has got wheezing and moreover he is overweight for his age. In over weight kids it is difficult to control in winter when they get this wheeze. Your doctor is probably right in prescribing him a steroid and wheeze medicine. I suggest you continue it in the prescribed dose and if your kid is becoming breathless or his distress is increasing, then take him to the nearest emergency room.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "HSG done. Test shows hydrotubation greater than 2. Significance?\n\nSir,my wife has been suggested by doctor for HT (?) on D-09/10 of next cycle. The very small description of the recent medical investments is listed below for your perusal:1.\u00a0\u00a0\u00a0\u00a0\u00a0 DIGITAL RADIO GRAPH OF HYSTERO-SALPINGOGRAM:a)\u00a0\u00a0\u00a0\u00a0\u00a0Contrast filled urine cavity is normal in size and caliber.b)\u00a0\u00a0\u00a0\u00a0\u00a0No intrinsic filling defect noted.c)\u00a0\u00a0\u00a0\u00a0\u00a0Left fallopian tube is opacified.d)\u00a0\u00a0\u00a0\u00a0\u00a0Right Fallopian Tube is not opacified and no free peritoneal spillage is noted in either sides.e)\u00a0\u00a0\u00a0\u00a0\u00a0Right Cornual Block & Left Fimbrial Block.2.\u00a0\u00a0\u00a0\u00a0\u00a0Report on Hormones:a.\u00a0\u00a0\u00a0\u00a0\u00a0Serum T4 : 8.67b.\u00a0\u00a0\u00a0\u00a0\u00a0Serum TSH : 1.18c.\u00a0\u00a0\u00a0\u00a0\u00a0Prolactin : 10.03Sir, my questions are that1.\u00a0\u00a0\u00a0\u00a0\u00a0What does it mean by HT?2.\u00a0\u00a0\u00a0\u00a0\u00a0One of my wife\u2019s friend said it may indicate \u201cHydroTubation\u201d! And she added that it is an \u201cobsolete\u201d practice and usually do harm to the female in future!Sir, please enlighten me in this regard. Is it really harmful to that extending? Please help.Actually we need a baby and for that we consulted with doctor. My semen analysis seems ok with a)\u00a0\u00a0\u00a0\u00a0\u00a0 Sperm Count: 142 Mill/ MLb)\u00a0\u00a0\u00a0\u00a0\u00a0Morphology: 90 % Normalc)\u00a0\u00a0\u00a0\u00a0\u00a0Motility (within 1 hour): 70 % Grade A; 5% Grade B, 15 % Grade C; 10% Grade DAll tests done on 7th September 2013",
    "doctor_response": "HelloThanks for your query.Based on the facts that you have posted it appears that your wife has Fallopian Tube blockage on both sides hence there are no chances of her to conceive.unless her tubes  become patent. Hydro Tubation is time tested safe effective ,non invasive procedure where a saline with Hyluranidase is injected in uterine cavity to remove the blockage .This is a painless procedure done as OPD care procedure for three consecutive days for 3-4 cycles.This helps to open the blocked tubes and helps to have  natural conception.Dr.Patil..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can erectile dysfunction after controlling ejaculation for 2 hours during foreplay be treated?\n\nI am having trouble in getting hard or having the right solid eraction after last foreplay . Actually i had foreplay for about 2 hours but dint ejaculate now after one day m having pain in mya testicals and also having problem in getting the normal eraction . What to do now",
    "doctor_response": "it is psychological problem take counseling from clinical psychologist.i is simply psychological problem take balanced dieat fresh fruits and vegetable yoga and meditation may helpyou.change your life style.exclude diabetes. you are having anxiety neurosis. control your anxiety",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes muscle cramps while on Cholestyramine?\n\nHi, I am taking Cholestyramine for diarrhea. I have Crohns disease, and trying to get it under control. I am having cramps in my toes and tops of my feet. Also some in my fingers at the end of the evening. Is this a side effect? Thank you Georgia.",
    "doctor_response": "chosteryoamine like drugs are given for problem for gall bladder disease, bile acid malabsorption diarrhoea and hypercholesterolemia etc. it had been reported cramps assciated with this drug",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will intake of Siphane help in conceiving while being on thyrox and glycomet tablets?\n\nHI am xxxxx  29 yr married for 5years have not concieved till date ...my weight is 84 kg with height 5.4'' was diagonsed with thyroid but now it is in control am taking thyrox 25 mg and glycomet tab from 3 months and dr said me ki my follicilar growth is good and advised me to took siphane 50mg from 2nd  day of my cycle ...how will it help in pregnancy ...and what is its chance in getting   me pregnant",
    "doctor_response": "Hi, siphene helps in growth of your follicles and inducing the ovulation.  It increases the chance to get pregnant.  There is 7 to 10 percent chance of getting pregnant in one cycle. You can take it along with your thyroid medicine and glycomet tablets.  Hope I have answered your question.  If you have any other query I will be happy to help. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My grandfather is throwing up with cold, chills and coughing up phlegm. What should we do?\n\nHello doctor, My grandfather is 92 years old. He had been throwing up with cold chills, hot flashes, coughing up lots of phlegm, sore throat, back, and stomach pain. But there is no fever. What should we do? What could it be?",
    "doctor_response": "Hello,  Welcome to icliniq.com.  After going through your query I must admit that the first possibility is of pneumonia or lower respiratory tract infection. As he is having all signs of pneumonia other than fever. It should be ruled out with a chest x-ray and complete blood count. With the advancement of age, it is common for a person to present without fever or even hypothermia in case of chest infection. The other possibility in your grandfather is of abscess in an abdominal cavity particularly sub phrenic area. It can be detected with the help of abdominal ultrasound and complete blood count. In case if there is associated urinary frequency, urgency or burning of micturation present with all these symptoms then the urinary tract infection should be ruled out. I request you to get the following details from a nearby laboratory. 1. Complete blood count. 2. Urine microscopy and culture with sensitivity. 3. Chest x-ray. 4. Blood widal. At the same time, you are requested to visit your primary care physician as soon as possible. The presence of infection at this age may have grave consequences including acute confusional state and death. Before you can get an appointment with him, give him anti-emetics, antipyretics and lots of fluid. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to conceive while continuing Depo shots?\n\ni want to get pregnant but I am on depo injection it works for me to take away the cramps and the bleeding the cramps are to much to handle and pain killer doesnt take it away the depo injection is the only effective way that i have found to do so but i really want to get pregnant i just want to know if there is anyway for that to happen with out gowing off the depo",
    "doctor_response": "HI,   I understand your concern.   Depot shot relieves you of menstrual cramps, but it also prevents ovulation- which is essential for conception.So conception with depot shots is out of question.   To conceive, you have to stop having the depot shot,wait till you have normal ovulatory cycles ( it takes about 6-10 months ).. & then plan for pregnancy.   You can take duphaston pills/ anti spsmodic pills/ pain killers with home care to manage cramps those days.    once you conceive, the cramps would disappear  mostly for ever.   Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for breast pain after lifting weights\n\nAfter lifting weights yesterday I felt a pain in my right breast. Today it is red and warm to the touch . It\u2019s in the same area where my plastic surgeon made an incision for my breast implant and wondered if I may have irritated the scar tissue or if is more serious. It\u2019s not as painful today but the redness concerns me. My email is YYYY@YYYY",
    "doctor_response": "Hi, The breast pain after lifting weights is likely to be a muscle pain. This should subside with rest, hot compress, local analgesic gel and mild pain killers. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could blood blister like raised spots under penis be thrush?\n\nI have a question, ok I noticed I have spots on the underside on my penis. I know it s not herpes, got tested. They are blood filled, almost like a blood blister. They don t hurt, they are barely raised above the skin, and they don t pop on their own so no scabbing, unless I popped one because I wanted to see if they were blood filled. I thought it could be thrush . Any answers",
    "doctor_response": "Hi,.There is nothing like blood filled blister except a hematoma following an injury or an arterial malformation. As you guessed, possibility of yeast infection is there. Reddish tiny eruptions along with some white collections if uncleaned are signs and symptom of yeast infection.After confirming the diagnosis by a Dermatologist, with topical and oral anti-fungals for a period of 3-4 weeks will solve your problem. Your sex partners are also to be treated simultaneously.Get well soon. Dr S.Murugan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can someone have Cushing's and Addison's disease?\n\nHello doctor,I am having vertigo, water retention, muscle weakness, muscle pain all over, tired, weight gain (obesity), severe mood swings, depression and swelling face, feet, stomach, etc. Can someone have Cushing and Addison disease? Can they have both? My cortisol levels fluctuate. Can be very low or high? Currently taking Paroxetine, Zyprexa, Metroprolol, Amlodipine, when needed, Lamotrigine. At times when I do not take my medications, I cannot function nor concentrate and I still get retention.",
    "doctor_response": "Hello. I just read your query and from what you have mentioned it is seldom that Cushing\u2019s disease and Addison\u2019s disease occur together. The results that you have provided (attachment removed to protect patient identity) could be attributed to the stress levels endured by your body over time and the various medications that you are prescribed. You can benefit with salt-restricted diet. Regular brisk walk 45 to 60 minutes daily and a healthy diet rich in fruits and vegetables and avoiding junk food. You could do a 24-hour urinary cortisol measurement as well again after a few weeks. For more information consult an endocrinologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for yeast infection\n\nI have a yeast infection and last thursday I was given fluconazole 150 mg. I still feel a bit of itching and when I called my doctor they told me to take some monistat cream (They had asked where it felt itchy, which was external). I looked it up and realized there are three different types (1, 3, 7) as well as some itch relief cream. I m wondering what they meant. Any chance you know?",
    "doctor_response": "Hello,Thanks for posting your query.Fluconazole oral tablet & Monistat cream both are good to treat yeast infection.So take treatment as advised by your Doctor.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair fall in males\n\nHi my name is Peter. I have suffering from hair fall . around 20 hair strands fall everyday in the morning. I used to use hair gel in till mid of last year and then i stopped. now i apply almond oil every morning after the bath. Apart from the I use to keep my hair wet does it contribute to hair fall..?? My dad is also bald. So i would also have the same hereditary problem but what could be done so as to reduce the hair fall rate.??",
    "doctor_response": "Hi Peter..It seeme that probably you may be having male pattern baldness like your father. In your case, it may be starting phase..stage I. It is also known as androgenetic alopecia.You consult dermatologist for firm diagnosis. Reduce stress and anxiety related hair loss. If you wish, you may start treatment,otherwise you may wait.Finasteride 1mg daily with biotin containing tab may be suggested by your dermatologist. He might prescribe minoxidil 5% soln to apply on the scalp.You may cleanse the scalp with ketoconazole containing shampoo.Have patience for the good result.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for tingling and numbness in the fingers?\n\ni had a ganglion cyst removed surgically on the palm side of my wrist 5 months ago....I have extreme numbness in my fingers along with tingling and shock like pain....at night my hand feels like burning sensation and pain also.It is not improving after all this time",
    "doctor_response": "Hi,  You might be having carpal  tunnel syndrome secondary due to ganglion which upon surgical excision causing has not resolved completly .So visit a orthopaedics clinc for clinical evaluation including phalen test, tinnel sign ,neurological evaluation etc and accordingly investigations including x ray, NCV test...etc.and managed according to the diagnosis .HOPE THIS WILL HELPTHANKS N REGARDS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stress\n\nHello I used to suffer from panic attacks in the past and was prescribed Fluoxitine. That sorted the problem out  :It's now a couple of years later and I have since emigrated to another country and life is quite tricky and hard and I feel I am getting bogged down with stress daily again.  I wonder if I could order myself some more Fluoxitine online and start taking it again ? Cheers",
    "doctor_response": "Hello and welcome to Healthcare Magic. Thanks for your query.I understand that you are going through a difficult time due to your stress-related problems. Now, stress is well known to trigger anxiety / panic attacks and this is probably the reason for the re-emergence of your symptoms.Panic attacks can be treated with medication (like SSRIs) as well as psychological therapy like CBT. I would advise you to consult a psychiatrist in your place for detailed evaluation and to decide on the type of treatment that would be best suited for you.Wish you all the best.Regards,Dr. Jonas SundarakumarConsultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am seeing white circles after getting bitten by a stray cat. Is it rabies?\n\nHello doctor, I think I was bitten by a stray cat eight months back. I do not know if it landed its fangs on my finger but I noticed a very small dot sized wound on my finger. I have received three PEP regimens and the last regimen was six years back. I did not receive the last shot on that year but my two successful shots are complete. I frequently experience muscle twitches in my foot and legs because I love to walk home. I am seeing small white circles in my peripheral vision but when I look into it it is like disappearing. Is this a fruit of my imagination? Am I covered with that vaccine? Do I have rabies?",
    "doctor_response": "Hello. I have read through your question and would like to tell you that the chances of getting rabies from a cat bite are very less. And since you have received a regime of anti-rabies it erases the chances of getting rabies. The muscle twitches you are experiencing may be happening because of some other reason. Most common reason being electrolyte imbalance. Drink lots of water and keep yourself hydrated. If you still experience these twitches get yourself checked by a physician.  For more information consult a family physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for numbness and tingling feeling with epilepsy\n\nI have had cold hands all my life, and in general have been always on the cold side. I have had had back and sciatic related leg/foot pain issues for the last four years involving L4 region. I have been diagnosed with epilepsy 12 plus years ago - coinciding, time wise, with a stressful marital divorce. I question stress and or sleep apnea as a trigger, since the University of Cincinnati is studying a possible link to the apnea and epilepsy. I have been totally controlled for over 10 years with dilantin and Keppra (generic) and would love to get off medication, if not needed. Recently, I was diagnosed with mild sleep apnea and wear an oral appliance which is working very well. Now recently, I am experiencing an increase in numbness and tingling in my hands and feet. Also, about six/seven years ago, I started having a series of skin eruptions - small, itchy, and crusty - occurring anywhere on my body, mostly on my trunk. They are more intense initially then subside yet leaving a small, permanent and crusty eruption which may flare up on occasions. A dermatologist diagnosed this as Grover s disease. My last blood tests were mostly normal except for a high good cholesterol reading, which my M.D. stated out weighed the overall high cholesterol reading. First, what is your opinion on the skin eruptions, and secondly, how might my other issues be perceived. My blood sugar levels have been fine over the years, yet I do wonder about type two diabetes particularly with the tingling extremities. I also wonder about a possible thyroid involvement, since the blood tests have revealed a borderline reading. No history in the family of either issue. My back issue has improved recently - curiously, as the tingling became more apparent. Connection? With the present state of hurry-up office visits, my questions are superfluously addressed. - frustration. Thank you for your opinion!",
    "doctor_response": "Hello, Regarding the skin eruptions, the diagnosis of Grover disease is likely, it has the characteristics which you mention. However, I am afraid that it is difficult to express a decisive opinion without being able to examine them or at least some photos of them. As for the tingling and numbness symptoms they can be a manifestation of peripheral neuropathy. It is unlikely to be due to diabetes as diabetic peripheral neuropathy generally occurs when there is long-standing confirmed diabetes, not as an initial sign. Thyroid disorders may cause it too, but with a borderline result it's unlikely. An electrolyte panel is advised if not already done as alterations in magnesium, calcium or potassium levels may also be a cause. If no metabolic cause is found I would advise nerve conduction studies to check for nerve damage. If all is normal then peripheral neuropathy is less likely and anxiety should be considered as a possible cause. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Olsi Taka, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever and green diarrhea in a child?\n\nmy 6+yrs old daughter is given zanocin oral solution (100mg/5ml) two times a day and the dose is 5ml. she is having fever for last seven days. she is having green diarrohea also. today we have given blood urine and stool for culture and routine test respectively. i feel its typhoid. so if it comes positive can the treatment be continued at home with doctor guidance.",
    "doctor_response": "dear userat begining i would like to tell you that  diarrhea is very common problem in infants and you need not to worry about that but you should do simple steps....... diarrhea may result from more than one cause but the most common cause in that age  viral infection of the intestine ....viral infection causes severe watery diarrhea with vomiting and may lead to complication as dehydration......dehydration is the problem we worry about it because infant loss fluids in diarrhea so you should give your baby oral rehydration therapy and fluids...management at home is surely possible by oral rehydration sachets administered to protect her from dehydration and it is the most important step in management...if you do that your daughter will be fine shortly and improve...if typhoidal infection suspected she would administered antibiotics like cefotriaxone and could be managed at homewish your daughter healthy life",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does dark and goopy blood indicate?\n\nI had a blood test this morning.  The lab tech commented that my blood was dark and \"goopy,\"  which I assume means thick.   Two months ago I had a dnc that require the use of an IV at whicih times the doctors took blood as well- my blood stopped coming out of the tube which they used for the IV, it simply stopped filling the tube with blood.   Two tubes were required, not much at all.   They had to go in a second area for more blood.   Are these issues related?  What might be the causes?   What type of doctor should I follow up if at all?",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Your blood appears to be coagulating too fast or there is increased cells.2. Peripheral smear and coagulation profile is necessary to evaluate for any cause.3. Dehydration, hemostatic disorders, protein disorders are common causes.4. Meet an haematologist for tests and diagnosis. More details necessary for further opinion.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for fluctuating BP levels with anxiety\n\n21 years old with a varying blood pressure when visiting the chiropractor has been around 148/97, been checked twice in two months. I know that my blood pressure spikes wildly, I've been to the ER twice in the past year and my blood pressure has been ridiculously high upon entering the ER but eventually calms down to something relatively normal, about 123/73. I plan on seeing my doctor within the next week about this, because it concerns me, though I do have a General Anxiety Disorder and a Panic Disorder as well (not to mention some social and health anxiety).  The question is, should I be seeking more immediate medical attention since my blood pressure has registered that highly twice in a row now?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, you are having high blood pressure reading mostly due to stress, anxiety and panic disorder. At your age of 21 years, possibility of hypertension is less. So if we control your stress and anxiety, your blood pressure fluctuations will also control. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and Start working on its solution. You may need additional anxiolytic drugs too. Don't worry, you will be alright. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe itchiness in the gums?\n\nMy 6 year old son says his gums are EXTREMELY itchy. He has been clawing them with his nails until they bleed. (Upper gums only. Around the exact same teeth on both sides. Molars.) I don't believe it's gingivitis because he has been to the dentist in the past 6 months and they say he has been doing a wonderful job brushing. Is it just new teeth coming in and moving around? He has only lost the bottom front teeth so far.",
    "doctor_response": "Hi..Thanks for the query..Yes, it can be probably due to erupting permanent teeth as itching and soreness of gums is commonly been when the teeth are about to tear from the gums to erupt..When the erupting teeth are about to break from the gums the gums become inflamed and itchy and creates a deep urge to itch over the area..If the itching is so annoying you can do cool compresses over the itchy gums and can also apply Lidocaine gel for relief..Anti inflammatory painkillers like Ibuprofen can be advised by a Dentist..Also doing warm saline gargles can relieve..In case if there is still no improvement then you can consult a Paediatric dentist and get evaluated..Hope this helps..Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could a swollen vein with growing pimples on lower back indicate?\n\nSo today i woke up with a pain on my lower left back side, like right where your love handles are. Its a thick strip, looks like a swollen vain , its really red now, im not bothering it. it has 2 tinypimple looking bumps on it and it feel like its getting bigger by the minute. its really painful any ideas what this might be?",
    "doctor_response": "Hi,Appearantly it seems that you might be having developing Herpes Zoster, a viral infection.On clinical examination it will give clear clue about herpes zoster.Consult your doctor and get examined.after examination and diagnosis, treatment can be decided accordingly.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain, hip pain, feeling hungry all the time. Spotting, supposed to get periods. Pregnant?\n\nHello. I was supposed to get my period today and when I thought I did it was very light. I went to the bathroom again a couple hours later and there was no blood. Went again and I m spotting very light. I ve been hungry all the time and never seem to get full but when I do get full I m hungry again like an hour later. I ve been having back pain and hip pain. Could I be pregnant?",
    "doctor_response": "Hello dearUnderstand your concern.If period is delayed, it may be pregnancy symptoms if you have unprotected sexual intercourseYou should check by urine pregnancy kit , 10 days after missed normal period date.Other causes may bePremenstrual syndromeHormonal imbalanceExcessive stress, excessive weigh loss or gain, sudden change in life style, endometriosis, ovarian cyst, endometrial dysplasia, thyroid problem.Drugs like OCP.Take following advice:For pain: Take tablet Meftal Spas Two times a day for 3-4 days.Do regular walking and exercise.Eat healthy dietProper restDrink lots of fluidAvoid alcohol, smoking and caffeineRelaxation exerciseAvoid stressIf period will not come , consult the gynecologist and do proper lab test to diagnose above causesAlso note thatMenstruation required co ordinate action of various hormone that secreted by ovary (estrogen and progesterone) and brain (FSH and LH).If any above hormone is decreased or increased there is imbalance in menstruation.So please do full hormonal profile : Estrogen, progestron, LH, FSH, HCG and thyroid hormone.Also USG, ENDOMETRIAL biopsy,PAP smearThat help to diagnose hormonal imbalance.After confirmation you can take treatment according So please go ahead.Hope this may help youAll the best.Stay healthy.Best regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Heaviness in the gum. Suggested to take stolin gum astringent. Pain recurring. Why?\n\nI had a check with my dentist last week regarding my gum heaviness in upper right , they took OPD & told me that there is no problem in tooth but your gum has gone up by 1 to 2 mm & they suggested me to take STOLIN GUM ASTRINGENT  & massage gentley on gum twice a day for a month or two . Sometimes pain vanishes ...& sometimes it starts again..",
    "doctor_response": "Hello there , Thanks for writing your query, Swelling and heaviness in the gums is the sign of gingival inflammation known as GINGIVITIS. It is caused due poor oral hygiene ,improper brushing and flossing that leads to accumulation of bacterial plaque and calculus deep in the gum pockets and root surfaces of the teeth. Gingivitis presents with symptoms of redness , bleeding gums , swelling , pain ,recession and sensitivity. It needs to be treated by thorough professional deep scaling of gums and root planing of the teeth to remove all the irritants ,this will help in resolving the symptoms followed by a course of antibiotic and analgesics. i would suggest you to go for symptomatic treatment at home like gargling with lukewarm saline water or antiseptic mouthwash like chlorhexidine or betadine. i hope this helps , take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling nauseous and getting cramps in stomach. Noticed change in urine color. Any relief?\n\ni have stomach cramps for like 6 days now, they go and come, somtimes dull and sometimes I have to curl to bear the pain. My poo has also changed in comes out in small clumps. My pee is a bright yellow colour. I feel nauseas alot. Could I have cancer or something. I m only fourteen!? Please help. I get panic attacks alot.",
    "doctor_response": "No this is not cancer. Mostly its stomach infection spreading to liver You will need some blood tests and medication",
    "dialogue_context": ""
  },
  {
    "patient_message": "While planning to conceive, how would Primolut (to regulate delayed period) affect conception?\n\nHi Doctor,My periods is delayed for more than 10 days due to work pressure ..Doctor prescribed to take primolut for 3 day and I will be getting my periods with in 10 days .. I am planning for pregnancy on coming cycle ..I  am worried due to intake of  primolut will it impact my pregnancy and will it impact baby health ? Kindly please advise .",
    "doctor_response": "no because you are taking premoult n before conception it will not effect the babyyou will conceive if your cycle is ovulatory",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lumps on the ankle?\n\nI have a small hard lump just above my left ankle and I don t know what it is. I don t have one on my right ankle and I don t think there is much pain but it is hard to tell because I rolled my ankle a few days ago so it s been hurting anyways, but I have had this lump for a few weeks and I have a feeling it is slowly getting bigger.Any idea what it is?",
    "doctor_response": "HiIt could be a cyst arising from joint spaces.Please get an X ray and Ultrasound of the affected area for a clue.If it is inconclusive, then MRI should be taken. If you come back after the report,I will clarify further. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have difficulty in conceiving. Have regular periods. Does my weight affect fertility?\n\nhi,i m amulya,25years old,while my husband is 34....its been two and a half years that we are married,but have not conceived yet....i was away from my husband till last august,since marriage due to my studies in a different place,so could not have intercoarse regularly for more than 2-3 months,though we are wanting for a baby since last year....,right from last august we are together,but have still failed to conceive though i have regular cycles which usually comes between 28-30days.. i weigh 64kgs,is this effecting my fertility?",
    "doctor_response": "Welcome to HCM.Complete successful intercourse is requires during fertile period that is from 12th to 16th day of cycle.First go for routine investigations like semen analysis of your husband.CBC,RBS,THYROID,B12,HORMONAL STUDY for you.Also go for usg abdomen and ovulation study.Plan your pregnancy according to ovulation.You will definitely get conceive,avoid stress and anxiety.Eat good balance diet.Take b12,folic acid,dha supplement.Consult gynecologist for better line of medical management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Depression, irritated, sleep disorders, anxiety, defensive nature. On panex cr, modalert, etizola beta. Advise?\n\ncould you please guide through the depression and anxiety problemage is 29, gender - male, have 5 years of work-ex in MNC. Now gap in job from past 1.5 years. Defensive nature, still trying for MNC job only although the knowledge is not enough, getting job nowhere. Not ready for a lower level job. very irritated and sleep disorders. too much anxiety.Currently he has started following medicine:Panex - CR 12.5 mgModalert 100mgEtizola beta .25 mghow should he go furthur...he is facing problem from about past 4 years., not cheerful, always lost in his own thoughts",
    "doctor_response": "Hi,Thanks for using healthcare magic.I have gone through your available history.Panex contains peroxetine which is good drug to control depression with anxiety features.Usual therapeutic dose is 25 to 50 mg per day. He should regularly take the drugs till your consulting doctor advise to have. Anti depressant drugs usually takes time to start action.He will also get benefit by combining psychotherapy or counselling along with  drugs.He may also do stress management and relaxation techniques like yoga, meditation for better control over anxiety.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for asthma\n\nRespected sir...I have asthama and taking asthalin rotocap 2-3 tablets per day(.from 12-14years) Is it safe? I m taking otrivin for nosal relief What i have to do for completly relief from asthama? Somebody told allergy test is useful for this..isnt it ?...please help me to solve this problem.Awaiting ur reply. Thank you",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your history and would like to make suggestions for you as follows:1. Common side effects of Asthalin (salbutamol) rotacaps are tremors, palpitations, increased heart rate, etc. However, inhaled salbutamol is better than tablet salbutamol.However, if you need to take 2-3 rotacaps daily, it is not recommended as per my opinion. It suggests that your asthma is not well controlled and you need to take regular asthma controller/preventer medications. 2. I usually suggest my such patients regular montelukast, levocetirizine and inhaled corticosteroids for at least 6 weeks. Please use Asthalin (salbutamol) rotacaps for as-and-when-needed use only and not on regular basis.3. I also do not prescribe decongestant nose sprays (such as otrivin) for more than 3 days at a stretch. As there is possibility of rebound nose congestion/obstruction upon stopping such nose sprays. As suggested above, montelukast and levocetirizine will work for allergic rhinitis.3. I would also suggest you allergy testing for common air-borne allergens such as house dust mites, molds, pollens, insect proteins, animal dander, etc. It will help you identify the substances causing allergies to you and also to know how to avoid them.4. Based on allergy testing, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which works on immune system to gradually improve allergy symptoms.5. In general, I would suggest you to avoid exposure to dusts, smokes and air pollution.6. Regular exercise and a healthy diet will also help you in a long run by improving lung capacity and immunity respectively.7. I would like to mention here that treatment of asthma requires combination of medicines, immunotherapy, yoga/pranayama/breathing exercises, life style and diet changes. With such combined efforts, one can have a improved life with minimum possible use of medications. Such treatment requires patience and understanding of the disease from patient's side as well.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing back pain due to a surgery\n\nHi my 17 year old daughter fell off her horse onto her back and hit the back of her head about 18 hours ago. Right after the event  she had little head ache and felt kind of out of it - but seemed fine coherent could follow conversations etc. She has no bump on her head.  This morning she woke up and said her neck hurts and she feels tired.  Do you think I need to take her to the ER?",
    "doctor_response": "Headache  followin head injury indicates to visit a doctor. Neck pain may be due to spasm  which will subside..but still u need to rule out cervical spine injury..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stools while urinating in a 3 month old?\n\nMy baby is 3 months old. Since the past one month he is having motion every time he urinates. Its more than a month that he has not been able to pass a bit solidified potty. We have referred to 3-4 doctors but nothing works. We are really worried. Is it a serious problem? We have a 4-year old daughter who very often puts her mouth & nose on the baby s lips and kisses him. Can that be a reason for our problem? Please advise.",
    "doctor_response": "looks like baby has some gut infection , or he is unable to digest lactose in his milkget her stool for reducing substances done if It is positive use lactose free formula milk",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain with bruising\n\nHello, I am 34 and developed sharp pain in my lower right abdomen 3 months ago which I went to the emergency room for. They performed urinalysis, blood tests, and an MRI which all came back negative for appendicitis (and anything else they were looking for). It went away, and just came back last night along with a yellow bruise that is not sensitive to touch. Is this something I should be concerned about?",
    "doctor_response": "Hi.Pain in abdomen with a yellow bruise is suggestive of a few things. First is the possibility that you have done too much hot fomentation thereby the skin color is changed. There is another possibility of an abscess of the underlying tissues , may be subcutaneous or deep in the muscles or may be deep within like appendicitis, or colonic pathology like diverticulitis , tuberculosis or Cron's/ Get a clinical evaluation by a Surgeon and investigations accordingly to find out the cause and get treated accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes acute glomerulo nephritis in a child?\n\nshe was diagnosed w/ group A beta hemolytic streptococcal infection that led to the development of acute glomerulo nephritis How did this progress from throat infection to renaldisease I have an 11 year old girl who is in end-stage renal disease. I am very confused and frightened. My husband asks the staff how this could have happened his little girl. The events leading to this situation began, and desires to learn more about how his daughter has diminished to the point of needing a kidney transplant. We we ask them how this all began, we were informed our daughter had a group A beta hemolytic streptococcal infection that led to the development of acute glomerulo-nephritis. We just would like for someone to explain/describe to us the progression from a simple throat infection to renal disease?",
    "doctor_response": "Hello,I have seen your query and understand your concerns.The infection in throat stimulated production of antibodies against group A beta hemolytic streptocci. But unfortunately the antibodies cross reacted with the glomeruli of kidney. Glomruli are the basic units of kidneys. Damage to them resulted in renal failure.The incidence of renal failure is only 2 %. 95 % of children usually recover from the disease.Hope your concerns have been answered.I pray for your child's health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure itchy red rashes in the groin area?\n\nI started with a red, extremely itchy rash in my groin area a week ago. I was taking Omnicef at the time for a u.t.i so my GYN assumed it was an allergic reaction. Also, nightime cramping in my legs and knees began when the rash appeared. The rash has now spread to my neck, scalp, arms/underarms, bra line, abdomen, and legs. I am taking Prednisone, and Diflucan for possible candida. The rash isn't clearing with the steroid. When I wake up in the morning, the rash is at its itchiest and subsides as the day goes on, but I find new areas where its spread as well. What is this? Do I see an allergist, immunologist or dermatologist? I have no clue.",
    "doctor_response": "Hi,You might be suffering from tenia cruris,  terbinafine cream can be used twice daily and oral itraconazol is the preferred drug for treating this.Hope it helps. If you have any other question please do not hesitate to contact us.Regards,Dr. Atishay Bukharia",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having nightfalls. Is there any effect on brain and memory. How to get cured?\n\ni was doing masturbeating for 2 years than i stopped it for 4 months now i have nightfalls(wetdreams after every seven days now i am tired plz tell me measures to prevent it also tell me is there any effect of this on brain and memory i am reading in 10th class right now .plz help no one is able to give a right answer i tried everything",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have problem of night emission.It is normal to get night emission at the age of adolescence and it does not have any negative effect on brain or memory.Following general measures will help  you to boost up your confidence and improve your performance .1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning.2) Take high protein diet rich in vegetables and fruits and Vitamin A,C,D,E.and Zinc3)Take anti oxidants like Almonds 5-6 everyday..4) Avoid alcohol and smoking..There are no medications to prevent night emission.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Found lump in left groin area. Had surgery for vulvar cancer that included removal of ovaries, lymph nodes\n\nI am female, 56 y.o., 5'4\" 1/2\", 132 lbs.  I am 3 years post surgery for vulvar cancer (squamous cell.)  My surgery included removal of both ovaries and all the lymph nodes in my groin. Lymph nodes came back negative for CA.Found lump in left groin area that was there 3 days ago. It's about the size of a quarter and in line with my scar from original lymph node removal.",
    "doctor_response": "Welcome to Healthcare-MagicGreetings of the dayIt's likely that they could be recurrent lymph node. It requires thorough clinical examination and assessment. I would suggest you to get in touch with your operating surgeon for further management.Take careRegardsDr T ShobhaMBBS MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for constipation in a 4 year old\n\nMy 4 year old has been trying to get a stool out and cannot get it to pass. It is too large to pass comfortably. I finally got her to stop trying and now she is sleeping from exhaustion (crying and pushing). This happens occasionally and is very painful. How can I help her get it out?",
    "doctor_response": "Hello. I just read through your question. you can use either a Pediatric enema or a Pediatric glycerin suppository. neither option is pleasant, but they will both do the job.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can tooth pain be treated?\n\nHello, Im having bad pain in my tooth and I see a little red line going from in back of that tooth a bit to the side of the tooth and it hurts A LOT my left side molar is growing its halfway grown but my other side (where my tooth is hurting) is ... I think now growing because Its high but its a lot of pain ive had this pain for like 1 month now",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.Pain in the last molar will be due to acute pericoronitis usually caused due to the impaction and infection in the gums around the erupting tooth.I would advice you to visit your oral surgeon and have it evaluated .A radiograph will provide a picture of the position of the erupting tooth.If impaction ,get it extracted .If not wait for the complete eruption of the tooth.For pain ibuprofen will provide relief ( if you are not allergic to any medicine).Amoxicillin 500mg and Metrolag 400 will help in infection reduction on prescription .Do salt water gargling.Hope this was helpful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Stalopam plus the right medicine for stress?\n\nRespected Doctor, As prescribed by doctor, I started Zolfresh 5 Mg 2 years back and for the past 1 year I had to increase to 10 Mg. Now I got addicted with this. Recently, I had consulted Psychiatrist for my high stress and doctor prescribed Stalopam Plus. Doctor also advised to discontinue Zolfresh. Though I tried, I could not stop Zolfresh. For the past 1 month I am taking both tablets at night. Though I find improvement in my stress level, I am NOT getting proper sleep. Request you to please guide me Doctor.",
    "doctor_response": "DearWe understand your concernsI went through your details. Both the medicines are indicative for stress, anxiety and mild depression. You new doctor prrescribed stalopam because he felt it will be a better option for your problem. Your psychiatrist prescribed you with this medicine after assessing your situation thoroughly. He even asked you to discontinue the old medicine because he felt no need of it. But you did not. There are two things acts here. Your lack of trust to the new psychiatrist. Second being your mental obsession and apprehension about leaving zolofresh. You need to overcome these two problems. Trust your doctor and do as you are told by him. That will be the best option. Take care.If you still need my assistance in this regard, please use this link.  Please remember to describe the whole problem with full detail.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent abdominal pain after unprotected intercourse?\n\nhello,just had unprotective sex on saturday and my abdominal hurts..feels like a constant pain, the pain will go away for a period after taking ibprofien but comes back shortly... i dont ever have unprotective sex so i'm really worried tht i may have something now...i just got all my cultures back from doc last week and blood work ,everything fine  so i hope i'm alright now... i do want to stress the fact tht i havent had unprotective sex in years and tht i  always use condoms with my partner of 13 yrs",
    "doctor_response": "Hi.Thanks for your query. It is wonderful that you never had unprotected sex for 13 years. The possible causes of pain after unprotected sex can be ... PID- Pelvic Inflammatory Disease.Salpingitis.Ovarian problems. I would advise you the following :Ultrasonography and per-vaginal examination by a Gynecologist will help in the diagnosis and treatment .It is possibly best that both you and your partner should get treated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain on sides of groin and pelvic region\n\nHi, I have unbearable pain in both sides of my groin, my pelvic region and my hips. This has come and gone several times over the past 6 weeks. This is the worst- I cannot walk due to not being able to cope with the pain. The pain won t allow me to even bear my own weight. What do you think Lynn",
    "doctor_response": "Hello, It may be due to some muscle or ligament injury or can be due to symphysis pubis dysfunction. As of now you can take analgesics like Ibuprofen or Diclofenac. If pain persists, you can consult an orthopedician and get evaluated, an MRI scan may be required to evaluate the pelvic region. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause for swelling in the scrotum after hydrocelectomy?\n\nHello doc, My boyfriend has a swollen scrotum, he went to the hospital and the doctors confirmed fluid in the scrotum and they performed a surgery and the fluid was removed on the 22/102018. Until last week, there seemed to be improvement but Sunday he complained that the swelling had started again. One side What could be the problem! Please help.",
    "doctor_response": "Hi, If the fluid drain is the procedure done, it is not a permanent cure for hydrocele. Eversion of the sac is the procedure can be a permeant cure. If the operation of eversion of the sac was already done, it can be due to infection. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden urge to sneeze and dizziness after sneezing?\n\nSo I suddenly had the urge to sneeze consecutively out of no where and it just wouldn t stop so I head to the bathroom to grab some tissues hoping I could get enough stuff out of my nose to cure the sneezing I did this about 3 times and the third time i don t what happened I guess I put too much pressure on my nose and when I sneezed I felt very lightheaded and the room was literally spinning, I m just curious to know why this is. Did I unintentionally inflate air into my head? Please deflate my balloon of curiosity",
    "doctor_response": "HIWell come to HCMAllergic rhinitis is very likely, and this can be treated with Tab Levocetrizine 10 mg three times in day, while sneezing just take care be gentle, avoid blowing the nose too forcefully else this could cause dizziness, drink more water and have a steam inhalation, everything would fine soon, hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any problem in masturbating without ejaculating?\n\nI am in my seventies and love to masturbate. If I ejaculate I do not feel like it again for about 3 days so mostly I masturbate for about 15 or 20 minutes and stop before ejaculating. In this way I can enjoy it much more often. Is there any harm in doing this? I probably ejaculate every 3 or 4 days but can masturbate during this time for several hours.",
    "doctor_response": "Hello, You are practicing ejaculation at every three or four days. So no need to worry. If you are not doing ejaculation for more than 3-4 weeks than aseptic prostate inflammation or vesiculitis can occur in a few patients, not in all. So you need not worry at all as you are regularly doing the masturbation and ejaculating your semen. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluttering sensation in the chest despite treating a blocked artery?\n\nMy right decending artery is 100% occluded and has veins that have formed to compensate, so no surgery was needed. (from March 2017) For the past few days i have had a flutter in my chest. I notice it maybe once or twice an hour or so. i see my cardiologist oct 25th for a recheck. I m just wondering if i should be concerned or not. There is no pain or discomfort. I just feel this sensation. Thank you",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. (no active chest pain and discomfort is good but palpitations are bad). Are you using your medications regularly? It's better to get one E.C.G and check your B.P because if your heart is in arrhythmia. You must be treated accordingly. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes popsicles in mouth in children with cerebral palsy?\n\nmy grandson is 6 yrs old and has cerebral palsy. He is having excessive amounts of foamy saliva. He has a G-tube, a partial fundoplication, and is having Albuterol treatments and wears a vibration vest. He currently is fed a liquid Nutren and supplemented with baby food and yogurt by G-tube. He also has popsicles by mouth and some pudding. What can be causing this?",
    "doctor_response": "Hi, Foamy saliva suggests that there is a lot of air in the secretions.  Since he has a G-tube then, there is the possibility that there could be an incompletely sealed connection where the G-tube is inserted through the skin and this could be letting air into the stomach which eventually can find its way in the esophagus and come through the mouth where it aerates the salivary secretions causing the foaminess you mention. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bloodwork shows increased AST and ALT levels. Taking Tricor and Lovaza. Abdominal sonogram shows fatty liver. Serious issue?\n\nI have received bloodwork back from my doctor showing AST 56 and ALT 94. I am 39 years old on tricor 145 and 4grams of Lovaza. I also take mutlivitamin, 2 cinnamon pills daily, 2000 IUs D3, and Urocit twice daily. I do not smoke or drink. I have shown on abdominal sonogram to have fatty liver . I am 5 10 and weight around 200 lbs. Recent labs show total cholesterol of 195, LDL 120, HDL 41, and Trigs 169. I am very worried- is this a serious issue? What can I do to reverse this?",
    "doctor_response": "Hello, In the absence of alcohol,the other common causes for increase in SGOT and SGPT are  diabetes,high triglycerides levels,obesity,anti cholesterol medications etc. TRICOR 145 and LOVAZA are both meant o treat high triglycerides levels plus the TRICOR in itself can cause high SGOT and SGPT. what to do... Reduce your calories and weight. Avoid junk foods and colas Do regular aerobic exercises for 40 minutes a day. Try o bring your weight in normal range of BMI. Take a super B complex vitamin along with 1000 mg of VIT C daily. Your fatty liver shall reverse in next 4 to 6 months. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will phsiotherapy help lowering my back pain?\n\nHi, i have lower back pain from last month and got worsen after lifting heavy weight, with pulsating pain in lower half of body. I did xray and it shows last vertebrae disc with less gap. Doctors reffered phsiotherapy and suggested MRI scan for any bulging soft tissue. Would request you to provide your suggestions.",
    "doctor_response": "Hello, I had gone through the case and found that you must go for MRI and then go for physiotherapy.It will report exact cause and help in physiotherapy.Meanwhile do not bend forward and avoid to lift heavy weight.Do leg stretching exercise.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rash on neck and legs of a child?\n\nMy 5 y.o. Daughter developed a sudden rash while in the shower. She was using a mild cleanser that she uses all the time & the water wasn t too hot. The rash wasn t itchy, she said it didn t really hurt, and is fading now. It looked somewhat like a splotchy sunburn all over the front of her trunk, neck, & legs.",
    "doctor_response": "Hi, As per your query, your child has symptoms of rash on neck and legs which is mainly due to contact dermatitis. Need not to worry. I would suggest you keep this area clean and dry and apply a cream containing azelaic acid. Apply warm compresses with a soaked towel and apply vitamin C serum at night. If the condition doesn't get better then consult a dermatologist for proper examination. The doctor will examine physically and may prescribe immunosuppressants. Avoid itching and pricking rashes. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Harry Maheshwari, Dentist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it dangerous to have fever and yellow vomit while suffering from cough for which inhaler has been prescribed?\n\nMy 5 year old has had a cough for the last couple weeks so my pediatrician put her on an inhaler because its always hard for her to get over coughs. Tonight she woke up with a fever and chills/shaking and has been throwing up bright yellow. Should I take her in or is this something a dr is just going to send me home for saying there is nothing they can do and wait it out?",
    "doctor_response": "HI, thanks for using healthcare magicShe likely has an acute onset of another viral illness.You should give her paracetamol to help reduce the fever.Other aspects of fever management are tepid sponging and making sure that she is dressed coolly.In terms of the vomiting, the main aspect of treatment is preventing dehydration. Oral rehydration fluids (pedialyte) are the best choice, she would not need to start these fluids tonight but if the vomiting continues in the am, then she would need them.She would use very small amounts frequently. If her symptoms worsen then you should take her to see her doctor.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recurrent minor nose bleeds with continuous headache, history of brain tumors, cerebral cavernous malformation and pituitary tumor. Allergy?\n\nHi, I am 43 for the past several years I get sudden minor nose bleeds along with a continual headache that will last a few weeks out of the year. It s not really at a particular time of the year could be during any given month. I will get a couple of nose bleeds (only from right nostril ) a day along with a headache lasting a few weeks. Wondering if it s allergy related. I do have a history of brain tumors Cerebral Cavernous Malformation and Pituitary tumor. I know the headaches can be an issue with the tumors, but are nose bleeds a separate issue?",
    "doctor_response": "Hello,Nasal bleeding have many causes. It is prone for epistaxis due to the rich anastomosis and presence of small blood vessels.The most commonest cause is nose picking. Epistaxis happens due to trauma to the blood vessels.Dehydration, rhinitis and hypertension are some of the other causes.Epistaxis may be related to the malformation and tumors but it confirmation through diagnostic procedures.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Long period, had unprotected sex after first depo-provera injection, back pain, cramps. Normal?\n\nHello, I am close to my third depo-provera injection . I am full aware of how effective it is and the consequences. However, I am still worried. My current period has lasted way over a week (nearer to two) and I m still bleeding . It s not specifically light or heavy, it varies. I have had unprotected sex about four/five times since my first injection on the 31st May, this year. I have what feels like period pains almost all of the time and I m starting to feel sharp pains in my back and also on and around my right boob. My stomach will often have more pains if I lean down onto it, more than usual. I am unsure as to whether this is normal for this specific contraception . Thank you for your help.",
    "doctor_response": "hii  have understood your concern.Please do not worry.I will suggest you to opt for a healthy diet and regular exercise regimeFor bleeding to stop use of Tab PAUSE NF 3 times a day will be of help.Also, use Capsule of Vitamin D 3 60,000 IU once a week for 8 weeks  and daily calcium supplement will be of help.Your stomach pains and breast pains seem to be PMS - premenstrual syndrome. For that Vitamin E, B LONG F and PRIMOSA one each at night for 3 months will be of help.I hope my answer helps you.ThanksDr Purushottam",
    "dialogue_context": ""
  },
  {
    "patient_message": "Using Trigestrel. Habit of taking the medicine early or lately. Chances of getting pregnant?\n\nHi,I started using Trigestrel birth control pills about a year ago because my fiancee and I had a lil problem of forgeting to use a condom. Ever since I started using them we completely stopped using protection, can that somehow lead to pregnancy or is it ok? And sometimes my schedule can get so hectic that I get tired and drink the pills either 20 to 30 minutes early or maybe 30minutes late. Am I in the danger zone?",
    "doctor_response": "Percentage of women getting pregnant with pills( used correctly) is only 0.1 percent which is very low and you are safe if you are using them correctly. This much variation in pill time is acceptable. no need to worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have back pain and large lump below the incision  site post back surgery?\n\nMy son had back surgery on Dec.16 & has developed a large lump just above the incision site.  There is no drainage, he has no fever, only increased back pain.  He saw his surgeon today who looked at it & prescribed Keflex, which indicates to me that he suspects some type of bacterial infection.  He has a follow-up apt. in a week, at which time the surgeon said, if no improvement, he would schedule another MRI, & has not ruled out the possibility of another surgery.  What is your take on this, & what else beside infection could be causing the lump?",
    "doctor_response": "hiyou are right the first cause may be infection and second one can be haematoma.my advise would be after consultation with the treating surgeon to do  the aspiration test to know the content of the lump and send the fluid for pus culture and sensitivity.take care and do tell me the progress of your son",
    "dialogue_context": ""
  },
  {
    "patient_message": "Skin rashes in children, Aveeno cream, Eczema ?\n\nMy grandaughter is 3 years old & I noticed a severe rash on her legs & buttocks when she came to visit yesterday.....A raised pimply like rash on both of her buttocks..and raised patches on both of her legs..She said it does not itch so we ruled out poison.he She also has a severe raised path on one her her wristes which will not go away...Her father was treating the rash on her wrist as eczema with Aveeno cream as prescribed by her pediatrition, but only sees her every other weekend.....",
    "doctor_response": "Hello sir. Your description of the rash suggests it could be id eruption or Henoch-scholein purpura (HSP). Both the conditions have got definitive treatment and it would be advisable to establish the diagnosis after consulting a dermatologist as soon as possible. The raised patch on her wrist could be dermatitic (eczematic) or fungal infection. The latter is known to precipitate id eruption. If she has associated joint pain and abdominal pain, then she could be having HSP. The third possibility that I can think of is papular urticaria but the rash in this condition is invariably itchy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cold induced urticaria?\n\nLast night I had a panic attack, this isn t my first one and I know in a few days I ll feel back to myself. But I was also diagnosed with cold induced urticaria today and started taking a CVS brand of zyrtec which left me feeling a little out of it, with senses hightened and muscles tense. I also get a pain in the back right of my head sometimes, almost every day, it doesn t last long but it scares me to think it may be a symptom of an underlying problem for my panick attacks and cold urticaria. Please let me know if I should be worried and what it could be because I don t have the money or insurance to keep visiting doctors and emergency rooms. Thank you",
    "doctor_response": "Hello!I carefully passed through your question and would explain that cold induced urticaria is a known disorder in allergic diseases. Regarding your headache, it could be related to tension type headache, which is caused by anxiety and physical stress. Cervical column chronic degenerations can lead to headaches in this region. From the other hand, Zyrtec can cause similar adverse effects (headaches, drowsiness, fatigue). In my opinion you have nothing to worry about. I would recommend performing some additional tests:- complete blood count for anemia- thyroid hormone levels- a cervical column X ray studyYou should also try to manage better your anxiety. I would advise you consulting with a specialist of this field. Hope you will find this answer helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden dizziness after an RCA angioplasty surgery?\n\nhi, i underwent a agioplasty in jan 21 wherein i had 3 blocks from that 2 blocks have being stented, now 1 is remaining. From past 1 week m facing a problem of sudden giddiness, i also have spondilities problem but no diabetics and no Bp problem. i dont know what is the cause of my sudden dizziness, is it becoz of the medicines or my spondilities etc. pls guide me on whether and within how much duration should i do my next RCA angioplasty?",
    "doctor_response": "Hello! Thank you for asking on HCM ! I understand your concern, and would like to explain that your clinical scenario is more compatible with your spondilities problem. If you haven't cardiac ischemic symptomatology, and no any abnormal changes on your vital parameters (BP, heart rate, no dyspnea, etc) or any other clinical signs at all, there is not any reasons to worry for the moment.Nevertheless, I recommend you to perform a medical check up, for a careful physical exam, resting ECG, and some blood tests (complete blood count, complete urine test, liver and renal function tests, blood electrolytes, a cervical X ray, etc). Regarding your next RCA angioplasty it depend on your coronary lesions anatomy; on ho severe is the remaining coronary stenosis, and on the intensity of clinical signs it may probably produce. A review of your coronary angiography report, and a cardiac stress test would be necessary to decide the right time to intervene.Hope to have been helpful to you! Greetings! Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in my knee and lower back?\n\nHi I have had a fall resulting in pain in my knee and lower left back. My MRI shows nothing but the pain is still unbearable and preventing sleep and giving pain if sat in a position or standing in a position for more than 20 mins. I also experience pain in my left side and have agonising headaches what could this be",
    "doctor_response": "Hi,Thanks for your query. After going through your query I came to know that you  suffering from injury left back and knee.You can get your x Ray done to rule out fracture however it does not look like so. Its treatment is rest and analgesic such as ibuprofen for pain relief. You can discuss with your treating Doctor about it. I do hope that you have found something helpful. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for liver cirrhosis\n\nI know this is a difficult question, but, how can 2 doctors have such opposing views? My hepatologist/liver doctor is saying i need a liver transplant, based on the bilirubin (13) and Meld score (22). My brother in law, vascular surgon, says remove the spleen and everything else will resolve itsself. The brother in law keeps asking for fractionated bilirubin count, hepatologist says it does not matter, its way too high. Brother in law says put a shunt into portal vien and hepatologist says it would kill me. I am 46 year old male and currently have cirrhosis from years of drinking too much alcohol. I have been clean for 90 days and will remain that way. Not proud of of current situation, but, it is what it is. My father said not a damn thing you can do about the past, live, learn, and make the most going forward.",
    "doctor_response": "Hi there,Thanks for posting in HCM.Cirrhosis is an irreversibel condition.Liver transplantation is the only definitive treatment.The suggestion given by your hepatologist is the right one.Whatever your brother in law has suggested is only supportive care to prevent complications of cirrhosis. But unfortunately some of these options like shunt itself would lead to many other complications.Yes fractionated bilirubin not needed.I hope that answers your query.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for throat pain and stomach pain in a child\n\nMy 3.5 year old scratched his throat while eating tortilla chips 2 days ago and doesn't want to eat. He complains of throat pain and stomach pain. I am worried that a piece is stuck or that the piece he swallowed caused some tearing in the throat or elsewhere. He only sips small amounts of water after we beg him and managed to get him to eat ice cream and an icy berry smoothies we made and also a bit of yogurt drink. His breath is a bit smelly probably because he hadn't eaten much and may be dehydrated. I'm very concerned. He seems to have energy and all but when the food subject comes up he gets upset. I'm concerned and would like him to eat and drink.",
    "doctor_response": "Hi dear,I understand your concern. If your baby doesn't want to eat,then don't insist,because he can vomit .I suggest1.ORS solution should be given during all day in amount 1 litre,then uric acid will release by kidneys,bad ell will disappear, appetite will improve.2.Give Charcoal 1 tablet/10kg for absorption toxins,don't give chips ,it containea lead in colour and will cause intoxication, cramps in intestine.3.Potato,porridge,soup,bread can be given,diary products and fruits should be avoidedHope it helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe throbbing pain in lower back\n\nHello, I have been experiencing severe throbbing pain on my right lower side the shoots towards my lower back. The best way to describe it is as though I ran so much and I have a side pain then at sime point bothe sides begain to throb. A couple of years ago I experienced something similar and I was admitted for a kidney infection. I took the medications as directed however the pain has always come back at some point. As of monday I woke up with a horrible stomach ache it felt as if I was punched in the stomach, it hurt to breath normal and my stomach was obviously swollen. The pain in my stomach has subsided however the pain has relocated to my side again under around my ribcage. Throughout the day the pain in my stomach comes and followed by the side pain on rhe right. Now both sides are hurting located by the ribcages and its a throbbing feeling. I have no insurance and dread the bill but I need some possible symptoms to push me in to the urgent care. I am a 28 year old female. Thank you",
    "doctor_response": "Hello, I have studied your case. Due to compression of this nerve root there is pain in your ribThere is another possibility of costochondritisI will advise you to do MRI thoracic spine, HRCT [CHEST] and EMG- NCV [nerve conduction study]For these symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.I will advise to check your vit B12 and vit D3 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes liver failure?\n\nMy daughter who is 15 is in the hospital for liver failure. Enzymes are over 1700 they have ruled out Tylenol. They are still running test to see what is causing the failure. They have no answers to what is going on. It is not drugs or alcohol those were the 1st things they ran on her. I am thinking maybe could be mono or something alone that line that kids would get. Reye Syndrome..",
    "doctor_response": "Hello welcome to the health care magic Your child having acute liver failure cause and admitted for that... The causes can be as follow which should be ruled out with history,  examination and investigation accordingly... -Drug induced (hepatotoxic drugs) -viral hepatitis (if jaundice, abdominal pain  present at the time of admission)-Metabolic disorder like Wilson disease,  alpha 1 antitrypsin deficiency etc... -cardiovascular problem like septicemia,  heart failure etc... So according to cause found treatment will be instituted until then Symptomatic management done Hence suitable investigation done according to suspected cause like serum hbsag testing by ELISA, HBA ELISA,  HCV ELISA,  serum ceruloplasmin,  EKG etc.... Take care Hope your concern solved",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am having some allergy on skin. How should i avoid ?\n\nthere is a certain period of time in day when i scrach my hand,neck or facial skin i could find after few seconds my skin getting swollen and redish in colour, as if somebody beaten with hunter and it remains till few mins and thens vanishes, showed to one doctor he said itz just an allergy as he took my blood test but the reports were clear he said u must take allegery tablets, other said to do stole test but i dint went for it. is it allergy only? shall go for stole test? how should i avoid. cauz it happens everytime, even i have avoided certain food items like ambadae ki baji, and excess eating of fish,etc.",
    "doctor_response": "Hi!, Welcome To HealthcareMagic forum, Yes ,its a kind of allergy called \"urticaria\" .And when you scratch and get red raised lesion that is called \"symptomatic dermographism\".Along with allergy it can be triggered by any infection in the body like infestation of worms in the stomach,bacterial infection in teeth or any fungal infection on body.Even food items which you are allergic to can cause such kind of lesions.Stool examination is to see if you have any worms in the stool. In such cases better is to de-worm the patient by giving him albendazole tablets.Along with this you would also require a long course of anti allergic medicines ,since it is difficult to find the exact cause of allergy.You should also rule any tooth decay and thyroid problem.It is at times associated with thyroid disease. Couple ways to find out the allergen is - PRICK TEST & secondly immunological testing where in all food items are tested . So,consult your dermatologist with this back ground .I hope this would help you to understand your disease better. regards, Dr.chawda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is ursodeoxycholic acid safe for fatty liver condition ?\n\nI have been diagnosed with fatty liver. i feel heaviness and little bit of pain on the right side of the abdomen. i have been prescribed 300m of ursodeoxycholic acid twice a day after meal. As i mentioned about heaviness it's been increasing day by day and becoming irresistible. i have been prescribed 300m of ursodeoxycholic acid twice a day after meal. but it doesnot seem to be working. the condition has worsened now than what it was before taking medicine. Well .pls suggest me a way out",
    "doctor_response": "HiIt is given as a hepatoprotector. It helps to abort apoptosis of cells.However it is not given in decompensated liver cirhosis.It helps in decreasing of liver enzyme levels. If your fatty liver is caused by alcohol then by refraining from alcohol you will have a good prognosis.Regular follow up with your doctor is necessary.Liver enzymes should be checked regularly at intervals.Hope this may help you.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed prostate cancer, increased PSA. Had testicles removed. Chemotherapy?\n\nhello Doctor My father (68 years) is diagnosed with prostate cancer . He already had a testicles removal operation in May 2011. But now again his PSA increased to 328. But physically he is not suffering from any difficulties or abnormalities. I just want to know treatment he suppose to continue. Is any medicine available for treatment or chemotherapy is the only option?? Please give your valuable suggestions. Thanks",
    "doctor_response": "Hi, Rising PSA value in a prostate cancer survivor is alarming issue. It should be verified whether there is any metastasis or not. Treatment will differ according to the site of metastasis. Chemotherapy is mandatory only after confirmation of visceral metastasis. At first you should go for a detailed metastatic work up of your father , consult an oncologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does UTI cause weak erections?\n\nHi, I went to the doctor because of a very small external hemmoroid that was treated with a cream. I told my doctor that for the past 10 days I have been getting weak erections.She asked me do i drink water,and i told her not much. After urinating in a cup she said i have a urinary tract infection. I was given the antibiotic Sulfameth for 2 weeks. I'm on the 7th day. My question is: Is the weak erections that don't last long most likely coming from the U.T.I.? . I am only 26 years old and have never had erection problems. And how long will it take to go away?",
    "doctor_response": "Hi ,   Penile erection is due to engorgement of blood in cavernous tissue present  in penis  . Infection which occurs in urinary tract hence has almost no relation with penile erection . If you have UTIrevealed by urine investigation of cuture and sensitivity then it is needed to be treated according to urin cs  report .    Regarding your penile erection problem u need to visit a urology clinic n need to find out the cause (neurological , cardiovascular, local,.....)through clinical examinations n investigation  and treated accordingly . As its recent onset so the prognosis can be good .Hope it ll help Thanks n regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the cause for neutropenia?\n\nHi doctor, My son is 15 months old. He was diagnosed with neutropenia. The neutrophils are critically low. My question is whether the illness is related to cancer? Also, what kind of treatment can be given?",
    "doctor_response": "Hi. I have reviewed your query and here is my advise. When there is a decrease in neutrophil count, the chances of infection are more. So, a close clinical observation is needed. If any unusual fever, dyspnea occurs, you should consult the doctor immediately. The low neutrophil count will not cause cancer. Infections can suppress the bone marrow and makes the count low. The CBC (complete blood count) report with peripheral smear examination report has to be checked for giving more comment. You can attach your report for giving more comment. For more information consult a hematologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for high blood pressure\n\nmy blood pressure continues to be elevated and my doctor has increased my medications several times.  the bottom number is in range but the top number will not come down.  sometimes it is lower and sometimes not.  I am 54 female 5 foot 7 and 200 pounds.  Have taken  blood pressure medicine for 20 years.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, in my opinion, you are mostly having systolic hypertension. Only antihypertensive drugs are not always sufficient to control systolic hypertension. You need to follow certain below mentioned lifestyle modifications also. 1. Strict salt restrictions in diet. 2. Avoid oily and fatty food. 3. Start using sunflower oil in food preparation. 4. Do regular aerobic exercise like running, cycling, swimming etc. 5. Avoid stress and tension, if you are having stressful life. Don't worry, your blood pressure will control with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does few punctate loci in periventricular white matter on MRI suggest?\n\nAfter a car accident 3 months ago I ve had post concussion syndrome. MRI showed a few punctate foci of T2 prolongation involving the periventricular white matter and left centrum semiovale which are non specific and most likely represent gliosis. What does this mean.",
    "doctor_response": "A gliosis is a remnant of a previous injury, sort of like a scar in your brain. So it could be after the accident you mentioned. There is not much you can do and shouldn't worry too much about it as it shouldn't cause any serious problems.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause of the raised TLC count?\n\nhi, i am 36 years old, couple of day ago I i test my blood CBC. It shows TLC count 17000 (Normal range is i think 4000 to 11000).I am concious to see that. apparently I have no kind of infection or have t gone through any surgery in my life. what could be the cause of this raise.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Your total count is high.  You may have some infection or some other cause.  Please send me report of differential wbc count.  So that I can help you further.  In most of the cases it is due to infection.  So don't worry much about that. Just be relaxed.  Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause vomiting with nosebleed when suffering from a host of conditions?\n\ni have lupus scelerderma crones disease fibromyalga severe raynauds copd compressed disk osteoprosis a bone spur in the back of my neck and no feeling in my hands due to nerve damage i also have thes violent vomitting sessions that are phegmy spitty and very acidic and they last 48 hrs or more constant puking during the whole 48 hours or more    now this time my right nostril poured bright red blood during every time i vomited do u have any ideas what could cause this     please  and thank you",
    "doctor_response": "Dear Sir,There may be a possibility that scleroderma might lead to this as symptoms of dysphagia and vomiting . plus a possibility of pancreatitis also needs to be ruled out .Dr. Shruti",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for brain seizures\n\nMy son aged about 5 yrs. has brain seizure for the last year. We have done all the test as said by the Neuro physician. Eveything was normal except mild problem in EEG. He prescribed some syrups, we have been using.To take a second openion we had consulted a Paediatric neuro physician again we have gone through all the test including Lumber puncture. Everything is normal, problem has detected in EEG. Eptoin syrup was using earlier, now the doctor has said to stop it immediately. Is there any problem stopping it? Now we are using Levipill,Encorate syrups and Sizodon 0.5mg, Meloset 3mg and revitrol tablets. could u plz advice us.",
    "doctor_response": "Hi, unprovoked seizures are very common entity in children. Many times no cause is founf for the seizures. In your case, the EEG shows some abnormal activity suggestive of some neurological abnormality. Syrup Eptoin(phenytoin) is a good drug for control of seizures but is found to have a role in Generalized seizures. Also it has a number of long term serious side effects like Megaloblastic anemia. Going by what your child is currently taking, appears that your child has partial or myoclonic epilepsy or a syndromic disease. Syurp encorate(valproate), Levipil( Leveretacetam), Sizodon(Risperidone) are all good drugs with less side effects and good coverage for seizures. I suggest you continue with these drugs as these antiepileptics are stopped once the child is seizure free atleast 6 months-2 years.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in chest,jaw,back and neck with skipped heart beats?\n\nI m a 25 year old female. 5 8 and 250 lbs. I have been having chest pains on and off for about two years. It comes and goes, but everytimes it starts back, something else hurts too. Now its my chest, jaws, back, neck. I went to a cardiologist about a year ago; had a normal ultrasound. Every now and then my heart feels like it skipps a beat. No one has been able to tell me what is wrong. (This all started before I gained ~60 lbs). It is a dull, achy pain in the center, and left side of my chest. Dull pain in left shoulder blade. Tingling pain in jaws. Should I still suspect my heart? What else could it be?",
    "doctor_response": "Hello!Welcome on HCM!Regarding your concern, I would explain that your symptoms do not seem to be cardiac related. Anxiety or a musculo-skeletal pain could be the cause of all this clinical scenario. Gastro-esophageal reflux can not be excluded either. Coming to this point, I would recommend performing some additional tests: - a cardiac stress test for coronary artery disease- inflammation tests (PCR, ESR)- a chest X ray studyI would also recommend trying an antiacid. If this helps relieve your symptoms, it would indicate gastro-esophageal reflux as a possible cause of your troubles. If all the above tests result normal, you should consider anxiety as the main cause of your symptoms. You should discuss with your doctor on the above issues. Hope to have been helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is almox 500 effective for oral infections?\n\nHi Doctor,I met with an accident. My tooth broke. Dentist told that my nerve is exposed to oral infections and puss might accumulate. I would be getting my treatment done in 2 weeks. Is almox 500 good medicine to avoid infections and dry puss during this time?",
    "doctor_response": "Hi,Welcome to HCM.Almox is brand name for amoxycillin which is a beta lactum antibiotic and is effective against gram positive bacteria which most commonly cause oral and dental infections. Dosage of 500mg twice daily for 5-7 days is adequate to control infections in the mouth.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which of vaccines are safe and dont interfere with the conception ?\n\nI am 26/f. I take medication for hypothyroidsm. I take 137 mcg of levothroid daily. I am actively trying to conceive and become pregnant . I have to take following tests and immunizations for immigration purposes and I want to know which of these are safe and dont interfere with the conception. I was told some of these vaccinations if taken, then I should not conceive for couple of months. So I want to avoid those. The following are the tests/vaccinations I should take: 1. TB skin test 2. Serologic test 3. Mumps 4. Measles 5. Rubella 6. Polio 7. Tetanus and Diphtheria 8. Pertussis 9. Hepatitis B Thanks",
    "doctor_response": "Hello Thanks for your query. None of the test mentioned carries any risk. Vaccination is also reasonably safe. Nonr is going to interfere with conception. \u2018Hope I have answered your query, I will be available to answer your follow up queries, \u201cWish you Good Health and trouble free speedy recovery\u201d",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for depression and mood swings\n\nHello! I have a problem and I don't know what to do about it, my life is very screwed up. Ii don't know how to be happy, I'll hurt people and I'll wake up angry for no reason, my mood will change and I will feel attacked by everything, I can't be comfortable when people say my name and I don't know what it's about, anything that happens hurts my head, it won't stop thinking and it gets painful, i get hateful with my self for it, I don't know what to do anymore... I have a therapist appointment but it's getting worse. I checked my boyfriends phone because Ii was paranoid that I was being talked about, I don't understand what is wrong, I just want to be happy and not hurt people, I want to stop running away and getting angry for no reason, please answer me, I want answers.",
    "doctor_response": "Hi.I  understand  your  concern .Sad  mood  /mood  swings  /irritability  / lack  of  sleep  are features  of depression .paranoid  features  suggest  psychosis  or psychotic  depression.It can be treated  with  medicine s/ psychotherapy  /  behaviour  therapy  /  ECT   etc.Choice  of  therapy  is depend  upon  symptoms  and its severity.Medicines  like  SSRI  can  be  useful. In  SSRI  sertraline  /  escitalopram  /  peroxetine  can  help.It is useful  for  moderate  to  severe  depression .Psychotherapy  and  psychological  councelling  can  help  in mild depression.ECT  means  electro  convulsive  therapy  is  the  choice  in  psychotic  depression .Go for proper  psychological  evaluation  and get well soon .Consult  psychiatrist  and  get  help .I  hope  I  have  answered  your  question .Thank  you .",
    "dialogue_context": ""
  },
  {
    "patient_message": "White mucus in stools, hard and soft stools, yellow greenish foul smelling mucus. Cancer?\n\nI have been noticing white fluffy mucous in my stool for the past few months now. The stools are also very often hard to pass, or very soft; rarely average or normal. There are also times when I feel as though I need to go, but all that comes out is a jelly-like, yellowish-green, foul-smelling substance. is this a sign of cancer",
    "doctor_response": "Hi, this is called as altered bowel habits common in cancer of colorectal area and mucoid stools can be due to infections or rectal cancer.please see your physician, undergo per rectal examination, proctoscopy, stool examination and if required colonoscopy. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain when diagnosed with Kawasaki disease\n\nyes please,, my grandson has a heart condition. he had Kawasaki disease when he was 2 and had 17 aneurisms. he takes aspirin everyday. but for two days his heart rate has been 105-110 per minute.. blood pressure is fine, but he has been having severe chest pains and feeling bad. is this normal to have a heart rate of 110? I cannot affor to pay but thanks anyway",
    "doctor_response": "Thanks for your query. Kawasaki disease usually iinvolves heart vessels. Pulse rate of 110 is certainly abnormal especially when associated with chest pain. Meet the  cardiologist or immu nlogist of your area.Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "hi my sperm takes more than 4 hours to liquify in the lab in 37 degrees oven, what can i use to improve the time?? some doctors recommended Bisolvon for 3 months + vitamin C, and others recommended Triam amp. please advice! regards.",
    "doctor_response": "i'm astonished of this site!!! do you even have any doctors? 13 days and 79 views with no replies!!! shame on you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe cramps in the thigh muscle?\n\nLast night, as I arose from my couch after watching television, I had SEVER cramps with the inner muscle (from the knee to the groin) of both thighs. No matter what position I took, the pain remained, or worsened, til I nearly fainted. After 5 minutes, it all went away and hasn t returned. What happened??",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Your symptoms seem to be related to muscle cramps.Some suggestions that I can give to you are:-Stretch the cramped muscle and gently rub it to help it relax. -Apply heat or cold. Use a warm towel or heating pad on tense or tight muscles.-take vitamin b and magnesium supplements Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from severe upper abdominal pain\n\nI suffer from severe upper abdominal attacks. They come on suddenly without warning. I get extreme pain in the lower back as well. After a couple of hours the pain moves into what I feel in my bladder area. These attacks come in clusters it seems, maybe a few over a couple of weeks, then nothing for a couple of months. I have taken Oxycodone to help relieve the pain, but they don t help very much. I end up vomiting and itchy after the initial upper pain. I am also loosing my hair and am easily fatigued. The pain will subside after several hours, but my abdomen will remain tender for one to three days afterwards. The pain does not come in waves it is constant and equivalent to child birth. I have had four natural births without complication. I am a 42 year old woman. This started in 2008 and was bearable then, but over the years has progressed into what it is today. G.I. has said it is irritable bowel, which i occasionally do suffer from, and is always relieved with a bowel movement. this pain stops on it s own and never is associated with a bowel movement. Almost always the attacks happen after 10 at night or before 10 in the morning, never through out the day.",
    "doctor_response": "Hi.To recapitulate :Sudden onset- at night only- upper abdomen -lower back->bladder area- no relief with medicines- Subsides after several hours but tenderness for 2-3 days- constant and equivalent of childbirth-  almost 5 years now- not associated with bowel movements.I hope by this time you must have undergone all possible investigations as you have already consulted the Gastro. I hope to get some results about diagnosis with :Color doppler studies and / or angiography of the abdominal blood vessels preferably during an attack of pain .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the reasons to get headache while talking?\n\nHi doctor, I feel headache much often during interaction with anyone. Is this some illness and what is the reason?",
    "doctor_response": "Hello. Since you have not mentioned in detail about the headache, it is difficult to diagnose with limited case history. However, I will try to discuss the various causes and the treatment. Temperomandibular joint disorder : Common symptoms include pain in face, jaw joint area, neck and shoulders, in or around the ear when you chew, speak or open your mouth wide. Clicking, popping or grating sounds in the jaw joint when you open or close your mouth or chew. This may or may not be painful. Tension headache: Tension headache occurs because of stress. The headache is usually present in the forehead and temples due to any stressful trigger that vary from person-to-person. Migraine: Migraine pain is moderate to severe, often described as pounding, throbbing pain. Migraine headaches can last from four hours to three days and usually occur one to four times per month. Migraines are associated with symptoms such as sensitivity to light, noise or odor, nausea or vomiting, loss of appetite and stomach upset or abdominal pain. I would advise you to try the treatment that I have mentioned. However, if the symptoms persist please consult a doctor nearby for further physical evaluation and treat accordingly. For further information consult a general practitioner online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for kidney cyst\n\n64 y/o male patient with complaints of difficulty in passing urine. Urinalysis shows normal, kub ultrasound shows simple renal cyst, right. Small non obstructing renal stones, left. Grade 2 prostatomegaly. Cystitis. Patient is smoker, coffee drinker. Past history, mild stoke 4 years ago. Treatment and management please. Thank you",
    "doctor_response": "Welcome to the forum.I would attribute the difficulty is passing urine to enlarged prosate with or without Urinary tract infection.You need physical exmination, uroflowmetry and urine analysis.Treatment of the infection if present and treatment of the enlarged proate is necessary.The small simple renal cyst and renal stones do not need any treatment as of now.Hope this helps,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes smaller size of penis when erected?\n\nhi i am 23 my wight 78 my panis is only 2in when was strong and street then 4 in' size iam not marret so iam nourbaj now what can i do? please answer me my name is rajib plise give my name with answer sorry doctor what is the mining query  idon't know so please you give me easy ans.",
    "doctor_response": "Use Shri Gopal tail  and himcolin gel  ,2 Neo tablet1-1",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anger and frustration?\n\nI feel very dizzy at times and sometimes think i am going to pass out. I have been getting very angry and frustrated really easy and have been getting bad tummy pains i am on my period but i dont usually feel this sick. i just literally want to roll into a ball and sleep/cry.",
    "doctor_response": "Hi,The symptoms that you have mentioned are suggestive of depressive episode. However, one would need more information like duration of symptoms, and regarding other symptoms like sleep, appetite, self confidence, etc.You should consult a psychiatrist for proper evaluation. Treatment with ant-depressants like escitalopram might help you. Regular exercise and relaxation strategies will further help in your symptoms.Hope you get well soon. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Typhiod widal test: S TYPHI H-1.20,O-1.61,AH-1.160 & BH-1.20\n\nHello Doctor,Actually my Typhoid widal test result is as follows:S.TYPHI \"H\": 1:20 diluS.TYPHI \"O\": 1:160diluS.P.TYPHI \"AH\":1:160 diluS.P.TYPHI \"BH\" : 1:20 diluPlease kindly let me know whether i have a serious health problem..Do I really have Typhoid..?Thanks",
    "doctor_response": "Thanks for your query at HCM!Your \"O\" titre is = 1:100 and \"AH\"= 1:160 which suggest that you probably are suffering from Typhoid fever/Paratyphoid A fever. I would like to know had you received TAB vaccine in recent past?You have not mentioned your symptoms?Based on symptoms you can start antibiotics like Ciprofloxacin/Azithromycin for 10-14 days after getting prescribed by a local physician.I suggest to confirm your diagnosis you must repeat the test after 15 days to see rise in \"titres\" which will confirm your diagnosis.There is nothing serious it is completely curable. You can get other tests done like haemogram, blood culture, TyphiDot test to be completely sure.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need bladder replacement to prevent cancer. Is it safe?\n\nMy urologist told me that i need to have total bladder replacement surgery within 45 days to prevent cancer to spread in my body .What is this surgery .I need information's .How safe it is ,what complications can occur .How successful this surgery is.How long time will take for me to recover.,to be normal again .Please help",
    "doctor_response": "If you have been advised bladder replacement surgery then i am assuming that your cancer is invading the muscle layer (in the biopsy report) and it has not spread to any part of your body (bones/lungs/liver). Also, the neck of the bladder should be free from disease else this surgery is not recommended. If that is the case then you need to get the surgery done at the earliest and not wait for 45 days as the tumor may spread even before that. It is a major surgery and carries a 5-10% risk of death depending on your health and the expertise of the surgeon. Besides this, complications include bleeding, infections, urinary incontinence, impotence, pneumonia. in expert hands and in properly selected patients it gives a 75-80% chance of cure to the patient. You will need a month on an average to recover",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden high bp and pulse rate?\n\nI have glomerulonephritis, fibromyalgia and possibly chronic fatigue syndrome, i had my bp and hr done today and they were high. Bp was approx 143/94 pulse was 129 bpm, usually these re fine but since last months chek have shot up, shouldi be worried?",
    "doctor_response": "Hi thereYes your heart rate us high but your Bp is at upper borderline range. before starting on any meds for bp I suggest you to adopt few lifestyle changes like low salt diet, limit your fluid intake to 1.5 ltrs per day, start vigrous morning walks for 45 mins a day 5 days a week and get a bilateral renal artery doppler study done to rule out any renal artery stenosis that can give you frequent episode of high BP.Good Luck \u263a",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My baby suffers from cough the whole night. Should I give Levolin syrup?\n\nHello doctor,My 26 months old baby suffers from cough the whole night. She has a cold as well but no fever or spasm of the chest. Should I go for Levolin syrup?",
    "doctor_response": "Hello. It is better not to give it. It contains only Levosalbutamol which acts as a bronchodilator which is useful in bronchial asthma or bronchitis, etc. There is no mucolytic or antihistamine in it. It also causes palpitations and tremors. I suggest using Flucold syrup. It contains Paracetamol, Phenylephrine, Chlorpheniramine, and Sodium citrate. It acts as a decongestant and antihistamine. Depending upon the weight of your baby, you can use the above syrup. Consult your specialist doctor, discuss with him or her and start giving the medicines with their consent. Use water vapor inhalation and salt water gargling. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could inactive lupus with swollen glans sores & fever suggest?\n\nMy WBC is 3.4, my MO% is 8.8, my BA% is 1.2, my New # (AND) (x 10^3/uL) is 1.84, my Glucose is 104, my Total protein (g/dL) is 8.9, my Globulin (g/dL) is 4.2. My lupus is inactive but I feel like my body is going into a flare, swollen glands, sores in mouth, fever and aching all over. What do you think?",
    "doctor_response": "hiit is active lupus, your WBC is low and globulin is high. you need to see your physician for full workup",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had gall bladder surgery last year, feels like hard ball in stomach, chest pain. Is it possible during surgery esophageal have been nicked?\n\ni had gallbladder surgery last May and since it feel like i have the feeling like i have a hard ball in my esophageal/ stomach. I have been sick, acid reflux , irregular heart-rate and bradycardia , chest pains that felt like a heart attack. My doctor thinks i have a hietial hernia . My question is, during surgery , is it possible that the esophageal have been nicked with the incision made for the cameras? Since this surgery i have had one problem after another and now i feel like i m getting the run-around.",
    "doctor_response": "Hi and welcome to Healthcare magic.Thank you for the query.Esophgaus is extremly rarely damaged since the operative field is far away from esophagus. It can be postcholecystctomy syndrome or more likely stomach issue such as gastritis, gerd,hiatal hernia.it should be evaluated by gastroscopyand then treatment can be startedWish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Twitching in eye, insufficient sleep. anxiety, stressed. Any remedy?\n\nhi. i have a lower left twitching in the eye for the past month or more.its really worrying me also i have not been sleeping alot lately as i seem to wake up in a shock with my heart pumping fast.i have had an anxiety attack not long ago and dont know if it is stress as i think alot and have a job with high expectations.i have taking a rescue remedy but i cant carry on like this.doctor can you please give me a potential problem? thanks",
    "doctor_response": "Hello Welcome to Health Care Magic Twitching of eye may be part of anxiety. You had symptoms of anxiety and recently developed restlessness with pumping heart. It was also episode of anxiety attack. There is possibility of either Generalized anxiety disorder or Panic disorder. Please visit a good psychiatrist for proper evaluation. Treatment options are - Medicines as SSRI, SNRI, Benzodiazepines etc. Psychological treatment as Behavior therapy, relaxation exercises etc. Thanks and take care Dr. Seikhoo Bishnoi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes occasional abdominal flutters?\n\nFor the last 2 days, I have had an occasional fluttering in in my lower abdomen while sitting with my laptop on my lap. The closest thing this reminds me of is the feelings I had when pregnant more than 50 years ago.  I do not feel this when standing or walking. There is no pain.",
    "doctor_response": "Hello dearWarm welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This seems in relation with non specific intestinal spasms or movements     in  relation with particular position , it is clinically non significant .*  However if more bothersome , can get evaluation with ultrasound to rule    out  any other abnormality inside .Hope this clears your query .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Low BP, irregular heavy periods, have hepatitis C with frequent UTI's throughout the year. Taking Cipro, Flagyl. Suggestion?\n\nHi I inquired about what looked like a nite on my arm , but I have also had low blood pressure and irregular heavy periods. I am only 30. I have been sober for 3 years . However, I do have hepatitis C , but it is gardly detectable every year when I get it checked. I am now taking Cipro and Flagyl for my 4th or 5th UTI already this year. So I made an appt with an OBHYN Monday, What are your thoughts? O won t hold them against you HA!",
    "doctor_response": "Hello. Welcome to hcm Firstly i am more worried about hepatitis C. It is a condition which can have impact lifelong. You need to take treatment and later regular follow ups to see if you have chronic hepatitis C. As you are getting recurrent UTI, it is better to get culture of urine done before starting antibiotics. Also, immune system should be checked. Blood pressure and irregular bleeding can be managed in out patient and not worrisome All the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to relieve back pain\n\nhi, im 28 y ,male ,176 cm,79 kg,i experienced low back pain 2 years ago due to long and chronic wrong postures during education and job x-ray reaveled no abnormality detected and took conservative ttt with excellent results but from now and then the pain return , i notice on standing ;exagerated lumbar lordosis ,also i accustomed to waer elevated shoes and i cant stop using them cuz lordosis shorten me and i want to catch my actual height without lordosis so i wear them plz help",
    "doctor_response": "Hi Welcome to healhcaremagic After going through your query I concluded that you are having chronic backache. It may be related to muscular weakness and vitamin deficiencies. Its treatment is back exercises and vitamin supplements such as Evion LC Mecobalamine. Vitamin D3 test should be done as it is important cause of backache. If it is low then it should be supplemented. You can discuss with your treating Doctor about it. Hope your query get answered. If you have any further questions then don't hesitate to writing to us . I will be happy to help you.You can also write to me directly on below link: you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe back and abdominal pain, fever, hot flashes. Thickened uterus. Biopsy suggested. Worried\n\nHi im only 27 and Im experiencing Severe lower back and abdominl pain on left side, fever , body hot flashes it sometimes hurts during sexual intercourse and my periods are fading away for about 7 months now and i just went to the doctor and they told me my blood was normal and my uterus was abnormal it was really thick? But they want to send me in for biopsy what does that mean? could I have cancer",
    "doctor_response": "Hello and welcome to HCM,An endometrial biopsy o curetting is a procedure in which a instrument is inserted into the uterine cavity.A bit of endometrial lining is taken with the help of the instrument and is send for histopathological examination.This endometrial lining is examined under the microscope.Any abnormality in the endometrial lining is determined by this examination.The symptoms of lower abdominal pain and fever are suggestive of pelvic inflammatory disease (PID) or infection of the genital tract.Pain during sexual intercourse also suggests PID.Menstrual irregularities can be seen in cases of PID, hormonal imbalance, etc.The biopsy will help in picking up the abnormality in the endometrial lining.Consult your gynecologist for this investigation.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are he side effects of pantocid HP?\n\nI am 54yrs male. I was getting acidity for 2-3 months. taken the medicines according to Doctors advise,as there was no relief Dr.has done gastroscopy,diagnosed as mild antral gastritis. then started tablet pantocid HP 3in the morning 3 in the evening for 14 days. iwanted to know is it advisable to take for 14 days. is this tablet is having any side effects.as iam not comfortable when I started this medicine taste of the mouth is changed. please advise.",
    "doctor_response": "Hi,Pantocid-HP is a combination of a proton pump inhibitor (lansoprazole) and two antibiotics (clarithromycin and amoxicillin) which is commonly prescribed to treat H. pylori infection. Its common side effects include nausea, vomiting, diarrhea, metallic taste, flatulence and allergic reactions. It is quite effective if taken for 14 days. Continue taking it as prescribed.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with NAFLD, prescribed Heptral, udliv post LFT, non-smoker or non-alcoholic, have healthy diet. Advice?\n\nI am diagonised with NAFLD and my LFT test results are as below: SGOT 76 SGPT 56 Bilirubin Total 0.88 Alkaline Phospate 60.7 Bilirubin Direct 0.35 Protein Total 7.195 Albumin 3.989 Globulin 3.206 A/G Ratio 1.2 As such I do not hve any symptoms of non functioning of level and all my systems are working perfectly. I consulted a Doctor who has prescribed the following medicines HEPTRAL 400 1 -1-1 UDLIV 600MG 1-0- 1 BYMULTIGOLD 1-0-0 GATE 400 1-0-1 SILIBON 140 1-0-1 I do not take drinks and I am a nonsmoker and do not take even cofee/tea. My brekfast for the last 20 years is Papaya fruit/Cornflakes or Oats with 2 dates and 1 spoon of honey. Mu lunch is Rice, Dhall and Yogort and dinner also indian food. I shall be thankful for your advice. Regards Vasu",
    "doctor_response": "Hello Mr Vasu ,I have understood your concern as to why you should be having NAFLD inspite of being a teetotaler.I would say that your body habitus and also genetic predisposition play an important role in getting  NAFLD.Kindly get your BMI tested and probably you need to keep a watch on that ..also get a lipid profile done and consult your physician ..Daily brisk walking for 30 min , 5 days a week would help ...You can continue the medications as advised by your physician..Hope I was of help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had spinal surgery. Can i join my work?\n\nyes I had surgery on my spine 1-9-09 when I return back to work in either april that year or june the doctor wrote paper work recommending light duty, I was denied light duty told we don't have light duty was told I was assigned to give road test for dmv as if that was all I can do, I got the union involved the union after talking with director and assistant n maybe human resources was finally told they didn't have to offer me light duty because health issue was not caused on the job, was I being discriminated against. thanks for your assistance.",
    "doctor_response": "Hello and welcome to HCM,In order to get the work which is most suitable for your health status, you need to get a medical certificate from the doctor/ doctors who treated you.If the requirement of light work is for short duration, you can take leave on medical grounds.You can get more details about this issue from the rules and regulations of the company/ organisation where you are working.A doctor can only help you to furnishing you with a medical certificate.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "On medication for fungal infection on the penis. How to stop the recurrence?\n\nI am 28, and for last 3 years having some fungal infection of my penis and near area. Intially the outer layer of my skin started itching and then some white rashes appeared, and thereafter bad smell is coming out. My doctor gave me antifungal cream, within a week it was cured. I stopped the medication , the itching started and white rashes came back the skin on the penis and near area . Again I visited my doctor , who advised me to continue the anti-fungal cream for some weeks, which i continue. When I stopped, two - three days later then the rashes came back. I consulted my doctor again, and he referred me to Skin specialist. The skin specialist , after checking gave me another cream (gentalene) and tablet (Fusys 150 ), and told me to continue for 3 weeks .............but when I stop medicine then rashes are coming back and some bad smell at that area....pls help me",
    "doctor_response": "Hi there, I can understand your concerns,first of all I would have asked you if you are circumscribed or not and also is the foreskin or the glans of penis involved or not, It seems like you are having Irritant balanitis. And people with the same problem do have recurrent problems like these. If such is the case then you are a candidate for a circumcision.after the procedure the skin of the glans become thicker and the sebum secreted by the foreskin is no longer there and the problem can be solved gradually. I hope that help you. Thanks and all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low hemocrit and hemoglobin?\n\nI have a low hemocrit and hemoglobin. I have been anemic since the twenties or before. I am 87 and was found consistently anemic. there has been a recent drop in the hemocrit and hemoglobin. I have felt in good health with some esophogeal problems, but no loss of weight or appetite. I work   10:00 am to 5:00 pm and do not feel debilitated. any suggestion as to whether  this is serious?",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern.  Most common cause of drop in hematocrit and hemoglobin is gastrointestinal bleeding.  You should search for that.  Ultrasound abdomen is also helpful to search some internal cause.  Consult your doctor and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause of excessive sweating of palms and subsequent peeling of skin ?\n\nwhat could be the cause of EXESSIVE sweating of palms and soles in teenager boy. Subsequently skin is peeling. what could be the cause of EXESSIVE sweating of palms and soles in teenager boy. Subsequently skin is peeling.",
    "doctor_response": "hi u have hyperhydrosis. it mainly due to over activity of ur sweat glands. it may be related to genetics. Nervousness or excitement can exacerbate the situation for many sufferers. Other factors can play a role; certain foods and drinks, nicotine, caffeine, and smells can trigger a response. most of the time it is normal. u need to apply powder to reduce it. consult dermatologist for treatment",
    "dialogue_context": ""
  },
  {
    "patient_message": "sufferring from internal piles and anal fissure, please suggest\n\nHi ,My name is Apurba Ganguli age about 50years have been sufferring from internal piles and anal fissure since May2010. Please let know what medicine should I take.my Mobile No 9830181138",
    "doctor_response": "Hello There are various grades of piles.It depends on how severe the problems is. Depending on that the treatment can be either medical or surgical.To treat your symptoms you can start with stool softners(if you have hard stools),lignocaine jelly for local application at rectum before passing stools.If there is active bleeding surgical option is better.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause my breast feeling a pulling sensation and tingling?\n\nI had two breast lumps taken out years ago....both benign....went on tomoxifen to prevent breast cancer for 5 years.  I am now 5 years in menopause (surgically)....am 49 years old.  Where the old incisions are, I'm suddenly feeling a pulling sensation and tingling.  I'm due for my mammogram on Oct. 1st.  Last year I was called back for a repeat due to architectural distortion.  The second mammogram was cleared.  My surgeon cleared me.  I'm worried about these sensations since my sister got breast cancer at 40 and died at 45.",
    "doctor_response": "Hi,Thanks for writing in.It is important to get breast ultrasound done to assess the area under the skin where the lumps were earlier present. This can help to know of any recurrent lumps or an infection in the area. Post operative healing and scar formation also causes tingling and pulling sensation. Ultrasound uses sound waves to get a picture of the structures under the skin. It is radiation free and an easy method of breast evaluation recommended for all ages.Please consult the surgeon who operated and removed the lumps in your breast a year back. Get yourself examined clinically and clear doubts of any suspicious cancer by getting ultrasound scan for both the breasts and axillary regions and most likely it will be normal. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hyper pigmentation in the legs. Reddish brown hair follicles, eczema patches on the calves. Will permanent hair removal help?\n\nI just turned 41 and the last few years I have noticed hyperpigmentation on my legs were the hair follicles.are. I don't have the keratosis pilaris bumps, but every follicle is red and brown. its mainly on the front of my thighs and lower legs.I have also developed eczema patches on my calfs which came out of nowear and I never have rashes.I recieved steroid cream.for the eczema patches, however the hair follicles are another issue I did a tca peel years ago on the front of my thighs just to help rejuvenate the skin, but now I feel like that might have caused the problem now. I have tried glycolic creams, scrubs, microderm but it doesn't get rid of the redness and brown  it is like tiny red and brown spots all over my legs. Do you think permanent hair removal will help, as the follicules seem to get redder after shaving, also what.about a photo facial on the legs to get rid of the brown spots? I don't have tonsof money to spend, so any prescription creams you recommend? I'm European descent, northern Italian and Croatian. Thanks",
    "doctor_response": "Hi, With this much history, it seems that you are having one type of capillaritis. Schambergs disease. , also known as progressive pigmented purpuric dermatosis .. However, you should be investigated to rule out any internal disease. Actually there is no perfect and sure cure of this disease..But, Oral vitamin C, vitamin K, cholchicin,aminaphtone.. etc should be tried. Thrombophob with steroid cream should be applied to relieve itching and to fade the redness.  Avoid to remain in standing position for long time. Keep the legs in elevated position while sleeping.. Condition is benign and some time self healing , so do not worry.. Ok, But consult dermatologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "CT brain shows white matter. History of alcohol addiction. Can it be recovered from abstinence from alcohol?\n\nMy 82 yo dad is in hospital following several falls. He has a history if heavy drinking (stopped 10 years ago), high blood sugar and irregular heartbeat.  His cholesterol is normal.  He suffers from depression. A CT of brain was normal except for \"extensive confluent areas of low attenuation in white matter, consistent with marked chronic ischemic degenerative change.\" also Mod. To severe diffuse volume loss, marked atherosclerotic calcification of carotid siphons and distal vertebral artery.He has some confusion-- couldnt recall his exact birthday, but he continues to read voraciously .  Could he have suffered a mini stroke?  Does the CT indicate alcohol induced brain damage? With abstinence from alcohol and controlling blood sugar, can his white matter recover or is the loss permanent?  Thank you.",
    "doctor_response": "Hi,Thank you for posting your query.CT scan findings denote ischemia- decreased blood flow to brain, mini strokes, which could have occurred due to his diabetes and alcohol intake.Diffuse volume loss of brain is also related to his age as well as alcohol effects.With abstinence from alcohol, good control of sugars, and use of aspirin, we can expect improvement, however, return to complete normalcy is unlikely.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the bumps in arms?\n\nI have some small clear bumps on my hands. They are mostly on my palms, but also on the sides and tops of my fingers. They can also be mildly itchy. They are most visible after my hands have been in the water for a short while. What is it? Can I get it to go away? Thanks!",
    "doctor_response": "Hi, Greetings from HCM.From your description I think you may be suffering from scabies which produce small clear bumps mostly on hands.It is mildly itchy .so you need to consult a dermatologist and apply anti-fungal cream.This cream has to be applied on all exposed parts of your body and also to your family members to avoid spread of infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could swollen lumph nodes in groin, night sweats and fatigue with history of having thyroid cancer indicate cancer?\n\nI started out with one swollen lymph node in groin on right side and then got two more on left side now I have 7 in total 4 on left and 3 on right side measuring 3.8 and sore, i also get night sweats and tired.. they say their not cancerous but have more and bigger in a course of 6 months, I have had cancer before in my thyroid",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You may have lymphnode enlargement. It may be due to reactive hyperplasia most likely. It may be due to tuberculosis. Chances of cancer are very low. You should go for fine needle aspiration cytology or biopsy. It will give you exact cause. Then you should take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can degenerative changes in the shoulders and spine along with bibasilar atelectasis be treated?\n\nThe Cardiomediastinal silhouette is mildly enlarged. Degenerative changes are noted in the spine. Thoracic aorta is tortuous and ectactic. No pleural effusion,focal consolidation, or Pneuothorax. There are also degenerative changes in the shoulders. Mild bibasilar atelectasis is seen. I am 75, and in good physical shape...and do physical work, and workout on weights. Have my kown business. Some things I am aware of, and others not so much. Appreciate some interpretation. Thank you. Mac",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It is not a serious issue.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from severe back pain during breathing, yawning, and laying down. Why?\n\nHello doctor, I am a 31-year-old female with two kids. For the past five days, I have severe back pain, and trouble when I breathe, yawn, or when I lay down. When this first began, it was hurting so bad that when I would lay down, I would hyperventilate. My pain is currently around my right kidney on my back that radiates to my shoulder (more towards my arm) and my neck, all in the right side. I can breathe better today, but I have the back pain, shoulder, and neck pain still (very sharp stabbing around the kidney and pain level from1 to 10). My UA showed some signs of stones, and WBC count was elevated. I started antibiotics yesterday. I had a CT scan where they did it have any abnormal findings. The pain medications are not doing anything for the pain. I had undergone gastric sleeve completed on before two weeks, and have not had any problems with it. Do not know what to do from here?",
    "doctor_response": "Hello. You are having two separate problems. 1. Kidney stones, along with urine infection. You have been started on pain medicines and antibiotics rightly. But the tablets will take time to act, and you need to give two days for it. If your pain is not tolerable, you need to go to the hospital and get injectable pain medication and also injectable antibiotics. You did not mention how big was the stone because the treatment depends on the size. If it is quite big, medicines may not be of help to you. 2. Your neck pain, shoulder pain, and pain while breathing is not due to kidney stones. Probably you might be having a nerve pull at the level of your neck. You need to get an MRI scan of your neck for the confirmation of the diagnosis and also to know the severity. The medicine Gabapentin what you are taking will help you in reducing the pain, but it takes three to four days. You can double the dose of Gabapentin for faster relief but after consulting your treating doctor. I hope this information was useful for you if you have any clarification, feel free to ask. MRI cervical spine. Cervical radiculopathy. Renal calculi Drink plenty of water.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for leg rash?\n\ni have a very swollen feet. My both legs are a very bad rash and some times there is a little discharge of white pus sort of thing. I am 83 year old man. I have seen my GP on Wednesday he prescribed some cream to apply a few a times a day. He did say that it is not ulcer.",
    "doctor_response": "Hi, The white pus can be related with a bacterial infection. This diagnosis need antibiotics treatment. Meanwhile I suggest you to use antibiotic cream for local treatment. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Excessive tiredness, depression, body aches since receiving the depo provera shot. Could this be due to medicine or something else?\n\nHi I recently received the depo-provera shot on October 9th. By the 12th I started feeling tired and now I can t even go to school with out feeling sick and very very tired. I used to workout (run and strength train) at least 4 times a week and now I can t even get through a 20 minute run which used to be a breeze. My resting heart rate was 72 and is now 87-95. I feel depressed and I m very put of breath and have flu like body aches. I sleep on a heating pad every night because of back pain that started last week. I m 18 years old, 5 6 , 126 lbs and I have low protein s (why I got the depo vs. the pill). I received the shot in my right buttocks . I called my nurse who administered the shot and she told me no one has ever felt like this, which I know is a lie because looking online and talking to friends who got the shot told me they felt the same way. Is this from the shot or could it be something else (mono, the nurse suggested) thank you!!",
    "doctor_response": "Hi Cassctiexx Thanks for writing in to Healthcare Magic! The change of mood, deprssion, lack of concentration can be expected with Depot Provera but the other things like feeling tred and unwell and fast heart rate are unexpected sequelae. I think yours nurse is right you may be having some viral syndrome like resp. infection or infectious mononucleosis etc. If you have any further query please let me know I would try to answer it for you. Wish you a great health!",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get pregnant after discontinuing Depo shots?\n\nI recently finished with my first time on Depo Provera, I now want to conceive as soon as I can but lately I have been hearing some horrible stories of women who are now infertile because of that shot, or they must wait a year or more to try for a child! I really wish to conceive soon and would do anything for it, What I want to know is what I can do to conceive soon?",
    "doctor_response": "Hi, I think you can try naturally for getting pregnant.  It may take 6 months to one year for ovaries to regain it's function after stopping the depo. But it is not uncommon to get pregnant before that also. Be in contact with your husband every 2 to 3 days after your periods stop.  It will increase chances of your pregnancy.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My daughter finds it difficult to fall asleep. Why?\n\nHi doctor, My 6 year old girl is showing unusual behavior from the last few weeks. She has a\u00a0problem in sleeping. She says that she could not sleep. Sometimes, she wakes up after 2 hours of sleep and starts crying. It\u00a0will last for at least 2 hours, and then she again goes to sleep. She says her throat is dry and takes water again and again. Also, she snores. What is the reason?",
    "doctor_response": "Hi. I understand that you along with your child are going through tough time. For further information consult a paediatrician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure lump on the shin?\n\nI have a lump on my shin, it s been there about three weeks. the gp has said its a lypoma , and will need to be removed surgically. Since seeing the GP it has grown slightly and is red and though it has been painless to date it is now tender to the touch. It s about the size of a cherry tomato. thanks",
    "doctor_response": "Hi,Dear thanks for the query to HCM virtual clinic.I studied your query in full details updated from you.I understood your health concerns.Based on your query data, In my opinion ,Dear Your baby seem to suffer from -Non-Lipmatous lump on your shin,as its tender lately with redness over last 3 weeks.In My opinion,you need to rule out the Varicose Veins of shin.Color doppler with dual image USG would fix the cause and would fix line of further treatment.Other possibility of Sebaceous Cyst needs to be ruled out.Surgeon would be  needed to fix these health issue with you.Hope this reply would help you to evaluate your case and treat it with your doctors in time to come.Hope this would resolve your query and worry and Anxiety accompanied with it.Welcome for any further query in this regard to ME.I would love to help you out.Awaiting for any further query.Wish you fast recovery from this intriguing health problem.Have a Good Day.Dr.Savaskar M.N.M.S.Genl-CVTS -Senior Surgical Consultant",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can one have spondyloarthropathy without some symptoms ?\n\nspondiloartropathy I am 16 years old. Before 2 years I felt pain in my hips. Then pain spreaded in the rest of legh and in arms. My doctor said I have spondiloartropathy. I don t think it is right diagnose because I don t have all sympthoms of spondiloarthropaty. Can I have spondiloarthropathy withoit some symptoms?",
    "doctor_response": "Hello, As you mentioned you been diagnosed with Spondyloarthropathy, which is little unsure with as per me. You need to undergo a couple of test before claiming the same. The pain in the hip can be due to muscle strain or may be due to Inflammation of the hip joint. Need an x-ray or MRI to check the actual situation of the joint. You take the medicines prescribed by the physician and meantime try to find an appointment with an Orthopedic surgeon so you can actually get the area well examined for any other a normalities like the pain is originated from the Hip or is the secondary pain due to the Spinal column. Along with medicine, regular exercise for strengthening the muscles of the affected area and core. Also, stretching exercises needs to be present to have the optimum range of motion of the joints involved. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is alcohol consumption safe while on Fetzima?\n\nI am currently taking Fetzima ER (began June 2016) at 40 mg a day...my doctor currently increased my dosage to 80 mg because of maintaining symptoms of depression. After about 4-6 weeks on the medication, I started to occasionally drink a 6oz glass of wine, maybe 3 to 4 times a week. I haven t experienced any side affects. Do you see any reason why I should not be able to have a glass of wine occasionally with a meal.",
    "doctor_response": "Dear userWe understand your concernsI went through your details. Alcohol can increase the nervous system side effects of Fetzima (levomilnacipran) such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid the use of alcohol while being treated with levomilnacipran. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest me treatment for sore from lower thigh to groin area also muscle is sore.\n\nHi Dr, I am a 45 year old male with a history of factor five laden. But have been off my warfarin for more than 3 years on doctor's advice. Haven't had any additional problems in the last few years, however, the last few days I have a sore lower inner thigh, running from under my groin to knee as a red sunburn or rash that is sore to touch (feels bruised). It has grown from a small patch to the knee in the last two days. The muscle also feels sore. I cycle and did so on Fri and Sat (the bruising feeling started Sat morning) I had originally thought the bruising pain was from my young son kicking my thigh with his shoes on but it seems to be getting worse. Other than that I feel no other symptoms. Can you give me some advice? Thanks",
    "doctor_response": "Hi, As the first line of management, you can take analgesics like Ibuprofen or Tramadol for pain relief. If symptoms persist you can consult a physician and get evaluated. Possible causes may be a neuropathic pain like in sciatica. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe cervical spondylosis?\n\nHello, I have been diagnosed with Severe cervical spondylosis . There is reduced signal intensity of all the cervical intervertebral discs, suggestive ofdiscal degeneration and oedema. There is posterior herniation of the C3/C4, C4/C5, C5/C6and C6/C7 intervertebral discs. There is anterior indentation of the thecal sac by theherniating discs, without significant spinal canal stenosis or cord compression. Similardegenerative changes are also seen in the visualized proximal dorsal vertebrae.There is irregularity of the endplates of the C6 and C7 vertebrae.No sign of ligamentum flavum thickening or facet joint hypertrophy.There is no abnormal paravertebral soft tissue mass.Myelogram done shows mild reduction of the CSF space around the spinal cord",
    "doctor_response": "Homeopathy has a very promising role in the treatment of cervical spondylosis. The long term results of homeopathy are very encouraging. Homoeopathic treatment of cervical spondylosis is dependant upon an important factor i.e. amounts of degenerative changes that have taken place in the bones and the disk. In other words the extent of damage to your spine will determine the speed at which your problem gets cured and also to what extent you get cured. In cases where there are mild to moderate changes in the cervical spine the cure is much faster and the recovery is very substantial. Along with medication we need to realize the importance of prevention of diseaseAs we get more and more absorbed into modern lifestyle like increased working and prolonged driving hours, sitting in front of computer and television for hours together and sedentary life style, it leads to increased wear and tear in our neck muscles and spine. This is what further predisposes us to early and rapid changes in our bones and vertebrae. Thus lifestyle modifications are the first step in preventing the further degeneration and an early onset of cervical spondylosis.Consult me for homeopathic treatment without side effects.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why would a patient with esophageal cancer have a feeding tube inserted surgically into the duodenum ?\n\nWhy would a patient with esophageal cancer have a feeding tube inserted surgically into the duodenum and not into the stomach? Why would a patient with esophageal cancer have a feeding tube inserted surgically into the duodenum and not into the stomach?",
    "doctor_response": "Hi,thanks for query.Depending upon the extent of spread of cancer the things are decided.If the growth of cancer is extending beyond stomach this must have planned.The idea of inserting tube is to make sure that the patient gets proper nutrition and his general condition remains good to support the treatment. wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever,night sweats and tremors along phimosis?\n\nThank you. My 62 year old boyfriend has been experiencing his penis becoming glued almost shut. A few times he had fever and night sweats with shaking, and after these episodes, (at times of more stress in his life, ) his penis will be completely clear and functioning normally, only to slowly close up with glue again. Can you explain possible causes?",
    "doctor_response": "Hi there and thank you for your question.I appreciate your concern regarding this issue and I shall be glad to help.Thie issue of the recurrent discharge with swelling and closing up of the foreskin sounds like a recurrent infection of the head of the penis. This is usually caused by the fungus Candida albicans and is called a fungal balanitis.The reason this happens is because of a weakened immune system and the causes of this can be numerous.The reason behind the recurrent fevers, sweating and rigors he gets needs to be worked up by his doctor. If this is due to an infective process then the cause needs to be determined and treated. It could be a reason why his immune status is struggling and thus the opportunistic infection of the penis.Diabetes is another major cause of fungal balanitis due to its effect on the immune system and also needs to be excluded.Once all these issues have been dealt with, then the chances of the balanitis recurring will decrease dramatically.I hope this helps to steer you in the right direction and good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sensitiveness on the stomach and back?\n\nHi, about a week ago (after a workout) i have begun to have quite bad sensitivity issues to the right (as I see it) of my stomach and my back. It feels like a constant feeling of sunburn however there are no marks, redness, signs of any trauma etc. I have had no loss of appetite and everything else seems to be working fine - i am planning to visit the GP but any advice on this would be really useful. Thanks on advance.",
    "doctor_response": "Hi,Thanks for your query, an elucidate history..The most probable cause of such symptoms of bad sensitivity to the right of your stomach and back can be due to :-Herpes zoster- it shows the redness after a few days - never immediately on symptoms. -Muscular strain / sprain -Internal problems of the liver, gall bladder , kidney, large intestine.I would advise you the following:-Blood, urine and stool tests.-Ultrasonography of the abdomen.-X-ray Chest for any underlying lung/ pleura issue.The treatment will necessarily be as per the findings on clinical examination and investigations reports.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cause for chest pain with shortness of breath and cough\n\nMr. Jackson, age 65, comes to the doctor s office complaining of a sharp pain in the right side of his chest. He says his chest hurts when he breathes deeply or coughs. This is a problem, he says, because he has been coughing a lot, has difficulty drawing breath, and feels a tightness in the center of his chest. What condition or conditions might the doctor suspect? What methods of diagnosis would the doctor use, and what specific signs would the doctor look for to pinpoint the cause?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. According to his symptoms, possibility of bronchitis or lung infection is more likely. He is having pleuritic pain (pain on deep breathing).Pleuritic pain is characteristically seen in pneumonia and bronchitis. So doctor will auscultate his lungs. If it sounds like wheezing then bronchitis is more likely and hence PFT (Pulmonary Function Test) is needed.If it sounds like crepts then pneumonia is more likely and hence chest x ray is needed. Hope I have solved your query. I will be happy to help you further. Wishing good health to your patient. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any serious side effect of taking eptoin for long period?\n\nI am status epileptic patient .I have been taking eptoin 100mg a day for the last 3 years . I have got a seizure on last December,2013 ,After that I have been taking eptoin 100mg a day daily. For the last two months I have no seizure. could I stop taking the medicine. Is there any serious side effect for taking it long for period.",
    "doctor_response": "Hi, Welcome to HealthCareMagic.com I am Dr.J.Mariano Anto Bruno Mascarenhas. I have gone through your query with diligence and would like you to know that I am here to help you.Phenytoin, when taken can cause few side effectsBut when not taken can cause fits and fits can cause even deathSo Please take Phenytoin instead of worrying about the side effectsHope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in HealthCareMagic at  Best Wishes for Speedy Recovery Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for burning sensation and numbness in the toes\n\nMy toes feel hot and numb. My 2 toe nails have fungus under the nail. whay can I do to stop the pain and numbness?",
    "doctor_response": "Hello, I think your pain and numbness will be related to the nerve Impingement. Doing core stability exercises will help improve the stabilization of the spine and avoid any nerve Impingement. Also, lower limb static quadriceps, static hamstring and ankle toe movement's will also improve the circulation. Regarding the fungal infection, I will advise using antibiotic ointment prescribed by the physician. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hard lump has formed after wisdom tooth removal and still paining. Should I be worried?\n\nI went to get my 2 wisdom teeth pulled out 4 to 5 days ago and im still in pain ( on my left side ) . But where i got them tooken out it doesnt look infected or anything but there is a Hard lump beside it... I need to know what to do & i dont want it to be there for 2 or 3 months or if i should be worried .",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,    You have mentioned that you have undergone extraction and now you feel you have still hard lump dont worry it can be bony spicule in socket ,that you feel as lump , treatment is alveoloplasty for this , visit dentist if you feel you have problem,  Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will duromine cause pregnancy?\n\nI ve been on loette now for three years and I ve just started taking duromine for my weight loss. I don t use condoms with my fianc\u00e9 and was wondering can I fall pregnant? Thankyou, I hope I get an answer I ve looked everywhere and can t get an answer.",
    "doctor_response": "Hi, Duromine capsules contain the active ingredient, phentermine. Phentermine is combined with a resin which slowly releases the drug and lasts longer. Little is known about phentermine use and its effect on a developing baby or pregnant women Pregnancies with exposure to Duramine are kept in category B2. Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Ajeet Singh, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Going through puberty. Severe stomach ache. How to cure?\n\nHi I woke up at 4:00am yesterday with a stomach ace. It's lasted until about 5:00-5:20 somewhere in that time. I didn't feel like I was going to throw up I went to the bathroom and had a bowl movement. I am still going through purbety. Is there away I could stop this? And when I have stomach aces what are natural ways to heal it?",
    "doctor_response": "Hi,From history it seems that you might be having some stomach upset.Avoid fried, chillies and junk food.Avoid taking food at late night.You may take tablet Dicyclomine as and when required.Take plenty of water.ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My father got struck with a metal brooch in his left eye. What should I do?\n\nHello doctor, My father got struck with a metal brooch in his left eye corner and the eye became red. There is a kind of brown spot at the corner. At the very end of his eye, a bubble is formed. Now, what should I do? I am worried, and it is hurting him a lot. Please help.",
    "doctor_response": "Hello. I think the injury to the eye by the metal brooch has caused a collection of blood there. It is known as a hematoma. This is the reason for the brown spot and bubble formation. You should consult an ophthalmologist for an eye checkup to confirm that there are not any pieces of metal lodged in the eye or skin around it. If that is normal, then you need not worry. The doctor will prescribe some pain killers to reduce pain and redness. Everything will be back to normal within a few weeks. But be cautious, and get it checked by an ophthalmologist at the earliest, so as to avoid any potential complications.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat swollen forehead?\n\nHello my husband got really upset and bashed his own face into a wall where he then picked up my iPad and proceeded to hit himself around ten more times(forehead right in the middle he has hot this spot before.). The area is very swollen and his body feels very hot and even I m very warm but he s shivering. What s wrong with him? Should he get rest? Because he just started a new job and had take a day off for graduating his program and if I told him he had to go to the hospital he would straight out say no. What should I do?",
    "doctor_response": "hi,thank-you for providing the brief history of your husband.A thorough neuromuscular assessment is advised.As he had banged the head in the wall and also hit himself with an ipad, by the impact of the object to the forehead, there may be an irritation to the sinuses which led into the sinusitis. Because of any impact to the human body, the first reaction is inflammation, which one calls as swelling. Application of the ice will help reduce the swelling.Usually in about a week of time he will be fine. There is nothing to worry as such.Also, if he had any darkness over the face he can undergo a neurological assessment as may be after hitting the face in the wall he may have internal bleeding. for which a neurologist advice is recommended. But if no darkness in the eyes or bleeding from nose or ears then just don't worry, it will be just a muscular injury and will heal in about a week of time.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for milk allergy, hives and frequent stomach upset\n\nchronic hives since nov 2010, allergy test shows only milk allergy, hives continue,  frequent upset stomach/indigestion.  out breaks caused by food-corn, soy eggs and more.  Have had three negative strep tests this year b/c throat hurts so bad at times.  5'7\" F 136 pounds, was 150 last Nov.",
    "doctor_response": "Hello and welcome...First of all avoid all those things to whom you are allergic to...because prevention is better than cure.You can use medications like antihistamines...cetrizine and H2 blockers like ranitidine twice daily...Hope the answer...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are the HIV tests done by me right?\n\nHi doctor, I am a 32 year old male. My weight is 95 kg and height is 174 cm. I had protected vaginal and oral sex with CSW. Then, I did the following HIV Screening tests and all of that came back negative.  ELISA on 26th day - non reactive, ELISA on 40th day - non reactive, HIV 1 and 2 antibodies on 60th day - non reactive, RPR and VDRL serum through slide flocculation method on 60th day - non reactive, anti HCV - non reactive and HBsAg - non reactive. After 65 days, Chlamydia trachomatis and Neisseria gonorrhea tests were negative. HIV 1 and 2 combo test (CMIA) on 90th day was non reactive.  I also had blood test, liver function test, urine analysis and urine culture on 100 day after consultation with my GP for certain symptoms. I have attached the reports for your reference. As there were a few high LFT values, I had a liver scan. It showed grade 1 fatty liver. My kidneys are normal. My urine report showed presence of pus cells, but the urine culture report was normal. My symptoms are slightly yellow urine, sometimes pain while urinating, frequent urination, white saliva, sometimes feeling of fatigue, anal burning after defecation and muscular pain under armpits. My GP said it is muscular, but I am very concerned here. From yesterday, I can see slight swelling under the knee joint. There is no fever so far, but I feel exhausted sometimes and under extreme stress. Based on the above tests, can you please help me. Are all the above tests correct? What is the conclusion on my various STD statuses in terms of the days when I conducted tests? Is HIV combo test confirmatory at 90 days? Are anti HCV and HBsAg done at 60 days confirmatory? Do I need any more tests? My GP has given me tablets for urine related issues. I have not told him about the above encounter. I am on Doxcef, Pyridium and Rabesec. Please help me as I am under extreme stress and getting all weird and extreme thoughts.",
    "doctor_response": "Hi. I have read your query in detail and viewed all the reports (attachment removed to protect patient identity) and do understand your concern. As you indulged in protective sex, your risk of acquiring any STD (sexually transmitted disease) or HIV (human immunodeficiency virus) from someone is already very meager.  All your tests are correct and there is no need to get them repeated. For gonorrhea and chlamydia again PCR has been done, which is extremely reliable and can pick up even a few organisms if present in the body. Fourth generation HIV ELISA test has been done, which is very accurate and can pick up infection at very early stage. There is no need to repeat it. Anti-HCV (hepatitis C virus antibody) and HBsAg (hepatitis B surface antigen) done at 60 days is not confirmatory. If your physician suspects any symptoms, then you may get them repeated after three to six months. Viral load test for HCV and HBV are very accurate if done now and confirmatory, but are quite expensive. No other test required. Your symptoms of slightly yellow urine, sometimes pain while urinating, frequent urination are due to urinary infection. For urinary infection, your doctor has put you on suitable antibiotics and these should be taken religiously. Other concerns like burning after defecation, muscular pains, etc., all are non specific symptoms. It can also be seen without any underlying cause. Some symptoms are psychological, which happens very commonly when you are living under the fear of acquiring HIV. For further information consult a HIV AIDS specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Difficulty in conception, negative result with IUI treatment, husband on fertisureM, uterus healthy, laparoscopy done. Suggestion?\n\nI want to ask that the reports of my & my husband is normal we don t have any problem in our report but still i can t be a pregnant . can you advise me what we will have to do for that. my husband take fertisure M from last 6 months I also took tretment of IUI for 5 cycle but never get positive result. Also laproscopy done and there is no problem in my utres",
    "doctor_response": "hello welcome to health care magic as mentioned in your query - both you and your husband are normal In such cases its called unexplained infertility and you can plan couple of more IUI or go for the next level of treatment like IVF hope to have answered your query Dr Nandita Thakkar drnanditathakkar@hotmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain radiating to abdomen?\n\nI ve been having back pain for the last 2 years. I ve seen countless doctor s and had MRI s, and x-rays but they all turn out to be fine. This pain radiates from my back to my stomach, and sometimes causes spasms, but yet nobody seems to know what it is",
    "doctor_response": "Welcome to health care magic. After going through your query it seems to pain related to kindey and ureters .you can get your ultrsound  kindey ,uretes and urinary bladder done to rule out.consultation with urologist will be helpful.I think this answer will be helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause spitting of blood and dull pain in ribs?\n\nhi ...i quite smoking about a mounth ago and was feeling fine but since i quite i haven't been coughing a lot and past week spittting little blood in the morning , not much then goes away . dull pain in my ribs on left side . im very scared , could it be anxiety ? and do you think it will go away",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. No, this is not normal and not anxiety related. You are having hemoptysis (blood in sputum). You are also smoker. So possibility of pneumonia, tuberculosis, bronchitis and lung cancer is high. All these are common in smokers and can cause hemoptysis. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system. 2. Chest x ray. 3.  PFT (Pulmonary Function Test). Chest x ray is needed to rule out pneumonia, tuberculosis and lung cancer. PFT is needed to rule out bronchitis. So 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, poly cystic ovaries. Prescribed regestrone birth control pill. Will it help in conceiving?\n\nhi i am 23 years old lady and planned a baby and so that i take treatment for it i have suffer from polycystic ovarian and take medicines name B-long f and seacruptin from last month my doctor also suggest a regestrone tablet here my question is this treatment is right and i get pregnancy or not bcoz regestrone is a birth control pill so i have a doubt with my treatment",
    "doctor_response": "Hellothanks for your query.The treatment you are taking is supportive.Registrone is not a birth control pill but hormonal preparation to regulate your cycles.Have a follicular monitoring cycle, and if you fail to ovulate, take ovulation inducing agents like clomiphene after consulting with your doctor.Meanwhile have your husbands semen analysis done, and your HSG also done.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe back pains\n\nI recently went for a CT scan for a colon problem, but mentioned to my specialist that I have severe back ache. Upon receipt of the radiology report, it read as follows: Bilateral pars defects are present at the L5 level with no significant spondylolisthesis at this level currently. There is however, uncovering of the L5/S1 intervertebral disc. The pain has been getting more and more severe and it is at its worst after spending two hours on my feet, or after a night\u2019s rest. Please could you tell me who is the right kind of specialist to see wrt this problem.",
    "doctor_response": "Hi,Looking to the history your problem is with lower vertebrae and pinched nerve pressure.Consult Orthopedic surgeon/ Neuro surgeon for diagnosis and plan of treatment.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest methods to control elevated GGT levels\n\nHello doctor, I am 25y/o female and i had my laboratory test done SGOT and SGPT are normal (sgpt 20, sgot 20) but GGT is elevated (ggt 49). The rest blood chemistry redult are normal. I have read that it indicates the liver condition and it is due to some liver disease and other. I am not an alcoholic drinker, I took iron and vitamin c (not regularly) and food supliments. I am also taking analgesic sometimes. How do I get my ggt level to normal? Is this level of ggt pertains to a serious liver damage? Is this life threatening? Its freaking me out! :( Thanks doctor.",
    "doctor_response": "Hi thanks for contacting HCM...Here no need for taking tension...Your GGT mild elevated..Yes your knowledge right it is elevated in liver damage esp...bile canaliculi damage...So consult surgeon or gastroenterologist for examination and accordingly investigation ...Get your USG done first for rule out gall stone or cholangitis or cholestatsis like condition...If needed endoscopy retrograde cholangiopancreatography done...According to cause treatment guidedTake low fat diet...Fatty food taken less...Carrot , mustard green , spinach , avocados and beats are some good food for liver pathology....Take care..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes temporary and recurrent lumps above the eye?\n\nMy husband keeps waking up with lumps rite above his eye. This is the 3rd time it s happened and every time it s on a different side. I thought it could do something with his sinuses. He said it s a little sore and they only last a day then goes away. What do you think it could be?",
    "doctor_response": "hi.noted history of recurrent lumps above the eye. it may be a chalazion or meibomian cyst formation. usually, it resolves spontaneously. if the condition persists, antibiotic treatment may resolve it. if it's severe, surgical removal may be recommended. it is best if you consult with a doctor, preferably an ophthalmologist, if it's bothering you and is affecting your daily function already. also, avoid manipulation of the affected area.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of raisin lodged in my lung pipe?\n\nI have a raisin lodged in my lung pipe. i was coughing and still feel it in there deep and I am starting to freak out i am manic out like my breath is shallow and I am getting all stresses and there is no ER nearby. i try breath, cough it not helping me!!!!!!! i try youtube video not help.",
    "doctor_response": "Thanks for your question on HCM.I can understand your problem and situation.If you aspirated raisin than your all symptoms like coughing and breathing difficulty are due to aspiration. So we need to rule out aspiration first.So get done bronchoscopic evaluation of lung pipe. It will also help you in removing raisin if aspirated.If bronchoscopy is normal, than no need to worry much.You may have stress and anxiety. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution.Avoid stress and tension. Be relax and calm. First rule out raisin aspiration through bronchoscopy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for tingling sensation on the tip of the penis?\n\nThis is embarrassing to ask..... But I'm worried what it is from or what it means. I'm a 25 year old Male, 5'8\", 150-160 lbs, haven't been sexually active with anyone in 2 years. I'm circumcised and around the top part of the tip of my penis has occasionally tingled the past couple days. Not for a prolonged period, it's almost like a spasm for a few seconds, but I never experienced that before. Is there anything to be worried about? Thanks for your time and if there's anything else I need to answer or tell, just ask.",
    "doctor_response": "Hi, If there is no visible lesion on the skin. It can be neuropathic pain or loss of masturbation/sex. Doing blood sugar can help you. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fainting spell in a child after an injury?\n\nSo basically what happen was that there was a spinny coil at a playground (im 12) and then i hit my knee on the pole in the middle wrapping the whole entire piece so then i felt pain in my knee and pain that i said ow. then all of a sudden i look down and i closed my eyes and i saw something but cannot remember then i woke up all hot and light headed and didnt know what to do. Seizure? Or anything of that specific kind. So then my dad said am i alright and i said no. What was i suppose to do? And does this mean anything?",
    "doctor_response": "Hi dear,If you had no head injury, there is nothing to worry.Svere pain or such unexpected incidents can some times cause such fainting.There is nothing to worry in this.Take care .Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does cramping without spotting after taking follistum tablet mean pregnancy?\n\ni took the follistum shot at the begining of feb. i was to ovulate feb 14 and take a test on feb. 28 i wanted to wait to take it til i was pretty sure i was pregnant. i have had some slight cramping going on but no bleeding or spotting at all. am i pregnant?",
    "doctor_response": "No cramping is not a sign of pregnancy.  Wait for few  days if no periods go for upt tests. If negative still wait for few days before consulting your gynaecologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause stiff lower back, tight stomach and difficulty breathing?\n\nyes im  31 male and right now i woke up with a stiff lower back when lying down so i got out of bed to make coffee and noticed my stomach was tight and ia hard to breath... its very hard for me to breath my back (lower) and my side of my stomach is very stiff",
    "doctor_response": "could be Ankylosing spondylitis. Usually males gets affected from this disorder. You have typical symptoms of that.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for loose motion\n\nDear sir, My 18month old girl having watery stool yellow in color every 1 or1.5 hrs.,after giving walamycin 10 ml in three divided doses in a day its not controlled. The weight of my child is 9.7kg. Please tell me what is the solution? S.K.Dubey Katni, M.P. mob.0000 email. YYYY@YYYY",
    "doctor_response": "Your girl is suferring from acute gastro enteritis. No matter how much medicines you give it will not resolve before before 5 days. the only danger with loose stool is dehydration which you have to prevent with plenty of fluids orally along with ORS. normal feeding has to be continued. Give her Zedott( anti diarrheal) 10mg sachet twice daily and Enterogermina (probiotics) 1 such twice daily. Also add syr Zinconia(zinc) 5ml once daily for 14 days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is deviated uvula normal in 3 year old with sore throat?\n\nHello, My daughthroater is 3 yr old.She has got little sore throat .ed to Presently on antibiotics.Today I just happened to see her uvula.Which is deviated to left side along with enlarged glands on both side of uvula.Is it normal to have deviated uvula or shall i conatct GP.Plz advice.Thank you . Swati",
    "doctor_response": "Hi...sometimes deviated uvula is a normal finding in some kids. The only thing you need to look for is sudden change in voice and nasal twang in the voice or choking while feeding. If these are not there then you need not worry about the deviation of the uvula.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain, back pain and burning sensation\n\nhi, i have chest pain for past six month and back  pain and buring sensesation.presently i ahve taken for HP kit tablets for past two days before that i have taken for nextpro RD. still i have pain in chest ( i have done EGC ,eco ,TMT test , It is normal Only) please advice",
    "doctor_response": "Chest and mid-back pain could be from excessive or strenuous use of the arms. With these tests negative (as well as a chest x-ray I assume) then it is likely safe to assume it is musculoskeletal in origin. Seek out physical therapy from your doctor. But acupuncture works real well in this region also.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can extreme stress induce sharp chest pain?\n\nI have been having sharpe pains in my heart that last only about a second.  I have about one every couple of hours for the last four days.  I had this about a year ago and went to the emergency room where they did a test for a blockage by using some sort of liquid that was given to me by IV and doing a Scan.  They found nothing wrong at that time.  Could this be stress related because I have been under a lot of stress lately.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Yes, stress can cause similar kind of intense chest pain. No need to worry for heart diseases as your angiography is normal. In my opinion, your chest pain is mostly due to uncontrolled stress and anxiety. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on it's solution. You may need anxiolytic drugs too. Don't worry, you will be alright with counselling and anxiolytic drugs. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause recurrent fever and appetite loss in a child?\n\nMy 10 yr old son has had a mild off and on again fever for about a week (usually around 99 & 100 degrees, maybe as high as 101.9 - right now). His appetite is off and he is getting up and about but seems off/sluggish. Just today complaining of sore arm and neck. What are your thoughts?",
    "doctor_response": "Hi, By what you say I feel that your son is experiencing recurrent viral illness. It is common in this age group. I will explain to you how a viral illness behaves so that you can be more confident. Fever of a 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. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for tooth problem\n\nHello doctor, Am working at MNC company, age 29yrs, height 5'4inch, weight 50kg, sir upper teeth of mine not in uniform and i look very akward when i smile, i just want to know  it is feasible if i make my teeth?... kindly advice me please.. Thanking you",
    "doctor_response": "Thanks for using Health Care magic.Read your query.Irregular positioning of teeth as mentioned will require an orthodontic consultation with a orthodontist.Based on the position of your teeth,space between and crowded teeth and keeping your age in consideration and with appropriate radiograph,the treatment has to be done.I would advice you to consult a good orthodontist in your area and get evaluated if you need any orthodontic treatment or any restorative procedure which can help your teeth be more correct.Hope this was helpful and you get a beautiful smile.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain\n\nHi, I have been having abdominal pain, bloating, pain over my bladder and lower right quadrant pain, nausea without vomiting. Had 2 positive blood and leukocytes found in urine. Had KUB and cat scan done. Both were negative. Still having the pain. What should I do?",
    "doctor_response": "HI.You have pain in bladder and lower right quadrant area with bloating, nausea. IF there is an infection either in the urinary tract and/ or the gastrointestinal tract, the treatment almost remains the same in the initial period. That is : antibiotics and supportive and symptomatic treatment. As KUB and CT scan are normal the mainstay remains the same. Go for the blood tests for indication of the infection by WBC count, urea , creatinine, sugar to rule out diabetes.Urine -routine, culture and sensitivityStool - routine and microscopy.These findings will guide for the further treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pulmonary eosinophilia?\n\nHi, may I answer your health queries right now ?  Please type your query here... Hi i have suffered with pulminary easinophilia for 15 years now, and i have just started back work (1 year) i have had so much time off, with this lung condition, which leads to chest infections etc, would i be able to claim DLA, if i were to pack up work and stay at home with my children ??",
    "doctor_response": "HIWell come to CHMChronic allergic condition may be likely, absolute eosinophilic count need to be done with X-ray chest some other etiology would be possible and this need to be differentiated, steroid some time helps, but you must be qualified for this, better to have a word with physician, hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can the polyps in the esophagus be cancer?\n\nHi doctor, My wife had an endoscopy, and they found polyps in her esophagus. I am so worried that it could be cancer. Can it be cancer?",
    "doctor_response": "Hi. Revert with the asked details for better help. Revert with more information to an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a upper lobe mole cause respiratory problems?\n\nHi my details are age = 28 years height = 5.5 weight = 48 years I had some respiratory problems some 5 years. Doctor diagnosed that it is happening because i have a mole in right upper lobe and their is nothing to worry about.Now i am facing this problem again. I am really worried.Please help???",
    "doctor_response": "Hi welcome to health care magic... You have not mentioned which mole is present... You might need to confirm nature of lesion to decide whether it is benign or malignant one... It could be hydatiform mole or any malignant lesion.... According  to cause further treatment  can be guided. ...If it is malignant than surgical excision or chemotherapy  whichever  suitable can be done..... Take careAdvise :I would like you to consult pulmonologist  for auscultation  and subsequent  investigation......So consult without delay Hope this will help",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes flare ups on scalp, neck, torso when suffering from hives?\n\nI have had hives for about 6 months and I am on quite a few medications but I am still getting flare ups on my scalp .neck and torso . I have had blood work but nothing shows up. About 6 months ago, I had an injection of Uflexah in my knee and I have had the hives ever since. I am seeing an allergist but she has not yet determined what might be the cause.",
    "doctor_response": "Hello,Welcome to HCM,Your symptoms suggests me that you are having some allergic reaction, the allergen causing these symptoms should be identified.To identify the allergen causing hives all over the body, you need to undergo skin prick test for the allergens.you should be tested for most prevalent allergens like dust, mite,pollen,food and medicines.This will identify the allergen causing all these symptoms and you can avoid that allergen.For your present symptoms you can take drug having combination of antihistamine and mast cell stabilizer.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "my wife try to commit suicide, please help her\n\nSir my wife is a psychiatric patient 5 times in 15 years try to commit suicide .4times she try to do murder also . She is always complex and try to blame huz and his relatives. almost 10 years taking medicine no any developments, pls tell me a solution. Mostly she is very suspicious mind about her huz.normal time she is very active and good.",
    "doctor_response": "Hi.. Medical treatment would only help with regular counselling and family support.. She could be having symptoms of schizophrenia or depression and has to be treated..Consult with your doctor and consider behavioural therapy with counselling if it is feasible",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I have auras that make me jump with fright?\n\nHi doctor, I am a 43 year old man, who has lived with epilepsy since I was 13. I have had very few seizures, maybe one every 4 or 5 years. The last one was four months ago. After I had that one, I recovered and was fine, but about a month ago, I started having what seem like auras. They are different than the auras that I have had in the past. There are two types, from which one was not so severe. I will be working on something or thinking of something, and it seems like my brain just turns off for a second. These are distracting, but not very disturbing. I have several of these during the day, up to 15. The second type is more severe and disturbing. It usually causes me to jump with fright. For a few seconds, I can hear what is being said to me, but I cannot understand the words. Sometimes I can, but I must really focus. Sometimes, I can still speak, but I also have to focus hard. I might have two or three of these each day. Afterward, I have a headache that might last an hour or two, and NSAIDs do not help much. I take Tegretol, 200 mg three times a day. I was also taking Klonopin after the seizure four months ago. This has been going on for a month now with little change. It just started one day, and it has been the same ever since. I did not have any head trauma or seizure activity since the one four months ago. The access to healthcare here is good, but doctors get patients in and out as quickly as possible, so I do not feel like the doctor is going to do anything if I am not in danger. I have already had an MRI and EEG, and everything seems normal. It is just very upsetting because I cannot enjoy my normal life. Every time it happens, my head hurts, and I am scared and nervous that something is wrong. I am continuing to see the doctor, but I do not have much hope that it is going to help.",
    "doctor_response": "Hi. I have analyzed the symptoms you described in the query. The appearance and pattern of aura are actually suggestive of the fact that the electrical activity of your brain is out of control. Though it is not a full blown seizure, it is surely an early phase of seizures. I suggest you increase the dose of Tegretol (Carbamazepine) to 200-200-400. It would be best if you can repeat the MRI brain whenever the pattern of seizures changes. There is a possibility that something might have changed in brain structure also. When you go for MRI, please get an MRI brain epilepsy protocol. This protocol studies the medial temporal lobe region of the brain in detail. The way your seizures are; most likely they are coming from the medial temporal lobes. I hope my answer helps you. For more information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for sore calves\n\nI get sore calves when walking or when I first get up after sitting or lying down. I had plantar fasciatis (not sure if thats how you spell it) diagnosed a few years back and although it is similar to this pain I don t have the pain in my heels/feet so much now. I have also been having a lot of neck pain and this morning woke up with terrible pain in the lower parts of my arms and hands which subsided quickly in my right arm but is still bothering me a bit although less severe in my left arm and hand. I have coeliac disease. My neck has been bothering me for quite a few months now but is gradually getting worse, could the sore calves be connected to my neck? I also get pain in my buttocks and lower back and have had sciatica in the past.",
    "doctor_response": "Hi, The only relation between your calf pain and cervical pain (neck pain) is possible if both of them are of spinal origin, as you give history of sciatica their are high chances of the two pain related to the spine. You need to get a mri lumbar and cervical spine done to reach out for a diagnosis. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Rohan Shanker Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the health check up with 322/HDL-40/LDL-196/TG-406 indicate?\n\nmy ecg is normal and i am healthy (162cm/61kg) and i walk a lot. in a master health check up, i was shocked to know that my chol level is 322/HDL-40/LDL-196/TG-406 but my ECG was normal. Please let me know if it is very harmful and do i have to take static tablet?",
    "doctor_response": "Hello, I understand your worries. But hopefully, the situation is reversible.Your Total cholesterol and the remaining variables are abnormal which puts you at a risk of developing cardiovascular diseases. Having a normal weight does not mean you are not your lipids and cholesterol are going to be normal. I advise you to eat more of vegetables, nuts, whole grains. Avoid junk fatty foods and smoking. You have to see your G.P probably you will undergo more test and will decide if you need statins. Best regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes angina attacks?\n\nI had a stent implant last October and in December I again had angina attacs. My doctor said it was unusual and does not quite know what could be causing it. I had a additional CAT last week and it showed muscle spasms after the position of the stent. any other reasons for the angina attacks, they usually happen between 6 and 10 am. Nitro does help, but do I have to take it for the rest of my life?",
    "doctor_response": "Hi,This type of angina is caused by a heart vessel spasm. Usually it s diagnosed with coronary angiography with a special methods. Early morning is a common time for such angina. Treatment is with nitrates and/ or calcium channel blockers. You should initiate the treatment and it will be better if you take long lasting nitrate before going to bed and not only nitroglycerin during an angina attack. There are chances that the disease may stabilize in 6 months and you can withdraw the medication, unless there is significant blockage in coronary arteries on coronary angiography.Take careCome back if you have any further questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for rashes in the mouth\n\nHi my one year old son has developed a rash around his mouth and nose area, and has spread to his hands and feet. They are red pimple like spots. He has had all his shots, latest ones at 12 months. Could these be the measles? I don't think they can be chicken pox. Can you help?",
    "doctor_response": "Hi,You said that your son has reddish pimple like lesions on face around nose and mouth and spread to other areas. He has taken all vaccinations. With this much history, I assure you that it is not measles. But, most probably it may be impetigo. It is a bacterial infection caused by staphylococci. You consult dermatologist for firm diagnosis.Antibiotics and antiinflammatory drugs in proper dose may be considered. Antibiotic like sisomycine cream may be applied on lesions twice a day and in nostril at night. Give him bath with few drops of dettol containing water. Improve his immunity with nutritious food after taking advice from his paediarician.I hope this would help in managing his skin problem.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is lump that causes pain in nostril when touched?\n\nHi, I'm a 15 year old boy and today I noticed that my left nostril hurt when I pressed on it and I felt it and it's kind of a lump,it only hurts if I touch it or if I open my mouth too much,I don't think I had it for long because I would have noticed it,probably go tit yesterday night.",
    "doctor_response": "Hi,From history it seems that there might be having ingrown hair follicle infection.Go for one antibiotic medicine course for 3-5 days.Apply antibiotic cream inside the nostril.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes anemia along with confusion and chills?\n\nHi,I am a58 year old white male. I m experiencing some signs of anemia. I get cold real easy and have restless legs i have lost 15 lbs in 2 months. But i still have a appetite. I get confused easy. My hands and feet get cold often. My bones als ache. Mihgt i be anemic?",
    "doctor_response": "Hello,There could be a possibility you should do labs and as per your age have to check prostate once. This anemia is due to poor diet, blood loss from the body or renal problems or chronic disease and as you mention you have an ache that should be evaluated.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Bhadresh Lakhani",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure ring worms on arm and neck?\n\nHi, ive had two ring worms on my arm since may 2011. Both of my arms had one but they went away. A few months back i started getting it on my neck, and then on my right arm it came back. Then i started getting it on my face. The docters gave me ketoconazole 2% cream. It did not work so i went back for a refill. It still didnt work so they gave me pills. The pills did not work either. About a month ago my aunt brought me the same cream but from the Dominican Republic. It was working really well, untill i  came back to my school on campus and took a shower it started getting red. My friend told me about useing clorox bleach. Ive been useing it for a week now and its just very red on my neck and arm. What should i doooooo!",
    "doctor_response": "Thank you for writing us,Hope you'll get satisfied answer here.Brief Answer - Ringworm, also called tinea, is a skin infection caused by fungi, microscopic organisms that are similar to yeast and molds. It does not have any relation to worms, but is called \"ringworm\" because the infection can produce ring-shaped patches on the skin that have red, wormlike edgesDetailed Answer - If you have jock itch, athlete's foot or ringworm of the body, you usually can be treated with a nonprescription antifungal cream, lotion or powder. Your doctor can recommend the appropriate treatment for your condition. Some of the nonprescription medications available include terbinafine (Lamisil), tolnaftate (Tinactin), miconazole (Micatin and other brand names), clotrimazole (Lotrimin, Mycelex) and undecylenic acid (Desenex and other brand names). Be sure to follow the directions carefully when you apply the medication. If your symptoms do not improve significantly after you have used a nonprescription medicine for about two weeks, call your doctor. Your doctor may suggest a prescription antifungal medication that will cure the problem. For extremely stubborn infections, the antifungal medication may be taken by mouth rather than being applied to the skin.If you have a fungal infection of the scalp, beard, fingernails, or toenails, your doctor may treat you with an oral antifungal medication, such as oral terbinafine (Lamisil), itraconazole (Sporanox) or griseofulvin (Grisactin and other brand names). You also will have to apply antifungal creams or shampoos to your hair and scalp. Complete treatment can take two or three months.When To Call A Professional",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can antibiotic cause dizziness in seven year old?\n\nHi my seven year old son  had bad tonsilitis last week and is currently on an antibiotic yesterday he had an episode of feeling strange, he said that everything was very loud and things looked to be far away also had a feeling of floating lasted for a short while had another episode tonight which only lasted a few minutes id be greatful for any advice",
    "doctor_response": "your child seems to be having ear infection too .Please consult your pediatrician or ENT specialist for management.Antibiotics should not cause these symptoms",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does prolonged masturbation cause problems?\n\nhi . i am doing this hand job since i was 8 now iam 25 . due to work i will not do it regularly but in a week i do it 7 times. but some time on weekends i do it 4 to 5 times continuously . will this cause problem. i know this is not a bad habit but if i stop doing it will it effect on my health please answer me to  YYYY@YYYY",
    "doctor_response": "masturbation is ethically wrong..it makes you weak and drains calcuim and  protein content in your body.. it creates nervousness and neurological problems..it is the main cause of erectile dysfunction..it addicts u the more you do it the more u cannot control it..it creates drowsiness, u will need to sleep and become very tired after doing it..it causes stress and strain in your mind and soul..it creates depression and makes one feel bad on his own.. it leads to the noxious problem that you can not see any girl without having a single though: sex..it leads to illegal contacts because the urge increases dau by day.. it is the main cause of speedy sperm relaese during intercourse so it will create dissatisfaction to you and your wife..  it reduces sperm count..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is my CBC showing increased eosinophil count?\n\nHi doctor, I took a CBC test a few days back. Is everything normal? My eosinophil count has increased from 3 to 6 and I am worried as the normal range is 1 to 6. Can you please get back to me on this and if it is fine? Absolute is slightly high but within range. Please let me know if everything is alright.",
    "doctor_response": "Hello. I have seen your complete blood count report and understood your query regarding about eosinophilia (attachment removed to protect patient identity). First of all your reports are normal and counts are also normal, no need to worry regarding this. Your absolute eosinophils count 480 is within the normal range, and of course, in percent form, it is higher normal levels up to 6 %. If we will talk about eosinophilia if more than 500 cells divide into three categories of mild, moderate and severe. It is called eosinophilic syndrome when it is more than 1500 cell for more than six months. If we talk common cause is a simple parasitic infection, any allergy like rhinitis or skin eczema, up to blood malignancy. So you do not have to worry as you said your eosinophils count has increased from 3 to 6 % until you have any symptoms like rashes, pruritis, breathing difficulties, diarrhea, arthralgia. Repeat your absolute eosinophils count after three months, or if you have any symptoms above, then contact me. Otherwise, it is not significant.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent bowel movements in a child?\n\nGood evening she s 4 years old i bring her to the ER last feb2, until now shes still pooping a lot (its been 12 days..there s blood in her poops they do blood test & stools test..they say its acute gastro enteritis..my questions why until now shes still pooping all the time.. We give her banana, apple sauce pedialite & gatorade",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Acute onset symptoms you mentioned are suggestive of gastroenteritis most commonly. Do revisit your pediatrician to review the case and plan treatment. continue oral rehydration therapy. Most importantly source of infection. Usually occurs through unclean water, food or not washing hand before food. So ensure good hygiene practices so that it will prevent the infection to others or in future to child. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cream should I apply to get rid of dullness, patchy skin and blackheads on nose ?\n\nhello DR. i am pooja yadav age 21 years. in my skin the problem is different what type of this i do not understand. i have try all types of skin cream. but the problem is not going they are still like that. the dullness, wounds, patchy skin, whiteheads or blackheads on nose. all types of problem i am facing the pollution & sun rays etc. u should please recomend a medicine or should i meet u.",
    "doctor_response": "hi pooja your skin first to be examine by dermetologist.u can send ur snap. normal cream dont help u ,they just pamper you. solution of every skin problem is there ,so dont panic,all is well do you have pimple right now? what u apply routinely on your face? which face wash u use? have a happy face. dr gaurav patel,ahmedabad drgbpatel@yahoo.co.in",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for back pain & weakness in the legs\n\n44 year old male, herniated the l4/l5 disc 8 years ago. I still have occasional bouts of back pain, some of which can be debilitating for days.  I also have periods of weakness in my legs (normally both) that can continue upto 2 / 3 days at a time.  I have also noticed that since I damaged my back I am less likely to sleep through the night without having to get up 2 or 3 times for the toilet.  Should I now be looking at possible surgery",
    "doctor_response": "HiThank you for asking HCMI have gone through your query.Your problem is most likely due to nerve compression due to Lumbar disc herniation L4L5.MRI is necessary to rule out the extent of injury or compression.In such cases i advise my patients with muscle relaxants like thiocolchicoside NSAIDs like aceclofenac and neurotropic drugs.I also advise them to do muscle strengthening excercises and send for physiotherapy along with this.For some i prescribe belts for wearing in lower back also.If no improvement with all these or the extent of nerve compression is more then surgical options like microdiscectomy or chemonucleosis.Hope this may help you.Let me know if you have any further query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I be allergic to staph that causes impetigo?\n\nI find a link between impetigo flare-up on my scalp (puffy beneath skin with some flare-up s resulting in runny puss) and astham flare up, Is is possible to be allergic to the bacterium stap that causes the impetigo. ? I have also been treated for staph that becamse systemic in the past?",
    "doctor_response": "Hi,Thanks for asking.It seems from the history that you are having impetigo on the scalp.Based on your query, my opinion is as follows.1. Impetigo is bacterial infection of the skin and it can affect the skin of the scalp.2. It is caused by the infection of the bacteria and one of the common bacteria associated with this is Staphylococci.3. This requires treatment by the use of antibiotics and anti-inflammatory drugs.Hence you need to consult your doctor for evaluation and treatment.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for mild hydronephrosis and hepatomegalia after surgery\n\nHello Doctor, I have made pcnl of my both the kidneys just after surjry i have reported inflammation and burning sensation on my lower abdomen. but in USG a mild hydronephrosis with mild hepatomegalia. after 20 days of surjury the inflammation remain same . i am taking prulivfloxacin for UTI. but it is same and inflammation is visible by naked eys. Pls adevice what the cause.",
    "doctor_response": "HelloThanks for query.Based on the facts that you have posted I think you have developed UTI after surgery of Bilateral PCNL for removal of stones in kidneys.In most of the cases of stones in kidney there is infection in center of the stones and fragmentation of stones results in to bacteria being liberated in general circulation causing infection (UTI).This is common sequel after PCNL .Please get your routine urine test and urine culture done to find out the organisms causing this infection and antibiotics to which they are sensitive to and take appropriate antibiotic as per culture report.Ensure to drink more water .This will help to flush out the debris from the  kidneys.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child having stomach infection. Advised echo test. Reason for doing echo test?\n\nHI my daughter is 1 yr and 5 mth old she gone to india to meet her grand parents , she got infected with some stomach infection but while examining her the doc asked us to do a 2d echo test ... 1. Is it required in children after birth might be few mths later to go for this test 2. Whats the exact reason behind going for a 2d echo test My daughter is very active right now and in that case also is it necessary for me to take on 2d echo test",
    "doctor_response": "Hi, I think the docter must have incidently found a heart murmur in your child and he just wants to rule out any congenital heart anomaly in the child.This is non invasive test to look at the heart structure and dynamics of blood flow just like an Ultrasonography. It   can be done anytime in the life after birth.Since the docter has advised go ahead and get it done it will do no harm but will rule out the doubt in the mind of the docter. Bye Take Care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain on the right side?\n\nI have pain on the right side of my back I had this pain for three to four days n I been drinking water since then Ithought it was going away but it is still there what is it please iIneed some answers to why? my name is terra Iam 41 years old i use to drink alot of cokes n the pain seems to get worst no matter what I do I cant lay down walk nor breath at times what is it?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.It would be advisable to show to a doctor and get an ultrasound of abdomen done. The symptom goes more in favor of a renal stone. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Fahim Sheik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from spinal fluid cancer, unable to walk and bed ridden. Is it a primary CSF cancer?\n\nMy sister has been in the hospital since Sept and has been slowly deteriorating. She is bed ridden, unable to walk and can barely move her arms. She has had extreme back pain ever since Sept that has not responded to pain meds. She had 3 spinal taps that all came back negative for cancer and everything else they could think to test for. She also had several MRI s and CT scans that have all been negative. Jan 12th the doctor said that she had a very rare virus that they couldn t identify??? The following week they did a biobsy and now they say she has cancer in the spinal fluid, but that she does not have any tumours anywhere else. All the reading I have done points to CSF cancer as secondary, is it possible for it to be primary in very rare cases?",
    "doctor_response": "Hi, Spinal fluid positive for malignant cell definitely indicate a malignancy in leptomeninges. you have to go for a immunohistochemistry for finding out the primary. treatment will be done after detection of primary tumor. many a time lymphoma has got similar presentation. consult your doctor .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest tests to detect rheumatoid lung disease\n\nthe pulmonologist found something wrong with my lungs he is suggesting an open lung biopsy to determine if it is rhuematory lung, sarcoidosis or basal cell lung cancer. is this test the only tests to detemine which of t he three ? he is leaning toward rhuematory lung disease due to bllod work that shows elevated levels, but the rhuemotologist doesn t think it is such so wont treat me. what other test can be done to determine rhuemotory lung disease?",
    "doctor_response": "Hello! Rheumatoid arthritis is diagnosed based on clinical presentation of inflammatory  arthritis involving three or more joints in your body. The blood tests which help in diagnosis are Rheumatoid factor , Anti - CCP (cyclic citrullinated peptide), ESR (Erythrocyte sedimentation Rate) and CRP (C reactive protein). Blood test that helps in diagnosing sarcoidosis is Serum ACE (Angiotensin Converting Enzyme)level . Rheumatoid Arthritis is an autoimmune disease (the body reacts against it's own tissues and damages them )so it can affect lungs as well and not just be restricted to your joints.  The various common manifestations of rheumatoid lung are interestial lung disease (ILD) , pleural effusion or thickening , inflammation of airways or blood vessels of the lung , rheumatoid nodule . There is also increased risk of respiratory infection due to immunosuppressant drugs prescribed for Rheumatoid.. Sometimes the drugs used for treatment of rheumatoid themselves can be toxic to your lung and cause damage.  Hence this needs careful evaluation . So the lung lesion can indicate any of the problems mentioned above.  If on clinic radiological correlation , it does seem obvious that the lesson is due to your rheumatoid, then treatment of rheumatoid will help in the resolution of your lung lesion as well . If however there is doubt regarding the cause for your lung lesion then it would be better to sample the tissue from the affected area in the lung and study it under the microscope and arrive at the diagnosis.  For tissue sampling open lung biopsy , though the best , is not the only option .U can discuss with your Consultant in person regarding feasibility of a bronchoscopy guided biopsy or CT guided biopsy instead of open lung biopsy .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My anal region hurts and found some blood in toilet paper. Why?\n\nHi doctor, I am having stomach pain in the lower abdomen for the past few days. I am also feeling bloated abdomen along with stomach pain. All day I have been trying to poo and I just did once. When I looked at the toilet paper there was a tiny bit of blood. Also, my anal region hurts. Now, it is itchy and sore. My urine is also dark yellow in color. Please help.",
    "doctor_response": "Hi. Per rectal examination. 1. Anal fissure. 2. Hemorrhoids. 3. Irritable bowel syndrome. Constipation and anal fissure. Tablet Rabeprazole, once a day early morning on an empty stomach to avoid any acidity. Consult your doctor, discuss with him or her and take the medicine with consent. If there is increased bleeding per rectum, fever and vomiting, then immediately head to the emergency room. 1. Drink plenty of water. 2. Keep anal area hygienic and clean. Wipe using wet wipes. 3. Eat healthy diet of fruits and vegetables. For further information consult an internal medicine physician online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What course of treatment should be done for fatty liver and kidney disease?\n\nI have recently been diagnosed with a fatty liver and kidneys. I have been going to various GI doctors for years to try to discover why I have UTIs and IBS, mostly post a perforated colon in 2004. No questions were answered. I drink only occasionally and have four hernias post 2004 colonoscopy disaster. Had a 6-month ostomy bag but have never been able to get my questions answered re treatment. I am really concerned about this fatty liver diagnosis now when no doctor paid any attention to this in the past.",
    "doctor_response": "Hi, There are two main types of fatty liver disease so treatment depends on this: Alcoholic liver disease and Nonalcoholic fatty liver disease. You can get alcoholic liver disease from drinking lots of alcohol. It can even show up after a short period of heavy drinking, other causes are obesity and hepatitis B and C. If you have alcoholic liver disease and you are a heavy drinker, quitting is the most important thing you can do. Talk to your doctor about how to get help. If you don't stop you could get complications like alcoholic hepatitis or cirrhosis. Even if you have nonalcoholic fatty liver disease, it can help to avoid drinking. If you are overweight or obese, do what you can to gradually lose weight -- no more than 1 or 2 pounds a week. Eat a balanced and healthy diet and get regular exercise. Limit high-carb foods such as bread, grits, rice, potatoes, and corn. And cut down on drinks with lots of sugar like sports drinks and juice. This should lead to improvement. You should repeat your liver markers in 3-4 weeks. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ivan R. Rommstein, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a painless lump above navel be a hernia?\n\nfew days ago I noticed a painless lump just above and to the right of my navel. After eating it protrudes alittle, barely noticeable with naked eye but easily felt. I can push on it and it will protrude but return a short time late, painless and no discomfort. I am 50, 6-3 300 but a body builder so although I am heavy I am not overly fat. I believe it is a hernia but not sure what kind",
    "doctor_response": "hi,thank you for providing the brief history of you.A thorough musculoskeletal assessment is advisedAs mentioned in your history about a painless lump just above the naval, a very little a physician could do, as you do not have pain and lump is just a soft tissue.Also, since you are a heavy body builder, you may have formed a hernia in that place, since the muscle run there is just the rectus abdominis , ab due to over training, the skin tissue has just gone a bit up & down. You can under go physical therapy where your ab strengthening will be modified to ensure the lump goes back or vanishes and the rectus abdominis strength stays to optimum to help you continue weight lifting in future.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump and tenderness in chin after injury\n\nI fell down and hit my chin two weeks ago.  There was severe bruising which is totally gone, but now there is a small hard lump under the surface of the skin on my jawbone.  When you touch the lump, it is tender but not too painful.  I am healthy, 40 years old, and have had no prior trauma to the area.",
    "doctor_response": "Hi.Thanks for your query...This looks to be a small remaining part of hematoma going into a stage of organization. This will resolve but take more time, so nothing to worry about.More important is to see that the TM joints are normal. Get checked by opening the mouth widely and close. If there is no problem in front of the ears , you are lucky, as these type of injuries cause trauma to the joints. You need no active treatment, although you may take anti-inflammatory for a few days to see if the swelling is reducing better , you can continue till the lump is resolved.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for a solid lump in the breast\n\nsir/ maam my wife suffer from solid lump in breast .we checking from doctor ,doctor give antibiotic enjuction for five days 1gm .she feel lump size from 60mm to 30 mm. then doctor give only medician for pain and lump .but after 6days solid lump size seems same size 60 mm . pl give path and medician for best result .because my wife fill very sad.",
    "doctor_response": "hi.it is best if you consult with a doctor, preferably a general surgeon, for medical and physical examination. based from your description, it could be a cyst, a benign breast lesion. it could also be a fibroma or fibrocystic lesion. other tumor types such as malignancy must also be ruled out. these lesions are best evaluated clinically. further diagnostic examinations, such as breast ultrasound and mammography, will be requested as needed. regular breast examination and follow-up with your doctor is highly recommended in these cases.  management (medical and/or surgical) will be directed accordingly.hope this helps.\u00a0\u00a0\u00a0\u00a0\u00a0good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for tightness in the head?\n\nSir.. I got fix kind of problem over neck and shoulder. I met doctor and I am taking medicine for this. My one side head near to hear back is giving tightness and up normal thinking. I do not feel manliness , pennies enlargement issue due to this one side tight ness. kindly advice me for this problem",
    "doctor_response": "Hello ! I read your question and understand your concern. In my opinion the troubles you have are related to muscular contractions of the scalp muscles and the neck muscles. The main problem may be in the cervical spine, degeneration of the bones or the intervertebral disks, causing irritation of the nearby structures ans muscular contractions. I would recommend a cervical Xray to examine this part of your column for these problems. The headaches and the tightness may also be attributed to psychological stress, to a wrong position of the head and neck during the day etc. The tightness in the head is the typical pattern of Tension type headache. It is a common type of headache , induced by all the factors I mentioned above , and can be treated with antidepressants. Hope to have been helpful!Thank you for using HCM!Best wishes Dr. Abaz Quka",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain on the right side?\n\nLast night I woke up and went to the toilet, I am on my period and when I tried to use the toilet a sharp pain came into my right hand side. The pain was so bad it took my breath away and I become clammy and my vision blurred ever so slightly. I managed to get back to bed and lay until it went away (an hour later) today the pain is now in my lower right side in my back. I first thought it was my appendix but I am not sure as the pain is mostly in my back rather then the front.",
    "doctor_response": "Hi ! Good evening. I am Dr shareef answering your query.From the history and shifting of the pain to your back, without a clinical assessment, the diagnosis goes more in favour of a ureteric colic due to a ureteric stone, and/or a renal pain. If I were your doctor, I would advise you to consume sufficient water along with an anti spasmodic drug, go for a routine/microscopic examination of your urine followed by a culture/sensitivity test if need be and also an ultrasound of whole abdomen to get a clearer picture of the diagnosis. Further treatment would depend on the results of assessment and investigations.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high BP\n\nSir,My age is 34 i am an engineer by profession.my problem is that i usually have high BP. I have done certain tests for TSH, Cholesterol,Triglicirides  . the results are usually on higher side that means Cholesterol /Trigilcrides above normal.and TSH 10.44. from last two one year i am on low salt diet and low fat diet and i am taking medecine for TSH as well.Now the results which came few weeks before are very good.everything seems to be within limits.but my Blood pressure is still not coming down. Right now it used to be 140/100 which is making me very uncomfortable.like i usually have headache and my eyes are also blurring .I haven't taken any hypertensive drug as yet.I am not able to understand what is the real cause of my raised Blood Pressure and how to cure it.is it safe to start taking hypertensive drugs at this age .do i have to continue taking them even if my B.P gets stable say after one week or so.Do i need to do more investigation to know the real cause and cure it accordingly ?                                     My Email Id: YYYY@YYYY",
    "doctor_response": "Hello , The symptoms you describe are due to higher pressure.  Particularly the lower blood pressure ( diastolic ) of 100 is a concern . Though 34 is a young age for having high pressure,  but genetics ,  lifestyle,  work stress are important precipitating cause . As you have already tried lifestyle modification for so long it's better to start on medication as the longer time your pressure are on higher more permanent damage it causes to your body . Once you have started the medication continue atleast for 3 months and than depending on the pressure decrease the dose very gradually.  Your target blood pressure with or without medication should be less than 140 / 85 by all means . Regards Dr Priyank Mody , Cardiologist,  Mumbai",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can metopic suture ridge cause sleeping problems and crying?\n\nI have a son with a metopic suture ridge that has just formed. He is 11 months old. He, in the last 3 months, has stopped sleeping through the night. He now wakes up crying every 1-3 hours. Are these possibly related? He used to sleep 10-12 hours every nigt.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The metopic suture is one of four sutures on the infant's skull. The sutures ought to remain open until 2-3 years of age. There is no relationship that I am aware of between these sutures and sleep problems. At your son's age, separation anxiety can result in increased bedtime resistance and problematic night wakings. All infants and children normally arouse briefly 4-6 times through the night. Babies who soothe themselves back to sleep have brief arousals rather than prolonged night wakings.  The ability to self-soothe is associated with being put to bed while drowsy but still awake and without sleep onset associations (being rocked, held, bottle fed or breast fed) that are not available during the night. During nighttime wakings, infants can alert parents by crying. Persistent difficulty in self-soothing is associated with frequent night wakings. Transitional objects (pacifier, blanket, mother's well-worn knotted T-shirt with her scent) are important during infancy. Baby should be weaned from middle-of-the-night feedings and should not be put to sleep with a bottle. 25% to 50% of infants the age of your son have night wakings. I hope I have been able to help you.  Please return if we can assist you again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent coughing in pregnancy?\n\nHi, I am in my 3rd trimester. Coughing since 2nd month of pregnancy. In last month, two instances where I ran out of breath and had to rush to ER, First time they gave me ventolin and it helped and they concluded it s asthma second time, ventolin was not helping. docs did all kinds of tests and every organ came out clean, now they want to do lung imaging.",
    "doctor_response": "Thanks for your question on HCM.I Can understand your situation and problem.In my opinion you should consult pulmonologist and get done1. PFT (pulmonary function test).2. Ultrasound examination of chest.PFT is needed for the diagnosis of asthma. It will also tell you about severity of the asthma. And treatment is based on severity only.So PFT is must for you.Chest x ray is contraindicated in pregnancy. So better to get done ultrasound examination as it is safe in pregnancy and can diagnose pneumonia and pleural effusion.Ventorlin is having levosalbutamol. It is short acting beta 2 agonist (SABA) and action lasts for only 2-3 hours. So better to start long acting beta 2 agonist (LABA) as its effect lasts for 10-12 hours. So consult pulmonologist and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shortness of breath, headaches and chest pain\n\nI had a Lupron shot on Nov 17th and have been experiencing side effects all of a sudden. It seems as Dec 10th I started having shortness of breath and now I am having headaches and chest pain. I went to the emergency room Dec 30th. I notified my Doctor yesterday and they did a phone appt and she told me that Lupron shots do not cause chest pains at all. What should I do about the pain in my chest.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. This injection is used for prostate cancer. And prostate cancer can cause pulmonary embolism (PE). Your all symptoms like sudden onset breathlessness, chest pain, headache etc are commonly seen with PE. So better to consult pulmonologist and get done clinical examination of respiratory system and CT pulmonary angiography for the diagnosis of PE. If you are found to have PE then you need to treat it with thrombolytic therapy. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and losing of balance while moving head?\n\nI get dizzy every time I look up or bend my head back and even when I get up off the couch. This has been happening for about two weeks straight. I loose my balance also when I get dizzy. And the girls at work have seen this happen to me and they say my eyes roll back in my head. It is kinda freaking me out. What could this be?",
    "doctor_response": "I have gone thru your query regarding dizziness and loosing balance while moving head . I can understand your concern . Dizziness can have all kinds of different causes, as it is a symptom of many different ailments, diseases and conditions. That all is the outcome of your weak Immune System  due to our faulty food habits and derailed  life style .Dear , your  worry  about some  other serious health condition , may have lead you such a situation . Hyperventilation , dehyderation ,Anxiety  ,Iron Deficiency , Poor blood ,lack of sleep  .Circulation or Lack of blood ,High Blood Pressure  ,stress are  some of the causes . By removing the cause you can reinstate your health . That all is the outcome of your weak Immune System  due to our faulty food habits and derailed  life style . A proper diagnosis is required, so that you can treat the cause of the dizziness  rather than just treat the symptoms of dizziness. By removing the cause you can reinstate your health .I would like to suggest you to  modify your life style and food habits .A regular  balanced diet including all essential nutrients natural form    sufficient hyderation  sleep - fresh fruit ,veges ,ginger, garilc ,amla ,Aloe vera juice , a spoon of turmeric powder + Almond oil with a cup of hot milk at bed time help stay healthy . And for eliminating gas /acidity ,do exercise , brisk walking ,yoga , Pranayam -deep breething , Vajjarassan , Kapalbhatti help alley acidity help stay healthy.Avoid fried fast foods too much of sugar, tea, coffee ,alcohol , smoking ,stress ,constipation . Hope this helps solves your query .Take care , All the best .Don't hesitate to get back if have any further query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy bleeding in gums\n\nHi my name is buster The gums in the middle of my teeth are pushigh them from each other. I noticed this when i absent mindedly pushed the gums between my bottom two front teeth forward. The gum actually moved forward with a little blood. Should I get this checked out by a dentist.",
    "doctor_response": "HiThanks for your query with HCM,With the description it looks like you have a periodontal disease which needs an immediate attention by your periodontist to save the teeth before they become mobile. Till then you can use mouthwash like chlorhexidine trade name clohex plus    rinse this for 3-4 mins then don take anything for 15 mins. This is temporary after thus you must visit your periodontist Hope my answer would be helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain under rib cage?\n\nHi I ve been havering a lot of pain under my right rib cage and in my right Brest and going around my back doctor gave me antboicts 3 weeks ago and I was ok for 2 weeks and now the pain back it s keeping me up and night and hurt when havering intercouse",
    "doctor_response": "Hello, As per your history, it may be due to muscle sprain. For that you can take tablet acetaminophen. Apply diclofenac gel or ointment locally. Heating pads will also help. In case of not getting relief you may require chest X Ray after consultation. Take proper rest. Avoid strenuous activity Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Was a meth addict previously, lung collapsed, was in hospital. Later had seizures. Still have sensation. Reason?\n\nWhere do I start? Back in 2004 I was a severe Meth addict. I stated feeling these electricity type sensations in my chest , at the time I thought I was possessed, howeverabout a week later art work I collapsed because of these sensations an ambulance was called, I was rushed to the er woke up threedays later because my lung collapsed.never felt them again until 2009 and was diagnosed with seizures that simply disappeared 6 months later. I still feel the sensation during different times I just would like to know what could possibly be wrong? Numerous scans have shown nothing...",
    "doctor_response": "Hi,Thank you for posting your query.Based on the description, these are suggestive of seizures.In partial seizures, one can have abnormal sensations without loss of consciousness.A prolonged EEG recording would be helpful in confirming the diagnosis. However, one should remember that EEG may come as normal too in cases of seizure disorder.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Medication for depression after an accident?\n\nHi my name is Courtney and I was in a car accident last year and I was knocked unconscious and had a bad concussion and recently I have been experiencing depression and anxiety and I was wondering if the accident could have an affect on why I'm acting this way? Many people say I act different in some ways as well",
    "doctor_response": "HiThanks for using healthcare magicMay be you have organic depressive or personality disorder. In that case, you should a psychiatrist for proper mental evaluation. That would help to make proper diagnosis and treatment would depend upon the diagnosis. Better to take one of your friend with you for detailed information about you while making diagnosis.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for persistent fever causing dryness in the mouth\n\nMy daughter is 21 months old, she has had a fever since Saturday. She is not keeping alot of liquid down, the inside of her mouth is very dry, her top lip is chapped and I can't seem to keep her awake for more than 20-30 minutes at a time. Do we need to go to the ER now or can I wait to take her to the pediatrician in the morning?",
    "doctor_response": "Hi..Thanks for the query..As per your complain and presentation of symptoms the most common cause of the symptoms that your daughter has are due to viral infection and dry mouth and chapped lips are secondary to dehydration as she must not be drinking enough fluids..Nothing to worry, just give her Acetaminophen or Tylenol so that fever will come down..Feed her with more of cool , bland fluids to prevent dehydration..Cool milk, juices etc can be soothing as well as reduce dehydration..apply petroleum jelly over the lips to prevent cracking and maintaining lubrication and it also locks moisture..Take her to the Paediatrician in the morning and get a proper evaluation and treatment done..Hope this helps..Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can penile pump cause my penis to be numb?\n\nHello doctor, I am using a penile pump under the direction of a urologist. Over a period of each of five days, I think I had overstretched the penis and now have a loss of sensitivity and soreness with no erection. Do you know if it will and how long it may take to recover sensation and remove the soreness? What are the treatment options? The numb penis is very distracting. I am not sure how much damage the penile pump could cause. I am worried waiting too long. Thank you for your help.",
    "doctor_response": "Hello. A penile pump is a form of physical or mechanical treatment. Have you tried oral PDE5 (phosphodiesterase type 5) inhibitors like Viagra (Sildenafil)? It is not advisable to use a penile pump for long durations as any form of physical treatment is bound to cause some form of damage. I discourage you to use a penile pump as it has started to cause physical damage. Maybe your technique is wrong. Numbness and soreness are very common and it will revert back to normal but after how much time, it cannot be predicted. It may take four to six weeks. If you are interested, I can guide you in use of injection therapy in which you inject erection drugs with a small syringe in your penis before intercourse (you should not have any heart ailments for injection therapy).Injection therapy also has a few side effects. At present, you just discontinue using the pump and wait for it to heal. If you want you can continue using it provided you know the correct technique. For more information consult an andrologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of lump in my right breast?\n\nI am 26 yrs old, I wiegh about 123 pounds and I am 5'3. I have had pain and discomfort in my right breast for over 2 months. There is a lump there that I can feel and it is a little grey where the lump is. My right breast is now slightly larger then my left and sometimes my nipple hurts and itches. A heating pad will relieve the pain temporarily and then it comes back. Some days are easier to deal with then others. I did have a benign tumor when I was younger in 2001. It was removed along with two others they diddn't see on the sonagram. Is this just another episode of what I have experianced in the past or is this different? To touch my right breast is a little painful.",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. In my opinion you should consult doctor and get done 1. Clinical examination of breast 2. Mammography of breast. Possibility of recurrence of fibroadenoma is more. But since you are having pain and slight color change of overlying skin, possibility of breast abscess (bacterial infection) or early breast malignancy should also be  evaluated. So better to get done mammography and biopsy if needed for the diagnosis of breast swelling. Don't worry, you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be wrong if I cannot move my left eyebrow, cannot close my left eyelid, cannot smile, numbness in left side of face, pain below left ear?\n\nHi my name is chandra, from last two days i cant move my left eye brow, i cant close my left eye lid completely., i cant smile properly. When i see myself in the mirror and tried to smile only the right part of my lips are moving. I can feel slight numbness on left part of my face. While eating food am not able to open my mouth completely, the left side of mouth, both the upper and lower lips not moving. Im having a slight pain at the bottom of my left ear. Im worried. Please try to help me.",
    "doctor_response": "Hi Mr Chandra,Thank you for describing your problems in detail.These are suggestive of left sided facial paralysis (also called as Bell's palsy). This is most often caused by a viral infection such as herpes simplex. Diabetics are also more prone to get this illness.You should consult a neurologist, who would examine you and do a facial nerve conductions to confirm the diagnosis.Treatment would consist of medications such as aciclovir and prednisolone. In addition, physiotherapy would also be useful.Most people would recover within 3-4 weeks of treatment.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for rashes\n\nhi, i m 32 years old just had a c-section a week back and following the operation i started developing severe itching with rashes all over the body.  At 8 and 9th month of pregnancy i had a bad itching on my stomach and now after the c section it spread throughout the body, like armpits, legs, back, etc, pls guide me asap.Telma",
    "doctor_response": "Hello,Thank you for posting on HCM.It\u2019s very difficult to approach conclusive diagnosis unless for proper physical examination, anyways from your description it seems you are suffering from scabies.Scabies is a contagious disease caused due to mite and it spreads among people who are in close physical contact and by use of common household articles.Treatment is pretty straight foreword. Firstly, i would suggest treatment of your secondary infection (if any) with oral and topical antibiotics.The key to successful treatment of scabies lies in treating everyone simultaneously in the family and others who are in close physical contact. Your doctor would prescribe oral drugs like ivermectin which will kill the parasite. You might also be advised application of permethrin 5% cream and a corticosteroid with fusidic acid cream. Apply the medicated creams exactly as advised by your doctor. Take antihistaminics as advised to relieve itching and irritation. Avoid sharing of clothing and toiletries and launder all you bedding and clothes in warm water.Hope this will take care of your issue.Wish you best of health.Thank youDr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Ritalin for narcolepsy, new doctor reduced dosage that doesn t help. What to do ?\n\nI have narcolepsy...Have had it since childhood...and since 1984 I have taken 20 mg of ritalin 5 times a day....(5 pills at 20 mg each)   I have always worked and supported myself....Ive retired 3 Dr.s over the years..lol...But my current Dr to whom I was refferd to from my former dr does not want to prescribe the 5 pills a day....So to keep the peace(and get my script filled)  I agreed to take 4 a day ......This is not working for me.....At 5 a day my meds would take 15 min to kick in,,,,Drowsy for 15 min then alert for about 3 hrs...At 4 pills a day i wait about 4 hrs then take a pill...It takes about 30 to 40 min to kick in....This is no good...as I drive allot with my job ect,,,,,This dr I currently have did no test to come to his conclusion of lowering my dose....29 years it has worked the same for me (Im 50 yo)What can I do...I really need help...signed  AAAAA",
    "doctor_response": "Hi, you know what problem you have , and how to over come it. though it is organic, you should consider it to be the psychological, and you only can give treatment to this ailment.                         Practice mild yoga, meditation, regularly. Read books of your interest , and hear music, when you are free during day. Try to sleep in the night at a particular time and wake up at a particular time. Practice hearing music at a low sound while sleeping so that you get sleep only when you hear music at that sound only.                         Take green leafy vegetables, pulses, sprouts, and proteine rich foods. Take juices of palatable vegetables. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can one be immune to Molluscum or could the virus be dormant?\n\nMy boyfriend has had molluscum for about four months. Not knowing what these bumps were and assuming it was just a rash since there were no strange symptoms, we had unfortunately been actively having sex since then. We just found out very recently that he has molluscum. I do not have any visible bumps on my own body and am surprised that I have not developed anything since. Is it possible that I either 1) have some sort of immunity against it or 2) that I have this virus in my body dormant as a carrier and somehow passed this on to him through sexual intercourse? Also, what are the best ways to treat this virus? And are there any ways that we can continue to have sex while he is going through treatment (although that is not my primary concern)?",
    "doctor_response": "Hello,Welcome to HCM,Molliscum contagiosum is a viral skin disease which is contagious and can spread to other areas.Isolated lesions can be expressed or removed by minor procedure. Topical treatment includes imiquimod cream or tretinoin cream application on those lesions will cure the problem. As you are aware that it is a viral infection and it will subside by itself in few months to years, it is true but there are some remedies which helps to control the infection and faten the recovery. But they do have some side effects 1. Freezing the growth of molluscum. 2.Curettage of the fluid from the lesion , but it is painful and may leave scar. 3.Application of creams like podophyllin, tretinoin, and cantharidin Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rashes on skin, itching, black in color. Taking medication. Suggestions?\n\nMy maid has rashes on the skin, which starts as a small spot and then on itching,it becomes a big rash spot @ 1\" -2\".  It also becomes black in color.  The spot does not have any swelling.  This condition seems to be exists for 6 months now. It has started to show more prominently since last 2-3 months. She has seen a couple of doctors. She was prescribed Tri-o-bloc cream. She used it for 2 -3 weeks and stopped it since its expensive.  The next doctor prescribed Tenovate NM cream, Laveta tab, Betnesol tab and AF 400.  The condition has not improved.  Please advice.",
    "doctor_response": "HiThe data you have provided is insufficient.The most important data here is site. Where is the black spot located?If on face then we are dealing with melasma.But from what i can guess from history you have provided is that the patient has tinea incognito.But ti tell with certainity i need the location of the lesion and if possible  a photograph.Treatment of this condition is oral and or topical antifungals for appropriate duration. Incomplete treatment will lead to relapse.Hope it helps RegardsDr amit",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white blotches on legs while standing for long period?\n\nHi! Thanks for any help you can offer. My entire life I've gotten white blotches on my legs after standing for a period of time. Sitting down is the only thing that makes them go away. My legs don't hurt, itch, or anything else. Is this just something to do with my circulation? I'm 21, 5'3 and 117lbs. I don't get a lot of exercise, but I eat healthfully. I drink solely water, and don't drink alcohol that often.I suppose that's all the information I have that could possibly be relevant. Thanks again for your help!",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Standing for a long time, commonly edema could be seen, which could be due to increase vascular perfusion.2. Color doppler of lower limbs is necessary to rule out any varicose veins.3. Check if any veins are prominent around the white blotches.4. Image of the white blotch, complete hemogram and color doppler investigation details necessary for further opinion.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain after choking on water due to Lapband?\n\nI have the Lapband, as I was getting tightened 2 days ago I had too drink some water. The band was so tight the water didn't go down right away and it came back up as I was laying down like I was choking. Since then I have a bad chest pain and shortness of breath I have never felt this before do I maybe have water in my Lungs. Thank You",
    "doctor_response": "Hello!You seem to have respiratory tract infection.  I would suggest you take a course of Tab. Amoxyclav for 10-14 days . You can take tab. PCM if you have high fever spiked anytime.   Also get a Chest X ray done to see how severe your chest infection is.  Before you start antibiotics it is advisable to get your sputum tested for gram stain and culture sensitivity and Acid Fast Bacilli.  These tests give an idea as to what organism has caused the infection and what antibiotic will work against it and cure the infection.  This result will be a good guide with regards to the right choice of antibiotic for you.Hope this helps.  Do drop your valuable feedback .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain and weakness / pins needles down left leg. Ive Had lower back pain for two years and have to now have epidurals For the pain As the pain is so bad. My last Epidural was on was dec 22nd. For five weeks my left knee has been very painful for no apparent reason and now I ve got severe pins and needles and weakness down left leg all the way to my toes and my back is killing me. Please help. I m 37 female and noone seems to be bothered! I ve done Physio, chiropractor, acupuncture etc. I can t live with this pain. MRI two years ago said minor disc bulge but nothing major.",
    "doctor_response": "dear pt did you had mri of LS SPINE.its appears by history that your motor power is compromising as you say weakness,in addition sign of compressive radiculopathy are there too. u can discuss ,think about interventional procedures avoid surgery we are performing these techniques in india",
    "dialogue_context": ""
  },
  {
    "patient_message": "Acne problems, chronic condition. Taking birth control pills, using salsic acid face wash, isotretion tablets, no relief. Treatment for acne?\n\nI am suffering from acne problem. i am married and iam suffering from this problem since my teenage. i have taken azithromycin tablets and also after that isotretion tablets but of no use. iam also taking birth control pills. my age is 27. iam applying persol 0.5% on my acne. washing my face with salsic acid face wash from cipla since last night.",
    "doctor_response": "Hi Madhuri, Welcome to HCM, I have read your query, the surest route to success in treating acne vulgaris follows 3 steps. First, establish the type and severity of acne. Second, select medication appropriate for the patient\u2019s condition and skin type. In general, patients with oily skin benefit from solutions or gels, while those with dry skin do better with creams, lotions, or ointments. Third, educate yourself about the disease, the different types of medications (including birth control pills) and their side effects, and expectations for improvement that are realistic. Realistic expectations should enhance compliance and lead to the successful resolution of a chronic debilitating disease. All of which result from a multifactorial pathophysiologic process in the pilosebaceous unit: sebum production, follicular hyperkeratinization, proliferation and colonization by Propionibacterium acnes, and the release of inflammatory mediators. The resulting lesions include noninflammatory open (blackheads) and closed (whiteheads) comedones, as well as inflammatory papules, pustules, and nodules. A variety of medications are available for the treatment of acne vulgaris. Note that most treatment regimens should be used for at least 6 to 8 weeks to judge their effectiveness before considering alternative treatments or adding other agents. Will recommend to visit your clinician or dermatologist before switching or trying any medications. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain and dizziness during pregnancy?\n\nMy wife is 4 months into her pregnancy. She has a very small bump on the bottom of her stomach. She has been having really bad pain in her stomach, shortness of breath, dizziness, peeing herself, hasn t been able to eat, and has been extremely tired, and not being able to do much throughout the day. We went and saw a doctor but they didn t give us any information what so ever it was very disappointing. Is there any info you can give me?",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your query, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.Please do not worry. Sorry to hear about your wife's complaints.If she has all these complaints with frequency of urination, it can be due to UTI- urinary tract infection.Please get urine routine examination done.The bump that she is feeling may be because of growing pregnancy.She should take plenty of water in a day.Tab CALPOL 650 mg as needed for fever and body pain.Tab Azee 500mg once a day for 3 days will be of help.Let her relax, take rest and meditate. All things will be fine.I hope my answer helps you.Thanks.Wish you great health.Dr Purushottam S Neurgaonkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent coughing after treatment for low heart pumping rate?\n\nHello Doctor my mom is 55 yrs old in Jan 2011 these year she faced breathing problem and she was hospitalised. Doctor said her heart pumping is low 20-25% . She is treated now with the medicines Cardivas 3.125, Lasilactone 50 , Cardace H 2.5, Dexorange syrup. Her haemoglobin was 7.5 . Doctor she is coughing too much mostly she is coughing in every 10 minutes and it lasts for 1to2 minutes. The sound of coughing is too severe. Doctor please tell me what has to be done to get rid of her severe cough and how to improve her heart pumping and also make her heart healthy and strong and also inform what she has to eat ?",
    "doctor_response": "Hello,First thing is to find out the cause of this weak heart function. We need to rule out the blockages, so I guess that was rule out.    In her medicine, she should get lasilactone dose increased. Cough is there due to excessive fluid in lungs so there should be fluid restriction including milk, water, tea, juices etc. to less than 1 litre per day.     She should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. Regular exercises like brisk walking, jogging according your capacity atleast 30 min a day and 5 days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn't abdominal fat deposition or obesity. Get your lipid profile and sugars tested once..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can multiple myeloma or antibiotics effect tooth enamel?\n\nI have been diagnoses with multiple myeloma in Nov,2014. Up till now no chemo as I have an infection on my chest. I have been on an antibiotic protocol 3 days a week...2 azithromycin,3 ethambutol, 2 rifadin. It has been 6 weeks since I started and I notice my tooth enamel is eroding and there are patches of black. Have not seen my dentist yet? Any connection between tooth enamel and antibiotics or multiple myeloma?Thanks",
    "doctor_response": "Hi Dear ,Welcome to HCM.Understanding your concern.Thanks for your query . Yes antibiotics are known to cause discoloration of teeth.Multiple myeloma in not known to cause any discoloration.I would suggest you to consult your general practitioner and dentist to find out the solution .Doctor may prescribe you alternate medicine or readjust your dose . Dentist may perform procedure like bleaching or prescribe tooth whitening medicated toothpaste according to your condition. Hope your concern has been resolved. Please write a review about your experience with me and do click at i find this answer helpful if its valuable for you.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent vomiting\n\nTwo year old vomiting for about two weeks, no fever, started out only vomiting during the night after she would go to bed and now in the evenings. Doctor prescribed and anti-biotic. She stopped throwing up for about two days and now it is back and worse than ever. Doctor ran a CBC and ordered a stomach x-ray it they were normal. Anyone have an idea on what this could be?",
    "doctor_response": "Hi, tahnk you for posting your query here. Forom what you ve described, it seems like your child has GERD (reflux). they tend to vomit when going to bed or after a heavy meal.My advice would be to give smaller meals, a little more frequently, avoid chocolate/tea/coffee which increase reflux. To make her walk around a bit after her meals, not immediately lie down. keep her bed reclining at a 30 degree angle (you could put some blocks under her head-end side of the bed).Ask your doctor about starting domperidone which helps reflux. ondansetron half hour before food will help the vomiting.Hope this helps you, take care.Regards,Dr. Vaishnavi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am i not able to conceive even after undergoing ovarian drilling?\n\n5.4' ,70kg I done - Hysteroscopy, laparoscopy ,ovarian drilling ,D/C under Ga on )05/05/10 under Dr pranab Dasgupta atAMRI. Uters -nomal size, moblie ,surface smooth . Ovaried -both ovaries polycystic ,ovarian drilling done ,serous fluid drained. chromotubation done - good view ,surface smooth ,both ostia visualised Cx -Endocervix health, but still not consive",
    "doctor_response": "Hi , Ovarian drilling alone is not a treatment for PCOD. Try to reduce 4-5 kg weight but diet restriction/ Low calories diet & regular exercise for middle segment of body.Hope GOOD VIEW in report means the tubes were patent. Hope you have confirmed Husband's semen parameters. If cycles are irregular & scan shows no good follicle growth- kindly go ahead with Ovulation induction tablets with hormone injections for eggs to come at right time & number , thus increasing pregnancy chances. PCOS has a very good pregnancy chances, don't worryAll the bestDr.Balakrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are hydrocodone and oxycodone medicine same for broken back?\n\nyes and thank you--- my brother has been saying than oxycodone is much stronger than hydrocodone and I thought they were pretty much the same. He has major back trouble due to broken back ,rods, ets.--neuropathy in feet and legs --hip replacement approx. 3 years ago. Am not taking either and am not sure which he is on but he has brought it up several times and would just like to know the differences. They both have acetaminophen. I am a retired nurse so just curious. Thanks. bonnie",
    "doctor_response": "Thanks for the question Bonnie.Both are schedule 2 narcotic pain relievers and have the same indications. The differences are1) H is more for severe pain while O is for moderate pain2)H is a class C drug not recommended in pregnancy while O is class B not recommended while  breastfeeding3)Dependence and abuse potential is higher for O4) H has a longer half lifeH-HydrocodoneO - Oxycodone",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the count of .40 thou/mm3 from AEC blood test suggest?\n\nSir /mamwhen i come in contact with moisture or sometimes even water i get small swelling  on my legs and arms but they tend to vanish with in few minutes,  during the time i have is it itches a lot and stops as it vanishesi wanted to know why does it haapen and is there and cure or medicinei just got the AEC blood test done and the count is .40 thou/mm3",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You may have some allergy.  It leads to eosinophilia and itching.  You should go for allergy test.  Avoid the substance against which you have allergy. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be concerned about the platelet count of 397?\n\nI just had a lab done and my platelet was 409. Then my doctor had me do a follow up in a month and told me to drink a lot of water before testing. I only had one bottle of water the morning prior to my test. My results came back and my count was 397. Should I be concerned? And is there anything I should be doing?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Your platelet count is absolutely normal.  No need to worry about platelet count.  No any drug treatment or follow is required.  Just be relaxed. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is autoimmune disorder?\n\nHi, would like to know about 2 things:   1) I have spherocytosis (hereditary) and no spleen.  Had pheumovac shot.  is this an 'autioimmune' disorder?   2) had 'relations' with a person with Morganella Morganii - since then Ive had weird itching under the skin, confusion, just feel ill.  IS THAT SEXUALLY TRANSMITTED?  How do you CATCH that from someone?",
    "doctor_response": "HIWell come to HCMThis is not the sexually transmitted disease and the spherocytosis is not the auto immune disease if you have the itching symptoms after the contact of some person then this could be contact dermatitis and not the sexually transmitted disease , hope this helps. Thank",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lack of concentration and focus at work\n\nI have been having trouble concetrating and staying focused at work.  I was prescribed to adderall for ADHD in my high school / college years , but stopped using when I finished with school.  I am wondering if that was a mistake and maybe I should of kept up on the medicine.",
    "doctor_response": "DearWe understand your concernsI went through your details. I can understand and I request not to underestimate the real benefits of addrall. You needed that medicine at that time, and you were prescribed. That is past. Usually ADHD corrects itself. Your problem could have corrected itself.Ask yourself. Is the low concentration in your work due to lack of interest in work, procrastination, lack of motivation, lack of passion in job ? If your work is of mechanical nature or stereo typed, it is obvious that you loose interest and concentration in your job. In that case, your problem is not related to ADHD. You need to learn to cultivate passion and love towards your job. Please let me know if your problem really is related to ADHD. In that case, CBT should work well for you.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to Cure Candidial Balanitis?\n\nHi doctor, I am a 44 year old male. I have itching on the head of the penis and the foreskin. It started about 3-4 days back. But now it seems that I have symptoms of balanitis. I found white substance under the foreskin. There is also some minor tear which make it difficult for me to move my foreskin. I have applied Candid cream for that. Please guide me.",
    "doctor_response": "Hi. There is a difference between Candid cream and Candid B cream. This seems like you are having candidial balanitis. Please apply Onabet cream (Sertaconazole) twice daily for a week. Wear loose cotton underpants. Do not wash your foreskin everytime you use the bathroom. Keep the area dry. Also get a fasting blood sugar level done. After a week you can take a follow up consult with a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Prescribed ornidazole for green stools and indigestion after an attack of dengue. Is it a result of having fatty liver?\n\ni had dengue IgM +ve 25 days back fever got controlled but till now i'm not able to digest food and the stool color is sometimes light greenish and sometimes pale yellow. scanning report- impression ---fatty liver.there after fibroscan - 4.9 kpa.medication used ofloxacicin+ornidazole 5 days (10 tabs)rifaximin 550 mg - 5 days ( 10tabs)but even after use of those medication prescribed by the doc i could not stop excreting foul smelling, yellowish stools even after 30 days of degue attack please tell about my condition",
    "doctor_response": "Hi friend,Welcome to Health Care MagicThe stool must be tested! \u2013 for infection, occult blood and so on.Black or green stool may mean occult bleedingIf the problem continues, you may need endoscopy, from both ends\u2026Consult a gastroenterologistGood luckTake care\u00a0\u00a0\u00a0\u00a0\u00a0Wishing all wellGod bless",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain on back, bump in lower stomach, bruising, painful when touched. What do you think?\n\ni m a 16 year old female and i cannot remember when this even started happening but for a while now ive gotten these random pains where i cannot move at all, i cant stand i have to lay on my back for over 20 minutes each time for this pain to finally go away, i recently found lumps in my lower stomach left hip area and now there is bruising. the bruise is very painful when touched, i do not know what to think",
    "doctor_response": "Hello. Thanks for writing to us. The appearance of spontaneous bruises with multiple painful lumps is a worrisome finding. This could be related to autoimmune or a hematological disorder. Proper investigations are needed to detect the cause.I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL  Regards, Dr. Praveen Tayaldrtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nose bleed and fever?\n\nHi My daughter 2 and half years old has got fever for a week but not consistenly with max temp around 102.4. My doctor has adviced ibugesic plus syrup and Augmentin DDS along with XYZal Syrup for cold. For past two days i can see mild blood from her nose along with the cold that comes out. Please let me know what i should do for this blood coming along with cold. I have stopped ibugesic from yesterday and today her max temp is 100. Please adivice me.",
    "doctor_response": "Hello dear!This mild bleeding can be due to nasal trauma while nose picking as children do due to irritation during cold and flu and also could be due to dryness again due to cold.Nothing to worry about if its just a spot but for your reassurance get her CBC and PT/aPTT done ,if its normal then nothing to worry about(which will be normal hopefully) but as a mom i can feel your concern.The medicines are perfect except ibugesic,Replace it with paracetamol for fever 4-6 hours apart in presence of fever.Also try some home remedies like 1 teaspoon of honey in a cup of luke warm water and avoidance of cold drinks,ketchups,sour and cold foods like icecream and tamirind etc.Give him saline nebulizations and steam inhalation preferably to help prevent dryness of nasal mucosa.Hope it will. Be blessed :-)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes Diarrhea in a stage 3 Multiple Myeloma person and undergoing chemotherapy?\n\nHi Doctor,My father was detected to have a stage3 Multiple myeloma 45days ago and he is undergoing Chemotheraphy. He is on Tab Acivir and tab Sepmax, and a weekly injection dose of (Cytomib+Endoxan+Dexona) INJ. The third cycle was on last friday and BORTENAT 3.5mg INJ was used instead of Cytomib. He is suffering continuous diarrhea since yesterday evening(since 24hrs). The hospital remains closed on Sunday.Can you help in any case?Thanks a lot,Phani",
    "doctor_response": "Thanks for your question on HCM.Diarrhoea in chemotherapy patients can be due to1. Gut infection2. Side effects of chemotherapy drugs.Chemotherapy makes patient immunosuppressive and more prone to infection. So infection is first probability. Chemotherapy drugs are cytotoxic. They may change and kill normal bacterial flora of gut. So this can also lead to diarrhoea. Treatment consist of1. Plenty of fluids orally. ORS (Oral Rehydration Solution).2. Avoid junk and outside food.3. Eat only freshly, properly food. Avoid uncooked food.If not improve in 2-3 days better to get done stool culture.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent upper back pain?\n\nHi. I am a 67-year old female, 5'6 1/2 and 139 to 141 pounds I have a pain in my upper back between my shoulder blades. It feels like a dull knife could be coming into me from back to front. It comes and goes, and has been flaring up about once a week for the past month. It's especially uncomfortable today. No nausea, no weight gain or diarrhea, no other chest pains.i have just taken 2 chewable Tums to see if this is acid-related and the Tums could give some relief. I had something similar about 17 years ago. The doctor ordered an endoscopy and I didn't have anything significant, but he said the act of the scope going down may have stretched a constricted area.  Any suggestions? Thank you",
    "doctor_response": "hi sir/madam,Thanks for your question on Healthcare Magic.Let me advice you for your problem.Low back ache may be a pre-monitory (prodromal) symptom in fistula in ano, sciatica, gouty arthritis, hernia, emaciation disorder etc. Pain is confined to lower part of the spine (back bone) especially lumbar region or lumbo-sacral area (rarely sacro-iliac region also). If it is secondary, earlier history of fall or injury may be associated. Rarely, radiating pain may be complained by the patient towards lower limbs. But it is quite common in low back aches if the defect is in the discs between vertebrae (back bones). Often the movements of lumbo-sacral region like flexion and rotation are hampered either partially or completely.Low back pain may be found in mild form in case of anemia, sciatica, rheumatoid arthritis, hemorrhoids, urinary calculi, uterine disorders etc also.Line of treatment as per Ayurveda:-The general principles of treatment of vata dosha are adopted in case of katishoola (low back pain). It includes various measures to suit its varied clinical entities, stages and associated complaints.1. Snehana (oleation) \u2013 by sneha dhara (pouring oil), abhyanga (oil massage), avagaha (tub bath with oil or oleaginous medicaments), kati basti (retaining medicaments on the back) etc.2. Swedana (sudation) \u2013avagaha sweda  (sweating treatment with tub bath), pizichil (kayaseka), nadi sweda (sudation through a tubular device \u2013 local sudation), panda sweda (sudation through medicated paste or powder) etc.3. Mridu Samshodhana -mild purgation.4. Basti (medicated enema) like eranda basti, vaitarana basti, pippalyadianuvasana basti etc.Formulations indicated in Low back ache as per Ayurveda:-1. Dashamoola kwatha.2.Maharasnadi kashaya.3. Rasnaerandadi kashaya.4. Sahacharadi kashaya.5. Gandharvahastadi kashaya.6. Trayodashanga guggulu.And for local application these oils will help:-1. Ksheerabala tail.2. Mahanarayana tail.3. Dhanwantaram tail.4. Maha narayan tail.Avoid these for better results:-1.Bitter, astringent and pungent food2.Cold water3.Fear4.Exhaustion5.Standing6.Driving7.Cold food and beverages etc.Yoga is also very helpful in treating your back ache.Now for your backache do these yoga aasana:-1. Ardha Matsyendrasana(Sitting Spinal Twist).2.  Dhanurasana (Bow Pose).3. Marjariasana (Cat Stretch).4. Balasana(Child Pose).5. Halasana(Plow Pose).6. SUPTA MATSYENDRASANA(THE TWO KNEE SPINAL TWIST POSE).7.Adhomukha Shwanasana (Downward Facing Dog).8. Urdhva Mukha Svanasa",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does MRI scan report-no evidence of disc bulge indicate?\n\nI have severe back pain. At work I was hit on the head with a 500lb backhoe bucket. I think my pain is caused from that. I recently got an MRI and it staes the following findings: the visualized images of the abdomen and pelvis are unremarkable. the conus terminates at L1-L2. There is no loss of vertebral body height, Alignment is maintained. No marrow signal abnormality. There is very mild degenerative disc desiccation at L3-L4. there is no evidence of disc bulge. No central spinal canal or neural foraminal stenosis. what does this mean?",
    "doctor_response": "Thank you for the question. Your MRI r/o any spinal abnormality directly. It is possible that at the time of the impact you may have abnormaly crouchedor fallen downwith suddencontraction ofback muscles causing some muscle injury/sprain or pull alongwith other soft tissues  around spine.You may stop bending/lifting heavy objects for  a few  days  and take adequate bed rest to ease the muscles. Do  fomentation and take Ibuprofen 600mg twice a day after meals alongwith chloaxazone 500 mg twice for 5 days",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes skipped heartbeats?\n\nI have been having 50-60 skipped heart beats a day for the last 5 months.  I have had several test and everything appears to be normal.  I currently have an appt with a cardio dr.  But could you give me a clue what this could be I am going to be 53 in a few weeks.  I am female.",
    "doctor_response": "hello i have gone through your query. i can understand your concern. before i would comment on the missed or skipped beats i want to know if you are having any symptoms like loss of consciousness or dizziness. have you done an EKG or a holter monitoring. if you dont have any symptoms then 50-60 beats per day are harmless. however for youe safety i want to rule out any cardiac element. dont be tense. do an EKG, TMT (TREADMILL TEST) and holter monitoring. Wishing you good health thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent vomiting in a diabetic?\n\nMy husband has been sick all day. He's vomited 3 times and he has pain on his left side of his abdomen. Could that be his gallbladder? We were in Fishers, IN over the week-end at our son's home and we both ate the same things and I'm fine. He does have diabetes but it is controlled.",
    "doctor_response": "Hello,I have gone through the details and understand the concern. It appears the food taken has probably caused the gastric problem, may be due to increased acidity and reflux. In a person with diabetes this kind of a condition can develop due to sluggish stomach. It is better if he takes a drug like Omeprazole with Domperidone. Plus stick to a bland diet for next few days, strict blood glucose control is also to be maintained, and should avoid smoking and alcohol.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Prabhakar Laxman Jathar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the red splotchy rashes that itches all over the body, hands, face and legs be the side effect of Amoxicillin as I am having a history of allergy to sufa and sulphur drugs?\n\nmy son is allergic to sufa and sulfur drugs and had a tooth pulled a week ago . the dentist put him on amoxicillin 500 miligrams 4 times a day, He just woke up with a red plotchy rash that itches all over his body, Hands, face, legs butt and warm areas.",
    "doctor_response": "Hi there,Thanks for your query.The rashes are nothing but allergic urticarial rashes, apparently due to amoxicillin. Ensure that amoxicillin is not prescribed in future to your son. Always tell his doctor about sulfa and amoxicillin allergy.A short course of an oral anti-histaminic drug, such as, Levoceterizine; and, oral steroid, such as, Prednisone, will cure the allergy.Consult your doctor and apprise him of my opinion. I am certain that he will agree with me and substitute amoxicillin with a safer antibiotic; and also prescribe anti-allergic drugs as advised.If you find my response helpful and informative, do not forget an \u201cexcellent\u201d (5-star rating)  to my answer, to ENCOURAGE ALL doctors- engaged in social service- to render sound advice to the FREE queries. Take careDr. Rakesh Karanwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does the itching in leg after injury means it s infected?\n\nHi, I recently stepped on a sharp (brand new/clean) blender blade. And I wasn t sure if I should go to the doctor. Cause the bleeding stopped, so I didn t think i needed stitches. Its been about 4 days since ive done it and constantly 24/7 my lower legs and everywhere on my feet constantly itch! It drives me nuts.. theres no rash or red marks where ive itched. Like theres nothing wrong.. but it itches like crazy.. most nights I cant even fall asleep cause it feels like I have severe poisin ivy! I cant walk on it still. And the wound kinda looks a little red around it. Does this mean that its infected? Causing it to itch so bad???",
    "doctor_response": "Your wound is unlikely to be infected as there is no pus or discharge from your wound. The itching that you are experiencing is because the wound is in the process of healing; granulation tissue is being formed which is causing the itching.Your injury was caused by stepping on a clean blender blade; despite this I would advise you to take the tetanus shot to be on the safer side.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have heavy bleeding after slimline copper IUD fitted. Normal or remove?\n\nHi, I had a TT380 Slimline copper iud fitted three weeks ago and have been bleeding quite heavily ever since. Is this normal? Will it ever stop? I am 37, height 5ft 5in, weight 10st 3pounds (not normal weight had first baby almost 5mths ago I am in the process of losing weight). I am in no pain just bleeding lots and not passing any clots. Any advice? Is it not suitable for me? Should I have it removed? Also due to have period next week.",
    "doctor_response": "Dear helbridle, The intrauterine device is by far the most suitable method for your age. Excessive bleeding is a side effect, but there is medical treatment. First of all you should exclude organic causes, the most important of which is displacement. This could be ruled out by a pelvic ultrasound, preferably transvaginal. If the IUD is in place, you may start medical treatment and there are many options, some of which are the following: - mefenamic acid 500 mg tid for 5 days and resume with the beginning of menses. - ibuprofen 600 mg once daily throughout menses. - tranexamic acid 1 gm qid for 5 days and resume with menses. Another option is to change this type by the progesterone medicated type. I hope these words were usefull and wish you the best of luck. Dr. Ahmed Bahaa.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and shortness of breath with low blood pressure?\n\nI m male, 51-years-old, 5 8 , and 230 pounds. I take 10 mg of lisinopril and 12.5 mg of coreg 1 x day. For the past week I ve been lightheaded and short of breath. My blood pressure reading 10 minutes ago was 118/72 and my resting heart rate was 111. Should I be concerned and go to the ER? I have an appointment with my doctor on Wednesday morning.",
    "doctor_response": "Hi welcome to healthcare magic,I understand your query and concern.Your symptoms are suggestive of heart failure secondary to ischemic changes in the heart.I advise you to get an ECG,2 D Echo,lipid profile,hsCRP immediately to confirm the diagnosis.Drugs like clopilet,ecosprin,atorvas ,inotropes like digoxin will be helpful.Coronary angiogram with or without stenting will be the procedure of choice.Consult your cardiologist for expert management.Hope I have answered your query at the moment,Post your further queries if any,Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the ways to treat disc desiccation with pain in leg?\n\nHello doctor, I have disc desiccation. There is a pain in my right leg while walking.",
    "doctor_response": "Hello, Welcome to iclinq.com. In Ayurvedic Panchakarma therapy, there is a procedure named kati basti, which is helpful in this problem and your treating Ayurvedic physician will also prescribe you oral medications while performing this procedure. It is a noninvasive procedure done with the help of medicated Ayurvedic oils. You can visit a nearby Ayurvedic hospital or Panchakarma center and ask for the details.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for itchy and swollen foreskin\n\nHi i have developed a bad rash on my penis' foreskin. It is swollen and itchy and looks like thrush. I am a college student and developed this 2 days after i had unprotected sex. 1st please help me stop this terrible itchy sensation and also a cure for the actual problem",
    "doctor_response": "HelloThanks for query.Based on the facts that you have posted I would state that you have acquired Fungal Infection of Foreskin due to unprotected sex .You need to take broad spectrum antibiotics like Cefixime and anti fungal medication like Fluconazole twice daily along with topical anti fungal cream like Candid cream for local application  over genital.Ensure to wash your genital with warm water twice daily Ensure not to get indulged in sexual activities till it gets cured completely.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes electric shock like sensations in the heart?\n\nHi I have electrical shock like sensations going into my heart while falling into sleep ... I dont have any anxiety related issues. It seems like a nerve thing that is shooting into my heart for a few secs and then nothing happens ... I also have swallowing difficulty and dizziness. I wonder if this has anything to do with my esophagus or stomach.",
    "doctor_response": "This may be atypical presentation of ischemic heart disease. Get ur EKG done with cardiac checkup. If cardiac investigations are normal, then think of esophagus or gi problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on the head after an accident\n\nHi, my husband is 38 and has had a lump on the front part of his head. He hit his head with a pile driver at work about 10 years ago. It s about the size of a quarter. Its raised up and moves around. It seems like some days it more raised up than others and he gets dizzy and has headaches. What could it be. Please help.",
    "doctor_response": "Hello and welcome to HCM,A lump in the head after a head injury can lead to symptoms like headache and dizziness.A head injury should be followed by CT scan because asymptomatic injuries can lead to blood clots and hemorrhage which be serious later on.Thus, I suggest you to get a CT scan of the head region for assessment and thus management.Consult your physician or preferable neuro-surgeon for clinical assessment and thus management.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is frequent collapsing in kids a cause for concern?\n\nHi, my 12 year old son is after falling from a chin up bar, he fell hard and says he banged his head off the wall, this was a half an hour ago, he is now feeling dizzy and shakey, he has falling twice now in the house, it appears that his legs are going from under him... What do you think I would do?",
    "doctor_response": "Hi...by what you quote I feel that he had a concussion of the brain due to the injury he has sustained. I suggest you take him to the nearest emergency room and get him evaluated by a physician.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with multiple PEs, blood level dropped, have phlegm. Taken warfarin. Dosage of blood thinner higher?\n\nHi two months ago I was diagnosed with multiple PEs and a few days ago my blood level dropped to 1.6 after begin in the 2 range for three weeks. The doctors upped my warfarin level of warfrin to 6mg instead of 4mg. I have been spitting up some phlegm with a tiny bit of blood the doctors said its probably because the dose of blood thinner is higher?",
    "doctor_response": "Hi,The blood in your phlegm is most likely secondary to the increased dose of warfarin. You should be having your INR checked regularly to make sure it is in the correct range. You should seek urgent medical advice and an INR check if you have significant bleeding such as dark stools, heavy nose bleeds, bright red blood in stools, blood in your urine or bleeding gums.Regards,Dr K A Pottinger,MBChB  FRCA",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will Aranesp shot help in getting hemoglobin and RBC higher?\n\nMy father is 85 years old with low Hemoglobin & low RBC. Extreme fatigue, lethargic and weak. He's had a colonoscopy, endoscopy, swallowed a camera (to take pics) and a bone marrow test. All came back with no sign of any cancer etc.  He was told bone marrow may get \"lazy\" with old age.  He had his 1st shot of Aranesp friday? Will this likely help in getting RBC and hemogloin higher?  He formerly walked 4 miles/day and did workouts 5 days/week (3 at fitness center and 2 at rehab from heart attack in 1996). Podiatrist told him to stop walking 3+ months ago due to small toe pain so I worry he's had muscles also atrophy.",
    "doctor_response": "Hello,aranesp is indicated for patients with anemia and chronic kidney disease (CKD) or malignancies. Your father seems to have none of them although at his age CKD is possible. Aranesp increases the bone marrow production and may indeed help in increasing the hemoglobin and hematocrit if sufficient iron stores are present. The reason that the official indications are the ones I've mentioned is that its utility is doubtful in other situations (like most cases of the myelodysplastic syndrome for example or anemia of frailty). So the answer is that it may help or it may not! According to the information you've provided You'll have to judge by the results. Do not expect much though...I hope I've helped!Kind Regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a red scar and extra skin at my urethral opening. What has to be done?\n\nHello doctor, A few weeks ago, a red or pink scar and extra skin showed up at my urethral or where the pee comes out. What has to be done? Currently, I am taking Monistat 7 and had a yeast infection previously.",
    "doctor_response": "Hi. I have gone through your query. I would like to know a few more details as follows: From the images (attachment removed to protect patient identity), it appears to be a slight prolapse of the urethral mucosa. However, a clinical examination is necessary to confirm. The reason is just inflamed, hypertrophic mucosa that is probably protruding out. If it is asymptomatic, then there is no cause for concern and should resolve once the yeast infection settles.  For more information consult an urologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to conceive with a cyst in ovary?\n\nHi,I m taking ovral G from my last LMP on 21 march from 5th day.my docter told there is cyst in ovary.I m trying to get pragnant.How is this possible I m 25yr old hight 5.3,weight 55kg.no medical history.due to stress my periods are irregular from last month",
    "doctor_response": "Hello,What is the size of the cyst? In next cycle, on day 2 if there is a cyst do serum estradiol level then do serum TSH and serum prolactin, take Letrozole or Clomiphene with gonadotropins until follicle size increases to 18 mm do follicular study after that do IUI.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sheetal Agarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe sensitivity in left hand index finger?\n\nthe tip of the index finger of my left hand (I am right-handed) has been overly sensitive to pressure. When I use my hand normally, my fingertip feels like I hit it with a hammer. When I rest my hand, the pain subsides in about an hour. I ve also been waking up with pain in this finger. It feels slighty warm and I can see a very faint, small, light red mark under the skin of the side of the fingertip. I don t recall injuring or over-using my hand or fingers recently",
    "doctor_response": "hithank-you for providing the brief history of you.As you mentioned that pain is in the index finger a thorough neuromuscular assessment is needed.Now to understand this, that the pain is triggered on activity and subsides on relaxing. As you mentioned the nature of the pain is sharp in nature on the tips, what are the other associated symptoms along with the pain. Like any kind of numbness or the pain is just restricted to one location and of one kind.to assess further, are you a high computer usage person? or a high smartphone usage person? any injury or skin color changes in the painful area, are the nail beds intact?Since it is totally a sensroy symptom, we need to assess two things here. One is to assess the nerve with Nerve conduction velocity test and the other is the MRI of the cervical spine.Nerve conduction study will help assess the course of the nerve and it's functioning also any carpal tunnel compression is present will be revealed.Incase this test is negative than an MRI of the cervical spine is guided to see the soft tissues compression on the nerve roots.Also, how is your motor functions of the strength. Is there any difference in the strength of both the hands? if so than a musculoskeletal assessment will help further. Now since it is a sensory issues of the radial nerve, as radial nerve supplies the index finger and control the motor and sensroy functions of it, assessment done in detail will help come close to diagnosis and guide for further rehabilitation plan.with the grace of God I wish you a speedy recoveryregardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest a remedy for severe pain in receded gums post dental implant\n\nAfter implants  I am having severe pain where gum meets  bone. My gums have receded a lot. The new crowns look awful. They curve out. The implant I had at the end of last year looks like it is growing on a stalk!  Thus week they are removing  three crowns and making new ones, I am so scared this will not solve problem. I take pain killers like smarties? Any ideas",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain it seems that you are suffering from Peri-Implantitis  that is infection and inflammation around the implants leading to destruction to soft tissues as well as bone..Therefore recession of gums and bone destruction is evident..At times proper debridement of the damaged tissues and maintaining proper hygiene by doing antiseptic mouthwash gargles and proper brushing can help..In case if there is excess loss of bone then crowns aa well as Implant needs removal and bone grafts might be required..Consult an expert Implantologist and get proper evaluation and x rays done and after a second clinical examination only you should proceed with treatment..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be the reason for lump in the crevice of the large labia?\n\nI am a 53 yr old female, haven't been sexually active for over 5 years and I have a swollen \"bulb\" like area in the crevice of the large labia.  The whole left side of my groin is tender and I have an area on my left thigh that is sensitive to the touch.  what could be the cause of this...Oh, I am the mother of 5 children",
    "doctor_response": "Hi,From history it seems that you might be having infected Bartholin gland cyst giving this problem.due to this infection tthere might be having enlarged, tender inguinal lymph nodes giving troublr in the groin.Consult Gynaec and get examined.Keep local hygiene proper.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure itchy skin between anus and scrotal?\n\nI am undergoing treatment for intertrigo for last 3 months the rashes seems to go down however recently I have developed intch on the skin between anus and scrotal and also my scrotal skin has gone red. This creates problem when I sit for a longer time as it hurts. the itchness increases in night and the skin swetas a lot in the night.Could you please advice. I have been applying sertconzole cream for the intertrigo and applying cotrimazole powder to avoid sweating.",
    "doctor_response": "It depends on cause:An antifungal cream will clear fungal infections and thrush.Antibiotics may help with certain other types of infection.Anal conditions such as piles (haemorrhoids) or anal fissure may need treatment.A medicine can clear threadworms if they are the cause.Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intermittent chest pain?\n\nI have lupus, and I frequently have chest pain on my left side, kind of high up  just above left breast. I also have a hard time taking deep breaths, both with this pain and without, intermittently. All the research i've done leads me to beleive it's not my heart but I would just like some feed back on this issue.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Lupus can affect lungs and heart. In lungs, it can cause pulmonary embolism, pulmonary infarction, lung infection, bronchitis etc. And all these can cause cough, chest pain and breathing difficulty. Similarly, Lupus can cause heart diseases like pericarditis, myocarditis, angina etc. All these can also cause similar kind of symptoms. So we need to investigate for both the systems (lungs and heart). So get done ecg and 2d echo to rule out heart diseases. Get done chest x ray, PFT (pulmonary function test) and CT thorax to rule out lung causes. So better to first diagnose your self and then start appropriate treatment.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes palpitations while on beta blocker?\n\nI have been taking a beta-blocker for six months.  I began having sever palpitations in late June (>5,300 in a 24 hr. period).  They did many heart tests and my heart is not the problem.   My thyroid blood tests were normal as was an adrenal test.  I still get the palpitations, but they are manageable while I am on this medication.  Now I am getting goosebumps!  From my head to my toes several/many times per day.  Even while I am covered up in bed and not chilly!",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Since you are on beta blocker, heart related diseases are unlikely to be cause such symptoms. Sometimes, undiagnosed stress, anxiety and panic disorder can cause similar symptoms. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need additional anxiolytic drugs too. Don't worry, with counseling an drugs, you will be alright. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for communication disorder\n\ndear mam, am not able to converse with anyone properly.. am highly anxious .. am lacking that basic thing to speak to anyone properly.. am highly depressed because of that and avoiding people and staying alone all the time even am not able to speak to my servant properly.. people say that the way am looking at them is scary and my eyes are like starring  at them.. so please help me how can i speak properly and fluently without any hinderance as everyone speaks normally?",
    "doctor_response": "HelloYou have problem of anxiety and stress on talking to any one. You are not able to speak and converse properly. This is causing significant distress and you have started avoiding people. You have to stay alone at home most of the times due to this problem. From available history I can conclude that most likely you have Social Phobia Disorder. This is a type of anxiety disorder and individuals have difficulty in conversing and they can't speak in public and on presentations. On severe cases they can't even move out of home because of fear of embarrassment.Consult a Psychiatrist for management of this disorder. Medicines like SSRI anti depressants as Sertraline, Escitalopram, Fluoxetinet etc are commonly used in this disorder. Other medicines like Propranolol are also useful. This drug helps in improving anxiety before some important event.  Behavior therapy and assertive training by a Psychologist is also used as one f treatment modality.Thanks, hope this helps you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be worried about the pain and lump on the hip after a fall?\n\nFemale, age 60, with osteopenia. I fell on hip 3 weeks ago and after about 3 days the bruise showed with little pain except to the touch. Now bruise is gone but hip has more pain with lump at the previous bruise site. Is this normal? The pain seems to be radiating from inside out. Maybe I should not have gone dancing or continued with exercise. At what point should I go to the doctor? Thanks, T. T.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. In my opinion you should immediately consult orthopedic doctor and get done 1. Clinical examination of hip joint 2. X ray of hip joint. Since you had fall 3 weeks back and having gradually increasing swelling and pain, possibility of fracture is more. So don't wait at home. Consult orthopedic doctor and rule out fracture. You may need painkiller and anti inflammatory drugs with immobilization. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shooting pain and crack sound when eating?\n\ni had a operation on thurs b4 good friday were my lower 6 tooth wes removed as a shadow was locatated od my jaw when investigated ing was found since then ive had a numb mouth after a check up when all was fine it has been hurting like the mad and the pain has been getting worse to the extent sunday i could hardly eat then on monday night i went 2 eat some bread my jaw made a loud crack followed by shooting pains i went 2 casualty they xrayed it said it wasnt broken and gave me painkillers the pain is getting worse and painkillers dont seem to help also i cant eat and can hardly swollow to drink and its excruiatingly painful an y advice",
    "doctor_response": "Well if x rays sound normal than u probably got an infected extraction socket wch is called as dry socket.go c ur dentist.medication along with a sedative dressing will cure u",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for having stomach pain every day?\n\nMy brother is 69 and is suffering from severe stomach pain every day. He has been tested for it and the doctors can not find the cause.  They have prescribed medications but the meds only help him for a short period of time and then the pains are back.  What do you think?",
    "doctor_response": "Hi.I would have been happy to know the exact site of pain and any associated other symptoms too; like vomiting/ constipation/ jaundice and so on. Please attach any reports done till now.Everyday pain can be due to many factors like pancreatitis , gall stones, gastric ulcers, internal herniation, may be a mas in abdomen and so on.Go for CT scan of the abdomen if not done yet.Consultation with a Gastroenterologist is needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I took contraceptive pill after unprotected sex. Will I get pregnant?\n\nHello doctor, Last week, one night, I had unprotected sex twice with my fiance. The next night, I took Escapelle on a full stomach. After two days, I was experiencing cramps and I had noticed a white discharge with a mild scent. This carried on until today. After each meal, I felt extremely nauseous, emotional and tired. Now, I have started spotting and I am feeling extremely nauseous followed by cramps. Is it possible that I could be pregnant even though I took the pill? This is the fifth time I am using Escapelle within seven months.",
    "doctor_response": "Hi. The morning after pills are large dose Progesterone and they can cause irregularity or delay of periods. You have been taking it too frequently and it is not advisable. You should better use condoms as they protect not only against pregnancy but also prevent sexually transmitted diseases. The chances of getting pregnant are less in your case but still, you should go for a pregnancy test after two weeks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for loss of consciousness and presence of mind\n\nI'm 52 years old and working as a Manager in UBI but these days i'm feeling very low in terms of conciousness and presence of mind. I too have a problems with my stomach but the tests conducted shows nothing much serious. Though i don't have to do a certain level of hard work or efforts but still these days i'm feeling very tensed and unstability on my thoughts which makes me to lower the desire of living my life.",
    "doctor_response": "HelloYou are a middle aged male and you are having symptoms like low concentration, multiple complaints related to stomach. You feel tensed through out the day and you have negative feeling towards life. See from your summary it appears that either you are having some form of anxiety disorder or depressive disorder. The problem in stomach may be the part of depression with somatic symptoms or it may be due to irritable bowel syndrome. Low desire further aggravates it. Consider to consult a psychiatrist for expert opinion. Medicines like anti-depressants and psychological treatment in from of cognitive therapy can help to improve the condition. thanks, hope this helps you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from burning sensation on the feet for three days. Kindly advice.\n\nHello doctor,I have a burning sensation on the feet for three days. I am currently under Clonazepam.",
    "doctor_response": "Hello. Causes of burning feet include peripheral neuropathy and plantar fasciitis. I suggest you use footwear even at home and take over-the-counter pain medications to alleviate pain. You may also use Diclofenac gel for local application. If the symptoms do not subside over one month, please get electroneuromyography of the lower limbs to look for nerve involvement.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is meaning of expiry dates on copper t pack?\n\nIn Copper T pack expiry dates are written. SO may i know which part of cu t device gets expired  because in some pack Mfg and exp date gap will beof just 2-3 years but the cu t is of 5-10 yrs of duration. So bit confused what is the significance of exp date and which part get expired. Dr Paras.",
    "doctor_response": "hi,you have to see the expiry date before insertion.it should not be beyond the expiry date at the time of insertion as the duration of efficacy is much longer.all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dry cough for years. On asthma treatment. No improvement. Something wrong with the larynx?\n\nI am currently being seen by my regular dr. I have had a persisten dry cough for years and it is getting worse. She has started me on a shtmah treatment which IO have never had before -Montelukatst 10 mg pill daily, Pantoprazole 40 mg twice a day, Flonase nasal spray teice a day, Qvar 80 inhaler twice a day and Abutural inhaler as needed. Cough not getting any better actually worse. Uncontroled coughing fits pf 30-60 minutes--seems to be keyed by when I sing in church talk on the phone. Could it be something in my larynyx?",
    "doctor_response": "Hi friend, Welcome to Health Care Magic Long duration cough is an indication for X-ray Chest (may be a CT scan) and Spirometry (Lung Function Test).  You should see a Pulmonologist. Larynx is less likely - you will have hoarseness by now. Take care Wishing speedy recovery God bless Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can you please advise me if my semen analysis is normal?\n\ncan you please advise me if my Semen analysis is normal or not? and can i get a baby? volume :4.5 ml coulour :Gray PH :8 liquefaction:15 viscosity:slightly viscous sperm count: 27.2 mill/ml total sperm count: 122.4 mill WBC :0.1 mill/ml agglutination:not seen cellular debris :present Motile:35% sluggish:15 % immotile: 50 % normal shape:79 % thanks,",
    "doctor_response": "Dear customer, As per the reference normal range of semen analysis you fall within the normal sperm count and morphology so you should NOT worry and can bear as a father. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in upper lip?\n\nGood morning.  I woke up to some nasal congestion as I have been sick with a cold for over a week.  As my sinuses were clearing I noticed a tender \"pop\" or \"snap\" like feeling.  My upper lip, right side, is now swollen and numb, as if I have received a lidocaine injection for dental work.  Should I be concerened?",
    "doctor_response": "thanks for your query, i have gone through your question. the lip swelling could be secondary to the tooth or , take care.um infection resulting in pus formation causing cellulitis or it can be allergic reaction to some drug or food items. the local anesthesia effect will be there for 1 hour after injection during that that time lip will be numb and you will be feeling like its swollen but it will not be swollen. consult a oral physician to rule out these two. if im your treating doctor i would have prescribesd a course of antibiotics and analgesics along with a antihistamine. i hope my answer will help you",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat bruise on the right of lower tummy?\n\nHi,my 7 years old daughter has two bruises in lower tummy,on left and right side.each around 1,5 inch big,dark red ,blue colour.Just find out yesterday.I seen it os same place weeks ago but much smaller and just light brown.i think it was from fast growing but now I am worried.What do you think it could be,please?",
    "doctor_response": "Thank you for asking question.First of all find out if she had any trauma.If not then consult your doctor and get cbc coagulation profile done as it coulx bd start of bleeding disorder.Hope you find this useful.Rate the above answer if you like it.Regards,Dr rushikesh kute",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are side effects of valparin 200ml (if any)?\n\nWe are using this Valparin 200ml syrup for fitz complaint. My son is very speed in all his activities but some times he was fell in like unconsious. After long sleep he got up and normal with tired. Is this any indication of any side effect please help me.",
    "doctor_response": "Hello, Valparin is used to control your son's seizures. If he still falling unconscious his fits are not controlled. He may sleep more with Valparin but becoming unconscious is not a side effect. Please contact his doctor, he may need a change in the dose or an additional medicine. Do get back to me if you have further questions. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Noble Zachariah, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to ascertain the real father of the child?\n\nhey can you help me to get an idea of the father of my baby please? i did not find out i was pregnant until i was 20 weeks at this point i had an ultrasound. according to my 20 week scan i am due on the 4 of november. i was having regular sex with my partner until about the 12th of feb. we broke up and i had sex with someone else around the 9th of march.. i have no idea when my LMP was and i just need sort of an idea before i go crazy im aware of paternity testing but i just need an idea to ease my mind! please help",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic.I have gone through your query. I think I have understood your concern, I will try to suggest you the best possible treatment options.1] As per 20 weeks scan, and due date of 4th November, LMP will be around 28th January or so.2] In that case, tour fertile period will be falling somewhere around 6 to 16th of february. This calculation will help you ease out your worry.3] A word of caution -- please have safe and protected sex with trusted partner to avoid STDs.I hope my answer helps you.Thanks.Wish you good health.With regardsDr Purushottam",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump under the skin?\n\nI fell about a month ago. Blunt truama to inner left thigh with cement edge of pool . I had a large bruise , but started taking aspirin 2 daily one in am one in pm bruise cleared up after a week. Now I have a small lump under the kin (not suprficial) and some tenderness . No redness , no fever . If seroma has developed what should I do ?",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern.  Your lump may be due to hardening of your oedema. No need to worry. No any treatment is required.  Just ice massage or hot water massage is enough It will regress slowly.  Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is lumbar puncture a treatment that helps to get relief from chronic lymphocytic leukemia?\n\nI was diagnosed with CLL back in 2009 and my blood levels are being monitored closely at which chemo is not something my Dr feels is in my best interest right now. Recently I had a spinal tap done due to jabbing pains in my right temple every time I bend, cough or sneeze. I was just told the other day that I need to get another spinal tap as there were some abnormal cells found in the first test. My friends tell me that its probably my leukemia and that I have nothing to worry about. Are my friends right or are there other possibilities of a more serious condition and if so what are they.",
    "doctor_response": "Hello, Generally, several chemotherapy drugs are combined to help prevent leukemia cells from developing drug resistance. Maintenance Therapy. The third phase of ALL treatment is called \u201cmaintenance\u201d. The goal of maintenance therapy is to prevent disease relapse after induction and consolidation therapy. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Esmeralda Sera, Oncologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can having unprotected sex followed by intake of pill cause pregnancy?\n\ni had sex with my girlfriend before 4 days of her period time...She is virgin that's why i can not f..k her properly because of her pain...and our sex is not finished properly...but i gave her unwanted 72 within 48 hours of our incomplete sex...her regular time period  is 20june approx..i gave her this tablet on 18june and today is 23june but still she is not on date..I worried???If she got pregnant??? Plz...rep...help me...",
    "doctor_response": "hello...thanks for trusting the health care magic doctors for ur health related issues.first of all I want to tell you that . Relax.. nothing to worry. your girlfriend in safer side because u had already gave her unwanted 72 within right time, for that I m appreciating you.second thing is that u had sex during safe period in her menstrual cycle.so don't worry.. relax. pregnancy couldn't happen in ur situation. sometimes period will delay after sex due some hormonal effects in the body.good luck..feel free to ask for further queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can severe enamel dysplasia cause major heart issues?\n\nMy son has severe enamel dysplasia. He was brushing his teeth and his front tooth broke off at the gum line. This is more than just a cosmetic issue and it effects all of his teeth. His teeth seems to be rotting away, even though he brushes and eats a healthy diet. My nephew also had the condition and had to have all of his teeth pulled at age 17. His pediatrician said the severity of his enamel dysplasia could cause major health issues, namely with hiws heart if it wasn't taken care of. is this true?",
    "doctor_response": "Hello,I would think the pediatrician is warning  you that there is a high risk  of infection without the shield of strong enamel. Decay can advance quickly in the dentin layer. Once into the pulp, bacteria has a chance to travel in the blood stream. Describing a 17 year old needing to pull teeth is a very severe situation. Placement of bonding or crowns to replace enamel and protect the teeth might be an option. If the recurrent decay rate is high, continued restorative care may be problem better treated with extractions and implants placed. If the condition is part of a syndrome with other organs affected or deficiencies, then treatment of or inability to treat the condition would affect dental treatment choice options.I hope this is helpful. I am glad to answer additional question if you have additional details to provide or more questions. Thank you for your inquiry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood in urine every time I do urine test?\n\nHi i am 50 years old and every time I have a urine test done I am told their is blood in my urine what could be the cause of this?. The last Dr I went to has ordered a scan of my kidneys , was a different Dr than my normal Dr and she seemed quite concerned . I am female",
    "doctor_response": "It could be stone, inflammation or something serious like cancer. I agree with the scan , but also get  a scope of your bladder performed so they can see inside. Please rate 5 stars! I strive to provide you with the best answer possible!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have pancreatic cancer. Will chemotherapy prolong life expectancy?\n\nHi Doctor My auntie is diagnosed with pancreas cancer, advanced stage. She is 60 years old, the doctor recommended chemo for her but mentioned that there is only a 10-15% chance to shrink and chemo is the solution to prolong her life. I would like to know if she should really go ahead with the chemo? I do not think it will prolong her life and instead I would think she may not be able to take it. Hope to receive yr advice soon. Thank you",
    "doctor_response": "Hello, As with many other types of cancer, the outcome of pancreatic cancer depends on how advanced your cancer is when it is diagnosed. Overall, pancreatic cancer has a poor prognosis.\u00a0Of all those people diagnosed with pancreatic cancer, only 20% are alive 1 year later. Sadly, only about 5 % live \u00a0for 5 years after diagnosis. For people diagnosed with locally advanced disease, which cannot be removed by an operation, the average life expectancy is about 7 months. For people whose cancer has already spread to another part of their body, the average life expectancy is only a few months. But all these are statistics and a person may live more beyond expectation but one must receive the chemotherapy,no matter what the prognosis says.It definitely prolongs the life.One should not be denied the due treatment. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes depression while taking femara for breast cancer?\n\nI have stage 1 breast cancer, non invasive of lymph nodes, had surgery to remove cells, followed by radiation. Now on Femara for about a month. I am 78 years old but been very active, ballroom dancing and competitions. I seem to have a sense of desperation, maybe just depression. I can t decide if it is just a normal reaction to all I have been through or the Femara that I have been taking. Lost interest in dancing and really uncomfortable around other people. Will see my doctor in about a week, do you advise trying another form of the pill I am taking?",
    "doctor_response": "hi.just continue taking in your medications for now. tell the things you're experiencing right now when you do your follow-up. also, a psychiatric/psychologic consult might be of help if available.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting after taking a feed in an infant?\n\nmy baby is 2 months old. He use to take out milk (bit dry) after taking the feed. Took him to the doctor and he gave Lanzol medicine ( 1 tab in 3 days). After having the med the child started taking out more milk in liquid form.The child has taken medicine for 10 days now. Is it beacuse of medicine this is hapening",
    "doctor_response": "Hi...this is not due to the medicine. Lanzol actually helps in such condition. By what you quote I feel that the infant is having severe form of GER (gastroesophageal reflux). Your kid will need - 1. Antireflux therapy - Proton pump inhibitors + antiemetics2. Always make him lie down in a propped up position - as in the care seat. He should not be sleeping completely flatly.3. Avoid heavy feeding and feeding more times and in small aliquots.He needs expert gastroenterology consultation.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a stuck syringe in the gums\n\ni  got a xray today,to check for a dentist syringe that the dentist said he broke off 1974 ,i took a stroke 2001 just make sure .the clot 4.5 by5.5.the xray  was neg.but mri say different.by the way the dental syringe is 4.57.should i get another mri?",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain it seems that you have broken needle struck into your gums due to breakage while anaesthesia injection that is being shown in your MRI..You should not go for MRI Scan again and consult an Oral Surgeon and get evaluated along with a close examination of your MRI..The removal of  the broken tip of needle is a a must from the tissues as it can act as a foreign body and can cause severe inflammation that can cause swelling and pain..Surgical removal of the same has to be done followed by a course of antibiotics and painkillers..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I just received the answer to my first question from Dr. Praveen Tayal and had one more related question to ask in light of his answer. Are you saying that I could possibly have vascular dementia if the lesions are responsible for memory impairment.Are small vessel ischemic changes the same as having lesions? I forgot to mention that my cholesterol was high and I was put on Crestor which has helped considerably.Thank you in advance. It is not my understanding that I pay for the second question and I keep getting directed to the Pay page!!",
    "doctor_response": "Vascular dementia can be caused by both infarcts of big size and by microangiopathic changes. You are also having high cholesterol which is a risk factor. Kindly visit a neurologist for starting of donepezil or memantine which help as cognitive enhancers.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe knee pain\n\ni have woken up today with quite severe knee pain. I was flying yesturday on a 7 hour flight and today am in quite a lot of pain in my right knee. I am struggling to walk or climb stairs and feel like my leg will collapse under me at any point. Can you help. I suffered with growing pains in my knees when i was a teenager. I exercise although not too much as if i run too much without at least a days break between then my knees also hurt. I sometimes hear a cracking noise from my knees when i stand after sitting down although this is not painful",
    "doctor_response": "Hi,Knee pain could be due to any ligament, tendon, meniscus injury or auto immune / inflammatory condition like arthritis etc. But the one with cracking or popping sounds in or around the knee joints could be a sign of emerging osteoarthritis. With this feature, age, gender, weight should also be considered as it might increase the risk of arthritis. I advise you to:- Do X-ray both knees- Analgesics like Tab. Ibuprofen or Aceclofenac + Ice pack  + Regular exercises- Intra-articular gluco-corticoids if pain and swelling persists even after using analgesics- Chrondro-protective agents twice daily- If chronic pain, then short wave diathermy can be done Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Yogapriya Vasudevan, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How soon will you get the symptoms of pregnancy after having intercourse ?\n\nHow soon will you get the sign and symptoms of pregnancy?. Will constipation starts on the first week of pregnancy? And will the Dr. do an internal U/S during pregnancy?.",
    "doctor_response": "Hi Priscilla,welcome to HCM. Earliest you can suspect of pregnancy is when you miss your regular period. Earliest way to detect pregnancy is by serum B HCG test. One week later it becomes  detectable by urine pregnancy test. These tests detect pregnancy much before you start having symptoms of pregnancy.Constipation is not a sign of pregnancy. Internal ultra sound is done in the first three months of pregnancy, after that generally it is done transabdominally.Wishing you all the best and hope you are pregnant.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Six year old daughter having intermittent periumbilical pain with fever, diarrhea. Could it be due to appendicitis?\n\nMy six year old daughter started to complain of intermittent periumbilical pain approx 3 weeks ago. She awoke abruptly in the middle of the night with severe abdominal pain and fever. Within a couple hours the pain was gone and the fever was gone later that day. Since then she has had intermittent periumbilical pain. Nothing seems to relieve or worsen the pain. She started in yesterday with pain again and diarrhea . She has had 4-5 episodes of diarrhea. No blood in stools . No nausea/ vomiting . She is running a low grade fever today, however she did just get over a viral URI approx 2 days ago...but hasn t ran a fever for two days. I m unsure if this could be appendix, intestinal issue, or what other etiology. Do you have any advice? Thanks!",
    "doctor_response": "Hi Rachy, Thanks for writing your query. After reading your post, it seems that your daughter is having some infection in intestine leading to pain in abdomen, fever and diarrhoea. You can send her stool for examination. She should be treated with antispasmodic like dicycloverine , antacid like omeprazole, probiotic  and antibiotic according to the report of the stool investigation. Paracetamol can be given for fever. She should be given any medicines after getting her medically examined by her Paeditrician. Give her light diet with less spice and oil for few days until her stool is normal. Her pain doesnot seems to be due to appendix as the appendicitis pain is more towards right side of umblicus. I hope this is helpful to you. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from stomach pain but all the reports are normal. Can it be stomach cancer ?\n\nI have stomach pain in the upper part. I had a heavy feeling initially about two years back , now i can feel the pain very often. I have done two times endoscopy , 2 normal scans one normal x-ray and even one MRI scanning . results are normal. BUt i still feel the pain . I now for sure its not a gas problem . I have a feeling that it might be a ulcer or stomach cancer . PLease suggest me a cheap and best hospital where i can undergo stomach cancer diagnosis",
    "doctor_response": "Hi Welcome To HelathcareMagic forum. Since you have already done few tests in which endoscopy is one among them, it is good enough to diagnose an ulcer or cancerous changes, a biopsy would be generally done when they do endoscopy. I would suggest an ECG  also, if not done get it done for a good hospital, can we know your in which place? Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest herbal treatment for anxiety and depression\n\nWHAT ARE THE BEST HERBAL PRODUCTS TO HELP WITH ANXIETY AND DEPRESSION. I AM JUST GETTING INTO THE STUDY OF ALTERNATIVE TREATMENT FOR THIS ISSUE. I HAVE BEEN READING A LOT OF INFO OUT THERE, BUT WHO EVEN KNOWS IF IT IS ACCURATE OR HYPE FOR SELLING THEIR PRODUCT. i RECENTLY RAN INTO A PRODUCT CALLED RED CALM WHICH CONTAINS SEVERAL NATURAL PRODUCTS SUCH AS Ashwagandha root, L-Theanine, Passiflora extract(PASSION FRUIT?), 5-hydroxytryptophan (5-HTP), AND LEMON BALM, WHAT IS YOUR KNOWLEDGE OF THESES HERBALS?",
    "doctor_response": "Hi.  Great question.  There are quite a few herbs that function as well if not better than prescription medication.  The first is St. Johns Wort that you've probably heard of.  It increases serotonin in the brain as do the SSRI's (prescription medication) with fewer side effects. It is effective for both depression and anxiety but can interact w some prescription medications so I would ask your physician.  Other herbs include passionflower, gingko biloba (also helps w memory but has a positive serotonergic effect), vitamin D, magnesium, and passionflower to name a few.  These are generally safe and effective.  Kava is as effective as xanax or ativan however there have been rare cases of severe liver disease with it, so I would not recommend it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could tailbone pain be a result of spondylotic changes?\n\nI am having terrible tailbone pain, did x-ray of ls spine it showed some spondylytic changes. So was told to do MRI of lumbosacral spine but the report is normal. What exactly is the reason of that severe pain and if the MRI report is normal, then how to find out the cause",
    "doctor_response": "Hello, Thanks for your query.Tailbone pain could be a result of spondylotic changes.Cure for your coccyx pain-1.Use a well-padded seat when sitting and avoid long periods of sitting when possible.2.Do sitz bath- take warm water in a tub and sit in this.It will relax the muscles around the coccyx.3.Do exercises that will strengthen your tailbone's supporting muscles and stretch ligaments near the pain. Consult a physiotherapist for this. Therapists may perform a combination of:Levator ani massage and Levator ani stretching.4.Correct your posture. Poor posture may be contributing to your tailbone pain. Try to sit upright. If you get a sharp pain when getting up from a sitting position, lean forward and arch your back before rising.5.You can take anti -inflammatory drugs like Tablet Motrin 1 tablet as and when required ( do not repeat a dose before 6 hours) with food will help relieve the pain.6.Apply diclofenac gel on the affected area.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cough with phlegm\n\ni have had a persistent cough for 2 years which feels sometimes like theres phleum but nothing comes up. Constant feeling to have to clear my throat. Also shortness of breath and have had chest xrays allergy shots and operation last october to coterize my terbinites (in nose) please help!! Cannot deal with this feeling anymore!",
    "doctor_response": "Hi and thank you for choosing HCM to post your question.I read carefully your question and my opinion is as follows:Your chronic cough,constant feeling to clear the throat and the operation in nose,all these are compatible with the clinical picture of upper airway cough syndrome caused by rhinosinusitis.After avoidance measures of potential environmental factors(fumes,allergens),an empiric course of a first generation antihistamine(like chlorpheniramine),combined with a decongesant (such as oxymetazoline)is typically recomended .Newer antihistamines like loratadine,desloratadine,ect may help in allergic rhinosinusitis but not other forms of rhinosinusitis.Inhaled nasal decongestants should be used no more than 5 days to avoid rhinitis medicamentosa.I hope my opinion can be helpful.Wish you good health.Kind regardsDr.Dushi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest diet for lactose intolerant kid\n\ni have a ? my daughter is lactose intarent sorry i cant spell um i dont no what i can do about food choices at the store that doesent have diry in them im so lost i dont wanna give up hope what do i do shes in pain in her stomach every time she has any food tht has any hidden dairy dont no what to do",
    "doctor_response": "Thanks for putting up your query at HealthCareMagic. I understand the cause of your concern but you have not mentioned the age of the child and that would have been important.The dietary changes for lactose intolerance should initially include the exclusion of those foods rich in lactose. If the symptoms resolve then small amounts of lactose containing foods may be reintroduced, and symptoms monitored. Most people will be able to determine their tolerance level for lactose. Very rarely people may be so sensitive that they will need to exclude foods with lower levels of lactose including biscuits, cakes and other processed foods. It is important to find a suitable replacement if important foods are excluded from the diet. The lactose content of dairy foods varies widely, as do the serving sizes consumed. Breast feeding need not be stopped unless the baby has severe problems with it. Being lactose intolerant is not the same as having milk allergy, which is a more serious problem affecting a much smaller portion of the population. Had I known the age of the child, I could have commented better but the following food can be given if age appropriate:* Spinach* Canned salmon or sardines with bones* Calcium-fortified orange juice* Raw broccoli* Canned white tuna* Calcium-fortified soy milk* Dark green leafy vegetables* AlmondsA guide to a healthy lactose free/low lactose eating planBreakfast:A bowl of high fibre cereal such as weetbix or porridge with fresh fruit and soy or low lactose milk (if tolerated ) and/or wholemeal or grain toast with milk free margarine e.g. Sundew and honey or vegemite. Tea or coffee with soy or low lactose milk.Lunch:Sandwiches made with wholemeal bread with lean beef, tinned fish such as salmon (include the bones for calcium) and salad. Milk free margarine if necessary. Tinned or fresh fruit. Water, tea, diluted juice or cappuccino made with soy milk.Main Meal:Water with lemon juice. Chicken and vegetable stir fry served with steamed rice. Fruit and Fruccio dairy free ice cream, or custard made on soy or low lactose milk.Snacks:Fresh fruit, crackers or microwaved pappadums with salsa, popcorn. Toasted fruit loaf with milk free margarine and. Water, juice, tea, coffee or hot chocolate made from cocoa and soy milk.I hope that helps. Feel free to revert back with further queries if any.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen and bruised chin\n\nMy chin is bruised and swollen with a blood line in my gums running below my bottom, front teeth from an accident where a box struck my head forcing my jaw to slam my top and bottom teeth together. How do you know if you have a fractured jaw and should I be concerned about the blood line in my gums?",
    "doctor_response": "U have sustained direct injury to ur chin n jaws and ur gums r bleeding. There is possibility of tooth avulesions or jaw #.  Better go n meet OROMAXILLOFACIAL SURGEON  and take OPG (ORTHOPANTOMOGRAM) to rule out these things",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cheek bone hard to touch, bump on forehead. Taken benadryl? Had an allergic reaction? What is going on?\n\nMy husband woke up two days ago with his one upper cheek bone hard to the touch.  Yesterday it spread to his forehead and under his eye.  He has a bumb about the size of a quarter on his forehead.  Thinking it was an allergic reaction to something he took Benadryl which did not relieve the swelling.  This morning it's worse and painful.  It is also warm to the touch.  He does have seasonal allergies.  Any thoughts as to what this might be?",
    "doctor_response": "it mihjt b any thingchange of season very cild and very hot temperatures increses the allergiesyou have to maintain temp between 25 to 49 degrs of external environmental and foods you take in these temp tyou are confirtableget allergy dignosed to find out the causetake allegra 120 mg morning and ebastine 10 mg nightapply clindamycin gel mixed with mometasone on affected area bdtake for 3 wk",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Prescribed Clomid, Fertomid and folic acid. Chances of conceiving?\n\nHi am 24years and my husband and I have been trying to conceive our first child for a year and a half now without any success. I went to the doctor a month before and he prescribed clomid for 5 days, I lost one tablet and took 4 tablets 1 a day and it didn t work, he said i should take it from day 5-9. I went back and he gave me another cycle for fertomid he says I should take it from day 3-7 and he put me on folic acid too 1 tablet a day. I am afraid it won t work second time around, what are the chances of me conceiving this time around?",
    "doctor_response": "Hi, Thanks for your query. I read your query and understand your concerns. Following is my reply: Clomid is given to increase the follicular size. It doesnot guarantee the pregnancy. Folic acid is to support pregnancy in case if it occurs. I suggest you do following test: 1) HSG to check your tubal patency. 2) semen analysis of your husband. 3) Regular follicular growth scan to see follicular growth. I hope I answered your query. I will be available for any follow up queries you have. Regards, Dr.Mahesh Koregol IVF & Infertility Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump in the armpit causing severe pain in breast?\n\ns ept had melanoma clarks level 4 had surgery wide margins and 7lymph nodes removed.   now in dec, i would say, ihave been having tremendous pain in my right breast abd undrarm  also the is now a very decent size lump in my armpit and let me tell you it hurts\"  i had an mri done and they say there is a hot spot look on the mri where they marked my armpit. suggest to get a needle biopsy. i may say that the lump has grown and is hard and hurt,  the pain now sometomes radiates down my are, i amd also feeling very depressed! thoughts?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have enlarged lymphnode with history of melanoma.  Your MRI also shows hot spot.  You may have metastatic malignant melanoma in axillary lymphnode.  You should go for biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Levolin syrup be given to a child for cough?\n\nHello doctor. Im in canada and doctor here hasnt prescribed any anyibiotics for My 16th month son had caught a viral with fever cold and cough last week. After monitoring his fever and giving regular doae of tylenol and advil his Fever has gone down, runny nose has reduced, but from last 2 days he is having continuos bouts of dry cough and is unable to sleep. I have a bottle of levolin syrup with me? Can i give that to help reduce hos cough? What dosage can be given? Plz advice. Thanks in advance. A worried mom.",
    "doctor_response": "Dear W. M.,No, Levolin is useless for dry cough, so please do not use it. Ask the pharmacy if they have herbal cough preparations which can be given across the counter. Those should be safe. Dr. Taher",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes infection inside the rectum?\n\nI'm a 23 year old male, 5'8, and weight 183 pounds. I have excruciating pain in my rectum area. I went to the emergency room, the doctor did a rectal exam but couldn't feel anything. They did a CT scan and found a strand of infection inside my rectum. They said they think I may have a pilonidal cyst, but I don't see any pimples or holes near the top of my crack. I can't sit, and I can barely walk or lay down. I have not had a bowel movement in a few days, and now I'm having problems urinating. What do you think this could be?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern looking to the history given here I could say that this could be non-specific pain and not the infection of rectum in my opinion this condition need to be treated with the following medicine, 1) Tab Metronidazole 400 mg twice in day 2) Tab Omeprazole 40 mg once in day 3) Prolecresulen oint. hope this information helps you take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is result showing blood urea is 47mg/dl  indicate problem for kidney?\n\nhi doctor i'm tripti from pune, my  husband vaibhav barde'sblood urea is 47mg/dl and his sr. creatinine  level is normal.. is this indicate that his kidney or liver functioning is not proper?what should he take care for this, he is also suffering form acidity frequently..",
    "doctor_response": "Hello, as you have specified that his serum creatinine is in normal range and urea is slightly raised. Its not so much high as to get alarmed.Urea is produced as by product of nitrgen metabolism processin body. I would suggest you to watch on his protein intake. Try to maintain a 1gm/kg/day protein balance in his diet. If hes used to consume more non veg food, he should cut it down.Follow this advice for a few weeks and get a repeat serum urea report done and notice for the change. If its still high or same consult a docotr as you made need some further studies.I hope i have answered your query.  If need more clarification you can ask me. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Get convulsions surging through head since episode of injury, growth seems to be retarded. Reason?\n\nRespected doctor,i am an 18 year old male. About two years ago I hurt my head pretty bad. Even today my head hurts and I can feel convolutions surging through the part of head that was hurt. Before that incident I was growing at the rate of an inch every year,, i stopped growing after the incident,. ps. my hands are pretty long compared to the rest of my body parts and people complain about that. Why do i have such strangely long arms.",
    "doctor_response": "Hi,Thank you for posting your query.It is possible that you have post-traumatic headaches or a migraine equivalent. You would benefit from preventive medications such as topiramate, beta blockers, etc.Unusually long arms can be seen in Marfan's syndrome. Please see a doctor to confirm the same. Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My eye power was -0. 5 and it has increased to -1. 5. How to get rid of spectacles?\n\nHello doctor,My eye power is only -0.5, but now it has increased to -1.5. I think it is due to the side effects of Perinorm tablets, which I was taking before six months. I am currently taking homeopathic medicines to remove my glass. Please suggest to me how to get rid of spectacles?",
    "doctor_response": "Hello. As you grow in height and built, similarly, your eye size changes, so as your glass number. Usually myopia (minus number) starts at 7-8 years of age and keep on changing till 20-22 years. Your glasses number is small. Keep using glasses and visit your doctor once in six months or once in a year for any change in glasses. Once the number stops changing and get stable, then you can get rid of glasses with Laser surgery, that is very simple. But for that you number should be stable and should not be changing. So you might need to wait till that age. No need to take any medication. Change in number is just like your change in height and your shoe size. Do not worry. Do not take unnecessary medicines.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Provide details about Ehler Danlos Syndrome in children\n\nyes my daughter had a repaired muscle capsule this summer with a orthopedic specialist ( Dr. Bradley..team Dr. for the Pittsburgh Steelers ) he mention my daughter has Ehler Danlos Syndrome. Can you give me some details or recommended Dr. listing for treating this Syndrome in Pittsburgh, PA?",
    "doctor_response": "Hello,It is a congenital condition affecting collagen synthesis which might cause different problems during the growth and development. The collagen based structures like ligament and bones will be brittle and the child might be prone to develop fractures and injuries more frequently. There are various types and prognosis may vary between them.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hurting lump on my gum\n\nhad a teeth pulled 5/21.  molar plus front 3 upper for partial denture.  had descaling 6/16.. came down with parotis 6/20.  hospitalized and treated.  now have lump on outer gum of pulled molar that hurts. also, cannot open jaw..what needs to be done?",
    "doctor_response": "Thanks for using Health Care magic.Read your query.The symptoms you have mentioned in the query, suggests the non healing of the tooth socket and also there is a formation of abscess which is causing you the pain and difficulty in opening the mouth.I would advice you to visit your dentist so that he will have a look at it and if there is an abscess he can do the required treatment to induce the healing of the socket.Additionally you will require antibiotic like amoxicillin three times a day and metrogyl tablets , ibuprofen ( if you are not allergic to any medication).Warm saline gargling will be of major help to you.Maintain a good oral hygiene and avoid vigorous gargling .Hope this was helpful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life expectancy of a person with heart problems, diabetes and on kidney machine?\n\nthis is a 69 year old man.  He has congestion heart failure, one leg due to dibetis, sorissus of the liver non alcoholic, and he's on a kidney machine.  The doctor told us that his heart is to weak for the surgery to remove the gallstones, and his stomach hurts and he don't eat.  How long can a person live in that condition with galstones",
    "doctor_response": "Hi. This is a tough question to be honest with you. Life expectancy is obviously dependent on crucial factors like general health. With heart condition, diabetes, and liver problems, life expectancy is greatly reduced. So the answer to your question is that probably less than the average (men in US/UK live till they are 80 years or so). The more important question is if there is any danger of dying in the short term. Gallstones wont kill you, so the answer to that is no, it does not oppose a danger. The problem is that gallstones can cause an infection, in that case they put in a little tube and drain the infection out and most likely it would be ok.In this case I would say that having Diabetes and being on the dialysis machine does not mean that there are just a few months or even very few years to live, with good medical care one can live quite a while like this. The heart condition, however, is more unpredictable. Over all, no danger of dying in the short term. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause dry heaving after eating in a child?\n\nMy son has been dry heaving after eating (not everytime but about once per day) for the last two weeks. He complains that it feels like he has butterflies in his stomach, but no cramping. Pepto seems to help after the fact, but doesn t stop it from happening. He will be 8 yrs. old in a month, healthy weight and height, only other ailment is allergies. What could be the cause and how should we treat this?",
    "doctor_response": "If you can make your child chew cardamomum seeds off and on, it will help controlling dry heaving. There are many other measures such as ginger boiled water, holy basil leaves boiled water but often children do not accept it.Plenty of water, eating sweet food and banana also helps. Then any suitable, mild anti nausea medicine is of much use. In Ayurveda Balchaturbhadra chooran - a polyherbal combo of four child friendly herbs is given 1/2 gm to 1 gm with honey, thrice a day for few days to control such conditions harmlessly.This powder is commonly available in India but can be found elsewhere too. It's a classic ayurveda medicine.Hope it helps. For any further query pl feel free to contact me through direct question. I am available at your service.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe anxiety along with mood swings and excessive anger?\n\nmy son is very driven. Has two MA degrees. Works out and stays very busy. However, he is always anxious, has severe mood swings that mostly result in losing his temper. He says he is always tired, and attributed that to always being busy. He was just diagnosed with Narcolepsy. What??? I don t see the symptoms. How can a clinic diagnosis this with so little information other than I have always had a hard time concentrating and I m tired all the time.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Narcolepsy is a chronic sleep disorder that causes overwhelming daytime drowsiness. Is your son actually suffering from it? Tiredness, anxiety, and timid characters could be due to depression and anxiety. These can be treated with drugs, counseling, and psychotherapy. Consult a psychologist. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do swollen blood vessels under the tongue indicate?\n\nThe blood vessels under my tongue are bulging and swollen, thick and more bluish/black in color.  Last year a black spot was looked at by the ENT surgeon and he said to watch the spot for any changes. It has not changed but the veins under my tongue, below the spot, are 3/4 distended into my mouth, of the bed of the tongue.  I have no pain but it feels funny and looks horrible.",
    "doctor_response": "Hello,Veins under the tongue or the lingual veins can appear large and dark, and it can be normal to see large veins under the tongue. At times there can be dilated veins under the tongue. As if there is no pain, you need not worry about it. However, if you have doubts, please send me pictures of the underside of the tongue and the black spot so that I can guide you better. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to improve penis size and strength?\n\nMy penis is going small and weak due to much masturbation last 8 years and my penis skin hide my penis skin.Due to this i much worried about such problem because my parents want to marry me very soon but i m refuse due to this problem. Please suggest me some treatment regarding as mentioned problem.... Thanks",
    "doctor_response": "helloThanks for query .You alleged  to have your penis being small and weak.The penis has dual function 1) In flaccid state as a tube to pass urine out of the bladder 2) After getting hard during erection it functions to have intra vaginal sex with female partner too have sexual satisfaction .The size of the penis in flaccid state has no significance at all .It is hardness of the penis on erection that is important for sexual satisfaction of both the partners .The size of the flaccid penis of 2 inches in length and 4.5 inches after erection is adequate to have enjoyable sex . Consult qualified Urologist for clinical examination and to confirm the size of the penis in both the states .This will help to allay your anxiety .Please note that there are no medications that can increase the size of the penis Dr.patil...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a jump in the blood pressure?\n\non metformin (500 mg 2x per day) have not been faithful with the checking of my bg ... just started back again today (after 4 months of not) and my BG was 185! ... decided to eat an orange thinking it had been a while since I had eaten ... and an hour later it was 187 ... I was also just recently diagnosed with Crohn's Disease and put on Pentasa for that ... could that be the reason for the jump in bg? ...",
    "doctor_response": "Hello,So you are diabetic, and you take metformin;also you might suffer from hypertension. I don't think that Pentasa can affect blood pressure so I recommend you monitor your blood pressure 5-6 times a day for a few days and write that in a paper. You might need to start treatment for hypertension if the values are high.Hope I have answered your query. Let me know if I can assist you further.Regards,   Dr. Anila Skenderi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause bubbles in the semen?\n\nHi Doc. My male partner has bubbles on his semen.We saw this yesterday when thet remained inside the condom. Today he went to mensclinic and they gave him antibiotice because they said he has a bacterial infection.He got treated for MUS or MUF cant remember now. Is that serious and they said I should be tested too",
    "doctor_response": "Hello and .As an Urologist,i can understand your anxiety.The bubbles in the semen,is due to air getting mixed up with semen.Some condom's are chemically coated and could be due to a reaction effect.A lubricated condom has chemical,which may react with the semen.To confirm doubt about infection,a semen culture can be done.Semen infection is not life threatening and can be easily treated.If you've any doubts,you may send it to me,as a direct question.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hi Sir, Can you please tell does \"IMITINEF MERCILET\" cures Cancer? Is it available in Hospitals? if so where? Pl. mail to pvpmohan@gmail.com. Thanx for the help",
    "doctor_response": "Thanks for the query Adyar cancer institute, chennai is supposed to supply these medicines. I dont know if it will cure blood cancer since there are different blood cancers and stages as well. PLease give them a call and enquire with them Have a healthy life",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling in the shoulder?\n\nMy right shoulder goes numb and tingles off and on throughout the day. It comes and goes and happens frequently. I talked with my dr but she s not sure of the cause. What could be the causes of this, and could it be anything I should be concerned about?",
    "doctor_response": "hi,thank you for providing the brief history of you.A thorough neuromuscular assessment is advised.As you have numbness and tingling it you need a thorough neuromuscular assessment.As these symptoms will be a cause of pinched nerve in the cervical spine which is a classical symptom. Performing a clinical examination and later If needed an MRI of cervical spine could help us the soft tissue status.Post which with simple medication and physical therapy you should be fine. Later stages, exercises will be taught and can be performed at home or under the supervision of the therapist.In my clinical practice I see cases with such symptoms and is most of the time pinched nerve and they respond well to physical therapy.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chronic swelling in lower abdomen, painful. What is it?\n\ni m having a chronic problem of painful swelling in lower abdomen which appears every now and then.i have consulted various dermetologist but every one has come up with different diagonosis. some said it is herpes( i did herpes test,it was negative), some said it is an unidentified ulcer ,whereas some said is a cyst . whatever it is,its very painful and occur most of the time in the same area. recently i have read about this disease atopic dermatities and i think i m having it. only locoid lipocream gives me relief. have already done various antibiotic course but it was of no use.my locoid oinment has finished, can i use candiderma as a substitute?",
    "doctor_response": "Hello,Candiderma is an antifungal and antibiotic ointment.If the condition is atopic dermatitis as you're suggesting then candiderma has no role to play.In this situation I will prescribe topical steroid cream to my patients.Consult with your doctor for more help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mobizox and spasmo prox capsule for back pain, side effects of gastritis, solution\n\nMy doctor has advised to take mobizox and spasmo prox capsule for treating my back pain . It was told that with this combination it will not cause any gastritis . Usually whenever i take these pain killers always suffer with severe gastritis. If this combination of medicines are fine. Then i ll go ahead and take it. Kindly help with this.",
    "doctor_response": "Hi Meghana Thx for Using Health Care Magic Check that you are taking those pain killers after eating your meal Don't take them on an empty meal for the risk of having gastric ulcers Thanks once more Dr Peter S Clinical Nutritionist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does 18 count of eosinophilia means?\n\nDr. This is Nijam. I had a wheezing problem for the past 1 year. My wheezing problem is confirmed by \"Grace Kennett Foundation Hospital - 8, Kennett Road, Madurai - 625016\" But now i consult the doctor in Tenkasi his name is \"Dr. Ramnath (ENT Specialist)Near Pothigai Medical - Tenkasi\". He said that i had no problem. But cough is so heavy and throat pain also. what would i do, My esonopilia count was 18 (Too heavy the doctor says).",
    "doctor_response": "HelloThe normal eosinophil counts is 2-5 % , while in your case it is 18 % , very very elevated and call as eiosiniphilia , reason may be:1 Tropical eosinophilia , reason of this may be filarial infection Diagnosis can be confirmed by peripheral blood film.2 Allergy , as this is most common cause , as you mentioned that wheezing present with cough, so high eosinophils count  may be due to some allergens .3 Asthma , cough m wheezing ,throat ( due to infection) pain may be due to asthma .Due to some allergen there develop bronchoconstriction , hence wheezing and cough . This type of allergy also elevated level of eosinophils .When such patient visit I prescribe montelukast+ fexofenadine tablet one or two in day .I also advise my patient \"DIETHYLCARBAMAZINE \" 100 mg twice or thrice in day till complete relief.Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does my brother's chest CT scan mean?\n\nmy brothers chest ct scan reportimpressionArea of coalescing linear consolidation with air bonchogram in biletral lower lobesplease suggest whats this and what is the persentage of life risk does this situation is criticalwe had done this ct scan due to he had hospitilised for nimonia so suggest",
    "doctor_response": "HelloCT scan findings suggests consolidation in bilateral lower lobes(pneumonitis) of lungs.Pneumonia is indicated by air bronchogram which is typically seen in pneumonia.Patient may empirically need broad spectrum antibiotics after clinical evaluation.This condition also need follow up.This is not a very critical finding.Patient usually get cured by antibiotics.Patient may also need routine investigations like hemogram,etc.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility in men\n\nHello, We recently learned that my husband had zero sperm in his ejaculate during a recent sperm analysis. The doctor suggested he do blood work and see a Urologist to learn more however a few days later and a week stay in the hospital we learned my husband endured a Pulmonary Embolism. He is now taking Coumadin and working with his doctor to keep this monitored. My questions: is there any correlation between the blood clots and his lack of sperm? Also, does Coumadin have any male fertility/infertility history? Thank you in advance!",
    "doctor_response": "Hello, thanks for the query. First of all there can't be any possible relationship between pulmonary embolism and lack of sperms in semen as the blood clots won't affect blood supply to the testes.  Secondly, coumadin doesn't cause male infertility  . The cause of male infertility is unlikely because of the above mentioned.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to overcome depression\n\nI have a depressed housemate, the major issue for me to deal with this is that he is very hard on himself and has always hated to cause an inconvienience to anyone so when I begin to express concern he stops talking because he doesn t want to be a pain to me. He is completely withdrawn the only contact with people he has outside of work is with me and my other housemate. He is unmotivated to do anything at all including buying food, going to the gym, going to faculty meetings or even cleaning his room. This is a massive worry as he is usually a healthy eater, a regular (daily) gym attender, goes to all the meetings and keeps his room spotless. This has happened over the course of a few months and I want him to be happy and don t know how to help. Can you please tell me what i need to do",
    "doctor_response": "hi dear,first of all need detail regarding his symptoms like whether his sleep adequate, appetite adequate?is he easy irritable, abusive to any body, any fear, suspicious over anyone ?What ever you described about him suggest that he might have depression or negative schizophrenia.But to differentiate between two detail history and mental status examination is must.such complain started immediately or gradually ?There are many medication like antidepressants and anti psychotic .Consult psychiatrist first.  Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for phobia and panic attacks\n\nI am constantly scared to death about something.  I fear catastrophies the most.  A house burnt down a few houses down and I am now paranoid that mine will.  I think I smell natural gas, but my wife dosent and thinks I am crazy.  I often obsess about pipes bursting during the winter, things that go bump in the night, etc.  I am scared to death of becoming ill, getting cancer, aids, or even deep lacerations.  I am scared about finances, bankruptcy, etc although there is little threat of them happening to me.  I was once afraid that I pissed God off and was convinced for months that I was going to hell despite what my pastor, family, and other religious council told me.  I am scared to death of losing my job.  I sleep next to a loaded gun for fear of intrusion or that the government will go rogue overnight and be trying to haul me away to some fema camp in the morning.   I sometimes lose sleep over these fears.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. From the description you gave I can see a paranoid personality disorder with OCD in you. I am wondering why you had not started psychiatric treatment for this condition. I suggest you should consult a psychiatrist immediately. 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.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure slipped disc?\n\nHi doc, im a 40 yrs female having a slip disc problem and on simple medication. Doctors have adviced me bed rest for few days. Im very confused and want to know what actually slip disc is? is it cured properly? can i live a normal life doing all activities like driving,climbing stairs at home and all normal household affairs? Please help me because im getting very depressed. Thankyou.",
    "doctor_response": "The vertebrae in the spine are separated by a spongy tissue which is the disc. If the disc ruptures, the tissue in it can slide out of its normal place. This narrows the space between the vertebrae and may cause pressure on the nerves in the spine. This is called a slipped (\"herniated\") disc. This usually heals up on its own without any specific treatment except control of the pain. Some people may need physical therapy or even surgery to fix it. Once it has healed, you can live a normal life and do all your activities as before. I personally had a very bad slipped disc when I was your age. I took some medication for the pain and did not have surgery. The disc healed and I have been able to do all the activities that you mention since then. So there is certainly much hope that this will happen with you too, and no need to get depressed.Hope I have answered your query. If you have any further questions I will be happy to help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chesty cough, extreme hot flashes, sweating at night, dizzy spells, shakiness, sensitivity to light, no relief with medicines. Help?\n\nHi Can you help? I have been pretty ill feeling for several weeks, Chesty Cough , extreme hot flashes, sweating at night, dizzy spells, shaky, sensitive to sunlight. I was at the doctors last week on Wednesday and was advised i still had a chesty cough from way back in June. I was also advised i could have an underlying condition. I was prescribed antibiotics , steriods and a blue and brown inhaler . The antibiotics and steriods are now finished but i still don t feel great. Can you help?",
    "doctor_response": "thesere allergic symptomps inhaler is not o be used antibiotics do not result in curing take allegra 120 mgm bd tab singualr 10 mgm bd syp ascoril 1/2 tsf night syp tossex 1/2 tsf night syp mucaine gel 2 tsf tds do for 3 week you are okay then do permanenttretment for allergies10",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does positive anti-gliadin IgG blood test indicate?\n\nmy 11/2 yr old daughter blood tested antigliadin Igg a weak positive and anti endomyesal IgA negative.. the ped says, its a borderline case and only need to avoid wheat...is she really celiac? or is it just some temporary thing? should i be taking it more seriously? she is only 8.5kgs even though she eats well..",
    "doctor_response": "hi, welcome to hcm. Can understand your concern.As per the report that you have written, anti gliadin IgG is weakly positive, this suggest that your child might have celiac disease.In celiac disease, there is allergy to wheat and it should be avoided lifelong.However, to confirm diagnosis we need to do intestinal biopsy. Kindly do intestinal biopsy test to confirm diagnosis.I hope this helps. Wishing your child good health. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for TB and stabbing pain in my chest\n\nHi Doc, I was treated for TB about 5 years back...Now, from last 6 months I have a stabbing pain in my chest while deep breathing...I feel a heaviness on the left side of my chest...I don't have cough, nor loss of appetite or weight loss...infact the weight is growing...I did an xray about 5 months back and it was clear...What may be the cause? has the TB reappeared? I use to smoke which I have ceased and since then the pain has aggravated. What should I be doing?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, you are mostly having post infectious bronchitis. Bronchitis is inflammation of airways. And it is common after lung infection like tuberculosis. You are also an active smoker. So possibility of bronchitis is more. Your symptoms like chest pain on breathing (pleuritic pain), heaviness in the chest etc are commonly seen with bronchitis. So consult pulmonologist and get done clinical examination of respiratory system and PFT (pulmonary function test). PFT will not only diagnose bronchitis but it will also tell you about severity of the disease and treatment is based on severity only. You will mostly improve with inhaled bronchodilator and inhaled corticosteroids (ICS). Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for throbbing pain in the foot\n\nThe bottom of my feet hurt if I am standing or sitting with them on the floor. I also get a sharp pain that runs up through them sometimes for about 5 - 10 seconds. When I put them up they are pretty good except when I first put them up I get a few sharp pains through them. Verna",
    "doctor_response": "Hello your pains are mostly heel pains from a tight plantar fascia which is a flat band under the heel and the sole.Though not a serious condition this can cause disturbing pains esp on walking first in the morning.Please do regular ankle stretching exercises by lifting the forefoot up as much as it will go when.This can be done while sitting or standing.Physical therapy by shock wave give good relief. A local steroid injection at the site of the pain is another option if this persists.Meanwhile check your uric acid level in blood and if diabetic make sure its wll controlled",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Liv 52 safe for liver disorder?\n\nthe liver function test report shows some kind of liver disorber....almost all values are high. But I cannot trust the lab centre at which the test was conducted. in such a case I need advise if I can start taking LIv 52.......would that be a good precaution and remedy incase the problem actually exists.",
    "doctor_response": "hii,LIV 52 is nothing but an placebo ,actually there are no proven articles that really helps in improving the condition of liver,as gastro physician i  dont recommend LIV 52 ,but when you know that there is some problem with your liver better consult your physcian for the same. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can one manage shortness of breath, fast heart rate and dizziness?\n\nI have shortness of breath after walking a short distantance and my heart will race.I have back stenosis with pain and leg weakness.My dr. said its anxiety and sent me to a physicologist,I have no problems in that regard,and did help.Iv; had some heart tests and wasn t told any thing except to start walking and I would love to,but I get dizzy and fall which I never did before sorry for all mistakes. joan",
    "doctor_response": "Hello, According to history, you should do an ultrasound of the heart to exclude heart problems. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jnikolla, Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for wrist pain even after having braces\n\nwrist pain ok so i have been having alot of pain in my wrist my Dr gave me some steroids and had me get a brace the steroids are gone and the brace really hasn t helped i wear it all the time like she told me to and it hurts so bad it feels like something is being pinched between bones i don t know what it is or to do",
    "doctor_response": "Hi, Please undergo MRI wrist region to know the exact cause of pain. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Varinder Joshi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat palpation,chest pain?\n\ni have been having palpations daily, they are short, cause me stress and sometimes come with a sharp quick pain in the upper left chest. my ecg came back showing slighltly overworked but doctor was not concerned, should i be???? i am also prone to ocd and having anxiety over my health",
    "doctor_response": "Hi,If your doctor see your ECG and told you not to worry, it means there is nothing serious and you shouldn't worry. I have many patients with palpitations, when they start not to worry about their palpitations, complaints and palpitations disappear gradually.Try to be more in fresh air, eat healthy, walk much, exercise regularly, avoid caffeine, nicotine,  and you will feel the difference soon.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having pain on left side of my rib cage?\n\nHi, I m a 25 year old female who s been having pain on my left side of my rib cage starting at the sternum and radiating out laterally. It started about a week ago, appeared to be going away and then sudden sharp pain woke me from my sleep, followed by constant pain from deep breathing. Any ideas of what could be causing this? I take Advil fairly regularly for neck pain and that isn t helping with this pain.",
    "doctor_response": "Hello, As this could be just acidity issue and nothing more. Because at your age having major pathology of the organs is very very rare. As you are taking advil for your neck pain, it won't help this pain, o will advice to take any antacid medicine which can help reduce the acidic activity and avoid pains. Due to acidity there will be compression over the diaphragm and inturn increase the intra thoracic pressure leading to pain in heart symptoms. With simple antacid and drinking more water, you should be fine. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing discomforting pain in lower back, abdomen, nauseous, light headed\n\nHi About three days ago I have been experiencing discomforting pain in my lower back. The first day pain started in my abdomen and than both my back and abdomen started hurting by night. The second day and the third my abdomen stopped hurting and my lower back continued to hurt and worsened. Also through-out all of this I have been feeling nauseous and light headed . I was wondering what could this be? Please help",
    "doctor_response": "It may   be  simple  backache and nothing  else. Take  rest  and do  hot fomentation.It will  subside.Apply muscle relaxant gel  to back  after  fomentation.do not bend forward or lift  heavy objects",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can backache and pain in the thighs be treated?\n\nI have been experiencing back and thigh pain and have been taking 1000 mg of Niacin at bed time. I am wondering if it could be due to Niacin. I do have bulging lumbar discs and sciatica issues also. Also a 40 year health care worker who has done years of research and does not really believe any longer in the whole cholesterol theory of heart disease. I am aware of C-reactive protein, lipoprotein A, homocysteine and all the sub types of LDL. I am considering reducing dose back to 500 mg and wondering if this is wise. I will not take Statins.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Getting pain in your back and thighs is most likely due to disc problems (disc prolapse). The sciatic nerve, which gives nerve supply to your leg starts from your lower back and descends to your back of the thigh. Feeling back pain associated with thigh pain means that something happens at the root of the sciatic nerve and the pain in your thighs is just radiating pain. You should perform MRI on your lumber rejoin of your back (lower back) and to be assessed for the grade of that bulging. Analgesics are temporary but not cure. You may need physiotherapy on your back or surgical repair of the bulged disc. Whatever happens, it is not that danger thing to worry about but you have to visit your doctor soon. Don't carry heavy things, avoid standing for long time, don't run and keep your weight healthy. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Large gastrinoma, spreading to liver, severe itching. Taking antidepressants, atarax. Cure?\n\nmy husband has a very large gastrinoma that has spread to the liver... he is most bothered by severe itching that keeps him from sleeping despite numerous forms of narcotics.. antidepressants ( seroquel , mirtazapine are of no benefit) he has tried various types of benedryl , atarax with no use. Just wondering if you have any other suggestions for the severe itchiness. I was reading that hyperparathyroidism is also associated with his condition and if increasing his vitamin D would be of any benefit pertaining to the itching. by the way his serum bile is not elevated - any help would be appreciated",
    "doctor_response": "Hello!Thank you for the query.His severe itching is caused by jaundice. Due to bile ducts obstruction or liver failure bilirubin accumulates in the body including skin. This causes yellow skin (not always visible), itching, dark urine, stools can be white. He should visit his doctor, have abdominal ultrasound, blood work, bilirubin level, liver tests (AST,ALT,AP,GGTP) and amylase. In case of elevated liver tests, ERCP and stent to bile ducts should be placed.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get moles in my chest area after a sunburn. Why?\n\nHi doctor, I am a 27-year-old male. I have never had an increase in moles, except for the past two weeks I have had over 50 show up on my chest. In the past two months, I moved from one country to another, and a month ago, I had a really bad sunburn in Indonesia.",
    "doctor_response": "Hi. Moles are genetic collection of melanocytes which go through a cycle of emerging in childhood then become darker and fade by middle ages. In fair skin up to 50 are normal more than that increase the risk for skin cancer. And change in size, symmetry, color, symptoms also is a risk factor. Mole or nevi as called in medical term appearing in adult age like in you are always a risk factor. And in such an abrupt manner more so. They need to be followed up for any change in color, size, symmetry border, symptoms, and so. All your moles that I can see in the photo are harmless. (attachment removed to protect patient identity).  Mole does increase after prolonged sun exposure as you give history. I hope you do not have any other medical problems. I advise you an initial in physically examination by a dermatologist, you can wait for lockdown, not an emergency, then you can do it yourself, all the mole for the changes described earlier, at least once a month and a complete work done by a dermatologist once every six months. Lifetime risk is very low but if you have fair skin, adult moles, more than fifty you need that follow-up to be on the safer side. I hope this helps. Sun exposure. Workup for changes. Seborrheic keratosis. Screening for changes. Every six months.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness on toes after walking on ice?\n\nHi...I was hunting; walkling around in snow all day dec 4...my toes were extremely cold at the time. My toes are still numb on the tips - no discoloration or blistering. I have no doubt I damaged something...My questions is - will the numbness stop/go away over time?",
    "doctor_response": "Hi, Continuous exposure to cold temperatures results in construction of blood vessels,which in turn results in numbness due to loss blood supply to nerves. Recovery of sensation is unpredictable. If I was treating doctor, I would have advised few investigation and proceed accordingly. I would recommend that you visit a foot surgeon at the earliest. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Rajesh Gayakwad, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for scaly rashes on skin and scalp and for nasal blockage\n\nGood morning doc,I m here to discuss my 8 months old baby boy health issues. ...since his birth he has redness on scalp and it turned scaly and patches all over the scalp. ..and hair started falling as patches and smells bad....Doc prescribed covate-s lotion to apply all over the scalp and used ketaconazole shampoo weekly once headbath. ..He lost all the hair and when he was 4 months old and got new normal hair...then I stopped using lotion... 5th month we found reddish rashes on stomach....paediatrician gave desonide ointment. ..It was cured. ... Now he is 8 months old....again 2 weeks back scaly patches were found on left shoulder and went doc....He gave momate. ...used but no result. ..Instead it spreads to the right side also on back....and reddish rashes on left arm...now another doc gave eumosone. ...and now on scalp front portion again reddish rashes develops along with itching. ..can I use same covate over there again or eumosone on scalp... One more important thing is he has nose blockage problem since his 2nd month...still it s there...During summer also he struggled a lot. ...We give nasal drops..and sometimes steam through nebuliser using normal saline. ... I and my husband have dry skin.... Please doctor I need guidance to take well care of my son...He struggled a lot so far because of these issues... Can you suggest me healthy diet also? and which medication is good for skin,scalp,and nose blockage? What are the precautions should I take? In two weeks we are going to remove his hair as a ritual, is it a right thing or not?",
    "doctor_response": "Hi,Thanks and welcome to HCM .You can safely perform your ritual after 2 weeks.Your history suggests that he is suffering from Seborrhea .Better consult a Dermotologist for correct diagnosis and treatment .It takes along time for cure.Hope this reply is OK for you .Please feel free to ask further queries if any.Dr.M.V.Subrahmanyam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recommend diet foods for high ALT\n\nHi doctor, i made the blood test and 3 times. In first my ALT was 194IU/L, AST-86 and BILT-30. During 1 month I drank GEPTRAL and URSOFALK, after  ALT was 102IU/L, AST-60 and BILT-25.After a month  ALT became 150, AST-65 and BILT-28. Please advice what kind of food I shall use and  what drugs I need?",
    "doctor_response": "Hi welcome to health care magic... First your full liver work up done for exact diagnosis. ....-USG -Urine urobilinogen -Peripheral blood smear examination -Hbsag detection and Anti Hcv by ELISA -Retic count etc... After specific diagnosis treatment given accordingly... If you are chronic hbsag carrier and this is your active stage than antiviral medication given... Take more fruits. ...Avocados,  Indian gooseberry,  spinach,  mustard green,  onion,  lemon juice are some good food for liver... Avoid excess fried food.. Sunflower oil good for liver... Take care Consult gastroenterologist for discussion and examination",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes spondylolisthesis?\n\nHi this is Mohamed from singapore, I has been diagnosed spondylolisthesis 2nd grade with cervical pain but two years before started only neck pain then continued to back pain and iam worried my concervative treatment was chiropractic,, physiotherapy and one time was steriod injection but still my pain maintain and iam using tramodol 50 mg every day two times then only my pain will control pls advice me and here one neurosurgeon said disco plasty will reduce the pain which is very expensive shall I try any suggestions pls",
    "doctor_response": "as a alternative to disc replacement or fusion surgery you can try flexion excercises and physiotherapy in the form of ultrasonic massage or ift",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can erectile dysfunction after electrocution with 4000 volts be treated?\n\nhi my name is GARY, i;ve been having problems getting a erection, I;m 47 years old an never had a problem like this before until i got shocked by 4000 volts, ever since than it;s getting harder to get a full erection. Do you think that has something to do with it?",
    "doctor_response": "Hi, I think erectile dysfunction can be due to the shock. There may be some neurological causes for it. Get yourself evaluated to rule out the other causes. Consult an andrologist.  Medicines can lead to some improvement.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to reduce swelling on forehead\n\ndear docotor, my child having swelling on fore head, when we press it it will goes arount two to there milli meter inside what is the reason for this, on the head top of fore head one bowl is there it comes out after that we found this what is the reason for this what is the remedy for this, whoom i have to consult doctors specelisation please thanking you sir d.s.sridhar",
    "doctor_response": "Hi , I understand your concern. From what you are describing, it seems like your child has a hematoma, which is a collection of blood that occurs after mild injury or fall, or a dermoid cyst which occurs in some children. You can consult a pediatric surgeon if the swelling does not come down in a week. Meanwhile, if the swelling is rapidly increasing in size, or your child has pain/increased crying or pus discharge from the swelling, take her to the hospital to see a pediatric surgeon.Hope this helped you..!",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a lump on top of foot?\n\ni looked down at my foot only to notice a knot sized lump was beginning to develop where the top of my ankle meets the top of my foot. it has developed rapidly and began to bruise almost instantly. it is sore to the touch, and also almost numb feeling. my foot is very cold. the bruising is getting more spotted. should i go get it checked now or wait?:",
    "doctor_response": "dear friend,you have not mentioned since when you are having this symptom and how it started. do you have any other swelling in the same limb. it could be a enlarged tortous vein ( varicose vein) , infected bursa or a ganglion. you need not be panicked. Better not to wait. Go and consult a surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for reflux in 7 weeks old baby\n\nHi Doc, I have 7 week old baby diagnosed with reflux. His weight is 5.2 kg and is gaining weight. Remains unsettled. We have been giving him losec 5 mg twice a day 1 ml and Zantac 1 ml mid day from past 4 weeks but his situation has nt improved at all. Can if increase medication or is there any other medication we should try. Thanks ... Smita",
    "doctor_response": "Hi...a 7 week old baby weighing 5.2 kg is  a well baby. Please do not use any medications at this age. Reflux needs to be treated only if the weight is low and is hampering the growth and development.No need to increase the medication. Infact I urge you to stop all drugs.If the baby's weight is normal it is not reflux and it is only regurgitation which is quite common in this age group. It is physiological.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tender bumps on scalp and forehead?\n\nMy 13 yo girl has a hx of Hashimoto s thyroiditis, svt, severe scoliosis, and strabismus. (Medications at this point. Moderate allergy to bee stings. Suddenly today has developed 5 grape sized bumps on scalp and forehead tender to touch. What could this be? No Meds at this point.",
    "doctor_response": "If the child has history of Hashimoto thyroiditis, and history of skin allergies, This condition could be due to the same problem. Hashimoto is associated with Mucocutaneous candidiasis, vitiligo and alopecia and other ectodermal dysplasias. These bumps could suggest another allergic reaction to any antigen or it could be due to a dermal infection(? fungal). I suggest you consult a dermatologist and by that time , give her tablet Atarax one tablet daily.Thanks and regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take gestin for infertility?\n\nhidoctor,i am infertile since 12 years.my doctor prescribed me letroz on day3-7,inj.ivf{menotropin}on 3rd day and tab gestin on day16-25 for 3 cycle.age 34,weight 70k.g,married 12years before.ihave conceived 3 years before but after that i am not succeeding.is there any chance this time?",
    "doctor_response": "Hello,Welcome to healthcare Magic.I have gone through your query and Would like to reply in detail as follows:1. This will help but not on its own.2. Get husband's semen analysis done.I hope your doubt is clarified. Let me know if you wish any other information.Regards,Dr. Mahesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes left sided chest pain with tingling in hands?\n\ni have been having chest cramps on left side.feels like my heart muscles are twisted and need to be massaged. and also sharp needle like pains in heart area. and pressure . i often have to take deep breaths and stretch my left arm out and massage my heart area. also my hands and feet are tingling and numb alot lately. and my hands swell and have no color. what is going on?",
    "doctor_response": "Hello,I would like to tell you that your symptoms do not look like cardiac but can be associated with lymph node or muscular tenderness.But to exclude underlying heart disease, you need basic cardiac checkup which includes ECG, Echocardiography and Treadmill Test. For hand swelling, kindly consult your physician personally for physical evaluation and treatment.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhanu Partap",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes black bruises after a penicillin injection?\n\n27,54\".135lbs,male ellergic to pennicellin im getting black black bruises some are a little size of a dime it hasnt gona away yet and there are more on the inside left upper arm on my muscle and a few on the right inside arm i also have a yellow spot quarter size on my right chest thank you",
    "doctor_response": "These bruises are a kind of drug rash that can occur in patients allergic to any drug. In your case it seems to be a case of reaction to penicillin. These spots are permanent and dont disappear with time. They have a tendency to occur at other body parts if you take penicillin in future. Although these spots can lighten with application of clobetasol cream.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the right cheek and around the nose?\n\nI have pain in my right cheek center and lower and a bit over the nose. It feels like nerve pain not a tooth ache pain. It first started when I used a toothpick between two teeth. The pain would start and leave in a few hours or a day. The dentist pulled my wisdom tooth, the pain did not go away but is getting worse. I have the same pain on the outside of my right leg. Numbing, burning but doesn't affect walking. It's just there.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The pain on cheek that you are explaining can be due to any proximal decay that is on the wall of tooth not visible to eye.Other cause can be sinus induced pain or nerve pain or Neuralgia.However Nerve pain is generally in bouts of severe electrifying pain.So if it is that way it can be nerve pain.You should consult an Oral Surgeon and get checked and a clinical examination and an x ray can be done to rule out the exact cause of pain.If nerve pain is suspected then an MRI Scan can be done.For now you can take painkillers like Ibuprofen to reduce pain and also take soft meals.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have broke out like shingles on back. Told to be allergic reaction. Given pepcid and benadryl. Have itching\n\nmy 84 year Mother broke out in what at first we thought was shingles on her back but her doctor said no that it looked like an allergic reaction.   he sent her for allergy testing and said she was allergic to milk.  he put her on singular, Pepcid, and Benadryl.  the sores on her back and arms are dry patches now but driving her crazy.   she is itching continuously.  she  can't sleep or relax.  the doctor gave her some lotion that doesn't help.  any suggestions to help relieve the itching would be greatly appreciated.",
    "doctor_response": "Hi, thanks for using healthcare magicThere are anti histamines that may be stronger than the benadryl and may work better for her. Some examples are hydroxyzine and cyprohepadine.In addition some persons combine these anti histamines (which are HI antihistamines) with type 2 anti histamines. Though type 2 antihistamines are more commonly used for reflux, they may also help some persons with allergies.Examples of type 2 antihistamines are ranitidine and famotidine.She may want to consider visiting an allergy specialist for additional help.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can hep c be transmitted other than blood?\n\ncan hep c be transmitted by any other means than the blood?,chemicals (benzene etc.),I was in the military and was poisoned by the toxic water which has killed 1 milliom marines on camplejeune,n.c.ialso need help in cleansing my blood and fat cells as that is where these chemicals are stored.",
    "doctor_response": "Thanks for asking in healthcaremagic forum    Do not get panic. Hepeatitis C cannot come from chemicals. Other methods by which Hepatitis C can spread is 1. By Sexual contact                                                 2. Blood products                                                 3. Body secretions    So, if you were intoxicated by any chemicals, you would have had symptoms. So, I would like to suggest you to visit psychiatrist/psychologist for counselling. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for extreme pain in right calf muscles\n\ni have extreme pain in my right calf that is caused by a dvt after i fractured my foot. The dvt is over 10 cm. The doctor has me on endone with panadol as well as panadeine forte and nurofen. None of it is helping with the pain. I don t know what to do. I am elevating my leg and using an ice pack and a tubigrip. Please help",
    "doctor_response": "hi,thank you for providing the brief history of you.A thorough neuromuscular assessment is advised.As mentioned you have DVT and on medication but still the pain has not come down I will advice to undergo physical therapy. As physical therapy is a non-invasive process and will help you to improve the metabolism and strengthening of the muscles which will help reduce the compression due to DVT.Also by use of physical modalities the physical therapy may give you instant pain relief. I see patients with DVT in my daily clinical practice and with the combination of medication and physical therapy they respond well.regardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment to get pregnant?\n\nhi there..im trying for a baby at the mo so i was wondering could you help me..i am nomaly on the pill so i dont no my cycle.. after i came off my pill it was 34days till i got them again..does that mean that is my new cycle now??? my last period was the 2th dec so i dont no when im due my period???",
    "doctor_response": "Your cycles may remain disturbed for a few months after stoppage of pills.you will resume your earlier fertility and cycles within 3 months or so.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in collarbone and shoulder while breathing?\n\nI coughed and now I ve got a pain in left collarbone towards shoulder, it now hurts (collarbone area) when i breath in, I ve had a virus in last few weeks which was a really bad cough but that s cleared up just cough now and again. Thank you for you time in reading and answering this query",
    "doctor_response": "try focusing on doing deep breathing exercises. do slowly and gradually. if the pain increases kindly meet a specialist and get yourself checked.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should Carbidopa Levodopa be weaned off while suffering from dementia?\n\nHi took my mom to neurologist today to get results of a scan she had on her head and he said she has frontaltemporal dimentia. She has been taking carbidopa levodopa for 7 years cause at first they said she had Parkinson\u2019s. Dr said I can just stop cold turkey giving her carbidopa levodopa she gets 2 a day do you think I should wein her off?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. First of all I do not think carbidopa levodopa can be given to a person without parkinson disease over the last seven years. If your doctor thinks that he can diagnose front temporal dementia just with a scan I feel he has not done the required neurological examination.In my opinion she need complete neurological examination before deciding in favour of parkinson disease or front temporal dementia or otherwise. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have had an awful headache for six days. Please help.\n\nHi doctor, I have had an awful headache for six days making me very agitated. Pain is going into an eye and the side of my head feels slightly spongy. I have not banged head at all. Usual painkillers are not working for long. It is driving me insane.",
    "doctor_response": "Hi. I am giving you my opinion as follows. If your pain is throbbing in nature with nausea or intolerance to loud sound then a migraine should be ruled out. Check your blood pressure as high bp can lead to a headache. Provide a history of an ear infection if present for giving more comment. Chronic stress can lead to a headache as well. Hypoglycemia, lack of sleep, smoking, prolonged fasting, etc., contribute to a headache. If no, any inflammation present and no cause identified than CT scan advisable. Take care. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Red itchy rash on stomach, contact dermatitis, itchy, dry, bumps. Causes for symptoms?\n\ni have a red itchy dark rash patch on my stomach below my belly button for a few months now. recently it has been itchier then ever and has gotten a little bigger and raised on my skin. i beleive it might be some type of dermatitis maybe contact dermatitis but i cant be to sure. i tend to shave in the same area where i have the patch (happy trail) and maybe the razor i was using at the time was a bit old which i already threw out once i noticed the rash 3-4 months ago but its still itchy and bumpy and dry. please help me ease my mind i am a very paranoid person.",
    "doctor_response": "it can be allergic or fungal or bothin some patients allergy occur on same portion whenever exposed to specific allergeni medicines taken even if sos like paracetamol calcium vitamins diet suppliments or other problems can trigger itcan be oils shampoo cooking oil soaps and body application materialscan corelate or consult allergy doctor who can help to find the causeattime can use anti allergic tabhistocalamine and anti allergic  ointment in affected area of skinyou can also add fluconazole 150 mg once awk for 4-6 wk to counter any fungal effect",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for abdominal pain\n\nsir, my name Biplab, age 30 years, from siliguri, dajeeling. i feel sometime pain in stomach in right side from I year & suffering white spot in stool like dysentery but Dr. says that is mucus. I take medicine continuous 4 months. But no recovery. I go latrine one time in morning. Please help me sir,",
    "doctor_response": "Hi Biplab! Good afternoon. I am Dr Shareef answering your query.If I were your doctor, I would advise you not to have any food from outside, if you do, which might bring in intestinal infections like amebiasis which is very common in this subcontinent. I would also advise you for a routine stool test for ova and cyst, and treat the infection if positive with appropriate antibiotic. Even if you took proper medicines and were cured, constant and chronic creeping in of intestinal infections through food from outside would give you recurrent problems. I would also advise you on your diet towards more of roughage and liquids. Going once to the wash room would be normal for many of us, and so you should not worry on it.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe pain after back surgeries be treated?\n\nI have had four back surgeries. The last one on 6/7/18 was a OLLIF back surgery fusion. The implant spacers put in two different disc And one failed and fell out a few days after surgery. I m now in severe pain and my Doctor said I need another MRI and he needs to take out failed disc separator on right side of my L3 - L5 and put in rods , screws etc. It will take at least s month before I get new surgery. I am on oxycodone 10-325 and 25 mg extended release but my pain is unbearable. I won t make it a month from now",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. In my opinion you should the second Surgery ASAP and not weight for % months. The Disc which has slipped could be bad . Also use a lumbar belt for the time being. I suggest you take muscle relaxants with painkillers for the time. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes diarrhea in a child?\n\nI have a 17 month old baby who is cutting all 4 of her stomach/eye teeth.Her older sister came home from school yesterday vomiting (I m guessing stomach virus but she only threw up a few times). Today my 17 month old has had a little bit of diarrhea. She hasn t eaten much--mostly just been drinking her cups. Would these issues be her teeth or should I be concerned?",
    "doctor_response": "Hi...teething wont cause diarrhea. Infants keep whatever possible in their mouth to soothe the  pricking sensation due to eruption of teeth. The articles which they put in the mouth need not be clean.Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause severe pain in chest radiating to upper back, shoulder and arms?\n\n2 weeks ago I was reaching across the table and my back spazzed out (right side), from the buttocks up. I did the usual remedies; heat, cold, pain meds, inflam meds, stretching. It's better (still a slight twinge in said area). yesterday I woke up with a very heavy feeling in my chest which got progressively worst during the day and today. It feels as if I was hit in the chest by something (not someone except maybe HEman (master of the universe). Also today it has migrated to my upper back, shoulders and when I lift my arms it's uncomfortable. If I take a deep breathe it's also uncomfortable.",
    "doctor_response": "Hello Thanks for posting at HCM. I could have helped you better had you mentioned your age, and other associated health issues if any. Going by your symptoms, here is a possibility of cardiac involvement vs muscular spasms. To rule or cardiac element, I suggest an ECG and a 2 d echo test. If both the above tests are normal then a treadmill test or a stress test should be done. This will give us sufficient information about the heart, its functioning and possibility of a cardiac element in near future. If above tests at normal, then you should take antiinflmatory non steroidal medications (NSAIDS) like diclofenac for five days duration. Wishing you good healthRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why the 3 month old kid is not able to move her neck and arm?\n\nMy uncles daghter is 3 months old and isnt able to move her neck or one arm. Her mom fell down the stairs when she was a few weeks old she didnt think she hurt the baby. Now shes being tested for all these diseases (mainly cerebal palsy) could she have an injury from the fall? Pinched nerve or something like that",
    "doctor_response": "If at this month of age he or she not able to move head and arm thinks in the line of cerebral palsy or floppy infant. If significant birth history is there then strong possibility of cerebral palsy. Go for mri. That may give some clue.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do i feel sick after eating?\n\nMy mother just suffered a mild stroke 5 days ago, she had a feeding tube put in today and is complaing about feeling too full and feeling like she was going to throw up an hour after they started to feed her. 3 hours after begining she trew up what looked like bile. Should we be concerned, could this cause infection...",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.There are two reason for possible vomiting. One is gastritits associated with the drugs your mother taking and second is the injury to the vomiting centre of the brain which is arises because of the stroke.Bile vomiting is always suggestive of the brain centre injury. This requires a drugs which suppresses brain centre for vomiting. Gastritis can be controlled with the pantoprazole and domperidone. You can give it as a injection form. Please take all above medication under your doctors guidance.Some simple step can be help ful to reduce the vomiting. Head up position after eating can help reduce reflux and so vomiting. Small frequent diet should be given to the patient instead of one single heavy diet.Spicy food should be avoided. Bland food devoid of spices should be preferable. Cold milk can help neutralise the acidity. So some times small cold milk can neutralise the acidity.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in middle of upper chest?\n\nhi, im a 15 year old girl and around 2-3 months ago ive been getting really bad chest pains. right in the middle of my upper chest, it last about 5-15 minutes and comes here and then. when i lay down it seems to help but i cant figure out how to get rid of this pain or what exactly is it. Im getting a bit worried because i have a little bump, when i touch it it hurts and i feel like my hearts beating really fast. help!",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have read your question closely, I understand your concern and will be helping you with your health related problem.This do not seem to be heart issue as heart pains are not tender and they aren't relieved by position change.I would suggest you to visit your doctor and get a complete examination only a doctor can tell what kind of lump you do have and if it is safe or dangerous for you secondly it seems that you have simple muscular pain it can be relieved by simple pain killer, I would suggest you do visit a doctor and do not start self medication.I hope this answered your question, if you have more queries I am happy to answer you.Regards,Dr. Muhammad Ahmad",
    "dialogue_context": ""
  },
  {
    "patient_message": "Unable to cope up break up, palpitation, nausea, drug overdose, unable to focus. How to overcome?\n\ni am 21. i am unable to cope up with a breakup that happened 5 months ago. i fear going to college now, i palpitate, and experience nausea . i tried cutting my hand and doing a drug overdose to divert the pain to t he physical wounds. i have lost 9kg and i am too disturbed to focus on studies. i have missed exams and my performance has severely gone down. i dont have enough money to see a psychologist. please advise how i should cope up. i tried eating well, meeting other people..every possible thing one should do to beat depression but nothing seems to be working. i see him every day with someone else ( and that someone else happened to be my own best friend). i feel exhausted and have given up now.",
    "doctor_response": "hello welcome to health care magic I  can understand what you are going through. According to your details, you have depressive symptoms and you might be suffering from \"reactive depression\". The best thing you should do is to visit a psychiatrist as there are wide range of treatment options available. But since you can't afford, so you can try the following- 1) Discuss all the stuff with one of your friend or family member if you feel comfortable and let your thoughts come out. 2) Divert yourself with the things you really like to do (your hobbies etc). 3) Try relaxation exercises like meditation, yoga or deep breathing. 4) Have a break from college and plan some family trip 5) Make new friends if possible Hope this helps Wish you good health Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My pregnancy tests are negative. Can I be pregnant after taking i-pill?\n\nHi doctor, My wife got her periods on 25th and on sixth we had unprotected sex followed by i-pill, which she had within four hours after the act. On seventh, we had protected sex thrice with new condoms for each act and after each act she washed herself with water. On thirteenth, she had bleeding for three days similar to her periods (around 60% of bleeding) but with less flow and few clots in them. These three days the bleeding was on and off. Her periods were to be due on 25th. We did a home pregnancy test that week and the results were negative. After ten days, we got the second pregnancy test done, but still the results came negative. At last on fourteenth, we got a urine pregnancy test and the result was again negative. She has no symptoms of pregnancy. On 17th she felt cramps and abdominal pain that was followed by thick white discharge. Is it a sign of pregnancy? Or is it a sign of her periods? Or is she pregnant? Please guide.",
    "doctor_response": "Hi. I have gone through your history and understand your concerns.  For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "High prolactin levels in blood. Not pregnant even after having unprotected sex many times. What does it indicate?\n\nHi there I have had a blood test which has shown high pro lactin. I had the test because my periods have been very light and irregular and my boyfriend and I have not been using protection for the last two years and I m still not pregnant. I m tired and very thirsty all the time and for about a week a month I feel dreadful with blocked sinuses and puffy eyes and a headache. I m having another blood test today to see if my levels are still high. What can this mean?",
    "doctor_response": "Hello,Welcome to healthcare magic,Increased prolactin levels can be seen in conditions like Polycystic ovary disease, Chronic renal failure, increased stress, Hypothyroidism and prolactin secreting pituitary tumors. It can cause infertility and irregular and decreased menstrual flow. In view of head aches and increased thirst I will recommend you to do a CAT scan brain to rule out pituitary adenoma. Also do a thyroid function test and renal function test.Hope this helped,Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for sore throat and fever?\n\ni have a fever almost a month and now i have sore throat, what kind of sick symptoms is this doctor???4 moths ago i have gononrhea and after i taken the  medicine from my doctor i started fever, then i went back my doctor again and she give another drugs and i still have a fever..those medicine for gonorhea..but until not i still have a fever and 3 days i got sore throat until now. bout my gononrhea i stop discharge now but i dnt feel better coz i still feel burning of fever..i was worried now.. thanks",
    "doctor_response": "Hi, Thanks for posting in HCM. I have read your description and understand your concern. The symptoms what you have been describing appears that you are having repeated upper respiratory tract infection. Kindly do the following to overcome them. 1. Do salt water gargling with warm water thrice a day. 2. Use steam inhalation to liquefy the mucous for easy drainage. 3. Take mucolytic-decongestant medications in the form of syrup containing Ambroxyl/Bromhexine, Guaifenesin and Chlorpheniramine maleate as ingredients. 4. Take medicated lozenges for throat soothening effect when necessary. 5. In case you feel feverish and body aches, you need to take Tablet. Paracetamol with Ibuprofen combination after food. Strictly avoid consumption of cold items like cold drinks and ice cream. Your symptoms should getter soon by adopting to above measures. Hope the information provided would be helpful. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have white rashes on my throat and also fever and throat pain. Please advice.\n\nHi doctor, My throat is showing white rashes all over. I do not know what that is. Now, I have fever and throat pain also. The ear is closing and opening sometimes. I consulted a doctor earlier. She prescribed me Metorda 500 antibiotics for bacterial infection.",
    "doctor_response": "Hello. Your symptoms are fever, throat pain, and ear blockage. Your clinical findings according to you are white rashes all over the throat. The two most probable causes in your case seem to be: I suggest: Other possible causes include: You may continue with the prescribed antibiotics. Additionally, Paracetamol for fever/pain and warm saline gargle may help. Also, your ear blockage suggests you are having nose blockage/discharge too which is causing your eustachian tube to get blocked. So a Xylometazoline nasal drop in both your nostrils may help. Consult a specialist doctor, discuss with him or her and start taking the medicines with their consent. Avoid having cold drinks or exposure to cold air for a few days. Be sure to drink plenty of water. For more information consult an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the modifiable and non modifiable factors of abi incompatibility ?\n\nwhat is the modifiable and non modifiable factors of abi incompabibilty??",
    "doctor_response": "abo incompatibility usually occurs in case of RH neg mothers having RH postive husbands. In such cases Anti d is the treatment of choice.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is spotting during pregnancy dangerous?\n\non 24th jan 2011 i got married & got my periods on 27th of Jan 2011 but next month i do not got my periods so i tested home test the test confirmed iam pregnancy then after on 10th of march 2011 i got periods then i consult doctor they said that my pregnanancy got aboson then doctor ask me to take novelon tablets as per doctor instruction i had taken tablet from 17th march 2011 but within 8days i got periods but flow of periods is 5- 6drops its dangerous?",
    "doctor_response": "Hallow Dear,You had abortion. When the abortion is in threatened phase of abortion, i.e. the baby is still viable with threat to pregnancy, attempts can be made to arrest the process of abortion. However, it seems that your baby was already non-viable; hence the process of abortion could not be arrested by the medicines doctors gave you.  What you feel you got period was in fact starting the process of abortion. It is better if you confirm the diagnosis by ultrasonography as urine pregnancy test requires about a week to ten days to become negative. If ultrasonography reveals that this is incomplete or missed abortion, better get it completed by surgical evacuation. If still the baby is viable, continuation of Novalon tablets might help you to stabilise the pregnancy. I hope this serves the purpose.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Want to conceive. Using mirena. endometrioses by laparotomy. Advise?\n\nI am 42 year old female diagnosed with endometrioses two years ago and had chocolate cyst which was removed by laprotomy . I have one child 6 year old and would like to go for another. I have mirena currently and my amh is 0.03. But I am advised to remove mirena and wait for period . and in periods I will go for a scan wherein ovaries will be checked. Pls advise whether women with endometriosis can try for pregnancy with age similar to mine",
    "doctor_response": "Hi , you are 42 years female, have endomatriosis, and chacolate cyst which is removed 2 years back by laprotomy. have one child and looking for another.                         you have a gap of 6 six years after the first child, and your age also 42 at the margin of the fertility.                          Nothing is impossible,your doctor will be the correct person to judge the position, her statement is correct, and in the correct way. and there will be chances, wishing for a good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for inflammation in the ribs\n\nSo, the top three ribs on the right side of my chest are inflamed and have been for about 3 days now. (It starts at my sternum and ends about 1 1/2 inch away) It is not as noticeable when I sit up, but when I lay down you can feel the height difference between the right and left sides of my chest. It seems as if they are just elevated as they do not cause any pain. Occasionally, there is a bit of pressure but nothing major.I am a 22 year old female and just trying to figure out what it is before wasting money at the doctors. Any ideas would be wonderful!",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .*  Primary guidelines for better recovery-  Local application of ice pack 5 min. each 3 times a day .-  Intake of tab. ibuprofen ( 400 ) mg 3 times a day after meals preferably    with antacid tablets .*  Follow up after 2 days about the progress .Hope this  will help  to clear your doubt   .Wishing you fine recovery .Always welcome for any further assistance anytime .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does severe nasal inflammation cause breathlessness and tightness in the chest?\n\nI have severe nasal inflammation/ and I had to stop the prednisone because of severe gastritis . Dr put me on antibiotics  but D/c cause CT showed no sinusitis. ENT is testing my allergies which is his treatment for this issue. Still having trouble breathing and this morning chest so tight and hard to get breath from mouth. Told Dr Friday was having chest tightness and SOB ./he said anxiety. Well This am I Had to use Albutetol -one from a while back -to open up airways. I have a pulse oximeter -and when I woke read-87.  It has since gotten into mid 90\u2019d. Who would you suggest I see about this. Something is wrong . I am having trouble breathing . \u00db",
    "doctor_response": "HelloAs you explain the situation you should add in your current treatment antihistamines drugs such as Telfast orally twice and topical steroids.Please discuss with your doctor for the aboveRegardsDrJolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What disease can occur if child sufers from eczema type rash?\n\nHi, this is regarding my 17 mo old baby. He s just been sick for the first time: throwing up. He doesn t have a fever or any other flu symptoms other than nausea. He s puked btw 5-8 times in the last hour and a half. I m concerned about the dark color of it. It s very brown close to black. It almost seems as though the mucus and bile are this dark color. No matter how much he gets sick and how empty his stomach is, it s still this dark color. He has no existing health problems: has been healthy since birth. I d say he s about 25 lbs. Can you tell me if this is symptom of anything or if I should be concerned. He has also been developing an eczema-type rash over his chest and back over the last day or so. I don t think it s related but worth mentioning: I was crediting that rash to dry skin possibly. Can you help? Thanks!",
    "doctor_response": "vomiting in children can be caused by early gastroenteritis ( infection of the intestines ) which is usually viral , the skin rash you mentioned mostly is not exzema, it's probably from the reaction of virus it self . the brown color you see is a very small amount of blood that is digested in the stomach and gives this brown color , it's caused by the excessive vomiting and it's called  ( Mallory weiss tear ) , a small tear in the esophagus.  this excessive vomiting can cause dehydration, so it's better to take him to his pediatrician to assess him and confirm the diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for red patches in palate\n\nHi, Thank you for taking my question. I have a red patch on my palate. At first it was just small red bumps, but now it s changed shape and gotten bigger. It s been there for about six months. I actually forgot all about them until I went to the dentist. They do not hurt. They are just there. Thank you for any input.",
    "doctor_response": "Thanks for your query, I have gone through your query.The red patch could be because of the fungal infection like candidiasis or it can be erosive lichen planus or it can be pemphigus. Consult a oral physician and get your self examined to rule out the above mentioned conditions. You can use topical steroids like triamcinolone acetonide (0.1%) if it is erosive lichen planus or pemphigus. if it is candidiasis then you can take topical antifungal agents like candid mouth paint.If it is not healing for more thah 3weeks then you have to get a biopsy done to rule out any malignancy.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could the clot like swelling around wisdom tooth indicate?\n\nMy daughter had all 4 of her wisdom teeth one of them had a cyst which was removed and tested it was fine. A few weeks later a hard lump was felt  by that same sight and her right side was swollen a clot formed and surgeon released it and she was fine. A panoramic X-Ray was done and everything looked fine. Recently a small pinkish spot appeared by her jaw where the lump is still hard. Don't know if it's related. Can you help.",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. This spot which you are mentioning can be collection of pus , which might have occured because of infection of bone or tooth. Better you visit your dentist again,  and get it properly examined as not to take any risk in a follow up case of cyst.Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy rashes all over body after recovering from fever?\n\nhi , i had fever for a couple of days and right after my fever has been treated i have rashes all over my body. the rashes are small red dots and is very irritating and itchy.my palms hurt too.ive taken blood test twice and my platelets are normal. what do i do",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern looking to the history given here I could say that this is could be auto immune reaction and this happens some time when there is history of fever but this is nothing to worry about this, this could be possible with the viral infection too, hope this information helps you, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe asthma with recurrent fever?\n\nmy son has been sick for 4 weeks now he is a sever asthma and the drs have given him 3 lots of antibiotics and he is on 2 puffers ventlin and the orange one he has a very harsh cough and a fever that comes and goes he seem to get better and al of a sudden he is back worse than he was in the first place wonder if you can help me figure out what is wrong with him.. He has had extrays done and no signs of pnomonia",
    "doctor_response": "Hello,Exposure to irritants and allergens trigger the attack of asthma in susceptible child. Allergens or irritants may include pollens, dust, mites, infections, air pollution, some chemicals, medications, or sometimes exercise. Continue medications and consult immunologist to find cause responsible for asthma and then try to avoid them.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Khan Shoeb Mohammad Sher Mohammad",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any side effects for long term use of L-Montus pill?\n\nI suffer from severe throat itching every night. I am also ashmatic. But the symptoms are gone when I take L-Montus ( once a day). I am taking this medicine since a year now. Could you please let me know of any side effects for long term use of this medicine ?",
    "doctor_response": "Hello, Neuropsychiatric disturbances may occur. Like sleep disturbances, bad dreams and agitation can occur. A little bit rare but serious. Quit the habit. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.T. BALAMURALI, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Blood clot in teeth. Bleeding teeth with pain while brushing. Pyria, how to avoid?\n\nHello, I use a soft pepsodent brush and sometimes in the morning when i wake up i sometimes find blood clot in my teeth. Also usually when i brush i get blood (the teeth part form where the blood comes having little pain, i brush for a few moment in the same part than it feels like the blood is finished and the pain goes away). And i am afraid if it resulted in pyria :(. I think its too expensive for the treatment.  So please can you tell me what can i do to avoid it? Is it that expensive how i am thinking??",
    "doctor_response": "Hello, It seems like you are having Gingivitis. Get your teeth scaled by your dentist. Brush your teeth twice daily, floss regularly, Use a mouth wash twice daily for 1 month, clean your tongue using a tongue cleaner. Scaling of teeth will help in resolving the gingivitis problem. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly suggest the management for chronic shoulder pain.\n\nHello doctor, I have extreme chronic shoulder pain in both shoulders. It keeps me away from sleeping every night for the past eight months. It is hard taking a shower or bath. Kindly help.",
    "doctor_response": "Hello. I would like to know if there was any fall or hit on the shoulder. In my opinion, I would recommend getting some soft tissue work on your shoulder rotator cuff muscles. Keep icing your shoulder frequently for 15 minutes once for every two hours. Do some posterior capsule stretch, and rotator cuff regularly stretches each stretch to be held for 30 seconds. I hope this is helpful for now. Kindly revert after a week to let me know the status of your shoulder.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen forehead after injury\n\nHi! my one year old fell and hit a rock with his forehead (right at the hairline). It wasn t a hard fall as he halfway caught himself, but it put a dent about the size of a nickle in his head for a few minutes. He seems fine, not much crying and such, and its starting to swell a little. Should I take him to the ER or wait and see how he does?",
    "doctor_response": "Hello.   I just read through your question. Because he didnt lose consciousness at the time of the injury, there is very little concern for serious head trauma. The next thing to look for Is vomiting within the first 24 hours. As long as this does not happen, there is no cause for worry. An ER visit is unnecessary.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Laproscopic surgery,bleeding ovarian cyst,appendix removal.\n\nHi, I had laparoscopic surgery on Tuesday (5 days ago). The reason of the surgery was bleeding on my ovarian cyst . Furthermore, they took my appendicitis . Now I use two antibiotics, one is aksef (Sefuroksim Aksetil) and the other is Biteral (Ornidazol). They will cease tomorrow morning. Today I want to smoke marijuana. Is it dangerous for me?",
    "doctor_response": "I do not believe that there is any interaction between marijuana and the medications that you are on. Also, assuming that you just had a routine laparoscopy with no concern regarding infection within the pelvis (i.e. it was just a bleeding ruptured cyst), then there is no reason that you should still be on antibiotics.  The standard of care is to just give you one dose within 30 minutes of the start of the procedure. I hope this helps!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a person to collapse with foamy saliva from mouth?\n\nmy junior sister collapse in class at school with foamy siliva from her mouth n was rush to de hospital.after treatment the doctor wrote on her report siezure disorder and she was to go in for a CT scan.the scan was perform on her brain with the result indicatn normal for all result.can i know is there is any other medication for her,well,she is not an epeleptic.",
    "doctor_response": "Hello, Besides CT scan your sister should undergo EEG since seizures are suspected. Anyway, treatment should be started if a second seizure occurs. Discuss with a Neurologist for these issues. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tenderness in hand after injury\n\nHi, 2 days ago a toy fell on my hand. I have no real bruising or swelling but my hand, fingers and wrist have pain to my elbow, mostly stiffness. I have use of my hand its just tender and not full strength. Should I get an x-ray or could I have just hit a nerve?",
    "doctor_response": "hihope this msg finds u in good health. it doesn't seem to be a serious injury its just a soft tissue injury take rest..analgesics. .n it will heal upif there is a problem. then get an xray done nothing to worry about thanks Take care god bless",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes involuntary shaking of head and hand?\n\nYes, I have been shaking from my head a lot and my hands. Also inside shaking, when I get it I get shortness of breath. I have had some chest pain at times. I've had 3 heart attacks over the past 15 years. I went to the cardiologist twice and my ekg was fine both times. I take my blood pressure dailey for the past few days. It's been ok but my standing pulse rate is not what my normal is. Resting rate is usually in the 60's. It's been between 75 and 95. I also went to my GP doctor and all the blood work came out negative. What do I do next.",
    "doctor_response": "Hi, Welcome to HealthCareMagic.com I am Dr.J.Mariano Anto Bruno Mascarenhas. I have gone through your query with diligence and would like you to know that I am here to help you.Question 1 : What causes involuntary shaking of head and hand?Answer 1 : This can be titubation with intentional tremors. These are signs of cerebellar involvementQuestion 2 : What do I do next.Answer 2 : Consult a Neurosurgeon at the earliestHope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in HealthCareMagic at  Best Wishes for Speedy Recovery Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggestions for pain in the upper stomach after eating contaminated food and other time as well in a celiac diseased person?\n\nI have celiac disease and always have upper abdominal pain right below my ribs. Had ultrasound done and didn't show anything. I ate some food a couple weeks ago that was contaminated.  I've had severe pain in my upper stomach. Doctor says he can't find anything wrong. Any suggestions?",
    "doctor_response": "Hi. As you are a known case of celiac disease You should have avoided contaminated food. Well, a course of antibiotics after the proper blood and stool test should help you. ultrasonography is not always helpful. This is just to rule out any other problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heat inside body?\n\nWhy does my body feels like a fire inside? I m burning up hot on the inside but no fever. I feel so tired and drained and fatigued all the time especially after eating. I only feel a little relief when I put ice on my hands, feet, and stomach. What is wrong with me?",
    "doctor_response": "HiThank you for asking HCM.I have gone through your query. Your problems can be due to high cholesterol or hyperthyroidism. Check your lipid profile and thyroid profile. Also go for routine blood count and ESR to rule out any possibility of infectious process running in the body. Getting proper exercises like jogging will be helpful.Hope this may help you. Let me know if anything not clear.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Soreness in rib cage and hip area after drive. Why pain? Kidney tests normal. Infection?\n\nhi, I just got back from a 6day driving trip. When i left i was fine. My first night i noticed a pain/soreness between bottom of my rib cage left side and just right of my hip bone in about 2inches. Each day that passed i notice abit more pain.. naging pain.. especially when ever i would bend over.. On the way back home i notice the pain increasing more and more. Not debilitating, but becoming more of a concern. Yesterday i saw a doctor.. he doesn t seem to be to concerned. I have appt. for ultra sound in 6days. I told i was concerned if it was my appendixs. Says no. wrong side. So having tests for kindney & blatter. mm after doing some reading here i figure i don t have any stones of any kind.. Just wondering if i could possibly have a simple infection of some sort. Sometimes in the last 24hrs the pain doubles me over.. but doesn t last long maybe 40sec or so. I m female 54.",
    "doctor_response": "Hi, most possible cause of your problem is out of long drive .fatigue back muscles and hip muscles giving rise to soreness and pain . Possibly you have sprained your spine and that causing pain on walking and incresing . Please get a check up with ortho surgeon and find out . Not likely that you are having infection ,appendicitis or kidney problem . Till you get a check up get rest and avoid strenous work . hope you be all right soon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cut few nerve bundles close to bladder while prostate shaved and is affecting sexual ability\n\nI had my prostate shaved, but now have issues. I do not have prostate cancer, but they may need to remove my prostate. Since it is not cancer, is it not so that they should not have to worry about cutting into the 2 sets of nerve bundles that are close to the bladder, that might result in incontinence, as well as affecting my ability to have sex?",
    "doctor_response": "Hello and .Your concern is understandable.As an Urologist, i assure you, there's nothing to worry about .The reason being that, the prostate  gland is located below the bladder.The nerve bundles you're worrying about is located outside the gland.Some degree of incontinence occurs after relief of obstruction, in the immediate period ,after surgery.This lasts for few days to a week or so.You certainly can have sex in a months time after surgery.The semen after sex will go into bladder, instead of coming out.Tou can contact me if you have any doubt, by name.Dr.Matthew Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could an ingrown wisdom tooth be the cause for a painful lump under chin near jawline?\n\nOkay so my wisdom teeth are growing in and one of them hurts a lot. I have to get them removed but in the mean time I got this lump under my chin near my jaw line. It's almost directly under my hurting wisdom tooth I was wondering if that normal or something else is wrong. It's pretty painful",
    "doctor_response": "Hi,Thanks for asking the query,    Yes this could be because of the impacted wisdom tooth.I would suggest you to consult to an Oral surgeon get a thorough checkup done take an OPG radiograph and plan for the removal of tooth.Take  a course of antibiotics and analgesics.At home take lukewarm saline rinses and antiseptic mouthwash gargles.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had hernia surgery. Pain like baby kicking but not pregnant. Since surgery hearing pop in stomach. Any suggestion?\n\nHi there.. ok years ago i started with the pulling pain on my right side lower tummy area but few yearz later a Dr said i had a hernia so i had surgery for it jan 2013 , then like 2 weeks later i felt loud pop in my stomach so i brought it up to the same dr , you know wonderin if the mesh popped out he said no.. he didnt really check ,he did no ultrasound nothing.. but since then every month bout week or week and half before i start my menstrual i getting that hard pulling pain again kinda feel like a baby kickin you while being pregnant but i am not prego.. and also since the surgery and since i heard and felt the pop now like i said bout week to week and half before my mentrual i also getting i cant tell if its nail polish remover taste or metallic taste and these symptoms are only before i start.. i hope you can give me idea what this is...",
    "doctor_response": "Hi, I'd advise to consult GI specialist again, to do fibro-gastro-scopy together with abdominal ultrasound to check for the condition of hernia. Infection is also to exclude, I recommend trans-vaginal ultrasound to check the genital organs (ovaries, uterus, vagina) together with vaginal swabbing test and urine analysis. Large bowels problems are also associate with the symptoms you experience. Abdominal ultrasound and physical examination would determine better course. Hope it helped!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What alternatives are there to opioid medication?\n\nDepression after long-term chronic pain? 9 back surgery on lumbar due to infection of cord. 4 cervical fusions....I hurt but how can I overcome pain and depression...after years of high doses of opioid....now have no reason to get up...its sad .what alternatives are there to opioid?",
    "doctor_response": "Hello, There are many different treatments other than opioids that you can try to help with the pain. In particular, there are some antidepressants that can help with pain as well, such as duloxetine, that might be a good choice for you. So I would suggest discussing this with your doctor, and hopefully, that can help some with both your pain and your feelings of depression. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Aaron Branch, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for wheezing in a kid\n\nHi, My son age is 2.10 years, he is getting continues cough in night times and wheezing. this is happening 2 months once. Right now we are giving nebulization with Levolin but its not controlled from past 2 to 3 days. Apart from this nebulization we are ging Asthelin Syrup 3 time per day as prescribed by doctor. Please help to improve his health. If a kid gets continues cough(dry cough) after nebulization how we can we treat this situation. Thanks much, Srinivasa Reddy.P",
    "doctor_response": "thank you for using healthcare magic.hi mam. I think your sons asthma is poorly controlled that is why he has been having attacks every month. Better to see a pediatric pulmonologist for this problem. Your kid needs a step up in the asthma controller medications. This means you have to add other medications (ex: steroids, montelukast, cetirizine, etc.) to ur current salbutamol nebulizations. sincerely, Mark Rosario MDpediatric pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for a lump under the skin\n\nHello doctor, about a week ago I suffered a punched in my right arm that bruised pretty badly, the same bruise kept getting hit and bumped causing it to heal slower now that the bruise is finally fading I have a small hard penny size lump under my skin when the bruise occurred",
    "doctor_response": "Hi,Nothing to worry, there might be having some localized hematoma due to injury.Gradually it will be absorbed.Apply ice pack for few days.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for recurrent fever,cold and runny nose in a child\n\nhello doctor.. My baby is 21 months old and hes got a cold but what i m concern is that every month he gets it and i don t know what to d no, hes got temperature, running noise, whissiling chest, and coffing, i give him milk and he takes it back out, what can u suggest me please.?",
    "doctor_response": "he might be having wheeze associated lower respiratory tract infection.. if you are facing same problem every month,, have a portable nebulizer at home,, whenever\u200byou feel the child is having difficulty in breathing with audible respiratory sounds, give nebulization with salbutamol (asthalin) for every 2 hrs.. along with antibiotics and anti pyretics.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can cancer be treated in a critical stage?\n\nHi Doctor, My friend attacked by cancer. Till now he has undergone, 3 chemo cycles. Now his condition is critical. Is there any way to save him. We are from  India and there is no money problem to us . However we just want to save his life. He has small kid with 11 months old  and got married 2 years back. -Ravi",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Your friend have cancer. Treatment depends on type of cancer, Site of cancer, Stage and spread of cancer. In early stage surgical removal is helpful. In late stage only chemotherapy or radiotherapy are the treatment options. Please send me her report of cancer type and stage so that I can help you further. Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vibration type sensation on left side of chest?\n\nAll day today I have been having a vibration-type sensation on the left side of my chest. It doesn t feel like it is in the skin but deeper in the chest. I don t have any pain associated with it. It feels like I have a cell phone in my pocket and it s vibrating except there is no cell phone in my pocket. I do have high blood pressure and take medication for it. Other than that, I am fairly healthy. Any ideas?",
    "doctor_response": "If you are having associated symptoms like giddiness, and this symptom is persisting then you need to be evaluated with an ECG as it could be some disturbance in heart rate as well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is hairy cell leukemia?\n\nMy husgand has hairy cell leukemia.  Each time he goes tot he doctor and the doc asks how he feels he says \"great\".  I am going next time because he is always tired, sweats alot, bruises, is very pale, and breaths heavy.  If he doesn't tell the doctor this, the doctor doesn't know.  Also, his counts have dropped considerably.",
    "doctor_response": "Hi,Thanks for writing in.Hairy cell leukemia is a type of abnormality in lymphocytes which are white blood cells. If his counts are going down then you should consult his doctor and acknowledge them about the bruises, feeling tired and sweating. It is possible that he requires aggressive treatment for hairy cell leukemia and his general health also should be cared for.Giving him a healthy diet and adequate amount of fluids is required. Many times counts might drop during recovery also but if it is persistently reducing by large numbers then it requires to be discussed in detail keeping in mind his health condition and development of weakness and fatigue. The main features of hairy cell leukemia includes hairy cells are found in the blood and bone marrow. The number of red blood cells, white blood cells, or platelets may be lower than normal. The spleen may be larger than normal. Patients are followed up for response to treatment with chemotherapy medicines and most of them are treated. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes soft spot on the head along with headaches?\n\nI noticed a soft spot about a month ago,but didnt think much of it. I just recently noticed it was extreamly bigger than it was. Ive had bad sinus trouble for about a year or longer with painlful headaches that sometimes feels better when i squeeze my head. Could tge soft spof be realted?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have soft spot on the head along with headaches. Well there can be many reasons for symptoms you mention in query like migraine , follicullitis , fractured bone or hematoma . I would suggest you to consult dermatologist for proper examination. Doctor may order CT scan , ultrasound and physical examination to check tenderness and consistency . Doctor may drain the hematoma , prescribe antibiotics along with anti inflammatory or may prescribe vasograine along with diuretics and betablockers. For now apply warm compresses and take ibuprofen or acetaminophen for pain .Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What could be done to cure UTI causing difficulty in urination?\n\nHello doctor, I am newly married for 25 days. 10 days ago, I had UTI with burning sensation while urinating for which I was prescribed Augmentin 625 and Cital syrup. I took medicine for three days and had some relief. Then three days back suddenly I was not able to urinate at all. My bladder was full but I was not able to dispense urine. I visited the doctor. They emptied my bladder using Foleys and 500 ml was emptied. I was prescribed: 1. Tablet Oflox 400 mg once daily. 2. Tablet Flotral (Alfuzosin) 10 mg once daily. 3. Tablet Urispas (Flavoxate) thrice daily. 4. Cranbe (Cranberry) capsule 300 mg twice daily. I was advised a urine culture and ultrasound KUB. Reports are attached. Now I am able to urinate but have to apply all my force. I feel my bladder is full then I go and sit for 10 minutes but urine does not come till I apply full force. It is very painful for me. I am not able to pee normally for the last five days. What has happened to me? And how to return to normalcy?",
    "doctor_response": "Hi. Urinary infection is common in young married women. You had UTI and it was treated with antibiotics, causing no growth on culture. Only thing of note is draining 400 ml through a catheter, usually, retention is not common. You should not hold urine for long. Never postpone urine for more than three hours. Do you have associated constipation? How many times you get up at night to void, do you feel an urge to pass urine? Was there straining to void before this UTI episode or passing urine was effortless? Any fever?",
    "dialogue_context": ""
  },
  {
    "patient_message": "How should Metformin be taken while suffering from diabetes?\n\nI am taking metformin for the first time.  I did take 2 tablets 500 mg and my blood sugar is much higher than it was this AM.  On the label it said to take 2 tabs by mouth every day. Nothing about taking 2Xs in a day. It did say with food. How long does it take to see any change. Is it a few hours after or is it days?",
    "doctor_response": "Hello,Get your Hba1C done before starting any OHA (Oral Hypoglycemic Agents).We should not rely on just fasting or post lunch value we need to see the past 3 months sugar levels from today to start any drug.However, you can start with tablet Metformin once daily and homely monitor your sugar levels with the help of glucometer.Monitor your sugar levels every 8th hourly for 5 days and consults the general physician or diabetologist or endocrinologist.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mohammed Abdullah",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe gastritis problems after the removal of gall bladder?\n\nI had my gallbladder removed and have had alot of gastro issues in the last three or four years...I used to drink alot but don't anymore...if I drink a beer everyone in awhile it will make my face an neck break out in hives...I have had all kinds of tests which show no other issues, If my liver was bad wouldn't the dr have noticed this while doing my gallbladder surgery",
    "doctor_response": "HiThank you for asking HCMI have gone through your query. As you used to drink a lot before risk of pancreatitis also will be there. Gastritis can be controlled by medication like pantoperazole or omeprazole. You should better undergo an ultrasound of abdomen to rule out a pancreatitis. If it is there you should get treated for that also. As alcohol will worsen your problem it is better to avoid it.Let me know if you have any further query.Have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Constipation in baby who had an anus surgery and colonostomy done during birth.\n\nmy baby is put on milk of magnesia and sometime she is having constipation problem. anus surgery and colonostomy done during birth",
    "doctor_response": "THankd for the query Your query has no question in it, i kindly ask u to reconsider and frame a better query so that we can be of help Have a healthy living",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is surgery the only option for knee buckling?\n\nHello doctor, I am a 36 year old male. I have\u00a0been having knee buckling problem for\u00a0some time. The problem started in the right knee about four years back and since then I have stopped sports. However, at times during some movement or jerk, I get this buckling problem and pain for two to three days. About two weeks back, I had a\u00a0similar problem in my left knee as well while trying to jump and take a photograph. It is paining since last two weeks. I have attached the MRI and CT scan reports. Do I have to go for a surgery? Or can it be cured with exercise and physiotherapy? My weight is 97 kg and height is 5'9\".",
    "doctor_response": "Hi. I have gone through your history and the reports attached here (attachment removed to protect patient identity). For further information consult an\u00a0orthopaedician and traumatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does azzospremia in the report suggest?\n\nAge-29,height-172cm,weight-55.My English is not very good ..but i try at my best...I married before three years..I have no child...report are as follows...azoospermia,prostateis normal in size,shape.echotexture.the right seminal vesicle is highly atretic.the left seminal vesicle is absent. No prostatic system seen vascularity normal  i am financially weak ....so plz.. Suggest cheapest solution....my email - YYYY@YYYY",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Sperm needs nutrition from prostate and seminal vesicle secretion. Your prostate is not seen and so your proper evaluation needed. I need to see your full semen report for giving more comment. Your serum testosterone, FSH and LH need to be investigated thorough blood sample provided to laboratory. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling hesitant & nervous to talk to girls\n\ni m 22 years old . i have problem to talk to girls. i have so much hesitate and nervosness.i feel very disturbing if any girl seat around me. i cant talk to girl and for completeing my sex needs i used to do daily masturbeating. i want to stop it and i want to change myself .what should i do plz help.",
    "doctor_response": "dear friend. it seems you have a anxious personality. try to make friends with girls, always make eye to eye contact and talk confidently. i know you will feel anxious but to face the situation will only help. masturbating daily wont help to overcome your anxiety of talking with girls.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to avoid hair falling while shampooing?\n\nHi, I am a 24 yrs female. I want to ask how can we avoid hair fall during shampooing, oiling and combing. I have black, wavy, dry hair. Please suggest some products for dry hair to reduce the hair fall. I lose much hair during shampooing and oiling. If I oil massage the scalp I lose many hair. Please suggest something. Home remedies will do too.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.Hair fall during shampooing is absolutely normal phenomenon. Do not worry. Only if you lose more than 100 hairs a day, you can consult your family physician or dermatologist.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stress and depression\n\nsir i have a problem in eating,i think this is a psycho problem because when i am not alone and i can not concentrate on my throat i swallow food easily but some time it stacks in throat which cause same breathing problem i suffer in this problem from the last 1 year,in eating some thing spicy i feel jealousy in throat.by using tablets such as Amoxilin i feel good only for a week.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. I sincerely opine that the problem you are facing now is of your own creation. I think you are obsessed with thoughts an negative thinking about your throat and swallowing. You had the strange sensation onece, twice or thrice. You should learn to leave the thinking part there. If you have any doubt regarding your health, consult a physician. If you are perfect leave the matter there. Otherwise, take treatment.If you still need my help, please describe the whole problem in detail and post a direct question to me. I shall definitely help you with psychotherapy techniques to over come your problems.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is cervical canal length of 3.2 cms normal at 17 weeks of pregnancy?\n\nI am 17 weeks into my 1st pregnancy. I am concerned about my Cervix. The ultrasound that I had says that my internal os measure 04mm and cervical canal length measures 3.2 cms. Can you please advice if I am at any kind of risk and that I need cerclage",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the cervical length is considered to be small if it is less than 2.5 cm.But incompetent cervix is diagnosed by history of any previous miscarriages and short cervix.Also it needs physical examination before accurate diagnosis.According to length given that is considered as normal.Best regards...Dr Srilatha",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for upward bend lingual arch\n\nMy lingual arch is bent upwar because I keep flicking at it with my tongue and other objects I stick in my mouth such as pens, sticks, knives. What do I do about this? I don't want to go to my orthodontist because I don't want to get charged extra. I just want to know if there is a way I can bend it back downward.",
    "doctor_response": "Its not advisable to correct that bend Lingual arch on your Own. I would above you to visit your orthodontist and get it corrected. This way you will learn not to play with your Lingual arch next time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having asthma symptoms. Chest x-ray normal. Stopped smoking. Spit test normal. Suggestions?\n\nhi, at the start of december i had flu symptoms and had some time in bed ,but blood tests came back normal, amoxacillin and steroids cleared chest infection but now have athsma type symptoms which has laid me up as cant walk far without stopping generally feeling awful chest xray ok but had to stop my five a day smoking spit test normal can i be ill and have normal blood test also came off fluoxetine in september after 5 years did it over 2 months",
    "doctor_response": "YOUR ALLERGY CAN DEVELOP  AT ANY TIME WITH ANY SUSTANCE AT ANY AGE NORMALLY IF YOU MIS DIAGNOSE ALLERGIC SYMPTOMPS WITH FLUE AND TAKE ANTIBIOTICS PARACETAMOL AND DIETRY SUPPLIMENTS IT INCREASES ALLERGY AND ASTHMA AL TESTS ARE OKAY IN ALLERGY EXCEPT IGE LEVELS IN BLOOD AND EOSINOPHIL COUNTS fluoxetine LEAVING HAS NO SIDE EFFECTS OR LINK YOU GET DIAGNOSED FROM ALLERGEOLOGIST AS PER ALLERGY GUIDLINES",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a flight journey advisable post a mild head injury?\n\nWe are in Jackson Hole, Wy skiing. This afternoon my daughter (age 15) did a jump and fell landing on her feet, Butt then head. She didn\u2019t blackout, but she has a headache. She mentioned feeling pressure. We had ski patrol look at her and they said it\u2019s your call. She is alert, currently singing in the shower. She was wearing a helmet with no visible damage. We are scheduled to fly home tomorrow back to NY. Should we delay our flight? Should we go to emergency for a cat scan?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I have noted the details. The injury seems to be minor. In my opinion, it would be safe to fly tomorrow. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have pain in abdomen, rib cage. Limited movement. Sensitive to touch. Ultrasound shows clear liver. Treatment?\n\nIve woken on two occasions 3 weeks apart with excruciating ripping pain, in the upper right abdomen, immediately beneath the rib cage, very difficult and limiting movement after this, improves slowly over days - still very sensitive to touch (even wearing a bra).  Just had ultrasound and sonograph cleared Liver and Gall Bladder - any other thoughts?",
    "doctor_response": "Hi and welcome to HCM.It may indicate some other liver disease such as hepatitis or liver cyst as well as some oancreatic issue. also it may be temprary bile duct obstruction by stone which may have passd so undetectable by ultrasound. but yours symptoms by my opinion is more like neuromuscular pain so it may be intercostal pinched nerve or pulled muscle. take painkiller in next several days together with muscle relaxantas and I am sure you ll feel better soon.Wish you good health.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat kidney problem with creatinine level 11 and what could be the diet?\n\nMy mom is suffering from kidney problem.... her creatinie 2 months back was 6 but 1 week before when her tests were taken she was a bit ill and her results were shocking.... she had 11 creatinine :( ..... now whatever she eats, she vommits it out and is not even able to take medicines... she is vomitting from 2-3 days whatever she eats, rather it be medicines or anything else.... any suggestions for her condition ..... what should be given to her for eating??",
    "doctor_response": "HiThanks for your queryWith a creatinine level of 11 you need to see a nephrologist ASAP. We will need to initiate hemodialysis. The persistent nausea and vomiting are probably due to severe renal dysfunction.Hope this helpsGood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the present lower back problems with pain?\n\ni got shot in the back when i was 12 the scar reopened when i was in weight lifting during football practice when i was 16 and the doctors patched it up again im 18 now and im starting to get lower back problems underneath the scar could it be from my accident or could it be from weight-bearings cause i still weight lift for rugby in college and i go swimming often",
    "doctor_response": "Dear patient it seems your back pain is not due to accident but might be due to adherent scar and weight lifting. Since weight lifting itself leads to back strain and bursitis undernith scar also lead to back pain you need to investigated for both. I would like to advice ultrasound of the scar area and digital radiograph of spine to  come to conclusion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe lower back pain\n\nMY mother aged 58 years is suffering from lower back for 3 years but since last couple of months, the pain has spread to both of her legs and below knee she feels absolute numbness. Doctor has advised her to wear cotton shoes and not  to remain bare footed as any injury at this stage would lead to complications. Request Neuroloist to sugest for further medication. She is heart patient and non diabitic. She is little over weight.",
    "doctor_response": "HelloAs per your description of the clinical symptoms it seems that your mother has a PIVD ( prolapsed intervertebral disc ) with radiculopathy, which means there is a nerve root compressin at some level of her spinal cord and the pain is radiating to her lower limbs.If I were the treating doctor I would have suggested a MRI scan of her spine ( lumbo-sacral region,being the most common) and with relevance to her present symptoms and other medical conditions a Decompression surgery may be required. relief of symptoms in these kind of surgeries are prompt and magical.Hence, I would suggest you to visit a spine surgeon ( orthopedic or neuro surgeon), get her evaluated and proceed accordingly.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat pain and swelling in the ankle?\n\nHello. For a week and a half now I have been experiencing some pain on my right ankle. I thought it would go away, so I didn t really do anything for it. I kind of regret it now, because today it started to hurt really badly for the first time, and it started to swell. What should I do? Oh, and I do not know how I hurt my ankle, which sucks because I just don t remember doing anything to it that may have hurt it. Is that normal? Thanks!",
    "doctor_response": "Your ankle needs rest - make sure your off load it . Use walker or crutches till pain subsides. Use compressed ice packs on the ankle every 4 hours for 15-20 mins each time. Elevate ankle above heart level while lying and use compression bandage to reduce swellingIf the pain and swelling does not subside in 1 week, you make want to get an xray and seek medical help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the reason for testicular pain and burning sensation in the leg?\n\nHi doctor,Actually, I feel sometimes pain in my right testicle for last two months. Sometimes also feel burning sensation, weakness, heaviness in the right leg. For past four months, I was under severe stress, anxiety, and depression due to an unprotected sexual exposure .five months back. It caused self-guilt feeling inside me. Had medications for that. Checked also for HIV (duo combo), VDRL and HBsAg. All were negative till 100 days after exposure. Last month I saw blood in my sperm which got treated and the reason was excessive masturbation because after 15 to 20 days, I masturbated but it was all clear. No issue. For my mind satisfaction, I chose for testicular USG, urine culture and PSA test. All were normal. I want to know if all reports are fine and normal then what is the reason of the testicular pain and burning sensation in the leg.",
    "doctor_response": "Hi. Testicular pain can happen due to any cause like a simple infection of virus or bacteria. So you do not have to worry about it. The burning sensation of the leg could be due to some allergy or something. Your problems are in mind and not the body. You are anxious and guilty as you said. Kindly calm your mind with yoga or meditation. Do activities which interests you and get involved in that. If you still have problems then come for follow up after two weeks to us. For more information consult a general practitioner online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mild chest pain, headache and elevation in the BP level?\n\nHello my name is Talia I had a medial nerve branch block this morning around 8:45 AM and have started feeling funny having a little chest pain and headache took my blood pressure and it s 175/105 could this be from the diagnostic nerve block I had today",
    "doctor_response": "Hellothank you for trusting HCMDear elevated hypertension nay cause hypertensive emergency in which may cause end irfan damage .may present with head ache and cardiac pain (due to elevated atrial pressure,decreased diastolic coronary perfusion),renal involvement us there. but median nerve palsy may be due to carpaltunnel syndrome. may be not related to hypertension. first you have to take antihypertensive drugs and need to consult cardiologist . then he will examine and treat you accordingly. I think I answered to your question if you have more questions feel free to ask.take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for left ventricular dysfunction\n\nsir my mother age 52. Principal diagnosis: DM/CAD/OLD IWMI/SEVERE LV DYSFUNCATION/SVD-RCA ATTEMPTED PTCA/STENTING TO RCA-ABANDONED. HISTORY: Admitted for PTCA/Stenting CAG and revascularizatiom. CAD/OLD AWMI/Sev.LV dzsfunction with SVD-RCA. No history of HTN/DM/COPD/TIA/CVA/Drug allergy. Bowel and bladder habits normal. On examination: HR 70/MIN BP 120/70 mmHG CVS-S1 S2 + RS-naormal.",
    "doctor_response": "Hello Thanks for posting at HCM. Going by your description it is evident that your mother has sustained a heart attack in the inferior wall of the heart which is supplied by the RCA. The RCA which was blocked and caused he attack was attempted to be stented but was not possible due to chronic total occlusion or calcification. Because of the heart attack, the heart muscle in the inferior wall of the heart sustained damage, that's why the severe LV dysfunction. Since RCA could not be stented, there is only the option of medical management. Bypass surgery is done only if there is involvement of the LAD. So she has to be on medications like two blood thinners , cholesterol lowering medications, diuretics to decrease load on the heart and other medications like beta blockers which prevent the remodeling of the heart after a heart attack. She should do well if she is compliant on the medications. Since RCA could not be opened and the past of the heart supplied by the RCA is already damaged, there is no need to re attempt the stenting. Wishing her good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shoulder blade pain during a pregnancy?\n\ni am 33 weeks pregnant and for the past 2 maybe 1 an a half weeks i have been getting an annoying pain just under my right shoulder blade, like i need to click my shoulder blade or something, is this referred pain ? Do i have anything to worry about? Baby is moving lots still!",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the pain under shoulder blade can be due to muscular origin or gastritis.Avoid spicy and oily diet.Take antacids.Also some type of non specific pains are common during pregnancy which subside spontaneously.Take panadol for pain.Apply hot fomentation and local irritants.Nothing to worry.It will subside.Best regards....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Been having heart palpitations, stressed, tingling down the arms, shortness of breath. Will it leave?\n\nI ve been having heart palpitations for about 3 weeks. I have had them before but just for a day or so and it goes away. I thought it was just due to the stress of the holidays but this last week it s gotten worse. Every single day and all day long intermitantly. I had a really bad day a couple nights ago where it did really big flips like my heart was going to jump right out of my chest , I had tingling sensations down my arms. It seems to have improved now but still going on. And I m having shortness of breath also. I ve made a doctors appt, but it s not for 4 more days. What is going on? Will this go away?",
    "doctor_response": "Hello, Thanks for choosing health care magic for posting your query. A lot can be answered in a better way ifI was knowing your age. But the kind of problems that you have described doesn't appear to be physical in nature. It more so ever appears to be psychological. You should get an ECG done and get a consultation from a cardiologist. If he says it is fine, which mostly is what he will say, then you should visit a psychiatrist who can train you with some relaxation techniques and also help you with CBT. He may use some drugs initially to make you feel better. All said it is not something big you need to worry about. Hope I have answered your query. I will be more than happy to help you if you need any further clarifications. In case if you want to discuss with me directly you can use the link:  Wish you a good health!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for random chest pain\n\nI have been having random chest pain over the last 2 years or so. The pain comes on quick and usually lasts about 20 minutes or so. It feels like its right at my sternum. It comes on mostly when I am sleeping but has came during the day. Nothing makes it feel better, but if I can vomit it helps. I have had a ekg and my doctor says my heart looks fine. So why the sudden pain?",
    "doctor_response": "Thanks for your question on HCM.Since your cardiac workup is normal I think your symptoms are mostly related to anxiety. Better to avoid stress and tension. Be relax and calm.Another possibility is GERD. It is Gastroesophageal Reflux Disease. It is due to laxity of gastroesophageal sphincter. Due to this acid of the stomach tends to come up and cause the symptoms. So tty to follow these for better control.1. Avoid spicy and hot fod.avoid stress. Avoid large meals. Take frequent small meals.2. Start proton pump inhibitors. 3. Go for walk after meals.4. Keep 2-3 pillows under head in bed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What specialist doctor should be seen for chronic pain due to bulging disc?\n\nEvery disc in my back from T1 to S1 is bulging or herniated and impinging on the thecal sac. I am in chronic pain 24/7 and my doctor seems to think that there s nothing wrong with me. I also have a plate from C1 to C7 and rods from my skull to my shoulder blades. What is the best specialist to see for this?",
    "doctor_response": "Hi there. Thank s for your question at HCM.Considering your history of previous surgery. I would suggest you to consult in an institute or a group practice where pain specialists , Neuro and Orthopaedic spine surgeon are available under single roof. A combined multi disciplinary approach would be better for  pain management in your scenario. Hope this helps. All the best.Regards.DR.SBK",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there something wrong with me if I think animals are cuter than babies? I enjoy the company of my cat moreso than my brothers babies. I get that fuzzy feeling whenever I look at a cute animal but I get nothing out of looking at babies. My family finds it shocking that I would prefer an animal over a human and criticize me for it. You guys may say that everyone has their own tastes, we re all different, yada yada, but every time they tell me I m not normal I can t help but feel inhumane... My family are real bigots when it comes to anything they don t see as normal . I wish I knew how to convince them that just because a person has different feelings doesn t make them crazy...",
    "doctor_response": "Preferring animals over humans is not a psychiatric problem or a disease as such. Hence there is nothing to worry to be frank. Every individual has their own likes and dislikes, even you have liking for cats. There is nothing wrong in that. But do not hate human beings, thats it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does pain under rib cage, shortness of breath, chills, sweats and wheezing with CT scan showing thick walls mean?\n\nI have had pain in lower left area below breasts...it feels as if its under the rib cage..the pain is also traveled to the right side.i experience shortness of breath, stabbing with unbearable pain,chills, sweats, spasms in the areas of pain which also travel to the back. Wheezing with a whistle sound. What could this be? I honestly feel like I am dying..doctors thought it was intestinal problems but all test have came back fine. My original ct scan said that ther was a thickening of the walls..what walls I do not know. The inflammation was shown to go under the breast across as well as down both sides",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. In my opinion you are having bronchitis. Your symptoms like cough, wheezing and shortness of breath are seen in bronchitis. And the thing you are mentioning \"wall thickness\" is seen in bronchitis. The bronchial walls are edematous and appears thickened. So better to consult pulmonologist and get done1. Clinical examination of respiratory system. 2. PFT ( pulmonary function test ). PFT will also tell you about severity of the disease. And treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and antihistamine drug. So consult pulmonologist and first diagnose yourself and then start appropriate treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bubbly yellow sticking out discharge from wound?\n\nHi. I m not sure what to do - a large table fell on my finger today - offcourse at first i felt serious pain, and noticed that there was a small wound with something bubbly and jellow sticking out of it. I thougt it was skin, so i Tried to Cut it with a scissor, but that was too painfull. What do you Think it is? Becks",
    "doctor_response": "Hi Becks and thanks for visiting HCM.The bubbly yellow stuff you described sounds like serous exudate.Serous fluid is normal - all of us have it in our bodies. It is found in many of our body's cavities. It contains proteins, water and cells necessary for day to day functioning. So when there is a wound, serous fluid can sometimes seep out (exudate). Please do not try to use a scissors on your wound. Gently clean it to prevent infection and dress it. Do ice that sore finger every two hours to reduce the swelling - if there is reduced movement after a few hours, please visit your regular doctor to rule out a fracture.Hope this helps, thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I continue taking Felodipine?\n\nhi,,im 43 yrs of age,5'8\" in height with normal built...last wed i go to doctor because i felt dizzy and found out that my BP was 140/100..he give me prescription felodipine 5mg once a day..then i took lab test but the result for my cholesterol,triglyceride and FBS were normal..id like to ask for second opinion coz the doc said to me that i will maintain the felodipine for the rest of my life..",
    "doctor_response": "one blood pressure reading may not sufficient to decide. I think you should maintain a blood pressure chart. Also consume low salt diet and regular exercises. if blood pressure readings are Persistently low we can think downgrading the medicine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes darkening of the lips?\n\nWhat are some possible problems if a baby has a darkened lips? She is 7 months old. She currently has colds. Is that one possible reason? I am sure that when she was born, all the tests done have good results. We just noticed her lips few weeks ago about the same time that she had colds.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query your child have symptoms of darkening of the lips which could be due to many causes like minor trauma or contagious like herpes, canker or allergic, due to minor traumatization of blood vessels. You should consult dermatologist for proper examination of these darkening and start treatment accordingly. You should maintain good oral hygiene and avoid hot and spicy foods. Take cotton dipper in apple cedar vinegar and apply on lips.Antihistamines drugs to combat allergic cause.Take folic acid with vitamin b complex supplement. Keep drinking plenty of water.Give cold compresses twice a day which help in reducing swelling. Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "How many Clexane injections can be used during flight when suffering from heterozygous factor V Leiden?\n\nMy 17 year old daughter has heterozygous factor V Leiden,Cardiolipin IgG and Protenaise C. She will be making a long haul flight of 8 hours then 14 hours immediately.She then stays in Barcelona for three days ,then a two hour flight to Santiago.She is there for two weeks then does the same trip back home.We have had conflicting advise as to how many clexane injections to use and when.She had full length grade 2 pressure stockings.This is all prophylactic as there has been a history of blood clots and PE in the family. Please can you assist me. Thank you Jacqueline",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  She has high chance of clotting. She need prophylactic warferrin therapy.  Dosage depends on her INR level. She should maintain her INR between 2 to 3. Consult your doctor and det the dosage accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for red blisters on the ankle region\n\nI have looks like bits mark around my ankle they have be about 4 in the last 4 days . They get red and burn and blister. I have them to come on side of my arm. I don t go out side much. I was thinking it could be spider but now I don t think it is. Hope you can help me.",
    "doctor_response": "Hi, Your rash could most probably due to an insect bite hypersensitivity reaction. But the rash could also be a bacterial infection. Diagnosis could be confirmed only after proper clinical examination. Empirically, you can take an antihistamine tablet along with the application of an antibiotic ointment. I request you to consult your dermatologist if you do not get any improvement in a week. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Siva Subramanian, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes weight and persistent abdominal pain during pregnancy?\n\nHi my name is Dia and I am currently 10 weeks 6days pregnant and I am very fearful for my health. I haben t gained a pound and since finding out I was pregnant I have lost at least 10 pounds. My normal weight is 132.00 but I am 121 at the moment and have been very sick and unable to keep down or digest any real food. I am in constant pain with aching stomach and crippling cramps; both abdomen and back. I do not know what to do. I have no money for an abortion but I also am scared if I continue in this pregnancy I may become seriously ill or die from deteriorating health. Please tell me what I should do. I am very scared",
    "doctor_response": "Hi,    Thanks for asking. I understand your concern.    Please relax. Loss of appetite,nausea,vomiting in early pregnancy is due to pregnancy hormones... to which pregnant lady is not used to.It goes away as she gets adjusted to it...so relax,it's a normal process.   Only thing is you seem to be more sensitive & reactive to hormones... so the excessive symptoms.  In such conditiin you aught to get  IV fluides along with vitamins &medicines to control nausea / vomiting /low apetite ....followed by normal diet.   All other symptims like absiminal & bacj ache need to be examined & trejatejd accordingly.    Please viait ER / some charitable or givernment hospital.     Thabka.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have echogenic liver, gallbladder removed, abdominal pain,evidence of benign hemangiomas, BMI 31. Any treatment?\n\nI was told from a CT and ultrasound that I have a \"slightly echogenic liver\".  And there is also evidence of \"most likely benign hemangiomas\". I have had my gallbladder removed due to gallstones and continue to have upper abdominal pain.  My BMI is 31, I am not diabettic and do not drink.   Should i be concerned? Do I need further treatments or test?",
    "doctor_response": "Thanks for query on HCM.Benign hemangiomas does not require any active treatment at present.Keep regular check up for liver.Upper abdominal pain is most like due to indigestion,it usually occurs after gallbladder removal.Your bmi 31 indicates obesity grade 1.You have to take care for your general health.Take simple,high fiber diet,drink more liquids like buttermilk,fruit juices,vegetable soups.Avoid oily,spicy,high calorie diet.Try to reduce your weight.Go for exercise,yoga,swimming,cycling.Keep in touch with your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling pain in the legs?\n\nI have enometreosis and lots of other unexplained pain..recently I have been getting a needle like stabbing or tingling pain in a lace like of web like pattern on my trunk,back and legs and a crushing or grip like dull pain across my diaphram, midfrift and low waist",
    "doctor_response": "Hi, The symptoms are more likely suggestive of neuropathic pain. Consult a neurologist and get evaluated. A detailed evaluation including nerve conduction studies is required for further assessment. As of now, you can take vitamin B supplements for symptomatic relief. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could jelly like stool with blood in a child mean?\n\nHi, I have noticed blood which is bright red in my 4 year old boys faeces. His actual faeces is very pale sort of beige, he has always had quite small dry faeces which the dr says is his system and is normal in him and no cause for concern. The last few days has also seen some jelly like stool along with normal stool and the red blood, I have an appointment tomorrow but am worried just now. thanks",
    "doctor_response": "blood in stool means dysentry .it is of infective origin.start antibiotics n antihelminthic drud to reduce severity.syrup satrogyl-o 5ml 3 times a day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes flutters in middle of sternum after eating?\n\nLately I ve been having flutters right in the middle of my sternum, especially after eating. I had an echo about six months ago and it was normal, other than having a hyperdynamic left ventrical. It happened several times while I was on the treadmill the other night. Should I be worried?",
    "doctor_response": "Hello, It could be due to acid reflux. As of now, you can take antacids like Omeprazole or Pantoprazole for symptomatic relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in stomach?\n\nI am hurting so bad in my stomach at times, and I know it s not an ulcer I had that before and know the symptoms. this is very different.. I m thinking it s a hernia, but the pains moves all under my chest, sota like something is sliding around and it is very painful at times.. I am having an appointment with an (Can t Spell) that will stick some kind of light down my esophagus to see what it is.. my question is , can they tell from doing this? the pain is gettin worse everyday..",
    "doctor_response": "Hi...Welcome to healthcare magic.....According to your complain you have gastroesophageal reflux disease...In GERD burning sensation at abdominal area occurs....Endoscopy examination is helpful for further diagnosis...Detail history and physical examination give exact idea...Consult a gastroenterologist for further diagnosis..I hope my guidance helpful to you...Take care. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does pain in the gums on the left side indicate?\n\nIm having teeth sensitivity that comes and goes. Pain goes into my gums and it's mainly on the left side.  This has been ongoing for a few days and occurs during the night also. I thought maybe sinus problems but I'm not having a headache or pressure other than in my teeth.",
    "doctor_response": "Hello,Pain in gums with teeth sensitivity can occur due to causes like gum infection like gingivitis or periodontitis while it can also be due to a sinus infection or sinusitis if you have some associated symptoms like nasal congestion, nasal discharge, facial pressure, headache etcetera.So my suggestion is to consult an oral physician and get evaluated and a panoramic x-ray should also be done, so that the teeth, as well as the sinuses, can be radiographically examined.In case if there is gum infection, then a thorough cleaning or scaling will be done followed by a course of antibiotics like Metronidazole and gum paint massage. Also, take a Vitamin C pellet or candy daily as it helps in strengthening gums.If it is due to a sinus infection, then antibiotics like Augmentin and decongestant nasal sprays like xylometazoline, saline nasal irrigation, and steam inhalation can be advised.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "How often should I take laxative to show in colonoscopy?\n\nHow often would you need to take a laxative/how muchfor it to show up in your colonoscopy?? Are we talking every few days randomly, over a 6 mo period, or years to show up taking daily, I m doing a paper on this but I can t find anything that gives any specifics on dates...",
    "doctor_response": "Till you have full evacuation of the bowel to permit a good colonoscopic examination.You can take full prescribed dose on the night of second day morning examination.Dr. J. Ticku",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could lumps on anus with swelling indicate?\n\nHi, may I answer your health queries right now ?  Please type your query here... I have a lump near my anus that extends up to the gooch. I had unprotected anal sex with my boyfriend about two months ago but it wasn't a sudden swelling, it has been gradual. Every time my boyfriend rubs it during sex it swells up a bit and is a kind of purple colour. However, it doesn't hurt in the slightest. There is no visual cut that I know of and it is the size of a grape. What do you think it may be?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some hemorrhoid ( piles ).  You should go for examination.  Take plenty of water and high fiber diet.  Avoid constipation. Permenent treatment is surgery.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for renal cortical cysts\n\nMy MRI shows a left mid pole lateral cortical renal cyst (12 mm) and it also mentions left upper pole simple renal cortical cyst (10 mm) . Are these the same cyst looking from different angles on the MRI, or are they two different ones. The 10 mm is on the lumbar spine report and the 12 mm is on the thoracic spine report, done by two different doctors. Also, what would the treatment be, if any?",
    "doctor_response": "Helloyou dont need to do anything for kidney cysts...cysts r a very common finding in many healthy n normal people n they dont do any harm to ur kidneys so just relax",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I see a doctor for pain in the tailbone after an injury?\n\nI hurt my tailbone 10 days ago. Someone hit me with their knee on my tailbone. This was instant pain, brought tears to my eyes. For several days it only hurt if I sat to fast or to hard. 1 week after it happened, I was sitting sown and was startled and pushed harder into the chair, instant pain and tears again. Since then the last 4 days it (tailbone) has hurt 24/7, sitting, standing, sleeping. Bending causes a surge of pain and near tears. Will this just go away? I take 10mg oxycodone 4 times a day for chronic back pain, these aren t helping the tailbone pain at all. Also taking acetamephine several times a day. Do I need to see a doctor?",
    "doctor_response": "Hi, The pain in tailbone after injury can be due to coccydynia or due to dislocation. In case the pain is intense or persistent then do consult an orthopedician. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had IUI, tested positive, had bleeding then no fetal heartbeat, another scan shows 4 weeks, advised bedrest. Miscarriage ?\n\nHelo sir my. Last period date was september 19 gone for IUI on the 17 th day I went for pregnancy test it showed positive went for an ultra sound on 21stt nov 3 sacs were seen but no yolk sac no fetal note no heartbeat two days after bleeding started so went for another ultra sound at a different place there it was seen two sacs yolk sac was seen but no fetal heart beat and gestational age is 4 weeks 5 days gave an injection and asked for bed rest today again I m bleeding can u reply what it is am I having a miscarriage",
    "doctor_response": "Hi, Thanks for your query. I have read your query & I understand your concerns. There is evidence of yolk sac. Hence it is reassuring. But I expected heart beat by now. I advice you to repeat the scan after one week to confirm heart beat. Please go to an IVF centre and get transvaginal ultrasound scan done (TVS). Take rest till then. All the best. I hope I answered your query. I will be available for any followup queries you have. Regards, Dr.Mahesh Koregol IVF & Infertility Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "can using mobile while masturbating cause cancer ?\n\nI was using mobile for 5 mins and then masturbated. Can I get cancer?",
    "doctor_response": "No, you cannot get cancer simply by doing those two things in that or any other sequence. Quit worrying!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have vision loss in right eye, and scissoring reflex on retinopathy. Please interpret my MRA findings.\n\nHello doctor, I am looking for a detailed read and interpretation of the MRA. Please be as detailed as possible with any abnormal findings you may see. My symptoms are progressive vision loss in the right eye, temporal headaches, and tenderness on the right side, headache on back of the head (right side), scissoring reflex via retinoscopy. I have attached my files.",
    "doctor_response": "Hello. I have seen your reports. (attachment removed to protect patient identity).  MR arteriogram shows The intracranial parts of both internal carotid arteries appear normal in caliber. There is hypolplasia of the A1 segment of the right anterior cerebral artery. The proximal left anterior and bilateral middle cerebral arteries and the arteries of the circle of Willis are normal in caliber. The right posterior cerebral artery is hypoplastic. The vertebral, basilar and left posterior cerebral arteries and their branches appear normal. No aneurysm or dissection or vascular malformation. There is no obvious vascular looping around the bilateral trigeminal nerves in the cisternal parts in the given images.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat arthritis problem?\n\nMy wife who underwent hysterectomy in 1990 and had remaining ovary removed in 2000 developed arthritis problem ever since and as per her latest condition doctors have advised TKR for both the knees. However, one of the doctors who is happy with the degree of her flexibility in the legs, says, perhaps the TKR could be deferred. She is having pain but may be her pain tolerance limit is high. She has been taking glucosamine for over 5 years now. Can TKR be postponed in this condition or should it be proceeded with? Thanks and regards, V K Naageswaran Husband, Chennai 61",
    "doctor_response": "Hello, If the mobility is present and she can lead a considerably normal life without a replacement now then it is best to postpone it for a few months or years. Regular physiotherapy can help. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life expectancy of a diabetic person with a heart attack?\n\nMy husband is 49 years old and has been Diabetic Insulin Dependent for 4 years. The other day he lost control and fell to the floor on a 103 degree day. When EMS was called they told him that he had a heart attack. Now he is in the hospital with CHF and I m very nervous because they say the life expectancy of this disease seems to be between 5 and 10 years. I m wondering if this condition can in any way be reversed?",
    "doctor_response": "Hello, Heart failure is a clinical syndrome with certain life expectancy. I would like to review his cardiac ultrasound report for a more professional opinion, if you could upload it on this site. Anyway, with an optimal therapy and a healthy lifestyle, the life can be prolonged, although we can not reverse this syndrome. Hope you will find this answer helpful. Let me know if I can assist you further. Wishing you all the best. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for getting shock after touching metal railing\n\nthis is going to sound stupid but im very worried i was eletricuted the other day i recvied help but today i touched a metal railing and a ark of light shocked me i was knocked to the floor and after the railing was boiling my friend toched it and got shocked",
    "doctor_response": "Hello!Welcome on Healthcaremagic!I understand your concern and would explain that it seems that you have been in contact with an electrical shortcut. As you are feeling better now, there is nothing to worry about! It is quite normal to faint after an electrical shock, but it seems to have caused no damage as you have not physical signs now. So, just try not to think about it any more!Hope to have been helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe heart palpitations and breathlessness?\n\nHi I am 47 years old , have lots of heart palpitations, had an episode of shortness of breath and sudden sweat , did Echo that showed multiple segmental wall abnormalities with hipokinesis but due to poor endocardial definition they are going to do contrast echo . The doctor said without the contrast it showed the same problems but when they injected the contrast the heart looks pumping and closing properly. They did neuclear stress test that was fine. I still have at times shortness of breath and heart palpitations and it is very severe . I have never had those symptoms before the last tow month ago . What that can be or what other test I might need to do? I must say I do and always did lots of sports and the doctor indicated that on the stress test it looks like my heart is an athlete heart . I feel very very not healthy and not able to breathe normally. Please help",
    "doctor_response": "Hello Here, we need to rule out the possibility of cardiac arrhythmia like Paroxysmal Supraventricular Tachycardia  or atrial fibrillation, in which heart rate suddenly goes up and also suddenly decreases. Usually ECG is normal as it is usually done in between the episodes. ECG done during episodes will show abnormality. You will need 24 hour Holter monitoring. Also, hemoglobin and thyroid test should be done. lnorder to abort such episodes you should try to cough hard. Is there any stress or anxiety associated. Till the time your evaluation is complete, you can ask your local doctor for tab Ciplar LA 20 mg once a day. If none of the above is successful then last option is of electrophysiological studies which is invasive test which can diagnose and treat the arrhythmia permanently in most of the cases. Hope this helps you and get back if you have any doubts. Regards Dr. Sagar Makode, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best medicine for depression?\n\nMy husband is 40 years old, and we have been in hospital almost a week now...hopefully tomorrow they release him. He is very depressed, and didnt know if antidepressant would be good for him. Also, im totally lost on what I can cook for him now? ?? No salt at all? O\u0155 just lower the take of salt . Thanks ashannon",
    "doctor_response": "Thanks for writing.The information you are providing is not sufficient.More information needed in terms of episodes,severity,reason for admission etc.In general antidepressant takes  approx.15 days to start its effect so one week is not sufficient to see the outcome of medicine.You can serve him anything he likes .Salt is not restricted in depression.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it safe for a 60 year old to use Terifrac for osteoporosis?\n\nHello doctor,My mother is 60 years old. She is being treated for osteoporosis currently for which we are already consulting a specialist. I am attaching few other reports towards which would request you to evaluate the same and let me know your interpretation and concerns and treatments if any. For cholesterol and kidney levels findings what should she do? Regarding osteoporosis (revealed through DEXA scan), she has been advised Terifrac injection 20 mg (8 units) daily for a year plus a calcium supplement. What are the side effects of Terifrac at her age and with regards to her other reports, especially ones related to kidney, creatinine etc.? Is it safe to use for her? Any suggestion for her rheumatoid results? My mother also is under medication for BP. Currently, her BP was 130/8. Should she continue with her dose of Losacar H one per day or modify the same?",
    "doctor_response": "Hello. I have checked the attached reports thoroughly (attachment removed to protect patient identity). Here is my comment: Fortunately, there are no autoimmune rheumatoid arthritis or SLE (systemic lupus erythematosus) as both ANA and anti-CCP are negative. Unfortunately, the DEXA scan shows there are osteoporotic changes which increase the risk of fracture and requires treatment. Calcium supplements and Terifrac (Teriparatide) are suitable medications for the osteoporosis. Terifarc may cause some depression, gastric upset or muscle weakness, but generally, it is well tolerated by postmenopausal women. There is no rheumatoid arthritis. Her blood pressure is well controlled and there is no need to change the medication. Regarding the kidney function, it is the high normal level with evidence of hydration (could be the effect of Losacar H). So, I recommend good hydration and follow up of renal functions after two weeks. I have noticed that she has anemia as well as high cholesterol levels which require medication to be controlled. Her blood sugar level is normal. Best wishes. For more information consult a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for alcohol addiction,anger issues and ADHD\n\nmy younger brother who is 18 and live with his nan and grandad drinks to much and gets voilent as he also suffers with ADHD,anxiety  and anger we have try for a year to get help but no one wants to help and he has been past from pillar to post. i have even tryed to get him sectioned and they wont even do this.  I am really worried for my mum and dad safety when he is drunk and dont know where or who to turn next. we have even got him arrested but no one seems to want to do anything? can you give me advice as how i can get him help",
    "doctor_response": "HiI admire your concern.But alcohol addiction and intoxication can cause many problem in general health and social issues.1st step is alcohol DE addiction after all other symptoms will treat as such.Anxiety and anger can be a part of alcohol addiction and treated with it.So consult psychiatrist or De addiction center near by.Indoor treatment is must for De addiction .If require then go for rehab. program and take advise.Thank you.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Elevated BUN, serum creatinine after radial nephrectomy. Sign of chronic renal disease?\n\nHello Sir, I am patient of lymphoma who also underwent radical nephrectomy of right kidney! Recent blood test indicated elevated BUN 60 and Serum creatinine of 3! Had edema of feet,also had high PTH values! BP was elevated! But now after BP medication BP is under control, edema is gone and i have stopped getting up in the night to pass urine! Do you think i have chronic renal disease",
    "doctor_response": "HiThanks for the query.It is difficult to diagnose if you have chronic kidney disease based on the information provided.You need to repeat the blood tests as well as do urine exam and Ultrasound of the kidney and bladder.Based on these tests and a careful analysis of your past history and medications etc.; a nephrologist would be able to comment if you have chronic kidney disease.Hope this helpsGood luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of undergoing dialysis?\n\nin a pt w/fluid overload who undergoes a procedure to place an ij catheter for dialysis access & the pt has SOB, worsening resp distress, pleural effusions, & declining O2 sat on supp O2, is the risk of draining the fluid in the OR after the procedure minimal to the pt? isn't it to the pt's benefit to get fluid drained prior to xfer to floor for dialysis, thus causing delay & additional resp distress?",
    "doctor_response": "Hi,I have gone through your query and understand your concerns.A patient with symptoms like you have mentioned will get some relief only with dialysis. He is having extra fluid in his body which needs to be removed with the help of dialysis. It is good that he is having IJV catheter but he needs a AV fistula as the access for dialysis.Hope this answers your query.Regards,Dr.Alekhya.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the buttock and tenderness in the elbow?\n\ni have a pain deep in my right buttock, i feel a twinge sometimes when walking or just sitting, like a spasm, gives a sharp pain. no numbness or tingling feelings anywhere else.also have a tenderness pain in my right elbow. causing a slight difficulty in gripping. dont know whether there is a connection bewteen the 2, but the severity of the pain seems t alternate between the 2.",
    "doctor_response": "Hi,There is no connection between the 2. For your buttock pain you need piriformis stretching. For your right elbow you need a physiotherapist who can give ultrasound. Visit a good physio nearby who will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the lumps behind ear be due to cold?\n\nHi, I am a 36 year old  5 ft tall woman.  I have a 9 month old son and weigh about 175 lbs.  I have recurring hoarseness, seem to be losing more hair than usual, am tired,often cold and earlier this week found two lumps behind both ears. Should I see my Dr and what could be causing this?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. He may have enlarged post auricular lymphnode.  It van be due reactive hyperplasia as result of infection in upper respiratory tract or head and neck region. He should take a course of antibiotics. If it doesn't respond to treatment then biopsy diagnosis is advisable. Antibiotics like azithromycin or amoxiclav is useful.  It is prescription based medicine so consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could i be pregnant with chocolate cyst ?\n\nhi am anu married since 8months my LMP is 24/3/2011.i did TVS last month it showss bilateral chocolate cyst abt 2cm i want to knw wther am ovulating and try for baby this time",
    "doctor_response": "Hi Welcome to HealthcareMagic As cysts are small ( 2cm) and normal ovarian tissue is also present . Ovulation can occur in cases of bilateral chocolate cysts also so keep trying. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to plan for baby while one partner is on methotrexate?\n\nHi, my boyfriend is currently on sulphasalazine (apologies I think I have spelt this wrong) but it is likely he is going to have to take methotrexate soon. I know that it is not advised to have a baby while either partner is taking this drug so my question is, what options do we have if we want to have a baby in the future? From what I understand methotrexate is a long term drug i.e. he will take it forever.",
    "doctor_response": "Hi.If his condition is better controlled, then you can discuss with his doctor options of conception and taking him off the drug. There will be a wait period during which the doctor will continuously monitor him and also check to see if he will be fit for natural conception.After this, you can go ahead with natural conception. Or else, a donor sperm or adoption are last resorts.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are bumps on urethra, related to fungal infections?\n\nHey,I am 24 years (virgin) old and have had these white bumps extern near my urethra for as long as I remember (2 left and 7 right). They don t itch, irritate...Could they be penile bumps? I have had myself tested for std s nothing came out...I do have these bumps on my penis itself, foreskin and under my glans which is normal.Could this be some kind of rash, fungal infection, Trichomonias? Next month I m seeing my dermatologist as I also want to remove my fordyce spots.In attachment you find 2 pictures... as this is what they look like.WWW.WWWW.WW WWW.WWWW.WW",
    "doctor_response": "Thanks for your query .As I understand it could be sebaceous cyst .because such cyst do not produce any symptom ,these are multiple under the skin layer. I suggest you to consult a general  surgeon for examination and correct management .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Influenza for 6 years, digestion problem, muscle pain and headache\n\nThe illness is that influenza (may be water of brain ) is always flowing inside & outside of the body slowly and slowly and because of this body is not able to growth, stomach is not digesting food properly, liver is not making blood properly, shoulders muscles pain, always remains headache. I am very thin now and do not have better health than 6 years ago. The problem of influenza has been running for 6 years. I am very disturbed with my life. Some years ago I was a beautiful and good looking boy. Alas! I am not now.",
    "doctor_response": "Hi, Welcome to Health care magic forum.                     It appears that you are an young boy,you do what you have to do. concentrate on what you do.                       I accept that you are sick, you stop browsing  net for information and consult a doctor.                      None of the facts you are thinking are not facts. and you are thinking in a false way. with this you may become hypochondriac, and may need to have different treatment than the treatment to the body.                       Take more of green leafy vegetables,pulses,sprouts, and protein rich foods to have good health and resistance.                                 Concentrate on studies, practice yoga, meditation etc.                      Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain with stiffness. Had sciatica during pregnancy. What is the treatment?\n\nI am experiencing lower back pain for the past week. It hurts to move, soreness and stiffness. Some pain in one side of my buttocks now and again. I am about 30lbs overweight, need to change my mattress that I sleep on and recently had a very demanding day, prior to feeling this way, where I had to rush around a lot, walking and running which I am not use to. I have also been ill with a gastric bug recently for a couple of days. I have had sciatica in the past also, when pregnant.  I have a bit of bruising where the pain is located from but this could be from applying pressure to the spot which when done alliviates the pain.",
    "doctor_response": "HI, thanks for using healthcare magicIt is quite likely that the pain may be related to the increased demands that you had to place on your body recently.It is possible that this would have resulted in mild trauma or strain on the muscles in the back.The increased weight would also increase the pressure on the back.Signs and symptoms of more serious back injury are : numbness or altered sensation in the genitalia or anal region, numbness or altered sensation in the legs, weakness, urinary incontinence or retaining urine, fecal (stool)  incontinence.You may want to consider the use of an anti inflammatory pain killler to help reduce the pain. This would include medication such as ibuprofen, aspirin, diclofenac, naproxen, celebrex. These medications should be used on a full stomachIf the pain continues despite the use of medication then you may want to be evaluated by your doctorI hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Difficulty in sleeping due to pain post wisdom tooth extraction. Taken nurofen. Can I take parecetamol?\n\ncan i take paracetamol if i have taken my dose of nurofen Ive had a wisdom tooth out and I can t sleep because I m in pain, I took my last nurofen at 9 o clock they are 256mg",
    "doctor_response": "hello, Yes you can take paracetamol along with nurofen (ibuprofen) if your pain is intense.. you can also  do ice/cold application on the region it will help in easing out the pain as well as will prevent post-operative swelling.. avoid any hot food/fluids for first 24 hrs after extraction.. use antiseptic mouthwash and follow the antibiotic and analgesic course properly in the duration as prescribed by doc.. maintain your oral hygiene properly.. if your pain doesnot decrease in next 2 days then contact your dentist for check up and further treatment.. take care..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is blighted ovum? Is D&C a must for it?\n\nHi doctor, According to my LMP now I am 9 weeks pregnant. I went for USG TV 20 days back and it showed that I was 7 weeks and 2 days and now it would be 8 weeks. USG shown gestational sac with no yolk sac and fetal pole. They said it is BO and to go through D&C. I am confused what to do now. Shall I wait with hope or go through D&C? Please tell me how gestational age will be calculated from LMP or conception day? I am not sure when I ovulated? Please help me out.",
    "doctor_response": "Hi. At 6 weeks and beyond we expect a fetal pole or yolk sac to be visualized on USG. By 7 weeks, we must see the cardiac activity. If there is no embryo and no heart beat even beyond 7 weeks, we call it a blighted ovum (BO) with only a sac and no contents inside. It can happen due to a chromosomally abnormal gestation and hence does not survive. It regresses on its own. To date your pregnancy, we calculate period of gestation by LMP (last menstrual period) and then confirm it with an earliest scan within 3 months of pregnancy. In case there is no difference between the two dates or a difference is less than a week, we consider the LMP to calculate the expected date of delivery and period of gestation. Do not worry, you can conceive again. But no hope with this pregnancy. Start Folic Acid 5 mg daily for 3 months before next conception. This will help in a healthy embryo, reduce chance of miscarriage and prevent neural defects in the fetus. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does ondansetron and nausea effect brain chemistry ?\n\nI was just prescribed Ondansetron for nausea caused by gastro intestinal issues, but I got concerned when I saw it has an effect on brain chemistry like serotonin HT5 something. Does this effect brain chemistry? If so, are these temporary and resume to normal when stopping the medication?",
    "doctor_response": "Hi, Welcome to HealthCareMagic.com I am Dr.J.Mariano Anto Bruno Mascarenhas. I have gone through your query with diligence and would like you to know that I am here to help you.Question : Does this effect brain chemistry? Answer : Yes. It prevents vomiting by affecting brain chemistry. Without affecting brain chemistry, vomiting cannot be stoppedQuestion : If so, are these temporary and resume to normal when stopping the medication?Answer : When the drug is stopped, the chemistry will return to normal Hope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.Best Wishes for Speedy Recovery Let me know if I can assist you further.Take care.-oOo-PS 1 : After all your doubts have been cleared, kindly (a) Close this Question (b) Rate my Replies and (c) Give your Feedback. PS 2 :  In the future, for continuity of care, I encourage you to contact me directly in HealthCareMagic at",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is itching the side effect of triptomer 25mg?\n\nwarm welcome , i have take triptomer 25mg for past 6 months daily night once. time being i having an itching in my hole body. i think it would be leads to itches i have an tingiing effect in my head ie right side only .doctors advice to took 25mg triptomer for day on night only",
    "doctor_response": "Hello,Yes, you are right although rare but tryptomer can cause itching over the body. For whatever purpose you are taking thus medicine i suggest you to consult your physician to run some tests for liver dysfunction and change your prescription accordingly.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sameen Bin Naeem, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have mirena IUD. Sharp pain in the abdomen after having intercourse. Nausea, fatigue and excessive hunger. Any chance of pregnancy?\n\nHi, I have had the mirena iud for about 18 months now. I have recently started to get nervous with it. I haven t had apperiod at all the whole time I have been on it but now during and after sex I have sharp lower abdomen pain. Mainly on my right side. I get the pain during the day for no reason. My belly feels hard and sometimes looks a little big like I would be pregnant. I have recently been getting nausea and hungry more frequently along with being more tired. I have taken two pregnancy tests about 2-3 weeks ago and they both came out negative. I have no idea what s going on. Can you give me any advice please?",
    "doctor_response": "Hi, Thanks for the query. IUD can cause side effects like amenorrhea, pain abdomen etc. So your symptoms could be because of that. But as  ectopic pregnancy is one complications with IUDs better to rule out that. You once consult gynecologist and undergo ultrasound which can rule out intrauterine and ectopic pregnancies and can also confirm the position of IUD. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does vitamin B12 deficiency cause SVT?\n\nI was recently diagnosed with a b12 deficiency, my heart had been running fast with missed beats. After my fourth b12 injection my heart went into svt, and I was hospitalised. Is this linked to a b12 deficiency? I'm now on beta blockers and waiting to see cardiologist. Thanks",
    "doctor_response": "Hello ,Vitamin b12 deficiency or excess will not directly result in ST , so be reassured for the same. Beta blocker is one of the safest drug to be given for SVT.  There are many different reason of SVT and  depending of the subtype , a evaluation and specific treatment should help in prevention of further recurrence.  Regards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mycobacterial dna pcr detected, Can I get pregnant after 5-9 months course ?\n\nMy doctor take menstrual blood and my report shows mycobacterial dna pcr detected and tuberculosis complex is found. Can I get pregnant after 5-9 months course. She told us that after this she may take some more test of tubes if any problem will raise. I am worried about my pregnancy that can I conceive the baby if everything will fine after this, plz guide me.",
    "doctor_response": "Hello, Welcome to healthcare magic, Menstrual blood Tb PCR is an outdated test, I suggest u go in for endometrial biopsy n the sample to b sent for Tb PCR RNA(NOT DNA), PCR RNA detects only live bacilli wheras PCR DNA also detects dead bacilli. If PCR RNA is positive u need to take treatment for atleast 6 months, Following which u may require diagnostic hysterolaproscopy. Today due to advancing technology it is possible to obtain pregnancy in almost any case, al the best..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low blood pressure\n\nHi. Thanks for your time. I ve been on bp medicine for quite a few years. I took my bp Friday night for the first time in ages and was shocked to see it at 106/68. It was almost the same the next morning. Do I need to worry that it is getting low now?",
    "doctor_response": "Hi,If you have no complaints you should't worry.Just monitor your blood pressure for a week. And make sure if you drink adequate quantity of water.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for hydronephrosis?\n\nhi sir my child is just 3 month old and he is suffering for moderate hydronephrosis with PUJO. What option you suggest surgry or wait & watch.after test of ultrasound ans DTPO function is normal. what is your suggestion?sir mail id is  YYYY@YYYY",
    "doctor_response": "HelloModerate hydronephrosis due to PUJ obstruction and with normal DTPA in this age should be followed up with serial ultrasound examination. In ultrasound if there is further progression of disease repeat DTPA may be needed. If repeat DTPA shows decreasing renal function(Other than this if there is repeated symptomatic urinary tract infection,this is also an indication for surgery.RegardsYou can ask me directly",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Parkinson s disease\n\nMy husband has Parkinson s. He s been wearing Depends because of problems with incontinence. Now there is a raw area where the top of the leg connects with the torso. He can t wear Depends or any other type of shorts that would touch that area. Been back to boxers, but we need to begin applying some sort of treatment to the area to heal it up. I bought some Desitin ointment and mixed it with Neosporin this afternoon. What do you suggest?",
    "doctor_response": "Usually the area seems to be infected with the contents of defecation which might have caused the area to inflame and subsequently develop a skin breach. The most important thing is to keep that area clean and apply soap water at home to clean and dry and apply some antibacterial ointment to prevent further bacterial growth. In case the area is big, consult a surgeon for dressings on a regular basis else in long run, it may lead to non healing ulcer only amenable to surgery. Remember, don't try to treat it yourself.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes contractions at 34 weeks of pregnancy?\n\nI am 34 weeks pregnant and have been having contractions/tightening since Sunday. My doctor says unless they are about 5minutes apart, there is nothing that is to be done. The pain comes every 10 to 20 minutes and believe me, it is no Braxton Hicks. I have a cervical stitch in place and is to be removed at 37 weeks. What do i do? I don't know how much longer i can endure this. My waters have not yet broken and there is no blood.",
    "doctor_response": "Hi there,Since you are having regular contractions, you need to get examined by a doctor, especially sine you have the stitch. If the pain is present for some time it could indicate that you may be in labor. Then the stitch will have to be removed immediately as it can tear the cervix. It is also necessary that you get examined to see if there is any infection or not, for which specific medicine will need to be given.Also you need to take steroid injection for maturity of the babies lungs,(if you indeed are in labor).Do not neglect these pains.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it dangerous to have high levels of creatinine and BUN in hypertension patient?\n\nHello doctor, I am a 52-year-old male. My recent labs show elevated levels of BUN and creatinine. I have hypertension and it is controlled by medication. I am a weight trainer and boxer. I have followed a high protein diet over the years. My lab repot shows: eGFR - 71. BUN - 27. Creatinine - 1.32. My fluid intake has been down with my irregular schedule since the pandemic. I have increased my water intake now 64 plus oz of water a day and I have stopped taking any protein supplements.",
    "doctor_response": "Hello,  Welcome to icliniq.com. I would like to know which medicines you take for hypertension? I would like to know, whether you have done any urine examination? Rest eGFR (glomerular filtration rate) of 71 is within normal range for you, if urine examination is normal. I would advise you to decrease the protein intake and avoid protein supplements. You take water as much so that urine daily passed is around 1.5 liters. You should avoid any nephrotoxic drugs (painkillers, herbal medicines). If a urine examination was not done previously, I would advise you to undergo one routine urine examination and one ultrasound of kidneys.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes goose bumps when diagnosed with chronic spine pain?\n\nI have almost every disc is almost completely degenerated.... Stenosis, foramina Noramal (cant spell it) and other diagnosis regarding messed up back..... starts at base of skull and goes all the way to tail bone..... X race car driver..... I have recently been getting goose bumps from pain in upper back / neck region.... Is this normal..... I have been chronic pain patient over 15 years",
    "doctor_response": "Hello!Welcome on Healthcaremagic!Your complaints are related to chronic degeneration of the cervical spine. Unfortunately there is not too much to be done in this clinical situation. But, I would recommend performing a cervical spine MRI study to exclude possible spinal canal stenosis in this region, which may need surgery. A cervical collar can help reduce the pain. Hope you will find this answer helpful !Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sciatic nerve pain in lower back. Will surgery relive pain?\n\nHi I suffer with sciatic nerve pain in my lower back and I've had this problem for ten years and just the last three weeks I've been in so much pain and are unable to work and walk properly due to the pain, I have a referel to see a pain specialist and I was wondering would they let me know if I need surgery to relieve my pain",
    "doctor_response": "Hello,Meet a spine specialist in your region. After proper clinical evaluation he will be able to tell whether you surgery or conservative management.Any try Physiotherapy by an expert before surgery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why i am not getting my periods and what can help me to conceive ?\n\nHi, My partner and I have decided to try for a baby so, 6 months ago, I came off my Pill, Cerazette. I haven t yet had a period so am starting to worry a little now, as pregnancy tests are all negative. I saw my GP but she wasn t very helpful. I am keen to start Clomid to help with the conception or would this be a waste of time as no periods generally mean no ovulation?",
    "doctor_response": "dear laura it could be very useful to you, it may be due some side effect of your pils last time, please dont worry if that also dont do please carry out some investigation it may be due some hormonal imbalance in your body Take care thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes right-sided foot pain radiating towards ankle?\n\nI have been having foot pain. It s not when I walk on it but first thing in the morning or anytime I have been off my feet for any amount of time. When I get up to walk pain in my right foot hurts bad its all the way down the side of my foot to my ankle.",
    "doctor_response": "Foot pain is extremely common and can be pretty uncomfortable.  Since your foot pain comes after long periods of inactivity like getting up in the morning or after having been off your feet for some time, it is likely from a combination of muscle tightness and tendonitis.Tendons are the structures that connect muscle to bone to help joints move.  You have tendons on the inside and outside of your foot to help your foot move and to keep your foot stable.  These tendons can become inflamed in some situations of overuse or other situations where they are being overworked.The mainstay of treatment for tendonitis is ice(20min 4 times a day) and anti-inflammatories.  In addition, I like to recommend a combination of soft tissue treatments and exercises for the foot.  You can use a lacrosse ball on the bottom and sides of your feet to work out tight areas.  You can then follow by strengthening the foot by grabbing a towel using your toes and the releasing and repeating for 3 sets of 10 twice a day.  If you continue to have pain, I recommend Xrays to rule out other causes and an examination by a specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe depression, anxiety, ADHD and PTSD?\n\nI m 19 years old, male. I believe I am 5 foot, 1-2 inches, weighing about 120 pounds. Apparently, I have a somewhat normal/healthy BMI, but I have a lot of excess body fat, and I have a bad binge eating problem, despite the fact that I m trying to lose fat. This is just the start, I m noticing a ton of health problems with my body, and I m honestly horrified of what s to come, and I feel hopeless. I have severe depression, severe anxiety, ADHD, and PTSD, but these are only my official diagnoses. I believe I have more problems. Right now I ve been trying to work out to lose weight and get fit, but it s a huge challenge, because I think I have a torn meniscus, which I got last year and haven t had checked because I DO NOT HAVE HEALTH CARE. I ve had bad posture a lot of my life and bad diet, which I m trying to change, but at this point, even though I have all this extra fat, I can feel my spine from the bottom of my back to my neck, and it s starting to really hurt when sleeping, or when I try to run/jog, or jump rope. (Jumping rope feels a lot less harsh on my knee than running as a method of workout.) I also think I might have chlamydia even though I m a virgin (excluding oral sex),because when I m well hydrated it burns when I urinate, and a couple months ago, I was masturbating to reliee stress and I rubbed my eyes a little without thinking about because I was tired and got a really bad case of pink eye for a few weeks. This is just scratching the surface of the problems I m having, I don t know what to do, I can t afford healthcare, I have no income, what doI do? PLEASE HELP. :(",
    "doctor_response": "DearWe understand your concernsI went through your details.I suggest you not to worry much. You do not have ny income. Means you do not have a job. That means you are idle. Idle mind is devil's workshop and you have devil in your mind. Unnecessary thinking and lazyness increases the symptoms of aniety and depression. Over and above, they become worse. You just are depressed and anxious. Both these conditions and ADD are disorders and are bound to be cured with changes in your life style. Simple inflammation and chlamydia should be differentiated. Leave it to your physician. It is not your duty. You do not have any problem except unnecessary worries and associated lazyness.Concentrate in your studies and career and be busy and energetic. You should be alright. Your life nd diseases and other future happenings will be taken care of by god. Don't worry about them because you do not have any control over them.You can post a direct question to me for psychotherapy techniques to cure your problems.Include every details possible.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for runny nose, dry cough and green stools in infant\n\nMy five month old is congested with a runny nose and dry cough. She doesn t have a fever and output is normal but has had 2 green poops. Should I take her to a doctor? Also, she has a red birthmark at the base of her neck which is the same place mine is but it has dry skin that keeps peeling. I ve been putting olive oil on it but it seems to bother her, do you know what this could be?",
    "doctor_response": "Dear Parent,Cough and cold in an infant is always better evaluated by a pediatrician who can examine your baby to rule out lung infection and give medications for the relief of symptoms. Red birthmark at the base of neck can have various diagnoses. I would suggest that you see your pediatrician who can examine the birthmark and give you the diagnosis and more information regarding it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility problems\n\nhi i am 34 years old.i got married one n a half year back.but have not been able to conceive last month i took ovofar 100 mg for 5 days.my periods got delayed by 5 days this month. this time my gyn has given me rejun for 5 days n modus tablets also.wt r my chances of conceiving?n wt is modus used for?",
    "doctor_response": "Hello, there are no chances in this cycle and modus is given to you to get periods now.From next cycle take clomiphene citrate again and try for conception.In case you have any questions in future you can contact me directly on",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of survival for a person undergoing multiple ailments?\n\nWhat is the chance for survival for a person undergoing off-pump redo CABG to the one artery (LAD) left to be bypassed? Left ventricular function around 50% Hypertension, Hypothyroid problems, diabetes from medication Had CABG 4 years ago and now LAD is the only artery that can be operated on and has two blockages.",
    "doctor_response": "Hello, Redo CABG for one single artery is not recommended if coronary stenting is possible. In my opinion, you should consult a Cardiologist for proper evaluation and see if he can put a stent inside. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Painful lump in the stomach. No pain on touching. What could it be?\n\nLately I have been having slight pain on my right side. I thought it was my appendix. I was feeling around my stomach and found a small lump near my left hip bone . It doesn t hurt, but when I press on it, it gives me just a bit of pain. Like gas pains. I don t want to get scared about something that isn t major. It is just better safe than sorry!",
    "doctor_response": "Hi friend Welcome to Health Care Magic Your description sound like - it probably is in or under the skin. Most likely, it may have nothing to do with your pain. It may not be of any significance. But unless examined by an expert, a definite opinion is not possible. - see your doctor. The surest and safest approach in case of doubt - is to remove it and get it examined. Take care Wishing speedy recovery God bless Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump on the forehead indicate?\n\nHi i have a lump in the middle of my forehead its squishy and if i press on it it moves not far but does move when i take my finger off it goes back to where it was i saw a doctor for it and he said to wait for a couple months and go back i had it 2months before i saw a doctor and now its been 5months and its still there and gotten bigger and sore when u touch it kind feels like its got fluid in it wanna know what it could be and what i can do to figure out what it is and hopefully get a cure for it please help me",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. * As per my surgical experience, the soft lump with such movements indicate soft tissue lesion as sebaceous cyst, dermoid or others. I would like to assist further with a clinical photograph of the lump in follow up conversation. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is traveling safe, during 30th week of pregnancy?\n\nhi doc, im 26yr old female primigravida my 30th week of pregnancy has just started n recent ultarsound 4 days bk shows everything to be alrite,i have an intension to travel by car for a period of 12 hour to my village with my family ,ill be not driving ofcourse,baby s movement is gud ,plz tell me would it be safe to travel by car at this stage?",
    "doctor_response": "Hallow Dear,If you are in a developing or undeveloped country, the conditions of the roads are not good. So I would not advise you car travel. However, if you are in a developed country where the roads are in very good condition, car travel is allowable. I would urge you to prepone travel by two weeks. Pregnancy is most stable in the second trimester; i.e. between 12 weeks to 28 weeks. After 28 weeks, the uterus becomes more irritable to stress and strain and thus there is always a risk of preterm delivery due to travel. So try to travel before 28 weeks. And then travelling at a stretch for 12 hours is going to be quite uncomfortable and strenuous for you at this stage of pregnancy. In the car you are in sitting position throughout the travel. I would advise you to have a break after every 2 hours for about 15-30 minutes when you get down from the car, ease out your legs and back, pass the urine and then restart the travel. I know this will increase the travel time by about an hour or more, still it is better for you and your baby. Otherwise the best travel is air travel; however airlines also accept the passengers under 28 weeks of pregnancy and that too with an Obstetrician's certificate.Hope you will reschedule travel by two weeks earlier. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bad dreams, inability to socialize and loss of touch with reality?\n\nI have suffer so much abuse in the past, but I only start feeling very weird little by little symptoms 1o years or so after, I sometimes can t sleep, because I have bed dreams, I cry a lot thinking I be possibly be attacked by the same way again, I am fine sometimes, it s hard for me to communicate with people I don t know, and right now I am just taking chance, even though I do have a psychiatric I just feel out of reality, right now I am so afraid of being who I am.I am unemployed, I cannot afford it anything, sorry this is one more thing that are disturbing me right now am I speaking with real doctors, I am concerning also and wish I didn t said anything,",
    "doctor_response": "first of all,its brave that you are speaking out,many people cant take this step because they fear what others will say.But speaking out about it,the feelings of fear inside you need to be eliminated.I dont know if you have visited a psychiatrist in person,I would suggest you to take appointment with psychiatrist and psychotherapist.It s going to help you.In the beginning you might feel that am I doing the correct thing,will they judge you etc.let me tell you one thing their job is to help you not to judge you.Here also no one will judge you.go through few sessions,it will help you.And whatever happened in the past,its gone.You should not think about it,if you are getting dreams and thoughts about it,do not react to them.It happened in the past so it doesnt mean that its going to happen again.You need to be strong.keep your mind busy into things that give you happiness,try to think positive in situations or conditions that you face daily.Take your time.Meditate everyday,it helps a lot.Take steps to socialize,face the fear with confidence,its you who can help you.You need to start practicing it.With time and help of your family,friends,doctors you can overcome the phase which is bothering you.Discuss about it with people  whom you are comfortable to chat.come out of the past,try to build present and future for yourself.And start doing things that you like,so that your mind ll be fresh and you can think about working and you can earn.For now you should be giving importance to your mental health than anything else.when you are mentally and physically fit,nothing is impossible.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat enlarged prostate grade 2?\n\nHi, may I answer your health queries right now ?  Please type your query here... Age64 weight62 height5'4\"   history-     HB-11.1,Blood urea-35.12 ,Syrum-1.11,blood urea nitrogen-16.4 ,SyrumK-4.1,SyrumCa-1.9. The patient is catheiterised and prostate enlarged grade2. Requested for kind advice",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You have benign prostatic hyperplasia grade 2. Alpha blocker like prazocin and finasteride are useful in this condition. It is prescription based drugs so consult your doctor and take treatment accordingly. Your other reports are normal so no need to worry about that. You should also go serum PSA level and ultrasound abdomen regularly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for hyperechoic foci posterior acoustic shadowing in the interpolar region of the kidney?\n\nIn layman's language what is meant by: both kidneys are normal. at least 2 hyperechoic foci posterior acoustic shadowing are seen in the interpolar region of the left kidney adjacent to an anechoic structure with the largest measuring 0.51mm? what should i do?",
    "doctor_response": "HelloYour findings may suggest two small calculus in left kidney.You may need clinical correlation and calculus dissolving drugs like magnesium citrate syrup etc.It is good that there is no complications like hydronephrosis etc in kidney due to calculus.As calculus is small,it is expected that calculus will flush out out of the body with medicines and adequate hydration.You may need to drink plenty of water.Anechoic structure in kidney may be a simple cyst.Generally it is not concerning.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I always get bitten by mosquitoes. Why?\n\nHi doctor, I am always bitten by mosquitoes. I am the only person who is bitten here in our house. The insect bite remains red for days, then will eventually turn dark. I want to ask is there something in my blood? And what remedies can I use to lighten my scars?",
    "doctor_response": "Hello. To understand why mosquitoes do bite you always, you should know what attracts them to get you bitten: 1. CO2 production as per metabolic rate because mosquitoes are attracted by it. 2. Obese, overweight people with low metabolic rate. 3. Wearing dark clothes. 4. Mosquitoes do tend to bite when it is dawn, when it is high humidity and less windy, so try to use a fan at that time to keep them away. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My father is having brain stroke and now his eye cannot see clear vision\n\nHello Sir..,My father affected in brain stroke since last month and we given continues physio treatment.he was affected right hand now it is little bit improved but last two days  we are facing his Eye is not clear vision. we checked blood sugar test is 265,",
    "doctor_response": "plz mention CT brain report..  The reason of stroke also need to evaluate in detail  to prevent further stroke.. poor vision might be because of stroke might have involved brain area responsible for vision.. So needs further investigation and management",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can typhoid be treated?\n\nHello. Sir....I am having typhoid fever ....my widal test was positive for s.typhi O 1/160....plz provide gud medicine....I have been precribed gudcef CV 200 as antibiotic, dolo 650 for fever and nutrolin b plus...I am taking it from 4 days...but still I am having fever from inside plz help",
    "doctor_response": "Hello,Gudcef cv is an antibiotic which is usually given for typhoid..Complete the course directed by your physician..After completion of the tablets if you still feel feverish you might need extension of antibiotics.Report to a nearby doctor if vomiting,abdominal pain,loose stools occurs.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent cough and running nose\n\nHi, I am 30 years Male, I am suffering from cold from more than last 3 years. It is continues running nose & sneezing, I have to take cetrizine everyday for releif. I got the treatement from so many doctors, all said that this is alergic cold but & most of them have asked me to take Telecast-L tablet everyday. Please help me to cure Regards Kamal",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. By your history and description, possibility of allergic rhinitis is more likely. Best treatment of this is 1. Intranasal spray containing steroid (fluticasone) two puffs in each nostril twice daily.2. Take combination of antihistamine (levocetrizine or fexofenadine) and anti allergic (montelukast) once a day at night before going to bed.Since all these are prescribed drugs, better to consult ENT doctor or allergy specialist for prescription. Allergic rhinitis is curable disease, treatment is prolonged but very effective. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could pain in neck and head with blurry vision mean recurred cavernoma?\n\nHi, I am a 41 year-old female with right parietal cavernoma. I have been slightly symptomatic (headaches, blurred speech, vision issues at times). Recently I developed pain on the left side of my neck, as well as pain on the left side of my head. I have been experiencing blurred vision more than usual. Is this yet another symptom of cavernoma?",
    "doctor_response": "Hello !  I understand your concern. In my opinion these troubles are not related to a recurrent cavernoma. The neck pain may be caused by a disc bulge or just cervical spondyloarthrosis. This causes pain in the neck, irradiating the the head, caused by muscle contractions. The blurring vision , is an important sign, but it may also be caused by a cervical disc problem, especially when associated with dizziness or vertigo. Have you had these problems lately ? I would recommend you to go to the doctor and have a physical examination and a cervical column x ray. If the headache and blurring visions get worse , a head MRI may be needed to exclude brain lesions. Hope to have been helpful!Thank you for using HCM!Best wishes, Dr. Abaz Quka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling hot and feverish, burning in the head. History of colitis and anxiety. Suffer from pain and dizziness. Worried about stroke\n\nhi dont know if you can help, im really fed up because i dont know whats going on, ive been feeling quite hot and feverish quite often when just been walking around a while or in a hot room/having hot shower/ and strange  burning/cold feelings on top of head for weeks now, then feeling miserable and cold for ages afterwards.  I have colitis(on azathioprine/colazide) but seen specialist over that they say it isnt flared up and under control and probably not related, although vhaving scan in 6 wks as have been having lower pains from time to time.  Im going to a gp again tommorow, and have already been, they keep saying im very anxious, that it isnt an infection, but last few days seems worse. bit dizzy eye went bit bloodshot in corner, went to a doctors last night, he said id got inflamed eye/conjunctivitus, that i dont need a cat scan,blood pressure was normal, im scared its something to do with a stroke/tumour/lymph thyroid/adrenal proble, its making me feel anxious all the time.",
    "doctor_response": "Hello, Thanks for choosing health care magic for posting your query. From the description that you have given it appears that you are surely having anxiety symptoms. You might have noted yourself that your symptoms keep changing and are of transient in nature. It doesn't fall into any specific disease. You should visit your psychiatrist who can discuss carious treatment options with you: 1) Cognitive behavioural therapy 2) Medications like escitalopram, mirtazapine, venlafaxine, desvenlafaxine. 3) Propranolol and clonazepam will also help . 4) Regular exercise and proper diet will also help in long run. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. If not, you can close the discussion and rate the answer accordingly. In future if you wish to contact me directly, you can use the below mentioned link: bit.ly/dr-srikanth-reddy Wish you good health, Dr. Srikanth Reddy M.D.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Arcolane shampoo control hair fall and dandruff problems?\n\nHi, my name is Eric, i am 24 years old, height - 5.10 and weight - 81 kg. I am having hairfall problem past 5 years. Also, i am facing dandruff issue. Doctor has advised me to use Arcolane shampoo, could you please tel me how effective it is and how frequently do i use it in a week.? Thank you. Regards,Eric Yan",
    "doctor_response": "Hello Eric,Welcome to healthcare magic.I understand from your query that you are having hair fall and dandruff.Your hair fall could be androgenetic alopecia which is the most common type seen in men. We have US FDA approved medications like minoxidil and finasteride for it but you need to take it for a long time as we cannot cure the genetic problem but can halt the process.Arcolane is a good shampoo for dandruff. Use it on alternate days for 2-3 weeks and then maintain the effect by using it once a week.Hope this helps you.Tae care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with prostrate cancer, removed testicles in surgery, chemo done as spread to bones. Hb reducing. Any ways to increase it ?\n\nMy dad is 70yrs old and was diagnosed with ca of prostate in 2007. Surgery was done to remove the testicals in order to reduce the production of testosterone. From bone biopsy we found that it has spread to bones and chemo was done for 2 cycles out of 3. the last one could not be completed because of severe side effectsHis hb keeps reducing every 3-4 months and he requires transfusion. Is there a way to avoid this and increase the hb naturally? He eats a very healthy diet rick in iron but effect of Hb is slow",
    "doctor_response": "We Use in our patients  Erythropoitin 10000 units every 2 weeks. You can consult  your doctor who can guide you the form and route of administration.Truly,Dr. J. Ticku",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the lump on the anus with bad odor be the Strep with no rashes and fever?\n\nmy husband has a knot like thing near his anas it finally ruptured and the doctor took a sample of the substance and said its strep but he has no rash or fever he has had the knot for several months now a really bad smell is coming from the substance",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern the given history here is suggestive of perianal abscess and that need to be drained first and anti- biotic should be initiated one more important thing is this should be differentiated with the \"fistula\" in short great care need to be taken for this ideally the pus or the contain what ever it may be should sent for culture and sensitivity, hope this information helps you have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rashes on hand and leg, primrose oil capsule\n\nI am 63 years old and diabetic. I developed prostrate enlargement due to costipation. After medication i am now fine. Since last july i developed rash on my hands between the elbow and wrist and on the legs between the knee and ankle . I took medication like primerose oil capsule and loridon with two creams for application in december 2011. Still i have a slight rash and is scratches. Could you please answer my question.",
    "doctor_response": "Hi,It seem that your has developed allergic dermatitis to some contact allergen. Do not apply any home remedies which can aggravate the situation. You can apply cortisone cream and calamine lotion over affected area.Use a good quality medicated moisturizer  for 3 times a day. Protection from direct sunlight is must . For itching you can take benadryl or loratadine by mouth.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest an alternative to Oxycontin for right-sided palate pain while EBV and B-Cell disorder\n\nI have EBV& B-CELL LYMPHOPROLIFERATIVE DISORDER on the right palate in my mouth that is very painful. I have stage 4 Lymphoma and am undergoing tests before starting the chemo. The biopsy reveals significant numbers of EBV& cells which have a similar distribution as the PAX5 cells. Of course there is more- but although I have OxyContin 5mg to take 1 to 2 every 4 to 6 hours as needed- it s not really helping. Is there anything else that I can do for pain while I wait for the chemo to start? Ny gums are swollen and there is necrotic tissue and it seems to be worse every day! What about an antiviral medication?",
    "doctor_response": "Hello,I hope you are feeling better now.You may ask your doctor regarding tapentadol PR for replacement of Oxycontin.Since you are already on high dose medication , I would suggest you to do saline rinses.Also apply a local anesthetic gel over the ulcers so that you get some immediate temporary relief.Maintain the oral hygiene. Drink more water. Vitamin B complex and Vit C would help in healing as well.Hope you get well real soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Continuous cough, running nose, wheezing due to allergy. No relief with medicines. Asthalin pumps or rotocap can be taken?\n\nhi doctor, i am 34 yrs female suffering from continuos cough ,runny nose, wheezing ,mainly in the mornings and night when i am about to sleep.I was given allegra ,some nose drops,cough mixture plus had tried homeopathy but nothing seems to works.This attack isnt throughout the day comes in spurts but is there everyday time may differ,seems i have a allergic condition as described by my doctor pls suggest if asthalin pumps or rotocaps can be taken.",
    "doctor_response": "hi, it is allergic problem ,homoeopathy should be taken for long time to get cure from a good homoeopathy physician.thanx",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe knee pain\n\nAge 20 female.i had a problem in left knee two year ago.but now severe pain in right knee. Done mri..doc told its knee effusion.had medicines.having vitamin d as doc sugested.going through exercises ...still it pains after walking fr a long distance. What are the chances of complete recovery?",
    "doctor_response": "HelloPain in knee need proper clinical evaluation and investigations.Besides routine blood investigations,most important is MRI(right knee).Pain may be due to many causes like ligament,meniscus injury etc.MRI can evaluate soft tissue like ligament,cartilage very well.It can also assess knee effusion nicely.You may need surgical intervention after evaluation.You will be fine with proper diagnosis and treatment.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment do you suggest for pain in left shoulder?\n\nmy dad 79 years old high bloodpressure diabetic  just yesterday found out had cellulitis on keflex 500 already had 6 pills has a pain in left shoulder took bloodpressure 240 over 150 had squad come went to 204/150 want to know if keflex can raise it",
    "doctor_response": "Hi and thank you so much for this query.I am so sorry to hear about this cellulitis. Keflex cannot cause this sudden and alarming increase in blood pressure. I will suggest that you get your father to the emergency room because these numbers are very high and need immediate attention to avoid related complications like stroke, heart, kidney damages, etc.Cellulitis in diabetics should be approached with full force because of the fear of severe complications. If the  improvement is not remarkable withing 48hours, please talk to his treating doctor.I hope this helps. I wish you well.Dr. Ivo, D.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat concussions?\n\nMy husband is scheduled to see a Dr. July 9 in our city in regard to a concussion he sustained in January. We have been waiting a long time for this appointment. I have now come across some very upsetting reviews in regard to him. Many more negative comments than positive. Not sure if we should just go and take our chances or ask our GP for a different referral??",
    "doctor_response": "Hello dear You have not provided adequate information.  Head concussion due to trauma presents variedly and management and treatment is accordingly. If your husband got concussion injury with no loss of consciousness, vomiting, seizure or bleeding through ear or nose then you need not to worry. Even presence of such symptoms with no complains after months are also of no concern. Only late complications of concussion injury may be subdural hematoma presenting as headache, weakness or seizure. If your husband is not having any complain at present and imaging of brain is normal then be positive. If there is presence of any symptoms then do mention in your question again. Hope all comes good God bless you and your family",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mold found in coconut. Allergic to mold. Can it be eaten after removing mold?\n\nokay I ve heard that some molds are safe to eat and kind of douted this answer will be a yes but i got a coconut from a wholefoods today and it had what looked like a small portion of blueish black, pink and yellowy mold in a small ring alound where a cut area was placed for easy opening i already threw out the milk but was wondering if I was able to salvage the rest of the coconut or shouldnt because i am allergic to mold",
    "doctor_response": "i think better avoid the mouldas we dont know the time since how long it is with coconut as this mould grows itcan effext internal parts of coconutan allergic patient can react to even minimum amount of exposureso dont take chance",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes left chest pain, arm numbness, right abdomen distention and bruising?\n\nI am burping what tastes like eggs, although I haven't eatenI am burping what tastes like eggs, although I haven't eaten any eggs at all in the past week or so. I have chest pain on the left side as well as a numb left arm, and the upper right quadrant of my abdomen is distended and feels bruised.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. In my opinion, we should first rule out cardiac diseases for your left sided chest pain. So get done ecg and 2d echo. If both these are normal then no need to worry for heart diseases. GERD (gastroesophageal reflux disease) can also cause burping, left sided chest pain, bloating and abdominal pain.So take pantoprazole and levosulperide combination on empty stomach twice daily. Avoid hot and spicy food. Avoid junk food. Go for walking after meals. Loose weight if you are obese. Quit smoking and alcohol if you have these habits. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for blockage in arteries\n\nneighbor has SCAN medical coverage and he had a shortness of breath so the did stress test . they stopped it as showed signs they did not like. they did hear catherization and said he has 80 blockage in 3 arteries. but they Never really informed him of danger of his condition. hes 84 and still does all his tasks. after my heart surgery i had to slow down but still ok. since he has Not had Any Surgery and Now Says He Feels Great (hes Afraid as hes 84) Where can i find Information to let him read so he gets his head back on himself. since hes Chinese there is Language Issues and Nobody Wants to Give Him doctors office second language spanish",
    "doctor_response": "Hello Thanks for posting at HCM. As per your description, he has got blockages in all the three arteries of the heart. In this case a bypass surgery is adviced. But as he is 84, the risks and benefits of the surgery must be weighed. Also other things that matter are associated health issues like diabetes, blood pressure, kidney issues etc. The decision for bypass surgery also depends on where exactly the arteries are blocked i.e. very close from yheir origin or distal from their origin. Another important factor is his expectations and his desire. I dont know him personally, but you must ask him what he wants to pursue, what type of activities he expects himself to do. I would not advice a bypass surgery for him at this age. It is putting him at more trauma and discomfort. One approach can be angioplasty to stent only those arteries which are more critically blocked and can cause a life threat. Rest can be left upon medical management. Second approach will be  a trial of medicla management. He may remain asymptomatic with medications and can go around with his daily activities. I need to watch his angiography pictures to comment more. Information can be availed all over the internet with a simple search, but those searches do not take into account his age, his personal preference and many other factors. wishing him good healthRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat back pain?\n\nhi ihave been experiencing pain in upper back,shortness of breath sometimes after eating and i have piles on daflon500 medication and also feel pain in right side ribs ,abdo and right leg did usg a cyst of 18*18mm on left kidney and its fine now need help abt gas problem.....",
    "doctor_response": "Hi.For gas problem you should rely on herbal medicine which have unparalled effect to treat the problem and no side effects.Tab Gasex and Shankh Vati are very popular, economic, effective and safe medicines for such purposes to be taken with warm water preferably.Any Ayurveda doctor can tell you how it helps to prevent fermentation of food in gut and how it cleanses the GIT. So, better avoid synthetic enzymes.Hope it serves you well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What dosage of trimop tablet should be taken with history of taking trimop forte 1 tablets?\n\ni was using trimop forte 1 tablets once in two days which contain 25 mg of trioxsalen and now because of unavailability of trimop forte tablets now i am taking only trimop tablet which contains 5 mg of same contain.i want to know that how should i take this trimop tablet??2 tablet once in two days or same as last ....",
    "doctor_response": "Hi, Psoralens are a bit tricky and the effect of a new formulation often is not the same even if the milligrams are the same. Basically, one has to see how it goes and adjust the dose up or down depending. It needs careful monitoring as it can cause skin reactions other than the ones desired and affect lens opacity. I hope this answers your query. I remain at your disposal in case further medical assistance is needed. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for sudden crack in head causing pain in neck, shoulder and difficulty in moving neck\n\nHi i was laid in bed this morning and when i have gone to get up i heard a crack in my head i cant move my neck to the right and have really bad pain all down my shoulder and can only keep my head tilted to the left, what can you advise i do please the pain is excruciating and i have 2 children to look after",
    "doctor_response": "Hi..Your neck pain is due to face joint irritation...Due to sudden forceful movement your facet joint is loaded and capsule is stretched causing excruciating pain slowly increasing spasm around muscles.. responsible for your ackward neck position...Don't worry...I suggest you to..Keep icing your neck frequently say 15 mins for every 1 hour..care should be taken..as temp should be normal before next application..If you have any Anti inflammatory medication prescribed to you previously you can have them with GP' s advise...If you have a soft collar keep your neck supported..keep it supported with rolled Roseland pillow while sleeping..Don't do any movements forcefully..and dont keep checking the pain...Don't lift anything heavy ...once pain slowly comes down then...stretch your neck gently...bringing your chin to tge chest..again don't do forcefully...Hope this is helpful for you..kindly revert back in case you need any further clarification...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness of right side of face, hand and wrist?\n\nAt night I feel numbness on the right side of my face, my right hand swells and I feel some numbness in my hand and wrist. When my hand swells it is difficult to bend my fingers. Lately when I wake up I feel light headed. All symptoms subside when I get up and walk around. Recently During the day I feel a slight numbness on the right side of my face.",
    "doctor_response": "Hello, First of all, you should measure your blood pressure and if it were high, you should receive a medical treatment, take aspirin 160 mg twice per day after meals, decrease salt and fat intake, besides doing an ECG and an ECHO on your heart. If you take hormonal therapy for contraception or replacement therapy you should ask a gynacologist for help. You should assess the fasting blood glucose and the lipid profile in your blood. If the lipid profile were high you should receive medical treatment. Second, you should take vitamin B complex once per day. after meals, Benfotiamine twice per day after meals. You should stop smoking and drinking, besides eating a healthy diet. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dr/Mustafa, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Got red bumps after using a soap. Should i be worried?\n\nA few days ago i used summer s eve soap but im allergic to the spray and didnt realize it till after i ised it a coiple of times and stop for awhile bt on that particular day i wasnt paying attention to the soap. The next day i started feeling ichyness than today i saw a few red bumps ive used destin in the past and it worked. So i put some on tonight nd hope it feels better in the morning. Should i be worried about anything",
    "doctor_response": "Hi, As per your statement I understand that you are allergic to sprays, for which destin ? gave relief. Now after applying soap you developed itching red bumps for which also you used destin which gives relief. Any anti allergic drugs will give relief for any form of allergy. First we must try to analyze the cause (if possible) for the allergy. Your history and dermatologist's examination are the deciding factor to find what may be the cause for the allergy. Avoiding  those particular item and any allergy producing medications, food, smoke, smell, environment should be avoided. Periodical deworming  is must. Best Wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen groin area for pneumonia patient?\n\nMy husband had a flue jab and a pnemonia jab on Saturday and has felt unwell since, but today his groin area has swollen up both sides and is itchy, we have been to the doctors today but he seems to think if it is symptoms of the jabs, these things will disappear in a few days.",
    "doctor_response": "Hello welcome to 'Ask A Doctor' service.I have reviewed your query and here is my advise.Your enlarged lesion could be from enlarged lymph nodes. It can be reactive lymph node enlargement. If it doesn't disappear in few days than investigating with FNAC (to rule out nature of lesion) is advisable.Hope I have answered your question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can same blood group of parents cause any problem to baby?\n\nHello doctor, Me and my wife blood group are same A positive. And my wife is five months pregnant. I want to know that is there any problem with our baby?",
    "doctor_response": "Hello. The same blood group not at all lead to any problem in conception. Same blood group people can marry and can produce a normal child. So as far as same blood group concerned do not worry about that. But as a doctor I will advise you to check your wife thalassemia minor report by Hb electrophoresis by HPLC method. You can provide me with reports for further interpretation. If you both are relative in nature then genetic counseling is needed. For more information consult a hematologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for red mark on cheek after a cheek bite\n\nsmall mark left after i chew my cheek. Befor it gets heal i chew that again. Now it healed very fast but it left a red dot like mark which i can feel with my tongue. It is been one month now the time i chewed it. I showed it my dentist and he priscribed hexigel. I have applied it for three days but no improvement. Please suggest",
    "doctor_response": "thanks for your query, i have gone through your query. the black or reddish mark on the cheek could be because of the bleeding that has ocurred during cheek bite and which has clot. or it can be melanin pigmentation secondary to cheek bite. dont worry it will not trouble you. if it is because of bleeding(ecchymosis) it heals in weeks. if it is pigmentation it might stay till you stop biting the cheek. i hope my answer will help you take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated GAMMA GT?\n\nI am a 46 year old female, standing at 1.57 cm and weighing 51 kg. Received my health screening report- my liver profile is normal except for an elevated GAMMA GT reading at 66. Is there any reasons that would caused the elevated reading? I have been advised to take another test in 3 months time.  Thks Sally",
    "doctor_response": "Hello Thanks for writing to HCMIncreased GGT indicates liver injury.It is important to know about other parameters of LFT like SGPT,SGOT,bilirubin level etc.It is important to know about alcohol history.You need proper clinical examination and few more investigations.Other investigations include routine hemogram,RBS(Random blood sugar),Viral markers,Ultrasound of abdomen.Further investigations can be done if needed.You may need medicines after proper checkup.You should avoid alcohol if you take it.Hope i have answered your query.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain, vomiting, weight loss. History of gall bladder removal. Suggestion?\n\nCentral and right upper abe pain with vomiting weight loss of 55 pounds over 3 years all test come back normal. Pain is getting severe and usually only at night like a spasm. Happens at least 5 night a week. Galbladder out in 1998. Have had upper gi, lower gi, mri for stone, ct, stomach emptying which was slightly on the slow side. Very frustrated any suggestion on what to check for next?",
    "doctor_response": "Hi,The symptoms that you describe are classic for gall bladder stones. Treatment is simple. All you need to do is meet a surgeon who will take the stones out. This will help you greatly. Follow this advise and everything should be fine. All the best.Dr Vineet",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe pain in the fingers while suffering from osteoarthritis be treated?\n\nI have a little bit of ostoarthritis which usally just makes my fingers hurt. Recently I have been getting pain in my whole hand, wrist and muscle up to my elbow. I take diclofenac which doesnt work to good. Its getting harder to work and my doctor doesnt seem to have any answers for me. Any ideas for relief?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You need a stronger pain killer like Tramadol along with calcium and vitamin D3 supplements. I hope this information has been helpful for you. Regards, Dr. Praveen Tayal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes big belly in a child?\n\nMy 2 1/2 yr old as always had a big belly. At her 2 year check up the pediatrician questioned why it so big (like we would know), but she never seemed to concerned. My 2 yr old lately has been complaining of her tummy hurting and last night it felt really hard. Usually simple things help, like giving her a snack or something then she will say it doesn t hurt. Could it be more serious or just growth and changes in eating habits?",
    "doctor_response": "a few things needed to be answered first what is the baby's weight ? does this distention come and go , or it is the same all the time ? do you noticed any itching, discoloration of the skin or skin rash on the legs ? is she developmentally well ? what is her nutritional status ? a complete physical exam by the doctor will exclude organomegaly ( big liver or big spleen) .if the distention comes and goes , flat abdomen in the morning and big one in the evening this means that is some sort of maldigestion, most commonly from carbohydrate at this age and some medicines are helpful with that if this distention is present all the time I recommend the following tests : cbc , albumin level , thyroid function test , stool for reducing substsnces , celiac screen , abdominal songoraphyI hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can be done for tiny bumps on face and dark circles?\n\nHello doctor, I had small tiny bumps (not pimples) all over my face. Also, I had dark circles with puffiness under my eyes. Please provide me some home remedies or methods to cure these problems.",
    "doctor_response": "Hello. I understand your concern. Inadequate water intake can sometimes lead to the occurrence of bumps over the skin and dark circles. I recommend that you increase your fluid intake to at least two liters daily. Sometimes, Vitamin A deficiency can cause similar symptoms. This can be replenished by eating food rich in Vitamin A like carrots, red peppers, spinach, mango, muskmelon, watermelon, papaya, and guava. If you are a non-vegetarian, eggs, lamb liver, salmon and tuna are good sources.  Stress and lack of sleep can also lead to dark circles. So try meditation and regulate the sleep cycle. Sleep and wake up at the same time daily. If there is no change after one month, meet a doctor personally for a clinical examination.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can excess tuna fish consumption cause tightness in chest?\n\nmy son eats alot of fish...tuna, exercises hard each day, does alot of cardio...once had tighten of chest at gym...his ekg was adnormal...doc said maybe sinus bradycardia..now has to go trough 24 hour heart monitor and echo...never took a mercury poison test...should he do so. never had a problem with heart..only one time short breath pulse is 38-46...",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!Regarding your concern, I would explain that bradycardia is quite normal in healthy and active persons. It can be related to chronic physical activity in sport persons. I agree with your doctor that a Holter monitoring is necessary to investigate his heart rhythm for a prolonged time. A cardiac ultrasound is also necessary to investigate for the presences of cardiomyopathy. Regarding the fact that he eats a lot of tuna, I agree with you that he may be at risk for mercury intoxication. For this reason, it is necessary performing mercury plasma levels. Hope you will find this answer helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe knee pain\n\nFell on both knees on 1 week ago swelling went down 3 days ago I developed a pain on my calf right leg ice &heat Raise my leg up doesn t help either The pain is getting worse asthe days go by and it s getting unbearable Some times it s hard to catch my breath",
    "doctor_response": "Hi,Get xray of leg with knee of both sides get in AP and Lateral view and send me the report.Till then avoid squatting, upstairs etc.Have tab. aceclofenac+serratiopeptidase combination by prescription  of your family doctor.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes anal pain, rhinitis, headaches with general aches and pains?\n\nMy 6 year old son is comlaining of sever anal pain. He has no itching but also has a runny nose, headache and general aches and pains but the bum is causing him the most pain. He has been unwell for around 5 days now but today is by far the worst he has been.",
    "doctor_response": "Hello,The same bacterium that causes Strep throat can cause an infection of the anal area that is bright red and very painful. I advise you to spread his buttocks apart and carefully look at his anal area. If it is red, it will need to be treated with an antibiotic.Sitting in a tub of warm (not hot) water for 10 to 15 minutes, then getting up, patting the painful area gently, and applying Vaseline or A&D Ointment may provide some relief.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Arnold Zedd",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lipoma removed from under rib cage, umbilical hernia repaired, urinary catheter inserted\n\nI am having combination surgery under general anesthesia . I am having a lipoma removed from under my rib cage and an umbilical hernia repaired, both with open method. It is an same day, outpatient procedure. Will i have a urinary catheter inserted for this operation?",
    "doctor_response": "Hi,You are unlikely to have a urinary catheter inserted unless you have had a previous problem with urinary retention post operatively. If you have been told that you will be going home the same day then the surgeon must consider both the operations are relatively straight forward. In which case you should be up and about within a couple of hours after the operation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Super nauseated and weak after oral graphing and implant surgery of canine. Is this normal ?\n\nHI I JUST WENT THROUGH ORAL SURGERY BONE GRAPHING AND IMPLANT OF MY CANINE/EYE TOOTH . IM SUPER NAUSEATED AND WEAK (I ALSO TRIED TO GO ON THE TREAD MILL FOR 60MIN AFTER MY SURGERY) . I HAVENT THROWN UP IS THIS NORMAL SHOULD I BE WORRIED? ALSO IV HAD LOWER BACK PAIN AND SLIGHT NAUSEA THE LAST THREE DAYS AND I GUESS I FIGURED I POSSIBLY MAY BE PREGNANT OR THE BAKED CHICKEN MY FRIEND MADE SMELT SOUR BUT AS FOR THE PREGNANCY THING I AM EXTRA CAUTIOUS IM ON BIRTH CONTROL AND I USE CONDOMS WITH MY FIANCE. SO BASICALLY DO YOU THINK IM WORRYING TOO MUCH (HA) OR WHAT IS YOUR OPINION ON THE CAUSE OR CAUSES OF MY NAUSEATION ? THANK YOU.",
    "doctor_response": "Hi, Thanks  for  asking  the  query, Nausea ,  weakness ,  feeling  of  fatigue , dizziness ,  tiredness  are  common  side  effects  after  dental  surgeries .  donot  panic  follow  the  instructions   given  by  the  Dentist   properly . After  surgeries  healing  process  starts  and  there   is  increased   salivation   due  to  which  you  can  feel  nauseating . Take  complete  course  of  antibiotic  and  analgesic  . Take  saline  water  gargles  3-4  times   a  day . Use  chlorhexidine  mouthwash  gargles  twice  daily  it  will  prevent  infection  and  promote  healing  . If  not  relieved  you  can  take an  antiemetic  drug . Hope  this  helps  out. Regards.....",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of advil on baby?\n\nMy 2yr child managed to find an advil in wife s purse. She bit into it and more than likely did not enjoy the taste, so she vomitted. I was searching online for answers, found no harm will come from this even if she would have swallowed it. Is this true?",
    "doctor_response": "Hi,Advil is a non-steroidal anti-inflammatory drug commonly prescribed for the treatment of painful conditions like toothache, body ache, joint pains and also for fever. Its common side effects include heartburn, upper abdominal pain, vomiting, stomach ulcer, and bleeding.Since your daughter vomited immediately after taking advil accidentally there is nothing to worry because she has not swallowed it so harmful effects will not occur. However, seek medical attention if your daughter starts vomiting, or complains of abdominal pain, rash, itching or difficulty in breathing.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Urimax-D cause side effects like mouth ulcers &dental infections\n\nI was recently advised to changeover from Urimax 0.4 mg to Urimax-D along with Himalaya s Himplasia bpd. Since then I have been continously having mouth ulcers & dental infections. Is there any connection ? I am 66 years old and take Revelol Am 25/5 one per day.",
    "doctor_response": "Hello,There is no such side effects of Urimax-D. Mouth ulcers and dental infections are commonly caused by poor hygiene. Vitamin B12 and iron deficiency. You are suggested to get clinically assessed by a dentist and get treated at the earliest. In the meantime, take Vitamin B12 and use mouth wash after every meal. You are suggested to maintain good oral hygiene.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Nupur K, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Z pack be used for cough with mucus?\n\nIn March, came down with some type of cold, lost voice almost, got a bit better.  Then I got sick again, small cough, fever of around 100-101.5.  Self medicated with amoxil 500, and seemed to go away.  2 1/2 weeks later, chills, low fever 101 at highest but normally around 100.2, and cough came back.  Strange fever - would break during night and I'd wake up w/sweat like my clothes came out of washer, then around 2 or 3 p.m., fever come back with slight chills, would go to about 100 or so... then it would repeat.  This went on and off for about 10 days, and the cough started getting worse.  Over the course of May, the cough has continued.  No fever/chills now at all.  The cough has been so severe a couple of times that I did almost throw up... couldn't stop coughing.  Lying down is worse.  I don't hear any indication of crackling in chest with scope.  Bringing up light to dark yellow mucus, mostly thin, but couple mornings it was a thick blob.  No ins., will z pack fight it?",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .*  It  is  definite  underlying  lung  infection  in  form  of  bronchitis  or else.*  Z pack will help for sure , but I recommend to get evaluated with your     family doctor  for  basic  lab tests , x-ray chest to precisely diagnose    the  issue  and  manage  perfectly .Wishing you fine recovery .Feel free to ask any further  queries .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms and treatment for parkinson disease?\n\nI m a 45 year old female and just a few months ago I have a tremor that starts inbetween my thumb and finger causing the finger to move slightly. you can see the area between the thumb and forefinger pulsating. It happens only to my right hand when at rest and is increasing especially before bedtime. This seems to be the only symptom at this time. Could this be an early sign of Parkenson disease and what tests can be conducted to rule this out? Kathy",
    "doctor_response": "Brief Answer:Your symptoms are not typical for Parkinson disease.Detailed Answer:Hello,Thank you for using HCM.Your symptoms are not typical for Parkinson disease. Parkinson disease consists of a progressive and irreversible loss of dopamine sensitive brain cells. Its symtoms vary, depending on the stage of the disease, but are always manifested symetrically. Tremor (trembling of arms and fingers) especially increases when trying to approach the target (a glass of water toward the mouth), rigidity (slow movements of the upper and lower limbs), speaking and swallowing difficulties due to impaired laryngeal and esophageal muscles function, etc... The diagnosis of Parkinson disease is mainly made by clinical symptoms. The diagnostic imaging exams serve only to exclude other diseases. Treatment consists of dopamine restoring medications such as: Levodopa or Sinemet (a dual combiantion of Levodopa with Carbidopa in a single tablet). Amantadine (an antiviral drug which has been shown effective in improving Parkinson symtoms) may be included into the treatment. Deprenyl (Selegiline) is a MAO-Inhibitor which is also a possible choice to be added to Parkinson treatment.So what to do next ?Try not to get stressed because it may be related to your symptoms or may aggravate them.Try to have a balanced life, not to work with extended hours and to sleep well.In case of increasing tremor or development of any new symptom , please consult a neurologist.Hope this is helpful.Let me know if you need more clarifications. Otherwise please close and rate the answer.Kind Regards, Dr. Juarda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause and treatment for dizziness?\n\nhi my name is deven and i am 16 years old and i wanna ask you a few questions im really feeling dizzy every morning when i get up from bed i faint idk what it is but my bus comes for me about 6:50 am and later on after school i get on the bus and i feel dizzy again and i fell on the gound my princiable called the nurse and got a wheel-chair she came and took me too the nurse. what does that mean?",
    "doctor_response": "My question is from how many time you are suffering from this and is there double vision or any improvement of this dizziness when day go on eg in evening",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could gyneco mastia and pelvic hair distribution be due to hypogonadism?\n\nI'm 22 years old male,have the following syptoms and signs:1.Gyneco mastia(disc is present below nipple but not tender) 2.triangular pelvic hair distibution (feminile)3.Never had a we dream before4.However I masturbate efficiently Is that hypogonadism? I don't have any chronic illness or any other sypmtomsthx in advance",
    "doctor_response": "Hello, Gynecomastia needs to diagnosed properly. Good amount of physical exercise and chest muscle exercise can tighten your chest muscles. Triangular pelvic distribution is normal at your age. Wet dream is never a necessity. Masturbation is efficient in itself is very clear that you do not have any hormonal problems. So do not worry about it because worry can create erectile dysfunction and premature ejaculation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cervical cancer, removed by laser surgery. Thyroid problem, gangrene in cervix. Vomits blood. Any treatment?\n\nMy daughter is 32. She had cervical cancer twice (age 25 & age 26). It was removed by laser surgery . The second time it came back it was a different type of cervical cancer (cell shapes were different and grew outward also. At age 31 she had a thyroid problem that the doctor predicted would turn into cancer. A few months ago, emergency room doctors found gangrene in her cervix and ovaries. It was removed surgically. Now she goes to clinics every day for intravenous treatments for plasma because she vomits blood and it pours out every opening in her body. Over the year she lost 30 lbs. She can t have a pet scan because she is allergic to the dye. The doctors said her body is shutting down and she could expect a painful death.",
    "doctor_response": "Hi, Extremely sorry to hear about your daughter's condition. The reason of blood vomiting is not very clear, probably her complete blood count may be helpful to assess her condition. Cervical cancer can rarely produce this sort of complications. Probably some other etiology is responsible for it. Anyway supportive treatment should be continued and depending on pathology report of ovary and cervix specimen any treatment can be planned, consult your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Despite taking medicines for stomach pain, I did not get any relief. Why?\n\nHello doctor, I am having stomach pain from about one and a half months. The pain generally begins after lunch or dinner\u00a0and may last for one to four hours. It is episodic in nature\u00a0and increases in severity, and then gradually goes away. The pain occurs in the lower left region near the navel. The doctor at the local hospital said that\u00a0there is some tenderness in the colon, and the pain may be because of some infection. Widal test was also mildly positive (report attached). Following it, I was admitted to a local hospital for five days and was prescribed some antibiotic and laxative treatment which did not help much. All my endoscopy, colonoscopy, x-ray, and ultrasound reports are completely normal and are attached. The medications that were prescribed are\u00a0Mebiz SR and O2 tablet, both twice a day, Ultracet and Hyocimax tablet, both when required.\u00a0Despite doing a full course, I did not get any relief. Please tell me if there can be some other reason for the pain and its cure.",
    "doctor_response": "Hi. I have seen all your reports (attachment removed to protect patient identity). For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruise on forearm with bump in middle while on Cymbalta?\n\nHi, may I answer your health queries right now ?  Please type your query here... I have a gold ball size bruise on my fore arm and i dont remeber hitting myself at all and it has a white bump in the middle. I am on cymbalta is this something to worry about I have been bruising easily",
    "doctor_response": "Hi,Welcome to HCM.Based on the facts of your query,the bruise on the forearm with white bump in the middle,seems to be due to Boil with cellulitis with pointing white head/ or it could be a insect bite with bruise/cellulitis with poining head.As you don't remember any bite or trauma and worried,Second Opinion from Dermatologist /or GP,would help you to rule out any other causes of such a bruise with a lump.I doesn't see Any relation of this bruise with bump to Cymbalta.You should not worry as it is not Cancerous and is treatable bruise with bump.This reply would resolve your current issues and would reduce your anxiety with it.Hope this reply would help you to plan treatment with your doctor.Will appreciate your Hitting thanks and writing excellent review comments to help needy patients like you. Welcome with any other further query in this regard.Good Day!!Dr.Savaskar,Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having irregular periods. Scan showed retroverted and bulky uterus. Can I conceive?\n\nmy report says that uterus is retroverted in position and bulky in size meauring 9.3*6.4*6.00 cms dimension. there is hypoechoic nodule noted in anterior aspect of body of uterus measures 2.8 vms i n daimeter. endometrial thickness is 10 mms .right ovary is enlaged measures 5.9 * 5.0 cms in dimension. solitary thinwalled cyst nited in it measures 4.3 *4.0 cms in diameter. I have irreular periods and slightly more bleeding than normal during last 8 months. can i concieve , what should be done ?",
    "doctor_response": "You need to get few basic tests like fsh lh prolactin tsh to see whether your hormones are allright...then get ypur tubes testes gor patency that is by hysterosalpingography to see whether they r patent. ...for bulky uterus and cyst which most likely is a follicular cyst...tske antibiotics amd anti inflammatory for few days and may be you have to tske low dose pills for 3 months to get your periods regular as well as for the cyst to resolve.....get your husband semen analysis also done....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is Siphene 100 & Susten 100 is prescribed?\n\nhello this is malani got married 10mths back looking for the baby, iam taking medicines last mth but i couldnt make it, as iam using these medicines siphene 100 and susten 100. i want to know why the doctor prescribed this medicine and what is the advantage and disadvantage of these medicines",
    "doctor_response": "Hi,Siphene is primarily used to treat female infertility. It works by stimulating an increase in the amount of hormones that support the growth and release of a mature egg (ovulation).Its common side effects include stomach upset, bloating, abdominal / pelvic fullness, flushing, breast tenderness, and headache. Susten is a form of female hormone progesterone commonly prescribed to regularize the menstrual periods, support and maintain an early pregnancy.Generally it is well tolerated however it may cause headache, breast tenderness, and abdominal pain. Continue to take them as prescribed. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take Angina for a person having two leaking heart valves?\n\nI HAVE A CARDIOLOGY QUESTION. I AM NOT SURE THAT I HAVE ANGINA ATTACKS , IF SO SOMETIMES IT WILL ONLY BE ONCE EVERY COUPLE OF MONTHS, .. I WAS GIVEN A PRESCRIPTION FOR ISOSORBIDE MN ER 30 MG ONCE DAILY. SINCE I AM NOT SURE THAT I DO HAVE ANGINA ATTACKS I AM AFRAID TO TAKE THIS MED. I HAVE TWO LEAKING HEART VALVES , MITRO AND I THINK TRICUSPID, NO SEVERE AT ALL. IS IT SAFE TO TAKE THIS IF YOU DONT HAVE FREQUENT ANGINA, IF AT ALL",
    "doctor_response": "Hello! Thank you for asking on HCM!  I understand your concern and would explain you that first you should clarify that issue regarding possible cardiac angina.  You need to perform a cardiac stress test. If nothing results from the test, and if you don't have coronary risk factor, then you should look for another explanation of your experienced pains. Otherwise, if stress test results positiv for cardiac ischemia, then you need a further diagnostic work up including coronary angiography to confirm coronary artery disease and establish the most appropriate therapy. Greetings! Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is taheebo tea one of the medicine for breast cancer ?\n\nFemale 73 years old. Small lump found with mammogram . I m in good health with the exception of high blood pressure , controlled with meds. I am considering using taheebo tea for the lump. Will the tea have an interaction with my blood pressure meds?",
    "doctor_response": "WELCOME TO HEALTHCAREMAGIC please consult onco surgeon and get tests done to find the nature of lump and get treatment accordingly",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are low grade fever, vomiting and a rash on the face symptoms of fifth disease?\n\nMy grandson, 4 yrs old, has had low grade fever for 3 days, nausea, occasional vomiting and now today a slapped cheek appearing rash on left side of face. He was just at emergency room few hours ago. Dx was gastroenteritis and constipation. Could this be fifth s disease and what is treatment?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Yes, what you are describing is classic for fifth disease. There is no treatment. The fever ultimately resolves on it's own as does the rash. No need for concern. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying for conception. Stopped taking cezarette. No periods. When will my periods occur?\n\nHi I ve stopped taking cerezette 2 months ago but had no period. Me and my husband are wanting to try and conceive our 2nd child. We didn t have any problems with out 1st and I was on cerezette then and had a period within weeks of stopping it and was pregnant after 4 months. If there anything that could bring my periods back? Thanks Thanks",
    "doctor_response": "hi, after stopping the pill the time taken for recurring of ovulation and menstruation will deffer from person to person, usually you will have withdrawal bleeding while on pills, now the cause for your delayed periods could be hormonal imbalance or pregnancy, so you once consult gynecologist and undergo blood test for pregnancy which will rule out that possibility, then if comes negative you can undergo physical examination and ultrasound to find out the cause for your problem. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain and difficulty in swallowing with asthma\n\nMy 8yr old son is 4 ft tall and weighs about 75-80 lbs he sporadically complaints Of pain in the Middle of his chest also has pain in his ankles and headaches at times..he is asthmatic. And is currently! on an asthma action plan oh yea sometimes he says its hard toq swallow ...can u help me please?",
    "doctor_response": "HI...by what you quote I feel that the kid is having severe form of GER (gastroesophageal reflux). Your son will need - 1. Antireflux therapy - Proton pump inhibitors + antiemetics2. Always make him lie down in a propped up position - as in the care seat. He should not be sleeping completely flatly.3. Avoid heavy feeding and feeding more times and in small aliquots.4. This type of GER is the root cause for the constipation he is having.He needs expert gastroenterology consultation.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can medical Marijuana replace Vemlidy for treating hepatitis B?\n\nMy doc is telling me I should start taking Vemlidy for hep b. Side effects are scary.. Should I look for a second opinion? My son wants me to seek a medical cannabis... My brother died of liver cancer 3 yrs ago after getting a liver transplant. I am worried...",
    "doctor_response": "Hi, In the case of hepatitis B of the virus is multiplying in body than antiviral medication needs to be taken to stop its replication. Your son can get investigated with sgpt, sgot estimation, HBV DNA by PCR and Hbeag estimation to check whether virus multiplying or not. If all these reports normal than no need for medication or else medication need to be taken. Kindly revert back with reports once done. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is tooth extraction safe while on recreational drugs?\n\nHello,I am scheduled to have four impacted wisdom teeth removed this Friday, February 17, 2017.  It is a non-emergency, elective procedure at this time.  I am an otherwise healthy 30 year old male.  I had a medical checkup and bloodwork with my general practitioner about 6 months ago, and everything appeared to be normal.  During my consultation with my oral surgeon, my blood pressure was taken throughout most of the consultation, and no one mentioned to me that anything was out of the ordinary.  I regularly exercise 3 days a week with no significant shortness of breath or dizziness.  For my procedure on Friday, I am scheduled to undergo \"twilight\" anesthesia as explained by my oral surgeon.  I am unsure what exact drugs they will be using, but my understanding is that they will be similar to (if not the same) drugs used for general anesthesia.My question and high concern involves my recent recreational drug use and its potential adverse effects with the anesthesia.  I typically use alcohol and marijuana on the weekends (including this past weekend) with friends, which have caused no problems in the past.  More recently (as recent as last weekend), I have also engaged in moderate cocaine use.  I will be taking any and all steps necessary to abstain from cocaine usage going forward.  I would not consider myself \"addicted\" to it at this point, so abstinence should not be an issue.My understanding is that cocaine, due to its relatively short half-life, will typically leave your system within 72 hours.  I will be abstaining from all previously mentioned usage this entire week, and it will have been approximately 5 days between any usage and the procedure.Due to the nature of my work and my father's relationship with the oral surgeon (he is a dentist, they refer work to each other, and I have given my father permission to view my medical records if necessary), I would strongly prefer to not mention any of this to the oral surgeon.  At the same time, I understand my safety is important.To boil all of this information down to my question, if the cocaine metabolites have left my system by Friday morning, will I be in a safer condition to undergo the procedure?  Because the procedure is elective, I have no problem postponing the procedure for another 1-2 weeks at a minimum to ensure my system is clean and my vitals are stable.  I have read conflicting medical research online, with some journals indicating a coc",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Yes, it is true that you should be clean of any recreational drugs in your blood before you go for any anaesthesia procedure. You should be free from any drug intake for about 2 weeks.But still without intimating your Doctor/dentist, it is not appropriate to proceed for treatment procedure. So, my suggestion is to discuss with your dentist and get a blood test done and once you are assured then you can proceed for anaesthesia and treatment.  Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness and discoloration on the toe after a fibula fracture?\n\nMy husband broke his rt. fibula approx. 4 weeks ago. He has had a plate and screws put in during surgery., a cast put on as well.He is using crutches and keeping his leg up above heart level, however there is some bruising/discolouration on some of his toes. He also feels numbness in them as well, and there s one toe he has no feeling in at all. Is this normal after a break?",
    "doctor_response": "hithis is Dr RohitI would like to explain you regarding the query you havebefore that I want to know at what level is the injury1.upper third leg2. lowerthird legbut by the surgery you mentioned I would think it is lower third as plating is done usually for lower third fibula fracturecauses could be1. during trauma injury to sural nerve2. injury to nerve during surgeryI would like you to taket. methylcobalamin 1-0-0 * 6monthsmight see some resultthank youfor any queries feel free to ask",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pains in lower back while sitting?\n\nI have a pretty sharp pains in my lower back while I sit on the floor, or just laying down. Almost makes me sick to my stomach, but I am able to tolerate it ( haven t done anything about it yet). Could you explain to me what this is, and what I should do? Should I see a chiropractore? I m 19 years old, and 120 pounds so excess weight is definitely not the issue. Get back to me as soon as you can, please & thank you!! Alli",
    "doctor_response": "Hi, Thanks for your query. After going through your query I came to know that you are suffering from chronic backache. It may be due to vitamin and trace element deficiencies specially vitamin D and vitamin B 12. You need to done MRI to rule out other causes.Back exercises, neurotropics such as mecobalamine and analgesics (DICLOFENAC 100 MG SLOW RELEASE TABLETS) give relief. Sometimes vitamin D deficiency can aggravate this so serum vitamin D test is advised if it is low than vitamin D supplementation will be required. Avoid long continuous standing. Sit in a straight posture. Eat milk, fruits and green leafy vegetables daily.You can discuss with your treating Doctor about it. I do hope that you have found something helpful and I will be glad to answer any further query. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does extrarenal pelvis mean?\n\nUsg report says my both kidneys are normal in all respect but have prominent extra renal pelvis. Doctor advised to report after two or three weeks with another usg for further review,treatment.. Kindly advice .some I have back ache. Urine flow is normal .I am taking allusion 10mg, one tablet daily for enlarged prostate treatment.",
    "doctor_response": "Hello and welcome to HCM.As an Urologist,i can understand your concern.Prominent extra renal pelvis,means the drainage system from kidneys to bladder,is outside the kidneys. Normally,located completed inside kidneys.There's nothing to worry about it,as this is seen as a normal variant.It doesn't affect the kidneys in any way.The USG scan must be repeated in about 3 months time.If you've any doubts,you can send it as a direct question,to me.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore joints post arthritis medication withdrawal?\n\nI have mild Rheumatoid Arthritis and osteoarthritis. I was on methotrexate and Celebrex and experienced a big spike in my cholesterol. I stopped taking my medication for arthritis and it has been 2 months. Ok at first now I have extreme fatigue, sore joints, back ache, muscle aches and feel like I am coming down with the worst case of the flu. This has been going on for about 10 days. Something new or a flare up of arthritis?",
    "doctor_response": "Hello, Consult an orthopedician and get evaluated. As of now, analgesics like Aceclofenac or Tramadol can be taken. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for breathing problems\n\nHi I have discomfort in breathing fully.I can breathe, but only with discomfort. I feel that its just my left lung which makes it difficult to breathe. It happens only sporadically throughout the day. No other symptoms. Could it be A1AD? and what are foods rich in  A1A?",
    "doctor_response": "Hello,No, it is not due to Alpha 1 antitrypsin (A1A) deficiency. A1A deficiency causes bronchiectasis in the lungs. And it will cause chronic cough, expectoration, and breathlessness, not sporadic. So in my opinion, you should definitely consult a pulmonologist, and get done a chest x-ray and PFT (Pulmonary Function Test).All these reports are required to rule out lung diseases. If all these are normal, then no need to worry about lung diseases. Sometimes stress and anxiety can also cause sporadic breathing difficulty. So avoid stress and tension, be relax and calm. Hope I have answered your query. Let me know if I can assist you further.Regards,\u00a0\u00a0Dr. Kaushal Bhavsar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Temax for hypertension. USG shows bilateral renal disease. What will happen?\n\nDear sir i am 29/m weight 100 kg height 178 cmi was been suffering from  hypertension for  a year and i was prescribed temax-am and serum creatinine was 12 after six months i rechecked and my result was serum creatinine of 12 , urea of 98 and uric acid of 8.81, hb of 9.8 and mu usg report impression was CMD lost and chronic bilateral renal disese ,my right kidney measures 82*36 mm and left measures 92*32 now my bp is 140/90 after taking telvas am what will happen",
    "doctor_response": "HiThanks for the query.Serum creatinine of 12 with USG findings of medical renal disease usually indicates advanced chronic kidney disease (CKD).You need to see a nephrologist as soon as possible. He will evaluate you clinically and may prescribe additional tests to modify your prescription.Also at this level of creatinine he will advice you whether dialysis is needed at this stage. Hope this helpsgood luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is IBS ? Can mebervine be taken to treat it and what are its side-effects ?\n\nhello, i was told that i had ibs and was given mebervine on monday, i had cramps, trapped wind and bloating . i now have a few minor cramps feel like i need to go to the toilet all the time especially when i eat and have trapped wind i take 1 x 135mg mebervine three times a day, the trapped wind is very painful, is there anything i can try to stop this or do i need to give the tablets a little more time i have only been on them 2 full days",
    "doctor_response": "Hi, Welcome to Healthcare Magic Forum. You are on correct medications for IBS. Just take the drug regularly as prescribed by your Doctor and go for regular follow up. Your symptoms will gradually subside. Take Care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Abdominal ultrasound showed enlarged liver and diffuse coarse structure. Please help.\n\nHello doctor, I had an abdominal ultrasound scan done today and report shows that my liver is mildly enlarged and shows diffuse coarse structure. No focal lesions noted and span is about 15.5 cm in the mid-clavicular plane. I am a known diabetic for the past 6.5 years, and even has some blood pressure around 130/80. I am using Betaloc-50 for that. I am having acidity problem regularly. 13 years back, I had a mild fatty change.",
    "doctor_response": "Hi. Such findings in ultrasound represent fatty liver disease. The causes can be alcohol, non-alcoholic fatty liver disease, chronic hepatitis B, and C. In such case, I would advise you to get liver function test, anti-HCV antibody, HBsAg, In case these reports are normal, and you do not consume alcohol, it means you have a non-alcoholic fatty liver disease. Get the tests done and revert back with reports.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be the diet in jaundice ?\n\nMy daughter is having jaundice from 5 days. She was getting fever and jaundice. Doctor asked us to do blood tests and urine tests. it showed that she had jaundice. Doctor told nothing to worry, she will be fine in one weeek. I just want to know, what foods can be given to her.",
    "doctor_response": "Hi welcome to HCM. You must understand that liver is the chemical factory of the body that processes all that we eat. So if it is affected, we must reduce its work load by eating very small amounts at a time, more frequently. We must also eat foods that are easily digested, and give the liver plenty of sugar so that it does not have to work to produce sugar from the glycogen stored within it. So give your daughter very small frequent non oily meals, and more of fruits and sweetened juices till she is better.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does my hand pain and shake while i write?\n\nmy hand is pain and shake while i writte especially while start to write, then the flow goes well but again have proplem while restart. i have to put more pressure on the pen also against the paper the hand write also very worst its happening both while i alone and in front of others.",
    "doctor_response": "carpal tunnel pressure try not to rest on your wrist while writing also take alphinturn 3 times a day for 1 week you will be fine",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tingling sensation in the buttock\n\nMy four year has just out of no where started complaining about her bum tickling. At first I thought she was just not want in to go to the bathroom but I made her go and she is still complaining. She says it don t hurt, and there s no movement but it really tickles. What s Goin on?",
    "doctor_response": "Hi there.Tickling and sometimes itching sensation in the anal region could be due to parasitic infection or acidic stools. Give plenty of well washed green leafy vegetables. Drink plenty of water. Avoid feeding undercooked meat. Get his stool tested for parasites.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My head is feeling heavy. And i am suffering from loose motion\n\nHi i am suffering from loose motion. My head is feeling heavy and i am feelinglike having fever but my temperature reading was normal. I am feeling weak too.o am a male aged 27.",
    "doctor_response": "hi, its feeling of lethargy due to loss of water from your body. dont worry, as you dont have fever, unlikely its infective. so keep drinking plenty of liquids-rice janji water, coconut water, plain water, ORS mixed water or any liquids, you should feel better very soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could fatigue be related to HCOM despite undergoing Septal Myectomy?\n\nMy husband (25 yr old)  had a septial myectomy in Jan 2011 to help alleviate his symptoms of HCOM.  At the three month checkup he was feeling great and had plenty of energy.  His test results all came back in the \"normal\" range.  Now he is extremely fatigued and feels like he did before the surgery.  Could this be related to his HCOM?",
    "doctor_response": "Hi Welcome to HCM,I can understand your concerns.Yes it's definitely related to that.Get 2D echo done and consult your Cardiologist Post your further queries if any,Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the meaning of mild to moderate ligamentum flavum?\n\nI just received my MRI report and it read as follows. L4-L5: there is 2mm posterior disc bulge. There is mild Ligamentum flavum and facet hypertrophy. L5-S1. There is a slight left paracentral disc bulge with a small associated annular year. There is mild to moderate ligamentum flavum and facet hypertrophy . Mild left lateral stenosis. What does this mean and what kind of treatment is needed. Effect my bowel movement.",
    "doctor_response": "Hi, I am Dr.Bruno.  I have read your question with care and understand your concerns. Let me try to help you Question : What does this mean and what kind of treatment is needed. Effect my bowel movement.Answer : This means that you have mild compression of nerves near your spinal cord. Treatment can be 1. Life Style Modifications2. Physiotherapy 3. Exercises4. Tablets If hypertrophy increases, surgery may be neededHope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to normalize the hormonal level and conceive\n\nHello, I am 28 yrs old,my height is 5.1' and weight is 60.5kg.I am suffering from irregular periods and so i consulted a gynac .She suggested me to go for an hormonal test.The test showed my LH level as 16.42mlU/ml,which is high as per my doctor's knowledge.She had given me dimet 500 and asked to take it twice a day and also asked me to reduce my weight.I want to know whether my hormonal problem will be solved and can i conceive without any complications?",
    "doctor_response": "Hi, your problem can be solved through medicines. You can have a normal pregnancy.  For that, you will have to take some medicines apart from dimet.  You can take some medicines for growth of your eggs like clomiphene.  You can keep a track of your follicles growth and be in contact with your husband every 2 to 3 days after your periods stop.  It will increase chances of your pregnancy.  You may need a injection for rupturing the follicles. Hope I have answered your question.  If you have any other query I will be happy to help. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain, lightheadedness, abdominal cramping. Not pregnant. Severe weight loss. Cause?\n\nI have been experiencing lower back pain, light headedness, abdominal cramping. Always tired. I have taken numerous pregnancy tests. Not pregnant. I have a history of ectopic pregnancy. Still have one tube left. In the last 4 months many changes to my body as I have been watching what I eat and exercising. Have lost 52 pounds.",
    "doctor_response": "Hello,   Welcome at HCM.I have read your question.It looks from your details that you had ectopic pregnancy & at present you are feeling lightheaded,lower back pain & abdomen pain.These symptoms can be there due to following reasons--Anemia-Adhesion formation after surgery for ectopic pregnancy-Low or high blood pressureYou should consult to your doctor & should have following investigations--Routine blood examination.-ULTRA SONOGRAPHY Abdomen.-Serum electrolyte estimation.You should also ask for routine blood pressure examination.Till then you may have relief by following--Take an antispasmodic medicine like dicylomine on prescription from your doctor.-Avoid dehydration.Drink plenty of water.Hope this all will help you.With best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of yeast infection?\n\ni have been having pain in my vagina, history of bacterial infections my clitoris is sore and itchy. sore when i wipe..cwhat do i do..cani use bacterial infection medicine from a year ago or do i buy yeast infection medicine..dont have rides to the doctors",
    "doctor_response": "Hello,Welcome to HCM,The history of sore clitoris and itching suggests me that you may be having some fungal infection.The fungus are the normal commensals of the genitals which will be kept under control by the helpful organisms, whenever there is a change in environment the fungus gets activated and produces the symptoms.Repeated bacterial infection can also lead to fungal infection as it can reduce the immunity of the individual. For your symptoms I would suggest you follow1.Good hygiene practices by keeping the area clean and dry.2.Topical Anti fungal cream like miconazole should be applied.3. Oral Diflucan and the recommended dose is 150 mg as a single oral dose.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any solution for delayed myelination ?\n\nmy daughter of age 2yrs 8month she is having delayed myelination problem shows on mri brain report . there is any solution for that?before 2 years shewas talking but now she is not able to talk sit properly can,t walk .",
    "doctor_response": "hi ! Greetings from health care magic Myelination is a deveolpmental process which is far from complete at birth and as was pointed out to the parents of this child the process continues for a few years after birth. There are various causes of delayed myelination, prematurity being one of them. Intracranial hemorrhage while birth is another possibility. But this is good news in so far as definite improvement can be anticipated in proper homeopathy treatment. visit www.multicarehomeopathy.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in the tooth\n\nI have severe tooth pain in my mouth. I just brought Oralgel to use. As all people, I am terrified of the Dentist. I have a history of prodontics gum diease. I was on chemo treatments a few years ago and had 6 teeth removed. If I go to the dentist, do I go to a prodontics or general Dentistry. What can I do in the meantime.",
    "doctor_response": "Tooth or of two types .1. Sensitive or pain to hot and cold ..If such is the pain you can try desensitising tooth paste ..will find some relief 2. Is sever continous type ..where you have to go to a dentist ..get a dental x ray done to find exact cause of pain. It should follow with appropriate treatment required Hope I answered your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain under rib cage?\n\nI am having sever pain just under my rib cage on the left side. It was thought to be a kidney stone in the ER. However it is not a stone so they gave me Dicyclomine 20mg. I can noy get in to see my Enteroligist for several days. I do not understand how this drug will help me.. I do not have crones or any other abdominal conditions.",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, this could be due to hyperacidity, if I would get such patient then I would treat this with following medicines 1) Tab Omeprazole 40 mg once in day2) Tab Domperidone 30 mg once in day these drugs must be taken at evening time for better result, hope this information helps, have a nice day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for unilateral body weakness and reduced alertness\n\nmy brother is a 58 year old alcoholic who was treated in hospital. He was walking around the ward for two weeks and then became lathargic with reduced alertness. He is now unable to swollow and has a weakness on his right side. The hospital thinks that these symptoms point to Central pontine myelinolysis and was caused by raising his sodium levels too quickly. I would like to know what, if any, treatment he should receive, and what his prognosis is.",
    "doctor_response": "Hello, This is a very serious condition with a poor prognosis. There is no special therapy, besides support therapy and physiotherapy. Anyway, a brain MRI is necessary to differentiate between a possible stroke and this condition. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of potential pregnancy?\n\nHi there, my period is due around this time of the month and on Friday morning there was a little bit of blood when I went to the toilet so I assumed I was getting my period. But no more blood came till Saturday night and again it was only a little bit. No more untill Monday. is this spotting a sign of pregnancy ?",
    "doctor_response": "Hallow Dear,Spotting is not a sign of pregnancy; it is the non appearance of the regular menses which arises the suspicion of the pregnancy. In fact missing a period is the first cardinal symptom of pregnancy. All other symptoms mentioned bellow appear about 10-15 days later. They are:1. Nausea & vomiting with pica2. Frequency of urination3. Breast changes:    * Engorgement & tenderness    * Dark discolouration of nipples and areola with increase in areolar size    * Appearance of small nodules (Montgomery's tubercles)  under the areola    * Colostrum secretions from nipple However, the pregnancy cannot be diagnosed only by such symptoms. You have options of undergoing some tests:1. Pregnancy test on overnight first morning urine sample about 8-10 days after missing period. Earlier, these tests may give false negative results. 2. Beta hCG test which is very specific and sensitive. These tests can give reliable results even few days before missing a period.3. Ultrasonography 10 days after missing period will provide a direct visual evidence of the status of pregnancy.4. Clinical examination by an Obstetrician 2 weeks after missing period. I hope this provides you good options and gives you opportunity to take an informed decision. Dr. Nishikant",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. After 25 months of unprotected sex, why am I having various symptoms?\n\nHello doctor, I have few questions to ask regarding my health problems. After 25 months of unprotected sex, I went for an HIV test called comb AIDS test, and the result came negative for both HIV-1 and HIV-2. At the same time, I also took a test on HBsAg, HVC, scrub typhus, Widal test, and blood sugar, but all the results were negative. I again retested comb AIDS test after three months, but the\u00a0result came negative again. Not satisfied, I went for HIV ELISA test, but even this time, the result came negative. But presently,\u00a0I am suffering from many problems such as, extreme tiredness, ulcers in mouth and tongue, weakness, reddish spots at the back, frequent thirst, frequent urination, pungent smell of urine, occasional itchy and spot eruption in private parts, occasional and pain in ears, itchy and reddish eyes, no energy to talk, easy catching cold, and uncontrollable sneezing. I recently got malaria, and I recovered after medication. Is there any possibility that my immune system was too weak to detect antibody after 25 months of unprotected sex? What is the period fo HIV to become AIDS? Is it possible that I am already into the last stage for which the HIV tests gave a\u00a0false negative result? Is there any further HIV test, which will give 100 % result about my HIV status? Some people suggest me to go for a CD4 count and PCR RNA. So, do I need to go for those test? What is the possible cause of all the symptoms that I mentioned? Lastly, I humbly request you to give a patient reading to my problems and answer my questions systematically. I will be grateful to you. Thank you.",
    "doctor_response": "Hi. I have gone through the details and can make out your anxiety. For further queries consult an\u00a0HIV\u00a0AIDS specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest methods to increase sperm count\n\nhi sir i'm akhilesh ..i'm doing masterbulation for the past 10yrs continuously i would like to check my sperm count i don't know whom should i ask and where to check ?....so please  tell me the remedies for this problem..and also how to increase my sperm count ??",
    "doctor_response": "Hi.Welcome to healthcare magic.I have gone through your question.semen analysis can be done in every infertility hospital.My  opinion to increase the sperm count includes,1.avoid stress.2.sleep 8 hours a day.3.avoid wearing tight innerwear.4.avoid alcohol, cigarette smoking.5.take nutritious diet.6.taking speman capsules twice daily helps to increase sperm count.thank you.hope my answer will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How much liver enzymes might elevate after one night drinking?\n\nI am wondering how long liver enzymes might be elevated..( if at all) after one night of drinking at a reunion. I am otherwise health 50 yr old female that does not consume any alcohol except on very special occasions... 1-2 times a year. I likely had 16 oz of alcohol over 14 hours....maybe more. WHat do you think?",
    "doctor_response": "Dear Madam,Welcome to Health Care Magic. I read your query and I understand your concern.I think that there is not any problem with your liver enzymes if you drink only on special occasions. You do not mention what kind of alcoholic beverage did you take, since different beverages contain different percentage of alcohol. I ensure you that your liver enzymes are just slightly elevated or not elevated at all for the amount of alcohol you took just in one special occasion. Liver Enzymes are normally elevated in binge drinking or chronic drinkers. Alcohol, to be more specific ethanol - the active ingredient, damages liver cells and spills the liver enzymes in the blood flow when is consumed in large amounts and regularly. Alcohol doesn't have just negative effects on your health, on the contrary, taking in consideration your age, I would recommend you consume 1 oz of ethanol, or 1 glass of wine a week, in order to help maintenance of cholesterol balance in your blood.Hope I answered to your question. For further concerns or follow up questions, feel free to ask again.Kind Regards,Dr. Ina",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes erection when i get drowsy?\n\nHi. I am a healthy 43 year old male. I'm a personal trainer. When I get drowsy I get an incredible erection. It has been this way for as long as I can remember. My lady friends think I'm special and impressive since I'm 43 and need nothing for assistance down there. So what's your oppinion on this condition? Some women think is \"priceless?\" Thank you",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. This may be due to just relaxation of mind. It is not uncommon phenomenon. It can occur while deep sleep in many persons. So, it is not surprising. I hope this would clear your thinking. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for headache,cold and pain in lungs\n\nsir!! im himalaya ,18 years old...... im suffering from nose problem ....in this my nose septum instead of being straight is tilted to extreme... due to it i suffer huge pain in head and i always have cold......nowadays even my neck is giving me problems with a pain in lungs wen i cough out.....plz advise me a solution....",
    "doctor_response": "Hello ,I understand your concern. I am Dr. Arun Tank, infectious disease specialist, answering your concern.Your condition in medical terminology is known as deviated nasal septum.The final cure for such a condition is surgical correction. You can do your correction by the ENT surgeon.Until you correct surgically the problem of headache and neck ache remains as such.Till you do not visit to the surgeon I advice you to take the Tab. aceclofenac for pain tablet cetrizine for nasal discharge under your doctors guidance. Please do maintain good hygiene in nasal cavity otherwise infection do occur in noncorrected nasal septum.I will be happy to answer your further concern you can contact me here or you can contact me on bit.ly/DrArunWe wish you a best health at healthcare magic. You can hit thank you button if you are helped.Thank you,Dr. Arun Tank",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is surgery the right method of treatment for a contracted gallbladder?\n\nHi..I had a recent repeat gallbladder ultrasound and they said it was contracted. A follow up visit is scheduled for two weeks. I am not having any fever, chills, nausea or vomiting. I have had a few episodes of really bad abdominal pain that radiated to my back. This happened twice recently...but the pain subsided after about 20 minutes. I took advil and also drank some apple cider vinegar with warm water as I have read that can help. I have also been eating bland for two weeks...and doing fruit and veggie smoothies as well. I am very scared and concerned. I have never had any surgery and am afraid of anesthesia. Any thoughts? Do I go to ER if pain comes on again even without any other symptoms? Thanks.",
    "doctor_response": "Hello, You have been diagnosed to be having contracted bladder, contracted bladder occurs due to gall stones (hardened cholesterol & bilirubin, inflammation). Gall stones block the bile ducts & trigger sharp pain, loss of appetite, nausea/vomiting, diarrhea & jaundice. You are suggested to be clinically examined & treated by a Surgeon. Your treatment will depend upon the severity of your symptoms & the pathology detected. You will either be treated by shockwave lithotripsy, cholecystectomy,  ERCP, etc. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Nupur K, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is ejaculating blood serious problem?\n\nI just ejaculated blood. It s difficult to pin down any other symptoms - they would be vague at best. I checked the list of causes. Prostate massage is a possible cause (and the most benign of those listed), but would the symptoms persist? Should I wait and see if it persists before I see a doctor? Thanks if you can advise.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Tjere are mamy cause of blood in semen.  Most of thrm are temporary and cure itself. You should wait for some time. If it is not cured then you should go for examination and investigation to search cause. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can forearm bleeding and discoloration be treated?\n\nHi, I have had a problem with discoloration and bleeding on my forearms for approximately four years. First noticed when my sholder bag (heavy) slipped off of my sholder and hit my forearm. Next up was bleeding without knowing I was doing so. I couldn t bump into anything without causing myself to bleed. I am not a vain person but I DO have Diabetes, Fibtroymyalgia, hypothytoidism, and arthritis. and when my largest organ starts making holes for germs to enter it makes me very nervous. Thanks, JR PR I stopped taking Cymbalta after my doctors and I went over the pain relief cmpared to it s bleed factor.",
    "doctor_response": "hi,thank you for providing the brief history of you A thorough musculoskeletal assessment is advised.As you are diabetic there is always a possibility of the bleeding to not stop. Tying the compression bandage to stop bleeding and stopping blood thinner for hypertension should work.Also, you need to be careful with the wound healing, as wound healing will be delayed in diabetic.Also, for your arthritic and fibromyalgia pain undergoing physical therapy should work well.you should be always conscious with your blood glucose levels as it should be always into control. As due to non-controlling of the blood glucose levels any smallest injury will lead to major symptoms.For skin discoloration you need to wait as it will go slowly. Due to high blood glucose levels the healing is slighlty delayed. With proper care the recovery is expectedregardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can black itching spots in the face and lip be treated?\n\nname divya age 22 skin allergy skin blacken & itching block spots in face below lips and in hand swelling sometime loosing taking steroid medicine immediate response after some time again repeating in allergy test all food articles mentioned as allery prone",
    "doctor_response": "Hi, if u are allergic to food then it should be clear from which food u r having problem,second the dark spots over face and lips can be treated with proper dermatologist treatment and if u have taken steroids on your own then don't do that.steriod s are powerful drugs but should be used very cautiously and strict under medical monitoring.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long first iui can get me pregnant?\n\nHi doctor, i had my first iui on 27/06/2014 and my doc suggesed susten 200 mg 1-0-1 daily. Yesterday morning was last day for medicines and today i had white discharge it looked like medicine s part. Also i am having backache and daizzyness. I had my fallopian tube blockage and those were removed in dec 2013. Please suggest when can i have pregnency test. can it be positive?and what are symptoms of pregnecy?",
    "doctor_response": "Hi, you can do a pregnancy test after completing the course of susten tablets. There is 10 to 15 percent chance of pregnancy in IUI cycle. So you can try 3 to 6 cycles of IUI. Pregnancy symptoms are nausea, delayed periods, acidity and weakness. In your case your periods may get delayed due to use of susten tablets. You can get your periods in 2 weeks if pregnancy test is negative. Hope I have answered your question.  If you have any other query I will be happy to help. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will fibroids cause problems in getting pregnant?\n\ni just found out that i have several fibroids one of which is in a submucosal position measuring 2.4x 2.2 cm will this affect me from gettting pregnant i am 42 years old 198lbs height 5ft 8inches tall clean bill of health so far until today one child 19years of age",
    "doctor_response": "Hi, Fibroids is the most common benign masses in uterus. Just the presence of fibroids do not warrant removal. Submucosal fibroid will need removal, as it can interfere with baby attaching to uterus.Can be removed hysteroscopically.You already have risk factors - Age >40 yrs, Overweight & Multiple fibroids .Long gap since last pregnancyBest would be removal of fibroids , if not pregnant within 3-4 mths , plan for IVFAll the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat broken wrist?\n\nhave just broken my wrist and wish to fly tomorrow, it is in a temporary cast and I am supposed to go back to the hospital in three days time to have it put into a full cast. I am desperate to fly tomorrow. will I do myself any harm if I go ahead and fly.",
    "doctor_response": "Your age please?If the bones have set right & there is very little swelling & pain,Then you may undertake the flight.But, it will be better, if you consult the treating doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent painful burning urination and painful ejaculation?\n\nSince late September I have had painful, burning, and frequent urination.  Have also had pain during ejaculation and have also had difficulty maintaining an erection.  I have been on an antibiotic(Bactrim) for around 21 days and symptoms did get somewhat better but after about a week being off the antiobiotic the symptoms came back.",
    "doctor_response": "Thanks for contacting HCM with your health care questions.You are concerned about having painful urination and pain on ejaculation. Your symptoms sound like you have prostatitis and your doctor has been treating you as such with a 21 day course of Bactrim. Unfortunately prostate infections are sometimes very difficult to cure and may require an additional 4-6 weeks of a more powerful antibiotic. In my practice I will use cipro or Levaquin for 4-6 weeks to treat difficult cases of prostatitis.  In summary you may have chronic prostatitis and need additional antibiotics for 4-6 weeks. Please contact you medical provider to proceed with treatmentI hope this answers your question. Please contact HCM again with any of your health care concerns",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to switch from divacon to ovral-g?\n\nHi,I am using DivaCon for birth control right now which is a 21 day pill pack...Now I want to switch to Ovral-G contraceptive which is a 20 day pill pack..How do I do the transition? When should I start the Ovral-G pack after  complete my present birth control pills?ThankyouNiveditha",
    "doctor_response": "HI Niveditha,Compared to Divacon pill Ovral G is a higher dose birth control pill. So there is no change in the schedule of use of pills. Start the first pack of Ovral G after the pill free interval of 7 days like before. I hope I have answered to your satisfaction.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to relieve stomach pain above belly button\n\nHi I m 34 years old , I have concerns about having stomach pain right above belly botton I talk to doctor about in India about this pain , I lost my appetite and doctore said food pipe so please tell me the prescription name if it s help me for this pain please",
    "doctor_response": "cannot say in your particular case wihtout seeing you BUT, if it is the gastrointestinal tract usually an acid neutralizing substance will lower the pain right after taking it (tums, milk, etc.) this strongly implies it is irritation of the food pathway.Then.... any acid blocker is quite effective. Nexium, prevacid, protonix, aciphex are a few of the stronger ones.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I get rid of withdrwal symptoms after regulating Veniz dosage?\n\nhi,i had a breakup with my boyfrnd 2 years back n since i was depressed,i was taken to a doctor n from then im taking d veniz.but now when doc asked me to decrease the dose to half im not able to.i feel drowsy n weak when i skip the medicine...wat to do? help pls!",
    "doctor_response": "Dear User,Thanks for using health care magic.From the available description it appears that you are having withdrawal symptoms due to veniz.In my view try to decrease dose of veniz about 20 % per week not the half from the first day. You will need six to eight weeks to discontinue it from the current dose.'Hope I have answered your query. If you have any further questions I will be happy to help\".Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes spasms in left side of face?\n\nThe left side of my face is having spasms.  Sometimes it only involves my eyelid and part just under my eye.  But sometimes it affects my eye, cheek, left side of nose and lip.  These spasms sometimes leave my face, and left side of my nose and lip feeling numb for a while.  The past few days they are getting almost continuous.",
    "doctor_response": "Hi,Thank you for posting your query.These movements or involuntary muscle spasms could be due to blepharospasm or hemifacial spasm.This can involve involuntary blinking of eyelids, or involuntary contractions of one side of face.Most often, there is no underlying cause. However, if it is new symptom, then, an MRI of brain is needed to exclude an underlying disease.This would respond to botox injections.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it related to Thyroid?\n\nWhen I see upward and Cough I get Vibrations to my Back Shoulders and knees is it related to Tyroid , Spondalitis or its some thing related to muscle pulling or just due to sinus Male 36 ,",
    "doctor_response": "HI, Most probably it is due to cervical spondilitis,There is stretching of nerves coming out from vertebrae due to spondilytic changes in the vertebrae. You go for Xray cervical region and confirmed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and weakness in the left shoulder and left arm?\n\nI m having pain in my left shoulder and weakness in my left arm. I m also having numbness in my nose and fingers. I am having nausea and dissinsess and shaky I m not sure what is going on",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You are suffering from cervical spondylosis , take Methylcobalamine daily. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain and difficult breathing after taking 'ritalin'?\n\nI have been taking Ritalin for a few months now and have been experiencing dull chest pain around the lung area as well as pain in my spleen area. I also have trouble breathing about 30 minutes after taking it but that trouble goes away after about 15 minutes after it starting. Are these side effects anything to be concerned about?",
    "doctor_response": "Hi. I can understand your concern. You will need to undergo a detailed evaluation with a chest x ray and ECG to look for cause of your chest pain. Consult a doctor at the earliest.Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest OTC medication for difficulty in reaching orgasm\n\nI had radical prosectomy about 12 years ago. At that time the urologist prescribed cialis as a treatment therapy, a pill a day, but I couldn t afford it. Now I am completely impotent. I can however achieve orgasm, with extreme diificulty. I have good medical insurance. I notice that viagra helps a bit, but insurance still won t pay. Can a urologist help. or is it time to shop around for a monastery, Sleepless in Fairbanks",
    "doctor_response": "Hi, You can try herbal supplements available in the markets. For proper treatment you have to consult an andrologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Acne on chest, back. Using acne free with cleanser, toner, repair lotion. Alternative?\n\nMy son is 17, has severe acne on his chest and back. He says it hurts all the time. He is continually picking at his back. He has been using a product called acne free, which has a 3 step process of cleanser, toner and repair lotion. It helps some, but is not helping with his pain. Is there a better product out there that will help him faster. He is very uncomfortable with this pain.",
    "doctor_response": "This is a typical case of acne vulgaris affecting the trunk. few things can be done for him 1. use some anti inflammatory drug to relieve him of the pain but should be taken with a doctor's advice. and specially after meals. 2. he should not prick any of the lesions as it will worsen the disease and will increase the infection. 3. use some anti acne soaps that will help to reduce the excess oil on body. 4. consult your nearby dermatologist as he may need an expert opinion based on the type of lesions and duration of his illness. Dr Gaurav Bhaskar Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white spots post a phenehren injection?\n\nMy mother was given a phenehren injection. Immediately after the injection a white spot with a red and black ring came up. Shortly after the center turned black. Now 2 days later she has a nickle size white spot with a red edge. There is no drainage but seems to be hard under skin. What could this be?",
    "doctor_response": "Phenergan Injection can cause severe chemical irritation and damage to tissues regardless of the route of administration. Irritation and damage can result from perivascular extravasation, unintentional intra-arterial injection, and intraneuronal or perineuronal infiltration. Adverse reactions include burning, pain, thrombophlebitis, tissue necrosis, and gangrene. In some cases, surgical intervention, including fasciotomy, skin graft, and/or amputation have been required",
    "dialogue_context": ""
  },
  {
    "patient_message": "Two headed sperm and wierd tales. What does it mean?\n\nwe had a seman test done and it came back abnormal stating two headed sperm and wierd tales. also that the count was only 33% were normal of the 42 million. what does this mean? he does smoke marijuania. is this the reason?",
    "doctor_response": "Hello. Thanks for writing to us. Abnormal shapes of sperms is most commonly seen due to genetic or chromosomal defect. Marijuana smoking might be one of the factors in decreased motility of sperms. You need to take zinc, l-carnitine, vitamin E supplements to improve quality of sperms. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drtayalrakhi@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does  pituitary adenoma suggest?\n\nMy father 65  had a slight double vision on left eye ,  we contacted many doctors (eye specialist) but no progress at last one doctor recommended MRI . The MRI show Pituitary adenoma compressing left optical never sizing 40mm x 27mm , unfortunately the CBC shows WBC cells more, doctors has put him on imatinib 400 and WBC are reducing , can we make the surgery for Pituitary adenoma and the cost and the type of surgery I want to know..?",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your father's symptoms and diagnosis.Pituitary adenoma needs surgery for treatment, as there are no medicines to reduce it completely. Also, this tumor may press on the optic nerves resulting in greater loss of vision.The surgery would be done by a neurosurgeon, and is mostly done through the nose.The cost differs among different centres in India and may range from 5000 to 10000 USD.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for persistent diarrhea\n\nHi, My 8 month old son has been having diarrhea for the past 1 month. No medicines for first 5 days then OFM suspension for 4 days. It seemed to help but again watery stools came back. Then a routine stool test showed pus cells as 'plenty' and he was put on Syp Flagyl and Syp Taxim-O forte for 7 days. He seemed ok towards the end of course but 3-4 after finishing the course, diarrhea came back. WE have stopped formula as well as milk based cereals for him. Also he caught viral fever after the anti biotic course for 5 days. F",
    "doctor_response": "Hi, I had gone through your question and understand your concernsI seems that your child is suffering form post infectious chronic diarrhea , if such a come to me I like to  rule out any precipitating cause and assocaited illness  with this type of diarrhea . If otherwise baby is active, not dehydrated , accepting feed , passing adequate urine ,  a trial of stopping all antibiotics, giving pre-probiotics , zinc , ORS if large watery stools , a diet low in lactose / lactose free diet like curd , rice moong khichdi , daliya , lactose free milk like zerolac ( breast feeding should be continued) can be tried for a weeks after consulting your doctor.Most such cases respond to this regimen.Hope this answers your question. If you have additional questions then please do not hesitate in writing to us.Wishing  your baby good health.\u2022\u00a0\u00a0\u00a0\u00a0\u00a0DISCLAIMER: - All the information provided here is for information purpose only   , it is not a substitute for the advice of a physician after physical examination , it is not intended to replace your relationship with your doctor. This information in no way establishes a doctor-patient relationship. Before acting anything based on this information do consult your doctor. I  recommend that online users seek the advice of a physician who can perform an in-person physical examination",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the pain in chest that radiates to back and left arm?\n\nI am 41 years of age, 5 feet and 60 kgs in weight.  For the last few months I have been getting some pin pricking pain in left side of my chest sometimes radiating in my back.  There is also pain in my left hand and my ring finger too.  Most of the I get headaches (some parts especially back side of my neck connecting my head.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Left sided chest pain with radiation to left arm and back is mostly seen with heart diseases like angina and coronary artery disease (CAD). So better to first rule out heart diseases. So get done 1. Blood pressure monitoring 2. Ecg 3. 2d echo 4. Stress test (trade mill test). If all these are normal then no need to worry for heart diseases. Sometimes stress and anxiety can also cause similar symptoms. So avoid stress and tension, be relax and calm. Don't worry, you will be alright. But first rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does sinus cold with congestion affect the Ca-125 levels?\n\nMy wife was diagnosed 3 years ago with Stage 3 Ovarian Cancer. Things have been going well. Her recent ca-125 done yesterday was 58, up from 38 in late Feb. She has been fighting a major sinus cold, with congestion amd mucus, could this affect the Ca-125 level",
    "doctor_response": "Hi,Thanks for writing in.Cancer antigen 125 is a substance that is produced in the ovary, fallopian tubes, uterus, cervix, and the lining the lining of the chest and abdominal cavities (the pleura and the peritoneum).The CA 125 level measures a sugar protein that may be released when cells are inflamed or damaged. CA 125 levels under 35 kU/ml are considered normal.Since the CA 125 rise can occur in inflammation therefore a common cold and sinusitis can certainly cause a slight rise in the level. I suggest that she takes treatment for the sinusitis and repeats the CA 125 level after a month when she is free of symptoms. This will help guide her during the next follow up visit with the oncologist. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could any of these cause that severe anxiety and no sleep?\n\nI think my wife was poisoning me I woke up one day thought their was smoke in the room their was not had dryness to mouth left back kidney pain and appendix pain  she kept bringing me coffee and Pepsi morning and night she has anti depressant pills plus seen javex pills and rat poisoning below sink could any of these cause that severe anxiety and no sleep either",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Anti depressant pills, rat poison can kill anyone if taken in excess. here the question is why your wife wants to poison you? do you have any issue with her which you want to settle? You should find the answers. Talk to your wife. Listen to her. Find if she has any annoyance for you. Address your issues with her. Ask yourself. You should find an answer.Are you anxious? Are you depressed? Are these mental conditions makes you to doubt your wife, where she is really trying to help you?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.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach paining and have Amoebiasis by drinking tap water. How to treat it?\n\nhi, im jane my boyfriend has an ambiases he said hes stomach is aching a lot especially on the left side,and hes balls also is aching hes thinking that its bec. of hes ambiases,is he right about that and what medicene should he take,he got the ambiases from drinking top water here in the philippines.",
    "doctor_response": "HI. One has to make sure that he is suffering from amoebiasis. Is he having stool with mucus? The treatment is simple - to take tab metronidazole 400 mg thrice daily ( I hope is available over the counter). To drink boiled and cool water. This has nothing to do with the pain in the testes. There will be another reason for this . He may add on antibiotics which will help treat the intestinal and testes problem at the same time say like cefixme or oflaxacin, for which he needs to see a Doctor too as these are prescription medicines. He also gets clinical examination  by the Doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump under the left breast indicate?\n\nI had major surgery 1 yr. ago aneurysm below belle button both legs artery so blocked by pass was done. Now my stomach has supposedly separated from muscle. Am looking for surgeon who accepts humana. I'm 72 yrs. old. Can't find any description of this is it possible?? Have not had any tests as yet. No pain just big bulge below left breast. What do you think?? Karen Krathwohl  my email is  YYYY@YYYY  thx for your time",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This is possible  epigastric hernia .*  Needs clinical confirmation with physical examination and ultrasound    evaluation to precisely diagnose .Hope this clears your query .Wishing you fine recovery .Welcome for any further  assistance .Regards  take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does bacterial infection cause low lymphocytes level?\n\nI have recently had a bacterial infection where my neutrophils were around 14,000.  I have noticed that my lymphocytes were near the bottom of the normal range at 1.49.  Is this normal after an infection or is this something to be concerned about?  Thank you.",
    "doctor_response": "in most of the cases of bacterial infection lymphocytes increases except typhoid and tuberculosis (commonly). so it  would be helpful for us if you provide us the diagnosis made so that we can exclude the other causes of lymphocytopenia.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I having body pain and muscle weakness after delivery?\n\nHello doctor, Pain started in my back after 2 months of delivery but now it is all over the body majorly at right side. Currently, having depression medication for the past six months and my doctor adviced me to consult a neurologist as physical pain and muscle weakness is not going away.",
    "doctor_response": "Hello.  I read carefully your question and reviewed your X-ray report. Your X-ray shows a normal vertebral column, just muscle spasm (attachment removed to protect patient identity). Coming to this point, I would recommend performing regular physical activity to help reinforce your back muscles and help relieve the muscle spasm. I would also recommend taking a muscle relaxant (Flexeril) to help reduce the muscle spasm. If this does not help, I would suggest considering also fibromyalgia as a possible cause underlying the muscle pain. It is also necessary checking vitamin D plasma levels and magnesium plasma levels for possible deficiency. Another treatment option to consider would be Gabapentine or Doluxetine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness and muscle spasms in the leg?\n\ni had been having numbness in my legs so I seen an nuerlogist and he ordered an mri. i had that procedure yesterday but since I went to dr ive been having really bad muscle spasms all over including hands and feet plus my hands and feet feel that they have been put on ice. I just looked at my back with a mirror and i see several small bruised lumps running up my spine I am having trouble walking because my legs are heavy I am very scared at this point.",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms seem to be related to muscle spasms. I suggest using a muscle relaxant such as Baclofen three times a day.I also suggest using magnesium supplements for muscle relaxation. I recommend warm compresses for local application. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for high BP\n\nYes I am a 38 ye old female who was on Corey for 6 months after a heart event( doctor wont call it attack cause hearts normal and no blockages I basically overdosed on a pain killer accidentally ) I was taken off Corey 10 days ago and now my blood pressure reads 148 over 50 will it get better? I exercise and eat vegetarian.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I understand your concern and would explain that your blood pressure values are above the normal ranges (the systoli blood pressure ). For this reason, I would recommend reducing salt and caffeine intake and closely monitor your blood pressure, frequently during the day. If these blood pressure values persist, I would recommend restarting Coreg. Some blood lab tests are necessary too: - Complete blood count for anemia - Thyroid hormone levels for thyroid gland dysfunction - Kidney and liver function tests - Fasting glucose - Blood electrolytes. Hope you will find this answer helpful! Wishing all the best, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will leptaden tablets help me in getting pregnant?\n\nHi doctor I have got done my laproscopy and founded the cysts and endometrics and adhensions around my utereus and the doctors treated me by giving luproid injections monthly once to reduce the endo and now it is been reduced. will leptaden tablets help me in getting pregnant",
    "doctor_response": "Hi, I don't think leptaden will help you in conceiving.  You will have to take medicines like clomiphene for the growth of your follicles.  track your follicles growth by repeated ultrasound and when your follicles is more than 17 mm, take injection for rupturing the follicles.  Be in contact with your husband for next 2 to 3 days.  Take progesterone for next 2 weeks.  Do a urine pregnancy test at home after that.  You can try like that for 3 to 6 cycles.  Hope I have answered your question.  If you have any other query I will be happy to help. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure the raised white bump on the middle of the tongue?\n\nI have a small raised white bump on the middle of my tongue. This could be a thrush-type of fungal growth since I was on 3 separate doses of antibiotics in the past 3 months. (Had an infected root canal tooth for an extended period that had to be extracted) I have been doing natural anti-fungal rinses and have access to an old bottle of Chlorhexidine oral rinse which may be expired. The rest of the tongue is improving but the white bump is still remaining. (about 7-10 days) Never smoked, never chewed tobacco. Any advice would be appreciated.How long can these things last and at what point should I have a dentist or physician take a look?Thanks, Doug",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. This white bump can be a fungal infection also or it can be a fibrous growth also, to get it confirmed you have to visit a good dentist as, he will examine the bump properly and if needed go for investigation accordingly treatment will be done. Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen cold blue colored hands and feet?\n\nmy 8 month old has a consistent temp of 104 since last night. tylenol and ibuprofen bring it down for a couple of hours, but it goes back up. his hands and feet are very cold and slightly blue and swollen. his body is speckled - as when one is cold. he is very lethargic; fussy and not sleeping well. He will drink pedialite and is having wet diapers. Should I take him in to ER?",
    "doctor_response": "Hi...these are signs of shock and I suggest you take him to the nearest emergency room immediately. He requires emergency care and immediate assessment.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are braces necessary for messed up teeth?\n\nHi , I was wondering about getting braces , because my teeth are so messed up. But my parents think it is not really a big deal right now , while my dentist said get braces asap . I'm pretty sure they are worried about the price ranges and coverage . What do you recommend i do ? :3",
    "doctor_response": "Thanks for using health care Magic.Read your query.Since you have not given much detail about your messed up (as you have mentioned) teeth,I would recommend to to visit your local dentist .He may give you and your parents a clear picture whether u need orthodontic treatment or not.Also you can get the price ranges from him.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a blister and swelling in the lower jaw?\n\nBeen having the feeling that my lower jaw was swollen for almost a week now. But i experinced no pain but tingle. And last night, my brother said that my face looked swollen. And following morning I think that I felt puss or liquid like maybe what I was feeling, was a blister or something. I had a Dr visit then I first notice the tingle and she said she couldn't find anything. All I can think of is of the dentist visit I had last month. Any thoughts??",
    "doctor_response": "Hi Thanks for the query If the jaw is swollen and you also feel pus can be due to abscess formation that can be due to any tooth decay Other causes can be due to infection or obstruction in the salivary gland So first of all you should get it checked and for this Dentists appropriate. In case if it is due to tooth abscess then treating the tooth or getting it removed depending on condition of tooth can help. It has to be done followed by antibiotics and painkillers. Secondly if it is due to infection in the salivary gland then antibiotics can help. So first the cause has to be ruled out Hope this helps. Regards Dr. Honey Arora, Dentist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain in kid\n\nHi - my 7yr old daughter has been having abdominal pain all morning. She has not eaten in 24hrs but has now began to vomit. My concern is that it is clear the first time with small dark specks (almost looking like pepper seasoning looks) and now it is bright blue!!!!! Seems odd- I always thought if it was bile it was more yellow or green....any thoughts??",
    "doctor_response": "Hi...Pain abdomen along with bright bluish speck signifies that she has accidentally ingested some synthetic material. I suggest that next time she vomits I want you to preserve the vomiting and take the kid and the vomitus to the nearest emergency room for evaluation.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How diarrhea in an infant be treated?\n\nHello my 9mth old daughter has had diarhea for the past 5 days a new tooth came out last wk and we attributed it to that but now im gettig worried as she had abt 10stools yetsrrday. All very small and some solid and some watery. She is eating and drinking and playing as normal but now she has diaper rash and is in alot of discomfort. Im giving paedialyte and one vial of enterogeina but no relief yet. She eats solids, has formula and breastfeeds at nights when i get home. Please advise.",
    "doctor_response": "Hi, I had gone through your question and understand your concernsIt looks that your baby is suffering from viral diarrhoea which usually  takes 5-7 days to resolve, in some case it may be prolonged due delayed recovery or post diarrhoeal intolerance. You can add zinc apart form ORS and enterogemina. In Diet you can add curd , khichdi ,mashed banana ,or banana with curd .For diper rash you can use cream like nappy rash cream B-4 nappy cream.if baby is well , active , accepting feeds adequately , no large watery stools , no high fever , there is no blood in stool , passing urine every 3-4 hourly , there is no need to worry.Otherwise or if diarrhoea  persists more than two more days you need to consult your doctor.take care,regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes kidney and abdominal pain in children?\n\nMy daughter is 16. She has had elevating kidney pain and some abdomen pain (around appendix area) for 2 weeks. We took her to the doctor. They performed an ultrasound. It showed an ovarian cyst had ruptured and another one was forming. We took her to the emergency room last night. Her blood work was completely normal. She had a catscan which was also completely normal. And a pelvic exam that was completely normal. Her symptoms conclude of fever, extreme coldness (to the point that she can't stop shaking), extreme kidney pain (mostly on right side, some on left), naseua, and elevated heart rate. She is so much pain that she can't walk or move. Any ideas on what it might be? Thank you.",
    "doctor_response": "Hi.Thanks for your query..The pain in the right kidney and appendix area, shivering, fever, nausea inability to walk... all these symptoms can be suggestive of severe Pyelonephritis - a condition in which the the infection of the urinary tract is so severe that even the kineys get infected. This may not be found on CT and USG. I would advise her the following:Urine culture and sensitivity Blood culture and sensitivity.Urea, creatinine and all other relevant test. Admission to the hospitalIntravenous therapy of fluids and broad-spectrum antibiotics.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a small lump along the jaw line indicate?\n\nMy husband found a small lump along his jaw line, and it is sort of hard... I dot think it is a pimple or a cyst type bump.  It has been itching and the itching has continued down to him neck and shoulder area.  The bump itself doesn't seem to be getting bigger-in fact, it is getting smaller if anything.  Today I noticed that it is scabbing.  What is this?",
    "doctor_response": "HelloThanks for consulting HCMRead your query small lump along jaw line can be due to tooth infection or due to gum infection. Dont be worried so much I will suggest you to consult oral surgwon for examination of lump and if needed go for investigation. Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in the chin after a root canal treatment?\n\nI had a root canal 17 days ago and feel a numbness and tingling my chin and lower lip where the root canal was conducted.  What is causing this numbness and tingling and when can I expect it to go away?  My Dentist prescribed Methylprednisolone and antibiotics. What will these drugs to do resolve the situation?  Thanks",
    "doctor_response": "Hello,As per your query, you have symptoms of numbness in chin after root canal treatment which seems to be due to traumatic injury or nerve injury which occurs while needle insertion and it could be due to allergic reaction to anesthesia.Need not to worry. I would suggest you to visit oral physician once and get complete examination done. The doctor can take x-ray of tooth to check underlying infection.You should visit allergy specialist once and go for allergy testing for anesthesia and start treatment accordingly. If it is due to nerve ending injury it will take time to recover.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to interpret liver test results?\n\nI RECENTLY JUST HAD MY LAB TESTS AND THE RESULTS OF MY TESTS ARE: SGOT 30.2 (0-32)U/L; SGPT 14.7 (0-33)U/L. IS THIS NORMAL? I WAS DIAGNOSED W/ METABOLIC SYNDROME AFTER RAI. THANK YOU. THERESA NERI --- I'M 5'21/2\", 59Y.O. AND WEIGHS 174LBS.I WAS HYPER-GRAVES W/ OPTHALMOPATHY. I HAD RAI AND NOW HYPO W/ METABOLIC SYNDROME, ON REPLACEMENT THERAPY, ENDO HYPERTENSIVE AND NON-ALCOHOLIC FATTY LIVER. THANK YOU.",
    "doctor_response": "Hi,Thanks for posting your query.I am Dr.R.K and I am pleased to assist you.The results you have posted are very much within normal limits.Your SGOT is 30.2 and the normal range is 0-32. So it is within normal limits.Your SGPT is 14.7 and the normal range is 0-33. So this again is within normal limits.I hope that answers your question.Regards,Dr.R.K.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the ways to treat prostate cancer?\n\nHi doctor, My father who is 79 years of age has got prostate tumor. We have done all the medical tests and pet scan. The oncologist has confirmed us tumor. Now due to lockdown we are unable to reach doctor also we want second opinion too. The doctor has told us that the solution is surgery. But if there is another solution or remedy we would go for it. As my father is 79 years of age and also his health has deteriorated day by day. We do not want to go for surgery. Please let us know some solution. Due to lockdown we are unable to take him to the hospitals as hospitals are also in red zone. Kindly suggest.",
    "doctor_response": "Hi. Your father has apparently a stage I penile cancer. The ideal management is surgery which may only involve a wide local excision. This can be done by a general surgeon or even a dermatologist who can perform skin surgery. Should you however cannot have the surgery done, the other option you may consider is radiotherapy of the penis. Radiotherapy is not the optimal treatment but given your current situation, this is the option that maybe more feasible. The third option is laser therapy directed to the penile mass.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for depression during pregnancy\n\nAfter having my first baby I was prescribed Pristiq to assist with coping with prenatal depression, during pregnancy I gained over 30kg, I lost ten but over the last year I have struggled greatly to loose that 20kg. I excercising regularly and watch what I eat. It s beginning to make me feel more and more depressed with my appearance and my relationship is suffering. I would like to try duromine. I have heard it can be prescribed for both my problems. Can you give me some more advice?",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic.I have gone through your query. I think I have understood your concern, I will try to suggest you the best possible treatment options.1] Please do not panic.2]I will suggest to indulge in a healthy diet and regular exercise regime.3]Have plenty of fruits, salads, vegetables in the diet.Dink 8 to 10 glasses of water every day.4] Please avoid deep fried foods, bakery products and refined sugars.5] Exercise daily. Have walking/jogging for 20 -30 minutes. And some resistance training for 10 -20 minutes everyday.6] It's good that you are exercising and watching your diet. Also keep track of your weight every week.7] Lastly, do not pay attention to what others say about your appearance. Be happy with what you are and what you have.I hope my answer helps you.Thanks.Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it harmful to take the oxyelite pro in the morning and lexapro before bed?\n\nMy doctor prescribed me on 10mg of lexapro, however I am have been taking oxyelite pro for about 2 weeks. I really dont want to stop taking the oxy since it really helps me with keeping up with my children, i was wondering if its harmful to take the oxy in the morning and lexapro before bed..",
    "doctor_response": "HiThanks for using healthcare magicThere is no harm in taking oxyelite pro with lexapro. Both are different drugs. Oxyelite pro is fat burner and  would keep you fit as well as active. Lexapro is antidepressant and helps to decrease depressive symptoms. You can take both. In case, you feel any problem, you can consult your physician. In case, you need any help, you can ask me.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to heal a sex mediated wound on penis area?\n\nHi sir,I have a small wound on penis happened during sex. Little drop of blood was there yesterday, no pain. The same happend 2 months back and used the ointment \"Herperax Acyclovir ointment USP 5%\" as suggested by doctor. So there was a wound mark after wound has been done. Now the wound has created on the same place, i believe since there is a mark and the strain occurred on the same place. Could you please suggest a way to heal it fast or what specialized doctor should i consult?",
    "doctor_response": "Hi. Thanks for posting your concern at HCMMinor traumatic wound on penis would heal on its own. You can apply a topical mupirocin ointment to prevent secondary bacterial infection.However as you mentioned, in the past you had applied Herperax ointment(as prescribed by your doctor) which contains Acyclovir(an antiviral) and also since it has recurred again in the same place, it suggests a possibility herpes to me.Since i don't have the opportunity to examine the lesion, therefore, I would advice that you visit a dermatologist for a physical examination of the ares of concern. Your dermatologist might ask you about your sexual history and also might ask you to get a few tests if he/she suspects it to be herpes.take careregards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does positive ANA in TORCH test during pregnancy mean?\n\nhello sir i am 25 yrs and i am pregnant 6 weeks as shown in sonography .my doctor suggested me of TORCH TEST. my torch results showed ANA Positive homogenous (+/_) Pattern & lupus anticoagulant value 44.5. what does this mean and how will it affect my baby.",
    "doctor_response": "Hi,I think you have got your results mixed up.The TORCH test checks Toxoplasmosis, Rubella, Chlamydia and Herpes infection in the maternal blood.ANA and Lupus anitcoagulant are done to see if you have Systemic lupus Erythematosis which can cause problems in pregnancy and delivery .They are two different things.Was there a specific reason you were advised these at 6 weeks of pregnancy ?Do you have any recent fever or any other disease ? Do you have previous history of repeated abortion.If you do have repeated abortion in you obstetric history then these results of homogenous positive ANA and LA 44.5 need to be seen by an experienced obstetrician or haematologist.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a painful lump in the arm indicate?\n\nhave nsclc went through 7rounds of chemo,and 8 weeks radiation one spot in left lung and twolyumph nodes center of chest, three weeks ago had ct, thought pain in arm was from that didnt go away had mri tuesday night 5.4 cm thing on arm bone right above elbow go for biosphy tuesday now what?",
    "doctor_response": "Hi,As per my clinical experience, this suggests metastasis most likely. Kindly consult with your biopsy report.  Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedy for itching and burning in vagina\n\nhi im an 18 year old girl and ive had this itchy and burning that has been goin on for two years now buy comes and goes but now its getting to the point where some spot of my vagina while bleed. i feel like its too dry at times but i dont want to over wet it because im afraid of further infection. is there anything i can do at home?",
    "doctor_response": "No dear my frank opinion is that you must be having some kind of viral or fungal infection which might have become chronic so it should not be neglected. It is advisable not to try to treat it by home remedies which may supress the feeling of itching & burning temporarily but would not clear the cause. You must undergo gynecological examination & may also require the culture & sensitivity examination of vaginal secreation if any. As continouing irritation of th vagina may lead to serious probles later ( cell hyperplasia may lead to atypia & further to cancerous conditions ). So it is better to treat this condition earliest. The exact cause can only be given after visual & per vaginal examination so it is advisable to have gynecological opinion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe sneezing and runny nose?\n\nI have allergies that cause me to sneeze violently all day a runny nose sinus blockage. The symptoms appear only when I visit home and start in the morning as I wake up. They improve when outdoors. I take l montis. The effect of the drug last about 24 hours and works well. How long can I keep taking the drug.",
    "doctor_response": "hello, thanks for ur query, sequence of sneezes,running nose, itching in ears, itching in roof of mouth, blackness under eyes are the symptoms of allergic rhinitis. it is best prevented by not to expose  to cold, dust, not to consume ice creams, fridge water, curd. best street ment is avamys( fluticasone ) nasal spray twice daily , tab. Montek- lc ( montelukast+citrizine once daily at bed time intially , it should be taken 2-4months then slowly tapered.. all the best. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will Septran cure pyelonephritic? Will she be affected again? Why wheezing?\n\nHello Doctor, I have 12 months F baby (second baby) , who is affected by recurrent UTI 1.UTI was when she was 5 months \uf0e0 Gave her Amikacin halfcc for 14 days, and no culture growth after this. 2.UTI was deducted last months \uf0e0 OF/OFX antibiotic syrup was given for 8 days, then repeated the culture, growth was there.. Took the below tests 1.MCUG Test , which show Reflux Right side with Grade 1 and left with Grade 2. 2.DMSA Test \uf0e0 Both kidney function is normal but pyelonephritic focus at upper pole. I have attached the DMSA & MCUG report\u2019s for your reference. I\u2019m giving her Septran 2.5 ml at night My queries are 1. Will this antibiotic cure the pyelonephritic or we have to go for any further treatments 2. Though doctor says it\u2019s under control, I\u2019m disturbed.. how much my baby is affected.. 3. Since kidney function is normal, doctor says this antibiotic is enough, I\u2019m scarred abt her future.. will she be affected again ? 4. Way to protect her.. she also have wheezing ( Bronchitis ) 5. If you could suggest any specialist available in b\u2019lore , so tht I could follow up with them. 6. She is pretty active and scared bcoz of MCUG test",
    "doctor_response": "Hi welcome to HCM. Your doctor has complete and proper workup and started the correct treatment. There is grade 2 reflux which need not any surgery and gets relieved automatically after age of 5 , till  we have to manage any infection as already started. Also DMSA scan is nearly normal. Even though Grade 5 reflux is also managed conservetively by antibiotics now-a-days. So dont worry. Thanking you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of ecosprin?\n\nheart problemw gud evn sir, my father is suffering from heart disease, parkinson, since last 10 yrs. he had bypass aurgery as well as angioplast 10 years before. yesterday afternoon he has started vomit whr only blood molecules are coming. we came to hospital took in to icu .but doc couldnt find d exact resion behind it. nd he has suggested to stop d ecosprin 75 mg. whuxh he taken last 10 yrs. kindly suggest us.0000",
    "doctor_response": "Hello,Thanks for Writing to Health Care Magic and putting trust in us regarding your Health related query.I am Dr. Saleha and I have read your message in detail, I understand your concern and will try to help you in this.I am sorry to know what have your father been suffering from , excosprin contain Aspirin which is a drug that works as blood thinner in simple words and protects the patients from having any cardiac events.There are two things which have happened in your dad's case.A) Vomiting .B) Blood in vomit.Now i will explain to you why this might have happened.A) Vomiting.Aspirin has a side effect that it might cause stomach irritation and even ulcers which cause stomach discomfort and vomiting.B)Blood in vomit:As i told you Aspirin is a blood thinner and it also causes ulcers in stomach so when there is ulcer and your blood is thin..blood oozes out of that ulcer into the stomach and cause blood containing vomiting.What to do about it?You dr did the right thing that he stopped Aspirin, now next thing is to protect stomach. For that your father should get few things done.+Avoid fizzy drinks,coffee,cafeine,chocolate.+Avoid smoking,alcohol,spicy food.(what ever applies).+Use much fibre in food.+Avoid pain killers, not prescribed by a doctor who knows about stomach issues.+He can take syrup gaviscon.+I would suggest my patients to take motillium which helps with vomiting and ulcer too.+PPI like omeprazole is also recommended you can discuss with your dr.I hope this answers your question.If you have more questions, I am happy to answer.Wish you lasting health.Regards.Dr.Saleha Saeed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shaking of hands and faster heart beat?\n\nHi, i am annemic, and i was wondering does this have anything to do with my hands shaking? it happens even when i dont drink caffine. My blood pressure goes up and down. I can feel it when my heart starts to beat faster i was wondering if you could give me some advice...",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Yes, anaemia can cause shaking of hands, palpitations etc. Arrhythmia (rhythm disturbances in heart) can also cause palpitations with shaking of hands. So better to first get done ecg, 2d echo and Holter monitoring (24 hour continuous monitoring of ecg). If all these are normal then no need to worry for arrhythmia or other heart diseases. If you are having stress then this can also cause similar symptoms. So avoid stress and tension, be relax and calm. Correction of anaemia is also needed. Don't worry, you will be alright, but first rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp chest pain?\n\nIt feels like I have a bubble or something stuck in my throat. It hard to swallow. Feels like indegistion but nothing has helped. Also have sharp pain in chest under right breast. Not feeling sick or anything like that. I also have burning in my stomach. Thanks",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You can have gastritis or acid reflux problem and it can lead referred pain in chest. For that antacid like Pantoprazole can be prescribed. Avoid excess spicy foods. Head elevated while sleeping. Your posterior pharynx should be examined to check if any inflammation present. Check your CBC as well. Consult physician for examination. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes increased BP readings?\n\nI have visited the doctor  a few days ago  as I was feeling stressed he had taken my bp which was 150/95 which he said was a little high.I have taken a few reading over the last few day which are as follows  151/99 -next day 162/83 and today 183/127.My pulse rate does not go above 70 and in the morning is typically at rest 56 to 60.I am a 43 year old male  keep fit by going to gym 2 times a week weight 80kilos and 1.71 m I am getting a litte worried that reading still increasing - got any answers Mes a week",
    "doctor_response": "Hello, Thanks for posting your query on Healthcare Magic...* Brief Answer: healthy diet and may add anti hypertensive is important to get your blood pressure controlled.*Explanation: My opinion is that high blood pressure on many occasions is an indication for control .That happens on many levels. First, be sure that high blood pressure is not secondary to any other diseases as Cushing or renal failure.Then ,Diet with low salt and less fat content is crucial. Exercise and other healthy activities are also a mean to control blood pressure. If all that dose not help, medications are a must .That is usually decided by your doctor according to your condition and comorbidities .Some drugs that are perfect for patients are not necessary good for others.Regular blood pressure monitoring is as important as starting treatment so that we could assess efficacy of the medication we started.I suggest my patients the following:avoid stress and excess caffeinated drinks. *Conclusion: I suggest you lower salt content in food and consult your physician to start treatment.   If you have any further questions I will be happy to help, If not, you can close the discussion and rate the answer. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sleep paralysis\n\nStatic Buzzing and fizzing, I m glad I m not alone, but it would be nice if someone could give this thing. Ok I get sleep paralysis very often, this drives me nuts i do often try to drink a lot to knock myself out and avoid the whole paralysis terror stuff. One of the worst SP incidents i had invovled this static buzzing fizzing pressure feeling in my head, as if my skull was the exaust for a jumbo jet engine. I thought my head was going to explode with static. This was the first time I d ever felt anything quite like this. Now you can see static on a tv, hear it on a radio, and even touch it on old cathode ray tv screens. This stuff across my brain felt just like the tv screen just much stronger, It was located on my temples and at the bottom of my right ear. But a few years ago a the height of my sleep paralysis Horror (Everynight multiple times for around 3 solid months) I finally went to the doctor, and got given citalopram, for depression. Started taking the citalopram, and i turned into a zombie, and these strange static fizzy buzzes started appearing. Now every bout of SP is preceded by and accompanied with this static. Also i find for a few minutes after I wake up from an SP incident, the static buzzes, still fizz in for a few more Aftershocks .",
    "doctor_response": "Hello, If you suffer from SLEEP PARALYSIS I would recommend your seeing a SLEEP SPECIALIST in order to obtain a SLEEP STUDY since you may be suffering from a sleep disorder which could be related to or even NARCOLEPSY for which there is a specific medication that can help if not place into remission. The other possible set of diagnostic studies that could be obtained would be imaging studies of the brain to include an MRI of the head with gadolinium contrast looking specifically at the CEREBELLOPONTINE ANGLE to rule out the presence of a small mass lesion that may not be big enough to cause headaches, nausea, or vomiting but may be big enough to cause severe TINNITUS. I would also do an MRA of the head AND the NECK. I might even recommend that a high-resolution MRI on a 3 Tesla (or higher) magnet be performed of the INTERNAL ACOUSTIC MEATUS (IAC) looking for any evidence of a cavernous fistula or breach of the cavernous wall or ceiling with an AVM or similar which could cause bizarre and debilitating symptoms of TINNITUS. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have backache during pregnancy and safe to take injection prolutant depot?\n\ni am 28 yrs female wt 60 kg,ht 5feets, 4 weeks pregnant and had a one misscarge last year at 6 weeks ..now i m having severe back pain and one of my family doctor advice me to take inj prolutant depot 500mg shot.....is it safe?backache is normal in early pregnancy ,how to get rid of this pain?",
    "doctor_response": "Postural... common during pregnancy..  but usually after 3 months.. do relaxation techniques Like yoga. Flat hard couch with pillow support underneath utur thighs 'll help u.  U can safely take t drug ur doctor has prescribed",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be the cause of knee pain?\n\nIf I sit for 30 minutes or more I have problem with my knees getting out of chair. I do have pain down the side of my legs. I eat healthy and exercise at least 4 times a week. I m a 54 year old female and take no medications. Do you have any suggestions as to what may be causing my knee pain?",
    "doctor_response": "hi,thank-you for providing the brief history of you.As you are 54 there will be degenerative changes in the normal physiological process of the body. Exercise and diet is good for making the physiological responses better but the degenerative changes cannot be predicted.Taking a thorough clinical examination and may be an MRI of knee or either the lumbar spine should give some inputs to the history. As the pain is in the knee and radiating down this can be due to either of the factors , either a ligament injury in the knee joint or may be a pinched nerve in the lumbar spine. Based on the clinical examination and laboratory investigation the treatment can be planned.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in knees,calves,hip and legs\n\nI recentky started a diruetuc for CHF. Now my knees ache when I walk or try to climb stairs. My archs ache very much and my calves cramp. At night my hios hurt as well and my pain through out my hip and legs feels like it is pulsing. All of thi as is new symptoms",
    "doctor_response": "hi,thank you for providing the brief history of you.A thorough neuromuscular assessment is advised.As mentioned you have pain in the lower limbs post taking diuretics it can be muscular pain. Also, the diuretics are prescribed for reducing the water content in the body by which the blood pressure falls down. As you have CHF you need to perform regular breathing exercises as to have a control over the Cardiorespiratory system. In addition performing regular general body exercises with breathing exercises will imporve your cardiac input output.Since the pain is in the legs, it is tough to correlate if the pain is dude to diuretics. As it cannot be case. Getting a thorough neuromuscular assessment will help us guide further the cause. You can try undergoing physical therapy as it will help reduce the pain and also improve the muscle strength.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does diet pill taken extra causes any side effect?\n\nhi i just mistakely took my 4th oxyelite diet pill - on the back of the bottle it says three max. i did not mean to do it, i was distracted and focusing on something else and i put two in my mouth instead of one. (i took two this morning) do you think something will happen? thank you mieky",
    "doctor_response": "Hi, Because of safety concerns FDA has banned this diet pill. Oxy elite contains anti-depressant fluoxetine (selective serotonin reuptake inhibitor). Taken in larger doses it may cause serious side effects such as sleep disturbances, sexual dysfunction, suicidal thoughts seizures, and serotonin syndrome. Serotonin syndrome can be a life-threatening condition characterized by delirium, hypertension, tachycardia, sweating, & tremors. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for lower back being very sore along with pain?\n\nI fell off a ladder and believe I injured my tailbone. My lower back is very sore. Trouble walking, painful sitting. I've noticed when I sit for more than 10 minutes both of my legs and feet fall asleep Do you believe I might have nerve damage or is this a symptom of the injured tailbone",
    "doctor_response": "Hi,these are symptoms that require a proper neurological review. A Ct scan and an MRI of the spine would be most suited to avoid any future serious complication. In case these symptoms persist with well controlled pain, seeing a neurosurgeon or a orthopedic surgeon for a proper review and testing would be most welcome. Kind regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to control increasing SGPT levels?\n\nHello sir,Recently, I have went through medical check-up and found that my sugar, GGT and SGPT levels are 144, 77 and 110. As I had suffered from Jaundice long before about 10 years back and also I use some alcohols after full curing of jaundice. After 15 days of above test/check-up, I again rushed to diagnose the above which count 93, 47 and 116 respectively. As the sugar and GGT were in control but SGPT is increasing, please advise me how to fully cure this problem and also state that by this high SGPT, can it be deemed that i am medically unfit..?YoursNG",
    "doctor_response": "Hello,I have gone through your query and understand your concern.I suspect you might have Alcoholic Hepatitis.because alcohol is the one of the common cause of the hepatitis.You are an alcoholic.That is why i suspect it might due to alcoholic hepatitis.You need further tests like Ultrasound abdomen and Upper GI Endoscopy to rule out any liver enlargement like fatty liver and Esophageal varices.You must quit alcohol now itself to control the further damage to liver. We cannot say as unfit for just a elevation in SGOT. You need through physical examination and investigations to say as medically fit or unfit.Hope this helps.Please write back for further queries.Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Damage in uterus lining, analysed as less chance of pregnancy. What should be done to conceive?\n\nso my sister was beaten and abused 4 years ago by her boyfriend and now apparently there's damage to the uterus lining and the doctors say that there's a small chance that she'll be able to carry a child due to the fact that there's only a 10% chance that the egg will stick to her lining. Is there something that can be done about this as she would like to eventually have a child with her current boyfriend.",
    "doctor_response": "Hi,Thank you for choosing Healthcaremagic. I feel she is having Ashermanns syndrome, where the uterine cavity is full of adhesions. Next best investigation will be Hysteroscopy to look inside the uterus and some blood investigations like FSH to know her ovarian reserve.I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow-ups. If you like my answers kindly rate it, and write a review as well. Please do not forget to accept it.Thank you,Wish you good health.Regards,Dr ArifYou can consult me again directly through my profile",
    "dialogue_context": ""
  },
  {
    "patient_message": "Would a diabetic with kidney disease (stage 3) need dialysis?\n\nI have just been diagnosed with stage 3 kidney disease as a result of diabetes. I had been taking Janumet for 10 years in addition to actose & glimperide. My dr. took me off Janumet and said I must now take insulin. Will I have to do dialysis in the near future?",
    "doctor_response": "Diabetic and niq stage 3 renal disease...first you were on oral medicine now switch to insulin..it shows you are not controlling your sugar level.As a result your kidneys are effected...We have got two situation ..diabetes and renal disease..Well the need for dialysis increases in such patient BUT if your sugar level is controlled within normal range and you do not have other conditions like hypertension, then you can do it with medicines (angiotensin reninin blockers..candesarton...or ACE inhibitors like lisinopril)for some time.Do your regular blood test and urine test to keep an eye on your kidneys.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from ADD, on Adderall, cannot manage clutter. Suggestions?\n\nHello. I have been dating a man approx. 11 years and he is ADD, on Adderall interchangable with Vivanse (mispelled?). He tells me he can get his clutter under control when there is normal stress , but he gets so stressed at times that his clutter piles up and his house doesn t get cleaned. Obviously I don t live with him but we are good friends. He said if he knows (acknowledges to himself) that it (clutter issue) will never get better that he will lose hope. What advise can you give on this, as we are very close yet I don t think I could marry the man. It is not my style to have clutter everywhere and when I cleaned for him before a few times, it went right back to the way it was, if not worse. Thank you.",
    "doctor_response": "Adderall - Used for: Treating attention deficit hyperactivity disorder (ADHD) and narcolepsy (sudden and uncontrollable attacks of drowsiness and sleepiness). It may also be used for other conditions as determined by your doctor. Adderall is an amphetamine. Exactly how it works is not known. Adderall affects certain chemicals in the brain that may affect attention span and behavior. Adderall and dextroamphetamine is a central nervous system stimulant. It affects chemicals in the brain and nerves that contribute to hyperactivity and impulse control. Lisdexamfetamine dimesylate (L-lysine-D-amphetamine; sold as Vyvanse) is a psychostimulant prodrug of the phenethylamine and amphetamine chemical classes. As opposed to Adderall, which contains roughly 75% dextroamphetamine and 25% levoamphetamine, lisdexamfetamine is a single-enantiomer (dextro) amphetamine formula. This pure formulation may reduce side effects, but certain individuals exhibit a better clinical response to the mixed isomer preparation. ADHD persists into adulthood in about 30 to 50 percent of cases. Those affected are likely to develop coping mechanisms as they mature, thus compensating for their previous ADHD. Along with taking medicine some sort of BEHAVIORAL THERAPHY is also needed. Then he will be far better than now. Best of luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why are Evion LC tablets prescribed?\n\nMy doctor advised me to take Evion LC tablets . I like to know for which disease this tablet is prescribed, whether any side effect will be for this medicine. age 67, height 5 2 . 120 lb, I am taking Rosuvas 10 one tab daily for last 3 years . Recently my Dr prescribed thyronorm 25mg. I am having muscular pain on my legs & upper arms and numpness on feet. I am not a sugar patient, blood sugar 83 (fasting) one week ago.",
    "doctor_response": "Hi,Evion LC (levocarnitine+vitamin C) is a nutritional supplement commonly prescribed for the treatment of carnitine and vitamin E deficiencies.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes aching sensation in the chest after eating cold stuff?\n\nI get a aching sensation in my chest after eating something cold... Almost like in my boobs if you don t mind my saying so... anyway it feels kind of strange sometimes. And sometimes it causes them to become very sore and slightly uncomfortable. Like on a scale of 1-10 probably a 2 or 3 but it s still rather strange to me. Is there a reason for this?",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. You have problem of chest pain esp in breast area after eating only cold If symptoms related only by eating cold things than allergy might be the reason. You can investigate with CBC and AEC along with auscultation. If no allergy and by auscultation, if needed then chest x ray can be done for further work up. For allergy decongestant like cetrizine can be prescribed. Consult a pulmonologoist for examination and Auscultation and accordingly work up will be needed.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can discectomy and laminectomy result in increased back ache?\n\ni had a distectomy and laminectomy 2 years ago discs L 1and 2 , it has now got so bad that i cant walk, the last few day i have had really bad pain in my lower back, i cant walk now and pins and needles in both legs front and back, im in cosntant pain even though i have taken my oxycontin and gabapentin and diclofenic, i also have really bad wind and tummy pains like a dull ache, im really concerned, what do you think this could be?",
    "doctor_response": "Hello, I hope that i can better help you understand your situation. From your symptoms it may be that you may have another disc herniation. While discectomy/laminectomy can help with radicular pain, you are more likely to re-herniate because the disc is disrupted at this level.If rest, anti-inflammatory meds, and pain medication are not working, you need to be evaluated by your physician and possibly be treated with steroids and get some current imaging of your spine.I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be done for lack of sleep in afternoon during pregnancy?\n\nI am 23 weeks pregant am trying to sleep in te afternoon but i am not able to sleep in my 1st pregancy i had nice wormiting and get tired and use to sleep but now am not able to rest when my daughter sleeps bcoz that is the best time to take rest so bcoz whole day i spend the time with her and tired so tell me which way i can rest night i get sleep but she will be playing so night i will be late to bed plz suggest me?",
    "doctor_response": "HI,   I understand your concern.   To have at least 8 hours good sleep is essential in pregnancy. THere are two ways how you can manage and have sleep    - Try to change sleeping cycle of your little daughter. keep  her busy with different activities in afternoon.so that she sleeps well in night.     In the night, put the lights off, do not play,nor encourage her to play. Try to sleep silently by her side. The child will try to cry/ shout to draw your attention .. do not respond. Ultimately, the child will play alone for some time & fall asleep.  This will a sound sleep because of exhaustion with whole day play.   - You can try sleeping with help of a yoganidra audio CD.in afternoon.   Avoid taking sleeping pills.    Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for symptoms of ADHD\n\nHow do I know if the Dr I am seeing helps with my ADHD? I have been to a 2 Drs one who was actually a PA and couldnt help me and the other who doesnt believe in ADHD medicine. I have been seeing a dr who placed me on Ritalin and it helped me with so many difficult areas in my life. Including sleep believe it or not. I am so tired of wasting my time and theirs.",
    "doctor_response": "HIThanks for using healthcare magicIn ADHD, you need medication like Ratalin or atomoxetine. These drugs would help to control the symptoms. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is low plate tablet safe for Kidney?\n\nIs lowplate tablet harmful for CKD 111 patient or safe for kidneys.I am 65 years,165 cms height,Diabetes/Htn for last 10 years.High creatinine identified in November 2010 when I was called by cardiologist for angiography.My serum creatinine level at moment is 168 umol/l and creatinine clearance 49 ml/min.Please advise.My e-mail is  YYYY@YYYY",
    "doctor_response": "Hi..You can take aspirin. It is not harmful to kidney at any stage of kidney disease. But it is preferable to take low dose(75mg).But avoid all other pain killers. Hope I answered your query. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes my daughter s severe thirst and frequent bowel movements?\n\nI have a 4 year old who has several bowel movements a day...Most very loose stools, and sometimes just has mucus come out, she has suddenly been complaining that her left side hurts...She doesnt eat much and she always says she is thirsty...any ideas? i was thinking IBS?",
    "doctor_response": "Hi, Need to evaluate properly. Investigations like serum electrolytes, stool examination (for Ova & Cysts) may help to some extent. IBS may be a possibility but cannot conclude with this at the first. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ajaygupta009, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes indentation of rib cage?\n\nMy sister s 14 year old son has indentation of his rib cage. His is tall for his age, and very slender. I have known other children with this condition that had to get surgically corrected. What is the term for what he has, and what is the surgery?",
    "doctor_response": "it's called Pettus excavatum which is a congenital deformity of the frontal chest in which the chest appears like it's sucked in .the corrective surgeries are of two types : 1- traditional method: involving a midline incision with removal of deformed cartilage and insertion  of peice of metal to allow for normal cartilage to grow and then removed 6-12 months later 2-two incision method : at both sides of chest with insertion of thoracoscpoe and placement of curved metal to correct the deformity and left it for 2 years I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I often have digestion issues and decreasing Hb levels. Can it be bowel cancer?\n\nHello doctor, I am a 30 year old male. My height is 5 feet and 7 inches, and I\u00a0weigh about 87 kg. For the past 4 to 5 years, I am suffering from indigestion. This got more serious in the recent years. It used to occur three to four times every week,\u00a0especially after lunch. I sought medical help and went to see a general physician, who ordered for blood tests. It revealed most of the levels\u00a0to be normal, except for a mild elevation of ALT and AST levels. Then he ordered an ultrasound which showed I have a fatty liver, though I rarely drink alcohol. Also, H. pyroli came out as negative. He asked me to take a healthy diet and avoid alcohol. For indigestion, he prescribed Rabeprazole 20 mg every day, which seemed to help, since I did not get any indigestion anymore.More recently, I developed frequent loose motions. On some days, I pass stools thrice and have excessive gas. Over this period, I had four to five\u00a0blood tests, which revealed that my hemoglobin was gradually decreasing. The first blood work done three years ago, showed my Hb to be 152 g/L, then 148, 143 and now in the last month it was 137 g/L. Also, my RBC count dropped from 4.89 to 4.5 million cells. My latest ferritin level was 194 ug/L. I asked my doctor here, and he ordered FOBT test. All three samples showed negative and no blood was found in the stool. Recently, he has ordered for a colonoscopy which I am waiting on, and I am really worried that I might have colon/rectal cancer. My question is, does negative FOBT and normal ferritin rule out any cancerous growth in the bowel and intestine? I have hypothyroidism and sleep apnea. I have no family history of bowel cancer.",
    "doctor_response": "Hello. So, discuss the above mentioned information with your treating physician. Follow up if you need more information regarding any thing else. Hope this helps. For more information consult a surgical gastroenterologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this MRI report of back indicate?\n\nIwas in a car accident i am having bad pain in my neck shoulder and upper part of my back mri showed straightening of the cervical lardoisis mold anterior spurring osteophysetes within the c5& c6 vertebral at c3 -v4 there is a diffuse disc vateophyte complex with mild canal and mild bilateral neuronforaminal narrowing could you explain",
    "doctor_response": "Loss of cervical lordosis....Is straightening of neck vertebrae.. usually due to postural changes..and line of managment is physiotherapy and neck exercises.. wth some analgesics and muscle relaxants...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sternum pain\n\nThe bottom ribs on each side and my sternum hurt pretty badly. I haven t hurt myself or over exerted myself, so I know I didn t pull anything. It s sore to move certain ways and to the touch, if I take a deep breath it also hurts. I heard that it could be a symptom of fibromyalgia, as I am sore (but not nearly as bad as my rib/sternum) all over. Muscle aches and extreme exhaustion. Please help :(",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Fibromyalgia is characterized by symmetric distribution of pain in more that 11 areas of body without any evidence on investigations.So its most probably not related to fibromyalgia.It could be due mechanical stress or trauma.Give rest, apply ice,take analgesics oral or topical.Pain may subside in few days.Do not panic. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat armpit rashes?\n\nhi doc, I have a pinkish rash on my armpit,looks likeskin been peeled off and its been there like 3 months now ,about a shape of quarter the palm size,can you suggest me what could it be?Im afraid is it anything to do with HIv as i had some encouters like 8 months back,pls advice",
    "doctor_response": "HIWell come to HCMHypersensitive reaction may be likely and this can be best treated with Mometasone cream, for the oral medication this can be treated with Tab cetirizine three times in day, take care for hygiene, hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring throat infections and fever?\n\nhi Doc, My 33 month old babby gets throat infection almost every month which is accompanied by high fevers that make him convulse sometimes. sponging does not help much neither does paracetamol for the first two days. What could be wrong? What can i do to prevent these infections or reduce the temperature when he has an infection?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query your baby have symptoms of recurring throat infections and fever which could be due to untreated respiratory tract infection and due to impaired immunity of body. Need not to worry. I would suggest you to apply warm compresses on neck externally. Take paracetamol for fever. Visit pediatrician once and get it examined and start treatment after proper diagnosis. Doctor may prescribe antibiotics like amoxicillin along with anti inflammatory and antipyretic . Milk boiled with a pinch of turmeric taken at bedtime for can be relieving as it has antimicrobial properties. Take soft foods to avoid irritation to the throat. Drink lukewarm water throughout the day as it can provide relief. Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for balanitis\n\nI think I may have balanitis, what are the treatment options. It is the result of poor hygiene rather than contact with thrush. Symptoms inc. splochiness, irritation, small blisters, bad smell, smegma. Should I be thinking steroid creams or antibiotics?",
    "doctor_response": "dear friendwash and clean the area apply antibiotic cream to start with  mupirocin 2% is a good option alternate it with a betamethasone + anti fungal ointment keep a good hygene",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sperm analysis done, opaque grey, motility, immature forms tested. Are they normal?\n\nCan anyone suggest me the following report is normal? How is my Sperm count report? Volume :- 2.5ml Appearance :- Opaque grey Viscosity/Liquifaction :- more than 2 hrs Total Sperm Concentration :- 26 mil/ml Active Motility 55% Sluggish motile 5% Non Motile 40% immature forms 6 abnormal forms 4 ph 8",
    "doctor_response": "Usually it takes 10 minutes to liquefy. Active motility is fair",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having high level of bilirubin. Waiting for autopsy results. What type of diet should be followed?\n\nhi my son has a bilirubin count of 37, they have done numerous blood test , 2 ultrasounds and a cat scan , and can not find anything wrong other then the bilirubin elevation and he is extremely jaundice. We are awaiting a biopsy , this week sometime, and are trying tto figure out what sort of diet he should be following at this time.",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum. In  head lines in this query   there is a blunder ( AUTOPSY) , who is responsible ?Any way serum bilirubin level is two type 1 direct 2 indirect First of all make sure which level is high ? Usually bilirubin level is 1mg & high means jaundice . Get in blood for serum amylase, S  G O T, S G  P T .  In ultrasound , if everything is normal then it is physiological jaundice and prognosis is very good. Consult a physician and get his opinion.Upload serum bilirubin's complete report. Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for red itchy rashes on torso after appendectomy\n\nAge 51, 5'5\" tall, 200 lbs.  Female. Had unplanned laproscopic appendectomy last Wednesday.  about 3 days ago i have a small red itchy rash all over my torso. Have not taken any meds for over 2 days but it is not going away or fading.  Feel extremely tired but no fever. Am allergic to penicillin and sulfa type drugs. was on 3 meds after surgery they were Ciprofloxacin, Oxycodone, and Metronidazole.  Took the antiobiotic for 5 days but not taking ANYTHING for last two days.",
    "doctor_response": "Hello, According to your complaints it seems to a drug rash. I would recommend you to apply calamine lotion on the affected area twice daily and take antihistaminic like tablet cetrizine 10 mg twice daily for 7-10 days. This will help in resolving your problem. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Asmeet Kaur Sawhney",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes loud painful popping in elbow?\n\nHello my name is Miranda and about 8 weeks ago I dislocated and fractured my left radial head. I also chipped a bone but the doctor isnt concerned about it. She put me in a cast for 4 weeks and since it has been off I have been doing physical therapy. I almost have my full range of motion back But for the past two I have been experiencing a loud painful popping in my elbow. I can tell before it is going to pop because it gets very stiff and my elbow begins to hurt a lot. After it pops it feels much better. I was just wondering what you think may be causing this to happen.",
    "doctor_response": "I think you might be having elbow ligament injury. I would suggest you to get MRI of the elbow and confirm the diagnosis. If there is such injury then you might need surgical intervention.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for panic and anxiety attacks other than taking Xanax?\n\nhi i just moved and i have been taking xanax for 7 or 8 years now. for panic and anxiety disorder. i was able to overcome agaorophobia. but i still have the attacks. i need a local doctor but they all worry about prescribing it and i understand why. however, i need to continue my regimen",
    "doctor_response": "Hi,Considering that you have panic disorder with agarophobia, it would be better that  you should be treated with some medication that will take care of the disorder per say like selective serotonin reuptake inhibitors, rather than only taking xanax. Xanax will help reduce your anxiety but not take care of the disorder as such. i would recommend you to meet a local psychiatrist immediately.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does scarlet fever cause red, burning and peeling rashes?\n\nHi, my daughter is 5 and has a red burning rash which peels on the virgina bone and under her arms. She had it about 2months ago aswell that then spread over her body and peeled. Our doctors suspected scarlett fever on a returning visit when the peeling started?? Can you please advise as we didn't know that scarlett fever was recurring??",
    "doctor_response": "Hello,I read carefully your query and understand your concern. Most cases of\u00a0scarlet fever\u00a0clear up after about a week without treatment.  With treatment, most people recover in about four to five days after starting antibiotic treatment. Without treatment, the person can be\u00a0contagious for one to two weeks after symptoms appear.It's possible to catch\u00a0scarlet fever\u00a0more than once, but this is rare.Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are cancer mutations inheritable ?\n\nas you know cancer is the uncontrolled division of cells and it is caused by mutation.mutation can be caused due to chemicals ,radiations etc Can these mutations are inheritable?",
    "doctor_response": "welcome to health care magic you are right mutation is caused by the external factors as you described. the chances of some cancers like breast, cervical increase if one has the family history of the same like in mother , aunt, sibling wish you health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for hair loss\n\nhi , I am a lady age 40 and since 6 month ago I have noticed a heavy hair lose on my front head , my GP did lots of blood test but couldn t find any reason and finally suggested to use either Ecophane tablet or Minoxidil lotion . but I don t know which one is more effective and have less side effects ??? I would really appreciate if you can advise me Many thanks",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.In my experience, I would suggest you to go for Minoxidil solution. It does not cause major side effects. But be patient as the treatment response is gradual and you have to wait for at least 6 months.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Semen analysis test report, production of dead sperms. Treatment for infertility?\n\nthanks for your response. I saw a urologist and I am getting my semen (culture) results XXXXXX tomorrow. So i will inform better tomorrow (22 nd November, 2013). My question still is how come I have a 4 year old daughter and why specifically testing for Semen-culture test? Why I my producing dead sperms? Will i ever in-pregnant my wife?",
    "doctor_response": "HelloThanks for your query.Please attach the complete semen analysis report so I can comment definitely.Also the reason for the semen culture report.If you have a child already, you would mostly be having a treatable cause of infertility.Get back with the complete reports for detailed answers.ALl the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could armpit abscesses be due to fungal infection?\n\nI suffer with armpit abscesses which started about 3 years ago, and I've noticed they only seem to flare up when I get thrush, could this be because of thrush or another kind of fungal infection? Thanks. I am 26, 5foot, 6, 13 stone. no other illnesses.",
    "doctor_response": "carbuncle is caused by bacterial infection, you can start on amoxicillin for 7 days. if it sore and fails to drain out pus then you should go for Excision and drainage thought surgical method.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for lower back pain?\n\nDear Doctor,                       I never had a problem of lower back pain, suddenly since last week the pains come in the morning but goes away when I hit the gym. My weight is 95 kg and height is 5 feet 9inches.I do sit long hrs in the front of laptop in my office and I have corrected my sitting posture also .What should be line of action? should I consult a orthopedic or wait this pain to subside.with regardsvijendra rawat",
    "doctor_response": "Dear patient It seems you are getting  morning stiffness of spine which may be early symptom of inflammation  due to arthritis.please consult  orthopaedic surgeon  nearby you  and get yourself examined.  I would like to advise radiograph of lumbosacral spine anteroposterior and lateral views to rule out bony abnormalities.  All the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes erectile dysfunction and premature ejaculation?\n\nhi sir i am 21 year old & i am facing problem with my panis upcomping 6 month i am gona marry but the problem is i am not able to have morthen 1 min sex problem is early fall of hormon........another thing is most of the time my panis is getting tight .......please help i am in kolkata & i want address of clinic",
    "doctor_response": "Hello, Please do not worry too much about your marriage. Please understand there is nothing called premature ejaculation while masturbating. PE can always be controlled with simple methods. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pulmonary hyperaeration\n\nIn my chest x ray showing Lung fields are hyperinflated with no active parenchymal infiltrates. The heart is normal in size. The aorta is unremarkable. Diaphragm and bony thoracic cage are intact No other remarkable findings. IMPRESSION: PULMONARY HYPERAERATION... Thank you in advance...",
    "doctor_response": "Hello dear, thanks for your question on HCM. Hyperaeration is also known as hyperinflation. And it is seen in following conditions. 1. Normal individual if chest x ray is taken after full deep inspiration. 2. Old age people. 3. Smokers due to COPD ( chronic obstructive pulmonary disease ). So if you are smoker or symptomatic (cough or shortness of breath) then get done PFT ( pulmonary function test ) to diagnose COPD. And if you are not having any symptoms and not a smoker then no need to worry much with this x ray report.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pressure in chest after masturbating?\n\nI am a man 40 years old.  I walk 9.1 kms every week.  Every time I go to the doctor he always tell me that my heart is smooth.  When I tried ECG it was perfect.  However after I masturbate I get chest pressures.  After 24 hours everything becomes normal again and I become a healthy man.Is there anything wrong that I get chest pressure after I masturbate?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Masturbation is a safe practice and it cannot lead to any major complication. But sometimes excessive masturbation can lead to groin discomfort. For your chest pressure if ECG is normal then no need to worry about that. I hope this will help you. Consult physician for examination is needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and heaviness in the heart?\n\nI have recently found that on random occasions my heart starts pounding and I can not see stright. I feel dizzy and cant seem to get enough air. If I go outside in fresh air and take a few moments to myself it subsides but Im scared about what is going on.",
    "doctor_response": "Hello!Welcome on HCM!I understand your concern and would explain that your symptoms seem to be related to anxiety. Anyway, I would recommend consulting with your doctor for a physical exam and some tests to exclude other possible causes that may mimic this clinical scenario: - a chest X ray study- a resting ECG- complete blood count for anemia- thyroid hormone levels for thyroid dysfunction- blood electrolytes for electrolyte imbalance.  An ambulatory 24-48 hours ECG monitoring would help examine your heart rhythm trends for a prolonged time and exclude possible arrhythmia. Hope to have been helpful!Wishing all the best, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for swelling on wrist due to red wasp sting\n\nMy wife is 14 weeks pregnant and was just stung by a red wasp twice. Once on the wrist and once on the back. Her wrist and back has quite a bit of swelling and she has a sever family history of allergic reactions to wasp stings.What can she take for the swelling and is the baby going to be ok?",
    "doctor_response": "Hi, thanks for using healthcare magicShe can use an oral anti histamine to reduce her allergic response. This would help her and would not harm the baby.An example is benadryl which is available over the counter.If she does not respond to the oral antihistamine or there is worsening of her allergy, she needs to be seen as soon as possible.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "How dangerous is a broken arm in a child?\n\nMy great niece (age 7) fell rolling skating Sat. and broke her left arm. They said it was the birth plate and I was wondering how dangerous that is? They had to pull it together and put pins in it. She is not in a hard cast, because they are waiting to take pins out.",
    "doctor_response": "Hi.... this is not dangerous. Don't worry. By what you say I feel that the treatment also is going on in the right direction. As they have put pins, the union will be perfect alignment. Don't worry about it.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever and red swollen gums?\n\nMy 14 month old daughter has been sick, running fever and is teething.. Behind her front teeth she has a whitish green patch of raw skin and her gums are extremely red and swollen.. I have never seen this in any of the other children. We brush her teeth regularly. What could be the problem",
    "doctor_response": "Hi...by what you quote I feel that she might be going through a viral illness. But the whitish green patch of raw skin and her gums are extremely red and swollen gums could be a fungal infection or oral candidiasis. I suggest you wither upload a photo on this website or consult your kid's pediatrician.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are hallucinations normal in a person taking morphine and oxycodone for broken back and neck?\n\nMy adult grandson fell and broke his back & neck a year ago & is wheelchair bound.  He has taken oxycolone (sp.)& morphine untill he started having hallucinations & went to rehab for the last 2 months.  He is still having these hallucinations.  Will this drug cause these & how long will they last?",
    "doctor_response": "Hiyes these drugs may cause hallucinations usually visual but at times auditory (   through ears )Good that at rehab he is being taken care ofIt may take some time . Please do not remain upset as he is already under treatmentWish him early recovery Dr Lal Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dog bite\n\nHi, my son (20 yrs) was bitten by a St Bernard dog on 24th of this month. He immediately took a Rabipur shot. He then took a second shot on 27th (yesterday). But he took the second shot from the same pack. Could u please tell me whether Rabipur pack has one or two shots.",
    "doctor_response": "Hi & Welcome.Your son must take at least 4 doses of Rabipur on days 0,3,7 & 14 following the dog bite. Each pack of Rabipur contains only one dose (shot) of the vaccine. So, he should take the subsequent doses from new packs.Besides vaccine he should also be given a tetanus toxoid shot if not immunized earlier.Hope this answers your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning pain around scrotum?\n\nI felt a burning pain around my scrotum area every on and then. Its no sharp pain but it sometimes burns and other times it feels normal. It doesn t affect me playing sports. I had an appointment a few weeks ago to get checked to see if I had a hernia because my groin area was burning for a few days but the doctor ruled out a hernia and said it was only a pulled muscle. I had been masturbating pretty frequently but only did it once this week and I continue to feel the intended n and off burning around my scrotum. Do you know what this means? I would really appreciate the help.",
    "doctor_response": "Hi,Burning pain around the scrotum can be a feature of scrotal dermatitis or frictional  dermatitis,  please wear loose undergarments and upon diagnosis you can use topical steroid with fusidic acid combination. Hope it helps. If you have any other question please do not hesitate to contact us.Regards. Dr. Atishay Bukharia",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome depression?\n\nhad a bang on my head march 26th wilst on holiday came home and got a bad chest,  had 2 lots of penicillane  had to hols my head when i coughed been doctors 6 times just gave me tablets for depression, have a tightness on my fore head and tenderness on right side of head thye say i don't head scan",
    "doctor_response": "What going in in your mind needs to be understand for better treatment. Are you feeling low and sad. Kindly tell us.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough and high fever in a child\n\nHi, may I answer your health queries right now ? Please type your query here...My daughter has had a feever up to 102 today. She is sleeping now and her temp is 96.8 her 6 mos old brother has rsv andthey both have a cough. Can you tell me if her temp is ok?",
    "doctor_response": "Hi...now her temperature is ok and need not worry.But if she develops fast breathing and grunting type od respiration then I suggest you take her to the nearest emergency room as soon as possible.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for degeneration of auditory nerves.\n\ni am suffering from ringing noise in both the ears . the condition is about 4 years old. MRI of brain was done . doctors have diagnosed it as degeneration of auditory nerves. i am 35 years old female. so, please suggest to me about how to treat this condition and where to go for treatment. i reside in new delhi.",
    "doctor_response": "Well, that's a rather vague diagnosis from where I sit and I would want additional information.  For example, have you had an audiogram done?  Have you had a TINNITUS EVALUATION performed (done by audiologists).  And as far as the MRI is concerned was it done with gadolinium contrast and was a high resolution IAC protocol performed to look for other causes of your tinnitus other than \"auditory nerve degeneration\" which should really not be happening in an otherwise healthy 35 year old young woman?  If you'd like to upload the results of the MRI scan to me I'd be happy to comment further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment should one take for muscle spasm causing lower back pain ?\n\nHello Doctor, I have been suffering from lower back pain for last 4 weeks. I was told that i am suffering from muscle spasm and need to take rest. I was asked to do some stretchable exercise, physiotherapy and hot showers on the affected area. But till date I have not got any relief. Now I am not able to walk independently and it hurts a lot while walking few steps. Please advise. PADMA",
    "doctor_response": "DEAR  PADMA, HI,I AM DR KAVITHA.I WOULD LIKE TO HELP YOU. ASSUMING THAT YOU HAVENT STARTED USING A NEW PAIR OF PARTICULARLY HIGH HEELS AND YOUR OCCUPATION DOESNT INVOLVE SITTING  FOR LONG DURATIONS,YOU WILL HAVE TO GO BACK 4 WEEKS IN TIME AND TRY TO REMEMBER WHAT YOU WERE DOING IN THE EXACT MOMENT THE PAIN STARTED .THIS WILL GIVE YOU A CLUE AS TO WHAT THE CAUSE MIGHT BE SINCE THERE ARE MANY MANY REASONS FOR LOW BACK PAIN WITH MUSCLE SPASM. MUSCLE SPASM IS USUALLY THE BODY'S WAY OF PROTECTING THE VERTEBRAL COLUMN FROM FURTHER INJURY BY LIMITING YOUR ACTIVITY.SPASM CAN ALSO BE CAUSED BY SOMETHING THAT IRRITATES THE MUSCLE. FOR EXAMPLE IF YOU WERE INTO SOME HEAVY  LIFTING ,OR JERKY TRAVEL,OR A FAST MOVING SPORT YOU MAY HAVE SLIPPED A DISC ...IN WHICH CASE YOU MAY  HAVE TO GO FOR A XRAY/CT/OR MRI AS YOUR ORTHOPEDICIAN MAY ADVICE. IF IT STARTED AFTER A FALL OR AFTER SOMETHING FELL ON YOUR BACK YOU MAY HAVE SOME INJURY TO THE BONE WHICH CAN ALSO CAUSE MUSCLE SPASM I ALSO WANT YOU TO THINK IF YOU HAD ANY OTHER SYMPTOMS BEFORE OR AFTER THE PAIN STARTED    LIKE A FEVER,AN ABDOMINAL PAIN,DIARRHOEA,URINARY INFECTION,ANY VAGINAL INFECTIONS OR EVEN A CHRONIC COUGH,ETC BECAUSE THERE IS AN INTRAABDOMINAL PATHOLOGY   CALLED A PSOAS ABSCESS THAT IS SO PAINFUL THAT IT CAN CAN EVEN STOP YOU FROM PUTTING YOUR FOOT DOWN DUE TO THE PAIN. SO IF YOU HAVE NOT GOT ANY RELIEF FROM YOUR PAIN SINCE 4 WEEKS I THINK IT IS TIME FOR YOU TO GET A SECOND OPINION PREFERABLY FROM A QUALIFIED ORTHOPEDICIAN.AND PLEASE BE WARY O F DOING EXERCISES AND PHYSIOTHERAPY UNTIL YOU CONFIRM THE CAUSE OF YOUR BACK PAIN.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for loose motion\n\nMy son is having loose stool and since evening he is not comfortable to sit and lay down. Doctor suggested to use ofm along with nutrolineb and ors as he might be having some tight contractions with his intestine.Do you suggest anything else to use?He is 2years old",
    "doctor_response": "hi, Thank you for posting your question.Since your child has complains of loose stools, the most probable cause I would think of is viral diarrhea. In that case I would ask you only to take care of his hydration, which can be done with ORS. Apart from that probiotics e.g. nutrolin b which was given to you would also be useful. Any zinc supplement may also be helpful to recover the zinc lost in stools. This could be done after consulting your doctor. For the pain and discomfort that your child is experiencing any anti colic drug could be used. Also look for peri anal redness which could also be the cause for his discomfort.Unless your child has any symptoms suggestive of bacterial diarrhea such as blood in stool, high grade fever or toxic look, I would not recommend using an antibiotic i.e. ofm. In loose stools the most important aspect of management would be monitoring his hydration status. Hence keep a watch mainly on the no. of times he passes urine and his mental status( whether very irritable or lethargic) and consult your doctor as and when required. Do reply back if you have any more doubts.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for skin rashes due to scabies\n\nI have been to the doctors four weeks ago and after 1 minute i was diagnosed with scabies.  I then treated myself with Malathion Derbac 4 times and i am still getting rashes.  I washed everything i come into contact with and it just seems to be getting worse.",
    "doctor_response": "Hi,Scabies is highly contagious skin disease and if perfect treatment is not implemented, the disease would not cure  by root and may lengthen the duration. So, proper treatment should be taken. I would recommend you to take scabicidal Tab ivermectin 12 mg single dose and may be repeated for few weeks. Apply permethrin cream daily at night till satisfactory improvement. Take bath in antiseptic like dettol liq. Hope this helps.Dr. Ilyas Patel, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe back pain?\n\nHi my name is Lakeisha and on about the 20th of this month I started having back pain. At first it was bare able but as the days went on the pain increased, it really got worse when my cycle came on Tuesday(24th). It is so bad at times I can t stand or walk. Is this a female problem and should I be concerned?",
    "doctor_response": "Dear Lakeisha ,I assure you that this problem of yours is neither very serious nor uncommon.In my clinic a whole lot of young women like you, come with low back and lower abdominal pain during menstruation.you just take some simple analgesic to decrease the pain intensity.then the pain will go after you complete this months menstrual phase.if it occurs in next month again yu just take some analgesic .In this way you will feel better.thank you for your patience hearing",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for bruises on the foot\n\nI was walking and rolled my left foot i had a bruise to 2nd from gr. toe I am now experiencing pain in the ball of my foot not able to apply pressure totally have to walk on the outer side of my foot. have pain migrating into ankle the bottom of my foot near toes has a sharp pain at times this happened 2 wks ago at first it was just a swollen bruised toe not this sharp pain and I could apply pressure YYYY@YYYY",
    "doctor_response": "Hi,Thanks  for  your query.An initial xray of the injured part is mandatory to rule out any bony injury (fracture). If the xray is negative for a fracture, then the other possibility is soft tissue injury either to the ligaments, tendons etc.The initial management for your condition is as follows -- Give adequate rest to the injured part and avoid any movements that produces pain- Apply ice wrapped in a damp towel to the injured area for 15 to 20 minutes every two to three hours during the day- Keep the injured area raised and supported on a pillow to help reduce swelling. I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest natural remedy for symptoms of menopause\n\nI was on Alesse for a year.  After 1 month I began to lose my hair.  Fast.  I lost tons of weight.  Around the 3rd month, my period flow began to diminish from a moderate to light.  The amount of days also reduced from a full 7 to 3 and then to none.  I did not get my period after stopping Alesse for 3 years.  Yes 3 years.  During this time I my hair continued to fall out and I gained weight.  135lbs to 177.  I have not been able to burn the weight off no matter how much exercise i do or eat healthy.  Something I have always done.  During this time, I also experienced Menopausal symptoms like severe hot flashes.  It has been 8 years and I rarely get my period. Approximately 9 times.  Is there anything I can do to correct this besides going back on a BC pill, progesterone and Metformin?  Is there something more natural?",
    "doctor_response": "**1. since AGE is not mentioned, but as it is mentioned in history: [rarely get period, approximately 9 times], thus it can be deduced that you might be a peri menopausal patient. [since getting menopausal symptoms]2. as loss of hair and weight gain is concern, thus appointment with a Gynecologist is must, who will perform necessary Examination [Per Vaginum/ Per Speculum] and Investigation [Ultrasound to rule out PCOD, Hormonal Profile for under active thyroid and sex hormones]3. Avoid fatty food,curd,late night work,soyabean,milk,mustard oil,cabbage, and take moong dal,tambul,saindhav,tandulodak,coconut water, vegetable soupsYoy may ask for prescription medicines like: raj pravartini vati, tankan bhasm, kaumarya assav, ashoka arishta.PS. because all H.R.T. [hormone replacement therapy] drugs being estrogens, thus one should have following things in mind:. self breast examination every month. look for vaginal bleeding, thrombo embolic disorders .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower abdominal pains, hurts on sleeping on sides. Urine test done. What does report mean?\n\nI took a urine test and here are two results that stick out to me- I ve been having lower abdominal pain and it hurts to sleep on my sides. The more I walk the more my lower abdominal area hurts. RBC , URINE HPF 0-3 0 - 3 /HPF WBC S, UA/HPF 3-5 0 - 5 /HPF BACTERIA, URINE HPF TRACE NEGATIVE SQUAMOUS EPITHELIAL CELLS, URINE SED, AUTOMATED COUNT, QUAL FEW N/A RBC, URINE HPF 0-3 0 - 3 /HPF WBC S, UA/HPF 3-5 0 - 5 /HPF BACTERIA, URINE HPF TRACE NEGATIVE SQUAMOUS EPITHELIAL CELLS, URINE SED, AUTOMATED COUNT, QUAL FEW N/A I m wondering if I have a bladder infection or kidney infection? Thank you for your help.",
    "doctor_response": "Hi these report appear normal Dont think you have a bladder or kidney infection. Get your ultra sonography done to see that there is no other problem. Hope this answers your query Wish you a speedy recovery",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tooth of upper jaw dislocated. Is it possible to place in order?\n\ngood after noon sir My name is Dev chakraborty 31 years of age from northeast India when I was 18 years of age I met with an accident in which one tooth of my upper jaw was dislocated now I want to place my in order to give my jaws a good shape having an attractive smile. Now is it possible sir and what would be the cost..",
    "doctor_response": "Hi,Thanks for asking the query,Yes this could be possible, the treatment options can be based upon the clinical examination and evaluation of the mouth, you need to take an x-ray of the tooth, can go for a root canal treatment followed by a crown placement or can go for tooth wirring.I would suggest you to consult to a Dentist and get the checkup done.Hope you find this as helpful,Regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of scoliosis at 77 years of age?\n\nI am wondering about symptoms of scolosis (sp?). I ve had it since childhood, and have many problems at age 77. I have difficulty standing for normal periods of time --- walk with a walker --- weak legs and hamstrings, etc. Please name other normal symptoms for someone my age with the disease.",
    "doctor_response": "Hi Thanks for your query and Welcome to Healthcare Magic. I am Dr Akshay from Fortis Hospital, New Delhi.Scoliosis is a s shaped three dimensional deformity of spine which can cause :- Cosmetic deformity if curve is large- Breathing difficulty especially if your chest is compromised- Pain in the back region- Pain going down in legs along with neurological symptoms like numbness, weakness in legs , paresthesias in legs especially on walking- An unbalanced curve can also lead to shoulder drooping on one side more than the other and subsequently cause degenerative changes in your hips etc.Do not hesitate to contact me if you need any further assistance. You can also discuss your case and treatment plans with me in a greater detail in a private consultation.Thanks & RegardsDr Akshay Kumar Saxena",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for white patch on penis and nightfall\n\nDear Doctor,I have a white patch on my penis shaft i.e inside skin for about 6 months now it wasn t there until I turned 18,it is not a bump just a mark not harmful.I suffered from various skin problems recently like acne etc.Also I had nightfall today as well.Please help!",
    "doctor_response": "HiI had gone through your query.White patches are due to infection. it can be due to fungal infection or any other autoimmune disorder like lichan planus.But it is difficult to say without examine it.So consult dermatologist for better assistance.Night fall is normal and it is occur due to semi erection of penis in sleep.Semen production occur 24 hourly and if you do not masturbate or doing sex then it will come out while we sleep.So do not think much. It is normal.Read and learn about sexual knowledge.Still have a query then feel free to ask.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low grade fevers with lethargy and nausea?\n\nmy son has recurrant low grade fevers with lethargy and sometimes nausea. lasts a few days, better for a few days, then sick again. his docter says its back to back virus. I don't believe that. just had blook work done and all labs normal. what is wrong with my son?",
    "doctor_response": "Hello,Welcome to HCM,The history, symptoms and the lab reports suggest me that you may be having flu like symptoms of viral origin. Most of the viral flu are self limiting which will subside by itself with symptomatic treatment.As your son is getting the fever repeatedly inspite of the lab report coming negative it may be a pyrexia of unknown origin.Which requires multiple investigation to rule out all possible cause of fever. I would suggest your son to continue with symptomatic treatment for few more days.If the symptoms are not subsiding then you need to undergo investigations.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for tooth infection with a history of hypertension\n\nMy mothor is 73 years old, she is hypertensive and has a stent in her heart. She has some tooth infection now, also has cough and mild fever. She lives in another city and I cannot check her temperature. Would you prescribe some safe antibiotic for her?",
    "doctor_response": "Hello,Thanks for consulting HCMRead your query, as your mother had infection in tooth with mild fever and history of hypertension dont worry I will suggest you to consult dentist and go for treatment of infection in tooth that will give her relief medication will give temporary relief only .  As you are asking for medication you can give her Amoxicillin for tooth infection by consulting with local doctor . Advise her to go warm saline gargle two - three times a day .Hope this will help you. Wishing her good health.Regards, Dr. Priyanka tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "SLE patient, no improvement with treatment. How to get it treated completely?\n\nhi , am a SLE patient, above 3 year ago i can recognize this disease, last 3 month ago i went to Chennai for the treatment. but i cant see any improve in my disease. on the other side my disease increase day by day . i wana come chennai again for the treatment in January. can you suggest me who is the best doctor for SLE. and what is the best hospital for SLE treatment ...",
    "doctor_response": "sorry i dont know anyone personally, but if you search for rheumatologist in chennai, you shd be able to find someone",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blisters and intense right-sided gum pain while having trigeminal neuralgia?\n\nI have Trigimenal Neuralgia. The Maxillary Branch.  I have a upper denture and my pain is in the right side of my gums. I am not having the sudden shock like pain of the past, but my gums are like they have been burnt. It hurts worse if I lean over to the right. I feel like this is the Neuralgia, but am not sure. I find when these attacks happen they last up to 2weeks. The gums look like the skin has been severely blistered and it's horrible pain to touch the gum when it hits. Is this really Neuralgia or something else? I have had it for about 7years and it's only on the right side. Started off feeling like horrible shocks and sometimes like abscessed tooth.",
    "doctor_response": "Hi Thanks for the query. Well it looks like some nerve related problem only. But in case if the gums become blistered then it can be a viral infiltration of the nerve. As it is a chronic condition you should consult an Oral Physician or an Oral Surgeon and get evaluated. An MRI SCAN can be done to rule out the exact cause of the symptoms and treatment can be done according to the diagnosis. If it is nerve related pain then neurotic painkillers like Carbamazipine, Gabapantin etc can be advised. If it is due to viral Infection then antiviral medication can help Hope this helps Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medication for a possible infection of foot after fusion surgery\n\nMy husband had foot fusion surgery a week ago, has been home and fine.   He just started with the chills, slight fever and nausea.    Could this be a sign of a possible infection in the foot.   The foot is bandaged, toes appear fine and there is no noticeable difference in foot pain.",
    "doctor_response": "These are nonspecific symptoms which can occur with any kind of infection, including a cold or a viral infection. They do not necessarily indicate the foot is infected. If there were an infection in the foot, he would experiencing local symptoms there, such as redness, swelling, heat and pain. You should let the surgeon know about the fevers and chills. S/he may want to take a look to be sure it's not the foot. If he develops other symptoms such as a sore throat or cough, then it's likely due to a virus or other infection, and not his foot. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having pain in throat, breathing problem, cannot swallow. Smoking per pack a day. Throat cancer?\n\nhi i have been smoking a pack per day for 3 years am 20 years old now i have a lot of pain in my throat that comes and goes its been on for 5 days i also have problems breathing when i sleep but like 1 time per day it feels like i cant swallow like only once i dont have blood in my spits no pain in the ears i still have m apetite is that throat cancer am really scared",
    "doctor_response": "Hi Moe.hadla, Thanks for writing your query. Smoking has many adverse effects in our body. It can cause chronic obstructive pulmonary disease, lung cancer heart attack, etc. Throat and oral cancer is more commonly seen with persons chewing tobacco. You should get yourself examined and investigated by an ENT specialist to rule out any cancer. Following investigations can be done :- 1. Throat swab culture. 2. Chest X-Ray PA view. 3. Sputum examination. Smoking can result in breathing problems as it can cause bronchoconstriction- narrowing of the air passage. You should gradually decrease the number of cigarretes smoked per day. Medicines, if needed, can be planned according to your clinical examination and reports of the investigations. I hope this is helpful to yo. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a swelling on the elbow crease be treated?\n\nI have swelling in the elbow crease in my right arm. It gets worse when I use my arm and I get swelling farther down my arm. I ve had it about a couple of weeks and it is bothering me more. It isn t due to muscle strain; it may more more vein related.",
    "doctor_response": "Hello, As a first line management you can take analgesics like Aceclofenac or Tramadol for pain relief. If symptoms persist you can consult an orthopaedician and get evaluated. An MRI scan may be required for further evaluation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do coloured urine and stool?\n\nmy 20 year old son has orange/red urine and stool, no appatite for two days, when ate vomited. He takes lithium for bipolor, and had high creatine levels almost two months ago and was told kidneys were shutting down, and then got better.  Just moved to another state and doesn't have doctor yet. He doesn't want to go to emergency because of cost, so a doctors office during business hours would be best.  Worried mom here, what can he do?",
    "doctor_response": "Hi, Welcome to Health care magic forum.                     There are so many causes of the orange colored urine and stools, with vomiting in 20 years old.                     The commonest may be the hepatitis,urinary tract infection, stone in the ureter,or kidney infection etc.                       I advise you to consult a gastroenterologist for diagnosis and treatment.                      He may need to have ultrasound,besides other blood tests for confirmation.                     Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are Bipolar disorders and depression the hereditary problems?\n\nThere is some kind of mental illness that seems to run in my family. It appears to come down thru my father and his father before him. I do have a 52 year old son who is on military disability and 3 weeks he had the flu so badly he couldn't take his medications. I saw a full blown bipolar episode and it scared me terribly. I am living in his home with him to help him because his wife died from cancer a yr and a half ago. When he is taking his medication is sleeps most of the day. Some days he says he feels just awful and other - never wants that to happen again. Now, I have a son who at age 34 committed suicide and had 6 different personality disorders. One of those disorders had to be bipolar from the things that happened in his home. I also have a 40 year old daughter who at around age 13-14 started having a problem with me. She started writing terrible little noted and leaving them on my pillow quite often. We both loved horses so that helped her use up some of that nasty energy she threw at me. All these years she has treated me badly but not many other people except her brothers and me. I am now 72 years old and she was wanting me to move into a basement app't they are building but because of the terrible things she says to me. Her dad and brother were killed in a field with a sprinkler pipe 37 yrs ago when she was 3 yrs old. The brother that committed suicide was 9 yrs old and saw the whole incident. He also started acting mean and up and down with his personality at around 13-14 yrs old also. The son who was 6 yrs old at that time has a brain tumor that discovered when he was 27 yrs old. He never showed the same personality traits as his brother that committed suicide but there were a few problems. After over 14 yrs with the glyoma (spelling) tumor so deep in is head he is doing fairly well after radiation and chemo therapy. I can see where his depression can come from but he is pretty good most of the time. Why would the one son and daughter start changing personalities at around  12-14 years old?   Karen...",
    "doctor_response": "yes , bipolar disorders are sometimes genetically mediated. many papers published on this .ofcourse, certain medisines taken for long time may cause the bipolar disorder & depression.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i contract any infection through saliva of dog?\n\nsir, near to house ,while i was carrying waste (food) carry bag to dust bin, i kept a side near to gate and i was closing the gate .the street dog fetches the carrying waste bag , then i made the dog to get away and carried the bag and throughed in the dust bin, is there any infection will occur to me while the saliva in the bag is touched by me, kindly advice.",
    "doctor_response": "Hello,It should not cause infection unless the saliva got into an open wound. Always be careful to wash your hands after you encounter saliva from any animal.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluid filled sac on the right knee?\n\nI have swelling and pain in my right knee. In Nov. the Rd, drained the fluid from it and gave me a cortisone shot. NowmI am having problems again. Pain and swelling, probably more fluid. I have to hold onto something to get back up if I stoop. Could this be a torn meniscus?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. Your problem is simply recurrent knee effusion , with such cases in my clinic I prefer doing Knee MRI to know the intra articular pathology( meniscal,ligamentous,bony or articular cartilage injury).I advise you to keep your leg elevated ,to use cold compresses,anti edematous and anti-inflammatory medications.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for high bp and trouble in breathing?\n\nblood presure and trouble breathingIt started last Sunday when I woke up with a headache on the left side of my head and my blood presure was 169/113 now I have problems breathing when I walk. short distance of. est 500ft or less the more I walk the harder it is for me to breath what could cause this",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!Regarding your concern, I would explain that based on this clinical symptomatology, it is important to exclude a coronary artery disease or a lung disease.  I recommend consulting with your GP for a careful physical examination, a resting ECG and a cardiac ultrasound, a chest x ray and some blood lab tests: - complete blood count- fasting glucose- blood gas analysis- thyroid hormone levels- cortisol plasma levels (adrenal gland function)- blood electrolytes, etc. A treadmill test and further tests may be needed if suspicions for coronary artery disease are raised. The respiratory tests may be needed to exclude a possible lung disorder. Hope to have been helpful!Best wishes, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low haemoglobin\n\nif a 70 year old female has a hemoglobin count of 8, weak, pale,10 dark stools and is taken to hospital and given 1 unit of blood and it drops to 7 and given 2 more units and only has a endosocopy done and sent home in 2 days but no answers and had 3 more dark stools after going home could there be bleeding somewhere?",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You have low hemoglobin and bloody stool.  You should go for ultrasound abdomen and complete endoscopy.  There should be bleeding somewhere in your gastrointestinal tract.  Search for the cause and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedy to increase weight and breast size\n\ni want to increase my weight as well as breast size naturally. pls tell me home made remedies for me. i read some herbs like fenugreek, fennel seeds, etc. but i don't know how to use it. pls say the usage of these herbs, also pls mention whether should i take this internally or do for massage.pls explain me clearly i need only home made natural remedies",
    "doctor_response": "HIWell come to the HCMIf You want to increase the weight then you can eat more calorie contain diet and this could increase the weight along with this the physical exercise is also advisable this could increase the size of your mammary glands, hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is rheumatoid arthritis curable\n\nHi doctor , I m uma. I m suffering from rheumatoid arthirits for about 3 months. Is this curable.Please let me know what kind of food i need to take.",
    "doctor_response": "Hi Uma, Welcome to HealthcareMagic Forum. In my opinion you must seek advise from a rhuematologist for best treatment of this problem.I would advise you not to delay your treatment as this will worsen the condition. This condition is not completely curable but you can control the pain and prevent damage to your joints.There is no specific food for this, but there are few tips which may be helpful for you. If you are overweight please lose weight, involve yourself in some form of exercise.Swimming is good but avoid situations where you need to strain your joints. Eat plenty of vegetables, fruits,lean meat and low fat diary products. Your doctor will also advise you on some medications to ease pain and movement of your affected joints.Take care and seek medical care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can history of diverticulitis be the reason behind abdominal pain?\n\nHI, I ve been having issues with abdominal pain for the past 3 1/2 days. I have a history of diverticulitis and when this kicked in on Friday afternoon and got a lot worse by Friday evening, I went to the ER to be proactive. They did bw and a CT scan. All was normal but the ER dr did say he felt it was caused by constipation due the amount of stool in my upper section of my large colon and they sent home and told me to take some magnesium citrate. It was 3Am by the time I got home so I took the recommended pain meds (800mg of ibu and 1000mg of tylenolPM) and went to sleep. When I woke up the pain was gone. We had a party so we went to that. After we got home at 4:30 I took the mag cit. It didn t kick in and so at 8PM I took a dose of miralax and within 30 mins, I had very loose stool. I thought that was the end of it. Then this morning I felt mild pain and it built until at by 1Pm it was pretty painful again. I ve had nothing but loose stool for the past 3 days so I don t think it is constipation. I have no fever, no nausea and no vomiting but the pain can get pretty severe, up to a 6 or 7, not debilitating but enough that I cannot concentrate and just want it to go away. Oh, I also just had a colonscopy due to the diverticulitis (had a flare-up in early June) and all came back normal, with the exception of the mild diverticulosis.",
    "doctor_response": "Kindly mention your age and sex also.As per the history one important thing has been missed. Stool examination especially for occult blood. How many diverticulae are there? there might be many and sometime numerous.However, even if there is only single of them it is always prone to recurrent inflammation causing pain, bloody diarrhoea etc...Kindly have a stool examination and physical check-up to rule out other possibilities like amoebiasis, drug reaction or appendicitis.regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for white macular lesion on lower eyelid of a child\n\nsirs, my daughter who is 6 months old now has a whitish macular lesion on her lower lid that started 2 months ago at the lateral part now involving the medial side. no other signs noted. we consulted a pediatrician who prescribed erythromycin ointment. there is no discharge. thank you",
    "doctor_response": "white macular lesion at lower eyelid is not due to infection. this is called as vitiligo. vitiligo at this site usually dont heal by medication. use of cosmetic to cover lesion is appropriate. skin transplant is only cure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am not pregnant, then why is my prolactin elevated?\n\nHi doctor, My periods were two weeks late, so I went to the doctor a couple of days ago, and the pregnancy came back negative. So, I went to have my blood drawn yesterday, and they said I had elevated prolactin. I started my period the day after I went to the doctor (or so I think), and I am bleeding now but no cramping, which is weird for me. Anyway, I have been reading up on prolactin, and it says that it will not release any eggs and you could become infertile. Now I am confused if that is true then how am I on my period?\u00a0 I am scared that I could be pregnant and just be reeving negative tests. Why would my body be producing milk? I have never been late on my prior periods, so I thought I was pregnant, but I clearly am not. I am just so confused. I did not get to talk to my doctor today about my results because I could not get them on the phone and they are closed now. I tend to be a worrier, and this is killing me. My doctor wants me to get re-tested for prolactin, which is what I heard in the message they left. How can you all of a sudden have issues with prolactin if you are not pregnant? This has never happened to me before. I am not sure if it is my period or implantation bleeding?",
    "doctor_response": "Hi. How are you doing?\u00a0Just relax, those are too many questions. Let me say even this anxiety can cause a rise in prolactin. Let me tell you about ovulation and then about prolactin. Hope I have been able to clarify your query, do write back.\u00a0All the best. For more information consult an\u00a0obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on the buttocks without pain?\n\nMy boyfriend had 1 hard nonpainful lump on his right side of his butt cheek for about 5 yrs and just recently notice another one on his left butt cheek what could it be? No pain at all no head on either they dont even stick out you only know its their by touching it.",
    "doctor_response": "Hi,From history it seems that he might be having lipoma on butt cheek.Nothing to worry, keep watch on them.If size increases, consult surgeon and get examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for breathlessness and hole in heart\n\nI am 52 yrs old female 5ft height and 72kg weight, I have hyperteneion High BP and high cholesterol and last year i suffered from miliary tuberculosis and treated for 6 months for it, though the treatment is over i still have breathlessness and when I go upstaris i feel short of breath , my Echocardiogram was done recently and doc said I have hole in my heart. Kindly suggest the line of treatment iam supposed to take ?",
    "doctor_response": "Hello there Your breathlessness on exertion is because of your lung condition and very less contributed by the hole in the heartJust get treated for the lung  with inhalers and hypertension with a bit of diuretics added. If you have pulmonary hypertension sildenafil will help youHope your doctor agrees with this planAll the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the hips on the left side?\n\nI have pain in my left hip that makes it difficult for me to raise my leg to go up steps or raise to put my leg into pants. Also, have lower back pain when standing for any length of time. It does not seem to be in a joint but in my behind, not like a bruise but deeper. I have had bursitis before but it was in my right hip in a different place. What could this be? It has been going on for quite some time now, maybe a couple of months.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I have read your description and in my opinion you are suffering from (L) sacroiliitis inflammation of the joint between pelvis and spine. I suggest pain killers , muscle relaxants and spinal extension exercises. If no relief in 10 days then Local injection of steroid may be required. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of Zinnat and Rhinocort during pregnancy?\n\nhi, I have got sinusitus and my doctor prescribed Zinnat & Rhinocort Aqua for me to take for 7 days. I m 21 week pregnancy and I am so worried about the safety of the 2 medicines. Pls kindly tell me that is there any side effects to my baby. thanh you very much",
    "doctor_response": "Hi,Both of these medicines are considered to be safe during pregnancy. Zinnat is commonly prescribed to treat infections caused by susceptible bacteria. It is not known to cause any harmful effects on your growing baby. Rhinocort aqua nasal spray is commonly prescribed to treat allergic rhinitis and is also considered to be safe during pregnancy. There is nothing to worry take them as prescribed by your doctor.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take Benedryl 2 weeks before surgery?\n\nI forgot to ask my Dr. about taking Benedryl 2 weeks before surgery. I am having sinus surgery at the end of April. I know I am not to take blood thinners, such as aspirin or ibuprofin, but what about my nightly dose of benedryl for my horrible allergies?",
    "doctor_response": "Hi,Yes. You can safely take Benedryl before your surgery to relieve your symptoms. Regards ,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump behind the ear after a temporary filling in molar?\n\nI I went to dentist 2 days ago,and he worked on a  back molar and replaced a very old filling with a temporary one. The next day I felt a lump behind my ear that hurts to the touch. Please advise? My age is 73; wt: 119 Med history. I have had cataract surgery several years ago, 2 back surgeries, and slight;y elavated blood pressure and cholesrtral",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. Just a filling in the molar tooth can not cause this kind of swelling.  But it can be possible that your tooth is infected and this infection has caused the lymph node which is present behind the ear palpable.For this problem you should visit your dentist again and tet x - ray done of the tooth as it will show the spread of infection and if necessary go for removal of the tooth. Till then you should continue with antibiotics. Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a lump on the armpit?\n\nHi, I have developed a lump under my arm just above my armpit, in the last few months. I have seen my doctor and he sent me for an ultrasound. The results were clear and the specialist did not seem to think there was anything there, although I can clearly see it and feel it. It is very soft and sometimes goes away for a few moments and returns. My arm it constantly tingling and the veins in my arm and hand seem to engorge more than normal. No one can tell me what it is. Can you help please? I have a job where lifting heavy tools everyday leaves my arm feeling strained. I am 28 female and small in size. Please help!",
    "doctor_response": "welcome to Health care magic.1.Since ultrasound examination is negative.2.With symptoms of venous engroge you can get a venous doppler study to rule out any varicosities or AV malformations. 3.I would think of any underlying medical conditions / systemic diseases might causing the lymph nodal enlargement.4.Treat the cause if you are known to any thing.5.Try giving rest to weight lifting in your job, which could at least find out the cause ( if reduces means some thing to do with the work related)Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough caused by allergy\n\nMy child a 5 year old girl, is suffering of some kind of cough allergies about 3 years now, she is being treated by a local specialist, he has prescribe a Budate solution for her. the coughing stopped for a little while but now it has started again. its a chesty cough she has it now for about 1 month despite using cough medicine  and the Budate itself it won't stop. Can you give me some advise please. thank you.",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your daughter's history and both allergic and non-allergic causes are possible.My suggestions for your daughter will be as follows:1. Personally I would consider a combination of montelukast and levoceitirizine for at least 2-4 weeks (depending upon response) to her.2. I would like to know the dose of the Budate. Also, I would like to review technique/device of giving Budate to her. (I guess you are nebulizing, it's ok, but I would like to review technique of nebulization also).3. Once montelukast and levocetirizine can control symptoms, I would like to gradually reduce dose of Budate.4. I would suggest you to consult an Allergist-Immunologist who will advice your daughter allergy testing, which will help you identify substances she may be allergic to.5. If any family member smokes, please at least advise him/her not to smoke inside home, if he/she cannot quit smoking.6. Please try to keep your daughter away from exposure to dusts, smokes and air pollution as much as possible.7. A nutritive diet rich in vitamins and minerals (e.g., adequate fruits, green leafy vegetables and sprouted beans) will also be helpful in a long run.Hope above answer will be helpful to you.Wish your daughter a quick recovery and the best of the health.Should you have any concern, please feel free to ask at HCM.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment for mercle cell cancer?\n\nMercle cell cancer is rare, only 1500 cases in the USA per year. My mother in law had it on the cheek, now it appears on her elbow and again on the other cheek. Both are quite large and she has increasing pain in her hip. She is 85 years. What is the best outcome?",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your mother in law's situation and problem. Merckle  cells are cells of skin. And their  cancer is very very rare. Surgical excision with chemotherapy and radiotherapy  are the treatment  options for this cancer. Enblock resection of involved skin with post operative systemic  chemotherapy  and radiotherapy  to the surgical site should be done to prevent  recurrence. Usual life expectancy is less than 15-18 months. And five year survival rate is less than 15-20%. So discuss all these with oncologist and then start appropriate treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cracking in mouth where lips meet and sore jaw?\n\nI noticed the other day the right side of my jaw was sore, but it only hurts when I touch itAnd it feels lumpy. Also the side of my mouth where my lips meet keeps cracking. The cracking goes away and then comes back and Looks open and crusty. I was wondering if the cut caused an infection which is why my jaw is sore? Also I felt the back of my mouth where the jaw pain is and it hurts worse. Thanks",
    "doctor_response": "Hi,Thanks for posting the query,This could be due to vitamin deficiency, allergies.I would suggest you to take multivitamin suplements.Take plenty of oral fluids rich in vitamin C like lemons, oranges.Apply moisturiser over the lips externally.Get a checkup done by the Dentist.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and numbness in the leg while having lumbar herniated disc?\n\nHi . My leg pain began in my left thigh with numbness and shooting pains . Now both legs hurt so bad I want to scream. They are so heavy I can hardly walk. Diagnosis:lymes ,fibromyalgia possible neuropathy . Ruled out M S from MRI . Yes I have bulging disks L 4 and L5 years ago and thought shooting pains and numbness in left leg was from that . Gabapenton helps . Without it my legs shut down .",
    "doctor_response": "Hi,The lumbar spinal nerves are affected the compression of the inflammation of your neurovascualr bundles at levels L4 and L5 . These nerve compressions  irritates your nerves and sends pain sensation to areas supplied by these nerves  . 73% of people showed reasonable to major improvement without surgery. treatment usually consists of non-steroidal anti-inflammatory pain medication (NSAIDs), but the long-term use of NSAIDs for people with persistent back pain is complicated by their possible cardiovascular and gastrointestinal toxicity. Epidural corticosteroid injections provide a slight and questionable short-term improvement in those with sciatica but are of no long term benefit Please click THANK YOU and consider a 5 star rating with some positive feedback if the information was helpful. Hope the above information helps you. Any further clarifications feel free to ask.Regards,Dr. Ahmed Aly Hassan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for two toned teeth?\n\nmy 17 year old son had psoriasis when his second set of teeth were coming through. when the teeth came through they were two toned in colour. greyish at the top and whitish at the bottom. Could psoriasis have caused this and can he do anything to get rid of the two toned teeth. (two toned only on top set of teeth. Bottom teeth fine)",
    "doctor_response": "helloo...read thru ur query...1st of all i can say its nothing to be worried at all...since it is discolouration from inside it has to be treated with bleaching treatment...it has different methods of bleaching...so go to an endodontist..he can look at the clinical condition and he may plan the bleaching...its an easy procedure..nothing to be worried at all..hope ur benefitted something from this!!have a healthy day!!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sore elbow after hitting at desk\n\nI hit my elbow on my desk at work. it was a pretty hard blow about 3 weeks ago i still cannot lean on a specific spot on the elbow and soar to touch. no swelling or brusing does throb into hand occassionally. when i touch the elbow I feel a dent in a specific spot then feeling around the elbow i get sharp pain",
    "doctor_response": "Hi, Please get your X-ray done, give hot fomentation, apply diclofenac gel, take over the counter painkillers, and if X-ray is normal than take physiotherapy. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Jaideep Gaver, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from anemia. Taking iron pills, tiredness, moody. History of bleeding ulcers. Cure?\n\nlat year I had 3 bleeding ulcers and had 4 unit of blood given to me, my HGB was 6 at the time. Now this year I am anemic on iron pills. My iron is 27, iron saturation is 7, ferritin 10, WBC 4.1 and RBC distribution is 16.8. Should I be concerned? Before I was prescribed the iron pills, I was tired, moody, exhausted and now I feel better being on pills. My HGB now is 12. Thank you",
    "doctor_response": "Now that you have improved with your blood levels, don't bother. Get the stool for occult blood checked. Add lot of green leafy vegetables in your diet.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for itching and swelling in foot, ankle, and leg\n\nHello! I get ringworm once or twice every summer, so I m familiar with it and know what it is when it happens. I recently got it again, however this time it s on my ankle. My foot, ankle, and leg is swelling up. The skin is tight and the ringworm is, of course, itchy, but I m not experiencing any pain. The ringworm area is warm to the touch too. However, the swelling keeps getting worse. Does it sound like I have an infection? Should I go to the doctor to get antibiotics? Or will anti-fungal meds do the trick?",
    "doctor_response": "HI, thanks for using healthcare magicFungal infections can be associated with increased warmth and swelling if the infection is extensive.If the infection is extensive, it may not respond to topical antifungals and then oral antifungals would be needed.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can omnacortil tablets help in decreasing platelet count?\n\nsirI am manjunatha from dandeliMy mother aged 65 yrs every week her platelets counts decreasing and doctors gave Ominicortil tablets, since then her sugar count is started increasing. This happening since last one month.mailid:  YYYY@YYYY",
    "doctor_response": "Hi manjunatha,Omnacortil is a corticosteroid. Looking at the details provided, if the cause of reduced platelet count is immune mediated due to antibody production (immune thrombocytopenic purpura), then it will be helpful.Corticosteroid are known to increase sugar level and dose needs to be changed.If required, insulin can be started or diet control can be tried.If the platelet count is not improving, other cause related to bone marrow needs to be identified.Any further queries, happy to help again.Dr. Prakash HM",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am 18 weeks pregnant and I am wondering why am I not able to feel any movements.\n\nHello doctor, I am 18 weeks pregnant with my third child, and I have not felt any movement or had any symptoms of pregnancy. I am wondering why I am not able to feel any movements.",
    "doctor_response": "Hi. Ideally, in multiple pregnancies, the baby movements are being perceived by 16 to 18 weeks. You may wait another week and then go for your antenatal visit and get an ultrasound scan done. You are already due for your anomaly scan between 18 to 20 weeks. That should answer all your concerns.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medical condition causes a skin lesion on the penis?\n\nI seem to have developed a skin lesion on my penis. I have not had sex in a while so its not a sexual disease. it is light brown in color sometimes is flat and at other times seems filled. i have only had it for a short time and noticed it just recently and didn t like it. No pain no discharge no discomfort doesn t effect my erections or urination.",
    "doctor_response": "Hi, Difficult to comment without seeing directly or pictures. Unlikely to form a skin lesion on penis. Feel free to ask your doubt with more details. Hope I have answered your query. Let me know if I can assist you further.  Regards, Dr. B. Radhakrishnan Nair, OBGYN",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for a high bp\n\nmy grandma's bp is 204 over 92 and she takes lisinopril -her doc just increased the dose from 10mgs to 20 a day... however it seems by the end of the day her bp goes back up to the 204 over 92.  We just started the 20 mgs today... she took one at 5am (bp was high) and another at 9:30 am.  Bp was fine all day.  Just took it before she went to bed and it was high... we will call and schedule an appointment with her doc tomorrow for this week.  She has had a history of high bp.  Should we space out the pills 12 hours apart?",
    "doctor_response": "Hello, Thanks for posting your query on Healthcare Magic...* Brief Answer: Lisinopril is a long acting drug should be once daily. it may be needed to add another drug at night.*Explanation: My opinion is that high blood pressure on many occasions is an indication for control .That happens on many levels. First, be sure that high blood pressure is not secondary to any other diseases as Cushing or renal failure.Then ,Diet with low salt and less fat content is crucial. Exercise and other healthy activities are also a mean to control blood pressure. If all that dose not help, medications are a must .That is usually decided by your doctor according to your condition and comorbidities .Some drugs that are perfect for patients are not necessary good for others.Regular blood pressure monitoring is as important as starting treatment so that we could assess efficacy of the medication we started.I suggest my patients the following : take lisinopril once in the moring , add another drug at night according to their age gender and risk factorsThe information provided by you is not sufficient to provide a good opinion. If someone comes to me with this condition I would ask them about other comorbidities like diabetes, hyperlipidemia etc.*Conclusion: I suggest you stick to a low salt diet and consult  your physician about your grandma's  medication.   If you have any further questions I will be happy to help, If not, you can close the discussion and rate the answer. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes injury in the shoulder post an accident?\n\nI fell 8 days ago and injured shoulder. I grabbed a limb as I was falling then dropped 8 ft. Pain has decreased, but it is still painful to reach up and up/ out. I am confident there was not a break, but not sure how long to expect this to resolve or if I need to see a doctor...suggestions?",
    "doctor_response": "Hello,Thank you for using Healthcaremagic.I read your question and understood your concern.I think you need to see a doctor definitely. It may be a fracture too.Dr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What neurology treatment should I take for my mom who has mood swings and speaks alone ?\n\nhi i m sheetal here. my mom is suffering frm some neruology problem frm past 10 yrs...//we dont no exactly wt it is? she is speaking alone...she will scream , she is getting angry soon........// plz suggest me wt kind of treatment is usefull for my mom",
    "doctor_response": "Hi,Sheetal, Thanks for query, This is due to senile changes in the brain causing problem. Consult psychiatrist and seek advice. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hypokalemia?\n\nI did a 24 hour urine w/o creatinine and the results came back as follows Creatinine 1.24 H eGFR non African American 52 L and creatinine clearance 71 L. Can you tell me what this means? The reason for the test is because I have a history of hypokalemia and we are trying to find out why. I am on Klor-con 8 er three times a day and my levels stay from 3.1 to 3.2",
    "doctor_response": "Hi I did review your concernHypokalemia can be due to multiple reasons ranging from kidney problems to gi problems. Most important is to rule out whether you have concomittant hypertension with it or not to rule out any adrenal problem.your creatinine is slightly high and creatinine clearance and eGFR are low indicating that your kidney is not excreting metabolites properly.I believe what now needs to be done is and arterial blood gas analysis and detailed study of your urine in terms of 24 hr potassium in urine analysis and blood urea nitrogen.I hope this helpsLet me know if you have any more questions or concerns.wish you all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe back pain post miscarriage\n\nI had a miscarriage three weeks ago (at 8 weeks pregnancy), after a lot of back pain and cramps for weeks before the bleeding started. Anyway, since the past week, I have been experiencing similar back pain and cramps again. What could be the reason?",
    "doctor_response": "post misscarriage cause pain due to streching of inner pelvic muscles.it will be normal soon.take some medicines if lots.and make sure misscarriage is perfect.if there is reminants might be cause of abdominal as Well as back pain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Polycystic ovarian disease, progyluton for ovulation, clomid to conceive ?\n\nim trying to have a baby my dr told me to take progyluton cuz i have polistic ovaries and i dont ovulate my question is after this medication are they going to prescrine clomid ?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice. Progyluton has been given to you to regularize your cycles. Once the cycles become regular, ovulation-inducing drugs like clomid are given along with serial ovulation studies to find out the effect of these drugs on your ovaries. Intercourse is then advised when mature follicles are formed.I hope this information has been both informative and helpful for you. Let me know if I can assist you further.Regards, Dr. Rakhi Tayal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Raised blotchy rash, been in contact with sick people. What could be this?\n\nhello doctors,first off thank you for your time and service. i have recently been having this raised blotchy rash that is itchy and the color is slighty red/pinkish(i'm african american not very dark or light skinned). i believe the rash started mid last month and would come and go. originally it began on the torso never on my chest area but both sides of my serratus anterior. then there was a week or two where it hadn't appeared at all. about a week and a half ago it started again but on my upper outer thigh area, and yesteday it began on my neck. it gives me reason for concern that i may have hiv. i say this because i believe i may have been at risk in early feb and within a week of possible exposure the lymph node in my groin swelled up and it eventually started to hurt alot but this only lasted for a week and then appearantly it ruptured and this milky smelly fluid leaked out for 2-3 days. after that no more groin problems just an occasional sore throat but around that time i had been in contact with a few sick people so don't know if the signs are related to my concern. anyway the rash is consistent and would like to know what you think and if there is anything information you may need please ask.",
    "doctor_response": "HiComplains of raised blotchy itchy rash coming on and off suggests you have urticaria.If duration of symptoms is less than six week yhan we call it acute urticaria and if it is more than six weeks we call it chronic urticaria.Duration  and line of treatment will depend on severity of the disease condition.Oral antihistamines usually helps but occasionaly oral steroids may need to be given.Blood investigations like serum ig e level may be needed to be done, decision being case specific.Hope this helpsFurther information can be provided by your dermatologist only after examining the area.RegardsDr amit",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had dental abscess. Had an extraction. Having foul discharge from nose and mouth. Prescribed ibuprofen. Suggest?\n\nHi, I had a dental abscess , from an upper right tooth , and I had an extraction today. I am having a large (I think) amount of foul, purulent discharge draining from my nose and mouth today. I gather that this is normal, that the abscess found a way to drain. What I am wondering though, is this - should I not be on antibiotics for the infection, as well? I am running on-and-off low-grade temps. They prescribed ibuprofen and acetaminophen for the pain, which I have been alternating every three hours as they told me, as well as soft foods, no sucking or spitting, etc. Any help at all is appreciated.",
    "doctor_response": "Hello and welcome to HCM forum, According to the dental history provided by you i would like to inform you that when a tooth is associated with an abscess, antibiotics have to be prescribed in order to treat infection. It is pus which is discharging and is responsible for foul odour , once the infection resolves, pus will disappear . Fever is also one of the symptoms associated with infection, currently your medication does not include antibiotics, therefore kindly see your dentist. Perform warm saline rinses(3-4times/day), it will help relief symptoms. use an antibacterial mouth rinse(twice/day). i hope i answered your query, i wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is surgery necessary for a nasal polyp?\n\nHi doctor, I visited an ENT two weeks ago for a check-up after noticing my tinnitus which I have had for more than a decade was slightly worse in one ear. He did an audiogram and balance tests and said my hearing was fine and not affected by the tinnitus, and that the cause was extra-cranial. He suggested taking Betahistine and Loratadine. During the examination, he also looked at my nose and saw a polyp in my left nostril. He then scheduled me for a nasal endoscopy. The endoscopy confirmed the polyp in the left nostril or sinus as well as a deviated septum and enlarged turbinate. I was then referred for an X-ray and CT scan. I will attach the CT scan report. According to the ENT, it is a case of a unilateral polyp and because of its size, it is a surgical case that will not respond to the nasal steroid spray he prescribed after the first visit. He asked if I had any pain or other symptoms and I said no, I have had no snoring, no sleep apnoea, and no pain, only the odd post-nasal drip which I have always had since childhood. Since I have (controlled) hypertension and type 2 diabetes he said the surgery was a risk but he recommended it, but I needed to discuss it with my GP and endocrinologist because of the risks involved. My main worry was that the polyp could be something malignant, but he seems to have ruled this out based on the endoscope and CT imaging. My feeling is that if I am not having any symptoms, and due to the risks of surgery and the likelihood the polyp will return after surgery, it is not a good option for me right now. I am basically looking for a second opinion, taking into account the CT scan results, is surgery definitely indicated now or can a waiting approach be taken? The tinnitus issue sort of fell by the wayside the Betahistine and Loratadine caused headaches. So I have not been taking them. All focus for now seems to be on this polyp issue. Currently, I am taking Nebilet, Dexilant, Glucophage, Victoza, Allopurinol, and Exforge HCT.",
    "doctor_response": "Hi. I have seen your CT scan reports (attachment removed to protect patient identity). I will want to see CT scan films myself. The typed report says that there are extensive polyps for which medical management might not be enough but I want to see films myself in all the cuts (axial, coronal). You have mentioned that you do not have any symptoms like a headache, nose block, snoring, sneezing, but tinnitus can also be due to polyps. Extensive polyposis can block eustachian tube and can cause a ringing sensation in ears (left ear). As of now you send me CT scan films and also you start taking steroid nasal spray twice daily (one puff each nostril) for six weeks (local steroid spray does not have any side effects, so you need not bother about that). For more information consult an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the ideal parameters of normal and healthy semen ?\n\nhello , I have just recived my Semen report and according to it Do tell me my result , is it normal or .... ? SPERM COUNTS : total count (million/ml) 0.05 Live count (million/ml) 0.05 MOTILITY Slow/Non linear Progression 100% Test Prepration Data preprapation methor ISOL Vol used 2.0 Ml total count (million/ml) 0.1 Slow/Non linear Progression 100% and in the comment section a note is written :- \\",
    "doctor_response": "Hi,Welcome to HCM.You have not provided the complete report.Your total sperm count is too low.Actively motile sperms seems to be 0 %.You need to undergo a thorough investigation by an Urologist, who will have to do various tests including Colour Doppler Study of scrotum and if indicated, testicular biopsy.At present your semen test is not satisfactory.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cracks on the back?\n\ni took my 4 month old to see a chiropractor on saturday, and was told that two of his bones on his spine was dislocated, the chiropractor cracked his back and he was fine after that. we took him for a follow-up yesterday and i was shocked that he had to crack his back again but on a different part of his back and this time it seems much more painful. i must contact the chiropractor next week wednesday to let him know if my son has improved. my question is do i have to take my son every week now to have his back cracked? and why is this happening why won t the bones stay in place is it something i m doing am i not holding him the right way or puting him down to sleep the wrong way. please help i can t see my son in pain whenever he s back get cracked.",
    "doctor_response": "Hi.No 4 month old child should ever--ever--be treated by a  chiropractor, especially with adjustments like what you're describing.He needs to be seen by a pediatrician to have his back properly evaluated and treated",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat chronic hip and shoulder pains?\n\ni have been diagnosed with herniated disc s, sciatica and have had mri s done for my back problems, and have been given shot s in the past for the pain, but it keeps coming back. i ve suffered with this for years. now i also have extreme pain in both my shoulders and i m unable to raise my one arm up, and if i move wrong, both the shoulders suffer with pain. i have gotten shots in my shoulders for the pain too, but it keeps coming back, and at this point the pain in my shoulders, and my hip, are getting worse! i am seeing an orthopedic doctor next week, but i am also considering consulting a neuro surgeon. the doctors seem to not know what to do for me, short of having surgery on my spine. can you help me out as to what you feel is going on with my body? i m 71 years old.",
    "doctor_response": "hi,thank you for providing the brief description of your history.As by looking to your case. I will recommend to undergo physical therapy like - Therapeutic ultrasound therapy and TENS therapy. This will help to reduce the pain. Also, you will be put into the exercises for the lumbar spine and cervical spine. The overall body conditioning will also be performed. Based on the improvements you will be assessed and moved further for the exercises which will be focus on strengthening. As to understand here is - your age is 71 and the ageing process is on. So there will be a wear and tear of the tissues. also, by taking medication or the cortisone the symptomatic relief will be good but also, post the symptomatic relief you need to undergo physical therapy.In my personal practice of dealing with geriatrics we induce protocol only taking to rest, medication and physical therapy. We found a 99% success rate.Also, to confirm the extent of the soft tissue Injury which is compressing the nerve roots , an MRI can be performed which will help further the physician for the medical prescription.Your indulgence in the exercises will be of importance as the muscles at this age needs strength for the propulsion of the body.with physical therapy the patients which I see are benefitted. and I expect same from you.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain, fever and pain, possible virus. On antibiotics. Any other solution?\n\nMy daughter has been complaining of stomach pain or feeling \"icky\" on and off for past 5 days. Fevers associated with pain. Doctor said probably virus but gave a prescription for antibiotics in case it didn't get better. Just gave daughter first antibiotic dose. She complained of pain when I rubbed her tummy, around belly button area and around the left low back, just under lower ribs. Is there anything else I need to do besides antibiotics?",
    "doctor_response": "Hi,Ask her to take plenty of fluids and fibrous diet. Give her a course of albendazole (1st and 15th day) anti spasmodic drug like hyoscine after discussing with your doctor. If symptom continues then she may require one USG abdomen and pelvis to rule out any pathology.Hope this helps you.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had a pomery tubaligaiton. Want to tie the tubes. Have six children. Have PCOS. Hard to get pregnant?\n\nHi i had a pomery tubaligaiton approximately 5 months ago and i am regretting evere deciding to get my tubes tied, i have six children to include my last pregnancy and would love to become pregnant again, after reading different post online im a little discouraged knowing that it may be impossible for me to ever concieve again not to mention i have pcos which according to many doctors makes it hard for me to get pregnant...APPARENTLY not right..however i wnat a reversal just not able to afford paying the charges associated with doing so...PLEASE HELP!!!!",
    "doctor_response": "Hi,If you have undergone tubal ligation, you have to get reversal surgery done. If its successful, you can conceive. If not, you have to undergo IVF.Regards,Dr. Mahesh Koregol",
    "dialogue_context": ""
  },
  {
    "patient_message": "When does pregnancy occur after having intercourse?\n\ni hope you can help me with my problem. Im half way in my pregnancy but i am not really sure who the father is. I first had my period round the 11th or 12th of june. My ovulation should have been round the 26th. I had sex with friend A on the 25th and 26th, and he came in me. Two days later i had sex with friend B, we did it twice in a row, but both times he didnt come in me. and i took \"the morning after pill\" the day after. So after that i had my period on the 9th or 10th of july (dont remember exactly). After this i have only had sex with friend A, havent had sex with friend B since that one day on the 28th/29th of june.. On august 5th when i should have gotten my period ( i have a cycle of 27 days every month ) I did a clear blue indicator test and it said was conceived 1-2 weeks, which means i was 4 weeks pregnant at the time. Period stayed away, i only had a little bit of brown blood like 2 weeks later when i was about 7 weeks if i remember correctly. I had an ultra sound on sept 2nd and my gyn told me i was 7 weeks and 5 days. I am so worried the period i had on the 9th of july wasnt a real period at all ( if i remember correctly i had it for about 3 days which i almost always have when on my period. but i dont remember if it was as heavy as regular ), and i am contstantly telling myself the indicator from clear blue can be wrong as well... I have also smoked cigarettes ( i stopped when i was 8 weeks ) so now im also telling myself because of the smoke the baby was smaller then she should be and that she wasnt really 7 weeks but more like 11 weeks from the month before... But on the ultra sound she really was a little shrimp, couldnt really tell it was a \"baby\"... im just losing it and i really want to hear ur thoughts.... Thank you for your help in advance.",
    "doctor_response": "Hi,You are pregnant with friend A, and your last menstrual period was on 9/10 of July. This corresponds to your ultrasound dates and your urine pregnancy result as well.Do not be anxious about it. Though the baby forms only after ovulation, the pregnancy is always calculated from the last period day, which might be confusing you.Do not worry and the early pregnancy ultrasounds are very accurate in diagnosing the exact dates of pregnancy .You were wise to stop smoking, but smoking will not cause the early fetus to shrink as you have described. Smoking usually causes the baby in the last trimester to be underweight by 500 gms or so.It doesn't affect so early in pregnancy. I would advise you to stay away from smoking and take help from smoking cessation services if required.Do not worry.Hope this helps .Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My face is red and inflamed after a chemical peel I did myself. Please help.\n\nHello doctor,Five weeks ago, I did a much too deep Jessner and a 30 % TCA combination peel myself. I swelled so much 24 hours after the peel that my eyes almost shut. Yes, this was a terrible mistake. My face is still red, but slowly resolving and I have been keeping it constantly moist and have been using aloe to reduce inflammation. I have two areas on either side of my forehead that are starting to worry me. When my skin first peeled they were quite deep red, not bleeding, but almost like a road rash. The rest of my skin was red but not a deep red. These areas healed quickly but now are forming a different texture from the rest of my skin. I can feel the texture difference to the touch. I believe they are starting to form scars. So my question is, Is there anything that I can do to reduce or prevent the scar formation? I have read that massaging the area aggressively helps break down the excess collagen formation, which is what I have been doing (with my fingers), but now the area appears red and irritated from the massage. Before massaging the area, it was not red or irritated. I can definitely see a texture difference. Should I continue with the massage to try to prevent the scar tissue from forming or is this making things worse? Any help would be appreciated. I live in a country where it takes months of waiting to see a dermatologist. I wish I could just walk into an office tomorrow. Please help.",
    "doctor_response": "Hello. I have gone through your query and viewed the images (attachment removed to protect patient identity). Regards. Revert after two weeks to a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause for blisters on the feet, hands, buttocks and legs in a six-month-old baby?\n\nMy 6 month baby had a fever with high temperature and two small blisters on her back when showed to a doctor he told its a viral infection and provided the medicines :panadrex,fucitin,primalan and julphamox.the fever has gone but the body including two legs,buttocks,hand,under the feet are covered with blisters.what to do doctor?how to treat this condition?",
    "doctor_response": "Hi, Your child is having HFMD.HFMD - hand foot mouth disease. It is a self-healing viral fever. No need to worry. It will come down on its own. No specific antiviral drug is available. We have to treat symptomatically. It will not cause serious problems. You can revisit your doctor for symptomatic treatment for blister and mouth ulcers. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Rajmohan, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful rashes on hips and legs of a child?\n\nyes. my son is 20 months and in the past 2 days has developed these things on his legs. i thought they were mosquito bite but they hurt him now. They r on his hips where the outer part of his diaper rubs it. Not sure if this is making it worse but it definetly getting worse",
    "doctor_response": "Hi...it can be an insect bite allergy but at the same time, when there is severe pain it could also be a condition called Henoch Schonlein Purpura. I suggest you upload the photos of the kid in the website or consult your pediatrician with this tip.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for hip and leg pain causing by chest infection?\n\nHi, I have been prescribed steroid tablets and clarithromicin for a bad chest infection. Since I started with the chest infection my legs and hip have been aching which is more noticeable at night. I was wondering if I can take paracetamol with the above? I was worried of the amount id be taking as I need 6 steroid tablets everyday for 5 days. Thanks Leanne",
    "doctor_response": "Hello dear, thanks for your question on HCM. I think you should consult pulmonologist and discuss your problem again.As high dose steroids are not given in lung infection. Steroids actually flare up the infection and worsen it.Your hip and leg pain can be due to 1. Infection2.  Steroid induced myositis. So better to consult pulmonologist and discuss all these. You may not require steroids.",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI reported nodular T2 hyperintensity scattered within the periventricular and subcortical white matter bilaterally. Meaning?\n\nFollowing an MRI with and without contrast, the report indicated that my husband has punctate and nodular T2 hyperintensities scattered within the periventricular and subcortical white matter bilaterally. Could you give me a fairly brief explanation of what this means for his future health and if it might be related to Alzheimer s disease. Thank you !!",
    "doctor_response": "Hi, Thank you for posting your query. I have gone through the MRI brain reports of your husband. The most common condition, which can cause these findings, is migraine. In addition, we need to exclude a diagnosis of ischemia (lack of blood flow to brain). This can occur in patients with high BP, sugars, cholesterol, etc. These findings generally do not suggest a higher risk of developing Alzheimer's disease in future. I hope it helps. Please get back if you require any additional information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair loss\n\nHi Doc.....I m 25yrs old female, from India....suffering from hair loss.....I have very less hair left on my scalp, more specifically hair are not sufficient enough to cover the scalp entirely....scalp is visible from every where....and because of this my confidence is reducing day by day.....and I am scared what if one day I become bald....I have researched a lot on the internet and I think I am suffering from telogen effluvium....please guide me what to do about this problem and also how can I confirm whether it is telogen effluvium or sum kind of alopecia....pls doc tell me which test I should undergo in order to know the problem and the treatment to reduce the frequency of hair loss....I m supposed to get married after 9 months I m really worried please help.",
    "doctor_response": "Hi Dear,Understanding your concern. As per your query you have symptoms of hair loss which seems to be due to compromised immunity of body, stress, systemic conditions, improper hygiene, fungal infection and hormonal changes.Need not to worry. I would suggest you to - Avoid covering your hairs with cap/hat or longer duration.- Take diet rich in supplements like Vitamin A ,Omega-3 and Vitamin E.- You should avoid using shampoos that contain excessive chemicals. - Take protein rich diet and healthy food intake on daily basis. - Do massage of hair scalp on daily basis.If symptoms keeps on persisting visit dermatologist once and get it examined and start treatment with antifungal medication and shampoo. Go for blood tests to check any underlying systemic pathology.Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicine for fair skin\n\nHI DR M FROM INDIA BANGLORE MY SKIN COLOUR IN BROWN NOT EVN SO DARK BUT MYREST OF BODY IS FAIR IAM 23 YRS I HAVE BEEN TRIED MELAGLOW , KOJIC ,BUT I DIDNT FIND ANY DIFFRENCE IN MY SKIN COLOR I DONT HAVE ANY ACNE PROBLEM R ANY DARK SPOTS OR ANY SUCH PROBLEMS CAN U GUIDE ME THE RITE CREAM SO DAT IT CAN GVE ME FLAWLESS FAIR SKIN",
    "doctor_response": "Hello,Welcome to healthcare magic.Your skin tone is determined at the time of your birth itself and it is decided by the concentration of melanocytes and circulation. Therefore any treatment or procedures can never make you fairer than what you were at the time of birth. But most of the people will acquire more pigmentation as age increases, we call it facultative pigmentation. Lot of factors determine it, most important being sunlight, others include dust, pollution, smoking, less hydration, intrinsic ageing and free radical damage, stress etc.Treatments should be to bring your pigmented skin back to your normal skin tone and make the skin tone even all over the face. I would recommend you to use a face wash twice a day ideally a one containing glycolic acid as it helps in exfoliation and to even out the skin tone.The most important product will be a sunscreen. Half an hour before going out apply a sunscreen and reapply it every three to four hours. At night you may apply a lightening cream containing kojic acid over the face before going to sleep.You may consult a dermatologist practicing cosmetology for few sittings of chemical peels for faster improvement.Hope this helps.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of the brown spots on my penis?\n\nI have brown spots on my penis after having what I thought were genital warts removed with cauterization (They may have been follicilitis or Fordyce spots, as none of my partners every developed HPV). Although, the urologist removed most of these bumps, one remains. How can I get rid of it and the brown spots?",
    "doctor_response": "If it is increasing in size or causing pain or discharge then you can get it removed with help ofa Urologist. Are the brown spots on the penile shaft or the tip or glans. If they are not causing any problems then you need not get them removed. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I getting pregnancy symptoms and test to be negative?\n\nI recently had my mirena taken out, I menstrated about a week after then again a week after that. I'm now about a week late and showing several pregnancy signs but every hpt I take comes up negative. I had several negative hpt's with my first pregnancy, could I be pregnant again?",
    "doctor_response": "Hi dear, I have gone through your question and understand your concerns. Irregular periods can be due to effect of the hormones released from the Mirena released in your blood.The effect continues for next 2-3 cycles.Negative urine pregnancy test rules out pregnancy.However, you can get the blood test done to confirm the pregnancy.Hope you found the answer helpful. RegardsDr Deepti Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat collapsed lung and stage 4 lung cancer?\n\nHi, my dad is in the hospital, they thought he has pneumonia, but after CT scan and ultrasound they said his lung collapsed and he look like has cancer that spreAd, stage four. They took some fluids out and sent to biopsy. If that is cancer stage four what is his life expectancy? He is on coumadin 7 mg a day, because of stroke, and he is 65 years old. He had stroke 8 years ago. Also he is smoker. Thank you",
    "doctor_response": "According to literature survival in stage 4 lung cancer is around 6months. This can be prolonged to around an year with chemotherapy. Though chemotherapy doesnt improve survival much in lung cancer, it brings changes in quality of life and patients feel better as long as they are alive",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe leg pain while on Reclast treatment?\n\nI have had 3 Reclast treatments. Last treatment March of 2016. I m having pain in entire left leg after walking, but it is only in the PM when trying to sleep. Pain is more extreme in thigh and groin. PCP says arthritis, in h ip but could this be related to reclast treatments?",
    "doctor_response": "Hello, Reclast treatment (once annual Zoledronic acid IV infusion) can cause unusual fractures in the femur (thighbone). Get x-ray Hip done. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Tushar Kanti Biswas, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain/inflammation in lower right corner of mouth?\n\nI've got pain and inflammation in the lower right corner of my mouth. It is very painful and hurts when touched. When I yawn I get a slight earache while my mouth is open. I've tried a lot to ease the pain but nothing has worked. Could this be my wisdom tooth?",
    "doctor_response": "thanks for your query, i have gone through your query. the pain in the corner of the mouth could be because of the infected wisdom tooth or the gums causing pericoronal abscess or pericoronitis. consult a oral physician and get a radiograph done and if sufficient space is not there for the tooth to erupt then it has to go for extraction, you need to take a couse of antibiotics. do saline gargling. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is numbness on the base of the neck a symptom of a pinched nerve?\n\nHi, I have ongoing numbness and the base of my neck between the tops of my shoulder blades. It is always numb to the point where i cant feel anything touching it. I also have periods were a tingling sensation radiates out from it. This has been ongoing for years but am only 28. Is this more than a simple pinched nerve?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Numbness may be due to herpes zoster infection or root compression or disc prolase or neuropathy etc. Until examination is done it is difficult to say what it is. Avoid heavy weight lifting, avoid smoking, avoid in even pillow under your head. Use cervical soft collar, use tablet Pregabalin once daily for five days. If symptoms not improved please consult your orthopedics he will take x-ray cervical spine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tiredness and irregular heart beats after exercising?\n\nDear Sir, i have a question in distinguishing a heart problem and deconditioning...i am 29 years old, previously professional athlete for 10 years but limited my activity due to arrhythmia episodes which were PSVT mostly but many many many PVCs as well...my functional class also reduced to III class...now i am apparently in calss I but i have two questions which i am not able to answer...i have started jogging on tread mill with 6th speed for 20 min daily...during jogging not any problem max one or two PVCs but about an hour after stopping the sports my heart beats becomes irregular...many PVCs as if even simple movement triggers it, chest discomfort and it may even linger to many hours if i get really tired...i am not able to distinguish whether this is deconditioning or still my heart is not doing well?",
    "doctor_response": "Hello, I passed carefully through your question and would explain that your symptoms could be related to an electrolyte imbalance or dehydration, probably caused by jogging. Coming to this point, I would recommend checking your blood electrolytes. An ambulatory 24-48 hours ECG monitoring would help exclude possible cardiac arrhythmia. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will there be any side effects using the sun tan removal creams?\n\nI wanna know the side effects of melaglow cream.I have been using since a week on doctors recomendation... Even if I get exposed for sun just for 5 mins my face gets tanned easily and have been using sunmate cream since 2 months.doctor had told me to continue it for 2 more months and m to use melaglow cream at night",
    "doctor_response": "Hi, Based on the history you have shared, it's better to use recommended sunblocks in such cases if your skin is prone to sunburn so quickly. Any formulation above SPF 30 is better however dermatologist review should be sought for a long term solution. Meanwhile, you can continue the formulation you are using. Depigmentation creams are not required for long at this stage. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Saddiq Ulabidin, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is traveling safe while suffering from bronchitis?\n\nI just found out I have bronchitis, and suppose to fly out on Friday... Its Tuesday, and I have the antibiotics to help. I also have high blood pressure but the bronchitis is pretty bad, almost pneumonia. Is it safe to travel.. Plane ride is 1hr 45 minutes. And then a 45 minute ride. But I m going from cool weather to pretty warm weather",
    "doctor_response": "Thanks for your question on HCM. In my opinion you can fly. No need to worry much. Bronchitis needs bronchodilator treatment along with antibiotics. So better to consult pulmonologist and start inhaled bronchodilators.Inhaled treatment in the form of meter dose inhaler containing LABA (long acting beta 2 agonist) and inhaled corticosteroids are mainstay of treatment. So better to start this so that your bronchitis can get controlled before air travel. And you can also use inhaled treatment in plane.So better to consult pulmonologist and start inhaled treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Headache, night sweats, CT scan shows sinus infection, red plaques on skin. Any ideas?\n\nMy mother-in-law is 76 years old, she has been suffering from headaches for over 3 months. She also has night sweats . She had a CT scan done and all her sinuses are badly infected . She has been on steriods and antibiotics for them and has been seen by an ENT specialist who has blown out the easier to reach sinuses. She still has the headaches, she also gets red plaques on her skin for no reason and then they go away. The specialist seems to think she has allergies and will test her next week with a special allergy test that is subcutaneous instead of the pricks on the surface of the skin. She has had several stents put in her heart several years ago and her breathing is not as good as it could be be other than that she is good. I am not convinced that it is allergies. Any ideas?",
    "doctor_response": "Hello, Headaches and night sweats can have several different causes and hope the CT scan of the paranasal sinuses also covered the head and excluded intracranial pathologies. Also thyroid function test would be an important test here. The red plaques are probably unrelated to the headaches and night sweats in time, and if they are itchy red lesions slightly raised and disappear without a trace it means urticarial eruptions. Here too thyroid autoimmunity plays a role and therefore best to exclude with TPO antibodies. I do not knwo what subcutaneous tests your doctor is going to offer but cannot be more sensitive than skin prick tests. Occasionally multople cardiac medications can cause the urticaria, so please check these out and discuss with your doctor. 80% of patients with urticaria do NOT have allergies. Long acting antihistamines non-sedative are usually fine but in the elderly needs some caution as it causes dryness of mucosae. Hope this helps. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why are there vomiting and headache in a hypertensive patient?\n\nHello doctor, My mother is suffering from a vomiting and acute headache from the last two weeks. I have visited a local doctor and he has suggested some tests. After doing all the tests he prescribed some medicine for vomiting and headache. But the problem continues. When we revisit the doctor he was suggested for MRI and further blood tests. I have already done all the tests. I am sharing the test reports with you. Please check the reports and suggest what kind of treatment she needs to recover from the problem. My mother has hypertension and essential hypertension and taking Telma 40 and TVS 10 medicines from the last one year. Also taking Vasograin for an acute headache.",
    "doctor_response": "Hello. I have seen the MRI brain report (attachment removed to protect patient identity), suggesting multiple sebaceous cysts in the brain, and ring like enhanced lesion on cerebellum (small brain) right side which can be infective lesion like tuberculoma, neurocysticercosis, toxoplasmosis or tumor lesion like astrocytoma or medulloblastoma or secondary metastatic tumor or may be benigntumor. That is why she is developing that condition. Her condition might be worse if she will not get proper attention. Kindly follow following instructions. Admit her in any hospital under neurologist. Keep her in ICU. Make her BP stable. Go for diffusion-weighted MRI for a clearpicture, CT thorax to rule out any lung or breast malignancy. Do lumbar puncture and CSF fluid analysis. Rule out through blood cultures any parasitic, worm, bacterial or viral infection according to that treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Would Exelon patches help cope with short term memory loss?\n\nI am 72 years old and I have therapy appointments weekly with a clinical neuropsychologist. My therapist and my wife have noticed me having short term memory loss. Would you suggest that I use Exelon patches? If your answer is yes, what strength would you suggest that I start with? Thanks YYYY@YYYY",
    "doctor_response": "Hello,Yes I suggest you to use Exelon patch which will increase acetylcholine in your brain and decrease the symptoms of dementia. Initial dose of 5 to 4.6 mg/24 hours. Gradually increase according to the clinical response, best tolerated dose after minimum 4 weeks treatment is 10 to 9.6 mg. Apply on flat, hairless area of the outer arm/upper back/chest/lower back, press firmly for 30 seconds and be sure it sticks.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Purva Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to use spiriva or combivent for COPD?\n\nhave copd .. d/g was air sacks getting hard......do I use spiriva or combivent........i got TB 42 years ago in USMC and was treat for that ......VA say may have caused copd   scarred right lung....got pneumonia 3 times while in the jungle....also ischemic heart disease (3 stents)       abdominal aneurysm of the aorta ( 1 big stent) and bladder cancer removed 4 tumors and had full bcg treatment twice    VA says some from agent orange.... but they are not very helpful, I use my personal doctors and not VA. Many of my brother Marines have died of these same problems lately.     Question is about spiriva and combivent   and any thoughts about agent orange and my medical problems....promise I will not use any your info..only for my personal knowlege",
    "doctor_response": "Thanks for your question on HCM.I can understand your situation and problem.Treatment of COPD needs following treatment simultaneously for better symptomatic control.1. Stop smoking. This should be the first step in the management of COPD.2. Start inhaled bronchodilators and inhaled corticosteroid. They are the drug of choice in COPD. Spiriva and Combivent are good in these aspect. So you should start spirova or combivent.3. Enroll yourself in pulmonary rehabilitation center where chest physiotherapy and deep breathing exercises are done. These will improve your lung functions.4. Take adult respiratory vaccine like pneumpcoccal and influenza vaccines to prevent recurrent lung infections (pneumonia).You need to follow all these steps simultaneously for better control in COPD.So consult pulmonologist and discuss all these.You should definitely start spirova or combivent.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be cause for the discomfort in the knee?\n\nI was playing soccer a week ago and I felt a pop at the top of my knee in the lower quad area. Now a week later I still have knot on the outside of my knee and can not straighten it all the way or bend all the way. When my leg is straight looks like there is a gap in where the muscle should be. My knee area is still swollen as well. Do you reccommed getting it looked at for a possible torn quad",
    "doctor_response": "Hi, You seem to have a partially torn quad tendon or muscle. This definitely needs looking into, a ultrasound test to asses the tear and then to decide if this need rest with a plaster cast or brace. If the tear is considerable then surgery will be needed. In any way, this should not be neglected. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. George Verghese, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for a bad cough & chest pain\n\nI have been feeling unwell for 5 weeks now, it started with me losing my voice, coughing badly, so much so that it hurts my chest and I am gagging when I'm coughing could this be from cleaning products being inhaled because I clean outside my house about 13 hours per week. I have been to my doctor twice he gave my two lots of antibiotics but neither has helped me. Please Reply     Vicki",
    "doctor_response": "Thanks to HCM I can understand you issue I came to know that you are working on house cleaning here cough is coming not only from infection ,, it may be due to irritating allergens in dust ..plz try to avoid that type of work for few weeks ,,or otherwise wear mask and do moreover lot of antibiotic will spoil your health ,, have a chest x ray once ,,cbp and esr .tests you can use antihistaminic like levocetrizine 5mg if not montair lc for 5 days with low dose antibiotics moreover be away from cold and cold items ok don't worry it will subside",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy rashes on stomach?\n\nhi ive recently noticed a rash on my stomach a few days ago it doesnt itch or anything but yesterday i noticed it on my left arm starting from my wrist goin upwards on the inside of my arm now it itchs from time to time on my arm but not my stomach there like little pin pricks anything i should be worried about?",
    "doctor_response": "Hi, According to your complaints it could be an eczematous rash. You can take tablet Cetrizine once daily at bedtime and apply cortisone cream on the affected areas twice daily. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain and shortness of breath\n\nMy wife has been experiencing shortness of breath and sometimes chest pain and or pressure...usually in the wee hours of morning for example 2-4 am....she recently missed a couple days work and was powerless as she said with some overall muscle pain...this has been going on off and on for several years..I am getting more concerned as this does not seem to go away for her. She was checked out at Riverside Hospital in Columbus a couple years ago and they said her heart was fine at the time..as far as heredity goes her mother has angina",
    "doctor_response": "Hi. I can understand your concern. Ideally ecg and 2d echo should be done first in your case. If both are normal than no need to worry for heart diseases. O it could be asthma.Asthma is most common allergic disease which is not a curable disease but definitely controllable, by controlling the same you can lead a symptom free life. Usually presents with cough, wheezing, difficulty breathing and chest tightness. If not treated appropriately can be life threatening.So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis. It will also tell you about severity of the disease and is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid (ICS)Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest tretment for reccurent fever symptoms\n\nQ. My 40 years old wife is suffering from recurrent fever for the last 3-4 months. It started with high fever with chills, so he was given anti-malarial drugs and he felt normal. Then again after 15 days he got the fever with chills then he was given antibiotics. Again after 15 days of the treatment, the same thing happened and he was given anti-malarial Flacigo.",
    "doctor_response": "If fever is persistent since 3-4 weeks it might be due to typhoid or some other infection so first of all I will advice you to go for blood test to rule out the cause. For treatment you can take some antibiotic preferably moxikind-cv or zifi-cv after an expert advice along with akilos-p or nimeson-p for high grade fever. You can take some multivitamin like metilda-forte or meganeuron-plus once daily preferably in afternoon. Do cold sponging to reduce the temperature of your body. You have already completed the course of anti-malarial so no need to repeat this again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does Creon and Esomeprazole take to reduce abdominal pain?\n\nDear Sir, My brother getting pain in abdomen at hypochondriac region ann it is decresed by bending forward and pain radiating to back. by this symptoms i concluded it as pancreatitis and now he is taking Creon tablets tid, and esmeprozole bd, now appetitie is increased, pain also releaved but for how many days i need to continue these medication and what is the prognostic examintions. Plese let me know. Thanking you sir Yours truly, Dr. R. Naresh Kumar",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  You are taking symptomatic treatment.  You should go for ultrasound abdomen.  Search the cause of abdominal pain.  Then you should take specific treatment.  You will definitely get benefits. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be done to maintain a normal pulse rate?\n\nHi, can I answer your health question? Please type your question here.. Blood pressure 120/54 Pulse 33 Light headed Headache - yesterday Get tired easily Medication 100mg Atenolol I m worried about the low pulse ... What can I do to get it back to normal?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I would explain that your low heart rate values are related to Atenolol. For this reason, I recommend reducing to half the dose of Atenolol. If your heart rate does not increase, stopping Atenolol may be needed. Your blood pressure values are perfectly normal. Hope to have been helpful! Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is increased Pramipexole dosage safe to be taken for myoclonus?\n\nI am a 74 y/o female who was diagnosed with myoclonus 3 years ago. My doctor added Pramapexole .25 mg three times per day to the previous .5 mg of ClonazaPam, since that alone was not working. Adding the Pram has made a huge difference in the severity & number of muscle jerks/jumps in my leg. My doctor wants to increase the Pramapexole to .5mg three times per day. I am wondering what effect this will have on my kidneys. I have taken the .5mg for two days now, and have not noticed any changes in urination. Thank you. e-mail: YYYY@YYYY",
    "doctor_response": "Hello,Pramipexole belongs to dopamine agonists. The drug usually started from the lower dose and the dose increased gradually. It is usually well tolerated by the patients up to 4.5 mg/day dose. About 90% of the drug cleared from the body through the kidneys. Pramipexole does not affect your kidney function. It might cause up to 10% of patients urinary frequency, urinary tract infection, urinary incontinence. If a patient has an underlying kidney problem, the dose needs to be adjusted, according to kidney function. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My 16 year old daughter has PCOS. What are the precautions I need to take?\n\nHello doctor, My daughter is 16 years old. She has irregular periods. Sometimes, the cycle lasts 15 to 20 days, while on some months, it lasts 40 days. Her doctor advised an ultrasound scan. She was diagnosed with cysts on the right and left ovaries. Her\u00a0cervix size is 7.5. She was asked to take estrogen tablets from the\u00a015th day of her menstrual cycle for 10 days. I would like to know the cause of this particular problem, and how it would\u00a0affect my child's health. Does she have to follow a particular diet or exercise? Will she be able to conceive? How long will she have to continue the treatment?",
    "doctor_response": "Hello. Initial periods around puberty can be irregular. If the diagnosis of PCOS (polycystic ovaries syndrome) is correct, she may require medicines to make her periods regular. PCOS girls are at a risk of obesity, diabetes, hypertension and endometrial hyperplasia. Many of those can be prevented by a good diet, regular exercise, preventing weight gain and taking progesterone tablets to induce a period, if they are irregular even after the age of 20. Regarding diet, there is no specific suggestion, but the consumption of fats and refined sugar should be cut down, and fiber intake increased. The calorie intake should be proportional to the calorie expenditure. In general, if she is following the diet and not gaining weight, it would suffice. Regular sweat-inducing exercise for at least 45 minutes is a must to avoid all the mentioned complications. Exercise is necessary even when she is not overweight. Regarding pregnancy, there is no need to worry, she can conceive easily with medications, if her periods remain irregular despite following the diet restrictions and exercise. There is no need to worry about it right now. Following a healthy lifestyle for the entire life is a must. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing my sharp abdominal pain with diarrhea?\n\nI just got back from Mexico and I have had very sharp pains in my upper stomache area I believe.  Right after the pain I have the diarrah.  The pain comes quick like a contraction then it goes away and I am fine. Can you tell me what it is. I have taken maybe 5 does of Pepto for the the past 5 days",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have symptoms of  sharp abdominal pain with diarrhea which seems to be due to disturbance of electrolytic balance of body. Need not to worry. It could be due to food intolerance , food allergy , bacterial or viral infection , parasitic infection or inflammatory bowel disease. I would suggest you to consult gastroenterologist for proper examination. Doctor may prescribe antibiotics like omeprazole along with loperamide. You should eat light and non spicy food. Avoid intake of outside food. You should eat fresh fruits and vegetables and eat fruits like banana. Take oral rehydrating solution as well.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excruciating pain from injury of lower left back?\n\ni recently injured my lower left back trying to pick up some of my kids toys and i have been in excruciating pain ever since i can t sit down or lay down i can t stand up or walk and i need to be able to move i have 3 kids in school and time off is not a option for me please any information on what i can do to help would be amazing!!!",
    "doctor_response": "Your complains seems to be due to lumbosacral disc prolapse causing nerve root compression.  Definite diagnosis can only be made after examination.  But if you don't have any limb weakness, bladder complains Or sensory loss then bed rest for 2-3 days and pain killers with muscle relaxant may help.  Try not to stoop forward or lift heavy objects. You may require xray or Mri of lumbosacral spine if symptoms persists. May you get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for skin allergy causing bruising\n\nHi, I have an English Bulldog, have had him for about six months. I have skin allergies, but they seem to be getting worse not better. My dermatologist gave me a steroid shot that helped for a while, but then my skin started to bruise. Now my skin is breaking out worse than ever all over. It is extremely itch. I think it is like eczema, but have not had a definitive diagnosis. Is there anything I can do to help this problem. I do not want to rehome my dog.",
    "doctor_response": "HI, thanks for using healthcare magicYou may want to have allergy testing done, it may not be the dog dander that is causing the problem.If there is another source then you may be able to reduce your exposure to it.If it is related to the dog and removal is not an option then you would need to consisting use anti histamines and topical steroids to help with your skin reaction.If severe then oral or injectable steroids can be used.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does being underweight cause problems in surgery?\n\nHi, I have to have surgery tomorrow removing my four wisdom teeth. I'm a little worried at the moment because I'm under weight and I was wandering if their could be any complications during the procedure since I'm going to be under anesthesia. I heard the dentist might actually say they can't do it if your weight is to low. Is that true?",
    "doctor_response": "Heloo pt-No problem in small surgery.A low body weight may be the result of genetic makeup, dieting, exercise or a combination of these. However, a low body weight can be the cause of issues such as fertility problems, lack of self esteem, low immunity and weak bones, and may stem from an eating disorder. In children and babies, low body weight can impede development and leave lasting detrimental effects.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat infertility?\n\nOnce in a while, not very often, I have a small amount of ejaculate come out while i'm on the toilet... my wife and I are also going through infertility treatment...  (beginning stages) could there be a connection between not getting pregnant yet and the semen coming out while pooping?",
    "doctor_response": "Semen coming out while pooping is not that abnormal, that too if it is once in a while. I would advise you to confirm that it is only semen and not pus due to infection. Just submit the discharge to the laboratory to confirm what it is. If it is pus or any discharge indicating infection, it will definitely hamper  the fertility. In that case you will have to undergo an antibiotics treatment.Anyway, both of you are undergoing infertility treatment. So all physical and laboratory investigations must be on the card. In that you may suggest the physician to find out whether you have got any urinary or genital infection.If there is no infection, do not worry  about semen coming out while popping. There is no connection otherwise with infertility.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes small lump in the pelvic region?\n\nHi, I m a 36 yo male, 5 10 , 175 lbs. I have no serious allergies and am generally healthy. Today I noticed a small ache in my right pelvic (inguinal) region, and found a small lump upon inspection. Aside from masturbation, I haven t been sexually active in months, so I doubt it s an std. Should I worry?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have enlarged inguinal lymphnode. It can be due to reactive hyperplasia, tuberculosis or lymphoma.  Your masturbation has no relation with it.  But any kind of infection can cause reactive hyperplasia.  You should go for examination.  If needed go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes black spot on the penile head?\n\nI am an unmarried male about 30 years old. My problem is black spot about 1/2 inch round on my penis head and others 2 are below the head. It spread day by day but no pain or itching problem. I had shocked at first seen. I got use a under wear 4-5 days continually. Please suggest me how can i do?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Possible causes are melanocytic lesions , post fungal infection associated pigmentation or mucosal lentigens or Fordyce spots etc. Until examination is done it is difficult to say what it is. Use moisturizing cream or lotions , avoid application of irritents. If symptoms not improved please consult your doctor he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Asthma exacerbation, cold, nausea, sweating, chills, body aches. reason?\n\nI have been sick with asthma exacerbation and a cold for a week; taking symbicort; metformin,sinular,diltazam, and lovastatin.  Have not been able to use my cpap due to coughing for a week.  today had scrambled eggs and cheese and dry ww toast at 11 but felt so sick all day.  some nausea, chills, sweating, body aches.  what is going on?  I thought a low blood sugar so I ate two cheese sticks and a little rice, 4 gummy bears now my blood sugar (2 hours later is 280",
    "doctor_response": "HiThanks for your queryI can feel your concernStart with antibiotics after consulting your doctor.Have a proper clinical examinationHope it helpsRegardsDr imran",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there pain in my inguinal hernia repair site?\n\nHello doctor, I am a 45-year-old active athletic female. I had inguinal hernia repair with no mesh six months ago. Recently during exercise, I noted a similar pain in the same exact area. If it is a recurrence, what happens next? Is there another surgery? It has only been six months.",
    "doctor_response": "Hello. I believe you had a mesh-free hernia surgery done six months ago. Now you have developed pain at the same site. I would need a few details before I can help you. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes delay in periods despite having negative UTP?\n\nHI,I HAVE HAD UNPROTECTED SEX ON THE 1ST OF APRIL AND TOOK A MORNING AFTER PILL ON THE 2ND OF APRIL, MY PERIOD NORMALLY COMES TOWARDS MONTH END BUT I GOT IT AROUND 15TH APRIL. ON THE 27TH OF APRIL I HAD UNPROTECTED SEX AGAIN AND TOOK NO MORNING AFTER PILL. I GOT MY PERIODS ON THE 7TH OF MAY AND IT WAS A HEAVY PERIOD. I STARTED USING DUROMINE ON 11 JUNE AND I AM WORRIED AS TO WHY AM I NOT GETTING MY PERIODS. I HAVE TOOK 3 PREGNANCY TESTS AND THEY ARE ALL NEGATIVE. I AM VERY WORRIED.. PLEASE ASSIST.",
    "doctor_response": "hello, sometimes stress causes delay in getting menses as it hampers the hormone level so it's better you wait for a week more and then do one blood test for level of betaHCG. or else u can do a pregnancy test too.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes extreme tiredness after eating sugar high cookies?\n\nAlmost immediately after eating a very high sugar cookie,I am extremely tired....to the point where I must lie down.  Over the last few months I am so tired that I can fall asleep sitting up reading the paper.  Yet I can't fall asleep easily at night in bed.  Could this be diabetes?",
    "doctor_response": "Hi,As you have mentioned feeling of tiredness after eating high sugar cookie.There are two possibilities for that-1) Reactive hypoglycemia:Low blood sugar level due to high sugar load (carbohydrate).This is due to rapid release of insulin in response to high carbohydrate load  which leads to low blood sugar level (hypoglycemia).Hypoglycemia usually associated with tiredness, sweating, palpitations, restlessness, unusual hunger, dizziness.2) Hyperglycemia (Diabetes- High blood sugar level)I want know 1) Any associated symptoms.2) Your height weight.3) Family history of diabetes.I will advise you to check blood sugar level during episode which will give clue to diagnosis.Depending on result further action plan can be done.If blood sugar level found low If blood sugar >70 then you can confirm diabetes by doing Oral glucose tolerance test (OGTT) or HbA1c.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes diarrhea, fever and sore mouth in a child?\n\nmy lil girl 5yrs old has been sick with some virus she has had a low grade fever for five days now she started diaharea after day four and hasnt eaten for days she says her mouth is sore and now she is sweating really bad while she is sleeping and cant seem to rest im really concerned",
    "doctor_response": "Hi,Fever and diarrhea usually indicates acute gastro enteritis. Most of these are viral and needs only supportive treatment with paracetamol and adequate fluid intake for 3-5 days.Here loose stools started on day 4 of fever, which is a bit odd and it is already 5 days, and she still has fever. So kindly take her to your doctor as this may need antibiotic treatment. Meanwhile, give her paracetamol for fever and give frequent sips of fluids like ORS solution after each stools to prevent dehydrationHope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam T. K., Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for an infection in the anus\n\ni noticed that my butt hole is bleeding when i wipe it, even if i didnt poop. it hurts a little to sit down but this just started happening. about a week ago my boyfriend put a small vibrator in my anus but idont understand why it would start bleeding NOW its been a week... what could be the problem?",
    "doctor_response": "Hello,It could be that you have a hemorrhoid that got inflamed with the vibrator. Use some preparation H or other hemorrhoid cream. If it does not resolve then see a doctor for examination and determination of cause of bleeding.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any treatment to do away with the white patches on the body ?\n\nsir, my husband 26yr old.his height is 5 8 .weight is 72kg.he had white patches(bolli in telugu)on his hip.but my husband says that this patches are heriditary because my father also had this patches on his back of his body. sir,i want to remove that white patches forever from my husband s body.is it possible.if possible what i have to do.plz tell me your suggestion sir..",
    "doctor_response": "Welcome to Healthcare MagicAre these patches itchy and scaly. It could be due to fungal infection. There could be sweat accumulation and bad hygiene causing this. Keep the body free from sweat accumulation, take bath regularly, change clothes regularly. Use cool cotton clothes. You need to show to a Dermatologist for proper diagnosis and treatment as what you described can be due to many possibilities.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is medical attention required for a small pimple on cheek of 7 month old baby?\n\nMy 7 month old son has had one red pimple like spot on his cheek for about 6 weeks now. It has no white head but is slightly inflamed and hard on the top.  It is about the size of a pin head and seems to give no pain or irritation.  Does it need treating or will it go away eventually?",
    "doctor_response": "Hi..by what you quote I feel that it could be a prolonged fungal infectioin or an eczema with secondary infection.But, skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be worried about pain in the back due to injury?\n\nmy son made a tackle in football today and came down on another player s cleat, landing on his right side towards the back of his torso. He is having pain (it feels like someone punched or kicked him there) and I am wondering if it could be a bruised rib or something more serious that we need to check out.",
    "doctor_response": "Hi, It could be a simple contusion. As of now you can use analgesics/anti inflammatory combination like Aceclofenac/Seratiopeptdase for symptomatic relief. If symptoms persist better to consult an orthopedician and get an MRI done. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for measles\n\nWWW.WWWW.WW think my son is infected with measles. He is 2 year 8 months old now. He's received all required immunizations up till he is 2 years old, and then when he is about 2 year and 2 months old, we moved from USA to Indonesia.This morning when I picked him up from his pre-school, I found red blotchy skin on his forehead. I suspected that he got measles after learning that the symptoms also include runny nose and cough, which is what my son has been dealing with these past few days, but he doesn't have fever. Should I go to doctor immediately?",
    "doctor_response": "Hello,Welcome to HCM.I understand your concern for your son.If your son has received all the vaccines up to age of 2 year, he should have received 2 shots of measles which will give adequate immunity with efficacy of 95%. This means chances of having measles is very less. Over and above, its extremely rare to have measles without fever.The rash on the forehead should be due to some other reason like sun burn, seborrhic dermatitis or something else. Cough and running nose may be due to some viral infection or allergy.Hope this will be helpful.Please let me know if you have any further questions.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Oligoasthenozoospermia\n\nHi. My name is huda , 35 years old ,married from 7 years, I have no child, in 2005 my semen analysis report is Sperm count 20 million/ml, Sperm Motility \u2013 30% Actively motile 10% feebly motile 60% Non motile, and the Comment was Oligozoospermia with decreased motility. From last 4 month I am taking  proxeed plus Today I have done again Semen Analysis and the report is 10% Active Motile, 30% feebly Motile,60% Non Motile (Motility within one hour of ejaculation) and the comment is Oligoasthenozoospermia. I am a smoker, occasionally alcoholic What is the Advice?",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.You are having oligoasthenospermia.I would advise you strickly please STOP SMOKING AND DRINKING. As these factors affect your sperms quality.Then i would advise you to go for ultrasound color doppler of scrotum to see status of testes, vascularity and varicocele.Consult a urologist with this report.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bleeding after the intercourse while on IUI?\n\nI am doing IUI with my doctor I did Clomid 50mg the first time, but no ovulation. Second time we did 100mg and on day 12 ultrasound everything looked well, went ahead with insemination. Finally took pregnancy test and got a negative, progesterone level was really low for blood work, my period never came. I finally had some light spotting, then just brown discharge for days 1 (day spotting) through day 10, took clomid 100mg and letrozole 5mg day 5 - 9. Intercourse on day 10 bright bleeding, light... very confused at what is happening... suppose to do ultrasound on day 12, what questions should I be asking my doctor, what could be happening here?",
    "doctor_response": "The cause of bleeding may be infection or some cervical changes imposed by the drugs used for ovulation induction. Just keep observation and if it recurs, go for check up of cervix by your gynecologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Unwell after being forced to stop taking zoloft cold turkey. Possible withdrawal symptoms?\n\nI recently lost my carelink due to not being able to afford the monthly cost of 65.00,  I had one more 3 month prescription of zoloft to fill, which I have been on for 20 yrs, but they refused to give me the medication.  I had to stop taking zoloft cold turkey, and am not feeling well. Can you explain the symptoms of withdrawl, and if it is dangerous for me to be in this situation.",
    "doctor_response": "Hi there ~It is unlikely that stopping the zoloft cold turkey led you to be unwell.  However I believe that the withdrawal symptoms are related to excessive anxiety related to not taking the medications.  I also think that you can pay for your own medications if you are no longer covered by the insurance or switch your provider to let them know of the fact that you are not doing well without zoloft, which would make them prescribe zoloft.  I hope this helps.  Take care and have a lovely day!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is chronic kidney disease related to lower back pain, testicle pain and lower abdominal pain?\n\nI ve been having pain in my lower back my testicles and lower abdominal area for about a week and a 1/2 to 2 weeks,it seems to be getting worse I have no appendix but have been diagnosed with chronic kidney disease,i don t know if its all related or not,can you tell me?",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have low  back pain ,testicular pain which suggests presence of stone either in kidney or ureter.Please consult qualified Urologist for clinical assessment and get following basic tests done to confirm the diagnosis.1)your routine urine test and urine culture done to find out the organisms causing this infection and antibiotics to which they are sensitive to.2)Ultrasound scanning of abdomen to rule out presence f urinary stone,Please take broad spectrum antibiotics like Cefexine along with urinary antiseptic like Nitrofurantoin twice daily and urine alkaliser thrice daily.Later on switch on to appropriate antibiotics as per culture report.Get the prescription of medicines from your family Physician.Ensure to drink more water.To keep your urine dilute This will help to control dysuria.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for a yeast infection\n\nHi. I took Anti biotic for my teeth, then thought I developed a yeast infection. Took Fluconazole 150 mg twice. At first seemed to clear up. I have no Discharge/ Burning/ Itching/ Pelvic pain etc. during the day, No outward symptoms, But, During Intercourse Have very foul odor. Almost like a bad tooth odor. Only happens during intercourse. Could it be a bacterial infection?",
    "doctor_response": "HIWell come to HCMHere some mixing kind of symptoms given by you initially you said for teeth and then you are talking about some kind of discharge, then you stated about the foul smelling, in way the condition can be treated with tab Metronidazole 400 mg twice in day for six days, hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause pain in the upper abdomen?\n\nWhat could cause dull pain in my upper abdomen, right below my sternum, that sometimes radiates to the left, sometimes to the right . It s high in my abdomen, right under my rib cage. also, when it radiates to my right side it sometimes radiates to my back. These symptoms are intermittent.",
    "doctor_response": "Hi. Thanks for your query. The causes of pain in the upper abdomen under the sternum and sometimes radiating to the left or right and to the back can be due to the following reasons :Pancreatitis Hiatus hernia Liver pathology You need the following investigations :CT scan of the abdomen Upper GI Endoscopy Clinical evaluation by a Gastrointestinal Surgeon. The treatment may be medical or surgical. I hope this answer helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for red spots on face of a child\n\nMy daughter is 2 Years and 4 months old. She has good skin, is happy and healthy but for the past few months her face (mainly T-zone area) is full of red spots, every morning and they seem to last all day-sometimes more, sometimes less. We do wash her face three times a day...",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could injecting air instead of insulin cause?\n\nI was going to have a lil snack and got my insulin out to inject. I then realized I was not too sure that I actually injected insulin. But may have injected air.. it was 10 units I thought I was injecting into my belly. Can anything bad come of that besides higher sugar levels?",
    "doctor_response": "hello, thanks for your query, u should be panic if air enters your blood vessels there can b a chance of air embolism. insulin syrenge reaches sub cutanous(just below d skin). air in these space will not cause any harm.all the best. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can following healthy diet get rid of gall stone without surgery?\n\nI have just been told that I have a 16mm gall stone, and am following a very good no animal fat diet at present. I was wondering if I continue to do this could I avoid having surgery to remove my gall bladder. I have had 2 lumpectomies for breast cancer and would rather not have any more surgery if possible.",
    "doctor_response": "HelloSo long as that one stone doesn't cause you any problems with attacks of abdominal pain and nausea, there's no need to remove your gall bladder.  The diet you're on is great and it should help keep you from having to have surgery",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had cancer surgery. Diagnosed as duodenal adenocarcinoma. Is chemotherapy required?\n\nhi... I am JAYAPRAKASH. my dad has undergone cancer surgery on 29-11-2012. Its been diagnosed as DUODENAL ADNEOCARCINOMA (stage IIB) PT2N1M0. some doctors told its necessary to undergo Chemotherapy and some told not required . I want to know whether he needs to undergo Chemotherapy? i have attached the REPORTS. Please kindly answer me",
    "doctor_response": "N1 in pathological report means you have lymphnode found possitively after surgery in specimen. it means you are high risk of relapse means if you don't take adjuvant(further ) treatment chances of disease to come back is high,. for that reason for disease to remain controlled further require chemotherapy(5 FU Based) course.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause frequent thirst in a 9 years sold child?\n\n9 year old female, original concern @ 4-5 years old: Always very thirsty & Behavior = to low blood sugar, blood sugar levels continue to test perfect. Acute Pain which bounces around her body, originally started around the rib cage (both sides) and upper abdomon. ANA + (Aug 4th 2011) shogrens is high, Augest 9-12 72hr. EEG showed slowing brain waves and she was diagnosed with Complex Partials - Two Neurologist state her seizures look like complex tics. Though her seizures have displayed as absance seizures as well... seizure episodes followed by beligerance. Estrogen Level is at 24. She suffers from stomach pain and nausia, pain in mussle and joint areas, confusion, missed information, exhaustion, heat and cold intollerance, loose stool and pain with stool elimination (no blood in stool). 85% in height growth - healthy weight. Adrenal system is perfect as well, brain MRI (1.5 imaging) show no tumors in her brain - No MRI done on spine yet. External sonogram showed perfect growth size for uterine development and bone growth x-ray was perfect. Acute pain also affects her head - headache type symptoms. Oh... periodic phantom smells - visual disterbances causing things to look as if they have a green haze. Periodic night sweats which will occure in succession 2 to 3 nights in a row. Vaginal discharge noticed in her underware seems to appear when she has excessive pain issues -no menstral blood as of yet. She tired of being tired and feeling miserable and she wants to go back to school - currently hospital homebound. Seizures happen predominately in the morning and evening. Seizues have also looked as if she had mental retardation. Seizues last 3 to 20 seconds and come in clusters. She is taking Keppra 1 & 1/2 500 MG tablet in the Morning and 1 500MG tablet in the evening. No success with Ozcarbazapine. No Success with Actaminaphine for pain. Keppra seemed to make the pain go away - but it is coming back again, pain may just not have been in a flareup state.",
    "doctor_response": "I think you must do thyroid function test and hepatic enzyme with serum ammonia may help you for diagnosis and treatment",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this semen analysis report indicate?\n\nSir; my seminal analysis is as following: Liqueficatior complete:2 hours, volume: 8ml, PH:1.5, viscosity: viscous, colour: normal, sperm count: 70.4million/ml, total count: 105.6million, Pus cells and RBC: 0-1, bacteria: 0, Spermatocy e:0-1/HPF, Fructose:278, Morphology: Normal-35% Pathological: 65%, Motility: (after 30 min, 3Hrs and 6Hrs respectively): Motile-30%,25%,20% Sluggish-20%,20%,25% Immotile-50%,55%,50%. Activity after 3 Hrs: very active-15% moderate active-35% slow active-50%please sir is my analysis bad? can i be father or not???",
    "doctor_response": "hellothank you for trusting HCMdear nothing to worry your semen analysis is normal.below some of the values of semen analysisVolume: 2.0 ml or moreSperm Concentration: Over40 million totalSperm Concentration: Over 20 million/mlMorphology: 30% or more normally formedVitality: 75% or more alivePH : 7.2-8.0White blood cells: Less than 1,000,000/mlImmunobead test (%sperm with beads): Under 20MAR test (%sperm with RBCs) Coagulate, Liquify, and Agglutinate: YesMotility: 50% or more with forward progression; more than 20 motile sperm/ccColor: Gray/Translucent No Clumping, Sperm-to-Sperm, and Sperm-to-Round Cell .I think I answered to your question if you have more questions feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat small bump in between scrotum and anus?\n\nI have a very small bump between my scrotum and anus. It isn't painful and it on itches occasionally. It looks kinda redish and isn't yielding any blood , just a little moisture when pressed at times. Other than that it's not doing much but just sitting there. I'm just worried about the possibilities.",
    "doctor_response": "Hi,It seems that there might be having friction bumps aggravating by perspiration producing irritation and soreness.Due to lack of proper hygiene and having more perspiration it is not cleared.Keep local hygiene clean, dry and airy.Apply triple action cream.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had an appendecectomy. Developed a hematoma. Medical cure for this?\n\nI had an appendecectomy 5 weeks ago. Turned out everything was normal with appendix but they went ahead and took it out anyways. A week later I developed a hematoma that they surgically removed. Now 4 weeks on after second surgery I developed really bad diahorrea 3 days ago that lasted 24 hrs and ever since have severe cramps going around abdomen into back. Almost like having co reactions when in labour. Extremely painful. I am passing has very frequently but no relief to cramps. Was wondering if this would be related to surgery. Saw surgeon 1 week ago for follow up who said that I still had a lump in left side if belly button but to watch and wait.....",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for choosing H.C.M.Forum. You had appendicectomy 5 weeks ago, one week latter you developed a hematoma, and doctors removed surgically, four weeks after second surgery, you developed very bad diahorrea,3days ago, lasted for 24 hours. since then you had cramps of abdomen and back.Your surgeon said there is a lump in the abdomen. Most probably the pains may not have any relation with the surgeries, as they have succeeded the diahorrea , it might be due to remnant infection of the intestines. I advise you to consult your doctor and explain about your diahorrhea. Yo may need to use anti biotics, anti spasmodics, protiolytics for resolving the lump, etc for the present. Wishing for a quick and complete recovery. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Where can i get the best kidney transplant ?\n\nhi sir who best hospital for kidney transplant in chandigarh,jalandhar,banglore and delhi.sir who paper i will ready for kidney transplane.sir i am very sad because my mother in suffer from kidney disies.sir if my mother will be not well then i am also died please sir help me please i am very sad.",
    "doctor_response": "thanks for choosing healthcaremagic.Your parents are lucky to have son like you.Any way you should consult a transplant surgeon and his team which normally consists of a social worker and counselor who will help you to prepare papers for this.They are used do it and also know the law requirements so they are the best person for you to get help.All the cities that you have mentioned are bigger cities so you can go either of them.If you have financial issues then go a government institute or else you can go private hospitals.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Veltam cause any harm to semen count in young men?\n\nSir,I have been subscribed a medicine called Veltam 0.4 . I am 26 years old and after reading the reviews I came to know that it is not for young male since it reduces semen count and there are many other side effects as well. what should I do ? please HelpRegards,Vishy",
    "doctor_response": "HelloThanks for query .You have been prescribed Veltam 0.4 mg once daily .You have not mentioned the reason for it being prescribed to you .May be you are facing problem of pain in abdomen due to stone in ureter .Veltam is alpha blocker that relaxes smooth muscles in bladder neck,prostate and ureter and is generally prescribed for obstructive voiding symptoms ,poor urinary stream or to hep to pas down the stone in ureter .Since it causes relaxation of bladder neck, during ejaculation it causes semen to enter in bladder instead of moving forward in to urethra what is called as Retrograde Ejaculation . This retrograde ejaculation is the cause for low volume of semen during ejaculation .However the problem getes resolved after you stop taking it .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat excessive fatigue while having sickle cell trait?\n\nI am 27 years old male. I have 11.8 heamoglobin, since 2 months. I have sickle cell trait, I have to cycle 15 km daily. I am Feeling tired and not enough energy for day to day work. I have taken medication before 1 month. But now still feeling same. Please advise. Thank you",
    "doctor_response": "HiAfter hearing your history i would recommend to treat excessive fatigue with changing your lifestyle which can help reduce your symptoms.I will recommend you to eleminate your caffeine intake will help you sleep better and ease your insomnia.You should also limit your nicotine and alcohol intake, too. Try to avoid napping during the day if it\u2019s hurting your ability to sleep at night. Create a sleep routine: You should go to bed at the same time every night and aim to wake up around the same time every morning.It\u2019s also important to pace yourself during activities. Overexertion can make your symptoms worse and bring on an episode of fatigue. Avoid emotional and physical stress. Take time each day to relax or participate in activities you enjoy.RegardsDr DE",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can be done to stop hair loss?\n\nHello doctor, I have hair loss. How can I stop it?",
    "doctor_response": "Hello. You can start with Wiesbaden 30 five pills in the morning, noon, evening, and night, Arnica hair oil (massage thrice in a week), Arnica shampoo, along with medicines. Have healthy food which has protein and calcium. Fenugreek is also good for hair. Have proper sound sleep. Mix coconut oil, castor oil, sesame oil. Do hair massage with it. Warm oil is good. Give follow up after one week to set the duration of treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower right abdominal pain and lower back pain?\n\nI having been having pain in my lower right side of my stomach that also makes my right side of my lower back hurt also. I thought it was a muscule strain but i have had continously systomps for one week. Is it possible i could be pregnant and am just experiencing ligement pain.",
    "doctor_response": "Hi.Thanks for your query. You have got pain in the right lower side of the abdomen and back. No pregnancy does not cause so much and such ligament pain unless it is advanced. This looks to be muscular. If you are not going to get a proper treatment, it will become chronic and untreatable as it is already 1 week. Better consult a General Surgeon to see and rule out other causes such as :Right ureteric stoneRetro-colic appendicitisLymph node mass and so on. Get investigations accordingly and get treated properly to get a cure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I get re-evaluated for cervical dystonia?\n\nI have seen one neurologist here in Boston and have been recently diagnosed with cervical dystonia after years of headaches, oral medications for headaches and muscle tension, physical therapy, accupuncture with no improvement. I also have a hx of c5-6 herniated disc in my neck, and recent soft tissue injury in 2011. I m floored with the dx of dystonia and have been getting Botox injections with oral amitripyline for the past 6 months with no real improvement. Should I get another opinion to be evaluated any differently for other causes of my neck, r shoulder pain and headaches?",
    "doctor_response": "As a neurologist I can fully appreciate the diagnosis of DYSTONIA as a potential cause/explanation to your symptoms.  However, if after multiple cycles of BOTOX nothing seems to be changing then, unfortunately, either the person doing the injections needs to rethink the diagnosis or the method of injection is inadequate, or the dosage of the BOTOX is inadequate, or the injector should consider an alternative to BOTOX such as MYOBLOC or another agent, etc.  Certainly, a 2nd opinion would not hurt if you are not getting the relief you seek from current therapy.  You may write to me at: www.bit.ly/drdariushsaghafi with more questions.  Please rate this a 5 STAR ENCOUNTER.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in the lower back?\n\ni have a problem with my lower back. i went to the dr demanding a mri they denied ,and i had an xray that only showed muscle spasms. its getting to the point where nothing is working the pain is so bad. they said i have siatica , i have a really really bad 10+ pain in my right side butt cheek close to my hip a muscle spasm , they gave me muscle relaxers 750 mlg, those litcane patches, anti anflammatories , physical therapy, i even went to a chropractor that helped but i had to pay , now they are referring me back to one with my insurance. what can i do in the mean time to help my pain i cant sit or walk without me crying it hurts so bad.........please help me!!!!!!",
    "doctor_response": "Hello,Welcome, and thanks for sharing your concern I went through your query, and I feel, the first thing you need is assurance and not an MRI. The usual indication of an MRI is shooting pain in the leg, and that is also what occurs in sciatica. Look for yourself1 Is the pain only in back or radiates to one of the limbs.2 Is there any numbness in the leg, or any numbness arising after walking, and what is the distance at which numbness occurs3 Do you have any back stiffness when you get up in the morning.4 Besides painkillers, what affects your pain the most, is there any position in which you feel more relief than other5 Do you have mild grade fever, or weight loss in recent days.If your answer to more than 2 questions is yes than you need an investigation and a proper assessment.I hope my advice would have been useful, in decision making regarding your treatment, still if you have any clarifications or doubts feel free to contact back.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat OCD, depression and bipolar disorder in a physically challenged person?\n\nHi, my name is Carolyn Lenczewski. I have been diagnosed PTSD, GAD, ADD, OCD, depression and bipolar. I am currently unmediated and it\u2019s a living nightmare. I have 4 small children and a disabled mother I take care of. I\u2019m tired of living this way. Do you have any suggestions?  Every psychiatrist I\u2019ve called is over a 2 month wait. Thanks in advance.",
    "doctor_response": "HelloI read your statement and i understand your concernIts important for you to go to a psychiatrist to evaluate you further as you are suffering from 4 different psychiatric disorder>PTSD is quite curable and response to medicine such as Sertraline, flouxetine>GAD, the drugs they will give you for PTSD will also cover you GAD. ie Sertraline is prescribed for PTSD but it is also an anxiolytic and antidepressant drug>ADHD, for this condition, you doctor will prescribe your some best stimulant such as Methyphenidate or amphetamine.>OCD: as i stated earlier, medication for PTSD will also cover your GAD, same is the case here, They will cover your OCD tooAll you need to consult a psychiatrist for proper evaluationIf any other queries, drop a question on healthcaremagic.com and we will be available for you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes small lump under the scrotum?\n\nI noticed a small pea-sized boil on the underside of my scrotum this past Saturday. It has not come to a head like a pimple. The surface is pink, and it feels perfectly round and semi-hard. Not sure what it is, it does not appear to be getting larger or smaller. It does not hurt, and only slight itches occasionally.",
    "doctor_response": "not to worry much as this is benign condition like sebaceous cyst or skin tags / fibroepithelial polypif really worries you can go for an FNAC test for confirmationall the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in the lower legs and ankles while having atrial fibrillation indicate?\n\nMy mother has Afib and has been hospitalized 3 times in the last 6 months. Fluid in lung - had to be drained- diagnosed with Pluercy but they cannot find what is causing it. She has been doing great for three weeks and though she does not sound like she has any fluid in the chest or lungs she is experiencing sudden serious pain after taking one of her breathing treatments. She lives at home by herself and house a nurse come in 3 days a week to take vital, etc. She also has some swelling in her lower legs, feet and ankles. Temp is 99.8 and BP was 124 over 88. and heart rate was 85. Can you tell me what could be happening?",
    "doctor_response": "Hello and welcome,She is highly likely having congestive heart failure (CHF). CHF is a clinical syndrome when the heart is unable to meet the body\u2019s circulatory demands. from atrial fibrillation. Variety of heart diseases can cause CHF such as atrial fibrillation, hypertension etc. Leg swelling is typical for CHF and patients also develop pleural effusions. She should have initially brain natriuretic peptide level (BNP) obtained. Increased BNP shows fluid overload. Certain medications (e.g. calcium channel blocker) may also cause leg swelling, and increased BNP excludes medication side effects. Transthoracic echocardiogram should be performed to distinguish systolic vs diastolic dysfunction, evaluate structural changes and heart performance. Treatment depends on the pathological condition of the heart which caused CHF. Overall treatment includes beta blockers, diuretics and ACE inhibitors.I hope the above information will be helpful for you. Please, feel free to ask me if there is anything else you need to know. Thank you,Malik Amonov MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden raise in the blood sugar level?\n\nHi doctor, my dad who is 72 years old and has not been known to be diabetic till now suddenly had sugar level shoot up to around 600 mark. we had consulted a doctor and he's been on glycomet 500mg twice a day since 2 days now. with the first dose of medication his sugar level dropped to 450 but since then further medication has not been able to bring  it down further. He feels very weak, he also takes medication for hypertension (has been on them for quite few years). any guidance will be appreciated",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You should consult your doctor and need to increase one more anti diabetic drug. If it is still remain high then you should start insulin injections according to your doctor's advice. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have dry scalp with white flaky layers on the front and sides. Please help.\n\nHello doctor,I have a very dry scalp. There is a white flaky layer on the front and on the sides of the scalp. I have tried different shampoos but no help. Hair is getting thin day by day. I shampoo my hair twice weekly and before shampoo only I apply oil. Please help.",
    "doctor_response": "Hello. You can start Sulfur 30 five pills in morning noon and night, Arsenic alb 200 five pills in morning and evening, Psorinum 1M five pills in morning empty stomach. (One dose only). Your complaints seem like scaly dandruff. Along with medicines have food rich in protein because protein is best for hairs. Mix coconut oil, castor oil, sesame oil and add 10 drops of Arnica Montana mother tincture. Massage your scalp with this mixture twice in a week. Do not change often oil and shampoo. Have black Sesame in whatever form you like (laddu or raw, etc.). Sesame is good as the hair tonic. You can also have Fenugreek seeds laddu. Fenugreek is also hair tonic. Have these medicines but I need a follow up with such details. Hair fall, smell from the head, itching of scalp, bleeding after itching of scalp, hairs stick together, any other complaints? Since how long you had this? Any illness before starting this complaint? These all details will help to decide further medication and duration of treatment. 1.Dandruff. 2.Psoriasis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain under the rib cage. Prescribed with tramadol, codine injection for pain. Suggestions?\n\nsince Sunday I have had a pain under my rib cage on the left side  . I have been prescribed tramadol by my gp. the pain didn't ease so went to A &E my urine showed trace of blood with protein my bloods however was clear. I had a codine injection for pain, but even though the pain is not as bad as soon as I eat the pain brings tears to my eyes and hurts also when I cough, sneeze and even yawn",
    "doctor_response": "IF THE PAIN IS NOT SUBSIDING WITH THESE PAIN KILLERS YOU HAVE TO UNDERGO TESTS TO DIAGNOSING THE CONDITION IT CAN BE KIDNEY STONES GALL BLADDER STONES APPENDICITIS OR CAN BE CARDIAC SYMPTOMPS GET ULTRA SOUND ABDOMEN FOR KUB AND APPENDIX ALL BLOOD TESTS ECG ECHO TO DIAGNOSE THE PROBLEM AND TREAT ACCORDINGLY",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent productive cough while having four stents due to heart issues\n\nI have had in the right side of my heart a year age. Ialso have 4 stents. Family hx. Of heart issues. Over the last few months have hsd a productive cough foabout 6 months of and on. Bp is up and dow a lot sometimes high then low. Alos having more wheezing. Could this be CHF alomg with CAD.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Yes, congestive heart failure (CHF) can cause productive cough and wheezing. CHF causes pulmonary edema and this will cause symptoms. So first get done 2d echo and stress test. You may need diuretics and other supportive treatment. Fluid restriction should be done to less than 1.5 liters in a day. So don't wait at home. Consult cardiologist and discuss all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes prolonged chest pain?\n\nHey , my name is CL , im 23 years old . Im a girl . My problem is i have been suffering from a chest pain for a long time everytime the pain is gone for a few days and then it goes back again. The pain is on the front most of the time but sometimes its from both back and front. I have a problem of taking a deep breath it feels like im being stopped in the meadel of it . Yesterday i was laying down and I strongly felt so much pain in the left side of my chest and i could move or sit for like 2 minutes its was painfoul . And im not sure if its a heart attack! What Should i do !? How can i stop this !?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.Sudden onset chest and back pain in young patient is mostly due to musculoskeletal pain, stress and anxiety.But better to get done ecg and 2d echo to rule out heart diseases.If these are normal then no need to worry for heart diseases.Avoid stress and tension, be relax and calm.Start calcium and vitamin d 3 supplements.Apply warm water pad on affected areas.Take simple painkiller like paracetamol if pain is unbearable.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in chest and arm?\n\nI have been having pain in my chest and back since around 11 a.m. It waxes and waines. I have also had pain/burning in both my ears as well as pain in my right arm. Should I go to the emergency room? I don t want an emergency room bill just for them to tell me it s indigestion.",
    "doctor_response": "Thanks for your question on HCM.In my opinion you are having muscular pain only.Better to start these treatment. 1. Avoid strenuous exercise. 2. Avoid heavy weight lifting.3. Take pain killers and muscle relaxant. 4. Apply warm water pad on affected side.5. Avoid bad postures in sleep.Try to follow these for 5 days. If not improving than get done ECG and X ray to rule out cardiac and pulmonary causes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chronic depression, OCD, anxiety, panic attack disorders, cuts on wrist, ankles. Treatment options for poor mental health?\n\nHi, If you are diagnosed with depression , OCD , and anxiety/panic attack disorder are you considered disabled? My girlfriend was told she suffered from these things about 5yrs ago. Shes 20 now and says it started when she was very young. She will not get anything from her doctor saying so because she doesn t want to be put on medication. We have been together for about 3 years and I love her. I recently found old cuts on her wrist and ankles that I guess she covered with makeup. I want to help her.",
    "doctor_response": "For your information, the listed mental conditions are very rare to occur together. Over and above your girl friend is just 20. These conditions are very problematic and should be treated to the core. Regarding disability. These conditions alone cannot be a case of disability. Each state government has different means of measuring mental disabilities. Please consult a civil psychiatrist in your state for more details.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to have a dental implant in the root of molar?\n\nHI there I need an implant for a molar and still have the root ...the tooth broke off at the gum line ..so is it possible to have an implant in this root or would it be needed to pull it out and implant in the jaw ??its the 2 nd molar fr back upper left side.Thanks",
    "doctor_response": "Thanks for your query, I have gone through your query.The broken tooth or root should be removed prior to the placement of the implant. The implant cannot be placed in the root itself. The root piece has to be removed, then the implant has to be placed. If required bone graft has to be placed and the socket should be left for minimum of 6 months for the new bone to form. Or else, immediately soon after removing the root we can place the implant, but the success rate with immediate loading implant is less compare to waiting for 6months and getting it done.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had removed the wisdom teeth. Feel like the stitches and the blood clot have fallen down. Paining. Suggestions?\n\nMy girlfriend had her wisdom teeth on the left side of her mouth removed on Friday, May 31st, and just now she thinks her stitches and blood clot might have fallen out of the bottom hole. She is in a lot of pain, and she's not sure what to do, and is terrified about a dry socket forming. Is there anything she can do right now to prevent anything bad happening before getting down to see a dentist in the morning?",
    "doctor_response": "Hi,Thanks for asking the query,According to your clinical symptoms  i suppose that you might have developed a dry socket a thorough clinical evaluation by the Dentist is required.Start with pain killer like brufen under prescription of your Dentist.Application of znoE guaze pack is required.Take lukewarm saline and antiseptic mouthwash rinses.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I wake up drenched in sweat in the middle of the night?\n\nHi doctor, I am a 35 year old with no heart problems, not taking any medications, no known inflammation, no abnormal body temperature, no allergies ever. Overnight, I only sleep 3 and a half hours maximum, and when I wake up my t-shirt is all wet like I was running a marathon. My eyes are red in the morning too. This has been going on for the past 30 days. Any idea what that could be? Thank you so much.",
    "doctor_response": "Hello. Increased sweating without any predisposing factors such as cardiac problems or any medication-overuse, but associated with eyed issues, can be a sign of increased thyroid gland activity known as hyperthyroidism. Associated symptoms include increased appetite, loss of weight, diarrhea, intolerance to high temperature, tremors of hands, etc. There may be increased pulse rate in this condition. You may need to get thyroid function tests which assess thyroid hormone levels which can diagnose the condition. If thyroid function test is normal then anxiety can also present similarly. You need to consult a physician or an endocrinologist for detailed clinical evaluation to identify the exact cause of your symptoms. For more information consult an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can the medicines taken for kidney problem have any effect on periods ?\n\nI have kidney stone problem. Ultrasound report says that right kidney reveals evidence of inimal back pressure changes, howeever no definite renal\\ureteric calculas could be recognised sonographycally. 4mm concretion is found in mid pole left kidney too. I am taking Urimax 0.4 mg medicine since last week and my periods are delayed by this much period/Is there any relation between taking Uximax 0.4 mg and Voveron tablet and late period???",
    "doctor_response": "Hi, welcome to HCM. The changes in your right kidney are minor and due to a previous stone that has passed out. They will not affect your kidney functions. The tiny calculus in the left kidney can be helped to pass out by drinking three litres of water a day. Tamsulosin or Urimax has been given to relax your urinary passage and help you to pass out this stone. You can also get your serum calcium, phosphorus and uric acid levels checked since you seem to be having a recurrent problem ---and get any abnormality corrected by diet and medication. Yes, any medication or illness can cause a slight delay in periods. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anxiety when diagnosed with RBBB\n\nI recently went to the e.r for a massive panic attack.. I ve had anxiety my whole life but this time I really thought there was something wrong like a heart attack.. Im only 23 so I know it sounds funny.. But the ecg came out abnormal and they said I have rbbb.. And now my anxiety wont let it go.. I have a cardiologist appointment in a couple weeks but my questions are is this something that can go away or is this going to be something I always have to watch out for? I ve also noticed sometimes when I consume alcohol it can make my chest feel tight for a minute or 2 sometimes.. When I google it I found something saying alcohol can effect the electricle currents in the heart.. Could this just be coincidence or cause for concern.. Again im only 23 and have constant fear im just gonna drop dead from cardiac arrest or ssomething.. Help me please! Lol",
    "doctor_response": "take setaline 25mgs after lunch and increase it to 50mgs after 6 days....take etizolam 0.25mgs when you feel very anxious",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My 11-year-old daughter is unable to control the urge to urinate. What to do?\n\nHello doctor, My 11-year-old daughter has been unable to tell when she has to urinate until she starts to urinate. Before, she was able to stop and run to the bathroom. However, in the past couple of weeks, she has been unable to stop herself and keeps urinating. Her mother and I just found it out this evening, since she can not hide the small anymore.",
    "doctor_response": "Hello. Please get the child evaluated physically for urinary incontinence. A USG (ultrasound) abdomen may be required along with urine routine and microscopy. If all reports are normal, fluid intake and urine output dairy may need to be maintained to see what can be altered without using medications. Desmopressin may need to be started on SOS basis. Imipramine also can be started by a pediatrician after a detailed evaluation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath,chest and arm pain?\n\nchest paini was seen in the er the week of the ninth for chest pain and shortness of breath. i also had a picc line in that was removed on the ninth but was placed the eighth. about a couple mins ago i felt sharp chest pain when i got up walking around and when i was just.standing.i also felt it.when.i was sitting down but not as bad as when i was standing. i do sometimes get.pain n my arms at the same.time but not.this time. i did get tired any suggestions before i just run to the er and to add the top of my.leg has also been numb for a min now.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. By your history and description,we should rule out Pulmonary embolism and heart diseases. You had PICC line. This can cause Pulmonary embolism. And your all symptoms are seen in Pulmonary embolism and heart diseases. So better to consult doctor and get done 1. Ecg and 2d echo to rule out heart diseases. 2. CT Pulmonary Angiography to rule out Pulmonary embolism. If all these reports are normal then no need to worry much for major diseases. Sometimes stress and anxiety can cause similar symptoms. So avoid stress and tension, if you have. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this ultrasound report signify?\n\nmy helper's ultrasound result:  normal sized kidneys with cortical cyst and peluiectasia on the right. Fluid filled anechoic focus measuring 1.7x1.5x1.6cm is seen in the inferior aspect of the right kidney.  Is this something serious? How is this treated?",
    "doctor_response": "You have renal cyst and thus looks like a simple cyst which usually does not cause any issue unless the size is really big, and at this stage I suggest you need not take any active treatment for the cyst but have a followup every year with an ultrasound test and intervene if it gets larger or you have pain or fever due to an infected cyst.Hope I have been able Yp allay your fears.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is gall bladder removal the right decision for digestion problems?\n\nCant decide to tae out gallbladder having problems for four years but all test are negative hydrascan ultrasound etc i usome sed to drink no more can tolerate foods but not fried some drs want to remove gallbldder to see if it helps im on the fence i",
    "doctor_response": "Welcome at HCM   I have gone through your query and being your physician I completely understand your health concerns....    Based upon the history you have provided it is difficult to diagnose. In your history I failed to appreciate any indication for gall bladder removal.    You should visit a gastroentrologist so that you can be investigated and examined properly....    Hope your query is adequately answered  RegardsDr saad sultan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in ribs while diagnosed with Lyme disease\n\nI ve had rib pain for approximately a month that mostly hurts when i m lying down. Its tender to the touch and has not gotten better. I ve been taking 6 advil a day for weeks. Not sure what to do. I was diagnosed with Lyme disease a few years ago...not sure if it could be that.",
    "doctor_response": "Hello, As a first line management you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes weakness,muscle cramp and dry mouth?\n\n4 month ago i have jaundice Bilirubin level 2.6 1month ago i checked it again then it was 1.7 Now i feel weak, muscle cramp, dry mouth, virtigo and balance disorder some time, blood pressure become sometime low or normal How can i complete cure from these What can i do ?",
    "doctor_response": "Hello, The symptoms that you are having can be related to decreased fluid intake and an electrolyte imbalance. This can also be related to cervical spondylosis. Do consult your physician and get a few blood tests done to find the cause. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for viral fever with cold and cough\n\nHi,My kid has just completed 2 years(Boy)He has high fever almost 102-103, took him to a doc and he suspected Viral.fever,though my son still has not shown other symptoms such as cough,cold or vomiting sensation.. My son was advised to be given crocin syrup or ibugesic if the fever is above 100.5... We gave 6.5 ml once since yesterday night (8:30 pm)... He wokeup weak",
    "doctor_response": "dear, viral infections in general cause a lot of weakness. do not worry.. your kid will be ok in 1-2 days. give him proper nutrition & fluids.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Took two missed contraceptive pills, five pills left. Should i start a new pack?\n\nHi,i missed two tablets of my contraceptive pills (wednesday and thursday). today Is friday and I just took the two pills (for thursday and friday..and discarded the missed pill last wednesday). I have 5 pills left (for saturday up to wednesday). The packet says that if I have 7 or less pills left,then I have to start a new pack immediately after the last pill. Like starting a new pack without having a \"free-days pill\". Is it ok to start a new pack of 21 pills immediately after I finished my last 5 pills on wednesday?",
    "doctor_response": "Hi, thanks for the queryAccording to latest guidelines, instructions on your pack are right. If you have missed less than 3 pills in 2/3 week of your pack, you should take one pill as soon as possible( which you have done) and start a new pack immediately after last of this pack without having free days.You are proceeding in a right direction.Hope this information is helpful and informative to you. If you have any further query you can directly reach out to me on the following URL:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tremor on lower lip after a dental procedure?\n\nOne week ago I had tooth #19 prepared for a crown.   The tooth had a large filling which was old and chipped. The procedure went fine.   The injection of anesthetic took a long time to wear off - about 4 hours.   When it did wear off I had a tremor in my lower lip.   The tremor lasted for about 2 - 3 days.  It then began to improve but it is not completely gone yet.   It has now been 7 days.    Is this caused from the injection?   How long will it take to go away? I have called my dentist office twice - he has not called me back. Thank you.",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. The tremor which you are feeling on the lower lip can be because of trauma on the nerve due to injection. To get it confirmed you have to visit thr dentist and get a full mouth x - ray done. And if there is something like that then  you should start with medications called neurobion capsules at least gor month and see the response. Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does prolonged bump and bruising after injury indicate?\n\nI was kicked on the inside of of my calf of leg by my horse. It has been almost a week now, and the lump is still hard and bruising has moved down to the inside of my ankle? I can push my finger into my leg and it stays dented in for longer than it should?",
    "doctor_response": "HI. This is an indication to be seen by an Orthopedic Surgeon to determine whether there is muscle necrosis or not. You may need to undergo ultrasonography or MRI only if felt necessary by the Ortho Surgeon.He may aspirate and see the contents. If this is just a hematoma, nothing to worry, with rest and medicines you will get OK.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rash on chest, back, heat bumps. Taking benadryl for itching. Are these associated with upper respiratory conditions?\n\nmy son has a rash on chest and back, it looks like heat bumps, the emergency room dr, told me it should go away on its on in couple of days, and there is nothing to take, but benyldr. for itching. It seems as though its confined to the same areal. not in the face or legs just on back stomach and chest. Can these types of rashes be asssociated with that of colds and sneezing ,etc. upper respitory condtions,which causes break outs in the skin.",
    "doctor_response": "yes the sneezing is allergic and it can also effect skin yo can apply tenovate oitment on that and antiallergics tabs",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is postprandial less than fasting sugar?\n\nHello doctor, My father's age is 80. My father's fasting sugar is 111 and PP is 83. Is it considered normal? Why is the PP less than fasting sugar? Please help us with your kind advice.",
    "doctor_response": "Hi. Is he taking any medicines for lowering sugar? If not, the PP (postprandial) might be lower as it depends upon the calories taken in during breakfast and the amount of insulin produced by the body. Provided both are in the normal range and above 75 to 80, it does not matter. The fasting sugar is the sugar produced by our liver during the night to provide glucose to the brain and other organs even though we are not eating anything. Two suggestions as you have not mentioned much in the question: For more information consult a diabetologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause abdominal bloating, diarrhea and vomiting in a 36-year-old schizophrenic patient?\n\nMy 36 year old son has constant diahhrea vomits daily, his stomach is hugh. his doctor office called and said his alkaline, neutrophils, are high. My son has schizophrenia and takes 4 medications. We can t get into the doctor for 2 more weeks, should we wait that long? He only eats once a day and its a very small amount he gets full fast so I can t see how his belly got so big???",
    "doctor_response": "Hello, This enlarged belly seems to be something quite new and abnormal in terms of USUAL body shape and size.  It sounds like he is producing an awful lot of gas resulting in ABDOMINAL DISTENTION. One reason could be the presence of H.Pylori which is a common infection in the stomach and is easily tested for and treated with certain antibiotics. The elevated neutrophil count may be signaling some type of infection.  The elevated ALP (alkaline phosphatase) levels could indicate some type of liver or gall bladder issue and this could also account for the increased amount of gas being produced in the GI tract. If he has diarrhea and vomits daily and doesn't eat very well then, my concern is for dehydration that can set in quickly. If the doctor's office is not willing to some how get an appointment for him then, I would recommend 2 choices. An URGENT CARE CENTER which may be able to at least make sure he's well hydrated and stays that way until the doctor's appointment OR ER where again they can make a decision whether he needs some immediate treatment with antibiotics, IV's, or some other diagnostic testing to tell what's going on with the liver and gall bladder to start with. Is your son by any chance having trouble with excessive use of alcohol because some of these symptoms could also suggest a form of hepatitis-related to alcohol use? Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "On antidepressants. Feeling weak emotions, no social activity, low energy. Need help\n\nHey I m really in a bad spot right now with every passing day its harder and harder and harder to do anything I cant function anymore I don t see the point anymore my memory , focus basically all of mental health isn t there I feel like a slow retard and I very rarely consume any mind altering substances also I have very little energy to do anything. When I m not depressed I don t care about anything and the things that I should care about and feel happy about them. I can feel how my brain or my whole self is just degrading with weeks,months and years passing, I have been trying to resolve it for years now, I ve taken antidepressants for 1.5 years altogether and the result I have is even worse mental function and weak emotions, more like ignore everything around me type of mentality, I respond very little to social activity (i.e. talk very little, don t know what to say, don t get the jokes or not find them funny). I feel like the end is near. I ve spent loads of money on supplements , herbal remedies to try and get more energy and fix my mental health but no big results came from that. I m so sensitive to everything and even the slightest things can upset me so much that if something really bad happens I think I might just end my life because from inside it s too much to handle. And I have another problem, I don t feel anything when having sex no joy or nothing and I can t reach orgasm s, I ve started my sex life when I just turned 17 and I m 23 now, male. If I don t get help and get better I think it s gonna be the end of me soon. I m sorry to pour all of this self pity on you but I m lost for hope and I can t talk to anyone about this because its pointless it s not gonna change anything if I do. Steve.",
    "doctor_response": "Dear Steve, I don't know what were the medicines you tried. But there are a lot of them (around 35) if one antidepressant did not suit you some other will be helpful. May be you are having Bipolar Disorder ad presently in a depressed state Psychotherapies will not be of great help at this stage. Electro Convulsive Therapy (ECT) is a safe and effective treatment for severe depression. More effective than any other treatment. It is a painless procedure with proven safety. Unfortunately it is a treatment which most misunderstood (due to propaganda by antipsychiatry groups). In spite of having long years of experience and good scientific evidence supporting it, the treatment is not popular due to these misconceptions. I think you should consult a psychiatrist and discuss this option. Also watch this video",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can taking Metronidazole and Dicloxacillin for tooth pain cause hives?\n\nHi, I have dental problem like Wisdom teeth. i am getting pain. I met doc today she given me antiboitics Metrinidazole and Dicloxocillin.. one year back i used some antibiotics for cough and pain..After using them i got Hives(chronic allergy). Now I am afraid to use Metrinidazole and Dicloxocillin and in doubt of getting Hives again after using these antibiotics..Can you please advise me..",
    "doctor_response": "hi. we understand your problem. some people may have increased sensitivity or adverse reaction to a particular drug. If its the same drug which you consumed during your cough  episode then yes it might again give you the same  allergic reaction. the best thing is to carry the prescription card which you were given earlier and show it to your present dentist so that he/she can make  necessary modification in your medications",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which creams can be suitably used to treat shoulder acne and acne scars ?\n\nbody acne remedies or cream....it has left some marks on my shoulder which looks ugly",
    "doctor_response": "Hello Thanks for nice query. Body acne needs keeping the system clean by drinking plenty of water ,avoiding junk and oily foods ,washing the skin many times a day . It can be due ti hormonal imbalance ,so consult skin specialist & gynec both. \u2018Hope I have answered your query, I will be available to answer your follow up queries, \u201cWish you Good Health and trouble free speedy recovery\u201d",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a solid non moving growth on the ribcage be cancerous?\n\nhi,i have recently found a lump on the left side of my ribcage it is above my breast and on the second rib bone down ,it is the size of a walnut,not painful at al ,feels solid as tho its part of my bone,it does not move an you can easily see it sticking out through my skin,im always tired and sufer with terrible backache,my nan passed away when she was 36,due to bone cancer,im 27",
    "doctor_response": "Hi, thanks for sharing your health concerns with HCM!    If someone comes to me with a non-mobile painless lump, my first and foremost reflex to your question would be \"CAUTION\" as for this case of hand lump, I would come up with three possibilities, these include: 1.\u00a0\u00a0\u00a0\u00a0\u00a0a neoplastic or malignant tumor  could be cancer!2.\u00a0\u00a0\u00a0\u00a0\u00a0The second possibility is of a benign bony lesion like osteoma or osteochondroma\u00a0\u00a0\u00a0\u00a0\u00a0or dermatofibroma!3.\u00a0\u00a0\u00a0\u00a0\u00a0The last possibility is of some normal / developmental nodule like muscular nodule or just a feeling for you!\u00a0\u00a0\u00a0\u00a0\u00a0Overall, it should not be neglected but you could go for FNAC test / CT scan of chest for confirmation before consulting a surgeon in your area!Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pressure in the chest?\n\nBeing having a chest tightness follow by weakness on the legs and clammy sweat. Went to the emergency room and electrocardiograms. Head scan and all other tests came back negative but this sensation is back because it feels like is sucking the life out of you. It gets worse at nights.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. * Most common reason  underlying is stress or anxiety associated. * Management with stress control via meditations, supportive drugs from your family doc will help to improve early. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe headache after using titanium dental implant?\n\nI have had titanium dental implants and both knee replacements  2000, 2010, 2012 all successful but in last two years have developed severe light-headedness. I do not have heart or blood pressure problems - my age is 82. Have had a brain scan - negative. I wonder if I have an allergy to the Titanium and if I do, what can be done - I could not have the titanium removed!",
    "doctor_response": "Hello and welcome.Thanks for sharing your concern.As far as implants are caused,they do not cause headache as side effects.you can meet your dentist and get your teeth examined once.There could be an infection or food impaction causing infection.Therefore please see your dentist.There is no need for removal of titanium.For now try to relax and be stress free and see your dentist for general checkup.Thanks.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have blood in stool. Eat spicy foods. Blood count down. Advised blood transfusion. Suggestions?\n\nI have blood in my stool and it has been going on for nearly 3 years now but it's on & off. Lately the blood in my stool was heavy and it squirts all over the toilet bowl. It lasted foe 3 days. So I thought maybe I have been eating too much spicy foods. I was rushed to a hospital but unfortunately the doctors was not a big help. They keep on saying my blood count went down to 75 H and that I need a blood transfusion . That never occurred because of their lack attention to their patients. I check out not knowing what's wrong. Been 2 days now since I check out and there's no blood in my stool. Just wondering though what caused it in the first place. I'm open for any advice.Thanks,Beth",
    "doctor_response": "Hi Beth and thanks for posting on this forum.I am so sorry to hear about what you have been through an dthe long standing blood in stools.From the information you have provided, you have a chronic loss of blood in your stool that was aggravated by the recent large volumes leading to this low blood count. There are several different causes of this from hemorrhoids, intestinal worms, inflammatory bowel disease, etc. My advice is that you should get consulted by a gastroenterologist who would investigate and get the cause of this. From there, personalised and adapted solutions would be proposed to you.Please, spicy food, though less likely to cause bleeding in the digestive tract, would not cause bleeding that manifests with bright coloured blood. It is clearly not related to this. Get consulted by a Gastroenterologist for adequate investigations and management.I wish you well in your pursuit of solutions to this.Dr. Ditah, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this ultrasound report indicate?\n\nG1p0 went in for US at 7-8 weeks gestation for moderate spotting and cramping. US revealed fraternal twins without heart beats. Went for hcg check and levels good. OB said to come back in one week for repeat US. I was wondering if repeat blood work would be a good idea? And is it normal to not find a heart beat on either twin that early?",
    "doctor_response": "Hello,Mostly, heart activity is evident by 7th week of gestation. Here, it might look bigger sized being twins, more over HCG findings are favorable.So, it is advisable to get USG (Ultrasonography) done after 1 more week to confirm heart beats, before taking any decision.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Vasudha Jayant Athavale",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic back pain\n\nHello.... tomorrow I am seeing an orthopaedic surgeon about back pain (L4-L5-SI), probably due to repetitive strain injury that got worse 5.5 years ago after a bad lift. I have nerve root damage, left leg/butt pain, muscle cramps in calve. On Lyrica almost a year, manage mostly with Advil. I can manage quite well, put up with a lot of chronic pain that varies from a 6-10 (10 being must take Advil and go to bed). I could probably just keep on living this way, but what really gets me down is that I have found it next to impossible to exercise consistently and regularly. Even Pilates!! Walking, cycling, yoga, pilates, Barr, ligth weight training, all cause flare ups to the point I end up having to completely stop exercising and get on NSAIDS (that don t really help). Basically I have less pain when I not active, once I get active I am experience a lot of soreness, pain which also interferes with my sleep. All this means I am not very active just to manage my chronic pain. So... I see a surgeon tomorrow... what are the top 5 questions I should ask him?? Thank you for your help. Chantal",
    "doctor_response": "I have gone through your question and appreciate Your concern. U are suffering chronic back pain.First if u want to consult surgeon u should consult neurosurgeon. U can ask for Mri of spine done.U can also be advised for blood test.Tha cause that is diagnosis of ur back pain should be made.Then treatment becomes easy and effective. General measures to improve the back pain are Avoid bending forward and lifting heavy Weights. Hot fomentation thrice a day. Muscle relaxants and analgesics for pain relief.Lie on flat hard bed. Local Analgesic gel for local application. Muscle strengthening exercises will help you In long term. Thanks.U can write me back for any query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe abdominal pain. Blood test shows raised bilirubin levels. Causes and treatment?\n\nThanks Dr ,i was having severe abdominal pain .Atfer test for blood we got raised level of s. bilirubin .indirect -3.02mg/dl ,direct -1.52mg/dl ,total 4.54mg/dl and total wbc count 0000/cumm sir i am strictly non drinker then what could be caused this ,what is treatment for normal level of bilirubin ? please answer.",
    "doctor_response": "hi....alkohlism is not the only cause of derange liver function.....this high billirubin level suggest hepato billiary pathology.....indirect billirubin indicates obstruction of biliay system by stone,worm,tumor etc....so further evaluation is needed....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red itchy bumps on legs and upper arms?\n\nOne week ago I began to have red itchy bumps on my legs, since that time they have multiplied and have began to appear on my upper arm. There are none anywhere else. They look like chicken pox, but I had chicken pox as a child. I have no fever, no pets, no other symptoms.",
    "doctor_response": "Hey.Welcome to Healthcare Magic.In my opinion it could not be chicken pox.It can be a skin infection or an allergic disorder of skin.You can consult a skin doctor near you, so that they can personally see those red itchy bumps, and then can prescribe you accordingly.Hope i have answered your question. If you have any questions i will be happy to happy you.Take good care.:)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What dosage of Ibugrsic syrup can be given to an infant?\n\nHello, In what doesge I can give ibugrsic syrup to my 5moths and 16 days old daughter - weight 5.6 kg and 5 year old son - weight 16 kg. We will be 18 hr long flight and both of them are having cold and cough. They have their antibiotic going on for last 7 days now and we are travelling tomorrow. I have used this medicen for them earlier too, just don t rember the dosage. Please advice. Thanks, Manyam",
    "doctor_response": "Hi...the dosage is 10mg/kg per dose thrice a day. The strength of the formulation is 100mg/5ml. 1. For 5.6 kg the dose will be 2.5ml thrice a day.2. For 16kg the dose will be 7.5ml thrice a day.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to control hyper eosinophilia?\n\nMy husband has been diagnosed with hyper eosinophilia. He has numerous symptom, not all at the same time, but we don t know how to control them. He gets very little sleep at night due to a fairly dry non productive cough and chest tightening. Several stomach/ abdominal pains (level 10). Diarrhea and vomiting. Hospitalized several times. Not much fever. Malaise and exhaustion. Eosinophil count at nor time up to 52 per cent. Currently between 3 to 9 percent. Any ideas?",
    "doctor_response": "HIWell come to HCMI can understand your problem actually underlying cause of eosinophilia is important once the underlying cause detected and treated then the eosinophilia comes under the control but first of all better to get done the absolute eosinophilic count, in most of the cases the reason is allergy, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is mid-lower back pain and yellowish skin patch on chest related?\n\nI recently discovered two patches of yellow-ish skin on my chest that were non-existent the day before. I m also experiencing some mid-lower back achiness as well if this helps matters any. Are the two possibly related and, more importantly, is there a cause for concern with these symptoms?",
    "doctor_response": "hello,I can see you have asked three questions. Let me answer them one by one. I do not think your back pain is related to any skin lesion. Are you having any itching in these lesion or burning sensation. As herpes zoster lesion can be associated with back and side pain but lesion are not patch but small blister. I would ask you to wait if patches increase or diminish. if  number or size of partches  increases, you should see to a skin specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pregnancy be avoided in first time intercourse?\n\nHello doctor am Sophy and am really confused am a virgin and I plan on having sex with my boyfriend on the 31st of this month but am really scared of getting pregnant and I have never taken any birth control pills before.I had my last period on the 6th of this month and it ended on the 9th.I need your advice doctor.thank you",
    "doctor_response": "Dear Sophy, I would complement you on starting your sexual life. If you had your menses on 6th of this month and are planning to have sexual debut on 31th, mostly it would be safe from pregnancy point of view. Egg is released (ovulation) 14 days prior to next expected menses. Egg has life of 24 hours while sperms are active for 3 days. Hence a period of about one week around the day of ovulation is considered as fertile window. I shall presume your cycle to be of 30 days. Hence your day of ovulation would be on 23rd and your fertile window would be from 19th to 27th. So 31st is far away from the fertile window. Hence, you will be having meagre possibility of pregnancy due to sexual relations on 31st. However, safe period is one of the most unsafe method of contraception. Hence, I would advise you to take post coital emergency contraceptive pills. These pills need to be taken ideally immediately but definitely within 72 hours of the unprotected sex. Any sexual intercourse after consuming the pills not protected against the pregnancy. So you can cover this sexual incidence with such post coital emergency contraceptive pills within 72 hours. If you buy them well in advance, you can take the pills immediately after the intercourse. However, if you are planning to have regular sexual relationship, I would advise you to adopt some regular, routine and reliable contraceptive method like condom, birth control pills or intrauterine device with the advise of your Gynaecologist. Use of post coital contraceptive pills is recommended only for emergency purpose; its routine use is not safe. I hope this provides you sufficient information. Wish you a happy sexual life. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for high calcium level in blood?\n\nMy Primary MDs office called to inform me that he wanted more blood work done on me because my calcium level was high and he wanted that repeated plus a speccific hormone level. I assume it was for thyroid. Among the meds I taKE I take 600mg of Calcium 2x a day.",
    "doctor_response": "Why you are taking calcium when already calcium level are high. I mean are you having osteoporosis or weak bones. Another thing, paratharmone and calcitonin increase calcium not thyroid.Patient with high calcium may develp stones or calcification at abnormal site. I would advice you to check with your doctor if you need to take calcium.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in knuckles?\n\nHi, I am a sixteen y/o male and I have swelling in three of my knuckles (two on the right hand, one on the left). There is swelling further up one of the fingers but it seems to be concentrated around the knuckle. It is red, not painful but at times itchy/tingly. It has appeared before, possibly two or three times, never causing any pain but it seems to swell and itch for around a week and then go back to normal. I have had it probably twice in the last two months but it is winter, and very cold, i m not sure if that has anything to do with it.",
    "doctor_response": "Hello, These knuckles might be what we call ganglion cysts or articular cysts or synovial cysts in the wrist or hand. This is the probable diagnosis in your age group. In older people might be rheumatoid arthritis nodules. I suggest you to see an orthopedic surgeon if it bothers you. Hope I have answered your query. Let me know if I can assist you further. Take care. Regards, Dr. Ivan R. Rommstein, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes radiating pain from hip to leg?\n\nHi. I was in a bicycle accident about a year and a half ago where I landed on the pavement and had a huge hematoma on my hip. I hit hard. Probably should ve gone and been x-rayed. I had a hysterectomy shortly after that and did not work out for a while. When I did start working out again, I started having radiating pain down my left leg, which I did not associate with my hip until recently. My periformus muscles seem to tighten and I am constantly stretching them. Recently the pain in my hip has started to feel like I have a catching in it and then it is a deep pain running down my leg. Could I have fractured my hip? If so, is there anything I can do about it now?",
    "doctor_response": "I have read your query.yes there can be injury around hip bonei will advise you MRI hip  .There can be associated hip cartilage injury. yes we can treat now according to diagnosis. I hope I have answered your questions. If you have further questions please feel free to contact us. I will be happy to answer. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hip pain and difficulty in walking?\n\nJust looking up hip pain (feels bruised but isn t) and trouble walking sometimes. Short rest (sitting) makes it possible to continue. 58, male Oh forget it. Of course you ll tell me to see my doctor. I was looking online to get available info first...",
    "doctor_response": "hi,thank-you for providing the brief history of you.A thorough neuromuscular and musculoskeletal assessment is advised.As the pain is in the hip area, it can be related to either of the pathologies. Either a hip joint pathology or a lumbar spine pathology.Based on the thorough Clinical neuromuscular assessment and musculoskeletal assessment the MRI may be advised.Usually there is difference between the ache and the pain. Ache is muscular and pain is neuropathic. Now you should be able to differentiate both individually and based on that the treatment is planned.Following which with simple physical therapy exercises you should regain the strength in muscle. Also, your age is 58, so after a thorough assessment the treatment planning will be performed.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for endometrium tb\n\nI was tested for hysteroscopy. I was detected with endometrium tb. Then my dr askes me to get checked for tb gold. But that came out negative. One of my doctors has asked me to take 9 months treatment and other dr says that im perfectly ok. Pls advise",
    "doctor_response": "Thanks for asking in healthcaremagic forum    I appreciate your concern. To start TB treatment, it is not neccessary to get positive results, mere suspicion of TB with positive risk factors can be taken as positive guide for treatment. Usually Tb endometritis is the cause of infertility in Indian scenario. So, it is you who has to take decision to follow doctor's advice or not. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sperm ejaculation while doing abdominal exercises?\n\nwhen i do a plank exercise for my abdominals, if I hold it for long enough 2-3 minutes i will ejaculate.  is this harmful to my body or just contractions stimulating the prostate causing this?  I don't want to continue these exercises if it is harmful.  Thanks",
    "doctor_response": "Hi, Yes, it is not good to ejaculate every time you do exercise. Doing an ultrasound pelvis can help diagnose any issue with pelvis. For a few days or until you find the reason, you need to stop doing plank exercise. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is stem cell therapy advisable for autism?\n\nDear Sir/Madam, My son is Autistic  diagnosed by NIHMANS , Bangalore in the year 2001 and presently we are residing at Noida (NCR). Recently we came to know that in India many of the private hospitals at Delhi, Mumbai, Bangalore, Pune started stem cell therapy for autism and claiming clinical improvement ,consequently it ignited a hope for his better future. In view of above we want to know that: 1-  Is stem cell therapy really beneficial in autism? Regards M.K.GOYAL +0000",
    "doctor_response": "Dear Mr. Goyal,At best, stem cell therapy is experimental in nature. I would be unable to either recommend it to you or deter you from going ahead. You should visit a stem cell therapy center and meet the doctor first and resolve all the doubts before you go ahead with it. You should note that the same thing applies to chelation therapy for autism. Beware of money-making rackets! Do your own research before submitting your son to an experiment which is likely very expensive.Remember also that autism tends to reduce as the child grows older. I hope you are going to the counsellor and their multi-pronged behavioural remedial therapy!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itchy red rings on the face and near armpit. What are these?\n\nHello, I have these red rings about 1 1/2 all around my neck , I ve had them for about 8 months and have done nothing about it, because they were small and didn t bother me. Since its gotten hot here in ny, these rings are now very itchy and have doubled in size around my neck, and 1 new ring is near my right armpit. Any ideas as to what they may be?",
    "doctor_response": "Hi..dear john.., Thanks for choosing HCM.., These are due to fungal infection.., called TENIA CORPORIS.., Apply Terbinafine....TERBICIP...cipla...cream 2 times daily., Tab TERBICIP 250 mg daily night for 10 days.., will give good result.., Tinaderm lotion every 2 hrs on affected part.., thanQ",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can staphylococcus aureus with urinary symptoms be treated?\n\nIast year 2 November,I had this following symptoms Sweet Urine,Consistent urge to urinate,itching around my scrotum,itching all over my body after bath,headache and sometimes joint pain.My doc sent for urinary analysis,urine M C S and swab. Swab came up that I had staphylococcus arearus.And it wasn t resistant to about four but I have used up the antibiotics except one left incase serious case.Now I am trying traditional herbal treatment for two weeks with the rules No alcohol,No sex,No sweet food.and this drug just have effect,the symptom I have is the movement sensitive. Please doctor I need an immediate cure this ,please help me.",
    "doctor_response": "If the Staphylococcus aureus is reported sensitive to 4 antibiotics - then you would need a prescription for a course. I am not aware of herbal therapies for infections. Advise you to seek help asap, lest the UTI gets complicated and difficult to treat later. Drink lots of water.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with fibromyalgia, neuropathy and degenerative spinal disease. Done Chemotherapy. Taking cymbalta. What is wrong?\n\nHi..last Thursday morning I took a handful of norco..had family issues, thought it was end of world...threw up and slept for 3 days..my vision is getting better, don't seem so confused, but still feel week, nausea, and my tongue feels weird, just wondering what to do to get over it faster or how lobg to expect this feeling...thank you",
    "doctor_response": "Hi,Thanks for writing in to us.Norco (acetaminophen and hydrocodone) is used to relieve moderate to severe pain. You must be having a serious problem to deal within your family and therefore took this step. You are one of the lucky few and I would suggest a consultation with a psychiatrist.Right now I would like you to drink enough fresh juices and water to flush out the drug from your body through your kidneys. Also eat healthy food and keep yourself engaged in busy activities.Hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes indention on the top of the skull?\n\nI just noticed an indentation at the very top of my head/skull. Right in the middle. I don t recall any head trama or hitting it recently. I am bald so I m certain this happened overnight or just today. It s about the size of a dime. My skull feels raised around the indentation. What could this be? My wife says she can viviy see it too",
    "doctor_response": "Hello,There can be some injury in the past which you may have forget. That has caused depression of the skull bone leading to such feeling. I would suggest you to meet a doctor and get your self examined. Though it will not require any special treatment.  Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "My test results for hepatitis A is 0.84 COI, grey zone reactive. Does it mean I have hepatitis A ?\n\nHi, My test results for Hepatitis A is 0.84 COI, Grey Zone Reactive . Does it mean I have hepatitis A? Thanks Charles",
    "doctor_response": "lets  know what type of test is done, IgM? if it is borderline as it seems so, you need to repeat it after 2 weeks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for the eye allergy causing more pain in the eyes?\n\nHello,I have allergy in my eyes since 1982 , actually I have glaucuma and I m 58 years old ,I use travatan(1time per day) and cosopt 2(2 times per day), but I have more and more allergy, I can not sleep because of the strong eyesache, My Dr in morocco had told me that tere is no alternative to cosopt and travatan , he had tried Azarga and eliminate cosopt , but inerocular pressure had became higher, so hes orders me to continue using cosopt and travatan, please there are any alternatives? I m obliged now to take frakidex sometimes evec i s a cortisone medicine.",
    "doctor_response": "Yes there are natural alternatives in Ayurveda to support your problem. With these herbals you will feel relieved, not necessarily 100% cured in short term.Please get extract of BAEL (Aegle marmelos) leaves and apply 1 drop each in each eye once daily in the morning. If bael leaves are available, you may get extract at home. But use only fresh extract or get lot of leaves and extract daily as per use.Ayurveda's Saptamrit louh is a medicine commonly available in India. No side effects. 250 mg approx daily to be ground and mixed in 1:3 ratio of clarified butter and honey (1 tsp) and licked.No interaction with other med. You will start feeling relief in four weeks.To my own patients, I have used it for decades. Success rate is very high.Hope it helps you too.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have stopped taking norethisterone tablets, is this unhealthy ?\n\nI have been taking the norethisterone tablets 3x a day for 4 months to stop my bleeding but i was meant to stop for one week in the month and i havnt stopped taking them yet is this unhealthy ?",
    "doctor_response": "thanks for choosing healthcaremagic.Any hormonal medication needs to be taken only in prescribed dose.Norethisterone is used primarily for timing menstruation and other problems related to menstrual cycle.any thing in excess is not good.So stop the drug and visit your doctor for choice of oral contraceptive suitable to you.I hope you had withdraw bleeding in between.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bleeding gums after brushing. Pain, burning in tongue. Was on antibiotics for dog bite. Suggestions?\n\nOn sat night after brushing my teeth , I noticed my lower gums started to bleed . Since then, they have continued to bleed with brushing. The underneath part of my tongue feels very painful, like a burning sensation as well as the tip of my tongue. After brushing this morning, one tooth on each side...towards the back look as if I brushed off part of the gum! I was on antibiotics for 5 weeks due to a severe dog bite, but have been off of them for 3 weeks now. I have an appt tomorrow with a periodontist, but am seeking some type of clarification since my mouth has been hurting for 5 days now with no relief :0( I should also add that its been several years since I ve been to a dentist , due to extreme fear, high anxiety and I even fainted once walking into a dentist office. But at this point, it s a necessity to go. Thank you!",
    "doctor_response": "Hi..Thanks for choosing HCM forum, I have read your concern. As you c/o bleeding while brushing teeth,your gums may be highly inflammed,ie,gingivitis. The gum infection may be due to- Plaque and food debris accumulation as a result of poor oral hygiene maintenance. Systemic diseases like diabetes mellitus,hypertension,epilepsy,autoimmune diseases. Improper brushing techniques. First of all I want to tell you that please do not be panic regarding dental treatments. If your dentist is doing any procedure,which will be painful,then surely he/she will administer local anaesthetic solution. Meanwhile,brush your teeth twice daily in proper manner. Get your teeth cleaned by your dentist. Include plenty of nutritious rich food into your diet. Bleeding from gums will stop,once the plaque underneath the gums are removed and gums become intact,firm again. HOPE THIS HELPS. TAKE CARE.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain, done CT scan. History of fever\n\nMy son age 27 year suffering from left side pain nearby kidney , pain coming from back to front side, CT scan of KUB and Spine done both report showing normal position. No disorder detected . Before one month he was suffering from fever , Malaria was not detected , he was admitted in hospital and Falsi injection with glucose are given by doctor. He was operated for appendix before 3 year, digestive system is weak presently. some doctor say it is infection. Now the pain as shows above are not reducing please guide me for further treatment please.",
    "doctor_response": "hi, pain in the renal angle could be due to infection, i.e nephritis/pyelonephritis. sometimes ureteric calculi i.e stone may cause this. see urologist for the problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain towards left side of heart?\n\nI have a small pain (lasts 1 sec or so) on my left side near the heart(not heart pain).This happens once a month(sometimes never)Today It happened 6 times during the day.I must tell you I'm overweight and I'm afraid of heart attack...(I'm only 24years old)Whats the problem?",
    "doctor_response": "Hi ThereAfter going through your query I understand your concernI would like to tell you that a heart attack at your age is very unlikely until unless you have a strong cardiac family history and even your symptoms are not suggestive of any heart disease.Its advisable for you to maintain a healthy weight and healthy lifestyle to reduce the risk of heart attack in future.Hopefully this has answered your query.Kind RegarsDr. Navneet Mahajan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for tooth infection leading to headaches\n\nI had a crown to a jaw tooth about 7 years ago. the dentist said she may need to do root canal soon. i didn't get it done. Then I had stage 3 breast cancer , went through chemo. and radiation. Now I think the infection under the crown has spread to my neck lymph nodes and I have head aches. Is this something I need to see orthodonist or regular doctor for?",
    "doctor_response": "Thanks for your query, I have gone through your query.The tooth infection in a crowned tooth is resulting in pain in the head. The lymphnode tenderness and enlargement. Nothing to be panic, consult a oral physician and get it evaluated. Mean while you can take a course of antibiotics like amoxicillin(if you are not allergic). Once the diagnosis is confirmed the tooth can be treated with root canal treatment.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for child suffering from prolonged cough, cold and fever\n\nHI,i am a mother of 3.1/2 year old daughter. Last 3 months she has a prolonged cough and cold and last 1 monthshe has continuous fever.she had admitted at hospital for 4 days and become cure but after few days she has again fever from last 1 week and she has also earache. my daughter is giong to school and said its common inevery children in their 1st year of school.we r staying in saudi arab.so plz kindly give some advice what i will do foe her complete cure.my daughter is underweight and she was also a low birth weight baby. plz give some advice",
    "doctor_response": "Hi,From history it seems that there might be having recurring respiratory tract infection due to coming in contact with this type of infection.As she is weak and low weight she might be more prone to infection due to weak immune system.But seeing the symptoms she requires some investigations to rule out primary complex.Go for, x-ray chest,complete blood testing with TC, DC, ESR.Montoux test.Ok and take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can antibiotics ( for sinus infection) affect the effectiveness of a birth control pill?\n\nHi, I've been on Lo Loestrin FE for about 1.5 years or so.  I have been taking my pills regularly, my husband and I had sex on Saturday, January 8th.  I know I ovulate on or around the 9th, and then two days later (the 11th) I started antibiotics (amoxicillan or augmentin, not sure which) for a sinus infection.  I know I will know in about a week or so anyways, but I was just wondering if taking antibiotics 3 days after sex, 2 days post ovulation could affect the effectiveness of the birth control?  Possible to get pregnant that way or no?Thanks!",
    "doctor_response": "Hi, I understand your concerns . Antibiotics do reduce  effectiveness of birth control pills. It will be helpful if you can tell me name of the exact antibiotic. You can get pregnant.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough\n\nSir my doughter is four year old she is allwayes suffer from  coughf (khashi) i consult maney child spacialist like bharet chaperwal sir but problem is remaining same not qure probelem is repet after few days of ending the tretmaint   help me my e-mail id is mob : 0000",
    "doctor_response": "For four year old child recurrent cough indicates lack of immunity and susceptibility to allergens. Modern drugs are good in acute and emergent cases but can't build immunity to resist further cough attacks. Slowly, this may lead to BRONCHITIS and other complications if not treated properly.My own recommendation on the basis of my three decades experience in clinical Ayurveda is that your child needs to strengthen the resistance against allergens, changing season and to clean the pulmonary system of accumulated cough.This is possible only by Ayurveda which may seem slow but action sustains for long.The scheme of treatment is cleansing the cough, raising the immunity and instilling the strength by special herbal combos designed for children by classical Ayurveda.Main ingredient used remains Piper longum herb - may be in in Bachaturbhadrika chooran or 64 prahari Peepal or anything else in combo with some other harmless things as per current condition and history. These are safe, harmless medicines and given with pure honey. One or two weeks' treatment will start showing benefits. Steam inhalation is also important.If you agree, pl consult through direct question for further directions.Hope it is helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infected toenail\n\nI had a very inexperienced doctor removal my toe nail. He numbed it with three shots directly above the toe line, had a very poor cut, and didn't properly cauterize it. It is one day after and it pussing fairly badly and looks terrible. What should I do? I am taking an Anti-biotic... but?",
    "doctor_response": "thanka for posting your query to healh care magic .removal of oe nail create a big wound and it will ake time to heal .you should maintain proper hygein and regular dressing of that wound to prevent it from infection and fast recovey.along with this you should take 1.complee course of antibiotics as recommend by your surgeon .2. antiinflammatory  enzymaic preparation like Serrraiopeptidase 10mg .two times a day .3.Multivitamin4.Pain killer like Aceclophenac 10mg two times a dayall medication should be taken under guidence of your clinician .thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe body ache after a fever?\n\nextreme pain30 yrs old. Female. 5'1, 170lbs. On Friday, 11/30/2012, I started feeling really bad, cold chills, stuffy, loss of voice and fever. my head felt very heavy. my husband drove me home.from work. I figured I was getting the cold going around. when I woke Saturday morning my whole body ached with a debilitating effect. I didn't want to move. I took some day quil and still slept all day waking to drink and nibble here and there. I'd say 23/24 hours I was in bed. today, I can move.my arms fine, my head is not.as heavy but.my back...it.is excruciating. I don't want to move my legs period. I took a naproxen, and to no avail did it help. I don't know how to function with this pain. it almost feels like back labor.please, what could this be. I've had kidney stones but I have no blood in my urine this time.",
    "doctor_response": "it could be viral flu which always associated with high fever and severe body aches caused by the antigens and antibody reactions occurring as a result of our immune defense mechanisms. it should get better with medications and as our system get rids of viral proteins",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dizziness, lightheadedness on standing with  momentary vision loss post spinal fusion, had silent heart attack before surgery. Normal?\n\nI had spinal fusion about 6 weeks ago and I am experiencing dizziness and light headedness. I am no longer on pain meds. It mostly happens when I stand up or look from side to side. I have even lost my vision for a few seconds upon standing. I had a silent heart attack before my surgery, but I don t know when. Is the dizziness normal?",
    "doctor_response": "Hello I am Dr Ravinder Sharma ENT surgeon On the basis of information provided it appears your dizziness can be because postural hypotension or it could be benign positional vertigo. I would advise you for a neurologust, ENT and a physician consultation to get on to the cause of dizziness. Dizziness is never  normal I hope this answers your concerns. Feel free to contact me if your need more information on this With warm regards Ravinder Sharma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Got tubes tied. Getting cramps with spotting. Pregnancy test came negative. What is wrong?\n\nI am twenty six years old and had my tubes tied on December 17, 2009. Around the time (the 1st) I was supposed to start my period this month, I had spot bleeding, I have not yet had my period. My breast are a little tender and have had some light cramps. I thought that I could be pregnant but took a pregnancy test and it came back negative",
    "doctor_response": "Hello ma'am and welcome.Please visit your doctor who conducted the surgery and discuss things in more detail with him/her, as it is quite clear that your doctor has not informed you anything in detail about pros and cons of the surgery, what to expect and when to report to youe doctor. Please schedule a revisit ma'am, and at the sametime discuss the problem of irregular periods with him/her. This might call for a few more investigations, to find the exact cause.Hope this helps.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for gas problem in baby\n\nMy 7 month old baby since starting solids seems to have an excessive amount of wind. She is breastfed and never had any other issues such as reflux etc, and was not colicky as a younger baby. She now wakes with stomach aches and passes a great deal of wind. Her bowel motions are also very smelly. Have used simethicone (infacol) drops which don t appear to make a great deal of difference. Eliminating certain foods (dairy etc) has made little difference thus far. Any suggestions would be appreciated!1",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.This is called evening colic and is quite common in this age group. This happens when the baby sucks at the breast very fast and in eagerness to drink milk will gulp in air too. Unless the air comes out like burping or flatus this discomfort will be there and next time check if the baby is sucking too fast and gulping in air too. You will be more convinced. Usually I don't advice any medicines for this as they give only temporary relief.The two best ways to relieve this distress is - 1. Do not put the baby in lying position after feeding till the baby burps out the swallowed air.2. If still crying - put the baby in prone position and keep patting the back gently so that the baby passes off the flatus and gets relieved.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "History of bone fracture. Now CT scan shows bleeding in brain. Mood swings, low testosterone. How to help?\n\nFive years ago, my husband was in a terrible accident where a young lady hit the dump truck he was driving.  She died at the scene even though he tried to help her.  He himself had a broken wrist, a huge lump on his head with multiple cuts and scrapes all over his body.  Two months later, after he just got the cast off his wrist, my husband fell outside during a major snow storm.  I quickly drove him to the emergency room.  I thought he was having a stroke.  The Doctor ordered a catscan and found out he had bleeding in the brain.  Fortunately for my husband, it stopped just in time before they had to do surgery.  Since then, my husbands moods have been changing to the point that one moment he is crying about something sad that happened to someone we don't even know and the next moment he would yell and curse out me or our kids.  Very Bipolar like symptoms.  He has been diagnosed with very low testosterone but refuses to take therapy.  He says there is nothing wrong with him and it is all me and the kids.  How can I help him?",
    "doctor_response": "Hi,Thank you for posting your query regarding your husband's health. It is unfortunate that your husband is not willing to accept the therapy.He definitely has psychiatric symptoms, which could be related to his brain injury. However, he needs medications and counseling under the care of a psychiatrist.He would benefit from anti depressants and antipsychotics. Best wishes,Dr Sudhir Kumar MD DM (Neurology)Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rib popping and discomfort in the left side of my chest inspite of having anxiety disorder\n\nI have been diagnosed with anxiety disorder for last 6months. I am overweight and started exercising since 6months and lost 20 kgs in 6months.i am experiencing rib popping and discomfort in the left side of my chest for last 5 months.i have done my tests related to heart and all seems normal.apart from rib popping/snapping I get left side chest pains and occasionally jaw pain.i have irritation on my right shoulder blade which burns on touching and gives sharp pains at times which last for a minute .i have food in small quantities and eat on time specially at night.i even take antacid tablets at times after meals fearing of acid reflux.my life is not the same I have done CBT sessions as well but that didn't help me much except the breathing exercises which i still do.i am fed up of this. The mentioned pains occur when there is no anxiety at all its when I am doing normal things and suddenly it hits. Now i constantly fear of having a heart attack anytime.Dr please help me to get back the real me.i request you to keep this confidential and not make my query public.thanks.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. You cannot say that you do not have anxiety symptoms because \"constant fear of having a heart attack anytime\" is an anxiety symptom. From simple anxiety disorder, I think you had developed somatoform disorder. You can get back to normal life if you do not ignore the advices given by your psychiatrist and CBT therapist. CBT is well known as a cure for every anxiety disorder. Take it as a challenge and do not tire. All the pains you are mentioning are related to somatoform disorder. I think you also have eating disorder. Get yourself tested by a clinical psychologist.OR 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.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bile duct block with fat food intolerance?\n\nI have had an ultrasound, which shows I have gallstones, an enlarged spleen, at 14.3cm & a slightly enlarged, maybe blocked bile duct, & a hyperechoic linea structure? Adjacent to the gall bladder wall, I feel very tired all the time, & can't tolerate any fat in my diet at all, not even gravy on my dinner. My blood tests showed ALTs of 119, do you have any idea of what the problem could be apart from gallstone? Thank you",
    "doctor_response": "Small gallstones can escape from the gallbladder and cause blockages of the large bile ducts coming from the liver. ERCP may be needed to clear these stones prior to having the gallbladder removed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest best medicine for anti-anxiety\n\nwhat is the best anti-axiety med for a 78 yr old woman taking plavix, crestor and BP meds, has 3 stents, but otherwise in good health. Is a CareGiver for 87 yr old husband who had 2 heart surgeries and a stroke, but is a walking miracle, and can talk, etc. Just all the workload falls on me, etc.",
    "doctor_response": "HiThanks for using healthcare magicIn old age, best antidepressant is tianeptine. It also helps in maintaining mood as well as controlling anxiety symptoms. You can try this drug. It would not available without prescription, so better to consult your physician for that. You can also try some relaxation exercise that would keep you calm. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is ovulation study?\n\nWe consulted gynacologist after a year of marriage as we were unable to conceive.The doctor has advised my wife to come for ovulation study one week later after her period has ended & also get an HSG done?My query is what exactly is \"ovulation study\".How is it carried out and how it helps us?How is it related to HSG?",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.Ovulation study is done to know whether follicles are developing or not. Is started from 9/10th day and continued till follicles ruptured.HSG histosalpingography is done to know whether fallopian tube is blocked or open.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On statins for cholesterol, high GGT values, advised Udiliv. Any side effects ?\n\nMy husband has cholesterol and has been on statins for almost 10 years now. He does enjoy his whiskeys on weekends and wine on some days.. His liver function tests have shown high GGT values.. The doctor has advised udiliv 300 mg, 1 tablet at night for 3 months. Does this medication have any side effects? Is this medication safe to have along with statins? Thank you",
    "doctor_response": "Hello High GGTP is due to the increased intake of alcohol. Although UDILIV has many side effects like nausea,vomiting,diarrhoea,joint pains etc and should not be taken along with statins,it's role in reduction of GGTP is very doubtful. UDILIV is basically used in treatment of gall stones. The best treatment for reduction of lver enzymes caused by alcohol intake is 1... Complete abstinence from alcohol 2... Regular exercises 3... Consumption of fresh fruits and green vegetables 4.. Avoidance of junk food and controlling of sugar levels if you have diabetes. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can an arm gash with a lump be treated?\n\nI fell down the other day on concrete and grass. my arm was not broken but had a pretty long gash. The cut is healing but I have a quarter size bump under the skin of the bruise/ cut. it is a bit tender when I touch it. what is it? It s the size of a quarter.",
    "doctor_response": "Dear Sir/MadamI have gone through your query and read your symptoms.In my opinion, the only thing to fear in your case is infection.keep it clean with dettol wash.clean and dress with betadine solution.take antibiotics and analgesics under the guidance of your doctor, and help your body heal itself.I hope that answers your query. If you want any more clarification, contact me back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long can the quality of life be maintained?\n\nI have stage 4 recurrent cancer, it is responding to treatment, and I feel fine and am continuing to work and live a normal life.  But I know this will not last forever, and that eventually this disease will take my life.  What I would like to know is how long before the end you start to feel really cruddy and can't work/travel, etc...",
    "doctor_response": "the pace of growth of cancer has been outpaced by newer medicines coming almost every month now. i don,t know the type of cancer, but, will suggest you to discuss with your doctor whenever this therapy fails. options of another therapy will be there to take care of you with adequate quality of life.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could sharp pain in lower pelvic region during certain movements be due to an inflamed muscle?\n\nHello, I have a sharp pain in my lower pelvic region but only when I either laugh, cough, or move a certain way and not every time. It been about 4 days and I have had no problem eating or anything else out of the ordinary. No other symptoms. It does feel like a muscle is causing this. Any clue if I need to see a doctor or is this most likely an inflamed muscle?",
    "doctor_response": "Sharp pain in lower pelvic region can arise due to several causes. In women, mostly a pathology associated with genitourinary system is the cause. But considering your symptoms, the pain looks to be arising due to a local nerve impingement arising due to some muscle spasm, not an inflammation. You need to see a doctor expert in pain management, such as a Physical Medicine & Rehabilitation Physician or an Anaesthesist. Some muscle relaxants and proper stretches can help you overcome the pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I had unprotected sex 5 weeks after delivery and took morning-after pill. Am I safe?\n\nHello doctor, I gave birth to my baby six weeks ago, and on the fifth week, I and my partner had unprotected sex. I took the morning-after pill, but because I did not get my period I was worried whether it worked or not. It is been a week and today my first period has started. Does that mean that I am safe and I am not pregnant? Or could there still be a possibility?",
    "doctor_response": "Hello,  Welcome to icliniq.com. After the delivery, it takes around six weeks for the body physically, hormonally to get back to non-pregnant level. I mean to say that the hormones which were very high during pregnancy will not allow ovulation to occur, that is why you do not get periods during pregnancy. After delivery, if you regularly breastfeed the baby, those hormones do not come back to normal till you stop breastfeeding. Indirectly you do not get pregnant. It is always advised to exclusively breastfeed the baby until four months. A gap between pregnancy will allow you to regain a lot of lost energy and reserves. It is time for this baby to get full care and energy as milk. The next baby will also have good reserves from the mother. But this is not an absolute method of contraception. Many get pregnant even without any periods. But as you had periods it means you are not pregnant. During this period you will need additional contraception like Cu-IUD (copper-T intrauterine devices), or injectable medications, etc., as per your doctors advice. In your case, if you had good bleeding, pregnancy is ruled out.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness, upper abdominal pain and tingling in legs?\n\nhello my symptoms are dizzy, upper abdominal pain, pain between my shoulder blades, legs are tingly and i cant eat everytime i do it hurts so bad and all i eat is dry toast. i went to the er on sunday and they did some test my white cell count was 14000 and they thought it was my gall bladdder. did a ultrasound today and the preliminary showed nothing significant.",
    "doctor_response": "you may suffer from retrophryngeal abscess causing eating difficulty and causing compression nerve roots too. so you should go to ENT specialist and should take antibiotic for your disease. if u want u can also go for CT neck straight forward for confirmation of diagnosis",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp, throbbing pain just below the navel on the right side?\n\nHi, i awoke 2 nights ago with a sharp , throbbing pain just below my stomach button, on the right hand side. The pain was nt to severe however, so i thought nothing of it. Since this morning, i am now feeling a vibration in my scrotum, it occurs every few mins or secs and usually only lasts about 2 secs.",
    "doctor_response": "Is this the first time you felt this pain? Any urinary complaints like irritation while voiding or difficulty in voiding? What is you age group? Any association with diabetes?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for fever and green discharge from the nose and eyes\n\nOur one year old grand-son has for several days approximately 38 degrees, yellow/green discharge from his nose and eyes. Any home-grown solutions or should he be seen by the doctor? (two weeks ago, he was diagnosed with retro-virus and also was given antibiotics).",
    "doctor_response": "Hi.... keeping in mind the background of retroviral positive condition and fever of 38 degrees celsius along with greenish discharge I suggest you consult a pediatrician regarding him. i am suggesting this because, even mild infections can get complicated with this background scenario.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I had sex couple of days ago and now it hurts to pee. Is it herpes?\n\nHello doctor,I need help. I think I might have herpes. I had sex couple of days ago and now it hurts to pee.",
    "doctor_response": "Hi. I am sorry to hear about your condition. But your lesions do not look like herpes (attachment removed to protect patient identity). They look more like folliculitis. That is bacterial infection of the hair follicles. It can occur due to improper hygiene, aggressive intercourse, and non-sterile shaving equipment. Usually, application of antibiotic ointments or creams help. Meanwhile also increase your water intake to prevent UTI (urinary tract infection) which can also occur along with this. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is dizziness and nausea related to post cholecystectomy syndrome?\n\nIs that post cholecystectomy syndrome? I'm 22 year old, i had a ling standing history of epigastric pain,dizziness, indigestion, nausea but without vomiting with frequent steatorrhea and diarrhea! sometimes vague shoulder pain and right upper quadrant (RUQ) pain, finally Weight loss with low grade fever! it was found to be chronic cholecysititis, diagnosed around 3 months ago!. I had chlecystectomy surgery about 1 month ago! after the surgery, the symptoms almost cured for 1 week, except for the RUQ pain after meals, but during that time i was still on a fat-free or low-fat diet. now i started eating normal food!!! i have weird bowel habit with occasional steatorrhea, nausea, very mild RUQ pain without radiation of pain to shoulder and dizzines!!!!! :( :( should i see my doctor for any investigations? or just go for a low-fat diet?? i actually miss eating junk-food :P and fatty foods!!!! i also want to know of gallstone disease and chronic cholecystits may cause steatorrhea, and how?? i know that choledechothiasis cause steatorrhea for sure! but thye ultrasonologist told me that the CBD is normal! so steatorrhea cofuses me..... plz help me i study medicine, you may explain any detail for me if it's comfortable for you",
    "doctor_response": "Hello,Post cholecystectomy altered bowel habits is a usual phenomenon because now the bile release is not in conjugation with meal intake. It will settle down slowly.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. B.dinesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomachache in a child only when lying down?\n\nhello, my 5 year old son has been complaining of tummy pain around his belly button area for the last 3 days only at bedtime. he says that he thinks he needs a poo but no luck when he trys. he is pooing normal during the day. its only whn he lies down that he feels the pain. what could this be?",
    "doctor_response": "Hi, welcome to HCM. In my opinion, your child has probably got stomach infection. During night time, the child is not able to pass gases and that's why he is having pain abdomen at night only. If I was your treating doctor, i would have given syrup oflox 5 ml PO three times a day for 3 days and syrup cyclopam 5 ml PO three times a day for 2 days. However, since this is a prescription medicine, i advice you to meet the local doctor to confirm the diagnosis.I hope this has helped you. Take care. Regards - Dr Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for a bump on the head near temple , which is about the size of a quater ?\n\nMy 2 yr old son has had a bump on his head near his temple for 3 months now. It is about the size of a quarter. It doesn't really bother him unless you keep on touching it. It hasn't changed in size but I am just worried because it hasn't gone away. When I called the nurse after it was there for over a month she asked the doctor and he said it could be a bone bruise and to just keep and eye on it and let them know if it changes in size.",
    "doctor_response": "Hi and welcome to HCM.Well it can be any subcutaneous mostly benign lesions such as lipoma,fibroma or cyst. If there is no rapid growth or pain you hsould not be worried,you can do ultrasoud if there is any concerns or it can be surgically managed and sent to patohystologic analysis.Thanks for the query. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a fluke inside my eyes. How to treat it?\n\nHello doctor, I think I have a trematode (fluke) on my eyes and it seems to enter behind the eye as well. The trematode passes the vision at times and I can then distinguish the structure of the body, quite complex body and transparent. When I go to the mirror to see it I cannot. What type of fluke can do this, live on the eyes and globe and also enter inside and behind the eye? And what medicine do I need to treat this? Triclabendazole or is there other medicine? I have tried with Praziquantel and it did not work. Also, I have tried Ivermectin, Albendazole and Mebendazole but it is stil in my eye. What can I do it is very painful and do I need a rehab treatment or sort like Cortizone or is it not necessary?",
    "doctor_response": "Hello. Regarding your problem, I am not very sure that it is a (fluke) trematode in your eye. By the description of the anomaly that you are giving, I think it is a floater. Just check for images of floaters eye on google and you should see exactly what I am talking about. Floaters are generally harmless and are present without any apparent visual loss and no significant lifetime morbidity to the eye. In some cases, having a floater can be a dangerous sign, which may signify posterior vitreous detachment, retinal tears, and other vitreoretinal pathologies. To diagnose further I will need the duration since when you have started seeing these floating objects in your eyes. If they have started very recently then it can be a start of posterior vitreous detachment or retinal detachment or tear and therefore, you should consult an ophthalmologist, preferably a vitreo retinal specialist immediately. In case of chronic, long term duration, most probably it is harmless and therefore you do not require any treatment if it is not affecting your vision significantly, but still, you should consult an ophthalmologist for eye examination regarding your problem to rule out any other issue. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for fever, fluid in lungs and infected blood\n\nMy brother has been in jail for 15yrs and has had three heart attacks now he was admitted with fever fluid on  the lungs and now has a mercer infection of the blood these two combonations has resulted in low BP  and a weaken heart with 15% and failing, what can be down if not done already.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.He has pleural effucsion and septicemia. It leads to low blood pressure. He should take intravenous antibiotics and fluid. Also he should go for pleural tapping and examination of that fluid. Consult your doctor and take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does head injury result in daze?\n\nMy daughter fell and hit her head on the sidewalk.  She has a huge egg on the side of her head near the back.  She says it hurts but has not thrown up.  Eyes look normal.  She said it was like a dream so she may have been out or dazed.  Recommendations?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. The smacks over head is always cushioned by hair and the sutures of the skull from reaching the brain itself. If there is contusion and swelling, that actually is a good sign. The blood vessels in that area ruptures and helps cushion the impact. The swelling shall come down within two days or so. I hope you washed the area with cool water.Daze and confusion do occur after the impact and it is actually the way body reacts to pain and agony. Wherever you get hit, there shall be daze or confusion. Therefore, in my opinion, there may not be anything to worry. Still for accurate confirmation,  you shall consult your orthopedist. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "mood swings,depression,taken Epilex crono and recita.gained weight,shall i continue taking them ?\n\nhi i am 41 years old height 5ft 11inches weighing 90kg. i am suffering from mood swings since last 10 years. in the beginning i use to feel better when i went on vacation to some hill station. but then it became a routine at the time of season change. I use to feel depressed didnt feel to work and i could sleep for hours continously. i also lost weight a lot. After that doctor gave me Epilex crono 500mg twice a day and recita10mg once at night. After that i felt better. i am taking these medicines since past 4 years and gained weight also during this period. please suggest whether i should continue with these medicines or will i have to take these medicines lifelong. presently i am taking epilex crono only 500 mg. Please suggest",
    "doctor_response": "Hi , lets first understand mood disorder-Mood disorder is the term designating a group of diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV TR) classification system where a disturbance in the person's mood is hypothesized to be the main underlying feature.The classification is known as mood (affective) disorders in ICD 10. Two groups of mood disorders are broadly recognized; the division is based on whether the person has ever had a manic or hypomanic episode. Thus, there are depressive disorders, of which the best-known and most researched is major depressive disorder (MDD) commonly called clinical depression or major depression, and bipolar disorder (BD), formerly known as manic depression and characterized by intermittent episodes of mania or hypomania, usually interlaced with depressive episodes. However, there are also forms of depression of MDD and BD that are less severe and are known as dysthymic disorder(MDD) and cyclothymic disorder for (BD). the drug prescribed to you is Valproic acid,which is a good mood stabilizing agent.follow your doctor advice for course of treatment,weight gain is a side effect seen with this drug ,however i advise you to consult your doctor again than stopping the drug on self. hope i replied your query. team -hcm",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to lose weight before having a knee replacement?\n\nI have type 2 diabetes and about 3 to 5 years I m going to need both knees replace, but first I need to lose weight. What is the best flaxseed I need to use to help me lose weight. Right no I am walking to help with weight lose, but sometimes these old knees hurry so bad I have to stop. Please help",
    "doctor_response": "Hello , Thank you for using healthcare magic . I read your question and understood your concern .I think you can loose weight with diet and instead of walking I suggest you to do stationary bike and swimming or other sport in sitting position and not stranding position like you are doing in walking. So, by avoiding weightbearing , your knees will heart less while you train.See a dietician to change you diet.Dr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard lump on back of leg?\n\nHello, I have a small hard lump under the skin on the back of my lower leg on my calf muscle it doesn't protrude but is sore. I have beeen excercising recently and thought it may be due to this. At the beginning of the week the area that is hard seemed bigger than it is now I have no idea what this could be.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You may have some soft tissue tumour like lipoma, neurofibroma, dermatofibroma or some other mass due to trauma. You should go for examination and if needed go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Excess hair growth, oligomenorrhea, swollen lips, body itching. Reason?\n\nhi.I am 23 year old female.Height 5 feet 4 weight is 96 kg.I have a problem of excess hair growth and oligomanorrhea as well.on ultrasound I was diagnosed PCO .For the past four years I get swollen lips and severe itching on my whole body from time to time.It comes in episodes.irregular but sometimes get more frequent.I can t seem to find any relation with season or environment.At first it used to start when I ate eggs or tea.I have got myself tested for food,or environmental allergy but it was negative.When I get these attacks my lips and eyes swell and I can feel my ears getting red hot.It used to subside with rigix but becoming unresponsive lately.I dont get respiratory symptoms at all.No one in my family has this or any kind of allergy.",
    "doctor_response": "According to my experience the Animal proteins are ngiving you problem.Your history also suggests.Stop taking animal protein .Milk is also animal protein.According to latest studies the harmone dependent diseases are due to milk,.Because milk also contains Bovine Female harmones wth react with Human Female harmones to give this kind of disease. You completely stop taking milk and diary,No animal proteins.Honey is also animal protein.Synthetic vitamins are also animal protein. If you Do this religiously you will get result in 3-6 months",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning in the fingers?\n\nHI, I RECENTLY WOKE UP FROM SLEEPING WITH ONE OF MY FINGERS (MY LEFT RING FINGER) BURNING, IN FACT, I WAS CONVINCED I HAD BURNED IT COOKING EARLIER IN THE EVENING, BUT LOOKED AND REALIZED THAT WAS NOT THE CASE. AS TIME WENT ON THE PAIN WORSENED AND HAD SPREAD TO MY ENTIRE HAND. THERE IS NO VISIBLE DEFORMITY OR SWELLING SO I AM NOT SURE WHAT COULD BE THE CAUSE OF THIS ISSUE?",
    "doctor_response": "Hello,Welcome, and thanks for sharing your concern I went through your query, and I feel, such burning sensation could be a sign of nerve compression in the form of CTS, or median cubital or ulnar cubital syndromes. A proper evaluation from the neurologist will greatly enhance the chances of reaching to the correct diagnosis.I hope my advice would have been useful, in decision making regarding your treatment, still if you have any clarifications or doubts feel free to contact back.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bumps on penis head and discomfort penis?\n\ni have flesh colored what look like swollen bumps on the head of my penis. They are not very big or terribly noticeable. I feel like i have to pee a lot. I have slight burning/discomfort only on the head area of my penis. It does not burn when I pee. I have no discharges. Other then that everything looks normal. Is this just a rash? Or could it be an STD? I m 33.",
    "doctor_response": "HiThank you for asking HCMI have gone through your query. Your problem can be most likely due to yeast infection. But if you have unprotected sex with risky partner then you should run STD tests to rule out those. If you were my patient with yeast infection then i would suggest using miconazole ointment for local application. Soaps and antiseptics should be avoided as it may increase irritation. You can use saline or warm water instead of that. Hope this may help you. Let me know if anything not clear.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will pregnancy occur in an unprotected intercourse?\n\nMy daughter is on an antibiotic for her acne called Doxycycline Hyclate. She is also on a birth control pill called Karivar.  Does she have a good chance of getting pregnant if her partner did not use a condom?  I Also calculated when she would be ovalating and it was the day she had intercourse.",
    "doctor_response": "Hello!Thanks for your query.Doxycycline reduce the effect of the pill.Pregnancy and breakthrough bleeding can occur. If she was ovulating in the day of unprotected intercourse,chances for pregnancy are larger.Additional contraception should be used for the first month from using doxycycline.TAKE CARE",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can lump on upper scrotum be symptom of cancer?\n\nhello just over the past few days i have found a lump in my upper scrotum. not attached to my testicle but above it and kind of beside it if that makes sense. I m really worried its cancer for some reason. i know cancer can happen at any age but I m 28. if this something to worry about?",
    "doctor_response": "The description that you have given is that of an epididymal cyst, although this can be ascertained only after examining you. These cysts are not cancerous and remain like that without causing any trouble. However, you should first see an oncosurgeon to be sure. If required, he will do some tests (FNAC-needle test) to rule out cancer or TB or other infections.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause for nodule on the bridge of the nose between the eyebrows of a child?\n\nMy 8 year grandaughter with autism (sometimes w/o clear verbage)was born with a nodule on the bridge of her nose between her eyebrows and in the recent months has become a behavior problem. No doctor has wanted to deal with this bump but I am beignnign to think it is pressing on the front lobe of her brain. Her hand wss scanned and she has the body of a ten year old, pubic hair and hair under her arm. Her mom has thyroid cancer but had thyroid removed but still has a piece on her larynax. So I developed more of a concern",
    "doctor_response": "Hi... The swelling you are Quoting that is present on the bridge of the nose could be a dermoid or a dermoid cyst. This  has got nothing to do with her autism or it pressing over the frontal lobe of the brain is also a far fetched idea. If such a tumor is pressing on the frontal lobe there would have been other dangerous signs like continuous vomiting, high blood pressure, serious and severe behavioural disturbances. You  need not worry about this.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest food and diet for 14 month infant\n\nHello my question is my son is 14 months old and he is teething also still eating belevit plus corn plus rice flavor kind of cerelac . He did not wake up early in the morning in the afternoon he has his breakfast second he has his fruits apple and banana in the evening and in the night he eat chicken plus potato , rice plus carrots, spaghetti plus peas . Is this kind of diet good for baby or you advice something else his weight is 11.5 . Can he eat cerelac two time in a day",
    "doctor_response": "Hi...a 14 month old weighing 11.5 kilos and eating healthy fibre rich diet like this means - you are doing an excellent job. He is perfect...do not worry. More than weight the activity is of utmost importance. If that is also good, then he is even more perfect.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rapid heart beat\n\nI have 18 year old son. He says his heart races about 5-10 times per day, blood pressure off and on can be higher and if exert self he says can race.  I took him off all caffeine but still happening.  Has had blood and urine test, and had ultrasound of heart that sows nothing.  What should I do next",
    "doctor_response": "Answer: Hello!Welcome and thank you for asking on HCM!Regarding your concern, I think he should get his thyroid function tests (TFT) done first. If TFT is normal and the symptoms occur on daily basis a 24 hour Holter monitoring will tell us whether the palpitations are benign  or needs some treatment with medicines.Hope to have been helpful!Wishing all the best, Dr. D Sunil Reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of recovering from a blood clot in the brain?\n\nMy brother had a blood clot in his brain. They used clot busters and got the clot. He was doing well, following commands, walking with assistance and the all of a sudden he was disoriented and weak.He is 79 years old in really great shape. What are his chances for recovering?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The chances are significant. Please upload medical notes and investigation reports if available. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat persistent lower lumbar spine pain while having degenerative arthritis?\n\nDr., I have been having severe ongoing lower lumbar spine pain for the last for weeks. I had a bronchitis infection around Christmas and had severe coughing for three weeks, I have asthma and some degenerative arthritis in the lower spine, I am 57 yo and 5 7 and 253lbs. I know the weight plays an important role, but I am having trouble sleeping, and walking sometimes sitting. I have been ibuprofen Tylenol, flexaril and codeine, but it does not go away. I just came from the ER and had a shot of toredol. My question is this I am scheduled to go for an MRI, butt I could not lay flat on the table,. What are my options?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.f I were your treating Doctor for this case:I would firstly advise you to do X- ray and MRI lumbosacral spine to assess the extent of problem (spondylo degenerative changes or disc herniation)-  I advise  you to receive proper treatment for the chest problem as It may cause constitutional manifestation that aggravates your back pain .- Finally It is better for you to lose weight, wear a  lumbosacral belt .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Achy body, chills, high temperature after getting kidney stone stent removed. Reason?\n\nI had a stent removed this morning. I was placed to do kidney stone causing swelling and abrasions. I was fine then several hours later started have a achy body all over, then started to get fever within 30 mins went from 99.9 temperature to 101.5... it has stayed around 101.5 but I also started to get chills and feel cold thats very unusal for me to get cold. And now have pain in my right kidney back area where pain was originally. Whats going on. I have had a stent 2 times before and never felt this way after removing it.",
    "doctor_response": "Hi,Thanks for writing in.Pain after stent removal can be due to recurrence of stones, stricture in the ureter or inflammation. As you have fever and pain, it might be due to mild infection. I would suggest  that you get a ultrasound done to check the possibilities. In case of stricture immediate action needs to be taken to prevent scarring.I would suggest that you visit your urologist and discuss the above mentioned possibilities for further advise. A urine culture and course of antibiotics might be necessary.Hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mumps symptom\n\nhello 38 years old had u.s rught teste and found ochitis showing symptoms of mumps but have had this when i was young... pain in neck lower spine buttocks radiating down back of both legs (feels like i've torn both hamstrings)... have had L4 L5 laminectomy...",
    "doctor_response": "Hey thanks for your faith in the health care magic.i have gone through your question and understood your problem.Treatment of the symptoms includes giving plenty of fluids. Paracetamol may be given for fever and pain. There is no specific antiviral treatment. Asprin should not be given to children under 12 years of age unless specifically recommended by a doctorHope I have answered your query. If you like my answers and wish me to answer in future, bring it to my attention",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the black dots on the tongue of a 6 year old kid?\n\nHello doctor,My daughter is 6 years old. About 10 to 11 months back we saw a very very small dark black colored dot on her side of the tongue. But now there are 4 to 5 similar sized dot around her tongue on both sides. The size has not grown. But it is just that new location has emerged. Lately she is continuously touching her tongue and her tip of tongue appears red. She says she feels like there is a hair on her tongue and there is some sensation on her tongue. I do not know if she is able to correctly describe her feeling. I am more worried about the black spots. Rest she is absolutely fine. Please advice.",
    "doctor_response": "Hi. Thanks for providing good quality images (attachment removed to protect patient identity). These are hyperpigmented macules. Most of the time these are asymptomatic. The cause can be hereditary or acquired (nutritional or poor hygiene or local trauma-thermal or mechanical to tongue). Diagnosis based on current images: mucosal lentigines or melanotic macule. My advice is to keep observation for new lesions. Take tablet Zincovit (Ascorbic acid and Biotin) one tablet daily. Maintain good hygiene. Do not panic about these lesions. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can i get rid of large vein on my legs an arms?\n\nI have big puffy vein in my legs an hand an arms.WHAT can i do to make them smaller or get rid of them.",
    "doctor_response": "I have big puffy in my legs an hands an arms.WHAT can i do to make them smaller or get rid of them.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in testicle and penis after encapsulated tumor removal?\n\nI have an achy pain 6/10 in my testicle and penis after a surface, encapsulated tumor was removed from the inside of my bladder. I have had chemo seeds put into the Sx site. I have no stinging or blood when I urinate, and no traces of infection or swelling/redness. I had a catheter, though it was removed two weeks ago. What do think it could be, and what tests should I have?",
    "doctor_response": "HelloThanks for query.The pain in penis and testicle is likely to be due to Stricture Urethra or Urethritis that you might have developed due to urethral catheterization  post surgery.You need to take broad spectrum antibiotic like Cefexime along with anti inflammatory drug like Diclofenac twice daily.If problem persists even after taking medication you may need to get Radiological tests called Retrograde Urethro Cystogram done to rule out Stricture Urethra.Further treatment will depend upon the results of this test.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for completely blocked artery\n\nMy father in law has had 3 heart attacks. This last one has left him with only 10 percent heart functioning. Surgery is out of the question. He has one completely blocked artery, one that is 80 percent blocked. He is being sent home with oxygen. what is the prognosis?",
    "doctor_response": "Hello,Age you did not tell me. Show me his ECG, Echo report. If Ejection fraction (EF) 10 % prognosis is guarded. What treatment is he on?Hope I have answered your query. Let me know if I can assist you further.Regards,       Dr. RS Gulati",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump in throat in a cancer patient\n\nhello sir, My granpa is sufferring from Cancer, there is a lump in his throat & he has a lot of difficulty in eating food. in fact now adays he is just taking semi solid khichdi and milk. doctors in  govt hospital told us that his cancer is at advance stage and now we'll have to take him to SUFDURJUNG HOSPITAL in delhi. but i saw that there is no facility for cancer treatment in that hospital however there is one in the AIIMS just opposite to that.. please advise what shuld I do?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. He may have oesophagus cancer.  If it is advanced stage then surgery is not possible.  Treatment of choice remains chemotherapy and radiotherapy.  For that you should go to fully equipped hospital with all facilities.  You can go to AIIMS hospital or other and start treatment as early as possible. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have chronic back pain after chiropatic adjustment. Treatment?\n\nHello doctor my name is Mark I m 26 years old form Nova Scotia, Canada. I have a had chronic lower back pain for two and a half years now. My pain came after a chiropractic adjustment, the chiropractor upset the subcantaneous tissue in my lower back I ve had pain and extreme stiffness ever since. What would you recommend to heal this. I went to other chiropractors for help, had massage, did physio, took muscle relaxers, went swimming. Swimming makes my subcantaneous tisse more sore. I also went to an osteopath I waisted so much money and time in my life it scary. I want to join the navy, but my back pain is too bad. Any information or guidance you could give me would be highly appreciated.",
    "doctor_response": "Hi, Greetings. Sorry for your suffering. In the long list of consultants you mentioned, i dont see neurosurgeon/Orthopaedician. I guess you should try and make a consultation with them and probably an MRI as the suffering is for 2 and half yrs. I hope im of help Regards, Dr.Susheel.B.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Depression after back Surgery. Is it a related symptom ?\n\nI had a back fusion 1 month ago. I am not taking pain meds now. I am taking 1 muscle relaxer once a day. At the time of surgery I quit taking St. John s Wort all at once. 2 weeks post op I had an adverse reaction to Tramadol. I am now very moody and easily irriated and somewhat depressed. I have started taking the SJW again. on it for 3 days now. Can all of this be related? I don t know what to do about being so angery. Thanks",
    "doctor_response": "Hi Yes, it COULD be the fact that you stopped taking SJW. This is just an educated guess since the antidepressant compund in SJW has not been isolated so we don't know if that has withdrawal symptoms if stopped suddenly but I think this should be a ok enough guess. It could also be due to unresolved pain symptoms and hence if the pain is chronic and sub clinical you would probably not feel it so severe to go for pain killers but would be so irritating as to make you feel irritable and angry and moody....here I speak both from personal experience of chronic pain and as a professional. I would suggest you check out with your doctor first about interactions of SJW with your current drugs. If you are a female, then we know for sure that it interacts with the pill. There may be other unknown interactions also. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for persistent fever and vomiting in a child\n\nMy 9 month old has had a fever (which spiked to 103.9) for 3 days. The fever was accompanied by vomiting and sleepless nights. The fever broke and a day later a rash appeared on the back of her head and ears, as well as her neck. Throughout the day her rash has spread to her back and stomach. Her breath smells now. I have no idea if her throat hurts or if she has swollen glands because she obviously can t tell me. I cannot get a look at her throat and tongue because she doesn t sit still long enough for me. She is still happy and playful and has continued to eat for the most part. She does gag when she first puts her bottle into her mouth",
    "doctor_response": "viral exanthema ..Measles with typical distribution of rash and prodrome symptoms.Give Anti pyretics ,anti histamines and calamine lotion application .usually self limiting.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to control mood swings in child?\n\nmy happy 10 year old has been getting mood swings. he gets lethargic and whiney. Crying at the drop of a hat. His teacher is as confused as I am. One day he is happy and smart the next he is almost fatalistic, and self depricating. He can whip through subjects easily, then the next he says he is stupid and can t do anything. Should I get him checked out? for what? and where? His regular doctor really seems only good for immunizations.",
    "doctor_response": "dear parent welcome to being parents of an adolescent.this is the beginning of adolescent swings.be patient. don't judge, don't comparejust be there with himkeep communication, be understanding.keep watch.he is developing personality, he is as confused. be very clear in what you are telling him.find an adolescent consultant and consult with her/ him how to handle an adolescent. you can take him to the adolescent consultant on some other pretext, like if child gets flu or so, so that he is familiar with the doctorthere after adolescent consultant will not guide you n him both. my personal experience says parents need more counselling than the child.if you learn now it will be easier in future.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can i Make out my ovulation period ?\n\nif i start having pain in my hip bones by evening 7 should i understand that ovulation has just occured and i now i have 24 hours or it may pain later or before. plz suggest",
    "doctor_response": "Hello riya; welcome to HealthcareMagic Ovulation does not give rise to any sort of pain in body so if you are getting pain in hip bones in evening it can be due to calcium deficiency;tiredness or a generalised weakness  so start on some calcium supplements and if the pain is severe then you can take a painkiller. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cancer in the pancreas, liver and in right lung\n\nMy dad is the hospital now the doctors said he has 2 months to live. They said he is 90 percent of cancer what does all this mean is he going to die like they said or is there something more I can do to help him recover ?",
    "doctor_response": "Hello and welcome to Health Care Magic Forum ,the process of cancer can be controlled by drugs and I do not think period  can be controlled but I do not think any thing more can be done ,take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does severe pain and bruises on back in the area of bulged disc suggest?\n\ni have had two neck surgeries and two mid back sugeries and they noticed i have a bulging disc below where the rods and screws in my back is. i have had severe pain lately. and i woke up with bruises on my back . and i have not bumped it. what is this from",
    "doctor_response": "Hello, I have studied your case.If your MRI says herniating disc then this can lead to compression of exiting nerve root which later on supply  lower limb.Due to compression of this nerve root there is tingling numbness in your leg and pain associated with it.Neurotropic medication like methylcobalamine and pregabalin will reduce pain; you can take them consulting your treating doctor.You may consult physiotherapist for further guidance. He may start TENS, or ultrasound which is helpful in your case.Spine extension exercises will help you.I will advise to check your vit B12 and vit D3 level.MRI shows disc compressing on nerve root then  re -surgery decompression is permanent solution.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly suggest medicine for relief from running nose, sore throat and fever.\n\nHi doctor,I am suffering from running nose, sore throat, body pain and fever since yesterday. Kindly suggest some medicine for relief.",
    "doctor_response": "Hi. You seem to have influenza or the common cold. Since it is viral, it will run its course. However, you can take some medications for symptomatic relief. Influenza. Common cold. 1. Tablet Cetirizine 10 mg once daily. 2. Tablet Paracetamol 500 mg not more than three times daily. 3. Do not take any other NSAIDs (nonsteroidal anti-inflammatory drugs) or Aspirin as you already have acidity issues. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Drink plenty of fluid and stay hydrated. For more information consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in abdomen while passing stools?\n\nHi I am 30 yr old female. Have been getting sharp stabbing pains in my lower abdoman and pain when trying to defecate. Is this just constipation? I am able to pass stools but am getting pain in my abdoman when doing so. At best it's a dull constant pain at worst stabbing pains take my breath away.",
    "doctor_response": "If it pains only during passing stool and stool is hard then chances of  pain due to constipation is high. You should take plenty of  oral fluid. Lots of fiberous food. If not relieved  pl see your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a sore inside the mouth?\n\nHello Doc,For the past several months I have noticed a sore inside my mouth that resurfaces every so often without any consistency. It will then just go away on its own after several days. This last time it resurfaced again but this time it actually looked more like a blister. It went away again on its own just about a day ago. I have taken a few pics for your review. What could be going on?Sincerely,Jose",
    "doctor_response": "Hello,  Read your query, as you have sore inside mouth dont worry this can be due to some factors it can be due to poor oral hygiene,  stress related , vitamin B and C deficiency , Nutrional deficiency, lack of sleep , hormonal influence , or due to viral infection also. For this you should consult dentist and go for proper investigations and oral examination , in meantime  you can do is take proper n nutritious healthy diet,  Drink fruit juices, Electrol , do warm saline gargle two - three times a day, Dont take stress , You can apply ointment Gum paint or Acivir on sore and take vitamin B and C supplements by consulting with your local doctor. Hope this will help you.  Regards  Dr. Priyanka tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i have any liver disease while suffering from Hepatomegaly Grade III ?\n\nHello Doc, I am unmarried, 27 years old female. 3 months back i was diagnosed with Hepatomegaly Grade III. Since then i have been on Evion once a day, Trental 400 mg thrice a day. I have been having constipation for the last 15 days and pain in the stomach on both sides. My doctor recommended a MR Abdomen , MRE and Endoscopy and says I could be having some liver disease also. What does this mean? I also have PCOD for which I take medicines every month around my cycle.",
    "doctor_response": "hi, are u  following the advice of dietician properly but the constipation may also due to medicines sideffect,confirm ur diagnosis & with that for hepatomegaly take chelidonium Q 20-25 drops in half cup of water thrice a day with lycopodium 200 & carduus mar.200 4-4 drops of each also half cup of water 3-4 times a day keep some time gap between chelidonium & other 2 medicines ,take medicines of reckweg from genuine medical store. wish u good health & recover soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need suggestions for treatment after being suffered from mild heart attack\n\nfather is 87 suffered mild heart attack two weeks ago. heart is functioning at 15 per cent, kidneys are producing very small amounts of urine. so they are failing. he is on oxygen at around 8 per cent. not eating drinking very little. How long can we expect hime to have to hang on thru all of this. thankyou",
    "doctor_response": "Greetings! Thank you for your question and welcome to HCM. I understand your concern. I am assuming he had a major heart attack, or at least, a prior heart attack and a second, mild, heart attack happened now. A heart functioning at 15% is accompanied with a poor prognosis. This means that heart pumps only 15% of its content, and this is not sufficient to provide enough oxygen and nutrient supply to the end-organs. Kidney is suffering from this phenomenon, because, as a compensatory mechanism, the organism \"sacrifices\" other organ supply to keep the brain going. Also, the pressures in the pulmonary circulation will be very high, since the pulmonary veins cannot drain their blood supply to the left heart chambers, because of the high content of blood in the heart, which is already there (the remaining 85%). This can easily produce life-threatening situations, such as pulmonary oedema. At this point, all the measures to prolong his life are mandatory, such as careful adhering to the treatment, which should include, among others, two diuretics, oxygen and an angiotensinogen converting enzyme; totally withhold salt from the diet, and confine to only minimal ambulations within the house, to perform necessary duties. I hope I was helpful with my answer. Regards, Dr. Meriton",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which is the fertile days after periods to conceive ?\n\nhello me n my husband are tryin to have another baby we had sex once on my fertile days can i still get pregnant if we only had sex once",
    "doctor_response": "Dear patient welcome to HealthcareMagic forum yes you got pregnency.if done sex on fertility period. because in that day.ovum are well doveloped.and highly risk period for pregnency. Thank you......",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are flu symptoms and bad cough in a child symptoms of whooping cough?\n\nhow can i tell if my 2 year old has wooping cough she has it twice before and was hospitalised but its not to bad yet like she hasnt changed colour or gasping for air she has had flu like symptoms for id say 4 maybe 5 days now and the cough has just came on but she might cough for a quite a while is their something i can do to prevent it getting worse!",
    "doctor_response": "hi..repeated history of cough in your child is pointing toward the diagnosis of episodic wheezing. pertussis (whooping cough) if you don't treat child will cough for 3months. if child is vaccinated for pertusis, unlikely whooping cough.your child requires complete physical examination, chest X ray. child requires inhaled steroids and oral montelukast.if you are happy with my suggestion kindly rate me.regards - Dr.Surendra.H.S",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for chest pain?\n\nHI Doctor, I,m having some chest pain since a month, I visited a doctor and took ecg,and ultrasound .",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Possibility of musculoskeletal pain is more. And your doctor prescribed you painkiller only. You improved with these drugs, so musculoskeletal pain is more likely in your case. So along with painkiller drugs, do following things for better symptomatic relief. 1. Avoid heavyweight lifting and strenuous exercise. 2. Avoid movements causing pain. 3.  Avoid bad postures in sleep. 4. Apply warm water pad on affected areas. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be concerned about the celluloid in 67 year old?\n\nHello my mom is 675yrs old few days ago she noticed red spots on her bilateral ankles warm on touch not painful but I would say edematous+2. She is not diabetic no kidney problems no heart issues, no vein thrombosis . She has HTN arthritis and hypothyroidism. Recently she has been taking Norvasc 10 mg daily, about 4days. Im worried about celluloid What do you think, DR? Thank you, Mercedes",
    "doctor_response": "Hi MercedesThis does sound like cellulitis and she needs to see her doctor for a course of antibiotics",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this BP level of 148/86 and pulse 72 indicate?\n\ni have high blood pressure and iam on lisnopril 20mg once a day , and my blood pressure has been doing real good, but i noticed today after taking my blood pressure its been high today  like 155/89 pulse was 78 i have been around a few people that has been sick, could this be the reason its been high today right now my blood pressure is 148/86 and my pulse is 72, should i contact my doctor?",
    "doctor_response": "hello,    Have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. If bp is persistently more than 140/90 mmhg, then you should be on medicines for it. You should be started on Tab Amlodipine 5 mg once a day.  You should have Regular exercises like brisk walking, jogging according your capacity atleast 30 min a day and 5 days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Get your lipid profile and sugars tested once..  Hope this helps you and get back if you have any doubts.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore, thin cuts on foreskin?\n\nHi, i , 29 years of age and have been out of a relationship since February this year. I have not had sex during this time. The past few weeks I have noticed thin small paper cuts on the foreskin of my penis, close to the head of my penis. It is quite sore and wondering if you would advise I check in with my GP or go to the pharmacy and purchase some Topical cream. Any suggestions? Thanks Doc.",
    "doctor_response": "Hi,It seems that due to not cleaning smegma collecting under fore skin might lead to crack and some infection on glans penis.Clean the glans by averting foreskin and remove collection of smegma.Apply antibiotic cream locally.Make a habit of cleaning smegma daily while taking shower.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have chronic Hepatitis B, stage 4 kidney disease, Crohn s with ilelostomy, suggested Truvada. Your suggestions ?\n\nI have chronic hepatitis b and stage 4 kidney disease and chron's diseases with ilelostomy and my hepitologisuggested taking Truvada to get the hepatitis b under control so maybe I can get a cadaver kidney, someone that had hepitis b. What are your comments on this situation? My chron's is under control or should I say in remission.  I take no meds at present time for it. Thank You,",
    "doctor_response": "Hi For the hepatitis B I am not sure for any medical treatment because it get cure it self only you have take care of your diet, low calorie diet would be more beneficial , Chron disease can be controlled medically. have a nice day",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lung spasms?\n\nwhat would make sharp lung spasms on a nice day to a non smoker, low blood pressure and normally well 63 year old woman on no medications? It felt as though I d taken a huge gulp of liquid and had an air bubble but lasted for at least 10 minutes. Thank you",
    "doctor_response": "Thanks for your question on HCM.There are many causes of lung spasm.Actually it is ptotective reflex to prevent further entry of causative substance.So causes of lung spasm are1. Infection like bacterial and viral.2. Inflammation due to any injury.3. Allergens like dust, pollens, fumes etc.4. Sudden change in temperature like in extreme cold.5. In your case water may be regurgitate in the lung and this may caused spasm.So cause for spasm are many.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anger disorder\n\ni feel like ive so many mixed emotions running through my body its confusing, like sometimes ive got so much hate an anger inside of me i feel like im literally about to blow, ma family an friends are sayin sometimes im really horrible to be around,  i forget things i say when im angry its like i cant controll what i say,... sometimes i can be right nice an easy to get along with, or im jus right emotional an often feel suicidle an worthless etc.. i feel like im sometimes a different person, i dont feel like me myself, im forgetting things, i feel paranoid to go place i feel everyone's against me an plottin agains me or setting me up, my moods are always changing an its like i controll them, im startin to seriously struggle with my day to dayy activites im finding it hard to focus and concentrate",
    "doctor_response": "Hello,your description suggests that you are on the initial stages of developing some psychotic spectrum mental disorders. The best option would be to start with a low dose antipsychotic medication like Risperidone rather then waiting for the problem to grow more.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the diet plans and precautions for bronchitis?\n\nhello, I just had an X-ray of my chest. it says that Bilateral hilar congestion with prominent broncho vascular markings- Bronchitis . I m suffering from cough for last 60 days. now i am under treatment..what should i do further for precaution and advice me to take proper food.",
    "doctor_response": "Thanks for your question on HCM. Try to follow these preventive measures for bronchitis. 1. Avoid exposure of cold climate.2. Avoid ice creams and cold drinks.3. Eat healthy food, freshly prepared. 4. Drink plenty of fluids including fruit juices. 5. Avoid dust, chemicals and pollution. 6. Avoid pet exposure at home.7. Chest physiotherapy with deep breathing exercise will help you alot in maintaining good lung functions. 8. Avoid smoking , both active and passive.9. Take adult vaccination with pneumococcal and influenza vaccines for prevention of lung infection as bronchitis patients are easily infected.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen calves and ankles?\n\ni have swollen calves, and ankles which has an onset in the afternoon, in the morning, they are not.they feel like mid calf is asleep, like you have slept on your hand and it falls asleep, but soon it recovers. I take Furosemide20 mg and try to drink water, which has water softener, recently, in my apt. complex. Now what.",
    "doctor_response": "hi,you need to keep your feet elevated above the level of the heart. it will surely help you reduce the swelling. post that try doing some ankle toe movements, straight leg raise and static quadriceps and static hamstrings in the lying position which will help you avoid the swelling in the future as the muscles will be strong to keep the venous return united.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe knee pain after putting pressure?\n\nA person put a lot of pressure on the medial ( once ) and lateral ( twice ) patella of each knee. This caused me a lot of pain at the time and the pain continues. Pain is the worse upon standing from a sitting position. The pain shoots to a level 8. what did this person do to cause all of this?",
    "doctor_response": "Dear Sir/MadamI have gone through your query and read your symptoms.In my opinion,you have hurt your cartilage of the joint, due to the pressure, Take analgesics, and some rest for 2 to 3 days and see if it resolves, if it does, its ok and if it dosent than you may need and X Ray and MRI of the joint to see what damage has been done.I hope that answers your query. If you want any more clarification, contact me back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to heart ailments\n\nI am a 60 year old male.  I had a MI in 1996 and a double by-pass following my attack.  For 6 years the only medication I took was a baby aspirin daily.  At age 50 I developed an atrial fibrillation and had a pacemaker installed.  Now at age 60 my cardiologist suggested an upgrade to a pacemaker that would improve heart function.  Is that an indication that my heart function has deteriorated to the point of not being able to reverse the effects of the CHF and problems I continue to have with fluid in the lungs?",
    "doctor_response": "Hello SirAfter reading the case details provided by you i would like to tell you that yes its true that probably your heart function have deteriorated over a period of time that's why you are having fluid accumulation in your lungs. As you have entered your 60's so its better to upgrade from just a PACEMAKER to a CRT-P Or CRT-D as it will help synchronize your heart rhythm which finally improve the heart function (LVEF) and also prevent sudden cardiac death due to some arrhythmia.Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can vomiting be prevented?\n\nMu son is going to be 9 yrs by this month end.from yesterday morning he is having vomiting and fever and tonsil. Doctors have given ondem, sporilac plus , zanocin 100mg. Yesterday I gave him 2 dose of ondem tablet but again today morning he vomited again. What should I do. Now?",
    "doctor_response": "Hello,I will suggest you to continue these medications in prescribed doses. It's normal to get vomiting off and on after starting treatment. As this problem is secondary to some infection, the infection takes at least 48 to 72 hours to start  getting adequately cleared. You need to keep his well hydrated by using oral rehydration salts meanwhile. If he vomits too frequently to get any rehydration or medications then only you need to get him to emergency of a primary care physician.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Muhammad Faisal Bacha, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed blood in saliva during spit\n\nI'm spitting blood mixed with spit. It started was 2 days back  when I had a weird taste in my mouth. so as I spit, I noticed the blood mixed with the saliva... i spit two three times and it goes clear... it doesn't come all the time... even if i try to spit from the very back of my throat, in 2 days i have noticed it two times in a day at random intervals of time like 1st day 4 hours and another day 7 hours. I am so much tense due to this, is it a symptom of something big, do i really need to worry about it? i couldn't even sleep well due to this thought. Also note i don't have any cough and cold and yes i do smoke 1 cigarette a day average",
    "doctor_response": "THANKS FOR YOUR QUERY,i have gone through your question, nothing to get scared, the bleeding could be from the infected gums...that is d most common cause of bleeding...do not be tensed just get your oral cavity examined by a dental surgeon and get your teeth cleaned...Do saline gargling or with mouth washes like chlorhexidine...with regardsDr. Mahesh Kumar T.S",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruising on skin after exercising?\n\nLately I have had excessively dry skin, I sweat terribly and now I'm having my veins burst under my skin.  Like I will get a swelling, then it turns to a bruise, and it will be after exercise or after bending over, not after getting injured. this has happened on my hand, my thigh, and now my foot. It's just odd, any clue of what could be going on?",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. It seems you are suffering from dry skin, along with vasculitis.2. The thin sin, is allowing for the blood vessel to get damaged, which leads to loss of blood subcutaneously and hence the bruise formation.3. Need to improve hydration. Dehydration is causing dry skin. Avoid hard soaps. Use soft soaps and bathing only once a day to preserve skin oil to avoid getting it dry. Also moisturizers for skin along with Vit A supplements is necessary. Bruise will take longer to disappear, usually upto 2-3 months. Avoid further  abrasions of skin.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Inflamed liver, low BP, headaches. On boxin. Had head scan. What can be done?\n\nhi doctor 7months ago i was attacked an i got punched in the head an ever since i have had headaches an now ive got to go see a dermatology in 3weeks but right now since boxin day my head weeps fluid an my body has bin goin into shock were i say an do things that i carnt remember an it isint me,my allergy started a year ago christmas was a hair dye they think then my body went into shock off antibiotics an my liver was immflammed an my blood pressure was low my body keep doin somethink to me an am weak everyday an have 2 lil boys an am scared of whats happining do you think my doctor should send me for a head scan",
    "doctor_response": "Hi and welcome to HCM. Thank you for your query.It can be part of postconcussion syndrome but it usually shouldnt last for so long. This can be simple migraine or there might be some other cause of your headaches.It is definitely indication for CT if symptms persits but i doubt that something will b efound on it. YOu just need to find painkillers that relieves pain. Also, your psychological and concentration problems should be managed by psychiatrist. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Large blisters on right buttock. Diagnosed for Haley-Haley. Treatment?\n\nI am a 44 year old female with large blister clusters that are very painful and extremely itchy that are on only my right buttock.   These have been recurring since I was 16 years old. These blister patches originally appeared only on the right side of my nose under my eye...sometimes affecting my vision.  But they eventually have stopped coming to my face and now appear in the same general area on my right buttock. I was originally diagnosed by an ER Dr as a spider bite., then at 35 was diagnosed as possibly having Haley - Haley disease, but I was not tested as this disease is genetic. So the treatment is usually a hydrocortisone cream.  My question is ... What does this sound like?  Are there any good treatments for this? Is this life threatening at all...can this form on internal organs?",
    "doctor_response": "Hi The treatment for Hailey Hailey disease is usually to keep the area free of infections. Avoid trauma, keep the area dry, use steroids if new lesions are developing, anti-biotic cream may be used for bacterial super-infection of the area. Some other treatments that have been used are laser, dermabrasion and skin graft. It is not life-threatening. It does not show up on internal organs.Dr Vaishalee",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump on the upper left arm indicate?\n\nI have a large \"knot\" on my upper left arm. It has been there for several years but in the last couple of months it has gotten larger.  I have ovarian cancer stage 3c but I'm in remission and currently taking chemo once a month.  What could this knot be??melissa",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  There are different  possibilities  for this lump as    -  sebaceous  cyst  -  lipoma  -  lymph  node  - neurofibroma  -   othersHope this clears your doubt  .Wishing you fine recovery .Welcome for any further  assistance .Regards dear take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the life expectancy in case of mucinous cystadenoma?\n\nHi doctor, I am 31 years old and weigh about 54 kg. I underwent appendix operation before four years, and the histopathology came as appendix with mucinous cystadenoma. After a few months, I started getting stomach pain and constipation, and doctors used to give me stool softners. My stomach pain became severe before two years and I got admitted to the hospital. They did a colonoscopy and said everything is normal but my problem did not go off. Recently, again I got admitted in the hospital due to severe pain and they did right hemicolectomy and said I have a mucinous carcinoma and it is not curable, only death can be postponed by giving treatment. Kindly advice and help me.",
    "doctor_response": "Hi. I have read your query and seen the attached files (attachment removed to protect patient identity), but nowhere is it documented that it is mucinous carcinoma and that it has spread. The uploaded colonoscopy was not done recently, what was done after that till now? Please upload all the doctors' notes and recent investigation reports for thorough advice.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes knee pain even after a knee replacement surgery?\n\nI had a knee replacement and was not aware that 3% of the chrome part of the implant was made of nickel. I had my surgery 6 months ago and still in a lot of pain. I happen to allergic to nickel and was not told that it had nickel in it. what can I do.",
    "doctor_response": "Hello, Well who said you that you are allergic to nickel. Yes Co-Cr implants contain nickel but that's the inert material. There are lots of other reason than what you are thinking. do regular quadriceps and hamstring strengthening exercises. take some pain killer. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Anuj Gupta, Spine Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Extreme upper abdominal pain. No relief with TRamadol, Trazadone. Solution?\n\nI ve been having extreme upper abdominal pain for the past two weeks, with very little relief. I have gone to my doctor who performed an endoscopy , and tried a colonoscopy twice. I did the prep twice and to no avial. The second time, I did go to the bathroom, thought I was cleaned out, but he said I was completely full when he went in. The pain is unreal, and I can t seem to get relief. I ve been taking Tramadol 50 mg, and Trazadone, which no longer work. I m starting to think I m crazy, no one will listen to how much pain I m in.",
    "doctor_response": "Hello! Thank you for the query. Upper abdominal pain has rather nothing to do with large intestine disease (if no bowels obstruction). Such pain can be caused by gallstones or pancreas disease. That is why, what you should have performed at first before any endoscopy is abdominal ultrasound, full blood work, liver tests (AST,ALT,GGP), amylase, bilirubin, urine analysis, abdominal X-ray. If gallstones are causing your pain, hot bath should ease it as well as soft muscle relaxing medicines. Hope this will help Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for bumps on butt due to tailbone injury\n\nI landed on my tail bone and went to urgent care to check for broken tailbone which x-ray was negative. I still have a lot of pain while sitting and a lump on my right butt cheek. When I slouch it really hurts especially coming from area of bump. What is the bump and is the pain coming from?",
    "doctor_response": "Hi,The injury you sustained can lead to quite a lot of pain even though your X-ray was normal. This is due to soft tissue injury and hematoma which is a collection of blood that spreads in the surrounding tissues. This will cause a lumpiness to develop in the area which can be very sensitive. It will return to normal but this may take a few weeks. In the meantime, take paracetamol and ibuprofen for the pain and swelling. You may benefit from sitting on a padded support under your tailbone. Avoid activities which make the pain worse. I wish you a speedy recovery. Regards,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should I do for uncontrolled BP with kidneys working at 25% and having a history of multiple spine surgeries?\n\nHi,My name is Brenda and I m 59 years old. I was just told by me PCP that my kidneys are operating at 25%. I ve had 9 spine surgeries over the past 7 years and HP pressure is out of controlled, Also, I m dealings with a 90 year old mother in law who stays with us,",
    "doctor_response": "HiThanks for your queryYou need to see a nephrologist. We need a detailed history and clinical examination as well as further investigations to determine the cause of your kidney disease.Once we have the above details, we can suggest furhter appropriate treatment in terms of diet, medications etc to decrease the rate of progression of your kidney disease.Hope this helpsGood luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Butrans patch effective in the treatment of lower backache?\n\nHello, I do benefit from the Butrans 20 mg patch for lower back pain and wondered if my daughter (36 yrs) would be helped by this patch, since she seems to be taking up to 8 tramadol 50 mg a day for chronic pain. My daughter was in an abusive marriage and has dealt with the pain with the tramadol but the amount she takes seems to a habit vs helping with the pain. Thanks",
    "doctor_response": "HiThank you for asking HCMI have gone through your query. Tramadol is a safe narcotic when compared to others. Butran patch is effective for chronic pain. But I would suggest short term NSAIDs like Ibuprofen and muscle relaxants followed by physiotherapy and exercises. This will avoid the need of narcotic drugs.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can dental procedure be done if having high blood pressure?\n\nI always get novacain from a dentist for a filling or a crown now that aim treated for high blood pressure and getting a crown should I get it done . Iam take medication for high blood pressure and the last time I went to the doctor it was 120 over 80 . While every other time I got it checked it was high .",
    "doctor_response": "Hello, I would explain that it is safe to have dental procedures while on antihypertensive therapy. So, there is nothing to worry about! Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for running nose and light fever\n\ngud morning doctors.. I m from delhi, my son is 2.5yr old. whenever whether is changed he got catched into running nose and light fever. we are taking treatment for him from our pediatrician as and when req. first of all on first day we prefer and use home remedies to overcome the disease of our son then if no progress we ll go to doctor. we also seen him to one other pediatrician. both docs suggested MAXTRA which suits my son and get relief each time in only 2-3 dose. we are also giving IRON,CALCIUM AND VITAMIN supplements syrups to our son recommeded by our pediatrician. I want to know which is the best medicine which is no/less harmful to be given to any kid in case of cough,cold and fever? and Is Paracetamol and ammoxyciline is harmful for kid under 5yr. pl guide with your valuable suggestions. Thanks and regards, Malkeet",
    "doctor_response": "Hello I read ur question By reading ur question, ur baby had allergic rhinitis Mextra is good drug for ur babyPeracetamol is to reduce fever and amoxicilline is antibiotic which is not to take without doctor permission",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My hands are rough and dry. There are many lines on my palm. Suggest me some treatment.\n\nHi, My hands are extremely rough since childhood. I am 17 years old now. I have tried almost everything to get rid of this problem. I also have so many lines on my palm and fingers. Suggest me some treatment.",
    "doctor_response": "Hello. Hyperlinearity (lines in the palm and fingers) of palms is a feature of a condition called atopic dermatitis. These patients, in general have dry skin in their palms, soles and elsewhere as well. I would suggest you to use a moisturizer twice daily upon the dry areas.  Especially those moisturizers which contain Urea or Ammonium lactate or Glycolic acid. Consult a dermatologist online for further queries -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does excess dandruff is an indication for psoriasis\n\nsir, does excess dandruff is an indication for psoriasis.  There is kind of dead skin tissue coming out when I picking out with my fingers, which is usually clears off after i take head bath.  there has been no itching or spots of blood. Can u please answer?",
    "doctor_response": "Hello. Thanks for writing to us at healthcaremagicDandruff if excessive or resistant to regular OTC shampoos can be due to some other cause like seborrheic dermatitis or scalp psoriasis. While seborrheic dermatitis is associated with itching and yellow greasy adherent scales, psoriasis is characterized by well defined patches, with thick scaling, commonly involving the hair line. In psoriasis there may plaques elsewhere on the body. The diagnosis is clinical, therefore a visit to a dermatologist would be useful in that regard.You may use an OTC antifungal shampoo e.g 2% ketoconazole, alternate days, lather it well and leave it for 5 minutes to act before rinsing it off.If this does'nt seem to help you may seek an appointment with a dermatologist for a confirmatory diagnosis. You dermatologist might also put you on topical steroid lotion for a period of about 2 weeks, if he or she feels that there is too much scaling and a shampoo alone might not be sufficient.Thereafter once the scaling is effectively controlled with topical steroid lotion, a shampoo would be effective for maintaining the improvement.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "My Husband had lump on his neck. Recovery time?\n\nMy Husband had lump on right side of his neck. done FNAC test and result is Granulomatous Lymphadenitis suggestive of Tuberculosis ( Right Cervical Lymph Node).  and the test is ZN stain : Negative for AFB.  How he will be treated and how soon he will recover.",
    "doctor_response": "Hi.Since FNAC is suggestive of tubercular lymphadenitis, he needs a course of minimum of 2 + 4 months treatment of antitubercular treatment. Your Doctor will prescribe you the medicines in the form of a Kit or different tablets as per his choice.Always do baseline liver function tests in addition to serum proteins and routine blood test.Repeat liver function tests after 2 weeks after starting the treatment.Inform your Doctor if you develop any tingling or burning in feet, visual disturbances immediately. He will have daily red stool or urine due to Rifampicin- this is normalNeeds high protein diet and mutiviatmins in the for of antioxidant capsules.Injection streptomycin is also a very good additional medicine- to be taken for first 2 months only.Lymph nodes take a lot of time to heal and shrink, so do not worry about the size reduction.Observe for increase in appetite, weight gain , feeling better and such symptoms and signs.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is UTI the cause for vomiting and fever with pus cells in urine?\n\nHi, my 6 and a half year old daughter is throwing up for last 8 days. She is having fever that comes mainly in the morning. Her urine report showed about 10-12 pus cells with leukocyte esterase positive. My peadetrician prescribed axenclav 200mg for five days (3ml 2x). But even after 5 doses, there is no alleviatio of her symptom. We went to dr again and he prescribed Taxim O after looking at the routine urine report. Please let me know if she has UTI or UTI and an enteric infeciton both? Her urine culture showed presence of enterococcus faecelis.",
    "doctor_response": "Hi....I feel it's an UTI. But to be certain that it's UTI due to Enterococcus faecalis infection I need to know the colony count mentioned in the urine culture report. Only if the colony count is more than 10 to the power of five, we can be 100% sure that it's due to the same organism. Please get back to me with above details by asking a direct question to me.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be follicle size on 9th day of follicular study cycle?\n\nHi sir, I am 26 years old and suffering from PCODs. At present i am on medication: metformin 500mg twice a day and folic acid. I am going through follicular study. On 9th day of my cycle, following are the ovaries measurents:Right ovary: 3.23*2.58*1.71cm Volume 7.45ccLeft ovary: 3.08*3.20*1.89 cm Volume 9.77ccRight ovary shows 10-12 follicles 2-7 mm in sizeLeft ovary shows 12-14 follicles 2-6 mm in size.Please let me know what should be the follicle size on 9th day of cycle?",
    "doctor_response": "HiThanks for writing to HCM .There is no rule that the day of cycle should have that sized follicle.  But on 9th day of cycle one ovary or both should have a dominant follicle of more then 10mm which will increase in size at rate of 1-2mm/day till it reaches 20-22mm and rupture. I suggest you to continue your follicular study on day 11 and also 13th and further to see the progress of the follicle does it rupture or regress.Some may have delayed ovulation like on 16th or 17th day . After your course of metformin you can take ovulation inducing drugs to increase chance of conceiving. Hope I have been helpful .RegardsDr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can i do as having bad throat infection?\n\nhaving bad throat infection. redness in pharynx and on tonsils. this happens evry while whnevr i go to out side i mean at dusty places or whnevr i ride a bike. having pain in neck n ear also. throat is paining while drinking water. head ache n jaw pain is also there.",
    "doctor_response": "hello, i think u r having acute recurrent phayrngitis. u need to take antibiotics to control infection. but this kind of reccurence warrants complete health check up n blood tests to know of any allergies or deficiencies. i suggest u to have a consultation immediately. get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should Fefol be taken for iron levels and hair growth?\n\nHi doctor, I am paromita. I have hypothyroidism problem and taking eltroxin 100 mg. I am suffering hair falls problem from last two years. 8 months  back I checked my iron, it was good but serrum ferritin level was 17 . so I was taking fefolz and after 4 month ferritin lebel increased to 36. Then I stopped my medicine and now again my serrum ferritin lebel is 23. my hair falls has increased. So what should I do now ? How long I should take iron tablet?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I would recommend taking Ferritin injections which are better absorbed into the system. Ferritin and thyroid are very important factors for hair fall and must be corrected accordingly. Subsequently you could also consider doing PRP (platelet rejuvenation plasma) therapy where your own plasma which is rich in growth factors and platelets is injected into the scalp which further reduces the hair fall, strengthens the hair follicles and stimulates new hair growth. Alongside also start applying topical Minoxidil 5% every night on the scalp which also stimulates new hair growth. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Smruti Pevekar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic respiratory alkalosis\n\nI have a right to left shunt, so far only significant at high altitudes and we live in TX now (relocated from CO). I have asthma. I had chronic respiratory alkalosis (resolved after leaving high altitude) PH was being considered, cardo said subjectively I have text book PH (pulmonary hypertension), though objectively, I did not And this morning, I was squatting and noticed that with increased exercise, blue veins on my chest, starting as noticeable on my right side, then becoming more and more prominent, from right to left side, as I continued to exercise. I stopped, the prominence of the blue veins decreased...about 10 min later, repeated the squatting, and the same thing occurred again, with in 1-2 minutes of exercise and continued to worsen as I continued to squat. Is this significant?",
    "doctor_response": "HelloIf this is a new finding than it would be better to consult your treating doctor if not than no worries.RegardsDr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "CT scan showing generalized disc bulging and flattening of the underlying ventral thecal sac, sclerosis of the end plates. What does it mean?\n\nhi i am looking for help to understand a ct scan. L3-4 level is normal. the L4-5 level; there is generalized disc bulging flattening of the underlying ventral thecal sac . There is no exiting nerve root impingement or spinal stenosis . there is vacuum phenomena within the degenerative right-sided facet. The L5-S1 level; there is a generalized disc bulge with associated vacuum phenomena. There is anterior osteophytic change at the L5 S1 level. There is sclerosis of the endplates of the L5 and S1 vertebal bodies. there is no exiting nerve root impingement or spinal stenosis.",
    "doctor_response": "Hi, . In simple words you seem to be having a chronic degeneration of the spine which is resulting in disc bulges at the mentioned levels.  It also seems you may have some necrotic changes resulting in gas formation described as vacuum phenomena. This needs to be further evaluated. I am unable to comment further since you haven't provided your clinical details. I would need a detailed medical history with past medical and treatment details to correlate these signs. Wish you good health Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it advisable for my wife to get pregnant at this time?\n\nHello! my wife want to become pregnant at the age of 48 in Dec., and I am 51 years and do not want to have a child at this age. Even doctor is not so much for it, but she is not listening to anybody. which is the safe way that she should not become pregnant.",
    "doctor_response": "Hi tehre,Welcoem to Hcm,At the age of 48 years, it is very unlikely for her to have a normal pregnancy and normal delivery. She should tak esome form of contraception until she attains menopause.Combined oral contrceptive pills are not the first choice in this age group. She could go for long term reversible contrception like mirena, intrauterine device or copper T. These do not cause much side effects and can be inserted easily on opd basis. Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Got Medtronic Spinal Stimulator Implant. Does only MRI reveals MS?\n\nMy husband has got a Medtronic Spinal Stimulator Implant. He needs to have a MRI of the brain to see if he might have MS. He had a CT Scan , of the brain, but it revealed nothing. Only a MRI will reveal MS. I was told there is a new MRI machine that could be used if you have the stimulator. Is this true and if it is where might i go to get one for him. I live in Missouri about 100 miles south of St. Louis.",
    "doctor_response": "Hello,It is true that only a MRI scan will reveal MS in most patients.Coming to the Medtronic spinal stimulator implant, I would suggest you to collect details of the stimulator and make sure the implant is MRI compatible and also take surgeon's advise on the same.On the other hand you could please contact your nearest MRI center and have a talk with the attending Radiologist.Please note that MRI machines vary only in their magnetic field strength and the patient bore (closed or open).MS can be diagnosed in all MRI machines.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump in the tailbone area\n\nI went to the Hostpial about six months ago and they found a lump on the left side of my tail bone and it only hurts every once in awhile they said they think it s a fatty tumor but not sure and wouldn t give me an mri.today it s hurting again and I live in a very small town now.inwas just wondering if it could be s.a.?and should I be worried about the placement?",
    "doctor_response": "I welcome you to healthcare magic for your health concernsI am Dr Fahim and I will looking into your problem     I have gone through your question and understood your concerns. There is lump near your tail bone and it is painless most of the time. It appears to be pilonidal cyst with differential diagnosis of lipoma as well, at present nothing is required except observation. There is chances of it to get infected, then it will results in pilonidal abscess. Timely drainage of this abscess in important, otherwise it will result in pilonidal sinus which will require a surgical excision of the sinus tract under spinal anesthesia. At the moment observe this lump and keep the area dry and clean, if it get painful consult general surgeon.I hope my answer will help. Do rate if you like it.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "16 year old with mild posterior annular bulge in vertebrae. Severe back pain. What to do?\n\nI am a16 year old girl.I was diagnosed with mild posterior annular bulge in l4-l5 vertebrae one and half years ago.I have a back pain all the time which is making my life miserable.As i am a student i have to sit and study For hours which makes my pain even worst. physiotherapy and medicines had not paid off.What should I do?",
    "doctor_response": "hi i am dr Usman.i can understand the agony you are going through. i dont know whether your bulge is causing compressing on your nerves or not? anyway i would advise if you can have a short course of steriods. it really helps in some cases. also start taking pre gablin 75 mg OD. its help relieve neurogenic pain. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for kidney calculus\n\ni have a kinnee stone but i havent be able to pee just a few drops i went to doctors and i have to cat my self for 9 days till i go back to doctors but my bottompart of my leggs fill realy tight and my face looks like i just woke up how do i no if the urin is causing the swelling",
    "doctor_response": "HelloTreatment of kidney calculus depend upon many things like its composition(whether it is composed of calcium,uric acid etc),size of calculus,site etc.You may need urine test for calculus evaluation.You should drink plenty of water.Small calculus may pass spontaneously.You may need calculus dissolving medicines like allopurinol(for uric acid stones),diuretics,sodium bicarbonate or sodium citrate,phosphorus solutions.Lithotripsy etc may be needed after evaluation.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Undergoing dialysis. Has swollen abdomen. Why? Can heart blockage be related to this?\n\nmy father is 67 years old undergoing dialysis thtice a week since last two months before that it continued twice a week for about an year. since last 2 to 3 months he is suffering from swollen abdomen . doctors are unable to find the exact cause of fluid retention. gastroenterologist is saying liver is ok. last week he went through a by pass surgerey as it was found that he has got 3 major blockages in heart. the operation was succesful. but the abdomen is still swollen.",
    "doctor_response": "This condition is called 'Dialysis Asites'.The treatment for this condition is repeated removal of fluid from the Abdomen & intensification of Dialysis.Other option is to change over to CAPD from HD,if above measures are not successful",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does masturbation changes the color of the semen to brown?\n\nI noticed after masturbating several days ago that my semen was a brownish color. Note: I had not masturbated in a couple months. I decided to try again tonight and the semen still had brownish color however was a bit less brown than several days ago. I am over 50 and have not had such an episode before. Should a wait a week and masturbate a few more times to see if this clears on its own or see my doctor ASAP. I am not experiencing any pain or discomfort. Thanks for your input.",
    "doctor_response": "DearWe understand your concernsI went through your details. Brownish semen can occur due to infections especially in the prostrate, and also due to bleeding in the prostrate. It is due to a tear in one of the fragile veins of the prostate.  The prostate is the organ that produces the majority of the seminal fluid in response to sexual stimulation. When the prostate contracts at the time of ejaculation, a vein may tear and blood mixes with the semen (hematospermia). Red blood indicates new and dark (brownish) discoloration indicates previous bleeding. Irritation of the gland (prostatitis) can also cause it to become inflamed and predisposed to bleed.  Some factors leading to inflammation include too frequent or too infrequent ejaculation, sexual arousal without ejaculation, withdraw at the time of ejaculation, excessive alcohol or spicy foods, prolonged sitting or bike riding, etc. Also certain tumors of the prostrate can cause this. I would suggest that you visit a urologist for complete work up and further assistance in treatment.If you require more of my help in this aspect, please use this URL.  sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for skin rashes in patients with hypothyroidism\n\nmy mom is 56 yrs old has hypothyroidism for 12 yrs now suddenly have rashes in her feet and legs , no fever,sore throat, no abd pain, no hematuria,no fever.i have the picture if you want to look at it. she is gone now to the doctor to do all the blood test.",
    "doctor_response": "Hello,Thank you for posting on HCM.From your description, its difficult to put forward a definitive diagnosis. I would thus suggest you to consult a dermatologist for proper management or alternatively you can post pictures to me via direct query so i can help you in a better way.Given the history of Hypothyroidism and sudden development of itchy rash i would like to put provisional diagnosis of Urticaria or hives.Its an allergic manifestation of skin, where an allergen leads to release of certain substances from your blood, leading to itchy skin rash and swelling over soft tissues. Its proper management requires thorough history, clinical and laboratory work-up.You may have to go for specific tests like patch test, food prick test, IgE antibody levels etc. As for treatment part, best would be the avoidance of allergen as far as possible. Try to eliminate possible triggering foods from diet. I would also advise you various anti-histaminics for long duration( atleast 3 months) with or without oral corticosteroids. For non- responding cases there are many other drugs like dapsone, cyclosporine, montelukast, omalizumab etc which can be used in certain selected cases. Hope this will take care of your condition.Kindly spare some time to rate my answer and drop your valuable review at the following link:  you require any further assistance in future, you can reach me directly through the above mentioned link.Thanking youDr Hardik PitrodaM.D Dermatology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause orange brown spots on foot?\n\nMy healthy 8-year old daughter has some orange-brown spots on her foot (just one foot). They are on and behind the toes and near the nail beds. Also one spot on the foot. They are not raised, itchy, etc. They look like marker, actually, but she doesn t remember using a marker near her feet.",
    "doctor_response": "Brief answer:Could be insect bite. Detailed answer:Hi, welcome to HCM. I have read your question in detail. I see similar cases everyday in my clinic. Your child has orange spot over foot which was earlier not there, this could be insect bite. Insect bite usually occur on exposed parts of body and result in red or orange spot like appearance at the site of sting. Itching is also present but sometimes can present without Itching. I suggest you to take 3 or 4 good pictures of the lesion and revert back to confirm the diagnosis. I hope this will help you. Wishing your child good health. Take care. Regards:Dr Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could i have damaged something in my neck if i have pain after a ripping sound in neck?\n\n3 days ago I had chronic neck pain, couldn t move it straight, to the left and couldn t look up or down. Today it was feeling almost a hundred percent better, but then I stretched back in my chair and heard a terrible ripping sound in my neck and then bam, the pain is back.. just as bad as when it first happened. Could I have damaged something in my neck? The pain right now is an 8 out of 10.",
    "doctor_response": "Hi,Since you have mentioned that you have strained your neck, most probably it would be a muscle spasm.- You need to use muscle relaxants and analgesics. I would have prescribed Diclo MR to a patient with similar complaints.- You can use voveran spray or gel to get relief from pain.- Do not massage rigorously.1) If your problem is severe you need to get X ray investigations done initially, followed by MRI only if required.2) Do not take analgesics excessively.3) You need to keep an erect straight posture of your back and neck.4) Do stretching exercises, when you wake up lie on your chest then using two hand lift yourself up, in a arc like position and then lie down slowly. Repeat this at least ten times daily. This will surely relieve back pain5) If your problem aggravates you need to get yourself physically examined.Hope these suggestion help you. Let me know if I can assist you further.Thanks and best regards,Dr. Suhas Chauhan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause bad mouth taste in a 5 years old child?\n\nMy 5 year old daughter has been complaining that she has a bad taste in her mouth for the last few weeks. She eats normally most of the time, but occasionally can t eat because of this taste in her mouth. Is this something I should be concerned about?",
    "doctor_response": "HI...usually bad taste in the mouth is drug related, like Metronidazole which is commonly prescribed for diarrhea (but usually not indicated). You need check her latest prescriptions if this is so.It could also be due to dental caries. If suggest you get in touch with her dentist regarding this.If everything is normal -  do not worry about her not eating well as the growth and devlopment and activity of a kid are more important than appetite.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower abdominal and back pain with vomiting sensation?\n\nHi, I'm feeling very strange this days. i have lower abdominal pain and also back pain. Sometimes i feel hot and sometimes i feel cold. I feel like vomitting but i can't and have a tingling effect on my face despite washing it several time. Please can u help me",
    "doctor_response": "Hi,It seems that you might be having urinary tract infection giving this type of pain.due to having infection you might feel hot and cold feeling due to having loe fever, malaise.Go for urine check up.You might require one course of antibiotic medicine for 5 days.Take plenty of water.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful and numb bump on shin after injury\n\nI fell down the stairs almost four months ago, and my leg is still sore and numb.  I had a very large goose egg on my shin and the side of my leg.  I had X-rays and a test for blood clots that were negative.  I also have diabetes.  Is it normal to still have pain and numbness?",
    "doctor_response": "Welcome to Health care magic.1.No its not normal to have pain and numbness through out - there could be some nerve involvement causing the above symptoms.2.After injury, collection with pain - can think in terms of infective process.3.Get an ultrasound to evaluate the type of lesion, where it is from and what content. A needle aspiration to assess the cells.4.After the results - a small incision and drainage followed by a antibiotic course will be helpful.5.If money is not an issue - MRI of the area / leg will help in good anatomical and biochemical delineation of the lesion. Good luck.Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Causes of mother deaths after delivery\n\nmy friend died 4 days after giving birth.\u00a0 she was African American with really light complexion, at her death her blood was clotted as soon as it was taken and her color was as black as tar.",
    "doctor_response": "well there  are few  known causes  of post partum  death.  instantly are  compications of pregnancy  , eg  large  amount of blood  loss , infections  .  DIC   in which  there is abnormal clotting  mechanism .  later  DVT  causes  migation of blood clots to lungs .  post partum  cardiomyopathy  in which heart gets weaker  and patient dies  in  months of arrest or  abnormal  rhythms",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to get pregnant. Taking erikas prenatal vitamins. Pregnancy test report negative. Any suggestions?\n\n, I have been trying to get pregnant really hard for 3 months I have been taking erikas prenatal vitamins  that she left for a month , I eat really healthy , I don't stress , I have sex everyday ,. I think I'm pregnant but I took a pregnancy test on Saturday  from the dollar store and it came out negative. I think I am pregnant though. I was supposed to get my period yesterday and I missed it",
    "doctor_response": "Hi,Urine pregnancy tests are conclusive only 3-7 days after a missed period. They should be performed with a fresh early morning sample of urine. If you do not get a conclusive result, you may repeat the test after a couple of days or go for the blood test and a trans-vaginal sonogram for a better confirmation. Ask your consultant for further suggestions. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to decrease stomach & weight ?\n\nHello  doctor is there any nice tip 2 decrease stomach&weight.",
    "doctor_response": "The only way to permanently lose weight is regular exercises and balanced diet.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic diarrhea in a child\n\nHi my daughter is 2 n hallf yrs old.shez suffering from diarrhea .doc.prescribed zioral and nizonide -o .the frequency of the loosemotion is less but nt y recoverd watecer shez eating shez passing stool which is greenish in color wd mucous .the nizonide -o dosage is over .still nt fully recoverd.wat shuld i do???",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron (as prescribed by your paediatrician).Regarding diet - Avoid fruit juices as they might aggravate diarrhea. You can give zinc supplements & ORS apart from normal vegetarian porridges & soups.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to stay unconscious even after 24 hours of surgery?\n\nHi my mother underwent a double valve replacement surgery at 7 :25 am yesterday. Her surgery lasted 6 hrs and she was shifted to the ICU post surgery. We were told surgery was successful and all her vitals are looking good. It has been over 24 hrs now since the surgery but she has not regained consciousness. The docs are saying that her vitals are good and it's normal for women at the age of 55 to stay unconsciousness for long. Pls tell me is this normal, what should we expect and do in this case? I am very anxious.",
    "doctor_response": "Her vitals are good and she is stable means there may not be any problem because of anaesthesia action she is unconscious and sedatives also given for pain relief so she may be unconscious. but if patient is unconscious then we should not extubate her till she regains her consciousness and muscle power",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can I do to alleviate charlie horse pain in my fingers and calves during nights?\n\nI am getting Charlie horse pain in my fingers and calfs....especially during the night. I am 75 and have numerous medical issues but these just started since my dr limited my fluids and potassium, because of kidney failure...is there anything I can do to relieve this pain.",
    "doctor_response": "Hi, As first-line management, you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist, it is better to consult a physician and get evaluated. An arterial Doppler also required to rule out peripheral vascular diseases. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chronic cough and breathlessness?\n\nI think i have asthma This has been happening since last year. Some of my symptoms that are always active. - i had a coughing attack, about 4 times last year. I couldn t stop coughing, i could barely breath! My throat was making weird sounds and it really hurt to breath. - I m always breathless. - I cough a lot at night and in the morning, I m fine throughout the day. - I m always so tired, as if there is no energy in my body. - I can t even eat or drink without feeling breathless, can t even breath while eating snd drinking. I always have to eat a tiny bit at a time. - I cant even vacuum the floor without being out of breath. I can t even unpack the sandpit or make my bed without feeling breathless. - whenever its reall cold; I can t breath good and it hurts to breath.",
    "doctor_response": "your symptoms indicates lower respiratory tract pathology, first you need to get chest x ray to rule out infection. you must also undergo complete blood count test since we are dealing with quite morbid symptoms, cannot quickly diagnose asthma. if blood reports and chest x ray are normal , diagnosis of asthma can be made and detail treatment protocol can be started. if you have difficulty in breathing now kindly report to nearest hospital for treatment.get well soon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain and tightness while ejaculating?\n\neverytime my boyfriend ejaculates he experiences chest pain and tightness. it goes after 5-10 minutes, he started smoking about a year ago and this has started about 3-4 months ago. . . im worried it could be something bad not linked to smoking. . he is vert fit, does excersise daily and his weight is normal. . . he is 21 5ft6 12 stone but very muscular, he has mild athsma",
    "doctor_response": "Hello, He needs to rule out any underlying cardiac disease if present by detailed evaluation. For that 2D echocardiography can be done for primary work up. The intercourse processes burn energy and some exertion occurs so it can be exertion induced effect of asthma precipitation.The spirometry will help in assessing the severity of asthma. So consult nearby pulmonologist or physician for detailed evaluation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest an effective alternative for Methadone\n\nI have been taking a low dose of methadone for pain from my doctor for over two decades. I know I am dependant on it, however my perscription is taken how it is supposed to be taken and I,ve never misused it I have never taken any illicit drugs, taken alcohol or smoked marijuana and have no desire to do so.my main question is there any other pain medication that would work for me that does not have such a negative reputation.",
    "doctor_response": "Hello, You can consider alternatives like hydrocodone. Gabapentin can also be tried. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does it take to recover from a knee injury?\n\nhello sir, i injured my knee, no fracture reported, but near complete acl tear was reported in MRI, grade 1 sprain iin medial and lateral collateral lig, Sprain in PCL small fractures of lateral femoral and tibial condyles, mild lipo-hemarthrosis. What will be the stages of recovery? This is my third week i started with some exercises but still i have pain in the joint. my knee motion is approx 110 degree now. When i will get the complete motion?",
    "doctor_response": "Hello,The recovery period depends on the injury. Simple strains or\u00a0sprains\u00a0can last for one to two weeks. More extensive injuries requiring arthroscopic surgery may take one to three months to heal. Major traumatic injuries to the knee may take up to a year to heal.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am i not able to walk by holding balance?\n\nI am healthy but cannot walk, cannot hold balance, two years already. Two years ago, played tennis, biking,marathon, soccer, and boom, cannot walk anymore. MRI good, blood, X-RAY, all good. UCSF doctors said we do not know what is go on!! ???????????????????????????????????????",
    "doctor_response": "I am a neurologist and would be happy to lend some thoughts but obviously I will need much more information than what you've provided.  Do you have access to the tests and reports that were done at UCSF? If you so, please collect as much of the information as you can including the NEUROLOGY CONSULTATION notes (if you saw a neurologist) and upload them with some more detail as to everything evolved over 2 years from playing tennis to not being able to stay balanced while walking and upload all that to: bit.ly/drdariushsaghafi     I will review it as soon as it's in hand and then, we can get to figuring out what's going on.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My hs-CRP is high. Am I in danger?\n\nHello doctor, I recently did a\u00a0complete blood test. In the report, it was detected hs-CRP 3.8 mg. My age is 36, and my weight is 103 kg.\u00a0Please advise how it can be lowered and do am in danger zone.",
    "doctor_response": "Hello. I understand you are worried about your health, but no need for much worries. Revert with more details to a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the red round itching patches in arm?\n\nHello doctor, From the past one week, I have itching problem in my arm area. It itches more and more and red round patches have become prominent. It is very humid here. Please suggest me.",
    "doctor_response": "Hello. I have seen your images (attachment removed to protect patient identity). The diagnosis is polymorphous light eruption (PMLE). It is UV rays induced skin allergy. So, main precaution is sun protection. The treatment involves tablet Wysolone 10 mg once daily after breakfast for 15 days, tablet Levocetirizine twice a day, Sunhalt or Sunheal or Photoban or Photostable locally apply three times a day on all exposed areas, Momate cream once daily on spots only at night. This is for 15 days. If it improves, continue sunscreen for long. If it develops again, you can use Momate on and off.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for soreness in the back from the lung area and soreness in lymph nodes?\n\nI was diagnosed with a flu like virus and went into upper resp infection. They gave me z pak and one week worth of protozone and then another week s worth. I still have flem, trying to get my energy back and now I notice that I have I guess lymph nodes very sore all down my right side and left side of my trunk. It is also sore on my back from the lung area down. What should I do?",
    "doctor_response": "Hello, Cannot say in your particular case, but generally, there is one type of uncommon pneumonia in which the Zpak is 100% effective--mycoplasma. Otherwise it fails about a third of the time maybe slightly more. With phlegm, fever, chills, etc. Those are quite serious signs and starting over with another DIFFERENT treatment would generally be done. Pain in the lung is a sign of pneumonia That would be bad, too. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for legs turning inward during walking\n\nhello my son is 14 months old, he has been walking for about two months and i have noticed his legs turn in really bad from the top which causes his shins to turn in and his feet, i thought this would sort itself out as he got better on his feet but its getting severely worse, the doctor has referred him to see a consultant but it is not untill next month and each day is getting worse and he is tripping himself up alot.",
    "doctor_response": "Hi... By what you quote it could be Rickets. Rickets occur due to vitamin d or calcium deficiency. I suggest you to do CBC, calcium and phosphate levels, and x ray wrist ap view for diagnosis. You should also start syrup calcium 5 ml two times a day for 2 months. Further treatment will depend on above reports. Regards - Dr Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Looking for information on hcg test\n\nhii.i m 24yrs old i gotmarried in may2010 nw i want to conceive. i hav gone through ovulation study twice everything is normal. so now my doc advises me to undergo HCG test. she says its an x-ray done wherein they put radio-opaque dye. bt i want the detailed info. about this with some diagrams to know what is it exactly.",
    "doctor_response": "Hi, it is HSG test. In this a radio opaque dye is instilled into your uterus. It is basically used to see the patency of your tubes. If the dye comes out through the tubes, it will be visible on the xray. If block is there, spillage from tubes will not be seen.It is a minor procedure.  No side effects will be there. You can see a video of that on internet. Hope I have answered your question.  If you have any other query I will be happy to help. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to lower fever and treat diarrhea in a child?\n\nMy grandson is 28 months old and illness started thursday with high fever and pea soup diahrrea. it is now sunday and fever is 101.5 (lower than thurs/fri) and straight watery diahrrea. Has been drinking pedialyte and finally chewed a baby peptobismal.  What else should I be doing?",
    "doctor_response": "Hi, since its already more than 4 days, you need to give antibiotic to child like syrup oflox (5ml =50 mg)  5 ml three times a day for 3 days. However since this is a prescription medicine, i advice you to meet the local doctor to confirm the diagnosis. Also, you need to give prebiotic like enterogermina ampule once a day for 3 days to increase gut immunity. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes penile itching and pain in infants?\n\nhi my one year old son has been itching his penus for about 3 months now and it has gotten really bad now and everytime i try to change his nappy he screams because when i touch his genitals it hurts him and it is very pink and tight and it looks like its wet as if clear puss is coming out of it, may you help please ?",
    "doctor_response": "Hi.... by what you say I feel but this could be a severe form of Eczema or it could be cellulitis in the region. Both of them require immediate medical attention. I suggest you consult your kid's pediatrician or take him to the nearest emergency room.Regards - Dr.. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "After getting blood work results, my Thyroid T4 was high so my PCP ordered an ultra sound. which showed I had three nodules.  He sent me to an Endocronologist who biopsied one of the nodules.  Results came back \"suspicious\".  He recommends surgery.  I though the biopsy would reveal malignant or benign.  Can thyroid cancer spread?  This is all very confusing to me.  I'm still waiting on a call from the surgeon to make appointment.",
    "doctor_response": "HI, thanks for using healthcare magicIn some cases, the biopsy results may not be clear and they are not able to definitely state whether the sample is cancerous or benign.If the result was suspicious, it would mean that there is a high chance that is it cancerous but they are not sure. This may not be the case.It is possible for any cancer can spread. If it is cancerous and has been caught early then there may be no spread.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever with stomach pain and soreness in leg\n\nMy daughter is 7 years old weighs 41 lbs. She has a low grade fever thats up and down 101.00 - 98.3. She also has stomach pain off and on and complains her legg is sore i think it is the right one. Brought her to her doctorthe other day he checked for strep which was negative and said it is just a virus. I am concerned about the stomach and why her leg would bother her. She is sleeping alot from fever my guess. Thanks for any info, William Engel",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. Viral illness can be associated with variety of symptoms such as fever, bodyache, joint pains, lethargy and poor appetite. Most such symptoms improve over a period of 4-5 days. If your daughter persists to have such symptoms then repeat clinical and laboratory evaluation to rule out any bacterial infection or inflammatory disorder is needed.Hope I have answered your query. Let me know if I can assist you further.Take care.Regards,Dr. Archana Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itchy rashes on tail bone, raised with red bumps. Massive headache, went away with advil. Related?\n\ni have a rash only on my tail bone about the size silver dollar. That is the only place that it is. Raised with red bumps , but not pussy , has gotten a little bit larger over the last 24 hours. I also had a massive headache today as well. Not sure if they were connected. Headache went away with taking Advil . Rash is mildly itchy.",
    "doctor_response": "Hello,Thanks for the query,I dont think these two conditions are related.You might have developed fungal infection.The area of groin around groin is very moist and is prone to develop these infections.Treatment can be with oral antifungals as well as with topical antifungals.Various antifungal powders like candid are availabe.These can help reduce the moisture as well as control the infection.Please dont use any steroid, it can worsen your conditionPlease meet a dermatologist for exact diagnosis.Let me know if you have any other doubt.you can ask a direct question to me on this forum, following the below link.  you  good health,Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for itchy allergic infections\n\nMy wife is suffering from itching all over the body and due to this, her whole body got just like swelling.  If the satrogyl 300 tablet is useful for this problem, as her doctor had suggested this medicine once she was suffering some allergy problem.  I am from India",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your history.Satrogyl 300 is used for treating some worm infestations. Although some worms can cause itching and urticaria, there are other causes also.So first I would suggest your wife to take montelukast and levocetirizine for at least 3-5 days depending upon response. However, if she has severe swelling, swelling inside throat, feeling of suffocation, or other trouble symptoms, she may require a short course of corticosteroids.Regarding Satrogyl, it will work only if her symptoms are due to worms, not if they are due to any other cause.Hope this will be helpful to you and solves your query.Wish your wife a quick recovery and the best of the health.Should you have any further query, please fell free to ask at HCM.Regards.Dr Parin N Parmar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should a CT scan be done while suffering from pneumonia?\n\nMy 62 year old sister is currently hospitalized for pneumonia that was dx after foot surgery related to a fall. She had Breast CA 8 years ago. Currently taking Tamoxifin. BRCA II gene. 3 sisters also with gene mutation and hx of breast CA. Youngest sister passed away from recurrance of Breast CA. (Mets to lungs, liver and bones.) Hospital ruled out blood clot in lung. Dx with pneumonia. Should CT scan be done since she has has a long standing cough and multiple bouts of pneumonia.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Yes, she can safely do the chest CT. There is not any contraindication of doing it in pneumonia. Regards, Dr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can bacteria infection in ears of a child be treated with antibiotic ointment be treated?\n\nMy 2 month old has dried white stuff in his ear. On Friday the dr said he had a bacterial infection behind his ears and gave me an antibiotic ointment to apply in the affected areas. He didn't check inside the ears though. Could the infection have spread?",
    "doctor_response": "If the bacterial infection is confined to the skin the antibiotic ointment will help. However, if your child has a ear infection he/she needs to be treated differently.Does your child: 1. Have fever 2. Cry excessively and tug the ear. If any of these symptoms are present, consult an ENT specialist. Your child could be having otitis media.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathing difficulty along with dry cough?\n\nI am having problems breathing. I have been provided a rescue inhaler by my doctor, but it only helps for a very short period of time. Difficulty often comes when I lay down for bed and is followed by shortness of breath and cough. The cough is very dry and often unproductive, but when something does come up it is very sticky and is almost a yellow color, but feels better when it does come up.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.It can be acute bronchitis and because of bronchoconstriction difficult breathing can be present Your Auscultation should be done first If bronchoconstriction present than spirometry done to assess severity CBC also should be done As per reports further management plan decided Antihistaminic drug like levocetrizine or phenylephrine can be prescribed If bronchoconstriction present than bronchodilator drug or inhalation given Take one tsp turmeric powder with milk daily Avoid excess spicy foods Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for elevated blood pressure and headaches\n\nI have a history of high blood pressure and take medication for it.  The last few days, my blood pressure has been elevated and I have been getting frequent headaches.  Tonight my blood pressure readings were 149/115 and 129/96.  What kind of medical treatment should I be seeking?",
    "doctor_response": "Hello!Thank you for asking on HCM!You should know that the headache seem to be caused by high blood pressure. But, I would like to know what have been your mean blood pressure values before.Anyway, I would recommend consulting with your attending physician and some tests to exclude other possible causes of secondary hypertension: - a chest X ray study- complete blood count for anemia- thyroid hormone levels for thyroid dysfunction- blood electrolytes for electrolyte imbalance- kidney and liver function tests- fasting glucose. If all these tests result normal, you should discuss with your doctor on the possibility of making some changes to your actual anti-hypertensive therapy (increase the doses or add new drugs), in order to have a better control of your blood pressure values. Hope to have been helpful!Wishing good health, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it possible for C-reactive protein level to raise from 6 to 15. 9 in 24 hours?\n\nHello doctor, Is it possible for C-reactive protein level to raise from 6 to 15.9 in 24 hours in my child, although there are no signs of sepsis?",
    "doctor_response": "Hi. C-reactive protein (CRP) is a marker of infection and inflammation anywhere in the body. It takes at least six hours for CRP to raise in the blood, once the infection starts and it continues to raise up to 24 hours at least. Though there are no signs of infection clinically, that is, the child is well symptomatically, it is still possible that CRP raises. Inference: Consult a paediatrician online for further help -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a sudden sharp pain at the right side of back?\n\nI've been having sudden, sharp lower pain in the right side of my back for the past few days. A few mornings my urine has had a very pungent smell to it. The pain does not stay for a long time and does not seem to get any worse when I move around or do any specific activity.",
    "doctor_response": "Hi, thanks for posting your concern in the HCM.Considering your current symptoms, I think that the following conditions should be ruled out.1. Urinary tract infection2. Pelvic inflammatory disease3. Mechanical back pain4. Radicular pain from prolapsed intervertebral disease5. Sciatica6. Renal pathology7. Liver diseaseYou should have the following Investigations done-1. Complete blood count, urea, creatinine, uric acid, LFT.2. Urine for routine examination3. Xray LS Spine-Ap/lat4. USG whole abdomenFor the time being my recommendations are-Tab Paracetamol 650 mg SOS for pain relief (min. 6 hr interval between 2 doses are needed)Plenty of oral fluid, preferably 3 lit/day.Avoid high protein diet, alcohol, carbonated beverages,spicesAvoid prolonged sitting or carrying heavy weight.Abdominal muscle strengthening exercise should be performed.Avoid unprotected intercourse.You should also consult a local physician for clinical examination and further management or you can write back to me directly after having the reports.Sometimes bowel problem may produce similar back pain. If you have irregular bowel habit, history of recurrent diarrhea, or altered bowel habit, you should have a stool routine examination done too.For any further questions, please write back to me directly.Regards,Dr. Kaushik",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of chest pain ?\n\nI have pain in my left chest which catches when I breath out and especially if on my left side. It is worse when I lay on my left side. Right now it spreads from just outside my left breast over to the top part of the chest. The pain is generally burning sensation with painful stabs when I breath out.",
    "doctor_response": "You will require evaluation in terms of Chest X ray and other tests. It is advisable to consult a doctor at the earliest.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes soreness in the penis after intercourse?\n\nI had sex with a masseuse and the condom broke, its been 2 weeks since the incident. Im already paranoid, i had a consultation with my urologistc undergone urinalysis. Pus cell: 1-3/hpf Ive been noticing more detail in my penile region. No sores, no dysuria,nocturia but sometimes theres a clear discharge usually in the morning. Like a pre ejaculation, but not foul in odor. I tried examining the inner walls of my urethra and it seems like there a sore inside. Not really sure. Please help",
    "doctor_response": "HelloThanks for query .You had unsafe sex with a masseuse two weeks ago and worried about acquiring STD or HIV .Since you do not have any urinary symptoms or symptoms pertaining to STD you need not be paranoid at all .It is your anxiety that is bothering you .Get screening test and test for HIV done to be rest assured about acquiring STI or HIV ,This will help to allay your anxiety .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to heal torn frenulum completely\n\nHi, I torn my frenulum about two weeks ago and I have it a couple weeks to heal. I checked it about 15-20 mins ago and it looked healed. So I tried to have sex with my girlfriend and I felt the stretch when I tried putting it in. Is there any way to best treat this for it to heal completely? Plus I noticed my foreskin has been dry lately. What caused it to be dry because its never been really dry. Would great appreciate what kind of treatment I would need. Sincerely, Oscar",
    "doctor_response": "Thanks for asking in healthcaremagic forum Frenulum tear can be due to rough/dry intercourse and recurrent balano-posthitis leading to contractionof foreskin. So, if you are getting it frequently and not healing, please visit  a doctor to rule out balano posthitis. By this you will get complete cure from your problem. Till then apply any antibiotic cream over there and give rest. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to alleviate chronic back pain?\n\nI have been experiencing back pain that I have been told that I have a lot of arthriris activity going on in my back. I also think maybe by sciatic nerve has been giving me problems. I haven t been able to walk without help for the last couple of weeks. My question is what can I do to help ease the pain in my back. I also was in a car wreck 5 days ago which just really aggravated the situation",
    "doctor_response": "Dear patient There are many reasons for chronic back pain and therefore different treatment. As you said you have got arthritic changes in your back which mostly is in facet joints xray will confirm diagnosis. I would advise xray of lumbo sacral spine anteroposterior and lateral views to confirm diagnosis. If facet joints are the culprit nerve blocks and ablation is very helpful in pain relief. If that is not the case MRI  of the lumbo sacral spine is very sensitive and specific for diagnosis of spine pathology. Please get it done from radiology centre nearby you. You need to consult pain care specialist with reports.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My son is 4-year-old has gas trouble and constipation. Please advice.\n\nHello doctor, My son is 4 years and 10 months old. His weight is 16.3 kg, and height is 3'6\". He had blood in stool six months ago and was treated with antibiotics. Now he has gas in belly, constipation. He was tested for occult blood in stool was found negative. Deworming was done the previous week. Now he does not want to take food as earlier.",
    "doctor_response": "Hello. 1. Please increase water consumption for the child and reduce the amount of bread and bread products that may or may not be consumed. 2. As of now, you can start the child on some laxative like syrup Duphalac (Lactulose) which will help the child to pass stool. Please give syrup Duphalac 7 ml twice a day with plenty of water for 10 days and observe. 3. SOS if the child still needs help in passing stools, you may give a Dulcolax pediatric suppository (Bisacodyl).",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can upper back pain running down to the arms be treated?\n\nI have dull pain in my upper back beginning in my shoulder blade and running down my arm to my elbow. Pain becomes severe when sitting at desk working on computer or while driving an automobile. I do not remember straining or injuring a muscle. Been to chiropractor twice and Advil helps relieve the pain but after three weeks still not better.",
    "doctor_response": "It seems to be a nerve impingement issue. i suggest you get a nerve conduction study done and have your spine checked out for cervical spondylitis",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high blood pressure spikes occasionally?\n\nI have occasional episodes of high blood pressure spikes (160+/100+ with pulse 120+) combined with shivering through my whole body for 15-30 minutes. I am taking 2 meds to control hypertension and 2 for diabetes as well as Pradax blood thinner.  I did have stroke 1.5 years ago caused by atrial frib. which I have fully recovered from.  One month ago, I had a seizure like episode lasting 3 minutes which my whole face and voice muscles were frozen.  These shivering/high bp are increasing in frequency.What could be casuing thise events?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Since you had seizures in the past, we should definitely rule out recurrence of pulmonary this seizure episodes in your case. Shivering of whole body can be due to seizure activity. And diabetes and hypertension can precipitate seizure activities. So better to consult neurologist and get done clinical examination, MRI brain and EEG (electro encephalo gram). You may need regular anti epileptic drugs on the basis of above results. If all these reports are normal then get done vitamin B12 level as deficiency can also cause similar symptoms. And if deficiency then you will need supplements too. Don't worry, you will be alright. But first rule out seizures. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain, depression and anxiety of my son\n\nWe live on Oahu, my son, Jude, and I. I have to sell my home soon because of a divorce after 33 years of marriage. My son has had several neuro-psych evaluations done. He has many indicators for Aspergers Syndrome. He has been in and out of several treatments centers and psychiatric hospitals here in Hawaii. But Hawaii does not have Medical Detox here so he begins too suffer from pain, depression, anxiety, etc. and ends up back home. This has been going on for over 15 years. I was diagnosed with a rare Lymphoma Cancer. When I went into the hospital to have surgery on my ring finger that I contracted staph from gardening, Jude had a total mental breakdown. When I came home 6 days later I found him in a depressing holding house and promised to come and get him the next day. My family lives in Michigan and I was desperately looking for a good place for him. I thought I did. It was in Battle Creek and called Best Rehabilitation. I checked references, even CARP. He was flown there with supervision. As the days wore on, I began to be treated quite rudely and unprofessionally. I sent my brother to go check the place out. Long story short, it turned out to be a front for Scientology. I had given them $5,000, over $3,000 in airfare. Then they demanded that I send a bank Cashier s check for $20,000 by that day s end or he would be taken to a hotel, given $20 and the rest was up to me. I threatened to call the police if they did this. He was sick mentally and physically. So now he is back on drugs and his behavior is getting worse. He s angry. especially at me, putting himself in dangerous situations, stealing from me, very disrespectful and at times yells and acts out of control. I need help for him. Preferably on the West Coast near upper California, Oregon, someplace. He is more interested into a Buddhist philosophy and not AA. He s very suspicious of other guys because he is teased and thinks everyone hates him. I need help. He is very suspicious and says he won t go to any more treatment/rehab centers again because they never work. He was very traumatized this last time. Any suggestions? Kathe O Reilly 808-261-6711 YYYY@YYYY",
    "doctor_response": "HiThanks for using healthcare magicYou did not mention about medication. In your son case, i would suggest paroxetine along with low dose antipsychotic like olanzapine. These drugs are not available over the counter,so better to consult a psychiatrist. Treatment in his case depends upon the symptoms. In case, you need further help you can ask.RegardsDr. Abhishek Kapoor",
    "dialogue_context": ""
  },
  {
    "patient_message": "Palpitations around solar plexus. Treated for H. pylori. What is it?\n\nHi i have been experience palpitations around my solar plexus for around 3 years Ive been back and forth to the doctors... I did HP plori and when i was treated for this 3 times it went however the palpitation didn't?... The best way to describe its like having anxiety constantly, which I know I am not... this wears me how and I m now getting fed up with it totally",
    "doctor_response": "Hi and thanks for the query,Palpitatations and infection of helicobacter pylori have actually no direct relationship. H. Pylori is mainly involved in causing gastritis and peptic ulcer disease. Eradication and control of H. Pylori should most of the relieve the symptoms associated to gastric irritation.It might be very appropriate to consult a cardiologist for advice with respect to heart problems like palpitations that could have various causes. The first thing is making a proper diagnosis and distinguishing it from anxiety. secondly, an ECG, Chest X ray and Cardiac ultrasound could be appropriate in characterizing the palpitations if effectively present. Treatment depends on likely cause and effectiveness.I would advice you book an appointment with the cardiologist for a proper clinical review and management. thanks and best regards.Bain LE, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for burning sensation in the lower abdomen\n\nMy wife has been suffering from lower abdominal burning together with hotness. She is diagnosed to be having 2-3 mm cyst in left kidney and 4-5 mm cyst in right kidney. Doctors have prescribed sorbiline but still her burning sensation is not cured. Pl. advise. Regards,",
    "doctor_response": "Hi.Thanks for your your query.your wife has burning sensation in the lower abdomen. The Ovarian cysts may cause any pains at all if they are simple. Sorbiline is not helping. I would advise you the following for your wife:CT scan of the abdomen, tests of blood, urine and stool. A course of an antibiotic and metronidazole should be tried under the guidance of a Surgeon after physical examination and investigations as advised by him .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have spinal cyst , low pain tolerance, lots of drugs. On benadryl. Bit by a spider. Red areas seen. Suggestions?\n\nhi,sorry to bother you.ok, sle, spinal cyst , low pain tolerance, lots of drugs....    4 red areas on skin, like a critter crawling up leg:  chilicerra just under 1cm apart, from what i can tell, 4 spider bites from yesterday  ..  live a mile as crow flies from lake superior, brown recluse just moving in.  slight ulceration starting at entry points of first bite    i am sort of into nature, did not see the spider but pretty sure these are spider bites. had flood last year and had an adult in basement that came with the flood.   they don't hurt......   so/?  mycitracin, benadryl, asparin, baileys ?   just watch?  it is rather fascinating   thank you gwen",
    "doctor_response": "Hi and thanks for the query,A spider bite generally produces an acute inflammatory reaction or allergy. This shall require use of anti allergic drugs. Anti histamines are generally effective in stopping itches and swelling. Steroids, either or local or injectables could also be useful in the management process. A key aspect in the management is surveillance. This important for failure to respond or aggravation of symptoms might require other drugs to be added or an increase in the dosage of the drugs used. thanks and kind regards.Bain LE, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can cause sudden blank out in a diabetic patient?\n\nHi doctor, My father is 77 years old and a known diabetic for over six years. His height is 170 cm and weight is 65 kg. This is regarding his recent angioplasty. He got it done before three months when he had a kind of seizure or fix. He was hospitalized for a week and got discharged with stable condition. One month back, again he dropped unconscious while having lunch. He remained unconscious till he reached hospital. He does not remember anything what had happen to him. In the hospital, they did CT scan, EEG, ECG and Holter monitoring. Everything was normal. The doctors are not able to find the cause for his blank out. Please advice.",
    "doctor_response": "Hi. I want to assure you do not worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case history, reports (attachment removed to protect patient identity) and can well understand your genuine health concerns. CT scan shows no significant lesion in brain and no focal hemorrhagic bleeding event which is one of the main causes in many cases. Heart diseases can also cause unconsciousness. In such cases, we monitor indoor patients on Holter monitor for any kind of rhythmic change in heart beat and to see if there is any atrial or ventricular fibrillation. Your father did not have a positive sign there. His heart rhythms are normal.  Sometimes there is an imbalance in the serum electrolytes and fluid; electrolytes imbalance may lead to unconsciousness and syncope. But, your father is fine on that too. Your father's angiography for single artery occlusive disease went eventless and normal flow to heart was restored with stent deployment.  My final impression is:-",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can kidney disease be transmitted through a needle prick?\n\nhi i am a lab technician and last i got pricked by a needle which has been used for drawing blood from patient, after that i ask the nurse about the history of the patient but she told me that the patient is suffering from kidney disease. after 1months i got headache, common cold and stomach problem, this is killing me every second because i'm scare if it might be a symptoms of hiv",
    "doctor_response": "Hi,Thanks for writing in.Kidney disease can be due to many causes and you should have been prompt at following up with the patient soon after having the prick. It is possible that the patient with kidney disease has other infections like hepatitis , hepatitis C and HIV which can be easily transmitted with needle prick. If possible please find from patient records if the patient had any communicable infection and get tested for it. You should not have ignored earlier just because patient had kidney disease. Many infections can be transmitted through pricks with needles. It is unlikely that you have any infective condition if the patient did not have any infective conditions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the treatment for inguinal lymphadenopathy?\n\nHi doctor, I am a 55 year old male. I am suffering from\u00a0inguinal lymphadenopathy. 2 years ago I have this on right side and now on left side. There is a square shallow knot present on the right side now. I have stiffness and rigidity especially in the left arm and occasional limited movements. Also I have discomfort in my legs and inguinal region. On ultrasound it was observed\u00a0lipomatosis of inguinal lymphs. I have\u00a0painful point in inguinal region, only if I press. I have\u00a0noticeable weakness, but no weight loss. Occasionally I feel very low energy and could not maintain erection. I feel\u00a0numbness in the shoulder or finger when wake from sleep. I have low sedimentation rate. There is\u00a0no abnormal blood and urine finding. I had blood test and it is\u00a0negative for all infectious diseases such as Lyme, cat scratch, AIDS, etc. Please help with some suggestion. Thank you.",
    "doctor_response": "Hi. I assure you not to worry as all things may get settled with proper care and follow-up. 1. Inguinal lymph nodes usually get prominent due to some infection (that you say have been ruled out) or some primary pathology of the nodes themselves.  2. The knots you are talking about also warrants to rule out if that is a vein pathology or lymph nodes can be benign or cancerous changes. Biopsy of the nodes is mandatory especially when there we see changes on ultrasound.  3. Weakness can be due to hemoglobin or red blood cell deficiency. Other causes of weakness may be hypothyroidism or fluid and electrolyte imbalances.  4. Your low sedimentation rate may be due to red blood cell, white blood cell changes and protein abnormality. Sickle cell disease also may cause it. But clinical correlation is the key and for that your physician needs to go for physical examination and if suspicion arises, he may refer you to hematologist.  5. Pain in the lymphatic region can be due to lymph nodes being pressed on or it is possibly from lipomatous changes.  6. I also prefer you to get a detailed heart evaluation from cardiologist as weakness, shoulder and arm issues warrant that too. This kind of symptoms also needs screening for hypertension and diabetes mellitus. Your physician can help you for that too.  7. If you have got tested the above in past 8 weeks, you may upload the reports here for my review and diagnosis. If more than 8 weeks old, please go for repeat fresh tests. Biopsy and histopathology of the lymph nodes. Can be decided on investigations and diagnosis. Revert back with the investigation reports to an internal medicine physician online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a herniated disc be treated?\n\ni have been diagnoised with a disc herniation at L2-3 with stenosis . The Dr said it was protrudding towards my spinal canal, is surgery necessary and what type of pain medication is appropriate? i also have severe degenative disc disease at mutilple levels.",
    "doctor_response": "Hi..Not all herniated disc needs surgery...Surgery is not performed untill the disc is irritating a nerve so severly and compromising it's function..I recommend you to do...Lot of core stability exercises...Strictly avoid any spinal extension activities as you have stenosis...Work in neutral spine position...Lower body weight training is helpful especially training glute stability and strength will improve and maintain spinal posture...If you have any pain and spasm... i suggest you to do lot of icing in that area...If you can maintain a good core and glute stability you are less likely to have a spinal issue...Hope this is helpful for you...Kindly revert back in case yiu need any further help in this regard",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling sensation in the hands and feet?\n\nI have been experiencing tingling in hands and feet that comes and goes since the beginning of the year. I also have periods of heat radiating from my body, especially my legs and lower extremities. At times, I have an internal feeling of heat and something I do not know how to describe. I described it to my doctor as a feeling of tension and abnormality. I had a nerve study test, all good. I have had labs, all good. I took 200 mg of gabapentin for awhile, and I am not sure if that helped or the problem subsided. I am feeling that way again, just need some advice where to go next. Thank you.",
    "doctor_response": "Hello,I think, you are facing a small fiber neuropathy- in this NCS can be normal. And, it also explains the burning symptoms you have.I would suggest you to continue the Gabapentin. I will also recommend testing the blood for FBS, ESR, CRP, ANA. A nerve biopsy may be needed.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Saumya Mittal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent headache and tingling sensation in the shoulders and back?\n\nHello I am at work right now but have had a headache for the past 4 hours that is not going away. I worked out yesterday which I haven t done in a while so maybe that has something to do with it but... I also have tingling in my shoulders and upper back and now its radiating down my legs. I feel awful...",
    "doctor_response": "You may have increased muscle tension in your neck and shoulders especially if you worked out these parts of your body more intensely than other parts of your body and this could be translating into headache pain.  Have you considered either a cold back or maybe even a warm pack to the back of the neck for 20-30 min.?  You should hydrate well and make sure you're not skipping meals which can also bring on headaches as well. Please rate this a 5 STAR encounter and write me at: XXXX for more questions or comments.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cramps on the ribcage?\n\ni get cramps on both sides on top of my ribcage anywhere from middle front of chest to the begining of my back just below where boobs start, can happen with anything from wiping my butt to steching to get something but for the last two nites i have waken with this cramp ,steching that area, and holding my breath helps but can tell it is still ready to cramp at any time then i wake in morning with it again ,this morning i tried pickle juice it helped but i still can tell it is waiting to happen again",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms seem to be related to a strained muscle in the rib cage. I suggest usling a muscle relaxant such as Baclofen three times a day. I also suggest using magnesium supplements to help muscle relaxation.Warm compresses and warm showers can help in relieving the symptoms.Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes an elevation in the blood sugar level despite taking Glimepiride?\n\nMy Dr just started me on glimipiride at 2mg once a day. I started my first dose yesterday morning. My first reading before breakfast was 189 and then 2 hrs after my reading was 238. My reading 2 hrs after lunch was198. My sugar level just before bed was 214. Morning of day 2, my wake up reading is 192. Worried that I can t lower my sugar levels down enough.",
    "doctor_response": "HelloI have gone through your question and understood your concern.Glimepiride is a sulfonylurea antidiabetic medicine. It works by causing the pancreas to release insulin, which helps to lower blood sugar.I can see that your diabetes numbers with 2 mg Glimepiride are not OK.You have high fasting and postprandial blood sugar levels and this means that Glimepiride is not effective.If you take the medication regularly,have a proper diabetes diet and do regular exercise every day this means that the treatement with Glimepiride is not the right choice for you,in this moment.If you were my patient i will recommend you to continue with this regymen of  therapy(glimepiride 2 mg/morning +diet + exercise) for a couple of days,because you just start it yesterday and it is too early to archieve the best results.If after some days with this therapy you have the same sugar levels ,than i suggest to consult your treating endocrinologist because it is necessary to add another diabetes drug or to start insulin therapy to improve your blood sugar control.YOu should learn how to live with diabetes.This is very important for you.My advice is talk to your health care team and learn how to take care of your diabetes.Follow the diet and exercise program given to you by your health care provider.These are elements to manage your diabetes.Hope this information is helpful.If you have other doubts,feel free and ask.Best regards.Glimepiride should be taken by mouth with breakfast or the first main meal of the day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes jaundice and moderate ascites?\n\nMy mother &77 yrs) has the problem as Hyponatremia & Gross Ascites; TB and malignancies were not detected. At present slight fever continues with abdominal swelling. CECT scan impressions revealed (a) Bilateral Plueral Effusion; \u00a0\u00a0\u00a0\u00a0\u00a0(b) Moderate Ascites; and (c) Mild contracted both kidneys . Her Uterus was removed in 1987 and was faced Australian Jaundice which was treated. In 2003 Urinary Bladder Tumour was operated which showed TCC Grade - 1. In 2011 Jan Urinary Bladder Tumour was angin grew and operated which showed TCC Grade - 1 and after this operation she was given Niftran. She used to take Amlovas AT regularly for her high BP. Recently after hospitalization she was treated for Na balance with 3% Na infusion. Her Haemoglobin (gm/dl) is 8,5. Please tell what disease is she suffering from.",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I canWell, jaundice is just a sign and not diseases, and treatment depends on exact cause.Jaundice is usually sign of certain liver disease and high bilirubin value.  Causes of jaundice vary from non-serious to potentially fatal. Levels of bilirubin in blood are normally below 1.0 mg/dL (17 \u00b5mol/L) and levels over 2-3 mg/dL (34-51 \u00b5mol/L) typically results in jaundice. High bilirubin may be due to liver diseases such as cirrhosis or hepatitis, infections, medications, orblockage of the bile duct In the developed world the cause is more often blockage of the bile duct or medications. Blockage of the bile duct may occur due to gallstones, cancer, or pancreatitis. Medical imaging such as ultrasound is useful for detecting bile duct blockage.Treatment of jaundice is typically determined by the underlying cause. If a bile duct blockage is present surgery is typically required, otherwise management is medical.Medical management may involve treating infectious causes and stopping medication that could be contributing. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could using Mensovit tablets multiple times and undergoing abortion cause problems in getting pregnant?\n\nI was married 2+ yrs ago, in that time more than 10+ times of pills (MENSOVIT) used  for non-pregnancy , + one abortion as done to my wife, now we are planned for BABY, is this any problem cause my wife health and my baby in pregnancy time, I am very blind on this case, I need clear result also, please help me.",
    "doctor_response": "Hi, I think there will be no problem in conceiving with one abortion and 10+ uses of the pill. The effect of pill is temporary and one abortion shouldn't cause much problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low appetite during fever in children?\n\nActually my daughter is suffering from fever for about 6 days. she is taking Crocin 6 days / Oflomac 6 days / Advent 3 days / and if req d Domstal. for the past 3 days the average fever was 100.4 But from this morning she felt better. But now in the evening again she is not feeling well. For these 6 days she did not take food regularly She took food only last night, But now from the morning she took about 30 Gm of Choco Kellogs. pl. let me know what is the reason. She is 3 Yr 6 Months",
    "doctor_response": "Hello.As per your complaints,probably your daughter is suffering from enteric fever and it is associated with decreased appetite.Whatever the cause is,children usually have decreased appetite in cases of infection.Secondly the medicines which she has been taking  also causes a bad taste especially after taste so the appetite is decreased.Dnt worry,she will eat normally once the infection is settled and medicines are discontinued.Hope it will help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could severe pain in right shoulder and under right rib cage be post gallbladder removal surgery?\n\nMy sister had her gallbladder removed on Wednesday, and is still in seere pain in right shoulder and under her right rib cage. the doctor put her back in hospital and did more tests but then said everything was normal and sent her home. What should she do?  She des have a diagnosis of fibromlagia.",
    "doctor_response": "Hi and welcome to HCM. Thanks for the query. Pain in shoulder and under rib is expected and commonly seen due to pneumoperitoneum which is done during laparoscopy. It should be treated by standard painkillers and there is no other specific cure. IT may persist up to 2 weeks sometimes. If there is constant abdominal pain or jaundice and fever then you should visit doctor. Wish  you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause severe pain in the knee after a meniscus repair surgery?\n\nA few years ago I had a meniscus repair in my left knee because I had torn my meniscus due to a discoid meniscus. Every now and again I get severe pain in my knee either randomly or associated with overuse and it can last anywhere from a few hours to a few days. It becomes very hard to move my leg from one position to another let alone walk. It reminds of the pain I experienced right after surgery once the anesthesia wore off and its not like what I felt before the surgery when I had the torn meniscus. Its been progressively getting more painful, more frequent, and lasting longer so I just want to know why my knee is still bothering me years down the line.",
    "doctor_response": "Hi, Meniscal repairs do not have very good results in general. If the problem persists then discuss with your surgeon about partial excision (esp of torn fragment). Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for white droplets from the penis after urination?\n\nHello sir,  i 'm 21 yrs old and want to ask you that after urination white droplets come out from my penis, sometimes sticky, and certain times liquid. Why is that happenning so? Is that owing to the seminal vesicles as they have become filled with semen or anything other?",
    "doctor_response": "HelloWhite droplets from the penis after urination may be leaked semen.It is a common condition and it may be due to inadequate emptying,straining,overexcited state etc.You may need to evaluate for constipation.You may also be advised to release semen intermittently.This is not a serious finding,you will be fine soon.Get well soon.Take Care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for persistent cough and congestion\n\nMy son is 6 years old he has asthama or allerji from dust by birth nowadays he has cough and congestion problem for ten days i dont want to give him antibitic plz what should i do i give him mytika sachet or tablet or any cough syrup and he doesnot eat food and he eats food once time a day plz iam worry about my son",
    "doctor_response": "yes you can use syrup terbutaline half tsf 3 times a day for a week.Syrup citrizine half tsf at bedtime.Start Myteka sachet ( montelukast) 1 at bed time for 2 months.Good luck:)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high fever and swelling of lymph nodes\n\nmy 15 month old has been sick for the last 3 months on and off with high fever and swollen neck lymph nodes.  She has been diagnosed with ear infections and pneumonia.  They have had her on 3 different antibiotics and inhalers.  She is good for a week after the antibiotics and then the fever and swollen lymph nodes return...what could be wrong?",
    "doctor_response": "Hi,Read your query and understood your concerns.She requires evaluation of her case and investigated.She might require,1, x-ray chest,2, complete blood testing like TC, DC, ESR etc.3, Montoux test,4, Routine urine check up.Consult pediatrician and discuss about this matter.After proper diagnosis line of treatment can be decided.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Prescribed Triamcinolone to treat sore in center of tongue. Q-tip did not stick. Taking anastrozole causing problem?\n\nmy dentist prescribed Triamcinolone to treat a sore down the center of my tongue.  I put some on a q-tip but it does not stick to the area.  I did not rub it as the directions said not to or it will get gritty.   It just came off on the ruff of my mouth.I have been taking Anastrozole after Breast Cancer surgery and inter-Beam radiation.  Could this medication be causing the problem with my tongue?",
    "doctor_response": "Hello and welcome.Thanks for sharing your concern.After reading your complete history posted, here it appears that the soreness of your tongue is not related to Anastrazole or to the radiation beam therapy.Therefore you can apply Triamcinolone on the affected area of tongue and watch for a week.The symptoms should subside,if not you can go for clinical evaluation and if required a small biopsy to exactly diagnose the cause.Hope it helps.Thanks.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the rashes near my child s anal area?\n\nHi, my baby is 6 weeks old and is crying continuously not sleeping. and also some rashes is there near anal area. we consulted with the doctor yesterday and doctor had recommended Mupirocin Ointment I.P. T-bact. Please advice as the condition is still the same.",
    "doctor_response": "thank you for choosing healthcare magic.you can add zinc oxide paste/cream with the mupirocin ointment. make sure that the diapers are not soiled and constantly dry in order for the rash to disappear faster. Apply this regimen every diaper change. Also, allow 2-3 days for the rash to subside. sincerely,Mark Rosario MDgeneral pediatric/pediatric pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain, increases during eating and swallowing. Treatment?\n\nI have upper back pain that started two days ago out of nowhere. its a constant mild aching pain however, when i eat food when i swallow the pain gets really intense as it passes down. The larger the mouthful the more it hurts. i have resorted to swallowing ridiculously small pieces just to even manage the pain. Esophagus nor stomach hurt, its just the upper back pain.",
    "doctor_response": "Hello, Thanks for writing to us.The pains that you have described are likely to be due to muscular spasm. Taking mild pain killers and muscle relaxants will bring a short term relief. Regular stretching exercise will be helpful. you can do a hot fomentation and apply a local analgesic gel on the area to relieve the spasm.I do hope that you have found something helpful and I will be glad to answer any further query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the ultrasound report indicate about kidney conditions?\n\nHello sir,My report of ultrasound of abdomen is as follows. Right Kidney shows 5-6mm size calculus in lower calyx without hydronephrosis. Left Kidney shows multiple (3-4) calculi, largest is 7mm in lower calyx with mild hydronephrois and hydrourerter. Left vesicouretric junction shows a calcalus of size 9mm.IMPRESSION: left vuj calculus (9mm)& bilateral renal calculi.",
    "doctor_response": "Hi,You have been diagnosed to have a single small stone in right kidney and a few small stones in left kidney. One of the stones from left kidney has dropped into the ureter (the tube connecting kidney to urinary bladder). Vesicoureteric junction denotes the site where ureter joins with bladder. This has caused mild swelling in the left kidney due to obstruction. Otherwise your kidneys are apparently normal.The stone in ureter usually causes pain in left flank with or without vomiting and burning urination. Usual treatment is an alpha blocker (eg. Tab. Tamsulosin) and pain relieving medications. If the pain does not subside or kidney function deteriorates or infection sets in, then it needs to be removed immediately. Otherwise, the stone can be monitored and if does not pass in 4 weeks then it can be removed using endoscopy (URS, ureterorenoscopy).After treatment for the ureteric stone, you need to be evaluated to find out the cause of stone formation. Kidney stones can be treated later, either medically or with flexible ureteroscopy and laser.I hope I have answered your query.If you need any clarification, please get back to me.Wish you a speedy recovery,Best regards,Dr. Raguram G MCH Uro, F EndouroConsultant Endourologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lung pain, sinus infection with phlegm and mucus in diarrhea?\n\nI quit smoking April 19,2011. I was getting bad lung pain on & off until about 2 weeks ago. i now have a dark yellowish phlem in the morning and sinus infection. Sometimes my right lung will make a very low click when i take a deep breath. The past few days * on & off i will get mucus in diarrhea. I am lactose intollerant and when i eat some greasy food my nose gets itchy ( guessing iam allergic)  i have been under a lot of stress ( loosing my dad suddenly arpil 16 then my dog april 22nd... any idea if the mucus in diarrhea is from my body cleaning itself from quitting smoking... sinus infection... stress or ????",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .*  Respiratory infection will give you lung pain , sinus infection , phlegm .*  Mucus in stool is in relation with intestine infection or other inflammation    issue .Wishing you fine recovery .Feel free to ask any further  queries .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take tramadol for hyperacidity causing stomach pain?\n\nI have stomach issues, pain and more pain... Have been to doctors by the numbers, had endoscopies, colonoscopies, ct scan tests, mri's, nuclear medicine, chest xrays, you name it...but nothing has been found. I am on Tramadol tablets, 2 by 3, and esomeprazole, as I have hyperacidity issues. Please help; it interferes with my daily life, school, work the pain is gut-wrenching. :'(",
    "doctor_response": "Hi.Tramodaol is not the right answer, although you can take it for any pain including the one you have now. This is just a pain-killer and not the proper treatment. If you want the cure , you still need to have ''another '' opinion and investigations is need be, to get the proper diagnosis. GO for an MRI of the thoracic spine and you may find the cause of the pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it ok to take folvite to conceive for person with pcod?\n\nHi, i am 26 yrs old, recently got married in the month os May 2011 and i have PCOD problem (irregular mensus) so doctor prescribed me to take Femilon. now i am plannning for a baby. so doctor now suggested to take folvite 6 mg. is this the right  method to be followed and is it safe to use?",
    "doctor_response": "Hi, thanks for writing..Folvite is folic acid which should be taken 3 month prior to planned pregnancy and continued throughout the pregnancy,.. It helps to prevent anomalies like neural tube defect in the baby.. It has no role in accelerating the pregnancy chances.. It is absolutely safe when you plan for pregnancy.. After 1 year of trial for pregnancy, it would be better to undergo routine investigation and take treatment like ovulation induction drugs to attain pregnancy faster..  Hope I have answered your query.. Good day..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swollen liver and spleen mono, given fluids, not on steroids\n\nmy son has mono with swollen liver and spleen . He was admitted into the hospital for 3 days and was given fluids and released. He still has a the symptoms listed on all inquiries regarding mono. His doctor never put him on steriods, should he have done so. Doctor did mention steriods but said he really did not want to do that. What is your opinion?",
    "doctor_response": "HI Thank for asking to HCMI appreciate your concern for your son steroid is not the symptomatic medicine again in case of infection it is to be given with extra care and under the close supervision, hope this information helps you have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden weight loss and pain in joints?\n\nI ve experienced a 12-pound weight loss over the last 3 months (not a lot but considering I wasn t trying to lose and went from a size 2 to a size 0, which is now too big for me), as well as constant unrelenting excruciating bone pain in every joint imaginable. These are my 2 main symptoms. Any suggestions?",
    "doctor_response": "HIThis obviously needs to be evaluatedThere are several possibilities--cancer, an autoimmune disorder like lupus, vitamin D deficiency are the top three",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long it takes to cure numbness due to a fracture in the chin?\n\nI was in a bicycle accident 1 week ago and landed on my chin and face. My mandible is fractured and I am experiencing numbness in my lip and chin in the area of the fracture. My oral surgeon said this is common and will go away, I am wondering how long it typically takes?",
    "doctor_response": "Hello, Yes, this is a common feature and it will take 10-15 days maximum for it to go if the injury is not that bad. Having a dental checkup is advised if any nerve impingement is happened due to the chin injury. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest and arm pain during urination?\n\nMy elderly mother complains that her chest and arms hurts when she urinates. The pain shoots down to her hands and stops when she is through urninating. Could this be a symptom of something else? She says she has a kidney infection but I wonder if she means bladder infection. Although, she says it does not hurt when she pees.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Neither kidney infection nor bladder infection can cause chest pain and arm pain while urination. These infections will cause burning and painful micturation, but she is not excreting having all these symptoms, so no need to worry for infection. Urination is considered as moderate heavy exertion. So basically she is having chest and arm in on moderate heavy exertion. So we should first rule out heart diseases for this. So get done ecg and 2d echo. If both are normal then no need to worry for this chest and arm pain. Sometimes, simple musculoskeletal pain due to awkward position while urination can also cause similar pain. So don't worry, she will be alright. Better to first rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent cough and abdominal pain\n\ngreetings i started coughing about 2 weeks ago the coughs were very strong and firm but they were tolerateablethe night before yesterday i experienced very firm abdominal pain which was not going so we called the family doctor and he diagnosed me with apendix and i went to the hospital to run a test for it and it turned out i didnt have it however the morning after that i woke up seeing that my lips and some areas around my genitals were swollen with hives i asked the family doctor again and he thinked it was for the coterimoxasol i was taking (due to the coughing i took coterimoxasol and metronidazol ) and so he cut out and prescribed sefixim instead and prescribed injections of sefalexin and betametazon so i took those injections they made the condition a little less tender but the hives expanded vastly and now i have contipation can i know diagnosis please? millions of thanks! oh and by the way he said to me that i stop taking metronidazol too",
    "doctor_response": "Your cough was probably caused by a viral infection which is quite common. But it is probably unrelated to the hives or acute urticaria that your doctor has treated you for. He has additionally prescribed antibiotics to be on the safer side and has tried to cover both for the cough and the hives. Please stop metronidazole and the other antibiotics after completing the five day course. The constipation could have been caused due to the normal intestinal bacterial flora being disturbed. Taking plenty of curd or yogurt should help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes diarrhea and belly bloating in a child?\n\nMy 17-month old has had several normal stools today. He has not eaten well, but seems in relatively good spirits. After giving him a bath, my husband and I were concerned that his belly looked very bloated and felt harder than normal. He has had diarrhea 3 times this afternoon. Should we go into the doctor or wait to see if symptoms worsen?",
    "doctor_response": "Hello,If the stools are normally formed, then you need not worry. If these are watery and associated with pain in the abdomen, fullness or bleeding per rectum, then you can consult with a pediatrician.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Susheel Kumar Saini",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is TB medication recommended in case of pain around spine?\n\nhi doc, i have got pain around my spine for 2 years but recently diagnosed through MRI, am currently on tb medication but still feeling slightly pain around the area. Am i responding to the medication? just 2 weeks of tb medication, i feel less pain waking up which gradual increase on activity of the day",
    "doctor_response": "Response is there since less pain and easir movement, however there should be periodical blood count,ESR to assess the effects of medicines",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair loss in central part of the scalp\n\nHello My wife has this problem of hair loss since childhood. Main part affected is central part of the scalp where there is patchy hair loss at many places. Recently I took her to a dermatologist who advised certain tests and then prescribed 1. Ketoconazole tab, 2. Ketoconazole shampoo. He called back after 1 month. Hair loss was reducing but new hair growth did not occur. After 1 month he reviewed and prescribed 1. Zinc tab 2. Folifast lotion 3. Diprobec lotion. Recently she has started having more hairfall than before. Is the treatment wrong? Can you please help me out?",
    "doctor_response": "Hello. Thank you for writing to us at healthcaremagicI suggest a possibility of alopecia areata.Alopecia areata presents as patches of hair loss/ baldness, most commonly on the scalp.The treatment that you have been prescribed is definitely not proving effective for your condition.Intralesional streoids and oral steroids are mainstays of treatment of alopecia areata.For just a few patches I prefer to treat my patients with intralesional steroids.However, for multiple patches I usually start my patients on Pulse oral steroids i.e 2 consecutive days every week.Oral steroids may have to be continued for 4-6 months, depending on the severity and response to treatment.Topical steroids, topical minoxidil are other treatment options that are usually combined with intralesional steroids/ oral steroids.You have been asked to use a topical steroid but that is a mild one and unlikely to be effective.I suggest that you seek another appointment with your dermatologist regarding the same.I think the best recourse of action would be either intralesional steroids Or pulse Oral steroids in addition to topical treatment with a potent steroid Or topical minoxidil. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking warfarin for Factor V Leiden blood clotting disorder. Is it possible for me to donate blood, platelets or bone marrow?\n\nI have Factor V Leiden a inherited clotting disorder. I am currently taking warfarin (10mg/day) and will be for life. Based on my readings, I understand I am restricted from donating blood . Am I also restricted from donating platlets and bone marrow? I could not find a definitive answer on American Red Cross website.Thank you!",
    "doctor_response": "Hello, Inherited disorder of the type you are having are caused by the changes in the DNA of cells. Every cell in our body contains the same set of genes and any cell that you donate will carry that defect in gene. So bone marrow donation can not be done. As you are on regular warfarin, you can not donate platelets also. However your concern and interest in going all out to donate these precious products is admirable.",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI states: The ill defined high flair signal areas in cerebral white matter bilaterally,on frontal lobes\n\nMy sister just had an MRI and it states the ill-defined high T@/Flair signal areas in cerebral white matter bilateraly, especially in the frontal lobes. Would you put this in simple terms. She was diagnosed w/a grade II astrocytoma in June 2011 & underwent radiation. Currently on Avastin.",
    "doctor_response": "Hello, I think you have a typo in your statement. You may have meant to say T2 flair signal areas in the cerebral white matter. In plain terms? Well, your sister's brain lobes in the front (on both sides) are demonstrating what is referred to as white matter degeneration which means that either the capillaries feeding the deeper parts of the brain are clotting off and causing the very smallest of infarcts or that the neurons are losing their protein insulation coverings which is technically referred to as demyelination. Radiation therapy to the brain is known to cause radiographic signs of white matter degeneration within 18 months of receiving the treatments so I'm not surprised at the read given her treatment that was given. It is not suggesting that there is any recurrence of a tumour if that's what you may be concerned about right now. Hope I have answered your query. Let me know if I can assist you further. Take care. Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Calpol safe to take for a 6 year old child?\n\nHi there. Please can you advise me. My son is six years old I gave my son 10ml of calpol at 11pm. I think he may have also had 10ml at approximately 9pm. It was calpol (for age 2+ months) NOT calpol 6+. Is this safe, or should I seek medical advice. There should be four hours between doses. Thank you so much for your advice. Ashley",
    "doctor_response": "Hello and thanks for writing in.Calpol contains paracetamol.i think what you have given is 125 mg of paracetamol.I don't think you have to worry too much.just keep a watch on temperature.Take careRegardsDr. Shesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe abdominal pain, pain in the ribs and skin. Could it be bug bite?\n\nI started out with severe abdominal pain upper and lower but worse in the upper left side around ribs no fever. I then started having very bad skin pain near my left ribs and around side. It is painful to the touch even clothes touching it. Last night it felt like something bit me on my left side back area and there was no bug found but it felt like I was stuck with a hot needle over and over very fast. The area is red and raised in several areas but does not look like a bug bite and was not there when the skin pain started. I have not started any new meds or used any new products that come in contact with my skin or eaten anything new.",
    "doctor_response": "Hi welcome to Healthcare magic forum.                           Thanks for choosing H.C.M.Forum.                            I started with severe abdominal pain, no pain,  severe in the left abdomen, around your ribs. last night you felt that some thing bit you on the back. The area is red and raised. You didn't take any new medicine or food.                           It appears to be the neurological pain, cause may be herpes infection, latter may proceed to watery rash, followed by neurolgia.                             Other possibilities could be gastritis, and utricaria related or not related to the pain.                              I advise you to consult a physician for diagnosis and treatment, to prevent permanent neurolgia, not relieved even after remision of the rash.                              Wishing for a quick and complete recovery.                              Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce pain in collarbone?\n\nI ve been working out lately doing two miles everyday. The last few days I ve noticed my collarbone hurts and it hurts when I swallow. It feels like everything is closed up. It hurts to breath. It s more on the left side of collarbone. What should I do. What can u do to make it less painful.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As per your history, it may due to trauma or overuse. You can take tab. aceclofrnac. In case of severe pain do x ray colar bone and consult with orthopedician. Do regular exercises.  Take care. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to leave an wound open after the stitches did not hold?\n\nso the story is that I fell on the way from school and got injured, got 7 stiches. Yesterday got the stiches removed, and the doc said it didn't stick and it was still open (don't know how, I didn't see it), because it got contaminated.  It is pointless to sow it again since it is contaminated and something like that. You should leave it open and clean, clean, clean, clea, clean it a lot; don't cover it (only when going outside) it will take time to heal but eventually. So I was told, but I have an uneasy feeling about leaving it uncovered and the injury open. I wouldn't have such an uneasy feeling if it was a scratch or a cut, but its a hole! about the size of a marble",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain in case if there is a hole at the site of wound and the stitch is fallen off then there is a possibility that the area is infected and it is true that stitching it again is not required and you should keep cleaning it atleast 2 times a day with antiseptic solution and apply antibiotic ointment over it..It has to be left open and it will help in drying and healing of wound faster..But in case if there is a hole in the area the it will although heal slowly but will definitely heal completely but can leave a depression in that area..You should also take a short course of antibiotics for faster healing and a Tetanus Toxoid injection should also be taken..Hope this information helps..Thanks and regards.Dr. Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do people with thalassemia have auditory or visual hallucinations?\n\n1. Do people with thallassemia ever have symptoms of hallucinations (auditory or visual) or dizziness/disorientation from that disease? 2. Do adults with thallassemia ever get umbilical cord transfusions today, or is it just treated medicinally? I m just writing a script--this is not an emergency.",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.No, thalesemmia never causes hallucinations.There may be some other reason in you that is causing hallucination in you.I suggest you to do your psychiatric evaluation before.Please take full sleep and do yoga and meditation early in your the morning.This help reduce your symptoms.I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dark black spots on inner labia and anal region?\n\nHi There was only one biopsy taken fron one spot just inside the vagina. No other spots were taken Can you please explain the above?",
    "doctor_response": "If all the spots are similar looking then it makes sense to biopsy any one of them to reach a diagnosis. You dont need to biopsy all of them. However if they are different and all have a suspicion of cancer based on clinical examination then all need to be biopsied. This only your clinician can tell. The treatment of course will depend on the biopsy result which you havent mentioned.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes calf pain?\n\nMy right calf has been hurting the past couple of weeks, feels like a cross between a pull and a knot.  2 weeks ago I rode in the car for an hour and my toes swelled on the same leg, the next day my calf hurt.  I have a small dime size bruise on my calf near the area that hurts but don't remember doing anything to cause the bruise.  Should I be concerned.",
    "doctor_response": "Hello,Swelling and pain after a period of stillness like a car ride could be an indication of a blood clot in the leg. Please see a doctor as soon as possible for an exam.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can teething cause cold sweats and low body temperature in a child?\n\nCan teething cause cold sweats and low temp? My son is 13 months and has been super fussy today and tonight. Woke up last night crying too. I assumed he is teething again. Tried a temporal digital thermometer on his head and it keeps reading between 96.3 and 96.9 but i know they arent always accurate. However when i do it on myself its much higher so i think his temp is low. Hes also sweating but very cold and clammy. Its not hot in our house. Im very concerned",
    "doctor_response": "Teething dont cause cold sweats and other problems. It only cause irritation at the eruption site so the baby wants to bite anything for soothing.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vaginal discharges and bleeding, abdomen pain during a pregnancy?\n\nhey, i just found out im pregnant and have had a miscarriage before. i havent been to the doctor yet but im guessing im about 2 months pregnant. ive been have severe pain after sex and i have started having discharge and some blood. im also having constant severe pain in abdoman especially on right side of abdoman what could this be",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the spotting in pregnancy can be due to various causes pike thyroid abnormalities,progesterone insufficiency,abnormal pregnancy ,bleeding from cervix etc.The cervix becomes soft and vascular in pregnancy so it might bleed due to intercourse.So usually we advise to avoidintercourse during the first 3 months.As youhad previous miscarriage I suggest you to consult doctor and get the necessary investigations like ultrasound,thyroid profile done to know the pregnancy status and rule out thyroid abnormalities.Avoid physical strain and intercourse.Avoid stress.Take healthy nutritional diet and folic acid supplements.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could swollen vein like lumps on the jaw indicate?\n\nMy daughter has a large swelling lump on her right jaw. She had an mri about 2 years ago because it would swell like the size of a pea now and then and was painful. The dr said it was a bundle of veins that she probably was born with. It flared up today and U.S. The size of a golf ball. If she leans forward on that side it hurts. What do you think?",
    "doctor_response": "Hi,Dear,Thanks for the  query to My HCM Clinic.I studied your query  in details and understood your health concerns.-Treatment Advise and Cause of your lump on the Jaw-a-In -my opinion-due to CT report-it is mostly-Hamartoma? Hemangioma with secondary infection in it? with Acute on Chronic-JD adenitis -secondary to  Chronic-Tonsillitis?The pain on movement suggest it to be as above.This advise would help you to plan treatment with your doctor.Hope this resolves your query.Wellcome for further query in this regard. Have a Good Day...!!With Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does a further gynaecomastia surgery need to be done for correction?\n\nLast year I went under the knife for gynaecomastia surgery. I was told by my consultant that the surgery would include liposuction and then a small incision under each areola to remove the circular lumps of excess tissue. After the operation, my dressings were removed to see how the swelling was. I could see that only liposuction had been carried out. I asked why this was and the plastic surgeon told me that if they were to have tried to remove the excess tissue they would have had to have made a large incision. The only reason I wanted this surgery done was because of the size of my nipples, the circumference was not necessarily big, but they were reasonably puffy. Now, they are even worse than they were before the surgery. I was wondering, would my doctor take this in to account and possibly attempt to get me on to another waiting list for more surgery to correct the problem?",
    "doctor_response": "Hello, You can now go for a procedure called subcutaneous mastectomy. It can be done under local anesthesia. Consult a general surgeon and he will direct you accordingly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause for clotted semen after an intercourse?\n\nHi After intercourse and masturbation my sperm comes out kind of clotted with a light colour of normal semen then a little bit of a more cloudy colour in and around the clotted bits of semen, so its like runny and clotted at the same time its kind of like jelly when its all accumulated. Sorry for the poor analysis its just new to me and hard to explain kind of confusing as well. hope this gives a good enough idea and some one could point me in the right direction as to what it is? Thanks",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have noticed that your semen is clotted .This is due to agglutinations of sperms mostly due to presence of infection either in prostate or seminal vesicle .Please get your semen analysis done to confirm the diagnosis .In case semen analysis reveals infection you will need to take broad spectrum antibiotics like Cefexine for 4 weeks to combat the infection completely.Please ensure to drink more water this will help to keep your semen normal.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How effective is mtp kit 2?\n\nHi doctor, i ate 1st tablet from mtp kit 2 hours before and m not starting bleeding yet. Actually m living in canada and my friend sent me tablets from india and she crushed every tablet in powder form and put every tablet in each burffi ( sweet). Now I am scared it will work or not? You can reply me on.",
    "doctor_response": "Hi, It is highly effective. Mifepristone and Misoprostol combined therapy is an effective and well tolerated medication in Indian adult women (\u226518 years) requiring medical termination of intrauterine pregnancy (MTP) up to 63 days' gestation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ajeet Singh, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes light blood in stool and abdominal cramping?\n\nI have been having slight blood in my stools, so I thought I must have a hemmoriod, but it didnt hurt.  Today I've been having severe pain in my stomach and lots of very hard bowels movements, but they come out with black flakes in the stool.  Should I be concerned?",
    "doctor_response": "Hello!I read carefully your query and understand your concern.There are many causes of red blood in stools and hemorrhoids is one of them especially if you suffer chronic constipation and you have lack of physical activity.The diagnosis can be confirmed by physical examination(rectal examination) or  lower endoscopy.The presence of black tar stools(not only darker than usually but black black) indicates upper digestive tract bleeding.Associated with severe stomach pain it indicates a peptic ulcer.You need a complete evaluation,stool examination to confirm the presence of blood,complete blood work,upper endoscopy to  visualize every possible lesion is stomach.I suggest to consult a physician and get evaluated.Take careDr.Rovena",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for HBV\n\ni have HBV can you help me ? is there medicine for this scare ?i badly need your help on this.in case you want to get in touch with me please my email: YYYY@YYYY ; please help me am in terrible pain in all most all joints of my body Kind RgdsAndrew Nsigaye.",
    "doctor_response": "HIThanks for posting your query.      By HBV I hope you mean Hepatitis B Virus. First of all don't get scared . If you are infected with HBV then we need to check whether the HBV virus is multiplying inside your or it is just sitting in your body without multiplying .      To know this you need to get a test called HBV DNA PCR ( quantitative ). Kindly get this test done as the necessity to treatment depends on the result . Hope this information was useful to you. Any clarifications feel free to ask .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment for PCOS patient when no follicles is formed after having progynova\n\nhi dr .my patient have pcos .i give her good ova plus tab 2nd day to 6th day of cycle .but 14 th day her endometrium size 4 mm and no follicles i prescribrbe her progynova 2 mg for day 11 but still no progress .what is the next treatment? last 2 months i gave her tab pco care",
    "doctor_response": "Hi,Thanks for writing to HCM .I would suggest you to prescribe ovulation inducing drugs like clomephine from day 2 to 6th day. This will help multiple follicles to mature and rupture . I would suggest you to start sidenafil tablet per vaginal route from day 6 to 14. This will increase local blood flow and help endometrium to grow properly.  Continue estradiol from day 8 for 10days. If clomephine also fails then you can add fsh injection with that. In same setting you can go for IUI . This will increase chances of conception. Hope I have been helpful .Regards Dr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain in the head?\n\nI think I may have caught an sti I have unbelievable sharp pains frequently on the head of my \ufe0for is I have scabs which are yellow and a few black 1s they are solid and dry and I am itchy all the time what would you suggest to slow this down as its went from 2 scabs to 6-7 in 3 days I work away and a really need to see a clinic asap the pains are horrible",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have sharp pain in the head. Well there can be many reasons for symptoms you mention in query like trigeminal neuralgia , cluster headaches , migraines , meningitis , encephalitis or tumor. I would suggest you to consult neurologist for proper examination . Doctor may order CT scan and MRI to confirm the diagnosis along with taking history . Doctor may prescribe betablockers , frusamide , analgesic along with anti depressants . For now take ibuprofen or acetaminophen for pain , avoid direct sunlight , loud sound and do mind relaxing exercises like yoga and meditation . Doctor may also give alcohol injection in nerve in case of neuralgia . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i take antibiotics while having feeling of lump in throat?\n\nSevere food poisoning, 6th day now am able to take in small amounts of blan foods. But now after eating within couple hour i feel a lump in my throat ...i have to drink plent of water because it feels like there still something stuck in my throat, i belive i have an infection in my throat. Am i able to take antibiotics now?",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: You need prescription from doctor and also assessment before taking antibiotics. Explanation: After severe vomiting sometimes it may feel like you have something in your throat. It may not be an infection always. So, dont diagnose on your own.                  Instead go to your doctor and get yourself examined for any throat infection if any present. Mean while you can gargle with salt water every 2hrs and can take plenty of fluids which will help to get rid of your infection if present.                  Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain,swelling and redness in thump?\n\nA 20 year-old mother stuck her left thumb on a safety pin while changing her infant\u2019s diaper. The puncture was on the palmar aspect of the distal segment of the thumb near the interphalangeal crease. Within two days there was severe pain and swelling in the thumb with some redness just above the wrist on the volar aspect. The patient also reported that she had been proned to minor accidents in her household activities recently. 1. What could have caused the changes observed in the region of the left hand after the pin prick? 2. Which bacteria are likely to be the cause of the inflammation in this case? 3. How could this case be effectively treated? Should a surgical intervention become necessary, which anatomical structures would need careful attention?",
    "doctor_response": "Hello,There are many type of bacteria like staphilococus epidermidis, and other bacteria present in the skin, which can cause the infection. Tetanus can not be excluded either. Coming to this point, if the infection is local, I would recommend alcohol local packs and a antibiotic ointment like neomycine or tetracycline.If the swelling persists and even progresses toward the palm of the hand, surgery to open it and oral antibiotics may be needed. You should discuss with the doctor on the above issues.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cysts in kidney of fetal baby\n\nSir ,I am 8th month Preganant in Sonography we came to know that our baby is having amulticystic in left kidney and right is normal .the left kidney has 2 cyst 9mm & 4mm . Sir please advise as i am much worried ,is there any medicine to cure .My due date is on 5th july.please advise",
    "doctor_response": "Hi dear,I had gone through your question and understand your concern .In this situation we should try to find cause:1.Hereditary.2.Mutation factor in first three weeks of pregnancy (sickness, tablets, radiation, etc).3. Infection (perform blood for Ig M,G to Chlamidia, Mycoplasma trachomatis, Ureaplasma urealitycum, Ig G to Cytomegalovirus,Herpes).If something will positive you should treat that infection.4.When baby will born you should examine him for following up infection and observe him by ultrasound in O-3days, 1 month, 3 months it can normalize,because it may be immature kidney",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high blood pressure?\n\nI have been to my primary care physician and I have white coat syndrome. I monitor at home at its around 125/75 fluctuating just a little. I have been under a great deal of stress lately and it seems to spike every couple days and now since I am concerned about it the result of course is making it worse. I have had an anxiety disorder since my teens and now am in my late 40 s. I am started to walk on the treadmill again. This seems to help. My question I suppose is how dangerous are those spikes?",
    "doctor_response": "Hello, These spikes in blood pressure values are not harmful and do not need any treatment. Anyway, a low dose of beta blocker (bisoprolol, propranolol) could help improve your situation and prevent those spikes during this stressful situation that you are going through. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Inflated feeling under rib cage, stabbing pain while lying on back, hep c since childhood. Is it due to liver?\n\nI have this inflated feeling under my rib cage on my right side. I get it often but it bothers me most at night as i feel like laying certain ways make the sensation more intense. If i lie on my back I get sharp pinching like stabs in my back like something is pinching one of my organs from the inside. I am 28 and have had hep c since age 8 with no treatment. Could this feeling be my liver?",
    "doctor_response": "Get an ultrasound  chest Xray and LFT profile.If they are abnormal then take treatmeant accordingly.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do you suggest for being sexually inactive after circumcision?\n\nI was circumcised at 18 and am now 62. After circumcision, glans was and continues to be very sensitive, so much so that I have never been able to tolerate oral sex and even regular sex has at times been painful. My circumcision left all of my frenulum intact. It is a huge flap of skin from below the corona to the tip and hangs down about 3/4 of an inch. I am just now finding out that it contains nerves. Can that be the problem? I lost my last girlfriend because she said she enjoys oral sex and I wouldn t let her and even her rubbing her hand against the glans makes me go soft due to the pain. I still want to be sexually active with a woman, but fear the same problems in the future. Any suggestions?",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.Its unfortunate that at the age of 62 you are still having the sexual problems. If the glans has been sensitive for these many years it difficult to reduce its sensitivity. The better way would be to control the senstitvity psychologically. Biofeedback therapy is one of the options.  It should help you.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, or want any further details about this same issue you can use the below mentioned link:bit.ly/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do gall stones cause high WBC count, diarrhea and anal pressure?\n\nSince Feb 26, I've had diarrhea or very loose stools. Last weekend (a week later) my right side was tender so I went to the dr who ran tests and sonogram and the sonogram came back with gallstones. The bloodwork came back with a high white blood cell count. I'm still waiting on the stool results. I've had a low grade fever 99-100.2 for over a week. I have pressure on my tailbone and anus. Could all these symptoms be related to the gallstones or could it be somwthing in addition to?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.Gall stones may cause some abdominal discomfort including abdominal cramps, diarrheas,nausea or vomit but it should not cause anal pressure of any kind. High wbc count is usually sign of infection or inflammation and it may be elevated if there is acute inflammation of gallbladder but is is usually associated with pain under right rib cage. If you dont have it then you should look for another cause of fever such as enterocolitis and stool analysis results are required or this. Later, you can consult surgeon about surgery need,but you should not rush with it.I hope I have answered your query. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for sprained wrist with bruises?\n\nMy husband fell and sprained his wrist and now its turning dark red (all of it) now the bruising is going up his forearm and his hand is darker red (almost black) its been 3 dayss and the swelling is worse and the bruises are getting worse instead of better",
    "doctor_response": "It might be a serious injury of muscle. I would suggest you to see an ortho specialist and get an xray first to see if there's any internal injury and immobilization of the wrist for few weeks depending on the severity.-Dr Gunjan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes noisy breathing in infants?\n\nI have a 3 month old boy that just developed noisy breathing overnight. He does have cold symptoms too, cough and congestion that also just started. After taking him to his pediatrician I am still worried. He gives me albuterol and says his airway is immature. Why is it just starting then? He is also spitting up milk (from his mouth and nose). What possibilities are there to explain this?",
    "doctor_response": "Hi I am dr Kadhir,At First you should ensure Few issues1.is your baby exclusively breast fed and gaining weight for age.2.is he active, play ful and has no fever3. Taking feeds adequately .Infants who are bottle fed usually have nasal regurgitation and posseting. These kids are prone to nasal block especially during mild viral infection. If he is with in his routine other than noisy breathing then saline nasal drops suffice.. I usually don't prefer salbutamol if child has no wheeze.. even than oral salbutamol works rarely in 3 months old kid.. 1.better try saline nasal drops 10 mins before every feeds.. 2.keep the room warm at night, 3. If using feeding bottle use appropriate size nipple.. thank you for using health care magic..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the solution for abnormal bowel movement since gallbladder removal?\n\nI am 29 y.o., and since I had my gallbladder out in 2006, I hardly ever have a normal BM.  They are never formed, always diarrhea, most of the time with mucus and mostly bile, and I can rarely make it thru a meal without having to run to the bathroom.  I have considered seeing a GI doctor as this is a huge annoyance but was wondering if it was worth it to try and get into a specialist.  I am 5'4\" and weight approximately 170#.  PMH includes, migraines, gestational diabetes, asthma, anxiety, depression, insomnia.  I am a smoker of 1ppd, and occasionally drink alcohol (about once every 2 months).  No street drug usage",
    "doctor_response": "Hello,1) Removal of gall bladder as such not produce such symptoms.2) Sticky stool of loose consistency (due to poor absorption of fat from diet) is associated with decreased amount of bile available for digestion of food and removal of gall bladder is not associated with this (as it neither affect production nor drainage of bile to intestine)3) When did you develop diarrhea? From immediately after surgery or after some period? or you had episodes of diarrhea even before surgery4) Most common complication after gall bladder surgery is mild abdominal discomfort in right upper abdomen.5) If you had episodes of diarrhea, bloating, mild abdominal discomfort before surgery then you might have irritable bowel syndrome in which diarrhea occur due to increased movement of intestine and indigestion.6) If you had developed diarrhea after surgery then you should do investigations to find out cause for that and might require CT scan of abdomen, colonoscopy, Stool culture examination",
    "dialogue_context": ""
  },
  {
    "patient_message": "My sister had a 3d ultrasound to see if they could diagnose down syndrome. The ultrasound showed the arms were not growing properly. They did an unscheduled amnio and will not get the results back for two weeks. What could cause the baby s arms not to grow as they should?",
    "doctor_response": "there are many syndromes that can lead to abnormal development of arm. wait for amnio results. and please let me know at what gestational age was amnio done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can erectile dysfunction even during masturbation be treated?\n\nHi... I can\u2019t seem to get myself hard with attractive woman like I used to... even while masturbating for hours I can\u2019t get it to stiffen up for me. :/ I know I\u2019m attracted to both sexes. And I think of them both. But nothing gets me aroused like it used to.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Erection problems can have many causes. These include physical problems, such as injury to nerves or loss of blood supply to the penis. Other health problems, such as diabetes, high blood pressure, anxiety, and depression. Side effects of certain medicines and stress, alcohol or smoking can be other causes.The exam, lab tests, and sometimes mental health tests can help find out the cause of the problem. Tretament is based on cause and includes avoiding tobacco and drugs and limiting alcohol.Also, talking about the issue with your partner, doing exercises, and getting counseling may be beneficial. Finding and then stopping medicines that may be causing the problem.In some cases, you can take different medicine that doesn't cause erection problems. Taking prescription medicine that can help you get erections.These include pills such as sildenafil (for example, Viagra), tadalafil (for example, Cialis). In most cases, this is sufficient for treatment but you should just be patient and do necessary tests.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Ivan R. Rommstein",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tongue to turn white, thick and rough?\n\nDear Dr., I am 35 years old, 28 weeks pregnant, and my Dr s P.A. told me I have a proliferation of taste buds. My tongue turned white about a week ago and I was scared it was thrush (I had been on an antibiotic). It also feels thick and rough on the surface. The P.A. said it was not thrush as it does not scrape off, is not cottage cheesy. She said maybe I should clean it better, but I brush it twice a day routinely with an electric tooth brush. I have tried to find information online about this condition but don t come up with much, if any relevant material. Is there anything you can tell me?",
    "doctor_response": "hellooo....first of all congrats for becoming a mom..regarding the tongue..it can be a fungal infection....but nothing to worry....u can apply nystatin gel twice daily..and scrape ur tongue twice daily...after brushing..use chlorhexidine mouth wash....meet the dentist he can give u tips based on the clinical situation...as a lot depends on clinical condition...more over be happy and no stress....hope u r benefitted something with my anser...have a healthy day!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicine for constipation\n\nmy 1.5 year old daughter is having difficuly passing stools..she is 10.5 kg and avg height, and is now fed on Lactose free milk as suggested by PD.But still no change.she has solids, dal-rice,banana squash, all fruits, and drinks good amount of water.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. 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 (fibre diet) appropriately?You can get back with answers at the following link - www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696Suggestions:1. 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 (I mean in squatting position) 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 Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mouth ulcers, nausea, painful. Related to antibiotics and stitches?\n\nHi. I have just experienced an outbreak of mouth ulcers , and I have a heavy blocked nauseous feeling in my stomach. The ulcers are very painful. It doesn t seem like a virus as I am not otherwise sick. I wonder if it could be related to a course of antibiotics I just finished for cutting my finger and receiving stitches last week? I also had a tetanus shot.",
    "doctor_response": "hello and welcome, the antibiotics can cause nausea if you do not  take .anti-acidity tablet. mouth ulcers appear either due to vitamin-b deficiency,intake of more salt and spicy food like mixture etc. always clean and rinse your mouth after every meals. these ulcers are of aphthous type. i would advice you to take tab.flanzen-10mg,thrice daily for 3 days and tab.wysalone-5mg,thrice daily for 3 days. brush your teeth mildly using soft interdental brush and dental floss. to relieve nauseous feeling,take tab.rantac-150mg,twice daily half an hour before food. take warm saline gargle and chlorhexidine mouthrinse frequently. maintain good oral hygiene. regards dr.bindiya",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for a viral infection\n\ni have done a blood test and bein told i have low esr levels. Doctor said i have a viral infection due to body insulation not being right.He put me on anti inflamitrys for 10 days which i finished 3 days ago. Since then aches and pains have returned to my joints.Could you explain more about these symtoms,and what i should do?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you are having low ESR and viral infection lasting since few days which could be due to impaired immunity of your body. As you have low ESR count means infection is present in your body. I would suggest you nothing to worry about it. You should take NSAID medication along with antibiotic such as Levofloxacin. You should take plenty of fluids. Avoid taking any sharp and oily food substances. You should take fresh juices in diet. Try to divide your meals in small fractions rather than having bulk at a time. You should take soft and bland food. Visit general physician once and get it examined. Go for blood tests again as well. Start treatment after prescription.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat cough in an infant?\n\ni have a 1 year 3m old baby and she hasbeen coughing too much non stop its not a whopping cough its regular it doesnt sound like mucus or anyting in the cough to ive gave her a little bit of dimetapp she did have runny nose but that cleared up now it just the coughing what should i give to her and how much",
    "doctor_response": "Hi,If she is not having fever, she is active and playful, and the cough sounds dry, nothing to worry. This is probably a viral respiratory infection like a flu. Here, fever if any, and nasal discharge clears early but a dry irritating cough may persist for up to 2 weeks.If disturbing, you can give her antihistamine and cough suppressant. I used to give cough syrups like syrup alex junior for 5 days. Take her to doctor if cough persists beyond 2 weeks, becomes wet type, or fever persists.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam T. K., Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy after having i pill?\n\nhi.... ma boyfriend rubbed his penis on my vagina after he came over me... we did not have intercose....and also some fluid was discharged from his penis.. and i had completed mu periods 6 days before... after 3 days that is on  5th day i had an i pill is there any chance of me gettin pergnant?",
    "doctor_response": "Hi,The precum contains sperms. So even if there is no intercourse, if the precum fluid has entered the vagina, there is a possibility of pregnancy.I pill helps in avoiding pregnancy.The earlier after unprotected sex you take i pill more effective it is. If taken on the fifth day it is about 50% effective. So if your period is delayed by more than a week, get a pregnancy test done.To avoid such unnecessary stress I advise you to consult your doctor and start regular contraception like hormonal contraception or have an intrauterine devise fitted as they are very effective in preventing pregnancy.I hope I have answered to your satisfaction. If you have any further queries do contact me through healthcare magic",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes delay in periods despite taking Mifegest tablets?\n\nHi what happen if mifegest tkn twicely regularly actually I hd mifegest in the month jan after dt I get periods heavily but in the month of Feb I hv not any periods then in the first week of March I tk megigest so yet mine periods hv not start I feeling scare what it will happen to me ..m feeling low and giddy ,nausea type pls doc help me",
    "doctor_response": "Hello,Thanks for writing to us. I would like to know why you used the medication repeatedly, whether to induce an abortion after confirming a pregnancy or simply to induce a delayed period. Whatever it may be, you should not self-medicate with such a medication. Please see a specialist as early as possible to get a complete appraisal of the situation and plan further management. A sonogram of the pelvis, preferably in the trans-vaginal route is needed to clarify the situation. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain in the thigh be treated?\n\nHi Doctor! I have developed a pain on my left thigh. It seems to be a muscle on the back of the thigh. It radiates to the hip area and sometimes to the leg. It is very painful when I go up the stairs, but not down. I exercise a lot and do weights ( circuit 2-3 times week .I do heavy weights. I am also a runner but have been stying away from running. When the leg is straight it doesn\u2019t hurt. It hurts when bending and certain movements. Is it OK to exercise through pain. I have been going up using mostly my right leg. What can I do to make pain go away? Thanks for your help!!!",
    "doctor_response": "Hi, Possible causes are sciatica or impingement of nerves may lead to radiating pain from lower back to leg. Other possibilities like herniated disc or muscle pain or osteoarthritis or spinal stenosis etc. Until examination is done it is difficult to say what it is. Please get X-ray lumbar spine, use muscle relaxant, use tablet Aceclofenac. Use tablet Pregabalin. If symptoms not improved please consult your doctor he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a rash in vaginal area in a child?\n\nMy daughter is five years old, she has had a rash in her vaginal area. Our doctor gave us Butt Paste to treat the area, however now she has small round ,almost pimple like spots around the vaginal area as well as her bottom and upper inner thighs. Could this be impetigo? And she has a fever today.",
    "doctor_response": "Hi, This is usually due to acidic stool or maybe because of urinary infection. It would have been better if I could have photos of the same so that it can be treated effectively. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sanmati Thole, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can loss of bone and food lodged causes pain in the tooth?\n\ntreatment of pain due to food lodgement between the teeth. my patient is complaining of dull pain in lower right posterior region .there is a crow on 1 molar & attrided 2 premolar. radigraph showed bone loss between them. i had done scaling too but pain is there",
    "doctor_response": "Food lodgement can be a cause of pain. As you mentioned the premolar being attrited,verify if rct is required. If not then I suggest capping both the molar and premolar with a bridge. Hope this answers your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could LG A for blood in urine and RBC count being 182 H with symptoms of aching kidney mean?\n\nOK - I ve never done this before, but, I m pretty scared. I ve had issues with aching kidney and have gone to the dr a couple of times. Week before last I went again. My urine sample had a lot of blood in it and they were going to send it out for analysis. I tried to get the results all last week but couldn t. Was in office with my mother yesterday and they gave me a sheet of paper and told me to go see a urologist. When I got home I looked at it and it shows LG A for blood in urine and my RBC count is 182 H. I called a urologist and they needed a referral. I called again today and they hadn t received it yet. Just need someone with knowledge to tell me it s OK.",
    "doctor_response": "Hi.I am Dr Ali and I am a urologist.I have seen your question I shall try to answer it.In the first place I assure you that there will be nothing serous ,usually small amount of blood in the urine comes with urinary tract infections and stones in the kidney.I advice my patients who come with these type of symptoms to take plenty of water and lemonades, analgesics to get relief from kidney aches.Ultra sonogram is needed to look for any stones.Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will outer skin attached to penis head give pain while making relation with girl?\n\nhello sir actualy this year i am turn to 21 but my outter skin which is attech with my penis head . and my frnds are told me that when i go for a relation with a girl then at that time it give me more pain . is it true? if true then plz suggest me how i open my penis properly",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern, you have been wrongly informed in fact you wont find this skin in the erection phase of penis so the question of pain may not be there just forget about this wrong information this is not true and no need to worry about this and thinking about this wrong information, hope this information helps you, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly advice on monoclonal B cell lymphocytosis.\n\nHello doctor, I am 46 years old. I have been diagnosed with monoclonal B cell lymphocytosis. B-cell markers CD19 is 36 %, Cd 20 is 33 %, and CD 22 is 3%. Dual expression Cd19/Cd5 is 31 %, Cd19/Cd23 is 31%, Cd19/Cd10 1 %. Blood was lymphoid gated. B-cell population coexpresses CD 45, 5, 19, 23, 20 dim and without surface light chain expression, and these comprise 31 % of lymphocytes 1.9 times. Kindly advice.",
    "doctor_response": "Hello. Based on your query, my opinion is as follows, 1. Going through the markers and the count, a diagnosis of MBL (monoclonal B-cell lymphocytosis) can be thought of. 2. Absolute counts are only mildly increased. Need to watch for rising counts and any lymph nodes in the future. 3. Usually, the population, if checked as a whole, more than 7 % show MBL. However, progression to CLL is low. Only follow-up with blood counts and clinical examination for lymph nodes is necessary. No further tests are necessary for now. I hope it helps. Any further queries, here to help again. Repeat counts after six months.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swelling below knees, bruised, had breast cancer. Worried about lymph glands. Suggest?\n\nI have swelling below the knee to the top of my calf from the front center of my leg toward the inside of my leg.  Sometimes it is two or three inches long and about 1/2 inch out from my leg.  It has been painless so I have not given it much attention.  It is in the same place on both of my legs.  Since I am a breast cancer survivor since 1994, my husband keeps asking me to get it checked out.  He is worried about my lymph glands.  Is this enough information for an opinion?  Linda",
    "doctor_response": "Hello Welcome to HCM You need not worry about symptoms you are having. It is rare to have metastasis below knee and extremely rare to have metastasis in bilateral legs in same place in both legs. It can be some orthopaedic problem.You should see your GP or orthopedics for the problem, Hope everything will be ok Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need help to recover from suicidal thoughts\n\npls help me sir i a am sucuidal thoughts ,oe i want to kill somebody , i am takin zapiz2 mg past 1 month pls help me sir , i am into very fear , i cust hair . i want to mureder somebody ,pls help me sirrrrrrrr  , i hav visited phycatrist but no use , i hav become obese pls help me or i will kill my self  0000",
    "doctor_response": "DearWe understand your concernsI went through your details. You are in distress. Certainly you are severely depressed. I suggest you to consult psychiatrist again and tell him that you are having suicidal ideation and you are in distress. You must sincerely follow the treatment he is giving. Please tell the whole thing to your family members take some of your family members with you to the psychiatrist. You may have to stay at the hospital for some days. Please do not misunderstand. If you do not take the treatment, things may slip out of hand. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Though the lump in my breast decrease on antibiotics, it is still tender. Could it be cancer?\n\nHello doctor, I am a 25-year-old female. My BMI is 22, I am a non-smoker with no ongoing conditions like diabetes. I am not breastfeeding and have never been pregnant. I developed mastitis very suddenly about three weeks ago, by that evening I was in A and E with a lump the size of an egg in one breast. I was prescribed Cocodamol and 500 mg Flucloxacillin a day. After the first course which was 10 days, I saw the doctor again as the lump had reduced to the size of a large grape but was still painful, I often had fevers and I felt unwell. Doctor put me on another seven-day course of Flucloxacillin and booked a breast cancer screening. I just finished my second course and I am still in pain, with lump still the size of a small grape, and still feel ill and feel like I am getting worse again. Breast is back to being red and swollen. My only option to see a medical professional before my breast screening is to wait for several hours at an urgent care clinic after work. Should I try and get more antibiotics? If so should I insist on getting a different kind? Also please be honest, I know there is a chance it could be IBC but as a young, healthy, childless woman, is it actually likely that I should prepare for bad news or not?",
    "doctor_response": "Hello. Let me assure you that there are no cancers which come suddenly and settles with antibiotics. One breast cancer which progresses over a few period is inflammatory carcinoma of the breast but it does not come in days and settle with antibiotics. You have a breast abscess that settled with antibiotics and some times a part of it gets walled with fibrous tissue were antibiotics do not reach it is called antibioma. I would suggest you take Linezolid 600 mg twice a day as there are chances of resistance to Flucloxacillin.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is back pain a side effect of depo shot?\n\nHi I had a pregnancy test and it showed up negative and went and got depo shot but come to find out I am pregnant and I m expediencing lower back pain and it hurts could there be something wrong becouse I got the depo shot for the first time while being pregnant",
    "doctor_response": "Depot shot has nothing to do with back pain.It could be sacral or lumbar spine involvement. But do not worry. Do not take pain killers. Apply some muscle relaxant t gel over back. Also take lumbar belt support.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to normalize blood pressure and heart rate\n\nSUFFERING FROM CIRRHOSIS OF LIVER ADMITTED ON 31/3/2010 FOR HEPATIC ENCEPHALOPATHY . THE BLOOD PRESSURE IS UNSTABLE AND LOW AROUND 85-90 SYSTOLIC AND 70-75 DIASTOLIC. HEART RATE IS FAST. WAS GIVEN ALBUMIN ON ADMISSION. PRUREAL EFFUSION IS PRESENT. WHAT SHOULD BE DONE TO NORMALIZE THE BLOOD PRESSURE AND HEART RATE. PEDAL EDEMA AND ASCITES PRESENT.",
    "doctor_response": "Hello, I understand your concern and would explain that the low blood pressure is related to the extravasation of blood and plasma into the extravascular tissues (in the abdominal area and lungs). The infusion of albumin is the main treatment, which can help maintain water inside the blood vessels and improve the heart rate and blood pressure values. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please tell me some remedies for chickenpox.\n\nHello doctor, I have chickenpox, and the blisters are\u00a0big. What should I eat, and what should I avoid eating? And please tell me some remedies.",
    "doctor_response": "Hello. You should consult a nearby physician to confirm the diagnosis of chickenpox. I suggest you try the following. It is the course of action only after confirming chickenpox disease. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. Diet wise, you should avoid oily and spicy food, and eat a lot of green leafy vegetables. And drink a lot of water. Do not burst the blister, as it is infective and will spread in the first few weeks. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "I want to know about dialysis\n\nmy father has got kidney failure...and doctor advised...dialysis..i want to know what is this dialysis..pls post a reply",
    "doctor_response": "Dialysis is a procedure for reducing accumulated waste products in the bood on account of kidney failure when kidneys no longer can do it on their own sufficiently.It can be used both for acute as well as chronic kidney failure.It is primarily of 2 types namely Hemodialysis(blood & artificial membrane based)done with the help of a dialysis machine & can be done both at home or in the hospital.Although in majority of centres in India it is done in Hospital setting.Other type is Peritoneal(Abdominal natural membrane based) also can be done both in the hospital as well as at home,& is a preferred modality by the people who want to do it at home.Both the dialyses are good for the patient requiring dialysis",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there a throbbing recurrent headache with nausea and dizziness?\n\nHello doctor, A throbbing and recurring headache, nausea, and dizziness. I am an 18-year-old female.",
    "doctor_response": "Hello. It can be a migraine headache as throbbing in nature and one side with nausea. You can be prescribed Naproxen or Ibuprofen for relief from an acute headache. If it cannot relieve a headache, then Rizatriptan can be prescribed. If a recurrent headache occurs, then prophylactic treatment with Amitryptiline might be needed.  Avoid aggravating factors for a headache like stress, smoking, lack of sleep, hypoglycemia, loud noise, bright light, etc. It is advisable to check your blood pressure as well. I suggest you consult a physician for examination and get prescription accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chronic congestions in a child?\n\nMy 4 year old son, seems to always be congested? Its been a problem for a year or so... Seems like he gets ok for a couple of weeks and then cold symptoms again and congested cough... It doesn t seem to bother him, but sometimes his breathing sounds heavy ... the cough sounds wet What could this be?",
    "doctor_response": "Hi, By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze. I have a few questions for you - 1. How many days per month does your kid cough or feel breathless? 2. How many nights per month does your kid's sleep get disturbed due to above symptoms? 3. Does your kid feel breathless when running around or playing with other kids? 4. Are the symptoms when there are seasonal changes? 5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.? 6. Is the cough always associated with fever? Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is allergy from a dog possible despite antihistamine medications?\n\nHi, may I answer your health queries right now ?  Please type your query here... I hope so, I have been given loratadin for 3 weeks and now I'm taking roxitromicin (macroilid antibioticc). I'm wondering, is it possible to have  an allergy to a dog (my husband bought it in the meantime), but  the quantity antihistaminic could be keeping me safe so far. I  have a cat and no allergy whatsoever thanks in advance",
    "doctor_response": "Welcome to HCMI have read and understood your query and appreciate your health concernYou forgot to mention why were you prescribed the antiallergic and antibiotic?Yes you can have allergy from the pets.It is possible to have dog allergy if you havent it from catsBut i cannot say anything for sure as you have not mentioned any symptoms or your history.If you are taking the antiallergic,yes it does mask the symptoms.I hope this was useful.You can get back with any other queryRegards Dr Faeza",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for an enlarged dental abscess\n\nHello.I currently have an enlarged dental abscess that has gotten bigger through out the day.The swelling on my face is making its way down to my jaw.I was perscribed Amoxicillin three times a day and in between I take Ibruphen three times a day.If the swelling continues shall I go to the Er or wait it out?",
    "doctor_response": "Hello,Thanks for consulting HCMRead your query as you have dental abscess for this you should go for treatment , as medicine will give you temporary relief .I will suggest you to consult your oral surgeon and go for its treatment Root canal or orap prohylaxis .As youbare asking about medicine Amoxicillin can be taken but you should consult your dentist before taking any prescribtion .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathlessness, ribs pain, wheezing, dizziness, headache with tremor?\n\nI have just been sitting at my computer when all of a sudden I started feeling short of breath. I have a sharp pain in my ribs, am wheezing slightly, and feel dizzy/faint. I'm also developing a headache. I have a history of asthma but haven't had an attack in a long time. I feel slightly shaky. All of this has been going on for about thirty minutes. Should I seek medical care?",
    "doctor_response": "Hello,Yes, you should definitely consult a doctor for these sudden symptoms. We need to first rule out heart diseases for these acute symptoms. So consult a doctor and get done ECG, 2D Echo and stress test (trade mill test). If all these are normal, then no need to worry about heart diseases. Also get done PFT (Pulmonary Function Test) because you have a history of asthma. If PFT is normal, then no need to worry about asthma. Sometimes undiagnosed stress and anxiety can also cause similar symptoms. To avoid stress and tension, be relaxed and calm. Don't worry, you will be alright but the first rule out heart and lung diseases. Hope I have answered your query. Let me know if I can assist you further.Regards,  Dr. Kaushal Bhavsar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have PCOS, irregular periods, taken FSH injections. Done ultrasound. Good chance of pregnancy?\n\nDear Sir / Madam, My name is Geetha located in chennai. I got married 1 and half years back and suffering with Infertility problem. When I consulted the Gynecologist she tested me and I came to know that I suffered from PCOS. Before that, I have not getting period regularly until unless I take tablets. And I was under her treatment and HSG says both my tubes are normal but FSH injections were not worked and my follicle size was not increased above 14 mm. So, my doctor done a laproscopy and removed the cyst and biopsy reports normal only. After a month of Laproscopy I again started my Infertility treatment. I got FSH Injections and HCG for Ovulation and below is my Ultra Sound report. On Day 5 - My Endometrium was Thin & both right and left ovary has MSF On Day 10 - My Endometrium was 5 mm & right ovary has MSF and left ovary has 12.5*12, 13*11 and 10*10 On Day 14 - My Endometrium was 9 mm / Triple Line & right ovary has 16 * 16 and left ovary has 19.5*19, 18*20, 15*15 and 15.5*16 On Day 17 - My Endometrium was 12 mm & right ovary has 19.5 * 18 and left ovary has 23.5*26, 27*25 and 17*19 On Day 20 - My Endometrium was 12.5mm & right ovary states collapsed follicle and left ovary says follicles reduced in size and got the comments as Free Fluid seen in POD. Moreover, My husband has no issues. So, Please advice me whether I have a good chance of getting pregnant this month. We had intercourse as specifed by my doctor right from day 14. Can any one please share your experience or advice on this? Awaiting for your reply.",
    "doctor_response": "Hello. Thanks for writing to us. The follicles were formed in both the ovaries and ultrasound findings are suggestive of a ovulation. If you had a regular sex till day 21- at least one day after ovulation then your chances of getting pregnant are there  in this cycle. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should a lump after a fall in an elderly person be of concern?\n\nMy 76 year old mother fell out of bed for the thirds time this moneth.  Her recent fall was this morning and she has a huge lump on her upper arm, there is no bruising as of yet and she can raise her arm without much pain she is just tender and achy.  The lump is about the size of a tomato.  Should we be concerned.  She is also on warfarin.",
    "doctor_response": "HI,Dear Carson-Very Good Morning from India.Thanks for your query.I understand your concerns.I studied your query in depth.-I would advise your mother not to worry.In my opinion its -post-traumatic HEMATOMA..-Treatment-l you need to consult ER Surgeon to avoid any infectio  in it and pus formation,which needs to be avoided.-He would treat it- by-a-Cold compresses-b-Tb Antibiotic,c-Tb NSAIDs,and would adjust the dose-of warfarrin accordingly d-Watch for any increase in Size of the arm lump.This would regress in next 2-3 wks time.-Hope this relieves your worry-some query. Wellcome for anymore queries in time to come.Have a Good Day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had sex, on combined pill. Any chances of getting pregnant?\n\nI had sex yesterday with my boyfriend, it wasn t unprotected as I am on the combined pill . But I had my period last week, and I took the pill on Sunday. It says you are supposed to take the pill for seven days to be completely protected. But we had sex on the sixth day and he ejaculated inside me. Last night I had a dream about all of my friends being pregnant. And this morning my stool is not solid, but it s not diarrhea form, it s quite soft. I was just wondering what you thought about all of this.",
    "doctor_response": "Hi, Thanks for the query. The chance of pregnancy is less, as you had intercourse in the first week of the menstrual cycle. During that period there is less possibility for ovulation in case of regular periods. When you think of something that can come in our dreams. And consistency of the stools can change depending on many factors. So you continue the tablets. Any if you miss your expected date of periods just go for pregnancy test once to rule out the possibility. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for recurrent mucus accumulation in the lungs\n\nMY WIFE HAS A LARGE AMOUNT OF MUCUS IN LUNGS . DOCTOR RANSCOPE DOWN IN HER LUNGS 9 DAYS AGO RINSED LUNGS OF ALL MUCUS 2 DAYS LATER MUCUS RETURNS DOCOR SAYS SOME TYPE OF BACTERIA WAITING ON TEST RESULTS TO RETURN FROM LAB HE SAID POSSIBLY NOT DUE TO ASTHMA. IS IT POSSIBLE THAT THIS COULD BE DUE TO EXPOSURE TO FORMER EMPLOYER",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As you explain the history yes it might be possible to be from dust environment. There are some known lung diseases causing from the dust. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause stiffness and shifting of jaw?\n\nI was giving oral sex and during it my jaw somehow shifted. I could not talk, when I got up and looked in the mirror it look as if I was a disabled person, my jaw pushed to the left and not able to speak clearly. Thank goodness it somehow fell back I place in a few minutes but it was terrifying. I have clicks in my jaw however I have never had something like this happen during oral sex. The male was holding my hair with one hand and my jaw with the other. Could he have somehow pulled the jaw out of the joint when it was open or it locked! Please help. Very scary.",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concern.... As per your complain it seems that you had a dislodged condyle [the portion of the jaw that makes a joint with the underside of skull] due to excessive opening of the mouth along with jerky movements leading to dislocation of the jaw and as only one side of jaw must have dislodged so you had deviation of jaw, and many a times the dislocated jaw rebounds back to its anatomical position either itself or manually placed by a dentist..Clicking sound may however be due to some abnormality with the articular disk that is a soft cushion present between the two bony portions of the joint and it may have displaced from its place or may be ruptured leading to clicking..You should take care as in case if you open the mouth too wide again the jaw can displace again..I would suggest you to consult an ORAL PHYSICIAN and get evaluated and get an ORTHOPANTOMOGRAM [OPG] done to rule out the abnormality and get treated accordingly..You can do warm compresses over the joint..Take a combination of muscle relaxant like Chlorzoxasone and painkiller like Ibuprofen..Take soft diet and avoid opening mouth too wide..Hope this information helps..Thanks and regards..Dr.Honey Nandwani Arora..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluctuation in BP?\n\nHi..my dad has the pressure problem from last ten years and he is on medicines..the doctor recommended tenormin 25mg..but he had to increase the power to 50mg i.e, tenormin 50mg(this was in 2007)..but then his body reacted in a weird manner..with pressure shooting up and going low also..so the doctor suggested..tenormin 25mg in morning and natrilix SR..(this was in 2008)but then he started getting the sensation of vommiting..so doctors recommendation he is having only natrilix SR in night..after dinner(till today)after discontinuing tenormin 25mg in 2008..he use to have two raw garlic pieces in the morning before having tea..but from last few days he again is having that pressure fluctuation problem..yesterday night it shoot up to 100/150 days before that it went low..can you tell me wwhat should be done to keep the pressure in control?? I have heard about a clinic in mumbai where in they attach a pressure reader on your hand for three days..the reader takes the reading at regular intervals..and after those three days the doctor analysis the reading taken by the reader and then suggests appropriate medicine as per the reading.so is there any special clinic which deals this way??",
    "doctor_response": "Hello There After going through your medical query I understand your concern and I would like to tell you that as per his BP fluctuations I will recommend you to run few test for him which is an ECG, Echocardiography and an ambulatory Blood Pressure for 24 hours. In the mean time keep his dietary salt low and stop all AntiHypertensive drugs. Consult a Cardiologist personally with reports for further treatment.Hopefully this information will guide you properly.Kind Regards Dr Bhanu Partap",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am a 22 year old female with chronic swollen lymph nodes only on my left side,which then leads to ear pain and jaw pain. I had my tonsils taken out a little over two years ago because of chronic tonsillitis.  I had blood work and the only thing that came up  was that my liver enzymes were really high, they were 250.  I had tests done on my live and everything came back to normal. Could my liver an lymph nodes be linked?",
    "doctor_response": "Hello,Enzyme values of 250 are not at all a matter of concern, and do to indicate any disease condition. In liver disease, the values will be above thousands. The swollen lymph nodes not linked with liver, and it could be due to infection or inflammation at the other sites. Look for any dental cavities or sore throat which are the common cause for swollen nodes in the neck. You can start on a short course of antibiotics, like most cases, the nodes will respond well with antibiotic therapy.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for recurring rashes and cough in child\n\nMy 9 year old daughter has been having a reoccurring rash, accompanied by tiredness, sore ribs and sometimes a cough and stuffy nose....and before you ask, I haven t changed anything, I m a little obsessive and anal about the things I use...i have always used the same soaps, shampoos, detergents, softeners, lotion... And as far as food goes, well, she s a VERY picky eater and hasn t eaten or drank anything different!!! I have been giving her Benadryl when it appears and it takes care of it...there is a part of me that thinks nerves could be the main contributing factor. As it started right before Christmas break...and started back 3 days before school starts back!?!? However, she is just 9, and I know children can have real stress factors, but she does great in school and nothing has changed at home...she comes from a home with both parents present, and love and support her! The thing that has ne perplexed is the very real cough, sore throat, and stuffy nose, and re pain she describes in her ribs... She is EXTREMELY afraid of doctors (and no, she s never had a bad experience) so this is my problem...can you give me any advice?",
    "doctor_response": "your daughter probably has allergy she need some tests and pulmonary function test refer her to her pediatrician to assess her status",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the lump on my husband s back of the neck?\n\nMy husband started having neck discomfort this afternoon. It gradually got worse through out the day. We noticed a lump on the back of his neck between the T1 and C7 vertebrae. The area is very tender. Is this something that requires immediate attention?",
    "doctor_response": "Hello Many thanks for contacting HealthcareMagicBased on your description of your husbands complaint , it\u2019s possible he may be having local bruising or a mild inflammation or a muscle spasm. Although I can\u2019t tell the exact diagnosis based on your description . What I can suggest is to observe the swelling for next few days and apply pain relieving balm or gel to the area where it hurts . If the pain and swelling does not subside within next 5 days plz consult your doctor .Hope I have answered your queries Wish you a speedy recovery",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can body heat cause chickenpox?\n\nHello doctor, My daughter got chickenpox last year. During that time we did not take her out and applied neem leave paste. It got cured in 15 days. Now, this year also, again she got chickenpox. Now, she is 4 years old. What to do now? Why has it come again? \u00a0She ate chicken and mango the same day. Is it because of that she got chickenpox? When I was a\u00a0kid, I got chickenpox three times. All the time we have applied neem leave paste only. Two years ago, I got again, and that time I ate more mangos and chicken. Is body heat causing chickenpox again and again?",
    "doctor_response": "Hi. Firstly, I would want to know if the diagnosis of chickenpox is made by you or a doctor. It is highly unlikely for anybody to get chickenpox twice and even if the person gets chickenpox twice least likely it would be once every year. Her weight 11 kg is very less for a 4 year old, which suggests she must either be frequently ill or malnourished. The fact that you also had the same issue in your childhood points to a genetic cause of some form of immune deficiency. If such is the case, then eventually the child will outgrow this problem as the age progresses just like you. Chickenpox is caused by Varicella zoster virus and not due to heat or due to eating some food item. Also, I would like to know if this child has been vaccinated to date and if not then please get her vaccinated. It is important to get the child evaluated with blood reports, and a physical workup with a pediatrician is necessary for diagnosing chickenpox. Please give proper nutrition to the child and avoid outside food as the weight of the child is very less for a 4 year old. For further information consult a paediatrician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to stabilize the ALT level which is shooting from 42 to 95?\n\nHello I recently had a blood test taken and my ALT had risen from 42 in December to 95 at the end of January. Are you able to advise how long it takes before ALT returns to normal. I was also taking Trazodone which can elevate ALT. I stopped taking this two weeks ago. Many thanks",
    "doctor_response": "The liver damage (hepatotoxicity)  with trazadone is idiosyncratic,  it means it is not related to the dose and cannot be predicted.  You did a very wise thing of withdrawing it,  as per recommendations the drug shouldn't be ever used back.  Try taking an alternative drug.  As for liver ALT you can repeat after 3 weeks and should have normalised by than.  However the above side effect is very rare,  make sure that no other drugs,  herbal preparation or even a binge of alcohol was taken at that point of time.  Regards Dr priyank mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump formation on elbow?\n\nHI, I noticed when I sat down tonight that I have a hard lump on the inside of my elbow. It is painful and I am worried it could possibly be a blood clot? Can you help guide me on what to do since it is Sunday night and I can't consult with my physican?",
    "doctor_response": "It could be blood clot lump with surrounding swelling.you could use1.Ice rub over swelling 2.Keep limb in uplift position during sleep.3.Start Tab Combiflame three times daily after mealyou will feel better.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden pain in head?\n\nI just had a cranial angiogram, for the possible treatment of a Basilar aneurysm, good news not an aneurysm, but said i have a looped vessel? didn t go into detail and i have know idea what this is? or if this is what is causing the intense sudden pain in my brain when i overexert myself or when i loss my breath. any ideas?",
    "doctor_response": "Character of pain you are describing may be due to sentinel bleed which is a harbinger for subarachnoid hemorrhage.  MRA may be normal.  DSA will be better investigation to detect if any underlying small aneurysm.Hope my answer will help you. Take care. Don't forget to rate me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain?\n\nI started having chest pain 7 hours after eating so tried alieve, mylanta and acid contoller. No relief so sat up all night. This morning same pain . I have good steady pulse and low pressure. This is a on going thing for me. Taking Flecinide for atrial Fib which no attacks for years now. Had lots of test for heart but no problem three months ago. Still the pain is causing me sleepness nights",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.By your history and description, possibility of GERD (gastroesophageal reflux disease) related chest pain is more likely.Only drugs are not useful in symptomatic relief. You need to follow below mentioned lifestyle modifications too.1. Avoid hot and spicy food. Avoid junk food. Avoid large meals, instead take frequent small meals.2. Avoid stress and tension, be relax and calm. Keep 2-3 pillows under head in bed.3. Go for walking after meals. Loose weight if you are obese.4. Quit smoking and alcohol if you have these habits.5. Start pantoprazole and levosulperide combination on empty stomach twice daily.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cough and palpitations after a surgery for ectopic pregnancy?\n\nHello, I just had a ruptured ectopic pregnancy, lost half of my blood supply and received a blood transfusion. Emergency surgery was performed and I am now home.  I've been having very frequent heart palpitations every time I sit or lay down.  They make me cough and feel very uncomfortable.  I am slightly short of breath and have a fever of 100.8. Also my stool has become orange/yellow in color.  I'm not sure if I should seek medical treatment immediately or wait until normal office hours as it is a Friday night.  I would greatly appreciate any help.  I am 36, and do not take any medications. I've had palpitations here and there but never this frequent.Thank you for your help.",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern.I will try to explain you something and give you my opinion.Palpitation has to do whith rhythm issues.It might be a sinus tachycardia meaning that the heart beats over 100 beat for minute.It might be an extrasistolic beat or other kind of arythmia.All of this cause palpitations, shortness of breath, anxiety sensation.Rhythm issues might have different causes like anemia, hyperthyroidism, electrolyte imbalances, cardiovascular disease, active infections or just stres.In your case, as you have lost blood you might have anemia causing this symyoms or an active infection.So, if you experience palpitation once a while you can wait, they're not an emergency.But, if you feel irregular, chaotic heart beats and important shortness of breath than I will recommend you to seek medical treatment directly to emergency room.You might have an electrocardiogram there, have a fool blood analyze and a cardiac echo.After if this result normal hou can take time to have a holter rhythm monitoring to see your rhythm tendency day and night.Hope I was helpfull.Best regards,Dr.Ervina.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from numbness after an accident where c3-c4-c5-c6 were pinched\n\nsir, my father had an major accident in which his c3- c4-c5-c6 gets pinched due to which he is suffering from numbness in the right hand and he always complain that the weight of whole body is on the waist and the whole body feels very shinked. sir please provide your kind advice regarding it we are suffering from 1 years badly sir please help.the mri report is also showing only that ones.",
    "doctor_response": "Thank you for choosing health care magic. I can understand your concern. Usually in such cases neurophysicians or neurosurgeons will wait for some time for symptom resolvement before they take any call for surgery. Sometimes even after surgery results may not be promising. I advise you to see a neurophysician along with reports. Based upon the physical examination he can advise you whether your father is the best candidate for medical treatment or surgical treatment. I wish him a speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for influenza\n\nHello , in the past 2 weeks my daughter had the influenza flu, I got part of it I guess but I don't present fever, mucus or allergy but I have been coughing since January 6 . Now I feel little better but my voice have changed a little and I feel I have something in my throat that is freaking me out because it bothers a little when trying to sleep. Any suggestion?",
    "doctor_response": "Hi, Thanks for posting in HCM. It is possible that you could have contacted with the influenza virus from your daughter but you remain fairly asymptomatic except for the presentation of cough. It is a viral infection, which is self limiting and would require only supportive management. Presently, since you do not have any other symptoms, kindly do the following to overcome the symptoms you are having. Take syrup containing Ambroxyl, Guaphenisin and Chlorpheniramine maleate as ingredients for cough. Do salt water gargling with warm water at least twice a day. You can also take chewable medicated lozenges to get relief of your throat and voice symptoms. Hope the information provided would be helpful. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of hardness at the bottom of my testicles when on provigor?\n\nI have a hardness at the bottom of my testicles after taking a product called provigor that s was to help with Erectile dysfunction along with another product called prosvent and now I have experienced a hardness of my testicles and occasional swelling and slight burning of urine",
    "doctor_response": "HiGreetings Since it followed after taking the drugs for erectile dysfunction,it is better to get it evaluated by an andrologist or urologist. It could be due to some infection either in your testicles or in epididymis. However you definitely need a check up at the earliest. Hope you are convinced. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rashes inside both thighs after injections for back problem. Is hydroxyzine used in treatment?\n\nI have developed a rash inside both thighs.  I am a male 57 yrs old.  Last year I had injections for a trigger point in my back.  two weeks later I developed the rash, but thought it might have been from being laid up with pajamas on for weeks at a time.   this year I had a bad shoulder, and the doctor again gave me an injection.  3 weeks late I developed the same rash as I did last year.  I still had some of the powder that was one part of treatment, but after a week of its use, I haven;'t seen any change.  I believe I was given a zpack of some sort last year, but I dont know what it was.  Is hydroxyzine used as one form of treatment?",
    "doctor_response": "Hello Welcome to healthcare magic forum Thank you for your query.I understand your concern regarding your skin problem.It look like you have allergic rash due to that injection.Injection may be of steroid or multivitamin.You need be very caution before taking medicine.It is better to consult dermatologistIf you have itching,hydroxyzine will work.You can apply calamine lotion over it.I hope I answered your question.Let me know if you have any query.Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it possible to contract STI through kissing?\n\nHello doctor, I had kissed a prostitute on lips and breast but did not have intercourse with her. I have no cut on lips and mouth. Is there any chance of me getting any STI?",
    "doctor_response": "Hi. It is really great that you want to know about an important issue and just do not want to make assumptions on your own. STIs are the diseases that are typically transmitted during sexual intercourse. It is unlikely to catch sexually transmitted infections with kissing alone, but with a few exceptions if the STI has manifested itself orally and/or in oral fluid of that person. Hepatitis B virus can be transmitted through kissing as the virus is found in saliva and other body secretions of HBV infected person. Herpes infection- This can be transmitted through kissing with a person who has a visible cold sore. Human papillomavirus (HPV) or warts and syphilis are less likely to be transmitted through kissing. So far, there is no reported case of HIV transmission through kissing.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any side effects from dialysis treatment?\n\nhello DR my father is a diabetic patient for the last 30 years right now he has some problem with his kidneys in test result we could see that CREATININE is 5.5 and the blood urea has gone over 200 docters sugest the next stage of treatment is only dialysis  his age is 60 is there any side effects in doing dialysis what tretment can be done to avoid dialysis",
    "doctor_response": "Hello and welcome to HCM.  As an Urologist,i can understand your anxiety.Your father has CKD (chronic kidney failure),due to diabetic nephropathy.You should've written his present medication,for expert opinion.Anyway he has two options : 1. Hemodialysis  or 2. kidney transplantation.Kidney transplantation is the better option,with better quality of life.Dialysis is done in two ways : hemodialysis or PD (peritoneal dialysis).There's no side effects routinely. In the long run,some side effects are seen.If you've any doubts,send all reports,as a direct question to me.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough and fever in a child\n\nMy 6 months kid is suffering from cough since 1 week and having fever around 100 F which usually comes in light and last till around after noon then fever becomes normal for rest of the day.since yesterday doctor has started giving nebulatizer with levlolin .63 mg 4 times a day and for 2 days, He seems to have relief but the fever came agin last night and was around 100 F which become normal aafter 6 hours. Kindly suggest on this",
    "doctor_response": "If the child is feeling better please wait for another 24 hrs. As medication take some time to make an impact. Go ahead with the medication at present and go for review again after 24 hrs of if the situation seems worsened, as the case may be.Continue nebulization.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the normal sperm values based on tests?\n\nHI DOC. I DID A SPERM ANALYSIS AFTER 4 DAYS OF ABSTINENCE AND HERE IS THE RESULT VOL.. - 6ML, VISCOUSITY - LESS VISCID, COLOR - GREYISH WHITE, TRANSPARENCY - OPAQUE, LIQUEFACTION - COMPLETED WITHIN AN HOUR, MORPHOLOGY: OVA HEAD 80%, PIN HEAD 10% GIANT HEAD 5% TAILLESS HEAD 5% MOTILITY 90% ACTIVELY MOTILE 40% SLUGGISHLY MOTILE 50% NON MOTILE - 10% TOTAL COUNT - 48.3M/ML PLEASE CAN YOU EXPLAIN THIS TO ME IN ORDINARY TERMS? WHAT ARE MY CHANCES OF IMPREGNATING A WOMAN? THANKS",
    "doctor_response": "Hello Your semen analysis suggests normal findings .Sperm motility,count and morphology are normal.Motility should be at least 55 %.Your findings suggests over all 90 % motility,so it is normal.Sperm count is also normal.It should be at least 20 millions/ml.Sperm morphology is also normal.Normal sperm have oval head shapes.Other findings like volume,viscosity,liquefaction time are normal.In short,findings are normal.Take Care Dr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for burning and tight pain in knees\n\nI have burning and a tight pain in my knee times 4 weeks from falling. Oddly it s inside under my knee cap. Swelling isolated to the inner lateral area, synovial rupture maybe? It resolved but felt like a water bed. 3 weeks physical therapy with no change",
    "doctor_response": "Hello, The pain after falling can be due to a soft tissue injury in the area. There can be an injury to the internal structures of the knee too. MRI scan is needed for proper diagnosis. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What could be the chest pain lasting for about 30 seconds to one minute?\n\nHello doctor,My father is suffering from chest pain for the last six months which is during for about 30 seconds to 1 minute and he says he is feeling like his heart is vibrating, poking during the pain. He has consulted a cardiologist four months ago and has taken ECG, echocardiogram, treadmill stress test but the report is normal except on comments it was mentioned as mildly hypokinetic mid and apical anterior septum and conducted treadmill stress test for possible ischemic but the result came as negative. And when asked about any prescription, the doctor has denied prescription suggesting it is gastric problem, nothing to worry about but again the pain has started and he is even afraid to sleep (keeping alarms once in two hours). Can anyone please suggest is this something serious?",
    "doctor_response": "Hello. It does not appear to be a serious problem. Cardiac pain is unlikely to occur for this short time. It typically occurs on exertion and relieves with rest, and persists for 5 to 10 minutes. Such rest occurs usually due to gastritis and reflux disease. He should avoid fatty, oily and spicy diet. Have some walk after having food instead of taking rest. Have multiple small meals instead of heavy meals. Have regular sleep habits and avoid stress. Lots of green leafy vegetables, fruits. Avoid smoking and alcohol if any. He should have tablet Pan DSR (Pantoprazole, Domperidone) 40 mg or Esomeprazole, Domperidone combination before breakfast once a day for two weeks. If not adequately relieved, then you should add syrup Sucral O (Oxetacaine, Sucralfate) or Gelusil two teaspoons three times a day for a week.  For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for foot pain when treating gestational diabetes\n\nNAMSTHE DOCTOR.....MY DAUGHTER IS SUFFERING FROM GESTATIONAL DIABETES  SINCE HER SECOND PREGNANCY. RECENTLY SHE IS SUFFERING FROM FOOT PAIN. PLEASE SUGGEST WHAT IS THE BEST NEUROPATHY MEDICINE TO AVOID FOR HER PAIN. HER AGE IS 34.  SHE IS HAVING 15MONTHS MALE KID. NOW SHE IS TAKING INSULIN 10 POINTS MORNING AND 10 EVENING. WHAT PRECAUTIONS WE ARE TAKEN FOR HER GOOD HEALTH WITHOUT ANY PAIN.",
    "doctor_response": "Dear sir, I understand your problem .. Please check her HbA1c and microalbuminuria .. Based upon n that we need to adjust the dose of insulin ..give her Tab.Nurobion forte.. Daily one for about a month ask her to take more of green leafy vegetables, fish, egg and use diabetic foot wear .. Let her take good amount of this whole grains, milets and fruits she need more of vitamins and minerals now ..she should keep her sugar in check ..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for type 1 diabetes in a child\n\nMy 6 year old granddaughter was diagnosed with Type 1 diabetes in April of this year.  She is constantly complaining about her stomach hurting.  She is just starting to recognize when she is low.  She is constantly down to the school office with a stomach ache, dizzy, her legs, arms hurt her.  Most of the time we have her blood in the normal range.  They just called from the school and her blood is in the normal range but her tummy, legs, and head hurts.",
    "doctor_response": "HelloIf blood sugar is well controlled and is within the normal range,these symptoms can be due to some other cause and not related to diabetes.The treatment of diabetes is injectable insulin.The Units may vary according to blood glucose,but other than insulin there is no other choice.The child should be educated about the symptoms of hypoglycemia like dizziness,sweating or anxiety. There must be something(containing sugar )with the baby always and whenever she feels these symptoms,she should have that.The low vitamin D land calcium level can cause generalised body ache.I would suggest you to get her evaluated by a pediatrician to find out the cause and any investigation if needed should be done.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to improve semen motility?\n\nHi sir,Today I got my semen analysis test done and I have three questions:1. My grade 4 mobility is at 0 how this can be improved? I am trying for the baby.2. My PUS Cells are in between 8-10 how this can be reduced?3. Volume of ejaculation is 1 ML how I can improve this?",
    "doctor_response": "hai,as your semen report indicates low volume and poor motility and pus cells indicates infection.i will advise you to rule out the cause for the above mentioned  condition andtake proper medication and treatment.along with that follow healthy lifestyle and diet.avoid stress,alcohol,tobacco.kindly consult a infertility specialist to rule out the reason for the above mentioned semen condition.thank youhope i answered your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen lips\n\nfpr the last 4 days the inside of the side of my lips feel like there swollen i can still move that side of my mouth an there no pain it jus feels uncomfortable it feels fatter on thsat side an feels like that side of my mouth is more tighter then o0ther side",
    "doctor_response": "Hello,You may have an allergic reaction or swelling from an infection. Try some anti-inflammatory medication such as ibuprofen or acetaminophen. The antihistamine, Benadryl, may offer you some relief.Try to decide if there are any triggers to this condition. If suffering from an allergy, think of any new foods or dental products you may have tried recently. Stop these products and see if you have relief. Have you started any new medications that may cause a reaction? Look for any insect bites. Eliminate any new cosmetics or lotions.Try to see if you can locate a tooth that might be a source. Is there a bubble on the gum associated with the swelling? Any sensitivity with your teeth?A dental exam would be helpful to make a correct diagnosis. Monitor your symptoms and report them to your dentist. A broken or infected tooth may be the source of the swelling or you may have an impacted wisdom tooth. See immediate care if the condition worsens. You may require a prescription antibiotic. A thorough diagnosis will determine the best treatment for your condition.Thank you for your inquiry. I hope you find some relief and your condition improves.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can cancer spread after operation?\n\nA person who was infected from cancer disease in 2007 The effected part was below part of knee ,a doctor remove his leg to prevent from spreading of viruses.he was suffering from the problem of Malignant tumor .Is there any possibility to spread viruses in other parts of his body in future?",
    "doctor_response": "Mallignant tumour spreads through by means of local spread,\u00a0 blood\u00a0 borne spread and or by lymphatic spread.. If the surgery and the removal is performed before spread, then metastasis prevented. But in an more advanced form of the conditon, when metastasis has already occured before surgical removal, the chances are high and cause spread of malignancy...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can CSF be the side effects of my job of aerial photography and high altitude drop ?\n\nDR. i have csf, i remmber that i have flight my job aerial photography the pilot drop from high altitude to low altitude very fast it cause high pressure to my head and ear i feel shark somthing moving in my head not normal ,my question is this the reason for my case, become csf. thank you",
    "doctor_response": "1. If you have confirmed CSF rhinorrhea, the treatment remains the same, irrespective of the cause. 2. If you consider barotrauma as the cause, proven cases are rare. You might be one of the first cases in the world with sinus barotrauma leading to CSF leak. This might have happened because you are predisposed by some underlying connective tissue disorder, congenital defect / anomaly or benign intra cranial hypertension. 3. A proven route of CSF leak is barotrauma causing a perilymph leak in the ear, draining to the nose via the Eustachian tube. This is also known as CSF Otorhinorrhea. However, this should usually be accompanied by ear symptoms or dizziness. Sometimes there are no ear complaints. You may include an HRCT Temporal Bones along with the CT cistrrnography.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Digox effective in the treatment of premature ventricular contractions?\n\nI have been recently told that I have PVCs. I have been taking Bystolic 2.5 for two weeks now. My heart racing sometimes especially at night. He recently prescribe digox. I don't think that I really need that but I want to take it if it's needed. Just getting a second opinion",
    "doctor_response": "Hello, It is OK but there are bette drugs to control VPBs. -Stop smoking. -Get Thyroid test done. -Tell me your age & BP. Show me your resting ECG. I shall be able to solve your problem. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes muscle pain and spasms while having connective tissue disease and osteoarthritis?\n\nI have a dx of Undifferentiated connective tissue disease and moderate osteoarthritis. Recently I am experiencing muscle pain, some random and short lived, and some long lasting and pretty severe. It is life changing in my ability to pick things up, etc. My Rheumatologist seems to say that I\u2019m almost sixty and these things come with age. My Mom is eighty-four And has better strength and mobility than I do. Should I ask for specific testing, see another doctor or just suffer through this?",
    "doctor_response": "take Ayurvedic medicinetab simhanada gugglu 2 bd along with mahanaryana taila for application.   You will get good result",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pneumonia\n\nI was recently diagnosed with Pneumonia. I had pneumonia when I was a baby but never since. I was shocked when I heard the diagnosis. The symptoms became apparent on March 28. I began taking Doxycycline Monohydrate on Monday April 3 and must take them for seven days. I am mega healthy and have not been sick in years. I can t even remember the last time I was sick. This has really knocked me out. I have zero energy and very little appetite. How does pneumonia manifest in the lung and how does bacteria get in there? How long will it be until I recover? I am really having a hard time with this. Help!",
    "doctor_response": "Respected user , HiThanks for using Healthcaremagic.comI have evaluated your query thoroughly .*  Mechanism of pneumonia follows as   -  Susceptible pathogens in form of bacteria enters the respiratory tract      via  nose or throat ( air borne ) , settles  there in respective lung tissues      through aleveoli and bronchi  -  start manifestations in form of various symptoms  of bronchitis ,      effusion or others .*  Treatment  guidelines   -  Maintain hydration with plenty of liquids .  -  Balanced nutritious  diet .  -  Regular antibiotics , anti inflammatory , decongestants as per advise      by your doctor .  -  Regular walking , exercises ( deep breathing ) , YOGA .  -  Avoid smoking , alcohol .  -  Have patience , recovery time depends upon the causative organism ,      host response factors and type of treatment ( it may take days to       weeks ) .Hope this clears your query .Welcome  for  any  further  assistance .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath after carrying weights?\n\nI am 68, in good health, I exercise (bike ride, yoga etc.) but get out of breath easily when I carry anything that is a little heavy. I was diagnosed with COPD 8 years ago but quit smoking immediately. Also when I climb stairs I am often out of breath.",
    "doctor_response": "Hello! Thank you for asking on HCM! Regarding your concern I would recommend you to perform a pulmonary function test coupled wit ha pulmonologist consultation to define the exact progression of your pulmonary disease. This could help to elucidate further your reduced physical endurance. Hope to have been helpful. Greetings!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does neutrophils count of 64 from blood test suggest?\n\nSIR, MY CHILD AGED 6 IS A HEALTHY BOY WEIGHING 25 KGS HE IS DOWN WITH FEVER WHICH COMES BACK SIX HOURLY SINCE LAST 4 DAYS. HE IS EATING WHEN THE FEVER IS DOWN I HAVE NOT GIVEN HIM ANYTHING EXCEPT PARACETAMOL. HIS BLOOD TEST DONE ON THIS THURSDAY SHOWS A NEUTROPHILS COUNT OF 64 BUT IS OTHERWISE NORMAL. NO MALARIA",
    "doctor_response": "Brief answer :It indicates infection. Detailed answer :Hi, welcome to HCM. Your child has fever for 4 days and neutrophil count is 64, this indicates infection in child. Since, malaria is negative, you need to do some more investigations like NS1 Antigen test for dengue, typhidot Igm for typhoid. In my opinion, your child will probably need antibiotics based on above reports. I hope this will help you. Take care. Regards - Dr Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the causes of my iron-deficiency anemia?\n\nHello doctor, I am a 50 year old male, who until recently was in relatively good health, other than idiopathic severe osteoporosis and depression. Over the past six months, I have become lethargic, out of breath after very simple tasks, and loss of memory. My primary doctor noticed that my hemoglobin had been dropping over the past year. After more testing, I was diagnosed with iron-deficiency anemia. I underwent eight weekly infusions, which finally got my hemoglobin close to the normal range. However, while my iron is low, my unsaturated iron binding capacity is high at 421, total TIBC is high at 471, and my transferrin saturation is low at 11. Prior to starting the infusions, my platelets had been high and climbing. After the eight infusions, my platelets were only normal for a week. They have begun rising again and are a little high at 502. My RDW has always been out of range and is now high at 17.9. Also, a month ago, my CRP was 1.29, it is now 2.2. I have had an ANA screening for autoimmune, and it came back negative. My stool has been tested twice and it has no blood. My homocysteine and PSA are normal. I am still lethargic and getting worse, and I am constantly short of breath. My short-term memory is not good. I now have a constant pain in my lower back in the kidney area, but all tests for kidney function have been normal. My current hematologist has ordered a CT scan of my abdomen with barium contrast, but my insurance has not approved it yet. I understand that anemia is a symptom of something else, then what is the CT with contrast going to look for? Should I be concerned about the pain in my lower right side of my back? If you were in my shoes, would you see your doctor again or wait a couple of weeks until the CT is complete? What does your gut tell you is the most likely cause based on the limited information listed above. I have attached all my test reports.",
    "doctor_response": "Hi. Based on your query and attached reports (attachment removed to protect patient identity), my opinion is as follows: Hope it helps. Any further queries are welcome. For further queries consult a hematologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have 6/6 right eye, 6/6 left eye and 6/5 uniocular vision with glasses. Please explain.\n\nHello doctor, What is meant by 6/6 right eye, 6/6 left eye and 6/5 uniocular vision with glasses?",
    "doctor_response": "Hi. In laymen terms, 6 by 6 means scientificly defined perfect vision. In medical terms, 6 by 6 means what you see from six meters, a person with normal vision also sees it from 6 metres. 6 by 5 means what a normal person sees from 5 metres you see it from 6 metres only means better than normal vision. In this case, 6 by 5 is possible with spectacles.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes irregular periods after taking nuvaring?\n\nI took my nuvaring out and got my period as normal then me and my boyfriend had questionable unprotected intercourse a few days after ending that period but he knows he didn t finish inside me and thinks I m overreacting but I haven t gotten my period in over a month since last time I had it. My periods were slightly irregular before starting nuvaring. The past three weeks Iv had breast tenderness, slight cramps, tinniest bit of spotting, back pain, acne, and irritability basically pregnancy symptoms .. Is that normal coming off nuvaring?",
    "doctor_response": "Hi Hope this message finds u in good health.I have gone through ur msg and understand your concern.it may be due to some sort of hormonal imbalances or variations in the body,though there may be other reasons as wellNothing to worry about, You should eventually get back to normal.Take multi vitamin and calcium supplements Do consult a gynecologist if symptoms worsenGet back to me for any  FOLLOW UP QUERIES anytime.Regards,Dr Mahaveer Patil...(MBBS,MS,Mch)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Has a glioblasttoma multiforme. What drips is he on? Life expectancy?\n\nhi my friend has a glioblasttoma multi for me and he was given 12 months to live,he is 47 and is now as of today finished the course of steroids he has been on as the doctors told him they can not give him anymore but told him they will put him on a drip every 3 weeks for 3 months and only said it will make his quality of life better,my question is what is in the drip and what is its purpose and what happens after the 3 months are up? thank you.",
    "doctor_response": "Hi, Thank you for posting your query. It is unfortunate that your friend has been suffering from glioblastoma multiforme- a cancer of brain. As was told by his doctors, it does not have a good long term prognosis. Regarding the drips, it is difficult to guess what that is. But I think it could be a chemotherapy drug, which is given to treat this cancer. It does not cure it but improves the duration of survival. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should the sperms be let out after injaculation and is it safe?\n\nHi I might just be paranoid but I tried something called injaculation and i heard other doctors advise against it but I ignored it. After I did it I felt light headed for a bit and I am scared to even urinate. Should I try letting that sperm out or am I just being paranoid and should never injaculate again?",
    "doctor_response": "HI. Injaculation is safe. sperms ( semen) should be let out . This is meant for it and it is very natural. Do not be scared to urinate. Do not think about it more than required . Take this is a simple natural process to relax,  but doing it 2 to 3 times a week is absolutely no problem. Do not follow someone's advise who do not know much.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Irregular periods after inserting copper T. Alternatives to copper T ?\n\nI had my period from the Oct 4-10, 2012 however i am now having a second period which started on Oct 23, 2012. Is it because i have a copper T inserted and what other method could i consider since i really do feel i need to take out the copper There is too much discomfort and it is now affecting my life in terms of work, studies and domestic activities.",
    "doctor_response": "you can try BIRTH CONTROL PILLS  under a doctor's  advice , if you want to really take out your copper T .IF this has been inserted only recently,then  it will take time to get adjusted.Of the all temporary contraceptive methods (women based ), copper T has least side effectsWrite your answer here",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having hearing issue and sloughing causing more pain. Why?\n\nHello doctor, I am having issues with hearing, pain, pressure, and sensitivity to noise. Can slough in ear be painful? I am currently using Topamax, Allegra D, Baby Aspirin, Tylenol, Aleve, and Ibuprofen.",
    "doctor_response": "Hello.  Sorry, I need more details but I will comment on the pictures as clear as possible. (attachment removed to protect patient identity).  The first picture shows a lot of shaded superficial layers of the skin. This can be painful. This may be a dermatological disease like eczema. I still do not know which ear is it, right or left? The last picture seems to be of the left ear. The drum is intact, no perforation, the white patches in the drum are called tympanosclerosis which is deposition of calcium granules within the drum tissue. This can happen spontaneously or after healed drum perforation and drum surgeries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the use and side effects of nexpro RD ?\n\nhellow 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",
    "doctor_response": "Hi,Nexpro-RD is a combination of a proton pump inhibitor (esomeprazole) and an anti-vomiting drug (domperidone). It is commonly prescribed to treat GERD (Gastro-esophageal 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, dryness in mouth, and headache. Most of these are temporary and usually resolve with time. On prolonged use it may cause thinning of the bones and increased risk of intestinal infections.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is menstruation like cramps during pregnancy normal?\n\nHi, I am in my third trimester 1st time pregnancy and am having severe menstrual like cramps (no bleeding) with a lot of discharge. I asked my dr. if this was normally and he said probably wasn t a very helpful answer. My stomach also gets very hard at times and I have alot of pressure, my last ultrasound showed that the baby s head is right against my cervix but I m not dilated am I just experiencing braxton hicks and is all this normal?",
    "doctor_response": "Hallow Dear,Any pain in the lower abdomen or related to uterus is not normal and is not a good sign. In cases of abortions, if the pain is followed by bleeding, these pregnancies cannot be salvaged. In cases of pregnancy outside the uterus (ectopic pregnancy), there is severe pain in abdomen. So please report to your obstetrician. Let him/her decide what sort of pain is this. May be you will require ultrasonography to ascertain the integrity of the pregnancy. I hope this helps you.Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can masturbation cause low libido and decreased penis size?\n\n: hi m40 yrs not married....my question is that the size of my penis is small and while having sex i come out soon....i masturbate 4 to 5 times a day...can this also cause a problem and can the size of the penis be increased.how can i increase my sex power",
    "doctor_response": "Hello, Excess masturbation can adversely affect your sexual strength and stamina. To get good sexual strength to stop masturbation. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathlessness and severe cold despite taking Amoxicillin?\n\nhave had a cold for over 4 months, have been to an er and 2 Drs. I have shortness of breath.I have had a severe cold for 4 months, have been coughing up severely gross gunk that looks like dead lettuce. I have had 2 chest xrays, saw nothing, they gave me amoxicillin, and one that was stringer that begins with an l (sorry) I AM exhausted ? any ideas?",
    "doctor_response": "Hello! Looks like you might be having bronchitis with infection .. Do you wheeze ? Is this the first time you are having such symptoms or you have had them anytime earlier too ? Was it exposure to cold or rain that precipitated these symptoms ?Do you smoke ? Kindly consult a physician  in person, get yourself examined and get your sputum examined for culture and sensitivity, the test that will tell what organism has caused your Infection and what drug will work for you . for your breathing difficulty you might need bronchilator drugs which will dilate your airways and ease your breathing .you might need a short course of steroid too.Also once your Infection is controlled you can undergo a spirometry testing(pre and post bronchodilator) if thought necessary by your physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My urine pregnancy test is positive with slight bleeding. Is this a matter of concern?\n\nHi doctor, I missed my period then I took a pregnancy test two days before and it is positive. I got two lines, the first line is dark second line is light pink. But today morning I got abdominal pain then light bleeding also. It is anything wrong I am really scared now.",
    "doctor_response": "Hello. I saw that the urinary test pregnancy is positive. (attachment removed to protect patient identity). Congratulations on your pregnancy. It will be better if you have written the first date of your last menstruation. So I can calculate the gestational age. In the first week of pregnancy at 5-6 weeks, woman can experience dark brown spotting, it quite normal due to the implantation of trophoblast. But there are also other causes as hematoma. If the bleeding becomes heavier, red with clots or lasts for several days you should discuss it with a specialist. At 6-7 weeks of gestation, you should consult with an obstetric specialist because you should undergo several lab analysis and an ultrasound to ensure an intrauterine pregnancy and to detect the heart activity of the embryo. Trophoblast implantation. Ultasound. The first lab examination IgG IgM for CMV (cytomegalovirus), rubeolla ,toxoplasma, blood and group blood analysis, TSH (thyroid-stimulating hormone), etc. Hematoma Folic acid.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. From the photo, can you tell me if the lesions are shingles?\n\nHi doctor, From what was being thought to be muscular inflammation of the back under the shoulder a week ago with constant pain since last week. I have lesions in my body, which look like shingles. I am attaching a photo of these lesions.",
    "doctor_response": "Hello. Your main complaint is pain under shoulder and you are suspecting herpes zoster (shingles). Herpes zoster begins with pain along the affected root of nerve followed by an appearance of the rash. The rash is painful and progresses over 7 to 10 days. The pain starts decreasing and the rash subsides. The characteristic feature is it involves only one nerve root. It is a self-limiting condition usually precipitated by stress, fever, and sometimes associated with diabetes. Pregabalin or Gabapentin is helpful in reducing pain. Regards. For more information consult a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could blood in sinus glands elevate blood pressure?\n\nMy mom is complaining about the pain in the one side of her face particularly in the forehead down to half side of the nose and cheeks and told about the itching of her gums also in the side of the face.  we checked with Nose, Ears and Throat Specialist and found blood in the sinus glands.  Her blood pressure is shooting up, could this be related?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. No these are not related . I have seen many trauma cases with blood in sinuses without elevation of blood . Some times decongestant drugs as Phenylephrine are given for sinus problem and it may rise blood pressure . Just take proper medication for blood pressure. With regards Dr varinder joshi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in arm. Xray showed a black smoky thing in arm bone. MRI showed presence of unidentified tumours. How can it be determined as malignant or benign?\n\nHello, I just want to ask about my mom we currently live in Saudi Arabia about 4-5 months ago she had a check up about her painful arm , the doctor then requested for an xray then when the xray result came there is like a black smoky thing in the bigger bone of her arm..the doctor suggested for an MRI then the MRI result came and they said she has an unspecified benign tumors inside her bone then he scheduled her for a biopsy they took out a sample then he adviced her to go to a hospital when we went to the hospital the useless oncologist didnt actually explain us anything further with her condition he just made a medical report which he just copied from the previous report then advised her to have a radiation therapy to kill the tumors but unfortunately the private hospitals here does not have this kind of treatment so we need to go to the government hospitals since we are not allowed to go there as it is government unless we have a ROYAL DECREE letter from a Royal Office as my mom s medical sponsor. we got frustrated and we tried sending her medical records from some doctors we know and they are saying that it is malignant so we are so confused some say it is malignant but her previous doctors say its benign..please help me",
    "doctor_response": "It is essential to know that if the tumor in the arm is benign or malignant. If possible you need to have second opinion on the biopsy report because the reports of two doctors are controversial.Request the doctor who performed the biopsy to provide you the slide for review. Secondly you need to see a competent orthopedic surgeon to take his opinion and see if the debunking or exicion of the tumor is possible. Even if proved malignant , after debulking or excision of the tumor radiotherapy will be more successful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe panic attacks be treated?\n\nOk I have had these I guess you could say attacks since I was about 18 where I get this really sickly feeling hot flashes my left chest tightens some times I have passed out from this on 4 occasions and woke up completely drenched in sweat ok so this is been happening since Wednesday comes and goes but has been for most of everyday I have been to the hospital 3 times they keep checking my heart and telling me I m not dying so that s all they can do they havent checked anything else I m so scared they told me I need to go to a primary care but I don t have one and I set one up but can t get an appointment till the 18th OK SO WHAT DO I DO ? IT REALLY FEELS LIKE I M DYING WHEN THIS HAPPENS!",
    "doctor_response": "Hello,In my opinion, it is important to do an electrocardiogram, and thyroid function tests. It would be useful to do start on antidepressants like Escitalopram and low dose Benzodiazepines.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Gayathri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is cortisone sufficient to heal back pain caused by disc hernia and increasing sciatic pain?\n\nHi there   I have a a moderate disc hernia at L3L4 level, not giving back pain but 6 monthes of gradualy increasing sciatic pain in r. buttock and leg. have now been off work 7 weeks, cant walk, sit or stand without severepain after 15mins up and about, but not actually limited in movement.Can you explain if the actual nerve may be swollen and being upright just worsens the pinch. Specialist has now given me cortisone tablets 5ay s only. It has relieved so far (day 4) but  can it cure the irritated nerve.? could the nerve be swollen at the foramenal opening after 6 months of untreated abuse/bending and no rest or care?i don't want surgery! Im resting heaps now, etc with other conservative treatment. thanks, kay.",
    "doctor_response": "you may get relief ,not cure from this tablet. i suggest you to continue conservative treatment like rest,muscle relaxant  and physiotherapy with advise to do x ray and MRI of L S spine  for further review.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Clonidine intake more than 3 times a day safe?\n\n79 year old female taking lisinopril once a day 20mg since first of month, not controlling bp. This week dr increased to BID since Wednesday. BP still increasing. Last night - 11:30pm 159/94, clonidine 0.1mg taken. 4am awoke - checked BP, 165/106. 0.1mg clonidine taken again. At 6:45am, BP 170/95, she took her 20mg lisinopril. 9:30am bp- 149/91, she took her hydroclorothiazide 12.5mg. At 11:00am bp 137/86. She is trying to control with the meds until she can see her dr. on Monday. Now my question - is it ok for her to take the clonidine more than 3 times a day to keep her bp down?    She has been told to call 911 if bp increases over 110 diastolic ...But she doesn't want to go to ER as she has been before and they monitor, get it down and send her home and tell her to contact her dr. She is trying to control herself until she can see her dr again on Monday.....thanks!!!",
    "doctor_response": "Hi,She can take up to 0.3 mg clonidine a day until you see your doctor. But you should do careful blood pressure control. Also I would like to mention that day by day the efficacy of Lisinopril can increase, so you may need less doses of Clonidine.Hope I could help youWishing you good healthIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe swelling in the feet after surgery?\n\nI have type 2 diabities and arthiritis I am a 74 year old male and a couple of months agoIhad surgeryto remove a defective hip implant.I have had to be hospitalized 2 more times since then for internal bleeding. they have been unable to locate the source of the internal bleeding but, since my last hospitalization I have had trouble with really swollen feet. It has gotten to the point where I am unable to wear my shoes. What could the source of this sweeling be?",
    "doctor_response": "Hi,I have studied your case with diligenceThere can be non union,infection or soft tissue impengment leading to leg swelling.If you can send all your x ray reports I can help you better.You can send your reports directly to me on this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in lower mid back after falling backward. Unable to get up, barely walk. Fracture possible?\n\nMy mother was bowling (82 yrs old) and while stepping backwards she lost balance and fell backwards and landed on her butt. She felt immediate pain in her lower mid back (none on her tailbone area--just back). She could not get up without help and could barely walk  to the car. Her lower back hurts and she is in a lot of pain (only when she moves) sitting in a recliner and refuses to go for X-rays.   she said when she walked the top of her legs hurt but there is no numbness or shooting pain. We put ice pack on it for about 30 minutes. This happened about an hour ago.  What does it sound like to you. She swears nothing is broken but I'm fearing the worse the longer she waits to go to hospital",
    "doctor_response": "in my opinion need to consult ortho doctor who can find the damage caused by fall by investigating throuh xray it can be muscle tear swelling nerve pressure or oedema of discs or fractures.immediately you can use muscle relextant and anti inflamatory tabs along with this medicines you can use local muscle relextant ointmentslow protein diet antacids as acidity increases back painplenty of water rest  till you get diagnosis",
    "dialogue_context": ""
  },
  {
    "patient_message": "Infant having itchy bum cheeks. Avoiding Gluten and dairy. Is this a type of food allergy?\n\nHello, I have a 3 year old that has had itchy bum cheeks for the last few weeks. I have tried to avoid Gluten and Dairy off and on. It's pretty much impossible to constantly avoid it. It seems to get better and then a bit worse again. Now it also gets itchy on her hips and tummy. Does this sound like a food allergy?She takes no medications and I know of no allergies yet.",
    "doctor_response": "this is food allergy as one of food proteins start reacting with body proteins it is definately milk wheat or otherin my advise consult clinical immunologist to do blood serum tests for antibodies for milk wheat potato chana rice nut eggwithdraw that protein for benefit",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes locked-jaw on the left side while eating?\n\nexperiencing jaw locking on left side when eating, no other symptoms or pain except when opening mouth wide and flexing jaw from side to side to ease the lock before eating; able to open mouth only 3/4 wide based on past capacity. condition arrived out of the blue some weeks ago but comes and goes.What have I got?",
    "doctor_response": "Hi, Welcome to Healthcaremagic.com. I had gone through your question I can understand your concern about your jaw. As per your history, symptoms and signs  it looks like you have unilateral recurrent anterior disc displacement of jaw. You need to avoid too much opening of your mouth, hold your jaw at the time of yawning so that it does not displace. There are always an associated cause related it like missing teeth on opposite side or same side, grossly decayed teeth, or even mal occlusion. You need to visit a dentist or upload a picture of your bite here so that we will provide you the cause. Hope my answer will help you and visit us back if you have any further assistance needed. Regards Dr Muzaffer Hussain Parray.",
    "dialogue_context": ""
  },
  {
    "patient_message": "ESR is 75, what precaution should i take ?\n\nI HAD TAKEN A BLOOD TEST WHICH HAS SHOWN THE RESULT OF 75 IN MY REPORT. IT IS TOO HIGH. PLEASE RECOMMEND SOME PRECAUTIONS FOR MY HEALTH.",
    "doctor_response": "ESR as such is not an indicator but only helpful 2 arrive at certain diagnosis based on signs/symptoms and other investigations kindly do inform about your symptoms or any other tests done by you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for eczema in baby\n\nmy 5months old baby seem to be suffering from eczema and it seems to come n go. We have tried everything from changing washing powder and formula. Im breastfeeding as well as formula if that has anything to do with it. Also there as days we would notice her eyes are red after waking up. The look of someone with a hayfever. Were not sure if its the new place were in. The last place we were at was tiles and now its carpet....",
    "doctor_response": "Good evening..!!Your baby is absolutely normal, nothing to worry.All babies upto 1 year of age will have some sought of skin allergies to anything in their surroundings.Thank you, have a nice day..!!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can growing cyst on my liver cause elevation in alkaline phosphatase level?\n\nI have a 5 cm cyst on my liver. My alkaline phosphatase is 239 and my ALT is 43. I have had a nasty sinus infection for 3 weeks and have taken three antibiotics to clear it. My doctor recommends an ultrasound to see if the cyst has grown. Could a growing cyst cause these elevations? I am very concerned. Thank you for your advice.",
    "doctor_response": "Dear Friend.Hi , I am Dr Anshul Varshney , I have read your query in detail , I understand your concern.Yes a cyst can cause rise in alkaline phosphatase.I am more concerned about the nature of the cyst.It can be benign , it can be liver abscess , and a lot of other things.It would be good if you could share your Ultrasound report with us and your symptoms.This is my personal opinion based on details available here.  If you want to discuss your issues further, you may please ask me through Premium Query directed on my name. I will help you my best.Stay Healthy. Dr Anshul Varshney , MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for T2 neurofibroma\n\nI have been diagnosed with a t2 neurofibroma or a schwannoma after a ct of my lower back.  I have had testicular cancer in the past.  My question is, should I be talking to my oncologist about my neurofibroma or is there another specialist I should be talking to to narrow down my diagnosis?  My GP doesn't seem to know much.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  You have schwanoma or neurofibroma.  You should consult general surgeon for that.  If needed surgical excision is the treatment of choice. Consult your doctor and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any adverse effects of Avapro withdrawal?\n\nMy doctor took me off the generic form of Avapro because my blood pressure began to drop often. But now I am away from home and my bp is 168/93 and my pulse is 59. I did not bring the medicine with me. I am a 78 year old female and weigh 150 lbs. I will be home tomorrow afternoon and will take an Avapro then. I guess I want to know if it imperative that I try to see a doctor(whom I don\u2019t know) tonight in this town.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Your BP is high, so you will need some medication to bring it down to 130/90. You need to start early as rebound hypertension I'd quite harmful. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medication should I take for my pimples as my skin is very sensitive ?\n\nhie i have pimples right from ma 8th std. i m being facinng this problem fr 5 yrs...... i hve noticed dat small holes are left on ma skin without even squeezing it........ i do hve pimples now.,,.... i hve tried maNY THINGS......... MY SKIN OS TOO SENSITIVE....... PLZ HELP..............!!! :((",
    "doctor_response": "Hi, Welcome to HealthcareMagic forum, You have not mentioned your gender  here ,plz do so. Pimples  are multi factorial, with reasons ranging from wrong selection  of cream and soaps to internal hormonal disturbances(esp in females).You should avoid all oily stuff on your face right from oily soaps to moisturizing creams. If you are a female and have any problem in your periods then you should get a hormonal profile done with a ultrasound of lower abdomen. If some  thing comes positive then you need a hormonal treatment. If not then you have two options \u2013either oral retinoids or oral antibiotics depending upon the severity. They need to be taken for long .Also use a good anti acne soap daily. You should also use anti acne creams like nadifloxacin or clindamycin.All these require a medical prescription and you should show to a dermatologist   for this. Drink plenty of water and take a god 7 hr sleep in night .Never squeeze your pimples or else they would leave marks. Regards, Dr.chawda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is having unprotected sex followed by taking new brand of contraceptive pill while being on tri sprintec risky?\n\nHello, I ve been on Tri-Sprintec for 3 full weeks today. I started taking the pill on the first day of my period. At day 14 I had unprotected sex and the following day I took a different brand of birth control pill as an emergency contraceptive. Am I at a great first for being pregnant since I m new to the pills? I ve read elsewhere online that it takes at least a month to be completely safe. Thanks",
    "doctor_response": "Hello,I have gone through your query and understood the concern. It is true that the initial couple of cycles after hormone contraception need additional protection as they are not completely protected. Yet, as you have taken the emergency pill soon after the unprotected intercourse, you are safe. The high hormone content in the emergency pill creates hormone imbalances. Thus, you can see some withdrawal bleeding and also expect your next period to get delayed by a week or two. In future, please do not go for any additional hormone contraception as with regular hormone intake, your cycle is well protected. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruises in the middle and index fingers?\n\nHi, Dr. Rynne: my index finger and middle finger seemed to be bruised or at lease look bruised, but it s getting worse. there are times that my pointer finger gets cold as well. and now the knuckle on my pointer finger is starting to hurt real bad. what could this be?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. In my opinion this seems like pressure on one nerve at your wrist called median nerve. This condition is called carpal tunnel syndrome, Diagnosis is by nerve conduction velocity test . Treatment is usually surgery. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red itchy lumps on the arms with clear liquid in it?\n\nHi, I ve been getting these random red small spots on my arms, I haven t been bitten, some of them have clear liquid in them. They are a bit itchy but when scratch them they hurt, I ve have just been on antibiotics, could it be a reaction from them? or could be from soap ect.? I have had them be for went to the doctor but the couldn t tell me what it was.",
    "doctor_response": "Hi.This is some form of dermatitis, the reason can not always be pin-pointed.They can be furuncles also.Does not look like reaction to antibiotic as you had them beforehand.Take an anti-allergic tablet like cetirizine once a day.Do no apply soap or any handy ointment.You can apply liquid povidone iodine - betadine locally to avoid secondary infection.Id necessary you may please  consult your Doctor for visualization of the lesions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What fever in infants with yellow mucus from nose suggest?\n\nhi, my daughter is 33 months old, This morning she had a fever of 100.5 F and has a yellow/brownish sticky mucus running out of her nose as of this afternoon. she has never had this color of musuc before and im starting to worry. What does this color of mucus mean?",
    "doctor_response": "Hello,Fever with yellow color mucous discharge suggestive of Acute Respiratory Infection (ARI) with secondary bacterial infection, may be sinusitis.Get an x-ray face, PNS, CBC, require to starts an antibiotic treatment.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sachin Kumar Agarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for flu and cold for past 6 months\n\nI keep getting the FLU / COLD for the past 6 months - Over and over, I keep forming abscess's under arm pits and in the small of my back (12) times over the past 4 years, I sweat for no reason every night, I have been tested for HIV (Negative). Many blood tests conclude nothing! I am tired all the time. Every time I go the the E.R. they want to excise the current abscess. My body is screaming for Antibiotics for some reason in my mind. Every doctor has been baffled, what can I do? Who should I see now (4) different doctors later. I am virtually broke now with no insurance! I am exhausted to no avail and sick again.",
    "doctor_response": "Hello, I empathise with your concerns. Three issues to be addressed :1. Recurrent coldsDo you have a history of asthma or allergies?  This could predispose you to get frequent cough and viral infections. If you recoughing atleast 20 days out of 60 days, with cough disturbing sleep, it is likely that you have asthma. Inhaled steroids like fluticasone and relievers like salbutamol will greatly help (and you can use them at home)2. Abscess in armpits -It is likely that you have a bacteria called MRSA on your skin that increase the frequency of abscesses. Treatment would be to apply mupirocin ointment on your nostrils, armpits twice a day for 5 days and wash well (especially armpits and groin) with.chlorhexidine body wash. 3. TirednessPlease check your hemoglobin, vitamin D levels.and thyroid function if not already done. If you re having chronic pain and tiredness, it is also.a symptom of infectious mononucleosis. A simple blood test for EBV VCA antigen will.diagnose this.Hope this helps and feel better soon!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I never had an injury. Why do I still have persistent back pain?\n\nHello doctor, I am a 29 year old female.\u00a0I have been dealing with back pain for over seven years now. I have never been in any type of injury and had MRIs done of my brain, cervical, lumbar, and thoracic spine five years ago. They stated I had three bulging discs and an annular tear. My thoracic spine noted a few scattered hemangiomas and a\u00a0questionable small vascular anomaly in the midthoracic vertebral body. This is where my pain hurts the most. On the cervical spine MRI, it stated that I had a\u00a0narrowing of the canal with degenerative disc disease with no spinal cord abnormality. My MRI of the brain came back fine with some inflammation within the paranasal sinuses and moderate lymph nodes in the neck which may be suspicious for shotty adenopathy.My first positive ANA was four years ago with elevated antistreptolysin O Ab, but never have I had strep throat or ever been diagnosed or treated for it. I had my adenoids removed when I was young. My CBC was all normal except for a slightly deranged RBC and hematocrit levels that were lower than the\u00a0normal range. My TSH was elevated at 5.870, but I believe I had that retested later on, and it was within normal limits. I was then referred to a rheumatologist due to the\u00a0positive ANA and other symptoms that I was having. Their results concluded no elevation of dRVVT or a PTT and ruled Lupus screening negative due to my levels being within normal limits. My C3 is at 121, C4 is 31 and rheumatoid\u00a0factor.",
    "doctor_response": "Hello. I went through your post. You have not\u00a0mentioned what you want to know and what your current problem is. Regards. For more information consult a rheumatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for underdeveloped kidney.\n\nHello Doctor, my friend is 16 years old suffering underdeveloped kidney(there is no corticomedully diffentiation).Here serum creatine level was 16.She has undergone dialysis for 6times.Now creatine level has got down to 7and she is anemic .Her hb levels are 7. I request you sugest a proper tratment available in India or in abroad.I request you to reply as early as possible.",
    "doctor_response": "Hello and welcome to HCM.As an Urologist,i can fully understand and share your concern.Your friend is having a kidney failure,which needs dialysis treatment, till the kidney function is stabilised.  Anemia is part of this kidney failure,which needs correction with oral tablets and Erythropoeitin injections.She'll need to be on regular check-up,with her Nephrologist, and check :1.Blood routine,creatinine,uric acid,sugar,and electrolytes.2. ultrasound scan of -KUB. 3.Follow strict diet as advised.If you've any doubts,send the reports to me as a direct question.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause of back pain, red swollen patch, and headache?\n\nhi  3-4 days before i was at my work  and had picked about  15 kg stuff i was on the same place standing straight and just moved my upper body to other side to see some one i felt exteremely weired pain in my back and same time red small patch with swelling in the middleof my back and after that i felt headache as well like darkness in front off my eyes...i came home and next day i  could bend and raise my legs without any pain but now when i pick something it gets pain in my back ...can u tell me plz but actually had happened with me",
    "doctor_response": "Hi, I have read your query. You should get your xray of dorsolumbar spine done in AP and Lateral view. Discuss report with doctor. Your doctor after the physical examination will tally xray report with his findings. Only then your diagnosis can be made. Till then apply hot packs for 30 mins in morning and evening. Try to avoid weight lifting as much as possible. You can take aceclofenac + thiocochicoside combination by discussing it with your doctor. I hope you have got your answer. Thanks. Dr.Singh.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is amoxicillin is the cause of rashes like hives after having teeth removed?\n\nhi I had 9 teeth removed last Wednesday. I was put on amoxicillin .500 mg. times a day. now I have a rash. the dentist told me to stop taking the medication, but now I have a rash like hives. I need something to relieve the itch and how long will the itch last. thank you",
    "doctor_response": "Hello and welcome to HCM.forum,I would like you to know that if the rashes developed after taking amoxicillin then you should stop taking it and visit your doctor soon.For now i will advise you to take an anti allergic which will provide you temporary relief.Also you can apply cold compresses to relieve itching and redness.Kindly see you doctor soon.I hope i answered your query.I wish you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in the gums?\n\nI have been sick since last wednesday or thursday and all of a sudden my gums are swollen my eyes burn i feel woozy light headed and bad chest pains from congestion and coughing and i feel warm and like i feel cold then hot is this normal? please help Best regards, Kristie",
    "doctor_response": "Dear kristie,                  u must be suffering from viral fever ,plz consult physician . for swollen gums use hexidine mouth wash and brush twice daily.                     keep smiling",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with fatty liver, on medication, loss of appetite, coughing, breathing difficulty, bruises on lower part of the rib cage, is it an emergency ?\n\nI have reacently found out my 15 year old daughter has a fatty liver . We were given instructions for medication and told her pains would go away. Its two weeks later, and three days ago she lost her appetite completely and hasn t gotten it back yet. She s coughing hard and constantly and also is having troubles breathing . She can feel bruises all along the lower part of her rib cage. Should i take her to a doctor immediately or let it go on?",
    "doctor_response": "HI Thanks for posting your query Fatty liver is due to metabolic disturbances of the lipid metabolism If left untreated it will end up in fibrosis and ultimately cirrhosis of liver I would suggest you take your daughter to a gastroentrologist and get her investigated and treated Hope this helps Am available for any followup queries If there are no further doubts, do accept this reply and rate it Wishing Your Daughter A Speedy Recovery",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest possible medication for swelling and pain in the ankle\n\nI have sprained my right ankle numerous times over the past dozen years. I have had several sets of X-rays and MRI s. The ankle stays swollen with edema all the time. The swelling subsides a small amount with elevation for long periods of time. Walking is painful intermittently. Pain comes and goes, sometimes lasts for days, mostly for a few months. This period of pain is very intense. I also noticed that cold therapy helps numb the pain, heat seems to make it worse. There is also some heat radiating from my the middle of my foot up to the middle of my shin. The pain is located on the inside and outside mostly, with some pain in the front of my leg and foot occasionally. I have seen an ankle specialist and he diagnosed me with RSD without the typical pain associated. I feel this may be incorrect, so do other health professionals, but no one has an alternative diagnosis. I cannot turn my ankle in to put on laced shoes - too much pain. I also cannot sit cross legged for the same reason. I would appreciate a response. Thanks",
    "doctor_response": "Hello, Your symptoms seem to be related to an ankle sprain. I suggest using anti-inflammatory medications such as Ibuprofen to relieve the pain. I also suggest using a brace to maintain the area immobilized. I recommend using cold compresses in case of pain. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tightness in the chest\n\nmy daughter has and is being treated for salmonella. she has tightness in her chest difficulty breathing, a low grade fever of 96, and green phlegm, turning tan in color as the day progresses. she developed the salmonella 2 weeks ago, only a little diarrhea left, but shes very weak all over. the hospital prescribed her sulphamethoxazole. Prednisone, which she has only one more dose of to take. Potassium and promethazine. she refuses to go to the emergency room bc she doesnt want to wait and get cold, also because of the fact that she only has Medicaid and she feels that she doesn t get treated very well as a result. I am not able to be there with her and I am very scared for her. do you have any thoughts on this matter?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your daughter's situation and problem. Possibility of bronchitis is more in her case. Bronchitis is inflammation of airways and it is common after bacterial infection like salmonella. Her symptoms like breathing difficulty, low grade fever, greenish phlegm etc are also suggestive of bronchitis. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of bronchitis. She may need inhaled bronchodilators and inhaled corticosteroid (ICS).. So better to first diagnose herself and then start appropriate treatment. Hope I have solved your query. Wishing good health to your daughter. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tooth decay\n\nMy husband has a rotten tooth or decaying tooth in his mouth and he still consist on given me oral sex. Now i have an irritation in my vaginal area and have two painful bumps on the outside left like cheek a little close to my vagina but not on the lips on the leg part. What is that? I also just had my routine papsmear examine and annual check up.",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. Actually the decay of tooth is caused  by a bacteria know as streptococus mutans , this mostly work in mouth. So it can be possible that the bump which has appeared,  is because of hair folical infection . But still the treatment of decayed tooth should be done.Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly advise whether the blood report shows blood cancer or not.\n\nHello doctor, I have my wife's blood test report. We fear that she might have blood cancer. For the last four months, she is having joint pain, sudden breath difficulty, hand pain, and chest pain. Kindly help.",
    "doctor_response": "Hello. As per the report, only apparent problem is that she has mild anemia, microcytic hypochromic (attachment removed to protect patient identity). Usually common in young females. Otherwise, platelets and WBC are normal. Does she have any other symptoms like fever or bleeding? Also, why are you thinking of cancer? To be sure you can repeat CBC with a peripheral smear. If needed, serum iron studies can be done to confirm iron deficiency anemia.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of taking Leofin XL,acomprol & attentrol?\n\nhai my name is shilpa i take leofin XL ,acomprol in the night and in the morning i take attentrol i am not a regular drinker of achocol i take socially when i take it my face become red my stomic starts burning i feel unresty i dont understand why this happens to me i even get omiting plz help me out",
    "doctor_response": "Hello, The symptoms seem to be related to alcohol consumption. They are not related to side effects of the medications that you are taking. I suggest to avoid alcohol and take a gastro protector such as Omeprazole 20 mg in the morning before breakfast. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes brown coloured discharge during pregnancy?\n\nHello, I m 8 weeks pregnant and just went to the restroom to urinate and saw that I had a brown color after I wiped. I had my first doctor appointment last week and saw the heart beating in the sono. He said everything looked good. What could this mean?",
    "doctor_response": "HI,    I understand your concern.    Brown colored discharge in 8 weeks pregnancy can be due to various causes like- fall/ trauma/exertion /infection . BUt most common & bother sum cause is deficiency of .. Hormone progesteron  which is essential for maintenance of pregnancy  Hormone replacement  in time ,recovers the condition & pregnancy can be saved..Please don't worry.      You should contact your gynecologist immediately, get examined & start with treatment soon.    Till then take rest/ avoid physical or psychological stress.IN case you can not see youe doctor immediately, you can add Tablet Duphaston 10 mg 12 hourly.. & seek doctor's advise as early as possible.    Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain. Blood work shows high WBC. Swollen lymph nodes in abdomen. CT scan shows hydronephrosis\n\nI was recently in the ER with stomach pain in my right side. bloodwork showed high wbc and the dr said ct showed lymphnodes in abdomen swollen. I went and picked up my cat scan report and it didnt say anything about lymphnodes but it did say i had a right extrarenal pelvis in borderline mild right hydronephrosis without a clear etiology. I was told i had this about ten years ago and since then I have had this re-occur several times. Should I be concered about this being ongoing for so long?",
    "doctor_response": "you should get a radionuclide scan like DTPA  Renography before and after lasix ( diuretic injection to know if the enlarged renal pelvis is due to obstruction or is just an extra renal pelvis without obstruction which doesn't require any treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why the right foot of my son is still swollen?\n\nMy son took a hard, loud kick to the right foot, outside. this was friday afternoon..we went to er on sun am when it was still swollen. it is now tuesday night and the goose egg on outside of foot is large..fluid filled, and swollen..should i go back to dr s or wait it out??",
    "doctor_response": "Hi, You have not mention that what the doctors did in ER? Did they took an X-ray? It was necessary. If not you have to refer back and have them a second look. If there is a significant local tenderness, possibility of a fractured bone exists and they should order an X-ray. If a fracture is already ruled out, he should have relative rest, with limitation of walking and even limitation of weight bearing during walking. Also, he can use a few days of a Non-Steroidal Anti-Inflammatory drug such as Ibuprofen, Diclofenac, etc... Another method that can be used (if no fracture exists) is gentle massage of the foot in warm water with a very small amount of salt dissolved within it. Assuming that there is no fracture, the problem should be resolved in 7-10 days. If not, further evaluation by an orthopedist and in some cases, a CT scan to find very small fractures could be necessary. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Hooman Mahmoudi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can 4th stage oral cancer be totally cured?\n\nI am Bidesh Bose from west Bengal. My father attack by oral cancer on buccal mucosa from 8 months, 1st time we take treatment from mumbai cancer hospital, then they give the procedure for treatment and they told that there have no scope for surgery, patient need to take chamotharapy and radiation, then we return at west Bengal, then we meet Dr. Asish Mukherjee and we submit the mumbai hospital s documents, then he give 6 round chemotherapy and told to us after 15 days please take a scan report and we do this and submit scan report to Dr Asish Mukherjee and he told that cancer is improved like 30%, then he suggest to us please go to kolkata medical college and take readiation, then do that, My father take 33 pcs radiation, after the treatment radiologist check to patient and told that I think the tumor is totally removed but it is 4th stage cancer but I will be sure about that after 21 days, but it is not curable totally but after treatment the life return to better life, please bring out the patient after 21 days for checkup. Radiation therapy completed 18 days ago, but my father fills too much pain and he take painkiller on the meantime, then the pain is relief but again pain is return after few hours, please tell me the reason for pain and how much days radiation is working to die the cancer cell ?",
    "doctor_response": "Hi4th stage oral cancer cannot be totally cured.Palliative chemotherapy can be given to prolong his survival.Tablet morphine 10 mg  after food twice daily is suggested along with radiation to control pain.RegardsDr de",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes palpitations with elevated heart rate?\n\nHi Doctor, I\u00e2??m in a seemingly unique situation in regard to my lung health for my age, and I hope to gain a more thorough understanding of what I can expect in the future. I am 31 years old, male, 6\u00e2??0\u00e2?? tall, 195 lbs, and I started smoking when I was about 23. I smoked around \u00c2\u00be of a pack a day during this time frame. Though seemingly not a lot of pack-years, I have a high strung personality, and I smoked very quickly if that means anything. Maybe a year or so ago I started noticing some issues with my body. Heart palpitations and significantly elevated heart rate at times (may be partially related to stress and/or anxiety). Also, I started to experience rib pain, sometimes for days at a time in one spot, but the pain would come and go, and be located in different areas of my chest. I also noticed that these pains would sometimes show up in my armpits, lower back, hips, and abdominal region, though most often in the ribs and armpits. These pains prompted me to ask my GP for a chest x-ray about 7 months ago. My GP determined that I had moderate lung hyperinflation and told me this is indicative of emphysema, but at its beginning stages. X-ray showed no signs of bullea. The doctor told me that this hyperinflation will reverse over the years if I quit smoking. I did some internet research, and I decided to see a Pulmonologist. A spirometry was ordered, and some of the values include (from memory but accurate, I do not possess the test results anymore): FVC: 127% of predicted FEV1: 108% of predicted FEV1/FVC ratio: 71% (Normal value for my age/gender/height/weight is 82% according to test) The interpreter\u00e2??s opinion is that FEV1/FVC is borderline, and the test results indicate normal lung function. Results not significantly improved after inhalation of Asthma medication, though some of the other values not shown above were improved a little. The Pulmonologist was not too concerned, but he did prescribe an Albuteral inhaler, as I do experience very slight shortness of breath. It seems that it takes a little more effort to breath than it used to, the use of the inhaler does help though. I have quit smoking since this ordeal, and the pains, palpitations, and heart rate issues have gone away. But I still do notice my breathing is not quite as efficient as before smoking. I usually sleep on my side as I find breathing easier this way. I really would like a second opinion in regards to hyperinflation being re",
    "doctor_response": "Hi, Many causes can do that like: anemia, thyroid gland dysfunction, electric over activity of the heart, anxiety and stress. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chronic hepatitis B, diet ?\n\nfew days back ,i come to know that i am suffering frm hepetitis b cronic.from that time onwards i am taking a very good care of my self am not eating any food with fat .can you help me with the kind of food i should have.what should i eat and what should i not eat.if ill take good care of myself .will i be able to get rid of this desiese.am lill confused about it..pls help me with this.thanks",
    "doctor_response": "Hi Surender, Welcome to HCM. Hepatitis B is a disease of the liver caused due to viral infection.Since you have mentioned its Chronic, you need to take good care of your liver. As you have mentioned, it is very important to avoid any food that add more stress on your liver. Liver is the main organ that helps in metabolizing the body nutrients. Excessive fat can end up in storage of fat in the liver sometimes which can be fatal over period of time. Hence, as you are aware, cut down foods which contain fat. Also, include more fruits, vegetables and lot of fiber in your diet to provide enough resistance to your body. Alcohol/smoking should be completely stopped. Also, care should be taken to not gain weight and maintain blood sugar levels as people with hepatitis B tend to get diabetic slowly as one consumes more calories while avoiding fatty foods. A balanced meal with sufficient calories and low fat is important which is easily achievable through whole fruits, vegetables, whole grains, pulses and low fat milk. Good luck to you !!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have diarrhea following constipation for a long time. Why?\n\nHi doctor, I am having a slightly upset stomach with bloating for the past four months. I thought I had a bug. Two weeks later, it seemed much better. However, my bowel movements did not return to normal. I had mostly constipation for about a month (even though my stomach did not feel as upset anymore). Then after that month, things flipped and now for the last four weeks at least, I have had movements that are almost diarrhea (very soft, formed only slightly). Colour does not seem abnormal and there is not a bad smell and I do not see oil drops in the toilet bowl. Every morning I have this. I also am having increasing stomach reactions. Every time I put food into my mouth, the gurgling starts. I am not feeling this is a food intolerance as it happens instantly no matter what I eat. I also get a lot of bloating due to the gas. I will, of course, be following up with my doctor, but wanted to ask here. I have a history of breast cancer, so I easily get concerned about cancers (I realize that breast cancer does not often spread to the bowels, but I am still worried about another cancer). I am not a person with a strong history of gastrointestinal upset. I did go through about 7 to 8 weeks of something about seven years ago and never really had a true explanation. Those symptoms accompanied many other symptoms such as nerve pain, twitching, cramping. I felt as though I was having an autoimmune type reaction and am now wondering if it was tied to hormonal changes as my periods changed at the very same time as I had those symptoms (perimenopause). I am currently on Letrozole for hormone positive breast cancer targeted therapy. I had my ovaries out two years ago. So my body is definitely experiencing a massive drop in estrogen over the past two years. I am wondering if you have any thoughts on what this could be? No blood in the stool.",
    "doctor_response": "Hi. Your history fits into the acid peptic disease. I do not find any sign of cancer over here (attachment removed to protect patient identity). I would recommend you the following. A combination of Pantoprazole and Domperidone once daily for a few days. A good probiotic, to take a soft and bland diet, to walk after all meals. I would also recommend you to get your thyroid profile checked.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am experiencing skin numbness in my upper right thigh and pelvic region\n\nI am experiencing skin numbness in my upper right thigh into the pelvic region. I have had it for a week now and it started when I was shaving that area. There is no pain and no other symptoms. It does not to feel in the muscle but just the skin. It is not a large area either.",
    "doctor_response": "Hi,I understand your concern and would explain that your symptoms could be related to a nerve compression. I think your symptoms will resolve spontaneously in the next days. But, if this does not occur, I would recommend performing a nerve conduction study to examine the nerves of the limbs. Hope to have been helpful. Let me know if I can assist you further.Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes warmth in thighs?\n\nAbout two hours ago, I noticed my right thigh was unusually warm to the touch. When I got home, i checked webmd and came up with deep vein thrombosis. I did some research and I m having a LOT of the symptoms of dvt. I noticed that I ve been having random heart palpitations more frequently recently, which is starting to seriously worry me since the article I just read said those are one of the more serious symptoms. Do I need to rush to the emergency room right this second, or can I wait until the morning when my doctors office opens?",
    "doctor_response": "Hello, It can be an early sign of cellulitis. Consult a general surgeon and get evaluated. Antibiotics might be started at the earliest. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blistery spots on the face of 2 month old?\n\nhello i have 2 month old baby. he developed tiny red spots like rashes to his face which im using dipro base cream for because its get really dry but later he also developed some bigger blistery type of spots around his neck . the doctor said it may be a fungul infection due to the rubbing of his skin. he gave me a cream to aply three times a day called clotrimazole cream. but now the blisters looked healed but it developed in to white patches which i am really worried about cause it looks similar to virtiligo and it may never fade...please help and explain what are those patches and will it fade away.. thanks",
    "doctor_response": "Hi... by what you say I feel that this could be and Eczema which got a partial response after using and antifungal cream.Usually skin conditions are best diagnosed and treated after seeing them directly. I suggest you upload an image on this website and get back to me so that I can guide you better.You can approach me at the following link.Once the page opens there will be an option below my image as \u2013 ASK ME A QUESTION \u2013 click on it.amperayani/67696Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will i get pregnant after taking medicine?\n\nGREETIS DOCTOR. IM ON ORALCON FOR 3DAYS. THE THING IS I WANT TO GT PREGNANT AND I WAS ON INJECTION SO IM NT FALIN PREGNANT. I HAV MY PERIOD REGULAR BUT NOTHIN HAPENIN. NURSE TOLD ME TO TAKE ORALCON FOR 3MTHS DURIN WHICH I MUST HAVE INTERCOURSE N MISS THE PILL ON THE DAY I HAV INTERCOURSE. WILL I GT PREGNANT",
    "doctor_response": "Hi,You have to stop Oralcon as it is oral contraceptive pill and prevent pregnancy. Your period is regular. I would suggest to consult gynecologist and undergo reproductive hormone analysis, USG scan and ovarian follicle study for better management. Following treatment will help you to become pregnant. Progestrone pill in second half of period: it make uterine environment favorable for implantation and support pregnancy. Tablet Ovacare will also help to become pregnant. Other drugs like Clomiphene, Metformin, HCG infection should be given after complete evaluation.Also go for Semen analysis of your partner to confirm no any issue in male reproductive system. Avoid stress, take healthy diet, drink plenty of water and do regular exercise.Hope this may help you. Contact further if follow up needed.Best regards,Dr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the swollen lump with vein bruising on the buttocks?\n\nLast night as I was getting dressed for bed I noticed this dent in my right buttocks. It was quite painful to the touch. I couldn t sleep on my right side and this morning when I woke up it was still there, but it had a vein/vessel showing a bruise with it. What could this be? Can this be fixed?",
    "doctor_response": "Hi. This looks more to be due a boil / infection / impending abscess.A course of antibiotic and anti-inflammatory medicines should solve the problem.Since its position is important I would suggest all such patients to have been examined by a Doctor so that a proper diagnosis  is made and proper treatment is initiated to avoid further complications .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can it be possible that i am montus positive and which medicines are advised for it ?\n\nHi I m 38 yrs old Jambhare (male), I frequently suffering from fever , I caught by cold when cloudy atmosphere comes or leave. this cold converts into fever and sometime typhide. A consultant suggest me for some pathology test i.e Hb (12.7), T.L.C (4500), DLC ( nutophils 46, Lympocytes 42, Monocytes nil, Eosinophils 12, Basophils nil) and ESR (Wintobe tube-14) and Widal test is normal, Chest X-ray is normal. but physician told me that the X-ray is doubtful and suggest for montus test. within 48 hours the points has appered hald and reddish ( Pathologist suggested me after 48 hrs result would be made and it may not be positives also). my weight is constant since last 5 month (44 kg). I neither suffered by cough. Can it possible that I,m +ve for montus. which medicine should be taken for how long? Plz suggest me.",
    "doctor_response": "Hi! Welcome to healthcaremagic.com.I presume 48 hours is over by now.What are the readings now??The person's medical risk factors determine at which increment (5 mm, 10 mm, or 15 mm) of induration the result is considered positive. A positive result indicates TB exposure.If positive you will have to take anti tb drugs for a minimum of 6 months-combination will be decided by your physician.Do not self medicate.Tb is totally curable.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for l5 sacralization\n\nHi, I have the L5 Sacralization, due to which i have severe pain ONLY in the right knee and toe while sitting or standing. Not able to concentrate on any work as all my attention is diverted towards the pain. Please advise any solutions or medicines if any.",
    "doctor_response": "Hello!Welcome on Healthcaremagic!I recommend performing a nerve conduction study to examine your nerves and discuss any possible surgical decompression with a neurosurgeon. Meanwhile, I recommend taking pregabaline or gabapentine for the pain. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back and leg pain?\n\nBad a misdiagnosis, many cortisone injections, then wound up with the rep who gave the surgeon the knee, gave him the wrong, DEFECTIVE, RECALLED KNEE TO USE. Dr would never acknowledge anything wrong. Horrible pain, leg, back since that surgery 2/12 , after found out knee was defective, new dr dud revision. Horrible pain 1year later.has arthroscopic, did nothing to help. Much dilaudid for 3 years. Becoming immune to them. Ready to give up. Ruined my life. Sick every morning, pain, horrible pain upon awakenin, back, leg. Seems narcotics of spinal cord stimulator all that s left. Leg like carrying tree stump. No strength. Now other knee starting after so much pressure on it for 3 years",
    "doctor_response": "Hi, Cannot say in your particular case, but generally, there is the fundamental problem---knee and orthopedic issues which would require new surgery and that is a big problem and the management of the pain. There's rather a lot of options for pain. One would be more drugs, but another would actually be less drugs. Besides getting used to them, narcotics also change the perception of pain. Every system in the body re calibrates. So, if you are out in the sun, you temporarily lose light sensitivity. With a lot of opiates, pain changes and blocking these systems with Suboxone would have a change in pain sensation and also be a safe way to take a narcotic. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for vaginal bumps in a child?\n\nMy 4 year old daughter has a small bumps on her vagina and about 4 larger ones on the cheeks of her buttocks that have opened and bled and then looked really dry and went away. They do not seem to bother her unless I try to put some sort of cream on them. What is this and am I doing something wrong?",
    "doctor_response": "Hello, Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website so that I can guide you scientifically. Please revert back to me with images so that I can guide you better. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain under rib cage\n\nI have been having a bad pain just under the edge of my middle left rib cage. It is slightly burning sensation that seems worse when I lay down. I also seem to have a lot of inner twitching for lack of a better term, on the right side just under my rib cage. I have no history of reflux, andhave only had heartburn during pregnancy. I am currently without insurance and would hate to go to the ER for gas or something relatively normal.",
    "doctor_response": "Thanks for contacting healthcare magic. You gave problem of hertburn at lying down position that may because of gastroesophageal reflux disease. Gastritis may cause burning pain in stomach.More gas or acidity may cause pain under rib cage area. Proper physical examination and history give exact idea. Consent a physician for further diagnosis. Avoid spicy food and citrus foods. Avoid alcohol drinking. Avoid stress. Elevate your head during sleeping. Eat small amount of meal and chew properly. Avoid immediate sleeping after meal. I hope my guidance is helpful to you. Take care. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infant having one leg shorter than the other\n\nHello My 5 month old s right leg is a bit shorter than the other and only noticed when she is standing on a flat surface. i was told in my pregnancy about the femur and tibia being shorter and Drs told me that it can be sorted out. She has been to the specialist twice since being born but nothing has been done and all i get it is as she grows it will get better as her foot was stuck against her leg and with massaging it has started to look normal again. i need someone with expertise to advise on this matter",
    "doctor_response": "HiAny treatment depends upon the underlying cause of this discrepency. Mild once can be easily overcome without any treatment as the child grows up. But severe once needs proper orthopedic intervention. I would recommend you to visit a orthopedic surgeon for clinical evaluation and definitive treatment.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I revive the lungs after quitting smoking?\n\nI am a smoker, taking three to four cigarettes a day. How can I revive the lungs after quitting. I live with the apprehension that in the later ages I will have lungs gongestion and breathing problem. Can you suggest simle steps to revive/reinvigorate the lungs?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Smoking is very bad habit. So you should stop it as soon as possible. After quitting smoking, for better lung health, do following things. 1. Avoid dust and pollution. 2. Start deep breathing exercises. 3. Start incentive spirometry. 4. Enroll yourself in the Pulmonary Rehabilitation center where chest physiotherapy is done. 5. Eat healthy food, rich in vitamin, protein etc to improve immunity. 6. Get done adult Pulmonary vaccination like pneumococcal and Influenza vaccines to prevent recurrent respiratory tract infection. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are risks in getting pregnant while having prunebelly syndrome?\n\nhey I'm a 28yr old female that was born with prunebelly syndrome and and has had multiply surgies to make me as normal as possible. I was wondering the risk of getting pregnant and how it would effect me or the baby. i know i need to speak to my personal doctors about this but was just wondering ya'lls advice on it. thank you",
    "doctor_response": "Hi , How are you doing ?Prune belly has a defect of Abdominal wall & urinary tract. So the chances of pregnancy is not much affected. Before trying for pregnancy, do have an evaluation of Renal function , as the functioning of kidney is affected by pregnancy. Have an ultrasound or MRI to evaluate any congenital problems in uterus , which may need treatment before or during pregnancy. There could always be variations in presentation. If all these are normal I don't think you will have any problem with pregnancyHope I have clarified your queriesAll the bestDr.Balakrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest tests to test disabitlities in children\n\nHi I was just curious do they provide testing for disabilities for three year identical twin boys? My boys were in a tramatic accident 2 years ago in dec of 2012 they climbed their dresser and it fell on them one them had to have plastic and dental surgery they have not been the same since. I am not sure if it is normal three year old behavior or if they are a little off now.",
    "doctor_response": "Your children may be exhibiting symptoms of chronic head trauma or prolonged concussive effect.  After head trauma children can also have seizures that are subtle in nature an difficult to identify on casual observation. They can be examined by their pediatrician and may also need to be examined by a Neurologist to ascertain the full extent of their problem.  Depending on the results of their exams and any indicated testing, a determination will be made whether they have injury requiring rest and time to recover or are perhaps experiencing some post traumatic subtle seizures or mild  psychological distress.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pulmonary TB?\n\ni was diagnosed with pulmonary TB, left lung pleural effusion which was drained 2 months back are on treatment for 2 months chest xray yesterday showd left pleural effusion again. Is this drug resistant TB or what. I did not have any symptoms of TB accept for pleural effusion and chest pain>",
    "doctor_response": "The treatment of TB can be difficult and very lengthy. It involves using 4 antibiotics for extended durations (usually at least 6-9 months). The culture results from the pleural fluid that drained should be able available by now (usually take 6 weeks) and this should tell you if the bacteria are resistant to the antibiotics or not. Ask the hospital or doctor for this information. I hope you feel better.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain due to broken ribs\n\nI had broken ribs since last October from coughing with a bad cold, they are still hurting, I also have pain in what feels like my stomache muscles, it feels almost like a runners stich that is constant it is on both sides but feel it most on the left",
    "doctor_response": "Thanks for your question on HCM. You are mostly having chest pain due to poor healing of fractured ribs which causes muscular injury too. And both these can cause pain on deep breathing,  coughing and sneezing. So try to follow these steps for better symptomatic relief. 1. Avoid heavy weight lifting. 2. Avoid strenuous exercise. 3. Avoid bad postures in sleep. 4. Take good painkiller and muscle relaxant. 5. Take calcium supplements. 6. Apply warm water pad on affected site. 7. Wear chest belt to avoid mobilisation of affected area.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause headache and rashes after eating chocolates?\n\na few years ago, i was allergic to chocolate. it went away after a month, and never came back. now, 5 years later, i got it again, having bad headaches and rashes on my face, and difficulty breathing. Now all i get is headaches when i eat chocolate. how can you explain this?",
    "doctor_response": "Hello,Welcome to HCM,The history and symptoms are suggestive of known allergic to chocolates, you should be very careful and try to avoid the chocolates. I would suggest you to undergo absolute eosinophil count (AEC) which will be raised in the allergic condition.I would suggest you avoid the chocolates which is causing all these symptoms  Otherwise you can prefer immunotherapy either with subcutaneous immunotherapy (SCIT) or sublingual immunotherapy (SLIT).For the present symptoms you can take Tab Montek LC which helps to control the symptoms, but it is temporary. You need to avoid these chocolates to protect yourself from getting these allergy symptoms.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any ideas about pins and needles after stent placement for bile duct leak?\n\nHad a bile duct leak after gb surgery. Stent put in place. Still having discomfort like pins and needles where gb was. Stent was supposed to come out today but now going for ultrasound to see if fluid is built up in that area. All blood work was perfect. Any ideas or have you ever heard of this?",
    "doctor_response": "HIThank for asking to HCM I can understand your concern, this type of pain is very common after the surgical procedure and this will come around on its own without any specific treatment, some time symptomatic  drug may required, but still I would advise you to tolerate this, and stop paying attention, this is nothing to take with the stent, hope this information helps you bye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Scan report showed cortical lesion with mild increased echogenicity compared with the renal cortex. Meaning?\n\nHello,  Would like to know what this means in a renal ultrasound, In the mid upper pole left kidney there is a rounded cortical lesion measuring about 2.4cm. This lesion is of mild increased echogenicity compared with the renal cortex. This is difficult to differentiate as a complex cystic or more likely solid lesion. Enhanced Ct or MRI would be of further value for better characterization.. No other cystic or solid left renal lesion is identified. There  is no hydronephrosis or perinephric collection.",
    "doctor_response": "HelloThanks for writing to HCMAccording to reports,There is 2.4 cm rounded lesion in cortical(outer)part of left kidney(in mid upper region)and this is mildly increased in echogenicity as compared to kidney.It can be complex cystic mass or solid lesion.Its nature can be confirmed on CT Scan or MRI.Other findings are within normal limit.Hope I have answered your query.Take CareDr.indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Painful spine, numbness in arm, pressure sensation in head and neck, tiredness. What can help?\n\nI have been having a major pain in my right part of the spine. It feels like a ball and it sometimes hurts to breath. I have arm numbness along with hand numbness. my legs have been hurting me for sometime now/ I mean very bad they keep me up at night. I have pressure in my head and neck I can not turn my neck left or right up or down and because of the pain I am very tired all the time.",
    "doctor_response": "Hello. Thanks for writing to us. The symptoms that you are having could be related to degenerative changes in the spine like cervical spondylosis. Methylcobalamin supplements and muscle relaxants can help you.I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal ,drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for blood count problems\n\nMy husband has been on dialysis for four years in July. He has a stint in his left arm. He has had three surgeries including the one that is taking place right now. The first time he had an infection on the site it bleed out. That was the same day that he was called with a kidney donor. We were already at the hospital for the ruptured site area. His red blood count went down and has never came back up again. Because of this problem his transplant has been put on hold. Today he is back in surgery to remove another aneurism from his site. He has been checked for cancer, also had a bone marrow test that came back clean. Four years ago he lost one kidney to cancer. He only has one kidney but the cancer has not returned. I truly believe that the infected site has cause this. The doc are now moving his site to another arm. In doing so do you think his chance of red blood cell rising are promising? Also, please tell me what is the best hospital and doctor for red and white blood count problems? Sincerely, Valerie Hornbeak",
    "doctor_response": "Hi and thanks for the query,Problems with blood count problems should be addressed to the hematologist. depending on the outcome, other specialists like internist could be consulted. Starting with a hematologist is the ideal. Kind regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chilling in hands and feet with temperature on head of a 7 month old?\n\nMy baby is 7 month old, developed a fever 2 days ago. Gave her Tynelno but not working. Her measured ear temp range from 100-102 sometimes with warm hands and feets, but most of the time her hands and feets are freezing cold. Only the head is very burning. We already went to the ER and was told to monitor for 48 hrs. I m very worried now.",
    "doctor_response": "it might be viral fever which of high grade temperature.. start giving antibiotics with plenty of fluids.. you're child will recover in 3 days",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am i not getting pregnant?\n\ngood evening doctor.This is bidulata from hyderabad.i have a question regarding my pregnancy.past few years we are trying for our baby but each and eveery month we got unsuccessful.i did the follicular study on 10th day and 12th day of my period.the result i m sending below. R.T.ovary:-12*8,L.T.ovary:-10*8,Endometrial reaction:-3.4mm R.T.ovary:-12*8,L.T.ovary:-10*8,Endometrial reaction:-4.8mm.as we are trying so can you please advice us is it a right move?Waiting for your response eagerly.",
    "doctor_response": "Hi,Your follicle size is not increasing and also the endometrium thickness is less.You need to check for Ovarian reserve, this can be by FSH levels or by AMH levels, this would give a better picture of ovarian function.Also other factors such as male, tubal, cervical need to evaluated and then form a plan of treatment, just follicular study may not help a lot.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bluish discoloration on scrotum in a infant?\n\nI have a 2 month old male infant patient with mild bluish discoloration of the upper pole of rt side of the scrotum. Testes are felt normal and the infant is otherwise healthy except recent pyloromyotomy. There is no hx of trauma. What could be the D/D? I am a pediatrician.",
    "doctor_response": "If the discoloration is stagnant and fixed, why not consider a birth mark? Is it extending into the skin over the groin?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any chances of getting pregnant after taking an i-pill? What are its side effects?\n\nI got period on 22nd December,on 26,27th December I had  sex and then on 27th morning I took  an I-pill (Emergency Contraceptive Pill),then again on 30and 31st December had sex.then on 1st January morning I have taken an i-pill again.So it is safe for me? is there  any chance to become pregnant or does the i-pill have any worse side effect?",
    "doctor_response": "Hello,I have gone through the query and understood your concern. Firstly, let me inform you that you had the intercourse during your safe period and did not need the emergency pill in the first instance. Presuming that you have a regular 28-30 day menstrual cycle, your ovulation would have fallen around the 7th of January. Since the sperm can remain active for up to 5 days after ejaculation and the ovum remains alive for 24 hours after ovulation, any unprotected intercourse during this period can cause conception, which you did not have. The emergency pill gives adequate protection when consumed within the stipulated time interval. As it contains high dose of hormone, menstrual irregularity can be expected. Your next natural period may get delayed by a week or two. Please restrict the use of the pill to one or two occasions per year. See a specialist for further support if you become overdue by ten days. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can heating pad be used for pain under rib cage due to enlarged spleen? Taking Ibuprofen, multivitamin\n\nMy daughter has a mildly enlarged spleen due to epstein bar virus. Her IGG was 8.0. She is feeling really bad. Really hurts under her left rib cage. Is it okay to put a heating pad on an enlarged spleen? Her ct scan performed 2 days ago showed mild splenomegaly. She is taking Ibuprofen and Tramadol for the pain. SHe is taking a multivitamin and B-100. He gave her Celebrex but she cant take Advil with that and the Advil seems to work better than Celebrex. Any other suggestions?",
    "doctor_response": "HIThak for asking to HCMHeating pad is used for superficial muscular problem say any inflammation not deep seated, one more thing I would like to say here that you can not use heating pad in liver pathology it wont help here neither this Technic helps in other way it is just exerting best placebo support and patient feel very good with worm sensation have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low sperm count\n\nHi , may I answer your health queries right now ?  Please type your query here... I am having low sperm count ,almost nill. I took sidda medicines for 5 months but no improvement. Then I went to homeopathy again they given tests for scanning of scrotum , but it is not that much problem regarding the size. But lateral sides are small. Every month conducted semen analysis but no improvement in sperm count. Hormones tests also they have done, results shows that low testestrones and high FSH. They given medicines but no improvement for me.  I took for 6 months and I left . No child after 2 years of marriage due to this infertility. Kindly give ur advise sir",
    "doctor_response": "Hey thanks for your faith in the health care magic.i have gone through your question and understood your problem.what is your sperm count what percent of your sperms are motile? Please let me know the entire report. About the erection problem, you can try Tab Tadalafil at a low dose of 5 to 10mg a little while before you need to perform. Also, time your performance according to her fertile period which starts on the 10th day after she gets her period. Meanwhile, get your Semen culture done to rule out any infection which can be a treatable cause of the problem. For the low count, you can try Ayurvedic medicines which have proven to increase the counts. Take care. Feel free to contact again",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for enlarged adenoids in a child\n\nHello, My 5 year old has enlarged adenoids, and is actually having surgery to remove them this coming Friday. My question to you is... Her nose is severely congested, but she can not blow anything out when she tries. If a little does come out, it has a pink tint to it (which looks like blood)... Is this normal? Her congestion seems to be getting worse.",
    "doctor_response": "Hi, welcome to HCM. This is due to enlarged tonsils. Surgery should be done to get relief. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sneezing and cough, green phlegm, chest tightness, buzzy sound in my ears, taken amoxicillin, didn't work out\n\nSince March I have had an itchy nose, sneezing and a cough. The iching has gone away but the constant green sudge in my sinus is still there. It goes on my chest at night and I am coughing up green phlegm constantly. Sometimes my chest goes tight and a Ventalin inhaler helps. The sputum is only ever green or yellow. I have a constant buzzy sound in my ears (which are frequently blocked too) a corse of 500mg amoxicillin did not work. I am really fed up now : ((",
    "doctor_response": "Hi, . The symptoms you have are consistent with upper respiratory infection - probably sinusitis. Presence of yellow/green discharge is concerning. It seems like amoxicillin hasn't worked in treating this infection completely. In such instance what you'd need is get the phelgm/discharge tested - a gram staining and culture / sensitivity test can be performed to identify the nature of infection and sensitive antibiotics. A course of broad spectrum antibiotic can be started emperically. I am sure your general physician or ENT specialist will prescribe the broad spectrum antibiotic to you while you await the results of the phlegm test. In addition, drink plenty of fluids. Take steam inhalation with menthol thrice a day - it will help you. With proper antibiotic treatment, your condition should improve in a week or two. Wish you a healthy and speedy recovery. I hope this answers your query. Best Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the stomach near belly button. Pain during bowel movements and urination. What is wrong?\n\nI have pains in my stomach right around my belly button and on the sides. It ferls light sharp shooing pains. I keep belching and it hurts when I move. I have had a bowel movement but my stomach hurts when I go also when I urinate. It hurts when I eat as well. This is the second time this has happened to me. Last time it lasted a week and I went to the ER and after a scan they found nothing wrong.",
    "doctor_response": "Hi, thanks for asking in Healthcare Magic. Many conditions can result in pain around umbilicus (belly button). The possible causes are 1. Irritable bowel syndrome. 2. Appendicitis. 3. Gaseous distension. 4. Inflammatory bowel disease. 5. Gastric ulcer. You are probably suffering from pain due to gaseous distension without any organic (intestinal) obstruction. It results in sharp colicky pain aggravated by any movement. It can occur due to eating food like meat, cluster beans, dairy products etc., Stretching of the intestine due to gas will increase the pain due to increased intestinal movements, Most people try to relieve pain by belching. Minimal gas may not be prominent in scan as the intestines normally have gas shadows. Only gas accumulation due to obstruction will be prominent  in scan pictures. Simethicone, an inert anti foaming agent can relieve the symptoms. But, if the symptoms persist or if it impairs the ability to perform normal activities then you should consult your treating Doctor. I hope this is useful to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness after surgery for carcinoma removal?\n\nmy husband just had a prolactinoma removed from the pituitary...he also had a carcinoid removed from the small bowel and a renal cell carcinoma removed from the kidney. His biggest complaint through all of this was vertigo...it seems to have ended the full blown attacks, but he still has lightheadedness and dizziness...his prolactin level is still 126 after surgery...could that be the cause of the dizziness?",
    "doctor_response": "Hello, Dizziness can be due to many causes. These include a problem with ear or brain. A detailed neurological and ENT examination is needed. Blood tests for hemoglobin, sodium and vitamin B12 should also be checked. Low BP can also cause dizziness. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Sudhir Kumar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from oilgospermia, taking paternia. Chances of sperm increasing? Wife's periods irregular, PCOD. IVF recommended?\n\nsir myself suffering from oilgospermia prsntly my sperm count is 35 milion,my wife sufffering from pcod ,she undergone follicular study ,she ovulate but delayed on 17 th day, and her menses was irregular erlier,her gyanc perscribe diane 35 to regular, metformin daily, n clomiphene citrate for 3 cycle ,her ovulation is now good n proper ,menses r also regular,but recently i knew abt my oilgospermia ,last year i chcked the count was 60 perc,i m non alchloic,no smoking , we have 3 yrs of marriage,i m on paternia tab,is there any chance tht sperm increase,or should we undergo ivf",
    "doctor_response": "Hi, Thanks for your query. I read your query and understand your concerns. Following is my reply: 1) You have been given wrong report. If your count is 35 million it is normal. Oligospermia is count less than 20 million/ml 2) IUI would be a better option before going for IVF. 3) The tablets you are taking wont make much difference in count. Please get retested in a standard laboratory. 4) Please see an IVF specialist to discuss necessity of IVF after showing all you reports in detail I hope I answered your query. I will be available for any followup queries you have. Regards, Dr.Mahesh Koregol IVF & Infertility Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Vision blurred, had double vision, severe nausea, platelet count went up, imbalance. Why? Related to brain stem stroke?\n\nOn 6th Sept 2012 around 6.30pm I was at a restaurant and the whole room was spinning before the food arrived, vision became blurred and had double vision and has severe nausea and was rushed to emergency. My platelet count had gone up to 670, my INR was higher than usual at 3.0. By midnight all symptoms disappeared. MRI did not show anything. The same thing happened yesterday as I woke up. I opened my eyes to see the room was spinning like mad. Vision was also blurred. Got out of my waterbed to find I had no balance and was falling all over the place. I did not go to ER and lay in bed all day and the symptoms were gone. I am taking it easy today but find I am drained of all energy. I had blood tests done this morning and am waiting for the results. I am on 8mg of Warfarin and 75 mg of Plavix besides avapro and diabex. I suffered a Brain stem stroke in 2000 caused by a vertebral artery Dissection/Occlusion with wallenberg syndrome and Horners syndrome and made a miraculous recovery. Ram",
    "doctor_response": "Hi Mr Ram, Thank you for posting your query. Your symptoms are suggestive of transient ischemic attacks (TIA) of posterior circulation (vertebro-basilar circulation). This is more so, as you have suffered a stroke earlier of the same territory. Since you are on adequate doses of warfarin and plavix, I would advise you to look at the risk factors in detail- such as sugar, BP, cholesterol, homocysteine, etc. A heart check up would also be useful. Otherwise, your current medications are sufficient to prevent a major stroke. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Apollo Hospitals, Hyderabad",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will sex during period cause any delay in next period?\n\nHello doctor, My last four months periods were on 24, 21, 21, and 22. When should my next date be? I had sex during my period. But there was no discharge inside me (we do not remember actually). So, will there be any delay in periods?",
    "doctor_response": "Hello. According to the tracking, your cycle is nearly 30 days. Your periods always need not be on time. You can expect in a couple of days. Also, you have not mentioned that you have had unprotected sex. Your periods might be delayed due to other reasons. I would recommend you to wait till the month end in case you have not had unprotected sex last month. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest alternative for reconica for hair loss\n\nHello Doctor. This is Sudip Kumar Oli from Nepal. I am suffering for severe hair loss. My dermatologist had recommended me Renocia Shampoo along with other products. I got to know yesterday that Renocia shampoo is no longer being imported in Nepal. Can you suggest me any other alternative of Renocia? Thank You.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.You can use Q Sera Hair serum or Keraglo XL hair serum.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What would be the cost of dental implants?\n\nhello, i have had an operation to remove my upper right canine, and still have a milk tooth in place there. i have been told i ll need a dental implant here. i have looked at prices of implants and can t find one cheaper than \u00a32000. i want both my upper canines to be shaped into a fang to create that beautiful hollywood smile . do you know if i can get implants cheaper? and how much will this work cost?",
    "doctor_response": "Implants are done in my clinic in 40,000 Indian rupees.And about your wish to shape your canines into the shape of `Fang' that can be done at the rate of 10,000/- per canine in Indian rupees.But you will have to scan and mail me your panoramic and lateral cephalogram and pictures of the shape of the fang you want your canines to be in. Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How safe and effective is taking Buspar-15 mg?\n\nHello, I am taking buspar-15 mg daily. Can you please tell me whether or not I can stop using it all at once, or should I taper off gradually. My doc said that I could stop it if I felt the need to, however, I forgot to ask how. She trusts my judgement to do so. She s out of town now so, I thought I d seek help here. Thanks so much! I appreciate your time. Della",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.You are right in your concerns. Buspar needs to be withdrawn gradually. Now that you are on 15 mg, you can make it half for a week and then stop it. You may also inform your treating psychiatrists about your plans to withdraw and can take up the step ones she is back and available. 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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevation in the BP level while on Amlodipine and Bystolic?\n\nI took 5 mg amlodipine on Tuesday morning along with my beta blocker Bystolic (all doctor approved). Early Wednesday morning (2am), my blood pressure rose to 213/117 and I felt horrible. I got up and had some juice - got pressure down to 209/ but I was up all night. My doctor wants to switch me to another med and I am afraid. I have taken the beta blocker for years with no problem (I have asthma) . my regular pressure is around 152/",
    "doctor_response": "Hello there I have read through your question and can understand your concern. You had an episode of hypertensive urgency . Sometimes it can lead to serious end organ damage. It seems Amlodipine and B blocker are unable to control your blood pressure. I would suggest you to track your BP for one week and if it remains on the higher side that is above 140/90 it is preferable to switch to another drug as your physician suggested. Diuretics and aldosterone antagonist s can be substituted. I hope that answers your question. If you have any further questions please feel free to write. Thank you for choosing healthcare magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause sudden neck stiffness with curling iron burn on wrist?\n\nI was being treated for bronchiatis and finished the antibiotic on November 13th. November 14th I work up and had a markting on my left wrist which looks like a curling iron burn. It is not a burn, though. It doesn t itch or hurt. Yesterday morning (rather suddenly) my neck stiffened and is very painful. I do not recall doing anything that may have strained the neck muscles. Any advice?",
    "doctor_response": "Hello,I read carefully your query and understand your concern. Your neck pain seem to be related to a muscle strain. I suggest using a muscle relaxant such as Baclofen three times a day. I also suggest using magnesium supplement daily. Warm compresses can also be helpful. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause toenail problem with big toe on foot?\n\nI m 13 and I have a toenail problem with my big toe on the right foot, there was a part of skin hanging off from the side so I peeled it off, but pulling it out hurted, and it s throbbing and feels a bit hot and heated and hurts if I press on it. Can you tell me what s wrong?",
    "doctor_response": "Hi, It could be a ingrown toe nail. It has to be removed to prevent infection. Consult a general surgeon and get it removed under local anesthesia. Nothing much to worry and it can be done in minutes. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent infection in belly button?\n\nI keep getting infections in my belly button. Each time I get prescribed anti biotics and take them and it seems to go away for a week or two then comes straight back. It causes pain around my abdominal area almost like a bruise (without a mark) and becomes red, hot a d swollen. Whilst infected large pustuels form and burst. It won't go away what should I do?",
    "doctor_response": "Hi,Welcome to HCM.Repeated infection of the umbilicus could be due to urachal abnormalities.Other causes include laparoscopic surgery, umbilical discharge, pilonidal sinus, infection due to hair follicles, foreign bodies, non-specific acute and chronic inflammation and abscess of the umbilicus. I suggest you visit a surgeon and get investigated for the above mentioned causes. If there is infection, a culture and sensitivity of the umbilical discharge will aid the treating doctor to prescribe appropriate antibiotics.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is bleeding normal after not having periods for 2 years with IUD?\n\nI have a question about the Mirena IUD.  Its been 2 years since I've had the IUD and my period has completely went away. This morning I woke up with cramping and I was bleeding.  I want to know is it normal to be bleeding after not having a period for 2 years with an IUD?",
    "doctor_response": "Hi, I have gone through your question and understand your concerns.Breakthrough bleeding may occur with Mirena even after 2 years. But you have cramps, check if the IUD is in place or not. Otherwise get a check up done.Hope I have answered your question. If you have any further questions I will be happy to help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having 3 stage kidney failure. Having 3 meal diet with3to 4 oz protein on each meal. Recommendations?\n\nI have been following a diet where I eat 3 main meals a day and a snack between them, and i must have 3 to4 oz. of protein each meal and at least 7oz. ea. snack,  but I am worried now about the protein because I found out I have stage 3 kidney failure, BUT I am doing so good on this diet and sense I am 300lbs .obese I don't want to quiet now , so what about the protein, can you help me please ?",
    "doctor_response": "HiThanks for the query.In chronic kidney disease, especially if it is associated with protein in the urine, it is advisable to restrict the dietary protein intake. This has been shown to delay the progression of the disease.The amount and type of protein to be consumed can be calculated based on your ideal body weight and dietary habits.So you should see a dietician and get a detailed diet chart.Hope this helpsGood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does electric shock like pains from cervical spine lesion make arms weak?\n\nI was diagnose with transvers myelitis on october 25 1 lesion on cervical spine, i have started having the electric shock that is making my arms weak and I just wanted to know if that is normal and expected... the numbness of waist down went away but now i am getting this feeling",
    "doctor_response": "Hello, I will suggest you to continue treatment advised to you for transverse myelitis. As per your description, there was an active lesion in the cervical spine, so there are definitive chances of getting sensory and motor symptoms (arms weakness with electric shock-like feeling). Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Muhammad Faisal Bacha, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I need to have a stress test done?\n\nI wore a heart holister for 24 hours about 3 weeks ago and the Dr.'s receptionist that just reminds patients of appt. called me on a fri. afternoon at 5 and says he wants you to go see a cardiologist and ahve a stress test done.  I am 5/7\" 120 lbs and took oxyelite pro a few months ago and i'm worried maybe this  has something to do with that.",
    "doctor_response": "what can I do without seeing your holter report..you didnt mention your symptoms. you didn't mention your report findings.please collect your all positive findings and send me .then we will discuss",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on inner thigh?\n\nI have noticed lately this lump on my inner thigh, right where I shave between my legs and this lump is about the size of a small marble and is hard inside almost. It s also filled with blood because it popped open and only a little bit of blood came out. If you can, please tell me what this is. Thanks",
    "doctor_response": "HelloAs per your description it seems that you have a Thigh abscess.If I were your treating Doctor then I would have suggested you to go for proper aseptic drainage of the abscess. An antibiotic coverage and a pain killer. And to maintain good hygiene. Please remember to use an antiseptic lotion before and after shaving the area.  Get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does being anemic affect soft tissue injuries and menstruation?\n\nhow does anemia (chronic, severe) affect the recovery from soft tissue injuries?  I have had 2 car accidents and have severe anemia.  How does this anemia affect the recovery from my injuries?  I am taking iron injections and my hemoglobin levels are increasing and also my ferritin levels, but not up to normal levels yet.  All investigation has been done as to the cause of my anemia and no answer has been found, other than possible heavy menstruation.  I am a 47 year old female about 160lbs 5'5\" in otherwise quite good health.",
    "doctor_response": "Thanks for contacting HCM. Being anemic means more time in recovering and healing during accidents. Heavy menstruation can be a cause of anemia. You need to get in touch with a gynaecologist to find out cause of heavy  menstruation and treat it other wise once you stop iron injections your hemoglobin levels will again fall. regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce high level of billirubin?\n\nMy son had Hep c and did the interferon, riboviran incivek treatment.  he is now virus free post treatment 6 month blood work shows high levels of billirubin.  is this as a result of the treatment or could he have developed Gilberts syndrome? neve had high levels while on treatment.",
    "doctor_response": "Hello! Thanks for putting your query in HCM. I am a Gastroenterologist (DM).As post treatment viral load is not detected then there may be some other reason for increased billirubin, it may be gilberts syndrome or something else for which he requires evaluation. So I will suggest you to to take him to a hepatologist for evaluation.I hope I have answered your query and this will help you. If you have any further query  I will be happy to answer that too. Remain in touch and get-well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stuffed nose and cold chills despite taking Nyquil and Sudafed?\n\nHi I been sick since last Wednesday with sinus nose stuffy nose coughing on and on off was dry heaving yesterday had cold chills nofever sat day and sun day I been taking Nyquil and Sudafed I been drikig tea gingerale water juices sucking on halls sorethroat andvitamin c drops where I work in middlebury VT at the residence at otter creek they have a lot of flu symptoms going around I been one a day women 50 plus vitamin and lisinpril and bayer 51",
    "doctor_response": "Hello,The cold or flu commonly presents with stuffy nose and coughing. In general, the symptoms last 7 to 10 days though can sometimes extend to 2 weeks.Using Nyquil and Sudafed drugs are fine until they do not contain similar essential ingredients. Fluids and rest are also important.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Michelle Gibson James",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the painful and swollen lumps on my labium?\n\nHello, I am concerned about little lumps (i would call it spots inside the skin) in my right labium, I found one earlier this week that sarted swelling up quite a lot and hurt terribly, it was difficult to find a way of sitting down comfortably. Now I found a second one in the same labium further down, a bit smaller, also tender to touch, if that starts swelling like the other one I wont  be able to sit at all. Then i started looking for more, and found one that is where my leg starts already, so away from the genital region at the start of the pubic hair area (loin/lumbar area). I am now really worried and would like to know what that could be, before I go to a doc as it is quite embarrassing. Thanks for your help",
    "doctor_response": "Hi,Dear Thanks for the query to HCM virtual Clinic.I studied your query with available details given in your query.I understood your health concerns.Cause of the painful and swollne lumps on labium-From the facts given in your query,you seem to have-infected hairfollicles/Boils,as your story goes by.The lump on the pubic area near by confirms it being boil.The chances of it being Barholins Cyst are less in your case because of the weeks history when the first lump in right labium got bigger and was tender , not allowing you to sit even.So Don't worry.Its not cancerous but is infective lump.This would help you to plan treatment with your doctor, whom you should plan your visit urgently , before it complicates any more.Don't Self-treat or medicate in your case as the case may go in to further complications.Hope this reply would resolve your query and would help you to plan treatment with your doctor.Hope this would relieve of your health concerns.Welcome for any further query in this regard before final suggestions are given in your query.Wishing you fast recovery..Have a good day.Dr.Savaskar M.N.Senior Surgical Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for viral infection in a child?\n\nHi my son is 21 months old, he had a viral infection and completed a course of antibiotics and other cough syrups just 5 days back, but today again he is sneezing and coughing.....isn't it too soon for him to catch cold as he just finished his medication. the weather is also hot here and not cold. what would you suggest?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.Cough and cold are viral 95% of the times in children. For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15mg/kg/dose (max ceiling dose 500mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.For cold you can use Cetrizine at 0.25mg/kg/dose every 12 hourly for 3 days.For nasal block, plain saline nasal drops will do, every 4-6th hourly to relive nasal congestion.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to drive and climb steps for a lumbar spondylosis patient?\n\nSir, I have been diagnosed as lumbar spondylosis.  Problem is with L-5 and I had severe pain in the lower bottom for two days.  Immediately consulted a Sr.Ortho and was hospitalised for pelvic treatment.  I did undergo physiotherapy and traction for six days.  Now the pain is considerably subsided.  I have some queries regarding the dos and donts. 1.  Is two wheeler riding considered a total ban in my case.  I am wearing a belt on doctors recommendation. 2.Is climbing steps a ban in my case.  I am working as Administrative Officer in an organisation.  I used to carry my office bag in the shoulder.  Is it allowed in my case. 3. I used to walk for about three miles in a day.  For the last one month I am not going for a walk fearing that the pain may get aggravated.  Can I walk. SATHISH KUMAR",
    "doctor_response": "two wheeler is considerably ban in your case reason is simple in bike we always are trunk forward and potholes or speed breaker can increase your pain and nerve compressionclimbing steps is ok but considering you lookout your posture.. too much stooping while climbing can cause paini would not suggest 3 miles a day... you can walk a mile or so if you wantabove all first get yourself relieved from pain via exercises with physiotherapist. then this precautions will helps for sure. for further queries you can contact anytime",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dry mouth\n\nI AM A DIABETIC PATIENT OF HIGH BLOOD SUGAR AND CONTROLING IT USING MEDICINE. BUT NOW I AM FACING THE PROBLEMS OF EATING FOOD. DOCTOR SAYS IT IS A CASE OF LOSS OF ELASITY POWER OF MOUTH. I USED GUTKA, ZARDA WITH PAN. HOW I RECOVER? PLEASE TELL ME WHERE CAN I GO FOR TREATMENT.",
    "doctor_response": "thanks for your query, the problem what you are facing looks like oral submucous fibrosis because of the gutkha and zarda chewing habit. the elasticity of the mucosa reduces and mouth opening also decreases. the dryness in the mouth could be secondary to diabetes and the drugs you are taking for diabetes. consult your oral physician and get it diagnosed and you can use wet mouth gel for drymouth and for oral submucous fibrosis you can take antioxidants and intralesional injection from oral physician. i hope my answer will help you..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Episode of paralytic attack caused twisted arm and legs, speaking difficulty. What precautions should be taken to avoid recurrence?\n\nHello doctor My father had paralysis attack in Jan, 2012. currently his treatment is going on from PGI Chandigarh. But after having attack in Jan he had another attacks twice in Aug and Sep. his left arm and leg got twisted completely and he was not able to speak for few minutes. After that he was normal as earlier. My question are: 1. What precaution should we take to avoid these attacks further? 2. Doctor suggest Liofen XL 10 mg to soften his nerves of left arm as this is not working at all, is this fine to go ahead with that? 3. What all action should we take immediately once he has attack? 4. Any medical advice to bring back him to normal activities of his own?",
    "doctor_response": "Dear Friend, I hink the cause of seizure in your father is cortical infarct.. He should be started on antiepileptics firstly.Liofen is  good drug to reduce stifness in spastic/paralytic limbs.During attack he shod be laid on soft surface on his side.But prevention is better than cure, so start an antiepioleptic immediately.  Phisiotherapy can help him yo do well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for mental health problem\n\nI have suffered from severe agoraphobia since I was 17. I am adhd and take adderall. I have PTSD which caused the agoraphobia to go out of remission and return , now I take 8 mg klonopin, 60 mg adderall, 600 mg seroquel. I am physically extremely healthy, my blood pressure is low, it s now 100/80. I was having severe panic to the point of things looking unreal, I was terrified to get off my bed, my brain was going a mile a minute. Out of desperation I took an extra 20 mg adderall, it worked so well I forgot my 4 mg nightly klonopin, and only needed half my dose of seroquel, I tried it the next day with same results, I m afraid to tell my psychiastrists, what do you think I should do",
    "doctor_response": "Hello; thanks for the query. Addrell (amphetamine+ dextroamphetamine combination) is a psychostimulant used in treatment of ADHD. It does NOT reduce the anxiety symptoms or panic attacks. By defination anxiety symptoms associated with panic attacks rise & fall rapidly within few minutes. Hence my guess is your anxiety symptoms reduced spontaneously. Also; I would like you to consult your Psychiatrist about medication named Trazodone which is an antideprssant with excellent anxiolytic properties & also helps in sleep induction. Alternately, also discuss about use of SSRI medication (like paroxetine) for agoraphobia & PTSD & use of propranolol/trazosin to reduce PTSD flashbacks. Also try doing yoga+ pranayama which are excellent relaxation tools. Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dark patches around penis, scrotum due to intense itching during summer. Which cream can be used?\n\nDear Dr.Rohit Batra Good evening, I am a 28 years Male From Hubli (Karnataka), I am a Medical representative working for Abbott India Pvt Ltd, I have a Dermatological Problem that I have a dark patches around Penis , Scrotum (around the under wear area) this is because of my bad itching habit due to heat in summer season which later lead to a dark patches, first few months I thought that this will slowly go off but It is not going, Presently I don t feel any-kind of itching but I feel that this will effect my sexual life in future. Please guid me which topical cream to be applied. Thank you E.Mail ID YYYY@YYYY",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.The black patches need to be examined to identify whether they are only hyperpigmented areas or they are fungal infection. Only then the treatment can be ascertained. 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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful lump on the armpit\n\nI had swelling under my armpit a few weeks ago, the swelling has gone down but there is a lump, feels soft around the edges with a pea shaped hard lump in centre. I am 53 years old with a family history of breast cancer. Have had a few biopsies in the past years and all have come back clear. Have very dense breasts also. Having an ultrasound diagnostic mammogram in a few weeks. Should I be overly concerned",
    "doctor_response": "HI,Thanks for the query to HCM.Treatment for painful lump in armpit-A  pea sized lump with dense breast should not worry you much.In my opinion,as the swelling has gone down lately,this lump is mostly-Boil in the armpit.Treatment is needed only if it grows in size again,as its dormant now and harmless to you.consult a surgeon when it grows and he would treat it accordingly with antibiotics.As you are going for mammography soon , it would resolve this lump issue also.Hope this would help you to plan treatment with mammography and ER doctor.Welcome for any further query to HCM.Hit thanks.Good Day.Dr.Savaskar M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Cypon syrup help cure loss of appetite in a child?\n\nHello Doctor, MY daughter is 16 years old, she is not able to eat properly. she is feeling heavy even with small quantity of food. I met a general physician and prescribed CYPON syrup.....In the reviews i see CYPON is for more allergic treatments....can u pl advise? Thnaks, Hari",
    "doctor_response": "Hello and Welcome to \"Ask A Doctor\" service.  I have reviewed your query and here is my advice. The medicine in Cypon is an antihistamine and some antihistamines are  appetite stimulants. Cypon contains this kind of antihistamine.  You are correct that Cypon is more often for allergic conditions ; the Cypon antihistamine also treats people's allergies.  Side effects of appetite stimulants are nausea, vomiting, abdominal pain, blurred vision, fatigue, nervousness and dizziness and they should be avoided if the patient has diabetes.    Unfortunately you have shared very little about your daughter's problem.But as I wish to help you and her, allow me to take you in a direction that  just might assist you. Anorexia nervosa is a common eating disorder that affects adolescent females.  Characteristics are the patient sees herself as being too fat even when she is underweight, refuses to keep a normal body weight, intense fear of becoming fat, excessive exercise, absence of three or more menstrual cycles without another cause and denies feeling hungry.  She may be socially withdrawn, irritable, depressed, have abdominal pain, and fatigue.This condition is most serious.  IF this is what she has, it can progress to need for hospitalization and even passing away.   She needs to have a medical evaluation in more than a superficial way.This to include a complete general physical examination because the reason for poor appetite could be something else.  Should the pediatrician who does the complete physical agree that an eating disorder is possible, than your daughter needs to be evaluated by a child and adolescent psychiatrist who is experienced in treating adolescents with eating disorders.   Please think about what I have typed.  Certainly discuss with your husband.  And select a physician(hopefully a pediatrician that both of you trust) who will agree to speak with you(even if he/she requires payment)alone about her situation.  Hope I have answered your query. Let me know if I can assist you further.  Arnold Zedd, MD, FAAP",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can steroid injection lead to hair thinning?\n\nHELLO I RECEIVED STERIOD INJECTION D/T BACK ISSUES  I NOTICED MY HAIR WAS THINNING.  WHEN I WOULD WASH MY HAIR LITERALLY HAIR COVERED BY HANDS.  IT EVENTUALLY STOPPED BUT STILL LEFT ME WITH THIN HAIR. THEN I GOT ANOTHER INJECTION AND AGAIN HUGE HAIR LOSS RESULTING IN EVEN THINNER HAIR BUT STOPPED THEN THE NEXT AND WILL BE MY LAST INJECTION LEFT ME WITH ABOUT 75% THINNING. I AM STILL LOSING MY HAIR AND INJECTIONS WERE IN JANUARY. I HAVE READ THOSE THAT SUPPORT THE ABOVE SIDE EFFECT AND THOSE WHO DON'T. WHERE CAN I GO TO FIND OUT THE TRUTH. FYI BY THE WAY WHEN I HAD MY SPINAL FUSION IN 2007 I ALSO EXPERIENCE HAIR LOSS AND WAS TOLD IT WAS D/T ANESTHESIA IT DID RESOLVE. JUST WANT TO KNOW WHY THE HAIR LOSS. I HAVE WAIST LONG HAIR AND HAVE ALWAYS HAD THICK THICH HAIR HAVE EVEN HAD TO HAVE IT THINNED. THANKS CVMB",
    "doctor_response": "Hi,I read history you provided. I got the your concern for hair loss and hair thinning. You feel that the problem you have is due to steroid injection. But, I assure you that steroid is not responsible for hair thin and hair loss. On the contrary hair grows after steroid injection.so, consult the dermatologist and get investigated to find out the internal cause.Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilyas Patel, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am having problem in motion with increased stomach\n\nHello doctor I am 28 years old. before this i never got this type of problem, but from last 10 days i am observing that not going motion free and my stomach is also increased. actually my body is slim but coz of the not free motion my stomach is increasing slowly like balloon. I got married 2 and half years back. i don t hv childrens. Let me know wat is the reason and wat should i do ?",
    "doctor_response": "Thanks Health care Magic for referral, Not getting motion free may be due either infection in stomach by bacterias or protozoans like Giardiasis or Amoebiasis or low fiber intake or low consumption of water ,you need to consult gastroenterologist,your problem will be solved. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can chronic sinusitis be treated?\n\nI continue to have acute sinusitis -- Have all basic symptoms -- Have been diagnosed with chronic sinusitis over last 20 plus years -- Finished antibiotic cefuroxime axetil 500mg 2-weeks back -- Still no relief -- Today is worse due to heavy biometric rainy day pressure especially in both ears.",
    "doctor_response": "Hello,As per your clinical history is concerned, please follow like this:1) Do a clinical examination by your Doctor [ENT] and to know exact status please do few investigations like this [CBC with differential, Nasal endoscopy, CT scan, and a sinus culture] to confirm exact cause.2) Use saline nasal spray regularly and take other prescribed medications as per investigation reports only.Do follow lifestyle modifications like this:1) Try to avoid upper respiratory infections. Minimize contact with people who have colds. Wash your hands frequently with soap and water, especially before your meals.2) Carefully manage your allergies. Work with your doctor to keep symptoms under control and do blood differentials count every month.3) Try to avoid cigarette smoke and polluted air. Tobacco smoke and air contaminants can irritate and inflame your lungs and nasal passages.4) Use a humidifier. If the air in your home is dry, such as it is if you have forced hot air heat, adding moisture to the air may help prevent sinusitis.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Uday Nath Sahoo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness and tingling in hands, blurred vision and numb ear canal?\n\nI have had numbness and tingling in both of my hands for months now. In the last few weeks I have had my vision go blurry about 3 times lasting between 30 seconds to a couple of minutes. Today my right ear canal has went numb but I can still hear.i have a neurology appt set for a month from now :( In the meantime I m wondering if all of these symptoms could be related. I guess I should also mention I have high blood pressure and I am a 39 year old female. Any input would be appreciated!",
    "doctor_response": "Hello, Yes all these symptoms are related, you have to check your sugar level, need to evaluate for Diabetic mellitus. Check Fasting and Postprandial sugar levels. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Krishnakanth. K",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can I get rid of the scars on my face?\n\nHello doctor, I have acne and a lot of scarring on my face from a breakout that occurred last month that is hyperpigmentation and it is lowering my self-confidence. I am trying very hard to find a treatment that is effective and works quickly. I have attached photos for your reference.",
    "doctor_response": "Hello. I saw your clinical picture (attachment removed to protect patient identity).  You have more dark marks from acne. We call them PIH (post-inflammatory hyperpigmentation). This takes time to fade off. Once there is scarring, the most effective treatment for scars is a fractional CO2 laser. There are medications to lighten the pigment. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. A pulp is seen in the ear after accidental eardrum damage. What is to be done?\n\nHi doctor,Five days back, my son put a plastic stick into his ears and the membrane got damaged and blood came out. We went to the doctor immediately. He gave us Azithromycin to give the child and told us to keep his ear safe from air, water and, all other materials. He also told us to watch out for fever. But after five days, a pulp is seen in the ear. Will it affect his hearing capacity? What should I do next? Please give me an answer immediately.",
    "doctor_response": "Hello. Since there was damage to the membrane you need to be careful. It can cause a decrease in the hearing if the damage does not heal properly or get infected. If pus is coming from the ear, kindly consult a nearby ENT doctor and take treatment for the infection. It can take a bit long for the membrane to get healed properly. Until then, you need to be careful and make sure water does not go inside the ear at all. For more information consult an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Oxycodone and Cipralex contraindicative?\n\nHi, my doctor gave me oxycodone for my wisdom teeth being taken out...However I take ciprelex for my depression and anxiety. Is that safe? To mix? Also I think I took one two many this morning. I took one I thought but didn t remember if I did and took another but I m not to sure I should be fine right?",
    "doctor_response": "Thanks for your query, I have gone through your query.The oxycodone is a opioid analgesic and a central nervous system depressant. Even though it does not interact directly with the cipralex which is a selective serotonin reuptake inhibitor(Anti depressant). The oxycodone produces depression So it is not ideal to take along with  antidepressants. Consult a general physician and take opinion. The other possible ways could be sticking on to Non opioids like non steroidal antiinflammatory drugs. Since the opioids have addictive properties, it is not safe for long term use.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the survival rate with jaundice and Klatskin tumor?\n\nMy mother-in-law has Klatskin tumor. She has had 3 stents and now her count is just elevated without blockage. She started turning jaundice last week. How long can she survive? There seems to be no option available to her at this point. Can she live months or are we talking days and weeks being jaundice?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.Klatskin tumor is cholangiocarcinoma at the confluence of the hepatic ducts and common hepatic duct above the level of cystic duct.It causes obstructive jaundice.Stenting / bypass are palliative options.Actually surgical resection is possible only in 5% cases.Condition has got 90% mortality in one year.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low white blood cell count with anemia?\n\nHi, may I answer your health queries right now ?  Please type your query here...my husband is 47 yo. white male and he's been experiencing low white blood cell count since a viral infection in june.  he has some liver damage too.  he was recently hospitalized because of fainting spells that were unexplained (now seems to be related to being possibly anemic and low in magnesium)  he's been referred to a hematologist. what conditions would they be ruling out?",
    "doctor_response": "Hello and welcome to HCM,Low white blood cell counts can occur due to severe infection or bone marrow depression.Viral infection can cause bone marrow depression, however, viral infections affect the platelets more than white blood cells.The liver functions can be assessed by getting liver function tests.If there is any evidence of anemia (e.g. paleness, tiredness, easy fatiguibility etc), you can get complete hemogram- hemoglobin, complete blood counts, iron studies, red cell indices and peripheral smear examination to know the type and cause of anemia.Consult your primary healthcare provider for clinical assessment and relevant investigations for further management.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nausea, vomiting, shivering and coldness after tooth extraction?\n\nI had a big back tooth extracted about three hours ago and following a light meal I began to feel very nauseous and felt like vomiting and eventually did . Iam now shivering and am practically covered with warm blankets and three hot water bottles and am still feeling cold and shivery is this condition considered appropriate and what do you think I should do.",
    "doctor_response": "What medications are you taking, normally the symptoms you describe does not happen after extraction, unless there has been untreated infection preop.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for fungal infection in buts?\n\ni have itching on my buts, its kind of fungal infection, i assume. I have it for almost 3 years or may be long. Doctors advised me SEBIFIN TAB and Cream, but it did not cured then second doctor advised GRISOFLUVIN (Gris OD) and Sebifin cream but it too failed. I am worried as i assume it is spreading and am really worried it may affect my child too.",
    "doctor_response": "Hello,Welcome to HCM,Fungal infections are more common in the genital and perineal area as these are the normal comensals of this area, which will be kept under control by helpful organisms whenever there is a change in the environment these yeast will activate produce their symptoms.As you are having the symptoms of fungal infection for which you have taken some treatment but your symptoms has not come down, I would suggest you to undergo lab investigations like KOH mount, CBC and urine routine examination. For your symptoms you can try these measures1.Keep the area clean and dry with the help of neosporin powder.2.Apply antifungal cream over the lesions3.Tab Diflucan, 150 mg single dose.4.Oral antihistamines to reduce the symptoms of itching.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My thyroid ultrasound results are suggestive of Hashimoto's. Kindly advice.\n\nHello doctor, I had an ultrasound done on my thyroid. Results are right labor 0.8 \u00d7 2.9 \u00d72.0 and left lobe 3.0 \u00d7 2.8 \u00d7 5.7. The texture is extremely heterogeneous throughout. They said some Hashimoto's. Can you tell me what this means? It has grown in two years (mostly left lobe). It is going to be another month before I see a doctor and not sure when I will see an endocrinologist. Please help.",
    "doctor_response": "Hello. Your one lobe is larger than other. It could be a simple overgrowth or a tumor. To differentiate between these and to tell exactly what is the problem in your thyroid gland, you need to get a test called FNAC (fine needle aspiration cytology) of thyroid or radioactive iodine uptake scan. Once you meet your doctor ask for these tests. Hashimoto's is one of the diseases where the patient initially will be hyperthyroid and gradually become hypothyroid, but in your case, you do not give any history of being hyperthyroid. So Hashimoto disease is less likely. Kindly get the tests recommended and revert with reports. Hypothyroidism.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for bone cancer?\n\nhi my name is imran and father-in-law is effected with some type of bone cancer and he is residing at nasik he has high pain in his back bone and near foot area also and he cant able to eat anything and can you also provide me your email ID to send you the mri report in order understand much more clear the condition of the patient",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Treatment of bone cancer depends on type and stage of cancer.  Surgery is the treatment of choice for localized cancer followed by chemotherapy or radiotherapy according to need and type of cancer. Please send me your mri reports so that I can help you further. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in forehead\n\ni have a sudden swelling on my forehead since a week. First it looked a bit like a rash. I went for a facial and she said it was a whitehead and said she took care of it. But the swelling remained thought it decrreases everyday. Now its barely there. But it kind of pains inside. Theres also two red bumps on my eyebrow",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It may be due to pimples and there is pus collection inside, which gave rise to nodule like appearance. Nothing much to worry and you can apply Clindamycin ointment for symptomatic relief. If the swelling persist for long, you can go for laser therapy, which has got good results in similar conditions. Wishing you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "stomach problems.\n\nmy stomach is making all kinds of nosies and its because i am hungry but i make noises at the upper part and lower part of my stomach and i have constant gas",
    "doctor_response": "Having some movements and some sounds on empty stomach is normal,they are known as hunger contractions.Pain in lower abdomen and gas may be result of your food habits.once in a while it is ok,but if you are regularly having this problem first watch out for your food habits,you should be avoiding heavy foods,junk foods etc.have something regularly throught the day.Avoid too much of tea,coffee or cold drinks they will make you bloat a lot and will kill your appetite.And try to walk for 10-15 minutes after dinner daily that will increase digestive juices and improve your digestion power.buy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having jaw pain after root canal treatment. Why?\n\nHello doctor, I had a root canal done in one of my lower right teeth. It was done in one sitting with the help of a laser. Everything was fine for a week. Then, one day my right jaw started aching and I was not able to open the jaw more than half an inch. There wa mild pain below the ear and it increased while chewing. My dentist says it is spasm and it has nothing to do with RCT (root canal treatment). I am taking Flexon MR and doing few muscle exercises keeping the jaw in movement.  What is the solution?   How long will it take to heal?   I am worried will it become permanent?",
    "doctor_response": "Hello. Yes, it can be due to muscle spasm but as it started after one week then it can also be due to infection in the root canal treated tooth. So, first of all, the exact cause needs to be ruled out. If Flexon MR (Ibuprofen, Paracetamol, and Chlorzoxazone) and muscle exercises are not resolving the problem then an X-ray of the tooth should be done to check for any infection. It can heal mostly within a week. No, it cannot become permanent and both conditions - infection and muscle spasm are treatable. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dry skin, flakes off. Not a de-tan user, or changed soaps and detergents. Is it liver perspiration issue?\n\nHi, I have a strange question concerning symtoms over the past 4 to 6 months. I do not use tanning products-fake or not and haven't changed any of my soaps or detergents. When I dry off after my shower my white towels look like I have been digging in the flower bed. Also, I notice that my underclothes are stained with the 'dirty' look. I just can't seem to get the nerve up to go to a doctor to help me figure out what is going on. So I would like to start with you. What is your opinion? It would seem to be something internal going on but I haven't got a clue. Liver-Perspirations issues??? Totally unsure!!! Thanks",
    "doctor_response": "Hello,I went through your problem. I can explain certain facts. You can use deodorant and not antiperspirants. Deodorants prevent odour-causing bacteria,   Antiperspirants use aluminum-based compounds, such as aluminum chloride, which are acidic in nature - along with your sweat stains the clothing. Moreover Only Dry wash clothing should not be hand washed.If this is OK for you, no need to go for any further medical checkup.Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible after unprotected intercourse while using Novelon tablets?\n\nHello! I am having my periods from Wednesday (16th March 10). I was taking Novelon from Monday (14th March 10) as I wanted to delay my periods because of some professional engagements and family commitments. In the Meanwhile on Thursday & Friday (17th & 18th) I had Intercourse without any protection. I am still on Novelon. But Will I get Pregnant in this condition. Urgent Help Required.",
    "doctor_response": "Hello,No, you won't get pregnant. In a normal 28 days cycle, ovulation occurs around 14th day and pregnancy occur during that time if u keep a relationship.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sheetal Agarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it to be concerned if there is scraps in hands due to a fall?\n\nHi, I recently fell on the ground outside. A kind young man who drove by me stopped his car to help me. He picked up my bags for me and handed them to me. I had some scrapes on both palms that started to bleed a little after I left where I fell. I also had scraped a knuckle on my right hand and my left knee that started to bleed. Should I be concerned?",
    "doctor_response": "Hello, It is just a superficial abarasions and nothing much to worry about it. You can apply topical antibiotics like mupirocin for symptomatic relief and wound will heal in couple of days. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high fever and infection after appendix burst\n\nMy son has had his appendix burst and the doctors waited 5 days before they went in to remove it because he had a high fever and the infection. After appendix was removed, his lung colapsed and the fever got even higher. He was placed in the ICU for 4 days due to the colapsed lung. Now he sits in a recovery room still having difficulty breathing and the fever does not seem to go away. Its been entire month and he still has a fever and he is still in the hospital. The doctors said that he had complications and they left some puss inside because they were afraid of scaring tissue. Does this sound normal to you? I am about to hire an attorney please help!!",
    "doctor_response": "dear user, thanks for your query. your history suggest your child develop severe sepsis and ARDS after appendix burst.  i think your doctors are treating in right direction. These complication not developed due to your doctors fault. i suggest you to have faith in your doctor and complete the treatment.regards- dr deepak vaishnav",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is dry cough with runny nose a common symptom of viral infection?\n\nhi my son who is 6 always seems to get a dry cough every few weeks or months sometimes with  a runny nose sometimes without. He had pnemonia at 17 months however the doctor said his lungs were not scarred. Is it just a viral infection or could there be more to it?",
    "doctor_response": "HI,Welcome to HCM!I am sorry learn about your son's condition. Yes, dry cough with a runny nose is most likely a viral infection. He might be suffering from headaches and bodyaches, which as also common symptoms of Viral infection.If he develops sputum in his cough (yellowish), it may indicate bacterial infection.As you must be aware, viral infections have no treatment and are self limiting. They take 8-10 days to cure.Till then, only symptomatic treatment may be offered for cough and runny nose.Hope this information helps. Feel free to ask if you have any doubt.Wishing your son a speedy recovery. With warm regards,Dr. Sridhar Reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible that anxiety and calcification in frontal lobe of brain would influence back pain caused by sciatica?\n\nIn 2001 after a bone scan I was diagnosed with a minor abnormality in my brain. I was told i had calci\ufb01cation in the frontal lobe of my brain. The Dr. who report the info to me said it was nothing to worry about. But in the past few years I have experienced anxiety, sciatica causing pain in my low back and left hip pain and depression. i m being treated with valium for anxiety, Ultram for sciatica pain but nothing has helped my depression. Now for about 3 months i have been having memory problems (repeating things to people what I ve already told them and forgetting what I was going to do etc...) My family has now brought this to my attention they re concerned somethings wrong. The most recent problem is i m having left arm and left leg pain, aching and sensitive to cold makes it worse. Could any of these symptoms be a result of the brain calcification? Thank You Krista Parks",
    "doctor_response": "Hello friend,Thank you for your query through Healthcare magic.Your health conditions have to be understood as going from bad to worse. As  a doctor, I have to tell the truth, even though it is bitter.In 2001, when your doctor told you the problem, it was not serious. There is no meaning in telling that the present symptoms are results of calcifications in brain. Then you forget to ask why the calcifications?From your query, you are aware of the present neurological conditions which are gradually deteriorating. These are processes that travel from bad to worse because you have not yet got a curative treatment. I am a Homoeopath and I believe that Homoeopathy has got a genetic and constitutional approach to this sort of diseases and therefore my suggestion is to undergo homoeopathic treatment from an expert Homoeopath. In Homoeopathy only your mind and body symptoms will be considered as equally important and a curative remedy will be selected to cure you.After Homoeopathy, you will feel the change. The symptoms will follow a reverse process and that is real cure in your case.If you cannot find an expert Homoeopath in your locality, you can view my profile and ask a direct question to me through Healthcare magic. Then I will be sending a case taking format in which you can enter your whole case. After studying your case in detail I will be able to suggest your curative remedy.With best wishes,Dr C. J. VargheseHomoeopath",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hypertension\n\nMy BP was around 150/100 and I was started on lisinopril at 20 mg.  After 3 weeks it is typically around 130/88.  However every once in a while (twice) it has spiked back up to 150/95.  Both times this occurred it was after a day when I had diarrhea.  Two questions - first could the lisinopril be purged following diarrhea such that it takes a day or two to get back to the normal effects of the drug and second.  While on Lisonopril is it typical to occasionally have your BP break through the effects of the drug",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.We usually see the overall or majority of the Blood pressure readings.If majority of the Blood pressure readings are fine except one or two in a week, then it is acceptable.This can occur with any medicine including Lisinopril.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "How should a buttock lump and kidney pain be treated?\n\ni had a fall down 5 stairs,i had a bruise from my bum crack to the outside of my body and about 7 inches long.After the bruising started going away i have been left with a massive lump and really painful kidney on the same side.Could i have done alot of damage to my kidney ??",
    "doctor_response": "Hi,Dear,Welcome with your query to HCM.Studied your query in full depth of its details.Reviewed it in context of your health concerns.Based On the facts, You mostly seem to suffer from-Post-fall Hematoma on buttocks and Loin(kidney) region.The pain and lump in Loin-kidney and buttocks -needs to be assessed for the size and resolving status.Remedy-Do clinical assessment of Lump and the tissues related to it by a Surgeon.As you don't have any hematuria,You seem to have only Muscle injury of the loin region.This would resolve over next 2-4 weeks depending on the damage to the muscles from the fall.Tab Motrin- 1 x 3 times a day x 10 days Tab Cipllox-5oo mg x 1 x 2 times a day x 10 days -as the lump of hematoma is huge - to control any superadded infectionTab Chymoral Forte-1 x 3 times a day x 10 days Tab Zincovit 1 x 10 days timeVoltaren gel locally over the painful areas on buttocks and Loin area.After SOS/ or / 10 days time-get USG/ CT evaluation of the big lumps you have.Plan for-Wide Bore -Aseptic Needle Aspiration with Compression Dressings x 5 days time.IF relieved ok.If  recurs / or if the size is increasing at any stage-of progress-Open drainage and evacuation/debridement of Clot and Wounded Tissue and bleeding Vessels is a MUST.this needs indoor management in Critical CAre department.Other causes of bony / ligamental/vascular damage need to be ruled out and treated if present accordingly from Second opinion from  Surgeon and Ortho-Surgeon if needed.Hope that ,This reply would help you to plan further treatment soon with your treating doctors.Best of Luck and early recovery.Welcome any further query in this regard,which would be replied in next session.Good Day!!Dr.Savaskar M.N.Senior Surgical Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat body bumps in a 9 years old child?\n\nMy children ages 11 & 9 have bumps all over their bodies including their faces. They are flesh colored not red but are on their arms, backs, torso and checks neither of them are complaining of itching. The same thing happened to both children about 3 weeks ago, but the bumps were red, as this time they are colorless.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My tongue has a white and yellow coating. Is it due to yeast overgrowth?\n\nHello doctor, I was wondering why my tongue has a white and yellow coating? Do I have a yeast overgrowth? If so, when I take antimicrobial or anti-fungal herbs, it gets worse as well as when I take garlic or oregano, it gets worse which makes me think it is not a candida overgrowth. In fact when I eat Dextrose, it gets better, my stomach deflate and I do not have a nasty taste in my mouth. My hydrogen, methane breath test utilizing glucose nade lactulose showed virtually no hydrogen or methane in my breath. Should I continue the anti-microbial and anti-fungals? Thank you for your help. I have been through all the test, endoscopy, colonoscopy, gastric emptying, gastric mucosa, X-ray, CT scan but the only thing they have said I have is GERD and IBS constipation. Any help or advice would be greatly appreciated.",
    "doctor_response": "Hi. I have noted your concerns. Having had treated similarly presenting patients at my practice, I want to tell you that it is not a cause of worry. Most often this condition is seen in individuals who have a geographical tongue, or as an early sign of jaundice or some other liver disorder. It has been noted at times due to the collection of skin cells that bind herbal pigments as in smokers. Most of such patients do not need any treatment except for good oral hygiene. You only need to have your serum bilirubin levels checked and be cautious if such discoloration extends to the white portion of the eyes or other skin areas. For proper restoration of normal color, one may use Hydrogen peroxide solution in diluted form for rinses and a good tongue cleaner. Please be assured that your problem has a good probability of getting better with simple measures as the coating is piled up surface cells and need no treatment unless some other features like those listed above appear. You might consider eliminating any medication for this purpose.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Freckles on the arm after a dental procedure. Are these related?\n\nHi, my name is Marissa. I woke up one morning, after a dental procedure and noticed brown freckle like spots on my arm. I also have a brown spot on the top of my hand from the knuckles to my wrist and it is expanding. I have had these for at least two weeks. Also, the brown spots I have are no bother to me. They don't itch, and no pain. What are these spots and what can i do? Please let me know as soon possible.                                                                                                 Thanks,",
    "doctor_response": "Hello there,I would like to tell you that the brown spots o your hand has no relation with the dental procedure. The spots o your skin can be because of various reasons like allergy, hypersensitivity reactions, or any type of infection. For these spots i would suggest you to take a dermatological opinion.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful lump in throat?\n\ntwo days ago i had a sudden feeling that i have a lum in my throat, it's between my chin and my adam's apple. it hasn't subsided what so ever and it's really painful. i've had some cold symptoms as well. i know what strep throat feels like and this doesn't feel like strep throat.",
    "doctor_response": "hi.first, you have to have a consult w a physician to do physical examination of your throat.. it could be an inflammatory reaction or any oropharyngeal pathology. if there's indeed a \"lump\", further diagnostic evaluation will be done such as neck ultrasound or ct-scan. antibiotic treatment will be prescribed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for facial acne\n\nHi, im suffering from acne some are looks bump in my chin lots of this and also in my nose, after the acne it follows by the scars they are so deep and very visible, what should i do is there any home remedies, and please suggest some surgery in a low cost. I m willing to give some photo of mine after you reply. Please give your email where I will send my photos. Thanks you",
    "doctor_response": "Hi..As you said you are having acne vulgaris and scars after healing the lesions.I would like to say something about acne.There may be different forms of acne..like white comedones,black comedones,inflammatory acne, conglobet and cystic acne . Acne vulgaris is a multifactorial disease. Hereditary factor may there. There may be some cause. Stress,anxiety,oily food,dandruff, sleeplessness, hormonal imbalance,drugs like pills,steroid ..etc may cause or exacerbate the disease. Oral drugs along with topical applications might improve the lesions.You consult dermatologist.I advise in my patients having acne as below..- to avoid all suspected factors which stimulate or exacerbate the lesions- tab azithromycine 500 mg thrice a week 24 hourly consecutively for few monthsOr cap minocycline 50 mg daily in the morning.- tab isotretinoin 5 mg in low dose daily at night- clindamycine gel, benzoyl peroxide or adapalene gel to apply at night on lesions only-cleanse the face with antiseptic face wash like acmed or acwash face washAfter total cure, scar therapy may be done by expert cosmetologists. It may derma roller,dermabrasion,chemical peeling or laser therapy. According to the conviniencies, any mode of treatment may be cosidered.Have patience as the good result may be there after few months. And relapse may be prevented. Be positive and remain happy for the good result.I hope you got my answer. You may contact me on this plateform of HCM,if you wish..ok.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Betacap TR be taken to control anxiety?\n\nDear Doctor, I have been taking xet cr (paroxetine) since last three year for social ANXIETY . I had taken xet cr 12.5 mg for two years then after I was not feeling well so doctor started 25 mg now I am on 25 mg since last one year. Now I am not feeling well so I consulted my psychiatrist. he added one more medicine named BETACAP TR 40 MG.(propranolol)in prescription. I want to ask you. If I feed good with this medicine, will doctor say to continue this medicine? or will doctor gradually stop this medicine? and If he gradually stops, will I feel o.k. after two three months? Best Regards, VIJAYpe your query here...",
    "doctor_response": "Hii understand your concern.Xet cr contains peroxetine a SSRI.It will help to reduce anxiety by supplement or balancing serotonin level in brain.Betacap is propranalol and it is beta blocker. It is also used to control anxiety by different machanism than xet cr.Combination is even more useful then single one.If you do not have any side effect than it would better to continue both till improvement.There are other modalities pf treatment in social anxiety like behavior therapy or psychotherapy.Combination of drug therapy with behavior therapy will give better results and out come.I hope i have answered your query.feel free to ask.wish you a very good health.Thank you.Regards.Dr Vishal Garala.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be worried about my child putting marker in his mouth?\n\nMy 2 year old son got a hold of a sharpie permanent marker, Despite the obvious Marker on everything, he also appears to have gotten it in his mouth(according to the calligraphy on his tongue) and even though he seems to be fine( acting normally) should I be concerned?",
    "doctor_response": "HiWelcome to the HCMInks contain dyes, some alcohols and a chemical called glycol or glycol ether.  Glycols and glycol ethers can be toxic in larger amounts, but the quantity in a pen or marker is very small, to the point of being insignificant. The main issue is usually the cosmetic staining of the skin or tongue, which may last for several days.  Ink can also cause mild stomach upset rarely.So don't worry. For any further questions, do contact us.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for consistent dry heaving cough\n\nI have a consistent dry, sometimes heaving, cough. This has been going on for a year or more. I am diabetic and have high blood pressure, high cholesterol, asthma, and gastroparesis. My med list is overwhelming...up to 12 tablets a day plus insulin. Could the losartan I take for pressure be the cause of my crazy cough spasms? Am I having an allergic reaction to it or the combination with my other meds. 65 units of Novalog insulin before am/pm meals 10mg Zetia daily 3.125mg Carvedilol twice daily 5mg (2) Glyburide twice daily 20mg Omeprazole daily 25mg Hydrochlorothiazide daily 5mg Metoclopramide 4 times daily (be efore meals and at bedtime) 20 mg Pravastatin daily 50mg Losartan daily 160/4.5 Symbiotic 2 puffs twice daily 90mcg Abuterol 2 puffs four times daily 59mcg Fluticasone Propionate 2 sprays each nostril daily 2500mcg Methycobalamin (B12) daily 1000 IU Vitamin D daily 500mg Inositol daily 3000mcg Biotiln daily 50mg Tramadol as needed for pain every 8-12 hours",
    "doctor_response": "Welcome. Ace inhibitors r known to cause dry cough. losartan is an arb receptor blocker but it too can cause dry cough less so than ace is. u need to do 2 things 1st) ask ur doc to change ur bp med to observe any improvement, perinodopril is a good option. 2ndly) go to a pulmonologist n get ur pulmonary function tests, cxr pa view done to rule out any co morbidity n do proper referal. thanx hope that helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump in jawline\n\nHi, I am a 26 year old female and I have a hard pea sized lump on my jawline and its been there for over three weeks. I have tried putting a heat pack on it which seems to shrink it but it just comes up again. Please help, I am very self conscious of it. I also went off the pill which I have been on for 10 years about 4 months ago which I thought might have been something to do with it.. I started taking it again last night. Any advice of how to get rid of the lump would be very appreciated.",
    "doctor_response": "Hi Dear,welcome to HCM.Understanding your concern. Thanks for your query . The most probable reason for swelling on your jaw line is stone in salivary gland duct . The condition is know as sialolithiasis . Stone in duct block the secretions of gland and make it swell. This can occur due to many reasons like certain medicines like antihistamines or not eating enough food.I would suggest you to to consult dentist or oral surgeon for proper diagnosis . Doctor may X-ray , ultrasound OR CT scan to rule out other causes like lymph node or osteoma. Doctor may recommend yu to suck on sugar free lemon candy ,drinking lots of water , and give gentle massage to duct area . Doctor may also apple pressure on duct to expel stone . If above methods doesn't work then there will be a surgical procedure for that.Hope your concern has been resolved.Get Well Soon.Best wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are HPF pus cells in a urinalysis test during pregnancy a concern?\n\nI am 31 weeks pregnant and just had my recent urinalysis yesterday. The result is 1-3 hpf RBC, 15-20 HPF PUS CELLS ,+++epithelial cells and Protein 7, Mucoide +++, PH 7, Amorphus (ure/phs) +. I don t have any symptom of anything. What should I be worried about. Thank you",
    "doctor_response": "Hi, Your suffering from urinary tract Infection. Even if you're asymptomatic treatment may be needed. So drink plenty of water avoid, for 1-3 days. Repeat urine test. Still, symptoms not improved please consult your physician he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Penchila Prasad Kandikattu , Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain, difficulty in movement, overweight for height. What could be done?\n\nhi, I have really bad lower back pain.  it is difficult to move when I lie down for any length of time. and when I try to get up.  it hurts when I walk and is normally on the left side above my left buttock.  I am 49 and overweight for my height I am also fairly buxom.  I am otherwise healthy and walk my dog regularly for at least an hour and a half a day, the back pain is getting worse.",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum. Knee joints and hip joints are weight bearing joints of our  body. They are made to bear a stipulated weight, if  weight is more than they have to suffer and hurt. Back pain is also due to over weight as you mentioned your query. For this pain please get in X ray of lumbo-sacral region. C  T scan will also help in evaluation of back bones ( lumber as well sacrum vertebrae) . Consult an orthopaedician and get his opinion. Mere walking with a dog with slow pace will not help in any way. Hope I have answered your question. If further any question I will help. Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for weird sensation in my neck with fused C5\n\nHi I m a c5-6 tetraplegic about a week ago i was looking down at phone on my lap then all of a sudden my neck felt weird and my body went into a warm flush sensation . It s been aweek now and my neck still feels weird I try stretching it but it sometimes feels like its worsenining it . My c5 is fused to.",
    "doctor_response": "hiI would suggest reassessment by a spine doctor,for position of cord compression, whether improving or some fresh compression- an x ray or MRI may be needed.If tetraplegia is of several years duration, depending on your age, one may like to rule out ostearthritic changes as fresh osteophytes may also cause some pressure at nerve foramina, also MRI may reveal soft tissue swelling or oedema if developing and need some decompression with additional medicinesIf tetraplegia is recent , (less than a year) there are chances of healing taking place gradually and sensations, functions may improve over a course of few months. recoveries are possible even upto 2 years since.So physical therapy, and TENS stimulation of muscles of all limbs, maintainence against contractures and muscle wasting should continue with passive movements by a physotherapistBest wishesRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ulcer on top of mouth\n\nI have an ulcer-type sore on the top of my mouth for the last week.  In the last 3-4 days, a same side earache has developed.  Havent treated it at all yet.  Wondering if salt water gargle or any other OTC remedies are appropriate?  Or should I see a dentist/physician for?",
    "doctor_response": "Hello dear,First of all dont worry and be relaxed. I will provide you with my best possible advice. According to the symptoms you have mentioned it seems that the you are suffering from apthous or herpetic stomatitis.As this disease is concerned usually  it heals within 10 days with or without any treatment. \u2022 Earache may be due to the radiating pain from ulcerated region to ear. Here I am advising few things which will give you pain relief and fastens the healing process.\u2022 Avoid hot and spicy food and beverages for 4-5 days.\u2022 Eat more green leafy vegetables.\u2022 Use Rexidine, hexidine etc (chlorhexidine gluconate) twice daily.\u2022 Apply topical gel like Metrogyl-Dg Forte or Rexidine-M gel (commonly chlorhexidine and metronidazole combination). Use it thrice daily for 4-5 days.\u2022 Do not eat or drink anything for 30 minutes aftet using mouthwash and gel.Most probably symptoms should start subsiding by 2-3 days.\u2022 Take multivitamin tablet/capsule once daily for around 1 week.Hope this will help you. If there is any more query or question regarding this in your mind, you are free to ask any time. Thank You and Take CareRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the precautions to be taken after an operation of ovarian cyst ?\n\nwat r d precautions to b taken after an operation of ovarian cyst? age:18 height:5\\",
    "doctor_response": "Hello. Thanks for choosing HealthcareMagic forum. There are no special precautions. All are the same as are expected after any major surgery like, avoid doing any heavy work or exercise for six weeks. Take a light easy to digest food for initial seven days after surgery.Have plenty of fluids post-operatively. Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden altered sense of consciousness and inability to recollect events?\n\nPlease forgive the story. It is the issue. My husband said our oldest forgot to grab a container and he would go get it. So he went outside and retrieved this container, comes back in, and goes to hand it to me. I grabbed the other end. He wouldn t let go and is steady staring at me. I thought he was playing, so I told him to knock it off. He didn t answer and still wouldn t let go...while still staring at me hard. So I put the sponge I had down and went to grab it again. He dropped this container before I got to it, steps to the side, kind of shakes his head, and asks me what Im looking at. ... ... I asked him what he had just done. He couldn t answer me. I told him to stop messing with me. He still acted the same, so I repeated what he had done. He told me our daughter got the tupperware and he had never gone back outside. When I tried to argue he told me to stop lying. If our oldest hadn t seen the whole thing from his back... I would swear I was crazy. Is this maybe just stress? I don t think I can get him to go to the doctor. He doesn t believe me, but I am freaking out.",
    "doctor_response": "Hi Good morningThis may be due to complex partial seizure or delirium.It require detail history, neurological examination, MSE and if require blood investigation.Better you consult neurologist nearby you.Dr Ramashanker YadavMD Psychiatry",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will watery semen cause problem in fertility?\n\nIve been trying for a baby for a year with my partner i have normal periods .. ive noticed my husbands semen is clear like water  i went to the doctors he said i dont fall into the criteria for fertility tests im twenty and my husbands thirty please help me",
    "doctor_response": "DearWe understand your concernsI went through your details. Watery semen doesnot mean low in fertility. The water content in semen depends on so many aspects and the thickness varies. You need to conduct fertility tests to determine the fertility of the semen. You told you are trying to conceive. There are time periods where you should try to conceive. 10 days after your period and 10 days prior to the next period is ideal time period. You get almost 10 days. Try to conceive in these days. If this is not a success, you may approach a infertility specialist for fertility test. If you still need my assistance in this regard, please use this link.  Please remember to describe the whole problem with full detail.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cat bite\n\nI had bitten by a dog last year (may2010) and i was vaccinated with tetanus toxoid and anti rabies (rabipur). I have completed the schedule, by the way. And now, i had bitten again by a strange cat. do i need to take up again vaccination or not? the doctor said to me that i need a booster shot? what does it mean? please let me know.. i need answers. . please..",
    "doctor_response": "HiThanks for posting your query on HCM.I really appreciate your concern for the treatment of cat bite.Since you have taken the anti rabies vaccine (rabipur) as per the scheduled advised by the doctor in May 2010, and the the fact that you have been bitten by a strange cat you need to take two booster doses of anti rabies vaccine on 0 and 3 days.Hope this answers your query.Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does suspicious densities noted in both upper lung fields overlying upon osseous structures indicate?\n\nHelo there are suspicious densities note in both upper lung fields overlying upon osseous structures.the rest of the lungs fields are clear.the hart is normal size and shape.the trachea is at the midline.both hemidiaphragms are sharp and distinct.the osseous thoracic cage showed no significant abnormality. What is this means?",
    "doctor_response": "Hello dear, thanks for your question on HCM.I can understand your situation and problem.Upper lung suspicious lesions can be seen in following conditions.1. Tuberculosis2. Bilateral pneumonia3. Old fibrotic lesions from previous lung infection.4. Sarcoidosis rarely.So better to consult pulmonologist and get done1. Chest x ray2. CT thorax3. Sputum examination for tuberculosis and pneumonia.First diagnose yourself and then start appropriate treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I had intercourse on 14th day of month and not got period yet. Am I pregnant?\n\nHello doctor, I am a 24-year-old girl. I had my last period a month back. I have not gotten my periods in this month. I am six days late. I have taken three consecutive urine pregnancy tests after the first day of my missed period and all of them were negative. Should I trust them? I always get my period four to five days late but never this late. Should I be worried? Can I trust the test results? I had intercourse on the first and 14th day of this month. Currently, I am taking Azithromycin for minor throat infection.",
    "doctor_response": "Hello. Yes, these tests are trustworthy. You should repeat it after a week if there is no period. We may get done blood pregnancy test if urine pregnancy test is negative after a week. Upto a week variation in period is quite common. Were the intercourse protected or unprotected? Did you have an I-pill, if yes it can cause delay in period? So overall, if I-pill was taken then it is a likely cause for delayed period, or else we will wait and get test done after a week. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What caused a mini paralytic stroke?\n\nA male aged about 59 years old, he is hypertensive since 6 years and suffered stroke H/O CV in 2005, since than he is on regular treatment. He is nondiabetic. He was operated for Total Knee Replacement (Left) Surgery with OA knee + TIA on 28/05/2011. On 31/05/2011 he suffered mini paraliticle stroke. What could be the reason?",
    "doctor_response": "Hi,After the orthopedic surgeries, such as knee replacement surgery, patients are at a high risk of developing stroke as there is a tendency of blood cloth formation after those surgeries. For that reason the patients receive blood thinners after surgeries, but still some small amount of patients can develop a stroke.Take careCome back if you have any further questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in finger and hip joints\n\nFor the past 4 months I have had continuous canker sores popping up inside my mouth. I also have had aching joints, mainly fingers, elbows, hip. I am a male, 50 years old. I have also noticed blurred vision that comes and goes. For the most part I am in good health otherwise.",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms seem to be related to a arthritis. I suggest to do an xray of the hands and rheumatoid blood factor. Meanwhile,I recommend using anti inflammatory medications such as Acetaminophen to relieve the symptoms. I also recommend using cold compresses for local application. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "On birth control shot, want a baby. How to regulate period ?\n\nHi i was on the birth control shot just once and also my period has been going on for about 2 months and me and my boyfriend decided we want a baby i was wondering what can i do to regulate my period like drink plenty of water and what is a fast way to become fertile and concieve (using supplements, vitamins, or go to the doctor) and ive also read about FERTILAID and reviews said it helped well but i dont know where to find it besides online",
    "doctor_response": "Hello. Thanks for writing to us. After stopping the birth control, the periods usually take 2-3 cycles to regularize itself. This will regularize on its own without any treatment. Please do not worry.I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal ,drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp stabbing pain in left side of lower abdomen?\n\nHello Doctor. I am 30 yrs old. Ultrasound shows 15.5mm cystic septate in left overy. My doctor suggested for CA125 test and after that Laproscopy. I have very sharp stabbing pain in the left side of lower abdomen. Is this sign of overian cancer? how much i should worry for this? Pls suggest. Thanks.",
    "doctor_response": "Hello It is too early to comment about ovarian cancer.Most likely you are suffering from complex ovarian cyst and in majority of the cases,it resolve spontaneously with time.But it is important to do work-up for ovarian cancer,so you are advised for tumour markers(CA 125).Only pain is not indicative of ovarian cancer.You should go for investigations and treatment depend upon findings.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for throat swelling,dizziness and palpitation\n\nI have been having these weird spells recently. The first time was about a month ago. We were at a seafood restaurant and I was eating steamed shrimp. About 3 shrimp in, my daughter noticed my chest was red and splotchy. I immediately noticed my ears started ringing and my heart was racing, and my hands were really shaky. I panicked, thinking maybe I was suddenly allergic to shrimp. A lady gave benadryl and my husband took me outside, and within a few minutes, I started feeling better. It happened again last week while I was driving alone. I pulled into the first store I came to, and there just happened to be 2 paramedics there. They said they thought my sugar had bottomed out. However, when they checked it, it was 90. My blood pressure was 130/92. I ve had a few of the same spells a couple more times in the past week. I also have the constant sensation of my throat swelling, and I have stayed dizzy and kind of in a fog, and keep having palpitations. Any suggestions on what could be happening?",
    "doctor_response": "have u checked ur thyroid levels? neck swelling plus palpitation can be cause for hyperthyroidism.Also get done ecg.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the effects of marijuana given to people with severe dementia ?\n\nHello, I am currently looking at the effects of mariujana given to people with severe dementia.  Mu husband is in a nursing home in high care however he is in severe pain every time he moves or I'd dressed etc.  My son talked about the relief the drugs may give my husband but I am dubious of how it would affect him.  Do you have any knowledge of t his treatment.",
    "doctor_response": "Hi,Thank you for posting your question here, I will try to answer it to the best of my abilities.Medical marijuana is currently only given to cancer patients. There are theories about its useful effects on dementia and Alzheimer's patients, but it is still being researched and hasnt reached clinical trials yet, as such to give your husband marijuana, is something that may not work out. So I recommend you follow the conventional treatment till the research has progressed and has proven the uses of marijuana.I hope this answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Persistent heavy acne on forehead even on using supatretc, considerable improvement on cheeks. Advice?\n\ni have lots of acne on my forehead ... from really years... all are very tiny ones...so consulted a dermotologist recently.. he gave me supatretc which he asked me to apply for oly 1hour nd wash it off nd a facewash cutishine(3times a day).. evn i had acne vulgaris on my cheeks too... but after starting dis treatment... all acne on my cheeks cleared completely within a week... but the forehead der is no much improvement... wat should i doctor??? as ll as my dermotologist mentioned dat its comodial acne",
    "doctor_response": "Hi Jerry, Persistence of acne over forehead could be due to oily scalp or dandruff also. So keep your scalp clean. Instead of using supatret c for an hour only apply it over areas of involvement overnight. However use very small amounts and do not rub as it can lead to irritation of skin. Also if one is not having much response, you can start with oral isotretinoin 20 mg for 10 to 15 days. To prevent further recurrences it is always better to get your comedones extracted manually or by radiofrequency. Once your skin is clear, use a mild face and a water based moisturiser to keep skin healthy and acne free. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes problem in speaking clearly?\n\nmy name is john traver. my friend is having a problem since 5-6 days, we are observing that he is not able to speak properly, while speaking he takes pauses, and it seems like somebody is clutching his throat, the words are not coming properly from him mouth, and the thing he is telling is, he has to apply alot of pressure to speak. we are very conscious, and wanted to know why its happening, he dont smoke, dont take liquor, and everything with him is normal like us, in past few days he didnt have some thing unusual that can cause this kind of problem, gargles are not resolving any problem, he is not able to speak properly, he didnt have stammering problem. although he is having sinus problem. please tell the solution or symtoms, the throat is not having any swelling.",
    "doctor_response": "HiThanks for using healthcare magicIn that case, you should consult a ENT specialist first and try to get a diagnosis. After that he could consult a speech therapist for proper management. If he needs further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treated for squamous cell carcinoma, recovered from effects. Weak, left lung consolidation, on Amoxicilin, potassium. Side effects ?\n\ngood morning doc!my father (70 y)was diagnosed with squamous cell carcinoma(throat cancer) six months back.treatment(surgury & radiotherapy )has been done..now just recoverd from side effects..he is also single kidny patient..very weak.. lost 15 kg.weight.he has caught lung infection ..doc conducted some test and found left lung consolidation.he is taking Amoxicilin and potassium 625 mg three times in a day,vizylac,cobadex 2-2 times, calpol ,one anti fungal also to relieve throat pain,,i want to ask wheather he can take vizylac three times to avoid side effects of amoxicilin or not? thankx AAAAA (noida).",
    "doctor_response": "Hi, what are the side effects your father is complaining of? there are some definite side effects of radiation which is not related to the drugs like dry mouth, loss of taste sensation. swelling in local region. He has got a lung infection and for this reason he has been prescribed with respiratory antibiotics. probable side effects will be loose stool. for this reason he has been given probiotics like vizylac. Two times a day dosing will be adequate. no need to worry. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe cold and itchy anus in children\n\nhello doctor, my 2 year old baby is suffering from severe cold and cough. she is getting it frequently nowadays.she is going to babysitting also.she is telling that she is having some irritation in the anus area. kindly suggest me some medicines. how this baby is getting this disease.",
    "doctor_response": "Hello dear!I would recommend to make sure he has a face mask whenever he is with babysitter or in daycare to prevent repeated infections.Give him benadryl 4ml twice daily for 1 week along with Ivy leaves extract commercially available with the name coferb plus/no kuff or prospan.i will also recommend some home remedies like 1 teaspoon of honey in a cup of luke warm water daily along with steam inhalation.Regarding anal itching,i would say its a sign of worm infestation.You have to take very good care of your baby's hygiene.Give him syp. vermox 5ml twice a day for 3 days for deworming.give him boiled and cleaned water ,wash hands before eating anything and especially cut his nails whenever long and dirty.I hope it will help.Be blessed :-)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rise in BP and headache while on medications?\n\nI am 33 years old women Iam a hyper tension patient about  one year. I using the tablet NODON AM 2.5 every morning . Now my condition is BP is 160/100. My weight is 56kg. Iam very tired and head ache. Help me doctor I consult which specialist. Iam living in Calicut in Kerala India",
    "doctor_response": "Hello, Thanks for posting your query on Healthcare Magic...* Brief Answer: Your drug is not enough to control blood pressure,high blood pressure readings may cause headache and tiredness.*Explanation: My opinion is that high blood pressure on many occasions is an indication for control .That happens on many levels. First, be sure that high blood pressure is not secondary to any other diseases as Cushing or renal failure.Then ,Diet with low salt and less fat content is crucial. Exercise and other healthy activities are also a mean to control blood pressure. If all that dose not help, medications are a must .That is usually decided by your doctor according to your condition and comorbidities .Some drugs that are perfect for patients are not necessary good for others.Regular blood pressure monitoring is as important as starting treatment so that we could assess efficacy of the medication we started.I suggest my patients the following : increase dosage of NODONAM if heart rate is within normal limits The information provided by you is not sufficient to provide a good opinion. If someone comes to me with this condition I would ask them about heart rate and other comorbidities exist.*Conclusion: I suggest you check with a general physician and consult him about best way to control your blood pressure.   If you have any further questions I will be happy to help, If not, you can close the discussion and rate the answer. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to avoid kidney stone formation?\n\nI m 32 year old i Have both kidneys problem for 3 years my body produce oxalate stone in one day after use of some medicine stone  passed throw urine then again produce  How i can stop the produce oxalate kidney stone in my body  plz help me i m so worried about",
    "doctor_response": "Good Day and thank you for being with Healthcare Magic!I would suggest avoiding coffee, strong tea, colas, sardines, herring etc. You may search low oxalate diet and you may base your diet plan. It is also important to take in 2-2.5 liters of water per day. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at:   I would gladly help you.  Best wishes.Regards,  Manuel C. See IV, M.D. DPBU FPUA",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes welts inside mouth?\n\nI am having an odd issue. over past few days I periodically will feel welts develop in my mouth in both cheek areas. It will subside after a short time. Tonight it also occurred inside lip. It has almost subsided. There s no pain or lesions. I have.t changed diet. I am exercising more but that s only change. I otherwise feel fine and had physical last week and blood work normal.",
    "doctor_response": "Small trauma keep occurring in side The mouth and when they heal it forms welts. If you have a habit of lio and chek biting then you may have welts more.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in left side under rib cage?\n\nMy daughter just turned 13 a month ago. She had pain in her left side under her rib cage all through the night and this morning. It is now better. I thought it might just be gas, but I am worried it could be something serious, such as her spleen. Should I take her to urgent care?",
    "doctor_response": "Hello,As she is better now and her age is 13 years, I don't think that it could be something serious.Most common causes for the pain in left side under the Rib cage are:1) Trauma2) Acid Reflux or acidity3) Abdominal distension4) Referral pain due to gas in colon5) Referral pain due to renal stonesSome rare causes are spleen injury, and other referral pains causes pain under the Rib cage on the left side. So, I will advise her to take to give tablet Rantac now.If these symptoms recurred again, then I will advise to do ultrasound abdomen and pelvis and review here with detailed history and reports or consult with surgeon.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain, cellulitis, hip pain, high liver enzymes. Done ultrasounds and X Rays. Have mirena coil. What is going on?\n\nI have 3children I'm 34 years of age. My youngest daughter is 1 and 5months. 2 weeks after birth I had cellulitis in the left breast very bad infection. I was hospitalized for a week to help fight the large lump on my Breast. A few weeks later I started having left hip pain and over time this has traveled to my right hip, left knee, lower back pain. Feeling tired all the time less urinating and I also hAve damaged kidneys. I've recently had swelling appear on my left three toes it last for 3 days Also my hand might swell up on and off.  X-ray showed all clear . Bloods came back with liver enzymes high. Ultra sound showed liver. Bladder, pancreas, gallbladder all normal but a large cyst is on my left ovary. I've been having stomach pains which I out down to constipation. My dr took more bloods and wants to discuss this week. I had the marina coyle put in 6 weeks after birth and I'm wondering could this be the cause and does the above look serious. Any advise would be much appreciate. Kindest regards Shirley",
    "doctor_response": "HIThank for choosing HCMYour IUD is nothing to do with your present complain, you had breast swelling, and you said it was pretty bad, so it could be infection, that might be a blood born infection, the infection of hip joint should be rule out, on tentative base you can start the antibiotic, or else should get done the investigation in this manner, the elevated liver enzyme is indication of liver cell damaged, it does not seems any thing much to worry, it will come around have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the upper back/neck after head injury?\n\nweight fell on my head and from this I have some pain in my shoulder blades or middle of my upper back and depending on the position of my body its hard to take a deep breath. funny thing is before this I seemed to always have pain in back of my neck shoulder and head but now its gone",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. It could be muscle sprain or fracture.2. Get an x-ray of neck done to rule out any fractures. If no fractures, you might require a cervical collar support for few days. Later on physiotherapy and neck exercises are necessary.3. If pain is severe, you can take NSAID pain killers.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sinusitis and upper respiratory tract infection\n\nI ve had a mix of what has felt like sinusitis and an upper respiratory tract infection for about 3 days now. It started with a sore throat that I could feel in my ears (if that makes sense), almost like an itchy sensation, hard to describe. That was day one. On day two it progressed to congestion in my sinues (pressure in my forehead and nasal sinuses), then on to stuffy/runny nose, and sneezing. On day three I have a burning sensation in the upper broncial tree area of my chest and I have a slight productive cough, with light yellow sputum. Do I need an antibiotic or do I just need to ride this thing out until my immune system kicks in? Don t wanna waste a co-pay. Thanks in advance!",
    "doctor_response": "hellowelcome to HCMyou should start drinking plenty of water and veg juice. start neti pot immediately.  eat vegetable and light food. don't take heavy meals. use warm clothes around your face for 4-5 times a day. saline spray and steam inhalation 2-3 times a day will relieve your symptoms more speedy.use paracetamol for relieving pain. i think antibiotics are not needed at this stage. it will needed if cough with more than a week or high temperature. if you have allergy from something strictly avoid it.thanks for contacting HCM",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a painful bump on the wrist?\n\nHI, My name is Daisy and I have a bump on the top of my wrist. It hurts when I move my wrist. I do pop/crack my wrist sometimes. About two months ago it appeared and I don t know how. But when I went up north, it did disappear, I also don t know how, but while up there, I fell off a wall and landed on my wrists, left more than the right wrist (the one with the bump is left), and I had thought I may have sprained my left wrist, but I never go to hospitals for anything so I just shook it off. When I got back home, I just then noticed it was there again. My sister and I think its a bone out of place. What do you think?",
    "doctor_response": "It may be a ganglion cyst.The cause of ganglion cysts . that trauma causes the tissue of the joint to break down, forming small cysts that then join into a larger, more obvious mass. The most likely gaglion cyst involves a flaw in the joint capsule or tendon sheath that allows the joint tissue to bulge out.Ganglion cysts most commonly occur on the back of the hand at the wrist joint but they can also develop on the palm side of the wrist. When found on the back of the wrist, they become more prominent when the wrist is flexed forward.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hello Doc, I hope You Can Answer My Few Questions.  Is it safe for a person with epilepsy to take benzonatate??The side effects appear to be somewhat dangerous. What about about fluticasone propionate? The side effects on that appear to be somewhat scary.",
    "doctor_response": "So both of these drugs are generally safe for use in Epileptics. Benzonatate is going to numb the nerves which are irritated and causing your cough (i assume a cough was the reason for the prescription). It shouldn't be used for a very long time. If your cough persists, please talk to your doctor. Fluticasone is a drug, very similar to a steroid which is generally prescribed for Asthmatics and/or people suffering from a disease called COPD (Chronic Obstructive Pulmonary Disease). It is usually inhaled since its absorption through the gut is poor.Fluticasone is a drug which should be used very carefully under physician supervision, especially if you have liver problems (because your liver has to break the drug down). Using it may require your doctor to change the dosage of your anti-epileptic medication (or medications)Overall I would say that they are both safe to use under medical supervision and with regular checkups by your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for itching and redness on foreskin\n\nI have oozing from foreskin, redness of forskin just below the head and redness of the head. I have washed it everyday for two weeks and put neosporin on it whenever possible. no problem with urination... I am at a loss, no sexual contact in three years!....confused",
    "doctor_response": "HelloThanks for query ,Redness of the foreskin and glans penis with oozing from foreskin is mostly due to infection of Foreskin and Glans penis (Ballano Posthatitis).Many a times these symptoms are presenting symptoms of impending diabetes hence get your blood sugar tests done to rule out diabetes .You need to take broad spectrum antibiotic like Cefotaxime along with anti inflammatory drug like Diclofenac twice daily along with topical antibiotic ointment like Neosporin twice daily.Ensure to wash your genitals with warm water twice daily.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is mold causing headache and sinus problems?\n\nHi, I have been having mold problems in my house, I thought I got rid of it last year but it came back.  Since that time last year I have had bad allergies, headaches, and sinus problems and trouble breathing.  Now I have had diarrhea for the last four days with pain in my abdomen, and am wondering if it is mold sickness.  Can I wait to schedule a doctor's appointment or is it something that needs to be treated right now?  I am 25 years old, 5'9, 170 lbs, I have had a history with allergy and stomach problems.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Yes, mold can cause all the problems that you have mentioned above.You should visit the doctor and get the antifungal medication as well as anti allergic medication. Fluconazole, cetrizine, prednisolone and salbutamol can be helpful in the treatment. Please take the above drug under your doctors guidance.Mold should not be present in the house otherwise it can cause multiple problems which can vary from the small health issue to the large health problem.Engineering method should be adopted this can be helpful in clearing the mold from the house. Wet area should ne sealed so that no mold arises out of it.Please maintian good hygiene as this can be helpful in treating and precenting this infections.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Painful breast, dark scar and spots. Ultrasound ruled out cancer. Prescribed femicol. What can be done?\n\nI was having some pain in my left breast , after 6 months, some dark scars or spots emerged over it and now its size is also reduced! I got an ultra-sound report veryfying the presence of a lump in it, doctor said its not cancerous and she prescribed me Femicol as medicine! i have been using it since last 4 months, the pain is reduced somehow bt i m seriously worried about its size-rreduction as well as the scars on my breast. plz guide me.",
    "doctor_response": "Hi, if your mammography report came as something like a benign lump you can surely rely on your radiologist. Fibroadenosis can be a diagnosis. no chance of cancer as cancer lump will not regress automatically. you may repeat your mammography after 6 months . at present nothing to be worried. Continue the medicine prescribed by your doctor and keep in touch with him. take  care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have swollen spleen, liver, legs and feet. Painful. Levoscolosis with compensatory spondylosis changes. Cause?\n\nI have swollen spleen and swollen liver. My legs and feet are swollen almost twice the size , the are hot, and hard and too painful to walk on. THEY  are red and tight.and a very painful spot on my side from my hip to where my ribs start. I have severe levoscolosis with compensatory spondylosis changes with apex at L3-L4. What could be causing the painful swelling  Thank you  !",
    "doctor_response": "Hi and welcome to Healthcare magic. Thank you for your query. there are various conditions which can cause kiver and speen swelling. Most common are haematologic disorders such as trombocytopenia purpura, haemolytic anaemia etc. Also some vasuclar diosrders and vascular obstruction,some methabolic diseases and infectious disease. You need detailed gastroenterologist examiantion and tests to rule all this out.  Hope I have nswered your query.  Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in upper right side in intervals. Physical exercise ok?\n\nMy son had upper right side pain after many sessions of tenis ,he plays everyday.becos of garden leave.he has no apendix was done at 10 years old. Also had galls stones taken out 17 yrs ago .now he is 41 married .last nite doctor gave him an injection to stop the pain ask him to  heck in hospital for checkup. He said he is not in pain now and will play tenis in afternoon. After research I think he should go imediate for checkup and rest instead of tenis . Do you think tenis is too strenous for him and might affect his liver pancreas..? He is difficult to have kids too. He should care for his kidney .thanks",
    "doctor_response": "Welcome to HCM.Pain is not due to playing because he plays regularly everyday.He has to go for complete investigations to rule out pain as well as fertility test.CBC,URINE and usg abdomen will guide for renal stone,gall bladder stone and other abnormality in abd. Semen analysis is necessary.If he wants child than his wife's investigations are also necessary.Better go to hospital for checkup and further diagnosis and management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain on left front side of skull along with high BP?\n\nI have pain in the left front, side and back of my skull, particularly over the left ear. My CT scan shows an anomaly on the left side of my head. There is no pain right of center. It feels like the bones are hurting. The pain started after a sudden raise of my BP ((194/109); however, the pain inow is present in the less high BP s as well.",
    "doctor_response": "Hi, welcome to our site. I am Dr Saumya Mittal, MD.Read your query. That is a very significant question and i appreciate your problem. I will try my best to answer your queryHowever, you have managed to skip the exact report of the CT scan. This is important because that itself can be the answer of your query.I therefore request you to upload the report completely so that we can give a useful advise to you.I hope this helps you. Inform the reports mentioned above/if any other so I can be of help further. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you. You can upload them on the site.You can upload them with the query, or if you have a problem, send them to attachments@healthcaremagic.com with Sub: ATTN 'Your Name'. Once we receive the photos or diagnostic reports, my team will send reports / pictures to me.Please do understand that some details could be extracted from a detailed history and examination.Please click on Thanks/Helpful if found useful.Please feel free to ask another query. I would be glad to help you. Looking forward to your return query with the details asked so that I can help you further. (If the answer has helped you, please indicate this)Best of luck.Dr Mittal.MBBS, MD (Internal Medicine), CC (Diabetes Mellitus), DNB (Neurology)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Began the pill Microgynon 30, had unprotected sex after it. AM I protected or not ?\n\nHi, began the pill Microgynon 30 on Tuesday which was the 5th day of my period. My doctor said I would be protected imediatly. So the day after I had unprotected sex, which I know was stupid of me to do, but by then i had taken 2 pills and was under the impression that i was protected. I was on top and i told my boyfriend to pull out but he didn t do it fast enough. I went to the toilet straight after and most of it came out and then there was only a little bit remaining the morning after. The BBC website and NHS website also say that if you take it on the 5th day you are protected unless you have a short ovulation cycle but my periods are irregular usually so i didn t know if i was in that category and many sites seem to be skeptical about it working imediatly on the 5th day . I recently read that if you take 4 Microgynon tablets within 120 hours of having sex and then 4, 12 hours later that is can act as emergency contraception . Being paranoid and panicking about the possibility of getting pregnant I took 4 tablets and i don t know whether to take another 4 in the morning because that would mean only having 7 pills left in my pill pack. And if i do that should i take the 8 pills out of the second pack and then bleed or should i just bleed when i ve finished my first pack. Everyone just told me to take my pills as normal but i couldn t stand the waiting. Please help!!",
    "doctor_response": "Welcome to HCM.First of all you had unprotected sex on 5th day and it is not the fertile period so there are no any chances of pregnancy.The day you started pill is the right day and no need to worry,you have to continue it till complete pack.It will definitely protect you to become conceive.Now wait for next cycle without any worry and if you miss the cycle than go for urine pregnancy test and consult your gynecologist for further guidance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long will it take to recover from liver abscess surgery?\n\nHi doctor, I got a\u00a0minor surgery for liver abscess\u00a0and a drain was installed. Pus in the color of chocolate and little thick is coming out. Is it normal? How much time it will take to recover? For how many days the drain has to be installed?",
    "doctor_response": "Hello. I had gone through all the data you have posted. We need to know some more details about your problem. Liver abscess is mainly of two types: Bacterial and amebic. From your description as chocolate like pus, it goes more in favor of amebic etiology. So, we need to keep you on tissue agents like Metronidazole, luminal agents like Diloxanide furoate and Paromomycin for elimination of ameba from the intestine. If pus culture grows bacteria or if abscesses are multiple, then we need to provide specific coverage against the organism. Depending upon the amount of pus inside, it is normal for draining of pus like that. Time to recovery depends upon the cause of amebic versus bacterial, size of the abscess and white blood cell count. Drain needs to be continued until full drainage of the collection is done. Repeat ultrasound scan has to be performed to look for residual collection. Manipulation of the position of the drain may be needed for drainage of residual collection. Once the collection becomes dry, then the drain can be removed. Revert back with the answers to the above questions to an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Small sized left and right kidneys, reduced crotical thickness, increased echotexture, effaced corticomedullary differentiation, compact pelivicalyceal systems. Indications?\n\nMy son Rahul , age: 21years, height:6ft 2inches , weight: 80 kg is reported # Right kidney appears small in size (71.2x32 mm), Crotical thickness is reduced. Ecotexture appears increased. Corticomedullary differentiation is effaced. Pelivicalyceal system is compact on right side. # Left kidney appears small in size (52.9x32.8mm), Crotical thickness is reduced. Ecotexture appears increased. Corticomedullary differentiation is effaced. Pelivicalyceal system is compact on left side. # Biochemistry Serum Creatinine 7.8 mg/dl Serum Urea 82 mg/dl # Other systems like liver, CBD, Gall Bladder, Pancreas ,Spleen, Urinary Bladder and Prostate are reported NORMAL.",
    "doctor_response": "Hello Thanks for your query.Based on the Ultrasound report that you have submitted it appears that your son has got Bilateral Renal Parenchymal Disease.called as Chronic Renal Failure This fact is substantiated by his increase serum Creatinine level which is 7.8 mg/dl and serum urea of 82 mg/dl.Please consult some Nephrologist for proper evaluation and further management. as he needs to  under go Dialysis.to reduce his Creatinine and  Urea levels.",
    "dialogue_context": ""
  },
  {
    "patient_message": "lymphocytic colitis. How to get rid of the pain ?\n\nMy husband is 66 years old who has lymphocytic colitis . Since he ate some butter baked squash and apple crisp 2 weeks ago, he has flare up and abdminal pain and sometimes his abdminal pain is so severe to wake him up in the middle of night. My question is: what kind of over the counter medications he should take to get rid of the pain?",
    "doctor_response": "A person should seek medical care if the diarrhea lasts for more than 2 weeks or is accompanied with symptoms such as weight loss, fatigue, and abdominal pain. The treatment of microscopic colitis has not been standardized because there have not been adequate large scale, prospective, placebo controlled treatment trials. The following strategies are safe and may relieve diarrhea in some patients: Avoid nonsteroidal antiinflammatory drugs (NSAIDs) Trial of lactose elimination (just to eliminate the possibility that intolerance to lactose in milk is aggravating the diarrhea) Antidiarrhea agents such as loperamide (Imodium) or diphenoxylate and atropine (Lomotil) Bismuth subsalicylate such as Pepto-Bismol budesonide (Entocort EC) 5-ASA (mesalamine) compounds such as Asacol, Pentasa, or Colazal Controlled trials showed that budesonide (Entocort, a poorly absorbed steroid) is effective in controlling diarrhea in more than 75% of the patients with collagenous colitis, but the diarrhea tends to recur soon after stopping Entocort. Though data supporting their use is lacking, some doctors may use medications that potently suppress the immune system such as azathioprine (Imuran, Azasan) and 6-mercaptopurine in patients with severe microscopic colitis that is unresponsive to other treatments.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for upper back pain and numbness in hand\n\nHello, I have an upper back issue near the rohmboid and scapula (right side). When it flares up I darn near have to take the afternoon off of activities with my kids. I m a single dad so I pretty much refuse to do that. I trudge through my day at work, my right hand goes numb. It is beyond frustrating, I first felt it roughly 1 1/2 years ago, while working extending with the arm repetitive motion doing janitorial.It has progressed worse and worse. I work fast repetitive motion all day long. I recently had an MRI of upper extremity focus on rohmboid right shoulder I got the Mri and supposedly it came back normal. They can feel inflamation, that s why 1 doctor wrote an mri for likely tear . Now the mri says normal my PA says I m fine. ?",
    "doctor_response": "Hello, If you are performing repetitive activities with your arm/shoulder and you feel the pain or sensation of discomfort/swelling in the mid to upper back region where the scapula and rhomboid muscle are located then, you could have a nerve entrapment syndrome of a twig of the dorsal scapular nerve that supplies that region. I recommend seeing a neurologist and describing your symptoms. This should prompt an examination of the back and the affected area to see if you have anything that we refer to as myofascial pain. In your area of complaints, swelling, WINGING SCAPULA, or any other physical evidence of trauma or positional entrapment of even blood vessels in the area that can occur from sitting too long in one position, sleeping on the affected side without moving enough, etc. An EMG/NCV study could demonstrate abnormalities of nerves and muscles in this region as well. Also, I would recommend either a CT or PLAIN X-RAYS of the thoracic spine and right shoulder girdle in both flexion and extension positions (something not able to be done on an MR scanner) which can demonstrate other causes of this sort of pain such as arthritic degeneration, scoliosis, other skeletal abnormalities irritating structures in that region. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain and burning sensation in back and area where gallbladder is removed.   Scanning showed bulge and shadow as if stone left in duct,  mrcp scan normal.   Non cancerous spots in liver.   Guide\n\nhi, I had my gallbladder out in may 2012 and still I am recieveing a lot of pain in the same area also radiating on my left side sometimes feels like a burning sensation also pain in my back also feeling very sick..i was rescanned back in November 2012 which confirmed I had a bulge and a shadow which looked as if I had a stone left in the duct I went on to have a mrcp scan and radiologist could not find anything???..I have had my liver checked which they found spots which where confirmed non cancerous they said something to do with calcium??..im very confused feel as if im not getting anywhere with my gp...",
    "doctor_response": "Dear Sir/ Ma'am,Sorry to hear about your problem. Your pain could either be due to a stone left behind, which has been ruled out by MRCP. The other cause of the pain after cholecystectomy is post-cholecystectomy syndrome which is because of faulty drainage of bile. It is a diagnosis of exclusion and the there is no standard management as of now.The spots in the liver have been confirmed to be benign and but multiple lesions could be another cause of pain.You should visit a gastroenterologist or a surgeon and have your symptoms and reports evaluated.Hoping for the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe shoulder pain?\n\nI have tremendous shoulder pain that feels like a scalpel has cut me open from my armpit straight up and over (like a strap) and the pain is also acute in the bottom of the shoulder blade. It hurts for my arm to hang at all, it is especially prominent when I m walking or doing anything which makes the hang or bounce more pronounced. I can not sleep or put pressure on it. It feels like an open wound! (It is not a torn rotator cuff.)",
    "doctor_response": "Hi, The symptoms are more or less consistent with a tendon or ligament injury. As the first line of management, you can try analgesics like tramadol or diclofenac for pain relief. If the symptoms persist, you can consult an orthopaedician and get evaluated, you might require an MRI scan in sever case. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain on the side of cheek due to accidental biting, looks indented and sore. How long will it take to normalize?\n\nhey there, i just have a quick question. i woke up this mourning and i have a pain on the side my cheek so i check it out and its like a huge piece of my month is hanging over i think. it looks like i bit it while i was sleeping and now its like en dented and vary sore i was just wondering if you ve heard of anything like that and or how long or if it will go back normal",
    "doctor_response": "hi, it seems that you accidently bit your cheek while sleeping, it will heal spontaneously within a week. You can apply mucopain gel on the affected area twice a day for pain releif, avoid eating hot and spicy foods till it heals. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is dilation of the ureter due to obstruction in the urine flow?\n\nmeans the part of kidney draining urine to ureter(connecting tube between kidney and urinary bladder)is dilated..it may be a temporary dilation or due to some obstruction of urine flow. \u0964\u0938\u092e\u0938\u094d\u092f\u093e \u0915\u094b \u0939\u093f\u0902\u0926\u0940 \u092e\u0947 \u0938\u092e\u091d\u093e\u092f\u0947",
    "doctor_response": "Hi, It may be due to some obstruction.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Indu Kumar, Radiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Liver test 200, cholesterol 7.7, shoulder pain, stomach ache, cold sweat, feel like heart attack. Suggestions?\n\nHi I had a liver function test 4weeks ago and have been told it is over 200 with colesterol at 7.7 my lft  2 years ago was 96 and colesterol was 4.5 I get intermittent left (my left)shoulder pain and every 6weeks approx. I get a bad stomach ache followed by hot n cold sweats and feels like I would imagine a heart attack would feel. It leaves me bed ridden for the rest of the day. I get occasional indegestion and am always tired. Thanks for reading this Lesley",
    "doctor_response": "Hello Lesley!  Normally gall bladder Infections present with epigastric pain and are  referred to tips of the shoulders, and cholestrols rise too but as you said pain is intermittent so it is more like a chronic history. then you said perspiration with anticipation of heart attack? how old are you ? above 40? i am suspecting 2 things1) more likely it looks like chronic cholecystitis ( your gall bladder) 2) inferior heart MI also presents this way so here is what we gonna do-Do an ECG to rule out cardiac involvement, followed by echo and MR scan of the heart if requiredif that area is clear- then we need to clear hepatobiliary suspicion. to do that i advise-U/S abdomen and pelvis-serum amylase, lipase, amylase to lipase ratio, urinary amylase, plain xray abdomen Ap view followed by a CT scan if required, serum calcium ( both ionized and total) HBsAg and HCV.Mean while trea yourself for symptoms-get Proton pump inhibitord like omeprazole etc 40 mg once a day an hour before the meal or 3 hours after it-Take some antispasmodics like Spasfon-use less fatty meals-lose weight-Get a broad spectrum antibiotic if you have a feveri am sure you will have your problem fixed with itGood luck and get well soon :)RegardsDoctor Shafi Ullah KhanMy Patient is my family",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bad breath and body odor with OCD\n\nKINDLY SUGGEST SOME MEDICINE TO ME AND REVIEW THIS ANSWER THAT I GOT FROM SOME INTERNATIONAL DOCTOR. I M STILL WORRIED ABOUT MY HALITOS PROBLEM... :(( ------ Dear Sameerq, Everyone gets bad breath from time to time; there s just no getting around it. When we eat, food particles get stuck in between teeth and collect on the tongue and from there they break down into a bacteria-infested mess. We can also have germs and bacteria in the back of the throat and anywhere along the sinus cavities, all of which get caught in the breath as we exhale. And odors from food itself can linger in the mouth; just try to eat garlic or drink coffee without getting bad breath! So to ask if your bad breath is normal may seem a bit strange since everyone gets it. However there are some that seem to have a chronic problem with this no matter what, and some who seem almost obsessed with whether or not their breath is bad. There is actually a condition where a person is afraid of bad breath, whether theirs or someone else s, called halitophobia. It s thought that less than 1% of the population has this particular phobia so it s very unlikely that your thoughts about bad breath are an actual fear or phobia; chances are you just want to be sure that you re not offending anyone every time you try to talk. It s also true that some people have Obsessive Compulsive Disorder (OCD), which is another mental illness where a person obsesses over minor details and often feels compelled to fix them. OCD also affects a very small percentage of the population so that s probably not your problem either. But realizing that your concern about bad breath is not a true mental illness also doesn t mean that you should start ignoring the problem either. Just as a person should be concerned with all aspects of their hygiene, bad breath should be something that is addressed and prevented where at all possible. A bad odor on the body can signal a need for cleaning, whether it s an odor from the underarms, soles of the feet, genitals, or the breath. Bad odor usually comes from a buildup of bacteria and germs and of course this shouldn t be ignored. The same can be said of your breath - chronic or consistent cases can be a sign of tooth decay, gum disease, and other problems in the mouth and throat that should be addressed also.",
    "doctor_response": "HiI had gone through all details and agree with him also.But detail evaluation about OCD spectrum disorder is must.Sometimes all these are interrelated in spectrum.Olfactory referral syndrome has same features of obsession about body odors and body dysmorphia is also same type o etiology.Obsession of body odor can be part of OCD.So Treatment Of obsession and OCD make all spectrum together.It can be treated with fluoxetine 60 to 80 mg and add on other medicines depends upon psychological evaluation.So please do consultation with best psychiatrist and discuss about spectrum and its treatment.Still have a query then feel free to ask.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in middle of the chest?\n\nGood day, I have a constant pain in the middle of my chest, in the centre. It feels like muscles contracting together and I have to stretch alot to get this pain out of my chest, but as soon as i sit down, or lie down, it's back again. I've been to doctors but their scans showed nothing wrong. But in my opinion there must be something wrong, for this pain is constantly there. Please advise.",
    "doctor_response": "HelloProbably stomach or muscles problems might be the cause.Discuss with your doctor for this.RegardsDr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes body cramps and walking difficulty?\n\nhi I am a 49 year old male don t smoke or do drugs I work it started about 3 years ago body cramps its just getting worse I cant walk legs will cramp up if I use my arms they will start cramp up and now I think my back muscles are trying to cramp up and when they do its very painful",
    "doctor_response": "Hello, The possibilities are neuropathic pain and peripheral vascular disease. Consult a physician and get evaluated. You have to get a vascular Doppler to look for vascular causes. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump around my neck, both arms and stomach?\n\nHave this small painless lumps around my neck on both arms and stomach. had a check 4 years ago and a biopsy was done on one of them and was told it is a sabecious cyst. Is there need to worry? they are still in the same exact positions. Do i need another check now?",
    "doctor_response": "HI.Great finding of so many sebaceous cysts , one of which was biopsy proved to be sebaceous cyst.There is no need to worry as such as they are never going to transform into cancer or so. But they are going to be a potential source of secondary infection..I would advise you to get them removed , all of them so that again you are going to have a tissue / biopsy diagnosis and the best part is you remain disease free.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recurring mouth ulcers. On tonact-tg, vitamin-E, folic acid for high cholesterol, triglycerides. What is the cause?\n\nI am 47 years old.just two months before i had my lipid profile done and my cholestrol and triglycerids both were high.so i was advised tonact-tg for two months with vitamin e tablet also and miltivitamins too.I am pure veg.I also do exercise ( gym/ yoga ) thrice four times a week.When ever I have time I also go for long walks.But now i am facing problems with mouth ulcers frequently in very mild form.I take folic acid tablets too.But it gets cure and comes back again.So is this due to tonact or some other problem.Please advice some remedial measures.Shall I do my tests again.hope for the answer soon.",
    "doctor_response": "Hello, There are different types of mouth ulcers that can occur in different physical conditions. Practically  higher cholesterol and triglycerides does not directly relates to any type of mouth ulcer. The anti-lipid drug that has been prescribed to you is also not related to formation of any mouth ulcers. But in suppressed physical condition some different mouth ulcers can occur. It is extremely difficult to diagnose such ulcers without seeing them. Your history of occurrence  \"gets cure and comes back\" shows that the ulcer is most probably Recurrent Apthus ulcer. A picture of that ulcer will confirm the diagnosis. If the ulcer is painful you can use Zytee or Mucopain cream 3 to 4 times a day to reduce pain. The actual treatment of mouth ulcers can only be done after confirming the diagnosis. For that you have to contact some local dentist( preferably a specialist in oral medicine whom you can found in nearby Dental College or hospital) or send your details here including photograph of the lesion. Stay well. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for difficulty in breathing and dryness\n\ni wasn t feeling well today. maybe i took too much spicy. i might have felt burns. i took pepto bismol. i used to have asthma, so i took my inhaler to improve breathing. i haven t used it in a while. i only took 1 puff, but then i felt worse. i feel as if closed breathing, not open enough. dry.",
    "doctor_response": "Hi thanks for contacting HCM...You have history of asthma ....So this time difficult breathing could be from asthma precipitation...I would suggest you to consult pulmonologist for respi examination including auscultation also ..If rhonchi heard than pulmonary function test done to assess severity and accordingly management ....If it is severe one puff might not effective and you might need short course of steroid or nebulization with levosalbutamol and budesonide ....Avoid smoking .....If you have problem of acidity also pentoprazole can be taken for that ..Hope your concern solved .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is my blood pressure medication effective?\n\nI have BP that goes from high 130-145 over high 80-95 with a pulse rate of 90 s. I am on a low dose of Metoprolol and now BP is better, 115-125/75-85, but, pulse is still around 77-90. I still don t feel right as my initial symptom before meds was feeling pressure in my head and like i was dizzy or going to pass out. What else could be at play? Should I try other meds? I am worried that my diastolic and pulse are still high.",
    "doctor_response": "Hello!Thank you for your question on HCM!Regarding your concern, I would explain that your symptoms don't seem to be related to your blood pressure. Your actual blood pressure values seem to be OK. Your diastolic blood pressure is within the normal ranges too. Regarding your heart rate, it doesn't seem to be elevated, becuase it is normal to have similar fluctuations during the day. Nevertheless, I would recommend performing a Doppler ultrasound of the cervical arteries to examine the blood flow to the brain and exclude any possible vessel stenosis, which could lead to the episodes of dizziness. Thyroid hormone levels, are necessary to exclude possible thyroid dysfunction. Regarding your headache, I would recommend consulting with a neurologist for a careful physical examination and a possible brain CT scan to find out the cause. A routine blood tests for chronic anemia or inflammation would be necessary too.  Hope you will find this answer helpful!Greetings!Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Not taking tri-sprintec pills since 6 months, had unprotected sex. Can I take tri-sprintec now?\n\nI have been taking Tri-Sprintec for years now, but about 6 months ago I stopped taking it. I have a prescription...I had unprotected sex and would like to use a method of plan b. Can I do this using the birth control pills I have? I heard if I take a certain amount of them that will work. I am 23, 5 5 and weigh 140 lbs.",
    "doctor_response": "Hi,Welcome to Healthcare Magic.I am Dr Ramadevi Wani. I will be answering your concerns.Plan B pill is more effective as emergency contraception than birth control pills used as emergency contraception. So it is better to use Plan B. Yes it is true that some birth control pills can be used as emergency contraception. Any birth control pill that contains ethynyl estradiol and Levonorgestral can be used as emergency contraception (eg LO/Ovral, Alesse, Lutera etc). The dose is 100 mcg ethinyl estradiol and 0.5mg of levonorgestrel taken as soon as possible after unprotected sex and repeated again after 12 hrs.Tri-sprintec  contains Ethinyl estradiol and Norgestimate. There is no evidence regarding its effectiveness as emergency contraception. Therefore don't use tri sprintec as emergency contraception. Instead you can use any of the above medicines as emergency contraceptive pills.I hope this is helpful.If you have any further concerns do contact me through Healthcare Magic.Best wishes,Dr Rama",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes prolonged body tremors and difficulty in balancing in a diabetic person?\n\nmy husband has been diagnosed with essential tremors. He has had it for over 30 yrs. They have gotten significantly worse. His hands both shake uncontrollably and eating with silverware is awefull. He is a diabetic and is having so much difficulty just doing anything. His balance is bad ... What can we do?",
    "doctor_response": "Hi, The symptoms you have described is neurological and complete cure is unlikely. You can consult a neurologist and get evaluated. You have to make sure that the diabetes have to be well controlled as uncontrolled diabetes can further worsen the neurons and worsen the symptoms. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could it be if body felt very heavy after waking up from nap along with lightheadedness?\n\nI've been lightheaded for years and tonight after getting up from my nap my body felt so heavy like I was being squished to the ground .. kind of like my body weighed a ton along with the lightheadedness & it goes away when lying down .. what could this be?",
    "doctor_response": "this is a symptom called orthostasis.   as with all symptoms there are many possible diseases that cause it as well medication interactions and only your doctor will be able to tell what the cause is.  the treatments will depend on the cause",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pregnancy happen while on Nuva Ring?\n\nHi, may I answer your health queries right now ?  Please type your query here...I've been on the nuva ring for alomost a year but over the past month and half I take my ring out when I have sex and when I take a shower. Sometimes I forget to put it back in sometimes up to a day. Than when I remeber I put the same one in. Over the past few weeks I have had a feeling like I want to throw up. What are the chances I'm pregnant. I haven't taken a test yet. My period is due tomorrow.",
    "doctor_response": "Hi, I think if you have not used nuvaring properly, there can be a chance of pregnancy.  So, if you don't get your periods in time, do a urine pregnancy test at home.  It will clear your doubt.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Passed a large number of clots on my regular period. Could it be a miscarriage?\n\nHi doctor, I am 26 years old and sexually active. Last month, I anticipated getting pregnant and hence, was sexually active during my ovulation. I started having funny symptoms like bloating, cravings and headache. I so much felt like I was pregnant. A day before my expected date of the period (27th day of the cycle) I did a pregnancy strip test, and it turned out to be negative.\u00a0On the 28th day,\u00a0I got my period and had a\u00a0large number of blood clots than the normal bleeding. I feel like I was pregnant despite the fact that my period\u00a0came on the expected date.\u00a0Is it possible that it could be a miscarriage?",
    "doctor_response": "Hi. The symptoms you mentioned could be due to pregnancy which may not have been healthy, and we cannot predict. If it had been healthy, you would have had a weak positive urine pregnancy test. So, most probably you were not pregnant. We have other possibilities like pelvic infection and polyps or fibroids. Regarding pelvic infection, sexually transmitted infection around uterus will cause discharge from the vagina, yellow or white or grayish, with or without itching or foul smell, more after sex or after periods. Throbbing pain in the lower abdomen before periods, bleeding is reduced, dark red or brownish color, with fleshy masses or clots, pain at the end of sex. It This would need an evaluation by gynecologist and treatment with antibiotics and antifungals to both you and your partner. The less common cause at this age would be polyps or fibroids, and it needs a scan. If you have been trying for around one year to get pregnant, then you can plan to get investigated for a cause. Kindly see if the following checklist of investigations is done. It is a must to confirm tubal patency. The tube is the connection between uterus and ovaries. It is a bridge where sperm meets the egg and forms a baby. It is in size of a hair follicle and cannot be seen on scans. Being such a small opening, the tube can get blocked easily. So, check with HSG (hysterosalpingography - x-ray with dye) or SSG (sonosalpingography with dye) or laparoscopy. If all the above are found to be normal, then nothing can stop you getting pregnant. All the best. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal cramps caused by an injury\n\nHi my boyfriend and I suffered an assault on Friday evening.. my boyfriend suffered head injuries from punches. He was swollen on one side of his jaw.. he had stiches in his lips. He has been having fluids but not eaten a great deal due to his mouth and the stiches. He has started eating little now but is suffering from stomach cramps.. could you please help?",
    "doctor_response": "Hello,He could have some internal injuries. He really needs to see a doctor for an exam. If he is unable or unwilling to see a doctor at this time give him liquids like soup and see how he tolerates that. If he still cramps he will needs an exam.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rapid pulse with skipped heart beats?\n\nMy pulse is up normally runs in the upper 70 s,,, today it is in the mid 90,s. for the past couple of weeks I have been noticing more skipped heart beats,, and today I have considerably more skipped beats. I guess it has happened a dozen or more times today. I did consume more scotch last nite than I usually do,,, I dont ususally drink but maybe every few weeks. Can this rapid pulse and more skipped heart beats be symptoms from a hangover ?",
    "doctor_response": "Hi,The rapid heart rate and skipped beats may be a result of consuming more alcohol than you used to. Don't worry, just drink much water and have a rest, it will go away in a day.Wishing you a good health.In case of any further questions don't hesitate to contact me.Regards,Dr. Baghdasaryan",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does peanut oil last in body after eating?\n\nI have a mild peanut allergy and just ate a chicken sandwich at Chick-fil-A. I didn\u2019t realize until after I ate it that all of their food is fried in 100% purified peanut oil. I read online that most peanut allergy sufferers do not react to purified peanut oil because of the hotness/purification or something like that. I do not think that I will get sick but I am most worried about my boyfriend. He is severely allergic to peanuts and when I go home tonight I don\u2019t want to give him \u201cthe kiss of death\u201d. My question is, how long will the peanut oil stay in my system, what do I need to do and how long do I need to wait before I kiss him, etc. again? Thanks!",
    "doctor_response": "Yor worry is concern to many people. though your boyfriend is allergic to peanuts, Your kiss or sex is not going to induced allergic reaction to him, if you had a peanut oil ingestion before a day or two.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does unprotected oral sex put someone at risk of HIV?\n\nHi doctor,I spent three nights with a girl I met online a week ago. There was no intercourse, but we had unprotected oral sex, mutual masturbation, and kissing. I later found out that she has had a pretty crazy sexual history (unprotected anal sex and vaginal sex). Am I at risk of HIV? My worry is that she tried to rub my penis with her vagina, but I stopped her. I am worried about what if it touched? Do my other activities warrant a need for a test? Please help me. I am in agony, and I cannot live like this.",
    "doctor_response": "Hi. Unprotected oral sex carries negligible to low risk for HIV acquisition especially if there are fresh cuts or sores or lesions or bleeding gums. Mutual masturbation and kissing are quite safe. Rubbing vagina without entry, I do not think will cause any harm. Overall, I suggest you to get tested for HIV at four weeks of the exposure and if the result is negative, get a confirmatory HIV antibody test at three months. For more information consult a HIV AIDS specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Traumatic, breakdown, jaw locked. Chances of stroke?\n\nMy wife had a traumatic experience during a family argument. She went into a bit of a breakdown. She calmed down in about 15 mins, but her jaw was locked (could not open it past a certain point) and she had some numbness in her face . An hour has passed and it has loosened a bit. I am concerned about the possibility of a stroke , but I have not seen any other symptoms. I don t want to stress her more by taking her to the ER but also don t want to take chances. Your suggestion? Thanks - Mark",
    "doctor_response": "hi this is called conversion disorder where psychic anxiety gets converted to physical symptoms that mimic epilepsy..consult a psychiatrist and get an EEG done..if its normal, then her internal conflicts need to be addressed by a counsellor and also medication may be needed to calm her anxiety..so please consult a psychiatrist..have a good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "For enlarged liver, can any external fixtures ensure pain-free mobility?\n\nMy name is Ellen and I have an enlarged liver. I am going to get blood tests today and next week or so will have an ultrasound done. My question is, is there something I can use to bind my side u?. I can sit back in a recliner or lay in bed and I am given great relief but I can't live this way.",
    "doctor_response": "Hi thanks for contacting HCM...You are having enlarged liver ....You have to take care about avoiding direct pressure over liver area ....Rest done and strenous work avoided to decrease morbidity ...Investigate with following .....-Peripheral smear blood examination -retic count -SGOT and SGOT-USG -Serum bilirubin -Urine urobilinogen and bilirubin etc....Than if needed HBSag and anti HCV done if history suggestive ......According to cause treatment guided. ...Above investigation will help in rule out hemolytic anemia  , hepatocellular or obstructive jaundice like causes ....In your case as history not classic I suggested above investigation otherwise you can minimize above test according to history and your physical examination...Hope your concern solved. ....",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain?\n\nall day today i have had a pain in my chest which feels like it is from my heart, every 5-10 seconds i get a dull pain which lasts maybe only a second. i am currently traveling, and have been in very smoggy cities for 2 weeks now, also the food i have been eating recently is quite salty and fatty, so just wondering if it could be because of this or could be more serious?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Since you are traveling and eating salty and fatty food, possibility of acute gastritis related chest pain is more. So follow these steps for better symptomatic relief in acute gastritis. 1. Avoid hot and spicy. Avoid junk food. 2. Avoid large meals, instead take frequent small meals. 3. Avoid stress and tension,be relax and calm. 4. Take pantoprazole tablet on empty stomach. 5. Quit smoking and Alcohol if you have these habits. You will mostly improve with all these in chest pain in 2-3 days. If not improving after 2-3 days then consult doctor and get done ecg to rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does my mom need a surgery for mitral valve leak?\n\nHi doctor, My mom is 46 years old. She recently had her routine physical examinations and they found out her mitral valve could not close fully, but very light degree. The doctor there thinks that she does not need a surgery and he did not mention anything else. So, I really want a second opinion on this. Does she need a surgery? What should she do now to improve her health?",
    "doctor_response": "Hi. Revert back with the reports to a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am getting a pack pain after 3 months of delivery\n\nHi, I HAVE DELIVERED A BABY THROUGH C-SECTION AND ITS PAST 3MONTHS FROM NOW ALL OF A SUDDEN I MY GETTING BACK PAIN EVERY NIGHT.PLEASE SUGGEST ME ON THIS",
    "doctor_response": "Hi! you can try spinal flexion/extension exercise,isometric abdominal exercise and IFT for some days And you have to change your ergonomics.If you have query about exercise then post here.",
    "dialogue_context": ""
  },
  {
    "patient_message": "In a 32 day cycle, when does ovulation take place ?\n\nMy last period started on 10th July-2011 and average cycle day is 32. when will be my ovolution date next ??",
    "doctor_response": "29th july is most probable day of ovulation. you may feel dull pain on the site of rt. or lt.ovary",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a lump causing an asymmetrical face be treated?\n\nOne side of my face/neck (kind of under the jowl area) seems to be quite larger than the other. It shows up as a large lump in all photos, but it is soft and it doesn't hurt. It is only on the right side. Is there a chance it would be the thyroid, or something like Metastatic Squamous Neck Cancer? What does that look like when someone has a problem with that?  I am not overweight or underweight.",
    "doctor_response": "Hi, how long that lump exists?. If its since childhood, cuctyic hygroma may be the cause.CT  would fix its diagnosis with biopsy HPR.if it worries get treated. Hit thanks.Gd day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest tests to find out whether we are able to have baby\n\nme and my partner have been trying for a child and havnt concived yet and weve been trying for a while now so wot test can we have done to find out if we are able to have a baby and what test would it involve as we are both terrified of needles because of our past's",
    "doctor_response": "HelloWelcome to HCM.I can understand your concerns.Both of you should visit an infertility specialist.For husband, the most important is semen analysis. I hope he is not having erection problems.For wife, hysterosalpingogram to know the status of uterine cavity and tubes, Hormonal assays of FSH,LH, progesterone and androgens, Ultrasound scan of abdomen.Another important issues is to address irregular menstrual cycle. This is to know the ovulation status.The infertility specialist will guide you to go for specific tests based on complete history.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hypertension when suffering from Parkinson s disease\n\nMy brother has Parkinson e Disease and very low blod pressure. His neurologist has prescribed Myrbetriq 25 mg/qd for bladder spasms but he is afraid to take it due to side effects. He does not have heard disease, kidney disease, pulmonary disease yet. How can I reassure him. One side effect I say was hypertension. This may actually be helpful to him:)",
    "doctor_response": "Myrbetriq side effects (except hypertension) are reported at low percentage, even hypertension is more likely to happen in those who suffers from hypertensive disease. Low blood pressure is in some cases  a symptom of Parkinson's or drug's side effects. He should have to drink plenty of liquids, try not to stand still for long eriods, and try to change positions gradually (from lying to sitting, from sitting to standing), he can do some exercise (this can also help with his main disease ), use elastic stockings, and also if he doesn't have any other disease he can add more salt to the diet.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen rib\n\nhello, i have a swollen rib on the left side which is very sore when I walk and can t sleep at night. the last few days it got worst as I have exterme migraine aroud the eyes. I had fever and chill the last 2 nights 2 too. I am also extermely tired. i also have now shooting pains in the legs.",
    "doctor_response": "Hello, You may be suffering from acute viral infection along with migraine or it may be sinus headache with fever or other causes like meningism or malaria etc. You have to get it done a complete blood count, neurological examination. Use tablet paracetamol thrice a day for five days. If symptoms not improved or developed an allergy to above drug please consult your doctor he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Penchila Prasad Kandikattu , Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment for neuroendocrine carcinoma\n\nHi My father just got diagnosed with the Neuroendocrine Carcinoma with mets into liver. his age is 73, colonoscopy is clear, CT with contrast showed no tumors anywhere else apart from liver, CEA is normal, Hep B and Hep C are also negative, Gamma GT is 100% more than normal, Prostrate is 40G, fasting blood sugar is upper borderline since last two months with no history of diabetes before that, hypertensive since 20 years. had an eye operation for cateract and lense two years ago.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your father's situation and problem. Since he is having liver metastasis, he is having stage 4 neuroendocrine tumour. It is inoperable tumour. So only palliative chemotherapy, radiotherapy, pain management and nutritional support are required. So better to consult oncologist and discuss all these and start appropriate treatment. Hope I have solved your query. Wishing good health to your father. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for lumps and swelling on face ?\n\nHi. Two days ago I woke up feeling like I had a scratch like cut across my left eyebrow and lid because the skin was tender all day as if cut. When I looked in the mirror in the evening, there were no signs of scratches or welts. Yesterday the feeling persisted, and throughout the day a lump on the left side of my neck developed that was sore as the day wore on. Last night the tender spots on my face began to swell until my whole left eyebrow was swollen. Also, my left ear closest to my jaw line began hurting as if there were a lump at the intersection of my cheek and ear. This morning I woke up and the swelling extended to my eyelid and my neck is still the same. I don t know what this is or what to do.",
    "doctor_response": "Hi.Thanks for the query and an elucidate history.The chronology of events have been nicely put on by you.You are most probable suffering from cellulitis of the eyelid with severe infection and the infection spread by the lymphatics to the lymph nodes in from of the ear and the upper neck giving the appearance you have.I would advise you the following:Rush to ER.Get investigated for sugar and CBC Get started on antibiotic and anti-inflammatory medicines.I hope this answer helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bumps beneath the skin on the inside of foot?\n\nRecently, I've noticed these bumps beneath the skin on the inside of my foot, under the arch. They're tender to touch or put any pressure on. The only thing I can think of is a recent (maybe a month ago) puncture wound on the same area from a piece of wood. At the time of the wound, it only bled a little so I ignored it and let it heal on it's own. Now the arch of my foot is in pain whenever there is too much pressure on it.",
    "doctor_response": "HI,Welcome with your query to HCM. Based on the facts of your query,you  seems to suffer from- FB lump with ?abscess or infected foot wound with cellulitis.Pain on pressing the plantar fascia and history of puncture wound by piece of wood confirms the infective reason of this lump. Hope this reply would help you. Welcome for any further query in this regard Will appreciate writing your feedback review comments,to help the needy patients like you at HCM. Good Day!! Dr.Savaskar,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower back pain and numbness in the leg\n\nI have had chronic pain in my lower back with numbness and loss of use of my right leg for the last year. I have been told that I have nerve damage from damaged disks in my back. I feel there is something else going on, I have a great deal of trouble swallowing at times, but not all the time. I have problems with the right leg, but it s not always pain, sometimes it s a loss of function. I also have incontinence and again, not all of the time the incontinence isn t due to coughing or sneezing but can just be that I m walking or just standing talking to someone and it will happen. I have also had a substantial weight gain. I have also been falling approximately 2 or 3 times per week at times and then there are other times that it doesn t happen at all. Can you give me some ideas please?",
    "doctor_response": "Hello. Thanks for writing to us. The pain and numbness is likely to be due to nerve root compression at the level of lower spine. You need to get an MRI scan done for proper diagnosis. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal . For future query, you can directly approach me through my profile URL  drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure swelling of hands and inside fingers and thumb?\n\nMy husband has a swollen thumb with a lot of swollen inside between the index finger and the thumb. There is a lot of swollen on top of the hand. This have been going on for a week or two. He has a history of gout in all his joints and does not remember injuring the thumb. He has been taking medicine for the gout, but the swollen has not gone down.",
    "doctor_response": "Hi,Thanks  for  your query.According to your description , pain over your finger and thumb seems to be inflammatory in nature. It could be an acute attack of gout.I advice you to give you rest to the part affected, take anti-inflammatory drug like motrin 1tablet with food as and when required (upto 4 tablets daily) to reduce pain and inflammation and consult your doctor for thorough examination and rule out any infective cause.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high esr and swollen lymph nodes?\n\nMy mom had very severe anemia Hg 5.8, She was admitted to the hospital, they did a no.of tests on her and found her ESR results were high, but the immunoglobins test was negative. she had her physical examination of the lymph nodes in her chest and abdomen and they were normal, doctor had seen some swollen lymphs in the xray, could she be suffering from lymphoma. her iron is 2.",
    "doctor_response": "Welcome to HCM.Severe anemia itself a cause of high ESR. On the basis of swollen lymph node we can not diagnose lymphoma.  Tuberculosis can also cause chronic anemia and high ESR with enlarged lymph nodes. You should not be worry. I suggest you that your mom really need a full work up to confirm diagnosis.You should also mentioned complete blood count report including peripheral blood film with duration of illness.Thanx for query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white fluid discharge and pain in penis?\n\nI have a long question. My boyfriend and I had sex but it was at least my first time idk about him but he's been sacrating white fluid out of the tip of his penis he got blood work done today and a shot which made him feel better please tell me what it is I'm desperate to know",
    "doctor_response": "DearWe understand your concernsI went through your details. The information here is not sufficient. You are describing a white fluid from the penis opening. That white fluid could be either semen itself or the pre-ejaculatory liquid. Lubrication. Will you be able to provide more description of the liquid and when it came?If you require more of my help in this aspect, please use this URL.  sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for breast cancer\n\nFour out of five sister had breast cancer . I just found out today the youngest girl got breast cancer. Also Mom haf a breast removed from cancer. What do you think I shold do beside a mamo every every six months that are three d. I was check and have a 26 th perscent to get it. This is also what my younger sister found out.",
    "doctor_response": "As you have mentioned you have a very strong family history of breast cancer.so I would suggest you for BRCA 1& BRCA2 genetic mutation analysis. Along with that I would also suggest you to go get breast MRI done every year spaced with mammography in a way that you get any one of the imaging every 6monthly",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why are there painful swellings near anus and vagina?\n\nHello doctor, There are swellings near anus and vagina with pain. I guess the wall was ruptured during the process of cleaning as the pressure from the pump was too high.",
    "doctor_response": "Hi. I need to know more details regarding the swelling. A picture of the swelling gives better information regarding its nature. When was it noticed? Any pus? Please revert with details so that I can give specific comments.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest a home treatment for central pontine mylosis\n\nMy wife was diagnosed with central pontine mylosis. We felt she was recovering, but has regressed lately with emotional breakdowns that come on in the spur of the moment. We can't seem to get in to see a neurologist right away. We do have an appointment Dec. 19. Any advice would be appreciated.",
    "doctor_response": "Cental pontine myelinolysis is a condition that is difficult to manage even in intensive care unit settings. So a home remedy is not possible. Rather than waiting for an appointment, I would strongly suggest that you take her to an emergency facility of a hospital with a neurological setup.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am feeling lightheaded and dizzy. Is it because of high BP and triglycerides levels?\n\nHello doctor, I am a 31 year old male, and my query is related to high BP, light-headedness, and high lipids. Let me first share a background and then I will come to the problem. I am over 6 feet tall, and my weight presently is about 113 kg. I smoke cigarettes regularly, around 6 to 7 every day, for the past 12 years. I consume alcohol rarely, perhaps once every month or once in two months. I do not exercise as such, but I do walk few kilometers at a stretch sometimes, perhaps once in a week or once in two weeks. Apart from that, I walk a little less than a kilometer almost every day. I have a desk job, but I do move around at brief intervals. I barely need to go out in the sun and stay indoors in AC mostly. I normally have home cooked food for breakfast and dinner. However, I take lunch outside. Apart from this, I normally eat out about once a week, and the food is oily and\u00a0spicy. I had been diagnosed with low vitamin D around six months ago, following which I had taken Uprise D3 60K once a week for three months on my doctor's prescription. Now, coming to the problem, end of last month, I had a severe headache, which felt like a constant banging inside my head in the night. This headache disappeared when I woke up next morning. However, since then I had a feeling of light-headedness, particularly, while staring at the computer, walking, etc., but not while lying down. I did not feel any weakness. There was no fever, nausea, and dizziness. This feeling of light-headedness lasted for about 4 to 5 days, which subsided and gradually went away. I visited a doctor within a couple of days after this headache, and he asked me to get a lipid profile, creatinine, TSH, and a brain CT scan done. All the results were normal, except LDL was 84, HDL was 37, and triglycerides were 292. It was also found that I have high blood pressure (140/100 mmHg). I was not prescribed any medication on that day for triglycerides but only Amlokind 5 for high BP. I was asked to totally avoid oily, spicy food for 10 days and then have another lipid profile test. I did so, and after 10 days my triglycerides level was found to have dropped to 192 with LDL and HDL having very negligible change. My BP had gone back to 130/80 mmHg. What may have been the cause of such high triglycerides, BP, headaches, and light-headedness? Kindly share such causes also, which are relatively uncommon or rare. Could eit",
    "doctor_response": "Hello. First of all, thank you for the beautiful history. Thank you. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe jaw pain\n\nHelloI am off ill at the moment - I have felt faint and light headed, muscles ache and glands feel swollen. Can't get an appointment at the doctors. Have just tried to drink some wine to cheer myself up but the pain in my jaw is really painful when drinking it - why?",
    "doctor_response": "Hello, Thanks for your query.\u201cPhysical therapy involves muscle relaxation and increasing the range of motion in the joint,\u201d .Yoga, meditation, acupuncture, and stress management can also help ease symptoms,. These treatments include anti-inflammatory medications to relieve pain and prescription muscle relaxants. \u201cIf there are some severely inflamed muscles that have restricted motion because they\u2019re in spasm -- the muscles are excessively contracted or hyperactive -- we can use some muscle relaxants,\u201d I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen feet and ankle while having an elevation in the BP level?\n\nMy 60 year old brother had a heart attack on Jul 29th. He was discharged from the hospital on Aug 2nd. On a blood thinner and 81mg aspirin. last week his blood pressure started rising --200/143 average for days. Physician sent him back to hospital to get the blood pressure down on Aug 25th. Put back on blood pressure medicine--which he is taking daily. Tonight, feet are swelling and hands are swelling; blood pressure is 190/107. Should I get him back to hospital?",
    "doctor_response": "Hi, I understand your concern. Your brother blood pressure (bp) is unstable. As he has developed swelling in feet and hands, with very high bp (190/107), then, should send him back to hospital. We must determine what is causing swelling:- meds he is taking to get bp down (nifedipine or amlodipine)- or his heart is not working properly (severe heart failure)Keep monitoring his bp and send to hospital. Wish fast recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the abdomen with a small bulge going up and down?\n\nI am a 28 year old female and have a dull ache in my lower right abdomen. It is just to the right, below my belly button. I get a small bulge that goes up and down after I eat dinner, before I go to bed and am lying down. It feels somewhat like a gas bubble but only lasts for a few seconds and happens a couple of times.This doesnt happen any other time of the day (only at night) but I feel some pressure on the spot during the day. I have loud gurgling noises and I feel some pulsing when it is happening.I had a neurofibroma tumor removed from my spine 15 years ago. Do you think it is a tumor growing back? Or Irritable bowel syndrome?",
    "doctor_response": "HI.This is not a tumor growing back or Irritable Bowel Syndrome.This is a form of an intestinal obstruction. Easily confirmed by a Standing X-ray abdomen when you have this attack ( if possible as this lasts for a small time). The best way is to request for a diagnosis called Enteroclysis ( barium contrast study) and/ or a Contrast enhanced CT Scan... The treatment can be decided on actual findings.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to relieve a toddler of excessive thirst and frequent urination?\n\nMy 2 year old son has a hemoglobin level of 9.1 and his platelet count is high but not sure of number. Something in his urine also showed an issue with his kidneys. The past 2-3 weeks he has had very excessive thirst and urinating very frequently. Pcp has referred him to a pediatric nephrologist. Is there anything I can do to help him before this appointment. Also how soon should he be seen if the appointment isn't very soon?",
    "doctor_response": "Hi, As of now nothing much to do, you can make an input/output chart to assess the urine output. Consult a nephrologist at the earliest and he might require an ultrasound scan for further evaluation. Wishing you good health. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussai",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could cramping on left side near vagina be due to implantation?\n\nMy husband and I have been trying for almost a year to get pregnant. I started taking birth control to regulate my period. After 2 month s I come off and my period was still not normal. But I took a ovulation test and it come back positive so we tried again that night. Which was 6 days ago. I have been having some cramping on my left side very low almost in my vaginal area. Could this be in plantation cramps? Is it to early to test? How long do I need to wait to test?",
    "doctor_response": "Hi,Implantation of fertilized ovum is around expected day of periods and is mostly signified by mild pain in lower abdomen and slight bleeding/spotting. Pregnancy can be detected earliest by blood HCG testing around expected date if menses OR by homepregnancy test (of urine ) after 8 days delay in periods. Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Vasudha Jayant Athavale",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Zyrtec be taken for allergies despite other medication?\n\nMy mom is having a very hard time with allergy but is afraid to take anything because she takes so many other medicines. She takes Metoprol Tartrate (50 mg.) Hydroxyurea (500 mg.) Folic Acid (1 mg.) and an aspirin. Can she take a Zertec or Zertec D? My email is YYYY@YYYY",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your mother's history and would like to make suggestions for her as follows:1. There are so many types of allergies so I would like to know more about your mother's symptoms as well as details of the other medications as well as medical disorders. This will help me to make more specific suggestions.2. As you have asked about Zyrtec D (use for allergic rhinitis - nose allergies), I assume your mother has nose allergies - nose obstruction, running nose, sneezing etc. 3. Zyrtec (Cetirizine) usually does not interact with the mentioned medications. However, Zyrtec D contains a decongestant medicine which may not be desirable for heart patients. As your mother taking Metoprolol and aspirin, I assume she might be having some heart-related problem.So, Zyrtec would be safer for her rather than Zyrtec D.4. If your mother has kidney or liver problem, then Zyrtec can cause more side-effects. So in that case, necessity as well as dose of Zyrtec should be discussed with your doctor before taking it.5. Another option is to use local nose sprays. Intranasal antihistamine (Azelastine) as well as intranasal corticosteroid (Fluticasone propionate or mometasone) are available in market. They act more locally, on nose membrane. As very small portion of these spray enter blood, they usually do not interact with other medications. They have less generalized side effects also.6. If your mother has severe nose congestion, please get her nose examined by an ENT surgeon as long term aspirin use can cause nose polyps. Also, metoprolol can cause nose congestion in some patients. Please discuss this possibilities with your mother's physician who will review her history and complaints in detail and then decide accordingly.7. Please do not reduce/stop metoprolol and aspirin by yourself as it could be dangerous.8. I would also suggest your mother allergy testing for common air-borne allergens such as house dust mites, pollens, molds, insect proteins, animal dander, etc. This will help her to identify the substances causing allergies to her as well as to know the measures to avoid them.9. In general, I would suggest her to avoid exposure to dusts, smokes and air pollution as much as possible.10. Regular breathing exercises and steam inhalation would also help her in a long run for nose symptoms.Hope above suggestions will be helpful to your mother.Should you have any further query, please feel free to ask at HCM.Wish your mother the best of",
    "dialogue_context": ""
  },
  {
    "patient_message": "What might be the symptoms of pain in chest, dizzy spells, anxiety and burning in throat for?\n\ni have a pain in my chest area almost feels like a cracked rib. it hurts to sneeze or cough. i have dizzy spells and my anxiety is acting up more and recently i been getting a burning in my throat when i eat. what do you think about these symptoms, any idea what it could be?",
    "doctor_response": "Hello dear,The symptoms as mentioned by you suggest that you might be having Gastro esophageal reflux disease, which is caused by the reflux of acid from stomach to esophagus due to relaxation of the sphincter at the lower part of esophagus.Management consists of:1. Lifestyle modification- like weight reduction, sleeping on the left side, or with upper body raised.2. Dietary modification- avoid consuming irritating substances such as acidic & rich foods, caffeine, nicotine, and alcohol.3. Medical management- Proton pump inhibitors like Omeprazole, Lansaprazole,etc. (which prevent acid formation in stomach)An endoscopy will be helpful to rule out any abnormality in the gastrointestinal tract.Based upon that, appropriate management steps could be taken.There is no need to worry, you will be fine.Wish you a good health & speedy recovery.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a slightly cut ball sack skin?\n\nI accidentally cut my ball sack slightly (just the outer skin, about 1-2 cm long). How should I go about treating it, I washed it with soap and water.I understand this question isn't super serious, I'm just wondering whether to put a band aid with neosporen on it or to do something else?",
    "doctor_response": "Neosporin is a good idea.  Otherwise, keep up with keeping it clean and it should heal in 2-3 weeks Please rate 5 stars! I strive to provide the best answer to your question. Thanks!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is one unable to conceive?\n\nhi i have tree miss.......ge an i smoke drink ,an my doctor said i must rest or wait on till tree month an after u can do any activite so i want to know, if i take multivitamin ,can it bill my blood an help me to have a baby the next time i get preg...........n yes or no i want to know now.",
    "doctor_response": "yes u can get pregnant but it is also important to know all congenital infection which can arise due to your smoking or drinking so be careful",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I want to know about the relapse regarding AIHA.\n\nHi doctor, I am 20 years old. I had a sudden onset of AIHA. At first, I had no response to steroid therapy, and after a week, I came back to normal. I want to know about the relapse with AIHA.",
    "doctor_response": "Hi. Approximately 80 % of patients respond to corticosteroids at a dose equivalent to Prednisolone 60 to 100 mg per day and nearly two-thirds achieve complete remission (CR). The initial response takes several weeks. But an absence of a response for 21 days is considered as a steroid failure. In responding patients, an incremental taper can begin, for example, when the Hb (hemoglobin) is more than 100 g/dL or after a maximum of three weeks, we can reduce the dose to 20 to 30 mg over four to six weeks, and then by 5 mg every month. In a series of 33 primary AIHA (autoimmune hemolytic anemia) cases, relapse was more common if the steroids were tapered to 10 mg in less than two months and when stopped in less than six months. Approximately 20 % of patients remain in remission after steroids are discontinued. Although a further 40 % can maintain an acceptable Hb by keeping Prednisolone at 15 to 20 mg, due to the long-term side effects of steroids, and a second-line therapy is considered.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can fever and headache in a child be treated?\n\nHi Dr. Rynne, My four year old daughter has been having fever between 100.5 and 102.5 with a headache every 18 to 24 hours for the last six days. Just wondering if she needs to be seen regardless of symptoms being present. She is fine one day and sick the next. Thanks, Kristin.",
    "doctor_response": "Hi, Fever of a 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 15mg/kg/dose (maximum ceiling dose of 500mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it normal to wet adult diaper unknowingly while standing?\n\nHello doctor,I have been wearing adult diapers to keep my bed dry cause there have been at times when I come close to wetting the bed. But a couple of nights ago I would wake up dry but when I would sit up or stand before I make it to the bathroom I would without knowing wet the diaper. My question is that is it normal and should I start to wear them during the day? I am 35 years old male and take no medicines. I was also told I have stress.",
    "doctor_response": "Hi. Since how long are you having night time incontinence? Is there daytime incontinence? Do you have frequency and urgency? Was a sonography done to look for prostate size and residual urine? Did you have urine infection in the past? Please get back to me with previous reports if any. Take care. For more information consult a urologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest natural remedies for getting regular periods\n\ni am 27 years old. i have unusual menses problem from the time i got my period at the age of 13. i was suggested some medication (diana) to regulate my period as my doctor felt that i get seviour acne due to unusual period,  but it was not effective. recently i got my period after two months. can you suggest me medicine or natural method.",
    "doctor_response": "Hai,To regularise ur menstrula cycle.you should follow healthy food lifestyle.because your lifestyle,food habit,stress will influence menstrual cycle as per ayurvedic medicine.avoid junk foods,oily,fried and caffeinated drinks. Take more leafy vegetables and fruits  .be hydrated.avoid stress.medication:To regularise the cylce u should take some medicine.(Ayurvedic)take ASHOKA ARISTAM- 20ML WITH 60ML OF WATER - TWICE A TIME.Natural method: I suggest to do yoga. that definitely regularize your cycle.thank youHope i answered your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Have 2 pins in foot after hammer toe surgery. Doctor says I will need to be sedated to remove them. Is sedation common?\n\nHi doctor, I have two pins in my foot after having a hammertoe surgery. The doctor said that I would need to be sedated to remove them. Although it is an office procedure, is sedation common?",
    "doctor_response": "Hi. Yes, sedation is common, as it will ease the doctor to do the procedure, and also it calms you during the procedure. The sedation is a very short one will last for only about 3 to 4 hours. But my advice is to avoid driving for the day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure back pain which persist after consulting orthopedist?\n\nHi, i am working with IT company and i use to to do work in front of the computer screen for 11 hours a day..i have been suffering from back pain from last 3 months and with this regard i had consulted with orthopedist but still pain is there..i am planning to get the MRI scan ..",
    "doctor_response": "Hello,i have seen many patients with same problem like you are facing. This occurs because of continuous sitting, which causes muscles of back to get fatigue and leads to pain. I understand that your pain will not improve very fast. You need to learn back muscle strengthening exercises, also muscle relaxant like myoril and myospaz will also help you. Remember muscle strengthening exercises will take months but this is only permanent solution. As far as MRI is concern you can certainly get it done, but i do not thin it is going to change treatment. Back pain need some lifestyle modifications also like how you sit, bend or sleep. Do not use very soft mattress.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to abort the pregnancy with blighted ovum\n\nI was just diagnosed with blighted ovum at 7 weeks and told that by uterus tips towards the rear. I read that if your uterus tips in that direction, that occasionally the ovum is not blighted but that the ultrasound couldn t pick up a reliable picture yet. They have given me some pills to miscarry the sac faster, but what are the risks of waiting a couple weeks to miscarry naturally. I would like to avoid a D & C so would waiting a week or two hurt or would I most likely set myself up for a D & C?",
    "doctor_response": "there are less chances that you can abort naturally, it's better go for pills. in 99% cases pills are effective and no need of D&C is required.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I feel everybody around me are dirty. What could be the reason for this type of thinking?\n\nI AM SUDHA BAJPAI AGED 46.TWO YEARS BACK I STARTED FEELING THAT EVERYTHING WAS DIRTY AROUND ME AND I REFRAINED FROM WALKING ON THE ROAD.I DID NOT EVEN LIKE PEOPLE COMING TO MY HOUSE WITH SHOES IN.LATELY THE PROBLEM HAS INCREASED AND EVERYTIME I USE THE TOILET I TAKE A BATH AND CLEAN THE TOILET EVEN AFTER URINATING.I FEEL DEPRESSED AND WANT TO CRY.I CAN'T EVEN CONCENTRATE OR DEVIATE MY MIND TO ANY OTHER ACTIVITIES.I FEEL EVERYBODY IS UNHYGENIC AFTER USING THE LOO.IS THERE A CURE FOR MY PROBLEM?ADVISE..I'M A RESIDENT OF DOON.",
    "doctor_response": "Hi.. It is good to keep yourself and your home clean and healthy... I feel it is completely normal behaviour.. However if these thoughts have been continuous and recurrent requring you to keep cleaning all the day and is hampering your other daily work, then you may need help.. You can sort help from behavioural therapy..",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat severe bad breath?\n\nI am really frustrated. I have had chronic bad breath for years. Now, I am getting an awful smell in my nose. I have had my tonsils taken out. I have gone to several dentists; therefore, I don't have a dental problem.  I have been to half dozen ENTs, and I've even had a CT scan, so I don't have a sinus issue.  Please don't tell me to brush, floss, gargle, or scrape my tongue.  I don't have an issue with any of that.  I don't eat garlic or onions, and I even stopped eating poultry and dairy.  I don't know what else to do.  I've done several cleanses: herbal and liver, and an all juice cleanse.  Why is it that I cannot find help?  This is very frustrating and embarrassing.  It's obviously a common problem that no one wants to talk about.  However, I see it all over the internet with people with the same problem.  I cannot find a doctor who knows what is going on.",
    "doctor_response": "hellooo...read through ur query ..1st thing i must say u that dont get upset with this..its just natural problem faced by most people...u shud remember its not something thats threatening to ur life (just think for a minute about those who have cancer and various other life threatening diseases ..u shud feel blessed)but yes thinking from ur view this is bad problem for you after so many precautions and steps follwed still its persisting...i suggest you to first reduce the stress and tension of life..try doing yoga meditation(to cool and soothen ur mind)when stress or tension comes ur mouth becomes dry and then bad breath occurs...so u have to keep ur mouth hydrated always..drink lots and lots of water...try using sugarfree chewing gums..and practice this before talking to someone stimulate urself ur saliva and hydrate ur mouth(dryness of mouth can cause bad breath)..follow this for sometime...practice yoga and meditation...keep ur mind cool and calm..tensionfree mind can solve and soothen ur probs...and still after a month or so still prob persists just meet a physician and check for any gastric or other systemic problems...hope ur benefitted something from this reply..have a healthy day!!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the semen analysis test normal?\n\nPlease check whether my semen analysis test is ok. Qnty 2ml, colour whitish, viscosity normal, reaction alkaline, liquifaction time 20 min., actively motile forms after 30 min 85%, after 60 min 75%, after 120 min 55%, after 240 min 35%, total count 125 million/cc, morphology of spermatozoa normal forms 85%, abnormal forms 15%, microscopic examination: leucocytes: 2-3/H.P.F., Red Cells: nil, Epithelial Cells : 3-4 /H.P.F.",
    "doctor_response": "Hello, Your semen analysis result is normal though the volume is on the lower side. Whenever you test your semen it should be after a minimum 3 days abstinence. 5 days would be better. I shall be happy to answer any further query Best wishes, Dr. Noble Zachariah M.D.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could pruritus and diarrhea be due to food allergy?\n\nI have general pruritis (scalp to feet) and I notice that it gets worse as I get closer to my menses.  I also have IBS and have been able to control is some with probiotics.  I'm wondering if these are two different problems or if I have a food allergy causing/exacerbating both.",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your history and would like to make following suggestions to you:1. Yes, it is possible that general itching as well as IBS symptoms could be linked to food allergy or at least some food component in diet.Common foods causing allergies are - milk & milk products, peanut, wheat, egg, soy, tree nuts (almonds, cashew, pistachio, etc), fish, shell fish, etc.Some preservatives, colors, etc in foods also can cause allergy like symptoms.2. As you have symptoms that worse closer to menses, I would also think of possibility painkillers or stress worsening both itching and IBS symptoms.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat chronic c5 and c6 issue with neck pain?\n\nDear Sir I am suffering from three years due to problem of c5 and c6 and facing lot of defficulties  and also there is pain in my neck so plz help me in thes regard and advise Thanks With Best Regards MUHAMMED HASSAN BROHI PHONE 0000",
    "doctor_response": "Hello Muhammed!Welcome on HCM!I would like to directly review your cervical MRI results for a more professional opinion. You should know that discal herniation or spinal canal stenosis should be treated with surgery by a spinal surgeon or a neurosurgeon. In the meantime, I would recommend holding a cervical collar. Gabapentine and pregabaline can help against the pain. You should discuss with your neurologist on the above issues. Hope to have been helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful infected lipoma inside cheek\n\nI have a lipoma on inside of cheek I also have multiple sores on inside of mouth was seen by oral surgeon and was put on amoxicillian (liquid) and got that filled twice and Peridex rinse and now I have Lidicaine to put on it but pain comes right through.I am getting really depressed over this and these sores have been happening for over a year now.I am diabetic and  have low white blood cell count too.",
    "doctor_response": "HelloIs your diabetes in control? As in diabetic, intra-oral   sores get routinely  infected so you need to bring that under control.Try using betadine gargle for 2 weeks also to heal those sores soon.Rest  treatment  is already being given by the oral surgeon.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause delayed periods after having unprotected sex?\n\nSir , i had taken i-pill around 20 th july, and then had brown blood discharge for 3 days, after that i had sex on 2nd August without using any precaution and now as per menstural cycle my periods is on 10th august but till now i dont feel any such situation.",
    "doctor_response": "As you had unprotected sex, the most probable cause for delay of periods may be pregnancy only, get a urine pregnancy test done. Besides, I pill is an emergency contraception pill that is to be taken within 72 hours of unprotected sex, it will not prevent a pregnancy if taken so many days before having sex.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes skipped and fast heart beat?\n\nHi my hear feels like it skips a beat then it beats really fast for 1 or 2 minutes it feels like forever and after its over my hands shake really bad and I feel like I have to poop what do you think this is I when to a heart Dr. awhile back he did all kinds of test and said everything was fine.",
    "doctor_response": "Hi,It is possible you have some kind of arrhythmia, which called premature heart contractions. If they are not very frequent, they are benign, and they can be seen in healthy adults as well.Wishing you good healthIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for depression and phobia\n\nHow can I fight with my stage fear and all sorts of fear,my hands get shivering in these situations? I m suffering from depression and suicidal thoughts, I don t wanna be a looser in my life but every time I fail in every attempt. What should I do? I really don t know I feel a deep sense of loneliness and suffocation.",
    "doctor_response": "Hello,In my opinion, it is necessary to rule out thyroid dysfunction. It is very important to rule out lipid disorders, and it would be useful to start on antidepressants like escitalopram and cognitive behavioral therapy. Start a moderate exercise and a good diet.Hope I have answered your query. Let me know if I can assist you further.Regards,      Dr. Gayathri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chronic sinus, headaches, tingling in ears and temples, tightness in chest. Been taking liquid chlorophyll. What now?\n\nI have had chronic sinus for years that has never been treated properly or gone away. I have been taking liquid chlorophyll in water the past week to help cleanse my system and feel like I have water in my ears, severe headaches with tingling in my ears/temple region. My throat is very hoarse, sneezing always and tighness in the chest when I breath. Im also getting nauseous. Can you tell me if this is the sinuses trying to clear and what I can do about it. Im also taking vitamin supplements and vitamin B liquid. I am sick of having chronic sinus and no solution. My head, neck and shoulders ache constantly. Any advice?",
    "doctor_response": "Your chronic sinuses symptomps are converted to acute sinusitis it got infected Newer studies show that synthetic vitamins increases sickness Stop all vitamins and dietry suppliments Take cefixime 200 mg bd tab Montair fx(combination of montelucast and fexofenadine )twice a day put see water drops in nose 2 drops tds and diclofenic sos for pain add antacid syp do for 10 days get your xry pns waters view consult ent specialist and treat your sinuses properly as they are outcome of allergies",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for clog in ejaculatory ducts?\n\nMy husband has a clog, in what I believe is his ejaculatory ducts.  His doctor said surgery can make this worse, is there other alternates to surgery as after ejaculation he has an achy testicle from the side where it is clogged.  This does not always happen, but does from time to time.",
    "doctor_response": "Hello, A method to treat ejaculatory duct obstruction is transurethral resection of the ejaculatory ducts (TURED). This operative procedure is relatively invasive, has some severe complications, and has led to natural pregnancies of their partners in approximately 20% of affected men. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vaginal discharge and back pain during pregnancy?\n\nHi I am 7 weeks pregnant. Over 10 days ago, I was getting brown discharge and light spotting. I went to A&E and as it was too early the scan just showed a sac at 5 weeks. My hcg level was 23,000 which I think is high. My cervix was closed. The doctor ruled out an ectopic pregnancy. The doctor said things look ok but we have to wait for the 7 week scan. However, since last night I am getting bad back pain and mild abdominal pain as if I am going to start my period. I am getting yellowish discharge but no spotting. My scan is in four days. Do you have any idea what this severe pain is in my back and is there something to be worried about???",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.1] First of all do not panic.2] If the discharge was minimal, and has stopped now; you need not worry.3] USG shows a sac, and no ectopic pregnancy and good HCG levels are the things in your favour.4] Please be relaxed, do not panic. Take rest.5] Pain in back can be due to changes happening in the body due to pregnancy. 6] I will suggest you adopt correct posture. Tab CALPOL 500mg as needed for pain.7] Yellowish Vaginal discharge if not itching or foul smelling, can be considered as normal.8] Please do not worry,Things will be all right. Let god bless you with bundle of joy.I hope my answer helps you.\u00a0\u00a0\u00a0\u00a0\u00a0   Thanks.Wish you great health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have two cysts on my upper jaw and a soft tissue growth in my maxillary sinuses. Please advice.\n\nHello doctor, I have two cysts on my right upper jaw on tooth number 3 and 4. I have attached the OPG x-ray of that area. I also have a soft tissue growth in my right and left maxillary sinuses. Under these circumstances, what should I do? Should I visit a dentist or an oral surgeon? Please tell me.",
    "doctor_response": "Hello. I have seen both the x-rays that you have attached (attachment removed to protect patient identity). For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain while breathing?\n\nA young man who is a friend of mine and lives in Haiti, is having alot of pain in his chest and it hurts when he breaths out.  He was hit in the chest with a ball several years ago and it was hurt then.  He was recently hit in chest again and now he says it is worse than before.  He doesn't have access to much medical intervention, what advice would you give him?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your friend's situation and problem. He is having repeated blunt chest trauma. This kind of trauma can cause rib fracture, pneumothorax, Pulmonary contusions and musculoskeletal injury. And in all these, chest pain on breathing is seen. So better to get done chest x ray to rule out all these complications. If chest x ray is normal then no need to worry for much. Possibility of musculoskeletal injury is more.. So ask him to avoid heavyweight lifting and strenuous exercise. Avoid movements causing pain. Avoid bad postures in sleep. Start painkiller and muscle relaxant drugs. Application of warm water pad on affected areas is also beneficial. Don't worry, he will be alright with all these. Hope I have solved your query. Wishing good health to your friend. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the early signs and symptoms of pregnancy?\n\nwell, i am 25 years of age and i am not having my periods... my regular cycle is of 27- 30 days and it has never got delayed. this time i am 9 days delayed. 12 days ago i along with my boyfriend had some sexual activities...although he was not inside me but we were very close to that. i have not taken any medicine...... am i pregnant??",
    "doctor_response": "Hello and I hope i can help you today. Pregnancy symptoms vary between women, and many women can have their period be late for different reasons- stress, changes in body weight and other hormonal issues. You can even be late from the stress of worrying about pregnancy! So really the best and most accurate way to determine if you're pregnant is to take a urine pregnancy test. The ones that can be purchased are just as accurate as ones done at a doctor's office. But if you did not actually have sexual intercourse and there was no contact of semen with your vagina and surrounding area you really do not need to worry about pregnancy.If you continue to have irregular periods it would be advisable to consult with an OBGYN doctor who can help diagnose the reason behind your symptoms and possible treatment. I hope this information was reassuring and that I was able to answer your question adequately. Best wishes, Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat upper arm pain?\n\nHello, I was prescribed Levofloxacin Feb. 17th. I lost the use of my upper arms.It was extremely painful. My arms have improved to a point,but my shoulders and upper arm sill hut. I can hear the bones in my shoulders crunch. Its very hard to lift my arms. WHAT AM I SUPPOSE TO DO??? HOW LONG WILL THIS LAST??? I am 66 years old. Thank you",
    "doctor_response": "hi,thank-you for providing the brief history of you.A thorough musculoskeletal and Neuromuscular assessment is advised.As you have pain in shoulder and upper arm along with difficulty in the movement of the shoulder joint a thorough musculoskeletal and Neuromuscular assessment is needed. This symptoms can be due to 2 reasons1. Shoulder complex pathology2. Cervical spine pathology.Undergoing an assessment post which an MRI of shoulder or the cervical spine will be needed to see what area is involved and what is the soft tissue status.Treatment of choice will be physical therapy like therapeutic ultrasound therapy and TENS therapy for pain management . For strength and ROM exercises will be taught by physical therapists.In my clinical practice majority of patients respond well to physical therapy and recovers in 2-3 weeks of time.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy rash on palm of hand and sole of foot?\n\nI have a circular rash on the palm of my hand which is now on the sole of my foot. They come and go but are very itchy. I have now found a raised rash in the pubic line which is not itchy. The rash seems to be like an insect bite and is more yellowish in the middle. Im male 28 and have not had any problems of this klind in the past and have not yet tried to treat this problem.Please help thank you.",
    "doctor_response": "Hi,As per your descriptions, it could be due to eczema,tinea,psoriasis, insect bite etc.You will require topical corticosteroid like beclomethasome or clobetasol or mometasome with antifungal cream like itraconazole or miconazole with oral prednisolone and fluconazole with antihistamines.This type of skin itchy rashes are required to be seen by naked eye of a doctor for confirmed diagnosis.So,better you consult dermatologist and start the treatment.You will be alright after that.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lumps on sternum and bruises on collar bone?\n\nI have a 9 year old son and the other night, he came out and asked about some lumps that were on his sternum.  There are 2 hard bumps near the end of his sternum, one on each side.  The next morning, he woke up with a rather large bruise immediately above his collar bone.  He hasn't hit it or anything, should I be concerned???",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern.  Lump above your coller bone may be some enlarged supraclavicular lymphnode.  It may be due to reactive hyperplasia or may be some other disease like tuberculosis or lymphoma.You should go for fine needle aspiration cytology to check 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for child passing blood in stools\n\nDear Doctor, A Happy New Year to you at first. My nephew has been passing stool with drops of blood since the last 2-3 months.He has been suggested to go for a colonoscopy. Since he is only 5 years old,so we are worried. Can you please tell what should be done now? Do we need to come down to Chennai at your place or this condition can be treated in Bengal only? If so please recommend us the name of a good Pediatric Doctor who will be able to take care of the entire matter. Based on your valuable information we shall be acting fast. Thanks & Regards, S.Chakraborty Siliguri. Mobile : 0000",
    "doctor_response": "Hello, By what you say I feel that we need to rule out a colonic for rectal polyp.He might require a colonoscopy. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the gallbladder area after cholecystectomy?\n\nhad gallbladder removed 2004. two months ago. experiencing crazy non stop pain in that area. CT scan of pelvic area..fine...blood checked...fine..chest xray...fine. Can t figure it out. get s worse if I run to catch a bus or walk long hours. I m dying to work out and this has stopped me. Inflamed as well. Mystery.",
    "doctor_response": "Hello, It looks like PCS, Postcholecystectomy syndrome. It commonly occurs due to some pathology in the biliary system(retained calculi, tumors, sphincter of Oddi dysfunction) or due to some non-biliary cause eg, gastritis, diarrhea. You may experience symptoms due to developing pancreatitis or gastresophageal ulcer or IBS. You are suggested to get re-examined by your surgeon & get a follow-up treatment done. You may have to go through some blood workouts or investigations like MRCP/ERCP, USG of the right upper quadrant, etc. Your treatment will depend upon the severity of your pathology detected. In the meantime, you can take antacids & PPI's to get relieved. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nupur K, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a blistered rash on the back with itching?\n\nI had total hip replacement on 12/12. I was put on Celebrex and then aspirin. One week after surgery I developed generalized itching and then an increasing deep blistered rash on my back and front torso. I also developed gastritis around 3 weeks post-op. I then went off all NSAIDS, taking Omneprazole. My question is about this rash, which is still very bothersome itch wise and the lesions are very deep and slow to heal. My neighbor had this same skin reaction after taking Celebrex! I wonder how long I should expect this rash to last?",
    "doctor_response": "Hi, Thanks for your question. I do understand your pain and discomfort. As per your problem is concerned it may be due to many causes so check these points-:1)Due to drugs-Once medication stops it will go away 2)Due to viral infection-full antiviral course is necessary3)Do CBC with differentialI hope I was able to address your query. If you have any further questions, please do not hesitate to write to me. Wishing you all the best. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dizzy and nauseous after taking Amoxicillin for dental infection. Allergic reaction?\n\nHello, my husband had a strange thing happen at the dentist a few weeks ago. He went in for an implant on a Wed. He got 2 shots of local anesthetic because the first one didn t seem to be working/ strong enough. The dentist also found he had an infection under the crown next to the implant although he did not give my husband Amoxicillin until Friday. On Friday my husband went back to dentist for more local anesthetic and root canal . He came home around noon, ate lunch, and started Amoxicillin. From that evening he started feeling really dizzy and nauseous. On Sat he almost could not function; he was eating but almost vomited and he had to take a very long nap in the afternoon because he was just too dizzy. Slowly, over the weekend, he began to feel better and was able to drive and go to work on Mon. He kept taking Amoxicillin for 10 days. Does this seem like an allergic reaction or a toxicity from too much anesthetic? Reaction to PABA or some other chemical in anesthetic? Dentist seems to think it is an allergy to Amoxicillin .... but my husband has taken antibiotics before w/o such a reaction. Also, he began to feel strange on Thurs even BEFORE starting Amoxicillin.",
    "doctor_response": "Hello, Thank you for the detailed query. However, the timeline of starting amoxicillin is a bit confusing when you say 'from that evening (i.e., Friday) he started amoxicillin' while the last sentence contradicts this. Anyway, you are right that this is unlikely a reaction to amoxicillin as he had CONTINUED to take this and was all right. If the 'dizziness' was part of a reaction to penicillin, then he would have been far worse after that! Local anaesthetic (LA) allergy or an intolerance reaction is more likely. Why I say intolerance is because occasionally adrenaline is mixed with the LA and if the injection accidentally goes into the blood stream you feel the adrenaline effects. Your husband definitely needs a full workup to ensure he is not allergic to LAs and there are several of them. Skin prick testing, followed by intradermal testing and if he does not react a subcutaneous challenge is then indicated. If he passes all these tests, he is NOT allergic. If he is alergic to the LA he was given then a series of other LA needs to be done at the same time so that cross reactivity is excluded. I hope this was useful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for congested nose, wheezing and difficulty in breathing\n\nWhat does it mean when your very congested wheezing and is having a hard time breathing. And while hes breathing it s intense like he s having a hard time breathing. And he s also very hot on the outside but he s cold. He says his stomach hurts while trying to breathe.",
    "doctor_response": "Hello dear,Wheezing and difficulty in breathing is caused due to broncho-constriction (obstruction of smaller airway passages) which is indicative of Hyper-responsiveness of air passages.Management consists of:1. Asthalin+ Seroflo inhaler- provide symptomatic relief by causing broncho-dilation (dilating the smaller airway passages, relieving the obstruction & increasing airflow to lungs).2. Montelukast preparations- used as a maintenance therapy to relieve symptoms of asthma.3. Antihistamines like Cetrizine and Xylometazoline nasal spray can also be used to provide symptomatic relief from congested nose.4. Also make sure that he is well protected from exposure to cold, dust or other allergens.If symptoms still persist, kindly consult a Pulmonologist for proper clinical evaluation.Wishing him a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for soreness in foot\n\nHi --- I burned my finger and foot on microwave caramel which I had intended to put over popcorn for my grandchild. The finger is healing but the foot is not completely healed in one area. Right now, it is quite red looking and sore. I had been using bactitracin on it but am not wondering if I need to stop using it as it has been 2 weeks today since this occurred. I also have tried aloe vera from a home plant. Any other suggestions?",
    "doctor_response": "Hello,This is Dr. Klarida Papaqako answering your question.From what you have described, looks like you are doing the right things to your burning wound. The area that is not healed yet must have been a deeper burning, or it is on the plantar/soft skin area of the foot.If I was your caring doctor, I would recommend to continue the antibiotic if there is still skin damage, but if its already healed then continue using only aloe vera, or any other cream with no smell and color.. Most important thing of healing fast though, is keeping always the skin clean and well moisturized.Massaging your scars with lotion will keep them moist, make them less sensitive and make your stretching easier. It may also prevent skin breakdown. Taking some pain killers as Ibuprofen 400 mg as needed, will help with the pain also.Hope this information is helpful.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does an abnormal lipid panel indicate?\n\nHi ! My daughter who is only 34 had her first lipid panel done . Everything came back high . Isn t she young for this? She didnt fast before test ,. My husband and I didnt start having those issues til we were in our mid 50 s. She has a cardiac risk factor of 5.8 , cholesterol 256, triglycerides 180, LDL 176, HDL 44 . should they be redone ? Thanks",
    "doctor_response": "Hello,Yes, your daughter\u2019s laboratory lipid profile is quite high. This could be a false positive result. Not fasting before the test is a frequent reason for abnormal lipid profile.She should re-take the test. But this time she should fast 12 hours before the test and should not drink alcohol 24 hours before the test.If she is taking medications (example as birth control pills), that may also be a reason for the abnormal lipid panel. Please, consult with your doctor regarding stopping the medications before the test.If the second lipid profile comes high again she needs further investigation (thyroid function test, blood glucose et cetera) to find out the cause of abnormal lipid profile.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Malik Amonov",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lump in my sternal notch area\n\nI have had a sensation of something being lodged in my sternal notch area since April I have had thousands of dollars worth of tests done only to be told they have found nothing..I have had 2 x-rays of my neck ((not sure if they seen the sternal notch area on those or not)) 2 chest x-rays, a Nasal Endoscopy, an Upper Endoscopy, an ultrasound of thyroid and several rounds of blood work and they still are saying nothing...My question to you is this: Why can I feel a lump in my sternal notch area and the Doctors cannot find it? DO I need a CT scan of my sternal notch area? My husband has also felt this lump, it is annoying sometimes because it feels as if something is always caught in my throat and sometimes if feels like food and liquid gets stuck...I just do not wanna have had cancer all this time and it not have been caught...That would devastate me...Thank you so much in advance..",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query.Yes, if I were your doctor, after all the tests done as noted above, and because of your persisting symptoms, I would go for a CT scan of your neck area to rule out any such pathology, which could not be detected by a physical examination and all other investigations. Further management would depend on the CT scan findings. Till then, I might consider you for a course of proton pump inhibitor drug.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can painful ulcers on the tongue be treated?\n\nFor 7-8 months I've had ulcers come on my tongue off and on as soon as they would go away some more would come on in another area on my tongue. It got to where some time it was very hard to eat or swallow. It also affected my ear by hurting. Then I noticed blisters (one or two small) would appear at a time. I'm going to a ENT doctor now to see what is causing this problem. He has ruled out cancer. It seems like I can't get rid of these or be told what I need to do to treat it or what can be done to make it all go away and stay away. Can you help me?",
    "doctor_response": "Hi.Thanks for the query..If the ulcers come and go that means if the ulcers appear but they resolve completely over the time then it is not cancerous because cancerous ulcers does not heal and are persistent..So my suggestion is to consult an Oral Surgeon and get examined and the first thing that should be done is Biopsy if ulcers are considered cancerous..Further treatment can be decided accordingly..For now you can apply a  steroid oral paste over it and along with it gargle with 1:1 solution of benadryl and milk of magnesia..Do warm saline gargles..Take Vitamin B complex supplements..Hope this helps..Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for body rashes with low iron\n\nHi. Ihae been diagnosed as being low in iron and have been prescribed ferrous sulphate twice daily.I have had quite a blotchy skin rash with this and I am due to be tested for hypothyroidism.Since I have been on iron my intensely itchy face has got better, but I still have a reddish rash. What do you think? By the way, my iron levels have gone up from 8.1 to 11 now and I do feel much better. Not so cold, not as itchy, and my head was feeling \"fuggy\"! Do you think Ihave signs ofHypothyroidism? I am due to have bloodtests for this in March. Thankyou.",
    "doctor_response": "Hello, I have gone through your query and there are many causes of itchy rash. Hypothyroidism could also be causing this rash. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on incision after hysterectomy?\n\nI had an abdominal hysterectomy 3 \u00bd weeks ago. Immediately after surgery there was an egg sized lump at the left of the incision, but above it.   Last week my doctor said it is a haematoma and will go with time, to rest & not exercise for a week, and put me on Tramadol for the pain and as an anti-inflamatory.     The lump is hard, has not decreased and is painful and swollen.  My entire belly is bloated and incredibly uncofortable.      I do not have a temperature. Will this lump go naturally?   If so, what is the time frame?   How will I manage when I run out of the pain killing medication? Has the doctor mis-diagnosed me, and is it a hernia?      Any further information is greatly appreciated.",
    "doctor_response": "Hi, thanks for sharing your health concerns with HCM!Well, If I were your treating Doctor for this case of scar lump following hysterectomy, I would come up with three possibilities, these include: 1. incisional hernia2. hematoma or blood-filled pseudo-sac3. suture granulomas and related wound infectionTherefore, you might need change in medication...I suggest you to see  a surgeon for a physical examination and to go for an FNAC and ultrasound of the lump for confirmation and to relieve your concerns!Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment for gall bladder calculus with prostatomegaly?\n\nI had a mild pain below my belly button last Sunday night and I could not sleep whole night. In the morning when I went to the hospital they advised a sonography. The ultra sound report states that there is Gall bladder calculus with changes of hyperplastic cholesterosis, mild gall bladder wall thickening and fatty infiltration of liver and mild prostatomegaly. what is the line of treatment you would advise?",
    "doctor_response": "Hi, thank you for posting.I had gone through your query and understand your concerns.To treat gallbladder calculus you should follow the below precautions:1- Change your lifestyle by eliminating egg yolk, butter, animal fat, spicy foods and sauces.2- Take antibiotic medicines, because gallbladder calculus is manifested with infections.3- Take antispasmodic medicines to avoid pain(colic biliary). I recommend you to take Butylscopolamine bromide 10mg, 2 pills twice a day, only when you have pain.If the above precautions, will fail in treating gallbladder calculus, then you will need surgery.To diagnose prostatomegaly right, except Ultrasound you need some other tests, such as:1- Rectal examination (palpation of the prostate through the rectum).2- Prostate-specific antigen test (PSA).3- Urine test.4- Urine culture.The above tests will show if you have prostate adenoma because there is a possibility that you are in first stage of prostate adenoma.You should consult your gastroenterologist and your urologist. They both will determine the needed treatment.I hope you find this helpful.Take Care.Dr. Behar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trans mutational cysts positive of ITMN neoplasm. Family history of ovarian cancer. Ammonia levels given, tumor marker is high.\n\nI had a scope 3 weeks ago looking for benign cysts.  The resultsts showed transmutational cysts positive of theITMN neoplasm.  My mother died of ovarian cancer 16 yrs ago however my 54 yr old cousin has survived for 38 yrs.  they did a total hysterectomy on me 27 yrs ago.  I also am showing signs of non- alcoholic cirrhosis ammonia level most recently 90 my pancreatic tumor marker is high also.  Thank you,Lynne Sullivan",
    "doctor_response": "HIThank fro choosing HCMI am not getting it clearly in what sens  you are saying ITMN, because merely scope can not say anything about the genetic origin of lesion these needs several investigations, biopsy would clear the clinical picture, even if you have family history of cancer but this is not hold true for other members too, so just take it easy, have nice time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pressure around teeth gum, tender cheek and eye socket. Should i meet doctor?\n\nHi , only today I have been feeling a lot of pressure around my gums teeth , my cheek is also tender and around my eye socket only on one side , I am convinced it's an abcess , but not all that sure, as I said it's only been today but right now I'm in a lot of pain I have taken paracetamol but haven't seemed to shift any pain at all , do I need to go get medical advice?",
    "doctor_response": "HelloTo your question the reply is yes you do need to see a doctor Please do not try any thing of your own as it is close to your eyeTake care please Dr Lal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes gum disease?\n\nI m 16 and height 5.1ft and weight 50 medical history nothing diagnosed as yet. Hi my inquiry is I ve had 4 panic attacks this month where I ve been rushed into hospital and since this I ve have had cold sensations in my chest for over 4 weeks now since it happened and vomiting blood I ve seen my Gp but he seems to say I m healthy but I ve been recently very depressed. And have had problems with eating and have suffered with gum disease I ve had a blood test today to check for any allergies but I don t feel this has anything to do with my chest and feeling weak and dizziness all the time.",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern and looking to the history given here I could say that you have not mentioned the disease of the gum in specific what type of disease you have for the gum, any way in my advise better to have a fresh fruits and vegetables, if the condition persist then better to see the dentist, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need treatment for abdominal pain with diarrhea\n\nI have had pain in my lower abdomen (ovaries?) for a couple of weeks now. It is, at times, sharp, stabbing pain and the rest of the time is just a dull pain. It stopped for the 4-5 days of my period and then started up again right away. I have also had diarrhea off and on for a few weeks now.",
    "doctor_response": "Hi ! Good morning. I am Dr Shareef answering your query.As regards your diarrhea is concerned, I would advise you not to eat from outside if you do, as most of the intestinal infections come from food and water which are prepared and kept in unhygienic conditions unlike at home. If I were your doctor, I would advise you for a routine stool test for ova and cyst, and give appropriate antibiotics if need be to cure the intestinal infection.The pain in the lower abdomen could also be part of the symptoms of intestinal infection and not necessarily due to the ovaries. I do not know why the thought of ovaries came to your mind. However, to clear your doubts and to have peace of mind, you can go for an abdominal ultrasound if need be after getting assessed by a gynaecologist.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I experience contraction in throat, nasal passage and airways while inhaling. Why?\n\nHello doctor, I have problems with exhaling and inhaling. My exhale is extremely quick with a pause. My inhale is really difficult. I can feel my throat, nasal passage, airways, and throat contract when I breathe in. Also, all throughout my back I feel pressure from my backsides and lower back when I relax to try and let my body take over breathing. But if I just end up rolling my back, my tongue slides back and maybe the uvula clogges the airway as well and breathing becomes laborious and takes all my energy and thinking. Sometimes I can take two breaths before it hurts and becomes laborious. I order to breathe alright I have to hold my lower jaw in a position, move my tongue out of the way and hold it there, try to flex my chest downward and relax my belly. It is a lot of work to breathe. It is causing stress and anxiety. I cannot sleep, I have a pounding frontal and temporal lobe headache all the time and I have weird acid reflux unless I breathe a specific way. If I stop manually breathing, inhaling becomes near impossible and my throat feels like it caves in on itself. Also causing racing thoughts since when I relax it feels like my jaw and tongue are being stressed out and they twitch around too.",
    "doctor_response": "Hi,  Welcome to icliniq.com.  I am sorry you seem to be experiencing some trouble with your breathing pattern.  First of all, breathing is an involuntary response, meaning even if you try to hold your breath your brain will override this command and make you breathe. Breathing is an automatic response controlled by the respiratory control center of the brain within the medulla oblongata and pons. The muscles of the tongue are controlled by the hypoglossal nerve. The jaw thrust maneuver you are describing when you lay on your back is designed to open your airway.  Have you ever had any trauma or head injuries? Have you ever sought care for this before? You mentioned that this had been occurring for several years, so I assume you have had it looked at by a medical professional. Did your doctor do any tests, MRI, or CT scan?  It sounds like you have a lot going on. While I believe everyone can benefit from chiropractic care, it is my professional opinion, based on what you are describing that you are not a chiropractic candidate and that you should be evaluated neurologically, at the very least by your primary care physician. I believe he will want to refer you to an ENT or neurologist. Be evaluated by your primary care physician. I believe that he/she will want to refer you to an ENT or neurologist. In the event of an emergency, go to the ER. Respiratory issues can be life threatening and require immediate medical attention.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which homeopathic medicines can be taken for spirometry?\n\ni have checked from the Dr. Arora and he advise me to take medicine for spirimetry-Early small airway obstructinons. i have take about 2 months medicine we get no results. we want only homeopathy medicine.so sugest me the best homeo medicine. thanking you",
    "doctor_response": "start stannum met 6th ,carbo veg6th alternate day & calacarea florica 6x 4 tablate three times a day",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the device that helps in maintaining the erection stopping the reverse blood flow?\n\nI am asking for my husband who had prostate surgery almost a year ago. He had the DaVinci robotic surgery and is doing well ( no incontinence) . We have both read the recommended book regarding pre-and post operative problems associated with the surgery. He had to use Viagra before the surgery and is continuing with it now. The problem which is very frustrating for him is that he can t maintain an erection due to the reverse blood flow. We understand there might be a device he can use to help with this, but don t know where to obtain them without going to any Internet site.",
    "doctor_response": "HelloThanks for query.Your husband has undergone Radical Prostatectomy for cancer of the prostate and has retrograde ejaculation .During surgery of Radical Prostatectomy entire prostate bladder neck is resected .During ejaculation bladder neck i gets closed tightly that prevents entry of semen in bladder .But as the bladder neck is resected during surgery the semen enters freely into bladder instead of entering forward in to urethra what is called as Retrograde ejaculation .This is known complication of prostatectomy and can not be cured by any device or medications.Thanks and Regards.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes leg cramp followed by fainting while running in the gym?\n\nDear Dr, Samuel, Hope you are doing well. While running yesterday in the gym i got a leg cramp and stopped and while waiting for the cramp to go, I got dizzy and almost fainted. What might be the reason this happened. FYI I never felt the same way, have been going to the gym for couple of months but had a long break of 3 months before this case.",
    "doctor_response": "Hi, It is very difficult to talk about dizziness like one in your case. There could be many reasons including electrolyte imbalance, secondary to cramps, or just BP Problems. I suggest you get a complete workup done to rule out any major cardiac or neurological issues. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain in middle of chest?\n\nI'm 16 years old and over a period of time I've had moments where I get a somewhat sharp pain in my chest, in the middle to be exact and with it, it gets a lot of pressure too and It's very difficult for me to breathe. It only lasts for a few seconds every time it happens.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. At your age, stress and anxiety are more likely causes for your symptoms (central chest tightness, pain, breathing difficulty).. But better to get done ecg, 2d echo and PFT (Pulmonary Function Test) to rule out heart and lung diseases.If all these are normal then no need to worry much. Consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic drugs (propranolol and flunarizine combination) too.Don't worry, you will be alright with all these. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the charlie horses occurring in odd places?\n\nI have been getting charlie horses in odd places for 10years.I am67.The TONGUE, the web of the left hand,as well as legs and feet.A year and a half ago I started getting them in the left thumb and the neck,5_6 times in a row.The thumb bends as much as possible and pushes against the palm,and I cannot move it.Recently I got 30 in my neck over an hour,followed by30 in the thumb.???",
    "doctor_response": "Hello, I have studied your case. Due to compression of nerve root there can be tingling numbness in your arm and pain.For these symptoms analgesic and neurotropic medication like pregabalin and methylcobalamine can be started.Continue your Physiotherapy like ultrasound and interferential therapy will give quick relief.I will advise to check your vit B12 and vit D3 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can MRSA be treated?\n\n48 y/o client Recent appendectomy Returned to hospital for MRSA infection in wound History of emphysema, still smokes 1 PPD Nursing diagnosis #1 : Goal #1 : Intervention #1 : Intervention # 2 : Goal #2 : Intervention #1 : Intervention #2 : Evaluation criteria:",
    "doctor_response": "Hello,There are many antibiotics that can be used to treat MRSA. You need to have a wound culture and get antibiotics based upon the results of that culture. Your doctor may put you on an antibiotic that usually covers MRSA and then change it (if needed) when the culture result comes back.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Nephrotic syndrome, suffered relapse, on ayurvedic medicines, has swelling in the eyes every morning that reduces by evening. Help?\n\nmy daughter has nephrotic syndrome since march 2010 was on and off steriods for 1 years and was okay ever since she was on ayurvedic but got a relapse now ten days past. ayurvedic doc says she will recover with ayuveda medicine. she has swelling in the eyes and today it has become less. it comes in the morning and dissappears by evening. her protien in 4 plus.",
    "doctor_response": "Hi,Welcome to HCM,After going through history of your daughter, she is suffering from kidney disease possibly Nephrotic syndrome.Look there are many causes of Nephrotic Syndrome and treatment depends on cause, if she was properly investigated by Nephrologist and with treatment improved it needs to be followed up on regular basis and if if relapse is there she must be seen by Nephrologist and investigated and treated accordingly. Mostly Renal function( BUN,Creatinine),Urine R&M 24 hours urine protein. Renal USG,Renal biopsy and other investigations.It is not clear if Kidney Biopsy was done or not and if yes what type of disease was there as not all pathology respond to steroid drugs.Steroid responsive is minimal change disease and other may require other treatment.In the mean time low protein,low salt and high carbohydrate and fat diet with limited fluid to continue.Be careful because sometime  alternative medicine may contain nephrotoxic contents hence we do not advise to take such treatment .Please take careGood Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What symptoms would one experience when the USG shows an oval unilocular exophytic cyst at the lower pole of the left kidney?\n\nI have a 3.8 cm oval unilocular exophytic cyst lower pole of left kidney. There is no solid renal masses. My cyst has doubled in size each year over the last four years. What are the symptoms I should feel from it? I also had low creatinine on a test...and a moderately distended bladder",
    "doctor_response": "symptoms from cyst may be pain or some dragging sensation or if cyst is large enough it may squeeze normal kidney tissue and person may present with decreased renal function..u have creatinine problem ...and cyst is increasing in size andcitvis complex cyst ..you should see your general physician or a nephrologist better ......as far as creatinune thing ...if it is low it is fine but if it is high it is not good",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for extreme pain in the tailbone area\n\nI ve been experiencing extreme pain in the tailbone area. I have swelling at the top of the butt crack, sort of in an upside down u-shape, that is extremely tender and warm to the touch. I ve tried icing it but doesnt help. I have bruised my tailbone before but this pain is much more excruciating, occuring even when there is no pressure on the area (i.e. Standing, laying on stomach). I am a young male and really want to find a way to cure this without seeing a doctor because i dont have insurance. Is there any way i can?",
    "doctor_response": "Tail bone fracture takes times to heal. But here do you have taken x rays? and checked that it is tail bone fracture only. If yes then all right. If not then take a x ray and get it checked with orthopedic. Since you are telling you have pain even when you sleep on your stomach I think you have also injured your lower back. So a specialist  consultation is must. Here I must suggest to think on early rehabilitation then the money part because the more you delay. Your recovery time will also be delay and so that there will be a loss of  effective working hours for you. You can also use the ring cusion comes like tube with hollow from center so that when you sit on it. It will not give pressure on your tail bone.I must suggest based on the injury there is physiotherapy treatment is also available so visit once and check on treatment therapy with exercise program for your problemTake care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Braces in mouth, have enlarged papillae on tongue, white streaks on gums, dryness in mouth, swollen lips, burning on using bactidol. No relief with kamillosan spray. What else can be done?\n\nhello. i m having enlarged papillae on my tongue , my taste buds are gone, my gums are having white streaks, having a dry mouth and every morning when i woke up, i have swollen lips but eventually subsides later on the day. i cant tolerate brushing my teeth and gargling with bactidol longer since im having stinging or burning pain. i just had my braces a month ago. my dentist told me this isnt allergy on metal since, if i had, it should have been last month upon putting my braces that these symptoms would occur. he prescribed me kamillosan spray. im using this for 4 days already and i havent seen any effect. help :(",
    "doctor_response": "the sole reason for experiencing this problem has to be inadequate intake of water and inability to properly clean the oral cavity. i would recommend artificial salivary stimulate like wet mouth, use of proper brushing technique with orthodontic brush,use of alcohol free mouthwash(which would prevent stinging and burning pain while rinsing) and 3 week course of vitamin c (Limcee) tablet once a day after breakfast. hope this would solve your problem. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a painful thumb?\n\nHi there, I am having a throbbing pain in my thumb and I don t recall smashing it with anything. It s almost like I feel my heartbeat in my thumb and it feels hot and sore. I ve had this before but I usually just wait it out a while. The nail is not black, basically appears normal. Any suggestions to relieve pain and what is it exactly?",
    "doctor_response": "Hello,I think it is a thumb extensor tendonitis which is an inflammation from may be overuse (profession or cell phone texting too much). If the pain goes to the forearm might be De Quervain stenosing tendonitis. The initial treatment is anti-inflammatory drugs such as Ibuprofen, ice packs resting the finger splinting with brace or cast. If not better the second stage is cortisone injection around the tendon sheath. If not better the third stage of treatment is surgery but this is rare.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Edvin Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes atrophy of the lower leg muscle?\n\nin 1998 I ruptured l5s1 and had a laminectomy, I did well for several years, but over the last couple of years have noticed atrophy of my r lower leg muscle, burning pain down my leg. I am on Neurontin, and wrap my leg with an ace wrap in order to continue working. Is there a way to reverse the atrophy and pain without surgery",
    "doctor_response": "Hi, I value your concern regarding the symptoms. I have gone through your symptoms, and in my opinion if the atrophy has been for more than a year than chances of it recovering even with surgery are minimal. meanwhile I would like to have your complete examination and MRI investigation to see the status of your spine now. there are chances that if surgery can no more be done than you would need good physio to have some recovery.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.Special note-  Any medication prescribed needs to be taken after consultation with your personal doctor only.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes soreness in thumb with arm pain?\n\nMy son has been around his cousin who I just found out had MRSA on the bottom of his foot. He also had a red line going from his foot to his groin. His father called me to tell me that he had a sore on his thumb from riding his dirt bike and now complaining his entire arm hurts and has a red line from his hand to his armpit.",
    "doctor_response": "he has developed a complication called lymphangitis due to the infection. as this is MRSA infection he needs to be treated with appropriate antibiotics as per the sensitivity pattern.  hope this answers your questions.  all the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any side effects of valparin chrono tablets 300 mg and 500 mg?\n\nhi i had taken valparin chrono tablets (300 mg in morning & 500 mg at night) for 4 yrs ...for the treatment of neurocysticercosis..now as adviced by doctor i hv stopped the medicine...but sometimes I feel unconscious after waking up in the morning...pls suggest if there is any side effect of these doses.. YYYY@YYYY",
    "doctor_response": "Hello, It produces neurological side effects like nystagmus, ataxia, etc. It also produces fulminant hepatitis, curling of hair. Some git disturbances also there. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.T. BALAMURALI, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the risk factors for pelvic dysplasia in pregnant woman?\n\nMy daughter is only 24 weeks pregnant but was just diagnosed with pelvic dysplasia. She has pain in her lower pelvis when she is walking around or certain movements. Dr checked baby & cervix and all is fine. but I am concerned as she has a very physical job as a physical therapist in a hospital, with long hours. is this a dangerous condition to her or a risk to her pregnancy?",
    "doctor_response": "hi,thank-you for providing the brief history of your daughter.As she is diagnosed with pelvic dysplasia, this is called the inflammation of the cervix. It means after a thorough clinical examination by the gynec should be commented after an ultrasonography.Also, as she is a physical therapist she needs to modify her role as a physical therapist and avoid straining alot. Also there will be pain due to inflammation but will be all fine with rest.In my clinical practice we teach pregnant females with Lamaze's exercises to help mother deliver the baby with confidence and also breathing exercises.We advice to avoid the stress and strain on the muscles and body.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the pill dosage to stop heavy periods?\n\nMy birthday is this Thursday and im currently on the 12 day of my period. My period usually lasts 1 month with super heavy bleeding and Im going to get birth control pills on Monday I was wondering how much does it take for the pills to stop your period.",
    "doctor_response": "Hi!To stop heavy bleeding you should start with one in a day .Only after birth control  you will have again heavy bleeding you should contact with your gynecologist to determine the reason of it.Best regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for a crushed leg?\n\nmy friend had his leg crushed by truck 25 years ago, since then there s infection in bone which is weeping, he got homeopathic drops some years ago which helped alleviate the prob. it started to dry up but discontinued due to house move. have u any idea what they may have been it was 2 drops orally daily",
    "doctor_response": "Hello, Sorry to hear about this. As the infection isn't getting subsided it needs proper medical attention to control the infection as it may spread to the bloodstream and other regions of the body. There are a bunch of homoeopathic medication and it's really difficult for anyone to guess what exactly the medicinal mixture would have been. Having contact with the infection specialist should help figure out what infection it was and which microorganism was involved in the infection. Controlling infection is better rather allow it to spread. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I feel less thirsty?\n\nI am 10, between about 1.3m to 1.2m, weigh 24kg and I haven t had any major illnesses, apart from being knocked out for a few seconds (I think) after a fall when I was around six or seven. I don t get thirsty, even when my friend, who is the same age as me, was extremely thirsty. I m also really thin, with not much muscle or fat. Is this dangerous? If so, what can I do?",
    "doctor_response": "Dear ,You are absolutely fine and feeling less thirsty is not a problem. 60% of our body is composed of water and intake of 2 to 3 ltd of water per day is good.Please try to see that you are taking atleast 2 to 3 ltd per day water,buttermilk or any home fluids.Your weight of 24 is less for that age. You should be 30 to 34kgs . So,please see that you take high energy dense food in small quantities more frequently, like black gram and jaggery powder,groundnut ,jaggery and ghee powder,boiled and cooked pulses.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there bleeding for over 24 hours after wisdom tooth removal?\n\nHi doctor, I have got my wisdom teeth out yesterday and they have been bleeding for over 24 hours. Is this normal?",
    "doctor_response": "Hi. Yes, it is normal. You just keep a cold cotton pack for the next two hours at the socket. This will make the clot. Then start with saline water mouthrinses five times a day for the next whole week. Take a 1/4th teaspoon of salt in a cup of lukewarm water and do its rinses. It will heal up your socket fast. Stay happy and blessed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does swollen lymph nodes in armpit suggest?\n\nI am a 25 year old female who often has slightly swollen and tender-to-touch lymph nodes in my armpit.  Is this something that I should be concerned about?  How do I know when there is a \"lump\" I should be worried about and when it is normal body shifts?",
    "doctor_response": "Hi,It seems that you might be having enlarged tender axillary lymph  nodes giving this problem.This shows that there might be having some infection in surrounding area like hands, some infection following shaving the part.consult your doctor and get examined and go for treatment of infection if present.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for ear ache and cold sensation in tooth after putting a crown\n\nI had a temporary crown put on 5 days ago.  I started having around the #31 molar with crown.  Had pain in my jaw and an ear ache.  I went back to the dentist today and he took a good look at it and adjusted the crown a little and did a couple of tests.  He did not think the tooth needed a root canal and thought it would get better.  He gave me some antibiotics.  I do not have sensitivity to cold and hot.  When I chew on it their is some sensitivity but not terrible.  He thought tooth was ok.  I am hoping the antibiotics help but I am getting tired of the pain.  What are your thoughts?",
    "doctor_response": "Thanks for using Health Care Magic.Read your query , where you have not mentioned what test the doctor had done.I would advise you to go and X-Ray done to evaluate the condition of the tooth and if needed get the root canal treatment done.Continung with the antibiotic you can take a pain killer (ibuprofen) if you are not allergic to any medicine.I recommend u to get the x-Ray done.Hope this is useful.Thanks and regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it concerning if there is pea sized superclavicular node in children?\n\nMy 11yo daughter had mono last April, an appendectomy in Dec. and is still experiencing fatigue. We went to physical on Wed. (had 3 vaccines) and her WBC is lower than last time and they want to recheck in 3 weeks. She is at 8% for her weight, fairly tall and active. Over the weekend, a pea sized superclavicular node appeared and is very tender. They said to wait and not come in. Should we be seen for this?",
    "doctor_response": "Hi...this could be a viral associated lymphadenopathy. But at the same time, I will explain you the danger signs when you need to get back to your doctor. Sudden increase in the size of the node, suddenly becoming extremely painful, persistent fever, loss of appetite, sudden and significant weight loss and bone pains. If these are there, I suggest you see the doctor immediately.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from asthma, bloating, obesity. On asthalin inhalers. Treatment?\n\nI am 41 years old & have been having asthma since my childhood! I have been using asthalin (Salbatamol) inhaler since my childhood too! However I am an athlete an work out extensively as in body building! Inspite of me being so I am still heavy & over weight & find I cannot lose weight & bloating is always there! Do you think it is so because of the inhaler that am am not being able to lose weight or cut the bloating??",
    "doctor_response": "YES INHALERS CAN CAUSE THIS IF YOU HAVE ASTHMA FOR LONG TIME IT MUST BE FROM MILK OR WHEAT YOU GET MILK AND WHEAT SPECIFIC ANTIBODIES IN YOUR SERUM AND YOU CAN GO FOR SLIT AS PERMANENT CURE FOR TIME BEING STOP ALL MILK AND DIARY PRODUCTS TAKE TAB SINGULAT BD TAB ALLEGRA BD SYP TOSSEX 1/2 TSF NIGHT AVOID ALL OILS MUSTARD COCONUT WALNUT GROUNDNUT AND ALMONMDS SOYA USE OLIVE FOR COOKING AND APPLYING AVOID ALL MILK AND NUT CONTAING SHAMPOO CREAM SOAP AND OINTMENMTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the lumps under the neck?\n\nHi I am a 48yr old female a few days ago as I prepared for a trip to Germany I notice what appeared to be a bug bite on the right side of my neck in the lower crease line. A few hrs later there were more small itchy  bumps in the crease. I thought heat rash but I now have a few more behind my right ear. As i palpate my neck I notice a few lumps under the skin on my neck. I think limp nodes maybe swollen. Any idea",
    "doctor_response": "Hi. Thanks for the query. As i understand, you have developed a localised reaction to the bug bite. You need not worry about them as they will disappear in a few days. Though you can take pain killers if you have pain. And as you guessed it right, the lump in the neck are lymph nodes which have got inflammed and they too will subside without treatment. But do consult a doctor if the swelling persists for a longer period.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can suction to biceps cause blood clots or embolism?\n\na woman created suction with her ear on my bicep when it was wet. This suction, when released, created a very painful reaction and a deep black/purple bruise to the inner part of my right bicep. I am wondering if there are any worries for such an injury such as blood clots, embolism or anything else.",
    "doctor_response": "Hello,No this kind of suction disrupts small blood vessels and can cause a bruise but nothing more serious. Just treat it like you would any bruise and it will resolve in a few weeks. There is no risk of clot or embolism in these small superficial vessels.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for continuous stomach upset after removing gall bladder?\n\nI had my gallbladder removed over a year ago now but ailments I had before seem to have worsened.i can t socialize and eating is a big issue everything seems to upset my stomach and make me poorly over a 3-4 day period..also I have terrible acid on a daily basis..help!",
    "doctor_response": "GALL BLADDER DISEASE AND PEPTIC ULCER DISEASES ARE KNOWN TO CO- EXIST. SINCE YOU REMAIN SYMPTOMATIC EVEN AFTER GALL BLADDER REMOVAL CONSIDER UPPER GI ENDOSCOPY TO RULE OUT STOMACH/DUODENAL ULCERS. OTHERWISE IT COULD BE A SIMPLE CASE OF BILE REFLUX IN STOMACH CAUSING GASTRITIS WHICH CAN BE RELIEVED BY AVOIDING SPICY AND FATTY MEALS AND ADDITION OF ANTACIDS/PPI GP OF DRUGS IN CONSULTATION WITH YOUR DOCTOR.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does severe pain in the lower back indicate?\n\nHi, I have been having major pain in my lower back for years. At the lower part of my back there is what looks like bruising that doesn t go away. I have problems standing for long periods of time, walking and bending is out. What could it possibly be?",
    "doctor_response": "Hi,Disk prolapse. In my opinion, these symptoms seem to indicate an intervertebral disk prolapse. I would like to investigate you with an x-ray and MRI. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Fahim Sheik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain behind the ear and temple after bumping my head in an accident. How serious is this?\n\nHi we rolled a truck about a wek ago. I received a few bumps on the top of my head. Those were sore for a few days but the pain subsided to nothing. However, behind my right ear and behind my temple about 2 inches there is and area which is extremely sensitive to the touch. If I push on the area with any pressure it feels like we'll I don't know. It just really hurts. Are there any major viens I could have done samage to?",
    "doctor_response": "HIThank for asking to  HCMAll head injury has to be  taken seriously at least for couple of days but here in your case that period has gone away so it may not be dangerous it may be soft tissue inflammation and will be subsided wth antiinflammatory drugs it is better to have antibiotic too take care and have good day",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of elevated liver enzymes?\n\nI HAD AML LEIUKEMIA IN 2001, AND HAD A STEM CELL TRANSPLANT ALSO. LATELY MY LIVER ENZYMES HAVE BEEN A LITTLE ELEVATED, BUT MY PLATELET COUNT IS AT 114,000 and MY FERRITIN LEVEL IS AT 2500. I JUST HAD A LIVER BIOPSY, BUT I AM WAITING ON THE RESULTS.I AM VERY NERVOUS WAITING, WHAT ARE YOUR THOUGHTS?",
    "doctor_response": "Hi thanks for asking question.You had aml and you treated well for it with stem cell transplantation.Usually liver enzymes elevated in hepatitis case.But in your case history of malignancy present and because of rich blood supply tumour can metastasise to liver.So for rulling out metastatic liver disease biopsy done.Second your serum ferritin level is high so by biopsy it will also rule out hemochromatosis if present.Third biopsy also helpful in filling out chronic hepatitis and its differential diagnosis.So wait for report and accordingly treatment done.Wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "My sister who is 21 she had polio attack in her childhood\n\nmy sister who is 21 she had polio attack in her childhood This is regd my sister who is 21 she had polio attack in her childhood... bcoz of that she lost her right leg.. she is not able to walk so she used to what we say, crawl since then folding another working leg which is right one..the nerves have been jammed we took her to Tirupati to the SVIMS hospital...they performed almost 5-6 operations for each leg...after that it was the physiotherapy which left out...but unfortunately due to unavoidable situations we couldnt make it..was not ablt to walk 5+ yrs now it seems the pain is reduced...",
    "doctor_response": "Physiotherapy is also very important for  your sister after the surgery It is very difficult to say how much it will help her without examning her take your sister to see an orthopedician and then for intensive physiotherapy/ as advised by the ortho. if you go to a medical college and the orthopedic feels that you just need physiotherapy then the total cost might be 100-150 RS per day for the physotherapy If the ortho feels that you might need more - then the cost may vary according to what is done from what you have told, she will most probably need physiotherapy for 2-3 months at least. St. Johns is a wonderful and very professional, well equipped hospital  you can definitely take your sister there for an examination Most people feel that medical college hospitals are not the best option.. but actually they are excellent",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itching in the groin area, discoloration. Reddish ring formed. Any medication?\n\nI'm a white male, early 30's. I have developed a uncomfortable itch in my groin area, mostly on the inside of my thigh where my scrotum is in regular contact. It started becoming discolored a few weeks ago, a light tan/brown color. Tonight I noticed a red ring outlining the discoloration on my left thigh. It mainly itches in the evening when I'm about to take a shower. Is this something gold bond or another otc powder or creme could remedy?",
    "doctor_response": "Hello,Thanks for the query,You are probably suffering from Tinea cruris a fungal infection.Apply oint clotrimazole for a month, you will get relief.If it persists you can meet a dermatologist.Let me know if you have any other doubts.you can ask a direct question to me on this forum, following the below link.  you good health.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dog bite\n\nhi...  My pet dog while he was playing yesterday his tooth got scratched my knees and i was not bleeding much, a drop of blood came out.... I have already got rabies vaccinated before 6 months i.e the course started from march and ends at april 2012... should i have to get vaccinated again or need not worry abt it ?",
    "doctor_response": "Hello,Welcome to HCM,Six months back you were bitten by dog for which you have taken all the shots of antirabies vaccine and once again you were scratched by a pet dog on your knee which led to bleeding from the site.According to WHO you were categorized into Re-Exposures and you should receive only two doses of vaccine on days 0 and 3. Even it is a Cat III bite there is no need of passive immunization.You will be having protective antibody titres and the vaccine on day 0 and 3 will boost up the immune system by anamnestic response and protects you from getting rabies even if the dog dies of rabies.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can diarrhea in an infant be treated?\n\nHello doctor My daughter is 20 months old, having loose motions yellow green in colour yesterday but now it s light green in colour and like mucous. Advice me medicine. I have given her bio combination 8 or for diarrhoea homeopathy medicine as she generally vomit allopathy medicine. But now ineed allopathy medicine to treat her asap. Kindly help me.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Green color stool can be normal or can be indication of hypermotile bowel. Just give child WHO ORS. Dissolve it well as per instruction (usually 1 packet in one liter water). If child vomits you can give antimetic like Ondansetron. Give syrup Zinc once a day for 15 days. Keep watch on activity of child and urine output. If you fill it's worsening visit your pediatrician. Generally children have diarrhea due to viral cause. 90 percent times only symptomatic treatment and hydration is needed. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headache , nausea ,numbness in arm and legs?\n\nmy father has been diagnosed with a infarct in his right side of his brain on 30 april was getting treatment  and was feeling better but fron last 20 days he is started hving problems severe headache, nosia, uneasyness , numbness in left arm, left leg and ribbs.",
    "doctor_response": "I think you will need to get him to the hospital againThere is a strong chance that he has developed another complication in the brainAnd this can be tested by an MRIOf course there are other possibilities. One of the main ones being a low sodium level. This can have all the symptoms that he has, and may in fact feel like he is having another stroke.So testing that would be as important. And can be done in a hospitalBest of luckDr Mittal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling jittery, chest pain, lightheadedness. Have asthma and anxiety. EKG, x-ray normal\n\nIve had two ekgs done, two chest xrays, my blood work.is Fine , but I still feel jittery alot, middle of my chest hurts, but I never lose my breath. I feel lightheaded. And when.I start running I feel weird. I do have asthma and thry told me i have high anxiety . My lungs and heart sound Fine. Could this be something serious?,",
    "doctor_response": "HIS IS ASTHMA NOT CONTROLLING SYMPTOMPS WITH MEDICINES IY CONTROLS DURING REST BUT DUING EXERCSE THEY CAUSE BREATHLESSNESSCAN ADD ABTIALLERGIC SINGULAR 10 MG BD APPLY NEOMYCIN EYE OINTMENT IN NOSE BD TO PREVENT ALLERGIES DURING EXERCISECAN CONTINUE LONG",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could negative Rh factor be the cause of elevated D-dimer?\n\nI am a 28 year old female.  I had my 4th child July 27, 2010.  3 days after his birth I was hospitalized for post partum pre-eclymasia and pulminary embolisim.  I was tested for everything in the book.  All tests came back negative for any genetic blood clotting disease, so the high blood pressure and PE were related to the delivery of my son.  My blood was thinned in the hospital with Heparin and I was sent home to give myself lovenox shots and put on cumadin for 6 months.  I finished my 6th month treament of coumadin and was taken off of it December 17th 2010.  My question is...  I had another d'dimer test yesterday and the results were 1.02.  I am Rh- ... could my Rh factor have anything to do with a slightly elevated D'dimer result?",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. your have rh negative blood group. But it has nothing to do with your elevated d dimer. If your fetous is rh positive then it can leads problem in baby at time of delivery. But as far as d dimer is concern, it has nothing to do with your rh negative blood group. So don't worry about that. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for chest pain with a history of anxiety?\n\nI'm a 23 year old female worried I may have a pancoast tumor. I'm a rather nervous person with a history of anxiety but lately it's peen the pain that worries me. I went to urgent care and was declared clear through urinalysis and blood work but my pain persists. The doctor said it may be a pinched nerve but didn't investigate. The pain is centered around my left armpit extending a little towards my chest and into my bicep. It's not excruciating but definitely bothersome. My left shoulder blade hurts a little too but not that bad. It doesn't bother me when I sleep but I cannot escape the fear its a sign of pancoast. My father recently passed away from lung cancer and had never smoked in his life, while I have casually dabbled. Would you suggest I get a ct scan? I have read x rays often miss these masses. Thank you in advance",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. The symptoms you are mentioning may not necessarily of pancoast tumor. Over and above, why are worrying about it. If there is a doubt about your physical condition please visit a physician for correct diagnosis and treatment. Don't worry yourself, don't self diagnose, don't have self medication.In a nutshell, the pains feels to be non-trouble and could mainly be of anxiety about your health, which can be named as hypochondriasis. There are psychotherapy techniques available for complete cure. Do post a direct question to me mentioning all your details and I shall prescribe some psychotherapeutic techniques which should help you.hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain under rib cage during sex?\n\nhi iam andy taking pamvax the pain  is just under my rib cage . when having sex itslike  a build up and then when it releases the pain has gone . its so weired . there 1 miniiut gone in the next  also feels like i need the toilet really bad when i go its just trickles out . but it feels like theres loads in there.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Sexual activity is considered as heavy exertion. So you are having chest pain with such heavy exertion. Your pain subside with once sexual activity is over. So we should definitely rule out heart diseases in your case because heart diseases commonly cause chest pain on exertion. So get done blood pressure monitoring, ecg and 2d echo. You may need cardiac supportive drugs. If all these are normal then no need to worry for heart diseases. Sometimes musculoskeletal pain can also cause similar symptoms. So apply warm water pad on affected areas. Take painkiller like ibuprofen. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest alternative treatment for gall bladder stone\n\nI have Gallbladder stone of 8.2 mm size. Is ti possible to remove the stone without removing the gallbladder itself. I am 50 years old. In case i remove Gallbladder, will there be any problem in future like life style changes, food habits, etc.. Kindly advise me.",
    "doctor_response": "Hello Findings suggests a large gall bladder calculus.Medicines are usually not helpful in gall badder calculus.You should go for definitive treatment of gall bladder calculus.Definitive treatment of gall bladder calculus is surgical removal of gall bladder(cholecystectomy).Gall bladder calculus is prone to infection and obstruction,so it is advised to get rid of calculus early.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of lump under my left nipple?\n\nI have a lump under my left nipple, slightly painful, tender and a bit hard when I touch it. Only noticed this in the last 24 hours. I am a 29 year old male, good health, non smoker and non drinker. Also, weight not much of an issue for me as I am relatively slim build. Any suggestions as I am concerned.",
    "doctor_response": "Hi,Welcome to HealthcareMagic.That lump could be a fibroadenoma or a cyst. You need to show it to a surgeon for a physical examination to help reach a diagnosis. He may even ask up to get a needle biopsy of the lump.Finally depending upon the diagnosis, its excision can be planned.Usually at your age the chance of malignancy is very rare, so you need not worry much about it aspect.Hope i have been helpful.Regards,Dr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have small lump near scrotum, weight loss and poor diet. History of thyroid and prostate cancer. Medication?\n\ni have a small lump ,pea sized , in my gooch area , between where the base of my scrotum attaches and my anus :( hurts if i touch it, i get spots and ingrown hairs, also i need the toilet alot, i have lost weight over the past few years (but this is more likely due to not eating through depression ), i have problems with my digestive system as well, but again i have very poor diet. i thought i might have diabetes and was going to go get tested until i found this lump, and i have found out there is history of both thyroid cancer in my family on my mums side and prostate cancer in my family on my dads side. i would also like to add i did have the odd problem getting it up with my last gf but i also have history of masturbation so iput these few occasions down to too mucha that....",
    "doctor_response": "Hello. Thanks for writing to us. A small pea sized lump in the area you have described is likely to be due to inflamed hair follicle or a sebaceous gland. You need to observe good hygiene and can apply antiseptic ointment like neosporin in the area for some relief. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is my free PSA abnormal?\n\nHello doctor, 50 years old, 5.8 inches, 260 lbs. On blood pressure pills. My doctor is out of town for a few weeks. I reviewed PSA test results and apparently I have one abnormal reading out of three. PSA total 0.5, PSA free 0.1, PSA % free 20. The PSA % free 20 is in red indicating abnormal. What does this mean? What causes it to be abnormal?",
    "doctor_response": "Hi. Free PSA should be more than 15 % to rule out prostate cancer. Free PSA is an additional tool used when PSA is above 2.5 and we want to check whether high PSA is due to benign prostate growth or due to prostate cancer. Some laboratories use 25 % cutoff, but most have 15 % cutoff value. Since your total PSA is quite low and free PSA is above 15 %, you should not worry. If in doubt, repeat after a few months.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the ways to treat patch due to hair loss?\n\nHi doctor, I have been experiencing a patch of hair loss and it is getting bigger. I had two but the one is gone now. I am very proud of my hair and this makes me emotional.",
    "doctor_response": "Hi. This is alopecia areata, and the patch on your backside of the scalp is ophiasis, a subtype of alopecia areata. It is thought to be an autoimmune disease in which hair loss is in the form of patches but comes back itself as you have told. Meanwhile, you can apply topical steroids over it like Fluticasone propionate ointment or lotion. Another option is a mixture of topical Canthradine plus topical Capsicum and Methylated spirit in equal proportion and apply for five minutes twice per week as they have an irritant effect. Topical steroids will be beneficial for you. Follow up at one month. Alopecia areata. Apply Fluticasone propionate ointment or lotion over the area, take Multivitamins.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can neck, back and, leg pain and nausea be treated?\n\nI have been suffering from pain in my neck, back and legs. I have also had numb arms when lying down, though whilst awake I regularly have an ice cold feeling in the back of my hands. I also have fatigue like I have never experienced before. I have a real problem with nausea and now get car sick even when I am driving which I have never experienced before, it is an extreme pressure on my head and I find I can not focus on anything as it is a fight to get my eyes to look where I want them to. I have also woken through the night and my right eye that I have pain in regularly is dimmer than my left eye, this can last for a few minutes before my eye returns to normal. I have had two CT scans as my lymph nodes were causing concern due to the number and size of them. I had a biopsy from adenoidal tissue and this came back clear, so thankfully no lymphoma. I am not working at the moment and able to rest but instead of getting better I am getting worse. I had 2 weeks were I thought I was getting better but at night I am back to my body aching all over. My GP thinks it is ME/ Chronic Fatigue, I am worried it could be MS, I have never had a head CT carried out to have this ruled out. Also I have been suffering a lot from heartburn and constipation.",
    "doctor_response": "I cannot comment on big opinions of others but I need to know your inter vertebral position of cervical and lumbo sacral region. It should be excluded. I think intervertebral disc space in cervical spine is compressed putting pressure on nerves and , may be some vessels too, causing first set of symptoms narrated by  you.If it's so please manage by traction or cervical collar support.Similarly for leg pains if any which is caused by lumbo sacral region. If not affected, other things may be thought of.Heartburn n constipation: have lot of walks, water intake, fibers in food and some safe herbals sometimes  since constipation is the habit of intestines and its not a disease. By above methods, peristaltic movements of intestines will be restored. For heartburn, primarily little qtys of cold milk with a cookie or half slice of bread may be taken frequently. It will neutralise excess acid. If not settled, antacid ( prefer herbal powder like Avipattikar chooran - little bitter) may be tried. If doesn't settle in a week, further checks for oesoophagitis etc may be done. So exclude simple things first. No need to take stress. Life is for limited validity like prepaid sim. Don't panic. Enjoy it.Hope it helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fibromyalgia and migraine\n\nHello and thank you for your time and assistance, I have severe fibromyalgia, migraines, adult onset diabetes, cervical radiculopathy, c4,5,6,7 moderate to severe bi-lateral foraminal encroachment , post concussion disorder, thyroiditis. Would you have ordered an emg test for any reason considering the pain that it could possibly cause a continual cycle of pain?",
    "doctor_response": "Hi, You need to focus more on doing exercises and allow the muscle fibers to regain the normalcy. Fibromyalgia is a common term used now a day's by most as they cannot do much with the pain medication. but fibromyalgia is a different terminology to address. The pain you have is due to the cervical disc degenerative changes which has led to chronic inflammation in the trapezius muscle. Doing regular exercise and getting correction of the muscle imbalance due to weakness and improving the stability of the paraspinal muscles should help further. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do pain and bloating in the upper abdomen on the right side indicate?\n\n17 weeks ago I woke up with pain on upper right side of stomach. By end of day I as bloated and in extreme pain. Ended up going to ER and kept overnight. Discharged next day. Said my entire digestive system was infected. Gave me 3 difference antibiotics and it made the pain go away but I still look like i m 9 mos pregnant (I m 56). Had every test imaginable. Nothing. I also used to run to the restroom constantly -bladder issues and I had a lot of foul gas. Now I never pass gas and I have to make myself go urinate a couple times a day. I just have to sit and wait to go. Sometimes up to 5 minutes. I ve lost 30 pounds in 17 weeks. What is wrong with me. If I eat, bile comes up my throat. I m getting desparate for help.",
    "doctor_response": "Hi, Most possible issue sounds here is lack of digestive enzymes or intestine motility related issue, where all of the investigations will turn out to be normal. Please provide me all reports as scanned copy for further assistance. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take narcotics and gabapentin for degenerative disc disease while suffering from hepatitis C?\n\nHello, I was diagnosed with hep c in 1980, am taking narcotics and gabapentin for pain relief from degenerative disc disease, I was apparently having allergic reactions to the gabapentin and was prescribed lactulose with no questions, warnings, contraindications or instructions to follow. Also, no instructions to follow at least 6 hours prior to a serum ammonia level test that was high, now have suffered severe insomnia, nausea, gas, bloating, headaches , rash and pain due to my reluctance to take my regularly prescribed narcotics(Oxycodone and Morphine XR) because they cause constipation, I am taking several of the medications that are contraindicated with LACTALOSE. What should I do and how long should I wait to take my medications that are contraindicated with lactulose. Thank You, Sincerely, Harry Hoskins",
    "doctor_response": "hi,thank you for Providing the brief history of you.A thorough clinical Neuromuscular assessment is advised along with MRI of spine.As you have degenerative disc disease and also on medication, then to make you understand and help better there is a limitation of the medicine for symptomatic relief. The degenerative disc disease occurs dude to weakness of the spinal muscles which allows the spinal column to reduce in size and then later provides compression on the disc and the pinching of the nerve roots.Usually in my clinical practice such cases with degenerative disc disease are recommended with physical therapy as to get the maximum outcome and reduce the medication. As medicine over a longer run are not good for the kidneys and may lead to damage. Physical therapy like - Therapeutic ultrasound therapy and TENS therapy are useful to control the pain without any side effects and also exercises on a later stages provide the maximum outcome score of Strength of the muscular system. Also, TENS works even better when you are under medication for a shorter time.regardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for pain in the right finger?\n\nHi, i have a pain in my right fingers (middle finger and ring finger) a friends doctor told me to take Nurokind-plus. I do have this already for 1year. Can this problemen come from my Back? Pleas advice. Is Nurokind-plus just a vitamine? I have read on the internet that this product is actually band. Thank you",
    "doctor_response": "Hello, There are many medical conditions related to pain in the finger. One common cause can be arthritis. I suggest doing a complete blood count, ESR level, and rheumatoid factor for further evaluation. Meanwhile, I suggest using anti-inflammatory medications such as Acetaminophen to relieve the symptoms. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe back pain?\n\nI have had back pain for almost 2 weeks. This in itself is not unusual, as i believe it is a pinching of a nerve which I have experienced before. This in turn creates a pain going down to the knee area. However, this is not my main concern. My right shin has a strange spongy feeling when I press against it, and the flesh stays depressed after taking my fingers away. Bruising follows after a day or so. I have been working whilst on my knees for short periods lately, but have had no injuries.",
    "doctor_response": "Hi,The spongy feeling you describe that is brought on pressing the shin is called pitting edema. It is not related to the back ache that you have been experiencing due to a pinched nerve. It is mostly related to either pooling of blood in your lower limbs or thyroid/ liver/ kidney issues. I would suggest you consult a general physician and get it sorted out after doing blood check for thyroid, liver and kidney function.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat mild nervous problem?\n\nmy mother last month suddenly became senseless and after some time her body was found jerking and something like foam came out from her mouth.she was admitted to a private hospital.threre CT scan,EEG,and many other blood test was done.other test except EEG was ok.in EEG report a mild nervous problem was reported.Levipil 500,Oxetol 300 was prescribed two times a day.now i want to know whether this to medicine is appropriate in this case.pls reply",
    "doctor_response": "Hello, Her symptoms and abnormal EEG suggest seizures. So, the drugs started are anticonvulsant drugs and are appropriate for your mothers' case. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Should I brush my teeth after a wisdom tooth removal?\n\nHello doctor, I just got all four of my wisdom teeth removed last week. I was looking at my back teeth, both top and bottom. On all the four teeth, at the very back of my mouth, just front of where the wisdom teeth were, I noticed what appears to be brown hairline-looking marks in the pits and on the sides of those back teeth. I am afraid they are cavities because, I did not brush much the past week, as I did not want to upset the wisdom teeth holes. Does this sound like cavities to you? I cannot think of what else they could be, but I did not realize they formed that quick. I am really upset because I am 18, and I have never once had a cavity in the past. And, now it seems like I do, just because my wisdom teeth did not allow me to brush back there.",
    "doctor_response": "Hello. If you still have some concerns, you can consult me by uploading a picture of those stains. For further queries consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe swollen glands\n\nHello, my name is Sheila Whitmeyer, and I live in Wilmington, NC. I was just diagnosed with mono, on Thursday. I am experiening severe swollen glands if I sit up or walk around at all in our condo. I have been home and out of work since Thursday. One of my questions is: 1. Should I be concerned that not only do I get swollen lympth nodes, by my neck on both sides, tonight I am experiencing very severe swelling in my upper back. I am just sitting up, and the gland are swelling very very quickly.",
    "doctor_response": "swollen glands especially in aged ones are things to worry aboutUSG along with FNAC test are recommended as these could be tuberculosis, viral infection, just physiological or even malignancyhave the tests if they persist for more than a weekall the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to increase sex drive and penis strength\n\nHello sir I am deepak 25 years old. Due to the mistakes of my childhood by the masterbation, I have lost my baody power, ability of sex, my penis has got short and bend and mussels are to weak and the semen falls with urin and I feel to lazy. Due to this sometimes I think for suicide. Plese suggest me which pathy can solve my desease with economly.",
    "doctor_response": "your problem is psychological. you have lots of myths regarding sex and masturbation inside your mind , which keeps you disturbed. you need to contact a psychologist or psychiatrist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are measles vaccination advisable while on antibiotics in infants?\n\nHi, my 9month old child is taking antibiotics as a part of his medication for cough and colds but he has a scheduled measles vaccination on the 2nd of february and that s also the last day of his intake of amoxicillin for 7days. Is is ok to proceed with the measles vaccine although he still has antibiotics on his system? Thanks.",
    "doctor_response": "Yes, welcome to HCM. Can understand your concerns. Measles vaccine can be given while on antibiotics but fever should not be present.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diabetic. Scan report shows blood clot in brain. Serious?\n\nMy father found to have guidiness yesterday. He is 60 years old and is diabetic.It was 222 last week. Suddenly it dropped to 72 yesterday and he was unstable. Went to hospital and was told there is blood clot in brain. Right lentiform nucleus infarct was there in the scan report. what does it mean ? Is it dangerous. is it curable",
    "doctor_response": "Hello,It looks like a Cerebrovascular Accident, A small infarct ??.  This infarct itself may not be dangerous if it is not evolving to a larger infarct. But you need to see a neurologist to get started on prophylactic medications to prevent similar events in future. Cardiological check up in view of uncontrolled diabetes and rule out a source of clot.Wish your father an earlier recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Blood test report shows pernicious anemia. Can b12 affect sugar levels?\n\ngot a blood test done today as the doctor told me last week my blood sugar was a bit high,i have pernicious anemia and my doctor told me today not to get my injection untill the results come back, can b12 effect sugar levels or is something to do with my immune system",
    "doctor_response": "No there is not relation or interaction between B12 and anti diabetic   drugs , you should administer your drug for DM now so avoid complication of DM Hoping you get well soon Dr.Adel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does clomid help in getting regular periods?\n\nI have been trying to concieve for 15 months, I am trying to educate myself about why I havent achieved a pregnancy yet, but the more I read the more I stress and and think it will never happen. My doctor is putting me on clomid because I am not ovulating and I have heard and read success but also a lot more failure with it. What more can I do or not do? I feel this month is my last chance to try because my period comes for 2 months then stops for 2 months. Will the clomid help me get a regular period back?",
    "doctor_response": "Hi, I think you should go for evaluation first.  Do a thyroid profile and prolactin levels and a ultrasound for your uterus and ovaries. also a semen analysis of your husband should be done. You can take clomid and then 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.  Clomid can make your periods regular because it results in ovulation.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause pain in lower back and spine after having spinal taps?\n\nI had 4 spinal taps when i had my son and about 1-2 wks after I had him I started getting pains in my lower back that go up as far as the top spinal was done and the pain feels like contractions like when in labor, what could this be? I also get pains in my hips to the point my hips are actually numb.",
    "doctor_response": "Dear patient lower back pain is very common complaint after spinal or dual puncture. And since there are multiple punctures in your case further increase risk of back pain. There are multi reasons for that like 1.local muscle spasm 2. Puncture site inflammation and infection 3. Decrease in spinal fluid amount. Get yourself examined for all this possible etiology. Numbness in your hips might be due to nerve irritation during spinal picture.  I would suggest you to visit expert spine surgeon and take an opinion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Atarax or Xyzal be given to a toddler for the treatment of eczema?\n\nMy son is suffering from eczema..he have rashes all over the body ..he couldn t sleep due to itching and crying all the night..he is 2 and half years old..he is suffering from cold and cough also. Can I give him atarax or xyzal..does it have any side effects",
    "doctor_response": "Hi, These are anti-allergic medicines. We can use in eczema to relieve itching. But main treatment in eczema is moisturizer. You can any good quality moisturizing cream. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Omprakash Ashokrao Deshmukh, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recommend treatment options for mitral heart valve disease\n\nHI,My father is 72 years old and suffering from mitral heart valve problem,we have done treatment at CIMS hospital Ahmedabad Gujarat where doctors suggested that it needs to be replaced but unfortunately PFT rreport is weak in this case and we are unable to operate for the same.Need your suggestion for any other alternative without surgery.",
    "doctor_response": "Hello,I have gone through your question.I need to know exact severity of mitral regurgitation to guide you exactly.if lungs are weak then valve replacement surgery carries high risk.Then at this age he should restrict his activity and take proper medicines .My best wishes Dr.Rajesh Teli,MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the medications for hypertension?\n\nhi i have been prescribed lisinopril/hctz 20-12.5 and carvedilol 25mg for my hypertension but my pressure remains high averaging 170/90. i have been on this medication for like 5 days now so i would like to know what to do if i should go back to my dr or what.",
    "doctor_response": "Dear Sir/ MadamThanks for your query.1. Most classes of medications used for controlling blood pressure on office basis take 2-3 weeks to show full effect. Only during emergencies like stroke, heart attack or very high readings with evidence of end-organ damage, we try to bring it down rapidly.2. If you have any trouble or symptoms which are bothering you, you must see your physician on priority.SincerelySukhvinder",
    "dialogue_context": ""
  },
  {
    "patient_message": "Oligomenorrhea, duphaston, endometrial cancer\n\nhi i am 22, single and not sexually active.. i have oligomenorrhea , having my period mostly every after 3 months. last year my doctor gave me a 5day trial pill of duphaston just to test if it s hormonal imbalance. i m worried about pcos but i am not obese . i stand 5 2 and weighs 47 kgs.. do i need to take OCP s? im afraid of the side efects and i really need to, will i take it with metformin? am i prone to endometrial cancer because of my cycle?i m so confused. A doctor required transrectal ultrasound for me.",
    "doctor_response": "Hi Oligomenorrhea is one of the most common menstrual problem during early years after menarche. Sometimes it may even go ypto 25 years. An ultra sound scan of abdomen will rule out PCOS. It may be managed by various medical protocols. There is no need to worry about endometrial cancer because of this. I guess you are very anxious because of your present problem which may still get aggravated because of your anxiety. So stay cool and your problem will get settled soon. All the best. Mohammed Ibrahim Surgical Oncologist mdibrahimdr@yahoo.co.in",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for occasional inability to walk\n\nMy friend, a female 58 yrs. old, has had thyroid removed. Now has occasional inability to walk, or remain conscious at times. Medical people treating her seem unable to decide what to do for her.She eventually seems to mostly recover, but it comes back at times. I'd guess, as a layman, that it may be due to some type of hormone loss due to the missing thyroid. It was removed a few years ago because she then experienced bulging eye problems due to thyroid irregularities. What likely could be done?",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.It may be related to less thyroid hormone. You can adjust your thyroid hormone level by taking thyroxine. You can get your thyroid function test ( T3, T4 and TSH) . If found abnormalities then you can take its treatment after consulting your doctor. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for an itchy rash on legs of a child\n\nMy 7 year old was using sidewalk chalk on Sunday and then on Monday she woke up with a rash over both legs. It is still there and is very itchy. I have tried to using store brand calamine lotion to help with the itching also I gave her some benedryl. Is there anything else I could do to help her? I am noticing that it appears the rash is spreading but it may be from her scratching.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query your child have symptoms of  itchy rash on legs which seems to be due to allergic reaction leading to dermatitis. Need not to worry. I would suggest you to start taking anti allergic medications such as Allegra. You should maintain proper cleanliness and avoid scratching the bumps to prevent infection. If symptoms still keeps on persisting you should visit dermatologist once and get it examined. go for patch test and blood tests and start treatment after proper prescription. You should apply a steroid ointment like cortisone over the rash area for relieving inflammation and itching. Application of calamine lotion will be effective to soothe the skin. Apply cold compresses over itchy rashes.Hope your concern has been resolved.Get Well soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain and numbness in hands and feet?\n\nI have been having some chest pain for about 2 weeks right in the middle of my chest (between my breast) and went to the doctor and I got referred to a cardiologist. Anyways, for the past 3 or 4 days I have been getting numbness in my hands and feet. It started in my right hand then right foot now I get the numbness in both hands and feet. Could this be related to my chest pain?  Any suggestions of what it could be or what I should do?I am a 21 year old female, 5'8 and 200 pounds. I also have been diagnosed with POTS (Postural orthostatic hypotension syndrome) Im not sure if could be related or not. Thanks for any help.",
    "doctor_response": "There are various possibilities for the etiology behind your complaints, and formal testing would of course need to be done with a practiced PCP, and or Cardiologist. Possible explanations include nerve compromise via Thoracic Outlet Syndrome, with potential refereed pain seeming to be cardiac in nature but in reality, Thoracic in etiology. Another explanation is Subclavian Steal Syndrome and or isolated chest pain (various reasons - for your demographic likely costocondritis or muscle strain) superimposed by limb and extremity numbness and tingling secondary to a variety of causes from nutritional to physical spine abnormalities. I suggest allowing a full workup by PCP with explanation of these here issues described.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medicine to use for SVT episodes white travelling?\n\ni am 54 years. i have svt episodes twice a year on average  half the time it stops on its own, half the time i have to be administered drug IV.. if i have svt episode while travelling (in flight for example),and cant get to a doctor , what medication can help",
    "doctor_response": "Hello and thanks for writing.I can understand your concern and would try to help you in the best possible way. You can take a calcium channel blocker to terminate SVT if no medical help is available. However after each episode you have to go to the doctor to get yourself checked up. Consult your doctor for a prescription and discuss with him alternatives available.I also advise you to consult a cardiologist as you are having recurrent SVTs. There are treatment options available like an EP study followed by RF ablation which works as a permanent cure is some types of SVTs. Do discuss that option with your cardiologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes grade II fatty liver?\n\nMy husband is 33 years old and does not smoke and drink. Mostly non vegetarian and doesn't have a balanced diet with vegetables and fruits.Tests end of December 2010 results are Cholesterol is 180, Triglycerides 308, Cholesterol HDL  31,Direct LDL Cholesterol 93,CHOL/HDL RATIO 5.8,LDL/HDL RATIO 3.0 And Very Low Density Lipoprotein 61.6.While the results as on 22.5.10 were Cholesterol 179,Triglycerides 201,HDL - Chosterol 31, LDL Cholesterol 112, VLDL Cholesterol 40.2,  LDL /HDL RATIO RATIO 3.61 while CHOL/HDL Ratio is 5.77.On 23.2.11 LFT was done and it was as follows : - SGOT/AST = 55, SGPT/ALT = 108, GGT = 41,Alk.Phophate=88,Total Protein =7.3,Albumion = 4.7,Globulin =2.6;Bilirubin (Total ) =0.6; Bilirubin (Direct ) = 0.2, Bilirubin (Indirect ) = 0.4.His ultrasound says he has Fatty Liver Grade II. His mother had primary billiary cirosis and has passed away.Stomach x ray shows no abnormality.He has been given Golbi 300 thrice daily, with Zevit one a day and Pantocit twice daily.Please  help us know what is his disease and is it very serious . What diet  can I give him to be healthy ?",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.There are two main types of fatty liver disease: Alcoholic liver disease and Nonalcoholic fatty liver disease. You can get alcoholic liver disease from drinking lots of alcohol. It can even show up after a short period of heavy drinking, other causes are obesity and hepatitis B and C.If you have alcoholic liver disease and you are a heavy drinker, quitting is the most important thing you can do.  If you don't stop you could get complications like alcoholic hepatitis or cirrhosis. Even if you have nonalcoholic fatty liver disease, it can help to avoid drinking. If you are overweight or obese, do what you can to gradually lose weight -- no more than 1 or 2 pounds a week.Eat a balanced and healthy diet and get regular exercise. Limit high-carb foods such as bread, grits, rice, potatoes, and corn. And cut down on drinks with lots of sugar like sports drinks and juice.I hope I have answered you query. If you have any further questions you can contact us in every time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "suggest treatment for ulcers in tongue\n\nHi, My mother in law, aged 50 yrs, has got ulcers on her tongue. She has visited three physicians in town(kanpur). Each doctor has changed the medicines and applications but she has not got relief yet. One ulcer on tip of the tongue with the size of a chewingum has been very persistent. One Dr. suggested, this may be because of tooth, hitting the ulcer, thus not letting it dry. Advised to get the tooth removed. Planning to show to ENT in town. Please advise and also refer any good ENT Dr. in Kanpur, if you know any. Regards, Ehtisham",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.As the dentist has checked and told it is traumatic ulcer , so you can go with the treatment if that is the cause.The ulcers can also be aphthous ulcers usually caused due to stress , vitamin deficiency and many factors.I would advice you to make her live a stress free life .Have a nutritious food which includes eggs.Take multivitamin tablets.On the ulcer , she can apply Mucogel or dentogel locally two to three times for few days.Continue with betadine mouth wash gargling.Hope this was helpful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for paralysis?\n\nMy sister went to the hospital with paralysis ect and they have told her she has malburg. Ms. She has been in intensive care. For three weeks. It is we have found out a very rare form of ms we have done just a little bit of internet research. She has the blindness quadrapadlegic her lungs are working and she can speak a little. Is . She went to bed one night fine and woke up the next morning like this the only symptoms she had was after a jaw surgery in November her tongue felt numb in the middle and a bit of tingling in her one pinky finger the doctor told her it was probably nerve damage from surgery, this ms diagnosis seems like a death sentence at this point. Is there any advice. U could give us at this point",
    "doctor_response": "I am sorry about the situation with your sister. Marburg's variant of MS is one of the worst possible forms unfortunately.Regarding treatment corticosteroids are the most used treatment, but at times other measures like plasmapheresis or immune suppresors such as mithoxantrone have been tried. However I have to say that their efficacy is limited in this form of MS and there are not any other proven options.I hope things work out for the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for vomiting?\n\nMy son is 6 years old and has been throwing up for the last two days. His throwing up flem clear and it gets stuck in his throat and seems as he is chocking. I ve got him on Gatorade and a few minute he threw up green i guess it s vile. He has no fever...",
    "doctor_response": "HIWell come to HCMThis could be allergic condition and does not need any treatment if this is mild one and no history of fever, if this does not improved on its own then this can be tried with \"Diphenhydramine syrup\" some time symptom remains there for couple of week even with the medicines, if this does not improved up to 5 to seven days then this need to be investigated with clinical examination, hope this information helps, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to give Omnacortil for cough in children?\n\nhi... this i am writing in concrn of my 20 months old daughtr.. sh was having nos flow...2- 3 days back...which latr turnd to coughing... w consultd with a doctor... h prscribd cough syrups for 3 days and if ncsary giv nbulisation... cough subsidd.. but aftr 3 days h suggstd to giv omnacortil... but i m a bit afraid ...to giv th sam... still sh hav coughinh...not that much... what to do..",
    "doctor_response": "Hi...it could be a simple viral cough and cold or a wheezing. But Omnacortil is a corticosteroid. Unless the kid is having low oxygen saturation in the blood and extremely breathless so as to be unable to feed, it is not required to give corticosteroids. But oral or nebulized anti wheezing drugs can be given.regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What kind of medical help is to be sorted for erectile dysfunction and premature ejaculation?\n\nI have a question. This is a bit personal. I am curious if youd suggest me looking into Male engagements. I am 24 years old. Its impossible to hold a erection and sex only lasts a few minutes. If you suggest me looking into some medical help please leave a suggestion on where to start. I ve tried at home treatments but nothing works. Thank you.",
    "doctor_response": "Hi, You can consult a urologist and get evaluated. A detailed evaluation is needed to find out what exactly causing the problem. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bite spots on the face, arms and legs?\n\nWe have recently been abroad and my daughter got bitten a few times. Since we have been back she has come out in lots of spots on her face,arms and legs. at first i thought it was the bites but now after a week she is getting more every day. she has already had chicken pox and we have been to the doctor and she said to wait and see if she comes out in any more. Tonight she has come out in a few more and i am starting to get a little worried about what it might be,",
    "doctor_response": "Hello,Skin conditions are best diagnosed only after seeing directly. I suggest you upload photographs of the same on this website so that I can guide you scientifically. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sumanth Amperayani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can sluggishness at  30% and abnormal forms in semen test cause infertility?\n\nDear sir,I have done sperm test and got the following:Sperm count: 35 Million/mlMotility:Active: 40%Sluggish 30%Nonmotile : 30%Abnormal forms: 30%Plus cells: 2-4/HPF Immature cells: 4-6 / HPF Clumps: FEW. I dont have children since 2 years. Please advise.",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.Your semen analysis has come 35 million/ml is normal.Motility : active 40% is also good.So both parameters are absolutely normal.And they don't cause infertility.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling non focused and depressed\n\nHiya I am 17 years old female, and finding to hard to say different words and forgetting what I am going to say half way through a conversation with someone, I also feel really happy one minute then next feel like everyone hates me! Please can you help you out best you can!",
    "doctor_response": "HiThanks for using healthcare magicI think, you are in stress and some antidepressant that would help to control the mood swing. You can consult a psychiatrist for proper mental status examination, You can also do some relaxation exercise that deep breathing or JPMR. You can also follow life style modification technique, but before doing that this, just consult a psychiatrist.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe cramps in the arms post spinal surgery?\n\nHi, I just had spinal surgery due to C3 and C4 slipped into my spinal cord. That was 3 months ago. I lost a lot of muscle mass. As I have been slowly increasing my walking I have started to get severe cramps in arms and legs. I am also constantly exhausted. What kind of Doctor should I see to investigate these issues.",
    "doctor_response": "Hi, Severe cramps in muscle can be due to calcium or vitamin deficiencies. You should consult a Neurologist or physician. Calcium and vitamin supplements can be taken for relief. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Neeraj Kumar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for fever in a child?\n\nHello I have an 8 months baby girl who has a fever for the past 3 days and runny nose and today her fever settled but she woke up with blood around her nose which is dry and some in the pillow and inside her nostrils as well. Therefore looks like a nose bleed. But it didn t happen again. Is it common in 8 months old and should I wait coz she doesn t bleed from any other site so probably it s dry weather.",
    "doctor_response": "Hello dear!I can understand your concern.It was probably a viral flu that settled on its own.This bleed is due to dry weather and the healing stage of flu that causes dryness and during that,any attempt of nose picking or a forceful blow will lead to bleed.Its quite normal and nothing to worry about but i would advise you to get a Complete blood count (CBC) and PT/aPTT checked from lab to be on the safe side.If the reports are normal ,it will definitely be due to dry weather and i would advise you to put 1-2 drops of olive oil in the nostrils twice daily especially before bed time.Hope it will help.Wishing your child good health :-)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for breathing issues during asthma\n\nGood afternoon, I am 56 years old and one year ago I had a mild asthma attack.  I got treated by our family doctor but a year after my asthma came back again.  The whole year I could experience discomfort in my breathing and I could feel that this disease is not making me free.  What shall I do?",
    "doctor_response": "Mam  u can gud  relief  by using  homeo medication.the medicine is blata orientalis  mother tincture .use the medicine as 15 drops medicine in 1/4 cup water morning evening twice a day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it harmful to lift infant by wrists?\n\nHi, my grand daughter is almost 8 months old and my son-in-law frequently lifts her by her wrists and also lifts her high in the air. My gut feeling is that this isn t good for her but I don t want to say anything until I know for sure. Can you tell me if it is harmful? thanks Anne",
    "doctor_response": "dear userbrief answer is yes it is harmfullifting infant from wrist can cause sprain or injury of tendons of the wrist jointand this will lead to injury and inflammation of wrist and other bad consequencesso it is harmful to do that......as wrist tendons get inflammed if sudden movement or lifting of the body from wrist ......wrist tendons may not be have the ability to support all the body weight if lefting the body from wrist.....please advise him not to do that behaviour it will have bad effect on the infanthope that helps you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent respiratory infection with history of breast cancer and lupus?\n\nYes I m a 50 year old white female with a history of breast cancer and lupus. I started two weeks ago with a respiratory infection. They treated me one week with Doxy but did not improve, went back on that Friday and was given a Rocephin injection and steroid injection, my white count was 13.7 on Monday I was still no better and went back received another antibiotic injection and was given Prednisone 40mg to take daily for 5 days. Was admitted to the hospital on Thursday due to failed outpatient treatment. MY CXR has been ok no pneumonia but I m still short winded and feel like something is closing over my windpipe blocking my air. In the hospital my white count was 14.9 I was getting Rocephin and Zithromycin IV twice daily and SoluMedrol plus breathing treatments. My oxygen sat was around 92% then dropped to 90% on room air. I was discharged Saturday and did feel better, came home with Breathing treatments and Omnicef, Prednisone40 mg daily. Yesterday was awful I felt like everything was just like it was prior to being admitted. I am still having the feeling of something blocking my breathing at times and I have begun to cough again with some thick white sputum being produced. They seem to be puzzled as to what is going on because my blood cultures were clear for bacterial infections etc, CXR was alright the pulmonologist thinks it might be an underlying problem with my Lupus. However, today is awful again coughing, no energy short of breath etc. she is calling me in another steroid similar to what I took in the hospital and if no better might need to be readmitted. UGHHHHHHHHHHH any suggestions this is really getting the best of me. They did check for cardiac issues and blood clots and those were normal as well. Sorry to write so much but I was trying to give you a history. This has been going on now for more than two weeks.",
    "doctor_response": "Hi there... Thank you for such a detailed history. Reading your description i did think of Pulmonary embolism that is related to both SLE and breast cancer, but if your doctors have ruled that out then its shouldnt be a concern. I would still like to think of Intertitial lung disease and Pulmonary Hypertension as a possibility. Do discuss these differentials on your next visit to your doctors. RegardsDr Hanif",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cold sensations in thighs, legs and back?\n\nI been experiencing some cold sensations in both my thighs, my buttock, and along the back and sides of my of both legs. It feel like cold water running down; sometimes as cold as ice cubes. These sensations come and go with the longest has lasting about 10 seconds. I had diabetes for a long time now, but my blood sugar values are quite in normal range for about three months.",
    "doctor_response": "Hello dear,Considering the history that you had diabetes for a long time, the symptoms can be attributed to Diabetic neuropathy (damage to nerve secondary to diabetes).So, it is advisable to consult your treating Doctor/ Neurologist and get a complete neurological evaluation done.However, other causes for such symptoms also need to be considered, such as:1. Paraspinal spasm & compression of nerve fibers at the Lumbo-sacral region or due to compression of nerve secondary to improper posture.2. Inadequate hydration status & electrolyte imbalance of the body.3. Dietary deficiencies of certain nutrients like Iron, Calcium, Vitamin D, Vitamin B12, Folic acid, etc. which help in blood formation & nerve conduction.4. Peripheral neuropathy caused due to any fluctuation in blood pressure level.Certain investigations like complete blood count, serum electrolyte estimation, fresh estimation of blood pressure & blood sugar levels & nerve conduction studies will be helpful to rule out any pathological cause for the symptoms.Symptomatic relief can be obtained by intake of nervigenic agents (like Vitamin B6, Vitamin B12, Folic acid) as well as multivitamin & multimineral supplements including iron, calcium & Vitamin D needs to be added in your diet.Wishing you a Good Health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tingling sensation in arm after getting electrocuted. Advice?\n\nHi, My wife was placing a plug into a socket and a spark went off, which she felt rush up her arm . I think she received an electric shock . 3 hours later she is still feeling a tingly sensation in her arm. I am concerned and would like to know if this is serious and she needs to be assessed thoroughly by a doctor or whether the sensation wil go by the morning (in 12 hours time). We are also on holiday abroad so consulting a doctor will require us to find nearest medical centre. What would you advise? Do i not need be concerned and is this just normal to feel and will it go away in the morning and she will feel normal again (no long term effects) or is it serious and should I take her to the nearest medical centre as soon as possible? Thanks Dav",
    "doctor_response": "Dear Dav the problem that your wife experienced is a periferic nerve problem.There is nothing yo be worried, is the same feeling we experience while we stay for a long time on one of our arms.Hope my answer will help you don't hesitate to contact for any other inquiry",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes  gasping for air and increased heart rate suddenly while sleeping?\n\nwhen im falling asleep i jolt awake gasping for air, and heart rate increased, this has been goingg on for around 2 years. i have had anxiety issues most of my life and suffer with ocd quiet bad whats happening to me, will this kill me, now 2 night with no sleep because i,m terrified. please help.",
    "doctor_response": "Thanks for your question on HCM.I can understand your situation and problem.In my opinion you are mostly having anxiety related symptoms only.But better to rule out obstructive sleep apnea (OSA) first. Because OSA is having same symptoms like gasping for air in sleep with tachycardia.So get done sleep study first. If it is normal then no need to worry for OSA.You are mostly having anxiety related symptoms only.So better to consult psychiatrist and get done counselling sessions.Try to identify stressor in your life and work on its solutions.Avoid stress and tension.Be relax and calm. Don't worry, you will be alright.You may need anxiolytic drugs too.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having back pain, puffy eyes, tiredness. prescribed ointment and anti inflammatory tablets. Suggest\n\nI started with lower back ache about three weeks ago....I say ache rather than pain....it felt more like an ache around my kidneys...the doctor did a urine test that came back clear...then did a hip x ray, again clear. For the last week my eyes have been very puffy especially in the morning. I've been prescribed an ointment for cinjunctivitus and anti inflammatory tablets for the back ache...neither of which seem to be making any difference. I've also been feeling very tired, and slept for virtually the whole day yesterday.",
    "doctor_response": "hallo dear friend i hv studied your case your symptoms suggest some systemic disorder involving multiple systems back pain can also be due to renal calculi so you may need USG abdomen n pelvis do you had any injury to back ? your age? you need some blood test for connective tissue disorder for further query contact drvaibhavg@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of potential candida?\n\nI have I think Candida symptoms, rash under breast my rectum itches in the evening and I get blisters starting my my mouth when I am stressed. I read that I can take probiotics to get rid of the candida in my intestine but it also said if I have herpes to not do that it that true?",
    "doctor_response": "Hi.As per your case history you are having fungal infection called as tinea corporis.My treatment advice is \u2013 1. Maintain good hygiene and bath twice daily.2. Apply an antifungal cream like clotrimazole cream twice daily on it.3. Take an antihistamine like levocetirizine for 7-10days .4. Other treatment options are oral fluconazole, itraconazole and terbinafine  given only after consulting a dermatologist.Thanks.Dr.Harshit Bhachech.MBBS, DDVL.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Frequently sick with chest or sinus infection, metal taste in mouth\n\nMy Dad is 67 and has had some sort of chest and sinus for a year. He has a metal taste in his mouth, is frequently sick. He also shakes and looks 10years older than last year. He won t let me take him to the doctors but he is clearly unwell. What could it be?",
    "doctor_response": "Thanks for your question on Health Care Magic. Recurrent chest and sinus infection need investigations to search for the cause. Chronic bacterial or fungal infection can be the cause. Allergy can also cause this. Bronchitis is common in old age and cause similar symptoms. So better to consult doctor and get done 1. Clinical examination of respiratory system and sinuses. 2. Chest x ray 3. PFT (Pulmonary Function Test) 4. X ray of para nasal sinuses (PNS). All these are needed to search the cause. So first diagnose himself and then start appropriate treatment. Hope I have solved your query. Wishing good health to your father. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for pain in the right shoulder\n\nHi, My husband is suffering from pain in the right shoulder from more than a year, please suggest me whom I should consult. His age is 33yrs, he doesnot have any other health problems, has a fit personality and healthy diet, is a software engineer by profession.",
    "doctor_response": "Hi,Did this follow any fall or trauma? Pain will respond transiently to analgesics like paracetamol or ibuprofen. But since its already 1 year, we need to evaluate for the cause, and treat accordingly. You can initially consult an orthopedist. If no interventions needed from his side, he may refer to a physiotherapist, who can guide regarding exercise and physiotherapy to strengthen muscles and ligaments there. Also, proper positioning of arm & hand while using computer in office is important.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam T. K., Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for high fever , abdominal pain and vomiting?\n\nHello Doctor,My daughter had high fever since morning (today). Later, she started vomiting. Doctor suggested we have a urine analysis which showed the following result:SG:1.020PH:6NIT: posPRO: 0.25 g/lGLU: normKET:5mmol/lUBG: normBIL: negERY: 25 u/lWBC: 200/mm3         Bacteria seenThe dr said that her result was not good and she has some kid of infection and that she should also come for a detailed check up.Can you please tell me clearly what is wrong with her. She is 6 years old. Is she having a kidney problem. She has never complained of any pain in abdomen except ones caused by gases (we found that out through x-rays). Why does she have a high ery?Please guide me.",
    "doctor_response": "Young girls get urinary infection frequently. Get USG of abdomen and pelvis done, give her as antibiotic and per paediatrician. She will improve and keep good hygiene. Keep watch that it should not recur.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Could you tell me the underlying cause for sciatica?\n\nHi doctor, I have been recently diagnosed with sciatica. I have some difficulty in walking. I am having Tramadol and Paracetamol for pain relief but they are not helping much. Could you tell me the underlying cause? Will I require a walking aid?",
    "doctor_response": "Hi,Welcome to icliniq.com. As you must be aware by now, sciatica is a term used when a person experiences radiating leg pain due to some pressure on the nerves. Assessment will include intensity of back pain, intensity of leg pain, the distance you walk without any requirement of analgesic and detailed neurological examination including assessment of motor power, sensory evaluation and evaluation of deep tendon reflexes. This will then be followed by dynamic x-ray and MRI scan of lumbar spine if required. Depending upon the correlation of clinical examination and investigation results, management can then be formulated. If you have localized back pain with some radiculopathy symptoms with no other neurological symptoms like numbness, weakness, paresthesias, etc., then you can start with following recommendations for initial period of two to three weeks. We will observe your response to this conservative management protocol for next two to three weeks. If you are not feeling better, then we might have to get some investigations like dynamic x-rays of lower back and few blood tests for evaluation. Enclose your previous investigation and doctor's prescription. I can see them and advise you accordingly. Disc prolapse. X-ray LS (lumbosacral) spine - AP (anteroposterior) and lateral (flexion and extension) views. Avoid lifting heavyweight and acute forward bending in mornings. Revert back with the investigation reports to an orthopaedician and traumatologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat persistent nausea, cough and cold during pregnancy?\n\nI m pregnant. 11 weeks. I ve been getting colds quite regularity over the last few weeks. Monday I woke up feeling quite terrible. Rough cough lots of nauseau, runny nose and very sore all over my body. Sore throat as well. My symptoms have not gotten any better through the week and now when I go to sleep I wake up with huge nasty eye boogers and today my eyes are very red and mildly itchy. I m sure with all my sickness and constant nausea with this pregnancy I am at least a certain amount dehydrated. But I am starting to get worried. Before wasting the money I m wondering if this seems like so,etching that will pass or something I should have looked at soon.",
    "doctor_response": "Hi, I think you are having some bacterial infection in throat. Take some antibiotics after consulting your doctor. Do warm saline gargle atleast 3 times per day.  Take steam inhalation also. You can take some antihistaminics and cough syrup also.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for chest pain near sternum.\n\ni m having pain in chest near sternum since one month.earlier i was having pain in knee then hips.initialy it was right sided then left sided.i had typhoid 5 years back.my crp is positive.i have done other investigations but all antibodies were neagative.i m taking diclofenac but there is not much releif in my pain.can u plz sugest me which diseases it can be",
    "doctor_response": "Hey Hi,See from your case it looks like it may be pain of gastritis as all reports within normal limit.take proton pump inhibitors orally, mostly it will work",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breast lump pain with nipple skin redness?\n\nmy fourteen year old daughter has pain in her left breast and i can feel a hard lump, quite big, and now she has reddness on the skin around the nipple area.. i am a breast cancer survivor with history of breast cancer on both sides of family, mine and husband.. i am worried",
    "doctor_response": "Hello, Of course you are worried!  But let me try to reassure you, it is very, very unusual for children to have breast cancer.  I don't know what stage of puberty development she is in, but it is not uncommon to have breast changes at this time. As long as it is pink not redness, painless without manipulation, located near the center or to the side of the nipple color and not leaking, you don't have to treat this as an emergency. Some adult women have very fibrocystic breast tissue - meaning lumpy, bumpy - and if she's destined to have that kind of breast, it has to start at sometime.  That may be all your feeling. Sometimes kids get abscesses or boils in any fatty part of their bodies - like the buttocks or breast, under arms - so if it's hot red, tender to touch and looks \"angry\" you should take her in to check that possibilitiy. In general, there's no harm in getting it checked out, but for reassurance, not because it is likely to be breast cancer. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Lisa Baker",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mental problem\n\nRESPECTED SIR, I AM SUFFERING FROM SOME SORT OF MENTAL PROBLEM. PREVOUSLY 3 YEARS BEFORE SUDDENLY I FEEL SOME STRESS IN MY HEAD & FEELING THAT MY HEART WAS COMING OUT OF MY BODY & CONTINOUSLY CRYING LIKE BABY FEELING INSECURITY OF LIFE & ALWAYS HAVING NEGATIVE FEELINGS OF DEATH. MY PARENTS TOOK ME TO Dr. SHIV GAUTAM & I HAVE TAKEN MEDICINE UNDER HIS CONSULTANCY FOR MORE THAN 2 YEARS BUT HE NEVER REDUCES MY MEDICINES. AND AT THAT TIME ALSO I HAVE ENGAGED & DUE TO PRESSURE FROM PARENTS I AM STOPPED TAKING MEDICINE. AFTER THAT 1&1/2 YEAR HAS BEEN PASSED SMOOTHLY & I AM WORKING SMOOTHLY. BUT AFTER THAT I AM AGAIN SUFFERING FROM SAME PROBLEM. THEN MY PARENTS TOOK ME TO DR. ANIL TAMBI WHICH IS ALSO MY RELATIVE.THE SAME PROCEDURE HAPPENED AGAIN & AFTER 7 MONTHS I HAD STOPPED TAKING MEDICINE AGAIN AND ABOUT 1 YEAR HAS BEEN PASSED SMOOTHLY BUT NOW IN 2010 I AM AGAIN SUFFERING FROM SAME PROBLEM. THEN I HAVE CONSULT TO MY FAMILY DOCTOR DR. SANJAY MEHNDIRATTA, BUT HIS MEDICINE GIVING ME TEMPORARY RELAXATION & AS SOON AS HE REDUCES MEDICINES THE SAME THING IS HAPPENING. BUT NOW I AM SUFFERING BADLY FROM COMING OF NEGATIVE IDEAS OF COMMITING SUCIDE AND TO KILL MY MOST LOVING KIDS TO WHOM I LOVE VERY MUCH IN MY LIFE & MY KIDS ARE MY LIFE. SIR I HAVE ALSO DISCUSSED MY PROBLEM WITH MY SCHOOL FRIEND WHO IS HOMEOPATHY DOCTOR, HE TOLD ME THAT IN YOUR MIND THER IS SOME DEFICIENCY OF SOME SORT OF CHEMICALS AND AS A RESULT OF THIS THOSE NEGATIVE IDEAS CAME IN MY MIND WHICH DISTURB MY WHOLE LIFE. HE ALSO LET ME READ THIS DISEASE FROM HIS SOME BOOK IN WHICH SAME THINGS IS WRITTEN WHICH I FACES IN MY LIFE PRESENTLY. SIR PLEASE HELP ME I HAVE 2 BEAUTIFUL CHILD & MOST COOPERATIVE WIFE WHOM I LOVE VERY MUCH & LET ME HELP TO COME OUT OF THIS PROBLEM. PLEASE HELP ME........",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. The idea about schizophrenia is wrongly interpreted here. You had been given with medications which gave you cure and you must also remember that even without medicines, you did well for a long period before and after marriage. Only you did it and you should get self confidence from those experiences.Let me assure you, your problem is treatable and curable. Studies all over the world shows that mental disorders can be cured with a combination of psychiatric medicines and psychotherapy. In your case, behavioral therapy and rational emotive therapy shall be useful. For the start of psychotherapy procedure,Step 1 - Practice Deep and full breathing whenever possibleStep 2 - Drink plenty of water and fruit juices. Step 3 - A Tomato a day keeps anxiety at bayStep 4 - Exercise regularlyStart these and follow strictly. After 7 days 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent panicking and startling suddenly?\n\nI get startled very easily, not by scary movies but just daily incidences.  I would scream on the top of my lungs at sight of someone (even family members) just because i wasn't expecting to see them. I'm pretty sure it has something to do with my childhood.  So I just want to know if there's a way I can train myself to be more calm and collected in this kind of situation.",
    "doctor_response": "Hi,From what you have mentioned, your symptoms of being startled seems to be manifestation of underlying anxiety. Your symptoms can be reduced with adequate treatment.I would suggest that you seek a psychiatric consultation for complete evaluation of you condition and initiating treatment. Medications like paroxetine will help you. In addition, you can also opt for behavior therapy sessions which will consist of sessions focusing on learning relaxation and help you become more calm and composed.I do hope that I was able to answer your query. Wish you all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does bruxism cause headaches with chin swelling and soreness?\n\nHi, I suffer from bruxism and soon will be fitted for a mouth guard. Three days ago I woke up with a headache, and a slightly swollen and sore chin. Is this because of the grinding? I have no fever, and its been persistently sore for these past few days. Should I be concerned?",
    "doctor_response": "Hi,Thanks for posting the query,      This could be because of bruxism, bruxism is treated by using an appliance known as mouth guard, take tab ibugesic plus to relief pain, avoid anytype of stress and anxiety, take complete rest.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed a swelling on abdomen & possibility of having lumps\n\nMy abdomen is swollen and I feel lumps in various places in my abdomen. My doctor ordered a CT with contrast of my abdomen and pelvis. My ankles are extremely swollen as well. I don t have medical insurance right now because I m working a temporary assignment. I have to wait to get the CT scan until I can find a job with medical insurance. I have no choice to wait as the CT scan is thousands of dollars. My question is this. Will having to put this off, be dangerous to my health? Or am I okay in waiting? Could the swollen ankles related to my my swollen abdomen?",
    "doctor_response": "Hi. You have noted no pain or any other symptoms. These can be multiple lipomas and of no clinical significance.if they are just under the skin and cause no pain , are free to move ...Get this confirmed by your Doctor . If he is sure about this , stop worrying.Swelling of ankles will have another reason- May be local problems of the joints , or due to general problem of anemia hypoproteinemis or so.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure sharp pain on the left side of the abdomen?\n\nHey there.... quick question of curiosity: about 1.5 years ago, shortly after I started to not eat so healthy (I had lost my appitite & I was content to only eat one good meal a day for a quite a while.), I started to get this sharp pain in the left of my abdomen, just by the pelvic bone.  It woke me up to my poor nutrition & I started to force myself to eat even when i was not hungry.  It took a while for the pain to get better.  It weakened & over time dropped lower, right to the bend with my left leg.  But that same pain seems to show up, although more mild now, from time to time especially when my stomach is upset or if meal times are too spread out.  Any ideas?",
    "doctor_response": "Hi! Good evening. I am Dr shareef answering your query.If I were your doctor, at the first instance I would insist for a regular timing of your diet. Keeping your stomach empty for a long time predisposes its mucosa to harmful effects of the natural acid produced inside the stomch, and if continued result in inflammation and possible ulcer formation in the long run. This could result in gastritis or a peptic ulcer in you giving rise to such symptoms of pain in the abdomen specially when your stomach remained empty. I would advise you initially for a proton pump inhibitor and a liquid antacid for a symptomatic relief at least for six weeks. In case it does not help, or the pain increases, I would not mind to refer you to a gastro-enterologist  for a possible endoscopic evaluation of your gastro intestinal tract. Further management would depend on the clinical assessment and related investigations.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the sharp pain in the heart?\n\nHello, I am curious as to what prompts this Sharp pain I get occasionally, seems to be coming from my heart. I'm 30 yrs old, male and in decent physical condition. Could afford to lose a few pounds, I'm thinking maybe my heart might be working too hard?",
    "doctor_response": "hi i can understand that everyone have a hard earn money and some people have a need of it but dear no need to worry just went to a doctor have a simple test of ecg that clears everything till then i just start you a mix treatment stuff as if might be gastric and cardiaccap.pantop-dsr 1oddigene syruph 2spoon tdscap.lipikind-as 1od get well soon thank you for trusting HCMregards dr.sahil wadha",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swollen tonsil, frequent dental infections. Wisdom tooth removal suggested. What to do for the pain?\n\nMy right bottom wisdom tooth is trying to erupt the skin but is unable to on its own. I will be getting it surgically removed in a few months. But in the mean time I need to relieve the pain. The tooth gets infected every once in a while and now my right tonsil is swollen and in a lot of pain what can i do? And if I don t take the wisdom tooth out in enough time can it do any damage to it surroundings??",
    "doctor_response": "Till you plan surgical removal of your right bottom wisdom tooth you can get that area cleaned by your dentist if you are prolonging than you  have to get cleaning done often. Analgesic as prescribed by your dentist should help you  to releive pain but restrict frequent use. Warm water with salt gargle regularly and even 4-5times a day will help you to keep your wisdom tooth area and tonsil area releived of pain and swelling.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for stabbing pain between scrotum and anus?\n\nhi, I have been experiencing a very sharp pain between my anus and scrotum. the pain is very sharp and brings me to immediately drop to my knees its just like 3or 4 stabbing pains per episode? I have suffered with this for the past year or so. any ideas please? thank you",
    "doctor_response": "HIWell come to HCMThis could be nonspecific pain such pain occurs some time without any reason with the symptomatic medicine and the best drug would be Ibuprofen 400 mg three times in day, in my opinion better to forget the symptoms even if you do not take nay medicine this would come around on its own take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for the pain in abdomen\n\nHi, I had a bad stomach ache for a few days when I am hungry and after eating. My pain is on the left part and it remains pain for a half day. I had this kind of history many years ago , but just now it starts again when I am very hungry. Can you me give advice on this matter and what medicine I should take?",
    "doctor_response": "HI.Thanks for your query and an elucidate history.You have a classical history which says that the pain on the left side of abdomen increases on empty stomach or after eating. This relation with the food habits indicates the following reasons:: Gastritis /gastric ulcer/ Duodenal Ulcer / possible gastric cancer/ Pancreatitis in rare cases. I would suggest you the following:: Zantac 12 hourly.Pepcid every 3 to 4 hours when on empty stomach. Add Domperidone or such motility regulators.Soft bland diet. No aerated colas / soda/ drinks.Early dinner. No late nights.Treatment for anxiety (as prescribed / needs a prescription by your Doctor)Lying in a reclining positionWalk around after dinner.Think of the factors which increased the present problem, GERD, anxiety and try to avoid. If no relief, get Upper GI endoscopy done and get prescription for added Medicines. Also needed is ultrasonography of the abdomen or a CT scan for ruling out other pathology of the pancreas and other structures of the upper abdomen.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shingles with excess leg pain\n\nI had shingles 2 weeks ago I ve taken the medicine for 7 days now after a week I ve been fighting pain in my leg to where I can hardly sleep at night I work most of the day and seem to do better when I m active but in the middle of the nite I m up for 2 or 3 hours I have not taken anything except anvil it dose t help what can I do",
    "doctor_response": "Dear patient pain due to shingles is known for long time persistence. This is due to neural involvement. You should start tab Norpregalin which contains nortrypriline and pregalin. it is very helpful for pain relief in shingles. Continue it for month once a day. if not helping please consult physician around you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart palpitations and dizziness?\n\nI have a frequent heart palpitations and while my heart is racing its hard for me to breath. Sometimes when I stand up I get dizzy. This has never happened before to me, just this past months and I remembered one night before I go to bed my chest (heart area) suddenly hurts, then after a few minutes its gone. May I ask what is my condition? Do i have any ailments?",
    "doctor_response": "firstly please specify your age your smoking habitsyour weightpalpitstions can be because of many causes ..as your palpitation comes off and goes away an ecg should be taken out during that  cycle if possible if not then at first go for these few investigationsHolter monitoring this test is like a ecg taken for 24hours continously ...it will record any abnormal beat during 24hoursa loop monitor if required (as you have not mentioned frequency of your palpitations)a loop monitor is like holter but it record beats for 1week tmt (tread mill test) it will serve dual purpose ..it will record any lack of blood supply to the heart (some times you have pain in chest ) and any abnormal beats arising during the couse of doing itapart from this thyroid profile should be done!these symptoms can be because of heart burn gastritis and anxiety so a detailed history is requireddizziness on standing up is called orthostatic hypotension(please specify if you are on anti hypertensive medication especially diuretic)how long does it last any history of fall or loss of consciousness as we have to rule out presyncope from orthostatic hypotensionthanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to stop yellow discharge from holes on armpit?\n\nmy armpit has one or two holes that have a liquid coming out this is yelow and smells,it also has a nob that is very sensitive when you touch it,this nob also sometimes appears and then disappears on my inner thigh,when i touch it it is also sensative,my doctor gave me antibiotics and this has not been working it has been there for some time now",
    "doctor_response": "Hello and thank you for your questions.It sounds like you have something called sebaceous cysts. If the antibiotics do not clear this up then you may need to see your doctor or a dermatologist to have them removed. This is a procedure that can be done in the office.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My 2-year-old baby has red itchy bumps all over the body. Please help.\n\nHello doctor, My 2-year-old baby developed small red pimple like bumps on her body about three weeks ago. The bumps were not itchy and were just on her stomach, back and limbs. We initially thought it was eczema, as we already know she suffers from this or measles, but she is up to date with her vaccinations. We took her to the doctor and they said it was a viral exanthem and it should clear up. Not but a few days later, she spent the day with the babysitter and they said they were out and forgot a diaper so it is possible that her urine was on her longer than normal. Later that night, she started saying her butt was sore and come to find out, she had a cluster of bumps in between her butt cheeks and a little on her labia, which her buttocks were the only part that was sore due to the acidity from her urine. Bumps also appeared on her face, most exclusively around her mouth (not on lips and not inside the mouth). But later on, she developed bumps on her nose and along her jaw up to her temple and some on her ears. We took her to the ER because it was clear that whatever she had, had progressed for the worst. She saw the doctor and as we were in the hospital room, she started saying she was itchy. She had never been itchy before, but now she was itchy all over and more and more bumps started to appear. Now on the tops and palms of her hands, tops, and soles of her feet and a lot more on her limbs. The only place that does not have bumps as of right now is her neck. We were confused because these bumps were never itchy before, but now she complained about how much it itched. It seemed to itch the most on her feet. The doctor diagnosed her with impetigo and prescribed us Mupirocin ointment and Amoxicillin and Clavulanic acid (Augmentin) to take orally. We were also told to give her Benadryl in conjunction with it. It is been a few days and it does not look like there is any progression in ridding her of this infection. Now she has some bumps that are inflamed and look white which kind of resembles a mosquito bite or something. Other bumps have a tiny black center to them. She ended up scratching her leg and within hours, it became inflamed in white and had tiny black dots in the center (not sure if dried blood or what it is). Then the surrounding area broke out even worse into tiny bumps like an actual rash. So much so, that her whole leg looks just red. Her other limbs started looking",
    "doctor_response": "Hello. Your description gives me two possibilities, one is skin infection which we term as pyoderma, which has a severity range of being mild to very severe. An antibiotic like Augmentin (Amoxycillin and Clavulanic acid), Mupirocin would definitely help. She also has an itching for which Benadryl is given. Did she have fever anytime? Second is an allergic rash for which might have gotten infected is another possibility. If there are no pus formation or oozing bumps, we can apply mild steroid creams, which takes care of both itch and rash. And the antibiotic covers the infection. So you can Tryptophan the cream which you were using for eczema before if you have it. I do not know if you can get it over the counter. It needs slightly longer duration of treatment as it has been there for three weeks. Some tests like a swab of the wound can be sent if lesions are not responding to Augmentin. A picture would have been more helpful. Continue Augmentin, Mupirocin, and Benadryl. Flutivate (Fluticasone) cream for local application for five days, to be applied as a thin application, but not on the face (only If lesions are not oozing or not having pus).",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could blister in penis indicate impetigo?\n\ni am 44. the 13 years old boy of my sister in law  apparently got impetigo in both legs an had swollen liymphs in the groin. The daughter of my brother in law few days later got a blister on one finger and another on on the leg. Both of them were at home all the days during the episode. i've got a blister in my penis days later near the place i had a very little cut. \u00bfcould it be impetigo? \u00bfshould i worry? now the three of us have the blister cured. The blisters were painless, red , with little yellow points. They had pus in some blisters. I only had one but no pus",
    "doctor_response": "Hi, Yes... it is impetigo bullous. It is a bacterial infection caused by Staphylococcus. Consult the dermatologist for the perfect diagnosis and proper treatment. I would recommend you to take an antibiotic like cefixime. Improve immunity and hygiene. Local antibiotic cream like sisomicin cream may be applied. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilyas Patel, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can tooth extraction be done in condition of prostate cancer?\n\nA 12-year-old crown came off tooth # 20, and the dentist advises that I have the tooth extracted because there's no way to remove all the decay in order to install a new crown.  I am scheduled to have my first Lupron injection for a recurrence of prostate cancer on the 29th of THIS month, and a second (3-month injection on the 26th November.  Is it wise to proceed with the tooth extraction in this situation?",
    "doctor_response": "Thanks for your query, I have gone through your query.It is better to take opinion from your physician whether you can go for extraction or not. Usually there are no problems with this drug. But if you are taking bis phosphonate then there are chances of complications like osteoradionecrosis.Nothing to be panic, there are no other options, you need to get the tooth removed, but you have to get it done under certain precautions like taking consent fron your oncologist and oral maxillofacial surgeon.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "When he pee it started to bleed, please suggest\n\nmy boy friend just pee n there was little blood in his pee what do that means no we didn't  just have sex it been days it just happen out of no were",
    "doctor_response": "1. blood in urine (hematuria) means there is problem in the urinary tract, which has allowed blood to get pass into urine. 2. a number of condition can lead to this passage including: .Urinary Tract Infection, Kidney Infection (pyelo nephritis), bladder (cystits) or kidney stone, enlarged prostate, Strenous exercises. 3. you have not mentioned about any associated feature along with blood in urine that whether it was painful or painless, or was there pain and burning during micturation and odor of the urine? 4.  Younger men are more prone to kidney stone or hereditary nephritis (Alprot's syndrome). 5. make an appointment with your doctor regarding Urine examination and Ultrasound Abdomen 6. as him to drink plenty of water, amla, pomegranate, drum stick,bitter gourd,green banana. 7. treatment directed will be to the underlying cause, so check with your Physician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce visible and red capillaries below urethra?\n\nHi,On my glans, right below the urethra and directly above where the frenulum attaches I have a small bundle of bright red, visible capillaries/tiny veins. I have had these for as long as I can remember (back into childhood) but it's quite unsightly.Is there anything I can do or have done to reduce the visibility?",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have visible veins on the glans of penis since birth.These are bunch of prominent veins which is of no significance at all.There is no medicine or surgery that can remove these veins .Please do not worry it will not harm you any way during sexual intercourse.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having menorrhagia and feeling tired with chest pain and indigestion problem. Why?\n\nHello doctor, I was suffering from menorrhagia after the birth of my second daughter. I went for medication and presently it is almost under control. I have to take Tranexa two tablets three times daily for the first two days of the menstrual cycle. Suddenly I notice that my hemoglobin has fallen to 7.12 g/dL. I am physically feeling weak and having chest pain (while walking and climbing stairs), swelling of legs, itching and indigestion problem. I consulted a local doctor and they prescribed Autrin twice daily and ZES-30 once daily.",
    "doctor_response": "Hello. Since you are 40 years old now and this problem has not suddenly cropped up. You are having menorrhagia (heavy bleeding) from the last 5 years or so, for which you are having 1 gm of Trenaxa to temporarily stop bleeding. That is the reason for anemia, which is low hemoglobin and feeling very weak. But please do not ignore your chest pain and swelling on legs. You need to be thoroughly investigated for this including all routine investigations like CBC (complete blood count), coagulation profile, PTI (prothrombin time test), renal and liver function tests. Above all ECG (electrocardiogram), and ultrasound abdomen to see the cause. Visit a physician and the most worrying thing which I want to rule out is any evidence of thrombo-embolism and DVT (deep vein thrombosis) for which you may be advised Doppler study of vessels of lower limbs. Be in touch and inform the reports if you like.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Enlarged liver with the result: TGO -79U/L , TGP-102U/L in a non alcohlic/non smoker and currently on Rosuvastatinum.\n\nHello, I was diagnosed with enlarged liver and have the following resultsTGO79 U / LTGP102U / Lmention that I do not eat fat, I do not drink alcohol, I do not smoke. I am always sick. I have 1,70 m and 87 kg. My doctor gave me Rosuvastatinum amd some homeopathic pills like golden Yacc.",
    "doctor_response": "Dear FriendWelcome to Health care magic. I am Dr Charu , I will shortly try to help you with my opinion.Yes , your Liver enzymes are raised. Since you are not an Alcoholic , following are the possibilities :1. Viral Hepatitis.2. Rosuvastatin Induced Hepatitis.3. Non Alcoholic Steato Hepatitis At present , i would advise you to stop Rosuvastatin under your doctor's guidance.If your liver enzymes , still don't settle down , you would require testing for Viral Hepatitis.Based on the available details, this is my best advice for you. You should discuss with your doctor and share my opinion , I am sure he/she will agree to my opinion.Good Luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can black head like thing on my upper chest be cancer ?\n\ni have this black thing on my upper chest . and it kinda looks like a black head . but it wont pop.i have had it for years. its the size of a blak head . should i get it checked out . can it be cancer .",
    "doctor_response": "welcome to healthcare magic, it may be a nevus. simple nevus may occur anywhere in the body. it is not a cancer.dont worry for that. remember some sign that demands attention are as follows- -rapidly increasing in size -itching -any bleeding from that -colour change of the nevus -pain or altered sensation otherwise nevus is completely harmless.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for fever with abdominal pain?\n\nmy 6 yr old has had a fever off and on since Monday with adominal pain he was admitted to hospital Tuesday overnight for observation for appendix, both pediatrician and hospital say it is a viral infection. But I am beginning to worry that it is something worse, he has had a fever with abdominal pain off and on through the day everyday for 5 days now",
    "doctor_response": "Hi.Thanks for your query.I can understand your plight of being a Mother / Parent.As the patient is admitted for fever and pain in abdomen, the Doctors definitely would have been giving antibiotics and supportive medicines. This is very true that when sometimes all the investigations are normal, Doctors label this as Viral Fever.Have some patience. He will be fine soon.Request the Doctors to conduct whatever tests are required. Give Paracetamol round the clock.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can high BP be caused due to injury to my teeth?\n\nI fell and hit my two front teeth 5 months ago. The left front has healed, the right front remains wobbly. I have been under the care of a dentist since it happened. Recently my blood pressure has risen to 190/90 and dispite medication cannot be controlled. Is there a corrilations between the two events?",
    "doctor_response": "HelloThanks for posting at HCM. Your BP is definitely on the higher side. BP can be higher after stress either mental or physical. However since it had been five months since your trauma and teeth extraction, it is unlikely that the BP would be high because of the trauma. So there is no correlation between teeth extraction or wobbly teeth and high BP. You should record your no regularly and if stil readings are persistently higher on the different days, you need to be started on BP medications.Wishing you good health.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My problem is low sexual drive. Please help me overcome this.\n\nHello, I am a 30 year old male, got married before 2 years. My problem is low sexual drive. Previously I used to masturbate a lot. But before 2 months I had quit these activities. Also I have strong erection in the beginning of the foreplay, but before penetration I will lose my erection. Because of this I am not able to use condoms. My penis is circumcised and I do not feel any sensitivity in my glans penis. I had an online consultation with a doctor. She prescribed me bupropion hydrochloride XL 150\u00a0mg for a month.\u00a0It is an antidepressant. Is it safe for me to have this pill on a regular basis? Are there any side effects? Does it increase the sex drive? I have a very good relationship with my wife, but when it comes to sex, nothing seems to work out. Please help me overcome this situation.",
    "doctor_response": "Hi. Do get back with details to a sexologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have fever and diarrhea with little blood. What does that mean?\n\nHello doctor,I have been ill for the past five to six days and seem to gradually be getting better. I had a very strong fever the first night, then very mild fever and lots of diarrhea over the last three days, but yesterday I noticed there was a lot of blood but also last night I managed to get the longest sleep. I only had to go to the toilet once and only a little blood and this morning almost nothing. Should I be concerned?",
    "doctor_response": "Hello. You are likely to be suffering from dysentery. It is like bloody diarrhea, fever, and loose stools indicating you are having an infection going on. I would like you to get a CBC (complete blood count), stool routine and microscopy tests also done. Till then you should drink ORS (oral rehydration solution) to avoid any dehydration. Regarding blood in stools today I think it will resolve with the proper antibiotics. Colitis. Ofloxacin 200 mg twice a day, Metronidazole 400 mg thrice a day for five days, Paracetamol 500 mg for fever SOS, and tablet Pantoprazole 40 mg twice daily for five days. Avoid eating spicy foods and a fatty diet. For more information consult an internal medicine physician online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could red, puffy and watery eye in an infant mean?\n\nThis afternoon my daughter screamed when my mother took her out of her carseat she is 4 months old her eye remains red and puffy. She can barely open in and is sensitive to light. What could be wrong? It is watery like it is trying to get rid of something that could be in there. Should it have been better by now if something is in it? What should I do? Could it cause any damage?",
    "doctor_response": "Hi.... by what you say I think that this could be a conjunctivitis... either viral or bacterial.Eye conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Regards - Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dry and pigmented skin\n\ni am 28 yr old single female, we have very oily skin in our heredity, a couple of year back i suffered from a kind of depression, for a whole year(2007), i witnessed so many changes in my skin ...it becomes dry and develope pigmentation, oils are no more there...but my elder sis still looks young",
    "doctor_response": "apply good quality moisturizer like venusia lotion/elovera lotion after bath. use shower gel with glycerine and aloe vera( NMF e shower gel) for bath. to prevent pigmentation apply sunscreen every 2 hr in first half of the day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of deriva cms?\n\nwat r the side effects of deriva cms when i first used it on my fore head all the pimples were gone but after many months the pimples started again but this time it also started on my cheeks again wen i used that cream it didn t get cured but it became more",
    "doctor_response": "Hi,Skin irritation, burning or tingling sensation of skin, redness of skin, peeling and blistering of skin, patchy appearance of skin, photosensitivity of skin, darkening of skin and scaly skin are the side effects of deriva cms gel.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Saranya Ramadoss, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please suggest the best drug for GAD and social phobia. What are its side effects?\n\nHi doctor, I will first summarize my case, and then I will put my query. I had been diagnosed\u00a0to have GAD and social phobia before 10 years, and I was taking Paxil 20 mg daily in the evening along with CBT. The result was excellent. The anxiety and depression went away, but with a very high level of weight gain, significant fatigue and some sexual dysfunction (low libido). Due to the side effects of the drug, I tried to withdraw it all together around two years back, and there was a relapse. Therefore, I have come back to the medication with some changes. Initially, my doctor replaced Paxil with Prozac and Wellbutrin XL, and then replaced Prozac with Zoloft. Wellbutrin had many side effects\u00a0on me. Hence, I avoided it altogether. He also avoided Effexor. I am currently on Zoloft 50 mg in the evening along with Buspar 10 mg four times daily. The query now is, which of the following strategies will have few side effects like fatigue, weight gain, impotence, decreased libido, and to delay the ejaculation? A combination of 20 mg Prozac during the evening\u00a0time along with Buspar 10 mg every six hours daily. A combination of 10 mg Lexapro in the evening along with Buspar 10 mg every six hours a day. A combination of 50 mg Zoloft\u00a0every evening along with Buspar 10 mg every six\u00a0hours daily. How would you arrange the side effects? I would like you to mention the side effects regarding\u00a0impotence, libido, weight gain, fatigue, drowsiness, negative impact on the system and liver in long-term\u00a0usage, control GAD, SAD and social shyness, delayed ejaculation as a positive side effect, interfere with food, other medicines and supplements etc., in a descending order. Please discuss every question in detail according to your practical experience. Best regards.",
    "doctor_response": "Hi. I read your query. Out of the three options, the third option would be the best possible concerning the balance between the effectiveness and side effects. Zoloft (Sertraline) and Lexapro (Escitalopram), both are almost equal regarding the side effects and efficacy. Based on my experience, Prozac (Fluoxetine) is a weaker drug regarding the effectiveness. With my practical experience, impotence and loss of libido are known side effects of all the three drugs. The probability may vary but, it is about 10 to 20 %. Lexapro is the most drug to cause weight gain when compared to Zoloft and Prozac. Again, fatigue and drowsiness are known to occur with all the three medicines. But, it is more familiar with Lexapro. Delayed ejaculation is not a predictable side effect. Hence, cannot say among the three. Zoloft and Lexapro do not interfere with almost all the medicines, whereas, Prozac may do so. The long-term impact on the body and liver is almost negligible for all the three. They are all safe on a long run. The effectiveness of control on SAD (seasonal affective disorder), GAD (generalized anxiety disorder), and social shyness is better with Zoloft and Lexapro compared to Prozac. Between the two (Zoloft and Lexapro) it is hard to judge. Some patients benefit more on Lexapro and some on Zoloft. To conclude, I reiterate that, based on the information you have provided, the third option is the best among the three. (Zoloft 50 mg with Buspirone 10 mg, every six hours). With best wishes. For further queries consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the treatment for whiteheads and enlarged pores in my face?\n\nHello doctor,I had acne for some time during school period and now have scares from the acne. The scarring left enlarged pores as well. The pores have whiteheads, and my nose has a lot of blackheads as well. My skin is oily in some places like the nose but dry around the cheeks. I was wondering what I should do to get rid off the whiteheads as well as reduce the number of enlarged pores. What treatment should I follow to get rid off the blackheads? I have already used many face washes with blackhead erasing ability, but none of them worked.",
    "doctor_response": "Hello. I have gone through your case. The best treatment for acne scar is CO2 (carbon dioxide) laser. No cream will benefit you for the scar. For shiny skin, apply Vitamin C serum at night. For blackhead apply adapalene gel only on blackhead and whitehead with a toothpick in the minimal amount on lesion at night for 20 minutes only. If you take too much, you will have a burning sensation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can triamcinolone be applied for rashes on the penis?\n\nthin red rash on penis shaft from balls nearly to foreskin, f s and balls bit red too, no itching, masturbate a lot...had fungal or bacterial skin infection few weeks ago, statred on arm then popped up all over my body,not large rashes though ...gone on body but not on penis despite same cream, triamcinolone",
    "doctor_response": "HIThank for asking to HCMI can understand your problem no need to apply steroid preparation (Triamcinolone ) you can use any soothing agent for this in the form of powder \"Povidone powder would be nice, hope this information helps you have good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for erosive arthritis and joints pain\n\nI took Accutane twice. 2 separate courses of the drug about years ago for acne. I had joint pain, fatique during the therapy and was told that was normal. Acne was so much improved it was worth it. At 59 I now have erosive arthritis. My knees were just rotten requiring total replacements. Hands, feet, elbows, even my spine are painful. I don t think I have Fibromyalsia. I got to thinking about the Accutane.",
    "doctor_response": "Hi,In my opinion you should think of total knee replacement first rather than any other option or medication.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat splin shints pain?\n\nmy son 17 got painful splinshints durin football season tried inserts from professional still bothers him at times when doin 2 days hurts bad his heart in into playin senior yr   hes a lineman   FLATFOOTED  last yr comin up from 1st part of july till season ends  8-9 hr days what to do to help",
    "doctor_response": "Hi and thanks for the query,This would require a proper evaluation by a doctor, preferably a sports medicine doctor or an othorpedic surgeon.  Treatment could range from ice blocks, non steroidal anti inflammatory drugs, physiotherapy and at times a surgical option. Kind regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can bactrim help deal with twitches in scrotum?\n\nI feel little random painless twitches in my scrotum.  They started happening after i started taking the antibiotic Bactrim last night.  I  saw a urologist recently and he said i have epididimytis and that everything else is ok.  Should i go back to a doctor to have him check it out again?",
    "doctor_response": "Hello,I can understand your concern. Bactrim is not associated with twitches in the scrotum. If your doctor said that your are suffering for epididymitis, then these spasms may be associated with the epididymitis and not the antibiotics. You can wait until the course is complete and infection is eliminated. Most probably it will go away with the infection. In addition, try to do some changes in your lifestyle so that if the spasms are muscular, it can help. You can try to avoid prolonged sitting and try to do some exercises like swimming or brisk walking. If you do not find any relief yet, then consulting a neurologist to diagnose muscle related problems is advised. I hope this answer helps you. Thank you for choosing HealthcareMagic. Let me know if you have follow up questions.Best,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can infected ingrown hair cause swollen inguinal lymph nodes?\n\nHello doctor, I have a history of skin picking, mainly ingrown hair. I have curly hair, and shaving often leads to ingrown hairs for me, especially in the pubic region. About a week ago, I was popping my ingrown hairs as usual and sometimes I go a little overboard and scratch and pick too hard. In the same time frame, I have had two sexual partners. Both I have slept with before, but one I had not had relations for a while until last week. The same guy also had sex with my best friend the same night (which I was unaware of). I also resumed having sex with my constant partner two days later. A few days had passed and the sores from my skin picking have not gone away, but instead, have ulcerated in some areas. There are probably eight or so ulcers. They scab up sometimes but the scabs do not stay attached. I am concerned now because my best friend has also noticed ulcerated areas in her genital realm and is concerned she has genital herpes. I fear that I might also, but at the same time, I am not sure whether or not it would be an STD or just from where I picked at my own skin. At first, she was concerned she had gonorrhea or chlamydia. I do not have as much concern about those. There are hairs centered on all my ulcers. The only other concerning factor is that my inguinal lymph nodes are swollen and sore. I know I need to go get tested and plan on doing so tomorrow. I just wanted an opinion on what else might be going on.",
    "doctor_response": "Hello. I have noted your concerns. Your details match closely a condition called folliculitis which is an infection of the hair follicles, with or without a hair in the center being visible, and can lead to ulceration and swollen glands in the draining region which is an inguinal area in your case. When you visit your doctor, he or she is likely to assess your signs and physical examination, and order some tests to look for the presence of bacteria in the lesions, and some other venereal diseases. Some of the conditions can only be confirmed by blood tests. It would be advisable to get your friend and contacts too examined and investigated at the same time especially if you are going to have them as partners in the future too whether directly or indirectly. At this stage, the main concern focuses on herpes (blood tests required), chancroid (tests required), and folliculitis. For now, it would be good to clean up the area with mild antiseptic, apply some antibiotic cream, and use a pain killer for relief from pain. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for ca rectum with liver metasis and nodular lesions?\n\nI AM A MALE AGED 67 YRS SUFFERING FROM CA RECTUM WITH LIVER METASIS AND NODULAR LESIONS IN BOTH LUNG FEILDS,HAVE UNDERGONE 2 CYCLES OF CHEMOTHERAPY WITH CETUXIMAB AND UNDERGONE KRAS TEST. NOW PRESCRIBED TAB CAPECITABINE PLEASE ADVICE FURTHER COURSE OF ACTION , NEED A SECOND OPINION",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.Unfortunately this is systemic malignant disease and chemotherapy is the only treatment option for this There is no purpose of surgery or radiation. Few chemoth protocols can be used but this should be discussed with oncologist.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.DR. Ivan Rommstein",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Metoprolol withdrawal help regain sexual drive and potency?\n\nA male friend of mine has been taking metoprolol for around 10 years now and he noted that he has low sex drive and at times impotent.  I've read that metoprolol has this side effects.  If he withdraws metoprolol, can he regain from his low sex drive and recover from impotence?",
    "doctor_response": "HelloMetoprolol has so many side effects one of them is DYSFUNCTION /IMPOTENCE .Since your friend used this drug for almost 10 years and he developed impotency .Now regain of sex drive depend on many factors;Age , if > 50 years less chance of regain.Heart disease or blockage ( hypercholestrolaemia ) , less chance .Regain is possible but for this consult a PSYCHIATRIST and get his opinion.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does it take for bilirubin level to be normal?\n\n3 Months before I was affected by jaundice. (Total bilirubin:2.3mg/dL direct 1.2mg/dL). As per a doctors advice, i am taking only Oil-less,Salt-less,mostly fat-less foods. I took only 7 days rest as i want to step into my first job(at starting state of jaundice). After that no bed rest, nearly 8hours/day i was sitting in-front of systems. Bilirubin level is going up and down for last 1 month. Now Bilirubin level is about 1.4mg/dL-Total(0.6mg/dL-Direct). In my testing report, it was mentioned that 1.1mg/dL -Total and 0.5mg/dL-Direct as normal.  Is it true that it will take about 4.1/2 months to come to normal?. As medicine I am taking only LIV52 syrup only. How long it will take for bilirubin to come to normal? Now there is no disturbance in my body. I want to know whether i am in normal recovery or any problem with my bilirubin levels. My last 3 reports: Total(mg/dL) Direct(mg/dL) 15-Oct  1.4 0.6 25-Sept 1.7 0.6 11-sept   1.9 0.5 24-Aug  2.0  0.7 As per Lab: <1.1mg/dL<0.5mg/dL as Normal Suggest some foods that i can take without any problem.",
    "doctor_response": "Hello welcome to 'Ask A Doctor' service.I have reviewed your query and here is my advise. You are havinv jaundice and you are on recovery phase. Your bilirubin only slight high. The cause for that should be ruled out by viral marker study, USG abdomen and peripheral smear examination. You have to take less fatty food for another one month. Sugar cane juice and apple juice can be taken more. Refined foods, junk foods should be avoided for one month. Hope I have solved your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is root canal advised for half broaken root ?\n\nSir, I am having teeth ache for the past 5 days. I went to the dentist for consultation. After examination of the dental X-ray, Dr. advised me due to half of the root broken better to remove the teeth. Only 30% possibility for Rootcanel treatment no gaurantee for success of root canal treatment. So that better to remove the teeth . I request for second openion through healthcaremagic Drs.",
    "doctor_response": "Hi, A tooth can be root canal treated depending on the condition of intact tooth structure present. If sufficient structure is not possible then the tooth should be extracted and you can go in for a dental implant or a fixed partial denture.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever, body ache and knee pain?\n\nmy mom is suffering from fever,acute body ache, since last three days. her knee joints are also paining and she can't walk now. what probably could be the problem. what blood test other test should i get done.? she is 65 years old,about 80 kg in wt. and suffers from gas/indigestion.",
    "doctor_response": "Hello!I really appreciate your concern. These symptoms are most likely due to viral fever. You should have complete blood count with malaria parasite test done to rule out malaria.Hope my answer has solved your query. Take Care.Thank you. Best Regards.Dr. Manan",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does braces on teeth work?\n\ni went to the orthodontist the other day and she said i need to get 6 baby teeth pulled out since the adult teeth are growing on my pallet. she said i need minor surgery and to have these teeth brought down by braces. how will they bring the teeth down? i am 14",
    "doctor_response": "Hi. Welcome to healthcaremagic.I read your query. Primary teeth are pushed out by growing permanent teeth. But at times the primary teeth do not shed at time and permanent teeth deviate from normal path. Orthodontist will study your dention and OPG. He will pull out primary teeth which are not shedding naturally. Braces are applied to permanent teeth and tighten so it exerts a required amountvof pressure on them.Slowly your permanent teeth will move into their destined allignment. Entire process will need 6months to a year.You may have to wear retainer after that for maintainence.Hope the answer helps you. Thank you!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could kidney stones cause burning urinary sensations?\n\nI have burning sensation inside the tip and under the head of my penis. It burns when I urinate. My abdomen feels tender too. My hips and lower back feel tender as well.  I do have a history of kidney stones but I've never passed one that felt like this before.  Any thoughts?",
    "doctor_response": "Hi,Thanks for writing in.There are many symptoms related to the location and size of kidney stones. If the stone is too large to pass easily, pain continues as the muscles in the wall of the tiny ureter try to squeeze the stone along into the bladder. One may feel the need to urinate more often or feel a burning sensation during urination. In a man, pain may move down to the tip of the penis. If the stone is close to the lower end of the ureter at the opening into the bladder, a person will frequently feel like they have not fully completed urination.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to control mood swings?\n\nhi, recently i'v found myseld changing between feeling happy and quiet exited to feeling depressed and irritated for no apparent reason, totaly unprovoked i can suddenly fbecome very snappy with people and just as easily i can become very happy and exited; i never noteced anything untill recently,origionaly i thought it was just stress but even when im in a relaxing situation i can change. it dosent always happen somtimes it dosent happen for days but im finding it increasingly harder to keep focused on somthing and im worried freinds and familiy are going to find me too frustrating to be around. any ideas on what the problem is and what i can do would be appreciated.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. From the description, correct diagnosis is a remote possibility. I feel that you are insisting that you be diagnosed with bi-polar disorder. I shall not do that. Be more descriptive with your description and never try to lead. you may be diagnosed as what you say and you may be prescribed medicines, but you may never have such a problem at all. Please beware. To have a proper diagnose, please consult a psychologist to get yourself assessed psycho metrically.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could dizziness and sweating be due to heart problems?\n\nat times the inside of my body gets hot and i feel some pressure at my sternum with this happens and at times feel dizzy and the outside of my body gets fire hot. but when i start to sweat i feel as if i have been rolling in insulation. could this be from my heart problems.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. Are you elderly, are there any risk factors like high blood pressure, high cholesterol or diabetes. If any of these is present then we can suspect heart disease. If not then the possibility of gastritis and acidity problem is also there. If any risk factors are present then It's worth to get yourself evaluated. Get your sugars, lipid profile, ECG done, also TMT if needed.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes brown vaginal discharge during pregnancy?\n\nI am 8 or 9 weeks pregnant and haven t gone to the doctors yet. I have an appointment tuesday but i m getting anxious. I have been having gas pains some like menstrual cramping on and off since I have found out and I m wondering if thats normal. Also today in the middle of the day i noticed brown slightly dark blood-like discharge when wiping, help?",
    "doctor_response": "HI,    I understand your concern.    Once pregnant, there should be no bleeding. It needs a gynecologist's consultation to pin point the cause & start with specific treatment right then.  *   Such bleeding at 7-8 weeks pregnancy can be  a weak pregnancy needing hormonal support for it's maintenance/ It can be threatened abortion/infection in genital tract/ it can abnormality in pregnancy like blighted ovum or tubal pregnancy.     If not yet confirmed by pregnancy test/ USG/ doctor's consultation.. it can be simply menstrual abnormality because of hormonal imbalance/ PCOD/ ovarian or thyroid disorder.   * Dull ache in lower abdomen is common in early pregnancy... but sever cramping need investigations & gynecological examination followed by specific management.You should take bed rest & consult the earliest. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to get pregnant without intercourse?\n\nhi, i was wondering if there was a way i could possibly be pregnant from touching of genitals- no insertion and/or ejaculation occurred near or in the vagina. i have an irregular period, but am still concerned that this may be the cause of not getting it.",
    "doctor_response": "Hello, Do not worry you can't get pregnant by touching and without ejaculating. If in doubt you can take Urine Pregnancy Test at home. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Meena Jethani, OBGYN",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Missed period, sickness in stomach, pregnancy symptoms. On birth control. Track cervical position?\n\nMe and my husband have been TTC for almost 2 years now with no luck. I missed my period for 4 months so i started taking bc. I got off it a little over a month ago. I am 5 days late for my period which lately has been pretty normal for me. But i have been getting sick to my stomach a lot recently and have had a few other early pregnancy symptoms. I use to track my cervical position all the time but stopped when i didn\u2019t have a period. I started doing it every day at the same time about a week ago trying to figure out when i was going to start my period and instead of dropping down and getting firmer it is rising and getting softer but i felt it today and it is very high and soft and slightly open and it is very big. I have never had this combination before and have no idea what is going on!",
    "doctor_response": "Hi, Since you have noticed a missed period and changes in cervix, better have a pregnancy test done if you are more than 7-10 days beyond your expected date. If it is positive, visit your obstetrician early [immediately if possible] as this is a precious pregnancy and an open cervix may indicate a threatened abortion. If the test is negative, repeat it after another 7 days, if still negative than I suggest the following measures need to be taken.If you are trying to conceive, birth control pills is not the first line treatment for irregular periods.If a couple is not able to conceive after 1 year of regular sexual contact we label them as having problems with fertility. Both you and your husband need to be evaluated regarding the causes. For any couple in my clinic with similar complaints, the first line is a gynec examination and pelvic ultrasound for the woman and her husbands semen analysis. The next is a hormonal evaluation of the woman. Further investigations and treatment are based upon the results of these tests. So get a pregnancy test done and if positive, congratulations!. If negative, do not get disheartened, visit a specialist and get yourself evaluated and you will conceive. Best of luck and have a good day!Dr. Madhuri BagdeConsultant Obstetrician and Gynecologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can amixide and nexitol cause hallucination in a patient diagnosed with Parkinsonism?\n\nMy wife has diagnosed as parkinsonism and cKD she has mild dementia neurologist has prescribed syndopa 110 mg 1/2 tab b.d rasalect .5mg hs nephrologist prescribed nicardia 10mgbd metaprolol25mg od she is on drugs for six months after starting drugs for parkinsonism she has halucinations later on it is improved now one month back rasalect has been stopped amixide and nexitol has started now she has hallucination loss of memory slight may I stop amixide and nexito",
    "doctor_response": "Hello Thank you for trusting HCM Dear Parkinson's patients experience occasional hallucinations. And few drugs that may cause hallucinations examples :Drugs that may contribute to hallucinations or delusions in people with PD include:1.dopamine agonists, including rotigotine,  pramipexole , ropinirole, pergolide , and  bromocriptine. 2.carbidopa/levodopa3.MAO-B inhibitors, such as selegiline and rasagiline. 4.COMT inhibitors such as entacapone and tolcapone5.amantadine. 6.anticholinergics such as Trihexpenidyl and benztropine message. 7.narcotics containing codeine or morphine8.NSAIDs, like ibuprofen. 9.steroids10.sedatives anti-seizure medications. Don't stop amixide and nexito immediately it cause with drawel symptoms. Please consult your doctor before changing medications.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have abdominal ascites, primary lung with liver and lymph node metastasis. What is happening?\n\nHow long can a patient expect to survive once abdominal ascites starts? The patient has primary lung with liver and lymph node mets and had been informed that the cancer in the liver is causing more issues now.the ankles and feet are very swollen then will go down, but still puffy at the moment. He has has 4.5litres drained 2 dayscago and the abdomen is already tightening. Please help me understand what s happening.",
    "doctor_response": "Hi, probably he has developed malignant ascites. This is to be proven by pathology report. anyway stage 4 lung cancer has got poor prognosis. regular draining of ascitic fluid will not be helpful very much as fluid will be accumulated quickly. chemotherapy can be tried. consult your oncologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower abdominal discomfort, history of urinary tract infection. Due to UTI or antibiotics?\n\nHi, I have been having Urinary Tract Infection for the whole of this year. Recently had it treated with Bactrim but it didn t work, so cipro did the job, now on second course. I have been having dull lower back pain for a few days in my first course then it went away after two days. Now on the second course to totally clear it, I m experiencing some lower abdominal discomfort. It s like something is pulling me on the inside. Feels more like cramps maybe but I really don t know what cramps feels like on the abdomen cos I don t usually have menstrual cramps if thats the closest I can associate cramps to. It s not pain, cos it s bearable and it s a very dull type of pain not sharp pain. Then the cramp proceeded to my lower left side. And that is some occasional sharp like pain. I m experiencing this only today. Im wondering if this could be affected by my UTI? or the antibiotics? But in the course of eating it I haven t experience much of any other kinds of symptoms as this, so Im puzzled by why I m experiencing this only when the UTI is almost cleared and in my final course of antibiotics. If it s not then what could it be? Thank you.",
    "doctor_response": "Hello and welcome to HCM You have had two episodes of UTI as you have mentioned. And now the UTI has cleared with antibiotic treatment. But you are still having pain in lower abdomen which is dull aching sometimes sharp. These symptoms indicate that you may have an urinary tract stone which couses down from the kidney to the bladder via ureter. Association of stone with UTI occurs quite often. The movement through the ureter is causing the sharp pain. First thing to do is to get an X-ray of the KUB (Kidney-ureter-bladder) region. The subsequent investigations will be guided by the X-ray report. Majority of stones show up in the X-ray of KUB region. The treatment modality will depend on the site or the stone and the size of the stone. Thanks and take care Dr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for heart ailments\n\nI have been on Metropolol for 4 weeks, prescribed for palpitations (400 in 24 hrs. per monitor) 50 mg. Also I have white coat syndrome, sometimes pressure rises, been under a great deal of stress, mostly apprehension re: heart tests, etc. Cardiologist says metropolol is good for bp also. I have a monitor, pressure is lower at home, only rises when I maybe active 150/62, pulse in the 70 s and has been as low as 112/60. Still I take readings to the Dr. to let him see that it really is when I am under stress. 50mg made me tired ( Cardio said it would be sluggish), I do feel calmer, had to do 25 twice a day. Still I can fall asleep sitting watching TV and that is not me. I think I could try 25 per day, that is how I started out, but my pressure in theDr. office was 162/63 so he changed it to 50. Now I notice my pressure is higher anywhere from 112 to 175 with the bottom # in the 70 s and my pulse in the 60 s. My Dr. didn t mention the fact that it was compared to at home readings, also because I am calmer in office reading was only 136/62 He thought all the numbers were good, but yet they were higher than before when I took them at home. I don t get it, I thought BP meds reduced your pressure.",
    "doctor_response": "With respect to palpitation, that is the sensation not the extra beats. The extra beats may not be harmful or even require treatment. If you have found no underlying heart disease or dangerous rhythm, the primary concern is to relieve your symptoms and anxiety. Finding nothing dangerous does not necessarily mean that heart rhythm is not the source of what you feel but knowing that its not dangerous is often treatment enough. The best way to interpret your blood pressure is to take only recording done on schedule. Single measures should not prompt concern, particularly no those done under stress. Record your blood pressure on a schedule every day. It should be taken seated after a 10-15 min period of relaxation. A two week average is what you use to make decisions about the need to take a medicine and its effect.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes muscle weakness, pain in body and difficulty in walking?\n\nI have had muscle weakness in my leg, pain thru out my body, and have hard time walking later in the day. This has been going on for three months now. It started with numbness and tingling in both arms and legs three days after being sick and going to the ER from non stop vomiting. I have had tons of tests and all normal results except for a positive ANA. What might it be?",
    "doctor_response": "Hello, The muscle weakness, pain in body etc that you are feeling after an illness can be related to electrolyte disturbance or weakness. You need to increase your intake of electrolyte rich fluids and see if ti helps. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath?\n\nI am having problem with shortness of breathe or discomfort for quite a long time. It looks as I am having arrhythmia. Some times it increases and other time it keeps just above normal and It never get normal very few occasions for short period of time when my heart beats normally I feel tremendous amount of relaxation and comfortness and I want it to continue but a little stress and nervousness disturb the heart rate and breathing process. Would you please suggest me what is happening with me is it about stress or something else?? What is its treatment if it cure with medication??",
    "doctor_response": "Thanks for your question on HCM. In my opinion you are having anxiety related symptoms. But better to rule out cardiac and pulmonary causes first  your intermittent  shortness of breath. So get done1. Ecg2. 2d echo3.  Holter monitoring ( 24 hour continuous recording of ECG)If all these are normal then no need to worry much for arrhythmia and other cardiac causes. Get done chest x ray and PFT ( pulmonary function test ) to rule out pulmonary causes. If all are normal, then anxiety related symptoms appear more in your case.So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. Avoid stress and tension. Be relax and calm.  You may need anxiolytic drugs too. Don't worry, you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a painful lump beside the little toe?\n\nHi, I have a question I'm a diebetic Type 2. I have seem to have a hard like a pee on the bottom of my right foot by the pinkie toe. Not on the toe but on the foot close to the edge. Sometime I feel pain when walking in sandles. Could it be the shoes.",
    "doctor_response": "Respected user , HiThanks for using Healthcaremagic.comI have evaluated your query thoroughly .* This is more likely to be callus  formation .* Must consult a general surgeon for the same or at least a high resolution    clinical photograph with mobile as an attachment is mandatory to    evaluate  it more precisely .Hope this clears your query .Welcome for further guidance .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower abdominal pain and blood in urine?\n\ni have lower abdominal pain, and just now started seeing blood in my urine, a few weeks ago i noticed some pain in my kidneys when i was running, not sure if these are related. And i just spent a weekend camping where i consumed very little water. im thinking stones, but need another opinion.",
    "doctor_response": "HI.Yes you may be right but stones causing such a problem do not develop in such a short span. They may be pre-existing stones with super-added infection causing all this . The blood clots do cause a sever pain as they cause obstruction to outflow. I would advise ::ultrasonography and blood and urine testsUrine culture and sensitivity. You need to start antibiotic treatment under a Care of a Doctor and take plenty of oral fluids.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for vetigo for F1 and a cholesterol level of 136mg/dl\n\nI FILL TIRED IN AFTER NOON .MY HEART BEAT IS IN THIS TIME ABOUT 65.MY PRESSURE IS NORMAL.MY AGE IS 60.ECG REPORT IS NORMAL.I ALSO FILL WEAKNESS IN THIS TIME. 15 DAYS AGO 1 EPISODE OF VETIGO FOR F1 MINUTE IS HAPPNE.MY SERUM LDL COLESTEROL IS 136mg/dl.I AM FIT IN MORNING.IN AFTERNOON WHEN I AM IN REST I FILL  SMALL PALPILATIN IN MY CHEST.MY WEIGHT IS SLOWLY LOOSING.WHAT IS MY PROBLEM AND IT'S TREATMENT.PLEASE HELP ME.HIGHT IS 172.WEIGHT 59 KG.",
    "doctor_response": "Hi,You need to undergo some examinations, such as ECG, serume glucose, carotid duplex ultrasound. Only after these examinations the right strategy may be found out. Your complaints may be caused by different conditions; heart disease, diabetes mellitus and for the episode of acute dizziness narrowing and blockage of carotid arteries should be excluded by carotid duplex ultrasound.Take careCome back if you have any further questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling and hives on the arms\n\ni have hives and need it gone it came back today after i took benadryl yesterday and i applied gold bond itch relieve on it. It went away yesterday night after a few hours of consuming the pills but some of the hives around arms are still visible barely but visible, well its all over me today i took some more benadryl and the itch went away but...still visible on the swelling.",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your history and would like to make suggestions for you as follows:1. Were I treating you, I would suggest you to take an antihistamine like cetirizine or hydroxyzine regularly for 7 days.2. I would also suggest you to apply a lotion like calamine lotion over the hives.3. Please do not scratch the itchy areas as scratching aggravates itching and hives.4. Please avoid tight, woolen clothing. Loose-fitting, cotton clothes are generally best for persons with hives.5. Please avoid exposure to excessive sunlight, extremes of temperature, too hot/spicy foods/liquids, if they are aggravating hives.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health ahead and a very good recovery.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is lichen planus result of fibromyalgia?\n\nI have severe oral lichen planus that has come and gone for at least 3 years. It was only every few months, but has become and ongoing occurance. I ve tried prednisone, Diflucan, topical ointments, etc. to no avail. I have had in the past a stomach disorder that has been linked to fibromyalgia. Is lichen planus also a result of fibromyalgia and what is the best course of treatment?",
    "doctor_response": "Following individuals can present with a combination of oral lichen planus and fibromayalgia,1. Female gender2. 50-60 years age group3. Patients on Cymbalta medication4. Patients with high blood pressureLichen Planus is basically rare type of oral rashes presenting as lacy, white patches or red shiny areas or bumps on the inner side of the cheeks or tongue. Its cause is unknown and not defined. Generally, mild forms of lichen planus do not need any treatment. In case of pain and discomfort in ulcers, it can be treated with oral and topical steroid and pain relieving medications. Oral forms of lichen planus usually increase the chances and risks for the occurrence oral cancer. Lichen planus can also affect skin, scalp, nails, and genitals.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can backache while suffering from shingles be treated?\n\nI have a mild case of shingles - two spots plus sensations in my neck. It has been one week and the two spots are improving but I have been getting this pain in my back. A shooting pain and achy feeling when I turn certain ways. Is this from the shingles or the medication they put me on? (valacyclovir and prednisone)",
    "doctor_response": "Hello,Yes, unfortunately shooting pain or any other strange sensations can be linked to shingles.It causes nerve related pain or symptoms. It is not likely related to any of the medicines that you are currently using.There are medications that can help with nerve related symptoms or pain for example, gabapentin, Lyrica, Tegretol, amitriptyline et cetera.If the symptoms continue, then you can speak to your doctor about an additional medication.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Michelle Gibson James",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and vomiting in 11 month baby\n\nmy girl child age 11 months old & had a fever of 99.7 since last 3 days. we had given her 0.8 ml dose of metacin for this 3 days. stll fever remains 99+. so we had visited famly docotor , she had suggested calpol( 3ml 3 times a day) with mefenamic (3ml 3 times a day) , ofloxacin and metronidazone (2.5ml 3 times a day). we had given 1st dose before 12 hours. just before 1 hour she had pass much light stool , fever is 98 now & she had vomiting 2 times & taken out small glass of wather that she had drunk in morning when she wakeup before 1:30 hour. should we continue all three medicines or sugest yur openion.",
    "doctor_response": "continue all three medications but you can add a syrup ondem for vomittings and if the baby is having more than 5 watery stools per day u can even add a probiotic like darolac sachet",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am planning for pregnancy for last 2 months. can you give me any suggestions ?\n\ni took meprate from 16th to 25th day and still had spotting on 25th day. i am planning for pregnancy for last 2 months. please help i took meprate from 16th to 25th day and still had spotting on 25th day. i m planning for pregnancy. please help",
    "doctor_response": "Hi Well come to health care magic Period usually starts after 3-5days of discontinuation of meprate.So wait at least 3-5 days for normal period to comme and take the advise of your Doctor",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is IVF the right option for me after a failed IUI ?\n\nim 28.6 year old,and we are trying for pregancy since 2years but it fail,one month back i did IUI it also fail,reason is unexplaine prganacy,i have hypothyroidism and hyperprolactine but with treatment bld report is normal,now we will think for IVF .please guide us is it right option or we will wait for few years?",
    "doctor_response": "Hi Welcome to Healthcare Magic Forum Yes, if IVF is a good option, if you have tried everything else, including alternative therapy like homeopathy. Usualy it takes a few attempts for one to become pregnant with IVF. Done lose hope, its not late . Takecare.",
    "dialogue_context": ""
  },
  {
    "patient_message": "2 1/2 year old diagnosed with allergies, asked to use montair 4mg, seroflo. Adverse reactions ?\n\nI have been advised to use montair 4mg once a day(at night) for my 2 1/2 year old who has been diagnosed with allergies-she coughs once or twice in a day sneez couple of time. she has also been prescribed seroflo 125, one puff twice a day followed by sip of water. the montair has been prescribed for 2 months. was wondering if there are any side effects/ adverse reactions. will she stay depened on seroflo 125 due to longer period of its use. thanks",
    "doctor_response": "hi, the treatment given to you child for allergy is correct..lot of people think that inhaler (seroflo) given for allergy and asthma cause dependence which is wrong.. these inhaler act locally on the bronchi ( lung ) and do not mix with blood.. hence the side effects produced by them is minimal almost zero.. the chemicals used in the inhaler does not cause dependence, in fact this is the best treatment available for allergy and asthma.. the montair given is also given in asthma along with inhalers..kindly follow the treatment given..it is going to stop the progression of allergy and asthma .. thank you dr. mukesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fatigue,headache,stomach pains,vomiting and body aches?\n\nHello, Yesterday I woke up feeling under the weather, queasy and fatigued. I developed a bad headache and stomach pains. I vomited uncontrollably to the pit of wretching bile, sweated profusely, develped chills and body aches with severe weakness. I had a fever of 99.9. Today I am feeling better and can keep down ginger ale, applesauce and toast. Do you think I had a 24 hr bug?",
    "doctor_response": "Hi dear, sounds like stomach flu, as long as you got better today then don't worry just avoid eating oily,chilly food for at least 2 daysAlso make sure you drink more water, as your body needs hydration after vomiting. Wish you all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for scoliosis\n\nHi I have been diagnosed with scoliosis andi found out in middle school that i had it and ever since then i been having severe back pain in my lower back in the middle. I was told by a specialist that i have scoliosis but its in the upper part and its curve alittle, i explained to them it s not hurting in the upper part its in the lower part. I just found out i was born with it but it was never disguised or thought about bac then, and i want surgery so i can get it fix and stop the pain as well, what should i do and i dnt have no insurance wright im in the process of getting one.",
    "doctor_response": "Hello, I have studied your case. If on bending forward curve of scoliosis disappears then its functional if it persist on bending forward then its structural.You need to confirm which type you have.You may need MRI spine to get detail diagnosis.For symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain which radiates to chest\n\nI was at the gym the other day and developed pain in my back very near my left shoulder blade the pain radiates to my chest just left of my sternum.  There seems to be a knot in the area of my shoulder blade that my wife could feel when trying to rub the knot out. I have tried heat which helps, and Advil but I cant get rid of it.  What can I do?",
    "doctor_response": "Hi,Welcome to healthcare magic.After going through your query in my opinion it is muscular pain as pain occurred after gym. Rest  and analgesics(diclofenac/ ibuprofen) is its treatment. Sometimes vitamin D deficiency can cause this so serum vitamin D test is advised if it is low than vitamin D supplementation will be required. Avoid  long continuous standing.Sit in a straight posture.Eat milk, fruits and green leafy vegetables daily.You need to done MRI TO RULE OUT other causes.I give local triamcilone injection to my such patients. Consulting with your treating doctor is advised. I think your query answered.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes premature ejaculation?\n\ni am suffering from premature ejaculation,problem is so high that ejaculation takes place with in 1-2 sec,sometime outside the vagina mean with penetration.i am a newly married,get married 7 months ago,my wife suffering from pregnency problem.Is PE a problem in pregnecy,i hace made sperm urine culture and normal test,all are normal,please tell me about PE.Can it be treated permanently and also tell me cause of infertility in between me and my wife,i will nb thankful to you for this",
    "doctor_response": "Hello,Premature ejaculation is more commonly a psychological problem.I usually give tablet paroxetine 20mg every night to my patients and have seen good results. You must try this.Hope this helps you.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for chronic lymphocytic leukemia?\n\nhi,I have been diagnosed with Chronic lymphocytic lukemia and the have been refered to a hemotologist .. my local gp doesnt know a lot about the disorder and has said not to worry as it is not a cancer..the net tells me other wise.. i am 46.. and have a 67 percent reading in my blood.. should i be concerned in regards to it being a cancer..",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern.  Chronic lymphocytic leukemia is a cancer. You should concern about that.  However prognosis is somewhat beyter than other leukemia.  You should consult haematologist and take chemotherapy according to his advice. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for trigeminal neuralgia?\n\nI have Trigeminal  Neuralgia, I am trying to manage it as well as possible by taking Amitripyline 10 mg one or two at night before going to sleep and also Codine for the pain, today though I feel quite good, which is a change.                         Cheers, Graeme",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concern...As per your complain it is good that you are managing pain caused due to Trigeminal Neuralgia by taking Amitryptiline which is a tricyclic antidepressant and codeine which is an opioid pain medicine although both are not first line drugs for trigeminal neuralgia..But in case if you are being managed well by taking these medicines you can continue with the same..In case if the pain does not improve by taking them then you should consult a NEUROPHYSICIN and get evaluated and he/she can advise you to take Carbamazipine that is the first line drug for treating pain in case of Trigeminal Neuralgia..Other medicines that can be given are Gabapentin, Baclofen, Lamotrigene etc..Hope this information helps..Thanks and regards..Dr.Honey Nandwani Arora..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. During pregnancy, is it necessary to take treatment for IgG positive toxoplasmosis?\n\nHi doctor, My wife is 4 months pregnant. Her toxoplasmosis report showed IgG reactive and IgM non-reactive. Our doctor prescribed her Rovamycine forte 30 tablets for 10 days. What shall we do?",
    "doctor_response": "Hi. I sincerely advise her to not take anything. Any infection produces two types of antibodies. They are IgG and IgM. IgG is from infections which occurred many years or decades ago. It is not harmful as it will not cross the placenta and will not affect the baby. IgM is an acute infection. It means she has an infection now. It will be dangerous to the baby. Usually, these infections occur once. Now if she has IgG, then it only means that she had infections sometime in the past. So, no need to take medicines unnecessarily now. Please share this with your treating doctor. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for recurring psoriasis in diabetic patients\n\nMy sister is having psoriasis problems since 18 years and having diabetes too she was visiting p k banerjee since 18 years it was curing nicely and almost gone bt now again it started coming out due to may be diabetes so please advise me what to do sir.",
    "doctor_response": "Hi,Psoriasis vulgaris is an autoimmune skin disease. Diabetes has no bad effect on psoriatic lesions. But, diabetes should be controlled with perfect medicines to avoid systemic and skin complications.Kindly consult the dermatologist have proper drugs to control the psoriasis.I would give...- tab. Methotrexate 15 mg per week in devided doses 5 mg 12 hourly in two days- cap acitretin 25 mg/d ...may be reduced to 10mg/d after control - apply salicylic acid with steroid oint like clop- S oint twice day- avoid soap bath,keep the skin moist with moisturiser - avoid stress,tension and worriesTreatment should be continued even after clinical cure to prevent the relapse.I hope this would help your sister.Thanks.Dr.Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluttering and spasms in the chest?\n\nHello, I have been looking on the internet for a couple years for an answer but have not yet found one.  I am a 40 year old male who has developed fluttering, spasms, twitching specifically in one area: the left side of the chest, right by the nipple.  I have it about 3 times a week.  It started about 6 or 7 years ago and has become progressively more intense.  I have visited doctors and have done research about it and have tried many different treatments and none so far have had any long-lasting effect. Doctors have told me that it is anxiety and that caffeine and smoking can exacerbate the symptoms but cutting down on smoking has not improved my condition and I don't consume beverages with caffeine.  I have tried magnesium which is supposed to calm the nervous system but have not noticed any difference.  The only correlation I can come up with is with sleep.  It seems that if I sleep poorly in the night, chances are the twitching will start with accompanying heaviness during the day.  The only causes I can think of at the time when it started were being very overweight and exercising constantly which led to a quick loss of 60 lbs.  I also had a tooth infection at the time which I didn't treat and subsequently became abscessed.  And lastly I had received 1 session of ECT therapy for depression about 11 years ago, after which I did feel strange numb sensations.  Any help would me much appreciated.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. By your history and description, possibility of anxiety and depression related symptoms is more. But better to rule out arrhythmia (rhythm disturbances in heart) first because this can cause similar Fluttering and spasm in chest. So get done ecg, 2d echo and Holter monitoring (24 hour continuous monitoring of ecg). If all these are normal then no need to worry for arrhythmia or other heart diseases. Better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic and anti depressant drugs. Don't worry, you will be alright. Avoid stress and tension, be relax and calm. Rule of arrhythmia first. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of ankle pain felt while putting pressure on foot and how can i treat it?\n\nI twisted my left ankle 10 weeks ago. I was able to walk with some pain after the accident, and around 1 week after the accident I was able to walk with very little pain. However after long periods of rest when I start walking I feel a little bit of pain localised in the sorroundings of the Talar-Navicular joint (Got this name from Google :). This is from the inside of the foot. If I press this location I feel a localised burning pain. I can move my ankle in most directions without pain. It is only when I try to put pressure on my foot sideways towards the big toe, that I feel pain. Any ideas what is the problem and how I can treat it. It seems to me that it is taking too long to heal. Thanks for your help",
    "doctor_response": "a chronic lateral collateral ligament sprain..you need physiotherapy and strengthening ex as this injury is commonly recurrent.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the 2 year old not able to keep the right leg on the floor?\n\n26 month grandchild unab;e to put right leg on floor. Unable to walk for 3 hours this morning but is now running around 4 times since leg gave away for a few seconds. Brought him to hospital no pain allingment is normal xray are all normal Any ideas This all started about 16 months ago",
    "doctor_response": "Hi, By what you quote it could be muscular pain due to spasm. In muscular spasm x ray is normal and it usually gets relieved without any treatment. I think that you need not to worry about this. Regards - Dr Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dental cavities?\n\nwhat would cause a cluster of cavities in a month?  I had my teeth cleaned a month ago and nothing was evident at all.   Today I just got 8 fillings on my top teeth. I am a type 2 diabetic on an insulin pump and take an antidepressant and mood stabilizer.  My dentist of 25 years really didn't have an explanation.  I haven't had a blood test in a while...generally my Endocrinoligist does full blood screens along with my A-1C-no red flagsI had a very slight upper respiratory issue after Christmas, but didn't last long.  I know I am not supposed to do this but I had some Augmenten that was prescribed for me this summer for an abdominal cyst and it didn't work but I kept it and probably had 5- 7 days of pills and I took them until I ran out.  Otherwise, I havenot been seriously ill or started new long term meds.   Any thoughts?",
    "doctor_response": "Hello and welcome to Health Care Magic, I have gone through your query and I can understand your concern. Dental caries is a microbial disease (microorganisms) which desteoys the hard structure of tooth. The Various factors that may help the microbial attack are: Food mostly CarbsNumber of Microorganisms itselfPersonal Immune/ Defence ResponseTime. Though some people have genetic predisposition for caries but other than that Any condition that may encourage the above factors will also increase the chances of Caries.Now as you suggested, You are a Diabetic Patient. In Diabetes the Recovery Time/Repair of Body from any insult/microbial attack/injury is hampered and also it increases the number of Microorganisms in the mouth. Thus Diabetics have a more predisposition for Caries as well.Moreover the Poor Oral Hygiene as seen with many Diabetic patients can also relate to it.I would suggest you to have a visit to your dentist, if you haven\u2019t had them filled all. Moreover, if i were your dentist, i would have advised you to increase your fibrous foods intake, Proper And Regular Cleaning of teeth.I would also advise you to Brush n Floss regularly and positively. Use Oral Rinses to decrease the load of Microorganisms in your mouth and for freash breath.Hope It was Helpful.Thanks and Regards Dr Himayun Mir",
    "dialogue_context": ""
  },
  {
    "patient_message": "Belly Button Pain While Walking\n\nHi I am a 28 yr old male and have had VERY sharp pains on the left side of my belly button for over a year. It does not affect my bowel movements in fact it hurts more sometimes. These pains come and go and hurt when I lean forward or even walk sometimes. I NEED HELP PLEASE.",
    "doctor_response": "Hi, Thanks for query, There are two possibilities, 1,you might have constipation, 2,You might have chronic amoebic dysentery, Go for stool check up and go for anti dysenteric course, Take antispasmodic tablet as and when require, Take plenty of water. ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat lower stomach soreness causing backaches and nausea?\n\nHi ive been having a lower stomach area soreness a lot. It hurts to slouch sometimes. I also have some back aches and nausea feeling. I had unprotected sex about a month and a half ago. Then i got a late period. It was late by almost 2weeks. I dont know why this is happenening, are there any possible things it could be?",
    "doctor_response": "Hi! Good evening, I am Dr Shareef answering your query.Unprotected sex  could give rise to a pelvic infection which might give rise to pain in the lower abdomen. However, an unsuspected pregnancy can not be ruled out and so I would prefer a serum HCG to rule this out and an ultrasound abdomen to be done to know the state of pelvic organs. Therefore, I would advise you to get your self clinically assessed by a gynecologist, and go for the investigations as per her advice for further management.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest therapy for blood disorder\n\nHi, may I answer your health queries right now ?  Please type your query here...\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0doc my sister is suffering from a blood disorder in which her white blood cells are above the normal and I am worried. she says that she had the treatment but the results are the same. is it dangerous",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Your sister has high WBC count. There are many reasons for high wbc count. Common cause is infection. However leukemia can also leads to high wbc count. You should go for Complete blood count and peripheral smear examination.It will give you clue to the diagnosis. Then take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i get pregnant with FSH level of 6.9?\n\nhi,iwould  thank  you for helping us i am 44y ,3 children ,2years ago i aboreted,my fsh=6.9,lh=5.8,i feel well i have not any problem,but i feel despair doctors says no pregnant at my age even using icsi ,i want to ask if i have chance to get pregnant and how ,i love children ,thanks you",
    "doctor_response": "At this age ovarian reserve is decreased.. So cannot get pregnant.. You can go for in vitro fertilization.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes small lump on bottom of butt cheek?\n\nHi there I have a small lump on the bottoms of my left butt cheek, it is a little red and hurts when I touch it or sit down on it. It is not a zit because when I touch it, I feel an oval shape lump that is very small but it is swollen all around it. What could this be?",
    "doctor_response": "It must be an abscess..in medical term we call it as furuncle.. If the lump is very hard take a course of antibiotic and pain killers..if still painful and the swelling has become soft with pus pointing,it requires drainage of pus.. If you get such swellings frequently get your blood sugar done.. Get well soon..have a good day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Id dizziness common post triple bypass surgery\n\nMy husband had Triple Bypass Heart Surgery four months ago. He has experienced extreme dizziness since the surgery. We have seen all specialists; ENT, Cardiologist, and Neurologist. He has had all tests available. Do you know what causes this and will it go away in time?",
    "doctor_response": "Hi welcome to healthcare magic,I understand your query and concern.Your symptoms are suggestive of ischemic changes in the heart leading to heart failure.I advise you to get an ECG,2 D Echo,lipid profile,hsCRP immediately to confirm the diagnosis.Drugs like clopilet,ecosprin,atorvas ,inotropes like digoxin will be helpful.Coronary angiogram with or without stenting will be the procedure of choice.Consult your cardiologist for expert management.Hope I have answered your query at the moment,Post your further queries if any,Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible with low HCG levels?\n\nHie I be been trying to convince .its been one whole year we r trying but we always end u in negative result ... this time I missed my period my last period was on June 8 . And yesterday I went for blood test and y hcg level was 0.1 I be Adobe altrasound urine test everything still I didn t get positive test ...do I ve chance of getting pregnant....",
    "doctor_response": "Hi, First important sign of pregnancy is a missed period. Please wait for 5 to 7 days more. Beta HCG levels below 5 indicate non pregnant condition and levels above 25  indicate pregnancy. You can wait for 5 to 7 days more. Then you can repeat blood beta HCG levels or get USG done. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Purushottam Neurgaonkar, OBGYN",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white patches on the chest x-ray?\n\nmy sister had undergone TB test- skin test shows 8 mm , but blood test and suptum test are negative..........but chest xray shows a white patches so my doctor suggetsed CT scan..................will it be the findings of the TB or not. Please advise me",
    "doctor_response": "Thanks for your question on HCM. There are many causes for white patch on chest x ray. Common causes are1. Infiltration mostly bacterial pneumonia2. Tuberculosis3. Old scar (healed Fibrotic) lesion. EtcSince her Skin test and sputum both are negative for TB, white  patch is less likely to be of tuberculosis. CT THORAX gives excellent imaging of lung parenchyma. And thus will be more helpful in rule out above causes. So get done CT and diagnosed her first.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Irritability, excessive anger. Taking adderall medication. Treatment of side-effects?\n\num, well adderall is seriously making me super irreitable/angry/mad.etc. i need something for motivation!!! something that will get me out of bed and ready to start a new day! also, i need something that will help with the super, super, feeling of being overwhelmed! shot,! i ll take any advice anyone could help me with!!! please!!!",
    "doctor_response": "Hello, The fact that you are using adderall suggests that you are probably having a condition called ADHD. And the complains of decreased motivation and energy and feeling over whelmed suggest that you might be having a co-morbid illness of depression. We need to know further details form you regarding this Do visit a psychiatrist and discuss with him your depressive symptoms. Hope I am able to solve your concerns. If you need further detailed discussion, I will be more than happy to help you. Dr. Srikanth Reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen uvula?\n\nI woke up with my uvula very swollen. When I finally looked at it in the mirror I was sort of shocked to see that the entire bottom portion is white. What in the world is going on? I've had a swollen uvula when I've had a sore throat before. But im not even sick this time.",
    "doctor_response": "Hi!Welcome to Health care magic.              The complaint that you have mentioned in the question is due to infection of pharynx and uvula by bacteria I advice you to consult an ENT surgeon for diagnosis and treatment.I usually prescribe to my patients with such symptoms the following drugs Cefixime,phenylephrine hydrochloride,citrizine,diclofenac and paracetamol.I also advice you to gargle with luke warm salt water.Avoid taking fruits juices, ice water, ice cream and cool drink.             wishing for a quick and complete recovery.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for vertigo and epileptic seizures\n\nHI MY NAME IS RODNEY G BANKS A 49 YEARS OLD BLACK MAN WHO HAVE BEEN SUFFERING WITH VIRTIGO EPILEPTIC SEISURES..FOR ALMOST 10 YEARS NOW AND CANT SEEM TO FIND ANY DOCTORS AFTER 4 YEARS WHO CAN HELP ME GET BETTER... HAVE NOT WORK SINCE 2010 BECAUSE OF THIS VERY SICKING DISEASE... THAT NO SEEM TO BE ABLE TO HELP ME...BECAUSE OF MY PHISICAL BODY SIZE I FEEL THEY THINK I AM PLAYING SOME TYPE OF GAME ABOUT MY ILLNESS BECAUSE OF MY BODY LOOK HEALTHY.AND THEIRFORE ALL DOORS OF ASSISTANCE HAVE BEEN CLOSED ON ME STILL SUFFERING ....ABOUT TO LOSE MY MARRIAGE BECAUSE OF THIS DISEASE...CANT WORK OR PROVIDE FOR MY FAMILY....FOR THE LAST 4 YEARS VERY HIGHT LEVEL OF ANXIETY AND DISCOMFORT... NEED HELP...682-234-7695",
    "doctor_response": "Hello !I understand your concern.Yours is a very rare and  specific condition.I would like to know more about the treatments you have tried before without results. Have you had a Braun MRI?This disorder can be caused by a structural  lesion of the brain . If you were my patient I would recommend you  a brain MRI and EEG to find out if there is any brain lesion.I would recommend you treatment with Oxcarbamazepine which has given good results in cases like yours. It is very helpful in vertigo too.Other drugs you may use are Carbamazepine, levetiracetam etc.If no results from therapy you may need brain surgery, if there is a lesion in MRI.Hope to have been helpful!Best wishes Dr. Abaz",
    "dialogue_context": ""
  },
  {
    "patient_message": "Ears popping, sinus infections, off-balance, muscles not working, testicle swelling. Any advice?\n\nNever ben to the dentice had one bad tooth that went into my iner ear and messed up my ballance was not my self after that. Could not work out no more becuse my mucles did not work the same they did not work togetherlike there sopost to leaveing me uneven was badly streest out then it led to my genitals and got worst they go up and down repetedly cant dicribe all of it but now it fills like i have blue balls ben suffering is this even possoble. ears pop and crackel all the time stuffed sinus infections like i have allergies with i dont plz help me no doctor can give me any good say so thank u for your time.?",
    "doctor_response": "it is sinusitis chronic allergic sinusitiswhich involved other organs like balls of your reproductive systemsget xray pns done to fing condition of sinuses get treated from allergy specialist when you treat allergies your testicle allergies will gotry to get blood tests done to find out allergens and avoid them for beter results",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe shooting pain in teeth\n\n47yr old male, 5 11 , 235lb. Controlled diabetes, multiple sclerosis, SVT, low to normal BP. Issue: momentary acute shooting pain in the three rightmost teeth, both top and bottom that happens a couple of minutes at a time, every hour or so. What should I do?",
    "doctor_response": "Hello,Your symptoms are appearing to be due to nerve related problem that can be due to trigeminal neuralgia as trigeminal nerve is nerve of face and short bouts of severe pain are commonly seen due to trigeminal neuralgia only. It is less likely to be due to tooth related problem. So my suggestion is to consult an oral surgeon and get evaluated so that he can rule out the exact cause as general dentist has a bit of limitation in treating this problem.If trigeminal neuralgia is suspected then an MRI scan can be done for diagnosis. You can be advised neurotic painkillers like Carbamazepine, Gabapentin for relief after a confirmed diagnosis.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause pain from the shoulder to the arm?\n\npain on upper right arm from the shoulder on down in the night disrupting sleep, I sleep on right side mostly throughout the night but never felt that pain.. has been continuos every night now for about 4 - 6 weeks I would say. In the day it subsides after I m awake an hour or so and for the day but will wake me up in the middle of the night again. I don t think a partially dislocated shoulder would cause that but I have thought about it. I think probably an x-ray is in order?",
    "doctor_response": "Hi, It may be due to ligament or tendon involvement as in rotator cuff injury. As a first line management, you can take analgesics like Aceclofenac or Tramadol for pain relief. If symptoms persist better to consult an orthopedician and get an MRI scan done for further assessment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent increase in my BP?\n\nI am 37, female, 5 4 and weigh 170 lbs. I have been on atinolol 100mg for approximately six years. Last year my blood pressure started rising again to 130/115. My Dr added another med. Macardis 80 mg daily. This week my BP has started rising again. (140/115) My Dr checked my thyroid last year and said everything was fine. He did not know why my BP was rising again. I have started walking 2 miles a day and have lost 30 lbs in the last two mths. What is going on?",
    "doctor_response": "Hello, Your diastolic BP is higher comparatively and is recommended for you to stop atenolol and switch to another drug because 100mg Atenolol can have another side-effect. And considering your age BP can be controlled with another group of anti-hypertension drugs. It\u2019s recommended for you to consult a physician personally for proper management. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the risks involved in having an operation in vertebra?\n\nI have klippel feil syndrome with fusion of c2-c4 and c5-c7, stenosis between c4 and c5 and poking into my spinal cord. I have spasticity, numbness in my left hand and losing my balance when I walk. I am 53 with HBP and a heart murmur. I have had mrsa and recently had staph infection in my lymph nodes and tested positive for Factor 5 (need blood thinner). What are my odds of having a successful operation to have my vertebra screwed to a plate to make me more stable?",
    "doctor_response": "Hello and Welcome to 'Ask A Doctor' service. I have reviewed your query and here is my advice. In your case,anesthetic risk is greater than general population as u have so many risk factors.The operative risk include infection, malposition of screws,loss of power in either upper limb, loss of sensations and respiratory paralysis rarely. Also u will need care postoperatively. I will advise you to get rid of your infection first before going to surgery. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Undergone major operation, having only one kidney, unbearable pain during mensuration, irregular, uterus thick, bulky. Reason?\n\nHi, my mother is aged 47 now. she has undergone a major operation and now having only one kidney.She often gets unbearable pain during her mensuration which is irregular and almost present for 15 days a month.Her uterus scan says her layer inside the uterus is thick and the uterus is bulky. What is the reason for this",
    "doctor_response": "Hello, and welcome to HCM! More details on your mother's medical history (what kind of major surgery, why was a kidney removed, has she ever had cancer before) would be necessary to truly answer your question.  In general, heavy vaginal bleeding in a woman your mother's age is concerning for a few problems.  With the uterus appearing \"thick\" on imaging, endometrial cancer and fibroids are certainly possibilities.  Both of these problems can cause heavy bleeding.  She should be evaluated as soon as possible by her doctor, who may decide to do further imaging or blood tests. I wish you good health, and thank you for posting on HCM!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diarrhea, stomach problems, loss of appetite. Blood work shows low potassium, elevated liver enzymes. Causes?\n\nMy husband recently had an incident of diarrhea for a week. He thought it was a flu bug. He continued having trouble with his stomach and had no appetite. he is 34 and in generally good health. His md ordered some bloodwork which revealed a low potassium level and elevated liver enzymes . He said they normally should be 60 and his were around 130. He still isn t feeling 100%. They did order a ultrasound of liver and more bloodwork. any idea of cause / diagnosis",
    "doctor_response": "Hi brackens140, Interpretation of laboratory test can be difficult without having the full report and the actual numbers. However let me tell you that every time I see elevated potassium together with elevated liver enzymes in a generally healthy person makes me think of a \"hemolyzed\" blood sample, meaning that the blood sample is not good, since the red blood cells have been broken down giving a wrong laboratory result. This can happen if the blood sample was not appropriately taken, if it was not stored at the correct temperature, if it remained too long in the lab before getting tested, etc. So my suggestion would be to repeat the blood test to confirm or rule out the abnormalities.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe pain in upper stomach and lower back, bright red, bean like substance in stools.  Any ideas?\n\nIf I have sever upper stomach pain what could it be im not pregnant nor im I on my perio been going on for a while now, and I have lower back pain also very bad bck pain, what could it be? Also I seen something that looked like a red kidney bean in my stool today very bright red.",
    "doctor_response": "Hi,   Upper abdominal pain can be due to gastritis,gastric ulcer,gallstones or renal stone.Kindly monitor your stool colour and watch for any alteration of colour or any fresh bleed in stools. I would like to know if you have any  history of constipation before the bleed,because excessive straining during constipation can cause anal fissure and bleed. In case there is any mass protruding out of anus ,it could be piles.Meanwhile you can watch stool colour regularly,take plenty of fluids and  high fiber diet .In case you have constipation try taking some laxative.hope it helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be concerned as i am getting greenish white phlegm while coughing?\n\nI was just diagnosed with amalignant esophagus tumer and i ve been coughing up alot of greenish white phlem.I ve had phenuemonia before(15 yrs ago)where they stuck harpoons in my back to drain it out(10 days in hosp).What could it be?I m only 50 yrs old.",
    "doctor_response": "Hi and welcome to HCM. This is usualy not indicating some serious disease but you need to do pulmologist work up to rule out bronchiits, emphysema or pneumonia. you should do xrays and  ventilatory tests. You nned to stop smoking if you do it and avoid smoky areas. if you notice pain in chest or fever you should see doctor asap.Thanks for the query. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for staph infection ?\n\nIn May I had  sore on side with staph infection and was givin 2 types of medicine because the staph was resistant too..now pain in bottom center of armpit, had since May and have had ultrasound in armpit area that came back normal on nodes, cat scan with dye contrast to check for abnormalties..it was ok too and a mammo that came back good..but this lump hurts more hormonally and is still there?  Should they biopsy?",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.I suspect MRSA in you. It is a type of Staphylococcus aureus infection which is resistant to multiple antibiotics.I advice you to do sensitivity testing of the staphylococcus bacteria.If it is found to be MRSA than it requires a strong antibiotic treatment.There is no need to do biopsy. And you also cures completely this way. Please avoid share of house hold with other family members as it can spread to other members also.Please maintain cleanliness and hygiene as it is equally important in treating infection as the antibiotics do.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have severe back pain. Advised to take medication. Have remission for AML. What to do?\n\nMy 24 year old daughter has begun her 5th year in remission for AML.  She has a very good prognosis.  She had 13 bone marrows and one spinal tap during the course of her treatment.  She has had severe back pain for the last several years.  She completed 2 rounds of physical therapy.  She saw a pain management docotor who just wanted to put her on more meds instead of finding a solution to the problem.  This has caused great difficulty with her moving forward with a job search.  She can't stand for long periods of time.  As a parent, it is just hard t know what to do...how much to push.  Have you ever heard of this problem before?  Thanks!",
    "doctor_response": "For symptomatic relief , sometimes pain medicines may be necessary. You must consult your doctor who treated for AML to suggest as spine pain is often seen in AML patients and with his experience  he may point to the real cause ,if possible. Second help can be from orthopedic surgeon who may have radiological investigations after testing spine for physical signs and if thinks could be due to spinal pathology primarily, then suggest for remedy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could small cyst in armpit with protruded vein be?\n\nOkay, about two to three weeks ago, I developed a bump in my left armpit. It grew and I figured it was a cyst of some sort. I asked around on the internet and I found a lot of people who had had it before, teenagers and adults alike. They told me that it goes away in about a week and that it was caused by putting antiperspirant on too soon after a shower. It did shrink away, disappearing after a little more than one week. There s still a small bump where the larger cyst used to be though, and I was supposed to go to a doctor about it. Now, the vein. For a while I had been feeling a slight discomfort in my left armpit whenever I lifted my arm up too high--and I also sleep with my arm up, under my pillow and head, and that would cause me discomfort as well. Yesterday I was pressing my fingers into my underarm and I felt... this vein that kind of protruded at the place where my underarm crease is. I can only feel it when my left arm is lifted up high enough, stretching my armpit. What is this? Now I m afraid to lift my armpit too high because I m afraid I ll snap that vein or something! I hate veins the way some people are creeped out by blood. My mom told me to take some ibuprofen, thinking it s an inflamed vein. I don t see a difference at all.",
    "doctor_response": "Hi, It may be a venous adventitial cyst. Though mostly cysts are of arterial origin but venous cysts are not that uncommon. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Rohan Shanker Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "After having dinner, started feeling itchy. Have welts. No change in food. Had colored my hair. Foot is swelled and tight. Treatment?\n\nThis evening while out eating dinner, I started feeling itchy throughout my body and getting worst. When I got home I noticed I had welts or hives. I have been to the same restaurant several times and ate the same foods. An hour before dinner, I had my hair highlighted (colored) and cut. I was not itching because of lose hair on clothing. I had changed my clothing before we went to dinner. I also noticed that my left leg, ankle and foot is swelled and tight. I put caladryl lotion and took 1 antihistamine pill. Can you tell me what my allergy could be? Is there anything else I can do to treat it? Thank you.",
    "doctor_response": "may be some brand of color reacted as it takes sometime to appea allergies and once exposed takes 3 week to recoverso you need to continue the antiallergic pills for 3 week and antiallergic ointment after 3week if recurs consult allergy specialist for finding answer according to history and examination",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump on the left side of the neck indicate?\n\nHi, I have a lump on the left side of my neck. (Under my chin and above my Adam\u2019s apple) and it has been there for a while now but the past couple days or so it\u2019s gotten bigger and the right side beside it is sore and kinda hurts. Enough to cause discomfort. Would anyone have any idea of what it could be?? Getting worried and pain get worse little by little. Please help!",
    "doctor_response": "Hello dear , hiWarm welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This is in relation with submandibular salivary gland or lymph node     enlargement most likely .*  Needs physical examination or even a photo pic evaluation as an     attachment herewith if visible above the skin surface .Hope this will help you for sure .Regards dear take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for constipation and bleeding in pregnancy\n\nI m pregnant and am having more then constipation problems. A part of the inside of my anal wall is protruding outside my anus. It s been like this for about a month, and I ve begun to bleed more then I think I should. Should I be worried and go seek medical help now, or wait it out. I only have a month left before my baby is suppose to be born.",
    "doctor_response": "HI,   Thanks for asking. I understand your concern.   You seem to have extreme constipation resulting in prolapse of rectum... where lower part of rectal mucosa bulges out due to excessive straining. It may get infected, swollen, start bleeding.   You need to consult an anorectal surgeon earliest & get the thing treated. it's important to get it corrected before your delivery... for it may get worse during child birth straining.    Permanent cure may need surgery, can be performed after child birth.   Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain and painful bumps on the tongue?\n\nI have an 8yr that complained of a stomache ache all of yesterday and this morning she felt like she had to vomit but, only salivated.  Her stomache still hurts  but not as intense as yesterday.  Her tongue has raised bumps on the sides.  Her tongue looks a little whiter than usual but, nothing outrageous.  The bumps don't hurt and they are the same color as the tongue.",
    "doctor_response": "Hello,It happens with children commonly, only give syrup Spasler 1 teaspoon (tsf) thrice a day with syrup Polypep for 3 days. She will be settled, also syrup Panadol can be given for pain.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Hina Javed",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure CVID condition?\n\nI have cvid and have been on IvIG for a little over four years i frequently run a temperature as well as constant nausea and diarrhea at least 1 migrain a week most recently I have experienced chest pain I don t think this is a heart attackand lower back pain lightheadedness and some difficulty breathing",
    "doctor_response": "Treatment for CVID-1)Ig may be administered intravenously or subcutaneously. Solutions of 3-12% intravenous immunoglobulin (IVIG) can be used on a regular basis to maintain a trough level of 400-500 mg/dL in adults. A dose of 400-600 mg/kg every 2-4 weeks is usually required. In patients with structural lung damage, a trough level of 700-800 mg/dL is required.2)Cyclosporin A has been successfully used in patients with CVID and lymphoid interstitial pneumonitis. The administration of anti-CD20 monoclonal antibody has been used to treat autoimmune thrombocytopenia and neutropenia.3)Antimicrobial therapy should be initiated at the first sign of infection. A narrow spectrum of drugs should be used when culture and sensitivity results are available. The prophylactic use of antibiotics should be avoided because of an increased risk of infection with fungi or other resistant organisms.Specific therapy is often necessary to target the organ system involved. For instance, patients with chronic lung disease often develop airway obstructive disease that requires treatment with inhaled corticosteroids and other asthma medications4)Surgery is required to treat the complications of common variable immunodeficiency (CVID). Chronic sinusitis may require endoscopic sinus surgery. Severe autoimmune thrombocytopenia or hemolytic anemia can be treated with splenectomy. Biopsy should be considered to exclude infection or malignancy in enlarging lymph nodes.If you have any doubts  let me know.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can using Monistat be safe for yeast infection?\n\ncan I use monistat in the anal area?   I have a yeast infection,  I do not know how I got it,  I am having no sex for years, none whatsoever.   I have had an unusual  amount of sugar and drink the last week or so,  celebrating my birthday,  but this is very strange,  it is only in this area.",
    "doctor_response": "HiThank you for asking HCMI have gone through your query. Yeast infection can occurs due to constant accumulation of sweat and greasy environment. Dysbacteriosis also can cause this. Taking kefir or yogurt is good for this. You can use monistat which is available over the counter. You should use this for 1 to 2 weeks to get proper effect. If you stop after 2 or 3 days fungus can recur. Avoid soaps and irritants to wash the genital area and instead you can use saline or warm water.Hope this may help you. Let me know if anything not clear.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause lumpy pimples on body of 8 month old child?\n\nMy 8 mth old has these little pimples on his back that are lumpy.they were weepy then disapeared by themselves.its been about 3 wks but now he has 3 which have formed on his head.he also has1 on the back of his knee.he has had problems with ecema but he drinks presciption formula elecare and has for bout 3mths.he is a twin and i have noticed my other son got afew on his chest afew days ago.any idea wot it could be??",
    "doctor_response": "Hi dear,I understand your concern. But dehydration due heat wave really give tiredness. I suggest - ORS, it will increase his tonus;- Zincovit 1 tablet daily for 1 month;- Spirulina 1 capsule daily for 1 month.Cardiologist is not required. If his haemoglobin is normal,then don't worry, give him fresh juices, more fruits, give him a rest.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest safe method to remove warts in a child\n\nmy son is 3 and he has 2 warts on the index finger and another one started on the middle finger and now my 20 month old son is getting one  what is a fast and safe method to do for treating the warts i dont want him to spread it on his face because it happened to my brother and it's not pretty at all.",
    "doctor_response": "HiWelcome to the HCMWarts, caused by the human papillomavirus or HPV, are noncancerous skin growths. They are contagious as in your children but typically harmless. Fortunately, warts do not harm a child\u2019s health, and often go away on their own.Doing nothing for warts is perfectly OK. In one study, researchers reported that warts spontaneously cleared in 40% of children within two years without any treatment.In case it's bothering a lot, you may apply adhesive pads with  salicylic acid or solution with propane or Freon that freeze the wart. These are available OTC. In case there is no relief, I would recommend you to go to a dermatologist. They may use liquid Nitrogen or Laser for treatment.Avoid sharing towels for preventing spread.Hopefully this will help you. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Delayed periods, have inserted Copper T. Could Cu-T have disfunctioned ?\n\nI was inserted a Copper T a year back, and my periods were regular since then. However, it has been more than 50 days now since I had my last period. I have a doubt, whether I have got the pregnancy, as I checked with the Pregnancy test card which is showing positive. Pls let me know, is there a posibility of the PT card show a error result? or the Loop (Coper-T) might have disfunctioned?",
    "doctor_response": "HelloThanks for your quer.The urine pregnancy test is 97 % reliable in diagnosing a pregnancy.If it is showing a positive result, you are undoubtedly pregnant.Pregnancies with the Copper T in situ are rare, but they do occur.Please consult a Gynaecologist immediately if you wish to terminate the pregnancy.take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for conjunctivitis in a child?\n\nHi, may I answer your health queries right now ?  Please type your query here... good evening!  when a child is diagnosed w/pink eye ... are you supposed to put the prescribed eye drops in both eyes - the infected and the good one - as a precaution for the condition not to spread?",
    "doctor_response": "Hello. I just read through your question. Though there really is no obligation to treat the uninfected eye, I always recommend to treat it anyway. It's common for children to rub their eyes and in doing so, spread the infection from one to the other. Therefore, I recommend treating both eyes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does this routine blood test with a low hemoglobin range show infection?\n\nmy father is 51 year old ,his haemoglobin range is decreased,it is around 7.2g%.is there any problem and his RBC count is 2.5mill/cumm and WBC count is 16,800/cumm.his rbc seems NORMOCYTIC AND HYPOCHROMIC NEUTOPHILS ARE AROUND 82% .his PLATELET COUNT IS 3.49 lakhs/cumm.does he have any infection.do this symptoms cause any disease. plz give a suggestions.",
    "doctor_response": "Hi,From report it suggests that he is having severe iron deficiency anemia.It also indicates that he is having some bacterial infection leading to increase WBC.He might require further investigations for this infection.Consult your doctor and get examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does small shadow on left lung mean?\n\nI am a smoker, well I have quit as of today due to fear. I had a chest x-Ray and MRI back in July for an anterior discetomy. I was told I was healthy. Yesterday, I went for my routine check up with my GP and he informed me that a small shadow showed up on my left lung. Of course, my response was what? And your telling me 4 mos later. His response was due to the report I am really not at all concerned and planned on talking to you about this at your next check-up . In his next breath he said I am going to send you for a CT scan anyhow. I asked him again if he thought I have lung cancer and he said No, I am quite confident it is nothing to worry about and I will see you in 2 weeks to go over the results of your CT scan and put your mind at ease. Just perplexed, not cancer than why the CT? Just a bit scared.",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. Yhere are many causes for small shadow in lung on chest x ray.The common ones are1. Fibrotic lesion.2. Cystic lesion (benign)3. Developing cavitory lesion. 4. Early abscess. 5. Rounded pneumonia. 6. Lung nodule (benign )7. Lung nodule (malignant).So CT scan is needed to rule out all these.Characteristics of shadow on CT is very important for diagnosis like its margins, calcification is present or not, associated lymphnodes etc. So get done CT THORAX.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Anemia. Eaten uncooked rice. Is addiction to it bad?\n\nHi,I am Vanessa Gowreesunkar and I am a lecturer by profession.I wanted to ask if eating uncooked rice is related to anemia? or any other side effects in terms of health.Since a few weeks now, I am getting addicted to eating raw rice daily and at regular interval.My email is  YYYY@YYYY thanksPlease advise",
    "doctor_response": "Hellostick to one particular diet can give rise to nutritional anemia ( iron deficiency, megaloblastic anemia etc)Why are you thinking that you are having anemia. Is there any symptoms?If you are concern then visit the Doctor and get complete hemogram done. Depending upon result further work up will be required Hope this helps, wish you best health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe phobia\n\nHi my mother n law is suffering from severe phobia where i can consult in guntur!! what will be the treatments!! she is suspecting everyone unnecessarly and thinking something and dreaming which is not happened!! she is fighting with everyone and gets angry all time..for 2days she will be in anger and moody and after that for 2 days she will be happy!! dont know what to do!! pls suggest on this!!",
    "doctor_response": "HiI understand your concern. Need proper evaluation. She has mood features like mood swings and irritability. Anger spell with mood swimg may be due to depression or other psychological stress.Proper diagnosis only can be made by consulting paychiatrist and evaluation of her thought processes.It can be treated with medicine like combination of  anti depressant and anxiolytic.I hope I have answered your question. Still if you have a query then feel free to ask. Thank you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes darker and harder right foot?\n\nI have been having really bad edema in my feet and ankles. I went to the er and was prescribed water pills and the Dr also saw that I have a uti infection. I am only 28 years old, very healthy and never have any health issues in life. My ankles did go down but I have bruising in legs that have been there for months.my right ankle is worse than my left. Now since there almost back to normal my right foot is considerably darker then my other foot and its hard. I m getting nervous because unfortunately no Dr can tell me what s wrong besides I may have heart issues and need to see a cardiologist asap. Help",
    "doctor_response": "hi,thank you for providing the brief history of you.as you been having skin discoloration of the feet I feel it should be related to vascular insufficiency. Also many a times due to kidney issues the water retention occurs and the skin discoloration happens.In my clinical practice I have only seen skin discoloration and swelling in patients with Cardiac issues, kidney issues, diabetes and some unknown factors.We try to examine first and go by the natural instinct and in many of the unknown cases it has worked well. We feel it is a metabolism issue and needs a booster for the same.We plan and program our workout session in a fashion where the we workout behind reducing the swellin by exercises and improving the cardio endurance along with improved metabolism. We get good results in the swelling reduction. For the discoloration of the skin we usually plan the whirlpool therapy and expose the skin area to the sunlight so a natural healing and skin color changes. we almost found cent percent results.regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have heartburn, dry cough, and nausea for almost a month now. Can you suggest medicines?\n\nHi doctor, I have been having heartburn, dry cough, and nauseous feel for almost a month now. I have amended my diet for more than two months and have not been eating pork or beef. I am taking veggies and fish now. Also, I am eating small portions already. At the onset, I experience that food has been stuck in my throat, and my stomach feels like it is always full, although I feel hunger. Both my toes cramps at the same time and my toe bumps are also painful. I have been diagnosed with gastritis since a decade ago. I am a 35 years old female and weighs 51 kg. Doctor, can you prescribe me medication? Thank you very much!",
    "doctor_response": "Hi. I reviewed your detailed history, which is more suggestive of reflux disease. I would like to prescribe some treatment at the moment, and I am hopeful that it will get better. There is nothing to worry about and nothing to panic. If you have any other query kindly get back to me. Thank You. No need at the moment GERD (gastroesophageal reflux disease). 1. Capsule Omeprazole 40 mg. One in the morning and one in the evening before meals for two weeks and then only one in the morning before meals for two weeks.  2. Tablet Levosulpiride 25 mg. one tablet two times daily before meals for two weeks.  3. Syrup Gaviscon 10 mL. Two times daily after meals. 1. Elevate the headend of your bed by at least 5 inches. 2. There should be at least 2 hours gap between dinner and going to bed. 3. Avoid smoking. 4. Avoid late-night tea/coffee. Get back to me in a week.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in the lower abdomen\n\nI experienced pain a week ago in  my lower left abdomen. It worsened and then subsided and went away. Today, exactly a week later it returned but didn't subside for hours, getting to a dull uncomfortable ache. This was coupled with a sharp shooting pain in my vagina. I occasionally get ovarian cysts, could this be the cause?",
    "doctor_response": "Ya ovarian cyst or kidney stones are the cause of ur pain.go for  ultrasound , if ovarian cyst , depends on size treatment varies..hope I am helpful.if u had any doubt let me know",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is only tetanus shot recommended for a dog bite?\n\nHi, last night my 30 year old daughter was bitten by a rescue dog she is fostering.  The dog had gotten a rawhide treat off the floor that was given to the other dog.  My daughter tried to pull the treat out of his mouth and he bit her.  His tooth went completely through her fingernail.  She nearly passed out from the pain.  She got in touch with her doctor this morning and they said all she needs to do is get a tetnus shot.  Are they correct?  Thank you for your help.",
    "doctor_response": "Yes, only a tetanus shot is necessary. She should watch the bite for any signs of infection. If it develops, she will need antibiotics. Since she is fostering a rescue dog, I assume it has been immunized for rabies, so this should not be an issue. Hope this answers your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on the hand\n\nHi, I have a lump on the back of my hand, located in my wrist that seems to fluctuate according to weather conditions.  It is very painful when it appears and affects the movement in my hand.  It tends to appear for several days at a time.  I have experienced the same in the other wrist too but not always at the same time.  I also experience pain and swelling in some of my fingers from time to time. Do you have any idea what this may be please.",
    "doctor_response": "Welcome to health care magic. 1.The history and symptoms suggest the possible cause will be ganglion at first place followed by hair follicle infection, lipoma.2.Ganglions arise from the joint space, tendon, ligament, bursar,nerve sheet - which when complicated cause the symptoms.3.In this case an ultrasound lump to evaluate the nature of the lump its source and extensions.4.Depending on the findings the treatment will be small incision and drainage followed by wound dressing and antibiotic treatment.5.So i would suggest to get an appointment with the GP, get examined and needful treatment. Good luck.Hope i have answered your query,any thing to ask do not hesitate to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated liver enzymes in a 9 year old?\n\nMy 9yr old daughter has an elevated liver enzyme. they have checked it twice(all I know is the Dr. said it was in teh mid 500) and they say it MAY be a growth spurt. No wthey want me to give her 400IU of vitiman D for six weeks and re-check. should I seek a second opinion? She is 5 3 weighs 145lbs. she also is adopted so we know very little familyhistory",
    "doctor_response": "the important question here , why they did a liver enzymes ? did she has any illness in current time ? I belive she is obese 145 pounds for a 9 year old kid , it might explain the elevated liver enzymes in the absence of any other information, that's why sever obesity can cause fatty liver which can appear on abdominal songoraphy, the surrounding tissue might get inflamed and cause this elevated enzymes but detailed history and complete physical exam will reveal the cause .I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sensitivity to certain food like chicken,bread and grapes?\n\nMy 14 yr old son has for sometime had difficulties when eating various types of food, ie., chicken, rice, apples, bread and grapes. He says he gets a sensation in his throat, his saliva becomes very sticky almost like mucus, and has difficulty in swallowing and breathing. He beomes very scared as he says it s difficult to breathe. This does not occur every time he eats, only occasionally. I have seen my GP who referred him to a speech therapist, who was unable to help.",
    "doctor_response": "Hello,I can understand your concern. It seems that your son is suffering from an allergy to some substance in the food items that cause him to experience the symptoms you have described. As you have rightly suggested, it is very difficult to ascertain what substance he is allergic to and what food items to avoid in future. I recommend you to go for a blood test for allergy that will identify what substance is acting as an allergic to your son and he will have to take care to avoid those items in food.It is important to find out the allergen as every next allergic episode may be severe than the previous one causing complications and health hazards. If he feels such reaction in future. he can take an antihitamine such as Levocetrizine 5 mg (Levocet) or Loratidine 10 mg (Lorfast) to control the reaction. Make sure you keep these medicines available to him when needed.I hope this information helps. Thank you for choosing HealthcareMagic. Take care.Best,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for pain in elbows\n\nI took a fall approximately 2 1/2 years ago in my kitchen. I hurt the tip of my elbow and the pain has progressively gotten worse. I thought at first it maybe a stress fracture and decided that it was something that would probably heal on its own. But as time has gone on its gotten worse. What could it be?",
    "doctor_response": "Hello,Your symptoms could be suggestive of a pinched nerve (ulnar nerve). For this reason, I would recommend performing nerve conduction studies and a joint X-ray study. You should discuss with your doctor on the above tests.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for the discomfort in the bones?\n\nmy husband is very sick. HE was up all night. He would get hot and sweat through his shirt and then really cold. He threw up three times and he is saying that his bones are hurting him. what should he be taking and is it the flu or should we go in to the doctors?",
    "doctor_response": "Hi, Excessive sweating with chest pain and dizziness is symptom of angina, get your ECG done and consult the nearest cardiologist as soon as possible. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jaideep Gaver, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest alternate medicine for Ortho tri-cyclen lo\n\nHi, I have been on Ortho Tri Cyclen Lo for several years and recently switched insurance companies. It used to be free but now it's going to cost me over $100 per month.  Is there anything similar to this on the market? I have had absolutely no side effects from the Lo and am very concerned about switching over to a new brand or different type of pill. Any information will be much appreciated. Thank you and have a good day. Melissa",
    "doctor_response": "**1. Ortho Tri-Cyclen Lo: (progestin and estrogen combination) is birth control pill usually prescribed to prevent pregnancy, regulate period, and help reduce acne with maximum women reporting weight gain,breast tenderness, headache and mood swings as side effect.2. If cost is an issue you may check with your Gynecologist regarding treatment options. [Trinessa/Kariva is one such alternative, but with Trinessa tachycardia, depression, loss of sex drive, anxiety, bloating, insomnia are associated side effects]",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the signs of having scleromoderma?\n\nMy 31 year old son was admiited to the hospital with pnuemonia like symptoms, a white cell count of 15000, treated with IV,count dropped to 5000,sent home, had a relapse,x-ray showed shattered glass in 5 lobes, he has asthma and nevus sebaceous since he was a child, bipopsy scheduled for tomorrow, O2 levels are 70, he is in ICU serious, I am afraid it might be sclermoderma.",
    "doctor_response": "Hello and welcome to HCM,The oxygen saturation of your son is quite low.He has to be kept in ICU till the saturation improves to 95% and above.Asthma is the probable cause of low oxygen saturation.Nevus sebaceous is a benign tumor of sebaceous gland.It is primarily managed surgically.Scleroderma is a connective tissue disorder which affects elastic tissue of skin and gastrointestinal tract.Are there any symptoms which favor sceleroderma?If yes then you can consult your physician for clinical assessment and relevant investigations.Scleroderma is confirmed by antibodies directed against centromere.Thanks and take careDr Shailja Puri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have chrohns disease and enlarged spleen. What medication is used?\n\nI have crohns disease for 17 years and recently learned I have an enlarged spleen . With long term anemia , crohns and the medications I have to take, it has given me abnormal blood levels when they take cbc and various blood tests. For this reason they are going to monitor the spleen and the levels before deciding if they need to remove it, if it may be cancerous, or fairly harmless. All the tests on my liver were good and they have ruled out my liver causing my spleen to enlarge. I have heard removal of the spleen leads to a higher chance of infection and a tougher time to fight bacteria, infection etc. What type of medications are used for people who have their spleen removed and will removing my spleen, put my body in a very compromising position since Im taking medications like Humira, Immuran, predisone and my immune system is pretty much shut off? I know I dont need to worry about the worse case scenario yet, Im just concerned if they remove my spleen I will either spend a lot more time in and out of the hospital or I will have to isolate myself even more due to increase risk of infection . Im curious about the quality of life a person with severe crohns disease taking immune lowering medications and has their spleen removed?",
    "doctor_response": "Hi there,First of all, let me assure you that many patients have their spleen removed, even in the setting of being immunocompromised and don't offer any ill effects. You are correct in that you have a greater risk of post splenectomy sepsis, but typically in elective splenectomy (planned removal of the spleen) we give 3 vaccines that offset this risk - Hemophaulis influenza, Streptoccoccus pneumonia, and Neisseria.  I believe that you have to have these vaccines repeated every 5 years, and that should cover you for the organisms that could cause infection without a spleen.  You shouldn't have to isolate yourself or take any special precautions after your spleen is removed, as long as you keep up with your vaccines.  Your quality of life should be unchanged, and most surgeons in the US will do these procedure laparoscopically, meaning it should be done with small incisions.I hope I have answered your questions. Please feel free to contact me if you have any further questions or if you feel I haven't addressed your question adequately.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pulsations under the ribcage?\n\nHi, i have a very strong abdominal pulse just under my ribcage, my stomach is feeling bloated, and hurting so bad for almost a month now everyday.   I also have the urge to burp all the time however it seems like something ia blocking my throat to let it out.  What could this be?",
    "doctor_response": "Hi ! Good afternoon. I am Dr Shareef answering your query.If I were your doctor, I would have advised you for an urgent ultrasound of abdomen to rule out any pathology of the vessels in abdomen. If there is no such pathology, I would refer you to a gastro enterologist for an endoscopic evaluation of the upper GI tract. Till then I would prescribe you for some prokinetic drug, along with a proton pump inhibitor and a probiotic. Further management would depend on the reports of all the investigations.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can she be pregnant if the pregnancy line is very fade?\n\nHi the last cycle of my started at 22july she supposed to be get cycle by today, we did the urine test and it shows positive . we are confused the pregnancy line is very fade.. is she pregnant, and what should we do if do want to go with this pregnancy ???",
    "doctor_response": "Hello dearI understand your concernPregnancy test will give true positive result 8-10 days after the missed period.Fade line could be due to improper use of test, evaporation line, early pregnancy,I would suggest to go for repeat the pregnancy test 8-10 days after the delayed period.You can also go for blood HCG test, as it is very accurate and give positive result even 10 days after the unprotected sexual intercourse.If you will be pregnant then you can still terminate the intrauterine pregnancy by the abortion pill under the supervision of the gynecologist.Avoid stress, take healthy diet, drink plenty of water and do regular exerciseHope this may help youContact HCM for further health queryBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes redness in palatoglossal arch?\n\nI am 28 year old female .Wt 134 ....my left side of the palatoglossal arch is red and have been for the past week and a half , they always are a little red but this side seems to be a little more so , also I have small raised bumps on back of my tounge and lower part of the palatoglossal arch next to my tounge on both side .I know that some are taste buds but i did know about all of them . is this normal ?",
    "doctor_response": "Bumbs are normal at back side of tounge.mostly seen on back upper and side at the level of your palatoglossal arch.its taste buds..but redness on ur palatoglossal area due to some infection.consult a ent or oral pathology specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Histroy of miscarriages due to rubella and toxoplasma. Partner also has Rubella. Chances of conceiving?\n\nhi doc im 27 years old women now i want to concive a baby but in past i had 2 miscarrige due to RUBELLA & TOXOPLASMA. TORCH TEST report is here- TOXOPLSMA IgG- 0.13TOXOPLASMA IgM- 0.27RUBELLA IgG- 3385.0 RUBELLA IgM- 0.42 CYTOMEGALO VIRUS IgG-50.0 CYTOMEGALO VIRUS IgM- 0.22 Plz doc tell me what can i do .suggest me which medcines can use to cure rubella IgG. My husband also suffers his Rubella IgG is 78.0 and CMV IgM is 11.0",
    "doctor_response": "Hello Thanks for your query. There is no medicine to cure Rubella Ig G nor is any cure required. Ig G indictes past infection or immunity against rubella. Ig M indicates active infectin. If you have taken the complete course of Rovamycin ( both of you ) then there is no cause for worry. You can try to conceive a baby now. there could be other causes of miscarriages such as : 1. genetic 2. Autoimmune 3. Abnormalities in size and shape of uterus 4. Other infections. 5. hormonal imbalance. Please consult a high risk pregnancy specialist for a proper workup Take regular folic acid supplements. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What chances of survival does one have with swelling and fluid in brain?\n\nHello. my cousins were in a car accident and one cousin is in a medically induced coma but her sister is on life support and in a coma. she hasn't woken up and she has swelling/fluid on her brain with half her skull gone. Can she still make it through without them pulling the plug?",
    "doctor_response": "Hi,Thank you for posting your query.It is unfortunate that your cousins were involved in severe car accident and have suffered serious head injury.Right now, you have provided incomplete data for us to predict the chances of recovery.I would like to know the complete CT scan brain findings, details of neurological examination including pupil size and reaction, and EEG findings to give you the chances of recovery.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, periods late, lighter, brownish in color. Had pregnancy symptoms, test negative. Pregnant?\n\nHi, My husband and I are tco and had sex while I was ovulating last month.I was supposed to start my period on 1/14. I started bleeding 1/20 but was a brownish color, now turned red but much lighter than my normal periods. I have always had a normal 27 or 28 day cycle, this is the first time I have been late. I have taken several test, all negative.I have also had very sore breast , I am very tired, low energy, cramps , constipated and headaches- Could i still be pregnant???",
    "doctor_response": "hello,First of all, you should undergo blood test for beta hCG and TVS scan (around 4 weeks) to confirm or exclude intrauterine pregnancy as early home pregnancy test may give false negative result. Brown vaginal discharge with late period seems to more likely implantation bleeding or sign of miscarriage.In exclusion of conceptional product, other reasons of light spotting are hormonal imbalance, stress/ anxiety, thyroid problem, wt gain/extreme loss, irregular eating habits etc.Do some investigations to rule out underlying pathology like USG lower abdomen, Thyroid profile, other hormonal assay, blood sugar etc. So consult with your doctor and take suggestive measures.Avoid stress, take healthy diet, control body wt and need proper sleep. Sore breast is due to progesterone hormone. Use tight breast support for discomfort and take prime rose cap.If you need further consultation with me, then you can visit  well & take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does raised lump on the back of hand indicate?\n\nI have a raised lump on the back of my hand. I am pretty sure it is a swollen vein.  It is extremely itchy and burning. I had to remove my wedding ring as it was uncomfortable although the hand doesnt look swollen.  What could thid be?  Thank you very much!",
    "doctor_response": "Hello!Thank you for the query.Such bump is usually a ganglion. Its a kind of cyst filled with clear fluid. It has connection with a joint. Can be painful. It is usually soft and rounded when touching it. The best way to find out what it is, is to have an ultrasound of this area.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause penile bump?\n\nI have had a bump at the end of my uncircumsized penis where I think the dorsal vein ends at the tip since I was a virgin, there is no pain, and over the years since I became sexually active, no one has ever gotten anything from me (no std etc tested clean etc) so I was curious what this bump was, and if it will ever go away or if getting circumsized would get rid of it",
    "doctor_response": "HelloI had gone through your question very diligently and I will definitely help you in best possible wayIf you can upload a photograph and provide me more information so that I will be able to tell you more accuratelyIs it growing in size or its of constant size since you have seen?Does it oozes blood or any kind of discharge?In my opinion if it is confined to foreskin only than it can be removed surgically with circumcision.Hope this answers your questionwaiting for your replyBest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for pain in the leg\n\nMy sister has pain in her leg, just below the knee, anterior/medial location, for a week. Now she is c/o pain in that leg if she takes a deep breath or coughs. Went to doctor Wednesday, blood work and x-ray done, no frx. Doctor said no clot but didn t do venous Doppler. She had greatly increased her activity by doing painting and trying to jog the past week.",
    "doctor_response": "For pain in leg here first you need to check either it's at knee level or at calf muscle level.  If it's close to calf muscle level then check with squizing calf muscle belly and if it pains then it can be related to vascularity it issue of lower limb and dopler test is needed.  But if this is  negative then it may be only over use injury. Now if pain is only at knee level then again need to check with few physical test.  As a conservative treatment management you can use hot and cold pack at pain full area with rest for few days and avoiding any activity which pains. But if it does not give pain relief then visit a good physio and orthopedic  who can check with physical test and evaluate the problem as well guide you with treatment and exercise program. Follow the advice and I am sure it will be useful.  Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain after heavy drinking?\n\nI'm a heavy drinker at occasion,therefore my problem-question. I drank one brutal fruit (4.5% alcohol) and started having severe chest pains and shortness of breath. I have to add it has been a few weeks since I had this \"fatal\" drink. It felt like I was dying, the pain moved up to the left side of my neck and arm as well whilst having a sense of immense claustrophobia and shortness of breath, I had these episodes 3 times in 10years and would just like to know what I can do about it? Can it be fatal? I am a smoker and drink heavily at occasion but this really scared me because it was 1 drink",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.There is a large possibility of gastritis and reflux disease. Do you also have upper abdominal pain, nausea, bloating, burping, increase in pain on food, sour water feeling in throat or chest burning? These are the other symptoms and may be associated. Another possibility is of panic attack. However, you should get an ECG done to rule out heart as a cause.You should avoid fatty, oily and spicy diet. Have some walk after having food instead of taking rest. Have multiple small meals instead of heavy meals. Have regular sleep habits and avoid stress. Lots of green leafy vegetables, fruits. Avoid smoking and try to cut upon alcohol.You can get prescribed tablet Pan DSR or Esomiprazole domperidone combination before breakfast once a day for 2 weeks. If not adequately relieved, then you should add syrup Sucral O or Gelusil two teaspoon 3 times a day for a week. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My 71-year-old mother had T8 vertebral body fracture. Kindly advice.\n\nHello doctor, I am living in a place, but my mother lives abroad in a country with limited access to spinal surgeons. She is 71 otherwise fit and well for her age. She slipped over and was told she has a t8 vertebral body fracture that is minimally displaced with no cord compression. She is in pain, but does not want to immobilise or stay in bed. What advice does she need to follow? Her sphincters are intact and she can control her bowels and bladder.",
    "doctor_response": "Hello. If she has a T8 vertebral fracture, that is I hope a compression fraction that you are talking about, which is minimally displaced and compressed. Then the treatment that is required is principally pain relief with minimal activities and physiotherapy initially to her mobilize with frame or support. She can use a TLSO brace (thoracic, lumbar sacral orthosis) and mobilize as able as tolerated by pain. Bed rest is only indicated in case of severe pain. Pain-killers like Co-codamol or Paracetamol or Morphine can be prescribed locally. Physiotherapy is given initially to get her up, and I can only give you an exact approach to this if you can send me the MRI report of the pictures. This professional advice provided by me stands subject to the actual examination of report or image and is based entirely on inputs provided to me. It should be correlated with clinical findings.",
    "dialogue_context": ""
  },
  {
    "patient_message": "is it normal for injury to hurt after 4 months with no bruise?\n\ni got kicked by a horse on my leg about 4 months ago. It bruised and was quite painful for about 2 weeks.  However although the bruise has gone i still feel pain in the area if i accidentily rug my leg on a table or something. should it still hurt 4 months later as im rather worried ?",
    "doctor_response": "Hi, even after healing of external bruise, internal healing can take several weeks more. There can be a torn ligament or muscle that may require immobilisation. An MRI would be a good idea--regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can breast pain and cramps after sexual contact mean pregnancy?\n\nHello doctor, I have PCOS. I had my period a month back. My periods are mostly irregular and I usually have cramps in stomach and my breasts hurt before periods not every time though. I had oral sex with my fiance yesterday, he was wearing a condom throughout but he rubbed his genitals on my vagina. I took an I-pill and Regestrone just to be safe after three to four hours. But today my breasts are hurting and I am having cramps. My vagina is also dry. Is there any chance that I am pregnant?",
    "doctor_response": "Hi. Since you have taken the emergency pill within 72 hours of intercourse, there is no chance of pregnancy. These symptoms could be because of hormonal changes due to the pill you have taken. So relax and do not worry. However, if you have a doubt then get back to me. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cold episodes, sore throat and fever\n\nmy daughter is 9yrs old and she seems to have developed a poly in the nostrils and has on and off cold episodes followed by cough, sputum turning into green, sore throat, fever. fever n sore throat reduces with antibiotics but the problem is the on and off cold n blocked and stuffy nose. the pediatrician has suggested ALLEGRA 30mg bid for a week n metatop nasal spray bid for a week n then once daily thereafter fro three months n c how she wl respond. my daughter has atopic dermatitis and history of asthma too. should i try homeopathy or jus give her allegra and metatop???",
    "doctor_response": "Hi...I suggest you give her Allegra and Metatop nasal spray. By what you quote I feel that she might be having moderate to severe persistent allergic rhinitis. With the history of atopic dermatitis and asthma the usage of Allegra and Metatop becomes even more prudent.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does high range of Eosinophilia count of 8% suggest?\n\nDear Dr. I am suffering from cold and cough for the past 4-5 months. I have taken some medicine such as livocet , mlivocet etc.. but it did not help. Recently i have done the blood test at pathology lab. The report shows the high range of Eosinophilia count i.e 8 %.  Please let me know what to do.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Eosinophils are one of the white blood cell (WBCs). It is usually seen in very low percentage like 1-2 %. Higher percentage suggest allergic disease. Other conditions like drug reaction, parasitic infection etc also show higher eosinophils. But in your case possibility of allergic etiology is more. You are also having cough and cold since 4-5 months. And not improving with routine medicines. So possibility of allergic cough is more in your case. You need to start combination of antihistamine and anti allergic drugs. You will definitely improve with this and your eosinophil count William also decrease. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat dog bite in a 4 years old child?\n\nhello..my baby just told me that she was bitten by a dog and we can,t believe it for we have nt seen it.but she s really consistent on saying yes mom i was bitten by our own dog.my baby will be turning 4 years old this june 25..please would seeing a doctor now can still trace any rabies on my baby if really she was bitten by a dog?",
    "doctor_response": "Hi,If there is doubt about dog bite one should not take chance so go for anti-rabies vaccination after consulting your doctor.go for tetanus toxoid shot as well.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment should I take for my gums problem ?\n\nEver since I was little, my gums bled all the time. When I brushed, rinsed, or got hit. The dentists always say that I need to brush better, but the the thing is I spend 30 mins brushing, flossing, and rinsing all the time. They have gotten better over the years. I m 14 and I m wondering if this is normal for such a young age. The redness used to hurt and had isiility, but not that much anymore. However, it still bleeds at random. Today I ha a Dentist appointment and they were saying that my gums are inflamed, extremely. They didn t say Gingiitis, but I m unsure. I have braces so it s kind of difficult to floss, but I try. Please tell me what I should do.",
    "doctor_response": "Hi, since your age is 14, you are at the stage of puberty. at this stage the even little infection will be aggravated. so i suggest go to dentist, take proper scaling sittings, if it is infected you may need antibiotics also. take proper care of brushing twice a day, learn from your dentist the method of brushing for proper care. as you have braces please dont use floss as it may entangle in your brackets and harm your wiring treatment(ortho) process. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe backache be treated?\n\nThank you , I have never felt so much pain, its like every cell is suffocating. when I walk my insides hurt, my head hurts so much, I'm in tears. I had some back pain and they tried to inject something into my spine, the bones were so close together, they tried several times on each side. It's like I went in one person and came out another, for 12 days I've been in extreme crazy pain...please help me",
    "doctor_response": "Hello, I have studied your case.Most probable reason for your symptoms could be postural problem as you may be sitting for long time and working on computer/table for long time.When such patient comes to my hospital we usually take x ray spine or if required MRI to see for any nerve compression.Medication like methylcobalamine with muscle relaxant and analgesic will reduce pain; you can take them consulting your treating doctor.Some exercises which can be done after pain has reduced include- Spine extension exercises, Lying on your stomach flat lift leg 6 inches from ground, do it for other leg.Now lift both hand and leg simultaneously, 6 inch off the ground and stayPosition for around 10 breathes. Core stabilizing spine exercises will help.You may consult physiotherapist for further guidance. He may start TENS, or ultrasound which is helpful in your case.I will advise to check your vit B12 and vit D3 level.Other less likely possibilities can be spinal disc bulge,TB spine Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you find this answer helpful do not hesitate to rate this answer at end of discussion.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reports showed arachnoid cyst, have difficulty with memory. Related?\n\nIn the report from a CT scan I had in 2003, it was stated that situated over my right frontal lobe , anterior in its mid portion, I have a low density CSF density lesion which measures about 3.3cm in width and 1.1cm in depth. The report said it was typical of an arachnoid cyst . I have difficulty with my memory , which although I have always been able to mask from my colleagues as I have systems to assist me, I feel it is getting progressively worse. Could this be caused by the above? If such a mass is occupying a space that opperational parts of my brain should be occupying surely this would have some affect. I was dismissed and told it was fine when I received the report but I have always had unanswered questions.",
    "doctor_response": "Hello, Generally a arachnoid cyst of the size that you mentioned in frontal lobe would not cause memory problems. If it increases significantly in size (which again is rare), then it can cause problems with memory. None the less there can be causes for your memory problems apart from this cyst. those causes need to be evaluated in you. You will need to consult a neurologist who will examine you and guide further tests and medications if required. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes visible lumps on back side of throat?\n\nI have two lumps in back of throat, visible. I have a stiff neck and neck pain, difficulty swallowing and ear pain and some minor chest pain. Some o the symptoms have been going on for 3 months what could this be? I have done Speed (Meth) and weed lately.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query visible lumps on back side of throat along with ear pain are pointing towards a condition known as granular pharyngitis, which is a infection of pharynx behind the uvula. It could be due to tonsilitis or throat infection . Need not to worry. I would suggest you to start with warm saline gargles and betadine gargles 3-4 times a day. For pain and swelling you should take ibuprofen or acetaminophen. Consult ENT specialist for proper diagnosis. Doctor may prescribe antibiotics penicillin or amoxicillin. Take mucolytic agent like ambroxol or decongestants. You should take steam inhalation as well. Do chlorhexidine mouth-rinse as well. Avoid hot, sharp , spicy food substances and carbonated beverages. You should go for blood and throat swan examination to find out exact etiology of your condition.Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any chance to get pregnant while taking deviry?\n\nHi, i m having PCOD and i m overweight.. I m having irregular periods. I consulted Dr. she told me to take Deviry for 5 days and i have completed the course but still dint got my peroids is there any chance of pregency while i have skip my periods after taking deviry.",
    "doctor_response": "Hi,Deviry is a progestational medicine. In cases of delayed menses, this medicine is prescribed for 5 days. After discontinuation of the tablets, usually within 4 to 7 days, withdrawal bleeding is observed. So do not be impatient. Wait for few days and you will get menses. However, Deviry alone is not prescribed to achieve pregnancy. Since you are having Polycystic Ovarian Syndrome (PCOS), you will have to take medicines for inducing the ovulation (egg release). PCOS is a condition which is characterised by failure to release eggs. The medicines used for induction of ovulation are Clomiphene citrate or HMG/hCG combination. You will have to undergo a battery of investigations like blood levels of FSH, LH, Oestrogen, Progesterone, Prolactin, and AMH.Based on the results of the investigations, medicine(s) for induction of ovulation will be chosen. The medicines for induction of ovulation are given only after inducing the menses to prevent their use in undiagnosed pregnancy. You have to work actively to reduce your weight. Please maintain your BMI between 18 and 23.9. Please report to your Gynecologist after you get withdrawal bleeding so that you can be given medicines for induction of ovulation. I hope along with resolving your dilemm.I have provided you some preliminary guidance. Hope this will be helpful. Let me know if you require further advice. For more detailed advice, you may ask me direct question on this forum. Regards,Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life expectancy after a kidney transplant?\n\nwhat is the life expectancy of a 67 year old male, that does not excrise ecellent with taking his meds, smoke a filtered cigar at lease 1 to two times a day.  on diaylias three time a week for the most part in very good healt.  has high blood ptrssure. diabetes run in his mother's side of family.  for kidney transplant.",
    "doctor_response": "Hello and welcome to HCM.As an Urologist and transplant surgeon, i can understand your anxiety.It's difficult to accurately predict, the life span for any person on dialysis.But the risk factors like smoking,B.P.,and lack of exercise are not very healthy, for a longer survival,with a good quality of life.The life expectancy in an otherwise healthy graft, would've been about 10-15 years, without any risk factors.You can certainly consider a second transplant,from a related donor, if possible,with a good HLA match.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain above the belly button. Polyp in the bladder. Are these related?\n\nI'm having pain about one or so inches above the belly button and the worst is just slightly to the right. I'm aware I have a palyp in my bladder (so far hasn't grown in 3 years), but pain isn't in same spot/doesn't feel the same. I don't feel any lumps but pressure hurts more. I consume only about a tablespoon of dairy each day (creamer). I also try to be careful otherwise w/diet.Any ideas of what it could be and what to do for it?",
    "doctor_response": "Hello,Lower abdominal pain for long time.Of late the intensity of the pain increases and the area of spread is more.You are a known as of polyp of the urinary bladder.Re Examine the polyp for any increase in size, pressure effects, ulceration and infection.If the polyp appears to be same like before than other causes has to be looked for.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pancreatic cancer, gastroparesis, increased sugar levels, pancreas burnt, painful abdomen. Taking metformin. Is it common?\n\nI had a whipple two years ago on Agust 5th for  pancreatic cancer.  I had diabetes before but food controled and one 500 metformin a day  Now my pancreas has burned out and my sugars are out of control.  I tried Bydureon for 6 months and it worked great except it slowed my motility down and I started having gastroparesis.  Stopped the Bydureon and now I take andtibotics for the gastorparesis when it occurs...The pains I get across my abdomen and diaphram are severe and it takes about 24 hours to get over the chills and fever and weakness.  My question :  is this common for post surgery patients and what can I do to prevent the problem?",
    "doctor_response": "Hi, it appears that the gastroparesis might not be due to the bydureon, but may be due to the diabetis.                         There are so many medicines which can be used for gastroparesis, like domperidone, and so many gastro kinetics, which you can use with the advise of gastroenterologists for relief from the paresis. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for boils in roof of mouth\n\nage 55yrs height:5 4 weight 183 Medical history not suffering from any illness. After eating a flour base item i felt a boil as small as a pin head in the roof of my mouth rinse it out with listerine and it became bigger as a bladder with blood in it which later burst and i am now expriencing pain to swallow and my mouth is red and my tonsil is swollen",
    "doctor_response": "thanks for your query, i have gone through your query. the blister could be  a mucocele secondary to the trauma or burn. nothing to worry, you can take topical anesthetic and analgesics like anabel gel. apply 3-4times daily for 5days. do not eat hot spicy and hard food. take soft diet. i hope my answer will help you. take care. if the lesion doesn't heal in 5 days then consult a dentist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain under the rib cage with difficulty in breathing?\n\nmy side a few days ago my upper right side under my rib cage started hurting it was only hurting a little but then it hurt to breath it is now to a point where it hurts to move my last cycle was a month ago and tubes are tied I do not have my a pendix and I have q history of sisit and ulcers I'm a 36 female and I'm at 158p if this helps should I go to the er",
    "doctor_response": "Hi thanks for asking question.Here are few possibilities.1.It could be simple musculoskeletal pain.Take simple analgesic for that.Hot compression for 5 to 10 minute can be helpful.During sleep take adequate posture.Avoid heavy weight lifting.2.second if you have viral flu like symptoms like headache, cough, fever , cold then muscular pain can occur.symptomatic management done for it.3. If still pain increasing then respiratory causes has to be ruled out.chest x ray helpful.Sometimes bronchitis like disease may present if cough and fever present.Pulmonary function test helpful for that.I hope my suggestion will help you.Wish you good health.Dr.parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the sudden cause for death be due to wrong setting of ICD?\n\nHi I was hoping that you may be able to assist me at this difficult time when my step-father has passed away. Just to give you some information and background to my step-father. He died very suddenly on 07/07/2010 at the age of 53, prior to his passing he had been in good health and didn t show any signs of distress. His medical background was that he had an ICD pacemaker fitted in June 2008 and had his heart ablated. He went into hospital in February 2010 for a minor TURP Prostate operation under aesthetic , prior to performing the surgery the hospital had to adjust his ICD. He went on holiday in June 2010 but prior to flying abroad he went for a check up at the pacemaker clinic to make sure he was ok to travel, he was informed by the clinic that the ICD was running at the wrong setting, stating that the hospital must not have changed it back correctly. He went away on holiday with my mum and enjoyed his 10 day holiday in Egypt without any problems. He arrived back from his holidays on 25/06/2010 and was fit and well until his sudden death two weeks later. When my mum had found him he was lying on the floor, previous to this he had been sitting at the table completing a crossword. There didn t see to be any sign of life, so my mum immediately called the paramedics, on there arrival they said he had already died and produced a print out of his heart reading showing a flat line. We have many unanswered questions and unfortunately at this stage two post-mortems have been carried out and the pathologist has not been able to determine the cause of his death. Can I ask you, is it possible that somebody can get an electric shock from an ICD that would be strong enough to kill somebody, the reason I ask is that he didn\u2019t die slump at the table and the position he was at on the floor next to the table with one foot caught around the chair leg. He also had what looked like a blue mark on his forehead. When we finally brought his body home to rest there was extensive bruising to the top of his head in a different location to the first mark. Can you think of any other explanations in relation to the ICD why he may have died. I really appreciate your time and feedback.",
    "doctor_response": "Hi, After going through your medical query I understand your concern and I would like to tell you that most likely cause of death was fetal cardiac arrhythmia in the setting of non-functioning ICD which wasn't switched on after TURP surgery. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for severe depression and fatigue\n\nI have eight years of education and owned a small business, I married a very wealthy man and was living a very rich life and walked out after one year. He was controlling and manipulative and narcissistic, I was probably codependent and needy a term his counselor came up with. I needed some stability and trust. He was 15 years older and I waited a long time to get married and do not have children. I was at fault as I had old fashioned and immature ideals of married life. I can t seem to get up and get going anymore. I am tired and depressed and life doesn t appeal to me anymore. I know that I have enough to survive on but I am so ambivalent about my future and ever being with anyone again. I have no friends or family to speak of. just an aging mother who needs my help all of the time. I know that I worked so hard my whole life, I am 56 and now I have nothing but material posessions which I don t even enjoy anymore. I have been to counseling for one year and he says I was emotionally immature and that I need to find something that I can become interested in once again. This man just kept going back and forth and lying to his ex-wife and then me his new wife and I just felt like my head was spinning around. I am so analytical and so capable of compromise but the truth and the needs never came out. I am also very angry as he moved on and found an older woman immediately and had her move in the home we bought together within three months. I just feel so hurt and betrayed and waited for him for six years and it was awful. What do I do to get my exhurberance back?",
    "doctor_response": "Hello and welcome to Healthcare Magic. Thanks for your query.I understand that you are going through a difficult time due to your problems. From the description of your symptoms, it appears that you are going through a depressive episode. As this seems to be affecting you quite a lot, I would suggest that you seek professional help to deal with this. Help is available in the form of anti-depressant medication or psychological therapies like CBT. So, I would advise you to see a psychiatrist in your place for a detailed evaluation and further management. Wish you all the best.Regards,Dr. Jonas SundarakumarConsultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain under the rib cage after hitting with elbow, diabetic, correct weight. Reason for the pain?\n\nI have a pain on my left side under and to the right of my lower rib cage. It feels more inside rather than just the rib. I fell about a week ago and I think my elbow hit the ribs. I am 61 years old and am pretty good health not over weight. I do have type 2 dieabeties no other problems except for derm problem. What is internal in that area of the rib. Also it hurts when I bend over.",
    "doctor_response": "Hello dear,The pain is of musculo-skeletal origin.Kindly take analgesics like Diclofenac+ apply muscle relaxant gel.You can also apply ice over the area.The pain will take some time to relieve.If it still persists, kindly get X ray of chest done to rule out any fracture.There is no need to worry, you will be fine.Wishing you a good healthTake care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blistering around the surgery site after a hip replacement?\n\nMy Mother had a hip replacement and came out of surgery with the surgery sight bandage and also a bandage on a lower part of her thigh. Dr it is getting larger it is blistered and has a red edge around it. The Dr. said he is going to do surgery to scrape and clean it out. But no one ever tells her or us it is Staph my question is- after he goes back in what are the chances it spreads and is it painful and does the wound or whole have to be left open for a while or do they stitch it up?",
    "doctor_response": "helloA culture from the wound may be done in case bacterial infection is suspected, this will decide whether wound can be stitched or not or secondary suturing be done-leave it to your doctor.culture and sensitivity test will also give choice of antibiotic,Sometimes skin is friable in old feeble persons breaching by dressing cotton, do not wory, it will be controlledthanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes loose motion and stomach pain during a pregnancy?\n\nhello doctor i am 24 weeks pregnant now.past 4 days i had loose motion almost twice a day.but today morning after i had break fast i had loose motion.before going to toilet my stomach paining a lot.i feel bad.but i could feel my baby movements.i called my doctor.but she didnt pick up the phone.will the loose motion affect my baby?i feel tired also,",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the loose motions and stomach pain might be due to stomach infection.Dont worry.They won't harm the fetus.But the loose motions if untreated might make you dehydrated and tired.The dehydration might irritate the uterus leading to pain sometimes.So take adequate fluids upto 3 litres per day ,electrolyte powder,coconut water,fruit juices to combat the dehydration caused due to loose motions.Proboitics also might be helpful.Avoid spicy and oily diet and take bland diet.Observe your fetal movements.With adequate treatment it will subside.Nothing to worry as such.I would like you to see your consultant.Hope this helps.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is causing muscle pain with frequent urination?\n\nHello doctor, My mother-in-law is suffering from muscle pain (no joint pains) with frequent urination. CBC, HbA1C and complete urine analysis were done and no alarming indications were there in the reports. Urine culture test reports are yet to come. Antibiotics and painkillers are not helping. Due to severe pain, she is not able to sleep as well.",
    "doctor_response": "Hello. Since when she is suffering? How old is your mother-in-law? Any morning stiffness? Since when is she suffering from diabetes? The possibility of fibromyalgia or rheumatoid arthritis or chronic fatigue syndrome or infection or menopausal symptoms, etc. Please get it done FSH, LH levels. Get it done ESR, RA factor. Use tablet Paracetamol thrice a day if necessary. Drink plenty of water. Please review with reports. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does growing lump on neck with history of breast cancer indicate?\n\ni have a mushy lump on the left side of my neck. I noticed it a couple days ago and it s gotten larger since then. I have had breast cancer in the left breast which was also HER2 positive. My breast cancer was very small and I had a lumpectomy in 2010.",
    "doctor_response": "Hi,From history it seems that there might be having secondary in your neck lymph nodes giving this problem.Consult your surgeon, who has done lumpectomy in the past.Your breasts are required for through examination as well.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggestions for brain MRI showing mild paraventricular abnormal signal changes?\n\nhi. i am 34 years old woman  and i had occasional dizziness(not vertigo) in  this month . my BRAIN MRI report only small mild right paraventricular abnormal signal changes.my neurologic & ophtalmologic exam  is normal and do not have any symptom.what should i do? is it a sign of demyelinize disease?",
    "doctor_response": "HIThank for asking to HCMI can understand your problem, the MRI report whatever given here is suggestive of within normal limits and that need to be correlated with the clinical condition, your symptoms may not be due to the brain, so need to worry about this and not the sign of any brain related disease, hope this information helps you have good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to come over depression ?\n\nhello sir my self vicky, age-21,male i m suffering from depression since 3 year but i didnt make any treatment kindly tell me how i come over depression iam very much in problem sir.",
    "doctor_response": "hello vickey... the best way to treat  it by taking homeopathic medicines n meditation..try n keep youself busy n involve wit the things u like .. lough a lot.. god bless..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is the blood urea and serum creatine level very high even after a kidney transplant ?\n\nsir i wants to know who is the best doctor of nephrology , who have so many of experience of transplantation with other related questions from appolo hospital madurai, for consult my question is my yanger brother mr anup mishra whose kidney was transplanted before 1 and half year past,but till now his serum creattnine level doesnot come below 3.2 and blod urea level is 32 after his post transplantation,this month it has gone to 3.4 and urea level goes up to 75.so please tell me the exact problems for which my brother will recover from the dieasese.and please tell the excellent doctor of appllo madurai",
    "doctor_response": "Hi, Thanks for your query. You have problem in transplanted kidney. Consult your nephrologist urgently. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on hip after anal sex,\n\nI am on pep after having protected respective anal sex with a transvestite sex worker. I have had no side effects from pep but three weeks after exposure I ve got a slight lump and a little discomfort where my left hip meets my leg. I ve also got some irritation under my right bicep. I ve felt a bit sick today but with a temperature of 37-37.2.",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query.The lump could be a lymph node swelling and along with fever it might indicate some kind of infection which might be related to the anal sex. I would suggest you to get it clinically assessed along with related investigations by your family physician/general surgeon in your area for a proper diagnosis and appropriate management.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from BDSM, submissive nature. How to get rid of this obsession?\n\nHi. I am 30 yr old male and my question is about BDSM. I consider myself a submissive. I believe I think too much i about BDSM and spend lots of time looking over bdsm photos over net. I also try to chat a lot about Femdom (try some online roleplays) and I feel anxious if I dont get anyone to chat with. I want to know if this is normal or not and if its not, are there methods to come our of this obsession?",
    "doctor_response": "hi..look this is called gender identity disorder if you are categorized at all..and medicine won't cure it..counseling may help in a great way if you want an orientation regarding gender..people may not want so and they are happy..so the ball is in your court..thanks..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can missing birth control pills lead to nausea and headaches?\n\nHi, I recently just had my period but 2 weeks early. I'm guessing that its because I missed 2 pills in the first week of my pill pack. But every once in a while I feel very nauseous in the morning. Its not every morning but just the other day I felt nauseous during my 8 am class and then threw up right after I got out. I just don't know what could be wrong, could I possibly be pregnant? Or was it just because my hormones were all thrown off because I missed those 2 pills. I'm also experiencing headaches. Thanks for any help!",
    "doctor_response": "hi there thanks for posting your query at HCMdear  did you get   any pregnancy test done . in that case i would first suggest that you get your pregnancy test   done . But you must refer  to your to gynecologist. and per she will also advice you a ultrasound  One important you must remember that if it  is not pregnancy  , you must be aware that the  oral contraceptive pills also have there share of   side effect . These include  nausea , vomiting ,. headache , weight gain . breast engorgement. cardiovascular problems , oi mean  related to heart and live functions are derangedSo if the severity of symptoms is very high , you must ask the gynoe to adopt another method of birth control for you , and for the present  symptoms take medication written by herTake care you must get yiurself",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Keflex advisable to treat cervical lymphadenitis?\n\nI have VERY sore , swollen lymph nodes on the left side of my neck. It hurts to turn head, look up and yawn. It has been 2 days. Went to ER today as I could not get an appt with my Dr. Dr said cervical lymphadenitis. Gave me 500 mg keflex to take every 6 hours. What would cause this so suddenly? Will it resolve quickly with Keflex?",
    "doctor_response": "Hi, Most probably the nodes are swollen because of associated infection and it will settle with timely antibiotics. Keflex is a brand name of Cephalexin and it is very much effective for similar conditions. Nothing much to worry and your symptoms will settle with a couple of days. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for bruising in the rib?\n\nI believe I cracked a rib coughing a couple of months ago, have honeycomb type bruising to my flank, which has gone away somewhat, but still there.  The rib area is still tender, but not as sore and I can sleep on my side now.  How long can I expect the bruising to be there?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Skeletal pain needs atleast 5-6 months for complete recovery. And most important part in healing and recovery is immobilization. Immobilization is very difficult in ribs due to constant inspiration and expiration. So to achieve immobilization and speed up the recovery, you should wear chest belt. Also apply warm water pad on affected areas. Start painkiller and muscle relaxant drugs. Avoid movements causing pain and heavyweight lifting. With all these, your recovery will be fasten. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stiffness in legs and hands in a diabetic patient\n\nHello, I have diabetic type 2 since 5 years having both the legs and both the hand stiffness no pain I am taking piopod Gm 1 teblet 1/2 3 times and b2 to 12 one capsules daily since 10 days I have started relvin M 1 capsules a days do you suggest me best medicine just for relive stiffness only. Thanks Aes.",
    "doctor_response": "Hithe drug you are on can cause hypoaesthesia, means reduced sensations and bony pains that could be causing stiffness, please discuss these concerns with your doctor and request him to change your drugs, also you may get screened for arthritis, specially inflammatory type.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest diet for a child suffering from febrile convulsions\n\nHi, my grand daughter 2 year baby girl had a convulsion with fever last 15 days ago, during that period  she took paracetamol, now she is recovered, but she do not want to eat milk nor she has got eagerness to take her principal food, DR, Sir what type of food should you suggest for her immunization.",
    "doctor_response": "Hi...there are no specific or special diets in this regard. You can feed her everything age appropriately.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for swollen vein between two front teeth?\n\nA week ago I had my front tooth which had bonding falling out due to an old injury repaired.  (a quarter of tooth missing and bonding had to be chiseled out and replaced) I think the bonding was not shaved down enough between two front teeth.  Now everyday I have woken up with puffbal on upper pallet behind front teeth.  Now I am noticing vein running between my two front teeth is very swollen/protruding.  Thought it was just a little infection to sit out but this is looking like a seriously pinched vein!  Help I am scared!  Thank You! Sasha",
    "doctor_response": "hello thanx fr cnsltng at hcm.i thnk it is infctn f teeth,may be labial frenum uppr may be cmng in btwn'eithr ways plz cnslt ur dentst.hp it helps'.tc",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a bruised lump on leg after an injury indicate?\n\nA baseball hit my leg and I had a really bad bruise which is to be expected. It s been two weeks and now there is a knot. It doesn t hurt anymore, but my there is still discoloration of the skin (a yellowish color) My uncle lost his leg due to osteomylitis of the bone that resulted from hitting his leg on a rock. Should I be concerned?",
    "doctor_response": "Hi,It seems that there might be having big hermatoma at the time of injury and now resolving and became encapsulated.It is advisable to go for x-ray leg to rule out any bone involvement.Apply ice pack.Apply thrombophob cream.ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for severe hairfall\n\nhi, i m having severe hair fall , for a last month i was on vb7 forte ,there was reduction in hair fall ,but as i stopped then after 15-20 days , i was having again severe hair fall .plz suggest me something i m 27 yrs old ,54 kg ,5'2 feet , blad spots are visible",
    "doctor_response": "Hi Dear,Understanding your concern. As per your query you have symptoms of severe hair fall which is mainly due to medication effects. It could be due to environmental factors, fungal infection.Need not to worry. I would suggest you to avoid excessive stress and drink plenty of water to stay hydrated. Maintain proper hygiene of your scalp and wash hairs every alternative day and take Indian gooseberry powder half spoon. Consult dermatologist once for proper examination. Doctor may prescribe Minoxidil preparations and along with that multivitamin tablets rich in biotin, Vitamin A and E.Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is creatine levels being 22 and having atrophic kidney major issue while being scheduled to have gallbladder surgery?\n\nI was suppose to have gallbladder surgery tomorrow ,but my Dr. Called to cancel until I saw a specialist about my blood work because my creatine levels were 22. I have a atrophic kidney ,we just found out ,though I have never had any problems ,kidney. Or such . What do you think could be the problem? All I need is to get this gallbladder out it is giving me problems, now this !!!",
    "doctor_response": "Hi thanks for asking question.Serum creatinine is usually below 1.Here it is 22 , means there has been significant damage has occured to kidney.Here kidney condition should be evaluated , and status of second kidney also evaluated.You can have shrunken kidney might be because of long term diabetic nephropathy, chronic glomerulonephritis or long term nephrosclerosis.Measure your blood pressure and estimate your blood glucose level.Here as further work up ,apart from usg, kidney biopsy also has to be taken for proper diagnosis and treated accordingly.so, better first to clear cause of shrunken kidney by investing and then go for surgery.I hope my suggestion will you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does ejaculating make you physically weaker?\n\nHi, Age - 29, Height, 5\"11, Weight - 62.. No medical history Do you get weak if you mastrubitate? and if yes, what is it that you need to intake / eat, if you get weak...(pls guide preferably veg food)? any specific comments with the details mentioned above on height and weight",
    "doctor_response": "Hi,  Sperm are regularly produced in our body along with fluids secreted from glands like prostate seminal vesicle etc it becomes semen . So if it is produced regularly it should be discharged regularly from body by sexual intercourse and manually through masturbation otherwise it comes out during nightfall . Now masturbation does not causes weakness or defect in sexual organ ( energy lost is almost similar to doing other activity in muscle contraction n relaxation) . It give pleasure durin act of masturbation and later calmness which is thought as weakness .  Your height and weight are normal.So in my opinion you don't require to supplement any diet if you are taking balanced diet .Hope this will help.For any queries feel free to ask.THANKS N REGARDS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes black and blue hard lump on the cheeks after falling?\n\nMy daughter fell about 3 weeks ago and landed face first on a wooden bench.  She developed a bad bruise which had started to turn yellow.  Today it is back to being black and blue again and there is now a hard lump and her cheek has a little dent in it.  What does this mean and what should I do?",
    "doctor_response": "Hi.Thanks for your query.There are many stages through which a wound healing takes place.Every person's response and outcome to a given injury is different.In case of your daughter , the wound is going through the normal stages of healing and getting hard is indicative of organization of a hematoma.Please give her anti-inflammatory medicines and  multivitamins for a better recovery, avoid exposure to the extremes of cold and / hot. No local applications at all, they do not help.You may consult a cosmetic/ Plastic surgeon since the patient is a female ( daughter ) and needs proper care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How do non-motile sperm end up in a post-vas analysis 6 months after surgery? I was diagnosed with RNMS, and I understand that means a successful surgery, but how do they get in there in the first place? And might they be non-motile because the lab had to wait too long before doing the analysis? Thanks for your help.",
    "doctor_response": "Hi. Non motile sperm can come in the sample either if the vas has recanalized or through tissues which still secrete the sperm and they are transmitted to the cut end of the Vas. There is a percentage of men who get this finding of non motile sperms even uptill 3 years after the Vasectomy operation. It almost means that you are infertile which goes to say that the surgery has been successful but the Ultimate test is absence of dead or alive spermatozoa. So I adivce that you use some other form of contraception till the test shows absence of any sperms. Take care.Dr Rishi, New Delhi, India.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat recurring Cellulitis of foot, antibiotics offer temporary relief?\n\nMy husband (34 yr old) has had recurring cellulitis in his legs for the past year. he has been on antibiotic for a year as well. They found out he has MRSA and gave him the correct antibiotics as well, but as soon as he stops taking them, no more than 2 weeks later the redness and swelling comes back, he develops a fever and I have to take him to the ER. They usually admit him and put him on IV antibiotics and send him home with oral antibiotics. This last time, they gave him clindamycin. What can we do to get rid of this once and for all??",
    "doctor_response": "HIWelcome.Since how long is he having this recurrent cellulitis? MRSA is a bug, which actually resides dormantly at some particular sites like anterior nares, Nail bed, Web space of hand. It is necessary to eradicate them, otherwise there always be a chance of recurrence. Hope it is clear. Thank you very much.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i give 2.5ml ventorlin for cold and fever of a 18 month baby?\n\nMy daughter is 18 months old and she is having cough and cold with mild fever for the last 3 days now. She is given Piriton CS 2.5 ml twice a day...but she is still coughing badly. Can I give her 2.5ml Ventorlin? She does not have any breathing trouble, though.",
    "doctor_response": "The symptoms you had mentioned are mostly suggestive of some sort of chest infection for which you can give your daughter some antibiotic mostly zifi-cv or moxikind-cv after an expert advice along with syrup tynol-plus or wikoryl for cold and fever. For cough you can give her syrup ambrodil-s or bro-zedex.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is medical marijuana safe drug for bipolar disorder?\n\nHello. I have a son who is 18 years old. He has bipolar disorder and refuses to take medications. He is afraid of the side effect. He started to use medical marijuana every night before bed. According to him, medical marijuana is safer than medication. Is this correct?",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.There are wonderful treatment options available for bipolar depression like valproate or carbamazepine etc. Medical marijuana is not a preferred  treatment for bipolar depression. 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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it to be concerned about dry blood in child's nostril?\n\nMy 13 year old son's nostril constantly have dried blood and it looks gross. I have him clean his nostrils and moisturize with vaseline, we use the cool mist humidifier. The condition only goes away when he takes antibiotics, but I do not want him on antibiotics constantly.  He has been tested for allergies and gets allergy shots. This all started 2 years ago when a dr prescribed a nose spray",
    "doctor_response": "Hi,Welcome to Hcm,I can't boil down to a specific problem in your child. However, I get a feeling that you are over treating him probably for something and that's what is causing this issue. Some local applicants in the nose can cause irritation over the skin of the nostril which can cause bleeing at the tip. I would suggest you to consult an ent specialist so that a proper examination of the nose could be done to rule out any local problem. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does delay in periods indicate pregnancy?\n\nhi, i took lovenell the day of unprotected sex, am now two weeks late. My last period was on the 24/9 and normally a 3 day cycle. I have done a pregnacy test and also done a blood test (HcG) and they were both negative. Am i worrying for nothing or cud i be pregnant???",
    "doctor_response": "Hi there,Since both the urine and blood HCG levels are negative it means you are definitely not pregnant. Taking Levonorgestrel may sometimes delay the periods. Repeat a urine pregnancy test and if still negative take a Tab Duphaston 10 mg twice a day for 5 days,and you will get periods.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause loss of balance?\n\nhello, two weeks ago, I felf I was going to fall off from my chair suddenly while I was sitting. Today, while I was walking, I felt I was losing my balance. I immedialty sat down and It went away. what is ahppening to me?. I did not feel my head turning at all. I only felt I was going to pass out. I appreciate your response.",
    "doctor_response": "Hello!Welcome on Healthcaremagic!Your symptoms could be related to different possible causes: an inner ear disorder, panic attacks, vertebro-basilary insufficiency, etc..I would like to know your age and your past medical history. If these problems persist, I would recommend consulting with an ENT specialist to exclude an inner ear disorder. Other tests to consider would be: a cervical spine X ray study for chronic degeneration of the cervical column, complete blood count for anemia, thyroid hormone levels for thyroid dysfunction, fasting glucose. A brain MRI study may be needed. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cure for asthma?\n\nHello Doctor My father aged 58 years suffering from Asthma. He can,t walk as not able to take breathe and feel harassment. They take rest. Not possible to walk on high path. In cold suffer he feels more and problem in breathing. Can U help me.    RegardsVINOD KUMARMob No 0000",
    "doctor_response": "normally as thma is allergy in my experience medicines can control  not  cure asthmai have treated many patientsin my opinion go for allergy tests eliminate avoidable allergens and take sublingual immunotherapy for unavoidable allergensalong with supportive medicines will have best option as per my eperience",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for insertional tendinosis of distal tendon\n\nI had an MRI of my elbow yesterday. The conclusion of the report says: There is moderate insertional tendinosis of distal tendon, accounting for the patient's symptoms. No discrete tear is demonstrated. Remainder of the examination is unremarkable. Conservative therapy would be appropriate.My doctor gave me a 1 month supply of Naproxen - SR 1000mg and said rest it. Every site I have looked at with my results says I should not use anti-inflamatories and I should be using heat and light exercises.What is the best course of action to take with a full recovery in mind.",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. Given the history of insertional tendinosis there can be degeneration of tendon involve so avoid heat therapy. Instead use ice and appropriate rest in elbow support for 6 weeks followed by eccentric exercises and stretching exercises, good nutrition with vit c , vit b 12 and calcium is also important for new collagen tissue growth and tendon health.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Harsh Swarup",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in breathing?\n\nhello doc.. i am ani.. 23yrs old married.. from past 2 days am having difficulty in breathing.. i dont have any cold or cough.. my doc had suggested me to take etizola 0.25mg and deriphyllin .. wil it be cured soon?? how can i get off with difficulty? plz help me",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern.If it id only of 2 days duration then it could be anxiety for which you are being treated. If it persists, then it could be bronchitis. Consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of bronchitis. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid (ICS). Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain on right side of ribs radiating to shoulder\n\nHello! Diagnosed with costocondritis. I have severe pain on my right side top ribs area. This pain started shortly after I had tendonitis in my writs and then one day my shoulder dropped down. There was no pain when my shoulder dropped but you could visually see it was very low. It went back up after a few days and then the pain began in my chest area. This pain has been on going for more than a year now. I have had cortizone injections that have helped but I still have a constant nagging pain. This pain also radiates to my right shoulder and I also have trouble with my left shoulder as well. Needless to say I cannot lay on either shoulder.",
    "doctor_response": "Hello,Thanks for the query.The two possibilities are costochondritis or tendon problems.As of now you can use analgesics/anti inflammatory combination like aceclofenac/seratiopeptdase for symptomatic relief. If symptoms persist better to consult an orthopaedic and get evaluated.An MRI shoulder is required for further assessment.Wishing all the best.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain and swelling in foot due to an injury\n\nI rolled my left foot playing basketball I jumped and landed on someones foot and rolled mine its been a couple of days the swelling has gone down alot but I still can t bend it the way I filled it I can walk on it but I can t make any cuts or moves on the foot there is a spot on the left foot that is buldging out it was bruised at first",
    "doctor_response": "Hello, As you have a foot injury and now difficulty in making any kind of normal movements like - plantar flexion, dorsiflexion, eversion and inversion I would advise you to take up an x-ray first or an MRI. MRI is far better than x-ray to rule out any ligament injury. Usually, ankle ligament injuries are common in sports and get unnoticed at times which may, later on, shows its reaction. Take up and MRI and following the ankle rehabilitation program - like balance board training should correct the muscle imbalance and improve the overall functions of the ankle joint. Balance board training have an effective outcome score for most sports injury of the ankle. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does the test results require immediate attention?\n\nSir, Today, I have tested for SGPT & SGOT. Results are SGPT-39.9 & SGOT -101.2 I was taking alchohal for last 11 years. Now I quit alchohal, In how many days I can get normal range for above test. Are the levels of these test very high or any serious condition is there in.",
    "doctor_response": "Hello, Thanks for using Healthcaremagic. i had gone through your reports that you have posted. the report suggestive of alcohol induced hepatitis.  ast > 2 times of alt again suggestive of alcohol pattern of hepatitis. this not serious without other manifestation like abdominal swelling, deep jaundice, breathlessness while walking. if you dont have any of the above manifestations u can be managed at home. kindly stop alcohol, take tab UDILIV 300 mg 1-0-1 for 2 weeks and repeat liver function test, hope it improves by then. hope this helps..",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can semen count causing infertility be treated?\n\ni am 29 yrs old,weight is 56, Height is 4\"10... medical history is slightly allergic to dust and cold(only seasonal) and my husband is 32 yrs, Height is 5\"7, weight 72, medical history is normal.. we had been married for 3 yrs.. we are not using any contraceptive measures..still we are failed to get progeny.. once, my husband's semen counts is tested... but it showed slightly count is low.. but not severe could be called as infertility.. please guide me , is any treatment is required",
    "doctor_response": "Hellothanks for using health care magicIt would have been easier to comment if you had stated the value of the sperm count. True, low sperm count causes infertility but it has to be really low.There are other possible causes of infertility such as less frequent intercourse, infections, hormonal imbalance etc.You should meet a fertility specialist or a gynecologist to do appropriate investigations and make a right diagnosis so that the right treatment should be given.Wishing you good healthDr Achuo",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to ease the pain caused by torn shoulder ligament?\n\nI have a torn shoulder ligament which I have had extreme pain for several months. After trying Arnica, cold compresses, tens unit aroma therapy and a cortisone shot over 2 weeks ago, which helped a little, but the pain has returned with a vengeance. Hurts so much, I have to drive with my left hand. Can t get appt til next wed and I can t keep my sanity until then and going to a clinic and waiting around to be seen would be intolerable. I have no allergies and have taken pain medication before, no side affects. What are my options?",
    "doctor_response": "Hello there,I have read your problem carefully, As you have mentioned torn shoulder ligament,  but on what basis you have mentioned this , if its MRI, than which particular ligament is injured?And how did this injury happened to you?And if its you guess that you have injured your ligament, than this could be a wrong guess.As other than ligament in shoulder joint there is possibility of labrum tear.You have mentioned driving is problem for you, so this indicates there would be major issue, if not treated early could lead to degenerative changes in joints .The best option available here for you is visiting a Physio/Orthopedic get the proper assessment done (if not done earlier)and get start with physiotherapy treatment as you have mentioned TENS , Steroid injection , but they are not effective on long term.So US therapy, Laser therapy could help you in healing process.Taking pain killers dose will damage your kidney, so wear a shoulder race untill you visit your doctor , give yourself some rest.Thanks and regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling below my penis head?\n\nHi Doc,I got swelling below my penis head while i was riding bike for almost 45 minutes in heavy traffic, due to rubbing my penis against my tight underwear over it i was wearing tight jeans. after returning home i noticed that i got swelling like erection under my penis.. full penis is normal size but only the ring below my penis is swollen as if it having erection. i am circumcised male., age 32 years.i have applied 'lobate gm neo cream' just now.please advise that i should use other tablets or creams to get relief or continue with lobate gm neo?thanks in advance.regardsJC",
    "doctor_response": "HiThis should resolve itself soon and it will be fine just to continue the lobate cream for now.  Nothing to worry about",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tremors in the left hand?\n\nI am taking two Curcumin tabs per day for osteoarthritis of the hips. I have been on them for about two weeks. I also take 4 panadol osteos, 7mls olive leaf extract, cerc, macuvision, lutein defence, COQ10, promensil, Metamucil, calcium, D3, B12. I have had a slight tremor in my left hand for about two years, in the last two weeks it has worsened and also has started in my left leg and right hand. Fine motor skills are slightly affected. I have a herniated disk between 5th and 6th vertebrae. The cardiologist is investigating heart arythmia. He has sent me for a thyroid test. I am on a very healthy diet but have started eating about 4 pieces of 70% cocoa dark chocolate daily. I am wondering if any of the above is leading to the tremors. I am 66. Robyn",
    "doctor_response": "hi A neurological consultation for tremor is better. The meds. mentioned by you may or  may  not be a cause, still other causes of tremor have to be searched for.cardiac arrythmias may also indirectly cause varied symptoms if affecting circulation, ask your cardiologist too.then there could be spinal causes due to cervical spondylosis.Trust a neurologist he will exclude all known causes with check upbest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can headaches and nausea be a result of pituitary tumor?\n\nSick for a year I have been  sick for a yr now. I have headaches that last for weeks, I've lost 65 lbs, I get sick in the car, nauseous alot, and constantly break out in these big knots that secrete pus and leave a hole. My pituitary tumor is back, so I thought it was that, but my dad and brother have them too and aren't sick. I've had 4 kids, been anemic alot, had several blood transfusions,  and just had a blood test run and the red blood cells were real low and so was my hub/act. Whatever that is and positive for barbiturates. My tumor was small last time but that neither was last may and I've been falling alot and eyes are acting crazy. Sometimes I can hardly see. I have no tolerance for the kids,  have infections all the time, feel like crap in general, and cry alot. What should I do? Am I gonna lay here and die while they drag their feet? Oh yeah, my nose runs at weird times,  sometimes bleeds, and im really thirsty!!!!",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  You have pituitary adenoma.  Your headache, nausea, vision problems all are due to pituitary adenoma.  It csuses pressure effect and produce all symptoms.  You should go for surgery.  Consult your doctor and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will the semen on the condom lead to pregnancy?\n\nI used a condom having sex and then after the first O took it off, put on another, and continued. I was careful and didn t notice any semen on my hands when removing the first one, but now I am concerned that an unnoticeable but pregnancy risking amount could have gotten on the second one. How big a risk is there of this?",
    "doctor_response": "Hello,Using condom alone carries a failure risk of 15 percent, though the use can be near perfect. In the manner you have described, it is likely that some semen may have entered the vagina after being stained on the surface of the second condom. If it is the fertile or ovulatory period and if you do not wish a pregnancy to occur, you may go for emergency contraception either as an IUD or a pill. If it is the safe or non-ovulatory period, there is nothing else to be done. In future, please use double protection. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the pain in the upper abdomen area with the presence of a lump?\n\nHI, my name is Michael I m having stomach pain right upper side I have a knot there it hurts off an on and when I eat something im very nausea I was told I have a enlarge liver.and was told in would go down if I didn t drink .the problem is I don t drink.can u help.",
    "doctor_response": "HI.Such a lump can be due to distended gall bladder or enlarged liver, or a colonic tumor/ cancer. Get an ultrasonography done. If required you can go for an upper GI endoscopy and colonoscopy. A proper diagnosis will lead you to a proper treatment, e.g. Go for cholecystectomy if this is gall stones with enlarged gall bladder. Also go for blood tests particularly - liver function tests and urine and stool tests. CT scan helps to confirm the diagnosis .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the WBC at 4.0 and platelets at 114 suggest?\n\nmy white blood cell count is at 4.0 and my platelets are at 114, but everything else in my lab work is solid, dr said even wbc is okay... referring to hemo to rule out ITP.. does this sound rt? Should I be concerned about ruling out anything else?  They said I may have a virus of some sort causing them to be low but ultrasound of organs, all my hemoglobin, b12, cbc and etc looks great. I have anxiety and I am trying to rest assured that ITP is totally treatable, and also the dr said she is not looking at lymphoma or lupus either...",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. Your wbc count is at low normal range.  And platelets ate also at lower range. Its slightly low  so no  need to big worry. You may have some viral infection most likely.  So if you don't have symptoms then no need to worry. just be relaxed.  if you have symptoms then take symptomatic treatment.  You should repeat your platelets count and  keep a watch on it. If platelet count decrease severely or you have any signs of bleeding then consult your doctor immediately. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What complications and symptoms will one face for an open bite surgery?\n\nI want to know that what problems will I face if I go for surgery to treat my open bite problem. My lower jaw is too back compared to my other parts of the face. I already used twin block treatment to bring my jaw in front. Now I want to go for a surgery, can you please tell me what all problems will I face during and after the surgery?",
    "doctor_response": "Hi, qWelcome to Healthcaremagic.com.   I had gone through your question I can understand your concern about the procedure to be done.  You will facing several transient deficulties during and after the surgery but these are small things for good gains.   A properly done surgery have least or none of the post surgical complications but following ones are the risk factots:Bleeding during procedure, mal placed jaw, numbness or loss of sensation, post operative infection, post operative muscle spasm because of new adjustments.     These things can be complication but they are not always. So you must trust your doctor and go ahead with the plan for physiological, esthetic and functional betterment of your jaw. Hope my answer will help you. Regards Dr Muzaffar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having multiple sclerosis, pain in lower back, stomach, feels nausea. Alternative for spinal tap?\n\nHi Dr. Grief, I have been having pain in lower back for about two now, thought it was due to moving furniture back that was about 3 weeks ago, now the pain is in my stomach and feel nausae. I have been taking ibp 600 mg and seems to help with pain but comes back. I am also having others syptoms that sounds like MS. 1993 I was having problems and the doctors wanted to do a Spinal Tap, which I refused at the time. 18 years later, been having some problems and have a Doc appt. set up. Could this all be tied in , my pain I m having with MS?",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your symptoms.The most likely cause for your pain could be a pinched nerve in the lower back. This can be evaluated by an MRI scan of lumbo-sacral spine.Regarding the possibility of MS, it seems unlikely as the disease would not remain quite for more than 20 years, if left untreated. Also, for diagnosis of MS, MRI of brain and spine are the first choices, not the spinal tap.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cough and breathing problem in child?\n\nMy daughter is 10 her dr head puunomia (sp) yj her left lower lung 3 weeks ago she tooK a 5 day Z pak now she on Ceftin because a week ago the dr said her lungs sound crackly.  My main issue is her cough is no better than it was 3 weeks ago and now when she coughs she has to gasp to breathe and then she devolops a headache.  Should her recovery take so long?  Whooping Cough?  Any ideas.  I am trying to not be neurotic.",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your history and would like to make suggestions for her as follows:1. As she has cough along with headache, I would first like to know about her nose symptoms, whether she has running nose, nose congestion, mouth breathing, sneezing, etc. If any of above symptoms are present, I usually prescribe my such patients levocetirizine + montelukast for 7-14 days repending upon response. Regular steam inhalation will also help.2. Whooping cough with pneumonia is unusual presentation. So I would not first suspect whooping cough in her, unless she has been in contact with a patient with whooping cough.3. Viral infections can sometimes be prolonged, may be up to 4-6 weeks. Also, cough takes long time to respond to medications. So I would personally think of viral infection first.4. Regular warm saline gargles will help soothing throat and hence may help early recovery.5. Please avoid exposure to dusts, smokes and air pollution as much as possible.6. Please have a nutritious diet with adequate warm fluids during days maintain hydration which may help early recovery.Hope above suggestions will be helpful to your daughter.Should you have any further query, please feel free to ask at HCM.Wish your daughter a quick recovery and the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to remove 3 wisdom teeth along with the lower 28?\n\nHi, I am a 20 year old healthy male that has all 4 wisdom teeth and I had two root canals on my lower 28. Unfortunately I will have to extract the lower 28 after all the work ive done on it. I hate the fact that i will have to walk around with a titanium rod in my mouth for 4-6 months. I was wondering if it is possible that I Remove 3 wisdom teeth along with the lower 28, then got braces to move over my other teeth and make room for my wisdom tooth (on the lower right not coming in compacted) to come in and act as a molar. If this is possible I would rather do this than have a false tooth in my jaw. I ask online because I dont want any bias from my dentist or the surgeon.",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. Yes it is possible to get extracted all wisdom tooth but it should not be done on the same appointment. But if the dentist is mentioning that 28 needs to be extracted then  there must be some infection left in the apical region of tooth which will create problem in the future.Better you should go with the dentist as he must have diagnosed all the conditions. Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do Myopia and Astigmatism kind of refraction errors cause intermittent squint? Can we cure squint with Ayurveda?\n\nHi Doctor, My child is 1.5 years old We have took him for eye observation to Eye as we noticed squit appear to his right eye sometimes Docotors diagnosed it as intermittent squint and SO they recommended to wear glass and review after 6months SO i would like to know from the experts that Myopia and Astigmatism kind of refraction errors will cause intermittent squint? Can we cure squint with Ayurveda Treat ment. Krish",
    "doctor_response": "1. myopia or  nearsightedness is the common refractive error seen in children, and yours is no exception, and thus in order to see distant objects clearly the child has to put strain on his/her eyes to focus better resulting in Squint. 2. astigmatism which is abnormality in cornea can result in association with mypoia/hypermetropia if the condition goes on worsening. 3. any symptoms of headache/eye strain or eye fatigue you noticed? 4. In Ayurveda, apart from herbal treatment we have specific panchkarma procedures related to eye which helps in improving eye sight and lessening the chances of developing squint.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication to stop continuous cough in a child after going to bed\n\nmy son is 8 years old, living in UK and he suffers from continuous cough once he goes to bed...we tried many home-made options....nothing works...only the medicated puf works....but that is a last solution which is used here....is there something else we can do ? please help.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Greetings from Chennai.By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze. I have a few questions for you -Questions:1. How many days per month does she cough or feel breathless?2. How many nights per month does her sleep get disturbed due to above symptoms?3. Does she feel breathless when she runs around or plays with other kids?4. Are the symptoms when there are seasonal changes?5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?6. Is the cough always associated with fever?Please revert back to me with answers so that I can guide you better.You can approach me at the following link.Once the page opens there will be an option below my image as \u2013 ASK ME A QUESTION \u2013 click on it.Please find the link below -www.yyyyyyyy.com/yyyyyy/dr-yyyyyy-yyyyyyyyi/67696Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain. Taking duphaston, cyclopam tablets for getting pregnant. Is pain due to tablet. Any side effects?\n\nfor pregnancy i have consulted a doctor and after whole the treatment she has prescribed tab duphaston 10mg for 14 days and i am taken it for 4 days now but from yesterday i am suffering from a bad stomach ache . Is the pain dueto the tab or what? in the morning i called a doctor who has prescribed me cyclopam tab .Want to know the uses of both the tab also do these have any side effect",
    "doctor_response": "Hi thanks for your question.Duphaston is a brand of synthetic hormone dyhydroprogestrone that is similar to the naturally occurring female steroid hormone progesterone.Progestrone is very important for maintaince of pregnancy. The symptoms you are having are side effects of Duphaston. Cyclopam is dicyclomine hydrochloride is used to treat hyperacidity nausea and irritable bowel. This has been prescribed to you to counter the side effects of duphaston.Hope this answers your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infection in ear in ayurveda\n\nhello doctor i am 27 year old woman i have hearing problems in both ear i have taken lots of allopathic treatment my left ear operated to replace eardrum & left for middle ear operation i was having infection from childhood now because of hearing loss i am facing lots of problems please suggest me ayurvedic medicine to treat the infection because after operation again my ear discharge is their",
    "doctor_response": "thanks for the query.On reading your problem it is understood that u r suffering from Chronic Suppurative Ottitis Media. there are good medicines for this complaint in Ayurveda. I would suggest you the following medication1. Pathyakshadatryadi kwath tablet 2-2-22. Guggulu panchapalam tablet 1-1-13. Biogest tablet 1-1-14. ksheerbala 101 for vertex application.expose the ears to the smoke of shallaki+vacha+turmeric+guggulu.continue the medication for 21 days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tightness and pain in the chest\n\nI was involved in a car accident a week ago where I was wearing my seat belt and the airbag deployed. I ve experienced different areas of pain since then but now the right side of my chest has tightened to where it hurts to extend my right arm through a full range of motion, blow my nose and even breathe too deeply. Is this internal brusing that could heal on its own or should I go to the emergency room and if I were to go a hospital/doctor what should I expect?",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. In my opinion you are having blunt chest trauma due to car accident. Following are the possible complications of blunt chest trauma that can cause similar symptoms. 1. Rib fracture2. Pulmonary contusions 3. Pneumothorax4. Muscular injury. So better to get done chest x ray. If chest x ray is normal then you are mostly having muscular injury. So follow these steps for better symptomatic relief. 1. Avoid heavyweight lifting. 2. Avoid strenuous exercise. 3. Avoid bad posture and movements in sleep. 4. Start painkiller and muscle relaxant. 5. Apply warm water pad on affected site. Don't worry, you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sores in the mouth?\n\nMy Mother has cuts and sores all over the inside of her mouth.  She  has not sense of taste.  She tested with a 1 titer fo sjogre's syndrome but her doctor says that she does not have Sjogren's yet has not other answer for her.  She has had this symptom for 5 months.  Any ideas?",
    "doctor_response": "Hi..Thanks for the query..Sores in mouth can be due to a number of causes like canker sores, cold sores caused by viral infection, allergic reaction etc..But they commonly heal within a period of 1-2 weeks..If the sores are present since 5 months and are not showing any signs of healing then you should immediately consult an Oral Physician and get evaluated..A biopsy can be done for confirmation of the exact nature of lesions..For now take Vitamin B complex and lysine supplements and do warm saline gargles..Gargle with soda bicarb solution in water..Avoid spicy and irritant foods.Hope this helps..Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the knee on and off?\n\nIn 2003 I was kicked in the knee by a horse, in 03 and 04 I played volleyball since then I have had issues with my knee off and on. It pulls in the back of my leg when I exercise and when I m just walking the outside of my knee hurts to bend and straighten. I have gone to physical therapy which helped for a little while however a few months later the problem happened again. They pt said I needed to get my knee stronger which I have been trying to do but it hurts so much to do any kind of exercise on my knee, I do wear a brace when I need it. Lately when I walk around it feels like both sides of my knee pull and my knee cap pops. What should I do?",
    "doctor_response": "Hello,It is necessary consulting with an orthopedist for a physical exam and performing a knee joint MRI study in order to study the meniscus and cartilage present in the knee. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain, hip pain, difficulty in walking. MRI shows disc bulge. Taking light medication. Recommendations?\n\nHi,My name is Jelena. I have excruciating burning back pain in the lower back and significant glute and leg atrophy down the left leg to the calf and can barely walk. I'm on Aleve, Tramadol and Valium to barely function. I have a disc buldge at L4 with annular tears and an L5 small central herniation into the thecal sac. The MRI shows no nerve impingment, but is it possible that it doesn't show it because I take the MRI lying down, but there is actually impingment to cause these symptoms. I've been like this for 7 months and no doctor has been able to help me. They just throw meds at me. I also have extreme hip pain.",
    "doctor_response": "hallo dear friend your MRI is showing significant finding are you having numbness or altered sensation in your lower limb you should start nerve compression releiving medication like pregabalin i s your symptoms are agrrivating ? are not able to do your daily routine activity ? if your symptoms are not relieved by medication then you may need decompression surgery of spine",
    "dialogue_context": ""
  },
  {
    "patient_message": "White spots and discharge from penis, sexually active. Treatment?\n\nrecently i have bin sexually active but i was safe but did have oral but i have two white spots at the bottom of my penis lips at first i noticed when my pee kinda bothered me(not anymore) this was like a week ago & also my pee hole was giving off this white discharge now i see these 2 white spot. i squeeze them & the same white substance come out b",
    "doctor_response": "you should have the discharge tested for an std.Please rate 5 stars. I strive to provide you with the best answer possible to your question!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having tiny red spots with pin prick white head?\n\nmy 2 yr old son has had a rash for 2 weeks tiny red spots with pin prick white head, now they are turning into large raised lumps and the pin prick is black. he has seen 3 doctors over the last 2 weeks they dont know what it is he also has a high temperature.",
    "doctor_response": "Hi, If I were your treating Doctor for this case of severe pain under the left rib cage, I would come up with three possibilities, these include: 1.The first possibility is of strepto- or staphylodermia. It looks mostly as bacterial infection.Try giving antibiotic -Amoxiclav 50mg/kg divided for 3 times for 7 days. Apply Chloramphenicol to affected area 2 times a day.2.At the second,I don't suppose it would be that molluscum virus? It's harmless if it is. You should apply also Betadine or iodine 3 times for 5 days. But in this case rash is not raised so much.3.It could be a post viral rash, or an allergic reaction to something, a contact dermatitis. You can discuss this with your  Dermatologist.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does anterior glenoid bony loss with focal chronic antero-inferior labral tear, showing stripping of anterior scapular periotism mean?\n\nin last one year my shoulder has been displaced 5 times , and I can not rotate my hand back word direction. . MRI result is below : 1. large hill sach s defect of 1.9 cm in length and 3.5 mm in depth at the posterior superior aspect of Rt humeral head. 2. Anterior glenoid bony loss (20mm in length and 3.5 mm in depth) with focal chronic antero-inferior labral tear, showing stripping of anterior scapular periotism - Perthes lesion. what is the best solution for my problem?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Go for arthroscopic treatment for Hill-Sachs lesion and labral tear. Consult an orthopedic surgeon with good arthroscopic experience.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Varinder Joshi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why there is change in semen?\n\nI am kallman syndrome patient. I started to take testesterone. and when I planned to get married and have baby, i started taking HCG injection as prescribed by my endocrinologist. I have noticed that my semen structure changed after starting HCG. it became thicker, less in quantity and slower in ejavulation. I was told the HCG injection will be followed later by another injection for the sperm production ! .. my concern is the change in my semen !!!",
    "doctor_response": "Higreetings. You are absolutely right.you have been given hcg injection which will be followed  the FSH.sperm production  will start after starting  FSH but will take some time.Injections should be continued until  sperm production starts and till fertility is achieved. The quality and quantity of semen will change as the hormones start acting on your testicles.hope my answer helps you. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can patient with addison disease be in contact with person receiving MMR?\n\nI have addison disease. My grand -daughter needs to get a MMR and a chicken pox shot . The shot is a live virus. Am i allowed to be in contact with her since this is a live virus? If I am not for how many days would I have to wait to be in contact with her?",
    "doctor_response": "Dear I can understand  your  concern . Dear  I would  like to inform  you  that  there  is no such evidence  that live virus  vaccine  can cause virus transmission  from one person to another. You can live with her always . There is no need to worry about  that . Hope this  will  help you . If  you  have  any  other  concerns  please  feel  free  to  message  me .  Thanks  for  contacting  HCM .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My eczema is coming back on and off. Am I allergic to gluten?\n\nHello doctor, I have had an issue with a topical dermatitis\\eczema for about a year and a half. I have been using steroid creams and anti-itch cream but it kept coming back on and off. Three weeks ago I started getting hives and before two weeks, they covered most of my body from my neck to my ankles. As per my doctor, I went on Prednisone and Cetirizine but it did not stop. Now I am on Methylprednisolone and Cetirizine and it seems to be getting a little better. I cannot figure out any triggers though, the itching and the hives are pretty much unbearable. It does not seem to be a sugar allergy, but I am uncertain about a gluten allergy. I have had a previous allergy test but revealed nothing except for allergy to a few animals, which I have none. I never had a gluten test. My current medications are Amlodipine, Paroxetine, Wellbutrin, Famotidine, and Cetirizine. Methylprednisolone for the past four days. I am 52 years old.",
    "doctor_response": "Hello. I have seen the attachments. (attachment removed to protect patient identity).  It must be difficult for you with the itch and the rashes. Can you upload the report of your allergy testing? Why do not you go ahead and get the flute testing? It is a blood test and not as costly as the routine allergy panel. Secondly, when did you start Paroxetine and Wellbutrin? Were those started recently? Is there any correlation between their start and the development of the rashes? When you take the steroid tablets and antihistaminics are you better off? Do the rashes stay at bay then? Are there any triggers inside the house? Any insects or dust particles? Any history of change of place of stay?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i consult a doctor as my house cat bit me?\n\nmy house cat bit me on the hand and left a puncture 24 hours ago.  It is swollen around the puncture, but other than feeling tight with some pain, it does not seem to be spreading.  Is there symptoms I should be watching for and do I need to go see the doctor?",
    "doctor_response": "Hi,Welcome to HCM.Cat bites can also cause rabies. I suggest you get in touch with your GP and get post exposure vaccination for rabies. If your house cat is vaccinated on schedule, then you only need to get a vaccine for tetanus. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment after analyzing MRI report\n\nHi, Iam a female of 23 yrs old and my weight is 88kg,i am  having lower back pain and leg pain for an year ,i have tried a lot of physiotherapy,pain killers,traction but still my pain have not reduced ,my latest MRI reports are like 1)canal stenosis from L2 downwards2)Acute compression fracture of superior end plate of T123)Broad based Disc Protrusion seen at L-2,L-3,L3-L4,and L5-S1 level narrowing the spinal canal and compressing the thecal sac and nerve roots4)central and rightpara central disc extrusion seen at L4-L-5 level narrowing the right lateral recess and compressing the descending L5 nerve root) right side)L4-L5   =03.8Ap diameter in mmsWhat should be my best treatment availablecan i go for a spinal decompression using DRX9000,will it cure my problem.",
    "doctor_response": "Hello, Thanks for your query.Your MRI suggestive of degenerative disc disease & it occurs due to repetitive overload or stress to the disc & it increases the risk of disc herniation & spinal canal stenosis.There are several treatment modalities with medicines, physiotherapy and with injections in the back called epidural injections and root/facet blocks.If you don\u2019t get better with these treatment ,I suggest you undergo surgery, by which the nerves are decompressed by removing the protruded disc (discectomy), which would significantly improve your symptomsI do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the treatments for sciatica?\n\nI am experiencing sciatica.  It has been persistent for over 6 weeks and is getting worse.  I can no longer sit for any period of time nor drive a car.What is the prognosis for most people? Is it episodic or is this the new normal.  What treatments are recommended?",
    "doctor_response": "I read your question carefully and I am sorry about the persisting pain you are in. In 80% of the patients the sciatica pain does subside gradualy over the course of the weeks. It may be recurring though, that is a possibility if there are chronic changes on your spine which with aging are not likely to disappear.If the pain has not subsided for 6 weeks though imaging evaluation is needed to see the degree and site of nerve compression. If disk compression by degenerative changes is confirmed then initial step remains physical therapy and pain killers, if those remain uneffective local injections of steroids and analgesics are tried. Last resort is surgery.I hope to have been of help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain, pancreas valve releases insulin three times normal size. Done X Rays and scan. Is it cancer?\n\nHi Dr Last January I was in  the Hospital for stomach pain. It turned out that my pancreas valve that releases yhe insulin was three times the normal size. He was very thorough. He had a sonogram. xrays,rscp scan I think that's what it was. And he put the endoscope ( tube down my throat  0 and said it was fine. Well i've been reading and finding out that pancreatic is almost always fatal. What should I do$ i lost my son to a rare type of brain cancer he got at 14 followed by non hodghkins lymphomia I'm really terrified that this is bad. Im really scared. I have no insurance  And don'y know",
    "doctor_response": "Hi,  Based on the information provided it seems  \" like a benign insulinoma\" which is a cancer of - Beta cells that produces the insulin, and the surgical removal of those cell mass will be a cure of your problem.   Its not a malignant pancreatic cancer you have been reading about, just a simple tumor that can be removed and 100% cure is obtained.  Now for the insurance issues, some hospital will allow a cheap surgical options, NEEDY MEDS  website will help you to locate such cheap location.Hope it helps.Dr. JAY PATEL",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does hernia operation cause infertility?\n\nI m a 30 year old male trying to get pregnant with my wife. I had bilateral hernia repair when I was an infant 18 -24 months. I would like to know if this surgery could somehow affect my fertility. We ve been trying for 6 months. She s in good health, 32 years old and has been seen by an OB/GYN.",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.As bilateral hernia impairs Testes vitality or not should be investigated with color doppler scan of scrotum to see vascularity of testes, Varicocele.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pins and needles on the head and eczema when stressed out?\n\nLately I have been stressed and when that happens I break out in eczema. My head has been acting up. It hurts on my right side sometimes or the back. It had pin and needle.feeling a times mostly when I have a strong sudden emotion, like shock, and it hurts when I touch sometimes. And I feel kind sick sometimes. I was wondering if this is stress or anxiety related.",
    "doctor_response": "Hi dear. I had gone through your query. I understand your concern. Stress and anxiety will lead to various symptoms it can be physical or psychological. Headache/fatigue/numbness etc are the symptoms. Try to reduce stress and  do pleasurable activities. Exercise and meditation can be useful. Proper sleep and diet can help.It can be treated with benzodiazapine like anxiolytic. Etizolam can ne taken as and when require. Do take advise from your treating doctor. Consult psychiatrist and get further assistance. Still if you have a query then feel free to ask. Thank you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe dizziness with neck pain?\n\nmy husband had an unusual neck pain last night along the back or side up to his head. today he feels dizzy and said the light on the electric blanket indicator was rising ...ie moving, which it could not...he had a visual episode. is this a stroke warning? He had been doing some work on a ceiling, looking up. He is 73, active.",
    "doctor_response": "Hi, Welcome to HealthCareMagic.comI am Dr.Bruno Mascarenhas.  I have read your question with care and understand your concerns. Let me try to help you You have mentioned the following complaints1. Severe Dizziness2. Neck Pain along the back or side up to his head3. Said Light on the electric blanket indicator was rising Neck Pain can be a manifestation of Cervical Spondylosis or some other problem of Neck Dizziness and the next complaint may signify reduced blood flow to brain which can occur in Cervical Spondylosis Left unattended, this can even lead to stroke laterHence I would suggest that you consult a Neurosurgeon at the earliest Hope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes an increase in the TSH during pregnancy?\n\nHi, I am 2 months pregnant and my TSH is 8.77I have my appointment with Gynic today evening. But meanwhile just want to check if 8.77 is concernable? I remember taking thyroid test some time ago and noticed it was perfectly normal. What made this TSh go high all of a sudden. please help.",
    "doctor_response": "Hormonal imbalance will be seen during pregnancy.Baby mental development depends on thyroid hormones.You need to be monitored regularly for TSH throughout ur pregnancy.Dont think too much about this.Just relax nothing will happen wrong.k.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes an anteroseptal infarct on ECG?\n\nif an ecg states that you have had an anteroseptal infart on several different occasions and an echocardiogram shows a thickened septal area and it is nearly a year since the incident that makes you think that you have had an mi, what is the likelihood that the anteroseptal event actually happened and was not just something like indigestion",
    "doctor_response": "Hello, Welcome to HCM.Anteroseptal infarct seen on ECG or EKG = electrokardiogram means that you did have a heart attack = the heart muscle was damaged by a clogged coronary artery and this is what causes the changes seen by the doctors on the ECG recording. These changes are quite specific and characteristic and it is not likely that other medical conditions like indigestion would have produced them. Also, since these changes were seen on several different occasions, this makes an anteroseptal infarct  quite certain.After an infarct the damaged area of the heart muscle undergoes scarring and it may also result in thickening of that area as seen on the Echocardiogram.Some patients, especially diabetics, do not have symptoms like chest pain when they are having their heart attacks, so it is possible to just see the EKG changes of an \"old MI\" old myocarial infarction on an EKG while the patient does not even know that they had a heart attack.Typically an acute heart attack causes severe chest pain, Shortness of breath and makes one very ill and treatment in the hospital is required , where blood tests are done to confirm a diagnosis of so called acute MI.Hope this helps you understand this issue.Wishing you best of health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen lymph nodes in the groin?\n\nHi, I appear to have swollen lymph nodes in my groin (underwear line) area and it is quite tender and painful to touch. When I push down it's as though there is a lumpy substance underneath. I am currently menstruating and wanted to know if this could be linked and if it's normal? It's quite worrying, please help!",
    "doctor_response": "Menstruation should not be causing swollen lymph glands. This is not normal. Swollen tender lymph glands are generally a sign of infections. There are a couple of sexually transmitted diseases that do this, as well as other types of infections. These need to be diagnosed and treated. I strongly urge you to have this evaluated by a doctor soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain, headache,lack of sleep and vomiting?\n\nhi, so i have chest pain(on the left side) for almost 2 and 1/2 years now,and many other symptoms including left arm pain if i carry anything light or heavy,got high blood pressure,never sleepfor more then 2 hrs and if i sleep an hr more i wakeup every 30 mins,painful headach which never seems to go away,sometimes got backpain,lately been having extreme cold feet,hunger cramps,drink lots of water and go to the bathroom like hundredh times a day(few days i counted how many times i go the bathroom and in 15hrs i went like 17 times),abdominap pain almost everymorning,whenever i get full i feel nauseas and feel likevl vomiting,since i was born i have this skin whichdifferent from other skin types it heals like almost never(too slow) a little cuts take weeks to heal and the tiny wounds spread bigger,uglier and more bloody,if people touch me like tickle or poke its too painful and hurt for days even might leave a dark bruise sometimes....i dont know whats wrong with me seriously...",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. By your history and description, in my opinion, we should rule out cardiac disease and diabetes in your case. Left sided chest pain with left arm pain in an hypertensive patient demands investigations to rule out heart diseases. So get done ecg, 2d echo and stress test. Diabetes can be the cause for your frequent urination and delayed healing of skin lesions. So get done fasting and post prandial sugar levels. Better to consult doctor, discuss all these and first diagnose yourself and then start appropriate treatment. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What may be the cause of discomfort and pain in stomach and left hand?\n\nSir I am 41 years old.Last september I had some discomfortness and i had pain started erecting from bottom of my stomach and i didnt have any pain in the chest.I was rushed to the hospital and docotors did ECG and 2dEcho and given thrombo injection.I became normal and on the next day doctor did angiogram and found LAD type III vessel 99% blockage and angioplast+ PTCA was done and drug eluted stent placed.I am using Brillanta-90 mg twice a day,ecosprin once a day,cardivas-3.125 twice a day taking. To my left hand i feel some pain at nerves and when i am rubbing that area the blood is getting clot and after 2 to 3 days clot is disappearing. Can you tell me why this is happening and any remedy?Kindly suggest what risks i have and how to minimize.",
    "doctor_response": "Hi.Thanks for your query.You had a diagnosed Heart attack ( myocardiac infarction), then only thrombolysis injection is given.Since you are taking medicines for the Heart ailment- it is possible to see the clots you are seeing on the left hand. Get your blood coagulation profile checked.Due to heart problems you have to continue on the medicines as already prescribed. These help to avoid clot formation in any blood vessels.Do not rub hard on the skin.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can liquid iron ingestion help in anemia?\n\nI have severe anemia and have been drinking liquid iron for almost a week now and my blood count still is dropping. Last week my blood count was at 9.5 and a few days later it went down to 9.1. I don't understand why it keeps dropping if i'm drinking the iron.",
    "doctor_response": "Thanks for contacting HCM. Dear patient you have not mentioned the cause of low haemoglobin, because if the cause is not treated iron supplements can't work, its like trying to fill a can with water with hole at bottom, whatever you pour in gets out of the hole. Also iron content of the liquid iron is very important as most of the liquid iron preparations have low iron content. You should take an iron preparation whose each dose should give you atleast 100mg of elemental iron and should be taken 2-3 times a day after meals. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower abdominal pain due to hysterectomy. Burning urination, swollen vaginal opening. Reason?\n\nI am 48, had f/c hysterectomy at 40. I have noticed on and off for about 1-1 1/2 wks now a mild pain in my lower right abdominal area (almost felt like i did when I was ovulating). Now tonight when I went to go pee I all of a sudden experienced severe burning and pain like some one dipped a cotton ball in rubbing alcohol then wiped me with it......I was in extreme pain...and now my vaginal opening is starting to swell. What could this possibly be caused from. And why all of a sudden with no other symptoms prior to tonight except mild pain in lower right abdominal area?",
    "doctor_response": "Hi and thank you so much for this query.I am so sorry to hear bout these symptoms and hope we find a quick solution to help you get over these worries.From the information you have provided, i am concerned that you have a vaginal infection. The description of your pains point more towards an irritation from the urine than a painful urination. Also, these symptoms and infections is unrelated to the surgery. This will require that you get consulted by your OBGYN for a complete physical exam. Depending on the findings, you may go on to provide a specimen for laboratory analysis from the vaginal. These would provide exact diagnosis and a treatment plan would be established to help you get over this problem.I hope you find this helpful Wish you a rapid resolution of symptoms and good health. Feel free to ask us more questions if need be. Thanks.Chobufo, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a congenital malformation of the L5 lamina, retrolisthesis and spondylitis. Please advice.\n\nHello doctor, I am a 31 year old male, 6 feet tall, and I weigh 215 pounds. Based upon an MRI scan 3 years ago, I have a congenital malformation of the L5 lamina, retrolisthesis and spondylitis. Degenerative disc in L3 L4 and L5 S1, slight curvature is seen in my neck. For the most part it is a nuisance that I tolerate. I went through pain management for a while, but could not afford the 200 plus medicines every month. Recently however the left side of my head and neck feel as if it has been caved in with a bat. No relief, no abation, just constant pain. As of last night, laying on my back causes both of my hands to go numb and a pain in my groin shooting to the back of my right leg has presented itself. I am no stranger to pain, but my day to day pain has elevated from a score of 6/10 to 8/10 and is pushing me to the edge of my endurance. Please advice.",
    "doctor_response": "Hello,\u00a0 Welcome to icliniq.com. I have studied your case.  Consult an orthopaedician online for further follow up -->  Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to stop yellow colored motion in infant\n\nHi, may I answer your health queries right now ? Please type your query here... mr doctor i want to know about my 3 month baby motion discharge yello colour last 12days i have been given medicine from children specialist but there is not stoping motion pls sugest me thanks",
    "doctor_response": "Yellow color stools is a normal finding in children. There is no need to give any medicine for this.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Atrophy and weakness in hand. Numbness in hands. Cause?\n\nwhilst using a screwdriver 12 years ago to drive a screw into a stubborn piece of wood i felt a severe twinge in my hand. after that i noticed tremors in that hand and arm. went to docs and was told it was dystonia . a few years later noticed atrophy in hand and forearm . after a few mri,s they thought mmn. had ivig but no improvement. atrophy and weakness now spreading to other hand and one foot. i like a good drink and i smoke . i get tingling/numbness in both hands in the morning after a night drinking. could it just be my lifestyle that is causing it all or is it something else?",
    "doctor_response": "Hi,Thank you for posting your query.Your symptoms are suggestive of a neurological problem, and the blame can not be put to your lifestyle alone.The most important condition is to exclude a cervical spinal cord pathology. This can be done by doing an MRI of the cervical spine. A condition called syringomyelia (where a cavity is formed in the spinal cord) needs to be excluded. Another condition to exclude would be anterior horn cell disease. This can be done by doing an EMG study. Please see a neurologist for evaluation and starting of the treatment.I hope it helps.Please get back if you require any further information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the lower left abdominal?\n\ndon't know yeah I have a pain in my lower left abdominal and I was wondering what it could be I feel weak all the time my veins start aching for no reason,I constantly feel tired and I don't know what to do. whenever the pain starts in my lower left abdominal I start getting dizzy",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.This is insufficient of the history. You should have provided more .Well, if one gets dizzy with the pain in the left side of the abdomen, this can be due to severe colitis. Get a clinical / physical examination bu a Doctor and ultrasonography to rule out any other internal problem.A proper diagnosis alone can lead to a proper treatment .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of fibromyalgia with lumps ?\n\nhi there my daughter has been diagnosed with fibremyalgia with lumps growing in her body.the dr had to cut quite deep into her back,these lumps had their own blood cells.the biopsy came back ok.Do you get lumps with Fibromyalgia or is it something totally different.she cant sleep properly because the lumps are growing and pressing on her nerves which causes her pain,especially in her back.Dr gave her trammodol which doesnt help thanking youEileen Laaks",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. She has fibromyalgia.  It is a difficult disease to treat.  She should take analgesic, antidepressants and antipsychotic drugs as her requirements.  Her lumps has no relation with fibromyalgia.  It may be due to some neural tumor like neurofibroma or schwanoma.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reaction of tamoxifen drug\n\nHello , I am a cancer survivor, I have been cancer free is 05 I'm going toward my 6th year.. Thank God... I am taking Tamoxifen 2 times a day. I was in the sun for a little to long like 4hrs I'm wondering if anybody knows if the meds has a reaction to the sun. I have little bumps and some big bumps across my neck where I was burnt and now coming up on my legs and arms.. I also take Lexipro thats the only 2 meds I take each day.. before when i went to the tanning bed (years ago) I had simular thing happen and was told it was tanners each. Any experience with these meds. help..thanks",
    "doctor_response": "I have seen oncology cases and havent seen such a reaction till now.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I having rashes all over the body?\n\nHello doctor, I have rashes all over the body from sauna visits I guess. I first noticed it three days ago. It started as bumps on ears and now they are all over my back, chest, neck, top of feet, knees and upper legs. Currently, I am taking Benadryl pills and topical cream.",
    "doctor_response": "Hi. I have gone through your case. It is an allergic reaction to the temperature and lights used in the sauna (attachment removed to protect patient identity). Please use Calamine lotion. Apply twice daily for seven days. Also, apply 1 % Hydrocortisone cream on as many lesions as you can at night. Only take a small amount. You can continue with Benadryl pills or use tablet Cetirizine 10 mg at night for seven days. Please avoid driving after Cetirizine as this induces sleep. Do not use any Dettol or safeguard or any other antiseptics. Try using mild soap. Wear only cotton shirts. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for loss of concentration after masturbation\n\nhi.... i am a man,182 cm,82 kg, and i am 23 years old, i did masturbation two times a day after i did it i felt trouble i can not focus my mind on anything ,is that true or it's just imagination and if true what i need to return to my usual state again .... thanks",
    "doctor_response": "HiThanks for using healthcare magicAfter masturbation, getting tiredness is normal. It is due to loss of energy from the body. It happens with every one after doing masturbation or sex. In that case, you can take 5 or 10 minutes power nap and that would help you to come out of that tiredness. In case, you need further knowledge about that you can consult me.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pelvic pain, indigestion. X-ray showed ovarian follicles. Any ideas?\n\nHello, I went to emergency last Saturday because of piercing pains in the lower right pelvic area. Also I had terrible indigestion for 5 days. The Hospital did some x-rays to say my appendix is fine( I thought it was my appendix) he said there were some follicles on my ovaries but no need for surgery. Now almost a week later the indigestion is back and I have sharp pains under my right lower rib cage? I was juicing for 3 days when these pains began. Please if you have any ideas could someone help? Thank you for your time.",
    "doctor_response": "Hi.Pain due to appendicitis will be in the lower part of abdomen on right side. I think Follicles in the ovaries are seen in Ultrasound abdomen.Pain under the right lower rib cage may be due to Gastritis/Stomach ulcer.Please avoid spicy food.take regular diet.Consult a Gastroenterologist for upper GI endoscopy if your pain is not relieved by Proton pump inhibitors.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment for hepatic jaundice\n\nhi......i am suffering from hepatitic jaundice from past 18 days. at that time the bilirubin level was 8.20 and SGPT count was 5860...know it is decreased and the count is now 221...and the bilirubin is 9.50....is it improving according the way it should??? and with this there is gas problem.....what is the reason for that?????",
    "doctor_response": "hi.thank you for posting query at HCM.noticed your suffering from hepatitis.most likely, it seems HepA infection. HepA infection is self limited disease.however, its recommended to rule out Hepb and hepC.have restcut fat in dietdrink sugarcane juiceavoid alcohol and junk food until liver enzymes return to normalrecheck liver enzymes after 6 weeks'wish you good and sound healthany further questions are welcomed.regardsDr tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should Tamsulosin be taken for the enlarged prostate?\n\nMy doctor just put me on Tamsulosin for an elarged prostrate. I told him that I had found that taking Ibuprophen helps considerable with the urge to urinate often. He said Ibuprophen wouldn t help at all and I argued with him about how I had used it for over 3 years with great results. I only took it though, before work or before going somewhere. What do you say? Am I better off taking the Tamsulosin, which I d rather not take, if I don t have to.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.No, you should take tamsulosin. It is better to take it than ibuprofen.Tamsulosisn is alpha blocker drug and helps on preventing oversize prostate. It also helps in urine flow. So seeing its prostate benefits you should take it rather than ibuprofen.Ibuprofen only helps in pain. It has no effect on urine flow and size prevention. So better option is tamsulosin.Also check the regular PSA value in serum. Increase in much higher value is suggestive of carcinoma of prostate and should be dealt accordingly.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stiffness in knees?\n\nEarly this week I woke up with stiffness in my right knee. As I walked I heard a pop and felt like something slide across my knee cap.Sometimes now there is no discomfort but other times the stiffness and popping occur. I am a 72 year old female in good health.",
    "doctor_response": "Hi...The stiffness and popping in your knee could be due to imbalance of muscles around the knee, especially tightness of gluteus and quads led to uncomfortable positioning if your knee cap...leading to stiffness and popping..I would suggest you toKeep a icing your knee 3-4 times I a day for 15 mins..Gently stretch your Front thigh muscles by bending your knee and touching your heel to butt...take it as far you can if you are not tolerable or flexible..for gluteus stretch bend your knee place your keg on a but high platform and try bending forward.....Gently knead above the the knee and around the patella to reduce the spasm and stiffness...once your knee becomes comfortable...then do bridging... clamshell...step ups...Hope this is helpful for you...Revert back in case you need any further clarification..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for asthma cough\n\nMy child is 7 year old (boy) and he gets this athma cough once in every month.I am using seroflow/forecart for almost 1 year .How long will he have to use that ? Can he play regular games,swim or climb ?Is there any other ways to avoid these attacks ? WWW.WWWW.WW",
    "doctor_response": "HI Thank for asking to HCMI really appreciate your concern if this is allergic asthma then you have to take care for underlying allergic factors, you have to keep the child from this, and in my opinion you have to consult the good pediatrician form there you would get the complete information, and if this is not the allergic asthma then the underlying  cause of this need to be ruled out, as long as the allergic problem is concern this will go away with the time, hope this information helps you, have a good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have stomach pain, on vesicare. It is not helping. Suppose to have a surgery for transvaginal tape. Ulcer or gall bladder?\n\nI am having pain in my upper stomach area after I eat.the pain does not go away and I have to take some meds to try to cqlm it cqlm it down.  Do I have a ulcer or gall bladder?  I am suppose to have surgery for transvaginal tape in the bladder area soon. I am on vesicare and it is not helping. I have beening on this surgery and have read a lot of negative on it lwhat do you this.  The ves9care 9s j0t helping me at all since she doubled the dose   Jackie in Ohio",
    "doctor_response": "Hello,Welcome to Healthcaremagic.There are many causes for upper abdominal pain.As you are waiting for surgery, it is essential to identify the cause for upper abdominal pain.Causes are indigestion, peptic ulcer, Gastroesophageal reflux disease, cholecystitis.Most probably it could be due to indigestion or gastric ulcer.Proton pump inhibitors like Pantoprazole and antacid syrups are helpful.Antibiotics may be used if H.pylori is suspected.But if it is associated with vomiting, belching, dark coloured stools need a investigations.Usual investigations are  Upper GI endoscopy, H.Pylori test, Occult blood in stools. etc..Consult a Gastroenterologist.Hope this Helps.Take care.Regards,Dr.Manjeth.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rashes on hand and wrists?\n\nI have a rash on my arms. It started a few days ago with tiny  pimples like rash on my hands and wrists. About 7 pimples. Now it moved up my arms almost to the shoulder on my right arm but the rash changed. Instead of tiny pimples I have about 1 cm size round red a little raised spots. I have three on my right arm. And had one on my left on on the wrist (2 pimples close together actually become a spot like that). I also have a couple spots on my right hand's fingers too. I think I might have a couple pimples on the back of my neck (lower part). It doesn't always itch, but when it does it itches a lot. I never had any allergies.",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, two possibilities are there one is allergic condition and second it could be some viral infection in either case first is to wait for some time it may come around on its own, second it can be managed with steroid and antibiotic like \"Beclomethasone\" and Neomycin\" cream, else this is noting to worry, hope this information helps, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Has portal vein thrombosis, cirrohsis, liver tumor, had peritonitis infection. Solution?\n\nMy mother was just told by doctors, that she has pvt (portal vein thrombosis ), cirrohsis, and a baseball size tumor in her liver . she was in the hospital with peritonitis infection...she s hemorraged # times in 1 month..has had 3 transfusions.....How long can this go on?????? she s looked 9 months pregnant and has went down some..... How long can she live like this?",
    "doctor_response": "Hi and welcome to HCM. Thanks for the query.Unfortunately this is very serious codnitions with poor prognosis and nothing cant be done to prevent the worst. it is hard to predict how long can she live but i am sure that doctor will give all to prevent significant hemorrhage and pain. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I get pregnant when on Mirena IUD?\n\nHi, I am 26 years old and I weigh 165lbs. Have had 3 miscarriages and 2 live births by cesareans on April 11, 2009 and April 16, 2010. I am currently on the Mirena IUD. I have been on it since September 17, 2010. I bled from then till this February 2011. I didn't bleed again until September 9, 2011 for 4 days, then again October 9, 2011 for 4 days. Then in November I checked for my strings and couldn't feel them, when I used to feel them monthly until September when I had this cycle. For the past two weeks I have been having cramps in my left ovary and I have been haiving sore nipples. Should I worry or take a pregnancy test, or should I just contact my gyno.",
    "doctor_response": "Hello,With Mirena IUD, chance of pregnancy is extremely LOW (less than 1%). However, you should undergo one home pregnancy test if you have missed your period.As you don't feel the thread of IUD (may be displaced), I suggest you to contact with gynecologist for pelvic examination. You may require one USG scan additionally.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could you please tell me tablets for sprain ?",
    "doctor_response": "Hello lakshmi; welcome to HealthcareMagic For sprain you can take a painkiller to get relief from pain.The more important thing is to see your weight as the dose of medicine depends upon the body weight of a person and you need to specify where you have sprain.The best option is to consult a doctor close by and get medicine prescribed. Take care. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes allergic rashes all over the body?\n\nMy wife is in carrying 9th month, since 3 days she is suffering from high allergy- she is not able to control the allergy, she is scratching allover her body.Due to which rashes appeared on her skin, we have consulted over regular Gyn. she has prescribed the some ointments but those ointments are not at all working. Could you please suggest how get rid of allergy?",
    "doctor_response": "HI, thanks for using healthcare magicIt may be an allergic reaction or one of the rashes that occur specifically in pregnancy.There are some skin conditions that occur only in pregnancy and can be associated with severe itching.In addition to the topical ointments, she can use an oral anti histamine. It will not harm the baby.These anti histamines are given both in pregnant women with allergic reactions and in some of the specific pregnant related rashes.Examples are benadryl, claritine, allegra, zyrtec.Should be available over the counter.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the sharp pain in my ribs followed by sweating?\n\nHi i keep getting a sharp pain at the top of my ribs on the left side it will last awhile then turn into a dull ache i just wanted advice also I have been sweating a lot which might be nothing to do with the pain but i don t usually sweat this much thanks for your time amy",
    "doctor_response": "Thanks for your question on HCM.In my opinion we should rule out cardiac cause as most common cause for left sided chest pain and perspiration is heart problems. So get done ECG and 2D Echo to rule out cardiac cause.If this is normal than get done CBC and thyroid level (S. TSH) to rule out anemia and thyroid diseases.As anemia and thyroid problem can cause chest pain and perspiration. If both of these are also normal than your symptoms are mostly related to stress and anxiety. So avoid stress and anxiety.  Be relax and calm.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes head spasms?\n\nHi, My son is 11 and is experiencing what I call head spasms he has had them for many years, but they have been seldom. They are occurring more frequently. Our Dr. just sent my son for an MRI. I was just wondering if you have seen this before and what it might be? thanks Stacy",
    "doctor_response": "Please stay with the doctor and await the MRI results. At the same time, there are rarer causes of such head spasms which need to be considered. Some of them are due to metabolic errors. An example is Wilson's disease, which is an error of copper metabolism. Please suggest this to his doctor if the MRI is normal or not going anywhere.Dr. Taher",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain on left side near heart when laying?\n\nI get a sharp pain on my left side near my heart whenever I lay down for a long period of time. It's worst when I lay on my left side. I went to the doctor for it in my mid 20's and they could not find anything wrong. I'm 49 (male), have always been very active, and in great health otherwise.",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!I understand your concern and would explain that your symptoms may be related to a gastro esophageal disorder (reflux or esophageal spasm). A musculo skeletal pain can not be excluded by this clinical scenario. Your symptoms don't seem to be related to any cardiac disorder. I recommend consulting with your GP for a careful physical examination, a resting ECG, a chest x ray study and some blood lab tests: -complete blood count- PCR, sedimentation rate (inflammation)- blood electrolytes- kidney and liver function tests. A GI endoscopy is necessary to exclude the above mentioned gastro esophageal disorder. Hope to have been helpful!Greetings!Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Taking homeopathic medication. Taking meprate and glycomet. What is the drug action?\n\nHello, married since 3 years.. Trying to conceive since then..For about two years i had homeopathic medicine.. but did not get any positive results.. hence we opted for holopathy medicines.. For about 2 and half months am taking the following medicines..(Meprate and Glycomet)..Please advice me what effects will these medicines have in me.. are there any chances in getting pregnant and how long should i take these medicines for getting pregnant..",
    "doctor_response": "Hi, Firstly, I would suggest that you see an infertility specialist who can assess you properly with all the necessary investigations before initiating any sort of treatment. Meprate is medroxyprogesterone, a hormone used to treat progesterone deficiency states. Glycomet is metformin, an anti-diabetic medication used when insulin resistance is suspected as a cause of anovulation. By maintaining the blood glucose levels, this drug aids in inducing ovulation. They may be taken until your doctor insists. Medroxyprogesterone may be changed to something safer while metformin can be continued. Please get further suggestions from your doctor. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On implanon, taking trimethoprim, nauseous, stomach pain, negative pregnancy test. Antibiotics affects birth control?\n\nI've been on implanon for around 2 years, and I was taking some antibiotic's called sulfameth/trimethoprim last month, and for the past few days I've been feeling nauseous, tired and having pains in my stomach, though they don't lest very long,. but I took a pregnancy test and it had came up negative. and I was just wondering if it would affect the test. and if that antibiotics would affect the birth control.?",
    "doctor_response": "Hi,Trimethoprim can affect contraception to some extent. I suggest getting a pregnancy test. Please repeat a urine pregnancy test if you see your cycles and have missed them or go for the serum beta-hCG estimation which is more sensitive and specific. You should also get a trans-vaginal sonogram to review the pelvic organs. Please also remember that the antibiotic itself can cause some amount of gastric distress. Please see your doctor for further suggestions. Hope you find this information useful. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do symptoms such as headache, ear pain, cough and burning throat indicate throat cancer?\n\nhi my boyfriend has complained today of having a headache, ear pain, cough, and burning throat. he's worried he may have throat cancer, i think it could be strep or something related. he is worried because he uses the juul and has had a cough with it, he said the cough started when he started chewing",
    "doctor_response": "Hello, It seems like a viral infection and you should not worry, but if the symptoms get worse consult your doctor. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Esmeralda Sera, Oncologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain with bulging disc\n\nWas told I had bulging disks at L4 and L5/S1 with calcification. I have had been in constant, moderate pain now for 3 yrs. I am not sleeping well due to the pain waking me up at night. First thing in the morning, I can barely move and again in the evening the pain increases. I have been to physio and the exercises I was instructed to do are making the pain worse. Should I stop or push through the pain?",
    "doctor_response": "HiThank you for asking HCMI have gone through your query.Your problem is most likely due to nerve compression syndrome from disc bulge.A physical examination and a X ray followed by a MRI if needed of Lumbosacral spine will be needed to find the extend and severity of condition.For mild to moderate cases i advise muscle relaxants like cyclobenzaprine NSAIDs like aceclofeanac, or tramadol.I send them to physiotherapy and exercise along with this.If no improvement in this or the condition is severe then i recommend surgical correction like microdiscectomy,laminectomy or chemonucleosis according to the requirement.Hope this may help you.Let me know if you have any further query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of washing mouth after tooth extraction?\n\nHi I got my tooth extraction today after we went to the dentist I decided to eat some noodles after I ate the noodles I seen my tooth wasnt blood no more so I decided to wash my mouth and literally brush my teeth away from the extraction side. After I brush it I seen a doctor papers showing what to do and not to do i feel stupid coz I didnt read it first so I kinda panic now coz I wash my mouth today that it not supposed to my question is what is the side effect of washing my mouth after my tooth extraction? I still feel pain and numb around my tooth..",
    "doctor_response": "Thanks for using Health Care.Read your query.Vigorous gargling after extraction is usually advised to avoid to prevent the dislodgment of the clot formed. If there is dislodgement of the clot it can lead to dry socket.Relax ,if you have already done it. Continue with the proper medication prescribed by your dentist. Pain and numbness will gradually reduce.Salt water gargling is to be done though not vigorously.Hope this was helpful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain and bruising in knee after a fall\n\nMy boyfriend s knee is really sore he fell off his bmx and had banged his knee severely he said its painful to touch and he can hardly attempt to climb up the stairs its bruised and cut is there any way possible to heal his knee so I can help him out.",
    "doctor_response": "Hello, As he had a fall direct impact over the knee, there will be pain and swelling. Since you will be adviced to take at least an x-ray for the safe side if any bony injuries are present shouldn't be ignored. For now, you can do icing and knee brace. This will help reduce pain and swelling. May be you can get it physically examined once. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have hemangoma. Have bulging enlarged veins in the forehead, Feels weak and looks pail. Recommendations?\n\nI have a student that may have hemangoma.  Doctors are still running tests to determine a definite diagnosis.  She has bulging enlarged veins in the forehead.  She often has episodes that cause seizure like symptoms.  She turns pail, has weak mobility, and then cries.  After these episodes that last about 30 seconds, she sleeps.  Doctors are concerned with a hit to the veins being fatal.  What recommendations would you have for a school environment to keep this child safe.",
    "doctor_response": "Hi,Her symptoms are consistent with seizure phenomenon ( fits) ,she has to be put on antiepileptic drugs.This will prevent falls and hit to the veins (hemangioma)Avoid stress at school, and requires timely tiffins at school.Hope this will help you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath and burping?\n\ni am a male of 21 yrs fully healthy,,,since from 5months m havin shortness of breath along with burrping continously,,havin some abdomain pain,tightness of stomach n chest part,,,went 2 hospital done all test ,like ecg,cbc.liver function test,endoscopy,x -ray,,evrything is normal..but having bilirubin direct n globulin little more,,,,,,can any one help me out please",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Since all your investigations are normal, no need to worry for heart diseases. Shortness of breath in young age (21 years) can be due to asthma. And for the diagnosis of asthma, you need to get done PFT (pulmonary function test). You have not done PFT yes. So in my opinion, you should first get done PFT. If PFT is normal then no need to worry for asthma. Stress and anxiety can also cause shortness of breath with burping. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on it's solution. You may need anxiolytic drugs too. Don't worry, with counselling and drugs, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I took Ovares plus tablet for 20 days and missed my periods. Please help.\n\nHello doctor, I have missed my periods for four days and last 20 days I have taken Ovares plus tablet. After two days, I took the test and the test was negative.",
    "doctor_response": "Hi. How are you doing? Ovares plus is Dehydroepiandrosterone Sulphate with Melatonin. Medical companies claim it has wonders, but trust me it is an innocent medicine with no much effect or side effect. The doctors advice that it increases the number of active eggs from ovaries. But in my own experience, eggs are God given in a specific number, no one can increase it. Unfortunately, you have not mentioned your age. Good age for lady to conceive is 19 to 35 years. After this, eggs reduce in health and number, that is when doctors claim this medicine will help. I mean to say whether you take Ovares plus or not nothing will change the periods. It is costly too. About your periods, you can wait for a maximum of seven days after periods, check your urine pregnancy, if still negative, have any of the oral combined contraceptive pills (Novelone or Dear 21 or Duoluton-L or Ovarel -G or Intimacy plus 3 ) twice a day for 10 days, throw away the 21st tablet. You will get periods within 10 days of stopping the tablet. Do not worry about any side effect. These hormones are the same produced by the body. If not checked have thyroid profile and serum prolactin checked early morning, empty stomach. These hormones can interfere with normal ovulation. If it is the doubt that you have adequate eggs in ovaries, check serum AMH (anti-mullerian hormone).",
    "dialogue_context": ""
  },
  {
    "patient_message": "Small bump on lower stomach, painful, difficult to walk. Treatment?\n\nI have a small bump on lower stomach just in the crease between abdomen and pubic mound. It is very painful, very difficult to walk, or move in general is very painful. Almost feels like after you get shot by paintball or something. On further inspection it is quite big, about size of golf ball, but it seems to be under skin. There is no visable lump or redness or spot at all. it really hurts and painkillers aren't helping.",
    "doctor_response": "Is the bump present at all times or does it appear only on sitting or standing position and disappear on lying down? please go and see your GP about it, he/she will be the best person to have a look at it and if need be do some investigations and suggest treatment for it. The investigation may include a ultrasound as well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the abnormal lab values for onset dyspne and pneumonia?\n\nwhat are the abnormal lab values that one can find in a patient with onset dyspnea, possible pneumonia, and open skin areas and bruises and also has had cirrhosis for at least 5 years but continues to drink 12 beers every night. and why would these test be ordered? thanks",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. If patient is having cirrhosis of liver with, pneumonia and dyspnea than he/she will have following laboratory values abnormal. 1. Low hemoglobin and high total WBC (white blood cells). 2. High ESR (erythrocyte sedimentation rate) 3.  Raised liver enzymes like SGOT, SGPT. Raised bilirubin. 4. Low protein levels a specially albumin. 5. Chest x ray will show consolidation and infiltration. So better to consult doctor and first get done clinical examination. Than order investigations and start appropriate treatment. Hope I have solved your query. Wishing good health to your patient. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "SGOT, SGPT, cholesterol, moderate drinker, suffer from jaundice, fatty liver, chronic acidity, taken gelusil and ranitidine. Exercise?\n\nHi, i am 40 years of age. recently during routine check up i found SGOT 95 & SGPT 63 cholesterol 250. i am moderate drinker, weekly 4 pegs., food mostly non-oily limited qty, non veg with no red meat, weight 67 for 5 6 height. I suffered from severe Jaundice , fatty liver at the age of 8. After that i never had problem but i suffer from chronic acidity, not severe, can be controlled with gelusil or occasional ranitidine 150. Otherwise i am healthy, active, fit compare to many others of my age and no problem from health. Pl advice, how severe this findings are, how can i reduce these values without changing my lifestyle & habits much. Any exercise or therapeutic medicines without side affects which may help this. Thanks in anticipation. - Shyam",
    "doctor_response": "unfortunately there are no medications to help much with this if you continue to drink alcohol. alcohol will continue to damage your liver and inflame it, and this can lead to cirrhosis, which is the terminal phase, and the liver slowly stops working and leads to a lot of complications. so no matter what supplements you try or medications you are recommended, none of them will do anything if you don't change your lifestyle.Losing weight will also help, but the \"fat\" in the liver is mainly from alcohol.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from chest pain for three months. Kindly advice.\n\nHello doctor, I have chest pain for three months. I took ECG, Echo, TMT, my reports are normal. But still, I have the same problem. I take Solopose Beta 0.5 mg. My blood pressure suddenly rises to 120/90.",
    "doctor_response": "Hello. I understand your concern and would like to explain that as all your cardiac tests have resulted in normal, a cardiac issue is almost excluded. A 24 hours ECG monitoring test (Holter) would be necessary to eliminate any abnormal arrhythmic event. Probably the most important aspect to explain your symptoms seems to be anxiety. It may exacerbate tachycardia and also unpleasant chest discomfort. But, before getting to that conclusion, I would recommend a cardiac magnetic resonance imaging test. Also, be careful with your current medication as it contains a beta blocker (Propranolol), which if not taken continuously may lead to a rebound effect (increased heart rate). I hope to have been helpful to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Clindamycin the right medicine for tooth abscess?\n\nHad severe abscess when out of townFound dentist who accepted emergenciesGave ne prescriptions for clinamycin and hydrocodone/acetaminophenTold not wise to start rc when traveling on SundayExcruciating pain from Thurs. a.m. through MondayWent to CWRU Dental Clinic Mon. a.m.Incised and drained by endo. to makean appt. with the dentist who would in turn get an appt. for rcI protested...still on agony...finally agrref to do rcNow Wed. and face and lips still numb, painful jaw bone, and hard lump o chinThey are putting me off...mesnwhile I feel worse and have only one more day of antibioticsNot thinking straight.. What to do?",
    "doctor_response": "Hi..Thanks for the query..If you have been to Endodontist then it is a bit surprising that he incised and drained the abscess but referred to another dentist for RCT,. although Endodontist is a specialist in Root canal treatment..So my suggestion to you is to better refer another Endodontist only and get the Root canal treatment done..For now if pain is severe then you can take antibiotics like Amoxiclav along with stronger painkillers like Tramadol or Ketorolac..Do cool compresses over the hard lump under Chon that is a swollen lymph node secondary to tooth infection..Hope you get well soon..Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in belly button region?\n\nhi, about 4-5 days ago i started haveing a pain in my belly button region. as long as i kept busy i didnt notice. like out of site out of mind. but if i put pressure in that region it hurt. like bending or leaning against it. at night, only for two nights, everytime i turned it hurt and i woke up. when laying on my back, i can pinpoint the origin of the pain. i am very overweight which can play a big factor in many conditions. what could be the possibilities of what this pain is?",
    "doctor_response": "It can be a umbilical or paraumbilical hernia which is hurting you. Please see a surgeon for the management of the same.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is dry cough and tightness in larynges sign of viral infection?\n\nI have had a strange cold this past week.  Started with tightness around laryns and dry cough a week go.  Lost my voice.  Cough finally brreaking up a bit after a week but throat is inflamed and swollen feeling.  Started having inflamed eye 3 days ago thought it was better but now both eyes extremely goopy and inflamed.  Still coughing and not much voice.  Got this afte 40 hours of travelling home from Indonesia.  Have had no fever.  Does this sound like more than a virus.",
    "doctor_response": "HIWell come to HCM,I really appreciate your concern, yes this could be just viral infection, and this may take a week to come around till then condition can be managed with, symptomatic medicine and this is nothing to worry,  hope this information helps you, take care,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest healthy food diet to recover from typhoid fever\n\nHi doctor, My father in law has diabetes and he is suffering with typhoid fever and jaundice. Can you please suggest what food need to take care to cure those. And one more thing he is tooooo weak. Please suggest to increase his energy level which diet need to take. Thanks in advance",
    "doctor_response": "Hello.Welcome to Healthcare Magic.After typhoid disease and fever there is too much weakness due to low diet during that period with indigestion.There is more weight loss as on mainly liquid diets.So most important things in recovery phase is weight gain, maintain immunity and proper diet planning.Please avoid oily and spicy diet with fast foods.Avoid bread, jam, pow biscuits etc.Take green veg and fresh fruits more.Fresh fruits are superior than fruit juices.Also take lemon and orange more with honey which is anti infective and give energy.Take protein rich diet like beans, peas, eggs etc, will help in increasing your immunity.Take rice,dhal, porridge, butter milk more in diet.Strictly follow this for 15-20 days.Do some exercise too.Hope these all will help you a lot.Thanks for contacting us.Take care...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does the x-rays show signs of bronchopneumonia?\n\nHello doctor, A 2.5-year-old young girl got X-ray diagnosis bronchopneumonia, but her blood tests are all fine, nor she has a temperature. Just cough. We would like to see a second opinion on X-ray images.",
    "doctor_response": "Hi. I have viewed the X-ray chest image sent by you (attachment removed to protect patient identity). There are mildly prominent lung markings in the bilateral lunes and this can suggest hyperactive airways or a mild lung infection. There is no focal lesion or patchy opacity visualized. There is no pleural effusion. Keeping in mind the above findings, there is a possibile mild respiratory infection. There is no obvious pneumonia patch visualized. It is important to keep track of the symptoms and report to your doctors if there is an increase in cough or persistent fever, which I guess is not there right now.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Small rash on lower back, stomach, started spreading. Food allergy?\n\nHello, I woke up 4 days ago to a small rash only on my lower back and stomach. Now it is starting to spread to my upper torso on the sides of my breast and arms. The only thing I can think of is that I ate a lot of cereal and milk being that I didn't have it in a while. I don't have any allergies, so I am trying to figure out what it can be. Is it a food allergy or did something bite me. Thanks!",
    "doctor_response": "milk is major offender in patientsif you have taken mikit can be cause of allergy and anything can react at any time at any agetak antiallergic tab for 3 wk and apply anti allergic ointment on areaand get blood serum tests for specific antibodies for foods you take to confirm and withdraw to keep well",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of premature ejaculation?\n\nI am 36 year old and i got married in April 2010. I am 6ft and I weigh 65 Kgs. I never had sex prior to my marriage with anyone or even my wife ( then girlfriend ). Its been an year now and since the first time, i am facing this Premature Ejaculation. That is, i ejaculate within a minute while intercourse.Before getting married, I used to Mastrubate. I am not sure if Mastrubation has anything to do with Premature Ejaculation. ( Let me know, if it is related in some way). Moreover, I do smoke and I had been smoking for almost 15+ years now.Also, my foreskin is tight and it doesn't retract while the penis gets erected. For past couple of days I am manually retracting it on daily basis on a doctor's advice ( locallly ).  During the first month of my married life ( sex life, to be precise ), I even had kind of erection problem. I couldn't hold an erection for even a minute. The penis goes flacid right when I try to insert ( probably tight foreskin, not sure though ). I would like to confirm, if tight foreskin could cause Premature Ejaculation.?My wife gave birth to a Baby Boy on March 12th 2011. Please advice on how to get rid of this Premature Ejaculation as we will be resuming sexual life again shortly. I want to satisfy my partner. She doesn't have anything to complain but still...",
    "doctor_response": "Hi, Prone masturbation can cause this issue. What type of masturbation do you follow - regular hand in penis or penis on bed? Regular masturbation won't cause premature ejaculation. Foreskin tight can be due to phimosis. Share a picture for confirmation. Yes, phimosis can cause premature ejaculation. Circumcision is a option if it is phimosis. Finding the cause for your issue is also important. Share your blood sugar value. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe pain in testicles, belly button with swelling, tests showed strained abdomen muscles, small hard knot on testicle. Cause of concern?\n\nAbout a month ago i began to have severe pain in my growing area and testicles. Sometimes i would have pain near my belly button. My testicles were swollen to about twice their normal size. I thought that it might be a hernia so i went to the doctor. He said i just strained my lower abdomen muscles and that the pain and swelling were just side effects. A few days past and the pain began to lessen. I then found a soft lump on my left testicle. I self-diagnosed myself with a spermatocele . I masturbated and it went away, and so did the pain. I have now discovered a small hard knot on my right testicle. It is painless and is a little larger than the size of a bb. It is about halfway down from the top of my testicle and is facing towards my rear. I am not sexually active and i am 18 years old. Should i be worried? Any help is greatly appreciated.",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through. A sprained lower abdominal muscle may not be responsible for swelling in the testis. The description that you are giving suggest that there had to be trauma or torsion. 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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, taken two rounds of clomid. Is it early to take pregnancy test?\n\nI am currently trying to conceive and have been for the past two years.  My last cycle began December 9th.  I have taken two rounds of Clomid and my blood counts have increased to 16.6 last taken 12/30.  I haven't began a new cycle but sort of scared/anxious to take a pregnancy test.  Is it too soon?",
    "doctor_response": "Hello. Thanks for writing to us. The pregnancy test is likely to be positive if your periods are delayed by at least 5 days. Before that the test can be a false negative. Do wait for few ore days.I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal ,drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain radiating in groin area\n\nI am due for hip replacement 2-1, I have had several extreme pain that radiates through my gut and into my groin area. I had an incident 1 week ago where I had to use all my strength to get up off a toilet that was not handicap ready, I used all my strength to get up. Since then, I have had several radical pains that just put me down. Not sure if I tore something, or if it is my hip that is just needing help. Thank you",
    "doctor_response": "Hello, As a first line management, you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant fatigue in muscle along with migraines?\n\nI'm a 16 year old girl with Mitochondrial Disease/dysfunction and was hoping for an answer to my peculiar case. Everyday, I constantly deal with muscle fatigue and pain along with migraines.. but now a few new symptoms arose. They include high heart rate (130 resting), anxiety (currently being treated), and a sharp pain within the left arm pit. We've visited the cardiologist (more than once) with multiple EKG, echocardiograms, and 24 hour halter monitors.. but every doctor is stumped. Now I've come here hoping for an answer. Do you think any of you will be able to help?",
    "doctor_response": "Hello, Your clinical situation and past medical history, it is important performing further tests to investigate your heart. In this regard, I would recommend performing a cardiac MRI. If this test results normal, you should consider anxiety as a possible cause underlying your complaints. It is also necessary checking vitamin D, vitamin B12 and blood electrolytes, coupled with thyroid hormone levels. You should discuss with your doctor on the above tests. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Ilir Sharka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for infection in the gums\n\nHi, For the last few weeks I have had on and off cold and this week I have realised that the inner lower part of my nose is swollen.  Also, a few days ago my teeth hurt - it feels like I have food stuck inbetween my teeth - I assume this is due to gum swelling....",
    "doctor_response": "Thanks for your query, I have gone through your query.The infection in the gums can be because of the deposits. The hardened deposits secrete acid that dissolves the supporting bone and again gap will be created in between the teeth. So consult a oral physician and get your teeth cleaned and get a root planing and if required grafting done. For the swollen inner aspect of the nose, you can take a course of antibiotics like amoxicillin. If it is not reducing, then consult a ENT surgeon.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes less intake of oxygen?\n\nI don t know if its worth seeing a doctor or not. But I always feel like I m never getting enough oxygen and my heart races a lot, even if I m just sitting down or trying to sleep. Sometimes my vision will fade away and then come right back. And I get confused or like a dream state. Tired all the time. I m starting to sleep 12 hours and more, and can still take a nap. Even though I sleep a lot I now have dark circles under my eyes. I have a healthy diet. I never eat fast food. And watch what I take in. But I m slowly losing weight like crazy! I m 5 6 and 107 pounds. Any clue what could be wrong?",
    "doctor_response": "Respected user , HiThanks for using Healthcaremagic.comI have evaluated your query thoroughly .*  This is most likely combination of  anxiety , stress ; deficiency of   hemoglobin , vitamins , anti oxidants ; alterations in hormonal levels  as  thyroid or others .*  Needs  thorough  clinical  evaluations  with  history , physical      examination and series  of  laboratory  tests .Hope this solves your query .Can ask further  doubts  without any  hesitations .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Excess mucus production. Done MRI. Any clues?\n\nGood Morning - my 87 y/o father has been spitting mucous (sometimes it is as severe as vomiting mucous) - clear or whitish. one month ago, he spent the night in Emergency Dept of the local hospital whilst tests were run and MMR scan of his brain - apparently to rule out stroke, clotting, bleeds and brain tumour . He had a severe headache which was reduced with strong painkillers but took all night to recede. He has now been prescribed an anti-acid producing medication, but still has daily spitting episodes - not so much heaving or vomiting as he did when he experienced the severe episode that had him admitted. He is in OK health for his age !! and takes blood pressure meds daily, exalon patch daily, gout med (when required) and warfarin (just recently prescribed in the last few months - since the mucous problem started, so not related). Do you have any clues as to this excess mucous production Dr? (it is never greenish or yellow to indicate infection, but rather clear - like thickish saliva - and sometimes a little frothy. Thanks so much",
    "doctor_response": "hi as per the information provided by you the source of mucus is the stomach not the chest. as per the history of gout where the patient suffers form gastritis also. the acidic pH of the stomach is irritating the gastric mucosa and making him feel nauseated, causing emptying of the stomach every now and then. antacids along with regular intake of water will help keeping the gastric pH to near neutral . it will take a weeks time for the gastric irritation to go away , take care and keep the follow ups with your gastroenterologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for persistent cough after chemotherapy\n\nI was diagnosed with breast cancer in  1997, had a mastectomy with no lymph node involvement.  I had a recurrence in the chest wall in 1998 treated with surgery, radiation and tamoxifen.  I have moved through Arimidexdex, FAC Chemotherapy, Aromasin, 6 cycles of Dosa Taxol plus Herceptin, Letrozole, and two years of Avastin and Xelodal.  Since August, I have had weight loss, a persistent cough (with sputum, and light-headedness with one fainting spell.  An October, 2010 Pet scan showed some cancer activity in a nodule in the lung and in the sternum.  I have been on a drug holiday since November 2010, as my doctor tries to get results from a pulmonary function test.  I have a colonoscopy scheduled for October 2011.  My cough is getting worse, and yesterday I developed a pain in my mid rib-cage every time I cough.Short term question:  Is there some kind of cough suppression medicine I could take to prevent the pain of coughing?Long term question::  Should I go somewhere like the Mayo Clinic to get an opinion my situation?",
    "doctor_response": "Hi You can take codeine tb for cough suppression and you can go to Mayo clinic to be more convinced about ypur situation. Regards Dr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to improve sperm count?\n\nHi, may I answer your health queries right now ?  Please type your query here...Hi, My sperm count is 5.5 million/ml. Can I increase the sperm count. How many months it will take approximately and whether is is possible to increase 20 million from 5.5. million",
    "doctor_response": "Hello,Yes, if anything reversible its possible to reverse it completely. Do regular exercise, eat healthy, take your vitamin pills rich in vitamin C, D and E. Screen yourself for testicular infection, or any cyst in cord.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Sameen Bin Naeem, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red spots above the penis in the pubic hair area?\n\nI'm a 25 year old male, 5'9\", 150 pounds. Never have had any allergies or any health issues ever. For the last several weeks I've noticed smaller red spots or blotches of sort directly above my penis in the pubic hair area and also on my inner thighs. I started shaving this area for the first time several months ago and the area was always irritated and red. I was having unprotected sex with my girlfriend of the time and never had any issues then. Now over four months later these spots show up. They do NOT hurt, itch or feel raised above the skin. They actually seem to get more red after long days at work where I move, stand and sweat. Now after I wash the area and I've been using hydro-cortisone cream they actually fade away drastically. They come back though and never go away completely. I've also not shaved the area anymore thinking it could be tied in with that. Again there is no pain, no itching or any other weird colors, odors, puss or anything being secreted. Does this sound like a skin irritation, heat rash or something horrible? Thanks for any insight, it's much appreciated.",
    "doctor_response": "Hi. Thanks for a detailed description. Its much helpful. It seems like it could have been triggered by the shaving but has an element of fungal infection called tinea cruris. I would advise that do not shave the area as you have already stopped and apply anti fungal cream or powder on the area twice a day after washing and drying it. Your problem should ger resolved with that. Take care. Dr Rishi, New Delhi, India.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and foot pain with history of spine/prostate surgery\n\nmy father is of age 61 and have done 2 times spine sugery (lamenectomy in 1992 and 2008) and now 3 months before have done enlarge prostate sugery ,now he is suffering from fever along with pinching pain in foot.he is having sugar from last 15 years.in urine routine pus cell is 20-30.and negative result.please suggest me i,m from rural area what to do ?",
    "doctor_response": "Hello,Since diabetic patients are at very high risk of developing urine tract infections and infected ulcers as well. I need to know if he already taking any soft of medicine before testing his urine or not? If yes you need to stop antibiotics if he is still running fever and retest him for urine tract infections and foot ulcer as well. You need to take him to nearest hospital for following things:1. His sugar control2. His BP control if any3. Symptomatic relief4. Specific treatment of infections5. Rehabilitation careHope I have answered your question. Let me know if I can assist you further. Regards, Dr. Sameen Bin Naeem, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does inhaling sewer gases cause lung problems for an asthmatic?\n\nCan smelling sewer gases over a period of time, maybe a year at least can this cause lung problems with someone who already has had asthma all her life and uses an inhaler? I was put in hospital in December with my oxygen level at 62 low. Doctors could never decide what caused this problem. They are now saying it had to be pneumonia but they are not sure. I never thought about the gases at my home. They sent me home on oxygen. Taking a long time to get my strength back.",
    "doctor_response": "yes this is very common problem as any gas can increase the asthma problems as we inhale the gas it irritates the bronchi to irritate it",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having cellulitis on left leg spreading to right leg. Diagnosed with lupus previously. Suggestions?\n\nR/O cellulites non specific, unclear/undefined maRGINS NOW HAS BEEN DEVELOPING ON RIGHT LEG IN 2 AREAS APPRX 2-3 WIDE. THE LEFT LEG STARTED AT ANKLE AND IS ALL THE WAY UP MID TIBIAL AREA. PT BRIEF HX: 41 Y/O/ CAUC MALE OTHER WISE HEALTHY DX LUPUS X 2 YEARS AGO. THIS IS THE 3RD SO CALLED CELLULITES ISSUE ( THE LAST ONE warranted an inpatient series iof IV vacomycin x 4 days///This isnt quite same. I hAVE PROGRESSION PICTURES AND TIME LINE IF NEEDED",
    "doctor_response": "hi, it could be related to lupus, like a vasculitis. has a biopsy been done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have crowns causing problems, fell out, needs post care, gum has periodontal disease. What can help?\n\nhello,i need alot of major dental work and is in need of emergency care. I have 2 crowns causing problems. 1 fell out and needs a post core build up and  crown or implant. the other one is already to be redone as the gum is causing periodontal disease. as I have a primary dentist who already examed me a while back last year . the thing is that i dont have any money or funds to pay for the service fees and need this work done asap. care credit has ran my credit and it is not good because of a few things and one being is a bankrupty. i have tried to get a personal loan but that was also not approved. it will cost around 3,ooo and need asistance and can make monthly payment with some other source than care credit plan which is the main one most of the dental offices use that I have researhed. can you give me some ideas or let me know how you can assist me here. thanks ken mcquilkin",
    "doctor_response": "Hi,Welcome to HCM forum,Your condition needs an immediate care as one of your crown has came out and other also needs assistance.Consult dentist ,have a thorough clinical and radiographical examination of your oral cavity.If you are not able to spend such an amount, then you can visit any dental educational institute or government hospital for your treatment to be done.Wishing you cure soonTake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had large kidney stone crushed, stent put, removed, lost weight, dizzy, tired. What can be done?\n\nyes i just recently had a large kidney stone crushed and a stent put in. Last tuesday  i had the stent removed. i have lost weight and my blood pressure is 76/42 heartrate 80 i havent had to take my bloodpressure since surgery. i do still take my cholesterol medication and metform pill. feel a little dizzy and tired a little nauseated",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum. Now mention the latest report of BLOOD PRESSURE. It was 76/42 mm of Hg , means in shock condition. The best way is consult operating surgeon and get complete check up as this blood pressure may turn into lethal stage. Dizzy and nausea are due to low blood pressure.Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for bleeding and clotting through wisdom tooth\n\nHi I got 1 wisdom tooth out yesterday and a blood clot formed over night. I woke up with blood on my pillow and all around my mouth. Is this normal to bleed this much over night? And how do I get rid of the blood clot or should I just wait until it comes out on its own?",
    "doctor_response": "Hi! Welcome to healthcaremagic.I read your query. Bleeding is not uncommon for first 24hrs aftr removal of wisdom tooth. Also, oral bleeding is generaly bleeding and saliva. So may be the amount of blood you saw was less than that.I would suggest you to gently put a guaze piece over the wound area and bite on it. You can also put moistened tea bag as its tannic acid helps in stopping of bleeding. Change gauze piece if required.Sit upright or in a recliner. Do not rinse your mouth forcefully or drink through straw as it may dislodge the forming blood clot which is essential for blood stopping. You can put ice packs out side your mouth on surgical area, which helps in constricting vessels.Tranexemic acid tablet can be used twice a day for blood control.If the bleeding persists beyond 24hrs, please show it to the oral surgeon for any intervention required.Hope the answe helps you. Thank you!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the arm after implanon placement. Difficulty in bending the arm. Bleeding through the plaster. What happened?\n\nHi I have had implanon in since yesterday and I still have the plaster on top as I was told not too remove it for 48 hours, everytime I move my arm it stings and I can t bend my arm because of the pain. Also I can see a blood type colour coming through the plaster which seems to be coming through more and more as time passes but I m not sure if it is blood or if anything could be wrong with it? Also I havnt tried to remove the plaster at all too look under neath it at my arm where the liquid is coming from.",
    "doctor_response": "Hi, Thanks for writing to us. You should consult a doctor immediately because bleeding should not be there after implanon placement and you have difficulty in moving arm also. So better get your check-up done, may be you required implanon removal. Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Did procedures with dye, had kidney infection. What can bring down creatinine level?\n\nYes my dad is 74 with past kidney problems and they just did 2 procedures on him with dye . it is 4 days after any procedure and his creat level is still 2.6 . he has a kidney infection also. he has been drinking water and cranberry juice and they have been using antibiotics on him. question is there any thing else that can be done to bring the level down?",
    "doctor_response": "Thank you for using healthcare magic Your question does not indicate what his pre-existing kidney function was and I am making the presumption that the dye used was an Iodinated radiocontrast such as used for a heart catheterization or CAT scan and not a nuclear isotope or MRI contrast. There are a few things which can be done prior to the procedure to augment some of the potential kidney toxicity however once this has occurred, there is not much that can be done other than the following: -Avoid potentially kidney toxic medications including over-the-counter medications such as ibuprofen or naproxen -Avoid changes in volume status such as with diuretics -Avoid overaggressive drop in blood pressure such as with antihypertensives If the contrast exposure was without vascular manipulation such as a catheter/guidewire as would be used in a cardiac procedure, majority of the time renal function will recover to pre-existing baseline. If this is your situation then at this point he would have to wait and see where things stand about a month from now. If contrast exposure included a catheter or guidewire, there is the added risk of atheroembolic renal insult (small debris from the wall of the blood vessel dislodged by the wire injuring the kidney).  Renal function recovery may or may not ensue. Again re-evaluation is required in about a month's time Take care and be well",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a surgery needed for the swollen lymph nodes and thyroid removed due to cancer?\n\nI had a my thyroid removed 8 months ago due to papillary thyroid cancer and was told I was cancer free. About 8 wks afterwards and a dosage of 100mcg Synthroid I started feeling the same symptoms as before the surgery. I had an abnormal ultrasound which showed a neck mass or possible lymph node enlargement, a later CT scan with contrast showed normal. My dosage was raised to 150 mcg Synthroid plus 5000 units D3 daily. My GP is forwarding a copy of the reports to my surgeon. Why would the reports be forwarded to my surgeon? Does this mean there could be another surgery? I m confused.and still have pain on both sides of my collar bone ?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  You have papillary carcinoma of thyroid.  Now you have enlarged lymphnode.  You should go for lymphnode biopsy.  Lymphnode metastasis is very common in papillary carcinoma of thyroid.  So go for biopsy. 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is itchy red line along the arm after implantation concerning?\n\nI ve had my implant in my arm for 3 weeks now and I m concerned about it. I ve had no emotional problems or anything but my arm has a red line down it and it is itchy. A friend of mine had hers done less than a week ago and you can t see hers. Should I be worried?",
    "doctor_response": "Hi,Once your body heals from the insertion of the birth control implant, you should not experience any itching or any skin changes.  The rod also should not be visible unless someone is examining your arm very closely.The fact that you see redness on your arm is very concerning that the area may have become infected.I would recommend that you follow up with your doctor or healthcare provider who inserted the implant, as you may possibly need to be treated with antibiotics or even have the implant removed.  There is no reason to worry, however you should be seen right away (within a week) or if that is not possible at your doctors office, a visit to a local urgent care center or emergency room would be a good idea.I hope that I was able to adequately answer your question today, and I hope you get diagnosed accurately and treated soon.Best wishes,Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could rashes from abrasion be?\n\nHi. I had a case of MRSA recently that ive recovered from. But where one of the abrasions used to be, i have a itchy rash of bumps on the skin on that region. It is on my left inner thigh. I had a blood test for hsv 1 and 2 and the results were negative. What could this be?",
    "doctor_response": "Hi,Itchy rash on inner thigh may be fungal infection most probably.. called tinea cruris. However, consult the dermatologist for the diagnosis and proper treatment. I would recommend you to apply antifungal cream and to take antifungal tablets and antihistaminics under observation of doctor. Avoid soap bath. Keep the area dry.Hope this helps.Dr.Ilyas Patel, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the growth of fungus on pubic hair?\n\nI'm having something grom on my pubic hair, it is a yellowish color and looks like a fungus.. this fungis or what ever it my be seem to grow as the pubic hair does.. I am extremely disscused but this and looking for a way to rid my self of this problem~!",
    "doctor_response": "Thanks for contacting HCMI see you are concerned about yellow areas on you pubic hair. This is called folliculitis, where the hair follicles become infected either from shaving or from rubbing. To treat the area I recommend using a topical antibiotics like Neosporin and reduce rubbing or shaving. Sometimes if the infection is bad enough then an oral antibiotic is needed. Hope this answers your question. Please contact us again with your medical questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does ultrasonography results-liver echogenicity increased indicate?\n\nhi sir, i have did my usg of abdomen and it shows tht i have liver fatty change and my kidney size is RK 9.6cms n LK 10.7CMS and also it has remarks Liver echogenicity increased, i have showen this report to my doctor n he tells me it all good, can u plz throw some light on my case, any help from ur side will be appreciated, thank",
    "doctor_response": "Hello,I can understand your concern for your health.1) Increased echo-genicity of liver suggest either inflammation in liver or fat deposition in liver.2) For further evaluation you need liver function test, lipid profile, to find exact cause for this.3) Either of this two condition do not require any specific treatment. Fat-free diet, carbohydrate rich diet, medication for pain are sufficient. Inflammation will subside by its own over period of time but it is necessary to find out exact cause for this liver inflammation.4) Fat deposition in liver is due to either increased fat content in diet or abnormal metabolism of fat in liver.5) Inflammation in liver is due to many reasons i.e. alcohol, viral infection, spread of inflammation from nearby region.Hope I answered your query. If you have any further doubts, I would be happy to help you.Have a nice day!",
    "dialogue_context": ""
  },
  {
    "patient_message": "How serious is a slight dilatation of the fetal pelveocalyceal structures?\n\nMy wife is in her 8th month of pregnancy on her 2 ultrasound it states fetal pelvieocaliectasia noted at the right. There is likewise slight dilatation of the fetal pelveocalyceal structures in the left. I am worried, Please tell me how serious this is.",
    "doctor_response": "Hello,Mild fetal pelvi-calyceal dilatation with size of renal pelvis at 1 mm. is associated with excellent prognosis. There is no need of any intervention during pregnancy except regular monitoring. After delivery, prophylactic antibiotic is given to the baby and preliminary investigations like voiding urethrogram, ultrasonogram and clinical examination are done to note the extent of deformity and also to plan further management. Regular 6-monthly follow up is advised until healing is complete. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high levels of IgE in blood test?\n\nHi, may I answer your health queries right now ?  Please type your query here... HI! my name is Steve and I live in Chile and my blood work came back pretty good. However, one test shows IgE Total 196 IU/mL and the chart says that for my age 41, this is high, yes?",
    "doctor_response": "Hello Steve,Thank you for asking at HCM.I went through your history and would like to make suggestions for you as follows:1. Yes, 196 IgE is high but it is not that high that you should worry too much.2. To derive conclusion, I would like to know whether you have any symptoms. If you do not have any symptoms and IgE was only a lab finding, you should not worry at all and I usually suggest my such patients repeat test after 6 months.3. If you have symptoms of allergies (allergic rhinitis, asthma, atopic dermatitis, etc), I would suggest you allergy testing for specific allergens (allergy causing substances).Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could it be if baby has a boil which does not leak when a hot compress is put?\n\nmy daughter is 6 months and has a boil/staph infection on her bottom.. i took her to the pediatrician when i first noticed it.he told me what to do, and gave me some ointment and oral antibiotic. once i put a hot compress on it, it formed a white head. so i popped it. stuff came out, but only when i squeeze it the more i squeeze she crys harded... it never leaked.. and doesnt have a head. but really hard, and bruised and red. how do i know if all the stuff is out..?? please help!!",
    "doctor_response": "Hi,Welcome to Hcm,If it's hard and painful that means the stuff is still inside. Once the contents have been removed then the swelling usually softens and pain reduces drastically.I would not suggest you to give pain to your girl. What you doing with hot compress is really good and continue doing it. That will soothen her and soften the contents inside and will in due course be expelled. Hope your child gets well soon. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Coronary heart disease\n\nI take medication for CHD, have had 2 stents put in 1 in the main right artery, take medication to control my angina and also for the heart, I have been taking this medication for nearly 5 years. I have started having dizzy spells over the last few weeks and my eyesight has since my last eye test 11 months ago suddenly got worse also the skin on the heels of both feet is splitting and not healing properly",
    "doctor_response": "hello,I have gone through your query.Thanks for using HCM.you must continue regular medicines and follow up for your post stent management of CHD.your present symptoms of dizzy spells ,deiminished  eyesight and non healing needs check up for blood sugar and doppler examination of lower limbs to rule out Diabetes and peripheral vascular disease.You should consult eye specialist for complete ophthalmic  check up,My best wishesDr.Rajesh Teli,MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tenderness in the penis after masturbation?\n\nHello, Last night, I was Masterbating and it was pretty much the same as normal. But when I woke up this morning, I noticed a discomfort it my penis. I can t really explain it but it was it was very tender and it burned. So when I looked at it I noticed it was swollen. As the day went by (on a school day) it didn t really bother me until I had to use the bathroom. Then when I got home it s still how it was the same as from the morning except this time it Is itching. Please help me! I m 15 years old. Also at one point last night I masterbated when my penis was soft. And I did it kind of rough. Could it be like this because of that? Please help me!",
    "doctor_response": "Good Day and thank you for being with Healthcare Magic! Yes it was because of excessive roughness during masturbation. Let it rest for a week without masturbating and drink plenty of water and vitamin c to let your body heal. If symptoms persists please a your local urologist so he can do a physical examination on your penis.  I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at:   I would gladly help you.  Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pulsating in lips,forehead and left side of face?\n\nMy father has had a neurological workup, heart has been checked, taken Botox, had EMG, taken muscle relaxers, taken Lyrica, and numerous other meds. He also had lower back sx (back feels great) in the last six months. He developed STAPH and took six weeks of antibiotics via pump. He had a hernia repair within six months. He also had an esophageal repair (not sure exactly what) within eight months. For the last six months he has been having a pulse feeling in his lip, forehead, and left side of face. It is not all the time but when it lasts he will develop a tension headache. He has started smacking his lips and pulling at his face when it gets intense. He will rest more than usual. He is not one to take any medicine other than ibuprofen or Aleve. He does have high blood pressure which is under control on medicine and an irregular heart rhythm, also under control for years on medicine. He describes it as feeling his heart beat in his lips and forehead. He will sit and count the beat.",
    "doctor_response": "Hi, This is typical of migraine symptoms, as per the history given by you diagnosis goes in favour of initial stages of migraine that pulsating sensation is just an initial sign the actual cause is the headache and not vice versa. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Rohan Shanker Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of lower back pain?\n\nyes I HOPE SO 1ST iVE BEEN FIGHTING LOW BACK PAIN FOR APPOX. 2 AND A HALF YRS. IRECENTLY FOUND A DISK FROM JUNE 2009 IT IS RESULTS FROM DISCOGRAM AND CT SCAN OF L1-L2,L3-L4,L4-L5,AND L5-S1 IT READS AS FOLLOWS L1-L2,THERE IS A DISC BULGE  WHICH IS ECCENTRIC TO THE RIGHT AND RESULTS IN MILD RIGHT NEURAL FORAMINAL NARROWING ,MILD CENTRAL CANAL STENOSIS AS WELL .L3-L4 THERE IS FACET ARTHROPATHY AND THICKENING OF LIGAMENTUM FLAVUM AS WELL AS ALEFT FORAMINAL DISC PROTRUSION. THIS BROAD-BASED PROTRUSION EXTENDS INTO THE NEURAL FORAMEN RESULTING IN MODERATE LEFT NEURAL FORAMINAL NARROWING ,AT L4-L5 THERE IS A DISC BULGE,FACETARTHROPATHY,AND THICKING OF LIGAMENTUM FLAVUM ,RESULTS IN MILD CENTRAL CANAL STENOSIS AND MILD BILATERAL NEURAL NEURAL FORAMINAL NARROWING,AT L5-S1 THERE IS A DISC BULGE  AND FACET ARTHROPATHY. THERE IS ENFACEMENT OF THE LATERAL RECESSESS AND BILATERAL NEURAL FORAMINALNARROWING,LEFT GREATER THAN RIGHT.DISCGRAM RESULTS AT L1-L2 THERE IS GRADE 4 ANNULAR TEAR NO CONTRAST EXTRAVASTION IS IDENT.,AT L3-L4 THERE IS A GRADE 5 TEAR ,L4-L5 GRADE 5 TEAR ,CONTRAST MAT. TOTHE POTERIOR MARGIIN L5-S1 GRADE 5 ANNULAR TEAR AS WELL  MY QUESTIONS ARE SINCE NO DR HAS EVER CONSULTED ME  OR MY FAMILY DR ABT THESE  FINDINGS WHAT IS THE PBOBABILITY MY CONDITIONS HAVE GOTTEN WORSE, FACT IS  I KNOW THEY ARE WORSE  THEY GET WORSE EVERY DAY HOW  OR WHAT IS BEST TREATMENT FOR CONDITION IHAVE PAIN ALL THE TIME IN LOW  BACK BUTTOCKS THIGHS,NUMBNESS IN FEET 60% OF TIME I JUST WANT SOME KIND  OF IDEA OF WHATS NEXT IVE HAD ESI'S DID NOT HELP MY FAM.DR WOULD NOT EVEN LOOK AT DISK",
    "doctor_response": "Hi,Welcome to healthcare magic.After going through your query I think  You are suffering from multiple lumbar disc prolapse.There are two treatment options.First option is Rest in position of relief(generally lateral position with both knee bend),NUROKIND GOLD ONCE DAILY and analgesics (Diclofenac three times a day after meals is effective). Sometimes strong analgesic(such as ultracet three times a day after meals) is required. OMEPRAZOLE 20 MG before meals prevent acidity caused by analgesics . This method needs patience as it take longer treatment times sometimes up to 6 months.Second option is go for surgical operation (Discectomy/Laminectomy)I think your query answered.Welcome to any follow up query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Slurred speech and numbness on lips after hitting head. Should i be worried?\n\nI hit my head on the ground about an hour ago and I have had slurred speech along with numbness on my lips. The numbness still hasn't gone away. Any suggestions? Emergency care is too expensive. I'm a student paying my way through college. Can I wait till the morning to see my pcp?",
    "doctor_response": "Hi,The numbness may be due to hitting a nerve as you hit the ground and it likely to recover. If your speech has returned to normal and you feel OK then there is no need to go to the ER. I do not even think you need to go to your PCP if you feel normal.Signs to look out for which would need you to go to the ER would be drowsiness, severe and persistent headache, vomiting and disorientation. I hope you feel better soon.Regards,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible by having intercourse 2 days after menstrual bleeding?\n\nHi I have a question. I have had irregular periods for years and I started my period on dec 18th, I got off of it the 23rd or 25th. Then on dec 27th I had unprotected sex but he did not finish in me. I appolgize for such crude language. I really just want to know what the likely hood of me being pregnant is.",
    "doctor_response": "HI,    Thanks for the query.     I understand your concern.Usually pregnancy occurs when semen having active sperms are deposited in vagina around ovulation day ( which is 14 days prior to expected date of periods.    There is possibility of conception in your case this month provided-     - your next period is expected with 24 days cycle ( quite possible as you have irregular menses ).. as you had sex on 10th menstrual day this time.     - Also, though he had . tried to withdraw before ejaculation.. few sperms/ precum  reached vagina before he could withdraw.   * In case you are eager to conceive, you should consult a gynecologist & get specific treatment after finding exact cause... this would help in long run.    Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sinusitis and tonsil infection in a child?\n\nHi my 9 year old daughter has been diagnosed with accute sinusitus.. The doctor has recomended a tonsillectomy followed by a sinus draining operation.. They are suggesting the cause of he sinus is the infexted tonsils.. Is this common.. Only an xray has been done not a ct scan",
    "doctor_response": "Hi... Greetings from Chennai. I am a consultant Pediatrician in Kanchi Kamakoti CHILDS Trust Hospital, Nungambakkam, Chennai.It is very uncommon for a 9 year old kid to be requiring an tonsillectomy and surgery to drain the sinuses.Now a days these are being treated simply by intranasal steroid and the results are fantastic.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. 2. 5 year old suffering from stomach ache. Which medicine has to be given?\n\nHi doctor, My son is 2.5 years old. For a week, he is complaining of stomach pain. After farting he is fine. Our family doctor recommended one antibiotic for five days and a medicine to avoid vomiting. He had small vomits twice, but later it was fine. Now, after completing the course of medicine he again complaints the same. His diet is almost nothing and he is not ready to take any food. He just has few mL of milk. He does not have fever. His stool was watery, but it is normal now. Can you provide any recommendation on diet and medicine? Please give me a solution to the problem. Thank you.",
    "doctor_response": "Hi. I can understand your concerns. Complain of abdomen pain with vomiting suggests that your child probably has acute gastroenteritis or food poisoning. Since, antibiotic is already given and now there are no loose stools or vomiting, there is no need to give antibiotic again. For abdomen pain, you can give syrup Cyclopam (Dicyclomine hydrochloride and Paracetamol) 5 mL on SOS basis (as and when required) that is when abdomen pain occurs. Whenever a child becomes sick, there is decrease in his appetite which improves as child recovers. Now, you should give him all the foods that you were giving him earlier. If he is not eating then you can start Glucon-D in water thrice a day for one or two days. Start a multivitamin like syrup Bevon 5 mL once a day for 15 days. Keep patience. Child will eat properly now as he has recovered from illness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the hemoglobin level of 5.8 suggest?\n\ndear dr, iwant to take yur suggestion about my sister's health. she is working lady, her recent tests indicates her heomoglobin level is5.8 she used to eat chalk pieces,once before and even betelnuts very ofen, and now present situation of heo level is still fallen down she's under dr's precription.pls suggest regards lakshmi",
    "doctor_response": "Hi, You have very low Hb level. Any thing can happen with this hemoglobin level. Even congestive cardiac failure may occure. So go to the hospital urgentely and go for blood transfusion. Then go for complete blood count, peripheral smear examination and ultrasound abdomen to search for the cause of severe anemia. If needed go for Serum iron or vit B12 level. Then take treatment accordingly. Hope I have answerd your question. If you have doubts then feel free to ask me.I will be happy to answer.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for breathlessness\n\nMy son is 29 years old. He has sickle Ss. For a few years now, he has had episodes in which he feels very hot and breathless, and if he tries to walk, he collapses. He doesn t lose consciousness. Usually these episodes occur when he is in bed, often waking him from sleep. He tries to walk because, being wakened, he has to go to the bathroom. Until now, the weakness and breathlessness has lasted only a day or two. He usually goes to work the next day or the day after (sedentary telephone job.) This time it has been several days. Just saying a sentence leaves him breathless. He can t work and feels driving is risky. Of course I have been trying to get him to a doctor, but he says they ve never been able to do anything in the past. Any ideas? Thanks.",
    "doctor_response": "Hi, As per my clinical experience, the breathlessness can be due to low hemoglobin level from the sickle cell condition. The basic correction of hemoglobin is a prime factor to control the breathlessness. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for an enlarged liver\n\nmy blood work came back normal with no issues regarding liver function, but my doctor pressed on my stomach and said I have an enlarged liver and has scheduled me for a sonogram, should I be concernced.  I am 5'9 and weigh 190, play racquetball 3 to 4 times a week as well as other excercise.",
    "doctor_response": "Hi welcome to the health care magic Your blood work normal but you have not mentioned which report has been done Sometime liver can be just palpable that can be normal but USG will reflect if any underlying cause present.... So you can investigate with USG abdomen and Liver enzymes estimation.... It is better to Also investigate with peripheral smear examination and if PS suspicious than hemoglobinopathy should be ruled out by electrophoresis... Take care Follow your physician advise and if needed above work up can be done...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for fungal infection on inner thighs\n\nHi, I have fungal infection in my inner thighs for the past 4 years.I have been suggested to use KZ cream by dermatalogist. but its not completely cured after using the KZ cream many times. that area becomes dark and very itching. can u pls suggest a good medication to completely cure this. Thanks.",
    "doctor_response": "Terbinafine ointment or cream could be of help to you. it seems the fungi are resistant to KZ cream so if you try out Terbinafine cream the results would be different, best wishes....",
    "dialogue_context": ""
  },
  {
    "patient_message": "What relieves the pain in the right hand along the wrist?\n\nHi. I have a pain in my right hand near my small finger side, by the wrist. Its a sharp pain when I press on it, or when people shake my hand. I haven t injured it, so I rule that out. Since it is not on the thumb side, I have ruled out carpal tunnel. Could you help me?",
    "doctor_response": "I may suggest an x-ray and MRI of wrist and hand and lower 3rd of forearm to detect pathology.consult a orthopaedic doctorUse wrist band or brace,avoid string it and take pain meds.like advil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What should be done for schizophrenia while already on medications for epilepsy, anxiety and depression?\n\nHello doctor, I have epilepsy from my childhood. I have anxiety, depression, and anger issues. Lately, I have been on Abilify, Divalproex, Lamotrigine, and Zoloft. I have been recently diagnosed with schizophrenia and do not know what to do about it, could you help me get on track?",
    "doctor_response": "Hello. You are already on an effective combination of medication to manage your underlying diagnoses. As you may know, you are on an antipsychotic ( Abilify), anticonvulsants (which are also mood stabilizers- Divalproex and Lamotrigine) and an antidepressant (Zoloft). Have regular follow-ups with your doctor so that dosage can be reviewed as needed. Do not stop any medication without guidance. If you experience any side effects, discuss with your doctor. In addition to medication, it is essential to have therapy and psycho-social support to help in your continuing recovery. Have you had any psychological treatment like CBT? CBT can be helpful in anxiety, depression, and schizophrenia as well. Have regular contacts with your trusted family and friends. It is essential to have ongoing social get-togethers and avoid social isolation. If you are in education or at work, try to make appropriate changes to manage your workload. Learn to manage stressors in your life. Apart from therapy, follow self-help strategies which can help you get back on track gradually. Ensure you are following the basics like eating healthily, having a good sleep routine, and regular exercise. Try to keep yourself optimally active.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with reactive airway disease, took antibiotic oxidil. How to get cured?\n\nHi Doc, my son is 09 months old, first he was diagnosed with reactive airway disease almost 02 months ago and was given a combinition of antibiotic oxidil,britnisol , cough syrup , bronchodilater & nebulizaion with normal saline , clenil and ventoline. he again had the same episode 15 days behind, now with nebulization bronchodilater & cough syrup he was advised britnisol for 5 days & myteka 4mg tab. my husband is asthma positive, please let me know will my son be ok? or we seek for some other advice? thanks,",
    "doctor_response": "these happens in many children when we add milk and diary children start getting these allergiesthe theory is this that child requires mother milk and after that no milk when we add milk with mothers milk it causes allergies if you withdraw milk and diary proteins completely child will be getting better and the recurence of diseas will go awayit take 3 wk for child to come to normal after withdrawing milk and diaryso for 3 wk give sympatomatic rx and after that no med or minimum med will be required",
    "dialogue_context": ""
  },
  {
    "patient_message": "Purple vomit then black vomit,please advise me\n\nI am 16, female, no medical history, and on no medication or treatment.Please help! Today i started vomiting after feeling sick since sunday, at first it was purple with food in it, about an hour later it was clear but coloured purple with yellow foam in it, an hour later it was the same and the same an hour after that, but there now it was a black grey colour with yellow foam in it, it wasnt cloudy but more clear, after the first time i threw up it didnt taste like vomit but weird like somthing i hadnt tasted before ? I also have the runs and a very very sore back and head, please advise me! Oh and i am really thirsty but if i drink water i just throw it back up? I throw up almost every hour.",
    "doctor_response": "Hi, and welcome to Health care Magic, vomiting have many causes such as Central Vomiting -pregnancy -Uremia -Diabeticketoacidosis Reflex Vomiting -Appendicitis -Cholecystitis -Peptic Ulcer -Biliary Colic -Obstruction of the Bowel -Gasterointestinal irritants -Raised intracranial pressures from the color of your vomit (Blackish) it could be bleeding ulcer, please go to your nearest Emergency room ASAP. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from hepatitis b with amebiasis. Is it danger to me ?\n\nI am a hepatitis b postive. For the past one suferring from amibiasis. is it mean my liver was worsen? is it danger to me? Should I hospitalised? I have been using homeo medicine. is it cure?",
    "doctor_response": "Dear ponduru Just going by amoebic infection the state of liver functioning can not be judged. It calls for more investigations if the problem remains. You have  to cure amoebic infection first with tab. amoebika or kutaj ghan vati. The hepatitis b has shown good improvement in many cases with tab. nirocil and sy. livomyn. Have light diet and donot grow panicky.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pain in right lung and back sign of lung cancer?\n\nI went to the dor for pneumonia and in the x ray they found a 2 millimeter nodule on my right lung. They then told me that they would look at it again in 6 months to make sure it hasn't grown. He also said that sometimes it ends up being nothing serious. But I have started noticing that when I smoke it hurts on the right lung and in my upper back behind my lung. The pneumonia is cleared up. Is this a sign of lung cancer?",
    "doctor_response": "Respected user , HiWarm welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This is not sign of lung cancer which include so many manifestations  as    -  respiratory  distress     -  loss of  appetite      -  chronic fatigue     -  weight  loss     -  chronic  unresponsive  pyrexia      -  occasional  hemoptysis depending upon the location of the tumor     -  others .Hope this clears your query .Wishing you fine health ahead .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could infertility be due to retrovade uterus?\n\ni and my husband trying to concieve for past 1 year but till now no success.testing for both are done and its normal.rather i have an retrovade uterus .is there any pronblem with that to concieve.i had my laproscopy test in september2011.report was normal.please help us by giving some suggestions...",
    "doctor_response": "Hi,I read your query and I understand your concerns.Following is my reply:1) Retroverted uterus is present in many women,2) You can naturally and safely conceive with retroverted uterus.Let me know if you have anymore questions.Regards,Dr. Mahesh Koregol",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of diarrhea in an infant?\n\nMy baby is going to be 2 months old on February 14th . Is it normal that she wakes up every morning congested and stuffed up ? Also lately I have been having to change her diaper more frequently because when she coughs or sneezes a little bit of poop runs out .. I m breastfeeding and I formula feed her sometimes also . What are considered normal poops ? And how do I know if she is sick or has diahrrea ? Her immunizations are coming up and I need to be sure she s 100% healthy ....",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Unless your baby is not playful and not passing stools and urine there is nothing to be worried of. I would like to tell you first that please do feed your own breast milk. unless your are having shortage of it. Babies who consume breast milk have the best immunity. Up to 6 months please only give your milk. If your baby passes so much of watery stools with mucus and blood you have to be worried. As age increases mostly the problem of passing poops and urine with cough will reduce. so its nothing to worry. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain, pain with lump under rib cage along side of back. Detected very small kidney stone, precancer cells in cervix. Possible cancer?\n\nhi i have been having pain and aches under my left rib cage along my side into my back with lots of back pain ... this has been going on for about 1 and half months.. they say i have a very small kidney stone in the right side and also have precaner cells in cervix ... i now have developed a lump on my left side under my rib cage kinda towards my back...can you tell me can this be cancer to please help",
    "doctor_response": "Hi and thanks for the query,Its too early to think of a cancer with such symptoms. It s true that the bone is a site of predilection of spread (metastasis) of many cancers. However, it might necessary fr a clinical and paaclinical review be done first in this case.A spinal X ray and CT scans are particular useful. Measuring levels of Alkaline phosphatase in blood, gives an indirect measure if the bone or the back has spread cancer from another area. A chest X ray coupled with a clinical review could be very informative.I strongly suggest you consult a primary care physician for an initial complete clinical review and management. He shall then orient you to specific specialists if need be. Thanks and kind regards.Bain LE, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain?\n\nMy daughter was in urgent care last night for abdominal pain. She has had the pain for 3 days...can t sleep well with it, can t find a comfortable position standing, sitting or laying down. If she does find one, she can t move without discomfort. She had a ct scan done and the doctor said that it was probably menstrual related and sent her home. She is now having diarrhea (from the barium sulfite?) and is light headed. The pain is now in her back as well. Any thoughts? She has a doc appointment for Monday with her regular physician. Thanks! a",
    "doctor_response": "Hi.Thanks for an elucidate history.The inability to change the position it self is suggestive of a need for exploratory Laparoscopy to determine the cause and deal with it. This can a perforated appendix or a lymph node mass or  PID or  Salpingitis and Mittelschmerz syndrome suggestive of ruptured ovarian follicle with lots of bleeding. It is best to get a diagnosis and treatment accordingly . I think, you must visit the ER and get the proper treatment done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for right sided abdominal pain radiating to back\n\nihave right pain on my side of my ribs down to my waist....i have had right breast cancer...but last week took all my mammogram and everything is good....my pain started about 2 weeks ago....can you help ..pain is radiating to myroght lower back...thankyou",
    "doctor_response": "Hi,thanks for your history,right sided abdominal pain may be due to many reasons like renal colic it usualy it presents as rabdominal pain radiating to back,it can also be billary collic,and as your detected with breast cancer it may be secondaries to liver,I reccomend you to take surgeons opinion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe cervical spine pain due to degenerative disc disease be treated?\n\nHi i have been having severe cervical spine pain for a few months, i had a ct that showed degenerative disc disease c1-c7, recently i have been having alot of urinary problems waxing and waning between difficult to start and poor pressure to 19 times a day and full pressure, now my blood pressure is high 153/102 in left arm and 144/92 in right arm, i also have spells where my legs get weak, i have nausea and get shaky. does any of this tie together?",
    "doctor_response": "Hello, I have studied your case and your report. For these symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.I will advise to check your vit B12 and vit D3 level.If nerve compression becomes symptomatically severe then surgical decompression will give permanent relief.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of lump on leg ?\n\nI had a big lump on my leg and it doesn't itch and it feels really hard! this is what it looks like  WWW.WWWW.WW can someone help me please! Its been there over 2 weeks now! could it possible be cancer? I know its not a pimple or white head!",
    "doctor_response": "it may be anything so work up is required. in most cases this is benign subvutaneois lesion such as ateroma, fibroma or lipoma but it can be surgically removed in every case",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes irritation in gums and tongue when using night guard?\n\nI have been wearing a nightguard for two weeks --off and on--for bruxism. I believe I am allergic to it. I am allergic to a great many things. The tip of my tongue is irritated and my gums have a strange sensation like when I eat something I am allergic to. Could I be allergic to my night guard?",
    "doctor_response": "hello thanks for consulting at hcm..r u noticing following wearing nightguard,,it could be allergic,,and u also rule out any odontogenic/teeth related problem ,, do salt water gargle,, and also do a deep cleaning tongue,,do review back with ur treating oral physician,,hope it helps..tc",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will the follicular rupture day make a difference in conceiving?\n\nHello Doctor, i had my 15th day follicular scan yesterday and the follicle size was 27 mm X 21 mm and endometrium measures 9 mm and it is yet to be ruptured. Sometimes follicle rupture happens at 14th day of my cycle. Will this difference make any challenges in terms of getting conceive. Please advise.",
    "doctor_response": "Hi, Welcome to HealthcareMagic .Usually follicle rupture at day 14 but it is not 100% everytime.  Upto 1 wk later also follicle can rupture  don't worry this don't have any impact on conceiving . It just egg should be released and sperms should fertilise it.Hope I have been helpful .RegardsDr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is sweating after flu infection and pleurisy normal?\n\nI have had a bad dose of the flu and pleusy been off work for nearly three weeks now. Starting to feel better but still waking up in the nignt wet through with sweat having to change nignt wear and bedding. Is this common after a bad infection and how long should it go on for",
    "doctor_response": "Thanks for your query at HCM!Excessive sweating is called hyperhidrosis it could be primary in some individuals. It could be due to various causes like infections and cancers. Sweating may accompany hot flashes during the menopausal transition. In your case it is likely due to infection. You can take prescription antiperspirants like Robinul or botox if it is bothering too much. I believe it will go in sometime on its own. But you can visit a local doctor.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for premature ejaculation & rapid heart beat\n\nI have fast & irregular heart beats every time I take something for premature ejaculation, and I need a safe topical or pills for premature ejaculation because I am afraid from sudden death. my age is 47 years. I do not have any heart disease or hypo/hyper tension. So, could you recommend a drug or generic name for premature ejaculation that not affect heart and beats? Thanks",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.All the drugs for premature ejaculation affects the heart.In fact the mechanism of action of this drugs are because of the vascular effect.I advice you to first get examined your cardiovascular system. This will give us idea that whether your system sustains the drug or not.You can take sildenafile citrate tablet under your doctors guidance. This will give you erection. If your heart is good enough than you will not have any problem with this drugs.Please avoid overdoses of this drugs.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lumps on armpit\n\nHowdy,I have got a lump under my right armpit that is swollen and red. I have had it for about a week now and at the start skin flaked off of it. It now appears inflamed. The lump itself does not continue far underneath the skin and is really just a surface issue. Prior to that, my lymph node had been slightly swollen. My left arm pit is now beginning to become very stiff whenever I try to raise my left arm.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have enlarged axillary lymphnode. It may be due to reactive hyperplasia, tuberculosis, lymphoma or metastatic carcinoma. Or you may have some soft tissue tumor like lipoma.  You should go for ultrasound study. If needed go for biopsy or FNAC.  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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "When should i take a pregnancy test if follicles have ruptured?\n\nhi doctor,i have pcos.lmpwas on 10th aug 2011.i took letroz from 3rd day of lmp.and now onduphaston from20th day of lmp.i did ultrasound on 26th of aug tht time two follicles were ruptured.i did home pregnancy test today .it was negetive.do  i need another preg test. if yes,when should i do the test",
    "doctor_response": "Hi, thanks for writing..Take a pregnancy test on 10th september.. This is the time implantation occurs.. If negative you will get your periods soon. Take letroz from day 2 for 5 days.. Hope I have answered your query.. Good day",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe pain in the upper right thigh be treated?\n\nHave a stabbing pain in upper right thigh that feels like a needle injection with it radiating outward lasting for a few seconds. Very painful when it happens and no rhyme or reason or visible sign on upper thigh. Help! (I don t have any money to pay for answer. Sorry.)",
    "doctor_response": "Hi, It may be due to neuropathic causes like sciatica. As the first line of management, you can take analgesics like Gabapentin for symptomatic relief. If pain persists better to consult a neurologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can getting rear-ended in auto accident cause a vitreous detachment?\n\nCan getting rear-ended in an auto accident cause a vitreous detachment?  I could see fine before the accident.....blurred afterwards.  One week later....began seeing 'lightening flashes' in my eye, and was diagnosed with V. Detachment.  Is it ok to lift heavy luggage as I'm alone on vacation???",
    "doctor_response": "Hi and welcome to HCM. Thanks for the query. this is likely to be cause of vutreius detachment. etiology of such diagnoses is differentWish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome emetophobia along with hot and cold flashes?\n\nI have severe emetophobia. I have been having hot and cold flashes for 2 hours now. I have mild headache (which I always do) and nausea. ( I think. to me, I always feel nausous ) anyways, I have no fever and am almost in sheer panic. What s wrong with me? By the way, I am an early teenanger.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Emetophobia is an intense, irrational fear or anxiety pertaining to vomiting. Do you have fear of vomiting or are you having food poison? Cold and hot flashes, nausea, head ache are symptoms associated with anxiety as well as food poison and anxiety. You are in sheer panic because you are not able to determine what is your problem and that is no emetophobia. Please consult a physician.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the possible treatments for pain in abdomen ?\n\nI have a problem getting my 2nd doctor to do some thing about my pain in my Abdomen, there is mores but every time I tell the rest of problems my doctor go to some things else, and there are others problems, my doctor did three blood test every thing is find but he want do any of test to find out whats causing.",
    "doctor_response": "Hello!Thank you for the query.Abdominal pain is very nonspecific symptom. It is very hard to diagnose it not knowing even its location, other symptoms like diarrhea, nausea, blood in stool etc. So please give some details about your pain, other symptoms, age, medicines you take if you want to get some help from here.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will it be wise to use Melbild lotion for vitiligo?\n\nHi doctor, A white patch is seen on the lower lip of my daughter. The patch probably came into being during last three to four months. The doctors are saying it as vitiligo. She is also having acne on the\u00a0nose and both arms. The details of my daughter are as follows: Age 14 years, height 5\u20193\u201d (160 cm) and weight 52 kg.\u00a0I have consulted two doctors and the prescriptions of both doctors have been uploaded. I am following the first prescription. According to this advice, my daughter is taking\u00a0Aziok\u00a0one tablet daily for five days, applying Candid mouth paint lotion and using Aha glow face wash four times a day.\u00a0For acne on the nose and\u00a0arms, she is applying Retino AC gel on the nose and arms, using Nizoral Shampoo and Moyzen Plus Bar during bathing and Aveeno moisturizer lotion on the\u00a0whole body. The blood test report (uploaded herewith) of my daughter is showing high eosinophil. For this, she is using tablet once daily, tablet Xyzal once daily at night for a month and tablet Banocide forte twice daily for 14 days.\u00a0Now, I would request you to let me know if I have taken right decision by following the first prescription. I am too much worried about the white patch on the lower lip.",
    "doctor_response": "Hello. I have gone through your query (attachment removed to protect patient identity) and I have noted your concern. The patch on the lip is definitely vitiligo. As far as treatment for vitiligo is concerned, Dicaris (Levamisole) is one of the treatment options for vitiligo in addition to other options. Dicaris has to be taken on two consecutive days in a week that is, every Saturday and Sunday, at night. Dicaris may have to be continued for weeks. In addition, I suggest her Tacroz forte 0.1% lotion (Tacrolimus) for the white patch on the lip, twice daily. Tacrolimus may have to be continued for weeks. Please consult her specialist doctor, discuss with him or her and take medicine with consent. Her prescription for acne and high eosinophil count is excellent. She may continue with it. For further doubts consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain and lightheadedness\n\ni am wondering what causes a person to have bad dreams ant tired all the time and sleeping unusual and when you go to get up you feel light headed and also have ringing in the ear and different emotions and stumeck pain and confusion and dont have any energy and pain in the body and very moody and heart feels like it beets unusual time to time and chest pain and toughe feels like it has a battery shock taste and energy going through your feet and hands",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. In my opinion you are having mostly anxiety related symptoms. But better to rule out cardiac cause first. So get done ecg and 2d echo .If both are normal then no need to worry for cardiac cause. Anxiety appears more in your case. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. Avoid stress and tension. Be relax and calm. You may need anxiolytic drugs too. Don't worry, you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid off cough and stuffy nose?\n\ni need help my son just turn 1 yesterday and last night he developed a bad cough it was so deep you can hardly hear his voice and his nose is stuffy and now he has a low grade fever but his cough is there is so deep like if is his chest is really congested what should i do i currently dont have insurance and idk what to do",
    "doctor_response": "Hi, I am sorry for the situation your son is going through. From what you are describing, most probably, he is having cold with laryngitis (as you are hardly hearing his voice). I advise to:- give him OTC anti-hystaminic syrup - give nose anti-congestant medication- apply cold balm on his chest and back- aerosol-therapy can help- give him anti-pyretic medication at bedtimeIf no improvement, should send to ER for immediate evaluation and specific treatment. Wish fast recovery!Dr.Albana",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Started IVF medicines. Ova not matured. Looking for advice\n\ni am trying to conceive from 2 yrs but there is no any improvement. now i visited to IVF hospital and started my medicine. doctors told me that ur ova is not matured yet as it s 11 day of my mensturation cycle. she advised me to sex and come after 7 days and if no result she will give me an injection i m confused acan you give ur advise to me?",
    "doctor_response": "hi, normally in case of regular cycles ovulation will occur around 14th day of cycle, so if you plan intercourse around 12 to 16 days at least on alternative days then the chances of pregnancy will be more, that is why your doctors suggested you like that, they will do ultrasound and look for the status of ovarian follicle, if they found it still unruptured then they will give injection for ovulation. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for right temporal contusion\n\nHello doctor . My brother met with and accident on 16 nov 2014. bewlo is diagnosis. right now he is not able to recall all the things . He is not able to move his left side . RIGHT FRONTO0TEMPORO-PARIETAL ACTE SDH WITH RIGHT TEMPORAL CONTUSION Fracture of lower end of right radius can u suggest something on this",
    "doctor_response": "He had sustained a very severe head injury.  He is very lucky to have survived it. After injury to the brain,  some functions will take its own time to recover and some might not even recover - that we can't predict.  With good emotional support and speech therapy,  there is chance that he might improve.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure enteric fever?\n\nSir I also a medical practitioner and usually overlook my own health. I got Typhoid last year on 18th or 19th of July 2013 . Got cures with Ofloxacin 1g for 10 days. This time the sympots appeared on 24th july and Labs confirmed the Enteric....Is there some periodic relationship ? How to prevent it next ? Thanks and regards. Dr Abbas Raza Syed YYYY@YYYY",
    "doctor_response": "Hello,Welcome o HCM,As you are have had typhoid fever for last one month it may be a fever of unknown origin (FUO) which should be thoroughly evaluated to find out the causes for the fever. As she is having for last one month all the relevant investigations should be done to rule out the cause of fever.To confirm it has typhoid after having fever for last one month you should undergo stool and urine culture to confirm it. There are many conditions which can lead to fever of more than one month which should be evaluated thoroughly.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes weakness,nausea and shoulder pain and tingling in arms?\n\nHello... I am feeling so very weak.. have been for days & also very nauseated, much pain in left hip/left, shoulder, back, arm... tingling thru out these areas.. no fever, bp was good at spine specialist on Mon.. mri shows mild stenosis, physatist doesn t believe that s the issue w/my pain.. please help... so weak & nauseated right now, along w/the pain????? also: should note I have periodontal disease",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have  weakness,nausea and shoulder pain and tingling in arms. Well there can be many reasons for symptoms you mention in query like peripheral neuropathy , middle ear infection , labyrinthitis ,panic attack , transient ischemic attack , cervical spondylosis or migraine. I would suggest you to consult neurologist for proper examination and rule out other causes . Doctor may order CT scan or MRI along with taking history . Doctor may prescribe medicine like vasograine along with betablockers and diuretics . Doctor may also refer you to ENT specialist for ear problem or orthopedic surgeon for muscle and bone problem . For now avoid bending forward , apply warm compresses to shoulders and eat healthy . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to relieve pain in right quadrant? Murphy sign positive. Polyps found in ultrasound\n\nI have recently had moderate to severe upper right quadrant pain, nausea ,and shocking belching . Murphy s sign is positive but on ultrasound no gallstones or inflammation , but it was found that I have 5 polyps the biggest only 4mm, I m told that this is nothing to worry about. Could you please give advice regarding my pain. It feels like I ve been punched in the ribs, under my right shoulder blade is quite painful also. It is the strangest pain I ve ever had. Please help or advise.",
    "doctor_response": "You had biliary pain due to gall-bladder polyps. If it would be due to gall-stones, laparoscopic surgery will be first choice of treatment, but its due to polyp and its size is too small so you may wait and continue to get pain killer. If your symptoms recurs repeatedly, then give thought for surgery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for HPV\n\nGood evening...I was diagnosed with HPV in spring, 2011, I had a DaVinci hysterectomy in May, 2011. The following year, my Family Practice doctor did a pelvic but said pap was not necessary. In 2013, he said no pelvic/pap. This year, I insisted due to the HPV. He did a pap and it came back abnormal and sent me to a GYN who examined me and said come back in six months. I questioned since I no longer had a cervix, what could go wrong, so to speak, and he said vaginal cancer would be one of the possibilities. I m going for my re-check on Friday. In order to be well-informed, are there any questions I should ask or information you can share now...? FYI: I m finding another FP... Thanks, Lacey",
    "doctor_response": "I,have gone through your query regarding HPV ,and abnormal pap test result .Genital HPV infections are very common. Up to 80 percent of sexually active adults will get an HPV infection of the genital area at some point in their lives. In most cases, these infections do not cause symptoms. They can cause genital warts .In women with genital warts, the doctor will do a pelvic and rectal exam. A Pap smear will be done to look for microscopic pre-cancer or early cancer of the cervix caused by HPV.HPV testing is not routinely needed. If a PAP smear is abnormal or inconclusive, a DNA HPV test can help determine whether a woman has a higher risk of developing cancer. Women with strains of HPV that pose a higher cancer risk may need colposcopy and biopsies. A woman with a low risk HPV strain probably will need only repeat PAP smears. As a Naturopath Homeopath and Magnato therapist ,want to help you to remove your agony a little at least .  For your info ' Magnitude of the survival advantage from improved nutrition, can even be greater than the magnitude of the treatment effects being targeted in current clinical drug trials .'As you are in doldrums regarding your treatment ,You can't sit back , see helplessly . Consult your doctor for your present problem .Take 2nd opinion also if needed . Meanwhile , I wiould like to suggest you to modify lifestyle to fight cancer is one of the most effective treatment options in my view . Many have been benefitted by These therapies which slow the growth of bacterias and kill on mass bases .Our health depends mostly upon 'what & how & when we eat, and our life style .Avoid processed foods, sugar , fried ,fast foods Tea , coffee ,alcohol smoking all will produce biochemical and metabolic conditions in your body that will decrease your immunity, so avoiding is definitely the first step in the right direction.Detoxing the body, boosting the immune system and changing the diet are important elements of treatment for cancer .One of the important strategies to achieve healthy body is a diet rich in fresh, raw whole foods .More of Fiber, protein vitamin C and goat\u2019s milk , fruit, egg fish ,fish oil for Omega 3, green leafy veges . Quality, organic, biodynamic, locally-grown food will naturally increase immunity .To keep metabolism on right path increase strength of immune system , take all supplements full of antioxidant serve as antibiotics and antibacterial .Raw garlic , ginger ,coconut water , Lemon juice with water twice before mea",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain below the ribs?\n\nhello. i always feel pain at just below my left risk. i think it got something to do with my stomach. because about 2 years ago i ve got my gallbladder removed due to gallstones. plus, this pain affect my heart where i felt tickling at my heart and the back. i wonder whats wrong",
    "doctor_response": "Hi,pain below left rib could be  muscular pain ,cardiac or may be acid peptic disease.Some time renal calculi also presents with same symptoms.If pain is persistent and severe than you require evaluation like USG whole abdomen.Till than you can try some NSAIDS for pain relief.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hole in the blackened tooth. Need to be removed?\n\nhello, it has been over 3 years since ive been to the dentist for a check up, i have had teeth problems in the past which required me to wear braces as well as get fillings, however i stopped going for check ups which in hind sight was wrong but i just totally forgot to make an appointment. recently though i have noticed a hole in one of my upper front teeth which has turned black... is there a chance they can save my tooth or will it have to be removed?",
    "doctor_response": "Dear friend.Thanks for sharing your concern.please do not worry if you could not visit your dentist in the past.you can visit now and get the x ray done.This will help you to know how much deep the decay process has involved the tooth,based upon this treatment can be done.If the decay is superficial ,simple restoration is enough.But if the decay has involved soft tissue like pulp then root canal should be done.Also, remember tooth can be saved if crown portion is not destroyed more than 3/4th the tooth.Hope it helps.Thanks.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had gall bladder removal surgery. Red rashes over midriff, abdomen. Cause?\n\nOn March 11 I had surgery to remove my gall bladder . I was initially nausiated and dizzy but returned home the next day. On 3/13 I noticed this red rash all over my midriff and abdomen as well as on each of my sides. It looks like prickly heat but doesn t necessarily itch. I had hoped it would get better by now---one day past a week but don t think it looks any better. What could this be caused from: anesthetic , liver, bile , ? ? ?",
    "doctor_response": "Hi and welcome to Healthcare magic.Thank you for the query.well,this could be allergy reaction to skin cleaning substance or wounds infectionb if this is around the incision. I am sure it will subside soon,if not you may need some topical or systematic antibiotic treatment. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have weakness, difficulty concentrating, numbness, lip tingling, shaking. Help\n\nI have some of the classic signs of hypoglycemia without the low blood sugar. Weakness, difficulty concentrating, numbness/tingling in lips, shaking... I used a blood sugar monitor for a few months but my blood sugar. didn't dip down. My GP thought maybe it was dehydration so I increased my water intake throughout the day, but that had little effect. I get these episodes about 5 hours after I eat a big breakfast, and sooner if I don't have enough for breakfast. If I had time for a snack, it would help, but as a teacher, my day is controlled by a bell system. When I need to eat, I feel weak, not hungry.",
    "doctor_response": "Hi,Thank you for posting your query.I agree with you that your symptoms are suggestive of hypoglycemia without the sugar being low. Sometimes, it may happen.In your case, you should exclude a diagnosis of insulinoma. Please discuss with your doctor regarding this.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can heart problem with inability to urinate in infant can be rectified?\n\nHello, my cousin has a new born, that was 2 days late of 9 months, so they proceeded with a C-section. The Doctor says the bay may have some sort of heart problem, but the baby cannot urinate as well. I read something about mothers milk and something called cal something. Can somebody please hel?",
    "doctor_response": "HiWelcome to the HCMI understand your concerns but do not worry. You may discuss with us the detailed condition of the baby including his heart condition. Many babies take upto 48 hours to pass first urine. In case he doesn't pass urine even after 48 hours then urinary obstruction such as posterior urethral valve or pelviureteric obstruction needs to be ruled out.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for wrist pain\n\nI BLOCKED A KICK IN TAE KWON DO WITH MY HAND/WRIST AND HAD PAIN SHOOT THRU MY WRIST, PAIN WENT AWAY AFTER A FEW DAYS, AND THEN CAME BACK 4 DAYS LATER, THIS WAS 4 WEEKS AGO AND PAIN IS STILL THERE AND AT TIMES REALLY BAD, LAST NIGHT WAS FIRST NIGHT I HAD PAIN WHILE SLEEPING",
    "doctor_response": "Hello, As of now you can use analgesics/anti inflammatory combination like aceclofenac/seratiopeptdase for symptomatic relief. If symptoms persists you can consult an orthopaedician and plan for an MRI scan. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain on the back of the head and neck with dizziness and memory loss?\n\nI have been having pain in the back of my head by my neck and goes all down to the middle of my back. Also my neck is stiff, my head is heavy. I have experienced dizziness, memory loss and pains and numbness in my arms. I have trouble sleeping and have muscle weekness. I also about a month ago had only what I can discribe as a prism effect in my left eye. It only lasted an hour or so but was slightly disturbing. Please tell me what to do.",
    "doctor_response": "Hello, As what I feel with your symptoms is you need to Meetup a neurologist and maybe an MRI will be recommended. As due to certain lesions in the brains over a period of time where ageing takes places and the white matter & grey matter in the Brain may have got affected. An MRI should be a good solution. Also, the tingling and numbness in the arms can be due to some nerve entrapment within the cervical spine. you need to get it checked by a professional before we confirm it. With a good diagnosis along with medication and exercise, you should do well. You may even have to make some lifestyle changes if needed. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Susten effective in the treatment of infertility?\n\ngood evening,i am 35-year-old i had 10 year old daughter, after that i never had any abortion or miscarriage.  three years back when me and my husband test done i got normal, but my husband sperm count was little low.  now recently i consulted gyn again all the test have done, sperm count has come to normal, but my amh is 1.27.  june 9th was my last period and again from july 14 i started spotting and from 19 my periods started, i consulted doctor.   she told me to use susten 400 mg after day 16 (10 days).  is this help me to conceive.",
    "doctor_response": "susten is effective in the treatment for infertility...ya it wil help u to concieve,u can do serum tsh n serum prolactin as well n serial follicular study n iui fr early results",
    "dialogue_context": ""
  },
  {
    "patient_message": "Teeth are yellow with red gums and they bleed. And it hurts a lot\n\nOK so I hardly brush my teeth and i regret it my teeth are yellow with red gums and they bleed alot they don t hurt at all what do i do i am really scared that if i go to dentist they will pull out my teeth or give me braces so what should i do? p.s i never go to the dentist i only went like 5 times in my entire life",
    "doctor_response": "hi.red and bleeding gums are signs of gingivitis, which is due to deposition of plaque and calculus.go for oral prophylaxis.yellow teeth may be due to external stains or due to dental flurosis.visit your nearby dentist,and go for thorough oral prophylaxis.wish u good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having lumps under lower jaw?\n\nMy 17 month old daughter had a high fever (103) that lasted for 3 days. Now she has lumps under both lower jaws, a red swollen upper gum, bad breath, drooling and poor appetite. She received her MMR shots a week and a half ago. No more fever. What is she going through?",
    "doctor_response": "The entire symptom complex suggests presence of infection in her mouth, more specifically, her gums (gingivitis). The lumps under her jaws are lymph glands, and they will subside once she is given antibiotics. Even her bad breath, gum swelling and poor appetite will go down. Please make sure she gets either penicillin tablets/syrup or metronidazole syrup to cover for certain common germs that cause oral and gum infections.I think she should improve in less than a week. The fever is unlikely to be related to the MMR vaccine, although the time-frame is certainly right. I am saying this because fever and rash are usually the late effects of the MMR and not fever and gingivitis.Dr. Taher",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump above spine and below hairline?\n\nHello. A couple of months ago I noticed a large lump on my back, at the top of my spine and inch or two below my hairline, pretty much center line. It was almost swollen at first, and thought perhaps I was bitten by a bug. After a while it got smaller, and then it got bigger to its original size again, and I flirted with the possibility that it was just a stress knot. I ve never had a stress knot, but heard they re common. The lump is still there, a few months later, not really any bigger, but is hard as a bone. I m curious your thoughts on what this could possibly be? I ll be heading to the doctor this week to check out it, but felt the need to reach out to someone tonight. Thanks for your help.",
    "doctor_response": "Current ratingGeneral Surgeon, Dr. Mukund Savaskar's ResponseHi,Good Early Morning.This is Dr.Savaskar from India,attending your query to my online HCM Clinic.-I studied your query in depth and Understood your health concerns.-Accordingly on the facts given by you-Treatment and Causes I would suggest is as follows-a-I think you are a case of-boil of the hair-follicle organising and developing in to Sebaceous Cyst /and or ?Chronic Boil-as a hard lump with reduction in size over months.b-The location indicates-Chronic boil on nape of neck? with Diabetes -which needs to be ruled out as its cause.FBS and PPS would fix the dianosis of cause of the lump on the Nape of the Neck.c-I would advise to consult a Surgeon -wh0  would do CBC,FBS/PPS,Hb1Ac and would  treat it accordingly by -Drainage with Excision of the Chronic abscess or Sebaceous Cyst.Hope this would help you on your impending doctors visit and would make you easy to plan treatment with your doctor.Hope this would help you with the relief you needed. Wishing you healthy living and early recovery of this query.Wellcome for more queries till you get the satisfied.Thanks for your query to HCM Clinic.Have a Good Day...!!Dr.SAVASKAR M.N.M.S.GENL-CVTS,Super specialist and Senior Consultant-and Expert in Non-Curable-Disease therapy for Cancer,Asthma,etc,Rejuvenation therapy and Tissue failure -reversal therapies.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does purple color, pea like lump under skin on back indicate?\n\ni have had a small pea like lump under the skin on my back for a while now which moved slightly when i touched it, however now it seems to have come on the outside of the skin and is a purple pigmented lump that almost looks like a mole surrounded by a purple circle.",
    "doctor_response": "Hello!Thank you for the query.If you have any suspicion that this might be the mole, please do not wait or ignore it. Consult dermatologist as soon as possible.If the lump is protuberant, it might be a sebaceous cyst which due to touching it or pressing it become infected and pus with blood has appeared around it. This could cause such color as well.In case of cyst, you should consult a surgeon and have it removed.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for fever and headache\n\nHi, may I answer your health queries right now ? Please type your query here...my 7 yr old granson has been running a temp of 102 along with a head ache for 2 nights, the first night he was also shivering cold...but seems perfect during the day...should i take him to the doctors?",
    "doctor_response": "Hello,Fever of a 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 15mg/kg/dose every 4-6th hourly that too only if fever is more than 100F.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sumanth Amperayani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment dizziness and breathlessness with dilated heart\n\nsir my heart is dilated since last two years Latest eco repors are as follows .(left ATRUM 46/AOROTA ed 31 /PWed13 IVSed 7 LVIDed 75 /LVIDes62/RVFWed-/RVIDed24 /2 2d ef 20% /EDV308 ml /ESV247ml  THEMITRALVALUE IS NOT SUITABLEFOR BMV. Sir a qam not welthy enough to undergo pacemaker surgery  at present iam feeling drouzzines all the time /breathlessness even after a slitest exertion/cannot take sound sleep/  please suggest me the proper medicine (ayurvedic)so that I may Become as before 2 years. Sir I have undergone by pass surgery in 1996 . Thanks  Ravi Dubey  Phone 0000 Hoshangabad Madhyapredesh Sir my present age is 69 Years",
    "doctor_response": "Hi your ejection fraction is just 20% you have valvular lesionif you cant undergo a pacemaking surgery follow medications advised by  cardiologistyou have bretathless ness on even mild exertion ,clinically called sage 4 heart failurei dont think that any ayurvedic medicine can help you weven you have to follow allopathic medicines by heart  to  get a bit better.advice cosult a cardiologist ,ayuvedic will land you in bigger problems,even sudden cardiac death is very likely sorry",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain in the lower side of kidney be managed if the USG report seems normal?\n\ndr. kindly tell me that I have pain in my lowerside of kidney but as result of ultrasound abdomen whole it appears that liver is noirmal in size measuring 16.2cm with regular margin fatty echoi pattern of parenchma of liver gallbladder is normal in size and shape with normal wall thickness clear fuid is seen in the lumen noi evidenc eoif calsuli mass in the gallbladder I think result is noirmal what you suggust dr.sb",
    "doctor_response": "Hello and welcome to Ask A Doctor Service. I reviewed your query and here is my answer.Your ultrasound report is normal except for liver size, the normal liver size is from 11-13 cm or some take 14 cm as normal but yours is 16 cm,  also it is fatty which means you may have fatty liver which occurs in obese people or people who takes high fat diet mostly. However you need to talk to your doc about increase liver size but if you have no other problem then taking control of your diet may bring it to the normal. Take low fat diet and have a good exercise daily.hope i answered your query, feel free to ask if you need further assistance.  Thanks.Regards.Dr imran zeb.G.P",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had Dysmennorhia for years, severe abdominal pain. CT shows cyst on right ovary. What to do ?\n\nHello, I have had dysmennorhia for years, I had a tubaligation at 21 I have one son now 28 yrs old! I went to er last week from doubled over abdominal pain er sic ordered Ct scan w/ contrast I had a 7x 3.6 cyst ob right overy er doc referred ne next day to obgyn last Monday ob doc dine pap, pelvic 3 biopsies, had me return on Wednesday",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum. It  means your age is  50 years and cyst is  there , quite large in size. As you are already in contact with a  gynaecologist , so take his advice . In my opinion  before  any surgery please get conservative treatment , if it fails  than opt  for surgery. However treating doctor  will assess all condition. Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could recurred, soft lump under the skin on forearm be?\n\nHi, I have a lump under my skin on the forearm side of my elbow. It is approx 1 inch wide and 2.5 inch long. It is soft and causes no pain. I had the doctor onboard drain some with a needle and it is just blood albeit an old purple colour. After draining 20mm two days ago it has gradually filled up again. Unsure what it could be and a search on the internet has not helped. There is no other fluid in there except blood. Thanking you in advance Daryl",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You may have hemangioma or other soft tissue tumour. Complete excision is the treatment of choice. You should go for surgery according to your doctor's advice. Consult your doctor and plan accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a person to live in hallucinations?\n\nhi sirsir one of my sister and me are very close.she just tell what every problem..she is very strong negatively.once a bad thought enters to her mind it's difficult to drag out that thought..before some day i played a tone laughing like an spirit...she got scared.she generally afraid so much.before some day she said that she hears some unpredictable sounds..some music of violin. and also she felt that some one is there with her.she sleep less and now a day out of fear she does not sleep at night.yesterday night we are talking.she told that she talked to a friend and she was telling about her room mate's bad dreams during childhood.she go very much scared..by listening about dream.at 3am today she said you sleep. i won't. I hanged the phone and after some time she sent a message and the message was like this\"some one is stopping me to talk with you,and with every one,that one wants time for him/her,she just felt when she will switch off the phone she can listen his/her new composition.that one want her to listen.\"she just typed the message and switched off the phone.after that at 9.30 today i called her and she said that after switched off she listen music from violin.even she is feeling that some one is with her till now.please help because i could not predict whether it is a sleep disorder or any spiritual activity.please help me sir.waiting for your answer.thanks",
    "doctor_response": "Hii had gone through your query.hallucination specially auditory hallucination may indicate psychotic illness.but it wold difficult to say without getting details about its origin/frequency/content/reaction/associated mood feature and other psychopathology.Odd belief or delusional belief cal also indicate psychopathology.mental status examination,Thought content and processes will give more confirmatory diagnosis.But she require psychiatrist consultation.Treatment only can possible after proper evaluation.So consult and get helpThank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low TLC and neutrophil levels?\n\nHi, may I answer your health queries right now ?  Please type your query here... I have a son of 17 years old. he has low TLC (3500) and low neutrophils (23%) What may be the cause of this? What Action can I take? and what kind of food can I feed him to raise this count?",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Not to worry. Total leukocyte is on lower side of normal. It is just below normal and not to worry.2. If neutrophils is 23%, he possibly has more lymphocytes indicating a viral infection. Not to worry, it will improve.3. Diet rich in Vit B12, folic acid and proteins is essential. However, do not take granulocyte transfusions. No complications at present. Do not worry. Nutritional diet will be helpful.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sinusitis, nasal polyps, allergies, asthma, mental fatigue. Tests done showing neutrophil and eosinophil count. Allergies or parasite infection?\n\nhello ---please tell me; i have a neutrophil count of 19 and an esinophil count of 28; and an neutrophil abslute count of .8 and a eos absolute count of 1.2; i have asthma, allergies, nasal polyps, sinusitis and feel tired often. also sometimes have mental fatigue . please explain what this could be....my allergist says she thinks it could be allergies or a parasite and that i should see a GI doctor. but i don t want to take a whole bunch of tests if that is not necessary. i have a surgery coming up for endoscopic sinus surgery; should i mention any of this to the doctor performing the surgery or to the anesthetist? any help you can provide will be so much appreciated...thank you",
    "doctor_response": "these are allergic reactions in my experience if these are symptomps i ask patient to stop milk and milk poroducts strictly take antifungal anti allergics for 3 months get your allergy test done and start sublingual immunotherapy i think all will go after this if there u can think of sinus surgery as these are allergies and the polyps  reappears after surgery please try other way which i explained  before undergoing sinus surgery",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is bone cancer curable?\n\nHi doc I wanted to know .. My Bf had bone cancer when he was 5 years old .. He got it operated 25 yrs back which he says its not reoccured are there chances of it reoccurin is it safe to marry him ? Right now he's takin NVR white tablet .. What is that for ? Kindly suggest ..",
    "doctor_response": "Hi,Thanks for writing in.Your boyfriend has been completely treated for bone cancer. Bone cancer is of many types, some are aggressive and some are responsive to treatment. If he has got the right treatment and his cancer has been treated 25 years back then it is possible that he will not get any recurrence. Regarding marriage, it is the unity of two people and their emotions. If you choose, you can request him to get a sperm count analysis done and know his fertility status. This is because he might have taken chemotherapy that might have affected his fertility. This is not a serious concern and I have seen many cancer patients who have had children after getting treated for cancer during childhood.There are many tablets with imprint NVR in the market and having different medications. It will help to identify the medication based on the imprint on both side of the tablet.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I feel pain in the epigastrium part of my stomach. Is it an acid reflux?\n\nHello doctor, I feel pain in the epigastrium part of my stomach mostly when I sleep or lay down. It happens only when I lay down at night or daytime.I have\u00a0heartburn,\u00a0constipation, gas, bloating\u00a0in my stomach\u00a0and I think it may be acid reflux. The\u00a0interesting part is that all of this happens while lying down. I go\u00a0to pee very frequently, and\u00a0this frequent urination becomes worse at sleep time. If I stand up, all of this disappear.",
    "doctor_response": "Hi. Based on your description it looks like GERD (Gastroesophageal reflux disease). Yes, sometimes it becomes chronic, and it is a very unpleasant feeling. In chronic cases, esophageal sphincter may be incompetent too, which leads to acid reflux. Conservative therapy with antacids and diet is the first way of treatment. I suggest you use Pantoprazole at morning and Maalox syrup after meals. Consult a specialist doctor, discuss with him or her and take medicines with consent. For further information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stools to be creamy yellow after treatment for diarrhea?\n\n2 yr old boy had severe diarrhea Monday aft/eve with some vomitting. Dr. suggested may be viral so keep him hydrated and feed him starchy foods. No milk or fruit juices. We ve fed him pasta, yogurt, diluted Gatorade, crackers etc. Vomitting is gone by late last eve and this morning his stool is creamy yellow. Is this normal or should we be concerned? Also, his appetite has diminished.",
    "doctor_response": "Hi..this is normal in recovering diarrhea. Do not worry. It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure sore left testicle and lump on vein after vasectomy?\n\nHi,I had a vasectomy 6 weeks ago and after four days, I had an infection. This was treated but on Christmas Day, I  had a sore left testicle and now I feel a lump on the vein below my left testicle. I am waiting for an ultrasound but the hospital will not return my calls about when the date is. It is very uncomfortable and I have sharp pains from time to time on my left testicle.",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern, this is very common complication being noted in vasectomy, due to the loose skin the infection parts spreads up very quickly and became painful, if I would be your doctor then I would treat you with Ibuprofen with Acetaminophen\" three times in day, I usually prefer Boric acid powder for fermentation, this is to be mixed in hot water (Boiled then bring the temperature at suitable level ) the boric acid about 5 gram should me mix with one and half litre of water then pour the water on swelling part, this also give quick relief, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is mass in right upper lobe suggesting primary lung carcinoma serious?\n\nHello. Here is my question. I recently had a CT of chest with contrast. Findings: right upper lobe mass cented at approximately image #32 measuring l.2 x 0.9 x 2.4 cm in its cephalocaudad, AP and transverse dimensions. This mass corresponds with the noduar opacity seen on the chest x-ray. No other masses or suspicious lung nodules are identified. No significant hilar or mediastinal adenophathy. Impression: There is l.2 x 0.9 x 2.4 cm right upper lobe mass. I favor this representing a primary lung carcinoma rather than a metastasis. This X-ray and CT were ordered by my otolaryngologist who removed a cancer from my tongue 5 years ago and was doing a follow up. I have not seen a pulmonologist as yet. From this information above, can I tell what type or stage this lung carcinoma is? Thank you. Dolores",
    "doctor_response": "Thanks for your question on HCM.In your case It is very difficult to say whether this lung mass is primary or it is secondary due to spread from previous tongue cancer.But in my opinion it is secondary from tongue cancer only. And you should get done PET scan to rule out metastases in other organs too. If only lung nodule is there in PET scan than you can go for lobectomy of involved lobe.This will cure your nodule.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the abscesses on my daughter s tail bone?\n\nHI, my daughter had 3 cysts or abscesses on her tailbone which were lanced this past Monday. In her follow up yesterday, she was told that these types of abscesses can tunnel and if she experiences any pain down her legs or in her lower back to see a surgeon immediately. What types of abscesses are these, what causes them and what are her chances of reoccurrence? Never mind, didn t know I had to pay.",
    "doctor_response": "There are some abscesses in this area which are quite deep up to bone (tail bone). If the abscess persists or recurs it is better to consult a surgeon who will incise it and will dress it regularly till it heals",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stoppage in periods?\n\nHie i was using triphasil now im on trigestrel my problem is that i menstruated twice in jan mid up to first week of feb then i stopped for 7days because i ran out of cash now im not menstruating is there a possibility that i might be pregnant or not,pliz help me my baby is an infant to have a sibling",
    "doctor_response": "yes, should do a pregnancy test.  only then you can decide what to do next .The other suggestion is , please take your pill regularly every single day to prevent to be in this situation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering form thphoid\n\nsir,its myself kuldip dubey. i'm suffering from typhoid for 2 years. there is no positive result from english medicines and ayurvedic. I've consulted many physicians. treatment given by them as follows :1.mahacef2.augmentin 6253.calpol 5004.multivitamin capsules5.zedocef-azi've taken these treatments for 3 months in various periods. finally i went to a homeopathic doctor and i got well in december 2012. but typhoid is once again back since april 2013. the temperature is constant at 99-100 degree. i've temperature in afternoon and it decreases at late night. whenever i go for dignosis, it comes positive. please suggest me some solution.",
    "doctor_response": "DEAR KULDEEP , I HV READ YOUR PROBLEM AND IT INDICATES ME THAT  u r suffering from a chronic carrier stage of SALMONELLA  ( CAUSATIVE ORGANISM OF TYPHOID). in such condition 4-6 weeks of specific antibiotic treatment is given , but before prescribing any antibiotic  i need a-ANTIBIOTIC SENSTIVITY TEST -to rule out the ineffective and resistant oneULTRASONOGRAPHY ABDOMEN ,  TO RULE OUT  HEPATOBILIARY OBSTRUCTION OR GALL BLADDER OBSTRUCTION, SPLEENOMEGALY ETC-LIVER FUNCTION TESTTILL THEN START some herbal medicineCAPSULE PICROLAX- 2 AT NIT DRAKSHASAV 4TBLSPOON + SAME AMOUNT OF WATER AFTER BRKFAST N DINNERCOME BACK TO ME WITH THESE REPORTS OR if u feel anything to ask pls mail me back....thanks for ur query tk care. good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can fever and a continuous dry cough be treated in a kid?\n\nHello doctor, My son is having a fever for the last five days and has dipped slowly from 102.5 F to 100.4 F in five days. The fever is backed up by a cough also. For the last 36 hours, he is having a continuous dry cough for which our physician suggested Levolin syrup 2.5 mL thrice a day. Please opine. He is also on Crocin Suspension DS and RespiCare and Bresol. He has also taken these in the past. Please help.",
    "doctor_response": "Hello. Your child is having viral upper respiratory tract infection. His fever will subside in another two days. Viral fevers last for five to seven days. A cough will remain for a few days. I suggest instead of giving syrup Levolin (Levosalbutamol/Levalbuterol), nebulize him with 1.2 mg of Levolin every six hours. This is a much lower dose than syrup and acts on lungs directly.  Apart from this, use syrup Benadryl (Syrup Diphenhydramine, Ammonium Chloride, Sodium Citrate) 5 mL thrice daily. Make him drink warm water, give him lozenges, and one teaspoon of honey in the morning and evening. This will take care of his problems. For more information consult a child health specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes reduction in growth rate and semi-solid stool in infant?\n\n1 yo daughter had older sister die from leukemia (high risk due to LiFraumeni). Child has fallen in growth chart to less than 15% in height and weight since 3 months. Constant watery/sandy stools-never solid stool. Now is seeing PT for low muscle tone and weak core/hips. She scoots on her bottom, doesn t crawl. Just learned to roll over back to front. Concerns of mine are in labs-Normal WBC 12.6 with 19%Segs, 71%Lymph, 5%Mono, 4%Eos, 1%Bands. 33.8 HCT, 11.4 HGB, 33.7 MCHC. Also 92 glucose, 4 BUN, 0.23 Creatinine, 146 Triglycerides, 4.2 albumin, 2.2 globulin, 1.9A:G, 1.11 Free T4. Obviously concerns abound. Doc now referring us to Neurology (not sure why-waiting on call from him). I assume we are focusing on muscle issues, but don t want to overlook GI issues and lose sight of the fact that we have a genuine concern about what we ve endured before. BTW-DD1 wasn t diagnosed with usual ALL symptoms. She went into ER for Hip pain that caused her to not be able to walk. It resolved in 2 days but returned in other hip a week later. 1 lab with a couple blasts (normal WBC, RBC, DIFF, etc), prompted doc to order a consult with hematology, dx 3 weeks later with high risk pre b-cell ALL. she died 1 year later after GvHD battle.",
    "doctor_response": "Dear friend,First of all, accept my condolences on the loss of your first daughter.Coming to your current question, nothing in her symptoms or investigations seems to point to ALL as of now. If your concern is with 71% lymphocytes, this can be normal in a year old infant. Her other cell counts and biochemistry tests are normal. As to whether she could be having a musculo-skeletal disorder, I am not currently knowledgeable enough to comment on what it might be, but I would suggest that if they want to get this diagnosis out of contention, they should consider a MITOCHONDRIAL disorder. I say this because both your children with illnesses were/are daughters, and mitochondrial myopathies are all inherited down the maternal line only to daughters.Do revert if the tests turn up anything.Dr. Taher",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for acute nervous breakdown\n\nHi Dr, I have a friend, uni student, 22 years old have been diagnosed by the GP as acute nervous breakdown and been given nexito 10, sertima 50 and another tablet(1/2) for a week already. She has been taken to seek religious(Buddhist) spiritual help too. Maybe she has been exorcised as Buddhist chanting seems able to calm her down. The question is should she carry on with the medication and if yes for how long? What are the side effects and whether any blood test can determined the side effect?",
    "doctor_response": "HiShe should consult a psychiatrist and a psychologist counselor to find out cause of anxiety..whether endogenous without environmental causes or some social or external stressful causes.As of now ,for deep anxiety ,breaking the spell is must for which the above prescribed meds are okay...once knowing cause, she could be tapered on meds and helped more by counseling.Meditation or religious practices if helping allay anxieties, it's good to follow..after all its proven by physiologists the benefits of meditative practices on thinking, brain functions,cognition and behavior patterns.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is reason for not being pregnant even after follicular study?\n\nhi doctor.. I have got married just 1 year.. before of my marriage my periods was regular..but after marriage it was irregular,, when I was undergone a ultrasonic scan ,it was known 2 us tat due 2 overweight..pco and irregular periods nu..after marriage my weight increased about 10 kgs... nw its reduced as 65kgs ..last month I have undergone follicular study and egg ruptured ..doctor advised 2 have interecourse and also v had..but this month I got my periods...but reason don t know???? why negative pregnancy test?? doctor advised my husband also 2 take semen test...his test of sperm count s 52 millions... n its normal,,but motility is low about 10 millions....so doctor gave him MAXOXA L powder and doxy 1oo mgs tab....for 2 weeks tab and 3 months powder..... I should want d reason why I didn t get conceive even after follicular study .. help me doctor waiting for ur reply ... Thank u",
    "doctor_response": "Hi, I think the motility of the sperms of your husband is a little low. You can go for IUI. that means the semen of your husband will be processed and it will have much better motility and then it will be instilled into your uterus on day of ovulation. This may work for you.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Khushboo Priya",
    "dialogue_context": ""
  },
  {
    "patient_message": "I having tenderness and pain after an occipital nerve block on the right side of my head\n\nI had an occipital nerve block on the right side of my head on Wednesday of this week.  I am still experiencing tenderness, pain and worst of all migraines.  I have never had this type of reaction before and was wondering if this is a normal response or something I need to have checked?",
    "doctor_response": "hi Good morning,Your cervical spinal muscles are in spasm which in turn is causing the pain in the neck and migraine like headache. You better get in touch with a physical therapist who can relieve you of the spasm and also your headache",
    "dialogue_context": ""
  },
  {
    "patient_message": "On ortho tri- cyclen lo. Feeling pressure in ovary after urination. Feels headaches and fatigue. What to do?\n\nI am on Ortho Tri- Cyclen Lo. I have regular periods each month, ONLY because of the BC due to my PCOS . I am 30, and my next period is due in about 12 days. I noticed a mild/pressure feeling in what seems like my lieft ovary about 3 days ago. It mainly bothers me AFTER urination when I go back to sit down, or sit and lean forward, but then subsides. I can feel it mildly when I walk, or move at all, but it does not really hurt.. just an annoying pressure. Kind of feels like it radiates to my left side of back, but not sure if it is just a feeling.. Other symptoms are regular when I am PMS , Breast tenderness, headaches, fatigue.. Just curious what this could be? Due to have a PAP next week.. thanks!",
    "doctor_response": "Hello. Thanks for writing to us. The symptoms that you are having are mild side effects of the pills that you are taking. usually the symptoms subside on their own in few weeks. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal ,drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for fever with shivering\n\n5 year old has fever x 2 days running around 100-101F. decreases slightly after administration of tylenol, but returns. lethargic. had brief periods of cool hands and feet. states she s cold and visibly shivering. can see carotid artery pulsating and moving down to throat area during rest. child hasn t been up and about to notice difference in carotid pulsating upon standing. no complaints from child other than feeling cold. have been giving child water to remain hydrated. viral or bacterial infection? wait it out until going to see peds?",
    "doctor_response": "Hi...what you quote seems to be a viral illness. Carotid artery pulsations are quite common due to hyper-dynamic state in high fever. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes raw, bright red skin between scrotum and thigh with leakage?\n\nMy husband has noticed wetness on the edge of his underwear in the past week.  I just looked and noticed that the area between his scrotum and thigh appears raw and bright red with some type of fluid leaking out.  He says it's not painful but it looks horrible and is only on one side.",
    "doctor_response": "Brief:allergy which can lead to cellulitisDetailed:HelloThank You for contacting HCM.Welcome to Health Care Magic.My name is Dr Muhammad Ahmad & i will look into your problem.I have gone through your query and would try to help you in the best possible way.sometimes it happens ,its a common complainSuggestions(1) Tab augmentin 1g twice a day for 5 days(2)Gentamicin on the area after every 6 hours(3)citerizine 10mg tablet in night daily for ten days(4)keep the area clean with good hygene(5)dont rub or wear hard clothesHope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. Wishing you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest tightness in asthma patient\n\nMy son is 26 years old and is an asthmatic. However lately he is experiencing daily chest tightness and shortness of breath despite being on the nebuliser and other asthmatic medications? Are there any other remedies for this situation? Please help.",
    "doctor_response": "HelloDiagnosis is established and your son is taking nebulizer and other medicines for asthma. Still he feel  tightness or congestion in the chest . ASTHMA sufferers may complains of s variety  of symptoms , none of which is specific for asthma .Wheeze, shortness of breath, cough , chest tightness .Since your son is still having tightness in chest , it means either diagnosis is wrong or drugs are not acting in proper way. When such patient visit my clinic I advise them to take monteleukast+ bambuterole tablet once or twice in a day depending upon the severity of  disease or symptoms .I also advise them to take terbutalin+ guaiphenesin+ ambroxol+ menthol syrup 2 T S F two times in a day.Hot coffee and steam inhalation also help in this type of cases. Since this is a prescription medicine so please consult a physician and get his prescription.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the lump on the leg be due to blood clot or scar tissue?\n\nmy 9yr old son has a lump on his left leg (been there for six months and has doubled in size)going for an xray on friday dr mentioned it could be one of 4 things a blood clot bone growning in a weird way scar tissue or cancer everything ive read on the internet just makes me more confused",
    "doctor_response": "Hi ! Good morning. I am Dr Shareef answering your query. Please be patient and do not get worried till the reports are ready.In my opinion you should wait for all the investigations to be over. As a physical examination is a must along with the investigations to arrive at a diagnosis, it won't be possible to opine on the lump as such over the net. All the best. Thanks for using healthcaremagic for your query on health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of anaemia?\n\nanemia?  my friend is having dizzy spells and  weakness and fatigue and nausious she  weighs 110 and is 16 years old about 5         foot 7 she is on adhd medication and has felt like this for a month, she has not been sexually active for 10 months and is super skinny",
    "doctor_response": "Symptoms of anaemia are tiredness, having little energy (lethargy), feeling faint, and becoming easily breathless.\u2022Less common symptoms include headaches, a thumping heart (palpitations), altered taste, and ringing in the ears (tinnitus).\u2022You may look pale.RegardsDR DE",
    "dialogue_context": ""
  },
  {
    "patient_message": "My Mom has anemia. Does she need blood transfusions?\n\nHello My Mom has anemia could that mean she is bleeding somewhere or does she need blood transfusions. She had 2 at the hospital because she had I think a TIA or mini stroke. Her blood count was only 8 and then went up to 12 after transfushion. please give me some feed back thank you.",
    "doctor_response": "Welcome to health care magic.My dear friend i will suggest you to repeat complete blood count ,ocult blood for stool and peripheral blood film which will help us to rule out the type of anemia and to help that patient has any kind of  bleeding or not.As you told me that she also had episode of TIA so you also do complete routine investigation like lipid profile,Echocardiogram\u2014to look for blood clots and valve abnormalities within the heart, other investigation after approaching nearest neurologist because TIA  serves as a warning for a potential stroke.Thanx and always welcome for any query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cough at night?\n\nI have a problem with my 4yrs old boy for his cough,sore throat has no relife,even we re given him allerkid and salbutamol ...and now given him an allerkid and ventolin nebule,but still having cough during night bedtime and while he is playing. pls.help me find an answer.",
    "doctor_response": ".Hi...Thank you for consulting in Health Care magic. Greetings from Chennai.By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze. I have a few questions for you -Questions:1. How many days per month does she cough or feel breathless?2. How many nights per month does her sleep get disturbed due to above symptoms?3. Does she feel breathless when she runs around or plays with other kids?4. Are the symptoms when there are seasonal changes?5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?6. Is the cough always associated with fever?If your answer is yes for any of the above questions, your kid might be having viral associated wheezing or multi triggered wheezing and I suggest you meet a paediatric pulmonologist who is near your place.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does non-itchy red scab on hand with pus indicate?\n\nI have a rash on my lower forearm one small spot on top of my wrist this on almost favors a bite it now has a scab but redness around it I also have one on my knuckle towards the inner of my hand between my finger and my thumb its not extremely itchy  does show clear puss pocket blister like but had when u touch the top of it any ideas? Thank you fo4 your help",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The description does sound like you have either an injury or an allergic reaction to some product. It would be useful to know since how long it has been going on. The pus indicates that the wound could probably be infected. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes foreskin to attach to glans and generate pus in a child?\n\nhi, i havea 2 yr old boy, and he is not curcomsized, and his foreskin has become attatched to the head of his penis, that was a while back, more than a year ago, but now theres a pocket of what im assuming is puss, and the pressure from the pocket has made the foreskin let loose just enough to make a small hole to let the puss out, i have a appointment with a urologist, but i wanted an idea of whats going on and what the dr might recomend, thanks",
    "doctor_response": "HelloThis sounds like phimosis and there's a yeast infection under his foreskin.The urologist will attempt to retract his foreskin and give him a prescription for ketoconazole cream.  However, after the infection clears up, the urologist may recommend circumcision",
    "dialogue_context": ""
  },
  {
    "patient_message": "Acne or rosacea on the nose, redness, bumps. Using clindamycin gel, metrogyl. Treatment options?\n\nHi doctor I m suffering from acne on my nose from last 12 yrs . i am applying clindamycin gel and metrogyl but it doesn t help me . May be it is rosacea on my nose but i.m too much fed up. my nose become red with bumps on it. someone suggest me erytop a .and i have also gone thru laser treatment. pls suggest me what to do.",
    "doctor_response": "Hi, Welcome to HealthCareMagic, Following Life style changes will be helpful:- Take nutritious & balanced fibre rich diet, sleep for 8 hours daily and drink more than 8 glasses of water a day. Never pick or squeeze pimples. Acne treatment is focused on (1) to unclog pores, (2) to kill bacteria, and (3) to minimize oil. Wash your face twice daily with a mild cleansing soap or liquid. It  will keep your  skin clean and minimize sensitivity and irritation or cleanse twice daily with a 5% benzoyl peroxide wash. An alternative for those who are allergic to benzoyl peroxide is 2% salicylic acid. A variety of mild peeling agents (scrubs, exfoliants, and masks) can be used. These products remove the outer layer of the skin and thus open pores. Retinol (derivative of vitamin A) can help promote skin peeling. To get rid of oil on your face and reduce the embarrassing shine, use a gentle astringent/toner to wipe away oil. Masks containing sulfur and other ingredients draw out facial oil. Antibacterial pads containing benzoyl peroxide have the additional benefit of helping you wipe away oil. Apply a gel or cream containing 5% benzoyl peroxide; an alternative is sulfur or resorcinol. At night, apply a spot cream containing sulfur to the affected areas. Use a light skin moisturizer and water-based oil-free makeup. You may require a course of Antibiotics (erythromycin, clindamycin , sulfacetamide or azelaic acid). Retinoids ( Retin-A /adapalene/tazarotene) are especially helpful for unclogging pores.  Epiduo gel contains the adapalene along with the antibacterial cleanser benzoyl peroxide and can be applied once daily. Some contraceptive pills have been to shown to have modest effectiveness in treating acne. Spironolactone act by blocking androgen (hormone) receptors. Cortisone injections make large pimples and cysts flatten out fast. Isotretinoin is an excellent treatment for severe, resistant acne. It should be used for people with severe acne, chiefly of the cystic variety, which has been unresponsive to conventional therapies like those listed above. Laser treatments of acne is best thought of as an adjunct to conventional therapy, rather than as a substitute. Superficial chemical peels (like glycolic acid) & deeper ones (performed in the doctor's office), are modest, and give supportive benefit only, and in general, they do not substitute for regular therapy. Don't be afraid to hide blemishes with flesh-tinted coverups or even foundation, as long at it is water base",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the trouble urinating, burning sensation and extreme back pain b due to bladder or kidney infection?\n\nHi! I have been having trouble urinating, a burning sensation when I do, and extreme back pain. I ve been using Aleve and AZO, but they just are not helping. I think I may either have a bladder or kidney infection. (I have also been nauseated and had a low-grade fever). Thank you!",
    "doctor_response": "Hi,Thanks for writing in.The symptoms of trouble urinating, burning sensation and extreme back pain can be seen in infections involving the kidneys and urinary bladder. It is important that you first get a urine routine and culture sensitivity tests done to know if there is any infection causing organism in your urine. If the fever gets worse and you feel sudden rise in body temperature then doing a blood culture test is also required. It is also possible that there is a stone in your kidneys, ureters or urinary bladder. This can be known only after doing an ultrasound scan. Other causes of your symptoms also need to be considered and this is to be discussed with your doctors. Meanwhile please continue to drink lots of water and fresh juices and visit washrooms regularly. Please do not hold urine for a long time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Persistent cough, pneumonia, bronchitis, have asthma, sleep apnea. Done inflammation CRP test. What is wrong?\n\nI have had a persistant cough for 2 years now after a about of pneumonia and bronchitis. At first I thought it is just lingering after the illness because it was a bad one.  I do have asthma but no allergies. My asthma is the type where ones body produces extra mucous.  I cough up white thick sticky gunk and sometimes it has a pale yellow color.  I have noticed at times my voice gets hoarse, not bad but I can tell its differant at times.  I have had multiply chest xrays, i have had a chest CT scan and the only thing it said in the report was this: Few upper limits normal sized mediastinal lymhph nodes slight increase in size from the Octoaber 2010 CT.  I know when they run the inflamation CRP test its like around 11 something and I know the normal is below 1.  No one is giving me an expanation.  Could this be just my next stage of asthma or something else.  my family history is my dad died at age 51 of a heart attack, My mom had her 1st heart attack at age 41 and died of congested heart failure at age 68, my half brother died at age 58.   I am 50, I don't smoke, drink, i am morbidly obese and just got diagnosed with sleep apnea and RLS.  I have had so many respitory illness such as bronchitis and pnuemonia I can't even begin to count.  I have had 2 sinus surgeries.  My cough is embarresing and I want to know why I am coughing.  In 2010 I believe was the year, I received a brand new prescription that had Methascopolomine Hydrobromide in it, after 20 minutes of taking my 1st pill of this prescription I was having stroke like syptoms and ended up in the ER room and hospital overnight.  A pharmacy accidently overdosed me with methascopolomine is what the ER doctor said is what happened.  It was about 1 month after this episode i came down with a very bad bout of bronchitis which turned into pneumonia.  Could this play into my persistent cough?  I have seen several doctors over this and no one seems to care to find out the cause.  Should i let it go and just deal with it or shall I keep searching for a reason.   My thought was-if it is like cancer-lets nip it in the butt but so far i learned nothing.",
    "doctor_response": "Hi, Thanks for using HCM.With the history, it does not look like asthma. Asthma is a type of allergic reaction, presents with wheezing, breath less ness with cough. I advice you to get done spirometry, as this will help you to find whether you are suffering from asthma or COPD.In your case you have RLS and also may be chronic pharyngitis extending even to larynz. Your CRP shows you are being infected some where. Get examined by direct & indirect laryngoscopy and get done once early morning sputum (yellow colour) / throat swab culture and sensitivity to treat the infection.You should reduce your weight, do regular 30 min outdoor exercises along with breathing exercises and have only required amount of calorie.Hope this answered your question. Get back with the reports and also detailed explanation on your symptoms for future discussion on your management. Consult your doctor for further examination and management. Feel free to ask me if you have any further queries.Wish you good health. Take care.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high fever and red spots all over body in children?\n\nHello, my 1 yr old has been running a fever or 103 the last 4 days. our pediatrician told us its just a virus and to let it run its course. today she woke up with red spots on her body, mostly on her trunk but some on her arms, legs and face. about 40 spots total.",
    "doctor_response": "Hello dear!.i would like to have aphoto of the spots and a little info regarding their characteristics.Do they blanch on pressure?Do they itch?.Any discharge or vesicles?Bleeding from any site?watering from eyes/nose?if not then its probably a viral rash and yes according to your doctor it will settle in a few days.Hope it will help.Stay blessed :-)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does HCG level of 18 14 indicate if trying to get pregnant?\n\nHi, may I answer your health queries right now ?  Please type your query here...Hi im 16 dpo(iui) and I took a pregnancy test on the 13 dpo and got a faint positive.I had a blood test the day after so 14 dpo and my hcg was 18 which was concided very low and she said to expect a chemical pregnancy or eptopic,I'm confused and upset as my pregnancy tests ate coming back darker.could I be pregnant or could it be eptopic?what do u think about my hcg being 18 14 dpo??",
    "doctor_response": "Hello,Your serum beta-hCG titers are on the lower side, but, do not confirm a chemical pregnancy. In the current scenario, I would ask you to get serial titers along with a sonogram of the pelvis preferably in the transvaginal route. Doubling of titers every 2 to 3 days suggests good progress of the pregnancy. Sometimes, the titers remain lower during the early days and pick up later. Take adequate rest and have a healthy diet.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Shanti Vennam",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the problem in getting pregnant?\n\nhey am 24yrs, weight 105, 5ft, I had an open myomectomy last year december, right now am around 5months since then. I have pains along myback at the wasteline and also at the edges of my abdomen. I tried getting pregnant this but unsuccessful. PLEASE ADVICE ME. Thank you",
    "doctor_response": "Hi, I think you can try naturally for 6 months to one year because myomectomy doesn't affect conception. But if it doesn't work in 6 months, get yourself evaluated.  Do a thyroid profile and prolactin levels and a ultrasound for your uterus and ovaries.  Also do a HSG to see the tubal patency.  A semen analysis of your husband should be done.  if everything is fine, you can try for 6 more months.  Be in contact with your husband every 2 to 3 days after your periods stop.  IT will increase chances of your pregnancy.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Signs and symptoms to look out for during IUI?\n\nHi... I had iui on Wednesday 5 th February ... It s now 7 days post iui... I ve been having back pains/cramps on and off the last few days.. Had menopur and hcg trigger ... Still another week to go till I test... This is my third iui the last too failed.. Is there any signs symtoms I should look for ..? Thanks xx",
    "doctor_response": "Hi,Welcome to HCM.There are no signs or symptoms to look for after IUI. If you are having lower abdominal cramps not related to bowel/bladder movements, you need increased progesterone support. Kindly contact your doctor for the same if cramps are not related to bowel/bladder symptoms.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can heart murmur with blood pressure be treated?\n\nI have been drinking several red bulls. Was recently told I had a heart murmor. Somtimes my eyes burn.also I have had very frequent uti since drinking them. Basicly I have realized I need to stop. Also having high blooid pressure. Will every thing return to normal if I do and the murmor I never had go away? I am 47",
    "doctor_response": "Hi There After going through your query I Understand stand your concern.I would like to tell you that Red Bull contains Caffeine and excessive use of caffeine leads to high blood pressure and high Blood pressure can cause LV dilation or LV failure which results as a murmur.It's advisable to limit use of Caffeine n Caffeine containing products and personally consult a Cardiologist to evaluate the reason or Murmur. Get one ECG and a echocardiography done and see a cardiologist with reports for proper treatment of High BP and murmur.Hopefully this will answer your query.Kind Regards Dr Navneet Mahajan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am not able to pass stools. What can be done for constipation?\n\nHello doctor, I am not getting the stool from three days and because of this, I am not able to eat food from three days. What is the reason behind this? Which disease symptom is that? What is the possible medical treatment for it?",
    "doctor_response": "Hello. You seem to be suffering from absolute constipation. If you are not even able to pass flatus, then you need evaluation for intestinal obstruction. I would advise you following: 1. To get a thyroid function test done as hypothyroidism might be the cause behind constipation that you are having. 2. To take Laxative like Lactulose in the night. 3. To increase fiber in the diet and to take fruits like Papaya which are bulk-forming. 4. You may alternatively take Cremalax in the night as you have been taking. 5. Another thing that you can take is Isabgulla Husk. You can take three teaspoons full in night time and as it is bulk-forming. It may help you with your constipation. In case you have already taken Creamalx and still not passing the stools, then Macrogol (Polyethylene Glycol) sachets help a lot.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Duphaston tablet helpful to get pregnant?\n\nI am 27 years and I have been under medical examination and treatment for pregnancy for the past 4 months. I have been diagonised with PCOD. My LMP was on 6th April and I started letroz on the 3rd day, I took it for 5 days and started Folicin(Folic acid tablets) after that. I usually ovulate on the 16th day of by period. I had unprotected sex with my husband on all the important days the doctor prescribed to me. From the 22nd day i was prescribed to take Duphaston for 5 days. I want to know what this tablet does. Will I get my periods or will i conceive? Kindly help me since I am very eager to conceive. I am experiencing very bad lower abdominal pain for the past 5 hrs. Today is my 27th day of cycle. Please help",
    "doctor_response": "Dear Shruthy,your anxiety and apprehension is fine.Just relax.Do not worry too much.PCOD is a treatable condition and after treatment the pregnancy rate are good.Duphaston is a  hormone given for deficiency of hormone progesterone in body.Whether you will conceive or will have periods depends upon whether pregnancy results or not.Pain in abdomen may a sign of menstrual pain or it may be due to some other reason also.Just keep patience and keep in contact with your doctor.bye and all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Nexplanon implant inserted. No period initially. Then heavy period, mood swings, headaches. Suggestions?\n\nhi, im 22 years old. i had the nexplanon implant inserted in january 2012 and i have had no period since then? until 3 weeks ago....i have been on for 3 weeks non stop, it turns from brown to bright red constantly along with mood swings, headaches etc....i sont understand? everybody says if it was not going to work it would of done it already but i just cant understand why i am on now? and why so long :(...i was hoping its my bodys way of just catching up and getting rid of some excess blood but i dont no....please help",
    "doctor_response": "Hi dear user, thanks for your query.Irregular bleeding is a major side effect of progesterone implants. It may be a breakthrough bleeding.All your symptoms are because of side effects of progesterone. In my opinion,you should go for an ultrasound first of all to rule out any pathology and you can try tablets of tranexemic acid 500mg thrice daily for 3 days to stop bleeding. If it doesn't help, then tablets of conjugated oestrogen 1.25 mg can be taken once daily for 21 days Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to prevent hemangiomas from forming on baby s neck and what is the treatment?\n\nDear Sir/Madam, My baby is 3months old femal (pre term). The small red color hemangiomas is in her face between ear and neck. the size of this pigment increased day to day. how to prevent? is it create any problem for her. any treatment is there? now the size of mark is around 5mm dia. Thanks Subramanian",
    "doctor_response": "Hello.  I just read through your question.Hemangiomas typically get larger during the first six months if life. Then over the following few years, the hemangioma fades. There would be nothing to do at this time other than wait.  In most cases the hemangioma disappears completely on its own.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for symptoms of female athlete traid\n\nI was wanting some information on female athlete triad. As I was training for a Musclemania competition I had all the symptoms (cramps, irritability...) of my period, but never bleed. After finishing the show I still experience very bad cramps. I did the show in May. I had a period last month (lighter than expected), but right now I am just having pain and bloating again.",
    "doctor_response": "HiIn athletes, it's often irregularity, missing of menses, dysmenorrhea or pain ,cramps..during such cramping mefanemic acid tablets are helpful..Consult a gynecologist alsoThanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could explain persistent numbness and tingling in foot and hand?\n\nI have persistent numbness in my left hand and foot.  Tingling with the inability to hold objects for any period of time. Also stumbling alot and difficulty keeping my balance.  Persisitant burning pain in my buttocks which at times travels down the entire leg and makes me unable to walk.. What is wrong?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.\u00a0\u00a0\u00a0\u00a0\u00a0It depends upon your age and other conditions. The only way to get an exact diagnosis and treatment is to see a doctor in person. These symptoms can be caused by nerve damage from diabetes or from disc or spinal disease.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Kathy Robinson",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the recovery rate for tuberculous lymphadenitis?\n\nHi. Good morning. My husband was diagnosed with tb adenitis.He is on his fourth month of treatment of multidrug. some of His swollen lympnodes in the neck erupted and now healed. What is the percentage of recovery from this kind of sickness? Has no fever, more appetite, gaining weight already.",
    "doctor_response": "Hi there..Welcome to HCM. I am Dr Jigar ( Infectious disease specialist).It appears that your husband is improving from TB lymphadenitis. As it is a type of extrapulmonary tuberculosis you should keep in mind that treatment needs to be continued for prolong period. Several study data suggest that if treatment regimen is strictly followed than the success rate will be around 75-80% in EPTB.You should be visiting your treating physician regularly and ensure that drug resistance is not in your case.If you have additional questions or follow up questions then please do not hesitate in writing to us.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain on the shoulder and breasts?\n\nI have severe pain and a burning pain that radiate right through my left shoulder like a knife into my left breast and back. I have been given much antibiotic but to no avail. What do I have and what should I take on X-rays I have calcification of the spine.",
    "doctor_response": "Hello,Possible causes are like:1. Nerve compression with pain.2. Cardiac pain that radiating to limb.3. Cervical spondylosis with radiculopathy.4. Myalgia or shoulder joint arthritis.Until examination is done it is difficult to say what it is. Get it done chest X-ray and ECG. Use tablet tramadol with paracetamol twice a day for five days. If symptoms not improved please consult with your physician he will examine and treat you accordingly.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for wrist tendonitis?\n\nI have a 8 months old baby boy. 2 months after my delivery I had tenderness in my heels and carpometacarpal joints of feet... Moreover wen I get up after sitting for long I cannot walk properly for a while. I also had wrist tendonitis wen I was 8 months pregnant wich is still continuing.",
    "doctor_response": "Hi i am Dr Ahmed Aly    thanks for using healthcaremagic site ,I had gone through your question and understand your concerns ..   From your given history i recommend less medical treatment for your baby breast feeding so you may begin with bed rest , relaxing , avoid heavy lifting , vigorous movements , hot massaging with topical gels ,muscle relaxants patches , painkillers only when needed ,slabbing or wearing wrist support will releive your pain will be effective if not visit your physician for proper evaluation . Please click THANK YOU and consider a 5 star rating with some positive feedback if the information was helpful. Hope the above information helps you,Any further clarifications feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump on the lower abdomen during pregnancy indicate?\n\nHi , I\u2019m currently 16 weeks pregnant and I\u2019m a first time mom.  I\u2019m kind of panicking over this situation.  So there is this mid sized lump at the bottom of my belly just above the pelvic bon that\u2019s noticeably sticking out to me and my dear husband.  Could this be the baby or something we should be concerned about ?  There\u2019s no pain or anything but it seems to shift from my left side , to the middle , and to the right of my belly.  I\u2019m not due to see my dr until another two weeks.",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .* This seems fetal part rather than a lump , should get an ultrasound of the   pelvis for confirmation .Hope this  will help you for sure   .Wishing you fine recovery .Welcome for any further  guidance .Regards  .Dr. Bhagyesh ( MS , FMAS - consultant surgeon )",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could knee pain after eating beef be due to allergy?\n\nHi, I am 27 years old. Yesterday I had a beef  in dinner and today morning I had a hard pain in my left knee. It also happened before whenever I had beef in lunch or dinner. I had my uric acid tested and it was fine. Is this some sort of allergy or anything serious? Please advice. Thanks.",
    "doctor_response": "Hello,There is no correlation with eating beef and knee joint pain other than raised uric acid level but that is normal for you.I would suggest getting the knee seen to by an Orthopod, with the relevant joints XRays. It could well be a ligament injury but only the Orthopod doc can decide on that.Best Wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I want to pursue my education after having second baby. Is it fine?\n\nHi doctor, I am 27 years old, with two daughters. My life seems like sucked up, no income as I decided to go to University last year, as I could not finish 6 years ago. Feeling like a loser, hating myself as after giving birth to my second daughter (she is 7 months now) have become very fat and ugly. Was it a right time going back to university with my small child? Will my husband still love me? Will I be beautiful again? Will I succeed?",
    "doctor_response": "Hello. You are motivated and want to work towards a better life but looks like you are troubled by self-doubts and confidence appears to be low at present. You have already taken the important first step in acknowledging the problem and trying to get some advice. You have the drive to succeed in your endeavours. It is natural to feel stressed trying to balance family life with university commitments on a tight budget. Anyone in your position will feel the same. Try to get some support to help you look after your children. Can your husband or grandparents help? Do not feel guilty or think it is wrong about going back to University. You are doing it for better long-term prospects for yourself and your family. Just try to get some practical support. Always spend some quality time with children and have fun daily. Try to exercise atleast 20 minutes daily. It will help you to regain your physical fitness and also improve your confidence and emotional wellbeing. Keep having regular talks, discussion with your husband about your feelings and aspirations. Also talk to a trusted friend and family member who can understand your journey and mentor you towards a fulfilling life. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower leg pain when sitting and slightly elevated?\n\nI have front lower leg pain including knee and ankle when sitting with leg slightly elevated such as when driving my car . It goes away when standing. ( I had the cartilage removed from knee in 1952, but this is a new problem.) Thank you for your ideas.",
    "doctor_response": "Hello, It could be an early sign of arthritis or can be due to ligament injury. You can consult an orthopedician and get an MRI scan done to look for any possible ligament or tendon injury. As of  now, you can take analgesics like Ibuprofen or Diclofenac for pain. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pilonidal sinus without surgery\n\nHello, Ill get right to the point. I have pilonidal sinus and i was wondering if it would be ok to treat it without the use of surgery. Ever sence ive had it i havent exprenced any other symptoms as in bleeding or drainage. Its simply just a painful infected hole.",
    "doctor_response": "HiInfact the treatment is only surgical .You can do the following till you  make a decision to  go for surgery .-Take a course of antibiotics and in my opinion Co-amoxiclav  and metronidazole  for a week , if not already taken any antibiotics.- do sitz bath  in a hot/lukewarm water 3 times a day - regular walk /exercises  daily  if you dont have any restrictions to do that .- Good healthy diet - To maintain a proper weight  proportionate to your height (normal BMI 18-25)._ proper maintenance of your personal and perianal hygiene.Hope these measure  help  you to  certain extent but not a complete cure.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for gingivitis like smell and taste from throat and back of mouth area?\n\nI am not frequent but I always brush my teeth and floss once a day with fluoride coated floss. But lately I've been tasting/smelling a gingivitis like smell conning from my throat and back of the mouth area. It gets stronger when I burp. I'm starting to get worried it's been three days and it's not going away. >.< help please",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. You are regular in brushing the teeth, and floss, but the reason of the bad smell might be some thing else. The reasons might be periodontitis, infection in the intestines, indigestion, infection in the nose etc. I advise you to consult a physician for diagnosis and treatment. Take more of green leafy vegetables, pulses, sprouts and protein rich foods.Hope I have answered your query. Let me know if I can assist you further.Wishing for a quick and complete recovery. Regards,Dr. Veera Raghava Rao Buddha",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lack of control over arms, fingers and fist?\n\nShortly after getting out of bed this morning the top part of my right arm is numb......from my elbow to the top of my hand....lost some control over my arm, fingers and fist.....can t write very well or hold a full cup of coffee......up at 4:30AM this morning and there hasn t been much improvement in about 3.5 hours .......no pain.....What might this be caused by and what might I be able to do for relief........",
    "doctor_response": "Hello,Your symptoms are related to a wrong position of the arm during sleep, which has lead to a pinched nerve (Saturday Night palsy). I recommend trying to move your hand as much as you can. Your situation will improve within a day or two.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to manage a yeast infection on face and neck?\n\nhow can I manage a yeast infection? doctor gave me a course of AB and a cream, but I had this recurrent and nasty itching face and neck skin, also a consistent and persistent painful nose sort of allergy problems. I just realised that it could be this yeast infection which is a sistemic thing and it won t go away just like that! help",
    "doctor_response": "Hi,First we should confirm the problem you are having.If there is yeast infection then along with anti-fungal lotion or cream you should take oral anti-fungal medicine like Flucanozole 150 mg once in a week for 4 weeks.consult dermatologist and get examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to confirm if the pregnancy test result is a false negative?\n\nHi. Im 24 years old. I missed my period for almost 2 months but my pregnancy tests are all negative . I'd tried it 8 times. My Doctor prescribed me duphaston.  Please help. I don't know if  I am pregnant or I have false negative pregnancy test. I thank you.",
    "doctor_response": "Usually the false negative rate of UPT is less only, but still if you have a doubt you can go for serum beta hcg testing and still already you have missed the periods for 2 months you can also get transvaginal ultrasound done for confirmation",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yellow patches on the gums and inner cheeks?\n\n2 days ago i found infected(yellow) patches on my my left gums and cheek that touch the gum, I tried brushing them real strong and then i've been rinsing with hydrogen peroxide and wiping with a q-tip with hydrogen peroxide over the area. a few months ago a tooth in this area split in half, haven't been able to fix it yet, is that part of the problem and can i kill this infection with peroxide ?",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain yellow patches over the gums and cheek touching the gum along with having a broken tooth in that area can be due to dental abscess, in case if the infection might have reached below the root tips of the toot leading to pus formation..I would suggest you to consult an Oral Physician and get evaluated and a thorough clinical evaluation and investigations like x ray can help in diagnosis..In case of dental abscess, treatment of the tooth with either root canal treatment or extraction depending upon the condition of the tooth, followed by antibiotics and painkillers can help..You cannot simply kill the infection with peroxide and needs proper treatment for complete resolution..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is cold and cough normal after teeth removal?\n\nhi I had a tooth removed two weeks ago-it was not infected, but rather cracked - anyway I had the tooth removed and 5 days after it was removed, I got a cough and cold like symptoms, which I still have a bit of today, after two weeks . I have no fever - is this normal?",
    "doctor_response": "thanks for your query, i have gone through your query. the cough and cold has nothing to do with the tooth extraction. it can be because of bacterial infection. consult an ENT surgeon for opinion and needful. you can do saline gargling 3-4times daily for 5 days. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for polycystic ovary\n\nDoc, I am Mrs. Chatterjee, aged 38, married abt 3 yrs don't hv any baby. I hv gone through lot of tests, which shows there is no prob in my fallipine tube and Uteraus. The prob is I am having Polysystic Ovary and overweight. Local Doctors asked me to go through IVF, pls suggest me wht should I do",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.You have polycystic ovarian disease PCOD. As it cauae andregen excess, insuli resistance, small follicles which dont mature.So pcod can be treated with medicines,1 control diabetes with medicines2 stimulate ovary with drugs like clomiphene.3 reduce weight, avoid cheeze, fatty diet.These steps help in conceiving.So coonsult gynecologist and discuss these measures.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Scheduled biopsy, nodule found on ultrasound. Had bloody discharge. Have breast pain. Aunt had breast cancer. Have chances?\n\nI am scheduled to have a breast core biopsy done this Friday for a 6mm nodule found on ultrasound, I have had bloody discharge twice in a period of 1 year. The Ultrasound is characterizing it at BIRAD 4 twice in a 6 month period , I have breast pain as if the breast had broken glass in it. Only breast cancer in family was in my aunt. What are the concerns I should have,,,the obvious is of coarse cancer",
    "doctor_response": "Bloody discharge from the nipple alongwith a lump on ultrasound and a family history of breast cancer are all ominous signs for you having cancer in the breast. BIRADS 4 means that the chances of the lump having cancer are in the vicinity of 60-70% and the least you need to do is get a biopsy. Problem is that to do a core needle biopsy from a 6mm lump is technically difficult. If the biopsy is done successfully and returns a diagnosis, then it is alright, but if it misses the lump (in which case the biopsy report will show only normal breast tissue), i would suggest you get operated to remove the lump and send the entire lump for diagnosis. That has a dual benefit. One it will give a conclusive diagnosis and two, it will remove the chances of this lump developing cancer later on. Even if it turns out to be cancer in the biopsy, it is at a very early stage and you shouldnt worry as you will completely get cured with proper treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of swelling in my foot and arm after breast cancer?\n\nI had breast cancer 5 years ago.Just now(last8 month). my hand has been swelling and my left foot.Now the swelling is starting to move up my arm . My ankle and foot swell. could tis be lympadema after 5 years? I have had it xrayed twice, No one seems to know wha this is.",
    "doctor_response": "Dear, Xray will not show anything. you must have undergone surgery as will as radiation therapy for breast cancer. Mild lymphedema of the arm due to radiation is a delayed process and can happen even after five years, but for edema of the leg you have to rule out other causes through an internist.Dr. J. Ticku",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are effects of infant swallowing Advil?\n\nHi, my daughter is 11 months old& we think she swallowed a gel Advil pill bc we had 2 of the pills& my daughter started choking, I noticed one bitten up stuck to her shirt so I immediately stuck my finger in her mouth to try to scoop it out& she started choking more like if she swallowed it more down into her throat so I grabbed her took her to the restroom& made her throw up,then I have her some of her milk& after that she fell asleep, should I be concerned still& worry about my daughter ODing!!. Please help, I am a first time mom",
    "doctor_response": "Advil contains ibuprofen which can be given to children also. Two pills should not be a cause of concern and since the choking has already been relieved you may relax. However, keep observing her and if you see anything abnormal, take her to a doctor immediately.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the painful lump on my groin?\n\nSo recently, less than a week, i have noticed a small lump on the left side of my penis. Its not on the penis nor is it on the scrotum. Its more in the groin region. Its slightly red and it hurts to the touch and when i bend over or stretch. I m really worried and i don t know what to do. It does not have a head to pop so its not a pimple or anything. Also i don t think it is an ingrown hair. Is this something serious? I m not sexually active and the most i have done with a girl is kiss a girl. I m worried and not sure what to do. Please help.",
    "doctor_response": "Hi,It seems that there might be having enlarged tender inguinal lymph node giving this problem.It indicates that there might be having some infection in surrounding area.Consult your doctor and get examined.A course of antibiotic medicine will heal the infection and you will be alright.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is delaying angioplasty a risk?\n\nHello doctor, My father, who is 62 years, had a heart attack before two months. He was admitted to the hospital and the first aid was given. His angiography was done after four days and the diagnosis was single vessel disease with Mid LAD 90% stenosis. Doctor has advised him 20 days of medicine and post that they will decide for further course of action either putting a stent (angioplasty) or continue medicine for some more time. Currently, he is on rest at home and feeling better without any pain or any visible or noticeable complaints.\u00a0I am attaching here the angiography report along with the diagnosis report and prescribed medicines.\u00a0How do you analyze the situation?\u00a0Is the course of treatment right? Can\u00a0medicine cure or improve the things? Is delaying angioplasty a risk?\u00a0Does angioplasty (stenting) have self-life or side effects?\u00a0If angioplasty is required, how soon we should do it? Also, please suggest any specific stent for long term benefits. Thank you.",
    "doctor_response": "Hi. I have reviewed your health query regarding your father and can well establish the sensitivity of the issue. For further information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had mid cycle bleeding while having Qlaira pills. How long it will last?\n\nHello,I have been taking Qlaira pill for a year now and have had no problems.This cycle however I have had mid-cycle bleeding(mostly brown discharge ,sometimes red) and has lasted nearly 10days.Is it going to last all the way till my period?I was planning to skip my period this month(continuous use of light yellow pills).Will I have bleeding for the whole time I will be taking the yellow pills or will it stop?Thankyou :)",
    "doctor_response": "Hello. Thanks for writing to us. The id cycle bleeding is usually light and is spotting only. This usually subsides in 4-5 days without any treatment. You can wait and watch if the bleeding is light.I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal ,drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from asthma attacks, cough. On ventolin, symbicort inhalers. Which inhaler is better?\n\nHi DR. XXX, I am XXXX, 56 yrs. old. I go to the gym and do cardio exercises everyday. After workout I enter the Steam Room for added comfort. However, since 1985 i started having Asthma . It starts with a Cough & then Asthma comes in. Ventolin Inhalers comforted me until I switched to Symbicort Inhalers 4 years ago. Until Lately I switched back to Ventolin thinking that Symbicort w/ Steroid can Cause Throat Irritation and Severe Side Effects & Erectile Dysfunction as compared to Ventolin.With this, I would like to ask which is better to use Ventolin Inhaler or Symbicort Inhaler? I have been using Ventolin Inhaler before I switched to Symbicort Inhaler 200 mcg. Symbicort was good for me. I only take it once a day & sometimes after 2 or 3 days. there was even a time when a whole month passed w/out me taking a dose. I noticed that my chest tightness usually happens when my stomach is full after dinner at night. Lately I switched to Ventolin Inhaler again but its effect only lasted for about 12 hrs. before taking another dose. Now continuous cough due to irritation of the throat is what I experience before an attack. My throat is itchy & chest tightness follows. Will i just discontinue Ventolin & go back to Symbicort Inhalers? Or can you prescribed a better Inhaler for me? If so, what is the best medicine for me to take. Likewise, a medicine to stop irritation of my throat due to this Medicine. Your advice will greatly be appreciated. Thank you very much!",
    "doctor_response": "Hi, You are 56 years, you have asthma since 1985,and using symbicort, you get tight chest, after dinner, switched over to ventorlin.                          It is an allergic reaction, i prefer to give the patient montelecast, and levocitrizine combination for minimising the attack, other wise i prefer to give triamcinolone for preventing the attack .                         With the help of these, you can greatly minimise the dose of the bronchodialator inhalers.                          ventorline is a short drug for bid dosage, and symbicort is with the action lasting for 24 hours. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Vertigo. Treated for carcinoma multcentric stage III. Administered with Fragmin injections daily and Neupagen shots. Problem?\n\nHello, Thank you in advance for your response! I am a 40 yr old woman currently being treated for inv.ductal carcinoma multcentric stage III. I had my 3rd cycle of neoadjuvent FEC chemo last Thursday 8 days ago. Chemo nausea subsided and taking no meds other than 0000 IU Fragmin injections daily (past month) for a large Blood Clot running from inner elblow ending at arm pit. -pic line(now removed) - I am also taking (past 6days) Neupagen shots. *** my question or concern today is regarding vertigo. I awoke this morning @ 1 hr ago with loss of balance and blurred vision. Feeling like I had too much to drink on a tug boat in stormy waters. I almost went head first into a wall before catching myself. So naturally I m concerned about a mini stroke precursing a massive stroke or hopefully perhaps low hemoglobin. My symptoms improve when lying or sitting still, but worsen with movement. I m hoping I don t need to make a trip to emerg. for a six hr wait. Thank you",
    "doctor_response": "Looks like you are suffering cancer.Regarding the complains better to do a MRI Whole brain tomorrrow.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes an occipital lump with tenderness?\n\nI have been bothered at night with a stiff neck...to the point it wakes me up (left side) and today I noticed that there is a lump on the back of my head, tender to the touch. If I put my palm on my left ear, I can cover the tender area with the middle to end of my fingers. It is quite tender and the more I touch it the more my neck aches.",
    "doctor_response": "thanks for sharing your health concern with us!well, it is just an infected sebaceous cyst or an enlarged lymph node and not to worry much for this. you have  to press ice-cubes or cold compress and take some broad-spectrum antibiotics like erythromycin; if not relieving within 7 days then consult some surgeon for aspiration /excision of the material inside; never poke it as this may invite infection! all the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and cold\n\nmy brother is 15 year old and he is suffering from fever and cold last two days and symptoms are running nose fever(103) after shivering in his body what type of fever it is and we are giving him the medicine LACTOCLAAV 625(2 TIMES) and ADMON-L (1 TIME) TUSAL-D SYRUP",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have symptoms of fever and cold and running rose which is due to upper respiratory tract infection . Well virus infection usually go away in few days by its own , but sometimes when infection become severe and it needs medical attention. I would suggest you to consult ENT specialist without any delay . Doctor may order throat swab test , viral culture test , CT scan and blood test to confirm the diagnosis . Doctor may prescrine anti viral ( acyclovir ) , anti bacterial ( amoxicillin ) , decongestant along with anti inflammatory . For now take steam twice a day to relieve the congestion and drink warm water with one spoon honey in it . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can doxycycl hyc 100mg cause difficulty in breathing and panic attacks?\n\ni am taking this medicine and i am having a hard time breathing. i am also taking doxycycl hyc 100mg cap mutual.cats these were given to me by my dr. for bronchitis. i am on about 10 other meds for different problems, but the same dr. has prescribed them all.. i say i am having panic attacks my husband says i am hypro ventulating. i just knoew something is not right and it is scaring me very badly and of course it is the week-end. please  help. thanks",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. No, doxycyclin can not cause breathing difficulty or panic attacks. In my opinion, you are not improving because you are not taking correct treatment for bronchitis. Ideal treatment for bronchitis is inhaled bronchodilators and inhaled corticosteroid (ICS). Without these drugs, it's difficult to control bronchitis. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is must for the diagnosis of bronchitis. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. So consult pulmonologist and start appropriate treatment. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Weight gain after taking birth control pills. No periods after stopping the pills. Is it safe to be pregnant now?\n\nHi! I have a question..I stopped taking contraceptive pills March 2012 and since then I only had my period...My last period was last July and its been worrying me..I have been to my doctor several times but all that she told me is to wait for at least a year until all the extra estrogen is released from my body.. I have been using pills since after the birth of my child and that was more than 6 years ago..I ve stopped taking it for 5 months in 2007 and I also gained a lot of weight since I started taking those pills..Please can you help me?Thank you in advance.",
    "doctor_response": "Hello Thanks for your query What you are suffering from is called post pill amenorrhoea. Sometimes, it lasts for upto 3 - 6 months after continuous use of oral contraceptive pills. But its already been almost 6 months, so you should definitely opt for some treatment now, particularly if desirous for children. you have not mentioned your age, please let me know that. Also, the rebound weight gain is also common after stopping the pills. You need to get your hormonal tests such as estrogen, progesterone, FSH, LH, etc , if required endometrial biopsy etc to know the cause of absent periods. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Which is the best way to abort pregnancy after C-section?\n\nHello doctor,I am in trouble. I have two kids, one 2 and a half years old, another 1-year-old. Both are C-section babies. Now, I have missed my periods by ten days and get to know that I am pregnant. Kindly help me and guide me on how can I abort the child.",
    "doctor_response": "Hi. Termination of pregnancy can be done either with tablets or surgical method like D and C (dilatation and curettage). The first one seems easier, but as you have a history of two previous cesareans, I would suggest you choose the later. MTP (medical termination of pregnancy) with tablets may lead to incomplete abortion and torrential bleeding in some cases (chances are higher in previous cesarean cases due to retained products of conception-RPOC). D and C on another hand is a foolproof method without chances of RPOC and severe bleeding, additionally being painless (thanks to anesthesia). Instead, you can get a MIRENA or Copper-T inserted or tubectomy done in the same sitting preventing any further unwanted pregnancies. It is to be done under strict medical supervision, so please visit a gynecologist for the same.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shaking of head?\n\nhi, i have been noticing my head is shaking a lot, and even down as far as my back arms and hands. it is really scaring me a lot. but no one seems to notice that i am shaking, so i guess it is all inside ? people help me, cause its really scaring me.",
    "doctor_response": "Hi, If your head is shaking, it would be noticed by anyone standing beside you. If in doubt, take a selfie video, and see for yourself whether your head is shaking or not. Head shaking is a common symptom seen in a condition called as essential tremors. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sudhir Kumar, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I rely on Eltroxin and Crestor after having my pituitary sac tumour removed?\n\nI had a petuitary sac tumour removed in April, 2014. Doctors put me on Solupred, Eltroxin and Crestor... I gained 20 kg over 5 months. I jut tappered off Solupred, how can i lose the weight gained? I feel heavy and tired most of the time.. I eat a lot of snacks, don t drink or smoke",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Pituitary gland is the master gland in the body which control all hormones in the body. So hormonal imbalance is likely in your case. So you need to take eltroxin (thyroid hormone supplement) life long. You are advised crestor mostly due to obesity. To control obesity, you need to follow strict diet, avoid snacks and exercise regimen. Ford this better to consult dietician. Avoid stress and tension. Avoid oily and fatty food. Avoid large meals, instead take frequent small meals. Eat high fiber diet like green vegetables, fruits etc. Do regular aerobic exercise like running, cycling, swimming etc. Don't worry, you will be alright. You willing definitely loose weight. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rapid heart rate\n\nHello, my husband has been experiencing rapid heart rate today. He has a history of high blood pressure and high cholesterol and is on daily medication. He said he thought after eating tonight it would help but he said it is still continuing. He just had his regular physical and blood work about 1 month ago and blood work looked good according to his internest. What would you recommend him doing?",
    "doctor_response": "I have gone through your question and appreciate Your concern. Rapid heart rate may be due to arrhythmia. Atrial fibrillation or Supraventricular tachycardia can cause rapid heart rate. It is Better to get Ecg done to know heart rhythm. If required holter monitoring can also be done. Thanks.U can write me back for any query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of potential pregnancy?\n\nI have been trying to conceive. I had intercourese before and on the date of my ovulation and fertile days.About 10 days later I started bleeding light then heavy.For about 4 days.It was 10 days after ovulation and two weeks early from my normal menstrual period.The questions are:could that be implantation bleeding? Could i be pregnant?",
    "doctor_response": "Hallow Dear,I have gone through your history. I feel there is some confusion in calculating the days of ovulation and fertile period. Ovulation takes place 14 days prior to next expected menses. The egg has life of 24 hours while the sperms are active for 72 hours. Hence the fertile period is a period of one week around the days of ovulation. Since the ovulation takes place 14 days prior to next menstrual period, your bout of bleeding cannot be 10 days after ovulation and two weeks before expected date of period. This statement suggests that you are having some misunderstanding about ovulation day and fertile period. Whether it was an implantation bleeding or it was Mittelschmerz (ovulation bleeding) can be decided only on confirmation of the pregnancy. You may take pregnancy test on the overnight first morning urine sample 8-10 days after missed period; done earlier these tests may give false negative results. Alternatively you may opt for Beta hCG test which is very sensitive and can give you reliable results even few days before missing period.  Since you had considerable bout of bleeding, I would advise you to go for ultrasonography after 10 days of missed period (in case pregnancy test is positive) to assess the safety of the baby. It will inform you whether the bout of bleeding has disturbed the pregnancy or not. This will resolve your dilemma. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there long term repercussions of not treating pneumonia which was diagnosed 5 months ago?\n\nMy 19 year old son was diagnosed with pneumonia 5 months ago and was given antibiotics but with minimal results. Unfortunately he still suffers from the same symptoms but since he is in the military he refuses to go back to the doctor for fear of reprisal. His cough is still deep and his energy is low. Are there any long term repercussions for his lungs if he continues without treatment.",
    "doctor_response": "Hello, As you explain the situation I strongly recommend you to send him to the doctor for a re-evaluation of the situation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jnikolla, Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have high SGOT and SGPT level. Reason?\n\nSir, I am male 44. My Glucose fasting is 115 mg/dl. SGOT (AST) is 91 U/l, SGPT ( ALT ) is 160 U/l. Are my SGOT & SGPT at genger level? Should I immediately start medication? What are the reasons and adverse effects of increased SGOT/SGPT. Can these be controlled by controlling the diet? Should I get an lever ultrasound? Am I be heading towards jaundice? Kindly advice other preventive measures to control them.",
    "doctor_response": "Hello, scsaini5294, Fasting blood sugar of 115 mg/dl is mildly elevated blood sugar that might indicate early diabetes. You should have HbA1C tested and also a 2-hr post meal blood sugar test to confirm the diagnosis. Your enzyme levels are elevated. If you are above your average weight for your height , this could all be Fatty liver related. After you get a Hepatitis screening tests for Type-B & Type-C to rule these out , then you can get a sonogram of the liver to see if you have fatty liver and it's grading. If you also have elevated lipid levels, you need to control that by dietary means and may be medications. You should be on a diabetic diet , cutting back on concentrated sugars. I also recommend that you start taking Vit-E 800 i.u. daily, along with Vit-C 1000 mg. daily, and also a Super B-Complex Vit. tab daily. Fatty liver is reversible if taken care of before cirrhosis sets in. I wish you good luck and good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe for kidney transplant with one kidney infected?\n\nCan a child receive a kidney transplant when her existing single kidney is infected or to wait for medication to control the disease. Swelling noticed in kidney after sonography as protein was noted leaking in the urine. Will the Infected kidney harm the healthy kidney recently transplanted",
    "doctor_response": "Suggest to treat the kidney infection prior to transplantation. Need for transplantation to be clearly specified. Is the child on dialysis or does the child have irreversible kidney disorder in the existing kidney. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can infertility be caused by taking postinor 2 ?\n\ncan postinor 2 cause infertility",
    "doctor_response": "Hi,Welcome to HCM. Postinor 2 is an emergency contraceptive pill, it causes side effects like nausea,vomiting,bleeding disturbances,headache,dizziness,fatigue. Causing infertility is very unusual. Hope i answered your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suspected to have a parasite. Will I pic it up too? Precautions?\n\nHello my sister in law has just come back from a holiday in Egypt and has been in touch with the out of hours doctor sevice and is suspected to have a parasite but we dont know for certain. My daughters are due to go and stay there for 3 days and I am trying to find out if they will pick it up too? they have told her not to touch people and to wipe all door handles and toilet with antibacterial solution she is a hairdresser but is allowed to work, are my 3 and 7yr old daughters going to be ok to go there?",
    "doctor_response": "Hello,There are certain diseases endemic to certain areas.people who visit that places should take prophylaxis for those diseases.These are contagious diseases and give a proper condition they may spread to others.Because of the doctors advice it is advisable to keep away people from exposure till the incubation period is over or treated completed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Elevated bilirubin levels. Breast cancer survivor. What is the reason for high bilirubin levels?\n\nHello, I am a stage 1 breast cancer survivor. My oncologist ran blood work and my total bilirubin levels were elevated at 2.0. I understand the normal range is 1.0 I checked old blood work and for like 5 years my levels of bilirubin have been elevated. In 2009, they were 2.0 and 2008, 1.8 and 1.1. What could be the cause of this elevation? What organ should I worry about-- liver? gall bladder? colon? kidney? pancreas? Could it be cancer? I am very worried and don t know how to proceed. Should i consult a gastroenterologist . I am also having a colonoscopy next week? Can they look while i am under anesthesia? What would the procedure be called?",
    "doctor_response": "Hi, to detect particular pathology both direct and indirect bilirubin to be measured separately. then obstructive or hepatocellular jaundice can be ruled out. Breast cancer has a chance to spread to liver causing early changes like increase in bilirubin and SGPT. so you should monitor them closely. You may consult a gastroenterologist but your oncologist can guide you better. reason of colonoscopy is not clear to me, because you have not mentioned related history. anyway follow your doctors' advise.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for random fevers and swollen glands\n\nHi I have been suffering from random fevers which last only a day or 2 for the last 6 munths, i constantly have swolen glands in my neck even when i have been well for a while, i have had blood tests taken and have been called back as they have found something in my blood tests. any idea what they could have found? i can keep wondering and have to wait another day until i can see th doctor",
    "doctor_response": "HiIt is difficult to give an answer  with insufficient informations.The blood tests reports will give sufficient clues to the diagnosis.It could be some chronic infection or could be some blood cells disorder.It is advised to see the doctor with the blood tests reports and discuss in details  any abnormal findings  .Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes gum tear after having dentures?\n\nI had all my upper teeth pulled about 12 days ago and have immediate dentures. I take them out at night and this morning when I woke up a piece of my gum was torn. Now there's a flap of tissue hanging. I believe that it was from my lower teeth digging into my upper gums while I was asleep. I don't know if I should be worried or if there is anything I can do to help prevent this from happening again?  Also my mouth started itching today and I don't know if I should be worried or if there is anything I can do for it. Thanks",
    "doctor_response": "Hi..Thanks for the query...I have gone through your query and will try my level best to resolve it..As per your complain it looks like some area of your upper jaw has not healed after extraction and the gum flap is left hanging, while other possibility is that you have got a gum tear during removal of your dentures..If your lower teeth touch your upper teeth then it can also traumatise your gums and cause tears..So you should consult your dentist and get evaluated so that the hanging portion of the gum can either be stitched back in position or can be removed to prevent further tear and discomfort..Also your denture will be rechecked in your mouth to see if it is fitting properly or not to prevent damage to the delicate soft tissues inside the mouth..Itching inside the mouth can be due to some foods that might be causing allergies and for this you can take anti allergics like Benadryl..In case if it does not get better or you have recurring episodes of the same itching problem then you can consult an Allergist and get evaluated..Hope your query is resolved..Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Being allergic to Codiene, how to treat tendon and left meniscus tear ?\n\nI HAVE ANAPAXALSIS FROM CODIENE AND IODINE.HAVE A SLIPPED DISK AT L3 AND 4.TORN LEFT MENISCUS AND A LEFT TENDON TEAR IN LEFT ARM FROM A FALL.THE MDS SAID THAT BECAUSE CAN I AM ALLERGIC TO CODIENE THERE IS NO PAIN MED I CAN GET TO HELP TAKE THE EDGE OFF THE PAIN.I DO NOT EXPECT THE PAIN TO BE TOTALLY GONE.IT IS TO THE POINT OF NOT BEING ABLE TO COMPLETE EVERY DAY ACTIVITIES WITHOUT STOPPING MULTIPLE TIMES. HAVE A STOMACH ULCER BUT TAKE CELEBREX DAILY.I AM DEPRESSED I CAN NOT DO WHAT I NEED TO DO.I WAKE UP IN PAIN AND CAN NOT SLEEP.IS THERE ANYTHING THAT I CAN TAKE???????I AM DESPERATE AT THIS POINT.",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. I will suggest you to visit a physiotherapy clinic as in physio. There are machines like (TENS, IFT) which relieve in pain and hot packs also helps in relieving the pain along with exercises (like assisted exercises, resistance exercises, stretching). You may get better, and it will also be easier for you to do your activities of daily livings (ADL's) normally. Also counselling session for curing for depression will help you out. Do contact us again once you are symptom less. A tailor made exercise regime can help you in long term which we may discuss later.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Harsh Swarup",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible after partner having abnormal sperm count?\n\nMy boyfriend has abnormal sperm count, and was told it will be difficult for his to get me pregnant naturally, my question is that is it possible at all as we don't use any birth control and unsure wether we should since he is unlikely to get me pregnant.",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice.If sperm are abnormal and low count then pregnancy is not possible. Following are normal sperm count: Count:(5th \u2013 95th percentile): 15 \u2013 213 million cells per Ml Motility:(5th \u2013 95th percentile): 40 \u2013 78% Volume:(5th \u2013 95th percentile): 1.5 \u2013 6.8 mL Morphology: (5th \u2013 95th percentile): 4 \u2013 44%.So if semen parameter are not in normal range  then natural pregnancy is not possible. So I would suggest to upload your semen analysis for better management. Take proper treatment for the abnormal sperm parameter after consulting urologist. Avoid stress, take healthy diet, drink plenty of water and do regular exercise. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can swelling in the ankles and feet with radio seed implants be treated?\n\nI had radioactive seed implants in my prostate a month ago, and 4 days ago, my feet and ankles swelled to where the skin looks like it could split...my Dr. gave me lasic pills and some potassium pills of a sort, and they only work for a couple hours, and then the swelling comes back...any suggestions?",
    "doctor_response": "Hi, The swelling may not be related to radioactive implant. You can consult a physician and get detailed work up to rule out conditions like low protein and renal dysfunction, which can lead to similar symptoms. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for kidney failure?\n\nHI SIR, MY MOTHER SUFFERING WITH KIDNEY PROBLEM. HER BOTH KIDEY HAS FAILED. WILL YOU PLEASE TELL ME ABOUT THE COST OF KIDNEY & KIDNEY TRANSPLANT FACILITIES HOSPITAL IN JABLPUR & KATNI MADHYA PRADESH. PLZ. ITS ARGENT. ANIL KUMAR CHAUDHARY VIKAS NAGAR KOTMA DISTT. ANUPPUR MADHYA PRADESH  04658 EMAIL ID  YYYY@YYYY  &  YYYY@YYYY",
    "doctor_response": "Hello Anil and welcome to HCM.As an Urologist, i can fully understand your problem.After kidney failure, how frequently is she on hemodialysis treatment.If need for kidney transplant is there, surgery and cost for medicines, to prevent rejection of transplanted, vary from hospital to hospital.It's costlier in private hospitals, as they usually have better treatment facilities. What you should understand is that, a kidney transplant should be done from a donor , who has a matching kidney, after doing the tests.(HLA).You may contact me with reports, if you've any other doubts. Wish her well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low appetite in a 1 year old?\n\nGood Afternoon Doctor, I am Jiya. My kid( 1 and 1/2 year old) is not taking any food. While feeding him he started crying, And if we are not feeding then he is ok. We started aptivate from Tuesday before meal but its also not working. We are forcefully feeding him. Please advice what to do.",
    "doctor_response": "Hi.. in this age group rather than quantity of food they eat, what is more important is the activity and development and weight of the kid. Moreover at this age the interest in play activities increase and take precedence over the food. So do not worry. There is not scientific basis in using appetite stimulants....I SUGGEST YOU NOT TO USE ANY APPETITE STIMULANTS AS THEY MAY MAKE THE KID DROWSY.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe abdominal pain post cesarean section\n\nHii had c ssection a week ago and three days ago i started to have upper abdominal pain very sharp like contractions. Yesterday after using glycerine suppositories I noticed that my stool has blood.Ipain is still  there....what could be causing this",
    "doctor_response": "Hi.]Noted your history of C-section a week ago. But started pain in upper abdomen along with blood in stool after taking Glycerin suppository. The most probable cause is colitis that is giving upper abdominal pain as well as blood in mucus.I would advise you the following:- First of all, to consult the operating surgeon for clinical evaluation, examination and investigations like X-ray of the abdomen in standing position, ultrasonography, tests of blood and stool. This will help to get a proper diagnosis and a plan for the treatment.If there is no relief, further tests like CT scan be necessary. Surgical exploration may be needed if there is a suspected post-operative complication.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluid discharge from penis during night?\n\nHi. I am 33 years old, I use to masturbate lot like once a week, then I moved to twice a week. every thing was going normal for few months, I will say at least 6 months. Then suddenly I start having wet dreams even without any sexual or any other thoughts. then one week I noticed I had wet dream 3 days in row. after that I also start seeing some white shine drops in my under wear without any arousal. I though may be I masturbated too much so I decreased the frequency. Its been a month or so. but I am still seeing same problem. some fluid leaked every day or night without arousal or sexual thoughts. in last few days now I noticing even I try to have sexual thinking so I will get ready for masturbate but I get erected for minute and when I try to masturbate I am done in 20 seconds. Would you please help me and explain me what is wrong ? One thing I was doing from last six months is regularly drinking 2 table spoon of fiber just before sleep because I had constipation issue and if I do not take this fiber I start having blood in stood. Now I also stop taking fiber for every night but still taking every after 2 or 3 days. Please advise Thanks in advanced MK",
    "doctor_response": "Hiwelcome to health care magic I have gone through your questionLooking at your history it seems that you might have contacted infection on urinary tract may be due to unhygienic practises please visit your doctor for through examination and a battery of test to confirm a diagnosis meanwhile have good balanced food with multivitamins and minerals supplements to boost your immunity and vitalityhave plenty of fluids dailygo for exercise regularlyhope this helps youwish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is acupuncture therapy helpful in increasing height ?\n\ni am 23 years old.is there any possibilty of hieght increment by acupuncture therapy i am 23 years old.is this possible to grow height by acupuncture therapy",
    "doctor_response": "hi and welcome to healthcare magic!! well i am sorry  to disappoint you but the age at which height increment stops is 18-20 years after which all the secondary centers in the bones are fused so to answer your question no acupuncture or any other method cannot increase your height at the age of 23. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why does my cousin have breathlessness on climbing stairs?\n\nHi doctor, I have a 21 year old cousin, who is 181 cm tall and weighs 120 kg. He has slight breathlessness when he climbs stairs.\u00a0He does not have any other health complaints and does\u00a0regular health checkup. Please take a look at the attached test reports and kindly let us know what has to be done.",
    "doctor_response": "Hi. I have gone through his\u00a0reports (attachment removed to protect patient identity) and found the following issues worth mentioning. For further queries consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for soreness in spine and bones\n\nHi there, a question from New Zealand. I am 50 years old, weigh 71kgs, am a landscape gardener as my profession. Over the last 2 years, I have been struggling with the body creaking a bit more, and had a few problems with my T2 T3 areas in my upper thoracic area and supaspinatis soreness(rotator cuff).I have gone from using a glucosamin/chondroiton tablet to a product called Puraz. This has a collagen hydrolysate formula, for rebuild of cartilage cells, collagen , and has a hyaluronic acid for lubricant.I am about to resume using a purified fish oil with Vitamin D, and EPA 750mg and DHA 550mg with other omega 3's of 300mg.Question; Is there any other oil or supplement that you would recommend to use in conjunction with the abovementioned, that may help me stay comfortable, and do my job for a few more years?Many Thanks, Ben Teeuwen.",
    "doctor_response": "Hi Thanks for your queryI'm Dr Sudhir KumarI have gone through your query and understand your concern. You can take Diacerine if it is available in your country. You can analgesic such as ibuprofen for pain whenever require. Regular walk and excercises will help you a lot.You can discuss with your doctor about it.Hope your query get answered. If you have any clarification then I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do persistent seizures need immediate medical attention?\n\nMy grandson, has been suffering from seizures for months. He have not been diagnoised with any type of disease but his current doctor has been saying that she is trying to get him into a specialist. This has been for several months. He is having seizures some time in the double digits per day. He can go weeks without having one and then when they return he has them back to back. As a matter of fact he is currently having one. We are at wits end. I suggested to my daughter that she need to take him to someone else who will take the problem more serious. They have moved his scheduled appointment with a neurologist from December to sometime later this month. He is having a second seizure during the time I have stated this text and now. Do I need to take him into the hospital or let him to continue suffer until his appointment later this month. YYYY@YYYY",
    "doctor_response": "Persistent seizures is definitely a great concern the child definitely requires hospitalized and further tests required",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could i be pregnant as i have abdominal cramps and sore nipples?\n\nI have sore nipples lower back pains lower abdominal pain cramps hungry all threw out the night nauseous after I eat certain food and vulva tender could I be pregnant . I haven t had sex in three weeks with out birth control and condoms I used the pull out method could I really be pregnant ?",
    "doctor_response": "Hi, if you have delayed the periods, then you may be pregnant.  You can do a urine pregnancy test at home to confirm. These symptoms can be premenstrual also. So, after pregnancy test, you can clear your doubt. Hope I have answered your question.  If you have any other query, I will be happy to help. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Vertebral artery dissection, pseudo-aneurysm affecting vision, balance and causing pain, taking tramadol ,ibuprofen. Further tests or treatment required?\n\nI have been diagnosed with a vertebral artery dissection and psuedoaneurysm. First, the left side was affected, and now there is also pain in the right side. My vision has been affected, as well as balance. I am currently taking aspirin and tramadol with ibuprofen for pain. I am waiting for a referral to another hospital. Is there anything else I should be doing. I feel like a walking timebomb!",
    "doctor_response": "DearI am sorry for the symptoms you are suffering.It will be difficult to treat your disease because you have already start the right treatment.It will be wise to control your vertebral artery periodically with brain MRI and MRA and if no changes are seen you will continue the same medication.Wish you all the bestRegardsDr Eris Ranxha Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How early can i take pregnancy test after intercourse?\n\nHi, My mensual cycle varies from 25 to 31 days after marriage. Now i am trying to become pregnant and we had our intercourse on 4th and 8th of Apr 12 and my last period was on mar 24 2012. Can you tell me how early i can take the home pregnancy test, as i am eagarly waiting",
    "doctor_response": "Hi,Ovulation usually  occurs 14 days before the next period. Your shortest cycle is of 25 days. Considering this your expected next period is on 17th. and ovulation around 3rd.The earliest Pregnancy  can be detected is 8-11 days after ovulation. So you may do the pregnancy test on 14th. But I advise you to do it if you miss the period only.I hope I have answered your concerns.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How should TB causing weight loss, legs swelling, loose motion be treated?\n\nMy brother is suffering from TB since two months, he is having the tablets given by the doctor as prescribed, but still he has lost his weight, his legs get swollen up, he has extreme thirst, fever and some times loose motion.  He was admitted in the Rajiv Gandhi Institute of Lungs at Bangalore for more than 25 days, he has lost hope in himself, Doctor kindly advice, what I have to do? His age is 40 years. kindly help me",
    "doctor_response": "Hello,The possible issue here seems tuberculosis with systemic sepsis condition.As patient is under hospital treatment, it is mandatory to evaluate the case with all details of the reports to comment further.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the treatment for the swelling that occurs after wisdom tooth removal?\n\nHello doctor, I had my right lower wisdom tooth removed three days ago. Now the swelling is somewhat near my lower jawbone seems to have hardened. The right cheek looks puffy. And have localized slight pain on pressing the lump. Could you suggest a solution for what the problem seems to be?",
    "doctor_response": "Hello. I understand your concern and feel sorry for the way you are feeling. Though the pain may last for five to seven days, hard swelling is unusual for us to see. Get it checked to rule out any possible complication. Ice packs are usually recommended, but I recommend you check it with your doctor as hard swelling may not get softened with cold application. Painkillers give patients virtually pain-free recovery over 7 to10 days. Some enzymes also help subside the swelling. Keep all this when you go for follow-up. I hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "what causes lumps in ear?\n\nI found a lump behind my left ear. It s above my jaw bone but in front of the muscle of the neck. So it s on the soft pocket of that area behind the ear. It doesn t move when I swollen and it s not painful at all. It s been there for about almost a month. Wondering what it could be",
    "doctor_response": "there is nothing to worry much about this as this is a simple sebaceous cyst or dermoid cyst.an FNAC test can confirm the diagnosis and take caution not to infect the swellingthen consult an ENT/general surgeon for physical examination.all the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the causes of diarrhea and nausea every morning, with terrible sinus headache?\n\nHello doctor, I have had a sinus infection for over eight weeks now. After trying to get rid of it using Neti pot and Flonase, I started taking antibiotics.\u00a0I had my sinuses scraped about four years ago due to a recurrent sinus infection.\u00a0I went to a dentist because of a broken tooth, that was causing me pain. The dentist put me on two more antibiotics to treat the pain. So, currently I am under Alprazolam 0.5 mg (four times a day), Truvada (once daily), Quetiapine and Buspirone at bedtime. I have horrible diarrhea and nausea every morning\u00a0and\u00a0wake up with a terrible sinus headache still. I am at my wit's end, and cannot see my regular doctor for a month. I am getting the tooth extracted in two days, hope it will help. Any guidance would be so much appreciated.",
    "doctor_response": "Hello. So you have two issues, one is your sinusitis, and the other is diarrhea. Gastritis is probably antibiotic associated, so you need to discuss with your doctor and change the antibiotics that are causing your diarrhea. I would suggest the following for your gastric problems. For sinusitis along with antibiotics I would suggest you try the following. For a headache, you can have Paracetamol or Ibuprofen whenever needed. If it is not helping, then you need to discuss with your local doctor for a short course of oral steroids. Consult your specialist doctor, discuss with him or her and start the medication after their consent. Get back if you have any doubts. For further information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does my TMT report suggest?\n\nHi I am 34 years old and my TMT report remakrs as below.1 Base Line ECG has ST-T changes in infrolateral leads.2 TMT was terminated at 7.22 min stage III of Burse protocol due to the achieved 97% THR.3 He has achieved 97% of THR & 8.7 METS.4 There is no ST depression in any leads at peak exercise as compared to resting ECG to suggest Ischemia, There is mulitiple VPC's seen during exercise and recovery period.5 Normal HR and BP response.6 No conduction disturbance during TMT or in recovery phase.7 No c/o angina, breathlessness.8 No sign suggestive of LVS3 Gallop or basal creps.9 Recovery is uneventful.10 Fair effort tolerance.TMT is negative for inducible ischemia at moderate workload.",
    "doctor_response": "more pvcs during exercise are abnormal. may be due to cad. though normal tt may do nuclear tt or coronary angiogram to r/o cad",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ankylosing spondylitis\n\nHello, My mother s caretaker has shingles. She had the vaccine last July and does not have blisters, puss or wounds. She did see her doctor within 72 hours, who told her that it probably didn t fully develop because of the vaccine. She was prescribed medication. Our concern is that my Mother is 82 and is taking many medications, including Enbrel. When will it be safe for her caretaker to return?",
    "doctor_response": "HelloThank you for trusting HCMDear  a person with shingles is not infectious before the blisters appear. Once the rash has developed crusts, the person is no longer infectious.Shingles is less contagious than chickenpox and the risk of a person with shingles spreading the virus is low if the rash is covered.Crust formation may vary from person to person depends on immunity status from 1-2weeks.I think I answered to your question if you have more questions feel free to ask.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for muscle pain\n\nSuffering from muscle pain from past 20 days. Doc prescribed ace proxyvon meganeuron and pantop 40 tablets. Got instant relief. But as soon as I stopped the medication pain has resurfaced....I m OK only when I take these tablets. Doc has now changed the medicines. Has prescribed lupoxa and nervijen. No relief at all.. please help. X ray reports are normal.",
    "doctor_response": "hithank-you for providing the brief history of you.i feel you should start performing some simple exercises for improving the cardiac endurance and later strengthening exercises.As most of the times medications are symptomatic and helps only for time being. Also, more of the medication will lead to damage to kidneys so I feel the physician has stopped the medicine due to this factor.Also in my clinical practice most patients respond well to physical therapy and exercises.regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Undergoing ICSI, have dull pain in ovaries followed by severe one, mild cramping gas. Could it be due to implantation?\n\nHello, I am 7 days into a 2 day transer with icsi last night i had a scare i was feeling a dulll pain which seemed like it may have been my ovary it kept me up all day and night around 11:30- last night i finally slept for about 45 min when a knock came on the door i jumped up and all of the sudden is was in severe pain it hurt so bad my body was shaking and i was crying for the last 5 days ive had mild cramping gas and other twinges this morning i feel nothing not even the faint dull pain that i also felt where my dr. put in the serem is it normal to go from feeling all of these things to nothing??? I m so worried something happened because of all the stress my body indured or is it possible that they have started to implant?? Please help im so scared i blew it",
    "doctor_response": "Hi, Thanks for your query. I read your query and understand your concerns. Following is my reply: The pain is related to egg pick up. When eggs are removed from body ovaries pain few times. Hence this happens to some women. This is not a sign of implantation. I hope I answered your query. I will be available for any follow up queries you have. Regards, Dr.Mahesh Koregol IVF & Infertility Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could high WBC count be due to infection?\n\nHi there doctor, I was taking the antibiotics Doryx until yesterday for 9 days because of a skin infection with boils due to a bad heat rash. Yesterday I did blood tests and this is what came out bad: Cholesterol total 218, high; LDL Cholesterol Calc 116, high; TSH 5.370, high; WBC Esterase Trace Abnormal; WBC 6-10 Abnormal. Could it be that the WBC is high because of the infection that I had? And if not, what would you recommend? And what would you recommend for the thyroid? Could the infection or antibiotics be affecting my thyroid? What is your general impression? Thanks a lot, I am a bit worried. Y.A.",
    "doctor_response": "HI, thanks for using healthcare magicInfections can cause a temporary increase in TSH and are also associated with an increase in WBC.Since you only completed the course of antibiotics the day before the bloods were taken, you should consider repeating them in 10 days to 2 weeks if you remain well.At that point the results can be taken as a true reflection of any issues that may be occurring.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility problem despite having regular periods\n\nhello doctor i am married for last 2.5 years and my age is 37,my periods are regular,all the tests are okay ,some times there is slight less growth of follicles and endometrum as well,donot know the exact reason of infertility,can you help with some suggestions?",
    "doctor_response": "Hi, there is age factor in your case you are 37 years old at this age ovary start decreasing its function less egg and less less ovulation ,if I would be your treatning doctor I would have been advised you ovulation induction and IUI for 6 month followed by IVF and ICSI. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and discomfort after wearing a mouth guard?\n\nI got a mouth guard a few nights ago. I started wearing it and am having a lot of pain. It's not jaw pain or muscle...it feels like I have sores or rawness in the very back of my left side (top and bottom). My mom said it is very red and swollen. Is that adjusting or is something wrong?",
    "doctor_response": "Hi...Welcome to healthcare magic. As per your complain you have problem of swollen and  redness in mouth after wearing a mouth guard. Overextention or improper adjustment of appliance lead to this type of problems. Consult your dentist again for oral examination and adjustment of mouth guard. I hope my guidance helpful to you.. Take care. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for loose motions\n\nHi, may I answer your health queries right now ? Please type your query here...my daughter is 7 months old and was suffering from loose motions since 21st feb. But now she is feeling better , doctor here adviced to go for blood test , stool test and urine test . In that we came to know that the phosphorus count is more. Please let me know what the effect it will be",
    "doctor_response": "hi, the level of phosphate can increase is sample is kept for long time, increased level do not usually occur in loose motion. Kindly repeat complete blood count so that it exact phosphate levels can be known. Also attached full picture including calcium levels and Alp levels.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the lump found in the colonoscopic result?\n\nrecently I had colonoscopy test and the doctor said that there is a lump in the finding what it can be. I am going for ct scan and surgery next Thursday. the doctor said it may be props or cancerous in stages 1 or 2. is it serious and life treatning, pls advise, I am tensed! I have a sometimes burning sensation in the belly, the stools are sometimes going bits & pieces, dark brown in color and bowels clearing abt 3-4 times a day, sometimes immediately after taking food. I have lost abt 8kgs over a period of 1 year.",
    "doctor_response": "Thanks for asking in healthcaremagic forum   Do not worry, medical science now a days has improved a lot and have solution and cure for many type of malignancies. Your history is suggestive of some growth and your loss of weight may point towards malignancy, but go for follow up and surgery as advised by your doctor. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high levels of prolactin?\n\nHi I had an mri and doctor said my pitituary gland was a bit bigger he send me for another mri because he dosent know what it could be he also send me to get blood draw and it came back my prolactive was high dose this mean I have a tumor its freaking me out",
    "doctor_response": "Hello and welcome to HCM, A pituitary mass along with high prolactin levels is very much suggestive of pituitary tumor. The high prolactin levels can be treated by removal of the piyuitary tumor. Thus, consult your neurosurgeon for planning of surgical removal of the tumor. Removal of the tumor will improve theprolactin levels. Thanks and take care Dr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for sore throat with lumps\n\nHi I have a sore throat and a fever which started 24 hours ago. I keep getting a lump in the back of my throat and feel like there is something stuck there. Its not flu or a cold. This morning I felt a fairly large (6-7mm) yellow soft lump come out from the back of my throat, on one side, that side feels better now but the other side is still sore. It feels like there is another such lump stuck there and waiting to come out. Can you help diagnose this and recommend a treatment? Thanks",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have upper respiratory tract infection.  Granular pharyngitis may leads to lumpy feeling.  You should take a course of antibiotics.  Azithromycin or amoxiclav can be useful.  Warm saline water gargles are also useful.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having knee pain along with muscular pain?\n\nI am a 38 yo woman with Lupus. I have been having muscular pains in both legs, mostly on the left side. Now my left knee is starting to hurt. I don t remember injuring my knee, but it hurts along with the muscular pain. Any thoughts of what could be the problem?",
    "doctor_response": "Hi,Given the history of lupus, your knee pain can be attributed to damage done by lupus to your knee joint. Kindly do hot pack twice a day and do low level impact exercises for your knees. Quardiceps isometrics exercises and heel slides, rotation of ankle. Pulling and pushing of ankles will strengthen the muscles of leg and will help you out in decreasing pain, you can also contact physiotherapy clinic where machines like (tens, ift) can releive you of your pain. Stretching exercises of quadriceps, hamstrings and calf will also help you out. Do swimming, cycling and steam bath twice a week will surely help. Hope you find the answer useful. Let me know if I can assist you further.Regards,Dr. Harsh Swarup",
    "dialogue_context": ""
  },
  {
    "patient_message": "Would leukemia cause absence of sperm?\n\nthis is a bit embarassing......i was diagnosed at 17 with acoute lymphoblastic leukemia and before i began chemotherapy i had sperm tests where no sperm was found,i then had a testicular biopsy and again no sperm was found.could the leukemia have caused this and will i ever have sperm?",
    "doctor_response": "Welcome to Healthcare Magic.. Absence of sperm in your semen analysis before starting any chemotherapy and also nil sperm in testicular biopsy shows that for some reason sperms have not developed...  This is unlikely to be due to leukemia..  If it is primary absence of sperm then there is no treatment available...  Hope this answered your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the treatments for nightfall and premature ejaculation?\n\nsir, im a student , i never had sex with a girl till now, but night time while sleeping my sperm get come out during sexual dreams, i cant control and while watching sexual videos if i starts masturbate i get cum in 20 sec, i want to extend my sexual thing before getting married,pls give me some advice",
    "doctor_response": "Hi,Nothing to worry, this is common at this age and frequency increases due to modern time style like having chatting with girl friends, seeing porn and sex videos.Early ejaculation depends upon how much you are sexually excited.Nothing to worry, you will have normal and satisfactory married life.Spend some time with your friends,sports, games.Remain busy with your study.Have some good reading and see some social tv serials in the evening.Wear loose clothes while sleeping.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Found congestion & edema in glans\n\nHi there , i had a circumcision the day before yesterday . However , the second morning i got up , i found some congestion and edema in my glans and my dick body ! i have been very worried about it . I wanna ask how i can mitigate that problem and just recover as well as before . pls help me \uff01 PLS",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern looking to the history given here if you have operated for circumcision then on second day of this operation the selling is the common complain and this is nothing to worry because with the proper medication and care this subsides soon and I guessed such medicine must be given to you, hope this information helps you, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high pain in heel?\n\nI HAVE TERRFIC PAIN IN MY RIGHT HEEL AND HAVE BEEN ICING IT REGULARLY BUT I DO NOT SEE ANY DIFFERENCE IN THE PAIN LEVEL. IS THERE SOMETHING I AM MISSING",
    "doctor_response": "If  you have been having more pain in the early morning hours andif it is at bottom of the heel and not at the back of heel ,most likely you are suffering from a condition known as plantar fascitis, which is not a worrisome condition.The soft tissue at the bottom of heel because of aging becomes inelastic and tight and cause pain ;more while walking.If the complaints are of short duration (less  than six weeks) you will be benefitted with a short course of painkillers like diclofenac,physiotherapy including local ultrasonic rays and stretching exercises for the lower calf and plantar fascia .However you will need xrays and blood investigations like CBC,ESR, Blood Sugar, Sr.uric acid ,if you fail to get relieved after a week to ten days of the treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility\n\nHello DoctorI, Mohammed Zafaruddin, male, age 39 around, I have a problem from many years that i could not give baby to my wife then doctor advice me for Semen Test Analysis.  He Prescribe me Andro garlin Tab.  If any other suggestion is their for me, let me know,  Awaiting for your reply.",
    "doctor_response": "To conceive you should having active motile sperms. If you are having problem in that then you should diagnose for that. Do some tests like ultrasound of scrotum to rule out Vericocele. Thyroid profile , Sugar etc.After these you can go for IUI, semen wash out technique etc.So consult urologist for the same. He is the proper person to guide you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the bumps on my neck?\n\nSunday I had a bump appear on my neck, not huge but noticable. Well it is now Wednesday and it is about the size of a dime and a small bump has just appeared above it. It doesn t hurt unless I mess with it and it isn t red or discolored. What could it be? I haven t been sick, beside the bumps I have only been fighting headaches.",
    "doctor_response": "Hello!Thank you for the query.Bump on the neck can be a lymph node (enlarged), sebaceous cyst or any other benign soft tissues lesion (like lipoma).As I am unable to see it and examine it, its really hard to give precise diagnosis.Enlarged lymph node can appear due to some kind of infection (which you may not even notice) including teeth infection, ear infection. Lymph node is usually hard, rounded and movable. In most cases lymph node does not hurt, however when pressing it or touching, can become painful.Sebaceus cyst is a benign soft tissues lump, filled with whitish masses. It does not turn into a cancer. However it may become infected (if so it starts hurting).The best you can do with this lump, is to have soft tissues ultrasound done. Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of weakness that cant even walk ?\n\nI would like to ask about a patient I have met in the remote area of my country when i was there for my field works, a patient complained that she initiated to have weakness and after 2 or 3 days she could not walk at all even to leave her leg, with this symptom how can we treat and advise her?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. However, the answer is a little difficult because such paralysis may be cause by many different causes, simply knowing there is weakness is by no means enough and tests are needed to identify the cause before we start discussing treatment which varies according to the cause. The most likely possibilities would be peripheral nerve damage like for example in acute polyradiculoneuritis (Guillain-Barre syndrome) or spinal cord damage due to inflammation, stroke, tumors etc. As I said a proper neurological exam as well as probably tests like spinal MRI an EMG are needed. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dry and cracked foreskin\n\nHi, im a 24 year old male and I have recently suffered with thrush which seems to have cleared up now. However, my foreskin is very dry and cracked now. I have been using e45 cream for a week and there has been no change. I'd appreciate any advice, thanks",
    "doctor_response": "Thank you It may be due to fungal infection.Please take following precautions.Use loose cotton clothes.Keep area dry.Apply antifungals like clotirimazole.clean the area twice daily with warm water.Treat your partner also to prevent recurrence.consult doctor if does not subside.You can get back to me for any clarifications with the photos.Dr Bharatesh D Basti Dermatologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stones in gall bladder?\n\nMy father is 55 years old. He has stones problem in gall bladder. When he sleeps facing left side, after 5-10 minutes he feel uneasy and had to change the sleeping direction. Please suggest what could be the problem? (His Heart checkup resulted normal)",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.Your symptoms may be suggestive of gallbladder stones so you should do at least ultrasound or CT scan to evaluate it more accurately. This is caused by stone in bile duct and is very common condition.  Stones are see more commonly in obese people and those with diabetes. You need to change your dietary habits first.  Need to avoid fried food, carbonated drinks, coffee, alcohol and spicy food. You should eat more milk products, vegetables and boiled food. If there is no improvement on lifestyle or dietary changes, then surgery is recommended. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest therapy for bad mood swings and disturbed sleep\n\nIm feeling really tired and exhausted everyday. My dad and Grandmother who i was really close too passed away within 2 weeks of eachother this year and i havnt been the same. I have really bad mood swings and i will break down and cry at the slightest things. Im sleeping at night but its not a sound sleep when i do wake i feel as if i havnt slept at all. please help?",
    "doctor_response": "Hi dear. I had gone through your query. Sorry for your loss. I understand your emotions and mood swings can be a part of this.It is grief reaction because of loss of loved one.You are in stage of bereavement and require support.Psychological and social support is must.All will gradually disappear as time passes.Never let yourself alone. Try to discuss and taking witj friends and relatives. Medicines like benzodiazapine can useful for sleep.Psychotherapy like grief therapy can be useful.Consult with psychiatrist and get help. Still if you have a query then feel free to ask. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Possibility for pregnancy on the same month after taking Primolut N\n\nHello Maam.. I would like to know if the intake of Primolut N does stop ovulation and folicule formation during that period? Can I try for pregnancy the same month I take Primolut N for postponing my period??? Its very urgent. Please help me.",
    "doctor_response": "Hai, 1. Primolut N has only progesterone in it. It is usually given in last week of cycle to get withdrawal periods. it has nothing to do with ovulation. 2. Pregnancy can be tried very well in the same month, 3. It has no effects on the fetus also.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in chest due to inflamed cartilage between sternum and ribs\n\nWhy has my chest been hurting I m 19 and don t really do anything much at first I went to the doctor and they said my cartlege in between my sternum and ribs was inflamed but its now back what could I do to ease the pain or get rid of it all together also I thought it might have been asthma",
    "doctor_response": "Thanks for your question on HCM.I can understand your situation and problem.You are having musculoskeletal pain.So try to follow these steps for better symptomatic relief in musculoskeletal pain.1. Avoid heavyweight lifting.2. Avoid strenuous exercise.3. Avoid movements causing pain.4. Avoid bad postures in sleep.5. Take painkiller and muscle relaxant.6. Apply warm water pad on affected site.Also take your asthma drugs regularly.Don't worry, you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the breathlessness be related to lupus or fibromyalgia or rheumatoid arthritis?\n\nHi my name is Janelle.  I have Lupus, Fibromyalgia and Rheumatoid Arthritis.  Lately I have been experiencing leg weakness and I am all of a sudden out of breath as soon as I stand up.  Could that be related to anyone of my diagnoses or could that be something else?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. Yes, breathlessness in connective tissue disease (Lupus or fibromyalgia or rheumatoid arthritis) is suggestive of lung involvement. These diseases can lead to Pulmonary fibrosis, Pulmonary embolism, bronchitis and lung infection. And all these can cause breathlessness. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. PFT (Pulmonary Function Test) 3. CT thorax. All these investigations will definitely diagnose if lung involvement is there. So better to first diagnose yourself and then start appropriate treatment. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling in fingers while masturbation?\n\nHello i am a 25 year old male and when i am masturbating my fingers in my right hand become all tingley and as if i have been sat on my hand to make it numb. also i get a shooting pain from my left armpit towards my nipple. are these related and if so do i need urgent medical help? Also when i am sitting down on the floor with my legs crossed and then stand up my knee is in loads of pain. could you please explain what these are and do i need help. thanks.",
    "doctor_response": "Hello, Masturbation alone cannot cause the symptoms you are describing here. Tingling right hand, shooting pain left armpit to nipple and knee pain all these are possibly not related. Do consult your doctor for a physical check-up. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Got hit in head. Did blood test. Liver, kidney enzymes, potassium level were high. Causes and treatment?\n\nHey, I just got back from the doctor. I originally went in because I was light headed after playing soccer and hitting my head on the post on Saturday. I went to the doctor after work on Monday. The doctor did blood work and my liver and kidney enzymes were above 250 and my potassium level was 6.4. My blood pressure was also pretty high. They sent me to the emergency room and I had to stay overnight. They made me drink something to get my potassium level down. The next day all my levels were normal except my liver. My liver enzymes were still at 69 or 89. Not exactly sure what they said. My light headedness has finally starting to go away. I had a ct scan and a sonogram done on me and they both came back good.They told me to come back and get it checked in a month, but did not tell me the cause or anything. Any thoughts on what it could be or what I should do? Thank You!",
    "doctor_response": "Hi! Thanks for your query. Well you have not given history eating and drinking habits. If you are consuming Beers and spend long time of fasting the liver enzymes may go up. Wait and watch and in case the liver enzymes are still high may need a Gastroenterologists opinion. Otherwise nothing to worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling on shoulder\n\nI took a fall from a scooter and landed full weight on my shoulder across a concrete curb (37 year old male). Had x-rays, no obvious break...3 days later still swollen (with ibuprofen and ice) and cannot take my arm across my body or extend it and raise it in any direction. The acromion is still not visible with the swelling. I am a carpenter and rely on my physical condition to work safely. I am thinking of contacting an orthopedic (or my trusted chiropractor) to further investigate, or should I give it a few more days? If there is other damage I don t want to wait too long.",
    "doctor_response": "Hi..since you had a fall, swelling might to due to trauma to some structure in the shoulder joint...it's good that you had a x-ray done..now I would suggest you to wear shoulder sling to take of undue load on shoulder joint..ice your shoulder frequently....like once in every 2 hours...I also suggest you to meet an orthopaedic or a qualified Physio to rule out ligament and muscle injury...so that adequate steps can be taken to prevent any later complications...injuries of this sort will take time to heal sometimes upto six weeks...as I told continue medications till as per your GP advise and icing frequently will definitely help to bring your pain down and assist in healing of shoulder...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive.   Diagnosed bilateral vericocele.   Sperm analysis showed 42% motility, total count 102 million.   Explain\n\nMy wife and I have been ttc for our first for over 2 years. I have been diagnosed with bilateral vericocele. My sperm analysis showed 42% motility and 10% morphology(strict), with a total count of 102 million.  24 million per ml. We are quite confused as to whether or not my semen analysis answers the question of if I am the cause of our infertility?",
    "doctor_response": "hi,thanx for writing to us.well according to the standards ur count is absolutely fine for a male to be fertile.well for more better results u can plan for iui treatment.well i dont know much about ur wife's results so i cant comment much.but from your side everythingz fine.u can consult a surgeon for correction of varicocoel. byee",
    "dialogue_context": ""
  },
  {
    "patient_message": "Result says Distended gall bladder with 6mm calculus. Taking Uscorol since a month. Better medicine than surgery ?\n\nmy test result says GALL BLADDER: Distended. Calculus measuring 6 mm is noted in gall bladder. COMMON BILE DUCT: Normal in size. I m taking 2 tablets(Uscorol 300 mg) every day from last 1 month. But, the size of the stone is decreased. Is there any good medicine available to dissolve the stones?. I am having very little pain(1 time in a week) in right hand side. Is there any surgery available to remove gallstone with out removing gallbladder?",
    "doctor_response": "Hello Thanks for your query.You have been detected to have  a distended gall bladder containing a stone of  6 mm size .Since you do not have obstructive jaundice and pain it is labelled as a silent gall stone .You may neglect it but you have to get your ultrasound scanning done repeatedly to watch the status of the size of the  stone, Please note that there is no medicine that can dissolve the stone.Since gall stones are formed because of gall bladder itself been infected best  permanent remedy is to get it removed by Laproscopic procedure which is very safe and result oriented surgery..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does blue black bruise on lower left side of stomach needs attention?\n\nyesterday the lower part of my stomach on the left side started hurting , and almost felt like a burning pain . i didnt think much of it . my stomach has been hurting on and off for about 5 days . i am over weight . bit i just noticed a very large bruise there on my lower left side of stomach . it is purple , blue and black .i do not recall bumping into anything . what could this be , should i got to the doctor or wait a day or two to maybe see if it goes away ?",
    "doctor_response": "U should very cautious about this, at the place u said spleen will be there, if it damage by any injury it can cause like u said, but u should rule out wether it confined to skin because of any superficial trauma or any insect bite..hope I am help ful",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the treatment and side effects of bug bite?\n\nMy 22 month old daughter was bit by a bug. We took her to the doctor and they gave us some cream to rub on the area. She has one on her arm and on the inner side of her elbow her veins look green and appear bulging out of her arm. Should I keep an eye on it or take her to the er?",
    "doctor_response": "Hi...by what you quote this looks like a spider bite. You can use Hydroxyzine at 1-2mg/kg/dose every 6th to 8th hourly for 7-10 days.Using only topical ointments will not be of much use.I suggest you take her to the nearest emergency room and get her checked once.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does sharp pain with lump on lower back mean?\n\nI have a lump on my left side lower back that appears to have a fever.  the pain in minimal but sharp. it appeared about a day after i had a kidney problem that ended in an infection. when the fever broke I had broken into a bout of shivering so severe I strained the hamstring in my right leg.",
    "doctor_response": "Hi, From history it seems that there might be having severe urinary tract infection producing pain, fever and generalized body ache.Take some medicine like Diclophenac, paracetamol combination medicine for pain and bodyache.Go for one course of Ofloxacilin  antibiotic medicine course for 5 days.Take plenty of water.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high fever and excessive breathing while having high blood sugar level?\n\nHusband has belching, retching at times, 102.fever, weakness, pain in thighs, out of breath, what can that be? His blood test only showed sugar was high. Is not doing blood culture to check for infection in blood. Fever yesterday was 106 and last night - heavy, rapid breathing, worse than his normal sleep apnea. What do you suggest? he took xray today - no results yet.",
    "doctor_response": "since he is diabetic and he is having high fever and is sugar level is too high. he might have some urine infection because of increased glucose output in his urine it might cause some urine infection. better to do on urine culture and to check whether any growth is present. taking antibiotics according to that might reduce the fever and infection.thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Memory loss, difficulty in speech. History of heart attacks, anemia and depression. Family history of cancer\n\ni have been having these spells as I call them for going on 3 years and cant get no answers... I have trouble with my speech I have memory lost ,get small shakes,  I get confused, I have went into stores and got lost due to them ... they last any where from an hour to a few days... and after they go away its like I have lost a day or so and they make me very tired afterwards and information would help me................ and to let you know alittle about my health I have had 4 heart attacts anemia depression and have a family history of cancers heart problems....Thank you bonnie",
    "doctor_response": "Hi, Thank you for posting your query. Based on the symptoms, there are two possibilities: 1. Transient global amnesia (TGA)- in this condition, there is lack of blood flow to left side of brain, leading to various symptoms as you described. 2. Seizures- episodic confusion with shakes can occur, but they do not usually last that long. Evaluation would include MRI brain and EEG. You are likely to do well with medical treatment. Please get back if you require any additional information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain on belly button, vomiting and loss of appetite?\n\nmy son is 4 years old and has been experiencing pain right on his belly button with occassional vomitting, complete loss of appetite. This has been happening for a week. We went to the hospital and they said he does not have appendicitis but could not explain why this is happening. Can you help me.",
    "doctor_response": "pain on right side may b due to swelling in liver due to several causes, gall bladder disease or right sided renal stones. all these condition are associated with loss of apperite and vomitting. so u should go for a good usg abdomen with kub.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes halt in height and weight growth at age of 16?\n\nHi, may I answer your health queries right now ? Please type your query here...i m 16 years old. i got my period when i was 12, and i m still irregular. i m 4 feet 11 inches, and i ve never had a growth spurt, my doctor says my knees are pretty much done growing and i ll prolly never have a growth spurt. i weigh approximately 98 lbs and i ve been 98 lbs for a couple years. my boobs aren t getting any bigger and my face is hasn t really changed. the only thing that could possibly indicate that i m a sophomore in highschool is that i have a bit of acne (a pimple or two) and body hair (that i shave off). as far as the rest of the world can see, i have the body of a 12 year old. my point is... WHY AREN T I GROWING?",
    "doctor_response": "u can have your thyroid and growtrh hormone levels checked i suppose to rule out any hormonal deficiency.. and 5 feet at 16 years appears pretty common though . dont worry. if your mother too has thyroid problems more chances for u to have t too",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stiffness & numbness in leg& medial shin?\n\nRight lower leg feeling tight with some puffiness and slight numbness, medial shin now radiating to right medial foot, it feels heavy with some weakness whilst walking, superficially a bit numb. This has come on quite suddenly within the last 10 minutes for no apparent reason.",
    "doctor_response": "Hi, This could be a sign of pressure on the nerves in the spinal canal- causing numbness, light feeling and radiation to right Medial foot. If it persists then start a combination of pregabalin and methylcobalamin and Get MRI of the lower back. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain during pregnancy?\n\nI m 19 years old and 4 months pregnant. I have been having sharp chest pains. A couple of days after it started I was at work and passed out for no reason. I went to the hospital, they said everything was fine. but didn t tell me what could cause it....",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the sharp chest pains can be due to gastritis.Gastritis is quite common in pregnancy.Avoid spicy and oily diet.Take food in small quantities every 2 hourly.Take antacids.As everything is normal you need not worry.Avoid stress.Take adequate fluids upto 3 litres to prevent urinary tract infections.Nothing to worry.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "EP, removal of ganglioglioma, anxiety attacks, depression. EP medications taken, surgery done. Advise?\n\nHiMy son is 18 years old and has just removed Ganglioglioma for the third time. He got epilepsy in 2006 and in 2009 they discovered the tumors on the left side of brain. He has tried so many EP medications and even though they have done EP surgery (taking away tumors and braintissue) three times he still gets EP. He has also got angsietyattacks and depression and feel Life is hopeless. My question is; is there certains medication that works better against EP caused by the tumor? If the tumor comes back - is there other treatments besides surgery? I know anti depressives are difficult to give since it doesn\u00b4t cope well with EP medication, but is there some anti depressive better than other?",
    "doctor_response": "Hi,Thank you for posting your query.In your son's case, as he has epilepsy and depression, it would be better to use either divalproex or carbamazepine. This is because these two medications are effective against both epilepsy and depression. Also, it is better to add anti depressant such as escitalopram as his quality of life would be much better, if his depression is also treated.Best wishes,Dr Sudhir Kumar MD DM (Neurology)Consultant NeurologistApollo Hospitals Hyderabad",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes drainage from eye and crusts on corner?\n\nMy son has a little drainage coming from his eye and woke up with a little crusting in the corner. The eye is not red and does not seem to bother him. Could this be the start of pink eye and is it safe to use an antibiotic drop. We are supoosed to be having a bday party for our daughter in 2days, is it safe to have people here?",
    "doctor_response": "I'd like to know your son's  age , because if he is a newborn , then we should worry about bacterial conjunctivitis which should be treated with topical antibiotics , and sometimes it is associated with blockage in nasolacrimal duct which is a small tube that drains the tears , and that needs massage , saline irrigation and antibiotics if your son is older than that , it's possible it may be  a viral infection and that is highly contagious to other kids and adults especially if there is a red eye , runny nose and mild cough .in that case we can use local antibiotic because it's difficult to tell viral from bacterial based on clinical alone. I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on left femur?\n\nThank You. We took our 16 year old son for an X-ray this afternoon. He has a lump on his left femur. He has had it for a few weeks. He is a competitive soccer player and lifts weights. He doesn t remembering injury to the area. We are worried it might be Bone Cancer. Any other suggestions?",
    "doctor_response": "hi.it is best if you consult with a doctor, preferably a general or an orthopedic surgeon, for physical examination and clinical evaluation. diagnostics, such as MRI, x-rays and tissue biopsy, will be recommended as needed to rule-in/rule-out different tumor types. management (medical and/or surgical) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for stomach ailments\n\nMy daughter age 2 months stool randomly changed from yellow to more of a pale green over the last couple weeks and for the last two days has been loose. The odor is also different since the change a couple weeks ago. She has no fever, not overly fussy, and she is formula fed with no changes in brand since the start. Can you tell me what this may be?",
    "doctor_response": "Hello. I just read through your question.Stool color can normally change during this period. Similar to stool pattern and stool consistency, this is not abnormal. As long as she is otherwise comfortable, there is nothing to be concerned about.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause severe pain in muscle?\n\nI am having severe pain in the muscle going from my neck into my shoulder. It is also radiating down my arm and into my elbow. I was diagnosed with a pinched nerve resulting from inflamed muscles. I was given Prednisone and Soma muscle relaxer. I have been sleeping in the recliner all week because it hurts too much to lie in bed. What do you think is going on? I m tired of being in pain.",
    "doctor_response": "Hi,Thank you for providing the brief history of you.A thorough neuromuscular assessment is advised along with MRI of cervical spine.Most times, this symptoms occurs due to pinching of nerve in the cervical spine due to any of the cervical disc prolapse, herniation, protrusion, etc. Understanding at which level this has occurred is more important.Also, the prednisone and the soma muscle relaxer are the symptomatic treatment plans which helps to reduce the pain. On a longer run, physical therapy is the choice as with therapeutic ultrasound therapy and TENS therapy the pain can be controlled, also, these are non-invasive techniques without any long term or short term side effects.In my clinical practice, we have never used steroids or pain killers for patients, and majority have responded well to physical therapy. Also, by strengthening the muscles of the spine, the patients long term recovery is maintained.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in pulling penile foreskin after masturbating?\n\nWhen ever I Masturbate once I will not be able to pull my penis fore skin back for 2 Days and the Inside area becomes red colour and in the early morning when i wake up my penis will be erected hard. Why is it, what's the problem.Name: Raghunath.Age  : 27 Yrs.Sex  : Male.Place: Bangalore",
    "doctor_response": "Hello, Inability to pull back the foreskin could be due to phimosis. The tightness of the foreskin. The best method to overcome it is to go for a minor surgery called circumcision. Therefore, I suggest consulting a surgeon for physical examination, diagnosis and treatment. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Sameen Bin Naeem, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be concerned for having multiple cysts on kidney and liver?\n\nHave had digestive problems and extreme fatigue for several months.  Had gallbladder taken out...still having lots of fatigue and stomach issues.  Had Ct scan done and they found multiple cysts on kidney and liver...is this something to be concerned with?",
    "doctor_response": "hi.noted ct-scan results. what are the characteristics and sizes of your cysts? are you experiencing any symptoms related to your urinary tract and liver/abdominal area? not all cysts need surgical intervention. some of them are there and just be observed and followed-up regularly. it is best if you consult with a doctor, preferably a general surgeon and a urologist, for physical examination and clinical evaluation. diagnostics and management will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure sore foot and swelling in ankle due to bilateral lung clots?\n\nI have had a sore foot and swelling in my ankle and foot. Slight bruising of the bottom of my foot but the pain seems to be working its way up my leg from when it first started. I was sitting in a chair and I could hardly move my ankle when I got up. I have been wearing pressure stockings and I am on warfarin from bilateral lung clots when I had a minor surgery in august. I have had a hard time walking on it since Friday and it seems to be getting worse. I wore a orthopedic boot for a day that I had previously and it seemed to help. It feels like I am walking on a piece of wood in the arch of the bottom of my foot. I do not recall hitting anything or doing anything that would cause a break. I had a unusually high blood pressure 190/90, 184/86 on the right side and a bit better, 164/84 on the left side after two high readings on the right she took it on my left side which was very high as it is usually around 130-140/70-80. Should I just wait till I wake up or go in right away? I can not afford to pay for any answer but if you can give me some direction I would appreciate it. Thanks, Jamie",
    "doctor_response": "Short answer: you should go to emergency immediately.Detailed answer: Any bleeding without an obvious cause in patient who is being treated on anti coagulants like warfarin should be investigated on emergency basis. Also raised BP on one side is also a reason for visit to the ER. Hope it turns out to be nothing. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for swelling in the nose & eyes caused by a bee sting\n\nI was stung by a bee yesterday above the eyes and today it has swelling into the nose and eyes. I have no problems with breathing and have taken Benadryl to help. Is this something I should be concerned with if swelling continues. I was able to remove the stinger and also applied baking soda paste to bee sting.",
    "doctor_response": "Hello,Welcome to HCM,The sting can result in an allergic reaction due to the secretion of venom. Allergic reactions can be immediate or delayed, though immediate reactions are more common.The treatment varies slightly according to the severity of the reaction. In severe reactions (decreased blood pressure, increased pulse, hives, difficulty breathing) hospitalization is required for treatment.Where there is only swelling and rash, you can treat at home by the use of oral antihistamines such as benadryl. In addition, if the area is painful, you can use paracetamol.If the severity of the reaction worsens, then you would need to seek medical attention.If you haven't had a tetanus shot in the last 5 yrs, you also need to take a booster dose.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Augmentin with Ventolin safe to use for an asthmatic cough?\n\nHi doctor, my nephew is asthmatic and has this cough that has refused to go. He has started taking augmentin and ventolin, he used the inhaler on Sunday night. Please I want to know if it is safe to use augmentin with ventolin. What other advise do you have. Thanks.",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your nephew's history.I would like to know more details like - What is age of your nephew? Since how long has he had asthma? What are his symptoms? Does he have fever? etc.However, from your given history, I would like to make suggestions for him as follows:1. Augmentin and Ventolin can be taken together. They do not interact with each other.Common side effects of Ventolin inhaler are tremors, palpitation (feeling own heartbeats), etc.Common side effects of Augmentin are stomach upset, mild diarrhea, vomiting, allergic reaction, etc.If he is not having these side effects, he can take them.2. Augmentin is an antibiotic, so unless he has a suspected infection, personally I would not suggest him Augmentin for asthma symptoms. It may be unnecessary if he does not have symptoms of infection.3. To make suggestions for asthma control, I would like to know freuqnecy and duration of asthma symptoms, other medicines he uses for asthma, etc. 4. I would suggest him to avoid exposure to dusts, smokes and air pollution as much as possible.5. A healthy diet rich in vitamins and minerals (adequate amounts of green leafy vegetables, fruits, sprouts, etc) will be helpful to him in a long run.Hope above suggestions and points will be helpful to him.Should you have any further query, please feel free to ask at HCM.Wish your nephew a quick recovery and the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tooth pain despite taking additional Novocaine shots?\n\nI had a bottom molar pulled today and few hours later while I was driving I fainted . Everything was okay but should I go to the emergency room and get checked out. Had to get a few more then normal shots of novacaine . Think I ended up with 6 to 8 shots , due to the fact i still feelt pain",
    "doctor_response": "Hello,As per your query, you have symptoms of tooth pain despite taking additional Novocaine shots which is entirely safe unless you are an asthmatic patient. Pain is high because while tooth extraction force required is very high.Need not to panic about anything. Your symptoms will start resolving in 4 to 5 days. Take cold water, ice cream for faster healing. Take soft food for few days.If your pain keeps on persisting even after 4 to 5 days visit dentist once and get IOPA ( X-RAY) done as it could be possible that dry socket could be the cause of pain.Don't touch socket with tongue again and again. Take Ibuprofen drug for 3 days at least. Do warm saline gargles on daily basis.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could pain in left hamstring be a symptom of heart issue?\n\nDay before yesterday I had an ache on the underside of my left arm and it radiated throughout my arm. Fair amount of pain....discomfort. I actually felt a similar pain in my right arm, but not a pronounced and it did not last nearly as long on my right arm. I had zero discomfort in my chest at all. Yesterday there was nothing. Today I m having tingling feelings in my left arm...almost like it was asleep and just getting the feeling back...not painful at all...just a tingling...but now I just started to have an ache in my left hamstring. I m 47. 5 10 about 195lbs. Used to be athletic. And have had issues with my neck from football days....Can a symptom of a heart issue be a dull ache in the left hamstring?",
    "doctor_response": "Hello, It is not related to cardiac problems.As first-line management you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist, it is better to consult a physician and get evaluated. You can go for an arterial Doppler to rule out conditions like peripheral vascular diseases. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to relieve pain while urinating in 4 year old\n\nmy 4yr old has had gas from birth and began haveing severe constipation and then scared of pooping, and know we are haveing off and on severe pain during peeing with drippling and holding, I am at my wits end try to tell docs to give ultrasound, they want uring test and can not get cause he has to go to bath water to try and go. I am just besides my self and can not stand to see him in this pain, it comes and goes. He took antibiotics and it seemed better for just a couple of days then crying and pain he says sticker pain and it can last for hour or so sometimes. please help me!!!!!!!!!",
    "doctor_response": "for burning micturition u can give Syp.citralka and to rule out UTI by doing tests like CUE and c/s.tests.and appropriate antibiotics.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bulge disk in neck and tingling sensation in the arm and upper back\n\nIm65. Ive been ssooo tired and sleeping in the afternoon after a seemingly have very sound sleep. Ive been having all my testing for everything done, and check out ok. My arms and upper back have been a broblem, so mri for neck tells me i have a buldge disk in neck. That explains the tingling in arms and upper back. Why Im I so very tired and weakness. Dont feel well either. head feeling light also.",
    "doctor_response": "HelloI have read your query. There is possibility of deficiencies of vitamin D. Vitamin B 12 or hemoglobin. Take physiotherapy like ten and matrix for cervical disc bulge. If required you may need epidural injection. I hope I have answered your questions. If you have further questions please feel free to contact us. I will be happy to answer. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can persistent diarrhea be treated?\n\nHello Dear sir . My name is Rubel Hossain from Dhaka Bangladesh Please help us . i have a one son he is 1 year 2 month old . he is Diarrhea disease . He has 10 times daily Diarrhea breaks . already buy Medicine Before one week but now don t result good . how to do . please help me sir . Please lets me know Rubel hossain Dhaka bangladesh Gmail: YYYY@YYYY",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As you already given medications for 1 week, but didn't help you much. I'd suggest you to do stool routine and culture, complete blood count after consultation with pediatrician. He may require IV rehydration therapy and antibiotics. Keep him hydrated. maintain proper hygiene. Give soft diet. Take care. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why did I have sudden pressure on my chest with blurred vision?\n\nyes i am a healthy 30 year old woman ,yesterday i had this strange thing happen,i was driving down the road and  a sudden pressure came on my chest and my vision blurred out....i slammed on brakes and no sooner then i came to a stop every thing was normal again.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Sudden chest pressure and blurred vision is indicative of some heart disease like high blood pressure, reduced cardiac pumping etc. So better to first rule out these cardiac diseases. So get done blood pressure monitoring, ecg, 2d echo. If all are normal than no need to worry for major heart related causes. Sometimes stress and anxiety can cause similar symptoms. So avoid stress and tension, if you have stressful life. Don't worry, you will be alright, but first rule out heart diseases. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is herbal medication safe to take?\n\nis it safe to take a herbal med that contains 500mg of Valerian with the prescription drugs I take which are: gabapentin, atacand, asacol, baclofen, crestor, vit D3, vit b complex, vit c, coq10 the hebal med is Somnapure, a natural sleep aid that also contains, passion flower, lemon balm, L-theanine, hops extract, chamomile flower, passion flower and melatonin. Kathleen",
    "doctor_response": "**1. since the said drug 'somnapure' have not been evaluated by the Food & Drug Administration, The FDA only evaluates foods and drugs, not supplements like these products. These products are not intended to diagnose, prevent, treat, or cure any disease. In best Interest I would suggest you to visit a sleep disorders doctor to get some expert help with whatever issues you're having.PS.. Using gabapentin together with valerian may increase side effects such as dizziness, drowsiness, and difficulty concentrating, you may also experience some impairment in thinking and judgment. It is important to tell your doctor about all other MEDICATIONS [as mentioned] you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can diabetes in a child be treated?\n\nMy 8 year old granddaughter is testing on levels on my glucose machine. Just because she is over weight I have concerns about her getting diabetes. She tested 301 and the 2 mins later she was 133. So you think this is the machine acting up or something I should be concerned about. i checked mine and they seem off too, what should kids her age levels be?",
    "doctor_response": "Get a laboratory test of fasting and post prandial blood sugar done. More so if there's any positive family history of early diabetes. Insulin is the treatment of choice for people with diabetes at this age.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to flexotide exovaler for 2 year old?\n\nmy baby is 2 and half year old,i am givind salbutamol exovaler if needed now she is having cough at night time some time day time too doctor ordered for flexotide exovaler for 1 month before i given oral steroid for 3 days so it is safe to give flexotide exovaler",
    "doctor_response": "Hi,Thank you for asking question on health care magic.Flexotide is a steroid.It is safe if you follow doctors instructions.Steroid given for a long time will have side effects.Inhaled steroids given for a sort period intermittently are quite safe.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes increased WBCc, swollen lymph nodes, vision problem with low grade fever?\n\nI'm a 23 year old male. I'm 5'11\" and weigh 200 pounds. I recived a letter after I went in for a check up due to not feeling right. I had a slightly abnormal kidney function, high white blood cell count, and high levels of calcium. I have also been having trouble with my lymph nodes in my jaw. My eyes have been giving me trouble, too, not blurry vision though. I had a low grade fever for a week and a half about a month ago. One last thing, I believe I was bitten by a spider or tick that resulted in a rash(not bullseye) approximately one month before symptoms occured.",
    "doctor_response": "Thanks for posting your query to HCM. As I understand you are suffering from a Pyrexia of unknown origin(PUO). there are so many infective and non infective causes are responsible for producing such condition .but your case is suggestive of infectious etiology. so you need to consult to a medicine physician and undergone1. blood culture examnination.2.widal test on blood.3.If any fluid id present in swollen lymph node :do aspiration fluid culture and cytological examination .these test will be helpful in finding cause for your illness.meanwhile you can take Aceclophenac 100mg for symptomatic releif .antibiotics can be started after investigation report.review me after investigation.take care  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i walk around after the removal of cast due to jones fracture?\n\nI had a jones fracture 4 weeks ago but the x rays shows no improvement. The doctor has taken off my cast nd asked me to walk around as pain allows. Though it doesnt hurt much the doctor has asked me to wear a crepe bandage. Is it okay? Can i walk around? I hope it will not cause further damage.",
    "doctor_response": "Hi,Thanks  for  your query.Yes, you can walk around as pain allows. At  weaks healing started. After cast removal do ankle range of motion exercises and strengthening exercises, It will help in early rehabilitation. It will not cause further damage.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sharp pain in neck which comes after having sex\n\nIts been about a week now and since the last time I had sex with my girlfriend I have a shooting pain in the back of my neck which is followed by dizziness and sharp pain. Even a week on and it still has not gone and when masterbating the same thing happens and seems to be getting worse. Iv gone to the doctor but could spot anything wrong but now it only occurs when having sex by the looks of things please help",
    "doctor_response": "Hi,Depending on how long the dizziness lasts, you can get a blood pressure cuff and see if the blood pressure is dropping. Tension in the neck can trigger a (false) signal to blood vessels in the neck that the blood pressure is HIGH when it is NOT. This causes a lowering of the pulse and blood pressure (vaso-vagal effect) more common if there is some arthritis in the bones of the neck. and often triggered by muscle spasm in the neck. cannot say in your particular case, but generally, these are more likely than stroke, near stroke or heart attack.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Churning in the stomach on erotic thoughts, intense pain on one side, have habit of excessive masturbation. Is it normal?\n\nI get a strong churning in my stomach on erotic thoughts. It started about a month ago. Now, the intensity of the churning has increased. And now, i have a pain in the left and right side of my stomach. The pain on my right started first and then the left started. Though both are only a slight pain, the left-sided pain is worrying me because it s more intense than the pain on the right side. The left-sided pain seems to increase when i take in a breath. But what REALLY worries me overall is the churning in my stomach. I am 14, male. Is this alright, doctor? PS: 1..I masturbate a lot. at least once or twice daily. 2..I RECKON THAT THE RIGHT-SIDED PAIN STARTED EVEN BEFORE THE CHURNING. 3..I started masturbating at 10 or 11 years. Thanks in advance, doctor.",
    "doctor_response": "DearWe understand your concernsI went through your description. I suggest you not to worry much. You are just 14 and you started worrying about so many things. That is the problem. When we worry, we become anxious. Anxiety produces so many uneasy feelings in the body and pain in different parts of the body iscommon. Pain in the stomach area is most common and you are victim to that.Instead of worrying about what you have not, concentrate on your education and career. Masturbation is common and natural and every man do it. Even animals masturbate. Masturbation twice a day is also normal in your age. When you grow, your priority changes to education and career and you start spending your energy towards more useful work.You might need psychological counseling., I am more than happy to provide telephone psychological counseling through healthcaremagic. Contact me through customer care, www.healthcaremagic.com.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain while walking after a surgery for muscle loss\n\nAm on zapain after surgery after a pitbull attack, have severe wounds and muscle loss and damage, that was 6 weeks ago, am in constant severe pain even after x2 tablets every 4hours. Wounds also look a bit red and angry and it hurts when I walk/move about.",
    "doctor_response": "Hello, Some pain is quite normal after surgery. Anyway, if they still look red, I would recommend consulting with your surgeon for a physical exam in order to exclude possible infection of the wound. In such case, antibiotic therapy would be needed. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat pain in hip?\n\nMy left hip hurts when I stand in one place or walk. I feels like cramps in the extreme left upper part of my hip. It also hurts at the same time in the front of my upper leg. I have scoliosis but not severe and have been told my left leg is 2 inches shorter than my right. Is there some therapy that will fix this problem?",
    "doctor_response": "Your age please?This is possibly due to limb length discrepancy. Use 1.75\"extra heel on left side. This treatment is being suggested on bases of the information provided.I would like to examine & investigate you in detail.Rule out Hypertension, Diabetes or any other metabolic disorder.Any way you may try---.  Dolokind Plus (Mankind) [Aceclofenac 100mg +Paracetamol 350mg] 1 tab.  OD & SOS. X 5days.--. Caldikind plus (Mankind) 1  tab OD x 10days.(You may need help of your local doctor to get these medicines.)--. Fomentation with warm water.--.Sleep on a hard bed with soft bedding.--. Avoid painful acts & activities.-- .Do mild exercises for Back, Knee & Legs. Foot & ankle.     --.(Take help of a physiotherapist or visit www.drncgupta.com). Do not ignore, let it not become beginning of a major problem.Do ask for a detailed treatment plan.If no relief in 2-3 days, contact me again. (phone.xxxxx)Kindly make sure, there is no allergy to any of these medicines. (Contact family doctor, if needed).For  emergency treatment visit nearest hospital.-Hope I have answered your question, If you have any further question, I will be happy to help.-Kindly rate the answer.-Wish you a quick recovery & good Health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does severe leg and back pain  with chills indicate?\n\nMy Dad has severe pain in his leg.  A few days ago he had bad back pain, so I wonder if the leg pain is related.  He has not left his bed in two days except to go to the bathroom.  He can get the pain stabilized while laying in bed, but after getting up it is so painful he can hardly stand it.  Sometimes his leg just starts shaking, and he gets chills while that is happening.  He said the pain is so bad, it feels like it's in his bone.",
    "doctor_response": "welcome to Health care magic.1.You need to see your doctor and get a x-ray lumbar spine AP/LAT done.2.Depending on the findings, you may have to get an MRI lumbar spine done. As it is good in nerve and chord characterisation.3.And few exercise for the back pain radiating to legs are there, you can get info on net or orthopaedic department.4.For remedy, please lie on a flat bet and implement the exercises, the symptoms may resolve.5.If there is any underlying medical conditions please treat them first,  then this pain will go off by the above mentioned things.Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are lumps one under the skin of penis shaft and other on the back of scrotum sack reason to worry ?\n\nI have two lumps one under the skin of my penis shaft and a new one on the back of my scrotum sack. I have popped one with a needle before and a cloudy clear liquid came out of it. They are long and narrow, aprox 1 long and narrow, kind of looks like a vein under the skin, but no blood came out when I popped it before.",
    "doctor_response": "thanks for sharing your concern!there is nothing to worry about this; it is nothing but a sebaceous/dermoid cyst and take care not to infect it and turn into boil.for confirmation an FNAC test is useful in such cases!regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Lyme disease\n\nI ve been diagnosed with lyme disease. Been doctoring for 8 years. I m now constantly experiencing a low grade fever 24-7 and ache everywhere. Walking is becoming harder. Is there a top notch LYME doctor out there somewhere who can help me? I m afraid of getting cancer on top of all this because of all the drugs , etc. etc. I m 44 - female.",
    "doctor_response": "Hello,Welcome to HCM,As you were diagnosed to have lyme disease which is an infectious disease caused by Borrelia bacteria and it is a tick borne disease transmitted to humans by the bite of infected ticks.The symptoms are suggestive of the lyme disease.I would suggest oral doxycycline, if you have taken this and if there is resistant to this you can take either cefuroxime or azithromycin. These medications should be taken for atleast one to four weeks.The drugs used to treat this condition is not known to cause any cancerous conditionsThank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the testicles to be of unequal sizes?\n\nHi, I am 24 years old. My problem is, I am having one big and one small pennis balls instead of two equal sizes and at morning when i woke up the skin around the balls is tight and after that it will become loose. Is there any problem,Y one of the pennis ball are un unequal size.",
    "doctor_response": "HiGREETINGS Testis can be of different size .If it is grossly small you need to consult an urologist .Scrotum skin will contract and relax according to the temperature. In cold weather it will shrink and in warm weather it hangs .So if it is uncomfortable consult the doctor.Hope my answer helps you. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infectious mononucleosis\n\nI've been sick for exactly one week. I was given amoxicillin. Two days ago, my blood test results came back positive for infectious mononucleosis. I was told that some people who take amoxicillin while sick with mono will develop a skin rash. I didn't develop a rash until today, two days after I ended my run of amoxicillin. The rash appeared rather suddenly a few hours ago and is a blanket of dots on my arms, shoulders, back, and the sides of my abdomen. It does not seem to affect my legs or feet. Is this rash related to the mono?",
    "doctor_response": "Hi thanks for asking question.In infectious mononucleosis, presentation is with fever, sore throat and headache with enlarge lymph node.You have suffer from rash also.Let me know you that approximate 5 to 10 % patient can suffer from generalised wide spread rash also.Usually first it involve trunks,abdomen , arms.Then face may be involved.After getting cleared from infection rest will disappear.So yes , infectious mononucleosis can lead to rash that you have asked for.I hope i have solve your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I continue martifur for abdominal pain?\n\nMy daughter,of 7 yrs.,suffering from abdominal pain for last 1.5months. She has taken med. of warm,several antibiotics,duphalac....Exams. done for urine R/E,C/S,but no abnormality shown. Last of all one dr. diagnosed for Urine Infection and prescribed Cephadroxil100mg once daily and Ofolaxacin once daily for 14 days. Now after 14 days he advised Martifur 100mg once daily for 3-6 months. Now my question is ,no growth found in Urine C/S report,Then why should I continue this Tab. for so long time? How long the tab. Martifur should be continued and for which reason? Partha Ghosh",
    "doctor_response": "HI.This is a very good question.There are certain infections in the body which take a long time to settle and get ''cured''. Martifur is given for the complete cure. It can be taken for 1 to 3 weeks. IF the Pain in abdomen and other symptoms are gone and the urine microscopy and culture and sensitivity reports are normal you may stop this. Also advisable in all patients having similar problems is to get an ultrasonography done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can hair fall with chest heaviness and breathlessness be treated?\n\nMy hair has been falling out. My feet turn purple it doesn't matter whether I am standing or sitting. I also have been having heaviness in my chest, along with chest pain for about two weeks now.. What may be the cause?? My hair has been falling out, my feet turn blue/purple no matter if I am standing or sitting.  I have also been having shortness of breath, and heaviness in chest for two weeks now... What may be the cause of this",
    "doctor_response": "Hi,You may be having telegen effluvium. consult the dermatologist for the perfect diagnosis and proper treatment. For the dyspnea and other physical symptoms,you may consult the physician. Blood tests may be done to diagnose the condition and accordingly both doctors would give proper treatment..okHope this helps.Dr.Ilyas Patel, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have advanced prostrate cancer, abdomen discomfort, ct scan shows nothing, goes toilet more. IBS?\n\nmy husband has advanced prostrate cancer and has been getting a lot of discomfort in his upper abdomen and his right side lower abdomen. he has just had a gastroscopy done and a ct scan of his abdomen he was told they didnt find any thing sinister but he still goes to toilet 3/4 times daily but not every day, do you think he could have ibs?",
    "doctor_response": "Dear Ma'am, Sorry to hear about your husband's problem. These problems can either be due to the cancer, which has been ruled out by Ct scan and an endoscopy. Other cause of this pain could be due to the medicines which he is receiving. It could also be irritable bowel syndrome but that is a diagnosis of exclusion and other causes should be ruled out before he starts taking treatment for the same. Hoping for the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ADHD\n\nI am 27 years old male, and i been dealing with adhd my whole life and have never took medication for it. I can not take the suffering anymore . I cant complete one task, i forget stuff all the time and most of all i cannot focus on any of my work . It is ruining my life . please help me get a medication to control this disease. Sincerly, Nicholas Scmidt",
    "doctor_response": "HelloYou have complaints like not able to complete a task, forgetfulness, inability to focus on a task etc. You have never consulted a doctor and never took medicines. Most likely these symptoms are not due to ADHD. Attention deficit hyperactive disorder usually begins in childhood and it cause significant impairment to child as well as to parents. You are 27 years old and as per my opinion the symptoms you are having are not due to ADHD though there is some lack of concentration. Lack of focus, inability to finish task may be due to some for of severe anxiety or due to some depression. Proper evaluation by a Psychiatrist is need to exactly label the diagnosis and for treatment.Anti-depressants like SSRI, SNRI drugs are mainstay of treatment. Cognitive therapy is also very useful. In some individuals medicines like Modafinil alone improves attention and general symptoms of drowsiness.Thanks, hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Male, lumps in breasts, pains when pressed. Breast cancer?\n\npankaj singh, i am 22 years old.actually i got lumps in my both the breasts when i was 14 years old..their size were small at that time.i did not take any notice these many years.but now i hear about male breast cancer in news.,so i thought to take advice from you.nw the size of breasts have increased.they dont pain until pressed.now what to do? Is it breast cancer?",
    "doctor_response": "Hi Pankaj thanks for your question Male breast cancer is  a well known entity . Relax. Breast cancer  involves one breast .and is usually painless unless it is in advanced stage. .swelling which you had at the age of 14 was mastitis (inflammation of breast ) which usually occur in male at the time of puberity  due to varoius hormonal changes and remain persistent for some years.what you are having this time is continuation of same process. so most probably your having mastits.which if remain untreated will get settled of its own.Get youself examined by a doctor to differentiate between mastitis and breast cancer.Hope I answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i consult a doctor as my daughter fell off from her bed?\n\nmy 8 year old daughter fell off her bed and her shin has a very large bump on it.  She has stopped crying but says that is still hurting very much.  She wont stand on it.  And when i was feeling around her leg she says pressure starts hurting about an inch and a half away from the bump.  also the bruise appears to be almost grey...  any advice?",
    "doctor_response": "HiWelcome to the HCMI have gone through your question and it seems that your daughter has suffered a severe musculoskeletal injury most likely a fracture. You should immediately take her to an orthopedic surgeon for proper clinical examination and management accordingly. They may advice you for the X Ray leg to look for injury or fracture.I would recommend you to splint the part by a board to help in transportation to hospital.You may give her acetaminophen or ibuprofen tablet for pain relief.Hopefully this will help you. I would be happy to help you out in any future health related questions.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My Hb level is low along with giddiness,headache and delayed periods. What to do?\n\nHello doctor, I am 25 years female. My HB level is reduced to 9 grams percent from 10 grams percent. I have a habit of eating raw rice and cardamom. I feel giddiness and headache and blackout of vision and my periods are delayed by one month and 20 days. And I am not pregnant.",
    "doctor_response": "Hello. You are anemic which can cause headache and blackouts in your vision. The consumption of those food products could be a sign of pica which is common in people with iron deficiency. It can take many weeks to build your iron levels back up with oral iron. If you are not pregnant, the delay in your menses is likely due to not ovulating with your previous cycle. I would advise further evaluation with laboratory work and to follow up your primary physician for the other symptoms you are having.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a pea sized movable lump in the breast?\n\nI have found a round moveable lump the size of a large pea near the nipple.  I have also had the mirena coil fitted about 7 weeks ago.  The lump is not painful, but i have been experiencing low level soreness/pain around the breast.  I am seeing the doctor today but am quite worried.  I am 34 and have had two children.  no history of breast cancer",
    "doctor_response": "Hello.  Lumps over the breast can be due to several reasons, but majority of lumps is due to the female hormones (estrogen).  Most lumps are still benign, however, to rule it out a complete breast exam, plus an ultrasound will help the physician to see whether your lump needs a biopsy or not.  personally, i don't request a mammogram for patients who are low risk under 40y/o, hence an ultrasound will suffice for now.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the signs for liver failure with leukemia?\n\nmy son is being treated for leukemia.  His billiruben was elevated and they have held his chemo.  they are running tests to see if its hepatitis, or epstein barr syndrome of just an infection.  what are the treatments for hepatitis A or B,  or epstein barr?  Right now he is jaunticed, stomach ache, loose stools and fatigued.  His liver is working fine according to the liver tests so what signs do I look for if his liver starts failing?  Our oncs told us this in not a big deal though,  but I worry.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Transient elevation in bilirubin is seen among leukemia patients and people who takes chemotherapy. It is not a big deal and no treatment is required. Only supportive treatment will be enough. You can go for a screening test to rule out viral hepatitis like Hepatitic C and Hepatits B. Treatment plans may vary if we diagnose viral hepatitis as a cause. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with azoospermia, testicular biopsy showed germ cell aplasia, normal hormonal reports, high FSH, low testosterone. Treatment option?\n\nsir i m azoospermic...i have gone for testicular biopsy ,the result was GERM CELL APLASIA and my doctor said me that there isnt any chance for us.......now i heard some other doctor saying on TV that in such cases that particular part of testis may not have spermatids or sperms but there is some chance that the other part may have them .when i went for biopsy my harmonal reports were normal but recently i found my FSH level higher than normal and TESTOSTERONE level low.i want to know weather we should go for needle biopsy now or shall i take some harmonal medication and go for TESE....what would be the better options for us....please help!!",
    "doctor_response": "Hi, Thanks for your query. I read your query and I understand your concerns. High FSH and low testesterone means you have primary testicular failure. I dont see great chances of conception. Any way undergo needle biopsy to confirm presence of sperms. If no sperms are found I am afraid you have to go for donor semen treatment for your wife. I hope I answered your query. I will be available for any followup queries you have. Regards, Dr.Mahesh Koregol IVF & Infertility Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does FEV1 71 % suggest COPD in a patient with productive cough?\n\nHello doctor, I had my first appointment with a new pulmonologist today. I presented with a productive (clear) cough which I have had for two weeks. I am very frightened by them and I am terrified that I have COPD, as it seems to appear from the numbers. The doctor was very non-committal about it, gave me a Breo inhaler and said to come back in a month. FEV1 is only 71%. And can you explain a percentage predicted the result for the FEV1/FVC value? It seems to me that the report is stating that my percentage is only 58 %. Is this low value dangerous? I am terrified right now. Please see the enclosed report and give your impression.",
    "doctor_response": "Hello. Percentage predicted means how much is your observed value to the expected value. The computer predicts based on your height, age and gender and on equations how much your FEV1 (forced expiratory volume) and FVC (forced vital capacity) values should be if you are normal. Then in the test we calculate how much are your actual values. To say as normal in FEV1 and FVC we want your calculated value to be not less than 80 percent of your expected. That is 80 % predicted. Here your FEV1 is 71 % percentage predicted. As per values it suggests COPD (chronic obstructive pulmonary disease). But few observations, 1. This test is not very reliable as your graph picture shown on right hand side is not an acceptable one. So I personally would like to repeat it. 2. I do not see a bronchodilator reversibility test here, which is a must to see if it is asthma. 3. If you were a smoker and have symptoms I would suggest a repeat test with bronchodilator reversibility to get a definitive diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed a bad smell and cremish discharge from urine\n\ni had taken unwanted 72 pills within 4 hours after sex. From then only  from my vagina a bad smell is coming and some creamish particles type extract is coming out with urine. And it is present in my vaginal area also. What is it ? And what is its effect",
    "doctor_response": "hello user,you can have a local examination from your gynecologist for fungal infection and urine microscopy test for urinary tract infection.and take treatment accordingly.keep vaginal area clean.wear loose cotton undergarment.drink lot of fluids.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in expressing thoughts and answering questions after accident?\n\nHi, my brother had an accident where he fell on his head from a moving car and was unconscious for several hours. He was transported to a hospital and while he is awake and show vital signs, he does not express himself clearly and can not answer questions. He is away from the country right now so I can t get news quickly and I am very worried for him.",
    "doctor_response": "Hi following head trauma many things can happento brain . It could br concussion or bleeding inside the brain. He needs CT scan of brain to see what happened to brain . If CT is normal then it could be just post traumatic shock.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes muscular aches with swollen ankles and feet?\n\nHave bad muscular aches wich do not respond to massage. Headaches shoulders arms and hands.take pain killers a lot(codiene/paracetomol mainly). Always struggle with good posture. Even my hands are really stiff in mornings. I also have swollen ankles and feet and aches in legs. Heres the strange bit....I play golf and go to the gym usually once or twice a week. It takes 2/3holes to warm up at golf then I m fine. But suffer always in the evening and next day. Re. The gym, I always feel good when I work out!!, but next day back to square one.",
    "doctor_response": "Hi Hope this message finds you in good health.I have gone through your complaints and understand your concern.You seem to have some sort of seronegative arthropathy causing multiple bones and joints to get inflammed and painful.Get a detailed blood profile done to find out the cause.Nothing to worry about.\u00a0\u00a0\u00a0\u00a0\u00a0I hope your question has been answered.If you have any follow-up queries,feel free to consult me anytime.Thanks,Take care,God bless.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the signs of sprained neck in baby?\n\nLast night I picked my 3-month old daughter up from her crib from a prone position, i did not support her head and as i brought her to me her head fell forward quickly. She immediately starting screaming. I fed her and she stopped and after the feeding she went right back to bed with no problems. However today she has been extra fussy and has had trouble sleeping and her cries are intense as if she s in pain. Could I possibly have sprained her neck?",
    "doctor_response": "actually neck holding appears by 3 months..by 5 months child tries to lift head from supine position.. it is normal.. there won't be any problem while lifting the baby ..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can losartan cause high pulse rate?\n\nCan losartan cause a high pulse rate? This is a new medication for my high blood pressure, 100 mg. My blood pressure is much better on this, however my pulse rate is elevated to a little over 100 resting. I m actually aware of my heart beating, which worries me.",
    "doctor_response": "Hi,Losartan is an angiotensin receptor blocker commonly prescribed to treat high blood pressure and other conditions. Its common side effects include low blood pressure, increased blood potassium and sometime dry cough. It is not known to cause high pulse rate which could be due to other causes for which you are advised to consult your doctor.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "For how Long should I give Myteka to my 9 month old baby?\n\nHello sir,I have a 9month old baby,he very frequently gets congested chest and coughs with breathing difficulty while feeding,doctor usually prescribes an anti allergic syrup along with nubiliser( saline solution and atem) to clear out the congestion,along with some antibiotics...he gets fine after the treatment but gets hit again after a few days.the only time he was fine was when he took myteka for 2months..so if I want to give him myteka for how long can he continue to have it?",
    "doctor_response": "Hi...it could be viral associated wheeze or multi triggered wheeze. I have a few questions for you -Questions:1. How many days per month does he cough or feel breathless?2. How many nights per month does his sleep get disturbed due to above symptoms?3. Does he feel breathless when he is active?4. Are the symptoms when there are seasonal changes?5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?6. Is the cough always associated with fever?Kindly get back to me with the answers and I will try to guide you. I don't thing removing tonsils is a solution for this problem. Moreover a kid less than 5 years cannot be labelled as asthmatic....9 months is too early.No point in using Myteka (Monteleukast) alone without proper assessment of symptom severity.You can approach me at the following link. Please find the link below.www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have symptoms of wheezing, shortness of breath, fatigue. Had been on advair, inhalers, antibiotics. X-ray, scans normal. Suggestion\n\nHi! My name is mike. I have been battling a breathing problem for about 4 yrs. it started when I rehabbed a room in a 130 year old house. My symptoms are wheezing,shortness of breath, fatigue. Basically asthma like but not diagnosed as. Over a period of 4 years I have been on advair,  albuteral inhalers, different antibiotics with the only relief coming from steroid injections and dose packs. I have also had chest x-rays and ct scans that were all neg. my sleep patterns are not good. My breathing seems worse at night and when I lie on my left side. Any suggestions or direction to head in??Totally fed up! Thanks",
    "doctor_response": "Hi,Welcome to HCM.Old houses most commonly are infested with moulds which may cause allergies and lung infection. But that has to be detected on X ray and CT scan. If your x rays are clear then it is most probably allergy that can be controlled by steroids. I suggest you undergo a complete lab work up for allergic asthma.It is important to know your triggers, so keen observation has to be done as to what starts these symptoms and what increases them.  It is best to avoid those triggers.A pulmonologist will be able to help you regarding this.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am type 1 diabetic and having vision changes with floaters. Is it due to diabetic retinopathy?\n\nHi doctor, I am 27 years old. I got late-onset type 1 diabetes when I was 25 years old. I was told diabetic retinopathy takes at least five years, but I have had some vision changes. I am concerned about that. I have been seeing rather large floaters. They are not crystal floaters but appear in bright sunlight as transparent dark lines and in dimly lit rooms, when they move over light, they appear white. A couple of days ago I was driving at night and might have seen a flash, but it also could have been lightning in the sky off in the distance but I am not sure. Since then I have not seen any obvious flashes but have been questioning whether I am seeing small, barely visual ones. I made an appointment for a diabetic eye exam and the soonest I could get into an ophthalmologist who takes my insurance is in two and a half weeks. Is this too long to wait? I will definitely pay out of pocket for an exam if scheduling sooner could save my vision.",
    "doctor_response": "Hello. I reviewed your history. The symptoms of flashes of light with the presence of floaters along with the history of diabetes require evaluation. Waiting for two and a half weeks will be too long considering your profile as you are having type 1 diabetes. Five years is the time period we give for the screening of diabetic retinopathy in type 2 diabetes, but in type 1 there is no time frame as such and this can occur early also. Hence, I advise you to schedule your eye examination early as possible with your ophthalmologist. I hope this helps. Vitreous degeneration, vitreous detachment, vitreous hemorrhage, diabetic retinopathy. Indirect ophthalmoscopy. Vitreous degeneration, vitreous detachment, vitreous hemorrhage, diabetic retinopathy. Vitreous detachment. Needs to be planned depending on the diagnosis. Avoid straining, lifting heavy weights, running, heavy exercises. Eye examination at the earliest.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful trachea while breathing\n\nMy 20 year old daughter says that her trachea hurts when she breathes.  It only hurts inside, no external pain, no pain on palpation.  She says it can also hurt when she bends over or jumps around.  Any ideas about a possible cause?  She has not sustained any injury nor had any recent illness and feels well otherwise.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your daughter's situation and problem. Pain in trachea on breathing and movement is mostly due to inflammation of trachea (tracheatis). The most common cause for this is infection. Amongst infection viral infection with Influenza virus is more common. So she might be having viral tracheatis. Ask her to drink plenty of fluids orally and keep herself hydrated. Avoid dust and smoke exposure. She should start antihistamines, anti inflammatory and painkiller drugs. Usually recovery is expected in 1-2 weeks time. If not improving by 2 weeks than better to get done bronchoscopic evaluation to rule out other causes. Hope I have solved your query. Wishing good health to your daughter. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching and rashes all over body?\n\nHi, I have a severe rash all over the body, the itchiness is unbearable. It started 10 days ago, but getting worse, my whole face is swallen, face, head, two days ago I was in a hospital, was prescribed prednisolene and had a shot of adrenaline, it did help, but only for 6 hours, it is getting worse, but doctors cannot find the reason why and can't help. I am in Ireland",
    "doctor_response": "I have gone through your query and it could be an allergic reaction, drug rash or eczematous rash.I would recommend you to take a short course of oral and topical steroids along with oral antihistaminic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause leakage from crowns?\n\nMy front teeth are crowns and recentley they leek fluid that smells I went to the dentist he said my bones are decreasing and I have to pay \u00a3600 for a deep clean,I cant afford this but I am so embarrassed by this I wont speak to people face to face incase they snell it please help.",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,  I have gone through your query, as you have pus discharge from front tooth dont worry you can do is Warm saline gargle two - three times a day Do Chlorhexidine mouthwash twice daily  If possible consult dentist and go for Scaling and currettage .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should I wait to drink alcohol again after liver function readings came to normal?\n\nHi, I was wondering how long I should wait until I should drink alcohol again.  I tested positive for glandular fever (mono), about a week before this past Christmas.  I was sick over Thanksgiving as well and I may have had it then but I don't know for sure. I had some pretty elevated liver function readings as well. I went for blood tests for 4 weeks straight until they returned to normal levels. They reached normal levels about 3 weeks ago. I'm 21 5'8\" 135-140lbs",
    "doctor_response": "Hello if you start again to use alcohol it may happen that your liver panel will be elevated again. So I would advice avoiding alcohol. best regards Dr.Klerida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from paralysis. Problem in walking, raising arm, speaking due to ischemic infarcts. Any ayurvedic medication for treatment?\n\nHi, my name is alok, my father is suffering from Pralysis since last three years, in left side of his body, due to ischemic infarcts, he has problem in walking, raising left arm, and speech problem. he had first strok in Nov 2010 and again in Feb 2011. Aftre first strok he improved almost 70%, but after second strok his movement is deteriorating, please suggest if any medicine is available n ayurvedic.",
    "doctor_response": "Hi, In such cases, the recommendations are as following: - keep his blood pressure within the normal range by taking the pills accurately- be in touch with his cardiologist to do regular check up- do regular monitoring of blood pressure, ECG, angiography as directed by the cardiologist- maintain health diet and plenty of water- physiotherapy as directed by cardiologistSo, the most important thing is to be always in touch with a cardiologist and follow his directions accordingly. All the best!Dr.Alba",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Ceylon cinnamon be taken for diabetes?\n\nDaughter just disg with type 2. Have reduced sugar/carbs but is now showing 3 plus ketones w/o neurological sequelae. Has energy, no lethargy etc. what foods can she eat w/o spiking sugar but can reduce acidosis. She had 212 blood sugar  two weeks ago but now hovering at 130-140. Do you know anything about Ceylon cinnamon for the reduction of glucose.  Thank you",
    "doctor_response": "Hello, Thanks for the query.If the she has T2 diabetes, then possibility of having ketones is very low. Plus her glucose levels 212 mg two weeks back and now 130 to 140 mg, can not cause ketones. When diabetes is well controlled FBG should be as regards her food the total caloric intake has to be based on ideal body weight, extent of daily exercise and whether she needs to reduce weight. High carb foods, simple carbs, high fat cheese, junk foods, pasties, bakery items , sweetened aerated drinks and sweet corn syrup containing foods should be avoided. Should consume a good deal of green leafy vegetables, salads and permitted fruits (about 100 g a day). Whole grain products are better. Avoid red meat. Poultry and fish, chicken in moderate quantity (with in the specified caloric need) can be taken. She should exercise for at least 1 hour a day.As regars cylone cinnamon, there are some studies conducted about the effects of cinnamon in diabetes. But the benefits have not been found uniformly. Taking about 6 g a day is said to be useful. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does Susten 200 help in a pregnancy?\n\nIm 24. Trying to get pregnant n my doctor advised me to take susten 200 after my ovulation today is my 16th day afte ovulation n 32nd day after last periods.. but still my result is negative.. lemme kno does susten 200 delay periods / it doesnot allow positive result in home pregnancy test.",
    "doctor_response": "Let me clear your doubt.in your normal menstrual cycle after ovulation your body starts secreting progesterone and which ultimately make the uterus suseptible to accept the pregnancy if pregnancy happens. So Susten 200 is Progesterone and starting after ovulation as your body starts secreting it. by doing this we are supporting if your body secrets in lower concentration than it helps. So it ultimately supporting therapy nothing else. and if pregnancy doesn't happen than bleeding starts withing 10 days after stopping tablets. normaly your body decreases its secretion and periods occur.Hopefully you get your answer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in stomach and groin area with a lump in armpit?\n\nI have recently discovered, what feels like a lump in my left armpit. There are no bites, punc tures or anything of that nature. I do have a strenuous job which requires alot of heavy lifting. I have tightness in the muscles in my arm and when I touch it, I feel sick to the stomach and shooting pain to the groin area. I know, weird. So 2 part question, are there nerves that extend that far and should I be concerned about the lump?",
    "doctor_response": "Hi,Thanks  for  your query.Well, without a clinical evaluation it would be difficult to determine the cause of the lump. Possibilities that may need to be considered include enlarged lymph node, lipomas, cysts, growths from underlying connective tissue etc.I would suggest getting this evaluated by an orthopedician for an accurate diagnosis and appropriate management. You may get the X-ray of the area affected and FNAC (fine needle aspiration cytology) of lump under his/her guidance.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the dosage of Maxtran 5ml for toddler?\n\nHi. My Child is 2.5 years Old. She is having fever and cold. Urine test normal but in Blood test WBC counts came 14700. She is prescribed Maxtra 5Ml. My question is that on the dosage section at bottle it is stated that 1/2 to 1/4th Teaspoonpful for 2-6 years. This dosage of 5ML is more than double. Than is it right?",
    "doctor_response": "The dose of Maxtra that you are giving is somewhat large. Please give no more than 2.5 ml for her age.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a growth near the testiclea in past cause infertility problems?\n\nMy husband used to have a growth next to his testicles in the sack 10 years ago which was checked out by a GP and was reassured it was \"OK\" it was just a growth which 2-3 years later \"vanished\" on it's own. Now we can't get pregnant. Could it be the problem on his side if everything is ok with me?",
    "doctor_response": "HelloI can understand your concerns.If the growth has vanished was labelled 'ok' by your GP, i think you should not worry about this.I would suggest for your husband to get semen analysis done. This would determine the fertile capacity.Please revert back with the reports or consult your nearest infertility specialist.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest cold after treated pneumonia in past\n\nmy son is 3 years old, and came down with a head cold wed, it moved immediately to his chest (he is a preemie-grad, and has had trouble with pneumonia and rsv in past) he is running a temp, and his respiratory rate is between 48-50.  I just don't know if i should wait it out a little longer to see what the day brings or take him in. I hate feelling like i'm always there for the slightest things with him, but his history proves medical intervention always was the case. It just seems so quick that a lung issue would be evident, when he only started showing signs of a cold wednesday night.",
    "doctor_response": "Hello,Your son\u2019s respiratory rate is too high. Please take him to ER immediately and take a chest x-ray immediately.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Siva Kumar Reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the lipid profile result indicate and suggest treatment?\n\nmy father age 55 weight 65 hight 5'6inch fell some upset docter advice a blood test so test is  total lipid ,570mg,triglyerides,180.4mg,cholestrol,195mg,hdl cholstrol,46mg, vldl,36mg,ldl clolestrol,113mg what is in any problem plese guide which test is sutable for this situtation  ECG or Engio or what is the cost of these test in chandigarh or delhi ?",
    "doctor_response": "Hello Your father findings suggests lipid parameters are towards upper limit.He condition need few more investigations lie routine hemogram,random blood sugar,liver function test.With these findings,I only suggest increased physical activity and diet alteration to my patients.He should avoid fried and fatty food.He should go for brisk walk.Follow up lipid profile should be done to assess his condition.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for oozing from sun burnt skin in case of psoriasis\n\nHi, I am a 33 year old male standing at 6 foot. My weight is 90kilos. I suffer with psoriasis. I was out in the sun for a long period yeaterday. I did use sun protection however I cound not have used a sufficient amount on my scalp which caused some burning. I don't feel any pain although it is sensitive to touch. The worry for me is it has been intermitantly seeping a clear fluid for a 4/5 hour period. Thank you for your help",
    "doctor_response": "Hello,Welcome to healthcare magic,From your description it sounds like sunburn alright. In severe sunburn seeping of fluid (oozing) is commonly seen. It will be beneficial if you could apply a cream containing a combination of steroid and antibiotic twice daily. Cold compresses will be beneficial. You should strictly avoid further sun exposure of the sunburnt skin till it heals. I recommend you to get this cream prescribed by your general practitioner.Hope this helped,Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Potassium level 7.5. What does it mean?\n\nI recieved my results from my blood test yesterday and everything was good except my potassium it was 7.5 Doctor didn t explain much should i be concerned?",
    "doctor_response": "Hi; welcome to HealthcareMagic Potassium of 7.5 is surely high .High potassium is not good for heart;but reports are a supportive evidence along with symptom to diagnose the disease a person is suffering from.You had some problem or symptom for which i guess you got investigated also you have not written any details about your age;sex;or the disease or problem you have .If the other reports are normal then please ask your doctor whether increase in potassium has any relation with your symptoms as he will be the better person to give opinion. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump on head, sore leg and scraped arms?\n\nI think I fell on Thursday night( had a couple too many) lump on head sore leg and scraped arms. It wasn t until fri evening I started feeling pain in my left side of my ribs. Last night they were very uncomfortable and the same this morning. The smallest thing and I am wincing now.",
    "doctor_response": "hi,greetings from HCM.It is quite common to develop contusion on head multiple abrasions legs and arms .if you fall on the chest you may develop rib fracture or contusion of chest wall.it will be very uncomfortable and you can have pain for several weeks.all you need is to take analgesic like diclofenac ,hot fomentation and antibiotics.if the symtoms are aggrevating you need to consult a doctor  and get a cat scan of your head ,x-ray of chest to rule out rib fracture or chest injury",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do blocked tear ducts get cleared as child grows?\n\nWhen my baby daughter was born she had blocked tear ducts and lots of discharge escpecially from right eye. Then at about 7 weeks under her right eye went puffy and her temple. She is now 11 months and still has almost swollen vein look under right eye and temple . it goes up and down. We have been told it is vascular . What is your opinion on it clearing up as she grows?",
    "doctor_response": "The problem is not unique and occurs as the opening of the nasolacrymal duct has not yet formed. Most often the formation of the structure of the tear secreting duct is complete, it is just the opening that is still not formed. You should massage the tear duct of your baby. Use gentle pressure with your finger on the outside of your baby's nose and then stroke downwards towards the corner of the nose. This should be repeated several times a day. This can help to clear pooled tears in the blocked duct. It may also help the tear duct to develop.I do not think that it has vascular origin. It should clear up long before she grows up.The swollen vein is unrelated and needs more evaluation. The cause could be vascular or something else. Cannot comment on it without further details.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffer with Beta-Thalassemia Minor as well as G6PD Deficiency. Are there any coupled effects?\n\nHi, I understand that I have both Beta-Thalassemia Minor as well as G6PD Deficiency. I also understand that both conditions lower the red blood cell count in my body in different ways. Please correct me if I m wrong. However, what I m curious about is that are there any coupled effects? For example does having both further decrease my red blood cell count leading to lesser available oxygen for my body and therefore lower stamina when engaging in physical activities like sports.",
    "doctor_response": "hiThanks for your queryi can feel your concernsyes,you are quite right.both are hemolytic anaemiasbeta thalassaemia is due to quantitative defect in beta globin chain while G6PD is enzyme deficiencyG6PD deficient individuals are usually normal unless they are exposed to certain drugs or foods.As you are compound heterozygous for G6PD & thalassaemia ,so any exposure to these drugs and food will further decrease down your baseline haemoglobn,which is already low due to thalassaemia minorHope i have ansewered your queryi am available for your help regardsDr.Amna",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause pain in the arm other than carpal tunnel syndrome?\n\nPain in the am-I believe I slept on it & did not wake up soon enough. Went to hand doctor who sent me to neurologist. Tested nerves in arm-reported to doctor I had moderate to severe carpal tunnel syndrome. I was informed that I could try a brace or receive an injection (More than one?) or surgery. Had injection which I did not feel any relief. Went to doctor 2 weeks after injection. He informed of many things and I asked every question I thought revalent. We decided on surgery two weeks later. Doctor told me it was not regular CTS but something very similar. Hand does not feel good, mostly because I have used my hand to do things I was told not to do. My question is, what may have been my problem-what was it if not CTS?",
    "doctor_response": "Hi, The symptoms are more likely suggestive of carpal tunnel syndrome. You can consult an orthopedician for expert opinion. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had Hep c. Have pain in stomach. Tired, depressed. Ultrasound done. On Interferon. Eyes are hurting. Treatment?\n\nHello Doctor, My name is Sherrylynn, and I as told I had Hep c in 2000. Ive been having a lot of pain  on the right side  of my stomach very tired and eek, I don't feel like doing anything , I feel depressed all the time  last time I ent to the doctor they asked me if I kne I had hep a b, and c I had all 3 through out the years. they have been doing all kinds of tests on oct 1st they are doing a ultrasound and there also going to start me on interferon oct 8 last eek they told me I also had to go see an eye doctor. my eyes are really bad and have gotten a lot orce lately. does my eyes have any thing to do ith my liver? thanks",
    "doctor_response": "Hi,I understand that you are worried and depressed. You have been advised to see an eye doctor because hepatitis can cause eye problems like dry eyes and retinopathy, which may worsen eye sight. Since these problems can be worsened by interferon therapy, you have been advised a baseline eye consultation before starting interferon.The other thing is that if you are depressed, please ask your doctor to put you on treatment for it as depression also is likely to be aggravated by interferon therapy.Hope this is of help. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain and tingling in feet/hands with history of GERD?\n\ni been having chest pain for three days some shortness of breath comes and goes starting yesterday my feet and hands feel tinglly like ther going numb especially the left side i have a history of gerd a lot of gi problems been taking all kinds of antacids last 3 days just lost health insurance so is this just my gerd acting up",
    "doctor_response": "Hello, After going through your medical query I understand your concern and I would like to tell you that generally GERD itself is a cause of chest pain but breathless is not a symptom of GERD, so it is recommended for you to get immediate medical attention, go to ER and get a basic cardiac evaluation done. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Constant nausea, lightheaded, fuzzy vision, fainting feeling, advised Adderall XR. Will it really help ?\n\nI, on a average, faint twice a month. I wake up instantly and I am no worse for the wear. In my daily life I have a almost constant feeling of nausea, and feelings of being light headed. I regularly lose my vision in a fuzzy gray fog, when this happens I simply sit down and the problem leaves quickly.  I worry that I might faint when this happens, but i never do. When i do faint it comes without warning. These issue have been present since puberty, but in my mind have become more problematic with my age. These issue make my daily activities seem drudging while interfering with my job and recreation. I have recently taken Adderall XR I noticed that my symptoms, like i described, went away. Or at least they were decreased to a point of it being noticeable. I have to say that without these daily, bothersome, and embarrassing issues I felt lovely. Like I was having a \"good day\" health wise. I have seen a neurologist about the fainting, the EEG and MRI tests came back normal. I did not expect to have a neurological problem. I have been told to see a cardiologist, I have not. I take the medications Lamictal XR (lamotrigine) and very rarely Seroqeul. I have only been on these medications for a little over three months. I would like to know what about Adderall XR that could be helping me with my issues? Why would it help with these problems? Any thoughts on this would be appreciated.",
    "doctor_response": "I HAVE GONE THROUGH UR NOTES ONE THING I AM NOT KNOWING IS CHEMICAL COMPOSITION OF ADDREALL XR. IF U CAN WRITE THAT , IT WILL BE GOOD TO FIND SOLUTION TO UR PROBLEM",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump under the rib cage\n\nHi I was reviewing your answers to a lump under my right rib cage that seems to pop. I have been walking a lot more lately - the last few weeks in a walking contest at work - trying to get in 5-6 miles a day. Unfortunately also an Ovarian Cancer Stage IIIC survivor for 3 years now. Could it be muscle relate?",
    "doctor_response": "Hi.Read your history and understood your problems.Nice to know that you are a survivor of Ovarian Cancer stage III C for three years. The lump, under the rib case , which pops up is indicative of a Hernia. Please get examined by a General Surgeon and then go for the investigations and see if the surgery is needed or can wait.this is thus related to muscles - a gap - a hernia.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could itching and redness in penis be due to yeast infection?\n\nhi i just got off my period about 3 days ago. i had sex with my boyfriend, now the head of his penis itches and it is red- irritated... i think i have a yeast infection, is it possible that the symptoms that he have is due to a yeast in men or is it more serious?",
    "doctor_response": "Thank you for query.It may be due to fungal infection.Please take following precautions.both of Use loose cotton clothes.Keep area dry.Apply antifungals like clotirimazole lotions.clean the area twice daily with warm water.Treatment of both partners is important to prevent recurrence.Both can take oral antifungals like flucanazole 150 mg twice daily consult doctor if does not subside.Condom can be used .You can get back to me for any clarifications with the photos.Dr Bharatesh D Basti Dermatologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ganglion cyst within right knee\n\nMRI few yrs back revealed lg ganglian cyst within R knee, asymptomatic. 3 days ago kneeling on floor heard deep POP within R knee, could it have ruptured? No pain unless try to kneel or sit with legs tucked under on floor. No redness, swelling observed. Knee feels very loose & posterior has tightness when standing from sitting & when bending over to touch toes.",
    "doctor_response": "cyst are usually found at posterior part of knee. when poplitues muscle tendon moves over cyst it causes sudden pop . rupture of cysts are usually very painful, which is  not in this case.hamstring stretch and static quadriceps muscle exercises will decrease stiffness and discomfort. Hope this helps.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for pain in the left lower chest and belly area?\n\n4 1/2 year old grandson c/o pain left side (lower chest belly area). He states it hurts when he touches his side and that it also hurts even when he doesn t touch his side. My daughter took him to his pediatrician few days ago but it was suggested that it may be an acid problem and Mylanta was suggested. This doesn t sound like an gastric issue to me; the way he explains it it sounds more like skeletal tenderness or muscular. It has been bothering him approximately two -three weeks now.",
    "doctor_response": "Hi, Pain in left lower chest area could be due to skeletal problem or muscular pain. Renal stone or constipation also causes pain sometimes so get him checked by a pediatrician again. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Prasanna Lakshmi, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will intercourse on specific days help in a successful pregnancy?\n\ni am 40 yrs from gujart. after so many medicines i was not able to be pregnent. i am doing medicine from a gynecologist the days he told me try the best to concieve he told days like 1,3,5,7,9 etc. i tried on 1,4,6. will it give me a good result. last time my period was on 18th feb, 28 days cycle. pls advise me",
    "doctor_response": "Hi welcome to hcm.I have gone through your question.To conceive best time is around ovulation.+/-3 days to ovulation is best time, is known as fertile period.If you have 28 days cycle then 11-17 th day is best time to conceive, do intercourse in 11,13,15 and 17th day.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I use eye massage pen instead of warm compress for Meibomian gland dysfunction?\n\nHello doctor, I have been diagnosed with Meibomian gland dysfunction and I was advised to put warm compresses under my eyes. The problem is that it is causing me a lot of dry skin and wrinkles. I found an eye massage pen online. It gives heat also to the area. Can I use this instead of the warm compress?",
    "doctor_response": "Hello. The main purpose of the massager pen is to remove wrinkles and not to provide heat. So, it will not help with your Meibomian gland disease. The rationale behind advising warm compresses is to force out pent up secretions inside the Meibomian gland. Giving this heat and later massaging in a way as to force secretions out would be the best way to get rid of your problems. In case you are not fine with water, you can use a warm cup of coffee or any other beverage to warm your hand with or you could use palming where you rub your hands together until they become warm and give the heat to your eyelids. Meibomian gland disease is usually a long-standing condition and only if treated properly, it can subside. For more information consult an eye care ophthalmologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of Potklor syrup?\n\nMy father is suffereing from Asthima and he was in Nursing Home for 30 in the month of Jan12. He was in Ventilation for four days. Doctor has suggested him Potklor Syrup. He is not taking this syrup because inside the mouth some infection has grown up and it bit painful. For which he is unable to eat any hot and salty food. My father has a believe that this has haapenned because of this Syrup and he has stopped taking this medicine. Pls. suggest.",
    "doctor_response": "Hi,Potklor syrup contains potassium chloride and is used to treat low potassium levels in the blood. Nausea, vomiting, irregular heart beat and increased potassium levels in the blood are the common side effects of the drug.Oral infections do not occur with this drug. Oral candidiasis could be the cause and anti-fungal drugs are required for treatment. Blood sugar levels should also be checked.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Saranya Ramadoss, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness and tingling in arm when suffering from rhuematoid arthiritis?\n\nhi i am 35 yrs old, i have thyroid problems also am aneamic and was diagnosed with rhuematoid arthiritis 2 yrs back, recently a week back I am having numbness and tingling in my right arm and cannt sleep due to that, can yoy tell me the cause and rememdies?",
    "doctor_response": "Hi, As there looks to be a nerve root entrapment at the cervical spine. Using a cervical collar, hot water fermentation to the neck, shoulder static exercise for shoulder stabilization, neck static exercises for spine stabilization, biceps static and triceps static exercise are advised to reduce the symptoms. Since you had RA it is possible to have spinal joint muscle inflammation leading to symptoms. Above mentioned therapeutic plan should yield good results. Hope I have answered your query. Let me know if I can assist you further.  Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for slight numbness in the calf and feet\n\nI am 63 yrs old in good health. Very active. Workout weights and aerobic exercises since I was 16 yrs old. Retired life is good. The past few days the bottom of my feet feel a slight numbness and tingle a little feel in my calf also. Not sure what it means. Annual check up every yr and blood work are good for my age. I know there could be more than one answer.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have  slight numbness in the calf and feet. Well there can be many reasons for symptoms you mention in query like sciatica , multiple sclerosis , herniated disc , supplements, B12 deficiency and neuropathy . I would suggest you to keep your legs in hot water tub with epsom salt for 15 minutest daily , take light walk daily and eat healthy . If condition doesn't get better then consult orthopedic surgeon for proper examination . Doctor may order certain tests like CT scan of back or blood test along with physical examination . Doctor may prescribe supplement , physical therapy or stretching exercises . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pricking pain in abdomen, severe on bending, getting up, sharp stabbing pain. Treatment?\n\nHi Dr, I am a 32 yr old women, and quite recently in started feeling a pricking pain on right side of my abdomen , just besides navel. The pain is more is more severe when I bend my self to pick something or get up from bed even. I feel something sharp is hurting me from inside. I need help for this. What it could be and what shall I do?",
    "doctor_response": "Hi ! The symptoms you have mentioned goes more in favour of appendicitis. Do you get  nausea or vomiting ? Any fever ? Any urinary symptoms ? When was your last menstrual period ? You have to go for an ultrasound if you have got any history of a missed period. I would suggest you to get yourself examined by your family physician/surgeon, who may advise you for some routine blood and urine test apart from an ultrasound abdomen.Wishing you an early recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for fractured vertebrae\n\nI had fractured 2 vertebrae (L1/L2) at my football practice and had a vertablasty done, not really a difference in my comfort from before and after, this was 7 months ago now it feels like that area on my spine is bruised. Very painful when touched. Please help",
    "doctor_response": "Hii have understood your query.For vertebral fractures, vertebrtoplasty is a commonly done procedures although results are very similar with those who are mamanged conservatively.kindly follow up with your past and recent X rays .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for flu & diarrhea\n\nHello doctor,my husband used to feel flu symptoms and didnt heal for 3 months he went to the doctor he said it s bronchite he gave him antibiotics after stopping it ,he made diarrheea for 3 weeks he was diagnosed with dysenteria,mycosis where present in stool test,the pharmacist gave him flagyl he took it for 14 days maybe because the symtoms after 10 days didnt stop while taking it he used to feel ear pain and throat pain after stopping it 10 days later he woke up one day with very strong diziness the world is spliting around and it didnt stopped they took him to the hospital immediately after many tests he was diagnosed with bvvp the doctors gave him exercises and betaserc we was relieved from diziness but the throat pain,eye tieredness,ear pain and sensibility to light didn t disappear.Disconfort in Gastrointestinal tract appeared we thought he had reflux we made H.Pylori urea and blood test both were positive,the doctor gave him Klacid500 mg twice a day,ospamox 1000mg twice a day pantoprazole 20mg once a day in the morning.all these medicines were taken in a period of 4months.After stopping the medications,the throat and ear and eye pain were still present although we are following the food and lifetsyle precautions for reflux the symptoms improved a little but he still have the pain.Yesterday we made endoscopy to see if the disconfort results from reflux we found out that he has mild erythematous exudative gastritis,involving pre-pyloric region was evident,oesophagus was normal.th squamo-columnar mucosal junction (z-line) was at 40 cm.The duodenum normal to its second part.He is not being able to eat a lot during the meals and not too much drinking with foods so he lost 6kgs in one month,and he will be underweight soon if he continue loosing weight.the question why does he feels throat pain he can t raise his voice,eye and ear pain all the time does gastritis makes throat pain,eye sensitivity to light and eye tiredness and ear pain and general tiredness ?and what will be the treatment for that?He has no body temperature .thank u soo muchh i really need your help.",
    "doctor_response": "thank you and pleased to answer you.The link between organes oral cavity and mild erythematous exudative gastritis is a  dental problems complicated with sinusitis.before doing anything, I would ask you two things:dental panoramic radiographs and Sinus X-rays .effectively, a bad dental status can link to a sinusitis, that can explain all your problems and a bad dental status can link to a gastritis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are my uncle's lung infection and non functioning kidney interconnected?\n\nMy Uncle is suffering from Multiple organ Malfunction. he was recently admitted to hospital and kept in ICU. The CT scan showed infection in his lungs due to some fluid and also his kidney is also not functioning properly. Is there any interconnection between the two.",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.In my opinion patient should be investigated for systemic illness.There are some connective tissue disorder which can affect multiple organs like lung, kidney, brain etc. So if your father is investigated further, you may find something pertaining, and van be helpful in treatment.Please maintain optimum blood pressure it is surely can help you in maintaining the blood pressure.I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Small child, bloated stomach. Liver test done, no blood disorder. Treatment?\n\nmy son who is 2 years 9 months , he had bloted stomach for which we did do test and found his liver which is 13.5cm and spleen is 11.8 cm , we had already done thelesmia test and found no thelismia . but he is leading a very healthy life with no energy down at any given point of time . in test even the Portal veain is also clear - no blockage, doctor is suggesting biopsy of liver - i am confused kindly guide",
    "doctor_response": "hi, welcome to HCM I am Dr. Das There are many causes for hepatospleenomegally in a child including some congenital diseases.   If all other tests like complete blood count, LFT and others, liver biopsy is suggested. Before going to do a liver biopsy, you have to do coagulation profile which indicates whether liver biopsy can be done or not.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high BP after stopping medicines for digestion problem?\n\nHEY I am taking normaxin(clidinium bromide,chlordiazepoxide,dicyclomine hydrochloride)  tablet everyday in the night for past 5 years due to some digestive problems.the problem is whenever i stop taking it,my blood pressure goes beyond 140 90. please help:(.i want to stop taking normaxin.",
    "doctor_response": "Thank you for contacting HCM. I would like to know your age and gender.  you have taken this medication for 5 years. abrupt stopping this can increase anxiety, each in turn increases his blood pressure.  You are taking strange combination of these medications for your digestive problems, let us know what exactly you have been suffering with. we would like to help you.  There are more cleaner and  new medications available for your digestive problems. we would like your blood pressure Give some more time, if you would like to give up this medication to see if your blood pressure comes down.  if your blood pressure is not coming down , you should see the doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I getting white hair in young age?\n\nHi doctor, I am 17 years old and\u00a0getting white hairs. They are white near the scalp and black in the tip. What to do?",
    "doctor_response": "Hello. As you are only 17 years old, the primary cause behind it might be genetic as your parents or grand parents may have white hairs at an early stage. The other possible causes might include poor nutrition, improper lifestyle, stress, etc. White hairs mean lack of melanin, the coloring pigment in hairs. Once the hair that grows white, there are fewer chances to revert them back to normal black color. But, you can stop further graying of hairs. First of all add foods like figs, curry leaves, raisins, fresh fruits, and vegetables in your diet. Avoid excessive caffeinated drinks, spicy and junk food. Quit smoking and drinking if you do. Sleep adequately at least for 6 to 8 hours a day. Try to go to bed before midnight. Avoid taking too much stress. As far as medicine is concerned, I suggest tablet Asthiposhak two tablets twice a day with water for six weeks. Apply Bhringraj oil on your hairs two to three times a week one night before washing hairs. Wash your hairs with a mild herbal shampoo. Have one glass of lukewarm milk and add a pinch of black pepper and turmeric in it and take it before sleeping. Try all these things, and you will soon feel positive results. 1. Genetics. 2. Poor nutrition. 3. Stress. Revert after a month to an ayurveda specialist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat prolonged cough?\n\nHi.  I have been having a persistent cough for over 3 months now. After lot of medication it stopped for a week and than started coughing and ended  up with high fever. Again I am under medication and still causing.Cough is bad at night and sometimes its like an attack. After coughing I am so tired and breathless I feel like fainting. My work is getting so effected. This time doctor said nothing to worry about its just an allergic bronchitis. I dont feel good. This is the fouth time over the past 3 years n this time there is just no cure.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. In my opinion, you are mostly having chronic bronchitis. Best treatment for bronchitis is inhaled treatment. Since you are not taking inhaled treatment you are not improving completely. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test).PFT will tell you about severity of the disease and treatment is based on severity only. You will mostly improve with inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone). 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump on the cheek in a child?\n\nHi, may I answer your health queries right now ? Please type your query here... My 22 month old toddler has a nasty bruise on his right cheek, right next to his nose. The peditrician said there was no broken bones or teeth right after he fell. Now, after two weeks the blue coloring is gone but 5 days ago I noticed a solid-like lump where his bruise was. The lump is about 1.2cm wide but not very high but you can feel it and see it is there is you look at him closely. It has not increased in size during the last five days but it has also not decreased in size. Question: Is this serious? How long does this usually last? Is there anything I should do? How long should I wait before seeking medical attention again?",
    "doctor_response": "Hello,What you are observing is probably a healing hematoma which may resolve by itself by getting absorbed in due course. Nothing to worry about it at all. But as you have asked for - if there is increasing redness around the area or high-grade fever, then you need to seek medical attention as it is suggestive of secondary bacterial infection, please.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sumanth Amperayani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headache, fever and diarrhoea in a 3 years old?\n\nHi my son 3yrs old was presenting with fevers headaches nod tummy aches, after 3 days he started with diarrhea still with fevers and tummy aches. He now is complaining of hand pain every time he goes down to sleep. Not sure if it is puns and needles? He has also started with a few red spots on his lower back and buttocks?",
    "doctor_response": "Thank you for the question.As far as hand pain is concerned it seems to me that he must be keeping hand in awkward position while sleeping which can be corrected easily.For headache, tummy ache and diarrhea he needs medical attention as soon as possible. He will look after the rash too.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can hair loss be treated?\n\nHi actuallli im 16 years old and i hve been having hair loss.....and i don`t kno waa to do about it ...i have tried all the diffrent types of shampoos/oils and even refered to my gp..he asked me to eat more fruit and vegetables and so i have been continuulesly but it is still the same ....could tell me other things that i should be doing",
    "doctor_response": "Hello, the most likely cause of diffuse hair loss at this age is telogen effluvium, you need to visit a dermatologist for the evaluation, also a few inv. are required viz. S.ferritin and thyroid function tests, the abnormalities of which cause hair loss.For the time being, i would adv you to take hair supplements like tab hairbless 1 od along with a volumizing shampoo like Xgain and a good conditioner for your hair.ThanksTake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sever headaches, painful cramps and with blood during ejaculation?\n\nPlease help me i dont have a credit card... knew this would happen I will never find whats wrong with me.... pleaase find it in your heart to answer this for me without having to be paid.. Please help i have had this problem for awhile but doctors have not giving me a explanation...Any time I try to have a bm. or Climax I get a horrible painful cramping tensing feeling in my head and i cant see when it does it... when it first begins it feels like a balloon, well this morning i was going to the bathroom and wasn t pushing hard.. my head did the cramping and tensing up well i blacked out and ended up on the floor. and when i checked the toilet there was blood again... when this happens I have to hold my head and apply pressure for it to ease up.. it also makes my nose bleed and side of my face num.... most time when this happens while im having a bm i will think i went and look and its nothing but blood and I was still leaking I went to the doctor for that and still no explanation.. everytime i have a bm its horrible pains i breakout in sweats I shake i go num, and throw up from the pain... I am begging you to please help me find whats wrong with me, i know my body and somethings wrong,, I have 3 great children i wanna be with them for a long time i know people say theres a age when things start falling a part, but please help me....",
    "doctor_response": "Hello, These symptoms indicate in most cases prostate issues such as prostatitis or hypertrophy and rarely it may be sign of STD infection. You should avoid intercourse for till symptoms persist and drink plenty of fluids. If symptoms persist it would be good to do a prostate ultrasound and check your PSA levels to rule out a prostate tumor or hypertrophy and further treatment depends on these findings. In most cases, it can be controlled with medications but sometimes, in case of a tumor, open surgery is required. And severe benign hypertrophy may be managed endoscopically so you should consult urologist about appropriate options. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Iven Romic Rommstein, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness in chest,severe coughing,vomiting and dizziness?\n\nI've had somekind of terrible bug since Tuesday, but it seems like it has different symptoms everyday. Tuesday I couldn't breath from a swollen throat and stuffy noses and was throwing up constantly. Wednesday I was feeling better. Still had a stuffy nose and swollen throat, but developed a cough. I went to hospital they said it was viral and they couldn't do anything. Today I'm feeling terrible again. My chest is extremely tight and I'm coughing so hard that I'm throwing up and getting light-headed to point the I'm dizzy and my vision is blurred. What's going on with this cough?! Pneumonia?",
    "doctor_response": "Thank you for asking at HCM.I have read your question and I understand your concern.Viral infections are mild and usually does not need vigorous treatment, and symptoms resolve within 5 to 7 days by itself, during this course 2 tablets of paracetamol every six hourly will help. but sometimes there is superimposed bacterial infection which needs proper antibiotic treatment, so if your symptoms are worsening there is no harm I a revisit to a physician or hospital.thanksdr. taimoor",
    "dialogue_context": ""
  },
  {
    "patient_message": "Earlier had thrush in cheek. Now have numbness of face, fingertips, toes. MRI, CT scan normal. Infection?\n\nAprox 1st week of January I had Thrush in the left cheek of my mouth ( I am 51 years old ,Male)  I went to a clinic and got some medicine , a week later my face on left side felt numb, I went to my doctors office and he said the thrush was gone, but my face left side was numb, and it could of been Bell's Palsy, he said if it gets worse come back.  A few weeks later my face was still numb along with my finger tips and toes mostly left side, I have MRI's Cat scans Spinal Taps e lots of blood work, even checked for HIV(negative), The neurologist I have been seeing , is very good I am scheduled for   results 27th of this month , very nervous, 3 week ends ago I was rushed to the hospital teice , they thought I was having seisures, but 2 neurologists said no , , My neurologists said after the 1st MRI it was shadowing on my brain from some type of infection",
    "doctor_response": "HiIt is common for thrush to occur on skin creases and mucosa. It has one more characteristic of spreading to internal organs like gut, kidney, brain, etc. It is possible that you may be having symptoms of systemic candidiasis. I think doctors will prescribe anti-fungals if they make a diagnosis of systemic candidiasis. Once you take an anti-fungal orally, you may need to take it for life as a prophylactic.I will recommend some life-style measures to build on your immunity. You need to exercise regularly for at least 20 min a day. Take adequate fruits and vegetables. Take hygienic food and clean drinking water to avoid stomach infections. Also take vitamin B12 supplements regularly.Take careDr Vaishalee",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am 12 weeks pregnant and I am suggested to do prenatest. Please advice.\n\nHello doctor,I am a 33-year-old woman. I am pregnant with my first baby in my 12 weeks. I had an appointment with my doctor two days ago, and she did an ultrasound to me, and she told me that th NT measure of the back neck of my fetus is 2.3 mm. She asked me to do a blood test called prenatest to be sure of that. Please advice what should I do? I am attaching the ultrasound report.",
    "doctor_response": "Hello. When NT (nuchal translucency) is towards higher value than a baby is more likely having a problem. Now there are two prenatal tests which can be done at 12 weeks. Most commonly done is a double marker test. Currently, both are screening test, and we come to know whether this pregnancy is high risk for some genetic disease like down's, Turner, patau syndromes. And if high risk than how much is the risk, statistically like 1:148, which means there is a chance of one pregnancy to come positive for downs in every 148 pregnancy. So for further confirmation have to send liquid around a baby for examination. In that, we remove fluid under sonography guidance and send it for examination. They segregate fetal cells from it and do a DNA test for confirmation. But this test is directly invasive and also have some possibilities of side effects, so we avoid on the first basis. Because if it comes as low risk in double marker than no need to send liquid around the baby. So consult with your gynecologist and have detail about which test is carried and possible results.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat stress?\n\nHi doctor My age is 25 and I have just completed my p.g from last 3 month I m going through lots of stress. Actually that is love problem she left me and I m going through a trauma. Even I cant focus on my career. I cant sleep whole night. What should I do I really dont know should I take sleeping pills. please help me.",
    "doctor_response": "Hello thanks for asking It is common in youngsters to develop symptoms of anxiety and depression after relationship problems especially after breakup. You are not able to sleep properly and this is causing significant distress and is affecting your carrier. Taking sleet pills will not cause the condition to improve. Ypu have to face the situation. Sleeping pill will make you dependent and this can prove deleterious to your health. If you are not able to control your anxiety and depression symptoms then I would advise you to consult a Psychiatrist for expert opinion. Medicines like Mirtazapine can be used as antidepressant drugs and the medicine will help in good sleep also.Thanks, consult a Psychiatrist for detailed prescription.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for enlarged liver?\n\nI am 33 years old man. I have non alcoholic fatty liver. My ALT increased 72 to 225. All reports are normal lipid profile is normal hepatitis is negative but alt increased  day by day. What treatment should be applied to control ALT permanently. Can fatty liver become normal again and reverse? My liver is a mild enlarged in size. What is the best treatment for fatty liver to control ALT permanently.  Plz  tell me in detail. I will be thankful to you.",
    "doctor_response": "Hi I can understand your concern...You have fatty liver....With proper life style habits yes fatty liver can be reverted .....it takes 6 to 8 month to revert fully....Following are some good advise regarding your case.Loose weight if overweight.Cutt off oil in cooking.Tranfat foods avoided like cheese, burger , pizza , meat , baked pestries etc....Refined food avoided.Fruits more.Sunflower , canola like good oil is to be used.Avoid alcohol....In stead of refined sugar honey can be used.Regular exercise done ....In lunch and inner include salad made of carrot, tomato and green leafy vegUdiliv tablet can be taken ....Hope your concern solved...Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a benign Schwanomma below right collar bone?\n\nHello, I have had diagnosed last week a 3cm schwanomma just below my right collorbone. I only noticed it about 2 months ago. it is a little tender but there is no pain as such. The doctor who did the biopsy said if it was a benign Schwanomma then it would be best to leave well alone. My doctor has said it should be removed. I am wondering which nerve it is on. Does the Vagus nerve go below the collarbone. How dangerous is it to leave it there? I have read that it will grow but how fast there is no way of telling. If it has to be removed, I guess it is better to have a smallish tumor removed than a large one.  Can you give me more information please. Thanks",
    "doctor_response": "Hi,Thanks for writing in.A schwannoma is a benign tumor that has got origin from schwann cells in a nerve. This tumor is in the collar bone area but the exact location can be known only if you have got a CT scan or MRI scan done. This usually does not cause pain but if it stets getting painful then surgery is recommended. Vagus nerve does not course along the collar bone but it is important to know anatomical details of your tumor before coming to a conclusion regarding the origin. The nerves supplying the arm form the brachial plexus and it passes close to the collar bone.It is important to do a detailed imaging investigation and also compare the symptoms of pain should you experience any and then go for surgical treatment. As there is no pain, you can get a MRI scan of the region and then discuss the findings. This will tell us if the schwannoma is arising around an important structure and will give rise to complications if left without surgery. If there are no important structures around the schwannoma and if the size is small then you can have the wait and watch approach. The tumor is usually harmless in most patients. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for loose motions in a child\n\nhi my baby is having loose motion for the last 1.5 week and he is getting very week, I went to the doctor , walk in centre and emergency three times but doctors are not suggesting anything apart from dyrolyte and calpol, could you please recommend me something which can help my baby to reduce motion",
    "doctor_response": "Hi, How old is your baby? The common cause in a small baby is a rotavirous infection which results in frequent watery diarrhea and subsequent dehydration. This is a viral infection and can result in severe morbidity. The mainstay of management is the replacement of the water loss in stools with an electrolyte solution. The food given will depend on the age of the child. Your doctor may advise a stool test to rule out bacterial infections, lactose intolerance and cow milk allergy. More information regarding the age of your baby and recent changes in the diet if any will be useful for any further advice. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Anil Kumar Bhatnagar, Pediatrician, Neonatology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bumps inside the vagina?\n\nI have bumps inside my vagina, not on my cervix. they are inside, not visible, inferior to the cervix on the anterior side. they only burn a little when touched, and there is a thickish white substance that I notice on my finger after inspecting the area. There is no smell, no itching, no pain. My gynecologist said I did NOT have a bacterial or yeast infection. I ve only ever been sexually active with one person, and we ve been sleeping together for about 2 years now. He has no signs of anything and never has had anything to his knowledge. I ve never had any symptoms prior to this. Please help? I m terrified and panicking at the moment.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have lumpin vagina just inferior to cervix.  It may be due to some benign cyst.  Batholin cyst or other cyst is common in this area.  You don't have any infection so no need of antibiotics.  Consult your gynecologist and go for examination.  If needed surgical removal is the treatment of choice. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What the Placentrex injections are for?\n\nI have undergone Laparoscopy surgery 15 days back and now my doctor prescribed me Placentrex injection for 10 days daily. what for these injection used and is there any side effect. I report does not show any tube blocks but she told that tube is swelled it does not allow for follicles to grow. please suggest",
    "doctor_response": "Hello,Placentrex injections are used to treat inflammation, pelvic inflammatory disease, to reduce the risk of infertility and adnexal mass, any type of tubal damage, fornix tenderness and uterine restricted mobility. You can take the injections it is helpful in conceiving. But side effects are associated with it, like weight gain, headache, dizziness, change of appetite, acne, nervousness, etc. If you have such symptoms you should report urgently to your treating doctor so that the doses can be monitored.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Nupur K, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have lost my tooth filling. Can I have a new filling or a crown?\n\nHi doctor, I have lost a filling present on my bottom left tooth next to my wisdom tooth. Some portion of the tooth has broken away. I do not have pain in that tooth now. Is it right to have a new filling on that tooth or can I have a dental crown on that tooth? Is it possible to have a crown on that tooth? Is it a complicated procedure?",
    "doctor_response": "Hi. A filling can be placed again, and the tooth is contoured correctly. A composite can be used to build the tooth and then the tooth can be contoured adequately. Then a crown can be placed. If the tooth is not broken much, then a cutting can be done, and a crown can be placed. If the crown of the tooth is broken more, a post and core can be used. All these measures are taken depending on the status of the crown structure. These measures are entirely noncomplicated and can be done without a problem. Please send a photograph of the tooth. It will be easy for me to guide you. If there is no pain, then it is easy to fix the problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fishy smelling discharge in a 13 year old?\n\nMy daughter is 13 yrs old and has a fishy smelling discharge. No pain and no itching. Not sexually active.  She started her period but this event is about 2 weeks after her period has stopped. I am thinking she may have a yeast infection but not sure.  Thank you for your consult.",
    "doctor_response": "Hi,It seems that she might be having some infection in her lower genital tract, either bacterial or fungal.During and after period if local part is not cleaning properly there might be having possibility of infection.Give her proper education regarding proper hygiene of lower parts.Apply antibiotic or antifungal cream locally.Keep local part clean, dry and airy.During period ask her to change sanitary napkins frequently after proper cleaning.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for severe headache caused due to tooth extraction\n\nHi,I had two of my upper right molars removed today. The very back two. I was not given any pain or nausea meds, though I have a standing zofran order due to cyclic vomiting syndrome. I am in extreme pain. I'm able to sip Gatorade but food is a no go. I also have a piercing headache on the same side of the head as the teeth were removed? I'm not sure if I should just call or what...",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain if you are not advised painkiller after tooth extraction then pain is not an abnormal finding because as the tissues are traumatised and inflamed after extraction of the teeth there will be pain..Pain in head is radiating pain from the extraction site..It is not a correct practice as not to advise painkillers and you need to consult your dentist back and get a script of antibiotics and painkillers..As of now you can take anti inflammatory painkiller like Ibuprofen and also do cool compresses over the cheek..Do warm saline gargles..Take a soft diet..Hope this helps..Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hair loss?\n\nI had the implant put in this May and have noticed hair loss within the last few weeks. It has thinned noticeably and I'm not sure if these two things could be related? If my hair loss is due to the Implanon, will the shedding slow down as my body adjusts to the hormones? Or will I continue to lose hair?",
    "doctor_response": "Hi,You seem to have telogen effluvium. There may be some cause. Your dermatologist might investigate to find out the cause of hair fall. Anaemia, thyroid dysfunction,vitamin deficiencies, internal diseases,stress, malnutrition..etc may be considered. Directly implant does not affect hair cycle. Probably stress related with implantation would have affected.I would suggest...- biotin 10 mg daily for long time- vitamins and minerals ..if needed- treatment of the cause- herbal shampoo alternate days- you may apply mild steroid lotion daily at night.... Along with herbal hair oilI hope you got my answer.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the possible treatments for seizure ?\n\ngood morning doctor, my son is 11 years old last  month he had seizure, on doctors advice We start EPTOIN 100mg in the morning n 150 mg duing bed time . we had MRI and EEG, as per doctor everything's fine and he advised to take Eptoin for 3 years. now he's having headache, drowsiness , head spinning doing morning. kindly advise. thank",
    "doctor_response": "HIThank for asking to HCM These are the common side effects of medicine, you can change the drug it would be better to start the :Carbamazepine\" 100mg once in day, this drug have very less or negligible side effects have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nausea when you are pregnant?\n\nI m 8weeks and 3days pregnant and have had really bad throwing up for the past 2 and a half weeks a week ago I was in and out of hospital and they said that there was nothing they could do for me so sent me home after the gave me morphine. I have not eaten for a while now couple days maybe and have been throwing up orange liquid and haven t had anything orange what does this mean?",
    "doctor_response": "Hello dear,I understand your concern.Iam sorry for your condition.In my opinion the vomitings are routinely seen in first trimester of pregnancy ie.,first 12 weeks.This is called morning sickness.But this can be controlled by medicines like antiemetics like doxylamine, metochlorpromide,ondansetron etc.If they are not controlled by medicines and general condition is deteriorated it is called hyperemesis gravidarum.But do not worry.Mostly they will subside by 12 weeks and rarely till 20 weeks.But till then try to take antiemetics and take food in small quantities every 2 hourly.Take adequate fluids upto 3 litres per day along with fruit juices.Relax.Hope this helps.Best regards...Dr .Srilatha",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I noticed a clear bubble under my tongue. It is not painful. Is this due to an infected tooth?\n\nHello doctor, I have had swollen glands for a few months now. I have seen an ENT doctor for the same. He ran a blood test and it came back normal. He told me give it a month and they should go down. They have not gone down or grown. Before going to the ENT doctor, I also visited a dentist and got to know that I have a tooth on each side that is infected. He said that the molar has to be taken out. Today, I noticed a clear bubble under my tongue. It is not painful. Are these related?",
    "doctor_response": "Hi . Revert back with the x-ray reports to a dentist online for further follow up -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat acid reflux causing foul smell ?\n\nMy grandson is 4 month old & breast feeding. He had regular bowel movements (like almost everytime he nursed) for the first 3 months. all of a sudden he quits having reg movements and goes as long as 5 days now - same diet - no food - just breast milk. Mother is very careful about what she eats and drinks. he is very fussy and passes gas that is very fowl smelling. He had a bm last night that was very runny and leaked thru his diaper and in the floor and all over mom. Thought he would feel better today but he didn t. Have had him to the Dr. and she says the fowl order is from bacteria. Is this normal? Don t know if we should take him elsewhere or what. We give him gas drops and gripe water and he is on a medication for reflux that he has been taking since he was about a month old. Can t tell you the medicine as I don t have the prescription bottle with me tonight.",
    "doctor_response": "Hi, I had gone through your question and understand your concernsIt is normal in infancy to pass motions in 5 days , provided it is not hard , baby active accepting feed , passing urine.Foul smell with gas is due to fermentation by bacteria , and as freq is of 5 days , it is more foul smelled . I do not think any reason to concern ,Hope this answers your question. If you have additional questions  then please do not hesitate in writing to us.  Wishing your baby  good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should i do in depression ?\n\ni am out of of depression . now, what should i have to do fix up remaining symptoms & to enhance my brain power , capability.",
    "doctor_response": "hi; try do do regular exercise ;meditation ;yoga these will help you increase concentration .slowly but surely in few days you will regain your brain power & capability.If you are still on medicines for depression follow the advice of your treating doctor for dosage of medicine. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are cough and breathing difficulties common side effects post cardioversion?\n\nGood morning.I am male 74 years old and have recently had cardioversion to treat an arythmia.My heart now seems to be beating regularly and I am taking Elequis and Flecainide to prevent blood clots and futher arythmia problems.However I am now experiencing a persistant cough and some breathing difficulties.Is this normal after cardioversion and will it eventually go away?Many thank s,Alan",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. No, cough and breathing difficulty are not common after cardioversion. In my opinion, we should definitely rule out bronchitis for your symptoms. So consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test).PFT will not only diagnose bronchitis but it will also tell you about severity of the disease and treatment is based on severity only. You will mostly improve with inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for spondylolysis and bulge disk\n\nI have spondylolysis and bulge disk..I am getting lot of stabbing pain and abnormal sensations in my back....I have tried several natural therapies..but not helped at all...I am 53 years old and have severe pain...cannot sleep on my back...cannot sit....cannot lie down sideways......due to think surgery will cure me",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern. You are likely to be get benefited by surgery of spinal fusion with or without bone grafting. However final decision depends upon surgeon on seeing your x ray and MRI report. Other methods which can be beneficial can be applicable of lumbosacral belt so that less movements occur at lumbar  spine. Physiotherapy by back excercises are of use. You can discuss with your treating Doctor about it.Hope I have answered your query.If you have any further questions then don't hesitate to writing to us . I will be happy to help you.Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i use a piece of gauze on both sides of my clitoris to isolate discharge because of herpes?\n\nI went to the ER for a possible herpes outbreak and the doctor said that I am correct with the diagnoses. This is my second outbreak. The initial outbreak was very very painful but stopped when I started to take acyclovir. I was wondering if I can stick a piece of gause on both sides of my clitoris to isolate the stuff that comes out once the lesions burst. Would this be a good idea or should I not do this? Thanks in advance",
    "doctor_response": "HI, thanks for using healthcare magicPlacing gauze in this area would not have an impact on the course of the infection and would not affect your ability to transmit the infection to your partner.It would be best to avoid sexual contact at the moment. Your partner should be aware of this infection because transmission can occur even when there is not active outbreak.Barrier protection (condoms) reduce the chance of transmission.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for nagging cough in cancer patient\n\nmy mother has been detected cancer of food pipe last week. She had nagging cough  since last three months. i want to know how much is the growth in three months. what medication you advice She is 87 years old. All paremeters are very good except infection of the lung ranjit",
    "doctor_response": "The cough that your mother has had may have developed due to a abnormal communication between the foodpipe and windpipe. That makes it an advanced tumour. If there is increase in cough, you may have to show a gastroenterologist for stenting.As she is already 87 years old, any aggressive oncological management is not advised",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling on lips and hives all over the body\n\nI am experiencing severe hives particularily on my lips.  Looking back at what I may have eaten or touch is not helping and then I thought that my husband and I have been engaging in the G Spot stimulation and I have been secreating alot of fluid during this sexual practice.  Could that be why I am swelling up on my lips and sometimes I break out in hives all over my body.  It has never effected my swallowing or breathing.",
    "doctor_response": "Hi Dear,Understanding your concern. As per your query you have hives and  swelling on lips which can be due to multiple factors which act as trigger such as environment, heat, cold, pressure and sun exposure.I would suggest you to - Give cold compresses to hives several times a day to prevent from swelling and itching.- Take over the counter antihistamine drug like benadryl. - Best way is to find the trigger factor so that it can be avoided. If symptoms still persist the consult dermatologist for proper examination and treatment. Doctor may perform skin test and challenge to find out the trigger factor and prescribed medications accordingly.Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for chest discomfort?\n\nChestIve been feeling a lot of pressure and heaviness on my lower chest for two weeks now . Along with random sharp pains that get worse when I breathe in . Its difficult to breath and its really uncomfortable . My heart is also pounding and I keep feeling like there is air stuck in my chest and I try burping . My chest also burns at random . I cant do any acivities anymore because I run out of breath fast and its difficult to sleep also . I want to know what I may have Age : 16 Height : 5'3Weight 96",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. By your history and description, possibility of gastroesophageal reflux (GERD) is more due to your weight. Obesity is known risk factor for GERD. It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms of burping, gaseous feeling in stomach, chest tightness, heaviness, burning central chest pain etc. So better to follow these lifestyle modifications for symptomatic relief in GERD. 1. Avoid stress and tension. 2. Avoid hot and spicy food. 3. Avoid large meals, instead take frequent small meals. 4. Start proton pump inhibitors and prokinetic drugs. 5. Go for walk after meals. Keep 2-3 pillows under head in the bed to prevent reflux. 6. Do regular aerobic exercise and loose your weight. 7. Avoid smoking and alcohol if you have these habits. Don't worry, you will be alright with above mentioned modifications. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from esophageal cancer spread to spine. Swollen thigh, vomiting. Is chemotherapy an option?\n\nHi, my step father has recently been diagnosed with esophagus cancer which unfortunately has spread to the spine . His right thigh has swollen considerably, but no blood clot showed on ultrasound, MRI leg scan shows probably cancer too. he is now vomiting since yesterday tea time and unable to keep even water down. Dr s have sent him home with a drip of pain relief and anti sickness. he lives alone and I am worried how quickly this is spreading and taking over. He still hasn t started chemo , due to start on Monday, do you think it is worth him going through chemo at this stage?",
    "doctor_response": "Hello Esophageal cancer is one of the deadliest malignancies and historically carries a dismal prognosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is daily masturbation harmful?\n\nhi doctor.....my age is 22...gender:malei am masturbating in the bathroom every time when i go for bath....i started this activity a week ago.....this activity giving me immense pleasure.....will it be a harm to my health if i masturbate daily??....or thrice in a week",
    "doctor_response": "Hello, At your age, daily masturbation is not harmful. But you should reduce it to thrice a week. Therefore, I suggest consulting a psychologist for physical examination, diagnosis and treatment. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are facial pain and numbness related to itchy and burning moles on head?\n\nHello doctor, Since the beginning of this year, I have noticed a couple of moles on the left side of my head have been very itchy and burning, and when I start to itch them it causes the whole left side of my scalp to burn and feel uncomfortable. I am worried it might be something serious. This year I have also experienced a lot of left side facial pain and numbness, as well as left eye blurriness. So I am not sure if the pain on the left side of my scalp could be related.",
    "doctor_response": "Hi. The ABCD criteria for moles you should be aware to see for malignant changes. One should always look for the change in color, size, margin, the surface of the mole, also if it is associated with itching and bloody discharge. I have reviewed clinical photograph attached (attachment removed to protect patient identity). There are no changes of erythema around mole or discharge. In photographs, there are two moles only. If there is an increase in the number of moles or increase in size, the best would be skin biopsy for histopathology to see for malignant changes. Presently, there is no inflammation also in these two photographs which you have attached to comment on itching sensation which you are experiencing. You should consider an ophthalmologist opinion for the blurring of vision. I do not think personally from these clinical photographs that mole and other symptoms are associated. Physicians opinion should be considered for numbness over one side. If you have any fluid-filled lesions on one side then keep watch for that too. Skin biopsy for histopathology should be done if specifically mole is associated with itching.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can ADHD along with dermatillomania and aggressive behaviour be treated?\n\nmy daughter, her brother and my xhusband have ADHD or ADD. I am now 69 and I feel that I fit the description but I had myself tested and she said I did not have it...neurologist. My daughter is always agitated by me and sending me unkind misrepresentations of why I do things that she does not like. I doubt she is on meds now but Adderal helped she and her brother and X so much that my son graduated from Harvard business and my daughter owns her own house, has a wonderful husband and the most incredible calm daughter. She is in daycare all day across from their workplace. I have been diagnosed GAD and my meds are fine but I have ataxia. I tried Ritalin years ago and wrote a paper that was 20 pages long and got an A on it which was unusual for this professor and she said it was the most confusing paper she has ever read. As you can see, I just go on and on and share to many details by voice. I just want to be less anxious so I do mindfulness medication and DBT which I feel really saved me from depression and isolation I was feeling. Now I see everything in a good lite, even my daughter. I m just trying to help her share her feelings instead of texting me with BIG LETTERS in a text and saying things about my emails and texts that are total misrepresentations. She has a good sense of humor and I do too but we are just triggered all the time. I don t want to tell her she needs meds but I have told her that I do not want large letters and drama like this. She is really smart and usually has clear thinking. I think she is overwhelmed and just needs meds. She is an amazing mother but she treats her husband like me, at least when I visit with them....they are long distance. Usually see her once a year. I have taken the course of not responding to her anger and just reinforce kind communication and by trying to listen to her better. Okay..that s it. My question? How do I let her know lovingly that she might want to consider Adderal again. Oh, she has a picking disorder. She picks her face and said she likes the pain. Sounds like BPD. In college (she s 34) she used to pick her leg till it bled and told me she wanted me to tell her to stop. My x abused me once physically which she saw and I took her to a friend s. I also called 911 twice for verbal and violent behavior to a lamp. Last summer she said her father had a terrific temper but I didn t ask why she said it...I just asked her if she ",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Atomoxetine and  Risperidone low dose, should be given. We should try to find out any stressing factor or reason of aggressive behavior. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed fear of crowd & anxiety\n\nHi I am Mezhu, 24 years of age, male and I am a student in Delhi. I have a problem of shaking and blank mind whenever I face people for presentation or public speech. And I have tried so many times to overcome this fear , but still it's not working, can you please help?",
    "doctor_response": "Hi Mezhu,I can understand your concern. You seem to be suffering from performance anxiety. I would further like to know if you are also anxious in any other social situations, or do you have any problems talking to strangers, etc., for arriving at a proper diagnosis.For the problem of performance anxiety, you can consult a psychiatrist. Medications like selective serotonin reuptake inhibitors and propranolol are useful in this condition. Behavior therapy methods which will include leaning relaxation techniques and other methods to overcome your fear will also be very helpful.Hope this information was helpful. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does it take to recover from a sprained foot?\n\nI sprained my foot on Friday. I stepped on what I thought was lawn. Instead I was a bit on the lawn, but the outside of my foot snapped down into a trough. My foot has been swollen since Friday. Today is Thursday. Kept ice on it for 24 hours. Bruising started after that, Now bruising is spreading. It is really dark on my toes. Pain is on outside of my foot, not on my ankle.",
    "doctor_response": "Hello, You have sustained twisting injury to foot which may lead to sprain or minor fracture in foot bones. Diagnosis needs to be confirmed by doing x-ray of the involved foot anteroposterior and oblique views to rule out bony abnormalities. If x-ray is normal RICE therapy is needed which means Rest Ice application Compression bandage and Limb Elevation. Tab Diclofenac sodium twice a day for pain relief and tab Chymoral forte twice a day for swelling reduction is required. If x-ray shows fracture Below knee slab may be given. If X-ray is abnormal please consult orthopedic surgeon nearby your area. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for hands vibrating?\n\ndear sir ,i m elilepsy patient ,i take valprin chrono 500 3 tablet per day .but sir my hand too much vibrates when i done any work . i treated from dr. satish jain from DEHLI.. my last atack 2 years before (13 aug 2010).sir plz. suggest me abhi maine 2 tablet lena suru kar di h bina dr. ke advice ke ,kya me sahi hu 3 tab. se mujhe nend bahut aati thi & vibration sa kafi lagta tha.?",
    "doctor_response": "Hello, Consult a neurologist and get evaluated. We have to rule out possible causes like Parkinson\u2019s and essential tremor. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be red dots on penis head with no itch or burn?\n\nI have one tiny red dot on the head of my penis. It is located about the center of the head. It does not itch or burn and is not raised up, but makes me concerned. I had unprotected sex 3 days ago. I am just curious if this is from friction or an infection or an STD?",
    "doctor_response": "Thank you for query.it is not clear about the morphology of rash if only uninfected red dot without symptoms.it may be simple friction.else needs to be examined to rule out infections.consult doctor if does not subside.You can get back to me for any clarifications with the photos.Dr Bharatesh D Basti Dermatologist and Venereologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat loose motion in an infant and constipation in a child?\n\nhello dr,my baby with 4 months old and having a weight of 5.9kgs and she is getting loose motion 3-4 times daily for last 2 days.Iam a medical representative in a pharma company,what medicine and what dose should be given to my baby to control suffering situation.My son with 4 years old getting motion very hard once in 4 days,what is the medication for him.So please solve these problems to my childs having by giving your reply. Thanking you Regards T.Madhu Krishna Kurnool",
    "doctor_response": "Hi...Regarding diarrhoea - Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron (as prescribed by your paediatrician).Regarding constipation -1. 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.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stuffy nose, chest congestion and diarrhea\n\nHello, my daughter is 10 months old. She has a stuffy nose, chest congestion, diarrhea , and nausea (or it seems so as she is gagging frequently). She has thrown up once. These symptoms have been occurring for approx 4 days. She isn t eating or drinking very much. She also has a fever of about 101. I currently don t have a phone to make an appointment with her pediatrician. Is there anything I can do?",
    "doctor_response": "HIWelcome to H M CI am Dr B M GUPTA answering your questionDon't worry she would be alrightAll symptoms indicate  viral-For fever you can give Paracetamol 4 hourly.-If fever increases apply lukewarm water sponging all over body-For stuffy nose put saline nasal drops each nostril 4 hourly-Steam with Vicks 4 hourly or just apply locally over nose and chest -Give plenty of water to drink,add salt and sugar  or ORS -Humidify the room(keep water boiling at one corner of a small room)-Give coconut water to drink,banana,semi solid diet(porridge),curd.Any queryShe would be well soon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause bipolar and can lorazepam help to treat it?\n\nhello, my 36 yr old son has been told he has bipolar.they have him on so many different meds. he just called me & said he doesnt know if he can handle life anymore,its just too hard.but he has 4 children & i think he hangs on for them.it seems as they prescribe him meds & just send him on his way!hes taking larazapan..cogentin..& a few more .I told him all the meds they give him all do different things & its like a tug of war in his head.have you got any suggestions?my heart hurts for him",
    "doctor_response": "Hello!Thank you for asking on HCM!I carefully read your question and would explain that this is a complex disorder and its therapy is complex too. Regarding lorazepam, it can help regulate sleep and also anxiety during the day. But it should be used for a short time, in the beginning of therapy, because it can cause addiction and tolerance. As this disorder is characterized by episodes of depression and mania, it is necessary to take antidepressants coupled with anti-psychotic drugs. From the other hand, anti-epileptic drugs (valproic acid, carbamazepines) can be used in addition to help maintain a humor stability. That is why he is taking a lot of drugs: because they act in relieving different symptoms of his medical condition. Hope to have clarified some of your uncertainties!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Painful reddish ring on the wrist. No itching. What could it be?\n\nHello, my younger sister woke up this morning with a painful mark on her wrist. It's white in the centre and has a red ring around it, and spans about 2cm across. It's not scaly and itchy like it would be if it was ringworm, and it's completely flat. She says nothing has burnt her or bitten her or anything. Any ideas what this could be? Thank you!",
    "doctor_response": "Hi Welcome to Healthcare Magic Forum Looks like your sister has developed a lesion of Vector dermatitis..also known as Paederus dermatitis.. Paederus dermatitis is a peculiar, irritant contact dermatitis characterized by a sudden onset of red lesions on exposed areas of the body. The disease is provoked by an insect belonging to the genus Paederus. Such lesions due to insect bite usually have a history of sudden overnight development. You need to apply an antibiotic/steroidcombination cream over the lesion (something like flutibact, fucibet) twice a day. Take oral antihistamine like levocetrizine once a day to decrease the redness Do not use any moisturizer or lipstick over the lips till the time the lesion heals Hope it helps Wishing your sister speedy recovery Dr Geetika Paul",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does lymphocytes-0.26 and hematocrit-0.45 in CBC result suggest?\n\nHi doc, my brother s cbc results are as follows: Sementers-0.67 Lymphocytes-0.26 Stabs-0 Monocytes-0.03 Eosinophils-0.04 Basophils-0 Wbc-8.10 HemogI obin-156.0 Hematocrit-0.45 Rbc-5.62 Please help me understand what it means.? His doctor will be available tomorrow and he will be checked. I just can t wait to know, do I have to worry.?",
    "doctor_response": "Hi, dear. I have gone through your reports. I can understand your concern.  Your lymphocytes count is 26%. It is within normal range.  Same way your haematocrit and rbc  count as well hemoglobin level all are normal.  You have absolutely normal report of complete blood count.  So no need to worry at all. Just be relaxed. Hope I have answered your question, if you have doubt then you can ask me. I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are Zentel drugs, effective for pinworm infections?\n\nHi, I am 43 y.o and have been suffering with pinworm and I took one dose of zentel (2 tablets 400mg). However I can still feel the symptoms (i.e itchiness) although it has lessened. Should I take another dose of zentel and will it completely get rid of the problem? Thanks",
    "doctor_response": "HelloAlbendazole 400 mg ( 2 tablets ) and still itching present . You are having PIN WORM or enteobiasis . When patient visit my clinic with pin worm infestation I usually prescribe \" mebendazole \" 100 mg single dose to be floowed by 100 mg after 2 weeks .In my opinion patient don't need any more treatment.Ivermectin 12 mg single dose is another drug of choice . Hope this will provide complete eradication of pin worm .",
    "dialogue_context": ""
  },
  {
    "patient_message": "How normal is bp around 103 over 89?\n\nhi i suffer from low blood pressure which cause blackouts. i'm on 200mg of frudocortisone and 2.5 mg of midodrin up to 3 times a day. my blood pressure today is slightly different today and i feel really light headed and sick. i just wanted to check if it was o.k. my blood pressure is 103 over 89 . when i get a low blackout pressure it normally is 76 over 40 so i'm not sure what i'm experiencing",
    "doctor_response": "you are suffering from hypotension..there are various causes..bit you are prescribed standard drugs...BP  should be above 90/50 ..Please take your medicine as prescribed",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could a placental position anterior and covering the internal OS completely increase the risks of a miscarriage?\n\nHello Dr. I m 14 weeks pregnant with my first baby.I ve old history of miscarriage of 2 and a half months fetous just 9 months back. Now I got USD report which states my placental position Anterior and covering the internal os completely, Os - closed Cervix- 4.8 cm FHR- 166 bpm BPD- 27 cm Placenta s position is making me worry.please suggest me..Thanks.",
    "doctor_response": "...mam as the placenta is anterior and covering os there is risk of vaginal bleeding and harm to fetus called placenta preavia ..in such cases i suggest caesarean section instead of vaginal delivery but be cautius as there may be painless vaginal bleeding anytime ..if such happens please rush to nearest emergency room as soon as possible and please avoid undue physical exertion keep your Hb level adequateif you have any other doubt i am here to help with regards dr varinder joshi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for hair fall\n\nwhen i comb or move the hand through head, i atleast get 5 to 6 hairs in my hand. I was not like this before. I had been on medication for TB before 2 months. I have a very good hair. There are a lot of gaps on scalp, basically the density is gone down. I am 30 years old now. I am really feeling bad and worried about this kind of fall. If i just touch they are falling off. Please get me a best solution. I use pantene Hair fall shampoo daily. i am about to get married in 2 to 3 months",
    "doctor_response": "Hello, I have gone through your query and would recommend you to apply Folliserum on the scalp twice daily and take hair supplements like tablet Follihair once daily for 3 months. This will stop hair fall. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Prescribed ebexid tab. Missed period, test negative. Will folic acid help in conceiving?\n\nI am 29 and married for 4 yrs...i am trying to conceive from last 1 yr and visited a gyne 4 weeks back who suggested ebexid tab for 30 days...i have missed my period this month but my pregnancy test is negative...there were no test conducted to check my thyroid level...and ebexid is for thyroid is what i learnt...can u help me understand 1. should i continue the tab? 2. is there any other tab like folic acid tht can help in conceiving",
    "doctor_response": "Hi there. The Ebexid tablet is not for thyroid but it is a multivitamin tablet for general health. It does not contain folic acid and you need to take folic acid 5 mg per day daily as you are planning for conception. Please start it right away. If you are trying for conception since a year without any fruit then do get your TSH, FT4, Anti-TPO, random sugar, hemoglobin, ANA tests and USG pelvis done as a first step of general evaluation of not able to conceive. Get back with the results for further assistance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy bumps on face and body?\n\nI am starting to get irritated bumps on my skin (mainly on the left side) in between face and hip. It has some spots on left, like 6 or 7 and some on my arm. They are really itchy and are on my face mainly by my moun but the majority is from below my chin th my hip on the left side. I swim a lot and I heard of a new disease in pools, could it be that or shingles or somthing else? I would like to know asap because these things are getting on my nerves.",
    "doctor_response": "HelloWelcome to health care magic,I would keep a possibility of acute urticaria or shingles first after going through your description.It might present as skin welts/swellings which can be seen commonly on hands and legs but it can also be distributed all over the body.Itching is subjective in individuals which could be mild to severe.Urticaria or allergic hives can occur due to various causes like,Infections (bacterial, viral, fungal) or certain drugs(Pain killers/ antibiotics or certain foods and food additives/preservatives or It might be physical urticaria occurred as a result of physical touch,pressure, heat,cold,anxiety, exertion etc.In a few cases, no underlying cause is found and are known as idiopathic urticaria.You can continue with oral antihistamine like benadryl (which you are taking already) or tablet levocetrizine 10 mg twice daily for 2 or 3 days.A topical soothing lotion like calamine would also be helpful symptomatically.I would expect that you will start improving in 2 or 3 days and in case not,then it would be advisable to see some nearby doctor who may order routine blood counts with ESR after careful inspection this rashes and can prescribe you appropriate treatment according to the underlying cause.Hope this will help you.Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for tooth pain\n\nI have pain in one of my tooth only when I drink water or after eating my meals, yesterday I went to my dentist and he told me that my new teeth was a little high but the pain will go away soon. But did not give me anything for the pain I am suffering, what can I take for the pain. Thanks a lot for your answer!",
    "doctor_response": "Hello,Dental pain can be treated with anti-inflammatory medication such as Tylenol and Advil. Try to take two Tylenol and two Advil at regular intervals if your pain is severe.If you have had recent dental treatment, you may need your bite adjusted. You refer to a new tooth as being high, so I am concerned that the pain is related to your bite and the high spot should be reduced to relieve your pain. I suggest contacting your dentist to ask this question.What is your age and do you having teeth that are erupting in your mouth? Your bite may be affected as the continue to erupt. I would still recommend that you take anti-inflammatory medication while this occurs. Rinse your mouth with warm salt water and maintain good daily dental care.I am glad to help you further if you provide me more details about your teeth. Please try my suggestions and I hope you will feel better soon. Thank you for your inquiry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are chances of pregnancy after menstruation?\n\nHi I had a situation and I was wondering if you can answer this question for me. I had got my period on september 1st and it ended about september 5th. I had sex with my boyfriend on september 7th and september 8th and he came inside me both nights. Is it like for me to get pregnant within that range of my period and that situation occuring?",
    "doctor_response": "HI,   I understand your concern.    You had unprotected sex on 7th & 8th day of menstrual cycle.. a sex around ovulation can result in pregnancy. If you have a regular 28 or 30 days cycle, it's not likely that you would conceive  on 8th/ 7th day of cycle, as that falls in safe period.    You need to wait for your normal period. If it's delayed till 8 days you can exclude pregnancy by UTP.   Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Liver function elevated, stopped copaxone injection, rest all test fine. How to correct it?\n\nI just received a call from my neuro that my liver functions are elevated and he wants me to stop Copaxone injections for one month. I have MS and have been on Copaxone since 2005. I am also on Estriol 8 mg (I was in a clinical trial) I am doing and feeling great. Bilirubin 1.28 direct .27 indirect 1.01 Otherwise I am very healthy Chloresterol 164 low blood pressure 5 7 137 pounds age 54 and very upset about this. Any thoughts?",
    "doctor_response": "Hi and welcome to HCM,thank you for your query.You just need to wait and follow hepatic diet till lft stabilize. avlod alcohol,fat food and hepatotoxic drugs. this is not some serious bilirubin elevation and it should be corrected spontaneously in 4-6 weeks after you stop copaxone. also,if you dont have symptoms you dont have to be concerned. you dont need to treat laboratory findings...Wish you good health. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure blood filling up my lungs after inserting tube for staph infection following broken ribs?\n\ni just got out of hospital yesterday for i forget but any way i had 5 broken ribs and it caused a staff infection in on top of my ribs so they cut my back and put in a tube in my chest the 1first 1 got clogged up and blood start coming out so they put in a other 1 and that 1 worked and i stayed in the hospital for a month and i got out 2days ago and today feels like i cant breath right and i did a quarter of a pill of ritilin i didnt do that for 2 months throw iv use i am not doing it any more can that effect my breathing right away im taking infection pills and it feels like my left lung aint getting enough oxegen because when that first tube they put in my chest messed up it filled my left lung with blood then tried to move in my right lung got half way but they emptyed it in time",
    "doctor_response": "Hello, I am sorry for your situation but in such conditions, you cannot do just anything as to believe to your treating doctors. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jnikolla, Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest viral fever treatment in a 3 1/2 year sold child\n\nmy child is a boy of 3 and a half yrs his wt is 12.5 kg and recently he suffered with viral fever noe his fever has gone down since he is very lean and thin the doctors adviced a blood test and an x ray of the chest in the reports his esr is 30 mm and the x ray of pa chest shows some haziness what does this mean",
    "doctor_response": "Hi,Thank you for asking question on health care magic.Viral infection makes the child prone to bacterial infections like pneumonia and even Primary TB.Without seeing the x-ray it is difficult to comment about haziness in the x-ray.Better consult pediatrician for thorough investigation and treatment.You ask for Mantoux test as the baby is going down and becomes lean and thin.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pea sized bumps on neck\n\nI'm 28 years old and I have about 7 or 8 pea sized to nickel sized bumps on the left side of my neck from about 2 or 3 inches below my ear down to my left trapezius muscle.  They seem to follow a muscle or tendon along the left side of my neck.  Any idea what it could be?",
    "doctor_response": "Hi,Dear,Thanks for the query from you to my HCM Clinic.I have gone through your query and after in-depth study on it, In My opinion-your chain of bumps in neck is  mostly due to-Lymphadenitis-due to  chronic mild-scalp-infection  / and or / it could be -TB lymphadenitis of post-triangle of neck.I would advise to consult ER surgeon or physician who would treat it properly.Hope this would resolve your worrysome query for now.Wellcome-to my HCM Clinic for any more query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Depressed and finding difficulty in anger control. Have alcohol addiction. Taking bystolic. Due to the drug interaction with alcohol?\n\nI recently had a sudden outburst of anger at my brother in law in a restaurant. I have also been depressed lately for no reason. I have been on bystolic for 3 weeks and was drinking alcohol.  I feel awful about the outburst. Now my brother in law won't accept my apology. I don't normally act this way.  Was it the medication and the alcohol together ?",
    "doctor_response": "Hi there ~ I understand that you have been having some problems with your work and personal life and it is affecting the way you are functioning.  I am sure you need help with your alcohol addiction since it can complicate the picture.  Once you are off of alcohol, you will need to be assessed if you really have anger management problems, bipolar disorder, depression or any other condition that needs to be looked into.  I feel like there is a scope to elaborate online, but you need to see a substance abuse counselor who will refer the patient to a psychiatrist if appropriate.  I am glad I could be of some help. Take care and have a lovely day !",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain?\n\nI've had abdominal pain for about 3 days now. The first day it felt like it was worst in the space between my ribs and navel then the second day it seemed to move into my lower left quadrant (from my perspective) Today is the 3rd day and it seems to be worst in the center under the navel. I've also noticed today a mass/knot like thing on my pelvis, about two inches to the right (again my perspective) of my navel and 4-5 inches down. The mass seems globular in shape and is just under an inch in diameter. It's not sensitive to touch and it's difficult to locate it when I'm sitting or laying down but when I stand it's very easy to find.I would describe the pain in my abdomen as achey or crampy and it was worst the first day. It seems to be worse at night and I feel like the pain is gone etirely when I first wake up but then within an hour it slowly starts coming back. Certain movements that put more strain on my abdomen seem to make it hurt more as well as touch.What could this be?",
    "doctor_response": "Hi.Thanks for your query. The key to the problem looks to be the mass you are feeling on the right side of the abdomen. This looks to be a hernia, the obstruction causing it to be palpable and causing the referred pain in the upper abdomen on day one, left on day 2 and then locally on day three. I would advise you the following:Get a physical examination by a Surgeon to have a clinical diagnosis.Get an ultrasonography and CT scan . If this is a hernia you may need urgent intervention to avoid the complications of obstruction and gangrene of the entrapped intestine",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ostiomolitis in hip bone\n\nHello, I have stage 4pressure wounds on my buttox and also now have ostiomolitis in my hip bone where one of the wounds are..I ve been this way since 2010 and seems like no one can help me. I m bed bound now and suffer from a lot of pain. I ve giving up on trying to live a normal life Noe or some what normal life. Please help me anyone in any state any where.",
    "doctor_response": "hi,thank-you for providing the brief history.As you have osteomyelitis this may be due to either infection or may be due to inflammation of the bone marrow . A thorough clinical examination and some blood routine tests needs to be performed and understand the possible cause. If the infection has reached the bone than may be with the proper understanding of the pathology may be a THR can help. Also an IV antibiotics for helping reduce the inflammation and infections should help further. A Dedicated team of rehabilitation needs to be approached for further management. If the team performs uniformly than your problem can be resolved.In my  practical experience the approach is made uniformly with the help of the team members and coordination. Most patients responds well and healing is expected sooner.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason of \"cloudy\" lung on chest X-ray?\n\nHi. About a month and a half ago my mother - in - law had a defibrillator put in. During the surgery, the corkscrew anchor perforated her heart wall. She had the surgery because she has a weak heart (pumps out to the body at about a 30 now). She had fluid in the sac of her heart and severe pain. The fluid was treated with medicine and she was sent home. Approximately a week later she had severe pain again, had to go back in to have the lead moved because it pushed through the wall. She also had almost a liter of blood drained from around her heart. She went home after 5 days in the ICU and slowly felt better, but another week went by and she was having pain again. She went to the doctors and has inflammation of the left atrium and some fluid. They changed her medicine, but she has been in pain again. This time they took her off the water medicine and have her on prednisone. They also did a chest x-ray which showed the bottom of her left lung as being \"cloudy\" Her doctor isn't sure why. My mother in law was a very high energy woman who had no symptoms of any problems before going for a routine EKG during a physical - she is 69 years old and lately she has barely had the energy to be out of bed for more than a couple of hours. You can physically see the change in her when all of the energy drains from her body and it happens very very quickly. Could you help explain why, when her surgeon says she shouldn't be feeling this way that she is, and what a \"cloudy\" xray could be? Her surgeon said that if she isnt better in 2 weeks, he is going to recommend her to a different heart specialist because he is at a loss to explain why she isnt getting better.Thank you.",
    "doctor_response": "thank you writing me, if you dont mind can i say something.... listen first if u can send me picture of xray then send me i will surely tell you that your mother in law has anythng in lungs or not. other thing that cloudy usually means whitish shadow in xray, it has a number of cause, rule out two things cancer and tuberculosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and redness in the testicles?\n\nyes my left testicle started to hurt also it gets red and swollen it feels like a mass on upper left of the sack now pain has moved into both feels better in morning I walk a lot for work pain goes to my groin area and lower stomach. when I sit or lay down pain starts to go away. I have been on cipro for a 4 days but no relief yet what do u think",
    "doctor_response": "HelloYou need proper clinical examination and routine investigations.Investigations include routine hemogram,random blood sugar,ultrasound and colour doppler of scrotum,urine RE/ME.Your symptoms may be due to many causes like epididymo-orchitis etc.Ultrasound of scrotum is important due to swollen feeling of testis associated with redness.It can assess many conditions in testis.Proper treatment depend upon findings.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a brown splotchy spot on the penis?\n\nHi i am a 15 year old boy with a brown splotchy ring around my upper foreskin i am uncircumcised and i also have a brown splotchy spot on my penis head about 1cm-1cm.I have had discolouration since december 2009 i think, and have gained more discolouration since but has seemed to have stopped.Could this be masturbation related and i must add that the discouration is not raised or bumpy at all its just normal skin with a brown discolouration it is just a splotchy brown ring.I have no discharge or any problem urinating or having erections.Is this a type of cancer or disease please help i am very worried.",
    "doctor_response": "Hi,Do not worry..it is not cancer. It is just the nonspecific discolouration and has no importance. It is not related with masturbation. Still, you consult the dermatologist for the perfect diagnosis and proper treatment.Hope I have answered your query. Let me know if I can assist you further. Regards.Dr.Ilyas Patel MDDermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it common to have abdominal pain after hydrocelectony surgery?\n\nMy husband had hydrocelectony surgery 11 days ago. Naturally he has some pain, but complains that it hurts more like a abdominal pain and diareha.  Is this common?  I know nothing is free, but it should be noted obviously on the first page. I can consult his doc tomorrow. Thank you",
    "doctor_response": "Hi...he is having those due to the antibiotics... ask him to take a ppi for a few weeks and preprobiotics...he will be fine...Dr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bronchitis\n\nHello.I have a bad case of coughing bronchitis. Had chest stray yesterday and was clear. My dr proscribed zpak and gaufenicin ac. I can not sleep after the cough syrup wears off as I am coughing so much.The label says to take at bedtime but doesn t say when I can take it again?Every fours hours etc?",
    "doctor_response": "You should start tablet azithromycin 500 mg for 5 days along with a codeine/dextromethorphan syrup 3 times daily.Sometimes bronchitis are resistant to normal cough and cold treatment band may require a use of inhalers.In that case you need to start inhalers like seroflo/advairSteam inhalations three times daily will help let know if things get better",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and tightening in head?\n\ni have an intermittent strange sort of dizzines tightening in my head that I feel like I am going to fall/faint, but don't i cant really describe the symptoms I never feel like I am going to black out its quite odd, I want to move when it happens, moving can make it worse",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern, the given history is suggestive of \"Vertigo\" and the most likely cause of this condition is low blood supply to the ear drum and that causes \"Labyrinthitis\" and the best option as long as the treatment is concern is \"Betahistine\" this tab three times in day gives excellent result, if this fails to responds then further investigation is advisable, take care and have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach pain in kid\n\nhello sir my son s age was 2.8 yrs.his weight was 15kg he does not eat anything from 2 days atleast milk also. and he said some stomach pain is there. isthis good for health ? everday taking milk thrice without adding any water. plz give me suggestion",
    "doctor_response": "Hi.. he is actually over weight slightly. Too much of milk will cause constipation. This stomach pain could be related to a worm infestation. Unless there is green colored vomiting or blood in stools or loose stools or severe constipation for 5-7 days, you need not worry. Get him checked with a pediatrician.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes light headedness and tingling in limbs?\n\nI am a 48 year old female,in very good health ,good fitness level..BP and heart have been checked and are normal, ENT fine, not suffering from anaemia or diabetes(all bloods came back normal) but for over a month have been experiencing intermittent light headedness combined with heavy and sometimes tingling limbs",
    "doctor_response": "You may be experiencing either alterations in blood pressure control referred to as ORTHOSTATIC HYPOTENSION or you may be suffering from the earliest stages of nutritional/metabolic deficiencies such as Vitamin B12, folate, Vitamin D, or Magnesium.  I would get all of these looked at through specific blood tests before embarking upon treatment because you don't want to be wasting time and money treating things that are not a problem, make sense?  You could also be suffering from a mild urinary tract infection which may seem almost absurd for the symptoms but one thing I've learned long ago as a doctor....and that is....there is always a reason why the MEDICAL TV programs always talk about getting urine tests on everyone......and that's because you'd be absolutely floored by the variety of conditions, symptoms, and sensations people can very quickly get rid of once they treat a mild urinary tract infection that they never suspected they had if not for their doctor just following the same recipe guide as the guys Grays Anatomy do!  LOL!!     Those are my opinions based upon your limited history.  Please rate this a 5 STAR ENCOUNTER and write to me at: www.bit.ly/drdariushsaghafi for more questions or to laugh back at my absolutely knee slapping HAHA!   Cheers!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having milky discharge from my penis all the time?\n\nWhat other problems could I possibly have if I have milky discharge from my penis all the time sometimes heavy sometimes light, also burning at the very end of urination when last of urine is coming out, but have been screened for all STD's and all came back negative?",
    "doctor_response": "DearWe understand your concernsI went through your details. If all the tests about STDs came negative, the answer to this question is simple. That milky discharge, in all possibility, is your semen itself. I would like to know, do you masturbate? or indulge in sex regularly? Your body produces semen whenever you are sexually aroused and it is stored inside your body If you do not indulge in masturbation or sex, your body finds its own way to throw the stored semen, because it is a waste product by then. Usually body throws it through urine or through nocturnal emissions. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain in the middle of the stomach?\n\nRight in middle of stomach , where my ribs are, I have a sharp. Pain so sharp that I break out in a sweat. It starts as an ache and then radiates to my whole stomach area. It might last 5-10 minutes. When this pain happens I can\u2019t touch my stomach it is so painful My email YYYY@YYYY",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Do you have spicy food? It can be an ulcer. Have Pan D tablet half an hour before food 3 times a day. Take for 5 days . If it is not reducing then you can show a physician and do an endoscopy to find whether there is any other reason. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pneumothorax along with shoulder pain be treated?\n\nMy 24 year old daughter suffered a spontaneous pneumothorax, at the last CT Scan her lung is still 10% collapsed.  She is still having pain in her shoulder and it runs down through her arm and hand.  We saw a surgeon and he did not suggest surgery as he said is was residual not recurring.  I am happy for no surgery but where do I go to get her the help for the pain and to help the lung heal.  This happen on May 2 and it is June 11.  She did have two different tubes inserted to inflate the lung, the first one was not big enough so they inserted the bigger one and put her on a box to pump in the air.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As per my clinical experience, the shoulder pain is referred pain from  phrenic nerve irritation. You will surely recover from pneumothorax completely without issues. Wish her fine recovery. Take care. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes soft raised bumps on each side of nose?\n\nI have had really bad sinus pressure and constant headaches for two days now, ears are popping, nose is stuffed up.  I noticed that i have two raised bumps on each side of my nose at the top by my eyes. I have never had this happen before and i'm concerned as to what it is. the bumps due not hurt, and seem to be soft. Any idea what this is?",
    "doctor_response": "Hello madam/sir, welcome to medical care magic.You have severe sinusitis. Please get one head and neck xray to confirm. Show the xray to ENT specialist . You should be treated with antibiotics to reduce the infection and steam inhalation 3-4 times a day if it is sinusitis.With this I hope I cleared your doubts. Any further doubts you are always welcome. Take care. Good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for UTI infection\n\nMy father is 85 years old. 3 years ago a vertabra fractured due to metastasized prostate cancer ( good news, though, on that - his PSA level has been normal since undergoing hormone shots every six months). Although he can move his lower body he can no longer bear weight has been wheelchair bound and has had an indwelling Foley catheter since the cancer was discovered. He is now, of course, experiencing chronic UTI's and his creatinine level has risen dramatically with the last course of antibiotics (he is developing some resistance to antibiotic treatment). What might be the next steps to control the UTI's without putting his kidneys at elevated risk?",
    "doctor_response": "Good Day and thank you for being with Healthcare Magic!Chronic catheterization is always a major risk factor for a UTI. It would be better to remove the catheter and start clean intermittent catheterization (CIC). This would decrease the risk for  infection. Also there is a BIG difference between bacterial colonization and bacterial infection (UTI). Colonization means that bacteria is in the bladder, catheter and urine bag but does not cause infection and does not warrant treatment while UTI would cause symptoms of urination like suprapubic pain, fever etc. If we always treat the bacteria in colonization then we end up developing multidrug resistant organisms and when the time comes where infection is present we do not have any antibiotics to use anymore. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at:   I would gladly help you.  Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a free transplant of kidney possible?\n\nOne of our neighbour has been diagnosed and found that both his kidney  have failed and his health is deteriorating day by day.  As financially they not very strong and hence want to knwo what can be done for him.  Can a free transplat possible to save his life.  Please suggest urgently so I can convey the message to his family. With best regards, Sanjay",
    "doctor_response": "Hi,Thanks for choosing HCM. You need to register for a cadaver transplantation in jeevandhan and also if their family member are willing to give kidney then under esi if they have they can definitely have a free transplantation done.Thanks,Dr.Alekhya",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is doxinate safe for nausea?\n\nHi I am 8 weeks pregnant and have been having a lot of nausea. I am also working, hence my doctor has advised me to take doxinate 10 mg, twice daily for atleast 15 days as of now. Is it safe to take this medication for this long or even later. Thanks RN",
    "doctor_response": "Hi.Yes, it is safe to treat nausea during pregnancy. Doxinate is commonly prescribed to treat nausea and vomiting associated with early pregnancy. It is considered to be safe during pregnancy. However, if your symptoms persist your doctor would prescribe other anti-emetic drugs along with treatment for dehydration.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am a 19 year old female. Have watery heavy white foul vaginal discharge every day since 4 months.\n\nHi doctor, I am a 19 year old female. I have watery heavy white foul vaginal discharge every day since four months. Is it due to hormonal imbalance?",
    "doctor_response": "Hi. From what you have described, it looks like you have a bad vaginal infection. You need to see a gynecologist doctor fairly quickly and get treated. This is important as untreated vaginal infections can spread upwards into the uterus. Hormonal imbalance has nothing to do with this. Your doctor will also check your sugar level if you are overweight, if you have PCOS, or have a family history of diabetes. You will also need a testing for urine infection as it is common for both to co-exist. Take care, hope this helps. Do not hesitate to post further queries to an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure dizziness, unbalanced standing pain, pressure in cheek, eye socket, temples ?\n\ndizziness unbalanced standing pain pressure cheek eye socket temples was treated 1 week ago ER for tremors/hypomagnesemia heart racing pounding i was diagnosed with thyroid cancer 6 yrs. ago had thyroidectomy levels are ok but have been elevated few times past years with adjustment to dosage im taking 1000mg. magnesium daynow it was 500mg past 6 mos. I am on BP medication also losartan 50mg/bisoprolol-hctz 10-6.25 I want to feel better ,and im still not? Feel scared",
    "doctor_response": "Hi welcome to hcm,I understand your query and concern.You symptoms could be related to uncontrolled hypertension.I advise you to monitor your blood pressure and consult cardiologist.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood blister on lower lip of a baby?\n\nHi my 9 week old baby girl as a blood blister on her lower lip in the centre, she as had it for about 7/8 weeks. I guess its from being bottle fed, she as the Avent bottles although i have bought a couple of Nuk bottles because the teats are much softer than the Avent, not sure what else it can be caused from or how to make it go away it just looks red and angry, my daughter does not seem bothered by it being there but it just don t look nice. Thanks Tammy",
    "doctor_response": "Hi Dear ,Welcome to HCM.Understanding your concern. As per your query your baby have symptoms of blood blister on lower lip which seems to be due to poor immunity of body leading to viral infection such as canker sore. Need not to worry.  I would suggest you to avoid hot, sharp and spicy food. In case of herpes use antiviral oral and topical therapy like acyclovir are helpful. Drink plenty of water. Suck on ice pops. Drinking plenty of water and cold liquids. Maintain oral hygiene. Consult dermatologist if symptoms keeps on persisting and get complete examination done and start treatment accordingly. Don't let that area dry and keep applying aloe vera gel or petroleum jelly on frequent basis as dry skin. Hope your concern has been resolved. Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach ache after taking food, swollen arse hole, fluid leaking from rectum, on anusol suppositories\n\nI m john.i usually feel pains in my tummy after food and this has lasted for over 2 years now. But more recently,i noticed that there s a swelling in my arse hole and an almost sticky fluid leaks out of my rectum occassionally and whenever i fart .i have been placed on anusol suppositories and a sitz bath recommended but the irritation and leaky rectum remains. what do i do?",
    "doctor_response": "Hello & welcome to HCM forum 1) As per history, you are suffering from Irritable Bowel Syndrome. IBS is a functional bowel disorder and it should be diagnosed after all relevant investigations 2) Pain after eating indicates cholecystitis, pancreatitis & peptic ulcer disease. 3) You should go for serum amylase, UGI endoscopy, and ultrasound scan of upper abdomen. 4) You should also consult with physician or gastroenterologist for better opinion 5) Symptoms mentioned by you are also associated with some sort of depression/ anxiety, you can also perform meditation and medical therapy for total relief of your symptoms Take care & get well soon Dr. Mayank Bhargava",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful and tingling in legs while on medication for strep?\n\nI just started antibiotic for strep today and I have had it for 5 days. I have run a fever constantly during that time. I just woke up and went to get more water, became extremely nauseous and went to lie down on tile. When I did, my body and arms began a very painful tingling, I couldn t move them. It felt like they were so swollen I could barely bend my fingers and my appendages were so very heavy. It also began to move into my legs and got as far as my knees. My husband put cool rags all over me. It lasted for about 3-4 minutes. Maybe longer. Now all my joints hurt.",
    "doctor_response": "HiThis means you are either intolerant or have adverse effects of the medication.It should be stopped if your treating doctor agrees..if I was your treating physician I would advise stopping all medications, review with some blood tests, CBC, ESR, allergen tests, and switching over to other medicationsSeek another opinionThanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have CLL. Prescribed fenofibrate 140 mg for hypertriglyceridemia. Prefered generic gemifibrozil 600mg. On blood plasma treatments. Suggest\n\nI have CLL and my general physician has prescribed fenofibrate for hypertriglyceridemia - however, it isn't covered under drug plan - they say gemifibrozil is the preferred generic for this but they are is 600 mg. and fenofibrate is only 140mg.  Not sure what to do about asking Dr. about the preferred.  Also, I have been taking blood plasma treatments for my CLL, could this cause the hypertriglyceridemia?",
    "doctor_response": "Hi, The doses are misleading, for one drug the dose of 5 mg may be more, and for another 50 mg may be low dose. So don't worry about the drugs and dosages.                            Usually no drugs will increase the hyper triglyserides. So need not worry about this also. Simply follow the doctors advises and be happy.                             Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dry masturbation?\n\nI used to maturbate with two types ! one is when  penis is erect i shake it up and down for atleast 5 to 8 minutes but i m not able to ejaculate sperm ??And other way of masturbate is when my penis not erected but i ejaculate within 2 minutes easily ? is this cause any problem ?",
    "doctor_response": "Hello, Yes. There is a problem. Masturbation and ejaculation without erection can cause problems in married life. You need to treat and cure it.  Therefore, I suggest consulting a urologist for physical examination, diagnosis and treatment. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Developed some rash in bottom & genital area. what could be done?\n\nHi , I have a baby boy who is going to turn 8 months this 28 april. He has developed some rash around his bottom & genital area. His paed advised that he is having a tummy infection and has given the below medicines.  1) colicaid  2) furoxene  3) Siloderm (ointment) to be applied  we have been following this for the last 48 hours, but unfortunately the rash doesnt seem to reduce. baby passes motions 4-5 times a day (semi-soft, greenish yellow) he is breast fed as well as has rice, malt, cerelac.  Please can you help us to understand what else needs to be done for the rash to be cured ? Many many thanks...    anxious parents",
    "doctor_response": "BREAST FEED IS NECESSARY FOR CHILD FO  YEARS I THINK HE IS NOT TOLERATING THE EXTRA SUSTANCES YOU HAVE ADDED IN THE DIET IT MAY BE RICE OR MALT SEE AFTER WITHDRAWING THE ADDED SUBSTANCES AND SEE AFTER THE WITHDRAWL IT WILL TAKE  FEW DAYS TO COME TO NORMAL WITH THESE MEDICINES YOU ARE GIVING THESE ARE SAFE MEDICINES",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could diarrhea and vomiting be related to accident?\n\nmy 19 year old son was in a car accident, he was check out at the ER, although he was most in a clench position with his body tensed up when his car was hit, it is now two days later and he has diarrhea and is vomiting.  He doesn't appear to have a fever or miserable like from the flu.  Can this be accident related and what should I do.",
    "doctor_response": "Hi,Many a times patient with impact on head presents with vomiting,but diarrhea along with vomiting is unlikely to be related to accident,But for assurance,I recommend you to take an surgeons opinion on it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I continue to use Etofree pain killer tablet 15 days after piles operation?\n\ngud eving sir, i hv used etofree pain killer tablet for last 15 days . because i undergo fissur and piles operation. can i continue the tablet are stopp the tablet pls advise meand also one more doubt surgery was held in 28 sep 2012 but till now i am having pain and bleeding wt can i do sir pls tell me",
    "doctor_response": "Using pain killers can cause many side effects 8n the long run tat after 18 , months post procedure.u can go for stoolsofteners, laxatives, local anaesthetic gels, high fibre diet for easy passage of stools",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, diabetic. Pinching pain in lower abdomen, frequent urination, thirsty, nausea. What to do ?\n\nHello doctor, I am married and its 3 years now. I am trying to conceive. Am diabetic. My ovulation period comes 19th of every month. and Had intercourse on 31st, 1st and 2nd of this month. TOday through out the day i had pinching pain in lower abdomen in the left side. Frequent urination, and feeling damn hungry, thirsty and nausea feeling ..though its there since 15 days. Kindly advise me what needs to be done. Regards, xyz",
    "doctor_response": "Hello,If you are ovulating on 19th,then your most fertile days for pregnancy are from 15 th to 21st.So doing intercourse on 31st,1st and 2nd is going to be non productive and moreover these days should co incide with your normal periods days.Your other symptoms of nausea,increased urination,thirst hunger seems to be due to uncontrolled diabetes.Control your diabetes meticulously and do the sex in your fertile period to have the best chances of pregnancy.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Worrisome nature, lately have heart palpitations, nervous tummy, runny bowels, temporary relief with anti-anxiety tablets. Suggestion?\n\nHi am worried bout my daughter she is 32..married with 2beautiful girls..and a good husband...but she worries about everything..lately she s been aving heart palpatations.pulsing head..funny nervous tummy and running to open bowels.in thatorder.doc gae her soe anxaity tablets. And she is to take half to start with..and she felt great for a month..now its all back again...",
    "doctor_response": "Hi, fannasroom, Thanks for query. It seems that she is having Anxiety Neurosis giving these problems. Consult psychiatrist and get her examined and start the treatment. Continue the medicine for long time and have follow up with psychiatrist regularly. If require psychiatrist may go for counseling. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it required to give packet milk for 4 months old?\n\nHello Dr, I have a 4 month old baby girl. I am feeding her with breast milk and home-made ragi porridge. Ragi porridge is given thrice a day (Morning by 9, Afternoon by 1 and Night by 7). Is it required to give packet milk for her? I should go to office from next week and she keeps crying if I am not with her. My in-laws or mother can t manage her once she starts crying? I can only come during my lunch to home for feeding her and it s difficult to come before 6 clock in the evening, Please suggest what should be done if she keeps crying.",
    "doctor_response": "hi,baby cries for lot of reason.hunger,loneliness or boredom.start her on formula feeds.dont give packet milk as it can cause allergy and it would be too heavy to digest.you can use breast pump to express milk and store it .it can be stored over 24 hours.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hypertension with diabetes?\n\nHi, I am 41 and have been diagnosed with hypertension.  My blood pressure was 198/116 on Friday and today it was 169/98, which is obviously still too high.  When I was first diagnosed about a year ago my blood pressure was 215/110, they conducted all the tests then, due to the fact I am also a type 2 diabetic.  Can you assist me with what may be causing the problem?",
    "doctor_response": "Brief Answer:You should see an internist.Detailed Answer:Hello,Thank you for using HCM. I understand your concern. Your age is too young and your blood pressure levels are to high , to have an essential (primary) hypertension.You should be screened for all the secondary possible causes of hypertension such as renal stenosis , renal parenchymal disease , Cushing syndrome , Pheocromocitoma, Hyperaldosteronism, Hyperthyroidism, Sleep apnea, Acromegaly, Coartation of aorta.For excluding each of them , you need to do a series of laboratory and imaging exams .The internist is the adequate doctor which may lead you in detecting the causing factor of your hypertension.I seems a little bit long way to do , but i encourage you to go under it , cause treating the causing factor once is better than treating hypertension for all of your life.There are even cases in which eventhough you do all tests for secondary causes , it doesn't get out nothing. At this case we are in front of an idiopathic hypertension , which we have to deal with. Hope this is helpful.Let me know if you need more clarifications. Otherwise please close and rate the answer.Kind Regards, Dr. Juarda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Which one is the better eye surgery option- LASIK or SMILE?\n\nHi doctor, I want to go for a corrective surgery and am confused between Contoura and SMILE. I request you to please give your opinion on the following doubts of mine. People say that all LASIK surgeries involve greater cornea related risks which SMILE does not. Your view on this? While for SMILE people say that actual corneal depth removed is more and even the appearance objects after SMILE is very artificial and is not as sharp or 3D like in Contura. Your view on this? Also, is there any clause like if one is not able to focus eyes on point or concentrate (which is totally in hand of the patient in SMILE) then he should not opt for SMILE as there is a risk of hurting eye. Is that true? Also, irrespective of which one we do, are these surgeries always accompanied by halos, glares and night vision problems? Finally, I am getting married in two months and I would be required to indulge myself in all the dance rehearsals, makeup, market traveling, etc. What do you think, is it the right time to go for a surgery? And which one (that is less risky and recovers faster)?",
    "doctor_response": "Hello. 1. If LASIK has greater corneal risk than a SMILE? This is true. LASIK does have a greater risk of flap-related complications. In SMILE, as there is no flap created, there are no complications associated with it. 2. Corneal depth in LASIK vs SMILE. The depth in LASIK is dependent on your refractive error. The more your refractive error, the more will the tissue abated. In SMILE, the thickness of the lenticular is preset by the surgeon and does not depend on the refractive error. In both procedures, the surgeon can also take measures to conserve thickness. So the answer is that it depends on the surgeon and your refractive error. 3. The sharpness of images Contoura vs SMILE. There are various studies done on this and a majority say that SMILE offers better results in most laboratory tests, but under practical and daily life situations, it can be assumed that both are pretty much the same. 4. Can hurt your eye in SMILE if you do not concentrate on a point? I am not very sure about the exact context of the question. I can tell you that in both surgeries you will be asked to look at a pointer light and the accuracy of your correction will depend on how well you maintain a fixed gaze on the pointer. If you look any other way for even a fraction of a second the outcome will be bad in both of the procedures. 5. Glare halos and night vision problems. These will be present soon after surgery in both, but will slowly resolve. Not a major problem in a majority of the patients. 6. Right time for surgery, which surgery is less risky and has a faster recovery? Right time for surgery would be around three months from your wedding, although some do get SMILE done just one day before their wedding. Anytime before 1 to 2 months, you will be in the recovery phase and will have to be instilling eyedrops- a bothersome task when piled along with shopping and organizing tasks before the event. 7. Less risky and has faster recovery- SMILE (small incision lenticule extraction).",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the causes for sticky fluid oozing from skin, eyes and neck after removal of bowel due to cancer?\n\nMy mother is 77yo. She had most of her bowel removed 4 months ago due to cancer. At the time she was diagnosed as stage 4, as it had spread to her lungs and liver. The latter is now quite enlarged and she experiences severe intermittent pain. Recently a clear sticky fluid has begun weeping from her skin, around the eyes and neck, with a significant amount now coming from the lower legs. This morning there was also blood trickling from her calf, her feet have become a very dark shade of purple. I have called the palliative care people, who dismiss it as \"the progression of the disease\". What causes this? Can it be treated? is it a sign she is nearing the end of her life?",
    "doctor_response": "Hi Thanks for your query. It appears that she is at the terminal stage of her disease. This current problem may be due to low protein in blood or compromised skin integrity or a coagulation abnormality. I am afraid there is no specific treatment for this and the doctors who have evaluated her are the best persons to suggest if there is any. Hope this helps. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the tooth after old filling fallen out?\n\nhi I had an old filling fall out and my dentist removed remaining filling in preparation for  root canal. He went on holiday and now I am on vacation and noticed that the empty crater is now being filled with flesh growing from the inside of the tooth.  what is going on? it hurts now too...",
    "doctor_response": "Hello thanx for consulting at hcm.the growth inside the cavity is pulp polyp.it definitely requires root canal treatment.. Meantime take a course of antibiotics amd analgesics if you have severe pain and earlier if you have not taken..do salt water gargle thrice daily.do not meddle with it.hope it helps.tc",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be done for bipolar,mania,depression and sleep disorder so that they don t worsen further?\n\nLexapro, lamatical, wellbutrion, I have been taking medication for over 20 years. Added every so often, Xanax. Unable to speak clearly, can not think clearly. I have been diagnosed bipolar, depression, manic, sleep, ambient as needed. I would like someone evaluate my brain. SO this effect does not became worst.",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.Well you are already on plenty of drugs. The only reason I see, why you are not improving is:1) Lexapro is an SSRI and will cause switch in a case of depression. This is undesirable in a case of bipolar mood disorder.2) There is only one mood stabilizer. That can be augmented with valproate. Valproate is one of the first line mood stabilizer and would be effective in your case. 3) Also there is an option of cognitive behavioural therapy (CBT). This therapy is taken by either a psychologist or a psychiatrist in which the therapist identifies impaired cognitions (Thoughts) and try to correct them. They are 15-20 min weekly session and there should be around 8-10 sessions to help you with your illness.MRI scan and other investigations of your brain will not reveal much if its a psychiatric illness. They will definitely not be very useful. 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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fibromyalgia\n\nI had fibromyalgia and am in a fibro flare where I couldn't sleep at all for 6 nights in a row. This causes extreme pain in my body beyond the usual. Also I felt like my brain was burning... I couldn't eat and have an extreme taste of metal in my mouth and my sense of smell is very heightened. Everything smells and tastes horrible and makes me nauseous!",
    "doctor_response": "hi,thank-you for providing the brief history of you.A thorough neuromuscular assessment is advised.As you have fibromyalgia, the pain can be understood to give abnormal sensations. Like , fibro-myal-gia is a condition where there is inflammation in the muscle fibers and that is leading to pain. As muscle contains numerous muscle fibers of which it is composed of, any abnormality happens there leads to pain and aches.Also, as you have sensory issues I suspect it to be a cervical disc degenerative changes due to which there is pain, weakness. change of taste etc.In my clinical practice such cases are referred to physical therapy . As with therapeutic ultrasound therapy and TENS therapy the pain can be controlled. Also with neck strengthening exercises and general body exercises the muscles can be strengthened.Performing meditation and breathing exercises helps to control the anxiety and improve the oxygen carrying blood cells which avoids the fatigue and the initiation of pain.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for severe cold and cough in a 2 months old?\n\nhi doc my son Ansh Nagare age 2.5 months old Weight 15.5 Kg Height Approx 3 Feets is having Cold & Cough since last 10 days for which i have given him Ziprax DT 100 (Cefixime) as an Antibiotic, Haldi cough syrup and duolin Respsules for nebuliation but stll found no improvements please help",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.Cough and cold are viral 95% of the times in children. For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15mg/kg/dose (max ceiling dose 500mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.For cold you can use Cetrizine at 0.25mg/kg/dose every 12 hourly for 3 days.For nasal block, plain saline nasal drops will do, every 4-6th hourly to relive nasal congestion.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a knot at the base of the neck along with pain?\n\nMy 3 year old has been complaining of neck pain. Last night she tried to look up at an airplane and winched in pain and held her neck. It s appears to only be the right side. We felt a small lump or knot at the base of her neck on the right side. Could it just be a muscle knot like adults get?",
    "doctor_response": "Hi,Welcome to Hcm,It seems like your child has torticollis that means muscle spasm of the neck which causes such severe pain. The knot feel can be muscle or even a lymph node which is very common in this age group. I would advice you to ask her to rest her neck and not to twist and turn a lot. Hot compresses Can be applied over the painful site. If too much severe pain , a pain killer cream would help immensely. Hope she gets well soon. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should I take to make me relax while learning things?\n\nI have had a learning disability ever since I was a toddler. I also believe, I have ADD. I am a very mellow (very low blood pressure) person. I do stress out a lot when I struggle to learn. But I keep it private. I do not want to go through a battery of tests. I would like to take a drug to help me to relax. I do not have any addictions. I do suffer from severe insomnia. Any suggestions for me? I am currently not taking any meds. I am a 55 yr. old female. I would like to be able to have better focus on what I am doing or learning as I mature. Thanks for any advice.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. First of all the symptoms you mentioned here does not warrant any medicines. All these conditions are just normal and positive thinking and right thinking can clear you off. Secondly, even if you want medicines, that has to be decided by a psychiatrist. You need to go to a psychiatrist personally so that he can assess your symptoms and correctly diagnose and provide medicines.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How do I stop flatulence, poor hair growth and acne?\n\nHello doctor,How do I stop flatulence, poor hair growth (baldness) and acne (black spots) in my system entirely?",
    "doctor_response": "Hello. Your all three complaints are different. I will give my opinion one by one.  Consult a physician for examination with keeping all these in mind.  For more information consult a family physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from kidney stone. Is potklor syrup helpful to cure from it ?\n\ndear doctor i am from doha qatar and am an indian when i am in india i suffers from kidney stone its two years back i got treatment now i have the same pain i went to hospital they prescribed scan and so many tests but in qatar its very expensive so i request to one of my friend to bring potklor syrup from india which i had for early treatment the problem is i am not remembering the quantity of medicine now i am having 20ml morning and night so could u give me suggestion",
    "doctor_response": "in qutar are ayurvedic medi are available if yes then it is less expensive then allopathic medi you can take varunadi kadha 2tea spoon 2time daily for some period.drink plenty of boiled water.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly tell the treatment for recurrent tinea infection.\n\nHi doctor, I appear to have a tinea infection on my hands. I previously hand one two years ago and symptoms are the same, peeling between fingers, sore and itchy skin, some scaly patches. A doctor here advised Clotrimazole cream and 150 mg of Flucanozole every week for four weeks. That initially worked well and it was clearing up. Then I have had a sudden relapse. I have been using the cream three times a day for three weeks and the tablets for two weeks. Any ideas? I am also prone to eczema by the way.",
    "doctor_response": "Hi. Is there any burning? Any other area affected? Looking forward to your response in order to help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the dull aching pain on my right side?\n\nHi i am a 44yr old female & i have a dull aching pain on my right side that seems to go from front to the back...it started when the skin on my back (just where you would put you hands on your hip) became sensitive to touch (& still is)....i also feel bloated and constipated...i've been awake with it all night...can you help please? I thought it might have been apendicitis but the pain has remained constant and not sharp!!!",
    "doctor_response": "Hello! Welcome to HCM.This seems to be urinary stone related pain.Stone in ureter causes obstruction to urine outflow & smooth muscles in ureter contract excessively to overcome this obstruction and cause pain.In my clinic, many such patients do come to whom I advise ultrasound abdomen & pelvis, X-ray KUB, urine routine, CBC, renal function tests.For temporary pain relief, I prescribe smooth muscle relaxants like drotaverine, pain killers like diclofenac, and tamsulosin.Definitive treatment is done according to the diagnosis.Also it is advisable to drink 2-2.5 litres of water in 24 hrs.Hope this helps.Wish you a good health.Thanks.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get pregnant after ectopic pregnancy?\n\nGoodafternoon, I am Santosh Bhagwanani from ahmedabad,now my problem is related to my wife Nidhi Bhagwanani as she had concieved pregnancy on 15/5/08 but by diagnosing for a routine check-up to a gyanecologist she replied that my wife had a bit of operated urgently due to ectopic pregnancy and she had operated on 29/5/10 while operating doctor reported that righ ovary is damagedand the infection of right ovary had drained to left ovary and it 25% damaged,and while in medication she had been given augmentin-1000mg and also pain killers. Now within in 1 year we had visited lot may gaynecs but our efforts got helpless,as by diagnosing to ou sperm and semen report it is positive and wile dignosing her ovulation report it is also normal but she has 2 fibroids on outer cavity of uterus and 1 in inner cavity but it wont affect pregnancy as told by gaynes. now she turns to 29 and i am 30,so please suggest what to do as we are bit worried. Please mail me on santosh_bhagwanani@rediffmail.c",
    "doctor_response": "keep a regular record on size of the fibroids. and if fibroids increase or cause any menstrual or pressure symptoms they need to be treated. practice regular intercourse. start taking folic acid tablet. if ovulation is normal chances to conceive are likely.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for infections post hip bone breakage surgery\n\nHello Doctor, I have a problem related to my father. He suffered a hip bone breakage and was admitted to Yashoda hospital in ghaziabbad for surgery. During post operative care , he developed various infections and we had to rush him to critical care in Fortis , Noida. He is still going critical . Though being , a CGHS benificiary, we are having to pay a reasonably big amount every day because Fortis has CGHS. Benefit for only CARDIAC and ortho dept. The treatment is falling heavily on his family as we are not financilly so strong. Can something be done by CGHS to help the patient. He is 90 years old and this is the most crucial moment in his life as well as his family",
    "doctor_response": "HII have evaluated your query thoroughly it seems like your father is in  post operative septicaemia .better you shift him in general hospital. because he has in critical condition. required higher and costlier medicine for cure there is required more days to Indore.  age is the major role for cure hope you have solved your query thanks for trusting health care magic regards bye take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain after total knee replacement\n\nHello I am going back to my Dr. Tuesday that I would like to find something to help my pain I just had a total knee replacement on the fourth when I was at the hospital I was allergic to everything they give me Names of all the drugs tramadl-Percocet-Alvaniy not sure if I m spelling that right , and also Dynamic, Advaned and also very allergic to a injection Dilaudid Thanks",
    "doctor_response": "hi,thank-you for providing the brief history of you.A thorough musculoskeletal assessment is advisedAs post TKR you are having pain this is common and it takes some time for the muscle to regain the flexibility. once the flexibility is attained the knee regains the mobility and the pain subsidesAlso, the Strengthening of the muscles around the knee is needed to avoid any muscle pressure pain.In my clinical practice we do find patients post TKR complains of pain. We look forward for a complete clinical assessment and recommend physical therapy. They respond well.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for conjunctivitis in infant\n\n3 month old infant who has been suffering from conjunctivitis since leaving hospital after birth. Has been treated with two sets of antibiotics that did not work. Finally had a culture done and as a result we know that he is infected with bacteria known as klebsiella oxytoca. New antibiotic has been prescribed for this bacteria. Is there any chance this bacteria could spread anywhere else in his body?",
    "doctor_response": "GOOD QUESTION,YOU NEED NOT WORRY ABOUT SPREAD AS THESE INFECTION ARE MOSTLY CONFINED ONLY TO EYES ONLY",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for erectile dysfunction?\n\nI'm in a fairly new relationship w/ a man who tells me that 5 yrs ago he had an accident and fell into a hold and totally destroyed his testicles.  He says he now cannot get an erection.  I accept that this is permanent for him.  what I'm wondering is:  does this mean he also has no testosterone production?  And if so, does that mean when he looks at me he isn't even physically attracted to me in the normal male/female way?  He seems to not look at me as regular men do, and has no desire to even touch me.  Does he look at me and want to be able to have sex but just can't or has he lost all sense of what that even feels like if he has no testosterone?  He doesn't even want to sleep in the same bed, so we sleep in different rooms.  I'm trying to decide how I want to respond to this.  I love him a lot.  We are older--in our 50s and I realize sex isn't everything, but touching and holding is very important to me.  But, more than this, if he only can look at me as say, I'd look at some 8 yr old kid, well, I don't know if I want to be in a relationship like this.   Lots of questions.",
    "doctor_response": "Hello,I have gone through your query and here is my advice. As per your history it may be due to strain and stress. For further assessment he may require complete hemogram, lipid profile and electrocardiogram, after physician consultation. For that he may require tablet sildenafil 1 hour before the sexual act. Avoid smoking and alcohol. Avoid stress. Hope I have answered your query, let me know if I can assist you further. Regards, Dr Shyam Kale, Family and General Physician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffered a pin stroke, no warning signs, was quiet, cant remember long drive. Fully recovered?\n\nI suffered a pin stroke on 9/22.  I was at a restaurant with my 2 oldest grandchildren (who were riding )with me.  My youngest son and his wife children were there.  I had no warning signs, but my son , daughter-in law did notice how quiet I was. I can't remember driving home 21 miles.  My grandchildren told me later everything I did.  One question is how can I tell if I'm fully recovered",
    "doctor_response": "Hi and thank you so much for this query.I am so sorry to hear about this pin stroke. I hope by pin stroke you meant transient ischemic attack which is stroke that the client fully recovers from within 24hours.The best way to tell whether you have fully recovered is if you have no problem. If your have no worrisome symptoms right now, then it means you fully recovered.The most important thing to do right now is to get consulted. A patient who has suffered a minor stroke would most likely have another in the near future if not well investigated. You would need to get consulted and investigated for the various risk factors of stroke which include blood disorders, heart and vascular problems, infections, cholesterol problems,etc. This would help identify the risk factors, address them and reduce your chances of having another stroke which may even be more concerning than the first.I hope this addresses your query fully and provides ample information for you to act on. Thanks for using our services and feel free to ask us more questions if need be. I wish you well.Dr. Ditah, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from Parkinson. Taking sinemon, difficulty in walking. Side effect of medicine?\n\nHI.. thank you.. my father is 78 and recently diagnosed with parkinsons.. and is treated with sinemon.. not sure on the spelling..sorry.. its been only a few weeks and he seems better mentally but now cannot walk or stand ..i am so worried.. is this a side effect or do u think he is just weak from being in the hospital for 3 weeks..",
    "doctor_response": "THIS TYPE OF WALKING IS CALLED PARKINSON'S GAIT.IT OCCURS IN PARKINSON'S DISEASE.DO GO FOR PHYSIOTHERAPY AS EARLY AS POSSIBLE.IT CAN IMPROVE HER CONDITION BETTER.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a risk of toxoplasmosis after being scratched and bled by a cat?\n\ni was scratched by a not so healthy looking cat this morning and it drew blood.  I am 5 months pregnant.  i cleaned the wound immediately and put on disinfectant...is there a large risk of toxoplasmosis?  also, i have to bike on a pretty bumpy road to get to town, is this safe?",
    "doctor_response": "HI, thanks for using healthcare magicIt is understandable to be concerned but toxoplasmosis would be spread by contact with cat feces (stool).Because this is the normal way of transmission then your chance is very very low.In terms of the bike riding on a rough rode, if this can be limited or eliminated then this would be best.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Thoracotomy and spinal fusion from T3 to sacrum done. Any treatment for weakness?\n\n7mths ago I had a thoracotomy followed by a spinal fusion from T3 to sacrum . It has left my left hip/leg quite weak. Currently I have a lift in my right shoe and use a stick for going out. Will this weakness gradually improve with exercise? Secondly the thoracotomy caused my liver to drop, is there any treatment for this? I am a 65 yr old female.",
    "doctor_response": "Hi,Thank you for posting your query.You would gradually improve with physiotherapy and exercises.You can do the exercises under the guidance of a trained physiotherapist.Regarding the dropped liver, you may discuss this with your surgeon.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to diagnose depression?\n\nWhat if your a 4 year student of psychology, and know DSM guidelines for diagnosing mental health issues and your going through a nasty divorce. While going through the divorce you go to a doctor you've never seen, and that doctor walks in without doing any testing or questionnaire, diagnoses you as being depressed.Also I've never been diagnosed with any kind of mental health in the past",
    "doctor_response": "There are some signals that indicates some mental health issues. For exemple, body language. So, the doctor can use this to help him to diagnose someone, but he needs a lot of more information to conclude it. Just observing the person is not sufficient. In this case, it's better to consult another doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have shoulder pain, tightness in chest and bloating after having kidney stones passed?\n\nI had kidney stones that passed monday. Now I am experiencing tightness in my chest, shoulder pain and bloating...i've been to the ER 2x they did say my kidneys are not functioning as they should, But i'm not able to get into the specialist until 5/10/12",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You have history of kidney stone. But your kidney is not functioning well so you need some treatment for kidney failure. Tightness in chest and shoulder pain can be due to heart problem so you should go for ECG once to rule out any heart problem. Also check you blood pressure. Then take treatment according to diagnosis.Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer.Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "After surgery on s1 nerve root and still have pain in left buttock and leg and foot\n\nhad surgery six weeks ago yesterday on s1 nerve root after surgery still have pain in left leg Hi had back surgery six weeks ago on s1 nerve after surgery still had pain in left buttock and leg and foot as well had a nerve block injection a week after surgery still no releif went back to nerosurgen and he said when he operatored that the nerve was very sensitive and he had to give me a muscle relaxent during the operation and he put me on nerotin 600mg per day i still had no releif so went back to see him again told him still having same syptoms so he sent me for another mri on tuesday phone his office yesterday and they said that they still had not received the results as yet i had phone call today from my doctors secrectary and she said that my doctor said that i have inflammation and that he was organising a nerve block injection and not to worry there are no other problems i am very frustrated i have 3 children to support and i need to get back to work i have no income at the moment can not sleep because constanly worried about my back please help",
    "doctor_response": "welcome to healthcaremagic hope you will be all right soon if it is simple oedema it will subside with rest and medicines nerve block will help you to cope with pain have patience and do not get depressed continue with physio therapy while getting nerve block talk to your doctor and know about the prospects",
    "dialogue_context": ""
  },
  {
    "patient_message": "Joint pain. Lump under arm pit. Suggest remedy\n\nmy husband has been having problems with his elbow for a couple of months very painful around joint and also muscle above and below elbow, often has pins and needles in his arm and hand and could not lift a pint glass of coke with extended arm last night.  I asked him to go and get it checked but he keeps saying he'll be fine.  we were talking this morning and for some reason i asked him if he'd found any lumps anywhere (not sure why i asked though) and he showed me a lump the size of a golf ball under his arm pit (same arm an painful elbow). so now i'm worried as its very difficult to get him to see gp (not alot of faith in ours)  sorry for the essay hope you can help",
    "doctor_response": "Welcome to Health care magic.1. The history suggests that there is a nerve compression which is causing the above symptoms.2.The possible cause could be some trauma / injury caused - he might have not noticed. Other possible cause infection / inflammation to the nerve.3.The lump under arm / axillary region could be enlarged lymph nodes. Enlarged lymph nodes are seen in case of any infection localised or systemic.4.The next step should be - see your GP get examined, and probably MRI elbow joint might be needed, for better evaluation of status of the nerve, tendon , joint space.5. You have to take him to GP or any doctor as symptoms seems like nerve compression - needs attention and treatment. Good luck.Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be causing muscle spams and bilateral elbow pain?\n\nHad spinal mylegram 2 weeks ago had pain and numbness for 1 yr right cervical spine degenerative disc disease bone spurs arthritis since mylegram left shoulder blade has hard thumping sensation that comes and goes and can last for hours and causes severe muscle spasms and bilateral elbow pain immediately following thumps. Can you explain this.",
    "doctor_response": "hi,Thank you for providing the brief history of you,as you mentioned you have been diagnosed with cervical spine degenerative disc disease, at what level the disc is degenerated is the first thing to know. Also, due to the disc degenerative disease the pain radiates of pain is felt with abnormal sensation like, numbness, tingling, sharp shooting pain etc based on the nerve getting pinch and its course as well, it can be arm, elbow, fingers etc.Spinal nerves carry two functions - motor and sensory. Due to the nerve pinching in the cervical spine there will be changes in the motor and sensory functions. Also you mentioned about the pain in the shoulder blade, this is a pain due to trapezitis, the release of the trapezius muscle will help further to get rid of the pain. I can surely understand this pain, as i myself had this pain in the past. Also many of my patients complain the same pain and MRI history. The simplest treatment line i advice is - posture correction and physical therapy.With therapeutic ultrasound therapy and TENS therapy the pain levels are brought down and inflammation as well. Post this, exercises to strengthen the muscles of the neck, upper back, shoulder, arm, Forearm and hand helps a maximum benefit. Till date this protocol has been 99% successful on myself and on my patients.I expect the same recovery from you.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing pain in the lower jaw & noticed a white spot on wisdom tooth\n\nWhere a wisdom tooth should be their is a white spot (soft) and my lower jaw hurts as if something is pushing on my teeth (mainly in the back of my mouth). My dentist told me that I do not have any lower wisdom teeth around a year ago. Could it be wisdom teeth or an infection?",
    "doctor_response": "Hi! read your query.Your dentist must have told there is no wisdom tooth based on the x-ray.Check if there is a decayed tooth giving you pain.A sharp tooth in the upper jaw can also be hurting the soft tissue .In that case, the sharp tooth must be rounded.Any infection in the upper jaw also can also be radiated as pain to the lower jaw frequently. wish you good health.Feel free to write any further queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "For how long should a child with chicken pox be quarantined?\n\nMy 5 year old has had chicken pox for 5/6 days now.  He has had it pretty mild (he had it as a baby too); he has had a very mild fever and he has been his 'usual happy self' throughout.  Most of the spots have now scabbed up, but he has 2 spots on his scalp with yellow heads (they do not look like they are about to burst; more like they are drying up).  Is he okay to return to school yet?  Thank you in advance for your time.",
    "doctor_response": "HiThanks for your query at HCM.I would like to tell you that the child of chicken pox remains infectious till there are scabbing present. Till scabbing is present do not send the child to school.T he AAP recommends excluding affected children from school until the sixth day of rash.Take careHope I answered your queryDr Sheetal Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does chemical imbalance cause hallucinations and making up of things?\n\nWell I was a little different when I was younger expanding on events of ones life and making things up. and then It is like I suddenly woke up. But you have to know the expanding part went on and on until I hit 45 and then suddenly it went away. I was on all kinds of allergy meds. and now I am not could the things I experienced be just a chemical inbalance caused by meds",
    "doctor_response": "HIThanks for using healthcare magicThere are few medicine that could lead to hallucinations like phenobarbitone, THC, Ketamine, LSD etc. In that case, you can try antipsychotic drugs to improve this. Better to consult a psychiatrist for proper treatment. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does pain in groin with pimple like mass in mid section indicate?\n\nI have a large pimple-like mass on my mid section. I am also having pain in my groin which causes pain when I stand or walk. I know I should go to the dr, but does it sound serious?  The mass shrinks and swells - at it's largest has been the size of a baseball.",
    "doctor_response": "Hi,This is likely to be a hernia. This is not serious but to confirm the diagnosis you would need to be examined by a doctor. Pain and swelling are the main symptoms of a hernia. I suggest a visit to your doctor. Regards,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long is dialysis required in case of diabetes?\n\nHi, my mother in law,she went to india she has diabets,high blood pressure,,,...one day she went to hospital....dr recomand dyasis..she had 4 i n hospital and now again suggested 4 more ,,can u tell me how long this process goes..she want to come back can she travel....",
    "doctor_response": "Hello, Dilysis in Diabetes is generally occur when patient developed nephroapyhy. In nephroathy, when developed Chronic kidney disease(CKD). In your description, it's not clear wether patient is suffering from acute Kidney injury(AKI) or CKD.Generally in AKI, patient needs dialysis for short duration of time unless creatinine level get down to normal or stable in medication without any symptoms. But in CKD, patient needs dialysis frequently depends on severity of disease for a longer time or for a life time. In that case, one should be think about transplant option depends on disease and another high risk factor.In your case, if she developed CKD then she will need dialysis frequently for life time and require transplantation if possible. Meanwhile at present case, if doctor said more dialysis she needed then definitely she will go for more dialysis and afterward if general condition becomes good then she can travel with medications. It will be no problem for her.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication after an operation in a child\n\nHi, Doctor.My name is mayuri sunkasalkar.My son age is 8years .so last year is done craneferongyoma operation in sahyadri hospital in pune .The doctor name is Charudutt pate.so i giving some medicine name is 1.Hysone 5mg. 2.Livipil syrup.3.Thyroxin",
    "doctor_response": "Hi...Following cranipharyngioma surgery, child develops hypopituitarism like hypothyroidism, diabetes insepidus and adrenal insufficiency. .. so child must be on nasal desmopressin spray to controle excessive urination, thyroxin, hydrocortisone.. Later child may require mri brain to look for recurrence.If u agree with my suggestion kindly rate me.Regards- Dr.Surendra",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for heaviness on the knees\n\nI have been running for about 3 months now, most nights. My knees are starting to feel a little heavy, if that makes sense. When I kneel down, my skin around my knees feels like it is pulled tight and then when standing the skin loosens, wrinkles. Why?",
    "doctor_response": "Hello, I think maybe you have lose weight and the skin wrinkles because the adipose tissue that was there has gone. Also, I suggest you to not over-exercise. The symptoms you have are because of tiredness. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Blerina Pasho, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling in my right leg thumb?\n\nHello Dr. I have been feeling pins needles like tingling in the thumb of my right leg from yesterday. I. M a housewife..most of the time on my toes... The skin below the thumb has become little hard too over the time.. And when I push it with my finger.. I can feel a sensation in nerve... Lately I have been experiencing knee pain also.. For that I took medication... My age is 25. Please let me know if this is a case of paras thesis or something related to my knee pain which has faded... But I feel weakness in my right leg",
    "doctor_response": "Hi, It may be due to nerve impingement or weakness of nerves supplying your feet. You can take analgesics like Paracetamol or Gabapentin for pain relief. If symptoms persist better to consult a neurologist and get a nerve conduction study done. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy, related with sore breast, back pain and drowsiness?\n\nHey ive missed my shot by 5 days and have still continued to have unprotected sex and he doesnt [pull out] im suddenly experiencing tender sore breasts, drowisness, certain smells make me gag, tiredness, back aches, weight gain. this is my second shot & i missed it. could i be pregnant?",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.1] First of all I will suggest you to get a morning's urine test done.It will help to find out your pregnancy status. 2]Most of your symptoms suggest early pregnancy. But missed period is important one.3] If urine test is positive then, get USG done to confirm.I hope my answer helps you.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe Social anxiety\n\nHi I suffer from severe social anxiety. I have read that CBT is helpful. Please advice me on how to go about it and whom to contact. I live in bangalore.",
    "doctor_response": "Hi.. CBT is done at any rehabilitation centres.. NIMHANS would be the best place for this. But it would take some time to get an appointment there as it is a central institute.. You may contact a clinical psychologist near your locality and check with him.. If you do not have one then you may search for one near your place.. I shall give you a link in\u00a0 helping you do this..  Hope you find it useful",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rash on the thighs and scrotum with pain for urination\n\nMy son 24 has a rash on his inner thighs and scrotum, he is special needs and was in the hospital for pneumonia they treated it with strong anti-biotics ... the doctor gave me a medicated cream.... it starts to go away but it has been 4 months now and has flared back up it really hurts when he pees",
    "doctor_response": "HiWelcome, I have gone through your query.I think two issues are not interconnected. For the rash I without suggest you to see doctor got examination and based on that one can come to diagnosis. Pain while micturation, indicate towards urinary tract infection. I would suggest to drink lot of water and drink cranberry juice, which is found to be helpful. I would have asked for urine routine examination and based on that I would have decided on the need to antibiotic.Hope this helps.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will the surgery for a deviated septum help me breathe deeper?\n\nI will be having surgery for a deviated septum and smr turb right side; a year ago I was diagnosed with asthma; though I have no wheezing; but difficulty getting a deep breath either by nose or mouth. will this surgery help me breath deeper or should I see an asthma dr. to check meds etc. thank you",
    "doctor_response": "Hi and thank you so much for this queryI am so sorry to hear about this deviated septum. The surgery would restore the patency of the breathing channels making breathing a lot easier and deeper if you so desire. I will suggest you evaluate after surgery whether you are doing  a lot better or there is still need to see a doctor for this.I hope this addresses your query fully. Thank you so much for patronizing our services and please do feel free to ask for follow up clarifications and information if need be. I wish you the best of health.Dr. Ditah, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can an infected skin lesion be treated?\n\nI have a skin leasion that was lanced about two years ago. Within the past few days it s become red and inflamed. Yesterday, it broke open and began bleeding and oozing. It is red around the edges with a dark center and is sore but not especially painful.",
    "doctor_response": "Hello,What is the color of the discharge? Does it smell bad? Does pus accompany with blood? Did you take any medications for the lesion? If not then I advise you to take tablet Keflex BD (twice a day) for 3 days and regular wound cleaning is advisable with Betadine solution. If symptoms persist I suggest you to consult a physician. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Indhu Priyadharshini",
    "dialogue_context": ""
  },
  {
    "patient_message": "Was hyperthyroid and did the radiated iodine. Have a nodule. Grown in six months. Had cough. Pressure on neck. Neck swollen. Prognosis?\n\nI was hyperthyroid and did the radiated iodine. I have a nodule that is 3.7 centimeters. It has grown a cm in six months. I have a biopsy scheduled and am having weird symptoms. A terrible cough that I thought was a cold, but has lasted way too long. Pressure in my neck to the point that I sleep sitting up. I feel facial tingling at times. Aching in my jaw and ear. My neck feels tight like it s swollen. Am nervous! Help",
    "doctor_response": "Hi, You took radio iodine for hyperthyroidism and you have a nodule in thyroid which is fast growing. I think you are being posted for a hemithyroidectomy and not biopsy or if not that then FNAC or trucut and not biopsy as biopsy is not done for thyroid nodules. You are having pressure symptoms on your wind pipe and you need to be investigated as under:1. A thyroid profile2. Thyroid USG or CT scan3. FNAC 4. Serum calciumThen your doctor can plan taking you up for surgery but in anycase not an open knife biopsy.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I get pregnant naturally after tubectomy?\n\nHello doctor, My age is 36 and I had tubectomy done 18 years back after second delivery cesarean like my first delivery. I do not know whether the fallopian tubes were tied, cut, clamped burnt, or banded. 1. Is there any scanning or some other method to identify the process of tubectomy done to me? 2. Is there any chance of getting pregnant naturally after tubectomy done by whichever method mentioned above? 3. To have a child now can we go for IVF, if so at the time of delivery will gynecologist come to know that I underwent IVF process for pregnancy? Because she has to do tubectomy again, she will go through with these tubes at delivery time.",
    "doctor_response": "Hi. The method of tubectecomy can be identified only after opening during caeserian section or through laparocsopy. If tubal ligation is done you cannot conceive naturally, if you try there are chances of ectopic pregnancy. You can go for  IVF for another baby. Course of the pregnancy through IVF and natural pregnancy will be same. In case of delivery if normal delivery, you do not have to go through tubes. If going for caesaerean section you can identify it was previous surgery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What precautions need to be taken after taking anesthesia?\n\nI'm 38 years old. I was born with a VSD (heart murmur). Over the past 15 years I have developed allergies and sensitivities to most foods and scents (I never had that issue before). Lately I have developed sensitivity to heat. I read recently that all these symptoms among others, may be Adrenal Fatigue. But the issue I currently have is that I am due to visit the dentist. I am always concerned when I have to because I am afraid that I would have adverse effects. Once I had double vision in one eye after given the anesthetic. Other times my heart races. I have also felt extremely dizzy once. Do you have any kind of advice or precautions that I should take.",
    "doctor_response": "helloi have gone through your query.as you have gone through dental procedure for some no. of times.i don thnk you had allergic reaction from anesthesia.plz mention whether the teratment was under local or general anesthesia.local anesthesia(LA) generally used comes with epinephrine which can cause pounding in the chest and light-headedness.if that is the case then LA without epinephrine cn be given.Patients who present with a history of \u201callergy\u201d to local anesthetics for them Injectable 1% diphenhydramine is a safe and effective method of LA.sometimes reactions result from increased sympathetic activity in response to fear, pain, or the sight of blood. This can cause light-headedness, fainting, and sometimes clonic limb jerking associated with a slow heart rate.according to your case you have to tell about all ur medical history to the dentist before any procedure.hope this ans helpsRegards Dr. shesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be the cause for pain in the groin area?\n\nI have varicocele but apart from that I also have intermittent sensitivity in my penis and the veins are swollen and darker. I have an aching pain in the area above my groin. The veins up near the glans of my penis under the foreskin are visibly redder and I feel discomfort when my penis retracts because of coldness. When the penis is erect the area under the glans is visibly redder like there is much more blood than usual inside. If the penis is not fully hard when I ejaculate there is pain in the penis head which goes away after about a minute. My doctor gave me moisturising cream and some steroid cream to put on after sex. She said it was a dermatological issue relating to hypertension but I am not sure this will be solved by the medication. The hypertension could be a result o\u0131f me being very stressed for about 3 months. These problems started about 2 months ago.",
    "doctor_response": "Dear, as early as possible get a colour Doppler of your penis and scrotum area. Otherwise you may land up in trouble. The blood accumulated around testes and penis due to varicocoele looks like have started clotting. This may lead to damage to your organs. So get started ASAP.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in right side of face and difference in movement of lips?\n\nHi ..My lower lips are moving sideways while speaking and my right side of the face and body is different than the left one, means right side of the face is swollen a bit. Is this the cause of bell s palsy? Which doctor should i approach. Im residing in bangalore.",
    "doctor_response": "Hello, It is possible from some of your description that you are suffering from an attack of BELL'S PALSY.  The most specialized type of physician for this sort of problem would likely be a NEUROLOGIST as opposed to an internist or family practitioner. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Valium for suspected Akathesia and Restoril for sleep. Do the two medicines fall under same drug category?\n\nwill Temazepam (Restoril) and Diazepam (Valium) test the same on a pre-employment drug screen I was the victim of Identity theft, stalking and assault in 2008. I did not discuss it with anyone except the psychiatric team I was assigned to because I had the misfortune of discussing in detail what I would like to do to the couple who robbed me, stalked me and beat me up. For that outburst, months after the event the doctor I told this to stated he had to report me as a 5150. I was angry because I was now the bad guy, I was constantly told I had poor coping mechanisms and labeled Child Interrupted because I would not attend sessions. I was started on Seroquel 125mg and by the end of 1 year I was taking 400mg per night. I took it willingly because it made me sleep and helped with the panic attacks I often had at night. I realized after a year I was using the Seroquel for sleep and quit taking it. Within a few weeks I noticed my hands would shake uncontrollably which I thought was an escalation of the panic attacks. When I consulted with my doctor on this she was very outraged and again reiterated my unwillingness to come to terms with what had happened and fired me as a patient. I did my own research and learned I likely had Akathesia. I was put on Valium 5-10mg 3 times a day and was given Restoril for sleep. I have sensed moved to another state and the symptoms are under control with the treatment I am now on. I am now concerned how this will be viewed by a potential new employer and am curious if Restoril and Valiun are in the same drug category.. Thank you for any information you may give me.",
    "doctor_response": "Hi,Temazepam and Diazepam are both benzodiazepines and both will cause a positive test on any drug screen that tests for benzodiazepines. If that will be a problem in getting a new job, then you can see a doctor in the city where you are now and get yourself assessed again. If it is indeed panic attacks that you are suffering from, then taking an SSRI (Zoloft, Paxil etc) would be a better option as it will give you very good control over your symptoms without any risk of testing positive on drug screens. You are also likely to have difficulty in getting prescriptions for temazepam and diazepam for long, while you not face any such problem with an SSRI.Hope this helps you. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I take Cifran 500?\n\nhi i have had fever, back pain feeling of tiredness, just came to know that i have typhoid through my blood report , now the problem comes here, my doctor prescribed me mahacef plus , calpol, and becosules Z, but when i called home today my uncle said to take cifran 500 if mahacef does do well in a few days... now i am confused",
    "doctor_response": "Hi,Cifran500 may not be effective to eradicate typhoid fever. Cifran (ciprofloxacin) was effectively used in the treatment of typhoid fever but unfortunately many of the typhoid bacteria (Salmonella typhi) are no longer susceptible to antibiotics of this type due to widespread resistant. Hence, your doctor has prescribed a combination medicine mahacef plus (cefixime + ofloxacin) which is found be effective against most of drug resistant typhoid bacteria. Continue to take the medicine as prescribed under the follow up of your treating physician.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "On Acetaminophen. Pain in stomach. Have an eating disorder. Lost pounds. Cure for symptoms?\n\nhi there,i took a single dose of 3500 mg of acetaminophen five or six days ago. since then, i started experiencing a pain on the right side of my ribcage, radiating to the stomach. it's not so sharp, but it's quite annoying and sometimes wakes me up at night. it also tends to hurt more when i don't eat.i also have an eating disorder. i've never been diagnosed, but it's clear that something's wrong. i've lost thirty pounds during the summer, but gained back ten since school started because of binging and purging multiple times a day. my bmi is about 18. i've had an endoscopy two months ago because of an eating disorder related accident where the toothbrush i used to make me purge slipped down my oesophagus. quite an uncommon thing, i know. since then, i seem to have a lot of stomach pains and heartburns.i was wondering if i should see someone.please excuse the mistakes i might have done, english isn't my mother tongue.and thanks for the answer!",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum.If I were your treating doctor for this case I would up come up with the following advice as,1 Accidentally you took 3500 mg acetacminphen and stated experiencing pain in the right rib cage.First of all I want to clear that maximum you can 4000 mg ( 4 gm ) of this drug without side effects, so all these symptoms may be due to gastric trouble . As in large single dose this may develops acute gastritis and all symptoms developed . Diagnosis can be confirmed by a physician  by physical examination.Take antacid & if severe symptom take proton pump inhibitors. 2 Next reason  of your problem is blunt injury in the esophagus due to toothbrush . As this developed esophagitis , this causes heart burn and stomach pain . Try raising  the head of your bed about 4 inches with blocks. It might also help to avoid eating or drinking for 2 hours before you lie down. To help control the stomach acid, one should not drink alcohol or drinks with caffeine in them or eat chocolates or spicy food or greasy foods. Also take some antacid but if symptoms are severe then you may need drugs like proton pump inhibitors.So in my opinion consultation with a physician will be helpful for you. Good luck. Dr.  HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent stool like green liquid in kids?\n\nmy daughter is having frequent stool from Thursday after giving her 10ml EvaQ on wednesday night as per Doctor consultation because she was suffering constibation before 4 days. Till date she is having frequent stool like green liquid ,no food she has been taken.....",
    "doctor_response": "HiLoose motion following constipation could be pseudo or false loose motion. It is likely to be due to impacted stools .I would suggest a thorough per rectal examination from your Pediatrician to rule it out.Take CareBest RegardsDr T Shobha",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest complications of congestive heart failure\n\nMy mother was 90 years  old .  We were not aware she had CHF .  We thought the subtle issues we were seeing were due to age . One morning she awoke and had difficulty breathing . Her breathing ebbed and flowed for a few days ..Finally she agreed to see a Dr. He did make a house call and said he had belived she had CHF would be back in the morning to do blood work..that she was fine   Over night  she became worse ...and we called the parametics ..to take her to the hospital . She struggled with the parametic and hospital personel  . She was not comfortable  and fearful  . They would not let me intervene to calm her down . She suffered a massive heart attack and cardio-genic shock . She died .  I am having a hard time resolvingh this issue personally . Can you give me some direction . I don't know much about this disorder and wonder if this were handled differently would it have made a difference",
    "doctor_response": "Hey,Heart attack with cardinogenic shock is a life threatening condition, especially at age 90 it is detrimental.Considering management of the condition include managing heart failure first with diuretics and ventilation if required with drugs which increase BP( inotropes). Their is a device IABP(Intra Aortic Balloon Pump) which increase the coronary flow and cardiac output. After this patient is taken for coronary angiography followed by revascularization. But despite all this a lot of patients die during and after treatment. So the doctors must have tried their best before the result. Wishing you good healthThanksDr Sameer, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Excessive sleep, severe dehydration, dryness in mouth, multiple sclerosis. Taken Roliflo. What is wrong?\n\nMy mom took Roliflo OD4 yesterday before sleeping. She felt excessively sleepy, rather drowsy the entire next day and was hardly able to get up. She also complained of mild headache , more like flashes of pain. And there was severe dehydration , with her mouth becoming dry. She is a patient of multiple sclerosis for last 12-13 year, fyi. We really think that she should discontinue with this medicine.. Whats your opinion. Thanks Deepti",
    "doctor_response": "CAN U PLEASE EXPLAIN COMPOSITION OF DRUG ROLIFLO 0D4 SOMETIMES PT'S OF MULTIPLE SCLEROSIS WILL HAVE ALL ABOVE MENTIONED SYMPTOMS BECAUSE OF DISEASE OR BECAUSE OF MEDICATIONS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump in shoulder\n\nMy husband has a baseball size lump on the top front of his shoulder.  It feels like a soft ball, but squishier.  It is under the skin.  He had not noticed it until tonight.  Could something this large, grow this fast?  There is no pain, it just feels tight when he raises his arm out.  It looks quite odd.  Any ideas?",
    "doctor_response": "Hi,Dear,Thanks for the query to HCM.-I went through your query in-depth and Understood your health concernsRemedy and Cause-In my opinion lump in front of top of the Shoulder-is Sebaceous Cyst.-But could be  fibromyoma/ Lipoma-as being painless went un-noticed till this time-So growth is not in a day but over many months or yrs.Its only today you noticed itRemedy advised-a-Consult a ER surgeon.b-Get the Clinical reasoning from Him.If its SEBACEOUS CYST-Excision after Enucleation in toto-is the curative treatment for it.c-If its benign tumour suspected by your Surgeon-FNAC BIOPSY would fix the tumor nature and would plan treatment by Excision / Enucleation of the benign lump.Hope this would help you  to work a plan with your doctor.Wishing you early and fast recovery.Wellcome to my HCM Clinic for further queries in this matter.Wishing you Good Health ASAP.Have a Good Day .Regards,Dr.Savaskar ,M.S.Genl-Thorasic CVTSSuper specialist in Asthma/Cancer and non-curable diseases.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Spondylolisthesis causing back pain. Advised fusion surgery. Consequences?\n\nI ve exhausted all options for my back pain . The problem causing the most pain is spondylolisthesis . The surgeon says the surgery to repair this is very risky and he doesn t want to because I m only thirty one years old. He says we can do fusion surgery thats lower risk and more likely to alleviate my pain. I would like to know how often this surgery is succesful and what kind of life after surgery I should expect.",
    "doctor_response": "Spinal surgery which includes putting in screws, rods and fusing the listhetic segment is a very common spinal procedure. It can give good relief to pain if done for the correct indication. It is likely to improve the shooting leg pain more than the low back ache. All surgeries carry some risk and here the risks which are to be highlighted are of leak of spinal fluid, damage to the spinal nerve roots causing weakness/bladder or bowel or sexual dysfunction and failure of the operation apart from complications like infection, bleeding etc. In the long term, the risk is of failure of fusion and implant failure. that said, if the operation is performed when correctly indicated and in good hands can provide good pain relief for most patients.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause blood clots in different parts of body initially starting from hand?\n\nSir , i am suffering from blood clots in different parts of my body from about 15 days.Blood clots initially starts from my hand .Now it appear and disappear in my most part of my body.and I am not feeling any thing else.Please help me is any thing serious.",
    "doctor_response": "HI THANKS FOR POSTING YOUR QUERY ON HEALTH CARE MAGIC.THESE BLOOD CLOTS ARE OF SERIOUS CONCERN AS IT CAUSE PULMONARY THROMBOEMBOLISM. YOU NEED TO BE EVALUATED THROUGH BLOOD TESTS LIKE PT INR, APTT.ARTERIAL AND VENOUS DOPPLER CAN HELP TO FIND OUT THE CAUSE.DRUGS LIKE HEPARIN AND WARFARIN ARE USED IN THE TREATMENT.CONSULT YOUR DOCTOR FOR FURTHER QUERIESTHANK YOU.TAKE CARE",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does presence of mild cardiomelagy indicate?\n\nHi Dr. A few days back had chronic cough and wheezing. The wheezing got better with asthama medications and puff but the cough persisted. on taking a x-ray and other blood tests dr concluded acute broncitis and put me on medication. The x-ray also showed mild cardiomelagy with slightly prominent pulmonary vasculature. Iam really scared as the dr has reffered me to a cardiac specialist. Is this very serious?",
    "doctor_response": "Mild cardiomegaly is something that is very subjective as per the diagnosis of different doctors. It can be normal cardiac shadow also. It is better to see a cardiologist and confirm or rule out any cardiac problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the upper abdomen and right arm having a lump under the chest?\n\nHello. I strained my upper abdomen changing a tire 2 months ago. A day after, I could hardly lift my right arm or move my right side without pain. All down my right side was in moderate pain. I just noticed a small lump right under my chest cavity and it doesn t hurt unless I press it hard. It is like a sharp pain. I can now lay on my right side but I feel slight discomfort. What are the possibilities I am dealing with here?",
    "doctor_response": "Hi. Your history and findings are more suggestive of a cervical spine problem causing the right sided pain. The lump may not have a direct bearing on the condition you are going through.Go for an MRI of the cervical spine",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nerve damage after removal of hermorroids?\n\ni have ciatica no by any herniation condition. i had hermorroids revome and i would doct thought was the problem. my bottoks or anus burns and my bottoks and i fell like sharp cutting pain on my legs and joins. mri done and cat scan was done. nothing rule out. one a doctor said nerve damage. what do you think?",
    "doctor_response": "Hello,Chronic anal pain after hemorrhoid removal is seen in about 2-30% of cases.The common reasons behind it are:-Presence of mild infection-Residual hemorrhoid disease-Use of staples-Previous fissure The best thing about such pain is that in absence of any reason such pain gradually disappears. At present, you may ask for an antispasmodic agent like cyclobenzaprine on prescription. The sacral neuromodulation by a pain specialist doctor is also helpful. Taking warm sitz bath does also relieve pain. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mukesh Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes splinter-like feelings on upper leg?\n\nMy younger son has multiple splinter - like feelings on his upper leg, he originally thought he had glass in his leg but we couldn t find any splinters or glass shards, and he wasn t near anything glass as he had just got out of the shower. What should we do?",
    "doctor_response": "hi Your son has  abnormal sensation of multiple splinters in upper thigh . In my opinion this kind of feelings come when there is pressure on the nerves  originating is the spinal cord. I would recommend Pregabalin , pain killers, and suggest S Vit B12 and MRI Spine( Lower Spine).",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fibroadenosis in both breasts, no family history of breast cancer. Am I at risk?\n\nIn april I was havin pain in my both breast sonography revealed a 6mm cyst in left breast with fibroadenosis in both breast.I was given evion 400 for two months later again had an ultrasound n then cyst was not found. I am given simrose and pyricontin for a month right now.I am suffering from fibroadenosis and I ve nodular feeling all over my breast.how dangerous it could be I had a lump on my left breast whn I was 14 n got it operated. I do not have family history of breast canver but my mother n sister also had lump in breast n got operated. Please help me regarding what should I do further how often should I go for testing? I it necessary to diagnose fibroadenosis.do I have more risk of getting breast cancer?",
    "doctor_response": "A fibroadenoma is not dangerous in and of itself and surgery to remove it is optional, but you may want to have a follow-up ultrasound, MRI and/or biopsy to confirm that it is indeed a fibroadenoma and nothing more, particularly if it continues to grow. Most fibroadenomas are left in situ and monitored by a doctor, or the patient in question. Some are treated by surgical excision. They are removed with a small margin of normal breast tissue if the preoperative clinical investigations are suggestive of the diagnosis. A small amount of normal tissue must be removed in case the lesion turns out to be a phyllodes tumour on microscopic examination.Because needle biopsy is often a reliable diagnostic investigation, some doctors may decide not to operate to remove the lesion, and instead opt for clinical follow-up to serially observe the lesion over time using clinical examination and mammography to determine the rate of growth, if any, of the lesion. A growth rate of less than sixteen percent per month in women under fifty years of age, and a growth rate of less than thirteen percent per month in women over fifty years of age have been published as safe growth rates for continued non-operative treatment and clinical observation.Some fibroadenomas respond to treatment with ormeloxifene.Fibroadenomas have not been shown to recur following complete excision or transform into phyllodes tumours following partial or incomplete excision.Regards and take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for penile discharge\n\nHello! I have a problem. I am doing masturbation from 2004 till now, and i am not married. From 2011 i have a girlfriend. and the problem is that when she with me my penis leaks some water, and also when i saw any porn picture then also do the same thing even when i listen about the porn or sex. What should i do?",
    "doctor_response": "Thanks for asking in healthcaremagic forum  It is normal to have this whenever you watch porn/be with your girl friend and excited. So, do not worry about this, enjoy. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest permanent remedy to cure psoriasis\n\nhello doctor...i am gunjan 25 years old having psoriasis from last 18 to 19 years...its a plaque type of psoriasis in which the patches are scaly , silvery white , stiff , itchy and sometimes painful...they bleed on itching...present on scalp , arm , knee ,back and umblicus...i have undergone alopathic treatment 8 to 9 years ago in which doctor prescribed me daivonex cream , diprovate lotion ,pagmatar , cream , coal tar and many more..by following them symptoms subsided for short duration...they relapsed always .. so i swithed on to homeopathic treatment...i had homeopathic treatment for 4 years but did not get relief...now i am taking baba ramdev's ayurvedic treatment from last one and a half year...but hv a very little improvement...sir kindly tell me is there any permanent treatment of psoriasis with you???",
    "doctor_response": "Hi,As you said, you suffer from psoriasis. It is a chronic and relapsing skin disease. I can understand your anxiety for your disease. But,you have to keep patience. You might get relief slowly. And due to some factors it might relapse...Remember it is a controllable disease. And there is no perfect treatment in ayurvedic or homeopathy.You consult nearby dermatologist for firm diagnosis and perfect treatment.I would like to suggest few things as follow....- acitretin 25 mg daily- methotraxate 15 mg weekly in three devided doses of 5 mg 12 hourly.- Blood tests ..routine & LFT may be done at regular intervals- Steroid with salicylic acid oint may be applied twice a day on the psoriatic lesions...on trunk and extremities- But, please avoid the use of betnovate on psoriatic lesions on foreskin and soft tissue areas..as it is a moderately strong steroid. You may apply mild steroid cream like mometasone.- Soap bath should be avoided.- All precautions may be taken to avoid dryness of skin. Winter might worsen due to dry weather. So, take care.After few months,you may be alright. But, maintenance therapy may be continued. And if there is relapse, you may restart the treatment.Have patience...Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to heal broken foot?\n\nHi I m 13, just broke my foot yesterday and in temporary plaster cast since this morning. Being a young teen, I m very self conscious and I m worried about the handling the smell of my player cast. Is there any way to reduce the odor that will come in the near future. Any help very much appreciated, thanks :)",
    "doctor_response": "Hi, Plaster cast smell only when one starts putting secent or powder in it. It also begins to smell when you stratch in side with the help of pen, pencil, spoons etc. Kindly do not indulge in any of such activities. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nirmal Chander Gupta, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does I feel heaviness in stomach?\n\nthere is constant feeling of heaviness in my stomach all the time.and full loss of appetite.this results in weakness in body and dizziness in head.no treatment is working.all the tests are ok.please help me.",
    "doctor_response": "Hi.. You could be having symptoms of indigestion.. Most often these are better preventable then looking for symptoms of relief.. Avoid spicy food. Eating in less amounts and more frequently, avoiding caffeine, good sleep, antacid medications can help in better control of the symptoms.. An endoscopy can help in finding the root cause for the symptoms..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Old aged, diagnosed prostate cancer, psa down to zero, went up slightly after radio therapy? Any problem?\n\nI'm 75 years young,was diagnosed with prostate cancer in 2004,prostatectomy\"radical\"in may2005,psa down to zero. then in 2010,radio therapy,33 sessions, psa went up slowly from:16.7 before my operation and after all that,it is now 0.12,should I worry,cause at my age they told me ,it's very slow ,would'nt cause any problems,I'm feeling real good,and do not beleive in Zoladex very much after reading the bad side-effects.what do you think the end could be??",
    "doctor_response": "The Surgery that you underwent and later radiotherapy are both modalities for treating cancer confined to the prostate but if PSA rises even after radiotherapy then there are chances that it is now going beyond the prostate.Zoladex is a form of hormonal treatment for this stage and if it has been advised it will bring down your disease levels again. As it is a form of castration, it does have some side effects but they can be treated by supportive medication or by intermittent (start stop )zoladex terapy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is albuterol is advisable for a child with cold?\n\ni have a 2 year old she is taking prednisolone and using albuterol and flovent she's asleep and i hear her heart beat fast and then slows down i took her pulse and is about 73 and 75 i'm worried about the medecine she's taking she doesn't have astma is just that during cold season she gets early signs of neumonia should i worry.A lot of people have told me that children using albuterol have heart problems",
    "doctor_response": "HiUsually we do not preferably like to use albuterol in infants but in some cases we use itDr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "How many cycles of siphene are required to get pregnant?\n\nI m 26 years old...I am diagnosed with PCOS. took Meprate to get my periods..and now took Siphene for  days...how many cycles of Siphene required to get pregnent. and what % of chances r there to get pregnant with Siphene. I m also taking glyciphage and folic acid.",
    "doctor_response": "Hi, the chance of pregnancy in one cycle of siphene is 7 to 10 percent only.  You can try 6 cycles of siphene along with trying naturally around the ovulation time.  If it doesn't work then you can go for IUI.  A total of 12 cycles of siphene can be taken. After that it increases chance of ovarian cancer. Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in sutures?\n\nHello Dr. Chetna. I wanted to know about c-section delivery stitches. i got my c-section delivery done on last August 2009. but my stitches are like swollen. it is not paining for me, but still i feel uncomfortable. i asked many of my friends, they said for few people it will like this only and it is because of less creation of healing harmones during that time. let me know your suggestion.",
    "doctor_response": "Hi,After so many years of C section question of healing of sutures are not there at all.The problem you are having might be due to formation of some adhesion at operating site producing stretching type of pain.There is likely of having painful irregular incision scar.Consult Gynaec and get examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain, high heart rate. History of hysterectomy\n\nHi I am 41 a female and weigh 70kg I have been feeling very ill since tuesday, I had such bad abdomal pain I thought I was in labour or having kidney stones . They did bloods and my white blood count is 13. I do not have medical aid and was given antibiotics. I still have alot of pain and my heartrate is 144 over 93 and pulse 103. What do you think is wrong. I had a historectomy 2 years ago and my kidneys are fine. Please help...",
    "doctor_response": "Hi You have not said which part of your abdomen is painful!  Obviously, the range of possibilities are too many. A blood count of 13 may be indicate infection - It may the appendix, gall bladder, urinary bladder and so on. You have stated 'heart rate' - I presume you mean Blood pressure!  144/93 is a little high and can be from pain, infection etc  One has to check again.  So is pulse of 103 Watch for fever An USG (UltraSonoGraphy) could help.   A repeat examination after a few hours also helps You should see your doctor again Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce difficulty for body movement?\n\ni am a former trapeze artist and after about ten years of not practicing, I took a trapeze class today and was stunned to realize that I couldn t continue because I had severe motion sickness. I am 58 years old and in pretty good condition. what can I so to prevent that from happening in future classes?",
    "doctor_response": "Hello, The severe motion sickness that you felt can be related to spondylotic changes in the cervical spine. You can get proper medicines prescribed after an examination by an orthopedician for relief. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is degenerative fraying at the medial meniscus along with a non-displaced cleavage tear at the lateral meniscus a serious concern?\n\nHello, my results from MRI on Right Knee. Impression: There is degenerative fraying at the posterior horn of the medial meniscus along with a non-displaced cleavage tear at the body of the posterior horn of the lateral meniscus. Minor degenerative change is noted although the chondral surfaces are within relatively normal limits. There has been a myotendinous strain of the vastus medialis as it approaches the medial retinaculum with an injury also involving the continuation of the adductor magnus as it approaches the epicondylar region... My notes - I would like to avoid surgery wherever possible. I have had the tear since 2015 and this is a recent check up as it has been very painful for about 2 weeks straight. All good again now after being on Mobic Anti-inflammatory tablets while in severe pain. Can you advise what this all means in short - due to go back to ortho soon.",
    "doctor_response": "Hi, Meniscal Injuries as described is unlikely to cause any acute pain. Pain is more likely to have been caused by degenerative changes in the spine. Start pain killers. Local heat therapy and knee muscle exercise to improve muscle strength. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for feeling of air trapped in ear while having flu\n\nHi, may I answer your health queries right now ?  Please type your query here... Hi, I have cold or flu for a few days and yesterday when I was driving back from mountain, I felt air trapped in my ear. usually it was going away fast for me, but this time it stayed for more than a day and still annoying me. can you please let me know why and what can I do?",
    "doctor_response": "Hi,It looks like you are suffering from ear infection otitis media.I would advise you Antibiotics ear drops.Consult your nearest ENT surgeon & get it confirmedwish you a rapid recovery.thanks.Dr.Ravin Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a shaking/twitching in the stitched part in the thumb?\n\nI cut the tip of my thumb off 8 days ago. I got seven stitches and just got them taken out today. For the past 5-6 days, my thumb has been shaking/twitching. It is controllable to an extent but I often find start to shake and sometimes have to physically hold it to make it stop. What is wrong with it?",
    "doctor_response": "Hello, It is not common but happens sometimes with some patients. Don't worry. It usually settles down in due course of time. Continue physiotherapy. I am sure it will settle down. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Nirmal Chander Gupta, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is vitamin B supplement needed during pregnancy?\n\nI am pregnant (9 weeks) and I have been prescribed follic acid tablets and Vitamin B supplements (Bevon). When i take Vitamin B tablets, I feel nauseated immediately vomit.Is Vitamin B supplement required during pregnancy? If vomitting continues, can this be discontinued? Is this mandatory to use Vitamin B supplements? Any alternative vegetarian food options?",
    "doctor_response": "Hi there,Nausea and vomiting is very common in first 12 weeks of pregnancy. If you feel that the vitamin B tablets are causing you to feel nauseated, you could definitely discontinue them. It is not mandatory to take supplements in pregnancy, unless you have a documented deficiency or follow a unhealthy diet.The folic acid is the only vitamin that is proved to be beneficial in first 12 weeks and thus is recommended. The usual dose recommended is 400 micrograms.You can take other multivitamins if required after 20 weeks to prevent the nausea, as this pregnancy induced morning sickness usually subsides after 20 weeks .Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dry skin and patches of blotches on legs of a 3 month baby?\n\nMy grandaughter has dey skin and patches of blotches of whitish discoloration especially on her legs and patches of hair and her scalp is dry. We especially started noticing this after taking her to the beach. She is only 3 months old but it is becoming more noticeable. Both parents have a history of eczema. Not sure what to do about it???",
    "doctor_response": "Hi... I sympathize with the kid and understand your concern. By what you quote I feel that it could be eczema.  The trick of the management is keeping the skin moist and never allowing it to be dry. For this oil massage and lotions like Oilatum will help. Regarding cure options - eczema is a sort of allergy...allergies can only be controlled and can never be cured. But usually kids grow out of it...that is as the age progresses, they become better starting from 6 months.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Been taking green tea extract and raspberry ketones, sore and tender stomach, esophagal spincter. Reason?\n\nI have been taking green tea extract and raspberry ketones . All the sudden yesterday my stomach became very sore and tender. When I move or breath deeply it hurts worse. It is in the very upper cental part of the belly, close to the esophogeal sphincter . Is is due to the pills or is this something else? I have also been working out and doing ab exercises.",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for asking a question to H.C.M.F. Your stomach suddenly became sour, and tender, hurts when you move or breath in, at the upper central part of the belly. Most probably it is due to the green tea, and rasberry ketones also can cause the pain. Probably you have taken them in empty stomach, or they may show irritation with out any reason also. If you happen to get the gastric pain it could be due to gasritis or ulcer. other causes are pancratitis,  gall bladder pain, hepatitis. Such occasional pains usually subside automatically, if no relief consult a surgeon for diagnosis and treatment. You may have to go for M.R.I.besides other routine tests for confirmation. Wishing for a quick and complete recovery. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swelling on ear due to bug bite\n\nmy great-nephew who is 3 is staying with us for the weekend. his right ear is swollen outside from a bug bite. I am allergic to mosquitos myself and have had my arm swell up from a bite before. his mother is 2 hours away. what can be done to help him?",
    "doctor_response": "For swelling on the ear you can give him some antibiotic preferably moxikind-cv or zifi-cv after an expert opinion along with syrup ibugesic-plus or syrup brufen junior for swelling and inflammation. You can give him syrup bandy-plus 10 ml stat at night. Don't worry he will be fine soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having pain after a gunshot which was done 7 months before\n\nHi Doc, About 7 Months Ago I Was Shot twice once in my thigh and once in my buttocks a exit wound for each, its been semi pain over the months but i dont know if its because of the cold weather (A freind who was also shot before suggested) but the pain has worsened, how can i fix this matter? Im sure its not infected but my leg gets soar out of nowhere sometimes.",
    "doctor_response": "Hi Welcome to healthcare magic forum The bullets could have severed muscles and nerves. So the pain is being experienced. You need medical attention. For pain relief, you can take homeopathic remedies safely. Takecare For further enquires- dranshita.rathore@yahoo.co.in",
    "dialogue_context": ""
  },
  {
    "patient_message": "UTI or Kidney Infection ?\n\nHello, three days ago, I was feeling pain in my back, no burning or pain when urinating, but a fullness in the bladder. I went to the clinic and a urine sample was taken. The doctor stated that I had blood and pus present in my urine. He is treating me for a U.T.I. What concerns me is that I do not have pain or burning when urinating. I can't physically see blood in my urine. Well, it has been three days on Cipro and I really do not feel any better. My back is still achy and I feel nauseous and extremely tired. What are your thoughts? Thank you.",
    "doctor_response": "Hi.. Presence of pus cells in the urine is a feature of urine infection.. And it is not necessary that you have to physically see blood in the urine if you find blood under the microscope.. Urine infections can cause kidney stone which may also be an cause.. I think you may need few more investigations like an KUB X Ray or an ultrasound test and urine culture test for appropriate treatment.. Discuss with your doctors...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes squeezing feeling behind the breast bone?\n\nLast couple of weeks I am noticing that when climbing stairs, I feel type of squeezing behind my breast bone. I am 43 year old female with non-specific heart palpitations. Holter Monitor and Cardio event monitor did not show anything of concern. I am concern about this new symptom. What would you suggest to me regarding this?",
    "doctor_response": "Hello I reccommend you to do a chest X Ray and a Spirometry test for lung function Regards Dr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Difficulty in breathing. Did I catch an infection of cold or ccough?\n\nHello doctor XXXXX i AM JUST ENQUIRING ABOUT MY BREATHING PROBLEM, Its in the middle of the chest , it is a bit like astmea but its not. I have had a breathing problems since about this time last year. What happened was i know this sounds silly but it did actually happen. A man at a swimming baths grabbed my head as i was about to sneeze , And discharged a cough down my throat . It was a chesty deep cough he did I think i breathed some of it in, before that i have never had breathing problems on this scale. Could it be that i have caught a disease or virus off him. After all they do say cough and sneezes spread diseases.",
    "doctor_response": "from qustion it looks like it is allergic you maybe having post nasal drip from sinuses which increases during a particular season you are allergic to normally it starts like this and then can start with wheezing and cough you take anti allergics tab singular 10 mgm twice a day syp ventrolin 1/2 tsf bd and combination of cpm+codeine syp 1/2 tsf in warm water at night take for 10 days and get diagnosed your allergies and sinusitis",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for heaviness in the chest and fever?\n\nmy father had a CABG done 1 year back in november 09..fit n fine after that.. presently he had a fever 1 week back..now weakness after fever..but he's NOT able to walk & feeling breathlessness while doing any activity & heaviness in chest.pls. sugest & help...",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Chest tightness, breathlessness, difficulty in walking etc are suggestive of heart failure. Since he is already a cardiac patient (CABG), you should definitely consult cardiologist for his symptoms.Get done 2d echo and stress test (trade mill test).Angiography is also needed if stress test is positive. He may need diuretics and other cardiac supportive. Hope I have solved your query. I will be happy to help you further. Wishing good health to your father. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause sore & inflamed gum?\n\nI had scaling done 1 week ago get it done every 4 months never had problem before.  Went back to my dentist because my gums have be sore and inflamed she gave me antibiotics just in case of infection.  It is still sore on the bottom right hand side of my mouth it worried me this has never happened to me before.  Can't figure out why now after having it done for so many years..",
    "doctor_response": "Hello:)Thankyou for choosing HCM.I appreciate you take great care of your teeth and gums.Scaling and root planning can be painful at times as the calculus deep in the gingival crevice has to be removed.Do not worry, as this is very temporary.Delay flossing for a few days.Use a soft brush.Be gentle.Use Chlorhex mouthwash thrice a week diluted in 1:1 ratio.Take a OTC painkiller if necessary.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Ultrasound shows fibroid in ovaries and shadow. Have back pain. What can it be?\n\nHi, I have today been told by my GP that a recent ultrasound I had completed, has come back and shows a fibroid on my ovaries and a shadow, as I am suffering severe back pain today and went to see her, she has advised I will be having a rescan within 2 weeks. Should I be worries, could this mean cancer?, I have had 2 children, and am 29 years old.Thanks Claire",
    "doctor_response": "Hi, ovarian tumor may be malignant but when an ovarian mass is found ideal management will be surgery.then frozen section biopsy to be done if found to be malignant then completion of surgery to be done and depending on stage adjuvant treatment selected. but mass may not be malignant most of the time. consult gynaecologist. surgery should be done.take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the combination of the Pill +Lupron the same as the Agonist/Antagonist Conversion Protocol?\n\nI am considering pursuing a fourth round of IVF. Two doctors have told me that I should use the pill + Lupron before beginning the Menopur/Follistim stimulation. My question: is this combination of the Pill+Lupron the same as the Agonist/Antagonist Conversion Protocol?",
    "doctor_response": "NO they are not the same. They are different regimes and you should follow as the doctors told you THe pill is artificial hormone progesterone and estrogen and leuprolide is gonadotrophin. Follistim is artificial FSH and menopur is menotropin. THey all act differently",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do I have delayed puberty?\n\nhi ... im a 20 yr old man. i av bin trying to convince myself dat im having late puberty but in afraid dat my system is faulty... i av a very small penis dat a cousin of mine who is 14 yrs old has a penis dat is almost bigger dan mine... i just started growing armpit hairz last yr wich den i was 19. . my age mates ar already growing beard nd moustache while mine is as smooth as new...i was introduced to masturbation but within 30 seconds .. i ejacuate without d desire of a second round... it was due to my lack of beard dat gave me little hope dat i might nt av reached puberty and still av a  chance but im starting to lose dat too wen i see my younger ones possesing wot i dnt av",
    "doctor_response": "HelloPlease get a serum Testosterone level and contact me back. This should be done in morning at 8AMDr SAATIISH JHUNTRRAA",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have back pain. Feels like muscle pain. Cure?\n\nI have lower back pain, it has been aching a while and thought it was my matress but since Monday it has really started to aceh all the time. I do go to the gym so not sure if its muscle pain or something else. It feels like I constantly have to stretch it over to pull it but doesn;t quite feel like in my muscles and seems to now also be going round the sides a little bit",
    "doctor_response": "Hi and thanks for the query,It might be necessary to precise for how long you have been having this pain and if there is an identifiable trigger of the pain. A clinical evaluation might be necessary. An R ray of the lower spine and a spinal CT scan might be useful. These shall depend on the clinical appreciation of your doctor. It might be necessary to precise if the cramps you experience always correspond to the pain or not. Any changes in the sensitivity or at times weakness in the lower limbs.Doing serum electrolyte tests to exclude any electrolyte abnormality like Low Calcium and Magnesium levels should be done and identified. Levels of Vitamin B12 and Vitamin D could also be useful.Erythrocyte sedimentation rate and C reactive protein tests to measure the degree of inflammation could be useful to ascertain a detailed insight.I suggest you consult your physician for a proper clinical evaluation and paraclinical testing.Best regards,Luchuo, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in neck and heartbeat sound in ear?\n\nHi, may I answer your health queries right now ? Please type your query here... Hello, I have been having pains in my neck for a few months now. It is under my jaw on left side of neck. Seems to be near where you would ckeck pulse. the pain I get comes and goes, but at times is like a throbbing pain. I also have sounds in my left ear that sound like heartbeat but I don t hear it constantly. Could you give me some advise please?",
    "doctor_response": "Welcome to ' Ask a doctor service ' , You should undergo blood pressure check up and evaluation of anxiety and temporal arteritis .Undergo lab test as ESR .As a precaution , whenever you have such symptoms , go for deep breathing exercises .With Regards , Dr Varinder Joshi .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please advise on nasopharyngeal carcinoma in a 17 year old male.\n\nHello doctor, This query is regarding nasopharyngeal carcinoma non-keratinizing. The patient is a male 17 years. His symptoms are epistaxis, lump on the right side of the neck, and weight loss. Blood tests, CT scan, FNAC cervical lymph node right side of the neck, EBV testing, and biopsy of nasopharyngeal mass is done.",
    "doctor_response": "Hello. I have seen the attachment (attachment removed to protect patient identity). It looks like a nasopharyngeal carcinoma (a head and neck tumor). But still, the staging workup is incomplete. So, you need to do a CT scan of the chest and isotope bone scan or a PET/CT scan to complete the staging workup. As this tumor is not common in this age group, it is advised to review the pathology specimen again with the use of immunohistochemical markers in a different lab or take a new biopsy as FNAC is sometimes insufficient to confirm the diagnosis. After staging workup is completed and pathology (second opinion) report will reconfirm the diagnosis, the patient may need and benefit from chemoradiation (radiation therapy and chemotherapy). This tumor usually responds well to chemoradiation and can be cured completely. For more information consult a medical oncologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the dose of azitharl for three year old child?\n\nHi, my son has cough and cold, he is 3 year old and weight 13 kg. he has 37.2deg celcius fever rightnow. I have azithral -xl for babies with me.. i am interested in knowing the dosage for him.. last time around 6 months back my doctor suggested me 2.5 ml once in a day for 5 days.",
    "doctor_response": "Hello, The dose will be according to body weight. For a baby of 13 kg the correct dose will be 130 mg per day. Generally, a five ml preparation contains 100 mg and you can give 6ml approximately. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fatigue\n\nYes, I have MS and severe fatique. I have been on Provigil for over 4 years. It helps me tremendously. I am now going on Medicare and the Part D plan makes my cost (and my premium) for Provigil terribly high. I take about 13 different meds so it s rather expensive. Can you help me at all?",
    "doctor_response": "fatigue in ms is very common the treatment of choice is amantadine 100mg once daily and can be increased to twice daily",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could vaginal spotting be an implantation bleeding?\n\nHi my name is Sara and I am 20 years old. I was not supposed to start my period unroll today but I started light bleeding three days ago and it was brown blood and a light pink color, I had unprotected sex with my fianc\u00c3\u00a9 and I was wonddering if this bleeding I had was implantation bleeding?",
    "doctor_response": "Hello,You check urine pregnancy test if it's negative it's not implantation bleeding. If it's positive it can be implantation bleeding or threatened abortion.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sheetal Agarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for numbness in whole body\n\nMy whole body from scalp to toe has lost a sense of feeling/touch. It has been going on for a 3days now. An example, when I scratch my neck, I don't feel like I am scratching myself, though I can feel that it is being scratched. i am really feeling very uneasy i just cant feel anything especially when i touch my body cant feel the sense",
    "doctor_response": "Hello dear,The symptoms as mentioned in your post can be attributed to:1. Entrapment of nerve fibers at the Cervico-thoracic region.2. Inadequate hydration status & electrolyte imbalance of the body3. Dietary deficiencies of certain nutrients like Iron, Calcium, Vitamin D, Vitamin B12, Folic acid, etc. which help in blood formation & nerve conduction.4. Peripheral neuropathy caused due to any fluctuation in blood pressure or blood sugar level.Symptomatic relief can be obtained by intake of nervigenic agents (like Vitamin B6, Vitamin B12, Folic acid) as well as multivitamin & multimineral supplements including iron, calcium & Vitamin D needs to be added in your diet.Physiotherapy & postural exercise will also be helpful.If symptoms still persist, kindly consult a Neurologist & get a complete Neurological examination done.Certain investigations like complete blood count, serum electrolyte estimation, fresh estimation of blood pressure & blood sugar levels & nerve conduction studies will be helpful to rule out any pathological cause for the symptoms.X ray & MRI of Cervico-dorsal spine can also be carried out to detect any nerve entrapment.Wishing you a Good Health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the neck,back and shoulder after waking up?\n\ni m a 60 yr old female in relatively good health. For some time now, when I wake up in the morning I have back of the neck pain, shoulder pain and it takes a couple of hours after being up when things start to loosen up. The neck pain lessens as the day wears on but never goes away. I feel a slight bump starting to form at the top of my spine. Osteoprosis?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Causes of lower back and hip pain are:1. Injury2. Blunt trauma3. Sprain or strain4. Spondylosis5. Spine related problems6. Improper posture7. Rheumatoid arthritis8. OsteoarthritisYou can take tab. aceclofenac. Apply diclofenac gel or cream. Apply ice locally. Do x-ray and MRI back and neck region. Do regular exercises. Consult your physician for prescription.Treatment mainly depends upon underlying conditions. Kindly follow with detailed history or consult with orthopedician.  Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Shyam B. Kale",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will the ACL surgery affect growth plate leading to deformity?\n\nsir my son, 14.5 years had ACL broken. Dr. has advised surgery for ACL reconstruction through arthroscopy. My concern is about growth plates which are still open. Will the surgery not affect growth plate leading to any disformity. Please suggest. My son s height is 6 feet.",
    "doctor_response": "Hi, Don't worry. It will not affect his growth plate and he will gain full height. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jaideep Gaver, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could a lump under the skin?\n\nI am 22, 5'8\" and probably 140 lbs. On my right shin I have a finger-long lump under the skin. It is only noticeable when I rub my hand over it or if I pull my foot up towards my face. I'm not too concerned about. I just assumed it was a fatty deposit. Could it be a fatty deposit?",
    "doctor_response": "Hi dear you should be concerned about it as its quite longYou need to consult a doctor and resolve it asap.It could be varicose vein Lump.Hit thanks.GD day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for psoriatic patch on calves\n\ni have a soariatic patch on my calve. This patch has increase over a period of 6-8 months. I have started getting similar patches but small on both my elbows, 2 on my scalp and i recently observed 1 on my naval and 1 near on the left side of my groin. pls help. it is causing a concern.",
    "doctor_response": "Hi,As you said you have psoriasis vulgaris. It is an autoimmune,relapsing,chronic and recalcitrant skin disease of unknown etiology. However,there may be hereditary factor. Dryness of skin worsen the disease. You have mild psoriasis,as it is on calves of the leg. There may be itchy scaly plaques on the legs. Avoid anxiety and worries. Do not apply soap on the affected parts. And take regular treatment for long time under observation of dermatologist. You consult dermatologist for firm diagnosis and proper treatment.Tab methotraxate 15 weekly in devided doses of 5 mg twelve hourly may be takem for few months or till good result.Take antihistaminics to relieve itching like hydroxyzine HCL 25 mg at night daily.Apply combined oint of steroid and salicylic acid..like dipsalic oint.And continue other medicines which you take.Have patience for the good result. I hope you got my answer.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Painful breasts, underarm pain, lump in breast, benign cyst, thyroid tissue produces hormones. Had mammogram. Will I be okay?\n\nI am a 38 year old female.  I have a few female issues and am not sure if it's all related.  I recently started having a sharp burning/stabbing pain in my right breast that travels a dull pain into my underarm. I have had this intense pain off and on for about a week.  I just ended my period.  Now I feel the same pain, but much duller in the left breast.  I had a mammogram about a month and a half ago and it was normal. I do feel a small lump in the right breast where the pain is. I do have a goiter on my thyroid that I have monitored every year (I've had it since I was 18).  It's been biopsied and it's a benign cyst with thyroid tissue that produces hormone. I also have difficulty every month with my periods.  Every month, two weeks before, I can feel a cyst on my ovary (I started getting them in my early 20's) that causes me pain for several days.  Then my breasts swell almost a whole cup size, my abdomen swells and I have pain sitting sometimes. I get acne during the same time.  My periods are becoming irregular and \"clotty\".  This is taking over my life.. I usually only have one \"normal\" week during the month before it starts all over again.  I do also have difficulty with intercourse.  I have the same swelling, discharge and pain in the abdomen about an hour after intercourse and it can last for a week. This doesn't happen with condom use. I'm starting to wonder if  I'm allergic to my husband. My blood tests usually come in the low normal ranges and I'm otherwise a healthy woman. I don't know if age is making me more sensitive or if there is something wrong with me.  I can't get a doctor to do anything because my tests come in \"normal\". Please help.",
    "doctor_response": "Hi there,I can't pinpoint anything suggesting cancer, but I feel you must see an endocrinologist and especially check your Thyroid function tests.Also an ultrasound scan of abdomen and pelvis can put to rest any concerns about ovary.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could itchy rashes on penis and face indicate?\n\nHello,i have a boyfriend,for the past week or so hes had a rashy and itchy face and penis,hes only having sex with me,and neither of us have stds,and i dont think hes used any new soaps or taken any new medication.what could possibly be causing the itchy rash?",
    "doctor_response": "Hi,Symptoms could be due to fungal infection, vesicular rash, allergic reaction. I would suggest to consult dermatologist and undergo examination to confirm cause. Following treatment will help you:- Fungal infection: tablet Ficonazole and Clotrimazole- For vesicular and allergic rash: Application of mild steroid ointment and antibacterial ointmentTake Levoctrizine at bed time. Maintain proper pelvic hygiene.Hope this may help you. Contact further if follow up needed.Best regards,Dr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dog bite\n\nHi I was bite by a dog 8 months ago the dog tore off my right bottom lip to my chin I had over 35 stitches inside and outside lip and chin now still after 8 month I feel some numbness and tightness below my lip plastic surgeon told me that I probably have permanent nerve damage and he doesn t want to perform another surgery I am 50 years old female is the pain and numbness feeling will be forever is there any medication I can take for the pain it is very uncomfortable . thank you Sandra",
    "doctor_response": "HI , thanks for using healthcare magicThere are medications that can be used to help with pain and numbness.Anti depressants and anti seizure medications have been found to help with these symptoms in persons with neither depression or seizure. Nerve related pain is another indication for use of these medications.Eg are amitriptyline, lyrica, gabapentin, tegretolI hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Left side pelvic cramping with a backache\n\nI am 33 years old, 5 children, 1 abortion many years ago, Never been hospitalized for anything other to deliver a baby.Nothing other that a the flu last year. No past health problems. I hurt my back about a week ago picking up a heavy object, went to the hospital and they gave me a muscle relaxer and some pain medicine, now I am having a cramping in my left pelvic area along with the back pain . I had intercourse last night and noticed a light bleeding when I wiped, but now it s gone. Do I have an infection? My tubes are tied ,so I am not pregnant.I have nt gotten my period yet, which it usually comes on around the second or third of the month. Since taking the Oxycodone and the Flexerel I have been a little constipated. It has been almost 2 days since my last bowel movement if I don t have one today.",
    "doctor_response": "welcome to healthcare magic, as to your symptoms it is more likely an infection in pelvic organ or a cyst in ovary related to menstrual cycle.you better have a USG of pelvic area,complete blood count and urine test for better delineation of your pathology.it will also exclude urinaruy infection that might be a cause.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain on shoulders, neck and wrist?\n\ni started getting pains about four weeks ago in my shoulders every morning.pains are getting worse waking me upthrough the night also pains in my neck and sometimes in my right wrist.can feel pain all through the day but much worse in the night and when first get up in the morning",
    "doctor_response": "Hello, It sounds like a Cervical Radiculopathy. During this, there is a change in the spinal column normal anatomical position and a disc Degenerative changes leading to nerve root entrapment. Need an MRI to confirm the diagnosis. Using cervical soft collar will be helpful to stabilize the spinal column. Hot water fermentation will help reduce muscle inflammation. Static neck exercise, inter-scapular muscle strengthening exercises, shoulder stabilization exercises and upper limb strengthening exercises are advised. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does an allergy to Penicillin persist for 50 years?\n\nAs an infant, about 59 years ago, I received a penicillin injection and was found allergic to penicillin. My mother said I then broke out in a rash over by body, and my skin got red. Since that time, I have not had penicillin because I thought I was still allergic to is. Question: Does one outgrow an allergy to penicillin after 50 or so years?",
    "doctor_response": "Allergic to drugs can persist life long.Especially drugs like penicillin are notorious for allergy.Always test for penicillin allergy before injection or if it is a known case then avoid and use a safe alternative.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are mild sore throat with mild temperature symptoms of Covid-19?\n\nHello doctor, I had a mild sore throat last Friday and started to take Strepsils then the pain gone last Sunday. But early morning today at around 2 AM I had chills until the morning. I took Paracetamol right away. My body temperature is 37.2 currently. Should I go to the hospital? Are my symptoms same as the Covid-19?",
    "doctor_response": "Hello. Viral infections produce similar symptoms. Common cold or seasonal flu produces similar symptoms as does Coronavirus. However, it is the severity of symptoms that are worrying in Coronavirus and the body's response to contain the virus. There is no need to panic right now. Just take precautionary measures like proper hand hygiene and proper respiratory etiquette and maintain a sort of isolation. Take plenty of fluids and other supportive measures as required. If symptoms do not improve or worsen over a couple of days you can visit a health facility. However, if there is any history of contact or presumed contact with someone with suspicious symptoms or a travel history then it is better to report.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Constant stomach pain and back ache. This pain is made worse by sexual intercourse\n\nI have had constant stomach ache in the lower left of my abdomen ,which eases and returns,I sometimes get the pain which is like a stabbing pain and cramp in the whole of my stomach.I have had this pain for over a year.This pain is made worse by sexual intercourse and when I have my period.I also suffer from pain in my ribs on my left , back pain and a sore left hip.I have been trying for a baby for a few months and never seem to get pregnant,I already have 3 children.I have had swabs and a smear test taken from my GP but they came back as satisfactory.And my urine has been checked.Please could someone tell me what s wrong?",
    "doctor_response": "hi welcome, you didn't mentioned about your bowels,appetite, interest towards food,distention of stomach.constipated,less appetite,no or less interest ,distended stomach are may be of tours if like that better treatment can drawn from an expert ayurvedic doctor of your area if not possible write to me thanking you christyjoseph1@gmail.com 09895313720",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from fits, lack of appetite, swelling in brain. Treatment options?\n\nhi im frm XXXX n my small bro he is not normal n not also abnormal .......he knows every thing do every thing just he is not eating n writing ....... and ...... just 2days before he has fits... n wn v hv takn to doctor nr by .he told that he is having a swelling in brain .so fr dt wt . to do ?????? so , he cn get normal",
    "doctor_response": "Hi, Thank you for contacting Healthcare magic. Based on your description above, we know that your brother has a problem in the brain and has fits. First of all, he needs to be started on anti-epileptic medications, with which his fits can be brought under control. Next, you have mentioned that there is swelling in brain. One needs to identify the cause of swelling. The commonest cause of brain swelling is brain infection. We can confirm it with the help of MRI scan of brain. Infection can be treated well with medications. For the best treatment, you should consult and follow the advice of a neurologist. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have irregular period, taking medicine to conceive. Can any online doctor help me to read my follicular study report?\n\nHello doctor, my periods were irregular for which i was taking medicine for past 4 months and now i have started with new medication for getting pregnant. My doctor has suggested me follicular study and on 10 day of my period the readings of Left, right and endo were respectively: 15mm, 8mm, 7mm and on 11th day my readings were 17mm, 8mm, 7.5mm. so can you please suggest me the status of my condition and which other steps do i need to take so that i can concive as soon as possible",
    "doctor_response": "Hi, thank you for query madam, The follicle needs to reach a size of 18-24mms in order for ovulation to occur.  Anything less than that will not lead to ovulation.  Without ovulation, pregnancy cannot occur.  So, based on the CD#11 ultrasound, your right follicle has not reached an appropriate size and may indicate that it is not growing, which in turn, indicates that the medication you used is not working.  My recommendation would be to repeat the ultrasound at CD#14 and CD#16.  If there is not ovulatory sized follicle at those points, then the cycle should be cancelled due to lack of response, you should be given provera for 10 days to induce a period, then start a new cycle using Clomid at 150 mg per day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in groin with a lump on epididymis?\n\nhi, i am 27 year old male.  In the last week or so i have noticed some pain in my groin area, i cant really tell if its a testicle or something in that region.  I just started playing american Handball again , the season just started about 3 weeks ago, it involes alot of running and stopping and changing direction and I read that this could be a strained groin.  I also have a small pea sized lump on my left Epydidymis that I have noticed for like 10 years now and it has never bother me before.  I have no other lumps on my testicles.  This small lump on my epydidymis cant be cancer right?  Surely id be dead if i have had this for at least 10 years already?",
    "doctor_response": "Hello, If its cancer it should have grown in the past 10 years. I suggest you visit your urologist to evaluate this further if it's dangerous or not, let's hope not. It seems like a simple epididymal cyst. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. SAMEEN BIN NAEEM, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can I manage depression and anxiety?\n\nHello doctor, I have been having depression. I suddenly get sad and cry myself to sleep. I cannot face people as I feel anxious and tensed. I vomit whenever I feel tensed and anxious which is effecting my health. I cannot eat properly or mingle with people as I am always in a fear that something bad might happen to me. I have not gone through any treatment nor consulted any doctors about this problem.",
    "doctor_response": "Hello. The symptoms like sad mood, crying spells could be due to some mood disturbance. Anxiety, fear, and anticipation that something bad will happen, poor social interaction, etc., are part of anxiety and mood disturbance. If these symptoms are resulting in distress and are impairing your functioning, then please visit a psychiatrist for help.  A behavior therapy and relaxation exercises can help to treat the symptoms. If the relaxation exercises do not help then drugs like SSRIs can be used to reduce the anxiety. Sertraline, Fluoxetine, Escitalopram, etc., can be used to come out of anxiety. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen ankles with dryness in mouth?\n\nI ve got swollen ankles, slight temperature(36,9) and my arms itch. I ve already seen a rheuma doctor and he asked me to do a lot o blood tests-The RF was negative as well as the AC.Anti-Cardiolipina and AC.anti-nucleares and as I don t have deformed articulations he says the diagnostic is difficult.What shall I do next? Please help me. My mouth is very dry and I m always thirsty",
    "doctor_response": "Hello,It looks that you may have synovitis of ankle. There are various reasons for this like inflammatory, infection or iatrogenic. If it continue to persist even after taking anti-inflammatory medicines then you may ask for biopsy to rule out the reason behind this. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mukesh Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffer from herniated disc, weight loss. Spine and nerve inflammation causing pain. Need help\n\nHaving problems with scarum geting out l4 l5 of place go to chiro, since 96 had large hernitaed dics l4 l5 spinal stenious degen, disc disease osterorathis, have bludge l3 l4 l5 inverted since 2000 full inverted   TN.  spine an nerve said infalamantion causing my pain, but scarum won,t stay now medicare refusing to pay, told by medicare to appell. I use all kinds of equipment for problem.  Thinking about buying nubax say it is better than inverting. Thank you very much. Live in music city have had acess to great chiop. ART chiop,that worked with the Titans. Healthy Back Instiute said i have forward pelivc till. Lost 30 lbs. Thanks very much.",
    "doctor_response": "Hi there ~I understand your concerns.  It seems like you are having chronic back problems that are not getting better with chiropractic treatments and your medicare is not not going to pay for the treatments.  It might be helpful to ask medicare as to what they would be willing for after getting an opinion about the kinds of alternative treatments for your condition.  I think that you are going to be highly benefitted by taking this step and finding out what your options are.  I hope this helps.  Congratulations on your weight loss.  I hope you are feeling a lot better with your back after the weight loss.Take care and have a lovely day!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of remeron rd 15mg ?\n\nhi anyone taking remeron rd 15mg? can you share some side effects? because i just started taking this meds and i am having bad experience... its hard to explain...i was involved in a bad car accident in february 2012..its a miracle that i am alive.. the Dr. fused C1 & C2, internal bleeding , Dr. did 4 major surgeries and searched for internal bleeding organs which was my colon , both kidneys, diaphram, and managed to save half of my liver . my recovery is doing great.. i been home since the beginning of may but my mood has changed... i get angry and get upset very easy... i talked to my doctor about it and he prescribed Remeron RD 15mg.. i started taking this pill and its not helping me.. its hard to explain.. but feels like i am having abnormal dreams.. tossing and turning.. please help.. thanks..jj",
    "doctor_response": "HelloThanks for your query.Based on the facts that you have posted it appears that you have survived and came out through a serious accident and having varied symptoms .Mostly these symptoms are due to stress and anxiety due to serious nature of  events that you have gone through.You have been prescribed Raveron (Mirtazapine )which  is an anti depressant and  has side effects like behaviour changes, sleeplessness ,panicky attacks etc..Please consult qualified Psychiatrist befeore taking this drug and explore te possibility of taking other anti depressive medication.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Calculus in left ureter, mid pole, GR1 hydronephrosis. Temporary relief from medicines. Solution?\n\nmy uncle is having a calculus of 4mm in left lower ureter near uv junction and GR1 hydronephrosis and also a 5 mm calculus at mid pole.... he is having continuous pain from last 3 days the pain gets relieved on taking injections and medicines  but as soon as the effect is over it again occurs  what should be done in this case?",
    "doctor_response": "HI,I AM DR.TIWARI.FROM YOUR HISTORY IT APPEARS THAT YOUR UNCLE IS SUFFERING FROM NEPHROLITHIASIS THOUGH THESE TINY CALCULI WILL BE PASSED NATURALLY .IT MAY REQUIRE FLUID THERAPY TO EXPELL THEM OUT. GET HIM INVESTIGATED FOR METABOLIC DISORDERS CAUSING KIDNEY STONES.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from unreal thoughts, depression. Prescribed fludac and nurotroy injection. Reaction from reglan and mexiron. Advise?\n\nhi! my bp is 120/88.i am 37 yrs.i am also suffering from unreal thoughts which makes me depressed doctors prescibed me fludac 20mg.sometimes i do feel heviness in my arms and legs.for this she prescribed me nurotroy injection .how ever i hav not taken the medicineas i am very sceptical of taking medicine as once i had reactin from reglan and mexiron.please advice me/",
    "doctor_response": "hi, welcome to health care magic Although you didn't specify your thoughts but fludac is a good antidepressant and very effective for obsessive compulsive disorder in which persons are in stress because of excessive, unwanted thoughts. chances are very high that you will get good benefit from this medicine, even if you don't have clear obsessive compulsive disorder. Fludac is an easily tolerable medicine and most patients take it without troublesome side effects. Probably you had dystonic reactions(rigidity of limbs, and slowing of movements) with reglan. This reaction is common with reglan, not with fludac. so rest assured and start fludac. Keep in mind that a good effect from fludac may take 6-8 weeks to start, so donot stop it earlier or without consultation with your doctor. best of luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I continue to breastfeed if taking HCQ 200mg and Azoran 100mg for SLE with lupus?\n\nsir,I am a sle patient with lupus nephrites classIV B Iwas on medicines wysolone 5mg azoran 50mg ,amolog 5mg,metformin 500mg .Iam a nursing mother My docter adviced me to start HCQ's 200mg and azoran 100mg .sir please give me a suggestion on whether to continue breastfeeding or not is there any bad effects.",
    "doctor_response": "Hi I am dr alok,  pleased to answer your health related  queriesYes hcqs and azuron both can be taken as there is no study which is showing that they can harm to baby, but it is always a good idea to stop breast feed as soon as possible because we do not have much studyHope this will help if you have any further queries, please don't hesitate",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lightheadedness , fever and body pain\n\nHi. I recently had sexual contact within the past 1.5 weeks with two partners. All contact was extremely low risk, only oral sex and dick/ass rubbing/frotting, without direct penetration; he did however line of the head with my hole and rub intently. Both claim to be HIV neg as well. However, yesterday I began to feel tired, and today it has gotten worse, as well as accompanied body aches, fever of 101.6, lightheadedness, and slight chills. I would typically be unconcerned, but given the symptoms, I am a tad worried even though everything was very low risk. Was do you think my risk is? Thank you.",
    "doctor_response": "Thanks to HCM I can understand your worry these symptoms due to either viral or fungal or bacterial nfections ..don't anyway test is negative ,I would like to suggest once have a CBP,VDRL,ESR and cue ..plz you can take paracetamol 500mg twice daily ,monocef o 200mg twice daily for 5 days .. genrally all the symptoms will subside don't worry after the reports check any abnormality is there or consult HCM MOREVER follow up screening test after 3months.. ok don't worry",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why my baby not gaoning weight?\n\nDear Sir, My 11 month son is weighing only 7.5kg adn is very thin. Height wise he is fine he is 66 inches. He is good in eating too. He loves his food and eats properly. I am giving him Cow s milk as it suited him. Other milk he was not able to digest and vomit so I changed to cow s milk after he was 6 months old. I wonder why he is not gaining much weight so I did a stool test and belwo is the result. color-Brownish Yellow,Reaction-Acidic,Consistency,Pasty,Mucus-Present(++), Microscopic Examination Helminths:nill Protozoa-Nill Callular Exudates- RBC-Nill Pus Cells:Occasional Macrophase:Nill Undigested food: + veg cells: + Fat Globule: Nill Starch:nill GStaphylococcus aureus - Wikipedia, the free encyclopediaeneral: Bacteria Flora:Moderate Yeast : Absebt I am very much worried for him as he is not gaining much weight. Please suggest.",
    "doctor_response": "hi welcome to forum, I would like to ask few question. 1. what is the child's birth weight? 2. what is his diet chart like? Since he is 11months I suppose he must have been already dewormed. If I were your pediatrician, I would deworm this child, start on Iron Folic acid suppliment and few multivitamin along with proper diet chart , and follow child's growth. Any child would triple his birth weight by 1 year. so if your child has tripled his weight since birth and is developmentally well please do not worry, and give stress in healthy feeding with high calorie intakeThank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting while on Bactrim?\n\nHi my 9 yr. old daughter has been on bactrim for 3 days now for a bladder infection and strep throat, now before she was put on bactrim she had bugbites on her face, they started to clear up but now they look worse she also vomited twice today should I be worried?",
    "doctor_response": "Hello, yes Bactrim can cause vomiting. My advice would be to switch to amoxicillin which is a very good drug for both bladder infections and strep throat.  Stop the bactrim, and give ondansetron for the vomiting. Nothing to worry, she will get better soon. Hope this helped you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluctuation in platelet counts?\n\ni have fluctuation in platelet counts...it goes as much less as 50% of the minimum count and becomes normal without any medication after a week or so. now i am in trimester (6th week). wl this have any complications in my pregnancy. what diet should i take to increase my platelet count",
    "doctor_response": "Hi there,More than the fluctuations in platelet count, we need to make sure that it doesn't get to be less than 1 lakh/dl. Platelets are known to fluctuate in pregnancy. But the lowest level should not be less than one lakh. As this will need precautions during delivery. And platelet levels less than 50,000 do sometimes require platelet transfusions. But do not worry as most low platelets in pregnancy are gestational and revert back to normal themselves after delivery. There is not much relation of platelets to diet and there is no recommended diet.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes left-sided leg pain and a lump while treating varicocele?\n\nHello my name is Lance. Back in September on I got a surgery for varicocele. After the surgery the problem became worse. So I went back for surgery at the end of January and that didn t help either. The pain goes right down my left leg because it is my left testicle that has the problem. Also in my back. Can be very painful if I don t take pain medication. Within the last couple months I also found a circular lump on the testicle. The size of lump is a little bit smaller than a pee. Please help me if you know anything I can do. I am getting another ultra sound soon.",
    "doctor_response": "Cannot say in your particular case and back pain is very common occurring at some time in the life of nearly everyone. The pain that goes out from the back and down the leg is classic for a pinched nerve in the back. This is where that nerve goes. You can get pain from the testical but that typically goes INSIDE and abdominal pain not down the leg.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain when diagnosed with Parkinson s disease\n\nHi, my husband has Parkinson s and it has gotten to the point where his back is hurting so bad it is hard for him to function with every day tasks. From the time he wakes up until the time he sleeps he is in pain. He has had the nerves burned once and fixing to go to the Dr. again to see if it will help him again, even if it is for a few months like before. He has started walking arched over and it s hard for him to straighten up. Please if there is any way to help him not be in as much pain we would appreciate any information that you can give us. Thank you and have a great night.",
    "doctor_response": "Since Parkinson's disease patients typically assume a HUNCHED posture I believe any back pain he is experiencing may be at least partially from this abnormal position of the spine.  At the same time it is also the case that a condition known as DYSTONIA occurs and that can contribute to lumbar muscle pain.  I would not be in favor of \"burning\" nerves....the procedure has a poor overall long term outcome and the more destruction of good tissue that it is done...the more likely he is to develop even more pain in the future from the development of scar tissue.  Very similar things happen in vein stripping procedures....and women who get it done will tell you that initially, it is wonderful and they're happy...but as time goes on they need to get the procedure done more frequently and veins that are taken out are even deeper and the whole picture becomes complicated as it's a never ending chase with more and more veins having to be taken out or sclerosed due to pain and/or cosmetic issues...until there are no more to take out and then, really bad things can happen.  The same goes for \"burning nerves\" as a way of dealing with pain....I would absolutely avoid that procedure.  It is a poor remedy for a problem which unfortunately has few options.  Please rate 5 STAR as an encounter and write me at: www.bit.ly/drdariushsaghafi with more questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does being on ADHD medication and smoking cigarettes cause blood clots?\n\nI am on citalopram  and on ADHD medication called Addoral. And I smoke cigarettes everyday but only like 3-6 a day sometimes...my brother told me that I can't smoke cigarettes and be on the meds cause it is not good for me and i can get a blood clot...so he told me he will take me off my meds without talking to the doctor first if I continue to smoke...but I love smoking cigarettes it helps with my stress...is what my brother telling me true will me smoking give me a blood clot cause I'm on my meds and I'm smoking cigarettes??",
    "doctor_response": "There are chances of clots. Because smoking itself is a risk factor for atherosclerosis And Addoral act on sympathetic nervous system that has role in clottingMoreover, smoking decreases the drug level in body, therefore, higher dose of medicine has to be taken. And taking higher dose of medicine means increasing the side effect profile of the medicineIn addition, smoking complicates the symptom profile of ADHD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Biopsy showing infected cells on cervix and advised to go for leep cone procedure. How long can I delay the procedure?\n\nHello, i am a 34 year old mother of two boys. i recently had a biopsy done becuause i have hpv. the results of the biopsy were that i have infected cells on my cervix. the specialist recommended that i get a leepcone procedure done but i would like to have more children and am afraid to run the risk of miscarrages from the procedure. i know i'm not giving you alot to work with here but how long do you think i can put of the procedure before running a high risk of the cells becoming cancerous? i was told i could also end up getting cryotherapy. i was told depending on which one the insurance would be that would be the one i end up getting. i am really scared.",
    "doctor_response": "HI, thanks for using healthcare magicIt is understandable to be scared. Though cervical cells can take a long time to transform from the initial changes to cancer, it would be best to have the procedure done when suggested by your doctor.There may be a slight increased risk of cervical incompetence (when the cervix opens during pregnancy) but this can be treated with a suture.The benefits of ensuring that there is no risk to cancer progression outweigh the risks.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for distended gallbladder with multiple calculi\n\ngall bladder is distended, its wall thickened , multiple small calculi are seen in the lumen of GB,the Larger one is 8mm, It is a report of USG of Gall Bladder, Now I want to know that how much it is large ,and how it is cured,, by medicine or sergery.pls explain. if u kindly help me ,,I will be bounded to you.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You have multiple stones in gall bladder with thickened wall. So it suggest chronic calcular cholycystitis. Treatment of choice is surgery.  Laproscopic cholycystectomy is the best treatment option. Consult your doctor and plan accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in lower central right side of ribs?\n\nIve been suffering severe pain/bruising to the lower central right side of my ribs, 2 or 3 ribs feel swollen, I  suffer when walking, sitting, standing, laying down, coughing, bathing an especially sleeping are issues?I woke 10 days ago with the pain, I gave up drinking 6yrs ago so I know thats not the cause",
    "doctor_response": "Hai. Thissort of pain, especially in the ribs I is very painful, due to the multiple vnerve innervation. Breathing is really painful.pls take good pain relief tabs like tramadol or dicloofenac, donot restrict ur breath. Go for good deep breathing exercise s, chest physiotherapy, incentive spirometry.u can apply local pain relief gel , it gives you good relief from pain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest an effective alternative for Verapamil\n\nI have had an allergic reaction to Spirolactone, Losartin and now Amlodopine. My Dr. is telling me that he will put me on a Channel BLock, either Verapamil or Diltiazen. After looking them up I don t feel I want to take either one of them. What are some other choices. My Dr. is an Internest, and, a good one. Should I see someone who specializes in high blood pressure such as a cardiologist. The reason my Dr. put me on blood pressure medication (I am 72 years old) is because pressure was jumping around. I have been on a very small dose every other day and it works.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Ok, so option left for you is of hydrochlorothiazide and beta blockers like Metoprolol. So you request your doctor for hydrochlorothiazide 25/50 mg depending upon the need and if need beta blockers may be added. Have low salt diet and regular exercises. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have swelling in the upper right part of abdomen. What could be the reason ?\n\nHi I have some swelling in the upper right part of abdomen above belly button There is a slight burning pain directly in that spot and pain to touch or when I turn Hi. Above belly button and going to the right, there is a little bit of swelling or maybe bloating . To the lower right of belly button, in a very specific area there is a burning/piercing pain. It s no agonizing unless I bend or turn or sit straight up. Should I be really worried??",
    "doctor_response": "Hello. Thanks for writing to us. Most likely you have pulled an abdominal muscle due to overuse. You can do a hot fomentation using a bottle and apply a local analgesic gel for relief. Taking a mild analgesic like acetaminophen will also help you. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drtayalrakhi@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes large itchy lump close to anus?\n\nAbout 2 months ago I had an anal fissure from a large bowel movement , it eventually healed and all symptoms had gone but I have now have a large lump with is hard where one of the fissures was, it has started itching just. Tiny bit and I also have a perfect circular red ring just next to my anus (I dont know if it s related) I don t know what this lump is?",
    "doctor_response": "Hi,from history it seems that there might be having recurring of anal fissure or might be having fistula in ano.formation of red ring might be due to some local skin infection like dermatitis.Apply antibiotic cream locally.If there is no improvement then consult your doctor and get examined.Keep local hygiene proper.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can chemical irritation be causing pain in rib muscle along with dry cough?\n\nHi there.  I had an incident while cleaning my toilet 15 months ago where I unknowingly put bleach in my toilet along with toilet bowl cleaner.  When I inhaled, I couldn't breathe and crawled out of my house unable to get a breath.  I couldn't talk for 2 days and then got better.  In the last 15 months, I have right side 'rib muscle' pain upon pressure, worse after strenuous activity or stress.  I have a dry cough and clearing my throat often.  Could this be long term effects from this chemical irritation and what should I do about it?  Should I be concerned? Thank you, Joni",
    "doctor_response": "Hi thanks for asking question.Noted you have chemical irritant exposure to respiratory tract...So just now by contribution from other causative factors you might have chronic bronchitis....For its diagnosis chest x ray done which shows prominent bronchovascular marking.Pulmonary function test also useful...If needed treatment done with antiinflammatory drug.If inflammation more short course of steroid  can be given...Avoid smoking ....Avoid excess spicy food.Take care.Hope your concern solved.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can the white discharge from gums after having a root canal mean?\n\nApprox 7 years ago I passed out and fell on my face, breaking my 2 front teeth and 1 immediately beside. I had a root canal done on one tooth and was on antibiotics after one day my whole face swelled up. The 3 teeth have since been filled, and not properly repaired due to financial reasons.For the longest time I have had 2 pus pockets on my gums above the damaged teeth that will not go away. If I massage the gums in that area a white creamy substance will come out on a daily basis. Will these pockets ever go away without seeing a dentist or specialist?",
    "doctor_response": "If you had surgery done for root canal and also you now after long time have  2 pus pockets on gums with white creamy discharge coming out this is sure sign of infection growing in your affected gums.This needs special attention by dentist or specialist who can examine the problem and suggest effective remedy for the same.you should not delay for this treatment any further.with best wishes Dr Chowhan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a red sore with blast spot at the center?\n\nI was under the impression that it had closed up ten years ago when I removed it; however, something made me check it today out of  curiosity, I suppose. Stinky, rancid white puss oozed out almost solid, yet malleable and intact. Once removed, there is a blood red sore with some sort of blast spot in the center. I cleaned it with peroxide and anti bacterial soap. What next? Anti biotics?",
    "doctor_response": "Where exactly is the sore .please spificy location and also are.you using any medications or have diabetes or hypertension?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does consistent twitching in lower eyelid indicate?\n\nHello doctor, I have consistent twitching in the bottom lid of my left eye. It has been ongoing for about for two weeks tomorrow.",
    "doctor_response": "Hello. This eyelid twitching can be caused by a number of different problems. In case you have only the eyelid twitch and have no other problems in your eye or other bodily diseases, we label such cases as essential blepharospasm. To reduce this, I suggest you do the following. Avoid tea or coffee completely for a few days. Get around eight hours of sleep at night. In case you have any burning sensation or itching or irritation use an over-the-counter lubricant eyedrop containing Carboxymethylcellulose acetate 0.5 percent 6 to 8 times a day. In case you have any other symptoms with the twitching or have already tried doing the things I just mentioned, please let me know. I would appreciate if you could share your doctor's records, relevant test results with me, I will do my best to help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest solution for loss of apetite\n\nif u have been diagnosed with bone cancer and have been taking the chemo pills because of age been elderly; and the elderly person has no appetite and now has a infection and is on antibiotics and now the white blood cells are to low and the doctor said it was nothing medical that can be done. what would you suggest? But the doctor want the patient to come back to the doctor because the patient is still taking the chemo pills, they want to see if the pills are still working. the doctor said the patient was malnourished because of loss of appetite and that the white blood cells was to low and there was nothing else he could do although the cancer has not spreaded in the bones. Its only in 3 areas, hip bone lower back and upper back.",
    "doctor_response": "Hi,Thanks for writing in.Loss of appetite can be due to many causes. In a patient diagnosed with bone cancer who is taking chemotherapy, the loss of weight is usually due to a side effect of chemotherapy it self or can be a psychological response to the disease condition. Please get a diet plan based on what the patient likes and dislikes. This diet plan should include 1800 to 2000 kcal per day in divided meals.The patient might not like to have large meals and this can be solved by giving small servings of meal every 3 to 4 hours in the daytime. Adding fresh juices and fluids will also help. You can also add cereals and energy foods and fruits. Avoid giving artificially flavored and processed foods.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for low vitamin D level causing numbness?\n\nmy sister underwent valve replacement surgery two month back she is taking acitrom 2mg and 3 mg alternative days after operation she complain numness in her lower right leg and some nerve make some bulge experiance we tested for vitamin d deficiency as per doctor advice it shows very very low what to do now",
    "doctor_response": "Hello, The\u00a0treatment\u00a0may include oral vitamin D2 at 50,000 IU per week for eight weeks. After\u00a0vitamin D\u00a0levels normalize, I suggest a dosage of cholecalciferol (vitamin D3) at 800 to 1,000 IU per day from supplemental sources. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce swelling in toe and discomfort while walking after hitting cot?\n\nMy left leg fourth finger(second from small finger) had hit with steel cot leg on 12.11.12. I have applied Thrmbophob ointment three times daily till date. I also taken suganril tab 3days 3times daily.Till date , Iam not comfort in walking as earlier and finger till swelling and unable to touch and move suggest.",
    "doctor_response": "Hello!Seems like Your toe needs X-ray to confirm diagnosis!Its better to make it and get proper treatment - splinting if needed.Injured toes is better keeping elevated, cold for 15min every hour.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am no longer attractive to my wife mentally. How can I solve this issue?\n\nHello doctor, My wife for 18 years no longer finds me attractive. Not physically but mentally. That is I no longer turn her on because I let her down, have lied and been lazy over the last years. She had already made her mind up to leave me before I knew we had a problem. For the children's sake, she has agreed to go into therapy but admits she does not see much hope of rekindling the lost passion and I am not 100 % convinced that she wants to. We are great friends, hang out a lot together, fitness, date nights, concerts, festivals, etc. We rarely argue, have no money issues, drug or drink abuse or violence. Is there any realistic chance that counseling can turn this around?",
    "doctor_response": "Hello. You have already taken the first step of acknowledging the problem and trying to address it. You have to gradually rebuild the trust, which is crucial for the survival of any relationship. You have admitted to letting your wife down and lying to her, which could have significantly contributed to your wife's negative feelings towards the relationship. It is difficult to comment further without knowing your wife's perspective. Couples therapy or marital therapy can potentially help to salvage the relationship. As you may know, you cannot predict success in all the cases, but I have personally seen several families benefitting from the intervention. I will advise you to attend therapy sincerely and take it from there. Make sure that your wife does not feel pressurized in doing things against her wishes. It is interesting to note that you are still great friends, and there are no significant conflicts involved. Did your wife not challenge you when you were lying and let her down? Has she internalized all her worries, anger instead of talking about them with you openly and seek a resolution? Therapy can help to find common ground and how to handle emotionally difficult scenarios. Marital therapy can come across as challenging but will be helpful. Continue with fun activities together as a family. I hope this helps. You can contact again if any further advice is needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe stomach pain\n\nI had this done in 1980 I have to many problems I cant eat things that are health for me when I try does hurt my stomach hurts bad but my body also I have so many different cancers in my body the food I try to eat I cant doesn t go down I had this done at luke st when this first came out my doctors cant fine out fine out whats going on no one does this here no more I need help to fine out answers here in Denver colo my eating it gets to where it hurts my stomach I live on mashed potatoes and gravy I cant take meats in can someone please help these doctors here don t know to much about this thank you",
    "doctor_response": "Hi.Thanks for your query.Read and understood your history.I looks that you are confused about the problems you have.You have pain in stomach, you can not tolerate many foods that give you pain in abdomen.You have to consult a Gastroenterologist to have detailed clinical evaluation, all the relevant tests.This will help us to get the proper diagnosis and hence the treatment. Please mention all the other problems like which caner/s you have, what is the treatment going on?The details will help us to help you more.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cancer near bladder after a pelvic exenteration\n\nHello . I have a family member that recently had a pelvic exenteration which removed the cancer but recently came back. It is now in the place where her bladder would have been. She has lost a tremendous amount of weight & is too weak for chemo. What other options does she have ?",
    "doctor_response": "Hi,Thanks for writing in.Cancer is a challenging condition but must be treated till the end. If your family member had a cancer near bladder mouth then she must have had locally infiltrative disease requiring exenteration. This is a surgical procedure by which most of the tumor and its adjacent structures are removed. Even after surgery, seeding of cancer cells might take place and has happened in her case.If there is recurrent growth of cancer then she must take combination treatment with chemotherapy and radiation. As you have mentioned that she is too weak for chemotherapy therefore focused radiation remains the most tolerable treatment at the moment but this depends on the general condition and local recurrence of the disease.Please have a discussion with the cancer surgeon and radiation oncologist and proceed with treatment as per the outcome of discussion. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling sensation and numbness in hands and feet?\n\nFor a couple weeks I have had tingling in numbness in my hands and feet also deep muscle aches in my calves but tonight I am having extreme muscle pain in my right outer thigh inhibiting the way I walk.....I have also been dizzy and extremely absent minded as late",
    "doctor_response": "Hi,Thanks for writing in.Symptoms including momentary absent mindedness, dizziness and numbness involving hands and feet should not be ignored. These might have a common origin in the brain and can occur due to reduced blood supply in certain areas or any similar abnormality limiting the functions of the brain. It is suggested that you consult your neurologist at the earliest and get your neurology clinical examination done in detail. Depending on your examination findings, your doctor might advise you to get a MRI scan or CT scan done for the brain. This will rule out any possible condition which might cause your symptoms. The above can be considered mini stroke like episodes and you should not wait anymore.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the symptoms of intrusive thoughts, suicidal thoughts and depression?\n\nHello, I believe I might be experiencing signs of either some type of anxiety disorder or worse. I don t know how to explain without sounding crazy. Intrusive thoughts, suicidal thoughts, depression, fear of everything and I don t know who to talk to.",
    "doctor_response": "Hi, It seems you are suffering with depression with comorbid anxiety symptoms. More details would have been helpful to make  a confidant diagnosis. I would advise you to consult a psychiatrist and start on medications right away as earlier initiation of treatment improves the chance of better outcome. In addition, start exercising on a daily basis.Best wishes. Hope you get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Persisting cough with trouble breathing. Asthma suspected. Not responding to inhalers. What else to do?\n\nHi i have had a persistent cough for 20 weeks now i had a chest x ray last week and that came back clear. I ve had trouble breathing ever since then that will come and go, doctors think i may have asthma but the inhaler doesn t help with my breathing or coughing after ive used it. Just wondered if you could give me any alternatives as to what this might be thank you.",
    "doctor_response": "HI persistent cough has few reasons. 1 post nasal drip  persistant mucus coming from back of nose into throat 2 gastrites 3 vocal cord problems 4 BP drugs so again consult your GP for review Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can shooting high blood pressure be treated?\n\nHello Doctor, I have had quite high blood pressure for about 1-1/2 weeks and I take 1 Coversyl (4mg) in the morning, however, I notice around 6-7pm my pressure starts shooting up again (around 150/88-89) and according to previous days this pattern keeps getting higher to around 189/100 etc. Is it safe or effective for me to take 1 more pill around 8pm - I have been doing this. Thankyou Penny",
    "doctor_response": "Hi,you can certainly take 4 mg twice a day, however you should get your renal function test done.The better option would be Telma AM 40/5 mg once a day, which i would have prescribed in my clinic.Also consume low salt diet and regular exercises.get your lipid profile and sugars tested once. if you have further queries you can get back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Deep purple blood with hint of brown stringy discharge. Should I worry of kidney infection ?\n\nmy doctors think i may have a kidney infection having my test today but after going to the toilet i noticed deep purple blood with hint of brown stringy discharge came out my period is also due in 2 days it has never been that colour should i be worried or what could it mean my white cells are up 14.9 and i did have obviously traces of blood in my urine.",
    "doctor_response": "Hello Thanks for writing to HCM Probably you are suffering from urinary tract infection. You need proper clinical examination and  investigations. Investigations include routine hemogram,RBS,urine RE/ME and culture sensitivity  and ultrasound of abdomen. Hematuria may be due to UTI. Hematuria can also be due to renal or urinary bladder calculus,tumour in kidney or urinary bladder etc. Your W.B.C is also increased ,this indicates towards infective etiologyYou need proper antibiotics,alkalizing syrups and paracetamol if fever. Get well soon. Take Care Dr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fatigue,constant high tempratue and stomach pain?\n\nMy 6 yr old son has been feeling quiet tried for ages now, always sleep and has high temps.And is always saying his stomach hurts. And isn't putting on weight or eating much One dr told me it was just end of school tiredness, when I know it isn't. We finally just had blood tests on Friday, some results say its low iron levels and an infection.What else could this be",
    "doctor_response": "Helmints, because anemia. You give cefixime 8mg/kg daily 5 days.If his weight 20-22.5  kg then give 4.5 ml 2 times if syrupe 100mg/5ml. Also you can give ORS 1 litr during day, charcol 3 tab before night, then after 5 days give albendazol- Zibend 10ml before night, then buy iron syrope. For further treatment i need his weight, then i will prescribe iron syrupe",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I get pregnant when suffering from PCOD and hypothyroidism?\n\nhello doctor, Myself shruti, i got married recently three months ago, and two months ago i got diaognised for hypothyroidism and PCOD condition. I am not getting my periods regularly. Is there any chance of conceiving? I got my TSH levels back in normal condition.",
    "doctor_response": "Hi Good evening PCOD and Hypothyroidism are easily treatable conditions. Follow your gynaecologist advice regularly to get your periods regularly. Then there should not be a problem in your conception. Check your TSH also regularly. Start taking Folic acid under your Gynaecologist supervision. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness,constant headaches and high heart beat rate?\n\ni am a 28 year old woman. for the last 6 months i have been lightheaded,constant headache, head pressure, fast heart rate. Ive had eyes checked and all was fine. Had bloodwork done and again all was fine. Was sent to cardiologist and many test and found nothing. was prescribed coreg to slow down my heart,but doesnt seem to  help. Im going to see a neurologist soon.Any ideas??",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Since your extensive investigations are normal, no need to worry for major heart related diseases. Possibility of stress and anxiety related symptoms is more. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on it's solution. You may need anxiolytic drugs too. Don't worry, counselling and drugs will solve your problem. So avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood in urine and itching of penis?\n\ntwo  days  ago  after  my  morning  pee  i  noticed  blood  in  the  bowl ....  later  that  day  i  noticed  blood  in  my  underwear  ...  now  ,   no  more  blood  when  peeing   .. my  penis  has  been   itchy  for  the  last   week  or  so   i  have  had  sex  with  same  girl  for  a  bout  a  year  and  she's   very  faithfull    what  could  be   wrong  ..???",
    "doctor_response": "Hello, This blood could be due to a number of reasons like stones in urinary tract or infection as well. I suggest you go to your doctor to have some tests to rule out these possibilities. Meanwhile drinking plenty of water to clear both infection and stone as well. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr SAMEEN BIN NAEEM, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe cramps in the hands?\n\nHello,my condition started with numbness in both hands mainly from middle finger to pinky. I could not even write my name very well. This lasted about 3 months. Then numbness in both hands went away. Then my hands started to cramp up really badly. This occurs when I start using my hands to do anything. They cramp up so badly I have to use my other hand to straighten then out. When I straighten then out and completely relax then, the cramping goes away. I had times during this past winter where my hands were exposed to the cold and became numb. I m thinking possible nerve damage because of this. What do you think?",
    "doctor_response": "Hi, Welcome to Healthcaremagic.com. I had gone through your question I can understand your concern about your hand muscle spasm and cramps. As per your history and symptoms your chronic muscle seems to be because of calcium deficiency or vitamin D deficiency. You may need the blood calcium and other electrolyte investigation done before starting your treatment. In case you have any respiratory related issue like hyperventilating one that can be the cause too. You need to take healthy foods with better calcium in it, also visit a general physician for further evaluation and investigations. Hope my answer will help you and visit us back if you have any further queries. Regards Dr Muzaffer Hussain Parray",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent muscle twitching in bicep, left eye and thigh?\n\nI have been experiencing frequent muscle twitching in the bicep of my left arm. It happens 3 to 4 times a day and is so prominent that I can actually see my muscle twitching. My left eye has been twitching as well and sometimes left thigh as well. It was all on the left side until today when I felt twitches on my right arm and thigh muscle. Should I be concerned. What could be the possible reason for this?",
    "doctor_response": "Hello, First of all, you might experience might be a simple muscle twitching medically also called fasciculation which could be due to many reasons starting from simple anxiety, neuropathy to seizure. You need thorough clinical examination and take proper note or keep writing of how many times twitching happens and get a neurology consultation. Till that time you can do the following. 1) Make sure you are not under any stress. 2) Chances of muscles getting fatigued like excess workout or other activities are nil. 3) You are getting proper sleep (as even getting not proper sleep can affect eye twitches). 4) Make a note and timing of the muscle getting twitched 5) With these consult a neurologist as he can look for any signs of muscle weakness or fatigue or wasting. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr ASIF, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the solution for Obsessive, compulsive disorder ?\n\nhi doctor my sis is 24 old and she is having habit of wasting much water like if anything to give for wash she use plenty of water so her hands become rough.we are taken her to sycologist he advice her that her mind set is like that so admit her in hospital for 5 days or 1 month and she is becoming very thin please advice what i have to do.i am not have intrest to admit her b coz in that hospital many different people i found and i feel that may be my sister will fee lthat we r admiting her in pagal hospital.",
    "doctor_response": "thanks for choosing health care majic.she is in need of psychiatrist help.I can understand your concerns for admitting her in mental hospital.But speak to your doctor and ask him if you can try something initially at home.some times a trial can be taken.In mean time explain her that this is not normal and why all of you are not doing this ? so this is not acceptable.Repeated counseling by counselor and relative support will really help",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have enlarged gallbladder, severe pain, nausea. Done Ultrasound. How to get relief?\n\nI have an enlarged gallbladder that is slow emptying and filling suffered with severe pain a number of times no stones ultrasound showed sludge I suffer with nausea which lasts for a week to 10 days at a time suffering with this for 4 to 5 months hope you can help GP said my symptoms have nothing to do with my gallbladder",
    "doctor_response": "Hello Welcome to HCM, I will try my best to provide you with best possible professional recommendations to your questions. As your doctor as said your symptoms are not attributed to gall bladder, you need not worry. you can take antacids like H2 blockers or proton pump inhibitors available over the counter, which may help you to relive your symptoms. REGARDS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bacterial vaginosis\n\nhi,i have been diagnosed with Bacterial Vaginosis twice in different clinics and even after the medication-Metronidazole it doesnt seem to clear,or sometimes it goes for afew days and the discharge is back,and it gets worse(amount and smell) when my periods are about to come like now.Could it be a misdiagnosis?",
    "doctor_response": "there is a possibility but a vaginal smear should be done before. because different antibiotics are specific for organism involved in vaginal discharge it could be bacterial or fungal.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had seizures. Now stressed. Can I take medicines after a boost? Will I be fine?\n\ni am 45 yr old male, in my life i had seizure complaint in two occasions. the first one was 25yrs back when i felt no rest for consecutive days and second one 2 yrs back when undergone treatment in a hospital for too much official work stress/ tension complaints.now i am taking medicine eption 100mg- 2 tablets/day in night for last 2yrs, recently as per doctor advise i was undergone mediical test for completing 1 yr but the result was not satisfactory infact the level gone up.my doubt is this may becos of alcohol comsumption once in while and medicine will be taken after reaching home from party with in the time gap 1/2 hr - 1 hr 1.now the question is it correct to take medicine after full boost becos doctor advised not to stop medicine even for single day? 2.why the result was not in favour since i am rare case of seizure complaint? 3. now i stopped consuming alhohol for last 6 months and medicine is continued. Will it be helful for next test? 4.give best suggestion.",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your symptoms. You have a mild seizure disorder, as you have had only two episodes of seizures in the past 25 years. I do not understand by \"the test result was not satisfactory\". Please explain what was the test and what was its result? Please upload it here. As far as I am concerned, you are seizure-free for two years while on eptoin (phenytoin), so, it is a good news.I agree that alcohol is not good, so, it is better not to re-start it. Also, keep yourself tension-free and get adequate sleep at night to prevent any recurrence of seizures. I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cough and runny nose in a child?\n\nHi, may I answer your health queries right now ? Please type your query here... I have a 19 month old son with runny nose, congestion and coughing for the past five days. He s not eating and drinking very little fluids. The good thing is their s urine in his diapper probably same amount of his intake. He s cough is getting worst and congestion. No fever but weak probably due to congestion and no food and small amount of fluids. Should I be alarmed?",
    "doctor_response": "Hi, welcome to HCM. This is most probably lower respiratory tract infection. You need to get the child examined by a doctor as soon as possible. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest care needed for boy with VSD having pulmonary lungs pressure\n\nI have a son of 11 yrs. age. He has a VSD in his heart. He is not in a position to operate & close down his VSD, because of his high pulmonary lungs pressure. He is taking Penegra 25 , 1/2 twice a day. His weight & height is normal. Previously he has some Breathing problem but now he is ok. Some doctors said that he will live only 27 to 28 years, some said that 2-3 years. For this reason I have lost my husband in a road accident. Now I want to know can u help me any way by prescribing diet,mediciness. ?",
    "doctor_response": "Hello There After going through your medical query I understand your concern and I would like to tell you that he should continue taking penegra and kindly consult a pediatric cardiologist personally for proper physical and diagnostic evaluation so that proper medical support can be provided to your son and to make him able to undergo VSD closure.Hopefully this information will answer your query.Kind RegardsDr Bhanu Partap",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for child suffering from fever and eyes pain\n\nMy 4 year old daughter has had a fever for about 5 days, her temperature has been 103 under her arm, it goes down a little when we give her ibuprofen and alternate with tylenol but goes right back up as soon as we stop.  She says her throat doesn't hurt, she did say a couple of times that her eyes hurt, but doesn't complain of anything else.  She looks really pale.  What should I do?",
    "doctor_response": "evaluate for viral fevers like dengue, malaria, typhoid.. because, all these fever are of sudden onset which are of high grade temperature and head ache along with retro orbital pain or eye pain.. do a complete blood profile with peripheral smear and widal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the maximum dosage of hydroxyzine hcl?\n\nHow much hydroxyzine hcl can i take at a time and how often? I suffer from Major panic and anxiety disorder. I was taking 1mg klonapin three times a day for 4 years. They cold terkied me off of it. Suffering from high blood pressure and high panic and anxiety because of this bright move by my mental health provider. My medical doc gave hydroxyzine.",
    "doctor_response": "high panic and anxiety levels have to be tackled first here blood pressure will be taken care of.the maximum calm mind the maximum normal blood pressure.here a combination of chandraprabha along with sarpagandha,kurasani owa.jatamaunshi,brahmi combination should be according to me.shirodhara nad nasya will be of additional benefit.yoga  therapy of anulome vilome and kapal bhati will be enhancing the the medicine effect.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have a bubble on penis head of an infant post circumcision?\n\nMy 1 week old baby got circumcised yesterday. When we got home everything looked raw but normal. This morning when I changed his diaper I noticed a bubble on the side of the head of the penis. Is this normal or should I take my baby to the doctors office? Please help",
    "doctor_response": "Yes after circumcision there may be ballooning at the edges where incision was made post surgery , once healing starts it will disappear gradually over next 7 to 8 days. not to worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Whom should I consult for my daughter's high prolactin?\n\nHi doctor, My daughter's prolactin is 238. What is the cause behind this? Whom should I consult for this? What is the further treatment? There is no headache or stress. She had some periods problem before and now she is fine with that. Please help.",
    "doctor_response": "Hi. I need a little more information to help you better. Revert back with the answers to the above questions to an endocrinologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pigmentation removal\n\nI have pigments on my face, how can I remove these ?",
    "doctor_response": "Hi!meenakshi, Welcome to HealthcareMagic Forum, Treatment of pigmentation on face depends upon the level of pigmentation..is it dermal or epidermal.There are lot of options available like topical creams ,sunscreens..to chemical peeling to lasers.You need to visit a dermatologist for proper treatment. take care, Dr.chawda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe itchiness in the penis and scrotum after intercourse?\n\nI haven t had sexual intercourse so that is ruled out,my groin mainly scrotum and base of penis is often very itchy and I scratch @ scratch until skin comes off and sometimes bleeds a little because once start to scratch I cannot stop until it all has gone but then taken off a layer of skin,WHAT is wrong with it please !!, from Chris in Lincoln England",
    "doctor_response": "Surely a skin issue and it may be a fungal infection of the skin. Sometimes, allergic reaction may occure to undergarments, secretions of vagina etc. It is better to clean the part with mild soap and apply mometasone caream. Clotrimazole dusting powder may also be sprinkled.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why my 5 month old is vomiting?\n\n5 month old has been sick for 5days. Took him to doc yesterday. They said hes probably almost done with it and well hydrated. This morning I woke up to him choking on thick Mucusy vomit. Every other time he's thrown up it's been really thin and watery. He didnt throw up hardly at all yesterday only once",
    "doctor_response": "HI...by what you quote I feel that the infant is having severe form of GER (gastroesophageal reflux).Your daughter will need - 1. Antireflux therapy - Proton pump inhibitors + antiemetics2. Always make her lie down in a propped up position - as in the care seat. She should not be sleeping completely flatly.3. Avoid heavy feeding and feeding more times and in small aliquots.4. This type of GER is the root cause for the constipation she is having.She needs expert gastroenterology consultation.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "History of hysterectomy. Have pancreatitis, low WBC, high liver enzymes. Have morphine pump. Nausea, pain. What to do?\n\nin 2005 I had a hystroactomy that is when I got this pain that was so painful . I was still in hospital and no one believed me. I got out of hospital. well I could write a book. no doctors believed me went to many doctors and two hospitals they all said it was in my head. to me all I knew was I was in so much pain I was dying and well I went to rio  grand hospital and they believe I was in pain and nothing was working. well it does not show up in my blood but they did a mri and they said I had cancer  my pancrase was very very large all I knew I was in pain and thank god they believed me. they said I had 6  or so months to live. well I have been to so my doctors I am still alive and in so much pain. about almost two yrs ago I had a morfin pain pump put in and I hate it  cause very so many weeks or so I get the pain so high again and I get so sick nusia and throw up all I have go in cause I am dihidered need iv and doctor up the morphln . I don't have a live. it harts to talk. and I cant do much with this pain I cant think. I don't know what to do any more. sorry about the spelling if you can help me. I think doctor did something wrong when he did the hystroacomy cause he was so unkind when I said I had this pain he got mad u don't know how ugly he was to me  a nurse said he throw away my medical records and made an other one so I don't know . at the time I just wanted my pain to go away.i never went back to him. I am in so much pain its been eight yrs  what do I do????????  oh they say what I have is cronic pancreatitis , low white count cells. high liver emz, my feet and legs swell up bad. bad gland and eight things in my tyroids that I cant get bioci need gland out first, and other things I didn't have. now I have every doctor and no money and It harts to eat.",
    "doctor_response": "Hi, sorry to know about your hystory, any how there wont be any relation between the hysterectomy, and pancriatitis. And you have so many problems, probably they are diagnised in finding the cause of pain, but not actually felt of the problem.                               I to my patient with such pain prescribe omeprazole, domperidone, dycyclomine hydrochloride, for pain relief and epitite.                              Practice diversion procedures like yoga, meditation, reading books and hearing music. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe abdominal pain , leg pain and swollen lymph node\n\nMy son is almost 8 he became very sick in April with abdominal pain swollen lymph nodes and legs hurting he has had blood test a cbc , MPv ,CRP and they have come back normal .but since then he has had very low energy and complains of his legs hurting all over and has started to gain weight. There have been times he didn t want to go to the pool and just wanted to lay down and he loves the pool. This is not growing pains. Or a normal energy level for a 8year-old boy Who used to be very active.",
    "doctor_response": "Hi.Thanks for your query about your son. Read and understood the history and the concerns. He has pain in abdomen pain in legs and lymph nodes enlargement. You have not mentioned the site of the lymph nodes. With the history your have provided and the reports of the blood tests remaining normal, it is imperative to have the following:- Get a clinical evaluation by a Pediatric Surgeon.Further investigations as may be required by Him.Most important is the FNAC or biopsy if the lymph nodes as it is possible toi get a proper diagnosis and a plan for proper treatment.. CT scan of the abdomen if required. I hope this answers your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes water blisters all over body along with loose motions in infants?\n\nyes my baby is 3 months ols and he has water blister all over his head and body which starts out in nots red ones they are on his back and ect,and he is bowel is running everytime he tajes an bottle it comes right out of him the doctors here are having an bad time tryintg to see what it is they are water bumps mainly on his head. what can it be please help",
    "doctor_response": "Hi...by what you quote I feel that your kid has got 2 problems which need to be addressed - 1. Skin problem in the form of blisters.2. Loose stools.1. Skin problem - kin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically. 2. Diarrhea - I  do not think it is diarrhea at all as he is passing stools every time after feeds - What your kid is having is not a diarrhea and is only a gastro-colic reflux. It is quite common for babies of this age group t pass small amount of diarrhea or loose stools soon after feeds. This need not be treated as diarrhea and especially antibiotics are not indicated.Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high ESR levels of 44\n\nHi, my daughter have 3 and half years old and the doctor said that she have irritable hips, he did the blood test for here and it was ok just the ESR was 44 any the found two + in here urine test can you advise me the the ESR is high.With RegardsZead",
    "doctor_response": "Hi,Thanks and welcome to healthcare magic.High ESR can be present from common cold to carcinoma.If it is very high like 70-80 or even more you can think of a chronic disease like TB or malignancy.In your case you need not worry .consult your doctor to rule out any infection,usually urinary tract infection .Hope this reply is OK for you.Please feel free to ask further queries if any.Dr.M.V.Subrahmanyam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump after fall from chair and its treatment ?\n\nMy 82 year old mother (alzheimer) fell last night from a stool Mere inches....it wasn't a hard fall but soon after a lump formed on her behind on what would be the fatty part if she had fat. What could this be? She can walk...but it hurts to sit or lay a certain way",
    "doctor_response": "Hello and welcome to HCM,The lump formed on the back could be due to trauma or the lump could have come into focus after trauma.A clinical assessment of the lesion is required.Relevant investigations are required to know the nature of the lesion.An aspiration cytology of the lesion is required to know the site, origin and nature of the lesion.After knowing the character of the lesion appropriate management can be done.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from ear pain, and feel like the whole head is blocked. Why?\n\nHello doctor, I am suffering from ear pain, and a kind of the whole head is blocked like sensation. The left and right ears are blocked with some air or water like state. I have this ear pain for four days gradually on the same pain note. I have taken Aceclofenac with Paracetamol and Amoxicillin. I have also tried Otorex ear drops but the pain neither reduced or increased. The right ear is a kind of inflamed and not even let the drops go through. I am already on Deplatt A, Concor, and Imdur in the morning and Amlong and Rosuvastatin in the night for my angina complaint. I am also on Thyronorm 75 mcg in the morning. I am scared to go out to a hospital due to the pandemic effects, so please advise.",
    "doctor_response": "Hi. It looks like you have developed what we call as eustachian tube catarrh. This tube ventilates both the nose and the ear and can get blocked due to allergy or sinusitis or in any upper respiratory infection such as common flu. If you have allergic issues, it has to be adequately treated. Tablet Sinarest (a combination of Acetaminophen, Chlorpheniramine, and Pseudoephedrine) one tablet two times a day, i.e., 12 hours apart for one week can be considered. Otrivin nasal drops three drops three times a day for 10 days should also help. Valsalva exercise 15 to 20 times a day. Steam inhalations also do give a little relief. Antibiotics and painkillers will not help as it does not treat the problem. However, complete the course of your antibiotics and do not stop them halfway. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure cyst on the gum with yellowish discharge?\n\nhi,i suspect i have dental cyst on my gums.2 weeks ago,i had an extraction,the dentist said that the tooth did not break so there isn't any part of that tooth still in my gums(it's a baby tooth without any adult tooth)the next day,my gums beside the extracted tooth became swollen.A few days later,i found a bump on the gum.I used my tongue to push it and yellowish liquid came out of the healing area(the place of extracted tooth was covering up)so should i continue pushing it so it can recover?(normally people say that for a cyst to heal,the substance inside have to be pushed out)or i have to consult a dentist?I need a answer as soon as possible because i am going to see my dentist to put on braces on tuesday.Thank You",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. Actually this bump with yellowish discharge means it is an abscess filled with pus, this abscess forms when there is infection,  so better to visit your dentist again and get an x - ray of that area where the bump is, it will show clearly the infection. Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cancer in bile duct\n\nmy husband was diagnosed with lung cancer withspread tobrain. the brain tumor was removed. has had chand radiation. after eight months has had right lung removed. now we have new cancer in his bile duct. astintwas placed to releive symptoms. is there any thing that can be done at this point",
    "doctor_response": "there is treatemnt but only in people who dont have any other sign of tumor in body. so tumor must be located opnly in bile duct. even then,prognosis ispoor but surgery could lead to com'plete tumor removal if this is well localizated. wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain with pressure, painful joints and dizziness?\n\nMy chest has hurt for 3 days now. It s hurts when I breathe, and cough. There is a lot of pain and pressure in the center of my chest, like my whole chest, especially when I bend, lay down, squat down. That pain when I do those 3 things spreads to my head. I ve had a headache for 4 days now. My whole body feels like I have the flu, achey and painful joints. I m a 34 yr old female, with SLS,and cardiomiopothy. I also get dizzy spells 5-6 times a day, lasting 10-30seconds, they cause extreme brightness in my eyes to where I can t see and my head feels hot. My BP is 88/ 57 and pulse is 80bpm. Any thought, help, advice I welcome. Thank you for your time.",
    "doctor_response": "Hi Dear !! Thanks for your query to HCM.Read and reviewed facts of your health query.I understood your health concerns. My Impression-Based on facts of your query,You seems to suffer from-LRTI with Low Blood Pressure from CardioMyopathy.Meticulous use of antihypertensive drugs,early checks to treat the cause of Chest pain would resolve your issues of dizziness/ headaches.Anitibiotic treatment for lung infections causing achy painful joints, which are common with cardiomyopathic failed cardio-respiratory functions.The review of anti-arrhytmic drugs and pacemakers for anti-arrhythmic problems would reduce the frequency of dizzy spells , which are mainly due to VFS/Premature beats/ AFs with Cardiomyopathy,Regular treatment reviews  from Cardiologist even for lung infections is needed in your case, as these lung infections are related to arrhythmia induced heart failures of your heartHope this would help to plan treatment with your doctors.Keep Me updated whenever needed , 24 x 7, to help you out by even,online tips for You, on weekly basis. Welcome for any further query in this regard.Good Day!!Dr.Savaskar M.N.Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in upper left chest and above the breast?\n\nFor over a week now I've been having pain in my upper left chest above my breast when my heart starts to beat really fast. It usually happens when I'm relaxed. My dr said my blood pressure was high in november 120 over 94 so he has me on Lisiniprol and also doubled my metformin dosage to 2000 mg per day. Are these symptons of a stroke or heart attack? Ive also been very bloated and gassy and the pain I have in my chest I've had  for years. I just have never had such rapid heart beats and its causing me to freak out. I'm due to go back to my Dr in feb. I also have shoulder pain but again, i have a bone spur there. The upper central part of my spine feels sore as well. I have a tons of issues going on in my life right now but I cant tell if its anxiety or truly heart attack/stroke related.",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!I carefully passed through your question and would explain that it is important peforming a comprehensive differential diagnosis of different causes that may lead to these symptoms: - gastro-esophageal reflux or hiatal hernia- a musculo-skeletal pain, including costochondritis. - a backbone disorderl - coronary artery disease, although the symptoms occurring at rest are not typical of this disorder- anxiety could mimic this clinical scenario I would recommend performing some tests: - a chest X ray study- a resting ECG and cardiac ultrasound to examine your cardiac function and structure - an ambulatory 24-48 hours ECG monitoring to examine your heart rhythm through the day- some blood lab tests (complete blood count, PCR, sedimentation rate) for inflammationA fibrogastroscopy may be necessary if all the above tests result normal, to help rule in/out possible gastro-esophageal reflux. If all the above tests result normal, you should consider anxiety as the main cause of your symptoms. In such case you should consult with a specialist of the field. Hope to have been helpful!Best wishes, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I use Kojivit gel to get fair skin?\n\nHi doctor, I am a 22 year old female. I have a dusky skin that is brown skin. I want to become fair. Can I use Kojivit gel? Or any other dermoatology cream can I use? My hands are also brown in color and full of tan. Do you suggest any creams to get fair? I want to become fair as my marriage is going to get fixed by next year. Please suggest me some creams, so that it should not show any side effects. Also, how long I should use it? If I use anything, then will it have any effect in case of pregnancy, etc? Please help me. Thanks in advance.",
    "doctor_response": "Hi. One's skin color has 2 components. First one is genetic, which cannot be changed. Every skin color is beautiful in its own way and we should learn to love our skin color and augment it and not hide or lighten it. The second component is acquired, which is due to the influence of environment, sunlight, hormones, aging, etc. We can only target the acquired component of fair skin color while attempting lightening procedures. I suggest you antioxidant capsules like capsule Antoxid HC (Beta-carotene) and apply sunscreen lotion Lashield gel at 8 AM and 12 PM. Also, you can apply Glyaha koj lotion (Hydroquinone) at night time. Start with an alternate night application initialy as it may irritate your skin a bit and after a week or so, shift to daily night application. Consult your specialist doctor, discuss with him or her and take the treatment with consent. You can go for chemical peeling or microdermabrasion from your dermatologist which will help in exfoliating and give you a clearer skin tone. All these treatments are free of side effects. You may use them for three months. For further information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the role of chronic glomerulonephritis in causing death?\n\nMy Grandmother died in 1943 @ 29 yrs old during a hospital stay of 16 days. The Death Cert identified the following. Immediate Cause of Death: Uremia Due to chronic Glomerulonephritis....Major findings of an operation identifed sub acute appendicitis and hydrops of gall bladder. Can you pls put this in context for a layman?",
    "doctor_response": "Hi,There are many causes of chronic glomerularnephritis1. Rapidly progressive glomerulonephritis or crescentic glomerulonephritis2. Focal segmental glomerulosclerosis3. Membranous nephropathy4. Membranoproliferative glomerulonephritis5. IgA nephropathy6. Poststreptococcal glomerulonephritis7. Lupus nephritisIn 1943, the medical research was still under progress and many of the causes were unknown. So your grandmother might have had one of the above causes for a while before she had appendicitis and gall bladder hydrops. Her kidney condition led to complications during surgery and death. It is very difficult to say which of the above conditions she had as in those days kidney biopsy was not done regularly and microscopes were also still under development. The actual pathological picture was still not identifiable.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from loose motion\n\nMY CHILD IS 12 MONTHS OLD.SHE IS HAVING 6-8 MOTIONS A DAY SINCE 8 MONTHS.I TRIED MANY DOCTORS BUT OF NO USE. CAN ANY DOCTOR SUGGESTS A SOLTION TO THAT.STOOL TEST HAS BEEEN CARRIED OUT BUT THE RESULTS ARE NORMAL.",
    "doctor_response": "Hello; welcome to HealthcareMagic. Since the stool examination report shows that the stools are normal it is usrely normal and your baby does not have any problems.Few points to remember are that :- -a child can pass stools as many times as it takes feeding. -if your baby is more than 8 months even teething can give rise to loose motions. -if the baby is treated with any sort of antibiotics then also it can loose motions. Presently if your baby has not lost weight or does not seem to be dehydrated then please don't worry as  the loose motions are normal and they do not need to be treated.Just in case if you still want you can give your baby a probiotic like Nutrolin-B 5 ml twice a day for 5 days and she should be fine. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can eating broccoli cause nosebleeds while suffering from cardiomyopathy?\n\nMy 10 year old has had blood in his nose the last two days. It was just in there yesterday but today I looked at him Nd it was running a bit down his nose. He does have Cardiomiopathy and Duchennes md. Might sound silly but he eats a ton of broccoli and I hear that can thin your blood but can it cause bloody noses?",
    "doctor_response": "Hello, Great leafy vegetables increase blood thickness and are not a cause of nose bleed, kindly consult with an ENT physician personally for proper physical and diagnostic evaluation and management. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sudden onset of cramps, stabbing in lower abdomen post sex with heaviness in belly, clear discharge, vaginal itching, have ic in kidneys. Help?\n\nHi two days ago my husband and I had intercourse about an hour later I had a sudden onset of cramps and a stabbing pain in my lower abdomine and lower left side of back . As the days have gone on I m now very bloated and the pain and cramps are a constant . I also have a feeling of heavyness in my belly there has been a clear discharge and a light itching in my vaginal area but no odor . A lot of movement seems to aggravate it I do have what Dr called ic in my kidneys and am on elmeron for treatment please help",
    "doctor_response": "Hi,Thanks for writing in.You have been given elmeron for interstitial cystitis (IC).Recently you are having cramps and lower abdominal pain (started after sex) and clear odorless vaginal discharge. There is documented painful sexual intercourse in women having interstitial cystitis. In women, the pain tends to worsen during menstruation.IC generally develops in middle age, and many people with IC also have other pain-related conditions, such as irritable bowel syndrome or fibromyalgia.Please discuss your situation with your urologist.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am 30year old & have bad acne & new spots coming again and again on my face. How to get rid of it ?\n\nI have very bad acne prob I'm 30year old I have tried to do every thing to clean my face plz help I am 30 year old f , I have acne prob every week new spots coming again and again on my face and it s very pain full as well plz tel me what to do when spots coming it s all on red color and then after one day turn to White I have to pop them up because it s won t looks nice on face plz help me how to treat them",
    "doctor_response": "hi, In Ayurvedic medicinal texts this disease is mentioned as Tarunya Pitika. The etiopathology of the disease is considered due to vitiated Blood (Rakta Dushti) along with vitiated Kapha and Vata. Vitiated Kapha blocks the normal excretory function of skin and get the waste material stagnated inside, producing symptoms like itching, pustules and nodules formation. Vitiated Rakta that also get stagnated and produces multiple irruptions, redness, raised local temperature, thick bloody discharge from the boils and abscess formation. Then irritation, blackish discoloration and ugly scar formation is worked out by Vitiated Vata. Raktamokshan (Blood letting) is a well-accepted treatment for Vitiated Rakta Dosha. Much better results can be obtained with supplementation of internal medicine and local application of Lepa (Face pack). Face pack made up of Lodhra(Symlocos racemosus), Vacha(Acorus Calamus), Dhanyak(Coriandrum Sativum), Chandan(Santalum album) and Ushir(Vettiveria Zizanioides) is very beneficial. Smooth paste of Jatiphala(Myristica Fragrance) will help to remove black spots of remnants of acne. Blood purifiers like Sariva(Hemidesmus Indicus), Anantmula(Tylophora Asthmatica), Guduchi(Tinospora Cordifolia) and Manjishtha(Rubia Cordifolia) are used for internal medication. for more information you can call me on my mob.no.9424883137 Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I expect regular period after consuming postinor post unprotected sex?\n\nHello Doc, I had unprotected sex with my guy and he thought some fluid might have leaked into me. The next day I took the Postinor morning-after pill. About 2-3 days after, my pill-period came. This was like maybe the 25th December. Just for the record, I had already gotten my regular period for that month. Now it is the 14th of January and I m seeing what appears to be another period. Is this my regular period back on track or not?",
    "doctor_response": "Hello ma'am and welcome.The bleed you experienced after taking the pill was a side effect of postinor. Your menstrual cycle should return to normal by the next expected period or the month after that.Based on the provided information, it does sound like your period is back on track.Hope this helps.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in feeding in infants?\n\nhi, my baby hasnt been very well the last month or so, she had broncitus and confirmed swine flue, before she was bad she was drinking nearly 5oz but now she goes between 3-4oz. sometimes when shes taking her bottle it seems like shes struggling and her body starts to tense up.",
    "doctor_response": "Hello,It shows her nose is stuffed give normal saline drops in both noses three to four times a day. Also, give the stream twice a day as it will help to secretions to flow and will be easy for baby to get feed. Do nasal cleaning when secretions got soft to keep baby in semi-prone position while feeding.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Hina Javed",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for high BP of 166 over 104\n\nI am taking a 50mg tablet daily for blood pressure over 4 years. I am  53 years.6 weeks ago my reading was 153 over 98 and yesterday when I got another reading in a health store it was 166 over 104.I am worried about this but for last two weeks I am getting stress headache over problem with girlfriend-maybe this is the cause. I eat healthy and exercise 6 days a week walking fast. Have not drunk alcohol in 3 weeks.my weight is fine at 12 stone 4 pounds and 6 feet tall.What should i do please.",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern.You should not worry about. I will try to explain you something and give you my opinion. You should know that when we treat hypertension our goal is to keep mean blood pressure values below 140 / 90 mmHg.A person might have high value during emotional and physical strees so its mandatory to judge on mean values. It is possible that a stressed period might affect your blood pressure values.If I was your treating doctor I would recommend some examination like a cardiac echo to evaluate heart function and walls, a full blood analyze to chek your renal function and a holter pressure monitoring to evaluate your values during day and night. After all this we can better judge and exclude secondary factors of this values and of they are really high in mean time.If it results so, than you can rise your medical dosage or add another class but you should discuss this with your doctor after previous examinations. Hope I was helpfull. Best regards ,Dr.Ervina.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Clonazepam, Fluvoxamine, Oxacarbezapine. Have hair loss, mood swings, weight gain. Problem?\n\nat present i am having many medicines which include clonazepam 0.5mg, fluvoxamine 50mg, oxcarbezapine 300mg, reperidone plus, lithium sr 300mg. ( all twice a day ). in past i have suffered from a relationship breakup (main),fear from people or any work , hair loss , weight gain , mood swing, fear of getting out of the home, negative thoughts etc. i am having these medicines from past 3yrs. i just want to know whats the main disease or problem i have and i want to quit them as soon as possible, my age is just 21yrs, i am from INDIA. waiting for a healthy reply and during first two years these dose were more than twice.",
    "doctor_response": "HelloYou are taking clonazepam, fluvoxamine, oxcarbamazepine, resperidone and lithium carbonate. You have mood swings, fear at work place, loss of hair, weight gain, negative thoughts and fear to get out of home. Such symptoms can occur due to a number of reasons and depression, bipolar disorder are common possibilities. I would like to know a little more about your symptoms to exactly differentiate your diagnosis. The medicines like lithium, resperidone, oxcabamazepine etc are usually used to control mood swings and any manic excitement. Hope I cleared your doubt, thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest possible treatments for bronchitis and Sinusitis\n\nhi, i was recently diagnosed with bronchitis and sinusitus and possible strep. i have been sick for two weeks now. i still have sinus issues but my main problem is my cough. its not productive, dry, and my chest is killing me. every breath i take makes me cough and its hard to breath. do i need to go back to the doctor? thanks",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Best treatment of bronchitis is inhaled treatment. Since you are not taking inhaled treatment, your bronchitis (cough) is noticed improving.So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test).PFT will not only diagnose bronchitis but it will also tell you about severity of the disease and treatment is based on severity only. You will mostly improve with inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heaviness in the chest and severe cough?\n\nOver the past several weeks, I ve had a heavy sensation in my chest which periodically will cause me to cough. My throat is not sore, there is no drainage, and my breathing seems normal. I do get laryngitis every once in a while with my last episode about a month ago. I believe the laryngitis was triggered by a severe case of acid reflux late one night. I m wondering if this chest heaviness, fullness could be related to the acid reflux.",
    "doctor_response": "thanks for asking your questioni completely understand your problemheaviness in the chest and cough can be related to acid reflux, no doubt, actually recurrent reflux causes some amount of acid to drag down into the respiratory tube that is trachea from the oesophagus so this reflux irritates respiratory tract and causes cough . for this kind of cough u need to take some proton pump inhibitors like pantoprazole before breakfast . other causes of heaviness in chest with cough can be bronchial asthma.u can consult a pulmonologist  to rule out the causes.thanks/regardsfeel free to ask more questionsmay god bless you with good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could bumps in mouth, rashes on left arm with bumps after eating chocolate suggest allergy to cocoa?\n\nHi doctor I have a question. So lately I ve been eating chocolate and it s been a long time cuz i really don t care for it but anyways ever since I ve been eating chocolate in been getting bumps in my mouth and some kinda skin rash on my left arm with bumps. Is it possible I m allergic to coco?",
    "doctor_response": "Hello,Welcome to HCM,As per your history and the clinical presentation it looks like you are allergic to chocolates.To confirm that you have to test your blood for absolute eosinophill count (AEC) and confirm whether there is any allergic manifestations in your body.If there is elevated AEC, you need to undergo patch test for the suspected allergen and confirm whether there is any allergic reaction for chocolates. If there is a allergic reaction you need to avoid the chocolates otherwise you will get the symptoms when ever consume the chocolates.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is chest pain normal after drinking beer?\n\nhi, i am 18 years old i weight about 145 im 5'2 and my question is if normal to have chest pain after drinking? last night i drank alot of beer and i didnt have a good meal, after drinking i took a couple of hits of weed and thats what got me really sick i was throwing up every 5 min but i would throw up black. Now i feel like my chest burns and my food stays in my throat. is it normal?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Yes, this kind of symptoms are common after heavy beer drinking. Beer is alcoholic drink. And alcoholic drinks are known to cause GERD (gastroesophageal reflux disease). GERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause symptoms burning central chest pain, nausea, vomiting etc. So better not to drink beer or other alcoholic drinks. Take pantoprazole and levosulperide combination on empty stomach for symptomatic relief. Avoid hot and spicy food. Avoid junk food. Avoid stress and tension, be relax and calm. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does Entocort intake cause severe anemia?\n\nHello doctor, I am a 62-year-old female. I was diagnosed with collagenous colitis following colonoscopy biopsies. I started on Entocort, three days later I have severe swelling in feet and ankles. I am fatigued the next day. On the seventh day, I had swelling of lips and a strange feeling in the throat. I called the doctor and he stopped the medication. My blood report shows: Hemoglobin - 3.6 g/dL, RBC - 1.38 million/mm3, Iron - 11, Saturation - 3. Fecal stool sample postive. I went to the ER, I was given two units of blood. My hemoglobin raised to 7.5 the next day. I was discharged. Endoscopy was performed and my biopsy report is negative. I had minor stomach inflammation. My next bloodwork shows Hemoglobin - 8.1 g/dL, RBC - 3.05 million/mm3, Iron - 51, Saturation 12. Vitamin B12 - 648. Immunoglobulins A and G are pretty low. Gastroenterologist says need to do small cap endoscopy to see if there is bleeding in the small intestine. My new stool sample results are not back yet, but stools have not been dark. What other tests need to be done to determine the cause of anemia? List the possible that medication caused anemia since I had such a severe reaction. Current medications: No prescription, only supplements. Vitamin D3, CoQ 10, Methyl B12, and Curcumin.",
    "doctor_response": "Hi. Entocort (Budesonide) is a corticosteroid. It is very unlikely to cause anemia, especially to the extent that you had. What was your hemoglobin prior to the colonoscopy? If it was near normal and then dropped to 3.6, that would be a huge drop. If you had gastrointestinal bleeding leading to such a huge drop in hemoglobin in a short span of time, I would expect that you would have noticed the blood in your stool. Minor bleeding over longer periods can lead to anemia, and in those cases, serum ferritin (a storage form of iron) would be low. Acute blood loss anemia usually does not cause serum ferritin to drop. Did you have a serum ferritin level done along with your other iron studies? If the serum ferritin is less than 15, it is almost definitely iron deficiency. Iron deficiency is either due to dietary reasons or blood loss. Dietary iron deficiency is rare in developed countries. So, blood loss has to be ruled out. If no obvious reason is identified on upper GI endoscopy or colonoscopy, then small bowel pathology has to be ruled out by capsule endoscopy. Other reasons for a rapid drop in hemoglobin would be hemolysis (where the red blood cells are destroyed for various reasons). This would be diagnosed by tests like: 1. Peripheral blood smear 2. Serum haptoglobin 3. Direct and indirect bilirubin 4. Direct Coomb's test 5. LDH (lactic acid dehydrogenase). Please attach any reports you have with you. That may help me give you a better answer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever in a child after a dog bite?\n\nyes my son was with his dad the other day and he got bit by a puppy . in which it barely broke the skin and he has a few blisters around the site of the bite. he is 2 years old, and he now has a low grade fever of 101.9 degrees F. should we be concerned..",
    "doctor_response": "Thanks for posting your query at HealthCareMagic. Dogs, like other mammals are prone to having a disease called rabies which is lethal in humans and does not have any cure. I would strongly suggest that you get your child vaccinated immediately with the proper course of anti rabies vaccine. The fever that you are talking about is not low grade and probably due to a bacterial infection that might have occurred during the skin breach. He may require some antibiotics after the blood work has been done. Please contact your pediatrician.Hope that I have been able to address your queries. Feel free to revert back in case of further questions if any.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are antibiotics the right medication for severe pain in the groin area?\n\nSomeone is having major issues with SERVERE PAIN IN HIS GROIN area ... had a MRI done and was told he has a bad infection in his groin (HUGE BULGE KNOTT ) causing unbearable pain he said ... first thought it might be a hernia ... however was told INFECTION IN GROIN and was put on strong anitbotic.",
    "doctor_response": "Hello Since the MRI shows the presence of an infection in the groin area so the right treatment is an antibiotherapy.For the hernia there are a number of symptoms which mainly is the existence of a bulge being more visible by effort and reduced by hand and it's not that painful unless if it's strangulated, Unlike the infection, which is painful with redness of the skin and increasing of the skin temperature over the area and sometimes a fever.I suggest that you trust the doctors and continue the treatment to prevent any further complication.Hope I answered your question Best regards Dr. Noor Farid",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ovarian cyst\n\nI am a 50, I have gone through Menopause. I have a history of having an Ovarian Cyst and have been treated for Polyps twice, I had 3 polyps removed in 2005. I seem to be having all the symptoms since last week of an Ovarian cyst, I am having some spotting and bleeding when I go to the bathroom. I no longer have a regular Dr. and not sure if I should wait it out or go to the ER. Thank you Lucia",
    "doctor_response": "Hello dear,I understand your concern.Usually absence of periods for 6 months during the menopausal age is considered as menopause.In my opinion any spotting or bleeding after that 6 months of period free interval is considered as postmenopausal bleeding(PMB).This PMB should be definitely investigated to rule out any endometrial pathology .Usually a  minor procedure called D&C is done where in the endometrium is scraped and sent for testing to rule out any endometrial abnormality.And ultrasound helps in knowing the thickness of endometrium.The endometrium thickness is considered to be normal upto 5 mm in menopause.Also the management of ovarian cysts depend on the size and nature of the cysts which are known by ultrasound.So relax.Avoid stress.Nothing to worry as such.Because nothing is confirmed without physical examination and relevant investigations.Kindly consult your doctor and get investigated to rule out the cause for spotting.Hope this helps.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of autism in a child?\n\nHi, i have a almost 14 year old child who was born with lots of issues. some of those are vsd of the heart, grand mauld seizures not sure how you spell that, and has serious delays when it comes to schooling... he is also very withdrawn and talks to himself alot , he was born with a partial deleted chromosome number 23 , theres actually lots of things we notice him doing , but im just curious could he possibly be dealing with autism",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The autism is characterised by spontaneous and repetitive movements, lack of social interaction (both verbal and non verbal) and limited language development. The autistic child often remain to themselves and rarely concerned with presence or absence of strangers/parents. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for missing tailbone in 21 month old kid\n\nI just found out our 21mo son is missing his tailbone and the doctors here are stating that this is a quite serious issue. We have had x-rays and an ultrasound done and are now awaiting an MRI for further evaluation. We can t find any real information on this issue and can t get any legitimate answers on the subject. Help please",
    "doctor_response": "Missing or absent tail bone can be a serious issue depending on the type. Actually what happens in this is that there is developmental defect in the lower spine which is of several types like partial abscence of tail bone , complete abscence, abscence associated with surrounding structures and bones. Symptoms can be absent in mild form to devastating in its severe form. Symptomps are like poor bowel and urinary control , incontinence and poor urinary control which can appear later as in this age gruop the control is not achieved. More severe symptomps are lower limbs deformities to various levels. First thing is to assess that how much structural defect is present, which can be best picked by MRI scan. Then only the prognosis will be clearly made to you. Do not lose hope first get the mri report, there are various treatment options available for the condition physiotherapy medical and surgical.",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI showed annular bulge on disc. Is there any treatment other than surgery?\n\nOn my MRI there was shown a slight annular buldge at L4-5 with slighyly more prominent left lateral asymmetric bulging componet versus mimimal left lateral disc protusion extending slightly into the left neural foramen. This asymmertic bulge and or minimal disc protrusion lies immediately adjacent to the exiting left-sided nerve root . There is an associated left posterolateral radial annular tear noted, can this heal itself, or would it take surgery",
    "doctor_response": "Hi, Thank you for posting your query. As per your MRI report, you seem to have mild disc bulge. In this condition, most patients would not require surgery. Treatment would consist of medications to relieve pain (such as pregabalin or gabapentin). In addition, physiotherapy and back extension exercises are also useful. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes upper stomach pain during third trimester?\n\nI'm 38 weeks pregnant and have been having pain in my upper stomach, mostly on the right side.  I've had it for about 7 hours now.  Sometimes it gets worse, but always a dull pain.  I've tried lying down on both sides, sitting walking and nothing seems to help.",
    "doctor_response": "Hi,it seems that this pain might be due to constipation or acid reflux common at this stage of pregnancy.take plenty of water and mild laxative after consulting your Obst.There is one possibility of having starting of labor pain as well.Consult Obst. and get examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest tightening?\n\nHi, im currently taking lagap doxylag 100mg to reduce my acne, and my face do shows and improvement. i took it 2mths back for a period of 1 mth and stop for the next mth. on the 1st time i took it, sometimes i experienced nausea, however when i started to take it this time, im having a chest tighthening. it still bearable and i really wants to get rid of the acne. why is it cause chest tightening? will it become more serious that can harm my body? thanks",
    "doctor_response": "Hello,   Most probably a gastritis and reflux disease.    Do you also have upper abdominal pain, nausea, bloating, burping, increase in pain on food, sour water feeling in throat or chest burning, these are the other symptoms and may be associated.     You should avoid fatty, oily and spicy diet. Have some walk after having food instead of taking rest. Have multiple small meals instead of heavy meals. Have regular sleep habits and avoid stress. Lots of green leafy vegetables, fruits. Avoid smoking and alcohol if any. Elevate head end of the bed or use pillows during sleep.You can get prescribed tab Pan DSR 40 mg or esomiprazole domperidone combination beforebreakfast once a day along with your medicine to reduce acidity, reflux. If not adequately relieved, then you should add Syr sucral O or gelusil two teaspoon three times a day for a week.   Hope this helps you and get back if you have any doubts.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dull ache in the left biceps\n\nHello. I m 41, and two years ago while doing pullups, I felt something give in my left biceps. As a former athlete I am familiar with broken bones, sprains, tendonitits, et cetera, but have been surprised that my biceps has ached off an on for two years. There is no bulge indicating a torn tendon, and really there has been no loss of strength either. Like I said, I m surprised the dull ache has continued and am asking for a course of action. Thanks.",
    "doctor_response": "Hi, According to me There may be biceps Strain or partial tear of fibers in both above condition you cannot see pop up of belly. I think you can avoid 4 week biceps exercise and allow those muscle fiber to heal and keep your arm in sling and then after 4 to 6 weeks, gradually start exercise if then also pain persists, get an MRI done. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Gaurang B. Shah, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do headaches, nausea, fatigue, eye and ear aches indicate?\n\nHi, I m trying to figure out what is wrong with me. I have a major headache in the right side of my head, it feels tense like a rubber and is wrapped around it, my eyes burn/have pain. Accompanied with it is nausea fatigue, feeling foggy, ear pains and noises, and hot/cold flashes. Can you please tell me what this could be?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. In my opinion, diagnoses to consider in your case include sinusitis, tension-type headaches, and, if you are female in your 50s, menopause. Discuss with your doctor about getting evaluated further in order to get diagnosed correctly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Erion Spaho",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mild stroke\n\nI had a mild stroke last November with no real obvious side effects. I was taking atorvastatin 10mg daily but my Dr took me off 2 months ago because I was having cramps in my feed and hands. I am still having cramps but also in my calves now. I am having pressure in my head and for a couple of days now I am having what feels like vibrations in my left chest on and off. No pain with it though and no shortness of breath. I don t know if some of this is due to anxiety but I never have a day when I feel good. I have had my heart checked and blood work and have an appt for bloodwork on Monday. My Dr doesn t seem to have any real idea of what may be going on. I have an appt with a neurologist in a couple of weeks but I am really worried about what all is going on. I am a 62 year old female, I do not smoke, I weigh about 167 and exercise regularly",
    "doctor_response": "I read your question carefully and I understand your concern.The symptoms you relate though don't seem to be related to the stroke it is more probable they are due to anxiety. It is good you have done blood work for some other potential causes, I hope thyroid function was included as a common cause of anxiety.As for stroke treatment it consists in identifying the cause and addressing it in order to prevent recurrences in the future. Most common causes are heart arrhythmias, high blood pressure, diabetes, smoking, high cholesterol. I suppose you have been evaluated for those. Also you should take a blood thinner.I hope to have been of help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Throbbing sensation in spine in sync with heartbeat. On lexapro and wellbutrin. No issues with thyroid. Thoughts?\n\nGood evening! I am a 29 year old BF.  280 lbs, 5' 4\".  I have a similar query as one posted on the webpage.  I have been experiencing a throbbing sensation in my spine.  It does seem to throb in sync with my heartbeat.  It usually occurs when I have just sat down or when I am about to stand up.  I have been on anti-depressants/anti-anxiety medications over the last 10 years.  I have finally gotten to a wonderful cocktail of Lexapro 40 mg and Wellbutrin 150mg.  (I am aware of being over the recommended dose for the former).  My tests have shown that I do not have any issues with my thyroid, I do not drink alcohol nor do I smoke.  I've experienced this throbbing for about 6 years or so, but it has been increasing over time- I may have the sensation 3-4 times per week.  They last for several seconds to a minute.  My reflex is to tighten up and freeze as movement makes the pain worse.  My body does seem to get hot during this \"attack\", and I do not normally feel tense or anxious before as it usually occurs when I'm relaxed.",
    "doctor_response": "Hi, it appears to be the pain due to the gastric hyper acidity, or a muscular pain due to the over weight.                             I advise you to consult a physician for diagnosis and treatment.                             I advise you to avoid spices, junk foods, and oily foods.                              Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the side effect of kingtropin?\n\nhello im taking kingtropin for the last 30 day and i notice that i have headheaches and wrisk pain. is there a mayor side effect? im 44 yrs old athletic and this is the first time im taking this or any other product. im injecting 2 units daily. what is the risk of taking it?",
    "doctor_response": "Hi, Yes, headache and wrist pain are important side effects of kingtropin. Kingtropin (human growth hormone) is commonly misused by athelete in an attempt to increase exercise capacity, improve bone density, build muscle mass, and reduce body fat. Its used is associated with a high risk for getting carpal tunnel syndrome (wrist pains), muscle, or joint pain, swelling of the arms and legs from fluid retention (edema), high cholesterol levels, high blood pressure, an increased risk of heart disease and diabetes, growth of facial features, hands, and feet (acromegaly), enlarged male breast, enlarged heart, and liver damage. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mohammed Taher Ali",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the dosage of Clexane?\n\nHi my 86 year old husband is on 2 x 20ml Clexane for a blood clot in his upper thigh. I usually inject him in the stomach at 9.30 am then again at 9.30 pm. I am wondering if it would be alright on occasions to vary the times to e.g 6.30pm then 6.00am. I am concerned that at some point of the time change the injection would be less than 12 hours apart.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I would not be worried, but I would recommend that you find a time of the day where you can reliably give the medicine and then again 12 hours later, instead of shifting back and forth. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Small stones found in both kidneys after a 9mm Kidney Stone laser blasted. Is this normal ?\n\nI recently had a 9mm Kidney Stone laser blasted in July.  My CT showed smaller stones in both my kidneys. A week after the surgery I had the stent removed. Later that night I passed a 3mm stone. A recent x-ray showed a stone in my right kidney and minute stone in my left kidney. The stone that was blasted was analyzed. The results were 100% Carbonate Apatite.My doctor gave me a diet to follow to reduce the possibility of new stones and keep the stones currently in my kidneys from getting bigger. I researched Carbonate Apatite stones online and now I'm confused. The information I found said most of these types of stones are caused by some kind of infection, most common UTI, but also kidney. Also, any stones should be removed from the kidneys. They called the stones, infection stones.Should I get a second opinion? I'm concerned I am not receiving the appropriate treatment. I am female - 51 years oldI do not have a UTI, and my urine is clear. I have never had a kidney stone prior to last month. Thank you for your assistance.",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum. Stone ( calculus ) in the urinary system causes sever  discomfort  but why stone formation take place exact etiology is not known. I usually prescribe my patients plenty of fluid in any form with lemon juice twice in day with water on empty stomach. 2 ndly I  prescribe disodium hydrogen syrup . In India only tablet calcury or neeri 2-2-2 till stone expel from urinary system. I tried a formula over many patient successfully without any side  effects , you can try , Take black pepper chew them one by one 10 first day  on empty stomach early in the morning . After chewing drink 300 ml milk add in it ghee ( butter )20 gm. Now drink plain water maximum as you can up to 7 hours . Diuresis will occurs .  2nd day take 20 black pepper and  drink milk as first days. 3 rd day 30 black pepper . No side effect. Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for an infected thumb?\n\nthe Dr here said I have a contushion along with an infection that resembles a terable pimple. he proscribed bactrum and that was 2 nights ago. sence then my condition has gotten worse. I can no longer move the end of my thumb (where the problem stemed from) and the pain has radiated into my index finger, palm and down my arm. I have no feaver or nausea. I have been takeing advil and the antibiotic. keeping it elevated and applying cold compresses. the area came to a head and I took a hyperalergenic tattoo needel and opened it to releave preshure. green and yellow puss excreated and then it was followed by blood. however it keeps filling and swelling. the pain is at an almost intolerable level and I ve already racked up a heafty co pay bill. what are some signes that I should be looking for twords a more serious condition? and am I doing everything I can at this point to make it better?",
    "doctor_response": "Hi,It seems that your infection spread all over your palm from thumb.It requires urgent attention, so consult surgeon and get examined as soon as possible.Once pus is formed, you have to go for incision and drainage which will be more troublesome.You might require iv antibiotics to control your infection.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Am i sweating because of anxiety?\n\nI am a fourteen year old girl with anxiety problems, I am on Prozac and Clomapam  for my anxiety. The anxiety causes me to sweat profusley and when I get really anxious I feel like I have to urinate all the time.  My underwear keeps getting wet and I am not sure if it is just sweating from the anxiety or if I am having bladder problems becuase I need to urinate all the time.  This morning I went to the bathroom and there was a little wet patch in the middle of my underwear, also I have a funny odor around my vagina which is sort of fishy smelling. For a while, I was having very thick discharge and went on a medication for yeast infections.  The fluid on my underwear today smelled fishy and salty.  Do have a vaginal infection, or is that just normal odor? Am I sweating because of my anxiety (I also sweat under my arms a lot too) or do I have incontince problems because of my anxiety? I am very confused and this is embarassing.",
    "doctor_response": "Hello and welcome to Healthcare Magic. Thanks for your query.I understand that you are quite distressed and worried about your recent symptoms. The symptom of increased sweating can very often be a manifestation of anxiety. However, there can be other medical causes like thyroid problems, etc.  The incontinence is unlikely to be a symptom of anxiety. Regarding the foul-smelling vaginal discharge, it is likely that it is due to an infection. Now, since you are having multiple symptoms, I suggest that it is better to see a doctor for a proper examination and evaluation.Wish you all the best.Regards,Dr. Jonas SundarakumarConsultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for fluid at the feet\n\nDear Dr. Agarwal, Last Sunday I had been fallen from the bike and there created a wound beneth my knee. The location has been swalloed with a reddish spot but not bleeding. That day I took a titenus injection and consulted with MBBS doctor, who suggested me for a 5 day Amoxicilin and Potassium Clauvanate Course alongwith Pain Killer and Betadine ointment. After using it for 5 days I found little improvement but nor remarkable one though doctor assured me it will be OK within 5 days. After that I consulted with another doctor who told that Amoxicilin is not perfect for this condition and suggested Cefuroxime Axetil Dispersible Tablets for 4 days with 2 tablet daily alongwith Chymoral Forte and ointment Mupirocin. After using this I found the would becoming dry but there fluid has started to gater at my feet resulting into problem in walking. Kindly advise what to do?? I am 45+ with no suger having medication of BP and is working in Office. Pl. note that I have attend Office due to some urgent work . Kindly advise suitably per return. awaiting for your reply",
    "doctor_response": "Hello, If I were a treating doctor,I would consider possibility of cellulitis only after clinical examination.Visit General surgeon who might apply Magnesium Sulphate Dressing along with change in antibiotics. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Rajesh Gayakwad",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest cold\n\nhi Im a sixteen year old male i am about 5 6 and 120 pounds.  think I have a chest cold? I dont know for a little while now mainly when i lay down to sleep I have shortness of breath or the feeling of holding my breath for a quick second. But also My heart begins to beat really fast. I do have aniexty and I am just starting to take my medication. Is this a chest cold or aniexty what should I do?",
    "doctor_response": "Hi welcome to the health care magic According to history it seems more like stress induce panic attack is the reason Continue to take anti-anxiety medications and do yoga daily Exercise and meditation will be beneficial Still here cardiac cause and PNH like causes has to be ruled out Work up done by... -EKG -Auscultation-Blood pressure measurement -PS examination etc According to cause further specific treatment given Take care Consult physician for examination",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes running nose and irritating cough?\n\nHi, I have irritating cough along with accasional running nose WITHOUT having cold. Sometimes it is dry, sometimes cough is yellowish and sometimes it is dark in color. I visited ENT doc and he suggested Amoxycillin tab, LCZ plus and RESWAS syrup. After having taken for 5 days it is not yet perfectly ok. I had sinus problem in the past.",
    "doctor_response": "HelloIrritating cough ,Running nose ,Cough is associated with yellowish color phlegm or sometimes dark in color,An old case of sinus problem.Amoxycillin , lecoceterizine and cough syrup ( reswas) are not working .When patient with these symptoms visit my clinic I usually advise them to take monteleukast+ bambuterole tablet once or twice in day till complete cure . If sore throat is there I advise them to take levofloxacin 750 mg once in day for 5 days .I also advise my patient to avoid contact with mite , dust , pollen , mold , sudden change in temperature , fine dusting powder , hay . Because these are predisposing factors causing sinus problem and allergy ( as you may have these symptoms due to asthmatic allergic bronchitis ) .Hot coffee and steam inhalation also act as bronchodilators . All these symptoms are due to bronchoconstriction caused by these predisposing factors.Since these drugs are prescription drugs so please consult a physician and take a prescription.Hope this information will be helpful for you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain and numbness in arm\n\nin August 2014 I was at work and I twisted my real fast and fill while my arm left arm head bashed into two metal pieces sticking upwards hitting my elbow and wrist which had took out a chunk of skin from my wrist.after that had taken place I lifted something over my head causing my left hand to go numb and tingle. Next day I had horrible pain. My orthopedic said no fracture just contusions and development of tendonitis. Later my shoulder and back started hurting (did nothing about it).then I was diagnosed with having symptoms of RSD. at physical therapy they seen major weakness 20lb l arm and 100lb right grippain with holding my arm out causing heavyness. And irritation to heat and textures. Arm turns purple when exercise. After doing a nerve compression exercise pain development I m left pink ring finger badly and new movements cause worse pain and numbess on top of horrible pain In the arm. Should I go back to orthopedic . what could it me . also I development high heart rate and bp after being examed after injury.",
    "doctor_response": "Hi your symptoms look like neural involvement, and you need assessment of your nerves of your limb. The best would be to consult a hand surgeon in your area. They are trained to deal with various nerve compressions of upper limb.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the medication for high BP?\n\nHi, i have high blood pressure since 3 months back with an average of 14.5/9.5 (Sometimes reaching 16/11). i started taking Amlor 5 mg twice per day however it didnt give full stability of BP in addition to the severe side effects. i shifted to Concor 2.5 mg then concor 5 mg once per day without getting a 100% stability for my BP eventhough my BP got reduced. Now, i moved to 1 pill of concor 5 mg morning and 1 pill of Amlor 5 mg evenning starting 7 days back where my BP become fully stabilized with an average of 12/8. Please advise if it is accetpable to take this dosage of BP medicine and if there are any inconvenience in taking AMlor + concor 5 mg on medium and long term and if this combination is considered to be a long term solution for my BP... thank you in advance.",
    "doctor_response": "Hi,After going through your case record it is clear that after trying different anti hypertensive medications your Blood pressure is stabilized with Tab Concor 5 & Tab Amlor 5.I want to know -1) Your age, gender.2) Family history of high BP.3) Any associated conditions like diabetes, high cholesterol, heart disease.4) Height and weight (BMI).5) Habits like smoking, alcohol.These medicines are usually safe and can be used for longer duration unless side effects develop.You should understand that your doctor has prescribed this medication because he or she has judged that the benefit by using them is greater than the risk of side effects. Serious side effects rarely occur with these drugs.You should know about side effects of these medicines.Concor (Bisoprolol):1) Tiredness, slow heartbeat, fainting and dizziness may occur.2) It may reduce blood flow to your hands and feet, causing them to feel cold. Smoking may worsen this effect.3) Mood change may occur.4) It may aggravate asthma if present.5) It may mask the symptoms and signs of hypoglycemia (low blood sugar level) in diabetic patients on treatment.Amlor (Amlodipine)Dizziness, light headedness, swelling over feet or flushing may occur.Other important factors that may help you - 1) Salt restricted diet. 2) Intake of fruits and green leafy vegetables. 3) Regular checking of blood pressure, lipid profile, blood sugar levels and keep them under control.   In conditions like Diabetes, heart diseases other medicines can be preferred because of there specific beneficial actions other than lowering blood pressure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does loss of differentiation of cortex and medullae in a kidney mean ?\n\nID NO : 96/387653 Date: 22-03-11 Patient s Name: Mrs. Nuzrat Tasmin I Age: 27 Years Sex: Female Refd.By : Prof. Dr. A BM Abdullah. Part Scan : ULTRASONOGRAPHYOF ABDOMINOPELVIC ORGANS SUMMARYOF FINDINGS HBS LIVER: \u2022 Is normal in size (12.7 cm). in right mid clavicular line \u2022 Uniform in parenchymal echotexture. \u2022 No focal or diffuse lesion is seen. \u2022 Intra hepatic veins and portal veins appear normal. \u2022 Intrahepatic biliary trees are not dilated. GALL BLADDER: \u2022 Is normal in size (5.8 x 2.6) cm. \u2022 Wall thickness is within normal limit (2.2mm). \u2022 No evidence of echogenic structure or biliary sludge is seen within the lumen .. CBD: \u2022 Is not dilated (4.0mm). , \u2022 No evidence of echogenic structure or biliary sludge is seen within the lumen. PANCREAS: \u2022 Normal in size. \u2022 Parenchymalechotexture is homogeneous. \u2022 Pancreatic duct is not dilated. . SPLEEN: \u2022 Normal in size (8.5 cm). \u2022 Parenchymal echotexture is uniform. \u2022 No focal lesion is seen. KUB: RIGHT KIDNEY : \u2022 Is enlarged in size in TD and in bipolar diameter. measuring about 14.0 cm. normal in shape and position. \u2022 Loss of-differentiation of cortex and medullae. \u2022 Pelvi-calyceal system could not be evaluated properly. \u2022 There are multiple anechoic lesions seen allthrough the parenchyma. the largest one is measuring about 5.7x4.8cm which contains internal echoes. LEFT KIDNEY : \u2022 Is enlarged in size in bipolar diameter, measuring about 13.5 cm, normal in shape and position \u2022 Well-differentiated cortex and medullae. \u2022 Pelvi-calycealsystem is not dilated. \u2022 There are multiple tiny an anechoic lesions seen allthrough the parenchyma. \u2022 Perinephric space appears normal. URETERS: No evidence of any obstructive feature seen in any Ureteric region. URINARY BLADDER: \u2022 Is partially filled and normal in outline. \u2022 Wall thickness is within normal limit \u2022 No intravesical lesion or calculus is seen. UTERUS AND ADNEXAE: Uterus: \u2022 Is bulky in size (8.0x4.8x5.6)cm, anteverted in position \u2022 Uniform parenchymal echotexture of myometrium. \u2022 Endometrial thickness is 9.0 mm, which is within normal limit. Right Ovary \u2022 Is normal in size, shape and position and has follicular activities. \u2022 The ovary is measuring about (3.1x1.9) cm. Left Ovary \u2022 Is normal in size, shape and position and has follicular activities . \u2022 The ovary is measuring about (3.4x1.6) cm. CUL-DE-SAC: \u2022 No free fluid is seen in cul-d~-sQc. OTHERS: NO EVIDENCE OF ANY ABNORMAL FREE OR ORGANIZ",
    "doctor_response": "Hello and welcome to healthcare forum. Your usg report is suggestive that you are suffering from adult polycystic kidney disease. As such there is no specific treatment to eradicate this condition and only option is kidney transplant. You will require renal function test every 3 months to know present status of kidney function and according to that decision of transplant will be taken. So, consult a nephrologist for further management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does concerta affect sperm count ?\n\nDOES CONCERTA EFFECT SPERM COUNT AND DESIRE?",
    "doctor_response": "welcome to healthcaremagic,sperm count and desire have no co-relation.sperm count can be low if also aperson is healthy and having much desire .it totally depends in the hormonal balance maintained in the body .this is only by having blood test done.for an expert advice consult a sexologist and with the blood reports",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tore frenulum during intercourse\n\nHi, my frenulum tore this morning and bled quite a bit during sexual intercourse. I retracted my foreskin once after it happened to look at it and it was quite painful so i put it back after quickly washing it. I tried retracting it a couple hours ago and it started to bleed again. I retracted it enough to put neosporin on the top of the cut but not all the way. Should I try retracting it all the way?",
    "doctor_response": "Thanks for asking in healthcaremagic forum Frenulum can get teared/injured during intercourse/masturbation if proper lubrication and method is not followed. So, if you are not getting relief by applying antibiotic cream please visit a doctor who can guide you in this and manage your wound. Avoid intercourse/masturbation and frequent retraction till it heals. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for painful hard lump on left side of calf muscle\n\nHi. I have a hard lump on my left inside calf muscle. It is painful when I press on it and it has a slight discoloration on the skin over it. I noticed it a few days ago. It isn't visible to the eye, you have to press on it to feel it. What could this be and should I be concerned?",
    "doctor_response": "Hi,From history it seems that there might be having some vascular insufficiency causing minor injury to capillaries leading to hard lump.There might be having varicose vein giving rise this lump as well.consult your doctor and get examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Got cavities filled. Getting pain in jaw and hurts to swallow. What's wrong?\n\nI got cavities filled on Friday today is now Wednesday. On the right side of my mouth it hurts to swallow , and my jaw hurts if I open it wide, and I have my wisdom tooth coming in on the bottom right side and the gums around and on top of it are swollen. The pain is so severe it wakes me up in the middle of the night. What is wrong?",
    "doctor_response": "Hello, I am Dr.Neha Gupta (dentist) and am glad to address to your query here. the type of history you are presenting here directly indicate to your wisdom tooth infection known as pericoronitis. In this situation pain may refer to ear, neck & head. immediately start up with warm saline rinses & betadine rinses, along with antibiotic course including amoxycilline 500mg TDS & ibuprofen 400 mg TDS. Than visit to your dentist for check iopa x-ray and treatment plan according to that. Take care and please keep me informed of your progress at healthcaremagic through my profile directly. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain around middle of back?\n\nFor the last 2 nights I have woken up in great pain....a band of pain around the middle of my back. No other symptoms...just a spasm type pain which makes it really difficult to move. Once I am upright, the pain starts to ease. Any idea what might be causing this?",
    "doctor_response": "Hello,Thanks for your query.After going through your query I came to know that you are suffering from muscular pain.Treatment of it is rest and analgesics (diclofenac three times a day after meals) andmuscle relaxant such as thiocolchicoside can be added. Vitamin B-complex and Vitamin C  supplementation can used to promote healing. It may take a week time to relief. However you can get his chest x ray done to exclude bony pain. You can discuss with your treating Doctor about it.I do hope that you have found something helpful and I will be glad to answer any further query. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly suggest the symptoms of breast cancer.\n\nHello doctor, Suspicious cancer in my breast scanning report. What are the symptoms of breast cancer? The report mentioned there is a relatively well defined hypoechoic mass with small calcifications at periphery. There is no necrosis. Suspicious cancer. No enlarged axillary node. BI-RADS 5.",
    "doctor_response": "Hello. Looking at this report, the suspicious finding needs to be evaluated further (attachment removed to protect patient identity). You need to do the following things. 1. Consult a breast surgeon or an oncologist, who takes complete history such as since when these symptoms started, any family history, etc. He or she examines this and gives his or her point of view. 2. If needed this mass should be biopsied or Fnac (fine-needle aspiration cytology) preferably under USG (ultrasound) guidance. Depending on the report we can take things further. Regarding symptoms of breast cancer, there are many such as a lump in the breast which is increasing in size, location of the lump, nipple discharge, and skin changes over the breast, etc. Occasionally there are none. Kindly revert if you have any queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dark vaginal discharge during pregnancy?\n\nHi, I recently found out I\u2019m pregnant I took two pregnancy test both coming up positive and then took a digital one to tel me how far I am gone which said 3+ weeks. Very early days I know. But I\u2019m experiencing a dark colour blood like discharge the past few days? I\u2019m so worried is this normal",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Please go for proper checkup, as this condition is not normal. I hope this information has been helpful for you. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful injury on ball of the feet\n\nI stepped on a broken beer bottle in the lake 24 hours ago. It was a large very pointy piece that entered the ball of my foot. It feels very deep and is extremely painful still. I am not able to put any pressure on my foot not even to wrap it. It is red around the wond and white right at the wond opening. Do I need to go to the er so it doesnt get infected due to the lake water and since my primary doctor isnt open till monday?",
    "doctor_response": "go to the ER to undergo a wound debridment if needed and wrapping. antibiotics as amoxi-clav (if you are not allergic) or doxycyclin, adding metronidazole covering (for clostridium perfringens/tetani) are mandatory. ER doctors will decide if giving to you them orally or through intravenous/intramuscular injection. if you didn't receive a antitetanic vaccine, ask for antitetanic immunoglobulins, that are fundamental.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it to be concerned about the pain in the back due to a fall?\n\nI fell down steps - actually the last two - but hit the edge of step with my lower back - on one side above my waist.I'm on Advil but without it, it's difficult to get out of bed.  Once up, it is just so sore to the touch and getting up and down at work.  I don't see any bruising so far (happened two days ago).  Advil does relieve but didn't know if I should get it checked out.",
    "doctor_response": "hello.... I must say you should do at least a xray of your lumbosacral spine.. that will rule out any fracture in your back...if there isnt any fracture on xray then only a rest for few days will suffice...",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to remove painless lump on forehead?\n\nHello, I have noticed that I have developed a lump over the right side of my eyebrow on my forehead. It has been there for several months. I am not sure if I bumped my head and ignored it, but it does not hurt and I forget its there until someone asks me about it. When i rub it feels like something is inside of it. What do you suggest?",
    "doctor_response": "Hi,It seems that there might be having small lipoma or sebaceous cyst producing movable lump.Nothing to worry, if size increase or it becomes painful then consult surgeon and get it removed.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shoulder pain?\n\nI had shoulder pain on my left one a few weeks ago. The doctors gave me a cortical steroid shot and after a few days the pain went away. Now the pain is back. I have heard of a frozen shoulder or tendinitis. I dont do any exercising or heavy lifting so we are unsure of what initiated the initial pain.",
    "doctor_response": "Hello, Your symptoms seem to be related to tendinitis of the shoulder. I recommend using anti inflammatory medications such as Ibuprofen 400 mg three times a day. I also recommend physical therapy to help recovery the movement of the shoulder. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my toddlers legs in deep purple color with red blotches all over the top?\n\nWe were at the beach and it was cooler out and we noticed that our toddlers legs were a deep purple color from the knees down with lacy red blotches all over the top of the purple. It didn't seem to bother him, and you couldn't feel anything. What could this be?",
    "doctor_response": "Hi...by what you quote I feel that it could be due ambient temperature which was lower. If the kid is well otherwise you need not worry. It will settle down once the ambient temperature goes up.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could improper bowel movement with slimy feces and bloating indicate?\n\nHi doctors, I have a two year old daughter. when I gave her solid food on 9 mos old, she had sticky, slimy poop, n then bleeding stool. so we stop giving her solid food until she was a year. she can eat solid food now, but she often gets stomac2 upset. In a few days, she poops well, then she can t poop for 2-3 days, then poop the sticky, slimy feces.She complains about having stomach ache quite often. I have paid attention to her food, guessing which is suitable n wihich is not, but cant find a conclusion bcoz she shows different reaction towards the same food, sometimes fine, sometimes not.What to do, doc? She gets lot of wind in her tummy. these last 3 weeks, she sometimes poops 6-7 times in 24h. She even sleeps in fear, rejects to wear trousers, n rush to training pot once she feels hurt or wants to fart. Doctors have given meds, vitamin, n What to do, doc?",
    "doctor_response": "hai.according to me first test for stool examination , culture  for  any cyst are worms  and any increased fat  and ultrasound abdomen  liver function and blood picture are there according to that we will start treatment .mostly she suffering with dysentry or fat indigestion  we should rule out and we will give treatment.according to that.still problem there go for colonoscopy and biopsy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedies for boil near tear gland of right eye\n\nsir a boil is developed near tear gland at my right eye.it is very small and there is a pin pointes white dot.my mother says it is due to body heat.pls suggest home remedies to cure it.also tell me the reason of boil.is it a common problem with people?",
    "doctor_response": "The tear glands are situated behind and above the upper eye lid. surely from your descriptions the site of the \"boil\" is near the caruncle or inside the eyelids. its the inflammation called as sty or an infection. Washing the eye frequently and applying eye drops Will cure your problem. if there is severe irritation or reddening or throbbing pain, you are adviced to consult an ophthalmologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for slight pinkish purple eyelid in infant after oatmeal bath\n\nhello my daughter 2 months old has slight pinkish purple eye lids, could this just be allergies? she has become very fussy as well, she was calm all day and now is starting to be fussy. me and my wife noticed this afternwe bathed her in an oatmeal bath aveeno for babys, please let me know what you think",
    "doctor_response": "HiWelcome to the HCMIn my opinion its a type of skin allergic reaction.You can try the following to relieve her:- Give her anti-histaminic drops or syrup, such as, Chlorpheniramine,Phenargan or Benadryl. This works as anti allergic and also sedative to calm her down.- Avoid allergens in future to prevent such reactions. For further questions, do contact us.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for border line BP and creatinine\n\nI am 71 yrs old, I run about 3 miles 3 to 4 times weekly. Recently my blood tests came back with a Creatinine level of .99. My blood pressure is borderline and I am not taking BP meds at this time. Do I need further testing? I know it is important to drink enough and I am not good at that, but how concerned should I be?",
    "doctor_response": "Hello, You should take tab amlodipine low dosage for blood pressure. Serum creatinine is to be ignored as such. Avoid dehydration, pain killers and nephrotoxic drugs as amikacin. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Varinder Joshi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in back and legs in supine position?\n\nHi, The last two days my one year old had a very bad cold and needed me to hold him all the time while we were both lying down (I never lay down or rest this much).  I have had a slight pain in my lower back but much more pain in both legs, like they are being squeezed very hard ever since.  What can this be?",
    "doctor_response": "Pain in back and pain in leg this could be related to each other or it could be separate issues also. You can check one thing lying position on your back legs straight. Now when you lift your leg up straight ( any one leg ) then how is your pain in leg and back. If you say pain is more in back and at the same time in leg also then it can be associated to each other and you have problem at limbosacral spinal level. Now if there is pain only at back and there is no pain in leg follow the another test. Long sitting position that is sitting only but keeping your leg straight ask some one to hold your calf muscle bulk and squeeze it or press it hard and check do you have pain in leg. If you say yes then it can be due to problem with blood circulation in legs.How ever the conformation can be done by only specialist like ortho or physio and you may need to under go for MRI of back as well dopler study for legs if needed.And based on result of physical examination and MRI ortho doctor for mild to moderate issue will suggest to take physiotherapy treatment and exercises along with medication. For major damage at spinal level he will suggest for needed surgical correction.Now if there is circulation problem in lower limb here doctor may ask you to visit a vascular  surgeon or some medications again for it.Doing exercises suggested by physio for back pain radiating to legs along with use of hot and cold pack at back also gives good relief.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for small patch of red pimple like fungus on face\n\nI have a small patch of red, pimple like fungus on my face. it starts out as small fluid filled bumps then it gets dry and crusty a few days later. I believe it is fungus because I have been using a cream that makes it better. However, it always comes back. I am on my 3rd tube. Is there anything else I can do?",
    "doctor_response": "Hi,From history it seems that there might be having some skin lesion like dermatitis or tineasis causing this problem.Apply triple action cream locally.If there is tineasis or fungal infection, go for one course of oral anti-fungal medicine like Flucanozole 150 mg once in a week for 4 weeks.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe pain and sharp sensation after tooth filling\n\nJust filled one of my tooth with composite last week . It had very slight sensitivity to begin with , hence the filling but now after a week of nothing I'm experiencing terrible pain and sharp sensations when consuming anything cold and even when doing nothing (most of the time) . I've read that this sensitivity is common after effect for upto 2 weeks from the date of the procedure but I'm not sure why it showed up for me the way it did out of nowhere . Is there anything to worry about ?Thanks for your time",
    "doctor_response": "Hello,Post filling sensitivity can be common. Persistant pain to cold raises the concern that you may need a bite adjustment. Do you feel that you hit the tooth first when you bite down or do you feel the tooth gets in your way when you slide your teeth? Call your dentist to verify your bite and make a slight adjustment if indicated. Your dentist will check your bite for high spots with  a paper that marks how you bite down. Avoid chewing on the tooth, try to stay with a softer diet, brush with toothpaste for sensitive teeth and use fluoride rinses.If you have gum recession or inflammed guns around the tooth, this may be a contributing factor. Try the above suggestions. Be sure to continue good daily dental care and do not avoid cleaning the area.If you notice an increase in hot sensitivity and pressure sensitivity, this can indicate an abscess. Did your dentist warn you that the filling was deep and close to the nerve? Taking Antiinflammatory medication such as Tylenol or Advil may help reduce discomfort, but see your dentist to evaluate. A root canal may be necessary.If the filling is cracked or leaking this could cause cold sensitivity as well.Thank you for your inquiry. I hope my explanation is helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nausea, abdominal pain, cramp and swollen back?\n\nTwo days ago, I started my day with nausea and some abdominal pain . By the end of the day, my abdominal pain was so bad, I was barely able to walk. My stomach hurt to move, and pain would radiate to my sides and back . The next morning , pain was not much , but it would cramp with movement such as bending down . Today I felt as if my lower right side of back was a bit swollen. Could something be wrong?! Thanks, Laura",
    "doctor_response": "HI.When the pain in abdomen increases on moving , bending and radiate to back and lateral aspect indicates that you had intra-peritoneal infection , may be needing urgent investigations and treatment. The causes are peritonitis, which can be caused by appendicitis with rupture, ovarian twisting, volvulus, perforation of the stomach or intestinal ulcer.I would advise you admission to the hospital, urgent X-ray of the abdomen in standing position to see whether there is perforation- gas under the diaphragm sign; ultrasonography and relevant blood, urine tests. You may need urgent Exploratory Laparoscopy or Laparotomy to treat the cause if the Clinical correlation with investigations suggest so, or medical line of management to start with.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for spinal stenosis in an elderly person\n\nMy mom is 76 and has spinal stenosis and was prescribed lidocaine patch. My question is where should she place the patch? She has been told apply to her low spine but instructions for use state to place where the pain is. Her pain has radiated to sides of both legs especially right leg. Thank you.",
    "doctor_response": "Hello!Welcome on Healthcaremagic!I understand your concern and would explain that although she feels irradiating pain in both her legs, the origin of the pain is in her lower spine. This is because the nerves of both legs originate in this region. That is why I would recommend putting the patch in this region. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have Parkinson's disease. Low appetite, walking slowly, trembling hand. Should I continue same treatment?\n\nMy father (age 77 years old) is having Parkinsons disease . He is very weak( low apetite, walks very slowly, one hand trembls). He is under allopathic treatment of Medical expert but there seems to be no improvement to his health problems. Should I continue the same treatment from the expert or go for other therapies? Would you suggest me addresses of experts for such disease?",
    "doctor_response": "Hello, Thank you very much for posting the query in HCM Please note that there are two types of Parkinson\u2019s disease. 1. Typical Parkinson's disease- this type generally responds to medicine. However, as the disease advances, the response to medicine may come down and patients may develop side effects related to medicines. I am sorry that i don\u2019t know the exact medicine your father is taking as of now. The best medicine will be Levodopa carbidopa combination, in a reasonably good dose depending upon his response and tolerance. There are other options in this parkinson's diases apart from medicine that is known as deep brain stimulation. He has to have regular exercises, physiotherapy etc. 2. Atypical parkinson\u2019s disease: Here the patients symptomatology will be more than the typical one. They may have memory problem, behavioral problem, and frank hallucination to start with. This can be recognized by a neurologist. Generally speaking these subgroups don\u2019t benefit much with treatment. There are so many types of these sub-types. Treatment depends upon the exact sub-type. So my advice will be to get evaluated by a local neurologist and then approach a medical unioversity nearby who will guide you regarding the various options as i discussed. Hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is back pain a symptom of pinched nerve?\n\nI am a 14 year old dance, within the past week I've been having lower back pains. Today after practice was the worst, if I even moved the wrong way a pain was sent throughout my body. Personally, I think it may be a pinched nerve because I've had them before in my neck/upper back and this feels relatively similar. What do you think it is besides a pinched nerve? What should I do about it? Thanks!",
    "doctor_response": "Hello,I had gone through the case and found that it might be muscle spasm or slip disc.So for precaution go for MRI of lower spine.If nothing comes in report then take mild painkiller and apply muscle relaxant gel.Avoid exercise and bend forward.Take neurobion daily one and vitamin D3 once a week .It will help in strenghting the nerve and bone.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could i be pregnant as i have delayed periods and cramps?\n\nHi, I am 12 days late but have been experiencing cramping and pelvic pain over the past 2 weeks. I have had 4 negative pregnancy tests. I am not nauseous, fatigued, experiencing headaches, or any other symptoms. I am typically regular maybe a day or two variance. Could I be pregnant? Would a blood test be warratned?",
    "doctor_response": "hello,i can understand your concern.if you had an unprotected sex in your last cycle, the chances of you getting pregnant are pretty high. 12 day delay strongly points out towards pregnancy as you have regular periods.i would advise an ultra sound and a blood test to detect pregnancy. urine tests take longer time than blood tests to get positive.the delay can also be unrelated to pregnancy.it can be due to stress or an hormonal imbalance.the first thing is to rule out pregnancy.hence get the tests advised and the further things can be managed as per the results.please get back to us with the reports.thanks for choosing HCM",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair regrowth\n\nhi .i am a 22 year old .my heigt is 5feet 3 inches weigt is 50 kgs..i use to have thick full volume hair with good heath...but when i was 14 year old i suffered first from diphteria n then from typhoid,now my hair density is very less compared to earlier....i want to get back my full volume hair.",
    "doctor_response": "Hi.As per your case history of hairfall.My treatment advice is \u2013 1. Take good nutritious diet full of green leafy vegetables and milk.2. Use a good herbal shampoo and coconut hair oil for regular use.3. Take an iron supplement once daily and vitamin b12 supplement once daily for 3 months.4. Other treatment options are topical minoxidil, oral finasteride and mesotherpy done by a dermatologist.Thanks.Dr.Harshit Bhachech.MBBS, DDVL.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am seeking your help regarding my MRI report. Kindly guide me.\n\nHi doctor,I am suffering from the seizure disorder.\u00a0I am seeking a neurologist help on my MRI report.\u00a0I had two episodes of seizure before three years and then, no episode. I had Folic acid 150 mg and Sodium dilunte\u00a0300\u00a0for the last three years. For the last two months,\u00a0I am not on any medicine.",
    "doctor_response": "Hi. I have analyzed your MRI brain report (attachment removed to protect patient identity). For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling on tongue and roof of the mouth?\n\nHello, Tonight as I was making dinner, my tongue and the roof of my mouth started tingling. A moment later I lost the ability to form sentences easily, and was confused on the meaning of words for about 10 minutes. I than started feeling quite weak, and within about 30 minutes I was nauseous with a head ache. I NEVER get headaches! I am 30 years old. Is this something I need to worry about? Thank you, I do hope you can offer some input.",
    "doctor_response": "Can you elaborate on any dental treatment that you ever got done, and has any member of your family had any similar symptoms or medical complains? If you haven't got any dental treatment done before and with the kind of symptoms that you are giving which is confusion, headache etc it suggests a neurological problem rather than related to dental,though the problem may be minor so you need not worry and better consult a neurologist as early as you can, because sometimes due to minor lesions in brain such seizure like symptoms may be seen. And the earlier you rule these out and start taking medications for such a thing the better. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have food allergies. Feel food is stuck. Scans clear. Thyroid inflamed. On drug. Cannot eat. Cure for symptoms?\n\nfor many years i have had many diagnosis of allergies and food allergies, GERD, and  Hashimotos most recently. for the past 6-7 weeks my \"food allergies\" seem to be increasingly worse, I feel as if food is stuck etc. Went to the Endo thinking thyroid was inflamed Scans were clear. Went Back to the PCP they said Yup its inflamed and gave me a drug that contains allergens so i cant take it. Waiting for GI next tuesday and I have to call and get an allergist appt. tomorrow. Foods i have eaten even the past few weeks are getting stuck or causing inflamation to my throat or tongue and tingeing like around the mouth etc. I have used both Mouthwash and Childrens advil (1tsp) and they help relieve the symptoms but i still can not eat ANYTHING. I have lost 23 lbs in the past 2 months and I feel like giving up? any suggestions on how to relive any symptoms until I can get to the GI and allergist? ---food allergies are Soy, Wheat, Corn, Codfish, Clam and Mushroom. Thanks",
    "doctor_response": "Hi,Thanks for writing to health care magic.If the allergy is to a particular food then avoidance of that particular food may help. Since there is significant weight loss a complete examination is required to arrive at the exact cause of the problem.Continue to ask further queries as required.Hope this helps.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is my spermiogram test with count: 110 million/ML normal?\n\nHi, I am 27 years old , I made varicocele operation 3 years ago on both sides ,  just made a spermogram test and the results were:Count: 110 million/ML, volume is 6 ml35 % active after 30 min , 20 % active after 3 hrs, and 8 % active after 6 hrsDo you consider these results good for acheiving pregnancy? and what do you suggest?",
    "doctor_response": "Hello Thanks for writing to HCMYou are suffering from low sperm count.At least 55 % sperms should be motile.You should do exercise and take nutritious food.You shouldn't wear tight underpants.Even if low motility persists then you may need assisted fertilization techniques like IUI.Sperm count is within normal limit.Hope i have answered your query.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am suffering from sharp chest pain. I am 17 yrs old girl. Should I be worried ?\n\nI have sharp pains in my chest and sometimes in my stomach rib area. and im a 17 year old girl. should I be worried ?",
    "doctor_response": "Hi, Pain may be due to chosto condritis but you go for ECG to rule out coronary cause. if it is normal then consult your orthopedic surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for red blotchy marks on ankle\n\nTwice in the last month after being outside doing a lot of walking, the lower inside part of my legs (ankle area) have red/blotchy marks and itch.  It goes away after 3 to 5 days.  Although it seems logical to attribute it to the walking and exposure to the sun, I have never had this response to activity and sun exposure before.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have symptoms of  red blotchy marks on ankle which could be due to  contact with allergic and poisonous agent, bacterial infection of hair follicle, eczema, fungal infection, and poor hygiene. It could be due to skin photosensitivity due to sun exposure as well. Need not to worry. I would suggest you to maintain hygiene and wear loose clothes as it will prevent skin eruptions. You should take anti allergic medication such as benadryl, cetirizine. You should apply topical antibacterial/ antifungal cream. You should visit dermatologist once and get it examined and start treatment after complete examination. You should take proper antibiotic course as well.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can mold cause pain in the nerve endings and in the throat?\n\nI inhaled mold threw my mouth and nose.  Since then I have had severe pain in my neck and not able to lay down due to the pain.  My neck seems better but it seems to be moving to different sides of my body as well as nerve endings hurting. My body feels like it has been beat up.  Would mold do that",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.No mold don't do it directly but it can do it indirectly. It creates allergic reaction in the body which in turn can cause such problems.As it initially stuck to the throat it initiated the reaction. Same way the allergen which is circulating the blood can cause various pains in the body.So I advice you to take the low dose steroid like prednisolone and chlorpheniramine maleate under your doctors guidance. This will stop the further reaction and so pain to you.I suggest you to take future care as not to expose to such a mold further.You can take some construction measure to stop the mold growth. This will prevent future exposure to you.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of depression?\n\nI am 51 with spina bifida I recently have been having a problem with mild to moderate depression.  I feel this is under control with symbalta and wellbutrin.  But for several years I occasionally get these very strange I guess headaches.  It is like a very very dull ache with a pressure feeling ONLY in the forehead area.  I have gone through many tests showing nothing and feel I am getting knowwhewre with my primary physician and do not know where to turn next.  THey are not os much painful as they are EXTRENELY annoying and change my mood dramatically and not for the better.  ANy suggestions as to what I can try or tell my primary physician  they are very hard to describe to him",
    "doctor_response": "HiThanks for using healthcare magicThese symptoms could be part of depression. Number of patients in depression has somatic concern and somatic feeling. In that case, you can try tricyclic antidepressant like amitriptyline. That would help to control symptoms in better way. You can also try some relaxation exercise like JPMR or deep breathing exercise. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure pain at the back of the rib,lower abdomen and towards sides?\n\nMy left area beloow my rib in back huurts to press on it, or if I lean over and move certain way. Also I wake up every morning with severve pain in my lower abdominal area, sides and lower back. Been goin on for months and its getting worse and more consistant. Had labs run for uti and its negitive??? Don t have an appointment to get in with doctor for another week? Thanks. Age 32,,158lbs had baby 14monthslots ago",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms can be related to a pulled muscle.I suggest to do a an abdominal ultrasound for further evaluation. Meanwhile,I suggest using a muscle relaxant such as Baclofen three times a day. I also suggest using a magnesium supplement for muscle relaxation. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "My sister is suffering from back pain and stomach ache. What could be the possibilities?\n\nMy sister has had a back pain last month, without any specific treatment because she insist on not having an X-Ray. The pain has eases, but she is now suffering with stomach ache and diarrhea . She also said that her tummy skin aches , although she is not vomiting. My sister is 30 years old, and she live in another country. Could anyone please advise on the possibilities of the above mentioned symptoms? Could the stomach ache be in anyway related to the back pain? Thanks in adv. for answering the question.",
    "doctor_response": "hi; back pain is common in people around 30 but that was different .now what your sister has is stomach infection;as you said she is not vomiting still she may be having amoebic dysentery where there is complaint of loose stools with mucus & stomach pain.she will require antibiotic for her please consult a doctor. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fits, stopped Eptoin, feel weakness occasionally, sudden rise in heart beats. Normal?\n\nHi, when i am 23 i got fits then i visited a neurologist and he wrote for CT-scan in that there is a wording like calcified granuloma in the left parietal contex and doctor said no need of any treatment it was healed, and for 7 years i never got any fits and i am very healthy and once again in 2009 my right leg started shaking for around 10-15 seconds and stopped again i went to doctor then he said there is a sign of fits and he prescribed epsolin er-300 i took this capsule for 2 years and now he said to stop epsolin and take eptoin 50mg decreasing a series of tablets every 2 months, but some times i feel some weakness and some scare at that particular time how can i make my self strong mentally as well as physically please clarify my doubt and my question is will it be permanently cured with this tablets ? now i stopped eptoin 50mg and when i was to sleep at 10pm night once sudden rise of heart beat strong when i am laying to right side on my bed after a minute it calm down to normal what does it indicates do i need a visit to my doctor or it is casual thing please do suggest me your suggestion is presious to me",
    "doctor_response": "Hi, Thank you for posting your query. Your doctor was correct. Calcified granuloma in the brain suggests a healed infection (due to tape worm). No treatment is required for the healed infection, however, it can cause fits. If fits recur, you may have to restart fits medications. Regarding heart beat and palpitations, it could be due to anxiety. However, if it recurs, please consult a cardiologist to exclude any heart rhythm disturbances. Wishing you good health, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for penis infection, vomiting and coughing\n\nmy 9yr old boy is having a infection in his penis,on top of that there is redish some time its burns and little pain and swailing is there.he is vomiting twice and coughing also,there is little temperature.can suggest me the medicine which get in dubai",
    "doctor_response": "Hi.. From your description I think your son has got balanoposthitis which is a local infection and allergic reaction in the penis.You can give him CEPHALEXIN capsules 250 mg 1......0.....1 for 5 days. Also teach him to cleanse his penis daily during bath. If there is no improvement or he has scrotal pain also please consult a pediatrician. For his cough you can use a cough syrup with DEXTROMETHORPHAN and CHLORPHENERAMINE combination if it's available over the counter in your country. Hope I answered your querries.Follow up for any further doubts. Dr.V.S.Sri Vidhya Chennai",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is dialysis the only option in case of chronic kidney problem?\n\nhello sir good morning my mother has chronic kidney problem she has only left side kidney which measurement is not normal or when i concern my local nephrologist . he says the kidney functioning only 7% .he suggest for dialysis bt what i do? sir piz tell me. i am so upset by knowing that.",
    "doctor_response": "HelloThanks for query.Your mother has solitary kidney with only 7% function .The main function of the kidney is to excrete end products of protein metabolism (Creatinine)If her serum creatinine levels are high she needs dialysis .Follow advice of your Nephrologist .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What chances of pregnancy do I have after unprotected sex without birth control pills?\n\nHi. Im on the pill & my period started before I started the inactive pills. I decided to stop taking the pill until my cycle ended & then would start a new pack. My husband & I had unprotected sex when I had finished my cycle but I had not yet started the pill. What ae the chances of a pregnancy?",
    "doctor_response": "NamastheWelcome to Healthcare-MagicGreetings of the dayits unlikely that you could be pregnanct, as you are in safe period that is first ten days of cycle, i suggest you to start using the pills and aalso advise you to use alternate contraception during 10th to 18th day of this cycleIn case you need any further assistance, will be glad to assist you.Wishing you happy and healthy lifeTake CareBest RegardsDr Deepak K KMBBS,MS,MCH",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from scrotal skin problem. Please advice.\n\nHello doctor, My age is 24 years. I have scrotum skin problem. Kindly advice.",
    "doctor_response": "Hello. I understand your concern, but there are no attached photographs in your message. Kindly send a picture of the affected area to help you better. I need to see the affected area to assess the condition and to suggest the appropriate diagnosis and treatment. Please send the picture of the affected area.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can i close a big gap in my front teeth without using braces ?\n\nhow can i close a big gap in my front teeth without using braces but dont cost very much ?",
    "doctor_response": "how do i fix a huge gap in my front teeth without using braces ?? but doesnt cost very much ?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please help me interpret my latest health checkup reports.\n\nHello doctor, I have been having the following symptoms for the last month or so.\u00a0Difficulty in falling asleep at night. I have witnessed sudden jerks when I am about to fall asleep. After such jerks, it becomes difficult for me to get good sleep. I do not remember having these jerks once I completely asleep. My spouse complains of me snoring afterward and quite heavily in the morning. I have weakness and fatigue the whole day. The weakness is so profound in the morning, that I do not feel like getting off the bed. From last few days, I have been having episodes of low sugar. The sugar level was around 70 to 55 when I checked. I feel very hungry abruptly, sweating on palms, and so weak that I feel like losing balance while walking.\u00a0I have a\u00a0family history of diabetes and hypertension. So, I have becomes anxious, which adds to my symptoms more. I have hypertension tendency.\u00a0I have had hypertension for five years, but I started taking tablets four months back.\u00a0Last week, I had my preventive health checkup done. I have attached the report.\u00a0Please advise.",
    "doctor_response": "Hi. I read your history, and I have\u00a0seen all reports (attachment removed to protect patient identity). I\u00a0am highlighting the abnormal results. For further queries consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest opinion on hair transplantation due to hair loss\n\nDear all.., This is Karthick from Coimbatore. I came to know about yr clinic through some reliable source. I am aged 27\u2026, I had a hair fall problem.. though it didn\u2019t lost completely as you shown in the photo Its getting thinning in my center head and also in fore head. So, I planned to do hair transplant before it will get lost completely. I had a few question before I am coming to your clinic, since it\u2019s a long way journey. 1.\u00a0\u00a0\u00a0\u00a0\u00a0If you done a hair transplant on my thinning area, then will my natural hair fall again and become bald once again ? 2.\u00a0\u00a0\u00a0\u00a0\u00a0Will my transplanted hair wont fall again ? 3.\u00a0\u00a0\u00a0\u00a0\u00a0 How long will my transplanted hair stays in my head ? i.e, how many years ? 4.\u00a0\u00a0\u00a0\u00a0\u00a0Can I go for regular hair cut ? 5.\u00a0\u00a0\u00a0\u00a0\u00a0will my hair be natural look or artificial look ? 6.\u00a0\u00a0\u00a0\u00a0\u00a0If I do hair transplant at this early age.., will this be permanent solution for my hair fall.., or it will fall again ? 7.\u00a0\u00a0\u00a0\u00a0\u00a0What are all the items that I need to carry before coming to your clinic ? Thanks in advance.., Looking forward your reply in this regard.., Karthick..",
    "doctor_response": "Hello, Hair transplant is the most effective way to restore hair loss. Apart from that I also suggest you take medical treatment with minoxidil 5% solution and oral finasteride tablet. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Kakkar S., Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sneezing frequently while at work. Taking advil daily provides relief. Permanent cure for allergy?\n\nHi I am a 45 year old woman. For the past three years or so I can t seem to stop sneezing every so often, mostly at work, I do sneeze at home as well, but not as much. I find that the normal allergy medication dosen t work, the only thing that seems to work is Advil , so I m taking Advil on a daily basis and don t really like that idea. I did get checked for allergies but nothing major showed up. Could you suggest what I could do or take to help me stop sneezing continously please.",
    "doctor_response": "Hi, Sneezing could possibly be due to an allergen for sure. Its possible you could be getting relief from Advil. However, Advil is Ibuprofen, a non steroidal anti inflammatory drug/ Treatment of allergies require medical and environmental/lifestyle modifications. It could be worth knowing whether you changed your room, office or are constantly exposed to dust, pollen or cold. If any of these symptoms aggravate the disease, then could try as much as possible to avoid it. Secindly, drugs do exist, ranging from topical antihistaminines, through systemic antihistamincs and corticisteroid. Dosage and mode of administration depends on severity of disease and cormobid conditions. Consulting your internist or allergologists for appropriate testing and management could be worthwhile. Allergologists also have specific immune depressing therapies in case commonly used drugs are not effective. It could help consulting an allergologist. Thanks for understanding and best regards, Luchuo, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it possible that I could be pregnant when on birth control pills?\n\nHello doctor, I have been on birth control for quite a while now. Just from yesterday, I started spotting and had the worst cramps I have ever had. Today, I continued with the spotting and cramps and I\u00a0started throwing up everything I ate. Is it possible that I could be pregnant?",
    "doctor_response": "Hi. I presume the birth control that you mentioned is about oral contraceptives pills. Sometimes, it is not uncommon to have spotting while you are on pills, especially if you miss a few of your pills and again start taking the rest. At times, it is possible to have some breakthrough bleeding even if you have not missed your pills. It is very unlikely to get pregnant if you are taking your pills regularly. But, if you do fall into the unfortunate group, who do get pregnant even after taking their pills regularly, I am afraid it is a concern as the incidences of pregnancy in abnormal sites (ectopic pregnancy) are common. So, I suggest you visit a gynecologist at the earliest to rule out the same. It might be a trivial cause of tummy upset like an infection, but we must rule out other serious conditions to be on the safe side. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest dosage for Flucloxacilin for 9 months old\n\nmy 9 month old baby was prescribed a week's dose of flucloxacilin due to an infection in his bcg injection. His bcg injection was taken a few days after birth and has yet to heal. He is supposed to take 2.5ml four times a day, but i am unsure if its to be taken at regular intervals or just four times a day. can i give it to him at 8am, 12pm, 4pm then 8pm?",
    "doctor_response": "The time interwal u are suggesting is not correct. Time duration between every two doses should be 6 hrs.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a doctor consultation advisable for sweating, dizziness and vomiting?\n\nmy significant other who is 38 has had a bug for almost 3 days now that has progressively gotten worse....he has tried sweating it out and sleeping it off. tried to keep fluids in however yesterday puked more than taken in and got dizzy and light headed. his cough has gotten worse especially today the 3rd day. he has major body aches and pains. is freezing. now he said he doesnt remember feeling this bad since young kid. back then he ended up in hospital and had siezure. I am thinking itis the flu but starting to feel he maybe should go in. 3 other people live in home but none are really in much contact but me and im ok. please help",
    "doctor_response": "Hello,Based on your description, it is likely the flu. The common cold would not present with such severe symptoms.Though some persons with flu can manage at home, if it is severe, it is best to see a doctor for assessment.In his case, with worsening symptoms, this would be advisable. It is very likely that with appropriate care, he would be fine.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Michelle Gibson James",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of chiari malformation?\n\nI have been diagnosed with chiari malformation and lumps on my thyroid. My energy has decreased quite a bit and my arms feel heavy and weak. Migraines are an everyday problem now. Vision is blurry off and on, just doing everyday things are a challenge. I have been seeing a chiropractor to help alleviate some of the migraines, but as soon as I go back to a full day of work I feel just as bad or worse. I also have problems with keeping my blood sugar up. I am not sure that this is what s causing this or if there is more going on than I know. Any ideas to what is going on?",
    "doctor_response": "First of all, the migraines are an issue with the brain not the spine. If a surgeon does not want to operate on the Chiari malformation then more than likely it has nothing to do with the headaches. There are many reasons to have chronic migraines and these should be evaluated by a headache specialist. Having chronic pain can cause decreased energy and visual issues. Chronic pain can cause lack of good sleep which in turn can cause less energy and more headaches as well. Hypothyroidism can cause this too so if you have lumps on your thyroid then thyroid hormones should be checked as well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest food diet for baby during summer season\n\nHi doctor, i am residing in dubai. My female baby is 17 months olds. She is so active, had food properly. But for the past 1 week she stopped having water, milk, juice.. all liquid foods. Having only solid foods like rice. I am worried, being in dubai, summer started, baby must have more liquid items. do advice me how to handle her.",
    "doctor_response": "Hello dear!i can understand your concern.You can make a diet chart of the required calories at this age for your child.That should contain a balanced diet with frequent intervalslike at 8 am in the morning give her egg,sandwich or bread with tea/orange juice whatever she likes.at 10 you can give her fruits rich in water like watermelon or melon/orange can also give cucumber etc and likewise can add different items after intervals containing foods which are rich in calories combined with fruits/vegetables having more water.Similarly you can give her different flavoured milks,you can add different flavors yourself like horrlicks,chocolate,cardamom etc.you can give her plain water too when she is playing around in attractive water bottles or you can make simple plain water attractive by making fruits like strawberry,kiwi,apple slices in water,in a clear bottles.These things attract the child,they drink this super amazing water and also healthy as it has antioxidants.Make one bottle of one litre water with half apple cut in slices,one strawberry and one kiwi in clear bottle.Make her drink this whole day in intervals.you have to keep this water a little cool (not ice cold but you cant make it warm as it will change the taste).Hope it will help.Wishing your child good health :-)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Folic Acid tablet suggested when trying to conceive?\n\nThese days m trying to conceive n I think not sure dt m pregnant nw my last menstrual date was 3rd August 2014, my question is should I start folic acid tablet nw ? I have a three years old son n after dt one miscarriage(due to fall on the floor) in march 2014 this is m 3rd time pregnant again n thanks to God my first pregnancy ws normal no complications n 2nd ws too .....",
    "doctor_response": "Hello, and I hope I can help you todayFolic acid is recommended to be taken during pregnancy because it helps reduce the risk of certain kinds of birth defects known as neural tube defects. While there is no proof that taking folic acid completely prevents birth defects, it is known that neural tube defects are caused by folic acid deficiency.It was helpful to take folic acid while you are trying to conceive because then you will already be on it at conception. However the neural tube of the baby only begins to develop at around 7 to 8 weeks gestation, so if you start taking the medication at around that time pregnancy the potential benefit is still there.So in summary, you should begin to take folic acid tablets as there is a possibility you are pregnant.I hope this information was helpful and best of luck to you for your future pregnancy.Regards,Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does SGOT-80,SGPT-142 from LFT test suggest?\n\nmy husband's lft test is done yesterday for the third time. first lft was done on march 26th,, that time bilirubin was 1.3 and sgpt  74, sgot 39 . after that doc gave him some meds and asked him to lft again after 1 week . after 1 week billirubin was 0.6 and sgpt 77 sgot 45. then doc suggested to do the tests after 40 days.. now ahain day b4 yesterday v had the lft test and now sgot 80 sgpt 142 alkaline phosphtase 362 and ggt 67. is it alarmimg ?? what to do?? m really scared...",
    "doctor_response": "Hi thanks for contacting health care magic....Here liver enzymes value are high.These enzymes present in hepatocytes and in bile canaliculi....So affection of them can lead release of enzymes in blood and so value high....So cause has to be searched for....USG abdomen can be done....It will help in find out fatty liver , gall stone or cholestatsis like condition.If history of eaten outside food then hepatitis A rule out by viral marker study for that by ELISA ....If history of unsafe sex or blood transfusion or operation hepatitis b and  c ruled out by ELISA.....If positive cardiac history or muscular problem then also enzymes can elevated.If cause undiagnosed then liver biopsy can done to rule out cause.With keeping this in mind consult gastroentetologist.Take care....Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this typhoid test results indicate?\n\nHi Doctor,My husband was having fever on and off, he was asked to get some tests done...as the doctor we cosulted suspected typhoid...The results are below, can u please tell me if he has typhoid?S: Typhi O 1:20S: Typhi H 1:20S: Paratyphi AH  S: Paratyphi BH",
    "doctor_response": "HelloFindings suggests negative for typhoid fever means widal test is negative.Antibody titre of O or H > or equal to 1 :160 is considered as positive for typhoid fever.Fever may be due to some other reasons.Your husband may need proper clinical evaluation and further investigations.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly review my blood and urine reports.\n\nHello doctor, I want to get my blood and urine reports reviewed. There are few things that show in red there. As such, I am fine. The only mild problem I have is burning eyes and palms and a little heavy back head after any meal. My BP ranges between 135 to 140 by 90 to 95 mmHg and blood sugar is 105 to 125 mg/dl (postprandial). I am currently taking antibiotics, Ocid 10, and Amlodipine 5.",
    "doctor_response": "Hi. I have reviewed all the attached laboratory reports (attachment removed to protect patient identity) and want to add that most of your reports are fine. There is increased liver enzyme (GGTP - Gamma-glutamyltransferase) that may be due to any reason but not limited to liver damage due to any liver disease e.g., hepatitis. Heart diseases and certain infections (e.g., pancreas infection) and taking medications that are toxic to the liver may also cause a raised GGT levels. You should consult a hepatologist for further probing and to see if there is anything wrong with the liver. He may go for hepatitis screening if needed. Your present complaints of burning eyes and palms may also be associated with the liver. You said you are taking antibiotics. Having an infection and being on antibiotics may also cause eyes and palms burning. Your blood sugar tests look normal. Cholesterol levels and other tests also seem to be normal to a large extent. No worries about that. If you do exercises regularly, your LDL (low-density lipoprotein) levels possibly would also come in normal range. You should take more and more water, and do a proper physical activity (exercise) in order to remain properly hydrated and active.  For more information consult a vascular surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to remove mucous due to COPD\n\nMy mother is 63 years old and she has had COPD for many years now. Here lungs are constantly full of mucous. Is there a procedure that can be done to remove the mucous; or is there any medication that will remove the mucous? She coughs uncontrollably throughout the entire day and her breathing is horrible because of all the mucous.",
    "doctor_response": "Hi. I can understand your concern. COPD is a  chronic disease.So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of COPD. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. She may need inhaled bronchodilators and inhaled corticosteroid (ICS)Don't worry, she will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lightheadedness and nausea while practising sports?\n\nMy 10 yr old daughter has started experiencing light headedness, dizziness, and shaking when playing or practicing sports. While playing soccer she breaths very heavy then hits a wall about 15 min into the game. Recently she has taken up ppitching for softball and during her lessons she sees spots, bright lights, feels like she will pass out, and becomes nausious. Our Dr thought it might be exercise induced asthma but even with the inhaler she still has these issues. Could there be something else I should have her tested for?",
    "doctor_response": "DearWelcome to HCMWe understand your concernsI went through your details. Your doctor, before coming to his conclusion, that the problem could be exercise induced asthma, must have went through ritualistic physical and pathological investigations. In that case,, if the investigations are done, the problem could be anxiety and obsession.Anxiety could also cause such symptoms but there will not be any organic reasons. Your 10 year young girl is learning life and at this age, they learn diseases too. At such an age, obsessing with health problems are also common. She could need health related psychological counseling. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes small lumps on the stomach?\n\nHello 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",
    "doctor_response": "Hi Kailash.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 bosy:-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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is hand,foot and mouth disease contagious?\n\nMy son is 20 months old. He has a fever of about 101. His 3 year old cousin has hand foot and mouth disease by catching it at school. I believe my son has it too but not sure. what should I do? I looked it up and it says you have to let it pass, there is no immediate cure.",
    "doctor_response": "Hi, Hand, foot and mouth disease is a contagious viral disease. Symptoms include: - sore mouth, throat, loss of appetite along with high fever- rash in hands and foot You should get him checked by pediatrician for further evaluation. All the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are chances of pregnancy after taking Duphaston and IVF?\n\ndoctor im trying to conceive and i was given fertile super to ovulate and so i did and then my husband and i met and then the doctor started me off with duphaston for 15 days twice daily . i normally have a 24days cycle and my periods were due on 15th of sep but due to duphaston i obviously didnt get my periods but bleed a little on 16th and spotted on 17th & 18th and stopped... i did hpt and it came negative...are they still chances of me being pregnant while im still using Duphaston for the next 3days",
    "doctor_response": "HI,    I understand your concern.  -  Duphaston is  a hormone progesterone preparation & it helps in maintenance of pregnancy. It does not affect pregnancy test.  - The spotting you had is likely  be due to implantation bleeding.    - HPT results are reliable when done after 8 days of expected periods.So repeat test might gve + ve pregnancy test. ..and will conform pregnancy.  - If the test is -va, you will have bleeding after 8-10 days of stopping Duphaston.   thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dyslexia\n\nI read an article about, how when you have dyslexia you have these weird feelings like you're almost floating and you kinda feel sick and I was trying to explain it to someone, but its hard to explain unless it's happened to you, and the article does a really good job at explaining it but I can't find it...I was wondering if you had ever head of this?",
    "doctor_response": "DearWe understand your concernsI went through your details. I think you are confusing with some other topic. Dyslexia, also known as reading disorder or alexia, is a learning difficulty characterized by trouble reading despite a normal intelligence. It occurs more often in people with attention deficit hyperactivity disorder (ADHD) and is associated with problems with math. Weird feelings like you're almost floating and kinda feel sick are symptoms which seldom comes under dyslexia spectrum. Please forget that article reading incident for your better. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes light spotting and brown discharge ?\n\nHi! I am a 17 year old girl who is sexually active.I take birth control and use condoms.I have recently started noticing brown gooey discharge around the time when I should be getting my period and my periods are now just spotting. Is this normal or could I be pregnant?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern and looking to the history given here I could say that the symptoms which you described here is not the sign of pregnancy and if you have some doubt then you can get done the ultrasonography test to rule out this, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated blood sugar levels?\n\nMy blood sugar level was under 140 fasting till 2 weeks before. I am a diabetic for the last 6 years.  I am taking diamicron mr 60mg in the morning and trajenta 5mg in the evening. But recently for the last 2 weeks the blood sugar level show 190 -200 on fasting. Why is this?",
    "doctor_response": "Hello and welcome to Ask A Doctor Service. I reviewed your question and here is my answer.If you were using those two medications regukarly and still your fasting was not below 110, then it means you had a poor glucose control and the medications were not enough for that. You should work on your diet as welk and exercise daily. How much is your HbA1C? If fastimg is still suchh high, then you need to increase your dose or add another drug for glycemic control. If your HBA1C is high, then your doctor can consider starting insulin as well. Talk to your doctor about this. Hope i answered your query, ask more if needed.Thanks. Regards.Dr imran zeb.G.P",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the episodes of coldness in chest at night?\n\nA lot of the night when I go to sleep in the midle of the night I will have this icy feeling on my chest it is very cold I have to put my palms to warm it up. sometimes after it is gone I will have a few more attack. sometimes only once but almost everynight.",
    "doctor_response": "Hello dearWarm welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This seems in relation with altered mechanics of temperature regulatory    system of the body due to certain hormone effects while sleeping , most    instances underlying stress or anxiety is responsible .Hope this will help you .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes thickening of saliva and pain while swallowing after molar tooth extraction?\n\nI hav just had my upper last molar tooth extracted. It had an abnormal root an hence had three stitched to close up the extraction site. What my problem is my spit is really thick an it is very painful when i swallow. My saliery gland really hurts. Ad if i hav tonsilitis. Please advise me on what to do.",
    "doctor_response": "Hello ,Thanks for consulting HCMRea your query as you had undergone molar tooth extraction now you have pain and thickened saliva dont be worried so much this pain swelling is seen in patients after wisdom tooth extraction . I will suggest you to follow post operative instructions given by your dentist and proper course of antibiotic prescribed and consult your dentist for follow up .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to improve penile size, strength and erection?\n\nHi there sir, I would like to ask that I have one problem which is I used penis developer pump 2 years ago ,my penis stretched so much badly after use of 3 days ,may be used very hard for extra time ,nobody guide me how to use this penis pump but I used it ,15-20 minutes straight , after 3 days use of pump , was no erection few days after use of pump because of over stretch of penis ,which effect still I have till today. Symptoms ; 1:Penis thin and small and shrink and soft like ballon, after use pump which was not before, 2:Penis stays tired and cold . 3: weak and short erection , 4: feeling or feel like to sex so much in mind but same time penis has no erection because of penis muscle stretched badly, feels even after 2 years. 5:while I am doing sex my mind and felling are 100% in it but my penis has no erection , if I have erection I did entered in Vigaina straight way without foreplay which is not good for my partner without foreplay sex because I am done but partner not. Note: I never ever had no any problem before usage penis pump ,physically I am strong and health , I wish to have sex so much in a day , but my penis does not supports. It Stays cold and tired. Experience and felt : After 2 year I found that my penis base is became very weak because penis too much stretched by (penis developer Pump, ) even after 3 time of use. Treatment ; Penis muscle need to get relax and strong , if muscle are strong then definitely strong and long erection will be. Please suggest to me exact medicine to cure and heel my penis problem. Please don t hesitate to ask anything. I will be waiting for your great response . Kind Regards",
    "doctor_response": "HelloThanks for query.Based on what you have narrated I would say that you a have probably sustained an injury to erectile tissue or artery that carries blood flow to penis for effective and hard erection due to Vaccum device used for lengthening penis ,Your  problem of erectile dysfunction is mostly vascular in orgin and needs to be confirmed by doing a test called  Color Doppler Ultrasound Scanning of penis ..Please consult qualified Urologist for clinical assessment and get the test done .Further treatment will be decided by him based on result of this test.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can you tell me why should I take Loprin?\n\nI was in 9month of pregnancy in 2009, I went for scan doctor diagnosed the baby is dead in the womb so they have induced pain and i delivered normally the baby. again in the month april 2010 I got concieved when I was in 8week complete absorption. Later in the month of september i had thyroid now i m taking tablet. Last month i went for checkup , doctor advised me to take Loprin 75 for two month and asked us not to plan for two months? Can you please tell me why I need to take loprin, why doctor advised us not to plan for pregnancy?",
    "doctor_response": "HelloReally very sorry about the loss of baby in 9th month and again abortion.Tab Loprin 75 is given in a patient who is having repeated pregnancy loss to take care of any disorder of blood which are responsible for pregnancy loss.follow your Dr's advice and trust me dear you will have successful pregnancy.All the best and don't lose hope.Dr.Mira Butani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in hands and legs?\n\ni have been hospitalized 2x every yr for the past few yrs.  i was dx with rrms in 2008 but they backdated it to 2006 when i first had my symptoms, trying to get help thru my primary physician, then a gastroenterolgist saying i had gastroparesis then a trip to shands.  about 6 months later a lost feeling in my feet and legs resorting to using a cane and being referred to a nuerologist at usf i have been thru all medications shots, tysabri (jc positive), and each of the oral medications.  my body rejected each treatment.  the last was aubagio with 3 hospitalizations this year.when i was taken off this.  I had been on steroids several times to treat my relapses but usf changed doctors and this one isnt easy to get calls returned.  or getting him to visit me in the hospital which is relatively close to his office.  I have been told by this doctor i have progressive ms because of the amount of lesions that are active in my brain- very little brain matter has not been affected by lesions and this past time i had no mobility inmy hips down and was in wheelchair much of my lesions old and none were active and my body was rejecting the medications and i received plasma transfer 5x and over 10 days after 3 days of the steroids before that in the hospital.  within hours of my last plasma transfer i was released.  i have been in a wheelchair for since june and finally this week i asked my home physical therapist to order me a manual wheelchair since i have been getting around house using transport through my primary physician which is being delivered.  I was release from hospital on 6/28th with orders to see my neurologist within 4 weeks but still have not heard back from him to schedule this appointment.  what comes after primary ms?  are there any medications specifically for primary ms rather than the rrms",
    "doctor_response": "hi,thank you for providing the brief history of you.As you been in a wheel chair and going though your history I can understand that it is a painful thing to have so many issues and ignorance by the physician.As in my clinical practice we offer the best care and time to queries of the patients, may not be so important according to us but for a patient it is important as the patient is desperate to know how his future is going to be.As you are currently under a physical therapy and also diagnosed with MS. i will advice you to understand that MS is something different to deal with the medication as all drug therapy are symptomatic and exercise is something which will help.regain the functions and also will help the body to reproduce it's own internal medicine.In many cases of MS in my clinical practice we have a team approach to help the patient and never ignore the smallest query by patient or a symptom too.In case you need any more assistance i will surely be present to help you. Never give up as many MS cases in my practice I Have seen recovering when a team approach is provided.Also, you can have a look to a YouTube channel of pfizernews and there many doctors have spoken about how better an MS can be handled and fought as well.  This is just a single example.As we understand your queries and request you to keep undergoing the physical therapy and make a deep communication between you and the medical  team.If you have any queries you can ask me and i will be happy to help you.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Unstable mental condition. History of using meth and other drugs. Mental breakdown?\n\nmy daughter, who has used meth and other drugs, believes that we (her family) are evil all powerful people who are trying to kill her.  She believes all manner of strange things she sees or tv or in books.  She has been so unstable in recent visits that we are getting a restraining order for her children. Could this behavior be from the drugs she has used or a mental breakdown?",
    "doctor_response": "Hi,thanks for using health care magic. Her symptoms may be due to 1) effects of mehtamphetamine particularly if she taking it presently. 2) Psychiatric illness like schizophrenia 3) personality disorder As she is harmful to self, she needs urgent psychiatric help and hospitalization too, if necessary. You should consult psychiatrist as soon as possible for detailed evaluation and treatment. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be random bruises on legs for a cancer remission patient?\n\nHi, I have a back round of cancer and I have been in remission for almost 4 years now. I have been having really bad anxiety and have been finding random bruises on my legs and arms with no idea of where they came from . Some are there but do not hurt when I push on them... and I have had an on going cold for the past month or so and have been in and out of the clinic and I don't know if I should be concerned or not. Please help.",
    "doctor_response": "Hi and thank you so much for this query.I am so sorry to hear about bruises. I am happy to hear you were able to take on the cancer battle and have been in remission for 4years. I think what you term bruises are small bleeds on the skin. I will suggest that you get your clotting system evaluated. A full blood count would tell us whether the platelets are in good number or not. This can open the door to different possible causes. Also, You need proper interviewing and examination before testing to gather more information. talk to your priary healthcare doctor for this.I hope this addresses your query fully. Thank you so much for using our services and please feel free to ask for clarifications if need be. I wish you the best of health.Dr. Ditah, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do my throat and lungs hurt with constant cough?\n\nI have been sick since may 2nd I've been hacking up \"lung butter\" and my throat hasn't stopped hurting. My lungs hurt , I cough constantly and throw up about every 3-5 hours , I had shingles last January( 2011) marks were on the back of my neck, also my wife has inactive TB , I'm beginning to think I may have it",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. You are having chronic cough with expectoration. This is common in chronic lung infection like tuberculosis and bronchitis. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x ray 3. PFT (Pulmonary Function Test). Chest x ray is needed to rule lung infection. PFT is must for the diagnosis of bronchitis. You may need antibiotics, inhaled bronchodilators and inhaled corticosteroid (ICS). If all these reports are normal then no need to worry for major Pulmonary disease. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for sinusitis\n\nI have severe pain in the soft palate area. Bright red post nasal drip. Lightheadedness. Weakness. Cold, frozen feeling behind left ear.  No fever.  No strep, been tested twice.  On amoxicillin 500mg 3x daily 10 day course.   Just completed day 5. Prednisone 2 days completed of 6 day course.  No improvement.",
    "doctor_response": "Hi..Thanks for the query..Post nasal drip, pain in soft palate and cold frozen feeling is appearing due to sinus infection.First of all get a sinus x ray done to confirm the diagnosis.If it is confirmed and amoxicillin did not work then Augmentin [amoxicillin +Clavulanate potassium] can be taken.Other groups of antibiotics like Cephalosporins etc can help..Along with it take anti inflammatory painkillers like Ibuprofen.Use specialised mouthwash like Magic mouthwash to gargles.Do warm saline gargles.Take anti histamines like Levocetrizine and decongestant like Phenylephrine..Do steam inhalation and saline nasal irrigation..Hope this helps..Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Vitiligo, white patches on hands, feet, elbows. Taking psorid capsules, ashwgandha. Side effects?\n\nHi, I am having vitiligo from last 18 years. I have white patches on my hands, feet , knees, elbows, waist bone area and few more small dots here and there. The treatment which i am taking right now from last 3-4 months is Psorid capsule one daily and application of Picon cream daily. Also Ashwgandha Anti-Stress Capsule from Himalaya. Just want to know if there are any sever side-effects from these medicines or not. Positive result can only be seen on elbows and on my left hand.",
    "doctor_response": "Hi, I hope you are taking these medicines under doctor`s supervision. If not, the approach followed is not right. Almost every medicine has side-effects. Psorid capsule contains ciclosporine. Regular monitoring of kidney function and blood pressure are necessary for its continuation. Though picon has low side-effect profile. It is better to have regular follow ups with your consultant dermatologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat knee pain caused by trauma?\n\nHi! About a week ago I was playing a game and the ball had went under the garage door which was half way open so I bent down underneath it and my left leg was planted and my body was shifting so my leg had twisted sideways and I heard 2 popping sounds. It hurt really bad afterwards and couldn t put pressure on it for about a couple minutes. And after that I thought it was better until I went to turn around and my pain came back. There is no swelling or any other symptoms just when I twist my knee it hurts. And the next day the back of my knee was in pain/ sore. I made an appt for tomorrow. Any idea of what it could be?",
    "doctor_response": "There are n no. Of   injuries that can occur in knee but as you complain pain in twisting it could be meniscal injury or collateral ligament injury plz do consult with orthopaedic physiotherapist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for libido & low erection\n\nI was getting since last year megalis 20 mg prescribed by urologist. recently i became father of a child. Now I feeling low libido and very less erection. I am getting these days right abdominal pain. recently I visit doctor and they advised for KUB and Urine routine but test was normal. what could be cause of abdominal pain. is it due to megalis 20 mg. please advise me what should I do now?thanks",
    "doctor_response": "dear, we need to consider the frequency of megalis you are taking. It has a longer half life therefore it's generally taken once a day, and only when one is to have sexual activity.low erection and low lobido needs to be further investigated for any stress induced psychological problem. A consultation to psychiatrist would help here.For abdominal pain, an ultrasound examination would help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes delayed periods and abdominal cramps?\n\nI have had some wierd symtoms lately.  I am over 3 weeks late on my period, I've had some slight abdominal cramping (not as stong as when I'm on my period), I'm so exhausted, my nipples are very VERY sore and every once in a while I feel nauseas.  I am on the pill and I've never had symptoms like this.  In February, I missed 3 pills.  Could I be pregnant?",
    "doctor_response": "If u miss the pills chance of become pregnant is more, as u said 3 wks delay go for urine pregnancy test..some time tensions also delay ur periods. ? Hopefully I am help ful..if u had any doubt let me know",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does furosemide stay in body system?\n\nHi dr. Mimi. I am sheila,26yrs old,female. I use furosemide for a month and my hair start to fall out. I take furosemide twice a week to lose weight. I dont take any medication. I have no disease. My thyroid is fine. I am still eat nutritious meal eventhough i am on diet. My question is how long does furosemide stay in my system? I am so scared. Thanks for your help",
    "doctor_response": "Hi!Welcome to HCM!First of all Furosemide should not be used to lose weight.Its duration of action lasts for 3-4 hours inside the body.Following are important side effects seen with the use of Furosemide:Hypovolemia and dehydration, decreased blood magnessium level, increased blood uric acid level and risk of hearing impairment. Since your body weight and BMI are not mentioned in your question, it is advisable for you modify your life styles, follow some dietary restrictions ( reduced salt intake--avoid fried potato chips, pickles, papads, etc, take plenty of water, take the whole fruits and increase the fiber intake in the form of vegetables.If you fail to notice a reduction in the body weight then consult your doctor.Regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hair loss and dandruff in a thyroid patient?\n\nHai i am a female with age of 34 getting hair loss from 1to 2 years having thyroid problems,and i am also suffering from dandruff problem with itchy scalp.what is the the solution to my hair loss,working with computers whole day  YYYY@YYYY  this is my email address.",
    "doctor_response": "Hello,Welcome to healthcare magic.Hair fall for 1-2 years is called as chronic telogen effluvium. The common causes include anaemia and thyroid abnormalities. Please get your hemoglobin, serum ferritin levels and thyroid status evaluated. You need to continue treatment for your thyroid issue.If the above tests are normal, you can take a tablet with biotin, cysteine and methionine for 3 months. This will strengthen your hair roots.For dandruff, wash your hair with an anti dandruff shampoo containing ketoconazole 2% and ZPTO 1% thrice a week. It is better to avoid oil. If you want to apply oil for conditioning effect apply it half an hour before bath and wash it off with a mild shampoo during bath. Eat a balanced diet with proteins , fruits and green leafy vegetables. Try to cut down mental stress.Hope this helps you.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My son has Nephrotic Syndrome.\n\nMy 5 years old son has Nephrotic Syndrome since August 2010. Since then Prednisone 45mg has been given on daily basis. As a result his weight has risen up to 31 kg from 24 kg. He has swelling as well. He recently started taking Cyclophosphamide 75mg daily (3 weeks before) along with 40mg Prednisone every alternate day. But his protein discharge level is continued to ++ (based of strips test early morning first urine). Almost daily he complains headache and his hair have started falling. Please suggest what to do in this case and how long it will take my son to get rid of this problem? Thanks.",
    "doctor_response": "Hi Kashif, Welcome to Healthcare Magic Forum. The symptoms your child is experiencing are the side effects of the medicines he is on. Don't worry about the side effects as the condition needs first priority, just see to it that he take the medicines regularly as directed by your Doctor and take him for regular follow up. The outcome of the disease varies, the syndrome may be acute and short term or chronic and unresponsive to therapy. The cause and development of complications also affect the outcome. A low salt diet may help with swelling in the hands and legs. Good Luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause high liver enzymes when hepatitis is negative?\n\nHi, my 16 year old sister in law is in icu and her liver enzymes were 175 last night and right now it is at 135 but the doctor can not figure out whats going on, and she is negative for hepatis, can you please give some suggestions of what could be wrong?",
    "doctor_response": "hi.thanks for posting querycauses of high liver enzymes, other than hepatitis1. alcohol2. obesity3. autoimmune disease4. drug5. iron overload6. wilson diseasethey maybe ruled out by specific blood testswish sis good n sound healthregardsDr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to control erection for longer time?\n\nhi dr's ...my problem is i am not gettting erection and so soft to erect *discharge with seconds  with in soft status i am  doing mustburtion since 12 years now my age is 30 .Can this cure able .i have consult dr but after left the medicine again same position .please help me .",
    "doctor_response": "Hi ....You have habit of masturbation ...Over masturbation restricted ...as it can lead pre mature ejaculation...You also have problem in erection....Rule out diabetes by random blood sugar estimation....If you are obese loose weight ....Rule out prostate problem by per rectal examination get done ....Check your blood pressure to rule out hypertension...Avoid smoking and alcohol habit ...Main important one is avoid stress and be relax during sex ....Healthy diet taken with more fruits ....Do fore play more and regular exercise .You can take sex therapy session....While urge to ejacule penis in middle can be squeezed for 30 second ...Serum testosterone and prolactine also checked....You can consult psychiatrist with keeping this in mind ...Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of lumbar herniated disc?\n\nI hope you can I have lumbar disc herniation without cord compression, what does this mean I had a prescription for wrote for hydrocodone-acetaminophen 10/325 and went do a different pharmacy and got a different prescription or different name brand it is U03 and white oval shaped this new medicine does not help my pain at all the bottle states the mfg is AUROBINDO pharm on my bottle what should I do",
    "doctor_response": "Hi I did review your concernLumbar disc herniation causes back ache and sudden pain shooting from back towards the back of legs sometimes till the heels and toes. It is due to irritation of nerves caused by prolapsed lumbar disk. Accoding to my valued peer Dr,narender saini sir's suggestion-Herniation of disc has various magnitude, if its a small herniation than that will not put any pressure on the root or cord, and thus will not be symptomatic, this is usually present in many of us, but if the herniation increases and start compressing the cord, backache develops, and if it compresses the root, radiating pain in the leg develops. Your pain if does not goes away with acetaminophan hydrocodone you need higher pain meds under doctor guidance  like naproxen, opiod analgesia and so on. Also to confirm diagnosis a MRI is needed if not yet done. You need to take rest for sometime time and lie in position that gives you least pain. after 3 weeks you can consult a physiotherapist to begin some physical exercise to strenghten your back muscles.I hope this helpsWish you all the best.Thank you for using healthcare magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can teething cause diarrhea?\n\nHi doctor, My baby is 6 months old.\u00a0For the past couple of days, he is suffering from diarrhea (watery stools and green type stools) five to seven times a day.\u00a0His gums are also hard and red, may be teething.\u00a0Currently he is on antibiotics, multivitamins and some medicines for diarrhea. I would be grateful for your advice on him.",
    "doctor_response": "Hello. Revert back after 15 days to a homeopathic physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes gray skin color, sweating and headache in child with VSD?\n\nmy 7 year old daughter has a large VSD and see s here doctor each year only over the last few months she seems more tired, ill looking a funny gray colour ok in a morning but by early afternoon goes completely sweaty says she has headache and feels funny. the local GP said it was a virus but how long can it last? i m now worried its her heart and no one will listen what should i do",
    "doctor_response": "Hello,As your daughter is having large VSD and she is getting more tired and having changes in skin color, she should be started on some heart medications like Lasix, Lasilactone, Digitalis, etc. Consult your doctor for these medications.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Khan Shoeb Mohammad Sher Mohammad",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat trouble passing stools?\n\nMy 3 year old little boy is afraid to poop. He is trained to go potty...but he holds in his poop. Simply Fearful and afraid. He used to poop at night in a pull up and now he is just afraid. I give a little bit of mira-lax in his drink...but nothing is working? Help",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Suggestions: 1. Natural methods are the best to relieve constipation. 2. Constipation is a risk factor for UTI 3. Maximum milk consumption per day should not exceed 300-400 ml 4. Minimum 3-4 cups of fruits and vegetables to be consumed per day 5. 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. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can mild knee joint enfusion be treated ?\n\nHi well i had a cast on for 2 weeks from the middle of my thigh to my lower leg(near my foot)  and i cant bend my knee back well(should i be worried) and my mri results came back claiming i had no torn ligaments but mild knee joint enfusion(when will the liquid subside)??",
    "doctor_response": "hello,  thank you for using Healthcaremagic.I read your question and understood your concern.I think you can cure the fusion of your knee by using the following measures: keep the leg elevated above heart level  take anti-inflammatory nonsteroidal medication such as ibuprofen 400 mg three times a day In the next 2 to 3 weeks don't use the leg too much but the rest most of the time. if no success the doctor can aspirate  with a needle the fluid in your knee. I wish you quick recovery .Dr. selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for fetal alcohol syndrome\n\nI recently gained custody of my fianc\u00e9e 20 month old grand son.i am concerned that he may have FAS. He has facial traits, and he is extremely stubborn, wants to hit people & throw objects. He also appears to have moments when he just stares, like he has checked out. He is of normal height & weight. His mother has admitted to me that she drank, but that he is normal. Should I be concerned?",
    "doctor_response": "hello... reviewed your question... FAS has many manifestations and affect many organ systems... u hv to keep eye on Developement of baby... at 20 months if he is walking with out support, speaks few words, exchanges things and plays with peers than his development is normal.means nervous system is ok...get his cardiac system checked by some pediatrician... oyherwise if his weight and height are normal for age than nothing much to worry",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe fever in a 5 year old boy?\n\nMy 5 year old has been running a fever between104 and 100 since 10/2. 2 visits to the doctor and I have been told it s just a virus. They did a strep culture, it was negative. Am I over reacting or is this too long of a period to keep passing this off as a virus?",
    "doctor_response": "Hi, severe fever can be due to viral fever, malaria, dengue or Respiratory tract infection. If your child doesn't have rash, chills and rigor, cough then chances of malaria, dengue are less. But If your child has persistent fever, then you should do CBC, Malarial antigen test, NS1 Antigen test. It will make the diagnosis clear. Till then continue Paracetamol for fever. I hope this has helped you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can cause RUQ pain?\n\nHello doctor, I am suffering from NAFLD for the last six months. Now, I am having RUQ heaviness, back pain and flatulence for the last three months. I had several tests and I have given the details below with the findings.\u00a0USG of whole abdomen - hepatomegaly with fatty liver, fibroscan - 3.2 kPa median value, upper GI endoscopy - GERD grade A and small hiatus hernia, hepatitis B non-reactive, hepatitis C non-reactive,\u00a0FBS - 94 mg per 100 mL, lipid profile completely normal, liver function test - indirect bilirubin elevated 1.3 mg per 100 mL and others are normal.My doctor advised me to avoid oily and spicy food. Also, prescribed two medicines named Sompraz D 40 and Liv 52 DS. I\u00a0have lost 9 kg weight in the last four months. Now, my weight is 75 kg and Height is 175 cm. My age is 30 years.\u00a0Actually, I am having a constant RUQ discomfort and right-sided back pain for the last four weeks. I had the same fine before some time and it recurred again. Also, sometimes I felt tiredness and dizziness.\u00a0All the reports, which I had shared, are all the recent ones that are taken before seven days. How to recover faster from this situation? Is it dangerous? Also, Please let me know about a perfect diet for me to recover faster.",
    "doctor_response": "Hello. Thank you for the detailed history. Revert back with the answers to the above questions to an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I having flashes of light and blurring of vision?\n\nHello doctor, One week back, I started to get a light glint in my right eye. It seems as though my sight is blurred in this eye and it is quite exhausting dealing with it. I had a significant sinus discharge the day before and on the opposite side the days before this started and now have this tiny blurring for a week.",
    "doctor_response": "Hello. By going through your query, I could understand that you are experiencing flashes of light and blurring of vision. Most of the patients visiting our clinic with a single episode of flashes do not have any abnormality, although we advise them to undergo a detailed retinal examination as soon as possible to rule out retinal detachment. Kindly let me know if the blurring of vision is gradual or sudden and also associated with any pain around the eye, watering, redness of the eye. Are you using any glasses, do you experience any headache? Are you experiencing black spots in the eye or experiencing a sudden drop of vision like a curtain falling down in front of your eye? Better to get a retinal examination done right away. If blurring of vision is transient, and if you are experiencing any dryness of eyes, it is treatable with eye drops.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to control temptation while seeing somebody urinating?\n\nhi i am having a very serious problem .i get extremely tempted when i see a woman pissing i even get tempted if i see small babies pissing in their panties  i had this problem since i was small may be from when i am at the age of 5 or 6 please help me",
    "doctor_response": "HIWell come to HCMThis is the psychological condition of yours and better to stop this, this could be harmful some time, as long as the social aspect is concern, not good, if you can to control your self then better to have a help form the psychiatrist, but first try to get out of this condition on your own, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fever in the evenings, head feels heavy. Due to exam stress?\n\nhello. lately,almost a week now i guess, i keep having slight fever/feel uncomfortable every evening onwards. By uncomfortable i mean my body feels kinda warm especially around the neck area.  My head feels slightly heavy as well. No coughing, no flu or whatever.i'm having my final exams anyway. can this be related to exam stress or something else? quite worry.thanks.",
    "doctor_response": "Hi, Thanks for writing your query. After reading your post, it seems that you are having your symptoms seems to be due to excessive straining of neck muscles while studying. This can be due to wrong posture while studying. Following precautions will be helpful :- 1. You should not bend your neck too much while reading. 2. Have adequate light in your room while reading. 3. Give rest in between to your body when sitting for long durations. 4. Doing yoga and meditation in fresh air in the morning will help to get relief from examination stress. 5. Take care of diet and water intake. I hope this is helpful to you. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes loose stools in a 17 month old?\n\nHello Doctor, our baby daughter of 17 months is suffering from lose motion since one week and refusing to eat, she also drinks less than normal. She cries when passing stools which is liquid and watery. We have shown to doctor here, she thinks she might have a viral infection. What can we do to cure her early, as its been a week now. Thanks a lot, A.Kumar",
    "doctor_response": "loose motion at this age are mostly due to viral infection which is usually self limiting.use of probiotics with zinc syrup help in early recovery. maintain water balance. racecadotril in very effective drug to decrease the watery content in motion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Microgynon 30 cause excess sweating?\n\ncan taking microgynon 30 cause excess sweating, i have been on it for about 6 years and have noticed extreme sweating since then. i was put on ovranette for a while and noticed it had calmed down alot. now i am back on microgyon 30 agaian and the sweating is getting worse",
    "doctor_response": "Hello, Seating can be caused by microgynon as you have noticed it. It is a rare side effect but can happen. Please talk to your gynaecologist to change them to another contraception pill. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Olgeta Xhufka",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood in stools in children?\n\nMy Son who is 7 years old is passing blood in his stools for last 3 months, flagil for 2 weeks did not work on him. He is showing positive tests for ameaboic infection. but i find that blood is not mixed in the stools , it appears to me like fresh blood. right now he is not on any medication, just giving him iron tonic. Can you please advise me all the possible reasons of his this condition and what procedure shall i follow for further investigations. your advice is going to be a valuable one to me.",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. You have said an important clinical clue that the blood is not mixed with stools and he is even passing fresh blood. In this regard the possibilities could be:1. Rectal or colonic polyp2. Solitary rectal ulcer I suggest you get an gastroenterology consult done and he might require an endoscopy. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can strain and pain below the knee after doing exercise be cured?\n\nHello doctor, I used to play sports. Now after a gap, I started walking and later doing some fitness workouts daily. During walking my muscle below the knee is getting more strained and paining (issue only for right leg). Please give me a right solution.",
    "doctor_response": "Hello. I read your concern. I feel you should do proper warming up and stretch before doing the activity. This will definitely reduce your tightness, pain, and discomfort. Do some basic stretch and strengthening and use good footwear. Apply ice on the painful area frequently. Get an iced bottle and roll your leg on top of it for a while say for 10 minutes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chronic lower abdominal pain along with bruising?\n\nI have had right lower abdominal pain for several weeks.  I have a particular sore spot in the same general area and this morning it is bruised badly.  Could this be my appendix?  I don't have a fever nor am I sick at my stomach.  I am a 55 year old female.",
    "doctor_response": "hithanks for askingas looking at your history the pain is suggestive of disease in colon......the presentation of appendix is not like that...........the sore area can be skin infection............i would like to suggest you to visit a nearest doctor",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching and red bumps between the vagina and anus?\n\nHello so i am freaking out right now about some itching from my vagina all the way to my anus and above. On top of that I have small read bumps between my anus and vagina but closer to my anus. they are small but there are quite a few of them. And I have been constipated and had some bloating of the stomach with a little pain that accompanies it.",
    "doctor_response": "HI....Thank you for asking Query.I read you problem ,as  i understood from what you said that you have bumps near to anus  , having itching due to this , the bumps in this area can be due to simple bacterial infection,but some viral infection of this area can cause it,if they are filled with pus/fluid  then bacterial infection can be the cause for it,some antibiotic ointment -Fucidin-can helpful apply  x2time over it for 5-7 days, +some oral antibiotic  like ampiclox capsules can be taken for 5-7days if you do'not  have allergy  to penicillin,  not pregnant now-if married,as you did  not told your age ,so the dose of medication need to be adjusted  by local DR      or  pharmacist.but if you have  nearby GP, better  to be examined by him/her .Hope you got the answer  ,you can freely ask any  other query next .RegardsDr Mohammed I. Khan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can we take tamsulosin for a mild enlarge prostrate and natural vegetables at the same time ?\n\nHi Dr Samuel  I have three questions :1. Can some one take tamsulosin for a mild enlarge prostrate and natural vegetables llke celery,tomatoes punkin-seed pomegranate at the same time.2. My doctor had prescribed  tamsulosin in summer of 2012 because of regular urination. After taking the first tablet  I did not like how my body was reacting so I didn't use any more and the pee improve automatically. But  3 months after some minor irritation in my testes I use the pills even though not every day.  About six month later I found out about the Natural treatment in question one and held off the pills for the natural treatment.  They worked better than the pills and really boosted up my libido and  sexual drive from  June last year until my prostrate act up again two weeks ago which I must explain . In January until mid February I was not in the USA and I did not find the time to get my natural product,nevertheless I was still ok. about two weeks ago I bought ' Digel ' from the pharmacy over the counter for gas treatment (contents were magnesium hydroxide and potassium hydroxide).  Five days after taking it I find I began to pee frequently every 1/2 hour. When I stop using the Digel  I  pee at a rate-SPACING  of some times 1&1/4, 1&1/2 hr,1&3/4 hr, or even  2 hrs . I started to use the tamsulosin again after 3 days of  pee symptoms and back on my natural remedies too. I  began getting minor pains in my testes from Friday night.  My made an appointment  to see a urologist with in two weeks. My question is will the mild pain go away on this treatment plan or I have to ask my DR for a more effective pill. ? My last PSA ratio was  1.0  ref range = 4.0   dated (9/13).3. Is there any better recommendation to stabilize my peeing and alleviating the pain.",
    "doctor_response": "Hello1 Along tamsulosin you can take any type of vegetable or fruit . Only precaution is to be taken ,not to take high liquid diet or fruit or juice 4-5 hours before sleep .( less urine formation )2  Tamsulosin is used in Benign prostatic hyperplasia ( for enlarged prostate ).Normal dose is 400 mcg and you can increase up to 800 mcg once daily after 2-4 weeks , if necessary . In your case as you stopped so many times so now you can restart but dose should be 400 mcg till satifactory result. 3. In few cases we can get good result with a combination  of tamsulosin+dutasteride after consultation with a surgeon .Your PSA level is within normal limit so need not to worry .Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to confirm what a stable spot in the lung is?\n\nHi, I m 22 y/o and I am applying as an intern in other country, however my x-ray shows a stable spot in my upper left lung since last year. I had a primary complex when I was an elementary student and it was treated. I consulted so many doctors but they have different opinions. One pulmonologist said it s a scar. Other said it s PTB. I had sputum test, it s negative. I don t have any symptoms. The affiliated doctor of the clinic, which is affiliated to our company suggests me to take treatment but I m afraid, what if I don t have PTB and then I took medicine. I guess it s hazardous to my health. Please advice me. Thank you.",
    "doctor_response": "What you can do is the best is to get a bronchoscopy done and a transbronchial biopsy to confirm or rule out tuberculosis. I agree that it does not seem to be an active tuberculosis if you arent suffering from any symptoms however you can also take emperical treatment with AKT for 6 months.Emperical treatment wont harm much except for the drug side effeccts that you would have to tolerate even wiothout any tuberculosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could painless lumps on clitoris suggest?\n\nmy friend is overseas, we are experienced icu nurses and stumped. She noticed a painless lump inside her clitoris a week ago the size of a grape. It feels like it is fluid filled. Again it is inside and painless. Cant find any research....any thoughts??",
    "doctor_response": "This may be a Bartholin's cyst. It is a benign condition. If it is painless it means it is not infected. However because of its size it has to surgically removed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for growing itchy rashes on the upper arm\n\nI am a 72 yr old male in good health. I have developed a rash on my upper arm that itches intensely and appears to be gradually spreading. It has a small amount of centralized crusting beginning to form. OTC meds such as Cortisone 10 temporarily stop the itch, but over the last 2 weeks it has slowly spread. Name: Steve Valand email: YYYY@YYYY",
    "doctor_response": "Hello, The rash could be due to an infection or an insect bite. It must by properly examined by a dermatologist to distinguish. So, I recommend you to visit your nearby Dermatologist. You could take an antihistamine tablet empirically. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pressure of 120/54 considered hypotensive?\n\nMy Dad is 87 but a young 87. He gets around real well and is very sharp. He is a veteran and is taken care of very well. He takes blood pressure medication and it is controlled. However right now his pressure numbers are 120/54. Is this considered hypotension even if the systolic is normal? He doesn't feel right and his face is red. Do I need to be concerned?",
    "doctor_response": "Hi,Don't worry. In his age diastolic blood pressure can be as lo as 30 mm Hg without any pathology. In patients with advanced age we pay attention only in systolic blood pressure. There is nothing to worry if diastolic blood pressure is low.Take careCome back if you have any further questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headache,fever,joint pain and stiff neck?\n\nI have had headache for the last seven days. Fever on and off , joint pain, stiff neck, stomach cramp, nausea and diarrhea for one day. Doctors did a spinal tap and ruled out meningitis. Waiting for blood cultures for bacterial infection. Do you have any ideas.",
    "doctor_response": "Hi,From history it seems that you might be having acute gastro-intestinal infection mainly of bacterial infection.Due to toxins released by bacteria there might be having stiffness of neck muscles, fatigue, tiredness giving rise all symptoms.After reports go for one specific antibiotic medicine course for 7 days.Take light diet and plenty of water.Take complete rest.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe upper abdominal pain\n\nI had an episode of severe upper abdominal pain.  Ultrasound revealed dilated bile duct, mildly enlarged liver,  no pancreatic lesions.  Liver enzymes, amylase, cbc, normal.  My cnp wants to consult with a surgeon.  Is this appropriate or are there other non-invasive tests which might aid in the diagnosis?",
    "doctor_response": "In regard to this present status, the best and most dependable Non-invasive test would be a MRCP scan.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Was on depo, came off it, started to bleed, painful sex, sore breasts, cramps. What is wrong?\n\nhi there right this is a long one ! i was on the depo for 2 years and i have been off it for 19months when i didnt have my shot i started bleeding all the time and when i stoped my period me and my would make the most of it as we wouldnt know when i would next come on and we are trying for a baby.over the months i was in pain when having intercourse but i did go to the docotors and they said oh you just have irregular cycles it will take awhile to get back to normal.so i gave it time but still nothing so i went back to the doctors and in the end they sent me to a gynecologits (sorry if spelled wrong) i got put on two diff anitibiotics as a course to see if i had any infection and also the pill to help control the bleeding. i go back 3months later and everything is a little bit better the pain had gone from intercourse the bleeding wasnt so heavy and more in a cycle so he said as everything is getting better i will see you in 6months time.so when my cycles got better i started to track my ovulation ect and getting all happy that i was normal i had 4 months of regular periods. then xmas came and i was stressed from work and home things and i came on again i had 3 periods that monthso a week free inbtween each one i know this can happen if you stress the body out so i wasnt to bothered it was 27th dec i saw blood lasted 7days and was heavy the next one was 7th jan and lasted 5days ! i am getting so fed up with this now because my period finished last week and my breast are still sore more than normal havin little cramps and cant go to the loo very well ! i know all the symtoms to be pregs but i never am and how am i ment to know if im always on my p! ? i cant take a test if i was on last week can i ? and when i wiped today there was a little bit of pink and i mean it was tiny what do i do ? could it be im pregs? i want to take a test but i have this feeling it wont work someone please help me many thanks",
    "doctor_response": "Hi there ~ I am sorry that you are having problems with your menstrual cycles.  For all that you might just be pregnant now, and you will have to get a pregnancy test to have this checked out.  If your test is negative, you will have to see a qualified gynecologist to have a complete gynecological examination, and maybe labs and imaging done.  Anxiety may have a relationship with heavy menstrual bleeding, and you may need treatment for the same with therapy or medications.  I hope this helps. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness, nausea and tightness in chest?\n\nMy daughter is out of the country.  She is 21. She broke her foot.  Two days later,   Drs. diagnosed (English not first language so possible vague areas) as a side-effect of cipro (she was taking for an unrelated infection), she had heat at the back of her neck, nausea, and what she said felt like \"tighness in her veins\".  Yesterday, a couple weeks after this incident, she was watching a film in a movie theatre - heart began to race, dizziness, same tightness.  She went to the ER in an ambulance.  The EKG showed no abnormality.  It was called an arrythmia -- but I had the impression the Dr thought it was \"anxiety\".  She was not anxious at the time of the incident.  This is of great concern to me and I am 7000 miles away. Any insight? I'd be grateful.",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!Regarding your concern, I would explain that a comprehensive differential diagnosis between anxiety and cardiac arrhythmia should be done. You should know that even the trauma she has gone through (foot breaking) could be related to anxiety and heart palpitations. I would recommend consulting with the GP for a careful physical examination , a resting ECG and a chest x ray. Some blood lab tests (complete blood count, PCR, sedimentation rate, thyroid hormone levels, cortisol plasma levels, fasting glucose and blood electrolytes) are needed to exclude other possible metabolic causes like chronic anemia, thyroid or adrenal gland dysfunction. An ambulatory 24-48 hours monitoring and a cardiac ultrasound may be necessary if suspicions of a possible cardiac arrhythmia are raised. If all the above tests result normal, the most probable cause of her symptomatology would be just pure anxiety. Hope to have been helpful!Feel free to ask any other questions, whenever you need!Greetings!Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Loud and repetitive sneezing, inhaler to recover\n\nI am a 55 year old male and for many years now I have endured very loud and repetative sneezing . It feel very self conscious as it can impact when least expected and with out any apparent cause. It s strength and repetativeness can be so great I need to take an inhaler to recover from an attack or I will struggle to breathe Graeme",
    "doctor_response": "Hello Gra, Welcome here on hcm. As far as your story is concerned I cannot reach to any conclusion. Your case has to be investigated for and respiratory or cardiac problem. Get your blood examined for CBC, Hb%, ESR, S. Cholesterol, Blood sugar, Blood urea. Get X-ray of chest AP and Lateral view. Get ECG done. After all these report here on hcm for further advice. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting stomach acid in a child?\n\nMy 3 year old is throwing up clear almost stomach acid looks like. No signs of sickness before but for 3 hours tonight out of the blue. She s ate today before the vomiting started. Now she s waking up to throw up and I got her to get some water down. What do I do?",
    "doctor_response": "Thanks for consulting at Healthcare Magic.Vomiting in your daughter might have been caused due to infection, reflux, or food poisoning. Give Ondansetaron or Domperidone for vomiting, ORS solution to prevent dehydration and Ranitidine for acidity.If no relief consult your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp shooting pain in chest in left side?\n\ni have had chestpains for a long time now . They come and go I have high bloodpressure . I have had ekgs and bloodtest done and chest xrays done and all where normal i also have had a stress ecko cardia and it was normal the pains are sumtime in center and pressure and some times they are on the left side and a sharp shooting pain should i still worry",
    "doctor_response": "Hi,Dear,Thanks for your query to HCM.Dear I read your query and reviewed it with context to your query facts.I understood your health concerns and feel Concerned about them.Based on the facts of your query, you seem to suffer from-High Blood pressure with Prinzmetal's angina, as it seems to disturb you when you are at rest and occurs with  breaks.Other causes/ types as stable / unstable angina- of the angina need to be ruled by Second opinion from Cardiologist Consults.Shooting pain is from recurring coronary spasm at rest and needs to be evaluated as it is risky and indicates uncontrolled.As all your tests seem to be normal, this suggests the need to control your lifestyle and the blood pressure..So you should worry and investigate with holtzer stress test to find out the coronary narrowed areas, which are missed on routine test in your case.Hope this would help you to treat your health issues in the best way possible.Welcome for any further query in this regard.Good Day!! Dr.Savaskar M.N.Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is lump in chin after being boxed?\n\nI am 26 years old, 5 foot 11, 205 pounds and have diabetes type 1. No allergies no other medical history. About a week ago today I was involved in a drunken fight with my room mate and he called me on in the back deck. Not thinking he was going to do anything but just threaten me I step out and next thing I know he swings a punch at him and hits me square in the chin. I get knocked out, police were called etc. Anyway I have a huge bruise on my chin and it's slowly going away but I noticed when I touch my chin there is a lump on the left side of my chin where I got hit. it doesn't hurt when I touch it, just feels like a lump. is that bad? Will it go away in time or do I need to see a doctor?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have history of trauma. So there is high chance of developing hematoma.  It is due to extravasation of blood. You should take anti inflammatory plus analgesic drug.  Drugs like Chymoral forte is helpful to reduce the swelling.  This all drugs are prescription based medicine so consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can an itchy and swollen lump on the butt cheek be treated?\n\nHey I m a 25 year old women I ve had this bump on the inside of my butt cheek for a yr now and it s dark red almost purple it s sometimes itchy but it hurts sometimes it doesn t have a head or anything but gets swollen sometimes I used to get lesions but have had a cream prescribed and I thought this was one but it s not it s different jus need to know if it s dangerous",
    "doctor_response": "Hi, dearYou may have some piles (hemorrhoid). You should go for examination and take treatment. Medical treatment is useful.  You should take high fiber diet, plenty of green leafy vegetables and plenty of water.  Avoid constipation.  You can use isapgul powder one teaspoon at night.  Local anesthetic gel can be used for pain relief.  If not improve with medical treatment then surgical excision is the treatment of choice. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is an MRI required for sciatica pain post accident?\n\nMy daughter fell off a scooter last summer and has had terrible tailbone pain since. Xrays show no bone injury and pt was ordered. 3 months later she is now having sciatica pain down her left leg and into her thigh and calf muscles. Is an MRI the next logical step?",
    "doctor_response": "Dear patient your daughter has got radicular pain most likely due to disc protrusion in lumbar  spine. Mri is very sensitive and specific for diagnosis of spine pathology. you need to get it done from radiology centre nearby you. Meanwhile start tab pregalin x 75 mg one at bedtime. Ask her to take rest in semifowler position and avoid forward bending and weight lifting. you need to consult spine specialist with report.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain in right side of chest?\n\ni keep getting a sharp shooting pain through my chest so sharp i have to grip it till its gone. but its on my right side right now, but its just a dull ache and its in my right shoulder and right side of my neck its all on my right side bit shoots across to my left side every so often and the middle of my chest. i dont want to go to the hospital and waste any time or be there till 3am to be sent home feeling silly and i dont want to call nhs either. any ideas what it could be and how to shift it? i dont have heart burn i dont feel sick i dont feel sweaty my skin is as warm as it can be in this weather i feel alert its just the sharp pains that are really worrying me",
    "doctor_response": "Hello! Welcome and thank you for asking on HCM!Your symptoms could be related to a musculo-skeletal pain or a pinched nerve. For this reason, I would recommend avoid neck movements and take painkillers like ibuprofen or acetaminophen. I would exclude any cardiac disorders, because your symptoms are not typical of any cardiac issues. If the problem persists, I would recommend consulting with your attending physician for a careful physical exam and some tests: - a chest X ray study- a cervical spine x ray study- complete blood count, PCR, ESR for inflammation- a nerve conduction study to exclude a pinched nerve. A cervical spine CT scan may be needed to exclude a cervical disk herniation. Hope to have been helpful!Wishing good health, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome panic attacks after moving to a new place?\n\nI just moved into a new apartment on a military base with my husband in new orleans. I've lived in a small town in Utah my whole life up until now. When I first got here I had a couple of really bad panic attacks. I'm terrified to leave my house. And it's preventing me from living my life and I don't know what to do.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. You know your condition. Panic attacks for you are not new. Panic attacks are caused basically by anxiety. Anxiety is a disorder and not disease. You must understand that.Are you under treatment for anxiety or panic attacks? Are you under therapy? If yes, fine. By now you must have learned how to overcome panic attacks. If not you should.Learn to relax. Positively imagine etc are some of the CBT techniques used to overcome panic attacks. I can help you overcome these. Post a premium question giving all your details and I shall help you overcome panic attacks and anxiety.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure dry patches of area on scortum?\n\nHave some dry skin on penis and dry patches of area on my scrotum. Is it due to masturbating? I really don t know. I m thinking for the penis I created friction that it is healing from excessive masturbation, but as for the dry itchy patches on scrotum I m not for sure. I believe it s from my job and pants and sweating and underwear chafing my scrotum",
    "doctor_response": "Hi, I have gone through your query.Dry patches you have mentioned are usually due to fungal infection. Yes, It is due to unhygienic conditions like sweating.First of all you have keep area hygienic and dry. You can apply ointment containing miconazole over the patches. It will help in resolving the problem in a week time.You can contact me on my page  you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a small bald spot on the head of a child?\n\nmy 5year old daughter woke up with a small bald spot about the size of a pencil eraser at the back of her hair part at the top of head. She has very long hair. She was sick last week with 103 fever. she had a problem in November when she threw up during vacation. She was extremely stressed and didn t want to go to school in fear of throwing up. then she would go to school but didn t eat much. Could this be caused from vitamin deficiency, stress, or alopecia? Should I take her to a dermatologist ? I didn t want to traumatized her.",
    "doctor_response": "Hi, This could be because of fungal infection of the scalp leading to hair loss. I do not think this is related to the viral illness from which she is recovering. I suggest you consult your Dermatologist regarding this, please. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can excess masturbation cause nerve damage with twitching of lips?\n\nGood Morning Doctor, when i talk, my lower lip pulls itself to the left involuntarily? I'm 39 years old, left my job due to overworked and overstresses. I went to a neurologist and he ran test, MRI of the head and jaw and found nothing. I went to my PCP, who stated i was just overworked and overstressed, nothing to worry about, suggested i take John's Wart and suggested Prozac? Some even say it's due to overmasturbation, I might have damaged a nerve? Please advise..thanks",
    "doctor_response": "Hello, Masturbation cannot damage your health or your nerves. Excess masturbation can cause some problems to your penis nerves. But not on your facial nerves. Your symptoms could be due to anxiety. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of lightheadedness, unbalanced feeling, fatigue, and cold feet?\n\nHello, I am Ryan Concepcion, 26 years, male. I would like to know what could be the reasons behind my chronic lightheaded-ness (whole day), unbalanced feeling, feeling faint, cold feet, and fatigiue. I am taking Stugeron for the motion sickness, Nexium and gasmotin for my GERD and Multivitamins.. A couple of months back, I was rushed to the hospital a couple of times due to a holiday heart syndrome. I was woken up a couple of times from my sleep due to numbness in both of my hands. Sometimes its just my pinky, at times my whole hands, either or both of my hands. I have been feeling detached from my body, which gives me a sense of blankness in my body. I feel as if I don't have full control of my body. I am very scared that I may have cancer or some sort of terminal disease. I also do have lumps in my neck. One in about 1 cm under my chin, and another one under the right side of my jaw, 2 cm. Both are wiggly, but are fixed. My EENT told me that it is nothing to be worried about. Should I see a neuro for this? or a cancer specialist? cardio? All of my test came back normal. CBC, Holter, Stress test, abdomen ultrasound. I am happy that they're all okay, but none of these test are invasive or aggressive enough to have an in depth look on my body. I just hope that my unbalanced feeling could just be due to some sort of problem in my eyes or ears. Im afraid of having cancer since my mom had one before. Thanks for your time. God bless.",
    "doctor_response": "HIThank for asking to HCMI can understand your problem, what ever happening to you or the symptoms that you have stated here are all because of your emotional and functional disorders, you are thinking in negative ways and that gives you weird kind of ideas, in fact this is your functional condition, and nothing wrong is with you, just take it easy, and no need to worry about anything, hope this information helps you take care and have good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat UTI?\n\nDear Dr. Parsons,It started with an ordinary UTI, but developed into feer and i went to ER. That was exactly a month ago.I was given antibiotics, had a catheter check for \"left overs\"  short manual prostate check and released home for treating with omnic and atibioticsthe urologist i went to prescribed tamsulosine (flomax) but that brought me again to the hospital with cardiac side effects. I was given Saw Palmetto instead but i still had difficulty urinating so i was given cadex 2 mg one daily. it did the same as flomax, just not that strong side effects. my urologist asked to stop i had ultrasound and the psa blood test showed last one 43 now i have pain - moderate in all the pelvic area and groin i urinate difficultly with pelvic pain sometimei keep taking the palmetto and two days ago started Himplasia twice dailyi don't feel better but i still can peewould it be wise to take both palmetto and himplasia, or should i decide to cut one of themmy urologist does not know himplasiaplease advisethank you for your time",
    "doctor_response": "Hi Sir,I understand your concern.Many of your symptoms are directly related to underlying prostate pathology.This in your case should possibly be BPH-Benign Prostate Hypertrophy.This can frequently lead to UTI's.Since you are reporting pelvic pain,it's high time that you are treated adequately with antibiotics.You possibly seem to have Prostatitis.The PSA can be elevated as part of infection and BPH process.Saw palmetto is superior to Himplasia in my opinion.Its very important that you continue both Flomax and Cadex as both drugs extremely superior in controlling the growth of the prostate,improving urinary symptoms and controlling the blood pressure respectively.I generally treat my patients with oral tablets of Gudcef CV and Norfloxacin. I suggest you to please see a doctor if his views are same and if can prescribe these drugs for you.Your symptoms will largely improve with these measures.Post your further queries on my health page if any.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long do bronchial spasms last?\n\nYes I was recently diagnosed with bronchial spasms I notice my oxygen level is fluctuating up-and-down as I move around or sitting still is this normal and how long can a bout last I have been drinking lots of fluid but I m not getting any sputum up",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Most common cause for bronchospasm is bronchitis due to viral infection. Usually viral infection is selflimiting in 1-2 weeks. Till this time, you need bronchodilators to relieve bronchospasm. So better to consult doctor and start inhaled bronchodilators (Formoterol or Salmeterol) and inhaled corticosteroid (ICS) (Budesonide or Fluticasone). 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from stomach cramps & lower abdominal pain\n\nI get random stomach cramps like lower abdominal pain and my side aswell especially when it s cold the pain is so unbearable that I can t stand straight sometimes and also I m bleeding but it s not time for my period the blood is red brownish colour I also have lots of blood clots during period",
    "doctor_response": "Hi.Thanks for your query. This is called inter-menstrual bleeding if you are not pregnant.This can be due to abortion if you were pregnant.The clots cause lot of pain like you have as the uterus tries to expel it. You can take anti-spasmodic tablets. If the bleeding is not controlled within a few days consult a Gynecologist, go for ultrasonography of abdomen and pelvis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes discomfort in the hand radiating to the shoulder and armpit?\n\nI have had both carpal and cubital tunnel surgery and whilst it did work to start off with, the pins and needles have returned. But now I am getting this feeling starting in my hand and goes up my entire arm into the shoulder and arm pit. this is happening at least 30-40 times a day and also wake me at night. should I go back to my consultant or GP. It also sends my arm into spasms in my muscles which is not a great sensation",
    "doctor_response": "Hi, It could be due to musculoskeletal pain. As the first line of management, you can take analgesics like Aceclofenac or Tramadol for pain relief. If symptoms persist you can consult an orthopedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant headache?\n\nHi! I m a 30 yrs old, female. I ve been having a constant headache for more than a week, green stools, almost a white out dizziness when going from the floor to standing, also once in awhile it feels like im on an elevator when im not? I m drinking lots of water and have taken otc pills for my head. Also have not been eating any more green veg than normal? I did get a promotion to a more stressful job about 2 and a half weeks ago. I m not sure that has anything to do with it.",
    "doctor_response": "Hello and welcome to \" Ask a Doctor\" service.I have read your query and here is my advice.Stress is a possible explanation for your symptoms.So, try not to worry much more than necessary, exercise, eat healthily.Hope this helps.Feel free to ask if you have further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Am i pregnant as there was a positive line after a few hours of test?\n\nIt has been five weeks since my last period on august 2(last day of period). In between, we had intercourse around ovulation time and then after some days I started feeling nausea and abdominal cramps. No implantation bleeding. Now i have missed my period (expected date was 31st august) but both pregnancy test have come out negative. my second test today (september 4) showed a barely visible positive line but that was after a few hours of testing. Could I still be pregnant? We have been trying to concieve since January 2015 and i am 33 yrs old now.",
    "doctor_response": "Hi you can be pregnant.  Just repeat a test again after 24 hours with a morning sample of urine. This will definitely confirm your pregnancy.  If that test also shows a faint line go for a ultrasound after consulting a doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Monocef injection given to hepatitis patient cause death?\n\nHello Sir,              My father was suffering from Liver disease.(liver was smaller in size),he was under treatment of DOCTOR since 7-8 months,recovering but on 7 feb .2014 blood was passed out from mouth and pain started..we have called doctor...doctor told for an injection MONOCEF (Ceftriaxone 1gm).We have given that injection within 15 mints he was no more....i have heard that the monocef injection is not given in Hepatic patient.I WANT TO KNOW THE CAUSE OF DEATH IS INJECTION OR NOT.",
    "doctor_response": "Monocef injection is never cause death in any patient. Unless your father has any allergy to ceftriaxone. But if he has received this injection in past,  chances are there he died because of liver failure.  History which you are giving is also very typical of liver failure,  as patient development bloody vomiting,  and  died due to this.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How do I reduce swelling due to allergy to preservatives in food?\n\ni am have an allergy by preservative things like after eating coke or lays chips, my body get small spot swelling, and i need to scratch that spots than for that i am taking levocetirizine. pls suggest me how to get free from this. My name is ravi shekhar",
    "doctor_response": "Hello, Welcome to HCM,If you are confirm that you are having allergy to these products, Prevention is better than cure.Try to avoid these food products.In unavoidabl circumstances , if you are having any itching or rashes you can continue the same medicine which is prescribed by yoir doctor.Hope I am able to answer your query.Than you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for high fever in a child?\n\nMy 7 month old daughter has a fever on and off through out the day for 2 days. Out of the blue fever, highest is 102. She had a minor cold before the fever, nothing else. She is cranky throughout the day but there is a moment where she is back to herself but then fever comes back. I have given Tylenol to help with the fever but it doesn t seem to help. Should I take her to the er or wait til Monday to see her pediatrician.",
    "doctor_response": "Hello. I just read through your question. I'm sorry your daughter is not well. Fever alone is not a reason to go to an ER. We do our best to control the fever with tylenol and motrin. Sometimes cool compresses to the forehead can help to. Then, at the next opportunity, she can be taken to the pediatrician who can diagnose the cause of the fever.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower right back pain after lifting weights?\n\nHi Dr., Five days ago I was working out at the gym. I lifted more weight than I should have doing hang cleans (swiftly lifting bar from knee level to shoulders) and felt sharp pain in my right lower back. My back was sore for a day or two and most of the constant pain has gone away. My problem now is, when I lift anything light or bare body weight on my back or sit down, there is more sharp pain. Also, my back will occasionally hurt when twisting. The pain is still focused in the right lumbar region. There is no pain in my buttocks nor my legs. Being the pessimistic person I am, I believe my problem to be a herniated disc. Of course it has been less than a week since the injury, but I would still like your opinion. I am 20 years old and have no history of back injuries. Thanks, Blaise DesChamps",
    "doctor_response": "hello , thank you for using healthcaremagic. I read to your question and understood your concern .I think you should take some rest and not lift weights for few weeks take some ibuprofen or other nonsteroidal anti-inflammatory medication.After the pain goes down you can start some physical therapy exercises for your back.If after two months you can go head and do a back MRI thank you Dr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Epstein-Barr virus cause nausea, vomiting and diarrhea?\n\nMy 8 year daughter has had a fever off and on for 6 days.  She has seen the doctor twice.  Her first symptom was a sore throat.  Since then she has had nausea, vomitting and diarrhea.  She also complans of a pain in her side.  The doctor kmows of of this but since she tested positive for the Epstein-Barr virus (we are waiting blood results), nothing else is being done.  I am more than concerned.  The doctor says EBV would explain all her syptoms but why is the fever almost continuous.  She has definitely loss weight and now stays in bed.  Should I seek a second opinion?  I have seen two different doctors in the same practice.  PLease help!",
    "doctor_response": "Hello,Welcome to HCM,Infection with Epstein-Barr virus (EBV) is very common and usually occurs in childhood or early adulthood. EBV is a contagious infection that spreads from person to person.EBV is the cause of infectious mononucleosis and the symptoms arefever, sore throat, swollen lymph nodes in the neck, and enlarged spleen. The symptoms like nausea, vomiting and diarrhea are very much rare with EBV infection.Individuals with EBV infections requires1.Adequate rest 2.Plenty of Fluids3.Corticosteroids to treat significant swelling in the throat4.There is no specific medicine to treat EBV infections.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes light headedness, muscle twitchesand high bp?\n\nYes I went to my dr today and was a little light headed and had a bp of 198/81. My hr was 99. Ekg was normal. I also have been having musvle twitches, especially in my face. i am 43 medical rep, overweight female. He put me on azor. What do you think it is?",
    "doctor_response": "hello thanks for posting hereyour BP was quite high during the episode. this accountd for your light headedness. muscle twitching can be due to low calcium levels. Please check your calcium and vitamin d levels. The doctor has started you on a medication to decrease your BP. Please check your BP regularly. If it is persistently high despite taking tab azor then another BP medication has to be added. thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itching on thighs, arms and feet. Normal liver and kidney function tests. could this be due to food allergy?\n\nI have itching areas started 6 months ago. Prescribed cream did not work. The appearance is like hives , red weblike, knot/hard. It goes away after 3 to 5 days. They started from my thighs, legs, feet, arms, fingers and now it is on my back neck. Doctor took blood test and it was OK; no liver , no kidney or blood abnormality. I am concern if this is something related to heart condition and etc. Two weeks ago it happened after I ate a little soy bean (tofu) and this time was I ate last night some peanuts and this morning at 5:00 the back of my neck started to itch. I took 2 aspirin at 5:00 am and seemed to stop the itch and then took another 2 at 12 noon and now it s itchy again. Thank you.",
    "doctor_response": "It  is allergy Ground nut,almonds,coconut walnut and soya oils increases allergies stop taking them take olive for cooking and olive for application take fexofenadine for controlling apply calamine lotion on affected areas get blood serum tested for fod specific antibodies",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for groin soreness after an injury?\n\nGroin soreness in both sides where groin meets crotch area, 1 side much worse than the other however. I have no recollection of pulling this during sport. Awoke up one day with very tight and sore groins, not all the way down my thigh however, just at the point where it meets the crotch area. I play football (Soccer) 3 times a week, the last time i played was boxing day, and the injury occurred 2 weeks before that. When i played boxing day it was still very sore, i have done absolutely no exercise since boxing day and it is showing no sign of improvement in the one side that was hurting more, the other side seems to have cooled down a bit. there is no inflammation, no bruising etc, just very sore. If i try and do a slow kicking motion, then it hurts, also if i push my knees outward and attempt to push back on it gently too add resistance, it also hurts at the point described. I have rested it, done slight stretches, and have had no sign of improvement. I am beginning to wonder if this is something more sever than a strain, although if this was the case, i surely would remember something happening to cause it. When i first woke up with the pain i hadn t even been playing sport for a few days before, so am at a loss for an explanation, i have had strains in my groin before which have eased after 1/2 weeks, however this feels a lot more raw.",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you are likely to have Inguinal Hernia However this can be confirmed only on clinical examination by a qualified General Surgeon.Please consult qualified general Surgeon for clinical assessment and further treatment. If turns out to be positive you need to get surgery of Hernia repair done .In the mean while take pain killers like Diclofenac or Brufen twice daily.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment for liver cancer?\n\nI have a best friend whose husband beat colon cancer but then it went to the liver. Her outlook is that he is going to die and shouldn't seek treatment if it means he is not going to have a good life. He had his gall bladder and part of his liver removed and it seemed very successful. Is the prognosis always death with colon cancer that menesthetizes to the liver? I think she's being very negative and don't know what to do.",
    "doctor_response": "Hi,Thanks for writing in.Liver metastasis occurs in half of patients with colorectal cancer. Treatment of colorectal cancer with liver metastasis includes the following methods.1. Surgery.2. Neoadjuvant chemotherapy.3. Local ablation (eg radiofrequency ablation).4. Adjuvant chemotherapy.5. Intra-arterial chemotherapy.Present medical treatment guidelines for metastatic colorectal cancer suggests the following.Currently, there are ten active and approved drugs for patients with metastatic colorectal cancer that are used alone and in combination with other drugs:5-FU.Capecitabine.Irinotecan.Oxaliplatin.Bevacizumab.FOLFOXIRI (irinotecan, oxaliplatin, leucovorin [LV], and 5-FU)Cetuximab.Aflibercept.Panitumumab.Regorafenib.With regard to chemotherapy, advances taking place each day in the field of cancer treatment, many of the metastatic colorectal cancers have been seen to respond to chemotherapy. There what is called the first line chemotherapeutic agents and if they do not show response then second line of drugs are used.An average time of survival might be anywhere from 6 months to 15 months. Few patients can survive longer by few months. The battle in fighting cancer must go on till the end.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in conceiving after discontinuing contraceptives?\n\nHi there. I had an abortion last year and had the implant put in at the same time, I had that taken out due tO pain in my arm, I went on the pill but stop taken it. I was last on my period on the 25th of June 12. And have been having sex while I was on and since then, why have I not feel pregnant yet?. Please help.",
    "doctor_response": "Hello,I have gone through your query and understood the concern. There are several causes for failure of conception. In this scenario, the possible causes are a delayed return to ovulation, other hormone insufficiencies, tubal factors, infections and the male factor. If ovulation is established, regular intercourse during the ovulation or fertile period is needed to ensure conception. Please see an infertility specialist if you fail to conceive even after six months of sincere trial. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and pain in kneecap?\n\nCan you herniate your knee around the knee cap? I am 30 yrs old, 5 9 175 lbs and farily active. I noticed my knee had a bit of pain when I crawled on it and some swellining a couple days after hiking. That was over 3 months ago and it has showed no signs of improvment. I did go hiking again a week ago and experienced no pain and no increase in swelling.",
    "doctor_response": "Hello,The symptoms seem to be related to an overuse of the knee. Iliotibial band syndrome, also referred to as IT band syndrome, is a condition in which this tissue becomes inflamed, tight, or\u00a0swollen. Again, this condition occurs with overuse of the\u00a0joint. I suggest using anti inflammatory medications such as Acetaminophen to relieve the pain. I also suggest to maintain the knee elevated and rest.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have pain in back, legs and thighs with high WBC and low Hb. What should I do?\n\nHello doctor, I am a 37-year-old female. I previously asked a query in icliniq and was attended by a doctor who advised as follows. Since all your reports are normal except for very mild anemia and a mild increase of WBC count, then the cause of your lower back pain that extends to your hip, thigh, and knees could be either sciatica or lumbar disc prolapse. This should be diagnosed by a CT scan of lumbar vertebra. You also need an x-ray of your hip joint to exclude osteoarthritis. For the anemia, you should take iron and folic acid supplements for a month. Last month I had pain in my legs, thighs, lower knees and in my back. I met an orthopaedician and find nothing wrong with the knee joint, PBH and lumbar spine. My USG abdomen and pelvis are also clear. Now my blood pressure remains high. I am feeling pain in my back, thighs, and legs below my knees. And I am feeling very weak. As per my last report, my WBC is high and hemoglobin is low (report attached). Currently, I am taking Ultra -D3 10000 IU once in a day, Fludac 20 mg capsule twice a day, Gemcal once in a day, Stamlo-5 twice a day.",
    "doctor_response": "Hello. After revising your x-rays (attachment removed to protect patient identity), it seems that you have degenerative changes in your knee joint and in your spines with diminished disc space between lumbar vertebra number 5 and spinal vertebra number 1. These degenerative changes actually indicated the presence of osteoarthritis which is a chronic progressive disease of joints. Treatment aims at stopping the progress and managing the symptoms, it should include analgesics and anti-inflammatory medications, corticosteroids, physiotherapy that should include stretching to improve flexibility and mobility of joints and excercising as well. As for your blood pressure, you should start a strict salt-free diet and monitor your blood pressure for 10 days, if still high then you will need an antihypertensive medication.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness in chest,dizziness and numbness on fingers after exercising?\n\nI am a 43 year old male.  Last Saturday after exercising, my chest starts to feel very tight, dizzy and numbness on my fingers.  The diziness went off after an hour however I continue experience tightness in my chest and numbness on my fingers for the next few hours.",
    "doctor_response": "Hello, These symptoms are very much suggestive of heart disease. You get your ecg and tmt done. You may need echo as well. Also get lipid profile and sugars tested. Avoid heavy activities and fatty, oily And high calorie diet. Avoid smoking and alcohol if any. Use tab Sorbitrate  sublingually whenever you have chest heaviness. You should get yourself evaluated on urgent basis.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sharp pain on left side with high BP\n\nI have been experiencing some sporadic pain on the left side between the armpit and the breast but I feel it is inside (heart area), for 2 days now. I am on hypertension medication and my blood pressure was 124/81 yesterday morning. Apart from the usual high workload I am not under any other particular stress. I have experienced anxiety episodes (due to the high blood pressure) before but never pain like this. I do regular exercise (aerobic). I have also been taking some Gingko Green Tea capsules to assist in weight loss. Please advice on possible causes of this pain.",
    "doctor_response": "Hello,Even if you have single symptom and is suggestive of cardiac elements, then it needs to be ruled out for the cardiac disease like coronary insufficiency.I could say that it is not the cardiac symptoms but it cannot be taken as granted or underestimated as you are hypertensive patient and have history of anxiety, so this could possibly cause the cardiac disease.I advise you to get done the EKG and stress test, just to clear the doubt of cardiac disease.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Akhtarhusain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is h and h derm cream an effective fairness cream ?\n\ncan any one use h and h derm...for fairness.i look dull.iam appearing for interviews.previously i use soundarya cream..can i use h and h derm cream.as my frnd suggested..to use it.as it was giving good results.siam using soundarya cream from 6 months..but the impact was not good enough.....so give me a proper answer for my prblm..its very imp to get fair now.as iam lacking confidence ..because iam dark.so suggest me a good ans",
    "doctor_response": "Hello, welcome to healthcaremagic. First of all you should know your skin type wether it is oily, dry or mixed. Nowadays most of the cosmetic items are customed according to skin type. You should apply sun screen lotion before stepping into the sun to avoid tanning. And regularly use a face wash atleast twice a day to impove your complexion. You can use the h and h cream to obtain good results. WIsh you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high fever in children?\n\nEarly this evening my 3 yr old daughter spiked a high fever 102.0. I am assuming at this point it is the flu since 2 of my other children are recovering from it now. However, after a dose of tylonel and brief nap she was up and back to normal. I frequently checked her temperature after she woke and it very quickly dropped to 95.8 and has been between there and 96.8 since. Is this something I should be concerned or is this a way for her body to protect itself also?",
    "doctor_response": "HI fever with flu is common as it is a viral infection .Symptomatic treatment like giving fluids, paracetamol when having fever will help.No need to worry now",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can 70% artery blockage be managed with medications and life style correction?\n\nMy wife had a severe chest pain last week. She was immediately attended by doctor and was kept under observation in ICCU for 4 days. She was administered ELXIM injection . Now she is diagonised to be having one artery 70% blocked . Attending doctors suggeste that stent is not must and it can be managed by medicines and proper healthcare. Can you please advise what to do under the circumstances.",
    "doctor_response": "Welcome and thank you for asking on HCM!I have gone through your question. As your wife was given Elaxim injectionshe probably had acute MI (heart attack).  She needs to take medicinesregularly (no doubt) and probably stenting too. she stands a risk of havinganother heart attack in the next one year. She needs to be very carefuland very compliant with medicines for the next one year .Hope to have been helpful!Wishing good health, Dr D Sunil Reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for elevated BP and rapid pulse rate\n\nmy normal b/p is 100/70, but yesterday suddenly b/p is increased abnormally130/80, chest filling cold & slight chill, breathing problem.palse  rate showing rapid.  (i am chronic sufurer breathing problem,muscle pain,thrwobing,hole body hair fall,cold skin, skin colour pale ctc. so what i do?",
    "doctor_response": "Hello I just read your query and from what you have mentioned it doesn't seem that you have hypertension.However I would suggest that you decrease your salt intake daily.Exercise 30 minutes daily.Sleep for 7-8 hours daily.Eat 5-7 servings of fruits and vegetables.Avoid fat and oily foods totally. Hope you find my advice of some benefit.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for tooth infection\n\nI had an infected tooth for 28 years. It never showed up on the xray. I had a root canal in 2008 and the tooth is fine but I have an infection that will not go away. I finally convinced a doctor to treat with clindamycin. After 15 months the ifection is 95% gone but the clindamycin doesn t work anymore. What medication would you suggest? I am 62 years old, male, and take no other medications. My continuing condition is bacteria growing under my teeth that provide bitter taste, burning gums and makes me sick every day with headaches and sinus problems. I have almost no immune response to this particular bacteria.",
    "doctor_response": "Thanks for your query, I have gone through your query.The tooth infection can be secondary to the deposits below the gums leading to abscess formation resulting in pus discharge and altered taste. The medicines will work for a short period of time, if you keep taking you might develop resistance to that drug and it might not work in future. So consult a oral physician and find out the cause for tooth infection and also take an opinion regarding previously done root canal treatment. Mean while you can take a course of antibiotics like amoxicillin and metronidazole combination. Do saline gargling.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of Polycystic Kidney Disease ?\n\ngood day sir/maam i just had my urinalysis,blood chem and hematology test but my doctor is im worrying bout my condition heres my test result. Urinalysis: MACROSCOPIC: MICROSCOPIC: color: dark yellow WBC:2-4/hpf transparency: slightly turbid RBC:2-3/hpf reaction:: 5.0 Epithelial Cells: rare specific: gravity: 1.030 amorphous materials: rare albumin:Trace Mucus Threads:many Clinal Chemistry: conventional units S.I units examination result reference values result reference values creatinine: 0.87 0.4-1.4 mg/dl 76.91 35.4-124 mmol/L Sodium(Na+) . 131.4 135-155 mmol/ l Potassium(K+) . 3.36 3.4-5.3 mmol/ l HEMATOLOGY: Hemaglobin: 156 hematocrit: 47 WBC: 5.1 (Differential Count) Segmenters: 46 (normal values 55-65%) Lymphocyte: 37 (normal values 25-35%) Eosinophil: 04 (normal values 2-4%) Monocyte: 13 (normal values 2-6%) Other exam.: Clotting time: NV:2-5 min Bleeding time: NV: 1-4 min hope u can help me...i got a PKD(Polycystic Kidney Disease) but last 2 yrs i never go to doctor then i went today because i felt something weird in my lower back...and my doctor is away after i got my result...",
    "doctor_response": "Hello and welcome to HCM.As an Urologist,i can understand your anxiety.Your problem of APKD(adult polycystic kidney disease),is probably the cause of your back pain.  It's also causing microscopic hematuria or blood in urine.The kidney function is normal.( creatinine ).You need to get a CT-IVU (contrast CT) scan done,to evaluate, the extent of'kidney cysts,in both kidneys.Pain can be relieved with a mild analgesic,like Paracetamol tablet.If you've any doubts,send it as a direct question to me.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain and headaches\n\nHi , I was seen in the ER for chest pain and headache. My first creatinine kinase reading was 603 and the second was 558. My troponin results were normal. The genius resident in the ER told me that all I needed to do is stop working out for a week and my levels should go back to normal. Prior to being admitted to the ER for chest and head pain, I have been having acute and chronic dizzyness. I need to know what doctor I need to see because I m still not feeling any better and now my leg is starting to hurt along with lower back pain and continual thirst. Help me please because no one else is trying to help",
    "doctor_response": "hi dear. thanks for query at HCM.try taking tab pan 40mg before breakfast for ten days. get a complete body check up done. your dizzness can be vertigo. get a neurologist's opinion. and what was your bp? check your sugars since you have thirst. revert back with all your reports and we will help you get healthier. thank you. please do rate my answer",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please suggest the dose of Anafranil for OCD.\n\nHello doctor, I am a 21-year-old male. I have OCD for past five years. I went to several doctors and used too many drugs such as Sertraline and Fluoxetine and Anafranil. The only drug that helped was Anafranil. I asked from my doctor to prescribe Anafranil but he denied and in every visit he prescribes SSRI, but it does not help me like Anafranil. What is the highest dose of Anafranil for OCD? Can I use only Anafranil 75 mg once a day? Please help me.",
    "doctor_response": "Hello. Anafranil (Clomipramine) is a type of older antidepressants, and it has some undesirable side effects like constipation dryness of mouth, at times effect on the heart. Because of the side effect for file usually, doctors refrain from going for higher doses. But if you are not facing any adverse impact, then we can increase the dose of drug top to 150 to 200 mg. The toxicity of this drug occurs easily as compared to SSRI (selective serotonin reuptake inhibitor) which is again a limiting factor for prescribing commonly. But always follow your treating doctors advice in increasing and decreasing the doses of drugs.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Levolin nebulization effective for cough and cold in a toddler?\n\nHi My kid was down with stomach virus ,fever and loose motions .from last 2 days she recovered but her apetite has gone down/ Also she is down with severe cough and cold due to which she is not eating and in the nights its is completely blocked that she is preferring to sit for easy breathing. Please advise if levolin nebulisation is gud for 2.9 years old kid",
    "doctor_response": "Hi, For such a small kid don't go with your feeling and self-medication. In such cases its better to visit a pediatrician, and not to use OTC drugs. You may try plain water nebulization, any nebulizer medicine, better be prescribed. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ratna Mulay",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for inability to express emotions\n\nhi doctor.. i dont know how to love.. but i just keep on saying i lov u lots to my bf.. but how should i love? even my bf complains that i dont give him peae of mind and i always do things which irritates him. am i actually in love with him or wat am i doing?? :-( My family- father, brother mum passed away when i was 12.. but i have a step-mom. Bt i am staying along with my uncle and maternal grand parents. please tell me doctor.. what is my problem?? I m 23 years old.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  All these things are just your thoughts. Your thoughts do not have substance. Defining love is not possible. When you breath, eat, drink, you are actually loving self. When you sympathize for another species, you show love. When you say, I care, you actually love. Love has so many meanings and it never can be taught or learnt. it is part of existence. Just don't worry about love and affection, you have it or not etc. Concentrate on your education and career. That is what you are supposed to do and is love towards your life.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long could it take to recover from low sodium?\n\nmy mom had a hospital stay of 5 days with low sodium from a uti infection last week.she has lost all her strength in her legs.she walked 3x a week prior too this.she is at a n home getting therapy how long until her mind and legs come back she is in great health for 80 yrs old thank you.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. She has low sodium secondary to urinary tract infection.  She should complete the course of antibiotics.  She should take saline transfusion.  In old age recovery takes some time so no need to worry.  She will recover soon. Take treatment according to your doctor's advice. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heel pain while having leg cramps?\n\nI am wondering if heel pain can be associated with low ferritin and low hemoglobin? My left heel suddenly hurt in the morning on 3/26/17 and today it hurts to bend my foot when I did nothing physical to provoke the injury, but am suffering from severe leg cramps due to my low iron (having a hysterectomy to resolve iron issue next week) and wonder if this could be associated as well.",
    "doctor_response": "Hello,\u00a0I have studied your case.\u00a0Muscle cramps\u00a0can be reduced byMassaging the cramped muscle with your hands or oilDrinking plenty of fluids to avoid dehydrationStretching\u00a0your leg muscles or riding a stationary cycle.Taking\u00a0diet\u00a0rich in calcium and potassium or oral\u00a0supplements\u00a0of the sameCheck your vit B12 and Vit D 3 levels.Till time, avoid lifting weights, You can consult\u00a0physiotherapist\u00a0for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.\u00a0Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does the growth hormone test report of a child with short stature indicate?\n\nHi doctor, Following is the growth hormone test report of my son aged 11 years and 7 months and his height is about 129 cm and weight is 32 kg. I am very concerned about his growth. Please comment in detail about the possible treatment and their side effects, if any?",
    "doctor_response": "Hello. I just read your report about your son and I am sorry to say that he has a growth hormone deficiency (attachment removed to protect patient identity). He needs to take growth hormone injections for it. These are to be taken on a proper prescription from a pediatric endocrinologist in your place. These are to be taken daily. The side effects are listed here like peripheral edema, edema, arthralgia, paresthesia, skeletal pain, flu-like symptoms, rhinitis, pain, hypertension, gastrointestinal side effects.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning sensation between the shoulders and back pain?\n\nHELLO MY NAME IS LORI, I HAVE HAD BACK PROBLEMS FOR A LONG TIME, BUT THE BURNING BETWEEN MY SHOULDER BLADES FOR AWHILE, HAD CORTISION SHOTS, EVERYTHING, I GET PHNHUENIA EVERY YEAR FOR LIKE 13 YEARS , I NEED HELP THIS IS TO MUCH PAIN, CAN T HANDLE MUCH MORE, CAN YOU TELL ME ANYTHING? ANY TEST? MY FATHER DIED FROM A BRAIN TUMOR 5 FINGER, CANCER I",
    "doctor_response": "Hi !      Thanks for the query in Healthcaremagic platform.                  Poor postures while sitting , standing & or in workings , nutritional deficiency related conditions and other musculoskeletal disorder can lead to various aches and pain in backs. So no need of worry. Consult your primary Physician in these matter.         Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes reddening and swelling of toe?\n\nI have a very red (swollen) 2nd toe on my right foot. It hurt a bit but not severe. Has been that way for about 3 weeks. I thought I had sprained it or stubbed it somehow but it is still red and does not seem to be getting better. What do you think it might be?",
    "doctor_response": "Hello, Thanks for writing to us, I have studied your case with diligence.It can be due to soft tissue injury or stress fracture .For these symptoms analgesic and anti-inflammatory can be started.Till time take medication and apply crepe bandage over foot or use supportive splint. Do ice fomentation and rest to foot. If pain persists you may need x ray foot to rule out stress fracture, you can consult your doctor and do required investigation.If you see any signs of infection like raised local temperature, increase in pain then you should consult your doctor immediately.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shoulder pain relief\n\nHi, I have two operations on my right shoulder which involved decompression of the shoulder and removal of the a/c joint in 2010 and in 2012. I am still in a lot of pain and now after numerous amount of physio and steroid injections I am now still under the hospital for intensive physio where they are mainly working on the muscles around the scapular where most of the pain and discomfort is coming from. I am also still getting pain down my arm like as if there is a weight in my top of the arm by the bicep, how can I reduce the pain ..I am not on any medication at the moment, but cant take much more as im not sleeping because of this.",
    "doctor_response": "HiYou may consult shoulder surgeon who may review your condition just in case a new pathology has developed.Physiotherapy is mainstay of treatment and taking pain medication such as tramadol and or Ace proxyvon for acute pain for 5 days.Use sling in daytime, apply voveran TPS gel locally.Your surgeon may provide the prescriptionBest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal discomfort upper left rib cage\n\ni am 55 yr. old female have had upper stomach problems for 9 yrs always went away up until this tine 3 mo had a upper gi xray last yr. it was normal now im real sick not pain pain but annoying some weakness stomach pressure getting ready to have a endoscope real concern about it",
    "doctor_response": "welcome to healthcaremagic please consult surgeon and get examined for any abdominal positive finding in gi xray a trendelenberg view is required to rule out hiatus hernia upper gi endoscopy will help in diagnosis of any stomach duodenal problem whole abdomen usg will help any abnormal mass there in abdomen get examined  and hope your problem solved soon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medication is suggested for Oligodendroglia?\n\nMy 41 yo. Husband was first diagnosed in Sept. 2000 with an Oligodendroglia.  Re had a resection and then we did the watch and wait.  The tumor caused no recurrence until May 2008.  He again went under the knife to remove the tumor and the tumor grade stayed the same   (Grade II)  In November of 2012 the routine MRI showed and reoccurrence, and after surgery and pathology it had progressed to  an Anaplastic oligodendroglioma Grade III.  He has started chemo soon after surgery PVC and then did 6.5 weeks of radiation, which was finished in oct 2013.  Dec. 2013 MRI revealed growth.  Could it instead be Necrosis from the radiation?",
    "doctor_response": "Hi, Welcome to HealthCareMagic.com I am Dr.J.Mariano Anto Bruno Mascarenhas. I have gone through your query with diligence and would like you to know that I am here to help you.MRS and Contrast Enhanced MRI PET are options to differentiate tumour from necrosis Medication is to be decided based on the Histology Hope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in HealthCareMagic at  Best Wishes for Speedy Recovery Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shoulder and back pain after ectopic surgery?\n\nI ve been leaning on my right arm alot lately watching tv and it feels like my elbow is going out also shoulder aches its also been five weeks since ectopic lap surgery I ve been depressed restless and once I lay down its hard to lay all the way flat like I can t relax my back I have to ease into it what s wrong with me?",
    "doctor_response": "Hello,Causes for lower back and hip pain are:-Injury / blunt trauma-Referral pain to surgery.-Sprain or strain-SpondylosisSpine-related problems-Improper postureHence I would like to advise you the following:-You can take the tablet aceclofenac. -Apply diclofenac gel or cream. --Apply ice locally. -Do x-ray and MRI back and hip region. -Treatment mainly depends upon underlying conditions. Kindly follow with detailed history or consult with orthopedics. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for swelling, stiffness in knee even after total knee replacement?\n\nMy husband had a total knee replacement in January 2014 and is still having swelling, pain at night and the knee continue to swell and become stiff when he sit or walk for a period of about 2 to 4 hours during the day. He has contacted his surgeon and the instructions given has not solved his problem. Thanks",
    "doctor_response": "Hi Hope this message finds you in good health.I have gone through your query in detail and understand your concern.may be its a implant related issue, may be not fitted properly.otherwise after replacement , the pain should virtually go away.get an fresh xray done to see whats wrongNothing to worry about, You should eventually get back to normal.Get back to me for any  FOLLOW UP QUERIES anytime.Kind Regards,Dr Mahaveer Patil...(MBBS,MS,Mch)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does a knife injury need medical attention?\n\nHi my friend, male 25 years old good shape, dropped a knife in his hand and cutting himself after doing this about two minutes later he fell to the ground not knowing what was going for about a minute, the sat up and got sick and is still really pail. Was wondering if need to go to the ER? Still a bit dizzy at times.",
    "doctor_response": "Hi,He might have to go to the emergency room. It is important to know if he lost so much blood, if he has had an infection of the wound, or some other lesions related to the trauma might have set in. This could have simply aggravated an existing condition that was not really taken seriously. It s better to see the physician in the ER room. Kind regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are causes & remedy for spreading rashes on face with fever?\n\nMy frnd has been taking trika for more thn 1 yr. He has been taking it like 10 to 12 pills a day n sometimes he also takes alchol along wid trika... He has memory prob difficulty in spking n sleep prob... Is he at any kind of risk n wht is d solution out for this prob",
    "doctor_response": "Hi,Alprazolam is a sedative antidepressant. It should be taken as 0.5 mg tablet at night. Your friend is taking excessive dose... And also with alcohol. Tell him to consult psychiatrist and get the proper dose. High doses might harm. ...okHope I have answered your query. Let me know if I can assist you further. Dr.Ilyas Patel,Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to have a child with low sperm count?\n\nHi I m 30 yrs. Old and got a sperm analysis result of 11 million sperm count, everything else is ok, only the countnhas the problem. Is it possible for me to have a child? How long could I wait? My height is 5 7 weight is 160lbs. I also have gout and taken cholcecine before. But I already stopped takingnit, instead I m taking organic meds from healthynoptions, boswella and bromelain.",
    "doctor_response": "Hi, your count is slightly low. 1. I suggest you get a Semen culture done to rule out any infection which can be treated. 2. Ask your Doctor or Surgeon to check for a Varicocele which can be treated and is a common cause of low sperm counts.3. I usually advice my patients an ayurvedic drug called Speman from Himalya Drugs for three months and has shown good results in increasing sperm counts.Take care,Dr Rishi, New Delhi, India.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does costochondritis result in high platelet counts?\n\nDoes Costochondritis result in high platelet counts? My recent blood test  done on 18th April 2018 reveals count of 513. It was 428 in nov/ 2017. I had also gone through acl reconstruction of my right knee on 21st march. - could my recent surgery be the cause for high platelet counts? I',m 34 y/o male 6'1\" tall weighing 85 kgs",
    "doctor_response": "Welcome to the Healthcaremagic.com I have read your query here. * As per my clinical experience, the high platelet counts is due to general inflammatory response to surgery, costochondritis or both. * In terms of absence of other systemic symptoms, I recommend to get regular follow up with your doc for the same. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could baby eczema cause spots under skin erupting as pimples in a child?\n\nmy 2 year old has lots of spots under his skin all the time and has had since he was born, these have recently started to erupt into pimples. They are also on his face. When he was a baby he had baby eczema and we have to mositurise his skin everyday otherwise it is dry. Could this be causing the spots?",
    "doctor_response": "The diagnosis of skin spots is difficult unless you provide details such as the size of the spots, their colour, and their distribution on the body. A picture would really help. I am afraid they could be anything, such as due to sweat glands retention of sweat, heat rash, allergic rash, or something else. Dr. Taher",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicine for increased neutrophils count\n\nMy Daughter, she is 3.6 yrs old after getting her blood test Doctor found that she has infection coz of high neutrophils count it is 82% in her blood. the rate is almost double. The anti biotics are not working . Can you please suggest what should i do?",
    "doctor_response": "Hi, neutrophils increase in infection. If antibiotics are not working then you should do blood culture test and CRP levels. Based on the report antibiotic needs to be changed. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am suffering from gums bleeding, please suggest remedy\n\nI am aged 28 suffereing frm gums bleeding, i use to have this frm last 4-5 yrs.doctor do the scaling regularlyand after it use to be ok.But this is the first time dentist sugested me this might be the problem wth vitamin-c deficency.So pls suggest me the good and regularly can be had foods wth vitamin-c.",
    "doctor_response": "Good Sources of Vitamin C Guava 1 medium Red Bell Pepper 1/2 cup Papaya 1 medium Orange juice, from frozen concentrate 3/4 cup 7 Orange 1 medium Broccoli, boiled 1/2 cup Green bell pepper / capsicum Strawberries 1/2 cup Grapefruit, white Haf Tomato juice 3/4 cup Mango 1 medium Tangerine 1 medium Potato, baked with skin Cabbage greens, frozen, boiled 1/2 cup Spinach, raw 1 cup",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in left breast, chest and irregular heartbeat?\n\nI have pain in my left breast if I lay on it, or if someone give me a tight hug. I do self exams, & have no lumps. I also have chest pain, & I take meds. for irregular heart beat. I see a cardiologist, But this pain is more in my breast when their is pressure on it.",
    "doctor_response": "Hello, As long as your heart problems have been totally under control, then, the pain you are having on your breast is due to muscular skeletal issues. Take Naproxen, but by cautiously monitoring blood pressure and other cardiac symptoms. Apply analgesic cream locally. Magnesium supplement can help but non higher than 300 mg daily. Discuss this further with your caring doctor. Hope I have answered your query. Let me know if I can assist you further. Take care. All the best. Regards, Dr. Albana Sejdini, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does pot stay in the system when pregnant?\n\nHi, may I answer your health queries right now ?  Please type your query herehow long does pot stay in your system when pregnant I used to smoke and am now 8 months pregnant I have stopped though should my baby and myself be clean by birth?...",
    "doctor_response": "Hi, Dr Purushottam Neurgaonkar here. I welcome you to HCM VIRTUAL CLINIC. I have gone through your question, and I think I have understood your concern. I will suggest you the best possible treatment options. I will suggest you to stop substance smoking at once.  As any kind of substance abuse is harmful to baby and mother. It can lead to mental health and learning disorders in the baby. Secondly, I will suggest you to indulge in a healthy diet and regular exercise regimen. Have plenty of water, use of cranberry juice can be of help. I will also suggest to indulge in recreational activities like reading , music. Keep yourself cool, calm. Happy. MAY GOD bless you with a bundle of joy. I hope this answer helps you. Thanks Dr. Purushottm Neurgaonkar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have burning sensation on my arm. Does this sound like MS or anxiety?\n\nHello doctor, Since yesterday I have had this burning sensation in a patch on the side of my left arm. It is not warm to touch but an internal warm sensation that feels like you put a warm cup of coffee against a patch of skin for a second or two and then it goes away. It appears in a wave-like pattern. It shows up in one-two seconds, then it disappears for about 10-15 minutes, then shows up again. So it is not constantly present. It is not painful at all, just annoying and it is really sending my health anxiety off. Does this sound like MS or anxiety? I do not take any meds. No other symptoms. Kinds regards",
    "doctor_response": "Hello. The intermittent burning sensation in your left arm could be due to several reasons. Most commonly, we see this if there is any cervical spondylosis with the nerve being pushed. This can lead to a certain area in the arm to be painful. Again, the pain can be intermittent depending on the neck movements. Another possibility is a neuropathy due to vitamin B12 deficiency which could be tested on a blood test. Multiple sclerosis is another possibility, but that seems less likely as the symptoms would persist for few days and then they start improving. It would not last only for 10 to 15 minutes and come back again. If all of these possibilities are ruled out by clinical neurological exam and/or diagnostic testing, then this could be a somatoform disorder which can be associated with anxiety. I hope this helps. For more information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have thyroid problem, my HR and BP fluctuates often. Why?\n\nHi doctor, I had a\u00a0highly varying HR (63 to 128 at rest) and BP (109/78 mmHg to 154/104 mmHg at rest) for around three days. I consulted my doctor on the third day and started taking Propranolol 20 mg thrice daily for seven days and twice a day after seven days. Yesterday night onwards, I was having discomfort and slight pain in the chest. Please help.",
    "doctor_response": "Hi. As seen in your brief history, there are some fluctuations in your blood pressure as well as heart rate. I would advise you to get an ECG done as soon as possible as we have to see what sort of heart rhythm are you on. The doctor who has suggested you Propranolol must have done your ECG. So, if it is a sinus rhythm (normal fluctuating rhythm), then it is not much to worry about. But, if it is some sort of abnormal rhythm (arrhythmia), then it has to be taken care of. Secondly, Propranolol 20 mg thrice a day is quite a heavy dose. Propranolol 10 mg twice a day should be started and should be increased every week if required. If you are having chest discomfort after having Propranolol, then just drop the medication for this morning and noon and see if you are normal. As of now, I would like to have a detailed history of you as cardiology suggestion can only be given after taking a detailed history. Revert back with the answers to the above questions to a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the prescribed dosage of Naxdom during pregnancy for migraine?\n\nHello doctor, I am 32 years old. I have been suffering from a migraine for over five to six years or more. I have been sensitive to light since childhood. I used to take Migranil initially. Around two years ago, I met a neurologist and he advised me Amitone at night and Naxdom 500 in case of emergency (at the onset of a headache). It had given me a substantial relief but then I had to take Naxdom almost every other day. I have been trying to taper off but have been unsuccessful. I still have to take Naxdom 500 every three days (on average) else I just cannot carry on with my day. I do not take Amitone anymore as it had started making me extremely sleepy in the morning and working hours as well. When I have a migraine:  I suffer from a throbbing pain usually emerging from the left side of the head and it keeps spreading. The pain grows into nausea and vomiting sensations. High intolerance to light (sunlight feels impossible to tolerate), sound, any distinct smell, non-cotton clothes. I am not able to handle even minor stress somehow which definitely does not feel normal. Naxdom is the only medicine that helps in such a case but how long can I keep depending on such painkillers? I had suddenly gained weight and had developed hypothyroidism in between. Can these medications be a culprit?  Also, I want to know all the possible side-effects of Naxdom and Amitone, please. Kindly note, I have hypothyroidism as well. I have recently gone through a miscarriage and will be trying for pregnancy soon in approximately three to four months. But, at least for a month or so I want to get rid of my migraine issues. When I was pregnant, my doctor had said if it feels absolutely necessary I can take Naxdom at times. I had it only twice though during my pregnancy. What is the prescribed dosage of Naxdom during pregnancy in such an inevitable case? Also, please note even without a migraine attack, am generally very very prone to nausea and exhaustion since years (when it is hot, when I am stressed, long working hours or just for no plausible reason). What safe medications can I take to get rid of these nauseous feeling and vomiting tendencies and any tests I should get done? All these factors have been affecting the quality of life adversely and I do not feel these are normal symptoms as I have tried multiple solutions so far.",
    "doctor_response": "Hi. Your symptoms are classically suggestive of a migraine only. Now, migraine can be well controlled with medicines and lifestyle changes. My choice remains Amitone (Amitryptiline) along with Flunarizine. Side effect profile of Amitone contains mostly sedation and weight gain. Otherwise, it is safe to take. Naxdom is a painkiller and should be taken in only severe headaches. Now, point is that you want to conceive now, so in pregnancy, we usually advise our patients to take Paracetamol for headaches. A lot of people get their migraine resolved during the pregnancy period. However, in cases where we need to give medicines, the recommended drug is Propanolol, which is relatively safe in pregnancy. So, if you wish to start treatment, then discuss with your doctor to start you on Propanolol. This drug can be continued even if you conceive.  For more information consult a criticalcare physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there pain in the stomach after taking Unwanted 72?\n\nHello doctor, My partner and I had unprotected sex four days from her period and she had taken the Unwanted 72 two days later. Her periods started four days before the due date and also stopped the same day. The flow was not normal and she was also having severe pain in the stomach. Kindly let me know if she is pregnant and the precautions need to be taken. Also, suggest the reason for stopping the bleeding on the same day.",
    "doctor_response": "Hello. Few basic facts about fertility. The ovulation occurs around the 12th to 16th day of periods. Life of the egg is 24 hours and that of the sperm is 72 hours. So I do not see any reason for you to worry as there is no chance of egg meeting sperms. But as she had an emergency pill, the hormone progesterone pill, the balance would have got disturbed. Usually, she will have the bleeding with thick dark blood seven to 10 days of the pill. Having a bleed after the pill means the inner lining of the uterus has gone. So, there is no chance of pregnancy. Maybe some more bleeding is expected. So, there is a pain in the lower abdominal area. Next period will be one month after this bleeding. For more information consult an infertility specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do these WBC and platelet counts indicate?\n\nyes, I am 79 years old, a dietabetic for 17 yearsi also have cml, for 4year. I have been on 3 diff. kinds of kemo pills, lastly tasigna. I quit the kemo med.s 3 months ago because after 4 years nothing was working to chg my sitition. I am now taking rso(rick simpson oil) . I just finished 120 days of treatment. my last lab showed my white count went from 3.64 to 36.88 and my platelets went to432 to1335 in 14 days. How do they measure the points and is my counts better or worse now then when white count was 2.25 and platlets were 132?",
    "doctor_response": "Hello,For the chronic myeloid leukemia, it's worse. You should continue your chemotherapy as soon as possible. Consult a hematologist for a further treatment plan.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Bhadresh Lakhani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is kidney pain normal after ureteroscopy and retrograde pyelogram?\n\nI underwent a ureteroscopy and retrograde pyelogram in the am on Friday 25 March.  It is now Monday 28 March and i am continuing to suffer from a severe crampy sort of pain around the left kidney area, it is bad enough that i can't sleep and over the counter pain killers are not helping.  Is this a normal after effect and what else can i do to ease the pain?",
    "doctor_response": "Hi and welcome to HCM.As an Urologist,i can understand your anxiety.Yes,it's an absolutely normal feeling,some people have for about 4-6 weeks.Drink about twelve to fifteen glasses fluids daily.You can take an anti-spasmodic tablet,when you've pain.Wish you well.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for memory loss\n\nMy mom is 83 yrs old and has developed memory loss, mood changes that have been quite dramatic over the past few month.----could not remember to take her meds, wasn t bathing, losing her keys, wallet, etc----did not remember what was said at the beginning to the end of a conversation. If she is developing Alzheimers-----can she be tested for this? We now have her admitted to an assisted care facility, but she says she is ready to go home now---very frustrating and scary. Just want to know if I can have her tested to be sure.",
    "doctor_response": "Diagnosing Alzheimer, is mainly clinical diagnosis and in corroboration with MRI brain and if required PET scan. Also i advice to get few investigations (S. Vitamin 12, serum folic acid,Thyroid function tset,  MRI Brian) with MR engine.few genetic tests are available, specially Early onset familial Alzheimer disease (eFAD)- mutation in the genes for presenilin 1, presenilin 2, or APP.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have longer and irregular periods problem. What to do?\n\nHi doctor, I have periods for more than ten days. For a few days, I usually have light bleeding. It will be dark brown with a little hint of blood. I will have like this for eight to ten days. Then, I will have a heavy period until it stops. I usually have periods for 10 to 17 days. I will not have periods for two and a half weeks. I always have irregular periods nowadays. I had a miscarriage last year and after this, my periods have become irregular. What can I do now?",
    "doctor_response": "Hi. Ongoing through your history, you can have PCOD (polycystic ovaries). It is a congenital condition. It is genetical. You can get it from your parents. When you have a sudden gain in weight, the cholesterol is converted into estrogen hormone. When there is fat in the body more than average, it is converted to hormones. FSH (follicle stimulating hormone) stimulates follicle from the ovary. When the follicle is ready to ovulate, the FSH is suppressed by the estrogen hormone from the ovary. When the estrogen hormone comes from fat, the brain becomes confused, and the follicle growth stops at a smaller follicular size, and it will not rupture. On the next scan, you will see these follicles as polycystic ovaries. It is usually associated with obesity, irregular menstrual cycles, absence of periods for a few months and later there can be a heavy period with clots and fleshy masses or spotting on off and off. There can be a thyroid abnormality and prolactin problem indirectly. You will develop an extra pad of fat around the mid-segment of the body, especially in waist, thighs, and breast. There will be an absence of fat below elbows and knees. There will be an excessive hair growth, hair fall, a dark shade over the lower half of the face, acne, oily face, black skin over the back of the neck, inner thighs and undersurface of the breast. You may have a family history of diabetes. Regular ovulation will not occur during this problem, and you cannot get pregnant until it is treated. It increases the chance of early pregnancy abortions. But there is a solution. Your weight has to be weight (kilograms) = height (in centimeters) - 100. When you have a reduction of weight to normal range, then there is no requirement of medicines to get periods or to get pregnant, and pregnancy will be healthy. Avoid eating junk foods, fast foods, and red meat. Reduce taking snacks in between meals. Have a low-calorie diet with high proteins. Do regular exercise (especially for waist and hip area), aerobics, yoga, and brisk walking. Try to reduce two to four kilograms per month. When there is a loss of weight of five kilograms, you can see changes. You will not require medications and the problems during periods will resolve soon without medications. If you want to have regular periods till you reduce weight, you can have birth control pills cyclically from the first day of the periods for three to six cycles. It will regularize your hormones and periods.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to diagnose rib cage pain naturally ?\n\nBurning pain in center of body, under ribs. Seeking natural remedy/advice pls. Hi, over the last few years I get this occasional burning pain in the center of my body, directly under my ribcage/chestbone, where my abdomen is soft between the bottom of my ribs. I m a 38 yo female, 150 lbs at 5 5 , working on losing weight. I m pretty healthy overall I think, no major issues. This pain started just in the last year or two, and I haven t figured out what in my diet might be causing it. Do you think it could be anything serious? If it s diet-related, what types of food/drink might be causing it? Is there any natural remedy I can use to alleviate the pain when it comes? Thanks in advance for your help!",
    "doctor_response": "welcome to healthcaremagic may be you are having gastric pain take regular meals do not fast spicy hot oily food will hurt you avoid such food and drinks no alcohol and no smoking milk products that is cold will help no painkillers in empty stomach hope the practice will help you if the complain persists consult doctor and take treatment",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is improvement of immunity possible after being diagnosed as not having one?\n\nMy Son had no Iga at the time of his test for Coeliacs disease and had constantly suffered from chest infections etc, and had to have antibiotics after every cold, however since he has been on a gluten and wheat free diet if he gets a cold it remains as just a cold and does not end up with infections.  Does this mean that he now has Iga and that it is improving? Is it possible to improve your immunity once being diagnosed as having none",
    "doctor_response": "Hi Thanks for posting your query on health care magic.Is possible to improve Immunity by using passive injection of immunoglobins.There is a possibility to synthesize new IgA when precipitating factors like gluten and wheat are removed from the diet.Self destruction of antibodies comes to halt when wheat is removed from diet.Consult an immunologist in case of further queries. Thank you,Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated SGPT levels?\n\nI am in entecavir therapy for last 15 months. HBV DNA was below 300 copies/ml with in 6 months. After 9 months it was below 12 . After 1 year it slightly increased to 12 - 52 range.  SGPT conitnued to decrease @ 29. However, after 1 year 3months SGPT increased to 45 (first increase after the treatment for last 15 months). What does this indicate?",
    "doctor_response": "Hello! Thanks for putting your query in HCM. I am a Gastroenterologist. Little bit fluctuations can be seen during the treatment. There is nothing to worry.I hope I have answered your query and this will help you . Wish you a good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Though I am on regular medicine, my stomach pain is present. Please help.\n\nHello doctor, I have been dealing with a stomach issue for almost four years. It originally was extreme pain and tarry stool once. It was first diagnosed as an ulcer as I was negative for H. pylori. I was given antibiotics just in case, PPIs and H2 blockers. Since then it has gotten worse, gotten better and so forth. I do drink a good amount of alcohol, although I stopped cold turkey two months ago because it was causing pain. I am currently taking Carafate; several PPI's a day\u00a0and H2 blockers. I eat\u00a0extremely low-fat diet, I have lost 20 pounds in the past two months. I eat a low acid diet, no caffeine, no alcohol, I take my PPI's on time, as well as Carafate, and as directed. I have no pain during sleep. Once I awake, the pain comes back in flat position. If I get up, it does not or is less pain. The pain is in one point upper abdomen, center, directly below or behind the sternum. It is helped by drinking cold water. Sometimes, it goes away after I eat. Made worse if I eat fatty food, even moderate amounts of fat. The pain is very close to the surface of the abdomen, and it does not go to my back. I have had sore throats as well. I would imagine that it is from acid reflux. I did have acid reflux for 8 to 10 years, off and on, and I did not do a good job of controlling it at first. I have taken Prilosec, Nexium and recently Dexilant. A year and a half ago, I had a cat scan with fluid drank before hand (I believe it was called a HIDA scan) and an ultrasound. The only thing that was found was a fatty liver, and no other problems were found. Is there any other type of prescription or medication I can pursue?",
    "doctor_response": "Hello. Reflux. Repeat USG (ultrasonography) abdomen and upper GI endoscopy. Gallstones. Hiatus hernia related GERD. Revert with the report to a medical gastroenterologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the swollen lump at the tip of my butt?\n\nThere's a swollen lump at the tip of my but crack its not on my butt its actually inside of my butt just where the crack starts and its swelling but there's no pus or blood and no boil. It hurts to sit, walk, and lay down on my back. What is it and what are the symptoms and ways to get rid of it?",
    "doctor_response": "Hi,These are the symptoms of a pilonidal sinus. This is a small hole or tunnel in the skin. It usually develops in the cleft of the buttocks where the buttocks separate. When it becomes inflamed, it will cause pain. There is a risk it may become infected leading to an abscess. In your case, it is inflamed. I suggest you keep the area clean and dry. Take daily salt baths. Keep the area free of hair by shaving. If it becomes infected then antibiotics would be the first line of management. If this is unsuccessful then surgical removal of the infected area would be advisable. Regards,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sinus infection, headache and teeth pain\n\nMy husband has sinusitis he has green mucus, coughing headaches, and teeth hurt: he gets this once a year and usually has to have three rounds of antibiotics Any suggestions",
    "doctor_response": "HI, thanks for using healthcare magicBased on your description he may need another course of antibiotics. In addition to the antibiotics, he may also need an antihistamine/decongestant combination as well as a topical steroid nasal spray as well.eg of topical nasal sprays- flonase, nasonex, nasocortAnti histamine/decongestants would be over the counter. He may to take these long term to prevent or reduce the chance of repeated infectionsI hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can dull rib pain be treated?\n\nI had back surgery in February & was in the hospital for deli caused by tylenol. I feel my liver has recovered but I still have the rib pain on my left side - seems it is along the last rib & sometimes feels like my intestions have pushed up under the rib cage. It is a dull pain and much better than in March but it will hurt when I try to vacuum or mow or sweep - I am 75 yrs old - weight about 110 or 115 - take bp rx and once a wk medication for osteo-poris - do you think this is just caused by that?",
    "doctor_response": "Hi i can understand the nagging pain must be a concern and frustration for you. Chronic dull pain over ribs covering abdomen can be due to multiple reasons. I would advice you to get yourself assessed by a surgeon and get atleast an ultrasound done as well as a stool test done to see everything is right with your bowels.Hope this helpsdo let me know if you have any more questions for me",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from jaundice. Can I drink green tea?\n\nHello Doctor, I m  aged 26. I m having a jaundice and following suggested diet by my family doctor. Just curious about drinking Green tea during the suffer of jaundice. My doctor adviced to take tea or coffee without milk. Please let me know, can i take green tea at this stage. if yes, will 2 cup a day be fine? Please advice. Thanks in advance! - A",
    "doctor_response": "Hi. Thanks for choosing HCM. Yes, you can drink green tea 2 cups a day. Avoid fatty, fried foods.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life expectancy of a male with one kidney ?\n\nI know someone who has a family history of renal failure.  He is left with one Kidney, My question is what is the life expectancy of a male with one kidney?",
    "doctor_response": "Life expectancy does not vary much (roughly -5 years), if a person learns to lead a controlled life. People usually sustain well, provided they do not have other co morbid conditions like hypertension, diabetes etc. However if family risk factors are present then there is a risk of other kidney also getting affected.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the correct dosage of valparin chrono 300 ?\n\nfor how long valparin chrono 300 should be consumed by a patient suffering from a seizure good evening sir.... i have been valparin chrono 300 from last 3and half yrs now i am completely seizure free from last 3and half yrs .plz tell me how long i have to take this medicine.",
    "doctor_response": "HiEpilepsy requires regular treatment with anticonvulsants for at least 3 years of seizure free period after which medicines may be tapered off unless seizures reappear. At present, there are no other effective treatment options.Hope that was helpful.Let me know if i can assist you further.RegardsDr.Saranya RamadossGeneral and Family Health Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of infertility?\n\nI've been taking oxy elite pro for about 2years and now my husband and I have decided to have our third baby but haven't had any luck getting pregnant. I've been off of birth control for 6+ months now and was wondering if this oxy elite pro might cause someone to become infertile?",
    "doctor_response": "Hi,Thanks for writing to HCM .  After stopping ocp's it will take 3 to 4 months for cycles to become regular.  And another 6 months to conceive.  Majority conceive by this time. To increase chance of pregnancy you can go for ovulation inducing drugs like clomephine.  This will help multiple follicles to mature and rupture . You can try for 3 months with this  . Hope I have been helpful .RegardsDr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does stabbing pain below the breast after abdominal surgery mean?\n\nI had abdominal surgery 7 days ago, and there have been complications. I have a bleeding vein and have been order by my doctor to bed rest until the pain and bleeding stops. Last night I began having a stabbing pain below my breast on the right side and pain when breathing deep. It has gotten worse today. I am dizzy and weak (but have been since the surgery). Is this just muscle spasms and a possible rib dislocation from the CO2, or is this a blood clot? Should I go to the ER, or wait till my Dr office is open in the morning. The stabbing pain has gotten worse.",
    "doctor_response": "Hello dear , hiWarm welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This seems in relation with different  possible  causes  as    -  Liver swelling ( due to congestion or other )    -  Intra abdominal ongoing bleeding or formation of hematoma     -  Diaphragm or lower lobe of right lung related  issue .    -  Drain tube  related  ( if it is in situ )Hope this will help you for sure .Wishing you fine  recovery .Regards dear take care  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nausea, emesis odor, vomiting and abdominal tenderness?\n\nHello. I have 9 yr old with no chronic/significant medical problems. He was nauseous earlier this evening. He began vomiting about 2 hours ago. He has vomited 3 times, approx. 1L. Each time, the emesis smells & looks like diarrhea; very thin, watery & brown. I m an RN & in my 11 yrs of experience I have NEVER seen or smelled such foul vomit. He is not complaining of abd pain (some superpubic tenderness), intermittent nausea. Afebrile. No diarrhea. Regular BM this morning. I ve given him 5mg zofran liquid, however, he s still vomiting. Any suggestions? (Im using my phone to type this, please give me some time to reply. Thanks)",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.It seems like gastritis and the brownish colour can be due to ulcer bleed. Stop spicy food. Start syrup Polypep thrice syrup Domel thrice a day and Risek sachet every night. Give him ORS after every vomit. Give banana for deficiency. If condition persists Transamine can be given after medical advice to stop bleeding.I hope I have answered your query. Let me know if you have any further questions. Regards, Dr. Hina Javed",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause wet penile tip?\n\nThe tip of my penis has been feeling wet and clammy recently. Almost like the feeling you get when you get a small drip of urine in your underwear. This has been a pretty constant feeling and it is very annoying. I am not and never have been sexually active. I am 18 years old, and masturbate frequently.",
    "doctor_response": "Hello, SirWelcome to healthcaremagic.I can certainly understand your concern.I have worked through your query in detail.The symptoms in your case are possibly related to retention of minor quantity of urine in the preputial fore skin, which later dribbles causing the wetness.This may predispose you to develop infection of the glans penis particularly bacterial infection.Procedure like Circumcision will help prevent this urine locking in the prepuce area, thereby preventing the locking of urine.It's advisable to consider the expert option of a urologist on this.Please check with your physician if he shares my view.Post your further queries if any.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is this semen analysis normal:Vol: 3ml,30min liqufaction,sperm count 115mn/ml,active motile 70%,sluggishly motile 10%,non motile 10%,abnormal forms 40%pus cells, 1-2/hpfspermatogenic cells 3-6/hpf?\n\nmy semen analysis is volume 3.0ml,30min liqufaction,colour white,alkaline,sperm count 115million/ml,active motile 70%sluggishly motile 10% non motile 10%,abnormal forms40%pus cells 1-2/hpfspermatogenic cells 3-6/hpf,sperm agglutination abscent. is my report normal",
    "doctor_response": "HelloThanks for your query,based on the report of your semen analysis  that you have posted it appears that your semen analysis is well within normal range as per WHO standards as far as sperm count ,morphology and motility of sperms is concerned except presence of pus cells.Presence of pus cells indicate infection of either Seminal vesicle or Prostate which can be cured by taking antibiotics for 4-6 weeks.Dr.Patil..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain followed by tiredness and weakness?\n\nhi last week i had a heavy crushing pain in my chest i also lost my balance and have felt very tired and weak since i am taking tablets for high blood pressure and colestorole i had blood tests taken all was normal except my mpv here in turkey normal is between 7-9 mine is 9.8 is this a problem",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. No need to worry for MVP. In my opinion, you should rule out coronary artery disease (CAD) for your chest pain. You have risk factors like hypertension, high cholesterol etc. So better to rule out CAD first. So consult cardiologist and get done ecg, 2d echo, stress test. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat pain on the left shoulder?\n\nI am having pain on the left shoulder since one month. X-ray did not revel any defect. I do light exercise of my hand per the advice of physical therapist. I take advil which is helping temporarily. It may be artharitis. Please advise me. Nagesh Rao",
    "doctor_response": "Hello,The first step to treatment is a correct diagnosis. Your xray was normal.I would advise you to get an MRI of the shoulder to look for soft tissue changes that the xray would not be able to show.Once that is done, you will have a clearer picture of what is going on and be closer to a permanent solution.Get well soon.Dr. E. Kwasa",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abscess in the buttock\n\nLast year I developed an abscess in my buttcrack. It was large,  hot to the touch,  and full of our that finally drained out upon leaving the emergency room. I did not have a surgical procedure to drain it,  Instead,  the antibiotics I was given through an iv drip led to the abcess going away. My healing process was quick and not painful. Everything was normal until I realized that my buttcrack felt different. It seems that my buttcrack skin fused together in one spot (where the abscess was) and then it splits like a buttcrack should.  It almost looks like a perinatal dimple and it feels like a scar. It doesn't hurt,  it just itches occasionally. Can you tell me what and how it developed and is it related to an abcess? Will I be okay?",
    "doctor_response": "HelloThanks for the query .This is  scar due to healed lesions. When abscess forms there develops swelling and this causes stretching of adjoining skin , when it heals ( subsides ) there develops fibrosis and from scar . When there is itching take levocetrizine 5 mg , whenever require . In my opinion this is a permanent scar and it will remain forever. Only surgery can help but in my opinion this is not good .If you don't feel any thing wrong ( about cosmetic purposes ) forget about this.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat pneumonia?\n\nMy mother-in-law was discharged from the hospital yesterday. She is fighting pneumonia and had been having diarhea. It is suspected she might have lung cancer, but finding out was judged too risky, as she s 98. She was previously prescribed questran for the diarhea and now avrox for the pneumonia. She is also taking enalapril, hydroxyzine Hcl, vitamins and iron. She recently started taking synthroid. Her doctor is on vacation. Today she has complained of confusion, and is very upset. I thought maybe it was because of the disruption to her routine after being in the hospital for 3 or 4 days. But I m wondering if it s a drug interaction.",
    "doctor_response": "Thanks for your question on HCM.I can understand your situation and problem.Pneumonia in old aged (98) patients is very fatal and complication rates are very high.Pneumonia can complicate confusion.So her present confusion can be due to worsening of pneumonia.So better to consult pulmonologist and get done 1. Repeat chest x ray2. Sputum culture and sensitivity Fresh chest x ray is needed to determine whether pneumonia is worsened or not.Sputum culture is needed to identify the causative organism and sensitivity will guide effective antibiotics.Don't give haphazard antibiotics, as it will worsen the pneumonia.Consult pulmonologist and start appropriate effective antibiotics.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the pain during electro stimulation lead to sterility?\n\nHi,The phrase \"curiosity killed the cat\" is perfect here. A week ago, I was curious and decided to give electro stimulation a try using a beginner TENS unit. I wasn't thinking logically but I read that putting it on your testicles tingles and feels good so I tried it briefly for 1 minutes tops on a low setting. It didn't really hurt when I was doing it but they still feel a little tender and I think a little harder then what I remember or think I remember how they normally feel. -I'm wondering if this would be enough exposure to cause me to become sterile, either temporarily or permanently?-I also applied the 2 pads to my shaft, one at the base and one below the glands, this was tried out for a little longer, maybe 5-10 minutes tops. Do you think this placement would have any effect on my testicles and or sterilization?About me:I am a 24, white male in good health",
    "doctor_response": "DearWe understand your concernsI went through your details. There are no concrete evidences which suggests electro stimulation can lead to sterility. You may feel so if you are obsessed with those thoughts. I suggest you to read articles and research reports available on the internet and satisfy yourself. Upon satisfying, please set aside the worries about the sterility.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Labs show mild hepatomegaly with fatty infiltration, non-dilated ducts. Is this alarming?\n\nI took my result after three days this was the findings. The liver is slightly enlarged measuring 15.67 cm with increased echogenicity. Hypoechoic region is noted anterior to the gallbladder . Ducts are not dilated. Common bile duct measures 0.3 cm IMPRESSION: MILD HEPATOMEGALY WITH FATTY INFILTRATION AND AREA OF FOCAL FAT SPARED NON DILATED DUCTS May I ask you to it explain further. Do I have to worry? thanks and kindest regards.",
    "doctor_response": "Hello, raymondqdatuon, Fatty liver can be present if you are over weight. Other causes of fatty liver include alcohol excess with poor diet, certain drugs such as NSAIDS,Ibuprofen,Naproxen,Sulfa drugs, Tetracycline family of drugs can cause fatty liver. Fatty liver of pregnancy is known. Some metabolic diseases including diabetes can cause fatty liver.If you have elevated lipids,diabetes, and are over weight, that fits \"Metabolic Syndrome\" with fatty liver. In your case, your liver is mildly enlarged and fatty changes are seen. Bile is produced in the liver and are carried by small ducts called Hepatic ducts (Channels) and drian into a bigger channel called the common bile duct which inturn brings the bile to the gallbaldder. Gallbladder stores the bile and releases it during digestive process after we eat food. In your report all the ducts are normal and not enlarged or blocked, which is good. You can start taking Vit_e 800 i.u. daily, Vit-C 1000 mg. daily avoid fatty foods, increase protein in the diet. Make sure you get checked for diabetes and take care of the blood sugar if high. If your cholesterol is high, you have to control that with diet and if needed with medications. I hope this information helps you. I wish you well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest dosage of 'tramadol' for tooth ache\n\nI'm taking tramadol activis (50 mg) for a toothache.  The tramadol is left over from a prescription for pain after a bike accident, and yes, I know one isn't supposed to save and self-diagnose, medicate, etc.  But I am doing so in order to get some relief.  Visited dentist today and he gave me prescrip. for penicillin as infection is his only guess since the tooth looks fine.  My question re: tramadol is:  what is a usual dose?  I recall originally being prescribed two pills, four times a day.  But I'm taking just one, and waiting approx. 6 hrs. before taking a second one.  Is normal  dose 50 mg four times a day?",
    "doctor_response": "hello thanks for consulting at hcm..Take pencillin and tramadol dose as prescribed by your dentist..Tramadolol dosage is usually 50-100mg,4-6 hrs, maximum 400mg/day..tooth ache requires check up and treatment..maybe problem is deep dental caries or periodontal etiology..Kindly consult with a oral physician..Hope it helps,,take care..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could frequent flying be a reason for cellulitis in legs?\n\nAt the end of May, I returned from a 5 day trip to NYC, flying from Tampa to NY.  I have lympedema in both legs and two days after my return, I came down with cellulitis in my legs.  I took Keflex for 12 days.  Then at the end of June, I traveled to Evanston, IL for a 2 day conference and then to Toledo to visit my parents for 4 days.  Three days after my return home, I came down with another bout of cellulitis.  My skin appears to be in good condition.  Could flying be involved in causing this condidtion?  Thank you.",
    "doctor_response": "Hi,From history it seems that having problem of swelling of legs might be due to having dependent part oedma due to long time sitting in flight.This can be normal edema.One possibility we should keep in mind having some vascular obstruction in legs venous system.If require consult vascular surgeon and get examined.Mean whie keep food end raise to get temporary relief.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is bent penis and foreskin covering only half of penis serious?\n\nI am 20yrs male. My penis's glans is bent downwards and my glans are covered only half part with the foreskin. I mean half glans cn b seen. I jst wnt 2 ask lL there b any problem with my penis in my latr sexual lif? Howevr tl nw I dnt nt xperienc ney prblm. Pls hlp . Abt my penis's glans is bent slight downwards",
    "doctor_response": "Hello,Not serious but it may hamper your sexual life. For further assessment you may require urosurgeon consultation. You may require surgical intervention after surgeon consultation. Avoid forceful retraction of foreskin. Maintain proper hygiene Hope I have answered your query...Let me know if I can assist you further.Regards,Dr Shyam kaleFamily and general physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for mouth ulcers after teeth extraction\n\nhi. I just had three teeth extracted last Friday and now taking Ibiprofin/ Vicotin and antibiotics. I started to have mouth ulcers around the stitches, which is very painful. I rinse my mouth with salt water and the mouth wash prescripted by my dentist. I wonder if there is anything i can speed up the recovery. I would like to take some B12 Vitamins but i wonder if it doesnt go well with the antibiotics. Thank you!",
    "doctor_response": "Thanks for using Health Care magic.Read your query.I can understand your concern. For the mouth ulcers you can apply mucopain or dentogel on it without disturbing the sutures as vigorous rubbing may distort the sutures.Continue with medicines and use a antiseptic mouthwash for gargling.You can start with the multivitamins and have a nutritious diet .Hope this was beneficial.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be done for inflammation and pain in the finger?\n\nMy 6 year old granddaughter woke up this morning and then lay back down and has slept for another 5 hours. When she woke up this time, her left ring finger and half of the top of her hand is red, with the red going up towards her forearm and swollen. She says it itches and the finger hurts. I gave her a chewable acetaminophen tablet. Other than some ice, is there anything else I can do?",
    "doctor_response": "Hello, Please send a photo to exclude allergic reaction and to exclude thrombophlebitis. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain and fever in 3 year old?\n\nHi, may I answer your health queries right now ? Please type your query here... My 3 year old daughter is complaining about abdominal pains, has raised temperature and is crying. She s off her food but all this has came on quite suddenly, we recently just brought home a border collie puppy which hasn t had injections and was allowed to run around the farm it came from. Is it possible it s picked something up off the farm and passed it to her? Nicole.",
    "doctor_response": "Hello,I do not think that this related to the dog. Zoonosis does not behave like this. I feel that this is related to a viral illness. This type of nonspecific pain abdomen and associated fever looks like a viral illness. Symptomatic management of pain and fever with paracetamol should do.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sumanth Amperayani",
    "dialogue_context": ""
  },
  {
    "patient_message": "High SGPT or ALT levels. Taking antibiotics for dental root canal treatment. Cure?\n\nHi I got my routine blood tests last week and got a high (152) SGPT / ALT level, which has never been the case before during my yearly checks. What was different this time was that I did the tests during am ongoing dental root canal treatment and was also using antibiotics. I do lot smoke, but consume 2-3 glasses of wine 2-3 times a week.",
    "doctor_response": "Hello,  welcome to HCM, I am Dr Das. Look, increased level of enzyme may be seen in hepatocellular injury. It is not caused by the antibiotics you have taken during rct. So, you have to take it seriously. Stop taking wine regularly. Take a liver protecting agent like sorbillin. Consult with your treating doctor. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible through intercourse 14 days before menstruation due date despite getting periods?\n\nHi I had unprotected intercourse 12 days before my period. I still got my peroid on time lasted 7 days. Two days later I feel nausea and light headed. Could I be pregnant? I am not on birth control.",
    "doctor_response": "Hello dear,welcome to Ask a doctor service. I reviewed your query and here is my advice. Since you got your period you are not pregnant for sure. If is two early to experience pregnancy signs first two days after cycle.If you don't want to get pregnant ensure a contraception method. Hope I have answered the question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get cold in the morning with pruritic rashes, nasal congestion and eye itchiness. Please help.\n\nHello doctor, I would like to consult for my disturbing allergic flares. I am a 33-year-old female. I am not known hypertensive, diabetic, or asthmatic. Within these three months I have history of morning colds, nasal congestion, pruritic rashes, and eye itchiness. I have no fever, no cough, shortness of breath, headache, and sore throat. I took Monetlukast + Cetirizine once a day and applied Olopatadine optic drops four times a day which did not relieve my symptoms. Therefore, I added Loratadine 10 mg 1 tablet at bedtime. I tried a hypoallergenic diet as well. After two weeks, still, without relief, I added Prednisone 5 mg tablet with a tapering dose for two weeks. There was no significant relief of symptoms. Now, I am still on Montelukast + Cetirizine once tablet once a day, and Loratadine 10 mg one tablet once a day at bedtime. My rashes are getting worse and my sneezing as well. Please help.",
    "doctor_response": "Hello. Regarding the treatment, I suggest you continue the medicines as they are. I would like to know how much of Prednisolone did you start with? Nextly, you must start on intranasal steroids to help relieve the nasal symptoms. Use Fluticasone furoate twice daily two puffs in each nostril twice daily. The brands available in the Philippines are Avamys, Flutiair, Nasoflo, Flusort. If you feel the antihistaminics are making you drowsy, then you may keep the Cetirizine for the evening and take Loratidine in the morning. Apply a mild steroid cream like Betamethasone valerate 0.1% topical cream over the affected skin. The brands available in your country are Diprolene, Diprosone, and Betnovate. Long term solution: You must do a skin prick testing to check what you are allergic to. Skin prick testing is better than blood allergy testing. Both the methods check for food and aeroallergens. Remember that before the testing you should stop the antihistaminics for five days. With such a test we will come to know the offending agent and give you the right advice to prevent that particular allergen. Do revert back for more details. Apply mild soap and wear loose-fitting clothes to avoid friction over the affected area on the skin.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is there any temporary remedy for shortness of breath in postural orthostatic tachycardia?\n\nHello doctor, I have been recently diagnosed with postural orthostatic tachycardia by my family doctor. I have been experiencing lightheadedness, fainted a few times after standing. My BP is really high 186/102 mmHg on average with a normal pulse while lying down, then as soon as I sit or stand up my BP drops quite low 104/75 mmHg on average. I have also been experiencing severe fatigue, my whole body just aches all the time and I constantly feel short of breath and get chest tightness and on and off pains. I have reoccurring tremors in my left arm and fingertip numbness. I become very foggy minded usually at night and I get words mixed and my speech gets slurred and stuttered. The worst most uncomfortable feelings I have is shortness of breath and have difficulty trying to breathe. I cannot sleep feeling like this. I have a 3-month-old baby to take care of, but I need some advice on getting at least some temporary relief with my breathing and chest pains until I see the cardiologist. Please help. I am currently taking Celexa 40 mg at night for depression.",
    "doctor_response": "Hi,  Welcome to icliniq.com. It is postural orthostatic hypotension, i.e. a significant drop of blood pressure which is causing fainting and giddy kind of symptoms. To prevent this avoid sudden movements like while getting up from the bed, sit with the legs hanging on the side for a while then get up. While feeling faint just lie down on the floor, do not try to control and stand, surely you will fall. Second thing, your resting BP (blood pressure) is high it needs to be controlled as early as possible. It looks like gestational hypertension (after pregnancy). Chest tightness and breathing difficulty are due to resting high BP. Take tablet Amlodipine 5 mg once daily until you see any cardiologist and avoid sudden movements.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can stress cause an increased CA 125 level?\n\nI am 60 years old and have a ca 125 level of 40, it has gone up within the last year....can stress cause this...I have no symptoms of ovarian cancer....but could this be.....My naturopath things that it is stress related, as my cortisol levels are also elevated.  Are there any tests that I should get done?  Thanks",
    "doctor_response": "Hi and thanks for the query,It is very difficult for stress to cause very high increse in the CA 125 levels. It is true that this marker could be raised under situations of acute inflammation or other metabolic diseases. If you noticed it raised, it might be necessary to rule out ovarian cancer and other gynecological malignancies. the opinion of a gynecologist is needed. Kind regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be done for the pain in lower back after hip being a bit out of place?\n\npain in my left low back. hip a bit out of place and affects my spine. hard to sit and sometimes stand whne the pain hits. went to chiro twice and pain seems to be worst. dont want to go back to chiro but wonder where i could go next to releave some of this pain",
    "doctor_response": "Pain in back looks like due to strain on back as you are saying that your hip joint is normal.  Have you got x ray of your hip.  If not than get x ray of hip and spine.  You can post your  x ray report in this forum.  Till than you should  learn  physiotherapy from a therapist  and do it regularly at home.  Take muscle  relaxant like myoril or myospaz  for pain.  Also take calcium daily.  You can use stick  for walking this will prevent  pressure on back muscles.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible while on patch?\n\nHi, i've been using the patch as my choice of contraception. My boyfriend and I have been having unprotected sex. I was wondering if it was possible for me to get pregnant because sometimes I dont change the patch on the correct day. So can I get pregnant?",
    "doctor_response": "Hello, and i hope I can help you today.The patch is most effective when you change it (and change the location) weekly for three weeks per month and then have a patch-free week.  There may be some medicine left in the patch after one week, so you may still have some pregnancy protection, but it is not possible to know if the patch is still effective because it was not studied.  Therefore, I would assume you have an increased risk of pregnancy if you do not follow the manufacturer's directions to change the patch weekly. I hope I was able to adequately answer your question today and that this information was helpful.Best wishes,Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for bartholin's abscess on the vagina?\n\nHello,  I have what I believe is a Bartholin's abscess on the upper, outer layer of my vagina.  I didn't realize I had strep throat and, in and intimate moment with my husband, saliva from my mouth was transfered to my vagina.  With in a day or two the abscess appeared.  It appeared 2 days ago (Friday) so I will not been able to go to the OBGYN until tomorrow (Monday), if they can get me in urgently.  This morning I woke up and feel another lump on the bottom left, outer area of my vagina.  I believe another one is forming.  Should I go the the ER to see an MD, or is this best handled by an OBGYN?",
    "doctor_response": "Hi.I don't really think you even need an OBGYN, if you try a few things at home religiously and experience an improvement. So heres what you can do:+Avoid wearing inner wear for a few days to prevent friction and pain+Warm compresses indirectly (rock salt heated on a pan and placed into a clean cloth) or a hot water bag wrapped with a clean cloth, placed on the region several times a day (as much as tolerated)+Warm water sitz bathes with epsom salt in it, soak yourself for at least 30 minutes or more at least 2-3 times daily+Do not shave the region+Keep the region clean and dry at all times+Do not try to pop them+Avoid both sexual contact and masturbation completely+When and if the region does pop, just clean it and apply neosporin ointment over it twice daily for 2-3 daysHope this helps.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat hair loss?\n\nI hit my knee with a wooden stick today while my leg was straight and pain shot through my knee and made it impossible to walk. But after awhile i could bend it again but I can't lock my knees without experiencing pain in the are above my knee cap. What is it?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Possible causes of knee pain after injury may be due to patellar fractures or cartilage injury of patellofemoral joint or tendinitis of patella or injury to meniscus or cruciate ligaments. Until examination is done it is difficult to say what it is. Take rest, use cold and warm compression, use tablet Ultracet twice a day for five days. If symptoms not improved please consult your doctor he will examine and take X-ray then treat you accordingly. Take care. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu",
    "dialogue_context": ""
  },
  {
    "patient_message": "30 years old female suffering from allergic rhinitis,taking allopathic medication but not satisfied with the treatment\n\nhello! my wife is suffering from allergic cough and cold as well as sneezing since 4-5 months i have shown her to a allopathy doc he said she is suffering from allergic rhinitis . which is characterized by an itchy/runny nose, sneezing, and nasal congestion . Other allergic symptoms include: itchy ears and throat, Eustachian tube problems (the tube connecting the inner ear to the back of the throat), red/watery eyes,cough,fatigue/loss of concentration/lack of energy from loss of sleep, and headaches . plz prescribe some remedy as allopathy medicine are of not effecttive as given. her age is 30 she doesn t drink tea/cofee but always thirsty of water, doesn t like sweet but like spicy and sour food. feels always warm and always in a hurry of doing things.her ESR, hameglobin and blood pressure is normal cheked recently.",
    "doctor_response": "hi she has allergic rhinitis and need to do allergic sensitivity test . after test we will find out the reason for allergy and can avoid it do continue with medicine it will take 2 month to many year to recover from allergy advise to take healthy diet and avoid dusty environment i hope i answered your question .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am on medication for fibroids and getting on and off bleeding. Is this the side effect of medication?\n\nHello doctor, I am 48 years old. I have two fibroids 9 cm total size and was advised to take 2 x 500 mg three times a day but it completely stops the bleeding but the bleeding starts after three days again. I have had on and off bleeding for two weeks now. Is this a common problem with the medication? I am extremely worried and cannot be normal. Please help and advise.",
    "doctor_response": "Hello,  Welcome to icliniq.com. It would have been helpful if you could attach the report of your ultrasound for me to have a look. Based on what you mentioned about the total size of two fibroids to be ~9 cm, I am assuming each one must be less than 5 cm and not so huge. Fibroids would not cause irregular bleeding unless they are lying close to the uterine cavity. Usually, in the perimenopausal age group of women, like you are already 48, we prefer to give medical management so as to control the bleeding in those who have excess bleeding. As with age, your menopause may set in and menses will eventually stop and then you will not have any problems because of the fibroids. This is done to avoid unnecessary surgery when the bleeding would anyways stop after menopause. In your case, I would like to know if the fibroids are close to the uterine cavity on ultrasound which may cause irregular bleeding. Also, in your query, the drug name has not come, but I guess it is Tranexamic acid (or Trapic or Pause) which just controls the excessive bleeding means will reduce the bleeding. But will neither stop the bleeding pattern due to hormonal disturbance in the perimenopausal abnormal bleeding nor due to the fibroids which bleed due to the close situation to the uterine cavity. Other causes if irregular bleeding apart from fibroids need to be evaluated like hormonal changes, thyroid issues, or uterine lining (endometrial) thickening, etc. If it is due to fibroid position that is causing off and on bleeding, it may not stop with Trapic (but only will reduce in amount) and may stop only after menopause or after the surgical removal of the uterus. But if it is due to the hormonal disturbance or due to the perimenopausal phase, it needs to be controlled with some hormonal medications. It would be good if you could connect with me through chat and share the reports of yours so that we can have a close look if any further evaluation needs to be done regarding the abnormal bleeding pattern. Ultrasound report needs to be reviewed. ? Thyroid abnormalities, ? perimenopausal AUB (abnormal uterine bleeding), ? Ca (cancer) endometrium, ? EIN (endometrial intraepithelial neoplasia). please revert back with reports.",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI says bulging annulus, mild central stenosis, moderate foraminal narrowing bilaterally. What to do ?\n\nHi i had a MRI and the impression says: degenerative changes with bulging annulus & broad-based disc-spur complex @ L5-S1 causing mild central stenosis and moderate foraminal narrowing bilaterally. These impression were taken in May 2012.since then i ve had Si joint injection ( no relief ) A double injection on each side of spine , Lumbar Facet ( no relief ). on nov 5 a Lumbar Epidural Injection. After 5-6 days back to severe lower back PAIN. stay on ENDOCET for pain w/ heating pad . I think i m getting worst. Can t stand up for a long period, or sit on anything hard. without pain. Sch tomorrow for another epidural. still in SEVERE PAIN.",
    "doctor_response": "See you have symtoms of canal stenosis ie as you can't stand for long.You also have symptoms due to  foraminal narrowing in form of pain.You should show your self to neurosurgeon he would phan a surgery to oped the canal and neural foramina then you will be relieved of symptoms,but it will take time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pressure in the head when I lay on the back?\n\nI have had issues with migraines and have terrible back pain I do not take meds when I lay on my back to ease my pain I get throbbing pressure in my head I have been in 3 car accidents and 2 motorcycle accidents with no signs of head injury or broken bones",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The headache is chronic migraine. You should avoid fasting, excessive tea, coffee or chocolates. Take timely breakfast and lunch. Medications like Amitriptyline , Flunarizine, Topiramate , Divalproate can be taken. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Flank pain, abdominal pain, low BP, fatigue. Had atrial septal defect, kidney repair, colonoscopy. Disorder of the endocrine?\n\nMy husband has had left flank pain for 4 or 5 years, which now travels across the front of the abdomen. He also lost 40 pounds unintentionally in the last year or two. He also has fatigue, and his blood pressure is getting lower, He had an atrial septal defect (3 holes) repaired about 6 years ago and was put on blood pressure medication to slow down his heart. My husband cut the atenolol in half within the last year. He had a kidney repair 36 years ago for because of a congenital anomoly where the kidney was not draining into the ureter because the connection was too small. His kidneys have been checked (left one only functions at 20-30%) and was told they are okay. He has had a colonoscopy, x-rays, MRI, CT scan etc, and many lab works done. They cannot find anything. He looks as though he is withering away. He is 6 feet 1 inches and used to work hard to keep his weight just under 200 pounds, and he now weighs 166 pounds. It started with the abdominal pain and the other symptoms are now getting worse. Could this be some endocrine type of disorder? He had a recent AM cortisol done which was okay, but he had it repeated today. Very frustrated!! He has also had a metal-on-metal hip placed 6 years ago. It doesn't seem to bother him very much, just on and off sometimes. Could this be the metal getting into his system? My husband still feels as though there is something wrong with kidney.",
    "doctor_response": "Hi ! Losing 40 pounds unintentionally is of course worrisome. When was his colonoscopy done ? If it was long back, then I think he should get it repeated. Was any biopsy done at that time or not ? If not, then you may discuss with your gastro enterologist for it during the repeat colonoscopy. Many times inflammatory bowel disease does not get diagnosed for a long time unless biopsy is done and this could be a reason for the weight loss and pain in abdomen. He should continue with his anti hypertensive medications. If there is no blockage in the pelvi-ureteric system after the operation for kidney, then nothing much to worry from that angle, but if there is a blockage persisting, then it could also give rise to the pain in flank. It does not seem to be related to any endocrine system. You can discuss with your doctor for a CT Scan or a PET scan if nothing is conclusive based on the weight loss, which is significant.I wish your husband an early recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I loose my post pregnancy weight ?\n\ni am 25years old ,i am having pcod problem .before pregnancy i was 78kgs after delivery i was 100 kgs and again i am 110 kgs now .i want to lose weight .i am having 10 month old baby i am going to stop him feeding .i started dieting and planing to go for yoga ,since i am having pcod i feel very difficult to lose weight .i planned to use herbalife with addition.pls tell me whether it is effective and safe.i am feeling very bad regarding weight.i want to lose it as much as possible .pls help me ...............",
    "doctor_response": "Hi I will try my best to answer your query. Studies on Herbalife products, few of them show they are effective , other studies suggests they are equivalent to placebo. I advice you to take proper treatment for PCOD, as that is also responsible for obesity. I think regular exercise and dieting is also very essential for reducing weight. Hope my answer will be helpful for you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have intermittent twinges on right side of stomach, tight feeling. Have mild hiatus hernia. Am i at risk of pancreatic cancer?\n\nI have intemittent twinges on the upper right side of my stomach but I can't tell if it is from my stomach or from the right side of my upper back which feels tight when I stretch it. There's no pain when I press anywhere on my stomach. I have a mild hiatus hernia. Sometimes the twinges are gone for days and then if I lean to the right or lean forward a bit, I feel the twinge again, I just can't tell if it's a referral pain or not. I'm terrified that I might have pancreatic cancer",
    "doctor_response": "NamasteGreetings of the dayWelcome to Healthcare-MagicPain is the last symptom or presenting feature in pancreatic cancer. It's unlikely to be due to it in absence of other symptoms and risk factor.From the description of your pain I would consider the possibility of duodenal ulcer/acid peptic ulcer and gall bladder pathology as top of my list. Would suggest you to see your physician and get an Ultrasound and Gastroscopy done in consultation with him to rule out the aboveTake careRegards Dr T ShobhaMBBS MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of leg pain while pressing ?\n\nI am concerned about the front on my right leg, as it is causes pain when I apply any pressure (however slight). It is only on the bottom half of the leg. There is no visible redness or swelling (although my legs and ankles tend to swell in the heat). I have noticed a couple of mosquito bites at my ankle but the pain is further up (more around shin). I have had superficial DVT about 22 years ago and am concerned that this could be a venous problem as it has a path of sensitivity which you can follow with your finger up the leg below the knee. I have had it for about 4 days now.",
    "doctor_response": "Hello, As a first line management, you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist you can consult an orthopedician and plan for an MRI scan. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have hair loss, oily skin, body sweating, increased SGPT, SGOT, high CPK enzyme, increased LDH. What can be done?\n\ni have very very high all over body sweating. highly oily skin\\rapid hair-loss-baldness\\grade-3-fatty liver\\increased SGPT andSGOT \\very high amount (966) blood cpk enzyme level.malaise\\hungry\\thirsty\\greasy hair\\ in fecal undigested food\\facial paresthesia\\increased LDH-------but thyroid enzyme levels are normal in range",
    "doctor_response": "Hi,From your exams it appears you have a liver problem. Further investigation such as Hep C, or B, abdominal ultrasound will have to be done to determine the cause on which treatment will be based. Generally, you will feel much better with the treatment. To improve you condition you will also have to avoid drugs/food that adverse effect on the liver: alcohol, fat, certain dugs. Generally, only take drugs prescribe by you doctor. You condition will improve following medication.Hope this helps. Dr Rogers",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden pain in the chest and jawline?\n\nMy husband gets sudden sharp cold poker like pain in center of chest between nipples and pain along jawline, sometimes one side, other times both sides. Doesn t effect breathing. Has to sit down. Slowly dissipates. Sometimes pain moves to right side under armpit. What is the cause??",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Pain seems to follow a specific pattern. He must undergo tests with your General physician to rule out Cardiac problem. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from pain and swelling in the ankles. Diagnosed with gout and CLL. Elevated uric acid levels. How to get relief from the pain?\n\nMy boyfriend has CLL and has been having a lot of difficulty with pain and swelling in the ankles. So much pain that we had to go to the emergency room because walking/bearing weight was impossible. The ER doc diagnosed it as gout & gave him a prescription without even doing labs. Follow up blood tests with his private Dr have shown normal uric acid levels and still no answers as to why the pain and swelling. He describes the pain as walking on shards of glass",
    "doctor_response": "Dear Sir,Sorry to hear about your friend's problems. His symptoms could either be due to the uric acid crystals deposited in his feet, which will take time to go away or as a side effect of the chemotherapy which he is receiving for CLL. He should meet his oncologist and seek the appropriate pain killer.Hoping for the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for rash on abdomen\n\nHello, I have am 32 years old, with two younger children ages 2 and 4. Over the last week in traveling to visit my family I have developed a rash on my abdomen, which itches but is not severe. My children do not have any rashes, any suggestions? Also I run and participate with outdoor bootcamp....",
    "doctor_response": "Hi, As per your query you have symptoms of rash on the abdomen which can occur due to our environment, heat, cold, pressure and sun exposure. It is the bodies response to the trigger factor. Need not to worry. I would suggest you give cold compresses to hives several times a day to prevent from swelling and itching and take over the counter antihistamine drug like Benadryl. If symptoms still persist the consulting dermatologist for proper examination and treatment. The doctor may perform skin test and challenge to find out the trigger factor. The doctor may prescribe other steroid creams (mometasone) along with anti-inflammatory medications. Stay in a cool environment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Harry Maheshwari, Dentist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for having runny nose, congestion and sneezing after drinking wine?\n\nWhy do I instantly get a runny, congested, nose and sneeze repeetedly every time I have a glass of wine?And how come sometimes I can drink and wake up feeling just fine, and other times i awake feeling groggy and a bad headache. When I drink the same thing.",
    "doctor_response": "in this  case i think you are allergic to it and immediately after drinking alleren shows its presence by causing allergic symptomps like you described i suggest to avoid the wine to get protection of immune system",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back/stomach pain and breathlessness\n\nHello!   My wife is wondering about her heart.  She has had back pain, stomach (does not feel right),  just had a quick wave a nauseau, some shortness of breath, (like hikingup hill).     My wife is 50.  Her parents both have a history of heat trouble, but not till 70's and 80's..    What would you recommend at this point?",
    "doctor_response": "parents had complaint .this means that your wife has first degree relative history so she is more at risk..donot take it lightly..please visit doctor and get chest x-ray and ECG and BP  check up ...majority problem will be covered..further echocardiography may be needed ..it may be IHD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are levels of ALT 95 and AST 108 be a matter of concern in a 5 year old?\n\nMy son is 5 years old. He was born with gastroschisis, do to many surgeries he now has short bowel syndrome. He was TPN dependent as an infant in the NICU. Therefor he has elevated liver enzymes from time to time. He has also gotten 6 blood transfusions through out his life. When he was 1 1/2 we faced a possible small bowel and liver transplant and a miracle happened that we didn t need it. My question is he had labs drawn on march 3rd and I got the results today his RBC is 3.98, Lymphocytes is 53.3, Eosinophils is 3.76, Glucose is 56, ALT is 95 and AST is 108 also his vitamin d is 21. I called the doctor to tell him i was concerned and his nurse told me they weren t and that they probably were left sitting in the lab which messed up the levels. I called the lab and they assured me his blood work was processed promptly. Should I be concerned? What does all this mean?",
    "doctor_response": "yes this elevated levels suggest there may be liver damage ..but this enzymes level also slightly elevated in case of hemolysis or other organ damage..you need to repeat the test after 1 week..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can vomiting indicate a concussion after a bad fall?\n\ntoday my son flew 4 ft in air and landed on his shoulder while sledding.  We went to er and they took x-rays and gave him 409mg ibuprofen.  Said his shoulder was just bruised.  He has been ok rest of day but is now throwing up...should I be concerned of a concussion and should I take him back to er to be checked?",
    "doctor_response": "Hi,Vomiting is common symptom after mild trauma due to vertigo (especially if head is involved) in your son's case as per your note he landed on his shoulder, if you didn't noticed any symptoms of head involvement It can resolve itself within couple of days. But if you are suspicious of head trauma only a CT scan can confirm concussion or serious head injury, if this is the case appropriate physician must be consulted (Neurologist). I hope this answers your question.Dr.Uppal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe abdominal pain\n\nI have severe, at times, abdominal pain that feels like someone is twisting my insides out with pain that radiates to the right side of my spine, like someone is stabbing me with a knife.  I went to the ER and they did a CT scan of my abdomen which was negative and lab work was unremarkable.  I had my gall bladder out 10 years ago.  I am wondering what else it could be?  They did say that I have diverticulois but that wouldn't be causing the pain.",
    "doctor_response": "welcome to Health care magic.1.After CT scan, it almost narrows the causes.2.It clearly demonstrate organs and the pathologies. Liver/Pancreas/Spleen/Kidneys/Spine. After all these ruled out even if diverticulosis is not found - one will think of some pathology in the bowel.3.In the bowel we can see IBD - ischemic bowel disease, Diverticulits/diverticulosis, obstruction, and inflammation of the bowel.4.Any of the above bowel pathologies would give the above symptoms.5.So improve your diet and evaluate bowel pathology with barium swallow.6.Hope it helps you.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for porphyria and its symptoms\n\ni have a history of variegate porphyria and possibly coproporphyria in my family, as i am an illegitimate descendant of the house of windsor (british royal family), who are known carriers. i have been symptomatic since age 13, presenting with acute attack symptoms, food sensitivities that precipitate attacks, and presentations of delerium and confusion when exposed to sunlight, along with tissue necrosis and severe edema in the extremities on several occasions. over the years, my photosensitivity has worsened, to the point where it is now a full-blown neurological reaction that causes paralytic seizures that require medical attention. because of the severity of my light-sensitivity, my condition is now life-threatening. the shortest wavelengths of light i can tolerate are in the yellow-green to emerald green range, which is consistent with VP. any wavelength shorter than emerald green causes me immediate burning sensations in my skin, general nervous agitation and anxiety, and a hot, swelling sensation in my chest and abdominal cavity. exposure to any source of white light is in most cases immediately painful, and exposure for more than half hour causes cramping, writhing, and ultimately a grand-mal type seizure, with convulsions or paralysis. i spend most of my hours in a bedroom with a window covered enough to make it pitch black in the room with the lights turned off, and i only using a single green-colored cfl for lighting. lighting is controlled to varying degrees in other areas of the house. although i can obviously use a computer, i turn the brightness all the way down, but it still causes aching pain in my facial bones, eye pain and increased pussing, and facial redness and burning sensations. i have similar problems with the television. unfortunately, i have not been diagnosed. i did not know about photosensitivity diseases or my family history until my disease became very severe in 28, and the two tests i have undergone (once at age 30, again at age 39) were ordered by general physicians; both tests were botched. the first physician ordered the wrong series of tests (for erythropoietic rather than hepatic porphyrias), and the second physician excluded some tests that may have given a positive result (specific fluorescence test to confirm or rule out VP, possibly others). i spoke with a hematologist when i was not insured several years ago, and he gave me a runaround, telling me that diagnosis was ",
    "doctor_response": "i'm very sadly about what do you say.many times what we need is simply more time to spend taking care the other.but i think in this moment you need help, but the one can help you is a good neurologist. you should choose the one you think the best and give him all the documents he need to modified or \"restart\" the therapy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is continued faster heartbeat after running long distance normal?\n\ni have just ran about 800 meters and i pushed myself  over the limit. my hart is still beating fast after 1 hour. i ate some food and drank 3 bottles of 600mill 2 clod one room temp. can u please help me i need 2 know what 2 do now i will try 2 c a doctor but i am at school now and i do not know if it is bad.",
    "doctor_response": "Hello, I understand how you are feeling.It could be scary to have a feeling of a fast heartbeat. It is normal for the heart to beat fast after physical activity. As much as exercising is good, you should avoid over stretching the limit your body can go  If for example you usually run 400 meters, it is better to gradually ascend to 500 or 600 meters before getting to 800 meters this way you can avoid injury and exhaustion. Warm regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of rash on my waist after having poison?\n\nhello, my fiance just had posion ivy a couple of days ago. Today I woke up with a rash on my waist that looks like big welts. It sometimes iches however it isnt all the time and didnt really bother me too much today. Could this be posion, or do you think it is something else?",
    "doctor_response": "HIMost likely it, too, is poison ivy.  Calamine lotion and benadryl should treat it effectively but, if not, you'll need a cortisone injection",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stiffness and lump like feeling in the mid area of the neck?\n\nYes - I have suddenly - 2 weeks ago - and then again today - had a squishy feeling lump that is quite flat appear on my neck between the occipital bone and mid region. I awaken with my neck very stiff for hours and a rounded feeling of a lump can be felt when my head is down. It feels numb when I rub it. I don t know whether to be concerned or not? My mom has sjgroens and I have lots of the symptoms but not an official diagnosis so I m not sure if it s related. I ve been tired a lot and have had mild headaches behind my eyes lately.",
    "doctor_response": "Hi, Consult an orthopedician and get evaluated. An MRI neck is required for further evaluation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to strengthen lower back after delivery of twins?\n\nI have been having lower back pain almost tailbone pain since my 3yr old twins where born.. I can't lay on my stomach or floor. Or sit on hard chairs or floor. Or if I wear flats. When my back has a fit it last weeks without muscle relaxers. Sometime stops me in my tracks with lighting pain running up into my shoulder. Laying hurts and when I sit my lower back hurts if I take a deep breath or cough sneeze.. It feels like my tailbone and lower spine aches like I have the flu and heat makes it worse. How can I strengthen it without hurting? Is it just muscle related?",
    "doctor_response": "During pregnancy muscles remain in disadvantage and that causes them to weak. Now my advice to you is to start back muscle strengthening exercises. This will need some patience but you will improve, also shedding some extra killos will help you. I hope you have taken iron and calcium during pregnancy as some time low haemoglobin can also contribute to this muscle fatigue.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could green tea elevate blood pressure?\n\nNormal bp reading is 140/80 for me.  I'm 60 yr. old female  with rhuematoid arthritis (being treated).  Recent dr.'s office vitals showed bp 200/90. Had green tea prior to appointment, could this be the reason for the elevated bp? Dr. prescribed ace inhibitor but I don't want to take it because of the side effects listed.",
    "doctor_response": "Hi,Usually green tea doesn't increase blood pressure. You should monitor your blood pressure, if you have high blood pressure, you should take medication systematically, utherwise you may develop many side effects of your heart, kidney, eye, brain if left high blood pressure untreated.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, took clomid. Ovulation test positive. Cramping, clear discharge, dizziness after intercourse. Pregnant?\n\nI had my period starting Feb 23rd, I took 50mg of Clomid days 5 thru 9 I took ovulation tests every day starting march 3rd and they came back positive thru march 9th. My husband and I had intercourse 3/3, 3/4. 3/5 and 3/9. Today I am feeling slight cramping, have clear discharge , and I am feeling dizzy. Is it possible I could be pregnant and feeling symptoms already?",
    "doctor_response": "Hi, Thanks for the query. As you had unprotected intercourse around the time of ovulation there is possibility for pregnancy. Sometimes pregnancy symptoms can manifest in early pregnancy itself. You better wait till your expected date of periods and if you miss the periods go for pregnancy test once. Meanwhile you can take symptomatic treatment and folic acid supplementation. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the ventricular echogenic focus seen in pregnancy scan?\n\nHi doctor, My sister got her 22-week pregnancy scan, and a small left ventricular echogenic focus was noted. Please advice.",
    "doctor_response": "Hi. I have gone through the attachment (attachment removed to protect patient identity). Let me tell you what is an echogenic focus is. It may be a calcium deposit, and it is commonly seen in the left ventricle of the heart in the prenatal second and third pregnancy ultrasounds. It is a rare finding, and it does not show any adverse outcomes in the absence of other factors. It will not cause any harm to the heart, and it will not develop any problem with the development of a baby. But in the presence of other risk factors, the doctor performs these screening tests, like Down's syndrome screening. Otherwise, just the presence of an echogenic spot will not raise the chance of getting any chromosomal or genetic disorder.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the tongue. Discomfort while eating. Need to see a dentist?\n\nlast night i started to feel some pain on the right side of my tongue , along the inside gums on the same side, and on the floor of the mouth same side connected to the gums. i am not sure what it is but it happened fairly quickly and i ve had steady discomfort and pain when i eat ever since. i do have a molar on the right side that has been decaying for quite some time, but i have not had it pulled due to lack of health benefits to make it affordable. if i apply pressure to the skin under the jaw bone i can feel pain inside which connects with the pain in the mouth. i would like to know how serious this is and how soon should i see a dentist? will doctors/nurses at a hospital be able to diagnose and/or treat it?",
    "doctor_response": "Hello & welcome As you said that there is a carious molar tooth on the same side you are feeling the symptoms this may be a periapical infection, and now this is spreading. so you have to immediately visit your dentist for further clinical investigation, otherwise this may lead in a serious space infection. go for a check X-RAY, treatment will be either RCT/extraction. in the mean toime you can start up with an antibiotic course including amoxicilline 500 mg TDS, metrogyl 400 mg TDS and ibuprofen 400 mg (SOS) thanks & t5ake care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is non specific distal colitis a type of Irritable bowel syndrome (IBS) ?\n\nhi my name is aaamir saeed khan some days back i had endosopy and colon scopy in that non specific distal coloitis is come can you tell me ibs is same or this ibd.",
    "doctor_response": "Hi welcome to Healthcaremagic Hi amir, IBS is irritable Bowel syndrome.. IBD is Inflammatory bowel Disease.... The above thing is IBD the cause of the infection must be found and treated, a dose of antibiotics is needed... consult a physician.. Hope I have answered your question.. Takecare...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I have itchy purplish rash on thighs above pubic area?\n\nI have a very itchy purplish rash on my inner upper thighs and above my pubic area in the crease where my heavy stomach hangs. It started when I was sweating a lot working in the heat. I have tried Gold Bond powder to try to keep it drier, to no avail. It itches more at night than during the day. It is very ugly!",
    "doctor_response": "Hi,After reading your query it appears to be due to Fungal infection of the area which is quite common due to heat and humidity. Fungal infection of the skin is quite common due to infection and hygiene as well as most commonly due to diabetes. To prevent the further spread maintain good hygiene wash it two times properly. Stay away from hot and humid climate.If I were your dermatologist then would have prescirbed clotrimazole cream or terbinafine cream over the affected areas under medical supervision. I suggest you to take antifungal tablet by mouth such as fluconazole 150 mg alternate days for 15 days.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes peeling skin with bright pink discoloration on the tongue?\n\nMy tongue suddenly swelled and woke me during the night. Benadryl eased the swelling but I developed a thick white coating on the whole tongue. This all happened yesterday. Today my tongue started peeling and is now bright pink and I can't really taste anything.",
    "doctor_response": "Hello,Your symptoms are clearly indicative of oral yeast Infection or oral thrush. Thick white coating is due to thrush.Bright pink appearance is due to inflammation of tongue with damage and inflammation of tongue papillae that is causing loss of taste. You should consult an oral physician and get evaluated.For now, you can start gargling with Nystatin mouthwash that is an antifungal mouthwash and along with it suck Clotrimazole lozenges and take plenty of probiotics like yogurt and garlic. Drink plenty of water. If the Infection does not clear, the physician can advise you oral antifungal medication like Fluconazole, Itraconazole, etc.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does ureaplasma urealyticum causes infertility?\n\nDear Sir/Madame, I'm writing to you because I was diagnosed with ureaplasma urealyticum abroad (routine STD testing) - no symptoms. I was prescribed seemingly strong antibiotics (looking at what other diseases it is used to treat), doxycyclin. I have learned that in some countries this is not considered an STD since it's presenton 70% of people. I also found a study online that advises against treating ureaplasma without any symptoms (because of the development of bacteria resistance), but also found articles that says that it's a very dangerous infection which can lead to infertility or joint problems. So I'm properly confused as what to do about it. Should I take the antibiotics? What about my partner? I don't want to develop antibiotics resistance either, or well I don't want the bacterias in me to do that at least. Can you please share your thoughts about this with me? Thank you, S",
    "doctor_response": "Hello, Ureaplasma urealyticum is a common bacteria that lives in the vagina. Usually, it does not cause any problems, and while it has been suspected to cause many different kinds of infection, it is hard to say whether this bacteria was responsible, or if it was due to another bacteria. While it is possible that it could cause an infection that would lead to infertility or many other problems, if you are not having any symptoms, such as vaginal discharge, fever, or pain, then it is not causing any damage, and there is no reason you need to treat it. So I would recommend not taking the antibiotics unless you have any symptoms that suggest an infection. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Aaron Branch, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the natural remedies for black spots around mouth besides lemon juice and honey?\n\ni have  balck spots around my mouth i have used natural treatmets like using lemon juice,honey all it's showing good result but the problem when i stop using agn it will become black i fed up to use all these things can u give permant natural solution to my problem",
    "doctor_response": "HIThank for asking to HCMThe steroid containing cream can be used and the best cream would be \"Beclomethasone\" apply this three times in day, the black spots will come around take care have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Jaw pain, done x-ray, suggested pain medicine gums swollen, contusion. Suggestions?\n\nHi! Im 23 years old and was hit in the jaw by my exboyfriend once we had gotten into a fight. I can't really chew on solid food because of the pain and also my teeth feel as if they had shifted a little bit. My chin hurts a little when I touch it. Also below my ear my cheek bone aches. Plus  I can't open my month all the way because my chin and teeth on the lower level hurt. I went to a walk in clinic and they did an xray but didn't see anything. They said that my gums was swollen on the inside and said I had a contusion and had given me some pain medicine. Can you tell me what is probably going on with my jaw because I never been punch in my jaw before?",
    "doctor_response": "Since the X-ray findings appear to be normal I suggest you to take pain medications.But if you are not able to open your jaw/excessive pain/abnormal movement at the cheek I would suggest to take a dental opinion(some times the X-ray depending on the position) might not have picked relevant findings.Hope this helps.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for weakness in the legs and headache\n\nI am having a lot of weakness in my legs and dizziness/headache etc. I have a retinal occlusion that has been bothering me and being treated for several months with no success. It doesn t seem right. How do you tell if there is something else I should be looking at?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I would explain that your symptoms could be related to vertebro-basilary insufficiency or a metabolic disorder. For this reason, I recommend performing a Doppler ultrasound of the carotid arteries and some further tests: -complete blood count for anemia -blood electrolytes for any imbalances -kidney and liver function tests -fasting glucose. A brain Angio MRI may be needed to investigate for possible vertebro-basillary insufficiency. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes light headedness and blurred visions for a moment?\n\nI am a football coach and while at practice today, I got excited for a moment and I got tingly headed and blurred vision for about 10 seconds. I was afraid to get excited again because of what the feeling was like. It felt as if my bp dropped. It also happened a few times after kneeling and standing.",
    "doctor_response": "Hi,What you feel is seen in low blood pressure or may be seen in hypoglycaemia. you need to consult a doctor. Check your blood pressure and sugar level. If its low then it may happen.  So diagnose your problem and take treatment accordingly. Thanks for using health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can MRSA cause a toe to swell?\n\nI had cbc and my absolute neutrophils and absolute monocytes are elevated but everything else is great.  I had been on steroids two months ago for mrsa and my toe swelled up on Sunday so I went to the doctor.  They don't know what to tell me.  Any ideas?",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.It is very bad idea to take steroid for the MRSA infection.Avoid taking steroid for any infection in the future.I advice you should take the vancomycin under your doctors guidance. VRSA is the drug used in treatment of the MRSA organisms.MRSA is very notorious so please take the complete drug. Once the drug is complete you can apply the mupirocin ointment to clear the remaining bug in the system. Mupirocin clear the MRSA from our body. You can check it by swabbing the groin, umbilicus and other parts. If the MRSA won't detected than you are clear from the MRSA and you will not receive any infection form the MRSA thereafter from this bugs.Please maintian good hygiene this is equally important as taking antibiotics.Good hand washing is also important tool to combat infection.Good cleaning locally and dressing should be done to clear the infection at earliest.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anxiety and stress\n\nHello, I ve got a common question. My beard has turned white since 2003 & am almost 39 years of age. Have been suffering from anxiety & stress during that time as well & the anxiety is still there. But the hair colour on top of my head is black. Also i tend to miss breakfast in the morning, go to bed really late at night & when I wake up in the I m dehydrated. Thank you",
    "doctor_response": "DearWe understand your concernsI went through your details. You must know the pattern of your hair graying. Normally that happens after the age of 45 and now a days it is more earlier because so many factors like stress, water pollution, dust, sedentary life habits, lack of nourishing to hair etc. In any case, the beard will be first area where hair grays in people who shaves usually. Second is above ear area, third edges of back, fourth upper forehead etc. In your case your life style and stress is the basic reason. You should not skip breakfast. Early to bed and early to rise makes a man healthy, wealthy and wise. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can cause cough with yellow mucus and hazy sinus in X-ray?\n\nHello doctor, I have had a cough with yellow mucus for a few weeks now along with what I presume a stuffy nose. A few days back I was given an antibiotic for it. The problem I am dealing with apart from the cough is night sweats. I have performed multiple tests today, results are attached but the summary is that total WBC, neutrophils and ESR values are raised above normal whereas lymphocytes have declined. The radiologist's X-ray report says that the chest is clear but the maxillary sinuses are hazy. What do these numbers mean? Should I be concerned? I would really appreciate a prompt reply, anxiety is killing me.",
    "doctor_response": "Hi. I read your symptoms and I also went through your laboratory investigations (attachment removed to protect patient identity). It shows increased neutrophil count and your hemoglobin looks normal. What I feel is that you are having sinusitis. So, in that infection of sinus people get similar symptoms that are what you have. So, coming to the management part, I would advise you to go for steam inhalation. You just have to inhale hot steam vapor from boiling water. I want you to take Fexofenadine 120 milligrams one side at night for five days and other medicines include Paracetamol 650 three times a day for five days, Amoxicillin-Clavulanate 650 twice daily for five days and the final medicine is Pantocid 40 milligram twice daily for five days. With these medications, we should feel better and the symptoms should subside. If you still continue to have the same symptoms, you should seek medical attention from ENT specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for recurring MRSA\n\nI am a 42 year old female, I have been suffering with recurring MRSA for the past 3 and a half years. I am in the hospital every 3 months with out breaks, usually on my legs, but I have had them on my eyebrows, chin, armpit, stomach, and right now I have 4 on my right butt cheek an one large one on my left butt cheek. The left side I have developed severe sciatic pain, and was wondering how I can tell if the mrsa has gone into my sciatic nerve. I am on vancomyacin twice a day since last sunday. My doc has given me Lyric to see if it would stop the nerve pain but it has not. as well I am takiing naprisin sups for inflamation and that is not helping either. I just want to get better and get home, this is my 8th day in the hospital and I don t know when I am getting out.",
    "doctor_response": "As per yur history please check these drugs whether you are given or not -Clindamycin 300-450mg PO three times a day.TMP/SMX 1-2 DS tabs PO twice daily.Doxycycline 100mg PO twice daily.Minocycline 100mg PO twice daily.Linezolid 600mg PO twice daily.if not given tell your doctor to add it.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hepatitis\n\nHi, Doctor, I am 28 years old,fat(Height 5.5, weight 82) I donated blood 2 months back during their examination they found Hepatitis C, Hence to reconfrim they took one more sample and confirmed that i have Hepatitis C, in report it says \"HCV: Reactive\". I donated blood 1 year back as well, but did not get such feedback. I am little stressed out because of this, 1. Could you please let me know whom should i consult. 2. I am married and plannig for a baby, is this transmitted by sex, what should i do now. 3. Should my wife also get examined. 4. Is this a curable?",
    "doctor_response": "Thank you for posting your query.HepC diagnosis.you need NOT worry.YOu Should visit a gastroenterologist/ hepatologist.HepC can be cured completely now. There are drugs like sofosbuvir/ribavirin which may completely aid in curing the disease.you maybe adviced a special diet ( fat free), abstinence from alcohol and smoking.HepC is usually NOT transmitted sexually. However, your adviced to take a second opinion from hepatologist, if your planing a baby.HCV is transmitted through  contaminated blood, injection drugs (sharing of needles or works) You may visit hepatologist and take your blood reports as soon as possible.if any further questions, feel free to ask.Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health.regards,Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for chest pains followed by shortness of breath\n\nI need to loose about 80 90 lbs will my testosterone increase. I'am 53 yr old w/m 315 lbs . My testtosterne lvels have been very low, started using Androgel apprx 1 year ago. In the last month I've been experience chest pains shortness of breath claimg. I'am schedules for Stress test Tuesday. Will test levels increase naturally with the weight loss. Thank You.",
    "doctor_response": "Hello,Sudden onset chest pain and breathing difficulty are seen with heart diseases. So, in your case, stress test is advised. Stress test is treadmill test.It will record blood pressure, heart rate and ECG (Electrocardiogram) while you are running on trade mill.It has nothing to do with weight loss or testosterone levels. So get done stress test to rule out heart diseases.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Kaushal Bhavsar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in mouth with redness and intermittent fever?\n\nMy 4 yr old son complains of pain in his mouth, the dentist found nothing wrong. It got worse, lots of redness, he has an off and on fever and does not want to eat or drink. One doctor thinks it might be herpes and prescribed Acyclovir. I just wanted a second opinion, thanks so much.",
    "doctor_response": "Hi,From history it seems that he might be having apthous ulcer in mouth giving rise this problem.Apply Candid oral gel on the site.If require she might require one course of antibiotic medicine.Give her B.complex syrup for some time.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could dark colouring around urethra which hasn't improved despite taking medicines for suspected gonorrhea?\n\nyes I have dark coloring around my pee hole, I went to my local health Friday to get check for thus problem I've been having which turned out to be gonorrheaand they treated me with a shit in the buttocks And two antibiotics pills.. And just now I notice the black coloring around my pee hole.. Could you tell me if its serious or not",
    "doctor_response": "HI, I have read your query and according to me there may be due to unknown allergy. If according to your doctor this is gonorrhea then you should get lab test for confirm the diagnosis.You should apply locally antiallergic cream.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain in kids\n\nI have a 4 year old daughter who has had problems for the past 2 1/2 years and know can figure out what is wrong with her. Her symptoms started when she was 2 years old and she would cry that her back hurt in her car seat, so we tried 5 different car seats and she still complained. Then it progressed to her back hurting when she would be runnin, playing and sleeping. Now that she is older she can describe her symptoms more detailed. She has a hot sensation in her back and feet, she has parasthesis of bilateral legs and incontinence of urine and stool and belly pain. She is followed by a Neurology, GI, Nephrology, Urology, Nuerosurgery, Orthopedics, Pain service, Pain Psychologist and know can figure out what is wrong. She has had 2 MRI (normal), 2 CT scans (normal), Lasix scan (normal), Nuclear bone scan (normal), VCUG (normal), ultrasounds (hydronephrosis), urodynamic studies ( abnormal- showed multiple bladder spasms), multiple blood test and urine studies ( 2 24 hour urine studies showed high protein and urea 3rd was normal but not 24 hour) and Upper GI showed gastritis. Any ideas??",
    "doctor_response": "Hi, She is having hydronephrosis, she might be having UTIs that leads to back pain and fever along with urinary symptoms like burning micturition and urgency etc. If USG showed hydronephrosis, MCUG shouldn't have been normal. It should be repeated, and the cause of hydronephrosis should be investigated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shehla Usman, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Droxyl-250 Dt effective for teeth cavity with swollen cheeks?\n\nHello Doctor ! My son is 7 years old now. And he is suffering from teeth cavity pain from last few days. But when he wakeup today we found his cheek has been swelled. Then we consultant to the Doctor and he prescribed Droxyl-250 DT thrice a day. Is it perfect or not ?",
    "doctor_response": "Hello,Medication should reduce swelling and should be taken as prescribed to be effective. What was the diagnosis? Additional dental treatment should be required and must be cometed to stop this condition from reoccurring. Decay should be treated in children's teeth and regular exams help diagnosis small areas of decay before a more serious condition occurs. Retaining your child's teeth helps maintain room for the second set of teeth to erupt. Infected children's teeth require extractions or root canal treatment.Thank you for your inquiry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication to remove gall stone without surgery\n\nhi i have multiple gall stone 3-5mm in size and gall bladder obstruction and bladder is distended has edematous walls plz help as i dont want to do any surgery or removal is thr any medicine which can dilute or melt the stone and pls sugest any doctor",
    "doctor_response": "Hi thanks for contacting HCM...As far as consulting doctor , gastroentetologist can be consulted for it...For gall stone ursodeoxycholic acid can be taken which dissolve cholesterol in bile...But here stones are multiple and lead obstruction so chances of complications can be there.....So your gall bladder needs removal in future...Take low far diet meanwhile....Regular exercise useful.Take care.Dr.parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What diet should be taken to increase the libido?\n\nHai docter iam 21 years old guy.16-20 in between gap i hope very very over hand job so my penis is sudenly not temper. And after temper liqer is very fast out...........normaly my penis is 2inch-after 5inch....normaly penis ingrese lenght and strong any ideas....and weight loss my weight-54 so what type of food eat sir.",
    "doctor_response": "Hello, There are many methods to improve your sexual energy and libido. The best among them is physical exercise. If you be physically active and exercise for one hour per day, your whole body functioning will become perfect and your general stamina will improve. You will become healthy. This general stamina and health converts into sexual stamina and sexual health. This should also clear your erection issues. Please make sure that you masturbate only thrice a week. Therefore I suggest consulting a psychologist for physical examination, diagnosis and treatment. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Number of swollen nodes , told it was due to allergy to pollen and dust, having no other symptoms. How could this be?\n\nI have a number of swollen lymph nodes, one in my neck, one beside my ear, and one inside the lining of my cheek on my jawline. I saw an ENT specialist who examined me and told me i have allergies to pollen and dust and that is the cause of my swollen glands. However, i do not have any other allergy symptoms, how can this be?",
    "doctor_response": "yes he is right sometimes there is post nasal dripping from sinusitis which is allergic and this post nasal drip can cause lymph nodes get xray pns done and if there is sinusitis get your treatment and tis will be fine",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure the dead feeling below my knee?\n\nthe area below my left knee is what i would describe as dead. i think this feeling commenced when i had a post operative stroke 5 years ago. i have played a lot of golf throughout my life. i am 74 years old. is there anything i can do to combat this feeling i have below my knee ?",
    "doctor_response": "Hello,The loss of sensitivity could be related to the stroke. Anyway, I would recommend trying gabapentine to help improve this feeling, although I don't think that it will make miracles.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain after having 3 epiduarls with my kids\n\nI have alot of back pain ive had 3 kids all epidural with all of them i heard that it could make your back hurt alot why ?",
    "doctor_response": "Its because it might injure the nerve endings of the spinal cord. Get a MRI done it could be more than only the epidural related problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tiredness and bruises all over the body?\n\nHello, I\u2019m always extremely tired and lately I\u2019ve been getting unexplained bruises everywhere . I have at least have 8 on my legs and 3-4 on my arms. I also have to go to school late some days as I just have no energy and my body feels so heavy. Any help would be great thank you",
    "doctor_response": "Hello,It is important to know the duration of symptoms and associated fever or joint pains. First important test is to get complete blood count. Based on symptoms it looks like you have low hemoglobin and maybe platelets too. There can be several causes from simply like viral infections or nutritional to bit more difficult. Best would be to do CBC PS and proceed further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sinus infection\n\nI awoke and found an indentation right below my right temple just above my cheek bone--no pain or loss of sensitivity.  I was having a sinus infection at the time.  I occurred on 5/7/2012.  When I wake up it is practically gone but as I move around it comes back. I saw a doctor and they thoutg I slept on my hand and that is what caused it.",
    "doctor_response": "Hi I did review your concern.Chronic sinus infection can be treated with antibiotics like azithromycin or amoxy-clavuclanic acid and also by accompanied by sinus draining surgery.I would recommend a CT scan of your sinuses and after confirmation start the treatment as soon as possible.i hope this helpswish you all the bestthank you for choosing hcm.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of taking fertisure m for low fertility?\n\nhi, i get married in feb 13 , 2013, we are plainning for a child but my wife not getting conceive, doctors says i have low fertility and recommented fertisure M tablet for 3 month, could u tell me what is this?, any side effect of this?. please check my siemen report and suggest plz. thanks",
    "doctor_response": "Fertisure M can be given in some cases of low sperm count but the efficacy is not very much proven. In some cases it can work and in some cases, do not. What we need to know first is the cause of low sperm count. If it is due to obstruction, no drugs can help. If it is due to low production by testes, some drugs can help but not always.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the side effects of continuous, long term use of proctosedyl ointment?\n\nI have used proctosedyl ointment for many years non stop. I am now very frightened because I have discovered that I should not have done this despite my doctor supplying it. I don t know what to do now as I am afraid I have damaged myself irreparably and that I will not be able to get off the ointment because of the effects.",
    "doctor_response": "Hi, Based on the history you have shared, it has steroids that's why the long term isn't recommended. Though if you had used it with significant cure and no apparent side effects related to it, hopefully, there will not be any in future, if you have stopped it already. If the problem for which it was prescribed is still persistent a surgical review and local examination is recommended to see if any other alternative is required or not. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Saddiq Ulabidin, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the semen analysis report normal enough to become a father?\n\nHad an 11 week miscarriage one year back after that on TTC with no luck.Can you plz tell me seeing my Hus semen alalysis my possibility of normal conception or elese what is the other treatment option.Volume 2ml Total count 54m Total motility 52% Rapid progressive 0% Forward progressive 28% Slow progressive 61% Sperm morphology 6% normal .",
    "doctor_response": "Thanks for asking in healthcaremagic forum   It is possible to conceive as your husbands counts, motility and morphology is normal in the above mentioned report.   Please provide other details(your reports) regarding you for further suggestions.   All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "ITP detected, prescribed wylosone. Breathing fast, feeling tired, fatigue after having steroid. Why?\n\nHi,  Two weeks back i was detected ITP and doctor started wylosone 45mg. My question is I feel always tired and fatigue since before starting medicine and still now. Why? I not able to walk more distance my breathing started fasting. I not feel still any better health after starting steroid. Why? Is tiredness is the part of ITP?",
    "doctor_response": "hello dearthanks for your query at HCMtiredness is not part of ITP. it could be due to steroids. steroids can cause tiredness and restless ness.but your saying tiredness is before starting steroid, other causes should be ruled out .important cause i would consider here is anemia, it can cause fatigue , restlessness, and breathing problems. get one complete blood picture to rule out any anemia.if symptoms are increasing, difficulty in breathing please consult doctor for further investigation and management.do not stop steroid abruptly for any reasonregards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. May I know the dose of Nemocid for my 3 year old?\n\nHi doctor, My son is three years old. He weights 11.6 kilograms. He is given Nemocid for every six months for disinfection. What is the dose of Nemocid for him now? The previous dose was 2.5 ml. If Nemoacid is not suitable, what is the other medicine advised for him? Please help.",
    "doctor_response": "Hi. You can continue to give Nemocid (Pyrantel Pamoate) and follow the dose of 2.5 ml for every six months. If he has any other symptoms like anal itching, decreased appetite, and abdominal pain, you can give Nemoacid 2.5 ml twice a week. You can also give Bandy plus. It is Albendazole, and it is a deworming medicine. You should provide 10 ml once in six months at night.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pain while sneezing due to hematoma after sternum injury?\n\nI received a Sternum contusion 6 weeks ago during an elbow to the chest collision playing indoor soccer and it still hurts when I laugh, cough, or sneeze. It hurts most when I sneeze. I got an X-ray the day after the injury and it was not a sternum fracture. Is the pain I feel during a sneeze possibly a hematoma that is situated somewhere behind the sternum? And if it is possibly a hematoma, how long before the hematoma goes away? Thank you!",
    "doctor_response": "Hi ..thank you for posting your question on HCM.Yes it is a possibility that a haematoma has had formed at the costostrenal junctions ..it takes 2-3weeks for this site contusions to resolve.I would treat it with ice packs and then hot packs .Palpable contusions can be managed by antibruising ointments application.Wishing you speedy recovery",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain, blood in urine and stool. Any ideas?\n\nhi there, these past few weeks i've been suffering with stomach pains and yes i did go to the emergency to get a check up and i was told that i have gulstone but the other question i asked wasn't answered at all. My question that i wanted to be answered is when i got to the washroom in my urine i have blood including my stool, could that be ulcers?",
    "doctor_response": "Hi,You have not told that you are taking any drugs or not.The blood thinner drugs may cause bleeding in urine and stool.The low platelet counts may also cause such symptoms.The other causes are leukemia, glomerunephritis, haemophilia, liver failure etc.YOu should have the blood counts, liver function test, upper gi endoscopy and colonoscopy as well as physical examination by doctor/surgeon to rule out any local pathology.The treatment should be aimed at the underlying cause.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain. Ultrasound showed prominent endometrium and minimal fluid in cul de sac. Urine showed ketones and protein\n\nI went to my OB for left sided lower pubic/ abdominal pain . I have a 25 day cycle. This was 8 days past ovulation. I had a temp of 99.8. I had a transvaginal ultrasound which showed prominent endometrium at 16.7 mm and minimal fluid in my cul de sac. Also my urine showed a moderate amount of ketones And protein. I am not diabetic nor do I have high blood pressure. Urine pregnancy tests also showed negative though I am trying to conceive.",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for calling H.C.M.Forum. You have got left lower abdominal pain, low grade fever. You had a trans veginal ultrasound 8 days after ovulation,  Which showed prominent endometrium at 16.7 mm minimal fluid in cul de sac. Urine showed ketone and proteine. You are not diabetic nor hypertensive. These changes may be normal to be before period. Your lower left abdominal pain suggests urinary tract infection, stones in the urinary tract, or pelvic infection, which may also influence the fertility. To be fertile the partner also should be tested for sperm count etc. I advise both of you should consult a doctor for infertility. Wishing for a quick and complete recovery. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hernia to appear again after the repair surgery?\n\ni just had a hernia repair 6 weeks ago and now i went to the docter and he thinks its back again, he said he cant fix me he has to send me to a specialist, im so upset because it was so painfull. the first time they did it they made 3 incissions this time it was 10 .what is going to happen next time? this time i was in the hospital for 1week because my inside shut down, it was awfull! he said it was a 12% chance of coming back this time, what adive can you tell me please",
    "doctor_response": "Hi thereit would be more helpful to know what hernia you had or have. There are umbilicall hernia, inguinal hernia, incisional hernia, diaphragmatic hernia. If you tell us what hernia it is we will be able to advice you appropriately. In general, if a hernia had been fixed using only your tissues, there is a good chance of it coming back because the very first reason why you have a hernia is because your tissues are weak and let your organs go out of their position, so repairing a hernia with only your own tissue will likely lead to a hernia coming back especially for inguinal and umbilical hernias. so surgeons will repair certain hernias by using artificial tissues called mesh to reinforce your tissues. I advice that you see a specialist general surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for Scholiosis\n\nI do not have a prescription for the pain medication that I have been taking for 12 years. I have Scholiosis and my doctor has lowered my dose of methadone. I don t understand him, or he forgot I have this uncurable disease. can I order from you with no script?",
    "doctor_response": "hi, I have gone through your question. I am a practicing anaesthesiologist and pain consultant.I can understand your concern and the pain you must be experiencing.As you are taking these medicines since long time your doctor must have reduced the dose, because these drugs are known to have abuse potential. It doesn't mean he has forgotten about your problem.Methadone is a opioid analgesic ( pain killer). It can be available without any prescription from doctor. you have the option of other pain killers like paracetamol and tramadol for relief, which are safer and available off label.Don't worry, I am always there to help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes metastasis?\n\nMy mom has been diagnosed with cancer due to the metastasis, that start on her overies going to her kidneys, liver, lungs, and brain, but she has no cancer cells. The Dr done a biopsy on the mass on her lungs and told her they couldn't say it was or was not cancer, they had not seen anything like it. How could the dr diagnose her with cancer if there is no cancer cells, and if not cancer what could it be?",
    "doctor_response": "A lesion in the ovary that has spread to the lungs, liver, kidneys and brain is in all likelihood a cancer. There are a few tropical infections that can rarely mimic such a picture like tuberculosis, but that would not be my first diagnosis. Also, a needle biopsy from the lung lesion can miss the cancer cells half the time as it is technically difficult. It does not mean that she does not have cancer. There is a simple blood test called CA-125. If that is significantly raised then there is no doubt that your mom has cancer. If it is not raised then you can get a CT guided needle biopsy from the ovarian mass. If that is positive for cancer then you dont need to biopsy the other lesions. They are taken as metastasis based on the radiological picture alone.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of rapid heart beat, tiredness and pressure sensation?\n\nHello! I have a question about a possible heart problem. As a teenager I was diagnosed with mitral (?) valve prolapse, which was causing some discomfort. I was told I would outgrow it and it never bothered me much. I am a 30 year old, generally healthy woman, my lifestyle is rather stressful (due to job). In the last year I have been getting episodes of heart palpitations (heart rate drastically increases for no apparent reason, feeling very tired and also having a tired feeling in the chest/heart area - I guess it could be pressure, it's just a feeling of tiredness, also in the left arm). 2 months ago I had a surgery due to rapture in which I lost 400ml of blood. I am taking Iron as a supplement and still feeling very tired most days. Could this be a heart problem that needs immediate attention?",
    "doctor_response": "Mitral valve prolapse is known to cause to palpitations. but the feeling of tiredness and weakness may be due to some other reason like low Hb!So please get yourself checked by a physician as you need certain blood tests like complete bleed counts, thyroid function test. Also an echocardiography to see the status of mitral valve prolapse as this can lead to leakage in the mitral valve in some people over a period of time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in upper left side of stomach, upper ribcage.  Ultrasound showed stored fat in the area.  Suggest\n\nI got this pain upper left side of my stomach, it started 2 yrs ago I went 2 the er and had an ultrasound done they told me its just some fat I've got there, usually it starts as a sharp pain then it goes away, especially if I eat spicy  or greasy food, I don't eat junk food anymore but now it hurts all the time, its this very irritating pain, upper left stomach, and upper left ribcage, please tell me what to do... thank you so much",
    "doctor_response": "hello user,As per your history, i feel that you are suffering from gastric ulcer/erosion, as its pain aggravates when you eat spicy food !!I dont think that pain is due to fat in your abdomen.If you are a bit obese and old age I advice you to do a ECG (Electrocardigraphy) done of your heart, to rule out any pain related to heart !Most of the ulcer pain resolves after taking a antacid drug or liquid, if u feel painless after antacid liquid, then definitely its gastric ulcer/erosion.Take some anti H.Pylori medication from your nearby Physician as it is the bacteria mostly involved in gastric ulcer/erosion , and pain is still not relived, get a Upper GIT Endoscopy done !!!hope my info helped youregards,Dr Hari Om ChandrakarMBBS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is taking Labetalol 200 mg during pregnancy dangerous?\n\nI would like to ask will labetalol 200 Mg (Trantalol) twice a day affect my baby??Now i am 34 weeks of pregnancy...I noticed that after taking the medicine my baby move lesses and even so quiet without any movement...Previously i just take labetalol 100 Mg twice a day but that did not affect my baby movement at all..He still quite active with his move...May I know why my baby become less movement??Is that because i take the high dose?? Thanks for the advise...",
    "doctor_response": "Hi Its doctors requirement to start as per your Hypertension to controll.So its Time tested tab for pregnancy induced hypertension.Decrease of fetal movement can be happen due to decrease of Liqour surrounding baby due to hypertension.U must require to do Sonography with colour doppler to find out wellbeing of baby.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can piles be the reason for burning sensations and pain in penis?\n\nDr, MY URINE HAVE A SLIGHT GREEN COLOUR FOR LAST TWO WEEKS AND INITIAL STAGE I GOT SOME FEVERISH AT NIGHT.AND HAVE BURNING FEELING SOMETIMES ON PENIS .I have internal piles problems(2nd. stage) also which started disturbing along with which I cannot go for jogging. yesterday night I have ejaculation had burning feeling also. please advise whom I have to see?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You may have urinary tract infection. Your internal piles has no relation with your pain and burning sensation. You should go for urine routine and microscopic examination and if needed go for culture and sensitivity test also. Then you should take a course of antibiotics like levofloxacin or norfloxacin. Consult your doctor and take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Carcinoma of gallbladder with liver metastasis at 4th stage. No significant progress with the medication. What to do ?\n\nMy maternal uncle(49) was diagnosed with carcinoma of gallbladder with liver metastasis at 4th stage about 8 months ago, and he is undergoing chemotherapy , till then 8th cycle has just been completed, along with consuming xeloda,oral medicine,.No significant progress has been experienced till now we are expecting good result. Can it be possible to treat him with the medication ? Please give me dependable answer to this.",
    "doctor_response": "In stage 4 with metastasis chances are generally not so good ,only option available to you is chemotherapy.outcome of chemotherapy varies from patient to patient,stage of cancer& sign & symptoms & their impact on function of vital organs.Medical oncologist is right person to contact. Disclaimer",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent back ache\n\ni have backache from the last 2 and half months and its severe in the morning...i went 2 a doctor , he told me 2 avoid cold, improve posture, sleep on hard matress,avoid using pillow and had prescribed voren. i have acted upon his advice but its getting worse day by day instead of relieving",
    "doctor_response": "Hello,I had gone through the case and advised you to go for MRI of spine because it might be more than muscle spasm.After the report take proper treatment and physiotherapy.Also go for vitamin D3 test and Meanwhile take rest and avoid to lift heavy weight and bending forward.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Prescribed ovacare tablets. Follicular study, PAP smear test done. Normal report?\n\nhi as i m planing to concieve i went for pap smear test (result was inflammatory smear) n den doc ask me to visit her once i get my mensus n den she gave me ovacare tab n den on 2nd day i went for sonography n which was normal n on tenth day i went for my follicular study n result was right ovary - 20x18mm light ovary - 15x13mm endo 4.5mm plz let me know if alls ok",
    "doctor_response": "There is no doubt that Ovaries are the most important part of the reproductive system. Without the fertilization of ovaries, conceiving a baby would not have been possible. However, ovary size not always is a cause of concern for infertility problems. The average normal size of ovary is In cm :       3 cm x 1.5 cm x 1.5 cm. In mm :       30 mm x 15 mm x 15 mm. In cc    :      4.5 cubic centimeters. There are many Homeopathic medicines that can be used according to symptoms. Homeopathic medicines have ability to improve chances of being pregnant and also protect from different problems during pregnancy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump under skin on knee?\n\nI have a moving lump under the skin on my knee and when touched it is very painful. I am a 60 year old housewife. over weight have had surgery about three times scoping. this just developed this year and at night the leg throbs like a tooth ache and I do not know where to put it..when I wear blue jeans and the knee bends the pressing of the pants hurts it.",
    "doctor_response": "Hi,Dear,Thanks for your query to HCM.Studied your query in full depth of its details.Reviewed it in context of your health concerns.Based On the facts,You seem to suffer from-Synovitis with Osteo-Arthritis due to old age changes in the knee joint and due to long standing obesity you have.Compression effect on the knee movements increases the severity of the knee pains you have due to arthtitis.Other causes-could be bursitis of the knee joint/or any other knee tissue tumour.Other causes need to be ruled out by Second Opinion  and physical examination from Orho-Paedic Surgeon.USG and CT knee would fix the causes of such a lump.Hope this reply would satisfy you and would help you to plan further treatment with your doctor there.Welcome any further query in this regard,which would be replied in next session.Good Day!!Dr.Savaskar M.N.Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. 2. 5 year old suffering from stomach ache. Which medicine has to be given?\n\nHi doctor, My son is 2.5 years old. For a week, he is complaining of stomach pain. After farting he is fine. Our family doctor recommended one antibiotic for five days and a medicine to avoid vomiting. He had small vomits twice, but later it was fine. Now, after completing the course of medicine he again complaints the same. His diet is almost nothing and he is not ready to take any food. He just has few mL of milk. He does not have fever. His stool was watery, but it is normal now. Can you provide any recommendation on diet and medicine? Please give me a solution to the problem. Thank you.",
    "doctor_response": "Hi. I can understand your concerns. Complain of abdomen pain with vomiting suggests that your child probably has acute gastroenteritis or food poisoning. Since, antibiotic is already given and now there are no loose stools or vomiting, there is no need to give antibiotic again. For abdomen pain, you can give syrup Cyclopam (Dicyclomine hydrochloride and Paracetamol) 5 mL on SOS basis (as and when required) that is when abdomen pain occurs. Whenever a child becomes sick, there is decrease in his appetite which improves as child recovers. Now, you should give him all the foods that you were giving him earlier. If he is not eating then you can start Glucon-D in water thrice a day for one or two days. Start a multivitamin like syrup Bevon 5 mL once a day for 15 days. Keep patience. Child will eat properly now as he has recovered from illness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for joints pain\n\nDear Sir, I am suffering with joints pain for last three years, in earlier stages once the treatment was not available with orthopedic, I have approached with rheumatology doctor in the first month in which the pain was started, but even after 3 years of this decease, my doctor is still not able to identify the decease. In the first stage they have started my treatment with SAZO 500MG (for delayed sulfsalazine release) + Nucoxia 90 MG on s.o.s. basis. But after analyzing my attached report now they have started the treatment for enthesitis, please suggest whether my treatment is going on a right direction or you the different view in this case. Please help me out to provide the proper direction to enable me to get rid of continue joint pain. Your early response in this regard will be highly appreciated.",
    "doctor_response": "Hello,I read carefully your query and understand your concern. Your symptoms seem to be related to a arthritis.I suggest to do a rheumatoid factor level for further evaluation. Meanwhile,I suggest using anti inflammatory medications such as Acetaminophen to relieve the pain. Cold compresses can also help in relieving the pain. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever due to throat problem?\n\nHi.Dr. My child(4 and half year old) having throat problem from last 6 month and due to this he was suffering with fever and some time doctor they are recommending antibiotic (Amoxoline) etc and now i deceided to consult with ENT specilist and he recommended for operation for sometink behind of ear,so i just need help from you.can you explain me is it necessary or not and also its advantages and disadvantages.",
    "doctor_response": "Hello!i would like to have a complete history of your child including the duration of each episode and the frequency of these febrile episodes in a year.If the episodes makes him skip the school and he is febrile with high grade fever for more than 3 times a year,he needs tonsillectomy i.e, removal of tonsills that are basically defensive in cases of infection but gets hyper-active in certain individuals,that needs removal.Every surgical procedure has some complications but as such there are no major complications if performed by an expert person with trained staff.Its a day time procedure and patient is usually doscharged after 24 hrs with complete recovery seen in 1 week.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever in kid\n\nHi, My kid suffering from fever for last 6 days. Dcotor sais he is infecteed by Viral fever and we are giving Ibugesic and kalpal. We are giving this dosage every 6 hrs since he is getting temp in that frequency. Since fever is not gettign reduced we are worrying like whether it will typhoid or what.. pl suggest",
    "doctor_response": "Hi, fever is persisting for 6 days, if I was your treating doctor i would have asked to do typhidot Igm for typhoid, Complete blood count and NS1 Antigen test for dengue. I think your child should be started on treatment guidelines for typhoid but for this we need exact weight of child as antibiotics are effective in proper dosage only. Secondly, do temperature charting that is record temperature every 8 hours and revert back with records. Hope this has helped you. If you have have any more questions, i will be happy to help you. Wish your child good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of swollen lump on my back just below the neck?\n\nim 5ft 4 186 lbs, started with stiff painful neck on right side, now i have swollen lump high on back just below neck. Neck still very stiff, cannot touch chin to chest, most pain when trying to do that...work .on computer all day....today im 196 (edema?)",
    "doctor_response": "Hi, dear I have gone through your question. I can understand your concern. You may have some enlarged posterior cervical lymphnode due to reactive hyperplasia or some soft tissue tumor. You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having upper and lower abdominal pain due to Ulcer and UTI. What caused droplet of blood and clear mucus?\n\nHi, three weeks ago, after my period, I found droplet of blood in my underwear and something long and clear like mucus, I had pain in my lower and upper abdomen. I had check up. Doctor said it was Ulcer that causes pain in my upper abdomen and Urinary Tract Infection in my lower. He gave me medicine for ulcer and UTI, the pain is gone but after like 2 weeks or so, I had pain in my right and also in my lower abdomen and also when I am peeing, and after a few days, my period came back. I want to know what causes the droplets of blood, the long, clear mucus, and all the pain? And is it normal to have period twice a month? Thank you.",
    "doctor_response": "uti is the infection of urinary tract in which blood and mucus can come as discharge of urethra it is related with that in my mind if you treat  uti and ulcers you will get relief from this symptom also",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Signoflam advisable for back pain along with rashes?\n\nI have back pain. Doctor gave me medicine and told me to take physiotherapy. So, i took physiotherapy. Now, on the back i got rash because of heating physiotherapy. Doctor told me to take cetzine and signoflam and caladryl lotion. Is signoflam ok for me? i am 23 years old.",
    "doctor_response": "SIGNOFLAM is trade name for ACECLOFENAC , It is a medication used for relieving musculoskeletal pain in adults ...It is not hazardous for you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does weight loss help in reducing blood pressure levels?\n\nI am on 50mg of larsotan and recently lost almost 10 lbs. I am now feeling light headed after taking it in the am like I have for the past 8 months. Is it possible that my weight loss has naturally helped my blood pressure return to normal and I either don t need that dosage or the medicine at all?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I would explain that your symptoms could be related to low blood pressure values. I agree with you on the fact that loosing some weight has lowered your blood pressure naturally. For this reason, I would recommend stopping Losartan for some days and closely monitor your blood pressure values. Hope to have been helpful! Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the mild difficulty of respiration be due to intake of Phenyl?\n\nwhat happens if some drinks 250 ml of phenyl and after 15 min had 3 glasses of water mixed with 12 spoons of salt to cause intentional vomitting and vomits several times instantly and can see traces of phenyl and food in the vomit .After 24 hours patient has symptoms of some sort of weight on the chest and have in respiratory tract with mild difficulty in respiration. Patient passed loose stool after half an hour of consumption .patient cant go to the hospital for next 8 to 10 hrs. please advice",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Phenyl is irritant to mucous membrane. So on ingestion, it is likely to damage esophageal mucosa. While ingestion, some Phenyl might have aspirated in trachea and lungs. So Phenyl ingestion is likely to damage esophageal and tracheal mucosa. Damage to esophageal mucosa causes ulceration and burning chest pain. Damage today respiratory mucosa will cause inflammation of the airways and bronchitis. This bronchitis is the likely cause for his breathing difficulty. Usually these all are self limiting in 1-2 days. Ask patient to drink plenty of fluids orally. Avoid hot and spicy food. Take pantoprazole tablet on empty stomach. He will mostly improve with all these. If breathlessness worsens or chest pain increases with vomiting then immediately consult doctor. Hope I have solved your query. I will be happy to help you further. Wishing good health to your patient. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hole on teeth\n\nhello sir my problem is there is a whole in my right side teeth,bcoz of that i cant eat with my right side teeths.. &that whole is becoming very large..im worried about my teths,,please sir advice me how can i get back my beautiful teeths... before there was a decay in my right side teeth &when i went to doctor they advice me to take out that teeth (2teeths)i said yes ,,after take outing that i got side effect of my right side eye became slow ..i got spects so im afraid that if i took out my teeth then might be problem of right eye .....so plzzzz doctor hlp mee ,,,im ur patient                                         i cant hide my pain with u& my lord                                                   thanks plzz answer      ...........samreen romana....*****",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concern...As per your complain as you have a hole in your tooth and there is severe pain along with it that means the decay has involved the nerves and irritation of nerves is causing pain..You should consult a Dentist and get an X ray done and in case if tooth in a condition that it can be saved Root canal treatment can be done followed by antibiotics and painkillers.In case if it cannot be saved due to extensive decay it has to be extracted..The other thing that I would like to make clear is that extraction does not cause any problem in the eyes and it is a simple myth, so better don't thing of all this negatives and go ahead for treatment..As of now for pain relief you can take TRAMADOL 50 mg thrice a day but not more than 5 days..Hope this information helps..Thanks and regards..Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does impacted wisdom tooth cause ear pain and sore throat?\n\ni have had toothache for the last month, its terrible in the morning, gets better during the day and returns in the evening.  I also have ear pain on the same side and a sore throat.  My doc has done bloods and all is good wih them.  I also have a bad taste off and on.  im having a bad wisdom tooth pulled soon, is this the cause??",
    "doctor_response": "Hello and thanks for consulting HCM. i have read your query and yes it can be due improperly erupted wisdom tooth.if the wisdom tooth is completely or partially impacted and causing pain and food lodgement then its better to get it removed.Meanwhile you can do certain things:~rinse mouth with lukewarm saline gargle~maintain good oral hygiene~apply dentogel over affected area~for pain a pain killer can be takenHope this answers your queryRegardsDr. Shesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause difficulty in conceiving while being on Vitalin 800?\n\nHi.. I am 35 years old and have a boy child of 6+ yrs. I had gone for an abortion 3 years back with Cytotec externally. Now I want to have my 2nd child and its becoming difficult to conceive. I am having Vitalin 800 now (1 daily). Why is it becoming late to conceive? Is it that I have not ovulating?",
    "doctor_response": "u check ur thyroid function n serum prolactin...rahe ur cycles regular...u have to ask ur husband to check his sperm count (husband seven analysis)...u should try having relationship with husband from 11 to 18 day after day 1st day of period",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from fever and stomach ache. Have jaundice. What is the status of jaundice?\n\nhello sir,my brother was suffering from fever and stomach ache for last 4 days.After consulting with doctor we found that he is having jaundice .In his report the S. Total bilirubin is 3.30, s.conjugated(d.bilirubin) is 2.60 ,s.unconjugated(in d.bilirubin) is 0.70 , SGPT is 5663 , HbsAg is negative and also hepatitis c virus is negative.So sir i want to know that what is the status of my brother jaundice.",
    "doctor_response": "Hi, Thanks for posting your query. Your brother is most likely suffering from acute viral hepatitis, it may be hepatitis A or E. Presence of raised bilirubin along with raised SGPT (very specific for liver disease) suggests the diagnosis. Very first week of acute viral hepatitis is symptomatic and may require hospitalization. SGPT in thousands occurs in only 4 conditions: Acute viral hepatitis, drug induced hepatitis, ishcaemic hepatitis and sudden passage of gall stones from common bile duct. You should consult with internal medicine specialist and should go for thorough check up. He should also go for ultrasound imaging study for better clarification. He should get hospitalization if severely ill. Recovery requires at least two months. Take care, Dr. Mayank Bhargava",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I observed a white round swelling in my mouth. What could it be?\n\nHello doctor, I observed a white round swelling at the right rear of my mouth cavity behind the last tooth. Also a white straight line behind my uvula. Sometimes I feel that something is stuck there in my throat. No other symptoms.",
    "doctor_response": "Hello. Your symptoms can be related to many diagnoses. A picture if possible would help. It can be a yeast infection, a viral or a bacterial infection. I suggest you do some examinations such as a throat culture and a blood test. Meanwhile, some tips: Hope my answer was helpful. For more information consult a general practitioner online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest diet for 1 1/2 year baby\n\nMy baby is one nd half year she is always sick when she eats banana she has flu.nw her chest infection I gave her antibiotics syrup amoxcyline and steam everyday. She was fine previous day but yesterday again she had fever nw the dr said she has infection her ear also again he gave antibiotics tblt what should I do. .?? I give her or not She doesn t eat any thing.. Can u plz suggest something for her diet?? which I gave her .. M worried about her so mch..",
    "doctor_response": "I feel that you kid is having an allergic component which is landing her up in frequent coughs and colds. If it is always associated with fever, it could be an episodic viral wheeze or if not a multi triggered wheeze. Both of these may gradually diminish over time. Coming to the diet part, as such any diet which is palatable for the kid can be given. If she is not eating what you want, try giving what she wants. At her age interest in play increases and interest in food decreases. This is quite natural. If she is active and playing around you need not worry. This age rather than the quantity of the food I suggest you concentrate more on the number of times you feed her and also make whatever you feed him calorie dense by adding good amount of ghee to it.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe lower back pain. Swollen legs and are hard. What could this be?\n\nhello, im 36yrs old, white female, ive been havin severe lower back pain, in the last 2mths it has gottin to the point were I can barely walj a blk. without my back lockin up with extreme pain, even standin to long also, now my feet have been swelling up like 3x their size, but ive noticed that from my calves all the down to the arches in my feet stay swollen and have began to hard, please help me, im scared.",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum.I would come up with these possibilities for this  severe pain in the back from last 2 months, these includes.1 Lumbar-sacrum degenerative disease ( L  S  spine disease ) . Diagnosis can be confirmed by M R I and X ray L S region. 2 Pelvic inflammatory disease , diagnosis can be confirmed by physical as well clinical examination . As sometimes this produces excruciating pain.3 Osteoporosis may be the nest reason. Diagnosis can be confirmed by estimation of calcium level in blood.In my opinion consult an orthopedic surgeon and get his opinion.Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should naturogest be used before or after intercourse?\n\nhi doctor..today is my 14th day..My doctor asked me to take naturogest 200 mg from my 16th day to 30th day twice a day vaginally..she asked me to have intercourse every alternative days..i want to know whether it could be used before intercourse or after..",
    "doctor_response": "Hello dearI understand your concernNaturogest contain progesterone.It will make uterine environment favorable for implantation and support early pregnancy.It should be taken into luteal phase of cycle/after ovulation.You should take after intercourse.Put it high in vagina. Do not go for urination after putting it and let it be for inside for 6 hours.Avoid stress, take healthy diet, drink plenty of water and maintain proper pelvic hygieneHope this may help youContact further if follow up neededBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What home remedies can I do for hair fall, dandruff and graying of hair ?\n\nHello doctor , my name is shahida(female) am now 23 years old i have hair fall from past 2 to 3 years, i have dandruff also, now my hair is very thin, and just before a week i found so many hairs becoming white from the root, till now i dint took any treatment for this and now am so so worried of my hair. Pls suggest me some homeremedies for this..",
    "doctor_response": "Hi, Thanks for query, problem of your hair is due to dandruff. Apply Selen shampoo on the hair as per direction written on the pack. After cure of dandruff you use some good branded hair oil. ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the reason for fever with pain in eyelids and forehead?\n\nHi doctor, I am suffering from fever for the past three days. I am taking Amoxicillin and Paracetamol as prescribed by the doctor. The temperature reduces for some time. I have other symptoms too. I have a sore throat, pain in both the eyelids and pain in forehead.",
    "doctor_response": "Hi. Fever is a sign of infection or an inflammatory reaction taking place in the body. Infections like flu, or any viral infection, tonsillitis, or any bacterial infections can cause a high fever. Take a complete blood examination to rule out the disease. You may have a bacterial infection, viral infection, pyrexia of unknown origin. Take lots of warm oral fluids, and take proper rest. Take antipyretics like Brufen (Ibuprofen). Change antibiotics to a stronger one if the blood test shows bacterial infection or antiviral drugs if the test shows a viral infection. Take lots of fruits such as oranges and vegetables. Take vaccination annually in case of influenza infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of meralgia paresthetica?\n\nI might have Meralgia Paraesthetica. I pretty much have every single symptom of it. Burning and pain in the thigh and such. I am 25 and have been maturbating alot. Some years back, i did so by lying in my bed with legs crossed over, (lile you do when you meditated) and one day the hip just snapped. I didnt think much of it, but later on got numbess feeling in the leg and knee. Now 2 years later, i cant maturbate witthout that position, cause it kinda open up for the sensation. I can keep at it all day if my legs are in line, but the second i cross em ( and maybe relief something in the hip area) i get the sensation back in. Its like something is blocked in there. Is it possible that Meralgia Paraesthetica can block the inguinal nerve, or somewhat other nerves, that is respossible for the penile sensivity?",
    "doctor_response": "Hello, Cannot say in your particular case but you are stretching a point. The nerves to the thigh and penis are separate and meralgia paresthetica does not affect the penis in general. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Ultrasound showed follicles, partner has low sperm count. Advised implants, had miscarriage. Suggestion?\n\nHello just had an ultrasound done this am and was told I had 6 follicles in left and 2 in righ. Also my husband has low sperm about 10million and 32% i am 38 years old and just had a miscarriage 8 months ago. I am so worried about my ability to concieve. Its my second miscarriage in my life first at 19. The doctor said that we could try implant with or without meds. What should I do and is this more about him or me. he is 36",
    "doctor_response": "Hi dear, Since you both have some problems (your husband has low sperm count and you are 38 years with 2 previous miscarriages), it cannot be decided who has more problems. If you haven't been able to concieve after 1 year of unprotected intercourse, its important you don't waste any more time and go for IUI with or without ovulation induction. If that fails then you have the option of ART with IVF. Hope for the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How should back pain caused by disc herniation and protrusion be treated?\n\nHi, My brother is 27 and has had an MRI very recently. he was informed about herniation in L4-L5 and protrusion in L5-S1 disks. He was suffering from back pain and went to the doctor to find out this shocking result. How bad do you think it is for him to get it at such an early age? Does he need a surgery or would it be fine if he does exercises? Please help us as we are worried about him.",
    "doctor_response": "Disc protusions and bulges are very common findings. Even herniations are common and tend to increase and decrease over time. If he has leg pain, then he needs treatment for the disc issues. Otherwise all he needs is core strengthening exercises for the back. We treat patients not MRI's.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent abdominal pain\n\nHi, I have been suffering with severe abdominal pains for a few years now that are getting worse and more frequent. The pain starts in the upper abdomin and moves around to my back and i feel great pressure on my chest. Pain killers dont help, all I can do is pace the room for hours and sometimes shower because the heat relieved the pain slightly. I used to get the pains maybe once evey few weeks but in december 2009 they began to get a lot worse. I had many visits to the doctors who thought maybe it was acid so I started a treatment for that which did not help. After weeks of agonising pain and missing work the doctor refered me to a specialist to check for an ulcer. This test came back negative and they suggested I have an ultra sound. The ultra sound showed some stones in my gallbladded and i had it removed in March 2010. Thankfully the pains went away but started back again in December 2010. I got them maybe once every two weeks. after christmas things got a lot worse, i started getting the pains every day and every night, waking me from a deep sleep and sometimes causing me to vomit. I went to the emergancy room where i had bloods done and an ultra sound. everything came back fine. i then had a CT which also came back fine. followed by urine and stool tests and an MRI which also came back normal. finaly I had an EUS to check for stones in the bile duct which again, came back normal. the doctors are completely stumped and have now diagnosed me with IBS. Eventhough I do not have irregular bowel movements?? I have not slept a full night in months and just want some answers  ive tried giving up dairy, carbs etc and nothing is workin. i keep a food dary but cannot see a pattern. I take anti spasm tablets to try relieve the pain but they only seem to be taking th edge off it and its usually too late by the time I take them because the attacks are the most painful at the beginning. Does anyone have any ideas or answers??",
    "doctor_response": "Try this medicines:1. Capsule Ganaton Total one at morning and one at night, 30 mins before your food.2. Syrup. Mucaine gel 10 ml after food, morning and night. (if you experience loose motion, you can reduce as to 5 ml four times daily.)3. Green tea morning and evening, preferably without sugar.Avoid oily, spicy, dry food, smoking, alcohol and stress.Hope this should solve your issue.TC",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the duration of Fertyl M and Hey Forte Plus tablet for infertility?\n\nHello doctor, I am a 30-year-old married male. Me and my wife are trying for a baby but not able to concieve. I did semen test, sperm count was 84 million, morphology 60 percent, and 40 percent viable but motility was very low five percent rapid progressive, and 10 percent slow progressive. So the doctor gave Fertyl M and Hey Forte Plus tablet (twice per day) to take every day. I am consuming for the past two and a half months and trying for a baby. How long I need to continue these tablets, and when will it be effective?",
    "doctor_response": "Hello. Usually, these medications take one sperm cycle (around two months to act). As you have already taken for two and a half months, repeat the semen analysis test to see the improvement. Further course can then be decided accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to control blood sugar level\n\nI am diabetic and taking insulin in following doses.Humologus 50:50 --- 20 / 20 / 14 units per day + Lanctus 8 units at bed time + Glycomet GP - 2 ( 1 --- 1) but my sugar is still high ( FBS - 198 & PP 394), HbA1c is 8.6. Please recommend medicine to control my sugar level.email : YYYY@YYYY",
    "doctor_response": "hai,yes your sugar levels are very high, your taking  medication  but along with that your diet should be in control'you please avoid rice and  take jawar are wheat ...please completely avoid  sugar sweets .not  more than 1fruit in one day. take frequent small meals with light food.still sugar not control meat doctor they will add acarbose combination",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for breathing problem\n\nhi i have been on finasteride for years have breething problems shortness of breath,testcale pain,swollen and painful breast weak ejaculint. have been to lung doctors.never considered it could be from medication have been complaining of beathing and chest pain for years.is it the medication",
    "doctor_response": "Hi thanks for contacting HCM...Here you have to examined in detail and respiratory examination needed by auscultation....As you have pain since years rule out chronic obstructive pulmonary disease , restrictive lung disease Or other respi causes by chest x ray ad spirometry....According to cause treatment needed....You might be prescribed with bronchodilator or steroid according to cause....Avoid aggravating factor for chest pain like stress.....Avoid smoking if habit..As you have muscular breast pain with some soreness viral infection can be there it might lead testicular pain as well....Maintain hydration and balanced diet....If condition worsen and no cause found then CT scan or MRI like higher investigation done....Take care Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does recurring fever in infant after falling down from bed indicate?\n\nMy 8 month old fell/slid off the bed yesterday. He didn't cry much and didn't have any evidence of concussion or serious injury. A few hours afterward he developed a fever and it can back after the Tylenol wore off. He is not acting differently orl hurting anywhere, but the fever concerns me.",
    "doctor_response": "HiWelcome to the HCMIf your child looks okay to you and seems to be acting normally, chances are the fall didn't cause serious injury. Be thankful, but keep an eye on him. Continue to carefully observe your him for the next 24 hours, especially if he bumped or fell on his head.Err on the side of caution: If you're uncomfortable with the severity of your child's fall \u2014 you think he must have gotten hurt \u2014 or if your child is acting irritable or confused or there is any restricted movement, take him to the doctor to get checked out.For further questions, do contact us.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are he side effects of andropenis?\n\nIm using the Andropenis now for few months and i have a groove or a fold on the bottom edge of my glance  like the can flip it over due tomuch pressure on it i think. Before it was a smooth edge but for a whille it very visable but can't see it when fully erected. I did go a few steps back in the program think i was rushing tomuch in my case but that doesen't change it and i like to know if i should stop the program?",
    "doctor_response": "Hi, Even though there are many claims that Andropenis work great, there are no medical or clinical studies related to it. So do talk to your physician in person. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat height phobia?\n\nHARRY YERRA HAS BEEN WAITING FOR A NOTE FOR SOME TIME HE LIVES ON THE 8TH FLOOR AND AFRAID OF HEIGHT CAN NOT LOOK OK ON SITE ON DECK PRETTY SAID. I AM AND SISTER AND PROXY AND VERY SICK ALSO ISTHERE ANYTHINGYOU COULD DO FOR FOR HIM. ALL HE NEEDS A NOTE BUT WILL NOT HAVE TIME FOR THIS PRETTY SAD. MY E MAIL. IS YYYY@YYYY nANCY gREENSTEIN HIS SISTER AND PROXY 617-610-7066 THANK YOU HOPE TO HERE FROM YOU OR SOMEONE. DR JORDON HAS DONE NOTHING ON THIS MATTER",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Fear of heights is generally termed as Acrophobia which an anxiety disorder.  Extreme or irrational fear of heights, especially when one is not particularly high up. It belongs to a category of specific phobias, called space and motion discomfort that share both similar etiology and options for treatment. The best way of treatment is not with medicines but with cognitive behavioral therapy. Specifically desensitization therapy. These therapies cannot be prescribed on paper. They are practicals. Consult a clinical psychologist for the treatment.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can shortness of breath and sore throat be treated?\n\nI was looking for some answers My daughter is 29 years old and suffers from asthma and allergies and just this past 8 days she has had an extremely swollen and sore throat. she ahs shortness of breath and uses her inhaler. She went to a doctor yesterday and the swabbed her for strep but must wait til Monday for the results come in. she is miserable. She has been gargling with warm salt water and taking benedryl but I was hoping to see if there was something else we may be missing",
    "doctor_response": "HelloAs you explain the history she needs nebulizers and steroids intravenously.RegardsDr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in stomach\n\nHi doctor My baby is 2 and half years old. She eat pomegranate and Guava just 1 hour back.now she is having a pain in stomach.I gave her a medicine scopinal syrup.is that a right medicine or shall I gave her some other medicine?Or shall I take her to doctor.she is crying too much Plz can you assist me",
    "doctor_response": "hisometimes food poisoning might lead to abdominal pain no need to panic in small children if any food poisoning causes diarrhea we need to supplement with some zinc contain vitamins and supportive medications only for the pain relief you might be prescribed by some pain killers",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why coughing and sneezing making trouble when i stop Moatemac-L?\n\nI have been taking Montemac-L from the last 2 years on alternate days . Whenever I think to increase the gap between taking the medicine , I start feeling breathless , I start coughing and sneezing furiously . I would be very thankful If you could tell me what is this problem in my body and is it curable or permanent ?",
    "doctor_response": "Hello dear,The symptoms as mentioned in your post suggest that you are having allergic rhinitis/ tracheo-bronchitis.Montemac-L (pharmacologically Montelukast+ Levocetirizine) is helpful in managing the condition.Levocetirizine is an anti histamine, which acts as an anti allergic in controlling the acute episode.Montelukast acts as a maintenance therapy to relieve symptoms of allergy.Both taken together provides protection from acute episodes + maintains a symptom free period.If you increase the gap between medications, their effect reduces & you get prone to allergic attacks.This condition is related to the hyper-sensitivity of your immune response.It can only be managed symptomatically.Complete cure will need complete shut down of your immune mechanism, which will make you prone for severe life-threatening secondary infections.So, kindly continue the medications as prescribed by your treating Doctor.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling and pain in back after falling down\n\nMy wife just fell on steps, and now has a bruise across her back. About a quarter of the way down where she landed on the steps, her back is swelling over her spine. I have ice on it, she says her spine is burning. We do not have money for doctor, should I take her to ER?",
    "doctor_response": "an ice bag on her back will aid her with pain, as NSAIDs, if she has no contraindications (i.e peptic ulcer, stomac ache, coagulation problems or oral anticoagulant therapy, etc). how old is your wife? this is important to assess how likely a spine fracture is. has she shown any other symptom after falling  (motor problems at lower limbs, loss of sensibility in the slip-covered area, urinary problems)? if yes, go to the ER. if she has only pain on the bruising area and stop, you can wait and go to the ER if pain is still strong/NSAID resistent after three days, or if other symptoms add",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please let me know my HIV status based on the test reports.\n\nHello doctor, What do this reports indicate? After one-year exposure, following tests were taken HIV 1 and 2, western blot, which was negative. HIV-1 RNA PCR qualitative- non-detectable. Please let me know whether I am positive or negative for HIV.",
    "doctor_response": "Hi. I have gone through the reports (attachment removed to protect patient identity). It is a confirmatory test. It is done after one year of exposure. You are free from HIV. You can allay fears of HIV from that exposure. Forget about the incident and lead a normal and safe life. You can get back for any clarification.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could fibroid in breast cause on and off pain in armpit?\n\nihave been experiencing left armpit pain that goes and comes...several months ago, i found out that i have a fribroif in my left breast and is requested to do a follow up in six months to check for growth.. could this be causing the pain i am experiencing?",
    "doctor_response": "Hello, It can cause pain in armpit also. As a first line management you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persists better to consult a general surgeon and get it removed. Nothing much to worry as it can be done under local anaesthesia. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anxiety and depression\n\nHi, may I answer your health queries right now ?  Please type your query here...Hello Doctor,I am suffering from depression and anxiety neurosis for  about  eight years.I am taking the following medicinces1.escitalopram-10mg2.clonazepam3.oleanz -2.5 mgIs there better medication . please tell me sir,",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. The medicines you are taking are should be apt for your condition. Psychiatrists prescribe medicines taking so many things into consideration. They know you better before prescribing medicines. Work with your psychiatrist for good results and cure.Many researches and researchers confirm that medicines alone cannot cure mental disorders. Life style changes, change in thinking pattern, relaxation etc are as essential as medicines. Psychotherapy can help you changing your lifestyle and thinking patterns. Yoga and meditation help you to streamline your metabolism and neurological balance. Please consult a psychologist for further information.If you require more of my help in this aspect, Please post a direct question to me in this URL.  Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lack of sensation in legs, migraine, blood test shows low levels of vitamin B , extremely high ESR, hysterectomy. Abnormal blood results show cancer?\n\nI have recently had my bloods done after a long period of exhaustion, lack of sensation in legs. I queried MS (I have been under the National Neurology Unit in London for the last 3 years for migraine - although the only migraine like symptom is flashing lights and loss of balance). My bloods came back with slight low levels of Vitamin B but extremely high ESR . I have had bi-lateral duct removal and a full hysterectomy when I was 34 (I am now 38). My endoscopy 3 years ago showed polyps that were removed and tested and whilst most were normal some were shown to be dubious . I guess I have a worry re cancer and need someone to point out some more rational reasons for my abnormal bloods.",
    "doctor_response": "You should have screening for cervical cancer.you have to do s pap smear to exclude cervical cancer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excessive fatigue, breathlessness and swollen feet?\n\nI have been feeling fatigued and malaise for the last several months. I get short of breath with heaviness in my chest walking short distances. My feet and legs have been swelling and sometimes I feel like I am swollen from the toes up to my chest. I have had intermittent palpitations and twinges in my left chest intermittently. I have never had high BP but yesterday my BP was 160/88. I am 49 years old. My last total cholesterol was I think 200 or so. Are these symptoms to be concerned about?",
    "doctor_response": "Hi thereAfter going through your query I understand your concern.I would like to tell you that chest heaviness along with shortness of breath and intermittent palpitation can be because of an underlying heart disease. We can call this Angina on Exertion class 3. Evaluation for this is required.It's advisable for you to get an ECG, Echocardiography , Chest X-Ray and a TMT test done and personally consult a cardiologist with the reports for treatment in a proper way.Hopefully this will answer your query.Kind Regards Dr Navneet Mahajan",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to ascertain that I am pregnant?\n\nhello doctor, I am 35years old second pregnancy positive, my last month period is 2nd January 2014, today I took ultrasound sound scan it shows single intra uterine gestational sac of GS measuring 7.91 mm corresponding to 5 weeks 1day. it is possible to growing baby. what will I do.",
    "doctor_response": "Hi there,,Yes, its possible that that you may have ovulated later than usual and the pregnancy was conceived. With a scan report corresponding to 5 weeks, I would advise you to repeat the ultrasound after 10 days to look for fetal heart. This would confirm the normalcy of the pregnancy.Do not worry, take your multivitamins especially folic acid and schedule a repeat ultrasound after 10 days.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in right abdomen during pregnancy?\n\nI am eight weeks pregnant.  I have been having slight cramping on my right side not super painful but it worries me. It feels similar to the pain I have had on and off for a little over a year that is normally triggered by stress. doctors don't know what is wrong with me or ultimately what causes the pain. I havent had any bleeding but I cant help but worry a liittle",
    "doctor_response": "Hi,Small cramps and aches are common in pregnancy. If you have had no bleeding or spotting then you need not worry.If you have recurrent pain on one side,it could due to a cause other than pregnancy ,like renal or appendix.These should also be kept in mind If pain continues or worsens please see a doctor to evaluate fully, including abdominal ultrasound, blood test including renal function test,liver function tests.Also rule out any urinary infection which could be chronic.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For uterine fibroid, how quickly should I get surgery?\n\nHi doctor, I am 46 and a mother of three children. I have been diagnosed with multiple fibroids a few in the anterior wall intramural and a few on the posterior wall and a bulky 134 x 74 x 87 mm uterus. The endometrium is displaced posteriorly. The symptom is mainly heavy menstrual bleeding that lasts for eight to nine days. The symptoms began not more than a year ago. Ultrasound with an interval of two months shows slight growth. My doctor advised hysterectomy. Is it absolutely necessary for my condition? If so, then how quickly should I undergo the surgery?\u00a0Is there any medication or alternative treatment that can be relied long term to avoid surgery? What are the possible consequences that I shall expect if I decide against hysterectomy?",
    "doctor_response": "Hi. You are having symptomatic uterine fibroid. Since it is symptomatic and you have had children, then the best for you is to go for a hysterectomy. This will make you to have peace of mind. If you do not get surgery, then there is a tendency of recurrent heavy menstrual bleeding resulting in fatigue and weakness. Then there is a chance of recurrent blood transfusion with all the complications associated with blood transfusion. The alternative is the use of drugs, which can only be used for a short period and the fibroid will grow back once you stop using the medicine. The drugs may also have so many side effects. As a consultant gynecologist, who sees patients with large fibroids, I will advise you go for a hysterectomy. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes infection in the lobes?\n\nhello docter,i am 23 years old ,having minimal infection upper lobe, i got know by the recent x ray reort.Is m smoker too. i don t know what is it ..kindly guid me that what were the reason that i got this infection in my x ray report .. reply me as possible as you can..",
    "doctor_response": "Thanks for your question. I am Dr Asanghanwa Carlson. Lung infections are due to the infectious agents like bacteria, viruses and fungi. A few conditions favour lung infections amongst these are smoking, alcoholism, exposing yourself to cold, and underlying immuno deficient conditions such as diabetes, HIV and other constitutive disorders. For your case, smoking favours the occurence of a chest infect and it can affect any lobe in your lungs though pulmonary tuberculosis has a predilection for the upper lung lobes. I would advise you to reduce and possibly stop smoking as this will expose to recurrent chest infections and possibly lung cancer. I will advise you visit a pneumologist for proper follow up. Have a great time",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for urinary infection\n\nI m 26 years old n 26weeks pregnant, last week my urine was tested and there was a trace of protein...i was later prescribed amoxicillin caps which I started taking yesterday.. my questions are; (1)will it affect my baby in any way and (2)is it safe 4 me to still have intercourse with my husband?",
    "doctor_response": "Hello dear,I understand your concern.In my opinion when there is albumin in urine the high BP is to be ruled out.If the BP is normal there is nothing to worry.You are prescribed amoxicillin capsules may be for urinary tract infection(UTI).It does not cause any harm to the baby.And yes you can have intercourse with your husband.Usually intercourse is best avoided during the first 3 months and in last months of pregnancy.I just want to say a few things regarding UTI.UTI is the most common infection seen in pregnancy.It should be treated because untreated UTI cause irritation of uterus leading to preterm pains.And taking adequate fluids upto 3 litres per day prevent UTI.So I suggest you to take adequate fluids and also rule out any high BP.As such nothing to worry.Hope this helps.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why vision, hearing, face and neck feeling lost with high functioning autism and epilepsy?\n\nmy daughter is 22 years old with high functioning autism, tourtettes, and epilepsy. She had an MRI, CT and EEG's in the past 2 weeks for increased seizures with no explanation. She has since then lost vision , hearing, feeling in face and neck, and has slurred speech (right side). Her vision is worsening in left eye. Neurology is not moving fast enough to find out what is going on and she is getting worse. I don't know where to take her. She has a swallow study today because she chokes on liquid. I feel I should make my own appointment today at a local ophthalmologist and maybe an ENT?",
    "doctor_response": "Hello!Welcome on Healthcaremagic!I would recommend performing a brain MRI to check for possible brain changes and an EMG to check for possible myopathy (considering the fact that she can no swallow). Consulting with an ophthalmologist is also necessary to check for possible eye or retinal disorders. There are many genetic syndromes which can lead to this clinical situation. Consulting with a geneticist could be helpful too. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with asthma, mold in house have a feeling of squeezed heart on bending with breathing difficulty. Cause?\n\ni am in excellent shape i move furniture for a living i run up and down stairs constantly carrying heavy stuff all the time.. in addition to that i go to the gym every single day. however i have asthma and im 1000 percent positive i have mold in my house.. sometimes when i bend over it feels like my heart is being squeezed and i have to catch my breath",
    "doctor_response": "Hello, Allergy to moulds can be a big problem especially for people who have asthma. Suggest you get either blood tests (specific IgE) against fungal allergens/mould mix or see an Allergist for skin prick testing against moulds and fungal allergens. Deepending on where you live, it will be important to get the right mix of moulds and fungal allergens tested. The Environment Agency can then also do a home air sample to see if there is a high concentration of moulds in your home. Mind you all homes will have fungal allergens but should not be high levels and as you are asthmatic it becomes even more important to exclude this.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is plan-B recommended after having unprotected sex?\n\nHi,I recently had unprotected sex last Tuesday. I took plan B within the 72 hour period. I was fine till yesterday. I noticed that it really hurts when I pee and blood as I pee. I've never had this issue before taking the pill. Is this some type of side effect of plan B?",
    "doctor_response": "hi,plan b is an effective emergency contraceptive pill and no such side effects are known till date.the pain and bleeding at the time of urination could be a result of uti or an erosion or abrasion if you were not fully aroused at the time of coitus.i would advise you to take a urine routine test to rule out urinary infection and drink plenty of water.all the best take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does kidney stones with nutcrackers syndrome suggest?\n\nI am a 63 year old woman who has lead an active life.In the last year I have gone downhill drastically. I was told that in an MRI to check for kidney stones they noticed that I might have nutcrackers syndrome.can you explain? It seems that I have symptoms associated with this.",
    "doctor_response": "Hi thanks for writing !Nutcracker syndrome is a condition is which the left renal vein gets compressed between two large vesels that is sup mesenteric artery and aorta. Symptoms might be blood in urine and flank pain. It is an anatomical abnormality and does not cause stones.You can write back with your queries..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What permanent solution is available other than surgery for removal of gallbladder stones ?\n\nwanted to discuss with someone regarding Gallstone problem. My husband is 45 years old. He has been diagonised with gallbladder stones (multiple). What are the options available for a permanent solution other than surgery as there have been instances where people have undergone gallbladder operation but the problem still persists.",
    "doctor_response": "Hello. welcome to HCM. Treatment of already formed gall stones is nothing but surgery. You are taking note of instances where people are not treated by surgery but there are umpteenth number of cases where cholecystectomy (gall stone surgery) has healed people. Laproscopic or open surgery is a safe option. Long standing gall stones may complicate issues by causing superimposed infection, perforation and even malignancy. So please be wise and judgemental for your benefit. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How effective is Loestrin fe on endometriosis ?\n\nI was recently diagnosed with endometriosis and I want kids, just not right now. I m hoping in the next year to start trying. I am currently on lo loestrin fe continuously but the pills make me nauseous. My doctor wants me to start the Lupron shot. Will this help preserve fertility better than the shots?",
    "doctor_response": "Dear member,Thanks for writing to healthcare magic.The lupron in leuprolide acetate inj which causes an artificial temporary menopause like period for say 6-8 months. The idea behind this treatment is that without hormones the endometrial deposit will shrink away and after a year when you are ready for pregnancy conception may be easier.Thanks.Dr Bhagyashree",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lack of bowel movements, fever and vomiting in cildren\n\nmy son is 1year5months and he s having a primary complex, but now taking his med , he cant poop and pee and his crying all the time in the morNing his having fever, and he s vomiting. loss appetite but he drink a lot of water. icant give him any med because he s taking his med for his primary complex, what should i do?",
    "doctor_response": "Hi, your son has to be given medicine for fever and vomitting. You don't have to refrain from using medicine for fever and vomitting just because your kid is on medication for primary complex. Give him a plain paracetamol and an antiemetic. Once his vomitting stops he will eat properly. You can then initially force him on some porridge and then slowly give him normal diet. Don't worry he would be alright. Inspite of all this if he is not accepting food then please take him to your doctor.Tc",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have high serum creatinine levels and increased protein output in urine. Have hypertension. On ecosprin, amolpin and resuvas. Will telma help?\n\nHello doctor, I have had a serum creatinine level of 1.58 with protein output in urine at 390mg. My blood pressure was at 140/90last week.I am taking amlopin 2.5mg along with ecosprin . And resuvas. Last week I was asked to take telma 20mg and get another test for creatinine done. Please let me know if telma would help my problem and what are the indications of these readings on the kidneys. My GFR was 93. Thanks",
    "doctor_response": "UR CREATININE IS BORDER LINE UR HYPERTENSIVE TOO DID EVER CHECK UR BLOOD SUGAR GET FEW INVESTIGATION DONE USG ABDOMEN TO RULE OUT KIDNEY SIZE RENAL FUNCTION TEST TO BE REPEATED MINIMUM ONCE IN S MONTH BLOOD SUGAR FASTING AND POSTPRINDAL HBA1C TREATMENT CONTINUE ANTIHYPERTENSIVE DRUGS TAB.ACILOC 150 MG ONCE A DAY ADVISE MAINTAIN BLOOD PRESSURE WITHIN NORMAL LIMITS MAINTAIN URINE OUTPUT IF BLOODSUGAR DEARRANGE THEN VISIT TO PHYSICIAN NEPHROLOGIST OPINION",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes continuous salivation in infants?\n\nHello Dr. I have 4 Months old Female Baby. First 2 and Half months she has no problem. After that she got Cold and his left cheek was little big. We consult the child doctor. He told nothing worry it will be alright within one week. But not, she cries cries cries. We consult More than three Doctors. But Still she didn t Stop Crying and also not feeding. Saliva continuously coming out of her mouth. for this we change 4 to 5 dress in a day. Please give me a solution for this. My Email ID: YYYY@YYYY . And also suggest a Dr. around Salem City, Tamilnadu. Thank you.",
    "doctor_response": "From 3 to 4 months of age, you may see your baby start drooling more often than normal. Teething stimulates drooling, which may be worse with some babies than others.As the new tooth rises closer to the surface, your baby\u2019s gums may become increasingly sore and painful, leading to fussiness and crying.Other possibility like gum infection, tonsillitis, pharyngitis etc. seems unlikely as your baby is not having fever right now.For further queries regarding this problem or its medications you may consult me at Healthcare Magic under section \"Ask Expert \" >>>\"Ask Pediatrician\".Dr. Khan Shoeb",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why my daughter is having cough repeatedly?\n\nMy daughter is 2 and this year she has been to the doctor  more than 4 times and always for the same thing cough no this time shes sick agai after not even a month of being sick but she cries so hard when she coughs of sneeazes im afraid its bad and hospitals arent doing nothing",
    "doctor_response": "Thanks for following up, your daughter is small and her immunity is decrease, children till 5 years have less antibodies in blood then adult,thats why they catch infection easier. Every throat infection and rhinitis will accompany with cough, because mucus goes inside pharynx.In this case its OK, you do not worry because cough is protective reaction. From other side , if child suffer bronchitis 4 times in year, then mother should visit allergist.  But you didn't tell me what diseases she had.It was bronhitis or usual pharingitis and traheitis. One more i advice you please show your child to ENT doctor, because she can have adenoids and can cough, because there are locus of infection. For decreasing morbidity i recommend to your daughter courses of vitamins:1.To begin with multivitamins-zincovit 5ml (1 teaspoon)-1month2.Then after zincovit-osteocalcium 5 ml 1 time-1 month3.Then B complex syrup 5  ml 1time 1 month If you see that she starts to sneezing give to her antihistamine and nasal drops and wash her nose with saline water then mucus from nose will not go to pharynx and trahea and she will not cough All the best Grow quicklier Dr.Svetlana",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest alternative treatment for Cholecystectomy\n\nCan a cut Bile duct after a Single-Site da Vincicho Cholecystectomy be repaired without surgery. A gastroenterologist used endoscopy to place a stent in te bile duct to keep the duct open and to let it heal on its own. So far after two months surgery and three hospital stays I still have systems related bile in the abdominal cavity.",
    "doctor_response": "Hello! Thanks for putting your query in HCM.  I am Dr.Amit Jain (DM, Gastroenterologist). Bile duct injury after cholecystectomy can be managed by Gastroenterologist as You said by placing a stent across the injury for few months which is known as ERCP. It is itself a non surgical method. There is none other non surgical method for repair of bile duct injuryI hope I have answered your query. If you have any further query I will be happy to answer that too. Wish you a good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is serratiopeptidase supplement effective in treatment of knuckle injury?\n\nHi, I injured my right ring finger about 4 months ago......a crush injury between the just distal of the 1st knuckle. I still have problems with range of motion and lack of sensation. Can a serratiopeptidase supplement help with both of these problems?",
    "doctor_response": "Hi, As for the range of motion you need to meet up a physiotherapist who can help mobilize the joint and help regain the range of motion. As range of motion of the joint cannot be improved with the oral supplement medication. It needs a muscle elasticity to be regained and joint to get free of stiffness and mobilization of the joint will be a right thing to look for. Regarding the sensation, we need to assess if any nerve damage has occurred. As mentioned by you about the ring finger than an ulnar never testing may be needed. Oral supplement to improve the sensory functions of the never can he helpful but as mentioned, before beginning any dosages we need to check on clinical basis for better results. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is dizziness due to labyrinthitis caused by germs from the neti pot?\n\nHi. I m sure it s been asked before but I ve been dizzy for about the past week. Went to ENT and he said it s most likely labyrinthitis. I used a netti pot about 3 weeks ago with warm, non sterile water from faucet. I feel constantly buzzed . Not so much dizzy but just out of it My question is could my symptom be from a parasite via the Nettie pot? If it s not labyrinthitis what else could it be? Thank you Steve",
    "doctor_response": "Hi,Thanks for your question on HCMI do understand your pain and discomfortAs per your history is concerned your problem is due to virus only but not parasite as mentioned by you which causes inflammation of your inner ear. Your second question was if it is not labyrinthitis then what it may be, my answer is dizziness can be due to various pathological causes among them for your case BPV, Vestibular neuritis, and anemia can not be ruled out. So Take cinnarazine tablets for dizziness and check your hemoglobin level if low take iron caps, Add a multivitamin capsules every day at bedtime.Hope that helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, irregular cycles. Prescribed duphaston, ovofar. TSH, Follicular monitoring study shows rupture after five days. Treatment?\n\nhello doctor, I am 42 old woman got married one year back.my cycle is not regular. I want to get pregnant as soon as .for this, I concealed to a OBGYN doctor and she suggested me DUFASTIN 1 tab three time for ten day and Ovofar tow tab a day for five day. I follow her guide line and did TSH and Folicular Monetaring test but after five days of FM test the age was ruptured. Again Doctor suggested to take same medicine. What shall i do for my betterment.",
    "doctor_response": "Hi Welcome to HealthcareMagic As you are 42 yrs old, chances of conceiving naturally is low because as age advances quality of egg becomes poor and fertility decreases. Your periods are irregular which suggests there is hormonal disturbance. As age advances store of eggs in ovaries also decrease. You need aggressive treatment rather than waiting for things to happen. I would suggest you to undergo 1-2 cycles of IUI combined with ovulation induction( Ovofar treatment ) and if it is unsuccessful IVF treatment will be best option. Even with IVF, success rate is low at your age. Other option is IVF with donor eggs which has good success rate. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Semen analysis test showed sperm count, severe oligospermia. On maxoza L. Is that sufficient?\n\nI got my semen analysis test, my sperm count is 2.5 million per 3 ml Doctor mentioned it as severe Oligospermia. Later he mentioned few more tests then said it is Ideopathy. Now I am under medication as belowEcozyme daily 2 tablets (chewable)MAXOZA-L powder daily 2 sachets.I am married since 2 yrs, we are planning for a baby. Whether the medications prescribed are right ? Is there anything additional that needs to be done ?",
    "doctor_response": "Hello.The first thing is to rule out pathologies that may cause oligospermia such as hypogonadism, varicocele and hydrocele.It is necessary testicles exploration and measurement of  hormones levels in blood(FSH, LH and testosterone).If the exploration and hormones levels are normal ,the oligospermia is idiopathic, the treatment that you are taking is right and your case it is not easy to solve because your oligospermia is severe (less than a million sperm per ml).I wish you good health. (If the answer has helped you, please indicate this)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in gums with a tear?\n\nHi..i got hurt in my mouth and had a tear on the gum of the lower lip....at times my tooth aches....but when i brush my teeth i get relief but...from yesterday....its paining much....even i went to the dentist he said i got hurt on the bone of the teeth and he suggested for root canal...please advice what to do",
    "doctor_response": "Hello:)Welcome to HCM.A x-ray is necessary to assess the bone and tooth.I do not know if your dentist took a x-ray. A fracture in the tooth or trauma to the blood vessels supplying the tooth can lead to pain you are experiencing now.A root canal will include removal of the pulpal tissue.This will eliminate the pain.I advice you to go for the root canal,but after a x-ray.Don't worry about the lip, cut or bruises in the mouth will heal very fast.Apply a soothing gel like Quadragel for few days.Ask your dentist if you will need a suture if its a deep cut.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rashes on the arm after tick bite?\n\nMy mom got bit by a tick and had a rash on her arm the rash has then spread to her other arm her under arms and her chest we went to the emergency room and they told her that this rash may be deadly but since then she s been to a skin care doctor and hasn t gotten any answers I mean they took samples of her skin from both arms gave her sleeping pills and also cream so that the itchiness can go away but it hasn t work it s just getting worse ! Please help ! :(",
    "doctor_response": "Hi,It may be lichen urticatus. Consult the dermatologist for the perfect diagnosis and proper treatment. It is hypersensitivity to the insects. Apply steroid cream on affected areas. Take antihistaminics like like cetirizine 10 mg daily and oral steroid in tapering dose. Avoid insect bites. Avoid soap bath.Hope this helps.Dr. Ilyas Patel,Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat swelling in right testicle and burning on tip of penis?\n\nHello.I am 21 years of age. Last week and this week i have been noticing swelling only in my right testicle, the week before I had pain on my left part of my rib cage or kidney area, i did an ultra sound and everything came out clear. Yesterday and today i have been feeling a little burning on the tip of my penis and still some sweling on my right testicle, when i touch it it does not hurt. I am a virgin so no i dont have sex. I did urine, feces and blood test and everything came out clear. I also have a little pain on my right leg. Help me with some information plz plz!!!!",
    "doctor_response": "HelloThanks for query.Swelling and pain in Rt Testicle is mostly due to infection of either Epididymis or Testicle .You need to consult qualified General Surgeon for clinical examination and Ultrasound Scanning of scrotum to confirm the diagnosis. You need to take broad spectrum antibiotic like Cefixime along with anti inflammatory drug like Diclofenac twice daily.Ensure to drink more water.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat chest pain?\n\nhi i am 28 years old male & i am student. i need your help for some information, i have little pain in my chest from last night but this pain is little not major & i was taking some pills regarding my high triglycerides the name of my pill is storvas ez, now i don't know i have to see the doc. or wait for sometime may be this pain doesn't belong to my heart. plzzz suggest regards varun",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Since you are taking lipid lowering drugs, you should definitely rule out cardiac chest pain. So get done ecg. If ecg is normal then no need to worry for cardiac chest pain. Sometimes simple musculoskeletal pain can be the cause. So avoid movements causing. Avoid heavyweight lifting and strenuous exercise. Apply warm water pad on affected areas of chest. Take simple painkiller like paracetamol or ibuprofen. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does osteoporotic wedge compression fracture occur?\n\nthey tell me i have an osteoporotic wedge compression fracture of the T8 area. how could this have happened . I repair lawnmowers, chainsaws, rideon mowers, how do i carry on at this work or should i look for a different type of employment. thanks cmb.",
    "doctor_response": "Hi, I don't believe that this finding of an osteoporotic wedge compression fracture in your thoracic spine necessarily means that you should change your employment. The most likely cause of this finding is from loss of calcium in the vertebral body which fractured. The remedy is to increase your body's calcium retention and incorporation into your skeleton. If you don't fix that then, no matter job you have you will still be open to the same problem in some other vertebral body later on. Make sense? If you have back pain and that is the reason you had this x-ray taken then, you may have to find less strenuous ways of doing your job for the time being until you correct the cause of this problem and also to make sure you don't fracture another spinal body. You've heard the saying, \"Work Smarter, Not harder?\" Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high blood pressure and chest heaviness\n\ni was feeling uneasy since last few days like heart burning and indigestion feeling, and 2 days before i was feeling heaviness to my chest and i checked my bp was 180/120. please advise wht should i do now am ad sea not possible to consult a doctor at least 2 days",
    "doctor_response": "probably you are having acidity problem as well as high blood pressure. Also heart problem can certainly be there. so currently we should address blood pressure. I would have started my patient in my clinic with amlodipine 5 mg once a day and low salt diet. Tab Pantop 40 before breakfast for acidity once a day. However you should get yourself examined and some investigation like ekg, lipid profile , renal and liver function test, blood sugars.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness in chest and increased heartbeat?\n\nHi I ve got a tightness in my chest and sometimes a bubbling sensation with it, my heart races and I feel like I m going to faint. I do suffer from panic attacks and have for years. I am not sure whether to be concerned or whether it is my anxiety. I have felt like this for about 4 days. I ve still done all my normal activities and I m not in pain just this burning sensation in the middle of my chest. Thx",
    "doctor_response": "HelloChest tightness with fast heart beat need proper evaluation.It may be due to coronary heart disease,reflux,psychogenic etc.You need proper clinical examination and investigations.Investigations include routine hemogram,random blood sugar,thyroid profile,liver function test,renal function test,lipid profile,urine RE/ME,ultrasound of abdomen,TMT,ECG in all leads,ECHO.Proper treatment depend upon findings.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a swollen lump under the collar bone indicate?\n\nHi I have a swollen lump under my right collar bone, I believe it s my right lymphatic duct. Or however you spell it, I ve got a bard chest infection so it could be fighting an infection, but it s worrying me as I ve researched on google and it s shown me the worst.",
    "doctor_response": "Hello and thank you for asking Healthcaremagic.I am Dr.Endri Katro and I will be answering at your questions.The lump that you describe probably it is a lymphnode. Since you have a chest infection,it makes sense for the lymph nodes in that region to get swollen.They stop the infection.I understand that you have searched in internet,and the answers in most of the case can be scary,but in your case probably there is nothing to be worried. First you need to use the right prescription with the antibiotics. It will take around 5 days to 1 week for the lymph node to get normal again.If this lymph node persist than an ultrasound of the lymph node or even a FNA (fine needle aspiration) would be the next step. Of course after consulting your physician. If you have any other question,don't hesitate to contact me.Dr.Endri Katro",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fibrotic shadow on lungs\n\nDear Sir, I have been suffering from TB. I have gone through Pre Employment Medical Test Ffor middle east. The medical center had given me UNFIT report due to Spot on Lungs (Fibrotic Shadow) I s there any medicine to vanish this spot by treatment. Best Regards",
    "doctor_response": "Thanks for your question on HCM.Sorry to say but there are no medicines available to remove these scars.Scar tissue is dead tissue and so harmless thats why medicines are not available as it is not a disease.It is due to healing process. In lung tissue any insult like infection, trauma can produce healing by either fibrosisor calcification. And these gives appearance of scar tissue on chest x ray. And this will remain as it is through out the life.One thing you can do. Get done CT THORAX and bronchoscopy with BAL (BronchoAlveolar Lavage) analysis for TB. If both these are negative than you can assure  medical center that you are not having active TB, the scar tissue is old lesion only.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could the white raised bump in mouth be?\n\nhi i have noticed a white raised bump -- feels hardish on the floor of my mouth on the side.  I can feel it when i move my tongue towards the side of my mouth.  I have looed at in the mirror and it looks like a ulcer or open sore -- the top that was white had fallen open and the spot feels a bit raw",
    "doctor_response": "Hello,Thanks for consulting HCMRead your query , aa you feel white raised bump in floor of the mouth this can be ulcer or inflammation of submandibular gland situated at the floor of the mouth so there is nothing to be worried but I will suggest you to consult dentist for oral examination of floor of the mouth . Inmean time do warm saline rinses , you can apply ointment like Mucopain or Mugel on ulcer , take vitamin B supplements. Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard and enlarged testicle?\n\nHello.. i am 30 years. My did have a cyst on my right testicle but it seems to have dissapeared after taking some medication for a while prescribed by my urologist. this must of been about 2 years ago. Now, my right testicle feels harder and larger than my left one. It also feels tight and how i can describe this tightness is as if you had to wear a smaller underwear and the pressure that it puts, this only happens on the right side. Its also always bulging on that side. Any advise for me please?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You need a physical examination with urologist to rule out hydrocele or hernia. Very difficult to comment without seeing. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My mouth not open properly because my tobacco habit\n\nmy mouth not open properly because my tobacco habit. what i do? my mouth not open properly because my tobacco habit. what i do?",
    "doctor_response": "Hi, Your condition could be oral submucous fibrosis. The treatment includes intralesional injection of steroids, excision of fibrous bands and exercises for TMJ. Above all the habit of tobacco chewing should be stopped at the earliest. consult an oral surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could constant heart palpitations suggest?\n\nHi, I am 30 year old female and i have been having what I think are palpitations everyday for about a month now. It just feels like a hard thud in my chest or like a skipped beat and  thats it. I do not have any other symptons. I was on the birth control camila aka (mini pill) I stopped taking that 2 weeeks ago because I thought maybe thats what was causing these but they have not to seemed  to have gotten any better. I usually get between maybe 10-25 a day. I also dont drink caffiene and I'm also breastfeeding. I can't see my doctor for another 2 weeks. Should I be worried? I'm scared to death!",
    "doctor_response": "Welcome and thank you for asking on HCM!I have gone through you question carefully. Palpitations in young females is usually due to low hemoglobin ( anemia) and thyroid problems (excess). If these two things are ruled out .. you can be assured there is nothing to worry.Hope you will find this answer helpful!Wishing all the best, Dr. D Sunil Reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Am I getting muscle fasciculations because of neurological problem?\n\nHi doctor, I am a 28-year-old male, approximately 93 kg, 1.89 cm. Over the past year, I have been getting muscle fasciculations on in my calves (mainly) and also in my quads. I have seen several doctors now and they have checked my reflexes and feeling in my legs and it is all fine. The fasiculations occur, or get worse when I do weights that strain the back of my neck, where it meets the base of my skull. For example shoulder press, or bench press. I have proven that this is the problem many times now. Caffine, alcohol, etc., are all stimulants that make it worse. However, the weights I mentioned above I am certain is the problem. The fasiculations are bad, I have had countless sleepless nights because the twitching is so bad. It is important that I find the problem as I do not want to stop weights permanently. I requested my doctor to prescribe me with blocker drugs and he has given me Gabapentin Milpharm 300 mg. These actually help and reduce the fasiculations. I also went to a chiropractor who was excellent in helping my mobility through my neck and back but could not stop the twitching. He said that I need to see a Neurologist. Does anyone know what is wrong with me? Or what I should do from here?",
    "doctor_response": "Hi. Involuntarily muscle twitching or fasciculations could result from various causes. Most common being anxiety, hyperthyroidism, nerve compression at lower back, restless leg syndrome, vitamin B12 deficiency, vitamin D deficiency. If we think of uncommon causes, they could be amyotrophic lateral sclerosis or multiple sclerosis. In my opinion, you need a comprehensive workup first. That includes thyroid profile, vitamin D and B12 levels, blood counts, MRI LS spine, EEG. So, you do not need to rush to a neurologist. First of all, go to your GP. Request him for these tests. Let the report come and then you can go for a neurology opinion. My recommendations in such cases for treatment would be taking Mecobalamineshots, Vitamin D and Calcium supplements. You can also ask your doctor to prescribe you Pregabalin in sustained release form for at least three months.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for trouble in urination in a child\n\nDear Doctor,My 4 years old son is having problem during urination. Some times he urged to urinate, but unable to urinate completely and after some time he urinate in his pants. He does not have any other problem and very active . Please suggest what is to be done?",
    "doctor_response": "Dear parent, this could be due to a urinary tract infection . you should get a urine analysis done to confirm the presence of urinary tract infection and then start the antibiotic treatment accordingly",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can hernia with low back pain be treated?\n\nHi I have a hernia an Lower back pain iam on a muscle relaxer an an anti inflammatory but it doesn t help with my pain one bit , I ve taken Percocet 5mg with acetaminophen an An I have to double up on them to take my pain down a couple notches but still in pain an the acetaminophen make me not feel well how do I ask my doctor for something stronger that actually works an to not sound like a pill abuser",
    "doctor_response": "Lower back pain is unlikely to be related to your hernia. Most of the times low back pain gets better with some physiotherapy and back strengthening exercises. Do see a spine surgeon if there is no relief in a few weeks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for malaria\n\nI stayed in Angola for 6 years and contracted malaria several times. I still have reminders thereof, as happened last week. I took Artusinate, but still there is something wrong. I am feverish with regular headaches and this morning my stool was red jelly like.",
    "doctor_response": "HelloLet me clear many things about malaria :4 types :Plasmodium, vivaxPla               OvalePla            malarial Pla             Falciparum ( this is also call as algid malaria or most dangerous in all ).Chloroquine is still the drug of choice in all forms.While arteether, artemether, artesunate , these all injections are used for plasmodium FALCIPARUM . Radical treatment is important  for PREVENTION of all forms of malaria . In ovale , vivax, malarial take as following :Chloroquine base 600 mg followed by 300 mg after 6-8 hours . On day 2 & 3 300 mg daily ( once in day).Radical treatment is as primaquine 15 mg / day for 14 days for all three forms.While for Falciparum 90 mg primaquine in single dose with plenty of fluid or liquid or milk.Some times there develop nausea and vomiting so you can take ondansetrone before this treatment . Pantaloc-d also helps .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard colorless painful lump on armpit?\n\nI found a hard colorless kind of painful lump on my armit. It s pea sized and it kind of just appeared. I m sure it wasn t there a couple of hours ago. A tiny bit of pus came out, but no more. I checked today and I don t think it s filled with anything. What do you think it is?",
    "doctor_response": "hi.it is best if you consult with a doctor, preferably a general surgeon, for medical and physical examination. based from your description, it could be hidradenitis suppurativa. these lesions usually occur on the underarm, especially after shaving or plucking and/or usage of deodorants with strong chemical contents. hair follicles get infected. inflammation and subsequent abscess formation occur.  medical (proper antibiotic regimen) and surgical (excision or incision and drainage) management will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medication for persisting acne\n\nHi, I m suffering for ACNE problem and already in touch with dermatologist for last 2 months but couldn t get any relief. here is the medicine list which s prescribed by the dermatologist : - Glyco Acid Cream 6%, Isoin 20 capsule, Azicip-500. Can you pls suggest me how to overcome of these Acne problem ASAP. Thanks in Advance! Regards,",
    "doctor_response": "Dear Rajeev, The prescription seems fine to me. Please clarify, if you really had NO response with the treatment being prescribed and if you took the medicines regularly. Two months is an optimum time to have good response. i would advise to continue with Isoin 20 and azicip 5oo. Topically apply benzoyl peroxide 2.5% in morning and adapalene gel in night. Use Cetaphil cleansing lotion to wash your face. Continue the same for 15 days. If this doesnot yield desired response either the dose of isoin can be increased or one can think of giving you salicylic acid peels. That would Surely take care of your problem. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dropped shoulder, tremors in the right arm and breathlessness?\n\nMy husband has come down with a few different medical problems and I don t know who to turn to. He is a VA patient so does not get great care. He is short of breath and cannot walk around the block without becoming winded. He also has a very shaky right arm and especially hand. He also has a problem getting his right foot to move when he begins to walk. His gait is not normal and one of his shoulders is drooping about 2 in.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Can be a nerve injury or a nerve root compression. I hope this information has been helpful for you. Regards, Dr. Praveen Tayal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes joint pain in women with a previous history of shingles?\n\nMy wife has joint pain and a pain in her right leg from the knee to and including the ankle but not in her thigh. She recently go over the shingles (lot of pain) but has not developed a rash. The shingles pain was around her waist and her left leg thigh. We don t know what is causing this current pain. Any ideas?",
    "doctor_response": "Hello, Consult a physician and get evaluated. It can happen after shingles and chikungunya. As of now, you can take analgesics like Ibuprofen or Tramadol for pain relief. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i get pregnant if I touch vagina with penis tip?\n\nhi....i am 23 years old male and my height is 5.9...i had a past medical history of asthma and i think thats it....my problem is that i tchouched my girlfriends vagina with the tip of my pennis and m sure that there was some precum for a short time withot penetration.is there chances of pregnancy its getting me worried and my girlfriend is a virgin...please help me out",
    "doctor_response": "Hi I think there is a chance of pregnancy. Precum contains sperms sometimes.  So she can take some medicines to avoid pregnancy after consulting a doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I weigh only 50 kg. What should I do to gain weight?\n\nHello doctor, I am a 23 year old guy with a height of 170 cm but my weight is only 50 kg. How can I gain weight? The major issue is that I cannot eat properly even if I feel hungry. What should I do to get rid of this underweight problem?",
    "doctor_response": "Hello. First of all, it is important to rule out any specific cause for not gaining weight like thyroid problems with serum TSH (thyroid-stimulating hormone) estimation. For gaining weight, you can take protein-rich foods and simultaneously gym also can be joined to build up muscles. With active muscle exercise, muscle hypertrophy occurs and your weight will gain. Try to maintain your BMI (body mass index) between 20 to 25. If your BMI remains within this limit, then no need to worry. For more information consult a family physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cold,phlegm and acidity\n\nI have been having cold and phlem for the past 5 months. The phlem is green and thick. Of late, my nose gets blocked and I find it difficult to blw my nose coz the phlem is very thick. Also I get a head ache very frequently. I am also highly acidic and I suspect all these are connected. My general physician gave me medicines for the cold and the acidity. But I am not rid of either. Please advice.",
    "doctor_response": "Hi, I did review your concern.I believe your symptoms can be due to what we call as chronic sinusitis where there is infection of paranasal sinuses and it causes sinus tenderness, headache and nose block with phlem. I would advice you to take steam inhalations to open up your sinuses and also take antibiotics under medical supervision after getting investigated. A CT paranasal sinus is needed to confirm diagnosis as well as to rule out any cause of blockage. Morever, if the symptoms persist, you can then consult an ENT doctor who can surgically open the opening of the sinus so that it drains well and you are relieved of your symptoms.I hope this helps.Wish you a very healthy and happy life ahead.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does rupturing the eggs mean?\n\nHello doctor I am Female 25 yr old I have pcos issue and having problem with conceiving a baby Me and my husband trying from last 6 months but failed to achieve till now. We have consult a doctor as well he suggest us some medicine to follow but now he asked us to come on some date he told then he will rupture the egg what exactly is this ? And how it is done ? Is it some surgery ? Can you please tell me how this is done in detail. We are worried we might not get down in some trouble. Thank you Anisha",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The doctor must have mentioned about the follicular study. It is an Ultrasound scan of your ovaries to see the size of follicles and whether it has ruptured (you have ovulated). It is not an invasive procedure. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Allergic to pork. What can be done?\n\nhI MY DAD AND GRANDPA HAVE THIS ALLERGIC REACTION TO PORK.I THINK I HAVE IT TOO WHEN I WAS LITTLE,MY MOM AND I WHEN TO I HOP AND I ATE A COPPLE SAUSAGES .THEN MY SYOMACHE STARTED HURTING SO I WENT TO THE RESTROOM AND I STARTED GETTING HOTI STARTED TO CRY.I EVENTUALLY COOLED OFF,BUT WHEN I WAS 10 I HAD ANOTHER REACTION BUT TO PORK RIBS SAME SYMTOMS BUT I HAD TO GO TO THE HOSPITAL",
    "doctor_response": "if SOMEONE IS ALLERGIC TO PARTICULAR FOOD ONLY ELIMINATON OF THAT FOOD IS RECOMMENDED AND THE SYMPTOMPS WONT APPEAR THE ALLERGY CANNOT BE CURED OFF AUTOMATICALLY AND WHENEVER YOU EAT THE SUBSTANCE ALLERIES WILL DEFINATELY APPEAR BUT IF YOU ARE DESPIRATE TO EAT PORK YOU CAN GO FOR DESENSITISATION THERAPY FOR PORK WHICH IS THE ONLY THERAPY WHICH CAN HELP YOU",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should ET cycle be cancelled due to period pain?\n\nhi, my name is sonia having a treatment medcated fet, my question is, i am having period pain just before et. my transfer is on tuesday and now i am having period pain, is it ok to go for et or shal i cancel the cycle. thanx. i am perfectly ok my hubby got low sperm count. doing fet/icsi. fresh ivf failed ad luck.",
    "doctor_response": "Hello, This cramping period like pain is common and there is no relation with the success of IVF and this pain so no need to cancel the cycle.In case you have any questions in future you can contact me directly on",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the swollen lymph node and a lump on my neck related?\n\nhi, i have a swollen lymph node on left side of neck its quite big but painless, just noticed it couple of days ago, and also have painful lumps on back of head at bottom left side  which about a week ago i think i had a rash or infection around as it was swollen and really itchy but its not as bad now but its the lump on my neck im wondering if that could be connected? thanks",
    "doctor_response": "Welcome to health care magic. 1. Painful lump which looks like a rash - suggest most possible cause is hair follicle infection. 2.Usually they arise form hair follicle with collection of the pus within.3.The lymph nodal enlargement are usually due to any infection / inflammation, can be localised or systemic.4.If it is resolving as you said - then nothing to worry, other wise a course of antibiotics will be required.5.Do not scratch / press / disturb the lump as in that way you will complicate it to heal. And maintain local hygiene. Good luck.Hope i have answered your query,any thing to ask ? do not hesitate to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a lump on the neck be treated?\n\nMy 3 year old daughter woke up with a lump on the side of her neck . it is hard and close to the size of a apple. The other side is slighty enlarged to the size of ping pong ball. She is otherwise well. The Dr checked her and ordered bloodwork and a chest xray. She has had no illiness since January(6 months ago) How concerned should I be",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  She may have enlarged lymphnode.  It can be due to reactive hyperplasia, tuberculosis or lymphoma.  She should go for blood test, x ray chest and fine needle aspiration cytology of 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump on the toe\n\n...I have an abcess like lump on my big toe...every few days it gets very very painful and I have to lance it, upon which I can squeeze a small amount of clear jelly-like substance out....I get immediate relief but it returns in a few days....what can I do to get rid of this firever?",
    "doctor_response": "Hi,Dear,Welcome to HCM. Based on the facts of your query,You seem to suffer from-Digital Myxoid Cyst(DMC)-in the DIP joint line.Excision of the Ganglion or DMCysts by planned Surgical procedure would be needed repeatedly,as complete excision in one seating is not possible.X-ray and CT study of the DMC would fix the diagnosis.HOpe this reply would help you to plan further treatment with your doctors.Contact with a Followup Premium question to ME. Will appreciate your Hitting thanks and writing excellent review comments to help needy patients like you. Good Day!! Dr.Savaskar, Senior Surgical Specialist M.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe pain in left lower abdomen.  CT of stomach normal.  On Donnital pills.  Help\n\nI have a 25 year old son . He has had bad abdominal pain in the lower left . He has had a  tests from the GI and is on all kinds of meds. The Gi stated that it is not GI .. We call the primary doc. and now they put him on Donnital pills. He just came home from work in intense pain. I want an ultrasound of his abdominal area but because his ct of the stomach came back neg. The Dr doesnt feel it should be done.  Help he is very upset and in a lot of pain....",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum. Donnital i.e.methadon is apotent pain killer not a treatment . As there is not pathology ( disease ) in stomach ,but may be a stone ( transparent ) in left kidney . Pain may be due to scrotal pain (most common among young). Amoebic colitis is another reason. In my opinion consult a physician and get his opinion. Ultrasound is very important so get in it. Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could small flaps of skin on the inside of mouth be due to poor fitting dentures?\n\ni have noticed two small flaps of skin on the inside of my mouth on both sides of my jaw i have upped dentures that i seldom wear but still have my bottom teeth they do not hurt but im concerned .could this be a cause of poor fitting dentures or something else?",
    "doctor_response": "Hello ,thank you for consulting with healthcaremagic. Yes actually sometimes ill fitting dentures does cause a growth of mucosa which looks like flap inside the mouth.  But it can be a normal mucosa also like frenums. If the growth is painful then it is because of ill fitting denture,  if not then it can be normal. Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes soreness in the left wrist?\n\nMy question is, my left wrist is sore but not real painful, has been for a few days. My fingers are fine, no pain or soreness in them. Did I possibly just hurt my wrist somehow? I also have no swelling. I wonder if this is a symptom of carpel tunnel or just something else? The most is that the soreness is on the top of the wrist, not underneath!",
    "doctor_response": "Hello, I have studied your case. As per your history there is possibility of TFCC/ligament injury to wrist.It may subside with time.Pain  indicates inflammatory process or nerve compression.I will advise you to do MRI and Ultrasound of wrist.Till time you can start analgesic and crepe bandage support.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in penis after going through mesh in swimming suit?\n\n4 year old male, uncircumsised, spent day in swim suit and water and mesh in swim suit is stuck. Appears that the delicate skin went through the mesh and then swelled. Is there anything we can do at home or does this have to be dealt with by MD? Pediatrician or ER?",
    "doctor_response": "HiThis is just a simple abrasion problem and it should resolve soonFor now you can apply aloe vera cream",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach and back pain with fever while having UTI?\n\nI have a urinary tract infection. I am due to take my last antibiotic pill tonight. But now I have pain in my right side and stomach and even in my lower back. I was doing better but now thee symptoms are a little different. I just took temp. And it is 99.9. Should I go to my doctor tomorrow? YYYY@YYYY",
    "doctor_response": "Hi dear. Welcome to HealthCareMagic. Thanks for trusting us. I have understood your questions. But before, may I know what kind of antibiotics do you use? How long have you consumed this drug? It's really helpful when I know surely the name of your drug so I can look for the possible cause of your condition.For urinary tract infection, the antibiotics which most given is from fluoroquinolone class such as ciprofloxacin, ofloxacin, levofloxacin etc. This kind of drug have several side effects especially in causing GI discomfort (abdominal pain, cramps, nausea or vomiting) like the symptoms you have. The others are dizziness, headache, fatigue, weakness etc.Another class of antibiotics usually used for UTI is cotrimoxazole (combination of trimethoprim - sulfamethoxazole). It also can cause nausea, vomiting and anorexia. Beside that, amoxicillin/clavulanic acid can be used for UTI and it minimally causes GI distress.The fever that you felt is called subfebris. If I were your treating doctor, you can take acetaminophen 500 mg for your fever. If any of your symptoms get worse, it's better to contact your local doctor.You should know that the goals of UTI treatment are eradication of infection, preventing\u200b complications and preventing recurrence. Take all the antibiotics like your doctor prescribed, because stopping it in the middle of treatment can cause resistence.For prevention of UTI you should drink plenty of water and drink cranberry juice. Some studies suggest cranberry can reduce recurrence of UTI. Keep your private area clean and dry.I hope this answer can resolve all your concerns. If there's anything else you need to know, feel free to ask me in HCM. I'd be glad to help you. Wish you get better soon. Take care.Regards,dr. Asti Yuliadha",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are liver enzymes expected to increase after gallbladder removal?\n\n.I had my gall bladder removed 2 weeks ago. Every time I eat anything larger than 1/4 cup of food, I have intense pain within 30 minutes. It continues for hours and is the same type of pain as before the removal. Today I had my third stool which was clay colored. I also had repeat liver enzymes done which are still elevated. Is this to be expected?",
    "doctor_response": "Hello, The pain after cholecystectomy is called post cholecystectomy syndrome. I suggest you take low fatty foods and less food for few days. The bile reservoir gall bladder has been removed from your body, so obviously digestion difficult. If your liver enzymes value increased more than two fold than only you need to worry or else not. So kindly attach the report. The Colestipol can be prescribed for your pain after operation. If no improvement than consult doctor for detailed evaluation and MRCP like investigation if needed. Hope I have answered your query. Let me know if I can assist you further. Take care. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for the cyst in the groin area?\n\nHi Ive been at the local out of hrs tonight. I ve got a massive cyst in my groin area. They wanted to drain it but sent me home with medication. If in 2 days it hasn t burst I m to go back to have it drained. I ve just been to the toilet and it s weeping blood. Is this normal or should I go back ?",
    "doctor_response": "Thanks for asking inhealthcaremagic forumIn short: Cyst cannot burst itself only a boil canExplanation: A cyst cannot rupture by itself unless meddled with. Only a boil can burst discharging pus. So, anyways please visit a doctor(surgeon) for its removal. Do not attempt yourself. Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tenderness in the chest after an injury?\n\nI fell on Sunday and went to the ER for wrist pain. They x-rayed my hand and found it wasn t broken. They gave me medicine for pain and gave me a brace for my wrist. Now 4 days later I have tenderness in my chest on the side that I fell on. Should if see my doctor?",
    "doctor_response": "Thanks for your question on HCM.Due to fall, you may injured your chest  and this can cause tenderness in chest.Blunt chest trauma can cause following complications and all cause chest tenderness.1. Rib fracture2. Pneumothorax3. Pulmonary contusions4. Muscle injury.So get done chest x ray to rule out above possible complications.If chest x ray is normal than no need to worry much. You may have muscle injury only.So try to follow these steps for better symptomatic relief.1. Avoid heavyweight lifting and strenuous exercise.2. Avoid movements causing pain.3. Avoid bad postures in sleep.4. Apply warm water pad on affected site.5. Start painkiller and muscle relaxant.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rashes on an infant s mouth and cheek area?\n\n12 month old continues to get small red rash on one side of her mouth and cheek area . She s been drinking whole milk since Dec 22 . She also drinks pear and prune juice , every other day or so. Not sure if this rash is from something she s putting in her mouth or just an irritation that keeps coming up .",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query your infant have symptoms of rashes on and around mouth and cheek area which are pointing towards allergic reaction. The allergic reaction occur due to some food or medication. It could be due to recurrent aphthous stomatitis caused by viral infection. It could be due to poor immunity of body. I would suggest you to :-- Apply dologel on these red bumps and avoid hot, sharp and spicy food.- Drink plenty of fluids.- Avoid taking food like nuts or sea foods .- To give cold compresses to affected area 2-3 times a day .- Take over the counter anti allergic drug like benadryl or zyrtec.Consult dermatologist for proper examination for find out exact cause . Doctor may order allergy specific test to find out what exactly causing allergy. Also consult dentist for examination. Dentist may prescribe antibiotics and start treatment as per diagnosis.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does flank pain with light brown discharge indicate ?\n\nHI, I AM HAVING SOME FLANK PAIN AS WELL AS LIGHT BROWN DISCHARGE ONLY FOR A FEW HOURS A DAY. COULD THIS BE A KIDNEY INFECTION?",
    "doctor_response": "Hello,            Thanks for posting your query. I would need a few more details to answer your query. Please write back with the following details.1. Are you male or female and what is your age?2. Are you talking about urethral discharge/ or if female vaginal discharge?3. For how long have you had these symptoms?4. If urethral discharge, then is there associated pain while passing urine, difficulty in passing urine, blood in urine, fever etc?The symptoms of a kidney infection would include high fever, shivering, chills, loss of appetite, pain in lower back and sides etc.Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "After the coronary bypass surgery there is pain & infection on legs\n\ni had coronary bypass surgery a month ago, the wound on my leg is not healing and now its infected. it looks hollow inside and i keep getting sharp prickly pains. They are going to start antibiotics intravenously, is there a possibility of losing my leg?",
    "doctor_response": "Hi,There might be having infection in leg wound.With starting of antibiotics IV and orally infection will be cured.Timely taken steps will give instant relief from infection and you will be alright.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in chest with cough and sneezing\n\nthank you. a week ago this monday I fell forward and the front left chest area hit a vaccum clean and fell over with me as I landed on it. The next day I began to have pain in that area. And now the pain is intolerable. Ir hurts to breath, cough, sneeze and so on. There is no bruising. But the pain is horrible. What could I have done?",
    "doctor_response": "Thanks for your question on HCM. You are having blunt chest trauma.  And this can lead to following complications. 1. Rib fractures2. Pneumothorax3. Pulmonary contusions4. Muscular injury. And in all of the above pain on breathing and sneezing, coughing present. So get done chest x ray to rule out all these.If chest x ray is normal than it is mostly muscular pain. Try to follow these steps for better symptomatic relief in muscular pain. 1. Avoid heavy weight lifting and strenuous exercise. 2. Avoid bad postures in sleep. 3. Take good painkiller and muscle relaxant. 4. Apply warm water pad on affected site. 5. Wear chest belt to avoid mobilisation of affected area.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numb sensitive front teeth post injury?\n\nI'm not sure if you can help me, but here goes, a week ago a crock pot lid fell of shelf hitting me on my 2 front teeth, now they are numb and some what sensitive, the gums behind these 2 teeth are irritated.My general dentist took x-rays which were negative for crack/fractures.",
    "doctor_response": "Hi.. Thanks for the query..As per your complain it is common to have numbness of teeth post trauma..Sometimes the numbness gets better with time if it is only due to the soft tissue injury around the tooth and not due to death of the nerves which are present inside the tooth..If you have sensitivity of teeth you can use anti sensitivity tooth paste for a week time..If you do not fine any betterment in the numbness or there is any change in colour of the tooth you should visit your dentist again...All this is a sign of nerve and blood vessel damage.In this condition you will have to get a ROOT CANAL TREATMENT done which will cure your problem..The irritated gums can be treated by using a gum paint.. Slowly the gums will recover..Hope your query is solved..Thanks and regards..Dr.Honey Nandwani Arora..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Painful blister ulcer type sores under foreskin. What could be the reason?\n\nI have sort of big blistery ulser looking sores under my foreskin & its very painful. I am only bak from being abroad and got upto the usual boys antics & cant remeber alot. Although i do remember trying to force my penis into a dry vagina and it being very painfil but the pain has only got worse in last few days. What do you think is wrong?",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have developed painful ulcer over under surface of foreskin mostly due to dry ,vigorous .unprotected (?)sex .Please get swab test of a fluid from ulcer done to rule out possibility of acquiring  STD.You need to take broad spectrum antibiotic like Cefexine along with anti inflammatory drug like Diclofenac twice daily.along with topical antibiotic ointment like Neosporin twice daily.Ensure to wash your genitals with warm water twice dailyEnsure to avoid sexual encounters till it heals up completely.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need treatment for dizziness\n\nI have been dizzy for several days...off and on. For the last six months I have been watching my weight and only eating 1200 calories per day.. Would this affect my blood pressure at all? Plus,, I have just finished a series of prenesione pills for a bad case of poison ivy. Would this affect my blood pressure. I took my pressure within the hour and it was 101 over 51",
    "doctor_response": "Hi, Welcome to HealthCareMagic.com I am Dr.J.Mariano Anto Bruno Mascarenhas. I have gone through your query with diligence and would like you to know that I am here to help you.101 over 51 is low BP Please eat properly Please do not reduce your food intake without consulting a dietician or a doctor Hope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in HealthCareMagic at  Best Wishes for Speedy Recovery Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lumps in armpits\n\nI have a lump in my armpit - it was thought to be an abscess - I went to general surgeon who advised it was not an abscess - it was a blockage- he said he can be taken care of by ointments and warm compression- i have used warm compressions and it is slowly going down but what ointments do i use for this issue",
    "doctor_response": "you are probably having enlarged lymph nodes, which could be secondary to any wound or infection over your hand or forearms or arms. make sure your hands are kept clean. you can try a course of antibiotics",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruising on arm above the wrist?\n\nI have some bruising on my right arm just above the wrist. It just appeared and it looked like if I poked it with a needle it would oze out blood yesterday. Today it looks more like a bruise. There are two spots about the size of 1/16 or an inch and 7 dots. What could it be?",
    "doctor_response": "Hello,In my opinion, it could be many possibilities, mostly nothing to worry about, this could happen to female patients having periods, and it can be a blood platelets problem due to many causes. A full history is needed and a picture would be ideal for proper diagnosis. Hope I have answered your question. Let me know if I can assist you further. Regards, Ayman Darrag, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I constantly feel bloated, full, and gassy?\n\nHello doctor,I am currently having a bit of a diet issue but I do not have the time to visit a doctor. The issue is that lately, I have been feeling constantly bloated and full, even if I eat little to no food. If I eat breakfast, it makes me too full and bloated throughout the day and so I had to cut it out of my meals. Currently, I eat two meals a day, lunch and dinner, sometimes a snack in between. I feel fine after eating lunch because I cut back on the amount I was eating but I do still end up feeling bloated a little. But after dinner, I always feel the most bloated and it does not go away the next morning either. I thought it was an irregular bowel movement issue. So, I tried to consume more fiber (like apples) but it did not really help. I just constantly feel bloated, gassy, full, and unable to digest and I have no idea why.",
    "doctor_response": "Hello. It may be caused due to the constipation problem. You should do regular exercise or yoga. Take ORS (oral rehydration solution two times in a day). Take a small meal at frequent interval, avoid any spicy food, take soup at breakfast. Take more water (at least 10 glass per day). You can take pineapple juice after lunch. Take half pinch ajwain (carom seeds) after any meal (one time in a day). You should meet a doctor for proper diagnosis. For more information consult a nutritionist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does being drenched after high fever cure fever?\n\nmy son has been running a fever since saturday. (101 plus) and last night i went to check on him and he was drenched. now has a normal temp. could the illness be gone? mind you we have been exposed to people having influenza type a. i was planning on going to doctor today.",
    "doctor_response": "Hi...I understand your concern. Drenching sweats after high fever is quite common. Nothing to worry about it. But as you are concerned the exposure to people with flu symptoms, I will suggest the danger symptoms when you need to worry and seek medical attention.Respiratory distress, fast breathing, excessive cough, diarrhea leading to dehydration, vomiting and decreased fluid or food intake. If these are not there you need not worry.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does marginal fatty liver suggest?\n\nbefore 3 months i had sgot 80 sgpt120 , now i have stopped choletorol medicine and reduced drink from 3 peg per wk to 1 peg per wk..now my sgot is 36 sgpt is 63 .. what should i do .. further .. i also had marginal fatty liver ..... age 47 height 177cm wt.75 kg",
    "doctor_response": "Hi thanks for contacting HCM....Let me know you previously your elevated sgpt and sgot is because of fatty liver.That is indirectly caused by high cholesterol level....Now with decrease cholesterol your enzyme level improving....Just now maintain your BMI with taking low fat diet....Regular one hour exercise done...Use very much less oil in diet .Sunflower like good oil taken...Best is avoid alcohol.Safe limit for drinking is 20 gm per day.Refined food avoided.Avoid non veg , cheese, butter etc like trans fat diet....With proper lifestyle measures your elevated  liver enzymes and fatty liver will resolved in few months.Dr.Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white pubic hairs?\n\nI'm eighteen years old and for as long as I can remember one half of my pubic hair has been stark white while the other is dark brown to black. Nowhere else on my body does this occur. Can you help me find out why this is and what would be a probable cause? I have one uncle who has a white spot in his dark hair that never goes away but I do believe he was adopted so I don't know if it is genetic or not.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Premature graying is all in the genes. In other words, if your parents and grandparents went gray early, you probably will too. When we are born, our bodies are already programmed with the information to begin the process.Other causes are vitamin B12 deficiency, anemia, vitiligo and pituitary and thyroid gland issues, stress etcetera.There is no perfect treatment for graying of hair until nutritional problems are diagnosed and treated. Please consult your dermatologist who will guide you in right way.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Penchila Prasad Kandikattu",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure scars on the upper lip after applying Nair kit?\n\nHey. At around 8pm last night, I put Nair on my upper lip and chin. I washed it off 4 mins later, and it left a rash. Now, I have scars that look like acne, I used Aloe Vera today. When will it diminish? Will it diminish by Friday? How can i make it disappear faster?",
    "doctor_response": "Hello. Thanks for writing to us at healthcaremagicThis rash is the result of Irritant contact dermatitis to the hair removal cream. Hair removal creams are notorious for causing irritant reactions.Instead of using aloe vera, If I was the treating doctor, I would have asked you to apply a moderately potent topical steroid e.g fluticasone propionate 0.05% cream, twice daily for the next few days.Steroids are antiinflammatory and therefore are effective and should make it fine over the next 3-5 days.An OTC oral antihistamine e.g cetrizine 10 mg once daily will provide you symptomatic relief from discomfort.Avoid using soaps on face till the rash heals. You may use a gentle cleanser Or just plain water.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful lump on the armpit\n\nOkay, so my friends were smoking pot on tuesday(four days ago) and I told them I didn t want to get high, I did take one hit even though I do not like weed at all. They hotboxed the garage and ever since then I ve had severe bloating and constipation. My skin is breaking out extremely bad all over, and I have a lump in my armpit. I haven t been able to eat much, and when I do it seems to make things worse. Even though I should have lost weight since I am not eating, it says I have gained!! What is going on??",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  Painful lump in armpit can be enlarged axillary lymphnode.  It may be due to some reactive hyperplasia, tuberculosis or lymphoma.  You should go for complete blood count, erythrocytes sedimentation rate and biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cure for the swollen and itchy bug bites with pus oozing?\n\nSo I have two bug bites, one on my back and one on my stomach. They have swollen and are really itchy! The skin is now feeling rough and is oozing a clear liquid. I don t know if it s a spider bite or what. It s been about a week and the one on my stomach does not seem to be getting any better.",
    "doctor_response": "Hello dear,Welcome to HCM.I have read your query and understood your concern.I usually advice my patients to apply antibiotic cream initially for 7-10 days twice daily like mupirocin 2% cream.For pain and inflammation , if no contraindication, you may take, anti inflammatory drugs like diclofenac/serratopeptidase for 3 days.I hope it helps, If you have further query, you may ask me.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is cough medicine safe while breastfeeding?\n\nHi doctor, My wife is a lactating mother of 2 months old baby. Since one week she is suffering with bad dry cough. For past 2 days she is unable to sleep. For every 5 to 10 minutes she gets cough. We consulted a doctor and had medicine. But, still there is no relief. I attached the\u00a0medicines that we have followed. Also had Ascoril-D syrup and Relent tablet.\u00a0How long does it take to cure the dry cough? Will the prescribed medicine dry up the breast milk? Can cough medicine affect baby?\u00a0We tried home remedies like\u00a0honey, ginger and black pepper.\u00a0After delivery my wife used to drink hot water only.\u00a0None of the above remedies worked. None of them reduced the cough.\u00a0Please advise us.",
    "doctor_response": "Hi. I went through your query and the prescription (attachment removed to protect patient identity). For further information consult a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i conceive after undergoing tubal recanilization surgery?\n\nHi..doctor I m NAZMA from Bangalore my operation of no more children was done in 2002. Now i m re married and gone through tubal recanilization on 17/12/2012 can i concieve a child after dat surgery can u pls help me any medicine or any tip to concieve soon pls doctor help me",
    "doctor_response": "Hi,Thanks for the query. The success of tubal recanalization varies from 30 to 50%.This depends on:-Time gap between tubectomy and recanalization. -Lengh of the tube remained. -Procedure used for tubectomy etc.After successful tubal recanalization, the possibility of pregnancy varies from 30 to 40%.To improve the chances of pregnancy:-Menstrual cycles, ovulation etc should be normal-Better to plan early after recanalization surgery. If you plan pregnancy in first 2 to 3 months after recanalization, the chances will be more. If recanalization is not successful, you may need artificial reproductive methods. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recovered after rehab from alcoholism, having gastro paresis and mesenteric artery syndrome, abusive husband for divorce. Suggestions ?\n\nHi my name is Ann and I`m so sad and worried about my daughter and four year old grand daughter. two years ago my daughter collapsed from alcoholism and after huge prayer and rehab . overcame this disease in our family. Now she has gastro paresis and mesenteric artery syndrone so a lot of symptoms resemble past lethargy and her husband is being verbally abusive at times and is definately triggered by past. His Dad, who he works with is the same way with him. At this time it looks like divorce or separation and my grandaughter is so distraught and cries easily. Her Dad does not want to go to alanon or counselling. He is a workaholic. What are your suggestions? We have been thru the terrible affects of divorce thru her Dad and my other children and am distraught to have 2nd daughter be in this mess. Her husband smokes pot every day at end of day. Thankyou",
    "doctor_response": "hi, it's very unfortunate for anyone to be in this situation. if her husband is not ready for counselling, only way left is regular counselling sessions of your daughter. Now it's time for her to overcome and even compensate for her past mistakes. During counselling whe will learn dealing with a difficult husband. It is possible that after some duration of her imporved behaviour, husband will start noticing it and may change himself. This will be very difficult for your daughter,but it is the only and best way to deal with this situation. She should make a sincere effort to save her marriage for future of her daughter. In your story it appears that her husband's abusiveness is due to past mistakes of your daughter, so chances are very fair that he will be ready to accept changes in her to save this marriage. best of luck for you and your family",
    "dialogue_context": ""
  },
  {
    "patient_message": "Broken teeth, pain in many of them, head pain, jaw pain, treatment\n\nI have several teeth that are broken, half gone and ugly! They have been like this for quite some time. Now- not being able to tell which one hurts, it seems that every tooth in my head has a dull ache. My jaws are sore and as well as my neck . I don t have funds or dental coverage to get it checked out. Can you possibly tell me what might be going on?",
    "doctor_response": "hello i read your problem,you have several teeth that are broken,half gone and ugly........ this is because caries spread to the roots and have damaged your teeth............. and your teeth pulp got infected because of that you feel pain.............. this pain radiate to the head region because of that you feel dull pain in your head region........... because of the same problem you have soreness........... i will suggest you please once go to the dentist and get proper treatment otherwise you will loose your      teeth....... so please go to the dentist at least once......... take care Dr.Gunjan Gupta",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes ear bleeding while suffering from viral meningitis?\n\ni was hospitalized for three day from june 5th through the 8th i was diagnosed with viral menengitus.....for the past three days my ear has been bleeding and hurting and now i cant hear out of it and my neck is starting to get really stiff again and the top of my head feels like ive been beat....should i go back to the hospital?",
    "doctor_response": "Thanks for contacting HCM I am sorry to hear that you have been having bleeding from the ear after having viral meningitis. I recommend that you seek medical attention. this could be as simple as an ear infection or onset of another type of infection or bleed.Hope this answers your question. Please contact us again with your questions and concerns",
    "dialogue_context": ""
  },
  {
    "patient_message": "Air hunger, dizzy, lightheadedness, tingling toes, fingers, radiating pain under left collarbone. Xanax ineffective. Advise?\n\nHi, a week and a half ago I went to the doctor because I had shortness of breath, and I felt like an elephant was sitting on my chest, and felt like I was drowning when I layed down. I was started on prednisone, Flovent, and givin azethromiacin on top of the albuteral inhaler, singulair and Zyrtec my doctor already had me on for asthma and hay fever. Yesterday I went back to the ER because I was having extremely bad air hunger, I was dizzy and light headed, my fingers and toes where starting to tingle and the pressure on my chest was worse and accompanied by a raidiating pain that started under my left collarbone down to under my left breast. The ER took blood and chest X-ray's that where normal and sent me home with a prescription for Xanax to help calm me down during an attack, threw out the night my left sided chest pain has gotten worse along with the pressure, and I have had no relieve using the Xanax, and I almost pass out every time I stand up. I've also had swelling in my hands and ankles when I work for the past few months. I'm worried about this pain and if I should go back into the ER today?",
    "doctor_response": "thour allergie might be due to increase in other systems i think you might be having heart involvement you much check bp as it may cause the chest pain swelling due to long term asthma and allergy there is backflow of blood leading to more congestion and swellingcontinue with med check bptake some diuretic to clear of fluids from body dony take any medicine like for sleep and anxietyconsult specialist under these guidelines described above",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back and shoulder blade pain after fall\n\nhello, I fell down the stairs on Saturday and I am still in a lot of pain. I have a large bruise on my right check and have a constant pain on the right hand side of my back and also my shoulder blade the back and shoulder blade only have a slight bruise. When I try and get up or bend down it seems to go in spasm/shooting pain for a few seconds. I have been taking ibuprofen which has helped a bit, have been trying a heated bean bag today which I thought was helping but now think it is making it worse. Could I have hurt an organ in my back? Should I go and get it checked out?",
    "doctor_response": "hithank-you for providing the brief history of you.A Thorough clinical neuromuscular exmaination is advised followed by an MRI of the cervical spine.As the symptoms insist more on the nerve impingement in the cervical spine and the symptoms like pain in shoudler blade, arms, forearm and hand.Treatment of choice will be a drug therapy to reduce the pain and also physical therapy to improve the functional abilities.due to falls certain times we can expect small trauma to the cervical spine as though your explanation about the fall also mentions same.For bruise on the cheek applying ointment for healing should make a help.In my clinical post fall most patients are advised for a thorough clinical examination and an MRI if needed.Physical therapy in combination with drug therapy has been helpful to majority of them.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to confirm an esophageal spasm?\n\nI know that I have a hiatal hernia. I also know that I get skipped heart beats. I also understand that heart burn can sometimes cause skipped beats. I sometimes go through a short period of occasional palpitations that are felt in the lower chest slightly to the right. When I check my pulse, I find that sometimes the palpitations have a skipped beat and other times not. The skipped beats are usually associated with the palpitations when I am under some sort of stress like excersizing or after eating a heavy meal. Could this palpitation be an esophogal spasm? I sure seems stomach related but feels like a skipped heart beat.",
    "doctor_response": "Hello! I understand your concern. In terms of skipped heart beats (that you say you know), I hope you have confirmed through examination and consultation with a cardiologist. If you have not confirmed I would recommend you to do some examination. First an ECG, second an echocardiografy to see the cardiac function, and finally a 24 h Holter cardiac rhythm to monitor your rhythm. For the problems with hiatal hernia and heart burn (gastroesophgal reflux) you need to do fibrogastroscopy and X-ray with contrast. Sometimes the skipping heart beat can be felt as spasms of the esophagus.In conclusion, I would like to say that it is better if you confirm the skipped heart beats and their nature, and get the appropriate treatment in case it will be needed and after consultation with a cardiologist. My recommandation is that you be careful with your meals because heavy meals are a known factor to \u200b\u200btrigger skipped heart beats. Also heavy meals worsen your heart burn. I hope to have helped you with my answer.You are welcome to write again if you have other questions. I wish you good health!Thank you for using HalthcareMagic Dr. P. Cerri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for enlarged liver and gallbladder pain\n\nMy daughter had her gallbladder out almost two years ago, she has suffered gallstone pain and very loose bowels ever since, she had a very swollen liver during her gallbladder removal and they put it down to all the infection. This week she was admitted to hospital again with severe gallstone pain, blood work is shower her liver is deranged? They think she has stones and sludge in her bile duct, would that be the reason her liver is so bad",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein and I will try to help you as much as I can.The cause is probably stone in main bile duct and it then causes liver to swell due to bile accumulation proximal to the obstruction. She must do ERCP to extract stones or surgery i this is unsuccessful. It should not be delayed. I hope I have answered you query. If you have any further questions you can contact us.Kindly regards. Wish you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Mirena cause alopecia areata with acute acne?\n\ni have had my mirena for around two years, a little over a year ago i started lloosing hair i went to a dermatologist who diganosed it at alopecia arearta it sarted of with one circle sport at a time, once the hair grew back another one woulld appear, the circles are now getting bigger and there are always 2 or three at a time. could this be the mirena i also have bad acne that nothing seems to clear up",
    "doctor_response": "Hello, I have gone through your query and your hair loss is not associated with mirena. Alopecia areata is a chronic autoimmune disease of the hair follicles. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Polycystic Ovary Syndrome. Take Duphaston. Had unprotected sex. Recommendations on taking Duphaston, Nordette\n\nI'm a 17 year old girl with Polycystic Ovary Syndrome.I got my period last year, I used to take Duphaston to regulate it.I had sex yesterday for the first time and it was unprotected. I've been told I have low chances of being pregnant but I'm very worried. This seems dangerous and risky but would it be bad if I started taking Duphaston again? Take one pill a day like how I was prescribed so I can get my period? Or will that just increase my chances of being pregnant?And would it be alright to take the day-after-pill Nordette?",
    "doctor_response": "Hi,Thanks for posting your question here, I will try to answer it to the best of my abilities.Duphaston is given to women with fertility issues, it is a synthetic hormone designed to replace the one your body isnt producing properly.Yes, if you start taking it you will get your period regularly and that increases your chances of getting pregnant. But that is better than having irregular periods and having intercourse when you didnt know it could get you pregnant.So keep using it and ask your boyfriend to use a condom.Yes, you can use nordette as a contraceptive pill, but I recommend you talk it over with your doctor once.I hope this answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does celestamine help to treat itchiness all over the body?\n\nHi Doctor, would it be possible to have allergies on shampoo?  Been using this brand before and I just stopped because I tried on a new brand and then I went back again to use the same brand. Then it sort of my scalp is starting to itch and I can feel itchiness all over my body.  But I have no rashes or anything.  Just weird itch all over.  Can I take celestamine for it and how for long?  Thanks",
    "doctor_response": "Hi,You can take Celestamine for itching and safe for long use.But important is avoid allergen causing this problem.Do not use shampoo for some time.Rule out other skin lesion like dandruff, fungal infection in scalp.go for regular head bath.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My intraocular pressure is 20 to 24 mmHg. Do I have glaucoma?\n\nHi doctor, I am 39 years old. My ocular pressure has been measured three times within the last month and values vary from 20 to 24 mmHg. The field vision test is fine. OCT shows some damage to the\u00a0RNFL. Do I have glaucoma? What treatment do you suggest?",
    "doctor_response": "Hello. In my opinion, we can still keep you in the category of 'glaucoma suspect' rather than labeling you with the diagnosis of glaucoma. To summarize, in my opinion, you are glaucoma suspect. If you have any family history of glaucoma, then I will start treatment for glaucoma. But if there is no family history of glaucoma, then I would like to wait and keep you under observation. I would like to get all tests repeated after six months for initial 3 to 4 times, and if findings are consistent and non-progressive, then we can reduce the follow-up to yearly once. I hope this will help you. Regards. For more information consult an eye care ophthalmologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Psychiatric patient unwilling to take medication. Prescribed Oliza and Sizodon. What to do?\n\nmy wife is a psychiatric patiant since 2007 now she is neither willing to take medicine nor visiting to any doctor ,currently taking Oliza-20 and sizodon fort but not finding elevant response.trying to feed her medicine makes her violent,she is assuming that we are trying to make her mental.what should I do so that she is ready to take medicne",
    "doctor_response": "hello welcome to health care magic In case the patient is not willing to take medication.........there are various choices of treatments like depot injections (required fortnightly), antipsychotic liquid preparations etc. You can also consider admission of the patient. Try consulting your psychiatrist for proper choice of treatment. Once she is stabilised, she will start taking treatment on her own. Hope it helps Good Luck Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain radiating from the mid back towards the nape of the neck?\n\nI am only able to sleep about 5 to 6 hours and then awake with pain in my middle to upper back, no matter how much I switch side to side it is painfull, but when I get up after about 30 minutes I feel fine with no pain the rest of the day, then back to bed and same thing happens again",
    "doctor_response": "Hi, The symptoms are more likely to suggest the possibility of spine-related conditions like disc prolapse. As a first line management, you can take analgesics like Aceclofenac or Tramadol for pain relief. If symptoms persist you can consult an orthopedic and get evaluated. An MRI scan will be required for further assessment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the treatment for eye infection due to pythium?\n\nHello doctor, My husband has an eye infection for the past two months. The doctors diagnosed that it is a fungal infection pythium keratitis. This infection might be from crops. They said that there is no anti fungal for this type of fungus and asked to apply Itral eye drop hourly, Zaha four times a day, Homide two times a day. A corneal ulcer is created and a white like thing is in the cornea. Vision is blurred due to this. Could only identify the objects. He is under treatment for the past 30+ days. Do we have treatment for this?",
    "doctor_response": "Hi. In case the organism is pythium as you have said, it has been found that it does not respond to available antifungals. Previously patients have been managed by corneal transplant to remove the infected organ so that it does not affect inner parts of the eye. Your decision will depend on how well the infection is responding to the treatment being tried. If it is increasing despite all the medications, a corneal transplant may be the only way forward. Better to keep serial photographs of the eye for comparison and easy decision making.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are sperm count 193.8, 63% total motility, 96% head defects, 24% mid piece defects, 10% immature cells normal?\n\nBelow are my husbands SA results. We have been trying for over a year with no luck. I am healthy and have no issues. What are the chances of us conceiving naturally with numbers like these? 2.8mL volume, 69.2 concentration, 193.8 count, 8.1 ph, 61% motility, 63% total motility, 4 progressivity, 2%\u00a0\u00a0\u00a0\u00a0\u00a0morphology, 96% head defects, 5% cytoplasmic droplets, 24% mid piece defects, 6% tail defects, 10%\u00a0\u00a0\u00a0\u00a0\u00a0immature cells Thank you",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern, as I always saying that pregnancy is more natural phenomenon and does not require any medicine, just single sperm fertilize the egg, it is just matter of compatibility, and luck too, in your case the chances of conception is fairly enough, just keep trying, be positive, you are definitely going to have baby, good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from cancer, got food poisoning. Taking cefspan injection. Continue to take?\n\nhi this is i wanted to ask that i am a cancer patient and i am taking medicines as i got injected recently... one of it is a antibiotic (cefspan) during all this i got food poisoning (yesterday) shall i still take cefspan which i was taking for my cancer thankyou loads :D",
    "doctor_response": "Hi Dear thanks for your question,your a cancer patient and on medicine for that,mean while you have got food poisoning,Dear there is no harm in continuing your medicine ,you remain continue with your cancer medicine ,that will not going to change course of your food poisoning",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is causing wheezing frequently in a child?\n\nHello doctor, My 5-year-old son has a wheezing problem right from one and a half years. A year back the doctor prescribed Foracort 100. I administered Foracort 1 puff daily for one year. Now, I have stopped it as adviced by the doctor. Still, he gets wheezing minimum one time a month and a maximum of three times during winter. He also gets wheezing whenever he has a throat infection. The allergy test was done and the doctor said my son does not have an allergy. Primary complex test (Mantoux test) proved positive but the doctor also looked at the chest X-ray and enquired about family history (no smokers, vegetarians, non-alcoholics). So she asked us to wait. No medicines were given. Why does he get frequent wheezing even when he has no allergy? Does he have asthma?",
    "doctor_response": "Hi. Generally, we would label your son a recurrent wheezer at this age. Asthma is not a diagnosis of the tender age. Wheezing is generally associated with allergy and not always can be found with a blood test. It can be an allergy to dust, pollution, dampness, pets or anything. Sometimes, we use Montelukast for a long duration to modify the wheezing condition. Ask your doctor for the same. Giving an annual flu vaccine also helps. Mantoux test is a non-specific test and does not confirm tuberculosis. Other investigations are performed in addition to the Mantoux test to confirm TB.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lumps in jaw\n\nI have a small lump under the left side of my jaw that I can move to the outside of my jaw. Its a little sore but nothing unbearable. My mom says she gets thoses sometimes too. I ve had this same lump before on the same side but they have always gone away after awhile. Any idea of what this is.",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You may have some reactive lymphnode or salivary gland inflammation.  You just need a course of antibiotics.  Mostly your lump will go away.  If it doesn't respond to treatment then biopsy diagnosis is advisable. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain at back side of neck?\n\nThe back of my neck is so sore and painful I can hardly turn it. I do not have any other symptoms - I have not slept on it wrong. This pain has been getting worse for the past month or so. The pain starts at the base of my skull and runs down the neck especially the left side",
    "doctor_response": "hiThere could be cervical spondylitis developing.Do hot turkey towel  fomentation, take muscle relaxant tablets like chloraxozone and aleve after meals.apply muscle relaxant gel like relaxyl, do not usepillow and use cervica collar in day time for few days till spasm is over,then by start isometric cervical exercises under a trained physical therapist.if it doesnt help, get MRI/xray of neck spine and visit orthopedic doctorthanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are the presence 2 pink lines in the pregnancy test a sign of pregnancy?\n\nHELLO DR. i want to know i m pregnent or not my last month my date was come on 25 July and today i done the test of prega news and result was 2 pink lines appear but one is dark pink line and another is light pink line is appear what is result m i pregnent or not.",
    "doctor_response": "Hello! Thank you for writing. Two pink lines means that you are pregnant, to be sure you can repeat the test again. Thank you. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of ovacare?\n\nim 22 married 3 yrs back....my gynac gave me ovacare for three months coz im now in abroad with my husband....two months have gone starting taking ovacare.....my due date was 5thjune but slight blood seen on 29th may....after that slight brown fluid is seen since 5 days.....what to do",
    "doctor_response": "Hi,Ovacare contains essential micronutrients commonly prescribed to help in increasing the pregnancy rate by improving the ovarian function. Generally it is well tolerated however it may cause dyspepsia, breast tenderness, irregular periods and loose motions. Based on the history you seems to have implantation bleeding suggestive of an early pregnancy. This bleeding stops on its own and doesn't require treatment. Get a home urine pregnancy test done and consult your doctor.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with allergic rhinitis, have itchiness, soreness and numbness on the chin with swelling on the lip. How can I do away with it?\n\nHi Doctors, For the last couple days my chin has been itchy, numb and sore, sort of like when novacaine is wearing off but I have not been to dentist and have not had novacaine. My lower lip is also swollen. I have a general rhinitis allergies and those allergies were going nuts last week as I had a brief trip to China and between the bad air quality in the long flights and the pollen from plants I wasn t used to my allergies were bothering me greatly. I have been home for 3 days however and this didn t start till Sunday evening, and the swollen lip didn t start till yesterday (Monday) evening.",
    "doctor_response": "these are allergies        as the allergic rhinitis patient it has effected skin and mucosanuts are known to trigger allegies   you can take antiallergic like ebastine 10 mg bdapply boroglycerine mixed with betamethasone locally in affected lips and mucosa continue 10 days and then get consultation from allergy doctyor andf treat allergic rhinitis this will cover allergies of skin",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is hypermobility syndrome and fibromyalgia is genetically transferable?\n\nmy daughter is diagnosed with hypermobilty syndrome, her physio has suggested she also had EDS 3, which my doctors wont refer her to get this proven and now ive seen marfan syndrome and she shows all the typical signs of this to aswell as fibromaygia, is this possable? I myself had HMS M.E/CFS fibromaygia, does this make her at risk of getting it?",
    "doctor_response": "Hi, I have gone through your question and I understand your concerns but unfortunately yes this increases the risk. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can primary complex relapse?\n\nhi..my son skin test or ppt is negative..y his pediatrician requested us to undergo him again for xray? then she reads the plate and said its still there..to think that we already finished the six months treatment of his primary compex. Is primary complex be repeated?",
    "doctor_response": "yes sir primary complex relapse can occur, in few conditions after the course duration finished also infection can persist, in that cases we will continue the treatment for some more time, mean while they can do culture also to know the sensitivity of the microorganisms, any resistance is observed they will change the medicines or dosages. skin test is negative doesn't indicate that it is cured, we will use other investigations also to confirm the result",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for palpitations,breathlessness and chest pain\n\nHi,I have had both atrial Fib & atrial flutter for approx 3 years.I have undergone cardioversion which lasted 2 weeks,then cardiac ablation which lasted 1 week.am awiting follow up in approx 5 weeks.Although symptoms are not as severe am still having palpitations,breathlessness,chest pain etc on average twice a week.I take warfarin and flecainide. Would it not make sense to fit me with a pacemaker as my quality of life feels poor and as a 57 yr old man i can t except that.Thanks Dave",
    "doctor_response": "Hello, I suggest you see your cardiologist and do a 48 or more ECG Holter monitoring to see the heart rate trend. Based on the result the doctor may change the medications. It's not a problem to destroy your normal biological pacemaker and put an artificial one, but it is better for your heart to work by itself, and regulate the heart rate with medications. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Anila Skenderi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated levels of SGPT and bilirubin?\n\nhello doctor my husband has just has their blood test every thing is normal but only sgpt rise to 65 and bilirubin direct to 0.43 so what does it indicates ? and my husband now also diagnose with a hbp of 135/95 and started medicines as amlopin 2.5",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.Liver enzymes are reasonably sensitive indicators of liver damage or injury from different types of diseases or conditions, and collectively they are termed liver tests or liver blood tests. So the next step is to look for certain liver damage and most common cause is fatty liver disease. It should be confirmed by ultrasound. Other causes are viral hepatitis,cirrhosis, medications, alcohol intake or autoimmune diseases. To verify exact cause, US, bilirubin levels and tumor markers should be additionally done Then appropriate treatment can be started.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat shingles of the face and severe UTI?\n\ni am 26 years old and just found out i have shingles of the face and i also have a uti.the meds are not helping and the pain is more than i can handle.the aclyovir is causing me serve chest pains and i dont know what to do plus my uti is getting worse.",
    "doctor_response": "Hi,The shingles will have to be treated with acyclovir. A painkiller can be added if you feel the pain is severe.Acyclovir is a peculiar medication because it causes your serum uric acid levels to rise which in turn can precipitate a kidney stone which in turn leads to aggravation of UTI due to urine stagnation.  But since the treatment options are restricted we can to continue with acyclovir. You can consume potassium citrate salts dissolved in water that are prescribed in UTI's to reduce your symptoms.I know it sounds bad but sometimes in medicine your agony peaks before you get better. So please hold on.Thank you for your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for multi minicore disease\n\nI have been diagnosed with multi minicore disease, an apparently rare genetic condition. Although I am now 71 years old, this condition was not diagnosed in me until I was in my late 60s when I consulted my GP regarding my sudden inability to hold my head up because of neck muscle weakness. A muscle biopsy was performed in December 2013 resulting in the above diagnosis. I have been trying to locate a neck brace or collar which will allow me to hold my head up in a normal position, as at the present time I must either force my head up by forcing my chin up with my fist or the open palm of my hand. I have tried a Miami J collar which was promising but was damaged to the point of semi-uselessness by the weight of my head causing buckling of one of the side supports. I was given an Aspen collar by the orthotist to whom I was referred, but it is so uncomfortable that I cannot use it for more than half an hour at a time without unacceptable levels of pressure pain along the jaw line and breast bone. I live alone with my 89 year old husband for whom I must help perform many activities of daily living. Any advice regarding a different type of head and/or neck support would be greatly appreciated. (I am an American citizen residing in the UK as the spouse of a British citizen.)",
    "doctor_response": "hiIn britain, it is easier to consult an orthotics expert anfd an orthopedic doctor in a hospital.Four post collar is designed for your purpose which has adjustable screws and may be obtained from rehabilitation centres or prescribed from speiality centres in UK. You GP should be able to guide you better and refer you to an orthotic/orthopedic specialistthanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Irregular periods, no ovulation, can bromergon help me conceive ?\n\nI am 28years old I have been married for 4years now an I have be trying to take in but no way and I have been having a mentral disorder ,some months the mentration will some months it doesn t come at all and I don t even ovulate at all,so. I want to know if their is any drug I can take.an socondly a friend of mine told me about a drug called BROMERGON but I havnt tried it course I don t know how it work.",
    "doctor_response": "Hi, Welcome to Healthcare Magic. I shall explain the standard line of action in a case like yours. If you are trying to conceive for 4 years & are unable to do so you should go to a fertility clinic with your husband. They will check both of you & find out all the causes preventing you from carrying a pregnancy for so long. Your period problem & lack of ovulation may be just one of them. There could be other causes as well. After full evaluation & listing all factors responsible for your sub-fertility as a couple, can a medicine be prescribed to you. Taking any medicine especially Bromergon without an indication, without a prescription & just as your friend says so is a very DANGEROUS practice. I strongly recommend against it. Wish you follow the correct path. Best of luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infected sebaceous cyst on lower back\n\nHi I am 17 weeks pregnant and last week was diagnosed with an infected sebaceous cyst on my lower back.  I was given an antibiotic to clear the infection but this does not seem to have worked as the area is still tender but has now turned purple.  What will be the next stage of treatment ?",
    "doctor_response": "Hello mem,Good evening, First of all congratulations for your pregnancy...Now coming to your question about sebaceous cyst infected sebaceous cyst...Generally sebaceous cyst is quit common n if it is there n yreatment of choice is incision n drainage...Now you have infected sebaceous cyst then treatment of choice first control your infection n then incision n drainage...So don't worry mem you are on right path of treatment...If you have any problem then just raise question to your surgon he/she ll give you ans after examining that part n cyst perfactly as without examination I can not give any comment for surgery...Thank you,Regards,Dr.Ravi Kotecha",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes coughing and fever in a 18 month old baby?\n\nHello doc, My 1.8 yrs old son has cough and cold from the past 10 days, he is on antibiotics since the last 6-7 days, he has bad cough and cold but no fever, his pedia asked us to get the TLC and DLC test and the results of which are : His Hb: 9.4 gm, TLC : 6300/cumm, NEutrophil :20%, Lymphocyte:77%, eosinophil:0%, monocyte: 03% and peripheral smear is 03%....can u please tell me its meaning and what is the cure...",
    "doctor_response": "Tests are not much bothersome except increased lymphocytes denoting infection or viral. And some nutrition has to be corrected by giving the child soups and juices containing iron.If I were your family doctor, I had insisted to give child most safe and harmless four herb combo esp designed in classic Ayurveda for small children to address seasonal and/or infectious respiratory tract congestions, fevers, lose motions, vomiting etc besides correcting metabolism, detoxification of intestines, carminative, creating immunity and cleaning lungs, bronchus etc. It is commonly available in India or ordered online. While you finish the course of current antibiotics regime, may start later too to convalesce fast or start giving parallel with some time gap. It doesn't Interact with other drugs. 1/2 to 1 gm is the usual dose with honey. Once addressed with it, ailment will not repeat anytime soon even in winter.Hope it helps. If you need more guidelines, pl do not hesitate to write direct question to me on HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in the hands of a child\n\nmy 2 year old daugther experiences hands (fingers particularly) and foot pain in the middle of the night. Or whenever shes about to sleep at night. She starts to scream and end up sleeping around 2 or 4 in the morning, sometimes, no sleep at all. This started two weeks ago.",
    "doctor_response": "i think not to worry for these symptoms. i supplement with syp calcium and multivitamin to these type of children and they respond by this . pain will go by the time",
    "dialogue_context": ""
  },
  {
    "patient_message": "Shaking hands from wrist to fingers. Cause? Done taekwondo training\n\nHello.I have a problem with my hands,especially the right one shaking from the wrist down to my last two fingers.It happened on a training camp a few months ago.I am practicing taekwondo for a few years now,and this year when we were doing a rutine technique exercise that requires punching really strong and fast I noticed my right hand just shaking really bad.I m 14,by the way.So,I was worried what might have caused this,but I guessed that I have probably just overtrained my hands and it was normal for the nerves to act that way.It continued for some days,though.a little shaking in the left hand and a lot of shaking in the right one.At the end of the camp that was almost entirely gone.Two or three months after that,on my last training session we again did some of those techniques and it started all over again.It s been two days,and I have a big international championship tommorow.I don t think that would really damage my performance,but who knows?So please,tell my what that might be and if I should consult my doctor.",
    "doctor_response": "Hi, thanks for writing to HCM.Shaking in hands or fingers after a vigorous workout or exercise is considered as NORMAL and may be Physiological. This usually results due to Hypoglycemia.These do not require any specific form of treatment. The fatigued muscles should be given adequate rest to recover. Drinking a small cup of juice or regular soda or eating a piece of fruit can stop shaking after exercise or workout resulting from hypoglycemia.You have to make sure that adequate hydration (not become dehydrated) is maintained before & after exercises.Hope this information is helpful. Good day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sever asthma and acid reflux\n\nMy daughter is 16 months old and ever since she was born, she has cried excessively at night. She has severe asthma and severe acid reflux. The doctors say that it s not her acid reflux, they have done multiple tests. She s had an EEG which came back normal. They said that they thought she had colic when she was an infant and that she would outgrow the excessive crying, which she hasn t. This is an every night occurrance. She doesn t just wake up a couple of times. This is 10-20 times EVERY night. No matter when she goes to bed, this happens only at night and never during her daily naps. When she cries she arches her back like she s in pain. This has been going on for 16 months now! I need help for my baby girl (and some sleep!)! Please help me!",
    "doctor_response": "sandifer's syndrome seems likely - she needs upper GI workup to rule out hiatus hernia and she needs a course of H2 blocker (esmoprazole) for 2-4 weeks and if she still has problem, get her evaluated as above suggestion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Blood test showing low hemoglobin levels. Had normal barium enema in the past. What is the cause for a low blood count?\n\nI am 46, 5 5 and 130 lbs. I exercise for an hour 6 times a week and recently I had a blood test in my annual check up that revealed my hemoglobin level of 104. Doctor called me in, and I discovered the previous year it was 109, the year before 115 and then 9 years ago it was 126. My weight has always remained the same for at least 20 years and I eat a healthy diet. 4 years ago I had a barium enema (as I had pain in my right side, which I still have) and it came back clean. A year later I had MRI on my liver and gallbladder and that too came back clean. I am now just worried why my blood count is low. I did get retested yesterday, and results showed 110, but it still is too low. I m just worried what could be causing this.",
    "doctor_response": "Hi, welcome  to HCM , I am Dr. Das         First  of all, to comment on a low hemoglobin level, a complete hologram including the hematocrit value is necessary. So, if you didn't do that, go for that test, upload that and then i will tell you what to do.            One small thing that may be overlooked many times is a worm infestation. So, just take a course of albendazole 400 mg once daily for 3 days. It should be taken after taking1 .hr of diner .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cirrhosis of liver\n\nI have cirrhosis of liver - I don t drink anymore and have not for 6 years - my doctor s office called at closing time and asked me to come in and redo blood tests because Bilrubin level is at 3.0 - it has only ever been up to 2.4 4-years ago / 2.2 9-months ago and I had an ultrasound done then - it showed gall stones - could the gall stones be blocking a duct ??? I just started taking phentermine 37.5 per day Monday to lose some weight - I have taken them before - have not had much sleep - body is stressed from 1500 calorie a day diet Current weight 182 - goal - 175 age: 49",
    "doctor_response": "hello dear.i understand your problem.being a patient of cirrhosis along with gall stone you will have raised bilirubin.to differentiate between these two look at report of liver function test. stone in Common bile duct causes raised direct component of bilirubin along with raised alkaline phosphatase enzyme.another mean is ultrasound study, which shows stone in bile duct or dilated bile duct and intrahepatic biliary redicles.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce stress?\n\nMy period usually comes around the 15th. When I noticed it didnt come I took a pregnancy test on the 20th that came up with a negative result. Its now the 27th. A couple days ago I started feeling a little off like slightly sick to my stomach and my back was a little sore. Yesterday on the 26th my period came. Or at least I believe it is my period. I was cramping all day which is normal for me on my period. It was heavy flow during the day and then it has slowed down later tonight. And now today my period is way heavier then normal. The last time I had sex it was on the 22nd of last month so it would make it 5 weeks ago. I was so happy when I started what I thought was my period cause that means Im not pregnant right? What does this sound like to you? I have been under stress. I had finals at school then when I thought I was pregnant i was freaking out. Should I retest it or is pregnancy ruled out? and also is it normal for a period to be heavier if its late? And if I should retest it does blood screw up the results?",
    "doctor_response": "If you have had periods it does confirm that you are ot pregnant. Heavy periods is likely if there was any discrepency in the length of cycle. There is no need to reset the period. There appears no reason to be worried as such. Dr Pankaj Borade",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of infertility in a woman with polycystic and endometriotic cyst ?\n\nHi doctor , my age is 30 year old and my i marry at 2009 nov,i have polycystic and endometriotic cyst but my period always regullar not any problem. My endometerial echos are 4.6mm. Is it normal? bcause i want baby all force is failaur.",
    "doctor_response": "Hello ruby; welcome to HealthcareMagic The most important requirements to get pregnancy are:- -regular periods -proper ovulation and rupture of follicle to release egg -patent fallopian tubes -normal semen analysis of your husband. Since you have endometrotic cyst and PCO(poly cystic ovaries ) you need to be treated for that first;then the doctor will help you with medicines and treatment for further management. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Upper back and shoulder blade area experienced popping sensation. Is that the reason why I have difficulty breathing?\n\nI was in the middle of sitting down and I sneezed. I heard a crack and now my upper back somewhat in line to shoulder blade hurts. I can t breathe right because it hurts bad. I m 15 and play basketball so it s important I please get a reply. Thank you",
    "doctor_response": "this may be the cause of your back pain and difficulty in breathing. for this type of symptom i prescibed the patients tablet acelofenac+thiocolchicoside twice daily after meal with pantoprazole  for five day and investigate with chest xray PA view.i advise you to contact your physician to prescribe drug and investigathio",
    "dialogue_context": ""
  },
  {
    "patient_message": "High BP and diabetic patient feeling tired, head heavy and breathless after climbing stairs\n\nHI im 42 ive been suffering with high bloodpressure type two diabeties i have been suffering with sickness and extrean tiredness for a long time my head feels heavy and when i climb stairs i feel out of breath and dizzy or when i walk ive been having muscle spasms also which stop me in my tracks",
    "doctor_response": "Hi,I would advise you to check your glucose and serum electrolytes levels.Also I would advise you to see a cardiologist to undergo a cardiological examinatoins to exclude cardiac cause of your complaints.Wishing you good healthIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to conceive after an ectopic pregnancy while having one fallopian tube?\n\nhi im 33 ive previousley had 4 children and approx 7 years ago i had an ectopic pregnency and had my left tube removed i have had an implant but i had it removed in jan 2011 i have been trying to concieve again but have had no luck is there nething i could try to help me medication wise?",
    "doctor_response": "HAI WELCOME TO HCM CHECK YOUR TUBAL PATENCy AND OVARIAN RESERVE.ovulation induction with follicular monitoring will make you pregnant.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with ear pain, cerebral atrophy. No relief with medicines. Help?\n\nMy mother is suffering with Tmj Ear pain hi im prashant My mother is suffering with Tmj Ear pain i hope ull help me my mother aged 65 is suffering with cerebral atrophy since 18 month.her symptoms are severe ear pain .we have got done all the tests like (CTSCAN , PNSSCAN, MRI ) where the doctors found it was this problem. her MRI test contrast has Age related cerebral atrophy. she doesnt have memory loss nor recognizing problem nor speaking disorder everything was normal except for the severe pain frequently what r the medicines to be used for reducing her pain of severe pain in the inner ear can we r very much confused y shes undergoing such pain .can any tablets be given to her for treatment of diffuse cerebral atrophy. Mri brain study report (A small vascular loop is in contact with cisteranal portion of right 7th & 8th nerve complex with normal course , thickness, signal intensity of nerve complex) Currently taking medicine :- Pregabalin 75 mg, Mecozen plus , pacitane There is no effect of above medicine she having a pain as it is please suggest any other medicines so that she will get well soon looking forward for ur help thanking u",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for asking a question to H.C.M.F. Your mother had cerebral atrophy, and un bearable ear pain due to infection of the internal ear. Your mother is under the treatment of a neurologist for cerebral atrophy. It is a permanent change with no way for complete relief.And she is using medicines for maintenance. Now she has got ear pain due to infection of the internal ear. That is to be treated completely . So i advise you to consult an E.N.T.surgeon for diagnosis and treatment. he will give treatment for medical treatment, if no relief he may propose mastoidectomy, with advise of the neurologist. There is a possibility of complete relief. Wishing for a quick and complete recovery. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What makes the oncologist prescribed 6 BP medications along with 8gm salt?\n\nHi, I have a 77 yr old relative who has had a brain tumor removed.  Prior to the surgery, she was on 2 blood pressure medicines.   After the surgery, the oncologist has placed her on 6 blood pressure medicines and is supplementing her with 8 grams of salt per day.    This seems to be counter productive and is very concerning to our entire family.   Any thoughts on why this would be the protocol chosen?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have high blood pressure.  Taking salt and antihypertensive medicine both looks slightly controversial. But you may need some salt.  You should check your blood pressure. Drugs depends on level of blood pressure and other factors.  Please send me your blood pressure reading and all antihypertensive medicine name. So tat I can help you further. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the early signs and symptoms of pregnancy?\n\ni got my periods on 3rd june and after unprocted sex with my husband took my ipill withing 24 hrs on 8th june to my suprise i had little bleding on 24th june and after one day it stopped andthen again next week i had little vaginal bleed for one day and on an off i was worried and i did a pregnancy test on last tuesday but it was negative,please tell me when will i get my next regular period, i am very worried",
    "doctor_response": "Hello dear,I understand your concern.The ipill is effective in 95% of cases if taken within 72 hours of unprotected intercourse.It is good that pregnancy test is negative.The ipill is a high dose progesterone which has sideeffects like nausea, vomitings, abdominal cramps,hormonal imbalance etc.Due to this hormonal imbalance it effects the timing and bleeding of the period.That means the period might come early or late and the bleeding can be scanty or heavy or irregular.So the irregular bleeding is due to ipill effect.This effect of ipill persists on one period but rarely its effect might be there for 2 months.So wait and check for the period.You might get the normal period around the expected date of next period probably around July ending.But the date of period cannot be told exactly.Hope this helps.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen glands on the face and neck with labrynthitis?\n\nHi there, I have been diagnosed with labrynthitis which started almost two weeks ago.  I was given Cinnarizine which was needed for 2 days before symptoms faded.  I had a busy weekend and on Sunday I became really ill again, vomiting and feeling extremely dizzy and week.  I re-started the Cinnarizine but for three days this didn't help.  I went back to my Doctors and was given prochlorperazine which has improved the dizzy, sickness, and feeling of a 'full/pressured' head.  However, this morning I have woken up and the glands down the one side of my face and neck are huge, and sore.  Is this part of the labrynthitis or do I have something else going on?  Many thanks",
    "doctor_response": "Hello,It can be part of the labyrinthitis. Often these types of conditions are caused by a virus and the lymph nodes swell up to help us fight off infection.See your doctor again if the nodes do not resolve in a few weeks or if you are developing new or worsening symptoms.Dr. Robinson",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is stem cell therapy ?\n\nexplain about stem cell therapy",
    "doctor_response": "hello welcome to health care magic. stem cell therapy is a relatively new modality of treatment being tried for certain diseases. there are only a few diseases which might benefit from stem ceel therapy. stem cells are the initial cells /embryonic cells which have the potential to divide into adult cells . these then are useful in treatment of certain diseases, particularly degenerative/neurological diseases. if you want to know whthere stem cell therapy can be used for a certain illness you must consult the specialist of that illness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is tremors a sign of Parkinson's disease?\n\nHi, recently i have been noticing that when i hold a pen in mid-air, i will start to have tremors. It is not really a big tremor but just a slight one. This is starting to worry me as i'm afraid i would have parkinson's disease (my grandfather suffered from it) . I'm only 16 so i wonder if it is possible to get parkinson's disease at this age. My exams are also coming up and i guess i've been stress too so i'm not really sure what's the cause of it?",
    "doctor_response": "HiThanks for using healthcare magicTremors at young age is due to stress or anxiety. It is not due to parkinson disease. Only basis of tremor, we never make diagnosis of parkinson. May be due to exam, you are in stress and in that case, you should do some relaxation exercise like JPMR or deep breathing exercise. It would help you to stay calm. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could relapse of high fever indicate increase in infection?\n\nmy pus cells is 20-25 and i was injected last night w/ paracetamol injectables due to high fever and chilling then i was relieved that night and i took antibiotic last night and early this morning. 5hrs ago i'm suffering fever and my temp reaching to 38.3. i would like to ask if it is getting worst? please advise.thanks",
    "doctor_response": "Hello and thank you for your question. Recurring high fever can indicate a worsening of the infection. It is also true that antibiotics can take a few days to start clearing the infection and thus lowering the fever. If your fever is not down in a few days you need to return to see your doctor. If you perceive that you are getting worse instead of better then a return to see the doctor immediately would be a good idea.Thank you for using HCM",
    "dialogue_context": ""
  },
  {
    "patient_message": "Small scratch on the arm, spreading and becomes huge scab. What is it ?\n\nHi , I am 14years old. I was playing around with my boyfriend at the park and I fell on the concrete. I had a small scratch on my arm, in the elbow area. I picked at it a little and it spread and got huge. It looks like a huge scab now. It has small bumps around it and it peels. I am really scared. My mom said it doesn't look right and she wants to take me to the doctor. I hope it is nothing serious. I am putting neosporin on it and i hope it goes down. Please help! I don't have herpes or anything, I'm a virgin.",
    "doctor_response": "Hellow, the commonest cause of scab after injury is Bacterial infection. you have wound followed by cellulitis, for this u need a course of oral antibiotics and continue topically Neosporin.. u can mail your pics on drjangid@gmail.comwill able to diagnose properly .. thnks you very much ..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does pain fumes increase hemolysis and spleen pain while having g6pd?\n\nOur son, age 24, has chronic g6pd. He has had two transfusions throughout his life. He helped his brother paint for two days and is now is experiencing pain associated with his spleen and increased hemolysis.  My question is, can paint fumes cause a crisis?",
    "doctor_response": "yes, in many cases it is observed that paint fumes can causes crisis in G6PD deficient patients. there are many drugs also which accelarates the G6PD deficient state. avoid paint fumes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is masturbation safe while wearing a holter monitor?\n\nDear Doctor! I have to wear 24 hour holter and i would like to masturbate to check on the diagramm. But i dont want to be look like as who cant wait one day.. Will the doctor knows i masturbated? I know its normal etc.. Sorry for my grammar but apprechiate ur help! Thanks, Tom",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Regarding your concern, I would explain that sexual intercourse is evaluated as a medium intensity physical activity. Masturbation is a similar activity. It may lead to some tachycardia, but nothing special. You can take note of the time and refer it as running or jumping. There is no way the doctor can know what you are doing at that moment. Hope you will find this answer helpful!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain radiating to shoulder and neck?\n\nI have had several episodes of severe abdomen pain with pain radiating out my left shoulder and nesk accompanied by violent diarehha and sometimes nausia. This always happens after eating.  I eat small portions because I thought this may stop it. My gallbladder is gone.  I am female 61",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.The causes of pain in abdomen with violent diarrhea and nausea can be due to an inflammation of the large intestine or an inflammatory mass near the intestine.What makes this odd is this is associated with pain radiating to left shoulder and neck. This occurs if the inflammatory mass is touching the left diaphragm, hence the diagnosis gores in favor of colonic diverticulitis ...As a precaution and ECG and cardiac check up is necessary. I would advise you the following :ECG as already said.Colonoiscopy and biopsyCT scan of the abdomen. The treatment will depend upon the findings of the investigations",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can I do to manage fatigue and backache while suffering from a kidney disease?\n\nI recently have been diagnosed with kidney disease and had an ultrasound done yesterday. But here is my questions. For some time now I experience fatigue, back pain that can be severe at times. It\u2019s not that I feel sick I just feel different. It\u2019s hard to explain. I have the desire to rest a lot but I am normally a very active person. What can I do to keep myself going and not want to stop so often?",
    "doctor_response": "Hi, The kidney disease is one of the cause for fatigue. So you need to get treated for kidney disease according to cause. Additionally you can investigate as follows: _CBC to rule out anemia _serum TSH estimation to rule out hypothyroidism _serum vitamin D estimation to rule out low calcium _SGPT, SGOT estimation to rule out liver disease You can revert with reports once done. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What was the sweating,swelling in face and headaches after a tooth extraction?\n\nHi, had upper tooth out today due to abscess but when i got home i was very unwell, sick, hot, sweaty, swelling to face and neck and very painful headache, earache and neckache....was worse than giving birth! Why was this...still not feeling to great.",
    "doctor_response": "Thanks for your query, I have gone through your query.the sweating,swelling in face and headaches after a tooth extraction is the radiating pain because of the inflammatory response to infection in the tooth. Nothing to worry, Take a course of antibiotics like like amoxicillin 500mg and metronidazole 400mg tid for 5 days (if you are not allergic). Do saline gargling.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard bump on my testicles?\n\nwhat dose it mean if i shave my testicles and then get a acne type spot and have to pop it but then it never really goes away it just has a hard bump in that spot that occasionally swells just like acne? what does it mean when the foreskin becomes balloon like???",
    "doctor_response": "HelloThanks for query .The repeated bump that you get on Scrotal sac is Sebaceous cyst and needs to get excised in Toto by a qualified General surgeon .The balloon like appearance of foreskin is termed as Paraphimosis that usually develops after dry vigorous sex or masturbation .Dr.patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On birth control, unusually light period, overweight. What is going on?\n\nI started low dose birth control on Friday May 4th.  It was the first day I had blood spotting for my expected menstrual cycle.  I have taken the pill every day since at almost the exact same time. And I have not had sex or any physical contact with any men at all during this time.My period was unusually light for an entire week.  I thought maybe this was a result of the pill.  But now it is 15 days later and my period is still going.  Today was the heaviest day yet.  Can this be because of the pill?  I should probably mention that I am overweight (5ft 3.5 inches 209 lb).  I have an appointment with my doctor on 5/30 but now I'm getting concerned.",
    "doctor_response": "Hi.Thanks for asking in Healthcare Magic.Light or heavy flow, delayed or frequent period, irregular period, spotting and bleeding between period are all the different types of effects of OCP seen in various people in the initial few months. It will take 3 to 6 months for the period to get regularized after starting the pills as you are taking a low dose birth control pill.Although you are not sexually active, you should continue the pills irrespective of the bleeding after the permitted gap for menstrual period. The bleeding will be controlled when the hormonal level increases if the pills are taken regularly.Obesity with light period may indicate PCOD. The OCPs can result in weight gain in the long run and so you should reduce your weight. Since the bleeding has increased and is persistent, it is wise to consult the Dr. A combination of drugs like Mafenamic acid and Tranexamic acid  will help to control the bleeding. Your treating Dr will know about these drugs.I hope this is useful to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can excessive masturbation cause testicular pain?\n\nim an 18 year old male and i used to masturbate ALOT, and now only do it like once a week or every other week, but even b4 i slowed it down, i have a little testicular pain and around that area often. is this something i should worry about or will it go away with time and less of doing it?",
    "doctor_response": "Hello, It will resolve with time according to my opinion. Sometimes excess vigorous masturbation can cause such mentioned discomfort. So you may need not to worry about that. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a hard swollen lump on the jaw?\n\nRed lump on Jaw Line-Recently i have had this hard red lump on my Jaw it is very senstive hard and swollen, now it has developed a white center that is soft when i push on it it is about the size of a fifty cent piece. I do have a cavity and before this happened i was experiencing a tooth ache.",
    "doctor_response": "Hello:)Welcome to HCM.You are suffering a abscess relation to the tooth which has a cavity.I suggest you to get the treatment done as early as possible to avoid any further spread of infection.Take antibiotics and analgesics to subside the infection.Get a x-ray done to assess the tooth and bone.Use a warm saline gargle twice daily.See your dentist immediately.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are stomach pain and hard stools with sticky substance symptoms of amoebiasis?\n\ngood morning. my son has been suffering for some nagging stomach pains the past 2 days, and each time it occurs, he has the tendency to move out . But his stools are not soft but contain some sticky substance. Does this manifest that he has amoebiasis?",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice.By what you say, I do not feel that your son is having amoebiasis. The symptoms you are quoting are more towards bacillary dysentery. I suggest that you consult your pediatrician as this might require antibiotic therapy. Antibiotics are prescription medicines.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "28 year old with swelling in the feet. Could it be heart or kidney related?\n\nI m a 28 year old male and I ve had an issue with my feet swelling up a lot, it s been happening off and on for about a year. They will particularly balloon in the afternoon and the skin is tight and it s very uncomfortable to walk around in shoes. in the mornings it s still swollen but not as much. There s no real pain, just the tightness of the skin and related pain from that when i walk in shoes. I ve tried reading up on what it could be but none of it really sounds like unless it s a heart issue or kidney or something else that could somehow have no other side effect.",
    "doctor_response": "Hi,welcome to HCM And Thank You for the query. I think it would not be genuine to just decide on the basis of given symptom. firstly i would souggest you to diagnose whether its pitting or non pitting type of swelling? Is it oedematous? It may be due to hypertension?go for Blood Pressure measurement. Go for Complete blood test.tell me more about your weight? Is there any swelling under eyes? Any Injury before ? Any medication you are taking? Any joint affected? Provide us with more details for further guidance. Hoping good health for you. Many Thanks , Dr Shilpi Gupta",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tiredness and irregular heart beat while on Curcumin?\n\nI am taking a supplement, curcumin as a pain reliever. I have noticed in the last 2 days that I have been very tired and my heart is beating irregular. I had SVT a few years back but was treated with surgery and Norvasc for hbp. I m not taking Norvasc now because my bp is norman to low. Today my bp is low also, 95/56 and99/62 and now back up to 114/76. Curcumin 1000mcg twice a day for a month. Could this be the problem?",
    "doctor_response": "HelloThank you for trusting HCMDear no studies have shown that curcumin cause tiredness and irregular heart rate.  if your allergic to drug there is a possibility of  some side effects. most common side effects related to gi problems. it is also cause renal stones by increasing oxalate excretion.dear please consult your doctor  probably your developing arrhythmias . if your allergic to this   drug please stop and see. cardiologist will examine and take ecg , treat you accordingly.take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for chronic back pain\n\nmy sister age 35 years sufferring from severe backpain from 2 years and now she could not able to get up. she is in rural place , doctor told to some tablets and told it will cure in another 2 months, but patient should take bed rest, doctor told that some pus is formed on the backbone you should not journey and take complete rest untill it is cured",
    "doctor_response": "HiThanks for posting your query.     There are many causes of chronic back pain but only few will cause inability to walk .      If your doctor's diagnosis is right then  she needs to be admitted and given injection not just tablets.         If you have any reports of her kindly upload so that i can go through and advise better. If none done its better you get MRI lumbar spine and revert back .   Any clarification feel free to ask .   Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure a crack on the left side of rib cage ?\n\nHi. I recently had a car crash and i may have a cracked rib on my left side. It aches constantly and is very frustrating and uncomfortable. There is a boney lump where the pain is but my main concern is when i sneeze or cough my left arm goes tingly and hot. Is this normal?",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, if the rib fracture are well stable then this is nothing to worry but you need to be very patience because this may take some time to heal till then be patience but later or sooner it will be fine, and then there would be no pain at all, some time rib cage brace would be fine and you can try this, hope this information helps, take care ( If the fracture is not stable then may need some surgical interventions)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for viral fever with temperature of around 106\n\nHi my daughter has had a fever for 2 weeks and initally diag with viral illness. Her PCP and hospital doesnt know whats going on with her and for the past week vomiting. All test came back neg, urine, blood and xrays. She was coughing so they gave her a antibotic and told me to call if it goes up again. I just checked it and its 104.6. When i went to the ER it 106..",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.By what you say this looks like a typhoid fever or a urinary tract infection or a prolonged viral illness. As fever has been there for almost 2 weeks, if I was your pediatrician I would have done blood culture and urine culture and a tube method Widal test before starting antibiotics. If fever is still persisting, I would give intravenous antibiotics.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sumanth Amperayani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is high TSH level harmful while going for IVF?\n\nHi Doc , I am planning for a IVF preganancy, my TSH is 18 uIU/ml. What are the consequences of this. Should I go for IVF or wait for TSH to be controlled with medication. My age is 33 years. The IVF specialist has prescribed me Eltroxin 50mcg. Do I need to consult and Endocrinologist. Thanks - Prerna",
    "doctor_response": "Hi prerna, Welcome to HealthcareMagic .Normal tsh should be between 0.5 to 5 micIU/ml. Yours is on higher side. You need to wait till your thyroid profile comes to normal range. Because if tsh is high it will affect implantation of embryo by inhibiting normal endometrium growth.Also if you conceive chances of baby getting hypothroidism is more. So its always adviced to control thyroid levels and plan for pregnancy.  Ya its better if it is possible for you to consult an endocrinologist. Hope I have been helpful .RegardsDr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause chest pain with immobility?\n\nmy bf is a truck driver and he came home saying he was changing a tire on a semi and he heard a loud pop in his chest. he is hurting now, has limited mobility, hurts when he moves his torso. there is no bruising on his chest or his back. what could be the possible injury?( i rubbed him down, front and back - massaged him)",
    "doctor_response": "Hi thanks for contacting HCM...Here your bf having musculoskeletal pain ...First if ribs are tender to touch then it could be costochondritis like inflammation of costal cartilage ....Second possibility could be rib fracture ....For which chest x ray useful ....If above two condition not present muscular strain could be problem...Here are few advise.../hot compress over chest useful./avoid posture or movement causing pain/proper sleep posture /ibuprofen 200 mg daily two times for five days taken..../rest done for few days/physiotherapy helpful for strain Take care ...You can consult physician with keeping this in mind....Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a medicine other than Hydrocodone and Flexeril be taken for severe backache?\n\nI was helping my husband move a HUGE OLD TUBE TV. The weight wasn t too bad and I was the one going backwards. Long story short, by the time we got to the garage door, my husband started to lose his grip, then he tripped over the cat carrier, forcing the TV to fly toward me and knock me on my back. Landed flat on the small of my back. I could not move enough to get to the hospital with out an ambulance. They ruled out damage to the spine, ribs or other smaller bones. BUT I have never experienced worse pain in my life, including natural child birth. They gave me Hydrocodone and Flexeril. Did absolutely nothing. I can only get out of my chair with help. HELP. Is there anything else I can take?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Short term steroids and Methylcobalamin can also help. I hope this information has been helpful for you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is bottom hip swelling, dizziness, pain in left side above the neck common after colonoscopy?\n\nI had a colonoscopy done once I woke up from my procedure my bottom lip was swollen and nom only on the right side its been 2 days and my lip still swollen and nom before my procedure I was having problems with dizzying and my head also was hurting in the back on the left side right above my neck on & off",
    "doctor_response": "Hi and welcome to HCM, thanks for the query.No,this is not common after colonoscopy and I don't think this is related to it. SO you should find another cause of your symptoms. It can be infectious disease, allergic reaction or something third, it is hard to say without additional tests.Wish you good health.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this lipid profile post viral fever indicate?\n\nhi i am 33 year old just i gone blood test like cbc lft kft and lipid profile : the following things is come out 1-my SGPT showing 52.0U/L beofore this test i had a viral fever i took some antibiotics and pcm 2 my Lymphocytes showing-41 3-Eosinophils 0.09 10^3/ UL 0.12-1.20 4-MPV 13.74 fL 5-PLCR 48.24 6-CREATININE - SERUM by PHOTOMETRY 0.58 mg/ dl 0.7 - 1.20 Lipid profile (LDL ESTIMATED) TOTAL CHOLESTEROL by PHOTOMETRY 124.7 mg/ dl 125 - 200 HDL CHOLESTEROL - DIRECT by PHOTOMETRY 28.4 mg/ dl 35.0 - 80.0 LDL CHOLESTEROL - DIRECT by PHOTOMETRY 67.50 mg/ dl 85.0 - 130.0 TRIGLYCERIDES by PHOTOMETRY 144.1 mg/ dl 25.0 - 200.0 TC / HDL CHOLESTEROL RATIO by CALCULATED 4.39 ratio 3.0 - 5.0 LDL / HDL CHOLESTEROL RATIO by CALCULATED 2.38 ratio 1.50 - 3.50 VLDL CHOLESTEROL by CALCULATED 28.82 mg/ dl 5.0 - 40.0 can u suggest me what happened with me should i take any medicne",
    "doctor_response": "hi.thanks for posting query.went through the lab results posted alongwith your question.LFT and lipid profile appears normal.no worries.have a nice dayregardsDr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is LAFB and how can it be treated?\n\nHi, I am Ved. My ECG checked by my doctor & revealed LAFB other wise NAD. Please tell me more about LAFB and treatment. This is first time as I am getting regular  check up every year. I am 42 years old of 166 cms hight & 68 kgs weight with early AO at telonavicular joint due to an exident and no other problem.",
    "doctor_response": "Nothing to worry about. Many people have left anterior fasicular block (LAFB) and are doing fine. It becomes an issue if you have chest pains, shortness of breath or lightheartedness - even then, simple work up by your Cardiologist can provide you with enough reassurances. It's simply means that one of the electrical pathways in your heart is a little sluggish. But the heart has other electrical pathways to help it beat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the increased dosage of Provera effective?\n\nI was so anxious to start my fertility drugs, that i doubled the dose to 20 mg for 5 days instead of 10 mg for 10 days. now i am regretting this decision because I do not want to risk my health. It has been three days since my last pill and I have not started my period yet. Will provera still be effective at this dosage and are there any increased risks involved? Many thanks for your help",
    "doctor_response": "dont worry this dose is not harmful. but ready for heavy bleeding. wait for 2  days more it will cause withdrawal bleeding. so dont worry. take care hope my answer is helpful to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe upper abdominal pain\n\nYes please. I am having severe upper abdomen pain that goes through to my back its kind of like gallbladder pain but I have had mine removed also was told I have a hiatal hernia and not eating well for the pain of being to full and i am just feeling worse as time goes by I see my dr every month but we can t seem to find a answer it always goes to my back being bad blown disk stenosis nerve damage its just I can t take no more",
    "doctor_response": "Hi.Thanks for your query. The pain in the upper abdomen and going to the back , with history of gall bladder removed and disc stenosis and nerve damage can be due to the disc but there may be additional or exclusively due to other causes like:Pancreatitis Gastric ulcer / cancer on the posterior wall. I would advise you the following:-First of all get an opinion of a Neurologist and a fresh MRI of the spine to see the position and to discuss whether this is due to it or not. -Upper GI Endoscopy and biopsy -CT scan of the abdomen for liver and pancreatitis This will give you the diagnosis and plan for the treatment",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for joint pain and clicking sound while bending legs\n\nMy name is uttam and i am 37 year old.I have a pain in my joints and I have shown to doctors what they say is that I have some cartilage problem. When ever I bend and straight my leg there is always a sound like tuk . I have thyroid problem for whichbi am talking altrocin . Suggest me what to do for my knee.",
    "doctor_response": "Hi,thank you for providing the brief history of you.A thorough clinical musculoskeletal assessment is advised along with MRI of knee.As you knee makes click sound and also as per doctors clinical examination says you have cartilage issues, an MRI will help understand better. Post understanding the soft tissue status in the knee joint, physical therapy shall be tried. As it will help to regain the full ROM and Strength in the knee joint and muscles. Also, with physical therapy one can get even the overall body benefits too.In my clincial practice, patients with cartilage damage undergo intense physical therapy to regain the functionality backRegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can xanax prescription be given for anxiety and depression in the absence of old doctor?\n\nI have been prescribed xanaxfor years for anxiety, anxiety attacks, some depression. My doctor is no longer available I need a doctor to take over, be my new doctor for my xanax prescriptions before I run out completely can you do this?he told me I needed to find Dr soon so as not to be without and go into withdrawals",
    "doctor_response": "Hello,welcome to Healthcare Magic.Xanax is used only for short term control of anxiety symptoms. In long term patient develops tolerance and dependance on it with exacerbation of anxiety.In long term and better control of anxiety and depression SSRIs medicines (Like sertraline, fluoxetine, paroxetine, escitalopram and fluvoxamine) are better. For which you can request your psychiatrist to start. For short term you can request other psychiatrist for xanax prescription to avoid withdrawal. Regards,Dr Ashish Kumar Mittalwww.99doctor.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for aggressive behaviour?\n\nmam i am a 20 years old boy and i want to discuss with you about my behaviouras i am too confuse in taking even small decisionsi also loose my temper and turn aggresiveand also irritate soon i also consult to neurologist and he tells me that about a conditioncalled brain atoropy as iand he told that i think like avery intellegent 40 year old person and my brain runs fastbut i just dont know about how to control my aggresive behaviouras it turns so aggressive that my heart beat and my blood pressure rise certainlykindly diagnose me the cure",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Please forget about brain atrophy. That has nothing to do with your problem. And no neurologist will tell you like that.You are youngster. You have vibrant brain. Your brain is so creative at this age that it cannot sit idle. If the brain (or you) are unable to find challenging activities suitable for its creativity and vibrancy, brain becomes lazy and stagnant. Such a stagnancy leads to dissatisfaction. This leads to aggressive behavior and anger. SIMPLE.Therefore, change you way of living. You are 20 and you have a lot of life in front of you. Do something so that your future becomes bright. Be active, vibrant and creative. YOUR PROBLEM IS SOLVED.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.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a bump near clitoral hood?\n\nI have a bump on the right side of my clitoral hood. It s been there a few weeks. It does hurt when I touch it. I have never had sex before. Should I be worried. Also I am constantly in the pool because of my job could that have something to do with it?",
    "doctor_response": "yes it should be paid attention immediately!possibly it is small benign cyst that has been infected recently. it could be a small abscess or even a small tumor-like condition.kindly get examined by a gynecologist before taking any medicine.all the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headache, laryngitis, nausea and dizziness?\n\nDont know exactly how to ask. Its a mystery diagnosis. Ive been to many drs and im still seeing them. At first my neurologist discovered the celeac and that helped a bit then my pcp thought it was allergies but no. My symptoms are headaches laryngitis nausea dizziness weakness",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, the symptoms may not be due to the infection but it seems to be due to the hyper secretion of acid called hyperacidity and it is worth trying the given medicine here Tab Omeprazole 40mg Domperidone 20 mg once in day try be stress free  hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Neck pain on coughing, gurgling sound in vein. On prednisone, albuterol. History of chronic asthma. Treatment?\n\nHello, I m concerned about my 12 year old son. Yesterday he started complaining of minor neck pain when he coughs, accompanied by a gurgling feeling.g and sound on the left side of his neck. I took him to a quiet room, and you could actually hear the swooshing / gurgling going through what I would assume is his vein . I monitored him all night and he slept well. He just came to me this morning and said he now feels it on the right and front sides. I put pressure on it with my fingers and I was able to feel the gurgles going through. Now, his whole neck is hurting. He does have chronic asthma , and is taking Albuterol and Prednisone (steroids) but has never had this happen before. Please advice",
    "doctor_response": "Dear wmtz, This seems to be a venous hum, so your surmise that it is a vascular sound is probably right. You should take him to his pediatrician for a check-up as this problem has occurred all of a sudden. In the meantime, please continue with his anti-asthma medications. For the pain, you may give him paracetamol (ADOL, PANADOL, etc.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for high folate and low serum iron counts?\n\nMy folate numbers are 66.6 range is 3.1-17.5ng ml which on my blood test says this is high but my serum iron is low it is 37 and range is 50-170 ug do. How do I correct this?i take 800mcg a day plus a vitamin with 400mcg a day. I understand too much frolic is not too good. What do you recommend? Thank you",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. Your folate level is high. Avoid and supplements folic acid tablets in multivitamin.  No any other treatment is needed. For iron you have to take iron reach diet like jeggary, dates,green leafy vegetables, dry fruit, bajra etc.You can also take oral or injectable iron supplements according to your doctor's advice. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of a lump?\n\nI fell of a horse at work and got strood on I have a bruise from my knee to foot I didn't attend medical attention I just left it however now I have a large egg sized lump that won't go it hurts to touch and slightly lose of sensational. What could this be",
    "doctor_response": "Hi,This may be hairline fracture underneath which is causing swelling due to blood collection or just a soft tissue swelling.Get xray of affected part in AP and Lateral view done and send me the report.Till the have tab.aceclofenac100mg +serratiopeptidase15mg thrice a day by prescription.Thanks,Dr.CHANDER MOHAN SINGH.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for sore nipples and abdominal pain?\n\nMy nipples are sore to touch and i've been getting lower abdomanl pain and have had a sore back which i thought was just my nerv pintching again and today i have been very light headed and had trouble focusing at work. could you give me any idea as to what it could be?",
    "doctor_response": "Hi.Thanks for your query.Nipples getting sore to touch have either a hormonal or psycho-sexual problem .Lower abdominal pains with Sore back like a pinched nerve can be a local problem of the back. Or the lower abdominal pains can be due to intestinal infection or infection of pelvis organs... Ultrasonography and a clinical examination will help to get a proper diagnosis and a proper treatment .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain on exposure to cold food after getting root canal treatment done. What should be done now?\n\nHello, I ll get right to it... Went to the dentist for first time in 4 years. Got a good cleaning and replaced 2 old fillings with new ones ( tooth colored now, old were silver/metal). The fillings were on my back 2 left teeth . He noticed some decay in next to last tooth. 1 month later, pain starts up from eating/biting/ cold sensitive. I go back to my dentist and schedules a root canal on next to last tooth. Root canal done, three days later I start getting pain from cold stuff again. Could the endontist have missed some of the pulp? (There was no infection, just inflamed) now, when I drink just water on the left side, the pain starts mild increases to BAD then decreases... All within 30-45 seconds. Getting a little worried, trying to stay calm about this. We schedule a re-eval with endontist for sometime soon... Any words of wisdom or comfort are welcome. My original visit over a month ago gave me a boost to want to go to the dentist more often and take better care... But this whole situation is really bumming me out. Any info or suggestions?",
    "doctor_response": "Hello and thank you for your question. The pain could be related to remaining infection in the tooth you have had done, or the tooth next to it was the one needing the root canal.  The level of pain you are experiencing means you have a dying nerve and are suffering from irreversible pulpitis.  Best thing to do is to go to an endodontist and have a pulp vitality test performed on all of your teeth in that area to determine which tooth is the source of pain. Best Wishes, Dr. Ward",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for positive HbsAg\n\nhi good morning doctor, my self chaitanya patel having jaundice before 4 years and that time i had medicine and got cured, now my HbsAg test is resulting positive. i want to undergone medical test for my job. is there any medicien which will cure my HbsAg test for short time.",
    "doctor_response": "Hello,Having jaundice four years back could have been either hepatitis B virus or any other virus. You must have developed the virus now, if u had no history of it. Once your Hbsag status is positive , please consult your Gastroenterologist , so that he can advice you further tests to know if the disease is active or not (hbeAg), whether your body have developed immunity against the virus or not ( Igm anti HBe), and how much is the viral load at present (HBV DNA- quantitative analysis) , with USG abdomen to see your liver status , only Dependimg on these parameters can anyone decide if treatment should be started or do you just need regular follow to know the viral status, and Hepatitis B virus spreads via bodily fluids, please ask everyone in your family to be evaluated and if they are negative for the virus, let them get vaccinated immediately , but anyone is positive they should go about it the same way as yours, hence please consult your Gastroenterologist and get yourself completely evaluated. Hope I could help you.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can coughing, runny nose and low grade temperature be signs of viral fever?\n\nI have been coughing, runny nose, low grade temp for most of the day it stay between 99.4-100.6 although last night it went up to 101.3. I did not take any fever reducer until 1:30 this afternoon when the temp went to 100.6. Before that it had stayed under 100 all day.  I'm wondering if this is viral I did have a flu shot but I know I may still be able to get the flu.",
    "doctor_response": "Hello,Welcome to HCMThe symptoms you are experiencing most probably suggests viral fever.I would advice you to take adequate rest for 1 week.Drink plenty of fluids especially hot water.Take paracetamol thrice daily.Take antihistaminics and cough syrup.Usually it will subside by 1 week.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent PICC site rashes?\n\nHello I had a PICC line placed last june to get IVIg weekly for ITP.  The line got infected and was removed.  I had to get another one in the other arm which was removed after I had my spleen removed last October.  Both PICC line sites have an itchy rash around them, that is localized specifically around the PICC sites.  What could be the reason for the site rash on these sites that were removed last year?",
    "doctor_response": "HelloThis sounds like a form of tinea corporis--a skin fungal disease that can be seen at the site of a PICC line insertion.Ask your doctor for either prescription ketoconazole cream or oral Diflucan.Either treatment should be effective for the problem",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bump on back with pus which looks like a black head\n\nMy Dad had a large lump on his back shoulder that looked similar to a black head . But, it was larger than a usual one and more under the skin. My mom decided to pop it, and the discharge was similar to one like a pimple but was much less oily and smelled bad. The other thing is that a lot of puss came out. Do you have any idea what it could be? My Dad is in his late twenties and has no severe medical history . He has delt with mild acne before but nothing like this.",
    "doctor_response": "Hi, It seems to be sebacious cyst on back. You may consult a homoeopath or contact a surgeon. In homoeopathy it can take few month to cure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for redness and swelling in thigh after a sebaceous cyst removal\n\nI have a subcutaneous cyst on my inner upper thigh, I had surgery last March to remove it and it had not come back until about 10-11 months later. Now it s back, red, swollen and turning dark at the top of it. I ve been doing hot compresses, Epsom salt baths, etc but to still hasn t popped. My surgeon can t see me until Tuesday. What should I do?",
    "doctor_response": "hi.it may be a recurrence of your sebaceous cyst. warm compress and pain relievers may help alleviate the swelling and pain a little but, those are just temporary measures. definitive management is still surgical excision of the cyst formation. proper antibiotic treatment will also be given. a follow-up consult with your surgeon is best.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I take Methocarbamol or Tizanidine for a muscle pull in the thigh?\n\nI fell over a rock outside and pulled a muscle in my outer thigh. I have iced it. I have Methocarbamol 500 MG and tizanidine 4 MG tablets. They were given to me for sciatica. Which one should I take? Or should I just take ibuprofen 400 or tramadl 50mg? Thanks Alan Berman",
    "doctor_response": "Hi, If you have muscle pull You can take tab ibuprofen 400 mg thrice a day for pain relief. It is good  for reducing muscle inflammation and pain. Keep ice packs on it. Applying crepe bandage will reduce movements and pain. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of Glimestar 2 and Alsertaian?\n\nHello! Dr. I am forty two years old male with diabetes diagnosed last three years.I am on the drug Glimestar 2 and Alsertaian AM ( for Blood Pressure ). I wanted to know the side effects of these drugs in the long run. Mail Id: YYYY@YYYY (Please answer on my mail id.) THANKS",
    "doctor_response": "Hi, Glimestar-2 (glimepiride) is a sulfonylurea commonly prescribed to control blood sugar levels in people with type 2 diabetes. Its important side effects on 'long run' include fall in blood sugar (which can be prevented by its dose adjustment), an allergic reaction and weight gain. Olsertain-AM is a combination of angiotensin receptor blocker (olmesartan) and a calcium channel blocker (amlodipine) commonly prescribed to control high blood pressure and to prevent its complications. Its common side effects on 'long run' include low blood pressure (which can be prevented by dose adjustment), increased blood potassium, dry cough, swelling of the face/eyelids/lips/ankle/feet, constipation and flushing. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can chemotherapy and radiotherapy causing ingestion nausea be treated?\n\nMy dad has recently begun combo chemoradiation therapy for cholangiocarcinoma. He has been nauseated pre diagnosis, with no meds consistently helping. He now continues with his nausea which I m not sure if it s really any worse since beginning treatment or not; however he is rapidly loosing weight due to not eating. We have tried everything possible but honestly he just wants to gag if you even put water in front of him. Would Sancuso 3.1 help with this kind of issue? Thank you",
    "doctor_response": "HiI would advise you to take tablet domstal 10 mg thrice daily before food for 1 week.RegardsDr de",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for upper back pain while standing up and breathing in ?\n\nHello. I have been having back pain for about a day now located in my upper back. I can feel it when ever i stand up and breathe in. Someone told me it may be pneumonia because it has been very cold out were I live for the last few days, and I have been outside for quite sometime. I'm pretty sure that is all but if you need anymore information feel free to E-mail me via  YYYY@YYYY",
    "doctor_response": "Hello, I have studied your case. Due to compression of this nerve root there is pain in your chest.I will advise you to do MRI  thoracic spineFor these symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.I will advise to check your vit B12 and vit D3 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "how can one withdraw from T-bact medication?\n\nHai Iam using t bact oilment for my faces for pimples and back marks I have questions tat how should I stop this oliment..bcz Dr.sukki he told me apply this oilment for faces in day 2time and he told me not use soap are faces wash any kind of cream to my faces I feel tat after using t bact oilment the black it s been reduces but faces bcm black nw the doctor is no more...pls help me to stop this oilment sir",
    "doctor_response": "Hi, Mupirocin (T- bact) ointment may cause contact dermatitis.You need to discontinue Mupirocin (T- bact) ointment and use other Topical antibacterial agents for acne such as Azelaic Acid, Erythromycin, Clindamycin which are also useful adjuncts to therapy. Hope I have answered your query. Let me know if I can assist you further. Take care. All the best. Regards, Dr. Tushar Kanti Biswas, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can i get relief from abdominal pain in pregnancy done through IVF ?\n\nim5 week pregnant;but every time im suffering for left side pain.sometimes pain is light but sometime high pain.i take pain killer.After three days i have first oppiontment with my doctor .im pregnant with treatment of ivf.i demaded doctor for pain he told me that this pain is normal for after ivf.im so worried is it normal or not.im 32 years old.this is my 5 ivf.2 ivf worked but ecotopic pregnancy .",
    "doctor_response": "Hi, Sidra, Thanks for query, As this is your precious pregnancy, any pain or discomfort more than usual you take it serious and consult your gynaec. Do not take pain killer, ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain, feels thirsty, x-ray, ultrasound, blood report, stool report and urine report normal\n\ndoctor can u help to i have pain in upper right side in abdomen last 10 yes x-ray ultrasound blood report stool report urine report both are normal. i am also a pathology lab technician but i can not understand this problem even i visit many doctor the not telling me what happen. and sir i fell very tasty too much water drinking in a day more the 10 glass of water, when my abdomen was empty night time when gas was pass that time i fell better can u advise what i have to do in this situation",
    "doctor_response": "Hi, Welcome to Healthcaremagic. The problem you have is typically seen in acid peptic disease where you may have gastritis with or without an ulcer. Do get an Endoscopy done which shows the interiors of the stomach and confirm the fact that it is acid induced problem . Taking antacids for 2 to 3 weeks will solve your problem if it is due to gastritis. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain at incision site?\n\nI just had a lump removed from my arm. I have stitches. After the local wore off last night I was in alot of pain. My incission was throbbing and stinging all night. I m still in alot of pain. I never had stitches before. Should they be this painfull? He told me to keep the bandage on for 2 days so I have no idea what it looks like. He also said that I shouldn t have much discomfort but I do. And I do have a high tolerence for pain.",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain pain after a surgical procedure is not an abnormal finding and it commonly occurs for about a week or more which gradually subsides when the healing proceeds..The pain needs to be controlled with painkillers during the initial post surgical period and it does not look like you are taking any medication for pain..You should take a short course of antibiotics like Amoxicillin or Augmentin for preventing infection..Take painkiller like Ibuprofen for moderate pain and in case if pain is severe Tramadol can be taken..You can also get an injectable painkiller like Voveran injection [ diclofenac] for relief from pain faster..Hope this information helps..Thanks and regards.Dr. Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can swelling and pain in the legs be treated?\n\nMy daughter has an irregular but somewhat round thickening of the skin on outside of left leg. she is fairly dark skin due to some American Indian heritage. At first It was just a round lesion, lighter in middle w/dark outter ring. Now is it has begun to grow another asymetericall form from original lesion.She is 37 years of age & it has been treated for ring worm- also with steroid cream which I thought was not quite smart. Dr. told her it would just go away. But now it is swelling some & her left leg has started to hurt in bone and up leg. Dr. has not done biopsy since she has no insurance. Any advice?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The lesion on the leg needs a direct examination and biopsy to find cause. The pain can be relieved with some pain killers. I hope this information has been helpful for you. Regards, Dr. Praveen Tayal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for sexual dysfunction caused due to masturbation practice?\n\nI am taking Pyschatrist treamnet for past 5 years. Initially i had masturbation practice which caused sexual disability. so i had gone for siddha even high siddha medicines.But they said because of antidepressant medicine your organs doesn't work.Kindly help me whether it is possible to recover.I am 29 years old and unmarried.Neuro doctor prescribedMorning: prodep tabletEvening: oleanz tablet          I had taken this medicine for 4 years.Now they are prescribingMorining: Floatin tabletEvening: olan and zaphige tablet               Kindly help me in this regard.Please inform me whether it is possible to cure my sexual dysfunction. I found lack of desire in sex.",
    "doctor_response": "Hello,Welcome to Healthcare Magic.Masturbation do not cause sexual problem or lack of desire. It is only myth or conception due to poor sex education. Even it is better to masturbate occasionally for unmarried person.Considering your treatment history, you have some complex psychological problem. That problem and its treatment may lead to sexual problems. But do not stop your medicine without your psychiatrist, as these are necessary medicines. Same time discus your sexual problem with your psychiatrist rather than other physician.You can provide more information regarding your psychological problem to help you better.Wish you good health and all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden unconscious state?\n\nMy husband was sitting in chair yesterday said he fell asleep. He seemed awake after that. A few minutes later I talked to him and had to yell and shake him to awake him. He said he was having some kind of a spell . He is not a heavy sleeper. My sense was that he was unconscious for a short (less than 5 minutes) time. What could cause this. He seems fine now.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. The state could just be deep sleep. Try to remember all those heavy works and stress before that. You may get the answer. Sometimes, low blood sugar level, metabolic imbalance etc can also push the body into unconsciousness. Do consult a physician and get the vitals checked.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on back of head\n\nI've had a small lump on the back of my head for a couple of years.  3 weeks ago I scratched it and it opened up.  There was a white, horseradish texture substance in it.  Since then it has been draining.  It has dry, hard, flakes of skin around it.  The past few days it has been very sore.  The right side nodule on the back of my head, just below the hairline, now has a lump on it and my throat is sore.  I feel a little disoriented, also.",
    "doctor_response": "Hi,The lump you describe is most likely to be a sebaceous cyst. This is not serious and they are commonly found on the scalp. The soreness may indicate that it is infected. I suggest you see your doctor who will be able to assess whether you need antibiotics. Surgical removal may be an option. The second lump you mention is likely to be a lymph node which is related to your sore throat. This will disappear when your sore throat is better. Regards,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent, painless urination after a kidney stone removal?\n\nI passed a kidney stone a few days ago. I am still feeling urgent urination, bloating and painful back. I am drinking green tea and lots of water, but I still seem to urinate often. Urination is not painful. The bloating concerns me after drinking a lot of fluids. Just uncomfortable and worried it might be more. I am 71 and in good health. Thank you for your help.",
    "doctor_response": "HiThanks for your query.We need to look for UTI which often produces an increase in urinary frequqency.I would advise you to get a urine analysis. Based on the results we could decide the further course of action.Hope this helpsGood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can withdrawal bleed occur even if I am pregnant?\n\nI had got period on 21st November den I missed a month n thought of taking regestrone . started taking it on 13th night twice a day for 3days I.e till 16 morning. I got my withdrawal bleed on 21st January which was light for the first 2days n den normal. but suddenly on 29,30,31 it became very heavy and I finished on 2nd Feb. my withdrawal bleed lasted from 21st Jan to 2nd Feb. can withdrawal bleed occur even if I m pregnant?",
    "doctor_response": "Usually not, withdrawl bleeding occurs only if there is no pregnancy. If you have further questions, you need to visit a gynecologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest dosage of ondem for treating vomiting in a child\n\nmy son is 15 months old and has high fever often fluctuating since friday. we gave him p-125 6ml in combination with sumo mf 4ml every 6 hours. today morning he had a vomit and was advised to take ondem syrup every 6 hours. what dosage should be administered ?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. With such presentations in my clinic, I would recommend dose: three 0.15 mg/kg doses (up to a maximum of 16 mg per dose).Try to keep your baby hydrated with plenty of water and ORS.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing your baby good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for yeast infection?\n\nI was diagnosed with both bv and a yi last week. At my follow up appointment with my ob I found out that everything looks fine now, but I'm still dealing with this unbearable dull itch/burning. I have used Vagisil and it relieves it a little, I also take ibuprofen because it can be painful. Could this be more serious? Is one or both things coming back?",
    "doctor_response": "Hi. Treatment for bacterial vaginosis and yi is a course of metrogyl tab. for 7 days.If you are still having symptoms after due treatment, then I will advise you to take medicine for both partners together in the form of kit containing Azithromycin, Ornidazole and Fluconazole, along with local application of cream like, Candid-B, and some anti- Histaminics orally. At the same time also get your urine routine ex. and Pap smear done.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does complete placenta previa at 18 weeks affect the baby?\n\nI am 24 weeks pregnant now. Was regularly having brown discharge (little thick), a quarter spoon - 2-3 times daily since 12th week. Diagnosed with complete placenta previa in 18 weeks ultrasound. Doctor told me to be careful but not advised bed rest. Brown discharge continued. At 22 weeks, discharge turned red with similar qty. and frequency. Again ultrasound revealed partial placenta previa (type 3). Doctor put me on bed rest since then. Baby movement is felt normal. I am really worried? What can I expect?",
    "doctor_response": "Don't worry  Relax    placenta Pravia is one of the complications of pregnancy. Treatment revolves around taking bed rest  , medications and frequent fetal monitoring. If u r vigilant and take proper care u can have a successful pregnancy outcome",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does rash on face indicate?\n\nHi... for the past three months i have been getting this rash on my face cheeks. They are like pimples but they are not infected. It gets worse right after I take a shower or wet my face anytime. If i describe them they are like bumpy, pink, and scaly. What do u think this rash can be? Please answer:)",
    "doctor_response": "Hi, According to your complaints it could be either acne vulgaris or seborrhoic dermatitis. I would recommend you to upload the pictures of the affected areas under the premium section of the site so that I can have a clearer picture of the condition and can guide you accordingly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "hi I have both pimples and scars on my face and i want to get rid of them for good. i have tried both medications at the same time but it doesnt seem to work. is there a medication which treats both at the same time?",
    "doctor_response": "Welcome to HCM. Consult Dermatologist for better medical management,because treatment depends upon your type of skin. Otherwise avoid stress,oily,spicy,junk food.drink enough water,fruit juices,Take good healthy diet,vegetables.wash your face properly with anti septic soap.Take atleast 7 to 8 hours sleep.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a hard lump on the side of the head?\n\nMy step son has a hard lump on the side of his head. When it grows it effects his behavior, learning capability and he also will pee his pants when it grows. I talked to his Dr and when it was swollen I ran him in to see the Dr but she has no idea what it could be. It's not where his soft spot was when he was a baby nor is it where tbe plates in the skull meet. He has had this ever since we knew him at the age of 2, he is now six. My husband and I just got custody of him, and from what we know the bio mother would hit him in the head and slam his head on the floor and so much more. He has an appointment to get it looked at on June 7th but they won't be able to see anything unless it swollen.",
    "doctor_response": "Respected user , HiThanks for using Healthcaremagic.comI have evaluated your query thoroughly .*  There are many possibilities for scalp lump as   -  Hematoma  -  Lipoma  -  Sebaceous  cyst  -  Dermoid  -  Bony  tumors       as osteoma or others .*  Needs  primary  skull x-ray  and  if required  further  MRI  to confirm  the    diagnosis and manage accordingly .Hope this clears your query .Welcome for further  doubts .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the early symptoms of breast cancer?\n\nAre there any studies on women who have been diagnosed with early, stage 1 ER/PR positive breast cancer (neg nodes) and have decided to go on low dose estrogen therapy to minimize menopausal symptoms? What is their absolute risk of recurrance compared to those who did not go on HRT.?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern and I would like to say that up till now lot of research and work done on breast cancer and now this is being detected in very early stage and successfully treated all over the word in every country awareness program going on, for breast cancer and women being educated, hope this information helps you take care and have a nice day. (Avoid taking the hormone pill)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Body rashes, condiferm-F, rashes went away, spread to another part, skin darkening, flucos 150 okay to take ?\n\nhi doctor i stay in gangtok . my wife is having a problem.she was having rashes on her body back portion so doctor here advised coniderm-F, after a week the rashes removed from that part but it again came in other parts.and some parts become black so we went to the doctor again and he now advised flucos 150and CLOP-GM WHAT TO DO? SHALL WE TAKE FLUCOS 150?",
    "doctor_response": "Yes mam u should continue the medicine. And dont expect the result in one or two days cause skin element takes long time and do stick to medicine time to time. Bye and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling pressure in the head. Pale eyes, sugar craving. What is wrong?\n\nMy fiance is complaining about his brain feeling dry, and pressure in his head. He says that the pressure isn't sore. His eyes water and he is pale in complexion. He says he feels 'weird' and doesnt know how to explain how he feels. He says he cant shut off. He keeps on yawning constantly and he is craving sugar. At first eating something sweet helped him feel a bit better, but now it doesnt help at all. What could the problem be? Should he go see a doctor?",
    "doctor_response": "Hi,Based on the details following possibillity need to be considered Anemia, hypothyroipoidsm and diabetes.He should be shown to general physician /Neurologist for clinical examinationHe may require battery of blood test like blood sugar, complete blood count, electrolyte, and thyroid profile.If tests are negative then imaging brain should be plannedHope this will help youRegardsDr Sandhya ManorenjNeurologistHi tech city Hyderabad",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for central precocious puberty\n\nMy 9 year old daughter has been diagnosed with CPP. I am doing research on Lupron Depot or Supprelin implant. I want to make the best decision for my daughter.... Which one is better? She hates needles, and I m also highly concerned of the possiblility of her having PCOS later on in life. Will either of these medicines prevent PCOS? Or will either of them perhaps inadvertently cause her to have PCOS?",
    "doctor_response": "First find out the cause of CPP either it is due to idiopathic (75% in girls) or neurogenic. If in case of idiopathic, medicine treatment is available but in case of neurogenic, treat accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can GERD cause chronic cough and can this turn into asthma?\n\nMy mother, 49 years old, has a chronic cough, throat clearing, tickling and breathlessness for few years, sometimes she wakes up at night coughing and out of breath, an inhaler helps ( uses Foradil Aerolizer 12mcg, which helps for a long time and Ventolin, for a shorter time) and when she wakes up in the morning she has a stuffy/ runny nose, sneezes sometimes. It looks like the cough started after a viral infection. In the beginning cough occurred in evenings and she felt breathless, now there's that throat tickling and clearing, which triggers the cough. Then she went to a pulmonologist, they did a spirometry, it did not show asthma ( she's allergic to animals, dust, bed mites, some foods). After the spirometry cough got better. Later she was diagnosed with hypertension, taken medicine from it and again started coughing, her medicine was changed to Tenaxum, it didn't stop the cough. When she went to cardiologist, he said that there is everything fine with her heart, yet her cholesterol is 7. In summer she did an X-ray, doctors said that there were small remains of bronchitis. Also she has GERD, we though that it could be from it, because it looks like the cough worsen after meals, when sitting or laying down, but no reflux medicine helped. Though when she went on strict diet her cough got better for few weeks. In December she did a second x-ray of her lungs, it showed nothing, they were completely fine and again went to pulmonologist for asthma test, FVC was 84% and no asthma again. Pulmonologist said that it could be from GERD or allergies. Now for a week she can't go to sleep without inhaler Foradil, because she wakes up in the middle of the night breathless. Could this be a developing asthma?",
    "doctor_response": "HiYes one of the cause of chronic cough is GERD.Gerd might exacerbate the asthma but does not cause it.Go on with the treatment.Dr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shoulder pain after spinal fusion surgery\n\nI had a spinal fusion in jan. This year of the 5th and 6th vertebra and was going well but last weekend I was having some neck to shoulder pain familiar of that before surgery. So I went to swing a sledgehammer at work and my right arm went week at my bicep. That Monday I went to my orthopedic surgeon and he X -rayed to confirm everything was in place. He put me on a dose pack do steroids for inflammation but weakness is still there after 5 days. It is getting more difficult to raise my arm but still have full range of motion. I still have more meds to take . Should I wait or get the MRI he wanted to do?",
    "doctor_response": "Hello,I have studied your case.I do not think that this weakness is due to nerve compression. But most probably it is due to shoulder muscle weakness or tear. So I would recommend you to get MRi of the shoulder joint to see if there is any tear in your rotator cuff which can present such picture.   If there is tear seen on MRI than you might need a arthroscopy surgery for the shoulder in which tendon will be repaired.I hope this answer will be useful for you. Let me know if there is any other follwup questions.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is drinking coconut water good in pregnancy ?\n\nHi Dr, I am 33 week preganant, I drink lots of coconut water, every day -1. I heard that if expecting mother drink coconut water hairs of the baby does not grow. Please let me know if this is right.",
    "doctor_response": "Hi,Sagar, Thanks for query, There is nothing like this.you can continue taking coconut water. This thing advised by old generation people,there is no scientific base. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get up in the morning with whole body pain. What is going on?\n\nHello doctor, I am a healthy 65 year old female. For the past six months to one year (approx), I have been getting up in the morning with lower back pain, and all around body pain. I teach yoga, so really I am fine. I have started doing some spinal twists in bed before getting up and forward bend at the side of the bed. This works wonders and I am usually good to go then. But what is going on? Is it my bed? I have gone through two different beds during this time. Sleep should be a restful thing, and one should get up without pain. Please help me. And thanks.",
    "doctor_response": "Hi. Morning stiffness and pain following a period of prolonged rest are suggestive of wear and tear process or osteoarthritis. Wear and tear is an age-related condition. As long as this pain is not affecting your lifestyle (I understand that you wake up with pain but sleep soundly, also you have the insight to act positively to control your symptoms through yogic postures), we really do not need to change anything at present. Please get your vitamin D levels tested along with ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), and CBC (complete blood count) to rule out inflammatory conditions and vitamin D deficiency. Hope this helps. For more information consult a physiotherapist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diabetic having abdominal pain. Pus cells in urine. Kidney infection?\n\nHi,My dad has diabetes, he's 63 now, lately he started having abdominal pain, dr diagnosed   some infection in kidney , they found some puss cell in urine sample the count was 70-80 but after antibiotic and other medication theres still no change it has reached 100 now.. Can you plz explain and suggest any expert dr in india and how fatal it is Thank you",
    "doctor_response": "Hi,Your dad is 63 yrs old and he is a known diabetic. He had abdominal pain and diagnosed as urinary infectio, because of pus cells in the urine deposit examination. Even after antibiotics the number of pus cells have increased in number. It is not fatal at all. Your father has got urinay tract infection (UTI). once the antibiotic given is not active, do a culture and sensitivity, that will reveal what type of organisms are there in the urine and its sensitivity to which antibiotic. If you have the correct antibiotic, mild diuretic and urine alkaiser definitely the infection will be controlled. It is difficult to control UTI for a diabetic, compared with Non- Diabetic. it is always better to take a USG - KUB area to assess the urinary tract. blood kidney function test should be done. keeping the Blood Sugar under contol is very important.Plenty of water + barley rice water is advised.Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "How much fluid should be given to an infant while teething?\n\nHI I have a 6 month old who is teething. He has started refusing his milk in the last couple of days but will have food and water. Just wondered how much fluid he requires a day so i can monitor it. He is probably having just under 6 wet nappies a day at the moment but seems ok in himself other than the obvious teething",
    "doctor_response": "Hello, There is no specific requirement at this age group and you can give on-demand fluids. But age-appropriately you may give the baby 600 to 700 ml of total fluid per day at this age group if you are not giving any milk. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. There are spotting and cramps soon after periods. Why?\n\nHello doctor, My wife had a cervical tumor or some kind of growth in her teenage years. Whatever it was, medication took care of it for her. Now she is 31, has had three kids, and for the last few months has spotted and cramped for one day right after her period ends. She has a pap smear appointment for next week, but I am extremely worried in the meantime. What are the chances that the symptoms are because of cancer? Are there other benign conditions that are more likely causing this?",
    "doctor_response": "Hello. Thanks for sharing this information here. First of all I would like to see her reports from the previous diagnosis and treatment and only then I would be convinced that it was a tumour. Secondly, from your point, it sounds that it was only a cervical polyp which is totally benign and after removal of it patient does not have any symptoms. And thirdly, pap smear does not detect cancer. It detects only early changes which Iead to cancer. So get relaxed now as nothing is wrong with your wife as she has given birth to three healthy kids. She must go for a pap smear without any hesitation and I hope it would be fine as well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of cancer?\n\nHello Doctor, Patient Name: Shivabasappa, Age: 59-60Years. Height-5.6, Weight-60KGs. Medical History: Last week BIOSPY was done and today got the report. As per report \u201cMultiple bits of tumor tissue reveals moderately differentiated Squamous cell carcinoma-Infiltrating type\u201d I understand from my doctor that this a kind of CANCER but Wanted to know the duration of the treatment for this disease and the expected cost for the this. Kindly advice",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have moderately differentiated squamous cell carcinoma. Treatment depends on site and location of cancer.  They don't mention the site of biopsy. Surgical excision is the treatment of choice for easily accessible site.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could stress, anxiety cause burning and itchy red rash underneath arms, thighs?\n\nI went to my family doctor yesterday. For my Depo. shot. That morning I woke up with a red  rash underneath my top part of my arms on both left and right sides and on both top and inner thighs. It burns and itch's. He said it was from stress and anxiety. I am worried. He put me on steroids. Should I be worried about this?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Stress and anxiety and itching rashes could be related. Stress Can Cause Hives. Mental stress increases the amount of corticosteroids released from your adrenal glands which are thought to alter the activity of your immune system. Hives develop after the release of histamine from immune cells in blood vessels near the skin causing swelling, heat, and itching. Reduce stress and live happy. Enjoy life. 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.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for basal cell carcinoma with fibrosis?\n\nI had a nodule removed from my right forearm. Earlier diagnosed as a picker s node or something like that but after removal, there was a final diagnosis of basal cell carcinoma, nodular, with fibrosis. The dermatologist wants to do Mohs surgery on it now. However, I had a second opinion and this dermatologist suggest that this does not constitute or fulfill criteria for Mohs\u2026however, it does need to be removed. Can I wait because I cannot afford Mohs?",
    "doctor_response": "Firstly, you do not need MOhs surgery. Mohs is reserved for skin cancers that are present in an area where you want to remove minimum skin such as the face. On the forearm this is not a concern and a simple wide excision of the skin around the nodule with a 1 cm margin is all that is required. However, it is mandatory that you undergo this excision else the cancer will return.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe fever in a child\n\nMy daughter is getting fever frequently with a gap of 10-15 days. I visited doctor two times and now again she got fever. Last time doctor suggested me AZEE 100 for 5 days but I gave it for only 3 days. Is it the reason that my daughter got the fever again? Please suggest.",
    "doctor_response": "Hi dear welcome to the HCM,Improve her immunity with high protein diet.Supplementation of iron and multivitamin syrup.Hand to mouth hygiene to be maintained strictly.Hope the query is answered,Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring fever while recovering from typhoid?\n\nHi ! I am in the third week of typhoid fever and i am through with the 2 weeks course of antibiotics. However,still i get fever of 100-101 C. Fever goes down to 97-98 C after taking anti pyretics but after 12 hours it shoots to 100-101 C. Please advice whether the fever of 100-101 C is normal in typhoid s third week?",
    "doctor_response": "Hi,In typhoid with proper treatment fever controls within a week time.In your case there might be relapse of typhoid or there can be another cause for having fever.If there is no control of fever, go for complete blood testing for TC,DC, ESR, MP, Platelet count.Routine urine check up,X-ray chest.After reports appropriate treatment can be planned.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes forgetfulness,unsteady gait and urinary incontinence?\n\nMy neighbor is a 6year lung cancer survivor. He is 73 years old. In the last few months, he is forgetful, unsteady on his feet, lists to one side, falls asleep when you are talking to him, is starting to get incontinant at night. He has had an MRI and blood work and various tests, with no conclusive outcome. Any suggestions?",
    "doctor_response": "Hi, I am Dr.Bruno.  I have read your question and understand your concerns. Let me try to help you Question : What causes forgetfulness,unsteady gait and urinary incontinence?Answer : There is a Condition Called Normal Pressure Hydrocephalous (NPH) which causes all these three The three symptoms you have mentioned are the classic features of Hakim's triad. Consult a Neurosurgeon at once. A Simple Surgery will offer Dramatic Improvement Hope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will it be safe to take pacitane 3 times daily for having early parkinson's disease?\n\nMy wife, 35 years age having an early parkinson disease, she is taking pacitane tablet 3 times daily, with pramifex .5 mgs 3 times daily and levera 500 mg. two times daily, zenoxa 450 two times daily, she is saying that she has sleeping mood all the time,pls suggest me is it correct dose to take",
    "doctor_response": "Hello Thank you for trusting HCM You can take pacitane three times in a day.   Trihexpenidyl is an antimuscarinic agent that acts specifically on M1 receptor and possibly on dopamine receptor. It is used in the symptomatic management of Parkinson\u2019s disease, especially in patients with severe tremor.Initial, 1 mg single dose. maintenance, 6-10 mg/d in divided doses tid-qid; increase dose by 2 mg increments every 3-5 d. Maximum, 15 mg/dUsed as an adjunct, in combination with LevodopaDoses >10 mg/d must be divided qid.Drowsiness due to tab. Levera and tab. Xenoxa. If you're wife feeling drowsy please consult neuro physicians for change of medicine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mild heart palpitation and chest pain?\n\nhello, i have been getting mild heart palpitations with a squeezing chest pain for quite some while now, i went to the doctors for an ecg and they said i had a little irregular heart best but it was normal for my age, im 19 years old, now my heart palpitations are a little stronger and its really freaking me out and i dont think my doctors taking me seriously about this, any suggestions of what could be the problem?",
    "doctor_response": "Hi,It is quite common for people of your age to have such symptoms. No significant abnormality is found despite extensive investigations. I usually prescribe a drug for symptoms control, typically one of beta blocker.Hope you are satisfied. HCM shall be pleased to help you in future,too. Please rate our services.",
    "dialogue_context": ""
  },
  {
    "patient_message": "High bilirubin levels. Liver ultrasound suggested. Worried about liver disease. Due to alcohol or high protein diet?\n\nHello, I am a 25 year old female and just got blood test results back that my bilirubin level is at 3.4. The assistant who called wasn t very helpful beyond saying I am supposed to get an ultrasound of my liver. I am starting to freak out and get really worried I have a serious liver disease or something due to lack of information. I know speaking with my doctor is the best thing, but she is out for a week and I won t be able to. Do bilirubin levels ever randomly spike due to alcohol consumption or could it be due to a diet high in protein? Help!",
    "doctor_response": "Hi and welcome to HCM. It might spike, dut not such high. This is severe elevated bilirubin and it should be evaluated especailly in such young people. It can be caused by liver disease in most cases but also some blood disorders as well. He recommended ultrasound because without it we cant find out the degree of liver damage. After that you ll know is this just fatty liver or there are signs of fibrosis. ALso it can be caused by biliary duct obstruction and gallbladder issue. All in all you dont need to worry, this is something treatable and reversible. YOu cant have cirrhosis or malignancy. It can be alcoohlic damage,autoimmune or caused by drugs and dietary. Whatever it is it will be found and you ll know further tratment, WIsh you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for mental health problem\n\nplease doctor suggest me to get rid of my tension i always feel like crying. Not able to concentrate on my work as my too close friend with whom i met everday, to whom i can cal any time, who can aslo call me anytime and ask to meet anytime and with whom i become almost dependent is going far from me and inspite of spendiing the remaining time happily she stops talking me and asks me to stay away from her stating that i have become too possessive towards her and she feel suffocated wid me so advise not to talk with her n further advise to concertrate on my career when i tried to convince her she not even picking my calls and not even want to see my face. Please suggest what to do as i do realise that i have become possessive towards and i cant see her going and moreover cant see that in these few days she stops talking me. Please advise",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. From the available description it is just a disappointment. Such disappointment are supposed to be in every human beings life. We are already tuned to overcome such problems. What shall you do if the friend dies?. You do feel sad and cry lot and lot of time. But life moves on. That is it. You cannot be in this shape always because you cannot. Consult a psychological counselor for further advises.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My son is diagnosed with rickets. Within how many years he will start walking straight?\n\nHi Dr. , my son is 15 months old and has been diagnosed with rickets due to lack of vitd, peditrician will let us know abit dose of vitd . Pls let me know as he is bowleggd. Within how many years he will start walking straight after this treatment and will it affect his height in future. Thanks",
    "doctor_response": "Thanks for follow up ,rickets is general disease , not cause only in Vit D. It can be deficiency of proteins, iron, vitamins, problems with absorbtion of calcium in intestine, some vorms (lamblia)can prevent absorbtion. Thats why i recommmend additonal examination- blood test for hemoglobin, Calcium,Phosphorus, albumins and general protein, stool analysis for ova and cysts, for digestion function at least.I hope that your child drink at least 1000 IU of Vit D3 together with calcium,because without Calcium you will not receive result.In addition your child should eat natural Calcium-spinach, sesame seeds, panir, dahi, milk, cheese.Also you add multivitamin-zincovit 1 teaspoon 1 time 1 month, give to him lots apples or natural apple juice, its helpful for legs. In most cases children start walk straiht and you will never suspect rickets.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath and palpitations?\n\n48 yr old male non smoker 79 bpm. after light activity I have shortness of breathe, slight heart burn, fluttering in chest, no dizziness only lasts for a few seconds, if i put my hands on my head after a few seconds it feels like my heart has hard beats, no swelling of any kind any were. I do have a prescription for omeprazole but i dont have a need to take it on a regular basis. Not sure what is goin on?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Regarding your concern, I would explain that it is important performing some tests to investigate for the possible causes underlying your symptomatology: a cardiac issue, gastro-esophageal reflux, a hiatal hernia, or a lung disorder. For this reason, I recommend consulting with your attending physician and performing some tests: -a resting ECG and a cardiac ultrasound- a chest X ray study and pulmonary function tests- complete blood count - an exercise cardiac stress test for possible coronary artery disease- an ambulatory 24-48 hours ECG monitoring to investigate for possible cardiac arrhythmia. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for recurrent cough and trouble in breathing\n\nLast month I have severe cough that last for 2 weeks .First doctor prescibed Toplexil, Cirrus, and azomycin but after 2 days of taking the medicines my cough become more persistent. Then doctor gave me Mucolyte, zyrtec and continue azomycin for 5 day, My cough still continue and I was given prednisolone 5mg and Factive to be taken for 6 days also advised to use nebulizer ( ventolin and atrovent) since I'm having difficulty braething as well, only then I got better.Now I'm having the same problem although my cough is not worse than of last month. Can I take Mucolyte and Aerious at the same time to treat my cough? do I need to take antibiotic ? I'm worried that I may have the same problem of last month. Looking forward for your help thanks in advance",
    "doctor_response": "Respected user, hi I evaluated your query thoroughly .* All  narrations herewith are given regarding the symptoms & treatment    line  but what about the diagnosis , finding the root cause to evaluate the    case  & management accordingly ?* Whether any laboratory work up , X-ray chest , Pulmonary function test ,   Diagnostic bronchoscopy  or  anything else was carried out as part of    diagnostic protocols , if so kindly   upload the results & if not also revert    back with the same so that we can  make decisions for further actions to    solve the issue , now much time has  lapsed of almost a month .Hope this helps you .Welcome for any further assistance .Thanks for using Healthcaremagic.com & giving me an opportunity to assistRegards dear take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for excruciating pain in lower left side of the mouth\n\nI have sharp, excruciating pain in my lower left side of my mouth from a bad tooth. Its the 2nd one from the back. It has a cavity in it. I had tried various home remedies to be rid of it, and nothing works. My funds are all but nothing, so I am worried a dentist may not help me....What can I do?",
    "doctor_response": "thanks for your query. i have gone through your query. the pain could be because of the infection in the root tip of the tooth. the home remedies will not help. we have to treat the cause by treating the tooth with root canal treatment or extraction. consult your oral physician and get radiograph done and start with the treatment. you can take a course of antibitics and analgesics like penicillin and diclofenac(if you are not allergic). i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for getting pregnant\n\nHi, am 23, 50kg. I have been on injection for 4 years, and every month have always seen dark red discharge. My last injection was in january this year, am planning for a baby, how long does it take 2 get pregnant? My cycle is more than 46 days. And am experiencing some pain in lower abdoman.",
    "doctor_response": "Hi I think you should go for evaluation first. Do a thyroid profile and prolactin levels and a ultrasound for follicles. A semen analysis of your husband should be done.  If everything is fine you can try naturally for 6 months.  If it doesn't work then you can contact a doctor for some medicines for ovulation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is there any chance of getting rabies when licked by a street dog?\n\nHi doctor, A dog licked my leg on the street. I have no wounds on the leg. When I came home, I washed my leg with soap and then I found out that I had a little scratch near my hand nail (I did it when I was doing manicure). Is there any chance to get rabies in that way?",
    "doctor_response": "Hi. I will recommend you to follow the dog's trails. If it is normal, then there is no problem. If you have any feeling of doubt, then you get a rabies vaccine. Licking an open wound can transmit the virus if the dog has a rabies infection. But, if the dog is good and if you do not have any open wound or scratch on your leg where the dog licked, get relaxed. You will be fine. But if you are anxious, then consult your general physician for further approach. For more information consult a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and swelling in leg and back pain with frequent urination?\n\nI have leg pain , legs swell, foot pain , lower back pain, sometimes get a sharp pain through my back, I am having difficulty walking and have fallen a few times. I feel pain through out my body and only feel relief when in bed yet at times I have trouble sleeping because of pain. When I am resting or sitting I feel the need to move my legs. I do need to urinate frequently usually about once an hour so can not sleep through the night. I have been gaining weight because I am not moving as much due to the pain.",
    "doctor_response": "hi,thank-you for providing the brief history of you.A thorough neuromuscular assessment is advised.As you mentioned your symptoms you need to undergo a thorough neuromuscular assessment and some special clinical test will be performed to figure out the possible causes of the pain. Post which an MRI of the lumbar spine and diagnostic ultrasonography will be advised to come closer to the diagnosis.As for the lumbar spine MRI, the reports will provide in detail the soft tissue status in the spine and will help us correlate with the clincal symptoms. post which with medication and physical therapy the further plan of treatment will be programmed.An diagnostic ultrasonography of the abdomen will help.us reveal any kidney issues to rule as as you have a complain of frequent urination.As you mentioned about frequent urination, you haven't mentioned your age and cardiac profile. If you are under any cardiac treatment then the frequent urination can be because of it.As for the pain radiating from the lower back to the legs, physical therapy will help you by - Therapeutic ultrasound therapy and TENS therapy. Post which and exercise plan will be programmed to ensure the strength in the muscles to get optimum results.In my clinical practice, a detailed assessment is performed post which the treatment is guided. We are able to manage 99% success in our patients symptoms and full recovery in ADL.regardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated levels of ALT and AST ?\n\nOn a my last blood test my ALT level was 102 and my AST level was at 60. My previous blood test 7 months ago they were ALT 36 and AST 25. Is this a considered a huge change and what Could cause it? I don t drink alcohol. I also had an EKG done that came back abnormal, could That be part of the elevated levels?",
    "doctor_response": "HelloIncreased ALT and AST may indicate liver injury.It may be due to many reasons like hepatitis,alcohol intake,altered lipid profile,medicines,auto immune causes etc.You may need few more investigations like routine hemogram,random blood sugar,viral markers,lipid profile,ultrasound of abdomen.I suggest tablet ursodeoxycholic acid 300 mg tablet twice daily for three months.It helps in regeneration of liver cells.Since EKG is also abnormal,you may need detail cardiac evaluation.You may need TMT,ECHO etc.Treatment depend upon findings.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can paranoia be managed?\n\nMy nephew is exhibiting very paranoid behavior. He denies he is on pain meds but we don\u2019t believe him. He is accusing his father-in-law of poisoning his water and his nephew of putting feces on his pillows for ex. He has had many back surgeries. Would there be some way we could speak to his dr. Considering the hips laws or do you have another suggestion.",
    "doctor_response": "Hello, People suffering from a paranoid personality disorder or paranoia do behave in such a way. That is the way their psychology works. You should be careful in dealing with those. He will never believe anyone near if you try to advise, contradict him again and again. You must consult a psychiatrist at the earliest for treatment. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could very low hemoglobin level lead to death?\n\nHow does low hemoglobin kill a person and is it a painful death? We brought my father in law home on a vent 2 weeks ago to pass, had bypass surgery in January and never got off the vent. Does not want anything done that requires a trip to the hospital. His hemoglobin is at 6 (this has been an issue the last 6 months with many units of blood given), our family understands that this could kill him, we don't want it to be painful. What happens when hemoglobin keeps going lower?",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Low hemoglobin leads to deficient oxygenation of tissues, which can cause cellular hypoxia leading to cell death.2. Due to low hemoglobin, the heart performs more activity for more oxygen to reach tissues, this overtime will lead to  cardiac failure.3. Tissue damage can produce free radicals, which cause further tissue injury.4. Cardiac failure, peripheral organs damage and risk of infection are the usual cause of death in severe anemia or low hemoglobin.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dehydration\n\nMy gf went to the ER last night because she was thirsty and not feeling good and found out she was dehydrated so they iv her over night comes home its hot as heck out side in the 100s shes been drinking water and gaterade non stop is it possible she could be dehydrated again?",
    "doctor_response": "Dear patient,it could be, but make sure she does a glycemia. Does she urinate normally or more than usual?Take care,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to avoid unwanted pregnancy?\n\nMy boyfriend I have been together for a year and a half and were starting to think about having sex the only problem is I want to get birth control and I don t want my parents to find out. how much is birth-control? I ve been told it takes three months to work, three months is around the time were thinking about having it will I need to continue taking it after a month, like will I have to take it for 3 months in order for it to work?",
    "doctor_response": "Hello dear.Understand your concernsLook dear,It not necessary to take bith control pill for 3 months.you can take it for 1 month also.but I advised you, to convince your partner to use condom to prevent the pregnancy & also prevent sexual transmitted diseases.This is also feel you fearless about worries of your parents also.I hope this will help you.ThanksDr.sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for painful lumps in the mons pubis area in pregnant woman\n\nI have a painful, movable lump under the skin on the mons pubis area of my body. I m also 37 weeks pregnant. It is a shooting pain and is causing a great deal of discomfort. It started the other day and lasted a few hours. Hasn t happened again since now.",
    "doctor_response": "Hi.Thanks for your query.Noted the history and understood your concerns.A painful lump on mons pubis in a 37 week pregnant patient can be due to either of the following:Boil or furuncle.Fat necrosis.This can be confirmed by the following:Clinical evaluation, examination preferably by a General Surgeon.High resolution ultrasound can help the best to get a correct diagnosis which is important as the treatment is limited by virtue of pregnancy as many medicines can not be given or best avoided for the safety of unborn baby.Safe antibiotics are given if boil is present.Fat necrosis does not need any specific treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes palpitations and chest tightness after gallbladder removal surgery?\n\ni had my gallbladder removed two weeks ago i was admitted to hospital on sunday after having what seemed to be a gallstone attack (however it was worse) they discharged me yesterday, i havent been able to eat since sunday im on paracetamol however my chest is extreamly tight, and i keep feeling a palpertation in my chest, i cant take in deep breathes/yawn/cough sneeze etc as the pain is excruciating, im also struggling to sleep. please help :(",
    "doctor_response": "hello,  Are you having a pain at surgery site, or some where else. If it's at surgery site, do you have fever, or the pain is increasing, if yes you should visit the surgeon to look for complication. If not then you can try some pain killer along with antacid.   If it's not at surgery site, then it can be acidity and reflux disease. Do you upper abdominal pain, nausea, bloating, burping, increase in pain on food, sour water feeling in throat or chest burning, if yes it further supports the diagnosis. You should avoid fatty, oily and high calorie diet. Have some walk after having food instead of taking rest. Have multiple small meals instead of heavy meals. Have regular sleep habits and avoid stress. Lots of green leafy vegetables, fruits. Avoid smoking and alcohol if any. You can get prescribed tab Pan DSR 40 mg beforebreakfast once a day for 2 weeks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness on the face post an accident?\n\nI had an accident on 6/24/2014. After the accident, I immediately felt numbness at the right side of my face, my head was uncomfortable and pressured, and my right shoulder and arm were hurt. I had a CT scan of my brain. The report said: there is mucosal thickening in the ethmoid sinuses. It is something that I should be careful.",
    "doctor_response": "HIThis just means you probably have a chronic sinus infection and that can be treated with  a course of antibiotics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why my semen is yellow and thin?\n\nOk I recently have noticed for the last two weeks or so I've had  dark yellow, thin semen. I've never had this before and am wondering what it is most likely. I keeping reading threads saying it could be an infection but I have yet to feel pain. What are your thoughts?",
    "doctor_response": "HelloThanks for query.Yellow and thin semen is mostly due to infection of either Seminal Vesicles or Prostate .You need to consult qualified Urologist for clinical and digital Rectal examination and get following basic tests done 1) Routine urine and urine culture 2) Semen examination and semen culture .3) Ultrasound Scanning of abdomen and pelvis take antibiotics like Doxicycline and anti inflammatory drugs like Diclofenac twice daily later on switch on to appropriate antibiotics as per culture report.Ensure to drink more water .Ensure to avoid sexual activities till it gets cured .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for knee pain post a meniscus repair surgery\n\nHi, I had meniscus repair in 2015 and was told I have arthritis in knee and had bone spurs that were removed and would probable need a knee replacement in a few years. This year started walking 2 miles a day, some squats and stairs with no problem. A few weeks ago my dog got out of the yard and I chased her, I felt like I stepped wrong and felt pain in my knee for about a week. I rested my knee, iced it and felt better but now feels like it wants to give out but I have no pain. I went to an Ortho who examined it and looked at X-rays taken in 2016, gave me a band to wear beneath my knee and told me to rest and ice it and offered me a cortisone shot which I denied because I have no pain but still feels like it wants to give out with a little pain so I have requested a second opinion and new set of images. I m frustrated, any other suggestions?",
    "doctor_response": "Hi, I had gone through your question and understand your concernsWith such presentations in my clinic, I would first ask for new X-ray for both knees (standing position) to assess the degree of Osteoarthritis now.New knee MRI will be also helpful to assess the menisci and any new degenerative tear.Knee osteoarthritis is very common after meniscal injury and meniscal surgery and could be treated by the following to delay knee replacement surgery:-weight reduction.-knee brace.-Avoidance of heavy activities, prolonged standing and prolonged knee flexion.-receiving medications as chondroprotective drugs and NSAID when needed",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for vertigo due to upper respiratory problems?\n\nHello, Im having issues with vertigo and I went to the dr and was told it from upper respirator problem. She told me to take my allergy and sinus med and gave me some motion sick meds. I got a little relief but it has return. What can I do now should I continue back on the meds?",
    "doctor_response": "Hi. I can understand your concern. YOur doctor is right . But it is advisable to consult your doctor before starting the medcines as you will require a detailed evaluation.Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "When should i take ovamet tablet to get pregnant?\n\nhi m ity wife is going to take ovamet to trying to get pregnant but a doctor say starting take on 5th day of the cykel but her friend had used it on the 1 day of the cykel and she say start take it on the 1 th day of cykel whats the right ting to do? chris",
    "doctor_response": "Hi,Ovamet contain Clomiphene CitrateIt help to increase FSH and LH, induce ovulation and increase chance of pregnancy. There are several documented regimens regarding Ovamet. The most common regimen is to take the Clomiphene (Clomid) starting on day 5 after the start of menses for 5 days ending on day 9.Another regimen is to start on day 4 through 8 and a recent publication indicates the Clomid can be taken on day 1 through day 5 with a very successful pregnancy rate. So regimen varies form doctor to doctor. You can follow your doctor's advise and go for USG scan/ovarian follicle study for monitoring after taking it. Avoid stress, take healthy diet, drink plenty of water and do regular exercise.Hope this may help you. Contact further if follow up needed.Best regards,Dr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for negative emotions like anger and hate\n\nI sometimes feel angry and capable of doing anything bad. I hate the whole world and everybody in it. Mom says she loves me but I over heard her telling grandma I am responsible for my kid sisters death. She also often tells me that I am an only child because I killed all the children before they are born. Dad left mom because I was not born a boy. I hate myself, my parents and everybody else.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. I suggest you should talk to your mother regarding this. Your problem could just be obsessions and assumptions. No mother can tell like that to her own child. Secondly, even if it is like that, why you are worrying? Every one of us are loners. We come alone, live alone and go alone. Who ever comes in between are just passers by. We are here to live our life perfectly. Do it.If you require more of my help in this aspect, Please post a direct question to me in this URL.  Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of potential pregnancy?\n\nI Had an u/s done on oct.22,2010 sayin i was 7 weeks due date june 10th. This Wouldve meant that i conceieved when i was with my bf sep.17 2010. But i just went to get another ultrasound done and stated that i was 20 weeks and 1 day on jan.17,2010, giving me a due date of june 5th, if you calculate my LMP(aug.29th) this would be accurate for a 28 day cycle but i have a 31 day cycle. I was with someone else on sep.10th once unprotected, but my bf has been getting all the symptoms, nausea, nosebleeds... should i worry or should i just go by the first u/s?",
    "doctor_response": "first USG scan is the most accurate for calculating LMP so go by the first. USG and take your edd to be exactly that by first USG",
    "dialogue_context": ""
  },
  {
    "patient_message": "Constant pain in chest, arms and legs after having birth control pill with blood taste in throat\n\nHi lets start by letting you know two weeks after taking a birth control shoti started to get left chest pain in a few days later it went down my left arm and sometimes radiated to my left leg..at this time i also started bringing up green phlegm.hospital checked fur clots by blood test, leg ultrasound,ekg, chest x ray with no dye and all was normal but fur the weeks it is constant only thing totake pain away is Oxycodone. Now the spectum was bright red (blood) when i woke up and this morning i could taste blood in my throat.what is going on..pain in chest and left arm is constant",
    "doctor_response": "Hi, If no blood clot found out, then, I suggest to consult with a GI specialist to rule out gastric problems (ulcer). I also suggest to do: - upper endoscopy- chest X-ray- abdominal ultrasound- EKG- cardiac echoto evaluate your health condition. I advise not to take the birth control shot for a while until the symptoms will get reversed. For the moment, I advise to: - drink more water- have small, frequent meals- avoid spicy, chillies, citrus, etc.Hope it was of help!Dr.Sejdini",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medicine should I take for the pain in my stomach and throat ?\n\nHi, I have a sandpaper feeling in my throat and my stomach. It feels like severe pain and i take lexapro to basically numb my pain receptors. My mother tells me it is indigestion . But, i don t know it seems more painful than regular heartburn . It s practically unbearable and i can t hardly talk when the pain is there. What do you think it may be? I need some help and i don t know what to do. Please help. :(",
    "doctor_response": "hi welcome to healthcare magic forum i you need to consult doctor it is not a normal heart burn it look like viral infection and gastritis . you need to take anti histaminic ,analgesic ,antacid and other medicine . do warm water gargle for throat pain take light and bland diet i hope a answered your question .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high blood sugar levels\n\nim looking for an endocrinologist for my daughter in lufkin texas..she is a type 1 diabetic..also she came home tonite almost passed out she was very pale her sugar was 377....did the keytone test it was high...she is refusing to go to doctor what should i do",
    "doctor_response": "hello there.the sugar levels of your daughter are very high and she is passing ketones in her urine which shows the high bloof glucose levels.I would highly suggest you to take your daughter to hospital.Doctor may need to start insulin therapy to lower down the blood glucose level.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of swollen scrotum, pain, redness and lower abdominal pain?\n\nwhat can be the causes of a swollen scrotum.  is painful and red and hurting in the lower abdomen.  How can we find a doctor specialized in this area.  My son had this problem 2 years ago and  ran every test under the sun with a GP with no clear cause.  It went away and no has come back.  What could be causing this?",
    "doctor_response": "Hi,Scrotal swelling may be due to some cause. As the part is reddish and painful, the disease would be infection of testis and epididymis..epididymoorchitis. You consult surgeon for firm diagnosis. After thorough examination and investigation, he would give a c ourse of heavy antibiotics with antiinflammatory drugs. Your son would be alright. I hope you got my answer.Thanks.Dr.Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "I had hip RESURFACING on my right hip about 5 years ago and I am still going strong with it but the recovery was very tough because it was done with the posterior approach ( a lot of muscle cutting. I now need my left hip done, but I m not thrilled about going through the all the physical therapy it will take. I have heard about the anterior approach to hip REPLACEMENT and it sounds like that is much less evasive and would get me going much quicker, but replacement is not for active athletes like myself. Can hip resurfacing be done with the anterior approach? I don t see too much info on this. I m 58 years old. Thanks",
    "doctor_response": "Hi Hope this message finds you in good health.I have gone through your complaints and understand your concern.Though posterior approach is commonly used,anterior approach can also be used to minimise the surgical injuries.But it needs to be done in the hands of a skilled surgeonNothing to worry about.\u00a0\u00a0\u00a0\u00a0\u00a0I hope your question has been answered.If you have any follow-up queries,feel free to consult me anytime.Thanks,Take care,God bless.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high cholesterol and stress\n\nhi, my husband is 40 years old, he has an hernia in his back, and has had a lot of stress, he has been moving his ofice to another side, so he has been picking up things, and his cholesterol is kind of high... but he is feeling really bad, and he doesn\u00b4t feel his hands and legs, he feels some sort of tinklingness,... he is exhausted and he felt asleep really fast without taking any pill. Should we go to a hospital or what should we do?.. could he have a heart attack? or should he get surgery?",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!I understand your concern and would explain that the tingling in his hands and legs could be related to a cervical disk herniation. I would like to know the region of the spine, where he has had his hernia before. The fact that he has been lifting weights, may have exacerbated his hernia. For this reason, I would recommend consulting with a neurologist for a physical exam and a cervical spine CT scan or MRI. Regarding his cholesterol levels, I would recommend starting a statin (atorvastatin, etc.), to reduce cholesterol levels. I would also recommend some other blood lab tests to investigate for possible causes of chronic fatigue: - complete blood count for anemia- kidney and liver function tests- fasting glucose- blood electrolytes- PCR, ESR for inflammation- vitamin D and vitamin B12 levels. You should discuss with his doctor on the above tests. Hope you will find this answer helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does an itchy red rash on the left foot indicate?\n\nI had approx half dollar size area on inside of my left foot that has now grown n size & 2 other areas have devolped approx dime & nickel size. Areas are red & flaky. And itch @ times. I thought ringworm however with treatments it continues to increase in size.",
    "doctor_response": "Hello, Your mentioned symptoms suggestive of fungal infection mostly. However, to confirm diagnosis I suggest you upload a photo of the lesion to comment further. Sometime fungus might not a response to usually used antifungal like Clotrimazole but luliconazole can be beneficial. But it's advisable to upload a photo before giving further comment. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is kidney issues related with low creatinine levels and water retention in leg?\n\nHello sir, My dad is having problem in kidney his creatinie level is 2 and his 1 leg is swelling and water gets accumulated in his leg...pls suggest me whether this problem is regarding kidney disorders or heart problem because his heart pumping capacity is only 15%",
    "doctor_response": "Hi and welcome to HCM.As an Urologist, i can understand your anxiety. Your father's age isn't given.Your father has both kidney and heart problems.The creatinine is elevated, due to kidney problem.The EF (ejection fraction) of 15%, is due to a heart problem.The leg swelling is due to multi-organ problems.Water gets accumulated,when the fluids aren't filtered out by the kidneys.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is chest pain on the left side  a symptom of a heart attack?\n\nHi doctor,I have been having mild pain in my left chest since 3-4 days now. I keep thinking it is gas pain as previously I did have this kind of pains. There was slight burning sensation in my middle chest and sometimes I feel the pain in right chest also. I tried drinking lot of water and I had to belch to let out the gas. But when I climb stairs I feel the pain can be felt. Even at rest, the pain comes and goes with no other synmtoms. Is it just gas or anything more serious like heart attack?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. By your history and description, possibility of GERD (gastroesophageal reflux disease) related chest pain and gaseous distention is more likely. But better to rule out heart diseases first. So get done ECG, 2d echo and stress test (trade mill test). If all these are normal then no need to worry for heart diseases. Take Pantoprazole and Levosulperide combination on empty stomach twice daily for GERD. Avoid hot and spicy food, avoid junk food, avoid stress and tension, be relax and calm. Don't worry, you will be alright with all these. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have bipolar, anxiety, suicidal thoughts, borderline personality disorder, insomnia. Symptoms can get worse with age?\n\nI have bipolar 1, but my symptoms or episodes aren't the same anymore. I used to have great highs of energy and happiness. Now its depression, frustration, anxiety, irritable, sadness, hopelessness. I went to the hospital last year for suicide thoughts. They were awful. They said after 2 days and talking to me once, that I was Borderline personality disorder. That I was manipulating and it all just didn't sound like me. I always do for others first, to a fault. Anyways, they cancelled my insurance and have tried local clinics. They told me no meds, its all in my mind. That sleep is over rated. I have always had insomnia. I don't know what to do. I don't have money due to not being able to work. Can symptoms get worse with age, change, be a different diagnoses? I am at my wits end.",
    "doctor_response": "HiLet me assume you are indeed bipolar1 Personality Disorder can coexist but to label you of borderline personality is difficult with the information provided. Infact sometimes it may become a bit dicey to differentiate Bipolar Disorder, borderline personality disorder and ADHD. It is a matter of detailed history taking and reviewing the information from as many sources as possible.Now the effect of ageing. Yes, Bipolar Disorder tend to get worse with age esp if left untreated . No,it will not change to be a different diagnosis, as they say-once a bipolar, always a bipolar. I think you should consult some other psychiatrist and start treatment DR SAATIISH JHUNTRRAA",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can smoking marijuana cause thyroid cancer?\n\nmy friend was recently diagnosed with thyroid cancer after having skin cancer that supposedly went away. I told her to stop smoking and she agreed but she claims that it is okay to smoke marijuana and that it will have no affects on her thyroid cancer. Is this true?",
    "doctor_response": "Hi, Cancer. There are a few ways in which cannabis can benefit people with cancer. First of all, the main bioactive cannabinoid Delta-9-tetrahydrocannabinol has been approved for treatment of cancer chemotherapy-induced nausea and vomiting (5).  Cannabinoids may also be beneficial in treating cancer-related pain (5). Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Monish De, Oncologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for sharp pain in ribcage\n\nI have a sharp pain coming from the right side of my ribcage every time I inhale deeply. It also hurts whenever I bend down or make any motion at all that involves my abs. It seems like the pain is originating from a small bump which also hurts every time I touch it.",
    "doctor_response": "dear friendpain you described seems due to muscular/costochondritis. take analgesic like ibuprofen or if severe pain take combination of aceclofenac + paracetamol + chlorzoxazon/serratiopeptidase. it will relieve the pain. if reccurent or severe once do x-ray chest to know other possible cause and also get examined by your family doctor first.hope this answer will be helpful to you.for more queries plz don't hassitate to ask.get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does heart murmur in a baby indicate?\n\nat my babys 6 weeks check up the doctor said he had a heart murmor and has refferd me to a cardioligist since he's refferd me does this mean it could be bad? My baby does get over whelmd when feeding and gets white feet alot does this mean anything? He is 9weeks and 4 days old... Thanks x",
    "doctor_response": "Hi,Heart murmur in babies can be in two cases1. if there is a congenital heart abnormality2. sometimes it can be seen without any abnormality, it disappears with ageIn case we hear a heart murmur, especially if baby doesn't eat well, and get white feet, echocardiography is indicated. If it comes back normal, then nothing to worry. But it should done, because in case of abnormalities, intervention is needed. Nowadays, congenital heart abnormalities are detected early, and usually after interventions prognosis is quite good.Hope I could help youIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will wearing eyeglass for fashion cause any future problems?\n\nHello doctor,Does wearing an eyeglass for a long period of time for the sake of fashion will cause any eye problem or dependency in my life? I have purchased eyeglass from a reputed store. From my childhood, I do not have any eye problem.",
    "doctor_response": "Hello. Actually, it is one of the rare times that I find someone put glasses with no need for it, most of the people try to get rid of them by lenses or laser, this case makes sure my idea that eyeglasses sometimes add beauty to the person. However, while you put glasses which are called Plano (without any power) there is no problem at all unless you use sunglasses with the bad quality it causes some damage to eye because it enables more sun rays to go to the eye. So sunglasses (the good kind) no problem. Plano glasses no problem. It is as if you look through the window.  For more information consult an eye care ophthalmologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause of swelling and colour change of scrotum after epididymitis orchitis.\n\nMy husband was hospitalized in Sept for severe epididimytis orchitis, 2 days ago his scrotum started to swell and has turned slightly purplish in color and has a pretty strong odor. He visited his urologist Monday and is on Ceftin twice daily, the swelling is a little worse, no pain though just tender, but the odor and color change are worrying us. The Dr. Said to come back if anything changes. We have an appt tomorrow but the problem is his Dr. Is not very detailed with information regarding this matter, he only told my husband to take the meds and come back if anything changed...",
    "doctor_response": "Hi, Welcome to Health care magic forum.                       It appears that it is the recurance of the epidedemo orchitis. The other causes may be the inguinal hernia, torsion of the testis etc.                       If the color changes to the brown or dark red he should immediately see his doctor to prevent the necrosis.                       For confirmation he may need to have MRI of the scrotum which is to be taken immediately when the color changes.                       Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility\n\nHi I am 38 years old asian man. I just had my semen analysis. 90% dead, 5 % semi sluggish, 3% sluggish and only 2% highly motile. Volume is 2 ml. sperm count 8m/ml. I am married since 2001 and had a baby daughter in 2003. Ater that we tried our level best but my wife could not concieved. we want another chid. is there any solution to my problem. please help me",
    "doctor_response": "HAI WELCOME TO HCM YOUR MOTILITY AND MORPHOLOGY IS VERY LOW.you can go for IVF WITH IMSI THEY INJECT MORPHOLOGICALLY GOOD  SPERM  INTO EGG .THIS WILL GIVE GOOD RESULTS.REGARDSDR.VANITHA",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicine for abdominal pain\n\nwhich abdominal complication includes urine tasting sour as a symptom? I'm 20yrz ole, with 76kgs,5ft 6in, been having stomach pain from friday and started feeling  better today, didn't have diarhea, orconstipation, just pain which got better laying on my left side, got bloated",
    "doctor_response": "Hi.. i understand your problem,Dont worry  nothing is wrong with you,I have treated so many patient like this,Your main problem is burning urine and pain abdomen,If i was your treating doctor i would testUrine analysis and an ultrasound abdomin.Then i would suggest,ciprofloxacin,along with a urine alkalinizing agent,For bloating first do dietary changes like avoid dairy products and fruits.If not improving then i would suggest antacid or H2 antagonits.These are prescription drug.consult your local doctor.I hope you are satisfied with my questionThanks for using healthcaremagic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itchy black scabs on breast. Had eczema. Chances of having cancer?\n\nI have itchy black scabes on my breast . They appear to be on the milk ducts. I have had eczema my entire life but I have never had it on my breast. I first noticed it about six months ago on my right breast but I used alot of different lotions and creams that eventually made it go away. Currenty I have a new one on my left breast that has been resistant to all differnet types of creams and lotions. I also notice that during my period they seem to be even more dry and itchy. I read that red patches and bumps could be a sign of some type of cancer but I have not been able to find anything on black itchy scabes.",
    "doctor_response": "Hi Welcome And Thanks For Your Question, I Want To Say, If Your Breast Don't Secrete Or Ooze Any Liquid Or Lump like Feeling It Is Then It Is Not Cancerous. Now ! About Itch I Want To Say Keep Proper Hygiene, Apply Anti Fungal Cream Don't Rub Then Take Anti allergy Tab For Itch. And Antifungal Tab Oral At Night. In Week You Will See The Difference. Be Healthy. Bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for redness in eye of a child after an injury\n\nMy 2 year old scratched her eyeball with her fingernail and at first it was just red. But now it looks like it has a white obstruction on it surrounded by red vessels. she says that it doesnt hurt anymore but it looks very strange. this happened 2 days ago.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Consult an ophthalmologist and get eye examination done. The ophthalmologist may prescribe some antibiotic or lubricant eye drops.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Khan Shoeb Mohammad Sher Mohammad",
    "dialogue_context": ""
  },
  {
    "patient_message": "Red mark on cheek, hot, swollen, blisters. Latex allergy or chemical burn?\n\nMy daughter went to the dentist a week ago. By the evening she had a red mark on her cheek, middle of the night it was hot and swell on, by morning it was covered in blisters. We took her to her pediatrician and he put her on a topical antibiotic and hydrocortisone cream which has been working great. The dentist said it was a latex allergy but I think it s chemical burn . What do you think it is?",
    "doctor_response": "Hello, Obviously after a visit to the dentist and an allergic reaction a few hours later, you are dealing with allergies due to various allergens (depending on the exact circumstances) such as: 1. latex gloves - usually used for examinations 2. antibiotics - if given before procedure 3. aspirin or NSAID based gargle or mouthwashes 4. chlorhexidine mouthwash 5. local anaesthetics Keeping in mind the above possibilities, your dentist now needs to exclude which ever ones he thinks not possible (as your daughter was not exposed to) and a skin prick test should be the follow up test after this. Latex allergy can be checked with a blood test for specific IgE and so can chlorhexidine. I hope that was useful. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a painful lump under the skin?\n\n2 weeks ago I had a skin infection and was put in hospital for it it started on my left foot and went up my left leg and the stopped it when it got to mu inter thigh ...but noe I have a red swollen spot that seems to be getting bigger and has pain lump under skin???",
    "doctor_response": "How Are Skin Cysts Treated?Cysts usually do notcause painunless they rupture or become infected or inflamed. Most cysts do not disappear on their own without treatment. Some cysts may need to be drained torelieve symptoms. That involves piercing the cystwith a scalpel and draining it. That doesn't cure the cyst, however. Some inflamed cysts can be treated with an injection ofcortisonemedicationto cause it to shrink. Cysts that do not respond toother treatments or reoccur can be removed surgically if they cause troublesome symptom",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for frequent cavities and decay in teeth\n\nam 25 yrs old single female ,wt 56,ht159cm.i got a new cavity or decay in my teeth every six month & sometimes once  a year . although i take care a lot on my teeths ,i brushed after meals & clean by threads also my mother and my bro has too but they r less comparing to me.so i want to now what shall i do? is their solution to stop it? i dont want my children to have it in future.",
    "doctor_response": "thanks for your query, i have gone through your query. the increased incidence of decay could be because of reduced salivary secretion or malaligned teeth or poor oral hygiene. consult a oral physician and get your self examined and find out the cause. you should get your teeth cleaned and examined once in 6-8months. you can use topical flouride application and use of mouth washes. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of heart stroke having high BP?\n\nmy mother is having bp for past 2 yrs.her age is 50 yrs,5.4 inches,65 kg.she went TMT test,ecg,echo,chest X-Ray,blood test,troponin test etc.she has been advised to take nebi*, placida and isosorbid tablets.i want to know whether she is prone to any risk of heart attack",
    "doctor_response": "Hi,If she has normal TMT results, and she keeps her blood pressure and cholesterol levels within normal ranges, then her chances are very low to have heart attack or stroke.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for weakness with body pain\n\nI am extremely fatigued. My whole body is sore to touch. I have an elevated cea of 7 something. I do not smoke. they had me do a ct scan abd/pelvis, chest xray, colonoscopy and a ct scan of chest because they saw a nodule but said it was benign. i am 56 yrs old. i can lay in bed and touch my toenails with my other foot and it is painful to touch. I have had colon cancer at age 44 and had 3 1/2 feet taken out. I did have hyperthyroidism and then turned into hypothyroidism but had a radioactive pill or something like that to kill the thyroid so I would not have to take meds for the rest of my life. Having some pains in left chest area. I also had a couple of nodules taken out of my right breast 2 wks b4 colon surgery. I am under a lot of stress at the present due to husbands severe stroke as I am caring for him and he is paralyzed on his r side. I have double duty on everything. I have pain in my hands and hard sometimes to grip things. My mother had rheumatoid arthritis. when i get stressed, my muscles in my neck hurt. I have several fibroids. I have had several d and c s, couple of laprosocopies. I feel pressure under my skin in my legs almost like burning sensation. I get charley horses frequenty and have to get up and walk them off and it sometimes takes a while, then sometimes, I turn it bed and it feels like my bones in lower legs pull out of place and twist. got any ideas what I may have or what I should be tested for. I have always had a high uric acid. thank you",
    "doctor_response": "Hi, Get a serum calcium and magnesium test done as sore muscle and bones may be because of calcium deficiency, in a few cause of magnesium deficiency too. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Rohan Shanker Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does the livogen tablet improve hemoglobin in a diabetic person?\n\nhello Doc, does the livogen tablet helps to improve the hemoglobinn in blood for the diabetic patient? I am 55 years diabetic patient (diabetic for last 16 years) weight ~62 kg, HbA1C checked 1 month before is 8. HDL, LDL within normal limit, hemoglobin little less than normal",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. Livogen help you to increase your hemoglobin even with diabetes.  Your Hba1c level is 8. It suggest that you have good control. Continue with your treatment. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What causes inflammation of urinary tract after protected sex?\n\nHello doctor, I have protected sex with stranger and after that I get inflammation in urinary tract. Should I get worried about it?",
    "doctor_response": "Hello. If you have symptoms of inflammation of urinary tract than you have to rule out urinary tract infection. For that, I suggest you investigate with urine routine microscopic examination report and urine culture for primary work-up. You can revert back with reports once done. Meanwhile, drink lots of water and avoid excess spicy foods intake. Cranberry juice extract tablet also needs to be taken for seven days. You have done protected sex so chance of sexually transmitted diseases is very unlikely.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for red colored rashes on the penis\n\nI am 72 yearold. Yesterday I notced that red rashes appeared on gland of penis though I do wash every day with soap and lukewarm water during my bath. I have no sexual relation ship since last 15 years. Would you please help me. I applied betnavite when I noticed yesterday and I think it aggrevated . It is become red and there is no pain or swelling only irritation. UK Nayar, email: nayaru @gmail.com",
    "doctor_response": "HelloLooking at your history and age it could a local inflammatory cyst or penile carcinoma please visit your doctor for.detailed examinationYou can apply antiseptic ointmentMaintain a good hygieneHope i have answered your questionthanks.for.your questionWish you good health take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does my streptococcus keep coming back?\n\nI got streptococcus after having a nissen fundaplacation and two hernias fixed. I also at the same time had to have both ovaries removed. My doctors can not get rid of it. i have been on all type of antibotics along with weekly B12 shots but it keeps coming back. Do you have any advise for me?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You have history of hernia surgery and now post operative infection. You are suffering from streptococcal infection. Your streptococcal infection may be resistant to routine antibiotics. You should go for culture and sensitivity testing. It will help to choose antibiotics. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat cirrhosis of the liver?\n\nHello My husband has cirrhosis of the liver from excessive alcohol consumption. What are the stages and life expectancies? He is in the hospital right now for sinus surgery, but staying longer due to white blood cells are low and slight pneumonia. They took 5 1/2 liters of fluid out of his abdomen. His legs and feet swell up all the time, he can t eat but broths and ensure. thank you",
    "doctor_response": "Hi,Thanks for posting your question in HCM.I am Dr.Siva and I am pleased to assist you.Your husband is having cirrhosis due to alcohol consumption. It is an irreversible condition.Initially it remains compensated without any symptoms. It may later become decompensated causing many complications. Some of the common complications are bleeding in the upper gastrointestinal tract due to engorged blood vessels ( varices), accumulation of fluid in the abdomen and legs, poor functioning of the kidneys and brain. Later the liver may even turn cancerous.The life expectancy depends of the severity of the disease. A scoring system called CTP score is done to assess the severity of the disease. Class C is the most severe form with poor outcome.I hope that answers your question.Regards,Dr.Siva",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the chances of normal delivery when scan report says head is not fixed?\n\nHello doctor,I am 37 weeks pregnant now. Today doctor told me to get admitted everything is fine as per scanning only head is not fixed. Are there any chances of normal delivery?",
    "doctor_response": "Hello. Is there any other reason why your doctor wants you to get admitted. If everything is normal with you and your baby, then we can safely wait till 40 weeks of pregnancy before taking a call for labor. There multiple factors like,  1. Whether the head of the baby has entered the pelvis (engaged head).  2. If your pelvis is roomy enough to accommodate the baby\u2019s head.  3. Any associated medical problems in you?  All these are few factors which help us decide whether you can have a normal delivery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dehydration and panic attack\n\nHello, my name is Doris, Jenny Hoyt recommended you. I was on a holiday in CO & NM and while there experienced altitude sickness, dehydration and shortly after panic attacks. While going through perimenopause 20 yrs. ago I had a bit of this. And can\u2019t stand sharing my space again with it at the moment. Would like to know what your schedule is like and see if we can connect, sooner than later, if you please. Blood work was taken today to follow up on my thyroid challenge, etc. and health. Jenny thinks the hypo challenge has manifested itself into hyper? Quien sabe, we shall soon find out. would like to meet with you at your earliest convenience, thank you. By the way, My heart, BP, and most of me is in pretty darn good condition, despite my unusual come and go quirks. I actually am a bit calmer at the moment, but have periods where I think I am doing all I can to hold on. Screaming is a good thing, as is crying, & of course some of my passions - - singing and dancing, though am not feeling much like the two ladder, which I normally, normally love! But then am not feeling so hot at the moment. I am 61, 34 yrs. married to a very loving and interesting chap, never had kids, infertility, am creative, like to work with my hands, garden, knit, sew, quilt, crochet, cook, metal smithing, broke my patella 6 yrs. ago, and clavicle when I was 3, had 2 laparoscopies 25 - 30 yrs ago, mother is still alive, have 4 siblings, they all reside in SoCal., love to travel, hike in nature, strolle the beach, enjoy the movies, cook & bake with friends, go out, dance all summer at the summer concerts. Studied Psych and Soc in college and graduated with a BA in Sociology, as did my husband. Was an academic advisor at UCSB for many yrs. Then stayed home for sometime, took care of sis and nephew when she had leukemia and later another niece, a 3 yr old, helped my brother and sister in law with her, cause they were having a difficult time coping, did many missions outreach trips to Europe & Mexico for years. Am a Tica, place of birth - Costa Rica, came to UCSB in 1975 and stayed, fell in love with the smallness of it and still love being here, over SoCal any day!!! Have two childhood best pals from age 9 and age 10. Looking for a mature spiritual type psychotherapist to start working with as soon as possible. Thanks, That\u2019s a little about me, more to yet be discovered! Doris Maria Scoltock-Smeltz, 451-3438, my best mode of communicat",
    "doctor_response": "Dear DorrisWe understand your concernsI went through your details. I do understand your concerns. I am not sympathazing because sympathy could worsen the symptoms. Panic attacks are usually due to underlying anxiety disorder. We need to find out how and why those anxiety disorders started and what are those anxieties? Do you have any phobias or fear? When people are dehydrated and anxious, mild to moderate panic attacks are normal and it is body's defense mechanism. You need to understand that defense mechanism and not to worry and be obsessive much about that. Awareness, change in life style, exercise, meditation and cognitive behavior therapy etc should help you in managing your anxiety and panic attacks. If you do not meet with a psychotherapist near you, I am ready to provide you the treatment through this medium. Please post a direct query to me with every detail. Take care.If you still need my assistance in this regard, please use this link.  Please remember to describe the whole problem with full detail.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of dementia?\n\nmy 60 year old husband had a colonoscopy 3 years ago and immediatly after awakening showed deminished cognitive abilities and memory. This conditioned has worsened over the last 3 years and he is showing symptoms similar to alzheimers. He has never had a taste of alcohol yet showed a high level in his blood work during a physical before this colonoscopy. His doctor was sure he was lying about alcohol consumption but he truly did not have any. Could this elevated level have anything to do with the dementia?",
    "doctor_response": "Hi, Welcome to HealthCareMagic.com I am Dr.J.Mariano Anto Bruno Mascarenhas. I have gone through your query with diligence and would like you to know that I am here to help you.1. When there is increased alcohol level in blood, we have to assume this to be the cause of diminished cognitive abilities. 2.Alcohol Levels can be high even if he is not \"consuming alcohol\" directly, but takes some substances (eg Cough Syrup, Pain Killers) which have high alcohol content So He need not be lying 3Coming to your question \"Could this elevated level have anything to do with the dementia?\", the answer is YESHope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in HealthCareMagic at  Best Wishes for Speedy Recovery Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in lower back and bladder\n\nThey believe that i had kidney stones in the past and had a stent put in while i was pregnant and now i am having alot of pain in my lower back and bladder it hurts to try to bend over and when i have to pee but doesnt actually hurt while i am peeing except in my bladder and back?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You said you have stent placed , i would like to know for how long stent is in your body? Have you got it removed?In either case i qould recomend you to get your ultrasound kidney, ureter and bladder done along with complete urine examination to rule out kidney stone and UTIThe stent should be removed within 6 months as the stent itself acts as a nidus for stone formation. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the complications of hemorrhagic contusion ?\n\nA small hemorrhagic contusion is noted in the left high frontal parafalcine region. This is what the ct scan report says for my brother who had met with a road accident. He had fallen down from a bike. Please clarify how serious this is and would it have further complications in future. Thanks. Sanjiv",
    "doctor_response": "Hello, The hemorrhagic contusion occurs in 20 or 30 %of the injuries. The contusion will recover gradually. Soft tissue\u00a0contusions\u00a0can\u00a0take\u00a0anywhere from a few days to a couple of weeks to\u00a0heal properly. Meanwhile, I suggest to rest, use ice compresses and use Ibuprofen in case of pain. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for cold and dizziness\n\ngoodmorning my name is panagiota last 5 years i have proplems with my period. starts in 2006. then in this march i had i year to see again my period i know that im in menopause  the syptoms that i have is i feel dizy, especially in the morning and i cant;n afford to be stand i feel sleepy and also i feel freeze and i have the need to be warm. also lately i had a bad gold and i took antibiots augementin and claripen. the gold pased but i feel exostic. what can i do know? for this situation? maybe to take vitamins?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have cold and dizziness which seems to be due to upper respiratory tract infection known as common cold which is a viral infection along with low blood sugar and iron level in body. I would suggest you to Consult ENT specialist for proper diagnosis . Doctor may order certain test like CT scan , blood test , MRI, viral culture test and examination with otoscope . Doctor may prescribe anti emetic drug , anti viral drug ( acyclovir ) , decongestant and anti inflammatory. Do warm saline gargles daily. Avoid intake of cold beverages along with hot, spicy and sharp food. Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Miralax suitable for patients with level 3 kidney disease?\n\nyes. my husband is dealing with constipation from a dose of sodium polystyrene powder. The pharmacist suggested taking Miralax, which contains polystyrene glycol. What is your opinion about this product for someone with level 3 kidney disease? What would you suggest? thanks",
    "doctor_response": "I think that, if you do not abuse it's use, there are not contraindications to take it. Remember that this drugs may affect electrolyte levels if taken in excess.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can calcification in right temporal region of the brain be removed?\n\nI am 52 yrs woman and recently  came to know through MRI Brain that i have a calcification size 8x4 mm in the right temporal region of the brain.  How can it be removed.  Please advise me medicine.  Do this calcification deposits can be deluted by medicine if so then how long it takesthanksparamjit",
    "doctor_response": "Hi Ms Paramjit,Thank you for posting your query on HCM.I have noted your details and MRI brain report findings.First of all, I would like to reassure you that the calcification in the brain is not a serious disease and there is no need to worry about that.There is no medicine or surgery to remove the calcification. The calcification is the result of past infection of brain such as tapeworm.In rare cases, this can cause seizures. In that case, you would need to be started on anti-epileptic medications.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for colic?\n\nHi my 1 year old son had colic as a baby. we gave him lactose free formula milk that helped a lot. Later we gave him Similac easy digest which worked very well. Now I want to switch to whole milk, and gave him parmalat first growth milk. He had bad stomach cramps and gas. Can I give him Nido or what must I give him? the Similac formula is very expensive.",
    "doctor_response": "As your baby is 1 yr old and he might have intolerance to lactose or any other milk contains. So you should consult a pediatrics first and do proper test to find out the reason.Till then avoid any milk or milk products..Get well soon...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling of foliate papilla on right side of tongue?\n\nI have what appears to be a swollen foliate papilla on the right side of my tongue. It is dome shaped and the same color as the surrounding tissue. The foliate papillae on the other side of my tongue are much smaller. Could this be serious?",
    "doctor_response": "Hello, Thank you for consulting with HCM.This kind of enlargement is seen in cases of allergy, it can be possible that you might have taken some kind of food which has caused this allergy. Better wait for  week , if it does not become normal after that also then you have to visit a good dentist and consult for the diagnosis and treatment.Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for mild heart attack?\n\nmy mum today went into DKA. an ECG shwed that she had a mild heart attack, but there was no chest pain.  Throughtout, her speech became slurred and now she does not know what year she is in, that i was born or anything. Her blood sugar levels were registering as HIGH on her machine reader and then 30.  What can be done? She is currently in hospital",
    "doctor_response": "hello Welcome to HCM .She is having disorientation due to DKA. DKA causes acidosis which affects major body processes including the functioning of he heart. She must be started on iv fluids, and continuous  insulin infusion for the DKA.  Insulin dose can be adjusted according to the sugar levels which should be monitored hourly. A 2d echo must be done to correlate with the changes in theECG. If the ECG suggest heart muscle damage then she has to be started on blood thinner medications and nitrates (drugs dilating heart vessels). Once her sugar levels are stable, acidosis is corrected and urine has no ketones, she can undergo an angiography. Sometimes DKA can also cause decreased pumping function of the heart. Patients with long standing diabetes do not have chest pain while having a heart attack. . So once she is stable she must undergo an angiography. Angiography will suggest If there are any blockages in the heart. Further treatment can be decided on basis of the results of the angiography. Wishing her good health Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain with fever in a child?\n\ni have a 6 year old boy and he got out of school yesterday and was complaining of stomach hurting then his eyes started to drop like if he had fever he only had 99.5. today they send him from school cuz he got pain in his stomach again they tolk his tempeture and it was for 102.6",
    "doctor_response": "Hi,Welcome To Healthcare Magic.I can understand your concern about your child\u2019s health.As you are saying he is having abdominal pain and fever, so these both symptoms  occur  when there is intake of indigested or infected food.  So, your child might had eaten some infectious food.For temporary relief in fever, start antipyretic medicine like, metacin 125 mg 7.5 ml, 3 times in a day(if no allergy) at the interval of 7-8 hours. Start syrup Meftal-spas, 5 ml, 3 times in a day(if no allergy)at the interval of 7-8 hours, for temporary relief in abdominal pain.Consult pediatrician.After doing all these things, I hope your child will get well sooner and please share your review about my answer on healthcare magic.Take Care,Thank You.From:- Dr. Nupur  Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest effective cure for sickle cell anemia\n\nHello I have sickle cell anemia and I went to the hospital last week and while there was told that my white cell count is too low and to hold my medicine called hydroxyurea. I want to know is there anything I can do to help boost it or get it back to normal?",
    "doctor_response": "HiSickle cell anaemia disease usually requires lifelong treatment.Children and adults with sickle cell disease will be supported by a team of different healthcare professionals working together in a specialist sickle cell centre.Your care team will help you learn more about the condition and work with you to come up with an individual care plan that takes into account all your needs and health concernsThe main thing you can do to reduce your chances of experiencing a painful episode (sickle cell crisis) is to try avoiding possible triggers.This may mean you need to:drink plenty of fluids to avoid dehydrationwear appropriate clothing to stop you getting coldavoid sudden temperature changes, such as swimming in cold waterIf you continue to experience episodes of pain, a medication called hydroxycarbamide (hydroxyurea) may be recommended. This is usually taken as a capsule once a day.Hydroxycarbamide can lower the amount of other blood cells, such as white blood cells and platelets (clotting cells), so regular blood tests will usually be recommended to monitor your health.If you experience a sickle cell crisis, you can usually manage it at home. The following can help:take over-the-counter painkillers, such as paracetamol or ibuprofen (aspirin should not be given to children under 16) \u2013 if the pain is more severe, your GP may prescribe stronger painkillersensure you have plenty to drinkuse a warm towel or a heated pad to gently massage the affected body part \u2013 many pharmacies sell pads that can be used for this purposetry suitable distractions to take your mind off the pain\u2013 for example, children might like to read a story, watch a film or play their favourite computer gameAnaemia often causes few symptoms and may not require specific treatment.However, dietary supplements such as folic acid (which helps stimulate the production of red blood cells) may sometimes be required to help improve anaemia if your child has a restricted diet, such as a vegetarian or vegan diet.Anaemia caused by sickle cell disease isn't the same as the more common iron deficiency anaemia. Don't take iron supplements to treat it without seeking medical advice as they could be dangerous.If anaemia is particularly severe or persistent, treatment with blood transfusions or hydroxycarbamide may be necessary.RegardsDR DE",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numb left hand?\n\nHi, My left hand is getting numb only during night time and few months back my wrist was hurting.I am lefty. Also little overweight.But do regular exercise pretty much 5 days a week.Also, sometimes I feel my heart palpatation is high. Please let me know what can I do.",
    "doctor_response": "Good day! The most common answer to the symptoms you are experiencing is Carpal Tunnel. It is compression of a main nerve in your hand that comes from repeated movement and compression of the wrist. The symptoms can occur often at night due to accumulated tension throughout the day. As for the palpation's, how high is your heart-rate? Common causes can be coffee, dehydration and or stress. If you experience any other symptoms certainly see a physician for a Cardiac Check-up. As for the wrist, try taking breaks from repetitive tasks involving your hands. There are wrist splints that can be bought over the counter, they are very useful. Stretching exercises may also help: make a fist and then spread your fingers out. I hope this advise can be helpful, and leads you in the correct direction. You have my warm regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the right side of the rib cage?\n\nHi, I'm a 30 year female with tolerable right side pain under right rib cage and into the side of my back. I also has lower back muscle pain. I have no fever, or vomiting and no changes in urine. I have no insurance and I'm trying to avoid going to the ER. I have had this discomfort for a couple of weeks. I was hoping that it's muscle related.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Yes, possibility of musculoskeletal pain is more in your case. So follow these steps for better symptomatic relief. 1. Avoid movements causing pain. 2. Avoid bad postures in sleep. 3. Avoid heavyweight lifting and strenuous exercise. 4. Take combination of painkiller and muscle relaxant drug. 5. Apply warm water pad on affected areas. 6. Wear lumber belt for back support. Situated with proper back and chest support. Don't worry, you will be alright with all these in 1 week. If not improving after 1 week then consult doctor. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dark patch of skin on the penis after sex?\n\nHello. I have had unprotected sex with my girlfriend who has no std s (was tested). And i have this scab on my penis (scab as in VERY dry patch of skin) located at the bottom right area of the tip. I got this scab like thing before i had sex as well (when i was a virgin). I believe this was from irritation from working out and masturbation with no lube. But now after sex, the dry patch got a very small crack/cut in it and bled a little bit from the irritation of my boxers rubbing against it. What should i do to make this go away? And is there any concern for me of it being an std? Thanks a lot.",
    "doctor_response": "Thanks for asking in healthcaremagic forum   It is mainly due to dryness and rough handling of the genital during sex/masturbation. So, please use lubrication to avoid this. If it does not subside then visit your doctor for examination and further management. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dry patchy skin in groin area\n\nDiscovered a very dry patchy area of skin located in upper crease area near the groin area. This area also had a nickel sized sore in the middle of the dry patchy area - looked like chaffing - top layer of skin missing. This isn't sore but is spreading. It is now the size of a quarter and have located additional eruptions starting to appear around  the main area that has been affected.",
    "doctor_response": "Hello,Thank you for posting on HCM.It seems you are suffering from Tinea cruris and corporis, a kind of fungal infection.I would suggest you to consult your dermatologist for proper management of the condition.I usually recommend proper course of oral anti-fungal drugs like Fluconazole or Itraconazole along with anti-fungal cream like luliconazole for local application at bedtime. You can additionally use antifungal dusting powder containing sertaconazole during day time and a soap containing ketoconazole for rinsing of affected areas. Take oral antihistaminics for itching as required.Maintain hygiene over those areas and avoid wearing tight undergarments.Hope your queries are resolved and wish you best of health.Kindly spare some time to rate my answer and drop your valuable review at the following link: you require any further assistance in future, you can reach me directly through the above mentioned link.Thank youDr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Cefotaxime be used for UTI in diabetic patient?\n\nHello doctor, I am 44 years old male and diabetic for past ten years. I have been having UTI almost for three days a week and have been taking Norflox 400 twice a day. I was an alcoholic taking 360 ml of brandy every day and recently a month back, I have quit that habit. I now want to focus on my health. I went to a diabetic center and started Trulicity for weekly insulin for sugar control. I gave urine culture ten days back and the report shows Enterococcus faecalis with a colony count greater than 1000000 and only four antibiotics as susceptible, namely, Cefotaxime, Meropenem, Imipenem, and Vancomycin. My diabetic doctor has prescribed Meronem 500 mg injection twice a day for five days. My question is:  I cannot afford Meronem 500 mg as 10 injections are very expensive. I found that Cefotaxime is the cheapest among the four of them. Can I have that injected for five days, twice a day?",
    "doctor_response": "Hi. Yes, you can take Cefotaxime 1 gm twice a day for five days after a test dose for allergy. Controlling your blood glucose levels will help to lower the episodes of UTI (urinary tract infection). Also, get a sonography done with pre and post void urine. For more information consult a urologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to conceive with only one fallopian tube ?\n\ni got married 20 months back.trying to conceive having only one tube patent and husband s sperm count is 40%.will i be pregnant? my age is 27 yrs. and my husband is 32 yr old.",
    "doctor_response": "Thanks for the query You can definitely get pregnant eventhough u have one tube. I suggest u meet a fertility clinic doctor after trying natural methods for six consecutive months around the ovulation period. I could have helped better if u hd told whther or not u are having regualr periods have a healthy living",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and cracking of the ankle?\n\ni was playing basketball and I came down on someones foot which resulted in my hurting my ankle.. as soon as it happened i heard a loud cracking noise for like 2-3 seconds then it was followed by discomfort in my ankle.. my friends said it was swollen within a minute of this happening.. it kinda is swollen and it hurts only when i apply pressure on the backside of my foot.. i can limp around tippy toing on it with minimal discomfort but when i apply pressure to that back of it it seems like it wants to just pop outta place and send me crashing.. it was very numb after it happened for a little bit too.. and i still dont feel all my toes .. very stiff after sittin for a short hour as well.. Is it broken or maybe just sprained.. I know there is something wrong with it.. but not quite sure what and if it is worth going to the doctor for.",
    "doctor_response": "Hi, We should take an X-ray of the ankle joint AP and oblique view to rule out any malunion due to complaints of stiffness. Do consult an orthopedist. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parkavi Gunasekaran, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes body itching with abnormal blood counts?\n\nhello my name is Sandra hall I have been having blood test I have a infiction that the doctor can not fine. my red cells have does not have a lot oxygen. I itches all over my body. white cell are going up platlets are going down .can you tell me what I should do?",
    "doctor_response": "Hello and welcome to HCM,Infection especially bacterial infection can lead to increased white blood cell count. Among the white blood cells, neutrophils are elevated.Red cells not having enough oxygen suggests low hemoglobin or anemia.Itchiness can occur due to many causes namely,1. Polycythemia2. High bile salts in body3. Skin ailments etc.A clinical assessment is required to look for focus of infection and site on body whether itchiness is more.In case of low hemoglobin, relevant investigations are required to know the type of anemia.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest a painkiller with the least side effects\n\nHi, I m seeking a moderate to severe pain reliever that doesn t interfere with my mental processes. I was prescribed Tramadol, however I do not want to ingest it as it causes me to feel high yet doesn t relieve my pain from two ruptured disc, L4 and L5. Do you have any suggestions. I can tolerate Hydrocodone yet do not wish to ingest acetomenaphen. Thank You, M. Ken Williams",
    "doctor_response": "you can use gabapentin for back pain or you can use pregabaline (lyrica) 75mg*2 then increase the dose",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurrent fever and weight loss?\n\nGood Morning. My Mrs. age is 59 & she lost 5 kg. weight in just one month & has 110 ESR .She had fever up to 100.5 degree c.After consuming anti biotic tablets fever comes down but it comes again when we stop taking anti biotic tablets. What should be the reason ?",
    "doctor_response": "Hi!I appreciate your concern towards your wife.Nothing to worry about it, she will be alright in due course of time!Fever not responding to routine antibiotics associated with weight loss and raised ESR could be due to chronic infection like Tuberculosis.Does she has cough with sputum?Any how, she must undergo the lab investigations like chest xray, sputum analysis, and other tests to rule out tuberculosis.Once it is confirmed complete treatment will ensure the eradication of the tuberculosis.Besides, she must take nutritious food like high protein diets, fresh fruits and vegetables.Regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for TB igm and fever\n\nsir my wife she is suffering from mild fever and done elisa test for tb igm and found  positive and the value is  1.020 and the doctor sugest for AKT4 and she is about to complete 2month and doctor sugest for 3month now her apitite is totally lost and she lost her weight and also feel very week pls sugest can she is continue the medicine or go for akt 3 after 2nd month",
    "doctor_response": "Hi,Welcome to health care magic.I understand your concern regarding your wife's weight loss but treatment for TB has to be taken for the full course and completed. She has been put for intensive therapy which is AKT4 for two months and AKT3 for the next 4 months. Regular follow up is necessary to establish complete riddance of the TB bacilli form the body. I also understand there are many side effects of the antitubercular therapy, like loss of appetite and generalized weakness but the treatment should not be altered unless the patient has allergic reaction to the drugs.I suggest you include a nutritious dietary plan which has increased protein and carbohydrate content. She will regain weight once she is free of TB. For now follow the suggested schedule of treatment.Wishing her a faster recovery,Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for pink spot on ball sack next to the bottle of shaft?\n\nThere is a flat pink spot on my ballsack next to the bottom of the shaft.  It's been this way for a month now.  It does not itch and it is not raised.  It is just a different color from the rest of my skin.  What can I do to remedy it?  I don't want people to think it's an STD.",
    "doctor_response": "Hi,You might be suffering from Cherry angina, ELECTROFULGURATION  is the treatment of choice in such cases. Hope it helps. If you have any other question please do not hesitate to contact us.Regards,Dr. Atishay Bukharia",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain while urinating?\n\nMy son is about 7 weeks old, he does not cry when urinating or fuss when he does. He did however wake up this morning with what looked like a tiny bit of blood in his urine. Should I be taking him to see his pediatrician or to the ER? Or will he be fine?",
    "doctor_response": "a blood in urine could be urethritis as long as it's fresh blood. check his penis for any injury- retract the prepuce to see and if it recurs only see the doctor and not to get panic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to confirm stage 4 cancer?\n\nIn June 2008, my mom was diagnosed with bile duct cancer, and the whipple surgery was performed.  Things were fine for a few years and in June 2011, they detected a tumor in her lung and since they could not determine if it was a metastasis with 100% certainty, they removed her lung.  We received confirmation afterwards that it was in fact a metastasis.  Then this past november, they detected a spot in her pancreas.  They sent her for a pet scan and it was detected that she also had a spot in her jaw and shoulder (all less than 2cm).  Right now, she is receiving chemotherapy once per week.  In reading, I can see that this would likely be considered Stage 4 (which I know is bad), but I would really like to know what this means in terms of time (i know there is not sure thing, but even an approximate amount of time could help us deal with the situation better).",
    "doctor_response": "Welcome to Healthcare Magic..  Cancer of bile duct with metastases like what your mother has usually has a life span of about 1 to 2 years.. but it also depends on the particular type of cancer..  She seems to have a relatively good type because she had lung metastases 3 years back and is still fit enough to have chemo... Let's pray for the best...  If you would like to know further please send me pathology reports of previous surgery so that I can help you out... Hope this answered your query..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What disease does the heart report indicate?\n\nmy sister is suffering  heart disease, i consultant  reputed  mbbs doctor  that he examined , heart related  doctor examined  such thing , I am not understand  what disease  my sister suffering . examined reported are below :-Aortic root- 1.9, left artium -3.8, right ventricle /RA - 2.2/2.2 , venticullar septum - 0.8, B) LEFT END  DIASTOLIC DIAMETER - 4.1, LEFT POSTWALL TICKNESS - 0.8,,LEFT END  SYSTOLIC DIAMETER - 2.7,  LEFT EJECTION FRACTION- 64%PULOMONIC VALVE - 0.8M/SEC",
    "doctor_response": "Hello , The echo report what you have mentioned in withen nomral , so in context of the same your sisters heart seems to be fine , however an echo report is far more extensive and so you may upload the same for a more comprehensive review . Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a sore on the tongue and backache\n\nHello, i've been prescribed antibiotics for a urine infection last Thursday and on Sunday I begn to feel ill. I'm not sire if it's the antibiotics or if I'm just generally run down but I have a really painful canker sore on the side of my Tongue which is making chewing and swallowing hard and makes me talk funny. I also generally feel unwell and have a really achey neck and upper back with hyper sensitivity on the skin there. I don't want to bother my doctor for an appointment if I'm just a bit run down. What should I do?",
    "doctor_response": "Hello thanks for writing in to us at HCM.some antibitics have a side effect of making the tongue sore and coated.If there are mouth ulcers you can use a (choline salicylate) mouth gel for relief. Antibiotics can give metallic taste ,nausea and a general weakness. Quite possible you have a viral infection. Dont worry kindly take the antibiotic medications and keep drinking lots of fluids. Syrup Disodium Hydrogen Citrate 15ml in a glass of water thrice a day can help neutralise the infection.Regards,Dr.Riyanka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Pradaxa, Sotalol and Isosorb for A-fib, is ablation required?\n\nI have a history of heart disease and have had a few bouts of Afib. Been taking Pradaxa, Sotalol and Isosorb. Had an ablation about a year ago and they stopped the Sotalol. Afib returned and I was put back on Sotalol. Lately, I ve had ongoing PVC s and PAC s for weeks. Was given Magnesium but they continue. Doctor is suggesting another ablation but I m not confident.",
    "doctor_response": "Atrial fibrillation had to be controlled, if it causing increase in heart rate it is life threatening. If not controlled with medicines, follow your cardiologist opinion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could the white bump near cracked tooth be indicative of?\n\nGood afternoon,I have a cracked tooth (tooth before the wisdom tooth in the left side) and the area around the tooth is red and has a medium size white bump next to it that just appeared today (10/7/14). I have a dentist appointment on  Wednesday, October 15th, 2014. May I know more or less what this could be? any opinions, will be greatly appreciate it.",
    "doctor_response": "Thanks for your query, I have gone through your query.The white bump around the cracked tooth can be a periapical or periodontal abscess secondary to infection from a cracked tooth. If i am your treating doctor, i would suggest you to take a radiograph like IOPAR to confirm the daignosis. If there is a infection in tooth, then get it treated with root canal treatment.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for injury in lower inside lip\n\nHi, my 3 year old bit his lower inside lip. It stopped bleeding, but now appears to have a clot in the hole where he bit it. He is eating ice cream and Popsicles with no pain. Do I need to be concerned with the clot that looks to be filling in the hole where he bit the lip?",
    "doctor_response": "HiThere is nothing to be bother about the clot. Clot is defines mechanism to prevent bleeding: Do not attempt to  remove the clot as it may provoke bleeding.Continue giving him cold food which will decrease the chance of rebreeding.Take CareBest RegardsDr T Shobha Deepak",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on the middle of the hand?\n\nHi, i have been training intensively over the past few months for a dance competition and about a month ago after a session i noticed this big lump in my vein on the middle of my left hand. it was sticking out a lot of was causing a lot of pain. for a while i was not even able to lift anything remotely heavy with my left hand. a month later it is still there and still causing pain. about 2 days ago the area started to bruise. any idea what it could be? thanks",
    "doctor_response": "Hi,Dear,Good Afternoon and Thanks for the query to HCM.I studied your query in details and understood your concerns.@My impression of your lump on left hand-is as follows-It could be-?thrombophlebitis with Acute on Chronic Boil of the left hand. -I would advise -a-Consult ER Surgeon who would check and fix its diagnosis.This would help you to plan treatment with your doctor.@Hope this would resolve your worrisome query.Welcome for any further query in this regard,and would love to help you to resolve this problem till it is solved to your satisfaction.@ One Small Request to you to Write strong recommendations promoting my services for the benefit of my new and old patients at HCM clinic.Wishing you fast recovery..!!Have a Good Day.With Regards ,Dr.SAVASKAR M.N.Super-specialist in NCCD-Non-Curable Chronic Disorders and Rejuvenation therapies in tissue and organ failures.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Being a PCOD patient, I missed my period and my pregnancy test is negative. Why?\n\nHello doctor, I am 23-years-old. I have irregular periods from five years. I have PCOD problem (hormonal imbalance, delay periods) three months before I consulted a doctor and gave me Ovacet and Regestrone (day16 today 25) for two months. In these two months periods are regular. Last month I used only Ovacet tablets I missed period in this month I have white discharge and back pain. The pregnancy test was negative. I am married since two years. Please help.",
    "doctor_response": "Hello. Patients with PCOD (polycystic ovarian disease) are advised low dose hormones for regularisation of cycles. In your case, you were given estrogen (Ovacet) and progesterone (Regestron) to be eaten separately. Ovacet forms endometrium and progesterone matures it into secretory phase so that on stoppage on 25 th day, the next five days you may have your menses. Now, this cycle you took only ovacet so only proliferative endometrium is formed, and if you are continuing ovacet even presently then in a few days, you may have some breakthrough bleeding but not what you can say menses. This missed period is because of not taking Regestron. A pregnancy test is negative, so not to worry. Start your Regestron from today for the next 10 days and wait for periods after that in the next seven days. Another advice instead of using the hormones separately, please use tablet Ginette one od (once a day for 28 days). For six months in toto for PCOD. Maintain a menstrual calendar as well for these six months. Lose some weight. Drink plenty of water. Ginette offers better compliance and better cycle control. So rest assured you are not pregnant. For any further query, you may contact me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in chest?\n\nI have had a pain on the right side of my chest for over a year had tests done but nothing found. Hard of breathing, feels like something is grabbing me tight and stopping me from breathing. It really hurts and sometimes burns. Last few times i have been to the toilet for a number 2, there has been blood in it and always getting bad heads, dont no if it is connected? I have also had a bad back since i was 14, i am now 22. Have been taking Ibroprofen since i was 14, stopped taking them for the last few month. Any idea?",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  There are different issues possible for chest pain as    - low hemoglobin level - deficiency of certain vitamins , proteins , trace    elements , micro nutrients - issues with lung immunity - others .Hope this clears your doubt  .Wishing you fine recovery .Welcome for any further  assistance .Regards  take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I have a wet feeling inside the anus?\n\nHello doctor, I have a wet feeling inside the anus for the past one year. I did a colonoscopy and sigmoidoscopy, and the doctor said that everything is fine. They said probably the wet feeling is due to sweat. Swab culture and sensitivity report showed up Klebsiella pneumoniae. I took Augmentin 625 and applied ointments. But I feel it is some liquid discharge from the anus skin. Can you suggest some medication?",
    "doctor_response": "Hello. An anal leak is mostly due to underlying reasons, which need to be thoroughly investigated. Although we can together try reaching out on differential diagnosis. Regards. Revert with more information to a cosmetologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for diarrhea\n\nMy little boy (aged 2) has had diahorea for over a week now. The only thing I can think of is that he seems to be eating more tinned spaghetti in tomato sauce. It seems silly, but is this the cause do you think? He doesn t eat a lot of dairy products (which some say makes diarhorea worse) just plenty of milk each day. He is fine in himself and eating quite well; most of his teeth are through and teething hasn t caused him to have diahorea for this long in the past...should I take him to the GP just yet? Kind regards, Corinne",
    "doctor_response": "Hello dear corinne!i would like to have a detailed history regarding loose stools,their fruquency?consistency?either they are foul smelling or not?do they cause abdominal pain also?do they contain blood or mucus?if nothing is there and the stools are about 2-3 per day and no abdominal pain no smell no blood in stool,it could be because of excessive eating.stop tinned foods .avoid too much milk ,one glass per day is enough for this age.should also give him more fluids like ORS and fresh fruit juices to replenish the fluid loss if he seems a bit dehydrated.Give him syp. Zinc 5 ml once daily for 10 days along with home made yogurt.hope it will help.wishing your child good health :-)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for recurring gland swelling and lesions in the mouth\n\nMy 6 year old had recurrent swollen glands and recurrent, painful lesions on his gums and sometimes inner lip. They sometime bleed during brushing. They eventually go away and reoccur in a different part of his mouth. Please help. His Pediatrician only says, it s viral and use oragel.",
    "doctor_response": "Hello,I can understand your concern. The recurrent swollen glands can be due to viral or bacterial infection, but the ulcer like lesions in the mouth seems to be like apthous ulcers which are painful ulcers healing in 7-10 days and recurring in different parts of mouth.Apthous ulcers can occur if the child has constant upset stomach or Vitamin B complex deficiency. I would advise you to start Vitamin B complex supplements such as B-Folcin once a day for 1 month. In addition, you can apply local Benzocaine gel (Mucopain) over the ulcers. It will help in faster healing of the ulcers and relief from pain of the ulcers. If the child is constantly having constipation or upset stomach, laxatives should be given after consultation with a physician. If the ulcers do not heal in 7 days or if they keep recurring, you should consult a dentist for clinical examination of the ulcers and further investigations along with treatment.I hope this information helps you. Thank you for choosing HealthcareMagic. I wish your child feels better soon.Best,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My dad died of multiple organ dysfunctions after a Whipple procedure. What was the cause of his death?\n\nHi doctor,This query is regarding my dad, who was diagnosed with obstructive jaundice last year. He was admitted to a hospital, and the doctor examined my dad and told us that they need to perform a Whipple procedure\u00a0on my dad. We did not\u00a0ask for a second opinion, and we let them go ahead with the surgery. The operation took 13 hours, and he was hospitalized for 41 days after the surgery. He was finally discharged after 41 days, but he was suffering from stomachaches, arms pain, and fever. The biopsy report showed stage 1 pancreatic cancer, and the oncology doctor told us that chemotherapy is not required. He just told us that CA-19-9 test needs to be done every three\u00a0months, for five years. My dad recovered, and he was on a\u00a0normal diet.Last month, my dad started complaining about stomach pain, so we admitted him to the hospital again. After an endoscopy and CT scan, the doctor told us that there was some infection in the operated area and that antibiotics will cure it, and my dad will be released in two days. After two days, the doctor told that the infection was still there, so they need to admit him for two more days. But after four days, my dad started having a fever,\u00a0vomiting, and shivering. So, the doctor changed his antibiotics and admitted him for three more days. We requested him to refer him to another hospital, but he said that he could handle my dad's case, and told us not to worry. On the tenth day, my dad was shifted to the ICU. My dad's nails and tongue changed to dark blue color, and the doctor told us that it was due to less blood flow. My dad was bleeding in the urinary tube, so we shifted him to the hospital where the Whipple was performed. Then my dad was again admitted to the ICU, and the doctors put him on a ventilator and other life supporting devices. The doctors informed us that he was suffering from multiple organs dysfunction. And the next day morning my dad passed away. I have enclosed CT, MRI, and other lab reports. How did my father die? What caused his death? Please help me. Thanks",
    "doctor_response": "Hi. I have carefully gone through all your dad's reports (attachment removed to protect patient identity). Hope that explains it for you.\u00a0 For more information consult a medical gastroenterologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am i suffering from regular stomach pain?\n\nHello doctor I am a pationt with diabetes high class And I have been sufariing regular stomick pain that at some times it is unbearable and could not stand the pain , I dont eat as much as I used to be Please advice what would I require to do to have a depth of understanding of the situation",
    "doctor_response": "i think you are referring stomach for abdomen in general. it would be helpful if you provide some information about diabetes being controlled or not. as is the case in uncontrolled diabetes there is chance of some neurogenic origin of pain. to exclude other cause of pain abdomen its better to have a ultrasound test of whole abdomen together with complete blood count. if still you are specific about your STOMACH its better to go for endoscopy test to rule out peptic ulcer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe abdominal pain and sternum pain\n\nHello, On July 12th I went to the E.R. due to pains in my right side. they did a cat scan and x-rays of my right side and found nothing. Ever since my entire stomach has been hurting with the main pain in the center right below my breast bone. I am wondering what this could possibly be. The pain is constant and feels almost warm or hot to the touch in that area. Thank you",
    "doctor_response": "Thank you for using HCM. From the description given it seems that you're possibly having acute gastritis/gastric ulcer since radiological imaging did not pick up any abnormality. Does the pain get aggravated with intake food? What are your dietary habits? Info regarding the same is required with further evaluation like a upper gastrointestinal endoscopy depending on the discretion of gastroenterologist whose consultation is needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mild sensation on the tip of penis,not sexually active\n\nHello, I am almost 30... not sexually active, and for the last week I have had this very mild almost none existent sensation in the very tip end of my penis ( urethra ). What might be causing this? I do bath in body wash as well, and am careful not to allow suds to enter into my urethra.",
    "doctor_response": "HIThank for asking to HCMI can understand this, this is nothing to worry this could be a nonspecific type of  feeling and will go away soon stop paying attention towards this, hope this information helps you have a good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I having creamy and black teeth with bad smell?\n\nHi doctor, I am 18 years old. My problem is the teeth has become white for the past few years. The back portion of the teeth has become dark or black. Teeth are quite creamy. Often a bad smell spreads out from my mouth. My mother also suffers from this problem. I use whitening toothpaste but all are in vain. So, please doctor help me and give me a suggestion.",
    "doctor_response": "Hi. I read your query and can understand your concern. It seems like you have staining of teeth and plaque accumulation. Our mouth contains a great number of resident bacteria. Sometimes some individuals have staining bacteria which leads to physiological stains. This is not any pathology or disease. This staining often leads to plaque accumulation and bad smell from the mouth. You need professional teeth cleaning (scaling and polishing) regularly (usually every six months). Continue brushing twice daily with any toothpaste that suits you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for foot infection?\n\nhey doc, Im just wondering is there any shoe sprays on the market that can reduce or even eliminate the fungi that causes Athletes Foot? I am doing a biology assignment on the fungi that causes Tinea Athletes Foot!! Can you please help!! thanks so much, James",
    "doctor_response": "Hi,Fungal infection is common in-between toes where there is always wetness.Wet area is ideal for growing fungus.so keep inter-digital area clean and dry particularly after taking shower and while removing shoes and socks after coming from out side.It is advisable not to wear shoes and use chapples for some time.There is no spray available for fungal infection.Use anti-fungal cream or lotion like Candid.Along with local application you might require one course of oral anti-fungal medicine like Flucanozole 150 mg once in a week for 4 weeks.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high level of triglycerides in a child?\n\nmy daughters triglyceride number was 386. she is 12 years old, not overweight, very active and eats healthy. I have one doctor telling me her cholesteral is extremely high and a second doctor telling me her cholesterol is normal and no need to worry. i am wondering if 386 is considered high or normal level for triglycerides?",
    "doctor_response": "doctor to doctor varies but i suggest you to take a urine examination just to rule out kidney related issues .... hope this helps...thankyou!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What pregnancy test to undergo few days after undergoing embryo transfer, have light brown discharge and back pain?\n\nHello my name is Muniba, I have 2 embroy transfers on day 3 and today is my 13th day I am having light brown discharge and lower back pain and feeling to have periods, can you please answer my question, should I take now blood test or home strip test? I am on progesterone twice daily.regards,Muniba",
    "doctor_response": "Hello MunibaThanks for writing to us with your health concern.The symptoms that you mention are not specific.Sometimes, they might indicate an early pregnancy.They can also indicate pre menstrual symptoms .There is no point in relying on any of them, to confirm the presence or absence of a pregnancy.It is always better to take a blood pregnancy test.You should take it  on the date recommended by your clinic.After day 3 transfers, the best time to take a pregnancy test is 2 weeks later.A home strip test is not reliable at all.Continue taking the progesterone supplements till prescribed.Dont stress out, it will negatively impact the pregnancy.All the best.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes gustatory hallucinations?\n\nHi, I am experiencing random tastes in my mouth, delicious food tastes from years and years ago. its very sudden and random, and doesnt last long, but there are emotional feelings associated with the olfactory hallucinations (like feeling happy remembering a time i had the food from my memory) what is this??",
    "doctor_response": "earWe understand your concernsI went through your details. I suggest you not to worry much. I suggest you to refer this symptoms as obsessions rather than hallucinations. Gustatory hallucinations is the perception of taste without a stimulus. These hallucinations, which are typically strange or unpleasant, are relatively common among individuals who have certain types of focal epilepsy, especially temporal lobe epilepsy. The regions of the brain responsible for gustatory hallucination in this case are the insula and the superior bank of the sylvian fissure. Therefore, instead of worrying about the problem, try to ignore it and you will be cured.If you require more of my help in this aspect, Please post a direct question to me in this URL.  Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in the stomach?\n\nHi, about 6 months ago I realized that my stomach had enlarged about 6 inches. My weight had increased about 20 lbs and I started having pain in the rib cage area, mostly at the back. I ask the doctor and she thought that maybe I just needed to lose some weight. Then about 3 months ago she arranged for an ultra sound and it showed nothing remarkable except a fatty liver. Then she arranged for me to see a specialist who sent me for a CT Scan. The test involved taking a creaming mixture and then the scan was done. I was told not to take any Metformin until I had a blood test. The scan was done on July 29th, 2014 and as a result I have not been able to take Metformin anymore. Also they say my Creatine is high and my Egfr is low. Creating currently is 108 and Egfr is 44. What is happening to me? Thank you",
    "doctor_response": "Hi.Thanks for your query, read the history and understood your problems.High creatinine and low egfr are suggestive that you are suffering from a kidney failure.This is causing you to gain weight by deposition of more fluid into the body or can be obesity. I would advise you to first see the Nephrologist and get further tests and a proper treatment .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pain in throat be related to a pinched nerve in back?\n\ni am being treating for neuropathy in my legs and feet. i have a known herniation on L4-5. i also have had nerve pain in my throat and nerve pain in my chest. can the nerve pain in my throat be related to the pinched nerve in my back? i also have a bulging disc in my thoracic spine.",
    "doctor_response": "No, it cannot.The throat gets it's sensation from a nerve from within the brain, so a nerve issue in your lumbar spine, or your thoracic spine would not cause those symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hematuria with discharges and bladder inflammation?\n\nI had proton radiation therapy about 2 years ago and my psa has been dropping to.09. I now am experiencing blood in my urine and the passing of tissue. I had a test with a scope and my urologist noticed some inflamation or something on my bladder and I am scheduled for a biolpsy tomorrow. i understand that it may be inflamation or bladder cancer. Is this typical after radiation? What is the cure if it is scarring and what is the cure rate if it is cancer.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Scarring is more common after radiation than cancer. So for your symptoms, possibility of bladder scarring is more than bladder cancer. But biopsy is must to differentiate between these two. So get done biopsy for the diagnosis. If it is scarring then treatment is available and your problem can be solved. But if it turned out to be malignant then you need to get done staging of the cancer. Future treatment will be decided on staging of the tumour only. Early stages of bladder cancer is having good prognosis with life expectancy of 6-7 years. End stage bladder cancer is having life expectancy of less than 2 years. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it needed to undergo the prophylaxis treatment?\n\nhi! i just had my apico xray for second diagnostic for my right upper lung fibrosis result..and it was still the same findings...but the remarks shows that i onbly have minimal fibrotic infiltrates..i just want to know if i still need to undergo the 6months prophylaxis treatment?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. No need to worry for this fibrotic lesions. And no treatment required for this. You are having fibrotic lesions. These lesions are suggestive of old, healed, inactive scar tissue. They are not active infectious lesions. And hence no treatment is required. But if you have cough, fever, weight loss etc than consult pulmonologist and get done sputum examination for AFB (acid fast bacilli-bacteria causing tuberculosis) to rule out active tuberculosis. If you are asymptomatic than no treatment is required at present. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I noticed cracks in my molar teeth. Should I wear a mouthguard?\n\nHello doctor, While looking at my teeth the other day, I noticed what looked like cracks\u00a0in my molar teeth \u00a0(2nd from the back) on either side. Recently, I went to the dentist for a cleaning and also was complaining about sensitive teeth to both hot and cold. On both these teeth, I have a bit of receding gums. Although the dentist did not find any cavities, he could not be sure if I needed a root canal treatment and referred me to an endodontist. The endodontist determined that there was not any infection in my gums or teeth and said I did not need a root canal\u00a0treatment. But he did suggested me to wear a mouthguard at night. I told him I noticed sometimes that I clench my jaw, especially at night. He also suggested a mouth guard because, the dentin is wearing away on some of the molars, the gums are receding and there are little periodontal pockets forming in those teeth. These cracks in my teeth are vertical, straight lines. They do not look jagged like a crack in the sidewalk. They are dark in color and very thin. It looks like a small piece of hair is stuck in the tooth. I have one on my right side tooth that is on the front facing part of my molar, and may be two on the left molar but facing towards the back of my mouth. When scratching my fingernail over the surface of the vertical line, it is difficult to tell if there is even a difference in the surface texture. I do not know if these lines appear inside my teeth or on the surface. The endodontist did not say anything about these. It is hard to believe he missed them considering I saw them with my naked eye and he was wearing a microscope on his forehead and eyes. Maybe, are they normal and not worth mentioning? The reason I am asking is that the endodontist said that people who grind their teeth or clench their jaw can develop small fractures in their teeth and over time, would cause the need for a root canal. What could this be?",
    "doctor_response": "Hi. Feel free to ask any further questions to an endodontist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for spinal cord compression?\n\nDear Sir,My mother is suffering  due to spinal cord compression from last sixth months. We visited many doctors in Pune and rest of Maharashtra ( INDIA)WALKE.RAHUL but she has no benefit. Please guide me.Thanks.               (Rahul Walke :0000)",
    "doctor_response": "Hello!My name is Dr. Aida and I am glad to attend you on Healthcaremagic!I would like to directly review your mother spine MRI for a more professional opinion. What are her symptoms? Consulting with a spinal surgeon and discussing about possible surgery would be a possible option. Regarding the pain, pregabaline or amitriptyline could help improve the pain. You should discuss with her doctor on the above treatment options. Hope you will find this answer helpful!Best regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to introduce salt in a 1.5 yr old child to retain water and wakeup less often?\n\nMy daughter is 1.5 years old. She eats very well - only fresh fruits, veggies and meat - i.e. nothing prepared or processed. She drinks anywhere from 30 to 90 oz of water at night. Recent blood and urine tests show all organs working perfectly, her nutrition balance is perfect . Is it safe to start introducing salt to her diet to help her retain water and wake-up less often? Thank you",
    "doctor_response": "HiWelcome to the HCMYes, you may start her on salt added diet. Kidneys are mature enough to handle salts by one year of age.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking antibiotics for acne. More medication needed?\n\nI need to go to a dermatologist regarding my acne and even tho it s not really bad I m afraid she will proscribe me with some acne pills. I m already taking antibiotics for my acne and I m able to swallow them because they re tiny like the size of the pill tablet. So I m afraid the tdermatologist will give me a massive pill to take??? Are acne pills usually big?",
    "doctor_response": "Hi, If you have grade4 acne it is better to take oral medications.Generally all the antiacne pills are not big except for doxycycline and Minocycline.You can start on oral  Acutret20mg for a month along with C.Evion 600mg and topical Nilac by night.after douing Lipidprofile and liver function test with strict dual contraceptive methods.Do get the tests done and report to me before starting treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for curved spine and convulted esophagus\n\nCan there be a relationship between a severely curved spine from osteoporosis, a convoluted esophagus with a 10 cm hiatal hernia and lesions, and iron loss? She is 80 years old, weighs 86 lbs, is losing blood somewhere internally but the hernia is not the source, has weak spells and her BP jumps from her normal 110/68 to 152/100 in spite of increased Medication (.25 to .5 mg Lisinopril in the last month) when symptoms of lower leg swelling and pain to the touch occur. Could there be a problem with the aorta since it must be curved like her esophagus?",
    "doctor_response": "Hi, If the scoliosis is severe then it is possible that the esophagus and aorta to be curved following scoliosis. The degree should be assessed with imaging studies such a CT scan of the thoracic spine. If severely curved and compressed then partial correction with rigid brace should be attempted. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could green tea cause mild black outs?\n\nI have been drinking green tea, for about 6 months now... I used to drink 4-5 cups of brewed tea everyday but had no problem for the first 3 -4 months... But these days whenever i drink a cup or two of fresh brew geen tea, i have episodes of mild blackout whenever i get up from sitting postures... I searched the net for side effects of green tea but didnt find an answer... I don t have any medical problem yet... I would be greatful if you would be kind enough to reply my question...",
    "doctor_response": "DearWelcome to HCMWe understand your concernsI went through your details. According to the available research findings, no side effects could be found in the consumption of green tea. But your green tea intake is fairly high, I suppose. I suggest you to reduce the gree tea intake to two cups a day. You should include more vegetables and fruits in your daily diet so as to have positive effecton overall health. As you have no other medical condition, the dizziness could be obsession. Dizziness while getting up from a sitting position or laying down position is fairly common. You may consult a general physician to get your vitals checked.  If you still need my assistance in this regard, please use this link.  Please remember to describe the whole problem with full detail.Hope this answers your query. Please feel free to post follow up queries. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my mom finding difficult to release her bowel after one week of undergoing TAHBSO ?\n\nMy mom is undergo in TAHBSO after a week she experience in difficulty in releasing her bowel what should I do My mom is undergo in TAHBSO after a week she experience in difficulty in releasing her bowel what should I do",
    "doctor_response": "hi, . this is the commonest complaint after any abdominal surgery.usualy such pts are send with stool softners if your mom in not on any stool softners then give her duphalac syr 30 ml at bed time for 10 days and food with high fibre content eg vegetables,fruits esp dry fruits,wholegrain breaskfast cereals,nuts,beans  ,peas etc hope that it will help your mom regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have bleeding in cheeks due to very dry skin. What could it be?\n\nHi dorian my left butt cheeks has sign of bleeding after suddenly realize by my girlfriend. There's no sign of a lump but theres deep bleeding and sign of dryness of the skin. (Very dry) . I do not feel any pain whatsoever even itchiness as well .. im truly worried what might it be, I can't find the correct explanation for it to be like that,  no accidents , didn't scratch and etc. Thanks so much",
    "doctor_response": "hi Welcome to Healthcare Magic Forum You have developed a bruise over your skin due to injury, A bruise develops due to internal tear in blood vessels and bleeding,,Just apply thrombophobe or hirudoid cream over the affected area.. Thrombophob ointment contains Heparin-Benzyl Nicotinate which improves the blood supply and prevents clots. so it will help in faster clearing of the clotted blood...And you can take oral vitamin C 500 mg twice a day orally for rapid healing.. Hope it helps Dr Geetika Paul",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for sudden c5/6 compression?\n\nMy husband had a severe c5/6 compression Jan 2013 and it was immediately addressed with fusion. New MRI &radiologist reports interval development of a small 3 mm focus of hyperintense T2 signal in cervical cord to the right compatible with myelomalacia. Our question is last July2013 MRI did not show this.. Why does it now appear ? Is it reversible ..can it be halted ..what is usual prognosis? He is a 56 male otherwise excellent health. Thank you for any insight you can share, Ellen",
    "doctor_response": "It can be missed due to scan positioning it is irreversibe but surgical option can be done to slow progress or even halt it i suggest finding a perfect orthopedic surgeon for this procedure Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes joint pains, fatigue and chilling inspite of having liver calcification?\n\nMy son was discovered to have liver calcifications incidently at the age of 7. He was followed by CT scans for a couple of years but not for the last 3 as nothing had changed previously. Last year at the age of 12 he lost a signficant amount of weight (18 lbs) but had started Citalopram 10 mg just prior and they felt it to be related to that until blood tests showed him to be neutropenic. We were also told IF it was the med things would level off and weight would return. Well they havent and since that time appetite has been decreased more so than previously, gets chilled easily (teeth chatter) will occ have a fever of 100-102 which lasts only a few hours and returns to normal. We have checked blood sugars as well and noted him to have a few minimally low blood glucose readings 72 to 68 at the lowest, he develops hives all over his body which seem to just occur randomly and sometimes take days to clear even with benadryl. We took him to MD for eval. She suspected anemia and possibly a virus causing the hives and said it would pass. She did blood tests only to appease us however Ferritin came back oddly high at 312 along with elevated CRP and neutropenia again. We questioned liver involvement and she didn t agree, we went to another MD as more symptoms had developed of joint pains who felt a referral to GI should be done and ordered additional blood tests which showed again elevated CRP, ALT, AST and Ferritin 278 and again is noted to be neutropenic. Mono tests were negative as was RA and Lupus. We continue to wait to get in to see the specialist and in the meantime he has developed cramping in arms, legs and abdomen (all over not just the right side) continues with chills, has worsening fatigue, tips of fingers were cold and blue for a few hours on two occasions now and then return to normal, feels dizzy at times. What could this be? Does this sound like hemochromatosis which the doctors seem to know nothing about or is something else being missed?",
    "doctor_response": "Hello, Consult a rheumatologist and get evaluated. A detailed evaluation is required to find out the exact cause. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I have intercourse with gaps or without gaps during my ovulation cycle? Which technique is more suitable for pregnancy to occur ?\n\nwhat is the best way to intercousre during ovulation period?with gap or without gap? maryam female 25 yrs old m/s 1.5 yrs infertility due to ovulation problem Hello doctor! I have used 2 cycles of Hmg injections then Hcg for rupture,in first month my egg was 2.1cm and this month 2.5cm. my question is that, when me and my husband contact with each other,means without any gap or one day gap?will sperms quality maintain when doing without any gap for a weak?",
    "doctor_response": "Hi,Welcome to HCM.Intercourse should be timed around the time of ovulation ie. A day before ovulation, on the day of ovulation and one day after ovulation, provided the ovulation has been documented by follicular growth monitoring on ultrasound scan.Technical problem involved is that we cannot 100 % predict that ovulation will occur in next 24 hours, the period after ovulation we can be certain of.Ideal would be to abstain from intercourse till 12th day of period and then have intercourse depending on the follicular growth status, if available.Continuous intercourse depletes the sperms and the count does get reduced with repeated ejaculation.Wish you all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red rashes on arm, face and legs?\n\nMy 2 yr old daughter has a light red rash on her arms, face, and legs. It s slightly elevated. She is not scratching the rash or complaining. She does not have a fever. It started on Saturday when I woke her up from her nap. She was sweating hot and I first noticed it on her arms. Should I take her to the doctor ASAP ? Advil and 1/2 tab of benedryl does not effect the rash.",
    "doctor_response": "hi, welcome to this forum. Can understand your concerns.- Red rash on arms, legs and face in a 2 year old child can be due to measles, insect bite, viral infection, chicken pox or allergic reaction to drug.- In insect bite, there is rash over exposed parts of body like legs, arms and face and fever is usually not present. There is itching which can start within 24 hours.- In measles, there is rash over legs, arms and face and it is usually associated with fever. It also associated with itching.- In chickenpox, there are fluid filled rash which occur simultaneously on all body parts. Fever is usually associated with chickenpox.- Viral infection can also lead to rash over body, but this rash usually subside within 48 hours, and does not lead to any complications like itching.- In drug allergy, there can be rash which appears simultaneously all over the body and results in intense itching.From the history, chances of insect bite or viral infection seems to be quite high. However, an examination by doctor should be done so that we may not miss any important finding.I hope this will help you. Wishing your child good health. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to cure rash on penis\n\nHello Doc, I humped on my bed yesterday and I was rubbing by penis on my bed again and again with my clothes on. And then I felt an itch on my side glans and when I turned my penis softly, I saw a cut/slash (its not deep and its not bleeding), and Im circumcised. Will it heal? What should I do? Is this a major wound?",
    "doctor_response": "Thanks for asking in healthcaremagic forum   Small cuts/dry rash can heal by itself if left as it is. You can apply oint soframycin locally for relief. All the best. Next time use lubrication and avoid rough handling of genitals to prevent injuries like this.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for throat cancer 3rd stage\n\nmy father has thort cancer 3rd stage,kimo therpyes  6 ho chuki hai,ab phir ukke gale main ghand hue hai,ab phir kimo chal rahi hai,mere father ke gale me kafi dard rehta hai,dard brain ki tarf jyada hota hai,after 3 hrs bad vo pain killer lete hai,plz tell me vo theek ho jyenge ya nahi",
    "doctor_response": "Hi and welcome to HCmTreatment for this stage is difficult an dit must be done in soecilised centre and combined surgical and oncologic therapy must be peerformed. Prognois is genraly poor but if whole tumor can be surgically removed then there are chnaces of long survival. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get a fair complexion and glowing skin? Have oily and pimpled face.\n\ni am having a oily skin and earlier i had some pimples ...nw they have gone due to the usage of facelin gel.. i am using suncros aquagel which is suiting me... my neck is very dark compared to face n dr has told me to use tri-o-block for neck and 20% aziderm for face at night..and antoxid hc daily....and also the dr. has suggested to take 6-7 sessions of peel...i am 20 years old...is the treatment going on fine???what else do i have to do for a fairer complexion and a glowing skin..??",
    "doctor_response": "Hi, Thanks for writing in. I think you are already doing a lot to your skin. In my opinion, just wearing a sunscreen(50-60 SPF), eating healthy and drinking plenty of water and exercising everyday is what you require. This is what you need to do in the long term. This treatment is anyway not going to have any long term beneficial effects anyway. regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for severe abdominal pain?\n\nI woke up in the middle of the night last night with abdominal pain. When I got out of bed I noticed I felt very weak and strange. I went to the restroom and as I sat there I began to sweat excessively to the point where my pajamas and body were completely soaked as though I had just got out of the shower. I began to feel weaker and shouted for my husband. when he came in I was on the floor and my body felt tight . My hands got stiff and in a strange position with my thumbs turned inward. I had no abilty to straighten them. although it felt like an eternity I think it lasted only a few minutes. Today I feel completely drained, tired and unproductive. I had the exact same situation about 2yrs ago....only difference is that I also had stiffness and uncontrolled movement in my face as well. I have not been ill with a cold or flu for a very long time.",
    "doctor_response": "Hi ! Good afternoon. I am Dr Shareef answering your query.If I were your doctor, I would advise you for a complete blood check up including a CBC, blood sugar, Thyroid function test, serum vit D3 estimation,serum calcium, and serum parathormone level. The symptoms you described goes more in favour of hypocalcaemia (low calcium in the blood) and so I would also consider prescribing Vit D3 and calcium for you for some time. You should also keep a healthy diet along with sufficient liquids to keep you well hydrated.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Painful mouth ulcers after placing bridge. Taking Maalox and Benadryl\n\n3 days after my Dentist put in my bridge I started developing painful mouth ulcers , I ve been rinsing with maalox and benadryl 50-50 mix its not helping. going on 4 weeks. I asked him to remove the bridge! do you think this will help me by taking the bridge out & doing 2 perm. crowns. I have never had mouth ulcers before....",
    "doctor_response": "Hi,welcome to HCM forum,Presence of ulcer can be due to trauma from it or allergy due to the use of material or there could be presence of infection.I would suggest you to get a thorough clinical examination done take an x-ray of the region.Allpy DOLOGEL oral ointment topically over the affected area.At home take lukewarm saline and antiseptic mouthwash rinses.Start with the course of multivitamin suplements.Maintain a good oral hygiene.Take complete balanced diet and drink plenty of water.Hope you find this as helpful,Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will Hifenac-mr taken twice reduce the back pain due to walking for long ?\n\ngood morning doctor,i am of age 23,i get back pain when i walk continuously for 3hours or when i work for long time which involve lifting weights (usually i don't get back pain) for which i consulted a doctor yesterday he suggested me with two tablets 1.hifenac-mr(twice a day) 2.gabaneuron 300mg(once in a day)so my doubt is whether i should use hifenac-mr  twice in day though i don'tget pain unless i walk or work for long time.hope you  suggest with some solution .thank you",
    "doctor_response": "Hello,Thank you for your query.Your doctor has prescribed you hifenac mr which contains aceclofenac 100mg, chlorzoxazone 500 mg i.e.combination of pain killer and muscle relaxant.You can take this medicine whenever you feel pain due to muscular work along with ranitidine 150 mg.Second medicine is given to strengthen nerves and relieves pain. This you take daily as per your doctor prescription. Hope this helps.Take care.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cold numb feeling on the right side of my head\n\ni got a cold numb feeling on the right side of my head it washed over me and went away again what was that a numb cold feeling washed across the right hand side of my head and went away again what was that???",
    "doctor_response": "that could possibly due to due to some temporary neurological event.It can occur due to stress or some neurological deft.You  can wait for sometime may 1-2 weeks and if such an event is repeated within that period than you need to consult your neurophysician for further management.Otherwise you may consult your nearest homeoapath, thanks jignesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high level of AST and ALT?\n\nI am a 25 y/o male with recent blood results showing: AST/SGOT of 82H and ALT/SGPT 139H, Albumin at 5.1H, Segs at 11.0L, Lymphs at 70.0H, and Reactive Lymphs at 6H. Everything else was within normal range. I suffered from flu like symptoms about a week earlier and had been using Panadol to suppress symptoms. Should I be concerned about these results?",
    "doctor_response": "Thank you for posting query.presentation of increased liver enzymes with acute history suggest \"acute hepatitis\". further evaluation needed.better to rule out viral causes so get following test results asap:1. HBsAg (if your NOT vaccinated against HBV)  2. antiHCY    3. anti HAV    4. lipid profile 5. complete blood cell countif you post the results at HCM, also mention your weight, height, alcoholic or not?meanwhile:- abstinence from \"Alcohol and drugs\" - NO fat diet should be followed for one week- NO red meat- vegetables should be ingested daily- Moreover, less activity should be carried out (no sports), REST more. - use lemon juice (lemonade) once in a dayHealth professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health.regards,Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I use Kojivit gel to get fair skin?\n\nHi doctor, I am a 22 year old female. I have a dusky skin that is brown skin. I want to become fair. Can I use Kojivit gel? Or any other dermoatology cream can I use? My hands are also brown in color and full of tan. Do you suggest any creams to get fair? I want to become fair as my marriage is going to get fixed by next year. Please suggest me some creams, so that it should not show any side effects. Also, how long I should use it? If I use anything, then will it have any effect in case of pregnancy, etc? Please help me. Thanks in advance.",
    "doctor_response": "Hi. One's skin color has 2 components. First one is genetic, which cannot be changed. Every skin color is beautiful in its own way and we should learn to love our skin color and augment it and not hide or lighten it. The second component is acquired, which is due to the influence of environment, sunlight, hormones, aging, etc. We can only target the acquired component of fair skin color while attempting lightening procedures. I suggest you antioxidant capsules like capsule Antoxid HC (Beta-carotene) and apply sunscreen lotion Lashield gel at 8 AM and 12 PM. Also, you can apply Glyaha koj lotion (Hydroquinone) at night time. Start with an alternate night application initialy as it may irritate your skin a bit and after a week or so, shift to daily night application. Consult your specialist doctor, discuss with him or her and take the treatment with consent. You can go for chemical peeling or microdermabrasion from your dermatologist which will help in exfoliating and give you a clearer skin tone. All these treatments are free of side effects. You may use them for three months. For further information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to ease the pain on my paralysed left side from hip to toe?\n\nhello, my name is Jacqueline im 44 5foot 8inches, 68kgs & im a 2x car accident victim with paralysis in my left hip, leg, foot and 4toes after 5 spinal surgeries but I have constant pain in that paralyzed area, my biggest problem is that I suffer on an almost daily basis with what I can only describe as \"electric shocks\" throughout my foot & toes that hit me every 30-60 seconds for upto &beyond 12hours at a time. The pain causes me to scream into a pillow like im being stabbed to death and even tho I have strong drugs eg: Ketamine,  it only helps minimally at best. I can't live through it much longer. Can anyone suggest anything? Legal?",
    "doctor_response": "hai,your condition is really pathetic.looks like u have already got addicted  to ketamine also.electric shocks are due to injury to the nerves firing  even with slightest injury.this usually does not have a permanent solution.u can go for gabapentin,pregablin,added with methylcobalamine twice daily.local irritation of the nerves can be decreased with application of  local painkiller ointments.good luck.take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does constant pain in the center of chest mean?\n\nI have Constant pain in center chest, has been for several months. Feels like behind the breastbone. Usually better in the morning, gets worse throughout the day. A strange sensation like rubbing near the top of a full deep breath, and also pain is worse with deep breath. Pressing hard on the area / rib cage can temporarily help to relieve the pain sometimes, or sometimes make it worse. If in the car and drive over bumps, can feel like a snagging feeling.",
    "doctor_response": "Thanks for your question on HCM.In my opinion you are having GERD (Gastro Esophageal Reflux Disease). But better we should rule out cardiac and pulmonary causes. So get done ECG and chest x ray, PFT (Pulmonary Function Test) to rule out these.If all these are negative than it must be GERD.It is due to laxity og gastroesophageal sphincter. Due to this acid of the stomach tend to come up in the esophagus and cause symptoms.  So tty to follow these for better control of GERD.1. Avoid hot and spicy food.2. Avoid stress and anxiety. 3. Avoid large meals, instead take frequent small meals.4. Take proton pump inhibitors. 5. Go for walk after meals.6. Keep 2-3 pillows under head in bed.7. Quit any habit if you have like smoking and drinking. 8. Loose weight if you are obese.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a treatment for cancer in naturopathy?\n\nDear Sir, My father has been detected cancer at 4th stage . please confirm if you have treatment in Naturopathy. his age is 67 years and presently in Sir Ganga Ram Hospital. Kindly confirm at  YYYY@YYYY  or my cell num is 0000. please allow me to discuss futher if u can treat and save his life",
    "doctor_response": "Hi,Thanks for writing in to us.Cancer is a condition in which there is uncontrolled proliferation of abnormal cells. If your father has stage 4 cancer then it is advanced disease and the treatment usually includes pain relief and slowing the progress of disease. Unfortunately with the recommended treatment and support, a patient having stage 4 cancer might survive for up to 2 years and without treatment the end is much closer.Naturopathy is unlikely to help because it is a slow method of treating health problems. Cancer is an aggressive condition and it is not possible to control the multiplication of cancer cells by naturaopathy. In naturopathy the body is repaired in a slow pace and enough time is allowed for the various systems to return to their normal quality of functioning. This is not possible in a patient having stage 4 cancer and the rate of disease progress is much faster than the healing process.Your father might like to follow meditation techniques for pain management and to keep him comfortable with a regular dose of pain relief. Please provide him adequate nutrition and support.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the productive cough and non acid reflux be related?\n\nLast year, after testing, I was diagnosed with non acid reflux disease. I am coughing up a lot of phlegm. My doctor said this was a symptom, but it seems to be getting worse. There is no blood or discoloring and I don t have chest congestion. Could this be related.",
    "doctor_response": "Hi. I can understand your concern.  Chronic cough is commonly seen in bronchitis and lung infection. Get a  chest x ray done if it is normal, no need to worry for lung infection. Possibility of bronchitis is more in your case. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of bronchitis. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid (ICS)Also avoid stress and tension. Avoid hot and spicy food. Avoid junk food. Avoid large meals, instead take frequent small meals. Quit smoking and alcohol if you have these habits. Go for walk after meals. Keep 2-3 pillows under head in the bed to prevent reflux. Loose weight if you are obeseDon't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dizzy, light headed, weak, numbness in hands, face and thighs. History of migraine\n\nI have been feeling dizzy, light headed and weak for about a week and a half now. I continually get episodes where both hands go numb so does my face and thights. My pulse in the wrist is very faint and seems to skip beats same with neck. I am a 32 year old female. I have suffered with migraine headaches for over 10 years. MRI results last year shows some white spots.",
    "doctor_response": "Thankyou for using hcm. Your symptoms like numbness dizziness and mri findings like white spots (white matter demyelination)point towards multiple sclerosis. You need to consult a neurologist and discuss with him about your symptoms. He might be needing you to undergo an MRI scan once again to look reconfirm. I would suggest not to neglect about this.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart palpitations?\n\nI have been having a racing heart for sometime, I researched the drug Oleptro I was on and a side effect of it was racing heartbeat.  My psych doc told me to discontinue the drug and I have and I am on the third day of not taking it and seem to be doing better.  I had the urge to stretch earlier and felt my pulse start racing again and indeed it had and took a while to slow down.  Any ideas?",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. Increased heart rate can be because of a lot of reasons. It can be simple increase of heart rate because of any stressor or after exercise. If it occurs in resting state, it can be also because of abnormal conduction system of heart called as supraventricular arrhythmia. So you need certain tests to rule out same.1) ECG at the time of palpitation. If duration of palpitation is small than we put a 24 hr ECG monitoring called as holter monitoring.2) Thyroid function test3) 2D EchoAfter these test get yourself evaluated from your doctor. Wishing you good health.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sameer Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is tailbone itch and bleeding sign of treated anal cancer?\n\nI have an itch at the tailbone and when I wipe it it is bleeding only on the paper but enough to scare me. And the is always pain in the lower back. I did have a fall about 2 years ago and bec. It was workers comp it went untreated also I id have anal cancer in 2008 can this be related",
    "doctor_response": "Thanks for your question on HCM. In my opinion you should first get done local examination of anus and rectum by surgeon. As possibility of recurrence of anal malignancy is high.So get done proctoscopy and biopsy if mass like lesion is visualised. Your chronic back pain can also be due to anal malignancy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Percocet safe for pain management?\n\nLast November I had quadruple bypass. I m 59 not over weight male, I thought in pretty good health. Well high blood pressure, arthritis, diabetes and cancer survivor. So maybe not so healthy. At the time I was on max anti-inflammatory, and meds for all the other and insulin. My question is now the Dr don t want me on any anti-inflammatory meds and in addition to everything else , they have me on Percocet 40 mg per day. Is this safe and the best way to go.",
    "doctor_response": "Hello, The risk of narcotics is a curve with a sharp and continually declining drop off. In the first year there might be up to a 20% risk of addiction. If people don't have the risk in the first year, their risk rapidly drops. People who've been on them for a while the risk of problems drops to about 1% per year. Oh, 40 mg a day is moderate. You should be advised of the risks of getting used to it and getting into a problem that you need more and the problems go up (this is in the first months not one year or, far more likely it will not happen). the guidelines for risks of narcotics start at 30 mg. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in conceiving when periods is delayed?\n\nHi! I m married 2 1/2 years ago. I m planning for a baby for past 6 months. My menses are delayed for 15 days this month but I m in menses now. How do I get pregnant. I was not on any medication or taken any contraceptive pills. Please give me a solution.",
    "doctor_response": "Hello dearI understand your concernYour delayed period could be due to hormonal imbalance.Normal hormonal imbalance, adequate maturation and rupture of follicle, patent fallopian tube and normal semen analysis will require to become pregnant.If you will not become pregnant then your both partner require infertility specialist consultation and undergo following investigations:reproductive hormone analysis, USG scan, ovarian follicle study, HSG test to confirm any problemSpecific treatment depend on problemYou can take tablet ovacre plus: it maintain reproductive healthYou can also use progesterone in second half to regularize periodAvoid stress, drink plenty of water, do regular exercise and maintain normal body weight according to BMIHope this may help youContact further if follow up neededBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for ankylosing spondylitis (sic) plus crowns, vasculitis and pern anemia?\n\nHi I have ankgolizing sponyolitis (sic) plus crohns, vasculitis and pern anemia, also addisons and thyroid problems. I take sulfalazine 4000mgs daily and am waiting to start anti tnf. My crohns is under control fom the meds but my GGT levels are rising and ive started to feel sick (I was taken off Immuran when same thing happened) GGT levels are only at 133 but Im worried liver is being affected again and I ll be taken off it? I cant bear my crohns to flare",
    "doctor_response": "Hi, If you are intolerant to sulfalazine, Sulfa-free aminosalicylate formulations, alternative azo-bonded carriers, 5-ASA dimers, and delayed-release and controlled-release preparations, like Olsalazine, alsalazide, delayed-release Mesalamine, controlled-release Mesalamine can be used. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Tushar Kanti Biswas, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is there any procedure other than braces, to get an adorable smile?\n\nHi doctor, I am a 22 year old female. I had started my treatment with braces in the age of 14 and it continued for around three years. Then, I used retainers for some time. I was told by my doctor that I have a small jaw and extracted four of my teeth. After getting the whole treatment done when I look into the mirror I see my jaw inclined due to which my face looks weird and not proportionate. The jawline and my teeth are still not aligned straight. I could not get the beautiful smile which I always admired. I do not want to go through the pain of braces again. Is there anything else I can do? And how long the procedure will be?",
    "doctor_response": "Hi. By looking at your pictures (attachment removed to protect patient identity), it seems that your orthodontic treatment was not successful. Now it seems that you have more problems in your lower jaw. So, it is better to correct lower teeth only. You should either try to put crowns (cap) over the lower central four teeth, or there is a method called veneering where we put a half cap over the front teeth on both upper and lower to give a good look to your smile. Ask a specialist that is an endodontist to give veneers to the front six teeth on both upper and lower jaw. The procedure veneering is a little bit costly but gives a very good aesthetic smile makeover. Your weight is also very low which means your overall bone growth is not up to the mark.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have irregular periods. Have PCOS. Taking Clofert 50. Can I conceive naturally?\n\nHi m suffering from pco m periods have been irregularly irregular since start my gny asked me to tak asmita for 6 min now we want to have a child he has prescribe me clofert 50 and blong f tab to be taken on 3 day of period for 5 days pls let me know cant i conceive naturally n r ther any chances of conceiving twins .doc pls help i m depressed with my pcod problem",
    "doctor_response": "Hi, At the outset, please do not get disappointed. PCOD is the commonest cause of infertility and hormonal imbalance observed in the reproductive age group and it responds very well to management. Before initiating any treatment, you should get completely investigated; a hormonal profile, glucose tolerance test, tubal patency test, ovarian reserve, serum DHEAS levels, serum prolactin levels and thyroid profile are needed. Your partner also needs to be assessed. You may need priming with dexamethasone or Metformin before induction. If you are overweight, please maintain a proper diet and exercise and regulate your body weight within the normal BMI (19-25). Natural conception is possible; twin pregnancy may sometimes occur with hyper-stimulation of the ovaries and this is why regular monitoring is done during induction. Wish you good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for tooth abscess with lumps\n\nHad an abscess under my tooth. Swelling under tongue and on cheek. Went to the ER for antibiotics. Have taken two days worth and now I have a purple lump next to the tooth. Does that mean it's healing and coming to the surface? I had no red bumps prior to this bump.",
    "doctor_response": "Hi..Thanks for the query..If you have an abscess under a tooth then it will commonly cause a white pimple like lump on the gum..Swelling on cheek is probably due to abscess.But the purple lump if it is under tongue then it can be probably a Mucocele or mucous cyst..Taking antibiotics will reduce infection and abscess but it will not resolve it completely..For complete resolution consult a Dentist and get evaluated..An x ray should be done..If tooth can be saved Root Canal treatment should be initiated followed by antibiotics and painkillers..If there is gross decay extraction is advisable..Hope this helps..Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the black spot on my aorta?\n\nI am having testing done right now and during the testing they found a black spot on my aorta.  that is all I was told and my doctor has told me that she knows what it is, but seems to be backing off from contact.  She hasn't order me to see a heart doctor.  What would the black spot be?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, it is calcified or scarred plaque like structure. Black spot on CT is mostly due to dead, scarred tissue. Aorta is likely to have scar or calcification. So these benign lesions are more likely in your case. Your doctor didn't bother too much about this and he didn't call cardiologist, so no need to worry for major illness. Such black spots are mostly due to scarring and calcification. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Redness and warmth in feet, blood in mouth, heart racing, dizziness, stomach pain. What may have gone wrong?\n\nI am on my period,and I took a shower,wasn t even that long at all,as the water was pouring on me,which wasn t even hot at all,it was just warm,my feet started to become red,I ignored it,I thought it was because of the water but it wasn t that hot so it wasn t,so,I found that strange but carried on,I hadn t washed my head yet,then when I did,I felt this weird taste In my mouth,I spit it out and it was blood ... I got out right away and luckily I live with my mum and my older brother,so,I told them about it. Currently my heart is beating quite fast and stuff :/ what should I do? Do you think I should go to the hospital? I don t even know if they re gonna do anything at all about it if I did... :/ also,I was a tiny bit dizzy when I got out of the shower,also felt like throwing up and my stomach somehow hurt. Still feel a little like throwing up. Also got a little sleepy as well which is a little strange too. What do you think this is? Will I die or something? :/ please help.",
    "doctor_response": "Hi welcome to Health care magic forum. Dont worry , some times it will happen like this, It appears that you had gastric bleeding due to some or other reason, due to that you started feeling like dizzy, vomiting feeling, heart rate is high , all these things are due to this blood in the stomach only. Reason might be bleeding peptic ulcer. Your period, hot water shower etc have nothing to do with. It is important to exclude hypertensinpon, I advise you to consult a gastroenterologist for diagnosis and treatment. You may have to get gastroscopy, besides other routine tests for confermation. Wishing for a quick recovery, and thanks for calling. Best regard.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes  soreness in lower ribs?\n\nI have sore lower right ribs along with feeling as though there is something there and by the end of the day I have throbbing pain in that whole lower area to my side, back and bottom.  The only relief I get is from laying down and sometimes that does not help",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Lower rib pain should always be evaluated for heart diseases first. So get done ecg and 2d echo. If both these are normal then no need to worry for heart diseases. Sometimes musculoskeletal pain can also cause similar kind of pain. So avoid movements causing pain. Avoid heavyweight lifting and strenuous exercise. Take simple painkiller and muscle relaxant drugs like ibuprofen and thiocolchicoside. Take calcium and vitamin d 3 supplements for faster recovery. Apply warm water pad on affected areas of chest. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How safe is taking Zyrtec and Singulair for whooping cough?\n\nmy son is 6 and has a very bad cough but no fever.  he had a slight fever yesterday (99) but now it's gone.  when he coughs he sounds horrible, but it's not whooping cough.  He does have mild allergies but has been taking Zyrtec and Singulair.  Should I have him see the doctor?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, possibility of acute bronchitis is more. Acute bronchitis can cause bronchospasm and this can cause coughing a wheezing sound while coughing. So better to take him to doctor an get done clinical examination of respiratory system for the diagnosis of wheezing. He may need inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (budesonide or fluticasone). Don't worry, he will be alright. Hope I have solved your query. I will be happy to help you further. Wishing good health to your son. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is being sensitive a mental problem ?\n\ni m 20 years old boy but sometime i cant take joke from my frnds or classmates which related to me...............??do u think this is my mental depressed problem also 1 think i m very sensitive person.",
    "doctor_response": "Hi, Welcome to Health Care Magic. Thank you for your query. Kindly attend Yoga classes,personality development classes(NLP etc),Get spiritual therapy and breath every moment joyfully. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there anything that can be taken for pain due toe osteopenia?\n\nyes , I have been told by my doctor that I have osteopenia ( after having had a bone density test ) I was informed by a letter from my doctor s nurse of the results from test . I was not prescribed anything but 50,ooo units of vitamin D . Am to take 1 per week for 12 weeks but nothing for pain which is very excruciating ! Is there anything I should be or could be prescribed for pain ? I would also like to know more about this disease . Can you please share more info on this debilitating illness to me ? MY ones ache and pain so much ! Thank you !!",
    "doctor_response": "Hi, As a first line of management you can take analgesics like Acetaminophen or Tramadol for pain relief. If symptoms persist better to consult an orthopedic and get evaluated. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to control blood pressure\n\nhow can I lower my blood pressure its 165 over 112 my left arm is been tingling and a little numb all day I do have a heart conditionI have been out of my medication for a long time I have no vehicle today so I need something to do at home with this problem",
    "doctor_response": "Hello! Thank you for asking on HCM! I understand your concern, and would like to explain that you can try 25 mg of Captopril sublingual, or Nitroglycerin 500 mcg s/lingual. If your left arm complains persist, then you should immediately consult an ER doctor in the hospital, to rule our any possible cardiac events. You need to closely monitor your BP values and consult your GP or cardiologist for a maintenance anti-hypertensive therapy.Hope to have been helpful to you. Greetings!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain even after treatment for amoeba?\n\nwhy is it that even after treatment of amoeba in my children they still complain of stomach pain and yet the medicine used was very effective to stop the diarrhoea. Also one of them, the stomach feel abit harder than normal.  How can we make the pain go away and are there some food we should keep off.",
    "doctor_response": "Thanks for your query at HCM!I went through your query!Amebiasis is caused by Entamoeba histolytica which is a protozoan.The trophozoites penetrates and invade the colon and cause tissue destruction and cause bloody diarrhea colitis. There are healing ulcers which usually cause pain even after treatment.There is a possibility that they have other infection for which you can get stool examined for ova/cysts/larva.Treatment will depend upon the finding.You can give them anti-spasmodic (Dicyclomine) to relieve pain.Consider deworming. You can visit a pediatrician if symptoms persist.Take care!Dr. Sheetal VermaInfectious Disease Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sinus,dizziness and vertigo problem\n\nHi, may I answer your health queries right now ?  Please type your query here... hi i am suffering with sinus with pain at back head behind ears also at top of my check bone and down the side of my face and jaw, I have also had virtigo and dizzyness I have now also got and sore tender spot in my grion at the top is this related",
    "doctor_response": "Hello. Thanks for writing to HCM.I read and understand your question very well.I try my best to help you in this.As you have sinus , dizziness and vertigo proble.I suggest you to take Tab. Diamonic DCA , twice a day. Also use Tab. Vertin 4 mg for vertigo , twice a day.You have sore tender in your groin region , it is not related to this. If symptom not resolve than consult a good ENT ( ear nose throat ) surgeon for this.I hope my advice will help you a lot.Thanks and Regards.Dr Vijay",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is having high blood platelet a form of cancer?\n\nI have high blood platelets, was treated  4 1/2 years on Hydrea now am on Anagrelide hcl 1 mg A.m. 1 mg.P.M. have been on this one 4 weeks, major headaches but no other symptoms as of yet. I will have Platelet Count this Friday for the 2 weeks on 2 MG per day, the first 2 weeks was on 1 mg. per day they went back up to 900  from 463.  Is high Blood Platelets a form of Cancer and am i being treated with a Cancer drug??",
    "doctor_response": "hi, high blood platelets count may be due to a cancer which is called as essential thrombocythemia. it is a myeloproliferative disease. or it may be due to reactive thrombocytosis. you should go to the hematologist and diagnose properly. then only take drugs. go to the hematologist, investigate properly and then take treatment accordingly.thanks for using health care magic,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden sharp pain in the lower right abdomen which worsens on moving the legs and shifting weight?\n\ni have a sharp pain in my lower right abdominal region. hurts worse when i move my legs or shift my weight, just started earlier today, after i went to the bathroom i couldnt walk it hurt so bad. Doesnt appear to be swollen. im 18 female and 120 lbs 5'3. i am not on my period.",
    "doctor_response": "Hi. the pain in right lower abdomen which increases on movements is suggestive of an inflamed appendix or a twisted ovarian cyst as the commonest of causes. I would advise you to have an urgent sonography of abdomen to ascertain the cause and decide further management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swollen and painful gum. Why did it smell bad? Why is tooth loose?\n\nHi, well this is hard to explain, my gum is a little swollen and it hurts, only in one spot though, in the very back, and i noticed that between my tooth and the gum there was something stuck there, as soon as i take it out it was something white that didn t have a normal smell, i don t know if it could be rests of food or what, i need help, also i would like to know, i ve been very paranoid because some of my tooth feel just a little bit loose, should i be worried?",
    "doctor_response": "hello it seem your gums have got highly inflammed called gingivitis. this occur because of food acculumation in between gums and teeth because of improper cleening under the action of bacteria gums get inflammed leading to swelling tooth loosening bleeding foul smell.white hard material may be calculus , it is a calcified structure stuck on tooth in case of bad oral hygiene.i would advice you to go for deep cleanin of your teeth called scaling ,use betadiene mouthrinse twice daily and learn the proper brushin technique. regards dr.sapna",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for renal cysts\n\nHi Dr. Bhushan, how are you doing?of lower left kidney I have three cysts: 1 upper pole cortical 0.7 x 0.6 x 0.7 cm stable 2 medial anterior mid left renal 1.5 x 1.4 x 1.4 cm increased from2012 3 exophytic lateral of lower left kidney 1.2 x 1.0 x 1.2 cm stable from 2013 Can I have your thought, please? Dino Kunic, Norfolk Va",
    "doctor_response": "Hellorenal cysts dont need any specigic treatment as these dont cause any harm n occur commonly in several healthy people",
    "dialogue_context": ""
  },
  {
    "patient_message": "What precautions should be taken to avoid fever in hot weather?\n\nDear Sir, This is liton from Bangladesh. I am working at HR dept. in a multinational company. Now in our country present situation is hot. Our workers are becoming sick. In last week, 10 workers have taken leave for fever. Please advice to take precaution so that we can circulate to our peoples.",
    "doctor_response": "Hello Heat stroke is a common thing due to hot and humid  environment.The best way is to avoid physical work .If necessary consume plenty of fluid , water ( with proper salts and minerals in it ).Physical cooling with sponging, fans, cooling blankets and even ice baths should be initiated immediately in conjunction with intravenous fluids .So order your employs cover their head with some cotton clothes , drink plenty of fluid , avoid physical exertion or exercise . Avoidance  for hot and humidity is the best way .Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stiffness in the upper legs\n\nI have stiff upper legs and legs that do not allow me to walk as I did a few months ago. I use a walker now and wheelchair. I have unclear thinking at times. In November I was still cutting down trees in Upper Michigan. I spent 12 days in the hospital on my back and 14 days in rehab. The doctors said I had a mixed connective tissue disorder and one has called it meningitis. Is there any medicine that can help me? I am very frustrated.",
    "doctor_response": "Dear Sir/MadamI have gone through your query and read your symptoms.In my opinion, what information you have furnished dosent seem to match, a mixed connective disorder is not called meningitis, this word means inflammation of the coverings of the brain. I hope that answers your query. If you want any more clarification, contact me back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have gastritis and GERD. Please advise proper food management.\n\nHello doctor, I have GERD and gastritis. I eat three times daily and timely but I am not able to meet enough nutrition gain. I want you to help me in the proper management of food.",
    "doctor_response": "Hi. For how long have you been suffering from this problem? Are you taking any medications for GERD? Is your weight is too low for your height? Do you smoke? If yes, please stop immediately. What about consumption of coffee/ tea? It should not be more than 3 cups daily (120 ml each) with a half teaspoon sugar. Please get back with all details to give proper diet advice. Small frequent meals are advisable. In between snacks, you can take buttermilk which is not sour. All fruits and vegetables are allowed. If you are sensitive to citrus fruits, avoid it. Do not eat any kind of fermented foods. If idly and dosa are sour, avoid it. Better if the batter is made at home, first day of both are allowed. Avoid all kinds of junk stuff, processed, bakery products, rich sweets, fatty foods, etc. Have light dinner by 8-8:30 PM, so that you have ample time before bed. Whenever you are eating high protein foods, followed by a light meal later. Include ghee two to three tablespoons daily in your diet. I hope this helps. Follow up with all the details for better understanding.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for tooth pain with swollen jaw\n\nDEAR DOCTOR,I've started to have tooth pain and swallowing in my lower right jaw. I can't open mouth properly. After I eat, it's started pain the whole day. Kindly give me suggesti.Thanks & Best Regards,Amy Tel: +65 8373 1227 email:  YYYY@YYYY",
    "doctor_response": "Hello and thanks for writing in HCM forum.As per the history posted here,it appears that there is a cavity formed in your teeth .As it is a bacterial infection,it requires proper antibiotic coverage and pain killers for next three to five days.you must visit your dentist and get it examined clinically.A simple dental x ray will give you the extent of damage caused.Based upon which treatment can be planned by your dentist.Hope it helps.Thanks.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are pregnancy chances good based on the above results?\n\nI am trying for a baby for last 3 years. I took  medicine for last one year(including letoval for 5 cycle), Very recently I had a blood test ( hb/fsh/lh/ft4,tsh ). Results are : ft4 - 1.8 TSH - 1.50 FSH - 26.5 LH - 43.5 MY doctor advice me to take an appointment from dr. baidyanath chakrabarty. But is will take quite a long time to ger an appointment of dr. chakrabarty. pls advice how much chances are there to get preagnant ? Also pls advice what should I do",
    "doctor_response": "Hello,Following is my reply:1) Your FSH levels and LH levels are very high.2) Please get the AMH test done to check the same.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mahesh Koregol",
    "dialogue_context": ""
  },
  {
    "patient_message": "What's wrong with my toenail?\n\ni have been having toenail problems for several years. I wore shoes that were too narrow from top to bottom or not thick enough and that's when it started. My toenail got really sore and never healed well. My grandson stepped on it several times and after awhile I had some green smelly stuff coming out from under it. I soaked it in epsome salts several times and it got a little better but ever since then I have trouble off and on. I  have recently had some clear but sticky juice coming out from under my nail and there are ridges in my nail running from side to side. I used antifungal cream under the edge of my nail and it would iimprove somewhat for a time but I can't seem to get it well. Now my toenail is hard to clip because the skin seems to attach to the nail farther out than the regular nail bed and every time I clip them it bleeds. Help!",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern looking to the history given here I could say that toenail infection does not eradicate that much easily if this is fungal one, the best way to treat this is remove the nail surgically form the nail bed, and then treat the condition, this is the best option, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tested for STD. Burning scrotum, WBC count high. Cancer? Worry?\n\nMy brother had felt some burning on his scrotum a while back and was tested for std and he said that was clear but they told him his white blood cell count was off or high, and then I guess they checked or looked at it and said it could be cancer and see a specialist. He won t see one, but I m wondering what kind of cancer and if that is a sign of it. He of course didn t tell me details about any marks, swollen, etc so i dont know what they actually looked at down there.",
    "doctor_response": "Hi Ashley, A high white blood cell count does not necessarily suggest it is cancer. It can be high is mild infections and inflammations. Jumping into the diagnosis of cancer straight away is not a good approach. First, rule out local infectious causes. Even normally, sometimes the WBC count is high. Cancer in the scrotum usually presents with a painless swelling or nodule of one testicle. In addition, sometimes it presents as dull ache or heavy sensation in the lower abdomen. Without actually confirming the cancer by histopathological examination, nothing can be said for sure. In my personal opinion, I do not think there is any cancer at all. Hope this helps. Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lump on breast, ear, cancer. Can it be spread?\n\nHi On Tuesday I had a mammogram and an ultrasound and two biopsies on a lump in my breast . The consultant has told me from this and the shape of the lump that it is cancer and that when I go back next week for the results of the biopsy they will discuss treatment but will be having an op to remove lump in breast and lymph nodes from my armpit. Just before leaving I told her that I had a lump behind my left ear on the boney part and she said I should have mentioned it but she will look next week. The lump is in my right breast. Do you think this is of concern ie that it has spread? I am obviously panicking and it would help me to at least get through the weekend knowing either way as next week is a lot of sleepless nights away worrying",
    "doctor_response": "HelloWelcome to healthcaremagicIt is good that you underwent biopsy for breast lump. It will give you definitive diagnosis and if it is breast cancer it can be treated with modern surgery/radiotherapy and chemotherapy.Regarding lump behind ear; there are retro-auricular lymph nodes in that area. It is commonly enlarged when there is infection in scalp .It is very rare to have swelling in that are with breast cancer. Although a simple test Fine needle aspiration biopsy will give you the answer that whether it is due to cancer or not.Regrads",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fast flow of blood?\n\nEvery time that I have given blood I have been told that my blood flows very fast; last month I was told that if I had finished the blood giving session 10 seconds earlier they would have had to call the medical team. Could you please give me some explanation as to why my blood seems to flow so fast? I am a 46 years old female. Thank you.",
    "doctor_response": "HIWell come to HCMNo there is no any criteria for this or any particular unit that could measured how fast your blood is coming out neither this is matter of concern once the blood leaves the system then the velocity of this depends upon the apparatus used and gravitation pull, but this is nothing to worry, no need to considered this, hope this information helps take care have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can tablets for cold be taken along with terbest and zyxal?\n\nHi I am 29 years old, recently I was suggested by a dermatologist for my skin allergy with medicine, Terbest + Zyxal, since last three days I started this medicine, I feel tiredsome and drowsy with slight head ache, already I had cold since last week and now I have developed a heat boil inside my nose and I sleep for 6 - 7 hours daily as my routine, I want to know whether I can use any tablets for my cold now during this course, and does zyxal+terbest are the reason for my head ache, please let me know how to go about it.",
    "doctor_response": "Hi, 1. Your tablet may be Xyzal and not Zyxal2. Xyzal is sufficient for cold, no other medicine to be added.3. Xyzal and Terbest are not reason for headache4. Please take Voveran SR 75mg two times a day to relieve pain and Fusidin cream to apply over Heat Boil.5. Add Cap Augmentin 625mg Two times a day for 5 days.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Pranij Vora, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat fungal toenails?\n\nIam retired female have had fungal toenails since teen yrs.-currently have some bleeding from 2 nails --have beensoaking foot in tepid water and applying hy.peroxide for onfection --not gatting much results--wear flip-flops to keep nails dry  any suggestions to remedy problem?  thanks",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Fungal infection in the toe nail is very nototrius it requires a long term treatment to cure it completely.You can take the oral fluconazole tablet 150 mg for two months under your doctors guidance.Please be patients as this is a long period therapy. Once the new nail grows it pushes the old infected one and new nail is free from the infection.Please do not shock your leg in water for whole day. Try to keep it dry as much as you can do. Wet leg provides good nutrition to the fungus and your infection continues.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sickness, body itching and pains with headaches on kissing?\n\nHi Doctor, I have a new girlfriend who I dont see often. Whenever I spend time with her and do deep kissing, i feel sick within hours with itchy feelings all over my body, headache, body pains etc. This happened the first time, i thought it was sore throat, complaine to my GP, got prescribed an antibiotic which clears the itchy feelings. We kissed again 2 weeks later when we met up and I have the same sick and itchy feelings all over my body again. What can be the problem?",
    "doctor_response": "Hello, It might be her lipstick that is causing allergic symptoms. See if you have these symptoms with only kissing or is it some food that you are taking especially during the meetup. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr SAMEEN BIN NAEEM, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for wet on lungs\n\nHello Doctors ,i have a 21 months boy and he stop drinking formula at 11 months.until this time he had a stange noise on the chest and all the dr sad that he is ok.from them until now he dont want to take any more milk, no goat,no cow,no soya! From few months when he is eating yoghurt cheese he became red on the face like a rush. We was to dr and they sad he is wet on the back(lungs) and i may be astma or is from the milk from the products . Now he is taking klacid antibiotics and no milk diary 10 day to see what is happening.what you tell me do do ... Im disperate to know an right answer! Thank you for make time to read my message",
    "doctor_response": "Most probably he is suffering from milk protein allergyMilk protein allergy manifested as vomitting, pain abdomen, bloody diarrhoea, skin rash following infestio of milk productsThat should be ruled out firstSerum IgE and specific allergen test may be helpful for diagnosisTreatment options are oral immunotherapy, anti-IgE medications",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic kidney disease\n\nUltrasound result-small left renal cyst. Increased echogenicity of the renal cortex suggests chronic kidney disease. Should I see a specialist? The nurse from my doctor s office called to give me the results and message to keep blood pressure controlled. No follow up. Thank you for the help! YYYY@YYYY",
    "doctor_response": "Hi,Thanks for writing in.Increased echogenicity of the renal cortex implies early kidney disease and requires you to consult a nephrologist immediately and get various kidney function tests done. You should get blood urea, serum creatinine, urine 24 hours protein, protein creatinine ratio among other tests. The GFR is also to be estimated by calculation. Depending on any variation form the normal you might have early kidney disease which can still be reversible with proper treatment and support.A small left renal cyst does not require any intervention. Please do not worry",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking pregnancy treatment. Took clomid, hcg injection. Eggs not grown. Prescribed ovral g, rantac. Suggestion?\n\nIn last month I have gone from preganancy treatment. Due to some reason IUI is not done only clomid and hcg injection is given. Now in this cycle doctor says that there was 3 eggs from that 1 egg is not rutured and we continue the treatment that egg will grow and other eggs are no able to grow. So she has given me T.ovral-G and t.rqntacD tablet. Please suggest",
    "doctor_response": "Hello. Thanks for writing to us. It seems that you are having overgrown follicles. That is why your gynecologist has prescribed you Ovral G for correcting the overstimulation of ovaries. You are getting the right treatment. Do go for a regular follow up.I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the ill effects of heparin?\n\nMy mom had a quadruple bypass done a month ago and we told the hospital she was allergic to nuts. She swelled so bad after surgery you could not reconize her. They blood doctor told us she was allergic to the Heparin they used. Doesn't heparin contain arachis?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Heparin doesn\u2019t contain any nuts and it is not a plant product, Some people experience allergic reaction to heparin. You can do a allergy test to confirm whether she is allergic to heparin or not. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "High fever, abdominal pain, elevated liver enzymes, mild hepatitis, green stool\n\nMy 7 year old went to ER yesterday. High fever. Abdominal pain . Told he had elevated liver enzymes and mild hepatitis . He has had green stool today. Should I be worried?",
    "doctor_response": "Hello,          Your son has been diagnosed with hepatitis and has passed green coloured stools. Green coloured stools are not a cause for concern in hepatitis. If he passes black stools or is constipated in that case you should consult your physician.            Hope that helps.           Wishing you good luck.Regards,Dr. Preeti",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which are the drugs that cause fibroadenoma ?\n\ncan u mention to me some drugs that cause fibroadenoma ?",
    "doctor_response": "Hi, Welcome to healthcare magic. Thanks for your query. Oestrogen may cause fibroadenoma. Phytoestrogenic food may aggravate the problem of fibroadenoma. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red bruised dots at the area of IV injection?\n\ni have small red dots and bruising at the site where I had got an IV last tuesday after being in the ER for abdominal pain and they gave me pepcid through the IV, the small red dots which after searching online seem to be petechiae on my right arm its spread out in about a 1 1/2 inch to 1 inch diameter under the entrance point of the IV i just noticed this yesterday is this something I should be worried about",
    "doctor_response": "Hi,It seems that there might be having some irritation at the site due to some leakage of injection material or developing Thrombophlebitis giving this problem.Apply ice pack for few days.Apply thrombophob cream locally.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful body movements after chest injury\n\nMy brother broke three ribs by the sternum L (aortic) and went to urgent care they told him he has to be off work 6 weeks but just started a new job. He is a heavy equipment operator and using aleve. He went to urgent care for the x-ray and that is how he was diagnosed. Now, no problems breathing, no blood, no discolored sputum and yet, he is having difficulty just maneuvering simple controls or turning side to side. He read he should not wrap because of restriction. He cannot take off work any suggestions on how to support his cage?",
    "doctor_response": "Thanks for your question on HCM. In my opinion your brother is having muscle stiffness due to injury. Ribs must be healed by now but due to immobilisation muscles become stiff and initial movements are painful.So for few days he may have painBetter to follow these for symptomatic relief. 1. Avoid heavy weight lifting and strenuous exercise. 2. Avoid bad postures in sleep. 3. Take good painkiller and muscle relaxant. 4. Apply warm water pad on affected site. 5. Wear chest belt to avoid mobilisation of affected area.",
    "dialogue_context": ""
  },
  {
    "patient_message": "No positive result from 3 IUIs.  First sample had 8% slow linear sperms, second sample 10% slow linear sperms.  Advice\n\nI and my hubby have done 3 iui .But still we couldn't success them. In the last iui, my hubby had only 8% of slow linear sperms in the first sample while 0% of rapid linear sperms. They asked us to take a second sample too,in the second sample there were 10% slow linear sperms only. Shall we become success of iui by having this infertility problem or should we attempt to have ivf in next time .Please give me an advice for my problem .",
    "doctor_response": "HIThank for asking to HCM Certain factors which are really necessary for pregnancy, here they are 1> Age for female Above 18 years and below 40 years for male 18 to 50 years both should be medically fit, 2> proper and and perfect intercourse particularly at the time of ovulation 3> enough number of sperm and normal parameters 4>Production of ovum, 5> Normal level of reproductive hormones. In your case the sperm count is low and the motility is sluggish, of course the intrauterine  insemination gives good result, but it needs several attempt, while going for second try, Abstenant (No ejaculation should be there in any way, and method )  period of 15 days or more is must to have positive result, Good luck (Kids are God gift just wait for your turn only condition is your name should be in list ).",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe abdominal pain on the left side after a gallbladder surgery?\n\nHaving pinching type severe  pain centre and left side of abdomen after keyhole surgery to remove gallbladder pain is intermittent taking tramadol which relieves pain for about an hour  surgery was 2 weeks ago tried a country walk today but the pain was coming and going all the time.  Was I walking too soon although still have the pain not walking !",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As you have undergone key hole surgery 2 weeks ago, there should be healing by now. As there is pain to left side and centre, I will recommend  ultrasound abdomen to rule out CBD ( common bile duct stone  ) or pancreas pathology. I also suggest to avoid fast foods and sour taste foods for some weeks. Also undergo urine test to undergo urinary tract infection. Avoid strenuous physical work but normal pace walking is not risky. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for keloids on chest and knee\n\nHi, may I answer your health queries right now ?  Please type your query here.I am Sudarsan from Kolkata. Am having Keloids on my chest, left leg near the knee and recently has developed on the back of my neck. I want to get rid of the same. Please advice",
    "doctor_response": "Hi thanks for asking question in HCM.There are various options available for treatment of keloid.First treatment modality is intralesional corticosteroid injection that is given once every 4 week.It is less painful and safe.Laser treatment also gaining popularity.But it is costly and several sessions needed for its removal.Freezing the keloid (cryotherapy)is helpful in removal of it , but it will lead to sometime dark pigmented scar that look cosmetic ugly.Interfeone injection also can be given.Some surgeon using fluorouracil and steroid injection together to be injected.Silicone sheets also can be available but it has variable result.Besides this main treatment modality some home base therapy also available like applying baking soda paste made with hydrogen peroxide.Lemon juice extract, aloe vera can be applied over it.Rose water. honey and levender oil local application also can be applied.I hope i have provide you complete list regarding treatment modality.thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feel tingling over the whole body, dizziness. Difficult breathing. Home remedies for muscle cramps?\n\ntingling in head full body tingling dizziness full body muscle tightness diffuculty breathing i cant take full breathe in hardly with out having to stress and i jus tried meth(ice)for the first time its been about an 1 hr the fullybody tightness and the trouble breathing are what im worried about if u can give me sum tips or home remedies for muscle cramps like can i eat or drink sumthin or buy sumthin frm the store without going to see doc or do sumthin to make it stop and if u got any for my breathing problem that wld be awesome!",
    "doctor_response": "hi dear and welcome to HCM...Dear here is a home made remedy which really work....mix a tablespoon of vineagar with a teaspoon of honey works in less than half hour....take it once or twice aday....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What foods can my 6-month-old baby eat?\n\nHi doctor, My baby has turned 6 months today. For the last 20 days, I have been giving her ragi and half a banana. Now that she is 6 months old, what cereals, vegetables, and fruits can I give her? Can I give her rice? Can I give her ghee and curd?",
    "doctor_response": "Hello. If you have any other doubts, you can contact me. For more information consult a\u00a0child health specialist\u00a0online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I cannot run, stretch, move or straighten my leg. Please help.\n\nHello doctor, I have been experiencing mild to moderate pressure from the bottom of my right bum cheek to the middle of my leg and I cannot seem to put pressure on my right leg at all. Could you tell me what this is or could be? I am taking 50 mg of Sertraline for anxiety, Thiamine twice a day and various other Vitamins. I cannot run, stretch, move in bed, straighten the leg fully, bend downwards, touch my toes or do practically anything without there being a distressing pain from the hamstring (the top of it).",
    "doctor_response": "Hello. I read your concern. I would like to know if you ever had back pain or had a fall on your back. In my opinion, you should work a bit on back stability and core stability. I would like to recommend you to get a thorough investigation like an MRI lower back and hip, which will help you to exactly locate the source of symptoms as sometimes disc irritation and facet issues can produce similar symptoms. I recommend you to keep icing frequently. Stretch gently. Do stability exercises. Revert back to me with full details of your problem.  For more information consult a physiotherapist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Lordosis\n\nI have been having some type of pain in the lower back region while lowering, lifting objects and even while sleeping. The pain is not too much but creates difficulty.So, as consulted from an M.D, I got an X-RAY done. The report says LOSS OF LORDOSIS. What exercises or consultations should I take.....?",
    "doctor_response": "Hi, The X-ray report states that there is a LOSS of NORMAL curvature of the spine. Typically, there are 4 curves to the spinal column in the human being. When a lordotic curve (or lordosis) is altered or \"lost\" in a person it is usually taken to mean that there is some kind of muscle spasms present in that region which is causing a STRAIGHTENING of the spinal column thus resulting in a LOSS of its curvature. Things to do would be to get an EVALUATION by a PHYSICAL REHABILITATION SPECIALIST OR EVEN a PHYSICAL THERAPIST.  Either one of those specialists should be able to come up with a series of stretches and exercises to help muscles to relax in the column and thereby release the pressure on the low back. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does gout cause extreme fatigue?\n\nI have been diagnosed with gout, but I was checking into pseudogout. My uric acid was 5.4 the last time I was tested, but I ve had several flare ups in that time. My hands and feet are extremely painful. I, also, suffer from extreme fatigue and wondered if that was part of gout. Does gout cause extreme fatigue and what are the differences in gout and pseudogout?",
    "doctor_response": "hi,thank you for providing the brief history of you.as you have pain and swelling in the feet this could be gout or RA.The difference between pseudogout and gout is little only but still needs a differentiation.Pseudogout is a form of arthritis that causes pain, stiffness, tenderness, redness, warmth, and swelling in some joints. It can affect one or several joints at once. Pseudogout commonly affects the knee or wrist. Less often, it can involve the hips, shoulders, elbows, finger joints, toes, or anklesGout is a form of arthritis characterised by severe pain, redness and tenderness in joints.So depending upon the laboratory tests and clinical assessment the differentiation can be made and the treatment will be guided accordingly.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach upset, fatigue and pumping problem in heart?\n\ndo u think u can help me figure out what's wrong with me? here's what happened....  about 2 days ago, I was on my way to work and out of nowhere my stomach started feeling upset. then my heart was feeling weird, like it wasn't pumping properly.. then I got this feeling like I was gonna die, so I started breathing in and out deeply and it barely helped. I felt really tired, so tired that i almost felt like laying down on the bus bench and passing out... I was very fatigued and almost fainted... luckily I made it back home. I drank 2 or 3 glasses of water and went to bed... I woke up and I felt a little better, then I stayed up for about 4 or 5 hours and the symptoms started coming back again.. I've been sleeping a lot over the last couple days, and it isn't going away... in fact, Just about 12 hours ago during the day...I felt fine, my friend drove me to work, then I walked around for about 10 minutes and I got that feeling like I was gonna die. upset stomach, fatigue, heart problems, fainting feeling.... so I went home and when I sat down to relax, most of it went away again! What do u know?",
    "doctor_response": "Hi Welcome to HCM,I can understand your concerns.It's could be Acute gastritis.Antacids will be helpful.If still symptoms persists,I advise you to get an ECG,Lipid profile , Serum electrolytes as a part of your routine checkup.Post your further queries if any,Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes uncomfortable feelings?\n\nI m so confused all the time, I feel like each time things start going well it all turns to shit. At first I felt sad for a while(a month or two), then I started feeling angry but now I feel numb. I don t physically hurt myself in any way but I do mentally. When I have loads to do such as homework I choose to procrastinate not only because I m lazy but in my mind I think when I finish this I ll be back on track and things will be okay and I ll be happy but something about just stops me and says no you can t.",
    "doctor_response": "Hello,        Your symptoms need more elaboration but the things you have put here if considered together then the inference is - you are suffering from moderate depression, which gradually affecting your working capacity. Being lazy - it might be your life style or a symptom of depression called Loss of energy and loss of concentration. Again when ever you decide to become happy after some time , your poor confidence (because of depression) you can't.         Depression is a clinical condition because of neuro-chemical problems in the brain, and needs medicines to correct the biological changes in the brain. So, don't waste your crucial time in sufferings.. either go for treatment or see counselor at least.         Set life goals and try to achieve them.All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Loss of balance when driving, perimenopausal, stiff neck, done tests. Any thoughts?\n\nHi, I m a 44 year old female who had a healthy baby girl at 42. Over the past 6 months I have been getting a loss of balance while driving, specially acute when I reach speeds above 30 mph. I believe I am perimenopausal as well, cycles are irregular, night sweats , hot flashes, poor sleep, anxiety . I have recently noticed I need glasses to read. My left eye vision is blurry compared to my right eye. I am unable to drive around the corner without experiencing this loss of balance. Feels as if I am going to faint, but never do. I also get a racing heartbeat and anxiety as a result, but I think it s just a panicky reaction as it is scary when it happens. I have a very stiff neck and upper back muscles from poor posture and carrying baby around didn t help. I am seeing a chiropractor. Have had carotid and brain MRIs, sinus CT scan, blood panels, Lyme testing, all came back fine. Also took antibiotics in case of an asymptomatic ear infection to no avail. Any thoughts? I wonder if it is a perimenopausal symptom, perhaps I need my hormones checked and balanced ? Not driving is horrendous, specially with a 2 year old, I need help. Thank you so much for your input and your time. Sincerely, Maria Peterson",
    "doctor_response": "Hi Maria, Thanks for choosing HCM. You probably have Benign Positional Vertigo with Acute Cervical Spondylosis which needs to be looked into by a doctor & appropriately treated. See an ENT doctor & Spine surgeon. In the mean while give plenty of hot water fomentation to the back of neck. Apply pain reliever gels to the neck at back. get your eyes checked.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Poison ivy rash is killing me. Can penicillin help ?\n\nMy poison ivy rash is killin me, and over the counter meds arnt working. I'm planning on going to the doctors tomorrow but I can't even fall asleep, what should I do? I have penicillin still left over from a prescription would that work? What will take away the itching and let me fall asleep? I've already tried a baking soda bath also with no results. Help meeeeeee!!!!!!",
    "doctor_response": "hello dear want help that penicillin cannot help you you should go nearer physician to consult and you should take seriously to this thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Done MRI scan. Can online doctor help?\n\nReceived copy of MRI scan of my brain without contrast. It states areas of FLAIR signal identified in the left, frontal and temporal lobes do not enhance. What does this mean? The impression states no enhancing lesions are identified with brain parenchyma. The differential for non enhancing lesions include gliosis from inflammation or ischemia (chronic) versus a demyelinating process. What does this mean? Is it serious? mS?",
    "doctor_response": "Hi,Your MRI brain shows hyperintensity in flair sequences involving L) frontal and temporal lobe.Lesion is not enhancing with contrast indicates the lesion is not activeDifferential include gliosis from inflammation or ischemia (chronic) versus a demyelinating process.Gliosis is a nonspecific reactive change of glial cells in response to damage to the central nervous system (CNS). In most cases, gliosis involves the proliferation or hypertrophy of several different types of glial cells, including astrocytes, microglia, and oligodendrocytes. In its most extreme form, the proliferation associated with gliosis leads to the formation of a glial scar.Gliosis can occur either due to inflammation of brain secondary to infection or trauma and it can also occur following decrease blood supply to brainOther differential is demyelination .Regarding the possibillity of MS depends on the history and clinical examination and comparison with serials of MRI done previously and other tests like VEP , CSF oligoclonal band.You should consult Neurologist for further plan of actionRegardsDr Sandhya ManorenjNeurologistHi Tech city Hyderabad",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take serenity formula for anxiety and depression?\n\nHi, I have been on Cipralex for 14 weeks and have been tapering off for two. I have had anxiety/ depression and shaking   since a ski accident in March. I am 65 years old and I would like to take a serenity formula a herbal solution. Am also taking 0.5 mg of sublingual Ativan. Can I do this safely.",
    "doctor_response": "HiThanks for using healthcare magicIn case of anxiety or depressive disorder, you need antidepressant as well as benzodiazepine. You should carry on with antidepressant. It would help to control depressive and anxiety symptoms. In case, you want to use herbal product, you can. There is nothing harm in it. There is no interaction between drug and herbal product. You can also try some relaxation exercise that would help to control anxiety symptoms. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for elevated heart rate\n\nMy heart randomly starts beating faster (feels like it is going to come out of my chest) after a few seconds it goes away. Has happened about three times in the past couple of months. After the most recent one I heard some ringing in my ears. Whats going on?",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern. I will try to explain you something and give you my opinion. You should know that this racing heart has to do with a rhythm issue. There are some electrical impulses that generates in parts of the heart different from normal sinus rhythm.They cause premature heart contaction or chaotic rhythm that's not a normal one. It might be what we call extra beats or arythmia like supra ventricular tachycardia, atrial fibrillation ect.The causes of this rhythm issues might be different like simple emotional stress, coffee or alcohol consumption or pathologys like anemia,  hyperthyroidism ,electrolyte imbalances or cardiac pathologys. In this situation you might experience palpitation, strong beating, heart racing, dizziness,  difficulties in breathing deeply.So ,if I was your treating doctor I will recommend some examination like an electrocardiogram,  a cardiac echo, a full blood analyze to exclude anemia ,hyperthyroidism , a holter rhythm monitoring to evaluate your rhythm tendency. Only after this we can better understand what we are dealling whith and if it is necessary to treat it.Hope I was helpful.Wish you good health. Best regards, Dr.Ervina.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is Losartan Potassium used for while on Triamterene HCTZ for high BP?\n\nWHAT IS THE MEDICATION GIVEN BY MY DOCTOR FOR CALLED LOSARTAN BY MY PHYSICIAN FOR. ONE TABLET DAILY. My COMPUTER IS GOING TO BE REPLACED. CAN YOU ANSWER ON THIS SCREEN.? DOCTOR ALSO IS GIVING ME TRIAMTERENE HYDROCHLOROTHIAZID 37.5 25 MGS ONE TIME DAILY & AT ANOTHER DAY. ACTUALLY PHARMACY FILLED ONE THINK ONE IS FOR BLOOD PRESSURE I DO NOT KNOW WHAT LOSARTAN POTASSIUM 100 MG IS FOR. LAST ONE IS FOR HYDRALAZINE HCL 50 MG TAB TEVA ONE TAB THREE TIMES DAILY., MAYBE FOR SOME KIND OF INFECTION GOOD TIL 10/19 I WILL CALL DOCTORS OFFICE AND DROP BY AFTER WEEKEND. I HAVE NEVER USED THIS SCREEN BEFORE. ONE OF MY SONS IS GETTING MY COMPUTER REPLACED. CAN T GET INTO IT FURTHER. THANKS. NADIA . if you cannot get into computer hope you can answer this way.",
    "doctor_response": "Losartan potassium is also a drug used for Blood pressure which belongs to a different class of drugs which acts in a different way to reduce BPTriamterene HCZ -is a water pill which also is used for reducing blood pressure Hydralazine HCL is also a BP lowering drug Always make it a point to check with your dr regarding the medications he has prescribed before you leave the consultation room and get it also rechecked with your pharmacist so that you do not get medication errors .Hypertension is a lifestyle disease which requires a lifestyle solution and not a chemical cocktail of medicines .You are already taking 3 medicines for BP and if you are able to make lifestyle choices you might be able to reduce  medicines and may be even stop medications at later stage hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe cough\n\nSymptoms:fatiguesevere cough - leads to convulsion - leads to partial black-out 2 April   - smoked heavily although I do not usually smoke            - lay outside on the grass in the cold wind until approximately midnight3-9 April: had a bit of a cough but I thought it was probably from the smoking - clear phlegm so no bacterial infection9 April:  Consultation Dr. Labuschagne prescribed cough syryp and antibiotics for later if needed11 April: started first Antibiotic16 April: started second Antibioticsevere hoarseness (13-18 April - 6 days)consultation Dr. Pottas Currently:total loss of voice (19 April to date - 7 days)confined to bed since 13 April i.e. 13th day in bed todayX-Rays = no bronchopneumonia; chronic sinusitisWhite blood count = normalCoughing = wet; white cloudy sticky phlegmfeverish sweats come and go",
    "doctor_response": "Respected user, hi I evaluated your query.*This is not simple Respiratory infection, there is definitely underlying  pathology confining you to the bed.*Priority is to evaluate the  diagnosis & then perfect treatment accordingly.*First thing you require is hospitalisation in good set up to get intensive  Intravenous treatment as oral medications are not at all going to work  in this scenerio.@Along with treatment you will be evaluated in further terms like   Pulmonary Function Tests , Bronchoscopy , CT Scan Thorax according to   the decisions  of your treating Pulmonologist.@ Till then gentle advise : - don`t smoke - maintain your hydration with plenty of liquids - avoid    exposure to cold - continue current medicines. Hope this clears your query. Thanks for using Health Care Magic & keeping trust in our medical services Wishing you fast and speedy recovery from the same. Regards dear take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any side effects from taking Telekast F, ennhale nasal spray and formoflo for high level of ige in blood?\n\nhi, i have been diagnosed with 1015 level of ige in my blood. My doctor has prescribed Telekast F, Ennhale nasal spray and Formoflo 250(2 puffs twice daily) for 6 months. Please advise if there are any long term side effects of these. Also i am taking herbal medicene for bleeding piles and Febutza40 for uric acid problem.",
    "doctor_response": "Hello,As there is no mention of symptoms, (cause of raised IgE)  it is difficult to make an accurate diagnosis (your doctor has made it). Topical applications and inhaler drugs contain very micro amounts of drugs, so very minimal side effects. The edible tablet telekast F is a combination of montelukast and anti allergic both good safe for a long term use. Bleeding piles Is usually a mechanical problem, if you are still bleeding it's better to get it fixed through a surgeon.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Muhammad Faisal Bacha, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does tonsillitis cause fever?\n\nHi, My 6.5 year old son developed severe spring allergies in the spring of 2013. He had them again this year. The thing that I am unsure about is that each year after his allergies have initially blown up is that he gets a fever with very little other symptoms every three weeks, +/- 2 days like clock work. The fever is about 102 and goes away after 2-3 days. This goes on from the onset of his allergies until the fall. Is it possibly tonsillitis or something that is causing the regularly spaced intermittent fever?",
    "doctor_response": "Hi, thanks for using healthcare magicFever occurs as a result of the body's inflammatory response.Though this inflammatory response most commonly occurs as a result of infection, it can also occur due to allergies and in severe trauma.Since the fever starts with his allergies, it likely that they are related to this.Tonsillitis would be associated with sore throat and this is not likely the cause unless he complains of this symptom.You can use paracetamol or ibuprofen (if there history of allergy to these meds) to help with the fever.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for gas pain in the chest area\n\nhello doctor, i am having a serious problem which includes gas getting stuck in my chest and i feel better after i burp but the problem is i do not get burps so easily, also i tend to puke when this happens and then i feel relieved . this is happening since the past 9 months and i am worried. recently i am experiencing chest pain as well. i am under depression since then, this does not end here as my weight is 130 kgs along with diabetes and blood pressure issues. i need a cure please help.",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. In my opinion you are having mostly GERD ( gastroesophageal reflux disease ). But better to rule out cardiac cause first for your chest pain as you are obese, diabetic and hypertensive. So get done ecg and 2d echo to rule out cardiac cause .If these are normal then no need to worry much for cardiac cause. You are having GERD mostly. It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause gaseous feeling,  burping and burning chest pain. And depression and obesity worsen the GERD. So better to follow these steps. 1. Avoid hot and spicy food,  stress and anxiety. 2. Avoid large meals, instead take frequent small meals. 3. Start Proton pump inhibitors. 4. Go for walk after meals. Loose weight by exercise and dieting. 5. Consult psychiatrist and start appropriate treatment for depression.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain and burning sensation in the mouth be treated?\n\ni found marked ulceration in the oral cavity with pain n burning sensation and few ulcer over the skin and also marked loss of hair.i immediately withdraw medicine my Doctor never told about the sideeffects could be so serious. please help me how get rid off this problem. patient age 62yrs. F.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.As per your explanation, it looks like you had a severe side effect of medicine leading to ulceration in the mouth with pain, inflammation, and ulcers on the skin with hair loss. So my suggestion is that as you have stopped taking the medicine, the symptoms will gradually subside.Also to reduce pain and inflammation inside the mouth, you can gargle with the specialized mouthwash like Magic mouthwash, suck ice pops or do cool water rinses, suck Cepacol lozenges and take vitamin B complex daily.For sores on skin apply antiseptic ointment over them and if there is itching apply Caladryl lotion and do cool compresses. For hairs massage the scalp with olive oil and take Indian Gooseberry powder with water daily.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in arms and hands and pain in shoulders?\n\nWhy do I wake up with my arms and hands above me head and after waking they are dead asleep and I am unable to move them and the pain in my shoulders is getting worse everyday. I begin sleeping on my side and then I wake this way early in the morning.",
    "doctor_response": "Hello,I read carefully your query and understand your concern. Sleeping\u00a0with your\u00a0arms\u00a0above your head can cause\u00a0numbness\u00a0by cutting off circulation to your hands.Avoid\u00a0folding your\u00a0arms\u00a0under your pillow\u00a0while\u00a0you\u00a0sleep. The weight of your head can put pressure on your wrists or elbows and compress a nerve.I suggest to sleep\u00a0with your\u00a0arms\u00a0at your sides instead of above your head.Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump in the throat indicate?\n\nAwoke with a full feeling in throat.  I feel a lump now and it seems to go down maybe .0000 when I swallow.  I feel full after just a few bites of food.  (I'm short and fat and eat the wrong type food).  So I know I have to change my diet.  I'm wondering if I should try famotidine or omeprazole OTC med",
    "doctor_response": "Hello,Here are various reasons for a lump in the throat as an inflammatory lesion, tumors or else. As per my knowledge suggests, you must get an upper GI endoscopy with a CT scan done for the final diagnosis and further management.Hope I have answered your query. Let me know if I can assist you further.Regards,    Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe pain in the left leg\n\nHi Dr. Rynne, thank you for your time first of all. For approximately 2-3 months my left leg, mainly on the outside and behind the knee and around the ankle has been aching especially when I am sitting in my car. The pain is almost unbearable to the point of me crying. It seems less intense if I am standing or in my recliner. Because I am so uncomfortable when I try to sleep in my bed, many times I have to try to get some rest in my recliner. The orthopaedist I have been seeing for injections in my knees does not know what is causing this intense aching. I have scar tissue on my tail bone from a fall I had some time ago. Is it possible that this has anything to do with my pain? What type of medical specialist do you believe i should see about this? A few facts: 68 yoa, female, overweight but have been on a diet and am losing weight about 10 lbs so far. This is probably not enough to go on but any advice you can offer me would be greatly appreciated. Thank you. Pamela Baker",
    "doctor_response": "Hello, As a first line management, you can take analgesics like Paracetamol or Aceclofenac for pain relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest painkiller medication for severe tooth ache and jaw pain\n\nPainkiller advice? I have serious tooth and jaw pain. I'm scheduled for a root canal (or possibly an extraction) in 2 weeks. Understandably, painkillers (opiates) are very regulated in my state; I have been to the ER twice crying uncontrollably for pain, and they can only give me prescription aleve and a sedative. Thinking about getting drunk and just pulling the tooth out. I've had a tooth pulled before (in a dentist, years ago) and the pain stopped immediately; pain from the wound was much more bearable. I understand it's unwise to do on your own because of infection risk, also getting drunk is risky. Is there an option I have not considered? I live in a rural area with just one dentist and one ER semi-nearby.",
    "doctor_response": "Hello,I have viewed your query and here is my advice:- If you are scheduled for Root canal treatment then it is clear that you have a deep decay in tooth leading to severe pain. - If Aleve is not relieving the pain you can consult your Dentist or Emergency room and ask aboutKetorolac and narcotic painkillers like Tramadol.You can also request your dentist to start root canal treatment early. If nothing materializes then you can opt for extraction of the tooth but no need to get drunk, you can get extraction under local anesthesia. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for severe pain at back of knee upto buttocks\n\nMy leg has started hurting today..a deep throbbing pain behind my knee that is going up to under my bum cheek. It only hurts when I stand (feels better when I walk or take my weight off of it). It hurts very quickly after I am standing. I am also pregnant.",
    "doctor_response": "Hallow Dear,The description of your pain suggests that you may be having sciatica. It is a condition wherein, the pain is along the Sciatic nerve. This can happen due to pressure on the Sciatic nerve due to displacement of vertebra or intervertebral disc. Pain killers will give you some relief, however it will be temporary. I would advise you to report this to spinal surgeon or neurosurgeon. You may have to get X-rays done, and if required, MRI also. If there is any disfigurement, get it corrected well in time. If ignored, it may progress to neurological affection of lower limb. I hope this helps you. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe lower abdominal pain\n\nI have noticed a slight occaisinal pain on my left lower abdomen . this is above my left hip and mostly to the side . I t does not hurt real bad but I have noticed it the past 2 weeks. I have been exercising a half hour on my eliptical machine daily . I;m also doing a half hour of physical therapy exercises for my right shoulder and right hip/siting bone area . I drive a city bus 39 hours a week.",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query. If I were your doctor, after a clinical assessement of your abdomen, I would advise you for a routine stool test for ova and cyst and occult blood, a urine test both routine and microscopic, a routine blood test like a CBC, and possibly an ultrasound of abdomen if need be. I would also advise you to avoid any outside food, and also avoid smoking and alcohol completely if you do. On the dietary front, you should go for a high roughage diet with enough liquids. Further management would depend on the reports of investigations and clinical assessment of your abdomen.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a permanent medication for allergic pharyngitis?\n\nHi, I am 32 female.i feel like there is some thing stuck at back of my throat every time I swallow. Doctor gave me medication for allergic pharyngitis and is all good till its affect lasts. What is the permanent solution to this,medication is for treating allergic pharyngitis",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.There is no permenant cure for the allergic pharyngitis.Except if you can find out the allergen and you can limit the exposure to such a substance.Only permenant cure for allergy is its prevention.You can take the cetrizine and low dose steroids under your doctors guidance as and when required. But this drug should be taken under your doctors guidance. You can use mask, helmet etc to prevent the exposure. I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What diet can a child be given to gain weight?\n\nthis is regarding my son age 6+. He is an active intelligent child and the only problem is his diet. The problem he faces what seems that moment he eats something . He vomits it out. He says he does not know how it comes out. He is underweight. Except his fooding habits he is perfectly fine.",
    "doctor_response": "Hello! Thank you for choosing Healthcare magic!Has this been a long term problem for your child or its something that just started recently? Does he vomit specific food? Is there a particular time when he vomits? Is he complaining of any abdominal pain? It can be that your child has gastroesophageal reflux disease wherein food from the stomach goes back to the esophagus. Esophagus is the tube that connects the stomach and the mouth. This may cause heartburn, nausea and vomiting. Patients with this will benefit from medicines such as omeprazole. It is best to have him examined by your doctor as well as to have his weight monitored.Hope I was able to help you.Sincerely, Hannalae Dulay-See, M.D.Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for persistent chest pains\n\nI have a chest pain that s been on for months First ECG in August 2009 showed all was normal. I had another ECG last Saturday and the pre-result shows sinus abnormality, left airial abnormality. The post result shows irregular rhythm, no P-wave found, right bundle branch block. Occasionally I have nose bleeding especially at night when I m asleep. There s no particular pattern for the chest pain but it tends to reduce or disappear when I m jogging. I m 34 years old",
    "doctor_response": "Hello,If you feel better when you are jogging, then the pain definitely is not of a cardiac origin.It may come from the spine. If it disturbs you much, I would advise you to refer to a doctor to undergo investigations for the spine.Wish you a good healthIn case of further questions don't hesitate to contact meRegards,Dr Baghdasaryan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffer from right para central dis osteophyte fusion, moderate disc protrusion. Do I need two surgeries?\n\nC6-7 moderate right para central disc osteophyte Fusion at C5-6 with hardware 5 years ago C4-5 moderate disc protrusion Neurosurgeon recommends surgery for C6-7 Question: should I request C4-5 be surgically addressed at same time C6-7 is being corrected? I do not want to need an additional surgery too soon and it is already protruding",
    "doctor_response": "The neurosurgeon will only operate what is necessary.there is no concept of prophylactic surgery.the neurosurgeon will do what is necessary,trust him.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for fever and white/brown splotches on tongue\n\nMy 1 yr old daughter has had a fever, not sure of the range just felt heat on her forehead and extremities. It was pretty intense for the first 2 days and the past 2 days it hasn t gotten as intense. She has also been pretty lethargic until the Motrin locks in then she gets a little energetic for a little bit but not to normal levels. I ve also noticed the past few days now that her tongue has white/brown splotches. What is it and how can I help her? She is very whiny and hard to deal with and I really would just like to get her comfortable.",
    "doctor_response": "Hi...this looks like viral illness. In viral illness it is quite common for the tongue to have some white patches. 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.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "what is the cause and remedy for rash on neck of 2 years old ?\n\nWhile bathing my  2 year old grandson I have often noticed that he has a red pin dot rash  at the back of his neck close to the  hairline,  that seems to come and go.. He has just had his 2 year old shots 2 day ago and the rash is very noticeable about 3 inches in diameter. Thankyou for any help you can give me.",
    "doctor_response": "Hi,It may be prickly heat or miliaria rubra. There is no need to worry. To confirm the diagnosis,you may consult the dermatologist. I would recommend you to sprinkle clotrimazole powder,whenever the rash appears. It may disappear as the time passes. Keep him in cool place. Keep him away from hot atmosphere.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilyas Patel, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in hips\n\nI will be 77 yrs old in less than 5 mos. For the past 6 wks I have had pain in the hips and low back and it got so bad for 3 days I could not walk. I thought it was fibro but it did not act the same way. I have tried heat, celebrex and aspercreme. I get swelling in right foot. I have stints at kidney and abdominal aorta.",
    "doctor_response": "Hi,thank you for providing a brief history of you. The age you mentioned and the stents you mentioned are the things to look into for any possible vascular compression in the body, which can be ruled out by simple tests. Gets assessed by a physician and possible advised diagnostic test will give a close clear picture for coming to conclusion. Doing a self medication is never advised and if done and is not working then ofcourse you need an expert to help you.I hope you will understand that nothing harm in meeting up a physician and take guidance.With the grace of god i wish you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will having sex daily decrease sperm count and what is the medication for treating premature ejaculation?\n\nHi I am married recently.I started involved in sex daily. Will daily sex decrease the sperm count ?I am not able to keep for more time with in 5 minutes getting ejaculation. .Help me here.Let me know about the medication.Iam 30 years old.Thank you.",
    "doctor_response": "Hello dear,Production of sperm occurs at its own specified rate, which is not influenced by the frequency of sexual intercourse.So, performance of intercourse daily will not decrease the sperm count.Regarding the problem of Premature ejaculation, it is mostly associated with stress.Since you have got married recently, it is very normal to be concerned whether you will be able to satisfy your partner or not.But the more you think about all these, the more you will stress yourself out.So, get rid of such thoughts from your mind and keep your mind relaxed.Get to know each other well, share your thoughts & feelings.Other than that, you need to make certain modifications in your diet & lifestyle:1. Have a diet rich in fruits, vegetables, fish, nuts & honey.2. Avoid fast foods & lipid containing diet.3. Avoid smoking & alcohol.4. Keep away stress, think positive.5. Exercise regularly & practice meditationThese measures will be helpful in building your confidence & remove the anxiety.One more thing, kindly do not get influenced by any over the counter medication which claim to increase the size of penis or improve performance...it may be harmful.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the uses of opiates?\n\nMy brother in law has been on opiates which were prescribed for pain following back surgery. It appears that he is having personality changes due to the mess. Could you tell me what the prescribed medication is to ease him off of dependency and still manage pain?",
    "doctor_response": "hi, I have gone through the symptoms you have mentioned, you have not mentioned the duration since he is taking the medications. anyway, opiates are prescribed for acute pain relief following surgery mainly for the first few days only, so if is already more than a week after his surgery then no need to take these medicines. shift him to the simple pain killers like tramadol and paracetamol. automatically he won't feel any need for opiates",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tuberculosis\n\ni am affected by  initial  tuberculosis.      Feel that my lungs are affected. In the morning  my throat filled with phlem with disturbance. therefore iam searhing for medicines and its side effects. iam belonging to karur district tamilnadu . can I have counsel from internet",
    "doctor_response": "Hi thanks for contacting health care magic.....For tuberculosis confirmation first examine your early morning sputum sample acid fast stain....Chest x ray also done....If positive then anti tuberculosis AKT needs to be started....It is taken for 6 to 9 month....If negative TB then bronchitis or bronchopneumonia like cause searched for.For that antibiotic needed.For cough expectoration ambroxol like mucolytic drug given...So first consult physician or pulmonologist  for physical examination and auscultation and confirm TB or accordingly investigated.....Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there delay in periods after physical intimacy with no intercourse?\n\nHello doctor, My fiance\u00e9 had her last period on the 6th. On the 25th, my fiance\u00e9 and I had physical intimacy but no intercourse. But she did not have her periods until now. She did a urine pregnancy test. It shows negative. We are very fearful after reading that pregnancy can happen even without intercourse. So she met a doctor yesterday and told only about the delayed periods and the doctor prescribed Deviry 10 mg for five days (taking for the last two days). But still she is tensed and so could you help us on the following: What may be the reason for the delay? Could you please tell us how we can 100 % confirm pregnancy?",
    "doctor_response": "Hello. How are you doing? I do not think you need to worry about pregnancy, as the urine test is negative. It detects hormone levels of above 25 miu/ ml. But if you want to have a final confirmation the best method would be to have serum Beta HCG. This will detect the smallest of pregnancy anywhere in the body. Even those less than 25 miu/ ml can be detected. 100 % confirmation test. Pregnancy need not be the only reason for the delay in periods. Other possibilities are: Hope I have clarified your query, do write back if any more queries. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i take ultrasound to check kidney stones?\n\nI have been diagnosed with kidney stones.when I had pain once in my abdomen . Stones are Less than 5mm in size, 2 in both kidneys. I am having noculi syrup and no pain since past 15 days.  Should I get ultra sound done now, to check status of stones ??",
    "doctor_response": "Hello and welcome to HCM, Ultrasound of the pelvic region helps to determine presence or absence of kidney stones. Only a minority of kidney stones are radio-opaque on X-ray thus ultrasound will pick up all other stones. In case stones are picked up on the ultrasound, appropriate management can be done- conservative or surgical. Thanks and take care Dr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to control FSH and AMH levels?\n\nhello Dr. my age is 31 yrs. i am 2.5 yrs married. since marriage i had irregular periods problem. a yr back i got to know that my FSH is very high and also my AMH is very low. doctors here have suggested to go for IVF. but i wanted to try for normal concieving. I want to know if there is any medicine or method which can help lower down FSH and increase AMH?",
    "doctor_response": "Hello, yes there is DHEAS tablets which are given to increase fertility potential.But the increase is usually not a lot so if your AMH is very low then better opt for IVF as soon as possible.In case you have any questions in future you can contact me directly on",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nightmares and nose bleeding?\n\nI have been having nightmares , and waking up crying / my boyfriend wakes me up because im screaming or crying , and i ve been having really bad nose bleeds aswell these past few days when i wake up .. is this serious or am i just stress? or could you explain why this could be happening?",
    "doctor_response": "HiThanks for using healthcare magicNose bleeding could be possible due to stress or high blood pressure or trauma. If there is no history of trauma, then may be due to anxiety or high blood pressure, you have nose bleeding. Better to stay calm and relax. In case, it persists, then you can consult a ENT specialist.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ADD\n\nHello, without going into detail my daughter has had a less the. Par childhood. I got full custody 2 years ago but the issues were having still persist and am wondering who I'd be looking to see, there high potential for ADD but there are also deeper issues which I'm noticing counselling doesn't work for. Thank you",
    "doctor_response": "if her ADD is not being helped by counselling i would suggest you to go for medicines. there are few options available like methylphenidate,atomoxetine,dextroamphetamine. in my opinion one should not leave ADD untreated it may effect her career, her social and personal life.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the pain in the lower part of my cheek?\n\nHi, I am having a numbing feeling from my temple down towards the lower part of my cheek. There is a slight pain that is constant and it gradually gets worse and then subsides for a bit. It basically feels like I've been hit in the face by something. Could it be stress?",
    "doctor_response": "thanks for your query,the pain in the temple region and the cheek could be from myofacial pain syndrome or radiating pain from jaw joint disorder...these two can get aggrevated by stress...so be tension free...you can take an analgesic with muscle relaxant(flexon mr) twice daily for 3 days and piroxicam 20 mg twice daily for first day and once daily for next 4days...you can give hot fomentation over the muscle...if the pain persist then consult a oral physician to rule out any tooth related disorder..with regardsDr. Mahesh Kumar T.S",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on the eyeball?\n\nMy 5 year old son has a red lump on his eyeball. It looks like part of a vein sort of, but it is raised and red. It has been this way for months, maybe a year. I have just never examined closely. He never complains about it hurting or itching or anything.  What could this be?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Following are the possible causes for eyeball swelling in children. 1. Hemangioma2. Hematoma 3. Retinoblastoma 4. Keratin nodule etc. Amongst all these, Retinoblastoma is malignant and so better to consult ophthalmologist and get done clinical examination and if needed biopsy of the lesion to confirm the diagnosis. Hope I have solved your query. I will be happy to help you further. Wishing good health to your child. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lethargy after exercising due to high blood pressure\n\nIm 41 yr female, have high blood pressure but not under doctor care. I don't exercise but not over weight 137 lbs. Exercise 20 minutes a day. Now trying to relax but feel very lethargic with blood pressure 200/115. Pulse 75. I feel a little anxious, can't get comfortable. How concerned should I be? I don't have heath ins, but have been diagnosed with high blood pressure.",
    "doctor_response": "Hi Mrs Xxx ! Thank you for posting your questions here. I would say that according to your blood pressure and the symptoms you have  this should be something that you have to start medication and to do further evaluation to find out the main cause if it's one  .In this condition we say you have high blood pressure stage 2Feeling lethargic ,anxious or irritability  are some of the symptoms of high blood pressure .Unfortunately  the medications against high blood pressure need a local doctor prescription .You should try to have a doctor appointment  , since you have been diagnosed with high blood pressure he /she may prescribe Enalapril 5mg x day  and other dosage or drugs until your blood pressure gets back to normal .The doctor will check your heart(ECG , ) , kidneys , cholesterol level and hormonal examination . According to the result he may also add other medication to descreae the blood pressure.Meanwhile you are waiting  for the doctor ,follow these advise:  -Don't do exercise when your blood is high - try to relax -Reduce salt and calcium , fatt  intake from the food , no smoking no alcohol ( if you do) Eat food that contain magnesium and kalium.If you have any chest pain or fainting call the hospital .Wish you good health If you have any other questions please feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for herpes simplex virus\n\nGreetings to the general public, Am Simran Mendy i want to inform the public how i was cured of HERPES Simplex Virus by a Doctor called Harrison.i visited different hospital but they gave me list of drugs like Famvir, Zovirax, and Valtrex which is very expensive to treat the symptoms and never cured me. I was browsing through the Internet searching for remedy on HERPES and i saw comment of people talking about how Doctor Harrison cured them. I Was scared because i never believed in the Internet but i was convince to give him a try because i was having no hope of been cured of HERPES so i decided to contact him on his email that was listed on the comment ( YYYY@YYYY ) i searched his email on net and i saw a lot of people testifying about his goodness. when i contacted him he gave me hope and send a Herbal medicine to me that i took and it seriously worked for me, am a free person now without problem, my HERPES result came out negative. I pray for you Dr Harrison God will give you everlasting life, you shall not die before your time for being a sincere and great men. Am so happy, you can also contact him if you have any problem Email: YYYY@YYYY add him on whatapp +0000. you can contact me for more information +1989-541-7345 or email me on YYYY@YYYY",
    "doctor_response": "I am not sure what you were trying to ask in this forum.however will like to inform you that according to evidence based medicine and clinical trials, valciclovir/ famciclovir/acyclovir have proven benefits in case of HSV.It might be possible in your case that some associated condition or alternate diagnosis was required.I wish you best of health ahead and be free to ask for any assistance required.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for knee pain in an obese person\n\nI have been having knee pain when I cross my leg horizontally and sit in a chair. Also, I feel pain when I bend down and try to get back up, as well as some popping when I walk. I haven t had any injuries to the knee but have had pain for about a week. Should I try ibuprofen regimen before I would have to see a doctor? I am a healthy 52 year old female and I am not overweight.",
    "doctor_response": "hi You may take ibuprofen after meals and do fomentation with hot water.After fomentation apply voltaren gel twice a day. you  shall be alright.You may consult an orthopedic doctor also.try to gradually reduce obesity with exercises and dietery measuresthanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a small lump on the back of the head?\n\nHello, my eight-week old son has what appears to be a small lump or bulge in a vein on the back left side of his head.  Is this something I need to be concerned about?  I am especially worried because my little brother died of a brain aneurysm caused by an AVM in his brain stem.  Thank you",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Your son may have some enlarged posterior cervical lymphnode.  It may be due to reactive hyperplasia, tuberculosis or lymphoma. Or he may have some soft tissue tumor or skin adenexal tumor.  He should take a course of antibiotics. If it doesn't respond to treatment then biopsy diagnosis is advisable.Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "dizziness, taking Stemetil\n\nI keep getting recurring dizzy spells, mostly when I am in bed and the whole room seems to spin, although I do get it a little whilst I am up. This seems to occur every few months or so - can you please tell me what might cause it - I do take Stemetil when I have it and these seem to help a bit .",
    "doctor_response": "Welcome to HCM!After reading your question carefully I found that you have spells of dizziness usually in lying down position, every few months.It would have been more helpful if you would have mentioned your age, if you have any other illness like BP, diabetes, arthritis or thyroid. I don't think you have ever got it checked and got any investigations done for the same? Had I been treating you, I would like to go for  x Ray neck AP and Lateral view, along with an MRI. Brain. These featus resemble cervical spondylosis which can cause dizziness. In your case the problem should be of milder nature as the spells of dizziness happen in months and rest of time you keep ok.these symptoms can also occur sometimes in case of low heamoglobin and low blood pressure, so by getting it checked one can rule this out.So, to nip the problem in the bud, please go and get your self investigated as dizziness is a symptoms due to some cause and it should be taken care of. Taking Semitil is not going to cure your illness but only subside it temporarily.Hope the reply is helpful to youFeel free to ask more questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is taking mucolyte syrup safe for cough?\n\nhi good day to all the doctors out there,i just want to ask my son is 3yrs old,and he has a cough with phlegm and whezzing chest.He took mucolyte syrup,5ml 8hourly for 5dys and nubalin 5ml 8hourly for 5dys.Is this good for him?And this time he has cough with phlegm still,yet the doses already over.And my son does'nt know how to spit out.He can't understand my instruction at this time.What should i do,",
    "doctor_response": "Kids tend to swallow the sputum rather than spit it out.. with time they will learn to do it.. mucolytics that are being given is a symptomatic treatment for the cough.. the cause of cough however needs to be ascertained because it has not come down even now after expectorant. . suggested further evaluation..",
    "dialogue_context": ""
  },
  {
    "patient_message": "When will the blood test give accurate result for malaria? My daughter started her fever last nite and she has spiked up again early this morning. I am going to request her pediatrician for a blood work. Is it too early to tell ? We travelled to Asia recently and that is the basis of my concern",
    "doctor_response": "Hello,Welcome to HCM,As your daughter is having the spikes of fever from last one day there are many conditions which can have these symptoms. The most common would be viral infections, malaria is one of the condition which can leads to spikes of fever.I would suggest you to wait for some more days and the fever may subside if it is due to some other etiology. It is very early to suspect malaria as you have visited Asia.The incidence of malaria has come down worldwide and your daughters spikes may be due to infection with other microorganism. So i would suggest you to wait for few more days by this time the fever would come down.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause burning sensation in the shoulders after a physical work out?\n\nHi I m a 55 year old male 5 7 150lbs fairly active. My issue is after a few minutes I get a burning in my shoulders like I ve been working out for hours. Same issue with thigh mucles. Any ideas.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It could be due to insufficient intake of protein and calcium,other minerals in diet. Take diet rich in milk,meat,eggs,fish, fruits and vegetables,also drink plenty of water. Do not work in heat. You will be fine. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest discomfort and restlessness in a smoker?\n\nDear @ i been having charas with very limited number of breaks for last six years but yesterday morning i played soccer after a long time and naturally i was tired and the back of  my chest was paining this i am sure was because of the smoking habit i had, however then in the evening i smoked up a joint of charas and after some time i started feeling so restless i had gas troubles after that, disturbance in the chest, fatigue and was not able to sleep because i kept thinking that i was gonna have a cardiac arrest.however i survived the night though and morning i wake up  i still had that uneasyness then i slept again.I have decided to quit any kind of smoking and intoxicating could you please tell me what is the probably the problem i am facing is there a remedy other than quiting smoking or should i go get an ecg and an x-ray done please reply i am i great need of your suggestion my email id is  YYYY@YYYY thanking you jeby t john",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Your all symptoms are due to smoking habit only. So please quit smoking as soon as possible. Other possibilities for your symptoms are bronchitis and heart diseases. So it is better to consult doctor and get done clinical examination of respiratory system, chest x ray, PFT, ecg and 2d echo. Chest x ray and PFT are needed for bronchitis and other pulmonary diseases. Ecg and 2d echo are needed for heart diseases. You should also consult psychotherapist for deaddiction. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes redness on cheeks after eating particular food?\n\nWhat might cause my cheeks to turn red after I eat some foods (some breads, tortillas, etc) and after I drink some beers. It isn't a consistent sort of thing... some breads do this, some don't. Some beers cause a reaction, some don't. When this happens, my cheeks turn bright red and have a ton of pressure in them. After a few hours the redness fades but pressure remains.",
    "doctor_response": "The complaints you are having with the particular foods or beverages are showing that you are having allergies to particular foods.So you have to test for allergy and consult your family physician. And if possible avoid such kinds of food.Get well soon...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for temple pain and ear infection\n\nI am having pain/pressure in my right temple and pain like a bruised feeling above my right eye.i went to. The walk in clinic and she said I have an ear infection in my other ear,not the one where all the pressure is coming from.i had a really bad headache that day I went in and the meds they have me helped but I still have the pressure on my right temple etc.",
    "doctor_response": "Hi, since the clinic doc found an ear infection and prescribed medications please continue on the medication until infection is resolved. ear infection even in the other side ear can lead to refereed pain felt on the opposite side.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stiffness and tingly sensation in hand during car journey?\n\nWhen I get extremely carsick, my hands will get tingly and contract. I can t open them as if they are paralyzed (looks like I have Dupuytren s Contracture) and when the carsickness is going away, my hands shake so bad and my fingers tremble uncontrollably. Is the hand paralysis normal for severe carsickness?",
    "doctor_response": "Hi,In my opinion that could be only over stress of muscles that is cured by relaxation, muscle relaxants, and physiotherapy. But if it is Dupuytren Contracture, it typically progresses slowly, over years. The condition usually begins as a thickening of the skin on the palm of your hand. As it progresses, the skin on your palm might appear puckered or dimpled. A firm lump of tissue can form on your palm. This lump might be sensitive to the touch but usually isn't painful. In later stages of Dupuytren's contracture, cords of tissue form under the skin on your palm and can extend up to your fingers. As these cords tighten, your fingers might be pulled toward your palm, sometimes severely.The ring finger and pinky are most commonly affected, though the middle finger also can be involved. Only rarely are the thumb and index finger affected. Dupuytren's contracture can occur in both hands, though one hand is usually affected more severely.The main or exact cause are still under researches till now. So I would recommend relaxing your driving hand and take some muscle relaxants with specific physiotherapy. That would be the best choice for you.Hope the above information helps. Any further clarifications feel free to ask.Regards,Dr. Ahmed Aly Hassan",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to heal the thumb smashed in a truck door which is numb and blue?\n\nI smashed by thumb in a truck door yesterday. It s still numb and is now blue. I called an ER nurse who told me to splint it and I did. The swelling has gone down a little but other than that no change. Will it heal if I continue to ice it and use the splint without going in to the actual ER?",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. In the beginning you ice it and splint it for the first 48 hrs. Elevating your hand or using an arm sling is useful. Use anti-inflammatory drugs NSAIDs (declophen), antiedematous, and also gel massages if possible. If you don't feel better go for an x-ray for possible fissures or fractures. Hopefully you would not use a cast or any other kind of fixation.  Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Ahmed Aly Hassan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes behavioral problems due to dreams?\n\nMy partner of 5 years, has told me for years that his dreams are real to him as his waking life, and the people in his dreams are as real as you and me. He has known the same people in his dreams for years. He says that they are his friends and he does not want them to go away. He told me last night that he has formed an emotional attachment to a woman in his dreams. She knows about me. He sees her every night, and now they have had sex. He said that she knows I exist and that they have talked about me. He confessed this to me last night as if he were confessing a true affair. I asked him more about it, and he told me I wouldn't understand because he has \"like 4 layers of his personality\". I am extremely concerned for him, and personally devistated, because this affair is real in his mind.",
    "doctor_response": "DearWe understand your concernsI went through your details. I can understand. Scientific community do not have any plausible explanation for such dreams and fantasies. Scientific / psychiatric / psychologic community terms such incidents / narration as fantasy. According to psychiatry, your partner is living in a fantasy world which he developed himself, away from you, where you do not have any place. In that fantasy land, he has his own world, pleasures and life. Hallucination disorder is what it is called.According Freudian dream interpretation, these fantasies are triggered by internal subconscious urges which are suppressed during previous years. I suggest you to convince your partner to take psychiatric treatment.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold during pregnancy\n\nI m 36 weeks pregnant and have a really bad cold. I ve been blowing my nose, and one time when I was blowing really hard, my temple had a sharp pain. Pain has pretty much gone away now. I m guessing this isn t a huge cause for concern, but just thought I d ask.",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic.I have gone through your query. I think I have understood your concern, I will try to suggest you the best possible treatment options.  1] First of all do not panic.2] It can be viral fever or simple flue.3] I will suggest you-  steam inhalation, warm salt water gargles.4] Tab SINAREST or Tab CALPOL 500 mg can be taken as needed.5] Please ensure plenty of water intake , have hot clear soups, 6] Avoid cold/chilled food items, deep fried foods.7] things will be fine. Let's give time for body to heal.I hope my answer helps you.Thanks.Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white platelets to be low?\n\nMy daughter is having surgery to remove a breast lump. Prior to surgery is having a platelet transfusion as her white platelets continue to be low. She has had the bone marrow and blood tests and still no answers but thousands of dollars in medical bills. What else can be causing this? What other tests can she do to get a definitive result?",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You have thrombocytopenia. There are many causes of low platelet count.  Like viral infection, malaria,  idiopathic, drugs, malignancy etc. So definitive diagnosis can be made by bone marrow examination.  It will give idea.  If it is normal then may be due to some idiopathic cause or viral. Thrn no need to worry.  Just consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on forehead of my daughter?\n\nHi my 6 year old daughter fell of her bike 2 days ago and had a really big lump on her forehead and a couple of scratches on her face she also broke her glasses.we went to ae and the said to keep an eye on her but now she has two black eyes and one of her eyelids is quite swollen is this normal",
    "doctor_response": "Hi,Having black eye after fall and forming hematoma on forehead is common.Due to gravitation of blood from forehead in eye causes black eye.Apply ice pack, 2-3 times a day for few days.Go for one antibiotic medicine course if suggested by your doctor.Black eye or redness in eye will remains for few days more.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for pain in lower abdomen\n\ni am a 27 year man. i am sufferring from slight pain in my right lower abdomine. 3 month ago my sgpt & shot ware high(114& 58). i have done usg of my abdomine but nothing is found. doctor gave me viboliv & golbi300. with those medicine i controlled my sgot sgpt. but now after 2 month i am feeling unsual in my right lower abdomine. what should i do?",
    "doctor_response": "Hi.Your liver problems is over.The most probable causes of pain in the right lower abdomen are: Appendicitis, colitis, or any inflammatory pathology related to the internal structures. The best way to get a diagnosis is to undergo a clinical examination, ultrasonography , a trial with a course of an antibiotic and metronidazole, bolld, urine and stool tests. The reports of the investigation will decide the further course of action.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the mass around the pituitary in a pregnant woman?\n\nHi doctor,I am 36 years old and pregnant. I have been experiencing more headaches in the last several weeks. I had an MRI (non-contrast) yesterday and it stated that I have a mass around the pituitary. I am very scared. The doctor today said I can have no further tests until after I deliver the child (which is four months away). I am concerned if it could be cancer. Is there a way to know more diagnosis without jeopardizing the baby? What are the chances it is cancer? Is there anything I can do holistically?",
    "doctor_response": "Hello.  Yes, there is pituitary mass known as a pituitary adenoma (attachment removed to protect patient identity), there are hormonal studies you can go for: S. growth hormone level, S. IGF, S. prolactin, S.TSH, FT3, FT4, S. ACTH, S. cortisol. But the values of these hormones would be altered due to the effect of pregnancy. But I am reassuring you that it is not cancer, it is benign pituitary mass, increased in size during pregnancy and causing headache and visual trouble.  Just complete your pregnancy without worrying about it, if your headache is severe and visual symptoms starts then we will think of neurosurgical opinion. Just wait and watch, it is not an emergency except your health worsens.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fatigue with heavy heart beats and lump on hip?\n\nI am a 24 year old male and I feel many times really tired and have no energy and just want to lay down and I feel a heavy heartbeat and I just feel not myself and absolute no energy, I been feelin like this for 5 years on and off and I was 18 I got sick with mono and I feel like since then I haven't been the same, I fear I have an illness because heart disease and cancer runs in my family, I also have a lot of anxiety. I also have a lump by my hip and a lump on my front left side of stomach and it hurts when I push the lump. I am really nervous I fear there is somthing really wrong with me because I get soo tired for no reason even with any amount of sleep. Can you please help meuery here...",
    "doctor_response": "Hi, based on your history, it seems most of your symptoms are due to anxiety. There are medications available to control anxiety and I usually prescribe beta blockers to young, anxious patients like you who visit my clinic. You should also visit your physician for a routine check up and get the investigations like CBC, ECG, and Echocardiography done. Now, coming on to the lump, you must visit a surgeon for further evaluation. You may be advised to get FNAC or biopsy done for the lump or as suggested by the surgeon. As far as fatigue is concerned, eat well and follow a good lifestyle. You can consult me after you get the test results or in case of any other query. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excess tiredness,sleeplessness and blurry vision?\n\nI am more tired that norman and cannot get enough sleep.  I get dizzy and have blurry vision before dinner time.  I have lost about 10 pounds in the last two months although i havent been excersing.  my blood pressure in 140/90 and my repiration rate is 12 breaths per minute and my heart rate is 80 beats per minute",
    "doctor_response": "Hello!Welcome on HCM!Regarding your concern, I would explain that your symptoms could be related to different metabolic disorders. So, I would recommend consulting with your doctor for a careful physical exam and some tests: - a chest X ray study - a blood gas analysis - inflammation tests (PCR, ESR)- complete blood count for anemia- kidney and liver function tests- blood electrolytes- vitamin D and Vitamin B12 plasma levels for possible deficiency. Hope you will find this answer helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for allergy of shellfish\n\nHello, i have a strong shellfish allergy (i get swollen if i touch them and if i eat them my throat closes up and i get very sick to my stomach) and im going on a cruise in July where they offer snorkling. I was wondering if it would be OK for me to snorkle with this allergy; and if not, can i take some OTC medications like Claritin D or Benadryl to alleviate any complications? I wont touch the shellfish, just be swimming in their vacinity. Thank you for your time. :)",
    "doctor_response": "Look as you have said that you have strong allergy to shellfish than first and fore most thing that you have to do is stay away from shellfish as much as you can. In addition to that as you are going on a cruise in July than you just carry some anti-allergic drugs with you like tab cetrizine or tab avil or tab faxofenadine or tab desloratidine whichever available. Whenever you feel disturbed with allergy just take any one of above mentioned drugs twice daily after meals, it will take care of you as well as of your allergy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in cheek after tooth extraction?\n\nHi there, I just got my bottom left wisdom tooth removed. I have a lot of swelling and my top teeth are digging into my swollen cheek. I took advil and I'm applying ice to my face. Should I be worried? Will this cause any harm in the healing process?Thank you.-Ashley",
    "doctor_response": "Thanks for your query, I have gone through your query.The swelling will come down in 3-5days. Ideally speaking, both the wisdom teeth has to be removed at a time(upper and lower) to prevent complications like the upper tooth impinging on the lower gums. Nothing to be panic, wait for a week, if the tooth is still impinging or hurting then get the upper wisdom tooth removed.Meanwhile continue the medicies. do saline gargling.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for amnesia caused by head injury\n\nMy boyfriend hit his head and had a bloodclot.He is out of danger now but does not seem to know who i am but he remembers his ex partner and still thinks he is with her.This is hurting me as his ex is enjoying it.Will his memory come back and will he remember me and if his memory comes back how long can it take.He has been in hospital for two weeks.thankyou linda",
    "doctor_response": "Hello and welcome to \" Ask a Doctor\" service.I have read your query and here is my advice.It takes more than two weeks for the memory to recover in such cases.So, give him time.Hope this helps.Feel free to ask if you have further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to control blood pressure and chest pain\n\nMy age was 28, and I have checked my blood pressure 155/95 and after 15 minutes again I have checked that time was 135/85. Without meditation any chance to reduce BP. After I check my BP I have in very fear about my health. And now I feel always little pain in my chest.",
    "doctor_response": "Dear, Welcome to HCMWe understand your concernsI went through your details. You should not worry unnecessarily by checking BP yourself. Blood pressure differs from morning to evening and due to various causes. After exercise, walking, tense condition, exertion, stress, anxiety, physical problems etc blood pressure will be high. Actual blood pressure reading is obtained as average after having a week's blood pressure reading. If you start worrying about your blood pressure and obsess with it, you will show high pressure even on the sight of the blood pressure monitor. Please be calm and consult a physician. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes joint pain below abdomen while having UTI?\n\nHi , Im 22, I had a UTI one month back and some vaginal infection. I underwent the entire course of medication and since then im suffering from pain in the joints just below my abdomen. I still have 4-5 pus cells in my urine. I got a abdomen scan done that said normal. My doctor has said that Its not related to the infection and referred me to an ortho... Please tell me what is this ...as I have no idea how to deal with this.. I do not have calcium deficiency and I have a good diet and exercise in moderation.",
    "doctor_response": "Hello, I think your pain is not because of uti or any calcium deficiency. It may be because of any wrong exercise or may be because of cramp which may occur when you lift heavy objects. Did you have any record of doing such activity in past few days please let me know so I can help you. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Rohan Sham Deo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child birth through C-section, back pain, discomfort. Taking codeine, paracetamol. Treatment?\n\nHi I gave birth to twins 6 months ago and got to 38 weeks and their birth weights were 7lb 6oz and 7lb. Since my c. Section I have had back pain however it has increasingly got worse within the last 8 weeks. It is on my right handside lower back. It is so uncomftable and painful and codeine or parecetomol doesn t help.",
    "doctor_response": "Hello, History noted, My suggestion is to follow some simple exercises and postural techniques. The relief will be gradual and makes you comfortable. Use a pillow under your thighs while sleeping, which straightens your back. Sit erect so that your back is straight while feeding as well as relaxing.Drink a cup of milk daily before going to sleep. For time being till you getting used to the modifications mentioned above, use pain relieving topical ointment twice a day. Good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "For how long should i take medicine to get pregnant with PCOD ?\n\n29yrs,pcod,irregular periods, taken three month course for pcod after that two months past doctor take USG but not found any major follicle in this. now she recommened another three month course. what would you suggest? another doctor recommend ovulation induction drug i.e some clomipine type.?IS this safe for me i am confused .which doctor i had to follow? i want preg soon. if i choose induction drug method Is it solve my problem .otherwise one more month would be wasted.and then i have to follow three month course.",
    "doctor_response": "hello welcome to health care magic first of all you had to choose best gynaecologist near you,and have faith on one.yes induction drugs can help you out,but please ask doctor for your fertile days.you had to wait for healthy baby so please follow ones line of treatment... gud luck take care payal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can shingles cause frequent pain in the underfoot and other body parts?\n\nI have shingles... Could that be what is causing my feet to hurt when I stand and walk sometimes? I have had corns on the pads of my feet, but not any of the shingles rash. And it is the pads and heels that hurt really bad when I stand up and sometimes when I m sitting or sleeping! And I have other parts that hurt sometimes for no apparent reason! Like under my left arm and breast. But none of the pain is all the time... But several times a day.",
    "doctor_response": "HI, thanks for using healthcare magicShingles would normally cause pain in a specific region only. It would not cause pain in a number of different areas.Shingles is one of many different causes of nerve related pain, which seems to be the pain that you are experiencing.Other causes include: (1)diabetes(2)low vitamin b12 or folate(3)thyroid disease(4)side effect of medication(5)liver or kidney disease(6)abnormal levels of vitamin b6(7)exposure to toxinsIn some cases, the cause is not found.It may be best to see your doctor if the pain continues.  A physical assessment along with investigations are needed.There are medications that can help with nerve painI hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat jaundice?\n\nhi..i am 25 years old weighing about 60 kg and 5ft 7 inches high.i am suffering from jaundice from last 15 days.my present bilirubin is 2.7 , just wanted to know could i start taking eggs and chicken which are cooked with very little oil and and less spicy.",
    "doctor_response": "Hello,the cause of this jaundice is more important than the symptom itself. It could be caused by various conditions - simple or more severe. Hepatitis is a common cause in young individuals but there are also benign causes like the Gilbert's syndrome (which does no harm at all) or genetic causes of hemolysis like heterozygous thalassemia that may also cause a mild elevation in bilirubin levels.So it all depends on the cause. You've got to investigate it with your doctor. Other tests of the liver function are going to be needed for this purpose and perhaps also radiological assessment of the liver, gallbladder, pancreas and spleen. I hope I've helped!I'll be glad to comment on test reports if you can upload any!Kind Regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for having anxiety and panic attacks in sleep?\n\nHi, I am suffering anxiety of panic attacks when I'm asleep at night.  I have not long had a hysterectomy, due to anemia problems.  My ovaries are still there.  I don't know what to do or how to treat this.  I am also an epileptic but controlled with medication.",
    "doctor_response": "HIThank for asking to HCMYou do have a medical condition and had history of  hysterectomy too so these could be enough for bringing the panic attack, but this could be avoided if you whish for it, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes occasional chest pain with difficulty in breathing?\n\nI get a sharp pain occasionally on the left side of my chest. When this happens, I can't take in even half a breath of air because the pain gets more intense. it only lasts for about two minutes. This has happened on and off since I was a kid. I'm now 46. my brother gets this problem too.",
    "doctor_response": "Hi. I can understand your concern. It would be advisable for you to get a chest x ray done. If it is normal then get a PFT done which will tell if you have any bronchitis.Consult a pulmonologist for the same.or it could be just a muscle pull. Do not lift heavy weightsPossibility of musculoskeletal pain is more. Ibuprofen is anti inflammatory. You will definitely improve with combination of painkiller and muscle relaxant drugs. Also apply warm water pad on affected areas. Avoid movements causing pain. Don't worry, you will be alright in 1-2 weeks.Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it normal to have mucus covered stool in a child?\n\nHello doctor, My son is (2 years old) and his poop has a large mucoid wrapped around his stool. It stopped for two days and I noticed it again today. He has not been on any medication. No obvious blood stains and he has been active with no abdominal pain. Please, I would like to know if this is a thing of concern, could it be something from his diet? I am so scared and worried.",
    "doctor_response": "Hello. Yes, I got your concern. Let me help you. From all these available information what I can say is that if he is active, playful, and eating well then just do not worry. Some toddlers have such kind of problems. If he continues to do so then will do stool routine report if anything is there.  Give him home food only, monitor his weight. If he develops tummy pain, vomiting, bleeding or fever, go for the nearby medical facility. Meanwhile, check it if he has been deworming Albendazole or not? If not then give tablet Albendazole 200 mg at night and repeat the same dose after a week.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I found a small bump on my gum. Should I be concerned?\n\nHello doctor, So, I found one small bump on my gum right before the tooth. I barely touched it and it started bleeding but it was only one bump. Should I be concerned?",
    "doctor_response": "Hi. As per your history, it seems to me that you are having acute apical periodontitis with a gingival abscess. For that, you need to take antibiotics for at least five days. The tenderness of the tooth is also because of the same reason. Grossly decayed infectious tooth. X-ray IOPAR (intraoral periapical radiograph). Acute gingivitis. Apical periodontitis with a gingival abscess. Tablet Amoxicillin-Clavulanic acid 625 for five days. For more information consult a dentist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cost of angiogram?\n\nhi my mom got a blockage on her heart but still we are not sure about her conditions that is why we wanna do an angiogram to know about the situation so how much it will take to have angiogram? and if she needs any ring how much it will cost? thanks regards",
    "doctor_response": "The cost of coronary angiogram (CAG)  varies from hospital to hospital.In Govt run hospital cost will be less but there may be waiting period.In private hospitals in India  the cost of angiography and angioplasty is in between Rs 150,000 to 200,000 lac .The coronary angiogram (CAG) alone will cost RS 15,000 to 20,000/-.Bare metal stents cost Rs 15,000-30,000 while drug-eluting stents, which are coated with drugs to prevent blockage, cost up to Rs 1.3-1.5 lakh.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can the polyp in the gall bladder cause similar pain as gallstones during pregnancy?\n\nI am 31 weeks pregnant. At 27 weeks, I started experiencing pain under the right rib and in behind the right should blade after i eat a meal...esp worse later in the day. I was out of town at the time and all indications from what I read online pointed towards gallbladder pain. I eliminated all fats from my diet and followed a strict gallbladder diet. This seems to help minimize the pain. When i returned from vacation, I went for an ultrasound of the abdomen and was surprised to see there were no gallstones found. The ultrasound did show the gallbladder contains a 5mm polyp. The common bile duct is normal in calibre and no intrahepatic biliary dilation. Liver was normal in size...kidneys both normal...spleen unremarkable. Poor visualization of the pancreas due to obscuring bowel gas. The mid portion of the abdominal arota is obscured by bowl gas. i still have this pain if i stray from the strict gallbladder diet. My question is: Can the polyp cause similar pain as gallstones during pregnancy? Does this typically resolve itself after baby is delivered or should i expect the pain to continue? How do they treat polyp in gallbladder? What do you suggest my next steps are?",
    "doctor_response": "Hello. I want to calm you wishing a happy end to your pregnancy and a good baby, because the polip of gallbladder I think is totally innocent in this right hypocondrium pain of yours. I think just this can be explained with volume and pressure changes caused physiologically by gravidance and I hope they be going down after delivery so keep calm till this time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why my father is not eating anything after two slight heart attacks?\n\nHi my dad is 94 years old and over the last week he apparently had two slight heart attacks at home.  Before this he would sleep most of the day but wake up enough to eat and use the bathroom.  He entered the hospital about three days ago and was doing as well as could be expected such as continuing to eat.  Starting last night he is only sleeping and not eating...could this be his way of shutting down or what else could it be",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. He is sleeping more means he is getting drowsy and it's a sign of illness in elder. He should be asked if he is having any fever, cough, burning while urination etc. He should undergo sodium levels and hemogram with total leucocyte count to detect any occult infection. He should be encouraged to eat but do not force if he is not willing. So he needs medical attention to detect what's going wrong.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What to do for swollen and painful penis head?\n\nHi doctor, I am a 26 year old unmarried male. My height is 6'2\" and weight is 73 kg. For the past three\u00a0months, I have pain in the left side of my glans penis. At the same time, I have a continuous pain on the left side of the anus. The pain around the anus is not severe, but it is enough to bother and depress me. Sometimes, the pain increases, but eases if I wake up from sleep. The pain in the glans penis area often increases during erection and more if I masturbate. I am also getting pain in the left side shaft of the penis and in the area between the anus and the scrotum. My glans penis becomes severely red and painful during or immediately after erection and the redness decreases after some time. I have consulted with a urologist. He recommended a semen culture test and the report suggested a heavy growth of K.pneumoniae for which I was given an antibiotic Levofloxacin 500 course of seven days. The pain around my anus did not get eased and so he extended the medicine for 14 more days. But, my pain is still present. For the penis pain, he examined and said that my foreskin is tight, which is causing the pain and recommended circumcision. I agree that the skin is tight and my glans gets swollen during erection and skin is almost impossible to pull down. But, the problem is that during erection the skin is still in its position and I do not attempt to pull it down even then the pain in the glans starts. I remember that around three months back, I masturbated and tried to pull my foreskin down. When I pulled half it got swollen and then I ejaculated. This problem started from that time. So, I am afraid if something went wrong at that time. All other reports are normal such as KUB x-ray, ultrasound and urine routine.\u00a0I do not know what to do and I am really depressed. Please suggest me something and help me out.",
    "doctor_response": "Hi. From your history and findings I am suspicious of chronic prostatitis, which is a longstanding infection of the prostate. It is associated with pain in the perineal region, which is neither mild nor severe. It needs to be confirmed with a per rectal examination in which prostate is painful. It needs to be treated with tablet Septran 960 mg (combination of Sulfamethoxazole and Trimethoprim) twice a day for four to six weeks. Please beware of Sulfa allergy and in which case it has to be avoided. As far as the glans is concerned, you need not worry. It is just balanoposthitis or glans infection with foreskin involvement. If prepuce can be retracted, then it can be left as it is. For further information consult a urologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing confusion, frustration and sadness?\n\nMy husband had gall bladder surgery and his gall bladder was filled with puss and he had quite a bit of scare tissue from the infection - he had no symptoms until a few weeks before surgery - he lost 2 units of blood during surgery (2 hours) and his PB dropped (he takes meds for high BP). His blood work showed kidney, liver, white count were all abnormal he also had a bit of confussion and anger. After 6 days he went to rehab but was re-admitted few days later as he had a UTI and was septic and his PB dropped to 57/42 and 02 levels were too low, after 4 days in CCU, with BP back up he went to step down unit and the next day he had a stint put in his small intestine to stop a small leak. The day after stint was put in he was back to his normal self and looked better then he had in several months. Unfortunately the step down unit forgot to resume his lasix ( he complained to them all afternoon that he was having trouble breathing and they said your 02 levels are ok) when I came to see him that night his hand was swollen, I looked at his legs and they were more then twice the normal size, I asked if they had resumed his lasix now that his BP was back to normal range on BP meds and they had not. A chest x-ray showed fluid all around his heart and lungs. After IV lasix and 4 liters of fluid he was much better. Several days later they transferred him to a new rehab center within the same medical network. Unfortunately he has had mental confusion, combativeness, frustration and sadness along with being alert at times ever since he retained too much fluid. Could this all be from the anesthetic?",
    "doctor_response": "dear,A post surgical delirium followed by secondary depression appears a likely conditionI would advice him to maintain proper electrolytes and have good pain control.Also, a course of anti-depressant is indicated for a couple of months.thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I ask a doctor to check my urinalysis report and advise ?\n\nURINALYSIS , COMPLETE Test Within Range Out of Range Biological Ref Range Units COLOR PALE YELLOW LIGHT YELLOW - DARK YELLOW APPEARANCE SLIGHTLY CLOUDY H CLEAR SPECIFIC GRAVITY 1.010 1.005 - 1.030 PH 5.5 5.0 - 8.0 GLUCOSE NEGATIVE NEGATIVE BILIRUBIN NEGATIVE NEGATIVE KETONES NEGATIVE NEGATIVE OCCULT BLOOD TRACE H NEGATIVE PROTEIN NEGATIVE NEGATIVE NITRITE NEGATIVE NEGATIVE LEUKOCYTE ESTERASE 3+ H NEGATIVE WBC 20-40 H NONE SEEN - 5 /HPF RBC 0-3 NONE SEEN - 3 /HPF SQUAMOUS EPITHELIAL CELLS 0-5 NONE SEEN - 5 /HPF TRANSITIONAL EPITHELIAL CELLS NONE SEEN NONE SEEN - 5 /HPF RENAL EPITHELIAL CELLS NONE SEEN NONE SEEN - 3 /HPF BACTERIA NONE SEEN NONE SEEN /HPF CALCIUM OXALATE CRYSTALS NONE SEEN NONE SEEN - FEW /HPF TRIPLE PHOSPHATE CRYSTALS NONE SEEN NONE SEEN - FEW /HPF URIC ACID CRYSTALS NONE SEEN NONE SEEN - FEW /HPF AMORPHOUS SEDIMENT NONE SEEN NONE SEEN - FEW /HPF CRYSTALS NONE SEEN NONE SEEN /HPF HYALINE CAST NONE SEEN NONE SEEN /LPF GRANULAR CAST NONE SEEN NONE SEEN /LPF CASTS NONE SEEN /LPF YEAST NONE SEEN NONE SEEN /HPF **Panel Comments** URINALYSIS, COMPLETE plz suggest",
    "doctor_response": "``Hello and thanks posting your query on HCM Your urinanalysis report indicates that there is presence of pus cells and epithelial cells in urine. Levels of leucocyte esterase is raised in urine which indicates presence of esterase positive bacteria in urine. You should get a urine culture done and start antibiotics according to the culture report. rest of the findings are within normal limits. Thanks and take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can disc bulging cause burning and swollen knees with back pain?\n\nCould my T8/9 disc protrusion indenting the anterior theca or my T5/6 posterior disc bulge indenting the anterior dural theca, now be doing some damage? I have now symptoms of tingles down both legs, major burning and swollen knees, burning and major pain in the middle of my back!",
    "doctor_response": "Hi,Thanks  for  your query.The symptoms that you are having are likely to be due to a nerve root compression due to disc protrusion at T5-6 and T8-9. You need to consult a neurophysician for proper diagnosis and treatment.Meanwhile you can follow these measures:- If the pain is severe, you need bed rest till the pain resolves. - Get some analgesics prescribed and apply analgesic spray or ointments.- While resting, keep a pillow under your knees if it doesn't bother you.- Avoid lifting heavy objects.- Back strengthening exercises and stretching exercises daily as advised by a Physiotherapist.- Avoid exercises in times of pain. - Using an LS contour belt of appropriate size might be helpful in providing support to back muscles.Also, maintain a proper posture while working, sitting and standing. Keep your back straight. Physiotherapy plays a major role in treating such conditions.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in left back side?\n\nHello I m a little sick and on antibiotic at the moment cough ect,my blood pressure on Friday was 154/104 I am on Cartia & blood atacan plus bp tablets, I m experiencing some pain in my back on left side and fells like I need to use a puffer and feel a little nausier",
    "doctor_response": "Hi welcome to hcmYour pain could be related to use of antibiotics.antacids like pantoprazole 40mg once daily will be helpful.Also take tab.domperidone to releive nausea.get chest x ray to know about your lung infection.consult your doctor for further queries.Thankyou.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes gland TB?\n\nHello doc, My mom in law is suffering from gland TB, she got the nodes on  both sides of the neck and she also has node like thing in the underarms, I was wondering whether it a part of TB or it is something else. can you suggest me what to do in this case. and she also gets pus from those nodes from time to time.",
    "doctor_response": "Thanks for your query at HCM!Your mom seems to be suffering from lymphadenitis.I it is freely draining pus then get tested for ZN stain and culture for mycobacterium tuberculosis.Also get tested for gram stain and aerobic/anaerobic bacterial culture and sensitivity testing done.You can also get tested for cytology of the smear.Depending upon the cause she will need the treatment.Antitubercular drugs if positive for TB will be started for 12-18 months.If bacterial infection she will need the course of antibiotics for few weeks.Follow up with investigation. Visit a physician and get tested. Do not delay in starting the treatment.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a big knot on shin after an injury?\n\nI got hit with a garden tool just below the knee in the upper shin area.  A big knot formed yesterday and this mornig it is very hard and very sore.  I am surprised because it did not hurt that bad when it happened, but by mid afternoon I had a baseball sized lump.",
    "doctor_response": "Hi,It seems that there might be having blood collection giving rise to big hematoma.Apply ice pack 2-3 times a day for few days.Gradually it will be absorbed.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a bony lump in the wrist and how to treat it?\n\nI am a 46 year old slim male. A couple of months ago in the shower my wrist made a sharp snap, and it felt is if someone had tapped the side of my wrist with something hard. Since then a lump has appeared in that location. It does not hurt. It feels like bone, but it seems to be able to move slightly. It is rounded and about 1 cm across at the base. Any ideas what it is and what I should do about it?",
    "doctor_response": "Hi, You have a ganglion on the wrist.This a a rounded thin walled swelling filled with gelatinous fluid like gel. It is attached to the joint capsule or ligament. This is harmless and does not need any specific treatment, and might disappear by itself. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. George Verghese, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffer from asthma. Using inhaler. Need to lead an active lifestyle. Options?\n\nI have asthma and I am wanting to work out to lose weight, but it feels like i cant get enough air. My asthma comes in intervals so it is not always a huge problem. But i have really bad alergies and everytime they start acting up (which is once or twice a year) so does my asthma and it puts me out of doing any kind of activity (including something as simple as stairs) for at least 3 months without feeling like i cant breathe. I take breathing treatments and and inhaler . Is there something else i can do to help me have a more active lifestyle with asthma?",
    "doctor_response": "Hi, thanks for your query. Well done for trying to lose weight. I understand that it is hard to do when you are unwell. Don't be discouraged by the periods during which your allergies and asthma flare up. Since you seem to have noticed a seasonal pattern to you asthma and allergy episodes I suggest preparing for them by: 1. Taking a long acting antihistamine (eg citirizine) two weeks before and during the three months that things flare up. 2. Escalating your asthma treatment during these periods so you are on more preventers. Ask your doctors to review your medication. You may benefit from an increased dose of inhaled steroids, a long acting beta agonist inhaler or something like daily Singulair. These two changes should be able to keep you breathing comfortably and active. To get the most from the exercise you are doing, review your diet so it is healthy and also not aggravating your allergies and consider taking up a wind instrument to increase you lung capacity. If you have been on asthma steroid treatment for long you should ask you doctor to check for adrenal suppression. This is a side effect of prolonged steroid use which could be contributing to you weight problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pains, shortness of breath, dizziness and nausea\n\nI have been having chest pains and shortness of breath for about a month and a half, as well as an increased heartbeat at abnormal times. I Have also felt dizzy and have fainted for the first time today. I have not been eating properly do to the fact that I have felt so nauseous.",
    "doctor_response": "Hi. I can understand your concern. Ideally ecg and 2d echo should be done first in your case. If both are normal than no need to worry for heart diseases. GERD (gastroesophageal reflux disease) can cause similar kind of chest pain. GERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause central chest pain and nausea. Take proton pump inhibitors. But along with drugs you need to follow certain below mentioned lifestyle modifications for better symptomatic relief. Avoid stress and tension. Avoid hot and spicy food. Avoid junk food. Avoid large meals, instead take frequent small meals. Quit smoking and alcohol if you have these habits. Go for walk after meals. Keep 2-3 pillows under head in the bed to prevent reflux. Loose weight if you are obeseDon't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it necessary to take I-pill after unprotected sex without penetration?\n\nHi doctor, I am a 20-year-old female. Yesterday I had my ovulation day. I had unprotected sex with my partner. But we had not done a penetration. He pulled out before he had the precum. But we are scared. Is it necessary to take an I-pill? If yes, then what are the side effects? My period is expected after two weeks from now approximately, and I have regular periods till now.",
    "doctor_response": "Hi. You were under an unsafe period, and even pre-cum also have live sperms. You are at risk of getting pregnant. You need emergency contraception within 72 hours of intercourse to avoid unplanned pregnancy. The most common side effects of I-pill are a headache, nausea, and bloating which can be prevented by increasing the intake of water. You will get a withdrawal bleed within five to seven days after the consumption of I-pill. It indicates the absence of pregnancy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will the birth control pill taken during pregnancy cause infertility problems?\n\nmy mother was on the birth conrtol pill when i was concieved, and did not know that she was pregnat with me for a few months, so of course, she continued taking the birth control pill while pregnat with me. can the medication from the pill have gone inside my embryo and made me infertile?",
    "doctor_response": "Hi,They are unlikely to cause fertility problems. Experimental studies in animals have shown evidence of birth defects or other malformations in the off springs following the exposure of hormonal contraceptives during their pregnancy. However, in human beings such studies have failed to support such harmful effects in the new born babies following intake of oral contraceptives pills by the mothers.Hope I have answered your question. Let me know if I can assist you further.Regards,Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high BP during pregnancy?\n\nI am from Ernakulam. Now I am at Yemen. In 2009 March . I was pregnant. My date was Nov. 22. That time I am also here. But from 6th month I had a little B.P. ( 140) and the 6th month last I went to Kerala. .Then I check my B.P. that time it increased 180 level. The doctor gave the medicine. And after one week again check the B.P. but its not decreased. (Those times I am not feel the baby s movement.) Then she had done scan. She said the baby was dangerous condition. In side the fluid is very less and the baby has low weight . Then suddenly refer another hospital (EMC) and done the operation. The baby s weight 800g. only. And baby has many deceases. (Heart problem, Less plasma) after one week baby passed away. About this incident Can you clear some doubts. 1) why like this happened ? 2) If I again pregnant, have I get again B.P. ? 3) In 3rd month I had very itching in my urinal area. Is that is the problem of low weight baby ? 4) When I try again a baby ? ( Operation done last September )",
    "doctor_response": "HI,   Thanks for the query. I am sorry to read what you had to go through & understand your concern. -  High blood pressure in pregnancy is known to cause  low birth weight / premature delivery & some times fetal loss also. So your early delivery can be due to high blood pressure.   - The vaginal itching you had in early months of pregnancy might have turned in urinary infection which in turn had caused blood pressure & low birth weight of baby..  - but the heart problem at birth, is not observed to be due to blood pressure.    - There is possibility of getting blood pressure in next pregnancy too. But stay cool, it can be very well managed by early diagnosis & regular medication treatment/ regular pregnancy checkups/few life style changes &  mind concentration exercises along with positive thoughts.  -- if not genetic ( either of parents having heart problem in family ) Congenital heart problem can be prevented by - Rubella vaccination ( 6 months prior to conception )/ having iodized salt, folic acid in pregnancy.   Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for lump near anus?\n\nhave a lump near anus ,out side,with magsulf dreassing started to bleed ,took antibiotics,anti inflamatory drugs,for two months still thr,doctor not willing to put knife, age 59,dm contolled ,oozing blood,since on anti biotics for 2 months ,what should i do?",
    "doctor_response": "Hello!Thank you for the query.This lump is most likely a hemorrhoid. It should be attached to the verge of the anus. If it is not that close, some abscess or fistula are the reason.Hemorrhoid will not go away without removing it. You can make it smaller using some suppositories but it will not disappear.Same thing with fistula. It will not go away no matter what you do. So in both cases surgery is necessary. Please consult proctologist and start right treatment.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for erection problems\n\nHI, i am 33 year old male, we are planning for a baby, but when i try doing intercourse with my wife my pennins doesn't errect properly and hence unable to insert into the vegina. please guide us the suitable solution for us sothat it doesnt get further delay as i am already at the age of 33.",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have problem of secondary Erectile Dysfunction As regards your ED  ,In absence of any major health issue cause of Ed and premature ejaculation are due to performance anxiety.Following measure will help you to boost up your confidence and getting good erection.and delay ejaculation.1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning.2) Take high protein diet rich in vegetables and fruits and Vitamin A,C,D,E.and Zinc3)Take anti oxidants like Almonds 5-6 everyday..4) Avoid alcohol and smoking..Taking Sildenafil Sidenafil (Viagra)as on demand will help to get good hard sustainable erection and to have enjoyable sex.Dr.Patil..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for meningitis\n\nHi Doctor I am a 30 year old male and epileptic. One day i just could not stand and it felt like my arm and leg muscles were being pulled backwards, after that i didnt have balance when walkin (walking as if am drunk). Got admitted at hospital and went for CT scan,they found calcified granulomas but said they need not treat them but only the symptoms which are sizures. Got discharged a week later. I recently started having these heavy headaches and sizures day and night. I went for a CT scan and this time they diagnosis was meningitis and they giving me Rocephin and Epilim because i still have sizures. What could be the problem and how can this be treated?",
    "doctor_response": "Hi,Thanks for writing in.You seem to be having two different problems at the same time. Calcified granulomas. These are because of old infections which have healed with time. This is not serious by itself but can cause seizures at any time if medicine is not taken. Patients are put on medications to control seizures and treatment may take 2 years or more.The actual problem you have is meningitis which is infection of the brain coverings. This needs to be treated immediately and Rocephin is a strong antibiotic which should be able to treat your condition. It is important that your diagnosis is confirmed as meningitis by doing tests like lumbar puncture and analysis of CSF. Please take adequate rest and flow up closely with your doctors till you are fit and cured. You should discuss any symptoms like dizziness, weakness, inability to walk and balancing difficulties with your doctors. Recovery might take days to weeks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can allergic skin reaction on the face be treated?\n\nIn December, 2017 I used a skin product to help erase wrinkles, etc. - 007. Since then I have experienced a sun-burned face/only where I used this product, and now the skin is pealing, along with red irritated eyes and there is always hair in the sink/hair loss - now sometimes have a low-grade temperature. what is your opinion?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Your condition suggests allergic reaction to the cream you used. After peeling off the skin, it has become septic that is why you have mild fever.I would suggest you the followimg treatment:1. Topical steroid cream 2. Oral anti-allergic3. An oral antibiotic coverageHope I have answered your query. Let me know if I can assist you further.Regards,Dr. Muhammad Adnan Iqbal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with nose allergy, kindly help me\n\nEzicas AZ and l montus are prescribed by doctor for Allergy . How to find out reason, which is causing the allergy.",
    "doctor_response": "Hello.Welcome.To find out the exact cause for allergy you will have to undergo allergy screening tests.In this test various commonly known food,inhalants and drug allergens are found out.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggestion remedy for throat congestion and shallow breathing while suffering from epilepsy\n\nHi I suffer from epilepsy, glaucoma and have a mix of central and sleep apnea. AHI 35.7 Snore sleep study. Have problems shallow breathing. stop up to 30 to 40 second. feel like food is sticking in my throat. had throat dialation last year to improve this. had grand mal and petit mals. waiting for hospital stay to confirm results prdominatelty central apnea? Have to go",
    "doctor_response": "seizure and sleep apnea are different entities. But in severe apnea with CO2 retention can precipitate seizures. Try BIPAP for sleep apnea. it's very handy and useful. I have patients who are using it for almost 20 yrs.take antiepileptics regularly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for the space between the teeth?\n\nSo, I had braces for 2 years, and now I got them off, but there are a few spaces on my top teeth. Any ideas on how to close them? I asked my orthodontist on if he can do that and he said it was just the shape of my teeth, but I really want them closed up. Is there anything I can use or do to close them up?",
    "doctor_response": "thanks for your query, i have gone through your query. the spacing between the teeth could be the relapse of the orthodontic treatment. you consult a orthodnotist, take a second opinion and get it corrected with a removable appliance. if it is not possible with braces get it corrected by building the tooth structure by tooth color restorative material (composite) to close the space. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can sinusitis and pain after tooth extraction be treated?\n\nI have sinus drainage that smells/tastes like rotting flesh. Recently had upper teeth extracted in preparation for implants and completed two series of antibiotics. Pain from extraction recently subsided but still have sinus pressure and nasty drainage.",
    "doctor_response": "Hello,May I know what antibiotic you have finished? Do you have headache or brow pain?As you have completed your antibiotic course its better you can consult an ENT surgeon. If still pain persists, you can take Paracetamol drug thrice daily.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Indhu Priyadharshini",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in shoulder blade along with tightness in back area?\n\nI am experiencing occasional pain in my left shoulder blade along with a tightness in my back in the chest area.  My left eye has been twitching and I am experiencing fatigue as well.  I was diagnosed with cervicular (sp?) degeneration about 4 years ago and I have stiffness in my neck and weakness in my arms quite often.  Was wondering if this could be at all related or something different.  I have had what I believe to be a couple of gall bladder attacks and I also have Barret's Esophagus.",
    "doctor_response": "HIWelcome to H C M For pain shoulder blade-  I advse X-Ray Chest .For left eye twitching- Consult Eye Specialist.For fatIgue -blood sugar fasting, & after meal .Urinalysis.For stiffness in Neck & Weakness in Arm -M R I   Cervical  Spine & Consult Orthopedic SurgeonFor Gall Bladder attacks-Ultrasound & C T  Abdomen.Barret's Esophagus- Gastric Endoscopy to see the progress report, being pre cancerous condition.When  we co relate all the  SIGNS & Symptoms & diseases we conclude to Consult Multi Specialist For Diagnosis, to rule out  Malignancy  & Secondaries.it is a team work depend upon age ,history of smoking & other factors.Hope every thing will be fine.If satisfied  give your  comments for follow up.Thanks for contacting .report after all investigations & eximination",
    "dialogue_context": ""
  },
  {
    "patient_message": "How effective is taking HCG ingection abd clomid to trigger ovulation?\n\nMy last menstrual period was May 15, 2014. I am seeing a fertility specialist. On June 11th, I took a home pregnancy test (positive) The following day June 12, I had HCG and Progesterone drawn. 6/12: Progesterone 33 HCG 59 6/14: Progesterone 35 HCG 149 6/ 17: Progesterone 24.8 HCG 294 My doctor says that I should be cautiously optimistic at this point. I have had one other pregnancy and it resulted in a miscarriage at 7 1/2 weeks. I am 29, 5 3 140lbs. I take Metformin to control my insulin. I also had an HCG injection to trigger my ovulation and Clomid 100mg. Realistically, how do things look for my baby?",
    "doctor_response": "Hello, Thank you for your query.  The blood values don't look promising. Hcg values should double up every 2 days in a healthy pregnancy and is usually seen in about 80%of healthy pregnancies. However, the remaining 20%can still have a normal pregnancy. The better prognostic factor is the presence of a heart beat detected by an ultrasound between 6-8 weeks from the last menstrual period. The presence of a heartbeat is a sure. Sign that your baby is thriving. Clomid and a trigger shot help in increasing your chances of conceiving & sustaining the pregnancy initially. After implantation, progesterone levels (natural or supplements) help in maintaining the level of hcg to ensure proper development of your baby. As these values vary widely within the normal range, it is better to wait for the scan to check for viability. I am sorry you are going through this. I hope this helps. Please let me know if there is anything else I can help you with. Wish you well",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recurring red spots o penis, had applied lobat gm. Had taken UTI treatment. What could be the cause?\n\nhello sir before 15 days i have tested my urine test then there was little infection on my urine.in my report no. of pus cells are 2-4.and protein are fine trace.it was about my report and before 1 month i had some red spots on my penis ,then i use fungle cream lobat g m. then they remove.after some days they appear again what is this problem",
    "doctor_response": "Hi,It seems that you might be having yeast infection on the part.Apply anti-fungal cream locally.Go for one oral anti-fungal medicine course like Flucanozole 150 mg once in a week for 4 weeks.Keep local hygiene clean, dry and airy.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mild abdomen and kidney pain?\n\ni have had low grade stomach ache and kidney pain the last 2 weeks. Started taking Hydrochlorothiazide about 3 weeks ago. can I just stop taking it to see if these issues go away ? did not have this problem before. Not consistent pains just intermittent.",
    "doctor_response": "HelloYou need proper clinical evaluation and investigations.Pain may be due to many reasons like acidity,liver,gall bladder problem,renal problem etc.You may need routine hemogram,random blood sugar,liver and renal function test,urine and stool RE/ME.Ultrasound of abdomen should also be done.It is very important and it can exclude many causes.Proper management depend upon findings.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for kidney tumor\n\nMy girlfriend has two tumors on her kidney one is the size of a golf ball and the other one is a little smaller. her Dr. wants towait until 3.17to.do surgery. I got really mad, and told her to call the dr. and get it set up ealier. what would you suggest.",
    "doctor_response": "Hello, Thanks for posting in HCM. Renal tumors do not progress rapidly.If date has been given to her for surgery it might be because of all the arrangements required for the surgery.Don't worry, doing it earlier or on that date won't change the outcome, as it don't progress fast.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. 2. 5 year old suffering from stomach ache. Which medicine has to be given?\n\nHi doctor, My son is 2.5 years old. For a week, he is complaining of stomach pain. After farting he is fine. Our family doctor recommended one antibiotic for five days and a medicine to avoid vomiting. He had small vomits twice, but later it was fine. Now, after completing the course of medicine he again complaints the same. His diet is almost nothing and he is not ready to take any food. He just has few mL of milk. He does not have fever. His stool was watery, but it is normal now. Can you provide any recommendation on diet and medicine? Please give me a solution to the problem. Thank you.",
    "doctor_response": "Hi. I can understand your concerns. Complain of abdomen pain with vomiting suggests that your child probably has acute gastroenteritis or food poisoning. Since, antibiotic is already given and now there are no loose stools or vomiting, there is no need to give antibiotic again. For abdomen pain, you can give syrup Cyclopam (Dicyclomine hydrochloride and Paracetamol) 5 mL on SOS basis (as and when required) that is when abdomen pain occurs. Whenever a child becomes sick, there is decrease in his appetite which improves as child recovers. Now, you should give him all the foods that you were giving him earlier. If he is not eating then you can start Glucon-D in water thrice a day for one or two days. Start a multivitamin like syrup Bevon 5 mL once a day for 15 days. Keep patience. Child will eat properly now as he has recovered from illness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does marginal zone lymphoma stage 111A mean?\n\nwhat does marginal zone lymphoma stage 111A mean? i can t believe you are asking for money you are suppose to help and what if a person does not have the money to give you to get an answer? this is so sad please all i need is for you to answer this question is there someone who can answer for me to have peace pf mind. sad so sad i never would think there are doctors who don;t care",
    "doctor_response": "HiThanks for your query.This is a low grade lymphoma and as it is stage IIIA, it is a bit advanced. There are many good chemotherapy and targeted therapies available to control it, in case it is symptomatic. Please consult any hematologist or oncologist for starting treatment.Hope this helps,Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a painful bump on the perineum?\n\nI got a single bump between my vagina and Anus. It was red with a white top but never looked to be a blister and didn\u2019t pop. It also didn\u2019t crust over. All of a sudden, it went away. It did hurt when touched or urine ran over it when going to the bathroom. What do you think it is?",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .* Possible inflammatory boil through some sort of bacterial infection .Wishing you fine recovery .Feel free to ask any further  queries .Regards  .Dr. Bhagyesh ( MS , FMAS - consultant surgeon )",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My scrotum and penis have become black. How can I manage it?\n\nHello doctor, What is this black mark and white spot? I am 22 years old, virgin and really worried about this. It is not itchy or painful but whatever it takes I want to get rid of it. Also, my penis and scrotum have turned very dark, therefore, I want to get back my original color. Also, I see some pimples kind of thing on my scrotum. And the whole area has too much foul smell. So, I need to get that cleared too. Please help.",
    "doctor_response": "Hello. Any history of injury over the white area? Since how long have you noticed it? Any itching or other symptoms? Secondly, The dark color is normal. It gets darker in teenage with hormonal changes (attachment removed to protect patient identity). I would suggest not to use anything to lighten it as it can have side-effects. Use Cetaphil cleansing lotion to clean the affected area once daily. Apply Phytoral dusting powder once daily.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am in stage of great depression and stress in 7 months pregnancy. How to get relief ?\n\nhi dr. i m 7 months pregnant for 2nd time. 1st kid is 4 yrs old. i have some serious adjustment problems with my husband & his family..we together consulted psychiatrists & counselling centres. i cant able to change my character. now i m in a stage of great depression & stress...my hus also.. i want a relief from my problem. can u help me dr. i am epileptic and talking oxetol 300mg & 450 mg daily..pls help me..",
    "doctor_response": "Hello Thanks for your query. Both of you should contribute & sacrifice at the same time to make a family life success. You can if you think with strong will power & think of benefit of family. \u2018Hope I have answered your query, I will be available to answer your follow up queries, \u201cWish you Good Health and trouble free speedy recovery\u201d",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are chances of getting Lynch syndrome with history of IBS and piles?\n\nMy father has Ca caecum found it himself, removed metastised to lung and brain 5 yrs later, mother was diagnosed with secondaries to liver (? Ca primary to lower GI-presented with double incontinence). I have had a couple of polyps in my lower GI removed, symptoms of severe irritable bowel syndrome (1996-9), and a sentinel pile which is historic but is becoming very itchy lately-I was informed that surgery could cause leakage. I am menopausal (post?) female, 53 years of age, being treated for hypothyroidism and currently weigh 10 stone 1lb, I jogging a couple of times a weekAm I at risk of Lynch syndrome or any other carcinomas and if so how can my GP arrange tests on the NHS?",
    "doctor_response": "hello,I understand your concern of familial predisposition of colon cancer inview of family history.It also appear that you have gone through literature search for the same as you are aware of lynch syndrome.If lynch syndrome screen is required you there are panels available with most of the private genetic analysis labAs you are talking about NHS, i believe that you are from UK. wont be able to give exact details in that case because I am not from the same country. However in most countries you can visit a  genetic counsellor and there recommendation are suffice for familial screening test. Even a registered oncologist can order those test. I my country Gastroenterologist also orders these test NOt sure it that is covered by insurance in your country. The country I practice such screening test are not covered by insurance.Moreover I suggest that you should also go for routine colonoscopy as part of screen starting at least 10 year before the age of diagnosis in either of your parents",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is poly sinusitis?\n\nJoceil Sanaco. 25 y.o. 4'11. 38kg. I've gone an operation of soft palate in the year 2002. I have just received my result of plain CT Scan. Negative finding for brain yet there is remarkable of Poly Sinusitis affected from left ear and nose. May i know What Poly Sinusitis really about and how did i ever have that kind of sickness??",
    "doctor_response": "HiThank you for asking HCMI have gone through your query. Poly sinusitis is the inflammation of multiple sinuses at one time. The other term we use commonly for this is pan sinusitis. Usual sinus which is affected commonly is maxillary sinuses on both sides of nose. But others like frontal, sigmoidal and ethmoidal sinuses can be affected at same time also. Irrigation of sinuses , using nasal decongesants , anti inflammatory drugs and antibiotics helps in such case. If that is not helping then endoscopic examination and correction might help. In some cases surgery will be needed.Hope this may help you. Let me know if anything not clear.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause dizziness during sleep?\n\nmy 11 year old son has had a couple of times when he lays down for bed and closes his eyes he says he feels dizzy. and can t go to sleep. any suggestions as to what would cause him to do this? He does seem to be pron to getting dizzy say on a fair ride etc. when he was really little he threw up after riding rides, but seemed to out grown that.",
    "doctor_response": "DearWelcome to HCMWe understand your concernsI went through your details. Your son is 11 years young. A child who complains of dizziness only on laying down, do not have the same symptom while on other occasions, must surely be obsessing with it. Feeling nauseated during carriage ride or motor ride is quite common and may not have anything to do with the present complaint. Your son will outgrow this complaint too. Motivate him to do so. You may consult a psychologist for counseling as an alternative measure. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does chest infection take to heal with antibiotics?\n\nMY 20 MONTH old daughter has chest infection she is on antibiotics and she has been on it for 3 days, i don't see her improve, not gone off food and doesn't want to drink so have to force, loose stool and only want to sleep, should i see the doctor again? how long does it take for Antibiotics to work?",
    "doctor_response": "Hello dearWarm welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  Antibiotic action depends upon many factors     -  type of causative organism  -  virulence  of  the  pathogen  -  host         immune  response  -  susceptibility of the bacteria  -  type  of         antibiotic  used  -  associated  co morbid  conditions  .*  If  symptoms  are  persistent  , should  consult  the doctor  for  further      assistance .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does depression cause weight gain?\n\ndoes depression cause weight gain when you ve always walked and excised ? I sold my home that GOD ALLOWED ME TO BUILD, because my baby girl of 7 children asked me to move with her because she was having my 18th grandchild 6 girls and 1 son. this was from 1 bad husbands.",
    "doctor_response": "DearIn atypical depression appetite is increased, may be due to neurochemical changes and. cravings for sweet foods and may be decreased physical activity secondary to depressive features This may lead to weight gainRegards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have Vitiligo, which food should I avoid ?\n\nHi Dr. I have Vitiligo since 2yrs i dont find any improvement and it has been spreading in many areas, is there any remedie or cure for it.. Also which food should i avoid",
    "doctor_response": "Hi! Milly, welcome to HealthacareMagic forum, Dr.tina jacob has nicely explained you the possibilities right from photo therapy to use of excimer laser.At this stage since lesions are spreading you definitely need oral steroids (depending upon your age) to stop the spread. Along with this get your thyroid profile also done as at time vitiligo is associated with thyroid problem (both are auto immune conditions). So consult a dermatologist for proper treatment. regards, Dr.chawda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I feel burning sensation in perineum with urinary frequency and discomfort. Please help.\n\nHello doctor, I have had the following symptoms every few months for a long time now. Frequent urination, burning in perineum area, and discomfort after urination. I have been treated for general urethritis three times in the last year. I do not have any STDs as I have been tested. These symptoms come along with no apparent cause. What is this and what should I do?",
    "doctor_response": "Hello. It can be prostatitis. Do you have a history of unprotected sex with a new partner before the start of symptoms? Is ultrasound abdomen has been done before? Kindly attach reports. Any report on urine culture? You mentioned that you have been treated thrice, which antibiotic has been given to you? Do you have a burning sensation after ejaculation also? Are you a diabetic or hypertensive?",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling between my collar bone and neck?\n\nI have had a soft swelling between my collar bone and neck on the left side for a few months. It can swell and then reduce in size. I have no pain from it.Im 52 and have been seeing a specialist at hospital because I am dizzy and often unsteady. No reason has been found although 2 years ago I had a really bad episode of laberinthitis",
    "doctor_response": "Brief answerlymph node enlargement due to infection or lymphomaDetailed answerhii appreciate your concerna unilateral neck swelling following laberinthitis may be due to lymphadenopathyit could be due to infection most probably or a lymphomain my opinion you must visit your doctor for battery of tests like FNAC of swelling and complete blood count testyou need to worry it will be alright with a course of antibioticHope i have answered you querythanks for using health care magicgood lucktake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have seasonal asthmatic attack with history of smoking. How could I control this?\n\nHello doctor, I am 19 years old and asthmatic. I weigh around 56 kg. My asthma is not severe and it is seasonal asthma and only happens during season change. Lately, my asthma is not going away I did a myteka and fexet course along an antibiotic course. I do use Ventolin inhaler which gives me relief. Normally, these days when I wake up I feel short of breath, again it is not that severe it is like 20%. When I am not sick my asthma goes away it does not bother me at all during any physical activities. I am a chain-smoker and have been smoking for two years yet it never made a problem. Any suggestions?",
    "doctor_response": "Hi. I can see that you are worried about your asthma. Let us start from scratch. Firstly, let us confirm your diagnosis of asthma and because you are having symptoms now it is the best time to perform spirometry. Secondly, for asthma, you have to use inhalational medication for at least a year after diagnosis and then we can taper-off as you are relieved of symptoms. I totally understand this is a long duration, but we need the medication for controlling your future symptoms. Thirdly, the medicine (Ventorlin) will provide you immediate relief but it will not prevent further attacks, so you need to add inhalational corticosteroids to your medication. And last but not least, you need to quit smoking. You already know the health hazards of smoking and in your case, it is worsening your asthma symptoms. It will be a difficult job but I can help you with that, only if you want. I hope this helps. Poorly controlled asthma due to smoking, not taking medicine regularly and not taking inhalational corticosteroid as well. Spirometry with bronchodilator reversibility testing. Poorly controlled asthma. Inhaler (Formoterol 6 mcg + Budesonide 200 mcg) with spacer, two puffs twice daily and can be taken up to four times daily if required and once exacerbation is over it can be tapered off for a month. Tablet Fexofenadine 120 mg once a day for a month. Quit smoking. Avoid exposure to allergens. PEFR (peak expiratory flow rate) monitoring. Follow up with investigations.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes gum pain after tooth extraction?\n\nhi,I had recently gotten one of my back teeth fixed at the dentist's (my tooth was chipped).and now the whole (right side) top part of my gums hurt. The pain comes and goes, and it sometimes gives me a headache. I'm not sure if the pain is due to the tooth, because I had gone to a different dentist and he had told me that the tooth the first dentist had fixed was \"defective\"and there was a small cavity on a tooth right next to that one which was in the back of the tooth. when I went back to the first dentist to get my tooth fixed (cause I didn't want to dish out another $200 to get the same 2 teeth fixed), he told me the chipped tooth that he fixed looked fine to him, and he was just going to fill the cavity of the other tooth. now it's been like 4 days and the pain in my gums is still there.help!",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,   I have gone through your query,  dont worry the pain can be due to the tooth that your dentist has fixed may there is infection in other tooth also   You consult your dentist and go for investigations Iopa X ray done then go for diagnosis what dentist is seen in Xray   May be due to restored tooth there is formation of periapical or periodontal problem that is Abcess which caising pain. Do warm saline gargle two - three times a day Take one tablet painkiller Diclofenac sodium twice daily and consult your dentist again and go for  treatment. Hope this will help you. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes upper abdominal pain and black stools?\n\nhi i have and have had upper adboniol pain, pain in between my rib cage and down put my ribs, now i am also having black stools when i use the bathroom. My doc told me i have ibs but its hasnt been bad for a couple weeks now and my stools have changed to black????",
    "doctor_response": "Start with the following:1. Capsule. Ganaton total twice daily (morning & Evening) 30 mins before food.2. Syrup. Ulgel-A 10 ml twice daily after food. (If this causes loose stools, reduce to 5 ml two times a day)Both medicines for a week.3. Have bland dietStrict avoidance of alcohol, smoking, spicy and oily food.If symptoms persists, Consult a gastroenterologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pressure in head, face, neck, ringing ears, increased pulse rate. CT of neck normal. No help from allergy medicines. Concerning?\n\nI have been experiencing head and face pressure, neck pressure, ringing in my ears and at times a fast pulse. I went to the ER with these sypmtoms 6 days ago and a CT of my neck was done and nothing out of the normal was found. I was told to take Sudafed, Benadryl, or Claritin as my primary care thought it was allergies. The head and face pressure is the same, and the ringing in my ears has not gotten any better either. Should I be highly concerned, or just diligent in my quest to find answers as to what is wrong?",
    "doctor_response": "Hello, Thanks for the query  to H.C.M. Forum. Sudaffed (pseudoephedrine+), benadryl , clarithromycin all these  drugs are most potent anti  allergic and antibiotics. Didn't help i.e. allergy din't present. After going through your query these symptoms may be due to high  blood  pressure , so please  check it. 2nd reason may be  due to tension ( stress ) . Consult a physician and get his opinion. Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of getting pregnant with retroverted uterus?\n\nHI am 34 years of age trying for 5 years to get pregnant... i had done an Hsg and a polyp was found ,the doc said said after a d&c and a flush my chances of getting pregnant would improve...i also have a retroverted uterus i am curious for your answer",
    "doctor_response": "Hi I understood your concern Retroverted uterus is a normal position of uterus.it will not affect your chance of getting pregnancy. Regarding infertility problems ,following are the tests which you should do first  before going to any type of treatment Husband-Semen analysis Wife-S LH,S FSH, S ESTRADIOL,S.PROLACTIN,AMH,USG PELVIS,HSGIf all this tests are normal than i advise my patient to  try for pregnancy by ovulation induction method IUI/IVF  which has success rate of 40%Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for diarrhea, vomiting and headaches?\n\nHi I have been having weird symptoms for the last 3 days shakiness headaches jittery nausea and vomiting. I feel like I have brain fog I feel very lethargic and when I eat I feel ok for 15 mins then back feeling worse I had some sugar then half hour later I'm sick again I'm very worried I also have diarrhoea",
    "doctor_response": "hello welcome to health care magic, you are suffering from gastroenteritis. with diarrhoea body loses water and minerals causing dehydration. dehydration is the cause of your symptoms. start taking oral rehydration solution and plenty of fluids. if the symptoms persist or you develop fever consult a physician for appropriate medication.  hope this info was useful",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes green semen post intercourse?\n\nI recently lost my virginity but of course I wore a condom. The last few times I masturbated I've noticed that my semen is a light green color like snot. This has been a problem even before any sexual activity. How can I fix this problem and should I be worried?",
    "doctor_response": "dear Sir.. the cause of the green colored semen is due to the presence of pus cells or bacteria in semen, most probably due to prostatitis...you need to see a doctor and get examined",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could raised erythematous rash be due to IUD?\n\nI have a patient in my office who had the Mirena placed 3 weeks ago.  She developed an erythematous, raised, sandpaper rash that is only getting worse.  She has not changed anything in her diet, soaps, or lotions. No new food, etc.  Could this be from the IUD?",
    "doctor_response": "Hello, Yes, some patients do complain of allergy rash after IUD insertion. Some get more prone to PID after inserting IUD. IUD may cause infection as the vagina contains bacteria & it can reach the reproductive organs while inserting IUD. Take care of your hygiene. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Nupur K, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for perirectal cancer\n\nHello, i am a female that had cancer in 2012; the doctors called it perirectal cancer, anyway I had to have a hysterectomy and my rectum was remove. I was told the pressure would go away, but my bladder has found an area to rest and it is very uncomfortable. I am still looking for help, I was told I would have to live with it or have major surgery. My question is what kind of doctor do I see, I was told that a gynecologist could not help me. Thank You.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  You have peri rectal cancer.  Treatment depends on type of cancer and stage.  You have gone through surgery.  But you still have problem.  You should consult onco surgeon for the surgery.  You need major surgery.  Consult your doctor and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough in a kid\n\nMy 4 yr old daughter s head hurts and she has a 101.4 temp. She doesn t care to eat either, just drink. She has a cough too. This has gone on for weeks. When we took her to the doctor they said she was getting over the Flu- That was 2 weeks ago. Little worried as she has Congenital corrected transposition of the greater arteries . She sees the heart doctor once a yr.",
    "doctor_response": "Dear parent,As she has heart disease,she can be frequently affected by lower respiratory tract infections.fever cold and cough suggests there is some infection.Please get a x-ray done and treat with proper antibiotics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain in the lower thigh?\n\nLast night I started having sharp pain in lower thigh from outside to above the knee. I decided to go to be to stretch it out straight. After few minutes the pain increased and kept coming and going. What could be causing this intense pain. It went away this morning while cooking breakfast but is back again.",
    "doctor_response": "Thank you very much for contacting healthcare magic. You have problem of sharp pain at thigh region that may be because of  any blood vessel blocakage by clog. Deep vein thrombosis may ruled out.Diabetic neuropathy may cause muscle pain problem. Check your blood sugar level also.You don't mention aggravated factor and duration of pain.Consent a physician for further diagnosis. Proper physical examination and history give exact idea about disease. I hope my guidance is helpful to you.Take care. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for sneezing, runny nose with itchy eyes every morning in a 3 year old ?\n\nDear Doctor , my 3 tear old kid starts sneezing every morning when he wakes up. it continues with runny nose anf itchy eyes till noon. after that she is completely ok. no cough or nasal block. it is going on for almost 1 year. she is now having kitotifen and montair 4 for two months and her doctor has suggested to have it for six months. her symptoms have been reduces but not cured. she will be going to school from july and i;m very much worried of her rhinitis . it would be very difficult for her to cope up with this at school everyday. plz advise what to do. FYI: she takes honey everyday.",
    "doctor_response": "HELLO & WELOCME TO HCM FORUM YOUR CHILD IS MOST LIKELY SUFFERING FROM ALLERGIC RHINTIS YOU SHOULD GO FOR ALLERGIC TEST WHICH INCLUDE SENSITIVITY TO FOOD , EDIBLES, CREAM, SOAP, POWDER AND PERFUME, DUST YOU CAN CONTINUE THE MONTAIR TABLET YOU SHOULD ALSO GIVE AZELASTINE SPRAY+ FLITICASONE. THIS IS REALLY A WONDERFUL DRUG AND WILL HELP IN SUCH UNTRATABE CASES AS PER OUR PERSONAL EXPERIENCE YOU SHOULD ALSO CONSULT ENT SURGEON TAKE CARE AND HOPE FOR RAPID RECOVERY DR.MAYANK BHARGAVA",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen rib cage\n\nIg OK t into a physical fight with someone about five days ago and we went down to the ground and fell on a bicycle and the handle bar went into my rib cage right where my heart is the pain is worse at night and its pretty swollen on the area but there s no bruise that can be seen also when I run my hand across the swollen area it like feels crackly like liquid moving and maybe bubbles I feel the pain is really bad at times and instead of it getting better its staying painful I m sorry I thought this was free",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. You had blunt chest trauma due to fighting and the cracking sound is mostly due to rib fracture. So better to get done chest x ray for the diagnosis of rib fracture. Follow these steps for better symptomatic relief in such cases. 1. Avoid movements causing pain. 2. Avoid bad postures in sleep. 3. Avoid heavyweight lifting and strenuous exercise. 4. Apply warm water pad and ice pack application on affected areas. 5. Take painkiller and anti inflammatory drugs. 6. Sit with proper back and chest support. Don't worry, you will be alright with all these in 1-2 weeks. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any inexpensive way to treat fertility problems?\n\nI have had a fertility problems for the last 2 years and I simply cannot afford a fertility doctor as well fertility medications and I am trying to find a doctor that can prescribe that for me a fertility I want so much to have a child that I cannot afford the sorbent price it would be for fertility doctor and they're hard fertility drugs",
    "doctor_response": "HiThank you for asking HCMBefore treating your condition first have to identify what problem you have.You have to rule out a Polycystic ovary by ultrasound examination and have to find out whether you are ovulating or not.For that an ultrasound examination and hormone analysis may be necessary.You husbands semen analysis also should be carried out.Then your treatment will be easy.You can consult a gynecologist and have a work out of all these atleast first.That wont be that expensive.Hope this may help you.Let me know if you have any further query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for pain in the right abdomen\n\nI have a pain in the right abdomen where I had been operated for appendicities 10yrs ago.I was advised to take an ultra sound.The result was normal.The blood test also was normal.I am presecribed Zenflox Nt and Rablet.But the pain stiil persist.What could be the problem",
    "doctor_response": "HIWell come to HCMThe symptom suggestive of some colicky pain and in my opinion this can be treated with Tab Dicylomine and Acetaminophen three times in day drink plenty off water if symptom dose not improved then this need to be ruled out for urinary stone, hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taken Nordette after having sex. Any possibility of getting pregnant?\n\nJan 3 twas my first time of having sex. We used condom, do the withdrawal method ( Coitus interruptus ), voiding/urinating (estimated time 30-45 mins after), i also took 4 nordette pills after the intercourse and another 4 pills of nordette 12hours after the 1st dosage. At this moment im very nervous and scared of getting pregnant. Is there any possibility of getting pregnant? Im 18 years old by the way, and my cycle is very irregular not in the average 28days cycle. Please, enlighten me.",
    "doctor_response": "Hi dear u have taken so many precaution then why to worry. Condom itself was enough. To get preg sperm must be deposited inside vagina. So dont worry at all. Even then if u have doubt. Do a urine preg test after 10 days. These kit u usually get in medical shop. Thank u",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with intestinal obstruction, found tumor. Chest and abdominal ct scan shows tumor confined. Looking for treatment\n\nhi! pls my mum was diagnosed with intestinal obstruction after the surgery which took place about 4weeks ago they found a tumour but did not remove it and therefore the doctors did a temporary colostomy for her. the histopathology showed it was was cancerous and other test including a chest and abdominal ct scan shows that the tumour is confined and has not spread to any other organs and its about 0.2cm in size. the doctors have talked about resection, reversal of the rectum to its normal position and chemotherapy . as a layman in this field i m confused. please in what order should these treatment take place and within what time frame? and please what is your candid opinion on this? please i need your help! thank you.",
    "doctor_response": "hello if tumor is localised they should go for resection followed by chemotherapy and reversal of colostomy/ chemotherapy may take 3 to 4 months depending upon regime used",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a persistent dull pain along my sternum?\n\nI am 22year old male and I have constant dull pain along the sternum, does not radiate, aggravated by crouching but alleviated by exercise and stretching. It is not costochondritis, ECG normal, Echo is normal No history of asthma or any other medical condition What is your take on this?",
    "doctor_response": "Hello dear , HiWelcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This seems in relation with ligament sprain  or  strain  in relation to     manubrium sterni  with or without neurovascular bundle  issue .*  Needs  MRI  evaluation of the same .Hope this will help you for sure .Regards dear take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Heart diseases in family. Have high cholesterol. What should I worry of?\n\nhI I AM A 61 year old132LB FEMALE hEART DISEASE DOES RUN IM MY MOTHERS SIDE OF THE FAMILY .my overall CHOLESTERAL IS 234 my Lp-PLA2 is 238 my LDL is 132 My Lp(a0 is 94 and my fraaitin is 160 My main activity for exercise is Yoga which i do at least 5 times a week at a studio Sometimes it is how yoga wherer the temps are 95 plus the humidity is cranked up can you tell me your assessment",
    "doctor_response": "hi raeandrews thanks for writing to health care magic as you said you have family history of heart disease and you have high cholesterol level as you are of 61 years old so should take proper care of your circulatory system it may harm you to have  high cholesterol level as it deposits to your arteries and causes blockage yoga is good for you  along with this you should follow the diet restrictions by avoiding fat and cholesterol rich diet and also reduce salt intake and its time for you to have regular touch with your family doctor for regular checkup of your blood pressure etc. i hope if you active and follow the the instructions you will be fine hope i have helped you take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "BLOOD AND SPERM LIKE MUCUS AFTER URINATING\n\nam a male 35 yearsof age .This my first time with this condition --Last 2weeks i was feelin a sweetnin sensation as if something is crepin in my penis that sometimes when i hold it or try scrup or rup it the sensation bcomes sweeter. After that i started havin a continuos discharge i tot 2 b sperm from my penis B4, after,& even durin pissin. Later i started feelin a burnin sensation at the end of pissin. Later the burnin sensation bcame sharp but later a sperm came out with something like blood in it wit a sharp pain after urinatin. now this week after urinatin-i think is blood but i might b wrong- comes out from my penis but this time without the sharp burnin sensation. B4 the coming out blood i feel that sharp burnin sensation in the cap of my penis-close 2 the openin of my penis anytime i pee. I was advised 2 take a MCS test which will b ready next week monday. But this blood comin out after urinatin is makin me uncomfortable n scared. Pls i need your explanation ,advice , recomendation and also wot MCS is .THANKS",
    "doctor_response": "This needs detailed investigation. Consult a physician or a nephrologist. You should get a urine examination along with urine culture. Also an Ultrasound of the kidneys and urinary tract is warranted. You should drink lots of fluid. But you should not worry. It looks like a easily treatable condition",
    "dialogue_context": ""
  },
  {
    "patient_message": "Missed contraceptive pill, had both together. Having pink discharge and pain in lower abdomen. Is it due to pill?\n\nHi, I m a 15 year old girl on contraceptive mixed pill , I missed it for 2 mornings and took both around 2:20 on the second day, and that evening (although I have been fingered 3 or 4 times before by the same boy) my boyfriend did it again, I don t know if it was rougher or something, but when I got home my discharge was pink, and I bled after that overnight. I have pains in my lower abdomen now. I have never done this before but I m slightly worried as to what caused it, a close call with the pill? Or did he break my hymen?",
    "doctor_response": "Hi,Thank you for posting your question here, I will try to answer it to the best of my abilities. Yes it is possible to break your hymen by fingering, but in your particular case I think your boyfriend was a little rough with you that is why it still hurts. So tell him to be gentler next time, you should be back to normal within a couple of days. Just give your body sometime to heal.If for some reason you keep bleeding and it doesnt stop, see a doctor right away.I hope this answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cyanosis during violent cough spells?\n\nA 2 year old developed a cold a week previous which progressed into a violent cough and the production of thick, ropey mucus. The violent coughing spells often results in vomiting. She was brought to the Emergency Department because she turned blue (cyanotic) during one of her coughing spells. What does she have?",
    "doctor_response": "Hi...she seems to be having a viral illness/ Upper respiratory infection or a pertussis. Turning blue is a symptom intense cough and more likely to be a Pertussis. Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cold, hot flushes, blacking out, vomiting sensation. On birth control. What is wrong?\n\nI woke up to get my son a bottle in the night and as I was preparing it all of a sudden I felt the urge to vomit. Then I felt real hot and almost blacked out. I had to sit down real fast or I would have blacked out. My husband felt me and said I felt real cold but I felt like I was burning up. It finally went away but now I still feel weird..not very good like it could happen again. I'm not on any medicines only birth control. What is this....",
    "doctor_response": "welcome to HCM!take contraceptive pill with milk.it might be causing gastritis.consult a nearby physician,confim the diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does pregnancy increase chances of cancer relapse?\n\nWhen I was 12 I was diagnosed with Non-Hodgkin's Anaplastic Large Cell Lymphoma. I went through chemotherapy and was said to be cured at age 13. Lately me and my finance have been talking about having kids and our future. I am just worried that if I have children my cancer could come back and then I could die and leave my husband and children behind. I guess what I am asking is what is the likely hood that my cancer could return. Do most that have gone through this live long cancer free lives or does it return?",
    "doctor_response": "Hi,Thanks for writing in.Pregnancy doe not influence the appearance of cancer cells. Lymphoma is a cancer of the lymphnodes and you had non hodgkins lymphoma anaplastic large cell type which was cured with treatment. These cancers respond well to treatment and your treatment was complete.Cancer is closely monitored for 5 years. Most cancers return in 5 years and require treatment. This happens in only few patients and rest live long cancer free lives. There is no need to worry about having kids and your cancer coming back. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a female be pregnant after having sex with a vasectomized male?\n\ni had a vasectomy eight years ago. I have been pretty active and now a lady said she's pregregant. I checked my sprem with an over a counter kit and the results were negative several times. is it possible that she can get preg twices in the same year.",
    "doctor_response": "Hi,I have gone through your query.Pregnancy is not possible after successful vasectomy. Even after one year of vasectomy body starts to form Anti-sperm antibody.In your case pregnancy is not possible.Do consider a positive feedback as a credit to my work. Let me know if you have any further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes round lump in front of neck?\n\nhi i found a small round lump in the front of my neck on the left hand side just above the collar bone. the doctor asked me to move my head from side to side and said its just a strain . How long does it take for the lump to disappear and should I get it checked out again if it doesnt go ? Thank you",
    "doctor_response": "Hi,It seems that there might be having enlarged supra clavicular lymph node producing this lump.It shows that there might be having some infection in surrounding area.nothing to worry if it is not painful or further increase in side.Gradually it will be subsided.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment for impotency\n\nMy boyfriend has experienced impotency issues. He has been drinking 2-3 protein shakes a day I heard this can cause problems with achieving and maintaining erections. He is a healthy 35 yr old mail. He had his prostate checked and its fine. Any suggestions? Shouldn't h stop taking the protein altogether?",
    "doctor_response": "Hi, The protein intake is not related to erectile dysfunction. I suggest you check his sugar level and measure blood pressure to exclude diabetes and hypertension. He need to loose weight if obese. Investigate with his testosterone and prolactin level as well. He can use Tadalafil for short duration. Advise him to practice more foreplay while doing sex. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to relieve from severe asthma symptoms?\n\nMy roommate has severe asthma and hasn't had medication for quite some time. Is there anything I can do for her to help relieve any symptoms? She needs a primary care doctor but no insurance, use county facilities which give her the run around and frustration.Well we are both currently unemployed with no income. So thanks anyway.",
    "doctor_response": "HelloThanks for the query to H.C.M. Forum.Bronchial asthma causes due to allergy due to some allergens .These allergens are , dust , mite, pollen ,molds , sudden fall and rise of temperature , anxiety , smoking , fine dusting powder .Avoidance from these predisposing factors help.Usually this type of symptoms occurs due to bronchoconstriction and there develops ,running nose, whistling sound during breathing, tears from eyes with itching .Bronchodilators +antihistamine (OTC ) will provide quick relief.Coffee + steam inhalation also help.Hope these information will be helpful for your roommate.Good luck.Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to improve the sperm motility\n\nsir i am 34 years old i had got married before 02 years when i test my semen analisis my count and motility was low and varicocele after the 06 months treatment like proxceed,clomid,vitamin E,,reparil,padutin now i had repeat test my count is 28 milion/ml motility 30% fast,progressive 10%,morphology 26%.please advice me to improve motility and other parameters.thanking of you",
    "doctor_response": "Hello, The sperm count and Morphology seems to be improved with medicines as they are within the normal range. But motility is still little low. You can take multivitamin tablet and hey Forte like tablet for that. You can discuss with your treating doctor and such medicines can be prescribed. Don't take the stress and avoid excessive heat exposure. Smoking and alcohol should be strictly restricted as it can affect motility. I suggest you get checked your testosterone level as well. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pimples on tongue\n\nThe top of my mouth is usually slimmy and I generally have like a pimple on the tip of my tongue.  I've been told you can have surgery to remove the bump.  Is this a good thing?  Also the roof of my mouth is usually slimmy also.  I have been using Oragel which helps a little bit.  What would your recommendation be?",
    "doctor_response": "Hello,Thanks for consulting HCMRead your query as you have pimple like swellimg on tongue dont be worried so much this can be inflammed  taste buds on tongue for this you should consult dentist for oral examination of tongue and inmeantime you can apply ointment like Mucopain and you can take medicine like vitamin B 12 supplements by consulting with your local doctor .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is kidney infection dangerous after spleen removal?\n\nI had a spleenectomy on May 13 after a car wreck. I am a MSK patient with a stone on the move. Since I have hot and cold spells which may be an infection,and was wondering if it is important to find out and is a kidney infection dangerous after spleen is removed?",
    "doctor_response": "Spleen is very important for preventing infections in body. So spleen removal increases all infections. You should go for vaccinations before spleen surgery. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be done for sharp pain in lower back with history of operations for skin cancer?\n\nI have been suffering from lower back pain on the left side for 8 plus weeks which consists of sharp pain above the left hip when walking and moving up and down, also when lifting I have severe sharp pain across the back - I have had in the last 2 yrs had operations for skin cancer - I am a 45 yr old male",
    "doctor_response": "your symptoms might be related to disc problem. When this is problem with intervertebral disc, it can impinge on nerve roots and cause shooting pains along the distribution of the nerve. pain can be felt on the back radiating down the limb. You need to be investigated further to locate the exact pathology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why did I not find any semen after ejaculation? How much semen is required to impregnate a woman?\n\n1. i ejaculate before my wife does and in most cases i see no semen after ejaculation? 2. can a man 38yrs with about 94.42 to 100,million sperm counts be able to impregnate a lady of 25yrs? 3. can a man 38yrs with about 84.42milloin sperm counts be able to impregnate a lady of 36yrs? my e-mail ID YYYY@YYYY",
    "doctor_response": "HiThanks for choosing healthcare magicYou need just one active and motile sperm to pregnant a woman, but at time of ejaculation your sperm count should be more than 20 million. It would increase the chances of fertilization. Rest depend upon mobility of sperm. In your case, sperm count is good, but get sperm motility checked. That would help you clear reason of your problem.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for less hair growth in moustache region\n\nHi, Good evening Doctor.One year back suddenly, hair growth stopped in my part(around 2 cms) of my left mustache. I consulted one of dermatologist and he suggested to apply Minoxidil in that area and i used it for two months and I didn't find any hair growth. Because of this I have to shave regularly. sometimes I am getting a feel like insect moving on the skin. Please give me the reason for this and how do I get hair growth in that area again. Please help me in this regardThanks in advance for your advice.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.In my opinion, you might be suffering from alopecia areata. Do continue minoxidil and it will take 6 months for treatment response. Be patient. You can also use topical corticosteroid cream under supervision of your dermatologist. Use corticosteroid cream only if the diagnosis of Alopecia areata is confirmed by a Dermatologist.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathing difficulties, chest tightness and burning sensations after quitting smoking?\n\nHi, I gave up smoking two weeks ago and since have had a very tight chest and find breathing more difficult, I also feel a burning sensation in my chest. I am 30 years old and have been smoking since I was 18. How long do you think this will last? Is this likely to be a symptom of giving up?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. No, these symptoms are not due to smoking cessation.Possibility of bronchitis (inflammation of airways) is more likely.It is commonly seen in smokers.. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test).PFT will not only diagnose bronchitis but it will also tell you about severity of the disease and treatment is based on severity only. You will mostly improve with inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruising and tenderness in upper armpit?\n\nFor the past year or so, I ve experienced my upper armpit area becoming bruised and extremely tender probably once every couple months and it lasts a couple days. I don t know if I m applying my deodorant too aggressively that I m irritating the tissue in there or if it s my lymph nodes trying to tell me something s wrong. Sometimes when I have this unexplained bruising it s also swollen, but this time I don t have swelling, just the bruise and tenderness. I m kind of concerned, I m only 18 so I hope nothings seriously wrong with me. I hope that was a decent description of my symptoms. Thank you.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have bruising and tenderness in upper armpit. Well there can be many reasons for symptoms you mention in query like hematoma ,muscle spasm, allergic reaction, infected lipoma, infected boil , lymphadenitis or cyst . I would suggest you to apply ice pack thrice a day , apply warm compresses after 48 hours , apply over the counter anti inflammatory , take antihistamine like zyrtec and anti biotic cream . Consult dermatologist if condition doesn't get better . Doctor may prescribe antibiotics like clindamycin along with anti inflammatory or may recommend surgical removal .Doctor may also refer you to general surgeon for proper diagnosis and rule out breast cancer like condition . Doctor may order mammogram . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it ok to put the person with down syndrome in a group of home residency where they are trained ?\n\nhello---I have a 32 year old ,down syndrome son on peritoneal dialysis.- which I do for him presently for the past 2 years-he has been approved for a group home residency-where an approximate 10 people will be trained to do the exchanges--because of the working shifts of the staff--this is the best they can arrange. is this a really bad idea?? (considering risks of peritonitis)--should I go along with this plan?--or forgo this slot.--thanks so much",
    "doctor_response": "HiThanks for using healthcare magicI think, due to such medical complication, it is good to get him trained at home. With this, chances of infection would decrease, but external exposure is also important in his case. You can take him out of home during weekend for some special class. It would teach him, how to interact with another people outside home, that he would not learn at home.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Delayed periods.    History of having unprotected sex and intake of primolut n for 10 days.    Possible pregnancy?\n\nI had my last period 1st week of april. Had unprotected sex on the 30th of april and 2-4th dy of may. Until now i didnt have my period yet. I took a pregnancy test last may 20 and it was negative. I also took primolut n on the 14th of may until the 24th. Until now i havent got my period. Are there any chances that im pregnant?",
    "doctor_response": "Hi,   Thanks for writing to us.   The chances of pregnancy have always been there with unprotected sex.    The chances of pregnancy in your case is less but the possibility is there.    You can consult a gynaecologist for urine, blood test and ultrasonography to rule out pregnancy.    Good luck.    take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I increase dosage of ondem to treat stomach pain in a child?\n\nMy daughter is 8 years old with wt. 17kg , ht. 120 cm . She is passing semi solid stool , though twice or thrice a day since 5-6 days and on and off stomach pain . She also vomited once complaining stomach pain but that improved with ondem two doses. Doctor has prescribed fragyl syrup for 10 days , 5ml thrice a day with enterogermina twice . Is such a long dose of fragyl is safe ? He prescribed that as she often complains stomach ache. We consulted another doc also who prescribed bacigyl n for 3 days only with zinconia syrup . Whom should we follow, we are really confused.",
    "doctor_response": "Check if the child has stopped passing loose stools , Its better if flagyl is started you continue for 5 days along with the second doctors prescription which can help your child to get rid of the symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for an infected wisdom tooth\n\nHi,  I got infection around 3 weeks back in skin flap around wisdom tooth and was cured by antibiotic course. Again last week, the skin flap got swollen and started paining. I did gargling with Salt water and applied clove oil. Now , feeling much relieved. Today I have visited Dentist and they suggested to remove the tooth. Later on, in x-ray, they have notice nerve may be touching and explained me, the nerve may get damaged, though chances are very less. But I am feeling scared now. It there any alternate? What you recommend",
    "doctor_response": "Thanks for your query, I have gone through your query.The infected wisdom tooth has to be removed since it is infected, if there was no infection then we could have left it like that only. Get a CBCT done, which shows the exact distance between the root tip and the nerve canal. Later we can plan acordingly and remove it without damaging the nerve canal and nerve. Consult a good oral maxillofacial surgeon and get it done. nothing to worry.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for red rash on face and itchy eyes\n\nI have a red rash on my face which has been there for the last 6 months, i also have this rash on my chest.  My eyes are swelling and ichy and it tends to be worst after warm showers and at the moment it is extremely infalmed and very red. What do i di?",
    "doctor_response": "Hi, since last 6 months u are facing this problem u haven't consulted any doctor that's surprising.This   can be due to allergy but a doctor need to see this rashes by his own eye if it rash or something else.Consult dermatologist as early as possible but don't get panick .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower abdominal discomfort. Negative pregnancy tests. Taking birth control. Bloated stomach. Reason?\n\nI have what feels like a baby kicking in my lower abdomen. I took pregnancy tests and they were negative. I also have a regular period every month because I am on birth control. My stomach feel bloated and I am due for my period to start at the end of this week. Why am I feeling this movement? It goes away but then returns around the time I should start my period.",
    "doctor_response": "hello, thenks for putting up your worry.firstlt, the correct use of your birth control pills means you just can't be pregnant. feeling this movements prior to your menses could just be the premenstrual syndrome since it usually comes with your menses.please just be relax, but if it gets worse, you should see your physician.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does it take to recover from a heart attack?\n\nI had a heart attack on 4/30, wAS HOSPITLIZED FOR FOR FOUR DAYS. . upon returning home I was extremely tired, used a walker, prepared my meals and rested. now I was told I could drive but only short distance. this week. I was an active person, walked 10 blocks 5 days a week, followed a heart healthy diet, took heart meds, managed a low sodium diet. How long does it take to return before I can return to a similar life style?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It depends upon the severity of heart attack and ejection fraction, however in majority of patients within 2 weeks,  patients restart their routine activities. Heavy activities should be avoided through out the life. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for erection problem?\n\ni am 25 year old and just married . my wife is 23 years old and I couldn t have sex with my wife due to no erection . I consulted doctor and he asked to go for ED test and the test shows everything positive . He gave me few tablets (tadalafil) but still have erection problem . That doctor is providing only negative replays . Pls advice how should I proceed",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have problem of Erectile Dysfunction and have no satisfactory results even after taking Tadalafil.You need to consult qualified Urologist for clinical evaluation and get following tests done to study the penile circulation.1) Colour Doppler Ultrasound Scanning of penis to rule out arterial insufficiency or Venous leak as a cause of your ED.Further treatment will depend upon the cause of your ED.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Worried for swollen feet and chest tightness after c-section\n\nI am 27 - just had c-section Sat., released from hospital on Tuesday and have had swelling in feet and tightness in chest when lay down.  Am nursing so taking in alot of water, but am voiding regularly every 2 hours.  Should I be concerned of chest tightness - not comfortable laying down.",
    "doctor_response": "You may be suffering from bloating of stomach(gastritis) because of which you are feeling chest tightness. Further the antibiotics you are taking post operation causes gastric discomfort. But if you are not anaemic there is no reason for swelling of feet. So go to your doctor for thorough checkup. An ECG will clear your doubts.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the MRI of the knee mean?\n\nHi I m Tiffany I had a MRI of tte left knee without contrast the findings show mild degeneration of the medial meniscus, mild thickening of the ACL, small to moderate joint effusion, mild lateral patellar tilt and medial patellar retinaculum is somewhat thin. What does this mean?",
    "doctor_response": "This looks like degenerative changes to an arthritic joint. Apply warm packs, avoid squatting, kneeling, cross leg sitting. If you have a lot of pain, arthroscopic debridement can be done to remove any bony debris and injured meniscus.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe lower back pain\n\nI started experiencing left lower back pain a few days ago. The pain is sharp and now is across the entire lower back. I had a burning/stinging pain a couple times mid-spine yesterday. About 4 hours ago, I started having lower abdominal pain and some crampy type pain. I also feel bloated. It seems to make it harder to breath, and is more painful to move, to touch, upon coughing. Some spotty type pain moves across the lower back, with some in the abdominal area.",
    "doctor_response": "Hello,Thank you for using healthcaremagic.I read your question and understood your concern.The cause of the back pain could be anything from kidney stone or abdominal organs problem , to discal hernia of lumbar spine . so I advise you to have a complet check and work up for this pain.Wish you all the best.Dr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is persistent pain and swelling after hematoma on gums normal?\n\nmy daughter got a hematoma on her gum above her upper front teeth as a result of bridgework. it has been several weeks and the pain has come and gone. However yesterday herllips and chheks swelled up again and she is in a great deal of pain. the pain medicine isn't helping her. is this normal and what can she do?",
    "doctor_response": "HiWith your quwry, dont know how did you confirmed it was a hematoma however such lesions must be clinically examined and treated for good prognosis otherwise it may act as nidus for infection.Hope your daughter is nit having any other systemic complications like bleeding disorders my sincere suggestion is visi your doctor and know the reason for sudden increase in swelling which is not a normal clinical sign.Hope this helps you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for acute kidney infection\n\nHi My daughter (age 20)  was hospitalised 6 weeks ago with an acute kidney infection. She was given an IV with antiobiotics and fluids for three days. Her right kidney was swollen as well as her right ureter. She was sent home with trimethroprim which she finished but developed rashes etc. Within a few days she started getting pains again even though her tests came back negative. She was put on Alprim for two weeks, followed by cilex. She is feeling better now at week 6, but is still having twinges when she moves about more, or lies the wrong way. Her last ultrasound a week ago showed there was still some swelling in the right ureter.  I feel she is doing better, she is taking D Mannose, garlic and colloidal silver, but the twinges still worry me. She can't get in to see a urologist for another two weeks. What I want to know is it normal to still have twinges. Other than that, no burning etc. Thanking in advance",
    "doctor_response": "Hi there, It sounds like your daughter had a moderate case of pyelonephritis, or kidney infection.  These infections often take a while to clear and even after some of the swelling can still cause pain and perhaps the 'twinges' that she is still having.  I would say as long as she is not having any blood in the urine, pain with urination, any fevers above 100.3 F or vomiting or back pain at rest this could all be part of the healing process.  I hope this is helpful to you and let us know if you have follow up qusetions,Dr. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications to avoid impotence and sterility\n\nI am going to take deca durabolin (Nandrolone Decanoate) for gain of muscle, what medication should i take to avoid impotence and sterility? Am going to do a deca durabolin cycle for 2 months, a 100mg per week. A total of 800 mg. Will nolvadox and clomid help? When should i start the medication? what other medication are available to stop any other side effects",
    "doctor_response": "Durabolin can cause sterility and impotence. But you should not stop it abruptly. Rather you should consult doctor to know whether it is necessary to continue or not. Now, regarding, sterility, we need to confirm the semen analysis report first. SO, please get it. For impotence, you need check up by doctor a it is very much important to know the cause first and then get it treated. Please read-",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe body pains?\n\nhi, my husband is sufering from severe body pains since 1 year. he is 29yrs old. his esr level is 20. he drives around 35kms daily on his bike .is it because of high esr or due to driving for long time . his reports are all normal. i am worried abotu his healh . can u help me out in suggesting a good solution.",
    "doctor_response": "Hello welcome to the health care magic I need to know which reports has been done His  CBC,  serum calcium,  vitamin D level should be checked If any deficiency present than corrected accordingly Daily driving with taking less food can make him tired as well Advise him to take daily breakfast and healthy diet in afternoon  also Take care Consult nearby physician for examination and if no abnormal findings present than no need to worry Hope this will help you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Blood blisters on inner butt cheek after being sick with stomach virus and diarrhea.  Suggest home remedies\n\nI have what looks like a blood blister on my inner butt cheek close to my anal hole. I just discovered it today and I have been sick with a stomach virus with diarrea. How and what are ny options to treat this is? Any ideas on what to use for over the counter or home remedys? I definately do not want infections. It does cause some discomfort when I walk.",
    "doctor_response": "Hi and thank you so much for this query.I am so sorry to hear about this blister around your anus. The truth is that diarrhea produces acids that can cause such findings especially in sever and frequent episodes. The best course of treatment is to practice sitz baths which consist in adding and antiseptic like iodine to 100cc of lukewarm water. Pour the water into a bowl and sit in it for 15mins at least 3times/day and after each stool. This will help keep the area sterile and prevent infections thus assuring its rapid healing. If it should not get better, then please consult the doctors to evaluate and prescribe antibiotics if need be. I hope you find this helpful. Thank you so much for using our services and please do feel free to ask for clarifications if need be. I wish you the best of health.Dr. Ditah, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does CCQ 100 tab help in conceiving and also taking Folic acid and M2 tone syrup?\n\nIm 28yr old and trying to conceive.I really dont have any idea about all this.I had my last cycle on Dec18 2013 and i missed my jan cycle so i consult with doctor he checked my report and it was negative so he prescribed me folic acid tab for 10 days n m2 tone syrup for 3 months.now my last cycle happened on 29th jan.So my doctor advice me to take CCQ100 tab for 5 days from the day one of my cycle.Is this tab helps me in conceving.Till now i didnt go for any check ups neither my husband.Can you please suggest something on this. Appreciate your quick response. Thanks & Regards Renu",
    "doctor_response": "Hi,I read your query and I understand your concerns.Following is my reply:1) These medicines will help in getting pregnant.2) Please get regular follicle growth scan to know date of ovulationLet me know if you have anymore questions.Regards,Dr. Mahesh Koregol",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child suffering from mild form of Tourette s syndrome and his tics worsening. How to make his life easy?\n\nHi, i am concerned about my 14 years old son.He was diagnosed with a very mild form of Tourette s syndrome about 6 years ago.He is attending high school first year.His tics worsen lately and he seems to be uncomfortable to go to shool as kids make fun of his twitching.I do not want to put him on any kind of medication.I just try to explain to him that at this age the symptoms may increase.What can I do to ease his life now?Thank Tatiana,mother",
    "doctor_response": "Hi and thanks for the query,this s syndrome that requires much expertise and a multidisciplinary team to improve the quality of life of the child. The opinion of a neurologist, a psychologist and a physiotherapist would be most welcome in this case. Support to the family and child are very imperative. Thanks and kind regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can exercise help control diabetes?\n\nMy blood sugar levels are high in the morning sometimes as high as 170. When I eat I recover without any problem and the rest of the day I seem to control everything with diet and exercise. I am on Metformin.750 mg lunch and dinner . Can exercise when I first wake up help my fasting levels drop before I have time for breakfast.? Thank you",
    "doctor_response": "Welcome to ' Ask a doctor ' service ,I have reviewed  your query and here is my answer .Please note that any exercise or exertion will cause  drop in blood sugar level .Exercise as aerobic or anaerobic decreases insulin intolerance besides reducing weight .I hope I have solved your query .Let me know if I can assist you further in this query .With regards dr varinder joshi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it advisable to go for ureter implant?\n\nsir hi have 6 months old boy. there was a mild hidronephrosis in left kidney that time when my wife was pregnant. now i consult to my pediatrician in jaipur. they advised me sonography. i got it done. there was again mild hidronephrosis. then i consult a urologist in jaipur. they said to me to go for DTPS scan. i again got it done. there was the problem in ureter that ureter is significantly diluted. then my doc advised me MCU. i got the MCU done. it was fine. now my doc is saying me to ureter implanment .kindly sugest me what should i do.",
    "doctor_response": "Hello,Hydronephrosis is a condition in which the kidney gets swollen due to accumulation of fluid in kidney due to obstruction or reverse flow of urine. Hydronephrosis can lead to loss of function and permanent damage to kidney. Significantly dilated ureter with hydronephrosis in your case is ideal indication for ureter reimplantation surgery which will prevent future damage to kidney.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Khan Shoeb Mohammad Sher Mohammad",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for semen leakage\n\nhi doctor...im a 15 years old n i started masturbating 2 years ago...now i ve got this problem of semen leakage...im afraid of tellin this to my parents ...i need a solution for this..feels like im gettin weaker by the day.....n i got this problem only when my penis is flaccid..please help me",
    "doctor_response": "Hi, Wed dreams/ night fall called as Nocturnal Emission is normal. It can be due to increased erotic stimulus mentally or physically or visually without sex or masturbation. Since you know the cause treating is easy. Reduce the frequent Erotic stimulus or masturbate / have sex. Ways to reduce the frequent erotic stimulus are: 1.\u00a0Sex education 2.\u00a0Physical exercises 3.\u00a0Sleep adjustment 4.\u00a0Quality of sleep 5.\u00a0Healthy and balanced diet 6.\u00a0Programming for leisure time 7.\u00a0Development of spirituality 8. Taking a cold bath. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes left-sided breast and armpit pain post disc fusion surgery in the neck?\n\nI am having pain in my left breast, armpit, shoulder, upper arm, neck and shoulder blade the pain feels muscular and nerve related. I fell last november and strained the tendons in my left shoulder. I also had surgery october 2015 disc fusion on 3-6 in my neck.",
    "doctor_response": "Hi, The pain in breast armpit and shoulder is not related to the disc fusion. This can be due to a muscle spasm due to abnormal posture or electrolyte imbalance. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes weakness, joints pain and vertigo?\n\nhi I am a 45 year old female whos been having episodes of the same symptoms every day. I feel weak, shaky, I have extreme joint pain, I have extreme vertigo, I have tingling in my arms and sometimes my face, I have nerve pain in my left arm, I have heart palpitations, I also noticed that I have blurred vison, I gained a lot of weight but I am a healthy eater Also, I cant go out in extreme heat or extreme cold. I am also extremely anemic. I was also told that I have sinus tachnycardia, a pituatarty tumor and I was disgnosed with other things but they cant explain what the episodes are. They are now 3 and 4 times a day starting around 8 in the morning.",
    "doctor_response": "Hello! Regarding your concern, I would explain that your symptoms could be related to thyroid hormone imbalances. For this reason, I would recommend first checking thyroid hormone levels. Another possibility to consider would be seizures. For this reason, an EEG is necessary, especially considering the fact that you have a brain tumor. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is surgery required to repair bursa sacs?\n\nMy hip hit the ground very hard in an ATV accident. I had a huge bulge on my hip that my doctor thought was a large hematoma. He had a radiologist aspirate it. However, there was a tremendous amount of fluid (about 7 tubes), and it was mostly clear. The hematoma refilled in a few days, although not with the same pressure. I am now scheduled for a second aspiration and a more thorough view of the area to figure out what is damaged. One speculation is ruptured bursa sacs. If that is the case, will I need surgery to repair the bursa sacs?",
    "doctor_response": "hi,why don't you try doing some small exercises within your limits of pain.I will mention a few and hope it will help you. try doing some lower limb exercises like static quadriceps, static hamstrings, ankle toe movements and straight leg raise.try lying down on the unaffected side and perfrom leg lifting and holding of 10-15 counts. repeat this for 10-15 times.then proceed onto lying on your back and life the thigh up while keeping the knee straight and holding for another 10-15 counts and repeat the same for 10-15 times depending upon your capacity of pain bearing.use icing for the surrounding area which will lead to vasoconstriction and reduce the inflammation as well.you can try taking therapeutic ultrasound therapy from a qualified physiotherapist as well.I wish you a spendy recoverythank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lack of trust in people?\n\nHi,I have a problem trusting people, and now I have a girlfriend and Iam always suspecting her and her actions, while inside of me I know she is a trustworthy. And its affecting our relationship now that I always ask her questions like ( where were you, What were you doing), and I don't want this to continue. can you please help me?Thank you Ayad",
    "doctor_response": "Hello Ayad, and thanks for your query. Having dfficulty in trusting people and suspiciousness can be due different causes. It can be due to person's personality - such as a paranoid personality or due to psychiatric disorders like psychosis. In your case, since you seem to be having a understanding into your problem, it is unlikely to be due to a psychotic disorder. So, it is more likely that you are having paranoid personality traits which are causing you to suspect and mistrust your girlfriend. In such a case, the treatment for your problem would be psychotherapy (counselling). I would advise you to consult a psychiatrist in your place and go for regular psychotherapy sessions. It would also be a good idea to discuss about your problem openly with your girlfriend so that you avoid relationship problems.Regards,Dr. Jonas SundarakumarConsultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does my widal test report suggest?\n\ni have the widal test report-----TO          =1:80                                                TH          =1:80                                                AH                                                           BH           what does it mean -- i have typhoid  fever?",
    "doctor_response": "Considering the above reports not to worry, it doesnt indicate the typhoid. Still for exact diagnosis it is important to know the refarance titer in your community/herd. If you are not having symptoms such as fever , malise etc with above reading it surely wont point toward typhod. But if you are having above said symptoms you have to repeat the test after 7 days so that exact comment can be given, as the increasing titer points toward the disease.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have itching and rashes in hands during specific climate. Please help.\n\nHello doctor, I just want to consult about my skin condition that happens annually. Every year, my hands has this condition where it will itch and form rashes with liquid inside then skin itself. Most of the time, it starts on December then end on February, however it differs every year. This year it started on March and up to now. I experience this every year, as in yearly so I assumed it is normal. It is not hereditary, I assume, because none of my family members is experiencing it other than me. My mother told me that maybe it is because of cold weather which I agreed. It is there for the past 11 years. I have never consulted any professionals about it since it does not look severe. However, I am curious what is this condition called.",
    "doctor_response": "Hi. Seasonal itch and swelling over the exterior parts of the palms, soles ear, nose occur due to a type of cold allergy called perniosis orchilblains. Lesions for increased itchy sweling occurs mainly during the start of cold weather and end of the cold weather when there is temperature change in the environment. I am not sure which part you are living in as you have not mention. Treatment for this is avoidance of cold exposure, wearing warm clothes. Calcium dobesilate gel twice daily. Diltiazem 30 mg tablet BD for 2 weeks during the lesions. For itching you use Loratadine10 mg once daily for two weeks or whenever there is itching. Apply aloevera moisturizing cream over the hands multiple times with rubbing of the hands and feet and the parts so that good circulation bring warm blood flows into those area.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this chest X-ray report indicate?\n\nExamination :CHEST (AP/PA/L/O)~XRPN-FILM[14x17 (1)] Interpretation: There are minimal suspicious hazes Opa cities in the right upper lobe. The hearth in not enlarge.The great vessels are not unusual. The trachea is at midline. The diaphragm,Sulci,and bony thorax are unremarkable.IMPRESSION:Apicolordotic view is suggested,What is the meaning of the doc.Thank you",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Normally chest x ray is taken in PA (posteroanterior) view. In this view, upper part of lung is overlapped by ribs and clavicle. So any opacity in upper part of lung is not properly visualized in PA view. So apicolordotic view is ordered. In this chest x ray is taken in such a way that upper part of chest is visualized without being overlapped by ribs and clavicle. So for better diagnosis of your left upper zone suspicious opacity, apicolordotic view is ordered. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for recurring tuberculosis in neck\n\nhello, my sister is suffering from TB 2nd time. 1st time it was in her back and 2nd time in her neck. Even if neck operation is done, she is having some \"gath\" in the neck which is recurring. Doctors are not able to stop it . Please suggest, which doctor should we see?",
    "doctor_response": "Hi,From history it seems that she might be having tuberculous lymphadenitis.Go for biopsy of lymph node for TB.Afterwards go for complete full course of anti-TB medicine for 6-9 months.Give her well nourished food and multivitamin supplements.Consult surgeon and get her examined and investigated.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does my brain freeze and cause difficulty in concentration?\n\nFor 2 years now all the brain freeze\u2018s I get all concentrates in my right eye literally in the eye ball I feel the brain freeze start of normally with the cold in the back of your mouth and it raises but as it going up it concentrates into a thin line going across my head and builds up in my right eye it\u2019s incredibly painful but am good at handling pain so it\u2019s no issue usually you can tilt you head up or out your finger in your mouth poking the top of it and it makes the brain freeze go away really quickly but it no longer works for me I have to wait for it to pass which is from 15seconds to 1minute and I am wondering if someone knows what this is?",
    "doctor_response": "Hello, The symptoms you are mentioning here needs to be evaluated carefully. I suggest you to consult a neurologist at the earliest. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest better medications for h. pylori infection\n\ni have h pylori ive been on it for about a week. ive had so many complications and reactions wuth this med. I told my doctor about the issue. she told me to stop. im feeling much better than before after i stopped. will i be cured only taking the meds for a week?",
    "doctor_response": "Dr. Hanif warmly welcomes you!Thanks for consulting at my virtual clinic. I have carefully worked through your case, and can well realize your health worries. Being your physician, I want to assure, I will take care all of your medical concerns.Recommended treatment is for 7-14 days. But if you had side effects that were unbearable and you have taken for a week, its enough. But, keep on taking omeprazole for two more weeks. It will help you in controlling the acidity in stomach.Hope I answered all of your questions. In future, if you need further, detailed and quick assistance on any health issue, feel free to ask me a question by writing my name as a reference in the start of your question. I will get back to you right away. Have a wonderful time ahead.Regards!DR. MUHAMMAD HANIFUSA",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having irregular periods and planning to conceive. Kindly advice.\n\nHello doctor,I have been having irregular periods for a while now and I am planning to have a baby but do not know the best moment to conceive. I had my last period a month back and three days after that I had unprotected sex with my fiance and thought I had conceived because I started having cramps and frequent urination a week later but my period came a few days back. I will love to know when best I can conceive, please.",
    "doctor_response": "Hi. Have your periods duration increased or reduced? It would be better if you send me your detailed gynecology, menstrual, obstetric medical history as well. There are two ways to regulate cycles. One is to have hormones (norethisterone or COCP-combined oral contraceptive pill) cyclically for three months (will regulate cycles hormonally) and have blood tests serum testosterone, serum prolactin, serum inhibin, serum progesterone, FSH (follicular stimulating hormone) and LH (luteinizing hormone) and thyroid function test on day two and the result should be checked and abnormality to treat . And, then try for conception as cyclic hormones will act as second to try for conception without hormones to have unprotected sex from day 8 to day 19 on alternate days without taking any hormones or test.  For 28 days cycle, if you have after hormonal treatment best days to try for conception are from day 8 or 9 to day 13.  For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a reccuring rash on face of a child indicate?\n\nMy two year son has a rash that comes and goes with 15mins either shows on his face or right hand side of torso. Has no fever nor has he been sick in last few months. He has been walking with a limp on the right hand side, to the point he is dragging his leg or not wanting to walk or stand at all. We have been to hospital for bloods and X-rays but can t find anything wrong. They have told us to go back in 3 days for possible MRI. Do you have any suggestions on what could be going on. He s not grumpy just really clingy.",
    "doctor_response": "Hi...this is suggestive of Struge-Weber syndrome and he will definitely need a MRI brain plain and contrast and I am expecting an anomaly to be picked up on the MRI. He already is dragging his leg and limping winch is a focal neurological deficit.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Had blood in discharge after I-pill, but my periods have not come. Please help.\n\nHello doctor,My last periods ended on the 1st. I had sex on the 5th. After 34 hours of sex, I have taken Unwanted 72 and again after nine hours, I took I-pill for more safety. But after that, I have no bleeding or vomiting but on 18th and 19th, I had a little blood in my vaginal discharge. Today is the 29th but my periods have not come. I have done urine pregnancy test on 28th but it was negative. But still, my periods have not come. I do not want a pregnancy. Please help.",
    "doctor_response": "Hello. The bleeding that you had on 18th was your withdrawal bleed, but it was scanty because you took two emergency contraceptive pills in a gap of less than 48 hours. The urine pregnancy test is negative which is done today on 29th, rules out pregnancy. However, the best way to conclusively rule out pregnancy is a serum beta hCG test which if less than 3 mIU rules out pregnancy conclusively. Your next menses now is likely to be delayed, probably after 18th of the coming month, if we consider 18th as the day of your withdrawal bleed. This can again be correlated with an ultrasound pelvis which can show us the endometrial thickness. If the endometrial thickness is less than 7 mm then you are in the proliferative phase of your new cycle already and menses would be around 18th. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What precautions should be taken for wisdom tooth extraction having a hairline crack?\n\nI have Sle, plus CNS complications, and Factor V Leiden[ heterozygous]. Amongst other things I am on Xarelto,as I developed clots. What are the precautions that need to be addressed to have one wisdom tooth out because of a hairline crack. The Dentist feels in should be done with my Medical team , in Hosp, in Sydney. I am a 64 year old woman. 63 kgs",
    "doctor_response": "Thanks for your query, I have gone through your query.Since you are on many medications and systemic illness you need to take lot of precautions.Regarding SLE, You might have been put on steroids so the doses might have to be altere.Regarding factor V Leiden, is a hypercoaguability disorder, that might result in blood clot in circulation and cause thromboembolism. Regarding Xarelto, is a blood thinner, Before extraction of the teeth this drug might have to be stopped after taking physicians consent since the adverse effect of this drug includes bleeding complications, including major bleeding events and fainting.Consult a good oral maxillofacial surgeon and get the tooth removed. Before that get your complete blood investigations done including BT, CT, and INR. If the INR is normal then no need to stop xarelto.The procedure has to be done as less traumatic as possible. You need to take prophylactic antibiotics before the procedures.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medication can be given to a 3-year-old suffering from fever, cough and nasal congestion?\n\nHello doctors My son yedhant is 3 years old weight 13kgHe often suffers from fever cough n cold.From evening he's again suffering from fever n blockage of nose I've  levolin ,advent forte 457 mg,vicosyl+and paracetamol paediatric syrup 125 mg.High fever about 102 Tommorow morning I'll visit the doctor but for tonight what medication may be done Plz suggest",
    "doctor_response": "Hi, Fever for few days without any localizing signs, could as well as be a viral illness. Usually, rather than fever, what is more important is the activity of the child, in between two 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 the 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 only if the fever is more than 100\u00baF. I suggest not using combination medicines for fever, especially with Paracetamol. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Ascertain liver function, slightly yellowish eyes, bilirubin 81. Advise?\n\nHi, I have just had bloods done to ascertain liver function as previously I had elevated bilirubin at 38. Checked again 2 wk later but Gp had no cause for concern. This was 6 months ago......Now.... The whites of my eyes have yellowed a little and bilirubin is 81. No other jaundice/liver symptoms. What would you advise next and what is considered normal bilirubin level? All other LFTs were normal... Thanks",
    "doctor_response": "Hi and welcome to HCM. Thank you for your query.You should find the exact cause of your jaundice and elevated bilirubin levels. It can be caused by hemolytic anaemia or more common by some liver disorders such as hepatitis, biliary obstruction or liver cirrhosis. So you need to do liver ultrasounds first and CT scan if necessary. Follow some hepatoprotective diet and avoid alcohol and smoking. Test your viral markers too to rule out infection. Also some genetic diosorders should be considered if you dont find anything by these tests. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest tretament for diabetes\n\nim 57years i old ive done concrete all my life the begening of auguest after work i laid down i was so tired i could not get up didnt hardley eat i lost 30 pound in 3 weaks now its december nothing much has changed . went to emergensy they told me i had type 2 diabetes they gave me metformin 1 time in the morning. my nombers are about 480 and up i dont no wat to do.",
    "doctor_response": "Welcome to H C M .Your blood sugar is 480 mg(normal less than 126  fasting & less than 200  2hour after food).It is very high.you have not mentioned is it fasting  or after food ,power of tablet Metformin..Investigations required are.1-blood for HBA1c,lipid profile,thyroid  profile ,Hemogram,K F T ,L F T.2- urinalysis  & for microalbumin3-Blood Pressure & E C G .4-Eyes for fundus examination .Take more salad,fruits(except sweet  fruits).Avod smoking,alcohol,colas,coffee,fruit juices.junk food.consult endocrinologist,dietitian.follow  instructions of your doctor very care fully.thanks for query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment given for normalising INR?\n\nHello Doctor... I am a heart patient and have already undo a cardio vascular surgery 3 years ago. Normally i am supposed to take warfarin of 6mgs and my INR is supposed to be 2.5. but today i have had a blood test where my sample was clotted and my INR has come to 1.2. can you please advice what is to be done to make my INR come to normal that is 2.5. Thank you in advance.",
    "doctor_response": "Hello, INR should be very strictly kept within the target range. Your INR seems low, but the clotted sample means the report may be wrong. Blood taken for INR, should always be taken in the special voil for PT/INR (blue cap usually). And the sample must be filed upto the market, no more no less. Do first get a repeat test immediately from a decent lab and then decide about anything else. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take Omez tablet daily with alcohol consumption?\n\nPlease advise if I can take Omez tablet daily or not ? or any other alternative please. ... Is it safe to take alcohol during this periods, does there any danger for th .... in hot weather, take a break and drink water after every twenty to thirty minutes.",
    "doctor_response": "Hi,It is not advisable to take alcohol while taking omez. Omez is a proton pump inhibitor which acts by suppressing the stomach acid and thus used to treat stomach acidity issues such as reflux disease, gastritis, and stomach ulcer.Alcohol causes irritation of your your digestive system. Drinking even a small amount makes your stomach produce more acid than usual, which can in turn cause gastritis. This triggers stomach pain, vomiting, and even bleeding.Since you are already taking omez for some stomach acidity issues and by consuming alcohol it may have serious complications. So it is better to avoid consuming alcohol.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing burning numb sensation in left leg with redness in shin?\n\nHi Doctor, I woke up with a burning numb sensation in my left leg & there is reddness on my left shin with a red dot I started moving & doing a little exercise & now my legs feel so heavy. What could this be I m only 36 yrs old. Thanks , Maria Antoinette",
    "doctor_response": "Hello, Consult an orthopedician and get evaluated. We have to rule out possible causes like cellulitis. A Doppler ultrasound scan is required to make a diagnosis. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My wisdom tooth has cut into my cheek, causing pain and swelling. Please help.\n\nHello I was due to have my upper left wisdom tooth taken out last Friday, but my dentist has been closed due to the Corona Virus. I had an x-ray done on my last visit and my dentist said it was a very awkward tooth to remove and not straight forward. I am in a lot of pain at the moment as my wisdom tooth is only half way through but has split into the side of my cheek. I am struggling to eat, clean my teeth, it's constantly throbbing and my face has swelled out on one side. I work in a hospital and had a telephone consultation today with a doctor who asked me questions over the phone, one being how many fingers could I fit into my mouth. I can only fit one finger in my mouth right now. My mouth tastes of blood and it bleeds lots when I try to clean it. I have been prescried anti-biotics for now, but I am very worried as after I finish the anti-biotics I don't know whether I will be able to have the tooth removed due to not being able to even open my mouth properly. Any help / advise is appreciated. Thank you.",
    "doctor_response": "Dear Patient, -I read your complete writing and I totally understand your concern, your mouth opening is really less now, I am sorry for the pain you are bearing. -The first thing you need to do urgently after reading this kindly begin warm water salt rinse 5-6 times a day.It will surely relax your mouth opening a bit. -Continue your antibiotics and stop as and when said, won't prescribe any medicine for now as you are already taking one session of antibiotics can't continue with this . Although you can give a gap of 4-5days and can again take a five day regimen. -If it still pains sometimes you can take a pain killer paracetamol or ibuprofen temporarily (as you haven't mentioned any allergies). -Do revert back for more queries. -I hope it helps. -Feel free to contact me again. -Kindly keep me posted about the improvements. -Stay safe.take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a sore lump at the base of spine with blood in urine?\n\nMy son, 19,  was diagnosed with Celiac 3 months ago when he was hospitalized at 6', 120lbs, after fainting.  (The hospital ran 4 days of tests- everything negative.)  It was 2 years of being sick and losing weight prior to the diagnosis. He has been eating gluten/dairy/soy free since.  He has gained a little weight, skin has color again, and energy is picking up.  Today he had visible blood in his urine.  He also has a sore/lump on the skin at the base of his spine.  He sits at his computer for hours. Could easily be an infected ingrown hair.  He has no insurance. Could this be related?",
    "doctor_response": "DEAR,Good Evening,Thanks for the query.I studied it in details and understood your health concerns regarding it.Sore lump at base of spine and blood in urine ? the cause could be-a-Diabetes secondary to Celiac disease with UTI leading to blood in urine b-OR due to the kidney affected by the Auto-immune disease process of Celiac Disease.Yes the reply-is Yes it could be Boil at the base of the spine ..!!and Yes the blood in urine is related and could be due to UTI secondary to Diabetis due to secondary hyperglycemia-in Celiac Disease.Hope this would help you to plan your treatment with your doctor.Wellcome for any further query in this regard.Wishing you good health.Good Night.Dr.Savaskar M.N.From INDIA.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for a bite\n\nchild bit me at place of work,went for hep b, had first one, then blood tests went again had more blood tests was told to ring for results,and to ask if i was immune,doc said i did'nt have enough antibodies and would need another vaccine with follow up,why is this what does it all mean?am i infected with hep b?",
    "doctor_response": "Hello and thank you for your questionNot necessarily. The doctor needs to test you specifically for hepatitis B antigen to see if you are currently infected. Not having enough antibody means that you have not responded to the vaccine yet. Often people need 3 doses of hepatitis b vaccine before they form antibody so that is not concerning. Some people even need an additional 4th dose.If the child does not have hepatitis b then you can not get that diseaseRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does irregular and nil mensse cause infertility ?\n\nhi..I am 27 years old weight 67 and no medical history as such . I am O negative blood group. Married to O positive. My mensus are not regular and if i get it , its so less which is equal to no. only some strains in my panty. not required pad. its since was in teens i have irregualr periods. I have consulted doctors many times, but every time they prescribe some medicine ..i got it that time then after some times its the same. Now wheni want to conceive and trying since 6 months no result. is it because of the mensus problem or something else. is been 2-3 month I didn t have mensus.",
    "doctor_response": "There can be several reasons for not conceiving , most common cause in your case seems to be ovulatory factor , you should go for follicular study on 11th and 13th day of cycle to see the maturity of ova under USG after consulting a gynaec.If the size of ova is less then 19mm your doctor will give you some injections like FSH but do not take them without proper guidance , before that your husband should go for the semen analysis.You should get your Endometrial biopsy done before your spotting to see the secretory phase . You have to take progesterone for luteal support.HSG is another test to see the tubal patency.Then there are certain immunological tests also. Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing pain & cracking of knee\n\nHello doctor. i have problems with my knees. they crack at certain times of the day, they sometimes hurt and the sound they make, make me wince. I m a 22 year old female so I m worried. can you suggest what might be the problem? I nearly go run over because of this problem Help",
    "doctor_response": "Hello, It could be due to conditions like a torn meniscus or a foreign body in the joint cavity. Consult an orthopedic and get evaluated. An MRI knee is required for further assessment. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to enhance self confidence?\n\nHi my name is Antoinette Thomas and I am 18 years old. I go to Eastview High and I am a junior. But back to the point, I really have low self esteem on my body and I my skin is dark. I have been trying to look for ways that I can make my skin light-skin but I don't have the ingredients or it's too much money. I live with my mom and she knows I hate myself and she hates that I don't love me like I should. I was wondering if there are any doctors or hospitals that can make my skin a light skin tone permanetly? Also, I hate other things on my body, like my bikini line, my breast and booty is not big enough, and i hate my whole face. I'm sorry for so much questions that I need answered, but I was wondering if I can get checked on having BDD or any disorders that has to deal with me not loving myself.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Love towards self comes when you actually know you. Numerous spiritual researches shows that once you understand yourself, you start loving yourself and what you are.You are you. In any case you cannot become another person. Therefore, instead of thinking and worrying about your short comings, concentrate and develop on your positive points. I am sure that you are having at least 100 positive points to go forward. 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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pregnancy be prevented after unprotected intercourse?\n\nSir me and my gf are in relationshion.without using condom ... At the time if discharge..i put out my pennis from her vergina....but i am not sure....that all sperms are outside the vergina or may be a small amount is in inside...plz suggest wht 2 doo...akmost 2 weeks are done.and...when...we..are...in.relation. after 4 to 5 days of her periods so...help me plzzx...sirr",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Usually after 4 to 5 days of menstruation the possibility of ovulation is less but in case of short length menstrual cycles with  cycle length of around 20 to 25 days we cannot completely exclude the possibility of ovulation on the day of intercourse  and leading to pregnancy. So let her go for urine pregnancy test once to rule out the possibility of pregnancy,  depending on the result for the management can be planned. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of insulinoma?\n\nI am a 45 year old female and had a gastric bypass 2 years ago. I lost 70 pounds and now am at a healthy weight. i exercise 2-4 times a week. for the last month my blood sugar levels have been drastically dropping down to 46. this is happening almost daily but i have never been a diabetic. i am trying to get into see an endocronologist but this is taking a lot of time. my doctor did some blood work and says my insulin levels are very elevated. I even had to go to the ER one night and he said all the initial labs that he could do in the ER came back fine so my issue was above his level. what do i do and what could be causing this? i heard a possibility could be insulinoma?",
    "doctor_response": "In your case, insulinoma is definitely a possibility. The symptoms that you have described plus the low sugar levels and high insulin levels, all point towards the possibility of insulinoma. It is a tumor arising from the pancreas from the cells that produce insulin in the body. The only definitive treatment is removal of the tumor surgically. For this, we have to locate the tumor first. For this, you should get a contrast enhance CT scan of the abdomen done. If it is normal ,then an upper GI endoscopy with endoscopic ultrasound should help locate the tumor. Meanwhile, always keep something sweet like biscuits or sugar handy and eat it as soon as you feel the sugar going down. Dont miss any meals.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for vomiting and low grade fever in a child\n\nMy 3 year old was hit in the nose and knocked down by a door I was opening. 24 hours later she has a low grade fever and has thrown up once. No other signs/symptoms of concussion. Energy levels were normal until the fever and some nausea started. Speech is normal. No complaints of pain and no swelling anywhere. Should we go to a hospital or continue to monitor?",
    "doctor_response": "Dear friend hitting in the nose and getting knocked down always warrants a thorough check-up by a doctor.if the doc feels so ,he or she can go for a xray of nose area and C.T.Scan of brain to exclude bone injury or blood clot inside brain.any kind of injury or bleeding can cause local infection resulting fever.also you should know brain injury causes delayed complications.so you should go to hospital E.R instead of monitoring in home.take care.thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can PCOS with irregular periods be treated for a successful pregnancy?\n\nHi Doctor,I have PCOD and I have been trying to concieve since the last 3 months in vain.I have been taking metformin tablets 500mg 3 times daily since August.My last menstrual period came on 26th August after taking modus 500mg.I am 27years old.4'11 height-57kgs weight.How can i get pregnant as soon as possible?",
    "doctor_response": "hello....thanks for trusting the health care magic doctors for ur health related queries.firstly I want to tell you that pcos can be treated with the medication but it takes long term medication.but don't worry it is treatable that's why ur treating doctor given u the medication.according to the information given by you ur weight is more regarding ur height. the medication metformin given mainly for weight reduction in pcos patient.advice-1. don't worry, relax. we can get pregnant with the help of medications.2. try to do as more as coitus during fertile period ( it is from 10-16th day of cycle).3. if u r in hurry then visit to nearby infertility specialist. he/she can help you.good luckregards-dr sudha rani panagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurrent dizziness and low BP?\n\nI started getting dizzy spells about 2 weeks ago.My hands shake, and my body jerks every once in a while. The dizzy spells are a little worse, and sometimes after a bad spell, my blood pressure drops to 87/45. in that area.What would you suggest is wrong.",
    "doctor_response": "Hi ThereAfter going through your query I understand your concern.I would like to tell you that low blood pressure is a cause of dizziness in itself. Causes of low blood pressure can be dehydration, lack of nutrition, blood loss, medicines, pregnancy or heart diseases etc.It's advisable to keep yourself Hyderated and eat healthy. Physician consultation is highly recommended to evaluate cause of low BP and treatment in a proper way.Hopefully this has answered your query.Kind Regards Dr Navneet Mahajan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can deodorant be sprayed on testicles?\n\nIs it safe to put deodorant on your testicles? I have been doing this for the past 2 weeks or so to deal with odor but I am now worried that my health may be put in danger because of this. I don't experience any itching, pain or any other symptoms so I am just curious.",
    "doctor_response": "Dear, We understand your concernsI went through your details. Most of the branded deodorants are skin friendly. They are manufactured and meant to be applied or sprayed onto skin. Testicle skin is also like any other skin are in your body. Therefore, having reactions are rare.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes panic attacks?\n\nafter eating and feeling full, within 5 minutes time I feel like I haven t eaten all day. I get light headed and a bit shaky. Almost to the point of panic attacks because it takes a while for the feeling to go away. I don t eat a lot of sugary things. Cheerios, toast, milk, bananas, almonds usually start my day. Any clue what this could be? I do have a doctors appt. on Tuesday.",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.You need to be investigated for diabetes. 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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Shall I go for open surgery for renal cortical cyst in both the kidneys?\n\nI have been diagonosed having simple renal cortical cyst in both the kidynes and the one on the right kidney is clinically observed to be of 7.8 cms length and I am having no urination problem except more than normal frequency of urination and little pain in my back between ribs and the hip. The Urologist has advised that in case of laproscopic surgery there may be a chance of the cyst again growing and only open surgery can get me rid of this. Further as long as it does not pose any serious problem like severe pain and any other complication there is no immediate need for going in for surgery. I would like to get your advice.",
    "doctor_response": "Hi,Thanks for writing in.Renal cortical cysts are common and can be seen in most people above age of 60 years. The cyst measuring 7.8 cm on the right side is a big one but as your doctor has said, it is not a concern if there is no clinical symptoms of pain, urinary retention in the kidney or any development of infections. If you are a male and above 60 years of age then your prostate enlargement can cause symptoms of increased frequency of urination and also please do PSA levels if you are an elderly male.Talking about surgery, I have seen many people with larger cysts than the one you have and without any symptoms. They have been doing well for years without any concern. I suggest you do not think about surgery and continue to get a follow up ultrasound every year. Please discuss the increased frequency of urination with regards to any bladder problems with the urologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lack of erections in a 17 year old diabetic?\n\nI'm 17 and I have not been waking up with erections in the morning for the past few months ( as far as I can remember at least). I also have not been getting them during the day. When I try to stimulate myself, my penis stays flaccid. This has been very depressing the past couple days. I have  also been a diabetic since the 5th grade and have had decent blood sugars over the years. What is wrong with me?",
    "doctor_response": "Hello, Your testosterone level is at its highest in the morning after you wake up. It is highest immediately after waking up from rapid eye movement (REM) sleep stage. The increase in this hormone alone may be enough to cause an erection, even in the absence of any physical stimulation. But not getting enough erections during daytime is contradictory. Presence of sexual stimulants creates erection behavior and further erection. Your worry may not allow your body to accept sexual stimulation, so no erection during the daytime. Stop worrying about both. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cluster of penile papules on either side of the urethra?\n\nOk so i have some pretty big pearly penile papules that cluster on either side of my urethra, just under the opening (in other words just under the pink part on either side of where you pee) The only real way you can get rid of them is to have a doctor use a CO2 laser to remove them. I really can't afford the treatment, so was researching ways to remove them myself. I came across a form of a guy who said to use a soldering iron and just touch the tip of the papule and they would disappear permanently. The guy who posted it said he did it himself and it worked, i first thought the guy was a complete RETARD!! but then i starting thinking about it and realized that all the CO2 laser does is burn off the legions with high concentrated heat, and don't see the fundamental problem with using a soldering iron on the papules. I do realize there are obvious dangers such as over burning, slipping while holding the iron, and scarring, but i want to get other peoples (and hopefully some doctors) responses on my idea to burn off these papules with a soldering iron. (FYI: i'm planning on buying \"Dr. Numb\" numbing medicine and applying it prior to burning them off which is exactly what dermatologists do when they burn off the paplules with the CO2 laser except with a more powerful numbing agent).",
    "doctor_response": "Thanks for contacting HCM with your medical question. I am sorry to hear that you are having problems with warts on your penis. These warts are caused by the HPV virus and there are different ways to remove the warts. In my practice I use a medication called podophyllin. This a topical acid that can be applied in the doctors office to help treat the warts. There is also a medication called condylox which is basically the same medication as podophyllin but you can use it in your own home. Both of these measures help to remove the wart. Your thinking of using a soldering iron to the wart to me sounds dangerous and potentially causing severe damage and harm. I would not recommend this technique. I strongly recommend you visit a health care profession for prescribing the Condylox or have them perform less invasive treatments for you wartsHope this answers your medical question. Please contact us again with your health care concerns and questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sugegst treatment for frozen shoulder\n\nI have a frozen shoulder due to a bad fall, I was given gabapentin at pain clinic.I'm only on a low dose at moment,but does it work for a frozen shoulder. I took tramadol and paracetamol and it helped. I could move my shoulder a bit without being in agony",
    "doctor_response": "In my opinion gabapentin is for neuropathy problems like pain related to nerve inflamation or compression as sciatica however it can help in shoulder pain if shoulder pain in radiating to your upper armIf i were your doctor i would prescribe pain medication for 1 week if it does not have a 100 cure effect on you , i will recommend physical therapy Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the painful lump above my left breast?\n\nHi, for a few years now I've noticed this lump above my left breast. It's hard but this last week I've been getting horrible sharp pains there to the point I cry out and to touch it at times it feels like a shap stabbing pain. It's not constant pain it just randomly comes and goes. Any idea what could be?  I was not injured at all there either.",
    "doctor_response": "Hello! Thank you for your concern. First of all, what is the size of the lump? I would suggest you consult a doctor to examine the lump and also do a mammogram test/FNAC.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having bumpy red rash that appears before going to bed?\n\ni have a bumpy red rash that only appears right before i go to bed and it is most severe during sleep (spreads from the concentrated region of my torso down to my legs and even on my face and ears). They are extremely itchy but do not puss or burn, it disappears almost completely when i wake up in the morning but appears again at night. It looks like hives but i have not been exposed to anything new that i know of. Please help",
    "doctor_response": "Hi and thanks for this query.I am so sorry to hear about this itchy rash. This description and symptoms are typical pf an allergic reaction. I will advice that you try some night time benadryl like a few hours before you get to bed. Though you are not aware of any new thing, actively look for the possible cause of this. It would most likely be something that you use shortly before going to bed. It must not be new so keep watch. This would be the ultimate solution while benadryl gains the time and relief you of your symptoms.i hope this helps. I wish you well and thank you so much for using our services. Feel free to request for more information and clarification if needed.Dr. Ditah, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medicine should I apply to remove dark line that appears across my nose ?\n\nI am experiencing a dark line that appears across my nose, just inquiring on a skin care treatment or cream you can recommend me to use.",
    "doctor_response": "HI dont clean u r nose so many time in a day it may be due to allergy or pigmentation apply NILTAN cream at night over it avoid direct sun light",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any home remedy for pain in tailbone region?\n\nI have been experiencing intense pain in my tailbone region since last night.  I did not fall down or anything out of the ordinary.  It hurts at all times no matter what position I am in.  Is this something that I can treat at home or do I need to go to the ER?",
    "doctor_response": "Without an actual examination, I cannot give specific medical advice on your particular health, but sitting on a hard surface, strains, minor trauma can cause minor pain.Rest, keeping off of the area, baths in warm water are all often helpful",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why did I miss my periods after the expiry of implanon?\n\nmy implanon, birth control, expired November 2013 and it is still in my arm. I had to have regular periods since January and just this past month I did not come on my cycle. I have been taking pregnancy test but they all come back negative. what should I do",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Sometimes hormonal methods of birth control can result in a delay in return of periods up to 3-6 months.  From your query it seems that this  response is a bit out of date. I hope your periods have returned by now. I would suggest having the device removed - now that it has expired, it is not likely to provide any birth control or benefit that was attended. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could intake of amplify be the cause of deranged liver levels?\n\nhi I have had hep c for 10 years it was getting better almost gone..I have recently been but on Amplify and my liver levels are through the roof..BAD BAD!! My doctor was in awe I have mad a appointment to see my liver doctor for Monday could this be the amplify and should I stop taking it? I am also on clozapine sub oxen leness marolax and 90mg of Adderall. the Clozapine Adderall have all been started in the last 2 weeks could that have anything to do with my liver?",
    "doctor_response": "Hi welcome to HCM...Clozapin can lead elevated liver enzymes ...For which close watch up is necessary with monitoring of liver enzymes value ...If needed this drug can be discontinued for sometime and after enzymes values goes down , treatment started again...You are having hepatitis c infection ...since ten years ....So hepatitis or cirrhosis has to be ruled out ...Investigate with .....1.PT2.USG abdomen 3.Serum albumin 4.Liver biopsy only if needed 5.Bilirubin level Meanwhile here take low fat diet ...Fruits more ....Spinach , green leafy veg , carrot will ne good for liver ...According to report further management decidedAdvise : Consult physician or gastroenterologist for examination whoever available nearby ...Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bruise in legs\n\nOur 4 week old gransdson has bruise like marks on his legs - it is definitely not an abuse situation. He is happy and feeding well although a little reflux. The marks are on his wee thighs and tend to circle around, the marks are not red or irritated or raised - just like a purplish line - any answers would be great",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms of your grandson can be related to a microtrauma.I suggest using cold compresses for local application.You can also give Tylenol in case of pain.Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for throbbing abdominal pain\n\nI am having pressure and throbbing p. It seems to be in my lower woman area. Right at the beginning of my vaginal area but right below my abdominal area. I have had a laparoscopic hysterectomy in December of 2013 but I kept my ovaries. The pressure makes it hard for me to walk but it doesn't keep me from being able to lift my legs nor hurts when having sex. But is difficult when I sit the to get up from sitting.",
    "doctor_response": "Hi Thank you asking HCM. you are reporting to  have abdominal( pelvic pressure) that worse after sex.at this situation to my  opinion  you need to  do  smear swab, pelvic  ultrasound,urine analysis it may be related  with urinary  infection or vaginal infection. wishing you all the best Dr.klerida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can anxiety cause hair loss?\n\nhello sir this is puneet. i am 24 years of age. from last 1 & half years i was suffering from an anxiety. thats why i lost my hair density. my hairs are going thinner. i heard that hair loss due to anxiety is temporarily. it comes back if anxiety is removed. tell me it is true or not? or do me a favour",
    "doctor_response": "Yes chronic anxiety can cause hair loss\"Daily shedding of upto 100 hairs is normal . Excessive hair fall can also be due to male pattern baldness, anaemia or nutritional deficiency or certain medical conditions like thyroid disorders, low serum ferritin etc.Take a nutritious and protein rich diet(pulses, milk products, eggs).Avoid routine application of gels or frequent blow drying of your hair. Use a sulfate free shampoo for your hair twice a week. Biotin containing hair supplements can be taken for 3-6 months. Hope this helps.Good luck!",
    "dialogue_context": ""
  },
  {
    "patient_message": "After having the blood work done noticed tenderness & swelling around the wrist & hand\n\nI just had some blood work done, thye took 3 viles about 2 hours ago. Aside from normal tenderness and slight bruising in the crook of my elbow at the injection site, I notice swelling around my wrist and hand. My fingers are puffy and showing white around the knuckles. Should I be concerned. I've done bloodwork before and never had anthing similar",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern.  You may develop hematoa formation. It happens many times at the site of injection due to extravasation of blood.  Don't worry about that. Just be relaxed.  Just apply ice on it. It will gi away within few days.Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I go for embolization for varicocele and oligospermia?\n\nI am a 34 year old male from Bangalore. I have been diaognized for varicocele and have very severe oligospermia. I found that Dr. Pradeep in Fortis Delhi does Embolization procedure which is non surgical. Can you suggest me if there is any other option in South india or Bangalore where I can get the embolization done. Thanks a lot Regards TK",
    "doctor_response": "Hello, Embolization is the latest techniques and is safe and effective. The problem with embolization is its cost. You can opt for conventional techniques like testicular vein ligation also. Consult a urologist and get evaluated. He will direct you to various treatment options. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat tuberculosis?\n\nmy brother is suffering from tuberculosis since 3yrsfirst two times had not use proper treatment so he developed now again tb since 2 yrs he is usin anti tb drugs but lt is cured lt side, rt is not cured proper so he is very deppressed now so we want famous doctors in ap in tb",
    "doctor_response": "HelloYou mentioned that your brother is having TUBERCULOSIS from last three years and he is taking treatment off & on i.e in  a haphazard manner .When such patient visit  my clinic I at once advise X RAY chest PA view, blood for C B C,  E S R ( it is very high in this type of cases , even > 100 mm 1st hour) , sputum for a A  F B . First of all keep this record at safe place . This is because your brother has developed a type of tuberculosis known as MULTI  DRUG RESISTANT TUBERCULOSIS (  M D R T ). Since treatment is from 3 years ,now you have to take this treatment for 30 months ( 2 1/2  years ) regularly ( even not allow to stop single day ).Assuming that the weight of your brother is 50 kg , I am prescribing this treatment . 1  Injection Capreomycin 750 -1000 mg / day for 3 months .2 Tablet ehionamide or prothionamide 250 mg one tablet twice in day for 2 1/2 years .3 Capsule cycloserine 250 mg twice in day for 2 1/2 years .4 Tablet \"levofloxacin 750 mg in the night ( one / day ) for 2 1/2 years .If your brother can tolerate ( show no untoward effect ) then start 5 Pyrazinamide 750 mg twice in day for 2 1/2 years.Because these are so many drugs so it is bound that patient will develop nausea and vomiting so I add antacid syrup 4 TSF twice in day + pantaloc-D twice in day.This is my own practical experience and also a standard treatment for  M D R T  cases.But keep one thing in mind , if your brother will stop this treatment intentionally than there it will be very very difficult to treat in future.Since all these drugs are prescription drugs , so consult a physician and get his prescription . Hope if you start this treatment  , please think twice before this .Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause pins and needles on and of in left leg and arm?\n\nI have been feeling unwell from last tue when I m sitting or standing suddenly for about 5 seconds I feel faint then it goes away I ve had pins and neddles on and of in my left leg and arm when this happens I feel as if my heart is racing like I m panicking?",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!I carefully passed through your question and would explain that your symptoms seem to be related to different causes: - transient ischemic attacks- partial sensory epilepsy seizures- a backbone disorder causing compression of the cervical spine- anxiety. Coming to this point, I would recommend consulting with your attending physician and performing a physical exam and some tests: - a resting ECG- a chest X ray study- an EEG - some blood lab tests (complete blood count, blood electrolytes, thyroid hormone levels, kidney and liver function tests, fasting glucose)- a cervical spine X ray studyA brain MRI may be needed is suspicions of Transient ischemic attacks are raised. If all the above tests result normal, you should consider anxiety as the main cause of this symptomatology. Hope you will find this answer helpful!Best wishes, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lumbar spondylosis\n\nI am shiv dayal from jagadhri(haryana) i am sending my MRI report Impression: MR imaging of lumbosacral spine reveals lumner spondylosis diffuse disc bulgs are seen at L4/5 and L5/ S1 levels causing indentation on the thecal sac, and moderate compromise of bilatetal neural foramina. Mild central canal stenosis is seen.Please sir suggetion me & give good treatment.Sir i am very worried its ill. Last thirteen years i m at bed. So please sir request again you send me suggetion my i.d.( YYYY@YYYY ). Thanking you.",
    "doctor_response": "HelloAs per description of your MRI report the symptoms you are having is a Radiculopathy, due to nerve compression at L4-5 and L5-S1 regions of your spine.For definitive management of this condition I would suggest you to visit a spine surgeon and take his opinion. ( as it will require a decompression surgery like- discectomy , laminectomy )For now, I would suggest you to avoid bending forward ,lifting heavy weights, sitting or squatting on floor. Instead, you should always sit with back rest. for sleeping please use firm bed and flat pillow. Please do not try any exercises now, as you have aggravated symptoms.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could extreme fatigue and brittle nails be due to anemia?\n\nturn vegetarian and love sports. now i feel extremely exhausted, tired and very low energy when i go run or play any sports. I played tennis today and my heart was beating really hard and felt really tired like I was playing for hours. I had only started for less than 15 min...I am scared it could be anemia...my nails break easy...any reason??? Should I have a blood test? physical exam?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Easy fatigue and brittle nails are seen in anemia. You may have some kind of nutritional anemia like iron deficiency anemia or some other. You should go for routine blood test first. If your hemoglobin is low then you should go for anemia profile. Consult your doctor, investigate and take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can cancer be hereditary ?\n\nAlmost everyone on my father side as died of some form of cancer am I at risk? I am a 38 yr old female, I want to know should I have real concern about cancer almost everyone on my father side has died from some form of cancer, my grandmother and my aunt died of ovarian cancer on my father side my mother believe but she is not sure, and two of his brothers died of cancer and a host of cousins, aunts, and uncles. My father died and before he died he was in the process of being tested for cancer of the liver . I also found out that one of my cousins from my generation has lupis. I told my doctor but she doesn t seem concern.",
    "doctor_response": "Hi  well come to HCM. From the history its apparent that  genetically your family is prone to cancer. Better you keep regular check up of Pep smear,Mammography,USG abdoman, Tumor marker etc for early diagnosis of cancer if at all it develops.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a movable mass on cheek of a child indicate?\n\nMy son is 12yrs old. When he was 3yrs old I felt a small movable mass on his cheek. Just over d jaw bone....later on it grew up to a small grapes size. Then I made a fnac and d report came it s a hematoma.. he feels tenderness if pressed...doctor told it can b removed by surgery..I m scaring because trigeminan nerve passes through that area...plz suggest me..",
    "doctor_response": "Hi...hematoma cannot go on like this form 3 years of age to 12 years without getting absorbed. It should be a haemangioma and if it is disfiguring the face then it can be removed. But it is a personal choice and its for aesthetic purposes and not of medical reasons. But I assure you that doctors will do all that is necessary to avoid complications during surgery.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Roof of mouth is discolored. Have swelling near throat and bumps on tongue. Mouth Cancer?\n\nThe roof of my mouth is white and discolored with kind of a yellow tint. close to my throat is red and a bit swollen and my tongue is kind of white with bumps close to my throat and one or two on the sides. it also is sore and seems to be kind of splitting. under my tongue there is also bumps and seems to be slightly swollen. is this mouth cancer?",
    "doctor_response": "hai, thanks for your query, the symptoms you have explained suggests you might be having some sort of oral candidal infection. if you are having any of these habits such as smoking , chewing paan , then you should go for a complete oral check up and if necessary a biopsy must also be done. antibiotics and mouth gargling with betadine solution , and a nutritional diet will help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a cyst in left kidney be treated?\n\nI am 50 years old had Ct scan and us found cyst in left kidney tingling and numbness in both legs down to toes weak tired cant even fold a load of clothes let alone walk without assistance. Please help getting no help from doctors. One says orthopedic another says endocrinoligst another says nephroligist",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Cyst size in left kidney is important for management. If small, it can be safely ignored.2. Tingling and numbness is possibly due to diabetic neuropathy or Vit B12 deficiency.3. Meet a neurologist to identify possible cause. If you have any back pain, Ct scan may be necessary. Continue treatment with Vit B12 and lipoic acid. It could show improvement within two weeks.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for numbness in arm,headache and neck pain\n\nHello. I was diagnosed worth a small syrinx without chiari in my neck at C6 through C7 right where all my pain is. Before the mri I suffered from numbing my right arm and hand and severe headaches at the base of my skull, also of course neck pain. It only got worse despite therapy. Ten months later my doctor still insist it s my muscle. Does it take longer than ten months for a muscle to heal? And does the pain often get worse? My doctor is not a specialist with syringomyelia as few only are. He is also 86 y.o. I m concerned I m being treated incorrectly. Thank you.",
    "doctor_response": "HI, Small syrinx in the neck is managed conservatively and with serial MRI.In your case pain has increased , so I advise you to repeat MRI of brain and whole spine screening to see the cause and increase in size of  syrinx.Treatment will be decided on MRI reports.Surgery is not always recommended for syringomyelia patients. For many patients, the main treatment is analgesia. Medications to combat any neuropathic pain symptoms such as shooting and stabbing pains (e.g. gabapentin or pregabalin) would be first-line choices.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Has severe allergy cold. Underwent surgery for adenoid and tonsils. Difficulty breathing. Why?\n\nHELLO SIR My son 12 years old is suffering from severe allergy cold for the past 4 years.last year he underwent a surgery for adenoid and tonsils.for the past 4 years he is under medication and takes levocetrizine tablet daily.but now he suffers from severe block in the nose and finds very difficult to breathe.now again he is suggested to go for a laser surgery in the nose for sinus and bent in the nose bone.we are helpless now.please suggest us the correct solution.please",
    "doctor_response": "Hello dear,Thanks for writing at HCMAs your son is only 12 year old.and last year he went for surgery and now in present if he has very much difficulty in breathing due to internal structure of nose the medication alone will not help.If their is a severe block then it could pressure on his other veins damaging it.So it is better to go to a specialize,who could diagnose the actual problem and suggest you betterHowever if your child goes after the doctor say for surgery then make sure it is done from specialize person in that field .But you dont need to worry, these surgeries do not have much complications and now days done successfully without any complication but a proper study of that individual case  or condition is neededThanksDr M.IqbalPsychologist & Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause hyper sensitivity in the lower back after a radiofrequency ablation procedure?\n\nI had radiofrequency ablation on April 3,2018. It\u2019s been almost 4 months and I hurt worst than before surgery..lower back is very sensitive to touch. Can you tell me what\u2019s wrong. They want to do back surgery where they put in a rod and screws. I\u2019m reuntant to even let them touch me again",
    "doctor_response": "Hello, Regarding your concern, I would explain that your symptoms could be related to a possible nerve damage. I would like to review your spine MRI report for a more professional opinion. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which medicine should an obese with irregular periods and pcod take to get pregnant ?\n\ni have pcod . overweight irregular periods 9mmfollicle found doctor gave duphaston for 15 days but now 16days past i have no periods .tests were neg. is there any chance of preganancy still no periods .my question is how could i be preganant?. we inter course regularly .what are about my periods ?what procedure should i take to get preganant fast which medicine should i take.",
    "doctor_response": "welcome to nhealthcaremagic you should consult gynecologist and get all tests done minimum thing required is your patent tubes and ovulation and normal semen you should take regular exercise and healthy balanced diet and reduce your treatment should take regular treatment for pcos if needed laparoscopy should be done for infertility it is required to take regular treatment for both if husband also having problem",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain when I take a deep breath?\n\nI have chest pain when I try to take a deep breath, lightheaded, very dizzy at times, some numbness and tingling in my hands, arms, legs and feet, at times quit bad and have been having a lot head, neck and shoulder pain. This has been off and on for about a month. I have fibromyalgia and autoimmune hepatitis but my last labs were fine. My fibro pain has been worse and I m extremely tired all the time. My mother just passed and one of my daughters just moved home with five animals so I m sure that some of this is due to stress. Heart and autoimmune disease runs in the family. Try to find a new family doctor and make an appointment or go to the ER?",
    "doctor_response": "Hello,There are many reasons for chest pain while taking a deep breath as - Lung lower lobe problems - Ligament or muscle related - Issues with diaphragm, liver, spleen - stress, anxiety related. I would recommend getting examined by a family physician for better management guidelines.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My 5 year old son's serotonin level is 583 ng/mL. Does he have a carcinoid tumor?\n\nHello doctor, My 5 years old son's serotonin\u00a0level is 583 ng/mL, and the normal range is 50 to 200 ng/mL. So, we did chromogranin A blood test. It was 16, which is slightly elevated, as the normal range is 1.9 to 15. Should we be concerned and see a specialist? Please advise. Thank you.",
    "doctor_response": "Hi. Revert with more information to a medical oncologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Oxycodone be taken for a long time for pain management?\n\nI had a bad fall on cement and a couple of other accidents hurting my knee. During recovery, from my first knee procedure I took a bad fall and slammed my shoulder into a door frame. I take Naproxen Sosium 550mg twice a day with Misoprostol 200mg twice a day. I also take one Cyclobenzaprine HCI 10mg in the morning. I also take Omeprazole once a day in the morning. I have had three knee surgeries. I had an unsuccessful shoulder surgery followed almost three years later with a very successful arthroscopic repair. During the nearly three years it took me to get an exploratory scope repair, I was taking Oxycodone HCI 5mg, two tablets four times a day. Is it OK for me to take these meds long term? I ow take 1 or 2 Oxycodone to manage pain from these incidents.",
    "doctor_response": "Oxycodone is only meant to be used for a few weeks at a time; using it for longer periods of time can cause serious health problems such as:    High levels of drug tolerance. Oxycodone is physically addicting, which means that your body needs higher amounts of the drug over time in order to experience the same effects. Thus, if you use Oxycodone for a long period of time, you\u2019ll need higher doses of it, which puts you at greater risk for respiratory failure. Respiratory distress. Since Oxycodone works by slowing down the respiratory and central nervous systems, you may experience respiratory distress if you take it for a long period of time or take higher doses of the drug. Symptoms of respiratory distress include difficulty breathing, lightheadedness and dizziness from lack of oxygen.    Physical dependence. After taking Oxycodone for a long period of time, users develop a physical need for the drug in order to function appropriately. Long-term Oxycodone users may feel physically ill if they don\u2019t take the drug.The long-term effects of Oxycodone use are increased physical illness and risk of death.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for constipation and lower back pain\n\nMy Daughter is 17 and is now experiencing painful popping and grinding feeling in her low back. She had an xray and the image according to radiology showed a L5 pars defect. Had an appointment with orthopedic he spent about 10 minutes during the examine said the xray looks nornal did a second xray and normal, told her to start running and doing core exercises for strenghthening. She tried, but to painful. Now she is begininng to miss school because of back pain and we are seeking a second opinion. Are there any specific x rays (flexation) or imaginging we should request.",
    "doctor_response": "i suggest you to go ahead with mri of back ( lumbar )spine and check the report in case if there is a severe damage or degeneration going on in spine then  take a view with orthopedic doctor and if there is no much problem detected in mri scan also then i recommend you to visit a physiotherapist. Here with physiotherapy treatment it will help to relax the soft tissues as well as it will also help to reduce pain. Physiotherapist will also suggest for different kind of back exercises like strengthening, stretching twisting, and combinations of all this exercises will again help her to increase the strength and stamina of her back.Here you are also talking about the constipation problem, i suggest to ask for regulating her food habits, like have more of vegetables and fruits in her diet.  keep your breakfast good, lunch average and dinner minimum before 8 p.m. Also do regular walking before going to sleep for at least 15 minutes.All this in combination will help her so just ask her to follow and if there is any issue post it again here or talk to your available specialist.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is gaining 10 gms in a day by a premature infant normal?\n\nhi, we have a premie baby 30 weeks. she is now 3 months old [from birth]. From last one month[ after she is home]. she is only gaining an average of 10 grams per day. Should we be concerned. We talked to pediatrician and he mentioned not to worry as long as she is gaining some weight.",
    "doctor_response": "Hi...  a premature baby has to be given some leverage for weight gain and should not be compared with the normal birth weight babies. You pediatrician is very much right. As long as the baby is gaining some weight and most importantly developmentally normal, you need not worry.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is diarrhea and discomfort on left side of ribcage due to enlarged spleen with chronic Myeloid Leukemia ?\n\nHi. I have Chronic Myeloid Leukemia and I believe my spleen is enlarged because I am having pain and discomfort on my left side by my ribcage. I also have diarrhea and was wondering if that could be a side effect of an enlarged spleen. Please give me an answer soon. Thanks",
    "doctor_response": "Hi,Thanks for writing in.Hope you are feeling better and continuing in your fight against your cancer. The spleen is an organ which is part of the immune system. It is located under the diaphragm on the left side. The pain you describe in the left upper abdomen might be due to an enlarged spleen. You should get an ultrasound scan done to see for the spleen size. The spleen grows from the left upper abdomen to the right lower abdomen and appears like a firm lump or mass. The pain might be due to spleen enlargement if present. However the diarrhea is unlikely to be due to the spleen.Commonest cause of diarrhea in patients taking treatment for leukemia is common stomach infections. Please consult your doctor and take a short course of antibiotics and eat healthy home cooked food. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is my ankle sprained or fractured?\n\nI have rolled my ankle many times in the last two years but we haven t gone to get it checked out yet. Today during soccer practice I heard a crack and my ankle immediately became numb. I can walk on it mostly normal but when I touch in certain places on the bone it hurts. I can t tell if it s a fracture or a sprain.",
    "doctor_response": "Hello, If you can walk, then it's not fracture. Fracture is very painful to walk. It could be sprain. My advice is to have an X-ray. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Phanindra Dulipala, Diabetologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, erection problem, duralast 30. Side effects?\n\nI m an Asian Male, 33 years old married for 5 years. Since a year,as my wife & I were trying to conceive, I have had problems with my penis maintaining erection during intercourse.Also, there has hardly been any penetration. I had a visit to the doc,who ruled out any issues with my penis.He has recommended to use Duralast 30( Dapoxetine tablets) at least half an hour before sexual intercourse . Does this tablet act like a Viagr a? Are there any side effects from using this often ?",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you are facing problem of Erectile Dysfunction and have been advised to take Dapoxetine,Dapoxetine is generally prescribed for premature Ejaculation.Please consult qualified Urologist for evaluation and tests to detect the cause for your erectile dysfunction.Following measure will help you to boost up your confidence and getting good erection.and delay ejaculation.1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning.2) Take high protein diet rich in vegetables and fruits and Vitamin A,C,D,E.and Zinc3)Take anti oxidants like Almonds 5-6 everyday..4) Avoid alcohol and smoking..In the mean while you can take Sildenafil (Viagra )as on demand .This will help to get good hard erection,.Dr.Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hallucinations and lack of sleep\n\ni want to ask a question about my 21yr old niece. after a domestic problem about two weeks ago, she started crying continuosly, she gets no sleep at nite. a week later we suspected cerebral malaria. she  was taken to the doctors but he said it isn't malaria. for the past five days, the problem has developed to another level. now she barely recognises anyone. she claims she is seeing a big rat in the house, but no one else can c this rat. she now talks all ady all nite. without sleeping tablets she gets no sleep. for a few seconds, she would have a proper conversation, and then she would go to her dream world where she seem to see things that no one else sees. we are very worried about her",
    "doctor_response": "Hello,Though the stressor is present when all these complaints started, still it will be wise to rule out electrolyte imbalance. Get her sugar levels, sr. electrolytes- Na, K, Cl, Mg. and blood urea. If all are within normal range -then all of it is more likely due to psychological trauma. Such cases show good response to olanzapine 5-10mg at night. Further dose adjustments depends on the response of meds.If there is no response in week or so, you may need to get an MRI brain (but this has a very little chance that she will not get better with treatment).So, please get blood tests and you may discuss the line of managment with your doctor and proceed.Wish you good healthDr. Manisha GopalMD Neuropsychiatry",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the right lower side of the back?\n\ni have a dull pain in the right lower side of my back,usually in the mornings, it feels like i need to pass stool, when i go to the toilet i relieves the pain but never feels its enough still feel a little bloated, comes and goes over the past 5 weeks",
    "doctor_response": "Hi, thank you for posting.I have gone through your query and I understand your concerns.Based on what you refer I can say that you suffer from a kidney disease.To determine the exact diagnosis you need:1. Abdominal ultrasound.2. Complete blood count.3. Glomerular filtration rate (GFR).4. Urine test.The results of the above tests will help your doctor to determine the treatment.Ask me for anything unclear.Wish you good health.Dr. Behar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fatigue and cold when suffering from low hemoglobin\n\nA recent CBC shows that I am anemic. RBC of 4.17, Hemoglobin of 10.9, Hematocrit of 34.0. My doctor says these values are fine and does not plan on treating. I am exhausted, cold, etc. I am taking oral Iron and eating more iron rich foods. What more can I do?",
    "doctor_response": "Hello and welcome to HCM,Iron deficiency can lead to iron deficiency anemia.Anemia can cause fatigue, weakness, tiredness and exhaustion.Replacement of iron is the treatment of iron deficiency anemia.You have been prescribed iron by your doctor.The iron replacement has to be continued for atleast 3 months.Take iron for 3 months and thereafter get hemoglobin levels and iron levels done.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is overdose of Folsafe harmful?\n\nDear Madam, I have done a blunder. I have been prescribed Folsafe tablets for 1 at a day. but by mistake i have taken it 3 daily. Is there any problem? I have not conceived and I had gone for treatment that is my periods were irregular. I am married. I had not still planned for a baby. But after the treatment i would like to conceive being healthy. My mother and grand mother are diabetic and I am 25 yrs old.",
    "doctor_response": "Hi,Usually it is not harmful. Folsafe-L contains L-methylfolate, methylcobalamin and pyridoxal phosphate which are water soluble vitamins commonly prescribed to treat their deficiency states causing anemia including during pregnancy.Since these are water soluble vitamins so even if they are taken in larger doses they are eliminated from the body without causing any harmful effects. It will not affect your pregnancy.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the following follicular study report suggest?\n\nHi, today is my 13 day of the month and my follicular study is going on. Today i had 2nd ultrasound and it shows that i am having 2 follicles 1 is of 16.7mm and 2nd is of 12mm. tomorrow again i ll be going for 3rd ultrasound. kindly suggest if i m having chances to get pregnant this month?",
    "doctor_response": "Hello...thanks for choosing healthcare magic for your query..Yes you are having a good chance of getting pregnant this month.Egg size is growing well.Once one egg becomes around 18-20 mm it can be ruptured with HCG Injection or can wait to rupture it naturally..At the same time it is important to note the thickness of endometrium that is layer of uterus and tubal patency and so many things...If you are asking about your chance of getting pregnant by looking at egg size then you definitely have...only other factors also play vital role...I hope this helps...Feel free to ask any further queries..Regards,DR TEJASHREE BHORGYNAECOLOGISTDHANORI,PUNE.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will the sperm count decrease after masturbation?\n\nHi Sir..I am 27 yrs old ..I masterbeat once in two days. I feel good for some time ..after that I fell guilty and I am also worried about my health...also about my future that wheather it will affect my sex life with my wife...or anything like my sperm count will decrease soo much that I will not be able to have child..Please help me out.. Thanks a lot in advance.",
    "doctor_response": "Thanks for contacting HCM with  your health care concerns.You are concerned about masturbation causing a decrease in you ability to conceive a child. With excessive masturbation usually several times a day the sperm count will decrease and can cause fertility issues. But only intermittent masturbation should cause only a minimal drop in sperm counts. Masturbation does not cause any other health concerns and should not worry you. I hope this answers your question. Please contact HCM again with any of your health care concerns",
    "dialogue_context": ""
  },
  {
    "patient_message": "How an I get rid of black tongue?\n\ndoctor i would like to know what is the remedy to cure black tongue , since i have got it . i feel very uncomfortable while visiting any doctor? kindly advice. thanks & regards, sylvia my email address is: YYYY@YYYY",
    "doctor_response": "Hello Welcome to HCM Black tongue is a condition when the dorsal surface of the tongue is either stained black, is unusually dark or becomes hairy in appearance.There are finger like projections called \u2018filiform papillae\u2019 around the taste buds. With the normal wear and tear daily, these papillae are shed off. But sometimes, due to certain conditions, this normal process of shedding of papillae is altered. The papillae then keep growing in size. Food particles get stuck up in these outgrowths. The food debris becomes a breeding ground for many bacteria and fungi, giving rise to a dark, fuzzy look called as the black tongue. Its chief cause is improper oral hygiene.But it can be due to fungal infection also. Its treatment includes maintaining proper oral hygiene by regulare brushing & flossing.Pineapple is also used as a black tongue treatment. In this treatment, small pieces of pineapple are to be sucked for about forty seconds keeping them near the base of the tongue. They are then slowly chewed over a period of eight minutes. This process is to be repeated two times daily for duration of seven to ten days till the time the discoloration fades away. Take Care Regards Dr.Neha",
    "dialogue_context": ""
  },
  {
    "patient_message": "Affected with lupus nephritis, continuous fever, seizure, kept under ventilation. Possible treatment?\n\nMy sister got admitted for kidney problem so they found that she effected with lupus nephritis now she s fine but again after a month she got admitted for days continous fever n 5th day she got continous seizere so now she s under ventilation and also they are taking csf test plz advise immediately that will br great N thankful many thx anu 0000_india",
    "doctor_response": "seizures in patient with SLE could be caused by inflammation of blood vessels of brain called lupus vasculitis or brain infection as a result of reduced resistance due to disease or its immunosuppressive treatment.CSF examination, CT or MRI brain and some blood tests for disease activity of SLE will settle this issue and decide further treatment.if these tests are done then the team of yourdoctors should be able to tell you about possible  outcomes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling inside right cheek?\n\ninside if my right cheek swollen?  I was examined two years back by dental surgen and was advised that my wisdom teeth are ericted with no problem and since yesterday I see a little meat covering my wisdom tooh and it causes the entire right cheek swollen.",
    "doctor_response": "hellooo....nothing to get scared off...its just due to errupting tooth...it is causing ulceration in ur cheek...nothing to worry...just do salt water gargle and do hydrogenperoxide mouth wash twice as it can debride any foot stuff in between the teeth and tissue...and go to dentist...get the tooth removed...hope you got the reply...be happy and take care...!!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from corneal ulcer after PRK surgery. What is the treatment?\n\nHello doctor,I have done PRK eye surgery about a month ago in both eyes. A few days later, my left eye had some weird blurred vision which turned out to be corneal ulcer that is in the center and relatively big. I got treated immediately with heavy antibiotics Ceftin or Vigamox. After two to three weeks there was some improvement in vision, redness and the loss of epithelial cells is about 1.2 mm, after which I started taking eye steroids, and vitamin C three times a day. Unfortunately, I found out today that there is another small epithelial defect that opened under the first one (both are still very small). I have bad light sensitivity, and I would like to know if there is anything to be done now apart from waiting to get better. I have been told to be patient at least three months since the scarring is still prominent and central, although it is getting slightly better every time I see the doctor. I am currently on, antibiotic eight times a day with steroids three times and Sythnomyine twice a day. Most of the scar is in the front stroma. But central, and it has been slightly getting brighter every time.",
    "doctor_response": "Hello. Indeed a corneal ulcer requires patience, time, and continuous monitoring until it is fully healed or scar forms. Sometimes it might take up to a year and more. It is however mandatory that you add to the list of eye drops that you are using a lubricant (artificial tears) because dryness is inevitable after any refractive surgery and once you are using eye drops that contain preservatives. You can use the lubricant every hour if you need but except the last hour before going to sleep. That is also very important if your job includes intense visual activities at the PC and or use of mobile devices. I wish you a fast recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headache, weakness and darkness in eyes when with TB?\n\nHi my dad as tb since last 2 month s firstly he was admitted for 8 day and he was ok till 10 days he was taking all the tablet then he suddenly left those tablets again after 10 days he started again headache he was admitted 6 days in the ICU total 20 days he was admitted in the hospital now discharged. Still at night he having headache and weakness ,darkness in his eyes.",
    "doctor_response": "Thanks for your query at HCM!You must make sure that your father has to strictly adhere to compliance of drugs daily. He must not stop his drugs at any cost without his physicians advice. e has to be monitored for any serious hepatic complication. Stopping treatment at owns risk will lead to emergence of dangerous MDR and XDR or TDR TB bacilli which is very difficult to treat. What anti-tubercular drugs he is taking?What were his symptoms?I suggest he must take treatment and good diet. His  other problems will go after a while.He can take analgesics for headache. If it persists he must visit physician and get investigated(CT scan may be required).He will get well soon and require treatment for many months after which he will be fine.Keep in touch for follow up with your physician.I hope I was helpful.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My left armpit is sore with swollen left ankle and bruise in left groin. Please help.\n\nHello doctor, I have three medical concerns that I think might be related. One is that I have soreness in my left armpit, another is that my left ankle has been swollen lately, and finally I have a one in circle ark that looks like a faded bruise in my left groin. There is no swelling associated with this and no pain. The last one has been persistent for a few months (and the circle got darker when I went on Bactrim for a UTI but then got lighter again). Could these three things be related? Is there any cause for concern?",
    "doctor_response": "Hello. Since when are you suffering from this condition? It may be reactive arthritis (Reiter's syndrome) in which urethritis or UTI (urinary tract infection) followed by joint swelling and rash. It may be associated with dry mouth and dry eyes. It may be a different entity like groin rash which may be a fungal infection. Joint swelling may be due to arthritis or gout or crystal-induced inflammation. Left axillary pain may be due to herpes zoster or boils or shoulder joint arthritis or rotator cuff problem or hypothyroidism. Until examination is done it is difficult to say what it is. Get it done urine culture and sensitivity, CRP (C-reactive protein), ESR (erythrocyte sedimentation rate), and x-ray of left ankle joint. Use tablet Naproxen 250 mg twice a day for five days. Keep limb on elevation mode while sleeping. Please review with reports or consult with your physician he will examine and treat you accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can the mifegest kit cause continuous bleeding?\n\ni m 24 years old and i was pregnant ( 1 month) i took mifegest kit. first i took the single tablet then on the next day i took one tablet orally and the other internally , started bleeding and repeated the same the next day . sir my problem is its 10 day i m still bleeding.. the first 5 days bleeding was heavy but now its very slow and is accompanied with lumps or clotted blood, what can be done plz help me...",
    "doctor_response": "Hello dear.Understand your concerns.Mifegest pill contain one mifepristone pill and four misoprostol pill.Mifepristone 200 mg should followed by the 4 misoprostol 200 ug vaginally/buccally after 48 hours.It is taken under the advice of the gynecologist after confirming the intrauterine pregnancy by USG scan.Normally bleeding/abortion process will complete in next 4-5 days.Bleeding last for 10 days after the abortion pill is not normal.It could be due to the incomplete abortion or retain product of the pregnancy due to inadequate or improper use of the abortion pill.I would suggest to consul the gynecologist and undergo vaginal examination and USG scan to rule out the incomplete abortion.Incomplete abortion is treated by the extra dose of misoprostol or D & C.I hope this will help you.Thanks.Dr.sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I give fruit juices for baby?\n\nmy son has just turned 4 months now and i feel milk is not enuff for him now. i wanted to know if i can feed him sumthing more then milk like juices or sumthng as well as sumthing in solid. please reply me.. he is my first baby and im too curious to be alright for him",
    "doctor_response": "Hello, If the child is breast feed then milk is sufficient till 6 month of age. If the baby is top feed then we can add semisolid diet as dal, khichadi, biscuits mashed in milk, ready to make food as cerelac. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sachin Kumar Agarwal, Pediatrician, Neonatology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause severe cold and cough causing vomiting?\n\nHi, my husband has had a some sort of cold for about a week.  Along with all the regular cold symptoms he has this awful cough that he gets at night that just sounds awful.  He gets coughing so hard that he will often throws up and sometimes there is even blood.  This cough seems to come everytime he gets a cold.  What could be wrong?",
    "doctor_response": "HiIt might happen to vomit after an excessive cogh due to the reflexes, nothing to worry about Regards Dr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does my USG report mean?\n\nI am a 48 years married woman. My USG shows liver is enlarged with heterogenous parenchymal echopattern. Intra hepatic billary channels are not dialated. No focal solid or cystic SOL seen. Lever span at mid clavicular line is 15.3 cm. what does it mean?",
    "doctor_response": "HelloYour findings suggests mildly enlarged liver and heterogeneous parenchymal echopattern may indicate liver parenchymal disease.It may be due to many causes like hepatitis,metabolic disorder etc.You may need routine hemogram,viral markers,random blood sugar,liver and renal function test,lipid profile,urine RE/ME.Liver biopsy may be needed after evaluation.You may need few medicines after evaluation.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "On and off severe pain in back after slammed back during fall.  No help from medications.  Is this serious?\n\nI was wondering if you could help me. Last year at my old house I was going down the stairs and I tried over my snuggie and I tried to break my fall but every step I fell down my back slammed off of it then I hit the bottom and also landed on my back it hurt very bad then after a few days the pain went away. But then a week later I noticed that my back would start to hurt and the pain has been on and off ever since. But this year for the past four weeks I've been having horrible back pain and it just won't go away I've tried taking medicine using back patches but nothing's helping. What do you think it could be??",
    "doctor_response": "Hi...try a course of muscle relaxants for one week....it should help...if it still persist show to a orthopedic surgeon...Dr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for blockage in artery\n\nGood morning. I did gym and other fitness activities after my first and last episode of status epilepsy that was in 1993. I rose to high position. However, after my negative test for TMT on Dec 3, I travelled. However, I had heart attack on Dec 14. A block 99% was treated by angioplasty. Another block was noted in a small side artery. The cardiologist tried but could not reach. My medicines are: Tab Revlol 25/5 1-0-0; Tab Eptoin 1-0-0, Tab Presudoc 10 mg 1-0-0; Tab Telma 80 0-0-1. Tab Atorva 20 0-0-1, Ecospirin 150 0-0-1; Tab Eptoin 0-0-2. I am 59 and maintain good health. My question to you is: What should I do with the second block? The doctors advised me to forget about it. After angioplasty, I have attained 50 min walking to cover 4 km each morning. My food is looked after very well. A week ago, my physician called me to his home for dinner and offered me a glass of red wine. What should be the frequency of red wine (1 glass)? I shall greatly appreciate your time. Anil",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. No need to worry for that second clot. That clot must be in the distal small artery so that the cardiologist did not Stent it.No need to worry for this kind of clot in smaller arteries. You are taking ecosprin and atorvastatin. They will look after that small clot. You are also doing good in terms of exercise (daily 4 km walking with good pace). This also suggest that your heart is working fine. And red wine occasionally (once a month) is actually beneficial to the heart patients. So you can take red wine (1 glass) only once a month, not more than this. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly guide me about taping my shoulder to avoid dislocation.\n\nHi doctor, I am 21 years old. I was wondering due to my shoulder being really bad and after doing surgery and still, even after that I am always dislocating it. I have been trying to tape it but I am not 100 % sure how to do that, so it will minimize the chances of it dislocating while snowboarding. I have been wondering whether the kino tape would be better or just a normal sports tape and if you could give me tips on how to tape my shoulder, it will be really helpful. I do exercises to try to stabilize shoulder but not with alot of progress.",
    "doctor_response": "Hi. I read your concern. In your case, taping can help you little in stabilizing the joint. However, Kinesio tape helps you to recruit or inhibit muscle and is of less help in providing stability to the joint. If you want to tape, then go for rigid tape. If you were my patient, I would honestly suggest you go to a good arthroscopic surgery and get your stabilization surgery properly and follow the proper rehabilitation protocol before attempting to start your sport. You have to first regain your stability range and strength before introducing to your sport again. If you are really keen only in taping, then tape your shoulder in that position which limits your sideways lifting and outward rotation of the shoulder which is actually a difficult position to limit. Stabilize your scapular muscles and can limit the scapular movement limiting the shoulder mobility. However, in a long run, this will not help you to make you independent. Just think about getting a good arthroscopic stabilization to your shoulder.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to develop carpal tunnel syndrome after trigger finger surgery?\n\nI was fin and had full use of my hand and no pain with the exception of trigger finger and two little sits ring finger and fore finger.. Surgery March 31st. Now I can t even use had till hours after I wake up despite PT. now I m told it s carpal tunnel. What went wrong",
    "doctor_response": "Hi, Carpel tunnel is a condition affecting wrist. The trauma might have predisposed to CTS. Consult an orthopedics and plan accordingly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "How accurate are BP apparatuses sold in super markets?\n\nHi, may I answer your health queries right now ?  Please type your query here... i wondering if the test blood pressures at supermarkets (publix for example) are fair, i mean if i can trust on those...i can believe that i have 137... i ussually feel the opposite.",
    "doctor_response": "Checking bp requires a quiet enviroment , you should sitting quiet for atleast 5 minutes and you should not be in the midst of talking or listening to music or watching TV commercials .your legs are to be firm on the ground No crossing of legs bladder should be emptyNo coffee , tea , smoking or alcohol 30 minutes prior to checking bpIdealy you should check bp before your breakfast and medications .You should bring your bp apparatus from home and compare your readings with your supermarket readings .since multiple users use the bp apparatus at supermarket there is a slight chance that it may not reflect the correct bp if it is not done in the ideal conditions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had sex. Period is late. Need to avoid pregnancy. Can I take Mensovit tablets?\n\nHi i had sex with my boyfriend, on the 19th day after my last periods and I have missed the next periods date by 5 days now.I am not sure if I am pregnant and kind of scared to find out too. Just want to make sure I am not pregnant and stop the pregnancy.I have mensovit plus in hand but not sure of the dosage and after or side effectsCould you please guide me on it ASAP..!!",
    "doctor_response": "hello,thank you for using health care magic,do not take monsovit tablet by yourself.. it sholud be taken under supervision of gynecologist..you are just five days late.. it can be due to stress.. wait for 5 more days and still if you dont get your periods take urine pregnancy test..however do not trust its result blindly it can be false negative in early stage.. take more confirmatory test like beta hcg level or ultrasound.. in future practice safe sex..use condom or o.c. pills.. if you fail to use this you can take emergency pills within 24 to 72 hours of unprotected intercourse..hope this helps you..take care...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes scabies in kids?\n\nMy 3 year old son has scabies all over, I have them also just not as much. My twin sons don`t show any sighn of scabies yet, but we all applyed the cream and I washed everything in the house. I also had the carpets cleaned. Anyway, I `m itching alot more & I`m sick to my stomach. I`m a very, very clean person! I was wondering because i cleaned everything the morning after the medicine did it work? I also have a small cockapoo dog, does she have it? (I did`t wash her) We are supposed to ues the cream on the 3rd and 4th night after the 1st night we applyed the cream. Should I wash everything in the whole house those days too? I don`t have time for all this and I can`t take poff anymore work to stay home and clean all day. What can I do and will they go away?",
    "doctor_response": "Hi, You need to treat all close contact along with the patient. Clean all clothes and bedsheets in house. Avoid contact with animal. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Omprakash Ashokrao Deshmukh, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Fever and chills in a child of age 3 years 6 months. What can be done?\n\nHello doctor, Fever and chills in a child of age 3 years 6 months. A mild cough is also noticed. What can I do?",
    "doctor_response": "Hi. Shivering may be because of a highfever, or because of urine infection or malaria. As of now use the below medication. Syrup Crocin DS (Paracetamol) 5 ml/240 mg, 4 ml if fever greater than 100 F every sixth hourly. Sponging with lukewarm water until the fever decreases to 99 F. Give Syrup. Meftal P 5 ml if fever not decreasing after giving Paracetamol or Crocin DS or when shivering present. For a cough, give syrup Ascoril expectorant (Bromhexine HCl, Guaiphenesin, Terbutaline HCl) 3 ml three times a day for five days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes knee pain despite a normal X-ray report?\n\nI have a pain on my left knee, i have done x-ray and the results show notting wrong with the knee but the hospital said i need to see an orthopedic surgeon. but if i sit down for too long it swells, at nite my temperature rises and i have loss of appetite. Please what next can i do",
    "doctor_response": "Hi, It might be due to some ligament or tendon related problem which may not be seen in X-ray. You can consult an orthopedician and plan for an MRI scan which is a better imaging modality and it is superior to X-ray. As of now you can take analgesics like Acetaminophen or Tramadol for pain. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Prolonged smell of copper after being hit on the head, faint ringing in ears. MRI normal, having constant headaches. Suggestions?\n\nHello, I had a question regarding concussions or hard hits to the head and immediate as well as prolonged smell senstation. I ve had more than a couple of hits to the head from explosions in Iraq to wrestling to mountain biking falls. Everytime I hit my head Ive had a copper-kind of smell for awhile and as of about a year, i ve had a that strange smell (which seems inside of my head) more days than not. I see fine, I do have a constant faint ringing in my head or ears for which i m going to see the ear doc. I failed some tests at the traumatic brain injury center which involved drawing lines from 1 to A to 2 to B to 3 to C etc. I have an issue forgetting things etc. The MRI is fine but for over a year I have been given no real answer. I also have some constant but faint headaches which they called occipital neuralgia . I appreciate any thouhghts. v/r J.",
    "doctor_response": "Hi,Thank you for posting your query.It is unfortunate that you have problems for so long after the head injuries, and moreover, no proper diagnosis has been made.Your symptoms are suggestive of concussion and all the symptoms can be explained on its basis.Normal MRI rules out any major problem or injury in the brain.Abnormal sense of smell is related to partial damage to olfactory nerves or its central connections.We expect gradual recovery in your symptoms, however, it may not be complete. I hope it helps.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can the back of the hand pain be treated?\n\nThe back of my hand REALLY hurts when I flex my wrist, and it also hurts when I extend it while pushing off (not so much if I just extend it for the sake of showing how it doesn t hurt as much). It s not my wrist that hurts, it s the back of my hand. It started a few weeks ago when I grabbed something to keep my balance. It hurts if i grab a door handle, turn and push.",
    "doctor_response": "Dear Patient, Welcome, and thanks for sharing your concern I went through your query, and I feel, Pain in the back of hand can be due to fracture of metacarpal bones, or injury to the soft tissue, moreover, it could be due to nerve compression or any tumor, a thorough examination will help us in this direction to differentiate the cause, moreover an X Ray is must, contact me once you have your X rays doneI hope my advice would have been useful, in decision making regarding your treatment, still if you have any clarifications or doubts feel free to contact back.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stiffness and heaviness in arms and legs with brain frost?\n\nI am 50 year old female. Woke up not able to get out of bed in december with heavy legs and arms. I was told I had a virus. now five months later I still have the same symptoms, now they say PMR. I am athletic and was running and lifting weights four days a week now I can only walk. stiffness and heaviness in arms and legs still and when I do sit ups I get extreme brain frost in the front of my head or when i roll back or go upside down. Taking lodine and now arthritis medicine but still no inmprovement. I was in great shape and I am thin before this happened. Advice?",
    "doctor_response": "In my opinion if you had PMR and you where given any antibiotics your problem will increase also you should be given antihistaminic drugsLodine is not a perfect choice if they suspect PMRGood Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cramping in foot suddenly?\n\nI have been on Weight Watchers for about 10 days and have lost 3-1/2 lbs.  For the past week I have had leg cramps while I'm in bed.  I couldn't even stand on my right foot this morning the cramp was so bad.  I'm eating properly and can't imagine why this is suddenly happening.  Any ideas would be appreciated.  Thank you !",
    "doctor_response": "Hi welcome to HCm Your cramps in leg is a matter of concern  but is a common phenomena faced by every 2nd person  at sometime or the other in life . Cramps are sudden, painful involuntary contractions of muscles of leg or any muscle.The cramp usually only lasts a few minutes, sometimes a few seconds.In most cases, leg cramps are nothing to worry about, and it usually just has to do with dehydration, whether it is  due to insufficient fluid intake or sustained and heavy exercise . Other causes include , standing for long periods, or muscle fatigue from walking on a hard surface. Both can result in nocturnal cramps. The toxins ingested by heavy smokers and The electrolyte imbalances that can result from excessive alcohol consumption may also be a source of sudden muscle cramps .Avoiding smoking , alcohol ,fast foodsKeeping  well hyderated , A balanced regular diet including essential nutrients  Little stretching or gentle jerk ,muscle-strengthening exercises before going to bed may give relief .Taking Homeopathic  Cuprum Met 30  2 doses helps relieving  the tendency of cramps .Hope this helps solves your query .Take care , All the best .Wish Get well soon .Don't hesitate to get back tf have any further query .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe tooth ache\n\nI've severe toothache in one of my molars the pain increases as I lie down to sleep. I've been taking 625 mg amoxicillin clavulanic acid tablet twice daily for 4 days but the infection doesn't seem to go. I've tried taking paracetamol+ibuprofen/Ketorolac/zerodol but nothing helps. the only relief is keeping ice cold water in my mouth. Please help!",
    "doctor_response": "Hello:)Welcome to HCM.Pain while lying down suggests you have a irreversible pulpitis.I suggest you to get the x-rays done and root canal therapy.Medication will subside the infection , but the source of infection(your tooth) needs to be cleaned, to clear the infection completely.This cleaning is done in a root canal treatment.A root canal will completely eliminate pain.You can complete the course of antibiotics for a total of 7days(you already completed 4 days).Take ketorol 10mg DT,you have to dispense the sachet into half glass water and have it thrice daily for 3 days.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can muscle twitching and fatigue be the cause of difficulty walking?\n\nmy brother has had a few episodes of extreme muscle twitching of all four extremities which cause him to have difficulty walking. after the episode is over he is extremely fatigue, wold sleep, when he wakes he is not having the shakes on the outside but says that he is having the shakes on the inside aand he still is having difficulty walking. Could this mean he might have MS",
    "doctor_response": "Hi,Thanks  for  your query.It seems that you have muscle twitches or fasciculations. These are small, local, involuntary muscle contraction and relaxation visible under the skin arising from the spontaneous discharge of a bundle of skeletal muscle fibers. You might consult your doctor who can order 1. a few blood tests including thyroid function tests, 2. Serum electrolytes including Serum calcium and potassium levels. 3. Serum B12 levels In case the above tests are normal further testing can be done including - nerveconduction studies, Electromyography, etc. These tests might help to diagnose any underlying neurological issues. I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do presence of nodules on the jawbone indicate?\n\nDid a panoramic, found I have to have oral surgery because I have a wisdom tooth that is infected and should come out. The dentist told me I have nodules on my jawbone behind my wisdom teeth. The bottom two. What is this and should I be concerned?Thank you,Michelle",
    "doctor_response": "Hi..Welcome to HCM..As per your complain nodules over the jawbone can be due to overgrowth of jawbone leading to Mandibular Torus formation..They are generally harmless and does not cause and problems..But first of all you need to get it confirmed that what is the nature and cause of the nodule formation..In case if it is a tori it can be surgically removed, but in case if it is due to some other cause, biopys can be advised and can be treated accordingly..Hope this helps..Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I being upset, shaky and fidgety?\n\nI woke up this morning all upset and started crying and had to write all that was going on mentally.  I feel all shaky and fidgety now and feel like crying I don't know what to do.  I did take an ambien last night but have never felt like this the next morning.  Am I having a panic attack or a relapse of depression?",
    "doctor_response": "HiThanks for using healthcare magicCrying spells, sleep disturbance, anxiety symptoms or lack of concentration is more towards depression. In that case, you need antidepressant with low dose benzodiazepine that would help you to come out of depression. Better to consult a psychiatrist for proper diagnosis and management. in case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a painful lump in the groin area indicate?\n\nI am a 27 year old male. While in the shower a couple of days ago, I noticed a lump in my groin area on the left side. I thought it would go away, but it has increased in size and is very tender. It's painful when I walk or sit. I also have pain shooting down the outside of my left thigh that absolutely throbs when sitting or lying down. This pain has only begun in conjunction with the lump in my groin. Is this something I should be worried about and have checked out? Or am I just being paranoid? If I need to get it checked out, whom do I see?  A urologist?",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .*  This can be possible hernia in groin region , needs to be assessed by    expert consultant surgeon .Hope this  will help  to clear your doubt   .Wishing you fine recovery .Always welcome for any further assistance anytime .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I having high SGPT and SGOT values?\n\ngoodevening.. for the last 6 months i have high levels of sgpt (400) and sgot (200). i have been tested for hepatitis but i don't have. they tell me to do a liver biopsy so as diagnose if i have an autoimmune hepatitis. do u think this is a good advice to follow? am i in danger having these high values? i am 35 yrs old, 53 kgrs, don't drink, don't take medicine of any kind. thank u for your time..mary",
    "doctor_response": "Hello Thanks for writing to HCMIncreased SGPT indicates liver injury.Increase in SGPT may be due to many reasons like hepatitis,alcohol intake,altered lipid profile,medicines,auto immune causes etc.SGOT is non specific and it increases in many conditions.You need proper evaluation.You need few more investigations like random blood sugar(RBS),renal function test(RFT),lipid profile,GGT level,urine RE/ME.You are rightly advised for biopsy to know the exact etiology.You should avoid red meat and high fat milk products.You should avoid fried and junk food.Medicines should be prescribed after complete investigations.Get well soon.Hope I have answered your question.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for bump on my lower right leg\n\nHi, may I answer your health queries right now ?  Please type your query here... I have quarter size bump on my lower right leg that feels like a large internal pimple. when I pop it fluid comes out with a foul/cheese like odor. do u know what that may be??? it keeps coming back in a day or 2 thanks",
    "doctor_response": "Hi,Welcome.The bump seems to be Sebaceous Cyst-as it has cheesy foul odor/ or it could be chronic Abscess with inspisated pus with bad odor on the lower right leg.Cure-By Planed Surgical Excision under Antibiotic cover,with excision of the cyst wall/ or abscess wall.Hope this would help you.Contact with a Followup Premium question to ME.Will appreciate your Hitting thanks, to help needy patients like YOu at HCM.Good Day!!Dr.Savaskar,Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I take treatment for minor degenerative disc causing stiffness in the legs with difficulty in walking ?\n\nI have had a weak, painful spine for over 15 years. Nothing showed up on last MFI but everytime I try to be active, my back/buttock/ neck muscles spasm , pain in groin , hip and rib cage and the stiffness is so bad in my legs I can hardly walk. My legs feel like two blocks of wood. I am managing the pain, but worried about the lack of function everytime I move about. As it has gone on for so long, should I consulant a GP? Been down the road of investigation about five years ago and was told bones good, minor degenerative discs, so reluctant not to waste anyone s time. The morning stiffness increases all day when I am up and about. Should I rest more?",
    "doctor_response": "Hello. Welcome to HCM. you have not mentioned your age.... considering you having pain for last 15 years, it is probably degenerative disc disease- which includes disc prolapse, bulge as well as lumbar canal stenosis. Best approach for you will be to visit a neurologist. Some minor physical tests and investigations will reveal the exact situation. Thereafter, you can go in for physiotherapy or minor surgical procedures whichever is best. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes body odor similar to alcohol?\n\nI work in a residential treatment facility...one of our residents fell and was taken to the emergency room...the doctor there said he smelled like beer...he was not drinking...he takes alot of medication for mental illness and for physical illness...he acted like he had been drinking...he has hep c...he also likes hard candy...can he smell like alcohol?",
    "doctor_response": "Hello, Alcohol odor is possible only when the person consumes alcohol. Maybe the doctor got it wrong because of some obsession. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain, vomiting, hiatal hernia, SGOT 74, SGPT 125\n\nShould I be concerned of an ast ( SGOT ) no. of 74 and an alt( SGPT ) no. of 125? The reason I had the lab work done was because of severe stomach pain with vomiting. I am taking the medication Nexium for a hiatal hernia . I had a test done to check for heart disease and a test on my stomach to check for ulcers. They were both ok. I am still having severe stomach pain at times. I have no gall bladder.",
    "doctor_response": "Dear Friend.Hi , I am Dr Anshul Varshney , I have read your query in detail , I understand your concern.If you consume alcohol this can cause rise in your liver enzymes.If you don't get your viral markers done.And you might be having acid peptic disease, presence of ulcers is not necessary for that.Review with reports.This is my personal opinion based on details available here.  If you still have any query you may please ask me.Stay Healthy. Dr Anshul Varshney , MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which medicine is more effective- salmucolite or ambrolite?\n\nhi doctor. MY son is 3 an half year old, His weight is 16 kg n height is 107 cm he is allergic to dust since yesterday he is coughing badly. He is coughing continuously. He vomited due to cough last night n today morning as well.I gave him ambrolite D. Can u suggest which is more effective salmucolite or ambrolite",
    "doctor_response": "Welcome to HCM. We cannot really recommend brand names here or differentiate between different brands. I would suggest treating him with any medicine that is appropriate for wheezing and narrow airways. Salbutamol should be part of his therapeutic armamentarium.Has your doctor considered giving him inhalers instead of the more risky syrups to control his wheeze.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is lower abdominal pain a side effect of Postinor 2 or a symptom of pregnancy?\n\nHi doctor Please my menses stopped on 4th of May an die had unprotected sex on 4th around 6pm and I took postenor2 around 8pm, but I have been having lower abdominal pains, no nausea, just that abdominal pains,  please does it mean am pregnant or is it the effect of the drug? Thanks Mandy",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.According to your description the possibility of pregnancy is less as :-If your periods stopped at around 5th or 6th day of the cycle the possibility of ovulation around that period is very less in case of regular 28 to 30 days menstrual cycles.-As you took emergency contraceptive pill within 2 hours of unprotected intercourse the possibility of pregnancy is very less as you can expect around 95% of protection.So, possibly abdominal pains you are having could be a side effect of the drug which will contain higher dose of progesterone but you have to rule out the possibility of vaginal infection.Analgesics can you help in treating simple abdominal pain if the pain persist better to consult your doctor once and get examined.Hope answered your query and I will be happy to answer any further follow up queries.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Elevated bilirubin, normal US scan and KUB x-ray. Can I take Liv52?\n\nhi, i have taken LFT test, my bilirubin level elevated to 2.1 mg/dL in total and 1.9 mg/dL in indirect bilirubin. I have taken US scan and KUB x-ray , all reported as normal.i consult an Gastroenterology specialist, she told me that it is Gilberts syndrome , no need worry about it and no medication required for this. can i take liv52 to reduce the bilirubin level in blood.",
    "doctor_response": "Hi, Welcome to healthcaremagic.com Gilbert's syndrome is a very mild disease and generally causes no symptoms or any long term problems. Liv52 was earlier thought to be a useful drug is not considered very helpful in many recent trials and studies. As the disease you have is very mild and requires no treatment there is not need for taking Liv52 for the problem. I would advise against it. Hope I have answered your query. If you have any further questions I will be happy to help Regards Dr. Om Lakhani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be done to help fatty liver?\n\nI am a 70 yr old lady with type 2 diabetes on insulin I have recently been diagnosed with a Fatty Liver. I also have an ileostomy done 40+years ago I am restricted on diet from the ileostomy to low fibre, with low carbohydrate to help control the diabetes. What can I do to help with the fatty liver?",
    "doctor_response": "HelloFatty liver is a reversible condition.It is often seen in diabetic patient due to metabolic disorder.It is due to deposition of fat within the liver cells.Fatty liver may also be due to many other reasons like obesity,sedentary life style,altered lipid profile,hepatitis etc.You need few more investigations like routine hemogram,lipid profile,liver function test.It is good that you are following dietary restrictions.You may need to take few medicines after proper evaluation.You should also increase your physical activity and go for brisk walk.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and itchiness of lower abdomen and right testicle?\n\nHello, I have questions ragarding ache or itchy pain in the lower abodomen top of my right testicle. It hasnt gotten worse but it hasnt gotten better. It feels like my vas deferans is swollen, no pain during ejaculation or urination but it seems to agrevate the feelings for a day after",
    "doctor_response": "HelloThanks for query .Pain in lower abdomen and testicle cis most likely to be due to infection of Epididymis (Epididymitis) Howevet diagnosis can be confirmed only on clinical examination by either General Surgeon or Urologist ,and doing Ultrasound scanning of Scrotum and abdomen .In the meanwhile start taking antibiotic like Augmentin and anti inflammatory medication Diclofenac twice daily .Ensure to drink more water .This should work and give relief from pain .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for sinus allergy\n\ni sneeze the same time everyday. it starts like at 10PM and last till like 4AM no matter were i am. i have had this for three years and have seen ENTS allergy doctors had allergy test no allergies. and of course my family doctor days in. what more can i do?",
    "doctor_response": "Hello!you can get yourself tested for atopy . There is a test called as phadiatop. you can get it done from SRL  lab. If its positivethen we can guide you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is tumerculoma curable?\n\nhi sir 10 years ago i felt with diseases tumerculoma and i consultant to doctore neurophysician they give me a eptoin100mg tablet for 3 years.at 2008 i stopped the tablets and mri also got normal  since  from 2 to 3 years im suffering from headeache plz sir suggest me is it curable diseases are not.....",
    "doctor_response": "hello.I am Dr Mittal.I have read your message.I think I can help you.Ideally I would need you to describe your headache in more details.Here is why-1. The symptom of headache could be related to the tuberculoma itself.There may have been some affection of the ducts that drain the brain fluid called as csf.This may be leading to a condition known as hydrocephalus.A repeat CT scan of the brain would be needed to know this. 2. The tuberculoma may be a treated condition.The current episodes may be completely different cause like migraine.So I would need more information.I would suggest a visit to your neurologist again.Alternatively, let us know the report of the repeat scan and let us know the details about the headache.Best of luck,Dr Mittal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My transferrin saturation, and iron levels are low but hemoglobin is fine. What should I do?\n\nHello doctor, I have psoriasis for a long time for which I have been taking Methotrexate. Last week I got my iron studies and blood test done. My transferrin saturation, and total iron levels are low but hemoglobin is fine. Kindly advice.",
    "doctor_response": "Hello. Your transferrin saturation and iron level are mildly decreased, and your hemoglobin level is normal. So you do not have iron deficiency anemia, but it can be an early sign of iron deficiency. You need to investigate with serum ferritin level because that indicates iron storage level. You need to take iron-rich foods like red meat, beans, pumpkin seeds, and green leafy vegetables, etc. There is no need for taking an iron tablet as hemoglobin level is within the limit. I hope this will help you. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a mini stroke cause sore spot on back of head?\n\nCan a mini stroke cause a person to have a sore spot on the back of the head? I went to local er because I was having slight chest pain and very bad headache but I woke up that morning with a real bad sore spot on the back of my head. At the er they did ekg xray and gave me baby aspirin and treated me for migrane My Blood pressure was going up as well and I am on bp meds. can you help me understand why I still have this sore spot on my head and my heart feels like its fluttering at times.",
    "doctor_response": "Hello!Thank you for asking on HCM!I read your question carefully and understand your concern. Your symptoms seem to be related to high blood pressure and migraine. I would exclude any possible stroke related to your symptomatology. You should know that high blood pressure can cause vascular type headaches, mimicking migraine attacks. The sore spot on your head is related to a temporary dysfunction and vessel constriction in that area from the vascular headache and high blood pressure. I agree with your doctors that the best therapy to control your symptoms would be aspirin (for the prevention of possible vessel occlusion related to the constricted vessels) and arrangement of your antihypertensive therapy. Regarding the palpitations (heart fluttering) that you have been experiencing I would recommend performing a careful physical examination, a chest x ray, an ambulatory 24-48 hour ECG monitoring and some blood lab tests like: - complete blood count- thyroid hormone levels- kidney and liver function tests- fasting glucose- blood electrolytes , etc, to rule in/ out any possible cardiac arrhythmia and investigate for any metabolic cause, related to this clinical scenario.  If all the above tests result normal, anxiety should be taken into consideration as a possible factor contributing in high blood pressure and tachycardia. Hope to have been helpful!Best wishes, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cause and remedy for back and chest pain\n\nHi, I wanted to know what might be causing my back and chest pain. I have had pain in the mid section of my back and chest on the right side. My doctor prescribed me naproxen for it. I have also been an alcoholic for a least five years now which I think it might have something to do with it. I have been taking naproxen for over a month now but it only seems to temporarily relieve the pain. I do a lot of physical work on my job but the pain doesn t seem to affect it then. The pain is always at its worst when I m relaxing like sitting on the couch or sitting at the dinner table. It hurts the most getting out of bed in the morning. Do you think this might be a serious liver problem. I am 32 y.o. And I have been drinking at least three to four pints of vodka week for the past five years. Any help would be appreciated. Thanks",
    "doctor_response": "Hi,Welcome to healthcare magic.After going through your query I think you are suffering from chronic backache.Treatment of back pain  is exercises and analgesics (diclofenac SR). Sometimes strong analgesic(such as ultracet three times a day after meals) is required.Consulting with treating doctor is advised.  Sometimes vitamin D deficiency is the cause so get your vitamin D checked .If it is low then vitamin D supplementation( weekly with milk) can be taken. Also get checked your Vitamin B12 level checked. As pain is on rest so it should also be investigated to rule out ankylosing spondylosis so get x-ray spine and x-ray SI joint,ESR,C reactive protein and HLA B-27 should be done. Avoid  long continuous standing. Sit in a straight posture.Eat milk, fruits and green leafy vegetables daily. I think your query answered.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the fetus measurement normal for a 6 week pregnancy?\n\nHi I wanted to get an expert advise. I have had an early scan at 7 wks exactly becasue of some brown spotting. The measurements provided were 11X7X 12 mm for the Gestation Sac and 1.5 mm for the fetal pole, the heartbeat couldn t be located. The sonography said my measurements were inline with 5-6 wks but I am definetely a min of 6wk 2 days based on my last period. I am 39 and worrying incase the fetus has stopped growing so my question is are these measurements normal or on the small side if I were 6wks 2 days minimum? this is my second pregnanct, my first was when I was 32 and I went full term no problems. I am still having brown blood which is 4 days now. I hope you can help and put my mind at rest. many Thanks",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, it is nothing to worry about the parameters found in ultrasonography only things is it must not be any congenital problem or major fetal defect else you need not worry even for the spotting also no need to worry   hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to pull teeth while having chest/head pains?\n\nI am getting 16 teeth pulled this week and haven't been to a normal doctor for years because of money issue. Only reason how I am affording to get 16 teeth pulled is because a family member is paying. But since 2003, I have had chest/head pains and I'm wondering if it's safe to get my teeth pulled if those issues are going on?",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.Having chest pains/ head pains is a matter of concern which says there is some underlying issue which has to be checked up.I would advice you to visit a GP doctor first and get a check up done in relation to your chest pain and then proceed with the tooth removal.Any underlying heart conditions may cause you damage when the local anesthesia is given .Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Crestor cause muscle stiffness in the chest and neck?\n\nMy husband was put on Crestor and told to stop taking Lisinopril this past week. Since then he has had muscle stiffness in his chest and particularly bad in his neck. He stopped taking the Crestor on Friday, but the muscle stiffness in his neck has not improved. Is this a side effect of the Crestor or could going off the Lisonpril have caused it.",
    "doctor_response": "Hello...Crestor (telmisartan)is a drug used to treat hypertension or high blood pressure as is lisinopril.It is very unlikely to be the cause of the muscle stiffness in your husband.The muscle stiffnes could be explained by a pulled or injured muscle.Why was he shifted over from lisinopril? Was he having dry cough?A common reason for shifting over from lisinopril (ACE INHIBITOR) to crestor (ARB) is appearance of dry cough with the former.I would advise you to visit your doctor who can examine the cause of the stiffness and prescribe a muscle relaxant if necessary.Please do not stop the blood pressure lowering medicine without consulting your physician first.Hope this helps.Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can an online doctor look into CT scan report and advise medication ?\n\nMy Mother is 78 years old. From last 25days her way of taking is abnormal. In CT scan it showed that 1. Lacunar infarct laft thalamus 2. Chronic deep white matter ischemic changesin bilateral cerebral parenmchyma 3. mild cerebral atrophy changes. Whether she will become normal or not? Whether she will become mad lady? what are the medicines we have to use to become she normal. - AAAA",
    "doctor_response": "Hi thanks for your question. The CT Scan report of your mother depicts that she has atherosclerotic stroke.In atherosclerotic strokes blood supply to various part of brain is reduced or totally blocked due to atherosclerosis of the blood vessel supplying to brain. Functions of brain can be improved by re vascularization of the narrowed or blocked vessel. But all depends upon,how much time has elapsed between the first symptom of stroke and re vascularization therapy. Consult some neurologist who will examine and advice about the management of your mother. Hope i answered your question",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to fix the crack sound in both my hands to get more efficiency in wrestling?\n\nHello doctor, I have been arm wrestling for close to seven years and with time I have noticed a couple of things about my wrist that are hindering my ability to have healthy progress in this sport. The main issue is with wrist flexion. My problem is that while doing the flexing motion of the wrist with a decent load on it, it cracks in some positions and I lose all my power. In my right wrist, I feel the crack around the ulnar styloid region and in my left wrist, I can feel it around the scaphoid area. The thing is that the thicker the handle of the weight is the better it feels on the wrist, once it is past a certain thickness the cracking stops and I can train properly. Another thing that I notice is that if I try to flex my wrist with squeezed gripper (it is like a plier that you squeeze) then the motion is not smooth at all. I can feel all sorts of cracks and it hurts. The cracks are mainly around the scaphoid area in both wrists, and it is less on the right. Do you believe that a chiropractor could fix this? Do you have any idea of what the problem might be? Please help.",
    "doctor_response": "Hello. I read your concern. In my opinion, the issue is with an excessive sheer force that you create when you flex your wrist is causing bone on bone rubbing and leading to those crack sounds. Depends on the concentration and loading of weight you feel it at different areas between the right and left wrist. You can get a chiropractor consultation to mobilize the wrist and relieve muscle tension. And then do stability exercises and load your forearm, that should be safe. The position of your wrist is always important as wrong positions tend to increase issues, so be cautious. Do a lot of stretching exercises and icing to release tension as of now. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump in the prostate indicate?\n\nI had a PSA test, and it came back 11 after my doctor did a prostate examination and found a  very small lump.Now he wants to do a biopsy and im not wanting that.I did research online later after the results came back,  and it said not to ejaculate 48 hours before the exam well, I did that 20 mins before my exam, and that made my PSA 11.why do I need a biopsy?",
    "doctor_response": "Hello,The high PSA with suspicious lump in prostate may indicate underlying abnormality in prostate in form of malignancy or else.To confirm the pathology as non-malignant or malignant, prostate biopsy is recommended.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pre eclampsia during pregnancy\n\ndear sir,my wife is 29+week pregnant now and has 3+ protein in urine,and she is suffering from pre eclampsia, B.P is fluctuating in a day as low as 120/90 and as high as 160/120,LDH,Uric acid,Platelets in serum are in normal range. using Methyl dopa 500mg Nifedipine Retard 20mg thrice a day and labetalol 100mg twice a day.but blood presuure is getting controlled,one day cardiologist suggested a diuretic 20 mg as a stat dose,immediately then b.p has controlled for about 2 days,we stopped taking it,again B.P is shooting up,i am very much worried about mother s point of vie first and then about baby.is it safe using diuretic in pregnancy?if not what can be done to control Blood Pressure?",
    "doctor_response": "Hi there ,,Pre eclampsia, especially severe pre eclampsia like the one seen in your wife can be a very difficult situation to be in. At 29 weeks its still too early and the care of mother and baby are very important. The best treatment for pre eclampsia is delivery, but at 29 week the babies survival is a concern. We need to monitor the mother's health and the fetal condition in way of  hourly BP monitoring, blood test, urine test, Fetal ultrasound and fetal Doppler and Fetal heart tracings in the form of NST.Diuretics have to be used very cautiously in pregnancy, and are avoided unless no alternative is available.If the maternal or fetal condition deteriorates at any point, its best to consider deliver, in a hospital with good NICU back up.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for chronic back pain caused by kidney stones\n\nmid day on Friday i went to a movie, upon leaving the movie, my right lower back was in severe pain. in the past i have had 2 kidney stones but the pain was much more acute and stabbing before, this pain is chronic and hurts most when coughing, standing up (getting up), almost like a muscle pull. only this morning a little bit of nausea as i drove to work. any ideas?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Kidney stones can present like this and the symptoms are typical of acute attack of a pain disease. As of now you can take analgesics like Acetaminophen or Mephenemic acid with antispasmodics like Hyoscin. In case of recurrent symptoms it is better to consult a urologist and consider removal of the stones. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe chest pain\n\nHi there, was taken into hospital by ambulance with chest pain. I am 48 years old, didnt feel good all day. Woke with chest pain, which disappeared, later that evening chest pain became more severe. Arrival to hospital, after blood test my triponin level was 10 at 10am, then a further test was given at 1am and my triponin level went up to 1,500. My heart was tested with an angiogram, no damage was done. I then had a check to make sure i did not have a lung clot, all was negative. Why did i have such high triponin in my blood?",
    "doctor_response": "Troponin is a cardiac enzyme which is raised during heart attack and falls after  heart attack.Probably your chest pain would have been relieved by medical treatment. As your angiogram does not reveal any block in the coronary arteries you might not be suffering from serious heart disease and that is why you were not subjected to angioplasty. However you should be carefully followed for controlling the risk factor such as hypertension, diabetes and cholesterol etc. To avoid heart attack in future.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be concerned about the pain in my lower back and legs?\n\npain in legs and lower back for the past week and a half, I have experiencing pain in my lower back and legs. the back pain is sharp, but the leg pain is almost like a pressure that intensifies while sitting or laying down. I am severely overweight. is this pain something I should be concerned about?",
    "doctor_response": "Hello, I have studied your case. Due to compression of this nerve root there is pain in your back and leg.I will advise you to do MRI spineFor these symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.I will advise to check your vit B12 and vit D3 level.You should reduce your weight early to get relief.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Prescribed Zoloft, lamictal, and ambien. Becoming unbalance, cannot move legs\n\nI am being treated with meds and cognitive therapy . I suddenly become unbalanced and sometime cannot move the(legs ). m.d. Psyciatrist says r/t stress Many meds have been tries . It occurs wit an obvious stressors and most time random. I had to leave my job I am currently on zoloft ativan and lamictal . ambien for sleep",
    "doctor_response": "Hi there ~ It is not uncommon for you to experience side effects while being on psychotropics.  However, not being able to move your legs is uncommon.  I recommend that you see a neurologist if you continue to experience these symptoms. Take care and have a good day !",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for spondylolisthesis\n\nI have already been diagnosed wth spondylolisthesis a year ago and have put off surgery for a year. I took a job sitting down but the pain has worsened. my question is will the surgery actually help or is this a progressing thing. I have applied for disability but I am wondering will this be a disabling thing in the future?",
    "doctor_response": "Hi, I am Dr.Bruno.  I have read your question with care and understand your concerns. Let me try to help you Question : will the surgery actually help or is this a progressing thingAnswer : Surgery will help you dramatically Question : I am wondering will this be a disabling thing in the future?Answer : Lots of people with Spondylolisthesis have been operated and are back to their work Hope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am 25 years old and i have uneven distribution of lip colour. How can i make it normal ?\n\nI am 25 years old and i have lip color problem , in the middle the color is red but in the corner side and color of upper lip is dark . I want to make it red please tell me about treatement for it.... I shall be thankful to you.",
    "doctor_response": "Welcome to Healthcare Magic You need to stop biting your lips because if you bite the skin then that area will develop dry black hard skin. Avoid licking lips. Use glycerine solution on lips to make them pink and healthy. Eat plenty of fresh fruits and vegetables. Drink plenty of water. Exercise daily for healthy body and good stamina as well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high BP after lifting weights?\n\nrecently,when i lift weight i have a headache and my neck si a little stiff.i try to measure my blood pressure with the blood pressure monitor immediately after lifting 15 repetition and blood pressure spike up to 200 in my systolic and 95 dyastolic.i am a concerned and worried if this could cause a stroke",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern. I will try to explain and give you my opinion.We talk about hypertension if we have mean values that exceeds 140/90 mmHg. It is normal to have higher blood pressure values after a physical or an emotional stress, so it is important to judge on mean day and night values.Pressures up to 200 might be normal after doing physical activity, but my opinion is that it seems like an excessive blood pressure rising just after  lifting weight.Hypertension is divided in two groups: essential or idiopathic hypertension without an identifiable cause and secondary hypertension, usually in young ages, meaning that is a secondary cause of it. This cause might be a renal disease, an endocrine problem, a cardiovascular pathology.High blood pressure might be without symptoms but it slowly modify your heart and left untreated it might even cause a stroke. It might give headaches, dizziness, chest discomfort.But you should not worry, we are still in time.If I was your treating doctor i will recommend a full check up with blood test analyze, a electrocardioram, echo-cardiography and a pressure holter monitoring to check your mean values during day and night.Only after this we can be sure how to treat it.Hope I was helpful.Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will one get abdominal problems after eating a cherry with worms?\n\nhello ,the other day i was eating cherry with my 4 year old child .after eating a hand full of the cherry my son came to me saying he tasted one that is different from the other tast .i looked at it ,it had white worms that look like long grain rice , but a bit fater .should i be concerned about it .and what should i do ? we did not feal any stomach ack or something else in our health .im worried please answer me .",
    "doctor_response": "Brief answer:No need to worry. Detailed answer:Hi, welcome to HCM. Your child has might ate a cherry with insect in it but i want to clarify to you that most insects or worms do not survive the acidic pH in our stomach. Also, since your child is not complaining of fever or stomach ache, i think that you should not worry about this. Wishing your child good health. Take care. Regards:Dr Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for pain in the knee when walking?\n\ni had cartilage removed around 3 years ago and in the last 6 months my knee has started popping out and a sudden jerk work put it right but one day i just couldnt grt it back in and if i am walking around and made a sudden turn i would be hurt and in pain again and it would take about 3 day to be walking right again . i saw a chiropractor last week was grand felt fine thought that might be the answer but today same problem what do you think is wrong with my knee can you have cartilage damage twice thanks a mill tim",
    "doctor_response": "Hi Hope this message finds you in good health.I have gone through your complaints and understand your concern.Removing the cartilage has made the knee bones to come near due to loss of cushion like catilage. That leads to loss of lubrication and every now and then u get such painful episodes.It can get cured by taking cartilage strengthening tablets.Physiotherapy,analgesics,anti-inflammatory drugs should help.I suggest you get an Xray or MRI done to find out exact cause. Nothing to worry about.I hope your question has been answered.If you have any follow-up queries,feel free to consult me anytime.Thanks,Take care,God bless.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes increased level of immature granulocytes and abnormal platelets?\n\nMy husband has vasculitis, (treated) He had a cerebral hemorrhagic stroke 13 years ago. His last blood test reads several markers I do not know. Immature Granulocyte Absolute - High 0.2 The other is Platelet Morphology Estimate that is marked as (highlighted) Abnormal. Until I speak to a vacationing doctor, I am concerned. Can you help?",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern.  You have immature granulocytes and abnormal platelets.  You may have either some infection leads to leukemoid reaction or you may chronic myeloid leukemia. You should go for LAP score.Consult your doctor and investigate properly and then take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had sex and took depo shot. Possibility of pregnancy? Any way to reverse the contraceptive effect of depo shot?\n\nhi..I'm june kathlene rafayla,RN,MAN..my partner and I make love April 26-27..and I was given depo trust shot May3,2013..Is there any possibility that I May get pregnant from April26-May2 just before I received the depo shot? And if I get pregnant and still received the shot, what will happen to the baby? Is there any way to discontinue or reverse the contraceptive effect of depo shot at this moment?",
    "doctor_response": "I need to know your last menstrual Period(LMP) and regularity of your cycles to know if you were in your fertile period at the time of making love.In that case you could have become pregnant.If it is Depo Progesterone nothing will happen to the baby.No chance of stopping or reversing depo action.What was your intention of taking depo shot?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I discontinue Risperdal and take buspar for Obsessive compulsive disorder?\n\nMy son, age 25, has OCD and taking 30 mg of Lexapro and.75 mg of Risperdal but continues to have daily health concerns.  Has increase weight gain and sleepiness.  What do you think about discontinuing Risperdal and augmenting with buspar? My son is anxious.thank you,",
    "doctor_response": "Dear User,Thanks for using health care magic.I am sorry to say that there is no role of buspar in OCD. In my view dose of risperdal need to be increased as 0.75 mg is too low for augmentation if he is not responding to this dose. Other than this there is no harm to change the SSRI from lexapro to other one. If he already tried all or most of SSRI than augmentation with clomipramine is another option.'Hope I have answered your query. If you have any further questions I will be happy to help\".Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedies for abortion\n\nhi I m a mother of my 8 month old daughter and again i found that i m pregnant i don t want this child coz i m not financially and physically ready for next baby i m 28 year old and i dont have any other sickness, my first baby was normal delivered, no cjuring.....plz give me some home remedy i don t want to have medicine coz i m afaird if its reduce my chance of getting pregnant in future...thank you",
    "doctor_response": "Hello,thanks for using health care magicI understand you have your reason for not wanting to keep the pregnancy which is more of a social than a medical reason.You have to understand that there is the risk of complication in all methods that are used to terminate pregnancy and the risk could even be more when termination of pregnancy is done without the concern or without being carried out under the supervision of a trained and qualified medical personnel. I will advice you meet a doctor who will examine you, confirm that its an intrauterine pregnancy and also estimate the gestational age in order to determine the appropriate method needed.Hope this helps you.Best regardsDr Achuo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason of nodules seen on chest x-ray?\n\nHad a quick question. Had a chest X-ray which showed three nodules. Then I had a ct scan which did not show the nodules. I know a ct scan can show more, however I'm not sure which one I believe now. I am breast cancer survivor, so I get chest X-rays every year and have never had a problem, let alone find three nodules. Should I repeat these tests, or get a bone scan to be on the safe side, or do you think everything is fine?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern.Since you are cancer survivor any lung nodule is a cause of concern. CT is definitely more reliable then x ray. It would be advisable to consult your oncologist to rule out any secondaries. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of lupus?\n\nI have inflammatory erosive osteoarthritis, according to my Rheumatologist, and recently had a rash that lasted over 4 months, while using Triamcinolone Acetonide cream USP, 0.1%, prednisone (5 mg/day), and hydroxychloroquine 200 mg 2x per day. My Dermatologist tested for ANA (positive, 1:4), and anti-Smith Antibodies (positive, 155), along with skin biopsies. They seem to feel the above 2 blood test results together were a fairly strong indicator of Lupus, or at least an autoimmune connective tissue disease, in addition to all the other blood tests and urinanalysis I had done, which also show inflammatory factors. Is it really likely that I do have Lupus?",
    "doctor_response": "Hello,          If u want answer in short then yes.  Lupus or SLE is I would say a best example of autoimmune condition in which body acts against its own. Symptoms of lupus are very wide as it can affect almost any organ in body. But usually it is said to affect young to middle age women. Usually starts with joint pains, swelling of hands, redness or rash over face, photosensitivity.         This is the time lupus is commonly suspected. Along with routine blood work what I usually do is order and ANA, urine analysis and dsDNA which can help in diagnosis. As I'm your case you had ANA positive along with anti Smith which is probably 100% specific for SLE.         Based on this I would say your diagnosis is almost clear. You need to undergo few more investigation to assess extent of disease and need for aggressive treatment. I think you should discuss with your rheumatologist regarding same.          I would be happy to answer any of your queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My fiancee is three days late on her period after sex. Is she pregnant?\n\nHello doctor, I had sex with my fiancee 10 days ago. I used a condom and checked the leakage or damage after ejaculation. There was no damage involved. But, she is having yellow vaginal discharge and is three days late on her period. What may be the reason? Could it be pregnancy?",
    "doctor_response": "Hello. I have gone through your history and understand your concern. Pregnancy may be a chance. So, just take a pregnancy test with home urinary pregnancy kit available in the market. You can do with any urine sample or with early morning sample. Do a test as early as possible and get back with test results for further discussion. Take care. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sharp pain on leg\n\nAbout 5 days ago I was hit hard in the leg by a baseball. It swelled but was not all that painful so I continued to pitch. I did not ice properly the first night and now the swelling is still there (though not as serious) but there is a sharp pain in the lower part of the leg. Will this heal on its own or could it be broken? I am away from home and don t have a doctor nearby to see.",
    "doctor_response": "Hi,thank you for providing the brief history of you.A thorough musculoskeletal assessment is advised.As the mechanism of injury was the direct of the baseball on the leg, and now the area is painful and sharp pain in the lower part of the leg, i will advice to undergo an x-ray if there is any bony injury. Usually, depending on the location the symptoms can be predicted, but as you mentioned that the ball hit the leg, it is tough to judge if the ball has hit the nerve and leading to sharp pain.Getting an x-ray and a clinical assessment will be good. If damage to any bone, muscle, tendon, nerve, artery is there, one needs a hands on examination.As you did icing and the pain is not coming down, you need to visit the doctor to get it check. Never ignore sports injuries, as one can never suspect the impact it does,Usually, if no major signs are present, then with simple sport physical therapy training , the candidate can go back to sport soon.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can chronic lower back pain be alleviated?\n\nPlease I\u2019m very hurting, lower back pain on right side. Unable to sleep. Been hurting off and on since MemoriAl weekend. I went into Urgent care with very high blood pressure and dr said it is muscle spasm and gave me medication due to posture. Medication did help and became better. Due ro more house wow Ok as well as yard work I\u2019m in pain again. Where are u from? My email is YYYY@YYYY .",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It could be muscle spasm due to excessive stress on your back. Avoid strenuous work that out stress on your body for few days and take proper diet rich in protein like milk, eggs, meat, pulses n nuts, cut down smoking and alcohol. Take proper rest and analgesics. Also do stretching exercises for your back twice daily. Hope it helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes face and leg lumps with runny nose and coughing?\n\nI have an almost 2 year old that has red bumps on her face and now I m noticing some on her leg, her other symptoms are runny nose and coughing. Her coughs sound very congested. I m starting to notice a few red marks on her almost 3 year old brother s face. He also has a runny nose and very mucusy coughing. What could this be?",
    "doctor_response": "Hello, It could be a simple upper respiratory tract infection. Consult a pediatrician and get evaluated. A short course of antibiotics may be started empirically. Saline nasal drops can be tried for symptomatic relief. Hope I have answered your query. Let me know if I can assist you further. Wishing you all the best. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cause for recurring joint pain with difficulty in walking\n\nI have been suffering from severe joint pains now for a month and a half.it all seemed to start after a virus I had for weeks.No matter the medication I take it just masks the problem and it returns. In the morning when I get up I have problems getting out of bed and walking. Some times even the bottom of my feet ache.Can you give me any ideas what I may be dealing with? This is starting to affect my daily life big time!",
    "doctor_response": "Hello, Consult an orthopaedician and get evaluated. You can take analgesics like Ibuprofen or Diclofenac for pain relief. If symptoms persist you can consult an orthopaedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from chicken pox\n\nhi doctor i m 30 yr old guy. 5 feet 4 inches long. i m in chicken pox for last 6 days. it appeared under the foreskin of my genital also. while bathing i used to wash it with dettol water. is it normal? how the crush will go from there? do i need to do anything more?",
    "doctor_response": "Hello,Welcome to Healthcare Magic,Chicken pox is a highly communicable 1-2 days before the appearance of rash and 4-5 days thereafter. After which virus tends to die out and looses the capacity to transmit disease to normal individuals. The scabbing usually begins 4-7 days after the rash and completed by 30 days. During the scabbing period you are child will be sterile and will not transmit disease to others.The disease will cause dehydration because of fever, the symptoms will come down once the rashes starts fading off. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pleurisy\n\nDr. I have a pain in my upper chest and I think it s probably Plersi. I got that a lot growing up. But it s been a while. What can I do to take care of that? If I didn t spell it right it s where the fluid between the muscle and the bone is gone. Breathing deep is when it is the most pain...no other pain at all YYYY@YYYY",
    "doctor_response": "Thanks for your question on HCM. In my opinion you should first get done chest x ray to rule out causes of pleurisy (inflammation of pleura ). The causes of pleurisy are1. Pneumonia2. Pleural effusion3. TB4. Pneumothorax5. Rib fractures6. Pulmonary contusions etc.So get done chest x ray to rule out these causes.You can take painkiller to relieve pain from pleurisy. Definitive treatment will only be after diagnosis of cause.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for phobia\n\nhello doctor,i am 27 years of age male,i am suffering from one mental problem,really i need your help,i passed my b.tech in 2007,my problem is that from last 3 years i am not able to go out side from my house,not even i stepped out from my home from last 3 years,i just sit in home,i am scared of every thing,24 hours i think that i am going to die,i found best place is my home,i am scared of every thing,i cant ride bike,i cant sit in car,i am very much disturbed,please say me doctor what i must do,how can i reduce my fear,24 hours i a cry seeing my self,i beg u doctor help me,from last 3 years im in home.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. From the description, it is very clear that your problem is social phobia or social anxiety disorder. It is characterized by intense fear in one or more social situations, causing considerable distress and impaired ability to function in at least some parts of daily life. Expert treatment requires for complete cure. Psychiatric treatment along with psychotherapy should cure you. Please do not delay and visit a psychiatrist. If you require more of my help in this aspect, Please post a direct question to me in this URL.  Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure surgical menopause as a result of ovarian cancer?\n\nOkie dokie, let's see if someone can answer my question ... I have surgical menopause as a result of ovarian cancer.  Had a hysterectomy, oophectomy and lumpectomy.  Most troublesome issue is edema, not so much because my ankles and legs swell up but because I end up with severe diarrhea each time it gets bad (please pardon the expression but I end up \"shitting water\").  I am taking estrogen which does seem to help a bit.  Also have Spina bifida lypomyelomeningocele, urostomy and left nephrectomy.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have history of ovarian cancer with oophorectomy and hysterectomy.  So you have deficiency of ovarian hormone.  You should take hormone replacement therapy.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pregnant, wants to keep child. On sprintec birth control, stopped. History of abortions. Will pills have negative health impact on foetus?\n\nI was on birth control pills after having 3 abortions. Most recent one in oct-nov 11. My doc put me on Sprintec. I stopped taking the pills about 2 1/2 months ago and found out that I m 3-4 weeks pregnant. I would like to keep the baby but I m really concerned if the pills have any negative effects on the baby.( I heard that the hormones come out of the body after 6 mos)",
    "doctor_response": "HelloThanks for writing to us with your health concern.SPrintec has no side effects on the baby.Please do not be nervous about it.The effects wear off in a matter of weeks.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is 'concor 5 plus' sufficient to control blood pressure?\n\nhow are you dr. ?I am female 43 yrs. hypertensive from 10 yrs agoBP:140/100 usually, cholesterol 300mg/dl . I taken concor 5 plus only, but in begin the disease received capoten then change due to rash in the face discoverd    Is this good or not . enough or not ?Can me change the medication (concor 5 plus )?",
    "doctor_response": "If Ur bp is 140/100 then definitely this dose and medication not sufficient.. need to add more drugs..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any surgery to remove the dark circle around the eyes ?\n\ni am 30 years old lady.i have one baby.i have severe dark circles around my eyes last 10 yearsdue to studies.plz can it remove it through any surgery .i have use many creams for removel it after doctors suggestons but no effect seen..",
    "doctor_response": "Hi,Yes there are surgery to remove dark circle around the eyeDark eye circles happen as a result of a hollowness forming underneath the lower eyelid. This hollow groove (called the naso-jugal groove) forms as a natural result of fatty tissue loss during the process of aging. Shadows fall into the groove, causing the appearance of under eye dark circles. Bags under the eyes are caused by fatty tissue visibly protruding within the lower eyelid. Once again, a shadow falls into the groove underneath the bags and the person looks tired and olderRenowned eyelid surgeon Dr. Rivkin has created a non-invasive, safe and cost effective method to remedy circles under the eyes without surgery.Blepharoplasty Non-Surgical Removal of Dark Eye Circles.Topical creams and similar products are another alternative treatment. They can be of assistance temporarily for the mildest cases, but are unable to solve the problem otherwise.RegardsDr Sandhya ManorenjNeurologist Hyderabad",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is Mometasone dangerous to use on Face to clear my acne pimples?\n\nHello doctor, I am seriously facing acne pimples problem. Sometimes they occur on my face when I masturbate. If I use Mometasone, it gives a good result. Is it okay to continue this?",
    "doctor_response": "Hello. Acne is a universal issue in the age group of 15 to 25 years due to hormonal changes in adolescents. However, there are multiple effective treatment options depending on the grade and severity of the problem. Mometasone is a topical steroid and is to be avoided strictly on the face and for acne as it can harm your skin in the long run. Acne is dependent on hormones hence excess masturbation may sometimes lead to an increase in the problem. I would advise you to stop Mometasone immediately and kindly upload appropriate images to help us assess your current grade of acne and treat you better. Regards. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for injury in the upper jaw\n\nMy 2 yr old tripped at the softball fields & hit his upper jaw, on his left side, on a metal bleacher seat corner. It's got a bruise on it right at ear lobe level, maybe a little bit higher. He is complaining that it burns when he chews & tips his head to the other side as well. Is this something he should see a Dr foror should we wait it out a bit to see if it resolves on iit's own, as I'm sure it's sore?",
    "doctor_response": "Hello,Thanks for consulting HCMRead your query as you injury in upper jaw yes you should see a doctor for examination of injury site and examination of tenderness , discontinuty of jaw . Consult dentist as early as possible that will be more helpful in reducing burning sensation .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to give antibiotics for cough and cold in infant?\n\nmy baby is 8 months old and has a bad cough n cold for past 4 days his doctor has prescribed bricanyl syrups but evn now after 4 days his cold is still there. with no improvement he is only on liquids for last 3 days. now the doc has advised him to take clavan bd dry syrup and omnacortil solution. is it safe to give him styroids and antibiotiche is just 8 months old plus he has not eaten anything solid?",
    "doctor_response": "I understand your fears, Apart from cold he would have had chest infection associated with wheeze, THis could be the reason for starting giving antibiotics and omnacortil. I would also do a Blood test and Chest x ray and also give nebulisation if wheezy bronchitis.There is no harm in giving a short course of steroid in a wheezy attack as this category of drugs are preventers of soft tissue swelling the respiratory tract and is combined with relievers like Terbutaline ( Bricanyl as is done  ).As he is taking breastfeed he is not on empty stomach as you fear. Some people may also give Rantac syrup to prevent gastric irritation.  YOu can review with your doctor and I wish your son well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause cough in a 6 years old child?\n\nHello, my son (age 6) received the flu mist today, he stayed up late. He woke up after about two hours coughing and had blood on his face! I used a wet wipe and noticed that the blood was chunky. Though, it didn t continue and he coughed a few times and now, asleep...Should I be concerned?",
    "doctor_response": "Hi...coughing up blood could be because of trivial reason like a simple upper respiratory infection or it could be because of serious causes like a Tuberculosis or a suppurative lung disease. I suggest you to take him to the nearest emergency room, just to rule out serious illness. Once serious conditions are ruled out you can be rest assured.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should i do for chest pain and dizziness?\n\nI have a diagnosed bundle block, atriel flutter and tachardia flutter. lately I'm having a hard thud in my chest , vomit in my throat , dizzy and right chest pain . I just moved and my last doctor I wasnt happy with. Should I wait until Aug. 13 for an appt.?",
    "doctor_response": "Hi the dizziness can be due to atrial flutter,  however it's not common when  compensated.  Sir the arrhythmia you describe should be controlled to avoid such symptoms ad well as prevention of clot formation in the heart which itself would have further risk.  Atleast a medication a medication like beta blocker and if you sure it's atrial flutter,  a ablation sos may help.  A ecg for interpretation and more detail history may help me prescribe the medication till your visit. And also preferably  I would like you to not wait for long period of time before you visit your doctor.  Regards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause pain in chest?\n\nIget nigglin pains in my chest in the middle and throughot my chest only at night and in.the mornings it feels.like.pressure and light stinging mainly on the left side it feels.like it sits there and then.eases.away I m very active play sport 24/7 but I eat a lot.I over eat and eat cheesemelts?",
    "doctor_response": "Thanks for your question on HCM. In my opinion you are having GERD ( Gastro Esophageal Reflux Disease ) mostly. But better to rule out cardiac cause first. So get done ECG. If this is normal than no need to worry much. It is due to GERD only. It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms. Try to follow these steps for better symptomatic relief. 1. Avoid hot and spicy food. 2. Avoid large meals, instead take frequent small meals. 3. Avoid stress and anxiety. 4. Start proton pump inhibitor. 5. Go for walk after meals. 6. Keep 2 - 3 pillows under head in the bed. 7. Avoid smoking and alcohol if you have this habit. 8. Loose weight if you are obese.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "S1 nerve sheath cysts, on each side of spine, not filled with liquid. CT scan, biopsy, needle aspiration done. Are these tumors?\n\nI have been diagnosed with S1 nerve sheath cysts . One on each side anterior to the spine . I went for a fine needle aspiration with ct and biopsy two weeks ago. They were unable, after many attempts and punctures of the cysts to pull any fluid. Not even enough for a biopsy. I am now told by neurosurgeon that he still believes these are cysts and another biopsy is not necessary. That we are going to leave them be. I have never heard of a cyst with no fluid. Two nurses did tell me they are not fluid filled and may be tumors. I m just confused. Please help. Should I worry? Should I push for another biopsy, and if so what type?",
    "doctor_response": "HIThank for asking to the HCMI really appreciate your concern, and I would like to say that this is such case that without observing the complete case report including the image film it is not possible to say any thing for sure from the history given I could say that you need to have the second opinion and concentrate on the clinical symptoms this is the very crucial factor as long as the prognosis is concern, take care and have a good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for violent and aggressive behaviour\n\nMy grandsons wife (16 years old) will not allow him to be by himself.  This even goes as far as going to the toilet, bathing, even leaving the room.  She is very violent, she has cut him on the face badly.  She is now pregnant, and I fear for the baby and my grandson, he has gone from a healthy 13stones down to about 6 stones with worry.  He is totally terrified of her, and he is scared to do anything about it for fear of reprisals to him and the rest of the family.    Please can you advise.",
    "doctor_response": "Hello She is showing violent aggressive behaviour and even she cut your grandson on face. She don't allow your grandson to be by yourself. She is constantly causing harm to him. Most likely these are the symptoms of some Psychiatric disorder. Main possibilities are some Psychotic disorder (acute psychosis or Schizophrenia) or Mood disorder (Manic disorder). In both of these disorders individual start showing violent behaviour and may even cause harm to other or to self. I would advise you to take her to a Psychiatrist for proper evaluation and to differentiate between psychotic disorder or mood disorder. Some times pregnancy can also induce psychotic disorder.Medicines like low dose antipsychotics as Olanzapine, Risperidone can help to calm her without causing serious side effects to developing baby. These medicines are also available in liquid form and can be given by mixing with food also. But before starting a medicine consult a Psychiatrist and take proper prescription.Thanks, hope this helps you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take AKT-4 and BENEDON for TB?\n\nSir, my wife is suffering of TB, FOR THE LAST TWO WEEKS, SO THE DOCTOR SUGGESTED AKT-4& BENEDON, NOW ONE OF HER EYES GOT RED IN COLOUR AND HAVING PAIN, AND WORRIED THIS MAY BE THE SIDE AFFECT OF MEDICINE, PLEASE ANSWER ME SHE IS 30 YRS OLD AND 67 KGS",
    "doctor_response": "Hi. I can understand your concern. It could be a side effect so better get evaluated by a ophthalmologist and do let the eye doctor know about AKT 4. Kindly consult at the earliest.Don't worry, she will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pinched nerve\n\nI ve been told I have a pinched nerve in c2 this was determined by 2 mris and a kat scan. This pain has been with me since January 2014. They tell me it very difficult to operate in that area. I have been on 3 perscriptions of Prenizone and 4 different pain meds. , also phy. therapy along with a series of 4 shots in and near my facete joint to no avail.",
    "doctor_response": "Hi,Generally it is amenable to surgery by a good spinal surgeon. I would urge you to seek a second opinion from another neurosurgeon and get it rectified. You have tried all the pain medications and procedures and I suggest you explore the option of surgery from another doctor. Unless there are absolute contraindications, it should be a possibility.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bad cough. Why does it happen when I eat egg? Have mitral valve prolapse. Related?\n\nhi doc, I am 5 ft 7 bout 145 in weight and I have developed a coughing problem while eating everything. Thought maybe something had scratched and irriatated my throat but just eating eggs make me cough like I m dying. Coughing, throat hurts and it feels extremely tight!!! I suffer from severe migraines, I had asthma when I was little but haven t had an attack in a good 10 years. I have had pleurisy and also pericidatis, I have mitral valve prolapse ....any idea what the cough could stem from",
    "doctor_response": "Hi Hillside, Is the cough productive;-brings out much sputum, I think your answer is-No! Then you have got a Hacking cough, It can be caused by many factors but because in your case eating anything precipitates a bout of cough; So I would think of a problem in upper airway rather than down it. Frequent causes are Viral/HIb Epiglottitis, Vocal Cord Palsy, If you are an eldderly then supranuclear palsy, Some benign/malignant tumors of vocal cord region, A Singer's nodule if you are excessive user of speech. A Otorhinolaryngologist is the right person to be consulted at the earliest. Take CARE!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sharp pain on the left of lower back, pressure on abdomen, painful urination. What should be done?\n\nThursday I had this sharp pain on the left side lower back and then had this pressure on the lower left side of my abdomen it was so bad I thought I would need to go to the hospital. Yesterday I had pressure lower abdomen all day and today when I go to the bathroom this pressure hurts.. Not sure what I need to do. I did start my period but this is different.",
    "doctor_response": "Hi, Welcome to HCM Your description pain is like you have colic which can be due to kidney stone some where in the urinary tract, painful urination could be part of colic or if you also have burning and frequent urination it may point towards infection that is UTI. As you have started period also some times pain of spasmodic nature may be attributed to period but unilateral nature of pain goes in favour of Renal Colic. Please visit Hospital/Surgeon who will examine and a Xray KUB and Sonography of abdomen would give cause of pain,a CBC and Urine analysis will help to know infection. For pain you may take simple analgesic like paracetamol. Take care Good Luck to you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are herbal natural products effective in increasing height?\n\nI'm 19 years old and i'm 5'4 and I came across a herbal natural product used for height growth and I wanted to confirm with a doctor if the product is safe to use? Here is the following link for the product: you could please respond back to me as soon as you can it would be greatly appreciated.Thank you.",
    "doctor_response": "hai,I gone through the website. first time heard about this product.If a patient come to my clinic with this query i will give the following advise:!. if your parent are in the same height category  you cant grow more than that. (more than  10 centimeter.)2. As your are already 19, no more growth expected in your bone (scientifically).3. i will  not  encourage any  product which say it will increase your height.Thank youHope i answered your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal cramps and diarrhea after eating restaurant food\n\nHi my girl friend get stomach craps and  diarrhoea after eating out at restaurants it happened about 1 in 5 times.. she got food poisoning once after a trip to a pub restaurant this was about 4 months ago could this be related.  Any help would be great full.",
    "doctor_response": "Hi, Abdominal cramps with diarrhea after eating outside food is indicative of food poisoning or intolerance to something specific.Hence the first part of treatment is not to eat outside food.Take Boiled for 20 minutes and cooled water.Consult a Doctor for clinical evaluation, examination and give prescription based medications like antibiotics, metronidazole and probiotics.Get stool and blood tests done.Eat only home made foods.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. T Chandrakant, General Surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for dull stomach pain , tiredness and fatigue?\n\nI am 43 years old male,188 tall,100kg.Medical history is only a back problem which achs a lot.Stomach problem started 5 years ago when i came home from egypt.Dull stomach achs.Thought it was mainly after yogurt products.Then from time to time i get the same symptoms .Now it has got worse.Efter eating i get dull stomach achs,no energy,tired eyes,dry mouth.It starts in the middle just under the brost bone then the dull feeling i get is in the stomach.sometimes i feel i have a slight fever thou when checking i have no fever.This lasts for 2-3 hours.At night i feel a bit acid in the stocmach .stools are fine no problem going to the toilet.Two years ago i lost 16 kgs on a quick shake diet.500 cals a day for 5 weeks.Had no problems.Have but back on 8kgs over the last two years thou. Life at home has been two young children in the last two years.not much sleep.",
    "doctor_response": "Hi.The symptoms you have mentioned may be due to Acid Peptic Disease, stomach ulcer or cancer. This can give to the back problem as you have mentioned. I would advise the following in such a patient:Continue Zantac 12 hourly.Pepcid every 3 to 4 hours when on empty stomach. Add Domperidone or such motility regulators.Soft bland diet. No aerated colas / soda/ drinks.Early dinner. No late nights.Treatment for anxiety (as prescribed / needs a prescription by your Doctor)Lying in a reclining positionWalk around after dinner.Think of the factors which increased the present problem, GERD, anxiety and try to avoid. If no relief, get Upper GI endoscopy done and get prescription for added Medicines. EKG for the heart n a safer side to rule out cardiac problems. This helps all my patients and should help you hopefully.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the ill effects of smoking pot?\n\ni have kidney disease and anyurisms in my kidney and lately everytime i smoke pot my heart beats so fast and my back starts to hurt and my head feels like theres pressure im scared i never used to feel like that before and im wondering if i should stop",
    "doctor_response": "Hello, I would explain that your symptoms could be related to high blood pressure or anxiety, probably caused by cannabis adverse effects. For this reason, considering your clinical condition and the possible adverse effects of cannabis, I would recommend avoiding smoking pot in the future. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do red and itchy lumps on neck filled with oily substance mean?\n\nHello, I get about 1/4 to 1/2 inch size \"lumps\" on my neck under my ear mostly, that get a little red and itchy, but don't go away.  I try to see if they have anything in them, but it appears to be a very oily substance.  I've tried everything but nothing seems to make them go away except time, which can be weeks.",
    "doctor_response": "hi.it is best if you consult with a doctor, preferably a general surgeon, for medical and physical examination. based from your description, it could be a cyst (a sebaceous or a keratinous type). these lesions can occur anywhere in the body and have the tendency to recur.  management (medical and surgical) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and bruise on the thigh?\n\nI am a very active 34 y/o male but I can not recall having any trauma to the posterior side of my left thigh. I awoke today to pain in said area, I looked and saw a cluster of about 10 bruises, none bigger than a quarter size and some as small as a dime.",
    "doctor_response": "Alteration in the coagulation cascade /clotting factors in blood can cause such conditions even without significant trauma. Certain diseases, drugs such as anticoagulants,antiplatlets,NSAIDS,etc can cause so. U may need to get a blood work up to ascertain the cause. Most of the time it may be of no underlying pathology and  left alone..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for back pain and chest pain\n\nmy papa is 55years elderly,weight is 55kg.height 5.3inch, he is diabetic,blood pressure, and his critinine is 1.3. is suffuring from diabetic since 12 years.he is telling his back bone is paining.now he was hospitalized due to severe chest pain.  can you plz suggest us wat precaution we need to take?he is taking glynaz mf.",
    "doctor_response": "HIWell come to HCMI really appreciate your concern unless know the underlying cause of his complaint it would be difficult to suggest something, if this is cardiac disease then he need to change the life style, very important is \"stress\" there should not be any stressful condition, kidney may need some attention because creatinine is not good, hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high BP and facial paralysis?\n\nhi dr. i want to ask about my brother face probelem. his age is 36, 5\"2,& weight is 106 kg. he is overweight. in april 2011 he feels problem like.when he wake up in the morning& he feels he can't move his lips &after few hours he can't move his left eyebrow. suddenly his bp is so high. why is happen that to him. pls answer. thanks",
    "doctor_response": "it's a stroke. it's occurs due to damage to brain. either there is brain hemorrhage due to very high blood pressure or due to clot in brain arteries lead decrease blood supply brain and damage the which controls the face.Both problem can occur due to high bp. so blood pressure should be controlled. also other risk factors involve smoking, high cholesterol level etc.physiotherapy may help to recover patient.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hot feeling at cheeks/nostrils/eye socket, coldness in scrotum with hep-C?\n\nI get a warming almost hot feeling at my upper cheeks nostrils and eye sockets as well as a coldness of my scrotum. This feeling is opposite my cheeks are actual cool to the touch! Any ideas? I have hep c/stage 4 but no real symptoms of this other than an occasional tenderness in the liver region.",
    "doctor_response": "Hello! Welcome to HealthcareMagic! First, you need investigation of your blood urine, scanning of abdomen etc after that only we can tell exact diagnosis. Based on your symptoms, I would suggest you to take some Ayurvedic medicine, like tablets Agnitundi Vati 2tab, 3 times day and Chandanadi Kada syr 5 ml, thrice a day. Thank you for contacting us. Hope this clarifies your concerns. Take care Regards, Dr. Naser Jani, Ayurveda Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of penile dryness and redness?\n\nHi , im 26 years old ... i masturbate alot and recently i realized that the tip of my penis is dry and there is some reddness right before the opening of the penis ... moreover the inner skin of the penis opening is also red and sometimes i feel pain from inside !!!.. i think the reason is due to my strong friction and bad hygiene after masturbation .. so if you could please help me to recover .. thanks",
    "doctor_response": "Thanks for contacting HCM with your healthcare concerns.You have notice dry red area at the tip of your penis from masturbation. This is a common occurrence and is related to use of lubricants and or trauma from masturbation. To help reduce the redness I recommend reducing your masturbation frequency. If the area still gets red then you can use a small amount of hydrocortisone steroid cream to the area. I hope this answers your question. Please contact HCM again with your health care concerns and questions or if you need additional information",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heaviness in legs?\n\nI am a runner and usually run 3-6 miles every other day. I also do some weight training/ toning exercises 3-4 times per week. I had been feeling great and having some of the best runs of my life up until about 3 weeks ago. Since then my runs have been slow, I feel sluggish, and my legs feel like they weigh 200lb each. Nothing has changed with my diet or sleep habits. I m very frusterated because I can barely finish a 3 mile run lately. I have also been getting more side aches than usual. What could be causing this and how do I get back to the level I was running at?",
    "doctor_response": "Hello,The symptoms can be related to overuse of the muscles. I suggest using muscle relaxant such as Baclofen three times a day. I also suggest using magnesium supplement daily. I recommend to rest a while and avoid activities that can trigger the symptoms.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful boil on shaft of penis?\n\non shaft of penis in mid way very small prickle is observed from my child hood that time i did not bothered but after 10 yr few of them still can be seen in very fine shape like heat prickle , but these are with hard and thin, few give little ertative pain i broke few of them and those are heeled,in normal view it can not be observed as very tinny.in sex there is no issue. please advise",
    "doctor_response": "Thanks for asking in healthcaremagic forum  Your description seems mst likely to be fordyce's spots. Fordyce's spots are visible sebaceous glands over there and are harmless. Please stop meddling with it if it is not causing you any harm. You can consult dermatologist if it is of cosmetic concern. It is not related to sexual ability in future. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for vaginal fungal infection\n\nI am recently married and there are certain things that is troubling me a lot. At first night,I found that she had fungal infection and  when I tried to have sex with my wife, she somewhat resisted and said that I am not able to do properly and she was feeling pain. I took her to doctor and after two weeks when I again tried to have sex, the penetration was very smooth with no pain at all to her.  She too lubricated a lot. My problem is that is she had sex with somebody else before marriage, she told me lie that she was feeling pain? Why she did not felt little bit pain and why is that there is no tightness in her vagina. I just wanted to know and please answer with brief explaination. I understand that these days this is no big issue but for my satisfaction I want to know the reality.",
    "doctor_response": "Hi,Do not think this type of panic idea which might affect your married life in future.During first time sex as you told she had fungal infection.At this time she might be having some bacterial infection due to itching and irritation causing pain and discomfort while penetration.After treatment she was ok and there was easy penetration.So forget about this thing and enjoy your marital life.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can low vitamin B 12 cause carnitine issue?\n\nI note a LOT of b12 issues, yet no answers like, perhaps it's pernicious anemia. ( For us non- Dr.'s it's a form of anemia that keeps you from absorbing b12 properly, causing you to need b12 shots.) In addition, this is under the category, can a low b12 count cause a low carnitine count. I see no answers on that one, and it's the answer I'm trying to find. So, can a low b12 count cause a primary or secondary carnitine issue?",
    "doctor_response": "hicarnitine deficiency is a genetically determined autosomal recessive disease it is inborn error of fat metabolismhowever vit B12 deficiency is completely different Hope I have answered your question. If you have any further questions I will be happy to help wish you good health Dr BR Hudda\"",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe hair loss\n\nhello doctar i am having daily thyronorm 75mcg ,tablets ,,,from past 1 year i increased 13 kg now i am 68 kg,,i am deiting hardly,,my hair is falling too much ,,i am n ot having rice also ,,,,,what may be the reason for all these doctar ,,, what i can do",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. thyroid disorder is the main reason of your hair fall what is your hemoglobin?i would like to suggest you an alternative method of treatment try homoeopathy consult a  doctor it will help you sure.many more patients have treated with homoeopathy nicely with no any harm/side effect.in homoeopathy your detailed case history is must.with all this you shoulf start yoga and pranayam it will benifit youHope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for stomach cramps, nausea, and watery stoolsii\n\nMy adult daughter has had stomach cramps, nausea, and watery stools for nearly a month. She has seen her doctor who prescribed some kind of muscle relaxer. She has had no relief. She has avoided dairy and generally has a very healthy diet. She needs some relief.",
    "doctor_response": "Hi,It seems that she might be having some GI infection, either bacterial or amebic.Go for stool test for ova and cyst and pus cells.She might require one course of ofloxacilin, tinidazole combination medicine for 3-5 days.Give her light food like curd, rice, buttermilk, apples etc.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is gestational age is calculated from the day of conceiving?\n\nThe start of my last menstural period was Oct 25 2010. Lasted about 7 days. According to that, I m supposed to be 12 weeks today (Jan 15 2011). However, I went for my dating ultrasound yesterday and was told I was only 10 weeks and 6 days. Therefore they couldn t do the Nuchal Translucency scan. My question is, what exactly is gestational age? Does this calculate when the baby was concieved? And if so, the baby would have been concieved the last day of my period (Unlikely, I thought?) I m confused as to which age I should be using. If my gestational age was different, shouldn t everybody else s be? I hear people say I was only off by 2 or 3 days , but wouldn t that mean they also concieved during their period? Please help.",
    "doctor_response": "Hallow Dear,The gestational age of the baby is in fact the actual age of the baby. Naturally it is from the day of conception. However, it is not possible in day to day life to locate the day of conception. Hence it is customary to calculate the day of expected due date of delivery or even the duration of pregnancy from the date of last menstrual period. This is the clinical way of assessing the duration of pregnancy. Total duration of pregnancy which is said 280 days is counted from the date of last menstrual period.Ultrasound calculates the duration of pregnancy according to the measurements of the baby. It has some error factor ranging from 2 weeks to few days depending upon the stage and duration of pregnancy. I hope this gives you clear knowledge about the age of the baby. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will there be any problem in getting pregnant at an elder age?\n\nHi good day doc. this is to inquire about my present situation I am still single a 43 yrs old virgin no any sexually involvement i want know to from you because i had plan to get married i want to know if there's a possibility my uterus have problem in getting pregnancy?",
    "doctor_response": "Hi, I think there will be a problem in getting pregnant because at this age the number of eggs as well as the quality of eggs decreases. Uterus generally is not a problem.  You can get yourself evaluated for that.  Do a day 2 or 3 FSH, LH and AMH level and a ultrasound for your uterus and ovaries.  This will tell you the present situation.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any other option other than surgery for cholelithesis?\n\nHi dr. I just completed my sonography' and the dr told me I am suffering from cholelithesis, I am confuzion what should I do' dr have advised me for surgery removing gall blader, is there any option' I don't want surgery, is there is med.  Course' home remedies,   plz help me",
    "doctor_response": "Hi,How are you? My name is Dr Suresh Raghavaiah. I am a surgical gastroenterologist and I will attempt to answer your question.Cholelithiasis or gall bladder stones is a very common finding in scans of the abdomen. 10% to 20% of population will develop stones at some time in their lifetime. Up to 80% of these patients will never experience biliary pain or complications such as acute cholecystitis, cholangitis, or pancreatitis.  Hence, most gallstones are clinically \"silent,\" and is an incidental finding often uncovered during abdominal ultrasound being performed for another reason. People with such asymptomatic cholelithiasis, however, eventually may develop symptoms (biliary pain) that require treatment, but this risk is quite low. An even lower proportion (1-2%) may develop major gallstone complications. Therefore, expectant management is an appropriate choice for silent gallstones in the general population. The exception is patients at high risk for experiencing biliary complications -  Large gallstones (>3 cm) or gallbladders crammed with stones that carry a higher risk of developing gallbladder cancer. So in your case if you are currently not suffering from any symptoms and all you have is a small stone in the GB, I would advice a \"wait and watch\" policy. If in future you do develop symptoms like pain, fever, vomitting, dyspepsia, etc then I would get operated on. Laparoscopic cholecystectomy is a fairly simple and routine surgery done in most surgical centers.Unfortunately once the stones have been formed, there is no medications which will help in treating them.Hope this helps and hope you start to feel better soon.Please do not hesitate to contact me for any further clarifications.Have a great dayDr Suresh Raghavaiah",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden weakness in an infant?\n\nHi, I have a 3 week old baby who has suddenly shown a lack of energy. He tried to breast feed but appears to lack the strength to do it properly, causing me to switch to bottle feeding. Is this serious? My doctor gave me an appointment for later today but I m still worried.",
    "doctor_response": "Hi Thanks for writing to Healthcare magic.Any newborn with fever, lathargy, decreased feeding or irritability is better examined by a doctor. Even if it may be a simple cause, we need to rule out any underlying cause. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a small lump on head indicate?\n\nMy mom has a small lump on her head underneath the skin. It doesn t move on it s own but if you take two fingers and press a tiny bit, you can move it. It s like a little rock under her skin. What is it? Does it sound like she needs medical care immediately?",
    "doctor_response": "Hi,This is most likely to be a sebaceous cyst. They are commonly found on the scalp and are not serious. She does not need to seek medical attention unless it becomes painful or swollen which would indicate infection. Regards,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does CT scan of kidneys suggest?\n\nSir, Kindly advise regarding below mentioned CT Scan report of 18 years son- Spltting of p.c. system seen on right with hyper dense area mid calys (1.2MM) & right lower ureter (4.1MM) Right renal concreation Right lower uretric calculus. Regards, Ashok Kumar Agrawal",
    "doctor_response": "Hi Sir,Welcome to healthcare magic,I understand your query and concern.Your son's CT scan report is suggestive of a renal stone located somewhere in the Right lower ureter.For this you need to get him Intravenous pyelography  for accurate assessment.I advise you to have Tab Tramadol and Tab.Pantop 40 mg,a course of antibiotic taken under medical prescription to control this pain.Further expert management depends on the outcome of the IVP  result.If the size of stone is more than 5 cm then depending on the location of stone Extra corporeal lithotropsy can be done.Meanwhile you need to take soft and less spicy foods.Drink 3-4 litres of water everyday.Fruits,fruit juices,vegetable salads,soups should be taken.Consult your urologist for expert management.Post your further queries if any.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for blue lump after injection\n\nhi, just last night i was trying to iv some adderall but i think i blew the vein, i thought tht the needle was inside the vein but no blood can out and i injected the substance. right after that, it started swelling up and now it is a good size lump, i think its turning bluish what do i do?",
    "doctor_response": "hello, thanks for your query, it could be due to double puncture and some fluid gone into superficial tissues. u can apply thrombophob ointment topically. it takes time to resolve.all the best. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is wheatgrass juice good for Chronic kidney disease ?\n\nmy brother is suffering from CKD stage 3, his creatinine level i think its 56-64% .someone told us to drink wheatgrass juice? Does wheatgrass juice helps to patients of age 34years with CKD stage 3, who is undergoing chemotherapy too? are the side effects of chemotherpy really scarry...! please advice.",
    "doctor_response": "Wheat grass should not cause per se any problem with either chemo or to CKD. . However wheat grass juice is high in potassium and CKD patients are unable to remove this potassium and develop hyperkalemia ( high potassium) which is dangerous. Some chemotherapy medications can be stressful for kidneys should be monitored during and after chemo. The concept of everything natural is safe is so obviously fallacious - as if there are no poisonous plants or fruits in nature. All plants are also chemicals - simplest example is sugar (actually a chemical C6H12O6) extracted from sugarcane (natural)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the signs of stress?\n\nAll this stuff is happening to me at one time I ve been really stressed and im not sure if my health is failing from it. I m nine days late for my period and I have taken 3 HPTs but they were all negative. I was also coughing up blood after crying and I have red spots in my eyes like my eyes are bleeding. Could this all be from stress?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. I sincerely do not think that the symptoms are due to stress. Please consult a general medicine practitioner and proper diagnosis. Self diagnosis and self medication can be dangerous.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Afraid to stay alone, numbness, heaviness in head. What should we do?\n\nhello Dr , My brother who is 35 y old , unmarried , since 6 month : at home not working , is very afraid to stay alone in the house specially during nights , as my mother went to her daughter s place for 6 month,he is feeling that his body becomes numb, specially hands and legs , head becomes heavy , and feels that he will have paralysis , He does want to sleep because of the fear, his vital parameter as all normal, what should we please suggest good Dr in thane",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern looking to the history given here I would like to say that this is kind of psychological condition your brother is having he must have lost the self confidence and feeling lonely eve develops the phobia because of this, he must be in need of counseling and for this you need to see the psychiatrist, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is there a safe and assured ayurveda treatment for autism?\n\nHi doctor, My 3.5 years old mild autistic son is nonverbal. The doctor has given Risperidone (Sizodon) and some vitamin supplements for the last six months. My son is under speech therapy also. As all the allopathy medicine has side effects, is there any safe and assured ayurveda treatment for this condition? To what extent can my son get improved? What is the probable time frame? My son is hyperactive. He cannot focus as there is some sensory issue. He avoids the unknown person,\u00a0especially same aged children. He is very selective in food and does not chew a few foods. He does not like almost any fruit. His MRI, USG, ECG, allergy panel and blood count were normal. He was vitamin D deficient.",
    "doctor_response": "Hello. I just read your query. As you have mentioned about autism, autism is a neurodevelopmental disorder. People start noticing the symptoms in their children during 2 to 3 years of their age. It might be due to some genetic problem, environmental issue, some infection during pregnancy like Rubella and sometimes no known reason can be ruled out with this problem. The other symptoms you have mentioned like hyperactivity, lack of focus and difficulty in interaction with other people are all associated with the same problem. The reason behind all this is that your son's neurological and behavioral development is not normal. Sometimes this problem improves up to a large extent with the help of medicine and other therapies. Sometimes, it can be there as such during a lifetime. No doctor or medicine can assure you about the exact time and the exact progress. But that does not mean you stop trying. Now coming to ayurveda medicine, there are prescribed many medicines in ayurveda which will help your baby up to a great extent. Genetic or environmental. Revert after a month to an ayurveda specialist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reddish rash like marks spreading on the cheeks. Allergy?\n\nHi,i m 28 male and over the last 2 weeks i ve developed red rash like marks on my cheeks.It started on the one side but now seems to be spreading.My neck is also begining to become itchy and very dry.This is usually after i shower or shave that it becomes dry and itchy.I then apply moisturiser which soothes it abit but the marks become very red.I don t know what s happening as i haven t changed a thing in terms of shaving cream/soap ect and it s starting to worry me as there is no sign of it getting better..help!!!",
    "doctor_response": "Hi, Thanks for posting your query. There is possibilities of fungal infection, Pityriasis alba and Fifth disease. Exact disease can be defined only after examining the disease. You should consult with dermatologist. You should avoid soap and shaving creams as it may cause dryness and may worsen the condition. Thanks, Dr. Mayank Bhargava",
    "dialogue_context": ""
  },
  {
    "patient_message": "How is the gender of a fetus determined?\n\nHello Doctor! I am Komal! I have been married since last 1 and half years. Me and my husband want to have a baby now. My in-laws are little orthodox and they want our first child to be a boy. Is there any way through which i can get the first child as a boy?",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the sex of the baby is decided by the X and Y chromosomes.The mother gives two X chromosomes and father contributes one X and one Y chromosome.One of X chromosomes given ny mother and one among those given by father fuse to form embryo.If both X fuse it gives XX a female baby and if X and Y fuse it gives rise to XY a male baby.This is all myth and little is known about it.So we cannot decide the sex before the birth of the baby.So relax.Avoid stress.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bump on the back of the head?\n\nMy one year old tripped and fell hitting her head in the driveway got a little bump and bruise which I iced right after but today I found two pea sized bumps on the back of her head near the right ear but not in same place as the bump from the fall that was on her forehead. The bumps feel Like hard peas and about that size any idea what this is I m worrying.",
    "doctor_response": "Hello. I just read through your question.What you are feeling are lymph nodes. these are normal. We all have them. In some of us they can be felt, in others not. they have nothing to do with your daughter's fall.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is mouth ulcers and blemishes side effect after using protein powder?\n\nI consumed Amway Nutrilite protein powder for the last 3 days and now ia m suffering from intense mouth ulcers and blemises in the throat and mouth. My tonsils is also paining. Is this a side effect or is it because of some other reason. I have never experienced this consuming anyother SOYproducts. Please Advise",
    "doctor_response": "Hi,You can stop taking the powder for a few days and watch for your symptoms.You might be allergic to any of the ingredients in the powder. Check for the ingredients in powder box for any known allergens.You could be allergic to even any of the preservatives and additives.Switch to other protein powder in case of doubt. Mouth ulcer gels can be used to reduce the pain.Drink plenty of fluids like fruit juices and tender coconut.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Saranya Ramadoss, General and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dry blood around the outer part of the belly button?\n\nHello, my question is the last few weeks or so I've noticed dried blood right around the outer part of my belly button. When I clean it out I get a dark brownish redish color blood and a horrible smell. I had my belly button pierced 6 years ago but have had it out at least 4 years now. I am a little over weight and my jeans rub right on my belly button. What could be the cause of this??",
    "doctor_response": "Hi,It seems that there might be having deep seated infection in your belly button.Due to over weight belley button might be steel deep producing difficulty in cleaning inner part prolonging infection.There is another possibility of having Grannuloma giving this problem as well.Consult surgeon and get examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is CT scan necessary to detect pulmonary embolism?\n\nHi, Im 58, 5'9\", 195, have panic disorder, periodic shortness of breath, poor spirometry score, and D-Dimer of 498.  My doc wants a lung CT scan to look for embolisms, but this shortness of breath has been going on for years w/little change. (Former smoker with hyperinflated lungs and granulomas on X Ray consistent with emphysema).  No cough or other problems  Is this CT scan for an embolism necessary, in your opinion?  Or could he be looking for something else w/hyperinflated lung X Ray, low spirometry score, and relatively high D-Dimer?",
    "doctor_response": "Hi welcome to health care magic.... You are having emphysema changes along with high D dimer score... So here yes pulmonary embolism has to be ruled out... For that you needs definitely angiography.. CT angiography and Echocardiography will be beneficial for that..... For embolism if needed than low molecular weight heparin therapy should be started. ...Than after oral anticoagulant given for maintainance as per requirement.... Calf examination also done to look for deep vein thrombosis.... For emphysema pulmonary rehabilitation and bronchodilator therapy useful.... Avoid smoking.... Take care Advise : Pulmonologist consultation for examination......If needed cardiologist advise can be taken after examination...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of lomela cream?\n\nHi my name is nj,ni 22 year old guy. I am using lomela cream for two years but now I am feeling some sideeffects with the cream it is causin skin reddening on my face. If I try to discontinue the usage I can feel the discolouration on my face. Please suggest me a remedy.",
    "doctor_response": "Hello and welcome to healthcaremagicThe cream (lomela) that you have been using is a drug combination of a potent topical steroid (mometasone), tretinoin and hydroquinone. It is a prescription product. Dermatologist's commonly prescribe them for facial hyperpigmentation/ melasma.It is not meant for regular use and should never be used without a dermatologist's advice and in any case not for more than 2-3 months since the steroid content of this cream can cause various side effects like acne, photosensitivity, skin thinning and telangiectasia and facial hair growth (hirsutism) which is specially troublesome in females.You should definitely stop using it any further.Rather I would suggest you to use a broad spectrum sunscreen, throughout the day to protect from sun since the skin would be sensitive and sun exposure would make it red.The skin would take some time to recover. Till the time your skin recovers from years of steroid abuse you should just use bland moisturising cream for night time application and a broad spectrum sunscreen during the day.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does chest tightness with gas trouble suggest?\n\nhello respected sir ... i m 20 year old boy .... i tend to have tightness in chest and experience breathing problems.. when i do exercises which focuses on chest muscles .... i have done all tests..and report suggests that my heart is in good condition.. my lungs is doing well too ..rib cage is in perfect shape .. i have gas problems !!!! plz help !!",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, possibility of GERD (gastroesophageal reflux disease) is more. GERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause symptoms gaseous burping, belching, chest pain, chest tightness, pressure, breathing difficulty etc. So follow these steps for better symptomatic relief. 1. Avoid hot and spicy food. Avoid junk food. 2. Avoid large meals, instead take frequent small meals. 3. Avoid stress and tension, be relax and calm. 4. Start antacid like pantoprazole on empty stomach. 5. Quit smoking and Alcohol if you have these habits. 6. Keep 2-3 pillows under head in bed to prevent reflux. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does pain in the upper back indicate?\n\nMy 44 yr old, 6 2 , 350 lb husband started with a pain in his upper left back a few days ago that has now expanded into his chest and his left arm. We have left a message with his physician, but it s been hours and no call back. I want him to go in and get checked but he won t without a Dr recommendation.",
    "doctor_response": "hi sir/madam,Thanks for your question on Healthcare Magic.Possible indications are:-1. Problematic kyphosis.2.  Scoliosis.3. Osteoporosis.4. Trauma/injury.5. Acid reflux (GERD).Upper Back Pain Treatments:-Pain relievers and anti-inflammatory medications may temporarily reduce pain and inflammation, but they do nothing to heal strained muscles or malfunctioning joints. They wear off after a few hours and the pain returns. Meanwhile, they\u2019re interacting with other medications you may take and creating unwanted side effects!Moderate exercise is certainly beneficial in helping prevent back pain; however, once the pain is present, that\u2019s a sign that something\u2019s not right. Exercising strained areas puts further stress on the muscles and joints, creating additional nerve irritation and potentially worsening the underlying problem.Trigger point injections are shots of local anesthetic such as Lidocaine administered directly to areas of acute pain. Like other pain relievers, they simply reduce pain temporarily without addressing the underlying problem.hope this was helpful.have a healthy day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in getting pregnant?\n\nhello, my husband and i are trying to get pregnant, but we hhello, my husband and i are trying to get pregnant, but we have been trying for seven months. i have never been on the pill, or anything of the sort, but it seems like the sperm come out of me too soon. could these be the problem. i am only 20 yrs old and he is 21.",
    "doctor_response": "Hi,   Thanks for the query.     I understand your concern.     1. Semen does come out after some time of sex. If you think it'early... try to lie down for half an hour ,with a pillow under buttocks. This would retain it longer.  2.pregnancy is possible only around ovulation (which is 14 days before the expected date of menses). Try to have sex 17th to 11th day before the next period date.   3. If no +veresult in one year... consult a gynecologist.   Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe jaw pain, swollen gums and headaches\n\nhave terrible pains in my jaws especially when I eat food whether its hot or cold I can chew only on one side. These pains make me grind my teeth together and get worse when i sleep, I can t seem to sleep its like i have swollen gums like a baby. It is really affecting me and my ear aswell I get headches too. What should i do? what do you recommend?",
    "doctor_response": "Hello,Your symptoms seem to be related temporomandibular joint and muscle disorder. The temporomandibular joints are the hinge joints on each side of your\u00a0jaw. Several things can cause TMD\u00a0jaw pain. I suggest using OTC medications such as Ibuprofen to relieve the pain. Cold compresses at the jaw area can also be helpful.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for golden staph\n\nI am worried about transmitting on golden staph/ msra and causing them a lifethreatening illness which could endi in death, as I would feel guilty if I had not done my best to prevent the spread .  My father is in an aged care facility and after a stay in hospital we were told he had golden staph.  The doctor said tha everyone can carry this bacteria from time to time.  I have read on line where it is carried in the nose.  Is it iside or the outside.  I have read that even to touch or rub your nose could spread the bacteria if it is there.  Has everyone got it in the nose? What is meant be colinization?  Aso how long does it last on clothes and bedding etc? Is and active infection the more likely form of transmission?  However if you can have it without knowing how can you ever be sure that your are not transmitting it.  What is the rational behind washing your hands because if it everywhere won't thay become contaminated again anyway.  Is it the degree of bacteria count present that is more likely to cause and infection?  I am really concerned as I have read it is on almost every surface so How can you be really sure that you are not transmitting the bacteria on others.",
    "doctor_response": "Hi XXXX Thanks for your query at HCM! I am Dr. Sheetal Verma an Infectious Disease Specialist answering to your query! I went through your query and understand your concern. The best treatment for Staphylococcus is by culture and sensitivity testing and taking appropriate drug like ampicillin, clindamycin, gentamicin, etc. Handwashing and testing for MRSA a resistant bug is also important. Hope I have answered your question. If you would like some more information I will be happy to provide. It would be kind if you hit a thanks if found helpful. You can also write a review for me. Wish you good health Take care!  Wish you best of Health. Dr. Sheetal Verma Infectious Disease Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get fair skin ?\n\nhi i have dusky complexion by birth but i want fair skin ... Is there a surgery for anti pigmentation so that my skin can be made artificially fair???",
    "doctor_response": "Hello. Thanks for writing to us. For lightening the skin color, there are different therapies like dermabrasion, laser based skin lightening procedures, etc. The extent of success depends on the present color of your skin and the extent of activity of your melanocytes. You can discuss these options with your dermatologist. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drtayalrakhi@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be worried of having a lump at the base of skull?\n\nHI, my eight year old daughter has a small lump at the base of her skull on the left hand side.  You can movie it around a little.  I also felt one in a similar spot on the right but it is a bit smaller.  She said it doesn't hurt.  I am panicking.  Am I being silly",
    "doctor_response": "hirelax there is a very simple way of getting this testedjust get a x ray of her skulland then a ct if requiredyou will probably be able to find what the swellings areif there is something you may need to get a biopsybut that comes at a later stagei suggest you be calmkids have a way of sensing your tensionget the testslet us know the reportlets take it from therebest of luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Would PTCA of LAD improve length and quality of life?\n\nI had a cardiac catheterization which showed normal systolic function, tandem severe mid LAD lesions with severe Diagonal disease, small diseased Left Circumflex; and very distal branch vessel disease of large RCA. I am taking all recommended meds and cardiologist is recommending I consider PTCA of the LAD. Would the PTCA improve my quality and length of life? What is recuperation from PTCA like?",
    "doctor_response": "hellothanks foe posting here. i have gone through your case history.going by your description, you have triple vessel disease. since the circumflex artery is small and diseased there is no need to stent it. also since the RCA disease is quite distal there is no need to stent it. the LAD supplies blood to 60% of heart muscle. since you have tandem lessons in mid LAD, your cardiologist has adviced to stent the LAD. ANGIOPLASTY has very good results. since if it's done through a small puncture through your arm or the leg, the stay in the hospital is not more than 2-3 days, some doctors discharge the patient next day also. also since your heart pumping function is preserved you have a very good prognosis. the quality of life is good, patients are usually mobilised on their own on the next day post angio plasty.after discharge the patient is asked to refrain from strenous exercises for 4-6 days, after which they can go about their normal routine including running and jogging. the recuperation and future quality of life is very good. please dont worry and go what with your angioplasty. Stents usually function well for minimum 10-12 years. however you must be very regular on your medications and do annual health check ups.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "I was 3 weeks ago diagnosed with hypertension 150/95 and my doctor prescribed losartan potassium. I have been on the drug for 3 weeks and I want to withdraw from the medicine. i don't want to be on medicine for life and it is making me depressed and suicidal",
    "doctor_response": "Hi,In case you have high cardiovascular risk, you should take the medication lifelong. In case your cardiovascular risk is low, the other option can be lifestyle changes for 6 months. If it doesn't help, only after it medical treatment can be considered.Your cardiovascular risk should be assessed. In case it is low, I would advise you to decrease the salt intake, exercise regularly, lose weight if you are overweight. You should avoid fast food and soda.Hope I could help youWishing you good healthIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can fever and cough in an adolescent with asthma be treated?\n\nMy 14 years son had fever and cough.he has asthma not on regular inhaler.he has taken antibiotics.fever reduced but not cough.This time he does not have any rhonchi or crepitations in the chest.His coughing sound is loud and only sometimes with mucus.Which cough syrup will be better for him?",
    "doctor_response": "please see your child needs antibiotics as combination of amoxycillin clavunate as tab augmentin 325 mg two timesplus steam inhalationand cough syrup syrup asthakind or asthared or piriton one tsp three times all these for 5 days if you have any further query then you can come back to hcm i will definitely help you and guide you appropriatelywith regards dr varinder joshi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can alcohol consumption cause heart pain?\n\ni've drank heavy alchohal the past 8 nights in a row, just with friends around this time of year. i am 22 years old, i have been a real heavy drinker, but ive been noticing little pains in my heart throughout the day the past 3 days. what causes this?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I would like to tell you that heavy consumption of alcohol causes serious health issues which involves temporary and permanent damage. Binge drinking is very common reason for heart failure and other heart\u200b disease. Kindly get a physician consultation for proper physical evaluation and management. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr Bhanu Partap",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why I am not getting proper erection?\n\nHi, I have had a problem... I m 25, very fit, and extremely sexually active... I have had sex with my girlfriend everyday for months yet last night I couldn t get an erection. It seems like the base of my penis and an inch upwards is flaccid when the whole tip and upper 2/3s is hard. I masturbated over 20 times yesterday could that have caused this damage?",
    "doctor_response": "HelloThanks for query .It is natural not to get hard erection after masturbation that too for 20 times.Wait and watch for a day or two .You will get hard erection as usual.Thanks Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Have small uterus. Need to lose weight. Given medication. What is likely to happen?\n\npls help us on this below issue.   1. Exact location is in the uterus not in ovaries  2. size is very small. while scanning they had shown to my wife dots and was also told that is too small and can be cured by if you can loose your weight. she is taking tables for  3. In July  her periods was delayed by 20 days and went to doctor. only at this time she had taken the scan and was adviced to take tablets(for periods and doctor told to her if you took this tables then only you will get periods every month).   i want to check if there are some natural cures. or what she has to do next. will this affect me in getting concieved? we have 5 yrs daughter, looking for 2nd child and her weight is 64 before 57",
    "doctor_response": "Hi thanks for your question.She has already given birth to one child and looking for the second. This is called as secondary infertility. Uterus cannot become small to such an extent after one pregnancy that it cannot hold fetus of second pregnancy. Obesity (more weight) does not directly interfere with fertility, however if obesity is due to some primary cause it can cause infertility, like hypothyroidism. If she has adequate height, 67 kg is not over weight not to talk of obesity. Your wife has already given birth to one child; she should be able to conceive again unless she has developed some other cause of infertility. I would suggest you to consult a gynecologist who may be able to evaluate her for secondary infertility and may treat her depending upon the cause.Hope this answers your question",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for frank hematuria\n\nHi I m 27,male experiencing frank hematuria for the last 7 years .i have done all the exams possible .but no unswers.im really worried because I can never know if the blood would come after the intercorse .and it never comes after masturbation .always after penetration.never with the ejaculation .its a lot of blood with big dry pieces.that hurt when comes of...my life is n stand by .no relationships and no plans for the future ...please help",
    "doctor_response": "Hi,Thanks for writing in.Treatment of frank hematuria is based on the cause for it.This might include, for instance, taking antibiotics to clear a urinary tract infection, trying a prescription medication to shrink an enlarged prostate, or shock wave therapy to break up bladder or kidney stones. If there is any problem with prostate and urethra like a stricture then that must be treated first.It is important to get imaging investigations like ultrasound scan and CT scan of the abdomen to know the origin of hematuria. There might be a stone anywhere from the kidney to urinary bladder causing the hematuria. It can also be caused due to any growth in the urinary tract or bladder. This should be investigated quickly and treated if present.If the underlying condition isn't serious, no treatment is necessary.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does elevated prolactin level affect health?\n\nI have a prolactin level of 149 according to my blood test results.  I had an mri done, they said that it grew but away from the nerves in my eyes.My endocrinologist put me on dostinex for treatement.  I wanted to know what else elevated prolactin affects...such as vision, headaches, weight gain?",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern.  Elevated prolactin level causes many problems.  If it is due to tumor than it will affect your vision. T produce mass effect and may affect your nerves. Prolactin level also causes infertility. Problem in your breast etc.So you should take treatment for that. Take treatment according to your doctor's advice. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do depo birth control shot cause muscle twitches?\n\nDoes the depo birth control shot cause muscle twitches? I've had several in my stomach and some throughout the rest of my body; however, I just had my second baby almost four months ago now and really do not want another so it has caused me to worry. I took a pregnancy test a couple days ago that was negative but jut concerned.",
    "doctor_response": "Hi, I think muscle twitches can happen due to calcium deficit.  So, you can take some calcium supplements.  It can be a side effect of depo also. So, it will go away with time.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a small lump on the front of the shin, a hematoma or a callous?\n\nMy son took a hockey puck on the front of his shin bone 4 weeks ago. It now appears he has a small lump right on the front of the shin where he took the puck. It is a hard lump, but he is experiencing no discomfort. Could it be a hematoma collected there, or callous material?",
    "doctor_response": "Hi ! Good morning. I am Dr Shareef answering your query. Even though a clinical examination would be more helpful, with the history described, most llikely your son did have a hematoma due to the trauma, which possibly got organised/calcified to give it a hard consistency. I would suggest you to show it to a general surgeon/orthopedic surgeon to be sure about the diagnosis, and furhter management if need be.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent loose stools in a child after being treated for typhoid fever?\n\nHi Doctor My 5 year old son was tested +ve for typhoid on 9th july & after that we had given antibiotic as per doctor s suggestion & doing well after 10 days or so but stool passing is twice or thrice a day.can u advise what could be the reason?the stool is semi solid.no blood with stool",
    "doctor_response": "Hi...semi solid stools while recovering from Typhoid fever is very common. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment. Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain at the site of triple by-pass surgery?\n\nI had a triple by-pass (LAD) back in April. I was told that they used mammory arteries to perform the by-pass. I am still having significant pain where I assume they used the mammory arteries, especially any time my heart rate increases whether I am exerting myself of just a stressful situation arises. Can you tell me why I am having so much pain in the areas again I am assuming are where they did the by-pass with the mammory arteries?",
    "doctor_response": "welcome to hcm ..pain should not persist for long there can be variety of causes at the said site as the infection or inflammation or straining of adjacent tissue or raised BP please visit your doctor who operated on you he will properly ascess you and treat you accordingly with regards dr varinder joshi",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat sore arm and leg in a 3 years old child?\n\nMy 3 yr old has a temp of 39.6 degrees, he is claiming he has sore arms and legs and he is lethargic. I have been giving him Nurofen every 6 hrs for the last 2 days and 1/2 an hr after he has the nurofen his temp drops but then it goes back up. What do i do?? take him to hospital?",
    "doctor_response": "Hi...what you quote I feel that the kid is having viral illness with myositis or inflammation of muscles.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. 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 15mg/kg/dose (maximum ceiling dose of 500mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What medicine can control itching after being bitten by a hairy caterpillar?\n\nHello doctor, I was itching all of a sudden today while eating dinner. I thought it would be a normal itch, so resisted itching. After around 70 minutes, when I itched on my groin and thigh area, it started itching too much and when I saw under my shorts, it was full of mosquito bite like appearance. Then, I saw one small hairy caterpillar on the outer edge of my trouser. So, this itching was because of that. I have included the picture of that insect. It is not the exact picture, but it is for your reference. I applied some salt and turmeric and washed with facewash since it was neem and soap two to three times and took a full bath. I consumed one allergy tablet as well. Now itching is under control. I want to know what should I do now and is there anything that I did wrong or should have done which I did not? No injections, as the hospital is very far. Also, I do not know if it crawled in my bedsheet as well. I will sleep on it. Should I change my bedsheet? Actually, due to some problem I cannot change it, so is there any way to wipe if it is absolutely required. I have one additional query. Should I always use an antibacterial soap if I have recurrent boils or folliculitis on my body? Can I use normal soap and shampoo? Can you recommend any antibacterial hair shampoo which can be applied to hair and one antibacterial body wash if there is any?",
    "doctor_response": "Hello. I have seen the photograph (attachment removed to protect patient identity). The insect could possibly be a kind of caterpillar commonly called as blanket worms. One may get reactions to its sting with rashes and urticaria. Apply Calosoft AF (Calamine, Aloe vera, and liquid paraffin) and could take a Levocetirizine 5 mg tablet to control itching. Consult your specialist doctor, discuss with him or her and with their consent take the medicine. You may require injections and antibiotics if there are sores due to its sting and if the rash is bad, you may need medications for a couple of weeks. Definitely, the blanket sheets and clothes need to be checked and changed. Please see a doctor to confirm the insect bite. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dialysis patient. Suddenly have sweating on forehead, hands, armpits, feet. Get cold chills. Cause?\n\nI am a 40 yr old dialysis patient. i have had my heart completely checked out and all is well. Out of nowhere i will break out in a sweat( forehead , hands, arm pits and feet ) and get cold chills. I take Sensipar for a high PTH. What could be the cause for this. Also my BP is usually in an acceptable range during these episodes.",
    "doctor_response": "Hi Check your sugar levels during the episodes to look for hypoglycemia. If the above symptoms are associated with palpitations you may need to get a Holter study to see if you are getting arrythmia episodes. Also dialysis catheter related infection needs to be looked upon as you get chills intermittently . Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cause for wetness of thigh and calf during femoral endarterectomy\n\nI had a femoral endarterectomy recently and now have a feeling of wetness on my thigh, calf and foot. This happens not only on the leg that had surgery but on the one that didn t as well. Can you tell me what this is and the reason for it happening? Thank you.",
    "doctor_response": "Hello,Please see a surgeon to evaluate whether you have any lump in the lower limb region. If there is no lump, then please get your Thyroid Profile done.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mohammed Abdullah",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could scraped bruise like pain in left wrist without any visible injury suggest?\n\nMy left wrist has a pain similar to a burn or scrapped bruise, but when I touch the area no pain can be identified. The pain has been with me for about a week. It is very hard to identify. Reminds me of when young when you skid your knee on a gym floor. This has no rash or visual identification. And when touched can not feel any areas that would get worse in pain when touched or pressure is applied, as if not there.",
    "doctor_response": "this could be carpal tunnel syndromeyou should seek help from a physical therapist ( apply untrasound , wax , deep friction massage)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for sharp pain in armpit\n\nI am having extreme pain on my left side slightly below and and to the right of my armpit. The pain does not bother me much when upright, or when working. (I am a carpet installer and do a lot of heavy lifting, etc.) The pain is worse at night if I try to roll over on my side in bed or on the sofa. Standing up is very painful, but once I m up it is not as bad. Sometimes, turning my head to the left, or back causes a lot of discomfort.I, m hoping it s a pinched nerve, or pulled muscle. The pain is very sharp, and almost immobilizing.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have  sharp pain in armpit. Well there can be many reasons for symptoms you mention in query like cyst , breast cancer , angina , bacterial or viral infection , allergic reaction or lymph node swelling . I would suggest you to apply warm compresses on armpit , take over the counter antihistamine like benadryl and take ibuprofen or acetaminophen for pain . Consult general practitioner for proper examination if the condition doesn't get improve . Doctor may order CT scan , mammogram , blood test and check tenderness and consistency . Doctor may prescribe antibiotics along with anti inflammatory and immunosuppressants .Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes not getting pregnant in 42 years?\n\nHi,   Im 42 years old separated and have BF.I have 2 daughters (with my ex)16 and 21 yrs old normal delivery . My bf want me to get pregnant again i want it too..But till now no hopes of getting pregnant again..is it because of my age? do i need to take fertility med? thank you",
    "doctor_response": "HI.We need to assess your fertility status, and we will be able to answer your questions only after that. But even if you do get pregnant, yours will be a risky pregnancy requiring constant monitoring and probably fertility meds as well.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in abdomen?\n\nIt all started as throbbing pain between the second and third finger of righy palm and coninued for a couple of hours . It then subsided and apparently manifested as an ulceric pain in the stomach . I slept after taking Alpras tablet and anti spasmindon tablet . In the morning the stomach pain has subsided to a great extent , What could it be ?",
    "doctor_response": "more likey it was a gastritis associated with GERD pain. gastroesophageal reflux diseas pain and contractile pain due to hyper peristalsis in bowel loops. u can take these medications along with adding of pantoprazole 40mg Once a day in morning before breakfast for 4-8 weeks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which hospitals in Delhi specialize in asthma treatment ?\n\nhi doctor my mother facing a problem of asthma last one year kindly suggest me best hospital in delhi .",
    "doctor_response": "Hello, Thanks for posting your query. You can consult any pulmonologist nearby. Just see that he has specialised in pulmonology post M.B.B.s. Any doctors with this degree are good. Hope I have answered your query. Wishing you good health. Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of ovarian cancer?\n\nHi I am 45 years old and had a partial hysterectomy 18 years ago. I started bleeding clots 2 weeks ago and pain increased significantly in lower left pelvis that comes and goes.  I have difficulty voiding sometimes not always.  So I went to the dr. this week thinking I had a UTI infection.  My tests said no UTI or bladder infection.  CT scan showed no kidney stones left ovary significantly larger than right and cysts on lower left pelvis.  My ob-gyne said my ovaries were OK?  I have family history of mother & sister ovarian ca and sister of bladder ca?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have family history of ovarian cancer. Symptoms of ovarian cancer are abdominal pain, mass in abdomen and other non specific symptoms.  You should go for CA125 test.  It is marker of ovarian cancer.  So if it high you should go for further investigation.  If it is normal then no need to worry. Just be relaxed. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever with extreme fatigue?\n\nI have had a fever for 19 days.  I don't have mono.  The results are not in for my CMV levels.  My b12 is very low.  I had a swollen throat on the left side for the first few days and it went away.  It is not getting a bit swollen and sore on the right.  My only symptom is being extremely tired.  I started taking b12 and am not as sleepy but my body is still so tired and sore.  My spleen hurts, and has ruptured before but encapsulated itself.  Any ideas?  I am going back to the doc tomorrow morning to get a b 12 shot and the cmv results.  The cause of the previous spleen rupture was cmv...",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have symptoms of fever with extreme fatigue this seems to be viral fever or flu. It happens due to poor immunity of body. Need not to worry. I would suggest you to take anti-inflammatory medications such as Ibuprofen to prevent fever and body-ache. Drink plenty of fluids, have proper rest. You should take muscle relaxant as well. You should do warm saline gargles on daily basis. Avoid cold carbonated liquids. You should not take fried, hot and spicy food.Do warm saline gargles. Take analgesic and take light diet. Your symptoms will resolve in 3-4 days. If symptoms keeps on persisting visit general physician once and get it examined and start treatment after proper examination and prescription. Go for blood tests as well.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does my SGOT and SGPT value indicate?\n\nHi doctor, I have tested for SGPT and SGOT. The result indicates that I have SGPT 214 and SGOT 197. Now what shall I do? Please suggest me.",
    "doctor_response": "Hello. There are a few things I am worried here:  Abnormal liver function test could be due to hepatitis C infection and non-alcoholic liver disease can occur as a result of cholesterol deposition in the liver or active hepatitis B infection or alcoholic liver disease. Also, you have high cholesterol, low vitamin D and B12. Are you taking any medication for this? 1. I suggest you to do the complete hepatitis B panel including hepatitis E antigen and antibody, hepatitis B core antigen and antibody and hepatitis B surface antibody. 2. Also, I suggest you to do the hepatitis C antibody and an ultrasound of the liver. I suggest you to take 50000 IU of Vitamin D once a week for 12 weeks and get B12 injection or 1000 mg of vitamin B12 daily for a week. Consult your specialist doctor, discuss with him or her and take the medicine with their consent. Revert back with blood and ultrasound reports to an internal medicine physician online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I get rid of these pimples ?\n\nhi i have pimples problem from past few years..my age is 25",
    "doctor_response": "Welcome to HCM. Pimples problems at this age is due to hormonal factor. Treatment depends upon your type of your skin otherwise you can apply clindamysin cream if you are not sensitive for it. Take care for local hygiene, wash your face properly. Avoid oily and spicy foods,avoid stress. Take good healthy diet. Consult dermatologist for better medical management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tiredness, depression, feels like starting of periods for a week. 4 weeks post operation. Opinion?\n\nI am almost 4 weeks post-op (laparoscopic myomectomy), the 5 incisions are healing well and I just returned to work after being out for 3 weeks. My problem is that I still feel extremely tired and just recently started feeling depressed. Also, my libido was extremely high pre-surgery now the thought of sex makes me feel ill. I had what I think was a period about 2 weeks after the surgery but I feel like I am about to start my cycle again but it hasn't. This has been ongoing for about a week now. Are these symptoms normal?",
    "doctor_response": "HelloPost surgery depression is a common thing. You are having tiredness, weakness, poor libido, lack of motivation etc symptoms and I would like to tell you that these are the symptoms of depression. Try to divert your attention in watching tv or reading good books. If possible exercise daily and practice yoga. These thing help to improve self confidence.Consult a Psychiatrist for management of depression if not controlled by exercise. Drugs like SSRI or SNRI are very useful in depression.Cognitive therapy is also a useful alternative. You can contact a Psychologist for this.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is lung infection medicines causing mild fever?\n\nMy Father 65 is suffering with Fever since one month. Slight tempreture till 100.5 F in the evening around 2-4 PM. He has been detected will Lung infection. From the time i have started medicating. Fever is coming frequently. What should i do either continue with medicines or look for other options.",
    "doctor_response": "Hi and thank you so much for this query.Medications rarely cause fever. However, if he would develop a fever shortly after receiving his medications, this may signal an adverse reaction to the drug. I would like that you get the drug reviewed If this is the case. However, if the fever has no time relationship to the medications, it would be very unlikely. Fever for a month may represent an atypical lung infection. Please ask your doctors what precisely they are treating at this time.I hope this helps. I wish you well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat back pain?\n\nHi, I have a strain on my back (just below the left shoulder). When I turn my head to the left or right side, It pains a lot in that area. There is also slight pain always even if I dont move. I applied Move this morning but it doesnt seem to have helped. Please let me know if there is any tablet or cream or any injection that I should take for this. Thank you in advance for your help. Regards, Noor +91 0000",
    "doctor_response": "Hello,I had gone through the case and found that it might be muscle spasm ,so take tablet Neucoxia 120mg twice a day and apply oxalgin or volini ointment and use hot water bag during rest. Avoid pillow and do mild rotation of neck.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard bump on top of belly button after laparoscopy?\n\nHi!! I had a laparoscopy 7 days ago to check for endometriosis. I just had incisions in the belly button. two days ago I felt a little hard pump on the top of my belly without pain, swelling and discharge. if a touch it hurt. Give me some advice , please!!!",
    "doctor_response": "Hello, greetings! Thanks for your query. You seem to be having a situation called hernia, where there is loosening/laxity of the abdominal muscles beacause of which there is spillage of contents below the layers of the stomach. I recommend you go to a general surgeon, who will gather up the loosened contents and enclose it in a wire mesh and will tighten up the lax muscles.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment for pain, bruising, swelling after knee injury?\n\nI had a fall 11 days ago. I fell on my right knee. It was immediately sore and swollen. I developed significant bruising on and around the knee within hours. I rested my leg for 3 consecutive days by elevating it. I applied a cold towel to try and stem the swelling in my lower leg. As the days progressed more of my lower leg became bruised and now some 11 days after injury I have total bruising from about 3 inches above the knee to my foot and into my toes. I  also have significant swelling of my knee to my foot.  i have been hospitalised in the meantime because the pain from the bruising and swelling got unbearable and I was concerned that I would exacerbate dvt which I previously had in my leg. I have been taking Xarelto tablets for the past few months and I think this has also contributed to the severity of my injury. I am on antibiotics at the moment for the swelling and bruising. I have returned to work and now have ongoing pain, bruising and swelling.  I try to elevate my leg as much as possible at work as well as at home. Is there anything else I can be doing to recover from this injury and heal quicker. I should also note that the leg has been xrayed and an ultra sound done which have confirmed no break but a small amount of fluid in my knee with no evidence of dvt.",
    "doctor_response": "HiGood that DVR been ruled out.Traumatic synovitis of knee and infection spreading down the leg is unusual,however.There should be culture and sensitivity test of fluid aspiration to know offending microbe, bacteria.Certain android bacteria are fulminating causes and tough to treat.culture will give a. Clue for organism and suitable antibiotic may then be selected.If I were to treat, I would proceed this way and add infusions of metronidazole 8hourly for covering android microbes too in addition to other broad spectrum antibioticsDo some knee strapping for support and discuss what I suggest with your doctor if possible",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment to be taken for the gastric problem for new born?\n\nMy son was born 12 days ago and for the last 2 days we are having problems with gas pains. He is being fed Similac sensitive which is intended for gas but is still suffering. He will cry for several hours at a time turning red in the face and tensing up his abdominal muscles passing gas every so often. I have tried massaging is belly and doing the bicycle leg motion which seem to help the gas pass but do not relieve the pain. Both parents have no known allergic reactions. I am wondering if giving him simethicone gas relief drops like Pediacare or Little Remedies or a product like Tummy Calm or Colic Calm would be safe? If he is awake and moving around after feeding there does not seem to be a problem with the gas, it is only when he is in his sleeping hours and doesn t get enough movement in to help push everything in the right direction. He was born 3 days late with no complications and is healthy.",
    "doctor_response": "Thank you for the query.It seems to be lactose intolerance. kindly pay attention to the timing of pain with feeding.Mother should be fed wholesome diet without chilies.Simethicone is quiet safe for some times but not to be used routinely.You can try putting baby on belly while sleeping it will help get rid of gases.It is still advisable to check with a pediatrician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painless lump infront of the ears?\n\nHi a day ago i found a pea sized lump in front of my left ear and right before my jaw it is hard painless unless i touch it. My family thinks its a cyst. I also had a stomach virus a couple weeks before so i dont know if that has anything to do wiith it. Thank you.",
    "doctor_response": "Welcome to health care magic. 1.Pain less tiny lump in from of the ear - the possible cause will be sebaceous cyst. generally needs to monitored unless causing any discomfort.2.They occurs when the gland blocks and causing the collection with in - usually take good time ( years ) to increase in the size.3.In this case the i would recommend you not to disturb the lump, do not squeeze, press or scratch - in that way you will complicate the process.4.There is no relation with the stomach symptoms you are facing, a very tiny possibility is enlarged lymph nodes due to stomach cause - but lump characterisation does not fit there.5.If any discomfort get it examined and take needful actions accordingly. Good luck.Hope i have answered your query,any thing to ask do not hesitate to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of lump of skin on my lip?\n\nI have an extra lump of skin on the left upper side of my lip. A long time ago my lip got swollen and due to the stretching there has been an extra lump of skin. Its upsetting to look at and is pretty noticeable. Is there any surgery or anything I can do to remove it and get my lip back to normal?",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query.Yes, there are many advancements in Plastic Surgery which could change the way your lip looks and as such the way some one looks like. Therefore, I would advise you to consult a plastic surgeon in your area who might after some routine investigations would take you up for a surgery to correct the abnormality.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I having sharp pain in my chest and left arm and neck?\n\nI have low blood pressure and some disorder where the low blood pressure leads to a lack of blood in the back of my brain. But recently I have started to have severe sharp chest pain and I also feel it in my left arm and neck. It will stay for a few minutes then go away leaving a dull pain in my left arm and neck. I am 24 years old, female, I smoke, and have an alcoholic beverage occasionally.",
    "doctor_response": "first thing to be done is quit smoking and alcoholprobable diseases can be -gastritis - peptic ulcers- cardiac diseasesyou need to visit a physician who can get a chest X-ray and an ecg and if needed an endoscopy to rule out the diseases and can prescribe you some medications .if ecg is normal and cardiac disease is ruled out he may prescribe you a proton pump inhibitor like pantoprazolethanksfeel free to ask more questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lumps in arm pit?\n\nHi,a couple of days ago I noticed a dime size red mark on my right armpit/ side breast. It is not tender or painful, when I touch it I feel a small lump inside. I do not notice any infection or white head. It is right in line with my bra wire. I have also been working out while wearing wired bras.",
    "doctor_response": "Hi,,From history it seems that there might be having friction bump due to bra wire or some allergy to synthetic bra strip.Wear cotton bra.Avoid tight bra and wired bra.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have no STD symptoms. Should I still get tested before I meet my wife?\n\nHello doctor,Due to work, I have been away from my wife for more than two years. I had a few sexual encounters with sex workers here. I had unprotected oral sex and protected vaginal sex twice last year, protected oral sex and protected vaginal sex once last year, unprotected oral sex and protected vaginal and anal sex early this year, and protected oral and vaginal sex last month. I am going to visit home soon and I am very worried about passing on any infection to my wife. During the period of these encounters, I had a severe rash\u00a0on my chest eight months ago. I have seen a dermatologist and she ordered a blood test and then treated me with two anti-allergic shots. I had this before as well. The skin allergy is a problem I had for years, but usually in the belt area. I was reading online regarding the potential risk of STDs like herpes, syphilis, gonorrhea, HPV, and viral hepatitis. I am really concerned now and want to go for a full test, but this is pretty expensive. So, do I need to get tested considering I did not have any symptoms but the rash I mentioned above?",
    "doctor_response": "Hello. I read your query and understand your concerns. I hope this answers you. Feel free to write back to me if you have more questions. Thanks and regards. For more information consult a sexologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hair loss & headache post vacuum delivery?\n\nHello i am 25 years old,165 height,66killo,i dont have any medical history i dilver in vacuum assistant, its alsmost four month & 3weeks after i gave birth but now my hair,my eyelash start falling i also have a headache with out fever but i dont know why this happen  i need your help.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As per your case history you are having post partum hairfall. My treatment advice is - 1. Use a good herbal hair oil and shampoo for routine use. 2. Take good nutritious diet full of green leafy vegetables and milk. 3. Take an iron supplement and vitamin B12 supplement once daily for 3 months. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Knot on roof of mouth, diagnosed with trigeminal neuralgia, pressure in teeth and sinus. What is the treatment?\n\nI have a knot on the roof of my mouth tha has been there for a few months and Ive been to the dentist before i discovered the knot and just felt the pain they said i didnt hve an absest and didnt see anything on the xray. Everytime inpush on it i can feel pressure in my teeth and sinus. I have been diagnosed with trigeminal neuralgia but wasnt sure if u can have aknot on the roof of your mouth from this. Any help would be greatful",
    "doctor_response": "It was very good on your part that as soon as you noticed the swelling on the roof ie called as palate in the mouth you went to the dentist. But as the dentist has told you that it is a trigeminal neuralgia I doubt on it, as in this disease patient experience a very severe, sharp and lancinating pain that lasts for few seconds only and no type of knot is present in it. The knot which is present on the roof it might be an infectious swelling that has been arised from the caries or any gum problem in the tooth, consult a good dentist and go for root canal treatment that is RCT in the tooth it might get relieved.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had negative reaction with fluconazole for yeast infection. Have elevated liver enzymes. Can take high dose of Acidophilus?\n\nHi Dr. Grief. My Mother is on a variety of medications for various conditions such as: isosorbide mononitrate Colcrys (colchicine) Iron Sulfate (ferrous sulfate) Lasix (furosemide) Protonix (pantoprazole) Prozac (fluoxetine) Toprol-XL (metoprolol) Insulin and she was just prescribed fluconazole for a yeast infection (not vaginal but in her system) but from what I can tell that particular drug has a negative interaction with several of the medications that she currently takes. She also has some kidney issues as well as possible elevated liver enzymes so I am leery about giving it to her. Can I give her a high dose of Acidophilus (lactobacillus acidophilus) for now, until I can speak to the Doctor on Monday. Please advise as she is uncomfortable and I would like to help in some way. Thank you in advance for your time! Regards, Dorian",
    "doctor_response": "Dear Friend.Hi , I am Dr Anshul Varshney , I have read your query in detail , I understand your concern.Lactobacillus are probiotoc , can be given to your mother. They are helpful bacteria not harmful.They are not going to aggravate yeast infection.However , giving it is not important this time.At present she needs evaluation for her liver and kidney problems.Wish her a speedy recovery.This is my personal opinion based on details available here.  If you want to discuss your issues further, you may please ask usStay Healthy. Dr Anshul Varshney , MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "72 years.  Recommended chemo after finding 2 positive lymph nodes post lung cancer surgery.  Can the body tolerate the therapy?\n\nMy mum is 72 & recently in may has had lung cancer due to smoking, she had had her surgery in may, now in july she has had the follow up visit back with her surgeon & everything healing well, they removed the tumour & 18 limph nodes, but 2 came back positive they are recommending chemo, 4 seesions over a 12 week period. My mum has no other problems what so ever, she in genrally a very active lady. Do you think she will cope with chem therapy, is she strong enough, she has never been in hospital prior to this & having 4 children, she is quite concerened with the side effects as well.  Please resond.  Thank you",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum. Please remove misconception from your mind that a strong patient can tolerate chemotherapy. Chemotherapy is necessary for  your mother as doctor has recommended , so please get in full course. 2nd thing in chemotherapy usually blood cells decreases , so doctor will  supervise it. Next point in chemotherapy patients feels  nausea and vomiting , so take care about that. Hope I have answered your question. If further any question I will help. Good luck for your mother. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do I have an eating disorder or am I just overreacting?\n\nI think I may have an an EDNOS eating disorder.. I am 15 and I found out that I was moving to a new state right after my father went through a big alcoholic phase.I have lost interest in many things and I have very weird sleeping habits and now I don t eat breakfast, lunch and dinner (i only eat dinner when my family makes me sit down and eat with them) otherwise i just have a small snack.So do i have an eating disorder or am I just overreacting?",
    "doctor_response": "Dear Anonymous, We can not and DEFINITELY SHOULD NOT, make any diagnosis, let alone a very non specific and vague diagnosis such as Eating Disorder Not Otherwise Specified (EDNOS)----all these NOS diagnoses in both ICD10 and DSM IV classifications are called \"waste basket diagnoses\" by us practising psychiatrits......as they are only made after exhaustive work ups and still not finding the right diagnostic or label to give. From the brief history you have given it seems you do have a eating problem....your age, your apparent intelligence (15 years old self diagnosing with EDNOS), your gender, your life phase transition/maturation problems, all seem to support this......but weather they are significant enough or broad enough to be given a diagnostic label needs a thorough history taking. Please ask your parents or carers to take you to a psychiatrist. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will too many abortion pills affect future pregnancies?\n\nHi, we are 2 yrs old married couple. Recently we faced a problem. My wife s Period was not starting in this cycle. So we had done urine test through Preg Detect and it Positive. Thn we use abortion pills and its 2nd time we use these pills.... My quistion is that these aboration pill will it be effected to next time pregenancy ya its harmfull...????",
    "doctor_response": "Hi,I understand your concerns.Following is my reply:1) Too many repeated pills are harmful.Let me know if you need anymore help.Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How often can Methylprednisolone be taken for backache?\n\nI started methylprednisolone (4mg tapered pack) this morning for unresolved post fusion back pain. If this helps my pain how often could I safely take this steroid for chronic pain? What do you think is the safest most effective amount? I m 68 and weigh 138 lbs.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You can take it for 10 -15 days safely . I hope this information has been helpful for you Regards, Dr. Praveen Tayal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever,vomiting and burning sensation on skin?\n\nHello. My mom has been suffering w/ an issue for about 5 years now. It appears that almost every time she travels when she returns she becomes sick. The symptoms are as follows: vomitting, feVer, redness (breast, back, and legs), has burning feeling on skin. Then the last of the illness sHe breaks out in chills (begins sweating and skin gets cool). Do you know what this might be? She's been hospitalized twice and has been to a few doctors, but nothing.  Please help!",
    "doctor_response": "Dear ,This is Dr. S. Tomar from healthcaremagic.com's medical team and I ll be your medical adviser for this question.First of all thank you for sharing your concern with us and showing trust on us.A weak immune system is always more prone to get any kind of infection . As you have noticed that your mother becomes sick after she travels then it shows that her immune system is weak . Stress , tiredness further makes the immunity more weaker . I would suggest her following:1. exercise regularly 2. eat a healthy diet3. sleep 7 hour daily4. practice yoga/deep breathing exercises5. get checked for diabetes , malaria , immunity profile , lyme's disease 6. for itching/skin manifestations/redness  can use OTC Loratadine.7. include multivitamin in diet .This is my initial response and discussion is open until you have any query or need further clarification.I wish you good health .sincerely,Dr. Shardendu Tomar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does BP level of 96/54 suggest?\n\nYes, I am trying to ascertain if a blood pressure reading of 96/54 is optimal or considered too low.I am currently taking blood pressure medication.Additionally, with a reading comprable to mine, would taking Viagra be dangerous or detrimental?...Mark.",
    "doctor_response": "Hello the blood pressure reading mentioned are considered low particularly when you are taking blood pressure medications . So a review with your doctor to decrease the dose and titer your blood pressure medication regime is justified in your case . Optimum pressure range should be man tinned atleast above 110 / 70 for beat health benefits.  If you are not on any nitrate based medication then you can safely take viagra , however if you are taking any likewise medication viagra is contra indicated.Last viagra can further decrease the blood pressure and so adequate hydration is justified.  Regards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any treatment in Ayurveda for cure of blocked fallopian tubes and increasing the production of eggs ?\n\nHello Am 35yr old married for last 4yrs trying for a baby for almost two years h Hello Am 35yr old married for last 4yrs. trying for a baby for almost two years h/ever unable to conceive. There are many reasons a) my fallopian tubes are block, got lapo-hystro but not useful. Doctors were unable to remove the blockage b)i don t produce egg and even if i do it is very less in nos. took medicine, not very helpful C) Last month we got IVF done, could produce only 2 eggs which didn t fertilise. We want to know if there is any solution in aurveda , pls help. thanks for your help . wbr SS Jadhav",
    "doctor_response": "Hello Mrs Jadhav Welcome to health care magic. I understand your concern. But as you know structural malformations cannot be corrected by any alternative mediicinal systems like Ayurveda/Naturopathy/Homeopathy etc. However the ovulation can be improved to a greater extent also the quality of eggs. I would suggest you to visit a Panchakarma ayurveda center to avil the benefits. Also practice yogasanas regularly to improve the circulation to ovaries. Dr.Sneha Sama wellness clinic Disclaimer",
    "dialogue_context": ""
  },
  {
    "patient_message": "How are heptral tablets to be taken?\n\nhello i am taking haptral tablets 400mg as i have been shown hepatitis b positive .i just want to ask .should i take this tablets before meal or after meal and my hbeag is negative and anti hbeag is positive .and hbvc total is positive  so is there any chance to get cured pls let me know my direct bilirubin is 0.8 & indirect is 1 total 1.8 sgot is 66 &sgpt is 105 and hbsag is positive pls let me know and i am on a noraml diet except oily food and fried foods",
    "doctor_response": "Hi, Thanks for posting in HCm. I understand your concern. Heptral contains is an oral amino acid preparation containing S-Adenosyl-L-Methionine (SAMe). SAMe plays a role in the immune system. Dosage: Starting with a low dose (for example, 200 mg per day) and increasing slowly helps avoid stomach upsets. The medication should be taken on empty stomach. The tablet needs to swallowed as a whole and should not be chewed or crushed. Daily dose should not exceed 1600mg. Kindly do follow-up with your consultant as per specified after taking the treatment. Hope the information provided would be helpful. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the alternate for lactogen?\n\nI am adopting a baby girl from the Caribbean. She is 2 months old. She is currently on Lactogen Gentle start. Since it is not readily available where I live can you suggest an option for me that would be comparable? Enfamil and Similac are available but was not sure which would be a better comparable option? I am trying to minimize her transitional stressors during the adoption. Thank you.",
    "doctor_response": "Hi,Thanks for asking the query,      Other than this cow milk or skimmed milk would be a better option.or else give diluted goat milk.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can prednisone cause rashes on chest and armpit spreading to leg?\n\nHi, i am a concern parent that has her son in florida state. He has develop a horrible rash on his body. He does not have an Family Doc and has gone to 3 walkin clinics. One in Tn, and 2 in Fl. I am trying to make the right choice of whom to see. An allergist, or an dermatologist. His Job requires him to travel. He has not gotten relief and going on the third day today. The reason he checked in in Tn was for bad headache and his lungs hurting. He was told he got a bad flu virus and that many walked in with same symptoms. No rash at this time which was last thursday. Prescription was prednisone. The rash began three days ago in Florida where he resides. He travel due to his job almost every week. Rash showed up on chest and armpits then spreading now to legs, groin and face. Went in to 2nd clinic, Another prescription and ointment. then the third same day late evening.. NO help. was told they could not do anything for him.. Do not wish to go to another walk in now..",
    "doctor_response": "HI, thanks for using healthcare magicA dermatologist would be the better option between the two. A dermatologist can treat any type of skin disorder including allergies whereas an allergist would only treat an allergic reaction.The rash may or may not be due to allergies.Since he has the flu, it is possible that the rash is related to it, a viral exanthem. This is a skin reaction that can occur with viral illnesses.It normally resolves as the viral infection improves.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "How safe is taking Bactrim for lung infection?\n\nI have been taking Bactrim for several months with two other medications for lung inflamation. I have had a horrible taste in month mouth the entire time. I originally thought that it was from the Prednisone but I m off that now and the problem is still with me. I take 3 per week. It appears to me now that it s worse the day I take it. I am also still taking Azathioprine 150mg per day. I also have nausea. I can t stand to eat anymore because everything tastes the same, horrible. I am getting very depressed. My doctor said that it can t be the Bactrim. Please advise. Thanks, Romayne",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, \"Bactrim\" is antibiotic and it works only when it is infection if this is not infection then it wont here, you have not mentioned the clinical symptoms any more, taking antibiotic without any indication is not at all advisable, better wait for some time stop all the medicine you are having, no need to worry about it, everything would be fine, hope this information helps, take care have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the spine and shoulders, stiff neck. Had an accident in the past. Advice?\n\nI have been experiencing a lot of pain under right shoulder blade, tender to touch, the pain extends to my right elbow. Also been having a lot of neck stiffness. What can this be caused from and what can I do to alleviate the pain, it wakes me up at night. Started just being at night and right when I wake up but has been getting worse and constant throughout the day. I injured that area back in 09 in car accident, nothing too serious, I believe just a really bad sprain/strain and whiplash. Fell and hurt that same area this past January, my arm was jerked really hard, noticed that sharp pain in shoulder and elbow right away but figured it was sore from the fall but this past month, the pain has returned ten-fold. Seems to get worse when resting, also forgot to mention mid-spine is very sensitive just a light touch to the area makes me yell in pain and almost brings me to tears. It feels very numb and tingly in that area. The pain is constant, all day and is worse when inactive. I woke up twice in horrible spasms last night. Took 10 mg s of flexeril right before bed with 20 mins of heating pad.I m 29 y.o no MRI or Xray, Dr. Wanted me to try P.T for a few weeks to see if I improve, going on 2nd week, no changes, may be worse actually. RX d muscle relaxers and on steady dose of anti-inflammatory, no redness, shoulder feels swollen from tight muscles.",
    "doctor_response": "Hi friend, Welcome to Health Care Magic It is highly suggestive of nerve root irritation. You need an MRI of the spine for definitive diagnosis You have not stated your personal habits, family history or co-morbidities, even age, gender...they could have an influence on the diagnosis and outcome... Non Steroidal Anti Inflammatory Drugs like ibuprofen reduce pain & inflammation Warm compress - help Physiotherapy helps Gabapentin and/or antidepressants - they raise the pain threshold... Take care Wishing speedy recovery God bless Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat dizziness with high BP?\n\nI am 71 years old, I had surgery on my eye on Thursday , post surgeoory med , includes Prednisolone acetate, I notice , I was feeling dizzy, I had my blood pressure take , it measured 130/ 140. I also have a heart stent, should this reading be of much concern?",
    "doctor_response": "Hi Welcome to Health care magic.I understand your query and concern.You certainly seem to have uncontrolled blood pressure.This warrants further investigation in the form of renal angiogram,since resistant hypertension to more than 2 drugs points to secondary hypertension.Its always safe to maintain blood pressure under 125/80 mm of hg.CHF revealed on echo needs correction with drugs like dopamine and dobutamine along with diuretics.This should keep you BP under strict control.Restrict the intake of salt to less than 6 gm/day.Repair of renal artery stenosis with stent will help to cure the disease.I advise you to have a baseline 2D echo and ECG on semiannual basis for better cardiac assessment.Consult an expert cardiologist for further help.Post your further queries if any.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does asthma with painful breathing suggest?\n\nI have a seven year old child that is 7 years old. He has been diagnosed with asthma. His xray showed airway disease.  He is constantly complaining he can't breath, yet he is breathing.  It is like he can't take a deep enough breath. He also says sometimes when he breaths it hurts his belly.  He is on a liquid steroid for a few more days and has been taking his inhaler every six hours. I don't understand why he says he can't breath, yet  he is breathing. He says its hard to breath. Could it be more than",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your son's history.If his asthma is controlled with inhalers and steroids, he does not have wheezing or fast breathing and still he complaints that he can't breath, I would first think of nasal or nasopharyngeal obstruction, the common causes are allergic rhinitis, sinusitis, nasal septum deviation and adenoid enlargement.I would suggest you to consult an ENT surgeon, who will examine his nasal cavities and may suggest you some investigations including X-ray to identify the cause. However, if he is having active wheezing or fast breathing or constant coughing, I would think his asthma is not well controlled yet and would suggest you to increase asthma medications after consulting your pediatrician.Hope this will be helpful to you.Wish your son a quick recovery and best of the health.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does high WBC and RBC count indicate?\n\nI had multiphase bloodwork done and got results back. My RBC was high at 4.84. WBC was 9.8. Also high were both bilirubin numbers, total was 1.0 and direct was 0.4. What does this indicate? Last tests didn t show these problems. I am a 59 yr old female",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Your rbc, wbc and bilirubin all counts are within normal range. No  to worry. Just be relaxed. No any treatment is required for that. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I-pill cause a thick white fluid to come down while urinating?\n\nHello doctor.",
    "doctor_response": "Hello. Please describe your problem. Revert with more information to a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have pain in the shoulders, chest, back, neck, hanks and arms. Had a spine surgery after an accident. What should be done now.\n\nI am a 38 year old woman and I was in a car accident in 2011, which led to compression burst fractures of T-4 and T-5. I had surgery a year later they put in rods, screws, a cage, and done a spinal fusion from T-2 through T-8. While testing before the surgery they found I also have osteoporosis of the spine, stenosis at multiple levels, degenerative disk disease and kyphosis. Anyway during surgery they found the spine wasn't straight and that it was worse then the MRI and X-rays showed. The Surgeon told my husband and family that he couldn't get the spine completely straight and the hardware could never be removed. I have been having lots of pain in the shoulders, chest, back, neck, hands and arms. At times my hands and arms feel like they are asleep and or I could be holding something in my hand and just drop it like my hand isn't even there. I can get cut doing dishes from a knife or burn my hands and not even feel it! When lifting my arms up or reaching something in my back, well the best way I can put it is, it feels as if something is pulling, snapping, and popping. I have been on Norco 7.5mg for 2 years now at first they were helpful but now they don't help at all. As of three weeks ago the doc decided to take the pain meds and told me to take Ibuprofen and over the counter Tylenol. Which I am having to take 1600mg of ibuprofen every 6 hours and 1500mg of Tylenol every 4 hours and that just puts me to sleep it does nothing for the pain. I think the surgeon believes it should all be better and refuses to listen. My back burns,pulls, feels like I am being stabbed from the inside out, and just plain hurts all the time, so I went back to my surgeon whom without any new x-rays or anything, in fact the last tests he done was 3 months after my surgery and they havent even tried sending me to physical Therapy. This same doctor now tells me they need to go in and take the hardware out. I reminded him of his previous statement about the hardware havin to stay in and he replays it will be fine. My questions are is this anywhere normal, what could happen if they remove the hardware? Will i be in worse shape then I already am? Should I even consider doing the surgery to have it removed? I am very confused and in so much pain that it effects everything in my life. Anyone with any Ideas? Anything Please!",
    "doctor_response": "Thanks for writing to us.I understand that you had thoracic spinal fusion for fracture vertebra. If possible please upload the xrays pre and post surgery to know more about the spine. Spine implant usually not removed unless there is a complication related to it. First of all we need to know what is the pain generator? Whats the situation of the implant? If your spine is fused then implant removal can be done provided it needs to establish that thats the pain generator.Please upload the xrays and also get a fresh ct scan of spine. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes anxiety and blood in stool?\n\ni have three 62 year old males in office with chf, cad, dm2, ckd2, hypothyroidism, anxiety and a-fib. one is on lasix had 2 stents placed in 2009 on metoprolol. on metformin and lantus and lisinopril for dm2. last bun and creatine was 24/1.3 in may 2017. taking synthroid with a tah of 3.1 in may. anxiesty is uncontrolled and no kedications for 2 months. a-fib on metoprolol and coumadin with a inr of 3.7 in may having complaints of more anxiety, bleeding on and off with bowel movements and diarrhea woth augmentin for his sinuses. the second patient had an echo in febuary with an ef of 50% on lasix and kci. had 3 stents in 2001 and 4 in 2012, and on lisinopril. dm2 uncontrolled with humalog and levemir. last a1c was 8.9 in april. last bun and creatine was 29/2.1 in april, tsh 1.2. ablation in january nsr now and no medication. having complaints of palpitations several times a day. he has been very thirsty but has been working in his garden alot. he no longer has to get up at night to uriniate and is now having more lef cramps. the third patient had an echo in 2015 with an ef of 30%, currently not on medication for it but has taken lasix in the past. last cath was in 2015, with 40% stenosis, lad. dm2 improved with diet. last a1c 6.1 in june 2017. previouslt on levothyroxine for hypothyroidism with a tsh of 4.1 in march 2017. was taking lexapro for aniexty now controlled wirh excercise. a-fib controlled heart rate of 65 today worh no medications. patient states he has been working hard to change his lifestyle and changed to a 100% wholefood, plant based doet. stopped taking his meds four months ago. complaining of being more lethargic recently. have constipation again and his memory is getting worse. who is the most important patient of the three patients and why?",
    "doctor_response": "Hi, Anxiety can be an inner feeling of bad happenings or outside situations which leads to it. Blood in the stool can be due to a local injury, infection or internal bleeding. There are many causes. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for irregular heart rate\n\nhi i am a 21 yr old female with pretty healthy lifestyle im a vegetarian and my main source of protien is fish. About two years ago i was startled in my sleep by my room mate and it made my heart rate rather irregular. Since then anytime i am startled in my sleep it takes forever for my heart to return to a normal rate. I have had a few stroke scares due to tingling in my left arm and entire left side of my body after having tests ran catscan and blood work they found no sign of stroke. The other night i was again startled in my sleep and it took a while for my heart beat to return to normal as usual. But shortly after i started feeling this awkard pressure in my head and it wont go away im just wondering if anyone has an idea of what it could be",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Most probably these are ventricular premature complexes. These are ectopic or extra beats. These are usually benign and not life threatening. These are frequently associated with MVP, also caffeine, alcohol, thyroid problems, stress may aggravate these. So before going ahead we need to confirm it. Since these are not frequent ECG may be normal, so in that case you ll need 24 holter monitoring which can diagnose these. You should also get thyroid test done. You ll beta blockers to control these. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal tenderness with pain against brushing?\n\nIm male, 35 years old, 5ft 11, 17st, ive got this area on the right hand side of my stomach which is really tender to touch but if pressed it doesnt hurt, but if you brush against the area lightly it hurts, please put my mind to rest to what this problem is?",
    "doctor_response": "Hi.Thanks for your query and an elucidate history..You are getting tenderness only for the brushing or just touching.The most probable causes are:Shingles meaning Herpes Zoster.Disc compression in the thoracic region.Neuritis of some sort, may a times these are idiopathic meaning no definite cause can be found on any of the clinical or lab investigations. The treatment is done after investigations:MRI of the thoracic spine.Neurologist's opinion.To check for Shingles This can be surgical if the disc is causing too much compression.Medical like tablets of Amitryptiline or gabapentin only if required. Be assured once your Neurologist opines so.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Took adderall, tongue feels swollen, swelling below adams apple, hurts. Is this an allergic reaction?\n\nHi. Im in college and it s finals week. I just took adderal for the first time ever. I took it Tuesday dec. 10th at 10am and now, 1:53am on Wednesday the 11th my tongue feels swollen, theres swelling below my adams apple and when I swallow it kind of hurts.i still have my tonsils and about a year ago I had a really bad case of tonsillitis. Is this an allergic reaction? Or something else?",
    "doctor_response": "Hi and thank you so much for this query.I am so sorry to hear about these symptoms after taking adderall. These symptoms are very unlikely to be related to a side effect of this drug, This may very much represent acute tonsilitis or pharyngitis. I will suggest that you get this looked into and treated accordingly and don't just ascribe it to possible side effects.Please, i understand the reasons for taking adderall but it never makes it a god idea. That is a substance of abuse and doesn't settle good. it can make you prone to future substance abuse.II hope you find the above information helpful.Thank you so much for using our services and please feel free  to request for clarifications or ask for more information if need be. I wish you the best of health.Dr. Ditah, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it fine to take Bifilac Dry Syrup, Carmicide and Actibile for pus in stools?\n\nNamaste!! I have a son of 14 months. He has a problem of diarrhea. He suffers from this problem every months and sometimes even twice in the same month. Doctor advised to have stool test and there seen mucus and pus cell 4-8. Recently, the doctor has advised Befilac Dry Syrup, Carmicide and Actibile 75 Tab. Are they ok for his treatment. What should I do for his well treatment. Plz, help.",
    "doctor_response": "Hi...recurrent diarrhea need not be worried about if the kid's weight and development and urine out put is good. Kindly mention these entities in your question and get back to us.Coming to your queries - 1. Bifilac is a probiotic and it is harmless2. Carmicide and Actibile do not have any scientifically proven benefits with regards to recurrent diarrhea, so you may avoid them after discussion with your pediatrician.regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ear infection in an infant\n\nI have a 10month old who has had 2 ear infections that are discharging puss. dr says her eardrum is swollen and she failed her hearing test for that ear. im wondering if tubes are the best answer or if I shoukd wait till the swelling goes down and redo the hearing test",
    "doctor_response": "Hello. I just read through your question.It is still premature to consider tubes for your baby's ears. It is a good idea to repeat the hearing test after the swelling has gone down. However, if the ear infections continue, I recommend consulting with a good pediatric ENT.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low blood pressure\n\nSir, my is suffering from low b.p. since last 5 days and has a fear of death. It happened once earlier when she gave birth to my first kid who is now 6 years old. The Psychiatrist suggested Chlonotril 0.5 tablets at that time. Whenever she gets depressed, she uses this medicine. Now, even after using medicine for improving b.p. and chlonotril 0.5 simultaneously, her condition is not improving. She is 33 years old. Kindly advise what to do now.",
    "doctor_response": "Hello, I understand your concern and would explain that Clonotril can help reduce anxiety, but it can lead to chronic fatigue. It does not affect blood pressure values usually. Nevertheless, I recommend increasing salt and water intake and discussing with her doctor on the possibility of starting an antidepressant, which can help against depression. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low temperature at night after fever?\n\nmy son is 7month and he has had a fever for days up to 101.2 but now his okay but concern about his body temperature taken on his armpit. Temp is between 96-97 during the day and drops at during the night to 94-96. Im concern do i need to take him to the doctor? He s all bundle up at night but his temperture is still low.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.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.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chronic pain in upper abdomen, vomiting after food?\n\nI've been feeling ill for months.  Feel sick immediately after eating - sometimes I vomit - sometimes I manage to keep it down.  I have bloated upper abdomen all the time.  I get chronic pain in my upper abdomen that lasts for a few hours - if not all night - this pain does not go away with pain killers.  My doctor suspects an ulcer and has tested me for H pylori and a full blood count.He has written to me to ask to repeat the full blood count and has not told me why.  I have rang the doctors and they will not tell me why the retest is required as the doctor wants to see me by appointment himself - I can not get an appointment for over a month.  Im scared this could be cancer.  WHy cant they just tell me on the phone what is wrong with me???Im sleeping 10 hours a day - but IM still absolutely exhauseted all the time.  I have no erergy to do anything.  IM so tired my vision blurs.  I sometimes pass blood with stools.  I feel gereraly unwell.I have no neglected myself - I have been to the doctors many times over the last 6 months - they keep trying different medications - but no one can really say what is wrong with me.",
    "doctor_response": "Hi Thanks for posting your query.       Based on your symptoms I feel you are suffering from Pancreatitis or Cholecystitis or Gastric Ulcer.      For diagnosis you need ultrasound abdomen upper GI endoscopy and not just blood test .       I advise you to get these above test along with serum Lipase.    I can't tell why a repeat test has been ordered. If you can upload the reports of tests done to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat pulmonary thrombosis?\n\nmy mom had a pulmonary thrombosis and acute anemia in march when she was released {after aven cava filter and 2 units blood they sent her home on coumadin she goes to a clinic for coumadin management but she continues to need tranfusions for the anemia the ran batteries of test and could find no bleeding should she be on coumadin",
    "doctor_response": "Yes she has to be on Coumadin to prevent further pulmonary thrombosis as it can be life threatening. However she has to be under regular monitoring for her bleeding time, clotting time and prothrombin time",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent cough\n\nI am 42 and got a ashtama attack 4 years ago in Bangalore. My weight is 80 and height is 5'8\". I am in mumbai now and got Bronchitus some 3 weeks ago. After Mox antibiotic and a cough syrup, the doctor put me on Sereflo 500 one week ago. Twice a day for one week and now once a day. My cough is still not going away, though chest is cleared out. Please advise how to handle the cough (it almost hinders me from talking)",
    "doctor_response": "sir cough medicines will clear the mucous again it will accumulate just do some general measures like Luke warm water gargling, steam inhalation these will make secretions soft and will come out as sputum. do some natural measures like black rock juice or seed keep it in cheek and sip it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this TMT test report indicate?\n\nMy cardiogram was normal and 2D ECHO shows 65*/* heart EF; but TMT test was positive total exercise time 6.43 minutes; maxi HR 160 bpm ;100*/* of maximum predicted 159 bpm ;maximum BP 220/90 ;maxi workload 7:70 METS; maxi ST level - 2.55 mm in stage 2 ; Exercise stage 3 6:43; Reasons for termination dyspnea target heart rate achieved, functional capacity normal, response to exercise normal; BP response to exercise; normal chest pain none ST changes depression downsloping overall impression : positive stress test suggestive of isochemia",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Positive TMT means their is suspicion of blockage in the arteries of heart. As I can see the ST depression are more than 2 mm and that too started in stage 2 which means their are high chances. Positive TMT needs further evaluation. I suggest you to directly go for invasive coronary angiogram in spite of doing other indirect non invasive tests. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Blood clot seen in the colostomy bag post colorectal cancer surgery\n\nMy mother had colorectal cancer her surgery was 6 months ago, surgery went extremely well and recovered she has had a temporaly a colostomy, and she has faced 7 rounds of chemo. Now she is admitted in the hospital, and has seen blood clot in her colostomy bag. What can be the problem?",
    "doctor_response": "Hi and welcome to HCM. Thanks for the query.This isnt indicating anything serious and it may be just temporary colon bleeding due to angiodysplasie or polyps. He should do red blood count and if this is normal he should not worry. if there is hemoglobin fall then he must do colonoscopy to verify is there some more serious colon lesion such as tumor recurence or ulcus caused by chemoth.  WIsh you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am hepatitis B patient with itching, fever and back pain on taking Omeprazole. Kindly advice.\n\nHello doctor, I am a chronic hepatitis B patient, I have ulcer too. I did a blood work recently for urea, creatinine, AST (SGOT) and ALT (SGPT). The physician said the result was fine. I was given Omeprazole. A few days ago I noticed I have constant body itch, fever, back pain, pain on my right abdomen, just under my right breast, I get tired easily too.",
    "doctor_response": "Hello. What is the status of your liver now? You are on treatment or not? Symptoms look like biliary pain. Kindly do an ultrasound, LFT, CBC, GGT. For hepatitis B we also need HBV DNA (quantitative), fibroscan, HBeAg, anti HBe.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Habit of regular masturbation, penis and back pain on failing to masturbate, relief on masturbating. Is there any remedy in alternative medicine?\n\nDear Doctor I am a 40 yrs unmarried male I regularly masturbate,but sometime if i fail to masturbate my area new my penis starts paining along with back-pain,as i masturbate i get relief ,this happen frequently with me ,i think i am suffering from vasocongestion or congestive prostatitis .Please advice me if there is any Homeopathy/ Ayurveda remedy for this. Thanks Regards",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. The problem you are mentioning could never be due to not masturbating but is due to the ill concepts.  Masturbation is normal, natural and not unhealthy. Even animals masturbate. Your problem must have arises out of anxiety from the ill concepts of masturbation. Back pain and penis pain are due to anxiety and imagination from your end. Therefore do not worry.You might need sexological counseling and sex therapy. You can post a direct question to me in this website. Include every detail as much as you can. I shall prescribe some psychotherapy techniques to control your condition. I am sure that the techniques should be a success.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause of black lips in infant after birth?\n\nMy friend just posted a picture of her baby that was just born the other day. It had passed away after birth but the pictures she posted the baby had black lips. Completely black like it had colored in with a black marker. What could be the cause of that?",
    "doctor_response": "HelloThis may be congenital cyanosis heart disease.In this condition mixing of deoxygenated blood to the oxygenated o blood or improper oxygenation of blood due to poor supply to the lung cause black or bluish discoloration of lips and body.Many of the cyanosis heart diseases are so severe that they can cause intrauterine death or death immediately after birth.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden sharp pain on and off in left ankle?\n\nevery now and then i will get a sudden sharp pain in my left ankle which lasts for about 2 seconds then goes,.it only happens when im up and about and moving it feels like my ankle is giving way and i slightly lose footing for a few seconds,.it happens probably 3 times a week.",
    "doctor_response": "Hi...Your ankle pain is due to some previous ankle injury that is still unhealed and would have damaged some ligament...Don't worry...I recommend you to kindly do...Lot if icing frequently in your calf and muscles over the outer aspect of the leg...Gentle stretch of the calf muscles..Gentle massage over the calf and muscles over the outer aspect of the leg...Start ankle strengthening exercises and glute strengthening...Glute strengthening like Bridging... clamshell..single leg lift sideways... squats..etcAnkle strengthening includes...with thereaband...pushing the ankle outwards. . pulling it inside...pulling it upwards...pushing it downwards...etc...Do these exercises for 4 weeks...Hope this is helpful for you..Kindly revert back.un case you need any further help in this regard",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment for toothache?\n\nHello my 15 year old daughter had toothache w/c 14/2/11, we went to the dentist 21/2/11 he could find no cause for toothache.  22/2/11 she had her bottom brace fitted, followed by a couple of days of dull ache as expected.  Pain free for a few days.  Back to school today and she comes home with a raging toothache.  Please can you help, could it be a stress thing?",
    "doctor_response": "Hello,There can be discomfort with tooth movement. Your daughter may bite differently and put temporary additional biting pressure on certain teeth. I suggest advising the orthodontist of her discomfort. Try some antiinflammitory medication such as Tylenol or Advil. If she does not feel better, make sure to have an exam and X-ray if needed to rule out a tooth problem such as an abscess.Thank you for your inquiry. Stress can add to this as well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cause for nasal congestion in children\n\nMy 4 year old son has had severe nasal and chest congestion for last 10 days..he has fever in the night all of a sudden and goes upto 102 or 103...he is on medication homeopathy which has eased out his congestion but fever is recurring in the evening night or morning...what could be the reason",
    "doctor_response": "Hello,This congestion is due to acute bacterial or viral infection. Evaluating the symptomatic severity with\u00a0fever grade, I strongly\u00a0recommend consulting pediatrician\u00a0for allopathy support to cure early and\u00a0prevent chances of development of\u00a0pneumonia\u00a0from this.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mouth sores, bad pain in jaws. Do i have oral or throat cancer?\n\nI dipped skin and off for 8 months, I only used 10 tins in that time. But I quit two months ago and soon after I started to have mouth pain. Now I have a few mouth sores and both sides of my jaw hurt very badly. I don t know if I have oral or throat cancer and I am very worried. I am only 15 and I have been to the dentist and he didn t see anything. Also I went to the doctor and she said it was just a viral infection but that was about a month and a half ago. Do you know what this might be???",
    "doctor_response": "Hi, Cancers are most often painless to start with. Multiple sore and very painful lesion goes more in favor of infective origin. You should maintain proper oral hygiene. In case of any doubt culture sensitivity from local ulcer can be tried. Viral etiology is common and most of the time they are self resolving. Consult an ENT specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high fever along with swollen lymph nodes?\n\nMy son is 18 and had a fever from Saturday to Wednesday. Went to Er on Sunday due to temp reaching 104.7 with Tylenol and Motrin on board. Ran many tests but no answer. Lyph nodes in neck have been swollen for months. Fever ended but he continues to have crazy sweats throughout the day. Any idea of what I should look into?",
    "doctor_response": "HelloYour son is having fever for 4 days and took treatment .But the cause of concern is enlargement of lymph nodes that too for many months , may be due to these reason , these include:1 Infectious , bacterial , viral , fungal 2 Immunologic disease like rheumatoid arthritis mixed connective disease .3 Lipid storage disease .However , there are so many more reason of enlargement of lymph nodes like tuberculosis , cancer but complete assessment is important .So I recommend you consult an immunologist and get his opinion .Hope this will be useful for you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes right sided lower back pain and delayed menstruation?\n\nHi, I have been having really bad lower back pains, but only on the right side. I was supposed to have started my period about 2 days ago. I don t know if that has anything to do with the cause of the pain. What would you recommend me do about the pain???",
    "doctor_response": "Hello! thank you for your query, The most common cause of missed menses is pregnancy. First of all, before you take any medications make sure to rule out pregnancy first if you had any contact with your partner. If you have a regular cycle and this is the first time you missed your period then I advise taking a pregnancy test. Other causes of missed menses include hormonal imbalances and stress. Regarding your low back pain, it may only be a muscular, but if your low back pain is accompanied by fever, difficulty urinating, you may do a urinalysis(urine exam) and Kidney Ureter Bladder ultrasound as these may indicate a kidney problem or urinary tract infection. Also, if there is an accompanied unusual vaginal discharge along with fever it may also be due to a pelvic inflammatory disease problem. Please check with your medical doctor for further assessment and evaluation if the pain continues.Meanwhile, I advise you to put hot water bag on the affected area for 15 minutes 2-3x a day, have plenty of rest and drink lots of water. If pregnancy is ruled out, then you can take any painreliever such as mefenamic acid 500mg 3x a day or ibuprofen 200mg every 6 hours for pain. I hope this helps, a feedback is greatly appreciated.Thank you!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having abdominal pain and black stool?\n\nHello, I have had abdominal pain for 2 days now it will only go away with ibuprofen but when the effect is gone it comes back again, the pain is on my lower left side, and to mention I am a female. I had black stool this morning and green later on. What do I have?",
    "doctor_response": "Hello,With the presenting complaints i would think of gastro intestinal infection. I would advice my patient to undergo a stool anylasis and a ultrasound of the abdomen. A course of antibiotic will be helpful to cure the infection.Consult your doctor for more information.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does frenulum injury heal itself?\n\nHi ...I was having sex with girl on top..she may not be wet enough and i injured my frenulum...there was a lot of blood and it stopped after that..there was no blood again..my penis stings a little ... will it heal itself ? do i need to see a doc ? please advise ...",
    "doctor_response": "helloThanks for query.You have sustained injury to frenulum during intercourse and has had bleeding ..You need to take broad spectrum antibiotic like Cefixime along with anti inflammatory drug like Diclofenac twice daily.along with topical antibiotic ointment like Neosporin twice daily. Ensure to wash your genitals with warm water twice daily .Ensure to avoid sexual encounters till it heals up completely. It will heal within a week.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How are pus filled pimples after shaving treated ?\n\nI dont shave regularly but after 2 3 days of shaving I get small yellow pimples all over my face After shave lotion doesnt help antibacterial face wash helps a bit but it is not a permanent solution Is there any permanent solution to fix this",
    "doctor_response": "Hello! This could be a infection of the hair follicle known as 'Folliculitis' Another reason could be that when the hair grow back, cause of their hard nature, they tend to irritate the skin leading to the formation of the eruptions on your skin. You can apply ' Mupibact' ointment on your beard region after shaving and continue with a daily application of the same for next 3 days. Do this everytime you shave. It will reduce the frequency of the eruptions. Take care Regards Dr.Sidhu",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. When is the fertility period of a woman?\n\nMy husband and I have been trying to have a child for several months. The books I ve read have differing advice on when the woman is the most fertile. Some say 14 days after the first day of your period , some say 14 days before you think you are going to start your next period, and so on. I am just clueless on when my most fertile time would be. Could you shed some light on this? Read More WWW.WWWW.WW Sign up for iVillage Special Offers",
    "doctor_response": "Hi there. Thank you for posting your question with Healthcaremagic. I will do my best to help you. There are two schools of thought about this. Some think \"fertile period\" is very important while others feel it is no such thing. It can leade to unnecessary anxiety in matters of intercourse even to erectile dysfunction in extreme cases. You are probably just as well off having intercourse when the mood moves you rather than when the calendar dictates. Good luck! I hope that I have answered your questions fully and been of some help.  If you have anymore questions please contact me again anytime. Dr Andrew Rynne. www.doctorrynne.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be concerned as i am having high ESR count?\n\nsir, just now I have tested my blood for hb and esr .though the hb is normal but the ESR count is little high.ie after 1 hour it is 56.00 mm/hr and after 2 hour it is 96.00 mm/hr.is it the worring factor for me and my monocyte count is 00 and basophil is 00",
    "doctor_response": "HiThanks for your query.Many times no cause is found for high ESR. If you do not have any symptoms of fever, weight loss, weakness, infections anywhere, then you may just observe it.Hope this helps,Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for rapid heart beat?\n\ni am Rajesh, 27 years old with 172 cm height with 84 kg weight, i am experiencing faster heart beat(more that 130bps) very often when feel weak or when i run .. atleast once in a month.. i consult a local doctor in singapore, but he gave medication and asked me to take rest.. actually after 10-20 mins heart beat is getting normal even i am not taking any medicines. there is not heart problem before for me and also in my family history.",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. Are there any precipitating factor for your increased heart beat like anxiety, panic or exercise. After exercise 130 heart beat is not abnormal. If it's increasing after some anxiety or panic then we can give you some medicine. Also get your hemoglobin and thyroid tested once. Is it associated with any fainting, dizziness or chest pain? If not then probably it's benign and try to ignore it. If yes you'll need further investigations.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain and nausea while having IBS?\n\nHello, I have been experiencing pain in my lower right abdomen right above my hip on the side for the past week and a half. The pain is not constant, it only seems to come at night for a couple of hours, and it comes in waves but is very severe. The pain causes me to feel slightly nauseas but there is no vomiting. I do have IBS, but I have never experienced this pain before with it or in this area. I thought about going to the doctor but everytime I want to the pain goes away. What should I do?",
    "doctor_response": "This pain may be due to kidnney or ureter,as it is colicky and not constant.Possibilty of acute appendictis is less likelyDo the following testsFull blood countUrine analysisUltrasound abdominThen consult with general surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for weak heart\n\nMy boyfriend just told me he was told 6 months ago he had the heart of a ninty year old and to be careful exercising. He is thirty one. He then told me he has had a few appointments and they say the same. What should I do shocked he hasn't told me sooner and worried. What does it mean?",
    "doctor_response": "hello,I have gone through your querry.Thanks for using HCM.I can understand your concern.I need to know exact diagnosis and echo reports to guide you properly.I can guess that he may have Cardiomyopathy.However I can guide you perfectly only after you provide me the detailed reports,My best wishesDr.Rajesh Teli,MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe pain in the leg , shoulder and wrist\n\nHello doctor... i want to know for my mom.. she has 55 yrs. She have seviour pain in her leg, shoulders and wrist.. she can t able to stand for few mints.. her total body has too tired and weak.. can t able to up her hand above the shoulders... plz tel Me what her problem...",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.She may be having frozen shoulder, vitamin and mineral deficiencies specially vitamin D3 deficiency.She needs investigation by Blood sugar fasting, T3,T4 and TSH and vitamin D3 deficiency. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden numbness in hand and feet followed by passing out?\n\nI got outside and pulled some weeds out of my flowers and by the time I got to the porch I was numb in my feet and legs and my hands and my face and lips and then I passed out, do I need to go to the er right now. it happened about 2 hours ago and I am still not feeling like my self and with a big headache, I hope you can help me",
    "doctor_response": "HI, thanks for using healthcare magicIt is possible that the symptoms are related inadequate fluid intake and excess heat exposure from your time in the garden.Excess fluid and electrolyte loss can cause altered sensations such as numbness and also cause fainting.If you have tried using oral fluids and rest with no response then you may need to visit your doctor for further evaluation.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the red streaks from a staph infection?\n\nMy daughter was diagnosed with a staph infection. She had red lines going up her foot from the blister and after 2 days in hospital, the red kinds faded. Today I see a dull red line all the way up further from the area that was infected. The blister is dried up and not red or swollen anymore. Is that red line a new infection? Is it the same ? My daughter is on oral antibiotics now",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.Red streaks on the skin are a characteristic sign of an infection of the skin or subcutaneous tissues.She is already taking the treatment of antibiotics so the only thing that I suggest is to finish the course of treatment.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Difficulty in conceiving due to thin endometrium. Irregular periods. Treatment options?\n\nhai i am sowmya from pondi i am in treatment from 5 years to get pregnent . after married from 2 years 2008 onwards i am in treatment but it was not concieve i.u.i also done 4 times and i change 5gnynics every one told that my endotorium was so thin like 3mm if is use the medicine it get 23 my periods is also regular but not concieve and my problem is i am suffering from some sexual problem automatically some times my body was struck totally my legs but that time i feell very well like i am in sex if ai am in sex i cant fell like that this problem it is from 7 years but every doctor told that is not a problem why because means in laprosccopy also ther is no problem but from 1 year it was not like that and my body is noraml but i think that effect only shows for not concieve so that please told me what is my next step and which type of treatment can i start please. why because means my age is now 29 running if i go for i.v.f doctors told that is the final treatment. now what can i do",
    "doctor_response": "u can go with classical homoeopathic medicine they have got very good result for these drswapnils@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Premature menopause\n\nI am 40 yrs old with one girl child. I suffered from premature menopause at the age of 32. What are the chances for me to conceive through fertility treatment and also my husband is a heart patient and has two stents and is on medication.",
    "doctor_response": "FSH needs to be done before anything is commented, however chances are poor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe back pain\n\nI slip and fell down on my buttocks hurt my back. I had my MRI, it shows disc bulge with mild canal stenosis, early signs of disc desiccation, posterior midline annular fissure associated small central midline disc osteophyte with mild canal stenosis resulting and potential for neural irritation at this level. Please explain?",
    "doctor_response": "HIWell come to HCMI appreciate this, looking to the given findings this could be disk degenerative disease,  it is highly recommended to correlate this with the clinical condition finding does not suggest anything because of fall, take care, and have a nice day",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a small lump under the abdomen indicate?\n\nI have a small lump under my abdomen but at this moment it does not give me any pain. I think this is the result of doing some heavy work without wearing my underwear. Please can you give me a home remedy for this as I do not like to see a doctor. Thanks",
    "doctor_response": "Thanks for your question on HCM. By your description and history, I think you are having inguinal hernia.It is protrusion of bowel due to lax abdominal wall muscle.Normally on coughing,  strenuous exercise or heavy weight lifting,  abdominal pressure rises and bowel loops can protrude but abdominal wall muscle prevent too much protrusion.  But if these muscles are weakened, bowel loops can protrude and gives feeling of swelling.So get done ultrasound examination of abdomen. If hernia is present then surgery is the only cure.You should avoid smoking, coughing, heaweightei, strenuous exercise,  constipation etc.Consult surgeon and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes varying fever in a child when having mono?\n\nMy 16 year old son was diagnosed with Mono on March 13 (symptoms began on the 7th). His fever will spike to 102 at times then dip into the 95 - 96 degree range. Is it possible for this to still be mono? We are continuing to have him tested for other things... Epstein Barr was negative, kidney functions are normal, no swelling of lymph nodes or spleen.",
    "doctor_response": "Hi,Thank you for asking question on health care magic.High spiking fever with sudden drop ( Pel Ebstain type of fever) occurs in Hodgkins disease.It is not called Pel Ebstein fever if not associated with Hodgkins disease.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "What diet should be followed to keep blood sugar levels under control?\n\nMy father is having diabetes for last 12 years, now aged 56. His FBS: 160mg/dl & ppbs: 240mg/dl. It is already in high range since last 1 year. Though he is under medication,, still, it is not decreasing. How can it be decreased? What are the medical issues I need to be careful? Which food must be avoided?",
    "doctor_response": "Hello, Fruits should be taken in minimal quantity per day, whole fruit is to be taken instead of fruit juice. He must go for a morning walk at a moderate pace for at least 30 minutes per day. Avoid smoking and alcohol. With these blood sugar levels must come down within one month. Otherwise, medication has to be increased. If still no effect , he should switch to insulin. Raised sugar impairs kidney function, fatty liver and fat deposits in arteries. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Varinder Joshi , General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for sperm leakage in urine\n\nplease help!!!!!! iam dying my age is 21, my problem is that sperm leakage in urine.the initial stream of urine is whitish it appears to be dense like sperms. It happens when I eat mutton or any meat+drink milk+fried chicken or drink juice even I ate bannana and offten when I sleep after launch. The urine appears cloudy and turbid.it actually starts two years ago one day I was mastarbating about 2,3 hours but holding cum inside.suddenly I feel I edgaculate it self.I donot mastarbate very frequently but about two years I constantly leakae sperms and pass cloudy urine. I already visits urologist and give multiple tests they always came normal. Any help regarding this problem I am very tense and becoming paranoid.and I am about to commit suicide please help!!!!!!",
    "doctor_response": "Thanks for asking in healthcaremagic forum  I understand your concern. Urine if infected may become cloudy. Sometimes semen ejaculated may remain in urethra and can be voided whenever you urinate giving it cloudy appearance. So, you do not have any illness/disease, it is completely normal to have this. Please stop thinking of suicide and instead go for counselling. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why are there white spots on cheeks of a 10-year-old?\n\nHello doctor, My 10-year-old son has white spots on his cheeks. They have been around for the last couple of years. Some appear to look like blackheads. I do not know how to treat them. Or if this is milia or keratosis. They are only on his cheeks and some tiny spots under his eye. But chin and forehead and nose are totally free of them.",
    "doctor_response": "Hello. The white colored papules are indeed milia. The others are comedones. Comedones are part of acne vulgaris. Comedian acne with milia. Milia, comedonal acne. 1. Adapalene gel 0.1 percent for local application once at night on comedones. 2. For milia, they require needle extirpation for removal. Sometimes they subside on their own in a few months.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump around right scapular that hurts on having cold things?\n\nNoticed lump around my right scapular .it started wit mild pains at that region each time I take cold water or cold drinks. It s been there now for more than three months. It s on top of the muscle under my scapular. It wasn t painful before. But recently l feel mild pains around it particularly when I take anything cold.",
    "doctor_response": "Hello and welcome to HCM,A lump on scapular region is most probably due to soft tissue swelling.Soft tissue can be muscle, fat, connective tissue, etc.Association of lump with cold things appears to be co-incidental. A clinical assessment of the lump over scapula is required.Imaging study will also help to determine the site, origin and extent of the lump.An aspiration cytology of the lump is required.In aspiration cytology, cells are aspirated from the swelling, spread on a slide and stained with appropriate stains.The stained cells are examined microscopically to determine the site and nature of the lump.Appropriate management can be done after relevant investigations are done.Thanks and take careDr Shailja Puri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for underweight\n\nDear sir my male child, age 3 yrs, has weight 12 kg and height 34 inches, i think he is underweight. he eats 3/4 times per day but less quantity, still palys and moves regularly. he was 2.5 kg at the time of birth. could u suggest me regarding his health and weight improvement",
    "doctor_response": "Hello,Your child's weight is low for his age.It should be at least 15 kg.You have not told what he is eating, otherwise it would be helpful to recommend some food.Anyway follow the following advise.1. The quantity of food should be 1.5 to 2 small bowl2. It should be given 5 times a day3. You can give the family food to the child, i.e. food you are making for family members to eat.4. To increase the weight of the child give him energy dense food like,     - grind the ground nuts and add some oil or ghee along with sugar, it is very tasty so your child will like it     - you can also give formula 100 i.e. take 90 ml milk and add 2 gm of sugar and 2 gm of oil in it and them add 10 ml water to make it 100 ml. give this every 3 to 4 hourly to your child.You will definitely get results from this.Hopes this helps you.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the bleeding due to the cyst or a miscarriage?\n\nHello,am 42yrs old, I am plus minus 8wks pregnant. I did my first sonar today and a cyst of 3.3 was noted. Now am starting to have brownish red bleeding. The pain on my left comes and go. The sonar could not show much about pregnancy,awaiting results of qualitative Bhcg. I want to know if the bleeding is from the cyst or is it miscarriage? Can I also take utrogestan since I have them?",
    "doctor_response": "Hello,Thanks for submitting your question here.Yes, probably the bleeding is due to a miscarriage as the USG could not find the fetus inside your uterus.The cyst is a normal finding and has nothing to relate and you could continue the utrogestan till you get your B-hcg results.Sincerely",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can multiple urinary tract infections and a prolapse be connected?\n\nI had a radical nephrectomy due to cancer in September of 2016.  Chemo and radiation not needed.  Since that time, I have developed a prolapse.  I have also had 4 UTIs since September.  Are these connected in any way?  If so, what can I do and what kind of specialist would I need to see?",
    "doctor_response": "Hi, I am sorry for the health problems you are going through. You report to have had a radical nephrectomy due to cancer in September 2016. Here I need to stop and ask a few details regarding the primary cancer: was it found in the kidneys? or in the nearby organs? If you have any test report or any other report regarding the intervention, I kindly ask to send to me to analyze the findings myself. If a radical nephrectomy has been carried out, it means that one kidney is completely removed; while there is the other kidney left. The one left is overloaded, and it is common to have UTIs after the intervention. So, you need to get close and frequent consultation with:- nephrologist- urologist- oncologistHope this helps. All the best and God bless!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why I cant keep my mind on what I am thinking about?\n\nI have been stumbling and my hands stay asleep but they hurt I cant keep my mind on what I am thinking about I have been falling and hurting my self my legs hurt have my head hurts all the time and so do my legs and neck can you help me my husband is getting tired of this?",
    "doctor_response": "HIThanks for using healthcare magicI think, you have underline anxiety disorder. In that case, you need some low antidepressant and low dose benzodiazepine. Better to consult a psychiatrist for proper diagnosis and management. You can also try relaxation exercise like JPMR or deep breathing that would keep you calm and relax. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent body itching?\n\nI have developed mild itch all over my body, scalp and face. I noticed some small dark spots on some places which are very few. Earlier, around 2 months back I suffered from fungal infection near groin and inner thighs for which dermatologist prescribed clotrimazole, ketocanazole and fulcunazole and it was cured.Now mild itch started again this time all over body including groin and scrotum. I am 23 years old male.once in a year or two i suffers from such skin problem due to which my inner thighs and butts have become darker.plz suggest some solution",
    "doctor_response": "Hi Dear,Understanding your concern. As per your query you have symptoms of persistent body itching which is known as dermatographic urticaria which could be due to increased skin sensitivity and compromised immunity of body. Need not to worry. I would suggest you to:-- Apply cold compresses to the affected area .- Avoid sun exposure. Apply broad spectrum sunscreen with SPF 15.- Drink plenty of water . - Take aspirin or acetaminophen for itchiness and burning sensation. Take over the counter anti allergic drug like benadryl or zyrtec .If symptoms doesn't get better in 3-4 days consult dermatologist for proper examination and treatment. Doctor may prescribe steroids or hydroxychloroquine.Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take zanax while taking keppra for Meningioma tumor?\n\nMy father is taking Keppra 500 mg 3 times a day.  he just had a Meningioma tumor removed six weeks ago.  I just discovered that he is also taking zanax 1.mg.  he cuts the pill in half.  I'm pretty sure he only takes it once a day before bed and maybe not even every day.  I am sure his doctor does not know about it....stupid question, but is this harmful to him?  If so, how?",
    "doctor_response": "HI, thanks for using healthcare magicXanax is the trade name for a medication called alprazolam. It is in the family of medications called benzodiazepines.If he is using a small dose and not daily, he may not experience any significant effects but this class of drugs is associated with developing dependence to the medication and tolerance (needing more and more medication for the same effect).There are also other potential effects such as confusion, dizziness, drowsiness.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can chest pain in left shoulder and upper chest be managed?\n\nHello doctor, I am a 34-year-old male. I am having a BP medicine (Telma AM 40). I am having pain in left shoulder, upper chest, back side. I had done ECG, 2D echo and a TMT and all the tests are negative. My doctor said the pain is not related to cardio. The pain is not constant it comes and goes, usually it pains in the night, and the rest of the day it is fine. I used to smoke and I quit smoking from the past three years. Please advice.",
    "doctor_response": "Hello. The characteristics of your pain are not typical of cardiac pain. There are two possibilities in you, first is of a spinal cause like spondylosis or compression of nerves and other is costochondritis. Does this pain increases on neck movement, or any neck trauma, these may be the associated symptoms. You should get X-ray cervical spine AP or lateral view. You need to visit physiotherapist after X-ray and also orthopedician. Does this pain increase on pressure over the area, if yes then it suggests the possibility of costochondritis? You will need a Naproxen then.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should I do for the swelling near the sutures?\n\nI had a knee replacement seven weeks back. After ten days I had allergic reaction apparently from ciproxin antibiotic. Then the vicryl suture came out after four weeks. My doctor removed the suture partially. After one week I had red skin and swelling near the suture. He drained fluid and gave me fucidin. One week after healing I have another swelling. I had asked him . I had asked him earlier to remove all sutures. He seemed reluctant to do that . I continue to have medication for rashes. What should I do?",
    "doctor_response": "Hello, Thank you for your contact to health care magic. I understand your concern. If I am your doctor I suggest you that first important thing is you have to go for culture and sensitivity, and treat your infection until all infection goes back. After that you have to look for the condition of the incision if it is approached properly you do not have to do anything. But if it is a gap than you have to do surgical reconstruction.I will be happy to answer your further concernYou can contact me. Dr Arun Tank. Infectious disease specialist. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "90 years old,cirrhosis of liver, swelling in legs, feet, ascites, losing weight, swallowing difficulty, thirsty. On Lasix. Suggestion?\n\nMy mother in law is 90 and has Cirrhosis of the Liver although she never drank much, most likely from pain meds for so many years, in any event, she has slurred speech today and does not feel well - she has a lot of swelling in her legs and in her feet, she is on Lasix which helps some, she also has Ascites, she is weak and losing weight, she has swallowing difficulties and is very thirsty all the time, but she keeps telling us she feels good, what do you think her prognosis is, how long do you think she has left and what should we expect in the weeks, months to come? She can t walk or stand because she is crippled and her good leg went out about 2 years ago, she is in a wheelchair or in bed, so she has a catheter, has also has bouts of Sepsis and was hospitalized with this a couple of times a few months ago - thanks for any insight into her condition",
    "doctor_response": "Hi and thank you for this query. I a so sorry to hear about the condition of your mother in law.From the information you have provided, I strongly suggest that her doctors evaluate and consider her for liver transplant. This is the lone magical procedure that can dramatically improve her state. All other measures are palliative and only a liver transplant can restore her health and guarantee her a good quality of life. With her age and other diseases, this may prove very very difficult.How long she can live is a difficult answer. This is because there are many other laboratory investigations that correctly maps out how much more functional liver is left and what are the already existing complications are. One thing is sure, if nothing is done, we shall witness a continued decline in her health status over months. Associated with all the other conditions, she has many months but not years to live.I hope this helps. sorry about this and feel free to ask more questions if need be. Thanks.Dr. Ditah, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump behind the leg indicate?\n\nHey I noticed a lump on my 5 year old son on the back of his leg last week. He said he fell at school the day before so I took him to the doctor and said it was a hematoma, but I talked to my friend and she said she noticed it on him about a week and half ago when I saw her. Should I take him back to the doctor again?",
    "doctor_response": "Hello dear , hiWarm welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This is in relation with trauma giving rise to accumulation of blood in the    subcutaneous space  of the area and hematoma formation .*  Get  recovered  with  ice application , necessary antibiotics and anti     inflammatory  molecules  for  its  resolution ;  surgical intervention in    some  of  the  cases .Hope this will help you for sure .Wishing  him fine recovery .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will taking zestril 10mg cause difficulty in breathing?\n\nI am taking zestril 10 mg twice a day. Also I am on catapres patch 2 and hydrochlorathyzide 25 mg. I started zestril with 5 mg but now i am on the 10 mg 2 x aday. can it cause difficulty in breathing. I feel like I get a knot in my stomach and cannot breath well.",
    "doctor_response": "HiI appreciate your concernthanks for using health care magicI read your question I think I have a better solution for you zestril causes dry brassy cough due to increased bradykinin level that is generally destroyed by ACEthat may lead to difficulties in breathing if it unbearable please ask your doctor to switch over to other antihypertensive medicineHope this helps yougood lucktake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had radiation and chemotherapy for breast cancer. Diagnosed with atrial fibrillation. Taking atenolol and tikosyn. Suggestion\n\nMy wife had breast cancer approx. ten years ago and had radiation and chemotherapy. After her treatments were ending her oncologist discovered she had a very high heart rate and she was subsequently diagnosed with atrial fibrillation . Cardioversion has not been successful in restoring normal rhythm for more than a few days. Atenolol and Tykosyn were somewhat successful until recently. She had cancer in her other breast last year and underwent radiation treatments. The Tykosyn has now ceased being effective at all. What is the likelihood of the radiation having affected her heart and precipitated her atrial fibrillation?",
    "doctor_response": "it is very uncommon for radiation to precipitate atrial fibrillation especially if it on the right side. Scatter is very rare with the latest technology radiation. you havent mentioned about chemotherapy. Some chemotherapeutic agents like doxorubicin and trastuzumab can have an effect on heart but the effect is mainly on heart muscle, though rhythm disturbances can also occur. But these effects are not longlasting and she would revert back to normal with time",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes progressing pain in sternum to back and right arm?\n\nI have intense progressive pain for the past 18 months located at the top of my sternum (the joint) which is swollen, I also have the same pain in my second rib from where it attaches to my sternum and I feel the pain all the way in my back, which is limiting my strength in my right arm. I have been lots of research the past 1.5 year.... my symptoms fits Gorham Disease, but its so rare. what can it be? Thanks",
    "doctor_response": "hiHope this msg finds u in good health. i have gone through your complaints and under stand your concern. frome the complaints u have mentioned u might have some sort of costochondritis..which indicates swelling of sterno rib joint..and it generally takes a lot of time to heal.i suggest u get an ct scan of chest to rule out any other cause. Nothing to worry about. Hope your question has been answered. if u have any follow up queries, feel free to consult me anytime thanks Take care god bless",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for vaginal folliculitis\n\nI've been diagnosed with vaginal foliculitis but I'm worrying because is it similair to herpes. I have a blister on my clitoris and it's so sore to urinate. Also red sores on the inside lip of my vagina and outside with severe discharge coming from everywhere. There is also pain and swelling around my vagina I'm in such pain with Infection basically. My doctor said he's convinced it's foliculitis from waxing as I have all hair removed and has put me on flagyl yesterday. There is a slight improvement but it's still sore. Is that normal only a slight improvement? I also have a septic throat ATM and what looks like a cold sore on my lip and chin. I'm very run down but have NEVER experienced this before down below. Never!! Not have I ever had a cold sore on my mouth but my doc says that's part of the infection from my throat. What should I do. Is it definately foliculitis?",
    "doctor_response": "thanks for posting your query to HCM.Your history of removing hair , large amount of discharge ,pain and swelling goes in favour of follliculitis. but folliculitis is formed at base of hair root and from here it can spread to near part  .you need to do one thing 1 collect the discharge/pus and send it to microbology lab for microscopy, culture and sensitivity examination . this test will guide you about nsture and cause of infection.I do not suspect it as Herpes infection because plenty of discharge is not feature of herpes .you need to consult a gynecologist for taking treatment  .meanwhile you can take Aceclophenac 100mg and Serratiopeptidase 10mg orally for symptomatic releief .review me with investigation report .take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath, dizziness and discoloration in legs?\n\nJust in the past two years I ve been having a few strange problems, including shortness of breath, excessive dizziness and strange discolouration and pain in my legs. I saw many doctors who checked my blood, heart and lungs but nothing has come up, I even saw an internist. Just last night I was laying on my side and I was just started to get tired when suddenly my heart jumped and seemed to this against my ribs. It felt like it was twisting and grinding against the left side of my ribcage. It continued for a few beats and then it seemed like it stopped beating altogether. I got scared and felt for my pulse and couldn t feel it for at least a second or two. But then it started to beat steady again. After it returned to normal, I felt a wave of heat come over me and I started feeling flushed and kinda sweaty. I kind of want to tell my parents but they think I m being a wimp because the doctors haven t found anything.. Any ideas on what is wrong with me? Thanks",
    "doctor_response": "Hi,After going through your question,I would suggest you must consult cardiologist because this is could be due to paroxysmal supra ventricular tachycardia ( PSVT) or premature atrial or ventricular contraction or ectopic beat or LBBB/ RBBB.Above terms are medical terms,may be you won't be able to understand but if you are facing this symptoms then you must rule out above causes first.Non- cardiac causes like anxiety, hypoxia,asthma,drug induced etc..As I said first thing is to rule out cardiac causes then consult accordingly since you have consulted   many doctors already.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure brown oval spots like clusters on palm and soles of feet and penis?\n\nHi I am a 21 yr old male and I have developed brown oval spots in cluster only on palm of hand and soles of feet..I also have somewhat oval whit patches on the actual penis and just felt discomfort/slight burning when urinating. Any thoughts? Is this typical of HIV?",
    "doctor_response": "Hi,No this is not a typical finding of  HIV although these spots can be seen in lesion of secondary syphilis. Please go for HIV testing as well as serum VDRL. Hope it helps. If you have any other question please do not hesitate to contact us.Regards,Dr. Atishay Bukharia",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does thread like discharge in urine indicate while having viral infection?\n\nI have had bad abdominal pain followed by diarrhea for two weeks now. I visited a gp who said it was probably a viral infection and it should clear up on its own. I have seen no improvement and today i noticed small thread like things when i went to the loo. what is it?",
    "doctor_response": "Hello,Welcome to HCM.Small thread like things are intestinal worms.It develops in our intestine after eating infected food or from dirty hands by us or others.It also cause diarrhoea and abdominal pain.Please consult your physician for proper medication.Don't worry it is curable disease.Take oral re hydration solution with zinc.Take fruit juices more.Take care...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red bump on my penis?\n\ni have had fordyce s spots for about a year or two and the other morning i didn t notice it till i was using the restroom on the side shaft of my penis it looked like a small almost red looking bump. then i looked closer and it looks like a swollen up fordyce s spot, but im worried it cause be genital worts",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: Fordyce's spots are harmlessExplanation: Fordyce's spots are whitish spots(visible sebaceous glands) which are harmless. If it is something else, like red lesions inflammed kindly visit a doctor for investigation and treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a persistent infection\n\nI have been having the simular problem my circumvallate papillae & Foliate papillae hveboth swollen for over a year. I was told it was thrush and have been treated three times for thrush have been tested three time for herpes(HSV), siphis,HPV, cancer,liver ,kidneys, HIV i had her test everything all negitive results my doctor said my immune system is low though. I have rinsed with salt water sucked on pieces of garlic, probiotics, vinagar i have tried everything i could!! they well not go away! I smoke about 10 smokes a day i drink coffee constantly with international delight creamers and have noticed that by the second cup my throat starts to hurt or feel irritated of i drink coffee with just milk and sugar it doesnt seem to bother me at all. when i brush my tongue there are little white pieces or tabs of skin on my tongue after. before i brush everyday my tongue has a film some is yellow brownish from smoking and where my circumvallate papillae is where it looks thrush like. I also think the are ulcers in my throat it seem like it my tonsils that hurt and if i stop drinking coffe and switch to jucie pop or water my throat doesnt bother me at all.Its just not going away. I also have had issues with my skin breakout everywhere that according to my doctor may be gluten but it is mostly my lower legs,face(nose),back of upper arms and hips these are bumps dry skin, blood blisters some heal in two day others stay for months i hive when i use expholiating stuff or anything oil of olay(posion) causes me to hive.and it all seem to be some thing to do with my folicals i think. anyway my doctor sent me to a dermy for my skin and she gave me six months precription of NU-DOXYCYCLINE Yes this is the same thing they use for some stds for you that want to jump the gun i well repeat have been tested 3 times in the past year not to mention once a year every year before that. and have had the same partner for the past year who also has nothing cause he was at the doctor about two weeks ago and my last appointment was just this past january. Anyway the NU-DOXYCYCLINE seems to be clearing the skin issues and seemed like it was clearing what is happening in my mouth but it has been a month im on my second month of the meds and it seems like its healing my mouth too but really slowly. i am going back to my doctor agian soon see if she thinks i need more oral thrush meds don t know what else to do I also have noticed fruits like pea",
    "doctor_response": "Hello Dear. First of all you reduce smoking and also the number of beverages per day. Brush twice daily. Eat lot of citrous fruits which are rich in vit c like oranges, Red peppers, Brussels sprouts, Broccoli, Strawberries, Grapefruit, Guava.In addition to it you can apply candid mouth paint inside your mouth around the sore areas three times a day. Avoid drinking very hot coffee or tea.Sweating around the T zone may not be anything related. May be just a normal phenomena.Kindly follow these things till you meet your doctor.Hope i have answered your question. Feel free to contact me if you have any more questions. I ll be glad to help you. All the bestWith warm regardsDr Sanjay Kini",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes seminal leakage with history of night fall?\n\nI have been diagnosed with Colin cancer and currently going though radiation treatment and chemo, been doing fine with it but at work I had to use the restroom had diarrhea and had to hold it in by the time I got to the restroom and used it I notice I had ejectulated a little this never happen before , I ve had wet dreams before but this wasn t that wat could this be?",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Colin cancer can be metastatic to the epididymis and other location of the ejeculatory ducts.This is the reason why you have been ejaculated.I advice you should do the USG of the genital system.  This will enables the clear picture of tje metastasis and accordingly management can be planned.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having noticed severe cough which is causing pain in trachea\n\nI have coughed so much over the past 2 weeks that my trachea hurts now... That's probably bad, huh?  I've been to the doctor; she gave me a course of Azithromycin but it mustn't have worked.  I take Tylenol Cold and Flu Severe, but it's not exactly helping... What do I do?",
    "doctor_response": "HelloI share your concern Coughing and inflammation might not be caused by infection only.It could be viral or allergic You need to identify trigger for an allergic reaction if you can pinpoint any. You may require another course of  antibiotics like calrithromycin or Penicillin group of drugs under supervision when azithromycin is not working.Here I would advise you for an X rat chest and sputum microscopy with blood profile for ESR and CBCMeanwhile do take steam inhalation and deep breathing exercisesPlease write back to me with more details like your age and relevant medical history So that I will be able to tell you more precisely.Best regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for erectile dysfunction\n\nHey doc. my girl and I were have sex and I had to stop and go take a piss when I got back into bed I could not get hard for the life of me. I also had a gassy stomach that night as well from something I ate. What could of caused me not to get hard again?",
    "doctor_response": "DearWe understand your concernsI went through your details. Erectile dysfunction (ED) or impotence is sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual activity. You have not mentioned about your previous experience with the same woman or other women. Usually, Ed is psychological. You also say you had acidity complaints during the intercourse. I also think you were too stressed and anxious. The most important organic causes are cardiovascular disease and diabetes, neurological problems, hormonal insufficiencies and drug side effects. I suggest you not to panic now and wait for a week before attempting next time. Then you can decide on consulting a physician. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a swollen lymph node in the left armpit indicate?\n\nHello. I have a lump in my left armpit. It doesn't hurt. I was told, by a dr who didn't really look, that it was probably just a swollen lymph node because at the time I had a double ear infection and it would go away; however, that infection was almost a year ago, the lump has actually gotten slightly bigger. I do have a family history of breast cancer. I wanted to know if this is something I should be concerned about. I know it's not the most common place to find breast cancer, but it still is a little unsettling.",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  The long standing axilla lymph node must be evaluated for the cause as    - chronic inflammation - tuberculosis - secondary involvement from     malignancy at other site - others .*  Must get excision biopsy of the same to cure and diagnose pathology .Hope this clears your doubt  .Wishing you fine recovery .Welcome for any further  assistance .Regards  take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can holes in lungs cause death in just born?\n\nI have a friend who s daughter just had a baby yesterday. The infant boy has 2 holes in his lungs. He was 8lbs 9 ounces. They took him by C section 2 weeks early. He is currently in the NICU and the doctors say he will reamin there for 2 weeks. Is this something the infant can die from? He is currently not on a respirator.",
    "doctor_response": "Hi,Welcome to Hcm,Your description of problem doesn't project a clear picture. Lungs normally have lot of tiny holes inside which gas exchange occurs but I am sure you are talking about something different here. However, the point that child is not on ventilator is very encouraging and so this might not lead to death in the child. But, till I know what the exact problem in the baby is, its hard to predict. At this point, I think you should just trust the caring doctor. It seems like the baby is getting good care. Happy to clear further doubts. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain after drinking coffee?\n\nI get chest pain after I drink regular or decaf coffee. I think it might be from the acid. I've been taking Nexium for about a month now, and this morning I tried to drink a cup of decaf coffee and right away I got the pain again. I also wanted to know if taking green coffee extract pills for fat burning would cause the same pain.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Yes, green coffee extract pills will also cause you similar kind of pain. Actually, in my opinion, you are mostly having GERD (gastroesophageal reflux disease). It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause chest pain. Coffee contains caffeine. And caffeine plays huge roe in laxity of sphincter. So coffee extract will also have caffeine and so it will also give you trouble. So better not to take those pills. Along with drugs following lifestyle modifications will help you more for relieving symptoms. Avoid hot and spicy food, junk food, large meals. Avoid tea and coffee. Quit smoking and alcohol if you have these habits. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain\n\nI am on a variety of medications, but what I am most concerned about is the effects they have on my kidney s and liver-I am 52 and have severe depression (sucidal at times), PTSD, ADD, along with degenerative disk diesease (already had a hip replaced) Was paralized for over 2 yrs. and worked to get my sences back-I take ritilan 10mg tid, xaynax 1mg 4x s day, tramadol 4-50mg a day, gabipenitn 5-300 mg a day-just to name a few-I need the safest med for my pain while delivering the best results-in a narcotic-no one gives me the answers for the safest narcotic med to take? There are a few other meds I also take but these are my consistant ones-oh. also 90 mg of cymbalta 90 mg a day.I am on medicade and medicare which renders me broke",
    "doctor_response": "As per your explaination i understand you are on too many medication for pain.But here you need to understand taking multiple medication only for pain is not a solution of pain. Pain is symptom and not a problem so always suggest all my patient to treat the cause of pain rather then the pain. I suggest to take treatment for your basic problems due to which you have so much of pain. Along with this I suggest to do regular basic yoga, and paranayama, keep your food habit healthy, take proper rest and do regular cardio exercise like walking or cycling up to the possible level. For pain try to manage with cold pack and hot pack. As well do strengthening exercise for your spine.The best way is consult a physiotherapist and talk to him about all your problems and take a good exercise program from him which can help you for improving strength and stamina of your spine. Along with this he will also guide you some more physiotherapy  for pain management. And the pain killer what you are taking is enough. As well understand there is no pain killer with out any side effects available in market. So better to take some thing after consulting your regular physician.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause and remedy for recurring pimples on the back ?\n\nMy mother gets small pimples-like on her back. Our family Dr recommended to use Labote-GM (Neo) cream. Whenever she stops using this cream, they come again. What is the reason for this & any solution?",
    "doctor_response": "Hi. Thanks for choosing HCM., Pimple like lesions on the back are called ......ACNE VULGARIS....., body type...due to.., Hormonal imbalance..., It is common in Adolscent, young..., and postmenopausal ages..., So follow this treatment..., 1) Back thorough wash with Fash bar.., 2) Apply 5% Benzoyl peroxide....(Persol 5%).., 3) Tab Doxycycline 100 mg daily for 10 days.., will give resutl..., Don't use Lobate GM....bcoz it is steroidal cream.., Withdrawal of cream will produce pimple like lesions..., that is called STEROID ACNE....So stop this tube..., Follow the above said treatment...ok...good luck..,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. There is itching and accumulated dirt in my foreskin. Why?\n\nHi doctor, I am having itching and some accumulated\u00a0dirt in my penis foreskin. Please help.",
    "doctor_response": "Hello. Follow up with the pictures to a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Non specific body itchiness, have Penicillin allergy, sensitive to peanuts, allergy induced asthma. Any thoughts ?\n\nI was diagnosed with a Penicillin allergy in 1991.  Subsequently,I developed sensitivity to peanuts.  I am 66 yearsold,female.  I tend to have problems with nonspecific itchiness....the middle of my back, then the palms of myhands will itch.  No rhyme nor reason it seems.  I was also diagnosed with allergy induced asthma when I developed the penicillin allergy.  I have done well the last few years and have not needed any inhalers.  I seem to have weird symptoms now that I'm older, such as the itchiness,but also experience my tongue becoming irritated for no apparent reason, or a sore throat will develop.  I must say none of my symptoms are particularly serious, just annoying.  Any thoughts?",
    "doctor_response": "allergies when not treated tends to recur and can start giving symptomps at any timewhen you have allergy to one sustance it may increase to multiple things as immunity decreasesyou can take continuously antiallergic like ebastine 10 mg once a dayor get tests to get full cure by immunotherapy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What could be the cause for coma in a two months old baby?\n\nHello doctor,I know this may be too extreme for this site, but I am seeking all the advice I can get. My two months old baby was normal, healthy, happy, smiling. One fine day morning, I walked over to get him and noticed abnormal breathing inhaling but not exhaling. His body was solid gray and unresponsive.I immediately called emergency service. He was transported to an emergency room. He is in a coma, on life support, the red blood cell count is dropping, fluid on his brain, having seizures, and his blood pressure was at 320 when he was transported. They have run every test for primary infections plus more, and all comes back negative. The pediatric unit has never seen anything like this. They have contacted other specialist, and there has been no diagnosis. If anyone might have any clue of what it could be, please help me. We want him to come home and return to our happy lives.",
    "doctor_response": "Hello. With the information you have given, I would try to analyze his condition. First, turning gray or blue means the oxygen levels in his body are low. Reasons could be many. From what you mentioned. He seems to be bleeding in the brain, that is why his red blood cells are coming down. Bleed in the brain also causes seizures and high blood pressure. Or sometimes high blood pressure itself can cause seizures, but the number 320 is very odd, I do not know if it is that much. This condition could be due to 1) infection, 2) Abnormal bleeding disorders, where the body cannot stop the bleeding process, due to deficiency of some factors responsible for it. It needs special tests. Ex; late hemorrhagic disease, deficiency of factors 8, 9, etc. 3) High BP could be because of the bleed itself, or high BP could have caused the bleeding, then reasons for high BP should be looked for.this needs special tests and scans, hormonal tests also. 4) Bleeding can be controlled by given FFP, cryoprecipitate in specific conditions. I know I can only provide you information, because the condition is serious, requiring a lot of tests, and treatment is not so simple. He needs treatment to control the bleeding, control BP, seizures. It involves a few specialties and can be life-threatening also.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in left back/chest below shoulder blade?\n\nHi, I have a dull pain in my left back/chest just below the left shoulder blade, under the rib cage. Changing my breathing rate and volume doesn't effect it, but swallowing cold liquids does make the pain noticably more accute. I have good reason to suspect that I have the condition \"Barrats oesophagus\", given that my brother and mother both have had it diagnosed, and I have daily extreme indigestion pain. I have had this back/chest pain for roughly 6 months. Do you have any ideas what it is likely to be? Many thanks.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Limitation of the pain to swallowing is a strong sign to limit the reasons in the gastrointestinal tract. Generally, dysphagia or difficulty on swallowing is aggravated by cold liquids, but a family history of Barrett Esophagus can't be ruled out.Other causes are Achalasia, Gastro esophageal reflux and esophageal stricture. You have to perform an upper endoscopy to figure out the cause.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mario Aiad",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mycobacterium tuberculosis infection?\n\nHi, I was detected with diskitis in MAy and have been taking treatment since then. It was M. tuberculosis infection. All parameters are now OK. Can I resume all of physical activities like going to gym etc? How do I confirm that my activities are hurting my spine?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Yes, you can take definitely start exercise and gyming as it is already 5 months of starting anti tubercular drugs and you are also feeling well.But better to start with mild and easy exercise and then go towards heavy duty exercise. If you are not developing any symptoms like pain after exercise means exercise is not hurting spine. If you develop pain after exercising better not to do it again and consult your doctor. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for ALT level being 94\n\nMy Alt is 94, still waiting for my Hepatitis Test results. I dnt drink alcohol at all. I dnt now what it is causing. I am only 24 and weight 90 KG. I will be seeing my Gp later this week, but i am stressing so much. Tell me what food i can take and which not. Also i started exercise can i still do that ?",
    "doctor_response": "Hi & Welcome.I can understand your concern.High level of ALT is suggestive of some problems with the liver or gall bladder.You need to do some more lab investigations like liver function tests, abdominal ultrasound scan to rule out the above conditions.Meanwhile avoid smoking and alcohol (if you are habitual), avoid fatty and spicy foods, take small meals, increase the intake of fruits and vegetables, drink plenty of water, and do regular exercise to reduce your body weight.Hope these measures will help you in lowering the high ALT levels.Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat trauma caused by head injury?\n\ni was walking three days ago and hit by head on a metal fence post it hurt for a few seconds nd took a few minutes to swell alot the spot i hit was the edge of my left eyebrow and i popped some vessels in my eye but i feel none of it. it just started to bruise up yesterday. what may be my problem?",
    "doctor_response": "hello, thanks for your query, post hit contusion with just bruise will be a superficial injury , will heal by simple pain killers . if the swelling increasing , double vision, defective vision, fits, vomiting, loss of consciousness, u need to be evaluated by ct brain plain and er physician.all the best, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dizziness and tinnitus in a hypertensive person\n\nI have been experiencing some dizziness and clicking either in my ears or head. I was out of my HBP pills for several days, could this be the problem? Today I almost passed out when the dizziness happened. It felt like I couldn t breathe right and sort of hot.",
    "doctor_response": "Hello , The symptoms you describe may be due to higher blood pressure. Considering that you have not taken your medication may have resulted in a shoot up of the blood pressure causing dizziness and shortness of breath . It's wise that you get the blood pressure checked and start medicine as soon as possible.  Regards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for breathing problem and restlessness feeling\n\nhi Sir my self bhagatsingh  arora form vadodara,gujarat,india.i have query about my stumuch ,i am suffering breathing problem from last 4 year ,i done all test but doctor said i m fine i don't have any problem abut every day i feel heviness in stumach and also breathing problem and i feel like there is nuthing in my body also like restless feeling. please help if it posible  for you. give sone suggetion for the same.",
    "doctor_response": "Hey BHagatsinghIf all your tests are clear then it must be related to gastritis.Gave plenty of water orally, Get omeprazole empty stomach in morning, Avoid oily and spicy food.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does breast feeding at an older age offer any benefits?\n\nhello i am a boy aged 19. My mother's age is 40. I have low immunity power. And to solve this problem my mother decided to breast feed me . Because we heard that breast milk has high immune power and my question is 'if it is ok to breast feed from my mother at this age ?'",
    "doctor_response": "Hello, Where from you got this wrong information? For a mother to have breast milk, she should deliver a child. The breast milk will be available only up to a maximum of 3 years from the childbirth or it will replete shortly after breastfeeding is stopped. At any cost, at this age, your mother will not have breast milk to improve your immunity, you should consult a doctor in person. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can hemoglobin count reduce due to loose motion and is this dangerous?\n\nHi, my mother was having loose motion for last one week and today as her doctor asked to go for blood test and the result of Haemoglobin came to 6. Earlier 2 months back it was 12. So, is it because of loose motion for past few days or something else and also is it dangeours?.",
    "doctor_response": "Hello and welcome to HCM,Loose motions alone will not cause fall in hemoglobin.However, if there is chronic blood loss from the gatrointestinal tract or any other site in the body, anemia or low hemoglobin can result.Get a peripheral blood examination done along with red cells parameters- MCV, MCH, MCHC and RDW to assess the type of anemia.Further full body examination needs to be done to know the cause of fall in hemoglobin- whether decreased production or red blood cells, increased destruction or blood loss.Consult a hematologist for further assistance.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from sickle cell disease. Antibiotics not working for UTI. Persisting pain\n\nHello, I suffer from Sickle Cell Disease, SS. I extremely familiar with this disease, including the fact that infection may keep u n pain. I ve. Had four anti-biotics for an uti , non of them worked. So, I tried Diflucan ...nothing I try or the Docs try wrk, and as a result, I stay in pain. Not sure what to do beyond what I have.",
    "doctor_response": "Hello and welcome to HCM,You have mentioned that you are suffering from urinary tract infection not responding to any of the antibiotics.In this case, you need to get an urine culture done.urine culture will isolate the causative organism for UTI.After identifying the organism, most appropriate antibiotic can be identified by culture sensitivity.Sickle cell anemia is known to cause a lesion in the kidneys called papillary necrosis.Papillary necrosis is characterized by necrosis or destruction of the tips of the papillae of the kidney.papillary necrosis cause blood in urine and pain.Consult your hematologist for evaluation of your symptoms, relevant renal investigations and hence management.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bigger neck glands in kid?\n\nHi my daughter is nearly four and her neck glands have been bigger than normal and she has started snoring around the same time when she sleeps!!! Took her to the doctor and her blood result show that her ESR is 32 and her CRP is 22!!! What could that be???",
    "doctor_response": "Hi...any child of this age can have insignificant cervical lymphadenopathy and this is quit common. The blood tests do not mean anything. Simple viral illness can cause such result in the blood tests. Unless the kid has got prolonged fever or morethan 2 weeks duration and loss pd appetite and significant weight loss, sever anemia and pallor you need not worry.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold and asthma in a child\n\nMy son 5 years old had severe cold with asthma last week and got cured. After two days again started with high fever n grinding teeth during night n crying sometines telling no reasons. Please suggest me what can be done. I give ventoline and doliprane regularly.",
    "doctor_response": "Most often respiratory tract infections in children is caused due to certain viruses. Antibiotics are ineffective in such a situation. Some antiallergic generally provides relief. Steam inhalation is helpful. In case if childhood asthma or wheezing is associated, inhalation of some bronchodialator like Ventorlin or Salbutamol might be required. It is best given using a spacer device. Doliprane (acetaminophen) will help in bringing down the temperature and should be given on when fever is present.Grinding of teeth in children, also called bruxism, often occurs due to no definite cause and does not need to be treated. But in such a case, grinding of teeth could be due to febrile convulsion and hence the child needs to be monitored carefully and taken to a hospital if the grinding of teeth seems to be associated with altered consciousness or stiffening of limbs.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for on and off blank stare, sudden check out of mind and loss of memory with intake of Topamax and Dilantin\n\nnew to seizures. had first one at 41 and still trying to figure out what kind I am having. I have a blank stare and kind of check out for a few minutes and then for about 10-20 minutes later I come back to I don t know. MRI shows brain is good so far. Currently on Topamax and Dilantin. Losing memory . I can follow directions during a :checkout: time but am not self so I am told. but have no recollection of it. HELP PLEASE :(",
    "doctor_response": "Hi,Welcome to Health care magic forum.                    It appears that you are getting seizures due to the hypertension, and there also may be atherosclerosis.                     It should be confirmed that the hypertension is always under controle, and never touching the higher reading.                     I advise you to consult a neurologist for diagnosis and treatment. You may need to have a C.T.scan,and E.E.G. for diagnosis.                    Avoid taking the drugs, having seizures as a side effect like antihistamines, fluroquinolone antibiotics etc.                   Wishing for a quick and complete recovery. thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to increase oxygen level\n\nI have sarcoidosis and have suffered with it for the past 20+ years with doses of prednisone used along with 2 different inhalers and other medications. Last week I was admitted to the hospital (for the first time) and was told that on top of this I have COPD. When I went into the hospital my oxygen level was in the low 30 s and should have been in the high 90 s. I haven t had a cigarette in 25+ years and am now on oxygen until I go back to the doctor to be evaluated to see if my oxygen levels are so that I can function without oxygen. What I want to know is there anything I can do to keep from being on oxygen the rest of my life. I m 65 years old and still work and able to function. Is there a low impact type exercise that I can do to help with my breathing? I also have arthritis (caused by the prednisone side affects). What should or can I do?",
    "doctor_response": "Thanks for your question on HCM.Sorry to say but end stage sarcoidosis with RA can cause great damage to lungs and deterioration of lung functions.Steroids are useful in some cases but you already have steroid side effect than it is not suitable for you.Honestly speaking there is no alternative for oxygen. But I can definitely give you some important information to improve your lung function.1. Enroll in pulmonary rehabilitation center.2. Start chest physiotherapy. 3. Start deep breathing exercise.4. Vaccinate yourself with pneumococcal and h.influenza vaccines. This will help in prevention of future infections.5. Do meditation and yoga.6. I insist you to continue oxygen in night atleast.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can uncoiled umbilical cord be treated ?\n\nI had my 18 week ultrasound on Monday. The tech had written that the umbilical cord was uncoiled. My doctor didn t seem upset. He even said he wasn t sure what that had to do with anything. Since reading online I ve seen many scary scenarios. Should I be concerned?",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the uncoiling of umbilical cord might not be significant.It does not have to do anything and I agree with your doctor regarding this.True knots and false knots are also seen in umbilical cord and that is also not significant.The only thing which matters is loop of cord around the fetal neck at term pregnancy.There can be tight loop or loose loop.The loose loop might not cause any problem but the tight loop might prevent thedecent of fetus during the labour.And tight loop might be the cause of failure of progress of labour in that case and caesarian is advised.So from the above explanation it is clear that uncoiling is not significant.Hope this helps.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "How soon can one resume sexual activity when diagnosed with T12 compression fracture?\n\nOn 2nd April 18 I have been diagnosed with T12 compression fracture with 30% compression with sever pain in the middle of spinal cord doctor has adviced for 3 weeks bed rest but my all leg and other parts moments are normal with this can I have intercourse with me)",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Well, a T12 compression fracture is not fracture of the spinal CORD. Your cord is intact. It's the vertebral body that has been damaged.  How you get back into sexual activity is by slowly experimenting with different positions in which the back and hips would be minimally involved in movement.  Everyone is different and so there is no one answer that works for all.  Typically, being on one's back takes away motion and mobility but it also tends to increase the amount of sheer weight against the spine and this may be painful. Sitting may also be an option on a chair with a high back for support. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for constipation in children\n\nMy 3 year old has been having trouble with constipation. I have been giving her miralax and I think it is starting to help. She still cries every time and is now saying it hurts her right side when she pushes. Is this common to have pain in side while pushing?",
    "doctor_response": "HI...It is quite common to have pain while straining at stool til the constipation is completely relieved. Suggestions:1. 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.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child having seizures, no fever, had episodes of seizures in the past with fever. What is the cause and treatment?\n\nhi I am DR. and am wanna ask a question reagarding seizures my daughter when she was one month old she had fever and cold with two episodes of seizures then after six months again she had two onepisodes of seizures associated with fever other day one episode without fever again after four months one episode of seizure without fever please advise YYYY@YYYY",
    "doctor_response": "Hi, Thanks for query, Your daughter had tonic clonic seizure with or without frothing from mouth ? As it is without fever we should not considered it as febrile convulsion.Most possible reason is epilepsy but you should go for EEG & Brain scan to rule out other possibility. Thanks again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump and pain while lifting an arm?\n\nHi, yesterday after playing 3 hours of basketball, I noticed a pain in my armpit. Everytime I try to lift my arm it starts to hurts, I also noticed that I have a lump in the area that hurts. Please tell me what s wrong and what I have to do to stop the pain.",
    "doctor_response": "Hi, This might be a case of frozen shoulder, tendon injury /inflammation, shoulder dislocation. You can get cold compression to reduce the pain and swelling and get an X-ray shoulder joint done for confirmation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Tanmoy Roy, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with acute acne that seems to have substantially decreased with leaving dettol overnight on the face. Is this method safe?\n\nHello Doctor, I am 28 yrs, female suffering from acute acne since 4 years. Of late I started applying dettol (non diluted) on face and leaving it over night and washing it in the morning. It has worked for me as the acne has decreased substantially. I wonder how safe this might be for the skin? Please advise...Thanks & Regards.",
    "doctor_response": "Hello, Thanks for writing to us. As you had mentioned that after dettol application your acne has decreased & that has being working for you. Its not safe practise. Its true that poor hygiene aggrevates acne so try to use a cetaphil cleansing lotion for cleaning your face. There are many topical antiacne creams & lotions that work well on acne. Try to consult your dermatologist, looking at your skin condition your doctor will prescibe you the suitable treatment. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest a remedy for c.diff\n\nI accidentally took 2 amox tr-k clv 875-125mg. I also suffer from inactive c.diff which was brought on by prescription Cipro antibiotics. I m assuming amox isn t toxic so, do you think the c.diff will come back or worse? Also anything else that may happen.",
    "doctor_response": "It's not that the amox is toxic, but that antibiotics can wipe out the normal bacteria in the colon, and if C diff is present, it can start to overgrow. Probably just 2 doses won't be enough to cause that, but it is still possible, so be on the lookout for C diff symptoms. Get treated right away if they occur. As far as the amox causing other problems, unless you are allergic, that was not a toxic dose so you should be okay. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for nervousness while talking to people\n\nMy problem is that I get so nervous talking to people and talking in front of people And when I talk sometimes I stutter and I get so embarrassed and blush I start shaking when I have to talk in front of people and my heart starts beating so fast even when I m making a phone call to anyone",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. This sort of complaints are very general. Once you get yourself accustomed with the situation, the problem goes away. never associate this problem with anxiety and shy away. Get into that. Specific phobias are always treated with involvement in that phobic area. Do indulge in such activities and ignore the nervousness.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Little bump rashes on side cheeks, spreading to arms, legs, stomach and back. Can Omnicef help ?\n\nHello my name is AAAAAA, my son is AAAAA, My 3 year old son was prescribed amoxicillin on Jan, 31rst for a slight single ear infection . I started him on it that evening. By Sunday the 3rd of February he started getting little bump rashes breaking out on his side cheek, then it would move to the other side, and would move to his arm , his legs, his stomach , back. The rashes were itchy to him and he also was starting to get mild fever . He complained and still does that his head hurts, and his body basiclly hurts all over. He is very tired, eyes look very tired, his bottom of his feet are itchy at times he says. I stopped giving him the Amoxicillin after that morning dose on the 3rd, and the rashes are much less it seems but still coming on at times. The doctor said he is allergic to the Amoxicillin which I assumed, and has prescribed Omnicef 250 MG 4ML by mouth once a day for 10 days. I have not started him on it yet in fear that it may cause worse conditions for him, that was on February the 6th. My son is still getting slight fever here and there, gets rapid heart beats at times, is very sleepy most the days, doesnt seem to be himself by far still. He is not having much of a desire to eat or drink. He still complains he hurts in his head, chest and basiclly all over he says. He still is getting slight fevers, and is still getting small rashes a few times, but not as bad as they were. I went to the doctor for a wellness check up and my son was doing fine and was his happy self, I only started the amoxicillin cause it was prescribed for his ear infection to head it off before it got bad. I dont know what to do... Do I get him on the Omnicef in the condition he is in, or do I.... thats just it, I don t know what to do. I researched side effects on Omnicef and I am afraid to make him worse off than he is now, but I don t want to be doing the wrong thing. I want my son to get better. Please help me, please. ( In the past he has had ear infections alot, but had been clear of them for some time now till that visit where I was told he had a slight infection in one of his ears )",
    "doctor_response": "Thanks for the query posted . I would be pleased to assist you with the same . Please do not start Omnicef on your own . He would need a thorough blood work up to see the cause of the illness. It can be a drug induced hypersensitivity or even a Viral illness resulting in Urticarial or Maculopapular drug rash  . Please do book an appointment with the Dermatologist or Pediatric Dermatologist . Thanks and Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for heart pains and dizziness after quit smoking?\n\nmy partner is 24 years old and father died at 44yrs old from a heart attack and for the last yr my partner has had heart pains,dizzy sdpells and breathless it worrys me has he is a interstate truck driver and was a heavy pot smoke going back 20 months a go and since giving up has had this problems",
    "doctor_response": "Hello!Thank you for asking on HCM!I understand your concern and would like to explain that his symptoms seem to be related to anxiety, probably related to smoke withdrawal syndrome. But based on his concerning family history for cardio-vascular events, combined with heavy smoking (as an independent risk factor for cardio-vascular disease), I would recommend consulting with the GP for a physical examination and some tests like : a resting ECG, chest x ray, thyroid hormone levels, routine blood test, kidney and liver function tests, blood electrolytes. A tread meal test may be necessary if suspicions are raised after the above tests. If all the above test result normal, I recommend consulting with a psychiatrist for anxiety. Psychotherapy may be needed. Hope to have been of help!Best regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long will tailbone injury take to heal?\n\nhi everyone im john im 14 years old and i hurt my tailbone a few months ago. When i hurt it it didnt hurn when i sat down but it look popped out a little not a lot just a little. I love to wreslte and i was wondering what is my injury and how long will it take to heal thank you very much",
    "doctor_response": "Hi John...Your tailbone pain will be reduced in 2-3 weks if you take proper care..I recommend you to..Do lot of icing in your painful area.. as frequently as possible...once in every 2 hours...for 15 mins....Gentle massage over butt muscles... no massage over painful area...Gentle stretching if butt muscles...Don't best weight over the painful area...U can use a Tyre like structure tobsit so that you Don't bear weight on the painful area...Can apply any Anti inflammatory gel prescribed to you earlier....Hope this is helpful for you...Kindly revert back in case you need anymore help in this regard....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lymphoma nodules on upper arm\n\nhello , im waiting for operation on upper arm its quite large and sometimes it painful , the consultant says it is lymphmina nodule which has to be taken out to be sent away and tests on it to see if it has spread , i had my MRI july 4th and have to wait till , WELL into the new year for operation , i think its quite a long time to wait as im quite worried about it , should i try another hospital , thankyou from jane",
    "doctor_response": "First of all, You should undergo a simple needle test from the nodule (FNAC).This will tell us about the nature of the nodule, whether or not it is likely to be lymphoma or is it some other disease. If it is indeed cancerous and needs to be taken out, then waiting on it till the new year is not a good option and i would strongly suggest that you see another surgeon for an earlier appointment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes episodes of electric tingling sensation in my body?\n\nLast week I had a strong electrical tingling sensation in my mid chest. Lasted only a few seconds, but was sharp. Later that evening I had several small, similar sensations also in mid chest, above sternum. Today, about a week later, I had similar electrical tingling in my left arm. It has continued for a couple of hours, but mild so far. Not as intense as the initial chest sensation.",
    "doctor_response": "Hi,Thanks for writing in.The nerves to the arms and chest originate from the spinal cord in the cervical and thoracic spine. The cervical spine is made up of 7 small bones aligned on top of each other and the thoracic spine has 12 bones lined up together. There are spongy discs between these small bones which give it a cushioning effect and help in forward backward and turning movements. There is a possibility that your discs at particular levels have been degenerating for some time. Since it has happened over the past week, it is important to rule out any nerve irritation or a condition that has developed recently. The tingling sensation is more frequent when there is pinching of the nerves in the region. Doing a MRI scan of the cervical and thoracic spine might be required. This will be decided after once a your neurological clinical examination is complete. Treatment depends on clinical and imaging findings.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does idiopathic allergy cause intermittent difficulty in breathing?\n\nI am somewhat confused. I have been \"diagnosed\" with three different disorders in the past 2 years. 1. An Idiotpathic allergy 24-months ago (told to take Citirizine twice a day) 2. COPD (no treatment planned) after an overnight stay in hospital (18 months ago)| due to my O2 stats falling to 86% 3. Hyperthyroidism (for which I have been prescribed Carbimazole in varying doses from 5-20mg, with dose varying according to blood test results and a \"definitive\" radioactive Iodine treatment planned in the next 3-4 weeks) The main problem I have is difficulty in breathing - but only intermittently. 2 or 3 times a year there will be a week where i have a cough, producing phlegm, and need to rest if i climb the stairs. After a week or so, the symptoms disappear completely - I have no breathing difficulties (for several months) and can run up/down stairs several times without any difficulty whatsoever. Is it more likely that this is caused by my allergy and is not COPD ?",
    "doctor_response": "Hello,As per my clinical experience, allergy will cause bronchi irritation, recurrent cough and intermittent breathing difficulty.In our clinic, we recommend immediate control of even minor respiratory tract infection so that breathing difficulty does not come in the picture.Regular basis walking in fresh air, deep breathing exercises, YOGA will help to boost immunity to best levels as well with avoidance of smoking if doing.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for knee pain and trouble in walking\n\nDear doctor , I am in my fourties and experience a deficiency from vitamin d3 and have a very bad knee problem, and have difficulty in walking. It hurts all times of the day even at night. I do not look forward for surgeries so in any ah could help or give me a prescription. Your help will be highly appreciated.",
    "doctor_response": "Hello, There are a set of exercises which helps the knee pain to come down.Static QuadricepsStatic hamstringStraight leg raiseAnkle toe movementsHip Muscle strengtheningCore stabilityReverse walking This exercises will help you regain muscle strength and also improve the knee joint space and reduce inflammation. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does upper abdominal pain imply with fever?\n\nHello, I had  a pain above bellybutton(2 inches or so) in a small section precisely in the center.  Not hungry, slight fever.  Can only lay. hurts when I stand or sit.  Currently still have fever, hard to go to the bathroom, but pain is not there, but feels uncomfortable(hard to explain)",
    "doctor_response": "Hi, thanks for sharing your health concerns with HCM!           If I were your treating Doctor for this case of uneasy abdominal wall nodule with recent fever, I would come up with three possibilities, these include: 1. it is possibly a hernial condition that has been inflamed! 2.Second possibility is a small parietal abscess or3.an infected cyst!So first of all, a physical examination is must and USG for confirmationIn worse condition an FNAC test can diagnose it accurately!Hope you got the answer; if still not convinced don't hesitate to write to us!I shall be happy to help you.Wishing you good health!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had unprotected sex during missed birth control, tender breasts, severe back pain. Could be pregnant ?\n\nIm 18 and weigh 170 pounds and I was on birthcontrol and I missed 2of them  me and my boyfriend had unprotected sex I had my period the 3rd of july I had tender breasts but figured it was my period after my period they were still sore to the point where I couldnt hug anyone it hurt so bad I felt nauseous I couldnt eat food that I normally could cuz it made me sick well I started getting back pain so bad that I would cry and I got cramps really bad then I started bleeding the 24th of july 21 days after my first period when my cycle is 30 days in between well it was really heavy bleeding it stopped after a week and everyhing that was wrong went away now its the 8th of august 15 days later and im getting cramps and I have some spotting in a panty liner but when i wipe after peeing theres a lot of blood I dont understand if im pregnant or my bodys out of wack I have had sex since the 24th bt imnot on birthcontrol anymore so could I be pregnant",
    "doctor_response": "Hi and welcome to Healthcare magic.Thank you for the query.It is hard to say are you pregnant or not,there is minor possiblity that you are and the only way to find it out is to do pregnancy test. However,even if there is no pregnancy, you need gynaecologic work up to evaluate your condition since it may indicate some hormonal disordersWish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Starting with IVF treatment. Taking oral dydrogesterone as experiment. Consequences?\n\nI m going to start with an IVF treatment. My doctor has asked me to participate in an experiment in which one wishes to evaluate the efficiancy, safety and tolerability of oral dydrogesterone compared with Utrogestan. I get during treatment to turn one of the two agents. In addition, every time I get a dummy so the doctor does not know which agent is administered. Are there possible consequences for my IVF treatment?",
    "doctor_response": "Hi,Welcome to HCM.Oral dydrogesterone is safe & equally efficacious to any other progesterone. Only thing is that it causes excessive sleepiness in some patients. So there is as such no need to worry.Wish you good health.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tailbone and muscle soreness, burning in buttocks and feeling that leg is weak?\n\nhave been experiencing tailbone soreness and muscle soreness, burning in the buttocks and some feeling of leg weakness for approx. 1-1/2 wks. have had no injury or accident to the area. have had tailbone flare-ups before but usually only last a couple of days. am concerned about bone cancer.",
    "doctor_response": "Hello,I read carefully your query and understand your concern. Your symptoms seem to be related to sciatica pain. I suggest to do an xray of the colon for further evaluation. Meanwhile,I suggest using painkillers such as Ibuprofen to relieve the symptoms. I also suggest gentle stretching exercises. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in conceiving?\n\nlast month i got my periods on 11th then we started having unprotected sex from 15th July onwards,average weekly 3or 4 times as we are planning for kids now...but in i didnt become pregnant and i got my periods in august 1 week delayed thats on 15th August,normally i have 28 cycle periods.Please tell me the reason for not becoming pregnant and reason for 1 week delayed periods,also tell me the safety measures to be considered in future to become pregnant.Me and my husband both 29 years old.",
    "doctor_response": "Hi, sometimes periods get delayed due to the stress factor. So, don't worry about it.  You can take some medicines for growth of your follicles and track your follicles growth by repeated ultrasound.  When follicles reach a size more than 17 to  18 mm, take injection for rupturing the follicles.  Be in contact with your husband every 2 to  3 days after your periods stop.  Take progesterone for next 2 weeks after the rupture of follicles.  Do a urine pregnancy test at home after that.  You can try like that for 3 to  6 months.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does taking hucog injections and prenone vaginal tablets cause stomach pain during pregnancy?\n\nI done my missed abortion in october 31st , 2013. now Am pregnant in 6 week 1 day. Dr.Advised to take 1 hucog 500 injection and prenone 200 vaginal tablets . whether these medicines create any stomach pain because i am using these medicine for past 8 days but i have the stomach pain. whether these stomach pain will affect my pregnancy baby , plz tell me sir , am very scared about these stomach pain",
    "doctor_response": "Hi and wecome to HCM Thanks for the query. Stomach pain can be one of the side effects of drugs that you re taking but in every case it shouldnt affect your pregnancy and baby so you dont have to bee worried. if there is pain in lower abdomen associated with abnormal bleeding then it may indicate something more serious and you should consult your gynaecogosit.Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to correct inclined teeth without braces ?",
    "doctor_response": "Hi, Ideally braces are the treatment of choice for correcting teeth positions, but newer types of treatment have also been in the market for a while called invisalign. These are trays which are used to correct positioning of teeth but they just like braces are a long term treatment modality which needs to be constantly checked by a dentist. further more not every case is a good case for invisalign, which your dentist will decide for you. Apart from long term orthodontic treatment such as braces and invisalign, other options are treatments which can be done in a couple of days, such as laminates and crowns to reposition the teeth or close gaps. The drawback for them is that healthy teeth are cut for the placement of the restorations. Patients who do not want such long treatments such as braces can surely look in this direction. I would recommend you to further discuss your options with your dentist. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for difficulty in breathing\n\nhello dr. ...i am 38 yr.old female [cancer surv,supraglotis..was treated 45rt and 7chemo..and cured but from last 2 yr. i have breathing prob.i feel as if my lungs r not pumping fully at left side as  it is in right side .some times it become so difficult for me to breath .i take inhaler....could u please help me .thanks",
    "doctor_response": "Hello and thank you for asking in HCMAccording to the history i strongly recommend you to see a pulmonologist for further examinations that probably you will need.After finding the cause than the treatment choice is the easiest next step.I wish you a fast recoveryDR.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking pills irregularly, periods delayed. Am I pregnant ?\n\nHi good day,I have been taking pills irregularly because I forget sometimes. The last time my menstruation is very early and now I am delayed for two weeks. Can I conclude that I am pregnant? And if I am is there a possibility to post phone my pregnancy? What is the best thing to do to post phone my pregnancy? Can I buy over the counter medicines? PLease help me.....",
    "doctor_response": "Hello,thanks for using health care magicIrregular in take of contraceptive pills is the number one reason for failure when using contraceptive pills. Pills are hormone based and irregular intake creates hormone disequilibrium that could account for the irregularities in your menses. It is also possible that the irregularity is due to a pregnancy. However, only a pregnancy test with early morning urine taken after the expected date of menses could clarify if there is a pregnancy or not.If the pregnancy is already there, it will be unfortunate for you because it can not be postponed. Pregnancy can only be postponed by effective use of contraceptive you have not been using effectively. Hope this helps you.Best regards Dr Achuo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain?\n\nI've been drink heavily every weeked for the last couple of months. Not to puking point but I still black out on some nights. However this last three day weekend of partying has got me concerned. I haven't drank anything in 48 hours other then water and green tea and yet I still have a massive pain in the left side of my chest and I've having a hard time taking in deep breathes. Could you help me with this?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.Left sided chest pain and breathing difficulty in alcoholic patients should always be evaluated for heart diseases.So get done ecg, 2d echo and stress test (trade mill test).If all these are normal then no need to worry for heart diseases.Acute gastritis due to alcohol can also cause similar symptoms.So take pantoprazole tablet on empty stomach twice daily. Avoid alcohol in future.Avoid hot and spicy food. Avoid junk food.Don't worry, you will be alright but first rule out heart diseases.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lightheadedness after taking Zoloft?\n\nI have switched from pristiq to zoloft this is day 3 and im really light headed when wi it go away.. was on zoloft 100mg before and was switched to pristiq 100 last wweek reduced to 50 with 25 zoloft and then stopped pristiq 3 days ago.. Bernard light headed for 5 days when will it end",
    "doctor_response": "Hello,Zoloft may cause dizziness and light headache in few patients. It is a side effect of the drug. The side effects may go away with in one or two weeks. But other causes of headache like migraine headache or tension headache or sinus headache treated separately. If headache not improved please consult with your physician, he will examine and treat you accordingly.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pregnancy still happen after having an implanon?\n\nI have had implanon for about two years now and I didn't even think twice about the fact that haven't had a period in 3 months. But I have been unusually snappy lately and exhibiting some signs of pregnancy. Like sore breasts headaches hunger, excessive urination,fatigue, nausea, and my psoriasis  had been flaring like crazy.  I took a home pregnancy test and it came back negative. I have read that the implanon can give false negatives is that true and if so is it possible that I am pregnant",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.1] Usually Implanon works to give good protection against pregnancy.2] If you have doubts, please get blood Beta HCG levels done.3] Your symptoms can be due to hormone contents in the devise.4] Please have healthy diet and exercise regime.5] Avoid salty foods, bakery items, deep fried foods.6] I will suggest Tab B LONG once a day for 3 months.I hope my answer helps you.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could frequent urination with swollen breast suggest?\n\nI am 8 days late on my period, swollen breast w/o pain, have noticed I do urinate more frequently, but took a home pregnancy test 2 days pass my missed period and it was negative. What could it be? I have never missed a period or been late before. About 10 days after my last period I had just a spot of pink creamy discharge, but didnt think anything sbout it",
    "doctor_response": "Your symptoms sound like early pregnancy. If you had a negative test recently, I would retest in a few days. It could just be that you ovulated late and your pregnancy test is not positive yet. If in two weeks you still have your symptoms and your test is still negative, I would go get checked out. Your symptoms could be from a urinary tract infection or a number of other infections. Good luck!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pimples and better complexion\n\nHi, I am 31 year old female living in Pakistan. I have an oily acne prone skin for which I got treatment for an year. I dont have acne now though pimples pop up every now and then, like 1 pimple at a time. I have wheatish complexion. I want to improve my complexion with better and even skin tone. What cream (like that of Fair & lovely, though I know it does not address hyperpigmentation and does not last long) or medicines like (supplements) or both (cream and supplements) should I use? Cream should have permanent effect unlike Fair & Lovely. Thanks",
    "doctor_response": "Hello, Thank you for posting on HCM.Complexion of any person is has two two components; constitutive, one which is predetermined by genetics and racial factors and usually cannot be changed with any treatment. The other component is due to external agents like environmental exposure, sunlight, use of any cosmetics etc and is amenable to treatment.You can get a series of chemical peels, which actually remove the upper dead layers of skin and stimulate regeneration of collagen and thus newer layers of skin. Many options are available in chemical peels depending on the requirement and skin type. (Glycolic peel, retinol peel, cocktail peel etc)Also, chemical peeling can be preceded by a simple procedure called microderamabrasion or commonly known as skin polishing to augment the results.Also, at home you can try using cream containing kojic acid, tetrahydrocurcumin, arbutin etc for several months (Melaglow cream) for additional benefit and maintenance.Always use broad spectrum sunscreen before going out in sun.Use a plain moisturiser like cetaphil DAM on daily basis for healthy and hydrated skin.Take plenty of fresh fruits and vegetables in your daily diet.Hope this will take care of your issue.Thank youDr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to restrain from passing urine until circumcision sore subsides?\n\nMy three year old son was circumcised today around 8 hours ago and is too sore to urinate. He tried but stopped when he realised how sore it was.He has dressing on that is to come off in the morning when he is to be bathed. Is it ok to let him wait until then to pass urine? How long should he feel this sore? Thanks in advance.",
    "doctor_response": "HiThanks for writing to us. There is no need to wait for sore to heal.He can pass urine.No issues. The pain should go away in a day. Don't worry. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is red bumps on palms of my hand due to antibiotics?\n\never since starting amoxcicillin, I have little red bumps on the palms on my hands. I also have 4 warts on my fingers. I can t tell if these are new warts forming bc I am on an Antibiotic and my ammuine system isn t working right, or just a reaction to the antibiotic",
    "doctor_response": "Hello,The symptoms seem to be related to an allergic reaction to the antibiotic that you are using. I suggest to use an antihistamine medication to lower the reaction out of the system. I also suggest using betamethasone cream for local application at the dots area.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does high ESR and PMN in a patient with history of cancer mean ?\n\nhello doctor . my mom got 95 ESR & 79 Diff PMN . please kindly recommend what is her disease. Last 8 year she got a cancer in her breast and she got rid off it already and she got cancer again in her liver and she cut one of her liver out . Now I have no idea It s relate with cancer or only normal infections. please kindly recommend.",
    "doctor_response": "Hello Thanks for query Raised ESR indicates some chronic disease  ,Raised polymorph indicate some infection .Cancer patients are more prone to infection. So her complete check up is essential along with detailed investigation. Hope I have answered your question well to your satisfaction. Wish you speedy complete recovery at the earliest.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constriction in chest and neck?\n\none week ago I felt my chest constricted, but thought that it was due to adding some free weights to my regimen.  Today, I'm feeling some slight constrictions, my pulse is 94, and I've felt some light constrictions in my neck, just behind my ear...what do you think?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. In my opinion, we should first rule out heart related diseases in your case because chest constriction, neck pain and high pulse rate (94). All these favour heart diseases more. So consult doctor and get done 1. Blood pressure monitoring 2. Ecg 3. 2d echo. If all these are normal then no need to worry for heart diseases. Sometimes muscular spasm cannot also cause constriction feeling. So take painkiller and muscle relaxant drugs. Don't worry, you will be alright. But better to first rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lymph nodules on the arms and legs\n\nHi, I have lymph nodules on certain parts of my body, which includes my arms, my legs and my belly. However I noticed some pain in my scrotrum recently and I suspecting it could be same located there and causing the occasional pain. What do I do and what specialist should I see",
    "doctor_response": "Respected user , HiWarm welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This seems more in relation with multiple neurofibromatosis condition .*  Needs consultation with consultant surgeon for further guidance .Always  feel free to ask any further doubts .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes terrible penile and testicular odour?\n\nAny idea the cause and/or solution of my terrible penile & testicular odor?  Washing helps, but smell returns sometimes even before i can get dressed.  Some days smell is there immediately after my shower and persists all day, some days I can work up a sweat all day outside and not have it smell at all.  I have a history of persistent sinus infections, so maybe an infection or some kind, fungal or bacterial?  Ideas?",
    "doctor_response": "Hello, When too much smegma builds up underneath your foreskin and because you sweat a lot or don't wash your penis regularly the possibility of odor is common. it can create smelly white chunks that can cause bacteria to grow. If left untreated, your penis can become inflamed or infected. Wash your penis daily and keep it neat and clean and dry. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat black spots around injection site?\n\nSir around 4 months before I was given laryago and voveran intra muscular injection then I developed a black spot around injection site later it started to form a thick scab eventually fallen out due to dress and I found red flesh like depression and applied bandage later again it scabbed and I removed it it became small but inner red fleshy depression now it scabbed again but small. I started to worry its blac around 1inch, pls help me out and guide me please. Thank you so much God be with you.",
    "doctor_response": "black spots can caaused my wrong injection technique or vit b12 injectionyou can treat it by  hot fomentationthis will solve your problem in no timeGood Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes expanding dent in forehead in thyroid cancer patient?\n\nI am a hairdresser and I have a client who after thyroid cancer surgery noticed a dent in her forehead it is over the left eye about 1 inch above the eyebrow.  It is getting deeper and wider with the progression of time.   Any ideas what it may be? Cat scan and x rays are normal..",
    "doctor_response": "hi..it depends on type of cancer.. if it was a follicular cancer..then chances of bone metastasis is more..but it wont be a depresssion...rather she would have developed pulsatile swelling.. consult an oncologist first for a bone scan if in doubt...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, on follicular study, taking siphene. High follicular size, low thickness. Will the endometrium size increase as I proceed ovulation?\n\nHi Doc, i an TTC and was on Siphene 100mg twice a day and took Humog injections from Day 3 to Day 5 of my periods. Now on day 8, i have 5 follicles in my right ovary and 1 in my left. My endometrium thickness is 5mm on day 8. Will the endoterium thickness increase by the time i ovulate (maybe day 12 or 14) since the follicles are already of good size and my radiologist said that they can rupture earlier.",
    "doctor_response": "Hi Nupur Welcome to HealthcareMagic Yes endometrium thickness will improve by the time ovulation occurs. Endometrial thickness above 7 mm is is good for pregnancy to occur. If follicle size is above 18 mm then it may ovulate any time. take care. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe lower back pain with rashes?\n\nI've never had back problems or pain.just recently started getting severe lower back pain.and woke up with a rash/bruise looking thing around my kidney area on my back.I've had lots of uti's before,and now I'm also getting pain off and on in my bladder area",
    "doctor_response": "Well...its called shingles caused by herpes zoster virus..it can subsides by itself...Apply calamine lotion locally on the rash and also take tab.tramal thrice a day for pain andStart tab acyclovir 800 mg 5 times a day for 10 days..You will be better in a week...Bye..see you in good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I keep switching between under and overactive thyroid functions. Why?\n\nHello\u00a0doctor,I am a 35 year\u00a0old male. I had a hyperthyroid since the last five years and was taking Carbimazole 5 mg thrice a day for the last two and a half years. Then, last month, I got my complete physical test done, and I got to know that my hyperthyroid had shifted to hypothyroid. So, the doctor put me on 25 mg of Eltroxin (Thyroxine sodium). Now, I just got another test done, and I am probably back to hyper as per the reports, and the\u00a0doctor has stopped my medicine for a month. Please advise. What is wrong with my thyroid?",
    "doctor_response": "Hello. I just read your query about your thyroid dysfunction and saw your reports in detail (attachment removed to protect patient identity). Hope you find my advice of some benefit. Goodluck. For more information consult an endocrinologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain and swelling and injection site\n\nhello, i got a gastroscopy today and the doc had problems puting the ansthitc nedel in my arm and after few times he put it somewhere to find out it was in pain and after telling him he moved it to the hand .now about 10h later i still have some pain and kinda swallen in the shot area especially when i move it . so should i do something about and how bad is this thing thank you",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Your pain might be because of extravasation of the fluid during placement of catheter outside the vein. Swelling is also due to accumulation of that extravasation fluid.Tratment is ice fomentation, strict limb elevation. Tab diclofenac 50 mg twice a day is for pain relief. Tab chymoral forte twice a day is for reduction of swelling. It has to be taken before meals. This will resolve in few days.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Jayesh Vaza",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause callous lumps on palm after every shower?\n\nHello I have these white callous bumps I get on my palms of my hands after I shower. They don t hurt or itch or irritate in any way, and they just eventually disappear after about an hour. This just started about a month ago and it s reoccurring after every shower. Any advice would be greatly appreciated. Thank you for your time.",
    "doctor_response": "HI,Thanks for the query to HCM.Treatment for callous  lump on palm after every shower.In my opinion,it could be Lupus erythematosus.Consult ER dermatologist who would  anti-histaminic and would treat it accordingly.Hope this would help you to plan treatment with ER doctor.Welcome for any further query to HCM.Hit thanks and write good review if this reply helps your health concerns, for the benefit of new and old patients at my virtual clinic at HCM.Good Day.Dr.Savaskar M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had bacterial conjunctivitis in eyes, very painful, had breast cancer, premenopausal. Done chemotherapy. Will I feel better?\n\nHello, I'm a 44yr old female, nursing student/medical receptionist/mother of two adult sons/happily married/too many hobbies to mention AND - I think I've had a virus for the past week. Firstly I thought I had bacterial conjunctivitis in both eyes from gardening the previous day, so I started using chlorsig every 3 hours. The pain in my caused my study to take the back burner, and even take the afternoon off work. It helped but took the full 3 days of treatment and on the 4th day I felt like i'd been run over by a bus, increasingly tired and totally depressed. To top it off, the very next day I started menstruating which shouldn't sound unusual, but after having chemotherapy for breast cancer back in 2006, I generally only get one period each year. Does any of this sound overly concerning to you, or am I just having a typical peri-menopausal crappy week? Cheers Mandy",
    "doctor_response": "Hello friend,Thank you for posting your query through Healthcare magic.I also think that you were affected by a virus for the last one week. But that virus is not what you are talking about. Virus is a biological waste particle in your body as a result of the disease and not the cause of diseases. I am a Homoeopath and so you be prepared to hear something different about your diseases. The virus I meant was something in the dynamic level, a mental conflict. Since in your opinion these mental influences have no significance, you did not mention anything about that in your query. These mental conflicts made you sick to the level of reducing your immunity. This made you susceptible to diseases. The first disease was a conjunctivitis, a relatively harmless affection. But when you started suppressing it with local application, it went to a deeper levels producing deeper affections. Your conjunctivitis was in the ectodermal level but the period problem and the unusual tiredness was in the Neuro endocrine level. That is why you had a very bad period this time. All your hormonal system got shattered and you suffered unusually bad this time. Now my suggestion is that you should stop external application or medication to control conjunctivitis . It can be managed simply by frequent washing of eyes with pure cold water. You are advised to have constitutional treatment to strengthen and cleanse your constitution. I can confidently suggest you to take  Homoeopathy for that. You have proved that your health is not very good because you have the history of cancer and getting periods only once in an year  after chemotherapy. My concern is more about your constitution which reacts badly to any stimulation and my advice is to get Homoeopathic treatment from an expert. I can also help you provided you ask a premium question or you contact me directly with more details about YOU because Homoeopathy never treats your diseases but treats only YOU. With Best Wishes,Dr C. J. Varghese,Homoeopath,drcjvarghese@gmail.com,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can I get rid of severe depression with anxiety?\n\nHello doctor, I have severe depression alternating with severe anxiety. I have tried many medicines. Currently, I am taking 40 gm Prozac in the morning and 30 mg of Remeron at bedtime. But during the day, I am a nervous basket case. No doctors will give me any Benzodiazepine for some reason. I have difficulty functioning enough to be productive and unable to enjoy anything in life. I need more help. I do not want to continue living this way. Earlier, I was on Buspar, Vistaril, Trazodone, Paxil, and Doxepin. Doxepin was the most helpful but does no good when I am awake. The laboratory tests performed were blood tests. Only triglycerides were elevated.",
    "doctor_response": "Hello. In my opinion, you can discuss with treating psychiatrist regarding the following options: Practicing a relaxation technique like breath relaxation excercises daily shall help. For more information consult a psychiatrist onlilne -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold sweats and breathing difficulty\n\nIt all started with black ant bite on left side of my chest nearly to my heart, after that breathing problem arises and feels like something terrible, after some days migraines started.. And then continues for a long time till now now sometimes feels cold sweating and breathing problem too... While eating food also cause cold sweating and feels like something went to food pipe but not coughing...",
    "doctor_response": "Hello, In my opinion, there is not anything to do with the lungs. However to sure go and do a general usual checkup. Discuss with your doctor. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Jnikolla, Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes body ache and weakness?\n\nWhy would my body ache all the time, I feel weaker and weaker as time goes by.. Like my muscles can t lift as much as I used to. I m only 23. As of about 2 or 3 months ago I could be just sitting down and would get very dizzy very fast and it is bad. What could this be?",
    "doctor_response": "Hi, The symptoms you mentioned in history could be just about the body getting weaker and having insufficient vitamins. Having a multi vitamin should be good of use. Also this has another differential thought is that the cardiac output must be low so having it checked and regular exercise along with this would help. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mitochondrial disorders\n\nI have mitochtondrial disorder, prone to high lactic acid, weakness, unbalance, went deaf. Lately I feel like I have the flu all the time. Fall asleep during the day, am forgetting things, night headaches. Just generally feel sick. Are things getting worse. Shortness of breathe. Trembling.. Am I having respiratory problems. ?",
    "doctor_response": "Thanks for your question on HCM. Mitochondrial disorders can affect all organs of the body. And it is genetic disease. So not possible to cure completely in older age.In new borns if detected we can go for gene therapy.  But in adults the results of gene therapy are not encouraging. So better to start symptomatic treatment.Start multivitamins and protien supplements. Take vaccine for pneumococcal and influenza to prevent future lung infections. Get done CT THORAX  and PFT ( PULMONARY FUNCTION TEST ) to diagnose restrictive lung disease as a cause for your breathlessness. As restrictive lung disease are common in mitochondrial disorders.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had dysplasia and cut pre cancerous cell out. Husband had worst breath and neck swelling. Diagnosed throat cancer\n\nI had severe dysplasia in1998 and 1999 my dr froze the cervix and then cut pieces out every three months . This was called pre cancerous cells only the next year my husband startedhaving the worst breath dr trated him with antibioticsand dentist a mouth wash this went onfora year. The my hus and neck swelled up 3xitsize and it hurt antibioticsagain sswelling even more  cancer throat  stage 4  chemo radiation surgery he survised I am still getting the runaround one doctor even said that at this time of my life let it go should i?",
    "doctor_response": "Hello and welcome to HCM,I understand from your query that you have had pre-cancerous lesion of the cervix.And your husband is having stage 4 cancer of the throat accompanied by enlargement of neck lymph nodes and he has taken chemotherapy and radiology.Since, you have had a pre-cancerous lesion of the cervix, it is important to stay on regular follow up for recurrence or distant spread of the tumor.In case there is recurrence or distant spread further treatment (chemotherapy and/or radiotherapy) may be required.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are fever and cramps in legs due to jaundice or any other problem?\n\nI was eating Bhang every day for almost a year.. I recently fell I ll with jaundice. Its bin 2 months of recevory now... but sometimes I feel feverish and pains between my legs when I stretch it. Almost like a cramp.. followed by mild fever. Is there another medical problem with me or is it related? When can I start drinking alcohol once a week at least..",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.It would have been great had I examined you on my own.You need to undergo various tests to find out the exact cause of the fever.It could be hepatitis.I would suggest you to- Stop smoking , stop eating bhang , stop alcohol- Have a bland diet- Avoid oily,spicy food- Get an abdominal ultrasound, Complete blood count , Liver function test, platelets, urea, creatinine , electrolytes done - This will help in the diagnosisVisit a physician . He/she can examine you and correlate clinically.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Used Fentanyl patches for neuropathy in feet. Advised withdrawal, prescribed neurotin. Unable to withdraw patches\n\nI have been on Fentanyl patches for neuropapy in my feet for about seven years. I m now on 50 Mg but my doctor wanted me to Withdrawal in about two He did not prescribe any thing for the pain except Neurotin which causes hot flashes or maybe it is the Fentanyl that S causing that. I Couldn do it. My life has become unmanigible. Please help me!",
    "doctor_response": "Hicaroler1170 You are not alone. Millions of people like you are getting drug abusers after prescription of the pain-killers. In my practice, I have never seen withdrawal from 7 years of using opiates as a \u201ccold turkey\u201d. The advice to stop taking opioids is not practical. The problem is that fentanyl requires increasing doses and decreasing doses cause hypersensitivity to any pain. Medically, it is called opioid-induced hyperalgesia or opioid-induced abnormal pain sensitivity. In my Ebook: Healthy pancreas, healthy you\u201d in the part 3, I describe in detail the process of withdrawal. Fortunately, it is possible to get rid of fentanyl with supervision of the knowledgeable, experienced, licensed health practitioner. Usually, it takes 5-7 days, and it is not so miserable and relatively safe. I don\u2019t believe in one approach. I use nutritional supplements, acupuncture, herbs, hypnosis, special diet, cleansing techniques, for example, colon hydrotherapy, etc. Using that helps to improve brain chemistry, detox from drug, alleviate the worst symptoms of the withdrawal, such as insomnia and pain, make aversion to drug, etc. Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for high BP\n\nI am on betaloc 47.5g to aid with my high BP which i take amlodipine besylate for. There is nothing wrong with my heart so was given it as a help for the BP. My question is that I have run out of Betaloc and there is no way I can pay/see a doctor until next week. Is this likely to affect me in anyway? Thanks, Bubs",
    "doctor_response": "Hellowelcome to HCM. Since you have run out of betaloc I suggest you to take amlodipine 5mg twice a day. But you must know that even though you say you have no heart disease betaloc is very beneficial for the heart. It also keeps the heart rate under control.  So amlodipine should not be used as a substitute for the betaloc. You must restart betaloc as soon as you are able to procure it. Wihsing you good health Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicine for stomach pain and vomiting\n\nHi my 8 year old son is suffering from acute stomach pain n vomiting. I ve tried giving him lanzol jr 30. But he s vomiting even that out. How should I stop his vomiting n what medication should I give him to relieve his stomach pain. I want to give him domstal to stop his vomit, but he might even vomit that out. So what do I do? He has vomited 4-5 times till now. Can I give him Enterogermina oral suspension?",
    "doctor_response": "Hi! Good morning. I am Dr Shareef answering your query.As you have tried drugs, and the vomiting is persisting along with acute abdominal pain, I would suggest you to take him to the ER of a nearest hospital to get him assessed clinically and related investigations along with appropriate treatment by the doctors to avoid any further complications related to the acute abdominal pain and vomiting.I hope this information would help you in discussing with your family physician/treating doctor in further management of your son's problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause chronic cough, severe fatigue, sweating and sleeplessness, also have history of IBS?\n\nI am so exhausted, very fatigued, sweating a lot and a cough I have had for months. Had night sweats, now just sweating at different times of the day.The fatigue is overpowering and I have not lost weight, but my stomach feels bloated a lot, but I also have IBS. Very stressed and do not sleep well at night.",
    "doctor_response": "Hello,As per your history and description, possibility of stress and anxiety related symptoms are more likely. So, it is better to consult psychiatrist and get done counselling sessions.Try to identify stressor in your life and start working on its solution. You will also need anxiolytic drugs (Propranolol and Flunarizine combination). Once your stress and anxiety are controlled, all your symptoms will subside.For IBS (Irritable Bowel Syndrome) and bloating, combination of Pantoprazole and Levosulperide should be started. Avoid stress and tension, be relaxed and calm.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Kaushal Bhavsar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will betnovate c and melacare cream make me fair?\n\nHi..i hav a dark complexion..my frnds suggested to use betnovate c for fairness or either melacare cream..r these cream beneficial..will dey gimme fair complexion..if not..den plz suggest me d best cream so dat i can get fair complexion with glowing skin",
    "doctor_response": "Hello,Thank you for posting on HCM.Betnovate-c and melacare are not good options for fairness as they contain steroids and other contents which can badly damage your skin.For better complexion, use mild cream containing kojic acid, soy isoflavones, arbutin etc on regular basis ( Melaglow). Use good quality water-based sunscreen regularly to avoid tanning and pigmentation due to sunlight.Use good moisturiser like emolene to keep your skin well hydrated.You can opt for simple office based procedures like chemical peeling, microdermabrasion, mesotherapy etc.Use glycolic acid based facewash for gentle exfoliation of dead skin.Hope this will help a long way in solving your problem.Thank youDr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in testes?\n\nI had pain & swelling in testes, my doctor has given me medicine i.e meftal forte tab & razo-d cap to be taken for 6 days.. but after taking 2 dose there is no pain in testes but swelling is there.. should i continue it for 6 days or i should not take it more??? please answer",
    "doctor_response": "HelloThanks for query .Pain and swelling in the testis could be due to infection of Epididymis (Epididymitis).Though pain has reduced with medicines you need to continue it for one more week to prevent recurrence of symptoms .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could blood in stool be related to lumbar puncture?\n\nI had a lumbar puncture today that came back with normal results after 24 hour a headache that was sudden onset and photosensitive and half hourly vomitting for atleast 5 hours until I got to the hospital and was gven IV analgesics, paracetmol and a lot of morphine. I am now home again and have blood in my stool. Could this be related to the LP?",
    "doctor_response": "Hi, The headache is very likely due to the LP but not the blood in the stool. If you are actually seeing bright red blood in the toilet itself then, it is more likely than not hemorrhodial bleeding. If the blood is within the stool itself as a formed clot or if the stool is tarry in color then, it is still not related to the LP but does indicate the possibility of an upper GI bleed and if you received IV paracetamol I am wondering if that could've been a factor since that medication can cause GI bleeding. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does eating of slate pencils cause any harm to fetus during pregnancy?\n\nHi, i have a bad habbit of eating slate pencils and i was very much sure that i would anyway not get pregnant this month as we did not have a proper sexual contact this month except on the 4th day of my mensus. But now i am worried a bit because my date is getting delayed and if i am pregnant, does the slate pencils that i ate, affect my fetus? Also i was not at all well yesterday and so had a tablet called Aceclofenac & Paracetamol. Hence will these two affect my fetus if at all i am pregnant?",
    "doctor_response": "Hi,It is very unlikely that you are pregnant as the first week after menses is usually safe period. But even if you were pregant the slate pencils or aceclofenac or paracetomol will not affect your baby.This habit of yours need to be evaluated.You may be having anemia /low haemoglobin because of it.I would advise you to get your haemoglobin checked and if found to be anemic start iron tablets .Try to get out of this habit which you yourself have realized that it is not good.Hope this helps.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the reason for constant fever in a nine month old?\n\nHello doctor, My 9-month baby girl has nine days of fever (every 6-8 hours). First four days antipyretic was given. From fifth to the eighth day, Cefixime oral was given. Ceftriaxone injection till now and the fever is not fading away. Test like CBC, CRP, Epstein Barr agar, blood culture, urine culture is done. Please help.",
    "doctor_response": "Hello. The clinical features and reports you have shown are indicative of the infection. But and the infection looks like a bacterial origin because of predominantly elevated neutrophils and CRP. The common infection in this age group are urinary tract and respiratory tract, but other sites may get infected e,g. Abdomen. We do tests sequentially. I want to do urine examination for routine and culture, and blood culture should be repeated with an adequate amount of blood, ultrasound abdomen to look for any evidence of infection e,g, abscess, pyelonephritis. Another thing is we should so repeat CBC and CRP to look for improvement. And if your child is irritable with poor feeding, then my dear we should also thought of meningitis that is infection of brain. For this get done a CECT head and lumbar puncture and examination of the CSF. Therapeutic intervention in your case, although Ceftriaxone is a good drug but in such young child and we should give two antibiotic combination e,g, Ceftriaxone and Amikacin. Because of the better cover of the causative organism.If she has respiratory symptoms, then a chest x-ray is indicated, and after that, we can add other drugs also depend on the finding of the x-ray. So, ask your doctor to do all these intervention and monitoring of the inflammatory parameters. And review back with detail reports or before that if you need more discussion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for palpitation with lightheadedness\n\nEvery so often i get palpatations wich im sure is obviosly the heart is this bad? also when i get these i get like a weird feeling in my neck if i stand up i feel light headed. i had a really bad one when i lived back at my mothers she called for an ambulance as she felt it and thought i was having a heart attack... been checked by doctors and hospitals since i was 13 when i had my first one im now coming up to 24 and still get them some days are worse than others... if i try to exercise they start if i do nothing the happen.. i try to exercise very light but the body dont like it and they start what can i do? havnt worked because of these for about 2-3 years now really getting borde and want a job but i know the bad ones will come back",
    "doctor_response": "Hello, I understand your concern and would explain that your symptoms could be related to anxiety. A possible cardiac arrhythmia cannot be excluded either. Coming to this point, I would recommend consulting with your attending physician and performing some tests to investigate the possible causes: -a resting ECG and cardiac ultrasound: - complete blood count for anaemia - chest X-ray study and pulmonary function tests to exclude a lung disorder - blood electrolytes for possible imbalance - thyroid hormone levels for possible thyroid gland dysfunction. An ambulatory 24-48 hours ECG monitoring would help exclude possible cardiac arrhythmia. If all the above tests result normal, you should consider anxiety as the possible cause underlying your complaints. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What home remedies are used to treat abdominal pain after a stomach hernia operation ?\n\nHello Doc my mom has got surgery for Abdominali dont knowbut they have done Surgeries in her StomachHernia thrice but yet she has got it againThe Prob is with she is a Diabetic Patient and she does all the household choresI think she isnt strong enuf for another surgery Is Laser treatment better??Suggest Home-Remedies for Her??Thank You!!",
    "doctor_response": "welcome to healthcaremagic it is sad that she is having recurrent hernia her diabetes should be controlled well before further surgery for hernia only surgical repair is the answer skilled surgery with mesh usually have good results before further surgery she should be well controlled in blood sugar,overweight if there should be tackled and no infection should be there before infection after operation follow advice regarding rest and type of works to avoid in post operative period till the full strength comes in the operated area few restrictions to be followed through out and that will give the best prospect",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment for sciatica? I have a failed back surgery with removal of the spinous process at L4 instead of a traditional laminectomy with fusion. I have muscle spasms in the back of my thigh, pain in the left SI joint with swelling, and a rocking motion from the spasms in my leg. Thank you.",
    "doctor_response": "hi,I feel you need to first relax the spasm muscles by speedy icing or by hot water fermentation. later on you can perfrom some exercises which you must be aware of as you may have been advised post surgery.still I will mention here.try some ankle toe movements, static quadriceps, static hamstrings, ankle toe movements, and straight leg raise.followed by this try performing some small stretches for your quadriceps and hamstring muscles along with calf muscles.followed by this try doing some core strengthening exercises and back strengthening exercises. if you feel to take a lesson on it you can hire a physical therapist.rest I feel you should be fine soon and I wish you a speedy recovery.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to improve shrinkage and enlargement of kidney s ?\n\nI have one kidney that has shrank and not suppose to be working and one that has enlarged to make up for the other one but they went to put a catheter in tonight to run some lab work cause my symptoms r getting worse and they had trouble putting it in and was very painful still suffering 4 hours later why is this",
    "doctor_response": "What fits your description is something called as compensatory hypertrophy of the other kiday because of reduced function and thus shrinkage in the size of one kidney. Nothing can be done for the shrunkun kidney in most cases but one can have enough kidney function with the sole kidney which has got hypertrophied. Addressing your second query is a bit tricky because the pain after catheter can be because of many reasons commonest being inadequate local anesthetic cream application or block in the catheter, etc.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling of hand due to insect bite\n\nI've been hiking/camping in the woods of Central NY all weekend. I got bit or stung by something on Sunday. I noticed a small blood trail coming out of the site shortly afterwards. Almost 24 hours later, I noticed a small blister looking thing at the site (about the size of the tip of a ball point pen), so I tried sqeezing it to get puss out. Over the course of the next couple hours, my whole hand swelled up to the point that I couldn't close my hand past 60% closure. I have taken 50 mg of Benedryl twice (at 4-hour increments) since the swelling began, and it has not gone down at all. Please advise.",
    "doctor_response": "Hi,see it is late hypersensitivity reaction due to insect bite over hand.if u are having pain,swelling and unable to close your hand within 24 hours.Then u will require short course of oral antibiotics (cephalosporins group as per my choice),analgesic and antihistamines.If problem persists then contact your physician or surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reasons for severe lower back pain and hip pain?\n\nOk thank you...I had a colonoscopy 2 weeks ago and I have severe lower back and hip pain. My doctor says it is totally unrelated to the colonoscopy buit I dont believe it. I am in pain and no pills seem to take it away.Appreciate your comments   thank you",
    "doctor_response": "Is your pain has arise recently or since months.  Most probably it could be due to weakness  of back muscles.  I would recommend you to get x ray of your spine,  and hip.  This will give you idea about real problem  start physiotherapy of your back and hip.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes skipping of heart beat?\n\ni have had problems with my heart skipping a beat every now and then for about 4 months or so. I have had a few ECG s and an ultra sound and not much come up. I have now had a 48 hour ECG but I am waiting for the results to come back.I am 26 years old 6 foot 2 inches tall and weigh about 189 pounds. I do regular exercise (running about 15 miles a week). I noticed my heart was skipping a beat quite regularly 2 weeks ago so I decided to not do any exercise last week to see if it stopped and it did! I really don t want to stop exercising, my aim is to run a marathon. Is my heart skipping a beat potentially dangerous, should I stop running?",
    "doctor_response": "Hi,Skipped heart beat could be simply VPC's (extra contraction from a normal heart) which can occur with exercise or it could be some other arrhythmia.Let the holter report come & further course of action will depend on its report. Holter is done when you are not exercising.I will also recommend you to undergo a TMT that will report these skipped heart beats during exercise.You can follow up with me after the report.ThanksTake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with hepatitis after suffering grand mal seizure, terrible ankle pain. Could this be gout ?\n\nHi there, I was just released from the hospital after suffering a grand mal seizure and then consequently being diagnosed with alcohol is hepatitis . I have stopped drinking (the wake up call was dramatic, I split my head open and needed 18 stitches), but in the last few days have been experiencing terrible ankle pain. Luckily, one side seems to be getting better, but the other is so bad I am using a wheelchair around my apartment. I have several friends who think this is gout , but I think it relates to the liver . WHat do you think?",
    "doctor_response": "Dear Trevor, liver has very important role in many biological processes. Your symptom could be related to your hepatitis problem but it can also be a problem for itself. I dont know the degree of your liver failure, but there are at least 2 factors which can effect on your ankles. The  first one is a higher possibility of infection and second one is a Hypoproteinemia. Those two disorders cause swelling and infection of any part of the body including ankles. Also I ll mention some condition which are not related to the live: tendinitis, arthritis, stress fracture, rheumatoid arthritis and gout of course. You should checl your urates blood level to rule out gout.  Check your liver function frequently and forget the alcohol...it can also worsen your epilepsy. Wish you good health, Dr. Ivan Romic (Rominho)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for spinal disc desiccation other than surgery\n\ni am samee mahar, 29 years female according to my MRI report i am suffering disc desiccation L4-5 & L5-S1. minimum disc bulges at the level of L4-5 & L5-S1. early degenerative changes in lumbar spine. i have used lot of medication and also taken physio therapy. but never found relief.i dont want to go on surgery.",
    "doctor_response": "Hello, Regarding conservative treatment for the prolapsed disc, these are a few things you should follow. 1. avoid bending forward and weight lifting. 2. sleep on the hard bed and always sit straight with back support. 3. use a lumbosacral belt in the day time. 4. give hot fomentation on the affected part. 5. apply diclofenac gel and give massage to the part. 6. do spinal extension exercises as tolerable. 7. take gabapentin and nortriptyline. 8. take any good muscle relaxant. Try these all for 1 month and still your pain is not relieved then there is no option other than surgery. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jaideep Gaver, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for liver cirrhosis with mouth bleed\n\nmy brother is 32 year of age and suffered from liver cirrohossis (alcohol) his health is getting down day by day and looks under serious condition. Blood coming from his mouth 2 times. He has gone for binding two times. Can you help me in knowing you have treatment for this disease.",
    "doctor_response": "Hello welcome to 'Ask A Doctor' service.I have reviewed your query and here is my advise.The vomited blood from cirrhosis could be because of esophageal varices condition. For that sclerotherapy or banding can be beneficial. Treat portal hypertension with beta blocker. If you are having edema formation than diuretic can be prescribed. TIPSS like less invasive procedure helpful in reducing portal hypertension. Ultimate treatment for cirrhosis is liver transplant. I suggest you to consult gastroenterologist for examination. Hope I have answered your question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can lower backache be treated?\n\nWell I need a neurologist in MS that takes Ambetter fom Magnolia Health and so far I am having no luck. I have had two neck surgeries have spina bifida occulti in my lower back and am in constant pain. My neurosurgeon says I have nerve and muscle issues and has reccomended I see a neuologist, but so far no one takes me because I have Oboma Care.",
    "doctor_response": "hi sir/madam,Let me advice you for your problem.Low back ache may be a pre-monitory (prodromal) symptom in fistula in ano, sciatica, gouty arthritis, hernia, emaciation disorder etc. Pain is confined to lower part of the spine (back bone) especially lumbar region or lumbo-sacral area (rarely sacro-iliac region also). If it is secondary, earlier history of fall or injury may be associated. Rarely, radiating pain may be complained by the patient towards lower limbs. But it is quite common in low back aches if the defect is in the discs between vertebrae (back bones). Often the movements of lumbo-sacral region like flexion and rotation are hampered either partially or completely.Low back pain may be found in mild form in case of anemia, sciatica, rheumatoid arthritis, hemorrhoids, urinary calculi, uterine disorders etc also.Line of treatment as per Ayurveda:-The general principles of treatment of vata dosha are adopted in case of katishoola (low back pain). It includes various measures to suit its varied clinical entities, stages and associated complaints.1. Snehana (oleation) \u2013 by sneha dhara (pouring oil), abhyanga (oil massage), avagaha (tub bath with oil or oleaginous medicaments), kati basti (retaining medicaments on the back) etc.2. Swedana (sudation) \u2013avagaha sweda  (sweating treatment with tub bath), pizichil (kayaseka), nadi sweda (sudation through a tubular device \u2013 local sudation), panda sweda (sudation through medicated paste or powder) etc.3. Mridu Samshodhana -mild purgation.4. Basti (medicated enema) like eranda basti, vaitarana basti, pippalyadianuvasana basti etc.Formulations indicated in Low back ache as per Ayurveda:-1. Dashamoola kwatha.2.Maharasnadi kashaya.3. Rasnaerandadi kashaya.4. Sahacharadi kashaya.5. Gandharvahastadi kashaya.6. Trayodashanga guggulu.And for local application these oils will help:-1. Ksheerabala tail.2. Mahanarayana tail.3. Dhanwantaram tail.4. Maha narayan tail.Avoid these for better results:-1.Bitter, astringent and pungent food2.Cold water3.Fear4.Exhaustion5.Standing6.Driving7.Cold food and beverages etc.Hope i was helpful.Have a healthy day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome the chest discomfort due to panic attacks?\n\nI have a history of panic attacks. two weeks ago I went er for a bladder in infections then which doctor asked if I had irregular heartbeats or a  fib ,which lead me getting very panicky. he decided to do a ekg then aid it was normal, but after that day im keep thinking on it. now keep feeling rapid heartbeats and palpations plus lot of chest discomfort and scaRES THE DAYLIGHTS of me. can all this me overthinking about what happen that day or can something be wrong with my heart ?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. From the description it is also clear that you have obsessive thoughts. Of course, these are part of anxiety and panic attacks. Your ER had confirmed that your heart is alright and you need to believe him. Second option is go for rigorous exercise schedule and strict diet pattern. Those exercises keep yourself fit and you start believing that fit body cannot have heart problems. Exercise also gets away with acidity which is also another reason for your chest discomfort.You should undergo psychotherapy treatment for your anxiety and panick attacks. 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.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for burning sensation in genitals\n\nhi my girlfriend used veet hair remover on my genitalia area (after telling me it would not hurt )but immediatly after it started hurting like hell a burning sensation and redness , no visible wounds or swelling and consentrated arround the scrotum is the most pain i did rince with cold water immediatly but now 30 minutes in i still get the burning sencation upon touch",
    "doctor_response": "Hi,Thanks for writing in,The most popular ingredients in veet hair remover might include strong chemicals like are calcium thioglycolate and potassium thioglycolate. When applied to hair, both chemicals dissolve keratin, the proprietary protein in hair. Due to its chemical nature, depilatories are not recommended to be used in the genital region where the skin is very sensitive. They also have the tendency to irritate even normal skin and you are having that.Please apply calamine lotion to the skin to decrease the irritation, do not let it enter the urethra.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for blood pressure fluctuation?\n\nGood day I recently moved from one city to another I am 57 5ft 3 weight unknown my idea if my clothes fit all is good Have never been told i had high blood pressure but low My doctor for many years never told me that my pressure was a problem Always to doctor for yearly check ups and did acupuncture instead of pills i have a new doctor And a new problem my blood pressure is a concern for her she told me to take my blood pressure for a 2 week period now it ranges from 119 to 157 what is going on.Does the time of day i take it matter as i seem to take it a few hours after i get up and i seem to be doing alot of rushing around to get over and get it done . I was told i need to cut down on my portion sizes of food which i dont eat alot or go for seconds little to none food is fried dont drink or smoke or use extra salt was told to walk as gardening or housework is not excersise Im at loss as to how and why all of a sudden And does magnesium tablets help or hinder sleep having trouble sleeping too at night go to bed really tired and within mins i am tossing and turning forever Will that affect blood pressure thanks",
    "doctor_response": "Good evening. There are many aspects which can cause fluctuations in blood pressure values. The main causes of alterations in blood pressure that I see in patients are most often caused by caffeine, changes in activity, and or stress. If you are finding yourself living a lifestyle where there is less consistency, and or stability, it would also show itself in your blood pressure results, and any hormonal imbalances and or previous cardiac conditions and or medical regimens can alter this chemistry as well. I will be honest in saying that 157 is concerning, wheras 119 falls in the range of completely normal. My suggestions to stabilize your blood pressure are as follows... 1. Hydrate. 2 Less Sodium (Salt) and or Caffeine. 3. Stress Relief 4. Maintain a steady medication schedule (if you take any medications - make sure to take them at the same time per day as instructed).I hope this advise helps!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I catch a cold with fever too often?\n\nHello doctor, Why do I catch a cold with fever too often? Symptoms include head pain, body pain, coughing, etc. I am a male, age 24 years, height 5'11\", weight 72 kg.",
    "doctor_response": "Hi. You can have repeated upper respiratory tract infection. For that DNS (deviated nasal septum), polyp, etc., like nose pathology should be ruled out by rhinoscopy nose examination. Allergic testing can be done to find causative allergen which can lead to allergic upper respiratory tract infection. Meanwhile, for symptomatic relief, you can be prescribed decongestant like Levocetirizine for five days. Take half teaspoon ginger juice and half teaspoon honey which can be mixed and taken when having cold. You can consult otorhinolaryngologist or physician for examination.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for soreness in earlobes after piercing\n\nIve had my 2nd and 3rd hole pierced for about 5-7 month. Recently they ve started to get bumps on the back and when I squeeze them blood and puss comes out, I clean them with alcohol and than put the earrings back in. Also when I squeeze my earlobes they feel hard. What should I do?",
    "doctor_response": "Hi, thanks for using healthcare magicInfection of the outer ear can occur as a result of ear piercing particularly if the person who did the procedure did not use a sterile technique.You would need to remove the earrings for now, till the infection has resolved.The ear should be cleaned daily with an anti septic solution such as bethadine, alcohol,diluted hydrogen peroxide.Topical antibiotic cream should be applied. This should be available at your local pharmacy.If the infection does not resolve with these methods then oral antibiotics may be needed.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest possible treatment for infertility\n\nhello doctor, I am 28 now, before one year i had 1 miscarriage, 1 &1/2 year past still i couldn t pregnant, recently consult the doctor, he said took clomophene for 3 months, I took but not possible result, again consult the doctor he said took letov for 3 months, If not success come again have to clean the tube, i cant wait until that taking medicine, I am going to crazy, without taking medicine can I clean the tube? please help me11!!!!!!!!!!!!Thanks.",
    "doctor_response": "I understood your problem dear.dont worry ,dont get sress.its a normal problem now aday  because of stressfull.its a hormonal imbalances.if u will wait for 1 year than u will start aayurvediv treatment.I  am sure that u will get result .I cant permit to undergo cleaning tubes.u have choice that aayurveda .I kindly request to  follow my advice.dont be hurry,now you are 28 years k?still u have time to conceive baby.its not late k.best of luck!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning sensation in chest while coughing?\n\nI have been sick for about 5 days with bad headache and slight cough, very little fever. While coughing last night, I got a strange feeling in my lungs.  It felt as there were hundreds of tiny needlles inside my lungs, both sides, kind of burning. Is this something I should be concerned about?",
    "doctor_response": "thanks for asking your questioni completely understand your queryin my opinion you have upper resp tract infection , infection is increasing to lower resp tract.excessive coughing can cause that feeling of burning sensation in the chest.mucous clearing and forcefull cough can cause the same symptomyou need to be started on broad spectrum antibiotics like cefexime and mucolytics like ambroxol.you need to take consultation from a pulmonologist and get a chest xray done and disscuss the above mentioned treatment ,so that he can prescribe as per his opinion.thanks /regardsfeel free to ask more questionsmay god bless you with good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dizziness Whenever I stand up\n\nI get dizzy a lot. Whenever I stand up, about half the time I have to hold on to something to keep my balance. I also kind of start to black out where I can t see or hear clearly. These symptoms are worse when I m hungry, but still happen when I m full. This has been going on for a little over a year now. While I ve never completely lost consciousness, I have fallen a few times. Is this something I can change? Also, I don t feel like it s vertigo, because the room is not spinning. I just feel faint and weak when I stand.",
    "doctor_response": "Hi, This can be orthostatic hypotension. You need to consult your physician and get yourself thoroughly examined. Regards Dr. Naveen Kumar",
    "dialogue_context": ""
  },
  {
    "patient_message": "With conradi syndrome can I conceive at the age of 39 ?\n\nCan i have a baby? I am 3 9 and i have conradi syndrome",
    "doctor_response": "Hi Welcome to HCM Read your prob, this syndrom happen due to genetic abnormalitis. it has many no. of symptoms , this does not affact fertility so you can get pregnant. nothing to worry. as this is rare syndrom n occure due to mutation of gene so there is less chance that your baby will have this syndrom.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will taking Plavic be safe for bronchial asthma?\n\nI recently found out I have AFIB & a blood clot on my heart. They gave me coumaden. Everyone thinks I should switch to Plavic?I am having a time getting my INR regulated & do not like all the restrictions with coumadin. I have bronchial asthma also & need antibiotics almost once a month & it is affecting my INR.",
    "doctor_response": "Hi there,I understand your concern regarding coumadin but only this is time tested and effective treatment for blood clot on heart with AFIB, Plavix is not enough for this condition and as the risk of blood clot may go outside heart and cause a stroke or embolism is high so I would strongly recommend coumadin for atleast 6 months. some newer anticoagulant like Debigatran is also available  which do not need INR monitoring  but experience with these agents are less. If you are not willing to take coumadin then you can consult your physician for debigatranHope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good healthDr Rajesh K Meena",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning pain in back\n\nI'm 61 years old 5'4\" tall  184lb  my ? is I have a burning pain in lower back but it will at times radiate from lower back to middle of shoulder blade all most like a burning pain or pulsating pain. what is causing this ? my father and son both have heart problems is my heart or bladder or what? I'm so strest out that I've got shingles now I would love to have an anwser. thank you for your help it means alot.",
    "doctor_response": "Hi, thank you for posting.I have gone through your query and I understand your concerns.All your symptoms are related to Herpes Zoster. It is a viral disease that affects skin and intercostal nerves.The diagnosis is determined by a physical examination that is done by a dermatologist.The treatment of this disease contains painkillers, tranquilizers and antiviral medications such as Oral and Cream Acyclovir.All the best.Dr. Behar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back pain and groin pain after being treated for right epididymo orchitis?\n\ni have Rt epidydemoorchitis before 6 months and i was treat that U\\S was done and the testes was completly normal now i have Rt lower back pain hip pain and some rt groin pain especially after urination and some rt scrotal pai alkaline urine mucus threads rare epithelial cells rare others are normal i was done U\\Sbefore 3 months and was normal",
    "doctor_response": "Hi there.There is possibility of urinary infection.  Get a urine analysis done to rule out infection.Eat plenty of fresh fruits and green leafy vegetables. You must drink 2-3 litres of water daily especially if you have burning sensation on passing urine. Get a Urological consult to rule out flare up of infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump under the armpit with breast pain and stomach cramps?\n\nhello there i havent felt well for about a month now i have had abdomial pains for a month it came out of nowhere after i finished my antibiotics course and and pains and cramps in my stomach and then i lost my appeitite and devolped a small lump under my armpit that hurt on my right armpit and developed a bruise on side of breast near my armpit but now it feels really really small like a dot and doesnt hurt but suddenly got pain in my left breast and never feel hungry and keep pooping all the time i dont know whats wrong we me but im very scared i am only a 30 year old female and i darent go see a doctor",
    "doctor_response": "Hi,Good Morning,Thanks for your query to My-HCM Clinic.I studied your query in depth.I understood your concerns.My opinion of your illness-Anxiety neurosis of the illness and recovery.-The lump in the breast -is mostly a fibroadenosis in Axiallary Tail of the breast with mastodynia / mastalgia.-Dont worry as its a abnormal hormonal response of the breast tissue and would go with after you have pregnancy.-Stomach cramps-are side-effect with antibiotics used-Tb Vit E for 2-3 mths,-HPB-Diet-Tb NSAIDs for few days x5 daysThis would control all the caos in your health. Hope this would help to recover from the testosterone hyperdosage problem.Wish you a Fast Recovey.Wellcome to HCM again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed a lump under the arm\n\nI have a lump under my arm, actually slightly lower than under the arm, just a little on the side ( Its hard to explain the exact position) It is about the size of a walnut, but I also have a bruise on the outer skin which is mostly purple and about the 3 inches long and 2 inches wide",
    "doctor_response": "Hi.The lump which is long and wide with a  purple skin on it has to be immediately investigated as this is not a normal thing to have , this is too large to be called a lymph node.This can be a hemangioma.Get this clinically checked and investigated by ultrasonography and whichever has been advised by your Doctor,.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to improve hemoglobin levels?\n\nMy father is 55 yrs old healthy and fit but now a days he feels fatigue. haemoglobin is 11. He goes for walk per day and has a healthy life style. But eats just 2 times 2 meals. Morning breakfast includes cornflakes and milk. He feels chapati and vegetable or curd heavy and tough to digest.He feels milk easily digestable. Please,suggest a diet chart for my dad.",
    "doctor_response": "HIWell come to HCMYour father seems doing very well and no need to give any medicine even hemoglobin is okay, at the most he can try fresh fruits as much as he can, green salad, otherwise no need to worry about his health, hope this information helps, take care have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Having bleeding along with urination after sex. What causes it?\n\nHi doctor, My partner has a problem while urinating. She gets blood coming along with it and also, has pain while doing it. She has this problem after having sex. I think that her private parts got injured and so, she has bleeding while urinating. Please suggest something to get relief.",
    "doctor_response": "Hi. If there is bleeding in urine, then consult a doctor soon and test her urine. If there is blood, do not take it lightly and it may require sonography and other tests to find out the cause. If it is bleeding from a private part and if it is not related to urination, then give time for healing and do not have sex for at least four to six weeks. If the bleeding is not stopped, then consult a nearby gynecologist to see the source of infection clinically. If she has bled every time after having sex, then consult a nearby gynecologist and check for a cervical lesion clinically.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing pain under the left shoulder blade & ribs\n\npain in my back between my shoulder blades. a lot of pressure it started hurting under my left shoulder blade and under into my top ribs now it switched and hurts under my right rib into that ribs. agin a lot of pressure my upper ribs on both sides are sore to touch",
    "doctor_response": "Hello, As with the history I understand it to be a Trapezitis. This can occur due to inflammation of the Trapezius muscles. I will advice you to take up an MRI of cervical spine as in most cases this is the primary factor for the spasm and pain. Once done MRI get back to me so we can plan the outcome score Now, I want you to follow this therapeutic plan. 1. Hot water fermentation for neck and upper back. 2. Using neck collar when not doing exercises. 3. Static Neck exercises. 4. Triceps strengthening exercises. 5. Stretching of pectoralis muscles and biceps muscles. 6. Strengthening of deltoid muscles. All these exercise are free exercise without having any weight implementation. In my clinical practice of 12 years most cases have been complaining of Trapezitis on/off and to workout behind the precise therapeutic plan we take the full history, assessment and examination. Most cases have a pain free movements now. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rapid heart beats and dizziness?\n\nMy 14 year old son has been having a rapid heart beat off and onFor the last couple days--he often gets dizzy when standingup..he seems concerned and I can only go by what he says andHe knows his body..should I be concerned and take him to the hospital?",
    "doctor_response": "Hi,Sometimes there are blood pressure fluctuations in his age. They can cause dizziness while standing. They are not dangerous and usually disappear with age.But if he has palpitations, I would advise you to check his pulse, if it is over 100 bpm, or not regular, I would advise you to see your doctor and have an ECG performed.Wishing a good health to your sonIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can taking Cheratussin be safe for chronic cough?\n\nMy 4 y.o. daughter has the flu and is asthmatic. She has been coughing almost nonstop all day and evening and her albuterol neb treatments haven't seemed to help. She has also had a dose of Brovex PEB liquid this evening, but it didn't seem to help, either. Can I give her Cheratussin just so she can get some relief and sleep? Would it help?",
    "doctor_response": "Hi,If your daughter is having flu with asthma and she is coughing continuously then it could be allergic bronchitis, infective bronchitis or severe upper respiratory infection or pertussis etc.Albuterol is a bronchodilator and can be used in asthmatic attacks but here she is having dry,non productive cough then it has no role.You can give brovex PEB or cheratussin but the important thing is to diagnose it first.You can take her to pediatrician for detailed history and thoroughly respiratory system examination.She may require antibiotics(quinolones or macrolides) orally in syrup forms with other symptomatic treatment like cough suppressants or saline nebulizers with steam inhalation to get rid off infection complete.So,better go to pediatrician rather than self medication.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having skin rash after working out in cold conditions. Hurts when clothes rub. Solution?\n\nI have been working on an addition to our house and in that part of the house it is not heated and it has avergaed 50 degrees, after working out there the other day I was very chilled and my legs and waist area where my jeans touched my skin had a burning sensation, I thought it was becasue I was so cold . But now it is not going away, my clothes rubbing me hurts and my skin is reddish in those areas and feels dry",
    "doctor_response": "Hello.i think you are suffering with milaria .use a calamine lotion over the reddish areas use antihistamine and vitamin c tablet",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have vertigo, dizziness and nausea after bumping my head near cerebellum?\n\nMy fiancee 32 y/o female bumped the back of her head and neck where the cerebellum is and she had taken one trazadone 50mg, I found her on toilet passed out lips yellowish, pupils dilated, sweating, unresponsive at first and snoring non stop even after being woke up, we went to er, she only fell back about 12inches slumped backwards against wall and metal shelving over toilet! I didn't think it was enough force to cause a concussion or traumatic brain injury or a mild stroke! But they did a ct scan and it come back fine at ER! It has been over a week and she still has vertigo,, dizziness, nausea, can't sleep or eat well! We have a neurologist appt, mri, and cardiologist appt., her hearing is moving from one ear to another sometimes, left side of body is in pain sometimes( hit on rt hemisphere of brain/neck), she says she feels like she's on nitrous oxide, slightest movements of head even chewing food makes her very dizzy! She needs help doing anything, even going to bathroom, she is using a walker now! We don't know what is wrong with her, please help, she is walking very slow and can't even think straight sometimes! Help, what treatment is there for this???? Thanks, David Wright",
    "doctor_response": "HIThank for asking to HCMI can understand your problem, the symptom and the history you gave here, that indicate nothing went wrong but still the symptoms are there then this could be functional in origin and  this will go away with the time no need to treat this, take care and have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will a hepatitis B carrier have any problems in the future?\n\nDear Doctor, hoping all well with you. would like to understand and get more information about Hepatitis B. my guy just founf out tht he has Hepatitis B but the doctors informed him that he had this since he was a child. may be through his mother. he is now 29 years old.. and just had normal tests and in those tests now he came to know that he is actually infected. but the doctors also informed him that there was nothing to worry as the cells are non activated. they are at a very veyr very low rate and that could not actually effect his liver. what i know and understand is that he is a carrier. the doctors juist agave him some tablets and had his blood samples tested and also came to know that his liver is also Functioniing well without any effect. but i am still scared and would like to know that he will be fine later in future also. what further precautions can i take? please help me.",
    "doctor_response": "hi.thanks for posting query at HCM.HBsAg can not be completely eradicated in a patient suffering from HepB.Treatment is ONLY advised if AST and ALT are > ULN and HBV DNA count on PCR is very high. As tests are normal in the patient, Liver enzymes and HBsAg status and HBV DNA PCR maybe done regularly every 6 to 12 months,even if HBV DNA count in PCR are not high, Liver enzymes should be monitored regularly while HepB markers maybe checked every 6 to 12 months.hope to answer your concern.wish patient good n sound health.regardsDr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it normal to have anxiety symptoms after a wrong diagnosis of cancer?\n\nHello doctor,Hope you can help me, please. I am a young breast cancer survivor in my twenties who had cancer a few years ago. I am now cancer free. However more recently than this, a doctor gave me a wrong diagnosis and told me he thought cancer had spread to my brain. It took weeks to get the brain scan and the results to find out it was clear. During this time I was panicking a lot and even now this event has passed a few months ago I am left with fatigue, internal shaking, head pressure and I jump out my skin to the slightest noise. I have all these anxiety symptoms, however, I am not worried about cancer anymore as the results were clear, but I seem to be stuck in some kind of stress response. I have tried Prozac and Citalopram (just in case these would help) and had a serious reaction to both of them (face going completely numb, vibrating and too dizzy to walk). I am not sure counseling would really help because as I mentioned the event that made me like this has now passed and I feel fine about it and do not think about it anymore. In fact, I am worried that might make it worse as I am trying to forget about it. I am not anxious anymore. I just seem stuck with these symptoms. I would just like to know if you have heard of this before and is it normal that this can happen? Also, do you have any suggestions what I can do? Should these symptoms go away in time?",
    "doctor_response": "Hello. I can understand your problem. The symptoms you have mentioned suggest anxiety only. When the doctor told you mistakingly that cancer has spread to the brain, that was the trigger for anxiety. Even now when you are clear but the anxiety triggered by that event is resulting in the symptoms you are having. The symptoms like fatigue, internal shaking, head pressure, startle like response even on slightest of noise, etc., are part of persisting anxiety only.  Yes, I came across many such patients who developed such symptoms after diagnosing with some serious issue. No need to get worried about that. Such type of anxiety is common. I would advise you to keep yourself busy and distract yourself from any thoughts. Try to follow a healthy lifestyle and take high protein diet rich in complex carbohydrates and low in fats. The symptoms will go away with time, no need to get worried. If you could not tolerate Prozac or Escitalopram then the probable reason was first dose effects of SSRIs. You could have prevented this by starting with a low dose that is 5 mg for Escitalopram or 20 mg for Prozac. I hope your thyroid hormone levels are normal. If these are normal then no need to get worried. For more information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in abdomen below ribs\n\nI had my rt ovary removed 5 years ago due to an 11.7 cm cyst.Last month I was diagnosed with a 4.8cm cyst on my left ovary as well as a 2.1 cm there as well. My question is the pain I am having is on my left side, front and back at the bottom of my ribs.The pain at times is very intense and causes nausea. Could this be from the cysts?",
    "doctor_response": "hi Tamara Brown, more likely your pain is due to two ovarian cysts on left side. as right side ovarian cyst and ovary is removed ,that side is fine. usually any pain in abdomen is associated with nausea or vomiting.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What diet restrictions should be followed after a dog bite?\n\nHi, I had a dog bite on 30th Dec 2013 and blood came from the bitten place, immediately washed the wound with soap and took rabies vaccine which is the first dose and on 2nd I took second dose and today I took 3rd with this I have completed 3 doses and 2 doses yet took be taken. I want to know the diet restrictions, reactions when rabiepur injection taken and also the time takes for complete recovery from the infection and injury.",
    "doctor_response": "Hello,Welcome to HCM,Rabies is 100% fatal but it is 100% preventable by proper and adequate treatment. As you were bit by a dog for which you have taken care of your wound with thorough wound wash and antirabies vaccine of three doses on days 0,3 and 7.Adequate and complete treatment is of at most importance in any dog bite. As such there is no diet restrictions and they can have whatever they are having regularly.If you are a alcoholic and smoker you need to restrict that as it hampers the immune system to produce adequate and protective rabies virus neutralizing antibody titres.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the causes and effects of high WBC and low RBC count?\n\nHi, I am a 45 yo white female who for a year now has had issues with my CBC (elevated white count, lymphocytes, platelets, and low RBC). I ve had recurrent pneumonia that clears with long courses of antibiotics but white count still never goes into normal range. I have what I am calling sores in my throat that are almost ulcer like, that I m getting ready to see an ENT for. I have been seeing oncology recently who has checked some lab values before doing a bone marrow biopsy and the latest showed an elevated Cd4/Cd8 ratio. I am married with no history whatsoever of drug use and no history of blood transfusion, so HIV is out of the question. What could be the issue and where should I go from here? I feel like I m spinning my wheels trying to get an answer. Energy level and immune system have been extremely low for almost a year now.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. What is the WBC count? How elevated is it? I feel it's better if you consult an oncologist. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do Atopine Sulphate and Atropine have the same effect?\n\nHospice told us they were prescribing Atropine but the pharmacy delivered Atopine Sulphate which is labeled as a opthamolic (sp) solution. The label says 2 drops under the tongue every 2 hours as needed for excessive secretions. I suspect they sent the wrong prescription, what would you say?",
    "doctor_response": "Hi,Yes, both of these medications have the same effect. Atropine sulfate and atropine both are anti-cholinergic drugs equally effective in the treatment of excessive salivary, mucus or other secretions. Hence, atropine sulfate may be used safely instead of atropine.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes short breath, high heart rate and swollen legs inspite of being on medications?\n\nHi, Dr. Grief. Lately, whenever I walk a short distance I become short of breath, my heart start heart racing, my arms and legs feel swollen with fluid like I have on a blood pressure cup. What s wrong with me? Brief History: I am a 44 black female with diabetes, high blood pressure, and high cholesterol. I am on an insulin pump. Since starting the insulin pump I have notice my body retains fluids and I swells. Feb. 19, 2014 my Endo diagnosed me with High Blood Pressure. She started me on Metoprolol 25MG, Losartan 50mg, and vitamin D. She stated once my pressure is down my cholesterol will come down. After taking the losartan I had an allergic reaction to it and they increased the Metoprolol to 75 MG one 25mg at night and 50MG in the Am. She put me on hydrochlorothiazide 25gmg daily.....my blood pressure is still 154/96 heart rate 98.......What s wrong with me,,,,,,I am taking the meds. Why is my blood pressure still high? How come when I walk a few steps I am short of breath and my arms and feet feels like a blood pressure pump is on me? I am not understanding what s going on with my body.",
    "doctor_response": "that is dyspnoea on exertion and feet swelling may be due to heart problem once u check with ur physician and if u have malignant hypertension then also bp can't be controlled check for renal pathology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling of the foot?\n\nMy son has just been skateboarding his top of his foot is swollen his right foot rolled and hit the side and he finds it hard to move his little toe which is nearest to his swelling , otherwise hwe is not in pain when foot is now levitated , they put is omit immediately which was 20 min ago",
    "doctor_response": "Hi welcome to the health care magic According to history provide there was trauma at ankle joint while playing Following can be possibility.... -Fracture (if pain,  swelling more) -Ankle sprain -Tendinitis -ligament injury Local part x ray needs to be done in both view AP and lateral or oblique view also If fracture not present and sprain is present then ibuprofen 200 mg bd for 5 days prescribed Ice packs can be applied Elastic compression wrap helpful in reducing swelling Raise ankle above heart level for one hour two times in day Physiotherapy later on if needed can be done Hope your concern solved Consult orthopedic surgeon for examination and discuss all these",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for the sore joints and bones?\n\nHi am 30 years old female getting very sore joints and bones red bloctchy rash hot to touch at times sore wrist like it s going through my veins at times ,swollen hand can hardly walk at times all sore under sole of feet tingling in finger tips got blood tests from doctor they were for cronic pain they came back normal this has been going on few months now after I had thrombosis piles and then gall stones please help",
    "doctor_response": "In my opinion you need a lymph node sample to be laboratory tested for viral infection , also do a CPR testGood Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "How effective are Alivher and Progynova in the thickening of endometrium lining?\n\nHi, I am undergoing IVF treatment and my embryos are frozen. On my 9th day the endometrium thickness was 5.9 mm. I was asked to take progynova orally and alivher internally. Now the dose is aliver es and 3 progynova 3 times instead of 2 tablets 3 times a day. How effective will this be in the thickening of endometrium lining. I am currently 36 years old. Please give some inputs on how the lining thickens during a cycle.",
    "doctor_response": "HIWELL I HAVE GONE THROUGH YOUR CASEWELL IT SEEMS YOUR ENDOMETRIUM IS NOT GROWING TO THE MARKALIVER AND PROGYNOVA WORK REMARKABLY VERY WELL IN GROWING ENDOMETRIUM KINDLY STICK TOITTHANKS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should the ER be visited for elevated BP along with headaches and nausea?\n\nYes my BP has been high all Day my Dr said if it over 140/90 to call in i did All day my bottom number has been 113 /117 and my top has been 150 or higher i just checked it now and it\u2019s 171/111 i have a really bad headache in the back of my head and I\u2019m starting to feel nauseous should i go to the ER",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Regarding your concern, I would explain that your blood pressure values are really high (especially diastolic blood pressure values). These blood pressure values are the main cause of the headache and nausea. For this reason, if you do not have any anti-hypertensive drugs at home, I recommend going to the ER for a physical exam and blood pressure medicine to help reduce your blood pressure values. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it good to remove gall bladder, will it affect in any other way ?\n\nhello, I suffer from intermittent stomach pain and the diagnosis revealed gall stones of 2 mm in size in a sludge in the gall bladder . Doctor suggests gall bladder removal for the same. Is it good to get the gall bladder removed? will it affect me in any other ways. I am just 27 years old.",
    "doctor_response": "Hi, Intermittent pain can be because of gallstones, however if the stone is solitary and a very small size less than 5 mm it is better to have yourself a repeat scan after few days of normal diet and the scan to be done after overnight fasting. Small solitary stones can be treated by medicines. Removal of gallbladder does not alter the health and digestive system in anyway. wishing you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Hydrocodon -Acetaminophen effective for tooth ache?\n\nI am suffering from terrible tooth ache and took ibuprofen and 1 aleve around 10 and it's now 2:30. I finally have in an took 1 hydrocodon - acetaminophen 5-325 that the dentist prescribed me about a month ago. I never take pain meds but am miserable. Will this be ok?",
    "doctor_response": "Heloo pt-The most effective toothache medication is a narcotic based analgesic such as codiene, hydrocodone, or oxycodone. Most manufacturers combine the use of over the counter analgesics with narcotics to achieve more effective pain relief.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Obese, using gels for low testosterone levels and C-Pap for sleep apnea, have a stressful job. Suggestive remedy?\n\nMy husband uses testosterone gel in the morning after showering. His levels are so low he uses 3 pumps per shoulder of the 1.62% prescription gel. He is 53 years old, causacian, 6 3 and 330#. I try to encourage him to exercise and lose weight but haven t been successful. He complains of being tired ALL the time and is grumpy most of the time. He also has sleep apnea and uses his C- PAP every night. His stress level at work is very high. What can I do to help him? I feel like I m losing MY mind. Thanks",
    "doctor_response": "Hi there, thank for asking. You are right in your observation, because many people with sleep apnea may find change in the mood and energy level as well. A good strategy is to encourage him to lose weight. It can help for improvement in apnea. it should be at least 15 to 20 pounds to be effective. Honestly his BMI is very high and it makes the effectiveness of the CPAP lower than expected. He should also know that the CPAP pressure should also be adjusted during sleep assessment every one or two years to be effective. I wish him the best health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could shock like sensation when touching right elbow and exercising be due to anxiety?\n\nHi, I seem to have like a shock sensation when touching off my right elbow. I also had these shock like sensations when doing bicep curls in the gym, I had got them months ago but they went away, just wondering what these could be. I also get shock sensation from my wrists through my hands, but think that could be anxiety",
    "doctor_response": "In my opinion this is trauma to your ulner nerve , simple rest and 3 days on anti inflammatory drugs will fix it no reason to worryGood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does an abdominal hernia cause a knot in the stomach and stomach ache?\n\nI think I have an abdominal hernia, I have a knot slightly protruding from my stomach. I have a lot of stomach issues, sometimes after I eat, my stomach hurts or I have nausea, or both. Sometimes this doesn't happen til after a bowel movement. Is this related to the hernia? I'm 60 yrs old",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Hernia can cause abdominal pain. Do a CT scan to look for any obstruction in the bowel. It is better to correct the hernia by surgery to avoid unwanted complications. Consult a general surgeon and he will direct you accordingly. Wishing you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abnormal menstrual bleeding, mood swings and dizziness?\n\nhi i am very confused about my body, i had done a pregnancey test that came up negetive and i had been on my period twicw but very lightly, i have been having very unusual mood swings and hot sweats and some unusual food cravings, i had drank alcohol and getting drunk very easily so had drank less alcohol (5%) and i still got very typsy off that, i am finding it hard to fit into my size 10 jeans which i had no probem with a few months ago, im not eating all that much as i hav had alot of nausea and depression and am exercising alot more so i cant have put any weight on as it it very hard for me to do naturally, i am also having alot of dizzy spells and i am very tired all the time and moody.when i did the pregnancey test it came up negetive but it came up very faint as a positive then disapeard which left me even more confused! i am very unsure on what to think about all of this, i already have 2 boys and me and my financee have been very very brudey lately",
    "doctor_response": "Hello and welcome to healthcare magic.Your symptoms point towards a generalised disorder related to your hormonal system. If your mood swings are related to the onset of your menstrual cycle then pre menstrual syndrome may be the cause of it. This doesn't explain the \"faintly positive\" urine pregnancy test.My advice to you would be to visit a general physician or a gynaecologist at the earliest for blood tests and ultrasonography to rule out any hormonal disease.I could have given a more detailed answer if I had known few details like your age, details of your menstrual cycle, history of medical ailments like diabetes (if any) etc.please do write back if you have any more queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does taking Champix to quit smoking interfere in my pregnancy ?\n\nhi im taking champix to stop smoking and i was wondering if that could give a negitive pregnancy test",
    "doctor_response": "Dear kim, Hi from healthcaremagic forum, Champix as per study does not have any such effect on UPT and so there are no chances of negetive UPT.If you are suspecting and you have lapsed your periods then you may consult your nearest gynaecologist for further help.Moreover it is not indicated during pregnancy. You can refer the following site for side effects of champix",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is dizziness and headaches related to c5 and c6 disc bulge?\n\nHi I have a C5 c6 disc bulge confirmed by an MRI in November I have done pt for 3 months and my pt is recommending a epidural. I am now having bad migraine like headaches as well as neck and  pain I think the pt made me feel worse I never used to get migraines before. I am feeling very dizzy especially at night when I get in the shower is dizziness and headaches related to c5 and c6?",
    "doctor_response": "Hi, Welcome to Health care magic forum.                      As you describe the head ache may not be due to the physiotherapy. It may be due to the bulge of the C5 and 6 .or may be due to the drugs used for it.                       I advise you to consult a neurologist for diagnosis and treatment.                       I usually prescribe to my patient with such symptoms alprazolam,neurotropic injections for 10 consecutive days, and pain killers.                       Avoid taking potato, other tubers, tomato, egg, chicken, and sea foods.                      wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rough skin on cheeks of an infant?\n\nHi, my 15 month old son cheeks feel like sandpaper. This is not the first time this acured but when the doctors did the strep test it was negative. So my question is this time should I take him to see the doctor and if the strep test is negative goes he still have scarlet fever.",
    "doctor_response": "Hi... I feel with the strep test being negative, it is highly unlikely that it is a scarlet fever. I feel it could be eczema, a type of skin allergy. The trick of the management is keeping the skin moist and never allowing it to be dry. For this oil massage and lotions like Oilatum will help.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best infant food for the baby suffering with constipation?\n\ngood day doc.I m 28 yrs old and have a 1 yr old baby boy.could you pls. suggest us which brand of infant formula is best for baby who often suffer from constipation also considering hypoallergenic one..we tried switching to a lot of formula-milk s-26,similac,nan-ha and now we are feeding him enfagrow but still crying while taking a vowel..hope u could advise us.thank u so much!",
    "doctor_response": "Hi...except breast milk any of the formula milk can cause constipation.Rather than suggesting a formula I will suggest you a diet and a plan to relieve his constipation.Suggestions:1. Natural methods are the best to relieve constipation.2. Maximum milk consumption per day should not exceed 300-400ml3. Minimum 3-4 cups of fruits and vegetables to be consumed per dayHope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have vertigo, head feels heavy, uneasiness when moving head or neck. Normal MRI. Taking Vertin\n\nHi I have had repeated bout of vertigo from the past 6 months MRI came out normal. Yesterday after the vertigo episcode my head feels very heavy and if I move my head/ neck I feel very uneasy and feel another one coming..what is the reason and I have taken vertin 28 mg 2 times..I haven t gotten of the couch I feel very scared..",
    "doctor_response": "Hello dear... The reasons for vertigo are: 1. Vestibular system pathology (it is located in inner ear and maintains equilibrium, when affected it can cause vertigo) 2. Cerebro pontine angle tumors 3. Blood related problems- such as  recurrent hypoglycemia Normal MRI is helpful to rule out the presence of any Cerebro pontine angle pathology. So...it will be better to get your blood sugar levels & blood pressure checked & consult an ENT specialist for proper physical examination. There is no need to worry...you will be fine. Wishing you a good health Thanks & take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for granulated wound after drainage of an abscess\n\nI had an abcess drained and they made an incision. It has been over 4 weeks since then and I have been going for dressing of the wound to heal. Only afew days back when the packing of the wound seized the nurse noticed that it had over healed. The over granulated wound tends to hurt me when i walk and i dont know what to do. It is red at times then looks white please advise",
    "doctor_response": "Hi thanks for  asking question.You have done correct treatment regarding abscess.Your wound is in healing stage, because granulation tissue is red.Don't worry about granulation tissue, it suggest your wound is about to heal.Some itching and pain will be there until wound healed.Just now dressing can be done with normal saline.If wound healthy suture can also be taken for faster healing.I hope you will understand my concern.Dont worry.within few days your wound will be alright.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does pain in the tailbone during pregnancy indicate?\n\nI\u2019m currently 29 weeks pregnant, and about a week and a half ago I started to notice tailbone pain. It wasn\u2019t too bad at first, I just thought it was from my ligaments loosening from relaxin. But now, it hurts so much worse. It hurts sitting, standing, walking, all the time. It\u2019s also not right on my tailbone anymore. I received an Rhogam injection last week in my right buttocks cheek, and after that I noticed a hard bump under my skin on the right buttocks cheek right next to the crack, almost in between my buttocks right under the tailbone (not on my tailbone at all). It\u2019s not the injection site. There\u2019s no redness and no swelling really, and also there\u2019s no drainage or any signs that it\u2019s there besides the really intense aching and occasional stinging (like someone is poking it with a needle). Tylenol helps a bit. I tried an Epsom salt bath and that didn\u2019t help at all. What could it be?",
    "doctor_response": "Hello, The pain in tailbone can happen due to coccydynia or constipation. Doing a hot compress and avoiding sitting on hard surfaces will help. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can allergic rhinitis and chronic cough be treated?\n\ni have cold-like symptoms-stuffy nose, pressure in my ears, sneezing, and coughing. what I am concerned about is i have felt this coming on and worsening for 4 days. now i am coughing yellow thick mucus from my lungs. my eyes also burn and itch. no fever , however, so this leads me to believe it might be allergies. my allergies have been with me a few years now (i'm 62), but i have never been this bad. should i see a doctor?",
    "doctor_response": "Hello,Provided the history you do need to go to a doctor and get sputum cultures. Yellowish sputum usually indicates infection. You might need to be on antibiotics for a few days. Hope I have answered your query. Let me know if I can assist you further. Regards,  Dr. Purnima Sharma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of a dislocation of the shoulder?\n\nI was holding an umbrella and slipped on wooden steps and went down. I hit my back and head and had immediate pain in my right arm. I became nauesaus, broke out in a sweat and thought I was going to pass out. For a few minutes my fingers felt numb. I went to the E.R. and they said there were no broken bones and that I would be sore for a few days and needed to use my arm to get rid of the soreness. At first to move my arm from my shoulder to elbow was excruciating pain that brought me to tears. I continue to try to move and am now able to move it some. However, in some directions the pain is still severe to move. It is a different kind pain than soreness. I plan to go to an orthopedic in the morning. My questions is...if there is a tear, break or dislocation will I make it worse by continuing to try to move. I know the E.R. said that there was no break. However, my gut tells me something is not right.",
    "doctor_response": "dear Sir I have understood your concern, see I will explain about symptoms of dislocation of shoulder joint, due to mal positions of shoulder joint the tissue around the shoulder capsule will be continuous in stretch so due to that severely intense pain will be felt and unable to do any joint movement and you will feel differently joint position may front to your shoulder joint. if you feel like that immediately go to consult orthopedic surgeon and relocate properly. after the tone is proper 2months start gradually strengthening exercises. I hope you have satisfied with the answer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of mcbm_69?\n\nactually we are planning for the pregnancy and we went to the doctor yesterday and she suggested to take these tablet mcbm_69 before pregnancy and after also is there any problem because we should not use the tablets im worrying abouat this and if we will use this tablets any effects will be there on baby",
    "doctor_response": "Hi, It is considered to be safe for both mother and the unborn baby. MCBM-69 is a multivitamin (folic acid, methylcobalamin and pyridoxine) commonly prescribed during pregnancy to treat the deficiency states. These vitamins are used to prevent anemia during pregnancy whereas folic acid also plays a vital role in preventing a serious birth defect (spina bifida) in the newborn baby. Generally it is well tolerated by most of our patients, however it may cause nausea, heartburn, altered taste and flatulence. So, there is nothing to worry take this medicine as prescribed. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mohammed Taher Ali",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for high BP\n\nAm taking Lozart h in the morning and Amdip 10 at night but my bp seems not to be going down The lower one is all the time 100The bp of always 160/100 somtimes 175/107. Is the medication weak or stronger?  Am so confused.  My email address is  YYYY@YYYY",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. If your blood pressure is 160/100 even after taking two drugs then it need concern. You should consult your physician. You need to increase the dosage of antihypertensive or add some more drug. So consult your physician and take treatment accordingly. Hope I have answered your question. If you have any doubts then you can ask me. I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "what is side effect of aldonil od?\n\nwhat is side effect of aldonil od i am taking aldonil od once in a day after taken I feel stomach problems,i can not digest my food properly. my email address is YYYY@YYYY diabetic, b-12 & d3 vitamin report is not okey I am taking zoryle m2 fort",
    "doctor_response": "Hi, Aldonil OD is an aldose reductase inhibitor used for the treatment of painful neuropathy associated with diabetes mellitus. Its common side effects include vomiting, abdominal pain, diarrhea, dry mouth and headache. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will taking a lot of medicines for pregnancy effect my health and my future pregnancy ?\n\nhello doctor ,am 34yrold, & got married in Nov19th 2010, got ma 1st period on 23rd nov 10 2nd period on jan 26th 11 ,3rd 5thmar 11, 4th april 11,& 5th on may 5th 11 and 6th on may 23rd 11 and doctor suggested me to take carnisure500mg for 20dys .... will it harm in getting pregnant doctor had prescribd 1st with fertly super100mg ,clomid progestrone , levtol 2.5mg& now carnisure ....and my husband is taking tablets for depression as follows Parkin ,Azur , Stalopam, Telma-H, Amlip-5, Matilda,Glizard... and my hubby done semen analysis was Nrmal ... and 2day had gone for pregtest it appear 2lines should i await until 23rd /24thjune to confirm whether m pregnant..... had consulted a doctor and she had prescribed me again with Miprogen , Fol123 , ulgelsyrup ,&nosic tablets... m worried whether m really got conceivd or not .... one of my friend told Miprogen shouldnot be taken .... is it true please let me know as soon as possible had already taken 3tablets... m quite worried about my pregnancy... got some little flow and done pelvis scan & transvaginal ultrasound on 3july 11 and it got stop & again it flowed on 6thjuly continuosly .....tilll 9th july.. is ma pregnancy had vanished ... had done agn scan but couldnot find gestation ring (sac) under gone HCG on 7th,9th,&12th of july .... it was Nil... doctor had advice me to take All9 tablets now for 2mnths .... is it possible to get concvice agn.... i dint get ma periods this month of august 5th .... and m not sure when is ma cycle also .... had intercourse 2dy ....is there any chance ofconceiv shall i go for pregtest .... if so when ... and m nt takin ny tablets now.... and hd agn intrcourse on 7thAugust.... & yet idint get ma period...... willl i get conceive.... if so when should i go for pregtst...... please me eager awitn to receive ma baby to this wrld.... had intercourse agn 2dy 10thaugust...... ma sis-in-lw told to take regulate5mg for 3dys to get period if i dont get periods before 16th morning go 4 pregtest....me getting more tension regrading this issue ... please let my knw what shall i do...",
    "doctor_response": "hello, welcome to healthcare magic. you seems hyper anxious to get pregnant. first of all be relaxed. the more  get anxious the lesser  are the chances of regular periods. i read your q properly. yor periods are irregular since a year, so first of all stop all hormonal drugs if u taking. and let ur periods come on whatever time its coming. 2nd thing is imp. consider ur 1st menses day as day 1. now frm day 10th to 20th are imp to have intercourse to get pregnant, follow this thing. 3rd tthing. try this schedule for about 6 months. even then u dont get pregnant then undergo proper screening tests by consulting the infirtility doctor. do not use ur own logics and relatives or frnds. if u r nder treatment for baby, tthen follow all instructions of ur doctor only. do pregnancy test only if u pass more than 10 days of your expected date ( as ur menses is a bit late) have patience. u can conceive till u r menstruating. whnever u r pregnant, its elderly pregnancy so take care of it. thank u.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for chest pain with shortness of breath\n\nHello, I have discomfort in my chest and there is an ache with shortness of breath. This occurs usually when I work because in my work, I usually lift no less than 25lbs. I do have asthma, but the shortness of breath does not seem like an asthma attack. What could this be?",
    "doctor_response": "Hellowelcome to hcmas you have described that your job is concerned with lifting heavy weights that points towards one of the following cause for your pain(1) MUSCULO-SKELETAL i.e due to streching of muscles of chest wall(2) COSTOCHONDRITIS i.e inflammation of bones/cartilage of the ribsso you just need to take a course of ANALGESIC + MUSCLE RELAXANTS...take the following medicines for 1 week(1) TABLET IBUPROFEN 3 times a day after meals(2) TABLET TIZANIDINE 2 mg three times a day after mealsavoid lifting heavy weights n operating machinary for 1 week till u take these medicinesregardsdr rahul rathee",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swollen tonsil, difficulty in breathing, snoring during sleep, negative strep test. Taken antibiotics, veramyst. What is the cause?\n\nMy son is five. A few weeks ago I noticed his voice sounded scratchy. I looked in his mouth and noticed his left tonsil was extremely swollen and red. His pediatrician gave him an antibiotic and he tested neg for strep . We finished his antibiotic and noticed that his tonsils were even more swollen than before. We went back to the pediatrician and he again tested neg for any strep. She prescribed us with veramyst for allergies and said that sometimes kids just have large tonsils. The veramyst is clearly not working as I am observing both of his tonsils continuing to swell more with each day. The redness is no longer present. He is now snoring and struggling to breath at night when he sleeps. I understand that some people may have large tonsils but I m concerned at the rate of growth. When you look at them, the left tonsil is extended past the halfway point in his throat. If the right tonsil was the same size they would easily be touching. The right tonsil is only slightly smaller.",
    "doctor_response": "there are chronic allergies and adenoiditis.wich cuses problems actually this occur in most of childrenaccording to milk theory chila need milk only breast milk 2 years and after that no milkif we add milk and diary they are animal proteins which arenot competible with human proteins and they cause various diseaseswithdraw milk and diary completely from diet add cerreals vegetables fruits child will reverse in symptomps and no recurencetill then go for sujpportive therapy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for high systolic pressure\n\nI am 56, a diabetic for last ten years. My latest tests are v good. Hb1ac 5.6 and all organ functions fine. i did get a Cat 64 done 3 years ago as my triglycerides were very high . The scan revealed moderate to mild stenosis. But the specialist , even recently, may be because of my excellent all round results, have said that until there are any symptomatic problems, I need not worry. My sistolic pressure , of late has bee rather high.. between 155 and 170.. The diastolic is perfect. I go for regular one hour walks, dont smoke, do pranaam and yoga. what is your advice for me ?",
    "doctor_response": "Hello, Please note that blood pressure should be controlled. You should take medication for blood pressure. Decrease salt intake up to 5 gm per day per person. Rest you are perfect. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Varinder Joshi , General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to improve rapid linear progression in semen immediately?\n\nHi i am thomas, i have checked my semen analysis, my sperm count per ml is 112 million/ml and ejaculate 134.4 million/ejaculate. rapid linear progressive is 12%, sluggish linear progressive 30%, total forward progression 42%, how to improve my rapid linear progression immediately.. i am waiting for your answer...",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that your semen analysis has revealed Rapid Linear Progressive motile sperms to be 12%.The grade one sperm (Rapid Progressive motile sperms )up to 12-15 % are within accepted range  by most of the Infertility Centers all over the world to.impregnate wife.Truly speaking there are no drugs invented so far to increase motility of sperms However Following measure will help you to increase and improve motility of sperms .1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning.2) Take high protein diet rich in vegetables and fruits and Vitamin A,C,D,E.and Zinc3)Take anti oxidants like Almonds 5-6 everyday..4) Avoid alcohol and smoking..Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump on the clavicle bone indicate?\n\nSudden lump appeared on end of right clavicle nearly 2 months ago. Xray found spur under it. Prior to lump appearing I d been to orthopod due to shoulder pain. MRI showed slight tear that I was told shouldn t cause pain and extreme inflammation in pectoral muscle spreading to ribs. The lump itself is hard as a rock and quite large, may be extending down to right and out, toward inflamed pec. Bouncing between orthopedic surgeon and primary care doc. Dramatically swollen lymph nodes on both sides of throat, under right arm and sudden lumps both breasts triggered trip to breast cancer clinic for mammos and ultrtasounds. This revealed one tiny cyst to check on again in a year. Screened for Lyme Disease--negative. Suggestions?",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .* Revealing the different symptomatology , answer to this is excision biopsy    of the lump to rule out underlying pathology in terms of benign or    malignant nature .Hope this clears your doubt  .Wishing you fine recovery .Welcome for any further  assistance .Regards  take care .Dr. Bhagyesh ( MS , FMAS - consultant surgeon )",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain while laughing?\n\nmy daughter is 4 years and 8 months old.she is a very few often complaing that , she feels a slight pain in chest while loughing.but soon after she gets busy wiht her plaing , jumping and others..... she is having  two separate  antibiotics for 5 days.due to an abdiminal problem.the doctor said its Mesenteric Lymphadenities.she got blood test ,ultrasound,and urin test for this abdominal problem,wher her urin test and ultrasound could 'nt find anything.but her WBC is 14.",
    "doctor_response": "Chest pain per se is not a concern in kids as isolated symptoms unless they develop breathlessness and become tired. Is she is playing around with no complaints, then you can ignore it as you said it comes out only in laughing and not in any other vigorous activity.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes discharge of sperm during urination?\n\nhello sir i m 27 year old unmarried student. i m suffering from a problem. in my urine i discharge sperm also. it may be occure at night without doing urine.i musterbate (Hand practice) only max. 5-8 time in a month.my wait is 67 kg n body is avarage. this problem is only 5 days old.pls sir tell me any medicine and precautions thank you sir.",
    "doctor_response": "Hello. I have reviewed your query and here is my advice. Semen can be found in urine. You already know that the tract through which urine comes, sperm comes out of the same tract. So urine can contain semen. The semen may be seeping after urination or during urination or when your bowels are compressed. There is nothing wrong in this phenomenon and this is absolutely normal. Therefore please do not worry too much about this.Hope I have answered your query. You can contact me for treatment options. Let me know if I can assist you further. Regards, Dr. K. V. Anand",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can one be free from skin rashes since long ?\n\nmy gf has been having issues with her skin most of her life she 20 years old and as a child she would get these rashes that covers her body..she says it happens a couple times a year which i find not normal...she also has acne and break out in rashes if shes overheating or her body temperature too high..she used to take doctor prescribed medince for the rash, but the was years ago...well now we dont have much money or insurance..and every rash cream we use dont work plus shes allergic to SPF in sunscreen she has rashes from that too what do she need a dermatologist?",
    "doctor_response": "Hi...dear user.., Thanks for choosing HCM., Skin rash since child hood and associated with Acne.., could be due to Hormonal hyperactivity..., She has having seasonal Allergy with Mast cell degranulation..., hence she is getting frequently this problem..., Treatment is ... 1) Avoid the triggers like...cold touch, Bitter fumes, Dust, etc.., 2) Tab..Fexofenadine 180 mg for 30 days.... after 2 tab weekly for 5 months..., 3) Tab Betamethasone 0.5 mg 2 tabs /day for 5 days.., 1 tab /day for 5 days, 2 tabs / weekly for 4 weeks., weekly once for 6 months..,( Pulse therapy) 4) Mast cell degranulation.....by...using Sodium cromoglicate,nedocromil.., Follow this ...total remission will occur ok..,bye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is daily masturbation normal?\n\nhi im 22 m im habitual for masturbating this habits continue for 6 -7 years long and now im feel depress as i do right for my health or a future point of view.Sir and another problem is relating to a mastubate when i talk my gf with the mobile phne im feel so exite her voice and do masturbate daily sir plz help me out i want to try to leave this habit but i cant find any soln",
    "doctor_response": "Hello Thanks for writing to HCMMasturbation is normally practiced by most of the males but its obsession is bad.You are very young and you should concentrate in your activities.You should avoid provocative literature and videos and try to keep busy yourself in your job.You can also try yoga and meditation,this will help a lot.Hope i have answered your query.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be concerned with high ALT liver enzymes?\n\nI just had some lab work done and also on the recovering end of an awful stomach bug lasting around 6 days with massive diarrhea. I have hydrated with IVs and Gatorade. All my lab work was normal except my ALT liver enzyme. It was 96. Is this cause for major concern or should I just recheck at a later date. Thanks",
    "doctor_response": "Thanks for your consultataion at HCM!!    I have gone through your case and being your physcian i totally undrstands your health concerns     Raised ALT occur in variety if liver diseases starting from simple FATTY LIVER DIASEASE to HCV ,HBV infection..    All you need is to do an ultrasound of liver and consult hepatologist so that the proper workup of liver has been done and exact diagnosis should be made after ruling out other liver diseases.       Hope your query is adequately answered if u still have any feel free to ask     Regards      Dr Saad Sultan",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the cut on my son's foot?\n\nmy 2 yr old has a cut on his foot not sure how he got it really, we are outside alot. but this morning it has a red streak coming from it. should i take him or dr in the morning there office is closed for the 4th of july or should i take him to the er today",
    "doctor_response": "HelloThanks for the queryBecause of their increased activity children are more prone to get injured.Many a time the injury is noticed later.Maintain proper hygiene to avoid infection to the cut site.Apply antibiotic ointment like mupirocin to prevent infection.If the cut is not deep it will improve within 4-5 days with this measure.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should do With indigestion problem?\n\nI have indigestion and running around the doctor, please help me... :(",
    "doctor_response": "hello thanks for choosing healthcare magic Dyspepsia as we call it in medical terms is a wide spectrum of disease with a number of symptoms such as indigestion , heart burn , bloating feeling etc. The  cause of which could be as basic as an  unhealthy life style, stress , bacterial infection, drug usage such as pain killers , steroids . First of all 1. Healthy food habits . 2. avoid spicy food and outside food 3.Do not starve yourself and do not overeat In case there is no remedy with these simple steps you need to start on antacids , proton pump inhibitors You can take the following medication for abouta month and see Tab . Pantoprazole 40 mg once daily , half hour before breakfast . If you have already tried the above medication with no relief then you might have to get an endoscopy done to know the exact cause . A gastro enterologist will be able to guide you on the necessity of a anti H. Pylori medication (antibiotics) hope i have answered your quesstion",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the lower abdomen and pelvic area. Could this be PMS?\n\nI have lower abdominal pain . Around my pelvic area more at my right side. I am also having headaches and random back pain and tender breasts, on and off.. My upper legs hurt too...It looks like PMS as I should be having my period anytime now. Last month I had it at the 11th. Could there be any other reason? It s the first time these symptoms Are occuring. Especially the pain pain in the abdomen",
    "doctor_response": "Hi there, Thanks for writing in. Most likely what are experiencing might be symptoms of PMS. It should get better in 2-3 days, once you get your periods. I'm assuming you don't have any other symptoms like vomiting , or high grade fever, which if present might point to some other pathology. Meanwhile you might want to take a meftal spas tablet for symptomatic pain relief. Drink warm water at regular intervals. Hope this helps. Regards, Dr. Divya Kuttikrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Where can we seek counselling for my sisters mental condition ?\n\nSir, I dnt know whom i want to ask this and to which category this question will comes... I have a sister, she is 21 now.we have a problem with her.She use to speak so much in nights with gents in very typical manner by this those guy will feel in different manner.she use to speak like that only.we are telling her from past five years.But still she is in that condition only.At the time we speak with her, she will realize but again she use to do like that only.we are so much worried about her behaviour.we don t know want to do.Finally we decided we have to consult a doctor for counselling.But we don t know where we have to go.We are staying in Guntur , Andhrapradesh .Can you suggestion to which doctor we have to consult.Sorry for the big story..",
    "doctor_response": "hi welcome to health care magic.how long she talk in sleep from childhood or after that?any incidence occurs after that she talked like that manner?I suggest you to concern any psychiatrist or any homoeopath which conduct her history give treatment according to that. thanks dr.dhara dhara.shah84@yahoo.in",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need guidance for various problems. I just feel like killing myself. any suggestion for me ?\n\nDear Doctor , I am a 46 year old married woman with 2 grown up kids, I have been working since I was 16, and have always been a go getter, and my family was the centre of my life, however lately I feel that I am losing interest in everything, I am not bothered about my looks, I am not bothered about how my home looks, I have had some issues with my husband s insensitivity related to our sex life for many years, which lead to me drinking and venting alone, I feel I can not rely on my husband for supporting me neither emotionally nor financially, I have been self reliant all my life but now I cannot go on any more. My husband does try to be supportive but for short periods of time only, though he means well he is not the doting husband types. I have worked in MNC companies (as a trainer) all my life but now I am working in a Pvt Ltd hospital and do not like my job, have not been successful in getting another job because of my age and have not done my MBA, just plain graduate. I am suffering from hypo thyroidism, (and taking .50 mg thyroxcin) I am obese and my weight is increasing, I suffer from hunger pangs on some days and on others I don t feel like eating and now I am suffering from depression and high blood pressure , my treating physician has given my Nexito 20 for 1 month, I am still not feeling energetic, instead I am feeling more low, and in fact now I am so deflated that I don t feel like having a bath or groom myself, I just feel like killing myself, but of course I am worried about my kids future, please advise",
    "doctor_response": "The first advise i could give is to remain in company and never sit alone. Talk about your feelings and give them a direction. Don't make you imaginary feelings of isolation. Enjoy the world. Bellieve in God and join some religious group. Don't expect any help from anyone as unfulfilled expectation causes more depression. Move out in company and see how nature reveals itself to you. In Ayurveda we offer Shiro dhara with medicated oils enjoy it and have Cap. Bravobol with ashwagandha churan 500mg. TDS. dr_patients@hotmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and dryness in lips?\n\nHello, I m at 22yo female and I ve been experiencing problems with my lips for the past three months and it has gotten much worse in the past 2 days. The best way I can describe the feeling is as a tightness in my lips - they look slightly swollen and feel dry (but not chapped or cracked). Sometimes it is painful or itchy as well, but always uncomfortable. I haven t had any sores on my mouth until the last day or two (but that is most likely a result of my aggressive itching) and I don t have a history of cold sores or anything like that. I ve tried a multitude of different lip chaps (I know not to use anything with dye in it because I get allergic reactions to those) and have mostly used vaseline to deal with it, but I feel like this is not enough anymore. Any thoughts as to what might be causing this problem and what I can do about it?",
    "doctor_response": "Hi,You seem to have chronic cheilitis. There may be erythema,dryness,mild scaling, fissuring and crusting. You might have mild pain,burning and itching. There may be some cause. Lip licking might exacerbate the disease. Sunrays exposure, cosmetics,lipstiks tooth paste, dusts...etc might be resposible. Vitamin B complex deficiencies,anaemia or nutritional inadequacy might cause the disease...You consult dermatologist for firm diagnosis and treatment of its cause.Have blood tests to rule out any internal disease or vitamin deficiencies.You may take folic acid 5 mg thrice a day with iron tab. Antibiotics may be needed if there is secondary bacterial infection. Apply antibitic cream with mild steroid like mpmetasone. You may avoid soap,cosmetics and lipstik for good and fast result. Avoid bad habit of lip licking,if it is there. Do not traumatise the lip skin with your nails.You might get good result after few weeks. I hope this would help you in your treatment.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Venlafaxine Hydrochloride safe for depression?\n\nI am presently taking 2 Sertraline hcl 100 mg for antidepressant how ever I am always tiered and my doctor wants me to start taking VENLAFAXINE HCL ER 75 MG CAP IN ADDITION TO THE SERTRLINE. I have read the REVIEWS on the VENLAFAXING AND THE REVIEWS ARE VERY SCARY. IS IT POSSIBLE THAT MY DOCTOR MADE A MISTAKE? PLEASE REPLY A SOON AS POSSIBLE. THANK YOU.",
    "doctor_response": "hi and thanks for quetion.yes venlafaxine is safe for depression.its a newer antidepressent with less sedative effects.if you r not better with sertraline than start venlafaxine. few side effect is there but its manageble. if u r scary than start desvenlafaxine which has lower side effects than venlafaxine. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pins & needles in hands?\n\nfor the past two days I have pins and needles in both hands. I am 48 years old and a smoker. I exercise regularly and I m in my healthy weight range. I have had no health issues in the past. No cough or shortness of breath and no blood pressure problems",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have  pins & needles in hands. Well there can be many reasons for symptoms you mention in query like pressure on hand , trapped nerve , diabetes or injury . I would suggest you to take proper rest , do not sleep on your hand , apply warm compresses on hand several times a day and do gentle massage with sesame oil . Consult orthopedic surgeon if condition doesn't get better . Doctor may order CT scan , nerve conduction test , blood test to rule out diabetes and physical examination . Doctor may prescribe muscle relaxant along with anti inflammatory . Doctor may also recommend physical therapy or may refer you to neurologist for nerve problem or endocrinologist for diabetes . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes palpitations while in hot bath?\n\nGreat!  Everytime I'm in a hot bath for a while I get heart palpitations, its happened for a very long time and it doesnt scare me as I'm a dancer and used to my heart beating strong.  But it has to do with the hot bath.  I recently experienced it again after a hot tub.  Is thisnormal?",
    "doctor_response": "Yes its normal...the herat could be affected by any change in the weather or any activity...don't put it in your mind....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tumors in stomach, stage 4 cancer. Chances of recovery?\n\nmy grandpa is 73 and had not eaten in over a month and then was sent to hospital. They ended up cutting him open and has to attach small intestine to large and removed large tumors.. he didn t recover well so they did surgery again found more tumors and gave him a collostomy bag because tumors were blocking it up. He is now home and real weak. He just saw onocologist who says his kidneys are weak and he still too weak for chemo and that his cancer is stage 4... what can we do to improve his chances?? And what are his chances of recovery??",
    "doctor_response": "Hello, welcome to HCM, Firstly in this area of gastrointestinal tract many types of cancer can occur. But, if we consider this to be a case of  adenocarcinoma which is most common, then there is basically lowest chance of survival present. Apprximately 60 to 90 percent patients die within 6 months. So, prognosis is very poor. This is a hard truth.try to belive this.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does a child has diarrhea and vomiting having tested positive for reducing substance?\n\nHello Doctor. My son is 2 ad 1/4 yrs old . He s getting into motion problems since December 25 ,2013. He took ofcomac (for a week), Ofcomac Forte &bifilac (for a week) , Metrogyl(5 days ) and z&d (2 weeks) .After the above treatment he became normal . 3 weeks later one night he got vomiting. He vomited 13 times n 3 hrs followed by which he was given Vomiset injection and got vomiting controlled . But had vomiting sensation and motion problems started again. He again took the medicines Propanz,zoxakind-o,Progurt, ascezin (10 days ) . After the above treatment he was normal for a week only. Now again he s stuck up with loose motion problems . i have give motion culture ,complete and a test for reducing substance. The report says 1.positive(trace) for reducing substance 2. Acidic and occasional pus cells 3. So far no pathogens found in culture ( still a day more for the culture result to come ) I am very confused and worried concerned about my son s health . why does he get this problems often? We are pure veg and his diet is a normal one for the past yrs ( milk ,idly ,dosa ,chapati,biscuits , fruit juice and chocolates ) . i dont give him outside food . I didn t try any new food except i had given a try for the horlicks and bournvita for adults occasionally . Kindly provide your valuable guidance . Will he have any internal problems ? like intestine problems ? Thanks in advance for providing ur valuable guidance .",
    "doctor_response": "He might be having lactose intolerance.avoid milk and milk products.put him on a very bland diet like rice ganji, vegetable soups,sooji or oats porridge and plenty of oral fluids like fruit juice etc give him Darolac sacchets-one packet mixed with pre boiled and cooled water twice a day for one week,if vomit persists give him emeset syrup 5ml twice a day before food for 5days,since u had already given antibiotic let us not repeat.avoid chocolates and cream biscuits for a fortnight,he will be fine",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to avoid food getting stuck in teeth?\n\nHi Doctors, recently and for the past one year now, I have been having food, especially meat, sticking so long between my molar and/or premolar teeth after eating. This has been a big pain when trying to use tooth-pick to remove the stick meat after finished eating.",
    "doctor_response": "Hello,If you have spaces between your teeth food may ocasionally get stuck. If the frequency has changed and you notice larger spacing, a visit to the orthodontist could be considered to close the spaces and improve your bite with braces. Another concern is your periodontal condition which involves your gums and bone.  Increased spacing can indicate tooth movement due to loss of bone. You would need to consult a periodontist. If you associate this with recent dental work, ask your dentist to check the contacts between your teeth. Broken or decayed teeth can catch food as well. Make sure you are up to date on your routine exam and cleaning to properly diagnose your condition and best treatment recommendation. Maintain good day dental care including flossing.Thsnk you for your inquiry.?i hope my suggestions are helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fibroid in uterus and low sperm count\n\ni m 30 year old women& married from last 3 year , past two year we had planned for no child but now we want child we both are trying desperatly but still no result after all treatment its result that i have fibroid on uterus body and my husband has less sperm count so is it possibility of child in such cases",
    "doctor_response": "Hi,I read your query and I understand your concerns.Following is my reply:1) Fibroids need to be operated by myomectomy.2) If sperms counts are low IUI can be tried.3) Visit an IVF specialist for ICSI option assessment.Let me know if you have anymore questions.Regards,Dr. Mahesh Koregol",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluctuations in the BP level while on Galvus-Met?\n\nSir. My age is 60 year and my angioplasty was done in the year 2001 (with one stent),After that Galvasmet50/500 started alonge with cardiac medicine,Now my BP is not stable BP range is,140/70,130/70,130/60.My Hb1C is 6 daily sugar level is fasting 110,PP after 2 hr is 210 and after four hr is 90 before lunch.Is it galvasmet is safe drug for me. Pl advice my further treatment,Thanks.Sir at present i have no money to pay any amount",
    "doctor_response": "hello thanks for posting here. your blood pressure levels are not unstable. they are within the acceptable limits. your HbA1c levels are also under control. please dont worry about them. please continue taking galvus met and your cardiac medications. wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any issues to conceive if have taken antibiotics in childhood?\n\nGood afternoon, I would like to ask you, if my desease is curable and is my body responsible to have a baby in the future? I am a girl, aged 24, and I spent my childhood on antibiotics because I was ill too often. I had a low function of Thyroide (cured by hormons to have menses) as a teenager. Since the age of 5 I have allergies but my problems became a lot more serious last two years: sIgE polyvalent, toal IgE 46 000 IU/ml, atopic dermatitis (everywhere), asthma brochiale, anaphylaxis (nuts), eczema herpetiicatum Kaposi (three times), infections caused by Staphylococcus aureus, HLA B27 positivity, eosinophilia, high PLT, ...I have no regular menses (my weight 60kg, height 170cm, but I suffered from mental anorexia five years ago).",
    "doctor_response": "Hi,Antibiotic use in your teenage years or atopic dermatitis, asthma and other forms of allergy will not affect your ability to conceive. Previous antibiotic use years before will not cause any birth defects. The cause of irregular periods such as nutritional deficiency, thyroid disorders or ovarian cysts should be treated. This will help in hormonal balance and increase the chance of pregnancy.Certain antibiotics like fluroquinolones, tetracycline should be avoided if pregnancy is confirmed. Penicillin and cephalosporin antibiotics can be used.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Saranya Ramadoss, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for a itchy rash on the top of butt crack\n\ni have a rash and itchy skin which runs from the top of my butt crack down about 2 inches long.  it is on both sides and when i scratch it it becomes raw and then scabs lightly.  I have tried hydrocortisone and that seems to work temporarily but doesn't seem to cure it.",
    "doctor_response": "Hello,Thank you for posting on HCM.It seems you have got intertrigo.Intertrigo is an infection which occurs over any opposing skin surfaces , mostly seen over groin folds. Its caused due to bacterial or sometimes fungal infection.Overweight can increase the friction and thus predispose to intertrigo.I would suggest you oral antibiotics and antifungal tablets for few days along with application of antibiotic cream like fusidic acid and antifungal cream like clotrimazole twice a day for few weeks.Use dusting powder containing clotrimazole on daily basis to keep area dry and reduce friction.Try to reduce weight and maintain hygiene.Avoid tight undergarments and use cotton garments as far as possible.Hope this will help youTake careDr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for constant yawning\n\nFor the last few weeks I have been having issues with constant yawning. It s getting worse and over the past 3 days I keep needing to yawn over and over right after the last yawn and it s making me crazy as it s constant so I don t know if something is wrong.",
    "doctor_response": "hi,thank you for providing the brief history.as you mentioned you are having constant yawning that means to under stand the physiologicalical needs here. since the body is in need of oxygen it leads the activity called yawning. Which is common at times. to avoid the morenof the yawning you need to Improve your metabolism and cellular functioning. Which can be done by performing general exercises.with the grace of God I wish you a speedy recovery",
    "dialogue_context": ""
  },
  {
    "patient_message": "Has prostate cancer. Done PSA test. Given Levoff. Help?\n\nHi, I am Rajendra Sonavane.My age is 42 complete. My father having prostate cancer. As  per Dr. I had test PSA test on 15.03.2013 , result is 5.01. Dr. atul Soni,Aurangabad give me levoff 500 and bevon tab for 15 days. Again I test PSA on 05.04.2013. Result is 4.33. As per doctor it is normal. But in report below 4 is normal. pls advice",
    "doctor_response": "Hello; A  common cause of raised PSA is infection in prostate. Therefor your doctor has prescribed antibiotic and your PSA is in decreasing  trend after treatment . PSA is non specific test for detection of prostate cancer. Although PSA level of 4 is taken as cutoff,no level of PSA can correctly predict whether a person has cancer or not.A person with PSA less than 4 has 15% risk of cancer,  4-10 have around 25% risk of cancer while >10 have around 67% risk. If your PSA is persistantly high and/or there is some abnormal finding in your rectal examination you can discuss with your doctor regarding biopsy-which is the only test that gives definitive diagnosis of cancer. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can asthma be treated?\n\nHi, my son has just turn 12 months old, he is breasfeed on demand and has breakfast, bananas and fruit smooths, the odd rusk and dinner with a petit flue. On Tuesday he was diagnose with asthma and so after neubalisers etc we came home and he is on two inhalars, one for preventing asthma attak and the other to help him with his breathing,  which we ll give him for a week. We are happy with all that, its just that since we came home he seems to be vomiting up everything he eats, twice or three times he has kept the breastmilk, this is acompanied by sticky  white mucus and soild nappies with A LOT of this mucus, its been 24 hrs.,he is happy and smily but hungry and unable to keep food down, any ideas? He also had taken for 3 days stereoids 20mg for three days, I manage to give himwater, but I am still worried!!",
    "doctor_response": "HelloAs your son diagnosed a patient of asthma , so I will try to explain you some preventive measures for your son for asthma . He is now taking steroid and one more inhaler , if your son don't have any symptoms or discomfort stop all medicines . 2nd point is about the vomiting , he is having . The cause of vomiting may be due to gastritis developed by drugs and asthmatic attack .When such patient visit I advise my patient to take ondansetrone syrup or mouth dissolving tablet before any medicine ( inhaler or steroid ) .Now I want to tell you that there are few causative factors responsible for asthma , these are dust , mite , pests ( cockroaches ) , hay smoking , sudden increase or decrease of temperature , pollen , molds , fine dusting powder . So if possible please avoid these factors . Measures to reduce exposure to indoor allergens .Wash all bed covers in hot cycle (55-60 degree C ) every week.Treat carpets with tannic acid.Clean upholstered objects in dust cupboard .Keep dust accumulating dust board.Replace curtains with blind 7 easily washed curtains .Hot wash/freeze toys.Use vacuum cleaner .Encase mattress Keep pets out of living rooms .Install air conditioner or dehumidifier .Eliminate suitable environment for cockroaches .These measure will help your child .When such case visit I prescribe monteleukast syrup with bambuterol syrup 0.2 mg / kg body weight / day once or twice in day depending upon the severity of disease . Since this is a prescription drug so consult your doctor and get his opinion.Usually I don't prescribe steroid to my patient except in EMERGENCY .Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe cold , cough and chest pain\n\nHello doctor iam suffering from cold and cough along with severe pain in chest and back .....which is unbearable for me ..... also iam expecting since last month ... is it safe for me to take azax 250 ....or else kindly recommend me something ..which is not harmfull for my baby",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. Better not to take azithromycin because it is not 100% safe in pregnancy. Better to take penicillin group of antibiotic like penicillin, cefixime etc. Along with antibiotics also take antihistamine like levocetrizine and anti inflammatory drugs like paracetamol. All these are safe in pregnancy. Also drink plenty of fluids orally and keep yourself hydrated. Do warm water gargles 5-6 times a day. All these will improve your symptoms with out affecting you and your baby. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the chest radiating to the back. Had a spinal surgery in the past. Reason?\n\nMy haemoglobin is 18 & hemotocrit is 53.8 does it create any problem. I have gone through the spine surgery before 3 years & nowadays i m suffering from right side chest pain radiating with back. I have gone through the blood tests, x rays, vitamin d3 , vitamin b12, sonography which appears normal but the pain exists. Kindly help",
    "doctor_response": "Hello, Thanks for posting your query. Normal value of hemoglobin in men range 14.0-17.5g/dL, as you are having slightly high hemoglobin levels which may be due to smoking, living at high attitudes, dehydration or any cardiac lung or liver disease. Chest pain radiating to back may be caused by pancreatitis,liver or gallbladder disease, peptic ulcer or cardiac ischemia. You are advised to visit doctor and get your LFT, serum amylase and endoscopy to reach causative factor. Hope it helps. Take Care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for loose motions in a child\n\nHi I m Dawn from Trinidad.....my 4-y-o son took enterogermina last night as he has been having loose stools...is that ok?He vomited a while ago too-has another dose to take-normal weight for his age-vomited once Saturday last with loose stool since.Very frequent trips to bathroom between 5 and 11opm last night. Thanks",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry.There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe abdomen pain with sweating and chills?\n\n22 yrs old male  5'3 130 Ib this morning I woke up fine three hours later I get a really painful stomachach with sweat and chills. I could not poop, but tried really hard after half an hour, diahrea came out. Still having the painful stomachache, I go to the bathroom again,but nothing, except for som kind of red liquid. I was constipated since yesterday. Is there any serious problem I'm having?",
    "doctor_response": "Hi.Thanks for your query.There looks to be a serious problem as per your history.The sudden onset of pain in abdomen- sweat and chills- unable to poop in the beginning , followed by diarrhea- pain continues and now red liwuid...This is very classical finding of a disease called ''intussusception''.In this condition the part of the intestine enters into the intestine to give a tube-in-tube  appearance. You need to rush to ER.Do not take anything orally.You have to go for :X-ray of the abdomen in the standing position and-Barium enema- as for diagnosis and many times it is the treatment on its own. The pressure of the barium can resolve the intussusception.Once the problem is sorted out temporarily, you have to undergo definite diagnosis by way of CT scan , colonoscopy and other investigation and the treatment then is well planned to remove the cause that caused this. At the same time this helps to rule out any other pathology.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for an infection in the chest\n\nhi this is anurag .we have a female baby of nine months .from last week my baby is disturbed from going out mucas from her nose continiously may be reason is cold.today in evening she did white potty.we are giving her atrax 7drops three times a day and lcz 2.5 ml onece a day",
    "doctor_response": "Hi... This is not infection in the chest. This is just common cold.Cough and cold are viral 95% of the times in children. For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15mg/kg/dose (max ceiling dose 500mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.For cold you can use Cetrizine at 0.25mg/kg/dose every 12 hourly for 3 days.For nasal block, plain saline nasal drops will do, every 4-6th hourly to relive nasal congestion.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe pain in the toes\n\nhow do I know my hormores are in balance? I have a lot of pain in my toes; my dark spots on my face are increasing, and I have cracks in the corner of my mouth that don t heal. I also have more grey hair than my parents. I recently got off depo shots as the last one left me feeling odd and achy.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Causes for pain at toes are:1. Injury2. Blunt trauma3. Sprain or strain4. Plantar fascitis5. Improper postureYou can take tab. aceclofenac. Apply diclofenac gel or cream. Apply ice locally. Do x-ray and MRI feet. Use ankle cap. Consult your physician for prescription.Treatment mainly depends upon underlying conditions. Kindly follow with detailed history or consult with orthopedician. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Shyam B. Kale",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the ways to get a glowing face?\n\nHello doctor, I want to glow my face. I am working in sunlight. What should I do?",
    "doctor_response": "Hello. I just read your query. First of all take measures to protect your face from direct sunlight. Always use sunscreen lotion. There are many sunscreen lotions available for men in the market now a days. You can choose a sunscreen lotion between 40-50 spf and with uv protection. Take some amount of sunscreen lotion in your palms and apply it gently over your face and other parts which get exposed in sunlight. Do it regularly and even if there are clouds then also use sunscreen lotion. If you work for longer shifts then repeat the application of suncreen lotion once again in the afternoon. Along with this always cover your head with a hat to avoid direct exposure to ssunlight Drink one glass of water before going outside as it will help in less water loss. Drink plenty of water whole day to avoid water loss from the body. Avoid cold drinks and caffeinated drinks and prefer fresh lemon drink and fruits having high water content like watermelon, etc. After coming home, wash your face with herbal face wash and then use aloe vera gel over face. Take some sandalwood powder and add a pinch of turmeric powder in it and some rose water in it and make a paste. Apply this over face for 10 minutes and then wash it away with simple water. You can use it two to three times a week. It will help you a lot. Use all these measures regularly and you will feel better results soon. three weeks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is brain tumor causing my headaches?\n\nHi doctor, I have suffered from sinus congestion in the past, but this time my headaches are different and the time is much longer. Normally, I get pain in my forehead and eyes.\u00a0This time the pain is in my forehead, eyes, ears, and it feels like my neck is throbbing. It is like I am being held upside down, this lasts almost the entire day. I have had this pain for two months now. I had an MRI, four years ago, that came out clear. I am wondering if it could be a brain tumor causing this pressure this time? I have never had pressure like this before for this long. Please help.",
    "doctor_response": "Hi. Revert with more information to a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on knee?\n\nMy wife has a small pea sized lump on the outside of the right knee. The lump is solid and hurts when its pressed. The knee hurts a little bit when going up stairs but is a lot more painful when going down. Walking is completley fine, no pain whatsoever.Our doc has given her anti inflamitories but still no change after 6 weeks.What do you suggest.",
    "doctor_response": "Hello....if lump is not responding to anti inflammatory drugs...pls get done local sonographic examination and knee joint x ray to rule out any bone or joint related problems...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for red blotches on the knees and between the thighs\n\nSon has a raised red blotchy rash under wrists, back of knees, and between lower thighs. Dots on rash, some are black and others looks like small blood blisters. Have treated for scabies with cream and pill twice in last 3.5 weeks and it has not gone away. It s spreading again 1.5 weeks after last treatment.",
    "doctor_response": "Hello, The probability of scabies is high in the rash which you have described. Make sure that you and your family members are adequately treated with antiscabietic medication as advised by your physician. Also be sure that your bed and clothes are mite free. In case that you do not get any improvement, I would recommend you to consult your Dermatologist. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does it mean to have attenuation nodule on kidney as shown on CT scan?\n\nI HAVE RECENTLY HAD A CT DONE THAT SHOWED A LOW ATTENTUATION NODULE ON MY KIDNEY. THE SIZE IS 1.9cm X 1.3 cm AND IT CONTAINS A CALCIFICATION IN THE POSTERIOR WALL.. SHOULD I BE CONCERND WITH THIS? WHEN I WAS LITTLE I HAD FREQUENT UTI S, IM NOT SURE IF IT HAS ANY THING TO DO WITH EACH OTHER.",
    "doctor_response": "Hi,Thanks for writing in.A low attenuation nodule in the kidney means that there is a small area containing fat or fluid of the 1.9 cm x 1.3 cm. The presence of calcification needs to be evaluated with the confirmation of whether it is fluid containing cyst or a fat containing tumor. Fat containing renal tumours are usually benign and considered as angiomyolipomas on imaging modalities. Some cases of renal cell carcinoma have been reported. Since the size is small and without knowing about the fat or fluid content, it is difficult to specifically confirm the diagnosis. It is best to get a review ultrasound scan after 3 months to monitor any increase in size. If it grows faster then it needs a biopsy confirmation of diagnosis.It is not related to your frequent UTIs in childhood.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for red itchy rash on body\n\nthank you, my neighbour is covered in a bright red itchy rash she has had 3 lots of antihistamines and liver and kidney function blood tests that have come back normal - the rash is extremely itchy she says it feels like a million bees stinging her ... can you help - she has also seen five doctors who dont know what it could be ... thank you soo soo much for your help",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms seem to be related to an allergic reaction. I suggest using antihistamines such as Cetirizine 10 mg daily.I also suggest using Hydrocortisone cream for local application. If the symptoms continue, I recommend doing steroid injections. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any doctors in Denver who treat chronic backpain?\n\ni have had 3 surgerys on my s1 L5 disn last one ending in a fusion i am looking for a doctor in the denver area that will take over my meds and treat my chronic back pain as well as try to operate or try other surgerys to help with the chronic pain.",
    "doctor_response": "You may contact to civil hospital ahemedabad india.This is one of best for spinal surgery.I have a long list of satisfied patients",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it dangerous to have a tiny matallic ball stuck in the trachea?\n\nThe other week I swallowed the ball of my tongue ring and it feels like it may have gotten stuck in my trachea.  Is that a possibility and could it still be there because it feels like it is and has felt that way since it happened.  It feels like it moved down a little the past 2 days.  It is metal so will it cause problems if it is in there?  Thank you!!",
    "doctor_response": "Hi and welcome to HCM. Thanks for the query. Yes, it could cause problems so it would be smart to visit ENT doctor to see where exactly it is. it is probably in pharinx or esophagus, not trachea but it should be move down or removed by doctor since it could cause some serious infections if stay in your body..Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough and wheezing in a child\n\nMy daughter is five years old. And suffers from cough n wheezing. I nebulusr her livolin n budecort. But some days , within an hour of administering budecort, she starts coughing n gets breathless. In that case what should I do? How many times a day should I nebulise her? I stop nebulising her as soon as she gets all right. Is it ok? Or do I need to administer budecort for a fixed number of days?",
    "doctor_response": "Hi...to answer your questions, I need more information which will help identify the severity of the disease in your kid. Questions:1. How many days per month does she cough or feel breathless?2. How many nights per month does her sleep get disturbed due to above symptoms?3. Does she feel breathless when she runs around or plays with other kids?4. Are the symptoms when there are seasonal changes?5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?6. Is the cough always associated with fever?Get back to me with the answers please.You can approach me at the following link. Please find the link below.www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in chest and upper arms?\n\nThis morning my boyfriend woke up around 9am (his usual time) then around 1pm he had a sudden achy pain in his sternum and both of his upper arms down to the elbow area is sore and tingly. I gave him baby bayer and he says the pain still feels the same, i took his blood pressure and it was normal. I tried telling him to go to the hospital but we have no insurance. Any clue as to what it may be? He is a smoker.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.Since he is smoker and his pain is no reducing with painkiller, possibility of cardiac pain is more likely.So better to take him to hospital and get done ecg, 2d echo and stress test (trade mill test).Smoking cessation should be done irrespective of heart diseases.Hope I have solved your query. I will be happy to help you further. Wishing good health to your boyfriend. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I change my mentality and avoid attraction to both the sexes ?\n\nfrom few days onwards iam staying in friends room, he is performing sex with me daily, we habtituated to that. but i dont know why i am getting attractions towards male as well as female. so, i dont want to be a guy,at once i thought waste of living with this kind of mentality.but how can i change my mentality, can i do any thing to become a normal men again. please suggest me solution.now iam 22 years . before marriage i want to change. please give ur suggestions.",
    "doctor_response": "Dear Ramu,  Homosexuality (GAY), Bisexuality and Heterosexuality are NOT diseases. It is the sexual orientation. The sexual orientation is influenzed by the environment. If you want to change to a heterosexual, you can approach a clinical psychologist / Sexual Medicine Consultant for counseling sessions regards Dr A CHAKRAVARTHY",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dental problem\n\nhi, i have a broken wisdom tooth and i require surgery to have this removed. It is painless unless i chew down on it but i am flying to the states a week on sunday for a trip from the UK and i am concerned that this may cause pain during my flight. I have purchased paracetamol and ibuprofen which my dentist has advised i can take together. Am i likely to get pain from the cabin pressure throughout my flight? Thanks, Kelly",
    "doctor_response": "Hello,Thanks for consulting HCM,  Read your query, as you have pain in decayed wisdom tooth dont be worried so much this pain can be due to formation of apical periodontitis for this I will suggest you to go for removal of tooth after coming back from your trip , In meantime you can take dispersable tablet of Paracetamol or Ketorol Dt for pain if you are not allergic to these drug that will give you fast releif in pain.  Hope this will help you.  Wishing you good health. Regards, Dr. Priyanka tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain?\n\nIm 18 years old, I weight 318 pounds im 5.9, and Im not really alergic to anything and except from being over my normal weight of 220, Im quite healthy. I Have never had any type of chest pains, this just came out of no where after sex. After I had sex i had went to the washroom to urinate and as soon as I sat down I began to feel a slight jabbing feeling in my left chest area, this pain continued although it was not severe because it only hurt when I took a breath. I tried everything to make it go away, it was uncomfortable. Ive never had this happen to me, recently Ive lost a bit of weight and I think its due to the way I have been eating. Im usually so busy during the day with meetings and such, I only usually have time to consume a minimum of 1500 calories a day but its usually all at one serving. Could i have any case of malnutrition or lack of potassium in my muslces which is causing the pain? I dont know whats up Wondering what you think...",
    "doctor_response": "Hello and Welcome to 'Ask A Doctor' service. I have reviewed your query and here is my advice. You need to take care of your self and your diet for better health however the pain does not looks to be associated with your diet. This is more likely to be a muscular pain which I hope will go away in few days .also do some massage. However in would like you get an X-ray done to rule out any chest problem which is less likely but still possible. Once that is normal I think u can be more assured. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Norgeston. Having heavy bleeding, weight gain. Suggestions?\n\nim taking norgeston and been on it for a month. so far iv already had 2 bleeds every two weeks and they are very, very heavy. i cant go through a pack of towels in 1 day. i can only have the mini pill as iv had a clot in my leg 6 years ago and bad headaches on other pills. this one seems much better apart from the bleeding and iv put on 5lb in a month of taking it. advice plz",
    "doctor_response": "Hi, Norgeston can cause slight weight gain which can be avoid by proper diet & regular exercise. For you its the best treatment. But if you are too much concerned , you can just ask your doctor to do one D & C & then start mini pills which will solve your problem. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for hard bumps on calf with swelling and nausea\n\nI have varicose veins in my left leg & had to wear compression hose when I was pregnant 6 years ago. We were playing soccer & the ball hit my left calf where the worse vein is & now a hard bump has appeared & is painful when I apply pressure. I put ice on it & elevated it, but am feeling nauseous & the swelling is not reducing. Should I apply heat instead?",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.You have got hematoma which will resolve gradually. You can take analgesic such as ibuprofen for pain relief. Local application of thrombophobe gel without rubbing will be helpful in resolving it. Local heat can be applied. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is my sister having blood infection?\n\nMy sister had a right lower lobectomy for a small growth in the lung. She has gone downhill everyday since Mon June 9. Dr states she should have been up and out after 3-4 days. She could not tolerate Incentive Spirometer, did not want to walk or deep breath and cough post op. We tried to encourage her to do what she needed to, but she was not cooperative. She now is on a respirator, has a pic line in for meds. She is getting epinephine for low blood pressure. Respirations have finally come down to 20. She is on propofol IV to calm her. today they told us it is possible she has a blood infection. Dont know what to think.",
    "doctor_response": "A blood infection is a strong possibility. They should be able to diagnose that for sure in a day or 2. Pneumonia after any surgery is always a concern; that is the the reason for incentive spirometry and deep breath and cough- to prevent pneumonia. I suspect she may have developed pneumonia as she wasn't cooperative with the preventive treatment, and now the infection has gotten into the blood. This would cause the blood pressure to drop and require medicine like epinephrine to keep it normal. I presume she is receiving an antibiotic combination as well while they are waiting for the culture results to come back. Blood infection, also called sepsis, is a very serious condition and can be life-threatening. Hopefully the doctors will get it under contro soon. Hope this answers your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can rabies vaccine be taken after three days of getting scratch from a pet dog?\n\nHello doctor, I have been scratched by my pet dog and I think it reached beneath my skin. I got red areas and I did not take any rabies medicine. And it is the third day, can I take medication now?",
    "doctor_response": "Hello,  Welcome to icliniq.com. Yes, you can still take the medication. Do you have rabies or tetanus vaccine? If not or you are not sure, I recommend you go to a nearby hospital to have a rabies vaccine and tetanus shots or at least booster shots. I recommend you to complete the dose as per your doctor\u2019s advice. In the meantime, I recommend you wash it with clean soap, Betadine solution, and clean water every day to avoid infection. If in pain, you may take Ibuprofen twice a day as needed for pain. Is there anything else I can help you with or anything that is not clear to you? I would gladly clarify them.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain and swelling in jaw\n\nI had my jaw surgically broken 24 years ago. I still have 1 plate in each cheek. About 2 and a half weeks ago I noticed my right cheek was swollen. It aches. It has progressively gotten worse. Painful. Treating with Advil. Went to dentist thinking perhaps I had a tooth problem. She took X-rays and said there was nothing she could see. She referred me to an oral surgeon and gave me antibiotics. My appointment with the surgeon is not for another three weeks. The pain is not getting better not is swelling going down. Thoughts?",
    "doctor_response": "It could be Parotid salivary gland swelling. Get an Ultrasound of the swelling. Consult your ENT Surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for mental health problems\n\nWhenever I talk about/ think about/ or am confronted by blood in anyway I feel faint, get very dizzy and feel like I will vomit. It is quite crippling and I often will need to lie down and distract myself before it passes. What is happening to me? Are there any remedies I can try? I understand it might be a psychological issue but what can I do when the symptoms become extreme?",
    "doctor_response": "Hi,I can understand your distress caused by your problem. You seem to be suffering from specific phobia of blood. The fear of blood is leading to anxiety which results in the symptoms that you have mentioned. It is a situation which can be taken care of with adequate treatment.i would suggest that you should consult a psychiatrist for your symptoms. Treatment with medications like paroxetine would be helpful. In addition, you can also try behavior therapy sessions. They will focus on gradually removing the fear of blood in a systematic way from your mind.I do hope I was able to answer your query. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had unprotected sex, on birth control. Having cramps, lower back pain, dizzines. Reason?\n\nI have unprotected sex regularly. my partner and i have a commited relationship and have both been tested. i have been taking birth control for over a year but i occasionally forget to take it. but i always take it within 24 hrs. for the last 5 days or so i have been having period like cramps . my period is not due for another 3 days or so. i have never had cramps prior to my period before. also i have been having a lot of lower back pain and while showering last night i felt very faint. ( im not sure if its related but my breasts are more tender than normal.) any ideas?",
    "doctor_response": "Hello,If you have been regular with your birth control pills in this cycle, your chances of conception are very minimal. Your symptoms could mean an impending period. To clarify about your status of being pregnant or not, you can get an assessment of the serum beta-hCG titres now or wait for your next period and go for a HPT 3-7 days later if you miss it. Urinary tract infections also can lead to similar symptoms of abdominal cramps and hence urinalysis also is essential in the current scenario. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does lump around vagina indicate sign of cancer?\n\nYesterday i had pain from my vagina and surrounding areas. I looked and found a dark spot. The spot feels like a lump and hurts to touch. It also bleeds slightly when wiping after going to the loo. The thing is I m only 16 and have never had sexual intercourse. I m on holiday and I m worried that it s cancer. I m scared.",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You may have benign cyst like lesion.  Don't worry. Just be relaxed.  Chance of cancer are very rare at your age. Consult your gynecologist and go for examination, if needed go for excision biopsy.  Don't worry. You will be fine.  Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health. Don't forget to click thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which medicine to be used as my penis is weak?\n\ngood morning sir nice to being with you i had seen you tv shows very good answers sir iam 23 year old i often m self sex or masturbute daily 2  times a day i feel my pennis are bieng week for few months and whom shall i to see or what medicine do you suggest me sir",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.1. Masturbation is a safe practice but it should be done within limit.2. The average masturbation is 2 to 3 times a week and it should never be done more than once daily.3. If you are masturbating 2 times every day then it is to be controlled and probably that is the reason for your penis weakness.4. Masturbation should be done slowly and gently and doing it roughly will damage the soft tissues of penis.5. Right now you do not require any medicine and you should try and stop getting masturbation thoughts regularly.6. Please meet your friends, do study and focus your mind in work to avoid sexual thoughts.7. Try and avoid pornography and when you get sexual thoughts then read a book and listen to music or go for walks. Do not touch your penis except during urination. Please do not worry. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Vivek Chail",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take Ampiclox and Flagyl during 13 weeks of pregnancy?\n\nHi Doc, Please, this is my first pregnancy.I am in my 13th weeks and I am having a brownish thick discharge, boil and Itch on my vj area.The boil is on the Vulva area and has ruptured.I went to see the doctor and was given Ampiclox and Flagyl.I hope this is okay for me and the drug interactions too is what I am bothered about. Thank you.",
    "doctor_response": "Hello, Ampiclox (ampicillin)  is safe to be taken during pregnancy while the data about metronidazole are a bit contradictory on causing birth defects. You can take ampicillin and possibly metronidazole since you are at the second trimester or can switch to suppositories. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Olgeta Xhufka, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does pain in hip and lower back indicate pregnancy?\n\nhi im on the microlite pill and hae been for about 2 years now, im with my boyfriend for a good few years now and for the first time he ejaculated in me, it happened 2 days ago and i have pains in my left hand side hip and lower back, but i usually have the pain in my back, so im wondering is there anyway i can be pregnant or is all the worry just in my head?",
    "doctor_response": "Hello,Welcome to this forum.You have pain following a sex in which your boyfriend ejaculated inside you.You may have a chance of getting pregnant through this act but as such there is no such scope of having pain or any other pregnancy symptoms so early. So, the pain may be due to other reasons.If at all pregnant, you may have symptoms which you could start feeling just before or after your missed cycle.SincerelyDr Sanjoy",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to live long with scoliosis?\n\n53 female scoliosis corrected with harrington rod lumbar curve jn 1972, still haveto significant upper curve, short ofto breath ,just diagnosed w/copd have 2% o2 at night quit smoking after 25the yrs what am i looking at for longevity? I will not carry around daytime o2!",
    "doctor_response": "Hello!Welcome on Healthcaremagic!I recommend performing physiotherapy and avoiding smoking contacts. Inhalation steroids or beta-stimulants  can help improve your situation. But, unfortunately there is not too much to be done in this clinical situation. Hope you will find this answer helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated liver enzymes?\n\nI am a 63 yo female on statins and BP meds. I am 5 1 135 lbs and eat very healthy. I exercise 2 times a week with cardio and weight lifting. I got my test results back to check liver enzymes and my ALT is high. The range should be 6-29 and mine is 35. I looked back on my previous tests when I was under another doctor s care BEFORE I was taking cholesterol medication and it was 28. The range they showed though was from 0-40 as acceptable, not 6-29. This most recent test was done because I was diagnosed with a benign hemangioma on my liver which was found incidentally looking for something else, a benign fatty mass on my kidney. I am also wondering if my high ALT is the reason my glucose is so high. It is 119. Before when I was tested under my other doctor when my ALT was low my glucose was low too. It was 92 so I feel there could be a connection between the 2 readings. So while my cholesterol is low, 174, due to the statins, my ALT and glucose are high as well. My current cholesterol reading after going through a life style change WITHOUT statins is 264. Do you think it s the statins that are causing my high ALT readings? Or is it the benign hemangioma on my liver? I am also concerned my medications are affecting my glucose negatively. I ate less healthy when my glucose was low. Now that I take care of myself, it s higher. The only difference I can see is statins.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Your ALT level is normal. No need to worry about your ALT level. There is minor lab to lab variation and instrument and kit wise variation in result. So no need to worry about ALT. Statin is not responsible for that. liver hemangioma is accidental finding and it is also not responsible. Statin does not increase the blood glucose level. Take low fat diet with high amount of polyunsaturated fatty acids. Continue your statins according to advise. Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fatigue,tremors and irritability?\n\nHi, for about 2 months now ive been constantly weak, shaky and very irritable. i went to the doctors last month and i was sent for a blood test. i was tested for 5 different things, cant remember them all but i know i was tested for diabetes, thyroid, bone?cant remeber the rest but everything came back fine.",
    "doctor_response": "Hello,If all the investigations are normal, the problems you have mentioned could be the part of anxiety disorder or depressive disorder. You need treatment on the lines of these disorders.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child diagnosed with Asperger's syndrome, has stuttered speech, difficulty in wearing trousers and shoes. Prescribed olimelt and dine. Will they help?\n\nmy son aged 17 years was diagnosed with asperger syndrome 1 year back he is in class 12 in a reputed school in kolkata he was prescribed risperidone 0.5 mg and prodep 50 mg 6 months back 2 months later he developed symptoms of stuttering , slurred speech, became withdrawn, refuses to touch things with hand keeps a napkin for picking up spoons,etc ,stopped writing, stopped using mobiles,computers,remotes, does not lock doors or use switches and has difficulty in wearing trousers, shoes. medicines hav been stopped since 3 months but condition has worsened. now he has been prescribed olimelt5mg and dine 5mg will thes help and are there any side effects pl help an anxious mother",
    "doctor_response": "hello, , all medicine as you had mention in above text has only temporary palliative effect. these medicines will not cure problem but keep it in control. Asperger syndrome is autism spectrum disorder. all symptoms you have mentioned are common in this disease. Homeopathy can cure this problem without any side effect. so consult to good homeopath and your son will be better in future with good quality of life.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest ways of good brushing\n\nThanks for ur reply doctor.But still I am having a doubt that how should i do like shall I use brush and paste for that.She dont know how to spit.So I cant na.Shall I use my finger with water..Is it good?...Now her teeth is little bit yellow.She is only 0ne year and having lots of teeth.Please reply.",
    "doctor_response": "Thank you for your query,If you use your fingers, then they will not clean the teeth properly.You can use children tooth brush, these are brushes with very small head and handle. They have very soft bristles. These brushes are meant for children.Regarding tooth paste usage as she cannot spit, you can use children tooth paste or plain water will do along with proper brushing.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high WBC count,fatigue,nausea and neck pain?\n\nI have had multiple tests where my wbc is 17000 to 21000. I ve been diagnosed with sinusitis. But I feel it s something else. Symptoms are high wbc, fatigue, nausea, Extreme neck and shoulder pain, extreme sweating episodes, dizziness. What tests should I be asking for",
    "doctor_response": "HIThanks for posting your query.     A high WBC count means Infection , that too a bacterial infection. It could be anywhere in the body as your symptoms are not localizing to any part of the body.  Sinusitis could be a possibility but what treatment has been given to you determines the response. Kindly let me know what medications were given to you. You require a Broad septrum antibiotics that will cure your infection.   I advise you to get Chest X ray , Widal, Urine Routine test, SGOT, SGPT and Blood culture sensitivity test. Hope this information was useful to you. Any clarifications feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it to be concern about pin hole phimosis in child?\n\nhi doctor,this is Souvik Roy from Asansol,W.B. my one & only son is now 4 years aged and currebtly he is suffering from pin-hole phimosis. now i am facing very much tension for this, and i had already contact to my pediatrics, and the doctor told me to do a surgery for this, So i need your help, for that where i can do this surgery",
    "doctor_response": "Hi,Welcome to Hcm,At the outset let me assure you that there is nothing at all to be worried about this condition and this is a very common condition and the surgery mentioned is done as a common ritual practice in our country too. So follow the advice and meet any pediatric surgeon close to your place and the job should be done without any issue. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do lumps on right inner thigh indicate?\n\nHi I have several lumps on my right inner thigh. It hurts a little when I walk. Generally the size of a small button and is soft and on the surface of the skin. What will happen to me if I dont see a doctor? Is there anything I can do to get rid of this? I suspect its a lipoma due to research",
    "doctor_response": "Hi,From history it seems that there might be having friction bumps or razor bumps giving this problem.Apply triple action cream locally.Gradually they will disappear.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a follow-up surgical biopsy to remove tissue that was attached to a nodule is the removal of breast lesion and what is the proper surgical code?\n\nThank you,Is a follow-up surgical biopsy to remove tissue that was attached to a nodule and removed by a needle biopsy considered to be a removal of a breast lesion?  It will be preformed in a hospital under a local anesthetic on an outpatient basis to make sure there is or is not cancer present.  If so what is the proper surgical code?Thank you",
    "doctor_response": "Dear Ma'am,The procedure you are talking about it known as a tru-cut (or core-needle) biopsy of a breast lesion and it is carried out under local anaesthesia. This does not amount to removal of the breast lump and the surgical code varies from hospital to hospital.Hoping for the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for hair loss and loss hair texture after having Tobi\n\nI have been using Tobi in my Nebulizer for months. One week on and one week off. The side effect I have noticed is that texture of my hair has changed and it is falling out a little each day. My hairdresser noticed how different my hair is. Is there anything I can do?",
    "doctor_response": "Hi,,welcome to HCMTobramycin is an aminoglycoside antibiotics which is used to combat infection....though textural change is not a well known side effect of the drug,,more likely the hairfall and textural changes you are experiencing is due to your health problem...Take a protein rich diet and eat fruits and vegs rich in all the vitamin and minerals...Exercise daily...Do frequent hair massage with tips of your fingers with lukewarm olive and coconut oil in equal proportion,,this will increase the circulation of scalp and improve the textyre of hairs too...Conditioning of hair is a must thing after wash...You can opt for hair spas or use fenugreek hair mask to combat hairloss...Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does my 3 months old cry before bowel movement?\n\nmy 3 month old daughter Ella strains and cries for ages before a bowel movement. sometimes up to 2 hours of intermittent hysterical crying and straining. After she goes she is fine, and the stool is soft and normal looking. formula fed on an easily digestible formula. this happens every 2nd day or so. if she hasnt gone in 2 days i will use a suppository, which results in straining and sooking but not as bad.",
    "doctor_response": "Hi, welcome to HCM. Your baby has intermittent crying and straining before a bowel movement, this is colicky pain. Some babies tend to have increase propencity of colicky pain. In most of the cases keeping the child on his abdomen in your lap for 2 minutes relieves the colicky pain. If pain is not relieved by this method then you need to give simethicone drops like colicaid 4 drops three times a day for 2 days and the pain will be relieved. As child grows older, these pain episodes naturally decreases. I hope this has helped you. Take care. Regards - Dr Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest possible treatment for cervical cancer\n\nI am a 54 year old female diagnosed with cervical cancer stage 1b and will be undergoing radical hysterectomy,bi-lateral salpingo-oophorectomy and pelvic node dissection in a couple of weeks. I have been on Nicorette lozenges to quit smoking for several weeks, this is one of several attempts over the past 20 years but feel I amready and successful so far this time at quitting. My question is the Nicorette helping to feed the cervical cancer cells? Is there a better alternative if this is the case? I have made many changes to try and help myself beat this disease. Can you also recommend a diet and vitamin regime that would be beneficial? I am an otherwise healthy woman.",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. In early stage of cervical cancer,  surgical removal is the best treatment. So get done surgery for better outcome. You are on nicotine replacement therapy (NRT). They are safe and don't cause cervical cancer. So don't worry about it. Continue NRT and don't smoke.About dietary advice, better to eat fruits, vegetables which are reach in antioxidants and minerals. Start multivitamin tablets and protien powder to improve immunity.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for kidney infections and lower back pain\n\nHi, I have had kidney problems my whole life, I suffered from kkidney reflux since I was about 4 months old up until I was about 10.. I always get UTIS and Kidney infections. I have severe Scar tissue both of my kidneys.. I also have Rotated kidneys... Kidney Disease runs in my family, My mother, and my Aunt has it. Are Rotated kidneys dangerous? What kind of doctor should I see? I always have bad lower back pressure on my right side.. feels like my kidney is going to come out of my back.. literally. and every couple of weeks I have this intense shocking horrible pain in my lower back my whole body tenses up and I cant move.. it last for about 10 secs then goes away. Please Help. I always go to the emergency room and they advise me to see my primary doctor to get a refferal but I dont have a primary doctor at the moment.",
    "doctor_response": "Hi, You should do kidney ultrasound and have urine-culture. Then appropriate antibiotic therapy can be planned. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Iven Romic Rommstein, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe pain and pressure in the chest\n\nHello, I started feeling a pain in the middle of my chest yesterday while I was at work. (I have an office job). It continued through last night and today. It is not so much of a sharp pain, but more of a extreme pressure feeling. It intensifies as I take a deep breath in, when I go from sitting to standing, and the worst when I lay flat on my back. It has gotten worse since yesterday. Is this something minor, or that should be checked out before Monday?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. Yes, you should definitely consult doctor immediately because heart related pain can present in similar way. So better to get done ecg and 2d echo. If both are normal then no need to worry for heart diseases. GERD (gastroesophageal reflux disease) can also cause similar symptoms. It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms of Central chest pain.So take proton pump inhibitor. Avoid stress and tension. Avoid hot and spicy food. Avoid large meals. Go for walk after meals. Quit smoking and alcohol if you have these habits. Don't worry, you will be alright. But first rule out heart diseases immediately. Hope I have solved your query.Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat hair loss and whitening?\n\nHi m facing excessive hair loss since 1.5 yrs. I believe i have dandruff and have tried loads of things but nothing seems to work. my hair strentgh has reduced to 1/3rd of what it was and i have lot of white hair now which i never used to have, i believe the water also has to do something with it. please help..i am 32 yrs old",
    "doctor_response": "HelloThank you for posting on HCM.It seems you are suffering from Seborrheic dermatitis,which secondarily leads to hairfall and thus its important to treat it first hand. I would recommend you a short course of oral antifungal drugs like ketoconazole/itraconazole and a lotion containing clotrimazole and betamethasone twice a day over scalp for few weeks. Use a medicated shampoo containing ketoconazole and salicylic acid twice a week. Take antihistaminics as required for itching. Avoid excessive use of hair oil.As for the hairfall, start oral supplements containing biotin and other essential vitamins and minerals (Follihair new) once a day for atleast 3 months.Greying of hair occurs when the melanin of a particular hair follicle is permanently exhausted.Premature greying of hair is attributed to many factors like diet,nutrition, UV rays, pollution, cosmetics/dyes/colors, genetics, medications etc.Treatment of grey hair is pretty challenging. I would advise you biotin and calcium pantothenate combination tablets for atleast 6-8 months. Apply Altris gel containing Melitane, which is a new compound shown good results in premature greying of hair. Also, a novel hair sunscreen cum hair serum Q sera black has shown good results in preventation of hair damage from sun and pollution.Take plenty of fresh fruits and vegetables in your diet and try to de-stress your lifestyle. Try to limit your smoking and alcohol intake. Hope you get well soonDr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can persistent right ankle pain due to a sprain be treated?\n\nYes. I m 63 yrs old. I missed the bottom step going out onto my patio about 8 weeks ago. At first I thought I had a sprain on my right ankle. I iced it for a day or so and it got a little better but he pain seems to have moved from the outside of my ankle to the front part. And I m still having pain when I have been sitting for a while or when I try to twist it. Help!",
    "doctor_response": "Hello,I would like to have more information from you regarding whether the ankle was black and blue in color. Usually, the ankle sprain should have been gone by now. I am afraid that you have some kind of fracture and you missed it. So, I would suggest you to do ankle x-rays and consult an orthopedic surgeon.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Valbona Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My penis becomes softer after using penile pump for enlargement. Please help.\n\nHello doctor, I am 28 years old. I tried using a penis pump for around 10-12 days, 15 minutes each to gain size. I used a vacuum to keep the penis enlarged. Maybe I was trying too hard, and vacuum it till it started to ache. I had no pain after thouse procedures though, ever. I was also masturbating around two to three times a day during that period (usually it was once a day). Now, I feel my penis has grown softer instead, flaccid or erect both ways. I cannot feel hard enough to penetrate. Even if I try to masturbate, it still feels squishy, and not hard. My sex drive is also diminished. I have not had a wet dream in 10-12 days, still I do not feel high as I used to earlier without sex or masturbation for a day or two. I do not feel any kind of pain, during penetration, or otherwise. I of course have stopped both pump and masturbation. Please help.",
    "doctor_response": "Hello. I am sorry to know that you are facing a problem with the hardness of penis following the use of penis pump to enlarge the penis size. It is foolish to believe that the penis pump enhances penis size as it is a scam rather than anything. However, we cannot correct the past and need to look for the reasons for the loosening of penile tissue. In my opinion, there is a tear over the blood vessel or sphincter leading to leakage of blood during erection resulting in inadequate tightness. However, I must assure you that the presence of erection (although poor) and stoppage of further damage should be enough to allow the recovery of proper erection in a few weeks. At this stage, it is important to manage your stress as it is unlikely to help you in any regard. At the same time, it is recommended to get penile doppler to assess the damage at the earliest level. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the upper chest and back along with nausea?\n\nSince last night, pain started in my upper chest area and upper back, if I try to eat I get sick, it is a heavy feeling in the chest area and if I turn my body to the right or left it gets worse. The shoulder blade pain is just a achy sharp pain that will not go away. I have taken tums just in case it is heart burn but now I am nauseous and it is making the pressure in my chest and back worse",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Can be due to gastritis or hiatus hernia. Antiemetic and antacids can help. I hope this information has been helpful for you. Regards, Dr. Praveen Tayal .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe lower abdominal cramps\n\nHi since Friday I have had terrible cramps in the very lower part of my abdomin to the point it actually hurt to sit. My bowl movement is normal and I'm weeing normally it feels like cramps but I have been in the menopause for nearly three years it has made me feel feverish but there has been no real temperature and I have taken nurofen every 4 hours which does take the pain away. Today I feel in myself a bit better but the pain us still coming and going. Anything you can recommend??",
    "doctor_response": "Hi thanks for your query and proper history. The commonest causes for pain in lower abdomen in a post menopausal woman are :Intestinal infections. Lower Ureteric Colic UTI with severe cystitis. Prolapsed uterus with rectocele and cystocele I would advise you to have consultation with a general surgeon for clinical evaluation, examination and investigations to come to the diagnosis and give you a plan for further treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure tooth pain?\n\ni have just been to my dentist in lots of pain he had filled my tooth back in october, and had dropped some dental glue in between my teeth he has scraped it off but im still in pain and all my teeth are sensitive do you think the pain will settle down or will i require further treatment",
    "doctor_response": "Hello, Thanks for your query.olive oil soaked on cotton applied to the toothcut a slice of onion and put it into your mouth near paincrushed garlic on the toothoregano oilclove oilbaking soda swished in mouthoil pulling (swishing in the mouth organic sesame seed oil for 5-10 minutes)I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the side effects of esiflo inhaler?\n\nHi I am using Esiflo 125 inhaler from past 3 to 4 years.....before i was taking theo-asthalin tablet. Can you please let me know the side effects of esiflo inhaler. We are planning for the baby and how does this inhaler have effect, Thanks in advance Cheers",
    "doctor_response": "Hello,Esiflo is a combination of salmetrol / fluticasone combination. It is a relatively safe drug with out much complications. You can very well continue esiflo without any concerns. It will not affect fertility and does not have any affects on fetus.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to concieve. High testosterone levels. Can I concieve?\n\nHi I am 25 aged and i want to get pregnant. My period seems normal but my doctor advised to take hormone tests.\\ My test results FSH , LH, prolactin , cortisol , freeT4, progestiron and estradiol are normal. But testosterone a little high 0.92NG/ML(normal level 0.14 - 0.76). My doctor said nothing to worry and my testosterone is still good and i still can get pregnant. But so far i still can not get pregnant. Could you advise whether can i get pregnant with this hormone level or i have to reduce my testosterone level ? If i have to reduce my testosterone level, then what medicine should i take ? thanks in advance.",
    "doctor_response": "Hi Lolita. Are you overweight? Since how many months/ years you are trying to conceive? If you have been trying since less than 3 months then keep patience and wait for pregnancy to happen on itself. If it is since more than 6 months and if you are overweight then please lose some weight for the male hormone- testosterone- to normalise. Also get your husband's semen analysis done. Get back with the results. Take care. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for a bloated gassy feeling in my left abdomen and a dull feeling in my left testicle?\n\nHi there,For just over a week I've had a bloated gassy feeling in my lower left abdomen and a dull 'naggy' feeling in my left testicle. I've examined my testicles and felt nothing out of the ordinary. None of the symptoms are consistent, they seem to come and go. I'm also slightly constipated.I'm going to see my GP as soon as possible, but wondered if you were able to shed any light?!Thanks",
    "doctor_response": "HelloThe bloated gassy feeling with pain in the left testicle may be due to ,1 Left renal colic , diagnosis can be confirmed by ultrasound of left kidney . As you  mentioned that there is pain also in testicle so more chance of stone in left kidney.2 Amoebic colitis may be the next reason , so get in stool examination for entamoeba histolica.In this type of cases usually colon is palpable so physical examination by  a physician is very important .3 Epididmo-orchitis is an important cause of such pain and gassy feelings , so physical examination by a surgeon is very important .In my opinion deal as mentioned above. Good luck.Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does IBS cause any problems in conceiving?\n\nhello doctor ,I'm nithya, i have completed an one half year...i went for check up everything is normal, i asked to take clomid citrate 50mg for three cycle...but not yet conceive...i have a problem of irritable bowel syndrome...does it affect my pregnancy....",
    "doctor_response": "Dear Nithya,    If you are not on any medicine for IBS then it should be fine.Take folic acid 5mg a day.Husband's semen analysis should be normal before you start clomiphene.ThanksDr Bhagyashree",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for severe chest congestion and sore throat?\n\nI have severe chest congestion and sore throat. When I lie down I get dry caugh with little mucus. I also having issues with my sleep. If I take wikroyl does it effect my sleep? Because it contains caffeine. I also have cetzine. Which one should I take?",
    "doctor_response": "Instead of wikoryl plain if you take wikoryl-L, it will be helpful as it has Levocetirizine.And I would advise you to take steam inhalations three times daily.Also if the cough is pretty bad and disturbing at night then you need to start a codeine syrup at night and sos",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to heal the place of belly button piercing?\n\nHi I got my belly button pierced about 7 months ago and sometimes it seems like it has healed, other times it gets a little sore and still has clear discharge that comes out some a little white pusy color. How else can I get it to heal? someone told me I can chop excedrin tablets and add water to make a paste and put it on the skin around the piercing and this should help...how true is this? I am  5'8 female 160 pounds no servere medical history at all. I just want to know how to get my belly button piercing to heal. Thank you...",
    "doctor_response": "HiWith you query, it is good you took it off but rather than using those drugs it is always better to visit your doctor and find the the best solution or treatment for this. Hope thus helps you .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does gluten intolerance cause chest pain?\n\nMy 9 year old child s blood test has come back with a gluten intolerance, he is awaiting the next test. He keeps getting poorly with tonsilitis and keeps saying his chest hurts. He has been given an asthma pump. Is this all to do with the gluten intolerance?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Gluten intolerance does not typically cause chest pain. If the pump doesn't help, ask you doctor about \"costochondritis\". This is a harmless condition that can cause chest pain. Hope I have answered your query. 'Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing the pain in my feet?\n\nI will admit that I am a 60 year old overweight woman but trying constantly to change this the healthy way. I have trouble with pain in the tops of my feet after standing or moving for relatively long periods of time or even upon getting up in the morning. I would not describe the pain as burning or stabbing pain but more of a tight skin and just a general pain for lack of a better description. I am painfully aware that one of the reasons is probably the extra weight on my frame that inevitably is being held up on my feet. Are there any other reasons that might be causing this that I need to be aware of and addressing.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have  pain in my feet and you are overweight. Well there can be many reasons for symptoms you mention in query like peripheral neuropathy , injury , gout , corns and callus , soft tissue injury or venous insufficiency . I would suggest you to consult podiatrist for proper examination . Doctor may order CT scan or x-ray along with blood test and urine test and physical examination to confirm the diagnosis . Doctor may also refer you to orthopedic surgeon for foot problem , who may prescribe diuretic along with muscle relaxant , anti inflammatory .For now keep your legs in hot water tub with Epsom salt for 15 minutes daily and keep your legs elevated while lying down . Doctor may recommend orthotic devices like special shoe . You should reduce your weight by doing light exercises like yoga and altering your diet . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "History of sunburns and acne. Does sebaceous hyperplasia lead to cancer? Treatment?\n\nFemale. Age 52. Fair skin. History of sunburns, and acne . Family history of skin cancer (basal and mm that metastasized to brain) Went to dermatologist for moles on my face that are increasing in size and number. He said it would be expensive, cosmetic (not covered by ins)and would require stitches on each incision to close and each of the ten would be sent to pathology at a whopping $1000 additional cost. He said Scarring would be more unsightly than mole. I left dissatisfied. He never mentioned sebaceous hyperplasia . But now I think that is my condition. My questions? Does sebaceous hyperplasia lead to cancer? (squamous is what I read) Will moderate to deep peels help to keep the gland and cell growth at bay? What other treatments should I investigate? Laser, electro, needles? I would like a treatment (diagnosis) that my insurance would cover.",
    "doctor_response": "Hi, Welcome to HCM. Firstly, a sebaceous hyperplasia is increased number of cells that forms hair follicle glands. It does not lead to squamous cell carcinoma rather it leads to sebaceous gland carcinoma . Now, a Mole is proliferation of melanin containing cells which may lead to melanoma.It is a devastating disease. So, dont  take it lightly, it does not matter what is the cost of surgery, whether there will be any scarring or not, whether it will be covered by insurance ......  Just GET RID of that. Thats all.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should the Lump in knee tested before knee replacement surgery?\n\nmy wife is due for knee replacement in two days. About a month ago she discovered a nodule on the side of the knee which is firm but movable and mildly painful to the touch. Her primary still sighed her off for surgery, but I am not good with this. Should not the lump have been thoroughly diagnosed before the scheduled surgery",
    "doctor_response": "HI. I think , yes. If the primary has thought that this is of no clinical significance, nothing can be done. But the best part is the operating surgeon would definitely bother about this.; will have a clinical consideration and would bother about it only if he feels so. Otherwise you too do not worry about this. Just See that it has been noticed and seen by your Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain an swelling?\n\nHello I had the coil fitted yesterday at 5pm and since then have been in constant (abdominal) pain. My abdomen and stomach are also visibly swollen. Is this normal? The pain hasn t really subsided nor stopped at any point since it was fitted. I didn t really sleep last night as it was so bad and feel that I may not tonight either. Should I go to the hospital? Thank you very much Sarah",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern and I would like to say that this could be colicky abdominal pain and this need to be managed with Tab Dicylomine with Acetaminophen three times in day, if the symptoms does not improved then you have to see the doctor for clinical examination take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can bronchitis with palpitations be treated?\n\nI was taken off Synthroid 88 last Sunday.Since then I was given Cymbalta,Lexapro and Xanax.I have been in the er twice for what I thought was an allergic reaction.I was told thursday I have bronchitits.I am not sleeping and having palpatations all day and night.I took buspar as I am not on any meds now and still nothing.What should I do?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. You were taking anxiolytic and anti depressant drugs in the past. So your current symptoms like decreased sleep, palpitations etc are mostly due to worsening of anxiety add depression. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You will also need anxiolytic and anti depressant drugs. Don't take psychiatric medicines (Buspar) by your own. You will mostly improve with all these. Bronchitis can not cause palpitations and lack of sleep. So it is unlikely for your symptoms. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have difficulty in swallowing and a sore throat. What should I do?\n\nHello doctor, I have a fever for almost three days. The first day it was not a high temperature. I had difficulty swallowing and I had a sore throat. Today, the fever is 39.3 Celsius. I had tonsillitis three times before and I have been prescribed Co-amoxiclav, Dequadin, and Strepsils. Please help.",
    "doctor_response": "Hello. I went through your post. You are already on antibiotics. It would be better to get a throat swab done and a CBC (complete blood count). I suggest you change the antibiotic to Levofloxacin 500 mg once a day. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the feeling of wetness after peeing?\n\ni have a 6 year old boy that uses the bathroom and when he s done he feels like he peed his pants, but nothing is wet. i have noticed a couple of days ago that he has a black spot with a hole around his ring. he hasen t complained or noticed it, but i seen it when i was drying him off after his bath. could the black thing be a blackhead and whats causing him to feel like hes wet?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. I have gone through your question. Do not worry. This can be black head or pigmented naevi. I would recommend you to visit a pediatrician for complete clinical evaluation and definitive treatment.Hope I have answered your query. Let me know if I can assist you further.Take care.Regards,Dr. Archana Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can poor posture or pelvis tilt effect erection and penile size?\n\nCan poor posture or pelvis tilt effect my erection and size of my penis? Im 30 years of age, and over the the last five years I have noticed it drop dramatically. Im fairly fit, played sports most of my life and now visit the gym regularly. Any advice would be appreciated.",
    "doctor_response": "Hi,Poor posture or pelvic tilt is not related to penis erection. There are 4 stages of penis arousal.Stage 1 excitementStage 2 plateauStage 3 orgasm and ejaculationStage 4 refractory periodWith increasing age, the duration of excitement stage increases and that is the reason you take longer time to have orgasm when compared to earlier times. This can be seen as the a longer time taken for full erection in your 30s as compared to your late adolescence and early 20s. This perfectly natural and with age the time taken for erection increases. It will help to reduce any stress related anxiety that you might be having.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat cold in a 2 years old child?\n\nHellow Doctor, I have 2 yers old son he is suffering from cold if once the cold comes it will stay 40-50days.We are using so many medicins but still that problem is there so can you sugest me how to take care and give the olution for this. Thanks, Pavitra",
    "doctor_response": "Hi Dear welcome to the HCM,Improve his immunity with supplementation with iron and multivitamin.High protein dietFeeding hygiene to be strictly observed,Avoid contact with persons who are already infected with viral RTI.Hope the query is answered.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be worried about the enlargement of liver?\n\nI had a USG of whole abdomen. In the report everything is okay except my liver slightly enlarged with bright parenchymal echotexture. No focal lesion noted. IHBR are not dialated. What does it mean?? Do I have any severe problem in my liver? Or I need to do a USG endroscopy for details? Please advice.",
    "doctor_response": "Hello! Thanks for putting your query in HCM. I am a Gastroenterologist (DM). It simply means you have fatty liver that is accumulation of fat in liver which in long termis is harmful for liver.There are many causes of fatty liver disease like high fat diet, hepatitis B/ C, metabolic disorders, autoimmune disorder, alcohol or drug intake etc. So for this you require evaluation and then appropriate management. So I will suggest you to visit a gastroenterologist for evaluation.I hope I have answered your query and this will help you. If you have any further query  I will be happy to answer that too. Remain in touch and get-well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on ankle with swelling?\n\nI got hit with a large desk about 2 months ago right above my ankle bone. It swelled a bit and bruised, now there is nothing but a fairly large bump. Still quite tender when pushed on, but not when walking or running. Wonder if that is usual that it can still be so tender after that long or if I should go in to have it x-rayed",
    "doctor_response": "hi,thank you for providing the brief history of you.A thorough musculoskeletal assessment is advised.As the lump is not painful you do not need to worry much. If it is restricting your functional ability you shouldn't be worried much as it be just a skin tissue.Also if you wish to get assessed than an x-ray will be of guidance but not so sure if it can show anything.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat dark circles under the baby s eyes?\n\nMy daughter is 3 years old. As of late she does not want to eat and as a result she is very lethargic and tired almost all the time, also occasionally she will say that her eyes are burning and stinging. Usually she drinks about 60-80 fluid ounces daily, craves salt excessively, and frequently during the day she bangs her head off the wall or on the ground for a few minutes at a time! She is our middle child, and yet at 39 months she weighs less than our 18 months old little boy. She looks malnourished, has dark circles under her eyes and her is very thin fine and not very long. She has been seen by a few different doctors but thus far NO ONE has been able to tell my wife and I what is the matter with her. Could you please help guide us, PLEASE? In the range of all possibilities, what could this be?",
    "doctor_response": "Hi.... I understand your concern. There are very important points which you have put forth in your query.... faling to the, dark circles around eyes and craving for salt and water.These are the possibilities which you need to evaluate her about- 1. Renal tubular acidosis2. Diabetes insipidus3. Cystic fibrosis.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes buttock cheeks lumps?\n\nI just had a baby 12 days ago and I had a small tear that needed stitches. That has healed and now I have noticed red, pimple like bumps on my butt cheeks. I take showers regularly, and I have been wearing pads due to bleeding from healing. What has caused these red bumps and what are they?",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You may have some infection or abscess formation in that area.  You should go for examination.  Then you should take treatment if needed.  Consult your doctor and take treatment accordingly. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the anaemia?\n\nis mazetol and tegretol same for a boy of 11yrs and taking medicine for 8 yrs.earlier it was 200 mg twice daily and now tegretol 200mg morning and 300 mg in the evening.He is anemic now and affecting his studies.Whom should we show and what should we do?Please help.",
    "doctor_response": "Hi,Thanks for asking.Based on your clinical history and query, my opinion is as follows:1. Due to his growth, the dosage is increased in evening. However, both are same drugs.2. Anemia is important and needs to be treated. Meet a pediatrician and get a complete hemogram done to identify morphological type of anemia and treatment can be started based on it. Specific tests may be necessary, if reticulocyte count does not increase after 15 days of treatment.3. Diet can also be improved with eggs, fish, green leafy vegetables, red meat etc. It will help in improving anemia.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling between knee and ankle with no pain?\n\nMy left leg between the knee and the ankle keeps swelling up.  There is no pain with the exception of some pressure.  I stopped drinking over 4 months ago as I had thought that the swelling was due to alcohol.  I don't feel sick but am tired alot.  I am 51 years old.   I just took my blood pressure with a digital monitor and it is 102/72",
    "doctor_response": "Helloi appreciate your concernswelling in one leg could be due to DVT deep vein thrombosis or cellulitis of the legIn my opinion you should consult your GP for examination and a battery of tests like blood for hemoglobin CBC ESR CRP and D dimer or an color doppler of legif you can upload me a photograph I will be able to guide you better wait for your responsebest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes parasite infestation in body?\n\ni had a viras 4 6 years docters here left me untreated also heavy thrush internaly and naw have some kind of parasitis inferstation in my hole body docters here wont test me or treat me 4 this can you tell me what kind it could be caused by hurpys viras",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.You must be having some misunderstanding or misconception as parasites and virus both are different thing.Herpes is virus. So if you are infected with it than you need to be treated with the antiviral drugs.If you are infected with parasites as you are saying than you should be treated with the antiparasitic drugs.But if you are not infected with any of the above infection than doctor won't treat you.It may be possible that this is only your thinking problem. So do not think much deep in to it. If you are infected you can be treated. If you are not infected than you should not be treated.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do I have a good follicle size for an IUI procedure?\n\nHi I have done a follicle study, with multiple ovaries with medication from day 2 to day 7 I took hcg injection when one ovary was 17 by 14 but the bigger one has ruptured after 36 hours the size of the ruptured ovary was 29 by 22. Is this good ova to carry out iui procedure ? This is my third iui procedure so don t want to introduce any infection",
    "doctor_response": "Hi, I have gone through your question. A follicle size of 17 mm is adequate and if it has ruptured after hCG injection, then it is a favourable situationfor IUI. IUI done within48-72 hours of follicular rupture.I would suggest you to get your IUI done within the stipulated time.Hope you found the answer helpful.Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can the elevated values liver enzymes be lowered?\n\nHi Doc. I'm 27 year Male. Moderate drinker. Yesterday i went to ultrasound. My result have shows that liver size - 17.5cm, increased parenchymal echogenecity. Impression - hepatomegaly with fatty changes. More over High cholestrol & triglycerides level. If i will stop the drinking, is it possible reverse my liver to normal form.",
    "doctor_response": "Hi thanks for contacting HCM...Here you have fatty liver...The cause is high cholesterol and alcohol.With proper life style measures yes it will revert to normal....Here are few advise....It is better to avoid alcohol ....Refined food less.Trans fat food like pizza , butter , non veg , meat , baked pestries avoided.Regular exercise done for 1 hour....Use less oil in cooking.....Sunflower and canola like good oil taken...Daily early in morning one garlic cloves peeled and taken on empty stomach....Green leafy salad and fruits more...Take care.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedy for muscle pull\n\nHi, I visited the hospital last thursday with pains in my shoulder. After xrays they advised it was a pulled muscle. I have had pain in my shoulder constantly and am finding sleeping difficult. I am just trying to find out the best home treatment, as co-codamol and mandafen are not easing th3 pain.",
    "doctor_response": "Hi there.Thanks for writing in.You are already on pain relieving medications. What you can do is avoid sleeping on the affected shoulder .Serratiopeptidase might help relieve the internal swelling/ edema.Vitamin C tablet might help improve healing process.Application of pain relief gel like diclofenac gel might help. The gel should be lightly applied and not massaged on the affected area. If massaged, can cause burning sensation in the skin.Half an hour after application of gel, do hot fomentation on the affected area. Do hot fomentation 3-4 times a day.If none of the measures seem to help, do consult a physiotherapist.You might also want to get your Vitamin B12 levels checked.Hope my answer was helpful to you.Regards,Dr. Divya Kuttikrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What do my eye reports reveal and what can be the treatment?\n\nHello doctor,I want to discuss my reports with the ophthalmologist. I have uploaded all the copies.",
    "doctor_response": "Hello. I have seen all the attachments (attachment removed to protect patient identity). The third picture has not been uploaded completely but from the first two pictures all that I can make out are: Keratoconus is a disease in which the cornea becomes weak and starts bulging out. The old protocol dictates one should try Rose K contact lenses though it will improve vision but will not affect the progression of the disease. It also increases scarring. Nowadays one should straight away go for C3-R (Corneal Collagen Crosslinking with Riboflavin), a small procedure that will strengthen the cornea and will prevent progression of the disease and it is not that costly. After that, one can go for contact lenses or glasses and that is the correct protocol. For more information consult an eye care ophthalmologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for nausea, lack of appetite and vomiting in a child\n\nHi...suddenly my so , 8. months old, has developed nausea and lack of apetite and vomitting out whatever fed. He is a bottle fed baby. Last week our peditrician adviced us to give Caldikind sachet 10 in number contiously for 10 days...my son developed these symptoms during the period of administration of this vitamin D3...could this be the cause...on checking up with the doc he said no infection and also conducted blood test...CBC...reports are normal...Please help and suggest remedies as the child is getting weak...Thank u",
    "doctor_response": "Hello. Welcome to HCM. i suggest you try to stop the Caldikind for 1 week and see the baby's symptoms. if the baby is going back to normal then dot give this medication but try another brand. If the baby don't show signs of improvement i suggest you to visit his ear for an potential infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could wheezing be related to suffering from hiatal hernia?\n\nHello, I have started wheezing at night , it started while i went to lay down for bed and it has now continued when i sit up in bed or lye down. It has been going on for about a month and a half. I have a hyatial hyrnia also. It was told that it might go up into my lungs.",
    "doctor_response": "Hi,Yes,it could be possible that your hiatus hernia is causing this wheezing because in this hernia,the protruding part might cause compression over diaphragm leading to irritation of pleural tissue.This mechanism might be the reason of your wheezing and it can also cause shortness of breath and dull chest pain occasionally.Usually it is not serious but consult your doctor if it troubles you more.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for severe chest pain and shortness of breath?\n\nHi, I've been using mercilon for 8 months, but I stopped 3 months ago. I had a chest pain together with shortness of breath about two months ago, but it subsided the next day (lasted couple of hours). Now, I have a chest pain, like stabbing, for 5,6 days..it's not so severe..but I wonder can it be from taking pills? Thanks in advance",
    "doctor_response": "Respected user , hiThanks for using Healthcaremagic.comI have evaluated your concern thoroughly .* Treatment depends upon the diagnosis  ( does not seem in relation with  mercilon which has been stopped before 3 months )* Need definite evaluation with clinical examination , x-ray chest , EKG    according to the demand of the case .* General guidelines for better recovery -  deep breathing exercises , YOGA -  regular walking in fresh air to get enough oxygenation -  tylenol ( 500 ) mg morning and evening after meals till diagnosis-  avoid smoking or exposure to dusty environments - avoid stress , anxiety Hope this clears your query .Welcome for further assistance .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe pain due to varicocele and bleeding during ejaculation\n\nhiI am a male 22 years. i have vericocele veins on my left side testicals. Few days before i started feeling extreme pain in my testies. When i Masturbrated sperm was low and yellowish. There was a drop of blood as well. I took antibiotics ( amoxycilin). So every time i Masturbrate it pains a alot. Any suggestions.",
    "doctor_response": "Thanks for contacting HCM with your medical questions.I am sorry to hear that you hare having pain on ejaculation and blood in your semen. These symptoms along with the pain in your scrotum usually indicate infection in the prostate gland. The antibiotic you took amoxicillin is not powerful enough to treat the prostate infection. I recommend that you seek medical attention to be treated for prostatitis which is an antibiotic for 4 weeks.In summary I think you have prostatitis and you need to seek medical attention for full treatment of your infection.I hope this answers your question. Please contact HCM again with any of your health care concerns",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there anything homeopathic I can do about spasticity ?\n\nI have be diagnosed with Multiple Sclerosis and have spasticity problems. I take calcium, MSM, bilberry , a super B complex, a multi vitamin and ldn everyday. I m hoping to find something to help control the spasticity I suffer from. I lost health insurance when I had to quit working and am considered uninsurable (the one company that would give me a policy was !AMAZINGLY! expensive, preexisting condition is the phrase I hear). So, I guess I m hoping/looking for something affordable that might help. PLEASE don t say go to the doctor ... see the insurance comment previously.",
    "doctor_response": "Dear Dumb jerk Going by herbal medicines in your case the drug of choice is ginkoba biloba. In addition to this supportive medicines which are considered as brain tonics or medhya in ayurveda also help. Amongst these medicines Brahmi with gold and vrihat vat chintamani ras give good results. dr_lakhanpaul@yahoo.co.in",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tingling sensation in legs\n\nHello Doctor, I m 73, a woman, a retired Ph.D. from biomedical research. My insomenia began around when I was 70. Now I go to bad 11pm, but would wake up every half or an hour for several times: during my wake up, I feel legs tingling which makes me turning and turning and can t stay in bed ( I hate this tingling feeling), so I have to get up to do something, and then go back to bed, trying to sleep again. I have to repeat this round trip several times every night until 2-3 am, then I can sleep for 2-3 hours, wake up, and then go back to sleep for another 2 hours or so until 8-9 am to get up. (If I get up early, then the day will be ruined.)",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. You probably suffer from Restless Legs Syndrome. This condition in most people  hasn't known underlying etiology ( disease), but in few cases neuropathy may cause it.I suggest you to consult a Neurologist and discuss further steps in diagnosis and treatment of your concerns.Hope this helps. If you have further questions feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for writing tremor\n\nI am suffering with writing tremor from last six or seven years. i have also visited so many doctors from then, but still the problem is same as before. i have eat so many medicine but without any result. pls suggest as soon as possible as this problem is very much serious for me. i am unable to write anything. pls take it seriously and suggest me the right cure.",
    "doctor_response": "Hello, I would explain that some treatment options would be: - propranolol - clonazepam - primidone, etc. Botulin toxin injections and deep brain stimulation can be helpful too. You should discuss with your doctor on the above treatment options. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "46 years old, taking BP tablet daily without any problem\n\nI am 46 years old,healthy,taking BP tab daily without any problem I am 46 years old,healthy,taking BP tab daily without any problem",
    "doctor_response": "hello dipak.. \u2018\u2019. along with the tablet u r taking ... i will advice u to take tonicard 15 drops in 1/4 cup of water twice daily its a homeopathic medicine .. it a tonic to the heart \u2018Wish you Good Health\u2019.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden stiffness in the body after a seizure attack?\n\nmy brother 57 had what appeared to be a seizure as his body became very stiff, eyes fixed and he fell backwards fracturing his skull causing internal bleeding that took his life 24 hours later. I want to know if the seizure caused the stroke or a stroke caused him to have a seizure? he was stiff for almost 10 minutes and until medics arrived.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I would explain that we cannot know if the trauma has caused the intracranial bleeding or the opposite. Anyways, the autopsy would have helped to exclude a possible brain aneurysm, which could have lead to intracranial bleeding followed by the seizure and head trauma. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the dosage of Asthalin during pregnancy?\n\ni am pregrant with twins, and now in 22 week, i have asthama problem, i have taken Asthalin inhealer 2 times last night. still it feel breathing problem, is there any restricition to take Asthalin inhealer at this point of time, any restricition on any number of times it shouls take?",
    "doctor_response": "Hi,It is absolutely safe to take Asthalin inhaler in pregnancy, as many times its required to prevent symptoms of asthma. So do not hesitate to take the inhaler .Also, asthma in pregnancy can be very troublesome.You need to take proper medication to prevent any attacks .Nebulization and steroid inhalers are also safe in pregnancy.Some women avoid taking medication thinking it can affect baby, but it is more harmful when medication is not taken to both mother and baby.Thus, it is very essential that you prevent any attack of asthma occurring in pregnancy, even it means taking a lot of medication. Please take advice of a good respiratory physician .Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for having bump/bruise on forehead and swelling in hand/foot?\n\nTwo nights ago I fell down a flight of stone steps at a friends house in a half awake state on the way to the bath room. I was lucky to have no neck or spine injury but hit my head on the wall on the way down. I have a good sized bump and bruze on my forhead but no headache or other symtoms. also sprained my hand and foot with a little swelling but no pain I can walk but can\u00b4t really use my hand although it is better today. Should I go to the doctor?",
    "doctor_response": "Hi, If you are not able to use your hand properly, it requires x-rays and consultation with your doctor. There could be a small fracture. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can turmeric be taken for joints pain?\n\nlast december i had a stroke and now take plavix and in august of 2017 my cholestral medicine simvastant which I had been taking for 15 years turned my blood poision and started attacking my muscles. It paralyzed my legs and i spent 7 days in hospital taking one iv after the other I have been at home and recouiping would it be advantages for me to take tumeric for joinf relief and arthritis I await your answer thank you",
    "doctor_response": "Hi, Turmeric does not help you with pain. You can consult a rheumatologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes faster heart beat and breathlessness?\n\nmy mother is 60 years gets breathless whilst sleeping and sitting.  She feels her heart is beating very fast and also feels her stomach is not normal she feels she is as if her stomach keeps jumping inside her.  strange symptom she is asthmatic takes her inhalers.  has had all tests including lung, blood diabetes and ashtma review all is normal please advice?",
    "doctor_response": "Hi, being breathlessness on lying down is not a good symptom. it can happen in many condition, predominantly in lung and heart conditions.I suggest your mother to have a consult a cardiologist and a pulmonologist regarding the same.as she's asthmatic, it may be more of a serious lung problem and hence get in touch with a pulmonologist first.also get an ecg and 2 d echo done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the medication for Carpal Tunnel?\n\nI would like to know if Meganeuron OD Plus has vitamin B12, and what are the uses of this drug. I also suffer from Carpal Tunnel. I have been taking Meganeuron since the last 1 year, but dont seem to be benefiting for Carpal Tunnel and I still feel very tired",
    "doctor_response": "Hello, As you are on medication which isn't helped you why don't you try for physiotherapy. Noninvasive and completely safe. The flexor retinaculum is tightened in carpal tunnel syndrome and needs a release of it. With therapeutic ultrasound therapy and TENS therapy, the inflammation and pain will be reduced. MFR and IASTM will help reduce the spasm too. Some exercises to improve muscle strength and avoid spasm as well. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could intermittent stomach cramps, during pregnancy suggest?\n\ni am 13 weeks pregnant and currently recieving stomach cramps in my right hand side of stomach. and every now and again i recieve these stabbing pains for a few minutes. i recieved these about 6 weeks ago and was in hospital for 3 days but was sent home because they did not know what was wrong. but i feel the pain is worse than before. do u have any advice?",
    "doctor_response": "dear,stomach pain can b due to growing uterusr u having any complain regarding urine or stool. it can b due to indigestion or acidity.if you having fever?any change in bowel pattern ?if so consult your drdr. Mira Butani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes an electrifying sensation in the left foot and chest?\n\nmy friend is having feelings of electricity through his left foot and his chest constantly. His heart is beating hard the electric feelings are driving him crazy can t sleep I think it is the new medicine they put him on Rexulti YYYY@YYYY",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Can be due to low levels of vitamin B12 or electrolyte imbalance. Have plenty of garotade and see if it helps. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause wheezing and coughing as a shadow was noticed in lung?\n\nmy baby had a shadow on his lung around 6 weeks ago, and also he gets poorly every 3 weeks max, with wheezing, coughing and going of solids and just drinking 3 oz a day of milk which he usually he drinks 708 oz docs keep saying it a happy wheeze or chest infection, what can it be?",
    "doctor_response": "Hibabies with initial damage to lungs during neonatal period may have wheezing episode later like happy wheezer. As the name suggests happy wheezers are happy. They grow normally and they have normal activity and appetite. If your child has poor activity and poor feeding it is more likely an infection which causes spasm of airway leading to wheezing. Let him get treated for acute episodes . If these episodes are frequent he may require metered dose inhaler.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause dizziness, hyper tense,nausea & sweating ?\n\nYes thanks I have mesa, I m a carrier and have not had many signs but its acting up now they put me on leviquin 500ml I m getting dizzy weak hypertension can t sleep nausea but no vomiting and the sweats a little dehydration also for abut a week now ,it started two days after I started the meds and is almost constant unless I m laying down and some times bad dizziness when I m sitting . I m in a wheelchair from a broken back 26 yrs ago,i also have a enlarged aorta that I can feel palpitating at times been to dr but no real suggestions do u have any words of wisdom I have a teen and have to get around do u have any suggestions of what may ease the dizziness and weakness, caffeine lots of water ??? I m not running a fever but am getting clammy and some nite sweats ???any suggestions, how consernedcshould I b and the dr told me to rest ,drink lots of fluids oh and my vision is blurred occasionally I have no money I m unable to work and on medicade only ,s Can just tell me if I should go to the hospital or should I b extremely concerned for now I m tired of suffering forthr last week please just a hint?",
    "doctor_response": "Hi welcome to HCM.I understand your query and concern.Chest pain in your case needs intensive evaluation in the form of baseline ECG and 2 dimensional echo of the heart.Any cardiac blood insufficiency can be detected through these investigations.Drugs like apirin,clopilet,beta blockers will help to control the blood pressure.Its is always advisable to keep the blood pressure under 130/80 mm of hg to pressure prevent the chest pain.Drugs like nitrates can control the chest pain instantly.Reduce the level of anxiety by adequate stress management.Regular physical exercise will help to control your symptoms.The overall risk of heart disease in your case is very low.Consult your cardiologist for further care.Post your further queries if any.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. A small amount of composite filling is chipped. Should it be replaced?\n\nHello doctor, If a tooth with a little bit of a composite filling that is chipped off at the edge should it be replaced? It is on a molar tooth and does not hurt. The dental explorer does stick in there but no signs of decay on the X-ray. What should I do?",
    "doctor_response": "Hello. As there is no sign of decay, so you need not worry for now. But be extra careful with that tooth, you should maintain good oral hygiene, clean full mouth with fingers after every meal, there should be no food lodgement in your tooth. Rinse mouth properly after every meal. Do revert back for more queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for stomach pain and acidity\n\nLately I have been experiencing stomach pain, but last night & this morning it feels kinda weird like something acidic inside & I almost feel like I have to burp like there is something stuck in my throat.  It's very uncomfortable l, feels like my stomach is empty almost feels like I have to eat to make it go away.  What's wrong with me?",
    "doctor_response": "Hi,From history it seems that you might be having hyper acidity and hunger pain giving this problem.Due to stomach empty in the morning and late night and secretion of acid continue, this type of feeling is there.Take pentaprazole medicine for few days.Take less but frequent diet.Take plenty of milk, buttermilk etc.Avoid spicy and junk food.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful blisters on feet?\n\nHi I am a farmer who has been wearing wellie boots for the last few weeks (we are lambing and the days/nights are long!) For the last few days my feet have been very painful and small blisters have appeared aand red blotchiness. I have to go back soon is there anything I can do to get rid of the pain?",
    "doctor_response": "HiThanks for your query at HCM.I believe that  you're doing a lot of walking, rubbing and friction. I advise you to change your shoes having soft inner lining. I suggest you to put on some antibiotic ointment or clean your skin with a sterilizing wipe and cover the area with gauze or a gel dressing.Hope I answered your queryTake careDr Sheetal Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe for cancer patient to undergo angiography and angioplasty?\n\nhi...i am somak from mumbai... my father has been suggested to undergo angiography and angioplasty while his treatment for NHL. i have the following queries 1. how costly is the procedure in totality? 2. is it safe for a cancer patient to undergo this procedure??",
    "doctor_response": "Hello, I don't know how much it can cost but I can say that this procedure may be lifesaving for your father (I mean for the heart problems). Angiography and angioplasty are not contraindicated in cancer patients. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Anila Skenderi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mild disc bulge in lower spine, pain in right hip. MRI done, wants to do ultrasound. What is free fluid?\n\nI had a MRI done because I was having pain, what appeared to be in my right hip but seemed to move to different places on my right side. I got the results today and it was discovered that I have a mild disk bulge in my lower spine. The MRI also revealed that I have Free Fluid in my abdominal area and the doctor wants me to have an abdominal pelvis ultural sound. My question is, What is free fluid?",
    "doctor_response": "Hello Dear, Welcome here on healthcaremagic dot com a site for solving your health problem online by qualified healthcare professional. I am very much concerned with your problem and certainly will guide you how to get rid of these. In my view Free fluid in abdomen means an abnormal fluid in peritoneal cavity, This is indicative of some pathology in abdominal organs for which your doctor has suggested ultrasound. I suggest you to Visit your family doctor for a detail close examination and advice for further treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be done for aneurysm?\n\nI have been having migraines for the last two weeks which have been so bad I had to go to hospital on one occasion. I went for an MRI and the results say it appears I may have a 2.5mm aneurysm at the junction of the right A1/2 segment, directed posteromedially which I have been told is at the front of your head on the right side which is where I have my migraines. I have been told I can get a CTA which will give me a more definitive result which a neurological surgeon will then look at to decide what action to take. I have however been recommended against having a CTA as it can cause infertility. Can you please tell me if this is true and if I do do it and it confirms the results what the likely course of action will be? Surgery/watch and wait?",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your symptoms and MRI brain findings.The aneurysm is small, however, it needs to be confirmed. Most importantly, we need to know its exact size and location to decide the best course of action.The gold standard test is DSA-digital subtraction angiography. I agree that there would be a small radiation exposure but the chance of infertility is low with that. The rupture of aneurysm can cause more harm than that of angiography.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does my knee pop when I walk?\n\nMy knee usually pops when i walk.  Doesn't hurt just makes a popping noise that others can hear.  Last night when I was sleeping, my knee started to hurt and almost felt like it needed to pop like you would with your knuckles.  Every once in awhile it does happen but not as often as my knee popping.  Any ideas?",
    "doctor_response": "Hi...The popping noise in your knee is due to friction developed in the knee due to muscle imbalance.The bone slides over the other and move, at the end of movement give rise to pop while releasing the frictional pressure..I suggest you to kindly do lot of stretching of the muscles around the knee especially Quadriceps  Hamstrings and calf...Do lot of icing around the knee...Do glute strengthening exercises like... Bridging clamshell..step ups...squats...Do calf raises...Hope this is helpful for you...Kindly revert back in case you need any further clarification...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard lump on head?\n\nI have a hard lump on the top of my head, I have had it for 10 years and has not grown nor is it painful, it does not move and is hard, and is about the size of a euro coin maybe abit bigger, it doesn t sound like a sebocous cyst has it s rigid. can you tell me what you think, I am very worried?",
    "doctor_response": "Hi,Dear thanks for the query to HCM virtual clinic.I studied your query in full details updated from you.I understood your health concernsBased on your query data, In my opinion ,Dear You seem to suffer from Dermoid Cyst(ectodermal/or teratatoid/or germinal) due to its site on top of head,or could be from Dermatofibrosarcoma  Protruberance(DFSP)locally malignant tumor-needs to be ruled out- as your tumor is hard,it is known to recur and prognosis is bad with death in 2 yrs/ or it could be AMS(Atypical Mole Synderome) with benign tumors of the scalp.FNAC Biopsy and CT of Skull to see the local invasion in the surrounding tissue is needed to find out the cause of this hard lump on the head,in your case.Team of GP doctor and Surgeon/ and Neuroo-Surgeon for craniotomy if skull bone is involved, would be needed to treat your health issue.Hope this reply would help you to evaluate your case and treat it with your doctors in time to come.Hope this would resolve your query and worry and Anxiety accompanied with it.Welcome for any further query in this regard to ME.I would love to help you out.Awaiting for any further query.Wish you fast recovery from this intriguing health problem.Have a Good Day.Dr.Savaskar M.N.M.S.Genl-CVTS -Senior Surgical Consultant",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does lower back pain related to scrotal cyst?\n\nhi, 2 mos ago, i was diagnosed with epididymal head cyst (thru scortal ultrasound), but before that i experienced groin pain & at my lower back, i undergone urinalysis, and i have hematuria, so the doctor prescribed me with ciprofloxacin 500 mg for 7 days, and the groin & lower back pain disappeared for a week, then it came back again, then i made a physical check up with my srotum and i discovered that i have a lump on my both testicles, then i go to the doctor then, he by feeling it he said this is only a cyst, just to be sure he requested for an scrotal ultrasound, it is an epididymal cyst, but until now im experiencing lowerback pain and occasional groin pain, does it related to my scrotal cyst? btw, my scrotal ultrasound was on july 3 2014, and until now im experiencing the low backpain. please help",
    "doctor_response": "Dear patient Back pain is not caused by scrotal or epididymal  cyst and both conditions are not related.  Epididymal  cyst us usually asymptomatic  and  diagnosed incidentally.your back pain might be due to other  causes like 1. Trauma 2. Weight lifting 3.  Infection  at the back . So I would recommend a visit to back pain specialist and radiograph  of  lumbosacral spine anteroposterior and lateral views to rule out bony abnormalities. If it's normal  start tab diclofenac plus thiocolchicoside combination twice a day for 5 days.  Do back strengthening  and back extension excersise. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lethargy and trouble concentrating\n\nI need to know what I should do. Im a 19 year old male who is 6ft1 and weighs 150lbs. No matter what i do I cant focus on my homework, and I am constantly tired everyday. I sleep for 11-12 hours a night because I cant get up, and Im still tired when I am awake. It takes +400mg of caffeine a day to get me by with out wanting to lay down.",
    "doctor_response": "HelloWelcome here.You have problems of hypersomnia and lack of concentration.I have some suggestions for your problems:1. Practice regular yoga or exercises to keep yourself active.2. Increase fruits in your diet and avoid fats. Fats make you lazy.3. Keep solving puzzles and if possible, involve in outdoor games.4. There drugs like modafinil(prescription drug) which are stimulants and keep your mind alert. These can also help.Visit your doctor for further treatment.Hope this helps.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hypertension\n\nBio 202 Cardiovascular Case Study #2 A 5 6 , 210 lb., 64-year-old male business executive had a physical exam prior to his retirement from corporate work. His blood pressure was 180/115 on three separate days. Further examination showed normal to low plasma renin activity, elevated total peripheral resistance (TPR), cardiac output (CO) of 7.2 L/min, x-ray evidence of left ventricular hypertrophy, retinal hemorrhages, and mild polyuria. Recommended therapy was weight reduction to his ideal level, a low-salt diet (2.\u00a0\u00a0\u00a0\u00a0\u00a0Explain the sites of action for the three pharmacologic agents prescribed for this individual: Diuretic, Beta Blocker, Vasodilator3.Why was the vasodilator not used before the other drugs were added? 4.How would you treat this persons hypertension? Include at least 4 options.5.\u00a0What are the pharmacological steps to treat CHF?",
    "doctor_response": "Hi,Diuretics act on kidney, beta blockers on heart, vasodilator on peripheral vessels. Vasodilator are not used because of their side effects like tachycardia and other side effects. Also they are not adequately studied. He should be started, either of three categories, ace inhibitor like Ramipril, arbs like Telmisartan or calcium channel blockers like Amlodipine, diuretics like Thiazides.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pinched nerve and nerve damage affect the heart?\n\nHello, I just left the hospital after having test for three days to find the cause of chest pain and pvc,s. I have had two surgeries on My neck with hardware, I injured it again resulting in pain, muscle spasms and head shaking. My Dr said that the pinched nerves and nerve damage is affecting My heart. Your comment,s?",
    "doctor_response": "Hi,Thank you for posting your query.It is unlikely that pinched nerves in the cervical region and nerve damage would result in heart disease. A qualified doctor would not make such a comment, so, I feel there may be some mis-communication between both of you. So, your chest pain and ventricular premature complexes are not related to the pinched nerves. If you can upload his prescription, I would be able to clarify the matter further. I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to care a patient post heart surgery?\n\nHello doctor, My question is regarding post-surgery care in heart-related ailments. How is the monitoring done? How often does re-admission occur? How to prevent this?",
    "doctor_response": "Hello. Regarding the care of non-cardiac surgeries in cardiac patients, If you are suffering from cardiac problems such as previous heart attack, heart failure, any cardiac valve problem you have to take cardiac fitness before surgery. If fit, then go for surgery. After the surgery you can take rest as advised by your surgeon. If the cardiac issue is stable, there is no need to reassess the cardiac problem. If cardiac problems, such as heart failure, worsens then you may need echocardiography and other related investigations. Regarding medicines, ask your surgeon not to prescribe you medicines that have a high amount of sodium, which may worsen your cardiac or hypertensive problems. You may take a low sodium diet and may start light exercise according to your surgeon. Regarding cardiac surgery: 1. For pain relief, you may take a pain killer for wound-related pain. 2. Gradually increase level of activity upto six to eight weeks. You may drive then also. 3. Eat a low sodium diet. Do not eat up to full stomach. Eat small amounts mutiple times per day. Readmission depends upon complications that may develop such as wound infection, heart failure, heart attack due to blockage of the grafted vessels after bypass surgery. If a heart valve is implanted, it may get stuck and it causes sudden worsening of symptoms. Some times bleeding may occur due to unmonitored blood thinners. To avoid: 1. Do not stop medicines on your own. 2. Keep monitoring clotting profile, in case blood thinner such as Warfarin is prescribed. 3. Take a low sodium diet. 4. Avoid excessive exertion just after surgery. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child shows no improvement in coughing and sneezing, has started with fever, taken allegra, levolin. Advice?\n\nHi, My baby is one year old, she was suffering with cold and cough and was advised Corex DX, Levolin and an antibiotic advent. She became alright but started having dry cough symptoms. I consulted a doctor and he advised allegra and Levolin. I continued using it for 2 days and today my baby is having fever as well and there is no improvement in coughing and sneezing . Please advice.",
    "doctor_response": "Fever is due to a superadded viral infection. Continue with  sy Levolin as it is a bronchodilator and will help relieve symtoms of cough due to small airway obstruction and inflammation ( bronchiolities0.  and give plenty of oral fluids. For fever give Meftal-P.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for headache and rapid heart rate\n\nI have rapid pulse rate, feel heart beat in chest, pounding headache, swelling in ankles from new blood pressure medication, been taking 10 days (amlodipine 10mg). Also taking third course of prednisone for hoarseness from cough due to allergies and 2 previous BP medications (lisinipril 20mg, losartan 25mg) with side effect of dry cough. I can t tell anymore what side effects of the meds are causing what anymore.",
    "doctor_response": "Hi,More probably swelling of your ankles are related to amlodipine.I think you can try to discuss with your doctor the possibility of treatment with beta blockers and diuretics. Beta blocker will eliminate your fast heart rate, and diuretic will reduce ankle swelling. They both will  lead to lowering of your blood pressure. Depends on your blood pressure data, there are three variants concerning to amlodipine1. withdrawal at all2.  replacement with other medication of the same group in low dose, which has less probability of causing ankle swelling3. continue with amlodipine, but with smaller doseHope I could help youWishing you good healthIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this HSG test result indicate?\n\nHi I just received my HSG result and this is what it reads. There are multiple linear filling defects in the uterine cavity likely due to uterine synechae or recent instrumentation. The left Fallopian tube is partly outlined but there is no intraperitoneal spillage of contrast medium ipsilaterally. The right Fallopian tube is not demonstrated and there is no intraperitoneal spillage of contrast medium,General Impression Bilateral tubal blockage? Spasm. Please what does this mean",
    "doctor_response": "Hi there, I have understood your concern. HSG - hysterosalpingography, is a test to know about the patency of fallopian tubes and outline of the uterine cavity. As per your reports, there is some filling defect in the uterine cavity. It can be due to adhesions or bands in the uterine cavity.  It can be due to infection or some surgical procedures like currette.  Also, both the fallopian tubes seem to be blocked and do not have patent lumen.  I will suggest you to get laparoscopy and hysteroscopy done.  If you are planning for pregnancy, this procedure will be of help. Thanks. Dr. Purushottam Neurgaonkar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have remnant ejaculate string in penis after ejaculation?\n\nHello im at 16 year old male and ive noticed that when i ejaculate sometimes a long elastic string of semen (or watever it is) stays in my penis and i have to either pull it out (wich is uncomfortabl) or i have to take a piss to push it out. Is this a bad thing?",
    "doctor_response": "Hi,The consistency of semen depends upon factors like period of sexual abstinence, age and intensity of sexual stimulation. There is no need to worry about. This is normal. There is no specific reason for it. String formation is due to sticky consistency. This is not a bad thing. Wish you good health.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Chintan Raval",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does shortness of breath indicate any kidney issue?\n\nHello doctor, I am a diabetic since I was 30 years and have heart issues from 15 years. Had bypass done eight years back. Now, lVEF is 25 %. Now, if I walk 50 to 100 meters, I feel breathless and after motion or urine, again feel breathlessness. Is it related to any kidney issues? And also, please suggest can angiography and angioplasty can happen without any risks? Recently, was admitted due to fluid retention in lungs. In 15 days after discharge, I feel same breathlessness and eructations, burps start continue for 15 to 20 minutes. Kindly let me know is this a heart block or kidney issue.",
    "doctor_response": "Hello. I reviewed your ECG and would explain that it indicates left bundle branch block. Regarding the shortness of breath, it is related to heart failure. Of course, the renal function may be compromised (as it is very common in heart failure). I would like to know your current therapy. The fluid in the lungs is another common feature of heart failure. An optimization of your therapy could help improve your situation. Regarding angiography or angioplasty, it can be performed in this clinical situation safely, if it is indicated by the doctor. But, first, it is necessary to evaluate your kidneys, by performing renal function tests, in order to be sure that there is no risk from IV contrast.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a hard lump under my tongue. Will it be cancer?\n\nHi doctor, I have developed a large, hard lump on the underside of my tongue. It is grayish white in color and does not hurt at all. It feels like a hard ball in my tongue. Also, I have other small red bumps. I do not know how long they have been there and I just noticed it before two days. These are weird and seem to be growing. I have never noticed it before. I have suddenly started getting acne all over my face and I never had it before in my life. Could this be related somehow? I am 25 now. I used to smoke but stopped some months ago. I drank a lot for a couple years. Do not know if that is relevant. Please help.",
    "doctor_response": "Hi. The hard lump under your tongue is mostly inflammation which usually gets very hard due to the structure of tongue. The bumps are formed when the inflamed tongue presses against the teeth causing that particular pattern.The inflammation of tongue usually becomes very hard to touch and grayish in color, it will take at least a week or two to return to normal. The acne problem might be due to increased hormonal activity in your body mostly and is not related to the other. I would suggest you to wait for 10 days for the tongue to return to normal. If you could take medicines over-the-counter, I would suggest you to take anti-inflammatory medication twice for five days. Kindly answer me, so that I can diagnose any other possible condition if necessary. Revert back with the answers for the above questions to a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "No periods on stopping Microgynon contraceptive pill, had little brown discharge. Why?\n\nhi i have been on the Microgynon 30 contraceptive pill for about 2 months now and i have been taking it at 11:30 every morning, and stop taking it for 7 days and continue as normal from there, but i haven t had my periods in the break just little bits of brown discharge . have been on injection before i was on pill and i had periods constant for about 5-6 straight.",
    "doctor_response": "Hi thanks for the query.Although, the chances of pregnancy are very rare but you should rule out it with the help of serum beta HCG test. Periods are usually shorter and flow decreases with the use of oral contraceptives.Hope this information is helpful and informative to you.If you have further queries you can directly reach out to me on the following URL:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Started having grand mall seizures while sleeping.  No other medical history.  Any ideas?\n\nMy husbands 42 years old and just started having Grand-Mall seizures and a most of them were while he was asleep... just wondering what may be causing them. Especially while hes asleep. We have no health insurance as he & I both have been healthy so no real reason to get it & now hes unable to work so we're just not financially able. Thanks. Just wondering what could be making this happen since hes asleep when it happens?",
    "doctor_response": "Hi,Thank you for posting your query.Grand mal seizures indicate a brain dysfunction, and needs evaluation to find out the cause. Important investigations that would help us find out the cause of his seizures would include MRI brain epilepsy protocol and electroencephalography (EEG). In addition, he would need treatment with mti epileptic medications to prevent seizure recurrence.I hope it helps.Best wishes,Dr Sudhir Kumar MD DM (Neurology)Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Tylenol be given for feet aching safely after Benadryl?\n\nMy 5 yr old was prescribed Benadryl for her itching she has exzema type of problem she has seen a dermatologist and that is one of the meds he gave her. Now she has an aching feet, well both her feet are aching and i want to give her Tylenol and im wondering if that will be safe to give her when she took the benadryl an hour ago?",
    "doctor_response": "Hello. I just read through your question.Tylenol is safe to give even one hour after benadryl. You can give it without worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurrent swelling and pain in upper lip?\n\nMy son developed a swollen upper lip last night, and it was gone again this morning however he had a lot of pain in it and was verydistressed he has been complainig of a sore mouth for a few weeks now and we are wondering is it hi teeth which are very small or would it be a gum problem he has",
    "doctor_response": "Thanks for your query, I have gone through your query.The swelling over the lips could be because of the allergic reaction or it can be extension of the tooth or gum infection. Consult a oral physician to rule out these conditions.If it is tooth or gum infection you need  to take a course of antibiotics and treat the causative tooth. If it is a allergic reaction, then it has to be treated with anti allergic agents like cetrizine.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for persisting fever\n\nhi my wife is suffering from fever from a week and the fever goes for 6 to 8 hours when she took medicine(nimesulide) and come after the effect goes her age is 28,weight 51,and height 5ft 6 inch.in between i have tested her for maleria and typhide but test was -ve and at early of fever,few days she was feeling very weak but now she improved but the fever and headache persist.what the remedy",
    "doctor_response": "Hello!I really appreciate your concern. From my clinical knowledge I suspect your wife is having viral fever. It may last for a week or two. Treatment is symptomatic management by analgesics only. You can continue to have nimesulide with paracetamol (Acetaminophen) tablet.Hope my answer has solved your query. Take Care.Thank you. Best Regards.Dr. Manan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe cough and chest pain while coughing\n\nhai...i'm suffering from Esinophils from almost 3 years....it always attacks in winter.......my mother had Esinopheles long back...i have been suffering from fever from 3 days with severe cough,chest pain while coughing...yesterday i went to doctor then he has given Avil injection...immediately after that my hands became stiff...he has then immediately given decadron injection...and it got cured...",
    "doctor_response": "Hello,Your probable diagnosis: allergic bronchitis. Investigations needed.-Auscultation -Chest x-ray -Spirometry if needed -AEC If your AEC more than 600 than start montelukast plus fexofenadine tablet course for 10-15 days. A decongestant like levocetirizine for five days can be prescribed. If bronchoconstriction present than bronchodilator needed. Consult pulmonologist for examination and get a prescription.Hope I have answered your query. Let me know if I can assist you further.Regards,     Dr. Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "Anxiety disorder, allergy, have chest tightness, sensitive teeth, dizziness, weakness. Cause?\n\nI have a generalized anxiety disorder and take wellbutrin and trazadone for it. I also have bad allergies and take claritin. Lately my chest has been tight and feels like when I have a chest cold and my lower teeth are really sensitive. I feel very dizzy and weak and want to sleep all the time. Does it sound like I am sick or is it something else?",
    "doctor_response": "Hi, Thanks for writing in. The dizziness and weakness could be due to side effects of wellbutrin and trazodone. The tightness in the chest and sensitivity could be symptoms of your anxiety and it is unlikely that you are actually suffering from any other illness. I would suggest that you speak with your physician if the symptoms persist. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have severe pain in right lower abdomen. Could it be appendicitis?\n\nHello doctor, I suddenly started having severe pain all over my stomach yesterday. I took injections for pain, vomiting, and gas from the nearby clinic. But the pain did not stop, and it continued till the evening. Then I went to a hospital, where I was told it might be an appendix and to ensure that an ultrasound scan should be taken. But after a while, I felt completely normal and returned without doing any tests. I did request for a prescription, in case if the pain comes back. I did a urine test, and it is normal. Now there is only a dull pain at the right bottom side of my abdomen, and it hurts a bit when I touch there. Could it be an appendix, and should I rush for medical assistance? As I am having my exams, I have to wait for two weeks to approach the doctor.",
    "doctor_response": "Hello. I can understand your unavoidable necessity to delay the treatment. 1) Based on the description of your stomach pain, it might be due to an appendicitis. 2) Another possibility for similar pain is kidney stones, but this was excluded from the normal urine report. 3) You must do the USG (ultrasound) abdomen and also continue treatment for pain and inflammation. 4) If the USG abdomen shows appendicitis, then you must undergo surgery, as medical management of appendicitis might cause repeated episodes in the future. 5) Recovery after this operation is quick and probably you would be able to appear in the exam also. USG abdomen, CBC (complete blood count). Right ureteric calculi. Appendicitis. antibiotics, analgesics, laparoscopic surgery. Follow up with the general surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for partial thickness & capsulitis\n\nHello sir,I have severe pain on right shoulder since 2 years.The pain started from the shoulder to wrist and on scapular region.Now same pain started on left shoulder.MRI scan of right shoulder shows partial thickness and capsulitis .All movements are possble with pain,but I am not able to do any work.I consulted many doctors and took many medicines including Ayurveda,still I have pain.Sir would you please advise a medicine for me.",
    "doctor_response": "Hello,I have studied your case and I think that you are partial cuff tear and adhesive capsulitis and in this there is no role of medicines apart from pain killers. I would recommend you to get opinion from arthroscopy surgeon and you might need arthroscopy surgery to treat cuff tear and adhesion.   Once your cuff is repaired then you can go ahead with physiotherapy.   I hope this answer will be useful for you.let me know if there is any other followup questions.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can I get rid of severe acne on my cheeks and forehead?\n\nHello doctor, I have severe acne mainly on my cheeks and forehead for a year, and now it continues to get worse, and there are no improvements. No matter how many times I go to the doctors. I am currently taking Lymecycline capsules for a month and the Differin gel at night. I have seen no improvements, inspite of eating healthy food, and drinking more water. I need help because it ruins my confidence and is a daily struggle.",
    "doctor_response": "Hello. During teenage, it is very common to get acne, especially on cheeks and forehead due to several reasons (primarily because of hormonal changes in puberty). It is advisable to wash your face multiple times to avoid the accumulation of dirt, which can lead to blockage of pores, and that results in acne formation. Use of a mild medicated facewash suggested by your dermatologist might help you to get rid of the present symptoms. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause lumps on leg?\n\nmy cousin has just had a angioplasty for two blockages in his arteries about 2/3 weeks ago, 2 lumps have now appeared on his outer legs not inside where the procedure took place he went to a/e and they said it is the medication he is taking which seems strange to me",
    "doctor_response": "Hi, There are a lot of reasons for lumps to form. First, it should be confirmed whether it is arising from the bone or the soft tissue. Hence, please get an MRI done. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Jaideep Gaver, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have spotting with headache and dizziness. Can I be pregnant?\n\nHi doctor, I have my cycle of normally 42 to 45 days. Last time, it was 55 days. This time on 47th day, I had spotting with headache, back pain, dizziness, low BP, and HR around 110 and BP around 70/100 pregnancy test are negative and it is seven days after we had unprotected sex. My question is, can I be pregnant? If not, why am I having all the pregnancy symptoms like headache, reflux, dizziness, and back pain?",
    "doctor_response": "Hello. According to your history, you are a 39 year old lady with a BMI of 28.4, having long cycles of 42 to 55 days. You had unprotected sex activity seven days back (do not know which day of the cycle you had activity) but on the 47th day of the cycle, you got spotting with dizziness, headache, and backache. You did a pregnancy test (do not know when, but it was negative). Regarding past medical/surgical/menstrual and drug history, you did not mention anything. My advice is to have blood pressure, pulse checked in a nearby health center with random blood sugar level and one serum beta hCG (pregnancy hormone). It will the clear situation. If spotting/bleeding continues even mildly, repeat beta hCG after 48 hours as well. If it is decreasing, it means pregnancy is subsiding. But if increasing, it means you have pregnancy (more than 60 % increase after 48 hours is in healthy pregnancy and less than 60 % means unhealthy or pregnancy outside uterus alarming). Transvaginal ultrasound also may help but need specialist hands. But first most important that your vital signs should be normal. In case of abnormal vitals, you need emergency detailed evaluation. If vitals are normal with no pregnancy you can be advised for day-2 menstrual cycle - I hope you understand my point. I will wait to hear from you. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What herbal therapy can I take for periorbital pigmentation ?\n\nmyself pinki,23 yr old,52 kg wt,am having periorbital pigmentation since childhood.please suggest some herbal therapy for this problem",
    "doctor_response": "hi welcome to healthcare magic forum you need to consult dermatologist undereye circle may be due to -heredity -stress -hormones -drugs -sunlight -improper sleep and diet -allergic reaction i think you have heredity reason there are different type of treatment depend upon it stage like -peeling -microderma -filler -laser etc . wear sunglass and drink more water use sunscreen regularly . i hope i have answered your question",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment should i give to my 29 days old baby for Erb's palsy ?\n\nDear Doctor , My daughter (age 29 days) is patient of erb s palsy . The problem identified on next day of birth . No moment or sensation observed by doctor. X-ray report is normal. The doctor at Raipur(Chhattisgarh) checked and identified the problem as compression of C5, C6 & C7 and prescribed for physiotherapy at home. Initially there is no strength in hand but now some power is appearing in forearm , but still there is no strength in wrist. No any other test was carried out. should i wait for six month as advised by doctor. What i can do for betterment of my baby. Kindly advise. Sunil Soni Korba (chhattisgarh)",
    "doctor_response": "hi well come to hcm Usually it can be diagnosed clinically as well.If at all you are intereste in gettin investi getting it you may submit her for X-cervical spine and EMG[Electro myography}.As far as Erbs palsy is concerned physio therapy is best trearment.So if you wish You may continue with physitherapy and wait for the out come. Thanks Better luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I feel pain in stomach while coughing?\n\nFor the last couple of weeks I have had sinus problems that have included both eyes watering and being closed in the morning, chest cold, sore throat around the adams apple, and now when I cough because of the mucus in my chest I feel a pain in my stomach and also in my nut, its not a sharp pain but a noticeable feelng.I've been on moxacillian for about 2 weeks now. Age is 60, height 5-10, weight 310, healthy except the once or twice a year sinus problem that has never been this severe.",
    "doctor_response": "HelloThank you for asking in HCM.So you are suffering from sinusitis .It is a chronic problem and in some patients it cause a chronic cough due to the secretions and this syndrome is known as PND syndrome (post nasal drip).Sometimes in chronic cough the patients may feel pain or a discomfort in the stomach area,probably from the contraction of the muscles that participated in the process of cough.But do not worry ,as the situation of the sinusitis became better and as a result the cough becomes rare or disappear at all you will not feel any more this sensation.I wish a good health for youThank youDr.JolandaPulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain after running?\n\nHello. My 7 year son is extremely active and athletic. He is constantly running and full of energy. However, after playing youth basketball this season, he stated that he wasn't sure if he wanted to play sports anymore because sometimes his chest hurts after he runs hard. He does not complain about chest pain while at rest and has said it has only happened twice. The pediatrician referred me to an allergist to see if he has exercise induced wheezing. Is this appropriate for now, or should I push to see a cardiologist. My son has no known health problems.",
    "doctor_response": "There may b several causes of chest pain starting from pain arising from chest wall, lung covering, lungs. Common causes are pleurisy, pneumonia, rib cage injury. You should consult pediatrician to rule out these causes. Cardiac causes are very rare in this age group.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high fever in 2 year kid\n\nmy 2 year old (14kg) had a high fever ()103) for 4 days and subsequently the doctor said he has a throat infection and started him on augmentine. The fever disappeared. After just 6 doses he has developed a rash all over his body and face (not arms and legs). He has had C-amoxiclav before with no reaction. Should I stop the antibiotic?",
    "doctor_response": "Hi,.. By what you quote it could be drug rash or dengue fever. In my opinion, you should stop the drug and do cbc, NS1 Antigen test. Treatment will depend on above reports. Regards - Dr Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and swelling in legs?\n\nMy husband has been on Coumadin for a number of years. Most recently his pt has been all over the board. He is currently taking 2.5 mgs 5 days a week, so 2 days a week he is taking nothing. About 3 wks ago, his right foot swelled up, he had considerable pain, they did an x-ray, no broken bones, they put him in a boot and in a couple of days, the swelling went down & the pain went away...2 days ago, it started over now pain in his elbow and swelling in his elbow and hand, right one. He is also taking Crestor, 10 mgs per day. Could this be DVT??? or a reaction to the statin which he has been on again for about a yr...he does not tolerate that well....didn t take it for a number of yrs due to pain in his joints...",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.It is not likely to be DVT as your husband already on Continuous anticoagulation and DVT is rare in the elbow  If I were your husband  treating Doctor for this case of recurrent swelling in different parts of the body with pain, I would come up with three possibilities, these include: 1- Side effect off Coumadin as this drug is anticoagulant and its overdose may lead to multiple hematomas and this could be assessed by bleeding investigations and prothrombin activity and the treatment is dose adjustment of the drug.2-Autoimmune disorders should be excluded by doing the following investigations(Rheumatoid factor, ANA,Anti CCP,ESR,CRP and CBC)3-Gouty arthritis should be excluded by doing serum uric acid.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My 2 months old baby is extremely agitated and not sleeping. Why?\n\nHello doctor, My son is 2 months old. He is a normal healthy baby. I did not have any trouble with him so far. Sometimes, he will grunt and raise his knees to his chest when he has gas but has always been able to get a normal amount of sleep.Today, though he has been very agitated and alert, the whole day he has been kicking with his legs and flailing his hands like crazy. Extremely agitated I would say. He was hungry and ate a reasonable amount (he is bottle-fed), but the rest of the time he keeps squirming and kicking. He did not get almost any sleep for 12 hours so far. He falls asleep and wakes up every 5 minutes, with startling reflex, throws hands in the air and then starts to squirm and kick. Then cries and weeps and this keeps going. Sometimes, he just stares super alert and kicks his legs and arms for a long time. This is not a usual behavior.\u00a0He occasionally has been like that, but not as much as today, and it never stopped him from sleeping.His temperature is normal (rectal 99.1 F). His food intake normal.There is no vomiting or diarrhea or constipation. He never had colic. He usually sleeps 12 to 14 hours per day (7 to 9 hours per night). I am\u00a0not sure about his problem. Can you help me? Does this sound serious? Should I go to an ER or is it likely something I can wait?",
    "doctor_response": "Hi. From your explanation, a few things are evident. This is probably your first child. For further information consult a paediatrician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am getting root canal treatment, but I feel pain even after three sittings. Why?\n\nHello doctor,I am doing a root canal on one tooth, it has been taking three sittings, and I still feel the pain during the procedure, and I cannot bear it. What shall I do? I am now terrified of going, and I want to deal with the painful tooth? What is your suggestion?",
    "doctor_response": "Hello. I understand your concern. Root canal treatment usually takes three to five visits. However, pain virtually vanishes from the second visit onwards. Underlying infection may make it difficult to obtain proper anesthesia, because of which it hurts during treatment. You should go through a complete course of antibiotics, as prescribed by your doctor, and in the same course, your treatment should also ideally get completed. Treatment may even take more visits, but pain automatically subsides with the elimination of infection. The procedure is almost pain-free.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will wearing retainers cause teeth to buck once again?\n\nSo, I had braces for approximately 3 and a half years, the reason why I got said braces was because of my tonsils.Well, when I was about..10 or so, I got them removed and got braces due to the overbite because of the tonsils causing me to breathe wrong, and I also had a small jaw, as a child.Well, after I had gotten my braces removed, I wore my retainer for a  month (it was lost, and never found), and also had about four to five teeth removed before I even got braces.Will this cause my teeth to buck once again? Or should I not be worried? A small overbite is fine, but I'd rather not look like a \"beaver\" again.Will my teeth shift back to the",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,    You are wearing braces and then retainer from few years ,  and for that Orthodontic treatment you had been undergone through extractions of your few teeth , fine     You have mentioned that you have problem of Overbite, and small jaw , dont worry much , I will suggest you that if you are wearing braces,  had extractions have retainer also then go for Complete Orthodontic treatment , dont leave it in between latter on if you have increased Overbite then you can have problem of attrition , senstivity, many more   so it is better you go for  orthodontic treatment. Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "5 year old has cyclical chest cough that has persisted for 6 months\n\nfive year old has cyclical chest cough that has persisted for 6 months my five year old son keeps getting a very bad chest cough every three weeks, hes sick for a week or so then it goes away and comes back three weeks later has been on this cycle for 6 months, was diagnosed with asthma but cycle has continued despite inhaler",
    "doctor_response": "he should be on 2 types of inhalers- one asthalin for relief of acute cough symptoms & a steroid inhaler like budecort for controlling frequency of attacks. please check if tehnique is correct & ur son is geting adequate treatment. other main issue is that, avoid all that is causing allergy in him like dust, smoke, agarbati, saambrni smoke and clean his mattress once in 3 days & sun dry it. these things can reduce the episodes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does puffy eyes,forehead and swelling around eyes after smoking weeds signify an allergic reaction?\n\nHi, on Tuesday night I smoked some weed and went to bed about 2 hours later. In the morning (yesterday) I woke up with puffy eyes, puffy forehead and swelling around my eyes. Today I woke up and it is still there. Did I have an allergic reaction? What can I do?",
    "doctor_response": "Hi, It is my pleasure to help you. Your medical history following smoking of the weed, may be you are allergic to it.We never know to which products we are allergic as you develop the symptoms following smoking of weed it might be reason for this. To confirm your allergic to weed you have to under go skin prick test. Hope you got the answer for the query.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and swelling at the incision site?\n\nHi, may I answer your health queries right now ?  Please type your query here...Hello DoctorI have gone through CABG on 6th Jan 2011 but there is pain on the left side of the stitches and i feel there is slight swelling on the right side of the breast. Do i need to see a cardiologist",
    "doctor_response": "Hello,It could be a localized pus collection near the stitches site resulting in abscess formation. A chest x-ray PA view could be helpful before visit a doctor for an opinion. I would advise you to take the opinion of a general surgeon as he would examine both the stitches site and right breast swelling and advice tests and medications accordingly.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Piyush K",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does intake of Levocetirizine result in brief spells of breathlessness?\n\nhello, i.am suffering from.allergy and taking antiallergics like levocetrizine from last one year. from about 6months i m feeling shortness of breath and difficulty in breathning wich remains for 5mins and gt over by itself. Are these Anti allergic safe ? should i continue them or M i facing these breathning prblms cz of these antiallergics, please guide",
    "doctor_response": "No long term side effects have been noted for levocetirizine. I have given many of my patients for years without any specific complaint. Pls consult internal medicine doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for a complication in the stomach\n\nHello. We just found out that my 5 month old son has relux and also his ligament of treitz is lower than it should be causing food to stay in his stomach much longer that it should. We are going to be referred to a surgeon soon. They talked about doing a surgery where they wrap his stomach around the esophegus to help with the reflux, but I m not sure what they are thinking they are going to do about the ligament of treitz. I was wondering if you could give me a general idea of what to expect of how they will correct this surgically and is it also somehthing they would do laproscopically?",
    "doctor_response": "Hello! Welcome to HealthcareMagic! Your child has a problem and it needs surgery, trust your doctor and feel free to ask him anything you want and need and are concerned about. Your surgeon should be the one to explain the diagnosis. No other person shall be able to tell you the diagnosis you are giving unless one has examined the baby. Take care Regards, Dr. Ratna Mulay, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the solution for discomfort in right kidney after taking chemotherapy for cervical cancer?\n\ncurious, I ve had chemo/radiation for cervical cancer and the chemo was stopped because my creatine level was leveled and I was dehydrated with that said I m now experiencing some discomforted in my back where my right kidney is ... I m really tired but I don t have any of the other symptoms that point to chronic kidney disease. I do have an upcoming appointment with a neurphogoist but not until Feb 19th",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have Cancer of the cervix and was under treatment of Radiotherapy and chemotherapy.The elevated creatinine level indicate obstructive uropathy on Rt side mostly due to infiltration oft of ureteric orifice by cancer cervix or due to radiation Cystitis.Please consult qualified Nephrologist and urologist and get following basic test done to confirm the cause of elevated Creatinine levels.1) Routine urine test and culture 2) Ultrasound scanning of abdomen 3) Endoscopic examination of bladder (Cystoscopy).Further treatment will depend upon the results of these test .You may need to put D.J stent in your Rt renal unit to decompress the same.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can painful dry feet with cracks be treated?\n\nMy feet are very dry and have cracks in a few areas on the side and on heel now I have a painful red line coming from the cracks across the top of my feet it s also very painful to stand on my feet as soon as I go to take a step the pressure in my feet and the pain is astronomical",
    "doctor_response": "Hello,Thanks for writing here.You are suffering from keratoderma.It can be due to dust ,soap allergy etc.At times such keratoderma can be a part of psoriasis.Use soft shoes and cotton socks.You need to apply a good keratolytic like whitfeilds ointment.Apply it at night.Painful red cracks suggest secondary infection.Applying antiboitic cream over it can heal the lesion.White petroleum jelly also helps in healing the lesions and keep feet soft.Hope this will help you.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does extreme bleeding have anything to do with kidney stones?\n\nHello my niece has been diagnosed with kidney stones whilst on holiday in Spain but was also bleeding heavily with an in between period and has severe back pain. Does extreme bleeding have anything to do with kidney stones. And also been given nolitol and Masapan to take . She is extremely sleepy during the day. Could it be the tablet. Also has urilit to take Thank you.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Your niece has kidney stone. But id she has vaginal bleeding in between periods then it is not related to kidney stone. There is some disease of endometrium. She should go for gynecological examination and ultrasound study. It will help you to fine the cause. If needed go for D & C or endometrial biopsy it will give you exact diagnosis. Then she should take treatment accordingly. If she has bleeding in urine then it is related to kidney stone and it needs treatment.Consult your doctor and take treatment accordingly.Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer.Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for strep throat with itchy body rashes and bumps\n\nmy five year old has been having chills for two days now, I took her to the ER and the doctor says that it is a virous. She has just gotten over the scarlett/strep throat with the bad rash over her body. Now she is complaining about the itching sensation and has some of the same looking bumps all over her back.",
    "doctor_response": "Hi...by what you say I feel that it could be an evolving scarlet fever. I suggest you get back to the emergency room or your kid's pediatrician regarding this.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "When can the HCG test be taken after an IUI?\n\nI'M 33Yrs old.i have done my 2nd iui on 8th oct &waiting for my pregnancy result.I'd like to know when can i take hcg test?. Atpresent i'm having pedal edema bilaterally with elevated body temperature.i was  given duphaston till yesterday and adviced to take pioglit 30.",
    "doctor_response": "Hi, you can do your Bhcg test day 14-15 of IUI . pedal oedema can be due to hormonal medicine that you are taking. All the best, Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain around the ribs be treated?\n\nI injured the right side of my lower rib cage pulling a pull start leaf blower about 2 weeks ago, I had some soreness and pain and it got better. When rolling over in bed I felt a crack and it hurt and then got better. Today out working in the yard I felt a crack again and now it hurts to walk and bend over also to get up out of a chair, I feel some heat and an aching in that area. Are there organs in that area that are in danger of being harmed? If my rib is out of place is there a way to get it back aligned?",
    "doctor_response": "hihope this msg finds u in good health. i have gone through your complaints and under stand your concern. ribs fracture can heal spontaneously with rest and rib belt. if treated adequately. u should get an xray done to find out whats wrong.. take analgesics and anti inflammatory tablets. organs mostly dont get damaged unless its a severe traumanothing to worry about. hope your question has been answered. if u have any follow up queries, feel free to consult me anytime. thanks Take care god bless",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long will petogen stay in the body as protection from pregnancy?\n\nHi I have been on petogen for a year now after giving birth in march 2013. My last injection was scheduled for 07-05-2014 and i did not go. I have then had unprotected sex. Could i be pregnant? or is the contraceptive still in my system? How long will it stay in my system before i can fall preggies again? Best regards Lee",
    "doctor_response": "Hi Lee, How are you doing ?Petogen is a depot preparation , which if taken for duration as 1 yr may stay for 4-6 mths after stopping. But a better way to know if the hormone levels are normal is , if you get periods the hormones are normal. But this is not definitive,  you can get pregnant even before you have periods .But after 3-4 mths of last injection the chances of pregnancy graduallu increases & by 6 mths the hormone is mostly gone.Hope I have clarified your queries, do write back if any more queriesAll the bestDr.Balakrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for erectile dysfunction and premature ejaculation\n\nI am suffering from side effects of over masturbation from past 3 to 4 years but I did not pay attention to all this and continued masturbation and now I have stop all thing but i am facing problem  like erectile dysfunction, premature ejaculation ,  Seminal leakage , low sex drive etc .. and I am very much worried about my sexual life , please sir give solution to solve my problem permanently and to leave a happy life .Regards ............",
    "doctor_response": "Hello,Masturbation is usually considered a safe practice. But as per few study or can lead anxiety and so premature ejaculation like problems. Try to do yoga, meditation for peace. Avoid watching excess porn videos and magazine for recovery from masturbation. Make short-term and long-term goals. If your erectile dysfunction problem continues then I will guide further investigation like serum cholesterol, blood pressure measurement, serum random blood sugar, etc.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tell me the best exercise for low back pain\n\nCan any one tellme the best excersise?im suffering from low- back pain since 2 years..? Can any one tellme the best excersise?im suffering from low-back pain since 2 years..?",
    "doctor_response": "Am not sure what this exercise is called by it strengthenes your lower back.. Lie flat on your stomach and put your hands under your chin.. Lift you head up along with your hands that is.. for a few seconds then relax.. and repeat....  For a more advanced exercise, try lifting your legs together with your head.... Maybe you should consult a doctor just to be sure its nothing serious..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for itchy scrotum\n\nWhat is the treatment of itchy scrotum ?it turn to a red skin and dry..it pell off when the red skin death.. it felt so bad that its burnt and very painful.. My Question are: 1) what cause these? 2) how can it be cure? 3) what medicine should i take... please help.......tnks",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have Jack Itch.Please take anti fungal medicines like Fluconozole twice daily along with topical anti fungal cream like Meconazole for local application.Ensure to wash your inner wares in boiling hot water mixed with antiseptic lotion like Dettol.Ensure to observe proper personal hygiene by cleaning your genitals with warm water twice daily.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes throbbing pain in lower middle part of the stomach?\n\nI have a throbbing pain in my middle lower Part of my stomach . it started yesterday morning and has not let up? I feel as if something is pushing on my bladder . I feel I have to pea but not enough to go. I m a 19 year old female. My down stairs area doesn t burn or itch it just feels uncomfortable.. I have a white milky discharge also. The pain hasn t stopped it hurts to walk at some points also .",
    "doctor_response": "Hi, It may be due to minor stones or calculi in your urinary tract which can cause radiating pain to the stomach. Other causes have to be ruled out also. You can consult a general surgeon and get an ultrasound scan to rule out conditions like stones or bowel related problems. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the groin area?\n\nI have pain in my groins particular my left one and I am a hiker and I had a fall today and it s much worse , I also find a pain in each of my bum muscles sometimes after walking have you any idea why . I am normally a very healthy person who eats healthily 5.6 and weigh 9 and a half stone",
    "doctor_response": "The most common cause of groin pain is muscle, tendon or ligament strain. Groin pain may occur immediately after an injury, or pain may come on gradually over a period of weeks or even months. Groin pain may be worsened by continued use of the injured area.Less commonly, a bone injury or fracture, a hernia, or even kidney stones may cause groin pain. Although testicle pain and groin pain are different, a testicle condition can sometimes cause pain that spreads to the groin area.In your case I suggest to visit a doctor for proer examination and treatment. Here doctor may ask you for some test like x ray or scan as per need. I suggest to go ahead for it and later plan treatment as per the diagnosis.If there is a minor to moderate issue at soft tissue level then use of cold pack along with physiotherapy and rest will help to get cure.In case if anything major issue like hernia or ligamental injury etc. As per the diagnosis surgical correction or repair also be needed.And after it again physiotherapy rehabilitation will help you.Here since i have not done physical examination. As per symptoms I have given you some guideline and I am sure it will be helpful if you follow it properly.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart pain with stress?\n\nI am a chain smoker for the last 35 years with thin physique. For the last few months I feel a pain in my heart occasionally. However this pain gets relieved when I used to have good diet and sometimes with the intake of milk. About a month back, I left smoking for a fortnight but I observed that the said pain occurred as usual. Due to work and domestic stress, I used to have sex almost every day. Please guide me.",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern.I will try to explain you something and give you my opinion.You should know that heart pains have some characteristics.They usaly are retro-sternal pains like squizzing , tightness or heaviness. They may irradiate to both arms, neck and jaw. They last from 5 to 20 minutes. We suspect heart disease if we are in front of a patient whith risc factors like age over 45, hypertension, diabetes, smoker and whith hereditary history of cardiac disease.Chest pains might have different causes like muscular, sceletic, neurotic or gastrointestinal.So, if you explain pain that relives after consumption of milk this makes us thing of a gastric problem.So, if I was the treating doctor I will recommend some examination like an electrocardiogram, a cardiac echo , a strees test, a thorax rx and a gastrohepatologyst consulting.After all this we can better judge what we are dealling whith or if its just stress or neurotic pain that soon will disappear.Hope I was helpfull..Best regards, Dr.Ervina.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach pain and loose motions in a child\n\nMy Baby is complaining stomach pain since few days. The pain comes at irregular times and lasts for few minutes (5 to 20 mins). She suffered indigestion and having loose motions with gum. We are administering Metrozyl (Spelling not sure) syrup. Is it fine, or should we use any other medicine.",
    "doctor_response": "HiThanks for writing to health care magic.Diarrhea is usually viral and may last for 5 days.Give ors and zinc.Metrogyl is not required unless there is bloodEnsure minimum 6 times urine output in a day.Try avoiding dairy products to see if that helps.Wishing your child good healthRegardsDr Arun",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes enlarged and hard vein below the head of penis?\n\nafter sex 4 days ago, a vein just below the head of my penis was enlarged and hard. it is now nearly back to normal. it was not painful. i did not fell any change before or during sex. could you please tell me if this is something to be concerned about.",
    "doctor_response": "Hi, It is very normal that dorsal vein of the penis becomes enlarged and hard during erection of penis and may remain enlarged for few hours after sex. So, there is no need to worry. Hope I have answered your query. Let me know if I can assist you further. Take care. Regards, Dr Ilyas Patel, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be concerned about the oozing out blister due to spider bite?\n\nMy husband was pulling weeds under our deck and thinks he got a spider bite yesterday? on his finger, he woke up this morning with his finger oozing and looking like a blister and is now turning  a purplish color.  Is this serious?  He does keep draining his finger",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain due to spider bite there is allergic reaction along with infection at the site of spider bite leading to ABSCESS formation due to which there is discharge and blister like appearance..Your husband should take a Broad spectrum antibiotic like Augmentin  antihistamines like Allegra.For pain you can take anti inflammatory  painkiller Ibuprofen (Advil or Motrin).Apply TRIPLE ANTIBIOTIC Ointment over the lesion after cleaning it using betadine solution and draining out pus..It will start healing in three to four days but if there is no healing or the symptoms worsen consult a physician..Hope this information helps..Thanks and regards..Dr.Honey Nandwani Arora..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes soreness and pain in the groin area?\n\nHello about a week ago i felt pain and soreness in the crease-groin area with a little knot that is very sensitive to touch. Now my menstral cycle has been goin on for 13 days now and counting. I hav had a paragaurd iud for 5 yrs now with no problems. Starting to worry now can u help???",
    "doctor_response": "Hello,Thank you for contacting me at \"Ask a Doctor\". I will try to answer your question to the best of my ability.This could be a simple groin strain or possibly a mild tendinitis in the area.I would continue to treat this conservatively for the moment.  Simple stretching and applications of ice will help.  Take ibuprofen if you need.  pain relief.  If the symptoms are worsening over the next few days then I would see your primary care physician for a checkup.I hope this information is useful for you. Please do not hesitate to message us back if you have any further questions.Best wishes,Adrian Rawlinson MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Unable to conceive for 3 years, undergone hysteroscopy, laproscopy. Regular periods. Treatment?\n\nhi, i am of age 33, married since 3 years but no child.we went to fertility specialist and with medicines, I had conceived in 2011 dec but it was biochemical pregnancy and got terminated in march. after that I had continuous consultation and then had hysteroscopy and laprosopy in Dec 2012. From that time I am still unable to conceive. My periods are regular of 28 days cycle. Please suggest what should I do now",
    "doctor_response": "Welcome to HCM.Go for usg ovulation study and hormonal essay.Plan your pregnancy according to ovulation.You can also go for IUI with your husband's semen if it is normal or go with donor's semen if it is abnormal.Keep in touch with your doctor for further recent management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have antiphospholipid and chronic renal failure, epilepsy hypertension, swelling in tongue. What is it?\n\nhi have antiphospholipid ,and chronic renal failure epilepsy hypertension had tia so put on warfrain , doctor took me of my medication to check if epilepsy still there after 9 year`s seizure free , tongue was swollen gone down but still aware it is not gone back to normal , that was a year ago  nobody will listen when i tell them as when i speak am able to control it , this syndrome is very complicated in all area`s  , was sent to ear nose and throat doctor he said was fine ,   cf.... thank u",
    "doctor_response": "Hi,Thank you for posting your query.It is unfortunate that you have multiple medical problems and are on multiple medications.The most likely cause of tongue swelling is a medication side effect.If you can send a picture of swollen tongue, as well as the complete list of medications you are on, we can suggest a diagnosis and treatment.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in chest and ribs?\n\nHi,i ve been having chest,right and left kidney pain,chest pain,throwing up,and now I have two new symptoms a tingley feeling below my right rib cage and a weird hard pulse thumping feeling in my right chest area.. I ve been to the er 7 times last month and all they say is it s from a uti... I don t believe that.. This is to much pain and symptoms for it to be a uti.. Please help me,i don t wanna due,in scared. Thanks.",
    "doctor_response": "Hi, there are many causes for pain in the chest and ribs, and most of these causes is not related to heart disease. The most common cause of chest pain is the pain arising from the chest wall (muscle, bone, tendon, skin) and they do not usually cause death. However, we should always research the most common causes, but that can bring risk of death, such as a heart attack, pulmonary embolism, dissecting aortic aneurysm ...The heart attack has sudden onset, intense chest pain like a bunning pain, accompanied by nausea, vomiting, profuse sweating... Theese makes everyone go the emergency room immediately. The chest pain pulmonary embolism also has sudden onset, is accompanied by severe breathlessness, faintness and impending death, so the discomfort makes patients immediately seek the emergency room. The dissecting aortic aneurysm is a very serious disease and the chest pain is described as the worst pain a human can feel, looking like a spear into the chest, causing the patients also seek the emergency room.For all that, the description of pain you reported does not appear to have the characteristics of these serious diseases. However, as the pain is being repetitive, it is important to look for a good doctor to rule out these serious diseases and arrange treatment.Hope I have answered your question. If you have any further questions I will be happy to help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Fosamax cause dental problems?\n\nMy name is Patt.  I'm 71 years old. I have osteoporosis, high blood pressure, diabetes (under control w/meds), 5'2\". Weigh 240 lbs. have IBS. Take Zoloft, atenolol, norvasc, 2400 mg. w/vit.D, calcium daily. Also take nexium, probiotics, zocor, glumetza (metformin that does not dissolve in stomach), Colestipol for IBS, and guifenisen for sinus problems. I know, I take a lot of meds. I have a great doctor and she has been my doctor for 30 years. My current problem: I am having a lot of dental work done. I am losing teeth.  Always have had a lot of dental work done over the years.  I have had two teeth break off and one crack in the last six months so now I need to have those pulled or cut out.  My dentist has just told me that Fosamax causing this and it's been a problem with dentists for awhile and some dentists are hesitant to work on women taking Fosamax. She is sending me to an oral surgeon for the extractions. I called my doctor and she sent word to me that she disagrees and I should keep taking the Fosamax. I have been taking Fosamax for over 10 years. I don't know what to do. I have 12 teeth left in my head, right now I have Vertigo from a bad inner ear infection. Could you give any advice for me?  I have a feeling that the damage is done and I should continue taking the  Fosamax. What do you think. Any information you could offer would help.",
    "doctor_response": "Hi..Thanks for the query..Yes, it is true that Fosamax can aggravate dental problems and other side effects..Also if you are on bisphosphonates like Fosamax that has active ingredient Alendronate  and if you go for extraction of teeth it can cause serious complications like Bony necrosis..So my suggestion is to stop Fosamax for at least 3 months before you proceed for dental extraction..Also make a clear note to the Oral Surgeon about the medication so that you do not get any complications due to medical negligence.Hope this helps..Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant coughing, nose bleeding and swollen eye?\n\nMy baby just turn one, and he recently got sick 2 days ago. He was coughing for the first day and today he woke up and had a swollen eye, & all of a sudden he had a nose bleed, his breathing has been hard and he is wheezing. Please let me know what s going on ,?",
    "doctor_response": "HI...I feel everything is fitting into a viral illness with this picture of multisystemic involvement. Bleeding nose could be due to the force of sneezing or rupture of small blood vessels under mucous membrane of the nose. Other possibility is that of a atypical infection due to Chlamydia or Mycoplasma. I suggest you approach your pediatrician with this tips and get him evaluated.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a hard knot inside the bruise on arm\n\nhello i have a bruise un my upper arm. it looks like a bruis that i get after giving blood but i havent given blood and it has like a little spot on the insid of the bruise and now there is like a little hard ball inside of it. like you can only feel it when you push on the bruis a little",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Possible injury has led to blood vessel damage.2. You are suffering from superficial thrombophlebitis, which is similar to after donation of blood for tests. Thrombus has formed inside, which feels like hard knot.3. Not to worry, it will dissolve on its own. The thrombus is too small, to cause any damage.4. Low molecular heparin cream application over the bruise could be helpful. No other treatment necessary. It will dissolve within a week. Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have had the IUD for 2 years. I have pain in the vagina, blood tinged urine and burning sensation while urinating. Please help.\n\nHi, I have had the IUD for 2 years now and my period stopped a year ago completely. I awoke from my sleep last night due to pain in the vagina. When I went to the bathroom, I urinated blood, a lot of it. I also had burning sensation while urinating. Why is this happening to me?",
    "doctor_response": "Hi. Revert back with the reports to a gynaecologist\u00a0online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest permanent treatment for hair loss\n\nHello, I am a 36 years old female. I am losing my hair for last many years. The front of the head is scantily covered now. I ve had allopathic (iron, vitamins, minoxidil solution etc) and Homeopathy (Dr Batras) treatments off and on. Only once when I was prescribed salt Ferrous fumarate by a Doctor in London, I saw some improvement. I understand that my Serrum Ferritin level goes low every now and then but when I start with Multi vitamins, I feel bloated and put on weight. The problem of hair fall increases in rainy season. I would like to know if there is a permanent solution to my problem or I ll have to go for Hair Transplat. Pl advise. Thank you.",
    "doctor_response": "Hello, You seem to have androgenetic alopecia which is mainly characterized by thinning from the top and mid of the scalp. In addition, low serum ferritin levels seem to exaggerate your hair loss. I suggest you consume food rich in iron like green vegetables, meat etc. In addition, I suggest you use a Minoxidil solution and take oral Finasteride for androgenetic alopecia. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Kakkar S., Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the black oval spot under the right foot of a baby?\n\nMy 22 months girl has a black oval spot under her right foot. Just notice it 2 weeks ago. I am sure It is not a mole. I assumed it was a dry blood under skin from a pinch or something like that. After 2 weeks it haven t change at all, I am worry now. Can this be someting else?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. l got a sore hard lump after the removal of wisdom tooth. Is it normal?\n\nHello doctor,I just got one side of my wisdom teeth removed both upper and lower six days ago, and I have another one scheduled after two days for the left side. The upper is 100 % fine, which they pulled. The lower they pulled the tooth without removing the root because it was too close to the nerve. I do have some stitching in this area currently on the lower cheek. Noticed a hard lump about 1 inch between my lower jawline and cheek area. Is this normal because of swelling or something else. Currently taking Amoxicillin 500 mg and Ibuprofen 600 mg. Please let me know what this hard lump is, also generally on the lower side where this lump is, remains sore.",
    "doctor_response": "Hello. The lump is mostly a hard swelling which forms postsurgical removal of the wisdom tooth or maybe even by swollen lymph nodes due to infection. It takes a week or two for the swelling to subside. Sometimes, if the root is still inside, the infection may be remaining there causing swelling. Get an X-ray done to find out the exact problem and stronger antibiotics like Augmentin (Amoxicillin and Clavulanic acid) along with a painkiller for a week. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Ct scan done, Cysts in both kidneys, Taking metformin 500 mg. Any advise?\n\nyes please this afternopon I had a ct scan with contrast after the scan they clearly told me to refrain from taking my metformin 500mg for the next two days and come back fri. for lab work on creatinine? levels. well I place my daily pills in a container and I blithely took all without removing the metformin now I am scared because I have cysts in both kidneys",
    "doctor_response": "HelloThanks for the queryOne tablet of metformin 500 mg wont do much harm, dont get panicky about it. But please inform your doctor that you have taken the metformin and be careful not to take metformin the next time. I hope I was of helpRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for onset of pain in left leg and thigh\n\nI am a 56 year old female. 5 4 and 118 lbs. I have quick onset of pain in left leg from mid-thigh to mid-calf. Seems to hurt more often when lying down than when walking. Only other symptom is a place on my right side near my left should (about the size of my hand) that really hurts sometimes but not continually. Seems to be worse when I sit a computer for a long while or when I stand or sit in one position too long. Any advice? Thank you so much. Jen",
    "doctor_response": "hi,thank-you for providing the brief history of you.As per your symptoms it looks more of a disc degenerative disease in the spine - cervical and lumbar. By which the symptoms are arising.Getting a thorough clinical examination and MRI of cervical and lumbar spine will help understand the extent of nerve root compression.Treatment Physical therapy like Therapeutic ultrasound therapy, TENS therapy and exercises has provided 99% success rate in the health recovery path of patients with Degenerative Disease of disc in my clinical practice.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause sudden onset of joint pain?\n\nfeelin low weak from inside an my joints are paining too this happend all of a sudden from yeaterday after i got fron my afternoon nap what could be the reason behind that an didnt not fell power in body today mroning after i got from my sleep so could not go to gym for weight traning session .... pls help",
    "doctor_response": "Hello, I think you overused or overstretched your joints and muscles after the nap. Or perhaps you had a bad position during the nap. Should take magnesium supplement together with applying analgesic cream locally. If the symptoms will persist should see your doctor. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Albana Sejdini, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes episodes of hard heartbeats with painless explosion on solar plexus?\n\nIt starts with a painless explosion (for lack of a better word) in my solar plexus, with a hot rush going up the back of my neck and head to my forehead. I sweat, get dizzy and don t think straight. A few times I have passed out, but only for a few seconds. Then I get up feeling as if nothing happened. More often (and this could be panic from the sensation) I feel like I cannot breath, though I know I can, and my heart pounds so hard I can see my shirt moving with the beat. If I lay down it feels like my whole body is pulsating. There is NO pain involved. I have been to a heart specialist a few times and apparently my heart is fine. These bouts can last a few minutes to a few hours. What do you make of this?",
    "doctor_response": "U must be having a type of arrhythmia - SVT.Go to the hospital during the period of this palpitation and get a ECG done. Get back after the ECG report.Dr Sameer Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this urine culture report indicate?\n\nHi my wife is 23 weeks pregnant and she is having UTI . since 4 months got reports also it says organisms isolated is Klebsiella species Colony count is >100000 CFU/ML Significant growth,Sensitivity pattern Netilmycin sensitit(24mm)CIP,OF,PTI,Gen,AK,IPM,LM,---SensitiveAMC AMP, CTX, CAZ,CTR,CPZ------RESISTANCE PLEASE advice HOW TO CURE IT.",
    "doctor_response": "Hi i do care for your concern. your history suggest of urinary tract infection that needs intervention. since she is in six months of gestation drugs such as cephalosporins can be given. However it is advisable to consult your obstetrician and know about different treatment option and adhere to one, regular follow up is a must. using antiseptic soap and clean undergarments will add to the help. Hope i have answered your question, If you have more feel free to ask. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hemoglobin level to be high?\n\nMy 3 year old recently had a well child visit with his pediatrician, in which his hemoglobin level was found to be 15 or slightly higher.  His doctor said this was high, but could be due to diet.  What is the normal range, and what could cause it to be high?",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. Your hemoglobin level is not high.  Its normal. Normal range is 13.0 to 16.0 gm. In children no any serious causes are their for high hemoglobin.  Even dehydration can leads to false high hemoglobin.  So don't worry about that.  Just be relaxed. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to treat my ADHD?\n\nHi doctor, I have ADHD. My common symptoms are disturbance of selective attention of auditory and visual input, disorders of visual perception, impaired organization and categorization of verbal material, disturbance of language comprehension, impaired long-term memory, altered personality and affective behavior and handwriting problems. Already, I have tried medicines like, Focalin, Adderall, Strattera, Quillivant, Ritalin, Topiramate, Metadate, Concerta, Vyvanse, Dexedrine and antidepressants like Zoloft, Lamictal and Wellbutrin. They all give me the same effect and worst my symptoms. \u00a0My brain SPECT indicates left caudate and right temporal hypoperfusion. These findings correlate with the reported symptoms of decreased attention and concentration when the temporal lobe is involved as in focal hypoperfusion. An interictal epileptogenic focus or learning disabilities may be present complicating the ADHD. I have no hope for this. Please help",
    "doctor_response": "Hi. I understand your symptoms and the clinical case scenario. Most of the medicines, which work for ADHD (attention deficit hyperactivity disorder), are not working well for you. Actually, they are worsening you. This is an observation which supports the possibility that we are not dealing with an ADHD alone, but also another co-existing disease, most likely medial temporal lobe subclinical seizures. So, you do not have any classical signs of temporal lobe epilepsy, but you do have T signs of temporal dysfunction. Revert back with the reports to a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for penile lymphocele on shaft of penis that has left darkish brown color on popping?\n\nHi I have a penile lymphocele on the shaft of my penis and from early morning scratching I accidentally popped it like a blister so I cleaned up the blood and puss that came out and let it be, now instead of a yellowy texture it s a darkish brown/black color, should I just let it be?",
    "doctor_response": "Hello,,Penis lymphocele are not dangerous, they are not infectious and they usually disappear on their own. As you noticed today morning and the bllod and pus as come out of this.If they appear after having sex or after masturbation you should drain them yourself by applying pressure on the blister. You have to avoid sex or masturbation for a couple of weeks to make them go away permanently.If they still continue to be a problem for you, you should address this matter to your your dermatologist.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Oxidon plus and melanocyl for vitiligo on palms and soles. Can continue homeopathy treatment parallely?\n\nMy son diagnoised with vitiligo on palms and soles ,is on narrow band uv treatment for the same in St. John's  hospital he is diagnoised by dr shubha  she has prescribed tab oxidon plus 1in the morning he is responding well to the treatment he is also given ointments like melanocyl in the morning and topgraf at night he is also on homeopathy parallely kindly advice on the same",
    "doctor_response": "yes you can take Ayurveda or homeopathy with your current medicine. just you can maintain some gap to take both medicine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could lower back pain be due to an infection?\n\nDoes your lower back hurt with a bladder or kidney infection?   I went to the chiropractor yesterday because my back hurt like it did before and she used an electric stimulator.   It worked the last time but not this time.   The chiro is closed today.",
    "doctor_response": "Yea ur lower back pain might be due to pelvic infection. Instead of treating the symptoms first get investigation done to know the cause. If it's an Infection u might be asked to use a course of antibiotics. Get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there itchy white spot on my penis head with a rough skin after erection?\n\nHi doctor, I have these itchy white spot on my penis head and also a rough skin after erected. The white spot will be better after applying Clotrimazole ointment, but I can still see some bumps under the skin.",
    "doctor_response": "Hi. Your concern is balanoposthitis. It is a candidal fungal infection which causes secondary irritation and redness. Start using Lulifin cream (Luliconazole) once daily bedtime for 30 consecutive days. Apply Efficort (Hydrocortisone) 0.127 % cream once daily during daytime until redness subsides, then discard it. Check your fasting and postprandial blood sugar levels. It is not contagious and not harmful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bumps on limbs, red, blisters, itching hurting, amoxicillin, augmentin, allergy\n\nHi. I have little red bumps on my hands and feet that look like little blisters and itch and hurt at the same time. My 7 month old son had them and had an infection and is on ammoxycilin. I think I got what he had and now am on augmenton. He had the same bumps. Could it just be from the virus or do you think it s an allergic reaction to the meds? My son had the bumps before he was on the antibiotic.",
    "doctor_response": "From your description,it seems you are suffering from urticaria which is an allergic condition. Allergy may be to intestinal worms, drugs or to anything else which may not be known all the time. If there is no superadded infection like pus dicharge , antibiotics may not be of much use and infact may be a cause for it. Take an antiallergic like allegra or cetrizine and apply calamine lotion for soothing effect. Also, deworm yourself with albendazole.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I get squint correction at the age of 26?\n\nHi doctor,I have a squint in my right eye and it has moved outwards. I do not have a proper vision in my right. I cannot see clearly through my right eye; even I recognize thing pretty hard. I want to know whether it can be corrected, so that both my eyes work together. I am confused as I am now 26 years old. Is the correction going to be difficult at this age? I am looking up for a second opinion from you. Thank you.",
    "doctor_response": "Hi. I have gone through the pictures of your eyes (attachment removed to protect patient identity). Revert with reports to an eye care ophthalmologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for stable angina ?\n\nMY name is Nasser, teacher, 50 years old, 84 kg wight, 167 cm hight, used to be a heavy smoker amonth ago Family history: nothing worth mentioning except that mother died of brain stroke at age 85. My problem is that one time after climbing stairs from one floor to the next I suddenly felt tight chest and difficulty breathing . Since that moment my life has changed by having what has been diagnosed as stable angina. I undergone catherization procedure and it showed no blocked arteries. My aquestion is : does having the angina with unclogged arteries means that my heart muscle was damaged in the attack I mentioned . Thank you for your time and consideration.",
    "doctor_response": "Hello,Thanks for using Healthcaremagic. i had gone through the data you have posted. kindly tell us what was the ECG showing at the time of your chestpain before undegoing angiogram. as angiogram was normal so  there is possibility of VASOSPASTIC angina  also known as PRINZMETAL angina, where there will be diffuse spasm of coronary arteries which cause decrease flow in blood vessel rather than block in case of atherosclerosis. so in prinzmetal angina Angiogram may show normal arteries. To know whether your heart muscle was damaged or not you may need to undergo tests like 2 Decho ,PET CT heart, dobutamine stress echo which can accurately tell information about damaged myocardium. hope this helps..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes knot on the rib cage with pain?\n\nI have had a knot on my right side at the top of my ribcage for years. This morning when I woke up, the knot and the area around it are sore. No physical activity yesterday that could have caused a muscle injury. The area is warm to the touch but not hot. It dully aches unless touched and then it feels like pain from a bruise. It seems swollen but the swelling is not visible. I had the knot looked at about five years ago and ultrasound doctor said it was nothing. The position is more towards the back versus being close to my breast. I m 30. And my menstrual cycle ended 3 days ago. The knot is mobile and I am able to move it between my fingers. It doesn t seem any larger than it was five years ago. It is hard but not like a bone or marble.",
    "doctor_response": "Hi! thanks for writing to HCM sharing your health problem!In short, swelling means collection, pain means infection/irritation and mobile means benign...Therefore, your lump on the rib cage is not a thing for worries but still it should be cured because of possible complications like infection, severe pain and morbidity.I must recommend a needle biopsy first of all to confirm the nature of the lump and as per my experience, it could be:1. lipoma/neurofibroma like benign skin lesions2. inclusion cyst like sebaceous cyst3. lymph node enlarged due to local infection even tuberculosis etc.4. ectopic breast tissue/tumor like fibroadenoma or fibrocystic diseaseHope you got the answer; please revert back to us if anymore clarification ir required!Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. l got a sore hard lump after the removal of wisdom tooth. Is it normal?\n\nHello doctor,I just got one side of my wisdom teeth removed both upper and lower six days ago, and I have another one scheduled after two days for the left side. The upper is 100 % fine, which they pulled. The lower they pulled the tooth without removing the root because it was too close to the nerve. I do have some stitching in this area currently on the lower cheek. Noticed a hard lump about 1 inch between my lower jawline and cheek area. Is this normal because of swelling or something else. Currently taking Amoxicillin 500 mg and Ibuprofen 600 mg. Please let me know what this hard lump is, also generally on the lower side where this lump is, remains sore.",
    "doctor_response": "Hello. The lump is mostly a hard swelling which forms postsurgical removal of the wisdom tooth or maybe even by swollen lymph nodes due to infection. It takes a week or two for the swelling to subside. Sometimes, if the root is still inside, the infection may be remaining there causing swelling. Get an X-ray done to find out the exact problem and stronger antibiotics like Augmentin (Amoxicillin and Clavulanic acid) along with a painkiller for a week. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain and back pain?\n\nAll night last night I kept waking up to upper abdominal pain. I felt like I needed to burp or get sick. I vomited a few times but haven't since. Nothing seems to make it better or worse. I'll be fine for a little bit then all of a sudden my stomach starts to hurt again. it's causing my back to hurt right behind the abdominal pain. Any idea?",
    "doctor_response": "Hi  ! Good morning. I am Dr Shareef answering your query. If I were your doctor, after a clinical assesment of your abdomen and back along with a general physical examination, I would advise you for some routine blood tests like a cbc,blood sugar,serum amylase and lipase, an LFT, blood urea, serum creatinine, an ECG and some radiological investigation like an ultrasound of whole abdomen, X ray chest and abdomen in upright posture, followed by a CT scan if need be. In the mean while, I would relieve your pain with some anti spasmodic and a proton pump inhibitor drug and advise you to abstain completely from alcohol and smoking in case you do. Further management would depend on the result of clinical assessement and the investigation reports.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain between legs and pain\n\nI have pain in the entire legs between knee and ankle. I also have osteoarthritis of the knees. What are the possibilities for pain only between knee and ankle. No pain whatsoever when sitting or lying only with standing and walking. After walking 20+ steps, the pain lessens.",
    "doctor_response": "Thanks for giving reference ...as per your history u have OA ....for pain between knee and ankle u should apply crape bandage for support. ..In my opinion pain can be releved with applications of local ointment like diclofenic and tab diclofenic 50 mg sos. ..If it still persist u sh visit a orthopedic surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bleeding on pulling back foreskin\n\nHi, a few days ago, i was having sex with my girlfriend. During foreplay, when she pulled my foreskin back, she did it a bit too rough and broke my frenulum. It started bleeding, and eventually the bleeding stopped. I tried washing the area but it there was a sharp pain when i tried to wash it. However, the pain got a lot better today. I also noticed that there was something that might ve been part of my frenulum still on the head of my penis, and I think there are a lot of nerves there since it is the same pain feeling when i Touch it. Is everything ok? Do i need to get circumcised? And will my frenulum grow back?",
    "doctor_response": "Hi,it seems that you got your frenulum injured and bled.Due to rough pulling of fore skin gave this problem.If foreskin completely pushed back on glans then you might not require circumcision.At present there might be having some soreness on the part due to infection.Apply antibiotic cream locally for few days.Frenulum will be alright after infection subsides.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes inflammation around the dog bite site?\n\nSir, I was bitten by a dog in July of 2008.I took injection of tetanus 26 or 27 hrs latter then i was injected with anti rabis about 27 days latter but i always feel inflation around bitten area.Sir, am i needed further treatment? please suggest me sir i live in tension.",
    "doctor_response": "Hi,I had gone through your query and understand your concern.Please do not worry.You were treated with proper medications earlier.The cause of feeling inflation around the bitten area may be due to fibrosis and scarring during wound healing.It will not cause any health problems and you do not need any further treatment for this.If you find signs of inflammation like redness,swelling,raised local temperature,pain etc,then please contact with your local doctor because it needs physicians attention to confirm the diagnosis and for proper management.Hope this relieves your tension.If you have further queries,please ask us any time.Wish you peaceful life.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a 73 Value of (SGPT) ALT considered dangerous?My ((SGPT) is 81 it seems to keep raising. I'm going to pain center for 2 neck surgeries and given med's every time I turn around. I already have a fatty liver. Last spring I quit all mets and valves went down to normal. However, the pain forced me to begin taking med's again. My kidneys and my liver valves continued to grow...I don't know who do believe.",
    "doctor_response": "hi,Usually ALT is elevated whenever there is some amount of hepatocytes damage,there are lot of conditions like hepatitis B ,C and even fatty liver can cause AST and ALT elevation,initially you can consider for avoiding fatty food and regular physical activity that will help you in normalizing the enzymes .But you can repeat the AST and ALT after 3 months still there is elevation or no change then we need to work up thoroughly for the same ,At that time you can consult a gastroenterologist for further screeningHope this information help you Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for brown crusty skin infections\n\nHi, may I answer your health queries right now ?  Please type your query here... I have had problems with my skin. I have had cream for bacteria infection, staff infection and exema or psoriasis. Brownish crusty stuff comes out of some of my pores. There is a spot on my chin that ajust fills with this stuff. I don't know what else to do. I havn't had skin problems since I was young. I'm 63.",
    "doctor_response": "hi sir, welcome to HCG, i understand ur problem,betamethasone + salicylic acid ointment apply this everyday, use texifen tab once a day for 21 days.. hope u understand my answer, thank u",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is my 3 month's old bowel movement normal?\n\nMy three month old baby, who is solely breast feed did not have bowel movement for seven days. when she did have one it was more dark yellow in nature, and the consistancy of soft iced cream.  It was also very fowl smelling.I know that her movements have been more watery and light yellow before with a smell of i would say buttered popcorn. Is this normal to have this king of movement with the consistancy and smell.",
    "doctor_response": "He dear,  I understand your concernSuch stool and smell are signs of dysbiosis.I recommend :-stool culture and sensitivity to antibiotics;- Econorm 1/2 sachet twice a day for 5 days,then babylac-probiotics for 1 month.-Dufalac 5 ml can be used for stool stimulation.Hope it helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath along with pressure in head?\n\nI m a 39 year old male who either works out or plays basketball 4 days a week. Over the last 7 days I ve experienced shortness of breath at times but now it s happening more frequently than in the beginning. Now I start to feel head pressure, a little fatigue and I have trouble doing a full yawn. What is wrong with me ?",
    "doctor_response": "Hello dear, thanks for your question on HCM.In my opinion you should consult pulmonologist and get done1. Chest x ray2. PFT (Pulmonary function test)3. ECG.There are few possibilities in your case.1. Lung infection2. Bronchitis3. Cardiac cause.So get done chest x ray to rule out lung infection.PFT is needed to rule out bronchitis.And ECG is needed to rule out cardiac cause.Breathlessness and head pressure is seen in all of the above causes.So first diagnose yourself and then start appropriate treatment.Don't worry, you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treament for a lump on the back\n\nHi, may I answer your health queries right now ?  Please type your query here...  My physical therapist just found a hard, stationary lump on the middle of my back. She and the head therapist don't think it is a cyst, as it doesn't move.  I use a cane with my left hand and assumed it was a tight muscle.  What are the other possibilities?  Thank you.",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.Read and understood your history of your Physiotherapist noticing a hard immobile lump at the back which they do not think is a cyst in the middle of the back. You use cane with your left hand and assume can be a tight muscle. My thoughts:If this would have a been a tight muscle, the Physiotherapist and hte Head would have definitely understood it as a tight muscle. The best way to get a proper diagnosis is:Get a clinical evaluation and examination done by a General Surgeon or an Orthopedic Surgeon.Get further investigations.Ultrasonography with FNAC may help in the initial stages of investigation. MRI will be confirmation.The treatment will automatically depend upon the findings.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Spinal TB, body pain, difficulty in movement. Taking atk4. Is pain due to medication? Healing period?\n\nMy father has just commenced treatment for spinal TB , ATK 4 has been prescribed. He has been suffering from body pain for over a year and now after two MRIs that show degeneration of D7&8 vertibre, they are treating him for spinal TB. The treatment commenced 8 days ago but the body pain has increased significantly, so much so that he is finding it very difficult to move about. My questions :-1.  Is this a reaction to the ATK 4 ?2.  How long for the medication to take effect ?3.  Does he need a second opinion / tests for some other ailment ?He is 75 yrs old",
    "doctor_response": "Hi. Spinal tuberculosis is treated for atleast 1.5-2 years with anti-tuberculous medications. It takes a long time to heal and for the pain to subside. Bed rest is recommended atleast for the initial few months. AKT4 usually does not cause body pains unless there is some side effect like hepatitis and loss of appetite associated with this. By the way, im not really convinced based on the MRI report that he has tuberculosis of the spine, because degeneration is a very normal physiologic phenomenon at his age. I guess you need to take another opinion from a good doctor for the same. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sharp chest pain\n\nI have been having some strange symptoms for the last several months. Today, while sitting at my computer at work, i started getting sharp chest pain like some stabbing me with one needle just below the collar bone on my left side.  At the same time, I felt an intense pressure in my neck area, just below my jaw bone on the same side. My shoulder also is a strange numb sensation, almost like i just got done working out really hard. And my left ear is red and hot to the touch. This is new to happen at the same time. I have been feeling the insense needle prick sensation for a while now.  When I dont feel that, it feels like something is scrapping along the inside of my chest.  I cant tell if it is lungs or the actual bones.  It almost takes my breath away sometimes. I did drink coffee today but have before and not had this issue. I am wondering if this is my heart?  Lungs? like an  infection?  Or ear infection? All of which is new to me. Please help!",
    "doctor_response": "Hello dear , hiWelcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This seems more in relation  with  psychosomatic manifestation of     underlying stress and  anxiety  issue  rather  than  organic  pathology .*  Still once evaluation with your physician for primary work up  in form of     EKG  & lab tests  is  suggested  to  rule  out  any  underlying  issue .Hope this clears your query .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Groin, scrotum and part of penis itchy with burning sensation due to dry skin. How to get relief?\n\nI have a very dry skin on groin,scrotum,part of penis on (base & tip),above anus. Its very itchy and sometimes it gives me a burning sensation. Its been there from past 8 years,it aggravates very rapidly and stays calm at sometimes. I am unable to know what it is,kindly help me",
    "doctor_response": "Hi,It seems that you might be having fungal infection or local dermatitis giving this problem.Consult dermatologist and get examined.After proper diagnosis, plan of treatment can be decided.Meanwhile apply triple acting cream locally.Keep local hygiene proper.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat stiff/sore neck?\n\nHello Dr. Grief, I was in a car accident last Friday. I was stopped and rear ended by a car going ~20mph (not really sure because they were braking). Anyway I was fine the day of the accident, but over the weekend I have developed a really stiff/sore neck and I feel tired and easily fatigued. I m in good shape and haven t tired this easily before.",
    "doctor_response": "Hello, As a first line management you can take analgesics like paracetamol or aceclofenac for pain relief. if symptoms persists better to consult a neurologist and get to rule out conditions like cervical spondylitis. Detailed evaluation is required including MRI scan. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red welts around the buttocks?\n\nmy daughter was at nursery and when she woke up she had a rash which then got worse. took her to doctors who said it might be fungal infection or allergy. we gave her the steroid cream and in the middle of the night she woke up crying covered in a red rash. gave her calpol and piriton. when she woke up it had completely disappeared. had no symptoms during the day but when she woke up this morning she had a few red welts around her bottom. what could this be? thanks",
    "doctor_response": "Dear parent,You have not mentioned age of the child.By your description it seems she has some allergic eruption. Keep in touch with the doctor. Some times it may take a few visits to come to a diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Blood hormones showed low vitamin D level. On estradiol, hydroxy. What do the tests mean?\n\nI just had my blood hormone levels checked and the results came back that I had low vitamin D levels.  The rest of the hormone levels all came back as normal; however, I don't think the results are based on my menstrual cycle.  When I had the blood work done, they didn't even ask the date of my last period.  Now I am really confused as to what the test results really mean.  Last period was 4/15/13 and I'm about a 31-33 day cycle.  Estradiol - 77pg/Ml; Luteinizing Hormone - 6.4 mIU/ML; Progesterone - 3.3 ng/ML; FSH 6.4 - mIU/ML; TSH 1.95 - uIU/mL; Hydroxy, Vitamin D - 20ng/ML.  Can you help me understand the results?  Are the levels really normal?",
    "doctor_response": "Hi friend, Welcome to Health Care Magic 'They' need not ask before doing the blood tests... The doctor interprets the level in relation to the period...and even then they may not ask, if the result is in range. Vitamin D is low / the rest are normal / it can be replenished rather simply - ask your doctor / weekly doses initially , followed by daily maintenance  will suffice Take care Wishing speedy recovery God bless Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure stomach problems?\n\nHello, DoctorI am 23 yr. old n my weight is 53.4 and i am 5 \"10 inch, Since Last three yrs i was suffering from thyroid problem, Food Allergy, and even bad stomach digest problem,  from last yr my thyroid level was under range due to which i was stopped taking medicines when i tested on last may my thyroid level is high i.e 6, now i m taking thyronorm 50mcg, and my body weight decreases over the last few mnths, also suffering from ill stomach and my hair is falling and very fizzy dull conditions ,Please suggest me Q.1 How to cure my stomach problems,?Q2. How to regrowth my hair and well conditions ?Q3. How to gain weight and good  health?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern and from the history given here I could say that for the abdomen pain you can have the symptomatic medicine like Tab Dicylomine and for gaining the weigh eat more calorie contain diet, for the hair you have not mentioned your gender here, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce the side effect of valprin and lamez?\n\nHi Doctor, I am epileptic patient from the age of 12 years. I am 26 now. Have had 11 seizures since then. 4 of them in the last year, because of negligence in taking proper sleep and skipping on medicines frequently. I was on Valprin (200 + 300 mg) & (Lamez 100 + 100 mg) at this time. After a dosage test it was found that Valprin level was very low in my blood stream. Since then I am on a very high dosage of (valprin 500 + 700 mg) and (Lamez 100 + 100mg) Since past months 4 months I have been taking these. And it has wrought severe side-effects: 1. Weight Gain and Water retention in body leading to a bloated look 2. Lack of focus 3. Weakening of eyesight and hearing loss 4. Hair loss 5. Nausea and slight loss in body balance 6. Loss of memory Do I have to take this medicine all life long?? How can I reduce these sideeffects.",
    "doctor_response": "Hello,As you know that Valparin and Lamez have been prescribed to you because you suffer from epilepsy. A doctor decides the dose of a medicine based on your symptoms and that is why the dose of both the medicines have been increased. Let me tell you that every medicine has it's side effects but a doctor always weighs the advantages and disadvantages of the medicine before prescribing it.As you are suffering from Epilepsy which can be life threatening,the medicines are much more important than the side effects. You will have to bear with the bad effects of the medicine as of now but it is also true that the dose may be decreased in future. Do not worry, management of epilepsy is primarily important.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Prabhash Verma, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest Oncovite dosage after treatment with BCG therapy for bladder tumor?\n\nI have been taking 4 oncovite tablets a day as part of Dr Lamm s treatment regimine with bcg after bladder cancer tumeor removal. I finished my 3rd maintenance bcg treatment and am wondering whether I should continue oncovite, cut back from 4/day or what.",
    "doctor_response": "HiOncovite dosage after treatment with BCG therapy for bladder tumor is once daily.It is a multivitamin,Never take more than the recommended dose of a multivitamin. Avoid taking more than one multivitamin product at the same time unless your doctor tells you to. Taking similar vitamin products together can result in a vitamin overdose or serious side effects.Many multivitamin products also contain minerals such as calcium, iron, magnesium, potassium, and zinc. Minerals (especially taken in large doses) can cause side effects such as tooth staining, increased urination, stomach bleeding, uneven heart rate, confusion, and muscle weakness or limp feeling.Take your multivitamin with a full glass of water.The chewable tablet must be chewed or allowed to dissolve in your mouth before swallowing.Measure the liquid form of multivitamins using a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.Liquid multivitamins may sometimes be mixed with water, fruit juice, or infant formula (but not milk or other dairy products).It is important to take multivitamins regularly to get the most benefit.Store this medication at room temperature away from moisture and heat. Keep the liquid medicine from freezing.Store multivitamins in their original container. Storing multivitamins in a glass container can ruin the medication.RegardsDR DE",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for pain behind the knee and calf?\n\nA week ago I began to have pain behind my left knee and calf. It is extremely painful to put pressure on the leg especially going up and down stairs. There is some knee pain in the front as well, but mostly in the back. It is behind the knee and slightly below it. It hurts to get up initially when putting pressure on the knee. It feels better when I stand up and stretch it out a little, but I can t walk for long without it hurting.",
    "doctor_response": "hi,thank you for providing the brief history of you.A thorough musculoskeletal assessment is advised.As by history i can understand that will clinical musculoskeletal assessment of the knee, the soft tissue injury can be determined, also the MRI may need to have an inner look to the soft tissues. Usually due to ligament injury within the knee joint, leads to the symptoms you are facing now. Following the advice of the ortho will help you to get ease of symptoms and later stages physical therapy will be advised to strengthen the muscles. As to avoid the load on the ligaments.Usually, in my clinical practice such symptoms come with meniscal or ACL injury, they respond well to physical therapy and 3-4 weeks of time the optimum results are achieved.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should the Clotrimazole cream be used only externally, on the skin?\n\nHi, I was prescribed with (Clotrimazole Cream With Applicator) but was advised to use the Clotrimazole Cream on the outside (itching area) instead of inserting, is this cream okay to be used on the outside? However i was given (Clotrimazole Tablet With Applicator) to be inserted.",
    "doctor_response": "Hello, Clotrimazole cream should be used for external application in the itchiness area. Instead, the Clotrimazole tablet with applicator should be inserted. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible naturally given these medical conditions?\n\nhello doc,i v been married for 1yr now ,no child.has done Hsg,hormone analysis.hsg showed perifimbiae adhesions,hormone profile showed no inbalance of FSH/LH. my husbands sperm showed reduced motility of approx 60% & he's been on medications for a month now & recently i m having scanty dark menses.   want to know my chances of getting pregnant naturally,then what next we should do.thanks",
    "doctor_response": "Hi, I think if everything is fine, you can try naturally for 6 months more. Be in contact with your husband every 2 to 3 days after your periods stop.  It will increase chances of your pregnancy.  Your husband semen analysis is fine. If you don't get pregnant in 6 months, you can take some medicines like clomiphene for the growth of your follicles and track your follicles growth by repeated ultrasound.  When follicles reach a size more than 17 to 18 mm, take injection for rupturing the follicles.  Be in contact with your husband for 2 to 3 days after your 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 cycles.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for wart on finger\n\nI have a wart on my small finger on my left hand and I keep knocking it. It has become quite big and bleeds profusely when i knock it. Can i treat it whilst it is like this? I have put a non-adhesive dressing on it to protect it. Should i just wait for a couple of days to let the healing process take place before trying treatment? Thank you",
    "doctor_response": "Hi thanks for asking question HCM.It can be treated to home or at clinic by doctor.the various options are available.The concentrated cold air can sprayed over wart and then wart scrapped away called freezing treatement.The patches containing salicylic acid can also be helpful.The duct tape can be applied over wart for several days and then wart soked and removed with rubbing.Your wart is bleeding .so better to go to surgeon for its removal.The liquid nitrogen today is mostly used which is very helpful and take only 5 to 10 minute for removal.It can also be surgically excised.After wart removed take following preventive measures.cover wart with bandage.regular hand washing done.keep hand dry.I hope i have solved your query and it will be helpful to you.thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fever, Pain, right kidney is malrotated, Hospitalised for 9 days. Could it be the kidney that causes this?\n\nMy son is 14 months old.... We recently found out that his right kidney is malrotated and he has 2 tubes coming from it to his bladder... Other side is normal... He's been having fevers that no one can seem to tell us why... He spent 9 days in the hospital and nothing... Could it be his kidney that's causes this? He also wake up in the middle of the night screaming as though something is hurting him( started when the fevers started in feb)",
    "doctor_response": "Yes it could be kidney for that u should undergo some invx like usg KUB.urine r.urine c/s.rule out tb by doing urine for AFB.dont worry things will be ok.show ur case to nearby nephrologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "suggest treatment for neurological complications\n\nHi Sir, My Sister is aged 31, around 5.5 and 51 kg weight and suffering from neurological complications resulting in right half of the body semi-paralysed. She is not able to actively use her right hand nor leg as its shaking profusely without control. She also complains of double vision in her right eye. She was diagonised with AIDS ten years back and doctors predict it to be infections as a result of AIDS, Kindly advice whether there is any treatment to cure the above symptoms",
    "doctor_response": "Hello Thank you for using our website. First of all,your sister may suffer from a secondary infection because of the AIDS. She should take the treatment for AIDS and Vitamin B complex once per day.Vitamin B12 and folic acid may help her. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Dr/Mustafa, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a painful bump on the shoulder along with sore throat indicate?\n\nI had a grape sized bump appear on the top of my shoulder. It was slightly painful, but disappeared in a few days. Then I got another one in my neck right under the back of my jaw, Painful too but starting to get smaller now and I had a fever for a day and sore throat.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You have got lymph node swelling due to sore throat. Lymph nodes are protective organs and prevent spread of infection body. Whenever there is sore throat, infective organisms drain to lymph nodes in upper neck and they swell. You need not to worry. Swelling will decrease once sore throat has subsided. Please start Betadine gargles. Avoid cold foods. Hope this is useful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning sensation in kidneys, joint pain and fatigue?\n\nI have a medium burning sensation in my right kidney area and I have had a body temp of 99 on and off for some time. I have had UTI s before and I do not think I have one now. I also have a non working thyroid and take synthroid. I feel achey and my joints hurt, also fatigue.",
    "doctor_response": "Hi thanks for contacting HCM...Noted you have burning sensation in kidney area....Here do the following investigation...-CRP -urine routine examination-USG abdomen-CBC If urine show pus cells , CBC leukocytosis and high CRP it could be inflammation if kidney...that is pyelonephritis like condition or you can have urinary tract infection....Drink more water...Cranberry juice helpful.Fruit juice taken more....Avoid smoking and alcohol ...Excess spicy food avoided..If needed antibiotic like cefixime needed.Consult physician for further examination and accordingly investigation....Take care.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can constant uncertainty regarding the future and one's purpose in life be managed?\n\nsir ,i m so worried about my future ,my studies and my physical appearance .I always wanted to do something different than others.I wanted to be unique .but i feel like i m simply wasting my time and i can t do anything .i m getting so bored with my life .sometimes i feel depressed,i m getting mad .i m always asks my self that who am i?..i don t know anything.sometimes i wanted to die to become free from this life.I wanted to live alone.but i cant....is i really have any problem???",
    "doctor_response": "hi sirI have gone through your question and understand your concerns.In my opinion, your currently suffering from severe depression which should be treated immediately.All your features like low self esteem, not interested in daily chores, feeling tired, sleep disturbances, hopeless and worthless ideas, bleak and pessimistic views about future and finally most dangerous suicidal ideas and acts are all due to depression only.If I were your treating psychiatist, I would recommend you to start medication immediately. My choice of medication would be an antidepressant like SSRIs or SNRIs or Mirtazepine along with cognitive behavioural therapy.I also recommend you to go for routine thyroid checkup.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pulmonic stenosis with cardiac cath?\n\nHi, may I answer your health queries right now ?  Please type your query here...My daughter was diagnosed with pulmonic stenosis never has had any problems with it she has a cardiac cath when she was 1 she is now 7 but the doctor said from having the cardiac cath it caused leakage but thats the nature of the beast as he put it after a cath I worry all the time about this.",
    "doctor_response": "Dear, first of all, please understand that pulmonary stenosis is basically the tightness of one of the valves on the right side of the heart and in your daughter's case, it seems to be by birth.You have mentioned that she underwent cardiac cath at the age of 1, but you didnot mention that only the cath study was done and what was the gradient at that time or the ballooning was also done.Now she is 7 years old and she never had any symptoms as per you (I presume she never had palpitations, loss of consciousness, chest pain, swelling feet or face, easy fatigability), so I would just do ECHO to look for the gradient across the pulmonary valve and then decide if the cardiac cath is required or not.Now coming to your worry about the leakage in  the valve. A tight valve is rigid and it doesn't close properly sometimes leading to leakage which can sometimes become worrisome and needs surgery. And ballooning of the tight valve can also lead to some leakage in the valve and this ballooning is done only if there is no leakage initially.I hope I have cleared your queries to some extent!!All the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for accidental swallowing of staples\n\nI am a stupid adult who accidentally swallowed some staples.  I had removed some staples from a pair of jeans and put the staples in a paper cup by the bathroom sink.  Later in the evening, when I was getting ready for bed, I quickly took a big sip of water to swallow my BP med and probiotic.  Afterwards poured out the remaining water and saw some of the staples.  Not sure how many I swallowed.",
    "doctor_response": "Hello there,Do not call yourself stupid, everyone has off days in which one tends to have accidents. You require 2 x rays. One of the chest and one of the abdomen. To find out where exactly have the staples lodged themselves. There is a very good chance if the staples are small that you would have passed them out normally in your stool but still to be on the safer side I would recommend you go and get the xrays done. Do not be embarrassed because believe me as doctors we have seen things lot worse than staples in an xray.hope this helps you,Thank you for your query,Dr Arun A",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with chronic auto immune neutropenia. Hard spot on hip, painful to touch, brown liquid when squeezed. Suggestions?\n\nI am a female age 15. I have a hard spot on my right hip that is painful to touch. It is very red it almost looks like a bug bite . I squeezed the spot and brown liquid came out of it. I kept squeezing then blood came out. It still has something in there but it s to painful to squeeze out. What is this? Also I have been diagnosed with chronic auto immune nutrapenia. I get these quite often mostly on my thighs. I have recently gotten one on my neck also but this one is verrrryyyy painful. Please help!!",
    "doctor_response": "hiThanks for your queryi can feel your concernsBecause of your disease i-e autoimmune neutrpenia,you are very much prone to infection.The function of neutrophils is to fight against forgein bacteria .Because of neutropenia your neutrophils cannot protect your body against bacteria.now you have got an abscess on your thigh.it is basically a collection of pus and bacteria.i advise you to take painkiller like brufen or paracetamol after consulting your doctorwishing you good healthregardsDr.AMNA",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can chewing tobacco reduce mouth opening?\n\nHi doctor, I can barely open my mouth up to three\u00a0fingers space. Is it bad\u00a0or normal? I have never noticed this before, only recently I happen to see this.\u00a0I chew tobacco.\u00a0Is that causing it? Is it serious?",
    "doctor_response": "Hi. Your problem is very common amongst regular tobacco chewers. I appreciate you got aware, and it is never too late for a new start. So, live an addiction-free\u00a0life.\u00a0Take care.\u00a0Do not worry. You will be fine. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for difficulty in getting pregnant\n\nHi doctor, I m 30 yr old. I having pcod and get treatment for 3 months i got conceived but it miscarriage in 37 days.after I didn t take any medication and got regular periods after 6 months again i conceived and miscarriage in 40 days. next month i got periods after that I didn t get periods. i went to the doctor , they asked to take several test, In that, I had prolactin of 62 and normal thyroid. I wanna try for pregnancy . what to do?",
    "doctor_response": "Hello,Go for Ayurveda treatment, you will get conceive. There are many medicines which help you. PCOD (Polycystic ovary disease), is normal for unmarried women, and it is not complicated.It never affects pregnancy. If you believe consult any good ayurvedic doctor for better treatment. Or call me 8818805637, or meet me at Srijan Ayurved clinic Bilaspur Chhattisgarh India.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Naveen Kumar Kaushik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can teeth fall asleep similar to foot or hand? Why did my teeth get numb?\n\nDo teeth fall asleep ? Everyone has had a foot or an arm fall asleep at one time or another. I mostly understand the physiology of this dynamic. However, I swear that this has happened to my dentition twice in the last few weeks. On both occasions, it has happened before I fell asleep while I was listening to music in bed while waiting to dose off. I have ruled out bruxism and occlusal trauma. My jawbone was in a relaxed position, slightly open, with my tongue buffering both the mandibular and maxillary dentition. After being focused on the music for 15-30 minutes, I noticed a slight numbness or softness in my teeth (especially the molars and premolars) in all four quandrants. When I gently closed my teeth, jaw I noticed a diminished tactile sensation. It was a milder sensation that a foot falling asleep. There was no accompanying stinging sensation. Also, there was no mobility of any teeth. I finally regained normal feeling, sensation within about 10-15 minutes. I have no known health issues. I am somewhat overweight (190 lbs./5ft.8in.) with normal blood glucose levels. 38-year-old caucasian male.",
    "doctor_response": "Hi, Sometimes there is numbness of teeth if the teeth have been abraded due to bruxism or acidity leading to dissolution of enamel from the tooth and mild chronic irritation to dentinal tubules and nerves. Please notice if you gym more, with heavy weights leading to clenching or are stressed as they are the factors leading to the same. I know you have ruled out bruxism but many a times it is night bruxism which you may not notice while sleeping and as is involuntary you may not even notice during daily activities such as driving, cooking , picking heavy weights etc. I would recommend you to visit a dentist to rule it out and to see clinically if anything else is the cause. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What relieves the tightness of skin at the head of the Penis?\n\ni m 23 yr old, my penis cover is not open fully i fear to open it, at the time of musterbate small skin cover is tightly attached, at my below of penis-forehead thats reason i m virgin till now, i m always thinkking how i can sex with my wife after marrige",
    "doctor_response": "HiWelcome I have gone through your query and you understand your concern.Based on the information it might be phimosis.But to know how severe it is we have to examine it. So I would suggest you to see general surgeon, on examination they can decide whether you need circumcision or not.Do not panic, you sexual life in the future is less likely to be affected.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for persistent chest congestion and cough\n\nA month ago, I has congestion, headache and coughing.  I went to a clinic and they gave an antibiotic, z-pac.  I finished that and felt somewhat better, then had a relapse.  I went to my dr. and got another antibiotic which made me very sick, including nausea, loose stool, bad headache.  I stopped it and called my dr., and got put on an inhalor.  I tried it a few days and did not get better.  Now I still have congestion, a lot of coughing, back pain, chest discomfort and bad heatburn.  What can I do??  What can I have??",
    "doctor_response": "Hi..you have cough ,congestion and headache for past few days and you are not better with antibiotics and inhalers.Possibly its time we need to take up investigations.Take an X-Ray chest (PA View),complete haemogram,erythrocyte sedimentation rate(ESR),Absolute oesinophil count(AEC),sputum culture.Depending on the results the treating physician should manage the cough.The other two symptoms of headache and gastritis are easy to manage.Right now we cannot predict the diagnosis.Feel free to contact us in case you need a second opinion on the investigation and diagnosis.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My lipid profile is worrisome. Can it be due to junk food?\n\nHi doctor, Few days back, I felt little dizzy and when checked my BP was quite high around 149/89. My recent lipid profile is also worrisome. What should I do now? I prefer eating junk food most of the time and dairy products like cheese and paneer more. I gained some weight now. I feel some slight vibration in the left side of my chest when I shout loudly. Apart from this, I have few kidney stones of about 3-5 mm. Now I am taking approximately 2.5 liters of water a day. Otherwise, I am healthy. I do not take any medicines except for kidney stones and injection Voveran for the same.",
    "doctor_response": "Hi. My advice to you as per your complaints and reports (attachment removed to protect patient identity), Avoid stress and follow the instructions and repeat your lipid profile after 6 months. Blood pressure (BP) also will improve with jogging and exercise but weekly once BP should be checked. If it is high like this, then we have to think of medicine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe hair loss and abdominal pain?\n\nHello, I am a 33 year old mother of 3. I am 5 2 and 114 pounds these are my symptoms that I have had for 15 years: hair loss that is progressing, abdominal pain, colon polyp at the age 20, hands and mouth shaky, muscle cramps in calves, tmj, pain during sex, lower back pain, headaches, severe headaches with exercise, nausea, lightheaded when standing and sometimes almost blackout and shake, heart palpitations, severe cold intolerance, numbness in hands and feet, night vision not so good at all, poor posture, acne, flushing, depression, and anxiety. New symptoms: night sweats, sweating during the day, hands swelling, joint swelling in hands, wrist pain, nose bleeds, hard to get up from couch, shortness of breath, vision disturbance, headaches more often, unexplained weight loss of 20 pounds, more hair growth, and change in menstrual. I feel like there is something wrong and has been for a long time. I am just getting worse. Went to endocrinologist and said nothing is going on everything is within normal ranges. My lab results are Dheas- 178.4 Cortisol- 6.3 IGF-1. - 170 A1C- 5.3 TSH- 1.470 Prolactin- 12.2 17-OH Progestrone LCMS. - 26 Testosterone, serum- 14 Testosterone, % free + weakly bound. - 7.9 Testosterone, F + W bound. - 1.1 Anti-Mullerian Hormone (AMH). - 1.61 CMP was done as well Please help me!!!",
    "doctor_response": "Thanks for consultation.I have gone through from your complaints and full case history and investigation.clinically all the symptoms are with clinical diagnosis of hypothyroidism.advise:Repeat with thyroid a fiction tests including with TSH,T3,T4,thyroid antibodies , thyroglobulin level.blood vitamin D level.blood Phosphate.calcium.magnicium,LFTs,if still no diagnosis then you can start thyroxine after consultation with your endocrinologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What else should I take to control my blood pressure?\n\nI am a diabetic of 44 years and about 3 weeks ago I had swelling in my feet and came down with a terrible cold. I am taking 40mg furosemide and my blood sugar jumps to 500 but if I don't take it my blood pressure  goes up to 189/107. (I take blood pressure medicine on a regular basis too) What should I do?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You should change your antihypertensive drugs.  Losartan or beta blocker can be helpful.  For that you should consult your physician and set the drig and dosage according to your blood pressure and response. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hypertension?\n\nI'm 23 years old boy. I've high BP that has been dectated 5months ago.Then it was200/160. Now it is 150/95 with taking medicines. But all the medical reports are normal. No cause has been caught out. Some psychiatric disorders are there in my background. I get too much tention in any problem. Can it be occurred from any psychiatric imbalance?age:23    weight:52kg   height:5\"7Blood sugar fasting:100,PP:118",
    "doctor_response": "Hi,Thanks for writing to Health Care Magic, I am Dr Asad Riaz, I have closely read your question and I understand your concerns, I will hereby guide you regarding your health related problem.In your age, hypertension is not caused by age related hardening of arteries so a cause must definitely be looked for. If you have undergone all pertinent tests and they turned out to be negative your hypertension will be called essential hypertension which is an inborn predisposition to develop the illness and runs in families. But if you have identified or out of the proportion anxiety, that is a very common cause of high blood pressure readings especially wjen BP readings increase episodicallyYou may try certain stress coping mechanisms and if that doesnt work, anti anxiety medicines like 0.5mg alprazolam are definitely indicated before antihypertensive medicationsBut those drugs have habit forming activity so it would be best if you try to control if with behavioral interventionsI hope this answered your question, if you have more feel free to ask.RegardsDr.Asad Riaz.General and Family Physician..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cysts on kidney, abdominal pain and discomfort\n\nhi! i was wondering about the cysts on my 26 year old daughter kidneys and why she has them. She was found the has some in her uterus about 1 1/2 years ago. What is causing this condition for her. She has had extreme abdominal pain and disconfort. She is undergoing numerous tests at this time but the doctors don t seem to want or be able to answer my questions. I reallly would like to have an idea of what questions to ask them. thanks",
    "doctor_response": "Hi,we need to do ct scan of abdomen to know whether it is simple cyst or multiple cyst of kidney.if it is simple cyst do not worry.if it is multiple cyst than we have to check whether it is polycystic kidney disease this can be inherited.investigations needed are sr creatinine,24hr urine protein,urine routine.ultrasound of siblings & yours.with this investigations you will get answer dont worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should hypertension medication be continued when BP is under control?\n\ndoctor i am using nebivolol tab 5 mg and cilnidipine & telmisartan (cilacarT) 50 mg daily, morning and night one tab  for my BP. But still my BP is on the range of 126/94 to 141/104 in different intervals. i am staying in a hilly area called Aizawl, Mizoram. I am controlling my food. not taking any non veg or dairy items. shall i continue this medicine. Pls advise me",
    "doctor_response": "Yes,  the blood you quoted is still in normal - to high normal range,  you are on three antihypertensive as you suggested,  it is because of the drugs your blood pressure is being controlled,  sudden withdrawal will push it to very high range which may precipitate a heart problem or brain attack in worst senior s (of relevance because of your stay) .  Rather as you are doing decreasing salt,  regular exercise and fish consumption (if available- for its omega acid) Will bring the readings to max less than 140/90 and then we can slowly think of decreasing the dose, till than plz continue with the same and rather increasing it slightly to bring the lower blood pressure less than 85 mm hg",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes palpitations and shortness of breath?\n\nGood evening, Today I experienced something scary. I was getting out the car to go in the gas station and I felt my heart beat rapidly, almost like it was about to jump out my chest and it was painful. I felt short of breath and I started sweating and both my hands started tingling. I grabbed a bottle of water and started drinking it just to see if it would help. I was afraid I was about to faint. The episode lasted for at least 20 mins. I didn\u2019t start driving until it eased up a little. Then when I got home I laced across the couch and and it passed over. But my chest still feels a little heavy.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I passed carefully through your question and would explain that your symptoms could be related to a panic attack or cardiac arrhythmia. Coming to this point, I would recommend performing some tests to exclude cardiac arrhythmia: - a resting ECG and a cardiac ultrasound - thyroid hormone levels for thyroid gland dysfunction - blood electrolytes for any possible imbalances - complete blood count for anemia - an ambulatory 24-48 hours ECG monitoring for possible cardiac arrhythmia. If all the above tests result normal, you should consider anxiety as the main cause of your complaints. Hope you will find this answer helpful! Wishing good health, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Done semen analysis. What are the chances of pregnancy?\n\nMy SA report is as follows.. Rapidly progressive : 0% Sluggish :1% Non motile :99% Normal Form =70 HPF Abnormal Form = 30 HPF Me n my wife are trying since 6 months but no result. What are chances of success from above SA data. and if its problamatic, how much time will it take to correct the figures. I used to smoke less often but drink alcohol very frequently. But quit drinking/ smoking since 1 year. Pls suggest. No drugs habbit.",
    "doctor_response": "Hi Welcome to HealthcareMagic Plz post complete semen analysis report. In this report you have not mentioned about sperm count. In your case sperm Motility is very poor. According to WHO, total motility should be 40% out of which 32% should be progressive motility. Some times poor motility could be due to infection. Get a semen culture done to rule out infection. Sperm morphology is within normal limits. With the above report chances of natural conception are rare. Get yourself evaluated by an urologist.Varicocele, if present need to be treated. You can take multivitamins and other antioxidants after consulting your doctor.Repeat semen analysis after 3 months. If there is no improvement then u need to undergo complete hormonal investigations. ICSI ( with own sperms )or donor IUI could be treatment options. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What yoga i can do during pregnancy ?\n\nHi I am 27 and Im 3 months pregnant .Please tell me what kind of yoga is preffered for pregnant women and by what month of pregnancy we can start yoga Hi I am 27,female. and Im 3 months pregnant.Please tell me what kind of yoga is preffered for pregnant women and by what month of pregnancy we can start yoga",
    "doctor_response": "Hi Rafia; welcome to HealthcareMagic Please consult first your Gynaec whether you can do yoga in 3rd month of pregnancy;if she says yes may be you can consult a yoga teacher or specialist who will guide you as to what type of yoga can be done in pregnancy. Take care Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I feel my clitoris is smaller than before. Is this normal during pregnancy?\n\nHello doctor, I am very concerned and need an answer. I am seven weeks and pregnant and have had no complications so far. But, today, my clitoris feels way smaller then it did yesterday. And I am way more nauseous then I have been. I cannot stand or sit up for too long before I am rushing to the bathroom to gag and dry heave, but not throw up. I cannot get into my doctor for 10 days, but I am very scared that something is wrong. I am 19 years old, have a uterine fibroid which my doctor said should not interfere with baby, and cysts on my left ovary. My clitoris is smaller, no sensation, very dry, and is sore. I am taking Keflex (Cefalexin) for a uti and Zantac for acid reflux. Please get back to me as soon as possible. Do I need to go to the ER, or am I paranoid with my first pregnancy?",
    "doctor_response": "Hello. Please do not be scared, and the vaginal symptoms are due to uti (urinary tract infection). Take a lot of water and a warm bath (not hot but warm) to relieve those symptoms. Nausea is a part of morning sickness, and besides Zantac, you can take Doxinate tablets twice a day for seven days. Also, increasing the intake of bananas will provide you comfort as they are rich in vitamin B6. Do not take any other medication than Keflex, Zantac, Doxinate, and Folvite (folic acid). I hope this helps. hyperemesis gravidarum doxinate vitamin b6",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is gout possible at the painful incision site?\n\nMy husband had heart bi-pass surgery just over a month ago and is now having severe pain in the outer skin at the top of his incision. Nothing shows signs of infection but the tenderness reminds me of his gout attacks in his foot. Is it possible to get gout attack in this area of the chest?",
    "doctor_response": "no it is not possible to have gout in area near chestbelow the skin there is a layer called fasciamost like its thecinfection of fascia called as fasciaitisconsult a doctor get culture and senstivity of a swab taken from near the area of incisionhe will be prescribed antiobiotics plus antiinflammatory drugs and steriods for a short time to supress the infection and inflammation caused by the infection thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for heart disease with liver damage\n\nMy brother has only 10 percent ejection fraction with liver damage. He has been hospitalized 4 times. He is alway put on breathing machine. He is only getting worse. He has 5 stints in his heart. Also has plastic tubing to provide circulation to left leg.",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, although you have not any specific question, still I would say that such case needs great care, with just 10 per cent ejection fraction prognosis is not good, you have not mentioned age of patient else something more specific could be thought, hope this information helps, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible while on an IUD and Norethisterone?\n\nHi. Im on the non hormonal coil at the moment and due my period when we are away on holiday. I was planning to take norethisterone to delay my period. My question is will I get pregnant if I had unprotected sex even with the coil and on norethisterone? Thank you so much",
    "doctor_response": "Hi, You can't get pregnant while using an IUD because it is a very effective contraception method. Also being in end of cycle and using Norethisterone doesn't increase the pregnancy probability. You are safe for pregnancy. Hope I have answered the question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for back pain and muscle spasms?\n\nhello my name is nicola and i have health query for my mum. she has been having really bad back pains what happened was she picked up a heavy bag of shopping one day and then she got these back pains.    she went to doctors and the doctor said its muscle spasms, ..she been taking tablets the doctor gave just a week ago now but the accident happen 2 months agao now and not much change has happened,, is there any treatments she can do? or exercise to do?...i think she may need a xray i told her to demand for one cos it bad, please help",
    "doctor_response": "Hello,I had gone through the case and found that this might be slip disc not only muscle spasm.So immediate go for X-ray to find the exact cause. Meanwhile do not bend forward and apply local muscle relaxant ointment and take hot water bagon the back.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my BP fluctuating after treatment?\n\nI had high blood pressure 3 months ago. My doctor laid it out for me. I came home started eating healthy and in 3 months lost 37 lbs. My blood pressure has changed but I am concerned that the bottom number is high??? I bought a tester and this morning it is 115/95 what has happened??",
    "doctor_response": "Hi, Good to know, you have brought your blood pressure under control. There is one possibility, I would consider- Is the instrument accurately calibrated.- check blood pressure of few other people and repeat it to test accuracy.Studies have shown that diastolic blood pressure is often over estimated.However, if it is really 95, nothing to worry. Recent data shows, no increased risk to heart due to pressure up to 95. There is a small possibility in future of developing systolic hypertension too. You can try low salt intake, avoiding alcohol, maintaining weight, no smoking and exercising regularly.Any further queries, happy to help again.Dr. Prakash HM",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for gum growing low that bleeds and hurt while brushing?\n\nI have braces and my gum is growing low. I brush my teeth for at least 3 minutes  per day before my gum started growing low. So when I brush my teeth, it starts bleeding and it hurts really bad. Is there any way that I can stop it from hurting, bleeding, and from growing lower?",
    "doctor_response": "Hi,Thanks for asking the query,Bleeding gums can be due to various reasons few are nutritional deficiency, improper brushing technique, hormonal disorders.I would suggest you to consult an Dentist, get a checkup done, also go for complete mouth scaling and polishing.Take complete balanced diet with plenty of raw vegetables, fruits, juices, citrus fruits like lemon, oranges.Drink plenty of water to keep yourself hydrated.Take multivitamin suplements.Use a soft bristle toothbrush, brush twice daily slowly in circular motion.Take lukewarm saline and antiseptic mouthwash rinses.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to drain blood after gallbladder removal surgery?\n\nAfter Gall Bladder removal, the tube and collector ?  Surgery on Monday, and still draining blood over 58 cc per day- is that okay? or should the Dr do some test to see why the drainage isn't slowing?  Apparantly the Gall Stone removed was over an inch and was in surgery for 2 hours.   Thought it would be simple-",
    "doctor_response": "Hello,It is not a routine practice, but sometimes surgery becomes difficult. So, to remove collected blood this tube is put inside.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. B.dinesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can anemia cause cramps in the legs?\n\nI recently had to have two separate blood transfusions due to anemia. My hemoglobin was 7.2. Came up to 9.1 then dropped again so I was readmitted for the second blood transfusion. I have been having leg cramps sense this time. Concerned as to why these are occurring",
    "doctor_response": "Hi, I will suggest you to check the electrolytic level to the blood for the probability of dis balance. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Esmeralda Sera, Oncologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Teenager.  Depression due to bad environment at home,  difficulty sleeping, inability to trust anyone, rage, suicidal thoughts, weight gain.  Help\n\nI've been having depression issues for quite a long time now. At first, it wasn't much of a problem but it's getting harder and harder day by day. I can't sleep (in the last 5 days I only slept for 6 hours). Basically the reason for my depression were my parents. They fought a lot and I was usually dragged into their fights somehow. I was scolded for no good reason. They yelled at me all the time. I wasn't allowed to leave the house either. It home to school and school to back home. But I got used to it. Later the few friends I had betrayed me iver and over agsin and I cut contact with them. After I got promoted to the next grade, I made new friends but they also betrayed me. Since then I've had serious trust issues and can't discuss my problems with anyone. I am unable to trust anyone. Now my parents have gotten even harsher and I don't know how to deal with them. I have to keep all my rage inside. I've now started to hate everyone, my friends, my family. My depression is at it's peak. Insomnia is killing me and I have to go to college everyday too. I'm 17 and thoughts like suicide and running away cross my mind everyday . I've tried many cures (as stated on the Internet). I don't know what to do. I need help.I don't really have any bullying problem but over the time I've started to gain weight and I am often teased because of it and I do mind though I keep silent about it.",
    "doctor_response": "Hi,Thanks for using healthcare magic.I have gone through your history.It seems that you are having depression but other illness like conduct disorder or borderline personality traits need to be ruled out.You should consult your doctor preferably psychiatrist for detailed evaluation and management. Doctor may rule out physical causes like thyroid dysfunction.After confirming diagnosis, doctor may advise to go for anti depressant drugs like desvenlafaxine or sertraline . You may get benefit by counselling and psychotherapy.Meanwhile you may go for stress management and relaxation exercise like yoga or meditation for better control over stress.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is right time for salvage therapy after chemo therapy?\n\nI have stage IIIA anal cancer and have already undergone chemoradiation therapy which finished in September 2010.  On MRI now however there appears to be secondary growth on my back (sacrococcygeal area) which will be rechecked by PET scan this Friday.  I am concerned that it is now 5 months since my treatment ended and it is too late for salvage therapy.  What is my likely prognosis?",
    "doctor_response": "Prognosis depends upon extent of the disease.Pet will tell the extent of the disease.Surgery or palliative chemo may help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Unable to get pregnant. Having irregular period and immature follicles. How to get pregnant soon?\n\nhi iam married age 24, i got pregnant before 5 years but that time we were too young to have a child so i got some pills from the pharmacy and got periods. actually have not done d & c. now we are planning for a baby for the past one year but we are not successeful. even my dh count was 16million per ml and 32 million in ejaculation oher tests are normal. my menstural cycle is irregular i have immature follicles. so i want to become pregnant soon. pls reply with a solution.",
    "doctor_response": "Hi,Since you did not get the abortion under medical surveillance, chances of tubal infections and subsequent tubal blocks have to be ruled out. Also, as you have irregular periods, hormonal disorders need to be excluded. You should consult an infertility specialist and get properly investigated. Meanwhile, please maintain a healthy weight, healthy diet and get some regular exercise. You would need a complete hormonal profile, tubal patency tests, trans-vaginal sonogram and follicular studies.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat small potion of penile foreskin attachment at the lower potion mediated pain?\n\nMy penis foreskin has detached but not fully. A very very small portion is still attached to my penis at the lower portion. So as a result whats happens when it is fully erect and the skin comes down i feel pain because of that very little attached portion. My question is can that little attached potion be cut by visiting a docotor??",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have a band of adhesion between frenulum and glans that gives pain on erection.Please consult qualified General surgeon or urologist .It needs to be excised under local anaesthesia .This is short and simple surgery and will offer permanent cure.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on head of a baby?\n\nMy 10 month old fell and hit her head on the tile floor a week ago. We took her to the ER and they checked her out as fine. She has been acting normal all along and never had any signs of a concussion. But there is still quite a large soft lump on the side of her head where she hit it. Is this normal? How long will it last?",
    "doctor_response": "hai.according to my opinion it is normal.it is a sweeling because of hitting.it will subside without medications also.if you want give medicines to decrease pain and swelling .non steroidal anti inflammatory medicine better like syp.ibugesic plus 5 ml two times daily that will subside 4-5 days",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will the SGPT will go back to normal if Lipitor is stopped?\n\nDue to elevated cholesterol of 6.58, LDL of 4.64, SGPT of 33.59, I was put on simvastatin 20mg (vidastat) for 2 months. However, after 2 months, the simvastatin did not seem to work, my cholesterol and LDL further increased to 7.52 and 5.12. But SGPT was down to 28.97. I was shifted to Lipitor 20mg. After 2 and 1/2 months of taking it, cholesterol (4.69) and LDL (2.77) became normal. BUT FBS now elevated to 5.72 and SGPT soared to 45.33! I am so worried that liver may have been damaged. Do I need a liver ultrasound? Should I start taking Essentialle Forte or Silymarin? Should i also start Metformin Glucophage XR 750mg, at leat for a month, to arrest any liver or sugar level problems. I am currently on maintenance meds for hypertension (micardis 40mg in the morning, and norvasc 5mg in the evening). I am also overweight by 25-30 lbs. I am 44 years old, female. If i stop the lipitor, will my SGPT go back to normal? Thank you very much.",
    "doctor_response": "Hello,First of all, your sgpt elevation is not that worrisome.  It's not even the double of the highest normal value. Sgpt values lower than three times the highest normal value are considered acceptable.Since you're overweight you should do a liver ultrasound which may reveal fatty liver changes. Fatty liver itself may cause liver tests elevation particularly if you had gained weight recently. If your doctor considers lipitor as the cause of thebhigh sgpt then you should do a repeat measurement after a week or so to make sure it won't get any higher and you can continue to take it afterwards.There is no need to take anything. You can try to loose some weight which will help you with a potential fatty liver and with the cholesterol as well.I hope I've helped!You can contact me again if you'd like any clarification or further information.Kind regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pain in the testicles?\n\ni have pain in my testicals ...it is that i am feeling pain in my weist also at same time in both sides. . past 3 days on words i am with my girl at evening times ....  yesterday i kiss him at that time i dnt have pain but after that very much pain in my testicals ... 2 to 3 hours .. please tell me suggestion",
    "doctor_response": "Hello, Pain in the scrotum can be the result of serious conditions like testicular torsion or a sexually transmitted infection (STI). Ignoring the pain may cause irreversible damage to the testicles and scrotum. Often, problems with the testicles cause abdominal or groin pain before pain in the testicle develops. Please consult a doctor in person for physical examination and diagnosis and treatment. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in the lips?\n\nHi, I have been facing Swelling of my lower / upper lips upto 4 times in the past 2-3 months. While I consulted a  doctor locally here I was adviced to take \"Atarax\" for allergy. Before taking this tablet I had regular itching in various parts of the body, which later subsided. Though there are no visible rashes, the swelling of my lips has happened 4 times now. The swelling is visible in the early morning as I get up from bed, however subsides completely in the 2-3hrs. Please advice me if I need to take any specific test to rule out a bigger problem or consult any skin specialist.",
    "doctor_response": "Hello,As per your query, you have a swelling on the lips which are pointing towards condition known as the allergic reaction, and it could be due to excessive lip biting as well.I would suggest you to:-Take over the counter antihistamine drug like Benadryl or Zyrtec.-Drink plenty of fluid, drink at least 8 glasses of water in a day.-Give cold compresses to affected area 2-3 times a day.-Do not touch the affected area with your hands as it can aggravate condition.If the condition does not get better in a day, then consult a dermatologist for proper examination and to rule out other cause like trauma and angioedema or a pimple. The doctor may prescribe antibiotics and steroid ointment.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it to be concerned about the bump due to varicose vein?\n\nlast night I felt a snap/pop inside my problematic varicose vein.  It instantly bruised (blue in color)  . I laid down..but the knot that had formed where i felt the pop has now traveled up my thigh and has stopped. I am pregnant - and have been seen by a doctor and had an ultrasound down on this leg. However - this happened last night - and now the knot/bump has traveled. Should I be worried?",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern.  You should go for doppler study.  It will give perfect idea. Use strip bandage over your varicose vein.Consult your doctor and go for test.  Then take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swollen and hurting legs due to filthy rugs, can see tiny hard scaled splinters under skin. What is this ?\n\nHi my naqame is AAAA and I have been tortured for 1 1/2 yrs. started in Jan.2012, I moved into a house and the rugs were fithy but I didnt want to say anything to land lord He let me go with security deposit and I was in a bad way at the time so I ripped them up my self and got bite all over I stopped and got a friend of mine to finish. N ext morning I woke up with swelled legs , hurting and you could see the thing under my skin with magnifing glass.I put alchol neosporin anti-itch everything and anything finally teatree oil I thought worked but I got more infected so I went to hospital they did not know what it was and wrotr dermatitis, gave me antibiotics got rid of me there tiny hard clear some are shaped like a splinter and scales slinter gets under skin shapes itself like horseshoe and littlefangs  come out and clamps my flesh ,crazy, and the scale slide in side ways one behind other in a rows and are hell to pull out you have to kill them first. they turn white when dead what are they",
    "doctor_response": "hello userYou are requested to visit nearby emergency department for your illness.Hope this information helped you. Let me know if you need any more clarifications.Regards,Dr Hari Om ChandrakarMBBS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can lesions on pancreas cause severe abdominal pain?\n\nMy brother has had severe abdoman pain for 2 mon VA Dr did x-ray ultrasound ct scan and with ct scan found lesions on pancreas 1 week ago still no call back for a biopsy or MRI are  to be set up are there other  reasons for lesion other than cancer from what I read time is important for treatment of any pancreas problem",
    "doctor_response": "HI.The lesion is already found in the pancreas. You have to consult an Onco-surgeon for further evaluation. Since the lesion is obvious, this may be the most probable reason for pain in abdomen.  Another reasons can be cholestasis, caused by pancreatic mass, pancreatitis itself. Yes time is very important as timely intervention can cure the patient.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for loose motions in infants\n\nHi My daughter is 13 months old and we just traveled from India to USA on Saturday and today i started giving her organic milk she was on formula till yesterday.Now loss motions started since then . Since morning she has 5 motions till now.Please advice",
    "doctor_response": "Change of feed can cause diarrhoea which is normal and nothing to worry and also u had travelled from India so take care to rehydrate the child and don't let the child go into dehydration which is a dangerous complication stop organic milk for now and continue formula feeds use probitics and ORS oral rehydration solution WALYTE P should be fine in 2- 3 days",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bleeding post removal of cervical polyps?\n\nHi,my name is jeanne I am 18 weeks pregnancy and on Monday the Doctor removed the cevical pollyps and on saturday it was bled again in the afternoon and five hours later the bleeding was increased and there was blood cloth come out.and now the blood still bleeding.What should I do, it is normal or do you have any sugestions?",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.1] Finding cervical polyp during pregnancy is not uncommon.2] If you are having bleeding after polyp removal, it needs to be looked again if the stalk of polyp is bleeding.3] If so,it needs to be tied or cauterized to arrest the bleeding.4] It can be done without anesthesia also.5] Please do not worry.I hope my answer helps you.Thanks.Wish you great health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have abdominal pain and back pain. Taking antibiotics for sinus. Had Hysterectomy. Remedy?\n\nHi. For about 3 weeks now, I have had a sharp pain on the left side of my abdomen just below the belly button and around to my lower back. Feels badly bruised but also crampy. I would think it is diverticulosis but I have been on anti biotics for almost 3 weeks now for sinus infection . I had a hysterectomy in November but my doctor said she never did anything in that area.",
    "doctor_response": "Hello Roxann, thanks for posting on HCM, From your description it is very possible that you are having a kidney diseases (infection or stones) which will require to be confirmed by a doctor. Urine analysis (if possible culture and sensitivity test performed), abdominal ultrasound (specifically look at the kidneys), blood test (CBC, urea, creatinine, BUN etc) will be needed in order to confirm the kidney diseases or exclude it. If that be the case, you will require another course of antibiotics, take antispasmodic drugs, drink much water and consult a urologist. Other possible causes might be from the GIT such as diverticulitis (like you rightly said and being on antibiotics does not mean you receive specific antibiotics for diverticulitis), severe abdominal colic due to intestinal infection ( i suggest stool exams + colonoscopy to be done). If pains are severe, I suggest you consult immediately or go to the ER. Hope this helps Dr. Bernard",
    "dialogue_context": ""
  },
  {
    "patient_message": "Weight loss, lack of appetite, slight jaundice, occasional cramps near liver, frequent night sweats, low libido. Suggestions?\n\nHi, my boyfriend has suddenly lost alot of weight 12-15pounds within this month, he is already small in nature, usually weighs in between 150-155lbs when healthy. His symptoms are lack of appetite, little jaundice in the white of his eyes, back pain and sometimes pain cramping near the liver, frequent night sweats, pale skin, feeling tired at times, low/no libido. He has seen a liver specialist to rule out any major diagnosis. Doctors have mentioned GS but he isnt fully diagnosed because of uncertainty. This is the third episode he has had within 2 years, and for each time, its after a certain period of time working nights that he gets all of these symptoms. Could there be a correlation with gs and working nights?",
    "doctor_response": "Hello, Thanks for the  query to H.C.M. Forum. Loss of weight,loss of appetite, back pain,cramps at  liver site,night sweating,pale skin,fatigue, no libido, Still no diagnosis ?   May be infection in liver,may be cirrhosis of liver, may be some  secondaries in liver, may be anemia. Consult a physician and Ultrasound of abdomen with complete blood examination for H I V , hepatitis, E S R,  C B C. Hope  you will understand  the seriousness of  condition and at once contact physician.  Good luck for your  boy friend. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest a substitute of 'ascoril' expectorant cough syrup\n\nHi, I have been using the Ascoril Expectorant cough syrup for my cough and cold problems in INDIA and it works well on me and I get instant relief. Presently, I have moved to Masachusetts, USA. Could you please tell me if I can get the same here or is there any other equivalent syrup available in USA?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Ascoril is having ambroxol, guaphenesine and terbutalin. It is having both properties, mucolytic and expectorant. In USA you will get all these in Brozodex syrup. So ask for brozodex. If you don't get brozodex, then ask for combination of ambroxol, guaphenesine and terbutalin. You willingness definitely get this combination in USA. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes discomfort in rib cage?\n\nit feels like i have a ball in my rib cage on the right side.I have not had normal bowel movements in a few days. the dr set me up for an upper and lower scope but i threw up all the meds they gave me to prep for that.no my stomach has gurgleing on the left side but no sounds on the right",
    "doctor_response": "Hello Thank you for trusting HCM Dear if feel in ball in rib caze why don't you have get it done ultrasound scan?? Usually the medicine that gave before colonoscopy can induce bowel movements so they may be painful don't worry. Podsible causes may be cholecystitis, lipomas, Enlarged tip of rib, rt colon swelling etc.. Please consult your doctor and get one ultrasound scan of abdomen and get treated accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and hot flushes?\n\nMy 14 yr old daughter had gallbladder surgery Oct 17th and was 3 weeks prior without being able to keep food down since her original symptoms are gone but she is feeling HOT and dizzy and nearly blacking out when standing I was wondering if this could be from the GA or is this typical?",
    "doctor_response": "Hi.... this is not typical but at the same time I do not think that it is due to general anaesthesia. The symptoms which your daughter is experiencing are due to autonomic imbalance. She needs evaluation for this. I suggest you consult a pediatrician regarding this or even better choice would be a paediatric Endocrinologist.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hi,My age is 33 and my semen analysis has the following resultsConcentration: 55 Million/MlMotility: 65%Vitality: 68%Morphology(Normal forms): 3%My doctor has prescribed Fertisure M though i have normal counts in motility and concentration. Can Fertisure M treat morphology as well? I cannot understand why Fertisure is prescribed for me? Can you help me? Secondly does Fertisure M causes hormonal changes?Thanks.",
    "doctor_response": "Hi,Thanks for writing to Healthcaremagic.Fertisure is prescribed to you because in morphology normal forms are 3%. It should be 30%  to conceive.It contains lycopene, zinc, sulphur etc which helps in production of healthy sperms and improves morphology.I would suggest you to take for 3 months and get repeat test done to see response. It is nutritional support with antioxidants so it won't cause hormonal changes.I would suggest that you rule out varicocele in you by a doctor. If it is there, get it operated.  And do some life style modifications like --\u00a0\u00a0\u00a0\u00a0\u00a0Reduce weight, do exercise.-\u00a0\u00a0\u00a0\u00a0\u00a0Stop smoking and alcohol. -\u00a0\u00a0\u00a0\u00a0\u00a0Avoid caffeine.-\u00a0\u00a0\u00a0\u00a0\u00a0Ware loose under garments.-\u00a0\u00a0\u00a0\u00a0\u00a0Healthy diet with multivitamin and zinc.-\u00a0\u00a0\u00a0\u00a0\u00a0Avoid trauma to testisHope I have been helpful.Regards\u00a0\u00a0\u00a0\u00a0\u00a0Dr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes anxiety after kidney dialysis?\n\nHi Doctor My Father is going through the dialysis 2 Times a Week. After the dialysis he feels very Anxiety during the night time and could not rest. In Day time condition improves and he can sleep. Kindly let me know the reason for Anxiety and uneasiness during the night time.",
    "doctor_response": "Dialysis itself is a lot ofstress and further twice a week dialysis is an additional negative factor being an inadequate dialysis dose. Now it is being well proven that patients on dialysis have sleep disorders and need to be adressed. He may need a sleep study and further management depending on the report. Discuss with a nephrologist sbout dialysis frequency as inadequate dialysis may add to the problems.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes brown discharge during pregnancy after taking Prontogest injection?\n\nHi. i am pregnant early stage, i have experienced dark brown discharge last sunday when i took a prontogest injection. then had a hcg test which resulted to 4411 after a hcg test that resulted 533 six days earlier. i am on utrogestan twice daily, and on materna and calcitron. yet i have discharged dark brown again tonight. i am not able to reach any hospital now for a prontogest injection again. i am extremely worried . am i miscarriying. urgent anser is really appreciated.",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the brown discharge might not be associated with prontogest injection.The various causes for brown discharge like thyroid abnormalities,progesterone or HCG insufficiency,bleeding from cervix,abnormal pregnancy,unknown causes etc.Infact the prontogest injection are given to stop spotting or bleeding caused due to hormonal abnormalities.The raise of HCG is also apt.The above causes should be ruled out by physical examination,thyroid profile and ultrasound.Dont worry.As the brown discharge does not always suggests miscarriage.I suggest you to consult doctor and rule out the above causes by examination and necessary investigations.It will subside with apt treatment.Avoid stress and physical strain.Take good rest.Avoid intercourse.Continue with medication as prescribed by your doctor.Hope this helps.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will i conceive while suffering from PCOD?\n\nSir, Iam 26 yrs. Married 6 months ago. I got my last period on mar 6 2011 yet till late i have not got my period did the preganent test 5 times result was negative. And finally went to a doctor she is telling that iam suffering from PCOD? will i be able to give birth to a child?",
    "doctor_response": "HiGREETINGS Definitely you can conceive.But you need to be under an infertility specialists follow up.Weight reduction has to be done if you are obese.Some times you may have to take treatment to regularise your periods.Also get your husbands semen analysis. Hope my answer helps you. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Allergy, running nose followed by loss of voice, chest pain, thick mucus with nasal bleeding. Is it inflamed bronchi?\n\nLast week I started having some allergies symptoms (running nose , sneezing so forth) however 2days ago I started losing my voice. When I talk my chest hurts like if I had no oxygen . I also had thick mucus and bloody nose. I don\u2019t know what I have, one of my co-workers told me, that my bronchi\u2019s are inflame is that true?",
    "doctor_response": "THESE ARE SYMPTOMPS OF ACUTE SINUSITIS WITH BLEEDING SINUSES DUE TO POST NASAL  DRIP THE DRIP GO INTO LARYNX CAUSING VOCAL CORD OEDEMA WITH DIFFICULITY IN BREATHING AND HORSENESS OF VOICE TAKE METROGYL 200 MGM TWICE A DAY TAB MONTELUCAST+FEXOFENADINE TWICE A WEEK(MONTAIR FX OF CIPLA) SYP VENTROLIN 1/2 TO 1 TSF THRICE A DAY TAB ZINETAC EMPTY STOMACH OTRIVIN NASAL DROPS NO STEAM GO IN FOR 2 WEEK TIME U WILL BE FINE VOICE RESTYOU HAVE TO HAVE STRICT B",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have white area on the spot i had tendon inflammation once?\n\nA month ago the to tot told me I had a tendon inflammation, he prescribed Naproxen which I took for 30 days, today the area that hurt has become white ( there s a white spot on my brown skin). Just on the exact area that hurt before I went to the doctor s. Is that normal?",
    "doctor_response": "can you explain more about the effected area, if it's still painful, swelling or any discharge or oozing of pus from it . if not then nothing to worry about, but if you have any of those symptoms you should see a orthoped nd start on antibiotics .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling tired and shaky. Had kidney stones, arthritis, other health problems. How to overcome?\n\nwell i feel very tired and some days shakey and feel that its never gona go away, and over the past twelve months iv had kidney stones needles in my knees for arthristis lost our home husband just got job after been made redundant over a year ago, and was in bad health too for a while and i was off with aniexty but had gone back to work with reduced hours, but off at moment feeling shattered again, will this go",
    "doctor_response": "Hi, Thanks for your question. Your problems seem to be multitude! My sympathies for all the financial trouble you have been through. Hope the  worst is over for you. With regards to your tiredness, kindly make sure your GP has checked your kidney function and haemoglobin recently. You probably will be under followup for your kidney stones under a urologist, else ask your GP to refer you to one. As long as your kidney function is good, you need to drink plenty of fluids to prevent stones in your kidneys. Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can diarrhea and lower back pain be related?\n\nFor the past month I have had light colored diarrhea, on and off. Then things started getting back to normal about 10 days ago. Well last Sunday I started having lower back pain on my left side, my stool is back to normal but it is lighter then normal and today I noticed some blood when I wiped. I have been to the doctor for my back pain and did mention the diarrhea but he said if you have no fever and felt fine, and no blood then it should be ok. So now I noticed the blood and I have another appointment Thursday and will definitly mention the blood, Can these two issues be related?",
    "doctor_response": "HIWell come to HCMCondition could be due to fissures, or haemorrhoid and this need to be ruled out if this is not the case then this could be intestinal infection condition can be treated tentatively with Tab Metrogyl 400 mg twice in day for five days, most of the times this comes to normal and if not then stool need to be analyse, hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat shin injury?\n\ni got hit directly in my shin by a team mates knee but it wasn t so serious. However the next day there was a bruise and when i rub the bruise there is a sharp stinging pain that moves down my leg to the lower part of my shin. what is this injury and stinging pain i have?",
    "doctor_response": "Hi, Pain, swelling, redness etc. are classic signs of inflammation. And trauma is a cause of inflammation. Unless it is significantly impairing function, it will go on its own. At best you need analgesics and if there is severe pain and limp, you may get an x-ray done. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Syed Tehmid, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does taking extacy during pregnancy harm fetus?\n\ni am eight weeks pregnant the father of the baby doesnt want me to have the baby. yesterday he came over he said to talk but he eneded up bringing extacy and pressured me into doing it so i would feel bad and have an abortion. now i feel horrible and i dont think i want the abortion and i dont know if i harmed the baby. im scared!!!!",
    "doctor_response": "Hello, and I hope I can help you today.Ecstasy, or MDMA, is a kind of a stimulant drug, and though it's prolonged used during pregnancy puts the unborn child at risk for behavior and developmental problems, one dose in the first trimester will not harm the baby.So if you want to keep the baby, there is no medical reason why you need to worry about the pregnancy.  You may need to re-evaluate your relationship if the baby's father pressures you into doing things that can harm you or the baby, but for now, there is nothing to worry about.  You should begin taking prenatal vitamins though, any brand is fine, and they can be purchased at your local pharmacy.I hope your situation gets resolved and I wish you the best of luck with the rest of the pregnancy,Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for removal of lump\n\nHave a hard immoveable lump more like a hard spot on the left side of my neck above collar bone. almost feels like it is on the main core muscle of the neck. 25yr old feamle 125lbs feel healthy other than stiff neck about three weeks ago when first notice the hard spot. What do you think it could be?",
    "doctor_response": "HI.Thanks for your query.Hard immobile lump is to be worried about.I would suggest you to go for FNAC- fine needle aspiration cytology to start with.CT scan of the area if there is suspicion about secondaries ( of cancer).A good clinical evaluation by a Surgeon to feel and examine the draining area.X-ray of the chest, Mammography if you are a female patient .All this is required to determine the future course of management. FNAC can guide further , if not conclusive to go for biopsy to get an accurate diagnosis and plan for further management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in elbows and wrists along with sore throat?\n\nI know a 15 year old female that has a really bad sore throat that wont go away, her parents do not like her taking antibiotics, she has a headache, nausea, and vomiting. Since yesterday her elbows and wrists have become swollen, and now she has little hard painless bumps around her wrists, What can be causing this, could it be rheumatic fever?",
    "doctor_response": "Thanks for treatment in HealthcareMagic, your girl has streptococcal infection, acute tonsillitis and complication for joints, for excluding of rheumatoid fever we should do antistreptococcal antibodies, rheumatoid factor and other rheumatoid test, which rheumatologist can prescribe to her. You should immediatly start to give antibiotic to her at least augmentin 1000 1 tab 2 times after meal 10 days, aceclofenac 1 tab 2 times after meal, loratadine 1 tab 1 time before night. Rince gurgle with chlorhexidine 4-6 times, take strepsils, sualin for resolution and lary spray 1 dose 4 times in gurgle. Check urine analysis also, because we afraid urinary infection. Give to her plenty of water, ginger, lemon and turmeric powder tea.Stay warm in bedTake careRecovery soon I will review after 5 daysDr.Svetlana",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high blood pressure while on antihypertensive?\n\nI had high blood pressure three years ago can t remember reading anyhow early last year I had a tumor removed and at hospital blood pressure was low they took me off my Medication to stabilise the blood pressure it has stayed low months afterwards so Dr kept me off the Micardis tablets. Recently have not been well and Dr checked blood pressure and it was 152/151 Dr put me back on Micardis pressure dropped to 135/110 Today it is 152/95 should I be concerned?",
    "doctor_response": "Hello, A single spike in blood pressure values does not mean uncontrolled high blood pressure. It could be related to physical activity, anxiety, a salty meal or too much caffeine intake. Anyway, I would recommend having some rest and taking a cup of lemon juice. If high blood pressure values persist in the next days, I would recommend increasing the dose of Micardis or add new drugs to your therapy, in order to help maintain your blood pressure values under control. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for white heads on penis shaft?\n\nHi, I have a small cluster of what appears to be white heads (6-8) on the shaft of my penis. Two months ago I had a blood test and urinalysis for STDs, all results came back negative. I ve been sleeping with one partner, she recently had a bladder infection and just finished her antibiotics which may have given her a yeast infection. We had sex Monday morning (1a.m) and I noticed the cluster Tuesday morning (1a.m). After we had sex Monday, I didn t practice good hygiene. I didn t take a shower until 2 o clock in the afternoon. I also work out a lot in compression shorts and wear boxer briefs. I wanted to know what this could possibly be.",
    "doctor_response": "Thanks for asking in healthcaremagic forum   White spot like lesion may be due to fordyce spots/pearly penile papules which are harmless. So, visit a dermatologist for examination and further management. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in knees and feet with severe temperature changes?\n\nmy son has severe temperature changes in his legs, swelling in his feet &/or knees, within cm of each other there is severe cold and heat, hot with redness & cold with mottling at times, feet mostly with the motlling, swelling and cold, knees mostly with the heat, redness and swelling, the hot and cold areas move from leg to leg and areas of each leg, he is paralyzed due to spina bifida so if there is accompanying pain he is not feeling it, it does cause his BP to elevate though and there is NOTHING wrong with his heart and no circulatory problems they can find",
    "doctor_response": "Hi, It seems to be a infection in the knee or in the leg, get your blood tests and X-rays done as soon as possible, you might need surgery to clear the infection if it is. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Jaideep Gaver, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump on the neck\n\nGood Morning sir,2-months back suddenly in the evening I saw a soft lump over my left neck above the collor bone. I was astonished, I had a pinpoint sessation in the middle like chilley. I cleared the place with dettol. Next day I visited the doctor. They game  me cietrizentab. and done FNAC test. It was un conclusive. The lump is not settleing down. Please help. I am restless.Rabindra PrasadDelhi",
    "doctor_response": "Hi,Welcome with your query to HCM virtual Clinic.I reviewed all the details of your query,in context of the soft lump in left neck above collar bone.Based on the facts of your query,You seem to have Boil,as it developed  overnight with a soft lump above collar bone with a pinpoint chilly like sensation in the middle,which implies boil with pointing head in middle.The cause of worry is because this lump is not settling downThese lumps could be due infective URTI / or could be Cold abscess,due to TB adenitis.To rule out these possibilities you need to get the Complete blood test/ESR/Interferron Gamma-release assay(IGRA) for latent TB infection.Possibility of NHL/ HL lymphom needs to be ruled out by CT and Excision biopsy with Histopath studies by a Surgeon/ENT Surgeon,as the  and FNAC Biopsy of this neck lymph nodes has come inconclusive.Hope this reply would help you to plan treatment with your doctors and resolve your worries.Will appreciate writing excellent review comments to help the needy patient visitors like you at HCM.Welcome any further query and information in this regard.Good Day!!Dr.Savaskar M.N.M.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes an altered sense of smell and bad breath after tooth extraction?\n\nI had a tooth removed sometime last year the dentist did mention something about nasal passages. afterwards my breath began to smell very foul odor. Ive recently this past week had another tooth removed due to an infection and I believed it was the tooth causing the foul odor smell but my breath still stinks horribly?",
    "doctor_response": "Hi..Thanks for the query..It looks like you have infection in your sinuses and it is the cause for bad smell from breath..As the sinuses drains through nose there is bad smell..At times if any piece of root of tooth slips into sinus while removing the tooth it can also cause infection in sinus..So my suggestion is to consult an Oral Surgeon and get evaluated..A sinus x-ray (PNS View x ray) or CBCT Scan can be done to confirm the diagnosis and treatment can be done accurately..A script of antibiotics, saline nasal irrigation, and steam inhalation can help..As of now do steam inhalation with a few drops of Eucalyptus oil in boiling water..Do saline nasal irrigation..Hope this helps..Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes positive ovulation tests?\n\nHi! I used Clomid for the first time this month.  I did develop a \"complex cyst/double ringed\" per my doctor found on an ultrasound.  Now, my period is late and I have been taking the ovulation tests (told to do by a friend) and they are all very positive.  So, the question is why am I having the postive ovulation tests (detecting high LH) when I am supposed to be on my period? I am 24 years old 5'4\" wt: 143lb and have been trying to concieve for over a year. I had no problem getting pregnant the first time.",
    "doctor_response": "it seems that you are having irregular hormonal levels that causes your cycle to be prolonged. pronlonged cycle includes delayed ovulation and delayed period. if you are having positive ovulation test then you should try to have intercourse in the following three days",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause irregular heartbeat?\n\nI have been referred to a cardiologist because I have an irregular heartbeat which is causing shortness of breath and is uncomfortable. My ECG concluded normal LV and RV function with a mile left atrial enlargement (42 mm). In the past 15 months, I've lost 25 lbs, ran a half marathon in December, exercising (with a trainer) 4 days a week, and eating healthier than I have since college (I am 37 years old). My grandmother (deceased) had and my mother has an irregular heartbeat so I feel it was inherited. I will see the cardiologist tomorrow but wonder how I've not truly been affected with the signs and symptoms listed on most websites and in most books. I enjoy exercising and beginning to Crossfit train (heavy resistance training) while continuing to jog/run (to include half marathons). My worry is that I would need to decrease training. I read LAE is treatable with medication. Is it possible for me to continue training/exercising whether or not I am placed on medication? I'm just beginning to feel really good with my exercise regimen and still need to lose 15 lbs. This is a huge concern as again, I would think I am healthier now than I've been in a while. Thank you for your response.",
    "doctor_response": "you have family history of irregular heartbeat means may be some accessory pathways may be there in your heart leading to irregular heartbeat and you check with other investigations and rule Out this condition and AF may be due to this reason or dilated cardio myopathy in ur family",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can infertility be treated?\n\nHi, my husband and I are trying to conceive. We have tracked my menstrual cycle and it varries lot 32-47 days. We used ovulation test sticks to identify ovulation but on the 6th day of positive results I got a heavy period that lasted about 3-4 days (normal 6 days). We want to use fertomed50 as prescribed by our gyne but we are confused as we dont know if I m already pregnant or just got a early period. Can I take the medz or should we wait and have more tests done?",
    "doctor_response": "Hi I think you should consult a doctor for complete evaluation. Get a thyroid profile and prolactin level done and also a ultrasound to see the uterus and ovaries to find out the cause of irregular periods. Get a semen analysis done for your husband. You can try ovulation induction with timed intercourse for conceiving. Talk to your doctor regarding this. Hope it helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever and fast breathing in a child?\n\nMy 8 month old has had a low grade fever all day today. We thought he was possibly teething. He now is asleep and looks to be breathing a little faster than normal. We checked his respirations and is between 60 and 64 for the past hour. Is this normal? We have been giving him motrin and Tylenol all day. Can that effect respiration?",
    "doctor_response": "Hi...fast breathing in kids of this age could be due to respiratory infection or due to high fever it self. But an 8 month old with a respiratory rate of 60-64 is not to be left with out medical attention. I suggest you you take him to a pediatrician right away.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive since long, advised HSG, ODOVA. History of ectopic pregnancy. Should we opt for HSG?\n\nme and wife age is 30 yrs. We have been trying since 2 yrs. Unfortunately (letroz (3rd to 7th day) + ) she got pregnant but ectopic case and need to be operated. Now Dr suggested to first go for HSG than start the same treatment as harmonal imbalace is there. Now she has suggested the ODOVA (Inductiona Ovulation ) from 3 to 7th day and 10 day follicular study and after that HUCOG 5000 double. Shall we go for HSG as my wife is bit tensed about this test due to pain ? An the process we are following is fine. She also has her cycle imbalance",
    "doctor_response": "Hi, She can definitely undergo HSG. Though HSG is little painful, pain can be by local anesthesia & painkiller. Continue the treatment advised by doctor. Its fine. Wish you good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for spotting during pregnancy\n\nHello Doctor, I am 6 week pregnant, 7 week is going on, my last period date is 16th Jan, I took hucog 5000 IU on 19 Feb & 2nd on 1st March, my doctor suggest me to take 4 injection and out of that i took 2 injection till now and I am taking these medicines ( Duphaston 10 mg daily 1 , Emfolic-dha daily 1, Ecosprin 75mg daily 1 for 1 month) which is sujested by my doctor, and today I got spot bleading one time in the evening, my doctor is not available so could you please sugest me what should I do... NIkita",
    "doctor_response": "hii..if you r having spotting then better to stop ecosprin for 2-3 days and then u can restart..continue to take other medications as advised",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lower back pain\n\nRespected,  I 22 y male. I am experiencing pain in lower back from past 7 month . MRI detected posterocentral bulge  in L5 and generalized bulge L4. there is no radiating pain to legs. I have taken physio therapy for 14 days last month. i have been doing all suggested exercise  daily twice.my question is will this pain reduce completely or i have bear this throughout my life time..   should i  resume my job (IT)  or  rest for some more time. i can hardly   sit for 45 min.",
    "doctor_response": "Hello, I have studied your case.Most probable reason for your symptoms could be postural problem as you may be sitting for long time and working on computer for long time.When such patient comes to my hospital we usually take x ray spine or if required MRI to see for any nerve compression.Medication like methylcobalamine with muscle relaxant and analgesic will reduce pain; you can take them consulting your treating doctor.Some exercises which can be done after pain has reduced include- Spine extension exercises, Lying on your stomach flat lift leg 6 inches from ground, do it for other leg.Now lift both hand and leg simultaneously, 6 inch off the ground and stayPosition for around 10 breathes. Core stabilizing spine exercises will help.Some life style modifications to prevent pain\u2013 Take break every 40 min from computer and do some lumbar rotation, stretches, walk and get back to work. Sit with taking support to your back, and do not watch television constantly.I will advise to check your vit B12 and vit D3 level.Pain will resolve if you continue spine exercises.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you find this answer helpful do not hesitate to rate this answer at end of discussion.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can strep B cause itching, constipation, abdominal pressure and stomach swelling?\n\nAbout 3 weeks ago, I treated myself for a yeast infection. After a few days the symptoms did not go away and I went to my primary care doctor. I was given diflucan and the doctor took a swab. About a week later, the doctor called and told me I had group B strep. I was then given Augmentin which after 5 doses I had to stop taking due to diarrhea and vomiting. I then was given Azithromycin. Now that I am done taking the Azithromycin, not only do I have hemorrhoids from the diarrhea, but the symptoms I originally had have returned. Can I possibly have group b strep again or was I mis-diagnosed the first time? My symptoms include itching, constipation and pressure on the left side of my abdomen with what feels like stomach swelling.",
    "doctor_response": "thanks for posting your query to HCM . clinical complaint as you mentioned itching , constipation etc are not caused by Strept gp B . this organism commonly responsible for causing throat/respiratory tract infection .these symptom could be due to derranged gut flora because of antibiotics . You can take probiotics and prebiotics to releive this  . thanks  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI of brain shows multiple small areas of restricted diffusion, lacunar gliotic focus at basal ganglia. Curable?\n\nWe have an MRI -Brain of my father which was performed using T1 weighted gradient echo, T2 weighted fast spin echo & fast FLAIR sequences. The report shows the following: 1) Multiple small areas of restricted diffusion seen in the bilateral cerebellar hemispheres, vermis and right lateral medulla. 2) Lacunar gliotic focus is seen in the left basal ganglia . Few Lacunar hyperintense foci are seen in the bilateral fronto parietal white matter on FLAIR images. what does it indicate? Is there a cure for this?? Nitin",
    "doctor_response": "Hi, Thank you for posting your query. Your father's MRI reports multiple areas of infarcts (lack of blood flow). Treatment requires use of blood thinners such as aspirin or clopidogrel. In addition, the risk factors for brain stroke such as BP, sugar, cholesterol and homocysteine should be identified and properly treated. With the above measures, we can treat him and prevent any major paralytic stroke. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Apollo Hospitals, Hyderabad",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does my ECG report suggest?\n\nHiMy mom age is 51.Her ECG results came, which was given as QRS(T) CONTOUR ABNORMALITY;CONSIDER ANTEROLATERAL MYOCARDIAL DAMAGE.Her readings where,Intervals:RR 559 msP 92 msPr 144 msQRS 76 msQT 350 msQTC 473 msAxisP 35 degQRS  -29 degT 4 deg.In the report its given as unconfirmed report. Please could anyone tell me what it is given?? Is my mom good?Please help me out.",
    "doctor_response": "Hi,  the ecg you Msgd is machine report ed so many a times its incorrect,  however considering her age and what you tell me I would suggest her to get a 2d echo,  if that normal go ahead with stress test.  It's because the ecg you send had prolonged pr,  not of much significance and anterolateral changes which means this regions of heart may have decreased blood supply.  Do mail ur ecg on Priyankmody86@gmail.com for more clarification.  Regards Dr priyank mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red lump on arm?\n\nHello, my girlfriend is 31 years old, 5 feet 6 inches, and 125 lbs.  She discovered a lump on her arm two days ago.  The lump is underneath her skin, toward the inner bicep and just above her elbow.  At first it was painful when pressed and has become more tender since.  Over the past two days it seems to have grown and is now about 1/3 the size of a golf ball.  It is red and does not move.  Any idea what this might be?  Thank you.",
    "doctor_response": "Hi,Dear,Good Evening from INDIA.Thanks for the query to HCM.I went through all the details of your query. on the details given by your query,In my opinion you suffer mostly from-though the information given in your query is less-on the facts there in-mostly you suffer from-lump with a bug bite mostly,as its red and non-movable.Treatment suggested would be-a-Tab NSAIDs x 5 days b-Cold compressesc-Tab Antihistaminic drugd-Antibiotics if need beconsult ER doctor for the script of drugs.Hope this would resolve your query.Welcome for any more query to HCM and ME,in this regard.Wishing you fast recovery.Write review ASAP with strong recommendations for HCM and for ME,for the benefit of other new and old patients.Have A Good Day.With Regards,Dr.Savaskar M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe hip pain\n\nI have a friend that lives in Boise Idaho and is 88 years old. she has a great deal of pain in her hip and back on one side. She doesn t have a primary care physician but needs to be diagnosed with an MRI to get help? Any recommendations for Doctor in Boise? Can she go directly to a pain management doctor and request MRI. Lynn Tackman YYYY@YYYY",
    "doctor_response": "Dear Sir/Madam,I thank you for having faith in Health Care magic and for seeking help on your issue; I have gone through your symptoms, and in my opinion, at her age the cause of pain could be either arthritis or she may have injured her neck, or AVN. to ascertain the diagnosis the first thing required is an X ray scanning of the hip joint, majority of diagnosis can be made by that , and treatment depends on the cause.I hope I have been able to provide you with a satisfactory solution, if you want to clear any doubts about my opinion, feel free to contact.Special note-  Any medication prescribed needs to be taken after consultation with your personal doctor only.ThanksDr. Narender Saini",
    "dialogue_context": ""
  },
  {
    "patient_message": "Ultrasound says. Pelvicaliectisia of right kidney. Ct scan done and no kidney stones stones. Reason?\n\nI had KUB Ultrasound and it says, the right kidney measures 9.8 x 4.2 x 5.9 cm and the left measures 9.7 x 4.4 x 4.2 with cortical thickness of 1.3 cm and 1.5 cm respectively. There is a dilatation of the right pelvocalyces. No visible mass or lithiasis. The impression is Pelvicaliectisia, right kidney. Then I had a Citi Stonogram but there's no kidney stone seen and the results are all normal. What could possibly be the reason of Pelvicaliectisia?",
    "doctor_response": "Hi and welcome to HCM. With the limited data you have given, Given that your CT scan is normal as well, I suspect it is just a normal variant and you do not have to worry if you are physically not ill and your kidney function tests (blood and urine) are normal. However depending on your symptoms, age, blood and urine tests results we may have to consider further investigations if any/ few of them are not right. I wouls have liked to rule out \"Vesico-Ureteric reflux' if you are young with history of recurrent unexplained fever or recurrent urinary infections. Hope this helps. BW. RB",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need treatment for back and body pain after lifting heavy objects\n\nMoved an office last Wednesday. Lifted multiple heavy objects. I usually sit behind a desk and do very little heavy labor. Woke up Thursday morning with an excruciating pain in my back behind my left shoulder blade. Pain has continued to worsen and now has moved around my rib cage and to my left breast/chest. Feels like I am being pierced thru the chest.",
    "doctor_response": "Hello, It is due to minor contusions after heavy physical exertion. Its quite common after strenuous activities and will settle with conservative measures. You can apply warm compresses and take analgesics like Ibuprofen or Diclofenac for symptomatic relief. If symptoms persist, you have to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does litium cure depression?\n\nI want to know if this litium would cure or help my depression,I have a doctor who has given me anti-depressants, but I guess I am getting too used to them . I saw this ad about  lithium carbonate, but I am 69 years old and a little scared to take it. I will ask my doctor next week, when I see him, if he thinks it will help. Isn't it a known fact that older people are in A group that really is in greater danger from dying frim it. I may be depressed but not ready to give up and die.",
    "doctor_response": "Hello sir As far as concern your question regarding use of Lithium in Depression, here i well tell you few things before we talk about the use of lithium in depression. See there many types of Depression in which two maine categoeries are unipolar and bipoalr depression. Lithium is second line treatment in management of bipolar depression one thing, another thing is Lithium is also a important drug in the treatment of Unipolar Depression as adjuent when the effect of primary antidepressant drug is satisfactory. When it comes to your fear about taking lithium, yes considering your age, you have to be very care full while taking lithium. It is must to know you the side effects of the lithium. If you face any gastrointestinal problem specially loose motion, immediately call to your doctor and avoid vigrous excercise it may lead to lithium toxicity. Thank you .....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have lower back problem, pain in left arm. Scheduled for surgery. Is this heart related problem?\n\nI have a lower back problem L3 L4, that is going to require surgery. I have stopped exercise for 45 days and lost lots of muscle tone. I have no other heart attack symptoms. I do have moderate to severe pain in my left arm around the bicep to the elbow. Pain goes away if laying down and arm on top of body. Heart related?????",
    "doctor_response": "Hello,The symptoms may not be related to heart problems. It is probably due to radiculopathy due to compression of the nerve roots at the spine. Lack of exercise as weaken your muscles.I would advise my patients to continue with back strengthening exercise. This will help in relief of the pain. Prescribe analgesic and vitamin supplements.Consult with your doctor if the symptoms does not improve.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Within how many hours one should take ipill to avoid pregnancy ?\n\ni had one ipill an hour after sex,am i safe plz help iam very scared hi, had sex 8 days after my periods and am scared of getting pregnant ,i took ipill after an hour of sex, am i safe,when will my periods occur again,is takin one ipill enough,i had sex on 14th june",
    "doctor_response": "Hi dear Welcome to HealthcareMagic. Taking ipill an hour after sex would definitely be efficient in achieving contraception.You would not be pregnant , but you can have menstrual irregularities like intermittent bleeding , delay of periods.Do not worry and it is better to avoid taking i pills frequently as they are high dosage hormones and can cause other health related complications. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated levels of SGOT and SGPT in blood in spite of medication?\n\nMy husband is hepatitis B carrier for the past one year.  He had a progression in SGOT and SGPT levels after taking Sebivo for the past one year.  The DNA level also came down from 7 IU to 1 IU.  But now this month, he checked for LFT and found elevated levels of SGOT and SGPT and we are awaiting results for DNA levels this week.  Could you guide me please.",
    "doctor_response": "HiThanks for your query.Based on your query my opinion is1. Raised SGOT and SGPT is indicative of liver pathology, in your husband's case, hepatitis. 2. Now that he is on treatment, the enzyme levels should have settled to normal. 3. Liver function would be better assessed by looking at other parameters like serum albumin and alkaline phosphatase levels along with DNA results.4. In the prevailing scenario, raised enzymes indicate continuing liver damage/ inflammation. Hope this helpsWish him good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stinging, increased sensitivity near anus after swimming with trunks. What could be the cause?\n\nTowards the back of my testicles, close to my anus , it stings and is sensitive. I don t know what I could ve possible done. Today I played basketball and felt fine, but after I went in the pool. About 20 minutes before I got out, my testicles started to ache. What do you think it could possibly be? Was it maybe that the net on my swim trunks were constantly rubbing on the balls?",
    "doctor_response": "Could be allergic reaction to chlorine and sweat in your anus. Use steroid cream and then see if the symptoms are better. Please rate 5 stars.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Calcified Granuloma\n\nHello, I have a 12 year old grandson that recently found a knot about the size of a half dollar near the left armpit on the upper area of his arm. He didn t realize it was there until his Mom ran her hand down his arm and noticed it. It doesn t hurt unless messed with but we had an US done and the diagnosis was Calcified Granuloma .How is this treated and do we need to see a surgeon?",
    "doctor_response": "Hi,Thank you for asking question on health care magic.The calcified granuloma is harmless.If you desire you may consult surgeon for excission for cosmetic purposes.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause a hardened skin over muscles near the tip of the backbone?\n\nyesterday I had hardened skin over muscles where the backbone ends (gluteus maximus muscles I guess) in my buttocks. No pain, not really itchy. For the previous 1-2 days I ate a lot of pastries with wallnuts and sugar in it. I also have some kind of arthristis in my joints (a rheumatologist from Istanbul is trying to diagnose at the moment - she says it may be spondillitis). Back to my hardened skin, I took a claritine (10 mg) last night and it looks like it is almost totally gone. Why did that happen? It was first time in my life.",
    "doctor_response": "Hi Hope this message finds you in good health.Such kind of hardened skin occurs due to paraspinal muscle spasm.Due to inflammation,the skeletal muscles under the skin go into spasm and become stiff.This occurs if you have underlying lumbar spondylitis.Get a MRI of the back bone done to diagnose.Taking muscle relaxant tablets will help.Hope your query has been answeredGet back to me for any doubts that you may have.Kind Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is this normal to have cold and cough with herpes?\n\ni have had a cough for 5wks now at first i felt like i had cold in my chest but now it's just a dry cough that want stop the doctor did have me on cough medicine but the cough came back  i also have herpes is this normal to have these syptoms with herpes?",
    "doctor_response": "Hello dear user!I have gone through your query and understood your concerns!Thank you for sharing them on healthcaremagic.Herpes (simplex), is a virus that generally \"wakes up\" when some other diseases are going through. So every time when people have a condition which decreases their immunity, herpes is possible. In your case, you have had for 5 weeks a cough (and possibly cold) that may be caused by any infection of your upper or lower respiratory tract. Such time is enough for the body to have a lower immunity and other opportunist infections. I would recommend you to see your doctor again after completing the cure he has prescribed you to see if the infection is cleared. Keep your body well hydrated with plenty of liquids, take vitamins in your diet.For localized herpes you can use topical creams of Acyclovir or tablets if the herpes is spread.I hope this answer was helpful to you!Please kindly rate it as helpful and write a short review about your experience with me! I would appreciate that a lot.Thank you and best regards!DR ERIOL.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for palpitation, insomnia and lightheadedness\n\nI took naddol (40mg) daily for years for rapid heart rate and hypertension. My insurance company put this drug in a different tier and suggested i take pindolol. My Dr. wrote a prescription for 10 mg twice a day. I am now up to 15 mg twice a day. My blood pressure is OK but my pulse is rapid -- about 90 rpm. I also feel nervous light- hreaded and have trouble sleeping. Should i switch back to nadolol?",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!I passed carefully through your question and would explain that your symptoms could be related to pindolol adverse effects. Nadolol has a longer half life and can be tolerated better compared to pindolol. Coming to this point, I would first recommend raising the dose of pindolol up to 30mg daily. If this doesn't help, I would recommend discussing with your doctor on the possibility to switch to nadolol again. Hope to have been helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in legs,arms and fingers?\n\nMy 15 yr old daughter has woke up the past two days complaining that her legs, arms, chest, fingers, and hands are very sore. She can barely walk. She has been working out everyday this summer so its not from starting a new workout regimin..she is very athletic and always active. Any ideas what this could be??",
    "doctor_response": "Hi, As what I understand with the mentioned history is that your daughter has pains in multiple joints. is the pain shifting from one location to another or it is present in almost all joints? There are two possible things which comes in my mind. (1) This could be a vitamin deficiency or (2) RA. Now I don't want to come to a conclusion with just a brief history and make you panic. I know it's too early to give a conclusion on any of the two. Until we get some urine and blood routine we cannot be giving comment and making you panic. Meeting up a orthopedist should be good to have physically examined first. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have cough for more than a week. Am I suffering from heart problem?\n\nHi doctor,I am having a cough for more than a week. It is like a\u00a0chesty cough, but little dry cough and I have some problem in my\u00a0throat.\u00a0My age is 42 and weight is 95.",
    "doctor_response": "Hi. I appreciate the genuine concerns regarding your health. I have carefully worked through your case and I can realize your health worries. There is nothing to worry about your heart. It is due to infection of the respiratory tract. I suggest the following medicine. Consult your doctor, discuss with him or her and take the medicine with consent. 1. Fexofenadine 120 mg once at night. 2. Ibuprofen oral three times a day. 3. Azithromycin 400 mg once a day for five days only. 4. Dry cough syrup two tablespoons thrice a day. For further information consult a cardiologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain on the tendon next to the shin\n\nYes I have been having bad pain in the tendon next to the left shin bone for about 5 years. I went through physical therapy and everything else. I finally got an MRI and there is a cist in the anterior tibulis. My doctor told me to ice it and in a few weeks if it doesnt get better he would set me up with a surgeon. What do you think",
    "doctor_response": "Hello, There is nothing much to worry and there is only some soft tissue involvement. You can apply icepacks for faster recovery. No vigorous treatment is required. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is abnormal ESR level the cause of pain in chest?\n\nHi. I  am 21 years old and i am having pain at the left side below the chest. I consulted a doctor and he told me some test to be done. And in the reports everything is normal but ESR is 24mm but normal rate should be 0-5mm it seems. So, is there any problem in that ad why am i getting pain ?",
    "doctor_response": "Hello. The ESR is a test that detects inflammation in any part of the body. It is a non-specific test, not diagnostic for a disease, and more tests are usually done to ascertain the specific cause.I'm unaware of what other tests you have undergone, but if your doctor says everything is fine, a trial of anti-inflammatory medicines maybe all that is required.Kindly discuss with your doctor for the same if pain doesn't subside/ worsens, for further workup.Hope this helps. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my infant passing stools drop by drop?\n\n20 months old baby is not passing Stools properly.Passing stools drop by drop whole day.we have used dulcolex suppostiries last week that time stools passed fine, after that again the problem started yesterday we have used dulcolex but no use..he is passing drop by drop.Today also the same till now stools passed 15 times drop by drop.Past three weeks only he is having this problem.Kinldy advise on this.",
    "doctor_response": "Hi, It is due to the feeding habits of your child that affect the stool pass and constancy, so return back to the food you were giving him. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does an Angioplasty helps to repair damaged heart muscle?\n\nhi. my husband has damaged heart muscle fro mwhat we think was undiagnosed heart attack years ago. he is on several meds: toprol, lisenoprel, coreg and newest niasen (sp)..he has been complaining of chest tightness at times, went to see his cardio guy. did stress test came back abnormal at \"tip\" of heart. he wants to do an angio. he had one and a stress test 2 years back and they were normal. at this point in time, is it worth a 2nd opinion or shoudl he go ahead with angio. dr told him 1 in 1000 patients dont survive?? seems high to me and i am scared for him",
    "doctor_response": "Hi,Positive stress test means their is possible blocked artery in the heart and the heart muscles are viable. If he has a heart dysfunction also so i recommend you to go ahead with the angiography as after opening it heart muscle may recover. Risks in angioplasty includes bleeding because during and after angioplasty we give blood thinners. This risk is also very low & very rarely is life threatening. Medicines along with opening of blocked artery will result in recovery of heart muscles gradually. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sameer Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment to get rid of masturbation?\n\nHi, may I answer your health queries right now ?  Please type your query here...i'm  26 and i was doing masterbuting when i was 13 . I have tried a lot to stop it , i also take antidepresants but all in vain . So that i wana to know  the way i can control it.",
    "doctor_response": "Hi, Masturbation is normal, it\u2019s just another way of having sex without a partner. It\u2019s a good practice, helps to calm your mind and release happy and stress-busting enzymes. Having 2 to 3 times a week is not an issue, more than that is also not an issue , but needs adequate nutrition and exercise which will be difficult to fulfil unless you are a professional. Ways to reduce Masturbation 1.\u00a0\u00a0\u00a0\u00a0\u00a0Sex education 2.\u00a0\u00a0\u00a0\u00a0\u00a0Physical exercises 3.\u00a0\u00a0\u00a0\u00a0\u00a0Sleep adjustment 4.\u00a0\u00a0\u00a0\u00a0\u00a0Quality of sleep 5.\u00a0\u00a0\u00a0\u00a0\u00a0Healthy and balanced diet 6.\u00a0\u00a0\u00a0\u00a0\u00a0Programming for leisure time 7.\u00a0\u00a0\u00a0\u00a0\u00a0Development of spirituality 8.\u00a0\u00a0\u00a0\u00a0\u00a0Taking a cold bath. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Ultrasound showed fat infiltration. Alright to drink occasionally after liver enzymes become normal?\n\nI am a 53 year old female, weight 146-height 5 4 . I recently had an ultra sound because of elevated liver enzymes . There was some fat infaltration. One month after the ultra sound my liver enzymes were AST-29, ALT-57. I was told to continue to abstain from drinking alcohol for a total of three months and have my enzymes checked again. I had been drinking 3 to 4 glasses of wine a night for many years because I have high cholesterol and thought this would help with the cholesterol. If my liver enzymes return to a normal range is it all right to have an occasional glass of wine?",
    "doctor_response": "Hello madam, I have gone through your problem. You said that you are drinking wine for many years and had fatty infiltration of the liver along with raised liver enzymes. Fatty infiltration of the liver is seen in obese patients and patients who take alcohol. You also had raised liver enzymes which shows that you had alcoholic hepatitis. Now your liver enzymes had returned to normal, but still there is a chance for you to have hepatitis (raised liver enzymes) in future if you take alcohol. My advice is to abstain from drinking alcohol and consult your physician for your high cholesterol. There are cholesterol lowering drugs with which you can maintain your body cholesterol at a low level. good luck to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tripping feeling after watching a bright colored fairy batting wings on TV. Help\n\nHey, please help no one knows the answer to this, but i was laying in bed watching TV when a scene came on with a bright colored fairy/pixie batting its wings very fast and it didnt send me into an epileptic seizure or anything i dont think but i literally started \"tripping\" as you would on acid though I was completely sober. Help is appreciated, Thank you.",
    "doctor_response": "Hi there ~I understand your concern, however I wonder if you have been taking any drugs lately or have recently quit substances.  Withdrawals can sometimes make you see things that are not there - visual hallucinations.  Also your electrolytes may be the reason you are having these problems.  A visit to a psychiatrist should help clear your problems.  I hope you do so as soon as you can.  Take care and have a lovely day!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pimple like rashes and itching on the waist\n\nI have small pimple like rashes on the side of waist which are itchy from time to time. After itching over and over, the pimples turn into rashes. The rashes then become dark patches and itchy. Initially, I get 5 to 10 very small pimples which then trun into rashes.",
    "doctor_response": "Hello,Thank you for posting on HCM.It seems you are suffering from Tinea cruris and corporis, a kind of fungal infection.I would suggest you to consult your dermatologist for proper management of the condition.I usually recommend proper course of oral anti-fungal drugs like Fluconazole or Itraconazole along with anti-fungal cream like luliconazole for local application at bedtime. You can additionally use antifungal dusting powder containing sertaconazole during day time and a soap containing ketoconazole for rinsing of affected areas. Take oral antihistaminics for itching as required.Maintain hygiene over those areas and avoid wearing tight undergarments.Hope your queries are resolved and wish you best of health.Kindly spare some time to rate my answer and drop your valuable review at the following link:  you require any further assistance in future, you can reach me directly through the above mentioned link.Thank youDr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Semen test shows 20% motility, adviced Hcg injections. Has bilateral varicocels. Treatment ?\n\nhai sir ,  in april my husband did semen test  . that one is colour : opaque gray , liquification time : 40 minites reaction : alkaline, t total count  : 5.6 millions , MOTILITY    Active 20%, moderate 35% Sluggish 15% ,nonmotile: 30% so Dr. adviced to take inj. HCG 5000iu  (8 doses)the last report is viscosity :viscous, appearence : gray opalescent , ph: 8 , liquification time >120 mintes , sperm count 62millions , motility:grade a 40%, grade b 30% grade c 10%, grade d 20% abnormal forms 15%  and my husband have bilateral varicocelswhat are treatments for this condition any type of food control to improve the lquification time",
    "doctor_response": "Hello and welcome to HCM,In a healthy semen, the active sperm motility should be atleast 50 %.Active motility less than 50% can lead to infertility.Varicocele is a condition wherein there is collection of fluid in the outer coverings of the testis. The patho-physiology of varicocele is an abnormal communication between abdominal sac and the sac formed between the testicular coverings.This accumulation of fluid may interfere with sperm functions like number, motility and morphology.The abnormal communication has to be repaired to prevent the accumulation of fluid.Correction of this abnormalty can improve the sperm motility.Consult your surgeon.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does fever with white  splotches on tongue indicate?\n\nMy 2 year old has had a slight fever (99-100ish) for about 5 days. Then today she had white splotches show up on her tongue. She has been pretty normal except in the morning and evening she has been a little extra sluggish, but not too bad. Any ideas?",
    "doctor_response": "Hi welcome to healthcare magic,I understand your query and concern.Your symptoms are suggestive of Acute bacterial infectioln.I advise to give him Syrup.orni o,tab.domistol for 5 days.Avoid spicy foods.Give ORS sachets,buttermilk,coconut water regularly.Maintain adequate hygeine.Consult your peadiatrician for expert management.Hope I have answered your query at the moment,Post your further queries if any,Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe mood swings with a feeling of sadness, hopelessness, irritability, physical and mental sluggish, sleeping trouble, low concentration. Medicines to overcome this?\n\nHi dr. I have a severe mood swings. i am not experiencing Delusions nor hallucinations but most of the time im feeling hopeless, sad, or empty, Irritable, Physical and mental sluggish, Sleep problems, Concentration and memory problems, Feelings of worthlessness or guilt. Please help me and What are/is the best medication for this mood changes.",
    "doctor_response": "Dear Madam/Sir Your symptoms are compatible with that of depression if it is persistent and pervasive for weeks together and require medication(Antidepressant). Best medication for this can only be decided after detail symptom profile and severity, family history, your age and gender, occupation, support  etc. Please consult qualified psychiatrist and take treatment immediately. Hope you will recover soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain. MRI shows mild disc bulge. Suggestions?\n\nI have lower back pain and it is so bad sometimes that its hard to get up from a chair or walk. It feels like something is moving out of place in my back. Some days are not as bad as others but it is getting worse and my back hurts 24/7. What could it be. I have had an MRI and it showed bulging disk but not bad enough to have surgery but the pain is so bad its feels like a knife is twisting in my back.I'm going for another MRI next week. My last one was Aug. of 2012 but it has gotten worse.",
    "doctor_response": "Hi,It seems that you might be having osteoartheritis changes in your lumbo-sacral spines giving rise to irritation and pressure on nerves giving rise to this type of pain.Go for physiotherapy, it will give good relief.Go for back extension exercise.Sleep on hard bed.Avoid forward bending movements and lifting weight.Take calcium, vitamin A and D supplements.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause of chest pain while breathing?\n\nevery time I breathe in I get chest pain, it feels like a boulder is sitting on my lungs its very difficult to breathe, i have to breathe in very deeply to feel like ive got enough air in my lungs, but it doesn t help with the chill feeling boulder on my lungs, queries?",
    "doctor_response": "Thanks for your question on HCM. In my opinion you should first consult pulmonologist and get done PFT ( Pulmonary Function Test ) and chest x ray. Chest pain on breathing and urge to take deep breath can be seen in1. Bronchitis2. PneumoniaSo PFT is needed to rule out bronchitis. Chest x ray is needed to rule out pneumonia. If both are normal than no need to worry much.  It may be due to anxiety or due to muscular pain.So avoid stress and anxiety and take good painkiller and muscle relaxant.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes head ache and pain in chest region?\n\nHi I am 21 years old. I have been experiencing a slight pain in my head all night that has now travelled through out my body. It's like a tingling sensation but when I try to rest or sleep it gets worse & my chest will start to hurt ( my heart area ) It's getting really uncomfortable and I don't know what to do. I have a cold but I've never experienced anything like this before. I was thinking of going to the emergency department because it's getting that bad for me to deal with. Any help would be great thanks",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, possibility of stress and anxiety related symptoms is more. But better to rule out hypertension and heart diseases because headache and chest pain are common symptoms of these diseases. So get done ecg and 2d echo. If both are normal then no need to worry for heart diseases. Uncontrolled stress and anxiety can also cause similar symptoms. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on it's solution. You may need anxiolytic drugs too. Don't worry, you will be alright. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump under the eye after injury\n\nI had a black eye a month ago after being elbowed in it while playing sports, the bruising has nearly gone but I have a lumpunder my eye near my cheek bone. It is not really painful except from if I move my face to much. I don t know what it is but I really want to get rid of it. What should I do ?",
    "doctor_response": "Hi,From history it seems that this might be due to hematoma formed after injury and now it is localized and encapsulated.nothing to worry, gradually it will be absorbed.Apply ice pack 2-3 times a day for few days.Apply thrombophob cream locally.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can itchy, rashes on face be caused by using derma roller?\n\nHi my name is Jeanette I used a home dermaroller in Thursday night ( this was  the third time I had done this) when I woke on Friday I had a rash like bumps on my face it's a little itchy  it Sunday today and it's still there not as bad however  should I discontinue use every again? Does this sound like an infection",
    "doctor_response": "Hi. Thanks for posting your concern at HCM.Seems that you might have done it a bit more aggressively this time which might have caused this rash. It can sometimes happen if it is done with excess pressure OR if the needle size is increased. No, it does'nt seem like an infection.If i was your treating doctor i would have asked you to apply a soothing lotion OR moisturizer twice daily for 2-3 days to make it fine.An oral antihistamine like cetrizine once daily will control the itching part.take careregards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Would excessive masturbation during childhood lead to erectile dysfunction in an adult?\n\nDear Dr. I am 41 year (male) my problem from last few weeks I have problem of erection while I am with sex. I mate Ayurveda doctor he told me that due to heavy mustervation in child days this problem arose. I am unable sex at all. please help me to protect my conjugal life",
    "doctor_response": "Hi welcome to the health care magic First of all search for following causes of erectile dysfunction... -Smoking,  alcohol history,  as they should be avoided -Diabetes by RBS -prostate problem by USG and PR examination -Hypertension -Obesity by measuring your BMI-thiazide diuretic like drug history -Depression etc... Sometime cardiac problem might be the cause for which EKG done According to cause further specific treatment can be given Sildenafil like PDE 5 inhibitor will be beneficial that is taken before sex Consult physician or psychologist for examination and further work up Hope this will help you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does finger stick test for kidney function yield accurate results?\n\nI had a test for my kidney function that was done from a finger stick. From the finger stick the results showed a creatinine within normal limits and a GFR that was low (57). Can the test be accurate with only a finger stick? My physician always does the four different vials of blood.",
    "doctor_response": "Hello and welcome to HCM.As an Urologist, i can understand your anxiety.Tests for kidney function are: urea,creatinine,and GFR estimation.This is done in a standard lab,with a blood sample taken from a vein.A finger stick report isn't accepted by any Urologist, or in any hospital.It's highly inaccurate and unreliable.Hope your doubts are cleared.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and elevated SGPT/SGOT levels in blood\n\nHi, My Father is suffering from Fever since last 10-15 days. 5 days ago, the fever increased and blood report showed increased SGPT and SGOT. The chest X-ray and sonography were normal. The doctors started giving anti-biaotic injections thrice a day and a dolo 650 tablet if fever above 100F . But the fever is coming back and is upto 101F once after 6- hours. Please suggest further investigations .",
    "doctor_response": "please do tests for leptospirosis and tuberculosis. In leptospirosis( spread by rat s urine), the liver enzymes are elevated but bilirubin does not rise till much later. TB can also cause raised liver enzymes due to granulomatous hepatitis. there are other sinister causes lymphoma which can be diagnosed by a bone marrow biopsy if the above 2 diagnosis are ruled out.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need treatment for crossdressing\n\nI am a 50year old crossdresser and I have just told my gp that I would like breasts and hormones I have had depression most of my life and am only happy when I dress but she does not know what to think and has said she will think about it and let me know by letter is this normal practice because I cannot wait to be the real me I have spent thousands on pils and creams off the net and nothing works that s why I told my gp",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.Psychodynamic psychotherapy focussing on your early life can help in dealing with your cross dressing. 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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful lump inside vagina\n\nI have a painful lump on the inside lip of my vagina. It s kind of squishy. I shaved the day before it appeared. I ve had one in the same place before but it went away so I just thought it was an ingrown hair. It s only painful when it s touched. Should I be worried or will it just go away like it did before?",
    "doctor_response": "Hi,It seems that due to shaving there might be having some minor cut on the part giving rise to some infection over the part.Apply antibiotic cream.If pain and swelling increases, go for one course of oral antibiotic medicine.Keep local hygiene proper.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is HHZole cream safe if it comes in contact with glans?\n\nI am 23 years old and I have a steady girlfriend since the last 2 years and we have been having regularly having sex. But since the last three months i have noticed that my foreskin has thickened causing the opening end of the foreskin to shrink in size. Because of this, I am not able to pull my foreskin back. So when I have intercourse i usually get a minute cut in the inside of my foreskin which causes pain. I met a couple of doctors, one of them ( a surgeon) said that Il need circumcision. but a dermatologist said that I can use HHZole cream on the thickened part of the foreskin. My question is that the thickened part is situated in the inside of the foreskin so to apply the ointment i have to roll the skin back as much as i can. And after I am done applying, I roll it down to its normal position (over the glans) which causes the cream to come in contact with my glans.Is the cream unsafe for glans? because the cream is said to be used for external use only.",
    "doctor_response": "HiYes you can use it on the glans penis it will not have any dangerous effect on glansBut due to inflammation of foreskin you might suffer from phimosis that is the inability of foreskin to retract over the glans leading to pain in glans penis.I actualy agree with your surgeon you should get circumscion done otherwise you will get this issue again and again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump on the front tooth?\n\nHad a lump above my froont tooth for ages like a good 5 to 6 months hurt when applied preasure but bar that it didnt bother me. In the past 12 hours its doubled in size and length and i now have sweeling to the face right by my nose and under my eye. Its very painful and ive had the lump since not long after having a filling in that tooth. Cant get in dentist till 28th as its christmas. Any ideas how i can keep the swelling down and pain away intill then. Any idea what it could be xx",
    "doctor_response": "Hi..Thanks for the query..As per your complain it seems like there is formation of dental abscess due to deep Infection in tooth leading to accumulation of pus below the root tips of the tooth causing swelling and pain..At times the pus perforates the bone and gets accumulated under the soft tissues leading to swollen lump and when the inflammation and infection increases there can be swelling over the face/ cheek in the area adjacent to the infected tooth..It should be confirmed by getting an x ray of the tooth done under supervision of an Endodontist....In case if it is an abscess and tooth is in a condition to be saved then Root Canal Treatment of tooth followed by antibiotics and painkillers will help..In case of deep decay  extraction of tooth will help in complete resolution..As of now consult an Emergency room and get evaluated and a prescription of antibiotics like Augmentin and anti-inflammatory painkillers like Ibuprofen along with Serratiopeptidases will help in reducing pain and swelling..Do cool compresses over the swelling..Hope this helps..Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching of the breasts?\n\nI have an itchy sensation starting from the right side of my left breast spanning across my chest underneath my right breast. first starting feeling itchy about a week ago. At first it was red and looked like a rash, now the rash is barely noticeable but still itchy. any thoughts as to what thi sis?",
    "doctor_response": "Hi,    I have read your query & understood your concern.    The itchy rash under breast is common in fat,diabetic,pendulous  large breasts.    In such conditions, there is lot of sweating,the moistness helps breeding of bacterias/ fungi ,thus a skin infections develops & itching increases.     simple sweating can produce prickly heat rash ( Cleanliness+coolness+ talcum powder help.     Fungus infection needs to be diagnosed by skin specialists & treatment accordingly. Allergy to material of under garments- stop use of the allergen/ use cotton garments. Bacterial rash has pus filled tubercles-need antibiotic .   Please consult a skin specialist for diagnosis & advice.   Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes decrease in the blood levels while on Warfarin?\n\nI have been taking warfrarin for more than eight years ,  I have been checking  the level every month . the last eight month it has been up and down 2.5 is good to 1.8 now it is 1.6 to 1.4 I  was having it check every two weeks now but today it drop to 1.4 NO BLOOD IN  MY URINE OR STOOL IAM 68 YEARS OLD BLK FEMALE",
    "doctor_response": "Hello,The use of Warfarin is associated with increased risk for bleeding. INR is the blood test recommended to evaluate this risk.As it has been getting reduced recently, changes in the dose of Warfarin should be made. Discuss this further with your doctor who prescribed Warfarin.Other alternatives can be considered including Rivaroxaban (anti-coagulant).Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Albana Sejdini",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I having thick white and greenish vaginal discharge with itching?\n\nHello doctor, I think I might have an yeast infection, I have thick white discharge, itching, and today the discharge is a little greenish. What should I do?",
    "doctor_response": "Hi, Welcome to iclinq.com.  If its appearance is like curd, then probably it is yeast and you can take a single dose of tablet Canestein 150 mg to treat it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "89 yr old, having blackouts. Xray shows small vessel ischemic change associated cerebral volume loss. Suggestions?\n\nHi my mum has small vessel ischaemic change associated cerebral volume loss and there is a focus of hypodensity extedning to the posterior frontal lobe cortex on the right suggestive of a very monor small infartc. and absent left P1 segment fetal supply of the left PCA from the left PCA but xray shows no mass or haemorrhage or collection or and no raised intracranial pressure written on xray. Can you please explain all this as my elderly mum is nearly 89 yo and the gp will see her tomorrow because she was having blackouts. Thank you",
    "doctor_response": "I think the  x-ray mentioned by you is actually CT scan or MRI of brain and it suggest old ischemic changs of brain. She might be having fresh episode of infatct in the brain which is showing us as blackouts at present You must show her to GP soon and give 150 mg of tablet Asprin immediatly",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for lack of appetite\n\nMy 6 month old daughter do not have syfficient food and every after 2 hrs she start crying. We feed her forcebily becouse She do not take any food and after feeding her see play or sleep.she take only banana but we affraid giving her too much banana.What is the solution?",
    "doctor_response": "Hello, The most important thing to know in this situation is what is her weight? If she is growing well, then she is getting enough food, even if it doesn't seem like it to you. At 6 months, she may still prefer formula or breast milk to solid foods. She will also have growth spurts and growth slow downs that might change her appetite and cause her to have days of eating more or less. Please get her weight and see if it is OK in comparison to her last check. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Lisa Baker, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of excessive masturbation?\n\nHi i am 29. I am badly involved in masturbation . Every day i make promise with self not to do it again,but can't help it. I masturbate 2-4 times in a day. Please help me out. I want to get rid of that.2. I am fat also. I want to reduce my fats. I joined gym but i feel tireness in my legs because of which i couldn't continue . I have acidity problem as well. Please help me in both the cases.",
    "doctor_response": "HelloThanks for query.You have been indulged in frequent masturbation 2-4 times in a day.Though it is harmless, excessive and frequent habitual masturbation does affect quality of erection and delays ejaculation.Please try to reduce the frequency of masturbation by keeping yourself busy in activities like sports,reading ,social work etc so that you will not get free time to masturbate.For acidity problem You can take H2 receptor antagonist like Pantoprazole twice daily Avoid spicy and junk food and include curd,milk in your diet..Taking small frequent meals at regular interval of 4 hours instead  of having 2 full meals will help to resolve the problem of acidity.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rhino viral infection\n\nMy son was diagnosed with rhino virus Tuesday and his pediatrician said moisture suckage and benadryl...If symptoms get worse or fever goes above 100.1 bring him back...he s coughing more and I have noticed him taking alot of deep breaths n the raspy sound in his breathing seems to be worse...should I take him back to doc or wait another day with benadryl???",
    "doctor_response": "Most of the cold in children is caused due to certain viruses including rhinovirus. Viral infections do not respond to antibiotics and resolve on their own in 5-10 days. The treatment is supportive. Rather than benadryl, I would suggest giving the child some antiallergic syrup like levocetirizine. Also give him steam inhalation. Water in the form of vapour will reach deep into the lungs and help in diluting the cough and give him relief. Paracetamol can be given for fever if present alongside. You can wait for a few days and see.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome the pain caused by a misplaced wisdom tooth?\n\nrespected sir ,my wisdom tooth is producing not in correct place doctor suggest me to remove it. i m suffering from throbbing in my head and ears , and too much heaviness in my head also. so is this because of wisdom teeth or is there any another problem..",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,  I have gone through your query, as you have misplaced wisdom tooth dont worry , Yes this Impacted tooth causes pain in head and ear . You Should consult Dentist and go for removal of wisdom tooth this will give you relief .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am getting clots but no periods after using abortion kit. Is this normal?\n\nHello doctor, Today I got clot after using abortion kit, but no periods. Before going to the doctor, I got two days period in that also I got clots. I am unable to understand my situation. Please help.",
    "doctor_response": "Hello. Following the intake of proper dosage of abortion kit, complete abortion occurs in more than 95 % of cases. Bleeding following consumption of abortion kit is variable, sometimes heavy with passages of clots, tissues sometimes it may be like menstrual bleeding. The bleeding may persist up to two weeks. You must get a USG lower abdomen done to exclude any retained pregnancy of conception.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I got flu-like symptoms for two months in a row. What to do?\n\nHello doctor, I am a 20 year\u00a0old male, who weighs 175 lbs and I am 5.11 feet tall. I had flu-like symptoms\u00a0last month, which lasted for about three days. And I just had flu-like symptoms again this month. It started three days back, and it is not as severe as the first time. First time I had a fever, chills, headaches, pain and sore throat. The symptoms this month started with a sore throat, then I got a fever of 101 F, followed by a\u00a0headache and back pain.",
    "doctor_response": "Hello. I have gone through your query, and I can understand your concerns. The symptoms you have mentioned are suggestive of pharyngitis (a sore throat) along with a common cold. You do not need to worry regarding this as it is highly curable and complications are rare. I suggest you consult a general practitioner and get the following things done. For more information consult a general practitioner online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for severe pain and heaviness in the occipital region ?\n\nhi,sir i feel sever pain in my occipital region,n also heaviness in this region while studying.whats d problem ?",
    "doctor_response": "The headache and heaviness aggravated by studying can be due many reasons. Assuming that you are a student, it is unlikely that you have a refractory error (near vision problems are usually seen in middle age). Association with studies almost rules out other causes like sinusitis and migraine. When mind is forced to do what it does not like, it will react in such a way that you have difficulty doing it. Headache, decreased concentration and forgetfulness are some of the problems commonly seen in students. High expectation from self and others only add to the burden. Following points may help you overcome this problem: 1. Take frequent breaks in between study sessions 2. Make the Studying process interesting (like group discussion, audio-visual aids etc) 3. Take help for difficult subjects(coaching/tuitions) 4. Plan well to manage time. Remember, \"Failing to plan is planning to fail\"",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of potential pregnancy?\n\nHiToday is the 8th day after taking 2 ipills together. I hav experienced spotting today only for few hour, the blood is abit darker than usual period. I have also being feelin dizzy past 2 days. Could you please tell me if i am pregnant or is this implantation bleeding or is the side effect of ipill. Please reply as early as you can",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the spotting might be sideeffect of ipill.The ipill is 95% effective if taken within 72 hours of unprotected intercourse.If you had taken within stipulated time the chances of pregnancy are less.The ipill causes hormonal imbalance leading to irregular bleeding spotting and the period might come early or late.So the spotting might be mostly the ipill sideeffect.The implantation bleeding usually presents as spotting around the date of expected period.The first sign of pregnancy is missed period.And all the symptoms of pregnancy like nausea,vomitings,increased urination,sore breasts start 2 weeks after missed period.Dont worry.Avoid stress.Wait and check for the period.As you have taken 2 ipills there is chance of more hormonal imbalance as compared to single ipill.So there might be more chances for irregularity in periods.Overall the chances of pregnancy are rare.I suggest you to restrict ipill for real emergency situations and not to use frequently to avoid complications.Hope this helps.Best regards...Dr .Srilatha",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower back pain\n\nSince I was 11 yrs old  occasionally I have had pain in lower back with movement of right leg. So severe it felt like one more step and my hip would fall out. I am now 42 yrs old right tail bone pain and right leg pain and pressure is every daY, all day, 3 weeks now doc wont prescribe pain management othetr than advil... i cannot walk, sit, lay or put any weight on entire right side",
    "doctor_response": "Hi,Looking to the history it seems that there might be having some problem with coccyx bone and sacral vertebrae like sacralisation of lumbar vertebrae.Go for x-ray lumbo-sacral region AP and Lateral view.Consult orthopedic surgeon and get examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in stomach/waist/leg of a child?\n\nmy 4 yrs old daughter is continuously telling me that she is having pain..but sometimes she is showing her stomach..sometimes waist..sometimes leg...and when she is having pain...she cries..but it stays for few secs..i really don t understand what s wrong with her.today morning she passed the motion and it was ok.will u please tell me...why these things happening?",
    "doctor_response": "Hi.... all this non specific pain symptoms could be because of a viral illness which she is experiencing.I will tell you how a viral illness behaves so that you can be more confident.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.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Effects of EDH\n\nmy sister fell down from stairs and she was fine. after some two hours she started vomiting and was bit little drowsy, we went to our physician and he advised CAT scan of brain. it said EDH and my sister became more and more drowsy. we were asked to go to neuro center where they said its life threatening and needs an emergency surgery. they did and after 2 days my sister was discharged. is EDH so dangerous",
    "doctor_response": "it is the injury that is dangerous a simple fall also can cause this. you need to be very careful about this as it will bleed inside it is not visible also. only CT scan of brain can find it so you need to get the CT scan of brain as soon as possible and consult neurosurgeon immediately",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does lutera posses any side effect?\n\nI was wondering if lutera the birth control could develop side affects after over. Month of not takin it my period went back to normal imeditally no side affects were there when I quit it, but now I think I may be pregnant all the symptoms are there but I don t know if it might just be from quitting the birth control though there have been no side affects in the past.",
    "doctor_response": "Hello,Lutera is a safe drug and does not cause any side effects. Nothing much to worry and your treatment is in the right track. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful lump on inner thigh\n\nI am a 22 yr old female.  I found a lump on my inner thigh when I was about 17.  I got it looked at and everything came back fine.  Back then it was soft and about the size of a small golf ball but smaller.  Back then there was no pain associated with it, and I only felt it when I was looking for it. Now it is bigger between the size of a tennis ball and golf ball.  When I sit I can feel it and it causes pain.  Sometimes it hurts all the time and other times its as if it isnt there.  It has gotten a little harder but still is a little bit on the soft side.  More recently with the pain I feel sick to my stomach all the time, never actually getting physically ill though.   I dont have insurance and dont know what to do...  any ideas on things I can look into further myself? Thank you for your time.",
    "doctor_response": "Welcome to health care magic. 1.Lump inner thigh, possibile causes could be enlarged lymph nodes.2.Lymph nodes are enlarged in presence of any infection / inflammation, it can be localised or systemic, and also lymph nodal pathology itself also.3.I can understand about insurance status but a minimal investigations are necessary.4.An ultrasound scan of the lump will give details about the nature of the lump its source and extensions. If required an FNAC - fine needle aspiration cytology would help to know the cell type.5.Fnally depending on the findings treatment will be proceed, Any illness you feel of please get it treated as it can be cause. Do not disturb the lesion - as you can complicate. Good luck.Hope i have answered your query.Any thing to ask do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic constipation and chest pain\n\nmy daughter is 12 suffering from chronic constipation chest pains facial swelling and occasionally spits blood and her doctor has no idea what the problem is oh and i cant forget the varices in her throat that was discovered  when she was scoped three weeks ago",
    "doctor_response": "Respected user , HiThanks for using Healthcaremagic.comI have  evaluated your query thoroughly .* Management of both are dependent upon the cause of the same .* Diagnosis is the prime concern for that .* General measures for the same to get better recovery -  Allow  her  plenty of liquids .-  High fiber diet .-  Soft , light diet .-  Avoidance of oily , spicy , non veg stuffs , beverages .-  Remain ambulatory with regular walking , exercises , YOGA .Hope to clarify  your query Welcome for further assistance Thanks for using Healthcaremagic.com & giving opportunity to assistWishing fine recovery to your Angel .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible while having i pill?\n\nhello doc i am 24 yo women on 9 th of October i had take ipill within 5 hrs of unprotected sex. last month my periods started on 2nd September i took ipill on 9th of September got bleeding on 17th september. do i need to take pregnancy test what will be my menses cycle now",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As per your history, as you have taken I-pill within 5 hrs of unprotected sex, its good, but its failure rate is 25%. So as you have missed period, so kindly do UPT test and ultrasound abdomen and pelvis after consultation to rule out any chance of pregnancy. Take care. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for recurring urinary tract infection?\n\nmy daughters is 6 years old, she gets urine infection on & off since one year. she was treated with monocef 200 mg, tablet sporlac, and soliderm ointment. now the infection has been reduced. but her bed wetting hasen t stopped. she has the urge to pass urine but does not know as when she would have urinated. can someone suggest me a solution for this.. Hema",
    "doctor_response": "Hi,We should find out the cause of having recurrent urinary tract infection.She might require,1,Routine urine check up and urine culture.2, ultra sound of kidneys,3, kidney function tests.After all reports we might have proper conclusion about her problem.Plan of treatment can be decided accordingly afterwards.Meanwhile give her plenty of water.Keep her local hygiene clean and dry.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having depression and suicidal tendencies due to family pressure. Meditation has not helped. Any medications?\n\nI am a 24 year old  MSc passed out from Panjab univ. with quite good marks and currently I am preparing for UGC NET. Within this 1 year my life has witnessed ups and downs, well more of the downs then ups. My parents and elder siblings have started putting up restrictions on me which they never did earlier, I am putting away from my home from past 6 yrs (though my siblings live in d same city i live). In this one year gap i got few job offers but my family din't allow me to join since they were contractual, They want me to clear UGc n then get married. whensoever I try to convince them my point of view for my life,  we end up in heated arguments and by end itz me who is made guilty , proved wrong, n blamed unnecessarily even for the acts which I have never committed. Now my siblings are nomore talking to me. All what is happening in my life is making me feel insane. I feel too low n at times i get suicidal thoughts.I feel all alone surrounded by so many people but there is nobody i can seek support from. I find myself too meek to tackle the situation. I was never like this ever before. My head keeps on aching all the time n I am not able to concentrate on  my studies too.. i tried meditation too but i failed. whensoever I try ti meditate my life z graph starts revolving around me and i feel like crying. Things get worst in d evenings. Earlier I thought it would get better with time but itz not going so. Cn I gt some solution to overcome this mental state of mine.. please medicate me before I end up my lifePS- i can't think and see anything positive in my life . so please don't ask  me to help by myself.",
    "doctor_response": "Hi, Thanks for using health care magic forum. I have gone through your available history. You are having severe depression with suicidal ideas. You should immediately consult psychiatrist for detailed evaluation and treatment. You may get benefit from anti depressant drugs like escitalopram or imipramine or sertraline. In severe cases, Doctor may consider for electroconvulsive therapy or deep brain stimulation. I hope you will be fine soon. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes scar on face?\n\nMy daughter was born with a scar on her face, under her right eye, near her upper cheekbone. At birth it was white & flat, but now, at 17 months, it is raised. I wonder if it has vernix trapped under it and this is the white coloring. Should we be concerned or is there anything we can do for it? Her pediatrician has never remarked. Thank you.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query your daughter have symptoms of scar on face which occurs due to clogged facial pores that get infected with bacteria. Need not to worry. I would suggest you to apply cream rich in Azelaic acid or Kojic acid. Avoid touching or pricking. You should take diet rich in multivitamins. It will lighten pigmentation on skin. use medicated sunscreen such as Tancare rich in SPF 30. Apply cotton dipped in tea tree oil to lighten the pigments.You can visit dermatologist/ pediatrician once and can go for chemical peeling or micro abrasion if your symptoms not resolving. Take supplements rich in vitamin C.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the lower abdomen. Ultrasound normal. Why an incisional hernia was not shown in the scan?\n\nI had an ultrasound for a suspected ovarian cyst , but the test came back normal. Is it possible that the ultrasound could have missed a incisional hernia from a c-section , or would that have clearly shown up? I have been having localized pain in my lower left abdomen on and off for a year and it has recently gotten more uncomfortable. No other symptoms are present.",
    "doctor_response": "Hello. Thanks for using this forum. Well the diagnosis of incisional hernia on an ultrasound can be quite challenging and difficult one to make. It depends on various factors ranging from size of hernia to the experience of the ultrasonographist. You should look out for symptoms such as swelling in the line of incision while standing up, while coughing or while picking up any heavy items. If any  swelling is seen, its a sign for incisional hernia. Sometimes such hernias are also hidden which means they dont reveal to the naked eye. As for the pain in the lower left abdomen, this pain could also be related to the c-section operation specially the suture line due to the fibrosis. Also get a urine exam done to rule out any Urinary tract infection and a consultation with a gynecologist would certainly help. Kindly feel free to ask if you have any further queries. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Eosinophilia. Had endometriosis, intersitial cystitis, dehydration, chronic diarrhoea. Suggestions?\n\nI was researching eosinophilia ...my daughter has it. She is quite ill. I was wondering if it could be connected with any meds she has taken. She is approaching 40. She has had endometriosis and been on birth control pill. She has also had intersitial cystitis and exposed to drugs for this condition. Now, she is suffering from eosinophillia...first discovered with thrush in esophagus . She dehydrates easily and suffers from chronic diarrhea. She actually came down with the eosinophillia after a trip to Spain, a few years ago. I will get back with you / pay on Wed when my check comes. Looking forward to hearing what you know about this disease. Sorry I cannot continue until Wed. Thank you.",
    "doctor_response": "Hi, Welcome to HCM, Eosinophilia might not having any relation with problems she had. there might be some allergy factors playing role in this problem, might be some internal or external allergens. Change of atmosphere as there was a Spain trip might have some role. There are all chances to have worm infestation as there is h/o  chronic diarrhea. In worm infestation there are maximum chances of having Eosinophilia. Go for anti helminthiasis medicine course. Then go for Di-Ethyl Carbamazine (DEC ) medicine course, after consulting your doctor, which will give very good response and will give cure. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest fertility treatment for PCOS\n\nHello Sir/Mam, My wife has PCOS and has underwent 3 cycles of IUI,Her tubes are patent and AMH is normal and as the induction is given the ovulation happens but all the three cycles have failed.So what should be the next step? Also the Thyroid checks have been normal",
    "doctor_response": "Hi,I read your query and I understand your concerns.Following is my reply:1) If you are overweight please reduce weight.2) See an infertility specialist for follicular growth scan.Let me know if you have anymore questions.Regards,Dr. Mahesh Koregol",
    "dialogue_context": ""
  },
  {
    "patient_message": "What kind of treatments should be done to become pregnant?\n\nHii i am 33 yes old married since 3 yrs and trying to get pregnant since last2 years.i was given ovulation induction tablets and injection Luperide.UCG was done 3 months back to check the fallopian tubes but there also everything was ok.Please advice",
    "doctor_response": "Hello dear, I would suggest u to get your partner go for semen analysis in the first placeThen you need to get specific hormone assays, a baseline ultrasound on 2nd-5th day of your menstrual cycle.If everything is within normal limits then you can go for In utero Insemination (IUI) - in this OPD procedure good quality sperms of your partner are injected inside your uterus (it is a painless procedure) Its better to consult your gynecologist for further management. God bless you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for loose motion and stomach pain in a child\n\nmy baby is seven year s old she frequently complaints about pain in stomach and she often complaints for passing liquid stool . some times she feels to have sensation of vomit too so can u piz. guid me about the medicine which i can store permanently in my home for this",
    "doctor_response": "Hi...the symptoms you quote are fitting into viral diarrhea. Regarding diarrhea - Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron as prescribed by your paediatrician.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rash spreading from torso to breasts, underarms, thigh and back?\n\nHi, I have a rash/hive--who knows? It literally looks like I ve been burnt and the skin is lifted. It started out in my torso, then my breasts, Underarms, lower inner thigh (close to vagina) and now ALL over my back. It s been coming and going for months but now it s spreading. Should I be worried?",
    "doctor_response": "Hi, You seem to suffer from urticaria. If it occurs more than 6 weeks,then it is chronic urticaria. Consult the dermatologist for the perfect diagnosis and proper treatment. After thorough investigations,your dermatologist might prescribe proper drugs. If any triggering factor is found, that should be avoided. Antihistaminics, steroids, etc, may be considered. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain in hip?\n\nWhen I bend over or twist at times I get very sharp pain in the upper right rear portion of my hip. I have no discomfort in the joint itself ever or any other areas on a regular basis, but with the slightest wrong movement the sharpness almost brings me to my knees. What is the deal",
    "doctor_response": "Hello,Looking at your details it looks that you may be having problem at your sacro iliac joint. It can be a sacro iliac joint dysfunction.You should not worry about this.Do following to have relief in this:1. Apply an analgesic ointment locally.2. Do warm water fomentation over affected area.3. Take an analgesic like ibuprofen ,aspirin or paracetamol.4. Avoid abnormal bending at your back and also avoid lifting heavy weight. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mukesh Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is conception possible with a nil sperm count?\n\nRespected Dr. We would like to take your valuable suggestion on the best way we can had our child. My age is 33 My Wife age is 27 Married for 3 years Recently I have done my Hormone Test when my sperm test was noted NIL and the results are : Sperm Count : NIL FSH 29.1 LH 8.5 Serum Testosterene 7.9 Also I am a Diabetic Patient.",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.In your semen analysis sperm count is nil is m matter of concern.Nil sperm count cause infertility.Fsh,lh and testosterone level are normal.I would advise to do color Doppler ultrasound of scrotum to rule out any pathology like varicocele, to see vascularity of testes.Consult a urologist with this report.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Kidney stones in right kidney, pain on passing urine. Taking oxalobact, repilif. Continue medication?\n\nhello sir, myself XXXXX 26 year old, i ve kidney stone in my right one of 7 mm for a long time i ve been taken medicines hydrazide 12.5, zurin 40mg, oxalobact capsule urodyi tab, repilif 4 , and potessium and magnisium citrate oral solution prescribed by a urlogist in a day, after 3 days i m suffering frm pain while passing urine and all time feel a desire to pass urine . give me suggestion weather i sud carry on or give other medicine thank you.",
    "doctor_response": "Hi Welcome to HCM. It looks like the stone is coming down and that is good news. The medicines are appropriate and pls continue. The only other thing can be done is to take enough pain killers - oral or injections depending on the situation. Get well soon. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump and bleeding on thigh due to fall\n\nI fell in a deep hole about an hour ago....in the dark outside. I was with a friend. I didn t seem to break anything but my thigh got hurt pretty bad...I now have a huge lump with it bleeding and bruised pretty bad same thing in my calf on the bone..do you think I could have internal bleeding? should I see a doctor right away. my thigh is numb.",
    "doctor_response": "Hello and welcome to HCM,A history of fall, formation of a lump, bleeding and bruising on the thigh suggests hematoma formation.Hematoma formation is lump formed due to internal bleeding and collection of blood.A hematoma changes color from blue to green to yellow and it clears away with passage of time.However, a clinical assessment is required and dressing of the wound is also required since you have mentioned that the site is bleeding.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower abdominal pressure/bloating?\n\n41 yr old, 5'7\", 175lb male with lower abdominal pressure/bloating with loss of appetite, that has persisted since 2009.  During this time have numerous tests including colonoscopy (normal), small bowel series (normal), and repeated blood work (slightly elevated WBC on a few occasions).  Additionally, tested positive for h pylori, which was subsequently treated successfully with antibiotics.  Recently, the bloating and pressure, which I'm guessing is the build up air/gas has become worse.  I have been told that this could be IBS.....which to me seems very ambiguous.  Although I have BM's once a day,  It feels like my bowels then clamp shut at times thus causing the pressure to build.  The degree of discomfort has interfered with daily life relentlessly.Any thoughts or suggestions would be be of great help",
    "doctor_response": "Hi. Thanks for your query. You are suffering from lower abdominal pressure and bloating for 5 years and investigations are within normal limits. This could be IBS. IBS comes in many forms. For us to say this as a IBS i.e. Irritable Bowel Syndrome, all the investigations should be normal.I would advise the following investigations and treatment in a such a case:Investigations:*Routine blood investigations like Complete blood picture, blood sugar, urea, creatinine, liver function tests, thyroid function tests.*Urine -routine and microscopy*Stool: routine, microscopy, occult blood, culture and sensitivity.*Ultrasonography of abdomen,*Colonoscopy All these investigations should be within normal limits for one to say you have IBS.Treatment:''STRESS'' = stress is the most important cause of IBS. Please remember and you must have observed that when you do not have stress your problem with IBS is reducedChange of lifestyle.I think 'may be' you are not coping with something. Vacation outside of your area, mobiles phones to be off.You must have noticed already that these changes help a lot. Try to avoid anything which you are / have to do against your will and wish. Get into the hobbies which make you forget the world around you. Life comes only once, boss.Medicines :: You need to have a prescription of a Doctor, please discuss this with a Gastroenterologist to get a prescription. I would like to know which medicines have you taken in the past and in which dosageVit A and Vit D in therapeutic doses,Multiviatamins , probiotics, anxiolytics help a lot.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can fever frequency be controlled?\n\nHi my 19 month old was at the doctor yesterday and had high temp of 40.8 and was diagnosed with an inflamed ear and throat infection and was out on klacid antibiotics then her temp went and now there dropping to 35.5 and then coming back  to 36.0- 36.8 within minutes",
    "doctor_response": "HelloMost of the time fever is associated with infection or inflammation.As infection or inflammation subsides fever also get relieved. She is already on antibiotic.For fever give her paracetamol.You can give paracetamol 4-6 hourly depending on the severity.Tepid sponging with leukworm water help in bringing down the temperature.Give paracetamol only when temperature is above 37 cent.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of chapped lips and small bumps on lips?\n\nI have had chapped lips with small bumps on the insided of my lips. I dont have any cold sore but when my lips get chapped they began to hurt. I use yo wear lip stick but i stopped due to this issue. It kinda consern me more because my husband has started developing them. Please help me",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,    I have gone through your query,  as you have mentioned that you have small bumps on lips dont worry it can be due to periodontal problem , go to dentist for Oral prophylaxis , if your problem continues then consult dermatologist for this.   Hope this will help you.    Wishing you good health  Regards     Dr. Priyanka tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the early signs and symptoms of pregnancy?\n\nOver the past month i have been getting symptoms of pregnancy. i have random head aches, backaches, the whole month i have had very painful cramps. running to the bathroom, nausea all the time, every thing i smell or eat makes me a little sick. i have a lot of gas from both ends, my breast are not sore but they have gotten bigger and the ring around it has also gotten larger. anything i take for these pains it still will not go away. i just received my period not to long ago. It was lighter than usual and it lasted the normal days. after my cycle i did take a pregnancy test after and it came back negative. I am still feeling the same problems i had before my period. i am a diabetic and i do know some of these symptoms can be cause by that. i still would like to know if i could be pregnant?",
    "doctor_response": "Hallow Dear, Engorgement of the breasts, widening of the areola and nausea are definitely suggesting the possibility of pregnancy. Though breast engorgement can take place if you out on weight, the areola will not widen without pregnancy. The other battery of symptoms you have mentioned are not pertaining to pregnancy. However, you got your menses, though scantier in amount. Your urine pregnancy test also was negative. This rules out the possibility of pregnancy. Urine pregnancy test done within first week of missed period can give false negative test. I would advise you to get Beta hCG test done which gives reliable test even before missing a period. Else ultrasonography done about 10 days after missed period gives direct visual evidence. Since you did not miss period, but had scanty period, consider that as missed period for the sake of planning these tests for confirmation of pregnancy status. I am more concerned and impressed with the widening of areola; hence do not want to right off the possibility of pregnancy without confirmation. I hope this helps you. Dr. Nishikant",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side affects of tetrasyl?\n\nI believe I am 5 weeks pregnant and have been taking tetrasyl for several months. We had IVF to conceive our first child so did not believe it was possible to fall pregnant naturally otherwise I would not have carried on taking tetrasyl. How dangerous is this to our unborn child? Very concerned and would appreciate some advice.",
    "doctor_response": "Hi there,,Tetrasyl is an antibiotic which is not recomended to be taken in preganncy, but it is not known to cause any major defect in the baby if taken during the first trimester.Studies have shown that it effects the baby if taken after 4 months of pregnancy, causing the babies teeth to be discoloured and can cause hardening and cause excess calcification of teeth and bones which is irreversible.But, since you are exposed to tetracycline at such an early gestation it is very unlikely to have affected your baby. Only minor abnormalities are known to occur in few women.Do not be overly concern and get a NT scan at 11 weeks and an anomaly scan done at 20 weeks to check for anomaly.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for mass in lungs\n\nI lam going to have a cat scan on my lungs for a mass there to see if it got smaller I have  a lcancer mass in my lung and my lymp nodes.  The blood down to my rear is involved to.  My lymponoids and blood are involved.  I want to know if my Tarceva drug  which causes a rash (doc. says it is a good thing) well, can you put moisturizer on my skin when I go for the cat scan or anything else? I am 83,5ft.4.I was 140 and begining of year.  I am now 125.  Age83 height 54 weight 125",
    "doctor_response": "HiYes the Tarceva can cause rashes and no problem with any moisturizer like Eucerin before the ct scan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for shortness of breath?\n\nIM 57 YEARS OLD AND HAVE HAD THIS PROBLEM FOR ABOUT 3 MONTHS. HAVE SEEN MY DOCTOR ABOUT 3 TIMES  AND AM LOST. I GET SHORT OF BREATH WHEN I DO THINGS AND ALSO WHEEZE AT NIGHT JUST WHEN IM LAYING DOWN. MY CHEST FEELS LIKE I PUT VICKS INSIDE OF IT, I ALSO FEEL LIKE COLD AIR WHEN I BREATH IN.I COUGH MANILY AT NIGHT WHATS THE PROBLEM, I AM FED UP",
    "doctor_response": "HelloWelcome in HCMI have gone through your concern and i will try to help you.According to the history you have difficulty in breathing mainly during the night and laying down.I strongly recommend you to do some tests for the lungs especially:HemogramCRPChest x raySpirometry test with b/dilatatorsEKGPrick testAfter having the results the pulmonologist will for sure prescribe to you some medications like inhalers ( Ventoline + Seretide) maybe oral corticosteroids for several days,some mucolitics and you will feel better again.If you smoke you have to stop it immediately.If you are obese you have to lose weight to do some exercises physical activity,a lot of liquids.So consult a specialist please.Dr.JolandaPulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will retro positioned uterus cause problems in getting pregnant?\n\nI always had urinary infection since my childhood. When i was 17 i was subjected to scanning. in that report i found out that i had retro-positioned uterus. Now i am 22 and my marriage is about to be fixed. am worried about this and wanted to know whether will the same affect pregnancy?",
    "doctor_response": "Hi dear and thanks for your query.Retro-positioned uterus is a normal position.You will not be faced with fertility problem while your uterus is retroverted.All the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in left buttock and left leg\n\nFell about 1 month ago and approx. 1 week after fall I have pain running from left buttock where i landed from the fall down back of my left leg to outer edge of my left foot (where i feel a tingling sensation. Cannot stand long and must sit down. Any answer to a cure would be greatly appreciated.",
    "doctor_response": "Hello, You are suffering from sciatica pain which is due to compression of nerves in your back, strictly avoid bending and weight lifting,take over the counter painkillers, give hot fomentation,apply diclofenac topical gel,and get your mri scan of lumbosacral spine done to confirm the diagnosis. Hope I have answered your queries. Let me know if I can assist you further. Take care Regards, Dr. Jaideep Gaver",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rigidity in the big toe\n\nHi, I had a gout attack at the big toe and had recovered after about 2 weeks of bed rest, strict diet control, and a course of colchicine. The problem is the recovery is not 100%. I would describe it as 95%, as very slight redness and very slight swelling is still present. Another 3 weeks have passed after the initial 2 weeks of bed rest, but the 5% remains. This is very unusual as in past attacks the recovery is complete after 2 weeks at most. i m able to move about without pain but with some discomfort, due to some rigidity at the big toe. if I spend more time walking, the big toe feel slightly more red/swell and a little pain returning. It is definitely not the gouty pain. Any advice you can give to secure a full recovery is appreciated. Thank you. Jimmy. email: YYYY@YYYY",
    "doctor_response": "Hello,It seems like you have recovered from an acute attack of gout. Are you on any tablets now like allopurinol to maintain the serum uric acid under control? If yes, then I would suggest you continue it and maintain the uric acid level below 6 mg. What usually happens with repeated attacks of gout is that every time while healing a small amount of joint damage occurs and it will lead to gouty arthritis. In your case, the remaining 5%of your recovery may be related to this issue. I would suggest you consult your physician once a year at least and to get radiographs of great toe to know the status of joint. Hope I have answered your query. Let me know if I can assist you further.Regards,       Dr. Santosh S Jeevannavar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden rise in blood pressure?\n\nhi dr, abt 7-8 months before one night suddenly my blood pressure went high at 180/90 the doctor gav me 3 doses 2 control it. Later after a day when i got it rechecked it was normal. This happenned to me twice in four days.Can you please tell me the reason for it? Is anything Serious? Nothing such happened again in this 6 months gap",
    "doctor_response": "Hi ThereI understand your concern and would like to tell you this sudden rise of Blood pressure in absence of any history of hypertension or heart disease can be because of anxiety or stress. You should check your BP daily for a week if it stays more than 160/90 then a regimen of lifestyle modification have to be followed for first 3 months that includes 1. Low dietary salt intake.2. Avoid fried food.3. Daily morning brisk walk of 45 min for five days a week.4. STOP SMOKING ( if you do).I hope I answered your query if you have anything other questions I available to help.I wish you Good healthDr. Navneet Mahajan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness and pain in chest after consuming mixed drinks?\n\nWhen I have a mixed drink, especially one with vodka or any hard liquor, my chest starts feeling tight and I get chest pains.  It will go away in about half an hour after I do t drink anymore.   It doesn't take much to set it off, just a half a glass.  I can have a beer or a glass of wine and no problems.  I am 45, 150 lbs, 5'6\" and have never been much of a drinker.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can I can understand your concern. Since chest tightness and pain are associated with alcohol drinking, possibility of acute gastritis is more in your case. Alcohol is known to cause hypersecretion of stomach acid. And this can cause acute gastritis. This inturn cause chest tightness, pressure, nausea, burning chest pain etc. So better to quit alcohol as soon as possible.You will surely improve without any treatment if you quit alcohol. You can take antacid (pantoprazole) at present to resolve pain and tightness. But better to quit alcohol. This is must for you. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain while pulling bin. Coughing when breathing in or out\n\nI was putting the bin out for collection lat night I was pulling the bin up and towards me when I got a very sudden sharp pain right in the middle of my abdomen bottom of my ribs where the end ribs meet in the middle now it hurts to move or straighten up don t know if its coincidence but I want to cough when I breath in or out",
    "doctor_response": "Hello, shelley.dee, If the pain is in the same location when you strain or cough, try to place your hand over that area and see if you feel any lump or bulge. You can also lean forward when you try this. If you are able to feel something , it is possible that you might have caused a hernia. Especially, if you already had a small defect in the lining of the abdominal wall, you could have aggravated it by pulling a heavy object. If the problem continues, you might want to have a medical check up by a doctor or a nurse practitioner. Wish you well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be the itchy blisters aside from my penis?\n\nHi, a couple of days ago I was masturbation a lot . three times back to back. With baby lotion. A couple days later some small blisters that were very very itchy appeared aside from my penis being sore. I ve had this problem in the past and went to the doc to get tested for herpes. It came back negative. Now what could this be? I m scared",
    "doctor_response": "HelloThanks for query.You have developed abrasion over penis due to dry ,vigorous and tight grip and handling of penis while masturbating .Take antibiotics like Doxicycline to prevent infection and anti inflammatory drug like Diclofenac twice daily.Wash and Clean your genitals with warm water and anti microbial solution Betadine twice daily and apply topical antibiotic ointment Neosporin.Avoid sexual encounters and masturbation till it gets cured completely.This should get cured within a week.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What diet to be followed after having surgery for gall stones and gall polyp?\n\nMy mother is 54year old.. she recently diagnosed with antral gastritis, hiatus hernia while she went for surgical clearance for Gall stones and Gall polyp. now she is on medications and planned to do surgery, what will be the diet that she has to continue after her surgery?",
    "doctor_response": "Hi,The treatment of gall stones and polyps is removal of the gall bladder. The diet should comprise of low fat. high protein moderate, carbohydrate diet  for at least 3 months.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have difficulty in approaching someone with more authority than me. How to overcome this?\n\nHello doctor, I suppose I am suffering from anxiety. Also, I get scared of certain people or situations where I feel that I will be judged. Always, I think that people are judging me on whatever I do. So, I get anxious. This is a pattern since long. I understand that I can overcome it, as I find that there are few reference points in my memory where I have handled those situations well. I think I need help now as it interferes in my day to day life. Although I am able to manage it till now and am leading a good life, I think that I can do much better at work and relationships and will be able to enjoy life.",
    "doctor_response": "Hello. I can understand your problem. Feelings that people are judging you, becoming conscious when people are around you could be occurring due to anxiety, most likely social anxiety. This should be evaluated properly. Social anxiety can be treated easily with medicines and behavior therapy. This will help improve your productivity. Please provide me more details in follow up. For more information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Issues with uterus and bladder, frequent urination. Urine test showed pus cells. Do I have infection?\n\nI ahve problem in my left side close to uterus and bladder so I made urine test what (pus cell) means ? dose 3-5 hpf normal consider as normal range ? have urination problem at morning I go 3-6 times to bath rooms in just 30 minutes, and the urine is very few , do I have kidney problem or I have arthritis , uterus infections :",
    "doctor_response": "Hello! Thank you for the query. You do suffer from mild urinary tract infection. pus cell is simply WBC (white blood cell) and a 3-5 hpf is slightly above the norm. I suggest you to have urine bacteriology checked and ask your doctor about antibiotic prescription. You should also drink more mineral water. Hope this will help. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could itching and rashes on body be caused by taking Metrogel?\n\nHi. i was on Metrogel about a month and a half ago for 5 days. While using it i startedhaving ichtyness on my stomach back legs neck armsand thighs? I am still having the itchyness. Is this fromthe Metrogel? I had no problems until i used it. There was at no time a rash present.",
    "doctor_response": "HIWell come to HCMHypersensitivity of Metronidazole is very rare, if the rash is not there then just forget about this to confirm the possibility of sensitivity of Metronidazole you have to try this again and if the rash appears then this would be for sure the reaction of Metronidazole, hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful lump on the armpit\n\nYesterday I just discovered a lump on my left armpit but I m not sure if it is a lump? And this morning my breasts were itchy and it was hurting but the pain was not so much. Since last week my underarms have been itching and I m really worried if it s some type of breast cancer. I told my mom about it but she said I was just overreacting.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have enlarged axillary lymphnode due to reactive hyperplasia or soft tissue tumor like lipoma or some axillary tail of breast.  You should go for examination of axillary region and breast.  If needed go for biopsy or fine needle aspiration cytology. 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid off the painful lump on the lower left jaw bone?\n\nI have a painful lump on my lower left jaw bone. Had an x-ray done and it showed bone loss and a tumor. I have an implant at the same site. The implant seems fine. It is not loose or sore. There is no drainage or foul taste in my mouth. I just have this painful lump that never goes away. Is this something to worry about. Plus I have been very tired. M.H.",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.Bone loss on the x-ray and painful lump at a spot you say go in favor of either a chronic osteomyelitis ot a cancer of the underlying tissue.Urgent evaluation by clinical examination . CT scan and most important FNAC- fine needle aspiration cytology will help to come to the final conclusion and treatment will depend upon the reports. Need of surgery is certain and do not make this late further.The role of the implant can be decided by CT scan only .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower abdominal and back pain, increases when urine is held. What is wrong ?\n\nI have lower abdominal and back pain. When I hold my urine it gets bad and after I go to toilet I can see light spotting. What this could be? I went for gyneco done Pap smear came normal no prob at all. Done urine test came also normal. I m having also gas in my abdoman and gets into my ribs and back.m just so worried don't know what is wrong with me. Could this be related to my colon???",
    "doctor_response": "urinary tract infectionit is trueyou can stat with norflox 400 mg bdlot of warm water syp citralka 1 tsf bd as it is local urinay antisepticacidity incrases ymptomps so add syp gelusil 2 tsf tdstake for 10 days get ultrasound abdomen for kidney and urinary tract",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does IBS cause pain the right side of the lower abdomen?\n\nI have bad but bearable pain in lower right side abdomen that is constant. At times when I eat I get cramps within minutes and then get diarrhea. Went to er a couple of weeks ago and they did blood work, checked urine, did a ct and said everything was normal and said it must be like ibs. Would ibs hurt all the time and just in one spot",
    "doctor_response": "Hi, As the pain is at particular point associated with diarrhea and cramps, it is most likely possible inflammation of right side intestine as terminal ileum or else. It is recommended to undertake a discussion of need of colonoscopy for definite management ahead. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Get red coloured ulcers on tongue after eating few particular things and goes after drinking water. Suggest?\n\nHi Doctor,  I need one information. I sometimes get red color'ed ulcers on my tongue after eating few particular things like Indian gooseberry or something which is sour and tangy.It again goes off immediately after I drink water or something which is cold.Please can you suggest what can be the reason behind this.",
    "doctor_response": "Hello,Thanks for the query to H.C.M. Forum. Actually few persons have sensitive taste  buds over tongue . These sensitive buds reacts with citric acid present in certain  fruits or other eatables particularly tangy and irritant fruits, need not to worry. The best way is to avoid such type  of fruits. 2nd option is apply local triamcilone  oral gel over  tongue immediately after use of such fruits. Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can persistent fever, tiredness with lack of appetite be treated?\n\nI have had a fever for a week now, I feel tired all the time, and I have no appetite.  I went to my doctors on monday and they gave me  Azithromycin and tomorrow is my last day of taking it, but it's not helping at all so far. Do you have any ideas of what I might have or what I should do? my fever is between 99 and 102.5",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have  fever, tiredness with lack of appetite  which is due to viral infection which is lowering down your immunity and making you prone for infection. I would suggest you to apply wet cold sheets on your head to lower down body temperature. Avoid hot, spicy and sharp food substances. You should take combination of antiviral drug along with anti-inflammatory drug. Take nimuslide along with paracetamol as well.Take diet rich in multivitamins and vitamin C. Your symptoms will resolve in 4-5 days.  avoid intake of sharp, oily and fried food. avoid cold carbonated beverages. If symptoms keeps on persisting visit ENT specialist once and get some routine blood investigation done. Take diet rich in multivitamins. Drink plenty of water. Take hot milk rich in turmeric as it will booster immunity.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Teeth's pulled out. Reaction to anesthetic, had Twitching. What could have caused this reaction?\n\ni went to the dentist to get 2 teeth pulled out but had reaction to the light anesthetic . i was twitching, i kicked my shoes of and pulled out the intravenous in my wrist and then the other one that they tried to put in my other wrist. woke up and had no clue what happened. i had mum and the dentist lady help me walk out to the car while i was having a random laughing fit. what could have caused this reaction?",
    "doctor_response": "Hello, Adverse drug reaction can occur with local anesthesia. Excess dosage of anesthesia, rapid absorption etc can lead to severe adverse reaction involving central nervous system and heart. Nervousness, lethargy, dizziness, sickness can occur because of allergic reaction. Adverse drug reaction with local anesthesia can be fatal.You can visit a physician for evaluation. Before getting any dental procedure done, tell your dentist about the symptoms which you experienced with anesthesia. Local anesthesia allergy testing can be done to know whether patient is allergic to particular anesthesia or not.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the natural treatments for redness in penis with white sticky substance and burning sensation?\n\nHi, I think I am having yeast infection and it has worsened now. Extreme red penis with white sticky thing over it. It s burning like hell and so much pain. I m in Singapore. Is it better to travel to India for the treatment? Are there any natural, effective and quick treatments for this? Thank you!",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have acute infection of glans penis ( Ballanitis).You have not mentioned whether you had unprotected sex very recently.Please get following basic tests done to confirm the diagnosis .1) Routine urine test and urine culture .2) Swab test of uerthral discharge 3) Blood test for STD ( if you had unprotected sex)You need to take broad spectrum antibiotic like Cefexine along with anti inflammatory drug like Diclofenac twice daily.along with topical antibiotic ointment like Neosporin twice daily.Ensure to wash your genitals with warm water twice daily.This should get cured within a week.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can neck pain be treated?\n\nI have neck pain that radiates down my neck to my arms and hands. My MRI shows facet degenerative/ hypertrophic changes. There is mild narrowing due to suggested arthropathy. My orthopedic doctor says that the narrowing is too mild to be treated with a shot of prednisone. hence, I m still in pain.",
    "doctor_response": "Hello,I have gone through your question and I would suggest you consult some physiotherapist for neck muscle strengthening exercises.You should also maintain a proper posture.For pain management you can apply hot water bag or take tab etoricoxib.You can mange pain with pain killers but for long term management only thing which can help you is regular exercise, that too only after consulting physiotherapist. Do only those exercises which he tells after examining you accordingly. Currently there is only mild narrowing which can be managed by exercise and calcium supplements. Thanks for writing us. Hope I answered your query well.Feel free to write to us for any other query or follow up.Regards Dr Sajal Singh",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to cure mouth ulcers\n\nhi, my partner has sever mouth ulcers that he gets every months lasting about 2 weeks at a time. They get so sever he can not talk and they bleed. He also has severe pain in both heels to the point he cannot touch the back of his heels. He has had pysio therapy, friction massage and ultra sound scans on his heels all to reveal nothing. A friend told me about bahcet ssyndrome and i didnt no if these were related",
    "doctor_response": "thanks for your query, i have gone through your query, the recccurent ulcers could be reccurent aphthous ulcers or errossive lichen planus or erythema multiforme. consult your oral physician to rule out these pathologies. if i am your treating doctor i would have put you on topical analgesic, anesthetics and topical steroids. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I give half valtrex when child suffering from cold sores?\n\nHi. Yes just a quick question. I have a 10 year old son he is about 95 lbs. I take valtrex for cold sores. My sun also has breakouts of cold sores. I take 1 gram when i have a cold sore. Would it be safe for me to give my so I a half one when he has a break out?",
    "doctor_response": "HiWelcome to HCMCold sores generally clear up without treatment. Treatment is needed if:-You have a weakened immune system-The cold sores don't heal within two weeks-Symptoms are severe-You have frequent recurrences of cold sores-You experience irritation in your eyesValtrex is not an appropriate choice for cold sores at 10 years of age. It would be better if you give him Acyclovir 200 mg 5 times a day for 7-10 days.These drugs help in shortening the course of illness but do not completely cure the infection.For further questions, do contact us.Dr. Archana Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have mild pain between my belly button and space between my breast after gallbladder removal?\n\nFive weeks ago I had my gallbladder removed. The doctor attempted to do it by laparoscopy but was unable and had to do surgery, I ve had what seems to be the usual discomforts, but recently I have developed a mild pain located between my belly button and the space between my breast. It bothers most when I am sitting down. Any idea what is causing this, or this an after effect of the healing process. Any guidance would be greatly appreciated.",
    "doctor_response": "Hi, Welcome to Health care magic forum.                      Along with the gallbladder problem, there will be some problem of stomach irritation, so it may continue even after the surgery also.                      I advise you to consult a your surgeon, for clarification, and treatment of discomfort.There may be some complications also which you can exclude.                      I usually prescribe to my patient with such symptoms omeprazole, domperidone, and antacid gel.                     Avoid taking spices, junk foods, and oily foods.                      wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain with swelling and tenderness in wrist?\n\nI was lifting a wight bar the other day, and felt a pop in my wrist. It hurt at the time it happened but not too bad shortly after that. That night I woke up several times from pain in my wrist. The pain is on the pinky side of my wrist. I have some swelling and a lot of tenderness near that bump at the base of my wrist. It also hurts pretty bad to turn my arm or pick up anything. Is this just a bad sprain, or something else?",
    "doctor_response": "Hello,It looks from your details that you may have a sprain of collateral ligament of medial side of wrist. You should do following to have relief in this:- Do cold fomentation over it for at least 3 days after injury.- Apply a ace bandage over it, starting from hand towards the wrist.- Take a good analgesic like advil, aspirin or ibuprofen.- Give rest to affected hand. Do all this for at least 5-7 days. Even after that if you have any problem then it will be better to have a X-ray of affected part and consult to your doctor. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mukesh Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for cough and wheezing in an infant\n\nMy 2 year old son is having allergic reactions to milk and milk products and sometimes to dust. once he had a reaction to MMR vaccination also.he shows repeated cough and wheezing. How can I treat/prevent/predict/manage the situation effectively. Is epi pen necessary. We have managed it using steroids and nebulisation and found him normal within 1hr",
    "doctor_response": "Hi, By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze. I have a few questions for you: 1. How many days per month does your kid cough or feel breathless? 2. How many nights per month does your kid's sleep get disturbed due to above symptoms? 3. Does your kid feel breathless when running around or playing with other kids? 4. Are the symptoms when there are seasonal changes? 5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.? 6. Is the cough always associated with fever? Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is Ecospirin av for?\n\nHello My mother in law has history of diabetes from last two years . Suddenly yesterday she developed numbness on one side of body for 1 hour After CT scan she seemed to have blood clot in head Doctor prescribed Ecospirin av 75 What is the use of that medicine and side effects Is there any cure for blood clotting",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your mother-in-law's symptoms and findings. Based on that, she seems to have suffered a brain stroke (lack of blood flow to brain).Ecosprin AV consists of aspirin and atorvastatin. Aspirin is a blood thinner and atorvastatin controls cholesterol levels. Both these medicines prevent the recurrence of brain stroke. They are reasonably safe medicines.In addition, her diabetes should be kept under control too.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on inner labia\n\nI have a small lump (slightly smaller than a pea) on the inner labia. It is tender. I notice just now another has appeared nearby (on the smoothe skin between inner and outer labia). I had all clear std screening a few months ago when I met new partner (as did he) and prior to that hadnt had sex since previous partner (husband of ten years) who was also clear when tested. Last slept with him in 2010. New partner and I not active for last five months. what might this be? It s fleshy coloured but when squeezed seems to lighten. im scared.",
    "doctor_response": "Hi,This is most likely to be a Bartholin's cyst. This is not serious and these cysts occur in this area. If painful then a warm compress or warm bath will help soothe. I suggest you see you doctor to confirm diagnosis. Treatment involves either leaving alone if it gives no problem or antibiotics and surgical removal if it becomes infected or inflamed. Regards,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What medicines to give baby if fever is back in one hour with Paracetamol?\n\nHello doctor, My 10 month old daughter has been sick for five days. She had cough with congestion and flu without fever. The doctor has given her Ciprofloxacin for five days. From today, she has a fever of 38 to 38.9 as I checked from her armpit. Kindly tell me what should I do? I have given her Paracetamol 5 ml also. It works for the hour. After that, the fever comes again. Kindly advice me as there is no good doctor here. Please help me. What to do? Is that normal or not?",
    "doctor_response": "Hello. I understand your concern. I suggest you give her Crocin (Paracetamol) 5 ml every four to six hours (Paracetamol 5 ml equals 125 mg). If fever is persistently more than 100 F, give her syrup Meftal P 2.5 ml (Mefenamic acid 5 ml equals 100 mg) every six hourly. In between fever, do tepid sponging of the whole body. The whole purpose is to bring down the temperature so that she should not throw febrile convulsion. Which is very common in very young children with high-grade fever. Usually, fevers are viral fever and do not require antibiotics. Why was Ciprofloxacin given? Just check with the doctor, usually, in children, it is least advisable. Give her warm saline gargles, throat infection is common in children, which can lead to high-grade fever. Review after two days. Happy to serve you. For more information consult a paediatrician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat dust and smoke allergy mediated dark skin patches?\n\nHELLO DOCTOR . i HAD MET AN ENT DOCTOR. mY WIFE HAD SERERVE COLD AND NOSE LEAKING LOT. SHE WAS ADVICE TO TAKE RUPANEX -M . THE DOCTOR SAID SHE ALERGIC OF DUST, SMOKE, WHICH HAS CREATED PROBLEM. AFTER TAKING 40 TABLAT OF RUPENXE -M .THE DOCTOR STOP THE SAME AND SAID IT IS NOW OK. BUT TWO DAYS BACK IT STARTED AGAIN . HER FACE CHANGED WITH DARK PATCHES .NOW SHE STARTED TO TAKE THE RUPANEX -M .NOW AGAIN SHE IS OK BUT THE SKING COLOR HAS NOT CHANGED .pLEASE ADVICE.",
    "doctor_response": "Hi    Rupanex m contains rupatidine  n montelucast which are anti histaminic  n mast cell stabalizer  respective and was prescribed to you for alergic rhinitis . But it wad not indicated for you to take it for 40 Days .Hence ur ENT surgeon advised you to stop n have it vn symptomatic again.  Again developed allergic rhinitis with skin rash so take same medication for 5 days and if symptom persists or aggravetes then visit versatility clinic n get reviewed .  Prevent condition to which allergic to use mask while going in dusty env or applyn simple hanky can work, avoid food allergic , clean  house n bed if possible with vacume cleaner n mop etcHope u stay in good health.  Thanks n regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a sore movable lump on the skull be a symptom of cancer?\n\nwhat is it when you have a movable little lump on the back of youre head on the skull are, what is it ,could it be cancer .its sore to the touch and sometimes he has a pain from that spot to his eye.occa h/a , no nausea at all ,no dizziness. had for about 5 mos . has not changed in size -thumb nail in size, what could this be",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. * The presentation of narrated symptoms suggest that there is possible sebaceous cyst over the skull, no threat of cancer at all. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump in the breast\n\nI am going to a doctor on Tuesday, but am going out of my mind thinking about this...maybe you can help.  I used to have a small lump in my breast that seemed to go away (this was about a year ago) A week ago it seemed to have returned, only now, it hurts and is a lot bigger.  Nothing is excreted and it is located behind my nipple.  I went into the shower today and noticed that there was a lump of some sort (maybe just like a pimple but a bit bigger) under my arm which popped but still is hard, raised and red.  What are the chances of someone that is about to turn 27 (who has had 4 children) having cancer? is it true that if it were cancer it would not hurt?",
    "doctor_response": "Welcome to health care magic. 1.If you are my patient i would have examined first and ask for a ultrasound examination of the both breasts.2.Ultrasiund will assess the nature of the lump and its sours and where all its extending ( like solid, cystic, ductal)3.According to the findings an mammogram would be helpful for things which can not be seen on the ultrasound, like calcifications.4.In your case i suspect ductal dilatation, the scan will help to determine.5.Chances of cancer is less at this age, it progress differently in different individuals. Good luck.Hope i have answered your query.Any thing to ask do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for muscle fatigue and high BP\n\nHi,I have a unusual issue that causes muscle fatigue, general fatigue, and slightly elevated blood pressure. I have been to the E.R. once, and they checked my blood, but said everything came back perfect . I know the doctor said something about checking for sodium potassium and thyroid stuff. I don t know what else though. I ve had this issue for about 3 months now, and it started simply with slight weakness in my upper legs, then as the the day would progress, it would move into calfs, neck and shoulders, etc. Now, anytime I try and walk up stairs,my legs burn, I have out of breath, and it s just very uncomfortable.",
    "doctor_response": "Hi, I understood that you have a concern about recently started muscle ache and fatigue. Also, You have high blood pressure. Muscle fatigue is a very vague symptom. There are various causes from simple vitamin deficiency to complicated as muscle disorder as myopathy or neuropathy. Not to get worried, simple things to do is the consultation with your family physician. Discuss your test with him and decide which test you need to get it done. I recommend the Thyroid function test, Vitamin D levels, ECG and A  2D echogram initially. If your blood pressure remains high then you need to start medication and restrict your salt intake to 2 gm per day. I am worried about your shortness of breath if it is frequent and troublesome then it should be addressed urgently. Some muscle disorder such as myasthenia gravis or endocrine disorder Cushing disease also should be considered. By the time you get all work up done, you can start some simple yoga meditation and adopt a healthy lifestyle. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. MAHENDRA SHIVRAM THAKRE, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to cure premature ejaculation?\n\nHi doctor, I am 32 years old married male. Since two years I am suffering from premature ejaculation. I tried to control it, but did not get better result. My wife is very much unsatisfied. How to cure this issue?",
    "doctor_response": "Hi. As you know that the first thing in medicine is establishing a diagnosis which is correct. So, I would like to ask you a few questions. Revert back with the answers for the above questions to a sexologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes trouble in erection when on prednisolone?\n\nhi my name is Richard bell, I have been on three corses of prednisolone tabs25mg over the last month or so I am having trouble getting an erection and maintaining it, how long will it be before this drug is out of my system, I would be thankful for your in put. thank you, Richard bell",
    "doctor_response": "HelloThanks for query.Your problem of ED is due to prolonged use of Prednisolone .Prolonged use of Predinoslone leads to reduced secretion of Testosterone by testicles which is the main hormone involved in process of sexual desire and erection.It takes 2-3 weeks for recovery after you taper off dose of Prednisolone. from your body.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in lower abdomen, sensations of dysmenorrhea, bowel movement, pain before farting, on standing. Causes?\n\nhi..i am 35 years old and a mother of 2 children (both via c section). i am experiencing a cramps/pain in my lower abdomen at the middle part since yesterday. Though most of the times the pain is tolerable.But there were times that the pain is too much for a least a minute like i am having a dysmenorrhea or like i m going to have bowel movement . Also, when i am about to fart , there is so much pain before it releases. Also, i feel the pain mostly when I am standing. Based on my usual menstruation cycle i will have my menstruation period most probably in july 2nd or 4th. Does carrying heavy objects, just the other day, than I usually do may cause this cramps? Please help me..thank you very much",
    "doctor_response": "hi, the possible causes of your pain are, -as you told carrying or lifting heavy objects can lead to muscle spasm and that can cause pain, -because of previous two cesarean sections there is possibility for adhesions and which may be responsible for pain, -some women may experience pain some days before period as part of premenstrual syndrome. anyhow better you visit local gynecologist get examined once and if any problem noted treatment can be taken for that, if no abnormality is detected you can take analgesics for pain relief with her advice, take acre.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain and tired always?\n\nIm 14, weighing 65-69 kg and im a female. I have pain on my lower left part of my back 3 days after running during PE. It has been a week now and it still hurts. I also found that i have a random bruise on the back of my elbow which is less reddish and purple-ish. I feel dizzy whenever I try to stand up quickly and i am always tired/sleepy. My skin has loss most of its tan but now it looks a little pale. Not too pale. Should i see a doctor?",
    "doctor_response": "Dizziness, paleness, bruising, and fatigue are a concern, especially for possible anemia. You should see a doctor and get vital signs and blood tests, including a complete blood count.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Vaccinated dog bite my daughter. Is anti-rabies vaccine needed?\n\nDear Doctor, My daughter is 5 years old. A vaccinated dog scratched her right hand with its teeth. There is no skin damage but deep red mark is visible. Is anti-rabies vaccine optional or compulsory for her?",
    "doctor_response": "Hi, Thank you for your query on icliniq.com. Let me explain the seriousness of the deep red marks simply : Visible deep red marks could mean a very small wound but it is still a large door for rabies virus to enter. If rabies has once developed, then it has no treatment. Prevention by anti-rabies vaccination is the only available treatment in a case of dog bite. Anti-rabies vaccine, available now are very safe. I advise you to give her the complete schedule of anti rabies vaccination after consulting a doctor immediately. Hope I have answered your query. For further clarifications regarding the vaccination schedule, consult a paediatrician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of potential pregnancy?\n\ni lost my virginity to my boyfriend. he wore a condom and even pulled out before he came. this was in july. my periods in august and september have been a little abnormal. I have bled heavy but for only 2 and a half to three days. my periods usually are heavy and last any where from 4-5. Can losing your virginity cause a change in your period, or could i be pregnant? I have had trouble with cysts and missed periods occasionally before but nothing like this.",
    "doctor_response": "Hello dear,I understand your concern.In my opinion though the period was different from usual it can be considered as normal.This difference could be due to hormonal imbalance due to stress or any.But nothing to worry.There is no chance of pregnancy as the period  has come regularly.The loss of virginity might not affect directly but it might induce the stress regarding the thought of pregnancy leading to alteration in bleeding.So relax.Overall there is no chance of pregnancy.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for allergic cough\n\nI have allergic cough ...initially there was flem...but now it is mostly dry. had a throat infection initially. Now after around 1 week, teh throat infection has disappeared, but the dry cough is persisting. I cough almost 2 times in a minute. Please suggest a remedy",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your history and would like to make suggestions for you as follows:1. I usually suggest my such patients levocetirizine + montelukast for at least 14 days.2. Regular warm saline gargles twice a day will soothe your throat and reduce coughing.3. Please avoid exposure to dusts, smokes and air pollution as much as possible. Have plenty of warm fluid during day and light diet. This will help early recovery.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat left rib cage injury?\n\nI FELL ON MY LEFT RIB CAGE ONE WEEK AGO.  I HAD CHEST X-RAYS TO RULE OUT BROKEN OR FRACTURED RIBS.  THANK GOD IT WAS NEG.  HERE IS MY PROBLEM.  SINCE THE FALL, I HAVE HAD GAS BUBBLES UNDER THE RIBCAGE AND AROUND TO MY BACK UNDER THE RIBS.  WHAT COULD THIS BE??  I STILL HAVE SOME DISCOMFORT BREATHING AND LEANING ON MY SIDE AND BACK, BUT WHAT THE HECK ARE THE GAS BUBBLES FROM?    I AM WORRIED THAT THERE MAY BE DAMAGE TO SOMETHING UNDER MY LEFT RIBCAGE.  THANKS",
    "doctor_response": "Hello,You have got a blunt injury to the chest wall. The gas bubbles what you feel is superficial subcutaneous emphysema. That is the presence of air in the subcutaneous tissues. You don't have to worry as x-rays have confirmed no rib fractures, any chest injury will take six weeks for complete recovery. In the meantime avoid aggravating activities like lifting heavy weights. Coughing and deep breathing will aggregate the pain. You can continue medications given by your physician. If you develop any breathing difficulty, then consult your physician you will be fine in a few weeks. Don't worry. Hope I have answered your query. Let me know if I can assist you further.Regards,    Dr. Santosh S Jeevannavar",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat hip and back pain caused due to hip injury?\n\nI have injured my right hip a month ago while changing the sheets on a bed. the pain is in the lower back, right side of hip and runs down the outer right side of my leg. I am walking with a limp. And it hurt to walk up steps. I am a 64 year old female, in good health and have been active all of my life.",
    "doctor_response": "Hi,I have read your query.Usually back pain is managed with pain-killers till 1 month period. If it persists beyond 1 month, then further investigations are done. Since your husband has a bad pain I will suggest the following: - Back pain can be due to many reasons. You should get x-ray lumbosacral spine done in AP and Lateral done send us report or discuss it with your doctor. Only then further management can be advised. - Avoid heavy weight lifting pushing and pulling heavy objects, because it will further increase back pain. - You can take medicine like painkillers + muscle relaxants by discussing it with your doctor. Your husband may need stronger pain-killers which are available on prescription only. He can try ibuprofen or naproxen till he sees his doctor. - Apply hot packs for 30 min in morning and evening . I hope it helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of uterine cancer?\n\nHi, last June I had my right ovary & fallopian tube removed due to suspicious looking mass on my ovary.  Thank god after the removal and biopsy, no CA.  This January was my last menses cycle and I was having menopausal symptoms, so I went to my doctor about a month ago and my FSH test came back that I am in menopause.  This past Tuesday I had a tranvaginal ultra sound and my uterine lining is 16.6 mm, and I have a cyst on my left ovary.  My doctor was concerned for both since my blood work came back that I am in menopause, and this is unusual for the cyst and thickness.  I am scheduled for an D&C, plus biopsy in two weeks.  I am of course concerned that this is CA, but everything I read states you bleed if you have uterine cancer, and I have not had any bleeding since January.  Can you shed some light on why this is happening during this time in my life?",
    "doctor_response": "Hi,Thanks for writing in.Your doctor is right in recommending you a D and C followed by biopsy. Any abnormal vaginal bleeding must be evaluated in detail considering your age and ultrasound scan findings that you are having. A 16.6 mm thickness of endometrium is increased and this can indicate abnormal cells, hormonal imbalance or polyp in the endometrial cavity. A polyp is less likely as it is not mentioned in your transvaginal ultrasound scan report. It will help to know if there is a history of gynecological cancer in your family and if you have been taking hormone pills in the past. In most cases this bleeding is due to benign causes and called dysfunctional uterine bleeding. The cyst in left ovary if smaller than 2.5 cm is not a serious concern. If it is a complex cyst then your doctor might ask for CA 125 level to be done. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes emotional outbursts and night terrors in a 3 year old?\n\nour 2 almost 3year old son is having bouts of uncontrollable outbursts lately. we try giving him space, asking if he s hurt, if he wants hugs, and just giving him hugs and holding him. the answer is often no and he may calm for a bit but winds back up. we also use a calm tone\u2026he s also been having night terrors. is this typical behavior?",
    "doctor_response": "Dear, Welcome to HCMWe understand your concernsI went through your details. A night terror is a sleep disruption that seems similar to a nightmare, but with a far more dramatic presentation. Though night terrors can be alarming for parents who witness them, they're not usually cause for concern or a sign of a deeper medical issue. occur in children ages 3-12. Night terrors in children are usually due to Stressful life events, Fever or Sleep deprivation. The following tips may help:a. Make the child\u2019s room safe to try to prevent the child from being injured during an episode.b. Eliminate all sources of sleep disturbance.c. Maintain a consistent bedtime routine and wake-up time.You may consult the child specialist, if the child experiences continuous night terror and sleep deprivation.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Happy New Year. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could dry rashes on knee in children suggest?\n\nHi, My son is eight years old, he has got beside his knee black rash, it looks, as if boil water or oil spills it was looking like a boil, Initially i thought boil water would have splashed, but now it is black flat rash. This rash is dry and itches for him, and nearby the rash small black rashes also started appearing, i consulted the doctor they gave him a cream ( iam sorry unable to remember the name of the cream) and every night one small table he has to have, after having this tablet and applying the cream, no changes, what could be the reason plz help",
    "doctor_response": "Hi, The rash could be a keloid or a hypertrophic scar. But there is another possible diagnosis too. So, it is very important to confirm the diagnosis by proper clinical examination before initiating the treatment. I request you to consult your Dermatologist for confirming the diagnosis and for initiating the proper treatment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Siva Subramanian, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes anisopoikilocytosis in red blood cells?\n\nhi doctor,im intan...malay girl not married yet...i just want to asking some quetions to you. i just do a blood test yesterday because i had fever for three days...and my result is good..no abnormal for dengue..but i just fount out at the result my red cell show anisopoikilocytosis.many ovacytes.some stomatosytes.mild leucocytosis.platelet appears adequate.red cell changes is consistent with hereditary ovalocytosis...i hope i can get fedback from you as soon as possible..thanks doctor",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  Anisopikilocytosis means variations in your rbc size and shape. Normal rbcs are of biconcave disc shape. Only few are oval. You have many ovalocytes. Hereditary ovalocytosis is a cause of hemolysis. You should consult a haematologist and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI showed Rathke cleft cyst. Have left sided facial numbness. Should I be concerned ?\n\nI was recently dx with a rethke cleft cyst was found on mri that was being done for headaches dizziness nausea loss of appitie just overall very fatigue. Strong family  of brain cance. The surgeons I have seen don't seem to ne concerned  now having left sided facial numbness should I ne concerned about everything or just take their word I am very scared.",
    "doctor_response": "Hi, Thank you for posting your query. I do not think you need to worry about the incidental finding of Rathke's cleft cyst on your MRI. They can be left alone and are not a cause of concern. Left sided facial numbness, however, is not related to the Rathke's cleft cyst. If the symptom persists, you chould consult a neurologist for evaluation. I hope it helps. Please get back if you require any additional information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for painful lump on lower back\n\nTo whom it may concern, i have a hard lump on my lower back and to the right of my spine. It is giving me some pain and when i touch the lump it is very painfull, i have been to see my Doctor and he prescribed Brufen 600mg FC Tabs but to no effect. I would be greatfull if you would give me some more information on my complaint. Thanking you in advance.Regards;Gary Burke.",
    "doctor_response": "Hello , thank you for your question . If you were my patient i would suggest physical examination by general surgeon . It is important to know if the lump hurts all the time or from time to time . I suggest you to think of surgical removal of the lump and hystopathology exam .Best regards !",
    "dialogue_context": ""
  },
  {
    "patient_message": "Teenager. Brown discharge, severe abdominal pain, bloating, constipation. Help\n\nHi docs, i need some help please. i am  14 DPO now and no AF, at 11 dpo i starred having severe abdominal pain and some brown discharge which lasted just some hours. Until date i have this severe pain which I've never felt before, i feel so bloated, and gassy, constipated. the pain is worse than AF. so what could be the problem.",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for asking a question to H.C.M.F. You have got pain during the period and have brown discharge, You feel bloated, gassy and constipated. The pain appears to be due to anaemia, urinary tract infection, or pelvic inflamation. i advise you to consult a gynaclogist for diagnosis and treatment. You may need to have M.R.I.besides other routine tests for confirmation. Wishing for a quick and complete recovery. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dent on top of forehead possibly on skull.  No history of any medical problem.  Help\n\nHI, I recently noticed a on the top (right corner) of my forehead, a dent that was not there yesterday. I slid my fingers across the dent, and it feels as if, it's in the scull. I do not have any type of medical condition that I am aware of.I am very nervous and confused about how this happened. I don\u2019t know if stress might be the culprit but that the only thing I can think of.Hopefully you can help me figure this out.Thank You",
    "doctor_response": "Hi,Thank you for posting your query.Dents in the skull are often asymptomatic (they do not produce any symptoms) and can be left alone. There is no need to worry about them. They can occur spontaneously (without any reason) or in relation to an injury to head.If you develop headache or any other neuro symptoms, please get a CT scan of th head done.Best wishes,Dr Sudhir Kumar MD DM (Neurology)Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for the painful bump in forearm\n\nMy husband who is 61 suffered a welding burn to the inside of his forearm by his wrist 30 years ago. It made a dougnut shape lesion about the size of a nickle. Lately there is a bump forming underneath which he says is a little painful if pushed. Today he had a sonogram on it. They said they really couldn t see what was there but he should get it removed. Tomorrow he goes to a surgeon. What do you think this might be?",
    "doctor_response": "Hello,A painful lump in the area of past injury can be a fibroma or a simple soft tissue swelling like lipoma. It is best to get the lump removed and get a biopsy done to find the nature of the lump. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can clomid help me to get pregnant ?\n\na friend of mine told me that if i was having problems getting pregant that i should get clomid and take it that it would help me conceive and help with my other problems. i need some help. i am really crazy i want to be a mommy so bad. its all i have ever wanted. and me and my fiancee are trying its just not happening. and it hurts so bad. so please anyone help me . give me some advice please",
    "doctor_response": "Hi Clomid is a ovulation induction drug.It should be taken under medical supervision otherwise severe side effects can occur.You need to consult a fertility specialist first who can do some tests to find out where the problem lies.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tender skull lumps with dizziness, fatigue and jaw pain?\n\nHello, my husband has been feeling very fatigued lately, at least 2 weeks, and states he feels foggy headed like sometimes the world is moving slow around him. He says at times it s a dizzy like feeling. He also just discovered 3-4 lumps at the base of his skull. very slighlty tender, but firm and not movable. He also has reported recent tooth/jaw pain. It s intermittent, but when the jaw pain comes it s bilateral. I plan on making him a dr s appt asap, but any thoughts?",
    "doctor_response": "dear CAN i know your husband age ? it seems acute to me , 2 weeks back ! so most probably it's infection of ears or nasopharynxi suggest for you to go to a good ENT doctor , doing full examination and mostly he will need to do a CT head to localize where is the lesion.hope he gets well soon and please keep me updated",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes spasms in the left side of the abdominal muscles?\n\nHaving a pulsating/spasm feeling in the left side of my abdomen. It s not painful and sort of just feels like a muscle spasm. It s not constant, but when it happens it feels like its in sync with my heart. I m just a little nervous since the only thing that s coming up when I search my symptoms is aortic aneurysm. Should I be concerned, or is it probably just a muscle twitch?",
    "doctor_response": "Hi, It could be a simple musculoskeletal pain. As the first line of management, you can take analgesics like Acetaminophen or Diclofenac for pain relief. If symptoms persist, you can consult a general physician and go for an ultrasound abdomen. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. NT scan shows placenta is fundo posterior lower edge reaching internal os. Is travelling fine?\n\nHi doctor, Our 12 weeks NT scan indicates developing placenta is fundo posterior lower edge reaching internal OS. The doctor advised 30 days complete bed rest. I need your opinion on the same case and also doing an ultrasound scan after two weeks. This scan was done 10 days back and since then I am on bed rest. I have a family vacation (one hour flight) planned to travel in 15 days. Is this something possible and non-risky to do?",
    "doctor_response": "Hello. At 12 weeks gestation with placenta fundo-posterior with lower edge reaching internal is a fairly acceptable finding for early pregnancy. It does not really call for bed rest if there has been no episode of any bleeding per vaginum. The safest distance of placenta is more than 2.5 cm from internal os but that is in the third late trimester when the lower segment is formed. The placenta tends to climb up by 32 to 34 weeks and the present low lying status shall change. However, care should be taken to avoid intercourse completely throughout pregnancy and not to lift the weight of any kind which can cause an increase in the intra-abdominal pressure which can cause bleeding. She can walk and do her daily chores with care. Travelling is advised even in normal pregnancy after 18 to 20 weeks when the placenta matures and the fetus has become resilient to any pressure changes with an increase in amniotic fluid. Unless it is absolutely necessary, she should not be traveling as a precautionary measure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bumps on jawline and inner thighs?\n\nHi Doc I have large hard bumps on jawline hard bumps on inner thighs and open sores in butts cheek creases looks like chancroids. starts off as hard bumps. But the ones in my face are so hard i can stick a sharp object in them and draw nothing clear fluid and some blood. And their really hard I really have to puch it thru if i try that",
    "doctor_response": "Hi,Dear,Good Mornig.Thanks for your query to my HCM-virtual clinic.AFter indepth study of your query,I understand your concerns.In my opinion-diagnosis -is -Early Cellulitic -Multiple bumps on jaw and inner thigh,with cellulitis and chancroid on the butt cheeks-with ?Diabetes? other possibilities needs to be ruled out by consulting with Surgeon.They appear to be infective early bumps, with the one on-butt cheeks developing in to chancroid due to the friction in the butt crease area.I would advise to check for the blood sugar profile and rule out Diabetes.Hope this would relieve your worrysome query.Wellcome to HCM for more queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for fluid filled boil on bottom\n\nHi, may I answer your health queries right now ?  Please type your query here...I have a 17 month old with a boil on her bottom.  It is red, warm, has a head to it like a pimple and fluid filled under the skin.  I am treating it with bacitracin.  Do I need to do anything else?",
    "doctor_response": "use ointment mupirocin.. it is very effective for skin infection.. apply trice daily over the infected fluid filled area.. do not try to break the fluid blister.. it may leads to further more infection to the surrounding area.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump on the leg\n\nI have a spot on my leg, it is the size of a quarter. It is on my right calf. I have had it for about 3 weeks. It is more like a bump. It is a little tender if I push on it. At first I thought of a clot, but it is not warm. I have MS thought I bumped it but don t remember doing that. Any ideas? Teresa",
    "doctor_response": "A bump or a lump, slow growth and pain only on applying pressure suggests a benign cause, probably a lipoma or neurofibroma. It can be left alone or removed if it causes discomfort.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the sore in back of the mouth caused by an injury?\n\nSmall injury 10 days ago in back of mouth in soft tissue caused by jamming a drinking straw into back of mouth has developed into a white sore approximately the size of 1 1/2 pencil eraser. Injury has developed into small appetite loss fever and chills 48 hours ago. 24 hours ago experienced severe muscle ache especially through the neck area, which has since subsided. Oral thermometer shows body temperature at 101.6\u00b0, with no document of previous temperatures due to unavailability of thermometer. No diarrhea at this point and today am constipated. Please advise",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.The injury area may have been infected which is causing the fever and sore throat symptoms.For the relief of pain you can take a panadol or ibuprofen (if you are not allergic to any medicine).Do betadine mouth gargling .Avoid spicy food .If still persistent ,kindly get it checked from the ENT surgeon in your area for a dose of antibiotics .Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fish scale stuck in throat.\n\nHello, On Sunday I was eating soup with fish and I accidentally swallowed a fish scale. It pricked my throat on the way down, but I thought it has passed. After some time I had a feeling like it was stuck in my throat, every time I swallow, I can feel it. Today it moved lower down my throat, I think since its so small and flat it is just stuck on my throat. What should I do? Is it dangerous? I am very worried, please help.",
    "doctor_response": "Boss nothing to worry an dlisten to me.Go to any homeopathic center and ask for the medicine.they give u a small bottle and will ask u to take twice a day. just take it 2 days and see the magic.don't go to any allopaths.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I was doing a Breast self examination have been pressing my breast again again from 3-4 days and as a result i have developed pain in my breast. So can this pain convert into a lump? Is the pain because of rigrous pressing or can there be any lump? Pls advise as i m worried!",
    "doctor_response": "Usualy A lump will be felt during a physical examination. Your pain might be due to recurrent pressing. Monthly once examination will be fine for the same.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump on the tibia?\n\nHi there!  I had acl recontruction knee surery performed in Dec 2009.  They used a quad tendon graph doubled up with a LARS. I have been struggling with my knee since.  during the last 4 months, i have developed a lump on my tibia which is where the screw is located.  Today i noticed that at the tip of the lump, is has a white tip. The lump is sore to the touch.  I do not know what to do... Help...",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. By your history and description, in my opinion you are having post operative joint abscess which is now coming out under skin. Following are the points which favours this diagnosis. 1. History of arthroscopic surgery and not improving after surgery 2. Enlarging swelling which is painful on touch. 3. Overlying skin point is whitish (pus point). So better to consult orthopedic doctor and get done 1. Clinical examination of knee joint 2. Ultrasound examination of local part 3. MRI of that knee joint. You may need revision surgery. So better to consult orthopedic doctor and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is shivering associated with Adderall?\n\nHi.I was out day drinking and I took an adderal of 10mg about 12 hours ago. I was wearing heals but they were my most comfortable pair. When I got back home I stared shivering like crazy with a horrible pain on my thighs. It felts like I had just worked out a crazy amount. The shivering stopped when i threw up. I still have the pain in my thighs and I can only sleep in a certain position without having a lot of pain. What should I do? Did the adderal tense my muscles? I am very nervous",
    "doctor_response": "Hello, Usually, ADDERAL is used for ADHD treatment in children and to treat some sleeping disorders.Usually it contains a mixture of amphetamine and dextroamphetamine..it is among one of the drugs which are severely being abused... They are powerful CNS stimulant. The symptoms you have expressed is may be due to the overdose of ADDERAL, if your doctor hasn't prescribed you the medicine them kindly stop taking it, as it may lead to dependence...if you are Benning taking it on prescription kindly see your doctor. TO CONCLUDE: 1) kindly stop taking the medicine without a prescription 2) if on taking the doctors instructions kindly consult him 3) for the pain in thighs kindly immobilize and use ice packs, if the pain didn't subside consider taking analgesics like ibuprofen Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. ASIF, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can swollen lymph nodes be treated?\n\nMy wife is suffering swollen  lymph nodes issues from last 1 month, We have done USG, CT scan , Biopsy. Biopsy result negative. Doctor tell occur due to infection. We have started treatment from Tata cancer hospital. Dr given antibiotic, Swelling reduce 95% from original size. After 21 days we have test USG. But report says lymph node size not reduce inside from neck. We have done also TB test, report confirm there is no TB germs in Hinduja Hospitals in Mumbai.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.Swollen lymph nodes are also named reactive lymph noes due to infection origin.When infection is treated they reduce slowly.The may need several weeks to return to normal.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I get pregnant while suffering from PCOS?\n\nHi, I'm 22yrs of age the gynae i've 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 i've been struggling to and i've seen so many doctors and none of them are able to help me",
    "doctor_response": "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 clomiphene 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a bone spur?\n\nI wonder if I have what is called a bone spur on outside of my right foot along the bone. It s hard, hurts and have lived with it for weeks. What is a bone spur and might one have it along the outside of one s foot? My email is YYYY@YYYY thank you Elizabeth",
    "doctor_response": "With such presentations in my clinic if i wre your treating Doctor for this case of bone spur, firstly i want to suggest forhis particular issue dont try to dig out the  cause because altering or avoiding the cause will not revert back your bone spur , also it comes in majority of people only in the foot. because since many ear may be due to bone weakness or long time walking making you foot bones abnormal contour and forming a spur. the treatment can be local exicision of spur. if you can bear it and symptom free you can just leave like that. Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My 4 year old son has bumps on his penis\n\nMy 4 year old son has had pimple like bumps around the head of his penis for almost a month now. Also a big like sack that looks deflated as if there was a pimple there under the part of the penis that lays ontop of the ballsac. I was wondering if it was normal or if I should worry? I thought that they would just go away if they were poped or left alone. After his bath today I noticed more little white heads around the head of his penis. I can not get a doctors appointment till next week. Please help.",
    "doctor_response": "Hi, Thanks for query, Nothing to worry,there may be collection of smegma underneath fore skin. Clean smegma by averting foreskin daily while giving bath. ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for knee swelling post a knee replacement surgery\n\nI have stage 3 CKD. I had a total knee replacement and the swelling and inflammation will not subside. So I cannot take NSAIDS. Can I try Medrol dosepack steroids or do you know of a good way to alleviate the inflammation? Will medrol harm my kidneys ?",
    "doctor_response": "Hello, Medrol is a steroid and should not be taken without proper indication or prescription. You can do a hot compress and apply local analgesic gel for relief. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for allergic cough\n\nI have a cough due to allergies to cedar-I only cough when I talk. I don't know what to use to help. Been to a specialist and was given medication stronger than antibiotic-but don't know what it was. I can't afford to go to him and want my primary doctor to know what it might have been.",
    "doctor_response": "Hello,Welcome to HCM,As you are having the symptoms of allergy to cedar L for which your doctor has prescribed the antibiotics to tackle the infection.This drug will helps to control the symptoms of infection.You need to test your blood sample for absolute eosinophil count to confirm the presence of any allergic reaction. Then you can test for most prevalent allergens in your environment like dust, pollen, mite and food.You need to avoid the allergen which is responsible for all these symptoms, or you can choose immunotherapy. Either you can take subcutaneous immunotherapy or sublingual immunotherapy against the particular allergen.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My nose looks weird with a bent and one nostril being bigger than the other. How to correct it?\n\nHello doctor, I have a large nose which I do not really mind. However, I have one nostril bigger than the other, and my nose looks bent at the top. It has been like this since around age 15. What could cause this? I cannot recall any trauma other than having large cysts or spots on my nose which I would squeeze.",
    "doctor_response": "Hi. The general appearance of the nose happens to change from the beginning until the age of 18 after which it more or less remains constant unless and until there has been an external source of injury to deform the nose. If you feel that your nose looks way too weird, and it is way bothering you too much, you might require a corrective surgery that we call as a rhinoplasty. Now, depending on whether the area in concern has to be reduced or augmented, it depends on what type of nose job you want to get done and the surgeon will operate accordingly. Rhinoplasty is preserved for patients who know what changes they really have in mind and understand that a near close picture can be attained through surgery. Most nose job surgeons these days do have software wherein you can assess whats the abnormality in the nasal appearance, what changes you want and how would it probably look after the surgery. All the abnormalities mentioned above can be effectively resolved through operative rhinoplasty and conservative techniques do not really fetch long term results.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How do I improve my low sex drive?\n\nHello doctor, I am a 57-year-old white male. My only medication is Metformin for a pre-diabetes watch. My blood sugar when I wake up is 100 to 121. I take it daily. I do not take metformin daily. My sex drive has dropped off to zero nine months ago. When I have sex, the quantity of semen is very less. Now when I go to the restroom, a lot of bubbles are created in the urine. It just started two weeks ago. My PSA is 3.1 and the urologist says I am fine. But, I know I am not fine. Please help.",
    "doctor_response": "Hello. I would like to know a few more details. To answer your query, Metformin has no role in reduced sexual drive and the bubbles in the urine. It could be an early sign of proteinuria seen in diabetics. I suggest you get an ultrasound and uroflowmetry to check for your prostate size, flow rate and estimate residual urine. I suggest you also check your testosterone levels to look for the reason for your reduced sex drive and then we will evaluate further or treat based on the results. For more information consult a urologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Spinal pain when someone talks loudly. Reason?\n\nEvery so often, someone talks really loudly while standing right behind me, like if we are standing in a line somewhere. If the person is really loud, my spine cringes/tingles and there is a sharp pain that makes me want to arch my back as much as possible. It leaves my spine feeling sore afterwards. Sorry if that doesn t really make sense but that is the best way I can describe it. This has been going on my whole life and I am 18 years old now. I have never heard of this happening to anyone else and I would just like to figure out why this happens to me.",
    "doctor_response": "Hi and thank you so much for this query.I am so sorry to hear about this experience of spine pain when someone shouts.This is most likely not an organic cause to this pain. It is all about the mindset. It has been conditioned to feel and react in this way \\each time such a thing happens.I will suggest that you consider visiting a psychiatrist for behavioral pschotherapy if this becomes so so worrisome to you.You may for now consider finding yourself in such situations where you may need to encounter such happenings until you get all figured out. I wish you well and all the best.Dr. Ditah, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can concussion cause sudden high fever in children?\n\nMy 13 year old son started not feeling good, and has went from normal to fever over 102 within a couple hours. I have given him motrin, and it keeps rising. He got a concussion last weekend, I dont think this has anything to do with each other, but should I call a doc or bring him in?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.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 15mg/kg/dose (maximum ceiling dose of 500mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is oral vaccination for Hep A and Typhoid B available?\n\nI am planning to travel to India from Canada for 3 weeks and want to know if A) I should take vaccination for Hep A and Typhoid B) If yes, is it possible to take oral medication when I arrive in India for the above 2. I was told that I can take Immunogolublin and Vivotif when I arrive in India.",
    "doctor_response": "Hello, Oral vaccine for typhoid is available. However, it is not available for HAV. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Loveleen Sharma, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in knees and legs after scoliosis surgery?\n\nMy Dad is 80 and had severe back surgery for scoliosis about two years ago. He now suffers from severe burning in his knees and legs when he walks. It seems to be worse in the mornings. He is on several medications for pain and depression too. He has no numbness or pain in his feet. The pain Dr. said he couldn t give him a shot in the back due to the rod and pins in his spine. We are not sure his problems are a result of e surgery or some other underlying problem. Can you help?",
    "doctor_response": "Hi,thank you for providing the brief history of you.As the surgery was performed for the correction of scoliosis at the age of 80 now due to the ageing of the spine and weakness of the muscular system there will be a compression on the nerve root in the spinal column.As the doctor already mentioned about the contra indication of the steroid dose, i will advice to undergo physical therapy as by which most of the muscular system can be activated an the current symptoms can be reduced.In my clinical practice, scoliosis surgery at the age of 80 is not a recommended one, along with physical therapy most of the symptoms can be controlled. Also, to the younger generation who have underwent the scoliosis surgery do get post surgery symptoms at early or later stages of life by having muscle weakness and nerve root entrapment. We advice the patient who have undergone or who have not undergone surgery only physical therapy as most of the symptoms can be controlled as well.I also wish your father a good health as ageing doesnt require any surgery but a proper care and approach as well.In my clinical practice, i see geriatrics with a lot of spinal problems, but surgery is not the choice to perform as due to the age factor chances of the future years to get trouble may become high due to degenerative changes in the body. Physical therapy is of choice as most symptoms can be controlled with physical therapy and medications.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the procedure involved in combined modality treatment for breast cancer?\n\na \u2018combined modality' treatment for the initial stage of breast cancer. State the two aspects included in this treatment. State the methods by which a radiation oncologist can administer these therapies. Additionally, state four major differences between the two modes of treatment.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Treatment of breast cancer depends on stage.In early stage pre operative chemotherapy should be given. Then modified radical mastectomy with axillary dissection should be done. It should be followed by post operative chemotherapy and hormonal therapy according to need and response. Consult your doctor and take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cold,cough,asthma in 1 year old\n\nhi i am having 12 months baby who has cold , cough , and asthma while from last 5 months. some times my baby gets normal for long period but again this problem occurs in regularly basis in time gap period what should i do? because right now i m giving nemolizer and ambrodil cough syrup and i think that cough problem is not going out so what should i do",
    "doctor_response": "Hi, welcome to H.C.M.Forum. it is a child hood asthma effects up to 4years of age. after that usually it disappears. it is caused by allergy, effects in winter and rainy season. these two seasons never give him fruits, juices, sweets, which usually increase the frequency of the disease.in summer you can be some what liberal. when dyspnoea is more antibiotic is necessory. thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe itching near the foot with no signs of bites?\n\nAbout 8 wks ago, I got an itch at the bottom of my leg by my foot w/no noticeable signs of bites, ringworm, etc. One night it itched so bad I just got my other foot and scratched until it almost become raw because of the itching. It has turned into a dime shaped ring, not ringworm as I ve had before in my life. It s gone from light pink to a dark red now, still itching, flaking w/it. I ve tried every OCD and it s looking even worse. Any ideas?",
    "doctor_response": "Hi,    Thanks for the query. I understand your concern.     Itchy foot could be due to-     - keeping it sweaty, lack of cleaning, being packed in shoes ( poor exposure to air )& socks most of the time.. socks not being changed / washed & cleaned over days.Such condition many a times results in fungal infection( tenia pedis - Athletes foot- This is a contagious infection-- may be contacted by using same foot wares )    - Dry feet due to damage of peripheral nerves- in conditions - diabetes/ old age/ tarsal tunnel syndrome- damage to nerves cause nerve malfunction leading to itching.   - Allergy   - to soap, talcum powder, material of socks, shoes can lead to allergic itching.  * keep the feet clean off the sweat, with scrubbing off the dead skin or flakes, & nourish it with a light massage with moisturizer & a dot of  steroid cream to it  / use airy foot wear, sprinkle anti fungal powder before putting on socks/ keep the foot open / apply moisturizer  mixed with steroid cream to feet before bed time./ avoid sharing foot wear.    -Avoid known allergens.    - If you have diabetes-- keep sugar levels in normal limits ( with help of treating doctor & diet control   * If no relief with home care- You need a dermatologist's expert advise for pin pointing the cause followed by specific treatment.  Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Painful tooth, had a root canal. Should I get a new crown?\n\nHi, I would like to ask for your help. Last summer I was supposed to get root canal done. My denstist told me he can do only one root, the other root he cant access. After ensuring me its not a problem he put a crown on and off I went. About a year later, this summer I went to Europe visit home and the tooth started to hurt. Xray showed its infected. The dentist had a really hard time to get to the bottom but she got it and then cemented the crown back. Now I got the pain back. So back to xray, oh it is infected again. We went to the best dentist in the city to get it treated, hopeing this will be the last time. But he wants to treat it and give me also a new crown. Do you think he is just trying to rip us off? Is there really a need for a new crown? Thank you for your answer.",
    "doctor_response": "Hello, I am Dr.Neha Gupta (dentist) and am glad to address to your query here. There are a number of possible causes of pain after the completion of a root canal. After a root canal is completed no living pulp tissue remains inside the tooth, but nerve endings remain in the ligaments that attach the tooth to the surrounding bone. These ligaments have nerve fiber associated with them that can feel pain. They are the source of any post root canal pain. visit the dentist and get an IOPAR done and plan yor reatment according to that. Take care and please keep me informed of your progress at healthcaremagic through my profile directly. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful lump on inside of mouth?\n\nI had a filling fall out, obviously the tooth underneath was rotten, now I have a hard painful lump on the inside of my mouth (about the size of a pea) and also in my cheek, I can feel a hard ball (about the size of a quarter)...what could that possibly be?",
    "doctor_response": "Thanks for your query, I have gone through your query.The lump on the inside of your mouth and cheek can be because of the abscess formation secondary to tooth infection. Nothing to be panic, consult a oral physician and get it evaluated. You need to get the tooth restored with root canal treatment. Mean while you can take a course of antibiotics like amoxicillin and metronidazole(if you are not allergic).I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does sore in the roof of mouth indicate?\n\nMy dad had MDS and has had chemo.  He has a bad sore in the roof of his mouth.  His cancer doctor took a look and refered him to an ENT doctor.  He won't do anything to dad until he has scan.  Dad is using magic mouthwash.  He does have some pain and he says his teeth hurt.  He has been having really bad headaches and some mornings he has blood in his mouth and before he started chemo he had a ct scan which was negative.  The sore has improved a lot since last week when I looked at it.  Is this common or should we be concerned?  I have him an appointment with a oral surgeon next week.  Thanks, Chris",
    "doctor_response": "Hi .Read your query and can understand your concern about your dad.Normally ,the bleeding in the mouth is due to gingival inflammation if the oral hygiene is not maintained well.In the query ,you have mentioned CT scan is negative ,relax and visit the dentist .A normal cleaning of the teeth will help your dad have relief of the pain and sensitivity.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can precum cause pregnancy?\n\nCan precum/pee make her pregnant? I *** after she gave me a hand and i touched my penis top to check if really came so i touched some semen . After that i rubbed her virgina but she had underwear on and she was kinda wet. Did that made her pregnant? Two days before i touched my penis top to check if i ***, i was not, so i fingered her. Can that make her pregnant too?",
    "doctor_response": "Hi, Thanks for the query. Sometimes pre-ejaculate fluid can contain spermatozoa. So it is difficult to say the possibility of the pregnancy. If the act occurred around the time of her ovulation the chances of pregnancy will increase. So you wait till her expected date of periods. If she misses her periods better to go for pregnancy test once. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My testicles are slightly hard and firm. Should I be worried?\n\nHello doctor,I had an enlarged painless testicle and I visited a urologist. They confirmed that it is a hydrocele and said it would go away on its own. However, now my testicles are slightly hard and more firm. But there are no lumps or imperfections. Should I be worried?",
    "doctor_response": "Hi. Get an ultrasound done. It will clarify the picture. Sometimes, a fluid-filled tense cyst may also feel hard. It transilluminates well with torchlight. It will not go away with any medicine rather it will remain like that if it is a hydrocele. The main problem with hydrocele is appearance and dragging pain. If not bothered by these factors, no need to operate. For more information consult a urologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is video game addiction and how can it be treated ?\n\nDear readers. My brother is suffering from computer games addiction. he is 16 years old and has been playing now for 3 years. He fits the bill for a games addict- v withdrawn, asocial, hostile, plays apprx. 18 hrs a day etc. Pls advise what we can do.",
    "doctor_response": "your brothers computer game addiction may be associted with his motivation for immediate high acheivement and inability to cope with failures. aversion towards studies may be a reason. habituation, compulsive behavior, adjustment problems Poor communication and realtionship building skills may also be pushing him towards these games where he ia ll by himself in a vitual world of his own Ample number of behavor modification techiques are available to treat this condition. so consult a clinical psychologist at the earliest to have appropriate psychological assessment done to understand the cause and provide effective remidies R.Manoj Clinical Psychologist rmanojcp@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can formonide cause numbness in shoulder?\n\nI am 32 year old and asthama patient and where I am staying is cold weather -5 deg C temperature I am taking formonide 400mg and since last one month my left side shoulder is sensless, Last year I fell on left shoulder during winter. please let me know is that because of this medicine or something else",
    "doctor_response": "Hello, Very unlikely. Formonide does contain a steroid. It also contains a bronchodilator. Although steroids can cause weight gain, when they are inhaled as Foracort is, the risk of side effects like that or ant shoulder numbness are pretty rare. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr AJEET SINGH, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for nausea, vomiting and headache post an injury\n\n2 days ago I tripped and hit the top corner of my eyebrow on the corner of. My Nightstand ad it swelled up and i had a huge knot on my eyebrow almost immediately after. Im still Experiencing nausea,vomitting, headaches, sensitivity to light and sounds....i feel a great deal of pressure and tightness around my nose and eyes... the swelling has gone down but I cannot keep anything down I feel sick all day I can t seem to shake this feeling.....What should I do?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I passed carefully through your question and would explain that it is important performing a brain CT scan to exclude a possible intracranial bleeding considering the fact that your situation has worsened instead of improving. For this reason, I recommend going to the ER for a brain CT scan and some blood lab tests (complete blood count, PCR, ESR for inflammation). Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain, itchy white bumps on the hand and dizziness?\n\nI have been having pain on the right side in my stomach I went to the ER they said my liver enzymes were a little high, I have been feeling very light headed, tired, dizzy, I have little white bumps on my hands that itch and feeling hot. What could be the cause of that?",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.The cause of stomach pain on the right side can be due to Hepatitis, swelling on the liver and / or gall bladder as you have raised liver enzymes.The cause of the white bumps on the hands that are itching and feeling hot can be due to Urticaria or Hepatitis.It is common to feel light headed, tired and dizzy due to Hepatitis. In fact, these are the first signs of the hepatitis in many cases.I would advise you the following:Consult a Gastroenterologist.undergo ultrasonography of the abdomen.Review liver function and kidney function tests and other blood tests, urine and stool test relevant fo the problem. You will be started on the Hepato-protector medicines .BED-REST is still the most important of the treatment for hepatitis and your Doctor will prescribe you medicines for symptomatic relief. Take full course of 3 months and if required to go for advanced tests if there is delay.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the allergic reactions be due to seafood?\n\nmy daugfhter had an allergic reation to something we are not sure, she went to the hospital and she at theat point became difficult time breathing tx along with other medications..steriods i.v and a dose of antibiotics. she was discharged. when she got home she wanted to eat some fish and shrimp as she wanted to. the bottom line is she woke up with numbness in both arms could be reation to the seafood/",
    "doctor_response": "Seafood is a potential ingested allergen. If your daughter is having recurrent symptoms, kindly avoid it in future.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment to get pregnant?\n\nI ve been trying to get pregnant for about a year. My tests have all come out okay. My husband went to have his sperm checked last week but I havent received the results yet. I ve heard about blocked vas deferens. What exactly is this and is it corrrectable?",
    "doctor_response": "Hi,Glad that your results are normal. Sperm count and composition will give us a clear picture of your partner's fertility potential.With blocked vas deference, sperm count will be zero.Vas deference block occur's when , there has been a surgery in genital region for hernia ,hydrocele or road traffic accident.It could also be due to a genetic condition called cystic fibrosis.So if he is diagnosed with vas deference block then he needs to be evaluated for cystic fibrosis as it can have an implication on your future  child as well.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i get conceived with multiple developing follicles in right ovary?\n\nI got my follicle report just now on the 9th day of my cycle and it shows left 14mm*12mm,17Mm*14mm, the right ovary shows multiple developing follicles avearge 10mm-MFD and the endometrial thickness is 5.3 mm.I know there is still time for growth but do I have chances of conceving this cycle",
    "doctor_response": "average follicles size should be 18 mm you should get your preg at that size n still u know u hv time to grow cz its only 9 days you should wait for 28 mm minimum n yes in this cycle you can conceive",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does pea sized pimple on scrotum indicate?\n\nHi. There is a pea sized pimple type thing on my scrotum, but when I try to pop it it does not pop and it is painful only when I touch it. I left it alone for 2 days thinking it would go away but it has stayed and now there is a little black spot inside of it. I'm a bit worried.",
    "doctor_response": "HelloThanks for query .Based on your statement I would state that you have developed a Sebaceous Cyst over scrotum .The scrotal skin is rich in sebaceous glands and hence prone to get  sebaceous cyst due to accumulation of sebum beneath the skin.Normally it fades away without treatment however  needs to be treated if increase in size or get infected.Take broad spectrum antibiotic like Cefixime along with anti inflammatory drug like Diclofenac twice daily for a week .If does not subside consult qualified General Surgeon for evaluation .He may advise you to get it excised in Totto under local anesthesia.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does one feel sick in the stomach?\n\nI have been recently diagnosed with PTSD/ Burnout so bad I was told to take 3 months off work - 1 month in . I am sick to my stomach and generally feel sick (better than it was) daily. How long is this going to last? When will I start to feel better?",
    "doctor_response": "hello,dont be worried.all that you are suffering is from stress disorder.do be calm.get relieved of your stress...do talk to people you trust.be positive.things will go fine",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vaginal discharge during pregnancy while taking Macrobid tablets?\n\nMy daughter (26) is just shy of being 6 months pregnant....she is experiencing kidney stone issues. Within the last 72 hours she ended up having a stent put in and they plan to leave it there until after the baby is born. She is on the antibiotic Macrobid and I was helping her look up information on this medication. She experienced an unusual discharge (vaginal) this morning - no pain, no blood...no cramps etc. Just a discharge she hasn t seen before and she called me to ask if I thought that was normal. (She is at work) so I looked it up and see that it is possible to have a vaginal discharge while taking macrobid. Question is - without pain, blood, cramps or anything - should she call her OB about the discharge or since she is taking the medication Macrobid and it says vaginal discharge is possible.....should she just see if she continues with this discharge. I also noticed it said not to take this medication while nursing and not to take it during the last 2-4 weeks of pregnancy. THAT bothers me - why is it safe for the baby NOW but not in the last few weeks of pregnancy?? Thanks",
    "doctor_response": "Hi there,,Macrobid or nitrofurantoin is the recommended antibiotic for Urinary tract infections in pregnancy except after 38 weeks as it can cause a rare type of blood disorder called haemolytic anemia in the baby.It is safe in the remainder of pregnancy and is Category B ( that is proven to be not harmful).It is secreated in breast milk which is why its not prescribed to breast feeding mothers.If she has discharge she should get examined by an obstetrician as vaginal infection can occur in pregnancy and these need to be treated promptly to avoid preterm delivery.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen foot and ankle after injury\n\nI had a fall down stone steps. Don t know how I didn t break something but I didn t. Didn t have it checked though. A very large and painful bruise and lump appeared and it was very painful. That was 3 and half weeks ago and the lump is still there, painful and my ankle and foot is still swollen. Have just come back from a long haul flight so expected my feet to swell anyway but the injured leg/foot is still swollen. Should I have it checked or will it go away on its own",
    "doctor_response": "Hi,Thanks  for  your query.An initial xray of the injured part is mandatory to rule out any bony injury (fracture). If the xray is negative for a fracture, then the other possibility is soft tissue injury either to the ligaments, tendons etc.Knot might be due to haematomaformation(collection of blood).you can take anti-inflammatory drug like motrin to reduce pain and inflammation.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is amoxicillin safe for folliculitis in the groin area?\n\nI have a bad case of folliculitis in the groin area. Have used benzoil peroxide wash, and doesn t seem to be helping. I have some amoxicillin that has been prescribed in the past, and was effective. Would it be okay to ask my doc for that again? I haven t been on it in over six months.",
    "doctor_response": "Hello,This is Dr. Klarida Papaqako answering your question.If benzoil peroxide topically have not worked, I agree with you, that you need to take systemic (orally taken) treatment.Amoxicillin in is not the first choice, as it may not clear completely the infection, since the bacteria that cause folliculitis may be resistant to it. If I was your caring doctor I would recommend to take one of these  first generation cephalosporins, dicloxacillin, flucloxacillin, fusidic acid or azithromycin.In general I give my patients Cephalexin (a first generation cephalosporine) 500 mg, 1 tablet every 12 hours, for 7 days. Hope this information helps,Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling and pain in the knee\n\nI have had a total knee replacement several years back and I have recently taken two falls to the knee cap in the last week. I can walk with some pain but it is extremely painful to the touch. it is swollen on and below the knee cap and some discoloration. what are my chances that I did any real damage?",
    "doctor_response": "Hello, Consult an orthopaedician and get evaluated. You have to get an MRI scan done for further evaluation. As of now, you can take analgesics like acetaminophen or tramadol for pain. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for throat cancer\n\nI have a friend that just found out he has throat cancer.and has gone through 5 weeks of treatment.he has one week to go,but is at a stand still,cause the radiation has burnt him so bad from the inside out.his neck is burnt on the outside.is that Normal?",
    "doctor_response": "Hi,Thanks for writing in.Cancer of throat requires to be treated with combination of surgery, chemotherapy and radiation. In early cancer doctors suggest surgery followed by chemotherapy and radiation therapy.In later stage cancer there is radiation and chemotherapy treatment which works better. After radiation if the cancer is down staged then the patient might get surgery done. Radiation is a type of high energy treatment which kills the cancer cells. This is known to cause effects like skin and mucosal burns in the area of the target radiation. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headaches after taking medication post knee replacement for BP and diabetes?\n\nI have been prescribed Mobic after knees replacement, over a year ago. I am experiencing a sick headache for two hours or more after taking the Mobic. I take an array of other medications for diabetics, blood pressure and cholesterol. I also take baby aspirin, the purple pill for an ulcerated esophagus, and several supplements. Am I having a reaction to the Mobic or a combination of drugs.",
    "doctor_response": "Hello,Based on your complains, medical history, and profession, I think you have carpal tunnel syndrome which is the compression of the median nerve in the wrist region due to overuse. I suggest you to do e nerve examination EMG and then see a hand surgeon, if the results show carpal tunnel syndrome.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Edvin Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is kidney cyst causing abdominal pain a serious problem?\n\nhello Doctor, my elder brother aged 45 is a drunker from long time. last week he got a pain near abdomen. after consulting doctor he scanned & found Right kidney 97 x 43 mm where left kidney measures 102 x 54. single thin walled cortical cyst measures 15mm posterior interpolar region of the left kidney.... Nw i want to know is there is any serious problem?",
    "doctor_response": "HelloSimple renal cysts are generally asymptomatic in nature and usually it only require follow up ultrasound.Your brother may need clinical evaluation.Renal cyst may cause pain if size of cyst increases or there is infection in the cyst.It generally doesn't require any treatment.Your brother has a small renal cyst and it is not a serious finding.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is bilateral hilar prominence in the chest a matter of concern?\n\nHi,My mother had her radical nephrectomy done 2 years back to remove one of her kidney.She was advised for USG-Abdomen and X-Ray Chest every year to check if there is any re-occurence of the tumor.This year,while.the USG showed everything normal,the X-Ray Chest says \"Bilateral Hilar Bronchovascular Prominence\" is observed.Rest lungs fields is clear and every thing else is clear/normal.Should I be worried,for a re-occurence ? Should I go for any further test for conclusion?Or could this be a normal thing ?",
    "doctor_response": "Bilateral hilar prominence is seen with: 1. Heart failure 2. Bronchitis 3. Lung mass 4. Normal X-ray. So in my opinion she should definitely get done ECG, 2D echo and stress test to rule out heart diseases and PFT (Pulmonary Function Test) and CT thorax for bronchitis and lung mass. If all these are normal then no need to worry for major heart and lung diseases. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pain and swelling in left leg with history of sprained ligaments normal?\n\nHello, 4 years ago, I sprained/strained ligaments in my left shin/ankle/foot. I still have pain & swelling. Should I still be having pain & swelling four years later? I was 46 at the time of my injury. My orthopaedic dr. is sending me an EMG. My email address: YYYY@YYYY . Thank you.",
    "doctor_response": "Dear patient Sprain takes about 4 to 6 weeks for healing if given  proper rest and protected for the same time. If not treated properly with rest it becomes chronic with constant pain and difficult  walking. We have to investigate  with mri of involved  ankle and  foot  and  not EMG.  MRI gives detail of which ligaments are sprained  and also helps in assessing  severity of sprain. Visit radiology center nearby you and get it done.  You should visit expert orthopaedic  surgeon with report.  All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the effects of spleen not functioning in newborn?\n\nmy granddughter was born 6 wks early. Wt 3lbs 8 oz. Mother had no amniotic fluid. born with an enlarged liver. but liver function level are WNL. Spleen was not functioning. has had 2 units of blood, but platelet count is still low. She also had low blood sugar, bvut it is now WNL also. How dangerous is the spleen nhot functioning properly. I m an LPN, but I know that preeemies are not the same as term babies.",
    "doctor_response": "Hi,Welcome to HCM forum,Spleen being nonfunctional is not dangerous but the problem that might rise due to it can be significant. Spleen is like an organ that protects body from encapsulated organisms whose infection can cause deadly diseases and so its absence can lead to infection from such organisms. So, its usually advised to get vaccinated from those organisms. You need to also know that spleen is removed in a great number of individuals, a procedure called as splenectomy and still they lead a totally normal life. So, in this case, awareness and precautions are more important than being worried about the situation.Hope I answered you query adequately. Let me know if there is any further clarification you need. Take Care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rash around waistline. Using gold bond anti chafing stick. Treatment for rash?\n\ni am on vacation and developed a rash around my waistline from wearing my wet bath suit all day. We are staying at a fresh water lake in XXXXX. I get this evrey year we come here, but it usually goes away when i get home after our one week vaaction. but this year we are staying 2 weeks, what type of medicine could i put on it for relief? I also have started using a gold bond anti chafing stick as well.",
    "doctor_response": "Thanks for asking question, The condition you have described is allergic contact dermatitis with wet towel .avoid wearing it and use dry clothes .also apply Synalar cream 8hourly and take Lortadine 10 mg daily for 3-4 days.let me know after it and bye for now.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause swelling in the corners of the face and ears during pregnancy?\n\nHi Dr. I have a question for you I just came from emergency room I have a problem with my ear there is no pain but is soon as I eat something sour  The corner of my  Face and behind ear gets really swollen I really don\u2019t know what\u2019s going on and plus  I am 11 weeks pregnant and they can do x-rays  they told me there\u2019s no infection no I need to come home and eat more sour stuff So I can produce more saliva help me please",
    "doctor_response": "Hello dear,welcome to Ask a doctor service. I reviewed your query and here is my advice. I think there is an inflammation of salivary gland or parotitis. Also sjogren is possible. Hope I have answered the question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have cloudy urine and burning sensation while urinating. Is it UTI or STD?\n\nHello doctor, I think I might have UTI, since I suffer from burning sensation while urinating, and then cloudy urine at the beginning. I did urine examination routine, in which leukocyte esterase was positive, nitrites negative, and high pus cells in urine 8 to 10. Also did urine culture after that and nothing such came in it. I had unprotected vaginal sex four months ago. Is there any chance, that this is not UTI but some STD? Please help me.",
    "doctor_response": "Hi. I have gone through your query and your reports (attachment removed to protect patient identity). I would like to know a few more details to answer your query better: It is unlikely for an STD to present for four months after sexual contact, also your symptoms are more suggestive of a UTI. It is possible to have a negative urine culture because of sampling errors (the urine specimen given may not have had an adequate bacterial load) or organisms that do not grow in culture or infection of the prostate gland.  You would require a detailed clinical examination by a urologist to ascertain the probable cause of UTI and also rule out STD. I would also advise a repeat urine analysis and urine culture and serological tests if you are concerned about the possibility of STD's from the unprotected sexual contact. In the meantime, you can drink plenty of fluids to help flush out any bladder infections. For more information consult an urologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden numbness,difficulty in speaking and memory loss?\n\nHi,For the past year I have had what I call funny turns. Without warning i become tingly all over and a feeling of numbness sweeps over me and i find it difficult to speak. I become a bit shaky and then it seems to pass. I can have up to five episodes a day or it can drop to once a month. After an episode it feels like everything has slowed down and i find it very difficult to get my words out & think of the most simple vocabulary. My brain doesn t work quickly and i feel removed from reality. I think these episodes are now becoming more frequent and increasing in duration. I have had an ECG but that was fine.Could you help with a diagnosis?",
    "doctor_response": "Hello there,Based on your symptoms you seem to be having TIA(transient Ischemic attacks). Your brain's blood vessels are not allowing enough blood through them and that leads you to have episodes that affect different parts of the brain. This can be detected if we can visualize the blood vessels supplying to your brain through a digital subtraction angiography and also a CT to study any areas of low blood supply in the brain. Since these tests are expensive I would advise you to consult a neurologist before proceeding further . other possible differentials could be focal seizures of the brain or raised intracranial pressure. Hope this helps, Please feel free to address any further queries to me. i will be happy to answer them",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can be done for microcytic hypochromic anemia and anisopoikilocytosis?\n\nHello doctor,My son has microcytic hypochromic anemia and mild anisopoikilocytosis with ovalocytes seen. No hemoparasites seen. What can I do? Currently, he is taking Cyclosporin 100 mg and previously, he used to take Prednisone 30 mg.",
    "doctor_response": "Hello. I have seen your attached reports (attachment removed to protect patient identity). As per the reports he is having autoimmune hemolytic anemia because of reticulocyte count high, normoblast is seen, DCT (direct Coombs test) positive, ICT (indirect Coombs test) positive. So for that continue prescribed medication that is a steroid that will be beneficial in your case. In autoimmune condition antibody forms against own cells so Prednisone will be helpful that has been prescribed to you.  Take care. Consult hematologist regularly for follow up. For more information consult a hematologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to forget past experiences and move on in life?\n\nI am unmarried 24 yrs old girl. Now i am studing MBA. Iam in love. We both love each other sincerely and seriously. Our love starts on 2004. During my UG, my parents came to know about my affair. They didnt accept because his native is tamilnadu and my native is kerala. I obey my parents words. Then i told him 'dont call me until i call you'. My love ends on 2007.             With the past 3 years he didnt call me even mail me. He respect my words. But now he re-enters into my life. Last November he mail me. Now he is going to marry another girl. His parents getting older. He is forced for marriage. His engagement on Dec 12 and marriage on April. He is not interested for marriage.               Then I again told to my mother for permission. But still she didnt accept our love. She told that if i marry that person means she will go out. I obeying my parents words. I am living only for my parents. I told to my affair about this. He said \"ok.without parents permission we cant do anything. But i want to talk to u upto my marriage\". Sadly we continue our love.             Now i am in  trouble. I am unable to think about my marriage. I want to recover myself from this problem.Please please help me.Please send ur valuable advice for me to this mail id  YYYY@YYYY .                                                                   Thank You",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. I can understand your problem. Amicable solution is to make up your mind for another marriage. once you make up your mind for another marriage, the conflict goes off. once the conflict goes off, the mental torture is bound to reduce and stop after some time. Decision making is the key. if your decision is strong, conflicts seldom happen. You have the capacity to take decisions. Do not under estimate your abilities. go ahead.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 the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does elevated blood platelet count indicate?\n\nI got the results back from my blood work..... ANA was negative, but MY BLOOD PLATELETS WERE ELEVATED. WHAT DOES THAT MEAN.? I am struggling with a horrendous skin condition that is a combination of rash, bumps, bleeding, scabs, itching, scaly skin, you name it. And it started on my legs last fall.....now spreading to my arms and back.....lots of itchy bumps. That\u2019s why they did blood work, to check for Lupus. So with negative ANA, I assume I do not have Lupus. But this skin condition is debilitating!",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The elevated platelets are likely a reaction to your skin condition, and in the absence of other blood anomalies, is nothing to worry about. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the hard lump filled with white stuff on my gums?\n\nI just found a hard white bump in my gums, underneath one of my lower canines. After poking at it with my finger, the white bit came out. My gums around the tooth are swollen and there s a pinprick of blood where the abscess popped out, but there s no pain. There was no pus, but I was able to squeeze the white bit after it came out. It made a popping sensation and a tiny bit of fluid leaked from that. Is this just an abscess? I gargled with mouthwash to kill whatever my bacteria might be around the site, but I can t afford dental care.",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You may have some abscess formation due to gingivitis. you should take a course of antibiotics.  Consult your doctor and take treatment accordingly.  If ypu don't get benefits then consult dentist for further investigation. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can 'exhaust fumes' cause any harm to health?\n\nI smell what appears to be \"exhaust fumes\" off and on throughout the day mostly in my home.  I know that there is data to indicate that certain smells can indicate health problems.  Does my situation sound like something you've dealt with in the past?",
    "doctor_response": "Hello dear , hiWelcome to Healthcaremagic.comI have evaluated your query thoroughly .*  Exhaust fumes can cause health problems to many persons  which     depend  upon many criteria .*  Needs  clinical  assessment  with  x-ray chest and pulmonary function     test  to evaluate the issue  and  manage  accordingly .Hope this clears your query .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Permanent solution of keloids\n\nhi.. i have keloids problem near the neck just frm 2yrs.. i had consulted so many docters but its not getting solved.. is der any permanent solution for the removal of keloids plzzz tel me",
    "doctor_response": "welcome to healthcaremagic if it is true keloid it is difficult to treat consult surgeon/plastic surgeon and get a check up be explained about the condition there are treatment like intra keloidal excision and others keloids are known for recurrence your doctor will guide you and do accordingly",
    "dialogue_context": ""
  },
  {
    "patient_message": "My skin pigmentation have reduced, but is Panderm+ cream safe for prolonged use?\n\nDear Sir, I had marks on my face and due to pigmentation my skin colour turned black. A known pharmacist has suggested me to use Panderm+ cream and i am using it from past 3 months. My skin colour has been changed to normal and marks has been reduced to 75%. CAn I continue using it as the pimples are still visible on my face. Kindly suggest",
    "doctor_response": "Hi, thanks for posting your query Panderm plus contains a potent steroid clobetasole , which should not be used without doctor's advise especially on face for more than 2 weeks as it may lead to thinning of skin , visible blood vessels and pimples You need to discontinue it and use clindamycin and adapalene combination for pimples and get it evaluated by a doctor for the type of acne and appropriate treatment . Once acne is under control you may use depigmentation creams as per doctor's advice Hope his solves your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to confirm melanoma?\n\nHi doctor, I have a mole on the right side of my face. It is uneven, weirdly colored, has no clear lines and bleed easily if scratched.\u00a0I have a lot of moles in my scalp but none like this.\u00a0Could it be melanoma? If it is not then can I just scratch it off?\u00a0I wish to know your opinion.",
    "doctor_response": "Hi. I have gone through your photos (attachment removed to protect patient identity). As per experience only two skin diseases looks like this. The first one is of course melanoma and the second is seborrheic keratosis. The main signs and symptoms of melanoma are as follows: It is true that white people are more prone to get melanoma, but your site of lesion is not common. In this age melanoma or other skin cancer comes over more photo exposed part of the body like face or hand. Now, let me explain the signs and symptoms of seborrheic keratosis. Now, I personally feel your problem goes more towards melanoma or BCC (basal cell carcinoma). You need to go for biopsy. Biopsy would be an ultimate tool to diagnose the disease. For further information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anxiety and stress\n\nhello sir my brother is 21 years old he is going to appear for chartered accountants intermediate exam in november suddenly on 9september he started fearing one of our family members saying she is going to harm and destroy the whole family and she is not a woman but a hermaphrodite we have consulted a near doctor who is a psychiatrist he has given medicines . actually once he traveled with our relative whom he is now fearing in a local train and they had to share their seat with a hermaphrodite from jaipur to delhi in 2008 he is linking it with that he has all awareness that he has to for exams is it because he studied late in the night",
    "doctor_response": "HIThanks for using healthcare magicI think, he is in psychotic episode. In that case, he needs antipsychotic medications that would help to control underline symptoms. With antipsychotic he would improve in few days or weeks. Better to consult your psychiatrist for diagnosis and management. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a swollen lymph node under arms suggest?\n\nMy daughter who is 28 yrs old went for a mamagram as she has had a swollen lymph node under her arm for 3-4 weeks. At the mamagram she was told it looked suspicious and was considered a B-4 ? and to go for a biopsy. My question is what does that mean suspicious and a B-4? Any help would be appreciated. Thanks,",
    "doctor_response": "BIRADS is a score given to Mamographically visualized lumps or lesions and given a score from 0 to 6 with chances of cnacer being present in the lump increasing as the score increases. 0 means incomplete assessment. 1 and 2 are negative for cancer. 3 means low chances of 2% of having breast cancer. 4 is suspicious with 20 to 35% chances of cancer. 5 is 95% chance of cancer. 6 means already proven cancer by pathologist. So in your case as the score is 4 yours is a suspicious lesion. Please go ahead with the biopsy at the earliest. Treatment can later be tailored depending on the report. You can let me know the report by asking a question on my profile page or by using the ' Ask a Specialist ' section of the site. Take care. Dr Rishi, New Delhi, India.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am i getting pain all over the body?\n\nI was diagnosed just over a year ago with an L5/S1 annular tear and after trying nearly everything I m no further along. Since day one though the symptoms have never fit together. Dull stabbing pain is clear as day in that S1 area but the radiating pain doesn t fit and I believe I may also be dealing with pinched nerves. Standing causes medial foot pain in the heel and numbness in the toes, especially the right foot and big toe. Occasionally I feel shooting pain under my left testicle as well. Any quick movement or resistance causes upper body trembling. Pushing through my abdomen as if I m straining to pee causes my lower back to tremble. My lower back behind my abdomen, and the abs themselves get on fire after awhile from standing, sitting, activity, ...basically anything. Often times I feel pain behind the ribs, especially the left side, maybe where the trigger points are? Every day I wake up and rush to get what I can done before lunch when I m forced to lay down with a heating pad and 5 mg of Oxycodone-Acetaminophen. I do the same until dinner and then one more time before bed. If I sit straight up with good posture or stand my L5/S1 fires up, and if I hunch and/or sit my lower back is on fire. Its not livable and nothing has worked. PT, chiropractic, epidurals, etc. I m trying to journal daily with as much detail as possible but how do I even know who to check with? I d like to see someone who can look at the total kinesiology and figure out the cause as well as a solution. Fusion surgery has been mentioned by the Spine Dr. but I feel that is but one of the issues and not the source itself. At least not completely.",
    "doctor_response": "Hi, I passed carefully through your question and would explain that your symptoms could be related to the chronic degeneration on your vertebral column and the pressure on the nerves. For this reason, I would recommend physiotherapy and trying Gabapentine or Pregabaline for the pain. Another treatment option would be amitryptiline. You should discuss with your doctor on the above treatment options. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dull pain and pressure in right ear?\n\nI have been to an ENT and they can t figure this out. My right ear has dull pain (every once in a while stabbing pain - Not too bad) and a tiny bit of pressure. It isn t enough to hurt really bad, just drive me nuts. It s not getting any worse, or any better. They have tried antibiotics, steroid, and drops. They also thought it might be T&J??? However, the tests (pressing fingers on my head) don t seem to cause pain. Also, my ear does not hurt to the touch. The doctor said my ear looked fine. What can this be?",
    "doctor_response": "Hi, I understand your concern. The ENT doctor excluded ear problems for your right ear pain. Then, we should look to other causes including:- TMJ (temporo-mandibular joint disorders) : that should be checked by maxillo-facial surgeon/specialist, and X-ray of this joint should be run- bad teeth : check it by your dentistI'm sure you'll find the right causative to the pain. Apply warm compresses locally to ease the pain. Sometimes, alternating with cold compresses can help. Wish fast recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair loss\n\nsudden hair loss. female,age 26, weight 120 lbs. I've recently found out about my hair loss.  sudden bald spot appeared on back of my head. I am concerned because I've take plan B pills twice over 4 months period.  I wasn't aware of the side affect until recently.  How can I prevent more hair loss and how can I recover from the side affect? is there a cure?",
    "doctor_response": "Hi,Welcome to HCM..I feel that most probably you may be having alopecia areata.Alopecia areat is an autoimmune skin disease characterised by bald patches on scalp. Exact cause is not known. You consult dermatologist and have firm diagnosis and treatment. Thyroid dysfunction should be ruled out.I would like to suggest as follow..- immunomodulator like levamisole 150 mg twice a week- biotin 10 mg containing tab once a day- apply methoxsalen solution on bald patches at night- apply mild steroid lotion- intradermal steroid injection...by expert dermatologist I can understand your concern for baldness.Avoid anxiety and tension to have good result. Take regular and proper treatment.Thanks..Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "On birth control pills, forgot to take first pill. Breast sore, feeling bloated, frequent urination. Should I worry?\n\nwell i have been taking birth control pills for over 10 months already. so now on this month i opened a new pack and forgot to take the first pill on this package.now it's been like 2 or 3 weeks later my breast feel  sore to the touch and a week before that started, I was cramping and felt bloated. I have been going to the bathroom frequently and my period is due in about 5-6 days . should I worry?",
    "doctor_response": "Hi and thank you so much for this query.I am so sorry to hear about the symptoms you are experiencing. Missing a single pill in a pack though not advisable would in no way increase your chances of becoming pregnant. The symptoms are typical of premenstrual syndrome. Maybe you are not used to this but it could be a possibility. For the frequent urination, I will suggest that you get your urine tested as this could be a sign of urinary tract infection.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.Dr. Ditah, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is my daughter's ear problem neurological?\n\nHi doctor, My daughter has nerve hearing loss of around 50 % in left ear along with tinnitus since 10 years. She is 22 now. On the second of this month, she had put a drop of oil in the left ear. In finding herself uncomfortable, she visited an ENT, who put her on antibiotics for middle ear infection. Audiometry at that day was normal of the right ear. Next day, there was a slight discharge from the left ear. Two three days later, she had heaviness, which was fine after 2 to 3 days. During the time, she visited home, and on 12th, the heaviness of the head appeared again. So, we visited the ENT again, who extended the treatment for five\u00a0more days. On 16th, she felt buzzing sound in the right ear also, and we visited another ENT. The doctor found a\u00a0mild hearing loss in right ear, and immediately put her on Omnacortil 20 mg on the\u00a0first day\u00a0and 60 mg on the second. After that, 30 mg for three days and 20 mg for the next four days.\u00a0On 17th, that is, the very next day of starting Omnacortil, audiometry was repeated, and this time, it was normal for the right ear. The doctors' observation was that probably yesterday she might not have responded properly or the medicine has covered the mild loss, but precautionary she continued with Omnacortil. The treatment is on, but she still has heaviness and slight pressure in the\u00a0ear. We have consulted another ENT, who did an endoscopy and suggested that she has inflammation in the nose and Eustachian tube blockage. He started treatment for the same in addition to Omnacortil, which is on reducing dose. However, despite all, she is still feeling heaviness in the\u00a0head and slight pressure in the\u00a0ear. She had undergone complete blood test also, which came back normal, including thyroid, except she has a\u00a0severe deficiency of vitamin D3 and B12. They were 7.93 and 173 respectively.\u00a0In view of this, kindly suggest if this is a neurological problem. Should I consult a neurologist?\u00a0She is depressed and scared. Thanks.",
    "doctor_response": "Hello. Revert with more information to a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the treatment for chronic gastritis?\n\nHi doctor, I am asking for my dad. He is 65 years old. He has chronic gastritis, gout and now an itchy rash. Also, he says that he is having a feeling of cold. I am not sure what is going on. His gluten test came back negative. Please suggest something.",
    "doctor_response": "Hello. I had gone through all the data posted.\u00a0Kindly tell me more details about his present problem. Revert back with the details to a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What doe a hard lump near the testicles indicate?\n\nHello, I have a question in regards to a lump I found on the left side of the testicle. I have a hard lump on the side of my testicle. The lump is not beneath the skin I can actually see it and feel it. The lump does not hurt but I do have a consistent discomfort/ache in my left testicle. Also I notice that my testicles hardly hang anymore in the sac. Also recently over the last week or so I notice a constant ache in my lower back and groin area. I have research testicular cancer lumps but I get a lot of different information. I am currently away from home and will not be able to see my doctor until next month. What could this be?",
    "doctor_response": "welcome to Health care magic.1.Testicular lump what you feel could be the collection in the sac, Cysts and mass.2.The inguinal hernia also seems like a mass, it does not give pain until it is strangulated. 3.All these questions can be solved by getting an ultrasound scan done - gives complete information and non invasive and cheap investigation.(even if its just skin thickness also evaluated.4.Dont be afraid as it not painful you can book an appointment with your doctor and get the scan done as soon as you can.5.Hope it helps. Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could it be if having a rash from thighs, scrotum to butt cheek?\n\nhi i have a reash from heat on my  thighs scrotum and up my crack onto my butt cheeks could heat rash have turned into a fungal infection it hurts so bad i cant hardly walk i used exssesive baby powder and try to stay clean and dry there is no ac where i am help",
    "doctor_response": "Thank you for query.It may be due to fungal infection.Please take following precautions.Use loose cotton clothes.Keep area dry.Apply antifungals like terbinafine which is fungicidal.Once subsides use regularly antifungal dusting powders like candid or absorb powder to prevent recurrence.consult doctor if does not subside.You can get back to me for any clarifications with the photos.Dr Bharatesh D Basti Dermatologist and Venereologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be done immediately after a head injury?\n\n14 yo son just suffered from an assault 3 days ago. Concussion, fractured jaw, broken nose and cornea abrasion. He has pressure in his head now but the catscan the day of said there was no bleeding. Should I take him to emergency because of the head pressure for 24 hrs now?",
    "doctor_response": "Hi and welcome to HCM. Thanks for the query. There is possiblit xfor delayed intracranial bleeding but this happens extremely rarely. ehad contusion usually goes with headache which is more significant several days after trauma than right after it so this is nothing unusual. he should continue with resting and painkillers and if there will be conciouness changes, then you need to take him to hospital asap.WIsh you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Ultrasound shows swollen intestines, abdominal and back pain, nausea, foul smelling diarrhea with blood and mucus\n\nHello, I went to my obgyn a couple days ago because I was having symptoms of pregnancy. They did a pregnancy test and ultrasound that both came back negative. However in my ultrasound it showed that my intestines were swollen. The symptoms i am suffering from is abdominal and back pains, severe nausea , foul smelling diarrhea that has been both bloody and with mucous. Do you know what I may be suffering from?",
    "doctor_response": "Hello first get your stool examination to find out the cause of dysentry it can be due to amoebic infection or enteric bacteria treatment includes fluids, oral or intravenous depending upon hydration status plus antibiotics depending upon cause",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sneezing and bleeding nose in a child\n\nmy 10 year old wakes each morning to sneezing and a bleeding nose. I have washed out nasal passages before bed as well as coating with olive oil. He also breaths thru his mouth verses his nose while he sleep. No Fever, mucus is clear once nose stops bleeding, eys burn and ears sometimes itch.",
    "doctor_response": "Hi...by what you quote I feel that your kid is having a moderate to severe persistent allergic rhinitis. In this the symptoms typically are like what you have quoted. But the reason for recurrent nose bleeds could be the habit of nose picking the dry crusts in the nose which needs to be curtailed. Eye burning sensation and ear itching could also be due to the same allergic manifestations.He needs evaluation and he may need to be started on intranasal steroids like Fluticasone or Mometasone which is the best approved therapy now currently. But before going ahead with the therapy he will require certain blood tests like complete blood counts/ Serum IgE and an imaging of the para-nasal sinuses.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I bled two days after intercourse. Is it due to nexplanon induced ectopic pregnancy?\n\nHello doctor, I am 20 years old. I have a 2-year-old kid. I currently have the nexplanon implant birth control. I had a pregnancy scare a month ago but started my period finally. The day after my period stopped is when intercourse happened. Two days after that I woke up and I had a little bit of blood in my discharge my cramps were scattered through out the day I thought I was fine though. The next morning I woke up with bad cramps. I felt a trickle down my leg so I rushed to the bathroom and I was bleeding. The bleeding has slowed down since morning and my cramps went from morning to evening in pain. On my mother's side, we have miscarriages, ectopic pregnancies, tubal pregnancies, but no one on my father's side has had any problems with getting pregnant. Also, the nexplanon increases your chance of having an ectopic pregnancy. So I was wondering what this seemed? Should I worry? or is it just me getting my period again? What should I do about it? Please suggest.",
    "doctor_response": "Hello,  Welcome to icliniq.com. Considering the fact that you are using nexplanon, it is unlikely that the bleed would be probably due to pregnancy or even ectopic simply because nexplanon is a progesterone implant which prevents ovulation, make the endometrial lining unsuitable for the implant and increases tubal motility with thickening of cervical mucous making it difficult for sperms to penetrate through. Hence pregnancy seems unlikely.  Postcoital bleeding as noticed in your case could possibly be due to cervical erosions or ectopy, which can be possibly caused by an HPV (human papilloma virus) infection or after a rough sexual episode as well. But in either case, a per speculum exam is required along with a pap smear test and an ultrasound pelvis as well to rule out any organic cause. It is not your menses for sure. So advise would be to visit your physician for a local exam first.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can an upper respiratory infection be treated?\n\nI have had an upper respiratory infection for 2 weeks and my left is has an ear infection. It doesnt hurt i jist cant hear out of it at all. I need to know how to fix it so i can hear again. I saw the doctor just the other day and was prescribed amoxicillin for my upper respiratory infection but it s done nothing for my ear infection. What should I do?",
    "doctor_response": "Hello,You may need to be reviewed; there are some bacteria that cause ear infections that do not respond to typical antibiotics. You may need to give an alternative course of medication.In addition, you may need antihistamine/decongestant combination. There may be a change in the pressure of the ear, which is causing the decreased hearing.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Michelle Gibson James",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long gap should be there between conceiving and losing weight due to intake of Duromine?\n\nHi there, I would like to know how long I have to wait after I took Duromine to loose wait. I have taken it for the last 2 months together with plenty exercise and lost 20 kg (from 95 kg down to 74 kg at 1.67 m height). When can we start to make a baby?",
    "doctor_response": "Hi,Thanks for the query. Duramine contains phenteramine.Half life of phenteramine is around 25 hours.So, after stopping the drug by this time the drug might have cleared from circulation. But as there is around 20 kgs weight loss in your case, that may have some impact on menstrual cycle. And it may take some time for regularization of the hormonal levels. So, better to wait for one to two months. Possibly by that time, your cycles will get regularized. Then you can track the ovulation in next cycles and plan intercourse around that period. This will increase the possibility of pregnancy. For more details :    care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes metallic taste in mouth with sore throat after a dental procedure?\n\nabout a month ago I had a tooth cap put in.  There was excess cement around the tooth.  About the same time, I got an odd metalic like taste in my mouth along with hoarseness and at times a sore throat.  The dentist has looked over the cap and sees no infection.  Any suggestions?",
    "doctor_response": "Hello!Thank you for posting here.You did not mention if you took any medication during the placement of cap and other dental treatment.Some medicines like metronidazole can cause metallic taste.This will reduce in a weeks time.Your dentist will remove any excess cement around the cap.Do not panic.Take  azithromycin for 3 days.Also take cetrizine for the symptomatic relief.I suggest you to see your dentist if the tissues around the cap are red or irritated.Do warm saline gargle thrice daily.Have more water intake.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicine for cold, cough, fever and loose motion\n\nHi, my husband is suffering from cold, cough and fever.. after taking calpal his fever gone but he had cold.. now after a week along with cold and cough He caught loose motion please advise..,, Age is 29, height is 154 cm and 59 kg weight.. no specific medical history.. he used to get cold often,",
    "doctor_response": "Hi,Welcome to healthcare magicI have read the query and the symptoms are more likely due to changes in climate and drinking impure water leading to infection.In such cases I suggest my patients to:1.Drink warm,purified water.2.Eat easy to digest food like rice,avoid spicy and fast foods.3.Regular steam inhalation for cold and frequent gargling with betadine gargles atleast 3-4 times a day will reduce the cold and cough.4.Proper intake of electrolytes with water is very essential due to loss of both electrolytes and water in diarrhea,so mix 1 sachet if electral powder in 1 liter of water and have it regularly till diarrhea persists.5.Tab.Ciplox-Tz twice daily for 5 days for elimination of infection causing the loose motions.Don't worry,he will be fine in a few days by following the above measures.Feel free to ask any further queries.Regards,Dr.Tushar Tamboli",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes right side abdomen pain and bloating?\n\ni was wondering if you could help, i have been having some severe pains on the right side of my abdomen very low down. My abdomen is also very swollen and i look about 6 months pregnant! i also have tender breasts. I know i cannot be pregnant as i have been having regular periods although they have been lighter in the last few months. I had a miscarriage in august although it was not complete and i didn't go back to the doctors. can you help?",
    "doctor_response": "Hi.The most probable cause of your distension of your abdomen can be intestinal obstruction, secondary to some pathology like Tuberculosis , Gastrointestinal cancer or chronic tubal pregnancy.You have to undergo the following tests:-Clinical examination by a Doctor, X-ray of the abdomen in standing position and ultrasonography and / or CT scan if needed. Proper diagnosis will help to guide for a proper treatment",
    "dialogue_context": ""
  },
  {
    "patient_message": "My period is 10 days late and i have a bad cramp\n\nhi my period is 10 days late today && im havin cramps. i took a hpt but it was negative. could i be pregnant?",
    "doctor_response": "Hi,Sanquitaji, Thanks for query, Some times hpt test may not give correct result. To be on safe side go for blood hct test. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could lung nodules with a spot be?\n\nmy husbAND is 58, smokes 2 packs a day for more than 40 forty years, he went to hte hospital and they found a spot on his lung and nodules on his lung, he also has one kidney and has to forced to drink water, i cannot get him to go to his regular doctor, HE ALSO DRINKS SEVERAL POTS OF COOFEE A DAY, A CONCERNED WIFE OF ELEVEN YEARS, THANK YOU",
    "doctor_response": "Hello,Since your husband is chronic and heavy smoking, we should definitely rule out malignant lung nodule. So get done CT guided biopsy from nodule or bronchoscopy and TBLB (transbronchial lung biopsy) for the diagnosis. If it is negative for malignancy, then no need to worry. But if it is malignant, then he will need surgical removal of a lobe of the lung. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Kaushal Bhavsar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had unsafe intercourse. Been using althea pills. Will I get pregnant?\n\nhi! i have been using althea pills for a year and stopped for about 3 years. Now, i again started taking them and on my 3rd day on my first pad of pills i had unprotected sex. It is my 12th day in the cycle and i realized i am not safe anymore. do i get the chance of being pregnant? i took 2 althea tabs the following day as a substitute for emergency pill. will this work? please help me. thank you",
    "doctor_response": "Welcome to HCM.12 the day of cycle is fertile period,during this day chances of pregnancy is there but  you are taking althea tab from 3rd day regularly then there is no any chance of pregnancy.It will work for contraceptive effect and even no need to take any extra pill.Don't get anxious.Continue your pill.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for the unusual thoughts that is distractive and troublesome?\n\nglad to. Most of the time I experience thoughts that bother me. I find them distractive and troublesome. From out of nowhere, I find myself wondering what women that I encounter in social situations, both young and older, would look like in or out of their underwear. I know this is pointless as I am a diabetic and could not act on any of the thoughts, but the thoughts/distractions are there anyway. Also, I find myself keying on peripheral details like details in movies that have nothing to do with the plot. eg: the number of rungs on a fence, or the numbers in an address etc.I have difficulty finishing projects though I start well. Often, I am not satisfied with my results. Any ideas?",
    "doctor_response": "Hi,I read your query and can understand your distress associated with your condition. The repeated thoughts that you are having are suggestive of obsessions and it is likely that your are suffering from Obsessive Compulsive disorder. In addition, you concern for excessive details and wanting to do things perfectly, not being satisfied with end results is suggestive of anankastic personality traits,I would suggest that you seek a psychiatric consultation for detailed evaluation and initiating treatment. Medications like Fluvoxamine will be helpful in controlling the repeated thoughts. In addition, you can consider cognitive behavior therapy as an option for both obsessive compulsive disorder as well as correcting the personality traits which is leading to distress.  You can discuss regarding the same with your psychiatrist.Hope this information was helpful. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat extra skin growth on the inner penis?\n\nMy penis s outer cover is attached with the top of the inner.. Now when I masturbate the inner part of my penis does not come out . the skin s small part is attached to it. still now i did not see my inner penis. Now my question is how to remove that unwanted skin? is there any operation for that?",
    "doctor_response": "Thanks for asking in healthcaremagic forum  I think you are asking about inability to retract the foreskin as I am not able to understand your query properly. If it is difficult to retract your foreskin and see your glans, you can go for circumcision(surgery) for cure. Please visit an Urologist or a surgeon for the same. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump on the intergluteal cleft?\n\nThere s this bump at the top of my buttcrack it used to be small and it was there for years.Everytime I went to the doctor I would forget to ask about it .A couple of days ago it started hurting and I could see it was bigger then usual .It started to grow on the inside but on both sides of my buttcheeks mainly on the right. I ve tried to figure out what it but nothing s matched .Ive tried using witch hazel ,ointment ,and cabbage.This morning I could see its gotten bigger ...swole and its hurts a little more .Please if you have an idea on what it is I would really appreciate the help.Thankyou",
    "doctor_response": "Respected user , HiThanks for using Healthcaremagic.comI have evaluated your query thoroughly .*  This is most probably pilonidal sinus .*  Needs clinical confirmation by examination to plan out further     management .Hope this clears your query .Welcome for further assistance .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold with history of TB\n\nHae doc.am morin.aged 20.height 5'8 weight 59.3      (QSTION)How cn i be treatd frm a T.B patch?          (histry)i got Tb 4 yrz ago.i undrwent trtment 4 8 mnths since ma lft lung ws severe.since thn i kip gtn colds b'coz bacteria r easily collectd.plz doc help me.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. TB infection in lungs heal by fibrosis and calcification. These lesions appear as Scar (patch) on chest x ray. These are inactive, fibrotic scars.So no treatment is required for them. They will be seen life long. To prevent recurrent respiratory tract infection in such patients, adult pulmonary vaccines are very effective.Pneumococcal (every 5years) and influenza (every year) vaccines should be taken.Protection rate is upto 80%.Another option is surgical removal of part of lung having this patch. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can wrinkles and dark spots be removed from the neck?\n\nHi doctor, I have these dark spots and wrinkles behind my neck. I am a little chubby but what should I do to remove them? It does not burn or anything. I have had KT for more than two years. Is there a way to remove the wrinkles and the dark spots?",
    "doctor_response": "Hi. Kindly let me know your age. With increasing body weight there is an increase in pigmentation in body folds plus wrinkles as you are saying. Try to maintain your body weight in good and healthy limits. It will improve dark spots and wrinkles. For dark spots apply Vitamin C cream at one time and Retinoid cream at night time. Adapalene gel applies at alternate nights on the neck area. Apply Vitamin C cream BD (morning and evening). Use sunblock of 60. Protection from sunlight.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest management of mood swings\n\ni having being feeling very down for about a month properly longer but i dont really no. last night while laid in the bath i was just laying there not really knowing what i was doing i was in the bath for over and hour which is not like me. i hate my self i lost my job in december and from then everything else is going wrong. i feel fat and ugly and im pushing my fiance away with my mood swings. one minuite im ok and the next im laid in bed not wanting to see anyone. for as long as i remember i have had really bad mood swings one minuite im really angry and the next im crying and wanting a cuddle. i feel like everything i do is wrong and find myself crying then thinking what have i being crying for. i tried speaking to my fiance but he really does not help he just tells me to get a grip. i just wanted to know if there is anything wrong with me",
    "doctor_response": "Disappointments in life are difficult to handle at times. When you have lost your job, it's a terrible feeling especially when you expect a lot out of yourself. The symptoms you have mentioned suggest that you might be having depression. It needs a detail evaluation. It's hampering your social and personal life. You need help from a psychiatrist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chest and arm pain, heart palpitations with lost of breath. Treatment?\n\nHello I am a 21 year old male about over a year ago I got my heart checked out by a cardiologist thinking that I had a heart problem because I would get chest pains like burning sensation that started by one day after using cocaine which I only used cocaine for about 6moths on and off . So I stopped using drugs cause of these pains and Anxiety ended up getting checked out and EKG ECG and stress test were all normal.now this was all over a year ago since then ive felt better but sometimes still get chest pains and left arm pain and I only drink alcohol now .. When I work out like running and hiking I'm fine so I've really started to think I got anxiety?! These past 2 days I started getting heart palpitations like skipping heart beats with some lost of breath and some not yesterday they lasted mostly all night and could not sleep. Now today it felt a lil different like a air bubble going up my chest to my throat . I have been stress out lately about a recent situation and I do worry about my heart a lot ever since that day after cocaine use .. Could it just be anxiety panick attacks  that give me all these sypmtoms that I somedays feel and some days don't ? Been to emergency about 7 times the past year all tell me anxiety :/   Thank you for your time",
    "doctor_response": "Hello,First of all let me advise you to abstain from any kind of drug abuse.You did not mention how much and how frequently do you consume alcohol. You must not take alcohol on daily basis, however once in a while a limited amount of alcohol in social setting is ok but never alone or excessive amount.Since you describe your investigations are normal its more likely that you may be having alcohol withdrawal if you are taking alcohol regularly and stopped it, if yes see a psychiatrist for it.And if you do not consume alcohol daily then you may be having panic attacks and anxiety symptoms. See a psychiatrist for it, for therapy and drugs to get better.Feel free to ask if you need any more help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump on the armpit\n\nI have a lump and discomfort in my right arm pit . Mammogram and Scan show no likely breast cancer. I am booked to have an aspiration to withdraw tissue for testing. Doctor said it may be fat deposit presiding on muscle or nerve. I am fit and active but am rather tired lately",
    "doctor_response": "Welcome to healthcare magicI am dr Fahim and I will help you with your problemI have gone through your question. You have a swelling in the armpit and you are worried that It might be Breast or any other carcinoma. I need answers to few questions as required always to understand the problem in better way- Exact site of the lump?- How you first noticed it?- How it bothers you?- Is its fix or mobile?- Can skin be pinched over it?- How is the conaistency of the lump? Whether its soft/ firm /hard?With available information and when screening for breast Ca is negative. This swelling can most likely be Lipomafollowed by Lymph node enlargement and sebeceous cyst. Ultrasonography can play an important role in differentiating between these. Small lipoma and sebaceous cyst need no intervension while lymph node enlargment need a cause, which should be look far. Excisional biopsy followed by histopathology of the removed specimen; will end all suspicions and give us tissue diagnosis.I hope my answer will help you. Do rate it, if you like it.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bumps in mouth?\n\nI ve recently discovered bumps at the bottom of the thing that connects my tongue to the bottom of my mouth. Also halfway up there seems to be tearing, and whiteness. I also found that one of my plica fimbriata dangling. Any Ideas what could be happening?",
    "doctor_response": "it is called a mucocele or a mucus retention cyst that arise due to obstruction in the way of salivary secretions.could be a hemangioma also...anyways, not to worry much about this!all the best !",
    "dialogue_context": ""
  },
  {
    "patient_message": "Been masturbating with Neosporine dome. Noticed red bumps on penis. Genital warts?\n\nI am married, 37, 180lbs, 5 10 , I have been masturbating with Neosporine dome until I started noticing small red bumps on the base of my penis and on my scrotum . They are dome shaped and then turned skin color after days with masturbation. They dont itch all the time, but now and again one or two do. I am worried they are something like genital warts .",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have what is called as Sebaceous Cysts on penis and scrotum.The scrotal and penile skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin.Normally they fade away without treatment however they need to be treated if increase in size or get infected.Please consult qualified General Surgeon for clinical evaluation and further treatment.If needed some of them which are bigger may need to get excised in Toto (Completely along with the sac).Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for weakness and tremors in legs\n\nI just woke up now, It s 7pm. It was a bit of an offsleep, but when i woke up i felt really weak, shaky, almost lighter. I m still shaking now. I tried just waking up a bit, Drinking some water and milk, Went to the bathroom. But i still fell weak shaky and light,",
    "doctor_response": "Hello !  I read your question and understand your concern. In my opinion the symptoms you have had may be related to a drop in your blood pressure. You should measure your blood pressure in sitting position and than in standing up position . A decrease more than 20 mm Hg in your blood pressure would be indicative of orthostatic hypotension. Low blood pressure can cause similar symptoms. I would also recommend a full blood work for anemia , a thyroid function test to rule out hypothyroidism or hyperthyroidism. Hope to have been helpful! Greetings!Dr. Abaz Quka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Wisdom teeth removed. Started periodic popping noise coming from nostril.  What is going on?\n\nEver since I got my wisdom teeth removed in November, I ve had a periodic popping noise (like a bubble popping) coming from my right nostril (they punctured the right nasal cavity during the extraction) accompanied by the smell of sulfur . Sometimes if I hold my head upside down, there will be a fishy smell as well. This never happened before the surgery. What is going on?",
    "doctor_response": "hi..the nerve at the region of nasal cavity has got numbed  due to the puncturing done at that area.the numbness has not gone still due to the deposition of local anaesthetic solution in large amount in that area.visit the dentist who removed your wisdom teeth .the dentist will find out the cause.take care..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty breathing and speech disorder in children?\n\nHi I have a nephew that is 5 years old he has always had a hard breathing murmur we saw a speacialts in mexico and was told he had a fallen palate how serious is this and is it dangerous to get fixed ...Due to that he does not speak very well what are ur thoughts",
    "doctor_response": "fallen palate mean an unusually long or extended soft palate, that might cause snoring or even lead to obstructive sleep apnea(lethal). This also affect language.   In these cases, either the palate can be trimmed by doing a uvulopalatopharyngoplasty  or stiffened by inserting implants to control snoring. i think this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could severe pain in right abdomen be due to liver damage?\n\nI'm scared I took a lethal dose of tylenol pm 6 mths ago did not receive treatment was really sick vomitting passed out woke up covered fecies was real bad for three days... then just moved on how didnt die dont know.. now i have a lot of pain on right side very sharp pain and have been really sick.. could this be liver from that and how serious.. should i seek medical atttention as soon as possible?",
    "doctor_response": "Yes, you need to visit doctor on nearest clinic and talk about all of that. You may damage your liver, because it paracetamol and also acetaminophen, is toxic on high doses for you liver. Get well.. good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes gap in ribs of an infant?\n\nMy five and a half month old (was almost six weeks premature) has what seems to be misplaced or missing ribs on her left side. The gap created by this seems to be getting bigger and more noticeable as she grows. I ve noticed it for months now, even before her last checkup, but it wasn t a concern to me till recently because it seems to be getting worse. She has another check up in two weeks. Should I try and get her in before that? What could this gap be?",
    "doctor_response": "Hi, this could happen in Rickets or vitamin d deficiency. I suggest you to do calcium and phosphate levels and x ray wrist ap view to rule out rickets. An examination by pediatrician should also be done. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will drinking alcohol affect the operation of VP shunt?\n\nI've had a VP Shunt since birth, and I have had no issues with it, I was advise to not drink alcohol by my Neurosurgeon when I was a child according to a parent. I now 29 and am wondering if drinking alcohol, little to moderate, would effect the operation of my shunt?",
    "doctor_response": "Hi, Welcome to HealthCareMagic.com I am Dr.J.Mariano Anto Bruno Mascarenhas. I have gone through your query with diligence and would like you to know that I am here to help you.Please avoid Alcohol if you have VP Shunt. Hope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in HealthCareMagic at  Best Wishes for Speedy Recovery Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause pain and heaviness in chest?\n\nhey i;ve a friend who has chest pain.mainly its either in d right side or the centre and when the pain tends to subside, he feels heaviness in his chest. sometimes, his limbs get cold and in few minutes he starts sweating n within next few minutes,body temp gets normal.Blood tests n other scans seem to be normal..what can it be??he's 18. thank u.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Hopefully an ECG has been if not done please get it done.If the chest pain is disturbing his routine activity then get  a chest x ray done to rule out any lung infection or it could be just a muscle pull. Do not lift heavy weights.Hope your question was answered",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for pain & flopping of arms\n\nmy right arm just flopped. not numb, it just flopped a few times. epidural 5 days ago for severe pain in legs from spinal nerve impingement. still in much pain, particularlny rt leg. took a total of 5mg oxycodone since noon today. the flopping arm scares me",
    "doctor_response": "HiNothing to worry..you should be on pregabelin,and methycobalamin ,and accelofenac tablets after obtaining prescription from orthopedic surgeon.Try physiotherapy for arm.Wear a lumbo sacral brace, avoid bending ,twisting spine or lifting any object from ground Consult your orthopedistBest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is a jerky septum? Is it normal to have it?\n\nHello doctor, I had a pain in the left shoulder blade as well as in the chest. After taking medicines, the left chest pain is gone but, the left shoulder blade pain has increased a lot. My ECG is normal. My echo is normal as well but, shows a jerky septum.\u00a0The doctor told me that a jerky septum is a\u00a0normal finding. Should I consult another doctor or go by his word? I am attaching my reports. Kindly have a look.",
    "doctor_response": "Hello. I have gone through your reports (attachment removed to protect patient identity). Best regards. For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are breast fibroids harmful during pregnancy?\n\nHi, I am 22 years of age and am now four months pregnant with my second bay. My first one is 3 years 8 month. I stop breast feeding my first child when she is 1 year and 3 months. Some months after that i feel slight pain in my breast (only when I touch it or when I bump into something) and moving lumps. After I did some test, some doctors said that i have breast fibrosis. So I just wanna know if this disease is harmful during my pregnancy or when I breast feed. Some weeks back I also feel slight pain in my underarms on both side. There is no discharge or anything like that. Is this dangerous?",
    "doctor_response": "hi..fibroadenoma of breast is a benign condition.. no need to worry regarding this..there will not be any difficulty during lactation..there will be slight discomfort with this ..this is not harmful ..thank u",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are breathlessness and chest pain symptoms of emphysema?\n\nHello, Dr. Jain. I've just started working out after a while of not working out, and in the middle of the work out I felt like a huge ball of saliva is blocking my mouth and I couldn't breath, I also felt chest pain and started coughing for about 15 minutes. This happened to me for the first time, I'm 21 y/o old and I smoke. When I got home I immediately opened up my computer and googled ''shortness of breath'' and found this emphysema, do I have that?",
    "doctor_response": "Hello, First please don't google to find the cause.Second as you explain the situation it's not emphysema. To exclude that you should do at least a chest X-ray and after having the results your doctor will say if it is or not? Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jnikolla, Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Homeopathy or Ayurveda better treatment for psoriasis?\n\nDear doctor, i am 27 year old, i am suffering from psoriasis from last 6 years. Now i am using allopathic treatment which involves using an immunosupressent and methotrexate tablets. It was under control till last 4 months back, but now again it re-ocuured. For better treatment of psoriasis, which tretment is good i.e. allopathy or homeopathy or ayurvedic.?",
    "doctor_response": "Hai,Psoriasis is an auto immune disease. whatever system of medicine you follow, if you are under mental stress and anxiety problem you cant get solution for psoriasis.Stress influence more in this skin condition. only medication will not give you proper result.anxiety,stress will aggravate the symptom even though you are under medication.avoiding/controlling/balancing  stress and anxiety will give you better result.in Ayurveda system of medicine certain type of psoriasis is completely curedwith oral and external medication along with meditation to balance your mind and stress level.Thank youhope i answered your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the lower back?\n\nI have pain in my lower back (flank?) but above my butt. Like right where the kidneys are. The pain is moderate and constant, aching and radiates around to my lower pelvic area. I m 10 years out of menopause, so it s not period pain. I am nauseous and seem to tire easily. The pain started about 1 wk ago. Recently, I was treated for a severe cat bite to my right big toe with surgery followed by IV antibiotics (Invanz for 6 wks} via a picc line. My infectious disease Doc then put me on Augmenten for another 2 months. If it was say.... a kidney infection, wouldn t the oral antibiotics clear that up? I have no dysfunction with urination. And I might add that I am a diabetic.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Can be postural muscle spasm or a disc prolapse. I hope this information has been helpful for you. Regards, Dr. Praveen Tayal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does mild proteus mirabilis bacteria in my urine culture indicate UTI?\n\nI have mild proteus mirabilis bacteria in my urine culture. Per ob gyne physical chk up, she said i also hve bacteria in vagina so it could be why i have the urine culture results n presctibed me suppository.Im confused if i do hve uti or another infection. If i do hve uti will the suppository help me . Or is it ineffective and i should tke oral? Im pregnnt 5 th month. Also have yeast for a month alredy due to an antibiotic which is why i am afraid to tke again",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.In my opinion you should repeat the urine culture and sensitivity testing.As you have vaginal bacterial infection it is likely that Proteus mirabilis in culture is because of contamination.If you find same organism again in urine we can say you have urinary tract infection.Please continue your previous medications as per doctors advice.Drinking plenty of water can help clear the urinary tract infections.Please maintain the local hygiene it helps clear infection fast.I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have spinal stenosis and pain in legs. Kindly tell me the solution.\n\nHello doctor,I have spinal stenosis from last five years. I took a lot of medicine but the problem remains same. Pain also includes my legs down, foot, hips and standing more than ten minutes cannot bear. Please tell me the only best solution.",
    "doctor_response": "Hello. For spinal stenosis, a non-steroid anti-inflammatory drug like Ibuprofen or Paracetamol can be prescribed to relieve pain and inflammation. Physiotherapy is also beneficial. For neurological pain, Pregabalin can be prescribed. Reduce weight if obese through exercise and dieting. If all above measures failed then surgical management can be done. Take care. Consult orthopedic surgeons for examination and management.  For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain. CAT scan showed no kidney stones. Heartburn, belching, sore throat. What to do?\n\nHI docotor.. Earlier in June i was suffering from right lower abdominal pain.. As i was diagnosed with kidney stones, doctor asked me to go for CAT scan.. I took a scan and the doctor said there is no stones and send me to internal medicine... The doctor saw the scan and all my organs (stomach, pancreas and so) are structurally good.. no need to panic... he didnt gave any tablets too... I have a bad habit of very sensitive nature... I started to think about it more... Then heartburn comes after two days... one of my friend said as you are so sensitive, the stress factor caused you heartburn.. He is right and am thinking all the time about it... After eatng, when i belch i started to feel the food coming back... I have a sore throat because of this.... Please help me, what should i do? I am sure all these symptoms are stress induced.. sometimes traces of blood in saliva too... not always.. my doctor friend said, this is because of the stomach acid.. help me...",
    "doctor_response": "Hi there,         Right lower abdominal pain and heart burn are 2 different entities.As your CAT scan is normal any significant pathology for the cause of right lower abdominal pain is already ruled out.So,there is no need to worry on this.Now coming to heart burn,its true that it can be stress induced.Some other habits can also contribute to this like irregular food habits,excess coffee,smoking,alcohol,high spicy food etc.Heart burn is due to to reflux of acid from the stomach upward into the esophagus.This can cause congestion in the larynx,which may be the cause for the sore throat that you are experiencing.Firstly try methods to reduce your stress,Secondly avoid food and other habits that increase stomach acidity and thirdly take antacids for 3-4 weeks.If you still dont feel the difference further evaluation in the form of endoscopy may be required.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the knot at the center of my feet?\n\nHi my foot has been hurting since I woke up the pad of my foot right beneath my toes in the center feels like a knot and is painful to put pressure on. It started to swell up and is hot, it feels tingly and throbbing it is also red in the area on the bottom. I'm not sure if I might've been bitten by something.",
    "doctor_response": "Hello,It could be a bite, a plantar wart, a cyst or infection. If it is red and hot, these are signs of inflammation or infection. It would be good to have a doctor or podiatrist take a look at it to determine the cause and appropriate treatmentRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for neck pain\n\nI have constant neck pain located about 5 oclock. There is constant pressure from the middle of my neck passed my hair line, with no relief. There is a lump that has double in size about 2 1/2 fingers since July now. I get spot headaches in the same place on the top of my head that only last a minute or less. I waken with chest pain and a strange feeling through the back of chest up to throat now it comes throughout the day. It s been over a year that I have had exstreme stiffness,and loss of movement.",
    "doctor_response": "Hello,With such symptoms, I shall advise you to consult to your doctor and get a MRI investigation. You problem can be related with swelling which can be either vascular or soft tissue mass. This may compress surrounding structures and can lead to your problem. Till then you may take a mild analgesic like acetaminophen for relief. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mukesh Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had jaw lock problem twice, very painful. What is the remedy?\n\nDear dr, Ghosh, I am from CR Park, New Delhi, a Bengali Hub. had jaw lock problem twice in last one month and ten days. However Doctor pressed it hard from inside to put it back and could close the jaws. Quite pain ful ? What is the remedy? Selg 64 years old and a diabetic. Have been suggested to take Flexon MR for seven days twice a day ? This hapeened while yawning, absolutely unconsiously. Request advice. Regards H. Das mail id : YYYY@YYYY",
    "doctor_response": "Hello Thanks for your query You have been getting dislocation of Temporomandibular joint repeatedly ( lock jaw ) This is a ball and socket joint like a shoulder joint and gets flattened in old age resulting in getting it dislocated easily.The only treatment for this is surgery.Please consult some dental surgeon who will solve the problem",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to conceive even after having PCOD ?\n\nhello sir iam 27yrs old diagonosed as pcod and using medications from 20days glycomate500mg twice and during periods i used clomid and now my doctor advised me to take low dose aspirin and conjugated estrogen tabs 0.625 for 5days and today 9th of april i have done follicle test and found that my endometruim thickness is 5.2mm .my hormonal levels and insulin levels all are normal.my hieght is 5feet 3inchs and and weight is 60kgs.pleas tell me can i conceive this month ?can my endometrium increase its size by above mentioned medications ?because i dont want to take injections please help me out",
    "doctor_response": "welcome to healthcaremagic so long you have ovulation and patent tubes and meeting partner aruond ovulation time and partner having good semen qualities will give you chance of pregnancy nobody can say for sure in which cycle this occurs continue with treatment till you conceive and continue afterwards till delivery",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I get rid of bad dreams as a result of which I am scared to sleep alone ?\n\nHello, my name is Shelby I have this situation it started when i was a little girl where id would be scared to go to sleep i would think someone was going to kill me but when i sleep with someone else in bed with me i dont have this feeling, i just feel like something evil is out to get me. also the stairs behind me i feel like someone will grab my legs and chop them off it went away for a few years for awhile actually. but Its back again but its has gotten a lot worse ive been sleeping on my parents floor for awhile now and im getting a bad back now when i go to bed i have really bad dreams that i m babysitting my younger cousin and she is stolen and murdered so i go home to find my mom and sister running away from this murderer i cant see his face though and i wake up ever time hes right about to get me. can you help me ?",
    "doctor_response": "Hi  Read your prob do not worry this is happened only due to your thoughts , your surrounding enviorment, or due to litrature which you read or think. so try to mix up with your parents with your friends discuss all good things with them, try to avoid such type of thought.along with it you should start some tab which reduse your mental clouding as per advise of your doc. do not worry you feel better after starting that tab. Dr Aseem aseemadhuri@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Low back pain. MRI shows minimal bulging with disc herniation causing narrowing of lateral recess. Suggestions?\n\nMy 17 y/o son plays basketball, had no real injury just weeks of aggressive play. Has low back pain radiating into left hip. Here is his MRI results: L1-2 minimal posterior annular bulging asymmetric to the left, there is no central canal narrowing or neural foraminal narrowing. L4-5 there is a disc bulge asymmetric to the left with a superimposed small to moderate broad-based left subarticular protrusion type disc hernaition. There is mild facet and ligamentum flavum hypertrophy . These factors combine to cause moderate narrowing of the left lateral recess , and likely impingement of the traversing left L5 nerve root . There is no right lateral recess narrowing. There is no neural foraminal narrowing. L5-S1 there is a disc bulge asymmetric to the left. There is mild narrowing of the left lateral recess but otherwise no central canal narrowing. There is mild left sided neural foraminal narrowing He is to start physical therapy in a few days. My question is - could he have sustained all of this through basketball?",
    "doctor_response": "Hello, At 17 yrs of age he is too young to have developed so many disc bulges. The symptom also suggests the compression of the nerve root due to these bulges. Usually such changes are seen in elderly. In your son these are probably related to basketball playing and associated exercises. He may be an individual who is predisposed to this and aggressive playing has precipitated it. The predisposing factors could be in the form of abnormality of collagen formation (there are diseases in which collagen protein s not formed normally and it can lead to musculoskeletal problems). He needs to undergo evaluation for that. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain below the rib cage and chest pain\n\nI am diabetic. I have been having sever pain in my chest and under left ribs. I have seen a doctor. He has ruled out the heart. He has sent me to therapy for a dislocated sternum. It has not helped at all. He gave me pain meds and a neuropathy med. it does not seem to be getting better. This has been going on for 4 to 5 months. What is your thoughts on this.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Diabetic patients are at increased risk of lung Infection like pneumonia or pleural effusion or tuberculosis. And all these cause rib pain, chest pain etc. So better to get done chest x ray to rule out all these causes. If chest x ray is normal than no need to worry for lung related causes. Musculoskeletal pain is likely cause. So avoid heavyweight lifting and strenuous exercise. Avoid movements causing pain. Apply warm water pad on affected areas. Take good painkiller and muscle relaxant drugs. Also start vitamin b12 and pregabalin as diabetic patients have low vitamin b12 and nerve related pain. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath?\n\nDear Doctor, I am 72 and live in a very calm and clean place in the mountains. Whenever I get out in the cold or undertake some light activity outside, I am short of breath. But after the initial struggle I become okay with normal breathing. I use an inhaler and started on a nebulizer whenever there is a need. Otherwise all my reports are okay. Could this be copd as I was smoking for nearly 40 years and now I have stopped for ten years. I would like to have hyour advise",
    "doctor_response": "Respected user , HiThanks for using Healthcaremagic.comI have evaluated your query thoroughly .*  This has possibilities of different conditions as   -  asthma  -  decreased lung compliance  or  immunity  -  altitude related   -  heart related issue as cardiomyopathy , valvular disorder , blockage in     coronary arteries    -  others .*  Needs thorough  clinical  examination , necessary tests in form of     laboratory , x-ray chest , pulmonary function test with or without 2D    Echo according to the concern of the doctor .Hope this clears your query .Welcome for further guidance .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause and treatment for bumps on penis and scrotum?\n\nHello i am 15 years old and I have noticed about 8 bumps ranging from my penile shaft to my scrotum. The bumps swell up and get red and itchy if I squeeze them there is a clear discharge, I have never had sex so I'm sure it's not an std. Any sort of answer would be greatly appreciated",
    "doctor_response": "HelloThanks for query .Multiple bumps on shaft of the penis and scrotum are mostly  multiple Sebaceous Cysts .The scrotal and penile skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin.Normally they fade away without treatment however they need to be treated if increase in size or get infected.Maintaining proper personal hygiene by cleaning genital area  is very important to avoid getting these cysts .Please consult qualified General Surgeon for clinical evaluation and further treatment.If needed some of them which are bigger may need to get excised in Toto (Completely along with the sac).",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is breast feeding safe while baby has pus cells/e-coli bacteria in stool?\n\nMy baby girl is of 3 months old. she has been revealed with PUS cell in range 65-70 with E- Coli bateria in stool test . The stool is yellowish green with smell in it. The baby is on mostly breast feed but when she been too crys a lot we give him bottle fed with cow milk. . Kindly let me know whether it is safe to give breast feed . Apart from this she has also medicated with the medicine for infection as detected in stool.",
    "doctor_response": "Hi dearWelcome to himYes breast feed to be continued, should not be discouraged. And there is no risk at all.Hope the query is answered.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low sperm count and anteverted uterus\n\nHello Doc, I'm debora i need to ask last lab test is in December and my husband has some prob with his sperm such as the quantity is not enough, some sperm without head or dont have tail, and some other normal and for me Doctor said that the position of my uterus upside down or it can say difficult position. Please let me know what should i do as i've already married for 5 years almost in this july",
    "doctor_response": "HelloWelcome here.I can understabd your concerns.For your husband, i would suggest tablet paternia. This contains lycopene, zinc, l-carnitine, CoQ10. These are claimed to improve sperm motility and morphology. 1 tablet taken twice a day for 3-6 months will help.For you, i think you should consult a gynecologist for surgical correction of uterus. This might help in conceiving.Hope this helps.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What prevents blood from flowing to the bottom of the heart?\n\nMy husband had a Thallium exercise stress test due to an abnormal EKG. The stress test showed the blood is not flowing to the bottom of (your) heart . It has been recommended he see a Cardiologist. What are the possible causes, and what are the potential ways to remedy the problem?",
    "doctor_response": "he has to get treated for any risk factors like stop smoking and excess alcohol drinking treat hypertension,diabetes,treat for any dyslipidemias like excess cholesterol or triglycerides.he has to take aspirin right now .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling and tightening in center of chest?\n\nAbout three days ago, I woke up and felt as if i had breathed in very cold air as I felt my chest muscles, tingling or tightening in the center of my chest. I feel the air as i breath in and out, in the center of my chest and my bottom teeth are also tingling. I had blood work done the week earlier and I learned i have a vitamin D efficiency. I took my first prescription supplement for vitamin D last night and will be retested in 12 weeks. Why am i now feeling this tingling in the center of my chest and the bottom of my teeth?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Your symptoms are mostly due to vitamin d 3 deficiency.This can cause muscle cramps and spasms which give feelings of tingling and twitching.So no need to worry much for these symptoms. Take vitamin d 3 supplements regularly. Apply warm water pad on affected areas of chest. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain\n\nMy son is having pain when he urinates and it just started he was in the shower and urinated and it was very painful he just went again and said it was painful not as painful as the first but still painful. He has also had some back pain over the last couple days and especially in the morning when he gets up. What could this be and what should we watch for. He is male 26 yrs",
    "doctor_response": "The symptoms you had mentioned are mostly due to some bladder infection. For treatment you can take some antibiotic preferably cefadroxyl or norflox after an expert advice along with akilos-p or meftal-spaz for pain and burning. You have to drink plenty of oral fluids for burning urination.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest diet plan for typhoid\n\nhi i am having typhoid fever from past 8 days..for the first 3 days i had moracef 1g injection 2/day... after that i started taking taxim-o 200 tablet.. Is that the right medicines? And what should be my diet?i am 5 10 height and 63kg in weight.. please reply",
    "doctor_response": "Hello,Welcome to HCM,Typhoid fever is a disease that is caused by typhoid bacilli by drinking or eating contaminated water and food. The treatment what you have been prescribed is proper and adequate which helps to treat your condition.It is a right medicine for the management of your condition. i would suggest you to continue the same treatment and in addition to this I would suggest you to follow1.Take adequate rest2.Drink plenty of hot water.3.Eat food rich in carbohydrates.4.Syrup having zinic will helps to boost up the immunity.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for large lump between my shoulder and neck\n\nI have a large lump between my shoulder and neck. It appears after I carry my laptop bag, then goes away after a couple of days. Warm to the touch but not inflamed. This has happened 4 times now during these same circumstances. Is this cellulitus caused by pressure from bag strap?",
    "doctor_response": "Hello...Cellulitis generally does not relives without treatment and may cause symptoms like pain and fever...It is quite possible that repeated injury by laptop bag strap in form of muscles pain/hematoma...Kindly avoid hanging laptop bag on same side few days... use analgesic if needed. ...get done ultrasonogram if condition is not resolving...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes to feel like heavy weight on lower back?\n\nI been having lower back issues since last October and no doctors seem to able to help. I feel like a heavy weight around my lower mid section . It seems like it s moving but it usually is on my lower back area and sometimes it moves to the left hip area. I have been to chiropractic and been to my primary doctor as wellL. So far nothing helps . What are your thoughts? I have not had a Pap smear in about 6 years ago.",
    "doctor_response": "Hello, Pap smears are indicated from age 20 to 60. without an exam, I can only give general information, and it is pretty easy to define if there is a lumbar disk issue because the discomfort would only be with particular movements and not constant. Various pelvic pathologies such as fibroids or irregular periods or other possibilities can cause a constant heaviness. Mostly a pelvic exam would find them. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from swelling that occurred after ACL reconstruction surgery. Kindly help.\n\nHello doctor,I had the ACL reconstruction surgery of my right knee before five years. At the same time, the medial meniscus was completely repaired and lateral meniscus partially repaired. After some time doctor opened my bandage and the knee was healed nicely. I had been advised to do some physical exercise (such as extension, flexion, etc.) and I was doing the same correctly up to nine days.But unfortunately, my knee started swelling, and the doctor advised not to do any physical exercise and did some medical examination. As appeared from the report, there was no infection found from culture and sensitivity tests of fluid. Although it is found that my ESR was little high, i.e. 40 and C -Reactive protein was 14.5. However, the latest medical examination revealed that ESR is 35, and C-Reactive protein is 2.5. Doctor advised me some antibiotics (Ciprofloxacin and Flucloxacillin), and I took the same. It has seven (07) weeks have passed. Still, there is swelling in my knee, and I could not do any exercise. Now, I feel stiffness and move with the assist of an elbow stick. My daily activities are hampering a lot, and I am getting frustrated day by day. Therefore, I would earnestly request you to advise me proper medications so that I can get back to daily life properly.",
    "doctor_response": "Hello. Firstly were you running fever three weeks post-surgery? Secondly, your first ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein) were raised, but within my comfort zone as post-surgery, they will usually be built up to six weeks to three months. The second report showed a good downtrend. Additionally, the culture was negative. I would not have started you on antibiotics unless you had,  1) Wound discharge. 2) Fever more than 101 F. 3) Redness and swelling and pain are worsening with each day. 4) Fatigue and loss of appetite. I would have ICED the knee and put you on a gentle ROM exercise program to combat stiffness and asked you to keep the compression bandage on when not exercising to get the swelling down and kept you on anti-inflammatories till your knee subsided and then started strengthening exercises. Seven weeks down the line stiff knee and no proven infection, you have an uphill task now to combat stiffness, and at the same time, you are worried if the swelling will return. My worry here is are we sure that the repair is good and nothing is loose and floating in the joint and causing the symptoms. Also is the ACL repaired in the right place as misplaced ACL will lead to pain and swelling if it in the right place. Please upload your MRI and latest post-op AP and lateral digital X-rays of the knee to get some idea about the tunnel placement.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fixation on a particular song?\n\nI keep going deep into thought and when i think of a song for example its realy hard to stop thinking about it and its like the song is on repeat in my head. But the more i try to stop myself thinking about the song the harder it is, i dont want to go to the doctor because im afraid he will think im crazy and im sure im not. PLEASE HELP ASAP",
    "doctor_response": "Hello,First of all I would like you to relax and be calm with the assurance that you are not going crazy. There is nothing to be afraid of.I think you are facing the problem of Obssesive-compulsive disorder (OCD) in which an idea/impulse intrudes itself persistently and impelling into the person's conscious awareness. Obsessions or compulsions are undesired, unacceptable and uncontrollable, the person recognizes obsessions and compulsions to be absurd and irrational and feels a strong need to resist them.Musical obsessions are those in which patients experience repetitive phrases, tunes or complex musical pieces that originate inside the head. These are less common symptom of OCD.You need to start with some anti-obsessional medications like Fluoxetine. Your problem will resilve but it will take some time.Try to divert your mind whenever the particular song originates in your mind instead of trying to repeatedly stop that song.Hope this helps you.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes soreness in the chest?\n\nstomachhey. i am a 16 year old girl, 5'6\" 120 very active and i take zoloft, minocycline, and sertraline... i have depression and terrible anxiety, sorry for my spelling. my boyfriend had stomach problems the last few weeks and has been throwing up and spending a lot of time in the bathroom. my sister has been having some stomach problems the past few weeks and claims she is becoming constipated. right now my stomach just really hurts and i feel like i really need to throw up but it just won't come. i am also very sore all over especially my ribs and chest. everyone keeps telling me i feel hot to them but in my opinion i am freezing. i wont eat anything and i am a tan girl but right now just look dead",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. By your history and description, possibility of GERD (gastroesophageal reflux disease) is more. Stress, depression and anxiety are common cause for GERD. So control of these are very important to control GERD. So better to consult psychiatrist and get done counseling sessions. Try to identify stressor in your life and start working on its solution. You may need additional drugs too. So don't worry you will be alright. Avoid stress and tension. For GERD start proton pump inhibitors. Avoid hot and spicy food. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nasal congestion, sinus pain and dizziness?\n\nI had a really bad allergy episode with a lot of congestion and sinus pain. I lost hearing and have felt a little off and had some dizziness. When I am around people talking it sounds really loud and almost hurts. Like I am very swollen. I have been on Prednisone and antibiotic, but neither helped much. It has been 4 weeks.",
    "doctor_response": "Either infection or allergy is responsible for your medical condition. What antibiotic did you take ?  It is always better to do a culture and sensitivity before starting antibiotic. Was that done ? I would suggest you find out which microbe is responsible for  take the right antibiotic which will deal with your infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vibrating sensation in groin?\n\nWeird but painless vibrating in my groin between the testicles and anus. Is that an artery problem, or a nerve problem? It blurs a few seconds, stops a couple seconds, starts again. I do have peripheral artery disease and a herniated lumbar disc--doctor gave me Celebrex August 1st and this feeling started happening last night, is much stronger and more frequent today!",
    "doctor_response": "Hello!I read the question and understand your concern.In my opinion the troubles you have may be caused be a nerve irritation in this region probably sacral plexus S2-S4. I would like to know your age.This irritation may be caused by a lesion in the pelvis tumural or inflammatory, degenerations of sacral bone, a pathologic fracture of sacral bones from osteoporosis, or even a peripheral vascular disease.I would recommend further tests like a routine blood test, a pelvic ultrasound and a CT scan of the sacral region with intravenous contrast to examine all the structure of sacral region.In the meantime I would recommend treatment with gapabentine or pregabaline which is very helpful for your troubles.Hope to have been helpful!Best wishes Dr Abaz",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain and itching on the roof of the mouth?\n\nI have chronic intestinal pain. I have flare ups with the roof of my mouth covered in a rough, itchy, and sometimes painful film, increased abdominal pain, anal itching and a feeling of fatigue.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The narrated symptoms indicate possible hormone imbalance (thyroid level or others) or nutrient deficiency of certain types with gut flora disturbances. I would recommend to get it evaluated with basic lab tests, supportive correction with necessary probiotics, deficient trace elements and supportive care. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the treatment options for bone spurs at L4 at the fusion point on MRI?\n\nI had fusion of L4 and L5 in 2008.  I have had numbness in both legs but mostly on the left side.  Over the past 6 months the numbness has increased and pain in lower back has become a daily occurrence.  My family Dr ordered a MRI that shows bone spurs at L4 at the fusion point.  What other options to surgery are out there.  I am only 45 and don't want a 4th surgery.",
    "doctor_response": "Hi, Welcome to HealthCareMagic.com I am Dr.J.Mariano Anto Bruno Mascarenhas. I have gone through your query with diligence and would like you to know that I am here to help you.Surgery is the best option Hope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in HealthCareMagic at  Best Wishes for Speedy Recovery Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bumps on penis?\n\nhi my name is bennie and i have a question i have these bumps on my penis and they been ther for some while now and when i got tested they were suppose to give me cream for them. it started when i shaved down there with an razor and ended with a small cut on the penis and now a few months later they have grown all over my growning area. i want to know what to do",
    "doctor_response": "dear Sir, bumps after shaving are probably due to ingrown hair.. you can get rid of them by natural remedies like aloe Vera cream or by using medical treatment as hydrocortisone 1% ointment.. apply any of them overnight until bumps disappear",
    "dialogue_context": ""
  },
  {
    "patient_message": "Confusion, mood swings due to fluctuating ammonia levels.   Have cirrhosis, diabetes and hepatic encephalopathy.   Suggestions?\n\nMy husband has cirrhosis,diabetes & hepatic encephalopathy.  He is in the hospital for high blood sugars (now under control) But he also has high ammonia levels, he was 95 at admission, then 47, 29, 60, 40 he was like his old self at 29 but the next day the levels went up & he was mean, confused & threatening. Can he be stable or will he continue to have his levels go up & down? How can I his wife & caregiver take care of him with his mental staus changing from nice to violent?  Does this mean his liver is worse & not processing the lactulose?",
    "doctor_response": "Hi,Your problem is of real concern, as cirrhosis is a chronic disease and the condition that you are mentioning is called hepatic encephalopathy and denotes advanced liver failure. Episodes of hepatic encephalopathy are common in chirrotic patients and can be prevented by mesures like avoiding constipation, monitoring the electrolytes level and and avoiding low pottasium levels, daily recommended protein intake control, prompt identification and treatment of any infection and most importantly by preventing gastrointestinal bleedinf by applying band nligation to the dilated veins in the esophagus (Varices)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for inability to extend the left leg fully\n\nI had surgery 2 weeks ago. There was a 13mm x 13mm hole at the top front of my left tibia. The surgeon put 10 pieces of donor bone in the hole. I had my followup appointment last week and the surgeon told me to get rid of the leg brace and begin applying weight to my left leg using crutches. I have been doing this now for almost a week. The area around my knee is still very sensitive. I can only bend my left leg to about a 40 degree angle without severe pain. When I lie in bed, I cannot fully extend my left leg and getting into a comfortable position is almost impossible. Is there anything I can do to get through this quicker or am do I just need to live with the (hopefully) temporary discomfort.",
    "doctor_response": "Hello, It will improve gradually. Progressive physiotherapy will be effective. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mucus in stool?\n\nMy two years old baby passes mucus a little often from the age of it s 8th months though it s stool is normal in color & solidity also. He is 11 kg weighted only though it is been feeded four times in 24 hours maintaining the suggestions of a pediatric specialist. From last 01 month he is being suffering from sticky mucus issue. What is the main causes of it s suffering from mucus & under weight & what steps can I take to release from it s mucus problem & develop it s health please???????",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Birth weight, previous eight records and a thorough history and physical examination needed. Please visit your pediatrician for further assessment and treatment plan. The treatment will depend on underlying cause and it's severity. Also ask for dietary advise. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for extreme depression,self harm and weight gain\n\nHi, I am a 14 year old girl. Over the past year, I ve been feeling extremely depressed. I use to self harm every single night, I ve tried committing suicide but couldn t go through with it. I use to thoroughly enjoy playing sports, because it was one thing I was good at. However, over the last few weeks I barely have the enegry to turn up to a game. My attendance at school has dropped dramatically, my grades have dropped with them aswell. I am known as an unreliable employee because I rarely turn up to work. I ve just woken up at 2.00pm, I fell asleep at 11pm. I seem to just sleep my days away, my weight as increased dramatically also. I ve been told I abuse the use of alcohol and drugs, but have never seen it until now. I m just looking for a hand, a little bit of advice would be nice. thank you.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. There could be several factors combined. First of all you should visit a physician and get your thyroid checked for T4, T5 and TSH. If you find there is no problem with thyroid, then you must address your tiredness and weakness. Though you are just 14, there could be wasting diseases such as anemia. You also could be disappointed. Work with your physician for correct diagnosis. Don;t diagnose self, please.If you require more of my help in this aspect, Please post a direct question to me in this URL.  Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a bump and bruise below the knee\n\nI had a basketball practice yerstesay and a girl plough into me. It hurted so bad for about 2 minutes. When I came back home, I took a nap and then when I woke up I had a bruise and a big bump below my knee. It was kinda difficult to walk at first, but it got better after. I didn t go to the doctor but I put ice on it, but it doesn t seem to cure. Should I get crutch or should I do something to help it heal faster?",
    "doctor_response": "Hi you had an injury below your knee on direct collision with a bruise and difficulty in walking. You had done the right thing to put ice on it. I think that it is a blunt injury in the leg causing local hematoma. I would suggest now hot fomentation , Pain killers and local support for 10 days and if no relief then go for x rays.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain\n\nMy Mom is having chronic back pain .. we have just visisted orthopedics doctor . He adivised to get MRI L-S Spine and he is suspecting that there must be bone displacement issue. What is the best approach to recover from the back pain?  does it need any surgery",
    "doctor_response": "Hi, Welcome to healthcare magic. After going through your query I think your mother is suffering from chronic backache.Treatment of back pain is exercises, NUROKIND GOLD ONCE DAILY and analgesics (diclofenac 100mgSR). Sometimes vitamin D deficiency is the cause so get your vitamin D checked .If it is low then vitamin D supplementation (Bon DK 60K weekly with milk) can be taken. Avoid long continuous standing. Sit in a straight posture. Eat milk, fruits and green leafy vegetables daily. To further investigate MRI of the region is advised. It sometimes needs surgery such as in case of spinal stenosis and spondylolisthesis .I think your query answered. Welcome to any follow up query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should Strocit plus or Nootropil syrup be taken for brain stroke in a diabetic?\n\nDear Sir, My Father , 60 years old, had suffered brain stroke in his left brain in 2008. After that he had consulted a doctor who had given him Ecospin 75 and Glycomate 500 since he is suffering from diabetes for the last 15 years. He is taking Glycomate 500 since last 2008. Before that he didn t take any medicine for diabetes, since it was under control. Recently, just a week before , he was diagnosed with another brain stroke in his right brain. After consulting a cardiologist and a neurologist, cardiologist has advised him to take strocit plus daily 2 tablets for 2 weeks or Nootropil syrup 2 tsp per day for 2 weeks and maxgalin 75, 1 tab daily for a month. Neurologist has advised him to take strocit plus (2 tab each day for 2 weeks) along with maxgalin 75. My question is since he is suffering from diabetes, strocit plus or nootropil syrup, which one should be taken? He is continuing Ecospin 75 and glycomate.",
    "doctor_response": "your father has ischemic infarct(stroke) two times and diabetic. please tell about history of hypertension and and addiction as smoking ,alcohol. there is no definite role of these drug strocit plus or nootropil syrup in stroke. we donot prescribe these drugs. these drugs are costly and no definite role in literature. but ther is no disadvantage it he is taking nootropil or strocit. so you can stop these drugs. important thing is diabetes should under control to prevent recurrent stoke. please take aspirin in dose of 150 mg as 75 mg is low dose. add me 40 mg atorvastatin to control hyperlipidemia",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat herniated disc mediated calf numbness and swollen ankle?\n\nI developed a herniated disc November 29, 2013.  I have been going to physical therapy and will see a Neuro Surgeon this Monday January 13, 2014.  I have numbness in my lower left calf (in front) which has been there since the herniation. I woke up this morning with my ankle swollen on same side. Should I be concerned? Just wanted to say this incident was the worst pain I have ever experienced.",
    "doctor_response": "Hello!Welcome on Healthcaremagic!Your symptoms (swollen ankle) do not seem to be related to the herniated disk. It could be indicative of a deep vein thrombosis or arthritis. For this reason, I recommend going to the ER for a physical check up and some tests: - a Doppler ultrasound of the leg vessels- an X ray of the ankle- complete blood count, PCR, sedimentation rate- D- Dimmer levels. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce swelling in the shin?\n\n5'9\" 18 years old. female got kicked in the shin (through my shin pad) and it bruised and swelled a little. after 3 days the bruising went down my ankle (which i hear is normal as th blood runs down) but it still hurts and does not feel like a normal bruise. What bothers me the most is the burning feeling i get. It does not hurt to walk but it hurts to kick a ball around. any ideas as to why it burns? this happened about 2 weeks ago.",
    "doctor_response": "use ice pack don't use it directly wrap it in towel then use it for 15 minute and elevate the part and use crap band that will reduce pain and swelling before raping crap band use diclofanec gel then rap the crap band it will be helpfull to you and do rest.wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling sensation on penis tip post urinating and dribbling afterward after unprotected sex?\n\nI recently had unprotected sex just over a week ago. about 4 days ago, i started having a tingling sensation at the tip of my penis after urinating and dribbling afterward. I have a wife and family and don't want to infect them. What could this be I need some advice ?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Please keep away from unprotected sex with even known people except your wife. That is safest. Tingling sensation is not a proper symptom to address. You need to worry if there pain, itching or burning. Dribbling could be caused in normal circumstances such as mild infections or skin irritation. Even though I don't see any STDs, In any case, it is always better to consult a skin VD specialist for further diagnosis and advice.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent head, shoulder and neck pain post an injury\n\nCan neck pain and shoulder pain cause head pain? I get sharp stabbing pains all over my head. I was in a car accident when I was 21. I have had neck problems scence then. I can touch the top of my neck where my spine feels like it ends and press down and it feels as if something pops. Also I can sometimes turn my head sideways and where I feel it pops in that same spot it will pop on it s own.",
    "doctor_response": "Hi, It could be a contusion or ligament sprain.As a first line management you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist better to consult an orthopedic and plan for an MRI scan. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can chronic depression along with body tremors be treated?\n\nHi I was diagmosed right after a TRAMA in my life. I had a physical breakdown,,,I couldn stop shaking. My Mom had SUDDENLY died in 2009 and then I was back & forth to & fro my Dads twice a day from two towns over taking a train & bus everyday. Then 3 mths later my House was lost to a Electrical Fire. Since then I call my pains the traveling tremors. they occur all over But in a pattern .. from say anywhere in right head down to right foot thru left foot & up to left side of head. Occur anywhere from eyelid to pinky toe totally random PLUS now I m premenapauseal SWEATS that are horrendous! Have any sgestions. Oh I denied any other Medications after was treated for my breakdown with all different Antidepresants I stayed on SEtroline a Serotonin re-uptake (what ever that means) on it for two years with counselining. Any suggestions?Laura Raymond PS Sorry I didn t know there was a fee I don t have the funds Sorry I wasted your time thanks anyway. Laura Raymond",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As per your condition, you are suffering from chronic depression with tremors. Chronic depression can be treated well with Setraline which you are already using and for tremors it's better you opt for beta blockers under supervision of your doctor(only if you are non asthamatic). If you still feel problematic even after taking beta block then consultant Neurologist and take is valuable suggestion regarding the origin of tremors even anticholinergics might help you. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What will happen if kerosene is consumed?\n\nMy child drink kerosene yesterday not sure how much?which steps I have to taken?I have to taken chest x-ray and meet his peadiatition and reports are normal.Right now he is ok.He had no wammiting or breathing problem.It can be harmful in future days.",
    "doctor_response": "HiWelcome to HCMKerosene is a low viscosity hydrocarbon which immediately spreads in body and can cause gastric irritation and pneumonitis. If your child is fine for the past 1 day and his chest X ray was normal, then in my opinion there is nothing to be worried about any more.Just keep the things which can be harmful for him, out of his reach to prevent such episodes in future.Take care and for any further questions, do contact us.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can an online doctor check the liver test reports and advise ?\n\nDear sir,I did many blood tests and all the results were normally except the results about the liver.ALT: 68U/l, AST: 57 U/l, LDH: 235 U/l, Cholerithrini 1,51mg%From January 2013 up to April 2013 I took some tablets of medicins (prednisolone: 4-6 tablets/day).To be honest the last 2 months I drunk a lot (5-6 drinks everyday).Please I would like to ask you if it is serious generally the results about ALT, AST etc.Thanks in advanceAAAA",
    "doctor_response": "Hello, thanks for contacting HCM. I like your honestyin admitting about your drinking excessively for twomonths.I can see that has affected your liver and has caused somedamage. Your enzyme levels are mildly elevated and the totalBilirubin is slightly high. At this stage , you can take chargeand change things around for better. One thing good is liver canheal itself fast if you don't do further damage. My advice, stopall alcohol. Eat a healthy diet with lots of protein. Fresh fruitsand vegetables. Take a good Super B-Complex Vitamin alongwith Vitamin-E 800 i.u. and Vitamin-C 1000 mg. daily.Have your blood tests repeated in another 4-6 weeks. You shouldsee improvement. It may be worth your while to get a sonogramof the liver to see if you have any fatty changes. Wish you well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump on the tonsil indicate?\n\nI have a small lump on my tonsil. It s pink, round and smooth. About the size of a pen tip. I believe it noticed it a few months ago but only recently got concerned now that it seems I can feel it. If I poke at it with a tooth pick, I can wiggle it around a bit. No pain. Do this appear to be anything serious? I have an ENT appointment coming up but I am concerned it could be cancerous. What do you think? Here are pictures",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .*  The lump on tonsil may be from various causes as    - tonsillitis - papilloma - others Wishing you fine recovery .Feel free to ask any further  queries .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it an emotional disorder to shut off everyone, stay away from communicating ?\n\nmy sister, who is 58 years of age has all of her adult life, lied to and about us - her family - and when we confront her about it, she shuts down, refuses to talk to us, and acts as if we don't exist. She can go for years with no communication. She will come back into the family when there is a big event - say a wedding or funeral, then before long, history with her lying and freezing us out begins again. Is this an emotional disorder with her ? What can we do ?",
    "doctor_response": "What an interesting and challenging situation! Yes, it does sound like your sister might have an emotional disorder.Doing something about it is the hard part.Here are my suggestions:1. Abandon confrontation... it has not been effective.2. Ask your sister if there is anything you can help her with.3. Remember that trying to change another person is very often a losing proposition, especially if she is not asking for help...so don't \"try too hard\"4. Do your best not to take her behaviors personally.5. Avoid reacting with anger.6. Focus on your own responses to her behavior, remain empathetic, but don't expect a cure to be forthcoming.7. If your sister would like help, the best suggestion would be that she seeks the assistance of a competent mental health professional (therapist).Hope this helps. I can understand your frustration. There is not an easy answer, that's for sure!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for feeling of testicular vibration\n\nDear Doctor , since this morning i am having a vibration feeling in my inner testis - no pain but worried about it ( the symptom is  like that you keep your mobile in your pant pocket in vibration mode) .  pls advise me what that could be and how to get rid of it",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice Very unique presentation you are having.There are no conditions which can vibrate in the scrotum. You may directly get it tested with an urologist. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat gum bleed?\n\nMy gums bleed treble and there is no pain. i took amoxilicin moxikin cv 625.... now my head aches all the time. i feel like im fainting. i have tried all the possible remedies. mouthwashes salt gargle limewater but the swelling just insnt going n its gettin worse. i cant work this way. plz suggest me a way. tx",
    "doctor_response": "Hello and welcome.Thanks for sharing your concern.Please try to meet your dentist to the earliest.your gums requires a small surgery called as periodontal surgery.Delay might land up in  mobility of teeth and finally loss of all teeth.Therefore its nice that you have taken a course of antibiotic,simultaneously see your dentist too.Hope it helps.Thanks.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for allergy causing cough and wheezing\n\nhi, my daughter is 6years old.we shifted to an area where every where construction is going on.so she started getting cough,blocked nose,sneezing and wheezing problem very frequently.we stay in Bangalore.she gets this problem earlier also when she was 3years old.she started getting wheeze problem but frequency was less.once in a year.recently one of a senior dr.gave her budecort mixed with saline 1:2 rato nebulization for 30 days as she was coughing while sleeping and after waking up in the morning.is it right way to give her nebulization mixing with saline..is it safe?can we use the same respule in the night after keeping it in refrigerator.dr.also gave her junior lanzol tablets for 30 days as she was complaining of stomach ache and not eating properly.vomitted 2 times in last 5days.sunday it started as we had outside food on Saturday.now she is fine no stomach ache complaining.i am giving her lanzol before food 2 times aday.for 30 days it is required.please suggest.",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your daughter's history and would like to make suggestions for her as follows:1. I would agree that she might require regular medications (like Budecort) for at least 30 days as she used to have frequent symptoms.2. It is important that a child gets right dose of Budecort and the nebulizer chamber is filled with at least 4-5 ml of solution. The ratio between Budecort and saline is not important. Your doctor might have suggested you dilution to fulfill above two requirement. So I would suggest you to continue with the same dilution. 3. Ideally, one respule should be used only once. The reason is there chance of contamination and therefore infection is one uses cut open respule.One more problem with refrigeration is that inhaling cold solution may directly cause constriction of airways and may worsen symptoms. So I would suggest you not to give her nebulization immediately from refrigerator.4. Most practical solution is to use one full respule at one time and it is very much possible as they come in different dilution. Please contact your doctor regarding this concern and he will prescribe you respules with appropriate concentration.5. Some children with wheezing have symptoms worsening with what we call \"gastroesophageal reflux disease (GERD). They need drugs like Lansoprazole (junior lanzol) for at least 4-6 weeks regularly.So if your doctor has prescribed her junior lanzol, I would suggest you to complete the course.6. Personally, I would suggest her allergy testing which will help you identify the substances causing allergies to her and also to know the measures to avoid them. 7. In general, please avoid exposure to dusts, smokes and air pollution as much as possible to her.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish your daughter the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling & numbness of toe,feet & heels?\n\nHow are you? I have been experiencing tingling and numbness in toes,feet,heels,burning sensation in feet and heels, slight burning,stiffness in joints in fingers and toes for a month at once it was quite painful to walk now the issue is getting much milder",
    "doctor_response": "Hello....You seem to be experiencing symptoms of peripheral neuropathy. Are you currently on any medication? Although it is good that the symptoms are subsiding , i would suggest that you get a complete blood panel done including sugar profile and thyroid function tests.Please consult your health care provider who can examine you and guide you further as regards any other investigations that may be required.Hope this helps...Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe back pain?\n\nHello Doctor, I am facing back pain since couple off days,earlier i thought it was due to some improper position of body movement.but its creating problem for me everyday.its becoming severe as i am not able to seat more than 5 min on chair or in floor,please help me on this?",
    "doctor_response": "Hello,I had gone through the case and found that it might be slip disc or muscle spasm.So go for MRI of spine and take proper treatment.Meanwhile take mild painkiller and apply muscle relaxant gel.If pain is unbearable and reports come then go for physiotherapy.Avoid forward bending and lift heavy weight.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in lower back, tingling in legs, arms and chest. MRI shows bulging disc on L5S. Treatment?\n\nMy lower back hurts. 2 years ago, I had an MRI which shows a bulging disc on L5S. I have tingling in both feet and legs and in my hands and arms. I ve also had this tingling sensation in my chest which scares me. Is this chest issue related to my back? My chest doesn t hurt, just feels like the tingling in legs, arms.",
    "doctor_response": "Hi jrobert3156 herniation of L5S1 disk explains the tingling in billateral lower limbs. you may have got some spinal problem in your cervical spine like cervical spondylitis which is causing symptoms in upper limbs. you may cosult orthopedician/ spinal surgeon for the same...in the meantime you may try tablet pregabalin 75 mg once daily to get relief and consult physitherapist to get advice of back extension exercises and neck exercises. you may also try soft cervical collar. best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in side after urinating. How to stop recurrence of pain?\n\nHaving pain on my left side. After eating fruit for breakfast and drinking 34 oz. of water I have to urinate a lot (expected) but then my left side hurts. Happens occasionally then goes away. First time it happened I was in extreme pain, went to the hospital and they didn't know what it was and the Dr. guessed that I passed a kidney stone.  I eat a pretty healthy diet and drink about 102 oz. of water per day. I do not smoke or drink alcohol. What is going on with me and how can I stop this from re-occurring?",
    "doctor_response": "hi.. as your doctor rightly said, it could be a renal/ureteric colic... Get one ultrasound examination done in order to see if there are any more renal stones.. if it is there, it needs to be treated based on the stone size.. see your urologist if stones are found in the kidney.. if it is not there, drink lots of water, aviod alcohol/smoking/aerated cool drinks.. stop palak/spinach, reduce intake of tomato.. do regular exercise, but dont dehydrate yourself.. all the very best..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause persistent cough?\n\nhello dont know if you can answer my quiry but im allways thinking that i have something seriously wrong with me this distrupts my everday lifestyle and my sleeping i have had a chesty cough for just over a month and and have been on antibiotics for three days now and its nt getting any better i think theat i have some sort of cancer or a lung problem i get a bit panicie when i start to think abt this but i cant seam to stop myself i keep thinking about this day and nighti have been on anxiety tablets in the past on and off since the age of 18 because of this",
    "doctor_response": "Hello dearWarm welcome to Healthcaremagic.comI  have  evaluated your query thoroughly .*  There are different  possibilities  for  the  same  as  -  Allergic  bronchitis -  Pneumonia-  Lower respiratory  infection -  Others *  Should  get evaluated  with  basic  laboratory and x-ray reports  for    the  diagnosis and further management  rather than becoming panic    for  the  condition .Hope this clears your query .Welcome for any further guidance .Regards dear take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the sperm count normal?\n\nCan u suggest how my sperm analysis report looks...is the report looking good Test Result Abstinence 5 days Collection Time 8:45 am Physical Examination Volume 4.5 ml Colour Greyish White Appearance Turbid Viscosity Normal Liquefaction Time 30 mins Chemical Examination pH 8.0 Fructose Test Positive Microscopic Examination (at liquefaction) Sperm Concentration (million/ml) 80.8 Total Sperm Count Per Ejaculate 363.6 million Progressive motility (PR) 58 % Non Progressive Motility (NP) 08 % Immotile (IM) 34 % Sperm Vitality % 92 Abnormal Forms % 34 Sperm Agglutination Absent Pus Cells Absent Precursor Cells Absent Other Findings Nil",
    "doctor_response": "HelloVolume                Normal value           You are having                           2 to 6 ml                  4.5 mlColor grey opalescent and homogenous and opaque . Normal in your case .Viscosity normal , liquefaction time pH  Normal 7.2 to 8 ( in your case it is 8 , so normal )Fructose test positive and normal Sperm normal > 48 million/ ml (80.8 million /ml in your case so normal ) Total > 160 million ( in your case 363.6 million , absolutely normal and AMAZING )Motility 90 -100 % but in your case it is 58 % so somewhat low in motility .Immotile 0-10 % ( in your case 34 % , this is low ).Sperm vitality for fertility require > 12 % and again absolutely normal morphology .In my opinion report is normal as far as concerned about SPERM counts but MOTILITY is below normal . So consult a  infertility specialist and get his opinion , if you have any problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should Carbimazole be discontinued by me to conceive ?\n\nI want to be pregnant ,yet i am on carbimazole. Should i stop the medication or it doesnt matter? Thank you.",
    "doctor_response": "hi sammy, welcome to health care magic, you need to shift to propylthiouracil a relatively safer anti thyroid drug in pregnancy.so once your pregnancy is confirmed stop carbimazole and get your thyroid profile done and start propylthiouracil in the lower doses.consult a physician who will tell you the exact dose as per your thyroid profile.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of a lump on the back?\n\nI have a small (quarter sized) lump on the left side of my lower back right about where pants hit. My back cramped and locked up a few days ago and the lump has been here since. It feels as if it moves, is very tender to touch, and hurts quite a bit. What is it?",
    "doctor_response": "Thanks for asking in healthcaremagic forum   It may be a contusion(blunt injury) or a boil. So, please visit a doctor who can examine you for the lesion and comment on that. All the best. A pic of it if possible is highly appreciated for further suggestions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes failure of pregnancy after an embryo transfer?\n\nHi Doctor,I had a frozen embryo transferred. I used an egg donor. The embryos were tested for any abnormalities, I had two embryos transferred, but my cycle failed. What could be the possible cause and what can be done different next time to have a better chance of success next time?",
    "doctor_response": "Hi, there can be many reasons for not conceiving after frozen embryo transfer. Many are still not known. You can go for a natural killer cell measurement in your endometrium. If it is high, then a medicine called grafile is given intrauterine after pick up of ovum or 3 days prior to embryo transfer. Also a test called ERA is available, but it is very costly. Talk to your doctor regarding this. Hope this will help. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in the lower back?\n\nAbout a week ago I woke up with severe pain in my lower back.  I stood up and collapsed because the pain was so bad. I could barely make it to the bathroom. I went to the doctor the next day & was put on prednisone & flexeril. It's been 6 days & I can finally sleep but it's still hard to walk. I'm supposed to be looking for a job this week but it's impossible to even just sit up for more than 5 minutes. How long will it be before I can get in a car & look for a job or even start a job? Also, I tried surfing behind a boat a week before my back spasmed like this. The doctor I saw said its probably not what caused it since it was a whole week before I had this problem. Do you think it could be from that? The only other thing I did that put any strain on my back was clean the bathroom? Thank you in advance for taking the time to answer me! I really appreciate it!",
    "doctor_response": "Hello, I read your query.probably you has some kind of disc problem.YOU REQUIRE REST and analgesics  for nearly two weeks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden sweating with trembling,weakness,headaches and palpitations?\n\ntoday while shopping, I got so sweaty that my shirt was soaked, started to tremble, felt weak, headache, heart started papitating, hyperventilating, got home, collapsed in bed, woke up 2 hours later feeling ok.  I am 65 never happened before. Not sure what happened.",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. Are you a heart patient, having high bp, cholesterol, smoking, chest pain, diabetes, or stress? Have you checked your blood pressure during the episode? This should be evaluated. Get an ECG, echo and if needed TMT done. Also get lipid profile and sugar tested. This could be a panic attack or heart problem. We will need to rule out heart problem before labelling it as panic attack. So get the above test done and let me know if it recurs.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from gastritis & stomach pain\n\nSir,I have been suffering from Gastritis since FEB\u20192013. I got treated in hospital & test done. Endoscopy report is as follows:Upper Endoscopy Report:-esophagus Normal-Stomach-Fundal erosions, Antral erosions, Greater curve, Lesser curve(N).Antral Gastritis+ Pylorus Inflammed+ OcdenatonsDuodenum Normal, No esophagitis.Important: Antral/Fundal Gastritis                     H. Pylori Report- NegativeProblems which I am Facing: Stomach pain under right lower ribs, umbilical region, middle stomach, left & right part of stomach. Pain is intermittent, not continuous, sometimes burning sensation in stomach, uneasiness, excess gas formation , tired, harassed & lazy feeling, heaviness in chest & head, always cough in throat, sometimes hurry for motion, stool enwrapped with mucus, Leg pain , Normal hunger & thirst, occasional  Irritation in stomachPhysical Appearance: Height-167 CMS, Wt. 68 Kgs, BP:120/80, No sugar, Age:44 Yrs., Sex: MaleI like salt more than sweets, None vegetarian Occasional, Non Alcoholic, No tobacco, I take tea & coffee only, Aggressive nature, ill tempered, Ocassional  skin diseases.Stool Test: No Parasite found, Urine Test: Normal, Blood test including TSH: Normal, Ultrasound : No Abnormalities FoundI took Allopathy /Aurveda / Homeopathy Treatment but got not much benefit. I want to know that is there permanent & guaranteed treatment is available. If yes, Please advise me the best suited homeopathy medicines & its doses.  Please help me. I am regular reader of HOMEO GAGAN Magazine. I have much faith in Homeopathy. I attached herewith all the test report. Please find it.Warm RegardsShashi Kant SinhaEmail:  YYYY@YYYY",
    "doctor_response": "*1. since Endoscopy reports have diagnosed the problem as 'gastritis' and other reports are Normal, thus possible/likely cause could be :. APD [acid peptic disorder] due to gastritis: cough in throat, pain, heaviness in chest, cough in throat.. IBS [irritable bowel syndrome]: pain abdomen, hurry for motion, mucus stool.. Aggressive nature means that Prakriti [constitution] is Pittaj [fiery] thus Dietary Regime will be initiated keeping in mind the nature of disease and symptoms1. avoid: heavy, dry,spicy food,mustard oil,citrus fruits,alcohol,horse gram, newly harvested rice, long night awakening, fasting, drinking excess water, walking in sun,chickpea flour.2. Take; old brown rice, honey,amla,pigeon pea,butter milk,sesame oil,soup, mint,coriander, coconut water.3. . mix 3 pinch long pepper powder in 4 spoon honey. eat it for a month. Do not drink water for half and hour. drink 4 spoons of aegle marmelos leaves juice for 14 days.. banana, cucumber, water melon are natural antacids.. suck 10 gm jaggery everyday [after meals] for constant acidity4. Prescription Mediicnes which you can ask for are: Takra arishta, Chitrakadi vati, syp livomyn, tablet alsarex/gasex, himcocid suspension, bilagyl lehya.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Allergic asthma, high eosinophil count, get cold easily. Can I continue hetrazan?\n\nSir i have allergic asthma my eosinophil count was high i was taking hetrazan tablet and inhaler now its undercontrol my query is about hetrazan tablet i get easily cold can i used hetrazan in that situation because after taking it i fell better can i continue with it or not and please tell me the side effects of hetrazan",
    "doctor_response": "Hello,Allergic asthma causes the eosinophil count to go up but hetrazan is NOT the treatment (definitely not for long-term). It should ideally be used when there is evidence of filaria that also causes the eosinophil count to go up but only for 21 days. Steroids are used when there is suspicion of tropical pulmonary esinophilia (TPE) along with hetrazan.Please stop the hetrazan if you have used for more than 21 days and discuss this with your doctor.You will need allergy tests (specific IgE or skin prick tests) to know what the allergens are (aero or respiratory allergens) and the asthma should be treated as per GINA guidelines.I hope you have had lung function tests to prove that you are indeed asthmatic.Best Wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "A male has a hard swollen abdomen but hospital had found nothing\n\nA male has a hard swollen abdomen , it s been going on for quite a while and the hospital had found nothing. there is no pain but he can feel a kind of ball thing in his belly. a couple of months ago he couldn t eat for a week because even without eating his belly swelled up a lot (i.e he couldn t zip up his trousers) i was thinking about IBS but that would show in the colonoscopy wouldn t it? the person in aged between 15-30 years old.",
    "doctor_response": "Hi, This is possible in some conditions. He might have absolute constipation which can give rise to fullness of abdomen and hard faecal maas may feel like lump in abdomen. If more fat deposited in abdomen,there is bulging of abdomen. Avoid constipation, take light purgative daily at night.take more green vegetables and salads. If more fat in the abdomen,reduce weight,do leg raising exercise daily.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for erection problems\n\nDear doctor im male 30 yes old, foe the last 6-7 yrs i do masturbation, but 2 times in a week, last week wen i do intercouse wid my gf, it discharge outside and my penis didnt go inside, but my marrige is soon , pls tell me this a problem, pls suggest me wat to do",
    "doctor_response": "Hello, Dont worry, sometimes having sex in longer times can lead to having early ejaculation. You need to relaxe for some days, and dont get anxious too much. please look for sensate technique and master-johnson technique in the google for knowing about how to increase the sexual performance time. You may visit a Psychiatrist for getting treatment for the same, because they are the experts in this area and you can clear your myths regarding this early ejaculation. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr SHOBHIT KUMAR PRASAD, Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is MRSA infection contagious?\n\nMy father (who has myeloma/secondary PCL) came home from the hospital with an MRSA infection on his back.  It responded to antibiotics and cleared up, but he still has the bacteria in his nose.  We've been practicing good handwashing and disinfecting surfaces.  This morning I woke with several mouth ulcers.  Could this be MRSA acquired somehow?  e.g., not using hot enough water to wash cutlery or something?  We don't share food.  I am also under a lot of stress, having been his solo caregiver through his cancer battle for the past 6 months.  Thank you, Doctor(s).",
    "doctor_response": "Hi & Welcome to HCM.I appreciate your concern for the MRSA infection.Yes, it is contagious infection, the bacteria (staphylococci) which are normally present in the nose can be transmitted by sneezing, coughing or shaking hands, direct contact with an infected wound or by sharing personal items, such as towels or razors, that have touched infected skin, etc.MRSA infection usually occurs in the skin with pus formation.Mouth ulcers are unlikely to have been caused by MRSA. Hope this answers your query.Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in leg leading to restricted movement in leg?\n\nHave had pain in my upper right leg,starting from under the right side like a burning needle then my whole right leg can not be bent and very heavy and paifullsince two nights ago,when l came on the plane from sanfrancisco,l feel feverish,l was 37 ,38 althought l have been taking urofhin,l can hardly bend it nothing is swollen,but have a lot of pain going down even on my foot, l have a lot of vareces veins ,l have to lift my foot yo straighten it on the bed cout l be having trombones, my son of 35 years twice had tramboses,l will go to the dr tomarrow,as it was week end thank you my email is YYYY@YYYY thank you",
    "doctor_response": "Hello,I have studied your case. I think that you might be having hip syovitis with thrombosed veins. A Doppler examination will confirm this diagnosis. If there is any thrombosed vein than it can be taken care of with the help of antibiotics and anti thrombotic medicines.   I would recommend you to show it to physician and start treatment accordingly. Thrmombofobe ointment can be applied locally. Heparin injections can be given accordingly. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the chances of STD from my encounter, especially HIV?\n\nHello doctor,I was recently in a sexual encounter with a sex worker. It was a condom-protected sex. The condom did not slip or break. But, I inserted my finger into the girl's vagina for two minutes. Is there any chance of catching an\u00a0STD from the whole thing (the intercourse and the insertion of the finger),\u00a0especially\u00a0HIV?",
    "doctor_response": "Hello. Hope your query is answered, but if you have any other questions, please revert. Best wishes. For more information consult an HIV AIDS specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the outward drift of the eye in a 3 year old?\n\nMy child is three years and two months old now. We observed mild outward drift in his left eye when he was one year old. Sometime a drift can also be observed in right but that is very rarerly observable.However the drift in any eye when looking close is not observeable. I got examined him by an eye doctor and he said that it is concordant exotropia . Please let me know is this type of squint is correctable by galsses and therapy, as I prefer the therapic method. The surgery at this age seems little difficult as the child may not take proper care and also he can not tell the actual situation.. Moreover what are the complications of surgery. Will the binocular vision will be improved. what if left untreated Please reply soon Thanks",
    "doctor_response": "Your little child has already been seen by an eye doctor .The vision is dependent on eye ,nerves and brain .If the drift occurs only ocassionally then there is time for you.Please enroll your child in a vision centre where he will get vision therapy in the form of patching one eye or intermittent patching,You have to reinforce exercises at home also .Regular check up every 3 months with the ophthalmologist is mandatory .Best of luck .he can improve without surgery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Problem after brazilian waxing, what should I do ?\n\nhi, i have brazilian waxed at home, and my skin is gone red like it ha been burning and it is painfull ,what should i do?",
    "doctor_response": "hi; welcome to HealthcareMagic The redness is because of skin irritation due to your brazilian waxing .It is a hypersensitive reaction please go to a doctor close by for proper help .Take care thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I use Kojivit gel to get fair skin?\n\nHi doctor, I am a 22 year old female. I have a dusky skin that is brown skin. I want to become fair. Can I use Kojivit gel? Or any other dermoatology cream can I use? My hands are also brown in color and full of tan. Do you suggest any creams to get fair? I want to become fair as my marriage is going to get fixed by next year. Please suggest me some creams, so that it should not show any side effects. Also, how long I should use it? If I use anything, then will it have any effect in case of pregnancy, etc? Please help me. Thanks in advance.",
    "doctor_response": "Hi. One's skin color has 2 components. First one is genetic, which cannot be changed. Every skin color is beautiful in its own way and we should learn to love our skin color and augment it and not hide or lighten it. The second component is acquired, which is due to the influence of environment, sunlight, hormones, aging, etc. We can only target the acquired component of fair skin color while attempting lightening procedures. I suggest you antioxidant capsules like capsule Antoxid HC (Beta-carotene) and apply sunscreen lotion Lashield gel at 8 AM and 12 PM. Also, you can apply Glyaha koj lotion (Hydroquinone) at night time. Start with an alternate night application initialy as it may irritate your skin a bit and after a week or so, shift to daily night application. Consult your specialist doctor, discuss with him or her and take the treatment with consent. You can go for chemical peeling or microdermabrasion from your dermatologist which will help in exfoliating and give you a clearer skin tone. All these treatments are free of side effects. You may use them for three months. For further information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nausea loss of appetite and pain in lower abdomen?\n\nMy mother has experienced nausea and loss of appetite since 2008. She was told it was parathyroid disease. She had the surgery. Nothing improved. Now, she has pain in lower side near colon, still nausea , tired and has all kinds of tests. Could it be cancer?",
    "doctor_response": "Hi.Thanks for your query.The history provided by you about Mother is suggestive of a chronic disease, one of them is cancer and Tuberculosis.Nausea with loss of appetite with pain in lower abdomen is more suggestive of tuberculosis. I would advise :::Contrast enhanced CT scan of abdomen, Enteroclysis, Colonoscopy and the gold quantiferon test for TB.. A clinical examination by a Surgeon plays an important part in early diagnosis as well as a proper history.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome the hard lump behind my ear?\n\nI have a hard lump behind ear that is red outside, my partner squeezed it as he thought it was a spot it hasn t reduced in three days, the tiniest bit of clear fluid come out when he squeezes it really hard could this still be a lymph node due to the fluid coming out?",
    "doctor_response": "Hi. The commonest swelling behind the ear is lymph node;The fluid and redness are suggestive of an infection plus you have fiddled with it.Needs an antibiotic and anti-inflammatory medicines and a consultation with an ENT to confirm",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the palpitations after playing games?\n\nHi, When lyin on my stomach just before after playing a round of golf, i got 3 heart pupatations within 5 mintues, almost like gas in my stomach but it happens then i feel my heart beats harder after each one then settles down. happens more lying on my stomach, is this normal",
    "doctor_response": "Dear- thanks for using our service. I read your question with care and want to advise you to consult with your primary care physician about this problem that you are having with palpitations. I don't know your age, but it is important to have a basic evaluation with a 24 hour holter to be able to identify what type of arrythmia you are having and what triggers it. You will need to have a complete laboratory exam to in order to check for abnormal electrolytes levels as potassium , chloride and calcium which can cause irregularities in the heart when the are not between the normal levels. The reason that happens more when you are lying on the stomach could be related that you are pressing that area and it is creating an increase of the blood flow to the heart.I hope that my advise has been helpfulDr.Sara",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the pain in the lower left side be due to the stress?\n\nI've been stressed lately, arguments here and there, busy with working bring a mom and taking care of my house I'm exhausted. Last night I have big hurtful argument and my lower left side started hurting I was experiencing sharp pains. What could it be and is the stress and fighting the cause?",
    "doctor_response": "HIThanks for using healthcare magicThat pain may be due to some muscular reason. May be due to excessive work, you get this pain. Just take a pain killer and with time, it would improve on its own. In case, it stay, then take opinion of general physician and try to find out the cause of pain. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for terminal bowel cancer\n\nMy son has terminal bowel cancer. He has a perforation and has an infection. This is being treated with Iv antibiotics. There is no chance of surgery. Is this course of treatment likely to work? If antibiotics don t work is there any further course of action to be taken.",
    "doctor_response": "If there is a perforation of the bowel through the cancer your son is suffering from, then it is unlikely to heal with antibiotics alone. The treatment is only surgical repair of the perforation. I hope there is a very strong reason for not operating upon him, since the situation is life threatening in the absence of surgery. The infection also will continue to spread as long as the perforation persists. A remote possibility is that the perforation seals on its own and then the antibiotics take care of the infection, but that scenario is very rare.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What causes shrinkage of endometrium on 13th day of cycle?\n\nHello doctor, I am on a 13-day cycle. My endometrium has shrunk to 7.7 which was 7.9 on 11th day. I am on Ecosprin 75 mg, Progynova 2 mg twice a day, Estrogen cutaneous cream. I was on Viagra vaginal insert for five days from day two. Now it has stopped. So, my question is why is my endometrium shrinking to 7.7 from 7.9? So my RE said will take a call after two days TVS. So, can you tell me what is going on?",
    "doctor_response": "Hello. A change of endometrial thickness from 7.9 to 7.7 mm is minimal and can be due to measuring bias. However, an ET of more than 7 and less than 8.5 mm by mid-cycle is an acceptable thickness for implantation. The medications that you are on are fine and should be continued. There is nothing wrong unless you develop irregular shedding or spots which can justify the loss of endometrial thickness otherwise the likely cause is USG measurement bias. Advise is to get a TVS repeated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tiredness, constipation with dizziness and missing IGG?\n\nMy son is 14 and is tired and withdrawn. We have tried gluten free diet that seemed to help with constipation. He has been having dizzy spells more often lately. His blood work last year indicated he was missing Igg. Any thoughts I could do to make him feel better or how to talk to the doctor?",
    "doctor_response": "With such presentations in my clinic, I would suggest IgG replacement therapy,it is the treatment of choice for most primary immunodeficiency syndromes. For dizziness you can use Betahistine 1 tablet twice a day for 1 week. For tiredness you can give multivitamins-Zincovit or Revital for man 1 tablet once a day for 1 month. For constipation try to follow the following guidelines. - High fibre diet, green leafy vegetables-beet,zucchini, fruit,fresh juices.- Cut down the processed food. White bread, doughnuts, noodles, pizza,rice should be completely avoided.-A 40 minute physical activity every day like morning walk, evening walk or a visit to the gym or swimming pool.-Dufalac 1 tablespoon once a day for 1 month.Start on these changes and get back to me in 2 to 3 months. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is Brown-Sequard Syndrome?\n\nHello doctor, In case of\u00a0Brown-Sequard Syndrome - left side damage, I am just wondering why the muscle strength grade of the left leg flexion 0/5 and left leg extension 2/5?",
    "doctor_response": "Hi. Revert back with the asked information to a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hepatitis-B infection\n\nHello Doctor. i have liver related problem. Recently I got jaundice.Now it came to normal stage. But I am also suffering from HBsAg. Today i have done blood test. The report saying POSITIVE (3961.68). Please suggest what should i do now.?Is it so serious? where can i get the medicines?I am living in Mumbai (India). Please advise me. Thanks Rajesh ( YYYY@YYYY )",
    "doctor_response": "hi.thanks for posting query at HCM.HBsAg can not be completely eradicated in a patient suffering from HepB.however, complications maybe prevented if proper medication is taken and proper diet plan is followed. Treatment is advised IF high values of liver enzymes AND high viral LOad on a PCR. also test for liver enzymes and visit a hepatologist or a gastroenterologist. Liver enzymes should be monitored regularly while HepB markers maybe checked every 6 to 12 months.hope to answer your concern.wish you good n sound health.regardsDr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this MRI report of spine indicate?\n\nI ve recently had an MRI of my spine. A little background.........in 2012 I had a fusion done at L4-L5 S-1. I had a complication the days following the . An arterial bleed in the space of the fusion. They went back in, stopped the bleeding and evacuated a blood clot that formed on my L4 nerve. After 1 year they determined my nerve damage was permanent. I ve had numbness on my left side, hip to foot. Recently I ve had new numbness from the bottom of my foot to my heel (the n top of my foot has been numb since surgery). Also, now the top of my thigh is numb too. The MRI revealed the following: L3-4 Partial disc desiccation and diffuse annular bulge. Moderate facet arthropathy and ligamentous flavum hypertrophy. What exactly does that mean??/ Thanks, Lori",
    "doctor_response": "HI Well come to HCM I really appreciate your concern, MIR finding are suggestive of disk degeneration pathological changes, detail of description of findings could be lenghty and it is not possible to describe here in short it is pathological changes seen (Disease condition of spinal disk)  hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe cramps with abdominal pain?\n\nI m a seasoned mom of 5 kids. my youngest will be 7 next month and this morning started showing symptoms of abdominal pain and complaining of both legs hurting. I gave him ibuprophen for the pain. then about 2 hrs ago I noticed him having a fever. fever now is 101. gave him the med at 9 am. something just doesn t feel right about his symptoms. that s why I m asking.",
    "doctor_response": "You have not mentioned any other symptoms so go on with crocin 250 mg sos ,it will take care of fever , leg pain & mild pain abdomen as well ,with cold sponging. As he is complaining of pain abdomen it may not be right to add ibuprofen as it may cause further gastric irritation. You can repeat crocin 6 hourly if not improve and develop other symptoms please consult a doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes congested feeling in chest after stent operation?\n\nGood evening, my father in law had a stunt operation 2 moths back , now he is having fever and saying that he is having a congestion feeling sensation from his  side of the throat to heart . is it dangerous? or is it manageable? why is it happening? he is even having motions also? took a medicine paracetmol for fever.",
    "doctor_response": "Looks like your father-in-law is having some upper respiratory infection it doesn't seem to have anything to do with the stent but check with your physician if he does not have any congestive heart failure otherwise got to treatment far flu on bronchitis our pneumonia thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of follicle rupturing after taking hcg shot?\n\nHi doc. I am 26 years old, height 5ft1\" and weight 63 kgs. I have PCOS . I am currently undergoing follicular study for conceiving.  I got FSH injections for increasing egg size on the 8th and 10th of my cycle. Then I got HCG 5000 shots on the 14th day. It is the 16th day of my cycle. My rt ovary measures 22 X 15 mm and my left ovary measures 18 X 13 mm, endometrium is 9 mm. Now again I have got HCG 5000 shot today ie the 16th day around 3 hours ago. I want to know, what are the chances of my follicle rupturing and conceiving after that. Please reply asap s",
    "doctor_response": "HelloThe size of follicle should be around 19 mm to 20 mm on 14-15 day at least to rupture . Endometrium thickness must be around 11 mm to conceive. It has been written in books that rupture ( dominant follicle ) take place on 14-15 day and in your case it din't ruptured although the size of left ovarian follicle was very close to full size required fro rupture . Get in study ( follicle i.e dominant which  having ovum in it ) of dominant follicle . In my opinion there are certain parameters which are not up to standard for successful conception .Once again consult your treating doctor and get his opinion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for pain management\n\nneed pain doctor willing to give narcotics for cronic pain, mva in 1973 tore me apart brok numers bones can hardly walk, back surgery in2002. I ve been hurting for 40yrs and in my older age the pain is unbearable, i live in cortez co 81321 willing to travel",
    "doctor_response": "hi,thank-you for providing the brief history of you.A thorough neuromuscular assessment is advised.As you had mva in the past and also a surgery post which now you are in tremendous pain, I will advice you to perform some simple physical therapy as it is non invasive way of reducing the pain Symptoms. Later stages performing exercises and maintaining the strength in the muscles should give you abundant relief.Also, you look keen on medication but my friend, medication are the symptomatic relief provider and your body is the self medicine of it it's own I have seen severe chronic pain patients with more of medication but unfortunately due to excessive consumption of pain killers there leads to kidney damage and physician will prefer to avoid prescribing one.Exercises are what I recommend then along with physical therapy and they respond well. Exercises will imporve the metabolism and also the immune system which helps alot in removing the aches and pains without medication. Ofcourse medicines are a first line to choose if the pain is not bearable but physical therapy is a parallel way of treating the pain.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cancer, recommended removal of left kidney, in need of urinating often. Suggestions?\n\nthey did a procedure to look at my kidney because a mass was there and when they could't reach the mass that is when they put the stent in to strech the kidney so when they did the procedure again they were able to reach the mass and to collect a sample of it and it turned out to be cancer so now the doctor wants to take the left kidney out but the problem I am still having with the stint is constant need of urinating about evey 3-5 minutes.",
    "doctor_response": "Sorry to hear about your problem. Incase of cancer the kidney does need to be removed and the stent will not affect the surgery. The increased frequency of urination is probably because of urine infection, which is quite common after stent placement. You should have your urine examination done and start an antibiotic before surgery. Hoping for the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cough with phlegm?\n\nI have a chronic cough that has been going on  for 5 years.  I do not have a sore throat.  But sometimes the coughing causes my gag reflex to get stuck and there is sometimes flem.  I do have cysts on my thyroid - could this be a part of the problem?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Yes, Thyroid cyst if enlarged and compressing internal tracheal wall, can cause chronic coughing. So better to consult ENT doctor and get endoscopic examination of throat to rule out this. Also consult pulmonologist and get done clinical examination of respiratory system and PFT (pulmonary function test) to rule rule out bronchitis because this can also cause chronic cough. PFT will not only diagnose bronchitis but it will also tell you about severity of the disease. And treatment of bronchitis is based on severity only. You may need need inhaled bronchodilator and inhaled corticosteroids (ICS). If thyroid cyst is the cause then you will need have time do surgical removal of cyst. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce BP?\n\nhi my BP is 170/120 as of now doctor advised telista AM everyday morning (one daily) permanant am 43 yrs old with ht 5'9\" wt 94kg. normal eating habits vegetarian doesnt smoke. How do i reduce my BP No other major illness no diabetes so far.Eats well,sleeps for 9 hrs at night. Thnks",
    "doctor_response": "Hello,  as your blood pressure is very high, it would not be controlled with lifestyle changes alone,  hence you need to start on medication at present,  one can slowly consider decreasing dose after a good control is a achieved.  Meanwhile you should start Exercise 30-45 mins a day atleast 5 times a week Decrease salt in diet to less than 2-3 gms a day Consider losing weight and try achieving ideal weight of around 80. Regards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling in lips and dry mouth with canker sores\n\nmy bottom lip is swelling - just started an hour ago.  My tongue has deep grooves-looks like a fissure.  My mouth is dry with two canker sores. Two hours ago I washed my mouth out with peroxide. What do you advise me to do now?  John Johnson of Lockport, Ill. YYYY@YYYY",
    "doctor_response": "Hello,  Welcome to healthcare magic.  I understand your concern , as you have dry mouth and cancer sore dont worry for this you can do is Apply local application of ointment Mucopain or Dologel two - three times a day.  You can take one capsule vitamin B complex once daily for one week  One Tablet anti oxitant once daily for one week  Take liquid intake , drink electrol and  glucose whenever thristy .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Big brown patches under armpit, spreading down stomach. What could it be ?\n\nmy daughter has formed big brown patches under her armpit. they have been there for a while but today she showed me they are spreading down her side & on her stomach. what could it be? She is 16 and her doctor put her on birth control pills after her surgery for endometriosis and something is up with her thyroid getting that checked again. but she had the brown spots for a few years before any of this. help",
    "doctor_response": "Hi,Thanks for writing to us.From the description provided i could think of few possibilitiesfungal infection or tineapityriasis versicolor- again a superficial fungal infection which can present as hyperpigmented lesions. However commonly causes hypopigmented lesionserythrasma- a bacterial infectionacanthosis nigricans thickening and pigmentation of skin.the exact diagnosis can only be reached either by consulting a dermatologist near by or by using ASK A SPECIALIST  feature of this website. Once the diagnosis has been confirmed, appropriate treatment can be provided.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it normal to feel pressure in the root canal treatment area?\n\nHello doctor, I had a route canal treatment done yesterday on my two lower incisors. The pain from the tooth has gone. However, the area where the infection was observed is still sensitive to pressure. I have not taken many pain killers because the pain has not been that bad. But my surrounding teeth are sensitive still. Is this normal? Will the infection subside? And will I require antibiotics?",
    "doctor_response": "Hello. 1. The pain you have after root canal treatment is because when you bite, there is a pressure distributed over the teeth and taken up by the tooth supporting structures around which is a sort of new irritation. 2. The sensitivity is a normal scenario after cleaning of gums & teeth, and you will automatically recover in a week. 3. You have mentioned that you are diagnosed with bruxism, hence relieving the bite(correction of the tooth surface so that it doesn't hit the upper when bitten) has to be done by the dentist.3. Or a nightguard covering all surfaces of the lower teeth has to be customized for you to wear(management for bruxism). 4. Either of these things will help you get rid of the pain. 5. The X-ray pretty much shows no infection down the roots, so you need not bother about taking antibiotics. 6. I advise you to visit your dentist for further follow-ups to ensure the tooth is surviving well with the fillings inside the root canal as well as over the tooth surface. Management of bruxism with night guard appliance. Do not bite hard foods like apple,guava,corn with the front teeth.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for severe asthma?\n\nHi. I have asthma am on Augment I'm steroids, voltarol via nebuliser and yet at night I feel I can't breathe. I'm bunged up. Not sleeping. Sitting upright. Exhausted. I went to my doctor yesterday and she used her machine and I felt I got relief but at home I am not getting the same outcomes as with her. I just commenced my prescriptions yesterday. My ribs hurt . I have been hospitalized in the past. My asthma gets worse if I get a cold",
    "doctor_response": "the addition of twice weekly dose of methotrextate 5 mgm twice a week can help you as per latest research this medicinwe work with steroid sparing side effectsothers you can continuemostly these types of asthma which is not controllable with the asthma medicine are allergiesin my opinion if you get allergy tests after controlling this and avoid food allergens and treat the envitonmental allergens by sublingual immunotherapy this may help you in m opinion",
    "dialogue_context": ""
  },
  {
    "patient_message": "What would be the cost of IVF treatment at AIIMS Delhi ?\n\nmyself 39 year old and my wife is 34 years. we are married for 6 years. but facing infertility problem. one laparoscopic surgery was done in 2007 to treat endometriosis . but still failed to conceive. facing other problems also. is treatment is available in AIIMS NEW DELHI. i want to know probable cost for ivf, ivm etc. please help with advice for treatment ...",
    "doctor_response": "Hello. Welcome to HealthcareMagic forum. If your wife is a known case of endometriosis then it is best to go for IVF for baby.For IVF you need to understand that at least 3-4 cycles/ attempts are needed for a successful pregnancy.Each attempt will cost you around one lakh rupees. Dr. Rakhi Tayal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Developmentally disabled, over weight, paranoia, agitation, short term memory loss. On antipsychotics. Help?\n\n29 yo developmentally disabled adopted daughter, (Hx. precocious puberty age 6, MRI negative, depolupron age 7 - 12), overweight but no other medical problems . Had sudden onset of psychosis (paranoid, aggitated and short term memory loss) lasting 7 days - 4 days were pretty bad, 3 days with improvement each day.  Started her mensural period two days after onset of psychotic episode.  ED gave her antipsychiotics and Ativan.... only gave her meds for 3 days and she is on nothing now and back to normal mental state. No other paranoia or episodes of pychosis previously.  Took her for medical check up - labs pending.  MRI of brain w/o and w/ contrast shows empty sella - otherwise negative.  Birth mother paranoid schizophrenic - so somewhat worried about that  possibility - but would seem like late onset?  Now the Q:  Can hormonal imbalances cause such a drastic event (very sudden onset of psychosis)?  Given that it started a few days before her period and the MRI shows empty sella, does this possible match up for a hormonal imbalance to trigger psychosis?",
    "doctor_response": "Hi, Thanks for using health care magic. I have gone through your summary of history. Psychological disturbances are usually present during peri menstrual period. it may range of irritation to psychosis. so the answer to your question is yes that hormonal imbalance can cause these type of symptoms. but you should consult psychiatrist for detailed evaluation and treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have applied more Lignocaine gel than advised on my kid. Please help.\n\nHello doctor, My 2-year-old son has hard motions. He has just had his circumcision surgery. My friends advised me to apply Lignocaine Hydrochloride gel between his buttocks. By mistake, I applied more. I am very much worried. I hope it is not harmful. Please advice.",
    "doctor_response": "Hello. Lignocaine (Lidocaine Topical) gel is a local anesthetic so even if you have applied more there is nothing to worry. If he is having constipation, I suggest you give him syrup Looz (Lactulose) 10 mL twice daily. This is a stool softener and you can give him until his stools become soft. You can stop it after four to five days. For more information consult a paediatrician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment of pituatory microadenoma\n\nHi I left the treatment of pituatory microadenoma in between . If i want to start what should i do ,should i consult the doctor from the beginning .",
    "doctor_response": "Hi.. You do not do every thing from the beginning. Get to a neurosurgeon all your reorts.. The old reports are quite sufficient..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain, redness and swelling after flu shot?\n\nI got both the flu zone and the pneumonia shot on Sept.8,2014. I ve already been to the Drs. and was told to take Advil for a severe swelling and pain and redness had two shots one arm at local pharmacy. No fever Next day a large lump on left side of neck shoulder area appeared, has subsided. I have another appt. tomorrow,not better yet, completely out of sorts since shots, complete brain fog. The pain in left arm(intense), numbness, tingling some facial nerve pain and some loss of motion, left arm. Pain in back of right arm pins & needles in hands, weakness ,can t sleep. Was told years ago had Fibromyalgia.",
    "doctor_response": "Hi! Your problem requires a pain killer stronger than Advil. I suggest that you visit a doctor and ask for these 2 drugs, Desvenlafaxine and Tramadol. These two drugs are SNRI's that have a powerful effect on the psychological perception of pain, in addition to this Tramadol is a synthetic opiate that relieves the emotional aspects of the pain that you describe. You need a prescription for both these drugs. Kindly follow these suggestions. You'll get better. Thanks, Dr. Neel Kudchadkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid from cyst in testicle ?\n\nI have a cyst in my testicle. In the eyepdimic I had a cat scan , its still there and has been for a month now or so I read about it. And they say the only way to get rid of it is to have surgery . But now for about two weeks my left lung looks like its down. And the cyst is in the left testicle. And also the left part of my body has been feeling down. And I m wondering if its effecting my brain in a way. I had a cyst in my mouth before and they had to remove it with surgery. I m 21 by the way. let me know please ? I don t have insurence and thinking about going to the hospital. I will have insurence but not till oct. My moms a rn and has been for over 30 years but doesn t believe anything I say.",
    "doctor_response": "Epididymal cyst is a benign condition.It does not cause harm.If it not too large,increase in size,pain or embarassement ,surgery is not contempleted.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold and cough with wheezing\n\nHello Dr My son is 10weeks old, had a cold and cough with wheezing and shallow breathing. Dr diagnosed bronchitis and prescribed Alex syrup, ambrodil syrup and started nebulizer initially every 2 hours, then every 4 hours. We went for a follow-up after 2 days, baby seems to be slightly better. But slight wheezing still present. So Dr asked to continue nebulizer and prescribed defcort syrup. I m concerned that this is a steroid and don t want to use it on my 2.5 month old baby. Can I skip the steroid?",
    "doctor_response": "Hi, No. If it is wheezing, steroid is the treatment along with broncho-dilators and antihistamines. Please continue the same treatment and if fever is there, you can defer steroid. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Prasanna Lakshmi, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in testicle and leg\n\nright leg thai heay pain it leads pain in below the right testcle, testing done is no harni,no vernco,no, sugar,spine is ok no bp,notyrod,all test done  still problem persisted as per the Dr pain will be their no other problem take pain killer what other thing to be do for pain?",
    "doctor_response": "Punarnava Mandur 1 tablespoon, Ashwagandha powder 1 tablespoon, Neo tablet 2-2,Kasoor gugulle2-2",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the red rash that burns after shaving the area around penis?\n\nI just shaved my balls and between my balls and anus now I have a red rash that kinda burns. I didn't check the razor I always use but I'm sure it was bad, I threw it Away before I could look. Anyways what can I do or what should I do or what the heck is this. I'm nervous. I've been doing this for years and never had an issue",
    "doctor_response": "hello,the most common thing which causes rash in the groin, thigh folds and anus region is fungal infection(mostly tenia curis)if its a day or two old you can prevent is by> keeping the groin area clean dry by drying off thoroughly after bathing and putting on dry clothing right away after swimming or perspiring.> avoid sharing cloths> wearing loose cotton underwear> avoiding tight-fitting clothes> using antifungal powders or lotions in case if symptoms get worsen immediately visit a dermatologisthope this will solve your problem",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure hair loss?\n\nI started losing a lot of hair recently. One of my friends said that she had the same problem and the doctor prescribed multivitamin tablets for her. She is taking 'Cutimin'. Can I also take the same tablet or do I need to consult with a doctor first?",
    "doctor_response": "Hi, As per your query you have symptoms of hair loss which could be due to hormonal changes, dandruff, stress and it could be due to hormonal changes as well. Need not to worry. You should take Minoxidil and Finasteride for hair loss. Do oiling of scalp regularly to avoid dandruff. I would suggest you to try to reduce your stress. You should consult dermatologist once and get it examined. Start treatment after proper prescription. Avoid taking oily, fried and spicy food. Take diet rich in multivitamins. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Harry Maheshwari, Dentist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood in urine and a small echogenic focus in kidney?\n\nI am a 58 yr old female with history of kidney stones, hypertension. Went to my",
    "doctor_response": "Thanks for the query.As you had 2 kidney stones shown in usg, blood in urine means hematuria is due to this.Stones erode kidney and ureters wall which makes blood in urine.As nonshadowing exhogenic shadow is most commonly due to hemangioma or fibrosis.There are less chances of cancer.But to rule out ct scan is best procedure.Get well soon...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain, foul smelling urine. CT scan shows orthotopic liver, calcified granuloma in kidney. Help\n\nHI My age is 33yrs, recently i got CT whole abdomen plain & contrast IN the liver it has given as ortotopic and normal size with dereased parenchymal attentuation. Few calcified granulomas at segment V. in kidney the report has give as apperas normal i size, density. no hydronephrosis . A 10mm cortical cystat at lower polar region of right kidney. Few small 2-3mm calculi at all calycies of right and left kidney. Kindly help me, i am getting back pain and fowl smell in the urine",
    "doctor_response": "Hi, Welcome to HCM. Cysts of this size need no treatment. Small stones just need plenty of water intake. Back pain could be postural pain and pain killers should do the trick, at least initially. Foul smell in urine is due to infection. Urine culture is necessary and appropriate antibiotics should help. regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cough with respiratory wheezing and metallic taste?\n\nI recently was ill with a head cold.  I started coughing up green colored mucus and was put on a Zpack.  I have completed that about 2 weeks ago.  I continue to have a cough with expiratory wheezing (sometimes inspiratory) and my proventil inhaler hasn't seemed to help.  I am also starting to notice a metallic taste when I cough but I haven't actually visualized any blood in my sputum which is white now.  Any suggestions?",
    "doctor_response": "Hi thanks for asking question.Here is few possibility for your case.1.According to history you have cough with green sputum.if chest pain also associated with fever, we want to rule out pneumonia by chest x ray to see for consolidation.Pseudomonas infection can lead to green sputum so sputum culture will be helpful.2.You might have viral infection induced bronchitis like condition . chest x ray useful.3.The wheezing could be because of asthma.You might have asthma and viral infections can precipitate it.To distinguish restrictive and obstructive cause pulmonary function test by spirometry useful.4.Finally still your cause not clear then bronchoscopy can be done if needed to rule out other obstructive causes.I hope you will understand my concern.Wish you good health.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat chronic charlie horses in calves?\n\nI am a healthy 44 yo W male and have been developing chronic charlie horses in my calves. Very painful in a sustained contraction for 3-5 minutes, left with muscle soreness afterward. I go for my routine PE and just had one and all was WNL. What do you think?",
    "doctor_response": "Hello, Consult an orthopedician and get evaluated. We have to rule out possible underlying causes like a peripheral vascular disease. Investigations like arterial Doppler is required for further assessment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can gum disease called pyria cause other infections?\n\nBy having gum disease called pyria---can this disease cause you to have several different can's of infection ---and the last 3 years I have continuously been suffering with flu, upper respiratory infection, walking pneumonia, bronchistis, sinus infection, viral infection.  Dose having pyria contribute to any of that?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have gum disease called pyria which is due to inflammation and formation in gums which can cause infection in blood stream as well and it can lead to spread of infection as well through facial spaces and can lead to sinus infection and upper respiratory tract infection. Need not to worry. You should visit Periodontist once and get it examined. Start treatment after proper examination. you should go for scaling and root planning of mouth. You should take Listerine mouth wash and do warm saline rinses. Take antibiotic as well to subside infection in your body.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medication for jaundice\n\nHi Dr. I was detected with slight jaundice my stats being bilirubin as 1.6 (std 0-1) and SGPT 138 (std 0-40). I took LIV52 as suggested by my Dr. After three months when I tested my bilirubin level where normal but I still had slight rise level of SGPT- 90 (0-40). Is this concerning? Please note that: I don t have fever nor vomiting or nausea but still my urine is sometime slight yellowish",
    "doctor_response": "Hello,      I read your question carefully and can understand your concern very well.      I would like to tell you that it takes few months for levels of SGPT to come down to normal after having viral hepatitis, which is exactly in your case.       If you have no associated symptoms and your bilirubin level is normal, then no need to take any kind of medications at this point of time. Just give some time and your SGPT will definitely come down to below 50. If it continues to remain on higher side even after 6 months, then you need to go for ultrasound to rule out other liver pathology like fatty liver.      Hope this will help you and feel free to ask your further queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. 18 weeks pregnant woman used spray pesticide. Is it harmful for the baby?\n\nHello doctor, My wife is around 18 weeks pregnant and, she started to spray pesticides inside our home. I am concerned that this might harm our developing baby. Please advise.",
    "doctor_response": "Hello. I understand your concern. Definitely pesticides of any category are harmful. If it can damage the pests, then that will be harmful to the baby. But we humans are bigger in size and damage is not significant, unless sprayed daily for many days, for a long time and directly onto the face. By 18 weeks, the baby is fully formed, so there cannot be any significant damage or long term effects on the baby. To be on a safer side better to avoid your exposure to pesticides. Do not worry, and your baby will be ok now. I hope I have clarified your query, do write back if any more questions and for your feedback.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for low BP and iron levels causing stress and dizziness\n\nI have alot of stress from work and home. I have been feeling sleepy alot,tired and i frequently get dizzy spells. What can i take to help me. I have had problem with my blood pressure droping and my iron levels being low.Im currently taking some iron suppliments.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Low blood pressure and iron deficiency anemia both are known to cause dizziness and weaknesses. You should take iron supplements like ferrous sulphate or ferrous fumarate. You should take iron rich food like dates, green leafy vegetables, dry fruits, jeggary etc. Gof low blood pressure you should regularly check your blood pressure.  If it hoes low you should take a glass of salt water. If not controlled then you neef vasopressor drugs.Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of L montus kid tablet?\n\ni am giving my 1 year 4 month old L montus Kid tablet since 1 month and would like to continue with it for some time as his reflux problem and nose conjestion just disappeared. can i continue with the same tablet for some more time . is it safe or shall i discontinue.",
    "doctor_response": "Hi,L-montus kid tablet is a combined (levocetirizine+ montelukast) medicine commonly prescribed to treat and prevent allergic symptoms associated with rhinitis and seasonal allergies. Its common side effects include drowsiness, dizziness, headache, stomach upset, nausea, diarrhea. Since your baby has already recovered from the symptoms, the medicine may be discontinued.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes increase in BP?\n\ni had my bp checked and showed 160/100 after resting for 5 mins it goes to 140/90 after 15 mins rest it's still 140/90. i had my blood chem checked and it all went normal, i had ecg too and normal results. where could my high blood be coming from?",
    "doctor_response": "Hello,I would like to tell you that Blood pressure (BP) is an ever changing phenomenon. Blood pressure changes according to your activity level, emotions and physiological conditions.Check your BP when you are in resting and relaxed at least for 15 to 20 min. If it is under 140/90 mmHg, then you need not any treatment.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhanu Partap",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood in mouth , temperature and difficulty in breathing?\n\nhi, today after my two year old daughter woke up i found her mouth covered in dried blood also there was a big spot of blood on the sheet. I did not see her coughing, vommitting or spitting blood during the day. She seems generally alright with a mild cough at times. A day ago she had temperature, and heavy breathing, probably due to the temperature. At first i thought it could have been an ulcer in the mouth, but then i got anxious as what else it could be.",
    "doctor_response": "Hi welcome to the health care magic Don't be panic about this condition... Work up done as follow ..... -Auscultation -x ray chest if needed -Physical examination including liver,  Spleen palpation -CBC only if needed This blood in sputum in your two year old child could be from viral or bacterial bronchitis or bronchiolitis like infective condition.... After her examination further work up can be decided... And accordingly prescription can be given... If needed she might kept under observation for few days in hospital Consult nearby pediatrician for examination with keeping all this in mind Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could result in sudden increase of heart rate?\n\nSometimes out of nowhere I feel my heart, instead of going baBUMPbaBUMPbaBUMP, go THUMP....... THUMP..... THUMP. Its like it beats harder slower, but only for a couple of beats. I feel it in my chest and throat. I don't want to go to the doctor because, it doesn't happen that often, so if I go there, and nothing happens, its kinda like I'm making it up... Does anyone know whats going on? Has this happened to anyone else?",
    "doctor_response": "Hello and thanks for writing.I can understand your concern and would try to help you in the best possible way. Your complaints seem to be due to palpitations, the common causes of which are:1. Anxiety2. Sleep disorders3. Overactive thyroid 4. Heart conduction Problems5. Coronary artery disease6. Idiopathic, without any causeIt is advisable for you to get yourself evaluated for these conditions. You may need a few tests like CBC, thyroid profile, ECG and others. If your problems are transient then a 24 hour holter study may be useful to detect any subtle cardiac conduction problems. You may consult a physician for the same.In the mean time you should have a sound sleep, avoid stress, take regular exercise to reduce your symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does vitcofol injection help to increase B12 in blood?\n\nMy age is 67 and I had problem of numbness in hand and feet,no test of any food.loss of memory and appetite .On consulting doctor and after blood test level of B12 is 45 instead of minimum 240 .Can I take Vitcofall Injections I had already taken 3 shots of 2cc but not much effectPlease advice",
    "doctor_response": "Yes vitkofol is the standard treatment for b12 deficiency. kindly complete the full course of that as per your doctor prescribed.  And it too early to sag you have no effect. just take it effect will come. It takes time to develop.so dont worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe left-sided pain towards the bottom of the rib cage?\n\nMy 8 yr old grandson is complaining of pain towards the bottom of his left rib cage..to the point of tears. It is not constant. Comes and goes. He has been treated for acid reflux. He says he throws up in his mouth. Doesn t want to eat because he s afraid he s gonna be sick. Could he be lactose intolerant and that be causing his to get sick and have his left rib pain? Peditrician has just kinda blown his mother off. Does have a follow up with his gastro dr in about a week. Daughter in law is getting very upset not knowing what could be causing this...any ideas?",
    "doctor_response": "Hi... with the minimal information which I have gathered from the question I suggest these possibilities - 1. Costochondritis of the region which maybe viral in origin. It may settle by itself in due course.2. Lingering pneumonia in the region which could be leading onto a plural effusion.3. Osteomyelitis of the ribs in that region.4. Extremely rare but a Bony neoplasm of the region.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat bruise like marks in the back of mouth?\n\nHi, I recently had my back molars removed because they became infected. And about 2-3 weeks after my surgery I have black bruise like marks on in the back of my mouth on my inner cheeks. Also my lip is beginning to swell a little and it has a bruise like mark now. What is this? Should I see my regular PHD or a Dentist?",
    "doctor_response": "thanks for the query, the black bruise like marks could be because of the ecchymosis secondary to cheek biting or normal physiologic pigmentation. the swelling over the lip could be secondary to tooth infection. consult your oral physician to take radiographs and rule out the causative tooth. if i am your treating doctor i would start with a course of antibiotics and tell you to gargle with saline. i hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have acute pain and inflammation behind the neck and shoulder. Please help.\n\nHello doctor, I have acute pain and inflammation behind the neck and shoulder. Tingling pain in the left-hand finger and pain in the middle back and sometimes lower back. I am male, 27 years old.",
    "doctor_response": "Hi. I think you must be suffering from cervical spondylitis with radiculopathy. This must have arose due to long time sitting posture or carrying a backpack. I suggest hot fomentation by hot water bag for 10 minutes with three sessions per day. Then, apply some local pain relief gel mildly. Approach a physiotherapist if the pain does not subside under three days. No exercises or driving to be undertaken. If needed, MRI.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for loosening of hip prosthesis\n\nI had a hip replacement 12/2012. I felt it move out of place the following Sept. I have been complaining of increasing pain since. I was finally diagnosed with a loosening prosthesis last week. Why did it take so long to diagnose and why isn t it an emergency to fix?",
    "doctor_response": "Hello, I have studied your case. PET scan will be useful now to establish the nature of pathology.You need to find reason for loosening after the total hip replacement surgery, I suggest you to consult another Orthopedic surgeon (preferably a Joint replacement surgeon who has not done your surgery) for a detailed examination, workup and further management depending upon the nature of pathology.Yes its not emergency , you need to find cause and then treat it proper planning and proper choice of prosthesis.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can you get pregnant from pre-ejaculation fluid?\n\nI lost my virginity on June 27,2104 around 7 days ago. We didn t use a condom for the first few pushes but We used a condom the rest after that. He doesn t know if he pre came inside me. Can pre cum get you pregnant? I know stress delays your period. I just want to make sure. Ive had a few symptoms but i read you get them also from your period. 1. I threw up 2 days after (due to stress)2. I have a faint pain in my lower right side of my back 3. Im bloated I just need to make sure to see if i need to buy a pregnacy test",
    "doctor_response": "Hallow Dear,Yes dear, pre-ejaculation fluid (precum) does contain some sperms which can cause pregnancy. The  precum is deposited in the vagina unknowingly. However, from your narration it is not very clear whether you have missed your period, and if so, for how many days? Vomiting can be a symptom of early pregnancy after missing a period; though, the other two symptoms you have mentioned are not characteristic of pregnancy. If you have missed your period, please get your pregnancy test done on the overnight first morning urine sample about a week after missed period; earlier the test may report false negative. Alternatively you may opt for Beta hCG test on blood 10 days after the last unprotected intercourse. I hope this provides you guidelines to resolve your query. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is pregnancy possible when precum enters vagina indirectly?\n\nHello doctor, My finger had a drop of precum, and I touched my partner\u2019s vagina indirectly through her cotton panties. Will she get pregnant?",
    "doctor_response": "Hello. I can understand the concern. Precum or pre-ejaculatory fluid also contains sperm to make a female pregnant. If your sperm has reached inside her vagina by any probability, there are chances of pregnancy. Also to be noted she should be in her fertile period (10 to 15 days from her last menstrual period) to get pregnant. If you are anxious, and if it is within 24 hours you can go for an emergency contraceptive pill (I pill). I hope I have answered your query. If you have further doubts, I would be happy to help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedies for black lump on the scalp and hair fall\n\nHi, My little brother had a black bump on his scalp a few days ago, he is 8 years old and he would continuously scratch it until one day it came off. And all of a sudden all the hair in that small circle where the bump used to be fell off. Now he is bald and the area is swolen red. It is a big red circle and it looks like there is quite a bit of pus in there, I am afraid to pop it because it is his scalp and a sensitive area. Please tell me some home remedies i could use to help it heal. Hi, My little brother had a black bump on his scalp a few days ago, he is 8 years old and he would continuously scratch it until one day it came off. And all of a sudden all the hair in that small circle where the bump used to be fell off. Now he is bald and the area is swolen red. It is a big red circle and it looks like there is quite a bit of pus in there, I am afraid to pop it because it is his scalp and a sensitive area. Please tell me some home remedies i could use to help it heal. Did u get this message Hello",
    "doctor_response": "Hi, dear it can be fungal infection , your brother needs antifungal  ointment to apply on the scalp.I would suggest apply tinactin cream on scalp three times a day and make a visit to dermatologist .Any home remedy would not be helpfull.Hopefully my answer will be help full.plx reply with thanks.Dr.Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am not able to open my mouth wide. Is my jaw fractured ?\n\nHello. I was punch in the jaw 2 days ago now i can t open my mouth wide. There was some swelling but a used a ice pack and it went down some. Didn t go to the ER. Does this mean my jaw is fractured?",
    "doctor_response": "Hi, Thanks for asking the query, Difficulty in mouth opening can be due to fracture of the mandible, as you mentioned you had a punch there are chances of condylar fracture. Due to swelling in the region there can be trismus causing difficulty in mouth opening. Visit to an Oral and Maxillofacial Surgeon and get the check up done, see for occlusion, mouth opening, mobility, sweling, mobile segment or fracture line. Take an OPG x-ray  to confirm the diagnosis. Start with the course of tab Amoxiclav 625 mg and tab brufen TDS for 3-5 days. Use betadine mouthwash gargles twice to prevent infection. Hope this helps out. Regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump to appear in inner breast before periods?\n\nhello my wife in her inner left breast towards the center of her chest she ha s small soft lump that hurts when you touch it. also, it hurts when she breathes in. she is 26, 115 pounds and relatively healthy. it is a pain that comes on an off. we are worried but also wondering if it has to do with her cycle. always seems to come a few days before her period...",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your wife's situation and problem. By your history and description, in my opinion, she is having benign breast lump due to hormonal imbalance during menstruation. Her breast lump and it's association with periods is  suggestive of hormonal lump only. So better to consult gynecologist and get done hormone levels to rule out hormonal imbalance. Hormone therapy is very effective in such cases. Also get done mammography to rule out other causes of breast lump like fibro adenoma or infection. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for ejection fraction\n\njst took 3rd echo ejection fraction went down to 25 last one i took 2 years ago improved to 45 and the first one i took 5 years ago was 15 almost dead doctors put in defribulator felt much better. I have had allot of stress this past year my son getting divorce my husband i think as he gets older is getting mean and yells at me all the time and im still working full time. i have 6 beautiful grandchildren i love them so much i want to live longer and be at there graduations from college and at there weddings most of all i just want to be here as their good friend so they have someone they can trust and someone that can validate them. Can you tell me what do i have to do to get better and improve ejection fraction. Like vitamins exercise should i retire from work help me please.",
    "doctor_response": "Hi,Welcome.Decrease in ejection fraction from 45% to 25% suggests some event in the heart which has caused heart function to decline. I suggest you to get a sone blood tests done like Troponin I, CPK & CKMB. If they are negative than go for a stress echo to rule out any blockage in arteries of heart.The cause for decrease in heart function is important for treatment.Till than continue your medications & keep fluid restricted to 1.5ltr/ day.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does on and off loose motions with gas and foam suggest?\n\nMy son is 5 month old, yesterday he passed motions 5 times, sometimes in qty, other times very little foam/gas bubles type. we started cerelac wheat giving only 1-2 teapsoons twice a day. he is also having a calcium/iron/vit d/zinc syrup since 3 days..... today he has done it twice. Is it normal, what to do? pls help",
    "doctor_response": "Hi... it is very common once you start introducing solids. Its nothing to worry about.Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry.But I suggest that you start complementary feeding only after the baby completes 6 months of age.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can intake of probiotics cause hair loss problems?\n\nI juice everyday, take probiotics and blood pressure medicine. I am experiencing sudden hair loss.When I juice I do kale, berries, fresh ginger, honey, soy protein, 1/2 cup of Kefir and a teaspoon of apple cider vinegar.Vitamins I take are: Multi, B, C, D, Calcium, EPA. Could something I am taking be causing the problem?",
    "doctor_response": "Hi there,,,welcome to HCM-The diet you are following is good for hair growth and can not be the cause  of your hairfall..-Get your Haemoglobin and thyroid profile checked as these are some of the common cause of hairloss-Give your scalp a frequent hair massage with lukewarm olive and coconut  oil with tip of fingers..this wil increase the circulation of scalp and inturn  hairgrowth..- I want also to mention here that falling of upto 100 strands of hair/day is   normal because every hair has a life cycle of its own which ends with it   falling out to make space for new one to grow..Sometime people   misunderstood this with hairfall.. Hope this will help",
    "dialogue_context": ""
  },
  {
    "patient_message": "Blood blister on finger. Popped with needle, bleeding continues. On kidney dialysis. Due to hiparin?\n\nYes doctor I had a blood blister in my ring finger . I punctured it by a needle sterlised by a flame. The blood came out but not stopped. I am a kidney patient having dialysis 3 time a week. What is the reason for drying blood slowely in my wound? It takes more than 1 1/2 days to stop bleeding from the wound. Is it because of hiparin during dialysis?",
    "doctor_response": "Hello sir/madam,The reason for continuous bleed could be due to heparin .Also platelet count could be low ,as can happen with dialysis patients. Kindly get your platelet ciunt checked.hope i was of help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the possible birth control measures after a unprotected intercourse?\n\nMe and my girlfriend had sex but I didn't ejaculate inside of her, but my sperm was on her vagina(during her period). Later that night, she wiped to check if sperm was on her vagina, and she realized that when wiping in an upward motion, she  wiped the sperm all on her vagina. Is there any chance of her getting pregnant? If so, then how do I prevent fertilization? It's only been two days since the incidence.",
    "doctor_response": "Hello and welcome,If the incident occurred when she was having her periods then there is no need for an added precaution as the chances of pregnancy are zero. However I would like to say that in case an emergency unexpected intercourse occurs in future then she can take the emergency contraception [ levonorgestrel tablet] sold as Ipill or plan B one step within 72 hours of contact and it is effective in more than 95% cases if used correctly. However it must be used only as an emergency measure, not more than once in one cycle and if the contacts are repeated use of other measures like condoms [ also prevent sexually transmitted diseases] or oral contraceptive pills, injections or implants [ after prescription from a doctor ] are advisable. Hope this satisfies your query. Thanks for using HCM.\u00a0\u00a0\u00a0\u00a0\u00a0Feel free to ask any more questions that you may have. Dr Madhuri BagdeConsultant Obstetrician and Gynecologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sprained foot, RBS: 99mg/dL, Sgot: 62.7U/L, losartan and prednisone\n\nhi! im 22 years old, female weighing 119Kg, recently i had a sprained foot so i went to a doctor my blood pressure was 140/100, i had hematology and blood chemistry done, the only problem was my RBS it was 99mg/dL and my SGOT is 62.7U/L, i also had ECG done and the doctor said i had some arrhythmia , the doctor give me losartan and prednisone and some pain medication for my sprained foot. unfortunately SGPT was not included in the work up. Now im scared i have Hep B, sometimes i feel a little discomfort on the right side of my stomach right below my rib cage everytime i eat, and i ate a lot!especially fatty foods and rice, im scared that i have hep b or fatty liver or liver damage, please i need an advise",
    "doctor_response": "Hi, U wud understand that all the above symptoms and problems that are occuring now with you are because of ur heavy weight. You need to take out a permanent solution for this problem. Weight loss surgery is the best solution. This is Baraitric surgery. For more details, log on to www.aasthahealthcare.com Dr Manish Motwani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in breathing?\n\nI am having difficulty breathing. I feel shortness of breath, tightness of my rib cage, and I have chest pain, back pain, but this is sometimes. I have seen a heart doctor, gotten tests done. He said that I have PVCs and some galloping but I don't have asthma and he said I may have some anxiety. I feel like I am not getting enough air to my lungs and it really hurts under my shoulder blades on my back. I don't know what to do and have been experiencing this ever since I was about 12, I am 18 now. What could it be or what should I do?",
    "doctor_response": "Get an appointment with a psychiatrist in your area and get yourself evaluated for anxiety disorders too",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is intake of dairy products advisable for a cancer patient?\n\nHi there, I am an overian cancer patient, undergoing chemo therapy at the moment. My last chemo was administered yesterday. Is it safe for me to eat yoghurt or take probiotics when my immune system is diminished? I have been advised not to eat soft cheeses because of the culture.",
    "doctor_response": "There is no restriction on diet in ovarian cancer patients but care should be taken to eat only healthy cooked foods. Canned, fermented and stored foods should be avoided for the possible risk of contamination. Dietary products like milk which can be boiled before consumption are preferable that stored dairy products",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the middle of the chest?\n\nI m a 16 year old female, and I believe I may have Lymphoma. I honestly can t tell if I have swollen lymph nodes, but the middle of my chest sometimes gets a pain in it, making it hard to breathe. I ve lost around 30 lbs in four months, resulting in me being underweight at 98 lbs (Without trying of course, I just don t feel hungry). I have frequent night sweats, my whole body itches, mostly my upper thighs and arms. I get out of breath easily, I just eel so weak and fatigued at all times. I ve tried speaking to my guardian about the possibility but she just tells me its all in my head. Should I speak with my doctor alone Thursday? Or am I just worrying myself over nothing?",
    "doctor_response": "DearWelcome to HCMWe understand your concernsI went through your details. The symptoms you are mentioning here are general ones and can be seen with a host of physical problems including simple acidity symptoms and anxiety and obsession. The pain in your chest could be due to acidity and that pain makes you feel anxious and therefore you lose appetite. You should consult the physician and appraise him of the matter and get his opinion. Then you may go for psychological evaluiation and counseling.If you still need my assistance in this regard, please use this link.  Please remember to describe the whole problem with full detail.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat for the painful spare rib at my neck?\n\ni have a spare rib at my neck and it swells and can be sore and i sometime feel like a jelly lump at my neck and think something is there i have had 2op on my shoulder in september and its sore again and had 2 get injection again but it very badley inflamed inside",
    "doctor_response": "Hello, A painful sore rib that has not responded to pain killers and local injections needs to be surgically removed. It can cause nerve root compression and can add to further problems. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fibromyalgia and chronic headaches\n\nI have fibromyalgia and chronic headaches since I was born and tonight my migraine feels super bad. Myhead hurts on every part of my head all the time, but the major pain is on my right side and right jaw.The pain has been on going for an hour.I have taken a bc powder about thirty minutes ago. I also took my usual nighttime meds which are two Zzzquil liquid caps, 2.5 mg of Melatonin, a probiotic, and a fish oil. Advil and Ibuprofen do not work on me as do similar medications. Should I just go to sleep and see how I feel tomorrow?",
    "doctor_response": "Hello ! I understand your concern.I would recommend you to take an antidepressant like Duloxetine if you don't have problems with your sleeping. If you have problems with sleeping I would recommend Amytriptiline or Fluoxetine . Amytriptiline can cause constipation,hypotension,  heart problems and an EKG should be done before starting treatment. The treatment with one of these therapy should be started slowly, with gradual increase of the dose up to an optimal dose , and should last for at least 3 months. During this period you can keep taking occasionally also Acetaminophen or Ibuprofen for the pain. I am sure it will help you a lot with your body pain and headaches. Hope to have been helpful! Best wishes, Dr. Abaz Quka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Toothache followed by pain in half jaw on lower left side. Should I be concerned ?\n\nMy husband started having a toothache this afternoon, which turned into the half jaw on lower left side and now its like someone yanked out a tooth without any novacaine. He says lighting bolts of pain are spearing his lower jaw. Have you ever heard of something like this? Even though its his mouth, should I take him to the ER?",
    "doctor_response": "Hello,Thanks for writing to us.Initially,cause of toothache has to be evaluated clinically by a dentist.Take ciplox and paractemol tablets.Grossly decayed teeth has to be extracted.Infected pulp ,if present,has to be extirpated.Maintain oral hygiene well.Gargle with warm saline.Abscess if present,has to be drained and curetted.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dryness and white coating on tongue?\n\nHi, for a few weeks my tongue has been feeling dry and I have this white coating on the back of my tongue. I've been freaking out lately about it... I went to the Dr a couple weeks ago and he gave me nystatin because he said it might b thrush... I took all the nystatin as prescribed, but nothing changed. I'm really worried.",
    "doctor_response": "Hello,Common reasons for a dry mouth and a coating on the tongue can include a side effect from medications especially antibiotics, gastric disturbances, sinus congestion and post nasal drip, salivary gland disorders and improper nutrition with dehydration.The nystatin may help treat the source of a fungal infection, but more time may be needed for your tissue to heal. You can take ant-inflammatory medication and make sure to stay well hydrated with balanced vitamins. Vitamin B12 is helpful to assist healing. Rinse with warm salt water. Request an additional prescription rinse with a combination of nystatin, pain and anti-inflammatory medication.Consider having a simple blood test to check your organs and systemic function if the condition persists. Are there any concerns with your medical or dental history?Thank you for your inquiry. I hope my suggestions are useful and you start to feel better soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My blood urea is 37 , serum creatinine is 1.5 and potassium is 5.6. What does this indicate ?\n\ni am a HT/DM/CAD patient ;undergone bypass surgery in 2000; i have been prescribed with medicines for all the above and am taking regularly ; the HT and DM are well under control;during a normal test of blood recently itwas noticed that my blood urea is 37 , serum creatinine is 1.5 and potasium is 5.6; what does this indicate",
    "doctor_response": "A creatinine of 1.5 indicates a kidney function of less than 50%. ( because creatine does not rise till 50% function is lost). Most likely it is due to DM and HTN. But it is good to do an ultrasound to check if there is no other problems. Get your urine checked for protein. Some of you heart medications may cause a mild rise in creatinine which is OK. You may need to restrict your salt and fluid (equal to your urine output) else it may put excess load on your heart. Avoid dry fruits, juices, and low sodium salts as they are high in potassium. Green vegetables are high in potassium - boil them for 15 mins and discard the water before preparations. Get a nephrologist to assess you in detail.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lethargy,nausea and sore throat?\n\nHI i am 23 and over last few weeks have symptoms like: tireness, nausea, dizzines when standing, tired muscles, sore throat and low back pain and breathlessness. I had tests and my sodium in my bllod is low but its very high in my urine. ive had tests for addisons disease but have not responded to hydrocortisone IV. Any suggestions?",
    "doctor_response": "HelloYou have salt losing nephropathy or interstitial nephritis. Need nephrology consult.This is a benign often self resolving condition due to some infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump between leg and testicles?\n\nHi, my boyfriend is telling me about a lump in between his leg and testicles, just above the gap between his leg and testicles. it;s on the left side, and there is no colour or anything. it hurt a little bit to touch it to begin with, but now it doesn t. What could it be?",
    "doctor_response": "Hi,Welcome to HCM.I studied your query.I understood Your concerns.Dear your boyfreind could be suffering from Boil (as it was painful to begin with )in pubic or groin area,which seems to have resolved on its own due to body defences.Your Query being very scanty,I would suggest physical check with your Surgeon/ or Gp doctor,who would examine and fix the diagnosis of it.Hope this reply would satisfy and would help you to plan treatment with the right consultant doctor.Contact with a Followup Premium question to ME.Will appreciate your Hitting  thanks and writing  excellent review comments to help needy patients like you. Good Day!!Dr.Savaskar.Senior Surgical Specialist  M.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for right brain hemorrhage\n\nHi, I\u2019m Seema, having two and half year old son who is suffering from right brain hemorrhage since from one month old baby. Here is the detailed scenario, When my son was one month old baby, suddenly he fell ill and after radiological examination the doctor said that he is having sub dural hemorrhage with intraventricular extension (right brain hemorrhage),during that period he got convulsions. Convulsions were controlled with phenytoin, gardenal and midazolam drip. In the medical report they have mentioned, Final diagnosis: intracranial hemorrhage secondary to late hemorrhagic of new born. Then he recovered, during discharge they suggested to give EPTOIN medicine 2.5ml (morning and night). We continued giving him Eptoin syrup and he grown with normal behavior. We consulted famous pediatric neurologist in India name Dr.Kumaresan MD, DCH, DM, he suggested us to do MRI scanning when my son was 7 months old. In the scanning report they have mentioned, Observation: significant atrophy involving right temporal, parietal, occipital lobes with dilatation of right lateral ventricle He also suggested continuing with Eptoin syrup and visiting him once in 6 months. Then when he was one and half year old we did EEG for him, The report suggested that, Conclusion: EEG is mildly abnormal and the findings suggest frontal parietal dysfunction only. But my kid activity was very normal as like other children. Once again we consulted doctor before coming to Beijing, he suggested the same Eptoin syrup morning 2.5 ml and night 5 ml and folic acid tablet once in three days in night. Currently my son is two and half year old, he is doing very normal activity. But last month suddenly he fell sick and he got fever of 102 F and he got seizure(he turned his neck left side and hold his left arm aside)for about 10 secs, after that he went sleep for 5 minutes and then woke and he was normal. Quickly we ran to hospital and consulted doctor. Doctor said that he is having some ear infection so he had fever they gave fever medicine and antibiotic. Now he is fine doing well. So we here i would like to know wehther we have to consult pediatric neurologist in Beijing as of now???? Please help me on this. Thank u in advance. Seema",
    "doctor_response": "Hi Seema, from what you ve mentioned, it seems that your child has a stable neurologic condition with apparently normal development well controlled with medications. His last episode of seizures was due to high fever spike following a probable otitis media (middle ear infection). This is very common in preschool age group. The recent seizure is mostly because his seizure threshold is low along with high grade fever. Any new lesion in the brain is unlikely. But having a Neurologist in the vicinity who is known about his medical condition is always good in the case that he can be looked after easily if any future emergencies occur.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sneezing, slight fever, eye pain, throat swelling, weakness. Allergic reaction to shrimp?\n\nI 24 years old female, on friday night at work. i steamed some shrimp, ate it. After that, i went home that night going to sleep and as i was sleeping, i notice sneezing , slight fever , eyes hurting, thoart felt swollen, runny noise and itchnesss in my nasal, shaky hands on saturday afternoon then lightheaded, weaknessness. Use to eat shrimp before and that never happen before. I felt that maybe i was just coming with a flu OR a allgeric reaction, but want to make sure before going to the hospital. Some one please tell me what is wrong with me",
    "doctor_response": "Hi Jcayo, Thanks for writing your query. Allergy can occur from any item. It is advisable that you get yourself examined at the Emergency Department for your vitals. Taking antiallergy medicines like Fenofexadine 120 mg once a day for three days will help in relief of your symptoms. It will also help even if you are having flu. Drink plenty of pure water. I hope this is helpful to you. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take pill while breastfeeding? Will there be bleeding after taking pill?\n\nGud day, my ob prescribed me daphne contra. Pill because iam still breastfeeding, I am new in using a pill I started the 1st tab 8 days ago,my ob told me that I will not have a period for the whole 28 days of taking the pill,and yet I have a bleeding this early in the morning, is it ok? Is it just a side effect, I'm quite worried because she told me I won't hav my period. Pls answer me it makes me paranoid, my 2nd baby is just 4 months old. I don't want to be preg. Again.",
    "doctor_response": "Hi,  Thank you for choosing Healthcaremagic. Daphane is progesterone only pill, which is safe during breastfeeding. About your irregular bleeding, its better to confirm if you are pregnant or not. Kindly consult your obgy specialist.In case of any doubt, I will be available for follow ups. If you like my answer kindly rate my answer and write a review as well.Thank you,Wish you good health.Regards,Dr ArifYou can consult me again directly through my profile",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in neck and shoulders?\n\nI have had pain in neck region and shoulders for months now. I ccant turn my neck all the way to the right and I have a hard time sleeping at night. My shoulders are more painful at night and my arms go numb during sleep. Is this a shoulder issue or spinal issue? I want to make a dr appointment but not sure who to see.",
    "doctor_response": "Hello, As this sounds like a cervical spine nerve root entrapment so does the symptoms. I will advise taking an MRI. Post which we can plan the treatment. Treatment included - neck stabilization by using the cervical soft collar, hot water fermentation for the neck, upper back, and shoulder. Post having this, doing simple neck stabilization exercise like static neck exercises and range of motion exercise will be helpful. Also, shoulder stabilization exercises, inter-scapular muscle strengthening exercises, upper limb strengthening exercises will help to reduce the symptoms to a greater extent. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am not able to release sperm after circumcision. Kindly help.\n\nHello doctor,I am 29 years unmarried man. My penis upper skin was tight so I did circumcision 50 days before. Before circumcision, I was not having any problem but after circumcision, I have lost the sensation and even if I watch porn, still sperm is not coming out. Could you please advice?",
    "doctor_response": "Hi. I can understand your concern about your symptoms. It is post-surgical, I can give some time. Other reasons are such as: 1. Stress. 2.\tDepression. 3.\tFear of failure. 4.\tLow self-esteem (chronic masturbation). 5.\tHomosexuality. 6.\tReligious constraints. 7.\tLong term illness. 8.\tA negative attitude towards your partner. 9.\tHormonal issue. 10\tLong term drug usage. If you can answer these questions, we can work it out.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the early symptoms of ALS?\n\nMy 38 year old son died from ALS Jan. 29, 2014. He played football in high school and all his adult life he exercised, ran and lifted weights daily. The one memory that continues in my mind is the pediatrician who saw him when he was 2 years old - the doctor s expression when he saw my son for a moment showed almost shock at my son s physic. My son looked like a little Hurcules . Has anyone studied or researched the early stages of an ALS person s life? My son donated his body to Life Legacy. His death was peaceful because he received morphine hourly to help with his almost continuous seizures. I think toxins in air, ground and water have contributed to cell mutations.........Thanks!",
    "doctor_response": "Time from onset to death in ALS is around 5-6 yrs.Early symptoms are in for of asymmetric weakness and thinning of limbs.in Bulbar variety, dysphagia is prominent. in such cases Seizures are rare. and sensory and eye movements system are never involved.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest water requirement and urination frequency for infant\n\nDear Doctor. My son is 13.5 month old.He is 8.8 kg in weight.He is not in to formulas or any other milk and still breast feeding.I feel like he is not taken enough liquid in to his body.He urinates 3-4 times per day.He is not showing any discomfort and active as usual.Am very curious of his water requirement and urination frequency.plz let me know how much of liquid shoud be taken my baby and how many times shoud he pass urine? Thank you. neela from clombo",
    "doctor_response": "Hi,The fluid requirement for your son's body weight should be anywhere between 800 to 1000ml per day. If he is urinating 6 hourly once, then you need not worry.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I bled during ovulation time and proceeded insemination. Could I be pregnant now?\n\nHello doctor, My periods was two weeks late. Since I have irregular periods I was not shocked. I ended up taking an ovulation test that came back saying I was in my peak and hours later I got my period. However, I still went through with my insemination and the next day my period was gone. Is it possible that I could be pregnant?",
    "doctor_response": "Hello. The bleeding you have experienced may not be due to your period at all. As your ovulation kit suggested that you are at your peak, it means your ovulation was due at any moment. Many a time during the release of the egg there is bleeding. As the egg is released, the holding follicle ruptures. Sometimes the wall of the follicle is vascular enough to cause mild to moderate bleeding, which is picked up by the tubes and present as vaginal bleeding. It may last from two hours to two days. So, in my opinion, you were probably experiencing ovulation bleeding and the good thing that you went ahead with insemination.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for abdominal pain and nausea\n\nHello.doctor My daughter 10 yr is suffering from irregular abdomen pain and nausea with acidity since 5 dys. I hv been trying normaxin. Appetite loss also. Rantac etc off and on but no help. I started ornof 200 ( 1/2 tab) bd tody with cyclopam 1/2 tab sos as she needs antibiotics . is it ok and when do i expect her to get better?",
    "doctor_response": "Hi! Good afternoon. I am Dr Shareef answering your query.If I were your doctor, I would advise you not to give her any food (including fast fried and spicy food) from outside, as intestinal infections could creep in from such kind of food, and in few the intestinal mucosa might be too sensitive to some of the components of these food. Next I would advise for a routine stool test for her for ova and cyst, a urine test both routine/microscopic and culture/sensitivity as many a times there could be a silent UTI in children with vague symptoms. If any of these come out to be positive, this has to be treated properly. In your daughter's case, you have already started the antibiotic, so continue it for at least five days. However, if there is no relief, then you must show her to a pediatrician in your area along with a possible ultrasound abdomen if advised.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain?\n\nI have sever back pain..doctors say that it is the initial stages of slip disc. just a few days back, i visted a sports medicine doctor and he said its not a disease so chill..he said its just maintainence problem and showed me some excersise...but still cant sit for long..any suggestion",
    "doctor_response": "Hello, I have studied your case. Usually nerve compression cant be seen on x ray you may need MRI for this.  there can be related spondylitis but if there is any nerve compression then that may need specific treatment.I will advise you to do MRI spineTill time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness in chest with occasional dry cough?\n\nHello..I am mildly asthmatic and take symbicort twice a day. I am male 5'9 and 11 stone in weight. For the last two weeks I have developed a tight chest sensation with occasional dry cough. Ventolin and/or symbicort do not make any difference. My peak flow reading consistently registers 610+ (as normal) when chest feels tight and this doesn't change after medication. My chest feels restricted, but I can exercise hard without any problem. The doctor has completed an ecg, blood pressure test and listened to my heart/chest - all is clear. I have a feeling that this could be anxiety, possibly a virus or an allergy to pollen. Please advice. N",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. I don't think, your symptoms are due to worsening of asthma because your peak flow reading is consistently high. So no need to worry for viral infection or pollen allergy. So possibility of stress and anxiety related chest tightness is more. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on it's solution. You may need anxiolytic drugs too. Avoid stress and tension, be relax and calm. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Partner suffering from herpes, hepatitis C. How to avoid getting infected?\n\nHi my name is xxxxx I am a married woman.. my husband have a herpes and hepatitis C ... this december only he tell me about it... i dont know what to do and what the best thing to do to not having it... the last time i had negative check up in hepa B is August.and last september 2012 i recieve my last dosage of Cervarix . I Need help and advice.. What i need to do?",
    "doctor_response": "Hi, thanks for writing in HCM. If you are hep b and hep c negative then I would suggest that you should go in for immediate vaccination . Till then you should use condoms to avoid infection. For your  husband he should take a full course of  interferons for hep c and acyclovir for herpes infection. I hope this answers your querry. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Allergic to dust and almost every fragrance. Why am I feeling cold in upper arms?\n\nHi,I both upper arms feels cold usually during the sleep, I feel same thing during the day but it doesn't bother me much. I have an allergy to dust, palm, sour grape almost every fragrance, I used to think that is way my upper arm feels cold. Even though room temperature is about 75 F or above, still my upper arm feels same thing. What do you think.Thanks in advance!",
    "doctor_response": "Hello, I have studied your case.As per your symptoms neck pain can be due to diffuse disc bulge compressing your cervical spine.Another possibility of thoracic outlet obstruction leading to vascular compromise leading to cold feeling.Some medication like methylcobalamine with muscle relaxant and analgesic will reduce pain, you can take them consulting your treating doctor.MRI and colour Doppler will help in diagnosis.Also check your vit B12  in your blood.Hope this helps. Wish you speedy recovery.  Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should i do as there is a spot on my lung?\n\nhi doctor how r u? i have a question in my mind few years ago i have found tb and after that i treat it very well now i am fit . but on xray i found there is a spot on my lung . can u plz tell me can i go uae on visa for work . or what should i do. wating in detail for your reply doctor.",
    "doctor_response": "Thanks for your question on HCM.I can understand your situation and problem.Any lung insult either tuberculosis or trauma or pneumonia ,once healed , produce scar (inactive) tissue. And this scar tissue will give white opacity on chest x ray. So this does not suggest that you are having active tuberculosis.To prove this ,I advice you to consult pulmonologist and get done1. CT thorax2. Bronchoscopy and BAL (Bronchoalveolar lavage) analysis for tuberculosis.CT thorax gives much better idea about scar tissue then chest x ray.BAL is more superior then sputum in tuberculosis.If both of these are normal then you can argue with visa faculty about not having active,infectious tuberculosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause discomfort in lower right side, tender to touch stomach while being overweight?\n\nI am 50 year old male I am having discomfort in my lower right side. it is tender to the touch when pushing in on the lower stomach. while I am standing it feels like something wants to come out of my stomach. no fever. I am over weight please advise",
    "doctor_response": "Hi.The most probable cause is hernia as you say there is feeling of something coming out . If this is long standing , get this checked by a Surgeon and get prated if advised.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Whats the dosage & side effects of Metopropal intake?\n\nI have been prescribed with Metopropol 25mg extended release for ventricular ectopics that I get when I have late dinners especially after alcohol. Otherwise although I do have occasional ectopics, they are not significant unless it s after a late night dinner. Is the dosage ok? Also, what are the side effects?",
    "doctor_response": "Hi,Metoprolol-XR is a heart-selective beta adrenergic blocker commonly prescribed for the treatment of premature ventricular contractions (ectopics) in the dose of 25 mg once a day. Its common side effects include low blood pressure, decreased heartbeats, cold clammy skin, fatigue, erectile dysfunction and difficulty in breathing.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain from thighs to calf?\n\nI get excruciating pain emaniting from the top of my thigh going right down to the calf of my right foot.This happens particularly after walking a while or simply standing.sometimes it goes away after a brisk walk.i get numbness in my toes while sleeping at night & have continuous pain in my right foot while asleep.i have a fused L5 n a slight problem in L3/L4",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. Radiating pain in leg may be attributed to sciatica where nerves are impinged in between their route. Try having some physiotherapy done and exercises do help. Don't do extreme range of movements at knee or hip. And use lumber corset while travelling. It will surely help in the condition.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Harsh Swarup",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I feel more aroused when I masturbate and not with my partner?\n\nHi, Im a 20y/o female, with average health. I've always been afraid to ask about sex whether with my gyn or my doctors. I'm not always sexually active, but when i am with my partner, I don't feel anything vaginally during intercourse, during foreplay I feel some but not much. However, when masturbating I'm perfectly fine, and I feel amazing. I have some slight anxiety, and I've had Major Depressive Disorder in the past, but now I'm doing much better on Zoloft 50mg, with limited symptoms now. Im aware that my medication has proven to have negative effects on my sexual libido, but my real concern is why there is such a difference in my sexual experiences when with my partner versus myself. Thank you !",
    "doctor_response": "Hello, Feeling satisfied in intercourse depends on a number of factors - Sexual desire (spontaneous sexual interest including sexual thoughts, erotic fantasies, and daydreams.etc.). Psychological issues. Relationship issues. Another important point is that during masturbation you are aware of the pleasure points in your body and can therefore attain maximum pleasure, while with a partner a lot of other factors are involved. Also, maybe you should consider using another drug instead of Zoloft 50? Sexual desire is typically more psychological and situational in women, influenced by how they feel about their bodies as well as the quality of relationship with their partner. I suggest you talk with your partner so that you can experiment with different techniques. Also to find what suits you and your partner best so that both of you can understand each other better sexually. (Many women do not experience desire until after they are genitally aroused, and arousal may require an extended period of foreplay)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Has dementia and lung cancer spreading to other organs and lso hospice involved. What to do?\n\nmy 92 yr old mother has dementia and lung cancer that has begun to spread to other organs. she is in a nursing home and also have Hospice involved. she is very affixed to me, I am her only family member left and she cries a lot when I am with her especially when I get ready to leave, It upsets her so and tears at my heart to see her like this. Is there anything I can do  to help her through this, I visit her each day, should I maybe go every other day or what. I need some help, Please",
    "doctor_response": "Hi, as you mentioned your mother has dementia, emotional outburst is common in this disease. the only way is to take a treatment for dementia with a good neurologist and make her feel comforable. the presence of lung cancer also make her deppresed and which will add to the emotional outburst. so if you have a biopsy of the lung cancer lesion, can go for EGFR testing. if it comes positive she may be started on oral tablets with TKI inhibitor with medical oncologist opinion. she may also need counselling with antidepressants. try to continue meeting her every day till some these medications take action and then gradually you can reduce the number of visits.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the painful lump on the back of my head?\n\nI have a lump on the back of my head which hurts after touching. I have tenderness on my neck as well. It hurts to lay on it. Lump is on left side of head in back. I found this lump on Monday. Then today I found a tick on my head. I went to an urgent care facility tonight and she is contributing it to the tick. Indicated it is toxins in my body from the tick and gave me an antibiotic. I m not sure the lump is from the tick since the lump is not where the tick was found",
    "doctor_response": "thanks for sharing your concern!there is nothing to worry about this; it is nothing but aN INFECTED  sebaceous/dermoid cyst and well, could be infection of the hair follicle also!for confirmation an FNAC test is useful in such cases!regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is quantity of sperm present in pre-ejaculate juices?\n\nHi im busy with a project for biology on sex, birthcontrol etc.. If you could tell me. How much sperm is there in pre-ejcaulate juices of the average man.. I know its very low to nothing.. but I need to make accurate calculations bla bla fishpaste.. thanks",
    "doctor_response": "Thanks for asking in healthcaremagic forum   We do not have any data regarding that. We know that sperms may or may not be present in precum. So, you should research it & tell us about this. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could my light period mean that I am pregnant?\n\nthis month i am having a very light period normally i have to use a super tampon adn this month i am easily getting away with a light one. i take birth control and have been taking it for a year or longer now. i take my pill around the same time every night and have not missed one. i usually always use a condom also. this month at around the end of my first week of pills my bf and i decided to try having sex without a condom. it only was for a few minutes and he did not ejaculate inside me. could my light period mean i am pregnant? or what could be the reasons for this? normal?",
    "doctor_response": "Hi,   Thanks for the query on health care magic platform.   I have read & understood your query.    If you have taken the oral contraceptives without having a break, this month.. there would be no chance of pregnancy with the unprotected sex you have mentioned.Condom you are using are not needed for contraception.. Yes, but use of condom is definitely helpful in avoiding STD.    Oral contraceptives being hormones tend to cause change in bleeding pattern over the time.. your menses must have been affected by the hormones , showing lesser bleeding this time.    Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for hair fall\n\nI am female of 27 yrs of age. I am experiencing severe hair fall since last few yrs. my hair falls in bunches while washing and I see hair all over the bathroom floor as well as my dressing table. Now I can even see my scalp on the front and touch it while running my fingers through my hair.I purchased mintop 2% solution but never used it because I read online that it causes hair growth elsewhere too like face and body. And also that it has some other long term side effects. Please help me am so depressed",
    "doctor_response": "Hi PiyaYou seem to have telogen effluvium ..... There may be some cause....like anaemia,vitamin and nutritional deficiencies,thyroid dysfunction, stress, anxiety,worries,travelling,any other internal disease,certain drugs.... ..etc. Poor hygiene and poor nutrition may be responsible for telogen effluvium. You consult dermatologist for firm diagnosis.Investigations may be done to find out some cause.To controll hair fall and to improve hair growth you may take biotin 10 tab daily for few months and apply mild steroid lotion on scalp at night daily. Kindly avoid minoxidil application. If you have dandruff use anti dandruff shampoo containing ketoconazole. For hair oiling and shampoo use herbal preparations. Take treatment for few years.Have patience..for the good result.I hope this would help you.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the red streak appearing in the wound caused by glass piece?\n\nMy 13 month old stepped on a small piece of glass yesterday afternoon, my husband thought he removed it all and cleaned the wound.. But she has a fever, the wound is red and hot and swollen and she has a red streak ,oving away from the wound . What could it be and what should we do",
    "doctor_response": "Hi, Welcome to HCM!Brief answer: Your daughter has developed infection (cellulitis)Detailed answer: The problems listed in your question like fever, wound which is red, hot and swollen due to glass piece injury are suggestive of infection caused by the germs on the skin. She needs to take antibiotic like Cephalexine and for the control of fever Paracetamil syrup or suppository will be sufficient. The wound needs to be checked for the collection of pus. etc and dressing should be done accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can chemo treatment get rid of polyps and tumors that are not cancer?\n\nI am a 35yr old female. recently I went in for a scope to see why I have acid reflux, I ended up getting a second scope and a colonoscopy. They found a 2 inch polyp that was not cancer, but said it couldnt be any closer. It was also sent off to get a second opinion that I am waiting on. I also have had a tumor on my ovaries from endometriosis and had them removed 2 years ago. I was advised to get a mammogram asap. Im really starting to freak out. I want to know if I can get chemo treatments to just get rid of everything even though I dont have cancer",
    "doctor_response": "Hi,Thanks for writing in.Chemotherapy is given only in the presence of existing or pre existent cancer in the body. It cannot be used as a general treatment to eradicate all cancer cells even before they occur. These chemotherapy medicines are strong and focused to work against rapidly multiplying and proliferating cancer cells containing altered cell nuclear material.As you have a 2 inch polyp, it will be best to get it operated and sent for biopsy. This will pick up even the slightest abnormal cells and then a chemotherapy might be recommended. In the absence of such features, giving a chemotherapy is not justified. You can also get serum cancer markers to know if you still have risk of any specific group of cancers and then become vigilant and get detailed testing done. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for manic disorder\n\nHI, MY ELDER SISTER IS SUFFERING FROM MANIC DISORDER, SHE WAS GIVEN MEDICINE SUCH AS LITHOSUN SR & SIZODON PLUS WHICH WAS STOPPED 1.5 YEARS AGO & AFTER THAT SHE BECAME THE AS EARLIER. 3YEARS BACK SHE WAS ADMITTED IN GURGOAN IN DR.NIKHIL RAHEJA'S NURSING HOME FOR 30 DAYS. I KNOW STOPPING HER MEDICINES WAS A BLUNDER ON OUR PART BUT SHE HAS BECOME VIOLENT & THINKS THAT SHE IS SUPERMAN . I AM PLANNING TO SEND HER TO A PSYCHIATRIC CLINIC FOR TREATMENT USING PROFESSIONAL PEOPLE AS SHE IS VERY DIFFICULT TO MANAGE. KINDLY SUGGEST YOUR OPINION.",
    "doctor_response": "Hi.I understand your concern. Manic disorder is classified under bipolar disorder. It is episodic illness. Require proper treatment of 1st episode otherwise it has high relapse rate.if she was responding to lithium in past then it is advisable to give lithium again.indoor psychiatric care is must. Treatment require under supervision.  Besides lithium medicines like sodium valporate/olanzapine/risperidone etc will be useful If she is not manageable at home then admit her in psychiatry institutions or hospitals. Injacatable medicines will useful to control her behaviour in intial stage.Do ttake advise from your treating doctor or psychiatrist. Happy to help you further. Feel free to ask. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain under left arm that radiates to shoulder?\n\nI have a pain under left arm it radiates to under arm an down through my shoulder blade and then then goes to my stomache or breast and there is pain under my brest and if I put pressure on and massage pain out it gurgles to my stomache can you tell me what this is?",
    "doctor_response": "Hi, I have read the details and in my opinion, this pain is due to pressure on one of the nerves in the cervical spine. I suggest pain killers, muscle relaxants and physiotherapy for 7-10 days and if there is no relief - consult an orthopedic surgeon. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it to be concerned about the lump in the chest of child?\n\nHi My baby has a small lump on his chest. when he was born i noticed a tiny hole and when we talked to the GP he said its nothing to worry about but now there is a lump in place of the hole and soft when pressed and kinda like jelly. he is not in any pain but am concerned what does this mean",
    "doctor_response": "Hi, welcome to HCM. I see similar cases in my clinic everyday. During prenatal period sometimes maternal hormones like estrogen pass in baby which causes swelling of breasts on 3 or 4 th day, a white creamy liquid may also ooze from the nipples. Usually, no treatment is required. Engorged breast should not be pressed, massaged or squeezed since this may result in infection. I hope this has helped you. Take care. Regards - Dr Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath, lung pain and chest tightness?\n\nHi  I am a 39 year old female, non smoker, not asthmatic however I keep getting pleurisy. Oridinarily I am in good health and am not on any medication. I have had 2 bouts of it in the past year and I feel it coming on for a third time. Ordinarily I don't suffer with shortness of breath or struggle to walk or run or dance. It is only when the episode presents itself in the form of pain in my lungs when I breath which worserns over time and the absolute exahustion and weakness that I feel. Once I had tightness in my chest as well and had what I describe to be like a panic attack when I couldn't catch my breath. That happened twice. I would be grateful if you could advise. Thanks Dawn",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. In my opinion, we should definitely rule out bronchitis in your case. So consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). If PFT is normal then no need to worry for bronchitis. Sometimes stress, anxiety and panic disorder can also cause similar symptoms. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution.You may need anxiolytic drugs (propranolol and flunarizine combination) too.Don't worry, you will be alright with all these. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for allergic cough and cold\n\ni am taking montek lc from last 2 years.whenever i get a symptoms of runing nose or persistent cough and it stops.there is no other way except taking anti allergy tablets.is this a way out or is it a safe to take.for how long we should montek lc if we get a symptoms of alergy.",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your history and would like to make suggestions for you as follows:1. Montek-LC (Montelukast + Levocetirizine) can control symptoms of allergic cough-cold. So it is desirable that you take it as long as you have symptoms if you are not experiencing side effects.Common side effects of montelukast+levocetirizine are sedation, drowsiness, stomach upset, etc. However, if you are not experiencing any of them, you can take it safely for years together.2. For long term relief of allergy, I would suggest you to consult an Allergist-Immunologist who will suggest you allergy testing and allergen specific immunotherapy.3. Were I treating you, I would suggest you allergy testing for common allergy causing substances such as house dust mites, molds, common pollens, insect proteins, pet dander (if you have pet).4. Based on allergy testing, I would prescribe you allergen specific immunotherapy which works on immune system to gradually improve allergy symptoms and reduces requirements of medicines over time.5. In general, I would suggest you to avoid exposure to dusts, smokes and air pollution as much as possible.6. Regular breathing exercises and a healthy diet will also help you by improving your immune system gradually.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What helps with severe back pain ? Feeling nauseous and had diarrhoea.\n\nI have had severe back pain since Tuesday morning and cannot lay down for more than 2 hours. For a while I was able to walk around but now have pain over the entire middle body section from under the breasts to the bottom of my stomach. I have tried the heating pad and taken Robax but I am still extremely painful. I seem to get better until I lie down for a couple of hours and now the pain is severe. I am also feeling nauseas and had dirareha Monday night and Tuesday night although that seems to be better.",
    "doctor_response": "Hi, thank you for posting.Your symptoms might be related to food poisoning. Food poisoning is manifested with: nausea, vomiting, abdominal pain, diarrhea, fever, etc.In rare cases these cases are caused by campylobacter infection. This infection can cause arthritis, too.So you need the following tests to determine the diagnosis:1. Stool culture.2. Urine test.3. Complete blood count.4. Liver function test.5. Abdominal Ultrasound.If the diarrhea continues I recommend you to go to Emergency Room, where you will get the right treatment for stopping diarrhea and dehydration by rehydration.Contact your gastroenterologist.I hope you find this helpful.I wish you a fast and healthy recovery.Dr. Behar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for recurrent loin pain\n\nhi im a young lady of twenty one years old,im am 1.69m n weigh 64kg.i started experiencin loin pain a mionth ago n went to the clinic n was given paracetamol n pro pantheline not sure bout the spellin,n the pain keep on comin time and again.what can i do now?",
    "doctor_response": "Hello and welcome to HCM.As an Urologist,i can understand your anxiety.As the pain is recurrent in nature,you should have an abdominal scan done.It's called an ultrasound-KUB scan.Loin pain is commonly caused by a stone.It's relieved by anti-spasmodic medication,in form of tablets or injection.It may also be caused by a muscular sprain.  Avoid lifting heavy objects.If you've any doubts,send the reports to me as a direct question.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for rashes and bumps?\n\nI have diabetes and have gone without insulin for weeks because of insurance problems.. I have rashes and bumps all over my back and arms as well around my mouth.. I feel just horrible all the time.. Until i can get back on some insulin i would like to know what i can do to help with the rashes and bumps.?",
    "doctor_response": "Hi welcome to HCM, I feel these are infective because of your sugar going up due to lack of insulin. I think you should buy some insulin/oral anti diabetic drugs for short term till your insurance problem is sorted. And you may need an antibiotic for rashes and bumps which can only be prescribed by a local doctor. If possible call up your doctor and ask him what you can buy. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can muscle atrophy with pulmonary fibrosis be treated?\n\nFormer Iraq Vet, Female, Surgeon, with c/o muscle atrophy in her Lower Ext. s. She surf s and paddle boards daily. She is Euthyroid. Has hx of Pul. Fibrosis(etio. unknown) but admits to exposure to unknown agents while serving in the military in the past.",
    "doctor_response": "hi,Pulmonary fibrosis. I hope you must have known well about this Pulmonary fibrosis by now. it's an irreversible condition. only way out is to do regular breathing exercises and try to do as much as possible. Doing costal breathing exercises will also help. for more details on exercise you can ask a cardio Pulmonary physical therapist. for the muscle atrophy you need to go through some tests once advised by a physician. but in general any weakness of muscle can be helped by doing some regular free exercises. as exercise helps the muscles and the Pulmonary system as well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Gum injury while eating mango. Growth in front of tooth, bad breath in the area, movable flap\n\nHi, the other day I was eating a mango, pulling the fruit off with my bottom teeth when the string bits hurt my gum real bad.. now I have this growth/flap in front of my tooth .. I can move it and fold it back plus I have been having really bad breathe since.. not sure if it is from the way I ate the mango.. or maybe even my lip ring that tends to sit in that position when my mouth isn t moving. Thanks :)",
    "doctor_response": "Hello Welcome to HCM I would like to clarify that eating mango or any other fruit never results in gingivitis i.e. inflammation of gingiva. Its just because of trauma due to that fibre of mango & it resulted in inflammation. You should go for oral prophylaxis.In future also try to maintain proper oral hygiene by regular brushing & flossing.Also use 0.2% chlorhexidine mouthwash once daily. Consult your dentist for further treatment. Take Care Regards Dr.Neha",
    "dialogue_context": ""
  },
  {
    "patient_message": "How many Aleve can a person take in a 24 hour period for severe back pain?\n\nHow many Aleve can a person take in a 24 hour period. I have L4&L5 problems with my back. I have an appointment with a back specialist in 2 weeks, but the pain is severe. I have had 3 injections and none have relieved the pain for more than 3 days! I have Tylenol with codeine, Ultram and Naproxen. Nothing seems to work as fast or as well as the Aleve. Unfortunately, the Aleve wears off also.",
    "doctor_response": "Hello, I have studied your case.You can take maximum 4 aleve in 24 hours.Ideally 2 or 3 times is recommended dosage.Medication like methylcobalamine with muscle relaxant and analgesic will reduce pain; you can take them consulting your treating doctor.You may consult physiotherapist for further guidance. He may start TENS, or ultrasound which is helpful in your case.I will advise to check your vit B12 and vit D3 level.If MRI shows disc compressing on nerve root then surgical decompression is permanent solution.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bleeding frenulum during intercourse\n\nMy frenulum broke while I was tryin to insert my penisIt started bleeding heavily I somehow managed at that time bt I m scared abut the futureI don't want this to b known by any of my family memberIt was my first time eitherI might have bleeded a little on her lips Will she get pregnantI m very scaredPlz help please I m very scared",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: If the tear is incomplete and small you can wait till it heals by applying local antibioticsExplanation: Bleeding will not cause pregnancy. And frenulum tear if small heals by itself with local antibiotics/oral antibiotics & anti inflammatory drugs. |If large/complete please visit a doctor immediately.                 Your family member will not be informed by a doctor , so visit a doctor at the earliest to prevent any problem in future.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe shoulder and upper arm pain\n\nI have been lifting 3 to 5 pound weights with my workout My shoulder and upper arm hurt. I have put mineral ice on it and it helps overnight but hurts a little the next day. This has been going on for 4 weeks. I want to workout but my arm bothers me when I lift weights. I didn t workout for a week and it still hurts. What do I do?marynethery",
    "doctor_response": "You could be having Rotator cuff tendinitis. Apply heat or ice. Avoid overhead activities. Get an MRI Shoulder to look for tendinitis or tear. Take pain killers for 5 days. Do physiotherapy for shoulder muscles strengthening.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes 'ureaplasma urealyticum' infection?\n\nhellow online doctors:) I'm just wondering, what does it mean to have an unbalanced Ureaplasma Urealytikum? How does a person get this ? by having sex with someone? or is it maybe just a family disease? my doctor recommends me to take some antibiotic! But I just need to know more about the disease before!",
    "doctor_response": "HI, thanks for using healthcare magicIt is not a sexually transmitted infection or an inherited family disease. It is a bacteria that can sometimes be present in different areas of the body.It can be transmitted from mother to child or direct contact between persons.It would be best to take the medication that your doctor has prescribed to help treat the infection.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hair loss, difficulty in getting up and coughing?\n\nAge,14.height, 5\"5. No medical history, I don't wake up in the mornings, I have to be woken up, I manage to wake up at about 3 pm sometimes. I have a loss of hair on the back of my head and a cough. None of these symptoms Are getting too much worse, but ive had them a long time, what is it?",
    "doctor_response": "Hi, The loss hair in the back could be due to longtime pressure in that area... which leads to hair loss due to pressure... and cough could be due to aspiration. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Saravanan, Cosmetic & Plastic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are chances of tuberous sclerosis after angiomyolipoma?\n\nHi, I am 44 years old, and had a very large angiomyolipoma removed when I was 29 after it ruptured and I was bleeding internally. Would like to know what my chances of having Tuberous Sclerosis are and what kind of tests can be done to confirm or rule out TS ? Thanks, Sam Allen",
    "doctor_response": "Hello,Angiolipomas may occur in kidney or other organs in TS. But it may wont shrink it's own need to surgical excision. There may recurrence chances also high at other site.Don't worry, please follow up with your treating doctor he will examine and treat you accordingly.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for itchy red rash on my husbands buttocks\n\nHi my husband has just had a spell in hospital he is 43 and had a heart attack, a week ago he had a triple heart bypass, he has come out of hospital with a itchy red rash on is lower back and buttocks, he has used Cream prescribed by the hospital which hasn t moved it please could you help.",
    "doctor_response": "Hi, I have gone through your complaints and would recommend you to apply topical steroid like cortisone cream on the affected areas twice daily. Also, take antihistamines like tablet Cetrizine once daily at bedtime for few days. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on the breast and neck?\n\nI m a 32 year old male and have had a knot about 3 inches to the inside of my right breast and about and inch up from my breast for several years. It doesn t hurt. But a few days ago I had one to come up on the back of my neck. I explain the place by...if you bend your head back like your looking up you make a crease where it bends. The spot is right below that crease. It is not sore either. What do you think they could be???",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  Lump in your head may be posterior cervical lymphnode due to some infection.  Your breast lump may be breast tumour or soft tissue tumor.  You should go for fine needle aspiration cytology. 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to confirm dry drowning?\n\nhi i went swimming with my 18 month old son today and at around 12.30pm he fell in the shallow end of the water face down for a few seconds or more he seemed fine after ate as usual had a long nap woke up for a few hours and has now gone back to bed, the difficult part is that he is staying at my aunties tonight so his not actually with me but ive spoken to my aunt and she says his looking normal and sleeping with no breathing difficulties im jus scared of this DRY DROWNING that ive been reading about, please tell me what im suppose to do?",
    "doctor_response": "Hi,I will list below the warning signs. If your child experienced any of the warning signs then seek medical care as soon as possible.  The warning signs include: 1) coughing 2) chest pain 3) trouble breathing 4) feeling extremely tired you should keep a close eye on him for the next 24 hours. Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Salah Saad Shoman",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest burning sensation?\n\nHi health care magic Doctor Got flucloxacillin 500mg to get rid of a cyst. For a week 4 times a day Working. However since using the tablets, I have a pain when I drink or eat anything in my lower chest. Like a burning feeling right at centre of lower chest. Please advise Is it the tablets, or something else? Or infection showing up because of taking the antibiotics. Thank you Christine Bradly",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. By your history and description, possibility of drug induced gastritis is more. Antibiotics like flucloxacillin is known to cause gastritis. And your symptoms are similar to gastritis. So you need to take proton pump inhibitors on empty stomach for gastritis. Avoid stress and tension. Avoid hot and spicy food. Avoid junk food. Drink plenty of fluids orally and keep yourself hydrated. If still you are not improving than you need to change the antibiotic. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are abdominal pain and brown discharge signs of implantation?\n\nHello, I had my embryo transfer 12 days ago on 25/04/12. I have had small discharges brownish in colour for 2 days now and am having severe waist pain which are my usual premenstrual pains.  I am due for my Urine Test the next 3 days. Can you tell me if the discharge or pains are signs of implantation, Thank you",
    "doctor_response": "yes of course you are right..it is called implantation bleeding and pain..you need not panic madamit usually occurs around time of expected date of menses",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to travel during pregnancy?\n\ni am 35 year old and due for 2nd baby in august 29th 2010. i have to travel from hyderabad to bhopal which takes around 22hrs. in the 2nd week of 9th month. is it safe for me to travel at this time? so far there is no complications and everything is fine. pl. advise me.",
    "doctor_response": "Hello,I have gone through your query and understood your concern. Travel by train is the best way at this stage of pregnancy since this causes the least jerks. Please make sure you have a complete antenatal checkup before you leave, do not travel alone but take a learned companion to help you if need arises. During the travel, take as much rest as possible and keep watching the fetal movements and also for any abnormal vaginal discharge. Carry all your medical documents needed. Take easily digestible food and liquids. Since your pregnancy has reached term and it is uncomplicated, there is no need to worry. Wish you safe motherhood.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I control my anger ?\n\nMy brother is around 30 yrs old tall and healthy, he was very good in early teenage that every relatives were talking about him, I dont remember exactly when he was sick he started changing jobs regularly and peoples where complaining about his rash behavior but it was not seen by my parents as I was working away from home and they always supported him. now the situation is he himself find a victim who ever tries to help him and starts abuses him breaks household things beats parents. he wants every body to be perfect even in his jobs, he has no activity if suggested he gets more violent he never wants stay from home and at the if angry he starts all ways to insults people around him. this has been for some years now, please help him",
    "doctor_response": "seems to be  suffering from serious behaviourl disorder ,needs urgent psychiatric consultation to avoid further worsening",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recurring skin problem on feet, diagnosed as eczema. Not recovering yet. Malassezia ?\n\nhello. I have a recurring skin problem on my feet. It was first diagnosed as eczema and the treatment that was given was steroid injections on the part that was infected with some tablets and cream. Since it kept recurring after the effects of the injection wore off I went to another skin specialist. He too did the same thing. Then I decided to go to an allergy clinic. So I was allergic to a host of substances but not much improvement even though I took the medication and applied the cream. I then went to a homeopath in India. She diagnosed it (after sending me to a skin specialist for confirmation) as a mix of eczema and psoriasis, which she said is not curable. I was also advised to take an comprehensive blood test to test for allergies. Anyways, I took the medication. I was posted in France soon after and I started getting itchy under my armpit and other places. I saw a skin specialist there and he suggested some cream and medication. After seeing that there was improvement with the cream he did not continue with the medication. He diagnosed it as eczema (no psoriasis). But i still had the condition in my feet and no more cream left. In Indonesia, where I live, I was advised to put a Chinese cream called pi kang shuang which i did. Also to wash my feet with betadine soap and clean with Dettol. Which i did as well. Then i went to India and my sister-in-law suggested that i use Cosvate (clobetasol) and pasitrex together and this combination helped me a lot. Within a month the lesions had disappeared. But i started wearing socks very often to avoid dust mites and dust particles because I was convinced that that was the substance that was causing my allergy. Now i have it on my soles and the heels of my feet. I have been using the cosvate and pasitrex and it has improved a lot. I consulted another allergist and he took other tests and found out that it is a colony of malassezia. He gives me some amniotic liquid which i have to apply once or twice a day, salicylic powder, brm capsules and anti-histamine in case of severe itching. Please advise what exactly is malassezia and what more can i do to get rid of it completely? Thankyou.",
    "doctor_response": "Hi malassezia is a fungus which usually causes tinea versicolor.i do not think it fits in this condition.it think u are suffering from hypertrophic eczema.regular moistersing and applicayion of propysalic ointment.use atarax 25 mg at night and antibiotic  curesc the condition  .avoid regular washing of hands frequently..a pply  moisteriser regularly cures it",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in the calf and feet?\n\nMy niece (30) was hospitalize yesterday for a pain an inflammation on the right ingle area. She got fever and HA as well. Dr. Did a Eco and said 3 limph nodes are inflamate and took a sample. Today she has both calfskin inflamate and so her feet. What is going on?",
    "doctor_response": "Hi, There could be many reasons for this. To define the exact reason we need to evaluate you clinically. The amount of information you have mentioned in query point towards some infective pathology. I need to see your blood reports and other reports to reach some conclusion. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Anuj Gupta, Spine Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in left scapula, shoulders, abdomen and chest?\n\nhi doctor i am female ,38, 72 kilo weight, and 161 cm height , i have some pain around my left scapula , shoulders , my left hand , a part of my Abdomen and my left chest from 4 month ago . i visited many doctors but they cannot recognize that. a pain from that do not permit me too sleep at night . some doctors said, it is Muscle spasms from stress and gave me some Nerve pills . and i began to eat them from 3 days later and i am better in night now . but i guess it is Angina . please guide me",
    "doctor_response": "Hello, The pain that you have can be related to muscle spasms or due to angina. Only proper investigations like ECG, stress Echo, etc can help in ruling out angina. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from trigeminal neuralgia\n\nHi i am a 26 year old female.I have been diagnosed with trigeminal neuralgia.I have the pain on the right side of my face but then i got it on the left side also.For the past few weeks i now have pain on my jaw,my whole head,down my neck and my spine.I am waiting to see a specialist.My doctors dont know whats wrong with me and i am just getting worse.",
    "doctor_response": "Hi,Thank you for positing your query.I have noted your symptoms and would like to reassure you that trigeminal neuralgia (TN) is fully treatable.As you are young, we need to determine the underlying cause of TN. This would require doing an MRI with angiogram of brain.Medications such as carbamazepine help in relieving the pain. In some cases, radio frequency ablation (radiation therapy) or microvascular surgery may also be needed.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. There is a little green thing in the hole left behind after tooth removal. What is it?\n\nHello doctor, I had a tooth removed from the back left of my mouth two weeks ago and I have been doing everything the dentist told me to do but I looked in it before and the hole is white but there is a little green thing in the shape of a square sitting on top which I think has been there since the tooth was removed. I was just wondering if you had an idea what it might be because I have looked online and I cannot find anything and now my brain is making me think it is something bad.",
    "doctor_response": "Hi. When a tooth gets removed from the socket, it is kept open for healing. By the time you start eating food, it is possible that a particle of food might get stuck in the wound which is very common. And if it is painful in mouth opening, then it could be a dry socket. So, please consult your dentist to check out clinically. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cannot eat food with extra salt. Reason?\n\nI don't normally use much salt in cooking or at the table. - a running joke at my house is that I say things are too salty or too sweet.  Lately, I've noticed that I can pick up on an extra salty taste in many foods (things like processed meats are out of the question).  I donate plasma 2x a week and have been OK for blood pressure.  59 years old.  Don't eat much meat, don't eat/enjoy sweets, drink lots of water, juice  veggies/fruits 2x/week.  1 - 2 wine/day.",
    "doctor_response": "Hello, Thanks for posting your query. Since you donate plasma,sodium concentration in  your blood stream will be high,resulting in increased salty taste in your mouth. It can also be due to altered taste sensation. Depapillation of tongue also can cause this. I would advice you to take a balanced diet. This is not a serious concern. Please avoid unnecessary worries. I wish you good health. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does excruciating back pain in a 37-week pregnant woman mean labor?\n\nHello doctor, I am 37 weeks pregnant and I have been having excruciating back pain since last night. It does not seem to go away no matter what I do. It hurts to move or do anything. Could I be in labor? And do I need to go to the hospital?",
    "doctor_response": "Hello. The sudden onset back pain in a full term pregnant patient is likely to be due to lightening when the baby's head goes down in pelvis and the sacrum and coccyx bone extend to accommodate the presenting part. If there is no abdominal tightness and contractions which are of increasing intensity and lasting for more than 15 to 20 seconds each, then unlikely that you are in labor. But it is always recommended to go to the hospital and get yourself evaluated by the obstetrician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for cough and shortness of breath?\n\nI recently began cardio to lose weight and find that after 15 minutes, I have shortness of breath and begin coughing non stop. I have a metallic taste in the back of my throat as well. Will these symptoms fade as I continue to exercise over the next few weeks?",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. You are having shortness of breath and cough after exertion. It is seen mostly in cardiac and pulmonary causes. So better to get done ecg first to rule out cardiac cause. Get done PFT ( pulmonary function test ) to rule out pulmonary causes. If both are normal then no need to worry much. Some short of shortness of breath can be seen after 15 minutes of cardio.So if your above mentioned tests are normal then you can continue cardio.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for respiratory problems\n\nHello! I m Suffering from breathing respiratory problems, are largely blocked each day but can easily sometimes but never feels quite optimal. Has shift nasal obstruction, no polyps or allergies and has tested koritson, mammomex? Nosespray and this is just a temporary solution and does not fix the underlying problem. When I underline with a finger on the bridge of the nose? When I approach the end, it feels like it leans to one side, I also have uneven nostrils At least one end of his nose ... cartilage as I think it is called the one who is leaning in one direction will cause it looks like a drop of water hanging extra on his nose one can also see how the cartilage piece or whatever it is puckers the skin., I ve read a bit here on the internet and it seems most relevant to the problem is crooked nasal septum? do doctor believe that there is or something else, or maybe more than just a crooked wall. to fix this problem is needed septum surgery or rhino?",
    "doctor_response": "thanks for your questionI completely understand your problemit seems u have a deviated nasal septum. first you should try medical treatment like nasal sprays and leukotriene antagonists along with a course of antibiotics ,if the nasal discharge Is yellow or foul smelling.if the problem is not resolving and symptoms persists you should get a xray of paranasal sinuses which will confirm I there is a abnormality in the sinuses or deviated nasal septum.u should consult a ent surgeon which will guide you. thanks/regardsfeel free to ask more questionsmay god bless you with good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having pain after inguinal hernia and hydocele operation. Please help.\n\nHi doctor, After suffering with groin pain, I had a double operation 12 weeks ago. During the operation, I had a repair of left side inguinal hernia and right hand hydrocele. I am now in more pain than I was before the operation. My testicle thorns with pain constantly and I have stabbing pain on hernia side. It feels like someone is sticking a bottle in me. I am struggling to walk very far, climb stairs and drive. I am unable to have a sex life. Is it normal to do both operations at the same time? Can you explain any possible cause for pain?",
    "doctor_response": "Hi. Well, ideally if you have bilateral inguinal hernia, or inguina\u013a hernia on one side and hydrocele on the other, the surgery should be done for one first before the other, not simultaneously so that when you are fully recovered of one, then the other can be planned and done. Pain can be due to entrapment of a nerve like ileoinguinal or ileohypogastric nerves which run with the spermatic cords or it could be also present if there is improper repair with subsequent breakdown of the repair and subsequent herniation of the bowel content into the inguinal ring or it can be from infection of the operation site. 12 weeks is quite a long time for surgical pains to have disappeared. You will need to do an abdominal pelvic ultrasound scan to see if there is any reccurence or failure of the surgery or if there is entrapment of visceral content.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from cancer, could my mother go into renal fail, sepsis or total organ failure?\n\nHi, my aunt is 68 currently gone through  4 round of chemo, for cancer in chest, liver and stomach. Her pep scan came back clear last week. She is now in icu with bp 60/ 40, renal out put down and catheter in now. An arterial line has gone in to give her more drugs, she is hyper pyrexial. She has 2 infections, uti and chest. She is very ill and I'm doing by best to keep my mother upbeat but honestly could she go into renal fail utter, sepsis or total organ failure?",
    "doctor_response": "Yes, any of those things may happen. Your aunt is very very ill. If the doctors are able to get the infections under control, she may be able to get through it. My hopes and prayers are with you and your family.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high BP after child birth?\n\nIm a 30 year old 132 pound female who is 5 6 . I never had high blood pressure untill I was pregnant with my daughter. Delivery was suppose to take care of my blood pressure problems. My daughter us 16 months old and im still having high blood pressure. Today my blood pressure was 133/90. Why am I still having high blood pressure?",
    "doctor_response": "During pregnancy few pioplw can have high blood pressure.But now 133 is normal.No need to worry about it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for gynecomastia\n\ni am 20 years old boy. i am suffering from man boobs issue... it is very embarrassing for me to remove my t-shirts in fron of my frnds... so i would like to undergo a laser treatment in order to get rid of it... so  can u pls tell me the treatment procedure & the cost details of it.(place of treatment is coimbatore).",
    "doctor_response": "Hi,Regular exercise can help you, if your not recovered by that, surgery is the only way to face that. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mood swings and depressed thoughts\n\nHi,I ve always had a problem with moodyness. I use to think it was both a good thing and bad. I can become overly happy and ecstatic for no real reason at all in a split second, but the simplest things can send me into an extreme fit. I m not really sure how to describe it, so I ll do my best. At times I ll become full of anger, rage, and just get irrational. I could be sent into hour long crying sessions, and not just like crying, but screaming and crying and rocking around almost like I m crazy. I get insane, so bad that by the next day I ll be swelled in the face and have sore throats; I ll get so angered I ll throw things, and break them. Its like a click goes off in my head and no matter how much I ve trained myself to stay logical I don t really care. I have to be in my mood because in my state of mind it s how I should be. Then once my mood switches off, I become normal again and ridden with guilt, because I know how I acted was wrong. I try and control it but nothing I do seems to help at all. It s mainly affecting my relationship with my boyfriend, he tells me all the time that my emotions he can t handle. For example on New Years Eve we hung out, but during the day he was helping his friend get his car to the shop, then bought a couch and I was so angry that I went into a fit, I started crying, and threw things around in my room, I started acting like I didn t care for him at all, I started saying things that I didn t mean. Once we did hang out, I picked a fight with him. As soon as I was done I became normal. Then we went to a party with his friends, and because we didn t kiss as soon as the ball dropped I instantly became silent and the rest of the night wouldn t talk, and at two in the morning when he was falling asleep I became angered with him for not talking to me, I jumped up made loud noises to wake him, he had to come over and grab me and hold me I started shouting and was irrational. Then the next morning before I went to work, he wanted to keep sleeping instead of going with me on the drive to work(his mom took me) and I became so angry and hurt. Like he didn t love me or something. So I sat across the room at him, it was about nine in the morning and he kept falling back asleep, so I was furious. After I made loud noises and shouted at him that I would go wait with his mom(i didn t have to leave for 40 minutes) he got up and kept asking me to come over to him and kiss him and s",
    "doctor_response": "HelloWelcome here.Your description suggests that you have frequent mood swings. The description is pointing towards a possible mood disorder.I would suggest you to visit a psychiatrist for proper evaluation. I think its the mixed bipolar disorder category which you fall under.You might need a drug treatment with mood stabiliser drugs like valproate(prescription drug). But that would be cobfirmed after a psychiatric evaluation.Hope this helps.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could large white welts in body be due to declining kidney function?\n\nmy son has kidney disease. for the past week he has been breaking out with large white welts all over his body. no change in diet, soaps, etc. benedryl helps after a few hours but returns the next day. could this be cause by his declining kidney function?",
    "doctor_response": "Thank you for choosing HCMI understand the anguish that you must be in. I think that you have a medullary kidney disease. It is possible that the kidney function has reduced which is causing an increase in the creatinine levels. The raised creatinine and the uric acid causes problems with the skin.You can treat this by first confirming the cause. To get to the cause, you need to get an Ultrasound done to help get to the cause. Once you know the cause, you can see a Doctor and get treated.Please follow up after you get an Ultrasound done. All the best.Hope this helps you.Dr Vignan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for bleeding through an infection on buttocks\n\ni had got a swollen because of hair infection on assi visitd doctor he said he needs to do surgerybut i didnt have time so i came home and removed all the pus from it.before it used to pain alot, but after removing that puse its not paining.now its just after some time bleeding from there.what should i do?",
    "doctor_response": "Dear I can understand  your  concern . I would  like  to  inform  you  that  there is no need to worry about that. You just need to press over that it will slowly  stop. Clean  that area with betadine  and apply  bandage  over that.No need of taking  any medicine  for bleeding . Hope  this will  help you .  If  you  have  any  other  concerns  please  feel  free  to  message  me .  Thanks  for  contacting  HCM .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bowel gas and hepatomegaly in a child\n\nhello my son is 5 years and 9 months ago he on and off told me about belly pain last night we go his scan (ultersound) dr told as that two things 1:prominent bowel loops with excessive bowel gas 2:mild hepatomegaly plz told me some suggestion about him",
    "doctor_response": "Hi.... BOwel gas Shadows And mild hepatomegaly does not mean serious illness. It can happen in viral illness also. If your son is complaining of intermittent pain abdomen the possibilities could be - 1. worm infestations2. Mesenteric adenitis -  lymph node enlargement in the abdomen3. We need to consider non organic chronic pain abdomen, but,4. Mild hepatomegaly also can cause pain abdomen like this because of stretching of capsule of the liver. If the kid is otherwise active and appropriate in growth and development you need not worry about him.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning sensation in lower chest?\n\nI have had a burning sensation (not really \"pain\") in my lower chest for the past two days. I wouldnt say it comes and goes, but moreso that I notice it more when not distrated by other activities.  Sometimes it feels like its more one side then the other. I am a 36 year old female who is overweight, dont smoke.  I have had reflux in the past, but seemed higher near throat.  Also the discomfort lessens a bit when I push my chest outward to stretch, often hearing a cracking.  I tend to sleep on my left side and wonder if it could be related or if its more serious.  Thanks",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. In my opinion, you are mostly having GERD (gastroesophageal reflux disease) and related symptoms. GERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms of burning sensation in lower chest. So we should first treat GERD in your case. For this, avoid stress and tension. Avoid hot and spicy food. Avoid junk food. Avoid large meals, instead take frequent small meals. Take proton pump inhibitors and prokinetic drugs. Loose weight and stay fit and healthy. Don't worry, you will be alright with all these. This is not serious condition. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes strange bumps on shaft of penis and ball sack?\n\nHello im a 16 year old male and I have strange bumbs on the shaft of my penis. In detail, they are mostly small and inside the bumbs contains a white substance. They are all over the shaft of my penis and my ball sack; and most of the time when I skip a shower for a day they begin to smell and If I end up not showering for two days then the smell is worse. Ive looked online and im not sure what exactly what they are and whats the best way to remove them if possible or just remove the smell. (Not sexually active yet but soon I will be and im kind of embarrassed about this and I just wanna know what they are)",
    "doctor_response": "Hello, I am glad to try to help.What you are describing sounds like some type of infection, possibly due to bacteria.  However it is necessary that a physician examine you in person, in order to make the correct diagnosis. You definitely want to clear this up before becoming sexually active.  Do not try to remove the bumps on your own.  Without knowing the cause, and treating the cause, it will not be possible to get rid of the smell either. Schedule an appointment as soon as possible.Best of luck, don't worry, but do get it checked out!ez",
    "dialogue_context": ""
  },
  {
    "patient_message": "On jaundice treatment, maintaining diet. Persisting high values of ALT, AST. Diet suggestions?\n\nHI, I am 26 year old female. I got blood test around 27dec 2012 and the doctor figured out jaundice in the reports. I was in India that time. I followed a strict diet avoiding all the spicy food, butter, curd and even milk with medicines liveril fort and ubexa twice a day with plenty of rest. I am in Canada since Jan3 2013. I got another blood test around Jan 7, 2013 and the values for liver enzymes ASt and ALT , billirubin were still little more than the normal values. I feel better than before and can feel the changes. I am planning to get another blood test may be in 2 weeks. So far I havent started taking any spicy food and stick to simple rice with sugar, salad, fruits and juices. I am wandering if you can give me some suggestions on my diet now. If I can start taking milk, egg or freshly prepared indian vegetable curries? Thanks.",
    "doctor_response": "Hi, Thanks for posting your query. You are most likely suffering form acute viral hepatitis which has span of almost 8 weeks. First 2 weeks are symptomatic and remaining 6 weeks are required for recovery. As such there is no need of any dietary restriction as liver also needs energy and by restricting diet body is deficient in basic needs and patient starts loosing weight. As such there is no need of restriction of milk, egg, fresh green vegetables. Initial 2 -3 weeks, serum bilirubin and liver enzymes shows rising trend and it starts decreasing after its peaks. Peak is different for each & every individual. You should remain in touch with your treating doctor and  continue with normal diet and prescribed medicines. Take care, Dr. Mayank Bhargava",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for high fever in a diabetic\n\nhi... doctor prescribed Olmezest 20 mg daily one tab almost a month back.My father is diabetic since 20 years. He is in insulin. All of a sudden, he has gotfever 100-102 since last 2 days and fever is not coming down. He has undergone angioplast as well.Please advise some medicine so that his fever can come down to normal.Thanks",
    "doctor_response": "thank-you user for your queryI understand your concern.in your case I want to suggest that kindly start giving him paracetomal tablet as when he develops fever. Get a complete blood counts done. Also get a test done for dengue and typhoid each do tepid cold sponging to lower down the fever, if required.Kindly consult a local physician or you can send your reports here also.God bless",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing pain in left ribs diagnosed with acid-reflux?\n\nmy name is michelle, I am 37 and do take meds. for high bloodpressure, mgraines, depression and pinched nerves. in the last few months I have not been well. it started with losing my voice five times within three months. then severe pain through my chest and ribcage. I saw my dr, they said acidreflux. put me on steroids and I have not lost my voice in a month or so but now I am having pain tingling and numbness under my left breast in my ribs under left breast. very uncomfortable",
    "doctor_response": "Hi, Acid reflux and its severe forms can cause chronic pain lasting for months. As a first line of management, you can take antacids like Pantoprazole or Omeprazole for symptomatic relief. Avoid hot and spicy foods also. If symptoms are severe, you can consult a gastroenterologist and plan for an endoscopy. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there option other than surgery for osteoarthritis?\n\nDear Sir, My wife (44 years) is suffering from osteoarthritis. She is working woman. She can walk but use of stare case is painful. Doctor suggested to go for HTO surgery for both the knee. Kindly advice is there any option for this surgery. Thanks a lot in advance.",
    "doctor_response": "Hello, As she is just 44 I think with the exercise she can again become better and back to normal life. Usually, in Osteoarthritis (OA) of knee there are degenerative changes in the bones and due to which there will be the weakness of the muscles of the knee leading to abnormal gait (walking) pattern and by which the joint compression. Doing exercises like - static hamstring, static Quadriceps, straight leg raise, reverse walking, improving the knee Range of Motion will be beneficial. In my clinical practice of over 12 years, most patients at her age respond well to physiotherapy and exercise under guidance. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be cause of stomach burning sensation?\n\nwhat causes stomach to burn , i mean become gradually hot everytime i sit and sometimes heats up to the extent of itching. This rarely happens whenever im standing. Also the stomach becomes itchy every time im near cooker . note my ody is not hot but my stomach each of these times. Thanks",
    "doctor_response": "Hi,  Burning in the stomach is commonly due to gastric inflammation. If you are on pain killers or if you smoke, it is right time to quit. Try an antacid like rabeprazole 20 mg once in the morning. Avoid hot, spicy and heavy food.   you should be fine in a coupe of days. hope this helped.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high fever in a child\n\nMy son recently started daycare and has gotten sick.  He is 4 years old.  Last night his fever was 102.9.  I've been giving him Motrin and he has a cold also, and trouble breathing, especially at night when he is quite loud and coughs a lot.  I just took his temperature again, and it was 96.7.  He is also really cold to the touch.  That seems low to me......should I take him to the hospital?Thank you, Lauren",
    "doctor_response": "Hi, Welcome to HCM. I have read your question in detail and I know that you are very concerned about your child. By what you quote it seems that your child probably has got wheezing episode. Due to wheezing episode he has difficulty in breathing at night. Since, temperature is also low, you should take the child to emergency and get the child examined. I hope this will help you. Wishing your child good health. Take care. Regards Dr Deepak Patel, MD Pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of chest discomfort?\n\nNormal heart beat.  Just feeling of pressure being released and going from chest down to fingertips. It is like something is backing up and then suddenly releases. This is happening on a regular basis.  Like every 5 minutes or so.  Have had problems with myocardial valve in the past.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Since you are having problem with heart valves in the past, better to rule out cardiac cause first for your symptoms. So get done ecg and 2d echo to rule out heart diseases. If both are normal then no need to worry much for cardiac disease. Vitamin b12 deficiency can cause similar symptoms. So get done vitamin b12 level. And if deficiency then you need supplements. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does third stage bone cancer mean?\n\nHi doctor, I have my aunt aged 65 yrs suffering from pain on her neck. We had the doctor diagonize and found the 3rd bone on the neck has been affected by cancer and was decalared at 3rd stage. She is undergoing chemo for past 5 days...what does a 3rd stage mean? is there any special treatment she could recover from",
    "doctor_response": "Hi,Thanks for writing in.There are many different types of bone cancer classified on the cell of origin and pattern of cancer. There are locally aggressive ones and ones that spread quickly and affect other organs.A stage 3 bone cancer means that the cancer is large in size and has spread locally. She requires aggressive chemotherapy to control the cancer and see if there is reduction in size and extent after giving few cycles of chemotherapy. Some bone cancers also respond to radiation therapy and this is given after chemotherapy. I am not certain if your aunt has a bone cancer that will respond to radiation therapy. Depending on the extent and response to treatment, survival varies. In stage 3 cancer people who respond to treatment might survive for more than 3 to 5 years however since a neck bone is involved in your aunt, the situation requires to be reviewed in detail. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of peritonitis?\n\nThere was inflammatory fluid, and the bowel was eviscerated. In the proximal jejunum, there was evidence of induration in the mesentery consistent with inflammation and possible perforation.  Is this enough information to ask the surgeon for peritonitis?",
    "doctor_response": "HIWell come to HCMThe given history may be the reason before the surgeon to say that this could be peritonitis because this is just enough clinical evidence and this may be the emergency may not take a chance to think something else, hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life expectancy for a person suffering with Thyroid cancer?\n\nMy ex-husband had thyroid cancer with lymph nodes involved..  His surgery took 5 1/2 hours and he has an incision from ear to ear.  He told me he has  a 50% chance of survival.  I am concerned he is not telling me the total truth.  Do you have any ideas as to where it might return if it does.?",
    "doctor_response": "there are 3 types of thyroid cancer. differentiated, undifferentiated and medullary thyroid cancer. you have not mentioned about stage of thyroid cancer after operation. if it is well differentiated, and it is not spread to any other parts, there is good prognosis. even if it is spread, radioiodine can be given that will prolong the life. if it  is undifferentiated,  prognosis is poor",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest best treatment for avascular necrosis of femoral head\n\ndr i suffrering from avascular necoris of femoral head .bilatral stage 2. right ifusion is more than left side. i m a 39 yrs old female. nw i m undergoing auryvedic treatment lik pillichal, navarathepu and kadivasthi.can u suggest me if ths treatment is ok or can u suggest any other treatment. regards thara",
    "doctor_response": "Hi , avascular necrosis of femoral head is not benefitted by aurvedic treatment.This requires surgery b/l total hip replacement.Advised to consult joint replacement surgeon.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of lung cancer?\n\nI have slight harden bloody nose. would that be a sign of lung cancer??? 76 yrs old, copd diagnosis, smoked until 6.5 years ago. worked with molten plastic and also on a knife bevel lathe, both with out protection. Am on 2 level oxygen. grew up in a smoking household, most members of my family were smokers, I am only one with a problem.",
    "doctor_response": "Hi,Thanks for writing in.A slight hardened nose is unlikely to be a lung cancer. Symptoms of lung cancer might include the following.Cough which does not improve on treatmentLoss of weight more than 10 percent in 2 monthsBlood in sputum which cannot be explainedLumps around the neckChange in voiceRegular respiratory infectionPlease get a cancer screening done at your nearest hospital and also have chest X ray done. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly explain about the usage of Lidocaine to numb the pressure due to retainers.\n\nHello doctor, I am trying to use Lidocaine spray to numb the pressure sensation I get from wearing my retainer. Could you please tell me how to properly use Lidocaine spray without numbing my whole mouth and tongue? I just want to target the lower jaw.",
    "doctor_response": "Hello. I should recommend you revisit your Dentist to get it adjusted. The retainer might be too tight ,it should not be as tight to take a numbing spray (Lidocaine). For now if you are using a numbing spray there is no way you can stop numbing your tongue in as you cannot manage the aerosol of the spay, eventually it is going to spread and numb the entire mouth as you are saying. For the time being, I might suggest Rexidine M Forte gel (numbing gel). It contains Chlorhexidine + Metronidazole + Ligocaine. It will help you better but its action might be less than the spray but definately will help you with the issue of numbing the entire mouth. Dressin mouthwash (relieves a bit pain upon using). These two.things will help you a lot. Pressure from a tight retainer",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure a large scab on stitches in corner of mouth?\n\nMy son has stitches in corner of mouth, inside and out. He is on antibiotics, but has a large scab that covers his stitches looks scary and I can't tell if it is ok. He followed up with nurse, but I am worried. He is eight, active, and this happened 2 days ago...thank you.",
    "doctor_response": "Thanks for your query, I have gone through your query.The scab what you are telling could be the deposits or if it is a absorbable suture it can be a dissolving suture mass. You can do saline gargling. If it does not heal then consult a oral surgeon and  get it irrigated with saline and betadine.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for an ear ache in a child\n\nhow do I ease my 10 month old infant.  Sat. I took him to the ER w/pus in his ear. Come to find out eardrum ruptured. Got antibiotics but he is still very fussy. Can I do anything to help ease his pain. He is lethargic and just wants to be held all the time. Minimal fever.",
    "doctor_response": "For treatment of ear ache in child you can give him some antibiotic preferably moxikind-cv or zifi-cv after an expert advice along with ibugesic-plus or brufen junior for swelling and inflammation. Use gatiflox or soliwax ear drops to put into his ear four to five times daily. For lethargy you can give him some multivitamin drops like zincovit or polybion two times daily.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Semen become viscous. Tell me the treatment.\n\nDr semen liquification time more than 6 hours . Any treatment there",
    "doctor_response": "hi semen liquification time is one of the important parameter and play major role . we must find out the reason for it ,may be due ti infection ,allerrgy or genetic better to consult infertility specialist and get treatment u need to take some immuno modulator also. dont take stress ,be relax",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes right side abdominal pain radiating to lower right side?\n\nHi there. I have had right side abdominal pain on and off (mostly constant) for the last 6 weeks or so. Sometimes the pain radiates the lower right, but it s mostly in the upper middle or upper right and wraps around my back. I have had lab work come back normal. I have had a catscan and the wall of my gallbladder is 4mm. They also found a cyst on my liver that has grown since my last catscan in 2007. Then upon an ultrasound the cyst seemed to have also grown a small bit more. About one inch in total I believe. The ultrasound didn t show any gallbladder stones. I had an endoscopy and colonoscopy where 2 polyps were removed and sent to pathology, all non cancerous. they did biopsies of my stomach and I don t have Crohns disease, ulcers, or colitis. But the pain is so bad it sometimes wakes me up at night. Tomorrow I see a oncologist about the cyst of my liver. Being that he is an oncologist makes me very nervous. Is it possible for a simple cyst on my liver to turn into something more serious? Thanks in advance for any feedback you can give me.",
    "doctor_response": "Hi.Thanks for your query and an elucidate history. Read and understood it. The simple cyst when said to be simple means it is not thought to be cancerous or so. Stop worrying if both the ultrasonography and CT scan had said this to be a ''simple cyst''.Now about the pain in the abdomen. This is right sided - off an on - sometimes radiates to the lower right side and wraps around the back. With the normal CT scan and USG, this may be due to the following reasons:Colitis - inflammation on the large intestine on the right side. UTI -Urinary tract infection / IBS Irritable Bowel Syndrome and so on. I would advise you the following:Get the urine, stool and blood checked. Take a course of an antibiotic and metronidazole, probiotic and an anti-spasmodic . If this does not solve you problems further tests will be necessary .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a 18 year old girl have breast cancer?\n\nI am 18 years old.And i can barely see my nipples.My breasts and nipples should be like an adult right?What i mean is fully developed.Or ist normal to be like this? And on the right side,i noticed the nipple is not normal,as if its growing inward.Is this the symptom of breast cancer?",
    "doctor_response": "hi, welcome to Healthcare Magic forum. its unlikely to be a breast cancer. its called retracted nipple which many females have which is not of a great concern.it needs slight maneuvering techniques to try & get it right. may be a slow suction with a syringe which is better done by a doctor. please consult a doctor if its a real concern. have a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sneezing and nasal congestion?\n\nI started sneezing like crazy around 2 in the afternoon yesterday.  Figured it was an allergy to something.  Today I woke up with congestion (even though I can breathe through my nose) and I'm very tired.  Is this allergies or a cold brewing?  Been taking zinc just in case",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your history and would like to make following suggestions for you:1. If you have these symptoms occasionally only, I would suggest you not to worry about allergy (may be an infection or an irritating reaction to something like smoke, strong smell, fumes, or any other irritant) or even they are seasonal, you may have seasonal allergies only.2. If you have such symptoms often or repeatedly, you may have allergic causes. In that case, I would suggest you an allergy evaluation by an Allergist.3. At present, I would suggest you an antihistamine like levocetirizine or fexofenadine and a decongestant nasal spray like oxymetazoline for 2-3 days.4. Plenty of warm fluids during the days as well as adequate rest will also help you.5. Usually zinc does not cause such symptoms, so I would suggest you not to worry about zinc.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swollen ankles and loose motions\n\nI m not feeling good. Feelng sick and last night was sitting on the toilet felt I was going to pass out. Just managed to get myself to bed. Today it s the same also last night my arms felt like they were on edge. Also suffer with swollen ankles. Also have been having to go to poo a lot and it s loose Also have pains in my right side.",
    "doctor_response": "Dear patient,you seem to be suffering from systemic infection, and you should not waste time in seeing your doctor early, as early intervention can be life saving in such cases.Swelling of ankle, an  pain (arthralgia) along with loose motions are sign of reactive arthritis, which can be even viral.See your doctor and get examined, you should not wait for your condition to get even more worst.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on scalp\n\nI have a huge lump on the back left side of my scalp under my hair i have been having outbreaks of mrsa and suspect that is what this is but its tender and sore to touch also has a burning sensation my husband has sone bactrim and cefalexin from when he had an outbreak would these 2 work",
    "doctor_response": "Welcome to health care magic. 1.The history and symptoms suggest the possible cause could be infective collection.2.Hair follicular infection / inflammation with collection with in. 3.IT needs to examine, if infective in nature and large in size, a small incision and drainage followed by a course of antibiotics will be helpful.4.Before you take any antibiotics - need to get examined, and assess the nature of lump, source and its extensions.5.Suggest to see your GP, get examined, if required an ultrasound lump - followed by the treatment.Good luck.Hope i have answered your query,any thing to ask ? do not hesitate to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is Stiff Person Syndrome?\n\nHi, may I answer your health queries right now ?  Please type your query here...I have been diagnosed with Stiff Person  Syndrome and the doctor says my GAD levels are very high at 2,200. Can you explain this to me? I'm 64 and 5'4\" and weigh 140 lbs. I do not have diabetes.",
    "doctor_response": "HiThanks for your queryBased on your query, my opinion is as follows1. Stiff person syndrome is a progressive disorder of motor neurons, characterized by muscle stiffness/ painful spasms of spine and lower limbs.2. It is autoimmune in origin with presence of GAD antibodies. 3. GAD antibodies are glutamic acid antibodies, which act against the nerve terminals in central nervous system and against beta cells of pancreas. 4. Presence of these antibodies in CSF correlates with CNS symptoms and the disease progression5. Beta cells are the site of insulin production, when targeted makes an individual prone for type 1 diabetes mellitus. So there is a risk of having diabetes with the present levels in your case.Hope this helpsRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. is there any medicines for dysmenorrhea ?\n\nHello doctor, I am a 24 year old female, who was diagnosed with dysmenorrhea about two years ago. Last year I was given Mefenamic acid by my doctor to take for the pain and nausea. But, the medicine is not helping me, I still\u00a0have pain and vomiting. Is there anything else I can take for this?",
    "doctor_response": "Hi. Dysmenorrhea is not a diagnosis, it is only a symptom. Let me put few possible causes and their evaluation and treatment forward. At this young age, the most common cause is spasmodic dysmenorrhea. The cervix is tight and the blood when trying to make its way during periods, will stretch the canal and cause pain. Pain is only during periods, on day 1 and 2. After that, the main bleeding is over, and pain disappears. If the amount of bleeding is more than normal, you can get a scan to rule out any masses or adhesions. The pain can be controlled by taking birth control pills for six months or more. It will stop ovulation, reduce the amount of blood loss and has no side effects, and it can be taken for any number of years. If you are sexually active, then it can be infection around the uterus know as PID (pelvic inflammatory disease). Vaginal infection is transmitted during sex, so both you and your partner have to be treated at the same time, or else you will get infected again. You may have white or yellow or grayish discharge with or without itching, foul smell, pain during sex. Before treatment, confirm that you are not pregnant. I suggest you try taking the following. Do treat it, as delay may send the infection inwards and may affect both of you. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. Another possibility is endometriosis, every month the blood flows out, but a small fraction also flows into the abdomen through the tubes. This can settle around the uterus and cause adhesions onto the surrounding muscles, ligaments, and bones. This causes throbbing lower abdomen pain before periods, which gradually increases and stays even after periods are over. Sex is very painful. A scan can be done and the restricted mobility of uterus can be seen. This can be solved by reducing flow or stopping periods with hormone pills. Get an ultrasound scan of the pelvis, to rule out any uterine polyp or fibroids. There may be nothing but pain only, gradually increasing every month. Hope I have clarified your doubts, do write back. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes body itching,muscle pain and hair loss with goiter?\n\nI am 44 yrs old female have nontoxic goitre last 12 yrs ,experiencing itching in body , muscle pain , hair loss .low vit d3 and calcium and b12 .,slight high testorone .not taking any medicine other then vit d and calcium, prescribed with Morris 5 ,3 times a week ,what would be side effects",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As per your case history of goiter, my treatment advice is - 1. Hair loss and itching are associated with goiter. 2. Take good nutritious diet full of green leafy vegetables and milk. 3. Take an iron supplement and vitamin B12 supplement. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Done stent surgery for jaundice. On tamoxifen. Has diarrhea, poor appetite. Cure for symptoms?\n\nMY SISTER HAS BREAST WITH METS TO LUNG ,ABDOMEN ETC.SHE IS BEING TREATED WITH TAMOXIFEN AND RECENTLY HAD TO HAVE STENT SURGERY FOR SEVERE JAUNDICE. SHE HAS CONSTANT DIARRHEA ,POOR APPETITE. EXTREME LYMPHEDEMA LEFT ARM AND NOW HAS GROSSLY SWOLLEN FEET AND LEGS. TO ME SHE IS DYING AND HAS BEEN GETTING MUCH WORSE SINCE SHE WAS DIAGNOSED IN JAN 2013. WHY DO THE DOCTORS NOT SEEM CONCERNED OR AT LEAST TELL THERE IS NOTHING THEY CAN DO. SHE IS VERY ANGRY.",
    "doctor_response": "Hi and welcome to Healthcare magic. Thank you for your querry. I dont think that doctors are not concerned, but unfortunately this is terminal malignant disease and she needs now only palliative treatment so doctors cant help much. she needs good nurse and palliative institution and you familly support. You need to treat pain,care for nutrition and prevent ascites and infection. EVerything else isnt in your or doctors hands. WIsh you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for suicidal behavior\n\nMy mom is called me and she was drunk and she was telling me how much she loves my and no matter what I m the best thing that happened to her. Scared and nervous I had my dad rush me to her apartment and she was just sitting there watching tv. After talking to her for a bit I found out she was suicidal and has had suicidal ideations for some time now. And my brother says its because of me and that she thinks I hate her. I comforted her as much as I could and when I felt she was calmed down I left. What should I do? My mom wants to take her own life because of me.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  Suicidal ideation is normally an after effect of depression. Not clinical depression. Disappointment in life as unforeseen events take place can also trigger disappointment and usually leads to a depressive state for some time. Substance abuse can also lead to suicidal ideation and depression. Therefore, correct diagnosis is necessary. Consult a psychologist / psychiatrist for diagnosis and treatment. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes palpitations and anxiety?\n\nramipril,my husband is 5\"7 weight now about 227, after losing about 35 lbs. has come off ramipril , after taking about 3 1/2 wks.  previous  on metformin, for about a years . he is 59 yrs . He has had many of the side effects , but the anxious, nervousness and racing heart come and goes mostly at night and in the morning .  How long should this be lasting he is on no medication now.    thank you,",
    "doctor_response": "Ramipril has no effect on the heart rate, my recommendation would be for a Holter monitor to evaluate the symptoms of a racing heart.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Kidney stone, severe pain, upper abdominal pain. Cause of upper abdominal pain? How long will this continue?\n\nI found out I have a kidney stone and been experiencing vary bad pain for usually about 3 hours a day. The nurse thought it was wierd when I me roomed my upper abdomin also hurts suing this time. I thought maybe my zipfoid process? It gets pretty intense. I had reg discomfort for about 2 weeks before this but now wonder why it hurts so bad when it does and why does my upper an hurt if it shouldn't be? Also how much longer is this going to go on for?",
    "doctor_response": "kidney stones are common these days not to worry there good medical and surgical methods for this..now for your kidney stone i suggest u consume plenty of water where smaller stones tend to pass down with urine..for if your pain worsens you may take effective pain killers like tramadol for once if you find no relief then consult your surgeon who would advice a sonography of abdomen..there are surgical procedures like shock wave lithotrypsy which has given good results..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for dust allergy\n\nmy daughter is suffering by dust ,smale and unknown eliments from a long time according to doctor.and she getting breathing problem at those times.she is now 8+yrs old .reading in class three.doctor has given her inheller and a tab montare.in a deep suffering condition we have to give her asthalin and budecord by nebuliser mechine.grouth rate of her health is very poor .can not want to eat food.less energetic .so what i have to do now.pls give me your valuable suggetion to keep her normal .we both are very much orrid about that. atanu bandyopadhyay. jalpaiguri.0000 mail - YYYY@YYYY",
    "doctor_response": "Hello Mr Atanu Bandopadhyay,I went through your daughter's history and would like to know more about her as follows:a. What are her nose symptoms - running nose, sneezing, nose congestion - and how frequent?b. What are her chest symptoms - wheezing, breathing difficulty - and how frequent?c. Does she get symptoms while physical activities like exercise, outdoor games, etc?d. Does she have frequent headaches?e. Does she have eye symptoms - red eyes, itchy eyes, excessive watering?f. Does she have any digestive complaints - frequent acidity, vomiting, constipation, frequent stomach pain, etc?g. Does/did she have any skin allergies like dermatitis or urticaria?h. Day symptoms or night symptoms?i. Seasonal variations?Above details would help me to know more about her health and therefore to make more specific suggestions for her.At present, from your provided details, I would like to make suggestions for her as follows:1. For identification of allergies, I would suggest her skin testing for common air-borne allergens like house dust mites, pollens, molds, insect proteins, animal dander (if you have pet), etc. This will help you identify the substances causing allergies to her as well as to know the measures to avoid them.2. Based on allergy testing, an Allergist-Immunologist may also prescribe her allergen specific immunotherapy which works on immune system to gradually improve her allergy symptoms over a long period.3. For symptom relief and prevention, I would agree with your current treatment. I usually suggest my such patients regular levocetirizine + montelukast.4. Allergies and asthma are a bit worrisome but not very much. With proper understanding of the disease, care and use of medicines children can live very normal lives like most other normal children.5. Please avoid exposure to dusts, smokes and air pollution as much as possible.6. A healthy diet rich in vitamins & minerals as well as regular physical exercise including Yoga & Pranayama will also help her in a long run by improving her immunity and lung capacity respectively.Hope above suggestions will be helpful to her.Should you have any further query, please feel free to ask at HCM.Wish your daughter the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can fertyl super and deviry cause missed period?\n\nI was under medication of fertly super 100mg from 7th day of my period till 11th day as advised by a well known doctor and also taken deviry 10 mg tablet for 10 days from 19th day to 28th day. my period was on 14th Jan and have missed for 5days.kindly advice..",
    "doctor_response": "Hi,Pregnancy test should be done to identify the cause of missed period. Deviry contains female hormone and taking the drug enhances uterine endometrial growth. On stopping the drug, the uterus sheds, causing withdrawal bleeding.Withdrawal bleeding usually occurs 3 to 5 days after stopping deviry. You can wait for maximum 10 days. If bleeding does not occur, I would suggest you to visit your gynaecologist since you may have hormonal imbalance.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Saranya Ramadoss, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a growing lump on the leg caused due to an injury?\n\nMy 8 mo old German shepherd puppy ran straight on into my 38 y/o daughters leg; she says a lump is now growing and it is tender. She states she also has shooting pains from it. I suggested ice. Shall we alternate ice and heat? What can we do to relieve the pain and reduce swelling? Thank you",
    "doctor_response": "i think it's either  abscess or infected haematoma which need to be drained by an incision  alongwith antibiotics and pain killers . you need to go urgently to a surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are chances of cancer in liver with biopsy 'suspicious for cancer'?\n\n52 year old male. Have a lump in my liver. Biopsy came back  \"suspicious for cancer\". What in the world does that mean? Had a PET scan today waiting a week to see the doctor.  How likely is this to be cancer?  I have not had a liver function test in about 3 months and thosse were mostly normal.",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.There are more chances to be cancer than not, but it should be confirmed with repeated biopsy and then therapy may be planned.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.DR. Ivan Rommstein",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for controlling behavioral changes\n\nI have a 9 year old daughter who for years has been lashing out and hitting me, throwing things and shows no remorse, she has just been hitting me on head while I was driveing because I didnt stop to get a DVD. I have had counselling for both of us, seen paediatricians and she is now undergoing sandplay therapy. Am at my wits end as she is getting bigger and stronger and extremely physical towards me and do not know what to do",
    "doctor_response": "Hi dear,you need to consult psychiatrist rather then pediatrician.your child is physical towards you only or others also?she is extremely stubborn as described by you.you need behavior therapy   and if needed medication also.for that detailed history and examination is necessary.hows her child hood, family environment etc?is there any other signs and symptoms she have?Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause pain in face under the eye starting from cheek bone?\n\ni have a sharp striking pain in my face just under my left eye , but starts on my check bone near my nose and runs down just a small bit. but the pain is sharp and last just a second for each strike. comes and goes, been doing this all afternoon and is still doing it now at 1:30 am.",
    "doctor_response": "Hello, Your symptoms might be the early onset of TRIGEMINAL NEURALGIA Disease. Trigeminal neuralgia is a painful condition that affects the trigeminal nerve, which carries sensation from your face to your brain. You may initially experience short, mild attacks. But trigeminal neuralgia can progress and cause longer, more frequent bouts of searing pain. It's advisable to go and visit a Neurologist who might ask you to go for MRI Brain for a confirmed diagnosis and treatment. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Saurabh Singh Rajan, Sports Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be done to treat pain after hiking?\n\nHi dr my friend was in a accident 4 days ago and was discharged from hospital his ears are still bleeding and he complains that I his head feels heavy... with that said yesterday afternoon he felt beter and went hiking all these pains came back last night...",
    "doctor_response": "Dear Friend.Hi , I am Dr Anshul Varshney , I have read your query in detail , I understand your concern.Pain in head can be due to Post traumatic Concussion syndrome.But bleeding ears is not acceptable.I would advise you to get treatment from your ENT specialist.Bleeding ears also require a CT Scan head to be done.For pain in head , he can take after discussion from your doctor Tab Escitalopram 5mg twice a day for 7 days.This is my personal opinion based on details available here.  If you still have any query you may please ask me.Stay Healthy. Dr Anshul Varshney , MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can bruised chest and rib be cured ?\n\nhi there I was in a car accicdent 5 days ago hit a powerpole i have rib bruising and chest bruising.The front of my leg is so sore to touch but has a numbing feeling but sore from below the knee to da middle of my leg on the bone yet I can walk fine its aa wierd sensation .",
    "doctor_response": "Hi and welcome to HCM. Thanks for the query.Well,first it should be evaluated by xrays to rule out fractures. if there was only contusion then hematoma is usual sign of it and it should subsde within several days. you should rest,apply ice cmpresses or heparine gel on it and be patient.Wish you good health. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes right flank pain?\n\nHi, I'm a 25 year old female with no serious medical history.  In the past 2 years I have had serious right flank pain that feels like someone is sticking a knife into my lower right back and it comes out my front.  It's a radiating pain, that comes and goes with no noticible pattern.  I've been tested for Kidney Stones, had ultra sounds of my abdomin and bloodwork done.  I dont know if it's something internal or muscular.  Help!",
    "doctor_response": "Hello and welcome to HCM.As an Urologist, i can understand your concern.Your pain appears to be typical of a right sided ureteric stone.You need to have a CECT(contrast-CT),to rule out a ureteric stone, easily missed on an ultrasound scan.You may take an anti-spasmodic tablet for pain.Once the CT scan is done,the cause can be easily made out and proper treatment advised.  Drink at least 12 glasses fluids daily.If you want my expert opinion,send the report to me,as a direct question.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for breathing difficulty after undergoing angioplasty\n\nSir, my father has facing birthing problem and I am admitting him on R.N.Tagore Hospital Kolkatta, under Dr.D.Roy. 13th Aug, Angioplasty done on left arteries and 15th Aug get riles from hospital. Then my father was fill good, maintain all medicine and suggestion properly as pear doctor suggestion, then after 4 day My father fill highly birthing problem, that time 10:30pm and I am phoned to doctor and he suggest a 20mg Lasix injection, because we are stay above 100 Kilo-meter fare of hospital and next day take my father to hospital, there doctor test well and properly, and relies that day. Like this time to time my father was facing birthing problem 3 times after last birthing problem he have get to improve still 1 month, then today he still decrees his health condition and back to the first stage before Angioplasty done he had. I am fill helpless what can I do? Please help me\u2026",
    "doctor_response": "After coronary artery disease breathing difficulty is mostly because of less pumping of heart. tell patient to reduce his water intake especially after evening. diruretics like lasix will help him to relieve the symptoms",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of lump under my armpit?\n\nHi, im 16 and I had a small pea sized lump under my armpit, it has now gone, but now I have found another small lump on the neck in the throat area.. It is under the skin and painful to touch. I have also knowticed that I have had swolen glands over the past few days although I have no flu like symptoms.. I haven t been to see a doctor as I feel physically fine.. just wondering what is causing these lumps and whether it is potentially dangerous ? Thanks very much",
    "doctor_response": "Hi,Welcome to HCM.I studied your query.I understood Your concerns.Dear You seem to have 2 separate health  issues in armpit and in throat/neck.Both are of infective origin. A swollen gland on this backdrop,Makes ME to suggest you to check up with ENT doctor.I would treat such a case In My clinic-By giving a antibiotic treatment to evaluate its regression.If not regressed,I Would rule out Chronic JD(jugulo-diagastric) Lymphadenitis due to recurrent old throat infections.Other possibilities of NHL/HL Lymphoma need to be ruled out,with FNAC biopsy and by CT studies.I would hence advise you toHope this reply would satisfy and would help you to plan treatement with the right consultant doctor.Contact with a Followup Premium question to ME.Will appreciate your Hitting  thanks and writing  excellent review comments to help needy patients like you. Good Day!!Dr.Savaskar.Senior Surgical Specialist  M.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Has prostate cancer. PSA down, CEA up. Denotes colorectal cancer?\n\nMy fiance has prostate cancer . We just ran his b/w again today and his PSA is down from .77 to .55 in 2 months but his CEA is up to 13.9. The highest it has ever been is when first diagnosed 2 and half years ago; 6.9. After prostatecomy and radiation , it has hovered around 1.9. The last time CEA was run was 13 months ago so it jumped from 1.9 to 13.9 in a year. Is this a sign of new cancer; colorectal?",
    "doctor_response": "Hi and welcome to Healthcare magic.Thank you for the query.CEA is a marker for colorectal carcinoma but also some other conditions can cause its elevation,this is not very specific and this is usually used in following patients with confirmed colorectal carcinoma.. This is just slight elevation and i dont think you should be worried, but I suggest to do colonoscopy just to rule this out.Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lump in the neck, advised x-ray to detect cancer. What could it be?\n\nMy sister neck has a lump on it,she went to Dr. and he her go o hospital to get x-ray they told her it was maybe cancer or and absess(she had popped an absessed tooth a few days before)and she would have to wait for someone to look at it and sent her home. They told her if her neck goes back down she should get back to hospital ASAP because that means it busted and if she makes it to hospital.They should have kept her.What could ot be?",
    "doctor_response": "Hi, Thanks for query, As she had popped an absessed tooth few days before the chances of lump in the neck is Lymphadenitis.This is an infection of lymphnode. The chances of malignancy is not there as it discharges pus. She needs antibiotics & check up to rule out it's tuberculos nature. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can anti hypertensive be taken after parathyridectomy ?\n\nhi,dear dr, i am suffering from hyper parathyroidism and  i had undergone for parathyridectomy three years back but today i am suffering from high level of bp flactuation renging from 170/120 .the question is did i take anti hypertensive medication or not please suggest me .",
    "doctor_response": "Ya hypertensive medicine can be taken after parathyroidecty Rather if you have high blood pressure you have yo take anti hypertensive medicine. Go to your doctor and take medication accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest opinion on cancer treatment\n\nDear sirFrom Dr : Nabih OthmanTop urgent Opinion please my sister Egyptian she is 55years old cancer ovary detected on 2005 ovaries and uterus and pelvic lymph nodes was removed followed  by radiotherapy & Chemotherapy treatment follow with all routine investigation  till 2011all were within normal limits. On January 2011 bony metastasis in neck of left femur and abdomen and ribs was detected in pet ct bone curettage done then chemotherapy given but no improvement on 17/7/2011 in pet ct  metastasis to liver seen 5.6x6.2 cm mass chemotherapy given immediatelyplease I need top urgent opinion if I can transfer her to imminent  ( Gustave Roussy Institute for treatment with new trained of cancer treatment such as freezing and thermal and stem cells or any other new strained she will be on my own coast and thank you Dr: Nabih OthmanEgypt - Cairo Tel 00000000E. mail ; YYYY@YYYY",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your sister's situation and problem. She is having metastases in liver and bone. This is classified as stage 4 cancer, inoperable cancer. In this stage only palliative treatment in the form of chemotherapy, radiotherapy, nutritional support and pain management are indicated. Stem cells, thermal therapy etc is useful in stage 1 - 2  cancer. Once cancer is in stage 4, these newer treatment will not help. So better to consult oncologist and discuss all these. Start appropriate palliative treatment for her. Hope I have solved your query. Wishing good health to your sister. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the lower ribs and constant aching in the left arm?\n\nhi,i have a pain in my lower ribs, left hand side,i was on steroids and antibiotics for one week,,no change,,so given different antibiotics on the second week,,which also do not seem to be working ?? i,m also getting a constant aching in my left arm",
    "doctor_response": "You have to start with nervemax Sr tablet in night at the time of sleep. Tab. Myospas twice a day.. ND cap.firstclave.... Then after five day show to nearest surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What measures can be taken to manage vomiting during travel in a child?\n\nHello doctor, My daughter's age is 05 years 05 months 24 days. Her height is 41 inch and the weight is 19 kg. She vomits when she travels by car. Tomorrow we will start our travel by car and my assumption is she will start vomit. Earlier we gave her Ondem syrup. But it did not work. So, we request you to kindly prescribe something (like Avomine tablet) to get rid off. Please note that everything is normal. She is a little fragile. She did not vomit in the train and plane journey.",
    "doctor_response": "Hi. Your daughter has motion sickness. It usually occurs in bus or car. You can give tablet Avomime \u00bd tablet 30 minutes before the start of the journey. Also, make her sit near the window. Also, good ventilation with fresh air lessens the vomiting sensation. Do not give too much food before the journey. Peppermint also helps. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the sperm test normal?\n\nWe are trying to conceive and my husband has a liquefaction time greater than 60 minutes and a high ph level from his semen analysis. He has taken antibiotics and there is no sign of infection.  He has had 3 semen analysis' done and results stay the same.",
    "doctor_response": "hai,i will address your issue. liquefaction time high indicates infection  and high ph  will destroy the sperm.semen culture will rule out infection . to do semen culture take opinion from lab personnel regarding the collection of semen procedure because culture is more sensitive investigation to rule out  any microbial origin or growth in the sample without influencing any contamination from external source.if your semen culture is negative. follow my below mentioned food advise.follow healthy diet plan includes nuts (almond,cashew,pea nuts,pumpkin seeds etc)milk and milk productsdates,wheatsesamejaggery,.pomegranate,arrowroot,cucumber seed,fig etc. add millet type of food (ragi,bajra) in daily food intake.Avoid junk,fried,caffeinated foods and stress(highly influential),tobacco,alcohol.be hydrated,do exercise.follow this for one month  and do a semen analysis again if still the problem persist consult an infertility specialist to rule the cause.thank youhope i answered your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can anxiety and low mood be side effects of taking Fluticasone Furoate?\n\nHi, I have been taking Fluticasone Furoate for 3 weeks now and have been experiencing anxiety and low mood. I am wondering if these symptoms can be a result of the medication. (I do not have a history of these symptoms, although, I have a lot of stress in my life at the moment).",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.Steroids can cause mood disorder. If you have symptoms after the onset  of steroids then the medication has to be changed as the mood will deteriorate further. If the medications cannot be changed then you need to be started on a a anti-depressant to alleviate the sufferings. 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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "PCOD, done follicular study, taking Susten. When should I have sex to conceive again?\n\nhi, i am 27 years old and i am PCOD patient. before my marriage i m having irregular period i went to the doctor she advice me Diane-35 and benforce i had those tablet even after my marriage.i got married on 21st jul 2011.i skip the tablet in april 2011 but my period was regular till oct2012.after that again i starts diane 35 and benforce but no progress i notice i changed the doctor now my present doctor ask me to do some test( blood , urine )and she advice me glucaphage ,zevit.then she ask me to do folicular study on 16day of my period my ovulation starts and on 14th and 15day my doctor ask me to have sex.from 17th day i am using susten vt 200mg.today is my 19th day i don t understand when do i have again sex to concieve did it required or not to get pregnant.",
    "doctor_response": "Hi madam. Well you don't get frustrated because you have fair chances of conception if you are ovulating.Now for conception purpose you need to have intercourse during and around the ovulation period say  48 to 72 hrs pre and post ovulation.But for your own pleasure and family life you can have intercourse later also,though it may not help you to get pregnant.You continue the medicines as prescribed by your doctor.. All the best madam.BYE TAKE CARE",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My father gets intense pain in thighs and shoulder girdle. Please help.\n\nHello doctor, My 85-year-old father had mild pain in his thighs and shoulder girdle for two months which intensified in the past two weeks to a point that he could not get up from his bed. He was started on oral steroids 30 mg once daily for the past three days and has shown a 40% response but cannot stand. Blood tests were done yesterday showing normal serum electrolytes, bilirubin, TSH, and CBC with some iron deficiency. Raised values are CPK - 272, BUN - 50, SGOT - 50, SGPT - 100, and leucocytes - 29000. His Hb is 9 and eosinophilia 42 since before. Kindly suggest the diagnosis.",
    "doctor_response": "Hello. Well as per your history, it does look.like a diagnosis of polymyalgia rheumatica. I would like to ask you a few more queries related to his illness. When is the pattern of pain more mornings or evenings? Does he experience morning stiffness as well? Any history of weight loss or appetite loss? Any history of jaw pain or headache or fever? Do you have his reports of ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), rheumatoid factor available? As they are the most important to monitor and diagnose. Did they do any scans of the chest and abdomen? As of now the reports do not seem very great with high leukocyte count and low Hb. Diagnosis of polymyalgia rheumatica looks certain but we should rule out any underlying trigger.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest therapy for mood swings\n\nHi, may I answer your health queries right now ? Please type your query here...I am having problems with mood swings that I am Completely fine then Someone says something that I dont want to do or want something different. It is almost like a childs tempor tantrum. I dont know what to do about it it is hurting my relationship. I am on zertec and singulair and yaz. What is wrong?",
    "doctor_response": "you are having bipolar disorder.drugs like lithium and valproate will cure your problem.kindly visit a nearby doctor.you will be fine soon.hope my answer helped you. take care. i wish you good health.plz rate the answer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dark stool during pregnancy?\n\nHi, I am currently 12+ weeks pregnant. I noticed my bowels have been dark (towards black) the past couple of days. I had constipation problems once awhile but these 3-4 days it has not occured. Passing bowels have been pretty easy. I am taking Folic Acid pills since I am pregnant and this week, I ve also started taking DHA, Calcium, Obimin supplements. May I know what is the cause of dark stools and would this be dangerous to my baby? Please advice. Thanks. Janice",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the colour and consistency of the stools depend on the diet and also on medication if taking any.Even in case of piles or anal fissure which are associated with constipation there is fresh blood in stools.So the dark.colour might be due to vitamin supplements.Even this type of stools is common during the iron tablet intake. Nothing to worry.As constipation is routinely seen in pregnancy  take adequate fluids upto 3 litre per day and high fibre diet to prevent constipation.Hope this helps.Best regards ..Dr .Srilatha",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am a chronic Idiopathic thrombocytopenic purpura (ITP) patient since birth and i have low platelet count\n\nI am a chronic itp patient since birth now i am 51 years male having creatnine 9 and urea 240..i dont want to undergo dialysis because of low platelet count as complications may increase i am nervous though slowly creatnine is coming down shall i avoid dialysis",
    "doctor_response": "Hi welcome to Healthcaremagic Hi..., The creatine and blood urea level are very high.. emergency dialysis must be done to prevent further complications.... please do not neglect the condition, get treated early.... Hope I have answered your question.. Takecare..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is croup, related with tongue ulcers in infants?\n\nmy 13 month old has ulcers on her tongue red swollen gums very tired fever highest 105.5 had a fever for 5 days. greyish coating noted on some teeth. went to doctor and was diagnosed with croup but I doubt it now. these symptoms did not come about until the next morning.  What could this be?  She was playing with toys at the dentist office the day before and I think she picked up something there. I am taking her back to the doc in the morning.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query symptoms such as ulcers on tongue, swollen gums along with high fever seems to be due to dental infection such as gingivostomatitis. I don't suspect this to croup as your child has no symptoms of breathlessness and decreased activity. I would suggest you to visit general physician once and get it examined again and get blood tests done. Start treatment after proper diagnosis. You should give child antibiotic along with Ibuprofen or acetaminophen. Apply Dologel on tongue and oral cavity. it will soothen ulcers of oral cavity. Give child plenty of water and liquids. Give multivitamin tablet as well. Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "My testies size is slightly increased. And for this i am getting pain\n\nhello sir, my testies size is slightly increased (suj) suddenly due to this i am suffering from pain. When ever i sit on chair the pain increases. Pls suggest a solution.",
    "doctor_response": "This could be due to orchitis or even hydrocele. Avoid wearing of very tight clothes.Internally use gokshur guggul and kaishore guggul one tablet each tds",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chronic rash on inside of thigh and lower scrotum?\n\nI have a chronic rash on the inside of my left thigh, crotch and part of my lower scrotum.  It is characterized by reddish bumps at the base of my hair follicles in groups of approximately 8 per square inch.  I wear a gel liner under a hard plastic prosthetic socket on my upper left leg.  There is an obvious association.  I have tried anti-fungal and anti-bacterial creams to no avail.  Could I have a contact dermatitis condition?",
    "doctor_response": "hello.Anti-fingal and anti-bacterial creames should be used longer time, very patiently, sometimes even fo 3 - 4 weeks. Also you should wear more cotton underwear.You also should visit your dermatologist, since you may need some corticosteroids creame localy, that might be helpfull.All teh best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "No ovulation and pregnancy even after treatment\n\nI have been suffering from irregular periods for past 2 years that i am married. its always that after taking uphaston 10mg twice a day for 5 days that my periods come. For past 7 months we are trying for conception but since the periods are irregular so no ovulation and hence always a negative result. My gynae tried Follicle monitoring ultrasounds on third day of perio and then a dose of siphene 100 mg for 5 days but follicles were never right sized. in this cycle also siphene gave no results and then i took duphaston for 5days twice daily but now its 10 days after finishing the dose but no periods. I am 25 years",
    "doctor_response": "hi, If siphene is not sufficient,inj. of HCG can help in further maturity & rupture of follicle,This has to be done under expert guidence of your gynac If you are over wright &have PCOD, Try to reduce ,it may help ovulation. Even Tab Hyponid 1 tab twice a day helps in a long way. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest suitable medication for deworming in children under 5 years\n\nHi, both my 2 yr daughter and my 3 and a half yr son are due for the regular deworming (& Vit. A). i have just procured Albendazole, for them, but have noticed that the enclosed info sheet contains a precaution that the drug has not been studied in children under 6 yrs of age. what should i do? Is there a more suitable drug for their age?",
    "doctor_response": "Albendazole can be used freely in any child above the age of 1 year as there are no serious safety issues. Each of your children will need 10 ml once.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Where can I get treatment for abdominal pain due to obstruction in the intestines ?\n\nI get cookery pain in my abdomin due to obstruction in my intestines,because of this i had to take only soft diet .Igot TB in my intestines in2007 I underwent laprotomy in that process now all that is cured but this pain in my intestines is left which is very painful, is there any treatment other than operation to cure my problem, is there any possibility that i can eat anything like others in my lifetime,i am 30yrs old now.I take buscopan and rantac tablets when i get this pain,it takes 4to5hours to relieve from the pain.Please help me what is the treatment and where i can get? is there any 100% cure for this problem.",
    "doctor_response": "Hi well come to HCM. Partial obstruction in your case could be stricture in intestine due to tuberculosis.If the tuberculosis is cured than final answer is surgery depeding on extent of stricture. may remove the stricture part of intestine or may do some by pass surgery as per surgical convinience. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for hot flashes?\n\nI have been getting very hot lately and randomly I will sweat a lot like A LOT my face and hands will lose all color turn white or green ish I can barely talk because I get tunnel Vision then I usually passout or throw up or both then its all better later on. Only thing I have noticed is I'm not hydrating that much the days it happens",
    "doctor_response": "Hello!Thank you for asking on HCM!Regarding your concern, I would explain that these symptoms could be related to different disorders: - low blood pressure - pheochromocytoma- thyroid dysfunction- carcinoid syndrome. For this reason, I would recommend you to closely monitor your blood pressure and heart rate during the day. Further tests may be needed: - a chest X ray study- an abdominal ultrasound- thyroid hormone levels- blood electrolytes- urinary metanephrine levels. An abdominal MRI study may be needed if an adrenal gland dysfunction or carcinoid syndrome is suspected. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for depression and disinterest in life\n\nmy daughter has cigna insurance she has been diagnosed as massive depression her life time meds that she has to take her dr does not take cigna she is now getting very depressed and stays in bed all day has no intersed in anything need a dr in fl help",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  If you are sure that your daughter is suffering from depression (mental disorder), she needs expert psychiatric treatment. In this juncture, insurance or money do not count. What counts is the cure of the problem. Please consult a psychiatrist at the earliest.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Steroids be taken to improve muscle strength in legs?\n\nI have been suffering from a loss of strength in my left thigh muscle for the last 18months now. There is no pain and I am an active fit person. I am 42 yr old male. It started when I would play tennis and it would be fine for the first 30 minutes but then my left leg started to feel like it was losing strength. My left foot would start to drag as I had to concentrate to lift my leg up as the leg felt weak. By the end of the game I was totally struggling to walk properly and felt paranoid that I had to over exaggerate my walking. The left leg was weak and shaking. Once I rest for 30 minutes its fine and back to normal. I have got by with it but it is starting to impact on my normal everyday life as the weakness comes a lot sooner now. Just walking around the shops and I can start to feel the weakness in my left leg. Just cutting the grass today was a struggle. the left leg is significantly weaker than the right one and sometimes when the leg is bent it sometimes feels like I am going to fall over. I have no pain anywhere on my body. I had an episode in 2007 for about 3 months where I lost strength in my left leg for about 10 seconds when I was running and then it would be fine. This just corrected itself after 3 months and went away I am considering getting some steroids to help improve my muscle strength.",
    "doctor_response": "Dear Sir/MadamI have gone through your query and read your symptoms.In my opinion, you have developed an misconception, no steroids are going to help you. PLEASE DO NOT TAKE STEROIDS.Now your symptoms are of spinal canal stenosis, which is a condition where the diameter of the canal from where the nerves come become less and gradually with work causes weakness, pain, and numbness in the legs. this can be easily seen with an MRI of the spine. Please consult a spine surgeon or a neurolgist and get yourself examined and evaluated.I hope that answers your query. If you want any more clarification, contact me back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can we treat my dad who has allergy to tomato and potato ?\n\nHello doctMy father suffers skin diseases when ever he eat either he eat many vegitable like tomatopotato etc whats the problem he is causing Please answer me",
    "doctor_response": "Hi,thanks for query.Please take him to a skin specialist for examination.some basic tests like blood counts,blood sugar are required.Without proper diagnosis treatment is not possible.Please make a list of foods that lead to allergy.This can definitely help in getting clue about the cause.bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Side effects of duphaston\n\nHi Dr, Iam on duphaston for 10 days .feeling slight abdomen pain.Is this normal? Does this tablet has any side effects?",
    "doctor_response": "Welcome to Healthcare Magic Good Day Duphaston's possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect. Headache Nausea Dizziness Bloating Skin reactions such as rash and itch Breast tenderness Menstrual spotting between periods Abdomen pain (20% of patients have this) Are you passing gas or having loose stools. Please visit your Gynaecologist to know for sure what is causing the pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On amox for a tooth infection. Swollen lymph nodes in the neck. Ear pain with rash on the lymph nodes. Why?\n\nI was put on Amox a little over a week ago for a possible tooth infection - a tooth which needed to be extracted.  After about 6 days on the Amox, I developed swollen lymph nodes on the back of my neck and just inside my hairline above my neck, both on the same side of my head as my problem tooth.  My dentist said we should go ahead and extract the tooth, but go ahead and finish the course of the Amox.  I had the tooth pulled 2 days ago, and I am having extreme ear pain and now a rash around the swollen lymph nodes.  I am taking 600-800 mg of Advil every 4 hours to try to alleviate the pain.  Should I be concerned about any of this? Thanks",
    "doctor_response": "Hello, Thanks for writing in. The tooth infection has severely progressed and lead into-lymphadenopathy,fever,headache etc. The ear pain and rash around the lymph nodes will subside gradually as the tooth has got extracted. Take warm saline and betadine gargle frequently. Maintain good oral hygiene. Brush your teeth twice daily using soft-bristled toothbrush. Rinse mouth after every meals. Use chlorhexidine mouthrinse to gargle. Please do visit your dentist in every 6 months. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My diabetic father developed some skin rashes with discoloration and pus?\n\nHello doctor, My father is 65 years old. He seems to have developed some patches on his skin. They are blackish red and also seem to have some pus. He is a diabetic and currently under medication for diabetes, heart and urine issues.",
    "doctor_response": "Hi. I have seen the picture. (attachment removed to protect patient identity). It is diabetic dermopathy with bacterial infection. Skin lesions like carbuncle, ecthyma are common in diabetics. Diabetic microangiopathy is responsible for diabetic dermopathy. Usually, they appear on legs but may occur on forearm (as in our case). Post-inflammatory hyperpigmentation are seen on forearm of long-standing diabetic patients. Also, faulty insulin injection techniques cause induration, scar formation, keloids, and abscess formation. The treatment is control of diabetes. Follow the adage do no harm. Potent topical steroid like Tenovate cream at night for 15 days can be tried (under occlusion). Focus should on preventing ulceration. Fucibet cream (Fusidic acid and Betamethasone) twice daily for 10 days. Use Cetaphil moisturizing lotion for 20 days and tablet Zifi 200 mg (Cefixime) twice daily for five days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How is tissue removal surgery for ulcer ?\n\nHi, my girl friend had abdominal pain from a while, and about a year ago the doctor discovered that she has helicobacter pylori. and lately her doctor said that she has ulcer but the pain remained and the treatments didn t work. yesterday the doctor made a Gastroscope and today she said she has to do a surgery to remove the inner tissues affected from the stomach... could that be an ulcer or something else? and if so what can it be? my girl friend age is 25",
    "doctor_response": "Hi Rami Welcome to HealthcareMagic. Your girlfriend probably has an ulcer disease.The treatment plan would be a combined antacid(PPI s) and antibiotic to eradicate H.pylori ,.A biopsy of ulcer would be taken while gastroscopy is done.If this treatment cannot relieve the symptoms there are surgical option available.Her doctor must have decided on surgery. Please get back to us with more information on what she is planning for and we can help you better. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain, hard feeling in throat and jaw pain?\n\nwhat would cause chest pain, a hard ball feeling in my throat, jaw pain, but NO sweating?  the chest pains are from the middle of the chest and radiate to the back.  It's painful, but 2 aspirin chewed usually takes care of it.  The cardiac rythm remains the same however.  When this occurs it's usually at night or when I'm just doing whatever like talking on the phone or washing dishes.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, we should first rule out heart related diseases because your chest pain is subsided by aspirin. So get done ecg and 2d echo first. If both are normal then no need to worry for major heart related diseases. Sometimes acute gastritis and GERD (gastroesophageal reflux disease) can also cause similar symptoms. So avoid stress and tension. Avoid large meals, instead take frequent small. Go for walking after meals. Keep 2-3 pillows under head in the bed. Avoid hot and spicy food. Take pantoprazole tablet on empty stomach. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dull ache around the right kidney area with foamy urine and negative dip test in a high BP and cholesterol patient.\n\nHi, I have a dull ache/tenderness around the right kidney area. I don t have diabetes, but I am on high blood pressure medication and lipitor for cholesterol, I did dip stick test on urine and it came negative on protein, although urine apears to be foamy recent blood tests are normal",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have UTI which is likely to be associated with stone either in kidney or ureter.Please get your routine urine test and urine culture done to find out the organisms causing this infection and antibiotics to which they are sensitive to.Ultrasound scanning of abdomen will help to rule out presenceof urinary stone.Please take broad spectrum antibiotics like Cefexine along with urinary antiseptic like Nitrofurantoin twice daily and urine alkaliser thrice daily.Later on switch on to appropriate antibiotics as per culture report.Get the prescription of medicines from your family Physician.Ensure to drink more water.To keep your urine dilute This will help to control dysuria.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes twitching in little finger?\n\nPLEASE HELP ME! i have had twitches all over my body for the past 20 years, fingers, legs, every muscle you can think of, but for the past 3 to 4 weeks my pink finger has been twitching like every 20 seconds. i have had it twitch before but not for this long. could any tell me what this could be?? i dont have any other nerve symptoms",
    "doctor_response": "Hello, The commonest cause of twitching is benign fasciculation syndrome (BFS). Unlike ALS, in BFS, there is no thinning or weakness of muscles. Muscle twitching in BFS get worse with exertion and anxiety. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Sudhir Kumar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Give suggestions after analyzing the report\n\nMarried for last 4 years. Trying to conceive baby. The semen analysis are as under---- (total vol. 4ml, color transparent, viscosity normal, PH 7.4, Agglutination nil, sperm count 5million/ml, total count 20million, motility after liquificatio 50%,  Grade 0 50%, Grade 1 10%, Geade 2 20%, Grade 3 10%, grade 4 10%, Morphology normal 60% abnormal 40%, WBC 5-6/hpf, RBC nil, Epithelial cells 1-2/hpf, fructose presence, Impression Severeoligozoospermia, Culture shows No Growth after 48 hrs of incubation). Doctors suggests to go through INTRA CYTOPLASMIC SEMEN INJECTION i.e ICSI. please advice accordingly",
    "doctor_response": "hi yes there is oligozoospermia but need to get some investigation to look for the cause and in some cases medication can definitely help to improve the count and avoid IVF or ICSI Dr. Prerna Gupta MBBS (AIIMS), MD (AIIMS), (Gold Medalist)DNB, MNAMS, MRCOG (UK)Commonwealth Fellow in Reproductive Medicine (BCRM, UK)consultant Moolchand prernagadodia@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the back pain after standing on the injured ankle?\n\ni twisted my ankle two nights ago. it is slightly swollen and not very painful, but today was my first long day back at work since the accident-standing all day.  i have horrific lower back pain on my right side, the same side as my ankle injury.  are they related? any advice on relieving pain",
    "doctor_response": "Hello, Thanks for writing to us, I have studied your case with diligence.Yes ankle injury and back pain can be related.Instability may increase due to tear and laxity of ligament.I will advise to repeat MRI ankle for soft tissue involvement.Till time you can continue use supportive splint or brace.Physiotherapy like ultrasound and TENS will help in early healing.If age is more you can manage it conservatively with brace and physio.Complication can be ankle arthritis ,profound instability ,recurrent fall ,inability to walk.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and light sensitivity while on Dexamethasone?\n\nI have a 16 yr old male son who was to hospital Sunday due to fever x 3 days, sore throat, dizziness and vomiting. He was treated with IV fluids, IV Gravol and Dexamethasone for his throat. He was then sent home with antibiotics for throat. He has continued to sleep since Thurs, drinking fluids, eating very little and today has complaints of headache, light sensitivity/strained eyes and dizziness/light headedness. He also has began having diarrhea. Would this require a return to hospital or might this be a flu, he has been sick since Thursday and does not seem to be getting any better",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The most common reason is side effect of antibiotic and steroid giving combined symptoms narrated here. I would recommend to call his pediatrician office and discuss the matter immediately without delay. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed fluid coming out from the big toe nail & also it hurts\n\nMy big toe is leaking fluid i dont know where its coming from its coming from the inside top bit of my toenail it really hurts and is painful i dont what this is? its hurting me a lot also i just wanted to mention that i am also pregnant. Has this got anything to done with it",
    "doctor_response": "HIThanks for posting your query to Healthcaremagic.      No it's not related to your pregnancy. What seems like is you are having Infection around your toe nail and Pus is getting accumulated around your toe nail .    Your require Antibiotic course and and may require Drainage of pus from your Toe Nail . Kindly consult for doctor for this soon . Hope this answers your query.Any clarifications or Queries feel free to ask. Happy to help you. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatments for marelgia paresthetic on thigh\n\nI AM 39 YEARS OLD WOMAN & I AM SUFFERING FROM MARELGIA PARESTHETIC ON MY LEFT SIDE OF THIGH SINCE LAST THREE YEAR I HAVE CONSULTED WITH SO MANY DOCTORS BUT COULD NOT OVER COME FROM THE DESEASE KINDLY ADVISE ME WHAT TO DO I COULD NOT EVEN SLEAP BY THE LEFT SIDE OF MY THIGH",
    "doctor_response": "Thanks for the query.Meralgia paresthetica is a painful mononeuropathy of lateral femoral cutaneous nerve. It is due to the entrapment of nerve as it passes through inguinal ligament. It could be because of injury or tight clothing or obesity or weight gain or pregnancy. If any of the above mentioned cause is involved. 1. Reduce weight2. Wear lose clothing3. Methylcobalamin 1500 mcg injections on alternate days for 1 month followed by capsules of 1500 mcg in multivitamin combination should provide good long lasting relief. This treatment is for long term benefit4. In unresponsive nerve block surgical decompression requiredIn your case if all the options of pain killers,  local lignocaine or corticosteroid injections are given already for temporary relief and methylcobalamin also given then kindly go for surgical correction.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes coughing blood and breathlessness while on medication for chest infection?\n\nI was put on antibiotics for a chest infection, but my symptoms seem to be getting worse, coughing up blood, finding it hard to breathe, very tired, my skin sometimes turns a purple sort of colour, my cough is also very chesty and I'm coughing up thick phlegm with blood... I don't wanna go back to the doctor and look stupid by saying I think I have Pneumonia...",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.You are having hemoptysis (blood in sputum) a day breathing difficulty despite of taking antibiotics.This suggest that your antibiotics are not working and your lung infection is worsening.So better to consult pulmonologist and get done sputum culture and sensitivity report.Culture report will isolate the causative organism and sensitivity report will guide about effective antibiotic treatment.By this we can achieve speedy and accurate recovery. Don't worry, you will be alright.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy /medication for bp in children\n\nMy son is 15 years old and his blood pressure is around 135/75 most of the time. His kidneys were checked and there's nothing wrong. How can I help him without giving him any medications. He is not overweight. He lost a couple of pounds since I changed his diet. But once in a while I let him eat junk food.",
    "doctor_response": "Hi ThereI've read your query and understanding your concern.I would like to tell you, Blood Pressure less than 140/90 is acceptable. It do not require any medication.You should better control on his diet and junk food once a while is acceptable. And you just need to do adopt some lifestyle modifications for him- motivate him for healthy diet- avoid canned products- eat fresh - Exercise or daily brisk walk of 30 minHopefully I answered all your queries Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this ECG report indicate?\n\nHi ,I have done my normal checkup and found some thing new1) ECG report-- low normal average cardic rate2) LFT ---69 SGPT3) lipid profile---hdl cholestrol---26,cholestrol---187,triglyceride--118,LDL--1424)uric acid--8.995) TSH ---5.6PLEASE ADIVCE  WHAT SHOULD I DO?Thanks in advance",
    "doctor_response": "Hello 1) ecg is normal if you are a active and have athletic built,  however heart rate between 50-60 is considered healthy,  second is if your thyroid is on lower side (Tsh here is just borderline) 2) lipid profile can be better,  your HdL should be more than 45-50, ldl less than 130 atleast.  Diet,  exercise and supplement like omega 3 fatty acid,  krill oil,  flax seeds may help 3) uric acid is high,  diet  modification or starting on medication recommended 4) sgpt  is also high (borderline),  considering other tests I would presume you are obese and do have the most healthy lifestyle.  Subtle change in life will help in long run.  Regards Dr Priyank Mody, Lilavati Hospital, Mumbai",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Ventrolin be given for child s fever, vomiting, cough?\n\nSir, My son is down with fever, vomiting, and cough, i have given him Ventrolin/Seecef/Domstal and bicaranyl, please advice if i can continue with the same medicine as our sons pediatrician is on leave. elder one is 7 years and younger one is 5 years both are un well.",
    "doctor_response": "HI Your son might be having a Upper respiratory tract infection and if fever is high grade and if associated with decreased activity and decreased intake of feeds, need to add antimicrobials to him",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swelling in the arms and hand\n\nMy arm and hand has been swollen over a week now, I went and saw a doctor and they referred me to specialist. Whenever I straighten my arm it feels like it s tearing or when I try and open a door. It s only getting worse my fingers are now swollen. The OAU. Runs through my armpit bicep forarm and hand. Advil and ice isn t keeping the swelling down or the pain.",
    "doctor_response": "HiAn MRI of shoulder region must be done for nerve,tendons implications by neurovascular impingement or compression.Orthopedic consultation required.In mean time support arm in broad arm slingdiagnosis is must before more specific treatment is advised",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having pain in spine, hips, legs, feet. Fatigue. Pain in ribs while breathing. Tingling, numbness all over. Suggestions?\n\nI have been suffering for 4 years with no diagnosis. I havemsevere bone pain , primarily in my spine , hips, legs and feet. I am extremely fatigued and my ribs hurt. It is very difficult to breath because I feel like somebody has duck tape around my ribs. I have a difficult time walking due to the pain. I sweat a lot and suffer from weekly migraines. In addition, I have sleep apnea and itchy skin. I also experience tingling , and numbing sensation all over. Plz help me. Plz.",
    "doctor_response": "Hello. Thanks for writing to us. Having a generalized bone pain all over the body along with tingling and numbness is likely to be related to vitamin D 3 deficiency along with a vitamin B 12 deficiency. A few blood tests will help in detecting the exact problem. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for productive cough in a 5 year old\n\nHi Dr My son is 5 yrs old now he s sick almost every month if not a cough with yellow or green mucous. It s fever or tonsilitis and he s always complaining of a sore tummy after taking his multivitamins and vitamin c gummy bears chewables even any other medications is this all related what can be the cause of all this? He s always been diagnosed with bronchitis ever since he was 7 mnths as he started kindergarden at the time pls help me understand if this is a norm for kids his age or you a picking something odd",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As he has repeated infections, causes may be re infestion due to repeated expoeure or decreased immunity. I'd suggest you too do chest x ray, complete blood count, blood culture after consultation. He may require antibiotics. Give proper balanced diet. Avoid contact with infected persons. Take care. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling feeling in breasts?\n\nI got mya period this month on time 28 daayz..i traveled right before and got mycperod during 3 day stopover. The day after i got my period i traveld again. My period lasted 4 days. I was feeling very nauseas the last day of my period which i never do and the next day..took tezt but negative. I still think im pregnant . Now its two days later and im having tingling in breast ..bloated..is it possible",
    "doctor_response": "Hello, Very unlikely. First, yeah, localized symptoms in the breasts are something with the hormonal cycle and NOT something with the nerves. Then, a lot of things change the hormonal cycle. The most obvious are changes in the hormones through pregnancy, birth control pills, weight gain or loss, changes in daily routine. Pregnancy tests are pretty good. Blood tests are a bit better. Of course, the delay between getting the second test means it will automatically be more accurate since the pregnancy is further along or isn't. Then, it can be a mechanical thing on the breasts like running or bra size change or other direct movements/irritation/stimulation. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump on the breast\n\nHi, I found a lump in my breast in January this year.. Went to my GP, who examined me and referred me on to a breast clinic.. They did a fine needle biopsy, and ultrasound.. Results came back that it was benign, a fibroadenoma.. No reason for treatment.. The issue I m having now is that I notice it seems to have got bigger, and this last week or so is sporadically causing me pain.. Do I need to go and get it checked out again, or is this normal for these kind of lumps?",
    "doctor_response": "HiAs per your description, it looks like a Fibroadenoma. As it is increasing in size, it is better to get it removed surgically. It can be done under Local anaesthesia as a Day care surgery.Nothing to worry. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will masturbation effect the sexual health?\n\nhi sir,am 21yrs old boy and nowadays am always getting sex feeling and always i need some kind of sex pleasure..i dont know why its happening like this nowadays...when i get sex mood i use to think of some girls and mastrubate everyday...because of this will there be any side effects?? or in future after i get married will there be any side effects in married life with me and my wife??? please answer my question sir...",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Masturbation is very normal and their are certain myths attached to it. Having sexual activity does the same thing. You can do as many times as you get pleasure but examine yourself that you don't have compulsive masturbation. Compulsive masturbation is when a person continues with frequent masturbation and neglecting other works like education, job or social obligations. Eat healthy diet and remove any myth you have regarding it rather than believing in it. Nothing wrong will happen with your health, married life. Nor it will drain out energy or make you weak. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itchy reddish rashes on the arms. What are these? History of mononucleosis viral infection\n\nmy wife has red circular red spots like quarter coin size on back of her arms and they itching she scratched on them they worst. we visit the doctor and he told us that are normal thing he prescribed two tablets and one cream we do not know what are those spots and why they are.four weeks before appearing of red spots she had mononucleosis virus she stayed in hospital for 6 days",
    "doctor_response": "Hi,Thanks for writing in HCM.The condition can be contact dermatitis,tinea corporis, acneform eruption etc.The proper diagnosis and treatment can be suggested only after examination.A visit to dermatologist will help in establishing diagnosis.Till the time you can take tab cetirizine  twice daily for symptomatic relief.Hope this helps.RegardsDrSudarshanMD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the reasons for having swollen lymph nodes above arm with a family history of having lymphoma?\n\nMy  54yo husband has swollen lymph nodes on each side right above the crease in his arm, my mother had lymphoma close to that area and we are just a little worried. He has an apt with the doctor in 3 days, any ideas would be appreciated many thanks?",
    "doctor_response": "There are many other causes of lymph node enlargement  other than lymphoma. if they are tender they may be inflamatory, if they have a rubbery feel one could suspect of lymphoma. if the lymph nodes are matted they may be tubercular. Examination of these is important and may need to be investigated.Dr. J. Ticku",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can blood in urine indicate cancer?\n\nHello doctor, I am a 30 years old, male. No smoker. A blood and urine test was done for me recently and the blood test was all fine, but there was blood in my urine (Ur RBC 155 Cells/uL), a more specific urin test was done after still showing (66 Cells/uL) of which 97% are isomorphic and of which only two were white blood cells. Further a CT urogram was done, were no stones were found or anything else suspicious. What could be possible reasons? There are still a lot of other explanations, but cancer, right? What should be my next steps? I do not know of any of the following things can be related: I had a kind of a cold for months already, but nothing seriously. Mostly just a runny nose and a bit tired. I had my ankle hurt a month ago and on and off it still hurts and gets swollen again. I feel slight discomfort around my bladder and urethra but mostly since, I got these results and maybe I just paying too much attention to that part now.",
    "doctor_response": "Hello. Firstly, likelihood of any malignant cancer is less likely because you do not have risk factors, no symptoms, young age and CTurogram in normal. Within three months period cancer would have increased in size and became detectable. So you are probably having some benign cause and most probably some arteriovenous malformations, venous lesions or small mucosal bleeds, calcium and uric acid in urine. Next step is your 24 hour urinary calcium and uric acid levels, and also urethroscopy and cystoscopy which will complete the evaluation and usually yields the diagnosis in most cases. Urologist does these tests. You continue to drink plenty of water and liquids.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower back and abdominal pain\n\nI have had lower back ache for the last month or so which I would describe as a pre menstrual ache.  It also seems to radiate to my lower abdomen.  I have had clear/yellow/creamy discharge for about the same time, not offensive at all.  My abdomen is tender on the right side when pressed.  I am not pregnant.  What could this be?",
    "doctor_response": "thank you for sharing your complain,if you have pain on back/flank with abdominal pain which radiate to pelvis/bladder and sometime it may be associated with burning or difficulty in urination, you should keep in mind possibility of ureteric/kidney stone. tenderness and pain on right illiac fossa also indicates of appendicitis. so you should first comfirm diagnosis by blood & urine investigation and also sonography of abdomen and pelvis. after final diagnosis take medicine rather than taking medicines randomly.low back pain may be due to muscular pain.for temporary relief you can take analgesics like ibuprofen or muscle relaxant like aceclofenac+paracetamol+chlorzoxazon, with omeprazole/rabeprazole.it will relieve back pain and abdominal pain.hope this answer will be helpful to you.for more queries plz don't hassitate to ask.get well soon dear friend",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause intense pain in nose while raising eyebrow with history of having stuffy nose indicate?\n\nI have an intense pain when I raise my right eyebrow. The pain is located on the side of my nose (right side). I have had a stuffy nose for a few days. Female. 23 years old. Wear contact lenses. Normal medical history. Never had surgery, allergies, or any type of medical procedure.",
    "doctor_response": "HI, thanks for using healthcare magicThe symptoms of nasal congestion and pain on the right side of the nose may indicate that the sinuses on this side are blocked.The use of an oral and topical decongestant along with an anti histamine would help. These are available over the counter at your local pharmacy.In addition ,the application of a warm compress to the face may also encourage drainage and relieve your symptoms.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any home remedy for swollen throat?\n\nPossible strept throat my fiance's throat is swollen and she is unable to eat since wednesday.  This morning she called and said she is still unable to eat and her throat is still swollen.  What can we do for her at home?  I dont know if she is running a fever or not, but I am wondering if she needs antibiotics at thid point.",
    "doctor_response": "**1. since possible infection is suspected thus examination with ENT doctor is necessary for evaluation of swollen tonsils and lymph nodes in the neck.PS. It is rare for streptococcus bacteria to invade the larynx, thus can be safely excluded2. It will be good to have examination since the bacteria can travel from throat to middle ear through Eustachian tube, as such ENT doctor can prescribe you specific medicine [antibiotic] or even go for swab culture.PS. other complications which though possible but rare are: arthritis, meningitis, glomerulonephritis. [but have to be excluded with suitable examination and investigation]3. . maintain good oral hygiene, rinse mouth after every meals, avoid smoking,    tobacco chewing,spicy/fried foods, have warm salt water gargles.. take salt,turmeric and embelia ribes in 6-6 gm quantity and mix in 1/2kg water and after filtering, have gargles with it [when still lukewarm]. sucking to 1gm curcuma zedoaria helps in sore throat, also sucking to liquorice has same effect.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bleeding gums?\n\nIs it possible that my contraceptive pill is causing my bleeding gums as it does not seem to be suiting me in general.  I had a case of gingivitis but now gums look healthy and dont bleed apart from a tiny speckle if that when brushing but I can taste blood 2 or 3 times a day?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern.As per your query contraceptive pills which you are taking can cause bleeding of gums as contraceptives will increase level of progesterone in body and any small irritant like food, plaque, improper brushing can gums to bleed, swell and can turn them red.  Gums become more sensitive and the moment you brush or bite anything hard you taste blood in your mouth. These symptoms of gingivitis keeps on increasing if remain unattended as they will cause further bone loss and poor periodontal support of all teeth and in turn loosening of teeth.Certain antibiotics like amphicillin, barbiturates will reduce this effect of oral contraceptives. I would suggest you to visit dentist and get properly prescribed contraceptives. Hope your concern has been resolved.Get well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Robinul advisable for excess salivation while being fed by NG tube?\n\nI am giving Robinul to a baby in the NICU for increased saliva production. She had a severe HIE insult at birth and just has a functioning brain stem. She is obviously being fed by NG tube. Should Robinul be given in the oral mucosa or down the NG feeding tube?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Robinul can be given through an NG feeding tube. I would not advise placing the medication in her mouth as there is the danger of aspiration.This is a difficult situation, take solace in knowing you are doing everything you can for her.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Arnold Zedd",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for splenomegaly\n\nMy husband has an enlarged spleen with pain and symptoms.  We have had several consults/scans/bone marrow bx/periphearl blood smear with no diagnosis.  He is heparin induced thrombocytopenic, status post two small strokes and SMA clot repair in 2004, and pneumonia before this splenomegaly.  We need help.",
    "doctor_response": "HIWell come to HCMThere are several medical conditions which causes splenomegaly and common some of then are anaemia, chronic malaria, some chronic infections, malignancy, liver disease, cardiac disease, if the spleen is really big enough can causes some discomfort then this is to be removed but this is rarely happens, else this does not cause anything danger, hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluttering in heart?\n\nI was diagnosed with PAC two years ago. Other than a fluttering feeling when they happen I am asymptomatic. My new Dr. sent my most recent ecg to a cardiologist who believes they are not normal for a person my age. I am 57. Do I need further investigation like and echo-cardiogram?",
    "doctor_response": "Hi,Some amount of PACs can be seen even in healthy adults, if they are not more than 400 a day, there is nothing to be concerned. In case they are frequent I would advise you to undergo holter monitoring, which is an examination, during which an 24h ECG is recorded and have echocardiography done. Hope I could help youWishing you good healthIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes twitching muscles in arms after taking mirtazapine?\n\nmy husband took his first dose of 15mg Mirtazapine, and is experiencing twitching muscles in his arms. Is this a common reaction for a first dose? Will it subside, or should we taper back tomorrow. He was prescribed this to go along with 100 mg of Sertraline for severe depression.",
    "doctor_response": "This may be sideeffects, but to confirm this you should do ionized and non ionized calcium. Calcium and  supplementation should be started to use once daily.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should the normal sperm count, motility rate or leucocytes count be?\n\nHi! I got married last year in January.My wife didn`t conceive till now.I got my semen examination and in the report i got 50million sperm count  and motile rate is 60% and lecocytes are large in number.I want to know that is this the only reason that my wife is not get pregnant.",
    "doctor_response": "hai,your semen analysis says your total count and motile count are within normal.but leukocyte from your quote says large in number.i didn't get exact value.increased more than 1 million shows infection, in that case semen culture needed.depending upon the culture report medication should start.other values like fructose and other parameters should also be considered.I advise you to visit a infertility specialist to go for further investigation.Hope i answered your queryThank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dry skin with flakes, sores forming. could it be due to the use of red bull?\n\nI've had some Serious facial skin changes in the last few months someone recently someone suggested that red bull could be a reason my skin has gone from being basicly normal, not problematic to extremely dry, large flakes thick dry skin coming off creating sores and my pores are continuously clogged, even over night, where no probably before",
    "doctor_response": "Hello,Welcome and thanks for posting your query to Healthcare Magic.After reading your query it appears the possibility of \"Contact allergic dermatitis\" or \"Actinic dermatitis.Both of these are common conditions and the former one is cased due to contact of the facial skin with some allergic material you are causing in day to day life while the latter one is cased by the direct sun damage to the skin. Otherwise also both the condition can be inter related.Red bull being an energy drink goes inside the body. So if it would had been causing the problem then should had been causing to the complete body or all over the skin and not on the face only. SO I don't think that this one is the offending factor.For the prevention and betterment kindly follow the suggestions below:- stay away from hot and humid climate.- DO not scratch any skin lesion or even try to touch unnecessarily.-Apply over the counter calamine lotion 3-4 times a day.-You can do cold water compresses to reduce the intensity of itching.-Do not scratch or rub the skin as it can lead to further aggravation.-You can take oral anti histamine like loratadine or levocetrizine under medial advise.Despite above measures if the problem is not getting better then it is better to consult a dermatologist for best guidance.Hope these informations will help.\"With good health wishes\"Dr Sanjay Kumar KanodiaMD (Dermatology & STDs)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take percocet after having undergone spinal fusion?\n\nI m seeing a doc I was referred to by a friend he I willing to do my pain management cuz I just moved here, I am on Percocet 5/325 2 x daily. I have had numerous spinal fusions, spinal stimulator and I don t want to be a druggie but the two a day that used help is not helping anymore. I just want to be somewhat pain free so I can enjoy life again. I m 57 female good health other wise just miserable",
    "doctor_response": "Hi,as you mentioned your history it appears you have pain but you want to avoid medicine also. This is an absolutely good idea. Since anything in excess may not turn out to be good.Alternative medicine is of choice you can opt for after having check done on your spine.First need to look for short term and then long term goals,Short term goalsImprove lung capacity (Respiratory exercises)Improve the strength in the upper and lower limbsMeditationLong term goalsCore stabilitySpinal muscle strengtheningStrength conditioningNow, Why to start anything with breathing exercise is because, cellular metabolism needs oxygen as the fuel. And a pure blood is of choice which can be achieved with breathing exercises. Even while doing the breathing exercises there are two types of respiratory muscles - primary and secondary which both gets strengthen and prepares the body for the next step. Lower and upper limb strengthening is because the body functions as a unit and for any goal to accomplish the unity matters.Next is meditation to control the mind . Control of the mind can provide a great achievement.Then core strengthening is to give the stability to the lumbar vertebrae. By which the injury to the soft tissue becomes minimal,Spine muscle strengthening is to keep the normal alignment of the spine, which is of utmost importance to avoid pain and aches.Body conditioning is because after strengthening the whole body needs a all new transformation which can be achieved by this.I hope to see you soon with out medicines and cheerfulRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe pain after gallbladder removal. E-ray showed surgical clips in the area. Is the pain due to these clips?\n\nI had my gallbladder removed in 2003. I have been having a lot of pain in that area pretty much ever since. I am told that there is no reason for this pain but what can I tell you, I know if I have pain or not. So I saw through an e-ray once that there are surgical clips in that area. Could these clips be causing me this pain?",
    "doctor_response": "HI Thank for asking to HCMThe pain may not be due to the clips, you can try some antispasmodic drug and I think you will get good result, Dicyclomine is the drug of choice along with acetaminophen try it, if it does not helped then it has to be investigated but I am sure it will come around with this have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for respiratory problems after radiation for breast cancer\n\nHello Doctor, following is regarding my mother",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. According to my opinion your respiratory problems may not be due to radiation treatment.  You should continue medication for your gastric problems.  Go for x ray chest.  You may have some chronic respiratory disease.  Then take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "When can i conceive after the treatment of hyperprolactinemia for my husband ?\n\nhi dr..me and my husband are ttc for more than a year..my h. did a hormonal profile and his prolactin was too high 39 ng/ml, dr. gave him dostinex 2 times per week for about 1 month(8 pills ),my q. is when can we expect an improvment in his lipido and his seminal analysis after taking the drug. p.s : his seminal analysis before the dostinex was like active motile:30% count: 8*10^6/ejaculate morphology: normal 40%",
    "doctor_response": "welcome to healthcaremagic once the prolactin level falls with treatment testosterone level will go up improving the libido and semen analysis report be under treatment continuously and follow advice",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tooth and headache?\n\nIm, 18 years old, 132 pounds im 5'2 i  have a histery of bad headaches well my pain started of with a very badtooth ache in the back where my wisdom teeth are on my left side  went to a oral surgen yesturday and he gave me some meds called clindamycin so on da way home i started developing this werid feeling in my head just on one side of my head in the front near my eyes so wen i got home i ate and took two clindamycin and drank plenty of water but this morning i woke up with that same feeling in my head and a funny feeling in my stomch i been to the bathroom 2 time this mornibg its normal like stool. Its no pain my stomach but it feels like pressure or somethingi feel like i gotta vomit but i dont that funny feling in my head i only geag dat when i sit up or lay down so rite now i am laying down cause either way i het it",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.Symptoms you have described suggests the side effects of clindamycin , the antibiotic may not be suiting your body.I would advice you to call your dentist office or visit him and get the antibiotic changed .Take the antibiotic on full stomach and have lots of fluids.For the pain you can take ibuprofen (if you are not allergic to any medicine )Hope this was helpful.Thanks and regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itching in palms and bottom of the feet, burning in stomach, vomiting and diarrhea. Could it be due to food allergy?\n\nI just had my second episode yesterday. My palms begin to itch and then it moves to the bottom of my feet , my stomache feels like it is on fire and about 20 minutes after the itching the vomiting and diarrhea begins. It is terrible and last about 4 to 5 hours. I thought it was maybe a food allergy , but what I ate for lunch yesterday, was leftovers from the night before. The first time I got sick, I ate pineapple. I had never had a problem with this food before. Can you help?",
    "doctor_response": "food allergiesmay be any get blood serun test for specific aniodies for vaious food you eat you will get results as it is not possible to dtect yourselfget blood serum or prick tests as hey are bestaccordingly pln your diets for preveting recurences further",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a chance to get cancer if brother and grandfather has cancer?\n\nHi I am a 53yr old white woman with a history of endometersois ,osteomyletitus, degenerative lumbar disease .My older brother just pasted away from liver, prostate, eye and brain cancer.What are the the chances I could get cancer? My grandfather on my mothers side died. of lymphatic cancer. My mother is cancer free. Thank you Gail",
    "doctor_response": "Thanks for your question on HCM.All most all cancers have hereditary nature. But they are not 100% run in family.Means children of cancer patient are not always have cancer.If if they are exposed to carcinogrn like smoking than chances of getting cancer in them are high.So if you have any bad habits like alcohol, smoking, any chemical exposure etc than you may have cancer.Otherwise no need to worry much.Just get your annual body check up regularly.  Quit habits if you have. Eat healthy and stay fit.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes 'crunching' noise and intermittent pain in shoulder?\n\nMy right shoulder has been making a regular 'crunching' noise for quite a few months and I have also has associated sharp intermittent pain ( sometimes pulsatile) firstly from the elbow to wrist and then in the elbow, hand, fingers and shoulder. It has been very gradually getting worse over a few months but has increased significantly over the past 2 weeks. My left shoulder has now started making a crunching sound and I have had some pain in the elbow and hand on that side too. I am 42 year old female.Do you have any suggestions on what this could be? Many thanks.",
    "doctor_response": "Hi..The pain what you experience is due to some neural irritation that could have caused due to disc... facet joints..reduced space between vertebrate..Initial noise out of shoulder is due to imbalance in the shoulder joint ..not to worry as this will settle down with stability exercises...I suggest you to kindly get an MRI done for your neck to rule out the cause and get it treated..Till then...I recommend you toDo icing frequently in the neck to keep spasm and pain under checkkeep your neck supported with a soft collar if possible.Keep your neck supported while sleeping...once neural irritation cone down then start working on neck and shoulder strengthening....Hope this is helpful for you..Revert back in case if you need any further clarification.. .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump in the side of neck?\n\nHi I have had a  painless lump on lower right side of neck posterior triange i think, it is hard and moveable, blood work came back fine and no other symtoms doctor said it would go away itself but may take a few weeks, lump is still there and wondering should i get it checked again",
    "doctor_response": "hi.did you have a recent history of infection? lymphadenopathies usually resolve when the infection causing it resolved. if it's still there and it's bothering you, you could request for a neck ultrasound or scan for further evaluation.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Skin rash. Dry spots, had colour, nose bleeds. Taking anti histamines. Suggestion?\n\nHi I have a a skin rash on my arm all spots very dry the spots had colour and bled when I scratched them. they are now clear still raised spots and have no colour and are still dry this is after taking anti hisamines as I assumed it to be an allergy of some kind but are still irratating what could this be Ive also been having nose bleeds which I never usually suffer from this is rather strange. thank you",
    "doctor_response": "Hi and thanks for the query, It could be interesting to actually do a more detailed medical evaluation. Bleeding from multiple sites, the skin and the nose should warrant exclusion of an associated medical condition. A complete blood count could be a good start t ascertain that the number of platelets are i sufficient numbers. Itchy skin lesions could be due to an allergic reaction. But persistence of these lesions on anti histaminics, without nay dominant classical allergy associated symptoms like itchiness and rapid spread should warrant considering other causes. Fungal infections, bacteria and viral sources could be at the origin. I suggest you consult an internist for a more comprehensive analysis of your health status and management. Thanks for the query and best regards, Luchuo, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for the swelling and pain in the Scrotum after Hernia repair surgery?\n\nHi, my name is Cyndi. I am writing this regarding my father. He had hernia repair surgery Jan 11, 2014. Has been back to the specialist three times and had just been told to be patient and give it time to heal. The doctor had never once done a physical exam. Since the surgery. My fathers complaint is that his scrotum is the size of a small watermelon, it has gone down in size a little since the surgery but the extreme pain has never stopped. He sweats and cannot even sit properly in a chair yet. He describes the feeling like there is a rod or piece of wood inside closure to the top of the scortum. If he sits or moves a certain way it pokes in and the pain is stabbing. He did have internal bleeding after the surgery. Which eventually stopped, but was discovered when his scortum expanded and he couldn t even walk. What should we do, I live a province away, he is in so much pain he can t communicate his problems anymore. Only that he is in pain. My mother is not well, and having a nervous breakdown because of all this. (Not her first ). My dad is suicidal and I am very worried. Please help if at all possible.",
    "doctor_response": "HelloThanks for query.The pain and swelling of the scrotum is due to infection of the testicle and spermatic cord (Orchitis) .Please get following basic test done to confirm the diagnosis 1) Ultrasound Scanning of Scrotum2) Urine routine and urine culture .He needs to take broad spectrum antibiotic like Augmentin  along with anti inflammatory drug like Diclofenac and Seropeptidase  twice daily.If problem persists even after taking medicines for 2 weeks and if he is in severe agony I would suggest to testicle get removed .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child suffering from low IQ problem. Getting treat by a psychiatrist. Difficulty concentrating. Is there any treatment in ayurveda or allopathy?\n\nSir, I am living in Bhopal (M.P.) I have two child my elder son is 13 yers old and younger child is 4 yrs old. My younger son is matally fit at all but my elder son has low iq problem. I have done treament for my elder son with sicatrist Dr. S. K. Tondon in Bhopal since last four years. The major problem with my son is poor consentration. He studying in Miriam School for Mentally handicapped (Asha Niketan). Kindly suggest me the best doctor for the IQ level treatment in child in india (Ayurveda/Aloepathy) if any chance. Yours sincerely Umesh Yadav (Cell : (+91 - 0000) Email ID ( YYYY@YYYY ).",
    "doctor_response": "1. what type of low IQ problem is there: is it with intellectual functioning  (intelligency) or with adaptive functioning ( activities /skills of daily living)???? 2. any complications during birth (neurological disorder), did he achieved his developmental milestone in respective age?, was Immunization schedule complete (till date and age)? 3. is he also poor with social,communication and functional skills?? 4. did the Psychiatrist labelled it as mild-moderate-severe or profound?? 5. any symptoms of aggression,self injury, or mood disorders noted in him?? 6. make sure he participates in extracurricular activities and social programs to gain self esteem and confidence. 7. As he is studying, make sure the environment is supportive and friendly to extract his full potential. 8. he will need constant and consistent educational,social,community and vocational support to lead happy life.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the benefits of consuming guava?\n\nHello doctor, How does guava help boost weight loss? Can guava\u00a0extract help in prostate cancer prevention? How does\u00a0guava work as a\u00a0remedy\u00a0for cold? Why is guava recommended for\u00a0better brain health? What can guava's high vitamin A content\u00a0do for our eyesight? What are the other benefits of\u00a0consuming guava (if any)?",
    "doctor_response": "Hi. Guava helps in weight loss as it contains roughage or fibers. Fibers include both soluble and insoluble fiber. Fibers are the part of plant foods. Not all fibers are completely digested by the human body, hence they will not add to your calories, but they add bulk to the food. After consuming it fills our stomach and makes us reduce the quantity intake of other caloric foods like rice, bread, etc. Guava contains vitamin C, hence it acts as a remedy for cold. Guava contains vitamin E and C which are very much needed for good memory. Hence, it is helpful for good brain health. Guava is rich in vitamin C, A, antioxidants and lycopene which help in the prevention of prostate and other types of cancers. Other benefits of guava are: Rather than consuming an extract, it is always advisable to eat the complete fruit to get the complete benefits.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have fever, red rashes, and low platelet count. Is it dengue fever?\n\nHi doctor, I am a 25 year old female, who weighs 24 kg and 5.3 feet tall. I have had a fever since last week. The fever was between 38 to 40o C. I also had headaches and lower back pain. Today I got tested for dengue, but that was negative. However, on my torso, neck, and face, there are these red rashes. The rashes are not itchy and flat, and they appear to be under the skin. Also, my platelet count was 79,000. I am currently taking Ibuprofen. I was wondering if it is possible that I tested too early for dengue and that it is possible that it is still dengue. If it is however not dengue, what could it be? Please advise. What to do?",
    "doctor_response": "Hello. Hope this helps you and get back if you have any doubts. For further queries consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes weakness and low appetite in infants?\n\nhi. my 2 months old baby is getting weak day by day.. she sleeps for 4 to 5 hours n after every sleep she only takes 2 oz of formula milk.. she also dnt take breast milk.. wat shud i do to maintain her health... on birth she was 3.6 kgs n now  after 2 months n 10 days she is of 4.6 kgs",
    "doctor_response": "Her weight gain is OK.Feeds every 4-5 hours is also OK, but I would suggest you try to initiate breast feeding as much as possible. Let the baby suck first whenever she is hungry. Breast milk is the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am not able to lower my blood sugar levels. Please guide me.\n\nHello doctor,I am not able to stop my sugar level from increasing. Last three HbA1c results are 7.0 %, 7.1 % and 7.4 % with the latest test. My work routine is sedimentary and as I have tracked the high carbohydrate diet which I am not able to change this much even after trying hard. For the last two years, I am taking 0.5 tablets of Gluconorm VG2 twice a day and one tablet of Telesta 40 once a day. Please suggest.",
    "doctor_response": "Hello. I understand your concern.  I always tell my patients that diabetes is not a disease as long as it is under control. When it is not under control, it leads to disease (complications) in the long run. It is extremely important to keep your sugar level under control at all times. How you choose to do it is entirely up to you. Nothing is impossible. Dietary changes are not very difficult if you make up your mind and take control of your life. Regular physical exercise also helps to a great extent. However, if you think you cannot make any changes to diet and lifestyle, the only way to get your sugar level under control would be to increase the dosage of your medication. Gluconorm-VG2 is prescribed for diabetes, but Telesta 40 is for high blood pressure. Please talk to your treating physician about changing the dosage of your medication, it needs to be done under proper supervision, and it seems to be necessary considering your current laboratory parameters. However, I insist that lifestyle modification is something that can help you a great deal to improve your health status.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is Mometasone dangerous to use on Face to clear my acne pimples?\n\nHello doctor, I am seriously facing acne pimples problem. Sometimes they occur on my face when I masturbate. If I use Mometasone, it gives a good result. Is it okay to continue this?",
    "doctor_response": "Hello. Acne is a universal issue in the age group of 15 to 25 years due to hormonal changes in adolescents. However, there are multiple effective treatment options depending on the grade and severity of the problem. Mometasone is a topical steroid and is to be avoided strictly on the face and for acne as it can harm your skin in the long run. Acne is dependent on hormones hence excess masturbation may sometimes lead to an increase in the problem. I would advise you to stop Mometasone immediately and kindly upload appropriate images to help us assess your current grade of acne and treat you better. Regards. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Specific drugs for cholecystectomy\n\nWhich specific drugs (like generic or trade names) would be given to a patient preoperatively for a cholecystectomy including anesthesia used? and also what drugs would be given intraoperatively and postoperatively. I know it would be specific to each patient but just in general what are the normal one administered?",
    "doctor_response": "Hi, There are a number of possibilities for the drugs used based on the patient's condition and the preference of the anesthesiologist. There may be no drugs given preoperatively or a pain-killer may be given such as paracetamol. Intra-operatively the drugs used may be propofol, opiates such as morphine, anti-sickness eg cyclizine, ondansetron. Post-operatively, pain-killers eg morphine, tramadol, paracetamol. These are only a few of the many drugs available for this type of case. Regards, Dr K A Pottinger MBChB  FRCA",
    "dialogue_context": ""
  },
  {
    "patient_message": "Disc bulging of bone in L4 and L5 section. Taking medication for it, pain resumes on stopping. MRI done. Treatment?\n\nSir, I m 22 years old...have done my MRI ...results shown that...there is a bulging of bone in L4 and L5 section of spine..i have taken tablets by the doctors advice as soon as i stopped these tablets..again pain has been more...right now..I m on bed rest and doing my psychotherapy at home..I didn t get any relief as if now...I m suffering from this problem for nearly 3 months! Can u give nay suggestion so i can get relieved from this problem.",
    "doctor_response": "Hello,Disc bulging indicates disc prolapse. That is also the reason you are suffering from pain.Your doctor will advise analgesic which can be Non steroidal anti inflammatory drugs, Non opioid analgesics or opioid analgesics depending on the intensity of pain.Other available options are1. Physiotherapy and exercises. Physiotherapy procedures like TENS, Ultrasound therapy, Muscle stimulation will provide pain relief2. Lumbar traction, lumbar support also help relive pain3. Surgical intervention may be necessary if pain does not subside with above mentioned methods. You may need to undergo discectomy which will relieve you of painHope I have answered your query. If you have any further questions I will be happy to helpThank you,Dr. Narasimha G L",
    "dialogue_context": ""
  },
  {
    "patient_message": "What shall i do for grown septated anechoic mass in liver?\n\nmy liver is with homogenous parenchymal echogenecity. a septated anechoic mass is seen at segment 8 of the right hepatic lobe measuring 3.1 cm in diameter. what shall i do in order for me to stop this from growing or to get rid of it? thanks and GOD bless.",
    "doctor_response": "Hi, Thanks for writing to HCM. My name is Dr Suresh Raghavaiah. i am a liver and pancreas cancer specialist and I hope to answer your question today. The differential diagnosis of a 3 cm lesion in the liver is varied. It could be a simple infection (abscess, bacterial infection, amoebic liver abscess) or something simpler like a cyst or a hematoma or even something sinister like a cancer. A complete medical history, esp regarding any previous history of jaundice, hepatitis or cirrhosis will help narrow it down. Along with this, blood tests (liver function  test, Serum AFP level etc) will help exclude some diagnosis.Also your report seems to be of a ultrasound scan. You will need a CT scan of the abdomen with contrast for a better definition of the lesion.The treatment will depend what the final diagnosis reached is. It could be just observation, a course of antibiotics or might even need surgery to remove the lesion. I would advise you to please get yourself evaluated by a surgeon, so he can make a diagnosis.Hope this helps and hope you start to feel better. Please do not hesitate to contact me for further details required.Have a great dayDr Suresh Raghavaiah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can addiction to masturbation, issues with eyesight and premature graying of hair be treated?\n\nSir I am 18year old an from 14year age I released sperm daily and sir now I using glasses -2.0 power h and sir my hair becoming white there are many sir I have question sir can any medicine or any which I can to become normal like I can see without glasses etc and how can I left this kind of habit of realising sperm having sex etc plz help me sir",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Honestly speaking, there is no medicine to treat this habit. First of all no need to worry or fear about this. This is absolutely controllable habit. You just need to consult psychotherapist. You need counselling sessions. Try to identify stressor in your life and start working on its solution. Avoid excessive porn stuff. Spend more time with your family and friends. Do recreational activities like sports. Don't worry, you will be alright with all these. You only need positive attitude. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Kaushal Bhavsar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a cat bite\n\nHello, I am currently fostering kittens. One has bitten my index finger today around 6:30 PM where it completely punctured it through the other side. It was bleeding for about 45 minutes and now it has stopped. I cleaned it with peroxide and alcohol then but antibacterial cream on it. Also, I had taken amoxicillin that was left over from another issue a while back not pertaining to a cat bite. My index finger is extremely swollen, hard, red, numb, and painful. The pain is not moving to the other parts of my body. Also I have other scratches on my other hand from the same kitten. I rather not be sent to the ER if it is not infected because I can not pay for my medical bills at this point. I am very very worried since the swelling is not going down. I do not want to lose my finger and I am very worried. Please advise and let me know what actions I should be taking. I am very scared.",
    "doctor_response": "Hello,Welcome to HCM,Rabies is a 100% fatal disease but 100% preventable by proper and adequate treatment. Dog is the known reservoir of rabies virus and can transmit rabies by biting.As you were bit by the cat following which there was bleeding and swelling of the index finger. You need to take Inj TT, active immunization with anti rabies vaccine and passive immunization with equine rabies immunoglobulin (ERIG) around the wound.ERIG is advised as there is bleeding from the site of bite. In addition to this you need a course of antibiotics like Tab Augmentin for five days and NSAIDs like Tab Ibuprofen.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Mucolite safe to be given for recurrent cough?\n\nHi my baby is 7 month old and catching cough very frequently from 2,3 months.she already taken antibiotics like cefrin,amoxicillin,cefixime.Now again from 2 days she having running nose,cough,watery eyes.Dr didn t give any medicine except nasal saline.but from night she having cough with vomiting.can I give mucolite syrup to her.Plz suggest",
    "doctor_response": "don't use mucolytic drugs as may increase the cough only keep using nasal saline and use antitussive as selgon supp every 12 hour and keep good feeding",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does a hemotoma clear up on its own?\n\nDoes a hemotoma clear up by itself? I had a hard knock in a football match just over two weeks ago. The bruising that appeared, has all but cleared up, but I am left with a distinct hard lump protruding just under the knee cap on the inner side of the leg. About the size of a 10p piece. It is still a little tender to touch. Please would you advise? Thank you.",
    "doctor_response": "Hello, A hematoma usually resolves by itself without any definite treatment. You can apply icepacks for faster recovery. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of prolotherapy?\n\nI had knee replacement surgery 1 year ago & am still having a lot of pain. The Dr. Has suggested Prolotheapy. Do you know if there are any side effects to this shot? My concern is that I am very prone to yeast infections. I am now just getting over one after 4 weeks.",
    "doctor_response": "Prolotherapy done with blood constituents like PRP have no major side effects. Pain, mild inflammation may be there at initial stages but should calm down and help in healing.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will alerid be helpful in treating cold and cough in a child?\n\nMy two month old son is suffering from cold & cough. He is coughing several times, specially during early morning hours. Doctor suggested that it is Acute Bronchiolitis (Pneumonia + Asthma). Today he has administered one injection and has prescribed two syrups- 1) Bro-Zedex and 2) Alerid (Cetrizine Hydrochloride Syrup). Is this treatment ok.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.Cough and cold are viral 95% of the times in children. For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15mg/kg/dose (max ceiling dose 500mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.For cold you can use Cetrizine at 0.25mg/kg/dose every 12 hourly for 3 days.For nasal block, plain saline nasal drops will do, every 4-6th hourly to relive nasal congestion.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain in left with bitter taste in mouth?\n\nHi Sir i am having chest pain since 3 years i met somany cardio but the result is negative and also gone through the CT Anagio which is negative report. regarding this i met many gastro doctors they said this is NCCP,.. but iam afraid still its paining some time sometimes sharp pain the left part of the chest .... and bitter taste in the mouth and it is heavy in the morning.... please let me know what it could be.....",
    "doctor_response": "your sharp pains in chest might be due to costochodritis inflammation of the ribs muscles Also You might be having postnatal drip, if not cleansed thoroughly by forcing them out with placing a finger in the back of tongue while you brush early morning  the secretions might be causing a bitter taste especially in the mornings. You need to force them out as if vomiting it, vomitus will be very bitter but you should do  and drink plenty water to thorough clean. To get rid of these symptoms need to take care of your food habits. Avoid all too sour and spicy foods.hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tight feeling in lungs, unable to take breath without coughing?\n\nThis morning my husband and i both woke up with a tight feeling in our lungs and unable to take deep breaths without coughing.  We are not coughing anything up and not running a fever.  He has had aches all over and i have felt nausea and been hot at times.",
    "doctor_response": "Thanks for your question on Health Care Magic. . I can understand your concern. In my opinion, you both are having viral upper respiratory tract infection. It is highly contagious, so one of you have transmitted the infection to other. Better to follow these steps. 1. Avoid oily and spicy food. Avoid hard to chew food. 2. Start antihistamines and anti inflammatory drugs. 3. Do warm water gargles 5-6 times a day. 4. Drink plenty of fluids orally and keep yourself hydrated. Do all these for 5 days, and if you both are still not improving then consult doctor. Hope I have solved your query. I will be happy to help you further. Wishing good health to both of you. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant leg ache?\n\nWhat can cause heavy feeling and constant aching legs in a man of 52 years of age. Blood work shows no anemia. Had a severe case of pneumonia in March and seems to have not recovered completely health wise. What type of testing could be done? YYYY@YYYY",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Can EB related to osteoarthritic changes or due to low levels of vitamin D3. Proper tests can help in finding cause. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for perception problem and inability to focus eyes\n\nI have a very serious problem about perception. I cannot focus my eyes for long on the face of whoever I am talking to. I always feel very concious of where my eyes focus but i really just can t control it. Years ago I had a public breakdown wherein I just let all my feelings out, I was angry because I am suspected of being a thief. My officemate superior made hints, remarks although not directly so as excuse himself I m sure that it made me uneasy, annoyed and depressed. I just go along usually by engaging on his insensitive remarks. By then, it became constant and he always try to trap me and then observe my reaction. As a result I became paranoid. He cannot target others because they are like him and I am only a civilian employee. Prior to my breakdown I was diagnosed with hormonal imbalance due to goiter. I feel when I talk to another as I try to avoid it so that I will not be suspected, my eyes still wander on material things like cellphone. I now have developed fixation about these things, which is due to overly being sensitive to gossiping and observation by others. My eyes are doing the opposite, my brain says don t look. My other officemates know that I didn t do anything but doubt is always there given the fact of what they have observed about me. Am I suffering my anxiety? With OCD? paranoia? I was no like this before... help me pls.. I just want to die",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. I sincerely think you are overly worried about this. A sort of obsession for the time being. But I thin OCD cannot be the problem. You are also not paranoid. Anxiety, of course, is part of obsession. Everyone are obsessed with something somehow. Some people check switches again and again. Some make sure that their looks are perfect. Some sees that their home is in order. etc. Such obsessions are of positive nature. In your case, your obsession can be treated as positive unless it is not interfering with your work or life severely. If it affects your work or normal life 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat back pain?\n\nim from Michigan and i moved to ga one week ago and i have really bad back pain and my tailbone has always been hurting during my pregnancy and after the birth and i also have fibromyalgia. im just in alot of pain i dont know what to do i cant sleep and im having a hard time walking i dont know that to do",
    "doctor_response": "Hello, Thanks for your query.You are suffering from coccydynia- inflammation of the bony area (tailbone or coccyx)Cure for your coccyx pain-1.Use a well-padded seat when sitting and avoid long periods of sitting when possible.2.Do sitz bath- take warm water in a tub and sit in this.It will relax the muscles around the coccyx.3.Do exercises that will strengthen your tailbone's supporting muscles and stretch ligaments near the pain. Consult a physiotherapist for this. Therapists may perform a combination of:Levator ani massage and Levator ani stretching.4.Correct your posture. Poor posture may be contributing to your tailbone pain. Try to sit upright. If you get a sharp pain when getting up from a sitting position, lean forward and arch your back before rising.5.You can take anti -inflammatory drugs like Tablet Motrin 1 tablet as and when required ( do not repeat a dose before 6 hours) with food will help relieve the pain.6.Apply diclofenac gel on the affected area.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any chance for me to conceive if my rub my vagina to the penis ?\n\ni have a problem. while me and my boyfriend were alone, i sat on top of him and rubbed my vagina on his penis from the base to just below the tip. but i cant be 100% sure i didnt accidentily rub on the tip of his penis. im a virgin, but im terrified i might be pregnate. can u help me please?",
    "doctor_response": "Hello, Most probably you are not pregnant. But please avoid taking such risks in the future. If you need more help, you can visit: www.med50.blogspot.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal cramps and diarrhea after gallbladder removal surgery?\n\nFor the last few years well more so ever since I had my gallbladder removed every time I eat main meals like breakfast, lunch and dinner I have very painful cramping and diarrhea. The pain lasts for hours and the diarrhea is a consistent problem for me. Any ideas as to what it could be or who I would see to get checked out.",
    "doctor_response": "Gall bladder stores bile which helps in digestion of fats.i would suggest to decrease ur fat intake since ur gall bladder is removed.and with every episode of diarrhoea replenish ur salt and minerals with ORS etc.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is my BP level a cause for concern?\n\nmy doctor has just taken my blood pressure and first time it was 188 over 79 and second time was 189 over 80 (he worried me). He wants me to go back to see a nurse on friday. Should I be worried?I am 38, 5ft 3inch, 16stone (just lost 2.5stone) and have a history of depression & stress (my eldest son has Aspergers which causes lots of stress)",
    "doctor_response": "Yes definitely u should be concerned...but need not worry. ...high blood pressure for long time and specially uncontrolled can lead to harm to eyes kidney heart brain ...so keeping in control will help u for long term...for that u just need to have regular followup exercise diet. ..low salt day today ...take care dear",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for an itchy skin rash in a child\n\nMy 5 yr old started crying on friday w/ a headache and nausea. It was very intense. About 6am she threw up some and the headache continued. Tylenol took it away and she played until about 4 and then the headache was back and a fever of 101. At this point she hasn t had tylenol since midnight last night and no headache or fever but she has an itchy rash under one arm and it looks a little sandpapery on her belly but she is not complaining of itching there. Just fluky or something to watch more carefully.",
    "doctor_response": "Hi, Sand paper like rash and itching along with fever could be scarlet fever. She needs antibiotics - Amoxicillin. Please consult your pediatrician.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is Mometasone dangerous to use on Face to clear my acne pimples?\n\nHello doctor, I am seriously facing acne pimples problem. Sometimes they occur on my face when I masturbate. If I use Mometasone, it gives a good result. Is it okay to continue this?",
    "doctor_response": "Hello. Acne is a universal issue in the age group of 15 to 25 years due to hormonal changes in adolescents. However, there are multiple effective treatment options depending on the grade and severity of the problem. Mometasone is a topical steroid and is to be avoided strictly on the face and for acne as it can harm your skin in the long run. Acne is dependent on hormones hence excess masturbation may sometimes lead to an increase in the problem. I would advise you to stop Mometasone immediately and kindly upload appropriate images to help us assess your current grade of acne and treat you better. Regards. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold and stuffiness in nose\n\nMy son has a cold, right now it s more of a stuffy nose, his throat hurts and it s coughing often. I have been giving him DayQuil, NyQuil and Emergen-C. The cough it s more now and I m not sure what else to do. I don t like seeing my son sick at all. He s been sick for a few days now. Thank you",
    "doctor_response": "use syp xyzal 2.5 ml once at night along with otrinoz pediatric nasal drops 1 drop each nostril 4 times a day for cough use syp ambrodil s 2.5 ml thrice a day. all for 3 days . if still not getting well consult a pediatrician he will start an antibiotic",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for congestive heart problem in a 91 year old female\n\nMy mom is 91 and just recently had a chest/heart x-ray which should some congestive heart problem with some water around her heart. Took her to cardiologist and he put her on Lasiks 1 per day and said to keep her feet and legs elevated. He wasn t real concerned, but did order an echo cardiogram to be done soon. Her home attendant just took her BP/pulse and reading was 128/77, pulse 100. She just started the Lasiks Thurs. May 7, 2015. She says she can breathe ok, but attendant says she s breathing heavy in a recliner chair w/feet up. She s adamant NO HOSPITAL. Do I need to worry?",
    "doctor_response": "Hi. Thank you for your query. I read it carefully.Now, the echocardiogram is really important in patients with congestive heart failure (CHF) in identifying the ejection fraction of the ventricle and in assessing the movement and compliance of the heart muscle. My opinion is that furosemide (Lasix) should be continued, but she should be put in a very low salt intake diet. Furthermore, she should be restricted to only performing routine activities of everyday life. The problem is that any moderate to vigorous effort, as well as other factors (e.g. salt) that increase the workload of a failing, insufficient heart, raise the possibility of decompensating the CHF and exacerbate severe symptoms, that may be even life-threatening. I hope I was helpful. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a need of chemotherapy or PET scan for ovarian cancer?\n\nGynacologist has identified my disease as Uterus cancer before the Surgery and the Oncologist has confirmed as Ovarian cancer on the 2nd of October' 2009. It was stage IV and grade III. I underwent Laparotomy surgery (both uterus & ovarian removed) and then followed by chemotheraphy. I have completed all 6 chemos on the 10 of Feb' 2010.My CA 125 report before the Surgery is 2750 U/ml, 3 weeks after the surgery is 385 U/ml(ie,before chemo), before the fourth chemo is 32.9 U/ml and after the 5th chemo is 15.4 u/ml.(it should be less than 21 according to the Lab.After that my CA 125, ultra sound scan and blood reports were normal up to Jan' 11. CA 125 reading is 76.90 as on 02/04/11. went for CT scan (chest, abdomen and pelvis) on 18/04/11 and the impression is as follows:Enlarged fatty liverLarge incisional hernia of bowelno features of a recurrent or residual tumour.CA 125 is 112 as on 04/05/11. do I need to go for chemo or PET scan? it is not available in Sri Lanka. how can I do it at Adaiyar cancer hospital. pl guide.",
    "doctor_response": "Hi,Thanks for writing in.You have a large incision hernia of the bowel probably through the laprotomy area. This is important to be repaired surgically and if required with the insertion of a wire mesh to contain the bowel and prevent hernia.Your CA 125 is constantly increasing as seen in the last two reports. Doing a PET scan is important to know if there is any hidden suspicious cancer activity that is not visible on the CT scan. PET scan shows areas with high glucose metabolism and this usually refers to areas where there is increase cell multiplication like a cancer. Chemotherapy can be started after PET scan confirms any cancer activity. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Gave lidocaine injection at rear of mouth to extract lower molar. Why? Stabbing pain while healing\n\nAfter dental injection of lidocaine into the lower mandible, and very far towards the rear of the mouth (in fact it was to numb for an extraction of the left lower molar next to bicuspid, and I questioned \"Why so far back?\" to the student performing the injection [unsupervised, I might add].  I thought that healing processs was not right, developed severe (and I do not use thi word lightly) pain starting in lower left mandible, but much more intense (like someome were stabbing me with a knife in my left temple and left eye...I pride myself on not crying from pain, yet this pain, at 51yrs of age has me sobbing and in a fetal position, what is so terribly wrong?",
    "doctor_response": "Thanks for sharing your concern in HCM forum. In the first part, the student, as you said, is not wrong in giving lignocaine injection at rear part of the jaw. The nerve that supplies all the teeth of lower jaw enters into the mandible through a hole from that area. It is called nerve block to anesthetized the whole side of the jaw. If the injection is given just beside the tooth it will not penetrate the thickness of the jaw bone to reach to the nerve for the particular tooth and that does not numb your tooth. It is generally done in child patients till 6 to 7 years of age when the jaw bone is much thinner . In the second part your suffering of pain is little unusual. Post extraction pain is generally not so severe. There are commonly three reason of sever pain after extraction of tooth. firstly there could be laceration or fracture of the tooth supporting bony part of the jaw, Secondly the area could be severely infected and lastly it turned to so called 'dry socket'. You should visit to your dentist as early as possible for diagnosis and get proper treatment. And nothing of these are 'terribly wrong' in their occurrences. Any such pain can be controlled by using analgesics. Until you visit your doctor you can start Aceclofenac 100 mg two times a day.Take this drug in full stomach or take 15 ml of any liquid antacid before this medicine if you have the problem of acidity. You can take paracetamol 1gm if you feel pain in between. Hope this will relieve your problem...get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes emotional instability along with mood swings?\n\nMy  son has schizo affective and biplar disorder.  He developed tardive dyskensia from anti-psychotic medication about ten years ago.  He is 41.  Currently he is hearing voices, very paranoid and emotionally unstable with strong mood swings.  His medical advisor wants him to try Latuda but he is afraid to do so, not trusting that it will not make his painful tardive dyskensia worse.  Is there another atypical antipsychotic that does not have the side effect of TD?  Or is Latuda not likely to worsen the TD?  Thank you for reading and replying!",
    "doctor_response": "hi there, there are few anti psychotics which has very less potency to cause tardive dyskinesia. The best one among them is clozapine. It is sometimes even use in tardive dyskinesia for psychosis. Other medicines like olanzapine, quetiapine are also useful in this condition. There are limited data available for lurasidone or Latuda as it is recently available still it has some risk for TD. Hope you find the answer helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause pain and stiffness in the shoulder?\n\nFor almost a year I have been dealing with shoulder pain. The pain is often a dull achey feeling that causes my shoulder to be uncomfortable and it often feels stiff. Recently the pain has been more jabby at the top at the bottom of my traps. I ve noticed that my shoulder often makes cracking noises when it gets stretched which aren t painful but are new. I also noticed recently that it is incredibly hard for me to raise it straight up despite it being my dominant arm. It gets stuck and hurts too much to raise it more and needs outside help, but my other arm has no problems with being raised straight up and down in the air",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You may have a situation called shoulder bursitis. To relieve pain use ice compresses, rest, anti inflammatory and pain medication such as Ibuprofen and Codein prescribed by your doctor. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will radiotherapy and chemotherapy curative effects be known after a few months?\n\nI have completed my Radiation therapy for 35 days and for chemo cistapline for Cancer LA on 7 April 2010.  My Oncologists say that total effect of cure can be known after 2/3 months and has suggested me for a visit on 28 May 2010.  What do you say ?",
    "doctor_response": "Hello dear. The effect of treatment can be said only after 8 to 12 weeks of the treatment as in between this period radiation effect persist and can lead to false results. So do not worry and get evaluated after a gap of 2 to 3 months. Hope you understand. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for having a lump under the jaw where tooth extraction was done?\n\nI had an extraction a few months ago because of an infection. Since the extraction I have a lump under the jaw where the tooth was. I was given an x ray which showed a dark show in that area and given stronger antibiotics for 5 days. I'm worried that this could be more serious.",
    "doctor_response": "Dear sir/mam,welcome to healthcare magic.You have not mentioned the dark shadow is well defined or not.if it is well defined then it is cyst, if it is not then periapical infection.A tumor is a growth caused by an overproduction of cells. A cyst is similar to a tumor, except that it is filled with fluid. Both tumors and cysts can form in the bone of the maxillofacial region, most frequently in the lower jaw bone, or mandible.The antibiotics are given to control the infection. donot worry the dental surgeon will take care of it. you can consult a oral maxillofacial surgeon for second opinion.thank you,Dr.Rahul Banerjee",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headaches and lump on neck?\n\nHi, I am a 43.  Have had right sided headaches/Pressure behind right eye, temple and sometimes pins and needles feelings on right side of face for about 3 years.  Had terrible pain when this first started and could not raise my right arm without pain.  Doc ordered Ct of head but, found nothing.  Now I have a dime size hard lump on the back of my neck it is on the right side also.  My neck often feels stiff if I turn my head to the right.  My pain is dull now.  Going back to the doctor again soon.  Any ideal what this could be?",
    "doctor_response": "Hi,Good Morning-from INDIA.I am Dr.Savaskar M.N.here to take of your health query from HCM virtual Clinic. Thanks for your Health-query to HCM Clinic.-I studied your query in-depth and I understood your concerns.-My opinion-this-complex of symptoms and history- is simply a-Cervical Spondylitis with root compression on right side , which is undiagnosed over last 3 yrs time may be by oversight or may be it was not clear symptom complex as its now.-Remedy-a-Tb NSAID-for 10 days time.b-Heat Compressess on neck or US treatment to neck and or Cervial Traction SOS / and Cervical Collar-for 2 wks time.c-Tb Serropetidase-if compression does not regress in 10 days time.d-Local-Muscle relaxant oint 2 times a day.e-Tb  Neurobion-for 2 wksd-Tb -Alprax 1 mg hs for 1-2 wks time.Still consultaton from Ortho-Surgeon  and fresh MRI-of Cervical area with head-is a must.This would rule out  headache and neck stiffness.-The lump in the neck is just a coincidental happening and it does not have relation to your headache and neck stiffness and would be taken care by the Surgeon-by Excision if it troubles you.-Hope this would help you recover fast out of the   Lump anxiety.Wellcome to HCM again for better Health and Living.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair loss and premature greying of hair\n\ni'm 23 year old working man height 5 7\" weight 60.... I 'm staying away from my home.... not gettin good quality food.. i'm facing problem of hair loss and hair greying.. is it possible to revert hair loss and hair greying???? should i go for vitamin suppliments???",
    "doctor_response": "Hi, I would recommend you to take hair supplements like tablet Follihair and apply hair growth serum like Anaboom Anti Hair fall serum. You need to continue this to see significant results. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Got pimples due to change in weather and left black scar. Applied melalite cream, got rashes and area became black. How to rectify the problem?\n\nIm divya and im 22 years old.recently i went out of station and because of the weather i got some pimples on my face.in 2 dayz d pimples were gone but im left with the black scar so my mother asked me to apply melalite cream on d scars.but the nxt day i got rash nd now the whole area became black were i applied d cream.So can u please suggest me what to do.",
    "doctor_response": "Write your answer hereYOU CABT APPLY OILY CREAMS ON ACNE SKIN PIM,PLES OCCUR IN OILY SKIN THE BLACK MARKS ARE DUE TOB REACTION OF CREAM YOU HAVE TO KEEP DRY SKIN INN PIMPLESDONT APPLY OILY CREAMS AND SOAPS IN SKIN DONT TAKE OILY AND FGRIED IN PIMPLES FOR PRESENT REACTION YOU TAKE CLARITIN ONCE A DAY APPLY CLINDAMYCIN GEL IN MORNING AND TRETINOIC ACID AT NIGHTT IF THE SKIN FEELS DRY U CAN ADD SMALL AMOUT OF FLUTICASONE IT MAY TAKE 3-4 MONTHS TO CLEAR M,ARKS WHEN U GO OUT APPLY CALAMINE OTION",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can complex partial seizures be cured?\n\nHello doctor, Recently my neurologist diagnosed me with complex partial seizure. However, after taking two different medications and increase in doses has not helped. So here is my story: several years back I had been going through an extreme amount of stress. I had some migraines: occasional sharp pain in the frontal lobe. As time went on, I have been having strange episodes from once a month, to once a week and every day now for several years. Symptoms:  Dozing off (spacing out) without realizing, lasting two to five minutes when it first started. But now it lasts less than a minute. Staring. Uncontrollable head movement from side to side. Head tilting downward. Feeling numb. Blurry vision.  In some ways, I feel paralyzed as in if I want to speak there is a delay. Also, if I want to move there is a delay. I do not know when I go into these episodes but I sometimes know when I come out of it. No abnormality in blood tests, no abnormality in MRI. No abnormality in EEG testing as well. My neurologist determined based on my symptoms. I was prescribed Lamotrigine 100 mg daily increased to 200 mg. This did not help. So, I went on Carbamazepine 400 mg daily increased to 800 mg. This did not help either. So, is it actually a seizure or could it be something else? Do I need to continue trying different medications? Please help.",
    "doctor_response": "Hello. Based on the description of these episodes, I agree with your doctor that these episodes seem to be related to complex partial seizures. I would like to directly review your EEG (electroencephalogram) reports if you can upload it. A normal EEG is not surprising in complex partial seizures. On the other hand, you should know that if two anti-epilepsy drugs, in their optimal doses, fail to control seizures, the chances to have success with the third anti-epilepsy drug are lower. Anyway, considering a normal EEG and normal MRI findings, I would recommend discussing with your specialist on the possibility of performing a prolonged EEG or video EEG in the hospital (up to seven days) or an EEG with sleep deprivation, to have more information on the possible location of the seizures. In such a case, switching to another anti-epilepsy drug could be an option. Another option if there is a focus on EEG, would be discussing with a neurosurgeon on the possibility of a brain surgery, in order to have a better control on seizures (considering pharmacoresistant epilepsy). Hope to have been helpful. For more information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can vaginal infection be treated?\n\nSo like two weeks ago I went to the doctors and was diagnosed with a yeast infection I started taking the monstait 7 and it went away but two days before I went to the doctors I was on my period but I got off and now I\u2019m back on my period and the burning and itching is back idk what to do",
    "doctor_response": "you should pay a followup visit to your doctor.It may be due to incomplete eradication of the causative agent or due to some new infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can one deal with the side effects like rashes due to medicines for primary complex in children ?\n\ni have a niece who is 1yr 3months who was diagnosed of primary complex or tb in children after having a ppd test APL chest xray she started her medication but after 2 days of taking it she had a prurit IC rashes all over her body she was given cetirizine oral drops but still rashes appearwhat is the best to manage this im 34yrs old, female and married.",
    "doctor_response": "Welcome to Healthcare MagicBest would be to stop the offending drug and use other drugs or 2nd line agents. The rashes will go away, you can apply Lactocalamine lotion on those sites. She needs proper treatment from WHO/RNTCP Government treatment regime for best results. She needs to be kept away from anyone in the family who has TB or chronic cough to prevent spread of drug resistant TB and also other infections. Let her use handkerchief while coughing. Proper handwashing technique to prevent infection as well. Give her proper diet rich in protein like pulses, cereals, eggs, chicken, lean meat. As of her drug allergy which is probably because of one or more of the drugs, it needs to be changed or dropped from regime. Consult her Doctor in this matter for solution and usage of possible 2nd line drugs.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could little wisp like lines after fall on ice followed by normal result in CAT scan suggest?\n\nHi, I slipped and fell on ice. Went to emergency room and had a CAT scan. They said everything looked good and to follow-up with a Dr. in 5 to 6 days. This happened yesterday. I'm still seeing \"lines\" not spots but actually little wisp like lines. My question is why and will it go away?",
    "doctor_response": "they are micro blood vessels beneath your skin they get ruptured and cause bruising, the redevelopment take 14 to 20 days depanding upon your age and your diet so it will subside don't worry about those",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mild fatty liver\n\nI had a high ggt since 5 months, but now increases to 214, i don't have any symptoms,my doc. advised me to have ultrasound then the conclussion was a mild fatty liver. all my liver function test was in normal level..doc what should i do? I am not  an alcohol drinker. thank you..",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.there are two main types of fatty liver disease so treatment depends on this: Alcoholic liver disease and Nonalcoholic fatty liver disease. You can get alcoholic liver disease from drinking lots of alcohol. It can even show up after a short period of heavy drinking, other causes are obesity and hepatitis B and C.If you have alcoholic liver disease and you are a heavy drinker, quitting is the most important thing you can do. Talk to your doctor about how to get help. If you don't stop you could get complications like alcoholic hepatitis or cirrhosis. Even if you have nonalcoholic fatty liver disease, it can help to avoid drinking. If you are overweight or obese, do what you can to gradually lose weight -- no more than 1 or 2 pounds a week.Eat a balanced and healthy diet and get regular exercise. Limit high-carb foods such as bread, grits, rice, potatoes, and corn. And cut down on drinks with lots of sugar like sports drinks and juice.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible post tubectomy surgery?\n\nHi, I have 2 kids(not normal delivery) and undergone with tubectomy(open surgery) also. I didn t get my periods in the last month. I have checked using the pregnancy kit and it is positive. How it is possible. Is it a doctor mistake that she didn t do properly?",
    "doctor_response": "Hello,Thanks for sharing your health concern with us. I have gone through your query and here are your answers. 1. Any contraceptive procedure, including tubectomy, has a failure rate. This does not mean that the doctor has not performed the procedure correctly. It only means that the tubes have re-canalized after surgery. 2. If you do not wish to continue with the pregnancy, please get further help from a specialist. Either way, you need to see a doctor for further management. 3. If you wish to clarify further, you can go for the estimation of the serum beta-hCG titres and follow up with a trans-vaginal sonogram. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My father has been diagnosed with stage 4 colon cancer and has been given about 6 months to live\n\nI am just depressed. My son wants nothing to do with any of our family since he married an girl in Indiana. She has taken him away from the whole family & he never talks to any of us. My father has been diagnost with stage 4 colon cancer and has been given about6 months to live. I just don t know what to do",
    "doctor_response": "Since your father has stage 4 colon cancer i would suggest u start palliative chemotherapy for him.The intent of treatment is palliation and not cure and improving his quaity of life.Also u can do a KRAS mutation report from his biopsy sample and if wild type then cetuximab can be added as targeted therapy to chemotherapy which may increase his average survival time.RegardsDR De",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain, acidity, acid reflux, painful and irregular bowel movements?\n\nHI, my daughter is 5 yrs old. In the evening she drinks pediasure 3 scoops in 200 ml water. Around 7 or 8 o clock she says she got acidity and afternoon food is coming up. not vomitting. sometimes complains of stomach pain. does not have appetite for dinner. lost weight. bowl movement irregular and hard. says she has got pain when passing stool. do i give her neopeptine syrup and what dose?",
    "doctor_response": "Thanks for expressing your query at HealthCareMagic. I have gone through the details provided by you and understand the cause of your concern. Let me first explain what happens normally. Acid is secreted continually by our stomach and is meant to be helpful for digestion. But if the gap between meals is more, more acid gets accumulated and this can now cause ulcer. The solution would be to put small amount of meals at frequent intervals so that the acid does not need to sit idle and can act rather fruitfully. The bowel movements are supposed to move the food downward upto the anus as the digestion proceeds on the way. The acid also comes down in same manner and does not accumulate if the bowel habits are regular. Regular activity/play and fibre rich foods enhance the stool formation and bowel movements. Give your daughter small but frequent meals and include isabgol husk in her diet (at dinner) along with more green leafy vegetables. In the evening give her some solid food containing both carbohydrate and protein, rather than giving supplements. I hope that will take care of the situation.Although many doctors advise neopeptine, I would not insist on giving neopeptine to her as it is broken down by gastric acid and is not quite effective in assisting digestion.Hope that the above information would be helpful. Feel free to revert back in case of further queries if any.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Last stage liver cancer, unconscious, making gestures. Taking morphine drip. Is he able to hear?\n\nMy grandfather is in the hospital going through the last stages of liver cancer and he s on a morphine drip and Ativan sometimes. He s unconscious but I feel like when we talk to him he makes gestures as in trying to say something. Can he hear us? And if he can is it painful for him to know he s dying but can t say anything? Is he in any physical or emotional pain? Thank you",
    "doctor_response": "Hi there, It is accepted scientifically that hearing is the last faculty to go before death and it is alright for you to talk to him.  Definitely we cannot comment anything, but about his physical or emotional pain better to communicate with the nursing staff and see if they see any physical signs etc for them to feel so. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the swelling of the right testicle during intercourse after vasectomy?\n\nHello, my husband is 34, 6 ft 5 and 300lbs. He had a vasectomy 4 years ago. When he had the vasectomy his right side did not take the doc said and he had to have that side done again. Now four years later his right side will swell up. When he ejaculates it goes down. This only happens before intercourse or every 5 days or so. This seems odd to me and I was wondering if there is a possibility that side has come undone again???  thanks",
    "doctor_response": "HiGREETINGS IF it is happening only during intercourse we need to rule out any spermatocele near the dissected area.Initially you can get an ultrasound scan of scrotum to find out or get a physical examination with urologist. Hope my answer helps you Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back pain long after treating back injury?\n\nHello, My name is Troy,,Seven years ago I had what was called a slip fall accident, twisting of the lower back. I had to distinguish my lower back Pain. Having follow up care with practicing physician. It would seem other than my pain of the lower back, high-blood pressure. I never had in any of past visits before..could there be a link?",
    "doctor_response": "Hi Mr Troy,I have gone through your question in detail and understand your concern.Yes,there could be a link between the two.You may be suffering from a lumbar disc prolapse causing nerve root compression.The trigger may have been the 7 years old trauma.I would suggest you to get a MRI of the lumbar spine done to rule out a disc prolapse and consult a orthopedist / neurosurgeon.I hope the answer was useful to you.Get back to me for any doubts that you may have.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of vyvanse 20 mg?\n\nIs 20mg of vyvanse alot for a 20 year old ? I am 150 pounds and i hear it can cause diebeties is that true ? I have been on vyvanse since i was about 15 or 16 and i have not had any big problems yet and i take it everyday so over all is this alot and is it bad ?",
    "doctor_response": "Hello, Vyvanse dose range is 10mg (smallest) to 70mg (largest) so 20mg that you are taking is not a very high dose. Vyvanse has a long list of potential side effects but diabetes has not been described as one of them. Serious side effects are heart related which is why heart testing is recommended prior to starting the medication. common side effects is loss of appetite and weight loss, again these are not related to diabetes. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Kamila Seilhan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infection below lower lip\n\nhi my name is Elizabethmy chin well  a little above that like right below my lower lip.it is leaking yellow stuff and it dries A little bit kind looks like the color of ear wax. what is it and how can i help it stop and what it it from . it was sore b 4 it happened btw",
    "doctor_response": "Hi...Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns...As per your complain it looks like FolliculitIs that is bacterial infection of the hair follicle and due to infection there is abscess formation and the yellow sticky discharge seems to be pus.Nothing to worry as it will be resolved by taking a short course of oral antibiotics like Augmentin for 5 days, Anti-inflammatory painkiller like diclofenac potassium or Ibuprofen.Clean the area with antiseptic solution and apply triple antibiotic ointment over it , do it twice a day and drain out pus as much as possible..Do not scratch the area with your nails if there is itching or do not try to peel it..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes irregular heart beats with sleep deprivation?\n\nok this has me a bit scared. i am 46 and use a cpap machine everything seemed fine until about 3 weeks ago. I just was getting very anxious and stressed out and literally broke down crying and took myself to the emergency room, my chest had been hurting for a while. I have noticed since then that when i lay down to sleep that my heart seems to be be beating differently or at least feels this way. My lungs seem full of fluid and I am NOT sleeping super well. I go to bed quite early, wear the mask and am often up at 2 and cannot get back to sleeep wearing the mask. Why so sudden? how scared should I be, I am tired all the time, but not falling asleep at the wheel or anything. I am thinking that something has really changed and that I am suffering from sleep deprivation",
    "doctor_response": "Hi,Is this a fast heart or irregular heartbeat, is there a shortness of breath associated? There is some problem probably in heart, likely atrial fibrillation which is common in patients like you. From your description or some other which is causing sleep deprivation and all secondary problems. So you should get yourself examined and one ecg should be done. If needed holter monitoring should also be done. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chronic cough and yellow mucus?\n\nHey I have been having chronic cough and yellow mucus in my throat and nose for three weeks now. I used to smoke 1 pack of cigarettes each day but for 2 months have cut down it to less than half a pack each day. This is the first time I am feeling so. Haven't had any such problem earlier. Can it be lung cancer ??? I am really tensed have taken tried antibiotics, cough syrup and nasal spray. I have been on them for 3 days. The mucus is still building up in my nose but seems to get settled in my chest as I cough real hard but very little mucus comes out.age : 21 yrs (male)Weight : 68 kghave been smoking for 4 years.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Possibility of lung cancer is very less because lung cancer is uncommon at your age of 21 years. Possibility of bronchitis is more because you are smoker. Smoke irritates airways and cause inflammatory changes (bronchitis). So better to first quit smoking. This is the most important thing in treatment. Also consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x ray (to rule out lung cancer) 3. PFT (pulmonary function test) for the diagnosis of bronchitis. PFT will also tell about severity of the disease. And treatment is based on severity only. You may need inhaled bronchodilator and inhaled corticosteroids (ICS). Don't worry, with proper treatment, you will be alright. But first quit smoking. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "what should be done to protect everyone in house from scabies mite?\n\nMy family has recently gotten the scabies mite... WE have cleaned our house top to bott om with hot soapy water, Rid, Used a cleaner on carpet/couch. we treated ourselfs with Permethern cream, Eurax, and i have used tea tree oils, poroxide, etc. Everyone but me and a older son has kicked it. I have went as far as sanding my skin....My question is what do I do to rid it once and for all SAFETLY! I was told Borax in a tub ....is that safe? HELP",
    "doctor_response": "Hi and thank you so much for this query.Can be very disturbing to get your entire household infested by scabies. Hygiene is the rule. Treating every sick person, washing and disinfection all linen as well as ironing would ensure that this bug is gotten rid of. So step up your personal hygiene after treating every affected individual and disinfecting all linen.I hope this addresses your query fully. Feel free t ask for more information if needed. Thanks for using this panel for your questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Discoloured discharge from vagina, problem in getting pregnant for second time. Help\n\nhi i have been trying too get pregnant for 2 and a half years now after my 1st son i fell pregnant quick with him but now im struggling too get pregnant again but iv started having alot of discharge now and its getting really bad my boobs are always sore and im bloating alot but i have just researched discharge and it says it can bloke tubes i am very worried not as i have had discharge for nearly 2 years but got worse as times gone on and changed in couler alot please help ..",
    "doctor_response": "Hello, I would advice you to get a check up done from your gynecologist to rule out local infection which can be a cause for discharge,if it is so then you need to take a course of antibiotics to clear the infection. Second advice would be to go for a thyroid function test since you say you are bloating up,as abnormal thyroid levels can also lead to infertility. Meet your doctor with the reports,and follow her advice on further management . It is not a big problem so don't worry it will get solved soon. Take care. Dr. Rishma lakhani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluctuation in the BP?\n\nHere is what is happening or happened: - Blood pressure keeps spiking to 167/90 throughout the day - The past week my BP has been going from 146/80 to 167/90 - Woke up around 3:00 am with huge pressure in head and I can feel that BP was up, when measured it was 167/90. - During the day it spikes , I do not measure but can feel it especially in head. - After waking from sleep with BP raised my arms feel as if I was sleeping on them. - Ringing in ears. - Very real dreams every now and then. - Sex drive normal. - Difficulty sleeping because of the above symptoms. - Sometimes will wake up from a very real dream and feel the pressure etc but when measured has been around 138/86, today was the first time I woke up from sleep with pressure in head and elevated BP. I am taking 25Mg Metoprolol twice daily early morning and early evening. I am also taking Lisinopril 40Mg once a day. I have not started the diarectic as not sure what is going on and feel it may make things worst.",
    "doctor_response": "Hello, I would explain that considering your situation, it is important performing some tests in order to investigate for a possible metabolic disorder: - complete blood count, PCR, ESR for inflammation- thyroid hormone levels for thyroid gland dysfunction- kidney and liver function tests- blood electrolytes. Increasing the dose of metoprolol or adding a calcium channel blocker (amlodipine, lercanidipine) to your therapy may be needed. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bitten by ants, redness, difficulty walking, have pain. Applied Cortaid and Benadryl. Have diabetes type 1\n\ni stepped in an ant pile. we got them off and out of my shoes. there were atleast fifty ants on me. I washed my feet in cold water for several minutes and applied Cortaid and took Benadryl. then I went to the grocery store and on my right foot on the right side has a red pone on it and I could hardly walk and now I can't walk on it without severe pain. I have diabeties type one also",
    "doctor_response": "Hello,Inflammation due to ant bite may have caused this problem.Foot care is all the important in diabetes.If left untreated it may progress to diabetic foot ulcer.Maintain your blood sugar under good control.Consult a podiatrist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in abdomen while blowing the nose?\n\nTwo days i ago i either had a stomach flu or food poisoning but I threw up all of the morning until 2:00. For the rest of the day I felt horrible. Then this morning I blew my nose and immediately felt an intense pain in my lower abdomen for the first time. The pain has been on and off throughout the day and can be quite extreme. Could these two events be related? Could it be from dehydration? Should I see a doctor?",
    "doctor_response": "Hi,From history it seems that due to frequent forceful vomiting there might be having strain and spasm of abdominal muscles giving severe abdominal pain while giving forceful blowing of nose.Take some analgesic with muscle relaxant medicine as needed.Within a day or two it will be alright.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could Urine Routine findings be serious while also suffering from kidney stone?\n\nI have 2-4 Epithelial Cells per HFP in my urine test and 4-6 pus cells per HPF.  Urine culture report is alright and no bacteria has been found therein. If there is something to worry about, pls let me know. I have 5.1 mm stone in my left kidney as per ultrasound report.  Sometimes, I feel some itching and white fluids coming out from penis, causing redness in and around outside. Pls guide me.  Thanx n regards",
    "doctor_response": "HelloThanks for query .Based on the facts that you have stated I would state that presence of 4-6 pus cells and 2-4 epithelial cells  detected on routine urine test with negative culture suggests mild UTI .and  stone of a size of 5 mm in kidney .Please take broad spectrum antibiotics like Cefixime   along with urinary antiseptic like Nitrofurantoin twice daily and urine alkalizer thrice daily .Taking Tomsulosin once daily will help to pass out the stone spontaneously.Ensure to drink more water to produce more urine this will help to flush out the stone .Dr.Patil..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blisters around the anus?\n\nHi, my 7 yr old has 6 small pimples around her anus. She is one of our 3 kids. All 3 kids have contagious mulluscum. We followed advice from our pediatrician and switched our kids to Antibacterial soap for cleanings. Do you think th red bumps are most likely the mulluscum or maybe an irritation from our new use of dial bar soap? What could I use on the bumps? I have some mupirocin?",
    "doctor_response": "Thanks for the query.It looks like there may some irritation, which is causing blisters.If ther are red, painfull they may be infected.You can apply mupirocin cream.Please upload imagae for better diagnosis.Hope i helped you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the child to eat papers, crayons and erasers?\n\nMy 6 year old has been eating paper and erasers off of pencils (at home). His teacher recently commented that he was eating crayons and pencils at school. From what I ve gathered this May be Pica. My question is should I start him on daily vitamins or set up a doctors appointment? Also, could this be a result of family issues or disorganized family structure? (I recently read this too but the source was not cited so unknown if reliable). We have had the paper issue come up before but the crayons and pencils are new.",
    "doctor_response": "Hi...you are right. This could be pica. But instead of multivitamins I suggest you use iron supplements. As this is a prescription medicine in many countries you need to consult your pediatrician. This could also be because of family issues... But you can try iron supplements first.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my new born advised to give antibiotic medicine?\n\nHi Doctor, My baby was birth on 24 March. The doctor gives me an antibiotic called \" Augmentin\". The doctor instructs me to drug my baby with the antibiotic. I have asked other parents about it. They dun even receive the drug from their doctor after they birth their children. Is it my baby is infected by bacteria or any reason cause she have to take the drug ?",
    "doctor_response": "Hello,The only reason for a baby to be given augmentin is if there is a bacterial infection. If you are not sure why the doctor gave it to you, I recommend contacting the doctor and asking before you give the medicine.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Eric Goldstein",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for dry flakes on skin?\n\nYes...I am a very fair skinned african american with very dry skin.  I wanted to know how I can get rid of the dry flakes that appear in my eyebrows, on and around my nose and sometimes around my mouth and cheekbones.  My skin is also very sensitive on my face",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern and let me tell you that this is dry skin condition and this would come around with the moisturizing agent and this can be applied with steroid preparation and the best option would be contains of lactic acid, liquid paraffin, and steroid (Mometasone) would be best combination, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes aspiration pneumonia?\n\nI have been diagnosed with aspiration pneumonia the ER doctor said it was due to being strangled unconcious a month ago but I read on line it could be due to a bad tooth, which I have. I asked my PCP to allow the dentist to pull the tooth in question after the xray showed it was badly infected. My doctor said that because my blood pressure was so high (we have been trying to get it under control for 2 years now still averages 180-190/124-102... But if I was able to have the teeth pulled the infection would clear up and my blood pressure would go down...Am I not seeing things right or is my doctor being over cautious??",
    "doctor_response": "Hello,You need to get Blood pressure under control. Such a tooth extraction really needs good experience, equipment and back up facility also.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Kaushik Saha",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is allergy to milk,curd,green chilly,mustard oil and yeast a food allergy or lactulose intolerance,and how can it be treated?\n\ndear sir i am suffering from intestine gas, constipation, nuesia, bloating and cramping, isomania from last 15 years. i went through Ige food allergy test. results show allergy from milk, curd, green chilly, musturd oil and yeast. day befor yesterday i did not taken ay milk product. and my stmoch is feeling quite comfortable. this is food allergy or lactulose intolerance. how it can be treated.",
    "doctor_response": "Hello.Thank you for asking at HCM.IgE food allergy test is not 100% accurate. So I would suggest you to consider your food allergy report as a guide, not a diagnosis.Milk allergy is very common. If you have it you will have to avoid all milk products and you will see a very good improvement within 2-4 weeks.As a practical option, I would suggest you to avoid the foods that you have tested positive for for 2 weeks, and if you are improved, introduce single food (from the list you have avoided) every 2 weeks. Please keep milk & curd as last foods to introduce as they are the most common allergies.If you do not see improvement after elimination of foods for 2 weeks, I would suggest you to consult an Allergist-Immunologist who is qualified to diagnose food allergies & also to interpret results of IgE test in a correct way.Regarding your next question, if your IgE levels to milk are significantly high & you also improve with milk elimination, it is food allergy, although sometimes lactose intolerance may be present along with it.As per modern science, mail part of treatment of food allergy is avoidance of the food you are allergic to. Probiotics, immunotherapy, herbal/Chinese medicine etc are other options but they are not always successful.Hope this will be helpful to you.Wish you the best of the health.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "17 month old having decay of tooth, foul smell from the mouth. What are the dental care to be followed?\n\nHello, Im a single mother. I have a 17 month old son. When I take my son to his check ups, I ve asked about when to start brushing their teeth they toldt. me not to worry about it yet. But now i noticed a change in my son. His teeth are coming in and i realized his mouth was starting to smell. His teeth are looking dirty, gums look purplish and his teeth are beginning to look rotten around edges. What can i do in meantime for the pain while i wait to make appointment to get him seen?",
    "doctor_response": "hiii it would be very early 17th month old kid to handle tooth brush...being his mother it would be your responsibility to provide & maintain his oral hygiene. since his teeth have started to come, the food debris that get entrapped between his teeth leads to foul smell....it is advised that you should rinse his mouth after every meal, clean his tongue with soft musculine cloth. maintaining his oral hygiene this way would even prevent early childhood caries known as nursing bottle caries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Loss of memory, poor concentration, difficulty reading, time to understand things around.  Help\n\nDear sir,My name is amit gupta. i am 37 yers old male. now a days i am feeling following problems with me. kindly advice me what to do?1  my memory is very now. i cant remember even 24 hrs back events2  my concentration has become very poor. when i read a book or any written paper i feel very difficulty to read it. i can see the words but the words did not impact on my mind. i can see the page but after lot of concentration i am able to read it3 some time i can see the things in front of my eye but it takes time to understand what this thing isall these kind of problems effecting adversely on my personal as well as professional life. you requested to advice me doctor so that i can feel relax",
    "doctor_response": "Dear friend,I am Dr. (Col) R Karanwal, M.D. (Internal Medicine), Consultant Physician,  for your assistance.Thanks for reposing your faith in me and post your query on this website. I fully appreciate your concerns.The commonest cause in today's society is stress disorder --> Mental depression/chronic fatigue syndrome. You have not mentioned about presence of mental depression/stress.Amongst the rare causes, is a possibility of a space occupying lesion in the brain.I would suggest that- if you do not have depression/stress- get a CT Scan of Brain done, which, if shows something, will be dealt by Neurologist.If you have stress/depression --> consult a Psychiatrist; do Yoga and meditation daily, take life easy, have a break from work, go out on a vacation, spend more time with your family. Please feel free to revert back to me in case of further clarifications, if any.I am confident  that you will benefit from the advice.May I assure you that I am always available for your assistance.  My endeavor would always be to give you a sound medical advice,  to the best of my knowledge and vast experience.HAVE A NICE DAY AND A SPEEDY RECOVERY.Fond Regards,Dr.(Col)  R KaranwalMBBS; M.D. (Internal Medicine)Consultant Physician(PLEASE NOTE :- My opinion/advice is based SOLELY on the details provided by you.)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes big lipoma behind the knee?\n\nHi, may I answer your health queries right now ?  Please type your query here...I have a lipoma the size of a golf ball behind my knee. Is it possible to reduce it's size at all?  I have very bad varicose veins that I am currently treating with sclerotherapy and basically very poor circulation. I am female and 43 years old, weigh 65 kilos and of good fitness but have a history of venous insufficiency in my family. Does it have anything to do with that?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  You have lipoma.  Your lipoma has no relation with your venous insufficiency.  Treatment of lipoma is surgical removal. It is very minor operation.  No need to worry. Just be relaxed. Consult your doctor and go for surgery. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for middle back pain?\n\nI fell last week and shortly thereafter I felt pain in my right middle back. It was pretty intense. I thought I had a kidney infection. Went to doctor and had a urinanalysis done and test came clear. Doctor believes the fall caused the pain I was experiencing. Said to take ibuprofen. Could something else be causing the pain. The pain has subsided somewhat.",
    "doctor_response": "Hi,Welcome to HCM. Going through your query it seems that your doctor is right, it seems to be muscular injury and pain due to fall. rest for few days and ibuprofen will probably relieve it. I think your query has been answered.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe shoulder pain and numbness in the finger\n\n65 year old patient with a pacemaker, why am I having pain in shoulder near the surgery site and numbness in my fingertips? I also experience night sweats, fatigue, and rapidly lose 20 pounds in the last two months, since surgery. Why is this happening to me?",
    "doctor_response": "It might b cervical radiculopathy.As far as pain concern you must start range of motion exercises of shoulder and shrugging and bracing isometric neck exercise.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Low blood levels. Had blood transfusion in the past. Feeling dizzy and breathless. Iron tablets finished. Need help\n\nHi, I had a blood transfusion last year- 2 units, my blood is now a 9. I ran out of iron tablets while in the Caribbean (so had none for a week) I went to the pharmacy and they put me on Trihemic 600, I am to take 2 a day until they run out- so that s two a day for 15 days then go back for more and take one a day- ...I have 3 days of double dose left but I have been feeling a little breathless in the last week (I had slight headache in the first week but pharmacist said this would happen) and now my eye has started twitching- it wouldn t normally be a problem- but that is what happened when I was at stage 1 blood loss- I m not bleeding (unless I am into my uterus again- but think Id know that right? I would bleed out like last time?) Sorry I m just being a dizzy blonde- I am just worried as I am here on my own as my fianc\u00e9 has just gone back to sea. Thank you! Kiki",
    "doctor_response": "hi if you are feeling breathless or headache with hg of 9........means either you are getting more anemic coz you are a female or other problems with your rbc production from bone marrow....or having malabsorption and trihemic not getting absorbed......or change trihemic with other tablets in market take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can swelling in the neck and a painful lump on the arm be treated?\n\nI fell two months ago on ice and landed on my shoulder. I developed swelling at the base of my neck looks like a lump and causes pain in my left arm and neck when I move in certain directions. I had a mri and cat scan both are negative for tumor and/or muscle ligament damage. Primary doctor says a fat deposit but that makes no sense to me. I can not close my collar on my shirt.",
    "doctor_response": "Hi, If CT scan and MRI studies are normal you need not to worry as both are very sensitive and specific for diagnosis of spine and muscle pathology. Swelling may be due to soft tissue oedema or hematoma at base of neck. Local application of ice packs and tablet Chymoral Forte thrice a day will help in reducing soft tissue swelling. Give rest to shoulder and neck for a week and swelling will reduce. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jayesh Vaza, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for small drop of dark urine? Has been diagnosed with slow kidney\n\nMy 87 year old mother is seeing a small drop of dark urine when she goes to the bathroom. No pain in kidneys or bladder, no fever and she has been diagnosed with one slow kidney. She otherwise is in fairly good health for her age. Wondering what the small drop of dark urine might be?",
    "doctor_response": "hi pt is 87 yr old,small drop of dark urine, means nothing to worry , firstly  do the test like - lft, kft,lipid profile and routine check-up .then consult with best physician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why the color of the stool changes to dark grey?\n\nfor the last week the color of my two & a half month baby boy' s stool changes from normal yellow to grey- dark grey. For the first one month from the birth he take breastfeed. Due to some reasons we started powder milk namely farex formula 1 after one month.  He is normally doing his potty with a gap of one day. There was no problem till last week when the color of the potty changes to grey-dark grey.  Is it normal or something to worry.",
    "doctor_response": "It happens because child eats formula, dont worry ,it is normal stool. You can give probiotic drops with BB-12 to baby, it will improve his stool",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bipolar disorder in a pregnant woman?\n\nWife is bipolar and pregnant. She refuses to get treatment for the bipolar. She is very moody. I can t talk to her without her flying off the handle. She told me if I mention treatment she is done. But the last two months has been a living hell. I can t do anything right. And she acts like she wants nothing to do with me. She says she loves me but my touch really annoys her. So we sleep on opposite sides of the bed and she doesn t even hug or kiss me without being asked. What can I do?",
    "doctor_response": "Hi dear,for proper diagnosis detail history and mental status examination is required and for that you need to consult psychiatrist.According to me if your wife pregnant and bipolar then admit her in psychiatric nursing home for better treatment and care for pregnancy and bipolar disorder.How you comes to know she has bipolar disorder?is she having such illness in past?there are many medication which helps her and for best treatment ECT (electro convulsive therapy) is available.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can liver abscess  cause symptoms like bone pain,vomiting?\n\nhelloit is about 5 days that my cousin has fever of 39 degrees centigrade with bone pain,vomiting and he is very sensitive to voices. His appetite is not good also.Doctors are susceptible to liver abscess. How do you assess this diagnosis?(The results of CT scan is not ready yet) Thank you so much",
    "doctor_response": "Hi thanks for contacting HCM....Noted here you have muscle pain , vomitting , fever etc.....Here if abdominal pain associated then liver etiology can be there.....First liver hepatitis has to be ruled out by liver enzymes study and viral marker study by ELISA.....Second yes it could be abscess....For that antibiotic needed....If large enough drainage needed.USG helpful...Let's see for your CT scan report which you have done.....Meanwhile take low fat diet to rest liver.Fruits ad green leafy salad more.Carrot and spinach juice useful....Take care.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is frequent masturbation harmful?\n\nI am 14 and I end up masturbating 6 times every week despite trying to cut it short to 4 times. Is it harmful? And, I read in some sites that masturbation more than 3 times a week causes lower back pain, fatigue, memory loss, hair loss etc. Are all these true?",
    "doctor_response": "Hi, Masturbation is normal, it\u2019s just another way of having sex without a partner. It\u2019s a good practice, helps to calm your mind and release happy and stress bursting enzymes. Having 2 to 3 times a week is not an issue, more than that is also not an issue , but needs adequate nutrition and exercise which will be difficult to fulfill Ways to reduce Masturbation 1.\u00a0\u00a0\u00a0\u00a0\u00a0Sex education 2.\u00a0\u00a0\u00a0\u00a0\u00a0Physical exercises 3.\u00a0\u00a0\u00a0\u00a0\u00a0Sleep adjustment 4.\u00a0\u00a0\u00a0\u00a0\u00a0Quality of sleep 5.\u00a0\u00a0\u00a0\u00a0\u00a0Healthy and balanced diet 6.\u00a0\u00a0\u00a0\u00a0\u00a0Programming for leisure time 7.\u00a0\u00a0\u00a0\u00a0\u00a0Development of spirituality 8.\u00a0\u00a0\u00a0\u00a0\u00a0Taking a cold bath Negative Effects of Masturbation 1.\u00a0\u00a0\u00a0\u00a0\u00a0The weakness of physical power 2.\u00a0\u00a0\u00a0\u00a0\u00a0Poor vision 3.\u00a0\u00a0\u00a0\u00a0\u00a0Damages to the sexual organs and impotence 4.\u00a0\u00a0\u00a0\u00a0\u00a0Lack of memory and forgetfulness 5.\u00a0\u00a0\u00a0\u00a0\u00a0Aggression and anger 6.\u00a0\u00a0\u00a0\u00a0\u00a0prefers loneliness Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could inflammed, red, swollen fordyce spots on penis be serious?\n\nHey, I am a 16 year old male, and I have 'fordyce spots' on the underside of my Penis. One however only recently seems to have become inflamed, red, swollen. Should I be worried, or will this disappear? Will it make the spot more prominent because of this swelling?",
    "doctor_response": "HelloThanks for query.You have Fordyce spots on penis which has  turned to become red and inflamed.This is due to secondary infection of the Sebaceous Cyst (Fordyce Spot)You need to take broad spectrum antibiotic like Cefexine along with anti inflammatory drug like Diclofenac twice daily.along with topical antibiotic ointment like Neosporin twice daily for a week.Ensure to wash your genitals with warm water twice daily.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes feeling uneasy and frequent hiccup?\n\ni  feel  uneasy   and  frequent  hiccup (I  don't know  the  what to say  to that, it  is not  normal hiccup  we  call   it Dacar ,  like  fart  it  comes  up   from mouth)   which gives me pain in heart .   and also feel  uneasy in my back neck . can you  suggest  what  this  symptom  mean ?",
    "doctor_response": "Hi, It would have been great if you would have mentioned your age. Considering your age between 30-50, with such symptoms it is required to rule out acidity and angina (heartache). I would advise you to get an ECG, Treadmill test and Echocardiography done. If angina is ruled out with these tests, your doctor may prescribe you antacids for acidity.Also, Avoid high fat foods, take frequent walks and avoid lying down just after your meals. Let me know in case of your further queries and/or reports.Dr Vishesh RohatgiMBBS, MD, PGDCC",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My 16 year old son is behaving aggressively and attempted suicide. How to control his mind?\n\nHello doctor, A known 16-year-old son misbehaves with others, not staying at home, does not care about his family, passes the time with his bad company, behaving rudely to parents, and not studying properly. Parents have no control over him, and he does not care when they request him to focus on studies. He does not ask what we say. All these happen within two years of time when he joins with a new circle of friends. Last time he tried committing suicide, writing a statement against his parents as a reason for his death. After his suicide attempt, he is forcing his parents to give him expensive things. Nobody can speak even a single word against him, as it is right or wrong. Otherwise, he will take the next step to attempt suicide. He is not under the control of anybody. We think he needs treatment to stabilize his mind.",
    "doctor_response": "Hello. I can certainly understand your concern. I have worked through your attached query in detail. As per the description, the possibility of a conduct disorder or a borderline personality disorder should be considered here in your child. In view of suicidal threatening, it is advisable to consider mood stabilizer drugs at the earliest. Detailed mental status evaluation is required in a head to head interview with your child. It is advisable to consider the expert guidance of a child psychiatrist. An inpatient requirement is also high. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high levels of enterococcus faecalis in semen analysis?\n\ni had my sperm tested and they found high levels of enterococcus faecalis. prior to this, i had groin pain and minor testicle pain. don t know if that might be related. how did i get infected? i ve never had sex, let alone anal sex (im 17). should i be worried? could this be infertility? thano you very much.",
    "doctor_response": "HelloThanks for query.Your semen analysis has revealed infection due to presence of Enterococcus Faecalis .These organisms are present in perineal area and around opening and migrate through urethra to prostate and seminal vesicles .You need to take appropriate antibiotics as per culture report.This is not due to infertility but may cause infertility due to death of the sperms.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is chronic elevated heart rate dangerous?\n\nI just turned 70 and on oxygen. Even when napping my heart rate rarely gets below 90. Sitting here it is 95 and gets up to 122 - 124 when sweepin, etc. Is this dangerous? I weigh 135 at 5\"4 which is the most I have ever weighed. I take Advair and Spriva. My lung collasped on 1-21-2011.",
    "doctor_response": "hiYes chronic elevated heart rate is problematic. one of the reasons is you are on inhaler advair , it has salmeterol which can increase heart so discuss with your physician if possible to decrease that content from inhaler.Do u snore, do u have interrupted sleep, day time sleepiness. If yes you probably have OSA and needs treatment for it.Also get oxygen level checked once , is it low if yes you will need home oxygen for that.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will a person suffering from Parkinson s disease be able to walk after completing the course of medications?\n\nI had essential tremor then I had the dbs operation before I had the operation they had put me on two parkinson\u2019sdisease medicine because nothing seem to stop mr shaking,thtn I decided to have the dbs operation about a month my walking was off icouldn\u2019t walk to good. They have been decreasing the Parkinson\u2019s medicines a little at a time. I still have a ways to go. My walking. Is a little batter. Do you think when I am done with the parkinson\u2019s Medicine I will get my walking back.",
    "doctor_response": "Hello, Sorry to hear about being diagnosed with PD. as PD is all about the dopamine transmission and it has to be done by the help of medication as the brain stops producing dopamine and leads to tremors and rigidity. Taking the medications prescribed by the neurologist and doing regular physiotherapy will help you. As per the research studies, PD patients have good outcome scores with medications and physiotherapy. Your symptoms reduction will be totally dependent upon the clinical therapy and your body's healing process. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy bump at the base of hairline?\n\nhi I started out with a small itchy bump at the base of airline about three weeks ago.  It has now manifested into a large itchy swollen bump that it about 3inches and now have a itchy rash all down my back and in my hair.  It is painful and I can't stop itching. My skin is itching everywhere including my ears.  Any ideas",
    "doctor_response": "thank you for query.with the description given it may fungal infection getting super infected with bacteria.So please take oral antifungals like griseofulvin after consultation with doctor along with oral antibiotics like doxycycline or roxithromycin.keep the area clean with warm saline wash twice daily.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever after tooth extraction in children?\n\nI just had my wisdom teeth removed on Friday. My bottom, left was impacted. I've been having nonstop pain ever since and I've noticed a hard lump on my jaw line that hurts when I press on it. My mom also thinks I have a fever but with no thermometer we can't be sure. I have an appointment tomorrow but I'm just curious as to what it might be.",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, such constant pain and swelling could be due to infection of teeth periodontitis is very likely, if this is infection then it may need antibiotic, and anti-inflammatory drugs, hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of severe thigh and calf muscle pain?\n\nI have severe thigh and calf muscle pain. The muscles in my legs thigh and calf s fatigue out. I can feel the thigh muscles having what feels like they are contracting, holding, then releasing on their own. It is very painful...any idea what this might be? Thank you",
    "doctor_response": "hi,thank-you for providing the brief history of you.As you have issue with the thigh and leg muscles I think this may be connected to the lumbar spine pinch nerve.As many a times the symptoms of lumbar spine disc degenerative changes start with small symptoms like itching, burning, tingling, pulling pain etc.With simple physical therapy like therapeutic ultrasound therapy and TENS therapy the pain can be reduced. Exercise in later stages will help improve the coordination between the muscle groupsAs muscle has an abnormal contraction and pain it may be totally due to nerve pathology and needs physical therapy.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Burn rash between fingers, oozing yellow liquid. Treated for poriasis, then for fungus. Specialist opinion required?\n\nMy daughter has an area on her left hand between the index finger and the next finger.  It started out as a rash almost like a burn, and has turned into a thickened area right underneath those two fingers on the palm, that have split, broken open and are oozing a yellow liquid.  Also the fingers are oozing. The dermatologist was treating it as psoriasis, but has changed his mind and treating it like a fungus.  They originally put her on PNVK (pcn) and then lamictal.  The pcn worked where as the lamictal has done nothing.  We go back 10-3-2013 to see the dermatologist.  Should we see a specialist of some sort.",
    "doctor_response": "Hi and thanks for the query,Due to recurrence of the infection and the age of the child, I think it is advisable to get the exact causative agent and treat. This shall be cheaper and also avoid any chronic infection, spread or complications.  Samples from this area sent to the laboratory for culture and sensitivity tests could be the best thing to do. The opinion of a dermatologist of a capital issue in this case. From a simple physical examination, examination of these  patches or affected area under a lens and results from the laboratory, in my opinion, are main gateways for appropriate diagnosis and treatment. I suggest you book an appointment with a dermatologist. Thanks and kind regards.Bain LE, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedies or pills for abortion\n\ni just came to know i,m pregnant its not even a month.and i,m 18 and i want to get my abortion done what can be done?i cant visit a doctor because where i live its a country where abortions dont take place whats the best way out?can it be done with any home remedies or pills please help me..",
    "doctor_response": ",Hello,It is risky to get an abortion all by yourself,It is safe to consult a gynecologist who will suggest some pills after checking your vitals as risk of excessive bleeding ,shock,incomplete abortion are commonThanks,hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for enlarged liver and spleen\n\nThankyou.Have enlarged spleen and liver,have lost 11kgs and was feeling great walking eating healthy.A week ago started on enhance p2detox and yucca blend fibre.Last 2 days have discomfort in liver area and feeling unwell,headaches and depression.I also suffer with bipolar2 which has been under control with meds.Wondering should i continue with detox? Denise",
    "doctor_response": "according to this scan reports should be there u can continue the detox yucca fibre to thia add the blood reports",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for infection in gums\n\nI had a lower wisdom tooth removed 10days ago, it was a tricky procedure and required several stitches  2-3 days ago a couple of these became infected and i was prescribed high strength antibiotics, these seemed to work initially, it stopped leaking, the pain reduced and the swelling started to go down. However last night it started to ache again and this morning it is swollen and leaking pus again.  This is day 3 out of 5 on my antibiotics, should I go back to my dentist or wait until the end of my course?",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.The signs which you have mentioned suggest infection in the tooth socket.Please continue with the antibiotics given .Do saline gargling.Please visit the oral surgeon and have it checked ,so that the puss if required can be removed in his office and induce healing process.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the right treatment for the problem of poor sperm movement?\n\nWhat is an effective treatment for the problem of poor sperm movement? What is an effective treatment for the problem of poor sperm movement My problem only weakness of the movement of sperm Viscosity. normal liqufation time. 30 min sperm count. 80million/ml sperm motility. 15%",
    "doctor_response": "HelloYour findings suggests low sperm motility.Normally sperm motility should be at least 55 %.Your findings suggest overall 15 % motility,so it is low.You may need proper evaluation for low motility.You may need clinical correlation and investigations.You may need routine hemogram,random blood sugar,ultrasound of scrotum,hormone profile,urine RE/ME.It is important to exclude any surgical cause like varicocele for low motility.You may need anti-oxidants.You should take healthy and nutritious diet.Avoid alcohol and smoking if you take these things.Go for exercise regularly.Other factors like sperm count,liquefaction time and viscosity are normal.If infertility persists then you may need assisted fertilization techniques like IUI etc.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in kidney and groin with history of kidney stones?\n\nI have a history of kidney stones. I went to a clinic last Thursday with flank pain like it was a stone moving, A car scan was done and a urine specimen taken. Tests show no stone in unrinary tract and 2 stones in right kidney. I am still having severe pain in right side and in my groin. My flow of urine is not being restricted. The pain is rather intense and pain meds are not helping. Why so much pain and in different areas? And should I seek another specialist?",
    "doctor_response": "HelloThanks for query .Based on the facts that o have severe pain i loin on Right side due to stone in kidney and ureter .The pain in abdomen due to stone is never due to stone itself but it is due to obstruction to the flow of urine caused by the impaction of the stone resulting into accumulation of urine causing dilatation of ureter and kidney proximal to site of impaction ( Hydronephrosis).The primary aim in treatment in such situation is to deobstruct the kidney to preserve it's function and to help the stone to pass down without pain .The standard modality is 1) Give I .V fluids  (If the patient is hospitalized )or drink more water to help to produce more urine.2) Give pain killers and smooth muscle relaxants .(Tomsulosin and Drataverine )3) Give antibiotics to prevent infection .In majority of patients this helps to pass he stone spontaneously .If the pain is severe one has to undergo endoscopic removal of stone by a procedure called as Uretero Renoscopy (URS) .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hair loss, heart palpitations, breathlessness on slight exertion, always tired, headache, lower back pain. Iron deficiency?\n\nHi I m a 21 year old female and for the last few months I ve had bad hair loss , heart palpitations, breathlessness on slight exertion sleepless nights, I m always tired and I ve had headaches and lower back pain . Could it be some form of iron deficiency and even though I ve been taking multi vitamins my hair loss is still pretty bad.",
    "doctor_response": "Hellowelcome to health care magicIn the query you didn't mention about the menses,,is there any over flow that is more bleeding..in general females have low hemoglobin and low iron level because of monthly losses due to menses..Regarding the above said symptoms they are symptoms of iron deficiency...Take a routine blood test in that hemoglobin levels are mentioned..Also take hemogram,,it will tell you the cause of low hemoglobin ..Consult gyneccologist(if you have heavy periods)/physician and he will prescribe iron tab.,,Mean while take good diet which is rich in iron like jaggery,nuts,meat etc..Regarding hair loss,,it might be dut to stress,genetic issues or doe to iron deficiency also..consult trichologist.Hope you understand my suggestion and answer.Thank youDr.siddartha",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruise along spine with burning sensation?\n\nwhat can cause brusing along the spine..I have not fallen or anything also my right hand on the thumb and down the side of my hand turns purple come and goes on the hand for 2 days. The spine brusing showed up today...Have a burning sensation along my spine",
    "doctor_response": "Hello, In my opinion, regarding the description of your issues, probably yours is a vascular problem.Vasculitis is a condition to consider.However, you should be seen by your Doctor and tests also are necessary for a correct diagnosis. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes discomfort in my neck?\n\nHiRecently have been having discomfort in my neck.  I assumed it was doe to sleeping wrong, as I woke up with a stiff neck last Friday, and have had pain continue now to my tricep area.  Not so much in my neck anymore, but still lingering in my arm.  Would this be the case of a pinched nerve?  If so should I see an orthopedic, or just let it run it's course?",
    "doctor_response": "HIThanks for posting your query.     Yes even I am of the same opinion of Pinched Nerve. In medical terms it is called Cervical Radiculopathy.    In this condition a nerve at the back of your neck gets compressed between your neck bones and this compression of nerve causes either pain or tingling sensation or numbness in the region described by you .     If the pain is not very severe then you can wait and start doing slow rotational exercise of neck and avoid keeping neck in flexed position for long time .    But if the pain is severe then better you consult an orthopedic doctor. Hope this information was useful to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is scrotum skin infection,  an indication of fungal infection?\n\nHello Doctor,I have been suffering from itchy scrotum since a year. Back in Dec 09, I had a secondary fungal infection on the scrotum due to excessive sweat. The doctor had prescribed Flucanazole tablets and Zole-F cream. It took 3 weeks to heal. But, the infection did not seem to cure 100%. My scrotum often goes dry and white and becomes itchy and with a burning sensation. When the scrotum skin is stretched, I observed a kind of drought area like texture with small dark patches in irregular shapes. Applying coconut oil provides temporary relief. It does not itch during night times, except in one or two instances. I am not sure if it is still a fungus infection. I do not have fungus infection on foot or else where. During the mid of the day, the scrotum skin becomes dry and the skin turns pale white and it burns a bit. This kind of infection is observed only on the scrotum, and not on the penis nor on the bottom of the scrotum. I also have developed 3 small blisters on the upper left side of the scrotum, which earlier were the size of a pea and now has reduced in size, but is still there. I apply coconut oil daily morning and before going to bed and stay calm for 30 mins until the skin absorbs it, and I am doing it since a year and yet no signs of cure. I fear of approaching a skin doctor as he might prescribe steroids which may worsen the situation. Adding to it, I recently developed 3-4 white patches on the left side of the groin area which itches quite often. I started applying a Micanazole Nitrate + Fluocinolone Acetonide based cream since last 4 weeks. Please let me know if my scrotum skin infection is an indication of fungal infection.Thanks in advance,",
    "doctor_response": "Probably you are suffering from fungal infection. Don\u2019t be afraid of steroid because topical steroid generally does not cause any side effect. Steroid will provide symptomatic relief from itching and rednessAdvice 1.\u00a0\u00a0\u00a0\u00a0\u00a0Apply antifungal cream containing clotrimazole, steroid and antibiotic such as Lobate GM  cream thrice daily for 15 days2.\u00a0\u00a0\u00a0\u00a0\u00a0Fluconazole 150 mg per oral weekly for 2 months \u2013 total 8 tablets3.\u00a0\u00a0\u00a0\u00a0\u00a0Keep your groin area clean and dry4.\u00a0\u00a0\u00a0\u00a0\u00a0You can use ketoconazole dusting powder also5.\u00a0\u00a0\u00a0\u00a0\u00a0Do not scratch 6.\u00a0\u00a0\u00a0\u00a0\u00a0Take high protein diet such as eggs and cheese to boost immunity7.\u00a0\u00a0\u00a0\u00a0\u00a0Investigation \u2013 blood sugar (fasting & postprandial)Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does a fall for a baby need looking into?\n\nMy 3 week old son rolled off my chest whilst i was sitting on my bed. He fell right down the gap between the bed and bedside table.i picked him up and he cried for a couple of minutes but settled quickly. There are no visible signs of injury and his pupils seem to be reacting to light. He wanted to be fed almost immediately after and has passed wind and im almost certain a bowel motion since this happened (about 50 minutes.ago)",
    "doctor_response": "hi I think he is fine, but be careful in future as some injuries can be fatal to kids of this age. kindly don't sleep while feeding and don't sleep while your baby is on you as you might be tired and don't know when you may roll on to him.hope this is helpful to you, rate it if you like it. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is there any way to get rid of post acne hyperpigmentation?\n\nHello doctor,I need to get rid of the post acne hyperpigmentation that is a year old. I have had post-acne hyperpigmentation on my arm and back since I was 15 years old and have tried everything to fade and nothing works.",
    "doctor_response": "Hello. 1. Post acne hyperpigmentation lasting for so long is not very common. 2. There are two kinds of options for post inflammatory hyperpigmentation. Either using creams at home which I will prescribe you below or going for cosmetic procedures like microdermabrasion, or chemical peelings. You can start with the creams. Use for six weeks and see the results. Post inflammatory hyperpigmentation. 1. Glyco 6 cream (Glycolic acid) apply locally once at night for six weeks. 2. Tablet Limcee 500 (Sodium Ascorbate and Vitamin C) once a day after breakfast for six weeks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can baby be affected by CMV IGg when in womb?\n\nDear Doctor, I am 30 yrs old female with a 42 days old female baby. I had opted for cord blood preservation. I received the maternal blood test report which is positive for CMV IGg.Kindly let me know if my baby could be affected while in the womb.I had undergone triple test at 18th week and amniocentsis in 20th week.Triple showed risk for down s and trisomy 18.Amnio was normal.In the cord blood report Total CD34 stem cell count result is showing as 12.93 against a specification of Not less than 0.1 million cells/CBU.My baby looks perfectly ok except that she weighed 2.4 when born.Request your kind advise. Thank you !",
    "doctor_response": "Hi thank you for your questioni think that you are inform that CMV may be trasmitet at the fetus during the pregnency.babys borned from a mother with CMV are testit for the posibility of infection,so your baby is testet for cmv so if he had any kind of problems you wil be informed.the some for the results of triple test they showed risk for that syndroms but your baby has born helthy and without problems as you said.the only thing i can say for you is stay in contact with your pediatrician and follow his advices good luck for you and your baby",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yellowish discharge with bad odor in a child?\n\nMy 7 year old daughter has been having a foul smelly yellowish discharge for almost 2 years and swabbed and doctor said to ignore it and nothing is wrong and there is no infection either.but 1 doctor said there may be a foreign body and must do a small testing that doesn t harm the hyman.i was shocked.still she has the discharge sometimes and rarely complaints of a tummyache.please doctor what type of a condition is this.",
    "doctor_response": "Hello, Vaginal discharge is normal in pre-adolescent girls. But if it is yellow or green with foul smell and itching, then there are chances of infection with traichomonas vaginalis. you should give appropriate drugs. If still the discharge present you can do X-ray or USG to look for any foreign body inside the vagina. Removal of a foreign body under anesthesia will relive the symptoms. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Rajmohan, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am experiencing psychosis after being sexually abused for years. Please help.\n\nHello doctor, I am an 18 year old, and I have been sexually abused as a child for many years. I have never told anyone, and now my parents got divorced. I am experiencing numbness and psychosis symptoms, but they do not affect my daily life, and no one knows what I am going through. I wanted to know if I have a mental illness. Am I in danger of a mental illness?",
    "doctor_response": "Hello. I empathize with you. Sexual abuse in childhood is perhaps the most brutal and tragic thing that can happen to a person. The scars of that enormous trauma never fade away. I believe you have post-traumatic stress disorder. It is not a psychotic disorder but a neurotic (anxiety spectrum) disorder. The symptoms are: If you think you are suffering from the above symptoms, visit a psychiatrist at the earliest. Medicines like Paroxetine and Escitalopram are very much helpful in reducing the symptoms. For more information consult a psychologist counsellor online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for erection problems\n\nDear Doctor ,I am 40 years old.Married , I am facing erection problem for the last one year.I am free of blood suger and my blood presure is normal .this is my first consultation with u. I've not tried any medication that are availeable over the counter. Please Help me to get out of this crisis. thanking You .",
    "doctor_response": "Hello, As per your history, performance anxiety. For that foreplay will also help. Take balanced diet and proper rest. Till then you can take tablet sildenafil one hour before sexual act. Avoid stress and keep your self hydrated Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this chest X-ray report indicate?\n\nI got an X-ray done of my chest (PA) yesterday. The report says as under : Few fibro streaks in both upper zones.Both lung fields are clear. Both costophrenic angles are clear. Both hila show a normal pattern. Cardiac and mediastinal borders appear normal. Unfolding of aorta noted. Is everything normal? If not, what is the remedial measures to be taken? Thanks & Regards",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. After going through your medical details I understand your concern and I would like to tell you that this X-ray report is showing fibrotic changes which needs a pulmonologist consultation for better management. Unfolding of aorta is an abnormality visible on chest x-ray which is mimicking Thoracic Aortic Aneurysm which further needs to be evaluated further if it is present or not. Kindly consult a Cardiologist personally for physical and diagnostic evaluation. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for high heart rate inspite of having 5 bypass surgeries?\n\nHi my name is Ellen I m very concern about my husband he s my life he has had 5bypasses 3yrs in June. His blood pressure 88/69 and his pulse is 140 his blood pressure had been like this since his surgery but is heart rate had been up for about a week what is the danger?",
    "doctor_response": "Hi welcome to hcmI understand your query and concern.Persistent palpitations in your case are suggestive of any arrhythmias of heart which means abnormal conduction abnormality of heart.I advise you to get an ECG,2 D Echo of your heart immediately to confirm the diagnosis.I also advise you to get lipid profile,complete blood picture,chest x ray immediately as a part of routine check upDrinking 3-4 litres of water and intake of fruit juices,fluids is mandate in your case.Drugs like Amiodarone,Betaloc,Pantop 40 mg will be helpful in your case.Avoid stress and anxiety.Avoid smoking ,alcohol,fatty foods.Abnormal lipid profile if present in your case should be treated with atorvastatin.Monitor blood pressure and heart rate immediately.EP study and radiofrequency ablation will be the procedure of choice.Consult your cardiologist for expert management.Post your further queries if any,Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for anxiety and panic attack\n\nHi i think i have anxienty issue but alsi ive been getting panic attacks and i do have some social anxiety aswell it is starting to effect my job as when it get bad i dont wont to speak or see anyone i feel sick and ive been crying alot morei dont know what to do?",
    "doctor_response": "HiThanks for using healthcare magicI think, you have generalized anxiety disorder and panic disorder. In that case, you should try few antidepressant and benzodiazepine. Better to consult a psychiatrist for proper management. You can also take help of a psychologist for some relaxation exercise like JPMR.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Adderall cause severe chapping with swelling in tongue and mouth?\n\nI m prescribed to Adderall XR 60mg a day, however, due to this shortage, I ve began taking 2 (20mg) standard adderall. Now I cannot control my lip movements, and other people are noticing. My lips are severely chapped, and everything inside my mouth (tongue, mouth, cheeks) are swollen. I imagine this has something to do with my change in adderall. It s extremely painful and embarrassing.",
    "doctor_response": "Hi, People with ADHD fidget and this includes mouth and tongue movements. You'd have to wonder if there were another neurological cause such as Tourettes, basal ganglion problems, use of anti-psychotic meds long term, or other causes. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hepatitis-C\n\nAOA.SIR  I  AM  STUDENT OF BS SE IN UMT  OF PAKISTAN.MY  FATHER IS  A TAILOR .BUT UNFORTUNATLY   HE IS  THE PATIENT OF  HAPATITES C  FROM 10  TO 12 YEARS.WE DID\u2019NT DO ANY TREATMENT  OF him  DUE TO  OUR FINANCIAL  PROBLEMS.THE  GOVERENMENT  OF  HEALTH MINISTER  OF PAKISTAN SAID  THAT THERE IS NO ANY OTHER OPTION FOR HIM BUT  LIVER TRANSPARENT .THAT IS NOT POSSIBLE IN PAKISTAN AND ALSO BY OUR FINACIAL CONDITION.SO  PLS HELP US .GOD  BLESS U  AND GIVE U ALL   THE  HAPPINESS.U CAN  CONTACT ME AT THIS NUMBER .0000 OR CAN CONTACT  ME AT THE MAIL OF   YYYY@YYYY",
    "doctor_response": "Hi I can understand your concern....Your father having chronic Hepatitis c ....Don't worry.Let me know you yes ultimate treatment us liver transplantation...It is unfortunate that your social condition poor....Here I can advise you some instructions for preventing complications......Take low fat diet.Fruits taken more like papaiya , grapes , apple etc...Use very less oil...in cooking....Avoid alcohol....Non veg and cheese , butter avoided...Regularly take grined spinach leaves and carrot juice....One tsp cumin seed with buttermilk can taken......Take low salt diet.If blood in vomit immediately consult er.Take care....Happy to help you further......Dr.Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "What caused red lump with itching?\n\nI think last week I was bitten a few times by an insect of some kind. They were very itchy (like a typical flea bite). However a few days have gone by and the itching disappeared. Today the itching is back on one of them and I now have a huge red lump there. Is it something to worry about?",
    "doctor_response": "Hello!Thank you for the query.This lump can be caused by an allergic reaction or some kind of an infection. It is hard to tell not seeing it. I suggest you to consult dermatologist with this issue. Some antiinflammatory medicines might be necessary.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mild mitral valve prolapse\n\nhi!i had this x-ray before and it revealed that i have mild cardiomegaly so i was asked to undergo the 2d echo and i find out i have a mild mitral valve prolapse..how can i prevent this condition?is there any other way that my heart will go back to its normal size?",
    "doctor_response": "Hello Thabks for posting here. Mitral valve peoplase is a relatively harmless condition. It cause minor leak between the heart valves. X ray has shown cardiomegaly, but please confirm whether 2 D exho has also shown enlargement of heart chambers. Also please update the 2 d echo findings whether there is leak or regurgitation between the mitral valve (MR). There is no way to prevent a mitral valve prolapse because you have it since birth. Only we can reduce the leak with medications if it is more than a moderate leak. The heart is not grossly enlarged and mild cardiomegaly can be ignored if chamber sizes on echo are normal. Wishing you good healthregards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for arm pain after playing baseball\n\nMy son plays baseball and he pitches and plays at second base and short stop. he throws with his right hand he started experiencing some pain in that arm last season. He has tried using a tens unit that I purchased from Walmart, but it doesn t seem to be helping. Do you think he should see an Orthopaedic or maybe just try some physical therapy?",
    "doctor_response": "Hello, It may be due to minor contusion or tendon involvement following the incident. As the first line of management, you can try analgesics like acetaminophen or diclofenac for pain relief. Apply ice packs also, if pain persists better to consult an orthopaedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the physical signs of bipolar disorder?\n\nwhat are the physical signs of bipolar disorder? My brother has both mood issues so they say he has bipolar disorder but can his physical symptoms be from bipolar disorder. He has headaches, trouble walking his leg barely hold his weight, tires easily, headaches, and always dizzy.",
    "doctor_response": "HiThanks for using healthcare magicBipolar disorder is a psychological illness and its never cause physical problems. Sometime due to poor insight, patients harm themselves, which lead to physical abnormality other wise physically patient remains sound. In your brother case, there may be some brain dysfunction or nerve compression in leg. Consult a neurologist to find out the cause.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does pain between the shoulders on the upper back indicate?\n\nHi I ve been having the occasional episode of upper back pain between my shoulder blades and mid section It usually happens when I m doing something stood up and all of a sudden I get what I call a take your breath away sharp pain right across my upper back- it feels like I m in a vice and I can t fully breathe out and can t stand up properly for a good few minutes as it reduces me to my knees . Each time I try to straighten my body up to stand, it grabs me again with a very sharp pain right across my upper back and I struggle to breathe . After 2/3/4 minutes it starts to subside and goes away. It comes out of the blue from nowhere at all. It happens every few days or so but I just can t work out what triggers it. It feels like my whole mid section is paralysed for a very short period. In 2003 I fell 20feet down concrete stairs and landed on the floor with my body at right angles to my legs - I was hospitalised for a week with what was initially believed to be a broken back but was ultimately diagnosed as muscular damage ( I was super fit physically at this time ). I then got lower back pain, worsening consistently and 5 years later in 2008 I got up to get ready to go to work one morning and collapsed in s heap on the floor and couldn t get up. I had emergency surgery on my back and was told that my L1-5 had been crushed and the substance from inside the discs had migrated into my spinal cord canal and had actually touched the cord and I was very lucky to undergo surgery so promptly. It took me 4 years to walk properly again and I now get bladder problems ( leakage ) and occasional period of not being able to move well. I wear a fentanyl pain patch . I m wondering if this is connected in any way ? I apologise for the length of this but I needed to paint a fuller picture for you . Jacqui",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Can be a muscle pain. MRI scan will help. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I take Progynova 2mg?\n\nhi... im married for 4 yrs, trying to conceive, doc advised ccq50 along with progynova 2mg and duphaston10mg. But i hv found that progynova drugs have side effec ts like breast cancer, it also suggests not to take them during pregnancy .... im confused, plz help.",
    "doctor_response": "Hello, Progynova replaces the hormone oestradiol that the body no longer makes and prevents or relieves symptoms such as hot flushes, sweats, sleep disturbances, depressive moods, irritability, dizziness, headaches as well as vaginal dryness and burning. If considered necessary, Progynova 2 mg should be used. Once treatment is established the lowest effective dose necessary for relief of symptoms should be used. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. AJEET SINGH, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure muscles reduction problem?\n\nHi, Please advice me on the issue of muscles reduction. My cousin having one side muscle reduction problem. Her arms and thigh muscle get reducing day by day without any pain.Please advice the issue relates to Neuro, if yes then to whom i should consult.",
    "doctor_response": "Hello, The history is too brief to put any comment. But since the muscle mass is reducing the first thing to do is to get it examined by a neurologist and may be some blood routine will be advised. Even a muscle biopsy might be advised if nothing is traced in particular in the blood test. Post which the treatment will be guided. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe lower back pain and weakness on legs?\n\nI have severe lower back pain that goes down into my left hip and into my left knee. Both of my legs feel weak and shaky at times and my left arm feels a tad weak. It is difficult and painful to walk or sit, my job requires me to sit in front of a computer for 8 hours.",
    "doctor_response": "After going through your query I think You may be suffering from lumbar disc prolapse. What is your age? What is duration of your pain and weakness? Presuming disc prolapse there are two treatment options.First option is Rest in position of relief(generally lateral position with both  hip and knee bend), NUROKIND GOLD ONCE DAILY and analgesics (Diclofenac three times a day after meals is effective). Sometimes strong analgesic(such as ultracet three times a day after meals) is required. OMEPRAZOLE  before meals  prevent acidity caused by analgesics . This method needs patience as it take longer treatment times sometimes up to  6 months.Second option is go for surgical operation (Discectomy). You can discuss with your treating surgeon.I think your query answered.Welcome to any follow up query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any treatment for my impotence?\n\nI am 23 years old. My pennis is very small and also not thick. I had sex with a girl of age 20. She says mine is not effective at the peak time. I don't hw to over come this and full fill my partner. Is there any treatment for this?Please suggest a good advice for me.....",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. I don't see any problem in you. Erectile dysfunction mostly arises out of psychological causes than organic ones. You are worried about the small size of your penis. Wrong. Even a penis with a 2 inch erect size is enough to satisfy a women. You should be having more than that. If one partner teases you, forget her and forget the teasing. Try to satisfy her with guts and not with anxiety.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.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having pain between my scrotum and anus?\n\nI am a 55 year old male, the last three day's I have had bad aching pain between my scrotum and anus. I am on flowmax for a slightly enlarged prostate. Are you able to tell me why i may be having this pain? (This pain is constant) Thank you, For your time.",
    "doctor_response": "This can be related to prostat. Get PSA Urinetest Ultrasound prostate blader kub. If all the test will be analysed, it will give some idea about the problem. Are you having chronic constipation ? For now take some analgesic like combiflam after food for two days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does lump on shin bone imply?\n\nI fell through my porch a few weeks ago and it bruised pretty bad and I was scratched all up. Anyway the scratches and brushing is gone but I have a huge lump on my shin bone still and the front part of my leg is completely numb. By the end of the day my whole leg and foot is swollen with some relief by mmorning. Could it be broken? I can walk...I have a doctor s appointment in 9 days but keep wondering if I should go to the er...",
    "doctor_response": "Hello and welcome to HCM,A history of trauma, redness of the overlying skin, formation of lump and inability to walk can be due to bone fracture or a soft tissue injury.You need to consult your orthopedician for clinical assessment and imaging studies.A fracture will be picked up on X-ray and appropriate management can be done.The other symptoms of swelling and redness can be managed by hot fomentation and pain killers.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there anything to worry after finding cortical cysts in kidney in ultrasound?\n\nDear sirs,my brother is 26 years old, ultrasound images showed that he has cortical cysts in his kidneys one of them is large it is about 7 cm is this a serious problem and there is an important issue i'm worried about we have a family history my father,my aunt and my uncle died with polycystic kidney disease",
    "doctor_response": "HiThanks for your query.It looks like your brother is suffering from polycystic kidney disease as well.We need to check his blood pressure and do some blood and urine tests to ascertain the health of his kidneys.Please see a nephrologist for further guidance.Hope this helpsGood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it normal to see a small tissue in the socket after extraction?\n\nHello doctor,I got my wisdom teeth pulled before four days, the very next day I throw up due to antibiotics. An hour later, a piece of tissue was hanging on the upper right clotted socket, is this normal?",
    "doctor_response": "Hello. The situation which you described is entirely normal. The area surrounding the wisdom tooth gets usually inflamed, which is known as pericoronitis. After the removal of the area around the socket, which is the gingival (gum) tissue undergoes healing. The piece of tissue which you mentioned is the gum tissue undergoing healing. The socket will take about a month to close completely. Make sure you rinse every day with lukewarm saline water and mouthwash about four to five times daily, which helps in accelerating the healing process. I hope I have answered your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this CT scan test result of the lumbar spine after an injury indicate?\n\nhi..I had a fall on the ice and fell on my back,,arms,,head...had ct scans and xrays....low back ct scan noted subtle lesions and nondisplaced fractures within the distal sacrum and coccyx...what treatment so I get for this..the er didn t recomend anything!!",
    "doctor_response": "Hi, Strict bed rest is needed for treatment of fracture in the sacral spine. Application of lumbo sacral belt is also helpful for pain relief. The non-displaced fracture usually helps themselves in a month and rest is recommended for that period. Take tablet Ultracet P for pain relief and include calcium supplements. Visit orthopedic surgeon for a detailed clinical examination. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jayesh Vaza, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the sperm analysis with 70% motility indicate?\n\nHi I'm a 42 year old male, hypertensive taking co-approvel. my liquefaction time is after 3 hours. with abnormal froms giant head 2%, constricted head 2% pin head 2% sperm count of 109,600,000 abstained from sex for 4 days and fructose positive.  Motility is 70%, with 65% progressive, 5% non progressive. Pap's morphology is 15%.What medications can I take, we are trying to have a baby.",
    "doctor_response": "Hi. Were there any pus cells in the Semen? If yes did you get a culture done? Your count is slightly low. Otherwise the report is within normal limits. If there are pus cells then you should take antibiotics in consultation with your Doctor. You should get yourself evaluated for a Varicocele which is a common treatable cause for low sperm count. If all this is ok I usually prescribe my patients an Ayurvedic preparation from Himalya called Speman for 3 months which help in increasing the sperm count. Take care and feel free to contact me using the ' Ask a Specialist ' section of the site. Dr Rishi, New Delhi, India.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had a transient ischemic attack and taking Alltaste. Speech is worse and struggling. Suggest suitable way to improve speech\n\nMy friend I fear has had a TIA on Friday.  The neighbors called me because her speech was off.  I went toher house and found no visible physical issues, but her speech was way off.  She has a problem withsaying nouns, she says you know the Thing.  She is a little eccentric and paranoid about a lot of issues.She will be 75 in March 2014 and as far as I know, (worked with her for 13 years)the only medication shetakes is 10 milligrams of Alltaste.  She is allergic to almost everything that touches her skin.  She can't take the generic form of anything.  Last time she was at the Drs. was 3 years ago and won't go now. She can read and watches her sport TV programs, not sure if she can write. I will see her again in the am and take her BP but the speech is what is bothering me, I don't believe it has gotten worse but she is still struggling.Just don't know what I should or can do for her!",
    "doctor_response": "HIThank for asking to HCM I appreciate your concern, you said it TIA but you did not say any thing about the imaging study did you take her for that like CT or MRI if you did not do it then I would advise you to get it done because without this we can not say whether it is TIA or anything else, have great day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need treatment for unwanted sexual thoughts\n\nI'm a OCD patient and I'm having these unwanted sexual thoughts since the age of 7. I'm now 19 and I don't know if I masturbate and it includes ejaculation  and I don't think I do that but I'm confused, please help me out. I'm totally irritated with these urges and thoughts. I don't enjoy doing it or thinking about it. please help me out. I don't want to masturbate or do sexual things with myself. Please give me a good advice, please  help me out please..",
    "doctor_response": "HelloAs you already know that you are suffering from a disorder called as OCD.  You need to meet a psychiatrist. There are various medications for ocd which might be helpful for you. Along with that you go through psychotherapy sessions also.RegardsDr. SushmaConsultant psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do Folic acid and Surbex tablets help in conceiving?\n\nI had a miscarriage on 2nd july...but again in august i had sympoths of pregnancy lyk frequent urination vomiting nausea...but my pregnancy strip test was negative...n my periods was 4 days late den i got periods n in dat i had 2 big white spots...was dat white spot means miscarriage...n now i m taking primolut n along wid surbex z n folic acid...can i get pregnant...",
    "doctor_response": "Hi I think you might have got some aftereffects of pregnancy go. If you got your periods properly and your pregnancy test is negative, you are not pregnant.  White spots can be vaginal discharge also. You can get pregnant while using primolut N, surbex z and folic acid. Hope it helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bleeding under forearms?\n\nI have bleeding under the skin on my forearms . It will get better but it will come back if I should get bump or the skin will bleed out under skin . My dr is puzzled about this . So can u please help me to know what to use . I am using DerMend & precepts. Meds creams for this . But I really would like to get to the bottom of this . I woke up with this in October . It got better . But if u touch my forearms now they hurt & itch . Can u please help me . Thank u Donna McCay",
    "doctor_response": "HelloI have studied your case,Bleeding can be due to infection or skin disease. you may need to start tab deflazacort consulting your doctor.You may get symptomatic relief with tab Tryptomer which you can start consulting your doctor.Another possibility is mixed infections with fungal and bacterial infections in which local application both anti fungal and antibacterial creams are required.Keep good hygiene of skin. Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for costochronditis\n\nI was diagnosed with Erythema Annulare last August. Cause as of yet unknown! I now am suffering my second bout of Costochronditis in a month. Really frustrated that any of the doctors or consultants I have been to cannot find a cause/cure. Any recommendations/diagnosis?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Costochondritis is inflammation of costal cartilage. It can be due to physical over activity, strain, trauma or viral infection. Irrespective of etiology, treatment remains same. You should avoid heavyweight lifting, strenuous exercise. Avoid movements causing pain. Apply warm water pad on affected site. Start painkiller and anti inflammatory drugs. Since these drugs are prescribed medicines, you need doctor 's prescription for them. No need to worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes over possessiveness?\n\niam a 25yrs old guy who has a girl friend. Iam highly possessive and which in turn makes me mad when somebody talks to her. I felt like I am, in general has some issues as I felt highly possessive when my elder brother got married which even created family issues. So i suspect i have sum psychiatric issues ...Please help",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Possessive in excess is a psycho-logic case. But in your case I don;t think so. You are free to be possessive. Be possessive. But make sure that your possessiveness do not interfere in that person's personal matters. If you interfere in that person's personal matters, that person might think bad about you and may hate you or ditch you. I don't think you will be able to accept it. be wise and behave like a wise man. If you require more of my help in this aspect, Please post a direct question to me in this URL.  Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does small lump on leg which is increasing in size indicate?\n\nHi, I have a small lump on the lower left leg, it's about the size of a dime. I've had it for many years and I have a doctor look at it years ago, she said it was nothing. I'm concerned, because it is now pulsing or tingling and seems to have gotten a little bigger. It does not hurt. What could it be?",
    "doctor_response": "Hello,The lump can be anything but the most likely ones are lipoma and neurofibroma. It is best to get evaluated by a surgeon so that he can perform a FNAC from the swelling to reveal the diagnosis.Dr. Souvik Adhikari",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should i take medication for low iron levels?\n\nHi My blood iron level is 3.5 . I am very very tired always. I am working full time and 49 years old. My doctor gave me iron supplements. We done lots of tests. They are normal excepts my heavy periods problem due to fibroids. How long I have take iron supplements to feel better. Sriya",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern.  You have fibroid uterus so that heavy bleeding occur which leads to iron deficiency.  So you should take treatment of fibroid first.  Once your heavy bleeding is cured then your hb level will become normal with iron therapy.  Otherwise you have to take iron therapy for long time till your bleeding is cured.Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to conceive after treating an enlarged ovary?\n\nHi , I have married for last 16 months trying to conceive, but not able to . after consulting my Gyna , some tests done & reports revaled that my left Ovary is enlarge in size. Dr refers me some medicine & treatment continues, But still no positive results have been shown.I am very much tense now what to do, how i will be able to conceive ?how long it will take me to be mother ?",
    "doctor_response": "Hello, There is no problem in enlarged ovaries and thus just get ovulation induction drugs and follicular monitoring done after which you can try naturally or follicular monitoringIn case you have any questions in future you can contact me directly on",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can I treat the symptom-less bumps on the penis?\n\nHello doctor, I am having a bunch of bumps on my dick. I think it is because I jerk off a lot but I am not exactly sure what it is. I have no discomfort, no itching, no discharge.",
    "doctor_response": "Hello Are you having any pain or burning sensation? These lesions look like herpes simplex virus infection. It may cause lesions on face and genitals also. Use Acivir cream (Acyclovir), and tablet Acivir 400 mg thrice a day for five days. If symptoms are not improved, please consult your doctor. He will examine and treat you accordingly. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the ways to control hair fall?\n\nHello doctor, I started losing hair a year ago. Probably after starting my job. Mainly hairs on my temples and side hairs on the front part of my head. I was using Nutrafol tablets and have used it for about four months now and have not seen any results. Please help.",
    "doctor_response": "Hi. You are suffering from androgenic alopecia. Use Minoxidil 5% lotion 1 ml twice daily and tablet Finasteride 1 mg once daily.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe spinal stenosis\n\nI have moderate to severe spinal stenosis but never felt this bad. I woke up to severe pain when I move, walk, reach - feels like a nerve. It s a throbbing pain and if I m still for five minutes, it will calm down but the moment I move, IT HURTS LIKE HELL! barely could walk this morning but I had some old Norco and took that - seemed to help. What else should I do - go to dr? Or wait a bit?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I understand your concern and would recommend consulting with your attending physician for a physical exam and a new spine MRI study. In the meantime, I would recommend wearing a lumbar brace. Pregabaline or Gabapentin would help improve your situation. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lyme disease\n\nI have been diagnosed with Lyme disease last week. I have been searching for answers for 5 yrs. Brainfog, extreme fatigue, memory lapses (severe) concentration difficulties, sleep only an hour at a time, panic attacks while sleeping only, hair loss, hearing loss, numbness in hands, joint swelling mostly knees, pain in joints, pack pain, three month new diarrhea and nausea. I have diabetes A1C is 6.6 now it was better, can t exercise it exhausts me. I had a partial thyroid dectomy for cancer. How do I find a Lyme literate Doctor. I would like to get healthy and prefer a Doctor who has experience. Unable to find anyone in SC so far. I have Blue Cross Blue Shield PPO state SC and Tricare as a secondary insurance. How do I find a lyme literate Doctor?",
    "doctor_response": "Hello,Welcome to HCM,As you were diagnosed to have lyme disease which is an infectious disease caused by Borrelia bacteria and it is a tick borne disease transmitted to humans by the bite of infected ticks.The symptoms are suggestive of the lyme disease.I would suggest oral doxycycline, if you have taken this and if there is resistant to this you can take either cefuroxime or azithromycin. These medications should be taken for atleast one to four weeks.You need a few tests including labs to check his kidney function and an ultrasound of the kidney area and an urine culture to rule out an infection. I think the best way to do this would be to go the primary doctor again and tell him or her the new symptoms.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Teenager. Diagnosed with cancer. Records of the same unfound by the hospital. Suggest for recheckup\n\nMy grandsone was dionosed with cancer when he was 16, he went to Johnson city childrens hospital..we need his records so he can be checked again he will be 21 in May,,,no one seems to know where they are, He also went to Pittsburg, Pa childrens hospital...How can I get his records so he can see if he is still in remission?",
    "doctor_response": "Dear bumblebee, You can see your primary physician who refered you  to Johnson Hospital. If you dont find the record with him you could give the tentative date of your visit to johnson hospital Medical records section who could find your grandsons record. If this does not help you the  health authority who maintain the National cancer register,  visit them and teling them the tentative date of  of completion of your grandsons treatment they might be able to give you the records. As regards wheather your grand son is in remission you can visit your primary physician and apprise him the  history of your grandson, he will perform necessary investigations on your grandson and let you know his present status. Hope the steps advised might help you in achieving your mission. Truly, Dr. J. Ticku",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Silvadene cream be used on an uncircumcised penis?\n\nCan silvadene cream be used on an uncircumcised penis? Initially there was a yeast infection. Treatment for that was completed but the skin continues to be inflamed erythemic and bleeds after being washed. Person is on Xarelto for a blood clot and has had spotty bleeding for over two weeks now. Anti fungal creams are not doing anything and won t stay on well due to seeping",
    "doctor_response": "Hi,Silvadene cream can be used on the skin aspect of the penis but not on the glans or the mucosal aspect of the penis. But, it can lead to some skin staining so it is best to avoid it. the bleeding must be due to the Xarelto which is causing the blood to ooze easily due to decrease in clotting capability.I suggest just keep the area clean and dry and wait for a week or so and then take a call whether anything needs to be done. You can then consult a Dermatologist for best advice.Take care,Dr Rishi, New Delhi, India.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for frequent infections and lymphangioma in left ear\n\nHi, my son was born with s lymphangioma in his next. ..right under his left ear. Up until a few months ago you could hardly notice it! He recently turned 3 and in the last few months it has grown quite large ( about the size of a small orange) Since it has gotten bigger he has been sick with colds and throat infections constantly. I want to know, is there a connection?",
    "doctor_response": "Hi....usually lymphangiomas are associated with recurrent infections but only locally due to pressure effect or impeded blood flow. A lymphangioma under the left ear (could also be a cystic hygroma) cannot be the cause for recurrent infections in the throat and upper respiratory tract. You need not correlate both. But as such the lymphangioma may need surgical excision and histophathological examination.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for mental problem causing memory issues and confusion\n\nhi myself ravikant  i have problem of mental  ihave taking teatment of psychitry in baramati and aiso problem of digestion  tab ; solaze50 due to allopathic teatment from 1year iwas became careless and long time not remember  email id  YYYY@YYYY",
    "doctor_response": "Hello Mr.Ravikant, You have mentioned that previously you have taken treatment for psychiatric problem.It will be very usefull to have much more details regarding the same. Considering your problems related to memory disturbances and confusion, it can occur in many psychiatric disorders. It can happen in depression wherein u have pervasive sadness of mood, loss of interest in routine activities, disturbed sleep and appetite,  decreased activities etc. and other major cause for memory disturbances is dementia wherein you tend to have loss of memory, geographical disorientation, difficulty in remembering d names of your relatives, etc. And as you haven't mentioned about your age it's difficult to tell what exactly you have.. I hope to hear from you with much more details.RegardsDr. SushmaConsultant psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in spine with nervousness and nausea. MRI of spine normal.\n\nAbout 1 year ago i had a sudden onset of burning, prickling sensation to my legs. In june this year i had generalised bach ache, flushed to the face. In the morning i woke with nausea and mod pain in back deep in under my ribs beside my spine. I couldnt eat due to pain and nausea. Lost weight and had fatigue. I have had numerous blood tests, MRI of abdo and spine, colonoscopy/gastroscopy, faecal tests. everything normal. Now in dec i have fatigue symptoms. Get short of breath when i exert myself, feel nervousness and gittery have mild nausea and niggling pains in rib area on back. My legs are still burning.",
    "doctor_response": "hello,thank you for asking this question.your problem may be related with a diseases calles pancreatitis. Pancreatitis is an inflammation of the pancreas. It has several causes and symptoms and requires immediate medical attention. The most common symptoms of pancreatitis are severe upper abdominal burning pain radiating to the back, nausea, and vomiting that is worsened with eating.Diagnosing pancreatitis requires two of the following:    Characteristic abdominal pain    Blood amylase or lipase will be 4-6 times higher than the normal variations, but this will be dependent on the laboratory that is testing the blood.    Abdominal ultrasound is generally performed first, which is advantageous for the diagnosis of the causes of the pancreas, for example, detecting gallstones, diagnosing alcoholic fatty liver (combined with history of alcohol consumption). They are both the main causes of pancreatitis. Abdominal ultrasound also shows an inflamed pancreas clearly. It is convenient, simple, non-invasive, and inexpensive.Kind regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does PSA test with history of prostate cancer indicate?\n\nMy husband had prostate cancer 4 years ago, he just had a PSA and everything is normal. Is the PSA test the first indicator that something may be going on in his body. He had is whole prostate taken out and also radiation. He had no involement of lymph nodes",
    "doctor_response": "HelloThanks for query .Your husband has Cancer of the prostate and has been successfully treated with Radical Prostatectomy and Radiation 4 years ago.PSA is an enzyme secreted by cells in the prostate .One has to estimate PSA levels frequently even after Prostatectomy to rule out any recurrence of cancer process as there are incidences of recurrence of cancer in residual prostatic tissue in body ..It is one of the most important tools to asses and rue out recurrence of prostate cancer .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the problem if I am unable to conceive despite taking Fertomid?\n\nAlo dr I am 29 yrs old have a 11yrs son nd been trying for one year ttc bt nothing,doctor told me I don t ovulate bt my periods a regular,put me on fertomid for three mnths bt nothing,I did a d&c nd nu taking pregnacare,wat can da problem be dr please advice",
    "doctor_response": "Hi,Welcome to healthcaremagic.I read your query and I understand your concerns.Following is my reply:1) Taking fertomid or pregnacare does not guarranty pregnancy.2) Please get semen analysis of your husband.3) Get HSG test for yourself and see an infertility specialistLet me know if you have any more queries.Regards,Dr. Mahesh Koregol",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is medicine the only solution for gout?\n\nHello doctor, I have gout, and my uric acid remains in the range of 8.5 to 9. Is medicine the only solution? I have not started any, but the doctor suggested Febutaz 40 mg. If I start my medicine and continue with my daily workout, is it fine to add a protein shake in my diet?",
    "doctor_response": "Hello. Hope this helps you, and get back if you have any doubts. For more information consult a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain with symptoms of flu?\n\nHi, may I answer your health queries right now ?  Please type your query here...Why do I have lower bache pain with my flu, which comes and goes as my flu dies and lifts or returns. It is reducing over days but I am a little concerend. Could the flu virus be affecting my kidneys?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have back pain with symptoms of flu which is because of upper respiratory tract infection leading to common cold, which can be caused by bacterial or viral infection. Need not to worry. I would suggest you to consult ENT specialist for proper examination. Doctor may order test like viral culture test , throat swab test and blood test to confirm the diagnosis and rule out causes. Doctor may prescribe antibacterial amoxicillin or anti viral acyclovir depending upon the diagnosis along with decongestants. you should take proper rest and drink plenty of fluids. You should take muscle relaxants as well. You should take steam inhalation along with vaporizers. Avoid hot, sharp , spicy food. You should do warm saline gargles and drink one spoon of honey mix with glass of lukewarm water.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain after intercourse?\n\nextreme general abdominal pain along with complete hematuria after intercourse with a history of nausea, chronic headaches, GERD, intermittent lower RT abdominal pain, with a history of 1 incidence of drug overdose and alcohol poisoning and numerous accounts of head trauma",
    "doctor_response": "Hi,Intermittent right lower abdominal pain and hematuria, suggest a right ureteric stone. Which due to incresed muscular contractions during intercourse could had lead to acute ureteric colic pain.General abdominal pain is due to gastritis with is not subsiding due to your continued alcohol and drug intake, despite having gerd.I would suggest that you get an ultrasound of your abdomen done along with a routine urine test to look for the stone and start on a ppi tablet like omeprazole or pantaprazole.Further management will depend upon the location, size and number of stones.Hope i have been helpful.RegardsDr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat painful gum after gold filling?\n\nHi my dentist put a gold filling in my top tooth about a year ago i kept gettin very bad pain i asked him 4 times to take it out and he refused n said use sesitive tooth pate which didnt help da pain in da filling has now gone but da gum above is now reddy purple lump its painful to touch",
    "doctor_response": "Hi! Welcome to Healthcaremagic.I read your query. If the filling hurt you so much, I wonder why it wasn't taken out. It appears may be filling was quiet deep and close to the pulp. over the years it caused irritation to pulp and infection. Also, any overhanging filling can also impinge into gums.I suggest you to visit a dentist and get x-ray of tooth done. According to tooth condition and infection, it may need RCT or extraction. Get a prescription of antibiotics and painkiller from dentist and take it.Do warm saline rinses. Maintain oral hygiene. Take healthy diet, multivitamin and mineral tablet one per day.Avoid spicy and acidic foods till treatment is over. Hope the answer helps you. Thank you!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could nausea and vomiting be a result of liver cirrhosis?\n\nI have liver cihrosis. Issue and varices in food pipe. Recently I developed chest pain . Dr cardiologist prescribed angiotec  and nikoran od tablet one per day. I read side effects of these and mentions nausea, vomiting etc. I am concerned whether I should take these pils?Shailesh Dave India",
    "doctor_response": "Hi thanks for asking question.Because of cirrhosis abdominal pain can be reffered to as chest pain.Here you gave prescribed enalepril and nicorandil drug.Enalapril helps in reducing blood pressure which is necessary in case of portal hypertension induced by cirrhosis.The nicorandil is pottasium channel blocker which help in improving blood circulation to heart and preventing further heart damage.These drugs can lead nausea , diarrhea, rash , headache etc side effect.But your doctor have prescribed these drug after examining you.And they are helpful in cirrhosis .so you can take.Meanwhile to control cirrhosis avoid fatty diet and do regular exercise.Take green leafy vegetables.Take more fruits.Take more water.avoid trans fat.Avoid refined and processed food.If bleeding occur by variceal rupture immediately contact doctor.If ascitis present diuretic can be added.Wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should the Duphaston tablet be continued?\n\nHello Doc i have 28days, regular cycle.i went for follicular study, egg reach 18mm on 16th day and hcg shot and next day went for scan to confirm egg rapture , bt it didnt and doc gave me another hcg shot, she gave me duphaston tablet for 2weeks from 19th day.now its 27th day , tomorrow my due date for next cycle , i still have 6 more tablets, should i continue taking tablet ..., plz suggest me",
    "doctor_response": "Hi, Welcome to HealthcareMagic. Do continue duphastone for 6 more days. After that if periods won't come then  get your pregnancy test done . If it is positive then consult your gynacologist and continue duphastone.  If pregnancy test comes negative then continue infertility treatment and stop duphastone.  Hope I have answered your query. RegardsDr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for non obstructive kidney stone with dull pain?\n\nI have a non obstructive kidney stone. I have good days and bad days. Good days, there is just a dull pain and a feeling of fullness, on bad days it feels like I am starting to pass a stone then after a few hours the pain will go back to a dull pain. I have passed 3 stones in the past 4 years, so I am very aware of the pain they cause. Is ther anything I can do or do I just have to suffer through it?",
    "doctor_response": "Hi,Thanks for writing in. The stone in your kidney is not causing any obstruction at present and does not require any specific medication in the absence of any symptoms. However you might choose to follow instructions below to avoid any more stones in your kidneys and to cause the stone to disappear.DOs for kidney stones(i) Drinking as much as 1.5 to 2.5 liters) a day may help flush out your urinary system. This will also allow small stones to pass through.(ii) Visit washrooms regularly and empty your bladder when you feel like doing urination.(iii) Please take fruits like apple, papaya, watermelon, pineapple, mosambi, bananas and orange, vegetables like, white gourd, ladyfinger, pumpkin, pulses like toor dal, moong dal, bengal gram(iv) If you are having pain and burning during passing urine then you can take ALKASOL syrup 15-30 ml twice or thrice daily, dissolved in water for one week. This will prevent acidic urine and stone formation.(v) If you have sharp pain then you can take tablet containing hyoscine (eg HYOCIMAX 10 mg or HYSCOPAN 10 mg) twice a day for 2 to 3 days, till you have pain. Though side effects are rare, please consult your doctor and take these medications under strict supervision.DONTs for kidney stones(i) Please avoid holding urine for long intervals.(ii) Please reduce foods containing oxalates like non veg, vegetables like spinach, tomato, cauliflower, brinjals, nuts like kaju, pista and almonds.(iii) Decrease extra salt in foods.(iv) Avoid spicy pickles.(v) Do not neglect any pain and consult your doctors immediately.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pricking pain in back\n\nHi Doctor, My mother is complaining of Back pain in the left and also a shoulder pain of the left arm. She does not have any pressing pain the chest. But there is a pricking pain in the back. Do I need to take her immediately to the hospital? She is a hyper tension patient and has high BP normally.",
    "doctor_response": "DEAR FRIEND I HAVE UNDERSTOOD YOUR CONCERN, AS PER YOUR QUESTION YOU NO NEED TO TAKE HER AT HOSPITAL... PAIN IN BACK MAY BE DUE TO IM PROPER POSTURE SO THAT SOME STRUCTURE UNDERNEATH MAY BE COMPRESSED SO YOU MAY HAVE PRICKLING TYPE OF PAIN. YOU NEED TO CORRECT POSTURE FIRST. SIT ERECT AND SUPPORTED WITH PILLOW. YOU TAKE ICE MASSAGE OVER THE AFFECTED PART BACK AND SHOULDER... FOR TEMPORARY PAIN RELIEF. YOU SHOULD SOME BASIC ACTIVE FREE EXERCISE OF ARM AND BACK FOR MAINTAINING FLEXIBILITY. IF POSSIBLE TAKE HER TO PHYSIOCLINIC AND SHOULD TAKE IFT AND ULTRASOUND THERAPY FOR QUICK PAIN RELIEF.... AFTER 15 DAYS AND POST PAIN RELIEF WE CAN START WITH GRADUAL EXERCISE OF BACK AND SHOULDER.....",
    "dialogue_context": ""
  },
  {
    "patient_message": "My sister having heavy stomach pain frequently. Can any doctor tell me the reason ?\n\nHello, My sister is having sharp pains in her stomach area. They usually come and go but they are really affecting her to the point where she may not go to work or class. Any idea as to what may be causing this and how to deal with it?",
    "doctor_response": "Hi well come to Hcm stomach? you mean abdoman what i under stand. I any abdominal many facors are to be assed like location of pain, svearity, relation with food. relation with menstrual cycle etc.So merely asking for stomach no conclusion could be found. Better you consult your Doctor and get done suggested investigation if needed",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in abdomen?\n\nsalam can any one answer me  i am a humble muslim and praying 5times on time and i am married age 50.  if i dont enter in to married life atleast  twice in a week; i get a severe pain below tummy and i cant walk properly unless i enter in to wife or remove by masterbation. what is the reason for this",
    "doctor_response": "Hi.Thanks for your query.This type of pain, which increases if the semen is not ejaculated is classical of prostatitis. This can be well determined by your clasical history and supported by an examination - the per-rectal examination to palpate and know about the situation of the prostate. This can be helped by an ultrasonography of the abdomen, srotun and if the facility is available , per-rectal ultrasonography o an MRI. This is going to give a diagnosis. Many times in such a case we give prostate massage for 2 reason;One to rupture is any small abscess is in prostate and Secondly to get a specimen of prostatic fluid for analysis, culture and sensitivity.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have recurring otitis media. How can this be fully resolved?\n\nHi doctor, I am a 46 year old male. I have been having recurring otitis media every year since three years. I was treated with various courses of antibiotics. Amoxicillin is already resistant. So Cefpodoxime and recently Cefuroxime is being used for treatment. I would like to know if there is any permanent solution to cure otitis media as I have also heard it could cause meningitis. I am having another bout right now with my left ear drum is inflamed and this time Cefpodoxime cannot clear it. So, the specialist has put me on Cefuroxime. I am still on this course of antibiotics. I have back aches, cough with phlegm with low-grade fever and feel generally lethargic. I also have high-pitched tinnitus which is very loud. Can you please tell me if I can take a treatment where this issued can be fully resolved?",
    "doctor_response": "Hello. Taking antibiotics is not the solution to the problem. If you have a recurrent infection and eardrum perforation, you need to undergo a minor ear surgery which is performed by almost all ENT surgeons. For more information consult an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for wrist and hand pain\n\npain started in a day--right wrist,went to hand md,had cortisone injection,,lasted 3 days , then went to reumatoligist,had carpul tunnel test,blood work, doplar sonogram --all neg. its 4 months now and im no better ,both hands swell .no one has a diagnoses. im on naproxin now. not working well.",
    "doctor_response": "Get a RA factor and ESR blood tests done. If positive, very likely, start treatment accordingly through your rheumatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are symptoms of vertigo, dizziness and itching in body common when suffering from urticaria?\n\nI m a 35 year old female. I had an unusual episode of vertigo for a week 2 years ago - woke up running into walls, dizziness & nausea. It finally passed after a week, so this may be unrelated to present. 10 months ago I developed a sudden subtle itching in my scalp. It then moved to severe itching in my hands & feet, then torso, back & finally arms, legs. The itching comes on worst at night. Went to multiple drs. & was finally told I have dermatographism/chronic pressure urticaria with an unknown idiology but was an auto immune response. About 2 months ago I started feeling deep in my right ear like I was going to get an ear infection when I laid down to go to sleep but I never woke with one. Both ears started to take turns sharing this sensation at nights. Then, 3 weeks ago I woke up with the sensation radiating down my jaw on the right. I figured I had finally gotten the ear infection. I went to the dr. & he said ears were fine but throat looked like had infection. I did not have a sore throat, sinuses or any issues to suggest this. I was put on augmentin. 2 days later I started spiking 104+ fevers & got very weak barely able to walk/talk & got rash on legs. Went back to dr & tested positive for strep & mono both & antibiotic was switched to azithromycin & our on methylprednisolone & told to keep temp down for next 24-48 hours to reduce infection risk. 2 days later fever was gone all day. Around 9pm I laid down to watch a movie & immediately felt like I was burning up from the inside out, not like a typical fever. I became concerned because did not feel right. I made some calls & was told was just infection & to take ibuprofen & go to sleep. I woke with itchy legs at 4am, which I was used to with the urticaria. Itched it out & went bsck to sleep. When I woke up in the morning, my cheeks were flush, skin was bright red & hot & had a rash all over my body. Went back to dr & was told had scarlet fever. Antibiotic was switched for a 3rd time. After ther steroid, the radiating feeling down my jaw stopped, but the ear pain is constant in one or both ears still & ranges in severity. There has been a lot if light tingling in my temporal area, left side of cheek more than right, top of head to the point I became concerned again & went to ER. Blood tests had some low/high levels but not enough to be remarkable. MRI was done & my braces threw artifact on the scans so diffi",
    "doctor_response": "Hi, Thanks for your question. I do understand your pain and discomfort. I have seen many cases with similar complaints.As per your history, Please find my advice below-:1)Do correct your iron and B-12 by taking injection weekly 3 upto one month and then once in a month2)Check fasting blood sugar ,renal & liver function test3)Do full blood count with differential 4)Do a stool exam(RE/ME)First do all these things if done then nothing to repeat once again.Do not worry at all and it is a minor problem.I hope I was able to address your query. If you have any further questions, please do not hesitate to write to me. Wishing you all the best. Thanks,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medication for hair loss due to medication for high BP and hypothroidism\n\nI m trying to see why I,m still losing my hair. I take meds for moderately high blood pressure,hypothyroidism and of course the third usual with the thyroid...cholesterol also moderately high. I was actually check in to see if there were any interactions between these meds.",
    "doctor_response": "HIWell come to HCMYou have not mentioned your age and gender, because if your are male then this could be Male-Baldhead-Patterns, then can use Minoxidile 5% local application to be applied on your scalp, this need to be continue for ling time, hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning sensation and swelling on tongue?\n\nMy tongue has been swollen and burns so that it is hard to know what to eat.  This has been going on for about 4- 5 days and my lips feel enlarged also as though they a re chapped and burned , but are not.  Could it be the sulfa drug I was prescribed for a bladder infection or the fever I continue to get every few days for some unknown reason",
    "doctor_response": "HIThanks for posting your query.     Yes it is most likely due to reaction to the Sulfa drugs. I recommend you to stop taking it and also consult doctor as soon as possible because this reaction to drug may persist and progress 24-48 hours after stopping the medicine.    If it progresses it can become life threatening also. So kindly go to ER where they will give you a shot of steroid which will counteract the reaction.Also you need to consult your treating doctor and get an alternate medicine for bladder infection. Hope this information was useful to you. Any clarification feel free to ask . Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to heal moderate hip pain?\n\nHello, I am 83 years old and had a total hip replacement on 22/04/2012. I still experience some moderate pain and have a trendellendburg sign which makes me limp. If my hip were to dislocate ,how would I know? Will it take a long time to eradicate my limp? David Nichols",
    "doctor_response": "Hello, As you are 83 and had THR in the past and now hip is having pain, I think you need to do exercises for stabilizing the hip joint and strengthening the lower limb as a whole on both sides. The knee, hip, core plays an important role in stabilizing the hip, knee and spine. Pain is accepted in 80+ years of age. Doing exercises to make the muscle stronger will help to reduce the pains. In my clinical practice of over 12 years, most geriatric cases are taken into consideration for geriatric rehabilitation program and they respond well with the reduction in pain. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to cure tongue twists and hand shivering in an alcoholic?\n\nHi doctor, My father is an alcoholic. He has not been eating for the last 15 days. He is now suffering from insomnia. He is able to see abnormal things like people standing near to him. He has lost weight. He is having heavy sweat at night on the forehead. His tongue twists and has shivering hands. His height is 5'8\" and weight is 62 kg. What is the problem with him now?",
    "doctor_response": "Hi. Sorry for your father's condition. If I am your doctor then I would like to treat you in the following way: For further information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bits of food in molar, pinched out with hand, starts bleeding, still feels bit of food there\n\nHi, I recently probed behind my left last molar with my tongue and discovered it was an unusual feeling but I disregarded it as bits of food. This was until I brushed my teeth and it was not coming out so I attempted to pinch it out with ny hands which caused bleeding but then I eventually got out a part of it but there is still a bit left between the molar and the gum nd it keeps bleeding now. If this isn t a bit of food what could it be?",
    "doctor_response": "hello, first of all its very difficult to assess from ur description as ur last molar can be second molar or third/wisdom too.. and the bleeding from gums is due to food lodgement and subsequent infection of region.. it is a typical pericoronitis case if ur third molar is in eruption stage.. ur age is b/w18-25.. then food lodgement is commonest in region.. use a good interdental aid to clean the area along with frequent gargle with mouthwashes and gum massage.. get radiograph done of the region to assess bone pattern in the region or any erupting tooth..if all is fine in radiograph , get professional cleaning and try to maintain proper oral hygiene with regular follow up visits..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the severe pain in rib area?\n\nDCTR I FEEL PAIN IN MY RIBS ON LEFT SIDE JUST ABOVE HEART WHICH MOVES IN MY LEFT ARM AND MUSLES...WHEN I TURN ON LEFT SIDE ON BED I FEEL THAT PAIN STRONGER....ON TOUCHING THE RIBS IT LOOKS MORE PAINFUL WHAT IS IT?MY AGE IS 24 ,HEIGHT 5.7 AND NO MEDICAL CHECKUP FOR THAT",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms seem to be related to mialgia which is a muscle pain.I recommend to do an electrocardiogram to exclude other causes.I suggest using a muscle relaxant such as Baclofen three times a day.I also suggest using warm compresses for local application. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of pneumonia and legionnaires disease?\n\nIn Oct. we went on a cruise to Mexico.  When we got off the cruise ship my son was sick with asthma.  I took him to the doctor and the doctor said he had pneumonia and legionnaires disease.   The pneumonia come back once after he finished his round of antibiotics. He has been on three antibiotics and steroids since Oct.  Ever since he was diagnosed with pneumonia he has been having severe asthma.  It is like he can not stay well.  He is on a nebulizer machine and is taking a steroid inhaler.  Is there a specialist that he might need to see.  His asthma keeps flaring up.  He has missed three weeks of school.  He also says sometimes when he coughs it tastes like metal.  Thanks!",
    "doctor_response": "Hi thanks for asking question in HCM.Your child have hypersensitivity reaction.If possible search for exaggerating factors that lead to acute attack of asthma.Ex.some have allergy because of dust, some have certain food allergy.Just now according to history given your child should regularly take inhalation steroid by rotahaler or MDI at the suitable dose.Take nebulizer to home .so whenever needed levosalbutamol nebulization can be given.While going to school cover nose with mask if possible.Drink more water.If having seasonal allergy then leukotriene antagonist drug can be given.Mostly with this measures asthma will be under control.I hope my suggestion will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. When should I remove my dressing after extraction?\n\nHello doctor,I had a tooth extracted yesterday from the upper right side. Last night the blood clot fell out, so I was worried about getting a dry socket. I went back to the dentist this morning, and he said I did not have a dry socket and packed it with a nasty tasting dressing. I do not know what it is, so am I supposed to remove it after a while?",
    "doctor_response": "Hello. 1. The dressing packed in the socket should be a medicated one containing Zinc oxide eugenol. 2. This has to be wisely removed by the dentist in three days. And by fact, it is the dressing placed for dry sockets. 3. I advise you to continue with the antibiotics and pain killers if prescribed and revisit the dentist to get the medicated cotton pellet removed. This is also to ensure that the socket is healing well. Meanwhile, if the cotton pellet gets removed with your routine oral hygiene procedures, please do not worry. You will be completely alright. 4. Also, please follow the post-extraction instructions as well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does abdominal pain with low grade fever indicate?\n\nI've been having abdominal pain (mostly around the belly button area) for about 8 days.  I've also been noticing a bad taste in my mouth for several days as well.  Today, I also have a low grade fever.  Anything here a cause for concern...or just to be written off as flu type symptoms?",
    "doctor_response": "Hi! thanks for writing to HCM regarding your health concerns!Well, whenever someone approaches me with central abdominal pain especially mostly around the belly button area) for more than 7 days along with bad taste in  mouth, I first like to know his/her age and sex and if any significant medical or surgical history! however, as per your description, it is possibly an infective / inflammatory condition like appendicitis, urinary tract infection, gut infection, intestinal gas formation or in worse case chronic pancreatitis.Therefore a physical examination and USG of the lower abdomen is necessary before any medication!Therefore don't worry but write to us with my queries or contact a local physician for detailed examinationHope you got your answer; please do not hesitate to write to us if still some confusion is there!all the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does cyclenorm medicine have its effect?\n\ndear sir /mam i had taken cyclenorm e and p acutally i had sex with my boyfriend on 15 th may for just few minutes and after 2 weeks on 28 th may i had taken this tablet so pls help me what i have to do to avoid pergancy it will effective this tablet will effective forme pls help me",
    "doctor_response": "Hi,You have not mentioned the dose and duration of taking cyclenorm. A single dose of tablet is not sufficient. The drug should be taken 3 times a day for 3 to 5 days.After which withdrawal bleeding can occur in 3 days.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Saranya Ramadoss, General and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for getting pregnant\n\nI am 44 and trying to get pregnant. My cycles have been off for the past six months. My daughter had a triple organ transplant and is fighting for her life, so i have a lot of stress. I don t know if i am starting to go through mentopause or if it is stress related. I have a new partner, we have never had children together but he has had three and i have had five. I have been trying for eight months. Do u suggest clomid?",
    "doctor_response": "Hi. Your situation is a little bit delicate. You are 44 and you have menstrual delay for 6 months. Do you have hot flashes? The greatest possibility is that you may be in the perimenopause, which is the phase around menopause. Anyway, what would give an accurate answer regarding the desire of getting pregnant is a single test which is AMH (antiMullerian Hormone). It could tell us your current situation of the ovary. If you want to take clomid, first you need to have menstruations and you should try Progesteron to take them back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does intake of thronorm 50mg & neksium 40 mg cause side effects?\n\nhi I m shweta age 27, i have hyperthyroid since 7 months and also hyperacidity since 3yrs right now i m consuming thronorm50mg for thyroid and neksium 40mg for acidity is there any side effects if i consuming both because i have irregular periods since i m taking thyronorm.",
    "doctor_response": "Hi, Thyronorm is actually prescribed to treat hypothyroidism (decreased thyroid hormones). It should always be taken on an empty stomach 30 minutes to one hour before breakfast. Nexium-40 is a stomach acid suppressant commonly prescribed to treat tastroesophageal reflux disease and other conditions.  It should also be taken on an empty stomach one hour before meals. These two medicines are generally well tolerated however they should not be taken together. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mohammed Taher Ali",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain due to injury in foot and toes\n\nI have been prescribed Nolotil 575mg for an injured foot and toes, 1 every 8 hours. I am still in agony 2 hours after takiing my last tablet I want to know if I can have another or if I can have some other pain relJeff ie paracetamol or ibuprofen. I have also been prescribed omeprazol mylan 20mg & clexane 40mg",
    "doctor_response": "Cannot say in your particular case but generally an anti-infalmmatory dose of ibuprofen (about the highest dose of it) will add up with the other pain drugs to relieve pain and are save to take together.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain?\n\nHi, I am a 19 year old female and for the past 2 weeks, I have been having stomach issues. The pain is mainly in my left upper abdomen and it's sharp and happens suddenly. Also, my stool has been either green or there is a lot of mucous mixed with blood in it. I am going to see a gastroenterologist tomorrow, but I was just wondering if you had any idea what it might be? Thanks.",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, given symptom of pain may suggestive of some intestinal infection, viral infection may be very likely, you have to be patience for days because this would be alright on its own, as you are going to see the gastroenterologist so this would be helpful you for discussion, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for boils due to proteus mirabillis\n\ni have a bacteria called proteus mirabillis and am in constant pain from boils going on 4 years now, I had my son in 2006, contracted a UTI from the hospital and ever since can not get rid of these boils, so many antibiotics I have been on, what should I do?",
    "doctor_response": "Hi thanks for asking question.You are suffering from proteus infection that is common cause of UTI.Over boil you apply local antibiotic cream.To get over this infection first try single dose ceftriaxone and then cefixime or levofloxacin  taken orally for 10 days.If still no benefit then from affected tissue or fluid ex.urine culture done for choosing antibiotic.If you are infected with multidrug Resistance proteus infection then carbapenam is only available drug.Meanwhile drink more water with cranberry juice can be helpful.Fruits and green leafy vegetables useful.Avoid spicy food.I hope my suggestion will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Am i going on a right treatment for pcod and high tnf alpha?\n\nI am 35 and married for 10 yrs, 1st prenancy in 2005 got aborted, 2nd through IVF got aborted in 4th month, 3rd time pregnancy on my own.. (am pcod, high tnf alpha, was detected latent tb taken att for 1 year... ). doc has advised duphaston, L dha, Folic acid hucig injectiin every 4 day... am i at right treatment.. please suggest",
    "doctor_response": "Hello, Yes, you had taken att for one year. now you are pregnant on your own. The treatment now is taking to protect the pregnancy with hormonal imbalance. It works well. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.T. BALAMURALI, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat BPD by myself?\n\nI have BPD. I have been seeing my gp every two weeks I found this valuble support and I get my medication at the same time. My gp has left snother doctor has said they will not see me and pamper me sort myself out. I feel hurt and rejected by my support network",
    "doctor_response": "HiThanks for using healthcare magicIn bipolar disorder, you need mood stabilizer like valproate or lithium. You can not get these drugs without prescription. In that case, you should consult a psychiatrist for proper medication and treatment. You can control yourself by keeping you relax. For that, you can try relaxation exercise that would keep you relax and avoid mood swings. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the red spots in the pubic region?\n\nHello i have red spot like things in my pubic hair now there not in one place and not closes to oneother thay ich from time to time i dont shave i only trim but i did not notice them untill i trinmed today most of them are where my pubs grow some are next to them",
    "doctor_response": "Hello,Probably, red spots in pubic region are due to fungal infection. It needs treatment with oral and toipcal anti-fungals under the supervision of a dermatologist. Avoid using tight clothes and jeans. Keep area dry. You can use anti-fungal powder like candid for this. OTC creams like clotrimazoloe are also can be helpful to treat infection.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. R.G. Joshi, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to get rid of ringworm on face\n\nHave ringworm on my face and have had it for about4 months but did not know it was ringworm until 3 weeks ago been using over the counter cream but the have be bleeding and hurt... I don't know what to do from here I don't have health ins. Help please thanks!!!!!",
    "doctor_response": "Hello,Welcome to HCM,Fungal infection of the face is called as pitryasis alba. As you are having fungal infection of the face for last three months I would suggest you to follow1. Keep the face clean and dry2. Apply cotrimazole cream over the lesions3.Take oral Flucanazole once in a week for 4-8 weeks.4.Oral antihistamines for five days.These measures will reduce your symptoms and improve your condition.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for semen leakage at night\n\nhi,i am 17 and i have the problem of semen leakage at night.i used to masturbate frequently,but frm 4,5 months i want to ignore but i keeps on getting on my nerves and at night it leaks once in two weeks especially after workout.What to do?IT IS WITHOUT MY WILL!!!",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It is called Dhat syndrome. It is just mucus leaking from mucinous glands of urethra and from prostate. It may be due to sexual imaging and thinking. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat meniscus tear extending from periphery and tibial articular?\n\noblique tear with grade 3 signal involving body and both horns of lateral meniscus.tear is seen extending on to the periphery and tibial articular surfacemultiloculated parameniscal cysts adjacent to the body af meniscal body is seen extending inferiorly and scalloping the lateral margin tibial condylend posterior horn.cyst in the region",
    "doctor_response": "Hello, I have studied your case.Meniscus injury can be managed by arthroscopic repair,and same day you can go home.Somtimes notchplasty may be required.Post operative rehabilitation and physiotherapy is important.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it correct to have the disc fusion between C6 and C7 causing severe pain?\n\nHi. I had my c5 and c6 fused last year. I now have severe pain down my neck shoulder and down my arm and into my fingers. I had am MRI and it showed that I now have a problem between c6 and c7. Do u think it s a good idea to have all these discs fused.",
    "doctor_response": "HelloIt is fairly common to develop a disc problem above or below where a fusion has been done.As for whether you need a second fusion, that would depend on the actual MRI report and results of nerve conduction studies and a cervical myelogram",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of reversed cervical lordosis ?\n\nWith a diagnosis of reversed cervical lordosis can symtoms include vertigo? i also have neck pain, occipital HA s, weakness in shoulders and trapezius muscles. Over head work like painting and hanging a shower curtain increase symptoms, as well a pushing a grocery cart, heavy lifting, etc.",
    "doctor_response": "Hello, Vertigo is very unlikely to be linked with the diagnosis of reversed cervical lordosis, other symptoms that you mentioned are linked with it. You should see a spine Specialist for your symptoms. Treatment with anti-inflammatory drugs and physical therapy may be necessary. Vertigo should be evaluated by an ENT Doctor. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pain in the rib cage and stomach?\n\nI fell really hard while rollerblading, I landed first o my bottom. I felt my ribs and whole spine compress, hurting my stomach as well. I had a failed Nissan in early 2010, one year later they redid the Nissan and meshed my diaphragm. Why is my stomach still hurting days later?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Your stomach pain is most probably related to your recent fall. You need to take rest, put ice on the affected areas, take analgesics (oral or topical) for pain relief. It will subside over few days. Do not worry about it. I hope I have answered your question. If you have further queries, I'm happy to help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain while coughing?\n\nI have cramping/pain off and on on my left side -- halfway up my chest, under rib.   I've had a bad cough for some time and when I cough hard it hurts, but sometimes I feel it when I don't cough.  Just wondering if it is something to be concerned with --",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. Chest pain on coughing is classical sign of pleurisy (inflammation of pleura). And common causes for pleurisy are pneumonia, pleural effusion, tuberculosis etc. You are also having chronic bad cough. So better to first rule out all these conditions. So get done chest x ray first. If this is normal than no need to worry for all these causes. You are mostly having musculoskeletal pain. So avoid strenuous exercise and heavyweight lifting. Avoid bad postures in sleep. Avoid movements causing pain. Start painkiller and muscle relaxant drugs. Apply warm water pad on affected areas. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be worried about taking ovulation tests and LH surge at the same time or use some other contraceptive?\n\nI have been trying for my second baby for almost 20 months , had a miscarrage (blighted ovum) in April 2013, followed by surgical removal, after which my periods have never returned. Scans and blood tests all normal.slight bleed this month for a matter of hours. Have now been prescribed norethisterone to takedown for 7 days from what I believe will be day 21 of my cycle. Should I be using other contraception. Worried that I am taking ovulation tests at the same time and have just picked up an lh surge?",
    "doctor_response": "Hi,History of total absence of menstruation followed by surgical (mostly Dilatation and Evacuation and Curettage) termination of blighted ovum pregnancy is suggestive of adhesions formation in the uterine cavity due to trauma to the uterine lining and the musculature. This entity is known as Aschermann Syndrome. This could be the cause of failure of conception. Hysterosalpingography / Hysteroscopy can diagnose this condition. If Aschermann syndrome is present, the adhesions can be severed delicately during hysteroscopy. Putting some intrauterine device and continuous high Oestrogen treatment may help regeneration of the uterine lining (endometrium). Norethisterone will not help the regeneration of endometrium; it will just be an attempt to have withdrawal bleeding. You need not go for ovulation tests at this stage. Please get the cause for loss of menses diagnosed and treated. Once you start menstruating regularly and normally, you may consider the ovulation monitoring. I hope this gives you preliminary guidelines. Let me know if I can assist you further. Regards,Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fainting sensation, tunnel vision and sweating on hearing about childbirth?\n\nWhen someone talks about the physical aspects of childbirth, I experience very unusual symptoms. I start to feel faint, get ringing in my ears, tunnel vision, and feel very warm and begin to sweat. Has only happened twice in my life, but both times occurred while I was listening to someone talking about the physical aspects of childbirth. Any ideas?",
    "doctor_response": "Hello,Welcome to Healthcare Magic.Your above symptoms can occur anxiety and phobic conditions. You appear to have excessive anticipated anxiety regarding childbirth, which lead to such symptoms in your case during discussion about childbirth.In such cases treatment in form of medical education regarding process of childbirth process with relaxation exercises will help.Wishing you good health and all the best.www.99doctor.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What remedy can be used to cure nosebleeds and discomfort due to pollen allergy?\n\nHello doctor, I have a problem with my allergies. I believe I am allergic to pollen and I have these allergies all year long. I am always snuffing, wiping, started to have nose bleeds recently. I tried every over the counter allergy pill and spray and nothing gives me release. What should I do? Is there a doctors prescription I should take? Or remedies I could do? Any suggestions for anything to stop this discomfort and nosebleeds?",
    "doctor_response": "Hi. Nose bleeds are due to running nose, dryness and crusting, all of which manifest in allergic rhinitis. You need to get a skin flick testing done to check what you are allergic to. Thereafter you should try allergen avoidance, pharmacotherapy and some precautions. If these fail, you can go for immunotherapy. If you need details, you may revert back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do i need surgery for disc bulge at L3 L4 with a annular tare?\n\nMri shows broad base disc buldge at L3 L4 with a annular tare that indents the the al sac. L4 L 5 broad base disc buldge with thickening of the ligamentum flavum causing mild narrowing of the spinal canal with facet arthropathy the same at level L5 S1. Do i need surgery I have pins and needles in both feet and pain in back",
    "doctor_response": "Hello. Thanks for asking from HCM.I can understand your concern. In case of disc disease, surgery or conservative treatment decision is made based upon multiple factors. MRI findings are correlated with clinical profile of patient, patient's dedication to follow precautions before and after surgery, physiotherapy .Now in your case, I will give you some knowledge and insight of disc disease. Based on that you may be benefited regarding management of your disc problem.As you have disc bulge at three level, it might be due to your age ( if it is more than 60 years, chances of disc bulge is unto 35-40%), your occupation (heavy weight lifting or keeping spine in flexed position for long duration). Now if you are less than 60 years, active, having no other illness, then you should consult doctor and get your neurological examination done. The doctor will examine your pain site, any radiation of pain from back to posterior part of lower limb. It is due to nerve compression from disc. Doctor will evaluate your urine, bowel and sexual function for any deficit. He/she will examine you for sensory loss in L4/L5/S1 territory which is your front aspect of leg and plantar aspect of your foot. After that, your lower limb power will be checked. If there is any deficit, then it will be correlated with MRI findings. It is known as Clincio-radiological correlation. Based on it, you will be advised pain killers like pregabaline/gabapentine, nerve vitamins like B12, folic acid and/or surgery. If you are >60 years, bed-ridden, having morbid illness like heart disease and not active, then you will be advised medical management most probably.Usually, disc surgery is advised in case of focal deficit caused by nerve compression from disc, acute disc with focal deficit, no relief in radicular pain even after full dose of pain killers after 6 weeks of therapy, disc herniation with unstable spine and patient is fit to undergo surgery and follow post operative advise.You are having diffuse disc bulge at L3-4, L4-5 and L5-S1 which is usually not treated by surgery. Mostly, disc extrusion or migration are managed by surgery. But final decision can only be made after complete clinical evaluation. Mean while, you should avoid weight lifting, avoid forward flexion, travelling long distance, prolonged sitting. Thanks. Hope it will help you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathing trouble after taking bath at nights?\n\nwhen my husband takes a shower at night, he puts lotion on his face and body, but has a hard time breathing the rest of the evening.  He says his skin feels like the hard foam you would put in a box.  He doesn't have this sensation when he takes a shower in the morning.  Wakes up all night not being able to breath.",
    "doctor_response": "Respected  user , HiThanks for using Healthcaremagic.comI have evaluated your query thoroughly .*  This is in relation with allergy or sensitivity to the lotion consumed after     night bath .Hope this clears  your query .Welcome for any further doubts .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes large lumps on forehead of a 2 year old child?\n\nMy 2 year old grandson suddenly had 2 large, quite hard lumps appear on the right side of his forehead even though he definitely had not bumped himself. He was fine in himself and after a nights sleep the lumps had miraculously disappeared. Could you please suggest a possible cause for these lumps ?",
    "doctor_response": "Hi.Thanks for your query.Noted the history related to your grandson developing two large bumps on theright side of his forehead even though he definitely had not bumped himself. He was fine in himself and after a nights sleep the lumps had miraculously disappeared. Could you please suggest a possible cause for these lumps?Such large bumps which vanish on its own are due to angioneurotic edema. This is an allergic reaction to something in food or in the air, that can be found out on observation by the family members alone. You have to keep the dosage of antihistamine and oral steroids adjusted to his weigh at reach at home so that the next time it develops you can immediately give him medicines as this can be dangerous if they appear on the neck, in mouth or inside. This can not be due to hematoma as it could not vanish within a night.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat painful gums?\n\nHi, I am a healthy 25 year old women.  I am 5ft 6, and 8stone 4pds.  Since Ive remembered I have suffered with extremely painful gums after exercise, it is my lower gums and comes on usually when I am running either outdoors or on the treadmill.  It lasts until I get my breath back and back to normality.  I do not clench my teeth and I have never smoked.  It appears to be that when I begin to gasp for my breath (even slightly) my gums begin to ache.  It is unusal and I have suffered it a very long time, I have recently decided to get fit again though I feel that knowing the pain I will face, it puts me off.  Any ideas wht it is or to prevent the pain?  Thank you",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.Running ,or thread mill are aerobic exercises which require heavy breathing .This is in opposite to what your jaws are used to .If your jaw muscles are not used to this kind of movement ,they stiffen up and cause the pain to radiate to the gums and associated areas.I would suggests to do simple jaw exercises before your exercises so that your jaws are used to it and are strengthened.Open and close your mouth tightly for a few times in a day .If it is too severe ,consult your dentist and get night guards done. Hope this was useful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can masturbating cause any problem with inguinal hernia?\n\nhey doctor, my name is victor and i am addicted to masturbation and i have tried to quit but i can't yet i have a girlfriend. i normally rub my penis to my thighs until i come. is there any danger about it since i have inguinal hernia? please advice me on how to quit.",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have been indulged in masturbation since many years and now facing problems related to sexual activities.First of all there is myth in a mind of common man that excessive masturbation is the reason of all sexual problems But I would like to state that it has been discussed in scientific forums all over the world and proved scientifically that masturbation does not have any negative effect on any organ or system in the body.All the problems that you are facing now are mind related and due to anxiety.Since you have inguinal hernia it may get complicated in to obstruction due to vigorous activities while masturbating.Though it is harmless, excessive and frequent habitual masturbation does affect quality of erection and delays ejaculation.Please try to reduce the frequency of masturbation by keeping yourself busy in activities like sports,reading ,social work etc so that you will not get free time to masturbate. Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I feel tired always, disturbed sleep and have increased weight. Please help.\n\nHello doctor, I am eager to get my reports examined and get your opinion. Reports attached for your reference. I would be more glad to seek your advice on my LFT/KFT and diabetes reports. What is required to bring all parameters to normal? I work for an IT company and mostly sedentary lifestyle. Hardly I walk for 3 to 4 km in the morning. No smoking, moderate alcohol, vegetarian. I feel tired most of the time, disturbed sleep, unknown reasons for weight increase from 82 kg to 87 kg in the last couple of months. Currently, on Ecosprin 150 mg and Fibbitor 20 (daily once in the morning) for eight years due to MI and was administered check angio. Please advice.",
    "doctor_response": "Hi. You have diabetes mellitus (type 2). This occurs due to deficiency of insulin which is secreted by the pancreas. You will require reduction of your weight, regular walk at a brisk pace for about 45 minutes to one hour daily for most days of the week. You should be on antidiabetic drugs too. You already have had an MI as per your history so you have to be extra careful with your weight and diabetes. You can continue the drugs which you are taking, in addition, you should be on tablet Metformin SR and one of the antihypertensive agents (ACEI or ARBs). Kindly consult a physician or diabetologist near you for the correct dosages of these drugs depending on your sugar levels and blood pressure records. For more information consult a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for jaundice\n\nSir,currently i m suffering from jaundice from past 2 weeks.My age is 25 weight 63kg.In the first report SGPT-2800 and Bilupin-4.3 and in the second report the SGPT reduced to 229 and bilupin to 3.5.i m still on complete bed rest at home.can i resume back to gym after a week or so...",
    "doctor_response": "Hi,Thanks for posting your query.I am Dr.R.K and I am pleased to assist you.You are probably suffering from acute viral hepatitis and are in the recovery phase.If not done already, get tested for hepatitis A, B, C and E to see which of these has caused it. Hepatitis A and E are self limiting and usually resolves in about 8 weeks. Hepatitis C and most often Hepatitis B usually leads to chronic disease and need to be followed up.Since you are recovering there is no need for any bed rest and you can resume your office work. You can start going to gym after 8 weeks once you start feeling better.I hope that answers your question.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life expectancy of a person with final stages of heart failure?\n\nI am 36 years old and have heart failure with my heart pumping 20% at the moment, my doctors tell me my lungs are what they expect to find on an 80 year old, a few weeks ago I suffered kidney failure and was admitted to ITU for dialysis for several days, can you please give some indication of my life expectancy as my doctors avoid this question",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. No exact answer, I see patients with heart failure with EF 20 living in reasonable conditions. However, unfortunately, you have multiple problems that may complicate your condition and can bring it down to 1-5 years. I hope God's hands touch you and improve your health to go beyond our expectations.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for orthostatic hypotension\n\nI think I have orthostatic hypotension but I am not sure. When I stand up I get the normal dizziness but my vision also fades to black for a few seconds. Sometimes I get tunnel vision. I am a runner so I thought it could be having a runner s pulse, but no one on my team experiences vision loss or as much dizziness. I am not dehidrated either. Is there anything I can do to stop this? Or do I need to see a doctor?",
    "doctor_response": "Hello, I passed carefully through your question and would explain that your symptoms could be related to orthostatic hypotension. For this reason, I would recommend consulting with your attending physician for a physical exam and performing a Head-Up Tilt test in order to investigate for this possible disorder. Some blood lab tests are necessary too: complete blood count for anemia, thyroid hormone levels for thyroid gland dysfunction, blood electrolytes for possible imbalance. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low hemoglobin levels\n\nHello I have a 17 yr old son who has complained of abdominal pain and fatigue. Took him and had some bloodworm drawn 1st set of labs showed total bilirubin of 2.2....I recently took him back for followup labs to see if the total bilitubin went down but it increased up to 2.6 and now his ABC are low at 4.1! I am very worried! Any suggestions as to what this may be?",
    "doctor_response": "Hi,Thanks for asking.Based on your clinical history and query, my opinion is as follows:1. Increased hemolysis is probably the cause of raised bilirubin and low hemoglobin.2. The RBC count could have been reduced due to similar reasons. However, do get a peripheral smear and reticulocyte count done to identify any abnormal cells in smear and whether the bone marrow response is present.3. Also check, if it is unconjugated bilirubin, which is raised. It would indicate hemolytic anemia. If conjugated is raised, possible liver cause or gall bladder obstruction needs to be ruled out.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump near pubic area with discharge\n\nI have a lump by my bikini line and it feels like a bruise but it's not physically visible. And then I felt sharp pains and when I checked I found dried blood about the sixe of a quarter and I felt a gushing period type feeling and checked to find an ordorless clear liquid that had red tinge to it. I started on the 7th or 8th of this month and ended around the 12th or 13th whats wrong with me?",
    "doctor_response": "hi.it might be folliculitis based from your description. it is an inflammatory reaction when you shave or remove hair from the area. it is very important not to get it infected by not manipulating or scratching the lesion, avoid shaving and products that may add irritation to your skin. usually, these cases, resolved on their own. but if the symptoms are persistent, and there's growth of the lesion, a consultation with your doctor is best. also, maintain a good hygiene and keep the area dry and clean.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Short term memory loss. X-ray shows scoliosis with straightening of cervical lordosis. Related to memory loss?\n\nI am a 53 yr old female and have been experiencing short term memory loss for the past 2-3 years, I recently had a c- spine xray and the finding were this: There is scoliosis with striaghtening of the cervical lordosis . There is mild retrolisthesis at C5-6 where there is decrease in the height of the interspace with oseophytes leading to foraminal stenosis bilaterally. There is no fracture. My question is this....could this problem with my neck be attributed to my memory loss?",
    "doctor_response": "Hi friend, Welcome to Health Care Magic Your memory loss can not be attributed to the problem of your neck. You have to see a neurologist - vascular insufficiency, early Alzheimer, simple ageing changes and so on  need to be investigated Take care Wishing speedy recovery God bless Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause pulmonary fibrosis?\n\nI was diagnosed with pulmonary fibrosis 2 years ago after a lung biposy... i was on prednisone for a couple of months.. but i stopped.. from now on im only using an inhaler (symbicort) but every morning as soon as i open my eyes, my cough starts... and it keeps going for more less 20 minutes.. no matter what i do it wont stop.. after those 20 minutes of coughing im just exhausted... i was wondering if there is anything that could help with my cough and the sputum",
    "doctor_response": "Hi,Dear,Welcome with your query to HCM.Studied your query in full depth of its details.Reviewed it in context of your health concerns.Based On the facts, You mostly seem to suffer from-Overnight Lung Congestion and would need Cardio-respiratory assessment.Remedy Suggest -for your case Bronchial Care-with Positional Chest Tappings would reduce the complications associated with these morning cough spells.Restriction of Fluids after 4 pm.Reduce on Drinks after 4 pm.Reduce on Salt in your diet.Use Inhaler infrequently.Practice Deep Breathing x 3 times a day x 10-15 mts sessionsAs I dont have access to cause of your Lung Fibrosis,Second Opinion from your Chest PhysicianOther causes need to be ruled out and treated if present accordingly from Second opinion from Chest Physician and Chest Surgeon.Hope that ,This reply would help you to plan further treatment soon with your treating doctors.Best of Luck and early recovery.Welcome any further query in this regard,which would be replied in next session.Good Day!!Dr.Savaskar M.N.Senior Surgical Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes green watery stools in baby?\n\nmy 20day old baby drank water while giving her Indian style bath to her . it happend 4 times in this 20days including to she makes noise while drinking milk , she has reduced drinking milk and passing green colour watery stool any suggestion on this",
    "doctor_response": "Hi... but what you say I feel that she might be having Viral watery diarrhea. Even otherwise it is normal for kids of this age to pass green coloured watery motion 5 to 10 times per day, especially after feeding. Unless the kid is having blood in the motion or green coloured bilious vomiting are sunken eyes or dry tongue and decreased urine output you need not worry. If the kid is feeding well and urinating well -  that means that baby is a well baby.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat memory loss and slurring of speech?\n\nWhen do you go to the er for a symptom due to mental illness treatment?  I have a 46 yr old male taking antianxiety meds and with high blood pressure, diabeties type II, and on cholesterol meds that has been sleeping for a day.  He has no memory of the day before he began sleeping and is slurrring his words.",
    "doctor_response": "Kindly visit the emergency soon. As the patient might be having delirium due to hypoglycemia or any other physical metaboluc parameters derangement. Visit soon as he has comorbities and need immediate assessment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause for the sudden loss of vision in a 3 year old?\n\nHi, My nephew is three and half years old. About a month ago he lost his vision on both eyes. After all the different exams, his doctor found out that there was a tumor in his brain which oppressed his optic nerves and suspected that he could have had the tumor since he was born and it was growing along with him. He has had his tumor removed three weeks ago and his vision has not come back. The doctor said that he had optic nerve atrophy. Since he is so young, is there any other possibility which could have caused him to lose eye sight or is there any treatment out there for him? We are desperately searching for miracles! Your response would be greatly appreciated! Lilly",
    "doctor_response": "I am really sorry to inform you but when a tumor compresses on optic nerve especially for years the atrophy will result in permanent vision loss. There are no treatments at the moment for this condition.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have flu with cough, fever, taken panadol, coronary patient, abdomen pain. What can be done?\n\nDear Dr. Santosh,  I have started a flu with cough since 3 days, with a fever reaching 39 Celsius Degrees.I have taken Panadol , two capsules each six hours, as I don't dare to take too much medicine since I am coronary and a MS Patient, and I have chronic medicine like Aspirine, Concor, ZOCOR, corvasal as well as Interferon(Rebif 44)  one Injection every other day.But the high temperature persists , I started to take Curam 1g, twice a day, along with my others medicines. The temperature is reduced the second day till 38 CD but I have started to feel a lower abdominal pain, I stopped to take CURAN, and I resume taking Panadol. The temperature is stable now at 38, and I am drinking two much water with taking Mucosolvan . The lower abdominal pain is still persisting. What do you suggest?  Thanks in advance , Joseph",
    "doctor_response": "Hi ! The very point that on taking Curam, your fever is reduced indicates that your respiratory tract infection has responded to the drug. The lower abdominal pain which you have developed could have been due to Curam (Amoxycillin+clavulunic acid) which is known to cause such lower abdominal pain as a side effect. It may also cause loose motions sometimes. This is not a worrying problem. You can change over to any other antibiotic not conataining amoxycillin  on consultation with your treating physician. At the same time, multivitamin product containing lacto bacillus is also found to work well in such conditions. The pain lower abdomen will gradually subside. Continue with other medications given for your heart problem. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes watery and thin blood?\n\nI checked my sugar with a meter and noticed my blood was very thin and watery to the point my strip did not want to draw it in,Why?My age is 48,weight 116 medical history is diabetes diet control only,COPD,Diastolic heart failure,dual chamber pacemaker,CAD etc",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You should go for routine blood examination for your hemoglobin level. Thin blood may be due to low hemoglobin. Investigate for that and take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had asthma, have dust allergy. CT scan showed septum deviated, hypertrophic turbinates, mucosal thickening. Explain\n\nHi Doctor,I have dust allergy since childhood.Since the past 3-4 years i am experiencing frequent nose block/frequent colds during winter and rainy seasons. Last year i had an asthma attack for which i am using preventer inhalers and my asthma is under control now.This year i consulted an ENT doctor for remedy to my nose block problem in my town and he referred for a CT scan .The CT scan report says 1)septum deviated to left 2)inferior frontal,ethmoidal,maxillary and sphenoid sinuses polypoidal mucosal thickening 3)Obliteration of both infundibulae 4)Narrowing of both OMC.5)Narrowing of both frontal recess 5)bilateral concha bullosa with mucosal thickening6)Hypertrophic turbinates 7)Visualised skull base apperas normal.The doctor asked to go for FESS and then long term medication(sprays and anti allergy tablets).My question is will long term medication alone not cure the problem.Is surgery necessary?I dont have any symptoms apart from nose block and frequent colds.",
    "doctor_response": "Hello dear,I have gone through the case history as mentioned in the post.1. Deviated septum, hypertrophied turbinates, sinusoidal polyp & other findings as observed in CT scan are all related to each other.2. These changes in the normal mucosal anatomy is responsible for your symptoms3. Intake of medications will only provide symptomatic relief. But, unless the underlying cause is treated, symptoms will keep recurring.4. You might have to take medications life long for this & have to suffer their side effects, while the mucosal changes may aggravate further to cause irreparable damage.5. Keeping in mind the above mentioned facts, your ENT Specialist might have advised you the surgery.Kindly discuss about this & then take a decision.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for blood clots in the lungs\n\nMy Grandma has blood clots in her lungs and was just rushed to Intensive Care.  She is Obese and has been in and out of the hospital for the past few weeks, but this time it is more than serious.  I would like to know what steps the doctors are going to take now, and if she needs surgery, what will happen?  Please answer as quickly as you can.  Thank You.",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .*  The condition of  Pulmonary  Embolism  is  very  critical  .*  Primary  management  with  IV  conservative  molecules of clot     dissolution , later if required  catheter  embolisation  is  mandatory .Wishing her  fine recovery .Feel  free  to ask any further doubts .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Got back problems, do smoke, blur vision, tummy upset. Reason?\n\nThis has never happened to me before I ve got back problems so I smoke a joint or two a day and this was at night and I smoked a joint had two small beers that are 3.5 percent I was laying in bed watching monsters inside us I started feeling like I had to throw up and I stood up and all of a second my vision started going black and I felt dizzy and started walking funny then I ran into the wall just before the bathroom and fell down and I sat up and was rubbing my tummy to get the upset and wierd feeling gone and next I know I m hitting my head on the wall and my husband woke up and goes u alright and he comes to me takes me into the bathroom and I threw up for about 8 minutes then my vision was coming in more clearly and I felt better",
    "doctor_response": "As is  obvious  you are already  aware  of wrong  effects and  its best  to  rid one off  the  habit gradually.Emotional  stability comes  from  non-dependency  and  it  is  best  to  shake it off  with  the  help  of  doctors  or  therapist who  wean or  help in  weaning  away  from  certain addictions.in my opinion  getting busy  with  hobbies,or domestic  chores  requiring  physical involvement,  gardening, carpentry  deviate  the  emotional pent  up demands. pranayam,yoga  and  meditation are other   ways.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for red spots on back, arms, face and scalp\n\nI have red spots on my back, some on my arms and some on my scalp, and two on my face. I have used creams that my dermatologists prescribed, but my rash has not improved. I am now wondering if I may have an allergy to coconut oil, which I use every night (I thought I had found my answer to dry skin). I also use argon oil and maracuja oil before applying make up. I am allergic to latex and have had two allergy test, but of course, each time the results are different. I am at my wits end trying to figure out what is going on with my skin. Do you have any suggestions?",
    "doctor_response": "HI, thanks for using healthcare magicIt is possible that you have an allergic response to one of the oils that you are using.It may be possible to have allergy testing for these oils as well, you should discuss this possibility with your doctor.You can consider discontinuation of one of the oils to see if the rash improves or stabilises.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should be waited after the treatment for cancer to get tattoo?\n\nHi, I am a 19-year-old female who has recently undergone treatment for Hodgkin s Lymphoma. I am wondering if there is a general guideline as to how long a person should wait after cancer to get a tattoo. For example, how long after chemo should one wait? (It s been 5.5 months) How long after radiation? (2.5 months) How high should the WBC count be? (... I forgot(: ) I will definitely be asking my oncologist before I committ to any inking, but I was unable to ask him this during my previous appointments because my (overprotective) father has always been lurking. I am treated at a Children s hospital so it is difficult to get around their tendency to include family members, especially since I have usually been so open in the past. If I have a general idea, I can ask him shortly before I plan on getting it and save him any grief from my father. (My dad does NOT like my oncologist.)",
    "doctor_response": "Hello dear,You can get tatoo after completion of your treatment and when your complete blood count is normal.there is no harm in tatooing .anything more you want to ask ?",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause pus on the scrotum?\n\nthank you firstly... yeah since one month i have developed a puss on my scrotum sack. not on testicles but it seems to be attached to the inside of the skin. two days before i washed it with hot water thinking it would melt. but next day it had become bigger. please help me how i can get away from it???",
    "doctor_response": "Hi,From history it seems that there might be having some local scrotal skin infection producing oozing from the lesion.Nothing to worry, it is simply bacterial infection.Clean local part with warm water and apply antibiotic cream for few days.You might require one course of antibiotic medicine for 3-5 days.Keep local hygiene clean and dry.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am i having an urge to take a deep breath like yawn every minute?\n\ni am needing to take a deep breath yawn like breath every minute or two. its getting irritating and cant sleep that good. Im 21 years old and this has been happening for the past 4 days. I breathe ok but every minute i need or have the urge to breathe deep and cant seem to breathe deep sometimes.",
    "doctor_response": "Hello As you explain the history probably, a stress situation might be the cause. Regards Dr. Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful bursitis in hips and shoulders\n\nhaving unabearable pain with my bursitis in hip and shoulders.can t sleep and it is very hard for me to do my job as a cake decorator.my company says this is not a job related injury so there fore working makes my pain worse as i am a cake decorator.ant suggestions as to so relief.already had 2 injections in both hip and left shoulder and hasn t touched the pain.",
    "doctor_response": "hello,I have studied your case and I can understand your problem. You are having severe pain in your hip joint and shoulder joint due to accumulation of fluid. I would suggest you to follow these steps.1.Hot water fomentation2.Tablet voveron 50 mg three times a day.3.Tablet tendocare one daily.   If this work is increasing your problem then you should stop this and start some thing else. I hope this answer will be useful for you. Let me know if there is any other followup questions.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the solution for leakage of semen after urine and also while lifting heavy things?\n\nsir i have a of leakage of semen after urine and even if i take any heavy thing then again leakage happens. the fluid which comes out is cloudy and thick and 5 to 10 drops leakage after when i urine .... kindly tell me what should i do. my age is 24 years weight 59 KG, height 5 feet 8 inches",
    "doctor_response": "DearWe understand your concernsI went through your details. Semen is a waste product. Body produces semen whenever you are sexually triggered or aroused. Such produced semen is stored in the groin. Body is supposed to throw the stored semen out. If you do not masturbate or indulge in sex and throw the semen out, the body does it automatically either through nocturnal emission or as droplets prior to or after urination. When you life weights, the groin area is squeezed resulting in the droplets. Nothing to worry. This is usual and normal.If you still need my assistance in this regard, please use this link.  Please remember to describe the whole problem with full detail.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tremors in hands, abdomen and neck?\n\nI have had tremors in my hands for about 4-6 months. In the last three weeks I am getting them in my adomin and neck. When I am tired they are more like convulsions. When I really try hard not to shake I can control them. I have been bowling better than average lately and shooting pool good. I have made a appointment with regular doctor and she has referred me to a Neurologist. My appointment is not for another 20 days. She says I probably have Parkison s but doesn t the syptoms come on more slowly? I am trying to get the appointment set up earlier. Should I be concerned and just go to the hospital?",
    "doctor_response": "Hello,If the symptoms have been going on for 4-6  months then there is no need to go to emergency. Make sure you are drinking plenty of water and take a multivitamin daily. There is not much they could do for you in emergency. You need a thorough evaluation by a neurologist in the office. I know it is hard but waiting 20 days is fine as long as no new symptoms developRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be given to a toddler for diarrhea and vomiting?\n\nHi my daughter is 3.5 years and vomiting from Saturday evening day one vomited thrice and day 2 vomited twice with one loose stool, day 3 she was usually okay but threw up steam apple that she had in her lunch, I am giving her ondem after she pukes and paracetamol for stomach cramp( they are very frequent) , today ( day 3) she manage had half bread toast for breakfast and 1 small steam apple with nothing else , she had market bought food, and I am suspecting food poisoning...my concern is how should I give her ondem, or should I wait until she puke??? Is ondem to be given empty stomach and what can be given for stomach cramps ?? She is not interested in eating anything, can I let her be or should I insist on eating a little bit ?",
    "doctor_response": "Hi, She most likely has gastroenteritis due to a viral infection and not from food poisoning.  You can return to the place where you purchased the food to inquire if other customers went back to the store complaining about vomiting and diarrhea. Paracetamol can be given to a toddler for pain such as stomach cramps.  Ondem is given to prevent nausea and vomiting that takes place after chemotherapy, radiotherapy, and surgery. It has side effects: -irregular heartbeats, -chest pain, -shaking, -fainting and dizziness, -headache, -constipation. I would recommend she not have the Ondem. Does she have fever? At this point you can give her fluids such as apple juice, pear juice, Pedialyte. These should be room temperature, not chilled, Jell-O. Offer 1-2 oz every 1-2 hours. If there is no vomiting after 4 hours, offer 3-4 oz every 2-3 hours. It is necessary to make sure she does not become dehydrated(no tears, dry tongue and mouth, doughy feel of skin, and reduced frequency of urination). When she becomes hungry, you may give her anything she wants. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Arnold Zedd, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard lumps on thighs?\n\nI was rubbing my upper inner thighs because they seemed sensitive and when I pressed down through the fat tissue my thighs felt like a series of small, hard lumps.  What could that be?  I am 5'8\" and 250.  I have good blood pressure and a clean medical history.  I am 25 yrs old.",
    "doctor_response": "HI,Dear,Thanks for the inquisitive query to HCM.1-I studied your query in depth.2-In my opinion , the multiple small lumps in inner thigh are the , Fat globules loaded fatty tissue , which is normal for your  body ,which is over-weigh for your height....excess by at least 43 kgs(ideal 70 kg-but you are 113 kg now) for your height.3-These series of small lumps are not to be worried,as its part of the normal fat cells, though overloaded for your age.3-a- These lumps are in no way-to be mistaken for \"-LIPOMAS\" at all.3-Treatment- 3-a-You need to reduce your weight-at least by 30 kgs over a time.3-b-Consult your doctor and start the treatment accordingly.3-c-Your bp and medical history may be clean,but its time you treat the overweight issue-which is quiet alarming issue of your health.4-Hope this would solve your query to your satisfaction.5-Wellcome for more queries to me On HCM.6-Thnks once again for your inquisitive query.Have a Good Day..!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes involuntary gasps?\n\nA few weeks ago... Every once in a while, I would just be at work standing at my cash register ringing up groceries & all of a sudden I would gasp for air. Just once... It s only happened @ (3) times... Maybe once there & twice at home.. I don t understand? Why would I do that?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Sudden onset involuntary gasp without any respiratory symptoms (cough, breathlessness, chest pain) is commonly due to stress and anxiety. But if you are smoker or having above mentioned symptoms then better  to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test) to rule out lung related causes. If you are asymptomatic and nonsmoker then no need to worry. Stress and tension can cause sudden involuntary gasps. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic drugs too. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling in lower abdomen?\n\nHello I have a tingling/clogged feeling in my lower abdomen and penis, there is only a little discomfort, no discharge and I have been checked for all STD's and I am clean.It also feels like my penis is shriving up when it is not cold. Do you have any idea of what this might be?",
    "doctor_response": "Hi.This rare type of sensation of tingling in lower abdomen and penis occurs due to cystitis and / or Prostatitis. The tests will always be negative as seen in your case. Only per-rectal examination and ultrasonography and examination of the fluid from prostate massage can give an idea. One of the treatments is prostate massage, antibiotic cover and supportive medicines.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a 17mm follicle large enough to produce a viable egg?\n\nHello! I took clomid on CDs 3-7 for ovulation since I have PCOS. I did an ultrasound yesterday on CD18 and had 1 follicle that was 15mm. It seems to be growing on average of 1.25mm a day. Well wed. my OBGYN wants to give me a trigger shot. If my follicle keeps growing at this rate it will be only 17mm. Would that be large enough to produce a viable egg?",
    "doctor_response": "Hi welcome to hcm.I have gone through your question.Follicles generally need 17/18 mm size to get rupture, so 17 mm size will be idle to get rupture.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bad taste in mouth and white coating on tongue?\n\nI had a bad taste in my mouth and then started to feel sick (like a cold coming on), then I got a dry mouth and a thin white coating on my tounge. I went to bed early and woke for in the middle of the night over heating/sweating but cold to the touch. I still have the white tounge this morning and still feel off. I had something simular to this 2 months aos and was given a bannana tasting mouth rinse. Four weeks ago I stared having stomach problems such as acid reflux, stomach upset and bowel pain. My doctor gave me acid reduces, but they have not helped out much. I have had blood tests for basicaly everything and all results were negative, except my immunity was a little low, probably due to stress. I'm 36, 5 foot 10, 190 lbs, but in almost athletic shape (workout consistantly, watch what I eat)",
    "doctor_response": "Thank you for your contact to HCM. You know our tongue is mirror of stomach.It seems you have gastritis. I suggest--Give blood for IgA,G to Helicobacter pylori-Follow Pevzner's diet 1-grinded,steam,stew food,avoid onion,garlic,spicy,sour food.-Phytotherapy-Flax seeds and Fennel(1 tablespoon of each boil with 2 glass of water-take 1/2 glass 3 times before meal during 1-2 month).-Bismuth subcitrate 20mg 1 tablet 2 times before meal for 1 month fr quick cure of your stomach.-Pantoprazol 1tablet in the morning for 14 days-For reflux you can use Domperidon 1 tablet thrice a day after 15 min before meal for 1 month-For white tongue resolve Fluconazole 1 tablet 1 time for 5 days and wash it with bandage,moisturised by soda water, rinse mouth with Listerin   You will get better,don't worry,just take following up remedies",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause heart palpitations?\n\nhello, I just ran a really fast heart rate that lasted about a good 5 minutes , then slowed down on its own. I have a Cardiologist, but he insist that my fast heart rates are anxiety induced. This time around it felt really different. This was the first time that it ever beat that fast. I am currently taking Metroprolol 25mg once a day and Xanax .25mg as needed.",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!Regarding your concern, your symptoms seem to be related to anxiety, but a cardiac arrhythmia can't be excluded only by this symptomatology. Did you take Xanax during this episode?I recommend consulting with your attending physician for a careful examination, a resting ECG and some blood lab tests: - a complete blood count ( to exclude chronic anemia)- thyroid hormone levels ( hyperthyroidism could cause similar symptoms)- kidney and liver function tests- blood electrolytes-fasting glucose. An ambulatory 24 hour ECG monitoring is necessary to rule in/out possible cardiac arrhythmia. If all the above tests result normal, the most propable cause of your troubles would be anxiety. In such a case you need to consult with your psychiatrist to start psycho therapy or a medical treatment (like an antidepressant). Hope to have been helpful!Best regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having been diagnosed with Epilepsy\n\nMy son is 12 with a 6 year diagnosis of epilepsy with no known origin. He is on 100 milligrams of lamotrigine bid. I have had to go to the school on multi occasions and pick him up because he is out of control throwing chairs, trashcans, hitting walls, and on occasion teachers. Could these outburst be seizure related? He does not remember the outburst or what he was mad at. He has ADHD,PPD-nos, ptsd.",
    "doctor_response": "The party line about neurologists/epileptologists has always been that directed aggressive or violent behavior with the intent to intent or hurt someone was NEVER seizure related and was assumed psychiatric.  However, now there is ample evidence that such events do happen as a result of massive aberrant electrical discharges in the Frontotemporal regions of the brain and patients can do very specific bizarre, complex, and even violent acts with the intent to hurt or destroy property.  Amnesia for the event is virtually universal in the patient and is usually a clue to its validity or not.  Multidisciplinary approaches must be used in such cases otherwise the patient will never gain any trust in anybody at school and in fact, could develop fears and anxiety syndromes if they cannot be made to be feel welcome in the midst of teachers of classmates.  If you'd like to ask me more questions and if you actually have any EEG reports on this patient then, please visit me at:  www.bit.ly/drdariushsaghafi and you may then, ask specific questions of myself.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fever, kidney pain, right hip pain and swollen back. Could this be a kidney infection?\n\nI feel feverish my right kidney aches and my right hip along side my lower right back is swollen. I'm very concern of what it can be. Can it be a kidney infection? or a swollen kidney? if so what can the doctors do for me? thanks so much for your answer in advance",
    "doctor_response": "HiThanks for your query.Fever with pain in loins could point to an infection of the kidneys. However it is difficult to determine the exact cause without a clinical examination.I would recommend a CBC, urinalysis and an Ultrasound of the abdomen. Please see a physician with these test results ASAP.Hope this helpsGood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have been bleeding for three months after starting Tri-Sprintec birth control. Why?\n\nHello doctor, I am a 21 year old female. I was put on Tri-Sprintec (birth control pill) three months ago. I have been bleeding for almost three months. I am wondering if the pill is not strong enough or that I have a serious medical condition. I am going to the doctor next week but I am really nervous.",
    "doctor_response": "Hello. Birth control pills contain hormones and those hormones have side effects as well. Few people get more and few less. Tri-sprintec contains Ethinylestradiol and Norgestimate hormones. Heart attack, stroke, breast cancer, blood clot formation, headache, liver disease, high blood pressure, endometrial cancer and per vaginal bleeding are side effects of this drug which appears more intensely in smokers and those aged above 35 years. Regarding the usage of birth control pills, I suggest changing after some time even if you are asymptomatic as some of these have long-term side effects. There are other more convenient methods of contraceptives like Mirena (Progesterone releasing contraceptive device) which can be placed for three years, implants, injection Medroxyprogesterone for 12 weeks, etc. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had bladder lift with hysterectomy. Suggested risk of renal failure. Taking naproxan for arthritis. Related?\n\nI had a bladder lift about 10 yrs ago with my hysterectomy, and havent had a bladder infection since. In the last 2 yrs i have been told im high risk for renal failure, and have had to cut back on my arthritis medication, naproxan.  The last week i have been  feeling like i have a bladder infection, the feeling i constantly have to pee, it stings a bit, and most of the time there is very little urine. I take ditropan and normally pee 2-3 times a day, now its every 10-15 minutes, could this be kidney related or bladder?",
    "doctor_response": "Hi ! From your history, it seems that you have a urinary infection which may originate anywhere from the kidney to the bladder. Urinary infection as you know will give rise to all the urinary symptoms what you have mentioned. In case of me being your doctor, I will advise you for a urine routine and culture/sensitivity test, and depending on the sensitivity I will also prescribe you some antibiotic apart from an alkaliser to relieve your stinging sensation.I am not aware of the situation for which your doctor has labelled you as being in high risk for renal failure. But once they have labelled you , you should cut short of all your pain killers, and other medications against which you are advised. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lethargic and breathlessness with depression?\n\nMy boyfriend is sick, he has something going on with his lungs, hes always lethargic, in pain, has trouble breathing at times and is continuously getting worse. Hes been seeing doctors with no results and he is just losing hope and falling in a state of depression. Where can he go that wont throw him to a million doctors with no results except putting him on anti depressants which do not solve the problem?",
    "doctor_response": "Hi thanks for contacting HCM...Noted here all his symptoms is because of depression...Stress induce panic attack can lead dyspnea...You have to try to fill his brain with positive thoughts.....Motivate him in study and work....Endulge him in some activity like sport.Avoid situation that lead stress.If needed behavioural therapy given by psychiatrist.....Antidepressant drug like fluoxetin can taken..Enough sleep and exercise taken....Take care.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Done gall bladder surgery. Pain below waistline. Constant nausea. What should I do?\n\nhad gall bladder surgery end of september of this year and part of the pain I experienced was just below my waistline on the left side on the back didn t know if it was hip/ joint pain ovaries or kidney related I am now noticing a flare up again after the surgery and wondering what I should do ... nausea consumes me constantly",
    "doctor_response": "Hello! Thank you for the query. Left lower abdominal pain can be caused by diverticulitis, left ovarian cyst, urinary tract infection, pregnancy, inguinal hernia. If you do suffer also from constipations, diverticulitis is probable. If your pain aggravates during the period, ovarian problem can be the cause. If you do suffer also from frequent urinating, burning when urinating it can be uti. If your pain aggravates when coughing and there is some lump in the groin, hernia is possible. Your nausea can be caused by one of mentioned disease or can be caused by peptic ulcer, acid reflux, bile ducts stones. It is advisable for you to have abdominal ultrasound, full blood work with liver tests(AST,ALT,GGTP), pancreas amylase, urine analysis and pregnancy test. Upper GI endoscopy might be necessary as well. Hope this will help. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should lung blood clots be treated with Xarelto or Coumadin?\n\nMy wife was found to have a blood clot in the lungs, as per cat scan. She is in the hospital with heparin sodium I V. We were asked to decide what medication to be given, Xarelto or Coumadin? She has hiatal hERNIA, gastritis, Acid Reflux, IBS-C, Extruding Disk, Hernieted Disk, Anxiety, High Blood Pressure. She has so many medicines already. Thank you for whatever advise you may provide. Jim",
    "doctor_response": "Thanks for your question on HCM.Your wife is having pulmonary embolism so blood thinner medicines are must for her.In hospital heparin should be given in injection form, and this should be replaced by oral anti coagulant at home for atleast 1-2 years. Both xeralto and coumadin are oral anti coagulant and should be started.There is no alternative to this drug in pulmonary embolism.  Sostart either of these drugs and regular monitoring with PT report is needed for dose titration.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a bump on my jaws and my teeth seem to be shifting. Do I require a surgery?\n\nHello doctor,Back of my jaw has a bump, and my teeth seem to be shifting. Do I need jaw surgery to fix my open bite? Kindly advice.",
    "doctor_response": "Hello doctor, The bump developed seems to be on your cheeks from the photo you shared (attachment removed to protect patient identity). Also, your lower second molars are erupting now, so the pain can be due to the eruption of that tooth. Even due to new tooth eruption, you may bite your cheek while talking or chewing. Please be cautious not to bite your cheeks and automatically the bump will vanish. From your BMI (body mass index) and weight, I suggest the bump may be your buccal pad of fat gets like bump due to some trauma. Once your tooth erupts, your problem will be fine. Follow rinsing your mouth with salt water twice daily. Your inflammation will subside. Let us wait and watch for 10 days. If the problem continues after 10 days, write to us again or consult your nearest dentist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication to stop loose motion in kids\n\nmy 3 months old baby is having loose motions from last 16 days. dr has asked to give enterogermina,mintonia,and antibiotic nutrolin b. reducing sugar test is positive. pus cells 15=20 hpf. what should i do. am giving all the medicenes on time but no affect. pls help me out..",
    "doctor_response": "Hi,Thanks and welcome to healthcare magic.You history suggests that your baby is suffering from infective diarrhea .If you send the stool sample for culture and sensitivity ,the causative organism and appropriate antibiotic may be knownThere may be transitory lactase deficiency during diarrhea which resulted in positive stool test for reducing substances.Continue breast feeding as usual.Colimex DF drops 3-4 times daily for reducing abdominal pain.If the diarrhea continues you may temporarily stop Breastmilk or formula and replace with soya based milk like Zerolac for 2-3 weeks till the diarrhea subsides.Hope this answer serves your purpose .Please feel free to ask further queries if any.Dr.M.V.Subrahmanyam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain, moving to left side of buttocks, pain on applying pressure. Tried heat packs. Cure?\n\ni have sever back pain, not all the time usually at night or when i rest. it goes down left side of my buttocks and hurts when i put pressure on that side of my body. for example when i put weight on left leg when i walk. is there anything i can take for the pain ? have been using a heat pack. but nothing really helps.",
    "doctor_response": "Hello and welcome, Thanks for your query. When you say your pain is usually at night, is it because you sleep on your back and thus apply pressure on your lower back and/or left leg (mainly till your mid-thigh) ? Does the pain start from her lower back and go down till mid-thigh? If yes, this could most probably be her Sciatic nerve being irritated and is also called Sciatica. Let me list few of the most common causes of sciatica: -Degenerative disc disease: The disc's in every human being undergo a degenerative process with age, and is considered to be normal. When these disc's undergo degeneration they tend to irritate the nerve root present in the lower back, which can result in sciatica. -Sacro-iliac join dysfunction: the lowest end of your spine consists of fused bones called the Sacrum. This bone articulates with the iliac bone (one of the three bones forming your pelvis), thus this joint is called the sacro-iliac joint. Any irritation of this joint can also cause the same pain that would be typical for sciatica. -Piriformis syndrome: There is a muscle present in the buttock region called the Piriformis muscle. The sciatic nerve passes under this muscle, and any irritation of this muscle can also lead the sciatica. -Herniated disc: The Lumbar part of your disc can develop a hernia which is when the inner core of the disc leaks out or herniates. This protrusion can irritate the nerve roots, also resulting in sciatica. --Isthmic spondylolisthesis: In this condition a small fracture allows one vertebral body to slip forward on another. Due to this the sciatic nerve can get pinched and cause the pain. -Lumbar spinal stenosis: Stenosis (narrowing) of the spinal canal can cause the sciatic nerve to get pinched and cause this pain Other causes can be: muscle strain, spinal tumors, pregnancy, scar tissue, infection, direct injury, etc. Please consult your doctor on the same and try to find the cause in order to properly manage the sciatica as different cause require different management techniques. I hope I have succeeded in answering your questions, you could write back to us anytime for further clarifications. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with GERD and Interstitual cystistics in bladder. Suffering from abdominal pain and cramps so hospital visit is required?\n\nHi! I'm suffering from pain in the abdomen and stomach area. It all started a week ago early a.m.. I was sitting on the toilet when all of a sudden I sneezed very had and sound like I tore or ruptured something in my stomach also forced stool when I didn't feel like I needed to go. My stomach cramps and with pain very bad. Do I need to go to the hospital or see my Dr.? I also have been diagnosed with GERD and Interstitual  cystistics in the bladder. I have had diarrhea since this has happened.",
    "doctor_response": "HIThank foe asking to HCMI think no need to go the doctor, the force which exerted due to sneezing might have pulled the abdominal muscle or smooth muscle of gut  might be affected just take a little rest this will come around for sure, your other problem of diarrhoea will also be fine and nothing to worry for GERD you might have taken treatment, if not then Omeprazole 40 mg would be the drug of choice and can be taken at evening time for six weeks hope this will help you have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for hand tremors?\n\nhi docI'am bassem 22 years old i have been experiencing hand tremors while i hold my hand doing nothing , they keep shaking .. i have no other medical illness. also when i try to write paper my hand shake a little bit. i notice that also on my father and my brother . my father have got DM 2 ... I go to the gym , i have no problems while lifting heavy weights.",
    "doctor_response": "propranolol 20mg twice a day is good for you and your father and brother if no contraindicationsthis is called essential tremor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can neck pain lead to dizziness?\n\nI get dizzy spells all the time...numbness in my face and finger tips....I have had a chronic neck problem and perhaps a pinched nerve....currently I feel no neck plain...so do you think my neck is the reason for my dizzy spells or could it be something else?",
    "doctor_response": "Hello, As due to pinched nerve there will be tingling, numbers etc for the upper limb and fingers. Which can be taken care of by MRI neck, soft collar, neck stabilization exercises, upper limb strengthening exercises and inter-scapular muscle strengthening exercises. But the symptoms on the face like numbness needs a cranial nerve examination and may have involvement of the higher motor functions. Post a diagnosis for the higher motor function we can guide for the medical treatment. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is heart burn & tiredness a side effect of cyclopam & esokit intake?\n\nHAVE BEEN TAKING ESOKIT AND CYCLOPAM MEDICATION FOR 4 DAYS,LAB TESTS ON STOOL SHOWED I HAD H-PYLORI,NOW I FEEL BAD TEST IN MY MOUTH,HEART BUN AND TIRED,ARE THOSE SIDE EFFCTS ON THE MEDICATION ,AM SUPPOSE TO TAKE ESOKIT FOR 7 DAYS,BUT CYCLOPAM FOR 4DAYS(1X3).PLEASE ADVICE",
    "doctor_response": "Hello, It is due to acid reflux and gastritis. Continue your esokit; and reside the intake of spicy foods. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of getting pregnant after having unprotected sex while being on Cerazette?\n\nHi i have been on cerazzete for 9 years never had a period i had unprotected sex on sunday morning i definetly dont want a baby so would like to know asap so if i am i can get rid of it.  I really do doubt it but was justy wondering how long u can take a test after it and itll tell you.",
    "doctor_response": "Hi and thanks for the question.I am Dr Nilajkumar a consultant gynecologist and I will be helping you in your queries. If you have been taking cerazette regularly then there is no chance of getting pregnant. A urine test will come positive 3 weeks after the date of unprotected sex so you can do it using the first morning urine sample 3 weeks after the date of sexual episode.In your case, you are already protected by cerazette so do not worry. Hope this was able to answer your query.Thanks for using HCM.Have a good day.Dr Nilajkumar BagdeConsultant Obstetrics and Gynecology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility\n\nhi I am Manchula married for 20 years no children age 42 (65kg,5 6 ) had fybroids and cyst removel 5 years ago. My husband now 53 (70kg,5 9 ) had varicocele operation 15 years ago. Now Dr find out 25% DNA damage in sperms. we had about 12 IVF including 2 donor IVF/ICSI method,we got 8 embryos fertilized with donor egg but all failed when implanted,one grow up to 3 month and failed. I also use to take big dose of hormone injecion during IVF, No the Dr suggest TESA with donor eggs. will this work or should we go for donor embryo. All IVF done in Australia. Please help us to take a firm decision.Thanks",
    "doctor_response": "for tesa, we need to know the husband's semen condition. in some cases it work very well. for ovum donation it needs proper screening and work up. pls read-  will get all answers regarding male infertility there",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath, dizziness and tiredness?\n\nI have been short of breath for almost 2 weeks now. My pulse has been around 96-112, and my BP is 126/94. I was on the Z-pak for would might have been bronchitis. Today I just don't feel right, I'm dizzy and so tired. I don't have a family doc that I normally see. I only go in for my yearly exam or if I have strep or something and that's usually to the minute clinic or urgent care. Should I go in and see someone?",
    "doctor_response": "Hi, thanks for using healthcare magicIt may be best to see someone to be assessed.The normal pulse range is 60 to 100 so a pulse up to 112 would be considered to be elevated. Infections and any associated fever can cause the pulse to increase.An infection would also contribute to your dizzy and tired sensations.You may need a course of antibiotics if the infection is thought to be bacterial.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the chest incision site to be hard?\n\nhello, im 30 years old female who had undergone laparoscopic cholecystectomy  about ten days ago..the doctors had removed the bandages today and removed the sutures..i noticed when i get home that the muscle in the incision area in the chest part is hard but it is not painful when touched..what could be the reason? im worried that i might be operated again.please help me with your answers.thank you",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.There is no reason for repeated surgery since this is probably fibroma or formed hematoma and this is commonly seen and should pull back in few weeks.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.DR. Ivan Rommstein",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cancer survivor, in rectum, swelling in stomach, neuropathy. Treated with chemotherapy, used folfox. Are medications right?\n\nHi, I am a cancer survivor, had ca rectum which was treated with 11 cycles of chemo therapy using Folfox 4 drugs and in the mean while was given 20 cycles of radiations followed by the removal of the part of the affected rectum.  Surgery was done in July 2012 and was successful.  I have now developed constriction at the area of the surgery which is just 6 cms from the anal verge.  After suffering from very small quantity of loose motions about 20 times a day and severe pain in stomach which swells and becomes very tight and very difficult to pass out the gas too, after surgery I have developed neuropathy, my feet became numb which is still being treated by lyrica caps, which has cured half way of my feet.  Half of my feet is still are numb. I also have sleepless nights. After the balloon dilatation I feel much better and the tightness and swelling of my stomach has subsided and I am not getting the loose motions in stead I get paste and the quantity has increased about 100 % and frequency also has come down to 3 - 4 a day.I saw a leading Physician last night who has suggested following medicines:  Pregab 75 mg one tab after dinner, Epitril .5 mg one tab after dinner, Ramistar 2.5 mg one tab after break fast, Methycobol 500 mg twice a week.  He also said my present situation / condition of health is that I am diabetic since past 10 years and I need to switch on to Insulin instead of tablets and have suggest 30/70 Human Mixtard insulin twice a day.  I appreciate if you could advise me if the present medication is fine for me.  I have become very weak and need to recover my body.Thanking you.Sincerely,M.  Maqbool Ahmed",
    "doctor_response": "Hi and thanks for the query,the medications used in my opinion all have the real purposes. Respecting the doses however remains a key issue. I would suggest you do not hesitate indicating to your treating physician in case you start experiencing any unusual symptoms. Exercise, vegetable, fruits and drinking a lot of water is an attitude advisable to be adopted.The main fear with the morphine you are taking is that of addiction. Except you do experience intense pain, they should be taken with caution. The opinion of your treating physician before altering the drugs is very much advisable. Thanks and kind regards.Bain LE, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain, fibromyalgia, arthritis when having plates/pins in lower back to spine/hip?\n\nhi, my name is rae i have serious back problems i have plates and pins in the nlower part of my back 4 blown out disk going up the middle of my spine ,plates and pins in my left hip and arthritis and fibromalgia and can not find a doctor to treat me i do have paperwork to back up everything i say but any doctor i see my boyfriennd raiseas hell when they give me something to help with the pain now i do without and can barely walk? what can i do?",
    "doctor_response": "I understand your symptoms and your question. You may have differrent diagnosis ,but you should exclude autoimmune disorders. Autoimmune diseases can cause harm to many sites in body like arthritis, fibromyalgia, neuritis. First, some investigations should be done like knee x ray, CBC, c reactive protein, rheumatoid factor, fasting and random blood glugose. Now, start with vitamin B12 injection once every 3 days and if there is osteoarthritis, take glucosamine tablets 3 times daily for 2 monthes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My baby has developed a red colored rash around the anus area. What could it be?\n\nHello doctor, This is for my 22 days old baby girl. In the last 2 days she has developed some red coloured rash in the area surrounding the anus area. She feels irritated while passing stools. I have attached the picture of the same. Please advise.",
    "doctor_response": "Hi. I have viewed the picture (attachment removed to protect patient identity). Management: Consult a paediatrician online for further follow up -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Type 2 diabetic. Elevated SGOT, SGPT levels after consuming alcohol. How to reduce it fast?\n\nHellow doctor, Past 1.5 years i am taking medicine for type 2 diabetics. last one months  back i have consumed alcogal etc more and finally the SGPT is 103,and SGOT 51 level .But this one month the glucose range is maintained with in the level and all cholestrol range also with in the limits.I have maintained very good diet. i have to go medical fitness with in 15 days to get resident visa in kuwait. So kindly suggest me ,how i will reduce the SGPT and SGOT levels fast?",
    "doctor_response": "Hi!welcome to HCM!Its good that your blood sugar and cholesterol are well within normal range and you maintain a healthy diet.SGPT value of 103 certainly needs evaluation. Alcohol is one of the most important toxic agent for liver, but it typically causes a rise in SGOT which is more than SGPT,usually SGOT is twice the SGPT and you have mentioned that your SGOT is 51 which suggests some other cause of high SGPT.Other important causes for elevated SGPT include viral hepatitis , fatty liver, certain hepatotoxic drugs, and autoimmune liver diseases. has your ultrasound shown fatty liver?  You can consult a Gastroenterologist who can help in determining the exact cause for your high SGPT. Meanwhile, you should certainly stop alcohol.I sincerely hope this will help you!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can usage of two or more antidepressants together cause any harm to the body?\n\nHello dr, my is Praveen, from Kerala, my dr prescribed talo-s 20 mg in night, bupron sr 150 in mrng & afternoon, norten 10 in mrng & 20 in night, waklert 50 in mrng. My question there is any conflict between using one or more antidepressionts same time. Thank you.",
    "doctor_response": "Hi, Yes, it is not advisable to two or more antidepressants together. 1. Taking bupron along with talo-s may increase the risk of seizures, which may occur rarely with either medication. In addition, bupron can increase the blood levels of escitalopram, which may increase other side effects. 2. Bupron and waklert may increase the blood levels and side effects of norten. You may need a dose adjustment or more frequent monitoring by your doctor to safely use these medications. Contact your doctor if your condition changes or you experience increased side effects. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the lump at the back of my head behind my right ear?\n\ni get a sudden lump at the back of my head behind my right ear. i have had this about 4 times now and the lump comes and goes. i also get this emmense throbbing pain with this lump and when the lump goes down the pain usuall stops but today the pain did not stop. the pain does not go away even if i sleep or drink water. i am scared that this is a brain tumor? please help me",
    "doctor_response": "Hi,Dear,Thanks for the query from you to my HCM Clinic.I have gone through your query and after indepth study on it, In My opinion-your todays paining rt ear lump ,by no means is Brain Tumour -as you think and worry.I can rest assure you  that its not the brain tumour.I would advise you to check up from ER Ent Surgeon.YOu need Antibiotics -Oflox with Ornidazole  , Tb NSAID, Tb.Serropetidase-for 10 days time  after the Pus-C/S sample is sent for study.YOur Ent Surgeon would take care of all this .Diagnosis-It could be mostly-Acute on -Chronic boil behind the right ear lobe/ or could be acute on chronic mastoiditis-In both the cases-Proper Incision and Drainage with scraping of abscess walls is needed.Treatment under cover of Surgeon or Ent Surgeon is the right  way to get the help.Hope this would resolve your worrysome query for now.Wellcome-to my HCM Clinic for any more query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness after removal of wisdom tooth?\n\nlight headed and dizzy after wisdom tooth removed, I have had benign positional verdigo before but not recently. not much pain or swelling feel good except for dizziness. I am taking antibiotic, which I have had before with no problems and taking Ibuprofin for light pain.",
    "doctor_response": "hellothnx for your query.feeling dizziness can occur after some surgical procedure.its not much of a thing to worry about as long as you don have any other complication.take the antibiotic course properlyRinse your mouth with warm saline mothwash.drink plenty of water.take a proper nutritious dietmultivitamins and iron folic acid tablets can also be taken.mostly the symptoms goes away in a week.wishing for your speedy recoveryRegardsDr. Shesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from dizziness and low BP. Shall I continue Atenolol 50 mg?\n\nHi doctor, I am on medication Atenolol 50 mg for the last 2 years. Nowadays, I am going through low blood pressure. Yesterday, my blood pressure was 115/65 mmHg. I am also having dizziness. I had gone through dizziness and low blood pressure of 110/65 mmHg last month and it remained for four to five days. Again, it is repeating, this month.\u00a0My fasting blood sugar level is 115 and triglyceride 240 mg/dL.\u00a0Kindly suggest.",
    "doctor_response": "Hi. I would like to ask a few questions. ECG and echo. Revert back with the answers to the above questions to a cardiologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does T2 intense lesion at L3 in the body or Hemangioma mean?\n\nDecreased  hydration and diffuse bulge of L4-5 intervertebral discs with mild indentation of central canal, lateral recesses and intervertebral neural foramina with no neural impingement.Define T2 hyper intense lesion at L3 in the body - hemangioma.",
    "doctor_response": "These are incidental findings of no likely clinical significance and would not be expected to explain symptoms of significant pain, numbness, tingling, or anything except the normal aging process which everyone experiences.  Disc bulges are not believed to be important unless clinical symptoms correlate to location of the bulge(s) AND there is some nerve root that is being compressed.  A hemangioma is common radiographic finding and is a small collection of capillaries within an organ or tissue.  On the skin they look like tiny cherry spots but cause no harm and they don't convert into anything else. Usually believed to be there long before they are discovered.  Please rate this a 5 STAR ENCOUNTER and write me at: www.bit.ly/drdariushsaghafi with more questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing reaction after knee reconstruction ?\n\nhi im 18 years old and i have had a full knee reconstruction of my Left ACL and 4 days ago i had an arthroscope on the same knee. i have been told to keep it covered in the bandages and gauze for two weeks, but i think im having an reaction. what should i do",
    "doctor_response": "Hello, If the reaction is on the skin, it might be due to gauze or bandage. You can apply topical steroid like betamethasone for symptomatic. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why there is pain and lump type feeling under my right ribcage?\n\nI ve been going to the gym (cardio and weights) I have a slight pain on the right side with a lump type feel. It is located right below my ribcage. when I was on the elliptical yesterday my heart rate went up to 155 during the tough workout. should I be concerned.",
    "doctor_response": "hi,thank-you for providing the brief history of you.As to let you know one of the primary act  is thorough musculoskeletal assessment is advised and also the cardiac clearance before undergoing gym. It is on a safer side to get clearance and then proceed.As mentioned by you that you have a pain under the ribcage or below it, it could be most of the time a muscular pain. Due to overtraining there will be a sudden mucle spasm due to stretch contract mechanism on the elliptical. Taking a rest with hot water fermentation should reduce the pain and after 3 days you can go back to gym. Also, if the pain doesn't come down, than taking up a thorough musculoskeletal and cardiac assessment is advised on a safer side. Since you have discomfort on the right side, the worry is less, may be just a muscle spam on the right hypochondria. It should subside in short time.This is on of the common injury in gym, as the body is not prepared to undergo the stress & strain on the muscles. Undergoing slow and steady training under guidance will help avoid such injuries in future.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for dental infection\n\nI have Primary Billiary Cirhhosis which has been stable for years. Lab results excellent. Now, however, I was given amoxicillin because of a dental infection. The infection cleared up quickly. Then I learned about the possibility of amoxicillin with liver disease. I may need another antibiotic treatment for the dental infection.Please advise.",
    "doctor_response": "Hi,Thanks for posting the query,       You can take tab ofloxacin BD, along with tab diclofenac , this medications will give you a temporary relief for permanent relief i would suggest you to get the treatment done.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring rash on breast and swollen lip?\n\nFor the fifth time I have had the same bizarre occurrence, my upper lip on the left side swells up and I get a round quarter size rash on my left breast. Each time they have both occurred in the exact location and the day prior I have had flu like symptoms with a low grade fever. I have asked my doctor and he thinks it s a coincidence and a mild allergic reaction. I feel like it s viral. Any ideas?",
    "doctor_response": "Hi,Recurrent rashes or swollen lips could be due to allergic hives.Rashes could be of atopic dermatitis, eczema,tinea corporis or psoriasis etc.You must undergo allergic testing and detailed thoroughly examination by dermatologist.You might require topical and oral corticosteroids with topical antifungal cream or ointments with other antihistamines and supportive treatment.So,it would be better you consult dermatologist or allergic specialist.Thanks and regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for blister on the roof of the mouth\n\nHello, I have a blister on the roof of my mouth that my dentist is saying is a toric bone. I have taken bone suppliments for some years now and this problem started when my plate broke and a blister started. Could you fill me in on what this condition is.",
    "doctor_response": "Hello!Welcome to HCM.You did not mention why your palate broke. Is it a accident or any other reason.You also did not mention your age.Tori appear in early adult life.This is extra bony growth and is not infection.It must be removed if it is disabling to the patient or causing discomfort while eating, etc.Sometimes presence of torus runs in families.This cannot be due to the bony supplements.Do not worry.If it is a torus,then there is nothing to worry.If the swelling is painful,tender or grows in size, you must be worried. Feel free to write to us in case any further queries.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will a bad rash be normal with mono?\n\nhi my son was diognosed in the er with mono almost 2 weeks ago. he had an enlarged spleen, liver function, ferver, sore throat. Over the past two days he is starting to feel better and now yesterday he developed a bad rash is this normal with mono?",
    "doctor_response": "Hi dear,I understand your concern. Yes,it is normal for mononucleosis, herpes virus caused it .I suggestAcyclovir 30mg/kg divided for 2 times for 5 days.Cetrizine syrup for 5 days",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling nervous, whole body shakes. EEG- normal. Is this a nervous or mental problem?\n\nWhen I'm nervous my whole body shakes violently,  I have this problem since 6 years. In 2008 I have consulted a neurology doctor, he checked my EEG and told nothing. But I'm feeling shaking always. Especially hands. Also when I'm feeling relaxed and having a thought I'm strong , there's no shaking at all. Is this a Nervous problem or mental problem?",
    "doctor_response": "Dear, When you explain your symptoms, you should be more careful. Shakiness and trmbling are two different things. When trembling, we have pulse and BP elevated, palpitation occures. These are  clear symptoms of anxiety disorder. Nothing to worry, as EEG is nornal. Please consult a psychologist for further advice. Wishing you a good future.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the meaning and treatment for mild cerebral atrophy ?\n\nWhat is mild diffuge cerebral atrophy ? hai sir, my mother age was nearly 60 years and from last 3 months she was often imbalance while walking. and her voice also ecoming unclear.we have consulted many doctors. and they advised as due to weakness. today back whan we consulted neuroogist, after ct scan told it was due to Mild diffuse cerebral atrophy . can u please explain what is mild cerebral atrophy. can we cure it. and can my mother walk normally again. please explain",
    "doctor_response": "Diffuse cerebral atrophy is a age related shrinkage of the brain tissue. It causes agradual cognitive decline. At times the person may find it extremely difficult to carry out activities of daily living. The treatment comprises of administering drugs which improve the blood suppy to the brain. Piracetam is one such medication. Even atrial of hyperbaric oxygen therapy may also help significantly. Whatever damage has occured cannot be reversed. Medications aid in preventing further damage and atrophy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and numbness in the legs,hands and arms?\n\nI have had rsd in my left foot since nov. of last year I have been getting steroid shots to try to calm the pain down the first shot lasted a day the second lasted 2 hours now they are talking about burning the nerve I was denied disability because they say I can work but since I applied the pain has traveled up my leg and my hands and arms go numb a lot. any ideas",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.I think you should search for the cause of this neuropathy and stop taking steroid. I suppose to do the following EMG and NCV FOR the affected lower limb ,  x ray cervical spine and lumbosacral spine,investigate blood sugar level to exclude DIABETES   I prefer receiving neurotonics and pregabalin.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Fucicort cream be used by both men and women for similar infection?\n\nHi, I have an infection around on my pubic patch, for which my gynae suggested Fucicort cream.It is helpful but my husband and I did not use condom while having sex. Now also has similar infection which itches. Can he use Fucicort cream too? Its not on the head of the penis",
    "doctor_response": "Hi,This cream can be used by both the partners.There is possibility of transferring infection with close contact.Keep local parts clean and dry.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mild cardiomegaly with minimal atheromatous aorta\n\ni`m 51 yrs old ,FEMALE ,5ft tall,50kilograms in wt. Last Feb 22,2011, i was diagnosed of : MILD CARDIOMEGALY WITH MINIMAL ATHEROMATOUS AORTA AND DEXTROSCOLIOSIS AT THE THORACIC SPINE.WHAT WOULD BE THE RIGHT TREATMENT FOR ME.I`M USING MY BIKE DAILY IN GOING TO MY WORK.",
    "doctor_response": "Hi,Are you a hypertensive? You need to get one echo done for cause of cardiomegaly. It can just be a x-ray Illusion due to scoliosis. You just need a healthy lifestyle like avoid fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly. Regular exercises like brisk walking, jogging according to your capacity at least 30 min a day and 5 days a week. Eat lots of green leafy vegetables, fruits, fish once or twice a week, and avoid meat. Avoid smoking and alcohol if any. There shouldn't be abdominal fat deposition or obesity. Get your lipid profile and sugars tested once.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated liver enzymes?\n\nhellow doctor i am 27years old men, recently i did SGOP & SGPT tests for new company recruitment, my SGOT is 47.5 and SGPT is 61.4, but now i came to know normal levels are 0.1 to 40, please let me know waht is the problem, i don t smoke but monthly once or twice i will took wisky/beer.",
    "doctor_response": "Hi, I have gone through your liver enzymes levels and I find them slightly elevated. There are various factors causing such elevation apart smoking, including:- drinking alcohol - being overweight/obese- lack of physical activity- diet rich in calories- fatty liverI highly advise to make some changes in your diet and lifestyle regimen and to stop taking whisky/beer occasionally until full improvement. Repeat testing after 6 weeks of implementing the changes. All the best!Dr.Albana",
    "dialogue_context": ""
  },
  {
    "patient_message": "Raw spot under tongue, in the middle of genital herpes outbreak. Can herpes cause this?\n\nI went to the dentist on Sat. I began having a raw, irritating spot under neath my tongue on the right side so I mentioned it. As he was looking, he noticed that I have a lesion on the back right side of my tongue and wants me to get it check out. However, I have genital herpes and am currently in the middle of an outbreak and I believe I got it in my mouth as well, but was never diagnosed. Could a herpes outbreak cause a red spot with a pitted center on my tongue and cause enlarged papillae? He suggested I contact an Oral Surgeon but if it is an outbreak it would just be a waste of time. Thank you for your time.",
    "doctor_response": "Hi k heather don't worry,herpetic infections are viral in origin and will subside after running its course.Mostly after  10-14 days symptoms wear off so my suggestion  to you is wait and be patient,have plenty of fluids and eat well and avoid any stress..Since you are in a middle of  the episode most likely you will be relieved soon .Get well soon. Ajay mahajan.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest discomfort with shortness of breath\n\nHi, i have been experiencing chest discomfort for the past few weeks. It was as if something is pressing onto my chest area. it would ocasionally make me feel breadthless and pain as well.  i have been coughing for the past one year already. May i know what is the cause of it? Could it be some symtoms of lung cancer? Thanks.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Chronic cough (cough since 1 year), breathing difficulty, chest pressure, pain etc are more suggestive of lung diseases like bronchitis, lung infection (pneumonia or tuberculosis) and lung cancer.So better to consult pulmonologist and get done chest x ray and PFT (Pulmonary Function Test).Chest x ray is must for the diagnosis of lung infection and lung cancer. PFT is needed for bronchitis. You may need antibiotics, inhaled bronchodilators and inhaled corticosteroid (ICS) based on the reports.If you are smoker then you should quit smoking as soon as possible. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing body pain especially back ,What treatment is suggested ?\n\nI fell from the stairs last december 2010 and since then i never went to the doctor. I cant sleep or position myself in a prone position cuz my back will hurt so bad. If i will, then I have to stand up slowly so it wont hurt. what do u think it is and what should i do? thank you.",
    "doctor_response": "Hello, I have studied your case. Due to trauma to back there can be injury to vertebra or sacrum ,you may need to do X ray spine and MRI spine.Due to compression of this nerve root there is back pain.For these symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.Core stabilizing spine exercises will help.I will advise to check your vit B12 and vit D3 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will I conceive as my periods have become irregular after my marriage ?\n\nhello sir.. i got married on august 2009.. till my marriage my period s normal.. suddenly after my marriage it became irregular.. we consulted a gynea doctor .. they advised me to take krimson 35 for 3 months.. n now i hav stopped it.. i dont hav throid problem.. will i get pregnant??..",
    "doctor_response": "Dear Gayathri, You should have absolutely no problem in conceiving, just because your periods are irregular. Have a positive attitude and enjoy your life.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Depression, anxiety, bipolar disorder. Taking lithium, switched to epilim, seraquel. Treatment?\n\nhello, i m XXXX here, i m 31 years old, before this i had depress and anxiety but now i do no why their change my disease is bipolar mood disorder their firstly change lithium ...setraline, apodiazepam and now to epilim 200, arip mt 10 and xanapam...and change again thirdly for seraquel, lsetraline and apodiazepam and now lastly i m using arip mt 10,xanapam and epilim........please help me?????",
    "doctor_response": "hello welcome to the forum In Bipolar disorder, there are alternating manic and depressive symptoms..... In your case it might be the reason that you were diagnosed initially as having depression and were prescribed antidepressants (when actually you were experiencing depressive part of bipolar disorder) ........ so you were not initially diagnosed as bipolar disorder.... and it sometimes happen in initial stages Now when your diagnosis is changed.........your treatment has been changed.... Consult your psychiatrist for all the doubts you have regarding treatment change Good Luck Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Undergoing RCT treatment on upper jaw. Suffering from litenoid reaction. Is dentogel?\n\nHi, I am undergoing RCT traetment for 10 teeths of upper jaw,I have started feeling inflamation in my cheeks and inner skin of mouth fewweeks back, I consult with the dentist yestareday , he told that you are suffering from litenoid reaction and suggested me the Dentogel liquid. But still i am feeling discomfort in my mouuth.",
    "doctor_response": "hello and welcome to HCM forum, first of all i would like to inform you that it is lichenoid reaction if i am taking you right, this is an allergic response which occurs due to a number of factors, some of them include; oral medication or drug interaction, dental fillings(amalgam), alcohol intake,etc. therefore, do not worry these symptoms subside gradually once the irritating agent is removed and as you mentioned your dentist has already checked and prescribed you a topical gel. this will definitely resolve the symptoms, you just have to make sure to maintain your oral hygiene by using antibacterial mouth rinse. also visit your dentist at regular intervals, to make sure that this reaction has subsided . just be calm and keep applying the gel, i wish you good health, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for mental health\n\nI have an aunt who thinks that someone is trying to make it appear that she is crazy.  She thinks someone is switching things out in her house - tv's, pots, cloths, changing door locks, moving things, taking things.  She lives alone (lost her husband 2 years ago). We the family don't know what to do.",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.The symptoms that you are mentioning are suggestive of paranoid schizophrenia. She certainly needs proper psychiatric treatment. Risperidon, olanzapine, clozapine, aripiprazole are all good drugs for the treatment of such an illness. These medications need to be continued for a few years and the symptoms will mostly reduce by 2-3 weeks. If she is not willing to seek help then you may seek help of police and law who can guide her to proper medical help.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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain while taking deep breath?\n\nHi I m a 18 year old female and for the past couple months i have been experiencing chest pains on the right side of my heart. At first the pain will be sharp and it ll hurt to take a deep breath and feel like someone is squeezing my heart which will last a few seconds. Then there will be a dull aching pain afterwards that drags out. I m not an athlete but my health and diet is very well and I rarely get stressed out plus I m pretty good at relieving stress. I m not sure what is wrong with my heart please help.",
    "doctor_response": "Thanks for your question on HCM.Chest pain on breathing can be due to pleurisy ( inflammation of pleura). The common causes for pleurisy are1. Pneumonia2. Pleural effusion.3. TuberculosisSo get done chest x ray to rule out all these.If chest x ray is normal, then get done ECG to rule out cardiac cause.If both are normal then you must be having muscle pull and muscular pain.So try to follow these steps for better symptomatic relief.1. Avoid heavy weight lifting.2. Avoid strenuous exercise.3. Avoid movements causing pain.4. Take good painkiller and muscle relaxant.5. Apply warm water pad on affected site.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rapid heart rate\n\nmy resting heart rate has been around 105 to 120 for the past couple of days.  I am on bp meds, cholesterol meds, a diuretic and I have an appt with a cardiologist on Friday morning.  my bp was 136/97 on Monday and my GP put me on the diuretic. should i seek further treatment before Friday for my high heart rate.",
    "doctor_response": "Hello,Do not worry about it simple anxiety also causes rapid heart rate. Coffee, tea, alcohol, other weight loss drinks may cause raised heart rate.Few conditions like arrhythmia, hyperthyroidism, hyper metabolic states, anemia, beri beri may cause rapid heart rate. Just at sleeping heart rate if it is normal then alright.Consult your physician if you have continuous rapid heart rate he may change to beta blockers to decrease blood pressure same time decrease heart rate.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Penchila Prasad Kandikattu",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can oedipal complex be dealt with?\n\nmy boyfrend suffers an oedipal complex. he is very inteligent, succsesfull in his bussines. he doesnt wont to see a therpist, thinking that his problems are just 'the way he is'. I need advice how to deal with him, and how to show him that i am there for him,without any expectations. thank you!",
    "doctor_response": "DearWe understand your concernsI went through your details. I understand your emotions. Oedipus complex is a desire for sexual involvement with the parent of the opposite sex and a concomitant sense of rivalry with the parent of the same sex; a crucial stage in the normal developmental process. If this is what you suspect of, your friend is in the process of development and is normal upto an extent. Your friend should understand himself and the society of his own. If it crossess the limits, he needs therapeutic intervention. Start with psychological counseling.If you require more of my services, please post a direct query with every Possible details.Hope this answers your query. Avilable for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for fever\n\nMy daughter has fever and his age is 17 years. Her Urine routine examination results are Specific gravity 1018, Reaction acid,Protiens nil, Bile salt nil, bile pigments nil, Pus cells/WBC's 8-10/HPF, RBCS occasional, Epithelial cells a few. Are these OK",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you are having fever which could be due to viral/ bacterial infection of body. It is due to compromised immunity of body. Presence of WBC's indicate level of infection. I would suggest you nothing to worry about it. You should take NSAID medication along with antibiotic such as Levofloxacin. You should take plenty of fluids. Avoid taking any sharp and oily food substances. Visit general physician once and get it examined. Go for blood tests as well. Start treatment after prescription. You should take fresh juices in diet. Try to divide your meals in small fractions rather than having bulk at a time. You should take soft and bland food. Take diet rich in multivitamins.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bronchitis\n\nLAST mAY i HAD bRONCHITIS AND WENT TO THE DOCTOR, GAVE ME ANITI-BIOTIC (TWO INJECTIONS0 INT HE HIP WITH BY MOUTH ANTI-BIOTIC FOR A WEEK, Most symptons went away except for the cough. Went through 4 bottle of cough medicines, nothing. went to a Pulmonogist (lung specialist) got xrays nothing showed up only a slight scar on the left lobe, both x-rays showed this. He gave me steriods for about 4 weeks, nothing still coughing.Now the cough is seems like its from the throat, I have to clear my throat a lot and it seems like a plug of mucus is in there, when I cough its gone, Never smoked, healthy I am 64 yrs old still working, Sleep all nite never cough at night, When I am up I cough, its more of a hacking cough not no fever, no other symptoms, Never had a cough like this before it seemed to come from the last Bronchitis I had and never went away. what do you think?",
    "doctor_response": "Thanks for your question on HCM. In my opinion you are having upper Respiratory tract infection ( URTI ) at present.  You are having throat discomfort which also suggest URTI. So better to start these treatment. 1. Drink plenty of fluids. Keep yourself hydrated. 2. Avoid oily and spicy food. 3. Warm water gargles 5 - 6 times a day. 4. Start macrolide group of antibiotic. 5. Take antihistamine and anti inflammatory drugs. Once this episode is over, get done vaccination for influenza and pneumococcal to prevent future infection.Get done PFT ( Pulmonary Function Test ).  And if Obstructive defect is identified than start low dose inhaled corticosteroids ( ICS ). Better to consult another pulmonologist and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest methods to reduce asthmatic attacks\n\nHi I am an asthma patient i have asthma since 23 years it is climatic and dust allergy i get severe attacks from june to march i have been inhalers i started taking nebulizers from 3 years earlier i used to have control for aweek once i take nebulization now i have to take everyday i take combimist for nebulization i use asthalin and budocort as inhalers please let me know what do i need to do to reduce the frequency of attacks My age is 55yrs",
    "doctor_response": "HelloAs you are an asthmatic patient and prone to allergy . I think you know very well to avoid , dust , mite , pollen , hay , fodder, fine dusting powder , humidity , sudden fall & rise of temperature because all these are predisposing ( triggering ) factors of asthma. Asthlin is a potent bronchodilator and safe and effective but budocort is a cortcosteroid ( many doctor like it but I never prescribe or advise except in emergency because of side effects).When such type of patient visit in my clinic I prescribe them to take monteleukast+ bambuterole tablet ( combo pack ) once or twice in day till complete relief .Hot coffee and steam inhalation are very safe and effective bronchodilator , so also try.For first few days you will require asthalin+ budocort , but after few days you will feel relaxed and dosage of asthalin+ budecort will subside ( I have tried in so many cases ).Hope this information will help you.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Placenta is on the right lateral wall 1 cm above the os. Is it low lying?\n\nHello doctor,I had NT scan at 12 weeks and 5 days in which was found placenta is on the right lateral wall, 1.0 cm above the os. Internal os is closed. Cervical length is 37 mm. Does this mean placenta is low lying? Is there a serious problem?",
    "doctor_response": "Hello. Yes, your scan indeed tells that you are having a low lying placenta. In such cases, chances of painless bleeding may be there. It would be better to avoid intercourse and heavy activities and to have a review of placental location in the anomaly scan at 19+ weeks. Almost 75 to 80 % of the times, the low lying placenta usually migrates to the upper uterine segment. So, the chances of bleeding come down by the term. So it is not something major to be worried about but yes the precautions are needed to be taken. Take care. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to permanently cure red and itchy rashes which is recurring after stopping prednisone?\n\ni was placed on new medication and developed what initally looked like goosebumps all over my body after about 2 weeks of starting the meds. Within days, these bumps looked like welts (but stayed the same color as my skin). Eventually they became red and extremely itchy. I was put on a 7 day course of prednisone suppressing the rashes. 3 days after stopping the medication, the rashes came back. I was once again put on another 7 day 30mg course of prednisone and the rashes were gone within 2-3days. This time around I was rash free for about 2 weeks. I developed a cold and all of a sudden I once again began getting goosebumps all over my body. Within 4 days, it covered most of my skin from neck down. This new set of rashes were worst that the initial reaction that I had. Ive also been taking 50mg of benadryl every 6 hours and have been using corticosteroid cream 2 times a day. These medications do not help at all. I am now on my third course of prednisone and I dont know what to do, as I believe that I will once again have rashes all over my body when the medication finishes",
    "doctor_response": "Hi i think u are suffering from acute urticaria.it can be cured by atarax 25 mg at night.alaspan in the night and bandy plus weekly once for two weeks and zinetac 150 mg before breakfast and application of calamine lotion twice daily.if no response go for patch tests which helps to know allergens",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurrent acute muscle spasms in upper body?\n\nEvery now and then I get a moment of extreme pain that stops me in my tracks, like a major muscle spasm, sometimes in my upper body area, lasting maybe 30 seconds or more before disappearing completely. I am a 67 year old female who is overweight and out of shape. What are these mini attacks ?",
    "doctor_response": "hi,thank you for providing the brief history of you.As per your age and history, it appears more of a sodium imbalance leading to sudden spasm of the muscles in the upper body all of a sudden. Doing regular light exercises for 30 minutes for upper body and lower body will help improve the electrolyte imbalance and reduce the spasm.In my clinical experience most patients in ageing respond well to physical therapy and exerciseRegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes feeling of having lump in the throat?\n\nI am a college student and I started smoking hookak a little while back. Recently my throat and neck have been feeling weird, kinda like its swollen.  I had strep and was on antibiotics and didn't smoke and started to feel better but than my glands and tonsuls were still swollen and they put me on a general really strong antibiotic.  After finishing my medication i waited a while before i smoked again and now that feeling of a lump in the my throat is back.  What is it?",
    "doctor_response": "Hi,I can understand your problem.Your feeling of uneasiness could be due to recurrent episodes of pharyngitis which is directly related to smoking.You have to quit or avoid smoking for long time.You can also start doing gargles 3-4 times a day and start some anti allergic drug.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the elevated values of liver enzymes be due to suboxone?\n\nMy 22 yr. old daughter began suboxone therapy for an oxycodone addition three months ago.  Suboxone dose was 12 mg for first month, 10 mg for second month and 8 mg third month.  Two weeks after beginning suboxone therapy, she was developed mono and had acute symptoms for two weeks followed by moderate symptoms for two weeks.  The drug treatment center performed a standard liver panel and the following tests were abnormal: direct bilirubin - 0.6mg/dl (repeated), alkaline phosphatase - 134, SGPT (alt) - 82.  All other tests were normal.  The drug/alcohol screen at suboxone clinic intake indicated oxycodone was the only drug tested.  Subsequent routine screenings indicate no detected levels of drugs or alcohol except suboxone.  She also takes Yaz birth control pills and, occasionally, Imitrex for migraines.  (Has taken two Imitrex in last two months.) Sub clinic counselor told her she needed to see her primary care physician for hepatitis testing.  She has to wait four weeks for an appointment and, although the doctor has her results from the clinic, Dr. will not order the hep tests until my daughter is seen in the office.  My daughter is in an extremely fragile emotional state right now.  She is progressing well in her recovery but is lonely because she cannot hang around with her drug addict \"friends.\"  This concern about the hepatitis has her very depressed.  I know she could have hepatitis but was wondering if the elevated liver enzymes and bilirubin could have other causes such as mono or suboxone use.  If I could tell her that those tests could be abnormal due to causes other than hep B or C, I think it would alleviate her worries until she sees her doctor and has further testing.",
    "doctor_response": "Hello.  The suboxone would not have elevated the enzymes, but the mono could definitely have done so.  And here elevations are not as high as I usually see with hepatitis so I don't think she should worry about that",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will prodep help to control anger and focus on school work?\n\nmy son 17years old is prescribed prodep 20mg by doctor. will he be able to focus on his school work? can he control his anger with this tablet? what do i do for the loss of appetite he has? can he be fully cured? iS IT DANGEROUSE TO SKIP A DAY WITHOUT TAKING THE TABLET?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. I must know why your son was prescribed with prodep. If your son is suffering with anger tantrums, and was diagnosed with it, with the help of clinical psychology psychometric tests, then he will be cured, of course. The diagnosis is the key.At 17, due to the adolescent factor, role confusion, peer pressure, social issues, a person do feel annoyed and be angry at everything and that is developmental task. There is nothing new in it. Understanding the anger by parents, society and the boy himself is important. I don't think he needs any psychiatric medicines. He just needs empathy.You can post a direct question to me in this website. Include every detail about your son. I shall prescribe some techniques to control anger. I am sure that the techniques should be a success.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Even after giving up alcohol, my GGT levels are high. Why?\n\nHello doctor, Serum GGT levels are elevated despite giving up alcohol. Even before, the frequency of drinking was maximum once in a week (90 ml). What does this imply? Please help.",
    "doctor_response": "Hello. There are a few questions regarding your health and lifestyle that would help in finding the answers to your query. 1. Have you had any jaundice recently or ever? 2. How long have you been taking alcohol? 3. Is there anyone in the family (siblings, parents) who has had liver problems? 4. Have you lost weight, how is your appetite? The reports are from last month, do you have any reports from before this (attachment removed to protect patient identity)? Have you done viral markers, like hepatitis C and B? The report shows raised GGT, but in your query, you had mentioned about gall bladder stones, but the report of ultrasound is KUB, which does not mention anything about liver, gall bladder or bile ducts. There are no reports of CBC (complete blood count) as well. Please do a repeat CBC, full ultrasound of abdomen (to look for gall stones and bile duct) and send.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is the lump on the side of my ear growing?\n\nHi, I have a limp towards left side of my ear just behind my sidelocks , I have this from almost 4years and i have no pain but from few months i can feel its growing and now its the side of almond its not visible but when i touch it i can feel extra growth . Could you please advise me on this .",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.This must be either a lipoma or a sebaceous cyst. Simply get this excised so that you can have the benefit of two things. The lump is gone and you get a diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if one of the incisions is infected following a shoulder arthroscopy?\n\nI had a shoulder arthroscopy on April 14, 2014. Currently I have three different incisions in my shoulder. Two of the incisions are perfectly fine but the third has puss and blood coming out of it every now and then, the side of the incision is also raised where it feels like there is something under the skin. What should I do, is this normal?",
    "doctor_response": "Hello and thanks for using HCM. This is not normal and you need to see your surgeon as soon as possible. Wounds do sometimes get infected and you need to be seen and get antibiotics right away. If you are having fevers go to Emergency. If not tomorrow would be okay but do not delay in being seen.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe hair fall\n\nHi, may I answer your health queries right now ?  Please type your query here...hello doctor i m swapna from bangalore, i am 27 yrs old married suddenly i m having an intense hair fall for past five months i consulted an doctor few months back he prescribed me keraglo tablet and tugain solution for hair but still there s no arrest in hair fall........i m adding that my family have no complaince of both male or female baldness dont know what to do need an advice............",
    "doctor_response": "Hi.As per your case history of hairfall.My treatment advice is \u2013 1. Take good nutritious diet full of green leafy vegetables and milk.2. Use a good herbal shampoo and coconut hair oil for regular use.3. Take an iron supplement once daily and vitamin b12 supplement once daily for 3 months.4. Other treatment options are topical minoxidil, oral finasteride and mesotherpy done by a dermatologist.Thanks.Dr.Harshit Bhachech.MBBS, DDVL.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swollen node in neck, mouth ulcer, sore throat, ear pain, blood report normal\n\nHi I have swollen lymphe node in my left neck. I felt it before 2 yrs . I did all the medical test along with FNAC also . report came on reactive cell presence.After that also been checking with doctor regular basis all my Blood report are normal .now couple days before i am can feel one more node been swollen slightly .I got mouth ulcer and sore throat and ear pain also . Ear pain happens for me regular basis . been to doctor they are tell its for cold please suggest what to do . Thanks",
    "doctor_response": "Hi, as your FNAC is reactive, it means that the cause is because of some focus of infection in oral cavity. The ulcer or sore throat or infective condition in throat ear can be cause for it. Still go to an ENT and have him/her have a look at the ulcer. Otherwise, symptomatic treatment for cold, analgesics, anti-inflammatory and hexidine oral rinses should do. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes weakness, dizziness, nausea, chest pains,shortness of breath and headaches?\n\ni have had 7 abnormal ekg's and failed my stress test. I suffer from weakness, dizziness, nausea, chest pains,shortness of breath and headaches. Swollen feet and ankles. My blood pressure is 95 over 55 on a good day and 83 over 41 on bad days. Nitro didn't help with the chest pains and Morphine helped me walk about with almost no problems. However there is no diagnosis. Im still in pain and no answers what do you think?",
    "doctor_response": "Hithis is most likely congestive cardiac failreadviceNT-pro bnp testSerum electrolytesStress thallium test to rule out cardiac functions , if stress thallium not available go for a 2 d echo As soon as possible .2d echo will reflect the functions of the heart , the left ventricle ejection fraction .after that copronary angiogram would be planned.most likely you are in congestiver cardiac failure due to blockage of coronary vessels.urgently contact a catdiologist he would start you on diuretics , nitrates, beta blockers and calium channel blockers.you low blood pressure is most likely because your lvef is low , so go for a echo asap.sorry but if you will neglect this , you can have a cardiac arrest soon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and pain in the lip?\n\nI woke up and the right lower side to the middle of my bottom lip is swollen it hurts to the touch and feels as if its about to split open. There is no marks of it being chapped or like I bit it. Its just red and all bushy. Should I be concerned about this? I am allergic to penicillin, mold, and citric acid but as far as I know I havent been around any of this.",
    "doctor_response": "Hello and Welcome to healthcare magic!If you have'nt been around any of those allergens it might be possibility of an insect bite or just any food which might have an allergen, do you remember the food you had last night. Try taking homoeopathic medicine Apis mellifica 30 every three hours six pills for a day.Wash your lip with warm water and apply milk cream or fresh cold youghurt.Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes behavior issues other than ADHD in 5 year old?\n\nmy 5 year old son is very bad. he was diagnosed with adhd, but i think its beyond that. he is very mean, hateful, throws toys and furniture. he swears, spits and likes to hit and call people names. he actually got kicked out of daycare for his behavior and not allowed back in. any other suggestions it could be?",
    "doctor_response": "DearWelcome to HCMWe understand your concernsI went through your details. The symptoms of attention deficit hyperactivity disorder (ADHD) can be categorised into two sets of behavioural problems.These categories are:inattentivenesshyperactivity and impulsivenessI suggest you to read further about ADHD. The problem with ADHD children is, they will never be able to understand they have these symptoms and mental disorder. Whenever they want to behave normal, these mental problems never allows and they get impulsive, frustrated, aggressive and show many abnormal behavior. They show these abnormal behavior because of their mental disorder with which they are unable to adjust. The present ADHD treatment should continue with psychotherapy treatment and calming meditations. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Troubled breathing, severe asthma, shortness of breath, inability to focus. Was given ritalin SR. Suggest?\n\nHello, I was given a prescription of 20 mg of Ritalin SR for my inattentive add and am having trouble breathing. I'm not quite sure if it is caused by my medicine, but I'm not able to talk to my doctor currently.I'm 15 years old, and have a history with severe asthma. Aside from the shortness of breath, the medicine greatly improves just about everything about my day to day attitude and ability to focus. Thank you so much.",
    "doctor_response": "Hi, Thanks for posting your query. With the available described symptoms, there could be possibility of acute exacerbation of asthma. Presence of shortness of breath along with past history of asthma suggests the diagnosis. You should consult with internal medicine specialist/ chest physician and should go for thorough check up. You should also go for complete blood count, erythrocyte sedimentation rate, spirometry and chest x ray. As such there appears to be no correlation between Ritalin and worsening of your symptoms. You should take antiallergics, doxophylline, and bronchodilators inhalers. Take steam for inhalation. Avoid and protect yourself from suspected allergens. Take care, Dr. Mayank Bhargava",
    "dialogue_context": ""
  },
  {
    "patient_message": "2.5 yrs old having breathing problem, having cold, advised inhaler. Is it safe ?\n\nhello doctor.. my daughter is 2.5 years old. In march2012, she was having breath problem. then our doctor give treatment through nobalize. Now she is suffering from cold . then i went to doctor for checkup. He gave us inhaler for her. Is it safe to use inhaler for 2.5 years old baby. and i want to ask that if we use inhaler now then it will be habbit for her to use inhaler...plz suggest me.",
    "doctor_response": "Hi welcome to Health care magic forum. Your daughter aged 2.5 years age had breathing problem then she was given treatment with nebuliser, now when she got cold was given inhaler. Both are same by function depending on age the doctors prefer the type. Inhalers are of several types, broadly bronchodialator and steroid.   broncho dialators we should use to get relief, steroids are used only when the severity of the infection is more. Steroids are to be used rarely when ever there is necessory. breathing problem usually develops due to allergy, and if you could find the allergen you can greatly minimise the severity of the attack. allergens can be traced by making a list of the things used and foods on daily basis. Note when there is cold or cough. Try to find out the things used on the day of the attack of cold and avoid such things which are common. Besides i advise you some diet recommendations  as avoid taking brinjal, fish, other sea foods, ice water, ice cream, cool drinks, these are common allergens. Don't allow her to play with water. Wishing for her continued good health, and thanks for calling.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it a good sign if I have breast pain, lower abdominal pain, mood swings, tiredness after embryo transfer?\n\nGood Afternoon, I had an emryo tranfer on the 30th Nov and tomorrow morning I need to do a pregnancy test. Very stressed. current simptoms are my breasts hurt, lower abdominal pain, mood change, very tyred, but I m not bleeding. Is this a good sign or i do have all these symptoms because my period due to come? Thanks, Sandra",
    "doctor_response": "Helloyour above mentioned symptoms are highly nonspecific. Breast tenderness, watery discharge per vaginum are common in early pregnancy.You seem to be anxious and  over stressed. Your psychic symptoms can confuse the real picture.urine or serum pregnancy test will be conclusive.wish you all the good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with diverticulitis. Treatment is Flagyl and Cipro. Aggravates back pain. What can be done?\n\nI was diagnosed with diverticulitis yesterday - 7 September. Treatment is Flagyl and Cipro and clear liquids and then soft foods. It seems like everything I eat aggravates the pain in my back - which I assume is my esophagus complaining, and the nausea and sometimes heartburn.  Chicken noodle soup seems to be ok, but grapes and yogurt are out as they aggravate the symptoms.  What can I do to alleviate the pain in my back? what are the clear liquids and soft foods I CAN eat?",
    "doctor_response": "HI, thanks for using healthcare magicIn terms of the clear liquids this would include clear sodas, broths, pulp free fruit juice, jello, popsicles.Once these are tolerated then soft foods can be used. This would include foods such as mashed potatoes or other vegetables, yogurts, soft pasta.In terms of helping the back pain, you can try paracetamol or the opiate family such as codeine, tramadol.You may want to avoid NSAIDS such as ibuprofen, cataflam or aspirin because they may increase the risk of bleeding.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does the rib cage hurt during pregnancy?\n\nHi Dr. Nirja! I am 27 weeks pregnant and have pain in my right side below rib cage. Its a pointed pain and sometimes becomes very severe. Pressing with hand helps to relieve pain little bit. Also recently I have started using thermal pads, which relieves pain for sometime. Could you suggest reason for this pain and anything to relieve it? Thanks.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Pain in rib cage is due to the stretching of the ligaments caused by the enlargement of the uterus. It is relaxed in a particular position, and there is no treatment for it. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bloated and heavy feeling in stomach, back pain, lower abdominal pain, tiredness. Suggestions?\n\nHi, I am 50 yrs old and for the past  couple of months I have had a bloated, heavy feeling stomach and lower abdominal ache and lower  back ache. It seems worse when i sit down.  I've had this since february but to begin with it was maybe a couple of days here and there but since starting hrt (Evorel conti) about 4 weeks ago it is now pretty constant. Most of the time I feel tired even though I am sleeping much better since starting hrt. I didnt mention this to my doc before starting hrt as I thought the symptons would go. Any advice would be greatly appreciated.",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for calling H.C.M.Forum. You are 50 years old, you had bloating, heavy feeling, and lower abdominal pain. It is worst when sitting.It is there since february, but more since one month. you feel tired all the time. The lower abdominal and back ache , more when sitting suggests urinay tract infection, or stone in the urinary tract. i advise you to consult a surgeon for diagnosis and treatment. You may need to have M.R.I. besides other routine tests for confirmation. Wishing for quick and  comfirtable recovery. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for body rash after treatment for mono\n\nMy daughter was diagnosed with Mono an got the all over body rash from taking amoxicillin when the doctor originally thought as had bronchitis. The rash was mostly gone after a week but then came back the next week only on her legs and this time with swelling in her feet and ankles. Is this anything to be convened about or is it par for the course?",
    "doctor_response": "HI..sometimes mononucleosis, in association with amoxicillin can cause rash. It is an idiosyncratic reaction. Noting to be worried about it. Only thing is keep a track of the activity of the kid and if it normal and urine output is normal, do not worry. Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for chronic plank pain\n\nhello der . . i av pain in both my sides . . close to d kidney area . . it gets worse when i strecth to the extreme or i run very fast . . the pain is for 7 to 8 years now . . i know its due to masturbation . . coz wen i masturbate a lot for some considerable then i am literally not able to do normal activities also . . got ol d tests . . urine , blood, ultrasound,xryas . . no symptom ever comes . . wt shud i do",
    "doctor_response": "Hi,As your all tests are normal you might be having generalized backache.It has nothing to do with masturbation.This can be due to lack of physical activity, sedentary life, weakness etc.Go for regular exercises like running, swimming, walking regularly for 30 minutes 5 days in a week.Take high protein diet.For pain take ibuprofen as needed.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for recurring cough in a child\n\nmy son is dust allergic and he coughs in the evening when he sleeps. if his head position is kept little higher he stops coughing. at present he is taking montair plus kid one tablet every evening from last 1 and a half month and furaspray nasal spray. what to do doctor his cough is repetedly coming?",
    "doctor_response": "Hi, As per your query, your child has symptoms of recurring cough which is due to upper respiratory tract infection leading to bronchitis/granular pharyngitis. Need not to worry. Already he is taking so much of medication still not getting affected, I would suggest you do warm saline gargles and take steam twice a day. Avoid the use of sharp and spicy food substances. Avoid cold carbonated beverages. Your symptoms will resolve in 1 week. if symptoms keep on persisting you should consult Pediatrician once and take proper treatment. You should get an X-ray chest done along with pulmonary function tests. The doctor may prescribe antibiotics (amoxicillin or penicillin) along with decongestants. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Harry Maheshwari, Dentist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with pernicious anaemia, tremors, tingling in hands. Taking B12 injections. Suggestions?\n\nI have been diagnosed with pernicious anemia and am being treated with vitamin B12 injections. It took quite a time before being diagnosed and I still have tingling in my hands and arms, tremors in my hands and upper body which are quite severe if I am stressed or tired. I have constantly cold hands and feet . When the tremors are severe I get bad back pains in the lower back area and in my neck almost as though my mucles have frozen up. Trying to use the mouse on the computer is difficult as the tremors in my hand wont let me direct it properly. All this has been going on for 6 months. Thankfully the depression and tearfulness have now gone but I am so fed up with not feeling really well.",
    "doctor_response": "Hi,Thanks for using healthcare magic.I have gone through your available history.It seems that you have anxiety disorder alongwith pernicious anemia. In fact anemia itself may be the reason for anxiety.While continuing vitamin  B 12 injections, You may consult psychiatrist for detailed evaluation and management.Doctor may offer you drugs like clonazepam or lorazepam or antidepressant drugs like peroxetine or sertraline etc.You may get benefit by doing stress management, relaxation tehrapy like breathing exercise and yoga.You may increase intake of food containing Vitamin B12 or food fortified with Vitamin.I hope it will help you.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ring around penis that burns\n\nhello. My son is 9 years old. The ring around his penis hurts and he says it burns and hurts. I asked if it hurts if he pees and he says not really. I gave him a tylenol and put chammomil around the head of his penis. It calmed the redness and pain down and he was able to sleep. This isn't the first time he complained of this, what could this be I am so concerned???Thank you,Momma",
    "doctor_response": "Hi,It seems that due to collection of smegma and not cleaining might give rise to some infection on the ring of penis.Clean local part with warm water and apply antibiotic cream locally.Make a habit of cleaning smegma by averting fore skin while giving shower.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Am I a carrier or patient of hereditary hemochromatosis?\n\nHello doctor, I have received a blood test back that I am confused about. I have previously been diagnosed with hereditary hemochromatosis but a new physician recently did the genetic test and indicated that I only had one of the genes present and thus was a carrier and not a patient.The blood test showed:  Iron, Serum 286 ug/dl range 35-169 (ALERT LEVEL) TIBC 435 ug/dl range 250-450 UIBC 149 ug/dl range 111-343 Iron Saturation at 66%   On the Transferrin Saturation   Iron 298 ug/dl range 61-157 Transferrin Saturation 56% range 15-55 Transferrin 377 mg/dl range 200-370 Ferritin, Serum 36 ng/ml  I had given blood about 10 days prior to the test being taken. I am looking for some guidance on whether these results should be of concern or not.",
    "doctor_response": "Hello. I have gone through your blood test results (attachment removed to protect patient identity). Your blood picture shows that the iron which is absorbed is not being utilized properly. Your transferrin saturation levels 56 % is high but not more than 62 %, which is indicative of homozygosity for the HFE gene. Moreover, genetic testing is confirmatory. Fasting transferrin saturation values in excess of 45 % for males or 35 % in premenopausal women (i.e. 300 ng/L in males and 200 ng/L in females) are recognized as a threshold for further evaluation of hemochromatosis. You have already been diagnosed as heterozygous for hereditary hemochromatosis, and these values are to be expected. Since your serum ferritin levels are towards the lower end of the normal range, you do not need to undergo phlebotomy. Serum ferritin in excess of 1000 nanograms per milliliter of blood is almost always attributable to hemochromatosis. The increase in RBC count and hemoglobin is a direct result of the testosterone therapy you are receiving. I would say that currently you need not worry but you need to keep monitoring your serum ferritin level and transferrin saturation in order to prevent the development of complications and receive adequate treatment when your iron stores reach levels that can cause them. Thank you. For more information consult a hematologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a lump on the upper lip?\n\nHi, I have a similar concern about what I am looking up (lump under upper lip and bruising surrounding the lip only on the right hand corner though. I have a couple tiny lumps on my right upper lip underneath the skin, and I am starting to get bruising there, I was wondering what can be causing this?",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.The lumps you described as are on the upper lip and causing bruising is possibly due a hemangioma. This is a collection of the blood vessels as due to its anatomical position in upper lip can appear differently than when it occurs at other site in the body.I would advise you the following:Consult a General Surgeon.Get examined.color dopler done to see the internal spread, which can be deceptively very large;if so get CT angiographyPlan a SurgeryGet operated.This will cure your problem and has two benefits.1. You get rid of the disease1. You get a Histo-pathological diagnosis .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes erection only while sleeping?\n\nI am 44 years old, for the last 2 years I am having an errection problems, however, I have noticed that I have a very strong errection when I am a sleep ( I wake up during the night and I notice that) but when I am a wake I have the problem. I also want to mention that I dont have any problem masterbating and I have a very good errection. Please advise if my problem is physical or psycological",
    "doctor_response": "Hi,Since you are getting good erection during sleep than your problem can be psychological not physical. Firstly, I would advise you for certain lifestyle modifications and non medicinal measures to get erection. Try to be more passionate towards your partner. Spend quality time together and spend more time in foreplay. Avoid smoking and drinking if you have a habit of it. Exercise regularly which will boost your testosterone level and subsequently you may get good erection. Make your bed room more comfortable and conducive for the sex by dim light or light music. If all these measures doesn't help than you can take Sildenafil or Tadanafil group of drugs under medical supervision for 3-5 days and once get your confidence again, you can discontinue these medicines.Hope this answers your question. Please feel free to ask for follow up question and I will gladly answer you.Best wishes,Dr B R Hudda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lump in back of neck\n\nHi, My name is Sam i wanted to ask a question regarding a problem that my mum has currently. Over 1 month now she has had a lump at the back of her neck, at first our GP thought it was due to high blood pressure because she is experiencing severe headache. Having done a ultrasound, which shows a lump at the back of her neck and the lump contains water inside. The GP has said theres nothing to worry about and with time it will get better. no medicing, no advice. My mum is really not feeling well and she is paying many visits to the GP but he is giving no medicine. Is there any treatment for this lump with water in it?",
    "doctor_response": "Hi ! Good afternoon. I am Dr Shareef answering your query. I would suggest you to get it assessed by a general surgeon who would be in a better position to explain you on its management. Without a physical examination, it might not be possible to opine on the problem.I hope this information would help you in discussing with your family physician/treating doctor in further management of your mother's problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the white spots under scrotum?\n\nI looked under my scrotum and theres like this white spots theres no lump or anything like that i havent had intercourse either it just randomly showed when i was checking my pravite area it was like rough white spot i sweat a lot too i have alopecia and theres no pubes",
    "doctor_response": "Hi,White spot usually indicate candida infection, sometimes post inflammatory hypopigmentation also present with white spot below the scrotum. Vitiligo of scrotum is also a common entity which present with white spot below the scrotum. If possible please send us the photograph.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Atishay Bukharia",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be concerned about the lumps under collar bone?\n\nI have found 3 moveable lumps by my right collar bone. My blood tests state that my platelet level is slightly over 400.I have been on antibiotics for 10 days 500mg 3x day. Did not lessen the size of lumps.I have not had toothache, earache or head traumas.Should I request a biopsy? Any suggestions would help greatly. Thankyou",
    "doctor_response": "Hi,Dear thanks for the query to HCM virtual clinic.I studied your query in full details updated from you.I understood your health concerns.Based on your query data, In my opinion ,Dear You seem to suffer from -Could be-due- to NHL as these lymphnodes did not regress after antibiotics/Could be due to Lung Cancer / or Lung TBCould be due to Breast upper outer quadrant(if you are female).For this you need to consult a Surgeon and get the Excision Biopsy/CT chest and abdomen to rule out the HL(hodgkin Lymphoma) and NHL(Non-Hodgkin Lymphoma)For this treatment Gp and  Breast/Thorasic/Onco-Surgeon team would be needed to treat your case.Thus you need to be concerned and need to ask for biopsy with your doctors.Hope this reply would help you to evaluate your case and treat it with your doctors in time to come.Hope this would resolve your query and worry and Anxiety accompanied with it.Welcome for any further query in this regard to ME.I would love to help you out.Awaiting for any further query.Wish you fast recovery from this intriguing health problem.Have a Good Day.Dr.Savaskar M.N.M.S.Genl-CVTS -Senior Surgical Consultant",
    "dialogue_context": ""
  },
  {
    "patient_message": "History of on and off using opiates, now clean. Severe anxiety, panic attacks, depression. Possible normal life again?\n\nI'm a 35 yr old female who has abused opiates on and off for 10 years. I'm finally clean after 23 days of stoping all meds. I'm wondering, will I ever feel normal again? Is my brain forever altered? My anxiety is out of control, panic attacks that make me feel \"crazy\". If this life after opiates, I want no part of it. I'm very depressed and was diagnosed with bpd 2 years ago but I don't want to be on more meds. My husband Is a alcoholic so he is no help. I feel stuck.",
    "doctor_response": "HelloThis is a good thing that you have stopped taking opiates. You have been taking the drugs for about 10 years and then stopped to take. Currently you are having severe anxiety, panic attacks, depressive symptoms and bipolar disorder. See opium cause dependence in terms of both physical and psychological domains. The long term effect of opiate withdrawal even last for 6 months to 1 years in form of anxiety attacks, craving of drug and other behavioral symptoms. But they don't occur continuously. These type of symptoms are also called as protracted withdrawal symptoms. The symptoms will decrease in severity with time. Please don't take undue stress and try to calm yourself with relaxation exercises. Opiates cause brain damage but the damage is not permanent. Consult a good psychiatrist for expert help.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes soreness on my gums after fixing partial denture?\n\nI am 55 year old female who goes to the dentist regularly and I have a partial denture on the top. For the past few months I have experienced skin shedding inside my mouth on my gums (upper and lower) and cheeks and bleeding when I brush and floss. I am also having discomfort when I eat, it feels as though the food is getting stuck at the top of my stomach. Could these symptoms be caused by the same medical problem?",
    "doctor_response": "Hi..The  most probable  reason is ill fitting partial denture. ...If it's not fitted properly then it would create food lodgement as well as other problems  mentioned  by you...Get new partial  denture by an expert..",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to relieve pain in shoulders, sternum and arms?\n\nSaturday I went out to eat. I couldn't finsh becaused I was having suck pain in my sternum and my shoulders and arms ached severely. It was so painful, i had to drive my self home and go to bed and it lighted. Then I went to mow grass and it came back with severe pain. What do i do?",
    "doctor_response": "Pain in the chest, shoulders, and arms is often tied to excessive or strenuous use of the arms. This seemed to be accentuated when you tried to mow the grass. Even though it acted up during your meal, it does not sound like reflux. First try regular anti inflammatory medications (ibuprofen/naproxen), as well as a topical anti inflammatory like Aspercreme. Topical ice would help also. If these measures don't work, seek out a chest x-ray from your doctor, who would also check for cardiac causes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the shoulder?\n\nhello i am an regular marijuana smoker (daily about 4 to 5 joints recentley i have a pain on my shoulder right shoulder i nomally get it at night times and it gets worse when i take a breath its not a pain i cant take but it is unconftable can u please tell me what might be wrong with me",
    "doctor_response": "Hi there.I think you have nerve pinching due to a slipped disc in the spine in your neck. I advise you to avoid lifting heavy weights, avoid bending forwards. Eat healthy. Avoid smoking or drinking alcohol. Apply hot water bottle to the painful areas to reduce pain due to muscle spasm. Take pain killer and muscle relaxant combination like Tab. Diclofenac 75mg + Thiocolchicoside twice a day. Consult your Orthopaedician if th pain is not relieved in 7 days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dental infection to re-occur?\n\nI am a 58-yr old female, with a tooth abscess of a root-canaled, crowned tooth for over a year now, and have been self-draining the gum boils when they appear.  I went for several months without pain and thought it had healed.  However, the infection continues.  I have been in the process of moving, changing jobs, and dealing with lots of stress, so I have put off going to a dentist.  I have always been active, though, (former runner, etc.) and have noticed shortness of breath-- particularly when carrying a load upstairs--that is totally uncharacteristic of me.  My doctor thinks it's asthma, but I'm wondering if the long-term abscess is to blame for the SOB.  What do you think?",
    "doctor_response": "thanks for your query, i have gone through your query. the abscess could be because of improperly treated root canal or secondary to gum infection. the abscess is not related to your breathlessness. consult a oral physician and take radiograph of that tooth to confirm the pathology and if there is any defect then redo the RCT or if gum infection is there then take a course of antibiotics and cleaning can be done. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does severe disc problem cause acute abdominal pain ?\n\nHi my mother is 65y old & she has severe disc problem she also has Osteoporosis , for the last 2 weeks she is suffering from bad abdominal pain .. we have done urin test & sonography the results were ok & nothing wrong.. she has the pain when she stand move or set when she sleeps she does not have that lower abdominal pain ... can this pain be caused because of her disc? & do you advice to take Metocarbamol?",
    "doctor_response": "Welcome to healthcare magic,this abdominal pain is refferd pain due to spinal canal stenosis.for pain first try analgesic and this  neuropathic pain response best to gabapentin or pregabalin.if not respond to medication,contact a neurosurgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause of infertility if I have a history of low abdominal ,neck and back pain ?\n\nmy age is 31yrs,weight is 70. medical history unable to get pregnant since 3yrs of marriage. i use to have low abdominal pain and back pain,& neck pain if am sitting now.",
    "doctor_response": "Hello Do medical investigations so as to find out for any gynaecological cause may be  creating lower abd.pain. You should try to lose your wt. If the tests are normal,go for ayurvedic treatment which will make help u to conceive. Panchakarma & oral medications together get you result. there are many effective medicines in Ayu. which will accurately work on your problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will Macrobid dose leads to bronchitis?\n\nHi, I am being treated for a UTI with macrobid, which is working..symptoms gone. However, I also developed bronchitis and have a low grade fever. My cough is productive, as they say, but I didn t know whether I should see my internist for an antibiotic that could cure both.",
    "doctor_response": "Thanks for your question on HCM. Macrolide is group of antibiotic. It includes azithromycin, clarithromycin, erythromycin. So it is not the cause for your bronchitis. Bronchitis is infection of airways. So possibility of same infection as a cause for bronchitis which is responsible for UTI (Urinary tract infection) is more. Better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x ray 3. PFT (Pulmonary Function Test). Chest x ray is needed to rule out lung infection. PFT is needed for the diagnosis of bronchitis. It will also tell you about severity of the disease. And treatment of bronchitis is based on severity only. You may need antibiotics, inhaled bronchodilators and antihistamines drugs. So consult pulmonologist and start appropriate treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have thallasemia minor. CBP shows microcytic anemia. Iron profile suggested\n\nHi Doc, I am a Thallesemic minor patient... and just became a mommy. my heamoglobin was down at 7.4 after delivery. But now after 2 months i got my CBP done and as per the report my hb is 9.5 and also my report is as below COMPLETE BLOOD COUNT , EDTA WHOLE BLOOD/SMEAR COMPLETE BLOOD COUNT RED BLOOD CELL COUNT 5.02 High 3.8 - 4.8 mil/\u03bcL HEMOGLOBIN 9.5 Low 12.0 - 15.0 g/dL HEMATOCRIT 31.3 Low 36 - 46 % MEAN CORPUSCULAR VOL 62.2 Low 83.0 - 101.0 fL MEAN CORPUSCULAR HGB. 18.9 Low 27.0 - 32.0 pg MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION 30.3 Low 31.5 - 34.5 g/dL RED CELL DISTRIBUTION WIDTH 16.4 High 11.6 - 14.0 % PLATELET COUNT 298 150 - 410 thou/\u03bcL MEAN PLATELET VOLUME 10.9 6.8 - 10.9 fL WHITE BLOOD CELL COUNT 7.0 4.0 - 10.0 thou/\u03bcL WBC DIFFERENTIAL COUNT SEGMENTED NEUTROPHILS 62 40 - 80 % EOSINOPHILS 4 1 - 6 % LYMPHOCYTES 30 20 - 40 % MONOCYTES 4 2 - 10 % BASOPHILS 00 1 - 2 % DIFFERENTIAL COUNT PERFORMED ON: EDTA SMEAR MORPHOLOGY RBC MODERATE ANISOPOIKILOCYTOSIS SEEN. MICROCYTES WITH HYPOCHROMASIA(++) AND ELLIPTOCYTES(+) SEEN. WBC WITHIN NORMAL LIMITS. PLATELETS ADEQUATE ON SMEAR. IMPRESSION PERIPHERAL SMEAR SHOWS MICROCYTIC ANAEMIA. SUGGEST: IRON PROFILE. can you please explain- RBC MODERATE ANISOPOIKILOCYTOSIS SEEN. MICROCYTES WITH HYPOCHROMASIA(++) AND ELLIPTOCYTES(+) SEEN.",
    "doctor_response": "hithanks for your queryi can feel your concernsyour blood picture is typical of thalassaemia trait.In addition you seems to have iron deficiency as wellAnisocytosis means red cells are varying in size and poikilocytosis means varying shape red cells.. microcytosis means red cells are smaller in size while hypochromia suggest that they are not well haemoglobinized.Elliptocytes means pencil shaped cells. these are the features of iron deficiency anaemiai advise you to get your iron profile and if found deficient then take iron supplements after consulting your doctor. improve your diet add meat, fruit and vegetables to iti am available for your helpregardsdr.imran",
    "dialogue_context": ""
  },
  {
    "patient_message": "What caused the bacteria, fungus and yeast infections in the wound?\n\nIhave  a wound where they took staples out in my leg",
    "doctor_response": "hi thanks for asking this on HCM. wound infections occurs if you had not been prescribed antibiotics after the procedure or if you failed to take the tablets correctly given to you. the air surrounding is filled with lots of microbes so if you have not taken good care of your wound it can happen. even in hospitals you can get such infection transmitted. the treatment for that is antibiotics and a wound culture should be done for finding the exact cause.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high fever in a child\n\nHi, my 3 yr kid is suffering from 103 fever. I gave him Meftal P 8.5 ml (his wt is 17 KG) but the fever returned after 4 hrs. Earlier Today, the fever returned after 9 hrs and then 5 hrs respectively. What should I do? Should I give him another dose of Meftal P in 1 hr time?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.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 15mg/kg/dose (maximum ceiling dose of 500mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.Meftal-P contains Mefenamic acid which is a NSAID. It carries the risk of gastritis and renal problems in the long run. Please do not use Meftal-P. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Done dialysis for renal problems. Need cheap medicine to decrease creatinine level\n\nRespected Dr. sahab My wife is suffering renal problems. . two session PD dylisis done in Nov 12 . Now she is on perscribed medicines for 15 days . The cretinine is 8.2 on 27.11.12 test . the medicines suggested by Dr. .. are -- nifidine ip 10 mg two tabs TDS with arkamine [ clodine ] one tab TDS.. folic acid iron tab BD , B-complex one tab daily .. calcium carbonate 500 mg BD , You are requested to suggest us any other medicines but cheap cost to decrease critenine lavel Other hand she is also with Anemea, Hypothyriod, HTN, . THE THYRIOD PILLS IS TAKEN IN MORNING . WEwill be thank ful to you . we don t want to go Another PD or HD . She is regular with toilet comfertable stool two times & 1.5 ltrs plus urine daily without any problem .",
    "doctor_response": "First of all I feel sorry about the chronic kidney problem your wife suffers; nevertheless, medications which you mentions are to control her Blood pressure as well she is on thyroid medicines. Taking calcium is very important and along with antacid to reduce phosphate absorption. I would like to know the present createnin level after PD. Did your doctor perform renal biopsy? Did he say she has SLE? You must understand one important thing that the outcome depends upon the etiology as well  the current renal status and then only I can suggest the prognosis. Don't carried away with the apparent recovery she is showing right now as renal failure management is a big commitment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the small lump in my testicle that vanished?\n\nhi, im poor there is no way im getting to a doctor it doesnt exist for me exept to a walk in free clinic type of thing, wich i have no ride and its far so its a verry hard thing to do for me.my question is i found a small .. pinsize bump? lump? on my right testical, i freeked out..... so I prayed to god .. many times to heal me. (since, its probably my best bet). i called around did research, i found some answers that it may be cancer becouse i felt no pain. 2 weeks later.. (now), its vanished. i cant find it, locate it and belive me ive been fealing...do i need to still worry  that im a die ?",
    "doctor_response": "Welcome to health care magic. 1.Probably an infective cyst or a lump, it can be hair follicular infection.2.If there was lump and disappeared after some time probably cystic structure.3.Other but its generalised enlargement - hydrocele, which does disappears by time.4.If still you feel any thing - some how you have to get an ultrasound scrotum done that will help in assessing the lesions, its nature and where they are from - sub cutaneous or testicular, and where all it is spread.5.Dont worry you have not mentioned any thing corresponding to cancer. Good luck.Hope i have answered your query.Any thing to ask do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes erectile dysfunction after started taking bisoprolol?\n\nHelloStarted taking the druc Bisoprolo (Ziac) approx 10 months ago and am now having problems with ED. I have no problem getting a erection at the start of having sex with my wife, but after about 5 minutes, I am no longer able to maintain the erection? I am 53 years old and never had any kind of ED problems in the past. Been reading articles saying Bisiprolol is a Beta Blocker and this could be a symptom. My fear is that if this is the case...is this permanent or if I stop taking this medication...will I be able to get and maintain the erection after stopping the medication. Please help as this is causing problems in my marriage as my wife thinks this is because I am no longer attracted to her which is in no way true....Thank You !",
    "doctor_response": "Hi ...Yes you are right....Beta blocker drugs like bisoprolol can lead erectile dysfunction ..If you have high blood pressure or heart problem then drug should not be stopped ...Instead consult physician if possible to switch over to alternate drug apart from thiazide diuretic and beta blocker....Here also investigate for diabetics, heart disease, obesity , surgery history, radiation history, prostate problem etc....For this problem sildenafil is good drug...that can be taken 30 minute before ejeculation...Be relax during sex and fore play practise more.Do sex in comfortable position....Sex therapy counselling session useful....Healthy and balanced diet taken with avoidence if stress....Consult physician or psychiatrist for your examination....Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Normal for numbness in lip, tongue and jaw after wisdom teeth extraction?\n\nHi I had 3 wisdom teeth out 3 days ago, my bottom right one as the surgeon said was a nasty one that was right on the nerve, I have a dead numb lip, tounge and jaw which is getting number by the day, and the pain is getting worse to the point where I can barley open my mouth. Should I go to my dentist and if so it's late on a sat so will it be ok to wait till morning or is this normal for wisdom teeth extraction. Thank u",
    "doctor_response": "Hello,Thank you for consulting with HCM.Actually when there is removal of wisdom teeth, it takes a little more time in healing and reduction in swelling but if you are mentioning that you are also experiencing numbness and pain in the jaw, it is something uncommon, it looks that there can be damage to the nerve below the wisdom tooth, but to get it confirmed you have to get an OPG (x-ray) done.You should continue with antibiotics and painkillers and even with vitamin B capsules for 2 days more, if the pain does not reduces after that also then you have to visit your dentist for the OPG and further treatment.Hope it will help you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the pain and belching even after a heart attack?\n\ni had minor heart attack 1 week ago, no heart damage. cathed through femoral artery, and small artery was angioplasied. the symptoms before attack were constant belching, nonstop, some pain in waves. i now have 9 different medications, and am going for heart imagery. is it common to still have all the belching, and sometimes pain. i was told i have angina.",
    "doctor_response": "Cause of belching minght be due to some other reason.Even the medications like aspirin is also tend to cause belching.So don't worry about this thing.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sex with unknown person, back pain, abdominal pain, pimples in throat, body rashes, greenish yellow urine. Grade one fatty liver detected. Treatment?\n\nhi doctor my name is XXXX i have been not well from the past 4 month during the month of ovember i had sex with unknown person and i was well for 6days in between that time some one pricked me with a needle and was bleeding it hit me on my bud i have had done hiv antigen test 4 time but no single tie it was detected but i feel lazy feel pain in my back and have pain in my left lower portion of my abdomen and have pimples in my throat .Also the sex that i had was that i was wearing condom i just kissed her or rather french kissed her. can you help me with the problem i do hot have fever but i have green yellow or white urine and have red raches on my body have red pimples on my thy and my eyebrow hair is falling as well fell pain while scratching on my head and my body is getting weaker help me. I have done all the tests complete body check up but there is just grade one fatty liver problem coming on paper rest every thing is normal. Now i feel trouble in eating food so kindly help me to find the problem.",
    "doctor_response": "Do a test called Torch test. It is to detect toxoplasmosis,rubella,cytomegalus, and herpes. there may be one of these infections you may have picked up.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for OCD\n\nMy daughter is having some problem. She takes lotof time in doin any piece of work let it be taking bath or making notes. Even ifthe small ting hapens aains her expectatios she gets upset. She has a phobia of type of ting for exta neateness. She ha a feelin ery were thereis dirt and if she douts there is sotng dirtt is there she takes a slot of time claeaing the same or does not ouch the ting. She does not care tocarry out te dal work een in time. Keepsthng as they are. She finds falut with others for not doing the work but she herself dos not do the work she says things are notperfect and se does ot want to do anytthing. The cothies getts iles without washing. If she does any wasing she may take hours for the same. She will wahsher hands for long time time counting the number of times that she wshes. Just because her daugtr got dwon rom the bedand wlked bre foot on the ground and got up to the bed she got upset tht the entire bed has become dirty and unclean and she could not use the bed. shemade herdaughtralsostand on the floor. She throws every thing on te grond in one of the room and does not get that room cleaned. what cold be done for this behaviour.",
    "doctor_response": "Hello After reading your history I come to conclusion that most likely she is suffering from OCD or obsessive compulsive disorder. She is probably having Obsessions of cleanliness and Compulsive hand washing. This is a type of anxiety disorder and is the reason for her abnormal behaviours like hand washing, taking time to bath, obsessive cleanliness etc. Even patients remain aware of their abnormal Behavior still that can't control the thoughts. I would advise you to take her to a psychiatrist for opinion. Psychological treatment like exposure and response prevention, systematic desensitisation are main treatments that have proved effects. They have good efficacy equivalent to drugs.Medicines especially Fluoxetine, Paroxetine, Clomipramine are very useful. The drug therapy and Behavior therapy when used together give best results.Thanks, hope this helps you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest heaviness, pain in neck and head and anxiety?\n\nHi I have been having chest heaviness upper teeth is sore feel like throwing up I have axciety but I took my meds but it doesn t seem to help my head is hurting my let side of neck always cramp up I went to the dentist they did a filing but it still hurts what can it be",
    "doctor_response": "Hello dear, thanks for your question on HCM.I can understand your situation and problem.It seems mostly anxiety related symptoms only.But better to rule out cardiac cause first for your left sided chest discomfort.So get done ECG to rule out cardiac cause.If ECG is normal than no need to worry much for cardiac cause.It is anxiety related only.I advice you to consult psychiatrist and get done counselling sessions. Try to identify stressors in your life and start working on it. Newer anxiolytic drugs are very effective and less habit forming. You may need these too.Better to avoid stress and tension.Be relax and calm.Don't worry , you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can ruptured disc only be cured by spinal fusion?\n\nHi I have ruptures C5/C6/7 and I have been told spinal fusion is my only option...... I also have L1-S5 herniated. My tri muscle was reattached after I got side swiped. Because I am just now 40 I want to wait as long as I can before back fusion.I have read A LOT of legitimate literature, not the drug pushing sites, that oral Anavar would strengthen everything and allow me to when myself off these damn opiates. Your advice would be well received.yours,Ridge",
    "doctor_response": "Hello, Spinal fusion will be the best option. You can also opt for techniques like steroid injection for symptomatic relief. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will having unprotected sex with dog cause rabies?\n\nHello doctor, Since last year, I am having a lot of health problems such as back pain, fingers joint dull pain, chest inflammation, irritation at penile area, inflammation inside the penile hole, body irritation, body weakness, fever. I often do sense inside my head, i.e., pricking with pins and needles and flu-like symptoms all the time. The reasons for the above-mentioned problems are due to unprotected sex with a creature (dog). Under the heavy influence of an alcohol, such a blunder was committed. I have an apprehension of contracting rabies from that encounter. Can rabies be sexually transmitted? Please suggest me what test should I need to do to rule out the above-mentioned symptoms. I have great hope in you as you are one of experienced and best doctor cum pathologist. Please advice me the test so that I can perform the test and revert it to you for treatment.",
    "doctor_response": "Hello. Rabies can spread sexually but your symptoms do not classically point towards rabies infection. The neurological symptoms like confusion, nausea, excess salivation, etc., are missing. So the chance of rabies is less as per my opinion. However, for rabies, testing multiple samples like saliva, spinal CSF fluid, etc., like examination are needed. You can rule out leptospirosis by serological ELISA testing as you have a history of sex with the dog. There are many zoonotic diseases which mean those infections which spread from animal to human. HIV also can be ruled out by ELISA testing. So your detailed evaluation is needed to do further work up. For primary work-up, you can investigate as follows. Blood pressure measurement, serum all vitamin B estimation, SGPT, SGOT, urea, creatinine estimation, ESR, full CBC, serum ionized calcium estimation, serum vitamin (OH) D estimation. You can revert back with reports. For your detailed physical examination, you need to consult nearby internal medicine specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bumps on the skin?\n\nI have a small bump, about the size of a pea, on my inner thigh, I found it a month ago, it went down even smaller, which made me think it may have been a pimple, but now it is back up to a pea.  What could it be.  The lump is hard, but not so much painful, I can tell its there, but no real pain from it",
    "doctor_response": "Hello, welcome to healthcare magic forum,It looks like some kind of cyst, it will be better if you can show it to a doctor and plan flan for FNAC (Fine needle aspiration cytology) followed by removal.FNAC is required for tissue diagnosis.Thanks,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Slight bleeding, trying to conceive. Implantation bleeding ?\n\nMy fiancee and I , are trying to get pregnant , but i think i m not able to get pregnant . i believe i was having implantation bleeding 3 days ago but it wasn t very light it wasn t heavy either it was in the middle , i looked on the internet to see what it was and some say it could have been a miscarrage.what do you think ?",
    "doctor_response": "hi, implantation bleeding is not a common finding, if occurs usually that can be seen around 1 week after fertilization, that could be minimal in quantity, so if your bleeding period correlates with the possible time of implantation, and if the bleeding subsided soon, you wait till the expected date of periods and undergo blood or urine test for pregnancy to detect the possibility, bleeding due to miscarriage will be rather heavy and usually presents with associated  pain abdomen. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any method or diet changes to avoid drawing of blood due to having too many red blood cells in future?\n\ni had to have blood drawn from me because i have to many red blood cells per u c davis doctors i need to know what to do to avoid this procedure to transpire in the future what foods should avoid . is there any foods i should avoid ? or is there any other suggescions you have.",
    "doctor_response": "hello and thank you for submitting your question.If you have too many red blood cells, you may have a condition called Polycythemia Vera. If so, this is due to a genetic mutation and diet plays a minimal contribution. Regardless, it is best to eat a well-balanced diet full of fruits and vegetables, low in saturated fats and sodium, and moderate in redmeat. It is important to maintain adequate hydration. If you have to much iron, you may have a condition called Hemochromatosis. If this is the case, it is important to maintain a well-balanced diet but to limit your intake of iron. It is important to note that neither polycythemia vera nor hemochromatosis can be cured by diet & future phlebotomy may be necessary, as determined by your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Teen suffering from neck, back pain. What should i do to get my energy back? YOGA?\n\nhi i am 18 old boy i done mistake when i was 14,15 old that is i done masturbate but since from 2 year i stop doing it and now and now i am suffering from neck pain and and back pain and also i am not able to concentrate in the class pls pls help me to get my states back. is it possible to get my energy back by YOGA if so tell me and also pls tell me what i have to do pls really u are the god for me because i am poor student please.......",
    "doctor_response": "1. masturbation by no means result in neck/back pain, but the guilt results in believing/associating your symptoms with your act. 2. It is the Act by which our body relieves itself of sexual urges/desires, so in no way its harmful. 3. because you are unable to concentrate has resulted in aggravation of these symptoms, resulting in a vicious cycle of masturbation-pain-low concentration. 4. regarding your pain: rule out with your Physician about possible X-rays of cervical and lumbar spine and treat accordingly. 5. For your concentration: avoid ginger-garlic-onions in your diet, eat fresh vegetables (avoid peas, kale, cabbage), drink plenty of water or fresh juices to stay hydrated. 6. avoid distractions,doing double tasks,focus on one task initially, in nut shell stay FOCUS.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I get rid of my acne when I have a combination skin type ?\n\nI have had acne since the 6th grade . I am now going into the 10th grade and it still hasn t cleared . I ve used every single face wash before from drugstores . When that didn t work , i started using Proactiv which didn t really help since it dried out my skin . Ive tried at home masks and everything . I don t pop or pick my face either . I have combination skin . When i m out , it would be really disgusting and oily . I have now been using skin id for a year now . It has worked the first few months but now , it just seems the same . I have a few bumps but you can see a lot of red spots on my face . I also have it on my back and now i m getting it on my chest as well .",
    "doctor_response": "already you are suffering from acne since 4 years. Three regions of your body already has acne. So it calls for strong treatment. Simple measures may not give you good and long lasting results. There is GOOD NEWS  for you.  some tablets are available which when taken for abt 6 months will reduce the acne permanently. But you need to meet a nearby dermatalogist for that, as the doctor should personally assess the severity of acne and your general health.Any form of treatment for acne will make your skin dry during the treatment duration and it is one disadvantage you have to accept.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could stomach pain be due to the side effect of taking lanzol?\n\nMy daughter is 8, she has been advised to take Lanzol Junr for 2 weeks. For last 2 days she finds stomach ache after she takes the tab. Is this a side effect? She in general has facing this problem for last 2 days. Even she was advised to take Rantac MPS which dr. now advised to stop.",
    "doctor_response": "Hello,Lanzol does not cause stomach pain as a side effect. On the contrary, it helps in treating the stomach ache due to the reduction of the acid in the stomach. I suggest to use Lanzol in the morning before breakfast. I also suggest to avoid food that can trigger the stomach pain.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "my child was very high speed breathing in evening onwards & some cough in my child in two days before & this time also pl. may i meet to you my child doctors & give medicin after also breathing is more",
    "doctor_response": "Apply coconut oil 4 spoons+ til tailam 4 spoons(in warm condition)+half tsp of salt,on ur child's chest for 3 successive nights.Due to this loose motions will start but don't do anything,it'll disappear after some hrs.Wish u a healthy life for ur child.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Painful bump on gums, swollen gums, bump on cheeK\n\nMy husband has a very painful bump on his gums in the back ,his gums are very swollen and its getting worse it started last night and this morning its spread to the other side and he has a bump on his cheek (the part that touches the bump also for years he s had an extra tooth its located in near the back but its like not on the gum line like all the other teeth i l ooks like a baby tooth but this morning i looks bigger like its more pushed down we need help he is in extreme pain and has no dental insurance",
    "doctor_response": "Hello and welcome According to the history given by you, it looks like a pericoronal infection which occurs due to incompletely erupted wisdom tooth, the reason of bump and swelling is due to the pus around the unerupted tooth. Right now you better start with Amoxycillin 500mg three times a day, metronidazole 400 mg three times a day and brufen 400 mg three times a day and betadine gargles, for the permanent cure you have to visit your dentist as this tooth may not erupt due to inadequate space and you have to get it removed after one check IOPA X-Ray",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excessive bilirubin levels in a Leukemia patient?\n\nWhat can be a possible cause for excessive bilirubin levels on a patient that has had Leukemia and had a bone marrow transplant and is in remission.   A liver biopsy was done and no problems were found there either. A cat scan has revealed no blockages.",
    "doctor_response": "Hi welcome to HCM....Noted yo have high bilirubin level....Your liver biopsy report and CT scan findings are normal....So liver pathology seems less likely...Let me know you hemolysis can lead to excess bilirubin production....So hemolytic causes has to be ruled out.For that peripheral smear examination and retic count done...LDH estimation also can be done....Even resorption of hematoma can lead high bilirubin level....So consult gastroenterologist for detail history and physical exination to investigate further.Tale care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of infection in the belly button?\n\nHi there I got my gallbladder removed on the 1st feb, I got an infection in my belly button then further up I got another infection my gp said it was cellulitis on thurs this week I had to get a 5cm abbess drained from upper wound, my gp has me on 5600 mg of antibiotics per day, both infections are weeping puss, please help what's wrong with me?",
    "doctor_response": "hello patient,I read your surgery history & current pus discharge too.You might be having diabetes that's why you caught infection after surgery.Pus drainage & Antibiotics will help to heal cellulitis .Conclusion you should go for diabetes blood sugar level lab test and continue Antibiotics & doctor observation Wish you rapid recoverythanksregards Dr.Ravin Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain and tingling in arm and leg at night?\n\nHello, I'm 19, skinny, and a smoker. For the past month I've have trouble going to sleep because of chest pain and random tingly feelings in my left arm and leg. With the occasionally pressure headache. Early I experienced a strong time stopping pain in my chest and about 5mins later it felt like a bubble burst, then my leg went numb. Any help thanks.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Since you are smoker, you are at risk of heart diseases. So we should first rule out heart diseases for your symptoms. So get done ecg, 2d echo and stress test. If all these are normal then no need to worry for heart diseases. Sometimes stress and tension can also cause similar symptoms. So avoid stress and tension, be relax and calm. Quit smoking as soon as possible as this is not a good habit. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Blood in urine due to prostate infection. Perforated kidney. Chances of bladder cancer?\n\nI have just seen a uroligist for blood in my urine. I have been under a doctors care who said I had a prostate infection. I have been on antibiotics for 6 mo. I had kidney stones about 5 or 6 yrs. ago, I passed one but the doc then said my kidneys looked like they have been shot with no. 8 bird shot. could this be my kidney stones acting up again or possible bladder cancer which kinda matches up with my symptons?",
    "doctor_response": "Hi and thanks so much for the query.I feel humbled being offered the opportunity to counsel on your health worries.I am so sorry to hear about the blood in your urine.Urine is produced in the kidneys and it flows through the ureters, get stored in the bladder and finally through the different parts of the urethral including the prostatic portion.Blood in urine can come from any of these organs. Kidneys/ureter/bladder/prostate/urethra etc. It is very non specific in localising the exact problem but at good telling us to dig further and get answers.We need to characterise this blood in urine...Quantity...all urine? Look for other urinary symptoms, abdominal pains etc before narrowing the list of options. Also, your age is going to be of great help.For now, it can be any of the above but until you get evaluated by your urologist, we shall continue to list even more. Please, you need a proper consultation and investigations to give you the exact answer.Hope this helps.Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dermatitis eczema, applied cream, esticles and penile shaft there are red swollen bumps. STD?\n\nHello, I have dermatitis eczema and ive put cream on my body and for the most part that is good but on my testicles and penile shaft there are red swollen bumps. They dont hurt just itch at times. The ones on my testicles seem to go away if i used powder. the ones on my penile shaft seem to get a littler better too but i notice when i masturbate they seem to get worse. I m worried it might be an std but when i looked up stds nothing i have seem similar with the stds. Are the irritated lumps/bumps from masturbating?",
    "doctor_response": "Hi,From history it seems that you might be having dermatitis or fungal infection on the part.Due to masturbation there might be irritation and friction there might be precipitation of the condition.Apply triple acting cream.Keep local hygiene proper.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic leg pain\n\nI have chronic leg pain in my tibia. I need to use heat pads at night when the pain interferes with sleep. I don t kntice it during the day. As a child I used to have bad leg aches so painful my dad would rub my legs. I have some arthritis/. including trigger in my right pinky, a recent development. X=rays showed some bone growth. In the past 15+ years I have had episode of Plantar s Fascitis, De Quarvain s Tenosynovitis, and another triggerfinger. I am 86+5months and in very good health. I had an episode of Hyperthroidism whichhas been in remission the last3+ years. I will see the priimary care MD this afternoon.",
    "doctor_response": "hi, i appreciate your concern.leg pains for long tome at your age seems to be due to cacium metabolism problem and /osteoporosis,may be associated vit b12,and vit d deficiency.it is suggested to get yourself evaluated for all above ,by ur orthoexpert,warm fomentations, pain releaving local application creams and neurovitamins, may help for the time being. thanks. i will be happy to answer any further quary.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stinging on penis tip while urination?\n\nI am a 62 year old male with a history of prostatitis issue beginning 20+ years ago.My PSA is 0.17 and hasn't changed though my prostate has enlarged over the years.I sometimes have a sharp stinging at the tip of my penis when I urinate, and sometimes a very slight burning afterwards, but after intial stinging no pain at all during urination.I've had several urine tests over the past several years that reveal no infection, blood abnormalities in the urine.I had a CAT scan that showed no problems with urinary tract or bladder.The symptoms seem to improve when I drink more.Is that the answer.drink more?",
    "doctor_response": "HelloI appreciate your concernsome times burning and stinging sensation may occur with concentrated urineSince all your urine reports came to be normal and your symptoms disappear with intake of adequate water, there are very high possibility that this could be due to passing of highly concentrated urine through urethraIn my opinion you can ask your doctor for urine culture if it has not been done earlierYou should take lots of fluids including fresh fruit juices and lemon waterMaintain good hygienewash your hands with antiseptic soap or solution every time you use wash room.Hope this helps you thanks and regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen tonsils\n\nMy 5 year old son was prescribed 3 days of prednisolone 7.5 ML twice a day for swollen tonsils. He has frequent strep and tonsillitis but this is the first time on a steroid. I m just weighing out the options of giving it to him or not. Most cases show the swelling comes back right after you stop giving the steroid. Thank you,",
    "doctor_response": "you must know steroids have many side effects especially on children however it give agood result in decreasing the swelling in tonsillitis but not favorable to use in tonsillitis the drug of choice in tonsillitis antibiotics (duricefe 250/6 ml every 8 hours) with antipyretic as paracetamol",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for klippel feil syndrome\n\nhi my name is kristy and im 27 i been diagnose with klippel feil about a year in a half ago they said i had it since i was 18 but now it got severely bad im in stage two for nerves in my spine and body and also my neck bone and spine bone im at a lost all i have is therapie and pain killers is there any other way to have releaf from evryday pain and i know its gonna end up killing me as i was born a sick child and allways been sick my whole life please help me with knowldge about klippel feil what to expect how worse is it gonna get and what can i do",
    "doctor_response": "Hi, Sorry that you've been diagnosed with KFS, however, you should know that KFS as its own entity rarely causes early death and people can and do lead relatively normal lives albeit with restrictions due to their musculoskeletal abnormalities and sometimes other organ system involvement. In terms of the pain I'm going to give you this link to look into because I've sent this information now to several of my patients who are in chronic pain for other reasons and it is an interesting concept that may develop into something you could benefit from since you're so young. It's called the Orphaneet/Anesthesia global project. Also, KFS can be approached surgically in such cases if pain and immobility of the neck or if scoliosis became so painful or obstructive to daily activities that other measures simply don't function. Scoliosis can be corrected if you have that problem and again, you're young so I believe your healing capacity is going to be excellent assuming you don't have any significant comorbid metabolic conditions such as diabetes, hypertension, etc. I think that with the right therapy program and support groups by your side you stand actually a much better chance at a very good quality of life that may not be completely full of chronic pain as you might think.  And just so don't think I'm trying to make things sound better than they are... HA!....check this link out on KFS (perhaps you've already seen it...but read way down where it is PROGNOSIS....and lemme know what you think). Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist  Also, did you know about the: Klippel-Feil Syndrome Freedom group which has a FACEBOOK PAGE and support presence on the web? Check it out. If you need more direction or links to anything or have more questions let me know by sending questions. I have a couple of KFS patients in the practice and they are not doing badly at all. Lots of options that I think can give you reason to believe that you're going to be doing better right on up through your 97th birthday!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurrent light-headedness?\n\nPAST YEAR EXPERIENCE LITE HEADEDNESS. HAVE BEEN TO HOSPITAL 3 TIMES. MIR, CAT- SCAN EKG, EEG. CHECKED CORTID ARTERIES, BLOOD FLOW. ALL OK I AM TOLD. REACHING OUT FOR OTHER IDEAS. LOST 20 LBS PER DOC ORDERS. THESE ATTACKS LAST ABOUT 2 MINUTES. LAST 1 ABOUT 3 HOURS AGO. 64 yrs old.",
    "doctor_response": "Well come to HCMThank for asking,I really appreciate your concern, if the concern tests are unremarkable as long as the headache are concern then it could be migraine and nothing could be else, it is a kind of depression and anxiety causes the symptoms and it may aggravates the migraine, such symptoms pretty common in female, I would suggest Tab Carbamazepine 200 mg once in day,  hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for heart palpitations\n\ni am taking proprananol for heart palpations,and they are not working being woken up with very fast heart beat and it makes me feel shakey,and tired even after taking beteabloker takes a long time to calm down,and repeats at any time of day also makes me feel sick,cardiology said it was physiological tachyacardia,do i need to go back to see them symtoms are getting worse",
    "doctor_response": "Hello, Yes, you need to see your doctor again, and I prefer to do some more tests like thyroid function test and complete blood picture. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fatigue, abdominal pain and loss of appetite with higher ALT level?\n\nHi. My wife had a blood test and it told her that her ALT levels were 118 which is understand as high. She had the blood test because she s been having these symptoms for a couple weeks: intense fatigue, abdominal pain, lower appetite, feeling of being full after eating, and headaches. Sometimes the fatigue is so strong she can t stand up for more than a few minutes. We are seeing a doctor next week, but wanting some answers. We are scared that it is cancer. What else could it be? Thank you for your time.",
    "doctor_response": "Hi Thank you for posting your query in HCM. I had gone through your question I understand your concerns. The symptoms you display are consistent with liver cell injury.In liver problems fatigue is the most common and characteristic symptom. ALT and AST are the liver enzymes , most sensitive indicators of liver pathology. ALT is more or equal to AST in acute hepatocellular disorders like fatty liver, heaptitis, drug induced toxicity, cirrhosis. I would suggest you to consult gastroenterologist near you for further evaluation and managementHope i have answered your question if you have further questions i will be happy to help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cough due to COPD\n\nGood Morning Dr. Grief. My husband David (DOB 5/29/43) has COPD, Parkinsons, RA,Fibromyalgia, and has been given for a cough which he has almost all the time heratussin AC. I ve just gotten on the computer and found that someone with COPD should not take this medication. His doctor has him on the nebulizer three times a day (he was on twice) and this cough medication. He is VERY prone to pnemonia or broncitis (?) whic is part of COPD. He was told this by the doctor. He s been in the hospital three-four times with severe pnemonia. No x-ray taken to see if there is any thing in the lungs, he coughs horribly and cannot bring anything up very often. What can I do to help. Thank you.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. In my opinion, you should first get done chest x ray to rule out pneumonia. If chest x ray is normal then no need to worry for pneumonia. For COPD patients, mucolytic and expectorant drugs are more useful than cough suppressant like heratussin AC.So give him N acetyl cystine (NAC) along with terbutaline, guafenesin and bromhexin.Hope I have solved your query. I will be happy to help you further. Wishing good health to your husband . Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for constant chest pains\n\nMy son is 8 years old and has been experiencing chest pain for 1 month not related to exercise. His ecg shows inverted twaves - 1 doctor said this is ok,the other was concerned. Is this growing pains or should I take him to a paediatrician. Thanks Karen",
    "doctor_response": "Hi.... Inverted T waves are very common in paediatric age group and are called Juvenile T wave pattern. This is usually seen in Leads V1 to V3.If the child is not having any loss of consciousness or palpitations or acute shortness of breath and breathlessness you need not worry about them at all.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in hip and leg while exercising?\n\nHi Doctor , I am Jeevan from India and working late nights & to be fit I tried to do some exercise in gym, but from last month I have started pain in my right leg but i continued exercising and now I have pain in my heap also(but its not more). but doctor said may be it can lead to disk problem. I am scared Can you please help & let me know how bad it is?",
    "doctor_response": "Hi, First, get the x-ray of lower back and MRI of the lower back. Yes, it could be a disc problem and can not be taken lightly.avoid weight lifting, prolong standing as much as possible. Do hot fomentation, apply any topical gel, take a muscle relaxant. In maximum cases, it will resolve by doing above measures along with physiotherapy but some times it can be serious issues. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jaideep Gaver, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for weakness, tiredness and low BP\n\nhello!my name is Danish,i had used to do masturbation for 9 years,but i have left since one year,now my age is 24,but i feel extreme weakness,sudden tiredness,stomach problems,extreme low blood pressure(60/40 today).please help me in my treatment,i need extrem help.plz plz plz........",
    "doctor_response": "Hi Danishmasturbation is a very normal physiological thing which at your age is bit from frequently done so first of all stop thinking that masturbation has caused your weakness and low bp. secondly the age group of your is highly lack healthy adequate and timely meals. i suggest you to improve your eating habits first, take a bit of more salt than usual drink plenty of water and avoid smoking if you do and let me know after a week of following my advise. ill be happy to hear from you.Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for vomiting and diarrhea in kid\n\nmy 4 yr old son has been vomiting and has diarreha and has 100.9 fever he has been doing this since midnight lastnight he cant keep anything down he takes a drink and within a minute or less he throws it right up he vomit is muscy and foamy?? what do i do?",
    "doctor_response": "he might be having acute gastroenteritis, give ors 200ml after each loose stools and syrup ondensetron 2mg twice. daily and paracetamol when the temperature is more than 100*f. make sure that your kid is well hydrated, if not admit in hospital for further management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is fatty liver related to diarrhea? Diagnosed with diffusive fatty liver. Colonoscopy normal. Cause?\n\nIs fatty liver relataed with diarhhoea? I have a fatty liver history and recently diagonised with diffusive fatty liver. Prior to that I was suffering from diarhoea which recurred twice which is why I went to the gastroenterologist . He conducted colonoscopy and stool test whose results were within normal. I used to drink occasionally once a week till my stomach problems started in May... Can anybody suggest whether liver disease can cause diarhoeea?..",
    "doctor_response": "liver disease should not cause diarrhea. Fatty liver in particular does not cause diarrhea. If your gallbladder was removed surgically, this can be a cause of diarrhea. There are so many other things that can cause diarrhea, including things in your diet that you can't digest well anymore (example: dairy products). Gluten intolerance. Parasites (diagnosed by stool samples). There is an entity called Microscopic colitis, which can only be diagnosed by biopsies of the colon - make sure your gastroenterologist took random biopsies of the colon. Some medications can cause diarrhea as a side effect. Drinking alcohol can also cause diarrhea.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are prednisone and flovent causing headaches in an asthma patient?\n\nHi. My daughter is 15 and has asthma. She recently had an overnight stay in the hospital for an attack. She had a week s treatment of Prednisone and has started on Flovent. For the past 5 days, she has been complaining of headaches. Could this be a side effect or something else? Nevermind. I see this costs money. I ll just call her doctor.",
    "doctor_response": "HI, thanks for using healthcare magicHeadache is a possible side effect of prednisone so it is possible that it is related to this.If the headaches are severe or associated with any other concerning symptoms then she should see her doctor for assessment.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Sundown Syndrome in a 66 year old female\n\nMy 66yr old mother has sundown syndrome. It started about 8 months ago. She is very delusional (hiding on the floor, covering vents and tv). She is convinced that her someone is out to get her and is going to kill her. She calls people all during the night to get them to stay up and talk to her all night. She has lost over 40 pounds during this period. Her doctor sent her for a blood test (she took) and referred her to a psychiatrist (she refused). She pays her bills and appears fine during the day. However, her stories are totally irrational and she can not be reasoned with. What can I do?",
    "doctor_response": "DearWe understand your concernsI went through your details. From the given symptoms, the 66 year old lady is showing typical paranoid schizophrenia symptoms and therefore she needs psychiatric treatment. Please convince her using any means. There must be someone whom she trusts. Take their help.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes black colored stool in infant?\n\n8 month old infant (eating prunes, taking pro-biotics and formula enriched w/DHA, eating other veggies and pears) started having dark black/green/tar-like poops. Is this normal? Also, once baby started eating solids, he will only take two bottles all day (5 oz) in a 10 hr period - we are giving him water, but he s only taking maybe total 3 oz. Is this ok, or should we reduce solids from 3 meals to 2?",
    "doctor_response": "Hi, this could be infection in intestine, do a stool routine microscopy test, stool for occult blood. Based on above reports, child will probably need Antibiotics. Revert back with exact weight of child. I hope this has helped you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will reducing the dosage of Fluxanol for psychoaffective disorder cause repercussions?\n\nHi! I have been medicated for Sychoaffective disorder for almost 30 years. I am taking Fluanxol 10 mgs. My question is that I have been reducing my dosis from 20 mgs. To 10 mgs. In a period of 15 years. I would like to reduce to 5 mgs. But I am not sure if it is not going to affect me. What are the possibilities I take 5 mgs. Every three weeks and not have some consequences? Thanks, Mirtha",
    "doctor_response": "Hi,.That you have to try and see.In case you feel disturbance you can always take an additional dosage.But if you are assymptomatic now and didnt have episodes since many years its worth a try.But if you have history of frequent recurrences it may not be a wise choiceRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for loose fingernails and toenails with clear discharge when undergoing chemotherapy?\n\nI am presently on chemo - taxol weekly and have had some nail discoloration which is a side effect. But now I have several fingernails and toenails that are loose and oozing a clear liquid  Is there anything I can do to help.  I am at risk for infections so I want to help prevent that if possible",
    "doctor_response": "nail infections and nail peeling off is expected complication with the chemo u r receiving. apply t bact ointment  and get daily dressing. if symptos are intolerable, it is better to delay the chemo, till ur symptoms subside.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having incessant pain in lower abdomen. Looking for a good gastroenterologist in Hyderabad. Help?\n\nHi, I am looking for a good gastroenterologist in Hyderabad for my wife who is having incessant pain in the lower abdomen and after consulting and changing few doctors apart from doing multiple tests I am still unable to decide what to do next. Some say there is lot of water in the small intestine, some say there is intestinal obstruction and some say that the small intestine is entangled. She has lost lot of weight in the due course, has become weak and is not physically and mental doing good. Looking for some good suggestion to help my wife get rid of this problem. Appreciate a quick response. Thank you.",
    "doctor_response": "Hi ! Your wife is possibly having some kind of chronic problem of the intestines. Does she have any low grade fever specially in the evenings ? Does any of her family members or with whom they are friendly recieved any long term treatment of a few months for chronic cough or any other chronic problem ? I would suggest you to talk to your family physician to investigate her in the lines of tuberculosis of intestines which is  a common extra pulmonary tubercular infection in India. even though all the investigations may look to be normal, intestinal tuberculosis may exist, and only a therapeutic trial may prove it to be the case. However, you must take the advice of your family physician before deciding on any such treatment. A barium meal follow through or a CECT abdomen may also be done to know the status of intestines and other organs of the abdomen. Your family physician can suggest you name of a gastroenterologist at Hyderabad. Hope this will help you out in dealing with your wife's condition. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is multiple myeloma curable?\n\nhello    my wife 57yr old suffering multipalmailoma since 30 months as diagonosed. she had put on thalidomide 110 mg cap od along with dexamethasine 8mg but patient could not respond adn platlat gone down to80000per cumm with five days of taking the medicene .it stoped and after one month lenolidamide10mg along with decmax 20mg started but patient not again responded and stopped .now tab melphalm 5mg bd along with tab prednisolone 40mg bd 4day in amonth started since last four month but patient feel very uncomfertable .i have seen on net that there is no solution of the multipalmama and not curable life span on threat 24month to 64 month. please advise .",
    "doctor_response": "Greetings. I appreciate your concern regarding your wive's illness. With the current available treatment Multiple myeloma is incurable.  But survival can still be prolonged as newer drugs are coming in the market. Moreover if she is physically fit, she can undergo marrow transplant which will again increase her survival. You can discuss the option of transplant or using newer drugs with your physician. regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any advise for GGTP reading of 138?\n\nHi, I got an LFT done and all the items are in range, except GGTP. My reading for that is 138.. I got the test done on Jan 1, after a night in which I had a few glasses of wine. Prior to that, I was taking paracetmol for 2 weeks as I had fight fever, headaches, etc. I got an ultrasound done, in which they said there is no liver damage. The doctors have asked me not to drink for several months and take Heptral 400mg. Please advise.",
    "doctor_response": "Hi,Thanks for posting your query.I am Dr.Ratnakar and I am pleased to assist you.Your doctor has told you the right thing.The one single step to get your GGTP to baseline level is to quit drinking alcohol.Good thing is that the rest of the values are within normal limits which indicate that your liver has not suffered serious damage due to alcohol intake.I hope that answers your question.Regards,Dr.Ratnakar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Premature greying on beard, have boils on cheeks with the costliest of brands. Effective treatment?\n\nI am 40 and my beard is already grey. I tried all most everything available in the market, Henna, Herbal powders or even Ammonia free but everything is allergic to me. My friends, relatives and Colleagues use various cheap brands with good results but Even the costliest brands make me have Skin boils on the cheeks. I look old in my friends company. Any treatment for people like me",
    "doctor_response": "Hi, Welcome to HCM Coloring with dye is very common but it is allergy to the similar chemical dye hebal or dye always do a skin allergy test if allergic donot use product it may be costly or cheap. Any allergy and infection should be treated accordingly. It is more important to have healthy skin and I would advise kindly consult a good Dermatologist to if there is any other condition like diabetes nned to be ruled out.,for beard a clean shave may be a option. Take up healthy life style do exrcise daily and healthy and balanced diet will improve skin a lot good and do not use alcohol,take 7 hours of sound sleep. Good Luck to you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do swollen testicles while suffering from liver cirrhosis need immediate medical attention?\n\nMy brother has cirrhosis of the liver due to due to diabetes. He has a meld score of 11. He is on insulin. He discovered his testicles are swollen to the size of a grapefruit tonight. Should he go straight to the er or wait to see his primary physician on Monday. He has no pain.",
    "doctor_response": "Hi, This type of pain and location is suggestive of epididymitis which is inflammation of part of the testicle and this not uncommon in males especially in young age. This is usually treated with 10 days of antibiotics, usually ciprofloxacin and there are no permanent consequences. Masturbation and intercourse should be avoided till pain persist, if possible since I may prolong inflammation course. Some more serious conditions such as tumors or torsion are rare but in doubtful cases, you should do Doppler ultrasound or scintigraphy. In this particular case, I don\u2019t think this is required and this should improve on antibiotic therapy. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ivan R. Rommstein, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for ADHD and anxiety in a child\n\nHello my child suffers from being able to focus on task and tends to forget school work and takes very long to start his school work, he also suffer a little from anxiety. What type of medicine would be best for him. He is not hyperactive but tends to wonder a bit.",
    "doctor_response": "Dear, Welcome to HCMWe understand your concernsI went through your details. First of all you did not mention the age of your child. At childhood, hyperactivity and fidgety is the basis of ADHD diagnosis. When age progresses, hyperactivity comes down and attention deficit become predominant. Anxiety is also common in childhood which usually is not associated with ADHD.I suggest, instead of asking for medicines here or online, please consult a psychologist in person. Let the psychologist assess the mental health of your child to determine whether the child has ADHD or not. Most of the ADHDs do not need medicines. Household and school training methodologies provide relief from the symptoms. There is no need to worry. Even if the child has ADHD, it is 100% curable.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Happy New Year. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for neurofibromatosis and tumors of the spinal cord\n\nMy son has neurofibromatosis and many tumors of the spinal cord. One is C2 and was operated on, but not eliminated, but merely made the place not pressed brain. Is there anything that could stop the growth of tumors. How should I live, so as not to harm.",
    "doctor_response": "Hi, I am Dr.Bruno.  I have read your question with care and understand your concerns. Let me try to help you Question : Is there anything that could stop the growth of tumors. How should I live, so as not to harm.Answer : Unless the Tumour is pressing on some vital structures, there is no need to operate it. Most of such tumours grow very slowly. So Please don't worry nowHope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a persistent itchy lump despite using anti-bacterial cream?\n\ni was recently in Atlanta Georgia for the weekend, while there i was bitten by something under my left breast which left a red mark bout the size of a quarter in a oblong shape. it itches and feels  like a bump, i used neosperon, alcohol, anti-bacteria cream on it. Its been 5 days and its still there still itching, but it has gotten a little smaller",
    "doctor_response": "Hello dearWarm welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This indicates local inflammation following bite .*  As per the narration , it requires certain antibiotics and anti inflammatory    medications for faster recovery and preventing secondary bacterial     infection .*  Better insight can be possible with photo pic of the same as an     attachment  if  possible and no objection .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes feeling of hot temperature in my penis?\n\ni am 33y, ht 1.65m, wgt 49  i am having problem with my reproduction organ.from lab test there is no sperm to count therefore i am asosperma and i have been to hosptal ui in nigeria and went via operation but no good result. i am married,i do feel temperature hot in my pennis, how can i have a biological child of my own.email_  YYYY@YYYY",
    "doctor_response": "Hi, It is quite normal and does not indicates any specific disease condition. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Continuous productive cough, severe congestion, chest pain while deep breathing. Remedy?\n\nIm 13 and I have been coughing for 3-4 days now its like a wet cough and mucus I have bad allergies but there allright now but I have no throat problems like my throat does not hurt its cold out and my ear kinda hurts but not that bad and my cough is constant and I have bad congestion like my chest hurts reall bad when I breath in deepand when I cough!!!!!! But I just started musinex yesterday one tablet a day",
    "doctor_response": "YOU HAVE NT WRITTEN WHICH MEDICINES ARE YOU TAKING FOR ALLERGIES IF YOU ARE HAVING SYMPTOMPS ACCORDNG TO THAT I RECOMMEND TO TAKE TAB SINGULAR 10 MG BD TAB FEXOFENADINE 120 MG OD SYP VENTROLIN 1/2 TSF BD SYP TSSEX 1/2 TSF BD add liquid antacid you can take for 2 wk",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is giggling of an infant while sleeping a concern?\n\nMy 15 month old son has had a fever for a few days now. Long story short after we took him To the e.r they said it is just a fever and nothing serious to worry about. Well he woke up laughing hysterically earlier. I have heard him giggle or laugh in his sleep before. But this time it was enough to actually wake him up. Since then he has been randomly laughing even when there is nothing to laugh about. Should i be worried that something may be wrong? Or is this just him being silly ?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.This is called Febrile delirium. It is very common during the height of fever in some kids. However, it does not cause any neurological damage to the brain.It is a self-limiting problem so, do not worry about it.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sumanth Amperayani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do blisters on penis indicate?\n\nI have been masterbating three times a day with no lube for years now. Recently I have been experiencing blisters on the head of my penis as well as on my penis. I currently am experience something under my shaft which look like extra skin and blisters I assume. The last two days I have applied head and neosprin and it s been healing. What causes this?",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: Dryness/friction can cause thisExplanation: Dryness with friction can cause erosions after masturbation. So, it is better to use lubricant while masturbating(Safe one) to prevent this.                   So, be smooth and keep the area moist to avoid this. YOu can continue applying ointment for time being.  Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough and wheezing with history of asthma\n\nI have been suffering with allergies and sinus problems since I was a child. I am now a 58 year old woman who suffers from relapses about every three months with severe coughing and wheezing. The wheezing seems to be more in the upper chest and throat area. I have been treating for chronic asthma and chronic bronchitis for approximately 5 years. I have seen my primary physician and 2 pulmonologist. One who diagnosed me with the chronic asthma and the other diagnosed me with acid reflux. Gave me a script for 30 protonix. I went to the ER yesterday morning for severe coughing and wheezing again. Gave my history to the doctor and he recommended that I now see a cardiologist to make sure my symptoms are not related to congestive heart failure. This desease runs heavy on my moms side. Her mother, my mother, two of her brothers, and my brother passed away from heart attacks and congestive heart failure. I want to consult with a cardiologist, but are there different kinds, and what particular cardiologist should I see.",
    "doctor_response": "Hello dear,The symptoms as mentioned in your post can be attributed to Acute exacerbation of asthma, secondary to the respiratory tract infection.Management consists of:1. A course of antibiotics based on culture & sensitivity reports.2. Asthalin+ Seroflo inhaler- provide symptomatic relief by causing broncho-dilation (dilating the smaller airway passages, relieving the obstruction & increasing airflow to lungs). So, it can be used during an acute attack.3. Montelukast preparations- used as a maintenance therapy to relieve symptoms of asthma.4. Antihistamines like Cetrizine can also be used to provide symptomatic relief.5. Also make sure that you are well protected from exposure to cold, dust or other allergens.As your treating Doctor has advised you to consult a Cardiologist, kindly meet him to rule out any Cardiovascular cause for your symptoms.You can consult any Cardiologist for this matter.Wishing a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swelling and pain on lips, face twitching. Benadryl reduces swelling. Is this allergy?\n\nFor a few weeks now my lip recently started swelling up with pain, twitching of the face on the side where it is swollen, and tingling . The pain sometimes is unbearable. And only benedryl seems to bring down the swelling. Is this an allergic reaction or maybe something else. This has been occurring atleast 2 to 3 times a week for about 3 weeks now.",
    "doctor_response": "Hello, You are having angioedema attacks of the lips that could be due to several reasons: 1. drug-induced: have you recently taken any drug after which this started or are you on continuous medication like blood pressure lowering drugs such as ramipril, enalapril etc 2. is there a history of tummy pain or facial swelling? - then you would extensive evaluation if all these occur together 3. or this could be an allergic episode - are there any existing allergies such as dust mite, pollens, insects etc? 4. the last option is idiopathic - which responds very well to long acting antihistamines such as cetirizine 10mg or fexofenadine 180mg; benadryl is good but a short acting and weaker antihistamine. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for having poor ejaculation with low sperm count?\n\nsir i am mazhar from india and i am having erection problems from last couple of months..my sperm count is also very low..i am able to ejaculate by masturbation but the erection is not right for intercourse..also even if i try it i loose ercetion immediately..i love my wife and i dont want to loose her..she thinks that i dont like so i have this problem..please help me..i consulted a doctor and he prescribed be ashwamed capsules and winofit gold..but its in vain..",
    "doctor_response": "HelloThanks for query.You have problem of Erectile Dysfunction which is psychogenic in origin .Following measure will help you to boost up your confidence and getting good erection.and delayejaculation.1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning.2) Take high protein diet rich in vegetables and fruits and Vitamin A,C,D,E.and Zinc3)Take anti oxidants like Almonds 5-6 everyday..4) Avoid alcohol and smoking..Taking Sildenafil (Viagra)as on demand will help to get good hard sustainable erectionand to have enjoyable sex.Dr.Patil..You need",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the pain in right abdomen be due to problem in gall bladder?\n\nFor the past four days I have felt pain on a level 6 out of 10 on the right side of my back half way between shoulder and waist. At first I thought it was an aggravation of a one-year-old bruised rib in the same spot and medicated with ibuprofen. However, there is also a lesser but growing pain developing in my front right abdomen just under the lower rib. Could this be a gal bladder issue? If so, can it be dangerous to wait eight more hours to be seen by personal physician?",
    "doctor_response": "Hi,Thanks for posting your query.I am Dr.R.K and I am pleased to assist you.Pain in the right upper quadrant of the abdomen could be due to gallbladder related issues, liver related issues or peptic ulcer disease.You can get an ultrasound scan of the abdomen done to see if it is due to gallbladder issue.If you can tolerate the pain, you can wait for 8 hours. But I would advise you to go to ER for evaluation.I hope that answers your question.Regards,Dr.R.K.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lumps in head with headache\n\nI fell an hour ago and hit my head on the cement.  it did not knock me out but i was dazed.  My pupils are equal, i have a huge lump to the back of my head and a little bit of a headache.  I still feel a little dazed but no blurry vision and no nausea yet.  I feel as if I am somewhat panicked and was considering taking something to calm my nerves but not sure what would be safe.",
    "doctor_response": "Hi! Good morning. I am Dr Shareef answering your query. Even though you need to be assessed clinically in person by a doctor in your place, from the history it seems to me that you have developed a hematoma (localised collection of blood) in the back of your head under your scalp. If you leave alone, I would advise you to go to the nearest ER and get yourself assessed. If you are having companion, then they should observe you for any change in the level of your consciousness, or change in behaviour, or any increase in the size of hematoma, and in that case, they shoud immediately take you to the nearest ER in your region. For the present, you could go for an anti inflammatory along with a proton pump inhibitor drug for a symptomatic relief, and put a pressure bandage over the hematoma. In uncomplicated cases, this hematoma should subsde of its own in about two weeks time.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can DPT vaccine cause neutropenia?\n\nHi doctor, My son is 15 years. He got his DTaP vaccine two weeks ago and had CBC 20 days later. All came well except neutrophil count, which came back as 800 and total WBC 2500.\u00a0We are going to repeat the test tomorrow. Can the vaccine be the cause for the neutropenia? And if so, how long will it take to recover?",
    "doctor_response": "Hi. Based on your query, my opinion is as follows: If the count continues to be low compared to previous report before vaccination then bone marrow aspiration or biopsy needs to be done. Revert back after the investigations to a hematologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the white blister on a toddler s lip, due to chewing it or a cold sore?\n\nMy 2 year old has a white blister on the right side of his bottom lip. It s just inside his lip. I can only see it when his mouth is open. The surrounding area is red. How do I know if it s a cold sore or if he s been chewing on his lip? How can I make it better? He woke up early this morning and pointed to his lip and said, What happened?",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns.As per your complain a white blister inside the mouth of your son that has a red surrounding area seems like an Apthous ulcer or canker sore or a traumatic ulcer caused by chewing or biting the lip and does not seems like Cold sore as cold sores appear as fluid filled blisters commonly present over the lips..I would suggest you to consult a Pedodontist or an Oral Physician and get evaluated and in case if it is an apthous ulcer he can advise him to apply a numbing gel but to be precise to apply only over the ulcer..You can be advised to apply a steroid ointment to reduce inflammation..Vitamin B complex in syrup form can be given..Tylenol can be advised to reduced pain..Applying cold compress or ice over it can relieve..Give him soft diet , more of fluids..Avoid spicy and citrus foods..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does gas affect the baby during second trimester of pregnancy?\n\nHello doctor, I am in my 5th month of pregnancy. I try my level best to avoid outside food, however today I had a veg sandwich outside. And now I am feeling gases moving around in my stomach. Will this harm my baby? I am really worried. Could you please help.",
    "doctor_response": "Hello, Having excessive gas in the abdomen is not going to harm the baby in any way. It can cause discomfort to you. You can have some ginger juice to decrease the discomfort. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Rakhi Tayal, OBGYN",
    "dialogue_context": ""
  },
  {
    "patient_message": "Scan showed straightening of cervical sine, osteo discal bulges touching the spinal cord. What treatment should be taken?\n\nMY WIFE HAD A SCAN AND THE REPORTS SAYS STRAIGHTENING OF THE CERVICAL SPINE WITH OSTEO DISCAL BULGES IN C2/3 TO C6/7. THE MOST SIGNIFICANT LEVEL IS C5/6 WHERE THERE IS QUITE A LARGE OSTEO DISCAL BULGE TOUCHING THE SPINAL CORG AND CAUSING BILATERAL FORAMINAL STENOSIS . OSTEO DISCAL BULGE AT C4/5 CAUSES RIGHT FORMINAL NARROWING. SLIGHT OSTEO DISCAL AT C2/3, C3/4 AND C6/7 ARE ALSO SEEN BUT WITHOUT FORMINAL STENOSIS.....SHOULD I BE REALLY WORRIED ESPECIALLY ABOUT LARGE BULGE TOUCHING SPINAL CORD AND WHAT TREATMENT CAN SHE EXPECT",
    "doctor_response": "The points you mentioned abour your wife is more of imaging findings. The imaging findings should always be correlated with her symptoms and the clinical findings on examination. The mri shows compression of nerve roots coming from neck to upperlimbs and also compression of spinal cord in neck. Intial managenent requires rest to the neck usinf collar and limitations of the daily activities.  Pain killers may be required depending on severity. Physiotherapy and rest to the neck are key to improvement. Patients who do not respond to these may require surgeey to neck depending on the patient symptoms and clinical findings.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes migraine headache followed by dizziness and shortness of breath?\n\nI am experiencing a weird combination of symptoms right now that I have never had. I went to take what I had been planning on just a short nap within a few hours of waking up due to having one of the worst migraines I have ever experienced. I ended up sleeping for several hours. When I woke up, the headache was a great deal less, so I decided to take the dog for a short walk to the gas station. While in the store I had a short wave of dizziness but felt fine within a minute or so. About 2 blocks into my 4 block return home, I started having a hard time breathing. It felt as if I could not expel the used air from my lungs all the way and that I was able to pull in less and less air with each breath. I made it home, forced myself to drink a few cups of water and sat down. I started feeling extremely weak. The headache returned with triple the force before I had laid down. I could barely hold my head up, lifting my arms was nearly impossible and my legs felt like the muscles were spasming to the beat of my pulse. My neck felt like it was swelling, stiffening to stone and as if it were breaking at the base of my head. The dog was looking at me and crying at me, still has not left my side. As I am laying down, I keep hearing sounds that I know are not there and I have caught myself answering a couple questions that no one had asked and that I cannot remember even thinking about. This is not normal behavior for me. Although I have not been able to keep solid food down for at least 5 days, I have been making sure I have been calories and nutrients using liquid options. As of this moment, I still have a nasty headache and I m sweating in my apartment that reads 60\u00b0 and my skin feels cold to me. The hospital in town does nothing when I go in there and the get me out the door as quickly as they can when they realize I don t have insurance.",
    "doctor_response": "Hello, I passed carefully through your question and would explain that your symptoms could be related to an infection or a metabolic disorder. For this reason, I would recommend consulting with your attending physician for a physical exam and some tests: - a resting ECG - complete blood count, PCR, ESR for inflammation - blood electrolytes - thyroid hormone levels. Further tests may be needed to investigate for the possible causes (including a brain MRI study). In the meantime, I would recommend you to closely monitor your body temperature and blood pressure values. You should discuss with your doctor on the above tests. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for sore throat , sinus congestion and fever?\n\nI've been having cold symptoms more than a week. It started like allergies, first started with sore throat and sneezing, then sinus congestion, low grade temperature and now having cough and chest congestion especially at night. I feel less energy to go to work and especially not feelig well from evening to night time. Decreased appetite as well. Should I see my doctor and maybe get atibiotics?",
    "doctor_response": "Hi welcome to the health care magic Yes You have to consult pulmonologoist or nearby doctor for examination ... Bronchitis or early pneumonia like infection  seems most likely here Your work up needs to be Done with Auscultation and chest x ray only if needed Decongestant like phenylephrine and suitable antibiotic prescribed for your condition Vitamin C lozenges useful Avoid smoking Take one tsp ginger juice with honey daily Salt water gargle done three times a day Take care Consult physician for examination",
    "dialogue_context": ""
  },
  {
    "patient_message": "Irregular periods, hair loss, weight gain, fefol-z medication for periods, chances of conceiving ?\n\nHi i am 30 year old working women ,two years back i got married.now i am trying to conceive but my periods are irregular.because of this i am putting on weight and too much hair loss . Doctor suggested me to take Fefol-z tablate along with other tablates to get my periods.daily i workout for 1 hour at least . i want to know the use of taking Fefol-z capsule.Please suggest me i am suffering from all these reasons.",
    "doctor_response": "Hi welcome to H.C.M.Forum. your quiry is what are the uses of fefol z. it is a combination of iron, follic acid, and link. it improves the hb , & blood picture. zink improves immunity. actually for infertility both the partners should consult the gynaecologist or infertility clinic. besides eat more of green leafy vegetables, fruits& juices.cereals for proteins. have sex between 10th to 20th day. male up position. lie down at least 15 minutes after sex. wishing for quick result. best wishes for a beautiful baby.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe body pain\n\nMy whole entire body has felt bruised for the past month. My muscles also ache. Even the back of my head and eyelids feel bruised. One day I couldn t even move in bed. I needed someone s help to roll over. This is extemely painful. Feels as if I ve been hit by a car everyday. My legs, arms, back, abdomen, anywhere you can think of hurts. Any ideas as to what this is?",
    "doctor_response": "hi,thank you for providing brief history of you.Looks like you have too much pain which is not allowing you to move around. Why don't you just see a doctor once who can help you by some medicine for symptomatic relief. Its never bad to take an experts advice.Also, in the mean time you can start some exercises which will help you to a certain level of your pain.Start with simple breathing exercises and steam inhalation. Why i am mentioning this is because when the body is weak it needs more energy and the biggest source of energy for a cellular mechanism is the oxygen. The more the oxygen the more the cellular mechanism to its best.Also, when you do breathing exercises, it will help nourish the cellular levels of muscle tissue which will make you feel better.Slowly try performing simple hand and leg exercises while sitting and lying down on the bed. It will make the muscle mechanism of contraction to function by which the muscular tissue physiology will be activated and the oxygen will help the tissue nourish.Later on you can go for short walks and try doing simple jogs at a constant place.If the bruises are not coming down you need to check with the dermatologist as the skin has to be examined for any particular infection.If you have more questions you can ask me directly anytimeRegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Whitish accumulation after using lipstick or lip gloss\n\nFor quite awhile now, I can\u2019t use lipstick and lip gloss for too long without having a line of white film from the lipstick or lip gloss accumulate on my lips. It is not dry or flaky but just a disgusting looking whitish accumulation that appear on the inside of my lips, the part where my lips are pressed together. This always happen when I\u2019m speaking for awhile in an air conditioned room and it\u2019s darn embarrassing because it\u2019s so unsightly. I always have to rush to the toilet to scratch it off with water and my fingernails!",
    "doctor_response": "Heya kimi. I empathise with your problem. It is not an uncommon one. You have what is called 'angular cheilitis' & it can have many causative factors but in your case, an 'allergy' to components of your lip gloss may be the likely implicated factor. You may want to consider a vitamin B (riboflavin) deficiency & may add a vitamin B supplement to your diet. I know this will sound difficult, but please avoid all lip products at least for the next 2 weeks. Drink lots of water/fluids & hydrate yourself. A neutral lip balm/moisturizer frequently used each 2 hrs or so, will be beneficial. After two weeks, you may wish to employ hypoallergenic lip products of quality available on the market. Trust this information useful to you. Regds & hope the problem resolves soon. Dr Praveen Rodrigues MD Dermatologist, Cosmetologist & venereologist, Bangalore, India",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the long term effects of itching,breathing problem and body spasms?\n\nYesterday I got some sort of bite, most likely a spider. Ten minutes later I started itching all over my body wich soon turned into burning, then found it very dificult to breathe and might have gone into shock. Got to the hospital and had body spasms and nausia. The heart was also affected. I am 74 years old and this happened in Mexico. Are there any long range affects or any need to worry.",
    "doctor_response": "Dear, your symptoms were due to an allergic reaction to the bite of spider, nothing else. since your symptoms got relieved after taking medication which your doctor might have given, you do not need to worry for the long range side effects. usually allergic reactions are transient & go off with a dose of antihistaminic. but, you should be aware of bites from any insects as they can lead to these kind of symptoms again. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat pain in the hip and knee joint?\n\nHi, I had a vascular problem with my arm. The surgeon removed a veian from my leg and did a branchail to ulner bypass to try to savethe arm, ehich later had to be amputated. Now I have quite a bit of pain in the hip and knee joint of that leg, especially when walking. Is there anything that I can do to alleviate the pain and help me with walking?",
    "doctor_response": "Hi Hope this message finds you in good health.I have gone through your complaints and understand your concern.The pain you are having right now may be due to straining of some sort of soft tissues,nerves.Avoid strenous work,take adequate rest.Physiotherapy,analgesics,anti-inflammatory drugs should help.Get an Xray to find out whats wrong. Nothing to worry about.I hope your question has been answered.If you have any follow-up queries,feel free to consult me anytime.Thanks,Take care,God bless.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Imitinef Mercilet cure cancer?\n\nHi I just received a forwarded mail from one of my friends saying \"'Imitinef Mercilet' is a medicine which cures blood cancer. Its available free of cost at \"Adyar Cancer Institute in Chennai\". Please advice, is this a true information or just a false one.",
    "doctor_response": "Hello dear. Imatinib mesylate is a drug which has done wonders for the patients of chronic myeloid leukemia. Of course the survival has prolonged upto years but still cure is not possible but right now it is on if the best drug available for its treatment. Hope that makes you clear.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in the lymph node of the neck in children?\n\nHi. I'm a 17 year old female. My lymph node or gland on the right side of my neck has been swollen for some time. I've been getting so sick recently and it goes away and just comes right back. I get SOO hot in the middle of the night and sometimes im freezing right after. I'm EXHAUSTED all the time now and just want to sleep. I lost my appetite and whenever i breath it feels like i have pressure on my chest so i have to cough. Is this lymphoma? what should i do?",
    "doctor_response": "Hi dear, Based on the symptoms you have mentioned in your question, from the way you describe it, it might sound like lymphoma but i highly doubt it.. The main reason i doubt that is because you said the swelling on the lymph node comes and goes, however people with lymphoma the swelling stays or gets worse as time goes by. The swollen lymph node that you have is possibly just due to infection, an upper respiratory infection. it would be very helpful if you could include in your question the time lapse of your condition so i could suggest you treatment options you can follow. I also suspect the reason for your difficulty breathing, feeling hot and sleep problems is due to anxiety, try to calm yourself down and don't worry much..At the moment i suggest you to wait for few more days and see if your symptoms is getting better, if not then visit a Doctor, to evaluate your condition and run the appropriate tests.So don't worry and relax, i'm sure you will be just fine ..Wishing you all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in right side of stomach. Normal scans. Taking paracetmaol, nefapam. Suggestions?\n\nMy 14 year old daughter was admitted to hospital last wk with pain in right side of tummy, scans were taken but everything came back ok also bloods were taken every two hours and that was fine. Due to the painshe was given paracetamol and nefapam and sent home the next day. I was told it could be a cyst on the ovary  maybe lymph nodes around intestine infected but they just weren't sure. Now a week on and she's been double up so back to hospital they felt her tummy and said there's no serious problems. My worry is what do I do if this continues as she is in a lot of pain when this happens",
    "doctor_response": "Hi, it appears that she has an urinary tract infection, or a small stone in the ureter, or may be the iliocaecal tuberculosis.                         So i advise you to consult a gastro enterologist for diagnosis and treatment. You may need to have M.R.I. for confirmation. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headache and abdominal pain in a child?\n\nYES MY 4YROLD GIRL HAS BEEN HAVEING HEADACHES AND STOMACHE PAINS HER THROAT ISRED AND SHE REFUSES TO EAT SHE SAYS IT BURNS AND MAKES HER STOMACH BURN SHE GETS THIS IN WAVES AND HER FEVER GOES UP AND DOWN PLEASE HELP. THEY SAY IT IS DEHYDRATION I WANT O KNOW IS IT STREP THROAT.",
    "doctor_response": "Hi...by what you quote i feel that your kid might be having a viral sore throat or a streptococcal infection. I suggest you see your pediatrician and get a rapid streptococcal antigen test done. If it is positive then she will require antibiotics. if it is negative then it might be viral illness and doesn't require antibiotics at all.Cough and cold are viral 95% of the times in children. For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15mg/kg/dose (max ceiling dose 500mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can hormonal imbalance cause pain in the hands and wrists?\n\nI am 56 yrs.old and appox. 6 weeks ago my hands and wrists have become so very painful/I have been tested for RH,have gone in with my husband to his specialist.He said for the length of time in has built up,the ortho specialist said that this can be caused by homone inbalance. or thyroid issues.I take meds. for both",
    "doctor_response": "Hi, Hormonal imbalances including thyroid dysfunction can lead to a condition called carpel tunnel syndrome (CTS) and can cause wrist pain. As a first line of management you can take analgesics like Acetaminophen or Diclofenac for pain relief. If symptoms persist, better to consult an orthopedics and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Planning pregnancy, ectopic pregnancy 1 year ago, HSG report normal?\n\nHi, I had right ectopic one year back, and we are trying for the baby from last 10 months with no success. I got my HSG done this month. The report says - The uterus is normal in size, shape and position. The right tube is visualised throughout its extent with peritoneal spillage of contrast on this side. The left fallopian tube is visualised through its extent with contained blotch of contrast at fimbrial end and delayed spillage. Could you please tell me the meaning of this report.",
    "doctor_response": "Hello. Thanks for writing to us. The report is suggeswtive of complete and patent fallopian tubes on both the sides. The spillage of tubes is suggestive of their patency. Please do not worry. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Off birth control. Missing periods, not pregnant. Advised to use soy milk and soy nuts. What's wrong?\n\nI recently few months ago got off the birth control pills after being on them for about 8 to 10 years.......I since then I am missing a period...I am not pregnant, have tested and seen the doctor since. Even had an ultrasound to double check. I weigh 112 pounds and am abput 5.5. Doctor suggested to use soy milk as well as soy nuts to see if extra estrogen would help trigger my period. I have told the doctor that I run a lot, and eat healthy, and do not eat a lot of meat, my concern was that I may be too lean to have a period? what could be potential causes for not having a period? anything I could do to trigger a period?",
    "doctor_response": "Hello. Thanks for writing to us. The absence of periods after stopping the birth control pills is a normal finding. The periods will return to normal in few weeks.I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal ,drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is night sweats caused due to olazapine?\n\nI have been taking olazapine for the past couple of years. I have not been diagnosed bipolar or schizophrenia but I do have some bouts of depression and the dosage is 5mg every night. I have really bad night sweats and I am thinking that maybe it is caused by the olazapine and I have also been spilling proteine in my Urine, I have not brout this up with my docotor, but I think its the medication. Give me your thoughts. Gabrielle",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.Olanzapine can cause increased night sweats but it is a very rare adverse drug reaction. There could be many other common causes as well. The fact that the olanzapine is causing it or not will be determined by following the temporal relation of taking the drugand the appearance of side-effect. If it is cause of the drug then the sweats should stop after 2 days of stopping the drug as the drug is completely washed out by then.  that will give you an idea.But from my experience O feel that the culprit is not olanzapine.You may inform your psychiatrist before you experiment with your drug. 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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sudden numbness in eye, cheek and left arm area. History of panic attacks. Any relation ?\n\nHi, i get these sudden numbness in my eye, cheek and left arm area. Can you please advise what it could be related to? I have been suffering from panic attacks from a young age. Could that be the cause? i have not been to the doctor 3 times last month and there is never something wrong with my heart, lungs etc. But having these symptoms of numbness etc is really desturbing.",
    "doctor_response": "Hi, Thank you for posting your query. It is possible that these episodes are related to the panic attacks. However, it is also important to exclude any underlying TIAs (transient ischemic attacks) (lack of blood flow to the brain), as a cause of your symptoms. You can get screened for the risk factors for TIAs such as diabetes, high BP, high cholesterol, etc and consult a neurologist. You could benefit from aspirin tablets. Please get back if you require any additional information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will there be any side effect with long-term use of Clobazam?\n\nHello doctor, My son is 3.5 years old; studying in kindergarten. He has been diagnosed with benign childhood epilepsy. There is an epileptic form discharge of 8 Hz spikes from his right occipital lobe. His MRI and CT scan reports came normal. He feels involuntary movements in his left leg when he is in a conscious state. At times when the epileptic form discharge gets severe, he loses balance and falls down. This tends to happen once in a week. With medication he is fine. We consulted a neurologist and epileptologist. Doctor has prescribed him tablet Topamac 50 mg to be taken twice a day and tablet Lobazam 10 mg for a period of three months. Will there be any side effects with long-term use of tablet Lobazam? I am very concerned. Please guide me.",
    "doctor_response": "Hi. It is good to know that your child's seizures are under control with medication. Tablet Clobazam is mainly used to control acute seizures and used for a short duration. The main drawback with long term use of Clobazam is physical dependence. It is observed that, if the drug is used for a long-term and suddenly withdrawn, it will cause withdrawal seizures along with other symptoms. Kindly discuss regarding this with your neurologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in the hip\n\nwhen i lifted a bucket of water i seem to have got a sprain! in my hip. a lady of 45 years with premenopause sydrome on normal contraceptive progestin estrogen combination for excess bleeding and regulating periods, on fertibex for thyroid. not much pain but pain n sitting and bending. two days. yesterday took proxyvon and masaged with ultragin oint. today doctor told me on phone to take myoril 8 mg and voveron and see. is it ok or should i go to doctor immediately. of course i have been sleeping the whole day feel slightly better",
    "doctor_response": "Hello,I read carefully your query and understand your concern. Your symptoms seem to be related to a muscle strain.I suggest using a muscle relaxant such as Baclofen three times a day. I also suggest using cold compresses for local application. I recommend taking magnesium supplement for muscle relaxation. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cough?\n\nI have RA and have been injecting 7.5 ml once a week followed by leucovorin 5 mg tab 12 hours after methotrexate. I have been suffering from a cough for 3 weeks. My Family Practicianer prescribed medicine for reflux and allergies, since I did not feel sick except the cough. Another week went by and my cough is worse and I am now coughing up some phlem, but not much. So now I am on azithromycin. My blood tests taken a couple of weeks ago all appeared normal except wbc is approaching the level of being low. I have not ran a fever. My question is when should I be concerned that my severe, non stopping cough is due to methotrexate toxity.",
    "doctor_response": "Hello dear, thanks for your question on HCM.I can understand your situation and problem.I advice you consult pulmonologist and get done1. Chest x ray2. CT thorax if needed.3. PFT (pulmonary function test).Since your cough is not improved with treatment and you are developing fever with phlegm (mucus) production, these suggest either of the following.1. Lung infection (pneumonia)2. Methotraxate toxicity3. RA associated pulmonary complications like bronchitis,fibrosis,infiltration etc.So chest x ray, CT thorax (if needed) and PFT are needed to rule out above possible causes.So consult pulmonologist and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I increase the size of my breast at the age of 20 years ?\n\nhi would u plz tell me that my beast has stop growing from my age of 13 because i pressed ice cubes on it in my age of 13 now their size is like a size of 13 years girl i m now 20 years oldplz kindly tell me the solution what can i do m worried.....!!!",
    "doctor_response": "Hi Breasts size will not reduce by pressing ice cubes on them . The growth of the breasts depend on the hormonal changes , breasts generally increase in size during puberty and reach a good size after that. frequent handling of breasts, general weight gain, ocp's can all cause increase in size But if your weight is less or hormonal disturbances, it will fail to grow, in some, familial causes , as in every women in family will have small breasts, such cases we cant do anything Advise you to go for a check up to a Gynecologist and some hormone tests and could be treated accordingly, else padded bra, breast augmentation surgeries are an option.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and pain in the tongue?\n\nI have a major medical mystery which I would like some help with. Here are the vitals: Age 52. Sex: F Weight: 145 Height 5\u00e2??9\u00e2?? BP, quite low even without the propranolol. Cholesterol: 221, HDL high, tri low. Chronic conditions: Pollen allergies, migraine headaches, postmenopausal. Operations: Lipoma removal on back. Endometrial ablation. Laproscopic hysterectomy. Three pregnancies, two live births, vaginal. Medications: Propranolol 60 mg LA bid, for migraine propylaxis Femring, Hrt. Omnaris spray, allergies. Zyrtec, daily, allergies. Benadryl nightly, allergies. Trazadone, sleep and mood, 25 mg nightly. Hydrocodone, prn migraine pain. Vit D, Fish oil. Current problem: Last September, 2009, I developed a weird taste in my mouth, something like dirt, but not quite. An earthy taste. It soon developed into a \u00e2??burning\u00e2?? tongue. The tongue is irritated and \u00e2??burns\u00e2??, worse at night than in the morning. The tip and front edges are the location of the worst of it. My lips sometimes burn as well, on the front inside. I first thought perhaps it was dental, due to the taste, and had my dentist do a total workup. Nothing. Then I thought maybe it was a pharmaceutical cause and talked at length to my pharmacist. We eliminated most everything I take and I got no relief at all. Then I began trying to eliminate possible foods : caffeine, tea, (I don\u00e2??t drink coffee or alcohol, or eat chocolate as they all trigger migraines), eggs, salmon, and never noticed any difference. I saw a second dentist for a second opinion, and he checked my saliva and all other aspects of my mouth and saw nothing unusual. My OBGYN put me on different hrt on the off chance that that was the culprit, nothing. I have done immense research on the internet and find that \u00e2??burning tongue syndrome\u00e2?? shows up among mostly post menopausal women, but nobody seems to have come across a remedy. On the chats that I have seen, people say it sometimes goes away in 5-7 years. By the end of a bad day (some days are not as bad as others) my tongue is painful, swollen to the point of being able to see the teeth imprints on the edges, and my speech can be impaired by my enlarged tongue. HELP! I am desperate. With such a sudden onset it seems like there must be a \u00e2??cause\u00e2?? which could be addressed. Any ideas would be appreciated. My family doc is at her wits end, and does not know who to send me to next. THANK YOU!!",
    "doctor_response": "The symptoms what I relate to in your case is probably due to anxiety and a very stressful life. Many a time antidepressant medication have helped in such cases. Further clinical evaluation would be required at this juncture.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for cerebral cyst?\n\ngood morning. my names james i have been diagnosed with a 53mm cerebral cyst wich they think is arachnoid 2 yrs ago. i didnt do any follow up when i found out because i was in perfect health besides the fall that required the ct scan  . about 6 months ago i had a massive headache wich i couldnt move talk or do anything becuase the pain would increase. i vomited and passed out for 30 hours. then about 2 months ago i randomly collapsed and again vomited and passed out. so i went to the doctors after that an got a mri. they confirmed my cyst grew to 7cm and they also found a venous angioma and hemosiderin from early cavernoma. i just want to know how worried i should be and if i should tell my family. also a little medical backround about family history- 2 of my sisters had surgery to remove cancer cells in there ovaries, my farther and my brother are epileptic my brother was for 10 yrs and stopped taking meds and has been perfect since(10+yrs). can someone give me and idear of what i could be dealing with or some ideas of things i should do.",
    "doctor_response": "Hi, Welcome to HealthCareMagic.com I am Dr.J.Mariano Anto Bruno Mascarenhas. I have gone through your query with diligence and would like you to know that I am here to help you.You need to consult your neurosurgeon at the earliestPlease do not delay Hope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in HealthCareMagic at  Best Wishes for Speedy Recovery Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stinging pain in chest and muscle pain?\n\nI have a stinging pain in my chest. I think it's a muscle pull, but I don't have some of the other symptoms I've read about. I'm female 46 years old. No history of heart problems. I'm overweight but not obese. I'm active, bp is ok, cholesterol as well.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Cardiac chest pain can present with normal blood pressure and cholesterol. You are having perimenopausal age and having obesity also. So you are at risk of heart diseases. So we should first rule out heart diseases for your symptoms. So get done ecg and 2d echo. If both these are normal then no need to worry for heart diseases. Do these things for better symptomatic relief in musculoskeletal pain. Avoid movements causing pain. Avoid bad postures in sleep. Avoid heavyweight lifting and strenuous exercise. Take painkiller like ibuprofen. Apply warm water pad on affected areas. Don't worry, you will be alright with all these but first rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain in back post pregnancy?\n\nage 30 height 5foot 2 weight approx 9stone 7lbs gave birth 11 weeks ago have had very bad cold and flu for over a week - started with runny nose, headache and sore throat - then sore throat, vomiting, coughing. saw a doctor and he gave me tablets for the sickness - cyclizine. now have sore stitch like pain in left side and back...",
    "doctor_response": "Hello,Thank you for writing your query to HCM,I would like to suggest you to take total rest during pregnancy.Its normal to have this issue during this time.It depends on you that how you face that because every woman having some issues like back pain, vomiting constant etc.So, You are one of them who having issue with back pain.So, no need to worry too much here and just take rest.If problem still there than concern physician soon because he/she will check you physically so they will have enough idea for medicine even.Hope you will better soon and my instruction may helpful to you.Thanks & Regards,Dr. Gaurav Prajapati",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes feeling of something stuck in throat during pregnancy?\n\nI believed I had tonsillitis, but I ve been on antibotics for 4 days 3 times a day, but now something is going on in my chest, it hurts like there is something stuck and my throat is not better what so ever, I m pregnant and I don t want to over react, but I also want to make sure I m taking care of myself and baby",
    "doctor_response": "these features are suggestive of tonsillitis and there can be a secondary chest infection so there is a foreign no body sensation I think",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hypothyroidism, exhausted, heart feels sore, anxious. Opinion?\n\nI lost my husband in 2011 & it seems the Grieving process never ends.....I have Hypothyroidism & am always exhausted, but when emotional crisis hit my heart feels sore as if it will break....I assume it is nerves,but wish I could talk with a knowledgeable source....so I'm 88 and old age ain't for sissies, but the whole thing makes me very anxious.....I guess I just need some TLC....would like your opinion on Heartsore.....txs......laurelle T.  YYYY@YYYY",
    "doctor_response": "Hi, Thanks for coming to HCMI can feel the pain you are going through since 2011Exhaustion and heartsore can be symptoms of uncontrolled hypothyoridism and complicated / unresolved griefFirst thing to do is to do a thyroid hormone level (T3, T4, TSH) checked, if they are not normal, then the symptoms for which you are worried for are because of hypothyoridism. Then consult an endocrinologistHypothyoridism is a risk factor for having such symptoms in response to stress (emotional crisis you are referring to)In addition, being in regular with with a psychotherapist or interacting within people of your age etc will help recovery",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had chesty cough, on and off running nose, had laryngitis. On augmentin. Allergy medicines?\n\nHi , My Name is carole My son is 20 month old . He had a chesty cough about 3 weeks ago ( and was prescribed augmentin antibiotics for 10 days) with an on-off runny nose for about 2 month now . 4 Days after we stopped the augmentin , the cough came back again , everyday louder than the day before . a week ago he had laryngitis , the cough got worse , it s been 2 days he has a fever and his nose is blocked . His father is asthmatic , the GP put him on allergy medications now. what to do ?",
    "doctor_response": "these are allergics dont overuse antibiotics you can take antiallergics off andon takemontair fx (combination of montelucast and fexofenadine once or twice a day syp ventrolin 1 tsf bd syp tossex 1 tsf bd apply neosporin h eye ointment in nose bd put sea water 2 drops in each nose night can use this without side effects for cure i advise you to go for allergy tests and slit therapy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any way to avoid pregnancy having had unprotected intercourse?\n\nhi im ankita i had sex with my boyfriend today and i am unsure wheathr ill turn pregnant or not.my boyfriend jus inserted 1/2\" inches of his dick inside n i pulled it out ... will i turn pregnant and what are the ways to avoid it .. ?how will i know that im pregnant .. i dont want to be pregnant .. is there any way of avoiding it right away .. ?",
    "doctor_response": "Hi, I think if there was no ejaculation or preejaculation, then it is not possible to get pregnant.  However if you are not sure of that, you can take some emergency contraceptive within 72 hours.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing pain on the right side of the rib cage\n\nIm experiencing pain in my right side under my rib cage it is swollen and i haven't done anything active to have a broken rib and if i put any type of pressure on it or when cough i have a sharp shooting pain. I'm also experienceing nausea and vomiting and a slight fever. Could it be my bladder?",
    "doctor_response": "HelloThanks for the queryIt can be either your gall bladder or liver which could be causing the pain. However local tenderness strongly goes against these, to know for sure you will have to get an X ray chest Anterior-posterior view and an USG abdomen and pelvis. Please visit your GP for local examination and further management. Tab Aceclofenac is a good painkiller in these types of painI hope I was of helpRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent pain in chest after an injury?\n\nMy 12 yr old daughter got hit in the chest by her younger sister s knee a couple days ago.She seems to be ok except she says it still hurts in the same spot she has no bruising and you can touch it,had her take some ibuprofen should I take her in or just wait a couple more days she has been able to do normal activity.",
    "doctor_response": "pain at tge site may be due to trauma to the muscle or minor fracture at ribs. both these are self healing. if there is no difficulty in respiration than ibuprofen alone is satisfactory. so wait and watch.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can premature ejaculation in less than a minute during foreplay be treated?\n\nHello sir i am 29 years old currently in bangalore , i am in love with a girl(whom i am about to marry in couple of months)we had sex 3- 5 times and i couldn t last for more than 1 minute, she is not satisfied that i can see that even she says she is ok, i have read many articles of premature ejaculation symptoms are the same. I am about to marry her but i am in a feeling where i may not make her happy. Is there a way where i can get out of this. And i am very shy kind of person to discuss this with others or donno how to approach anyone with this. Please suggest.",
    "doctor_response": "Hello,Anxiety is the main problem for premature ejaculation. Also, check for sugar levels and testosterone levels. Avoid alcohol and smoking. Eat green leafy vegetables helpful. After erection intermittent intercourse with squeezing, the technique may useful. Need counseling by sex therapist and psychiatrist helpful. Drugs like SSRI is useful in premature ejaculation. Please consult your sex therapist for further evaluation and treatment.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Penchila Prasad Kandikattu",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I get pregnant if condom broke off during intercourse after period?\n\nthe condom broke while he was in the process of entering me. My clit got wet and i am not sure if its the latex fluid in the condom or the pre ej. It was our first time and after the breakage we didnt do it. My periods ended 3 days back. .wij i be pregnant.",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. There is chance of the pregnancy as condom was broken. Preccum may enter in to the vagina and it contain sufficient sperm concentration that can cause pregnancy. If you had sex in the fertile phase of periods, then only there is a chance of pregnancy. I would suggest to wait for your periods. If period is delayed by 8 to 10 days then go for urine pregnancy test and or blood HCG to confirm the pregnancy. If you will be pregnant then you can still terminate intrauterine pregnancy by abortion pill under the supervision of gynecologist. Meanwhile avoid stress, take healthy diet, drink plenty of water and do regular exercise.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "I had an echocardiogram when I was 7 1/2 months pregnant 18 months ago (after a heart murmur was detected). The results showed a minor abnormality but I could continue with my pregnancy and delived naturally. I was followed up a year later. The echo had shown a right atrial mass and thickening of the wall. I was sent for a further echo (1 year after the first) which the sonographer said showed my heart was normal. The cardio dept have said that the mass has greatly reduced and they are less concerned. However they were surprised about the results as they thought it was a structural defect. In addition, they have no clue what this mass could be. I am scheduled for a transoesphegal echo in a few weeks to see if there is any residue. I am petrified what this could mean. Will this mass grow back?",
    "doctor_response": "Hello, Your symptoms could be related to a blood clot or a tumour. Anyway, both these conditions have no regression. Anyway, I agree with your doctors that a transesophageal cardiac ultrasound would give much more information on the nature of this lesion. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dengue rash, erythematous itchy, fever settled, loose motions not containing blood. How long will it take to settle?\n\nDangue rash, erythematous itchy, developed on 5th day of illness on trunk, followed by extremities and then palms and soles on 7th day with settlement of fever and improvement of general condition. But rash is ichy and not allowing to sleep and loose motions grade 4 to 5, not containing blood or mucus, not associated with tnesmus, developed on 6th day of illness are still present.today is my 8th day of illness, how long rash and diarrhea will take to settle?",
    "doctor_response": "Ho diarrhoea will settle within one week to 10 days according to presence of dengue antibodies.wheraes the rash depands upon the treatment used.normal dengue rash can be cired by 1530 days wheareas dengue haemorrage fever rash may present upto months",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the following semen analysis report suggest?\n\nMy husband age is 32, his sperm count is 8million, 40%active motility, 10% sluggish, 50% non motility, pus cells : 4-6 hpf. Doctor suggested oligocare tabs daily twice for 3months. My age is 29 doctor did a scan and told that everything is alright. Will there be increase in sperm count by taking these tabs. Please let me know as we are not interested in going to any treatments like IUI or so...",
    "doctor_response": "Hello,We cannot conclude anything from one semen analysis report. We need two reports from two different labs. This report is oligozoospermia. The count is low through his motility is good. Here nothing is mentioned about the morphology, which is another important feature of analysis which should be more than four percent. He needs evaluation because there are many causes for oligozoospermia. A clinical evaluation to check for the testes size and varicocele and check his male hormones to know where the problem exactly is and then treat the condition. But then all-male medications are to be used for three months because that\u2019s the time taken for production of sperms. So with this count, if you want to get pregnant, you should go for intrauterine insemination. So that best of the sperms are taken discarding impurities and dead sperms and directly place in the uterus. This method definitely increases the chances of pregnancy.Hope I have answered your query. Let me know if I can assist you further.Regards,       Dr. Avanti Sathineedi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain, bruising and swelling under the feet in a child?\n\nmy 6 year old daughter has pain, brusing,redness, and swelling on the bottom of her feet... she can t even walk. she didn t fall. she just woke up with the pain yesterday morning and then today it was bruised and swollen. what could this be? should i take her to the er?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.By what you say I feel that it could be 1. Henoch Schonlein Purpura2. Spontaneous bruising due to a bleeding disorder.I suggest you take her to the nearest emergency room.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sumanth Amperayani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Rosavel 5 and Irovel 150 right medication for super cardio?\n\nMy age is 47 years. Male. Physical fitness is OK. Ht 5.8 wt. 89kgs broad shoulders. Border case of BP 80/140. Having Lotenzyl AT 1 a day and now suggested to have Olmark20 1 in the evening.I do super-cardio every alternative day. I have not felt any thing physically. He had prescribed Rosavel 5 and Irovel 150  1time and 2times respectively. I want to know wheather medication is correct. Pl Advice.",
    "doctor_response": "All the other meds are OK.  However 1),olmark contains olmesartan,  while 2) irovel  contains irbesartan ,  which are same group medication and both used for blood pressure and according to the best of my knowledge should be 1 or 2 and not both,  as there is no added benefit and hence  not  justified.  Regards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which body gel can suitably reduce Raynaud's phenomenon ?\n\nprescribe body gel to reduce rayanads?",
    "doctor_response": "hi sarita rayanaud can aggravate by many factor. u need to avoid some factor -avoid cold weather -avoid cold contact -stress -spicy food -short temper nature good moisturizer cream will help you wear warm cloths",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of potential pregnancy?\n\nHi.I have a question about a possible pregnancy. My boyfriend and I had an argument and I had protected sex with my ex around the first or second week of December 2010. Definitely before the 8th... Not sure if it might have ripped or anything else.My period came December 13th...as normal. It was a normal 7 day period. My boyfriend and I were able to fix things and we had sex twice on Christmas Day, December 27th, and December 31st.Each time, my boyfriend ejaculated inside of me. As of last weekend (December 31st-January 2nd), I have not been feeling well. This has continued on into this week. I am due to come on my period again next week; however, I believe that there is an extremely high chance that I may be pregnant. If so, is there a possibility that it could be my ex-boyfriends?  or is there a definite chance that it is my boyfriend's child?- Concerned Individual",
    "doctor_response": "Hello dear,I understand your concern.In my opinion it cannot be due to your ex boyfriend.Because you got the period after intercourse with ex boy.That intercourse is no way related now to this cycle.So if at all you conceive this time it is due to the present partner with whom you participated in the end of December.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe pain in the big toe\n\nHi yesterday I got up and took a walk. Then I got this pain in my left big toe I could hardly tramp on my foot it was it I couldn t walk. I rest whole day trying to move my toe but it had a pricking pain as well as today and tonight it has moved to my ancle nd my leg has a burning vibrating pain I try to do some exercise with my foot bt still the pain there",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.Most common cause of pain in big toe is osteoarthritis of joints of big toe. Treatment of it is analgesic such as ibuprofen for pain relief, glucosamine and rest to joint. Second commonest cause of pain is gout as it involve great toe maximum. Treatment of it is analgesic such as ibuprofen, fabuxostat and hot fomentation. It will be better to clinical examination by Orthopedician. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain, stiffness and tingling sensation in the toe be treated?\n\ni think my toe it broken. At soccer practice yesterday, I can\u2019t remember if I got stepped on or went into a tackle, but i know somethings wrong with my big toe. When i started driving home, my big toe got all tingly, it hurt t apply pressure, and there was bruising. I got home and iced it for 20min, and have had pain ever since. I woke up at 1:45am this morning because my toe has just been in constant pain (it almost feels like a constant growing pain). my symptoms are: bruising, tingliness(just yesterday), constant pain, stiffness, there was a burning sensation about an hour ago, tenderness, swelling, and hurts to put weight on jt. I don\u2019t want to go to the doctor if there is nothing that they can do about it, and spend the unnecessary money. The problem is i have soccer games/tournaments this weekend and for the next couple of weekends and i have college coaches coming to watch me. I dont care what they can do, i just want to be healed in the fastest way possible whether jt be a cast, boot or whatever. thank you",
    "doctor_response": "Hi, Considering your symptoms you may be having a fracture in great toe bones. I would like to advise X-ray of the involved foot anteroposterior and oblique views to confirm the diagnosis. Treatment would be buddy strapping of great toe and second toe with a boot cast. Splinting may be needed for  21 days. Tab Diclofenac sodium twice a day for pain relief can be taken. Ice application and limb elevation help reducing swelling. Visit orthopaedic surgeon for detailed clinical Examination is recommended. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Jayesh Vaza, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in lower abdominal area, no nausea, flu like feeling. Any ideas ?\n\nHello, I ve been experiencing a pain in my lower abdominal area. It started yesterday in the morning, at it has not gotten worst. As a matter of fact, it mostly feels better, but sometimes it does hurt again. The pain has not traveled to the right side of my lower abdominal area, and when I apply pressure on this area it does not hurt more. I have not experienced nausea , but I do feel like I have a little bit of a flue.",
    "doctor_response": "Hello! Thank you for the query. The most common reason of such pain is urinary tract infection. Frequent urinating and burning while urinating can appear. Some other possible reasons are diverticulitis (left lower abdominal area), ovarian cyst, uterine infection. It is advisable for you to have abdominal ultrasound, full blood work, urine analysis and transvaginal ultrasound. Hope this will help. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i switch to lexapro from Effexor XR?\n\nI have been taking Effexor XR for about a month now. I am at 75mg. I do not feel as anxiety ridden, however my heart is racing and I feel so edgy and am very sleepy about two hours after taking it. I have used Lexapro in the past and do not remember feeling this way. Can I switch to Lexapro without weaning from effexor? Will it make me sick or are they pretty much the same drug?  Thx Krystal",
    "doctor_response": "hithanks for choosing healthcaremagicEffexor and Lexapro are pretty much same drug. right now you are at minimum dose of effexor. Dose can be increased upto 300mg per day. with high dose u will definitely get better response. Just discuss all ur problem with ur psychiatrist, he would increase the dose.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high platelet count?\n\nHi took my 9 year old sons blood count in which the platelid count is supposed to be high it reads 461 when the range is supposed to be 150-450 and his doctor has recommended a repeat of the test m so worried hope it is nothing serious and can be treated how ever would like your advise",
    "doctor_response": "High level of platelet count is insignificant finding in absence of any other abnormal reading. Thrombocytopenia( low platelet count) is what you should be worried about. Child or even an adult can have a very high platelet count as an incidental finding. It does not suggest any disease in the child.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe soreness and pain in the knee\n\nHi I am a runner. I have little or no pain in my knee once warmed up and running. My knee is sorest when I move from sitting to standing especially getting out of the car or up from my desk. It hurts most when I use the other foot to remove my shoe by standing on the back of it and pulling my leg up. I have a consistent but not terrible pain in the back of my knee and around to the top of my shin. But I can still run a pretty casual 30km without it hurting while in action. I m wondering if there is any harm in continuing to run on this knee. Please say there is no harm.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have severe soreness and pain in the knee. Well there can be many reasons for symptoms you mention in query like damaged Menisci , tendinitis , osteoarthritis , gout , bursitis or chondromalacia . I would suggest you to consult orthopedic surgeon for proper examination . Doctor may order certain tests like CT scan , MRI and physical examination . Doctor may prescribe muscle relaxant along with anti inflammatory and recommend physical therapy . Doctor may also recommend surgery in severe damage or to repair the meniscus . For now apply warm compresses , take proper rest , do not massage  and take ibuprofen or acetaminophen for pain . You can also apply anti inflammatory and analgesic cream like voletra . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and cracking noise in the fingers while bending?\n\nSome of the fingers on my right hand make a noise when bending, then snap back to straight as if there were rubber bands inside. It is a little painful and it s worse when my hands have been in active. Is this something I should see my doctor about?",
    "doctor_response": "Hello,The crackling sound what you hear when you move your fingers is normal sound which happens when the tendons move over bones. Now the second part of what you have said that your fingers feel like a rubber band and get stuck may occur when you have a condition called trigger finger. In this condition, the fingers make a snapping sound and get stuck and you are unable to move them. I suggest you wait for a few weeks and then if your fingers get stuck then consult a specialist. Hope I have answered your query. Let me know if I can assist you further.Regards,      Dr. Santosh S Jeevannavar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there an alternative to surgery for bile dust cancer?\n\nMy father had diagnoses with bile dust cancer,surgeon want him for operation, it will take about 7hrs.he thinks survival rate is low and refused to operate. What I am going ti do and I do not know about his diet. Your advice is highly appreciated.Mya mya",
    "doctor_response": "early stage bile duct cancer, operation is the treatment of choice. if surgeon is advising that he may be sure of completely removing that. hence  go ahead with surgery. ur doc rightly said, survival is low in these cancers. there is no specific diet.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with bipolar disorder, depression. Hear voices in head. Need help\n\nI need a psyciatrist to talk to i have been diagnosed with bipolar manic depresion disorder and I hear violent voices my medication does help but I cant get to a dr in the clinic i live to far away no one to tke me any more and I am affraid that i will have another break down and end up back in the mental hospital again..can u help me? i dont have any credit cards though???",
    "doctor_response": "Hi there ~I understand your concerns and hearing voices in your head is a sign of psychosis which is common in bipolar mania.  I also think that you are having frequent switches from mania to depression and vice versa.  Exercising, yoga and pranayama along with dhyana may help. I also think that keeping a journal and writing your thought when you feel like it will also help.  If you do not have access to a clinic calling the number 1-800-273-TALK might be useful.   However, make sure you call and make and appointment with your doctor.I hope this helps.  Take care and have a lovely day!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a Sodium Chloride injection advisable for infertility treatment?\n\nMy wife had hormones imbalance , we are getting treatment in china.foctor daignos some problem in overies size, due to which my wife isn t getting pregnant, she suggested some injection, written on paper in Chinese. I have translated which gave result sodium choloride would you please let me know the purpose of this injection. If I translate it right",
    "doctor_response": "Hello,There is no evidence regarding the use of sodium chloride in pregnancy. I suppose the Chinese script wrongly interpreted. Maybe your doctor meant your wife has polycystic ovaries which need some medication to help her get pregnant. So please ask your doctor details about the condition and treatment she is undergoing.Hope I have answered your query. Let me know if I can assist you further.Regards,       Dr. Avanti Sathineedi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should ibuprophen be taken for swollen leg?\n\nI think I somehow Hirt my knee, but I am not sure how I did. My vastus lateris is swollen on my right knee, and so is the rest of my right leg as well as my ankle. If I stand for long periods, then the soles and heels of my feet really begin to hurt on both feet, but worse on my right foot. My right leg has been swollen for about a month now, and I have been taking ibuprophen. It seems like it may be getting better slowly. Should I see a dr.?",
    "doctor_response": "Hi, In my opinion, you have already delayed treatment. Consult your doctor ASAP since this persistent swelling could be a serious condition like deep vein thrombosis. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause discomfort and pain in the groin area after an inguinal hernia repair surgery?\n\nI\u2019ve been searching for an answer even with my own Doctor but he seems to believe it\u2019s over exertion. I had double inguinal hernia repair with mesh 6 weeks ago. I live an active lifestyle and weight training is a large part of my life. I was cleared to begin working out again by week 3, but didn\u2019t start until week 4 going extremely light. I noticed when I did certain excercises, like leg press which I only did once so far, I\u2019d get the feeling like I was \u201ckicked\u201d down there. It\u2019d hurt most of the night but once I slept it completely went away. I\u2019ve experienced this feeling 4 superset times since returning to the gym. It\u2019s not an immediate or sharp pain, is a very slow, onset discomfort that gets very, very uncomfortable. I\u2019m tying to understand what it can be. Is a spermatic chord being pinched? I can\u2019t imagine I damaged the surgery because call me crazy but wouldn\u2019t I feel pain consistently and very badly? Or is it simply that the wound still hasn\u2019t completely healed and any time my core is even slightly engaged it presses the mesh and cause pain",
    "doctor_response": "Hi, It can happen after hernia surgery. It might be due to small nerve injuries during the procedure. Nothing much to worry and it will settle by itself generally. As the first line of management, you can take analgesics like Tramadol for pain relief. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of anti depressant medication?\n\nMy dad is 75 and his dr put him on citaloptram HBO and since he started it two weeks ago he us almost a zombie. Past history- stroke 2 yes sago with some balancing issues and 2 small Tia s in last 2 months. Also has him on two blood pressure medications. Will the anti depressant medication have this effect on him. He wasn t like this before",
    "doctor_response": "HiI had gone through your qury.It is not due to antidepressant.Antidepressants do not have such problem.It may arise either due to drug drug interaction when two or more medicines has been given together or may be due to stoke itself.It stroke or TIA there are chances for interruption of blood supply and gait problem.Elevated blood pressure may also causes imbalance and walking difficulties.So consult your neurologist for better assistance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i get pregnant if having rubella IgG level of 1.75?\n\ni am 36 yr old. i had one miscarriage before 3 months. at present my rubella igg level is 1.75 and my rubella igm is .30 and cmv igg is 1.87 and cmv igm is .47 and all toxo igg igm , hsv igg igm is negative. now i want to be pregnant please suggest me should i go for pregnancy. my weight is 65 kg..",
    "doctor_response": "Hi , How are you doing ? Let me start by clarifying a misunderstanding. TORCH infection , results of which you have mentioned, never causes recurrent abortions. Just forget these infections. If they come once, their antibody level will be there in body, it will stay life long . IgG means infection was there sometime in past & IgM means fresh infection now. In your result IgG level is always higher than IgM, so it mean you had infection in past. NONE OF THESE INFECTIONS WILL AFFECT YOU, I ASSURE YOU.You can try pregnancy any day. Most common cause of pregnancy is blighted ovum or genetic cause. This is like accident, any healthy lady can have it any day. You cannot diagnose it or treat it. Have Blood sugar ( Fasting & Postprandial) , Thyroid profile , both can be treated Just pray well & give it your bestHope I have been of use to you, do write back if any more queriesAll the bestDr.Balakrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for the sore gum having white patch that was caused due to an infection after a tooth extraction?\n\nI had a bottom thooth extraction two weeks ago a couple days after i ended up getting an infection on the extraction site went back to dentist they cleaned the area and put antibiotics in the extracted thooth,that night the area started hurting again and couple days after ended up getting ulcers on my tonge they were so painful couldent eat or sleep rang doctors had appointment for next day in meanwhile i used clorcydle mouthwash .went doctors they gave me antibiotics and adviced i continue using clorcydle mouthwash.after a week al my ulsers went and my extracted thooth is so much better.i have noticed a white spot on my gum near the extracted thooth when touched it hurts a bit .and also my bottom back thooth and upper back thooth when they touch and pressed hard it hurts .wanted to know is it normal ?",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. Actually sometimes the gums become pale and they look white,  till then there is nothing problematic,  but as you are mentioning that it is hurting also in that condition it can be possible that it is an abscess which is occurring because of the infection in the adjacent tooth which is also hurting. You should visit a good dentist, for the problem. Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to make my bend penis straight?\n\nhi iam zafer when my penis hard and tied it is not straight it turns left basically i am a right hand masturbation at regular bases since approximately 14 years back still i am doing same now i am 29 years old and i am not married now, can i easily doing sex after when i get married",
    "doctor_response": "Hello, The penis is never straight in erection position. It usually has curvature when getting erect for easy penetration into the vagina. So don't worry about that. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain with burning sensations?\n\nHI doctor, i have pain in my right lower back in the area where the right leg bone joins the illeal spine (pelvis bone)..The pain is like a burning sensation & it radites from top to lower part of right leg..I have history of prostate infection in 2007 later told nothing to worry by urologist.",
    "doctor_response": "Dear sir,Greetings!!Thank you for posting your query at healthcaremagic.comAs per your symptom it could be sciatica.  Sciatica symptoms occur when the large sciatic nerve is irritated.Here is my advice to you:-Exercise for abdominal muscle and back muscleUse of hot water fermentationStretching exercise of Hamstring muscle.See a physiotherapist who will suggest you the exercise after assesing you which will improve muscle flexibility, strength and promotes healing.If the pain is still unbareble see a orthopeadician/ Neurologist who would advice you to get an MRI and suggest you further treatment protocol.If you need any further information please revert back to me. I will be happy to assist you.With best wishesTehzib Saiyed (PT)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is short term memory loss due to dementia?\n\nWhen someone has pretty bad short term memory loss but are still enjoying life, socializing, driving safely and happy in their own home is there any reason to have it diagnosed?  My mum is almost 80, definitely has short term memory loss and we are keeping an eye on it but don't want her to have the sadness that a diagnosis of dementia would cause,  If she gets worse we plan to have a live in caregiver.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Your mother is already 80. She should be happy living with you and with her own family. Therefore please do not try to assign a caregiver even though she has dementia. Short term memory loss in this case could naturally due to old age and degeneration of brain cells. Don't read too much into the loss of memory. As long as she is happy and enjoying life and socializing and driving safely, then I strongly believe that the case is not dementia at all. Consult your doctor if need be.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take Eltroxin for tuberculosis?\n\nAGR 37 HIGHT 5'' WEIGHT 47 KG TAKEN ATT FOR 9TH MONTH IN 2002 FOR ABD TUBERCULOSIS.IAM TAKING ALTROXIN.TWO TIMES LEPROSCOPY DONE IN PATNA $ AIIMS(shift).(R)TUBE- FREE SPILL. (L)TUBE-MINIMAL SPILLAGE.",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: Eltroxin is for hypothyroidism not for TuberculosisExplanation: Eltroxin/Thyroxine is prescribed for hypothyroidism and not for tuberculosis. I think you have confused yourself with this. Please do not take medications on your own, visit a doctor for help. ALl the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be done for loss of appetite of a 2 year old?\n\nHello doctor my son is 2yrs 5 months. ..since 10 days he has stopped eating food completely....he use to have 4 meals a day but now nothing at all...we consulted our peadtrician he gave meds to clean his stomach nd suppositories to cure constipation. .but no improvement till now...he does not eat his favorite food either...he is playful nd active..no lethargic actions...but just refuses to eat pls advice wat shud I do. Thanks",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.I take this opportunity to tell you certain scientific facts and relieve your distress - 1. An active is a well kid even if he is not eating well. 2. Development of a kid is as important as or I would say even more important than growth alone.3. As the kids grow their interest in food decreases and interest in play activities increases so that they eat small quantity and run away to play. As parents we need to be more patient and feed than less quantity but more aliquots per day.4. This age rather than the quantity of the food I suggest you concentrate more on the number of times you feed her and also make whatever you feed his calorie dense by adding good amount of ghee to it.5. I suggest you not to use appetite stimulants on long run as they may cause drowsiness.PLEASE DO NOT GIVE ANY SO CALLED APPETITE STIMULANTS AS THEY ARE NOT VERY SCIENTIFICALLY PROVEN AND THEY HAVE THE SIDE EFFECT OF EXCESSIVE DROWSINESS.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does intake of Methylprednisolone help in treating gum infection?\n\nHello, I had a retreat on a root canal and after five days my gum feels very tender and slightly swollen, my dentist prescribed Methylprednisolone, but after reading the side effects of one saying this medication may cause you to be unable to fight an infection, I am worried about taking this medication.  Is this a good drug to take for an infected tooth/gum?",
    "doctor_response": "Hi..Welcome to HCM..As per your complain as you have a re-treatment Root canal on your tooth and even after that you have tenderness and swelling over the gum then it means that you still have infection in the tooth that might be lingering or there is a recurring infection..In this case although methylprednisolone that is a steroid can help in reducing swelling but it will not fight with the infection and will cause recurring flaring up on infection..I would suggest you to consult your dentist or an Endodontist and get evaluated and a course of antibiotics and a combination of anti inflammatory painkiller and serratiopeptidase will help in reducing infection and swelling..But in case if still there are repeated flaring up of infection then extraction of tooth is the only option..Hope this helps..Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause redness and itching in hands followed with dizziness?\n\nsometimes my hands and feet get so itchy and then turn red the swell very very big and I feel dizzy, Just now i took off my shoes and they immediately turned red started to swell and itched for such a long time my feet itch so bad alot and my blood sugar is great all the time please help me figure out what this might be.",
    "doctor_response": "Hi. Thanks for posting your concern at HCMYou seem to be suffering from Hives OR urticariaI would definately advice that you visit a dermatologist for a proper assessment of the rash.Urticaria OR hives can occur due to various causes like(to name a few) infections(bacterial , viral, fungal), drugs, certain foods, cold temperature, in response to strong emotions, exercise, pressure (prolonged standing, sitting), in autoimmune disorders like SLE, RA etc. A few cases have no underlying cause and are known as idiopathic urticaria.I would advice you to get few basic lab tests like Hemogram, stool for ova/cyst, Urine routine, Chest Xray.An oral antihistamine like Fexofenadine OR Loratadine once or twice daily for a week would be suitable. They are non-sedating and wont affect your alertness level.a topical soothing lotion like calamine would help you symptomatically.If your Urticaria still does'nt get better you might require a short course of oral steroids.take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "7 months baby have a severe cough with throwing up some white doughy like puke\n\nmy baby is 7months old coughing badly he just threw up white doughy like puke.what could it be?",
    "doctor_response": "Dear Lidya, Welcome to HealthcareMagic. Babies around this age are prone frequently to colds and coughs so, not to worry so much about the puking as it is the bodies reflex to bring out unwanted material. As adults we can easily bring out the phlegm accumalted in our lungs but babies tend to swllow and his body is naturally reacting by throwing out the phlegm which is a good sign. I advise you to kindly meet your paediatrician and take the medication he prescribes also it's better if you let your baby take smaller meals in shorter intervals than give him a large meal at a time which might further cause him discomfort, wishing your baby quick recovery and good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could lump in breast indicate IBC?\n\nI woke up with an unexplainable bruise on my breast. Dark purple, about the size of the round part of a pop can. A marble size lump in the middle. Was not there when I went to bed. No way that it s due to trauma and I sleep alone. Is this something that could be a sign of IBC???",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have benign cyst, fibroadenoma or cancer. However with short time history chances of cancer is low. You should go for breast mammography and fine needle aspiration cytology or core biopsy. 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have PCOD, irregular periods. Trying to get pregnant. Help\n\nhi sir /madam , my name is dhivyasriram one year past in marriage life but still i didn t get pregnant i consult near to lady doctor she said to check scan and test for mu husband and me and after that she said pod and gave medicine for three month to the irregular period after three month for me period become normal but i cannot became pregnant and for my husband their said low count and try after regular period but plse sir/ madam help me and tell me wt to do and tell me possible days for pregnant and my number is 0000",
    "doctor_response": "Hello Dhivya sriram, You are suffering from PCOD and irregular periods, so your doctor gave you medication for regularisation of periods for 3 months. Now you will need medication for ovulation induction and follicular study to see growth of the eggs and to tell you timing for having intercourse, so that chances for pregnancy can be increased. Also, if you are overweight, try to reduce weight. At the same time, you said, husband has low count, so, I will like to know the details of how low is the count. Accordingly, he will need treatment. So, i would suggest you to consult a fertility specialist. Hope this information is useful to you. Good luck. Dr. Mrs. Sumeet Baheti",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will ear infection cause headaches, red throat and also unspecific tooth pain?\n\nI was diagnosed with an ear infection on July 10, and completed 10 days of Augmentin. I improved, but now, 5 days later i have headaches, much mucus nose and throat, sore, red throat, but also unspecific tooth pain. Could I have a sinus and or ear infection back, or can tooth pain actually cause the other ? Don't know whether to go back to my Dr. or see a dentist (heven't in years).",
    "doctor_response": "tooth pain is other problem and is not related to ear or sinus infection. while headache, sore throat and mucus is due to sinusitis rather than ear infection. so first go back to your doctor before going to dentist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lumps\n\nmy 6 year old complained of a bugbite on his head last week.  i noticed today that he has a visible lump on his head.  It doesnt appear to be a bite and it seems bigger than it was last week. he doesnt remember hitting it and he says it doesnt hurt.  should i be overly concerned?",
    "doctor_response": "Hi.Yes , you should be concerned as the cause and effect is not known.I would advise you to consult a Doctor as he sees more of such atypical problems. IT may be a problem in a child of just 6 years. We have to confirm this is not infected and may need a treatment accordingly.Having a hematoma is definitely a possibility. But ruling out other problems is very important.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is undergoing nerve conduction test safe during pregnancy?\n\nMy waif is pregnant in 8the month and she is complaining of lift back pain since 5 years there was no treatment given unlace analgesic knew physician advised to do nerve condect test my question is their any said affect in pregnant for this test",
    "doctor_response": "Well, she is pregnant with a heavy load that shifts her balance to a forward position. Back pain is common during pregnancy and studies are seldom performed since pregnancy alters the normal body physiology. Physical therapy is frequently indicated during pregnancy. Tests are performed if pain persist after 6-12 weeks post partum or more according to the clinical findings. I would not perform nerve conduction studies since I believe that will be a waste of time and money with no clear benefits",
    "dialogue_context": ""
  },
  {
    "patient_message": "What casues jaw pain along with swelling in ear?\n\nI was moving my jaw from side to side and felt and heard a loud pop. It was quite painful. Now the inside of my ear canal is swollen and i m experiening a dull pain. This is the fifth day i ve been experiencing the pain and it doesn t seem to be getting better. No blood is coming out. It continues to swell however. I can still hear out of it. Is this serious?",
    "doctor_response": "Hi,It seems that you might be having acute Otitis externa i.e. infection in external ear giving rise painful enlarged sub mandibular lymph nodes.Go for one antibiotic and anti-inflammatory medicine course for3-5 days.Put antibiotic ear drops.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying for conception. Advised to take zentel and azithral for worm infestation and infection. Will it affect my chances of pregnancy?\n\nHie doctor, My husband n me had relation during my fertile days n we are planning for baby.My doc had suggested to take tab zentel & tab azithral course for a day to remove worms & infection any on 20 day frm the first day of my last menses.I was just worried as to will this not hinder in this process if conception n implantation occurs.Plz reply",
    "doctor_response": "Hi, Welcome to HCM, Thanks for trusting Healthcaremagic and posting your query. In my opinion there is no justification behind taking Zentel and Azithral tablets on 20th day of menstrual period. For any infection and infestation these should be given prior to ovulation. Azithral and Zentel comes under pregnancy category (US FDA) B and C, thus should be avoided after conception. Hope you found my response to your query informative and helpful. If you have further concerns in this regard, you can  submit those with Healthcaremagic as well. With good wishes,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does hyper aeration of both lungs from chest x-ray suggest?\n\nI had chest x-ray test last July 13, 2011. The report says both lung fields are hyperaerated with flattening of both hemidiaphragms. The trachea is in the midline. The heart is not enlarged. The pulmonary vessels are within normal limits. Both costophrenic angles are sharp and distinct. the osseous thoracic cage reveals no significant bony abnormality. Conclusions: hyperaeration of both lungs. I m 59, female, never smoke except for 1 to 2 sticks in my whole life. What could be the cause of this? How to reverse this condition? Thank you.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. I have gone through the x ray finding have attached. This x ray picture is suggestive of emphysema. Hyperinflation, hyperaereted lung fields with flattening of diaphragm etc are suggestive of emphysema only. And despite of negative smoking history, emphysema can be seen in old age (age more than 50 years). This is known as senile emphysema. Treatment is based on limitation in lung functions. So first get done PFT (pulmonary function test). PFT will tell you about severity of the functional defect. You may need inhaled bronchodilator (formoterol or salmeterol) and inhaled corticosteroids (ICS) (fluticasone or budesonide). Don't worry, you will be alright with these drugs.. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Extremely low WBC count, very healthy otherwise. Can I donate my kidney?\n\nCurrently I have been told that i have a VERY low WBC - below 1.5.. Doctor suggested I see a hematologist - please note that I do not have very good health insurance. Plus, I have always been very healthy (not even getting flu ). My question is, my sister is in need of a new kidney , would I be considered a candidate for kidney transplant with such a low WBC? Thank you for your help.",
    "doctor_response": "the lower limit of normal wbc count is 4000/cmm & you have only 1500.at first it should be evaluated properly.have you any recent history of fever,drug ingestion.repeat the WBC count,if it is same then consult with a hematologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does triamterene and bisoprolol work together to control blood pressure?\n\nStarted a new med Triamterene 37.5/25mg one in morning and still taking 2 bisoprolol 10mg at night how does the 2 work together? My blood pressure spikes at different times for no reason so she put me on this just wondering if im taking them at proper times and the facts of the two together",
    "doctor_response": "Hi, thanks for using healthcare magicAnti hypertensive medications work in different ways to help lower the blood pressure.Triamterene 37.5/25 is a combination of two diuretics and they would reduce the fluid volume to cause a reduce blood pressure.Bisoprolol is in the beta blocker family of medications. It works by relaxing the blood vessels and slowing the heart rate.They would reduce the blood pressure in different ways. Once you use them consistently at approximately the same time each day, it would be fine.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stress , anxiety and depression\n\nI am a long % year history of morphine ER . Starting 30mg and escalating to 180 mgs daily. Due to 11 reconstructive surgeries over the last 15 years. last 5 years awaiting a right complete knee replacement. It was successful and the added Oxy IR 30mgs 2-3 times a day, for post operative pain it works well. The Morphine ER was planned to be reduced as to it has become non necessary now . In fact is causing diminished breathing issues. it has been reduced by me over the last 2 months to a from 180 mg to even 45 mg. however even that is causing extreme breathing and anxiety stress. I have stopped it the last 4 days completely! i am feeling better , except the with drawl symptoms. extremely lathargic, sinus issues, muscle twitching and severely depressed already and edgy. I go to my pain management tomorrow morning. I need to have and have heard there some standard medications to be used with withdrawl issues non-narcotic preferred. My pain has been managed almost completely at least functional and able to make a good physical recovery as expected. with the Oxycodone IR 15-30mg tabs 3 times or less as needed for pain. do you have any recommendations?",
    "doctor_response": "Hello! From your question I come to understand that you have developed physical dependence to morphine and currently after the cessation of the drug you are experiencing withdrawal symptoms with can be very annoying and disturbing. The ideal way to decrease the incidence of withdrawal symptoms is by gradually tapering the drug before completely stopping it. As you have already stopped taking it, you might have these symptoms only for a couple of days after which you will be feeling normal. One of the most disturbing withdrawal symptom is lack of sleep, which can managed by using short acting benzodiazepines which can be tapered and stopped quickly. This can be done by getting yourself hospitalized ans supervised by a psychiatrist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain, occasional bleeding, abnormal WBC, cannot have sex, had C-section. What is it?\n\nI have a serious issue that s has been going on for 2 years now..I had a cesection in 2010 and ever since then I havse not been right...I have had multiple check ups from my ob/gyn and my gastro ...I have been havin continous abdomen pain..I have off and on bleeding but yet my doctor says he doesn t know why I have had blood work done and my white blood cell count came back abnormal twice but yet the doctor doesn t know why..I have been sick lately can not have intercourse can not work out without passing out and at times I can barely move...I don t know what is going on with me but I feel like its.getting worse everyday I feel like I should be on the mysterydiagnosis show since nobody seems to understand what is going on better yet figure out",
    "doctor_response": "Hello! Thank you for the query. Your symptoms are very characteristic for endometriosis. This condition is caused by appearance uterus cells (so called endometrium) outside the uterus, in your case in abdominal cavity. Such disease can be caused by C-section during which cells from inside the uterus are taken to the abdominal cavity. It gives pelvic pain, pain during intercourse, irregular bleedings and many others. This symptoms very often are getting worse during bleeding time. Endometriosis can also cause adhesions in abdominal cavity what leads to bloats, constipations and many others symptoms of partial intestines obstruction. Diagnostics of endometriosis is quite hard as ultrasound and CT scans can show nothing. The only method that usually visualizes this condition is laparoscopy - some kind of minimal invasive surgery during which the camera is put inside the abdominal cavity. So if you have abdominal ultrasound and abdominal CT performed, the time has come for laparoscopy. Hope this will help. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes muscle spasms in the toes and fingers?\n\nI ve been on Lipitor,Crestor,privastatin,all have given me muscle and joint pain, crestor gave me muscle spasms in toes and fingers. Why would I try lavalo with my history and I have a fatty liver and moderate kidney disease a3 Leeni YYYY@YYYY",
    "doctor_response": "Hello,I agree that you will probably have problems with the lavalo. Your best treatment would be to go on a strict vegan diet and avoid all fried foods. This would be good for your heart, brain and kidneys.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a sore frenulum?\n\nI had unprotected oral sex last night on my girlfriend (I am a female) I am also tongue tied so my tongue is very short and is uncomfortable to stretch it in general (it doesn\u2019t go past my bottom lip).  I woke up this morning and my frenelum was sore and there is a white bump on it, I\u2019m not sure if this is from me stretching my tongue so far or if it\u2019s an std. help would be appreciated.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.It looks like there is inflammation and injury to the frenulum and the white sore is due to a canker sore formation. It can be due to other causes like eating lots of spicy foods, toothbrush injury etc.So my suggestion is to apply Lidocaine gel over it and do warm saline gargles. Take the soft diet and avoid spicy and irritant foods. Take a Vitamin B complex daily. Avoid irritating or stretching it further.Hope I have answered your query. Let me know if I can assist you further.Regards, \u00a0\u00a0\u00a0\u00a0\u00a0Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent tenderness in the right knee and groin after a toe injury?\n\nA patient complains of persistent tenderness in the right knee and groin area. The tenderness started a few weeks after he injured the big toe of his right foot, which became red, swollen, warm, and painful. He says the toe improved without medical attention. The knee and groin tenderness remain. What could the physician identify as the cause of the patient\u2019s knee and groin pain? What is a possible treatment?",
    "doctor_response": "Hello,Due to your toe injury, there's maybe changing of walking gait lead to gives wear and tear effects on your knee and hip joint may give rise to pain in the hip and knee joints. Other possibilities like toe infection may lead to reactive lymphadenopathy of inguinal lymph node cause swelling and pain. Use tablet Ultracet twice a day for five days, take rest for few days. If symptoms not improved, please consult your doctor he will examine and treat you accordingly.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Penchila Prasad Kandikattu",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sneezing and blocked nose in a child\n\nHi, my 7 year old daughter was sneezing heavily about a week ago followed by blocked nose and is now complaining of dizziness, sore tummy and has tiny red spots on her chest. Also has a cough which was treated with puffers about 2 weeks ago. No fever at present but looks fatigued. Any thoughts on what could be the cause? Thanks.",
    "doctor_response": "Hi, the condition explained by you tells that the child has giddiness, pain abdomen, URI few days back and red rashes over the trunk. And the child is fatigued.if you stay in a Dengue endemic zone, get a platelet count asap and consult a physician.Dont give self prescribed anti inflammatory to the child(NSAID).continuously hydrate the child with ORS or any other fluid.Tab levocetrizine and a Nasal drop will help for sneezing and blocked nose.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can back pain be a result of sciatica?\n\nMy question is what type of doctor to see: I have low back pain and sciatica pain down the right leg, then at the same time, both my big toes are numb and pretty bad pain in the second toe on the right foot. I have had this sciatic pain down the left side too, like last week. This week it is in the right side. Now, who do I need to see, an orthopaedic surgeon or neurosurgeon?",
    "doctor_response": "Dear Sir/ Madam,Thank you for posting your query at healthcaremagic.comI suggest you to visit a superspecility hospital, where doctors work in team. You can go to either of one specialty. At first they would adivice to get investigation done like MRI, X-ray or CT Scan.Investigation will help them to understand the severity or worsening nerve damage, or a serious underlying problem.Hope this answer your query.Please feel free to revert back in case you need any further information.With best wishesTehzib",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headache and fluttering sensation in chest?\n\nHi, I am a 40 year old, 200 lb, female. I have been having headaches for the past 3 days. Today I decided to stop any check my blood pressure. The lowest reading I had was 135/89. I have also been having a slight beat or flutter in the middle of my chest. Is this something I should be extremely concerned with or maybe just watch over the next couple of days?",
    "doctor_response": "DearWelcome to HCMWe understand your concernsI went through your details. I think you have stress related anxiety disorder. Stress is the main reason for headache and momentary hypertension. Your decision not to monitor your BP is the right one. Because, the more you measure your BP the more you become obsessive and anxious.  Anxiety disorder is fear related. Whenever your body fears, or becoming anxious, body uses this defense mechanism. This is a natural procedure. You may consult a physician and get your EKG done to be on the safer side.If you still need my assistance in this regard, please use this link.  Please remember to describe the whole problem with full detail.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does sinus venosus ASD need immediate medical attention?\n\nmy daughter has been told she has a possible sinus venosus ASD and are waiting for a cardio appointment to get more answers. the hole is apparently 14mm. Should we be pushing for an immediate appointment and should i worry if she gets normal childrens illnesses in the mean time",
    "doctor_response": "Hi,Nothing to worry. It is not at all an emergency. There is no need of immediate appointment. You need closure of the defect but not on an urgent basis. Intermittent illnesses will be just like normal children, except that if develops a pneumonia it may take a bit longer to get resolved- so keep her away from people with fever, cold and cough. See your doctor if she develops the same symptoms for early treatment of respiratory infections. I also strongly recommend pneumococcal vaccine for her.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam TK, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of tingling in the forearms and hands post a fall ?\n\nSomeone ran into my husband while playing basketball, hitting him in the lower back. He fell and landed on his elbow . He was completely unable to move for a moment after being hit. Both forearms and hands are now tingling . Is this going to go away or is something wrong? A chiropractor friend said he may have shocked his spinal cord .",
    "doctor_response": "Hi there, This could be a case of brachial plexus injury/ulnar nerve injury. In minor cases, if the nerve injury is minimal, it will get better on its own. Is your husband able to move his arms , hands and fingers the same as he was able to do earlier? Any history of weakness of the forearms, hands etc? Any history of sudden onset of sharp shooting pain in the forearms and hands. If the above symptoms are present , I would suggest that you visit a neurologist, who might advise you to get nerve conduction studies or EMG done. I hope your husband feels better soon. Have a nice day :)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why did I suddenly have chest pain with tightness in upper abdominal area?\n\nhi.. about 5 weeks ago i spent an afternoon in hospital because i was having chest pains and felt tightness around the upper adomen and chest area and back. the hospital did xrays and blood tests but every thing was all clear. only they found i had a heart problem on the ecg. i have a leaky valve... already knew that. i take 75 mg of asprin daily.. my question is was it anything to do with my leaky valve? i passed my diploma level 2 in health and social care and carrying on with my level 3 appreniship. i met a good guy we in a relationship.. my life is good... dont want nothing to happen.. it kind of freaks me out...",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. Yes, leaky valve can cause chest pain of sudden onset.So I advice you to consult cardiologist and get done1. 2d echo2. Stress test. 3. Coronary Angiography if needed. Your valve problem might be worsened over time and now it is symptomatic. So get done above mentioned investigation s to rule out valvular heart disease as a cause for your symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rapid pulse rate during normal activities?\n\nI m inquiring re my daughter: She is currently experiencing rapid pulse with normal activities: lying in bed, standing, sitting. This along with sleeplessness for more than 1 month, not sleeping more than an hour each night. She feels anxious when the pulse is fast...91-116. She has a normal pulse rate in the low 70 s. She is a 43 yo female. Also she has had a low grade elevated temperature...99-100.2 per ear scan. She had a recent cellulitis below the right eye on the maxillary area. This was treated by two different antibiotics (oral) and steroid. She was using a topical antibiotic (OTC neomycin) but developed an allergic response which spread to the upper/lower eye lids. This has subsided considerably. Prior to the cellulitis she experienced a stone in the left parotid gland. Antibiotic had been given for this as well. The area is minimally swollen (1 month plus) presently. She has gone to the ER, Walk-in clinics and finally her primary care physician. Most of the episodes occurred while her PCP was not available for a routine appoinment. Blood work by her PCP came back negative for hyperthyroidism (she may have had a reaction to the iodine contrast with the CT scan while evaluating the cellulitis and subsequent eye infection. Today she is exhausted, persistent elevated pulse, awakens her when she does finally falls asleep, shortness of breath and anxiety. I encouraged her to go to the ER for a workup of the presenting symptoms. She is in IL and I am in TN traveling home to TX.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Above symptoms can be doe to a wide range of diagnoses ranging from anemia to anxiety disorders. She needs an extensive history and blood work. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having squint eyes, medication not working hence requested for surgery. Any option in Ayurveda?\n\nHELLO! DOCTOR. MY DAUGHTER IS OF 7 YRS OLD , ( 8TH IS RUNNING ) HER BOTH THE EYES ARE SQUINT ( PALSY EYES ) WE ARE TREATING HER IN AURANGABAD, THEY HAD TOLD HER FOR PATCHING ALTERNATE DAYS IN BOTH EYES , ALSO MEDICINES ARE GOING ON , BUT NO RESULTS, THAN THEY HAD TOLD HER FOR OPERATING BUT FAMILY IS NOT READY FOR OPERATION, SO PL. TELL ME WHETHER PALSY EAYES WILL BE CURE BY YOUR AYURVEDIC TREATMENT.",
    "doctor_response": "Hi.There are many medicine in homeopathy to treat such type of problem.but as a homoeopath physician,its my suggestion to you to operate the eyes according to your doctor.your baby will be cured very soon after operation.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Vyvanse tablet the right medicine for anxiety and depression?\n\nive been having binging on food for about a month and a half to 2 months (eating till i wanna throw up, and eating or snacking every hour or 2.) and am already seeing a psychiatrist (for depression, and anxiety) what would be the odds of getting vyvanse to help control my symptoms",
    "doctor_response": "hello user, thanks for contacting HCM for your health related query . your symptoms are suggestive of binge eating disorder and seemingly vyvanse is prescibed for that only - it contains lisdexamfetamine which is a stimulant class of medicine . although currently there is limited data for its efficacy , a clinical trial had shown its efficacy in about 50 % of patients taking 50-70 mg/day dose , these patients were those who had quit binging for 4 weeks period , apart from these in many other patients the binge days decreased and the drug is approved for this purpose, so it can help you and do discuss your concerns with your psychiatrist . hope i answered your query , if satisfied please rate the answer . any followup queries are welcome",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dull pain in lower back\n\ni have spinal stenosis affecting my left leg but with physio it has improved a lot and i can go for long walks but last week i felt dull pains in my right lower back i also been told that i have a gallstone large but that it may never boyher me i hav a soreness under my ribs right side and thought it was swollen a bit but nearly better now thought i pulled a muscle as i play golf",
    "doctor_response": "Hi, I am Dr.Bruno.  I have read your question with care and understand your concerns. Let me try to help you Question : Suggest treatment for dull pain in lower backAnswer : Your Description Fits in with Muscle Spasm. I would suggest you 48 hours strict Bed Rest. If paid does not improve, consult a Neurosurgeon Hope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have brown discharge after Depo shot?\n\ni am on depo shot and have had it three times over a period of consecutive monthes but when i use the bathroom there is light brown dishcharge is this normal this is the first time with depo i havent had a period but the brown spotting has happened before",
    "doctor_response": "NamastheWelcome to Healthcare-MagicGreetings of the dayIndividual on depo can have spotting occasionally due to withdrawal bleeding.There is no cause of concern.In case you need any further assistance, will be glad to assist you.Wishing you happy and healthy lifeTake CareBest RegardsDr Deepak K KMBBS,MS,MCH",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having lower back ache, over weight. How to reduce weight?\n\ni have lower back ache problem.from a very long time.its unavoidable.i am overweight also.70kg.age 31 height 5 feet 3 inch.how to reduce weight.what is ideal weight for me. my problem is since i was just 55 kg. thank you!",
    "doctor_response": "Good morming. I think if it is 50 - 55 kgs is an ideal weiht for ur height.do a lot of weight reducing exercises. For back pain keep a good postres while u sleep or sit. And do back exercises. U will be pain free very soon. Thank u",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of pain under rib cage ?\n\nHi, I m having pain in my left upper quadrant right under my rib cage. A dull pain that intensifies when I stand up and walk. I almost have to hunch over and walk really slow. I m also feeling light headed and nausea and not hungry. Still passing bowels. Crohn s patient on Humira only.",
    "doctor_response": "Hello, The symptoms seem to be related to bloating. I suggest using Simethicone medications to relieve the bloating. I also suggest using daily probiotics for relieve. In case of severe pain, you can use Spasmolytic such as Buscopan. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to ascertain that one is pregnant post unprotected sex?\n\nHi, I m 16 years old. I had unprotected sex a week or so before my period. Now I ve had two regular periods. I don t know if I m pregnant or sick. I vomit in the morning, I have abdominal pain, cramps, and I get dizzy. The thing is that I ve been sick before with those symptoms. But I also vomit in the afternoon, and I ve heard for pregnancy it s only morning sickness, so I don t know what to think. What s the chances that I m pregnant or sick? My ex-boyfriend said he didn t ejaculate in me, but I read online about pre-ejaculation. I m really freaking out. Help. Thanks.",
    "doctor_response": "Hi,As you had sex during safe period and again you had two regular period afterwards, there is no risk of having pregnancy.Your problem might be due to gastro-intestinal infection.consult your doctor and go for its treatment.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for vomiting at night in children\n\nMy grandson is 8. Over the past week he has throw up 1 time 3 different nights, usually after he has been asleep for about 3 hours. After that he sleeps fine the rest of the night, and feels fine in the morning. He said he feels fine all day and just wakes up and throws up. I am concerned.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. A possibility for nighttime vomiting in children is termed \"winter vomiting\" disease. Several different kinds of viruses can cause this illness. Winter is not the only season in which it occurs. The only symptom is vomiting, nearly always during the night. Diarrhea is most unusual. There is no fever.  The vomiting may recur. It is of short duration. There may be other children in his class with the same illness. Making sure he doesn't become dehydrated is most important. I hope this helps and your son will soon be well. Please return if there are any more questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if waking up during the night with burning hands and have a history of Lupus, herniated discs?\n\nHi, I am questioning a new problem. I am waking up during the night with burning hands. I have aching in my lower arms during the day. I have a history of Lupus, but negative ANA the last 3 ANA s. I have DJD in my neck and lower back DJD, slipped disk, herniated disks, and I spinal stenosis. I also have a history of major depression and anxiety for years, and fibromylasia. I have a lot of pain in my neck and shoulders and my lower back everyday.Aching pain comes and goes a lot during the day and worse during the night on my chins. So, burning hands?",
    "doctor_response": "If there is ANA is negative, there is very rare chance that you have lupus.see your rheumatologist again and discuss.With your history, it seems that you have carpel tunnel syndrome, involving both handsregards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen glands behind ear\n\nhi i have swollen glands on the back of my head behind my ears and on one side of my neck i just noticed one growing under my arm i am very worried. they dont hurt the one on the back of my head and by my ears are hard as rocks i feel fine what could it be",
    "doctor_response": "Hi! Good morning. I am Dr Shareef answering your query.If I were your doctor, after a general physical examination of yours, I would advise you for a FNAC (fine needle aspiration cytology), and an excision biopsy if need be for confirmation of the diagnosis of the FNAC. One could plan out a treatment only after getting the cytology/ biopsy report along with the  reports of some routine blood tests.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Frequent masturbation, shrinking of testicles, decreased penis size. Will I recover if I stop masturbating?\n\ni have masturbated alot since i started puberty and this has caused my testicles to shrink to the size of maltesers :( i wanna know if they will grow back to normal size if i stop masturbating and also does masyurbating effect the penis size ? can you please answer these questions i would much appriciate it doctor :) Thank You",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have You had been indulged in masturbation since many years and now facing problems related to general health First of all there is myth in a mind of common man that excessive masturbation is the reason of all sexual problems But I would like to state that it has been discussed in scientific forums all over the world and proved scientifically that masturbation does not have any negative effect on any organ or system in the body.All the problems that you are facing now are mind related and due to anxiety.Following measure will help you to boost up your confidence and getting good erection.and delay ejaculation.1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning.2) Take high protein diet rich in vegetables and fruits and Vitamin A,C,D,E.and Zinc3)Take anti oxidants like Almonds 5-6 everyday..4) Avoid alcohol and smoking.Get yourself engaged in some social activities ,sports,reading etc so that you will not get free time to masturbate.Dr.Patil..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of mild dilatation of pelvicalyceal system?\n\nHello Sir,My Baby boy is 13 days old and recent Ultra Sound Scan shows that he has Mild Dilation of pelvicalyceal on left kidney. What are the cause of mild dilatation of pelvicalyceal system on a newborn baby. Is this Dangerous and risky for the baby's life Can it be treated with Anti Biotics? Or surgery is need to cure this permanently. The size is 16mm",
    "doctor_response": "Mild dilation of pelvicalyceal system needs to be followed up regularly with USG.Renal funtion tests are done to check if the kidneys are functioning well.Often this mild dilatation settles on its own .If not surgical correction is possible.It is not dangerous and life threatening if corrected in time",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the surgical options available for a sprained ankle?\n\nHello doctor, I am looking for a second opinion for surgical options for a grade 3 sprained ankle. I have attached herewith the MRI results. The results show a ruptured anterior tibiofibular ligament and a partial tear of the\u00a0posterior tibiofibular ligament with disruption of distal tibiofibular syndesmosis with mild adjacent muscles edema, likely distal tibiofibular syndesmotic injury. They also show posterior talofibular, calcaneofibular and deltoid ligaments sprain. Mild marrow edema at the distal fibula. Tibialis posterior, flexor digitorum longus, flexor hallucis longus tenosynovitis. A small amount of fluid in the\u00a0tibiotalar joint. Subcutaneous edema around the ankle. Kindly provide your opinion.",
    "doctor_response": "Hello. I have gone through the images you have provided\u00a0(attachment removed to protect patient identity). This professional advice provided by me stands subject to the actual examination of report/image and is based entirely on inputs provided to me. It should be correlated with clinical findings.\u00a0Regards. For more information consult an\u00a0orthopaedician and traumatologist\u00a0online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lumps on gums and under the nose\n\nI have a bump on on my gum/under my nose. when it first arose i was in a lot of pain i went to the dentist and he said the x rays didn t show anything, he said there was nothing wrong with the tooth although i was in pain and couldn t bite. my front left tooth really sensitive because of the bump and the bump is really painful when touched. it also painful beside my nose... any idea on what it could be and what i should do about it (the bump is not visible but you can feel it it have gotten about 3 times the size in the last week",
    "doctor_response": "Hi,From history it seems that there might be having infection in root of upper tooth giving this problem.This infection may not appear on x-ray initially.Go for one antibiotic medicine course for 3-5 days.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a painful lump in the armpit?\n\nI have a lump on a stretch mark in my armpit. It has happened before and does not look like a pimple (judging from its size and appearance). I m just curious as to what it is. It s tender and painful to the touch. Also, it is about twice the size of an average pimple.",
    "doctor_response": "Hi,From history it seems to be enlarged lymph node in axilla.It shows that there might be having some infection in your upper arm or some infection in near by area.If require go for one antibiotic medicine course for 3-5 days.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should Progynova and Ultrogestan be taken during IVF cycle?\n\nI have had an ivf cycle. Test positive 15th this month. Prescribed Progynova 2mg tablets and Ultrogestan 200mg capsules for next 8 weeks, Is the capsules correct or should I have been prescribed suppositories.  Are the two drugs correct to keep womb thick and help with pregnancy?  Thank you",
    "doctor_response": "Hi,Welcome to HCM.You need both Progynova and Ultrogestan if prescribed by your doctor. Normally Ultrogestan 200mg capsules are prescribed to be used vaginally. If you are doing same, kindly continue the same. If you are taking it orally, kindly consult your doctor for vaginal administration. Normally these two hormones are sufficient to support early pregnancy.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for acute hepatitis\n\nHi Sir, I am 29 years old. from last week i am suffering from acute viral hepatitis. I conduct my first SGPT test on 11th june'11 and its comes out to be 1387 U/L AND now again on 19th june'11 i again done my LFT and the result which comes out is as follows:Total Bilirubin   19.3  mg/dlSGOT (Kinetic)  421.9 IU/LSGPT (Kinetic)   705.5 IU/LAlkaline Phosphate 245.9 U/Lplease advice is there is any improvement  from last time? Suggest remedies",
    "doctor_response": "Thank you for posting your query.increase in the level of liver enzymes reflect an INJURY to the Liver. medically, the condition is know as \"Hepatitis\".liver enzymes take 6 to 8 weeks to completely return to normal values.You need to test for HepB & C serology as well as Lipid \"Profile\" too.if all above causes of hepatitis are ruled out ,and y our non-alcoholic,then it maybe due to HepA (a self limited common cause of hepatitis)- abstinence from \"Alcohol and drugs\" - LOW or fat free diet should be followed- eat small meals (fat and red meat free) at regular intervals.- Moreover, less activity should be carried out (no sports). - use lemon juice (lemonade) once in a day- recheck liver enzymes after 4 to 6 weeks.- viboliv drug maybe usedwish you good health.further queries are welcomed.Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health.regards,Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could pink circles under eyes be due to allergy?\n\nMy daughter came home from school today with pink circles under her eyes.this is the first time I seen this with her.she does suffer from allergies outside and dairy wheat and gluten.I have her on a diet that eliminates all of that. Her allergies from outside have been really bad lately.is the pink circles from allergies?",
    "doctor_response": "Hi and thanks for the query,It could if this is the real first time you noticed and if they are itching. It is important to get a proper history on how she got them and how they are evolving. It is possible this could as well be an allergy to some substance. Kind regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the foreskin not to retract when erected?\n\nI am 28 years old male [married] from Bangalore.My problem is that i can pull my penis foreskin back and forth inerection as well as placid. But when my penis is erect the foreskindoes not roll back automatically ie it doesnt come behind the glans &it stays over it exposing just a tip of glans. Due to thispenis is very painful during sexual intercourse,and also problem witherection. I tried lubrication of the penis inner walls for two to three weeks,it worked for sometime but again the same problem came.Please help. Or suggest me whom i can visit in Bangalore near Vijaynagar.",
    "doctor_response": "Hi welcome to the health care magic When retracted foreskin can't get back over covering glans then it is called paraphimosis It might be complication from phimosis in which foreskin can't retracted over shaft penis Oil application,  cold compress, xylocaine jelly application etc are not the solution for paraphimosis For that you have to consult urosurgeon for treatment Surgical procedure like putting dorsal slit,  preputioplasty,  circumcision etc are some choices depending on clinical correlation Hope your concern solved Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for premature ejaculation\n\nHello Doctor. Kindly guide me that which oil i should use to massage my penis to cure prematureejaculation and also guide that how to massage. Secondly, PE is may due to my mind... i cant control when she touch me or want to grip my penis i got released however i enjoy a great fuck just after said release..i.e. second shot or eraction.. but u know its v.difficult also to make mind after first release or make penis eraxtic, once it got eractic i can make good fuck. Kindly advise. Thanks",
    "doctor_response": "Hello, Thanks for posting in HCM. Premature ejaculation is a common problem. Do not worry.Yes as you said it depends on your mind. You can practice what we say is start and stop method.In this method when you reach height of climax and you think you are going to ejaculate you should stop and let the urge to ejaculate go away.Once it goes away you can start again.This is most safe and best working method for premature ejaculation. Once your body gets used to it it will long laster without ejaculating. I hope i have answered your query well. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Going through fertility treatment. Having long periods, using aygestin. Have bloating, pain and night sweats. Advise?\n\nHi i am going through fertility treatment. I was having a 2 week period so dr put me on aygestin to stop it. I quit using aygestin last wednesday. Got a period Sunday and in the past 3 days I have been in hell. So much pain bloating night sweats....how long will this last. I swear I look 4 months pregnant?!! I can't even eat much because I feel like I'm going to burst and get dizzy. Supposed to start taking clomid tomorrow. Any help or ideas? I called dr today spoke to asst and they always blow me off. Said its normal but I'm miserable!",
    "doctor_response": "Hi, it could be due to the drugs you are on, so don't worry, you can continue to have the treatment. you explain your doctor it is miserable and unbearable so you want some thing to stop this pain before starting the clomed .  the thing depends upon the explanation you give to him. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can I confirm that whether my spotting is implantation bleeding or periods?\n\nHello doctor, I am 30 years old and married for 2.4 years. Now we are planning for a child. On 14th of this month, I experienced periods with very little stomach pain and pain in legs. The next day on 15th there was no bleeding at all, 16th I had spotting of light red colored blood flow, 17th the same thing happened and then the flow stopped. Again on 23rd night I had bleeding light red coloured blood flow, on 24th no bleeding at all, 25th I had fresh pink colored spotting. Then 26th pinkish brownish spotting occurred, 27th morning I did pregnancy test by urine, it came negative, and at 8 AM had brownish spotting, 28th had brownish spotting too. Please help me to know whether it is implantation bleeding or anything else.",
    "doctor_response": "Hello. This is not an implantation bleed at all as even urine pregnancy test is negative. Considering that you have been having regular spotting during this month since 14th of this month with hypomenorrhoea, there are possibilities that your serum Estradiol levels are low which is a possible cause of such irregular shedding of the endometrium. It is important that you get an ultrasound pelvis done to check for endometrial thickness which if less than 8 mm then likely that you would not conceive during this cycle. Please tell me what hormonal profile was done with thyroid levels, serum prolactin, serum progesterone, serum estradiol, FSH, LH and AMH levels to establish the cause of such irregular shedding.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful swelling in the right hand?\n\nMy top of my right hand is very swollen and very painful. (The palm looks completely normal.) The knuckles on my right hand are twice as large as the knuckles on my left hand. I do not see any bruising or bite marks. It is extremely painful to extend my fingers or clench my fist.",
    "doctor_response": "i understood your problem what you are facing.. look swelling on your knuckle could be result of trauma if there is no history of same episode in past.. in this situation you should go to radiologist and take an x ray of hand in anterio-posterior and oblique view... if there is history of similar episode then this could be due to of arthritis, here you have to consult specialist physician..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling with red blotches and discoloration with pain and stiffness in hands and legs?\n\nFor the past week and a half my hands have been swollen with red blotches and discoloration with pain and stiffness, my feet are also swollen and red with pain also there is pain on the pads of my feet. Hurts to walk on them and I can t put my shoes on. Do you know what this could be? What can I do about this? Forgot to mention that my hands and feet feel hot to the touch.",
    "doctor_response": "Dear Sir/MadamI have gone through your query and read your symptoms.In my opinion, you are suffering from inflammatory arthritis, and a battery of tests under guidance of your Rheumatologist can help you get them done and thus diagnosed, so do not hesitate and consult one.I hope that answers your query. If you want any more clarification, contact me back.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent vomiting in an infant?\n\nhello so ever since my son was born he ha been throwing up more than noraml babies and childern do. when he coughs, crys, burps and sneezes he may throw up. the acid from his belly runied his 4 front teeth so as a one year old he had some dental work done. even when i try to give him medicine when hes sick he throws it up. he gags very easy. i have taken him to 3 differnet doctors over time, and he has had xrays and uper gi test and lower bowel test, they have said nothing is wrong, but there is something wrong. im having to clean out more car and his carseat daily, and his teeth have began to discolor again. daycares arent wanting to keep him beucase they think hes always sick or had the flu, no one undertands, but i defintely know something wrong and its becoming embarssing for my son, and he trys to hold it in becuase of other peoples reactions to him vomiting. please tell me waht is going on? my son was breast fed and it was like my milk was souring inside of him, and now he drinks cows milk and water and he still throws up???",
    "doctor_response": "hi ,ur child is probably suffering from reflux oesophagitis  because of this he vomit regularly.please give him feed in small quantity and at small interval.this will definetly help.if it does not reduce symptom give him domperidon syp 1ml three times daily ..thans",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pressure in head and tingling sensation in spine?\n\nI have fibromyalgia & take meds for this as well as chronic anxiety and depression. In 2007, I became ill with what the dr thought was strep, & was laid up for a month. During this time, I experienced strange symptoms, one of which was the sensation of an electrical wave or current going up & down my spine. Since then, I feel as if there is a heavy cap over the top half of my head, making it difficult to even raise my eyebrows (know this sounds silly!), and often have headaches / pulses of pain there. Have had everything from my sinuses to my ears checked, but nothing. One dr. thought I should be treated for a fungal infection... Any help you can give me would be great! Cindy",
    "doctor_response": "Hello Cindy!Welcome on Healthcaremagic!Considering the sensation of electrical wave in your spine, I would recommend consulting with a neurologist for a careful physical exam and a brain and cervical spine MRI study, to exclude any possible lesions in these levels. I would also recommend checking vitamin B12 plasma levels. Hope you will find this answer helpful!Bert wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "White brownish discharge after taking after pill for unprotected sex. Could get pregnant ?\n\nHi! My girlfriend ended her period november 30th and we had unprotected sex on december 9th. Late evening on december 11th, she noticed a brown/reddish discharge on her underwear. The next morning she took the morning after pill before the 72 hours. Later on that night, she had a white/brownish discharge that looked like moucus. Could she be pregnant?",
    "doctor_response": "Hi THERE THANKS FOR POSTING YOUR QUERY AT HCMSee its too early to predict about the pregnancy of the patient . That can only be done if has one missed periodRegarding the discharge it could be inter menstrual  spotting which is known as mittelschmertz or it could be due to a  sexually transmitted disease that the infection has occurred .  I SUGGEST THAT YOU CONSULT A GYNOECOLOGIST  Hope you are satisfied take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any side effects of Loprin?\n\nAre there any side effects of Loprin as I am using it 1 tablet per week, for 2 years. I am asking this as I have got problem of hair thinning and loss. In addition , I must tell u that I am using BEPSAR PLUS ( diuretic, losartan potassium/ hydrochlorothiazide ) for last 1 year.",
    "doctor_response": "Hello,Loprin can cause as a side effect bleeding disorders. It can cause bleeding from nose, hematuria, purpura, ecchymoses, hemorrhage. In this case you should consult your gp for further examinations.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes throbbing pain in the molar tooth?\n\nI have discomfort on the left top molar.I cant eat anything on that side.It throbs when ever I put any pressure there to eat. I have fillings that are small. But I cant seem to find out if I lost it. I take naproxine to ease the pain. I'm not sure whats going on.",
    "doctor_response": "Hi..Thanks for the query..As per your complain it looks like your tooth is either decayed or there is fracture in your tooth that causes throbbing on putting pressure..Although you might have small fillings over the tooth but there is a possibility that the tooth is decaying under the filling, known as Secondary caries..I would therefore suggest you to consult an Oral Physician and get evaluated and a thorough clinical evaluation and investigations like x ray can help in diagnosis and treatment can be done accordingly..In case of deep decay root canal treatment can help in relieving the pain and removing infection followed by a course of antibiotics and painkillers..In case of fracture of tooth the treatment will depend on the type of fracture and that can be ruled out with x ray only..Fr further discussion and if you like to know the appropriate way to proceed for treatment you can send me x rays of your tooth by going to my profile and clicking on \"Ask me a Question\"I will explain in detail about how you should proceed for treatment after looking at the x rays and asking appropriate details..Hope this helps..Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pressure and pain in the anus and scrotum. Stones in urine. Kidney stones?\n\nMy husband is experiencing a pressure and pain in his anus and scrotum . Lasts a few minutes then fades but then comes back. Happening for about 30 minutes now. He also seems to feel better when he passes gas but then it comes back again. Any idea? He was just told he had crystals in his urine . Possible sign of kidney stone developing.",
    "doctor_response": "Hi, Welcome to HCM. It is difficult to diagnose by these symptoms alone. In my opinion, the description fits with bowel problem than with stone problem. Please get evaluated by a surgeon. best regards DR GS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a crush on an actor. How to come out of it?\n\nHello doctor, I am married with two kids and a loving husband. I quit my job a year ago and started selling clothing online.\u00a0I love watching movies. And recently I have a crush on an actor in a movie\u00a0that is about cross country sport.\u00a0Since I was young I used to get easily attracted to people who are good at sports. Hence, suddenly I am totally starstrucked by the lead character. And I follow the Instagram of the actor and I am trying to get to know about this actor. He is totally a good, charismatic person and have that odd looking feature. That is the thing I love about him. Now,\u00a0every single second I cannot stop thinking about this actor. I cannot do my job well because I would go viewing his instagram and watch his videos most of the times.\u00a0When I was young it was normal to have a crush, but now? I really feel my life is so complicated. I cannot stop thinking about the actor. I cry every time I had to watch him on television or view his Instagram and not doing my work properly. At this time I just hate myself. Please help me.",
    "doctor_response": "Hi. Firstly, I must say it is very courageous of you to share your concerns here and I would thank you for doing so. 1. Celebrity obsession. 2. Anxiety. 3. Depression. For further information consult a psychiatrist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause an extremely mild warm wave in the right leg?\n\nHello, today I have been experiencing an extremely mild warm wave on my right leg, around the outside of my calf. It is so very mild that I had to stop to wonder if I really felt something. It happened 3 times throughout the course of today. I am 35, female, active, drink a ton of water and don t sit for prolong periods of time. I am a stay at home mom with a 3 and 2 year old so they do not allow me to sit too long. Is this sensation something to do with a nerve?",
    "doctor_response": "Hi,you are absolutely right.This is definitely related to nerve.You may be suffering from sciatica and nerve inflammation causing this type of pain and warm sensation.Take methylcobalamin,pregabalin and folic acid tablets with anti inflammatory tablets.Application of local gel followed by hot fomentation and compression bandage will help.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does MRI report -the infraspinatus,biceps,subscapularis and teres minor are intact indicate?\n\nMRI findings explained......I m unsure of the diagnosis....I have a Doctor appt to follow up. (Orthopedist surgeon who performed the surgery). I ve had non-stop pain in my shoulder, upper arm, elbow, wrist and now hand, following a rotator cuff repair just over a year ago. It s been dismissed as arthritis in my neck (internist said it s very mild arthritis) and hand. I m not ready to live the rest of my life with this pain which increases when I m at rest, mostly at bedtime. The pain robs me of sleep.....And I do not baby the affected area during the day. I figure movement is probably best as long as I don t overdo it. MRI Findings:Postoperative changes are present with anchoring screw within the greater tuberosity from previous rotator cuff repair. There is moderate partial thickness recurrent undersurface tear noted without definite retraction or full-thickness tear. There is some free fluid in the subacromial bursa and if nonretracted full thickness tear is suspected, MRI arthrogram is recommended. The infraspinatus, biceps, subscapularis, and teres minor are intact.No evidence to suggest labral tear.No evidence of fracture or marrow edema.Mild glenohumeral arthrosis noted with joint effusion. Acromium is type ll with moderate acromioclavicular hypertrophic changes creating moderate impingement in the neutral position. Impression:1. Previous rotator cuff repair with recurrent moderate partial thickness understructure tear. There is free fluid in the subacromial bursa if nonretracted full tear is suspected., MRI arthrogram is recommended.",
    "doctor_response": "Hello,Welcome to the magical world of health care, I went through your query, and let me explain what is going on, despite surgery your acromion is probably hurting your cuff and that has now again torn but to a lesser extent, this has caused irritation of the adjoining structures and thus fluid is present. My advise would be to stop all exercises, take antiinflammatory medication for 3 weeks and let it heal .I hope my advice would have been useful, in decision making regarding your treatment, still if you have any clarifications or doubts feel free to contact back.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever with chills and body ache?\n\n10 days ago my husband was kayaking and the kayak hit his head, there was a slight cut to it also. 4 days later he had a 21kilo suitcase fall on his head from an over head locker. he went to the hospital because he was not feeling quite right, they ruled everything out and gave him a clean bill of health. 3 days later he nearly collapsed at the airport, was seen by a first aider, but still got on plane.!! 6hrs later he breaks into a fever starts shaking, pains all over his body and with shortness of breath, and very disorientated. It all cleared within maybe 12hrs. Doc was called and they said bad flu.!!! ( in Italy) He is due to fly again in a couple of days. !! Any ideas.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you havefever with chills and body ache which seems to be viral fever or flu.  Need not to worry. I would suggest you to do warm saline gargles. Drink plenty of fluids, have proper rest. Your symptoms will resolve in 3-4 days. Take analgesic such as Flexon and take light diet. You should take anti-inflammatory medications such as Ibuprofen to prevent fever and body-ache. If symptoms keeps on persisting visit general physician once and get it examined and start treatment after proper examination and prescription. Go for blood tests such as W.B.C count as well as increased count will indicate infection in body.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes random heart palpitations?\n\nWhy does my heart randomly start beating really hard and fast I can see it pounding through my clothes.it causes me quite a bit of pain and can last for hours sometimes it can wake me up in the middle of the night and is hard to sleep because of the pain I don t know what s causing it as it doesn t happen at any particular time I could be sat doing nothing and it will start up",
    "doctor_response": "You must be having some arrythmia. Most likely to be atrial fibrillation but could be any arrythmia. Please have a ECG and Echo done. If both are normal you may need Holter testing. Based on result you may be suggested some medications or life style modification.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes penis pain during intercourse?\n\nI am 50 years old and in reasonable health. I have recently started having pain associated with erection. The pain is located toward the base of the penis. It almost feels like it would if I were pressing down on an erect penis. I ve been looking around to see if this is normal for my age, but don t find anything mentioning pain associated with erectile dysfunction. Any ideas what this is all about?",
    "doctor_response": "Hi, Pain in the erected penis may be due to Peyronie's disease. It is characterized by development of scar tissue with in the penis. Other possible causes are like sickle cell anemia, balanitis or herpes zoster infection, etc. Lack of lubrication during intercourse also may be one of the reason. Use lubricants while intercourse. Use vitamin a capsules as early as possible. If symptoms not improved please consult your doctor he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes brown discharge in periods?\n\nHello. I have been diagnosed with PCOS and have extremely rregular periods. My last period must have been just over 3 monhs bac. Lately I have just been spotting lightly. On Thursday I discovered that I have a dar brown discharge-not heavy. I only saw it when I wiped myself with tissue. On Saturday morning there was something like a normal blood clot and then back to the brown discharge. Should I be worried?",
    "doctor_response": "Hallow Dear,It is a small trickle of blood that did not escape the uterus due to its quantity. Then it came out subsequently. Old blood is always brown. In PCOS, the menses are usually irregular, delayed menses followed by profuse bleeding. However, occasionally trickle or spotting may take place which may come out after few days as brown discharge. I do not think, there is any cause for worry. Just get your PCOS treated scientifically. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for soreness behind the gums?\n\ntwo days ago i had a painful sore right at the back gum the my tonsils started inflammation. Yesterday my tonsils hurt really bad and i felt sum pressure on my cheeks. Woke up this morning with a swollen left cheek with so much pain from my upper to lower jaw. I cant open my mouth properly and i feel some sort of growth in my inside cheek.Help!",
    "doctor_response": "Thanks for your query, i have gone through your query.The pain and swelling and limited mouth opening could be because of infection from the wisdom tooth. consult a oral physician and get a radiograph done to rule out the infection. if the wisdom tooth is infected then get it removed. mean while take a course of antibiotic like penicillins and metronidazole(if you are not allergic and sensitive). do saline gargling. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of body pain?\n\nI fell down the stairs earlier today, went to er and they said nothi g was broken, but iam having a real hard rime sitting or even moving. The nurse practicioner said i didnt break anything but when she was putting pressure on my ribs it hurt tremendously in the top. I have been using ice pak then heating pad then ice pack, what else can i do. Also i took two t3 which isnt helping at all with the pain.",
    "doctor_response": "Hi you have injuries on your ribs and are feeling difficulty in sitting or even moving. In my opinion , with this kind of picture you might have fractured a vertebra in dorsal spine. I would suggest pain killers , and an X Ray of Dorsal Spine before any thing else.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump under skin near forearm?\n\nA few months back, I felt a small bump, under my skin near my forearm- close to the bend on my elbow. There was no pain at that time. I have since noticed the lump is getting bigger and is sometimes painful to the touch. Is this something I should be concerned about? I am without insurance, so its not easy for me to be seen. Thank you.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some soft tissue tumor like lipoma or neurofibroma or dermatofibroma. You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Surgical excision is the treatment of choice. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bumps on the gums\n\nHello. I have a bump in my gums and a red vein? Wierd but on my upper front tooth I have 2 bumps very small. And I also have veins through it. Like. Little red lines. I also have 2 more bumps above another tooth. It's smaller but when I press it, it's a bit painful.",
    "doctor_response": "thanks for your query, i have gone through your query. the bumps on the gums could be multiple periodontal abscesses because of the gum infection. or it can be multiple excessive bony growths(exostoses). consult your oral physician and get yourself examined and get your teeth cleaned and take a course of antibiotics if it is of gum infection. do saline gargling. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain from damaged cervical discs be best managed until surgery?\n\nI have been diagnosed with damaged disk s C4,5- C5,6 and C6,7. I m currently under a Pain Management doctor here in Colorado and need to move to Mobile in the next couple of weeks. I need surgery to fix the problem and can t afford the surgery. No insurance as of right now. My last doctor would not order scans or proper procedures to diagnose the problem therefore causing the the problem to get worse. Continuing to prescribe opioid medication without proper diagnosis caused him to lose his license. He did this with several patience leaving many of us in the cold and with no treatment. In my case. I became so sick that I lost my job, insurance and means of support due to his negligence. My father lives in Mobile so for my well being and sustainable life I have chosen to move in with him so that I may find the proper help. In the meantime...I need to continue my pain management so that I can continue living my life (for what it is) until I can come up with an alternative plan for my treatment and an insurance that will take me there in Mobile. Given the current state of affairs with pain medicine and the prescribing of such medicine; I m sure you can see my concern with leaving my current situation. The pain in my back is unbearable and must be dealt with as soon as I relocate. On a personal note; I ve dealt with many doctors that were very cold and uncaring to mine and many other patient s conditions. I would prefer to avoid this type of treatment immediately and find a doctor that is well educated in the science of spinal injury and the pain associated with this injury. I can obviously have records sent ASAP for a doctors use and will be happy to undergo any exam needed to prove my condition. Thank you for your time.",
    "doctor_response": "Hello ! I read your question carefully and understand your concern. I would recommend a cervical column MRI to examine better the anatomical problem and if there is any compression to your spinal medulla from the displaced disk. The MRI would also examine the grade of the possible displacement of the disks, and would also help the neurosurgeon to decide if surgery is necessary. As far as I understand from your case you have been using for a long period opioid. They lead to tolerance development and dependence over the time. So I would recommend for the pain an antidepressant like amytriptiline , which is very effective in chronic nerve pain, and helps with your emotional state. Another good option would be gabapentine, an anticonculsivant , very effective too. These two medications should be given under medical prescription and do not cause dependence or tolerance. Hope to have been of help!Best wishes, Dr. Abaz Quka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for knee pain\n\nHi. I have pain burning, stinging in my right knee. It started with a small area the size and dime, and only lasted a few minutes. I would have no problems for weeks or months. Recently that same knee was burning,stinging of the in tire knee cap and lasted for 4 hours and. My right knee is beginning to feel the same just a shorter period of time. My knees don t hurt like bones hitting but when I work out I hear a great amount of grinding noise. This pain arrives quick and strong and leaves just as quickly.",
    "doctor_response": "Hi,Thanks  for  your query.your pain is due to Arthritis. When bone is not able to take weight due to arthritis than it has to be shared by muscles. It causes pain in thigh and calf muscles.Also some time it can be due to nerve compression. You can judge your self. If your pain increases on walking and relieved with rest, it is suggestive of nerve related pain.Arthritis pain is present even when you are taking rest.I will suggest you following.Hot water fomentation. Volitran ointment Tablet Pregabalin M one daily at night time .Calcium and vitmin D3 daily. Tablet Tramadol one daily.Please consult your doctor before taking those medicines.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red spots on baby s body?\n\nHi I have a newborn whose skin was clear and smooth however he began developing tiny red spots on his cheeks, which then spread to his neck, under his ears and now his torso. I m wondering if it is a heat rash or sensitivity to the laundry detergent?",
    "doctor_response": "Hello. I just read through your question. What you describe is consistent with baby acne.  This is harmless. Just keep it clean with plain water and it will eventually resolve.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I go to doctor and get it checked ?\n\nI am 19 yrs old. I used to have irregular cycle but since September last year till February this year, I had my periods regularly every month. Anyway, my period was 9 days late. I feel so tired, sometimes nausea recently and I have these symptoms everyday. Last night I had sexual intercourse with my boyfriend. This morning, my vagina bled. The blood is bright red. Its still bleeding and now I feel cramping at my lower abdomen and I have lower back pain. I have no idea whether this is period or not. Something wrong with me. Should I go to doctor and get it checked? I'm so worried atm. PLEASE HEPL ME!!!",
    "doctor_response": "It could be bleeding between periods which you can read about here...  or You could be pregnant... I would recommend seeing a doctor though... Hope I helped :) and Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest means to reduce numbness post injection\n\nI received a shot for nausea a few weeks ago and I'm still experiencing a bit of localized numbness at the injection site. I've been doing some self-massage and stretching which seems to be helping a bit. Should I continue this or do I need to see a doctor?",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concern...As per your complain numbness at the injection site is due to injury to the nerve endings by the pricking injection needle at the site of injection and the nerve injury leads to numbness..The time duration in which the numbness or the nerve injury will resolve is unpredictable and can take from a few weeks to months to resolve..But mostly complete resolution is seen in such cases..You can do warm compresses over the region and continue doing stretching for faster relief..Nothing else is needed as of now..Hope this information helps..Thanks and regards..Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy rashes around anus and yellow discharge?\n\nMy 4-year old daughter has an itchy ring like rash around her anus (red bumps). She's also had a yellow discharge for about 3 days, which she hasn't had before. Could it be a yeast infection? I treated with Clotrimazole 1% and cortizone cream as I didn't know what it is.",
    "doctor_response": "Dear parent , I understand your concerns . this could be either fungal or bacterial infection . you should keep this area very clean and dry all of the time . apply an antibiotic ointement together with an antifungal cream 5 times daily.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes milky/yellow discharge from vagina during pregnancy?\n\nI know I'm supposed to discharge but mine has turned into thick milky/yellow mucus like discharge and it's been gradually pushing out more, I keep having like a sharp pain, or a pinching pain on my vagina whenever I stand up. I've had severe back and pelvic pain here recently. This is my first baby, & I'm 33 weeks & 6 days pregnant.. Is this normal and should I worry?",
    "doctor_response": "HI,    Thanks for the query.     I understand your concern.    The vaginal discharge is increased in pregnancy, it's a clear discharge without white/ yellow/ green colour to discharge or symptoms of itching, burning in urine, pain in back, cervix.   Your symptoms suggest infection. you need to consult a gynecologist for internal examination & vaginal swab test followed by specific medicines prescribed by doctor.   - keep strict vaginal hygiene,    - take medication regularly,   - avoid sex till cured . mostly both sex partners need treatment simultaneously.   Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can thyroid lead to cancer?\n\nqus. related to thyroid problem which lead to cancer as suspected by Doc in Kolkata My close relative who is suffering from Thyroid problem which lead her to some sort of Cancer complication as Doc said in Kolkata now what should I do about it?...",
    "doctor_response": "As any other organ , Cancer can also affect Thyroid gland and it needs further management earlier the better.In early stage (known after evaluation by surgeon/Oncologist) Thyroid surgery is enough that is followed by further tests like Whole body I131 scan to know if the surgery is complete or not if not further therapy as required is given.But if at the initial stage there is spread to other organs (eg lung, bone or brain) the treatment is not simple it requires multidisciplinary approach eg Surgery with or without RadioIodine therapy (if the same is iodine avid decided by a Whole body Iodine scan)So in your case you need to consult your Surgeon who will guide about the best option available.Hope this helps youwith best wishes Dr Chowhan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Root canal, traumatic nerve injury to v3 branch, burning, throbbing in gums, pain in root canal area. Advise?\n\nI had a root canal on tooth 30, 21 months ago. I have been told that I have Traumatic Nerve Injury to the v3 branch from the Local.  I have tried all the meds out there.  I have a RFL which a numbed what the neurosurgeon thought it would, but my major complain of fierce burning and throbbing in my gums on the the right side is still there.  I did feel a horrible sharp pain through my gums and tongue when the root canal was being done( enough to make me \"Tap out\"  and I cried the rest of the procedure.  I have been to 2 oral surgeons. Ant thoughts?",
    "doctor_response": "Hello there , Thanks for writing your query, Any injury to the nerve branches during dental procedure takes a little longer time to heal. The nerve fibres regenerate with a course of time and the symptoms will subside . burning sensation and pain in the gums can be due to other gum problems , i would suggest you to get the examination done consulting a dentist. exact diagnosis can be made only after clinical examination and evaluation by taking radiographs. i would suggest you to get and OPG radiograph done which will help in diagnosis and accordingly treatment can be planned . consult an oral surgeon and get the examination done. i hope this helps , take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Perfect diet chart for a blood sugar patient\n\ndear sir, my name is bhawri solanki age63 female i have blood sugar frm last 15 years,and 2nd of this month i had suffagation pblm,after consuting with doctor iwas reported a shrinkage in kidney (RIGHT KIDNEY 7.2 x 3.4 and left kidney is 8.0 x3.6) doctors says there is no need of dialysis and not possible for transplant. now i want a perfect diet chart for this disease",
    "doctor_response": "Hi, Welcome to Healthcaremagic Thanks for your query You seem to have a chronic kidney disease due to diabetes. We need to know your serum creatinine, serum electrolytes and current blood sugar status. A diet plan is a specific thing for which you need to be examined by a dietician, but in general, avoid citrous fruits and low sodium salts as these contain high potassium, and a low protein high carbohydrate diet to keep your S creatinine on lower side. Also, water in moderation. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain after embryo transfer?\n\nhi i had embryo transfer before 9 days & since that time I experiece lower abdominal pain crampy in nature (like the premenstrual pain ) & i think it is uterine contractions , but day by day it is decreasing. does that means I am not pregnant & I lost the embryos ?",
    "doctor_response": "Hi,Decreasing pain doesn't indicate if you are harbouring a viable embryo or not. Just wait for your B Hcg results while continuing your folic acid and progesterone support.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Anjali Jain",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to relieve the pain in the shin?\n\ni hit my shin and when it first happened i had almost a golf ball size knot with bruise, the knot has gone down to a much smaller size. but it is still bruised and it hurts to touch it. not only that but it hurts almost to my ankle. hurts to walk on that leg and feels hot. what can i do to relieve the pain?",
    "doctor_response": "hi you can use ice pack  for 20 min to relief pain don't use it directly wrap it in towel and then use it. (2) you can use cold and hot therapy together for20 min  . you can use crap band that will also help to relief pain and to ankel toe movement and stretching that will help you wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ulcers in duodenum\n\nmy father aged 91 years had ischmic stroke in 2010 HTN is on medicne tryptomer 25mg avas 10 repach H stmlo 5mg deplatt A 150 lonezep.25mg Now on 15 nov 2014 it started bleeding through stools the colour is jet black immideatly we took him to hospital blood examination done hemoglobin was 7.8 .Then stool was examined occult blood positive endoscopy doneEROSIONS PRESENT IN MID BODY ALONG GREATER CURVATURE. MULTIPLE ULCERS PRESENT WITH CLEAN BASE IN DUODENUM BULB The Doctor Diagnosed HYPERTENSION OLDCEREBROVASCULAR ACCIDENT DUODENAL ULSERS.IRONDEFICIENCY.ANAEMIA. TREATMENT GIVEN...iNGrEKOOL 1AMP bd ing LESURIDE1AMP IV 8TH TAB SOMPRAZ hp KITTAB LESURIDE 25MGaPOSITIVE WHOLE HUMAIN BLOOD HAS BEEN TRANFUSED NOW HE HAS BEEN DISCHARGED WITH ADVICE TO TAKE THESE MEDICINE TAB SOMPRAZ HP KIT TAB RABLET 20 TABLESURIDE25MG TAB.AVAS10 TAB REPACH H TAB LIMCEE TAB LIVOGEN 2 TAB LONEZEP.25MG PROBLEM THE PATIENT NEVER SLEEPT FOR 2 DAYS AND STARTED TALKING LIKE MAD IRRELEVENT TALKS HALLICUTACIONS KINDLY ADVISE",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query. If I were your family physician, I would get him assessed by a neurologist in your area, and also try with withholding Lonozep in consultation with the treating doctor. The neurologist might advise him for a MRI to rule out any chances of an impending stroke. Further management would depend on the results of neurological assessment and report of the MRI.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the cat scratch site with fever and dizziness?\n\nhi, take my greetings, last 7/10/14 I was scratched by a cat, I did bleed slightly. soon I washed it with antibacterial soap for 20 minutes and took tetanus vaccine, the following day 8/10/14 in the morning I took rabipur vaccine 1st dose, and took the 2nd dose after 3 days, as I took vaccine within 24 hours, can I think that I am safe? I feel slight pain which comes and goes on my left hand where I was scratched. I also felt slight fever and dizziness, but it went away. plz answer my question.",
    "doctor_response": "Hello and thank you for your question. It is concerning that you are having fevers. There is something called cat scratch fever which can have many complications. I suggest that you see a doctor as soon as possible to evaluate you for this. If you have it you will need to be on antibiotics to treat it and prevent complications. Good luck to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can constant counting disorder be treated?\n\nEver since I was young, I ve always counted each step as I walk up and down stairs without meaning to. I thought this was just a little quirk and thought nothing of it until recently as it s gotten worse. I ve noticed I ve started to count my steps as I walk, I count each time I chew something, repetitive noises like the clicks on a fan oven - basically anything repetitive I have the sub-conscious need to count it. The only thing that I can do to make it stop is to listen to music, but I can t listen to music all the time. It s been driving me crazy because I don t want to know how many steps it takes to get to the kitchen or how many chews it took for that mouth full of food.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. First of all this is not a disorder at all, though many practitioners may call it with different names. Your present behavior is an outcome your past habits. If you change the habit, automatically the behavior changes. Don't worry too much. Hope I have answered your query. Let me know if I can assist you further. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do high eosinophil levels require staying away from others to avoid infection?\n\nMy GP told me today that my eosinophil levels were very high(never problem before). I have had lower resp.problem since end of Nov. and just developed upper resp infection past few days. So visited my GP for 3rd time, since Nov., yesterday.  My question is with eos levels high can I be around children or others or am I at risk for another infection.   Thanks  Mamaw in Ky",
    "doctor_response": "Hello,It appears to me that you are a bit confused on the advise given. Let me try to explain you in a different way to the best of my abilities. Generally, high eosinophil level indicates a sensitive person. By sensitive, I mean a person who is highly susceptible to allergies. So high eosinophil levels does not necessarily mean that you must stay away from others.On the other hand, you state of a history of prolonged lower and recent upper respiratory infection. This infections either viral or bacterial have the tendency to spread through respiratory droplets. This is the reason your GP might have asked you to stay away for a while from your family.Finally, high eosinophil count might also suggest a higher risk of allergies like pollen for eg and not commonly infections.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vein over left temple to be pulsating?\n\nThe vein over my left temple is pulsating.  No pain, but slight pressure on the edge of my left ocular cavity.  I have a history of panic attacks, and this occurs during them, but at the moment, I am not having an attack.  Could this be something other than stress?",
    "doctor_response": "Hi,Thank you for your query. I can understand your concerns.It is  not a vein but an artery, more specifically, the superficial temporal artery which pulsates.It is a branch of  the external carotid artery. It occurs in anxiety disorders.Pulses can be abnormally strong when the patient has an elevated pulse pressure.  This would result in a strong, bounding pulse that could also be asymmetric due to anatomic variation.Bounding pulse -commonly seen in hyperkinetic circulatory states where there is vasodilatation and increased stroke output. The pulse volume is high (due to high pulse pressure) with increased blood flow.Hyperkinetic circulatory states may due to excitement/anxiety. Other causes of hyperkinetic circulatory states giving rise to bounding pulse are Hyperthyroidism,Severe anemia,Beri Beri (thiamine deficiency),Arterio-venous fistula (e.g.  Paget's disease or hepatic failure).The most rapidly rising bounding pulse are found in AR(aortic regurgitation), PDA(patent ductus arteriosus), coarctation of aorta.Regards Dr. T.K. Biswas M.D.Mumbai",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes feeling of heart thumping in forehead?\n\nMy 5 year old son sometimes complains about his heart thumping in his forehead (or what I believe this to be from his description). He doesn't mention anything about pain, just 'sound' or 'noise' Otherwise he is a healthy, normal 5 year old. Your thoughts?",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. This looks like he has ENT problem. He is most likely having some arteriovenous fistula in ear or surrounding region which makes his abnormal pulsation feels like thumping heart. You should get his detailed ENT examination done, to look for av fistula. He may need test like Doppler or CT angiogram of vessel.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can be done for swelling and pain in cheek due to decayed tooth?\n\nHello doctor, I have had pain recently in a tooth that has a hole in it for several months and the pain has been horrible and a couple of days back, I woke up with swollen cheek on the side of my bad tooth and pain is also there. When I touch my cheek, pain shoots down to my tooth and I do not know what this means.",
    "doctor_response": "Hi. I have gone through your question and I can understand your concern. As per your history, it seems to me that you are having acute apical periodontitis with related buccal space infection. You need antibiotics for at least five days, so have non-steroidal anti-inflammatory medication. In case you want me to prescribe proper dosage, upload your picture of the swollen face so that I know the severity, and also your weight and height too. Or, you can visit a dentist physically but do not avoid it as the space infection can be dangerous too.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for depression and violent behavior\n\nI am searching for a child pyciatrist that deals with youths.  I have a client that will be 14 years old.  She is a cutter and hits her legs until they are black and blue.  They reside in New Castle, PA  does anyone know of someone that can help this girl that can be within 30 mins. driving distance.  I am a non-profit company from Hermitage, PA 16148.  You can locate me on my web    WWW.WWWW.WW   Please email or contact me at my home office 724-346-0667.  If I am unavailable if/when you call, please give me a phone number and a good time to return the call.",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.From what you have stated it is quite clear that you are having a depressive episode. Depression can occur with regular stress and it can also occur biologically without any stress as well. You need proper treatment for the same. There are various effective therapies for depression like fluoxetine, venlafaxine, bupropion, mirtazapine or escitalopram and they are all very effective and mostly safe. You may also require some benzodiazepines like clonazepam or lorazepam for a short period like 2-3 weeks to reduce the anxiety and help with your sleep.  If you are averse to the drug therapies then there is also an option of cognitive behavioural therapy. This therapy is taken by either a psychologist or a psychiatrist in which the therapist identifies impaired cognitions (Thoughts) and try to correct them. They are 15-20 min weekly session and there should be around 8-10 sessions to help you with your illness.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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can the tubes get blocked again after having them cleaned and opened ?\n\nI am 34 years old Hi may I answer your health queries right now I am 34 years old ,..i have done my laproscopy in march 201o and found that both my tubes were blocked. However the tubes were cleaned and opened and after that I was under AKT 3 and combunex for 3 6 months.after completing the drug I tried for two months but did not get pregnant . Now I will start with my ovulation drugs . However some of the doctors are suggetsing to go for another HSG as the tubes can get blocked again. Is it possible?",
    "doctor_response": "Hi Welcome to HealthcareMagic Yes sometimes tubes may get blocked again even after corrective treatment. As you did not get success in conceiving after surgery , it would be ideal to confirm tubal patency either by HSG or sonosalpingography before you go for further treatment. All the best .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and lumps in the armpit after delivery?\n\nI have just given birth to  baby girl five days ago, I am able to provide her breast feeding adequately.But I am observing some forms of lumps under my both arm pits causing pain, swelled . What may be the reason?? Is it normal? What are the remedies for that??",
    "doctor_response": "Hi.Welcome to HCMAre you breast feeding? If feeding is not adequate you may develop milk filled lump in breast which can cause lump in armpit with pain. Try to feed baby completely and also express milk if required. If pain persist you have to start antibiotics after showing to surgeon.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe pain in the lower back be treated?\n\nI am having severe pain in my lower back and hip area. I have had an X-Ray and the hip is fine. It starts out okay in the morning, but as the day progresses, the pain get worse. Especially after sitting, when I get up to walk I get a terribly sharp pain in my lower back and hip area. This started about a week ago. I am now having headaches every day and feeling generally tired. I also have had a rash, that is just going away (after taking Benedryl).",
    "doctor_response": "hi sir/madam,Thanks for your question on Healthcare Magic.Let me advice you for your problem.Low back ache may be a pre-monitory (prodromal) symptom in fistula in ano, sciatica, gouty arthritis, hernia, emaciation disorder etc. Pain is confined to lower part of the spine (back bone) especially lumbar region or lumbo-sacral area (rarely sacro-iliac region also). If it is secondary, earlier history of fall or injury may be associated. Rarely, radiating pain may be complained by the patient towards lower limbs. But it is quite common in low back aches if the defect is in the discs between vertebrae (back bones). Often the movements of lumbo-sacral region like flexion and rotation are hampered either partially or completely.Low back pain may be found in mild form in case of anemia, sciatica, rheumatoid arthritis, hemorrhoids, urinary calculi, uterine disorders etc also.Line of treatment as per Ayurveda:-The general principles of treatment of vata dosha are adopted in case of katishoola (low back pain). It includes various measures to suit its varied clinical entities, stages and associated complaints.1. Snehana (oleation) \u2013 by sneha dhara (pouring oil), abhyanga (oil massage), avagaha (tub bath with oil or oleaginous medicaments), kati basti (retaining medicaments on the back) etc.2. Swedana (sudation) \u2013avagaha sweda  (sweating treatment with tub bath), pizichil (kayaseka), nadi sweda (sudation through a tubular device \u2013 local sudation), panda sweda (sudation through medicated paste or powder) etc.3. Mridu Samshodhana -mild purgation.4. Basti (medicated enema) like eranda basti, vaitarana basti, pippalyadianuvasana basti etc.Formulations indicated in Low back ache as per Ayurveda:-1. Dashamoola kwatha.2.Maharasnadi kashaya.3. Rasnaerandadi kashaya.4. Sahacharadi kashaya.5. Gandharvahastadi kashaya.6. Trayodashanga guggulu.And for local application these oils will help:-1. Ksheerabala tail.2. Mahanarayana tail.3. Dhanwantaram tail.4. Maha narayan tail.Avoid these for better results:-1.Bitter, astringent and pungent food2.Cold water3.Fear4.Exhaustion5.Standing6.Driving7.Cold food and beverages etc.Yoga is also very helpful in treating your back ache.Now for your backache do these yoga aasana:-1. Ardha Matsyendrasana(Sitting Spinal Twist).2.  Dhanurasana (Bow Pose).3. Marjariasana (Cat Stretch).4. Balasana(Child Pose).5. Halasana(Plow Pose).6. SUPTA MATSYENDRASANA(THE TWO KNEE SPINAL TWIST POSE).7.Adhomukha Shwanasana (Downward Facing Dog).8. Urdhva Mukha Svanasa",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are my symptoms caused due to taking too much of Thyroxine or HRT?\n\nHello doctor, I have just received my blood results of thyroid and hormone blood test, and I require your help, please.\u00a0I am 54 years old woman, who is 5.6 feet tall and weigh 13.10 stone. I have suffered from ill health for many years and cannot remember the last time I felt well. I had a complete hysterectomy at the age of 37, and I was put on 2 mg of HRT Elleste Solo. I have Hashimoto's hypothyroidism and take 150 mg of Thyroxine. I was put on Thyroxine 175 mg, four times a week. I also take 500 mg Metformin tablets, three days. I was also diagnosed with exocrine pancreatic insufficiency, and I take Creon capsules. My fasting blood results are\u00a0HbA1C is 56, insulin is 62.5,\u00a0LH is 24.6, oestradiol is 300, testosterone is 0.9,\u00a0SHBG is 173, free testosterone is 0.005,\u00a0TSH is 0.58, T4 total is 178.5, free T4 is 19.62, free T3 is 4.25, reverse T3 is 28.0, reverse T3 ratio is 9.88, anti-thyroid peroxidase is 183.8, anti-thyroglobulin is 882, vitamin D and vitamin B12 all in good range. I have vitamin B12 shots every three months. The symptoms are fatigue, brain fog, forgetfulness, joints and bones aches, and weight gain. I can just lose a few pounds, but it comes back on as soon as I eat normally. My diet is good as I cannot eat fatty foods. Fats go straight through me, even with the Creon. Sugary foods make me feel weird. I do not drink or smoke. At the moment, I struggle to exercise as I get breathless. My legs ache and feel\u00a0that I am not getting enough oxygen to my legs.\u00a0I have high cholesterol of 7, which has come down from 10. I do not take tablets as they made me ill. I also have\u00a0forgetfulness, migraines, and breathlessness. Can you help me?\u00a0Am I taking too much Thyroxine?\u00a0Should I take T3? Should I take more Metformin? Am I\u00a0taking too much HRT?\u00a0Is the thyroid making me have high cholesterol?\u00a0I look forward to hearing from you.\u00a0Thank you.",
    "doctor_response": "Hi. I am sorry you have had to go through a lot. I really appreciate your writing all your problems in such a detailed way, which makes me easy to understand all your symptoms fully. Most importantly it is high time you stop your hormone replacement therapy. HRT should not be taken for more than five years after menopause. You have your hysterectomy at 37 years age when you entered menopause. HRT is associated with weight gain, which is a problem you are having. HRT is also associated with increased cholesterol levels, which is also one of the problems you are having. It is very important, and I am glad that your vitamin B12 and vitamin D levels are normal. Keep taking the supplements. Now the cause of early menopause at 37 years of age, you have a high risk of osteoporosis, which is low calcium in bones, which can explain your aches and pains. Please get a dual energy x-ray absorptiometry (DEXA) scan done for bone mineral density at spine, hips, and wrist to rule out osteoporosis. If we diagnose and treat osteoporosis, it can improve your aches and pains. Next, your thyroid is well controlled, as evidenced by a low normal TSH (thyroid-stimulating hormone). Hence, we need to reduce your Levothyroxine dose. Currently, you are taking 150 mcg per day. Let us reduce it to 138 mcg per day. Levothyroxine should be taken ideally first thing in the morning in the fasting state, with at least an hour gap between the tablet intake and tea, coffee, and breakfast. If your forget to take some day and remember it only later in the day, do not take at that time, you can take double the dose next day. That is the correct way to ensure pill count 30/30 in a month, and it is perfectly safe. Since your anti-TPO and anti-TG antibody titers are positive (high), you have auto-immune thyroid disease, and you probably have to take thyroid medicines for life. Since we have reduced your thyroid hormone dose, repeat free T4 and TSH levels after six weeks for checking. Other thyroid parameters are not needed. T3 is not safe and should not be used for treatment. Next, your blood glucose is mildly deranged. I would advise you to take 500 mg of Metformin in the morning after breakfast, 500 mg after lunch, and 1 gram of Metformin after dinner. Let us repeat HbA1C after three months. Check your monthly fasting and 2-hour post meal blood glucose value also. I suggest tablet Calcium citrate (1 g) twice daily for good bone health. Avoid Calcium carbonate, as it is linked with gastritis and d",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could back pain be treated by advil?\n\nI have back pain, right side, above waist, no symptoms otherwise of kidney infection nor do I get them. It's getting worse since last night when it started suddenly, Advil didn't dent it. Trying to figure out what's causing it. I'm physically active, no problems. Thanks! L",
    "doctor_response": "Quite often the cause of back pain is musculoskeletal. You may have slept awkwardly, or incurred some other gradual physical trauma. Topical ice would help control the stifness/spasms. You also could apply topical pain cream such as Aspercreme. If there are no other symptoms, the it's just a matter of rest and pain control until it heals and resolves. But if over the counter pain meds aren't cutting it, then you may need to see your doctor to get something stronger, and/or a muscle relaxant. Another quick option is chiropractic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can long term use of Eption 100mg be stopped due to CT scan showing no abnormality in brain?\n\nAt the age of 21 I suffered from neurocysticercosis later on fully recovered almost last 20 year any seizure or any kind of problem , but still taking Eption 100 MG one Tablet only every night, please suggest can I stop it immediately , in latest CT Scan no any abnormality observed in Brain.",
    "doctor_response": "I read your question carefully and I understand your concern.So if I understand you correctly you have been without a seizure for 20 years now and the latest scan showed no abnormality.It would've been preferable if you had an MRI instead of a CT scan, it is a more reliable exam. That being said though 20 years without seizures is a long time. Generally it is attempted to withdraw medication if a patient is without seizures for 5 years. Furthermore only 1 tablet a day is too low a dose, I wonder if it is providing any protection at all.So I would advise to stop it, of course after discussing it with you physician as well.I remain at your disposal for other questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does chemotherapy cause infertility?\n\nSir, My wife had undergone chemotherapy four years before (when she was 26) she got married at 29. now she is 30. We have been trying to get preganant for last one year, but no result. her periods are normal. the only abormal symptom is that her body use to get hot (for seconds) quite often and come b ack to normal temeprature. Can she become pregnant. is it due to chemotherapy. I think she did chemotherapy for six months and did not had periods for i year.",
    "doctor_response": "Thanks for posting your query to HCM.To get pregnancy you require:1 Normal semen analysis report .2. normal uterus with patent tubes tested by Histosalpingography .3.normal hormonal status of your wife :FSH,LH,TSH .I want to know the cause for which your wife had taken chemotherapy for long time because genital tuberculosis is a common cause of infertility and require long chemotheray .So you should check for above parameter and then consult gynecologist .best wishes for both of you .Feel free to communicate if any query.regardsDr.Manish Purohit",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for stage 3 kidney failure?\n\nHi, I am a 41 yr old woman with stage 3 kidney failure, have no ins & cannot qualify for Medical.I am having severe bodu aches with slight fever and my back is extremely achy & sensitive. I get throbing sharp pain through out my body that is intolerable, cannot find any thing to soothe. I last was seen by a DR 2 yrs ago & still have pending ER visit in the thousands, so going back and adding to my debt is not appealing. Advice would be greatly appreciated",
    "doctor_response": "Hello and welcome to HCM.As an Urologist,let me convey, that kidney function has 5 stages of failure.As kidney function deteriorates, the stage goes up. This is tested by checking, patient for swelling,urine routine and culture,microalbumin and protein,blood Hb,creatinine,urea,potassium,uric acid,sugar,ECG,chest X-ray, and ultrasound scan of abdomen.With these reports,your stage of kidney function can be staged, and proper treatment is advised. Fever is likely to be,due to infection.I advise you to see a Nephrologist at the earliest, with the reports. You can get my expert opinion,by sending the reports to me, as a direct question.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could not finding appendix in ultrasound cause bad abdominal pain?\n\nI have been having really bad abdominal pain for the last 3 week the doctor thinks I have a UTI, I ended up in the emergency department last night. I had an  ultrasound this afternoon and they told me they couldn't find my appendix. Is this what is causing my pain?",
    "doctor_response": "Hi thank you asking  HCM if  you  have  apendicitis, abdominal ultrasound  in  one of  diagnostic test,  so  you don't have  apendicitis. your  abdominal pain  is related with UTI. you should start the treatment with antibiotic. wishing you all the best DR.Klerida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Loss of strength in hands and legs, sensitive to hot and cold objects, taking Bisoprolol. Advice?\n\nHi ] My father (age 75) is experiencing severe loss of power in his hands and legs, he still works as an engineer but is now unable to hold tools due to the loss of power. his hands are also very sensitive to hot and cold items. He recently started 1.25 of bisoprolol as he has an irregular heart beat. Please can you advise as his condition is worsening day by day, we have requested an MRI of his neck .",
    "doctor_response": "Dear you should take contact with an neurologist because with the neurological exam the doctor is able to determinate the cause.Does your father has neck pain, because if there are no neck pain probably the problen isn't the neck.I would reccomend an electronervogram of 4 extremities.Hope my advice will help you wish you all the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to achieve hemoglobin level from 9g to normal while having severe hemorragia?\n\nI am a female 54 years old, non menopausal, my hemoglobin is at 9g (after 16 days of severe hemorragia and 2 days at the hospital). I am still feeling very tired, (hemorragia has stopped), how long will it take to get back to normal? Marie, Montreal, Canada",
    "doctor_response": "HelloThanks for writing to us with your health concern.If the hemorrhage was ongoing, you would have needed blood transfusion.Now that the blood loss has stopped, you would need to build up your hemoglobin.This can take time - 3 to 6 months in fact.First is medication.You can take daily oral iron supplements twice a day ( take it with folic acid, vitamin B complex and vitamin C ).Alternatively, parenteral iron injections can be taken.Alongwith the medication, dietary modification is a must.Please incorporate liver, beef, red meat, bone marrow, spinach, grains, nuts in your diet.It will take months to come back to a normal hemoglobin.The fatigue and symptoms should go away within a month of starting the medication.Be compliant though, as not taking the drugs regularly could leave you with persistent anemia.All the best.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fatigue, loss of balance while walking, slurry speech. Have sleep apnea. Ruled out Parkinson's and strokes. What else?\n\nA friend is going through diagnostic tests to determine what may be his problem -- he is extremely fatigued, is experiencing problems walking (tripping at times)  and his speech is continually getting slurred.   drs. have ruled out MS, Parkinsons, and strokes.  He had a sleep apnea test last night.   his MRI came back looking good.  What else could they be looking at?",
    "doctor_response": "Hi, Difficulty in walking with tripping episodes and slurred speech other possibility to be considered once MS, parkinsons disease and stroke are ruled out and MRI brain normal needs to rule out motor neuron disease (ALS) where both UMN and LMN affected and MRI brain can be normal You Need to consult neurologist for neurological examination and detailed history and evaluation is needed for further confirming the diseaseRegardsDr Sandhya ManorenjNeurologistHi tech city hyderabad",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had conservative breast cancer for right side, chemo given. Feeling pain in left shoulder. Reason for pain?\n\nMy wife has undergone operation for conservative breast cancer for right side and now one dose of chemo is given on 24/11/12 and next is to be given on 15/12/12. but today she is feling pain in left shoulder where hair type small scratch is seen which may be due to strap of bra. is it safe to give Mox 250 with combiflam my email id is YYYY@YYYY",
    "doctor_response": "Hi, Pain is not related to cancer. certain chemo has side effects like myalgia or musculoskeletal pain. you should have mentioned what chemo was given. mild injury not always needs antibiotic. there is no cotraindication of mox 250 with combiflam but may not be needed at all. clinical examination needed. consult your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the condition of varicocele?\n\nRespected sir,i am  25 yr old male from kerala. I had a torsion testis operation when i was 17. both testis were surgically corrected and i had no complication. no vascular compromise. four years back i felt a pain in the left side of scrotum and doppler study confirmed a varicocele. now at 25 again the pain increased and i have bilateral varicocele.my fertility count is 90 million. so my docter suggested no surgery. but i have pain which causes uncomfort. As i had one surgry earlier i am not interested in another one also. i hear about varicocele embolization. can u suggest me where it is done. any name of the hospitals where embolization is avalible in kerala.",
    "doctor_response": "Hi,Surgical correction is the only treatment of choice in cases of Varicocele. Medicines are usually not effective. Hope it helps. If you have any other question please do not hesitate to contact us.Regards,Dr. Atishay Bukharia",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of lump below the knee?\n\nHi I have had a hard bony lump on side of leg just below knee area of left leg, the lump is not painful but i do get a cold like cramp pain feeling in the lower part of my leg. I had a CT Scan a couple of days ago, while there i was sent for xrays to confirm what the scan was showing, but i was not told what the outcome of this was, they told me a report would be sent to my doctor. I know its nothing serious but am curious of what it could be. thanks",
    "doctor_response": "Hi,Dear,Welcome to HCM. Based on the facts of your query,You seem to suffer from-hard bony lump on the sides of the leg below knee of left leg.Cramps in the lower leg and X-ray study after the CT scan study,indicates something boney osteophyte of the knee joint,causing the issues with the lump below knee.This lump could be MB Cyst or could be Osteolcastoma of upper end Tibia / or could be osteophyte of the knee joint.Arthroscopic removal of the MB Cyst or Osteotomy of the tibia with Bone graft would resolve the lump besides the knee.CT and USG would fix the diaganostic ambiguity and doubts.HOpe this reply would help you to plan further treatment with your doctors.Contact with a Followup Premium question to ME. Will appreciate your Hitting thanks and writing excellent review comments to help needy patients like you. Good Day!! Dr.Savaskar, Senior Surgical Specialist M.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will taking Buccastem for dizziness be safe?\n\nHi I have just been diagnosed with Buccastem  for dizziness! I have read the internet and find out that it is for nausea and sickness. I do not feel nausea or sick. Is this right? Also I have mistakenly swallowed the first tablet, how will this affect me? Thank you. YYYY@YYYY",
    "doctor_response": "yes it is used for dizziness also yet i would suggest betahistine as the best treatment for vertigo depending on the cause for vertigo it is treated in different ways",
    "dialogue_context": ""
  },
  {
    "patient_message": "What injection can reduce platelets in blood for some time ?\n\nSir,i am ram (male/28 yrs) i have taken immunization today.INJ TT 0.5ml IM  & INJ TAB 0.5ml IM AFTER ONE HOUR I HAVE GIVEN BLOOD FOR PLATELET COUNT. MY HB IS 15.6MY PLATELET COUNT IS 1.4 LAC. THESE INJECTIONS WILL REDUCE THE PLATELETS IN BLOOD FOR SOME TIME IS IT TRUE .CAN U PLEASE CONFIRM THIS.THANKING U SIR",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. But tetanus injection is not responsible for your low platelet count.  It doesn't reduce platelets.  Moreover your platelets are of low normal so no need to worry about that. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rectal bleeding with back and abdominal pain?\n\nhi Doctor,  I have three questions for you, my first: I am 27 with diagnosed osteoporosis. I have recently been passing blood in my stool as well as have been in severe back pain with occasional abdominal painl, nauesa and faintness - would you know what could be causing the blood in my stool? I am not constipated, don't smoke or drink and live a healthy lifestyle. Second: My recent scan said that I have a generalised annual laxity of the L4/5 and L3/4 vertebrae. What is an annual laxity? My scan also mentions degenerative changes in the  L3/4. Third: What could I do to build the density of my bones?  Thank you for your time",
    "doctor_response": "Hi,Thanks for your query. After going through your query I came to know that you are suffering from osteoporosis . For this get your bone density checked.You should take calcium supplementation. Serum vitamin D test is advised (if it is low than vitamin D supplementation will be required). You  are passing blood in stool. You should get examined by surgeon for piles. You have annual laxity means annular ligament of disc is lax.It may be hereditary or due to vitamin and trace elements deficiency.Degenerative changes are age related changes.For building of bone density you need to do exercise specially walking and running .Take a high calcium diet.If you have vitamin D deficiency then its supplementation  can be taken.  For pain relief you can take analgesic such as ibuprofen. Vitamin B and C are helpful in recovering.You can discuss with your treating Doctor about it. I do hope that you have found something helpful. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause for the difficulties during and after dialysis?\n\nI would specifically like to speak to a nephrologist. My husband had PKD; he is now ESRD. His kidneys were removed last January 28, 2013 at Johns Hopkins in Baltimore. They weighed an astonishing 49 pounds. He was in JH for 77 days post-op; 16 days in the ICU. He is on dialysis at a facility close to our home -- and was doing well. However, a week ago he passed out during dialysis -- and felt sick and dizzy yesterday when I picked him up (I have never allowed him to drive after dialysis). He also says he experiences a burning sensation at intervals all around his waist. His nephrologist (who visits him weekly at the dialysis facility) does not have an explanation for the burning sensation or the more recent difficulties he is experiencing. He is now on the Active list for a transplant at JH. My concern is what could be causing him to experience such difficulty recently during and after dialysis. Any suggestions -- I have asked that he be given some water 15-20 minutes prior to the end of his session (total of 3 1/2 hours Monday, Wednesday and Friday.) Thanks.",
    "doctor_response": "hi, I am incharge and head of dialysis wing in our hospital for the past few years (though i am a physician), hope you don't mind me answering.  Many patients on long term dialysis develop postural hypotension due to salt wasting and uremic neuropathy. That explains occasional dizziness in them. A tip is, not to allow him to stand right away from lying down position; make him sit for 2-3 min and them allow him to stand. Burning sensation around waist (if you are sure it is coming from skin rather than from deep) can also because of neuropathy, if local causes like skin infections, are excluded.  hope this helped.",
    "dialogue_context": ""
  },
  {
    "patient_message": "74 year old with palpitations and night sweats. Concerned about marijuana exposure. Due to stress?\n\nI'm at my rope's end. My 74 year old mother is waking up with heart palpitaions and night sweats. She's convinced that they're caused by another member of our household who smokes marijuana and simply won't take his habit outside. She shuts herself up in her room. as do I, but he fires up an average of 2-3 times a day, either in the living room or the den, and she insists that every time it happens, she goes into the one of these rooms and catches him in the act.  It should also be mentioned that she is currently under a tremendous amount of stress from external factors. I can't get her to go to her doctor, because she's afraid the secondhand exposure to marijuana will show up in either her blood or urine, making the doctor think that she's a user. In your opinion, is it the marijuana, or the stress causing her palpitaions, or the stress? Can she be allergic? Obviously, she needs to go to the doctor to ascertain exactly why she has this problem, but can secondhand exposure to his habit cause her to test positive as a user?",
    "doctor_response": "Hi there ~I understand the concerns for your mother and believe that she needs to get out of the habit of using marijuana.  It seems to be the cause of her problems and getting off of it would need medical and psychiatric solution.  I would also think that you should take your mother to a group where they talk about the ill effects of usage.  It may also be useful to provide information from an outside source like a social worker who can help in your case.  I would think that medications are not the only answer, although they can be a big part of the answer and you need to have her see a psychiatrist.  I hope this helps.Take care and have a lovely day!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause to feel sleepy with weakness when on phenazopyridine hudrochloride for kidney infection?\n\nI take multiple meds due to ms heart disease hp and currently developed a copd flare and a lite kidney infection.the only meds added are generic Amox/k Clav 875 mg 2 xs daily and at the time I am also taking over the counter phenazopyridine Hydrochloride 95 mg 2 every 4 hours  problem about 45 min to an 1 hour after I take my meds I have a very disorientated feeling very sleepy and extreme weekness. it last about 30 to 45 min.  do either of these meds have this type of reaction?????Sincerely HELPSandra Harris YYYY@YYYY",
    "doctor_response": "Hi,Welcome to Health care magic forum.                  It appears that the drugs the combination of the amoxycilin, and clavalinic acid is an irritant to the gastric mucosa, and can cause dis oriented feeling, sleepy ness, and extreme weakness after taking the pills.                 Phenazopyrine also should not be used for more than 2 days.                 So first thing yoou should do is to stop th ephenazopyrine. And stop afthe amoxycillin and clavalinic acid combination after completion of the course.                    If still symptoms persists you can use ranitidine with your doctors advise.                  Wishing for a quick and complete recovery. thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Done follicar study. Took siphene. Sonography revealed enlarged ovaries. Treatment?\n\nhi m 27 yr old trying to conceive done follicar study was prescribed siphene 100 mg frm 4 to 9th day of my cycle took injection hucog0000 on 14 day but was nt able to intercourse on 14 and 15 day.but was doing it alternate days frm 10th day as told by doctor.sonography on 14th day reveled enlarged ovaries multiple large follicles size 20mm -25 mm in both ovaries wt r the chances of conceiving and what should i do now as today is 16th day",
    "doctor_response": "Dear user, welcome to healthcare magic.I see you are a good responder to ovulation induction so your chances of getting pregnant are great. Having intercourse at alternate days is better than every day.I am really concerned about the sonography report and I advise you to take care of the following:- do a scan before starting ovulation induction to make sure there are no cysts in the ovaries.- start with very small doses especially if you are going to take injections because you may have hyperstimulation easily.- good monitoring during the stimulation cycle for fear of ovarian hyperstimulation syndrome.Good luck.Dr. Ahmed Bahaa.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for difficulty in breathing with fever\n\nive got an appointment tomorrow with my local gp. but am worried i should be acting now, ive had ive got an appointment tomorrow pnemonia before when i was 11, and was in hospital for weeks, ive got an underlying congenial weakness, so my breathing is affected anyway, My temp is up quite high by what my forehead feels like, ive been dissy all day, i didnt sleep virtually at all last night",
    "doctor_response": "Hello dear , hiWarm welcome to Healthcaremagic.comI  have gone through your concern in depth .*  There are different  conditions which may lead to this as    -  bronchitis  -  pneumonia  -  decreased lung immunity  -  viral ,         bacterial  infection   -  others .*  Suggestions  at  present  for  better  recovery-  Do not panic  before  doctor`s visit .-  Maintain hydration with plenty of liquids .-  Deep breathing  exercises , YOGA .-  Prefer  semi reclining  position  when  doing  rest .-  Avoid  smoking , alcohol .-  Manage to have regular , sound  sleep of 8 hours .-  Tab. tylenol ( 500 ) mg 3 times   a  day  after  meals  .Hope this will help you for sure .Wishing you fine health ahead .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bipolar disorder and depression\n\nI am a 49 year old female with a lengthy medical history that includes chronic pain that is resist. I am contacting you because my primary doctor has taken an unexpected leave of absence for an indeterminate amount of time.\u00a0\u00a0\u00a0\u00a0\u00a0I could choose another doctor but the change would not be active until the first of the next month after I changed it. He has been my doctor for twelve years and if possible I don\u2019t want to choose someone else. Further, the remaining doctor at that just instituted a no pain medication policy so this is my only option right now.As I stated, I have been treated for pain for the following conditions:Periformis muscle symdromDegenerative disk diseaseMisaligned SpineFibromyalgiaMigrainesIT Band injuryEvery three to four months I get a RFG injection for my back..it takes a bit of the edge off but it doesn\u2019t go away , and I even signed myself up for PT, but the ones in my area are all backed up with appointments. I have to be somewhat out of pain to withstand the PT, and am due for one now. I have been told that people with fibromyalgia feel more pain than those without.In addition to the pain issues, I have (years ago) been diagnosed with BiPolar Disorder ll, with a lean toward reactive depression. With that comes the extreme anxiety, and add that to the pain and it\u2019s a vicious circle.I am o.k. on pain meds for now,  but really could use something for the extreme anxiety. I am jumpy and a nervous wreck most days, and at bedtime I can not sleep. If I got more than three straight hours straight in the last several weeks, I\u2019d be very surprisedCan you help me?",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.Mood stabilizers like divalproex sodium or lithium are the necessary drugs for bipolar mood disorders. Along with it bupropion is the recommended antidepressant. 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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rashes on inner thigh, knee, heel, looks like pimple, thought they were ant bites. What are they?\n\nI have had a few of these pop up in the last couple of weeks. I had a big on on my inner thigh area, a small one near my knee , and now I have a huge one on my heal of my foot . They start out little what looks like an ant bite. Thought maybe the one in my thigh area (Which appeared the same time as what I thoght were razor bumps where I shave around my Vagina .) but this particular one grew really big and became extremely pussy like a pimple . and now I have another on my heal. The one on my knee hasn t grown very large. And also two itty bitty ones on my arm ... (Which I thought were ant bites because they appeared after a mud run).",
    "doctor_response": "Hi i think the lesions explained by you are due to papular urticaria.they can be cused by antibiotic.combiflam tablet and mupirocin ointment over the lesions",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain and weight loss in kid\n\nmy seven year old daughter has been experiencing pain for 3 weeks in the abdomen, has had weight loss of 10lbs and has had difficulty eating , decreased appetite, cough for 2 months decreased energy and gets tired easily. has been hospitilized twice in 2 weeks because of not eating and drinking and the conclusion is some free fluid , mild renal pelviectasis (5mm diameter) what does this mean....they say it is normal and think she has emotional issues that's why she has pain and not eating, she had no problems before 3 weeks ago with eating ever.",
    "doctor_response": "Hi ! Good evening. I am Dr Shareef answering your query.I am not aware of your location. In case you are from a region where tuberculosis is not infrequently seen, then tuberculosis would be the most suspected culprit and the treating doctor should consider investigations related to that, like an ultrasound abdomen (which possibly has been done) , a CECT of abdomen to see the condition of the intestines, etc, apart from some routine blood investigations. A cough of two months duration adds to the suspicion. In case it is diagnosed, the condition is easily treatable, and your kid would become ok, but the medicines prescribed should be taken regularly and sincerely till advised. An LFT would be an additional blood investigation which could relate the side effects of an anti tubercular drug, if any.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "shall i get worried as some mercury spilled out near me ?\n\nI m a 20 years old woman. yesterday when i was doing an experiment in the laboratory some mercury spilled on me,i washed my hands only after an hour or more. now I m very much tensed.what would happen if i had got some mercury inside my mouth or inhaled its vapour? is it really fatal?",
    "doctor_response": "Hi dear Are you experiencing symptoms like cough , chest pain , headaches , blurring of vision or any other symptom?? No it is not fatal if timely treated. You are a Science Student , so i would list the treatment also : It is usually a chelation therapy using D-Pencillamine. There are other options also. Get yourself checked once at a nearest hospital. Good Luck!!!!!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are gnital warts contegeous in HBSAg non-reactive person?\n\nHi Doc, I m just a worried wife with HBSAg non-reactive result. My husband,28 got warts on his genitals just recently.I m just concern if transmission of said genital warts would be possible to me due to contact. What s the cure for it. Pls. help me. I m worried.",
    "doctor_response": "Genital warts are due to a different viral infection known as HPV(human papilloma virus). They have nothing to do with your Hepatitis B  status. You can still get them as they are also transmitted sexually.",
    "dialogue_context": ""
  },
  {
    "patient_message": "History of traumatic brain injury. Need new family doctor\n\nYes, please.I have a 24 year old son with a traumatic brain injury.  He sustained the injury 14 years ago.  We need a new family doctor.  I would like one who has experience with brain injury to manage the medications he's on.  The neuropsychiatrist who prescribed his meds has just died.  We live on the Main Line outside of Philadelphia in Pennsylvania.",
    "doctor_response": "Hi,Thank you for posting your query.Continuity of care is very important with regards to good recovery of your son after traumatic brain injury (TBI). Treatment involves use of medications, as well as counseling and physiotherapy. Regarding a family doctor in your area, you can find out from your insurance company or people residing in your neighborhood. Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My email: drsudhirkumar@yahoo.comMy blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the expected problems during wisdom tooth eruption?\n\nHi doctor, My wisdom tooth present in the lower left region is growing. I have a sufficient space for it to grow, and it is growing straight. I do not have pain in the tooth and half of the tooth is poking out now. But I have trouble in opening my mouth fully.",
    "doctor_response": "Hi. I can understand your concern. An eruption of wisdom tooth cause difficulty in opening the mouth, fever, swelling in gums, pain and neck swellings. You do not need to worry. Restricted mouth opening will get relieved after a few days. Still, to get relief, you can take tablet Zerodol MR (Acelofenac with Tizanidine) two times a day for three days after taking food. Take tablet Pantoprazole 40 mg one time a day for one week.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling feeling and debilitating neck ache after blood transfusion?\n\nI gave blood tues and last night (friday) my right hand kept having a tingling feeling so I turned on the other side to stop that and this morning I woke up with a neck ache that is debilitating. Is that anything serious to worry about? I am 79 years old.",
    "doctor_response": "there is no relation between neck ache/tingling feeling and blood donation. this is a co-incidence only.please consult orthopedic doc/ physiotherapist for the same.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can excessive mastrubation lead to low semen count?\n\nhello doctors, i'm 19 yr old and i weight 50 kg... I usually masturbate 3-5 times a day and i noticed that after masturbating 3 times consecutively, there is a decrease in semen and in worse scenario there is no coming out after masturbating....so my question is: Is it harmful to my genitals that there are no semen coming out? why there is a sudden decrease volume of semen or there is no semen coming out after masturbating? Someone tell me that is was called \"dry orgasm\" is it true? Do i over work my genitals?",
    "doctor_response": "Hello, Excessive masturbation will reduce the quantity of sperm for the time being. But not in the long term. Still, do not masturbate more than once in three days. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tiredness and paleness?\n\nHi My dad had prostate cancer a few years ago and had treatment. He saw the cancer specialist in Dec who told him he was in remission 4 years now. Last few months he has felt tired and looking pale. The dr has now said he is anemic and now last week she said to my mom she is worried about him and now today he had a call from the hospital to go for a anal camera monday. Do you think the cancer is back? He is 78 is in bad health with heart problems etc",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  He has history of prostate cancer and he is in remission.  He has anemia.  He should search for cause of anemia.  It may be due to iron deficiency, vitamin B12 deficiency or chronic blood loss.  He should go for complete blood count with peripheral smear examination and anemia profile.  He should also go for ultrasound abdomen to rule out any  cause of bleeding.  Search the cause and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of itchiness near motion area ?\n\nHello doctor, i am having itching problem near the motion area and in between the thighs.  i am using NUFORCE cream more than one month. but if i apply the cream only for two to three days. it comes again after three days also. i am using every cloth pouring in dottle. please give a good advice. thank u in advance.",
    "doctor_response": "Hello dear,Welcome to HCM.I have read your query and understood your concern.It is most commonly due to fungal infection.I usually advice my patients to take both oral and topical antifungals for atleast 2 weeks.For symptomatic relief, you may take tab levocetrizine/fexofenadine.I hope it helps.Get your blood sugar levels.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal for a child to vomit after suffering head injury?\n\nMy 2 1/2 yr. old fell off the bed and hit his head.  He cried, and then vomited.  He was also sleepy, but I did not let him sleep.  He seems alert now, and talks coherently.  Should I do anything....should I take him to a Dr.?     Pleasse tell me....why don't doctors hellp a desperate mother free?",
    "doctor_response": "There are certain ominous signs of head injury that we need to look out for. They are:* Vomiting* Loss of consciousness or altered consciousness* Severe headache* ConvulsionsThese signs could indicate something serious. The vomiting and the feeling sleepy after that raise the doubt and signify the requirement of a CT scan of the brain. You should definitely take him to a doctor and get him evaluated. If the reports are relieving, doctors would definitely be able to reassure you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruised skin on leg?\n\nI have had a bruised feeling all over my right leg and top of my right foot now for a few week and it s gradually getting worse skin feels bruised to touch and uncomfortable when walking or at night but there is not visible bruise there what could this be",
    "doctor_response": "Since there is no visible bruising, I infer that you basically have a burning irritation sort of sensation. Burning feet, or paresthesias, is the term used to describe a hot, painful, \u201cpins and needles\u201d sensation in the feet. Such a thing generally happens due to nerve damage which could be the result of conditions like diabetes. I insist that you visit a dermatologist and get it examined. He would be able to pinpoint the possible causes based on his findings.",
    "dialogue_context": ""
  },
  {
    "patient_message": "High bilirubin level, bloating, burping. Normal blood test earlier. How could levels rise?\n\nHello, I am 19 and have high levels of bilirubin and supposedly everything else is normal. I get bad bloating after meals and also very bad burping like a every single second. I have only been like this for a month. 2 months ago I had blood test checked when I went to the ER for chest pain but everything came out normal. So my question is, how could the bilirubin levels elevate in only 2 months??",
    "doctor_response": "hi before I tell you the causes of increased bilirubin in the blood let me explain the what the bilirubin is. the bilirubin is the yellow coloured pigment that the  liver produces due to the red blood cells destrtoyed and recycled so it is the by product of break down of hemoglobin . the causes for increased bilirubin in the blood due to sickle cell anaemia, allergic reaction due to blood transfusion, liver diseases like acute and chronic hepatitis, cirrhosis of liver, liver damage,  obstruction in the gall bladder, hemodialysis, side effects of medications, pancreatic cancer. so to rule out the exact cause consult gastro enterologist for necessary investigation and for the treatments. herewith I am giving you few suggestions to improve your health condition like drink plenty of water take healthy and nutritious food chew the food properly before you swallow avoid non veg spicy foods, junk foods, alcohol, smoking. have soothing diet do regular exercise to keep your health fit. hope this answers your query. take care. get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lipoma underneath the right scapula?\n\nI have decks syndrome. I believe I have a lipoma underneath my right scapula and I have had pain for 2 years now. I have complained to my surgeon, my primary, my pain management. Any ideas? I am in serious pain daily. I have had 28 surgeries in 3 years and I have had some painful lipoma but I believe this one is my second most painful lump.",
    "doctor_response": "Hello, Welcome to HCM. First of all your swelling should be confirmed as a benign condition like lipoma. You may be able to get the pain causing nerves ablated. After confirmation of the diagnosis, you should consult a doctor specialist in pain management. Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain while breathing?\n\nI pulled my back 3 days ago and it s in spasm for all these days.it hurts to breathe. I have been taking Tylenol every 4-5 hours with no relief. I m allergic to nsaids and aspirin. I ve tried ice packs, bengay and resting. Nothing stops the spasms. I m uninsured and wondering should I go to er? I d say on a scale if 1-10 the pain is an 8. I m 27 years old.",
    "doctor_response": "Dear patient for pulled muscle you need rest ,  hot water fomentation.  You need to start tab myoril 4 mg twice a day and tab ultracet once at night. this will help you in relaxing your muscle.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain and swelling in on knee\n\nAfter a fall from a bike I badly deflected my right leg. It is very swollen but 3 days later I have numbness to the knee to the right and below the knee which also occassionally gives a burning/stabbing sensation. X-rays at hospital were not thought to have shown any fractures. Can you advise please",
    "doctor_response": "Hello, What I understand from the history that x-rays might not consider the soft tissue and any fracture present will not let you stay quiet as the pain will be excruciating. Now the burning and stabbing sensation has two things to look for. either some nerve entrapment in it's course it leading this or either a ligament injury within the knee joint. An orthopaedic with being the right choice to look for and conclude based on the clinical examination and correlating with the clinical symptoms. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes seizures when diagnosed with elevated blood sugar levels?\n\nA relative is now hospitalized with seizures and an elevated blood sugar of over 1300. Has had recent hospitalizations with seizure activity. One doc said was not related to blood sugar. Another says, yes. Would a lumbar puncture be warranted to further evaluated?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I would explain that uncontrolled seizures are closely related to high blood sugar levels. I don't think that a lumbar puncture would help investigate for the cause. I would just recommend trying to correct his sugar levels as soon as possible, because at these levels, the patient may fall into coma. If seizures persist despite the normalization of blood sugar levels, then I would recommend performing an EEG and discussing on the possibility of starting antiepileptic drugs. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does alcohol abuse result in failure to ejaculate?\n\nHi, my partner is the most loving and noble man l have ever met, but when he drinks his mood changes like jekyll and hyde, from very happy and placid to aggressive, arrogant and trying to create an argument to storm off, he knows l am against drugs very strongly, so l dont think he would admit it to me, also, we have an argument and he says he needs to be on his own a while, how can l tell for sure. Sexually, he usually doesnt touch me until he has had a drink and then fails to ejaculate, even after quite some time, he is a big drinker on weekends, so lv always put it down to that, but am beginning to wonder now, any ideas. thanks",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.It is normal for a drinker to ejaculate at earliest. Drinking alcohol causes one to loose the mental control. Ejaculation is controlled by the autonomic nervous system. So once the man drinks the autonomic nervous systems becomes dumb.In my advice if you want to become pregnant than you can do the sex when he is not drunk. This will make you fertile. Such person perform better when they are not under the influence of alcohol.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat pneumonia in a 2 years 11 months old child?\n\nHi,My daughter (2 yrs 11 months) was suffering from pneumonia, was hospitalized for 6 days and was discharged 2 weeks back.However she started getting mild fever (99-100) since yesterday and we gave her crocin syrup. Today we took her to our pediatric and the doctor said it does not seem to be some stomach infection and suggested 5ml Vizylac and 5 ml zifi 100 twice a day and to use crocin or meftal-p only as SOS.It is night now and she is running fever again (100.5). i have given her Crocin Syrup (5ML) but the fever is only down by 0.5 degrees in the last 60 minutes. Should i give her some more crocin?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. I don't think this is related to her pneumonia 2 weeks back. 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 15mg/kg/dose (maximum ceiling dose of 500mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.Meftal-P contains Mefenamic acid which is a NSAID. It carries the risk of gastritis and renal problems in the long run. Please do not use Meftal-P. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the cyst in my neck?\n\nHello , I heard your who i need to ask. So I have a cyst in my neck & its very tender to the touch & within the last 4 days it has gotten pretty large , It went from about a dime size to a quarter size within those 4 to 7 days. I am uninsured & i dont have the money to get it took out. Please give me answers .",
    "doctor_response": "Hi,Welcome to HCM!There are several causes for a swelling in the neck. It would have been better if you had provided me the location of the cyst (where on neck?)It might be a boil/infection. For this, you need to take a course of antibiotics and get it drained as well if too large. You may also get fever due to the infection.Thyroid swelling? With a swelling in the front of neck, there is always a possibility of it being a thyroid gland swelling. You'll have to get it examined and investigated by a surgeon.It might also be a thyroglossal cyst. I'd definitely advice you to visit a surgeon an get it examined.However, since you are short of money, I'd advice you to take an antibiotic course and wait and see if it disappears. If it doesn't and is giving you symptoms, you'll have to visit a surgeon.Hope this information helps.Feel free to ask if you have any doubts.With warm regards,Dr. Sridhar Reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high fever with cough and nose block\n\nmy boy child of 3+ years had 3 times fever within 40 days duration ,1st for a period of 3days 2nd time fever for 1day and 3rd time fever yesterday night, and he is having sometime extream / mild caugh & nose block throught these period ,he used to get fits if the temp goes beyond 100 degree earlier and now also we fear so, please suggest what is the indication - 0000",
    "doctor_response": "Hi...by what you quote I feel that your son might be having a recurrent viral illness. To relieve your distress I will suggest you how a viral illness behaves.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.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for low grade fever in a child?\n\nHello, My four-year-old daughter has has a very low grade fever that seems to be higher in the mornings. This has been going on for about four days. She is eating constantly and playing normally but she complains often of not feeling well. When I ask her what hurts or where does she hurt she tells me she does not know but she just does not feel good. If she does name something that does not feel good, she names her stomach. Any suggestions?",
    "doctor_response": "your daughter may have a viral illness , better to be checked by her primary physicians to reach an appropriate  diagnosis .hope she becomes  well",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain. Diagnosed with cyst. Cancer chances?\n\nhellomy wife was told that her ultrasound showed an unremarkable cyst or growth and her doctor said that it was small. She has been experiencing back pain at the end of her period, other than that she has no other symptoms. She had 2 CA125 tests that showed her protein to be high. Can this be due to cancer or are there other reasons for these results?",
    "doctor_response": "Hi, Ovarian cyst is a common phenomenon. Ultrasound can reliably diffentiate between a benign ovarian cyst with some other suspicious ovarian tumors. CA-125 very often increased in many non malignant causes. Cystectomy may be an option in treatment of ovarian cyst but that can be decided by your gynaecologist. If any suspicious lesion is found on imaging more radical surgery should be done and pathology report should be obtained. Consult your gynaecologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in right side on the back region?\n\nA few yeas back a drill bit broke off and impacted in my liver area, For days I struggled to breathe really thought i was going to die. Externally the bruising was from my liver chest and down my right arm. Since then I get recurring excrutiating  pain in my back right hand side which puts me to bed for a few days. I have requested a cat scan what tests could I have?",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.Your symptoms may be suggestive of gallbladder stones so you should do at least ultrasound or CT scan to evaluate it more accurately. This is caused by stone in bile duct and is very common condition.  Stones are see more commonly in obese people and those with diabetes. You need to change your dietary habits first.  Need to avoid fried food, carbonated drinks, coffee, alcohol and spicy food. You should eat more milk products, vegetables and boiled food. If there is no improvement on lifestyle or dietary changes, then surgery is recommended. Other causes include pancreatitis or pleuordinia and should be considered if gallbaldder stones are ruled out.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to be sure about ovarian cancer?\n\nI need to find an obgyn in warner robins who is very good and a doctor who cares. I am hurting where my ovaries are. I have had a partial hysterectomy in 01 and my ovaries are still there. I am 50 years old and I am worriee that I may have ovarian cancer. Is there someone you can recommend?",
    "doctor_response": "Only just pain in ovarian region cannot be sure of cancer. It should be combination of symptom of pain, anorexia, early satiety, constipation- very non specific symptoms, and no single symptom is suggestive of cancer. get CA-125 levels, get USG abdomen, and if anything suspicious is there, doctor can further advise regarding on that.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat penile red bumps?\n\nhello doctor a day after having sex with my wife my penis starts felling itchy followed by some small red bumps. after 2 days the top inner skin layer of the penis peals off and i have new skin and the itching goes away. this has happen twice now and my wife is also having thick vaginal discharge that some times damages her underwear (like some kind of acid) and she fells itchy as well almost all days",
    "doctor_response": "HiThank you for asking HCM. I have gone through your query. You and your wife both are most likely having fungal infection. Both should be treated also. Clotrimazole cream for local application can be used for both of you to get rid off this. I also advise fluconazole tab weekly once to stop recurrence in my patients. Hope this may help you. Let me know if anything not clear. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What precaution should be taken after head injury?\n\nhallo doctor, my son aged 8 years fell off from a parked bike hitting back of his head. it happend about  4 hours back. he is doing ok. but what preacuation should be taken, kindly advice. he is complaing of  slight pain , back of his head. i checked for any swelling, found none.",
    "doctor_response": "hello,thanks for your query, blunt hit over back with out swelling and bleeding need not to be worry.u can give simple brufen 200mg twice daily for 2 days. if the site is increasing swelling, associated with constant head-ache, vomiting,fits, u need to be evaluated by ct brain and er physician.all d best.take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to increase chances of pregnancy?\n\nim 37 and trying to get pregnant,how can i boost my chances? i was told by a friend that taking a hot bath relaxes you and can help,i did have the implant taken out justb4 christmas and have now having regular preiods i am a smoker but have cut down alot",
    "doctor_response": "Hi,    Thanks for the query.I understand your concern.     Taking Bath would definetelyhelp my improving your mood. More scientific things to hrlp conception are-    -Folic acid 5 mg pill to be consumed by both the partners for 3 months before conception.     -Have a nourishing balanced diet/Avoid any illness (for both the partners. - quit smoking 3 months before conception    -A regular & oulating cycle &normal semen reports are to be confirmed. (by  srmen analysis after 3 days of abstinence &usg ovulation study)   - Monthly ovulation day can be confirmed by LH surge test.....have an unprotected sex daily for 6 days from +ve surge test.  *All the things strictly followed.. there would be conception within few months.  Test by urine pregnancy test after 8 days delay in periods &consult to start treatment imediately after +ve test.  *Go for detailed investigations ..if no +ve result in 6 months &consult a sterility doctor.    Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have long-sightedness. Will lasik cure it?\n\nHello doctor,I wanted to ask you about long-sightedness.",
    "doctor_response": "Hello. I have gone through your attachment (attachment removed to protect patient identity), you have myopic astigmatism in both with the left eye having high astigmatism. If you have any doubts about this prescription then please be more specific about it, I will do my best to help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should we check for any medical problems for the delayed puberty who is very active and has rapid weight gain?\n\nMy son age 15, Acts very inmuture ,has gained alot of weight, eats alot, does not have any signs of going into puberty, no hair, voice change,or any of the normal signs should we have him checked or is this just delayed puberty? Very short for his age 4ft 11 138# he is very active . I guess the rapid weight gain has me most concerned, pluss he still acts like a 10 yr old. He is in 9th grade and has withdrawn from alot of the kids he has grown up with because the are so much ahead of him and he feels he is being left behind. Any suggestions? should we check any medical problems?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Pubertal changes occurs in boys and girls aound the age of 13 and sometimes 12. The reason the change is the presence of hormones such as progestorone and testosterone. In some cases the weakness of the hormoney delays the puberty. Sometimes it is also possible some hormones inhibits the activities of the above hormones. Rapid weight gain could be suggestive to inhibition and thyroid problems. Hyper activity also points towards this direction. please consult a competent physician to ascertain the cause and to have proper diagnosis.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain under the rib cage?\n\nUpper right quadrant pain under ribs after taking Tylenol with codeine. It isn t my ulcer, it feels exactly the same as gall bladder attack pain.. Had it out years ago tho but same exact radiating pain up into right shoulder blade. Don t get it from regular Tylenol or other meds. If it s my liver, then why not the pain from regular Tylenol max dose. Confused..",
    "doctor_response": "Dear patient Most common cause of pain in right upper quadrant is liver and gallbladder  pathology  may be stone or liver damage. Tylenol is metabolised in liver and hence pain may be related to its intake. This needs  be investigated with 1. Liver enzymes such as AST and ALT levels 2. Ultrasound  of abdomen. Please get it done from reputed  laboratory.  You need to consult gastroenterology specialist with both reports. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can I do as feeling lumps in throat and headaches and insomnia?\n\nmy hair hurts growing on my legs and on top of my haid I just had a baby 4 months ago i am 38 I,ve been feeling a lump in my throat and pulling in the chest first i thought maybe post pardom anxiety but its not going away head aches and insomnia aswell",
    "doctor_response": "Hi,Dear,thanks for the query.It appears to be more of anxiety.Still to rule out your worry,I would advise surgeons second opinion.Hope this would resolve your issue.Wellcome for any query again to HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fluctuating sodium levels in the blood\n\nHello, I have taken Norco for about 13 months now at a dose of 10 mg once to twice a day for severe pain. I have also been taking Trileptal for 6 years at 600mg twice a day for seizures. About three months ago my doctor diagnosed me as hyponatermic and my serum sodium levels keep fluctuating but not too severely. Do you know if I should seek different medications or of any treatment? And I am a 18 year old female weighing 123 if that helps to explain my dose strength .",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As your sodium level is low I would advise you to take salt daily in your diet. You also need to decrease your dose of Norco to once daily. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have been diagnosed with severe gallstones, my bladder is apparently full of them. The bigger issue at hand is my lung capacity is only 30%, which they tell me is very low in order to perform surgery. What are my chances if I m put under anesthetic in order to have my gallbladder removed?",
    "doctor_response": "Welcome at HCM    I have gone through your query and being your physician I completely understand your health  concerns.   It is not possible to perform a surgery under general anesthesia with these compromised lung function. Alternative in this case would be CHOLECYSTOSTOMY under Local anesthesia. your surgeon will guide you through this             Meanwhile stay calm and use acetaminophen to relieve pain   Get well soon Hope your query is adequately addressed if you still have any feel free to ask   RegardsDr Saad Sultan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for severe pain in legs, feet and back?\n\nhi my name is heather i had a back fustion done , im in pain daily expcially nights im on pain meds that work when i take them every 4 to 6 hours , he gave me noroton and its not working my nerves are so bad my legs and feet are on fire my back hurts i dont know what to do,,fAmilys telling me to get on a pain managment that they would get me on the right medsthe meds i know wont take all the pain away but i cant live in agony every day ,,what can i do",
    "doctor_response": "Hi,I suggest you instead on totally relieving over medication have physiotherapy treatment also. As in physiotherapy there are various machines like (ift, tens and heat therapy which will  give you pain relief along with that graded patient centered exercise regime will surely help you in muscle strengthening and pain relief. Have diet rich in calcium and vitamin c and protein it will help in muscle strengthening and  to increase bone density.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Harsh Swarup",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Lyme disease\n\nI m a 53 female. Had a left pneumonectomy at 11 hers old. I know Ive got the shift in which other organs have moved. I have a bend in my thorax and my heart is way over under my left arm/chest. I do fine but sometimes am short of breath. I, also, sometimes experience fast or skipping beats. Back in 2005 I think I may have had a mini heart attack. I did contract Lyme Disease the previous year and know that does affect the heart and I had been ill from it during that time. I'm just wondering due to the shift inside, do I have more of a chance of having heart issues?Thank you!",
    "doctor_response": "Hi Lyme disease will have flu like symptoms  in most of them relieve day taking antibiotic if any one associated with other complications  and symptoms not releving had opinion of ur doctor",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain followed by nausea and dizziness?\n\nHello am wondering if i might had a heart attack or maybe a light ine not sure I was not feeling to good and i had some pain in my chest that hurt then i sat up and all of the sudden i felt a sense of nausea and at the sametime i got dizzy and lost feeling on both my legs and then instarted vomiting",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. After going through your medical details I understand your concern and I would like to tell you that chest pain followed by nausea and vomiting is very specific indication of inferior wall Myocardial ischemia unless you had GERD with food poisoning. It's recommended for you to get an ECG and Echocardiography done and consult a Cardiologist for further treatment. You may require to undergo Angiography. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a spider bite infection on the knee be treated?\n\nmy 38 year old son went to er spyder like bite on knee with puss pocket on dome i have had several brown recluse bites under houses just like it they say its was skin ailment gave him sulfameth/tmp800/160mg tb and cephalexin500 caps been taking 2 days nausea getting worse vomiting no diarea some delerium has been diagnosed in past with duadinal ulcer im his dad these tiype of meds send me to hospital with severe gastritus can he be same and should we continue or call dr. in the morning the swellings went down no redness",
    "doctor_response": "Hello, my name is Dr.Dorina Gurabardhi. I understand your concern. Some advices that I can give to you are :-Apply an ice pack to a bite or sting for 15 to 20 minutes once an hour for the first 6 hours. -Elevate the area of the bite or sting to decrease swelling.-An antihistamine taken by mouth, such as Benadryl,may help relieve itching, redness, and swelling. -A spray of local anesthetic containing benzocaine, such as Solarcaine, may help relieve pain.If symptoms of a skin infection develop see a local doctor.Hope my answer was helpful, if you have any other questions I'll be glad to help, thanks!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump on the face\n\nmy baby of 7 months has a raised bump on face its red but yet skin coloured no white head or anything like that i treid many time to squeeze soflty as i thought it was a pimple but nothing its been there for 4 months now and shes getting another on her eye lid.",
    "doctor_response": "HiI understand your concerns but don't worry. The most likely reason for such lesions is molluscum infection. I would recommend you to visit a dermatologist for proper clinical evaluation. If present, it's usually harmless and self resolving.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a feeling of lump in the throat but scan shows nothing. Please advise.\n\nHello doctor, I have had a feeling of a lump in my throat for over a month with a feeling of trouble swallowing. There is no pain and I can get food down but it feels like it takes more time to get the food down. I went to a hospital and they did a CAT scan of my throat and said there are no tumors. It feels like I have to throw up but when I try to, it feels like I am going to throw up a ball and cannot. I got this pressure in my nose and throat/chest when I tried to throw up the other day. Also, I saw small blood streaks in the saliva while I was trying to throw up. I have not seen blood any other time besides then.",
    "doctor_response": "Hello. Swallowing is a process which starts at the mouth and ends at the stomach. CT scan for your throat just investigates the pharynx and the upper esophagus. You have to investigate the whole track. A barium swallow is so helpful as it can detect strictures and masses along the swallowing tract. Barium swallow scan is cheap, safe and fast. The second step is pharyngoscopy and it may be needed or not according to the barium swallowing scan. For more information consult an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could pain in torso with bruises and abdomen pain suggest?\n\nI had systitis last week and ever since then I have had a dull ache in my torso, mainly in my back( left kidney area) which feels like it is bruised and all up along the left side of my rib cage. I also have experienced a sharp pain in the front of my abdomen which I thought mayb appendicitis but that has subsided. Any ideas what this could be?i have healthy lifestyle and diet and never get sick.",
    "doctor_response": "Hi.Thanks for your query. Cystitis is an infection of the urinary bladder and spread practically to all the urinary system including the kidneys. The infection of the kidney called Pyelonephritis can cause the symptoms of pain in the back, like bruise feeling sharp pain in front of your abdomen. I would advise you the following:Urine culture and sensitivity and routine examinations.Blood - CBC, sugar, urea and creatinine.Ultrasonography to start with. Once the diagnosis is made a proper treatment can be started and continued as per the reports of the cases.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent heart pain?\n\nI am having chest throbbing that s been going on for months . Heart palpations short breath. Lower middle anad uper back pain both arms tingle and cheeks too. What feels like heart burn after eating and throb on top of both breast that is constant.sometimes into armpit and ribcage. Sore to touch. I have a herniated cerabellum tonsil(possible chiari malformation) dizzy headache neck pain. Just had a chest mri xray and nuclear test done in octeber showing all is fine with heart but pain still persist. I need help!",
    "doctor_response": "Hello, I passed carefully through your question and would explain that your symptoms could be related to gastritis of gastroesophageal reflux. For this reason, I recommend performing a fibrogastroscopy. I would exclude any cardiac issues, considering your cardiac performed tests. Regarding the Chiari malformation, I agree with you that it could be related to the dizziness and neck pain. Anyway, I recommend trying to correct your posture and use an orthopedic pillow in order to investigate if a wrong posture is contributing in all this clinical scenario. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if there is pain, heat, numbness in the knee after falling?\n\nI fell of my bike knees first my rt leg is healing but my left knee is not doing so well my bottom leg is still numb in some areas and i elevate my leg and take pain meds and the pain is 4/10 but once i step on my leg pain can be 8/10 with heat on the numb area please advise",
    "doctor_response": "Tat paim is due to nerve ending injury due to trauma.u can go for ultrasonic physiotherapy treatment and oral methylcobalamine500 tablets daily once 4  one month",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in shoulder and arm with numbness in hand?\n\nI am a large woman of 50 - I have experienced pain in my right shoulder and arm - have numbness in my hand - have lost some strength to my hand and am plagued by pins and needles this has been going on since early August (3 months)- I have had physio therapy but this only provides temporary relief...... I have seen a show on MND and am starting to worry - although there is no history of this in my family",
    "doctor_response": "Hello,Your symptoms are not typical of MND. Instead, they are more suggestive of a pinched nerve or a bulging disc in the neck. For this reason, I recommend consulting with a neurologist for a physical exam and performing a cervical spine X-ray study and nerve conduction studies.Hope I have answered your question. Let me know if I can assist you further.Regards,Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for head congestion and chronic cough\n\nmy son has had a tickle/ cough for 6-8 weeks.He has tried everything from Bioxon, mucinex, nyquel, cough medicingw/ codine etc. is there anything that helps give him relief? he is a xc runner 10-15 miles daily and coughs terribly after runs. also ,very congested in his head but is not coughing up anything.He saw his physician, no fluid in lungs or bronchitis, she thinks maybe asthma oe allergies, was checked for allergies none.Any suggestions for medicines or liquids that help besides hot tea w/ lemon and honey and chicken noodle soup? thanks,tim",
    "doctor_response": "Thank you for following up.  Chronic cough can causes adenoids, sinusitis,chronic pharyngotracheitis. I suggest -1.Consult ENT doctor for rule out ethmoiditis, adenoiditis.2.Wash his nose with saline water 4-6 times, drop albucid(sulfacil sodium) 3 drops 4 times in nose.3. Rince gurgle with chrorhexidine4.Take kuka syrup 2,5 ml 2 times and tulsi juice for boosting immunity5. Give him hot milk with 1 coffee spoon of turmeric powder for night6.Hot drinks7.Lozenges-strepsils,sualin8.Take steam inhalations.Steam humidifies back of throat and really helps with the symptoms9.Avoid cold sour drinks10.Nasal decongestant(otrivin) if he has nasal congestion also11.Keep stomach acid free    He will get better don't worry,just use remedies which i suggest for quick cure.    Wishing you and your family good health!    Regards.    Dr.Sagar Gaurav Shrivastva",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a puppy bite\n\ni got bitten by our puppy who has not received any shots yet, he was already sickly during that time and today, 3 days after the incident, he died. I did not bleed when he bit me, but only had some scratches which were not deep and was not infected. Am i in danger, too?",
    "doctor_response": "Hi & Welcome.I can understand your concern.It is unfortunate your puppy died after the biting incident.Being not vaccinated against rabies, it seems to have died due to rabies or some other illness.But, since you are bitten by a rabid animal you must take five shots of antirabies vaccine on the following schedule, day 0,3,7,14 and 28. Since rabies could be the cause of the death for your puppy, you must take anti rabies SERUM immediately along with the first dose of anti rabies VACCINE on day O.Hope this answers your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had tooth extraction. Brown lump in area. Is this a cause for concern?\n\nHad tooth out this monday as had bad infection under tooth. Have rinsed with warm salt water every 4 hours and used corsodyl daily as advised after brushing and meals. But tonight checked the area where the tooth came out and found a brown meaty looking lump that has given me concers as i know this is not food as have made sure to not chew on this side of the mouth and wondering if there is cause for cocern.",
    "doctor_response": "Hello & welcome, Brown lump after extraction of the tooth is nothing but the indication of proper healing of the socket & needs no special treatment unless got infected secondarily. Even you have not mentioned any more symptoms related to it which shows absence of pain & discomfort. But as the tooth was infected before extraction, you will have to take care of the extraction socket by proper cleaning. Gargling after taking meals or after brushing is proper way to avoid any food lodgement in the extraction socket & you are already doing that. If you get any pain or swelling there in the same location ,you can visit your dentist for clinical examination. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in lower ribs. Elevated SGOT, SGPT, CRP. Need to go to ER?\n\nI have pain under my lower ribs where my liver is located. I do not have a gallbladder or appendiz anymore. My SGOT and Sgpt were elevated including elecvated CRP. My doctor wants me to wait a week and repeat labs. I personally think I need a CT or US sooner than later. I worked just as a unit secretary in an ER for many years. Would you go into the ER or would you wait?",
    "doctor_response": "HelloThanks for writing to HCMYou didn't mentioned your age.There may be various reasons for pain.You need proper clinical evaluation and investigations.Pain may be due to compromised liver function. You didn't mentioned about bilirubin level and alcohol history.Any way, you need routine hemogram,LFT,RBS,Lipid profile,RFT,urine RE/ME,viral markers, ultrasound of abdomen  and ECG and CT Scan  may be done if needed.Stop taking alcohol if you are alcoholic.Musculoskeletal causes of pain should also be ruled out.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Lamictal a stimulant? Can it be a cause of insomnia? I was on 200mg fr 10 years and on my own .. not knowing anything about withdrawal.. a year ago, I decreased to 100mg. I did the w Limittrol having been on fr 30 years. Went from 10mg to 5 mg. I went thru Hellish withdrawal and was never the same person. Had fatigue and tons of anxiety n sleep issues. Do you think that I need to go back on them ... could my body -not even me- just be addicted after so many years. If so, what s the best way to go back on? Titrate 1/2 pill of each.. or go fully back on one at a time? Or just go back completely on both full pills?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Lamotrigine (Lamictal) may create sleep problems, such as insomnia and tiredness. Talk to your psychiatrist for a change in medicine, if it is creating problems for you. Hope I have answered your query. Let me know if I can assist you further. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from anal fissure and using Lignocaine gel. How to heal it?\n\nHello doctor, I am having an anal fissure for the last three weeks. I took Paracetamol 500 mg, Cremagel ointment, and Lignocaine gel. How to heal the anal fissure?",
    "doctor_response": "Hello. An anal fissure can be a very troublesome problem. In my practice I suggest the following measures. Do sitz bath daily three times. Cremagel (Diltiazem 2%) should be applied in the orifice half an hour before passing the stool. Take two teaspoons of lactulose solution followed by two glasses of water during bed time. Increased uptake of green leafy vegetables, fibrous vegetables, and fruits. Quit smoking, and drinks if you do. Do cardio exercises regularly. If followed properly the fissure can heal. This region has peculiar anatomy. The fissure does not heal that easily, because the anal sphincter is tight which prevents the return of venous blood. When you do sitz bath with warm water and apply Diltiazem ointment the sphincter relaxes helping the blood to flow and go back. Thus the vascularity helps to remove inflammatory products and heal the wound. Increasing the fiber content of food helps in the formation of soft stools which do not cause the tear in mucosa while passing stools. The injury initially occurs due to constipated hard stools. Lactulose increases water entry into the large intestines and helps to form soft stools. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blister like rash on leg?\n\nI took weight training last year and during the summer I developed a sort of blisterlike rash on my leg a few inches above my ankle. It has faded but is still there. I am very concerned I may have herpes gladiatorum since I had staph earlier last year.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Herpes usually resolved in 3 weeks. According to your complaints it could be dermatitis. I would recommend you to apply topical steroid like cortisone cream on the affected areas twice daily for 10 days. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long will the graft lasts after cardiac surgery?\n\nEight years ago,I had a procedure which caused a nick in my aorta. A week later, I had another cardiac cath procedure and a dissection occurred and I had bypass surgery. I am curious as to how long I can expect this graft to last. I have no known heart disease at this time.",
    "doctor_response": "Hi,In case you follow healthy lifestyle, take your medication regularly, there are good chances that grafts will last for years, there are cases, with normal functioning grafts for more than 20 years.Wishing you good healthIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for allergic skin rash caused after taking Duolin\n\nMy niece is having flu like symptoms since 10to 12 days....she is 1yr old.... she has been prescribed .. cefixime and zerotus and esmol p..... no relief in symptoms.... duolin respules was prescribed..... Some time after inhalation she developed red rash on her body.... is this due to...duolin?...what to do... Why her symptoms of flu r not relived yet? What to do 4 the rash?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. It could be any viral exanthematous illness. But as you quote them as itchy blisters - the possibilities are any trivial viral exanthem. I do not think they are related to the nebulized Duolin. But as they have appeared immediately after the Duolin nebulization, do not give it again.  I suggest you use calamine lotion as its giving results along with oral antiallergic like Hydroxyziine or Cetrizine.Kindly approach your pediatrician for further evaluation.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have abdomen pain. Suffering from indigestion. Suggest\n\nHi I have had upper abdomen pain for about the past 10 days.  It started on Saturday a week ago when I woke up in the middle of the night thinking it was just gas.  I took something for it but made no difference.  It then eased a bit but is still there all the time just like indigestion.  It does get more sore when I eat.  It is more of an uncomfortable feeling and can be more sore sometimes.",
    "doctor_response": "Hello, Thanks for posting your query,                                                                 Because indigestion is a symptom rather than a disease, treatment usually depends upon the underlying condition causing the indigestion.Often, episodes of indigestion go away within hours without medical attention. However, if your indigestion symptoms become worse, you should consult a doctor. Here are some helpful tips to alleviate indigestion:Try not to chew with your mouth open, talk while chewing, or eat too fast. This causes you to swallow too much air, which can aggravate indigestion.Drink fluids after rather than during meals.Avoid late-night eating.Try to relax after meals.Avoid spicy foods.Stop smoking.Avoid alcoholic beverages.If indigestion is not relieved after making these changes, your doctor may prescribe medications to alleviate your symptoms.Regards,Dr.Sharmila",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the painful lump on his coccyx?\n\nfriend has a lump where their coccyx is, has been complete agony to move, literally screaming the place down, dr gave them tramadol, hasn't helped, hospital gave him co-codemal for the pain and have done nothing else, after 4 days of having this, today it has discharge and some blood? - could this be a cyst?",
    "doctor_response": "Hello and welcome to HCM,A painful lump on the coccyx region with a discharge and bleed is suggestive of an infective lesion. However, severe pain suggests that there could be associated nerve compression. I would suggest you to get a MRI of the spine to know the status of the spine and the spinal nerves.Also the relation of the lesion with the spine needs to be known.In the mean while, you can continue with your painkillers for the severe pain.Definitive treatment can be given after the results of investigations is received.Consult an orthopedician for further workup.Thanks and take Dr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for 100% heart blockage\n\nHi I have just found out that my dad has had a mini stroke and has been having them for some time now. Yesterday we had to rush him to the emergency room for treatment of yet another stroke. My dad has been told he had basilar arterial stenosis. We have been informed that he is 100% blocked on one side and 95% on the other, is there anything that can be done to repair this? Everyone I have talked too in the medical field has told me it is an inop surgery. What can I do to help my dad??? Please don t sugar coat a answer to me I need hard facts and in hopes you can help me understand what is happening to my dad!! Please Help.. Cooper",
    "doctor_response": "hi thank you for your question.this situation is probably result from intracranial atherosclerosis.surgery by experienced neurosurgeon is treatment of choice",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does one confirm low sperm count?\n\nMy age is 31 year male and I am married one year ago. I have been masturbating my whole life even after my marriage. I married one year ago. I am trying to make baby but my wife unable to conceive. I am suspecting infertility(Low sperm count or unable to produce sperm) in me.  Can you please suggest?",
    "doctor_response": "hai,masturbation is not a cause for infertility.but many other cause are there for infertility.you should go for a semen analysis with the help of a lab. that will be the initial stage investigation to rule infertility.lab personnel will guide you how  to get the  semen sample.with the report you can consult your family physician and discuss the report for further step.thank youhope i answered your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tremor in fingers\n\nMy father had the problem of tremor in fingers and limbs and doctors say it is Parkinson s disease. He was given Syndopa and Syndopa plus apart from other medicines. He then consulted another Neurologist after 6 months and the Doctor advised him to take Syndopa plus, Parkin and Rasalect. Within a week, he had problems of Hallucinations and then he again consulted the doctor. Doctor reduced the dose of SYndopa and increased Parkin 2 mg for 3 times (1/2 tab each time). Later, he got very much difficulty in his mouth and it appears it is psychological. He is having very tough time from his mouth - most of the time, he keeps on washing his mouth and every week his case of mouth kept on changing. For a week, there are two sets of teeth, he has got cages in his teeth, he keeps on cleaning his mouth, he also says there is something like glycerine, sometimes he feels if there is no muscle and skin on his face etc. possibly this problem has emerged as Side effect of medicine. He has left all the medicines and not taking any at the moment since last one month. THough eventually doctor advised him to take Parkin. What should we do? Please suggest.",
    "doctor_response": "Hello,The tremor that you have can be related to anxiety, hormonal disturbance, electrolyte disturbance, low levels of vitamin B12 or a side effect of medicines you are taking. Detailed investigations are needed to find the cause. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lumps on testicles\n\nHi I have a lump which appears to be connected to my testicles via some tube(?), 3 days ago I was hit in the testis with a ball and this appeared a day later. I plan on getting it looked at in a few days but I was wondering if you could offer any speculation to ease my mind?",
    "doctor_response": "Hi,Dear,Thanks for the query to HCM. I studied your problem in depth and I understood your concerns.Causes and Remedy-In my opinion your testicular lump is mostly epididymal cyst -post traumatic,which occurred after ball hit to testes.I would suggest you to wait and watch  for 2-3 days time.If the swelling subsides on its own,you need not worry but keep a watch.If not-Consult ER Doctor and take anti-inflammatory and antibiotics to reduce the swelling.If it grows in size consult ER Surgeon.So consult your doctor and don't worry.So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you, but just ask a query to HCM and be comfortable to resolve your health issues.Welcome for any more query in this regard to HCM.Write good resume and Click thanks if you feel satisfied with my advise.Have a Good Day.Dr.Savaskar M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please suggest some ayurvedic treatment for swollen legs, knee pain, and vitamin D deficiency.\n\nHi doctor, Both my legs are swollen, and\u00a0my knees are paining. I have full body weakness, and my vitamin D is less than 3 ng/mL. I feel that my entire body is swollen, and I have pain in my limbs. Please help me.",
    "doctor_response": "Hello. I hope you are satisfied with my answer.\u00a0Thank you. Revert after two weeks to an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting, fever, lethargy and loss of appetite with constipation?\n\nMy four 1/2 year old daughter has had occasional vomiting (3x in 5 days) on and off low grade fever, lethargy and loss of appetite for five days. Today she had hard pellet like stool so I insisted she drink a full cup of juice/water and she threw it up almost immediately. Do you have any insight as to what might be the cause or next steps I should take, thanks!",
    "doctor_response": "fever , vomiting, loss of appetite is due to acute bacterial infection, start amoxyclav for 5 days and anti emitics for vomifor 2 days..  ask took take plenty of oral fluids",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in legs and face stress\n\nMy daughter in India had pancreatitis ( no apparent reason ) 3 years back when 10, after 2 years also found that she has high CPK above 6000. High SGOT and SGPT ( 300 + ). All autoimmune tests okay, Muscle biopsy ( non electron microscope non conclusive ) , feels pain in legs mainly. faces stress, also falls frequently. Otherwise very active since birth and academically brilliant and good memory. What to do ?",
    "doctor_response": "helloI may suggest a thorough work up at any of country's PGI or AIIMS by a neurologist and gastroenterologist.it seems some liver dysfunction and skeletal muscle disorder are co-existing.treating doctors often prescribe cortisones, but a clearer diagnosis and cause has to be verified first.I may suggest to get her physical therapy, exercises and methycobalamin tabs daily in meantimethanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to eliminate the constant dizziness after recovering from dengue fever ?\n\nI am recovering from dengue fever.this is my second time having the sickness. I have recovered from all the other dengue symptoms except for dizziness.i am feeling dizzy all the time, it s very hard for me to concentrate in class like this.what causes the dizziness & how to eliminate it?",
    "doctor_response": "Hello,Welcome to HCM,The dengue fever is a vector borne viral fever which is transmitted by the aedes mosquito from one person to other.Persons with dengue fever will have wide range of symptoms from fever to shock.The fever will be followed by the rashes all over the body with severe joint pain and muscle pain. There will imbalance in the body fluid with abnormal blood volume parameters with variation in MCV, MCHC and PCV. This will leads to loss of body fluids and it may leads to feeling of dizziness.This is a self limiting disease and it will come down by itself but the fluid imbalance can be corrected by IV fluids like ringer lactate which will reduce all the symptoms but the the myalgia and joint pain can last for few months to year.Adequate intake of fluids and other medications will helps you to control symptoms like dizziness and other symptoms associated with this disease.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruises on chest in smokers?\n\nMy friends has a yellow bruise right in the middle of his chest and its sore to the touch and everytime someone touches it he is in quite a lot of pain , he smokes tobacco and weed and also drinks he cant remember banging it on anything or knowingwhat could have caused it he has experienced chest pains before",
    "doctor_response": "Thanks for your question on HCM.In my opinion it is not caused by smoking. As smoking does not cause external skin damage. It causes internal body damage.So the lesion is something else. May be some minor trauma caused this bruise.So better to get done dressing.And ask your friend to quit smoking and drinking alcohol.It is not a good for health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rashes, blisters between leg and groin, fading slowly. Herpes infection?\n\nI have a question about a unknown type of rash I got near my private part. Theres 2 blister like looking bumps on the crease of my leg near my groin . I woke up with them, and im not too sure what it is. I was looking into it, and it says it could be herpes . Im not quite sure though, they just look like blister from my skin rubbing. I noticed them yesturday morning and theyre starting to finally go away today",
    "doctor_response": "Hi.usually blistersin herpesvwill not fade within one day.i think it is allergic contact dermatitis.it can be cured by antihistamine.antibiotic and apply diprovate-g ointment",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pigmentation on wrist, mild improvement with oxidon plus and steromom. Can I continue this?\n\nhello sir, i have been suffering frm pigmentation on my rt hand ( wrist ) for last two years. recently i have consulted with one dermatologist and he advised me to take one oxidon plus daily and applying cream steromom, i found little change just u advice me shud i continue with this treatment because ow he said to take the oxidon plus for 1 month.",
    "doctor_response": "Hi , You should continue the treatment with Oxidon plus for one month. In addition, you can expose the RT hand wristt on sun light at an early morning atleast 10 to 15 minutes .Because ,the violet rays contains VIT.D  will improve the pigmentation positively.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is adenocarcinoma very harmful?\n\nMy husband lifted a heavy object, felt back pain which didn t require immediate treatment. After about 10 days he saw his Dr. stating he must have pulled a muscle (something experienced more than once through his life). Muscle relaxers and prescription Advil didn t help. Prior to seeing the Dr. and for a few days after, he had painted our entire condo inside and plowed driveway snow. He then had an X Ray, followed by a lower spine MRI which showed lesions. Then came a nuclear bone scan which showed Metastatic lesions needing more identification. A Pet Scan was scheduled but by then he was on the sofa all day unable to sit or stand. The scan never took place. He went by ambulance on 2/23/14 to the hospital, in pain but with his usual sense of humor. He spent 12 days in the hospital. A biopsy and full body MRI confirmed lung cancer which had spread to his liver and spine. It was too far gone for radiation. On the 13th day he was sent to a hospice where he spent 29 hours, then died. When dealing with his sudden death I feel he was cheated by not having more of a warning during the prior months or was he just too strong to recognize it? Maybe this cancer (adenocarcinoma) is just so aggressive and we should be glad he went quickly with minimal suffering but my grief is expressed more in anger than in tears of emotion. Can you comment to help me understand? Thank you.",
    "doctor_response": "Thanks for your question on HCM.I can understand your feeling and anger. But lung cancer can deteriorate rapidly.BronchoAlveolar Carcinoma (BAC) is a variant of adenocarcinoma of lung. BAC is rapidly progressive in nature and patient dies within a week of diagnosis.It is the nature of the BAC which spreads not only through blood and lymphnodes but also by continuous spread in bronchi.So by the time we reach the diagnosis cancer spreads to the entire lung.So he may have BAC variant of adenocarcinoma.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can high fever in a child despite taking paracetamol be treated?\n\nMy child who is 5 year old is having temp around 104 since yesterday. I was advised to give only paracetamol. Now the temperature is not coming down despite giving that. What should I do?Hican I answer your health question? Please type your question here...",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. In addition to Paracetamol, you can also use Ibuprofen. Make sure to separate the two by at least 2 hours. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Causes of pain on right shoulder on the top and around clavicle bone\n\nI am having paid on my right shoulder on the top and around my clavicle bone. Also I am having pain on the right side of my back from about mid way down to my shoulder blade. I have had two MRI s done, one for my shoulder and one for my neck and it doesn t show anything that is wrong. What could be causing this pain?",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It seems to be a muscular pain which is caused by shortening of muscles around shoulder and neck (trapezius muscle). Apply heating pad for 5 to 10 mins and then do some stretching of neck and shoulder muscles and sleep supine. Don't lie on right side (side lying position). If you know the stretches then well and good otherwise contact any physiotherapist. Your therapist will guide you with stretches. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Harsh Swarup",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for lower abdominal pain?\n\nHI i am having pain in lower abdominal portion, when i go for running it become more, if I stop & walk pain get less, i am also feeling like burning sensation on tip of my pinse after urination, kind of burning on tip of male organ. Urining routine has increased but burning sensation is arround after peing. i am 38 year old. i also feel like pressure on my lower abdominal part and on left side pressure toward back of kidney. please need your help, i already had before this problem and i used citralka syrup, pain were gone, but i could feel like pain in urinatory tack for many days.",
    "doctor_response": "Hi.Thanks for your query.You are absolutely right. You problem looks like recurrent urinary tract infections as suggested by your history of : Lower abdominal pain which increases on running, frequency of urination, burning at the tip of penis, lower abdominal pain going to the kidneys and helped with Citralka, the urine alkilinizer.  I would advise you the following in details:First of all get an Urine : culture and sensitivity, routine and microscopy. Ultrasonography of the abdomen particularly for urinary system.Intravenous pyelographyCT scan in some cases if cancer is suspected.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Has seizure disorder with cognitive impairment and mental difficulties. Guide?\n\nMy daughter has a seizure disorder with cognitive impairment and mental difficulties.  She has to take several medications but unfortunately she only receives $220 in general relief each month along with a $280 grant for her medications. Total costs come to more than $1600 a month. I just do not know how to get enough money to cover her meds. She has been out of 1 medication for 1 day and has already had 4 seizures today. Where can I go to get the money to cover her meds?",
    "doctor_response": "Hi,Thank you for posting your query.It is unfortunate that your daughter is unable to take medications due to financial difficulties.There are two options- one option is to switch on to cheaper alternative antiepileptic drugs (AEDs). Traditionally, the older drugs such as phenytoin, phenobarbital, carbamazepine, valproate, etc are cheaper than the newer AEDs. The other option is to take her to a govt hospital, where medications are given at a subsidized rate.The third option would be to take a loan.I hope it helps.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for skin rash\n\nmy 3 1/2 year old granddaughter had a rash, hive like, on back of her neck, then on her back. didn t see them on chest as of about 4 pm. Had itchy scalp later. Probably due to adult shampoo used for first time. Gave benedryl. Is it necessary to do more tonight?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.By what you quote it should be an urticarial or a simple skin allergy. You can use Hydroxyzine at 1-2mg/kg/dose every 6th to 8th hourly for 7-10 days. Most important thing to be remembered is that it has a propensity to recur (called as second crop) within 10-14 days. If this happens, you can start using the same medicine but I suggest you get the kid evaluated with your paediatrician.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cold shivering and washed out feeling?\n\nI am female 52 years. Suffer ulcerative colitis and awaiting knee replacement.Why do i have cold shivers that last for a couple of hours and feel totaly washed out.It used to happen now and again but has happened three times this week. Today1.30pm and I am only now feeling a bit betterat 10pm",
    "doctor_response": "Hello!Welcome on Healthcaremagic!Your symptoms could be related to a metabolic disorder (vitamin B12 or vitamin D deficiency, an electrolyte imbalance, thyroid gland dysfunction, etc.). Anxiety or Epilepsy seizures can not be excluded either. Coming to this point, I would recommend consulting with your GP for a physical exam and some tests: - complete blood count for anemia- thyroid hormone levels - blood electrolytes- vitamin D and vitamin B12 plasma levels- a resting ECG. An EEG may be needed if suspicions of seizures are raised. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have lost the purpose of my life and like to be alone. Why?\n\nHi doctor,I do not know what it is, but I feel as if I have fallen too hard. After a lot of try I got a job in a bank. It has been six months and suddenly I have lost all interest to go. I am on leave for the past one week. I feel like quitting my job. I feel like I lost the purpose of my life. I am in a relationship with a guy for past 8 years. I am in a live-in relationship with him for the past one year. No one knows about this except one of my close friends. Everyone thinks that we are married. He has promised me that he will marry me by next year. But, my mom does not like him. She does not know that I am staying with him. I do not know what I am going to do in my life. I have a good name at work. Now, after an uninformed absence of a week, I am scared to go back. I do not pick up calls anymore. I have uninstalled all the social networking sites now. I am not in touch with anyone and I do not want to be. I look around and see everyone happy. But, I do not feel that with myself. I cannot seem to at least try nowadays. I feel like no one understands me. I have hurt myself before. I want to die, but if I die I will never be able to prove myself to anyone. Please help.",
    "doctor_response": "Hi. I read your query and understand your concerns. From the available description, it appears that you are having depression, which is often characterized by sadness, decrease interest in almost all activities, including pleasurable one, indecisiveness, poor attention and concentration in addition to sleep and appetite disturbance. Most persons with depression feel miserable without any reason and that distinguishes it from normal sad experience. The presence of conflict with mother in regard to ongoing relationship could be the trigger for the onset of depression. In my view, you should see a psychiatrist without delay. He will ask you more questions to confirm the diagnosis of depression and to rule out other disorders presenting in a similar way such as bipolar disorder. Post evaluation he may prescribe medication or offer you psychotherapy after discussing with you. I must assure you that in current times depression is completely treatable illness and there is an excellent hope to recover from it. For further information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause thumb swelling?\n\nI am a 47year old female with an unremarkable past health history. I am 5 6 and weigh 150. I recently put on 10lbs in the past 3 months, without changing my eating habits. I exercise about 4x/week on average. Mostly walking 5miles at a pretty good pace. About a month ago I started having a different sensation in my right arm/hand. It started out with the pad under the thumb becoming swollen and sore, no burning sensation, just sore to touch. Then a week later, my elbow started hurting. At first I thought I must of hit it on something, it was sore on the outer side. Now I am experiencing a heaviness feeling in my bicep area. I can wake up at night and have to pick my arm up with my other arm. (Its like I cant move it and loss of sensation) It now is a constant sensation of heaviness and radiates down my arm. I have also had some pain in my right hip and right leg. Not near as significant as my arm. In the past 2 weeks, I have been nauseated and eating does not make it go away. My vision has also changed significantly in the past year, mostly my right eye. I have always has a weaker right eye I have worn glasses since the 7th grade. My blood pressure typically runs 115/70. No history of cardiac problems. Parents both with hypertension and cancer (breast and prostate). Dad also has diabetes.",
    "doctor_response": "Hello, Consult an orthopedician and get evaluated. We have to rule out possible causes like arthritis. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on the back of the neck?\n\nI can t seem to get my husband to go to the doctor(I m sure you ve heard this before) but I am worried about a sorta soft lump on the back of his neck. He s had it at least a year I think, and it has grown a little. Does not bother him, really. He has had dizziness that comes and goes along with a clogged ear that comes and goes (not necessarily together). He thinks it has to do with a fall where he hit his head hard at least a year ago.",
    "doctor_response": "hi.it is best if the lump on his neck is evaluated, especially if it's growing. it may not bother him now, but it might tomorrow. inside our neck is our air and food passage, along with many other important vessels. if the lump continues to grow, it might compress those structures leading to more problems. also, the earlier you know what this lump could be, the earlier you can do something about it, and a better outcome is at hand. a consultation with general surgeon or an ENT is best for further evaluation of the neck lump.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swelling of feet due to steroids\n\nHi, I had a double lung and heart transplant 3 years ago and due to steroids I get swelling and pain in my feet, the appearance is also blue with a constant full ache. Can I get rid of this, I m going on holiday next week and my feet balloon in the air, it s so bad it scares me, Is this normal?? I really worry about.",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern. Your swelling can be due to side effects of steroids. So this swelling will reduce after stopping the steroids if you can after consulting your doctor. Second your pain can be due to osteoporosis effect of steroids. You can be benefitted by vitamin D3 and calcium. It will be better to visit Orthopedician for complete treatment of osteoporosis. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does kidney problems, flank area pain with foot swelling need immediate attention?\n\nMy daughter is in pain & seems to match the signs of kidney problems, pain in flank area, swollen foot, this started on Thursday. She is 43yrs old & has MS. She is getting very upset. home alone. She is 9miles from me, but I have only driven 2X s in last month, I m disabled & not sure of myself behind the wheel. I have not driven in 7ys prior to last month & I m in panic mode. No one here either, I don t know my email PW, only Facebook. Does this seem to be a URGENT situation?",
    "doctor_response": "Hi, It may be due to some stones or calculi somewhere in her urinary tract. She can take analgesics like Tramadol or Diclofenac for pain relief. It is not an emergency and she can consult a urologist and get an ultrasound scan done. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Home treatment for boils ?\n\nwondering if there is any home remedies for treating boils",
    "doctor_response": "Here we use a very common plant found every where called as pathar chat [ bryophyllum ] having many leaf buds. Its leaf is heated with oil on one side and tied over boil. It makes boil to make a weak spot and expell all pyogenic matter. Use of black pepper and turmeric internally prevents recurrance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring pus and blood filled bumps near anus?\n\nI get recurring bumps on my inner butt cheeks sorta near my anus. They are soft and will fill with a little bit of puss and a lot of blood. It ll eventually pop and go away for a while but always comes back. I pop it with a needle sometimes because the pain is so bad I can t just pop it like a pimple",
    "doctor_response": "Hi, your history suggest that you might be suffering from recurrent staph infection.If i were your treating doctor, then i would advise,1) starting with antibiotics such as cefixime, and continuing for one week.2) To maintain adequate hygiene, such as bath with antiseptic soap, keeping undergarments neat and tidy.3) Do not prick with needle, as you might introduce harmful pathogens, always consult your physician, and get incision and drainage under aseptic conditions only.4) You didn't mention your age and other lifestyle disease any? as diabetes is one of major cause for causing recurrent abscess.Hope I have answered your question. If you have any further questions I will be happy to help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be done for elevated blood sugar levels along with frequent urination and excessive thirst?\n\nMy husband was prediabetic for years. We used to test but have not for several years. He has had some serious issues I think over the last few weeks. He is constantly thirsty, urinates all the time and has some slight vision problems. We tested his glucose and it read 264 once and 296 the next time. what should we do?",
    "doctor_response": "Hi, The sugar levels indicate diabetes. You're visit local physician and start anti diabetic medication. Also start to exercise for at least 40 minutes a day. Don't eat sugar or sweets. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "MOUTH ULCER IN BOTH TONGUE, IS IT CURE BY LASER SURGERY ?\n\nMOUTH ULCER IN BOTH TONGUE IS IT CURE BY LASER SURGERY?   I M SUFFERING FROM MOUTH ULCER IN BOTH TONGUE. IN BIOPSY REPORT IT SHOWN LEKEWPLAKIA.  DOCTOR ADVICE ME FOR LASER SURGERY. CAN U ADVICE IS IT CURE BY LASER SURGERY? OR IS IT HARMFUL FOR ME? PLS ANS ME",
    "doctor_response": "Hi,Thanks for asking the query,I would like to tell you that leukoplakia is a precancerous condition and needs to be cured immediately, laser surgery  can be an option.I would suggest you to visit to an Dentist and get the checkup done.Take an OPG radiograph, Biopsy of the lesion will confirm the diagnosis.If you are having smoking, alcohol consumption so have to quit it permanently.Take multivitamin suplements.Hope this helps out.Regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe lower back pain\n\nOn Saturday afternoon I was lifting a heavy object and heard a pop in my lower back.  Was painful right away.  After 30 minutes or so I was able to move around fine and was able to do yard work on Sunday.  But every time I sit down and get back up, it takes a few minutes to straighten up and for the lumbar back pain to go away.  Am a 48 year old male.",
    "doctor_response": "With such a presentation it is likely that you have muscle strain or a mild form of disc rupture. I would suggest you to avoid lifting weights, bending forwards, sitting on the floor and squating atleast for a week or so.You can use ice gel packs and pain killer lotion/ gel to soothen your back. Hope this helps . All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can new acrylic dental mouth guard cause breathing problems?\n\ni have a new acryllic dental mouth guard.after 3 hrs of sleep i wake up and my nose and throat airways are so tight its almost impossible to breath.i dont think my dentist understands this. i  have multiple chem sensities.it is not asthma thank you for any ideas......",
    "doctor_response": "Hello:)Welcome to HCM.Allergy to acrylic can cause local irritation and redness. It is not going to cause respiratory discomfort.Do not panic. You did not mention any other symptoms if your face is swollen and lip swelling.I suppose you have some respiratory infection.Consult your physician for a skin test if you are allergic to methyl methacrylate.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feels like losing mind. What is the treatment to be taken?\n\nI feel like I m loosing my mind, as if I m not in control anymore. Sometimes I ll wonder how I got to the place where I am, only to remind myself of it a second later. Its a very strange feeling as if I m not alive. This feeling can get better at times and worse at other times separated by normal levels of this feeling",
    "doctor_response": "hi..this may be derealization although its rare..you should also exclude syncopal attack and some form of underlying seizure disorder through investigations..consult a neurologist/ psychiatrist now..have a good health..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does taking Propecia for hair loss lead to breast cancer or Prostrate cancer?\n\nHi, Im 25 years old and have had cancer twice. I want to use propecia to help prevent more hair loss but the sight of seeing prostate cancer and breat cancer as two of the side effects that scare me. What, in your mind, is a ballpark percentage of me being diagnosed with prostate cance and/or breast cancer if I start taking procecia?",
    "doctor_response": "Hi,Thanks for writing in.Propecia is a 5-alpha reductase inhibitors group of medicine and contains finasteride which helps in hair growth. Treatment with finasteride reduces the risk of being diagnosed with low-grade prostate cancer. But there is an increased risk of a later diagnosis of high-grade prostate cancer. Please discuss with your doctor on the probabilities of propecia intake causing a higher incidence of high grade prostate cancer in later life. At 25 years age you might not have any side effect but with continued intake the risk rises. Instead of taking propecia you can apply lotion containing a combination of minoxidil and finasteride which works for hair growth. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does low platelet count, fever and rashes on face indicate dengue?\n\nI have a platelet count of 75000. Age = 48 yrs Height = 162cm , weight = 72 kg I have the following symptoms : Fever rashes on face , foot , leg constant headache since 6 days uneasiness unable to sleep Is it possible that I have dengue? What is the possible course of action?",
    "doctor_response": "Thanks for your query at HCM!I am Infectious Disease Specialist! I went through your query!Your symptoms suggest you are having acute viral infection could be dengue also.I suggest you to investigate yourself for NS1 antigen and Dengue Ig M antibody, Malaria smear and rapid test (ICT) and Widal test along with blood culture.Usually treatment of dengue is symptomatic. Take NSAID to relieve fever.Drink plenty of water and good diet. Take adequate rest. Get your platelet counts monitored regularly daily once/twice. If counts drop below 20,000 you might require platelet infusion.If any unusual bleeding from any site ( Gums, skin, etc) is seen visit your doctor immediately.Happy to take more queries! You can also write a review for me. If you would like some more information, I will be happy to provide. You can take a follow-up query. You can thank if information was found useful.Take care!Dr. Sheetal VermaInfectious Disease Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for swelling in hands after donating plasma?\n\nI donated plasma today, I used to do it regularly a few months ago but for some reason today my hands started swelling and I became very light headed and almost fainted. This has never happened before. My hands are still a bit swollen, Should I be concerned?",
    "doctor_response": "Hi Hope this message finds you in good health.I have gone through your complaints and understand your concern.U seem to have generalised weakness and deficiency of vitamins,calcium,minerals proteins and micro-nutrients.Though temporary,it will eventually heal.Take rest and some healthy protein powder.Physiotherapy,analgesics,anti-inflammatory drugs should help.Nothing to worry about.I hope your question has been answered.If you have any follow-up queries,feel free to consult me anytime.Thanks,Take care,God bless.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does lump in nipple indicate?\n\nhi i am 26years old i have three children and just the last day or so i have noticed a lump attached to my nipple and its in my nipple, its a different colour to the rest of the nipple. at first i thought it was dry discharge so i tried to pull it out and now it really hurts as its obviously attached. i also have one on my left nipple too but its not as big,, i dont have any history in my family of breast cancer but im very worried about this. any indications as to what this could be? it doesnt really hurt or anything but my breasts do feel larger too the last few days...thanks",
    "doctor_response": "Welcome to Healthcare magicI am Dr Fahim and I will help you with your queryI have gone through Question. It appears to be papilloma of the nipple. Its a not a breast carcinoma as presentation of breast Ca is quite different. Its treatment is simple and complete. If such a patient walks into my clinic I offer him two options. One, excision with a tiny disc of skin and the other one is tying the base of the papilloma and it will fall off spontaneously in few days.I hope my answer will help you with your query. Do rate it, If you like it.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathlessness at the age of 65?\n\nDear Sir/Madam.My father is 65 years of age.He is having severe problem of breathing in sense that he starts panting for breath every time he walks.even we got his EGG done.I could not understand it.Kindly helpme outwith this.Some say it bronchiis.Pls Help.",
    "doctor_response": "Hello, sorry to hear about you dad's ill health. There are many causes of breathlessness ranging from respiratory infections, cardiac problems etc.He needs to go to the hospital and be properly checked to see what is causing his breathlessness. Warm regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for congestive cough\n\nI have had a congestive sounding cough for 3 weeks and have pain in the right hand side of my ribcage. I am 63 years old, 185 #, and generally good health. I have been doing alot of deep cleaning in our dusty old attic and at first thought it was due to all the dirt--I do cough up yellow phleghm.",
    "doctor_response": "Hi thanks for contacting health care magic...Noted you have yellow congestive cough...History of dust exposure present ..So you could have viral infection and secondary to it just now bacterial infection can occur...You can here have bronchitis like infection.Take levoflixacin or cefixime for 7 days.If needed decongestent can taken like cetrizine or oxymetazoline...Drink more water....Steam inhalation....If condition worsen chest x ray and sputum examination done.....to rule out pneumonia like infection......Still according to my opinion your auscultation done first which gives clue for your condition...Dr.Parth goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump with blister on the crack of butt?\n\nWhile showering, I discovered a nickle size lump, with what feels like a blister on the crack of my butt. It's not close enough to the anus, to think it's a possible hemorrhoid. What I thought was a blister, looks more like a mole, because it's darker than a regular looking blister. The stream of the shower was painful. What could this be? Should I see a doctor? It may have drained just a bit. I've never experienced this before. Thank you.",
    "doctor_response": "Hi and welcome to HCM. Thanks for the query. It is hard to say what it is withou t seeing it but at this area we usually see pylonidal cysts, abscesses or folliculitis. it can aslo be std od herpes infection. You should see proctologist who can then decide is surgical removal necessary or not.  Wish you good health.  Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the following follicular study report suggest?\n\nHello I have done follicular study on 2nd of my period ET was 2.9mm then I have done on 9th day ET was 5.4mm then I have done on 11th day left ovary MSF was 13x12mm and the ET was 5.5mm. kindly help me whether I will be able to get pregnant in this cycle. I have taken Letroz tablet from 5th day of my cycle for 5days.",
    "doctor_response": "Hi, Endometrial thickness is very thin which will not augment your chances of implantation even if conception occurred. I would recommend that you refer to your doctor for progesterone supplements to increase your endometrial thickness. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high BP with throat infection?\n\nI'm a 31 year old male and 2 days ago, when visiting the doc for a throat infection and conjunctivitis (woke up with it), the nurse told me my blood pressure is 163/108. The doctor didn't address my high blood pressure. I checked it again at the pharmacy the next day and it is the same. What are the first things I should do?",
    "doctor_response": "hello,You being an young hypertensive you ll first evaluation for cause of blood pressure. You should undergo test like kidney function test, renal artery Doppler, Sr cortisol and 24 hr Urinary metanephrines. Also get lipid profile and sugars tested.You should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. If your blood pressure is persistently above 140/90 then you will need treatment like tab Telmisartan 40 mg or amlodipine 5 mg etc.   Regular exercises like brisk walking, jogging according your capacity atleast 30 min a day and 5 days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn't abdominal fat deposition or obesity. Get your lipid profile and sugars tested once..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with asthma, feeling of chest heaviness, wheezing. No improvement with medicines. Suggestion?\n\nhi i have been to hospital and doctor with my asthma problem..i am taking my medication for the last 6 days and it s still the same...i feel tired all the time...and also it s very hot and humid and there was forest fire smoke a while back,,,my chest feels very heavy all the time...and i have a lot of wheezing ..should i go back to hospital..any suggestions please help...",
    "doctor_response": "hi, your asthma has increased due to fire as you are mentioning, there might still be smoke residue in the area which is not letting you symptoms reduce, you should go to hospital they will increase the dose or add another medicine to you present prescription, also try changing your place of stay for a few days and come back later after that area is cleared of smoke, it takes a while for smoke to fully clear. your tiredness is also due to repeated attack of asthma. you must go to hospital soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Cortisone with Benadryl the correct treatment for itchy lumps?\n\nmy  daughter  was  swimming  and  has cmae hom  with  red bumps  on her and  she  say there itchy.. look  like  bug  bites   but they r not ..  she  has  had them  come   and go b 4  aftre  swimming .. i have  given her bendryll    allergy and  put  cortizone  oitment on  them..  did i  do  right  thing ?",
    "doctor_response": "Hi,It seems that these bumps might be due to some thing bite or allergy to chlorine water producing these bumps.Continue with Benadryl medicine or give her Cetrizine for time being.You can apply caladadryl lotion or cortizone cream.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shaky hands and head after surgical fusion of C3-T1?\n\nI am 6 most post surgerical fusion of C3-T1 . . . I also had cord compression only 6 cm in my normal 12 cm spine canel at C4 and C5. My hands and arms have started shaking when moving, also during my PT therapy today my head started shaking like i was having a seizure when I lifted it from the table and tried to support in while doing a chin tuck.",
    "doctor_response": "Hello,Your symptoms could be related to possible spinal cord damage or nerve damage. Another cause to consider would be benign essential tremor, not related to the surgery. For this reason, I recommend consulting with a neurologist for a physical exam and performing a brain MRI or CT scan (if any contraindications to MRI). It is also necessary checking thyroid hormone levels.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard lump on tender and swollen foreskin of penis?\n\nI have a hooded foreskin, and it has hard a hard lump on the end of it since my GF and I had extremely vigorous sex about a month ago. Now everytime we have sex whether vigorous or not, it becomes tender and swollen. It feels like it has a cord like lump on the inside of the actual foreskin.",
    "doctor_response": "HelloThnaks for query .The tender cord like lump that you have over foreskin is mostly a thrombosed superficial vein of foreskin .Take antibiotic and topical ointment Thrombophob for local application for a week .Refrain form sex for 10 days till it gets cured completely .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "PCOS, given Ovafar, asked to have regular contact from 9th day to 19th day. How frequent must the contact be ?\n\nI have just started my treatment for getting pregnant. I have PCO; and I am given Ovofar 50mg for 5 days to be taken from the day 2 of periods. I am asked to have regular contact from the 9th day to the 19th day. I want to know whether we need to contact every 24 hours; because me and my husband will not be together on the 14th day. How frequent should the contact be in these days??",
    "doctor_response": "Hello The most fertile period of yours fall between 9th to 19th day and since there are maximum chances of pregnancy during this period,you ate advised for sexual contact as many times as is possible for both of you. The more you meet,more are the chances of conception during this period. There is no binding that you have to meet once in 24 hours.You can meet as much as you wish. OVOFAR will help in ovulation induction in you. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "High TSH levels. Not able to conceive. Thyronorm suggested. Will this help in getting pregnant?\n\nHi I hv been trying to conceive for last two yrs all test are normal recently doc reported high tsh of 6.4 and suggested to take 25 mcg thyronorm for a month and go for test . T3 and t4 are normal.parallely tkng medicine m trying as well. Can this medicine hlp also m 31 without ny issue trying desperately for a baby. Jess",
    "doctor_response": "Hi, Thyronorm is not going to help in conceiving. But its very essential medicine which you should take. It will prevent bad effect of high TSH on baby's brain development if you conceive. For conception, you need to consult some infertility specialist who will guide you for faster conception. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Pituitary adenoma grow in size with increase in prolactin level?\n\nGood morning Dr. my name is Adri I was diagnosed with a putuitary microadenoma which appears uncomplicated at this stage according to the mri 8 x 8 mm diameter 9 x 9 mm in craniocaudal lenght. Blood test where taken on the 7/07/2014 prolactin level was 71.4 ng/ml three months later it is 110.7. What I like to know is this tumor growing more when the levels getting higher.",
    "doctor_response": "Hello. I have been through your question and understand your concern.Generally, microadenomas are monitored for their biological activity (hormone level) and dimensions. Basically, if your level of hormone is increasing it might understate that the dimensions are increased too. In your case I find it important to consider MRI every 6 months, because if it becomes >1cm, then it will be considered a macroadenoma and surgery can be helpful.Hope this helps. Please feel free using MHC again",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high levels of creatinine in blood?\n\nI am told that I have protein in my blood and high levels of creatine in my blood. My dr. spoke of folding proteins and how they accumulate in other organs. I have a CT of my kidneys schedule and waiting for a hematologist appt. What can you tell me about this. Dr. also spoke of possible biopsies of both kidneys and bone marrow. Can you provide and information?",
    "doctor_response": "Hi,Thanks for writing in to us.A high serum creatinine level means that your kidneys aren't working well.Some of the causes for elevated creatinine includesrenal impairment/failuredestruction of musclehigh dietary intake of meathypothyroidismincrease in musculature (e.g. bodybuilding) - related to increased muscle mass \u00b1 increased protein intakedrugs",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it advisable to take Amoxyclav for infection and swelling in foot?\n\nHello doctor,I have got an infection in my foot and it is on my right foot above the ankle. That particular part is a bit swollen and sometimes pus and some blood come out when I clean it. And because of that infection, my foot is swollen and I am experiencing pain while walking. I am going to a clinic tomorrow but till then is it advisable to take Amoxyclav 625 (one tablet) to reduce the swelling?",
    "doctor_response": "Hello. Yes certainly, you will need antibiotics to kill the bacterias. So Amoxyclav 625 (Amoxicillin and Clavulanic acid) is a good choice. So you need to have it three times a day for five to seven days depending on the response. You can certainly take it now and it should be taken after food and it is better if you have it with some antacids like Rantac 150 (Ranitidine) or Pantoprazole or Rabeprazole. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Also, it will not act immediately to reduce the swelling but its action will take 24 to 48 hours. For immediate relief, you need to have some painkiller medicine like tablet Diclofenac or Ibuprofen, or Paracetamol 500 mg whenever needed. Also, you need to apply some powder like Neosporin thrice a day till the wound heals. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for high fever in a child?\n\nMy daughter is 2.10 yrs old. She had 102.7 fever last thursday when she had gone to day care. Given Meftal to her which brought down the fever immediately. Then she had fever on friday morning. She is taking  Meftal, Tamim O and relent. Now she is having lower end fever. Is it Viral fever? how long it would be?  Note: She is active and taking food/drinks regularly",
    "doctor_response": "Hi, if fever is persisting then investigations like complete blood count, malarial antigen test and widal test should be done. Review with report. A re-examination by doctor should be done. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fever, loss of appetite, pain in lower stomach. Had jaundice, low hemoglobin weeks back. Normal results now\n\nI have this flu like symptom without fever for couples of days now. I always feel very very hot at night but no fever. I have hard time climbing the stairs without feeling breathless. My appetite also is poor and I have pain on my lower part of my stomach. anyway, I just discharge from the hospital 2 weeks ago because I was having jaundice and my hemoglobin was low. my visit to an hematologist concluded that I may have hemolysis but blood work came back all normal. but now I am feeling very weak.",
    "doctor_response": "Good Morning Healthcare MagicAdvice : 1. Avoid oliy food 2. Only home made food take3. Syp. Multivitamin Continue for 2 month4. syp. Liv-52 like liver tonic used for 2 month5. take glucose with water 3-4 time a day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest ways of enhancing the strength & gloss of hair\n\nhi sir...im 18 years old...i had hair fall problem since 2 years..be4 i had a very strong n thick hair.now it became weak n thin...and i had dandruff problem too..i did a lot 2 get rid off it..but i cant....wat shampoo i hav 2 use 4 dis and what products i hav 2 apply after head bath 2 look my hair shiny n straight???",
    "doctor_response": "Hello, Would recommend you to use ciclopirox olamine shampoo ( 8X shampoo) twice weekly. Also, take hair supplements like tablet keraglo eva once daily and apply hair serum like Anaboom anti-hair fall serum twice daily. These need to be continued for 4-5 months to see significant results. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How should the subserosal fibroid pressing the baby sac be treated?\n\ni have a 10 cm posterior subserosal fiberiod and am 5-6 weeks pregant. the ultrasound shows that the baby sac is pressed against the fiberooid and sac is elongated... i am worried about potential of miscarridge or abnormal growth please advise thanks",
    "doctor_response": "Hello,I have gone through your query. While the submucous fibroids carry the maximum risk of causing an abortion, secondary to the submucous variety, subserosal fibroids are rare to cause complications in pregnancy unless they are large enough. If you have a retroverted uterus and hence the posterior fibroid is pressing on the growing uterus, postural treatment can be somewhat helpful. If the sac is getting distorted as has been shown in your case, myomectomy may have to be contemplated to save the pregnancy. This should be managed in expert hands so as not to disturb the existing pregnancy. Uterine artery embolization may not be suggested in view of an active pregnancy. Hope you find this information helpful. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a non- surgical procedure to cure adenoids in a 4 year old?\n\nHello Doctor, My daughter is 4 years old and she is suffering from Adeniods. My family doctor had stated that it is 80% and it is good to undergo surgery. Can you please let us know if it is mandatory. Can we cure that using non-surgical methods or with Homeopathy? Please do give us your thoughts",
    "doctor_response": "Thanks for consulting at Healthcare Magic.Adenoids may become infected and remain enlarged or chronically infected, and subsequently lead to obstructed breathing , snoring / sleep apnea , sinus or ear infections, or other problems. In such cases adenoidectomy surgery is advised.As for any surgery, adenoidectomy also has some risks, benefits. Ask your doctor in detail about potential risks, benefits and complications.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes urinary incontinence in a child?\n\nMy question is... I have an 8 year old step daughter that appears to be going through puberty. Fairly large amount of pubic hair and breast development. She also complains of a stomach ache and urinates frequently in fact she will empty her bladder before leaving the house and return for a second time for what she calls a double check . She also has problems with urine leakage with laughing playing etc. Her urine showed trace protein and ketones. What could be going on?",
    "doctor_response": "Hi,Since there can be many causes of urinary incontinence in children.like nerve injury, neurogenic bladdder, or overactive bladder, diabetes inspidus and diabetes melitus.But from your daughter's history it seems that she might be having juvenile onset diabetes.I would suggest that get blood sugar level  fasting and random both and urine osmolarity test to rule out the cause.Then you  may further discuss with endocrinologist.Hopefully my answer is helpfull.Regards,Dr.Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had unprotected sex, took pills. Missed periods. Are pills safe?\n\nHi i'm 16 and I am on the pill but recently dotted taking them throughout the week to make them last until the weekend but I took them on Thursday Friday and Saturday night, on the Sunday I had unprotected sex with my boyfriend and after continued to take my pill as usual but I have messed up the cycle in a sense that I carried on a week over than I should of done and it made me ill, but now I'm having period cramps and frequent trips to the toilet only to find blood on the tissue only when I wipe, what's going on with me?",
    "doctor_response": "Hi,It seems that due to taking hormonal tablet irregularly and haphazard way, there might be some hormonal imbalance causing this problem.Now wait till 7-8 days passed of your expected date of period.If you do not get period, then go for pregnancy test to rule out pregnancy.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal for new born to have high wbc count?\n\nHello, when my son was born he had a little higher rate of white blood cell than normal rate. After staying one week at special kid s hospital where he was checked head to toe they found nothing wrong with him and released him after 5 days. I am expecting my second son in Nov. I need to know is this normal for new born to have a little higher rate of white blood cell or this could have been a sign of infection? . Thank you.",
    "doctor_response": "High counts can be normal in initial few days of life  if tests for infection are normal.No need to get routine counts if there is no significant medical history.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i take i pill after having unprotected sex?\n\nHello Doctor Me and my wife had unprotected intercourse last day and she took an ipill within 20 hours. However after taking ipill we again had unprotected intercourse within 5 hours of taking it. Her normal periods are due in 4 days and it will be for five days. Her normal cycle is of 25 days. Should I give another ipill to her? We havnt planned any baby yet so she doesnt want to conceive. Plz help me out here. Thanks.",
    "doctor_response": "Hello dearI understand your concernYou have did sex 4 days before the expected date of period.It is safe period of the cycle and pregnancy will not occur during this days as ovulation is not occur and so no fertilization.You already used one I pillBetter to avoid another pill as it cause more chance of hormonal imbalance.No need to take the I pill second time as you did sex in the safe period of the cycle.Do not worry if your period will delay by the 1-2 week as it will cause by the I pill only.Avoid stress, take healthy diet, drink plenty of water and do regualr exerciseHope this may help youContact HCM for further health queryBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stress and depression\n\nHello Sir,I am doing a mba from a decent college after 2 yrs of job in IT sector. I have come to realisation that I have been unhappy for past 8 years. I think that if I Die it would be sweet release from this hell.Please help me if you have any solution.",
    "doctor_response": "hello user - i understand your concerns - you have not detailed out all the symptoms however a long term unhappiness may be the feature of a dysthymic illness caused by certain biological , psychological and social factors - since you have psoted this question here i assume that still there is hope inside you which is battling with the death wishes , which obviously are not your true wishes and are a state of mind which can be assesed and treated with medicines and behavioural therapy with help of a psychiatrist and psychologist - Take care - availabkle for further queries",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause internal bleeding in the arm?\n\nwhat could be the possiblilities....My aunt had an Ultrasound on her upper arm to determine if she had a blood clot. She doesn t but she is bleeding internally in her arm. They think she tore something in her shoulder. what could be torn? and what are the possibilites for correct?",
    "doctor_response": "Hello, It can be a consequence of minor trauma. Nothing much to worry and in most of the cases it will spontaneously resolve without much complications. Conditions like bleeding disorders have to be ruled out. Hope I have answered your query. Let me know if I can assist you further. Wishing you all the best. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause sudden foot pain?\n\nMy appointment isn t for three weeks and I need relief now. I ve just realized what my problem is and we re leaving on vacation in two days. I can t hardly walk and when I take my shoe off it continues to hurt. What help can you give me. Please help me! Thanks in advance.",
    "doctor_response": "Hi, I had gone through your question and understand your concernsWith such presentations in my clinic, I would first rule out certain conditions:1-Gouty arthritis as It's one of the most common causes of acute foot pain ,can be excluded by doing serum uric acid and relieved by urate lowering drugs2-Metatarsalgia due to heavy activities as prolonged walking and this could be relieved by NSAID and reducing heavy work .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for small spots inside the mouth\n\nI have small spots inside my mouth, this might be the cause of my sore throat or not but it also makes it very hard to swallow or talk,as well as this i also have a headache and a earache and i find that i have no appetite, i ve been having sickly sensations every time i have a to eat. What coulld this be?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query  small spots inside the mouth which is causing difficulty in swallowing is mainly due to Reuurent Apthous stomatitis which could be due to nutritional deficiencies, stress, immune dysfunction or due to hormonal imbalances. I would suggest you to maintain proper oral hygiene by brushing and flossing twice daily. Do Listerine mouthwash rinses once a day. Avoid hot, sharp and spicy foods. condition still persist then consult dentist /oral pathologist for proper examination and treatment . Doctor may prescribe anti inflammatory medications for 10-15 days and your symptoms will resolve. Take probiotic food/drink like yogurt in your diet. Apply dologel and mucopian on these spots. Drink warm water sip by sip to have better relief.Hope your concern has been resolved.Get Well Soon.Best wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the small blue lump in the middle of my left bicep?\n\nI have a small, round, blue, slightly raised lump in the middle of my left bicep.  It's been there for years, I don't remember how many years, but around ten, I guess?  It looks like a varicose vein poking up through the skin.  It's been slightly sore the past couple of days, when I move my arm or press it, but it's not really that painful.  It doesn't look like something in or on the skin, but rather just underneath it, like a vein.  Any idea what it might be?",
    "doctor_response": "Hi.You are absolutely right. All such lumps are veins and they pop out for years together , the body keeps them like that for years.Yet I would advise to have a simple test of ultrasonic color doppler to confirm and to see that there is no hemangioma seated - deep-rooted.. Just for safety and become tension-less.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does the exposure to airborn asbestos cause shortness of breath and bronchiectasis?\n\nHello! I was exposed to airborn asbestos-like fine glass dust about 4 1/2 yrs ago. thereafter, I began having intermittent shortness of breath, and other uncomfortable throat and chest symptoms that have only worsened. since that exposure time, I have been diagnosed with Asthma, Autoimmunehypothyroidism(Hashimoto s). Vocal Cord Disfunction, Traecheabroncheomalacia, bronchiectasis, and there has been an increased amount of findings on chest Ct. Could my exposure have caused these problems?? I am struggling to breath each day, doing naturpathic treatments, using nebulized Albeuterol, nebulized Glutathione, spireva, and of course eating as many veggies as I can! I would appreciate any input or advice... Thank You!",
    "doctor_response": "Hello and welcome to HCM forum.Asbestosis,a condition that affects the lungs ,usually occurs after high intensity and/or long-term exposure to asbestos (particularly in those individuals working on the production or end-use of products containing asbestos) and is therefore regarded as an occupational lung disease .The primary symptom of asbestosis is generally the slow onset of breathlessness , especially on exertion.It may manifest from years to  decades after the exposure .In my opinion your condition may not be beacuse of asbestosis ,rather your Tracheobronchomalacia (TBM) and bronchiectasis could be the main culprits.An Xray can confirm the finding of fibrosis caused by asbestosis .You may need Oxygen therapy if your breathing does not improve with Nebulised Albeuterol and Glutathione .Some people might need surgical correction of TBM which a clinical examination and Pulmonary function tests should help in assessing .There is not much chance of reversing the changes in your lungs ,it can mostly be managed .I would like you to go through this link which is greatly helpful to most patients . this helps, take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat bruise across upper back & width of the shoulders?\n\nI have recently discovered that I have bruising across my upper back,across the width of my shoulders I have had no accidents, there is a niggling pain/aching,picking feeling where the bruising is it looks like big finger print markings should I go see my G.P.? From left to right it looks like nail marks,then bruises, a lot of redness and is like an s shape, It has been there now for some weeks they don t disappear, I would send you a picture to give you a better look at it but that option is not here please advise if you can. Thanks Gloria",
    "doctor_response": "Hi, I appreciate your concern. The picture you described gives an idea that you might be having some allergic phenomena or fibrofascitis. You are advised to consult a dermatologist as well as an orthopedic specialist. Accordingly, it will be investigated and advised. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. DEORISHI TRIPATHI, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Persistent back pain. MRI shows disc bulge, annular tear.  No relief with various therapies. Help?\n\nI have been having persistent  backpain for over 8 months now, I take tramadol and Cyclobenzaprine for muscle relaxer. I have done Physical Therapy, and had two epidurals to no relief. I have been tested for Spondelitis, and the only cause shown on MRI could be buldging disc, and anuluar tear. I am starting to get a feeling like i'm on a boat kind of light nausea, I feel as if i'm weak, and have a poor short term memory now. The black spot just appeared on my right palm, and not sure if Tramadol is causing the nausua or the Cyclobenzaprine. My pain is usually around 8-9 out of 10, I don't have the MRI's to show, Blood work comes up normal.",
    "doctor_response": "Hello and Welcome to HCM, Thanks for writing to us. I understand you have back pain . These symptoms are part of lumbar disc degeneration with PIVD where the nerves get compressed by the protruded disc. There are several treatment modalities with medicines, physiotherapy and with injections in the back called epidural injections and root/facet blocks. If you don't get better with these treatment ,I suggest you undergo surgery, by which the nerves are decompressed by removing the protruded disc (discectomy), which would significantly improve your symptoms Hope this helps you. Wishing you good health... Regards. Dr Saurabh Gupta. Orthopaedic Surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking antibiotics and Advil after tooth extraction. Swelling in cheek. Cause for concern?\n\nI recently had a tooth extracted (3 days ago non wisdom) I am in very little pain. Still on prescribes antibiotics and take advil when necessary. M question is in regards to the swelling, while it has gone down significantly I can still feel a tight& hard lump in my cheek. While there is no pain from the lump, I am worried about the tightness and hardness. Should this be a cause for concern? or is this all part of the process?",
    "doctor_response": "HI THERETHANK YOU FOR WRITING IN HEALTHCARE MAGIC.ANTIBIOTICS YOU ARE TAKING WILL REDUCE INFECTION AND ADVIL(IT CONTAINS IBUPROEN ) IS A PAIN KILLER.MILD PAIN AND DISCOMFORT AFTER HAVING EXTRACTION IS NORMAL .BUT I WOULD SUGGEST YOU TO REVISIT YOUR DENTIST FOR CLINICAL EXAMINATION.MEANWHILE MAINTAIN ORAL HYGIENE , DO WARM SALINE RINSES.BRUSH TWICE DAILY.FEEL FREE TO WRITE US BACK FOR ANY QUERY.TAKE CARE.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for spots on the head\n\nMy 19 year old daughter recently noticed bald spots on her head, 2 of them is dime sized and the other one is about the size of an egg. Also, she has a lump on her armpit. In the past, her lymph nodes were huge but eventually the swelling went down. She mentioned to me that sometimes, there s blood on her stool. I am so worried because cancer runs on her father side of the family.",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein and I will try to help you as much as I can.Spots on head are probably atheromas and these are small subcutaneous glands which may become clogged and grow. This should be surgically removed under local anasthesia. This is not serious. Her blood in stool is something else,however,cancer is the last thing to think of in her age. It is in most cases caused by hemorrhoids or anal fissure so she should see proctologist for further evaluation.I hope I have answered you query. If you have any further questions you can contact us.Kindly regards. Wish you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will Lysol kill any lingering hand foot mouth bacteria?\n\nWill lysol kill any lingering hand foot mouth bacteria? My friends daughter was diagnosed today and she was at my house playing with my daughters toys approximatly 5 days ago, if i spray her toys with lysol will that help and is that safe for my daughters toys that she may put in her mouth tomorrow?",
    "doctor_response": "Thanks for asking. I gone through your question and understand your concern. you said that your friends daughter has been diagnosed with hand foot and mouth disease. you said that she played with your daughter 5 days before, I want to a mention point here  that, duration(incubation period) between the virus that goes to body and the illness like fever is generally 3 to 6 days in hand foot mouth disease. so as you said that 5 days has passed since she not developed and symptoms. it is very unlikely that she will develop the s disease now. yeah this is  you can spray her toys with lysol to prevent infection but after spray with lysol wash with tap water before your kid touch them.  thanks hope I answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the lower right side of abdomen. Hurts to laugh, cough, walk. Stomach swollen. What could it be?\n\nI started having pain in the lower right side of my abdomen. It has now gotten worse and I can't even press down on that area nor can I laugh or cough without making it worse. It hurts to walk and it feels as though it may be spreading to my back. First I was thinking gas now I am thinking it could be my bladder as I haven't been drinking a lot of water. I am in so much pain even laying down doesn't help. I do not have any fever or vomiting at this time. My stomach is also swollen.",
    "doctor_response": "HIThank for asking to HCMThe lower right side of abdomen pain indicates the sing of appendicitis and your symptoms are also correlate with it so in my opinion this must be rule out first, for a symptomatic relief you can have Dicyclomine tab. three times in day it would be better if you can take this tab. along with acetaminophen, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have pain in root canal treated tooth?\n\nHi. I just got the second sitting (have one more sitting to go for hard filling) of my root canal treatment done. The anaesthesia is yet to wear off completely but I havae alreay started feeling pain (sharp pain when i press hard) in the treated tooth. Also, I notice redness around the gum. Is this normal?",
    "doctor_response": "No its not normal infection is still there. Until unless pain completely subsides dont go for final sitting root canal treatment. Consult your dentist. Are you talking any medication? ?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will the HCG injection help one get pregnant?\n\ni am 25 yrs old and my husband is 30.i am having the problem of PCOS.i am under treatment now for the last 4 months.in the first 3 months doctor prescribed just clomiphene citrate starting from dose 50 increased to 150 in the third month..with that my follicles did not respond.then in this month beginning ,doctor gave me 3 doses of menotropins along with clomiphene citrate(5 days),menotropins given in alternate days starting from the 3rd day of clomiphene.my body responded to it and in TVS it was found i was having 2 fully developed follicles of 20 mm size and they gave me hcg injection on 9th june to ovulate.i did pregnancy card test today and found negative.is there any chance that i will be pregnant?my LMP is may 29.i am 5 6 and 59 kilos.i dont have any other major illnesses.my husbands sperm count was low when he checked 4 months back but checking on last month showed he is having normal count now.he was taking Maxoza for the last few months.what is the difficulty in my case in getting pregnant...",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.The conventional system of medicine hardly has any cure for PCOS. Their focus remains on treating the visible and most troublesome signs and symptoms. The cause is left untreated. When it comes to alternative systems or complementary treatments for PCOS, homeopathy offers the best alternative. This is because homeopathy focuses on treating and curing the root cause of the problem. The homeopathic philosophy of disease is not based on the external causes of diseases. Homeopathy believes that the human body has been perfectly enabled by nature to keep itself disease free. It is only when the immunity or its own internal vitality is deranged that the body becomes incapable of keeping itself disease free. Therefore, homeopathy tries to restore the balance of that vitality. Once the vitality regains its original balance, it is able to nurse itself back to health without any external aid. That is why homeopathic medicines are given in very minute doses. Homeopathic medicines like apis, pulsatilla, sepia, lachesis, and graphites are often used in the treatment of PCOS.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Muhammad Amin",
    "dialogue_context": ""
  },
  {
    "patient_message": "End stage renal disease, awaiting transplant, on dialysis, diabetic. What could be the causes ?\n\nHi, I am a 65 year old woman with a history of smoking and have been smoke free for six years.  I have end stage renal disease, and am currently awaiting a kidney transplant, which I have medically qualified for.  While awaiting my transplant, I've been receiving dyalsis and am  diabetic.  Lately, I have been getting periodical \"night sweats.'  I am wondering what could be causing this as I know it cant be menopause.   I am on several medications for high blood pressure, cholesterol and insulin.",
    "doctor_response": "Welcome to HCM.The commonest cause of night sweats in your case would be nocturnal hypoglycaemia,also if you are on any painkillers/analgesics ,they may also induce night sweats,as would any systemic or urinary infection.Autonomic neuropathy secondary to Diabetes,and certain antihypertensive drugs will also cause night sweats.It would help discussing this with your doctor who can investigate and isolate the cause.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child is suffering from cold and cough. Tried so many medicine. can i give inhaler?\n\nHi, my daughter is 2 1/2 years old.. sh s having cough and cold frequently. we have tried so many medicines . but now doctor prescribed inhaler for her... Asthaline inhaler and budecort inhaler. she s under weight only 9.8 kg. I m worried for her.. what can i do for her... is this medicine will helpful for her..",
    "doctor_response": "Hi, Inhalers can be given to young children in episodes of acute bronchitis for symptomatic relief to be achieved in less time. In consultation with your doctor, you can definitely give this medicine. Inhalers are given via baby mask in young children. Regards Dr. Gyanshankar Mishra MBBS MD DNB Consultant Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am i having back pain and abdomen bloating?\n\nI was wondering after having my c section 7 months ago. I have recently started a new job thar requires heavy lifting since i started i developed symptoms back pain my incision hurts and abdomen bloating could the heavy lifting cause me to injure my insides.",
    "doctor_response": "Hello,I had gone through the case and found that it might be due to complication in cesarian.Normally we advise to avoid heavy weight lifting till 6 months.But before doing anything consult to gymecologist and go for proper checkup.Back pain might be due to spinal anasthesia.So take calcium once a day.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could frequent vomiting, spinning head with history of having spondylitis be just cervical problem?\n\nhellomy father is 67 years ild..he long ago suffered from spondilytist..hes in india and its quiet chilly there..2 days ago all of a sudden he started vomiting n vomited around 6 times in a day including head swirls..his doctor friend gave him a meficine to eat n a collar to put..my ques.is..is it jus the cervical problem or more than that n ehat should he do now",
    "doctor_response": "Hi i am Dr Ahmed Aly    thanks for using healthcaremagic site ,I had gone through your question and understand your concerns ..   In my opinion i dont think the cervical problem of your father spine is the main reason of that kind of persistent vomiting but sometimes the painkillers or medications used to treat the spondylitis pain could cause such side effects on chronic use .  I suggest he maintains a high fluid intake to flush his system , stop any kind of treatment and take the antivomiting and avoid high cholesterol and salty meals and make some lab investigations to rule the underlying cause of vomiting for proper evaluation and management .Please click and consider a 5 star rating with some positive feedback if the information was helpful. Wish you good health,Any further clarifications feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest ways of conceiving a baby\n\nhello sir i m 27 yr old male married since last year . we hv been trying for a child but are still not successfull. my wife is 26 yr old and her TSH levels are slightly elevated. she also has galactorrhoea since last 4 years. her prolactin levels are about 25 units. she had been started on thyroxine 25 mcg OD daily and tab cabergoline 0.25 mg once weekly recently along with tab oflox-oz 1 bd & tab fluconazole 150 mg stat . my semen analysis was normal except for 8-10 pus cells. what does it indicate. what investigations should i undergo? is this the right treatment we are taking? is cabergoline better then bromocriptine if we desire pregnancy? sir plz reply . we would be highly obliged",
    "doctor_response": "Hello dear,I understand your concern.In my opinion you are on correct line of treatment.Your wife has problems of hypothyroidism and galactorrhea both are the cause of female infertility.They might cause hormonal imbalance leading to irregular ovulation and irregular cycles.Cabgoline is better than bromicriptine and increases the conception chances.Cabgoline is given as tapering dose and the prolactin level is repeated after the course.The prolactin level is only mildly elevated.(upto 20ng/ml is taken as normal).But both the problems are correctable and once the level becomes normal the conception becomes successful.Presence of pus cells in semen indicate infection and it needs a course of antibiotics to be taken.Nothing to worry.Avoid stress.As both your and your partners problems are correctable and reversible.There are good chances of pregnancy once they are corrected.Hope this helps.Best regards....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Patch of red, dry, flaky skin on hips. Ankle, lower leg swollen. What could this be?\n\npatch of dry skin which is the shape and size of a nickel I have one patch of dry skin near pantie line which is the shape and size of a nickel on my butt. It s red with white flaky skin. it doesn t itch but i ve noticed it for two weeks now and it hasn t changed in appearance. my ankle and lower leg are swollen and remains that way.",
    "doctor_response": "Hi there, Regarding your first question,it could be Allergic or Irritant contact dermatitis and you need to see a doctor to have a live look and proceed further,but for now on you can apply white petroleum jelly on the patches. Secondly i am not sure that is the swelling in one or both the legs? It need a detailed history and discussion to clear things up and unfortunately its not a question answer session so you have to see your GP. I canot comment further cos of a very brief history i am afraid. THANKS VERY MUCH",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tumor in lung and brain. What is the best the treatment?\n\nI AM LOOKING FOR A LIST OF: THE BEST 'ONCOLOGIST DOCTORS' IN THE EUGENE, OREGON AREA?, AND;  I WOULD LIKE TO MAKE A LIST OF THE 5 (FIVE), OR 10 (TEN) 'TOP ONCOLOGIST, WHO ARE PRESENTLY WORKING AT THE RIVER BEND HOSPITAL IN SPRINGFIELD, OREGON?  ALSO, WAT IS THE NAME OF A OCOLOGIST WHO WILL BE ABLE TO TREAT BOTH A BRAIN TUMOR AND A TUMOR IN THE LUNG OF THE SAME PERSON? PREFERABLY, A DOCTOR WHO BELIEVES IN OUR LORD?  send a FREE ADVICE for this one?",
    "doctor_response": "Hi,Thank you for posting your query.If a person has tumors in both brain and lung, it is most probably starting in one of those areas, and spreading to the other area. In this case, the most likely possibility is a primary cancer of the lung, which has spread to the brain, a process called as metastases.You should consult a medical oncologist for this, as the treatment involves using chemotherapy. In some cases, radiation therapy may be required, for which he may be referred to radiation oncologist.This advice is absolutely free.I hope it helps.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking gildess for birth control pills. Will a dietary supplement change the effectiveness of the pill?\n\nI am currently taking Gildess FE 1/20 birth control pills, and I know some dietary supplements can affect the effectiveness of the pill. The dietary supplement I am taking is Herbalife, but just a powder that controls hunger, and I take it in the form of a fruit shake. I just don't know if this can affect my birth control pills.",
    "doctor_response": "which fruit shake ,timing of pill with shake is also imp  some fruits like grape seeds etc interfere with the metabolism of drug also timing of taking pill plz read the information along the pills care fully",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of parenthood based on this report?\n\nwe are trying for a baby for the past 3 years, my wife last hormone test results are: LH=8.7 FSH=8.2 These were taken on the 3rd day of her period which was 5/7/2010 my semen results are: count=70M 15% is normal can you please advice and help? Rgds, Ali Zayed Libya",
    "doctor_response": "HelloYour wife's report are normal.FSH and LH values are within normal limit.But,your semen analysis report shows borderline low normal morphology sperms.Sperm count is normal.Normally it should be at least 20 millions/ml.Normal morphology sperms are mildly decreased.Only 16 % sperms with normal morphology is required for natural fertilization.Your findings suggests 15 % normal morphology sperms.You should take healthy and nutritious diet.Take anti-oxidants also.Avoid wearing tight underpants.If findings persists then you may need assisted fertilization technique.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Zylopred be given to a child for eye infection?\n\nMy 1 year old baby was diagnosed with an eye flu 3 days back by a paediatrician. she was having just redness in her right eye and was prescribed oflox drops and neosporin ointment for 5 days. But the redness still persisted so i consulted an eye specialist. He now diagnosed as hypersensitivity & prescribed zylopred. Is this medicine safe for infants?",
    "doctor_response": "Hellowelcome to HCMyes zylopred is safe to infants.Do not worry.If you have any questions do not hesitate in asking us.wishing for your child good healthwith regards Dr Aamir",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a woman of 43 years conceive naturally?\n\nI need your opinon, can  women a 43 get prganant naturaly , having periods of 28 day cyckle. And what is the latest age to hope to have baby and continue trying. Hoping for the first pregnancy. Doctors diagnoses are good with hormones balanced and FSH 5, Thank you",
    "doctor_response": "Yaa a woman can conceive till her menopause.but apart from this after the age of 35 many complications occured during pregnancy.but with proper consultation and care any lady can have healthy pregnancy.so u can consult a nearby gybaecologist for conception.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the lower back on the left side?\n\nWe live in Tucson AZ.  I have struggled with lower left back pain for years.  We just went to Sn Miguel de Allende for 8 days and I had NO back pain.  Elevation 6,234 in SMA.  Elevation in Tucson 2,600.  Returned to Tucson and my back pain came right back.  Any thoughts??? YYYY@YYYY",
    "doctor_response": "hi sir/madam,Let me advice you for your problem.Line of treatment as per Ayurveda:-The general principles of treatment of vata dosha are adopted in case of katishoola (low back pain). It includes various measures to suit its varied clinical entities, stages and associated complaints.1. Snehana (oleation) \u2013 by sneha dhara (pouring oil), abhyanga (oil massage), avagaha (tub bath with oil or oleaginous medicaments), kati basti (retaining medicaments on the back) etc.2. Swedana (sudation) \u2013avagaha sweda  (sweating treatment with tub bath), pizichil (kayaseka), nadi sweda (sudation through a tubular device \u2013 local sudation), panda sweda (sudation through medicated paste or powder) etc.3. Mridu Samshodhana -mild purgation.4. Basti (medicated enema) like eranda basti, vaitarana basti, pippalyadianuvasana basti etc.Formulations indicated in Low back ache as per Ayurveda:-1. Dashamoola kwatha.2.Maharasnadi kashaya.3. Rasnaerandadi kashaya.4. Sahacharadi kashaya.5. Gandharvahastadi kashaya.6. Trayodashanga guggulu.And for local application these oils will help:-1. Ksheerabala tail.2. Mahanarayana tail.3. Dhanwantaram tail.4. Maha narayan tail.Avoid these for better results:-1.Bitter, astringent and pungent food2.Cold water3.Fear4.Exhaustion5.Standing6.Driving7.Cold food and beverages etc.Hope i was helpful.Have a healthy day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high BPM while resting, anxiety and depression?\n\nMy daughter is 25 and has a resting heart rate of 158..her blood pressure is norm and she is complaining of being tired and out of breath. She does have issues of anxiety and depression but says that she was not feeling any of that the time that I took her blood pressure and pulse rate.",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.The pulse of 158 is quite high and its not likely that anxiety disorder will lead to such high pulse. Panic disorders may lead to such high pulse rates but this increase is transient. If the pulse is still high then she will require a ECG. Sometimes certain cardiac conditions like ectopic beats may seem like anxiety but the treatment of these disorders are very different. 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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swelling in penis and puncture marks with green heads on them\n\nMy younger brother who just turned four was playing outside and he ended up sitting in an ant pile and the ants crawled up his shorts and bit his penis . When I took him inside to look at it, it seemed fine , but earlier on he was complaining that it was itchy and it hurt . Looking at it again the tip of his penis is all swollen and the puncture marks had green heads on them . I was just wondering what was the best way to go about treating this or if we need to seek medical help ?",
    "doctor_response": "Hi...this is insect bite allergy and ant bites have formic acid in it to aggravate the situation. I suggest you use calamine lotion for external application, along with oral ant allergic like Hydroxyziine or Cetrizine. These are prescription medicines and I suggest you seek your physician for a prescription or else use any over the counter antihistamines licensed in your country to be used in this age group.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for high fever and edema\n\nDear Sir Mr ward Prince had a road accident in Sept 2008 .In Accident he had three fracture in right leg below knee .he was operated by doctor at Jalandhar .They operated and put cross flap and simple graph ting .Afterward he is suffering from odima regularly and after taking  antibiotics it is cured but afterward He again  suffering from same . He also suffering from high fever .Please give me appointment and suggest me . With Regards",
    "doctor_response": "hiwelcome to HCMI can understand your concern.If he is having fever and edema means, there might be infection. if you had complete course of tab Augmentin 650mg B D for 5 days, if it is not reduced after taking that you meet your operated surgeon and go for i v antibiotics. if you are having fever take Tab Paracetamol 500mg BD.thank youtake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe chest pain\n\nHello my name is Ashley and Im 28 years old. My questions is that today Ive have been having severe chest pain. It hurts when I breathe and take deeps breaths in and out. I had really bad nausea a couple of days ago, so just not sure if it was indigestion or something else but this pain has been going on for a few hours now, thanks",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. Possibility of acute gastritis and related chest pain is more in your case. So avoid stress and tension. Avoid hot and spicy food. Avoid large meals, instead take frequent small meals. Drink plenty of fluids orally. Start proton pump inhibitors and prokinetic drugs. You will mostly improve with all these lifestyle modifications. If not improving than consult doctor and get done ecg to rule out cardiac causes for chest pain. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat persistent cough and breathlessness while having a tonsillectomy?\n\nMy son had a tonsillectomy 6days ago and has been recovering really well. However, he has a really chesty cough and was on steroids and antibiotics a week before the op for this. Today he is very chesty, tearful and complaining of it being hard to breathe. He had s terrible night and j wondered if I persist with regular meds or if I should ring out dr?",
    "doctor_response": "Hello,The persistent cough indicates underlying Respiratory Tract infection.In our hospital, we recommend:- Gargles with salted lukewarm water added Epsom salt.- Antibiotic as per the culture report of throat swab.- Plenty of liquids with dietary measures.- An X-ray chest and blood tests as per the progress.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on abdomen\n\nHi, I had a lump under my skin on my lower abdomen about 2 weeks ago.... In the last couple of days it looks like it opened up cause it's a little scabby and the skin around it is red and elevated. It is right at my pant line and is really causing me pain, and discomfort!Thanks for any advise!Jenny C",
    "doctor_response": "Hi ! Good evening. i am Dr Shareef answering your query.From your history, it seems that you have got a boil on the part which might have caused more inflammation of the surrounding tissues causing redness and pain specially when the pant rubs against it. In ideal conditions, you should get it assessed clinically by a genera surgeon, who might prescribe you with some broad spectrum antibiotics and an anti inflammatory drug after testing your blood sugar. In case of formation of an abscess , he might suggest you for a minor operative procedure to drain out the pus so that it heals well and faster.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in foot and difficulty in walking?\n\nHi , I have a swollen foot , and it hurts when I walk on it , under the skin I can see clear little spots lik bubbles under , it feels like a bubble around three toes , between my big toe and pinky toe, I didn t have any accidents , it just started two days ago out of where , I don t know what to do ?",
    "doctor_response": "Dear Patient.Are these hard or soft. If hard possibility of corn is there but if it is soft then these could be infective or water filled blisters. I feel u should see your doctor and get this examined. I hope that helps.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can increased prolactin levels in blood cause joint pain and fatigue?\n\nI have had chronic fatigue, joint pain, water retention, depression and weight gain over the past year and a half.  I had my blood work done and my Prolactin level is at 52.3.  I will be having more blood work in about 6 weeks.  Could Prolactin be causing these problems?  Oh and I am only 32 years old, I shouldn't be feeling this bad.",
    "doctor_response": "Hello and welcome to HCM,The symptoms of chronic fatigue, joint pain, water retention and weight gain are not associated with high prolactin levels.High prolactin level is caused by increased secretion of prolactin by pituitary gland.Increased secretion of prolactin can be due to prolactin secreting tumor.The symptoms of fatigue, water retention, depression and weight gain are suggestive of disorders of thyroid gland.Hypothyroidism can lead to similar symptoms.Thus, thyroid function tests are required to assess the thyroid functions.Pituitary gland also needs to be examined by imaging study to look for any tumor of pituitary gland.Thanks and take careDr Shailja Puri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for tingling and numbness in arm?\n\nHello. I had some blood work done at a local, well known lab back on October 3rd, 2013. The phlebotomist/nurse, (not sure of title) applied the tourniquet and then proceeded with filling out paperwork. I d say it was atleast five minutes before she attempted to draw blood. Normally, when you are having blood drawn, you feel the prick of the needle. Well, I didn t because my arm was numb at that point. She says that the vein rolled and she was having trouble finding it, as she is moving the syringe around in my arm. As with the initial prick, most folks would feel pain. I know that in the past, it has hurt pretty badly to have this done. But, guess what, I didn t feel it due to numbness. Now, once the tourniquet was removed, I felt immediate pain. I knew that she did not follow the correct procedure, but I figured the pain would subside within a few days, a week at most. As time went on, the pain (along with numbness and tingling) radiated through my arm and became quite unbearable at times. The pain extended from the draw site (left arm; outside edge of the bend at elbow) down the top side of my arm and into my wrist, top of my hand and into my fingers at times. At one point, maybe three weeks after, the pain moved into my bicep and into my shoulder. Well, it has been just over three months since I had the bloodwork done and I am still in pain! I do not have much strength in my arm and if I attempt to use it (pick something up, push or pull something) the pain is so bad that I have to stop or drop what I m doing. Even picking up my cup of coffee is painful! I can not even straighten the arm without cringing in pain. I have tried using analgesic pain creams, massaging the area and applying heat, as well as ice. Nothing seemed to help. I even tried wearing a wrist brace, thinking maybe my carpal tunnel was acting up. That seemed to only make it worse. Mid November, I finally came to the realization that something was wrong. Really wrong. My doctor sent me to a neurologist to have a nerve test done. It came back normal. My doctor sent me to have an MRI of my neck done (just to see if maybe the pain stemmed from there). It, too, came back normal. I now have an appointment scheduled with an orthopedic specialist to see if they can determine what the problem is. All I know is that the everyday pain is aweful and not having the full use of my arm is quite irritating. Do you have any idea what could have hap",
    "doctor_response": "Hello First of all, you should ask a vascular surgeon for help. You could have an injury in the veins wall and the surrounding tissues. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dr/Mustafa, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment and medication for osteoporosis and spondylytis ?\n\nam having knee pain and back pain , as doctors said its osteoporosis and spyomdolises can you advise me for better medication or what is the cure for this pain.",
    "doctor_response": "Hi, Welcome to Healthcare Magic Forum. Reagular mild exercise and physiotherapy are  better than continous use of medicines for pain relief. Always take medicines under proper physician guidance. Have a good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for chest pain?\n\nBeen having left side chest pain for over a year. Pain gets worse when laying on my stomach and subsides when standing. Pain  will last anywhere between 3 min and 10 hours. Had an EKG, heart ultrasound and holter monitor with no signs of heart issues. Tried many antacids with no response to them. Pain is not influenced with exercise. Have mad multiple blood tests all showing normal. Forcing gas out as what feels like an inside burp seems to relieve some of the pain.Pushing on my left rib cage and breast also seem to help.",
    "doctor_response": "Hello dear, thanks for your question on HCM. Since your extensive cardiac work up is normal, no need to worry for cardiac cause. In my opinion you are having GERD ( gastroesophageal reflux disease ). It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms. Along with antacids, you need to follow these lifestyle modifications for better symptomatic relief. 1. Avoid hot and spicy food. 2. Avoid stress and tension. 3. Avoid large meals, instead take frequent small meals. 4. Go for walk after meals. 5. Keep 2 - 3 pillows under head in bed to prevent reflux. 6. Avoid alcohol and smoking if you have these habits. 7. Loose weight if you are obese. Don't worry, you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for acne & lumps\n\nSir, I have nose acne, which create lump on nose, white thin worn like secretion and black head. And when I try to steam it or clean my face, the black head or the white secretion comes out leaving a pit, which is not healing and increasing with time.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have grade 4 acne. Don't try to remove it. You should take clindamycin, doxycyclin, acitretinoin according to your doctor's advice.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe pain in the knees be treated?\n\ni am a 47 year female with multipke myeloma history i am currently in remission after a stem cell transplant 2 years ago. i am currently experencing severe pain in my right knee to the extreme i need assistance to walk and severe pain in the achiles area of both of my feet. how can i releive the pain",
    "doctor_response": "Hello, Knee pain may be due to arthritis or tendinitis or meniscus tear ligament injury etc.Until examination is done it is difficult to say what it is. Get it done X-ray of knee joint.Take rest, use cold and warm compression. use NSAIDS for pain relief. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Weird stomach, don t poop right and its off and on\n\nmy stomack fells weaird i dont poop right and its off an on comes back on its own",
    "doctor_response": "THanks for the query Your message too less a content for me to help u. I need to know how long this has been happening, your age, habits like smoking, are u eating regualry. and  what exactly do u mean by weird?? Have a healthy living",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in ribs and difficulty in breathing after chest injury\n\nwhen i was skiing park, i fell on a rail and landed on my ski lock that was located in my breast pocket. i couldnt breathe properly for 30 min, and it has been 2 weeks and i am still having trouble breathing fully. it felt like my right side of my ribs were broken, what should i do?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. You had blunt chest trauma. And current symptoms like chest pain, breathing difficulty etc are suggestive of following possibilities. 1. Rib fracture 2. Pneumothorax 3. Pulmonary contusion 4. Musculoskeletal pain. All these are commonly seen after blunt chest trauma. So better to get done chest x ray first. If chest x ray is normal then no need to worry for rib fracture or pneumothorax. Musculoskeletal pain can also cause similar symptoms. So avoid movements causing pain. Avoid bad postures in sleep. Avoid heavyweight lifting and strenuous exercise. Apply warm water pad on affected areas. Take painkiller like ibuprofen. Wear chest belt to prevent mobilization of painful parts. Don't worry, you will be alright with all these but first get done chest x ray to rule out internal lung injury. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated blood pressure levels?\n\nI am a healthy 69 year old female and was in my Drs office today for my wellness exam and my blood pressure was high for me. It is usually 129/64. Today it was taken 3 times. 155/84, then 162/65, then 141/58. What could cause that jump in a year. The nurse practitioner didn t seem too alarmed but she wouldn t let me leave until it came down to the final reading",
    "doctor_response": "hi. Good to see your concern about your health. So far as your question is concerned, with the information provided there may be  many causes of increased blood pressure with most important being the age itself. Moreover, additional environmental and psychological conditions like exertion or anxiety may increase the blood pressure momentarily. That may be the scenerio in your case while ariving to the physician office you might have had a walk or may be gone upstairs. Additionally in such a settings, a little bit of anxiety may also be there. In such conditions i advise my clients to record their B.P twice daily for atleast a week. then come up with the B.P record to the physician for appropriate further action as a single reading or few readings taken in a short while is not the indication for antihypertensive therapy unless its to high that it necessitates urgent action. I hope these words might help to better understand your health status.Wishing you the best of health.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the pelvic pain am I having for a month?\n\nI have been having pelvic pain now for a month. I recently went to family doctor. I had a hernia check with they did not feel anything unusal. Said it was not from a pulled muscle. I was refered to a general surgen. Another 20 days to wait. The pain I am and have been having is a dual to medium pain in my groin area. I have a feeling of stiffness in my upper right thigh. There is also pain in my scrotum area. A feeling of a tugging on testicles (both testicles). Sometimes sharp pain in lower groin area. The pain can last anywhere from a few minutes to a while. I typically have it everyday or every other day. No pain when going to bathroom. I am sexually active but no pain with errection or when ejackulating. I have moderate IBS but was told it is more than likely not from that. I getting anxious and worried that it could be something major. I to tend to worry alot about health problems. I just looking for possible answers or suggestions i could bring up to general surgen when I go see him. Thanks",
    "doctor_response": "Hi. The surgeon will probably exclude the usual groin hernias - direct and indirect hernias. We also have what is called Gilmore's or Sportsmen hernia which is at the back of the inguinal canal and may not present with the usual bulge that inguinal ones have. Just ask the doctor to exclude that as well.Management is usually repair of the posterior wall of the inguinal canal.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower back pain\n\nHi, my name is Raymond and I have been having this lower back pain that shoots down from my right side of my lower back to the right side of my knee for going on four years now I can especially feel it when I bend over to touch my toes. I started experiencing the pain May of 2011 gradually after doing a workout routine.",
    "doctor_response": "Hello, I have studied your case. Due to compression of this nerve root there can be pain in your back and leg.I will advise you to do MRI spineFor these symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.I will advise to check your vit B12 and vit D3 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the solution for short term memory loss at 78 yrs of age?\n\nMemory loss issues.  My mom has been experiencing a progressive decline in her short term memory function.  She is 78 years old and a heavy smoker.  She has recently been prescribed Aricept-5mg in addition to the medications that she is already taking for high cholesterol and blood pressure.  Since Aricept, her behavior has been quite erratic, she is more confused and making things up that didn't even happen.  I am so worried.  She has had brain scans, blood tests, and all seem to come back suggesting that she just has age related brain shrinkage, but no one has said that this could be the beginning, middle or late stages of anything. What additional tests can I request a doctor run to take a closer look.  Something is definitely not right with her.",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.From what you have stated it appears that your mother is having symptoms of dementia and aricept is a good drug for the illness. Its unfortunate that your mother is not tolerating this medicine.The other option is memantine. 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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swollen urethra, bacteria in urine, pain on urination. Chlamydia, gonorrhea tests negative. Cure?\n\nHello, I have this problem where my penis hole or urethra is swollen and looks like a pair lips . I been tested for chlamydia and ghonarea and all came back negative, I still was give antibiotics for both just in case. Was told I had bacteria in my urine. Only burns when I urinate after that pain goes away. What could this be and how do I cure this",
    "doctor_response": "Hi,It may be urethritis in distal part and meatus. Take lot of water. Take alkaliser.You consult dermatologist. If needed , antibiotics like sparfloxacin may be taken.You may be alright. I hope got my answer.Thanks.Dr.Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nausea,vomiting,dizziness and neck pain?\n\nMy husband has dissy spells, somtimes on waking. Today he was gardening and had a sudden attack of dissiness, nausia and vomiting. He says he feels as though he is sea sick. He also complained of a sudden sharp pain in left back of neck. He had open heart surgery in 2004 to replace a bicusbet ascending aortic valve and a portion of damaged aorta. (please excuse spelling). These spells have been more frequent the last two weeks. We saw a new doctor today and he is going to fit him with a heart monitor on Friday. I am worried, could he be having small strokes? Or trouble with blook clotting?",
    "doctor_response": "Hi, I am Dr.Bruno and Let me answer your query.The Symptoms you have described 1. Sudden attack of dissiness, 2. nausea and 3. vomiting. 4. feels as though he is sea sick. indicate a problem in Posterior Fossa of Brain (mostly decreased blood circulation or rarely a space occupying lesion) The sudden sharp pain in left back of neck can be due to Conditions Associated with the above I would suggest you to visit a Neurosurgeon immediately and get evaluated If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On birth control, on free pill week, have not got periods yet, have sore breasts, no cramps. Pregnancy chances?\n\nHi, so this month was the first time being on birth control and me and my boyfriend have intercourse all the time. He has cummed inside me a couple of times and i started my free pill week on friday and so far i havent gotten my period. He cummed inside on the first day of my free pill week...which was on friday and he did it again yesterday. My breast have been sore and i havent had cramps which i usually get them. What are the chances of being pregnant? If i am ill be a very happy mother and so will he, be a wonderful happy father and if im not, we ll make it more protected. Thank you.",
    "doctor_response": "HI,  As you were taking oc pills regularly with sexual exposure the chance of pregnancy is least .when one starts oc pill then there is altered menstruation which gets regularised on regular use.   So in my opinion wait for one week for menstruation to come if it doesn't   comes then UPT .  and visit gyne clinic if result is positive .hope it ll h elp Thanks n regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant headache, bleeding gums and small pimple behind neck?\n\nHi I have been having constant headaches for the past four weeks I have recently quit smoking and drink alchohol pretty often, I have been having a bleeding gums for a whe now and I now have a small pimple like growth on the back of my neck these headaches are unbearable what can I do",
    "doctor_response": "Hello and welcome.Thanks for sharing your concern.Constant headaches could be due to many reasons,like migraine.Due to sinusitis,due to acidity ,vision problems, hypertension,etc.Therefore please visit  your physician and get your CBC( Complete blood count test )done.After the reports it can be treated accordingly.Regarding your gum problem,it appears to be gingivitis.It means mild to moderate infection of gum.For this you need to visit your dentist and get a course of antibiotics.After that a scaling or cleaning will be required as a treatment.This should help.Let me know for further doubts.Thanks.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness in a child?\n\nMy 11 year old son has been complaining today of feeling light-headed. He says everything seems to go light and then darkens....and then it stops and sits and feels better but tired. He has even had complaints of it happening when he is sitting and laying still. He has had no other symptoms today except for a complaint of a headache just at the very end of this evening. Earlier I checked his blood sugar and it was 82. In years past he has fainted 3 different times but they all were related to blood or getting shots. (He hasn t fainted in 3 years and has never complained of light-headedness like this before today) What could it be? Thank you, Melissa",
    "doctor_response": "Hi...I have just gone through your question. I have these possibilities in mind - 1. Complex Partial Seizures.2. Transient Ischemic Attacks.3. Intermittent Ischemia of the retinal artery.I suggest you get an EEG and MRI brain done and get it done after getting him evaluated by your pediatrician.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for raised PSA levels and metastasis in lungs\n\nhiI want to know if a perosn with prostate cancer treated 3 years ago with radiation IMRT/ IGRT and on hormone treatment since, now with rising PSA and metastasis in lungs , can adding bicalutamidew be the first line treatment or should we try chemo first?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.He has prostate cancer with metastasis in lung. It is stage 4 cancer and he already took radiation treatment. You should try chemotherapy first. However despite of all treatment prognosis remains poor. Life expectancy is not good. Consult your doctor and plan accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes brownish green coating on tongue?\n\nI have a brownish green coating on my tongue that appeared a couple of days ago.  I had a gum graft two weeks ago and have been using a mouth rinse and very carefully brushing around it but I brush my tongue everyday.  What could be causing this and is it serious?",
    "doctor_response": "Hi,Thanks for posting the query,       Which mouthwash you are using? are you having any type of GIT problems?It is very nice to hear that you are having good oral hygiene and clean your tobgue daily, still get an examination done by an Physician take lukewarm slaine rinses at home drink plenty of water and keep yourself hydrated.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest economic treatment for kidney stone\n\nHi..am a resident of gurgaon aged 35years. I am looking for surgery for kidney stone removal...the stone size is around 18mm and is stuck in the duct leading to extreme pain. Please note am a diabetic with fluctuating sugar levels...since my medical policy does not cover the ailment as of now, am looking for an economical solution...would appreciate if i could get an approx price quote too",
    "doctor_response": "Hey.Welcome to HCM.Let me first inform you that, if the stone size is less than 10 mm, then definitely there is a chance to flush it out from our body by specific medicines.In your case, the stone size is 18 mm and also it is stuck in the ureter as informed by you, which is giving you severe pain.In my opinion, you can go ahead for surgery.Do not worry it will be not an open surgery.Lithotripsy is done in such cases, which is minimal invasive surgery.Hope I have answered your question. If you have any other questions, then i will be happy to answer it.Wish you good health.Take good care of yourself.Warm Regards.Dr. Surender sharma.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child got mouth sore. What is the proper treatment?\n\nHello, my sone has today conttracted a school sore . We have taken him to the doctor and is now on a treatment oral for the infection. My questions to help with the healing of the sore/s. During the day is it best to leave them uncovered to try and dry them out as to speak? Is there a cream that is also suggested to treat them with? Many thanks, Patrick",
    "doctor_response": "HELLO, Your son suffers from recurrent aphthous ulcers.l This can be treated with vitamin-becosules supplements. -oral corticosteroids administration -steroid ointment ,1.5%cortisone acetate ,can be locally applied. -iron,zinc,folic acid supplements can be administered. -please avoid food precipitating allergy. --be careful while toothbrushing,to avoid toothbrush injury causing ulcers. -meanwhile-food with highly nutrition has to be taken regards dr.bindiya",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tissue under tongue turning white\n\nHi, the tissue on the floor of my mouth, behind my bottom teeth has changed from rounded tissue to ridgelike, with the top of the ridge turning white. I think it might be my sublingual papilla, from photos I have seen online. How concerned should I be?",
    "doctor_response": "hello, welcome to healthcare magic, rather than self examination through internet, go to a dentist and have a check up before it complicates.. take care..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe body cramps at night\n\nI suffer from severe cramps at night frequently making it impossible to move. I have beed advised Physiotherapy, Calcium intake and Neurobion Forte for improved Blood circulation. Please advise how Neurobion Forte helps. I suffer from hypertension and am prescribed Telma 40.?",
    "doctor_response": "Hi, All your medication seems to be normal. Increase your water intake. Ask your physiotherapist to do stretching and learn some self-stretching. Also, go for a walk before you go to bed to sleep. Hope I have answered your query. Let me know if I can assist you further. Regards, Sunny Anand, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Clomid is not supporting me to get pregnant for the second time. Why?\n\nHello doctor, I am suffering from irregular periods and PCOS for more than 10 years. I had to take Clomid and with HCG injection conceived my first baby three years back. Now I have been trying for my second baby with the help of Clomid. I took Clomid for six months, with no luck. This month my doctor had prescribed a combination of Clomid 50 mg (from day 5 to day 9, 10 tablets for five days) and Nolvadex 10 mg tablet (from day 2 to day 12, 20 tablets for 10 days). Going through the purpose of the tablet, I understand Nolvadex is for treating breast cancer. I am scared to take this tablet now as it also says that it may harm the fetus. Can you please enlighten me in this regard? Will it help wtih fertility? Please let me know the possibility of having a healthy baby by taking Nolvadex during TTC, will it affect the baby by any means?",
    "doctor_response": "Hello. Novaldex is Tamoxifen which is a selective estrogen receptor modulator. Yes, it is one of the most common drugs that is used for treating breast cancer patients and also certain birth defects are possible if you take this medication when you pregnant. In your case, this medication is being used because you are resistant to Clomid with failed attempts at getting pregnant with Clomid treatment. This is being given in the phase of your menstrual cycle when even the egg formation has not happened and basically to help your egg or follicles formation so that you can conceive with the medications. So there is absolutely no harm taking this medication to get conceived. Recently, few studies have shown improved ovulation rates with Tamoxifen in Clomifene resistant women. However, I would suggest you to please consult your fertility expert again before you start the course and be confident about your treatment and solve further queries regarding the same because trusting your treating doctor is important before you start any treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vaginal lump during pregnancy?\n\n34 wks pregnant and have 2 vaginal lumps 1 in the crease where my thigh and virgina meet and a smaller one just inside the lip of my virgina the outside one did pop and bleed a little but feels hard still :( is this serious is my 14 year partner a cheat ?",
    "doctor_response": "Hi.Thanks for your query. Noted your history of 34 weeks pregnancy and having 2 lumps, the bigger one at hte crease of vagina and the thigh and the smaller one at the lip of vagina. One of them pop up and bled but still feel hard.I do not think that your partner of 14 years cheated you  as these lumps appear to be infected cysts or so and not an STD.Please get checked by a Gynecologist to be ascertain about the diagnosis and have proper treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Headache, dizziness, nausea, sudden blood rush to head. History of concussion and dropping weight on head. Serious?\n\nI suffered a concussion about 3 weeks ago, dropped 95 lb weight on my head.  I have been to the ER and my primary care physician and I do have another appointment tomorrow to talk about the fact that I am still in a lot of pain (headaches), dizzy, and nauseous.  The reason I am asking you right now is that today I started having horrible blood rush to the head when I stand up or move too quickly.  I have been doing very little - mostly sitting/ laying to fully recover.  It's so bad that I have to brace on something or I will fall over and my vision goes completely black with stars.... It was so bad this morning that I actually ended up vomiting.  Is this part of the post concussion syndrome?  Is this something i should look further into?",
    "doctor_response": "Hi, Thank you for posting your query. It is common to get these symptoms, in a patient with post-concussion syndrome. For relief of symptoms, you may take betahistine tablets. If a CT scan of head has not been done so far, please get it done to exclude any internal brain injury. Please get back if you require any additional information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does pain in the lower back and right leg indicate?\n\nI am a 50 yr old female. Usually very active and healthy. Within a 2wk period pain in my low back, spine area began. It is now unbearable. Pain shoots down my right leg, knee, top of foot and ankle. I cannot find any position that gives any relief. I feel like water swelling around the spinal direct area. My lymph nodes at my same side groin are swollen and knotted.. What could this be?",
    "doctor_response": "Hello,These symptoms are more indicative of an intervertebral disc prolapse compressing a nerve. In my opinion, an evaluation with an MRI will be appropriate.Hope I have answered your query. Let me know if I can assist you further.Regard,Dr. Fahim Sheik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in ribs\n\nI ve had a pain in right side around rib area going on 3 weeks. No injury very painful to touch hurts to laugh cough when I lay on that side I can hardly get up. I ve had chest X-ray ultrasound nothing. Supposed to get ct Next week. Pain meds do not help. When I lay down I almost feel like there s a knot Or something?? I m so frustrated & need to figure out what this is. Any suggestions? I ve had gallbladder Out 2 yrs ago.",
    "doctor_response": "Hello,I have studied your case and I think that it can be due to hair line fracture in ribs which are not seen on x rays but it can be see on CT scan and even if there is no fracture present on CT symptoms are suggestive of bony injury. You need to take NSAIDS and also need to avoid weight lifting or any jerky activities. This pain will take some time in improvement.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for suffering from severe itching on back/arms/feet/under armpits/chest?\n\nHi. I have had unexplained itching for about 6 months. It is mostly on the back, upper arms, feet, under arm pits, upper chest. I have had every conceivable lab test and nothing has shown up. Just recently, I started getting hives when I have these itching episodes. They are made better by triamcinolone cream that I happened to have on hand. I cannot figure out any new food, soap, or other possible new allergin. I have some allergies to dust mites and pollens that I am aware of. These itching episodes are making me crazy! Any suggestions?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern and looking to the history given here I could say that the itching problem of yours could be due to the hypersensitivity reaction and no need to worry about this, it gives good response to antihistamine, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest a remedy for the shooting pain in legs\n\nI was on a roller coaster and there was a jult at the end and I bashed my knee on the metal pole in between my legs! There was an immediate shooting pain going right up and down my leg! I went to first aid to get an ice pack and got it bandaged up! What have I done? How do I deal with it?",
    "doctor_response": "You seem to have hurt your knee, get an Xray ray done to rule out any fracture,  if no fracture use knee cap for a period of 3 weeks with mild analgesics like Tab. Imol plus. Thrice daily for a week.  And you should be ok",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are nausea and headache in a 36-week-pregnant woman after exposure to perfume sprayed on clothes a cause for concern?\n\nI was exposed to skunk smell for about 1 hour after getting sprayed on my clothes only. I am 36+ weeks pregnant and about 4 hours later I feel sick and woke up with a headache. I took regular strength Tylenol and the headache is gone but I still feel nauseous. Should I be concerned and can the smell effect the baby?",
    "doctor_response": "Hi, The smell shouldn't really affect your baby donor worry about it. But if the nausea and headache continues you will have to visit your doctor and get your blood pressure checked. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Prakruthi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in one eye, localized headache with hyperventilation, chest pain, body spasms, long lasting blackouts. Diagnosed as hyperventilation syndrome. Can it be something else?\n\nI have been getting savere attacks the last few months. I have been in hospital for it 4 times over the last 3 weeks. Symtoms are, hyperventelation, chest pain , spasms (my whole body like a secure), black outs for up to 24 hours. I have resantly started getting saver pain in my right eye end very localised headacks. A doctor told me that it s hiperventelatiion syndrome but can it be something else?",
    "doctor_response": "hi well..this may be hyperventilation syndrome, but still some other things should be kept in mind like ischaemic heart disease followed by a transient ischaemic attack although I don't know your age, but its a common complaint in elderly..also it may be other syncopal attack due to any cause..may be attack of glaucoma...even migraine..so please visit a neurologist and an ophthalmologist before a psychiatrist..have a good health..thanks..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can the same sterile injection be used for two shots of methotrexate?\n\nPlease describe the process of using a hypodermic needle to inject liquid methotrexate. I have done it once with instruction but I need a reminder on all the steps for preparing the needle for putting in the little bottle of methotrexate. Plus I need a shot of 8mg and the medication is 1 litre? I can get two full shots from the bottle. Can I do a 4mg with one bottle and move to a second bottle for the second 4mg and still maintain the sterile injection? Or do I have to do 2 shots of 4mg with separate needles?",
    "doctor_response": "If you need just 8 mg Methotrexate shot, it is recommended that you get yourself vials of Methotrexate with lower amount (weight in mgs) e.g 15 mg. However, if you are having one with is 1 liter it would help seeing the strength in terms of mg/liter. You have to be careful that you calculate and take the exact strength. While it is always recommended that you get the shot from a trained medical personnel to avoid any mistake, you can try to take it yourself under SUPERVISION. You need to ensure sterility and hence it is NOT recommended that you use the same syringe to take medicine from two separate vials.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does high  tlc & dlv neutrophil count in blood suggest?\n\nDear Sir. i have an allergy  problem. allergy means whenever go outside from home then starting sweating, after that there is red color appear some where in my body and burning sensation is also there. then i contacted to doctor, Doctor has written Blood test. and my Test report is like this... T.l.C--10,900 4000-11000/cmm)D.L.C Neutrophil- 722 (40-75%) pl. suggest that sir , what are problem to high t.L.C & D.L.V Neutrophil",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your history and would like to know more about you like: a. Your age & sex b. Since when you are having this problem? c. How long the reaction lasts? d. Do you have any other allergies? e. Do you experience itching or is it only burning? f. Do you take any other medications regularly/frequently? g. Do you have any other medical conditions?Above details would help me to know about your problem better and therefore to make more specific suggestions for you.At present, from your provided details, I would like to make suggestions for you as follows:1. From your history, I would first think of solar urticaria (hives that occur due to exposure to sunlight). However, your detailed history would help me more.2. There is no relation with complete blood counts (TLC or DLC) with this condition.If you do not have any signs of infection like fever, I would suggest you to repeat the same test after around a month, it could be normal at that time.3. I usually suggest my such patients to use antihistamine like cetirizine and apply calamine lotion locally for symptom relief.4. Prevention is the best thing. Please make sure you are wearing comfortable clothes fully covering the exposed parts of limbs.I would also suggest you to apply sunscreen over exposed areas while going outside.5. Vitamin A supplementation could also help.However, please note that there are many causes for urticaria & hives, for diagnosis of such conditions, detailed information and investigations are required.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in the upper back?\n\nI have a burning, stabbing pain in the back, upper part of my head. Feels like it is just below the surface It happened before, about 6 months ago and lasted about 2 weeks or so. It is spiratic and lasts a couple of minutes at a time, then stops. About an hour or so later, it does it again.",
    "doctor_response": "thanks for your question,As the pain lasts only for couple of minutes ad related to activity it is mostly muscule spasm pain .I advice you to receive meloxicam 15 mg tab once daily when needed",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for asthma and allergy\n\nhii i need some help..!! frm past many years i use get sneezing attacks,,runny nose,ichy nose and some times shortness of breath with weezing,,.so around 2 or 3 months ago i told my symptoms to an e.n.t expert he told me m suffering frm allergies (dust allergies) and allergic asthma...and he prescribed me 1 tablet of montair lc daily..i start taking it daily...it controlled my symptoms..nw the problem is m not able to stop taking montair lc,,if i miss a single dose my symptoms come back within 24 hours even worst thn before... nw i dnt knw wat to do,,will i have to take this tablet daily in my whole lyf??if yes thn is it safe to take daily??wat will be the side effects in future if i take montair lc dailly",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your history and would like to make suggestions for you as follows:1. From your given details, I would agree that you could have allergies.2. I would suggest you allergy testing for common air-borne allergens such as house dust mites, molds, regional pollens, insect proteins & animal dander (if you have a pet). This will help you identify the substances causing allergies to you as well as to know the measures to avoid them.3. Based on allergy testing, an Allergist-Immunologist may also prescribe you allergen specific immunotherapy which improves immune system to gradually improve allergy symptoms over a long period.4. In general, please avoid exposure to dusts, smokes and air pollution as much as possible.5. For control of symptoms, I would agree with your doctor and will suggest you regular montelukast + levocetirizine (Montair-LC).6. Common side effects of montelukast are stomach upset, nausea, headache, etc and those of levocetirizine are sedation, drowsiness, etc. If you are not experiencing any of these side effects, it is usually safe to take for long duration.7. Regular steam inhalation will also help you in a long run.8. Regular physical exercises including breathing exercises (Yoga-Pranayama) as well as nutritious diet rich in vitamins & minerals will also help you in a long run by improving your lung capacity and immunity respectively.9. If stress is a significant factor in your life, I would also suggest you regular relaxation & meditation as stress can worsen allergies & asthma.10. I would like to mention here that allergies-asthma are dynamic and unpredictable diseases, so please do not assume that you have to take drugs for life time at present. Instead, with proper understanding of the disease, please try to improve your immunity, health and lung capacity so that gradually your drug requirements would decrease.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the feeling of standing outside my own body a side effect of trazodone?\n\nHello. I am 17 years old. I was put on an antidepressant at the age of 15. I have a weird side effect. I feel as if I am standing outside my own body. It feels like I am watching someone else live my life, yet I can react. I have told my doctor this many times, and have asked to be removed and/or change the medication. I take Trazodone 150 mg every night. It was originally prescribed to me for my anxiety and insomnia. Are these feelings normal?",
    "doctor_response": "Hi, Welcome to health care magic forum.                As you describe it appears that you have another psychological problem , may be schizophrenia, still dont worry.                I advise you to consult a psychologist for diagnosis and treatment.                Take, a balanced and nourishing food.Take more of green leafy vegetables, pulses, sprouts, and protein rich foods.               Practice yoga, meditation, and hearing music as a diversion procedure. These may not be necesory for your health, but keep you tension free.                 Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible through non-penetrative sexual activity?\n\nHi doctor, I was wondering if you can get pregnant if both were dry humping but he didn t have underwear on but I had it on however it s thin. My previous period started started on the 15th of sept. I m usually irregular. And if I want to do a pregnancy test, when can I take them? Thank you",
    "doctor_response": "Hi there, I have understood your concern and I will suggest you the best possible treatment options.First of all do not panic.As you might be aware that, for pregnancy to occur, spillage of semen in and around the vagina must be there. As per your history, there was no spillage of semen, hence chances of pregnancy are almost nil.If you are having doubt about pregnancy then I will suggest you to get pregnancy test gone at least 20 days after your last sexual activity. You can confirm the pregnancy by checking for beta HCG hormone levels in the morning's first sample of urine or in the blood test.  Still you have any doubt  then USG will be of help.Secondly, as you might be knowing that in a woman with regular cycle, day 10 to 20 of the cycle is the most fertile period of the cycle. If you happen to have unprotected sex activity in this period, then only there is chance to get pregnant.I will suggest you to get proper sex counseling done, about safe and protected sex activity,  this will help to prevent unwanted pregnancy and STDs.I hope this answer helps you.Thanks.Dr. Purushottam Neurgaonkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain and swelling in the shoulder be treated while having difficulty in moving the arm?\n\nMy father fell on his shoulder & is in a lot of pain. He can t move it at all & has difficulty getting up, moving & using one arm. Could it be broken, sprained or rotator cuff? There i=s a bruise on the arm. It may be a little swollen, but doesn t look like it. Arielle",
    "doctor_response": "Hello there I have read through your question and would like to tell you that pain and swelling along with inability to move the shoulder joint all point towards a diagnosis of fracture. I would advise you to get his XRay shoulder joint done as soon as possible as delay may lead to complications. Meanwhile it would be better that he doesn't try to move the shoulder too much and keep it restricted with the help of a strap. I hope that answers your question. If you have any further questions please feel free to write. Thank you for choosing healthcare magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat open wounds?\n\nHi I ve got surgery 21 may 2014, four days later I got a open wound, my doctor prescribed me silver sulfa, it s getting worst, aand I stopped ... And now the other breast is opening week later have green/ yellow secretions infection , I m taking antibiotics every 4 hour, I covered with gauze also I ve change every day,please I m so scare, my doctor always said that s ok we ll need two months to heal What can I do or eat or what to treat it?",
    "doctor_response": "Hello,Thank you for writing to HCM,Because most open wounds are minor, they can be treated at home by doing the following:1.    Wash and disinfect the wound to removing all dirt and debris.2.    Use direct pressure and elevation to control bleeding and swelling.3.    Bandage the wound with a sterile dressing or bandage (very minor wounds may heal fine without a bandage).4.    Keep the wound clean and dry for five days.5.    Rest.6.    Take acetaminophen for pain if needed.7.    Apply ice if there is bruising or swelling.8.    Do not pick at scabs.9.    Use SPF 30 sunscreen over the area until completely healed.See your doctor if:1.    the open wound is deeper than a half inch2.    the bleeding does not stop with direct pressure and/or lasts for longer than 20 minutes3.    the bleeding is the result of a serious accidenthope you will find it out helpful.Thanks and Regards,Dr. Gaurav Prajapati",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for vaginal bleeding during pregnancy\n\nMy age is 37 and i got conceived. Now iam in 8th week. Doctor suggested naturogest sr200 once in the night and i started bleeding for 1/2 day. scan says baby is ok. doc suggested to take naturogest twice. and it started bleeding whole day. Now its 1 week over but the bleeding didnt stop. Iam afraid if the baby is growing if all the blood is being discharged all through the day.Is it safe to use naturogest? How the bleeding can be controlled? Iam much worried. Please reply asap.",
    "doctor_response": "Hi there,I will suggest you the best possible treatment options.Please do not panic.I will suggest you to take rest.Be assured that Micronized natural progesterone tablet is actually a pregnancy support hormone tablet. It will not cause bleeding. It might be the bleeding that incidentally  started at the same time you started the tablets. Please seek prescription support from your treating doctor for beta HCG injection 5000 iu twice a week till 9 weeks of pregnancy. Tablet Pause and vitamin C twice a day for 5 to 7 days.I will also suggest you to get USG done to know about the viability and gestational age of the pregnancy and to look for internal bleeding if any.I hope this answer helps you.Take careGod bless youThanks.Dr. Purushottam Neurgaonkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "On tamoxifen for estrogen receptor breast cancer treatment. Concerned about the side effects. Any herbal medication? Is progesterone cream safe?\n\nI m on Tamoxifen for estrogen receptor breast cancer treatment . However, due to risks of side affects I prefer to take something herbal. What can I take that will not cause me to produce more estrogen. I need something anti-estrogen. I would like to get off the tamoxifen. I ve been on it for 3 mths. I was using a progesterone PMS cream, but when I got a yeast infection, I stopped using the progesterone cream . Is it safe to use the cream w/my BC diagnosis?",
    "doctor_response": "Dear Ma'am, Sorry to hear about your condition. Tamoxifen does have a few side effects but the benefits far outweigh the risks associated with the drug. It cuts down the risk of cancer occurring again by almost 50%. The only precautions you have to take with tamoxifen is to get a regular PAP smears and bone density checks done. Herbal medications can be useful sometimes but in this case numerous studies have proven tamoxifen to be beneficial. There is no harm in using progesterone creams with your breast cancer diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes disorientation and dizziness while stretching?\n\nOccasionally, when I stretch I feel slightly disoriented and kind of dizzy. I have been recently wondering if this is normal since I ve asked my friends if they have felt the same way but- to my surprise, they didn t. Is it the casual act of a 13- year old to feel disoriented while stretching?",
    "doctor_response": "DearWelcome to HCMWe understand your concernsI went through your details. Feeling of disorientation while stretching is not common if the stretching is frequently done as part of an exercise regime. If it is not, if the stretching is done just as stretching of body, the possibilities of disorientation are there, mainly because of the involvement of vestibular balance keepers. You felt disoriented and kind of dizzy while stretching. You should be able to tell how many times? You should also be able to tell, were you stressed, slept, anxious? Anxiety and obsession is another reason for experiencing the same feeling again and again. I suggest you to ignore the disorientation if it is not frequent and there is no other physical symptoms. Ignorance will help you if the problem is due to anxiety and obsession. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Took cefixime 400mg for typhoid fever 3 months ago and have headache, stomach upset during pregnancy\n\nhi i had typhoid fever 3 months ago i used cefixime 400mg for 14 days at that time i was 3 months pregnant i m now 6 months pregnant i have no appetite having headache upset stomach n weakness but no fever or low fever 99 F should i go for fever test hi,i am 26 years old i had typhoid fever 3 months ago i used cefixime 400mg for 14 days . at that time i was 3 months pregnant . i m now 6 months pregnant i have no appetite , having headache , upset stomach n weakness but no fever or low fever 99 F . is it be considered as typhoid fever ?",
    "doctor_response": "Dear kacho welcome to healthcaremagic I suggest you to carry out some relative test for comfirmation about this. For your and protection of heath of your child please consult your nearest doctor for further investtigation Please relax and rest enough Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Face turned dark after applying cold wax. Solution?\n\nHello, I have applied cold wax strips to my face. It has led my upper part of my face, my entire chin to become very very black and dark. Maybe because of the glue present in it. And since I am a fair girl, It is easily noticeable to people that i am fair and my chin is black. it is very ugly now due to the use of cold wax. I am desperate to get a fair chin and light skin coulour like before. Please help me.",
    "doctor_response": "Hi, You might have developed an irritant reaction to your wax strips that healed with pigmentation. To treat the same, use a Kojic acid, Glycolic acid  or hydroquinone based cream for couple of weeks. Also avoid sun exposure and use a good sunscreen. You may also consider taking sessions of chemical peels for the same as it helps in effectively reducing the post inflammatory hyperpigmentation. Hope that answers your query. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for diarrhea with mucous in babies\n\nHi, in the last 7 days my 14 month old has had diarrhoea, very pale beige poo, green poo and now normal poo but with lots of mucus in it. She has also been very windy. I have recent family history of Coeliac disease, Chrons disease and bowel cancer. I am getting very concerned.",
    "doctor_response": "Hi, green stools, pale stools with mucous sometimes can be normal or can occur in acute gastroenteritis, stomach infection or worm infestation. I suggest you to do stool routine microscopy test. You can give enterogermina ampule once a day for 3 days. Depending on the report antibiotic needs to be started. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for hair loss?\n\nHi,My age is 29. I have been loosing hair for last four years and becoming bald from the vertex of my head. Doctor advised me to use Tugain 10% solution and finax( finesteride) tablets. Though I have been taking these medications for last one month, my hair loss problem is getting accelerated. Can I hope to get benefits out of it. I am getting frustrated. please advise.",
    "doctor_response": "Hi,You seem to suffer from androgenetic alopecia. You consult the dermatologist for perfect diagnosis and treatment.I would suggest..- finesteride 1 mg daily- biotin 10 mg daily- minoxidil 10% like tugaine application daily twice a day- avoid anxiety- nutritious diet Take long term treatment...I hope this would help you.Thanks..Dr.Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having noticed swelling & numbness in hands\n\nHi ok for about 6 months now my hands occasionally swell and tend to be kinda numb. and i have gotten kidney infections quite often over the last five years. what is it and is it serious enough that i should go see a doctor, and im not sure its related but i have also had reaccuring miscarriages the last three pregnancys.",
    "doctor_response": "Hai,If there is a long standing kidney disease swelling in the hand and ankle joint is obvious at the end of the day.but urinary tract infection will not show any swelling in hands.frequent infection and miscarriage leads to rule out  diabetic cause.kindly investigate your blood sugar level,renal function test and urine culture  to fix your problem.Hope i answer3ed your queryRegardsDr.S.Senthilnathan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does continuous high bilirubin level indicate?\n\nHi doctor, I am suffering from jaundice for the last two months. One month before, my bilirubin level was 1.4. Before 15 days, the level was 1.2 and today 1.8. What is the reason for this change?",
    "doctor_response": "Hello. Revert back with the details to a medical gastroenterologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump on the buttocks indicate?\n\nMy 18 year old son has gotten this large lump looking thing at the top of his butt crack that goes down it about an inch of so and looks like scar tissue after a burn how it raises up on the skin. It hurts him to walk and bend over and can't lay on his back. It hurts to the touch. It just came up on Monday .",
    "doctor_response": "Hello,As per our clinical experience, the severely painful lump on buttocks with difficulty in walking suggest acute infection in the boil or other lesions. Needs immediate consultation with his doctor for further management guidelines.Hope I have answered your query. Let me know if I can assist you further.Regards,     Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for severe knee pain post a total knee replacement surgery\n\nI just had a total knee replacement surgery. My surgeon warned me that it was likely that day 4 or 5 would cause worsening symtoms and then I would slowing improve. I believe that I had been doing wonderfully, already having discarded the walker for a cane, etc. Today is day 5 and my pain has gone through the roof. Could you please compare the pain relief given between two medications? I realize one has the ibiprophen. They are Norco 7.5 and Oxycodone 5. Thank you, Carol",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Both the analgesic give a very good pain relief although Norco would be better for you in a postoperative pain management.Hope I have answered your query. Let me know if I can assist you further.Regards, \u00a0\u00a0\u00a0\u00a0\u00a0Dr. Fahim Sheik",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain on the ribs with dizziness after laughing?\n\nToday I heard a good joke and had a deep laugh the bottoms on both sides of my ribs had a very sharp pain a minute or so later I got very dizzy and could not breath well 1 had a total of 3 dizzy spells about 15 min apart were I thought it might be the end. The pain is still there but tolerable I have not been able to lay on my stomach for about a week or so with out hurting I thought I was just sore from splitting wood but after today I think its a lung problem. I am going to make an appointment tomorrow but I was just curious so I got on the Internet What do u think ? 36 year old, smoker, in great shape, normal temperature, the last 3 years I get a bad rash from the sun on exposed skin",
    "doctor_response": "hi,thank you for providing the brief history of you.A thorough examination of lungs and musculoskeletal assessment is advised.As mentioned by you about the symptoms, there are two possibilities as per me. 1. it could be costochondritis2. Intercoastal muscle spasm.Now for this a thorough assessment will help guide us to look for the proper diagnostic procedure like an x-ray or a CT scan. In CT even the lungs will be exposed and any pathology of it will be shown.Based on this, with simple medication and physical therapy you should perform well. Also, the physical therapy will teach you the best possible way of breathing exercises which will help improve the lung capacities.In my clinical practice I see cases with similar issues and they respond well to physical therapy in combination to drug therapy.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itching and swelling in the body, had some back bacons and fish cutlet. Took Avil. Alternate medicine ?\n\nHello, i had some back bacons and fish cutlet yesterday. It happens that i am having itching and the itchy region seems to be swollen. I had taken an avil tablet assuming that it is some sort of allergy to the food i had taken. Is there any other medicine for this purpose? Can you suggest a medicine for my problem. I am from india, Aged 24. Thank you",
    "doctor_response": "Hello and welcome. Thank you for your query. The food you have mentioned could very well be the allergen (cause of the allergic reaction). Sea food is a very common allergen, so is oil, which you would have fried your cutlets in. I would request you to notice anything different that you have consumed, may be a new brand of oil, or different source of meat, and if this food was consumed from an eatery outside, I would advice you to avoid the particular joint in the future. The description of your rash, does match that of an allergic rash, but there are many more rashes that do still match your current presentation as well. I would advice you to visit any physician, and show him the rash, as a rash has to almost always be inspected by a physician or dermatologist before prescribing treatment. I am from India too, and as we have the privilege of having many clinics, in almost every nook and corner of our Indian streets, consulting any one of these doctors should help you, as they can help give you immediate relief from your problem. If it is an allergic reaction, a shot of an anti-histamine (anti-allergic) medicine, should give you relief in 15 minutes maximum. I hope this has helped you to find the right treatment option. Wishing you a speedy recovery and good health from there on.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do diabetics develop diabetic neuropathy?\n\nHi doctor, Can you tell me, do all the diabetics develop diabetic neuropathy? My relative is 25 and just got diagnosed with type 2 diabetics. Will she definitely develop neuropathy. Can you also tell me the estimates of the number of diabetics developing it? She is diabetic but is not a BP patient.",
    "doctor_response": "Hello. Almost all the people having diabetes will sometime during the course of the disease will develop diabetic neuropathy. The reason is damage to microvasculature (small blood vessels supplying the nerves) get affected. Even with fairly well controlled diabetes this does happen. In case if the control is poor then severity increases rapidly. Hence it is very essential to achieve a strict glucose control all through out the course of the disease.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does pain on the left side of the buttocks indicate?\n\nI am a left side sleeper in bed. I have done this all my life. I m 62yrs old 330 lbs. I recently been not able to sleep on my side due to extreme pain in my lower butt area. Even when I pull my self out of bed I feel my backside hurt. Not my back but in the buttocks area. As I sit I feel a pain on left side. What can this be??",
    "doctor_response": "Hi, It may be due to conditions like sciatica or other related neurological pain. You can take analgesics like Tramadol or Diclofenac for pain relief. If symptoms persist you can consult with a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussai",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for irregular breathing\n\nHi my name is ben I smoked weed for 5 years and recently give it up as when I smoke I get panicky but worst of all when I am falling asleep my breathing pauses and stops for like 5-10 secs in between inhale /exhale .. And because I am aware of this it s like I had to manually tell my brain to breath then I get scared and won t sleep all night thinking I will die in sleep can u help",
    "doctor_response": "It seems u might have sleep apnea. Do u have excessive day time sleepiness and snoring. You should undergo a sleep study test it will be helpful",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hip injury. Should I get MRI?\n\nI waitress In a poker room and stepped on a poker chip rack and I slammed onto the floor hitting my right hip and gave myself whiplash. I got up and finished my shift but when I got home I felt like I had been in a car accident... It's been 4 months and I have put off going to a doctor because the casino has to give me a drug test and I won't be able to return to work until results are back. I dont do drugs but depend on tips to pay bills. Can I ask my regular family doc to give me a referral for an MRI ??? I just had thermography done and am waiting on those results",
    "doctor_response": "Hello and welcome to HCM,The history given by you suggests that you have sustained an injury around the hip joint and probably the back.It is important to visit an orthopedician for clinical examination and relevant investigations.Whether MRI is required or not will be decided by the orthopedician after examination.So, instead or getting a referral for a MRI, get a referral to an orthopedician.The injury should not be ignored as it can lead to long term sequelae.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on eyelid\n\nHi I have a big lump on my eyelid, right below the eyebrow. It is red, has no opening and it feels like a hard ball under the skin. It is more on the outer side of the eyelid and has gotten very noticable. It all started one or two months ago when I walked into a wall( hahah..). I got a little wound on the upper eyelid and I started plucking it, couldnt leave it alone:/. Then I noticed a little \"ball like pimple\" under my skin. It was not red or anything. I have put some hot compress on it but it wont really help. It has grown and now it is really red and looks swollen. I am going to see the doctor soon but I have a big event coming up and I cant wait for my appointment!! What can I do?",
    "doctor_response": "Hi.Looking to the history it seems that following injury on the part there might be having some hematoma and now there might be developing some infection producing lump.Apply ice pack 2-3 times a day for few days.If pain or swelling increases, collected blood or exudate should be drained to get relief.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long will fever with shivering take to subside?\n\nHi, My wife and kid has joined me in germany last month. My kid is 10 months/ 9.2 kg boy. He is now suffering with high temperature be 101- 104 F and shivering from yesterday morning.he s normal with no cold, diarrhea. He drinks mother milk n takes little solid.currently giving him lukewarm sponge bath for his head. Kindly advise further. How long will the fever take to subside",
    "doctor_response": "Hi....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.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red lumps with itching and black spots?\n\nMy son just started coming up with red bumps and in the middle they have like a black dot ,not itching or bother him and just right now I saw he has a red bigger bump with white in it? What could it be I checked for bed bugs and we have no spiders or anything else that could of possibly bit him.",
    "doctor_response": "Hi....By what you quote it seems like an insect bite allergy to me. But it could a;lso be urticaria or simple skin allergy. You can use Hydroxyzine at 1-2mg/kg/dose every 6th to 8th hourly for 7-10 days. Most important thing to be remembered is that it has a propensity to recur (called as second crop) within 10-14 days.But , Skin and conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Hypothyroid patient. Suggest any pre-workout supplement other than Nitrous Oxide.\n\nDear Doctor, I have hypothyroidism. My TSH level is higher than the normal range. T3 and T4 are fine. I go to the gym regularly and like to lift heavy weights. I am taking pre-workout supplement - Nitrous Oxide. I heard that this is not good for me but I want to take some pre-workout supplement. What should I do? Should I take some other type of supplement for strength, energy, focus, endurance?",
    "doctor_response": "Hi. That is a very good question. Revert back to a nutritionist online for further queries -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mumps in children\n\nhi my son is 6+ ,suddenly two days before when he got up his cheeks below the ear swallowed and fever around 101degrees and geting pain in cheeks i have shown a child specialist who told its a viral diseases called moms which will be 3/4 days and it will be cured and just gave medicine paracetamol and vitamin B complex syrup ,pl guide me",
    "doctor_response": "continue on paracetamol or acetaminophen or ibuprofen syrup every 8 hours to relieve the fever and pain you can apply ice packs on the swollen glandsmake sure your son drinks a plenty of fluids to avoid dehydration stick to soft and easy swallowed food as soup, yogurtavoid acidic or hard food no need for antibiotics as mumps is caused by a virus be careful as mumps is contagious for about 1 week following the diagnosis",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the chest and neck with dizziness?\n\nFor 2 months Ive had a headache daily. In 1997 I had ablation surgery for SVT. For many years I ve been symptom free. Over the last year I ve had more episodes of Svt. The past couple months more often then not . Im finding that I m having up to 15 episodes a day, they are acompanied by Chest and neck pain, sometimes arm pain and dizziness. I also notice my hands sweat alot and my feet and hands get blue in color. I guess what I m asking is... does this sound typical of Svt or could there be more going on ? I know the symptoms are similar to anxiety. I ve taken medication for anxiety and it does nothing for these symptoms. This also dosn t feel like any kind of anxiety I ve had in the past. Most times i have an episode I m relaxed and sitting. Any Ideas would be great. Thank you",
    "doctor_response": "Hello, Your symptoms could be related to a metabolic disorder (including thyroid gland dysfunction). For this reason, I recommend checking your thyroid hormone levels. It is also necessary performing an ambulatory 24-48 hours ECG monitoring in order to investigate for possible cardiac arrhythmia, including SVT. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Ilir Sharka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the test and medication available for wheezing in a 5-year-old?\n\nHello doctor,My 5-year-old daughter often gets cold, cough, and end up with a fever and slight wheezing. No history of wheezing in the family. What test and medication have to be done for wheezing?",
    "doctor_response": "Hello. Your child may be tending to develop asthma and allergy. When investigating the child with wheezing, it is better to get her clinically examined by the pediatrician or a pediatric pulmonologist. The tests required include a chest x-ray and complete blood count in most cases. Medication is to be given after confirming the condition and might include bronchodilators, inhaled steroids, anti-allergic preparations, and nebulization when needed. Please keep the child away from dust pollution and allergic plants. Allergy and asthma. Chest x-ray, complete blood count. Eosinophilia. Asthma. Bronchodilators, inhaled steroids, anti-allergic preparations, and nebulization Protect from dust and pollution.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the reasons for slight pain on top of penis during urination?\n\nHi I have a slight pain on top of my penis gets worse when I have to the toilet no burning when I go then get  some relief,am going to the toilet more than usual no pain when going,no visual sores urine clear in colour drinking plenty water to keep hydrated",
    "doctor_response": "Hello,,The pain may be due to minor breach in the lining epithelium of the urinary system.The pain on top of penis during urination is may be due to1.Injury2.Dehydration3.Intake of some medicine4.Renal calculi5.infection.These are some of the conditions which may lead to your problem. You should be completely evaluated to find the cause for your symptoms and appropriately treated.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of a groin muscle pull?\n\nI m wondering if I have pulled a groin muscle. I have pain along each side of my abdoman from my testicles up and to my hip joints. this started in December and has eased off but is still there. This started as a result of bending and twisting while putting wood into an outdoor furnace.",
    "doctor_response": "Hi Hope this message finds you in good health.I have gone through your complaints and understand your concern.I generally see many cases like this at my clinic.pulled groin muscle causes pain once you try to lift the leg or move it in either directions. also causes pain while walking,runningYou should eventually get back to normal in coming few days.Nothing to worry about, as long as i am there to help you.\u00a0\u00a0\u00a0\u00a0\u00a0I hope your question has been answered.If you have any follow-up queries,feel free to consult me anytime. Take care,God bless.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can hemorrhagic cyst be caused due to an accident?\n\nHi I had a car accident in January 2013. I took an MRI in march due to back, hip, and neck pain. A hemorrhagic cyst was found in my left ovary. I have never had this diagnosis befor and I'm 43. By Oct it had grown to the size of a peach. It burst and was not cancerous. I,m curious if this could have been caused by the car accident as all of my injuries are down the left side of my body.Is that possible?",
    "doctor_response": "HI, thanks for using healthcare magicThere are different potential causes for ovarian cysts but trauma is not a known cause.The risk factors that increase of developing ovarian cysts are: smoking, hypothyroidism, tamoxifen, tubal ligation, infertility treatments,pregnancy.In some persons no specific cause can be isolated.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore throat with bleeding in nose of a 3 month old?\n\nI m 3.5 months pregnant and I got a sore throat over the weekend which resulted in my very first nose bleed. It happened again last night with the nose bleed this morning. It s not pouring out of my nose, but running down my throat. Any suggestions?",
    "doctor_response": "Hi...it could be viral pharyngitis. I suggest you use warm saline gargles. No need to use antibiotics as you are pregnant now.Regards - Dr. A. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stuffy nose and wheezing in a child?\n\nHi, My 3 year old has a dry stuffy nose with dried blood in it every day now. I have been noticing this for more than 2 weeks. At first, everybody said it could be just allergies. But this morning, the mucus was a bit slimy (i don t know how else to put it). he doesn t complain of any pains but he does have trouble breathing because of the stuffiness. And breathes with a hard sound even when he is awake. what could this mean?",
    "doctor_response": "the most common cause of this condition is allergic rhinosinusitis , this mucous will turn into green in few days , and the post nasal drip will some times make him cough , the blood is because of the irritation of the mucous membranes .he is breathing difficulty because of the obstruction made by mucous plugs .since he has no fever, and no persistant dry cough there is no worries but something is needed to be excluded first , many children stuff their noses with any object the can find, so the possibility of foreign body stuck in the nose is there. so I recommend visiting you doctor to examin his nostrils . you can use nasal steroid sprays , it's very effective, you can use flixinase nasal spray twice a day, and zyrtic syrup will improve his condition .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes jaw tremors?\n\nOur 15 year old daughter had a sore throat, which started on September 12. It turned into a cold, however, a week ago Sunday (today) she woke up to her jaw involuntarily moving up and down, like a tremor. It went away late that morning but then in the middle of the night, Monday, she woke up with the tremors again (she woke up to get water and noticed the tremor was back). It has been constant since that time. We were first told TMJ. All of the blood tests that have been run by a family doctor and neurologist have been normal except her Vitamin D was low (20). She s periodically nauseas throughout the day, doesn t eat much and takes small cat naps, which she hasn t done for years, even when she s been up late with friends. The tremor of her jaw is constant unless she clamps her teeth together and it is less if she opens her mouth really wide.",
    "doctor_response": "Hello!Welcome on Healthcaremagic!I read carefully your question and understand your concern. Vitamin D deficiency may trigger this clinical situation. Anyway, I recommend performing a brain MRI and an EEG to exclude possible seizures (although her tremor continues through the day). Blood electrolytes (including copper, magnesium and manganese). As all started after a sore throat, I would also advice performing antistreptolysin O antibodies, to exclude possible Chorea Minor.  If all these tests result normal, I would recommend consulting with a psychologist or a psychiatrist. Hope you will find this answer helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can under weight cause pain in knees?\n\nI m 20 years old and I weigh 107.8 pounds I m skinny lately my legs I have been feeling weak like they will collapse under my weight and my knees have buckled. I ve tried laying down and walking around but neither of those options have worked. is there something I can do? is it serious?",
    "doctor_response": "Dear Sir/MadamI have gone through your query and read your symptoms.In my opinion, normal or low weight can not cause knee problem due to weight, and that is usually osteoarthritis, your age is 20 and this possibility is highly unlikely, if your knee have hyper mobility of deformity, than even normal transmission of weight can cause it to fatigue and painful. you will need,1 X rays to see the alignment and status of your knee joints.2 Blood investigations to see any cause of generalized weakness.3 if both are within normal limit, physiotherapy to strengthen the weak muscles, and guided use can help you a lot.I hope that answers your query. If you want any more clarification, contact me back.ThanksDr Narender Saini",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is nausea, diarrhea and vomiting related to stomach flu or pregnancy?\n\nCould I possibly be pregnant? I have a regular period, every 30 days for 7 days straight. My husband and I are trying to conceive. Sunday I started my period (2 days before schedule). Then Monday night I had severe diarrhea (going every hour to hour and a half from 7PM to 5AM) with nausea and vomiting twice. My period stopped Monday night once the nausea, vomiting and diarrhea began and just a little bit of spotting the next day or two. I had no fever, no abdomenal pain or cramps. Is it just the stomach flu going around and my could it possibly mean I'm pregnant?",
    "doctor_response": "I think you had stomach infection not pregnancy.  But still wait for few days and confirm it by upt test.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having severe breast pain radiating from left shoulder. Is it a cancer?\n\nHello doctor, I am a 25-year-old single female. I am in a painful situation. For the past two years, I have left side back pain starting from shoulder to bottom, and it is very painful like vein tightening. That pain continues and reaches my breast. My breast size is very small. I am afraid of breast cancer. I can not sit or stand anywhere. What can I do? How can I increase my breast size? I am very sad as my pain is increasing day by day and I am tensed. I am thinking about suicide. My marriage is fixed, but my mind is full of tension and thought that I could not live anymore. Please help. I am using pain relief ointments, Evion 400, Imol plus tablets.",
    "doctor_response": "Hello. If you have that much pain, then you should consult any surgeon nearby. Get mammography done for both breasts along with sonography of both the breasts. You can take painkillers. But let the surgeon examine first and decide is there any chance of malignancy or not. From the reports, there will be some guide towards whether there is cancer or not. And if nothing is there and it turns out to be normal, then you have to consult with an orthopedic and a neurophysician for their opinion about your pain. Do not think negative. Everything will be fine. Just be positive. First of all, you have to diagnose what it is and why the pain is there. Once the diagnosis is made, the doctor will tell you what to do and what to expect. Once this part is over, and pain is decreased or the problem is solved, then you can think of increasing the size of the breast. The plastic surgeon will help you with that. So do not worry. But do mammography and sonography of both the breasts. Take the pain killer and consult a surgeon nearby. He may advise you other blood tests and may CT (computed tomography) or PET (positron emission tomography) scan.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for hallucination with history of having mental problems\n\ni suffer from mental health problems for which i take 5 different medications ive been addmitted to mental health units about 10 times ive managed to stay out of them for 2 years now but im really worried i keep hearing voices i know its wrong but i have conversations with them  im worried im becoming unwell again",
    "doctor_response": "HiThanks for using healthcare magicAuditory hallucination is part of psychosis and if i am not wrong, you may have schizophrenia. In that case, you need to increase dose of your antipsychotic. You did not mention about the drugs, so i can not help in this area. Better to consult your psychiatrist for treatment and in case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment for phimosis?\n\nHello, I am and 85 year old male with what I have self diagnosed via Web MD as Phimosis.. Closure is still taking place and I probably need to have help with this concern. I reside in the city of Sterling Heights and most Doctors listed are Pediatrician;s. I feel that I am beyond that stage.",
    "doctor_response": "Betamethasone cream 1%.  Apply three times a day.  Will take about 6 weeks to work.  Another alternative is a cirucumcision operation. Please rate 5 Stars! I strive to provide the best answer to your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest congestion and throat irritation due to allergy\n\nNeed consultation on bronchial illness or allergen that I am trying to get the bottom of and the sickness may have been complicated due to extreme weather changes, extreme exercise, and travel.Symptoms - Irritation of throat and maybe chest.  Then congestion with headache.  Stress makes the chest congestion soreness worse.",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your history and would like to make suggestions for you as follows:1. I usually suggest my such patients spirometry with post-bronchodilator reversibility testing which helps to measure lung capacity as well as to know the type of lung/airway disorder you may have.2. For diagnosis of allergies, I would suggest you allergy testing for common air-borne allergens such as house dust mites, molds, pollens, insect proteins, animal dander (if you have pet). This will help you identify the substances causing allergies as well as to know the measures to reduce their exposure.3. Based on allergy testing, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which works on immune system to gradually improve allergy symptoms over a long duration.4. For symptom control, I usually prescribe my such patients salbutamol or levosalbutamol inhaler to be used on as-and-when-needed basis. However, spirometry will help to decide appropriate type of inhaler better.5. If you have nose symptoms also, I would add montelukast + levocetirizine to above treatment.6. In general, please avoid exposure to dusts, smokes, air pollution and cold air as much as possible.7. Regular physical exercise including breathing exercises and a healthy diet rich in vitamins & minerals will also help you in a long run by improving your lung capacity as well as immunity respectively.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest diet plans for patients with fatty liver\n\nHi I was told recently that I have a fatty liver and that my diet was the cause. I was wondering what I should stop eating and what I need to eat to stop this. Also what other than the test I was given does this fatty liver make me feel like or do I need to worry?",
    "doctor_response": "Hello,Welcome to HCM.It is now very easy and will helpful in prevention and treatment of fatty liver.Do regular exercise and yoga with meditation.Make exercise schedule fix.Minimum 1 hour brisk walking is necessary.Take fresh fruits and green veg more.Drink plenty of liquid daily.Also take protein rich diet, beans etc.Strictly avoid spicy and oily diet.Avoid fast foods including bread, jam, pow etc.Also take help from nutritional specialist.Hope these all will helpful to you.Thanks for contacting us.Take care...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burping after a rib injury?\n\nMy husband had a fall with a scaffold falling on top of him breaking 3 ribs, Ribs broken are the more middle ones on his left side. He seems to be doing ok except for burping very often. He has been prescribed pain meds and the use of an albertual inhaler. What could be causing the burping? He is very healthy and normal weight with a fresh checkup before the accident.",
    "doctor_response": "Hello,I read carefully your query and understand your concern. Burping dont seem to be related to the rib fracture.I suggest to take an antacid to neutralize stomach acid and prevent heartburn, which can cause\u00a0burping. Bismuth subsalicylate is particularly useful if your\u00a0burps\u00a0smell like sulfur. Take an anti-gas\u00a0medication\u00a0like simethicone (Gas-X).I also suggest to avoid food that can trigger the symptoms .Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this MRI report for ear pain indicate?\n\nI have had two separate MRIs. One was for the temporal bones while the other was of the cervical spine. Both scans indicate left mastoid air cell disease. My initial problems started with ear infection for which ENT indicated ears are fine. I continue to have both ringing and pain in the ears for the last three months. What do you make of the reference to left mastoid and how would you proceed? Thanks",
    "doctor_response": "Hi, The scans are suggestive of ear infection, which most probably has spread to mastoid region (located behind the ears). Initial treatment would be with antibiotics. If it does not improve, a surgery, a mastoidectomy may be needed. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I getting pain in lower back and lower abdomen?\n\nhi l have lower stomach pains like period and wind pain sametimes l have gass, l also have slight burning pain when going to the toliet but l got same pills for that when my lower back and hips started acking it helped and the pain went away but after 2 days the pain is back in the back and more so to the left side a litte. l rubbed my stomach on the left side and it tackes same pain out of my hips. Also l feel l'm haveing a little trouble with no. 2.",
    "doctor_response": "Hello,It seems to be a case of a urinary tract infection (UTI). Please visit your doctor for a urine test and an ultrasound to rule out any stone in the kidney. Have plenty of fluids.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. BR Hudda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having light bleeding, bloating, cramps, vivid dreams, dizziness after blastocyst transfer during IVF. Chances of pregnancy?\n\nDoing IVF had a 6 day blastocyst transfer on a Wednesday, following Monday had brown spotting, followed by light pinkish blood all day on the Tuesday. Woke Wednesday morning to what seemed to resemble heavy bleed , after wiping away the excess back to very light bleed. Could I still have a chance of being pregnant??? On cyclogest 400mg 1 at night & 1 in the morning, had loads of symptoms, bloating , cramping, vivid dreams, wooziness/ dizziness but all these could be associated with the cyclogest and I m on tablets for high blood pressure which could have resulted in the wooziness/dizziness. Blood pressure was closely monitored during IVF",
    "doctor_response": "Hello I appreciate your query. It is commont o have some amount of spotting / bleeding after embryo / blastocyst transfer. You must be taking medications for the IVF luteal phase support, hence the other symptoms are non specific. You must monitor your blood pressure as that could cause dizziness, as well as the medications for dizziness. As for the chances of your pregnancy, your infertility consultant could tell you how well your IVF cycle went. Also, the type of bleeding that you described does not rule out your chances of conception after blastocyst transfer. You would know for sure only after your B-HCG levels are tested as recommended by your consultant, to know whether the IVF cycle was successful or not. Please do not worry or panic till you know the result for sure, as minor bleeding does not rule out chances of pregnancy. All the best !",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have Budd-Chiari syndrome and I feel very uncomfortable due to ascites. Please help.\n\nHello doctor, He was diagnosed with Budd-Chiari syndrome before five months, and he is feeling very uncomfortable due to ascites. Currently on Acitrom 3 mg, and Udiliv Dytor 10 mg. Kindly advice.",
    "doctor_response": "Hello. Budd-Chiari Syndrome is a rare condition caused by narrowing and obstruction of the hepatic veins. Obstruction of the veins prevents the flow of blood from the liver to the heart. Obstruction is due to the formation of a fibrous web in the blood vessel or blood clots. It can be due to a blood disorder, infections, chronic inflammatory disorders, cancer, liver enlargement, and fluid collection in the abdomen, etc. Do LFT (liver function test), RFT (renal function test), CBC (complete blood count), CT (clotting time), BT (bleeding time), and US abdomen (ultrasound). Treatment depends upon the cause. But generally, treatment is medical or surgical. Mainly ascites fluid is taped to relieve tension and portal hypertension management is done. Some times liver transplantation may be needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the solution for short neck?\n\nHello doctor,I am having short neck since birth. I am attaching my recent x-ray report with this post. Kindly help me out in understanding my condition. What particular solution would you suggest for the same? I also came across cervical traction devices. Will they help in my case? Please explain.",
    "doctor_response": "Hi. I have gone through the x-ray (attachment removed to protect patient identity). For further information consult a spine surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the red spot on the side of my penis an indication of STD?\n\nI have a red spot on the side of my penis that kind of goes away with hydrocortisone but never full goes away. I might not be following through enough with the hc. The spot is just a little red blotch and has no pus, is not itchy, and is not cracking or hurts. Is this an STD? I have recieved oral",
    "doctor_response": "Hi,I have gone through your query. Spot on penis are very common and men are frequently worried they have STD. The lesion you have mentioned is completely harmless and is just a spot. Discontinue Hydrocortisone and leave it as it is.If it starts to show any other symptoms, then a local dermatologist can be consulted.Do consider a positive feedback as a credit to my work. Let me know if you have any further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause joint pain, back pain, mild fever and acidity?\n\nSir, MY name is neeta i am 36 years old i have pain in my hand joints,leg joints, i have mild fever last three month, i have accidity,i have hair falls, when i wake at morning i can get early cause i have pain my west pain leg pain back pain",
    "doctor_response": "Hi, It seems that you are having some sort of arthritis. To know the exact cause of arthritis, the following blood test are required:ESR CBC Anti-CCP Vitamin-D Hlab27 RA factorGet these tests done to know the exact cause of joints pain. Take over the counter painkillers. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jaideep Gaver, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any side effects for hifenac p, razo 20mg and chymoral forte?\n\nhello doctor, i having pain in back, and took mri scan. the report says that tissue or a layer between L4 and L5 is swollen. they prescribed hifenac p, razo 20mg and chymoral forte ds tablets and added that i should undergo physiotherapy treatment for 10 days.. is these tablet gives any side effects or it is better to continue with these tablet",
    "doctor_response": "the tablets are temporary relied of pain and spam but not an solution. i would go with your doctor adivse to do physiotherapy with tablets and refer him back if problem persist. to resolve your problem you need a physical therapy sessions and good rehab program. once completed you will be free from prblem. continuing tablet for long time can cause stomach upset, gas and many other issues",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for jaw pain\n\nhusband got hit by a baseball in the side of the neck and now has pain in the opposite side jaw and upper shoulder area. He did bite his tongue close to jaw linewhen it happened, so that could account for jaw pain, no pain or bruising at impact site, however. I ve read that we might be concerned about restricted flow due to possible injury to blood vessels, but no other symptoms other than what I ve described. Are there any immediate concerns?",
    "doctor_response": "Hello I have studied your case There is possibility of injury to tempero mandibular joint,[jaw joint]Laxity or tear of ligament can lead to persistent pain.  So I will advise you to consult a specialist and do further investigation.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the generic name of the tablet leon 500mg ?\n\ncan i know the generic name of tab leon 500mg?",
    "doctor_response": "Hi Welcome to HCM It is levofloxacin an antibiotic used in respiratory tract  infection..also available in 250,750 mg. Hope I have answered your query.take care Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hi dr. my son is 9 year old and almost 20 days passing and still he is doing bed wetting. what to do?\n\nHi dr. my son is 9 year old and almost 20 days passing and still he is doing bed wetting. what to do.",
    "doctor_response": "Hello.. our son is 8.5 and just starting to get a handle on it. we are using an alarm that hooks up to his underwear(pottie pager). it just help to create an awareness during the night so he can recognize that he needs to hold it or stop the flow.  my understanding on this is that it is quite common...we are all different.  my guess is this will help you and your child. hugs. N",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment after PTCA stenting\n\nHI sir, my self Kiran and i am from Bangalore. On Jan 25th , 2014 PTCA+ stentnig performed to me in one hospital. i was discharged after 5 days and was told to review in two weeks i.e. Feb 13th. But i am unable to get the appointment with the same doctor till Feb 24th. can you suggest me , how to proceed with medication and can I go to another hospital for review.",
    "doctor_response": "Greetings. Welcome to HCM and thank you for your question. I read your query. Well, yes, of course, you can go to another hospital or doctor for review and control. I am glad that you have followed doctor's advice with a great discipline. The procedure of percutaneous transluminal coronary angioplasty (PTCA) with stent placement requires a good discipline by the patient and careful controls, at least for the first 6-12 months, period during which, the probability for within stent narrowing is the highest. In our clinic's experience, we recommend to post-PTCA and stent patients that clopidogrel 75 mg should be taken once daily for at least 6 months (in cases of bare metal stents) and 12 months (in cases of drug-eluting stents); to discontinue smoking, if they are smokers; and periodical controls with a cardiac stress test after 1, 3 and 6 months from the procedure. Also, if the stent was placed in a terrain of acute myocardial infarction, an echocardiogram is required three to six months from the procedure, to evaluate if there is any gain in left ventricle function after the urgent procedure. Wish you all the best. I hope I was helpful with my answer. My regards, Dr. Meriton",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful lump on the mouth\n\nHi, I have two lumps on top of my mouth. One the size of a grain of rice just over top of my molar that you can see if I lift up my lip, and used to be a white now reddish colour. The other is a larger lump on the back side of my gums on top of the molar and is painful to touch. Sometimes when I press my tongue against this lump it sends puss out through the small lump on the other side. About a year ago this molar was filled. Since then that molar sometimes feels wiggly and is hard to chew on. What do you think is happening?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query two painful lump on the mouth could be because of tooth infection which is resulting in abscess and pus formation which is spreading to tissue spaces and causing facial space infection and pain. I would suggest you to consult oral surgeon for proper diagnosis and to rule out systemic causes like sinusitis and any infection related to middle ear. Take ibuprofen and acetaminophen for pain. Maintain oral hygiene by brushing and flossing. You should get RCT redone to drain present infection and start post and core or crown on that. You should try to relax yourself. Gargle with Listerine mouth wash. Penicillin, metronidazole combination with an analgesic will be effective to subside infection if you are not allergic. Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "I had partial hysterectomy June, 2009 for suspected adenomyosis. I started having similar symptoms that led to surgery in January, 2010. Utrasound March, 2010 showed ovarian cyst and fluid in fallopian tubes. What could be causing fluid to build up ? I am currently in the final weeks of training for a half marathon. Could it be from all the running ? I am currently running 20-30 miles a week.",
    "doctor_response": "welcome to healthcaremagic the ovarian cyst and collection of fluid in tubes not due to running blockage of tube at terminal end may give rise to collection of fluid known as hydrosalpinx ovarian cyst may be a benign condition ,cause not definite .may be due to hormonal imbalance please get a gynaecological check up and follow advice",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness and stiffness in the hands after excessive typing?\n\nI need all medications you would recommend for migraines. I have been using sumatriptan - 50 mg...to sub for Imitrex. I am unfortunately on sdi and need the most inexpensive medication. I normally obtain medications for around $4. I meet with my doctor tomorrow and try to aid her with my limited income; yet knowing I have to have a migraine medication not excedrin for migraines. Thank you.",
    "doctor_response": "Hello, It is just a musculoskeletal pain due to prolonged activity.  Nothing much to worry as it will settle in a couple of days with rest. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this semen analysis report indicate?\n\nMy husband has done semen analysis. >Reports says Colour - Greyish white; Volume - 3.4 ml sperm; Reaction - Alkaline; Viscosity - Moderate liquefaction time - 45 mins Sperm Count - 40 Million/ml; Morphology - 70 % Normal Forms, 30 % Abnormal Forms. Active Motile - 30 % Sluggish Motile - 5% Non Motile - 60% Pus Cells - 0 - 3 HFF RBC - Few occasional Absentce is 5 Days Please advice his report. Also if he can help me conceive? Waiting for reply.",
    "doctor_response": "Hello, In mentioned semen report sperm motility is less esp. Active motile sperm is slightly less. For that, you can be prescribed hey Forte like a tablet or maxoza like tablet that contains a substance which increases sperm motility. Multivitamin and mineral containing tablet also beneficial. Avoid strenuous activities and avoid smoking esp. Try to do intercourse around ovulation time that is 12-15 days of cycle considering cycle duration 28 days. Mostly these measures help is able to make conception. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does clop-gm and dk gel help to reduce red spots on underarms/thighs/buttocks?\n\nI had few red spot allergy of plants on my underarms,thigh & my buttock so I took treatment for little while and then I discontinued , but now those red spots had turn into brown/ blk spots n few of them are raised. My doctor prescribed me CLOP-GM 15g cream & DK gel.is it correct ? Since my Dr expired few days back I do not have dermatologist to go to. So please suggest a good dermatologist too.thank you for you help!",
    "doctor_response": "Yes the drugs prescribed by your doctor are correct as far as red spots are considered. Along with clop-gm and DK gel you have to take cap doxycycline 100 mg twice daily after meals with tab avil thrice daily or tab levocet twice daily after meals with tab rantac or tab famotid twice daily empty stomach.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have frequent gnawing pain when stomach is empty. Why?\n\nHi doctor, I have frequent gnawing pain when stomach is empty, which is relieved after eating. There is a continuous mucus accumulation in the throat throughout the day, which obstructs proper breathing and flares the nose nostril followed by dry mouth. It is particularly in the early morning hours. If light food is taken at dinner, discomfort in the stomach during midnight and whole body feels dry and no proper bowel movements the next morning. Most of the time, stomach gets bloated after eating. When the stomach is empty, nose flares up and breathe is very abnormally hot.",
    "doctor_response": "Hello. Hiatus hernia. Upper GI endoscopy. Helicobacter pylori infection. GERD. Treatment for acidity. Revert back with the reports to a medical gastroenterologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fertility period in women\n\ni wana pregnent",
    "doctor_response": "You're more likely to become pregnant in any particular month if you have intercourse during your most fertile period - the days just before and after you ovulate. Ovulation usually occurs about 14 days before the start of your next menstrual period. If you would like to figure out when you're likely to ovulate next, you'll need to know the approximate length of your menstrual cycle. Fertilization occurs when a sperm penetrates the egg - and this typically takes place in one of the fallopian tubes. The fertilized egg then travels to uterus and implants in the uterine lining. Dr Naveen Kumar M, The Apollo clinic, J.P.Nagar,B'lore",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have nerve pain in tooth. Taking gabapentin, amitrin. Help?\n\ni got the dental pain but Dr. told it is nerve pain then i get neurologist opinion and i taken the MRI Scan its normal and suggestion is clinical correction. but neurologist didn t explain what the disease but he R/s Tab- gabapentin - 300mg tds, Tab- zen retard - 400mg bd, Tab -Amitrin 25mg hs this tablets i am taking past 20days if 1 day i stop this medicine i got same pain how long i would take this medicine what is my disease please replay.",
    "doctor_response": "dear friend. thanks for sharing your concern. you have been prescribed amitrin that is tricyclic, antidepressant. and gabapentin is given in case of some pathology with cns(central nervous system.)like epilepsy. you will  have to consult your neurologist regarding its dosage,duration and continuation or discontinuation of the drug. because  you have been prescribed these medicine after clinical examination and various investigations.am i correct? so please visit your physician to understand its etiology,progression and effect.i am sure they will help you. so that you recover soon. and i am sure you will be fine. remember nothing is more strong than your will power to overcome any kind of ailement. now comming to your dental treatment you must visit your dentist once, get oral check up done. look for any kind of deposits on teeth,any cavities,etc as you mentioned you feel pain. on consultation, if required you can go for oral prophylaxis,and suitable restoration. hope this helps. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on back of head in a child after surgery?\n\nMy 3 year old son had surgery about 3 weeks ago and woke up from the surgery with a lump on the back of his head , took him to the ER and they just said it was a sore bump from him being asleep for 4 hours but now he has a bald spot where the lump was . What could that be?",
    "doctor_response": "After prolonged surgery or prolonged position of the head in a same position, leading to ischemia and reduced blood flow a point on the head skin due to constant pressure, this kind of thing can happen. It is called as a pressure sore and may lead even to permanent baldness in that region. Presently, just observation is required and you can apply an oil based ointment on it. Will reduce in size. It may long time to heal fully.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause of thick mucus in one with chronic sinusitis and asthma ?\n\nHi I had a CT scan confirm I have chronic sinusitis and also I have asthma . For over six months now, I noticed when I spit in to a glass water, this constant thick clear phlegm comes out all day long -NON -STOP , thick looking. When I spit in to a glass of water, it appears cloudy and streaks down and settles at the bottom looking cloudy white. Also, the phlegm is thicker in the morning when I wake up. I have been taking predisone , Amoxicillin , doing Nasal Netti pot, and Accupuncture and nothing seems to be curing it. I am wondering if I have candidasis ? At one time my mucus was thick yellow but after taking amoxiciling the sinus infection cleared, but still the thick mucus is coming all day long. Any idea what tests I should have done or what it might be?",
    "doctor_response": "Hi Genxbtq, Chronic Sinusitis and Asthma both can cause this type of mucoid sputum. When there is yellowish or green sputum from nose or mouth along with other symptoms like facial pain, cough, loss of smell and taste etc, there is an indication for Antibiotics. Once you start antibiotics, remember to continue it for longer duration ( not usual 5 days course) like 10-14 days for Chronic Sinusitis. I hope you are taking Inhaler for prevention of Asthma. The dose, and duration of Prednisolone tablet should be guided by your doctor. I would also advise you to increase the dose of preventive inhaler, as soon as you see any first symptoms of flu, sinusitis, allergic Rhinitis. Every year you should take Vaccine against Flu, and you must also take Vaccination against Pneumonia. You must continue doing steam inhalation two times in a day as a routine. Take good care of your food, and heigene. Avoid any allergen, if you have any. Wish you a stable health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for painful gash inside mouth on cheek\n\nhello i have what seems to be a small gash in the inside of my mouth where perhaps i cut or bit into my cheek. And it hurts, i took a flashlight to it to see what it was and it had a almost white film to it, it really hurt though so i kinda messed with it and then used mouth wash to kill bacteria. what can i do to help it along? will it get infected? i've had it for a few days",
    "doctor_response": "Thanks for your query, I have gone through your query.The pain in the cheek can be because of the traumatic ulcer with a pseudomembrane. This has occured secondary to cheek biting by the teeth. Nothing to be panic, you can apply topical anesthetic agents like lignocaine and topical analgesics like choline salicylate. This will heal in 5 to 7days time. You can continue to use mouth wash.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rashes, pain in the ribs and swollen stomach. Have surgical clips after a gallbladder surgery. Do I have pancreatitis?\n\nI had a lap. gallbladder surgery in 1993 I just gradually over the years kept getting sicker and sicker .I have 13-24 surgical clips in my liver area from that surgery.The last time I was in the hospital they told me it is a injury why I keep getting sick.It can be fixed but there is no one in this area qualified to fix me.And now today I got a letter from FDA on medical device report in the MAUDE database in the MedWatch program.Anyway I am in so much pain and very weak also my whole body is covered in rash ,and my stomach is so swollen it feels like it is literally breaking my ribs,now if I walk around the block it does that in my back also.Would you know anywhere I can go to get all those clips out?So I do not have to live on pain meds. and antibiotics also.Please Let me know if you can think of anything,this is begining to get scarey I think I had another pancreatietis again.There is no pain like that.PLEASE HELP!!!! YYYY@YYYY Diane",
    "doctor_response": "Hi Clips will be applied to cystic duct and cystic artery during gall bladder surgery. They should not be removed as there will be Bile leakage from cystic duct and the artery will bleed. It is not possible to remove them. 13-24 clips are more in number.They might have applied due to unexpected injury to any structure. But,complications after 20 yrs are rare. PAin abdomen and rash are due to some other causes. Get an Ultrasound abdomen or CT scan abdomen ,Serum Amylase and Serum Lipase levels. Consult a Gastroenterologist and proceed. Nothing to worry Wish you good health Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have hard, itchy lumps on the scrotum. What is it?\n\nHi doctor, I have lumps or cysts on the scrotum for a year of around 8-9 in number. They are of different size. There is no pain but I feel too much itching on the skin of scrotum. When I touch them they feel little hard. By seeing the photos which I have attached here for your reference please tell me what it is.",
    "doctor_response": "Hi. I have gone through the photos (attachment removed to protect patient identity) you have attached. For further information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and pain at the bottom of the feet?\n\nIve been getting swelling and pain on the bottom of my feet after getting a cold. It started a few months ago and has been getting worse. Also during that time, I ve had pain in my joints and muscles. Also the second time my lip was swollen for a few hours. Ive lost about 10 lbs and the hair on my legs is falling off. My PCP blew me off. Dont know what to think.",
    "doctor_response": "Hello, As a first line management you can take analgesics like Aceclofenac or Tramadol for pain relief. If symptoms persists, you can consult an orthopaedician and plan for an MRI scan.  In that case we have to rule out possibilities like plantar fasciitis. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does presence of pus cells and yeast in the stools indicate?\n\nHi sir..i m 24 years,height 6 feet,weight 60-65,had typhoid fever in last year.. I had diarrhea(with a foul smell) for 1 and half months,i have taken both antiamoebic and anti bacillary(entamizol and negram)treatment on suggestion of a doctor..now foul smell has gone but still i have diarrhea..stool d/r which i have done yesterday shows pus cells 3-5,yeast=1+..i live at hostel where food is not as hygienic as it should be.. what is your diagnosis?",
    "doctor_response": "Hello. Thanks for asking Healthcare Magic. You are suffering from a gastrointestinal infection as suggested by your stool report. I would suggest to start norfloxacin and tinidazole 400/600 mg twice a day and lactobacillus tablet twice a day for 5 days. Drink plenty of fluids and Oral rehydration solution. Take rest. I hope this helps. Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is augmentine  safe for kids?\n\nmy baby girl is 4 year old.for 2 days she has cold and then mild fever . Today she developed cough also. i gave her medicines like dimetap, amydramine cough syrup. Today ( friday) here in sharjah , clinics are closed. What should i  do now? Is augmentine safe for kids?",
    "doctor_response": "Hi, welcome to healthcaremagic. Yes, Augmentin or amoxycillin+ clavulanate is safe for children in appropriate doses. The normal dose for kids is 50mg per kg of weight of the child per day in three divided doses. For e.g., for a 15kg child, the dose would be 15X50mg=750mg per day and each dose will be of 750/3=250mg.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of lyme disease?\n\nMy daughter s boyfriend has three tick bites from a camping trip in Arkansas approximately four weeks ago. The bites are still there and are red, raised, and itch and located around his waist. They do not appear to have a clear center as described with Lyme disease.",
    "doctor_response": "Hello,Welcome to HCM,I can understand your concern. Regarding the symptoms he could have early symptoms of Lyme disease. Lyme disease has early signs and symptoms and later signs and symptoms. The early once appear within a month and include rash on the place where you have been bitten and flu like symptoms. So if you've been bitten and experience signs and symptoms of Lyme disease, contact your doctor immediately. Treatment for Lyme disease is most effective if begun early.However, diagnosis can be confirmed by ELISA for IgG against borrelia and can be confirmed by a western blot test.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy with nuvaring and condom broke?\n\nso i have been on nuva ring for almost a year now...this past month i became sick and was prescribed a z-pac. My boyfriend and i were having sex (the first day of my period) and the condom broke, some of his sperm was inside me... what do you think is the likelyhood of getting pregnant? should I even be worried?",
    "doctor_response": "Hello, and I hope I can help you today. The Nuvaring used alone is greater than 99 percent effective in preventing pregnancy. Many women use it without a backup method of birth control. In addition, because the Nuvaring is absorbed through the skin of the vagina, its effectiveness it not reduced by antibiotics because the medication is not swallowed so it is not metabolized in your liver like oral birth control. In addition, the majority of women do not ovulate during their menstrual cycle even  off birth control. So I really do not think you are at risk of pregnancy in your situation. I hope I was able to answer your question and that this information was reassuring. Best wishes, Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain on left side right above the waist line?\n\nI have been having pain on my left side right above my waistline for two days now. I have fallen twice in the past two years on my left side. I have sugar . I see a foot doctor for pain in my left leg. I had no problems till I fell. The hospital said I had messed up my rotor cup and had a contusion on my left rib. Would this pain be from so long ago.",
    "doctor_response": "Pls giv ur symptoms properly. Pain abv waistline is explained by contusions over ribs n it wil take some tym to resolve. But rotor cuff messed up is it than u need to see a orthopaedics urgently added by ur diabetic profile",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for legs,feet and arm swelling\n\nMy teenage daughter has been having trouble with light swelling of her legs, feet and arms. They turn purplish blue and also have white spots all over them. She also has several spider moles. She has had this for years, but seems to be getting worse. She also has food allergies.",
    "doctor_response": "Hello, We have to rule out possible causes like Reynaulds phenomenon and other vascular problems. Consult a general surgeon and plan for a vascular Doppler. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Irregular and light periods after hysterosalpingogram. Suggest\n\nHello Doctor Am 31 years old and married since two years.  Am actually following a treatment with the local gynae to be able to get pregnant.  In Feb 2013 had a hysterosalpingogram under the instruction of the gynae All hopefully happened well during the process But the very next month and ever since I am having ireegular period whereby i was always regular.  At first i did not have my period and my gynae prescribed me some medication for me to have my period but this month it is a very slight blood flow since 2 days. I normally have heavy periods for seven days   Plse help me doc",
    "doctor_response": "Hello, I would be happy to help you with your question. The HSG is not associated with causing your cycles to become more irregular.  This is probably related to whatever underlying cause that might exist that is causing infertility that led to the HSG in the first place.  I would check a pregnancy test to make sure you are not pregnant and get in to see an OB/GYN or fertility specialist to re-assess your whole situation.  Hopefully your partner has also had a semen analysis. I hope that this helps. If you have more questions, please click on \"ASK ME A QUESTION\" link above to directly ask me a question!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes diarrhoea for a 7 months old?\n\nmy 7 mth old daughter has had diahrea for 2 weks solid now upto 8-10 dirty nappies a day, stopped solids as thought it was linked but that was a week ago and still no change, been doctors but not been very helpful they sent of stool sample and still awaiting results and given cream for her burning bum but havent said wat it could be?",
    "doctor_response": "Two weeks of loose motion means baby has got some infection or it might be due to lactose intolerance. The stool  sample only can detect for infection if there is any bacteria. Based on that they will provide you with antibiotics and probiotics feed your child with plenty of water and reduce the amount of milk. And feed her solids avoid sugar because it may induce loose stool. The rash developed in her bum is due to loose stools. If they suspect lactose intolerance to physician will provide you with milk substitute which doesn't contain lactose.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How much does an appendectomy cost?\n\nOldest daughter has been having lower right side pain for 10 years. we think its her appendix. in and out of hospitals everything normal from all the tests over all the years. so without insurance how much does a appendectomy cost with doctors,hospital,etc.",
    "doctor_response": "Well, the cost of appendix removal depends upon which city, which hospital , which facility you want , whether you want an open appendectomy or Laparoscopic and so many such factors. History of 10 years of pain in lower abdomen can not be due to appendicitis as by this time it would have ruptured and caused many complications. The pains like this can be due to IBS- Irritable Bowel Syndrome or so. Get investigated and diagnosed properly by showing to a Surgical Gastroenterologist.I would advise a CT scan of the abdomen, Enteroclysis, all relevant blood, urine and stool tests.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pain in the lower back and testicle?\n\npain in my lower back ,that travels down to my testicle. my dr. has checked my prostate took a script of cypro antibiotics.had polyps removed from my colon. my dr. has me on muscle relaxers and tramadol for pain,but with no dianogis. I have been hurting for 5 wks.",
    "doctor_response": "HiI understand your concern.Testicular pain can needed assessment by scrotum color Doppler.Color Doppler can ruled out underlying pathology in testis.back pain has many reasons.Analgesic with physiotherapy can help.MRI spine is also indicated if not improved with medicines.Consult and get help.Still have a quetions then feel free to ask.Thank you.Get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "20month head injury, vomiting Are the vomits related to the fall? Could it concussion if he has only one of the symptoms-- vomiting?\n\nHi Drs, My 20months old son fell head-on from a sofa 3days ago just minutes after dinner when I stepped out into the kitchen so I didn t see how he fell. He vomited right away. But he resumed normal activity within minutes. And at night slept through the night. But the next day he throw up after his evening nap. His pediatrician was not available so I took him to see another doctor who examined him and said all his vitals are normal, except the vomiting all other signs were normal. He said the fall could have shaken his brain, minor concussion. He recommended de-vomit 3/daily and reduced his fliud intake (he drinks a lot so this was had for him). After giving the medication, he was very restless and barely slept through the night. So next afternoon (3rd after the fall) I took him to his pediatrician. He examined him and again all signs were normal. He resumed him back on his normal fluid intake and off the medication. Unfortunately at 3am today (4th day) after he took his milk in between his sleeping time, he vomited again. NOW I M VERY CONCERNED!!!!!. Are the vomits related to the fall? Could it concussion if he has only one of the symptoms-- vomiting? His pediatrician does not ecommend a CT scan for him. Do I insist, though I am concerned of exposing him to the effects? All possible advise is appreciated.",
    "doctor_response": "hi vomiting does not appears to be related to fall, but as you are concerned you can go for ct head. ent surgeon should be consulted to rule out any ear infection, internal ear injury .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden headache and blurred vision after episodes of TIA?\n\nYes i have had 2 light TIA s in the past and been going through a lot i was in the store one day 2 weeks ago and copped a headache vision went blurry and some numbness went to the ER bllood pressure was real high but tests showed ne signs of heart attack or stroke what could that have been?",
    "doctor_response": "Hello!Welcome on Healthcaremagic!Your symptoms could be related to a new TIA. For this reason, I would recommend performing further tests to investigate for the possible causes, underlying the repeated TIA: - a Doppler ultrasound of the carotid arteries- a brain MRI - a cardiac ultrasound- blood lipid profile for dyslipidemia- fasting glucose and HbA1C levels for diabetes- a cardiac rhythm Holter monitoring to investigate for cardiac arrhythmia. A blood thinner may be needed for the prevention of stroke, considering your repeated TIA. You should discuss with your doctor on the above tests. Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful lump on the palm\n\nI have a hard bony lump on the little finger side of the bottom of my right palm, the size of a pea.. It s hard, bony and very different from my left hand. I m very right handed. It is getting red and sore because it s the part of the hand I lean on desk when, say, using a mouse. It s like a bunion on my wrist. The wrist is very crunchy and clicky on manipulation. Help..? Thank you",
    "doctor_response": "Hi,Dear,Welcome with your query to HCM.Studied your query in full depth of its details.Reviewed it in context of your health concerns.Based On the facts, You mostly seem to suffer from-Flexor Tenosynovitis with Palmar Bursitis on ulnar side.-Crunchy wrist indicates tenosynovitis / with flexor carpi ulnaris bursitis.Other causes such as sesmoid bone/ bone dysplasias/ rehuematoid nodule/Ganglion from flexor tendons,gouti tophi?MRI / CT study of the painful lump on palm would fix the cause.Treatement-Second Opinion from Orho-Surgeon after MRI and CT Scan study would decide the line of treatment of the painful palm lump.Orhto-Surgeon would decide its treatment accordinglyTo start with -Tab Motrin / Cold Compressess would help.-Crunchy wrist indicates tenosynovitis / with flexor carpi ulnaris bursitis and treatment for it by NSAIDs would help .Hope that ,This reply would help you to plan further treatment soon with your treating doctors.Best of Luck and early recovery.Welcome any further query in this regard,which would be replied in next session.Good Day!!Dr.Savaskar M.N.Senior Surgical Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is xanax better than albuterol for asthma?\n\nall asthma meds I have taken cause a lot of nervous side effects. I used to experience bad tightness in chest and would sometimes cough till I passed out. Since I have been taking xanax on a regular basis I have had no tightness in chest and have never had a severe coughing attack since. I take Duhlera and spirva daily and 3 1m xanax a day and no emergency inhalers. Only side effect from xanax is it causes me to slober a bit but I never get sleepy from them. I ve been on same dosage of xanax for a few years An allergy doctor said I have anxiety induced asthma. I m 50yrs old weigh about 220 and very healthy other than this. I would like more xanax than endure side effects of albuterol or more inhalers. Am I mistaking in my thoughts",
    "doctor_response": "HI, thanks for using healthcare magicAnxiety and extreme emotion can potentially cause an acute asthmatic attack.If you only notice asthmatic episodes when you are anxious or stressed then it is possible that this is your trigger.If you can reduce your anxiety levels then it is possible to also reduce your asthmatic attacks.If the anti anxiety meds are helping to control your anxiety and therefore your asthma, then you can continue them.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for slight variation in ECG?\n\nMy father had  problem in breathing.today he consult a doctor.doctor told him take ECG & Blood test.Blood test is normal.But slight variation in ECG. I want to know anything serious.any problem in father's heart & Lungs. Doctor please help me the Queries",
    "doctor_response": "Hi,Slight variation on ECG usually are not serious, but I would need to have a look on ECG to give more precise answer. Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My penis is swollen with irritation. Could this be balanitis?\n\nHelo doctor, My penis is swollen in the front part with itching and irritation from yesterday. I was trying to check online, it says maybe it is balanitis, not sure though. Please guide what needs to be done? I am currently on medications for high BP and uric acid.",
    "doctor_response": "Hi. It is very likely to be balanitis with the background of acute infection and swelling. You can take tablet CISMA DT (Cefpodoxime) 200 mg twice a day, tablet NISE (Nimesulide) 100 mg twice a day, Tube Dermiford (for local application) twice a day. Take all these medicines for seven days. Review in a week if not resolved. Check your HbA1c (glycated hemoglobin) levels and send reports. Are you sexually active? If yes, is your partner having white discharge? If so, your partner also needs treatment to prevent balanitis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swelling of stomach, hands, legs, feet. Stomachache, backpain. On antibiotics. Suggestions?\n\nHello I am swelled up in my stomach like I am 9 months pregnant my legs feet and hands or swelled up to I am in a lot of pain in my stomach and lower back I constantly have to go to the restroom I have took Imodium ad but that don t help I went to the hospital and they said my small intestine was inflamed and gave me antibody but I in so much pain I feel like I am dying this is worst then labor I believe I am going to die plz help me I hurt so bad",
    "doctor_response": "Hi Such a pain is really worse and makes us feel very bad about it. For a immediately relief, I will suggest you to take Anti - Spasmodic medicines so that your pain in the abdomen gets relieved. I will suggest you to visit your local doctor or Homeopath to get immediate treatment. Further, I will suggest you to have a Complete Blood count (CBC), a Electrocardiogram (ECG) and a Ultrasound Sonography (USG) of your Abdomen and Pelvis. By these 3 investigations you will be able to know what is the underlying cause for the swelling of your feet, hands and hands with legs. Take Care With Warm Regards Dr. Apurva Tamhane",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with hepatitis C. Altered stool consistency, fatigue and acne. What should be the treatment?\n\nHi, I was recently diagnosed iwth Hepatitis C . I strongly believe I got it this past summer the month of August 2012. I was checked last year oct. 2011 and wasnt detected. But now I have it and I have symptoms of clay like stool, darkening of the liver , fatigue , tiredness, acne , loss of apetite. Is it possible to have symptoms approach this fast? If so, what can I do to change this reaction within my body?",
    "doctor_response": "Hello, amanda, Hepatitis- C can be contracted by a number of means. This occurs by coming in contact with contaminated blood. Drug abuse , shared needles or other paraphernalia even many years ago can be the source. Blood transfusion or blood products prior to 1992 (We did not have blood tests for Hep -C then). Other things that are risk factors include Tattoos,body piercing,sharing tooth brushes, razors etc. Accidental needle prick and exposure to contaminated blood (Lab technecians etc,surgeons ) I am giving you all this background to let you know , you can be completely well till the virus starts multiplying in the liver cells and causes damage. Now that you have been confirmed with blood tests, you need to get HCV -RNA viral count and the Geno-Type of the virus because the response to treatment or cure depends on this. Good news is ,there are very effective treatments using a combination of drugs. You can look for a clinic or a doctor's office that specializes in treating this. It takes patience, dedication and determination on your part to get cured and this can be done. You may have to put up with side effects from the drugs, again most people can tolerate well.Usually the treatment lasts for 24-48 weeks depending on the response of the virus count at 4-8 weeks. Please see the doctor and have all the proper tests done and start the treatment as soon as possible. I wish you well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is the left side of my waistline bigger than my right?\n\nI am a 61 year old male. Six foot tall and 200 lbs. It seems the last year or so the left side of my abdomen protrudes more than the right. It is in the love handle area. My overall abdomen is soft and there are no lumps or irregularities that I can detect. I have a slight beer gut and was wondering of one side can naturally protrude more that the other with weight gain and age?",
    "doctor_response": "Hi there. With ageing what happens is that the general tone of your muscles start become less. That means that your muscles start to become more slack. This generally manifests itself as wrinkles on the face, loosening of the muscles over your arms and thighs etc. So the same process is happening to your abdominal muscles which basically results in people noticing that they have a paunch belly. So most likely this is what is happening with you. Since the area where the love handles are present is quite prominent, this makes it more noticeable when you are concerned. There is no need to worry about it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bleeding upper lip post injury\n\nMy 2 1/2 yr old son fell off of the bed and hit his upper lip on something. He is bleeding on the top part of his gums where the flesh ligament thing under the upper lip and just below the nose is. It looks like there might be a small hole. The bleeding has slowed, but I am wondering if this is something that needs to be seen right now.",
    "doctor_response": "Hello... I ve reviewed your question... Can understand your worry... The part u have described has high vascularity so risk of bleeding is more... First of all press the part with cotton or gauze.... Then once bleeding slows down than look for any cut or laceration at local site... It may require surgical consultation and suturing..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the ears and jaw after a root canal treatment?\n\nI have had ear pain/jaw pain since a root canal a year ago. Shortly after procedure developed chills, fever, respiratory infection. Was also bit by insect (had bullseye) and treated for Lyme during same time. All Lyme tests were negative but had high wbc (12-16) all other labs normal except hypersegmented neutrophils present. ID doc thought CLL and wanted Flow test but was overruled by hematologist since no other symptoms. Over the course of a year have had several recurring illnesses, joint pain, low grade fevers, continued ear pain, jaw pain, tooth pain. Had several visits with specialists, had scans and bloodwork. Now told I have TMJ, LSN (vocal cord hypersensitivity), reflux, anxiety, and possible nerve damage in jaw from tooth surgery. Next move is an allergist. I am done with being passed around and having tests with no answers. Suggestions? Lyme, Leukemia, Tooth issue or just bad luck!!!",
    "doctor_response": "Greetings from healthcare magic members,Viewing your query, i can understand your reason of worry and bothersome. Since you have suffered from painful symptoms following root canal treatment, you are relating your pain to dental treatment. However, with such presentations as your case, i think that the cause of your painful symptoms could be multifactorial. There is a possibility of having nerve disorder called \"Trigerminal neuralgia\" (TN). It is a painful disorder of fifth cranial nerve that causes episodes of sudden sharp,piercing or electric current like pain on entire half of the face and may cause pain in teeth, joints and surrounding muscles. The pain usually last for two minutes or less and in most cases affect one side of the face. The pain often is triggered facial movements like talking, eating, smiling, chewing, brushing the teeth, shaving or touching the face.Dental procedures do not cause TN. The development of TN in association with dental procedures usually occurs because patients with trigeminal neuralgia often go to a dentist when they have toothaches, which often are caused initially by TN and not the dental maneuvers. It can also occur after viral infection (herpes virus etc) with fever, chills and blisters in mouth.However, before coming to any definitive diagnosis it is important to rule out other medical and dental conditions that cause similar symptoms.1. First rule out the dental cause: For that, i would suggest you to get your  x-ray done to look for any signs of infection remaining.2. Any areas of painful facial blisters \u2013 can be herpes  or shingles: Facial pain can last for weeks after the blisters heal, especially in cases of shingles.3. Any other systemic medical condition such as multiple sclerosisIf regular painkillers such as paracetamol/panadol is not relieving your painful episodes, you probably suffering from TN or other similar nerve problems. I recommend you to follow the aforementioned points and consult your general physician for further investigation. Hope this answers your question. If you have any further query then please do not hesitate in writing to us. I will be happy to answer your questions.Best regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "History of having hepatitis from eating raw oysters from warm water.  Explain whether it was hep A, B or C\n\nYes, thank you.  Which Hepatitis comes from eating contaminated shell fish?  For instance, I had hepatitis fromeating raw oysters that had come from warm waters, when later  I  was hospitalized and diagnosed with hepatatitis.Was it A, B, C, ?  I need to know so that fill out medical forms correctly.  Could you please answer for me?",
    "doctor_response": "Hi,Thanks for using Healthcaremagic,There are various type of virus which cause Hepatitis commonly contaminated food and water  cause hepatitis A & E,in your case it should be one of them it is not possible without proper test to say definitely.Other virus B,C & D are transmitted by blood parenterally and even sexually .You need to go to hospital where you was admitted and if it was tested then you may be having reports of viral markers.Hope this helpsTake care.Good Luck.Dr.Akhilesh Dubey M.D",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sediment at bottom of accumulated urine in a child?\n\nI was cleaning my three year old s potty chair. There was only urine in it. There was a sediment at the bottom that was like a white sand. What is this? She is in PERFECT HEALTH otherwise. She is up to date on immunizations & doctor visits. I m at a loss. I m going to call her doctor on Monday.",
    "doctor_response": "HIWell come to HCMMost of the time such finding are very common in this age group, and this could be formation of some crystal particle may due to some medicine that baby might have given, in my opinion stop the medicine, even the medicine if given some days ago then also such thing would be possible, and this is not to worry, this would come around encourage the child for drinking water, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain, diarrhea, vomiting and tenderness in abdomen?\n\nim a 20 year old female that is having abdomial pain on the left bottom side and as had it for a long time. i have dairiehia and vomiting and its painful to touch the area on my abdomen {lower left} changing positions adds discomfort i cant seem to get comfortable. on a scle of 1 10 for pain its starts at about a 2 and gradually progresses to a 10 the pain is dull at first but then it sharpens severly and this multiplies as time dragged out for certain periods of time at any given moment it wakes me from a deep slumber i take trazadone 100mg for sleeping issues i have and digesting food or not doesnt seem to affect it.",
    "doctor_response": "HI.The combination of diarrhea, vomiting, pain in abdomen which on a scale of 10/10 and increases on changing position is suggestive of an inflammatory process in the abdomen. I would advise the following in such a patient:Get admitted to the hospital.Intravenous antibiotics, fluids and supportive medicines . Blood- complete blood picture, kidney functions tests, blood sugar fasting and post-lunch, Urine- routine,microscopy, culture and sensitivity ( before start of antibiotic)Ultrasonography of abdomen.The diagnosis got in such a way will lead to decided whether you need a medical management or an emergency surgical intervention.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. l got a sore hard lump after the removal of wisdom tooth. Is it normal?\n\nHello doctor,I just got one side of my wisdom teeth removed both upper and lower six days ago, and I have another one scheduled after two days for the left side. The upper is 100 % fine, which they pulled. The lower they pulled the tooth without removing the root because it was too close to the nerve. I do have some stitching in this area currently on the lower cheek. Noticed a hard lump about 1 inch between my lower jawline and cheek area. Is this normal because of swelling or something else. Currently taking Amoxicillin 500 mg and Ibuprofen 600 mg. Please let me know what this hard lump is, also generally on the lower side where this lump is, remains sore.",
    "doctor_response": "Hello. The lump is mostly a hard swelling which forms postsurgical removal of the wisdom tooth or maybe even by swollen lymph nodes due to infection. It takes a week or two for the swelling to subside. Sometimes, if the root is still inside, the infection may be remaining there causing swelling. Get an X-ray done to find out the exact problem and stronger antibiotics like Augmentin (Amoxicillin and Clavulanic acid) along with a painkiller for a week. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for prominent bronchovascular markings in the lungs?\n\nHi, may I answer your health queries right now ?  Please type your query here...i  had done X-ray of chest and i revealed that i have prominent brochovascular markings in both lungs and i get breath through only one nostril subsequently.....can u tel its treatment",
    "doctor_response": "Hey Hi,Looking to your case if you don't have any symptoms like cough or breathing difficulty, there is no problem to have prominent broncho-vascular markings.Broncho-vascular markings could have been normally also.so, not to worry at all regarding that.Regarding your nasal block it could be deviated nasal septum, get done checked by ENT specialist to rule out other causes.Deviated nasal septum is the most common condition of nose block. you can get corrected from ENT surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for toothache\n\nI've started to have tooth pain in my lower left jaw. The weird thing: it only hurts when I swallow. Chewing doesn't hurt it. Trying to wiggle my teeth with my fingers to determine which tooth hurts doesn't work. None of them hurt by movement. Grinding my teeth together doesn't hurt.I thought maybe I was clenching my teeth when I swallowed, but I tried swallowing with my teeth apart, and I still felt the pain.",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM, I have gone through your query, as you have toothache dont worry this can be due to periodontal problem or carious tooth .For this you should consult dentist and go for radiograph X ray for evalution of caries or periodontal pocket and treatment . Do warm saline gargle two - three times a dayHope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can ankle bruising, swelling, ache with numbness be treated?\n\nHi, i have always suffered back ankles. I have had one ankle reconstruction but on the weekend i sprained what i class as my good ankle though i have sprained it in previous years but no reconstruction on this one. My concern is i have a lot of bruising and only slight swelling but i am always getting a numb feeling and pains and needles in it on and off and At night it does ache and throb. I havent had this sensation before. Is this normal. I haven t been to Dr and no X-rays",
    "doctor_response": "Hi, I value your concern regarding the symptoms. I have gone through your symptoms, and in my opinion your symptoms are due to swelling following injury, first and foremost keep the limb elevated on two pillows, take tab paracetamol 500mg three times a day, and get an X Ray done, if you can send the X Ray I would be able to tell you if there is any bony injury and the treatment to be followed further.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.Special note-  Any medication prescribed needs to be taken after consultation with your personal doctor only.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I feel a hard pimple under the penis skin. What is it?\n\nHi doctor, I am 28 years old. My question is I can feel a very small hard pimple under the penis skin. When I get erection and press it, I feel a little pain. What is that? I cannot figure it out. Is it a pimple or something else? Please help.",
    "doctor_response": "Hello. You are most likely dealing with a sebaceous cyst. They are similar to pimple. A sebaceous gland is a microscopic gland in the skin which secretes a waxy liquid known as sebum. It opens on the skin via an opening known as a punctum. When the opening gets blocked, the sebum collected in the gland causes a swelling known as a cyst. It hardens over time to become firm. They are quite common in the genital region. The diagnostic sign of sebaceous cyst is that it slips beneath the fingers and it mostly has an opening. In your case, they cause pain because the skin there gets stretched during an erection. If it causes pain all the time, it could be infected and might need local application of an antibiotic ointment like T-Bact (Mupirocin) or Neosporin (combination of Neomycin, Polymyxin B and Bacitracin) twice a day. You also need to keep the area clean and dry. They are benign and harmless and nothing to worry about. It could have been easier to confirm if you had sent a picture along. You could do an image search for sebaceous cyst and confirm yourself. For further information consult a sexologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having loose motions and stomach cramps. Can you suggest a tablet?\n\nHello doctor, I am 50 years old lady. I am having loose motions and stomach cramps for the last two days. Can you suggest a tablet?",
    "doctor_response": "Hello. I suggest the following: Consult a specialist doctor, discuss with him or her and start taking the medicines with their consent. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood clotting and pigmentation after donating blood?\n\nmy name is ramkumar from hyderbad male is age-30,weight-79,heught-5.5. the thing is exactly last week saturday morning iwas donated blood to heart patient in durga bhai deshmukh govt hospital,vidyanagar,hyd.since dan i am facing problem of blood cloting in my right hand and becoming very black color.present iam using thrombophob ointment for this problem.last in april in kamineni hoaspital iwas donated blood to pregnant patient and at that time i was fine and i never faced like this problem.please solve my problem????",
    "doctor_response": "hi, after donating blood hematoma formation occurs some times, its not at all worrisome. its just due to some technical error at time of venepuncture. so some amount of blood goes outside the vein in surrounding tissue. it will produce black colour. just relaxed. it will become faint later on and will go away after few days. just apply some ice on it,. no any treatment or intervention is required. you are absolutely normal. dont worry.thanks for using health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yellowish on bottom of eyes, bulging where gall bladder was removed?\n\nI RECENTLY HAD TO HAVE MY GALL BLADDER REMOVED. IT WAS FULL OF STONES. AFTER IT WAS REMOVED, THE PROBLEMS PERSISTED. I CALLED THE DOCTOR AND TOLD HIM, AND HE SAID I WAS HAVING PHANTOM GHOST PAINS. LOL. AFTER GOING TO THE LOCAL ER MANY TIMES THEY FINALLY TOOK ME BY AMBULANCE TO MARYLAND UNIVERSITY, BECAUSE I WAS JAUNDICE, MY LIVER WAS INFLAMED, I HAD PANCREATITIS, DEHYDRATED...ETC..... THEY HAD TO GO IN AND REMOVE 9 STONES THAT WERE BLOCKING MY BILIARY DUCTS. I DO NOT HAVE ANY OF THE PROBLEMS THAT I ONCE DID, BUT THE BOTTOM OF MY ETES ARE STILL YELLOW, AND I FELL LIKE I HAVE SOMETHING BULGING INSIDE OF ME ON MY RIGHT SIDE WHERE MY GALL BLADDER WAS REMOVED. COULD IT BE A HERNIA?",
    "doctor_response": "A hernia is a defect in scar or your abdominal wall which is mostly visible as a separate bulge (outward) on your abdomen.you can check it by coughing or straining if the bulge increases the its hernia if not then you can have your check up with any docter to examine you for hernia",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a lump in the armpit be a precursor for melanoma?\n\nI had a lump in my armpit which lasted for a few months. I didnt do anything about it and it disappeared. Then a few months later I was diagnosed with melanoma on the same arm which had the lump under it. The lump has never come back but do you think its connected to the melanoma?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  Your lump in armpit is not related to melanoma. It may be due to some reactive hyperplasia of lymphnode.  It is not precancerous for melanoma.  Consult your doctor and take treatment of melanoma. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for kidney related dysfunction\n\nSir, my maternal uncle has problem related to kidney dis function, the cretanine count is 14 mg/Dl, Urea 261.08 mg/DL, Uric acid 10mg/Dl, Haemoglobin 4.00 g/Dl, the problem seems very serious, we are poor in money can't afford expensive treatment please help??",
    "doctor_response": "Hello, seeing the reports patient is in serious condition and needs urgent hospitalization and treatment in ways of blood transfusion and hemodialysis and other supportive care. If affordability is a problem you can always go to government hospital for treatment or any medical institute where patients are treated free or at very nominal costs. Kindly take quick action and get him hospitalized as he needs urgent care. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for jaundice\n\nhi i suffering from Jaundice from Nov 2011 still it is not recover  I am on full diet like not having spici, oil, nonveg etc. Taking Tablet Liv52ds & Liopill  My Burlibin is t 1.72 & d 1.32  I getting leg pain  heavely  Plz suggest me the soluation",
    "doctor_response": "Dear Friend.Welcome to HCM. I am Dr Anshul Varshney.   I have read your query in detail. I understand your concern.We need to find out the cause of Jaundice.It might be Gilbert syndrome.But i can comment better if you can get me following investigations:1. Liver Function Test2. Viral Markers3. Ultrasound Abdomen.Review with me once you have the reports.This is my best advice for you based on available details. If you have any further query please ask me.Stay Healthy.Dr Anshul Varshney,  MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could lumps behind ear with oily discharge suggest?\n\ni have a lump behind each ear with slight oily discahrge if i sqeeze it which smells a bit of cheese! i have had these for over a year and im quite worried. they seem to go down in size after i have squeezed them but there is always a little grain left which i cant get out! should i be worried??? please help!",
    "doctor_response": "Hi,Dear,Thanks for the query to HCM. I studied your problem in depth and I understood your concerns. Cause of post-auricular lump behind both ears-The recurring lumps which you squeezed were of Sebaceous Cyst,which has cheesy white sebaceous or cheesy material which is oily.I would advise you to consult ER Surgeon and Excise it completely under antibiotic cover.so keep cool and Consult your ER Surgeon, if need be , who would treat it accordingly.So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you, but just ask a query to HCM and be comfortable to resolve your health issues.Welcome for any more query in this regard to HCM.Write good resume and Click thanks if you feel satisfied with my advise.Have a Good Day.Dr.Savaskar M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Restless feeling, sleeping all the time, weightloss, no interest in life and sex.  History of multiple family problems.  Visit to doctor needed?\n\nI am concerned about my boyfriend.  He is 42 yrs old and in good health.  In June his 45 year old brother passed away unexpectedly.  Approx two weeks later he lost his job.  His employer required him to work out of state for an undetermined amount of time.  He went to work and realized he could not be alone and asked for more time off.  They fired him.  He returned home and approx 6 weeks later he was robbed.  He lost personal items and work  tools.  This past week his pet died.  He has been sleeping all the time,  says he feels restless and cant sit still when he is awake,  has lost some weight and has lost interest in golf (this was a passion before) and his interest in sex has stopped.Is this still \"normal\" for the time frame.  What can I do to help him.  At what point do I become concerned that he should seek medical help for depression and how to I talk to him about it.",
    "doctor_response": "HelloA lot of significant events happened to him in a short period of time like death of a near one, loss of job, robbery and then loss of pet. These things have cause significant psychological trauma to him and this is causing depressive symptoms like lethargy, restless, loss of interest, poor sexual desire etc. He is in Adjustment Disorder with depressive symptoms. Best way is to talk to him regarding his low mood and then consult a counselor for help. If no improvement occur with counseling then consult a Psychiatrist for help. He really need treatment as if not properly given attention he may go into full blown depressive episode.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I hold my urine ?\n\nI am a 44 year woman,have 3 kids by operation, sine many years have problem With holding urine when I have cough. Pls suggest any exercise? I am good in general health, no health issuesat all single problem is the urinary problem.",
    "doctor_response": "Hi well come to HCM. If your urine reports are normal exercise for pelvic  and perineal muscle may help you. During coughing there is increase in intra abdominal presure which adds pressure on bladder in addition to pressure by collected urine. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could fatigue and muscle weakness be due to cholecystectomy?\n\nHi ,I am 66years and i had a cholecystectomy operation five years ago without any complication but since two years i am suffering progressively from fatigue and muscles weakness. I am taking regularly supplements like calcium , vit D3. My PTH hormone is usually a little high. vit D sometimes a little low and bone densimetry normal . In addition I have sever sleep apnea and I use generally CPAP. my EMG is normal. I want to know if at long term cholecystectomy cause fatigue and muscle weakness in my case . best regards",
    "doctor_response": "hi.your cholecystectomy 5 years ago is not related to your fatigue and muscle weakness. and the course of your surgery seemed unremarkable from the time of your operation. you have other medical concerns which are more important to look at. a consult with your doctor is best for physical examination and clinical evaluation. diagnostics and management will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain and swelling above the ankle after an ACL tear be treated?\n\nI thinkI have a small ACL tear in my right knee. It is swollen from above to my ankle. I feel pain if Ibarely twist my leg. My calve feels like I have had severe charley horses..sore. The more I sit, the stiffer my leg feels and I can\u2019t hardly use it. It loosens up the more I walk, but the pain is still there.. it\u2019s like a catch 22",
    "doctor_response": "Hello, Consult your orthopaedician and get an MRI scan for further assessment. We have to suspect ligament sprain or injury. As of now you can apply ice-packs and can take analgesics like paracetamol or Diclofenac for pain relief. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is iron supplement prescribed for?\n\nHi, Doctor Rynne:My doctor said that my blood shows elevated levels of red blood cells and ordered a 2nd test which was normal. Next he told me to buy SlowFE , an iron supplement. Is my understanding that iron promote red blood cells in the blood. Why he prescribed iron?",
    "doctor_response": "Hello,Iron is a part of hemoglobin which we need for oxygen transport to every tissue of the body. Your iron store may be low for which you should take it. Improve diet which contains iron like leafy vegetables, spinach, jaggery and citrus juice which increases iron absorption capacity.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhadresh Lakhani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling and black discoloration around the eyes in children\n\nMy 4 year old daughter bang heads with another little girl a couple of days ago while on holiday. She had a pretty bad lump but it s gone down and both her eyes and nose are now swollen and black. We are due to fly home tomorrow I a little worried and was wondering if she will be OK.",
    "doctor_response": "dear userthese symptoms of Swelling Black eye is because of ecchymosis caused by bleeding into the layers of the skin of the eyelids as a result of injury or traumayou need to consult your doctor for examination to rule out eye injury.Meanwhile, I advise to take anti-inflammatory meds like ibuprofen or paracetamol and give her erythromicin local antibiotic cream head injury(only minor in this case),and eye pain on bending forward is suggestive of some retro-orbital collection(hematoma).This may need antibiotic treatment to prevent complications like orbital cellulitis.also try for  application of ice packs for 10-15 minutes almost every hour. It will take a few days for it to resolve.if any  increase in swelling, pain or any discharge, I would suggest you to consult with a doctor in your area for a proper examination and management as it may be due to an infection.wish you healthy life",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing pain during heart beat\n\nMy question is -- sometimes I can feel my heartbeat hurt a little beat. With each beat, it is a very faint, but noticeable pain. What could this be? Its not always, just once in a while. I can feel it in the center of me (where my heart is) and in my back some, too.",
    "doctor_response": "HelloChest pain may be due to many causes like cardio-pulmonary causes,refulx etc.It important to know your age.It is safe to exclude cardiac causes first.You may need proper clinical examination and few investigations.Investigations include routine hemogram,random blood sugar,liver and renal function test,lipid profile,urine RE/ME,chest X-ray (PA view),ultrasound of abdomen,ECG,TMT,ECHO.You may need further test like angiography after these initial tests.Proper treatment depend upon findings.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for itchy lumps along jaw line and around neck with no help from antihistamines\n\ni have these lumps along my left side jaw line and round my neck in like a circular patern and are really itcy at night, one doctor says it may have been swollen glands so i tried a 7 day coarse of antihistimines but nothing changed, worse if anything.",
    "doctor_response": "Hi,From history it seems that you might be having tinea infection, a fungal infection.Apply anti-fungal cream or lotion on affected part.Take antihistamine like Cetrizine for itching.If require go for one oral anti-fungal medicine course.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic muscle pain\n\nI have been having muscle pain for a long time. Legs ache, hips, shoulders and neck are so tight that I have a headache most days. While in bed my back, hips, butt, neck, shoulders seem to almost get stuck. Almost feels like I have Charlie horse in my butt cheeks, and hips. When I wake up it hurts to move, I can t explain the muscle pain. I feel like I get stuck I used to say it feels like my spine will snap if I bend over. I can only be up on my feel moving for an hour or two before the pain gets bad, mostly my hips and lower back muscles get tight and ache bad.",
    "doctor_response": "Hello, I have studied your case and reports with diligence. there can be severe degenerative changes in whole lumbar spine with disc space reduction. there can be degenerative wear of bones, muscles, ligament and facet joint arthritis, due to deficiency of calcium, vitamin D, VIT B12.so supplements of these nutrients can relieve pain.Check your bone strength with DEXA SCAN and you can start medication according to level of osteoporosis,And also check your vit B12 and vit D3 level.I will advise you to do regular physiotherapy and exercises as my patients find much relief by these therapies.You may consult physiotherapist for guidance. He may start TENS, or ultrasound which is helpful in your case you need to take diet rich in calcium and vitamin D.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you find this answer helpful do not hesitate to rate this answer at end of discussion. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for mild chest pain\n\nhi there, just concerned...I am a 46 yr old female. Not overweight, average size...been having minor chest pains for the last 4 hours. Its not heartburn...but it feels painful off and on around my heart. My heart rate is normal...my heartbeat is not racing, I have no symptoms, like dizziness or sweating...should I be checking into emerg or doctor?",
    "doctor_response": "Hi thanks for asking question.You have chest pain only since 4 hour.Here are the possibilities.First possibility of simple muscular pain is more as no other symptoms present,it may result from excess weight bearing or improper sleep posture.Simple analgesic is taken.Second if associated headache, sore throat or runny nose present then chances of viral infection is there.Symptomatic management done for it.Third if sweating along with increasing constricting chest pain then ECG is done.If cough and breathlessness is present then chest x ray done.Just now take it as simple muscular pain and take analgesic for  that.If no relief then further work up done.I hope my suggestion will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for constant pain on left hand and chest\n\ni have pain with inflamtion in my left hand and chest from past 7 yrs.I was afraid of heart related problem and have taked lot of ecg and test which showed that i hvae no problem,but i still i have this problem.i want to know the ecxact problem and remedy for this.can you help me in this matter?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, possibility of musculoskeletal pain is more likely. No need to worry for heart related diseases. Avoid stress and tension, be relax and calm. Avoid movements causing pain. Avoid heavyweight lifting and strenuous exercise. Apply warm water pad and ice packs alternatively on affected areas. Take combination of painkiller and muscle relaxant drugs. Do all these for 1 week and you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for fever and nasal congestion in a baby?\n\nMy daughter (4 years old) is having fever and nasal congestion since yesterday. Her fever is under check by giving her crocin suspension every 6 hourly. We also gave her steam 3 times today. While the symptoms look viral infection, she is having trouble due to nasal congestion. Will recofast be the right syrup for her?",
    "doctor_response": "Hi,It seems that she might be having viral infection and will be alright within 3-4 days.You can give Recofast syrup to get symptomatic relief from congestion in the nose.Put Otrivin pediatric nasal drops.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had wisdom teeth extracted, aching, pus oozing out. Is it minor infection?\n\nHello.  My other three wisdom teeth (top and bottom left) have all come in straight and I have not needed to have them removed but my lower right wisdom tooth is cutting through the gums right now and for the past 9 days, I have experienced some aching near the site.  (Nothing too severe, mostly just a dull ache.)For the past 5 days, I have had some pus oozing out from underneath the gum where the wisdom tooth is erupting.  The pain is mostly gone, but I am wondering what I can do to bring the bad-tasting/ smelling pus flow to a halt.  I do no feel the need to go to the dentist or doctor since it appears to be improving day by day.What would your suggestions be?  Do I require antibiotics for this minor infection?Thank you!",
    "doctor_response": "Hi,Thanks for asking the query,According to your symptoms i suppose that you have developed infection at the site of extraction this could be due to food lodgement or there could be presence of any broken root peice a x-ray of the region is required.At home take lukewarm saline and antiseptic mouthwash rinses.Take  a course of antibiotics and analgesics.Avoid consumption of hot and spicy foodstuffs.Hope you find this as helpful,Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring fever?\n\nhi Doctor, i so worry about my 20 month old daughter now.every thing happen when she was 15 month and that was at the same time we replace the carpet. After we replace the carpet a few days then she got a runny nose, cough then fever but the fever last for only a few hours and go up to 101.It was 3 time in1 month. Then we decided take the carpet of and a week later we but another new carpet down, and this time we got the 100% natural wool carpet with out chemical and the padding too. but it have very strong barn smell,i mean like animals wet hair and crap.About 10 day later she got sick and fever it go 103,7 for 7 day and then i took her to the er room they xray her chest and told me she got a pneumonia viral and give her antibiotic and 2 time a day at home , but the next day she did not get any better so i took her in again and they tell me it wasn t but some other tricky viral. And her fever gone after 5 days ( total was 12 day).this is her fever history Jan 3 time up to 101for a few hr, Feb1 time 12day fever up to 103,7. Mar 1 time 4day up to 102,6. Apr 1 time up to 103, May 1time 2 day but very tired in 10 day, and jun100.4 in 1night but look tired and her head very warm and sweat like she taking a shower. it happen since May with her sudden fever. Is there some going on Please help. Thank you Doctors very much.",
    "doctor_response": "viral fevers can get repeatedly depending on child s immunity ,surroundings and exposure. if fever is not subsiding u need to evaluate for any rare conditions but its unlikely.medicines as prescribed by ur pediatrician are sufficient.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for paining and swollen knee?\n\nI fell a about a week ago on my knee. It is still swollen, hard to walk on, with burning pain and sharp pains constantly. Pain meds not working. I ve tried a knee stabilizer brace with rest & ice, no help. Pain shoots up and down leg from knee as well.",
    "doctor_response": "Hi, thanks for writing in to HCM.kindly take stronger pain medications like combination of paracetamol 500mg and aceclofenac 100mg twice daily for three days.Along with that you can apply diclofenac gel locally on the affected area.Also kindly visit an orthopaedician and get an X Ray done.Apply hot compresses for relief.Regards,Dr.Riyanka",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the lower back?\n\nThe physician at Urgent Care thinks I passed a kidney stone on Friday of last week. Now my lower left back is aching. Am I likely to have another kidney stone or could this be a kidney infection? I can t get in to see a urologist until May 9th! Suggestions?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. What kind of pain is this? Is it severe pain that comes and goes? If yes pain is most likely due to renal stone passing through ureter like colicky pain. If pain is constant type that relieves on rest likely cause is mechanical back ache. I would like to advise X-ray of KUB  to check for the renal stone? If report shows stone you need to consult urologist. Kidney infection is less likely as fever will be there. If report is negative for stone pain may be originating from back. In that case visit to spine specialist will be needed. You van take tab Ultracet for pain relief. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will indulging in excessive masturbation lead to premature ejaculation?\n\nHello doctor, I am 24 years old. I am having a problem with premature ejaculation. And I am afraid as I have all symptoms of premature ejaculation due to excessive masturbation. I need your help.",
    "doctor_response": "Hello. I am sorry to hear that you are facing premature ejaculation problem. Before we proceed we need to identify the cause of the problem. In some case, it occurs from initial time and known as primary. In few others, it occurs after a normal sexual period and known as secondary premature ejaculation. I hope you read my article at icliniq regarding premature ejaculation. If not, first of all, I request you to read it completely to know the basic information. Once you read it revert back to me with the following details. Your duration of problem. How the problem started whether it was on-off or continuous from the beginning? Frequency of the problem in a week or in a month out of what number of sexual interactions were a failure in a month? What are the factors that increase the problem? Factors that relieve the problem thoughts, situations, partner, place, etc? Your marital status and partner details, is she very critical, demands sex more than what can you think, does she feel superior to you? Effect on your relationship so far? Details of medical illness, if any? Medications you are receiving currently if any? Your description of the problem. Once you post these details I will try to analyze the cause of it and will suggest you accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are chances of conceiving after taking unwanted 72?\n\ndear sir i m a newly married girl i got my last period in the month of october 2011i.e 17th october i had sex wid my husband on 5th nov by using condom but since i was scared as i dont want to concieve so early i had taken unwanted 72 at night on the same day of having sex i.e after 10 hours but i m not sure whether i m safe or not as i hve heard dat after taking the pill one has an extra period before the exact period date my coming period will b on 17th nov plz help me am i safe or not as i didnt had any extra periods till now i m very worried as i wnt to built my career first",
    "doctor_response": "dear Ms. I understand your concerns but the unwanted 72 pill is safe to use and doesn't cause any extra periods. it has the sucess rate of 97% so you did right using it with a condom to increase success rate in preventing unwanted pregnancy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have MS and unable to take medication for achy legs and hip due to side effects\n\nLately when I lay on my right side, my legs feel achey and so does my right hip.  I do have MS and not able to take the medications due to severe side affects.  This has been going on for over a month now.  My legs do not go numb but they feel like they want to go to asleep like an achey feeling.",
    "doctor_response": "Hello,The best treatments are to do warm soaks on your legs and get a physical therapist to work with you on improving strength and mobility of your legs.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is a normal lung function level for a BAC test?\n\nI am a women age 64 who has never smoked, but have had asthma my whole like with 3 different scratch bac test starting at age 5 to about 41. It under control I do get exercise induce asthma . Its nothing that makes any difference to my life. I went to the doctor today about something simple and they did a routine specter on my finger. It was 92, I live in Kansas, not a high alitude. I have never had a 92 before it alway a 98 97 or 100 per cent. I want to know what the average number is for a woomen my age, I realize it is average. The reason I am concerned is because I have Alpha One anti Tripten lung inherited gene from each parents. I am on of the luck ones , I have never had any lung problems. My lungs last test was quote a few years ago. I have taken the IV prolastin once a week since 1990. I still feel no problems what so ever. The nurse said it was normal because I had been talking and stuff. I should know the answer to this but I do not. I just want a number for a normal lung function. Then I can take it from there, my doctor in Coloado said my lungs were so good I could not take medicine and mabe have no problems until my 70. 92 seem low to me but its been quite a few years 10 or so since my last visit, I have no pulanologist SP doctor is my small town in Kansas. Thanks Doctor\u2026. Linda",
    "doctor_response": "Hi, A Well 92 is a low value and I cannot say it is a normal one. You should definitely be seen by a pulmonologist who fir sure will order an arterial blood gases test for you. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jnikolla, Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have diagnose 16mm endometrial, Is it any other treatment beside operation ?\n\nDear Doctor, I have diagnose on the 11th Nov 16mm endometrial. my period started 20 october for 6 days or so. the doctor want to clean out the lining through operation, but I m concert will it be thick again after the operation, and what if the operation will cost infection ? Is it any other treatment beside operation ? looking forward to your asker. Many thanks, Sally",
    "doctor_response": "Dr.Khaleel . India ,Mob - 9902596161 , khals2000@yahoo.co.in Phase                  Days            Thickness                 Epithelium menstrual phase     1-4               thin                      absent proliferative phase   4-14              intermediate       columnar secretory phase     15-28            thick                     columnar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes long lasting cough and congestion?\n\n5 days ago I had the following sysmptoms. Fever, Chills, Chest congestion without any mucous coming up. Pain in Chest. Head aches. Continuous uncontrolable deep coughing but no phlem or mucous. Sinus congestion but no runny nose. So fatigued could barely get out of bed. I called my doctor but was to sick to make an appointment. He prescribed me Doxycyclin Hyclate 100mg 14 pills. I still have 2 days worth left to take. All my symptoms have finally subsided except for the dry cough but chest still feels congested and I cannot cough anything up. My wife is sick with the same her symptoms started 3 days before mine. Her symptoms have subsided aswell except for the cough and chest congestion. My question s are, was this just Flu and also how long will the congestion last?",
    "doctor_response": "Hi, Yes, the possibility of viral upper respiratory tract infection (URTI) is more likely. URTI can lead to bronchitis which causes chest congestion. Usually, this is self-limiting in 1-2 weeks. So drink plenty of fluids orally. Do warm water gargles and steam inhalation 4-5 times a day. Take an antihistamine and anti-inflammatory drugs for faster relief. If not improving after 1 week then consult a doctor and get done chest X-ray to rule out lung infection. Don't worry, you will be alright with all these. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Kaushal Bhavsar, Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for loose motion in hepatitis b positive patients\n\nhello dr. im 22 yr old (female). Im a hepatitis b positive patient i have symptoms of vomiting, low chest pain,giddyness,i have undergone all tests all are normal except hepatitisb postive, i.e anti hbs is negative,anti hcv negative, anti hbe positive,hbsag negative etc..these test were done in july first week.. now im getting motion in black colour.. plz suggest ..",
    "doctor_response": "Hi thanks for contacting HCM..Noted you are giving history of positive acute hepatitis b...Here In your report HBSag negative with negative other antibody also....So chance of acute hepatitis b is less.Even if you are infected with hepatitis b virus it might be resolved now....Take low fat diet.Include more fruits and green leafy veg in your diet....One tsp crushed carom and cumin seed with water taken in morning.Repeat test with liver enzymes and viral marker after few days...If needed molecular methods or ELISA used for viral marker study....Take care....Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from anger attacks, throws and breaks things during attack. Has dizziness and nausea on taking Arip. Suggestions?\n\nHello, I am from India. My husband has problems of anger attacks. He gets angry very easily on simple things and he also has mood swings. When he gets angry, he cannot be controlled. he throws things, breaks things and even once tried to put things on fire. He also beat me one day hard during his anger. I took him to a psychiatrist and he gave him Arip Mt 30 mg, but he is not willing to take it after taking 3 doses as he is experiencing nausea and dizziness . Kindly suggest.",
    "doctor_response": "Hi there ~ It is not uncommon to experience anger and physical aggression in psychiatric disorders.  Your husband seems to be having problems with mania which is common is bipolar disorder.  I am thinking that your husband gradually got worse over time and assuming this, it is easier to put someone on medications and try to wait and watch for results.  However, symptomatic treatment is recommended in acute and subacute cases and anger management or sleep management might be of initial use before going on to titrate the dose of the mood stabilizer, in this case Arip MT.  It may also help to seek the expert advise of a psychiatrist regarding medication changes and a counselor to help with any stressors/family problems. I hope this helped.  Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for constipation\n\nmy sixteen yr old son went to the dr this wk for back pain,x-ray showed he was completely full of bowels...he told him to take two dulcolax then drink eight doses of miralax put into 64ozs of gatorade he did this and since has been going..but no substance just liquid..i m concerned he s not actually getting out the hard substances?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. 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 (fibre diet) appropriately?Suggestions:1. 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.You can answer the questions at the following link - www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicine to gain fat on my face\n\nHello doctor I am 24years old I want to gain fat on my Face which gives chubby cheeks. My cheeks are very less which does not give fresh and younger look for me. My face looks too narrow could you please help me out with best medicine rather than surgery",
    "doctor_response": "Hello,For the chubby cheeks I feel you need to observe healthy life style as there are no medicines to cause accumulation of fat under the cheeks. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ashok Kumar, Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What makes me getting suicidal thoughts and avoid marriage?\n\nHello doctor, I do not know what disease I am suffering from but it is killing me deep down. I do not want to get married, my parents are forcing me. Please help. It is going on from past 3 to 4 months. At times, I feel like going away from the house or to kill myself but then I see towards my family and the idea of dying gets ruled out. I was suffering from mild depression but my parents do not know about it.",
    "doctor_response": "Hello. Let us summarize your complaints, thoughts of running away from the current situation, occasional suicidal ideas, avoidance of marriage. Marriage is a cause of joy but it is a stress in itself. So, maybe you are trying to avoid further stress because you are overwhelmed with the stress of your current life. Besides, medical education is tremendously stressful and enough to cause depression in the vulnerable.  Besides, you give a history of mild depression in the past. If you are having suicidal thoughts, even occasionally, it is a marker of severe depression and needs treatment by a psychiatrist. Other symptoms of depression include sadness, loss of interest in previously pleasurable activities, change in sleep, appetite, weight. Anxiety, guilt feelings, pessimistic thoughts, if you feel that you also have these symptoms, then it is likely to be a major depressive disorder. It can be treated with antidepressant medicines like Escitalopram or with counseling, psychotherapy with a psychologist. If you do not have these symptoms, then we will have to search for other causes of your current complaints. Send follow up to this query if you have any other symptoms. Take care. Consult a psychiatrist privately for more help, information, and guidance about depression and its treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe back pain\n\nMy mother is 70 years old and has continuous pain in her back. The pain does not subside with painkillers but goes away temporarily after taking pregabalin which the doc has given her. But if she stops pregabalin the pain returns after a day or two. What are possible treatments to solve the pain ?",
    "doctor_response": "Hi, Welcome to HCM. As pain is relieved by pregabalin, it seems nerogenic pain likely cause is vitamin deficiency.So METHYLCOBALMIN 1500mg daily for nearly one month may be of use.Hope your query answered.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could a swallowed piece of broken tooth cause a chest infection?\n\nI swallowed a piece of broken tooth last week and can still feel it moving in my throat, it shows on the xray but when they go down with a scope dont see it so they said nothing is there even tho a xray shows it...so now my throat and chest feels super tight and hurts and I cant breath it feels like I have a nasty chest infection from it....should I be worried it is indeed there and causing this?",
    "doctor_response": "Hi. I can understand your concern. CT scan of the chest would be ideal in your case to identify the exact position.So better to consult pulmonologist and get done clinical examination of respiratory system as well.Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe for the baby if concieved even after taking Mensovit plus tablet?\n\nHi Doctor,We had sex just 4 days prior to my period and for safer side, i had taken mensovit plus(6 tabs/2 days). but I didn't get my periods still yet. its already delayed by 10 days now. If i m already pregnant, shall I continue my pregnancy,  mensovit will do any harm to my pregnancy?",
    "doctor_response": "Hi & Welcome.Mensovit tablet is used to regularize the period when there is a delay.It is not known to cause any harmful effects if taken during pregnancy.Continue taking the treatment as prescribed. If your period is delayed by 10 days or more do the pregnancy test and consult your treating doctor.Hope this answers your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high sugar levels during pregnancy?\n\nHello, I m 27 weeks pregnant and just had my GD test. My results came back today and my fasting sugar level was 141. I m going in next week to take the 3 hour test, but I do have a sinking feeling that my sugar will, again, be high. My question is, is 141 considered very high for a fasting sugar level? Thank you, Sally",
    "doctor_response": "Hi Sally,Pregnancy, especially the later months can make women who are prone to get diabetes in the future have high sugar levels. Yes, 141 is a high value and you need to have a detailed sugar level done. Also you need to take care of your diet and check your sugar levels before and after meals.You will need the guidance of a physician trained in endocrinology or a obstetrician with special interest in diabetes in pregnancy.Also we need to monitor your baby, as in women with high sugar levels there are chances of baby putting on excess weight and also increased water around the baby, this may also need early delivery and you may require insulin injection on a daily basis to keep the sugars in control.Best to see a physician soon.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high fever in evenings?\n\nmy husband gets very high fever around 103F every evening for the past 10 days. No cold. Stomachis hot. Headaches. Sore throat is better but no change with respect to fever. It is as high as the first day. Initially doctor prescribed Azithromycin for 5 days. It didn't help. Then he has changd the prescription to Levaquin 500 for 10 days. It is the 4th day, bu there is no change. Actually the temprature shoots up after taking these medicines( both azi and leva). Please help.. What is it happening with him?",
    "doctor_response": "Hi,From history case of your husband requires evaluation as after courses of two antibiotic there is no result.Go for, Complete blood checking like TC, DC, ESR, Platelet count etc.S. Widal test for typhoid,Routine urine test,X-ray chest.After all report proper diagnosis should made and treatment can be decided accordingly.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes slow growth in 4 1\\2 year kid?\n\nHi Doctor, My child age is 41/2 years but he looks likes 3 years baby and he has tonsil. My question is because of tonsil he is not growing or what is the problem.He has not eating well everyday. And did tonsil and thyroid is the same? please help me.",
    "doctor_response": "Hi,Welcome to Hcm,First of all tonsil and thyroid are two different organs. Enlarged tonsils causing poor growth is not known. However enlarged thyroid can happen in thyroid hormone deficiency and it can lead to poor growth. Before analyzing all that, its mandatory for you to confirm objectively if he is actually having poor growth. No point comparing him with his age other kids, every child is unique. You need to get his height, weight checked correctly and plot it on standard growth charts and if he falls in normal range then need not worry. Children of this age dont eat as parents expect. Make sure he takes nutritious food what ever he eats. Happy to clarify further doubts.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swollen forehead after popping pimple. Does this require a visit to the ER?\n\nI am a 27 year old male with very little history of acne . I (foolishly, I know) popped a forehead pimple which was roughly a half in diameter and a quarter in raised. Then, I applied an OTC topical acne cream to it. About 2 hours later my forehead skin felt tight so I looked in the mirror and literally my entire forehead is swollen--swelling stops at all hair lines; scalp, eyebrows etc. I believe it is called pitting edema because if I apply pressure the dent remains. The swelling is of normal skin color, not red (other than the location of the pimple). Does this require a visit to the ER? Will warm compression help? If it does require a visit to the doctor, is it urgent or wait a day or 2?",
    "doctor_response": "Hello, Yes, you should visit a doctor now because you possibly require the intake of antibiotics for this. Also, nonsteroidal antiinflammatory meds are also required to decrease the inflammation that has been associated with this. Hot compresses would also help. However, it is better if you make a visit to the ER now and get the required prescription so that you can start off the meds without delay.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair loss\n\ni am 26 yrs old ,, and today for the first time i have used tugain 5 for men ,, i am using this because my hair has become thin and loosin hair in less and minor quantity i ride on the bike n wear helmet since a year ,,, i guess that is the reason for my hair to such a problem tough not a major but i m worried ,, please help me ,, i tugain a solution for my problem ,, dipesh..",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You seem to have androgenetic alopecia. It is a genetically predisposed hair loss. It is not due to wearing helmet as is common believed. Androgenetic alopecia is characterized by hair loss and thinning from the top  mid and vertex part of the scalp. I suggest you to continue up with tugain (minoxidil 5%). In addition I suggest you to take an oral finasteride tab once a day for long. Both of these are approved remedies for androgenetic alopecia in males. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the causes for swelling in face and eyes?\n\nMy daughter is 26 years old, healthy. Has had a few allergy related conditions, but today she has very read swollen face and eyes. She has not used anything different on her face, no different products. But the swelling and redness and blotchiness is quite extreme.",
    "doctor_response": "Hello,Welcome to HCM,The symptoms of your daughter suggests me that she is a severe allergic reactions. She need to test her blood for absolute eosinophil count (AEC) to confirm for the presence of allergic reactions. I would suggest you to undergo skin prick test with different allergens like dust, pollen, mite, food and chemicals. By identifying the allergens causing the symptoms, your daughter can avoid the allergens. If it is not possible to avoid she can go for immunotherapy. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy with IVF-ICSI?\n\nJust had first IVF-ICSI 4 days ago, wondering about signs of pregnancy? My breasts hurt last few days but not today and I felt some cramping last few days but not today? I had 2 embryos ( own eggs) transferred and I just turned 44 2 days before transfer. PT is not for 1 more week. I have one child ( natural) when I was 32. I am giving myself Progesterone shots daily.Dr. said I did well with transfer and had 1( 2grade cell plus) and 1 ( 3grade cell plus) Don't understand this grading system so much. My fsh was 8 I think and estradial went up to 738 before retreival. I egg didn't fertilize but other 2 did ( one at 21 1/2 and one at 22 1/2) What are my chances and what symtoms should I be currently having? What should my BBT be reading now if I am pregnant? Also, weight is 245, 5 ' 8\" and just turned age 44. Pretty healthy no health issues. Just taking Pre-natal and Calcium pills. Also, will baby aspirin help with ( hopeful) implantation?",
    "doctor_response": "Hi, you won't get any symptoms now. It is too early. Get your bhcg test done on day 14 after transfer. Around that time, you may have bloating, acidity and weakness. Aspirin will help in implantation.  Hope I have answered your question.  If you have any other query I will be happy to help. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long fever will last when taking medication for TB?\n\nMy father is 60 yrs and has been diagnosed with Tb and he is diabetic also. He has fever for 2 weeks now and on the TV medication for last 2 months.. He is not eating anything what ever he is eating he is vomiting ... Dr plz tell for how long his fever will last and when will he start eating properly... I am very much worried... Plz help ...regards, kams",
    "doctor_response": "HI, thanks for using healthcare magicThe time frame of the fever varies, it would depend on his response to treatment.If he does not appear to be responding then his doctors would consider switching him to a different regimen.In terms of his diet, you may want to try a high calorie diet to help maintain or regain weight.Ensure drinks may be helpful in this instance. His doctor may be able to suggest a nutritionist who can help you with a diet plan.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can I do for the rashes that appear after I shave?\n\nHi doctor, I have been getting eruptions and rashes may be brown or red spots, sometimes inflamed spots on my face after I shave. I am 25 and this has been happening since I started shaving my face. They do not burn. Sometimes, even blood gushes out from them, but does not burn at all. I have tried changing shaving creams, brushes and razors. After a lot of modifications, I have settled with a brush, cream and razor with minimum rash. I had been to a dermatologist a few years back and he told me it was a\u00a0barber's itch. He also suggested me a cream and I do not recall the name of the cream, which did not work at all. Kindly suggest me what it is and what can I do about it. Thank you.",
    "doctor_response": "Hi. I have read your query and examined your pictures (attachment removed to protect patient identity). For further information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can one become pregnant despite a vaginal Bartholin cyst?\n\nCan I still become pregnant, while having a bartholin gland cyst? My husband and I have been trying to concieve for the last 7 months. I am 22, he is 29, we are both in pretty good shape and health he is 6 foot and 160 lbs and I am 5' 4\" and about 120 lbs.  Three days ago, I noticed a small lump on my vagina lip which got bigger and found out it was a bartholin cyst. Is it even healthy for us to continue to try?",
    "doctor_response": "Hi, you can try with a bartholin cyst. It will not interfere with your pregnancy.  But it can increase in size and get infected. So, better to get it removed. Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can aquaphor be used to cure allergic reaction for tattoo?\n\nI recently got a tattoo while in Los Angeles on vacation. My last day on vacation little bumps appeared under the tattoo design. When getting home, I notice the tattoo ink disappearing. I went to the hospital and the doctor told me I had an allergic reaction. I been putting aquaphor on it. What else can I use?",
    "doctor_response": "Hello,Unlike vaseline (100% petrolatum), which is occlusive, Aquaphor (41% petrolatum) acts as a moisturizer. Yes, you can use it three times a day and also take tablet levocetrizine two times daily after food for seven days.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Paparaja S",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life expectancy on a child suffered a massive brain aneurysm, CT scan showing frontal lobe and ventricles like scar tissue?\n\nMy nephew is 6yrs old. one year ago Feb 4 2012 he suffered a massive brain aneursym. No speech, breaths on his own, no responsiveness to speak of, open eyes looks around, no smile, only cries. Was shown a ct scan yesterday, basil ganglia, and frontal lobe and ventricles are now scar tissue. Is there any hope or is he gone forever? april Marshall",
    "doctor_response": "Hi,A child 6 years of age can be taught with the help of neuro rehabilitation techniques. The basal ganglia and frontal lobes are important areas of the brain. The amount of scarred brain tissue is not clear from your query. However by starting early rehabilitation, you can try to make his life better. He may not be able to perform like a normal child his age but then you never know if techniques like brain stem cell transplant hold a promising future for children like him.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for cold and blockage in nose\n\n2year 7month baby,14 kg weight.she have cold.her nose is blocked and she is breathing in her mouth.we consult the doctor she gave amydramine syrub and otrivin nose drops.i continuned one week but still she have same. main is breathing in mouth.what i will do?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.Cough and cold are viral 95% of the times in children. For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15mg/kg/dose (max ceiling dose 500mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.For cold you can use Cetrizine at 0.25mg/kg/dose every 12 hourly for 3 days.For nasal block, plain saline nasal drops will do, every 4-6th hourly to relive nasal congestion.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes increased heart beats with pain?\n\nhi. i've just woke up from the most terrifying experience of my life. It was only a dream, but I feel overly confiident that I could've died during this experience. In my dream I was hanging with my friends smoking when all of a sudden I felt a very real, and painful \"numbness\" I suppose in my head. This came and went in my dream and caused a lot of alarm. Everytime this happened, maybe a total of 4, I couldn't speak,and I went partially blind. and my thoughts felt very fuzzy so it was impossible for me to communicate this issue with my dream buddies. Anyway on the 4th time this happened my heart began to beat completely out of control, I would estimate 200 bpm. It was incredibly intense. This is when I woke up. my heart was still beating way out of control.I looked at the clock to see that i'd only been sleeping for 30 mins, but it'd felt like days. I am still shakey from this scary experience, as i've never encountered so much pain or had such a fast heart beat. My heart still hurts. Could I have died of heart failure? what happened?",
    "doctor_response": "Hello , You had a bad nightmare and during such an event there is suggest surge of sympathetic action  which would suddenly release a large amount of hormones like cortisol and adrenaline in the circulation which would make your heart pump faster and harder and the blood pressure to go up which would cause fuzzing.  If this was just an isolated event and you are otherwise young and fit , don't worry God has given our heart tremendous capacity to cope with such stress events . If you smoke , try decreasing and nd stopping the same . Regards Dr. Priyank  Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to confirm for west nile virus infection if there is headache, body ache and tiredness after mosquito bite?\n\nWest Nile has been found in our home town and my daughter whose immune system is not good do to meds she takes has been bitten by mosquitos and woke up feeling like shes sick headaches slight body aches and tired how can I tell if its the virus or not",
    "doctor_response": "Hello,Welcome to HCM,This is a arboviral disease which is transmitted by Culex mosquito, most of the times in human beings it subclinical (cause no symptoms).In the cases where symptoms occur it may be fever, headaches, fatigue, muscle pain or aches, malaise, nausea, anorexia, vomiting, myalgia and rash. Similar any other viral infection it will also have the symptoms.Diagnosis of West Nile Virus infections is done by serologic testing, virus-specific antibody IgM and neutralizing antibodies.You need to confirm your diagnosis by undergoing lab investigations.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do these lab findings of lung indicate?\n\nFindings: There is subcentimeter nodular and atelectasis bilateral lung bases. This extends left inferior lingual. No contrast liver, spleen, pancreas, adrenal gland, and the kidneys are grossly unremarkable with the exception of lobulated contour and scarring more pronounced lower pole left kidney with pseudotumor. Contrast-enhanced abdominal CT correlation can be obtained if needed. There is no evidence of any bulky retroperitoneal abdominal adenopathy, bowel obstruction, or ascites. Appendix is unremarkable. Moderately distended bladder in the pelvis. There are few scattered left colon diverticulosis. Impression: Few scattered left colon diverticulosis",
    "doctor_response": "Thanks for your question on HCM. In my opinion you should not worry much about your CT report.Subcentimetric atelectesis and nodules are common  feature in old age or due to past pneumonia.  So no need to worry much as it is  benign thing, not indicating any Infection or tumour.Pseudo tumour in kidney can also be normal variant and accidental finding.And if you are not having any abdominal symptoms than no need to do anything for few scattered diverticulosis. So over all your CT report is normal.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure hair fall problem?\n\nMy name is Puspendu Simlai from Kolkata, India. I am suffering from continuous Hair fall for a period of 7 years.First I used Minoxidill 2% but it incresed hair fall rate. Now I am using Arish Hair oil(an Aurvadic Oil) in an alternaitve days but can't get any positive result. What to do?",
    "doctor_response": "Hello, i explain everything about hair loss in point twise manner1. 100-150 hair fall every day is very normal. So should be consider hair fall if number of hair more than this.2. In male Male pattern baldness or androgenic alopecia is most common cause of hair fall.3. Straightening and other procedure also cause weakness of root4. Other condition like fever, ptyphoid, maleria, thyroid, etc also cause hair fall( less common)Treatment1. Have good sleep. food., green vegetables , fruits2. Take iron and multivitamines like follihair atleast 3 month.3. Check you blood hemoglobine if it is less iron and folic acid supplements should start.4. Check thyroid and diabetes to rule out other cause. 5. Use minoxidle 5% hair oil over hair thinning area.6. Final and last treatment is hair transplant which is a minor surgical method but have good results",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore throat , fever and stomach pain?\n\nokay, im a bi sexual 16 year old boy, i have had many sexual encounters in my life, all of them protected and no contact with blood or feces. recently i have gotten sick with a sore throat (white spots on both sides in the back and coated tongue), pain swallowing, a fever of 102 which has been kept down with tylenol, earache, headache, and stomach pains. I recently had 2 sexual encounters with 2 different men one on decenmber 31 2010 and then again on january 13 2011. please help!",
    "doctor_response": "Hello,First of all, I need to know if you had any sort of oral sex or not? Yes, it could be due to sexually transmitted infections as well. You should immediately see a doctor to test you for all sexually transmitted infections and treatment if needed.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sameen Bin Naeem, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure itching and burning of the scrotum?\n\nI've had Athetes foot for years, on the tops and sides of me feet, sometimes bad enough to soak my socks with clear sweat like fliud, sometimes not bad at all. Yesterday it moved to my scrotum, it began as an itch, and is now a burn and literally SOAKS any shorts or boxers im wearing. Powder hasn't helped, and anti itch cream hasnt help much other then allowing me to sleep. I have been washing the area 2 or 3 times a night as well as changing shorts.",
    "doctor_response": "Thank you for query.Please take following precautions.Use loose cotton clothesKeep area dry.Apply antifungals like terbinafine which is fungicidal.Once subsides use regularly antifungal dusting powders like candid or absorb powder to prevent recurrence.consult doctor if does not subside",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rashes in body. Suggested creams, allergic reaction but no improvement. Rashes on my vaginal lips. Right medication?\n\nHello I have recently come up with a rash all over my body I went to my doctors and all he done was gave me cream for scabbies even tho he wasn't sure what it was. He also suggest an allergic reaction. It seems to be getting worse and recently it is now on my vagina lips and I'm too embarressed to go speak to this about my doctor",
    "doctor_response": "hi. It is very difficult to know the exact clinical picture without examination. Is the itching more at night? are their any other family members affected? What is the distribution of the rash?if the answer to the above questions is yes, then most likely you suffer from scabies. Scabies is a hypersensitivity reaction/allergic reaction to the mite.Apply 5% permethrin cream after a scrub bath at night over the whole body except face, leave it overnight. Itching will persist or a few days even after you have applied the medicine properly. Take an antiallergic tablet like cetrizine once daily for itch relief for a weekIf the condition still does'nt improve after a week or so, then review with your dermatologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On implanon implant. Severe bleeding, dizziness and stomach pain. History of stomach ulcers\n\nI have the implanon implant for 2.5 years. I have had no bleeding what so ever until today, there s quite alot of blood & clots. I have stomach problems anyway, have had for a year & half. I also have 3 tiny ulcers . I just wanted to know whether it could be a period or not. I also feel dizzy & keep being sick, the sickness is normal since i had stomach pains.",
    "doctor_response": "Hi ! However effective the contraceptive device may be  and however least the chance might be, there is always a possibility that you might get pregnant unknowingly by chance. The pregnancy might have got miscarried partially and there are retained products of conception in the uterus resulting in passage of such clots or bleeding.The problem could also be due to a side effect of the contraceptive device you are using due to the effect of hormones.To know which is true, you have to get reviewed by your gynaecologist, who may advise you for a urine preg-test, a serum HCG and an ultrasound abdomen. If all these things are alright, then possibly it is time to rethink of the alternative ways of contraception without any hormone preparation.Wising you an early recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain with overweight\n\nI have chest pain daily usually after i eat...it s in left side of chest in my back in my arms. and i also feel pressure when i press down on the mouth of my stomach below my rib line. I had extensive test about two years ago which icluded ekg s and even a camera in my heart...Cholesterol is okay. blood pressure is ok..nothing was found...yet i still have pain almost every day. any ideas? I am overweight btw and always burping.",
    "doctor_response": "Hello, I have reviewed your condition and it is gastroesophageal reflux disease. Take tab Pantoprazole for 3 months, add domperidone to it. Avoid heavy meals, fast foods, lying down after taking meals. Avoid smoking, dairy products, alcohol. Avoid tight clothes. Raise the head end of the bed by about 15 cm. You will get relief soon. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Varinder Joshi , General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What signs should I look for in a newborn to see if he has a concussion?\n\nHello doctor, What is a concussion? What signs should I look for in a newborn to see if he has a concussion?",
    "doctor_response": "Hi. A concussion is an injury to the head and consequently brain, that is caused by a fall or a hit. The danger is baby might bleed inside the brain. Three danger signs to look for in a baby with a concussion are: The type of injury also matters. Sometimes even if no signs may be present, it is better that the baby is seen by a doctor. Usually, if the baby is fine for 48 hours after the injury, then it is unlikely that baby could have suffered a serious injury. CT scan of the brain is done to rule out any bleeds, in case of suspicion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why having pain in chest and shortness of breath even while walking slowly?\n\nI get short of breath easy.  when walking slowly and only a short distance I get a pain in the middle of my chest.  Doesn't spread out, just in the center of chest.  Goes away when I sit for a few minutes.  I had a cardiovascular stress MRI last week and it was normal.  Any suggestions as to what I should ask my primary Dr.  I am going for physical next week.  Thank you.",
    "doctor_response": "thanks for asking your question I completely understand your question chest pain in centre with brethlessness can be due to cardiac and lung related .you should visit a cardiologist and a pulmonologist whi can guide you regarding stable / unstable angina , any lung ailment by requesting a ecg , treadmill test , chest xray and accordingly diagnose the conditionthanks feel free to ask more questions may god bless you with good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes strep throat and sinusitis in a 5 year old?\n\nMy daughter is 5 years old..she just got over her strept throat about a week and a half ago..she has a low fever again today and has been very thirsty the last few days..she just doesnt seem to be healthy lately..in fact all three of my children dont seem to be very healthy..my 8 year old boy just had pnumonia the same time my daughter had strept and my 7 year old girl has sinusitis..what is going on? is it the time of year or are my kids just not healthy..worried about my 5 year old though..thank you",
    "doctor_response": "Hello, Welcome to forum. From the history stated it seems to be a viral infection circulating in your house Its very common among children, and usually occurs in many family members at a time. Please give paracetamol in dose as mentioned on the bottle and also sponge the child from top to bottom with normal tap water with every fever spike. Give the child plenty of fluids and rest. Disclaimer:This provisional advice provided by me stands subject to the actual examination of reports/image and is based entirely on inputs provided to me. It should be correlated with clinical findings",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do elevated bilirubin, creatinine and WBC levels indicate?\n\nMy brother-in-law is in the hospital. His bilirubin, creatinine and WBC is really elevated. He also has a lot of pain and jaundice. What could this be? Please help. They have already ruled out Hepatitis and Primary Sclerosing Cholangitis. Also, he doesn t have a gallbladder.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I can suspect also autoimmune hepatitis . Sometimes appendicitis give high bilirubin levels and high  Leukocyte levels. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a large lump in right breast?\n\nHi I noticed a lump bigger in my right breast than in my left, but I do not know what kind of lump is bad. I am 18 and I know it is very rare for it to mean anything but I have been feeling very sick lately. Sick to my stomach and my neck, back, and all of my joints have been hurting very very bad for the past few days. I have been getting headaches through out the day, and I do not know what is causing this. There is no way I could be pregnant.",
    "doctor_response": "hi.it is best if you consult with a physician, preferably a general or a breast surgeon, for clinical evaluation. benign breast lesions (such as cysts and fibrocystic changes) usually occur when there are hormonal changes (i.e. before during menses, pregnancy, etc.). breast ultrasound may be initially recommended. if lesions are found, diagnostics and management (medical and/or surgical) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest low budget medication for hepatitis C infection\n\nHad hepatis c and was treated two years ago with the pills and shots. I stopped doing drugs but started again and have hepatitis c. 11.0 I received the drugs first time free. Are the new drugs less costly ? Also I have been clean since February and have no plans to ever start again.",
    "doctor_response": "Hello,my name is dr.Dorina Gurabardhi.I understand your concern.Treatment for hepatitis C, depending on:-How damaged your liver is.-Other health conditions you have.-How much hepatitis C virus you have in your body.-What type (genotype) of hepatitis C you have.Treatment with a combination of antiviral medicines can fight the viral infection and prevent serious liver problems .I suggest you to see a gastroenterologyst for a proper treatment after an examination.Hope my answer was helpful.If you have any other question Ill be glad to help.Regards,dr.Dorina Gurabardhi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent pain in right leg?\n\nI been having pain in my right leg for over an year. Er doc said I be on it to much at work. Another doc did an exam and said I was health. He did the knee reflect test. We ll I been off an week just relaxing g and the pain return after 3 months. The pain is so bad I stop while walking. It hurts when I sit and stand. Sometimes I grab on to something so I want fall. Please help me. I haven t fell or anything, haven t been in a accident or notjing.to injury myself",
    "doctor_response": "Dear Sir/MadamI have gone through your query and read your symptoms.In my opinion, your symptoms could be due to neural compression in the spinal cord, you will need an MRI for the diagnosis of this condition.I hope that answers your query. If you want any more clarification, contact me back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for breathing problem and chest pain\n\nhi, i am 29 years old married woman. since last two days i am having chest pain in left side. i can't breath properly. i often have this problem, but this time it is so much painful. i am out of country now so it is quite impossible to see a doctor but i have all first aid medicines with me please tell what to do?",
    "doctor_response": "Hi thanks for contacting HCM...You are mentioning you have breathing difficulty many times ....Do you have asthma like allergic condition...???For guiding treatment cause has to be known...If you have repeated such attack by allergic infection then steroid or salbutamol metered dose inhaler taken if handy....Steam inhalation useful for relieving inflammation...Sometime this symptom can occur by lower respi infection...For that antibiotic given...But here if nearby clinic available ECG done to rule out cardiac cause.....If needed Echo done later on....Take care....It is better to find doctor there for proper physical examination..Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What type of cancer causes painless hematuria and frequent urination?\n\n1.\u00a0\u00a0\u00a0\u00a0\u00a0 A 50-year-old industrial chemist presents with painless hematuria.  On further questioning he also describes urinary frequency and urgency.  After additional testing, a diagnosis of bladder cancer is made.  The patient\u2019s cancer is most likely which of the following types?a.\u00a0\u00a0\u00a0\u00a0\u00a0Adenocarcinomab.\u00a0\u00a0\u00a0\u00a0\u00a0Papillomac.\u00a0\u00a0\u00a0\u00a0\u00a0Sarcomad.\u00a0\u00a0\u00a0\u00a0\u00a0Squamous cell carcinomae.\u00a0\u00a0\u00a0\u00a0\u00a0Transitional cell carcinoma",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. History of frequent urination with painless haematuria and diagnosis of bladder cancer all features favour transitional cell carcinoma most likely.  For confirmation you should go for biopsy of bladder mass.  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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is root canal a suggested treatment when the dental filling is near the nerves?\n\nHi doctor, My tooth has been filled and I went to the dentist and he took an x-ray and the filling was to close to to my nerve. He said he will have to do a root canal which I do not want to do. I was thinking of other ways to go around this because my nerve has nothing wrong in it. I do not think I should get one if my nerve is not infected. I was thinking he could just remove the filling and and replace it with a new one which makes sense. Anyway if we do a root canal he is going to drill in the filling anyway. So let me know if a root canal is the only option because I do not feel like going through that.",
    "doctor_response": "Hello. It all depends on your symptoms. Why did you visit the dentist if the filling was already done? Are you experiencing any pain or discomfort in it? If yes, then unfortunately, there is no option left but root canal treatment for it, because it might have touched the roots almost.  Secondly, after the removal of filling, re-filling at the same point will not be possible because if the pulp of root is near as it cannot bear any sort of filling directly on top of it. If it is done in this way it will simply cause huge swelling or throbbing pain will start so the only way to save a tooth is to clean the pulp i.e. nerves of root canal through this treatment and then put a cap on it. You may delay this treatment until you experience any symptoms of a root canal. Can you tell me about your symptoms and provide me with a radiograph? So I can tell you exactly what you can do best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Late period, pink spotting, headache, lower back pain, clear discharge. Implantation bleeding?\n\nMy periods are never late. I had sex 5 days before my period was due and my husband left it in. I had mild cramping or burning sensations about 3 days late, at 6 days late i took a test and it was negative, I called to make a doctor appt when i was 9 days late she told me to wait til i was 14 days late and retest then call back. On the 12th day late I started spotting periodically throughout the day a very very light pink when i wiped. I put a panty liner in thinking i was getting ready to start but never did, that light pink spotting has lasted for 4 days and there was one day it was only twice when i wiped and it was a light brown color. No flow whatsoever. I am now 17 days late and going in tomorrow for blood pregnancy test . I have had headaches , lower back pain , and the first few weeks excessive discharge clear . Could I have experienced implantation bleeding? and what is the chances I am actually pregnant? Ive never done this before and I have a period every 3 weeks give or take one or two days at the most.",
    "doctor_response": "hello,.You did almost safe sex, 5 days before period. However, pregnancy should be ruled out through home pregnancy test or blood test for beta-hCG. In this case, chance of implantation bleeding is quite LOW as implantation occurs around D21 -D23. Late conception should be confirmed.Hormonal imbalance, stress, PCOD, over weight, pelvic or vaginal infection, change in eating habit etc may cause late period and above features.Review with test results and consult with your gynecologist for next level management. Take healthy diet, proper sleep and avoid stress.Be well and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is ruptured follicle a good sign for conceiving?\n\nhi, My name is Soumi Banerjee. I am trying for Pregenancy for the last 1 year. As advise by my doctor to take medicine Fertomid 100 frm 3 day of the period till the 5th day.On the 12 th day an injection Proficent 5000 was injected and i have under gone a Follicular study on the 13th day. The follical size in the left ovary was 23 mm and in the right ovary 13mm and endiometry was 8 mm. Today on the 14 day again have taken the injection and under gone a follicular study. today both the follicles have ruptered. Is it is good sign for convceving. what to do next",
    "doctor_response": "Hi, Thanks for writing to HCM .Its a good sign that your follicles have ruptured.  You should have relation with with your husband daily once for next 2 to 3 days. Once follicle is ruptured ovum will be alive for 12 to 24hrs . I wish you conceive this time but if it is not so then ,for next cycle I would suggest you to go for intrauterine ingestion of sperms (IUI). You can discuss this with your doctor.Which will increase your chances to conceive. Hope I have been helpful .Regards Dr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can numbness and burning at the base of the neck with shooting pains be treated?\n\nHello doctor, I am a 53-year-old male. My symptoms began about three months ago and include the following: Numbness and burning at the base of the neck. Shooting pains and stingers in the upper back and near shoulder blades. Soreness in shoulders. Muscle twitching that comes and goes particularly in hands, fingers eyelids and ankles almost all at rest. Body temperature regulation issues causing damp collar of my T-shirt after waking from sleep and now some anhydrosis on exertion because I did notice I do not seem to be sweating and I feel like I am overheating after some exertion. Foggy head feeling, especially in the morning. Dry throat upon waking up and sometimes during the day that will not go away. Frequent urination some days that sends me to the bathroom every hour to an hour and a half. Tests my internist has conducted in the last month to investigate my symptoms: MRI of my cervical spine that showed some bulging discs but nothing significant. CAT scan of my neck to look at lymph nodes and all was normal. Chest X-ray which was normal. Blood work which showed all normal except vitamin D which was low. I am now taking a supplement. I am obviously very scared that I am developing MND such as Parkinsons or MSA.",
    "doctor_response": "Hello. I understand your concern and would explain that your symptoms could be related to low vitamin D levels. Anyway, I would also recommend performing further tests if you have not already performed yet: 1. Thyroid hormone levels for thyroid gland dysfunction. 2. Vitamin B12 levels for the possible deficiency. Nerve conduction studies would help investigate for neuropathy or motor neuron disease. Regarding Parkinson's, a DAT scan would help investigate for this disorder. Anyway, your symptoms are not typical of this disorder.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does my heart beat increase when I sleep late?\n\nHi there, I feel like I have a very high heart beat and I feel it beating from my chest. Usually this happens when I have been sleeping late (I think) or out late. Should I be worried I'm suffering from a major heart problem? I was going to go see the doctor about it.",
    "doctor_response": "heaviness on heart and palpitation may be due to heart problem. Need to be confirmed with investigations like EKG, 2Decho and TMT. moreover it requires modification of life style with balanced diet with early sleep and good exercise daily. if symptoms appear frequent you need to see the doctor at the earliest.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Prescribed meclizine for vertigo after long flight. What causes lightheadedness and skull pressure afterwards?\n\nAfter flying for 4 hours, during the night, I woke up extremely fizzy and nauseous. I went to urgent care and was diagnosed with vertigo. He prescribed Meclizine, and I did feel a bit better after 2 days. Now ten days later,I am light headed, and have pressure in my skull, not a headache. I do not feel right, and not sure if this is indeed vertigo, or something else.My cholesterol is high, but that is it.. I am a 63 year old female, not on any medications.",
    "doctor_response": "Hello,Dizziness for you is related to the sense of balance and equilibrium. Changes in cabin pressure can lead to changes in your inner ear pressure.In most cases of vertigo, the complications arise from displacement of inner ear particles that are responsible for maintaining your center of gravity or equilibrium.When displacement of the inner ear particles occur, there is often a change in your sense of balance and the sense of balance is not restored for many hours, sometimes even lasting weeks or days.DO not need to worry about this.Hope this helps.Please write back for further queries.Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for loose motion and fever in a child\n\nHi doctor my son is 4 months old and. For 10 days as had loose motion and low grade fever of 101. I am concerned as we went to the paedeatrician who did a urine culture and said there was no infection. She provided babylyte but i am worried there has to be a reason he is in this pain...",
    "doctor_response": "Hi,For the low grade fever you should give acetaminophen or ibuprofen syrup every 8 hours. For the loose motions then you should use an over the counter antidiarrheal together with flatly. If the child did not respond to the treatment then you should have a stool analysis done.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Salah Saad Shoman",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I determine pregnancy without going to the clinic ?\n\nhow can i check that i m pregnent or not from my boyfriend without going any clinic & medical??",
    "doctor_response": "Hi Welcome to Healthcare Magic Forum u will get urine pregnancy kit in medical store, u can buy and test urself from ur urine, instructions will be given in kit. Hope I have answered ur question Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for chest pain on right side and back muscle spasms?\n\nI am having chest pains on my right side near the breast plate. When I bend over it becomes much worse. When I press on the area I seem to feel some tenderness. I am currently experiencing back muscle spasams as I recently has a Rizotomy and I think I over did it. So far this has lasted two days. Do you have any ideas? I am 54 years old.",
    "doctor_response": "Hi, Probably the problem is due to rhizotomy only where the nerves are not completely severed. Also, the possibility is that the nerve endings are irritated. I suggest you start some medicine to blunt the effect of nerves. It might take some months before you feel better. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medicine for knee pain.\n\nMy left knee (if look from the front) the right of the left knee is very painful (comes and goes ... More stay then goes) ... I have check on line knee pictures muscle, bone, tendon.... And I am not sure what may cause the pain... Sometimes I do feel my knee going to knee down... And I do know I have been using my right side very much because I try to avoid pain.... I also noticed I can put a fist under my left knee if I sit down on the floor compare to my right leg... Can some help me understand what may go wrong with my left kner",
    "doctor_response": "Hi i have read the details about your problem. In my Opinion you are suffering from osteoarthritis knee with fixed Flexion deformity with possible damage in medial meniscus. I suggest pain killers . hot fomentation , and MRI of the knee to arrive at specific diagnosis ( particularly meniscus tear or Ligament Injury). Further treatment will depend on the diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having pain and swelling in my cheek after getting a tooth filled. What to do?\n\nHi doctor, I had a tooth filling approximately 10 hours ago and felt excruciating pain when the local anesthesia was injected. I experienced pain from my cheek all the way up to my temple. The dentist was very rushed and just told me that the pain and numbing sensation could last for up to 2 hours after the filling. The numbness went away everywhere except for in my cheek. I have been experiencing a throbbing pain and swelling in my cheek bone and my lower eye socket. I also have a slight fever. Is this something to be concerned? It should be noted that I have sublingual and submandibular nerve damage from a wisdom tooth extraction that I had two years ago.",
    "doctor_response": "Hi. You have mentioned that you regained sensation, which means the nerve was anesthetized properly and has reverted too. The numbness, pain, and swelling in your cheek might be due to accidental injection into the cheek muscles. I want you to check yourself if you can open and close your mouth normally as before. If not, then it is a muscle twitch, for which you have to do mouth exercises to come back to normal. But the other possibility for your pain might be the tooth itself, as local anesthesia is not given for a normal filling. Maybe the tooth itself is filled deep without pulp protection. Please attach an x-ray of the tooth which you got filled.I will be able to give you an elaborate answer and treatment once you revert with the additional information. The history of lingual and mandibular nerve damage is not relevant for this scenario because it is in the lower jaw. Revert with more information to a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My prostate is boggy, and my semen culture showed E. coli bacteria. What to do?\n\nHello\u00a0doctor, I am a 27 years old, and I have been suffering from pain during ejaculation. After ejaculation, I feel severe burning during urination at the tip of the\u00a0penis, from the past six\u00a0years. From the past year, at the time of ejaculation, the semen does not come\u00a0out with force, and it remains in the urethra. When I urinate after intercourse, then semen comes out with urine. I started having erectile dysfunction also. The semen culture analysis showed E.coli bacteria. Since then I consulted many urologists and tried all possible antibiotics, but I only had temporary relief. Every time there was an E.coli infection, all the symptoms come back. After a physical examination, my urologist told me that I have grade 1 prostate boggy because my prostate was hurting when he was palpating. I have lost all hope, and I am depressed. I want to know about intraprostatic injection because it is the only thing that can cure me. The ultrasound and uroflowmetry are\u00a0normal. Please help.",
    "doctor_response": "Hello. Revert with more information to a urologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and fluttering in the heart?\n\nhi would anybody be able to answer my question? 3 days ago iwas trying to hold my breath, i lasted about 1 1/2 mins. then ever since i have felt like my heart flutters randomly but i can also feel it all around my body, legs,head and arms. this is also making me feel faint and dizzy and it lasts up to 3-4 seconds per time.",
    "doctor_response": "Hi thereI've read you query and understanding your concern.I would like to advise you to take immediate consultation with a cardiologist or go to emergency department .It looks like you had an episode of arrythemia( abnormal Heart Rhythm) that needs to be evaluated as soon as possible. It can be life threatening too. Wish you Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for shingles and night sweats.\n\nshingels night sweats I have had night sweats periodically for the past year. Last summer I started getting pink spots on my back arms and chest. They stay pink for a day or two and then turn white. They started appearing again this past week. 1 month ago I got shingels went to the doctor and got it taken care of and today I noticed my symptoms And shingels came back. It also seems like my short term memory has been getting worse. My left shoulder and neck also periodically hurt, and I have had a loss of appetite. I know this is a lot of stuff and it s freaking me out. Please respond",
    "doctor_response": "Shingles is characterized by a painful skin rash with blisters. It is caused by varicella zoster virus. Chickenpox is due to an initial infection with VZV. Once chickenpox has resolved, the virus may remain inactive in nerve cells. Shingles occurs when viral antibody titer and cellular immunity decline to levels that allow viral reactivation. Predisposing factors are old age, immune-compromised patients such as HIV infection, patients on chronic steroid and chemotherapy. Shingles resolves within 3\u20135 weeks, but secondary bacterial infection and chronic pain due to post \u2013 herpetic neuralgia may occur. Vaccination reduces the frequency of post \u2013 herpetic neuralgia. Advice 1.\u00a0\u00a0\u00a0\u00a0\u00a0Take Zostavax vaccine if you are more than 50 years under medical supervision2.\u00a0\u00a0\u00a0\u00a0\u00a0For fresh attack, you can take valaciclovir 500 mg three times daily per oral if blisters are covering large area. No need of oral valaciclovir if blisters are localized to smaller area3.\u00a0\u00a0\u00a0\u00a0\u00a0Apply locally aciclovir 3% ointment five time daily 4.\u00a0\u00a0\u00a0\u00a0\u00a0Do not take mental stress as it aggravates shinglesFor post \u2013 herpetic neuralgia1.\u00a0\u00a0\u00a0\u00a0\u00a0Gabapentin 100 mg three times daily for 10 days2.\u00a0\u00a0\u00a0\u00a0\u00a0Methylcobalamin 500 mcg once daily per oral for 3 monthsThanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the pain am I having in my chest below my breast?\n\nI have a pain that comes and goes from the middle of my chest just below my breast bone and radiates around to the middle of my back. At some points it feels like something flipped in there and the pain is really bad for about 3 seconds then it's gone.",
    "doctor_response": "thanks for asking your questioni completely understand your problemin my opinion at that young age peptic ulcer/gastritis is a possibility.cardiac diseases are less likely at that age.you need to take a proton pump inhibitor like pantoprazole once daily after consulting a general physician.actually physician can do an ecg and rule out any other causethanks /regardsfeel free to ask more questionsmay god bless you with good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could stomach pain/loose motion be due to viral infection in stomach?\n\nmy freind is 35 yrs old . She is suffering from severe stomach pians with loose motions since 5th June. She is admitted to a hospital and it is now 5th day and still there is no much improvement. The doctors say it is a viral infection of stomach. Is the diagnosis right. Is the respose of the patient to the treatment right?",
    "doctor_response": "thanks for posting here....yes it can be viral gastroenteritis caused by a number of viruses.... it is self limiting and patient will recover on his own just prevent dehdration by oral and iv rehydration therapy...regards and dont forget to rate us",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I continue the pregnancy happened after intake of i-pill?\n\nHi doctor,I have taken i-pill (72 hours) within 18 hours of intercourse but still, I got pregnant. Will it cause any bad effect on the baby during pregnancy or after delivery? Can I continue this pregnancy?",
    "doctor_response": "Hi. Generally, i-pill (emergency contraceptive pill) does not cause any serious effects on pregnancy. But, you need to follow up with sonography at 11 weeks and double market test at 11-12 weeks to make sure that everything is fine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for shortness of breath caused by asthma\n\ni am having extreme shortness of breath and my rescue inhalers aren t working and are out now. i v been having problems with my asthma for a couple of weeks now and have taken 3 prednazone (if that s spelled right) and an allegra d but i just can t catch my breath.",
    "doctor_response": "Hi,Dear,Thanks for your query to HCM.Dear I read facts of your query and reviewed it in context to your health issues submitted in your query.I understood your health concerns and feel Concerned about them.Based on the facts of your query the reply of your query is-Your current health issues seem to be due to -steroid resistant asthma.don't try prednisone blindly without doctors check and script,as this would complicate your asthma.I would suggest you -Take plenty of fluids and hydrate enough for 3-4 weeks asthma.Tab Singulair-Monteluecast- 10 mg x 2-3 times a dayCheck out sputum for other causes like TB infection.Hence Other causes-as cited above- need to be ruled out,by verification with Physician.Do's-Consult with Physician who would investigate history and physically examine to fix the cause of testicular itchiness.Get X-ray Chest / and Sputum AFB /bacteria.Start Antibiotics with plenty of fluids / adequate diet and Supplementary vitamins.Add Vit D / Calcium with Vit B12 to recoup with chronic cough.If need be You may need hospitalization, for this check with Physician.This would resolve the complaints of your's.Constant follow-up with local family or specialist Chest Physician for long term would give you long remissions of such pains in time to come,which would depend on meticulous follow-up treatment of your health concerns.Just don't worry and be patient and co-operate with your doctors,till you verify with your attending doctors.For early recovery-please follow above do's which would resolve your complex health issues.Hope this would help you to treat your health issues in the best way possible. Welcome for any further query in this regard to following link- Good Healthy Life!!Dr.Savaskar M.N.Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can high blood pressure be controlled?\n\ni'm working on getting my blood pressure down. it was  139/85 76 do i need to be concern about the second nummber the dr.is working with me on water retention which he thinks is causing it, all my blood work looked good. i take water out, it is a supplement  and does help me . could it cause my pressure no. go up.",
    "doctor_response": "hello,At this stage, you should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have LOW SALT diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. If bp is persistently more than 140/90 mmhg, then you should be on medicines for it. Regular exercises like brisk walking, jogging according your capacity atleast 30 min a day and 5 days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn't abdominal fat deposition or obesity. Get your lipid profile and sugars tested once..   I think healthy lifestyle alone help you to control your bp.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in the gums and eyes?\n\nfor about three days I had a sore gum line and sore leading up to nose this morning I woke up with eye swollen and little bag on jaw. been taking antibotics washing mouth out with salt water and it is painful also painful could barly put teeth together.",
    "doctor_response": "HI, thanks for using healthcare magicThe response to antibiotic therapy can sometimes be delayed. In addition to continuing your present course of antibiotics you may want to consider the use of anti inflammatory pain killers.Examples are ibuprofen, cataflam, naproxen. These are available over the counter.If after a few days of antibiotics and pain medication therapy there is no relief then you may want to see your doctor or dentist for reassessment.It is possible that a different type of antibiotic may be needed.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does lower backache on the left side indicate?\n\nI have lower sharp left back pain. Possible kidney stone? I had this pain one other time & was given a medication that took the pain completely away. That was 5+ years ago. I don t know what the medication was. I was only given one tablet at a surgery center.",
    "doctor_response": "Hello, I have studied your case.When such patient comes to my hospital we usually take x ray spine or if required MRI to see for any nerve compression and usg abdomen and pelvis to see for kidney stone.Medication like methylcobalamine with muscle relaxant and analgesic will reduce pain; you can take them consulting your treating doctor.You may consult physiotherapist for further guidance. He may start TENS, or ultrasound which is helpful in your case.I will advise to check your vit B12 and vit D3 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you find this answer helpful do not hesitate to rate this answer at end of discussion.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in testicles, thigh and waist?\n\nhi am 27 yr old having testicular pain in right side . i use to do smoking also . when meet doc and said about the insidence during coming by auto my testicles were pressed due as wewere four friends were in auto and after few days that pain started then he gave genral medicines but it was not fine then he said to go for ultrasound , in that mild hydrocele was detected . now he gave some medicines with that it was ok but now the same same thing is happening ....am having pain in testicles at lower end , pain in thigh , and in waist . what could be the reason and what should i do .",
    "doctor_response": "Hi,From history it seems that there might be having some infection in your testicle and spermatic cord giving this problem.There might be having some injury in testes by tightly pressing testes while coming by auto.Consult surgeon or sexologist and get examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes failure of reproductive insemination having endometrial cyst?\n\nhi doctors. i have a 2.4cm endometrial cyst in my right ovary. have undergone assistive reproductive insemination many times but failed. i am taking clomiphene nitrate. i have been married for almost 4 yrs now. i am 32 y/o. my husband has a low sperm count. Pls. advise. Ty.",
    "doctor_response": "Hi The fact that you have undergone assisted insemination suggests that your baseline hormone studies and Fallopian tubal patancy tests are normal. You have  not mentioned  how low is your husbands sperm count. Is there any evidence of infection in the semen analysis done. What about other parameters of sperm   like morphology , motility etc. Your husband needs to see a andrologist who can assess him better.  If you have already done six cycles of insemination and have not conceived the next mode of treatment will be IVF. ( in vitro fertilisation)Before IVF treatment the endometrial cyst needs to be aspirated to optimise the success rate of IVF treatment.Take one tablet of folic acid daily.I would also like to advise on simple measures. Maintain normal BMI ( 20-25kg/M2)If you both smoke cigarettes you need to quit smoking. Good luck. Keep me updated about your treatment. If you have any further concerns I will be happy to answer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have a pulling sensation in my lower abdomen but i don't have any infection\n\ni have a pulling sensation in my lower abdomin it comes and goes. It feels like something is being pulled out of me. I have reoccuring UTI's but i went to the doctor yesterday and i had no infection what could this be. I also have some right side back pain . i have a pulling sensation in my lower abdomin it comes and goes. It feels like something is being pulled out of me. I have reoccuring UTI s but i went to the doctor yesterday and i had no infection what could this be. I also have some right side back pain.",
    "doctor_response": "hi; The drawing type of pain in abdomen & back usually is either a infection of urinary tract or a small calculi .Since you don't have infection right now but you have suffered recently the pain can be due to retrograde infection & after infection is gone may be that will also go in 2-3 days. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for swollen lymph nodes on the right side of the neck\n\nI m aithne..i have 18 months old son, he has 3 days fever, doesnt want to bottle feed but able to drink milk if put to glass, and has swollen lymph nodes at the side of head near the ears and right side of the neck. he is active as usual and eating quite well though he loss a little weight. his weight is 12.5kg.",
    "doctor_response": "Lymph node enlargement is inflammatory.Give syp. clampkid forte 2.5 ml twice daily for 5 days along with calpol 250. 4 ml (sos).",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is lack of concentration a sign of ADHD?\n\nI am a 19 year old male college student. I feel that there is a strong possibility that I have ADHD. I am seeing a psychiatric nurse practitioner next month, but would like to know if the possibility is likely or not. My whole like I have always felt like my brain moves 10x faster than everyone else. I am always talking, thinking, or doing. In high school it was extremely difficult to concentrate in class, and now that I am in college it has only gotten worse. I did have speech issues when I was younger, as I was unable to pronounce certain sounds such as f . I also went through my elementary school report cards and found the teachers notes to comment on how they wished I would pay more attention in class. Now here is that last part that makes me think I might not have ADHD, I am a very good test-taker. During my first year of college, I missed a majority of my classes, but was able to teach myself the material THE NIGHT BEFORE the exam and somehow balance a 4.0 GPA. Opinions?",
    "doctor_response": "Dear, Welcome to HCMWe understand your concernsI went through your details. You are already 19. Childhood ADHD most probley would have cleared by the time you reach the age of 15 or so. Adolescent ADHD usually do not have the problem of notable hyperactivity. But lacks concentration. Adult ADHD is also almost certainly lack concentration but without notable hyperactivity.The symptoms you gave here do points towards ADHD but these cannot be taken into consideration fully. Mainly because there could be a bias in your symptom list. Once you think that you have ADHD, your version of symptom list will naturally have ADHD bias.Therefore, I suggest not to overly worry about the present symptoms. Consult a psychologist. Provide him all those symptoms you are facing. Please do not exaggerate or be biased towards ADHD. Let the psychologist assess your psychological disorder.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Happy New Year. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat severe knee pain that worsened after accidental twisting?\n\nI have had knee pain for several months and yesterday I twisted knee while stepping on my shoestring. I heard a popping noise and pain was so severe I thought I was going to pass out. I immediately sat down. I can stand and walk now but not without limping but pain is severe. It really hurts when sitting with leg extended straight.",
    "doctor_response": "Hi you had knee pain for several months and have now injured it during a fall. Knee is swollen and you can walk with limp. In my opinion you have probably damaged a meniscus  / Cruciate ligament in your knee. Take pain killers , use knee support for walking and get an MRI to arrive at proper diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I getting pain in my RHS hip?\n\nHi, I have been getting a pain in my RHS hip. Sometimes it is a constant pain but more often it spasms, or feels like a twinge when I move. It started after I started doing reverse leg lifts, and I am a cleaner, so I m not sure which of those are were the problem came from.",
    "doctor_response": "Hello, What I understand by history is this is related to your job profile. As using the hip in all different and awkward position is possible without one's knowledge. Try doing hot water fermentation to improve the vascularization so the healing of tissue is optimum and also try doing simple core and hip muscle strengthening exercises. This should help you. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What causes chronic cough?\n\nHello doctor, I am a woman, 23. I am 5'2\" 137 pds. I am currently taking Cetirizine. I have been coughing badly for the past 5 months when I got my new job at a preschool. I went to the doctor, he prescribed me the before mentioned drug. Although, when it gets really cold, I cough phlegm and other times a dry cough. I would like to have a second opinion on what I should do because I am tired of coughing.",
    "doctor_response": "Hello. In addition to Cetirizine you need to take a bronchodilator medicine that will help bring out the phlegm better. Salbutamol (Albuterol) is an excellent drug that helps widen the small airway passages and bring out the mucus. It is available in the form of inhalers. Take 2 puffs thrice daily and gradually taper over a period of 2 weeks. Whenever the climate changes or you start coughing start on the inhaler. Second, when there is excessive mucus, in addition to the inhaler take ambroxol hydrochloride medicine also. It is available in syrup and tablet formulations. You require 30 mg. If the phlegm is green in color and tastes bad, you may require a short course of antibiotic. It is also advisable you wear masks when you go outside, avoid cold air in the mornings and late evenings, take plenty of warm fluids (adequate hydration), use a multivitamin temporarily, have healthy diet rich in vegetables and fruits. Taking garlic is helpful as it is known to have ingredients that help relieve asthma and associated bronchoconstriction.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning sensation on the knee cap with enlarged blue veins?\n\nIm a vet tech and do lifting everyday. Im 30a years old with two children. I got sciatica when i was pregnant with my second child along with varicose veins. My question is that i am having burning, sharp sensations around front of knee cap along with more enlarged blue veins that are tender to the touch. Possibly it is a DVT?",
    "doctor_response": "Hello!The additional information is needed about Your case time period (duration). Burning sensation is related to veins in the most of cases.You should go to emergency ward if calf is swolen/red and hot!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intermittent heart pain?\n\nHello doctor, In mid-February 2011, had pacemaker/defibrillator placement for low EF @ 35% and irregular beats. For about two weeks I have had intermittent heart pain and pain on my left side at the level of the heart/breast. These pains do not occur at the same time. Could it be the device is lightly shocking? The pains almost feel like spasming. Heart rate and pulse are a.o.k. I am 57 year old female, 5 7 and weigh 175",
    "doctor_response": "Madam you had undergone ICD and you must be under medications.You have chest pain or feel like shock , then you must consult your physician.To rule out CAD  or ice shocks , please get your ECG and device interrogation done as soon as possible.I don't think there is much to worry about.Take Care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can allergy on groin and thighs be treated?\n\nhello doctor ,i  have had a skin problem when i was young . i had allergy on my groin and thighs which with out telling any one due to shyness made it worse and big .i used some ointment and got rid of them but the dark brown marks are still there. i want to get rid of them. it has become a big problem for me now.i am refusing to marry because of this  problem.is there any treatment for this. hope i find a solution from you sir. i would be really greatful to u all my life if i could get a solution .thank u.",
    "doctor_response": "HI, thanks for using healthcare magicIncreased pigmentation can occur as a result of any inflammatory process including skin rash.The use of cocoa butter, vitamin E may help. There are other skin lightening agents that can be used but it would be best to speak to your doctor to find out what would be best to use.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes whitening of feet ?\n\nHi i have noticed that the bottoms of both feet have turned white.i was at a marching band competition all day yesterday, it involved alot of walking and the shoes arent very comfortable. The white part is harder than the rest of my skin and it really hurts and on occassion tingles.",
    "doctor_response": "Hello,Your symptoms are suggestive of a skin disorder (calluses) due to the repeated trauma. For this reason, I recommend holding your feet in warm water with salt and then try to rub them gently. A cream can help after rubbing them.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red and white lump on buttock with bleeding?\n\nWhat is a red and white lump on buttock... When touch or pulled it hurts and a white lump comes out and starting bleeding a lot.. I am 100% sure it is not a pimple and has been there for close to 10 years. The bleeding gets worse every time it is picked.",
    "doctor_response": "Hi,This is likely to be a sebaceous cyst. These contain white material as you describe. If it is a problem for you, it can be surgically removed. This is usually a simple procedure. I suggest you consult a surgeon for further advice. Regards,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause sudden elevated blood sugar levels after dinner in an active individual?\n\nOK, I am not diabetic, but I was experiencing head issues after dinner so I took my blood glucose reading and it came in at 204. I am very active, 5 ft 5in and 120 pounds. My head is feeling better now (4 hours later) but I am wondering what I should do. I had this feeling before (not as bad) and had a reading of 142 (after a small bowl of ice cream).",
    "doctor_response": "Hi, Thanks for posting in HCM. I understand your concern. Based on one reading of post-prandial blood glucose of 204, it is not possible to conclude that you are diabetic. You may be in thew category of impaired glucose tolerance. Hence, you need to get your fasting glucose, postprandial glucose and glycated hemoglobin (HbA1c) levels checked once again and consult Diabetologist or Physician with the report for appropriate management. Hope the information provided helps. Best wishes. Regards, Dr.Ashakliran.S., MBBS., MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for stomach ache with black or red stools\n\nmy son 8 yr. old boy had a stomache and diarrhea his stool is black and soft and many. he also experienced amoebiasis last july.he is complaining that his stomache ache is coming from the upper abdomen at the center but it last for seconds after he goes to toilet. his pedia prescribed metronidazole when he had amoeba. I used it now. it stops his diarrhea but his stool is soft and black sometimes yellow i observed it this last week then this evening he again complain that he had stomache and his stool is already bright red.",
    "doctor_response": "Hi,Loose stools with bright red colour and abdominal pain usually indicates acute dysentery. This can be caused either by amoeba or bacteria. Since he not responded to metronidazole, this is likely bacterial and need treatment with antibiotics. I used to give cefixime or ciprofloxacin for such cases. Kindly take him to your pediatrician. Meanwhile, give frequent sips of fluids like ORS solution to avoid dehydration, and give paracetamol for pain relief.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam T. K., Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing pain in lower left jaw?\n\nhi im feeling a lot of discomfort in my lower left jaw. my wisdom tooth hasn t broken the surface yet. the gum over it is swollen and white at the top.. do you think its just trying to break through the gum or is it infected? its a really annoying pain.",
    "doctor_response": "Thanks for your query, I have gone through your query.The pain in the jaws could be because of the gum infection over the wisdom tooth (pericoronal infection leading to space infection). The white portion can be because of the irritation from the opposing tooth over the gums covering the wisdom tooth.Consult a 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.Mean while you can take a course of antibiotics like amoxicillin 500mg and metronidazole 400mg tid for 5 days (if you are not allergic).Do saline gargling. i hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can emergency contraceptives cause excess bleeding and changes in menstruation cycle?\n\nHey,My name is Ann. I bled for one day then it stopped. After two days,i had my periods. i have been bleeding for 6 days now. its unlikely because i usually bleed for five days only. The flow is light but dark in color . I took emergency contraceptives last month. Could this be the one that is causing the change in my cycle. Please help",
    "doctor_response": "Hello dearUnderstand your concernYes emergency contraception cause excess bleeding and change in menstrual cycle.Emergency contraception contain high progesterone level that produce hormonal imbalance lead to disruption of menstrual cycle.Bleeding for one day due to progesterone withdrawal bleeding and it is common side effects.And it also cause prolongation and excessive bleeding due to high progesterone. So do not worry, it is common after ECP.If do not stops consult the gynecologist get examined and take trenexaemic acid to stop the bleeding.So be calm, it is just side effects of emergency contraceptive pills.Hope this may help youBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Did my wife have a miscarriage due to slipping and falling ?\n\nHi dr.hi doc,my wife had undergone follicle study and the egg was ruptured on 19th day so my gyn told to have sex from 17th day itself.We had sex once in a day from 17 th day to 20th day . she gave progesterone tablet to her and told to come after 15 days ie 13/05/2011.On 13/05/2011 she went to gyn but gyn said that she can see nothing .therefore gyn told my wife to come on 19/05/2011 ie thursday.On Monday ie 16/05/2011 unforfortunately my wife fall on back by slipping of chappals on 10.00 am in morning .Afterwards she was alright.In evening there was pain in uterus and she had bleeding .I think due to falling she had miscarriage and bleeding started.i am very disturbed please help.will she b pregnant again? Is the bleeding due to periods or any thing else.please help me I am nervous,please reply. Pranati Gaware 27 years Old.",
    "doctor_response": "hi, welcome to healthcaremagic forum in your case pregnancy is possible so the bleeding may be due to either abortion or may be usual periods any way now itis already 38 day after her periods you can repeat the home pregnancy test , consult your gyne  and do a TVS (transvaginal ultrasonography)  to find out the present condition",
    "dialogue_context": ""
  },
  {
    "patient_message": "My son has got a hickie on his arm\n\nmy 3 year old got a hickie on his arm from his 9 yrs old brother My 3 year old son got a hickie on his arm from his 9 year old brother Step brother (his the son of my husb and has been living with me for the past 5 years) The problem is that the brother lies over and over shoud I worry about this? How should it be handle? is is normal for a 9 year old to experiment with hickies.....AM i overreacting. Am just upset because the 9year old lies all the times am afraid of what else he might lie about...",
    "doctor_response": "Hello and welcome to health care magic,please take consutation with a dermatologist,as if the disease is  then it is to be worried but if it is not then nothing is to be worried ,have a fungal scraping, tu rule out fungal etiology,take",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life expectancy for stage 4 ovarian cancer patient ?\n\nMy 79 year old mother has stage 4 ovarian cancer. She has refused treatment. What is her life expectancy ? I have read that some live as long as 5 years.",
    "doctor_response": "Hi.. The life expectancy in a cancer is dependent on multiple factors that include the stage of the cancer, age, presence of other risk factors, other medical conditions, presence of other co morbities, presence of metastasis and so on.. And hence it is difficult to predict the expectancy.. On an average, ovarian cancer stage 4, about 17 to 20% people can survive upto 5 years... Lets hope for the best..\u00a0 Our prayers and wishes to your mom..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of hives?\n\nFor about 5 days I ve been getting bites or hives. They show up at night when I am in bed and are pretty itchy initially, however, the itch becomes very minimal within 12 hours even though the bump remains. I think I ve eliminated bed bugs and am now trying to eliminate spiders and fleas. The only thing I can think of in my diet that has changed is blood pressure medicine. It is possible to get hives from Byhstolic (nebivolol) tablets?",
    "doctor_response": "Hello,Based on your symptoms, you seem to be suffering from Acute Urticaria. This can occur as a result of medications (yes even BP meds), insect bites, food allergies, airbourne allergens like pollen grains, basically just about anything can cause you urticaria. However, since you have a clear history of BP medication being changed, this may be the culprit. You can report this to your treating physician who may change the medication. Meanwhile you may take non sedating antihistamic like levocetrizine in the morning and sedating (if itching is severe) antihistaminic like hydroxyxine 10mg at night/before sleep. This alleviate the symptoms of itching.RegardsDr. Tushar Kdrtusharks@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can candid be used to cure the white layer causing irritation around groin?\n\nHello. I have a whitish layer around the glans and I need to know what could be the reason.My foreskin was tight for more than 2 years and I tried to push it back yesterday. The result was that I found a dried whitish layer rounding the base of my glans. I can send you a couple of pictures if you wish. There is no irritation as such, I apply Candid powder around my groin after a bath everyday. Thanks",
    "doctor_response": "Thank you for your query.you need not worry much about that white line .it may be your powder deposit or smegma(a normal white deposit at glans).feel free to ask more and yes you can send pictures too .hope this answers your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it advisable for herniated back surgery during pregnancy?\n\nHi, may I answer your health queries right now ? Please type your query here...hi I just took a pregnancy test today and its positive and I am scheduled to have back surgery on march 1st. i have a herniated disc that is causing me nerve damage its it safe for the baby for me to have the surgery right now",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.You need to weigh the risks and benefits of surgery, considering your pregnancy status.I will suggest that if surgery is going to be under regional anaesthesia like Epidural one then it will be of help.If it can be deferred till you deliver it will be better, but you need to take call about it from spine surgeon.I will suggest support of micronized progesterone or duphaston from a week before and after surgery.I hope my answer helps you.Thanks.Wish you great health.Dr Purushottam",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for white rashes on back of palm and fingers?\n\nI am having some skin allergy which emerges once the season changes and mostly when its changes from winter to summer. White rashes emerge at the back of the palm and onthe fingers. Really embarassing When meeting with people and have to shake hands with them.",
    "doctor_response": "Hi, I would recommend you to apply topical steroid like clobetasol propionate cream on the affected area twice daily along with frequent and regular application of a moisturizing cream on the entire hands 2-3 times in a day. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive for baby, had miscarriage 3 years ago, normal periods. Taking tertomid. Suggestions?\n\nhi doctors im 25 years my husband and i have been trying for a baby tor two years now  with no luck my doctor put me on Fertomid 50mg this is my second cycle on it im taking it on day 5-9 and today on day 6 im seeing spoting is this normal no any other Side Effects three years ago we had a miscarriage that left us devistaterd should i be taking any vitamins with this medication i Don't know what to do i have a normal 28 day cycle my doctor siad if i  Don't fall  pregnant within three months then he will refer me to a Specialist any advise",
    "doctor_response": "Hi,Thanks for discussing your problem with us.Any women who is trying to conceive should take Folic acid.As you have had a miscarriage, you are suffering from secondary subfertility. I think you should have seen fertility specialist before trying any medicine from GPs. The best course of action for subfertile couples is to have full investigations first. Once a cause for low fertility is found treatment can be specific & targeted which is likely to be more successful. If this spotting is part of your periods, there is nothing to worry about. If you have finished your periods & again this started you should report this to your doctor.Wish you best of luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could vaginal lumps with blisters suggest?\n\nHi, I have had a lump on my leg by my vagina for a month now, it was like a blister but 2 weeks ago it developed a large black spot in the middle. Ive also realised it is like a solid ball now right underneath my skin, it has just burst and ive got all of the fluid out but the black bit is still there and its still solid under my skin. Any ideas as to what it is because I cant get a doctors appointment for over a month and im really worried and in a lot of pain with it also the fluid is black then it went brown then to blood just coming out of it all pf the time.",
    "doctor_response": "Hi,From history it seems that you might be having infected Bartholin's gland cyst giving rise recurrence of emptying and filling again.It should be excised and whole sac is to removed.consult Gynaec and get examined.Meanwhile apply antibiotic cream after proper cleaning.Keep local hygiene proper.Oki and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe muscle spasms\n\nHi Dr I am suffering with severe muscle spasms in neck from 2006. I have been to doctors with no success. My neck can become very stiff an some stages I can t be in a certain position for too long. I have it really bad and with lots of pain. I did get a inflammatory tablet celebrex 200mg to take but I only tried it once. After 30 tablets and no cure I thought to stop seeing it doesn t take away pain. I am just like that... Why keep drinking things that doesn t make a difference. I don t believe in going to doctors anymore because nobody could help yet - from 2006 and it s a waste. I did read up about magnesium deficiency and am not sure about what to choose when I see all the negatives in the tablets. I also did see that it should contain Vit b6 and Vit D + selenium to be properly absorb if I remember correctly but find it hard to find in one supplement. Any advice please would be appreciated.",
    "doctor_response": "Hi,Thanks  for  your query.Neck pain and severe muscle spasm that you are having are suggestive of degenerative -spondylottic changes of the cervical spine.X-ray of neck in lateral view or MRI will help in the diagnosis.Treatment includes 1. Use of cervical collar helps in immobilisation and brings relief. 2. Medical drugs like pain killers - acetaminophen/ibuprofen and muscle relaxants might be helpful.3. Cervical isometric exercises are beneficial to maintain the strength of the neck muscles. Neck and upper back stretching exercises, as well as light aerobic activities, also are recommended under the guidance of a physical therapist. 4. Hot fomentation helps in relieving acute symptoms.5. You can avoid using a pillow.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "why is my head so swollen, red, full of clogged carbuncles full of yellow and white pus that burns my scalp?\n\nCan a patient with chronic folliculitis, and MRSA of the scalp from bacterial infections( that enter into my scalp from old surgery scars) still have a Staph infection if my blood culture comes back neg. for MRSA even though the pathology report states MRSA is present. I was also tested for fungal infections and that came back neg, My head is so swollen, red, full of clogged carbuncles full of yellow crusty pus and white pus that burns my scalp.",
    "doctor_response": "Hi,If carbuncle is there then rule out diabetes.Go for blood sugar testing done for fasting and PPBS.Consult dermatologist and get the proper diagnosis done.after examination and investigations go for appropriate treatment accordingly.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible if sperm count is zero?\n\nDear Sir, Myself Vikas from Faridabad. I am married from more than one year and I use to take Penegra 50 Mg before sex and I take it two times in a week. After discharge the semens into vagina. So much quantity comes out of it after pull out my penis from it. Is this normal? My second question is what if a male having zero sperm count or nil sperm. Can they have their own child? Pls suggest. Vikas - 0000",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.If sperm count is Zero then there is no chance of pregnancy. Zero count should be investigated with color doppler ultrasound to rule out varicocele, testicular structure abnormality and to see testes vascularity.Hope i answered your question.Would be happy to answer you in future.Wish you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the chest area while having emphysema?\n\nI am a 56 year old woman with emphysema. I have had symptoms from heartburn to sternum chest pain. Just had an echo stress test with no real results or finding but yet I keep getting pain in sternum area. Is this related to emphysema or is it heart relatled",
    "doctor_response": "Hi and thank you for asking!Since the echo stress tests was normal the pain isn't heart related. The pain most likely is associated with emphysema or acid reflux (heartburn).Wish you health!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life expectancy of an aged myeloma patient?\n\nMy mother (age 79) has been treated for multiple myeloma since January when she was diagnosed with multiple fractures.  After a chemo holiday, then after two weeks of returning to Revlimid, her numbers are way off IGA=2200, IGG =314, IGM=16.  Does this mean she has a limited life expectancy?",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your mother's situation and problem. Multiple myeloma is very notorious in behaviour.  It is very aggressive tumour.And in old age, it is not having good prognosis. She is also having very high levels of IgA and IgG. So her prognosis is not good.Life expectancy is less then 17-18 months.And five year survival rate  is less then 20-25%.So better to discuss end of life issues with her.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have twin baby girls. One of them is not gaining weight. Please help.\n\nHi doctor, I had a month old twin baby girls. They were born in the 34th week of pregnancy. One baby was 2.2 Kg, and the other was a little weaker weighing 2 Kg. Since there is not enough mother's milk after several attempts, I had to go for artificial milk powder. Initially, as suggested by the hospital pediatrician, they were given Dexolac Special Care, but after 20th day when their weight was around 2.4 Kg, they were given to Dexolac Premium 1. Out of the 2 babies, the weaker baby is responding well and quickly gaining weight (taking around 75 ml milk every 3 hours). But the baby which was born stronger is not drinking sufficient milk (45 ml in one feed, at an interval of around 3 hours), and is taking around an hour to take one feed. Also, she is having issues of gas and constipation. Because of constipation, she keeps crying. Now, this baby is not gaining weight and seem to be weaker. Please suggest what we can do in this case and shall we switch her milk to Lactogen or some other company?",
    "doctor_response": "Hello.  Keep trying to give breastfeeds as much as possible till 6 months completion. Different brands of milk powder have different tastes. So, you can change what they like (as advised). Do not dilute more or give more concentrated milk. Usually, dilution mentioned on the package can be followed, that is, 30 ml for 1 scoop for most of the brands. But check with the manufractures' note. Do not use feeding bottle. Use bowl and spoon.You can use undiluted dairy milk (pasteurized). Check with your local pediatrician for supplements if needed. Check if there is adequate weight gain. Maintain proper hygiene while feeding, when using formula feed or top milk. Do not compromise on hygiene. I would like to know the following: Finally, breastfeeding is the best for the babies.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having pompholyx on palms and feet. Prescribed with steroids. Symptoms aggravated on stopping medication. On zentel and clobetasol propionate. Advice?\n\nHi, I have allergy since four months. I am having phompholyx on palms and feet . They prescribed me steroids, Wysalone for two weeks. After its withdrawal symptoms aggrevated. Then he put me on Zentel for two weeks and Clobetasol propionate ointment. Even that din t work. Recently i had a blood test done for 20 allergens. Report is positive for shrimps and house dust, carpet dust. I have stopped having sea food totally. I can t do my work as earlier. I have to wear gloves, socks all time, cover my face with mask. I cannot clean the house, nor cook. After the blood test doctor put me on immunosuppresant, cyclosporine for 2 weeks. It causes severe weakness, fatigue . Now am taking antihistamine Oriel-M, since a week, and am again getting allergy on my palms. I am tired taking medicines. Please suggest me what has to be done. Will i be like earlier.",
    "doctor_response": "it is allergyget thourough check for food allergens get blood serum tested for specific antibodis for milk wheat potato chan rice egg nuts go foe elimination diet you will e oktake allegra 120 mg od for itching can continue apply diprovate on hand and effected parts of skincontinue till tests are sdone",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe pain around the navel be treated?\n\nHello. I have a 7 year old who is aHaving intermittent pain around her umbilical area. It will be more intense at times and not so bad other times. it has gotten worse over the last few days. had labs done today and they looked good. had X-rays done but unsure on results. she was diagnosed with celiac disease when she was almost 3. We haven t had any issues since then with her tummy. She is crying cause of the pain. appetite is less. she will eat but not much. Want some relief. What will help her",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. First of all I will suggest an ultrasound because it is more sensitive with abdomen problems. After that you should consult a gastro-enterolog doctor. During this time I will suggest  to have a healthy diet with plenty of water to avoid constipation because it can increase the pain. And as many time he has a celiac diagnoses it is important  to avoid foods containing gluten (bread,pasta,cakes,biscuits..). See the possible to do also a total blood analyses to be sure everything is ok. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring swelling on tongue and lips?\n\nmy husband has sudden sporadic tongue swelling which always occurs in the middle of the night. Sometimes his lips swell, too. It is quite frightening. His GP says if he were allergic to any of his blood pressure medications, the swelling would occur within an hour or so of ingestion. The only ingesting my husband routinely takes before going to bed is a swig of Maalox.",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your husband's history and I would like to make following suggestions for him:1. Yes, as suggested by GP, antihypertensive medications from the groups of  ACE inhibitors or Angiotensin Rceptor Blockers (ARB) (Kindly confirm whether he is taking any of these) can cause similar complaints.However, I would like to suggest that it is not always within an hour of consumption of the drug. Personally when such patient comes to my clinic, I suggest patient's physician revising the anti-hypertensive medicines and to change them, if possible.Please discuss above information with your GP.2. Even Maalox can occasionally cause allergic reaction. The symptoms will be similar.3. Were I treating you, I would suggest you to take a levocetirizine & montelukast when such symptoms occur. You can discuss possibility of alternative anti-hypertensive medicine (if your drug is from ACE inhibitor or ARB groups) with your GP. I would also suggest your husband allergy testing to identify whether any substance is contributing to these symptoms, if it is so, avoidance to that particular substance is the best measure.Hope above measures will be helpful to your husband.Should you have any further query, please feel free to ask at HCM.Wish your husband the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes an elevation in the WBC level in a stroke survivor?\n\nMy wife just found she has a 48000 WBC. She was recovering from a stroke she had during a hip fracture surgery 2 years ago. She had to stop therapy due to a foot wound (non-weight bearing). and therefore without exercise she is getting weaker. What could account for a spike in her WBC?",
    "doctor_response": "Hi thank you for querry.Septicemia according to the symptoms if she is bed ridden and having bed aores than these wounds are the cause of infection.if such patien came to me than after proper history and physical examination in such cases fever and altered sensorium history is omportant than i will go for FBC after systemic workup to rule out any chest disease or UTI.septicemia is most common in such bed ridden and bwd sores patients.hope the answer will help you for making decision.feel free to contact me for further querries.wish her good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are small blisters on the face and back of a baby?\n\nmy 3 week old baby s face is broke out. I thought it was baby acne but now it is on the back of his nect and his shoulder blade and looks like little blisters. He is a pretty big baby..he was 10 lbs 8 oz when he was born. what does this sound like...baby acne....prickly heat....other rash?",
    "doctor_response": "Hello, By what you say I feel that this could be atopic dermatitis keeping in mind the age of the baby. Topical emollients should be working well in this scenario. But skin conditions are best diagnosed and treated after seeing them directly I suggest you upload some images here so that we can guide you better. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can the penis size be increased?\n\nHello doctor, My penis is very small (3 to 5 cm). It is the size of a child. My age is 23. Please help.",
    "doctor_response": "Hi. Penis length is usually measured in an erect state and is between 2 to 6 inches normally. What we see in porn videos is not normal. For females, only outer two inches of the vagina has sensation. So for successful intercourse, any penis length more than 2 inches is adequate. Often duration of intercourse or masturbation can be short. If done frequently, and with time, this duration will increase. Right now you do not need medicines. If you have persistent issues, you may contact again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause coldness in hands?\n\nsir first of all i want to tell u that i am not good in english so pls ignore ny faults. sir...sometimes i feel my left hand cool, it happened in summer season. earlier...about a month ago i felt same thing. a doctor advised me to take NEUROKIND GOLD injections. that time everything was okay. but again i feel same thing. please advice me some thing. another thing is that...when i feel cold in my left hand..then i dont feel any weakness.",
    "doctor_response": "Welcome at HCM    I have gone through your query and being your physician I completely understand your health  concerns.  Based upon description it is difficult to comment. kindly meet your attending physician for proepr assessmment.             Meanwhile stay calm and use acetaminophen to relieve pain   Get well soon Hope your query is adequately addressed if you still have any feel free to ask   RegardsDr Saad Sultan",
    "dialogue_context": ""
  },
  {
    "patient_message": "I had my follicular study on the 12th day and i wanted to conceive for the second time\n\nhi i had my follicular study on the 12th dayand it measured  hello,Iam Mrs singh I am 36yrs old ,and have 7yrs old son. i wanted to conceive for the second time so i went through all the tests . my tests are normal .I had my last period on 25.5.11 and from day 10th my follicular study has been started the results are as follows : 03.06.11 :  10th day,   Lt Ovary 16mm      Endometrium  07.2mm 04.06.11 :  11th day,   Lt Ovary 20.5mm   Endometrium  09.1mm 05.06.11 :  12th day,   Lt Ovary 21.2mm   Endometrium  09.7mm I want to know whether the egg is normal or not and when it will rupture",
    "doctor_response": "Hi Welcome to health care magic your follicular study is normal ,you must take injection for rupture of follicle,do regular intercourse during peri rupture phase. \u2018Hope I have answered your query, I will be available to answer your follow up queries, \u201cWish you Good Health and speedy recovery\u201d Disclaimer",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause red spots in the mouth, fever, chills, nausea and dizziness in a 7-year-old?\n\nHi. My 7 year old has little red spots on the back roof of his mouth. He also had a temperature yesterday of 101.9 (ear) and complained of chills and a bit of nausea and dizziness. His fever Seems as though it\u2019s improved. I\u2019ve noticed a couple spots on his body but I think it may be a heat rash?!",
    "doctor_response": "Hi Dear,Understanding your concern. As per your query your child have symptoms of red spots in the mouth, fever, chills, nausea and dizziness because of upper respiratory tract infection leading to strep throat and it could be due to dehydration.Need not to worry. I would suggest you to start with course of antibiotics and anti-inflammatory drugs for your child. Avoid giving cold beverages. Do warm saline gargles 3-4 times a day with lukewarm water. Take diet rich in fruits rich in vitamin C as it will boost his immunity. Keep him sipping lukewarm water whole day. If symptoms keeps on persisting visit ENT specialist once and get it examined and start proper course of antibiotics. Steam inhalation is another treatment option for resolving it.Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will I get pregnant after having unprotected sex the night before I got my period?\n\nHello doctor, I had unprotected sex the night before I got my period. I got my period, as usual, the day after. But about two weeks later, I feel extremely nauseous as soon as I wake up and it lasts throughout the day. I feel light headed, I have headaches, and I feel crampy, my sense of smell seems to be heightened. I have these symptoms every day. Could I be pregnant?",
    "doctor_response": "Hello. No, you are not pregnant possibly, because having sex just right before periods does not result in pregnancy. Secondly, if someone gets pregnant even then the symptoms of pregnancy does not show up quickly (15 days after having sex). You might be having stress and anxiety which is causing all these symptoms. You need to relax now and wait for your next periods to start. Hope it has helped you. If you have any further queries, please do not hesitate to contact me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly explain the reason for dull pain and pressure in lower right abdomen.\n\nHello doctor, I have dull pain and pressure in my lower right abdomen for about six months which worsens while sitting. There is kidney pain while running.",
    "doctor_response": "Hi. I have gone through your case and can well understand your genuine health concern. As you mentioned that you are having abdominal pain from a long time, I suggest you get evaluated properly. Chronic abdominal pain that too on right lower has many causes. It may be related to some disease of the gastrointestinal tract or urinary tract or some muscular problem. Disease of small intestine involving ileocaecal junction like ileitis, typhoid ulcers, inflammatory bowel diseases, a disease of large intestine like colitis, IBD, a disease of the kidney and urinary tract like stones in the kidney, ureter, etc., can cause pain in the right lower abdomen. The pain related to the kidney is generally dull aching and present in the lumbar area and it can increase with activity. Sometimes, a muscle spasm can also cause severe pain which increases with activity. In my opinion, you need an ultrasound of the abdomen and pelvis to confirm the diagnosis. As your problem is a chronic one you need to consult a surgeon and get your ultrasound done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had subdural bleed after a fall, Has headaches. Can I travel?\n\nHi there my mother fell down steps and has subdural bleed 5mm. Never lost consciousness and no worsening of bleed and she remains with no seizures. She did have headache and nausea but cant help but think that is related to not eating she is very time oriented in her daily eating schedule. Not for medical reasons just habit. Can she fly on a 2 hour flight safely?",
    "doctor_response": "HI. Welcome to HCM. Subdural 5mm bleed without loss of consciousness is nothing to worry about. Headache and nausea can be due to both reason trauma and eating habbits. She can do routine activities including 2 hour journey in flight safely. just take care if she has projectile vommting anytime, otherwise everything will bw fine. Thanking you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest infection and high temperature\n\nMy Daughter nearly aged 3 has a chest infection. She has High temperatures for 5 nights now as high as 40.2.  Doctor has changed her anti biotic from Distaclor to Klacid.  At night time temperatures are the worse and during the day there low grade but she gets very tired on running around.  She has a corrected Congenital heart disease TGA which was repaired at birth.  Not sure if she needs IV Antibiotics - she is only on the klacid since today.",
    "doctor_response": "Welcome at HCM    I have gone through your query and being your physcian i completely   understand your health  concerns.    for how many days she is having fever? is there any sputum in cough? what is the colour of sputum? have u done her chest X ray?     As far as antibiotics are concerned , it take at least 48 to 72 hrs to start its affect. you need to be patient with it  and do complete the course in proper dose as prescribed by your doctor.    klaricid is very good antibiotic for respiratory tract infection. you should use  syp brufen with it to relieve fever. meanwhile stay calm and continue with the medicinesmay she get well soon Hope your query is adequately addressed if you still have any feel free to ask   RegardsDr Saad Sultan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain, shock like feeling in the legs. Due to pinched nerve from herniated disc?\n\nI do have  back pain for which I have has facet in my spine over the last 8 months.  I get electrical shocks in my legs and Doc  sys that its because  of the lack of oxygen becaue of pinched nerves from a 3 herniated disc.  I have had the nerves burned, but apparently one did not take and now we fight with my insurance.  Could this also come up in to my  left arm,   hand",
    "doctor_response": "Leg complaints are due to pinched nerves in the spine due to stenosis. Low back pain has nothing to do with arm however similar situation may be present in cervical spine with subsequent stenosis leading to arm pain.Treatment depends upon MRI findings and your disability in day to day life. Sometimes epidural block helps to relieve the leg pain and definitive treatment would be surgical decompression of the nerves. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for itchy rash on legs and underarms\n\nI had a rash, it appeared on my bottom, spread down my legs and then appeared on my underarms and elbows. I was prescribed triamcinolone acetonide and after a week, the rash went away, but I was still itchy. Now, two weeks later, the rash has come back on my arms. The doctor didn t know what it was and just prescribed a topical steroid, telling me that I might need to go to a dermatologist. But, I don t have health insurance and can t afford it for at least 3-4 weeks. I don t think I can wait that long! It itches very badly. It s not scaly and it s not raised either. What can I do? What could it be?",
    "doctor_response": "Hi, Most possible diagnosis could be tinea infection. But there are many other possible diagnosis. You could take an over the counter antihistamine tablet for itching. I request you to stop all the medications and to visit a dermatologist. He will examine you skin and confirm the diagnosis and will initiate the treatment. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dark gray area in x-ray of mouth along with spots?\n\nMy dentist asked if i had trauma because the front of my mouth when she did an xray showed up dark gray i never jad trauma to my mouth and no pain in that area..she also said she seen spots there as well..what can this mean should i be concerned..i have an appointment with an oral surgeon",
    "doctor_response": "Hello ,Thanks for consulting Hcm Read your query as you had dark gray area in x ray this can be periapical granuloma or periapical cyst in xray . This is commonly seen in patient with history of trauma in front tooth .Dont be worried so much consult oral surgeon for clinical examination and treatment .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can forgetting birth control pills for 3 days and having sex cause pregnancy?\n\nI have a question. Suppose you're taking birth control and 9 days before your due period you forget to take a pill for 3 days. You take those pills as instructed, but you have unprotected sexual intercourse 3 days before your due period. Is it possible to get pregnant even though you're not ovulating? Or will stopping pill use before you're supposed to get your period going to make you ovulate?",
    "doctor_response": "Hello,Thanks for sharing your health concern with us. I have gone through your query and here are some suggestions. 1. Missing three pills in a row makes the cycle unsafe. Additional protection is needed. 2. Pregnancy is not possible without ovulation. An intercourse just before the onset of the period is not likely to cause conception because even if you ovulated in the cycle, you were likely to be in the safe period. 3. Ovulation with abrupt stoppage of the pill is unpredictable. Hope you find this information useful. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can discomfort under the belly button be due to an infection?\n\nim 37 yrs.old, i had infection  on UTI, the last  urine test is ok now. But on my belly button lower part still bothering me. do i have  infection on my ovary?i tried to used lust cream for one time, just curiosity.   lust cream can made infection if i mess up on how to used? thanks",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Lust cream can't cause infection.But unhygienic condition when applying cream can cause the infection.In my advice you should apply antibiotic ointment over the umbilicus. This can cure the infection and give your relief.Polysporin ointment can be used for the infection cure.Please maintian good local hygiene by frequent cleaning and dressing.Ovarian or urinary tract infection won't spread to the umbilicus. Please avoid swear in the respected area, and wear a cotton undergarments.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart palpitations and fluttering?\n\nHello.  I am female, 41 yrs. Old, w/ no previous history of heart problems.  I have had infrequently and randomly over the past couple of weeks a sensation that my heart was beating a little faster than usual, accompanied by a feeling of a flutter, or a bubble pushing upwards, which disappears instantly.  My heart also skips a beat at this time.  What is going on w/ my heart?  I have no dizziness, nor lightheadedness.",
    "doctor_response": "Dear Mrs,You describe elevated heart rate, which is usually benign and can be caused by many reasons, such as stress, over-tiredness etc. You also describe some kind of arrhythmia, which can be benign, if is not very frequent, and can have same causes. If you have a stressful period, I would advise you, try to regulate your lifestyle, have a healthy  sleep, and everything will normalize gradually.If you see no improvement, I would advise you to see your doctor, to perform an ECG, and some labs, such as serum electrolytes, Hb, thyroid tests.Wishing you a good healthRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling and pain in face after dental fillings?\n\nSo i have pain and facial tingling 8 days after getting 3 fillings. He said they were deep but this is ridiculous. Would taking them out and doing them again stop my issues? PS this site should offer 1 question or 4 or 5 replies free then pay for the rest",
    "doctor_response": "HelloIf there is pain, either   of that  teeth may have very deep cavity and its root might be exposed causing  pain.You need to do root canal treatment.thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What makes me dizzy when I shout or blow hard?\n\nHello doctor,When I shout or blow hard with my mouth, I get headaches or dizziness. Why?",
    "doctor_response": "Hello. I understand your concern. The headache you feel is due to increased intracranial pressure when shouting or blowing. Avoid such habits. If it happens without shouting or blowing, I suggest you consult a neurologist to rule out neurological problems. All the best. For more information consult a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes leg and buttock pain after a lumbar puncture?\n\nI had a lumbar puncture last Friday that was very painful when the nerve would float in to the needle. It would cause pain in the right leg. Two days ago that leg and buttock area became very painful. Is it possible it inflammed the sciatic nerve and will it clear up?",
    "doctor_response": "Hello, As going through the history I don't think it will be sciatica. The pain can be due to multiple other reasons like muscle weakness, changes in the spinal column leading to nerve root entrapment. I will advise you first to take proper bed rest. Taking hot water fermentation should help release the spasm of the paraspinal muscles has occurred due to lumbar puncture as a protective body's mechanism. You need to wait and watch it if there are changes in the pain and symptoms. Then only we can conclude if it's related to disc herniation or prolapse. But for now, it's totally a muscle spasm at the lumbar region which needs to be corrected. also icing the lumbar region will reduce the pain as well. You should be fine once the paraspinal muscle spasm reduces. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does parkinsons cause muscle loss and pain?\n\nMy husband is going down hill fast...Muscles are disappearing...and he has severe hip and leg pain. He does not stand errect, and does not swing his arms, and neuro dr. says he is 80% sure it is parkensins. I have had relation who have had that and do not remember muscle loss and pain in him. What is your opinion? could it be myasthenia gravis?",
    "doctor_response": "Hi , It appears that your husband is suffering from Parkinson disease because of not able to stand erect and not swinging the arms while walking.Severe leg and hip pains and muscle loss are not related to this and need further investigations .Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tiredness, joint pain, abdominal pain, dizziness. Vitamin D, iron level very low. On medication. Advice?\n\nhi im 30 years old and have been feeling very tired over the past few months. I have pains in my joints, abdominal pains that I cant explain and I also bruise very easily when I scratch my body. I have also been feeling dizzy. I have had blood tests done over a month ago and been told my vitamin d and iron is level is very very low. It is under 10 but I don't know how low that is. I have been put on vitamin d and iron tablets a month ago. I never had the symptoms I have described a month ago. Can u give me any advice please.",
    "doctor_response": "Hi ! You can continue to have the Vit D and iron supplements as advised by your doctor. Based on your history of tiredness over the past few months, if I would have been your doctor, I would have advised you for a thyroid function test. Hypothyroidism which is very common does cause aneamia and tiredness. Vit D deficiency has also become common due to dietary deficiency and lack of sunlight in closed flat culture. If the thyroid deficiency is proved, then it is easily treatable with thyroid supplements and you will feel well. So get a thyroid function done and show the reports to your family physician for further treatment. Thanks and good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat poor penile erection and quick ejaculation?\n\nSir,I have two problem.First is that my penis is not getting hard and the second one is if it gets hard then its discharges very quickly Please let me know wheather this desease or problem is cureable or not and name of the doctor in kutch region",
    "doctor_response": "HelloThanks for query .In your query you have not mentioned about your age,marital status and whether you get early ejaculation while having intercourse with your female partner or while masturbating ..In majority of patients in absence of any major health issue cause of ED and premature ejaculation is mind related and due to performance anxiety.Consult qualified Urologist for evaluation and to get basic blood tests done.Taking Sildenafil with Dapoxetine as on demand will help to get good hard sustainable erection to have enjoyable sex and delay ejaculation.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it normal to bleed after intercourse during pregnancy?\n\nHello doctor, I am 13 weeks pregnant, and after having intercourse I passed a blood clot about the size of a quarter. I have a subchronic bleed behind my placenta. Are these two related?",
    "doctor_response": "Hello. Yes, they are related. Intercourse should ideally be avoided till the 18th week of gestation to avoid such episodes of threatened miscarriage. Any bleeding during pregnancy is threatened miscarriage unless proven otherwise and you have a sub-chorionic bleed which confirms it. You require Progesterone support and absolute bed rest for a week and review USG to follow up the sub-chorionic bleed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest natural ways to increase the HB level\n\ni am 33 years old woman, having one daughter of 4 years old and i want to plan another baby now but i have very low hemoglobin level -7.9. what are the ways to increase my hb apart from medicines and what would be the consequences of low hb if it does not increase during my pregnancy?",
    "doctor_response": "Hello,The commonest cause of low Hb is the deficiency of iron. The normal Hb is above 12 gm/dl. So you have a very significant anemia. Raising the Hb to normal levels with only iron rich food would take a long time and should not be the only way as with a pregnancy, the Hb will come down further and you and your baby would be at risk. If you cannot tolerate oral iron, injectable iron preparations are available. If your doctor feels that your Hb has to be raised immediately, there is the option of  packed cell transfusion. It is usually not required.Also you should see a doctor who will check you causes of loss of blood like excessive menstrual flow or loss in the motion. Take CareDr. Noble Zachariah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Done semen analysis. Is treatment required?\n\nSemen analysis report , please explain treatment required? Appearance: Creamy White Liquefaction Time(min): 30 Consistency Thin Volume 2.0 pH: 8.0 Rapid Progression: 65% b) Slow Progression:10% c) Non-Progressive Motility: 05% d) Immotile:20% Count / ml: 102 Million Normal:70% Abnormal:30% Head Defects:10% Tail Defects:10% Neck & Mid Piece Defects:05% Cytoplasmic Droplets:03% Headless Pinhead :02% Pus Cells : 4-6 Red Blood Cells : 4-6 Nil Epithelial Cells: 0-1 Miscellaneous :",
    "doctor_response": "Hello, Welcome to HCM, I am Dr. Das Firstly, Volume, consistency, liquefaction time, all are within normal limit. Sperm count is within normal limit ( normal is >15 millions / ml as per WHO 2009). Motility is within normal limit ( normal is > 40% total motility as per WHO 2009). Morphology is also within normal limit ( normal is >04% as per WHO 2009). Increased Pus cells and RBC indicates presence of lower urinary tract infection. For this, you have to take broad spectrum antibiotic like fluoroquinolones. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the dental work have been a contributory factor for minor stroke?\n\nRecently had extensive dental work, a broken tooth.  The procedure was so painful that the dentist had to stop and administer additional novocaine.  3-4 hours later an ischemic stroke occurred .  Tests revealed a minor stroke. There has been a rapid recovery but have now been put on blood thinner.  Could the dental work have been a contributory factor?",
    "doctor_response": "Thanks for posting your query to HCM.Long stressful dental procedures can be a cause for minor stroke especially in persons having history of heart problems.You have not mentioned anything about your history of any heart problem. Also sometimes some medication given during procedure can also affect.Next time whenever you go for any dental procedure, do inform the dentist about your history.Hope my answer will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excess saliva with inflamed taste buds?\n\nHi, I have had some weird things going on with my mouth/ tongue for say the past two months... It first started off with having a lot of saliva, it made my breath smell like ash even more (I smoke) and anything I ate would basically stay in my mouth... Then it looks like I have inflamed taste buds which are as big as small beads.. My mouth got really hairy and went brownish black... I got rid of the brownish black hairy likeness on my tongue and still have these blister looking things at the back of my tongue. Its also shiny red around the area. My saliva is now jelly like.",
    "doctor_response": "Hello,This is describes a condition possible for someone who smokes, has a fungal infection and needs better oral hygiene habits. The coating on the tongue is an irritation that can cause the papillea to elongate. These are not your taste buds. Brushing your tongue and improving your basic daily dental care can often help resolve this. You already have seen improvement. If the papillae do not return to normal, they can be trimmed to reduce them further by your dentist. Avoiding irritants  such as smoking is strongly recommended. The texture of the tongue changes to a smoother surface as you go further back. If you have inflammation due to an oral yeast infection or thrush, you can have swelling and redness. It often affects the surface of the tongue and your taste. Even with your initial reaction of extra saliva, now you most likely have less saliva and the consistancy has changed. A dry mouth is common. Treatment with Nystatin or other anti-fungal treatments can aleviate these symptoms. I recommend that you try these  steps. See your dentist for a prescription and definite diagnosis.Warm salt water rinses, keeping well hydrated with a balanced healthy diet and vitamins can offer relief. Acidodphillus may help rebalance your oral bacteria.You may have other medical conditons such as acid reflux or medications that have contributed to your symptoms. If your symtoms do not resolve other conditions should be considered and your tongue further evaluated. Make sure you are up to date with your dental exam and cleaning.I hope these steps are helpful to you and thank you for your inquiry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause difficulty breathing, back pain with problem in ribs?\n\ndetailed ondent on rt rib cg hi my name is aldo im 39 yrs of age and I have a problem with my ribs, its been progressing in the past 6 years now I have only half the space for my lung making it hard to breath. my doctors show no concern im to the point where my back hurts all of the time and it seems that im only breathing with my left lung and maybe only 10% of intake on my rt side can I get help with this",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, you should consult pulmonologist and get done chest x ray and PFT (pulmonary function test). Your symptoms are commonly seen with bronchitis, pleural effusion, collapsed right lung and fibrotic right lung. So chest x ray is must to rule out pleural effusion and collapsed lung. PFT is must for the diagnosis of bronchitis. You may need inhaled bronchodilator and inhaled corticosteroids (ICS) if it is bronchitis. You may need antibiotics and anti tubercular drugs if it is pleural effusion and collapsed lung. Don't worry, you will be alright with all these. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hello Dr Sam , I have a HSG test tomorrow\n\nHello Dr Sam ,I have a HSG test tomorrow morning and the doctor hasn't advices me on what medicine to take. In addition I am on metformin and as a I read through various forums it is not advisable to take metformin prior to the test.I am getting anxious about this. Could you please advice?Thank you,Shruti",
    "doctor_response": "hithanks for using healthcare magicGenerally there is no special preparation needed for this test. However, depending upon your diagnosis, you may need to take antibiotics to guard against possible infection. To ensure that you are not pregnant, the study is done between Day 7 and 10 of your cycle. Prior to the procedure you may take any pain killer like Ibuprofen 400 mg or Acetaminophen 500 mg a half hour before and one hour after the procedure.  There are no dietary restrictions. A small catheter is placed into the cervix and the dye is injected. You may feel heavy cramping during, and for several hours following this procedure. Expect a sticky vaginal discharge for a few days as the dye is expelled from the uterus. Use a pad or panty liner during this time to allow fluid to escape. Any dye that remains will be absorbed without any ill effect.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in arch of my foot and knee?\n\nHello for the past couple of years I have problems with the arch in my foot on and off and a about a year ago my right keen stated having pains and later on it when to my left keen .it s rare for them to both hurt at the same time but it Wil happened every now and then. Also when I wake up in the mornings my arch in my foot will hurt so much to the point that I have to set down and wait for the pain to go down. And the pains in my keens and feet aren t on and off any more .they have stated happening very day. For example right now I can t stretch out my right keen at all when I try to I get this awful feeling in my keen, it s like a bubble that s being crushed and explodes a sense of altering pain that that travels through my keen and other parts of my leg.",
    "doctor_response": "hi,thank you for providing the brief history of you.A thorough neuromuscular and musculoskeletal assessment is advised.As you have pain in the knees which keeps altering and also in the feet then a thorough clinical examination of the knee and feet is advised.Now something to understand here is when one side of the knee is having injury the brain itself acts as a protection and diverts 70% of weight to the other side of body and that is how the pain gets shifted from one side to the other.Also, the pain is having change of nature which may be due to neuropathic issues which needs a proper assessment. If the SLR Test is positive clinically than it might be related to the pinched nerve, if this test is negative then the issue is muscular.Also, if you have a bubbling sensation than understand of the vascular system is needed . If any skin color changes are present in the lower limbs a vascular hemodynamics is compromised which is leading to pain factor. If this is not present then have to come back to knee.usually when knee is Injured the clinical assessment is focussed to the knee only and may be an MRI to understand the soft tissue Injury as well. Performing a patella grinding test will help understand the muscle strength status. Any injury in the knee will lead to patella grinding test positive and the muscles will be weak as well.After a thorough clinical assessment, physical therapist will be able to assist you in strengthening the muscle groups and regain the mobility.Iny clinical experience after a thorough clinical assessment patient is advised to undergo physical therapy and majorty of them respond well to physical therapy.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from sleep disturbances. Kindly help me.\n\nHello doctor, I do not know where I should start. How will I tell you what exactly I feel? As I do not know either I was happy or sad, I cannot express what I think. I do not want to live, and I do not like to talk with my best friends, the family. They, ask me something about which I need to answer. I feel irritated and angry, and that makes me tired to reply to them. When I sleep at night, I sleep correctly on time, but I woke up daily at midnight at least 2 to 3 times at night daily. I fall asleep daily in the afternoon as well if I sleep midnight I woke at 11 am on the next day. And again at 2.30, I fall asleep. And the same problem is I woke up in the middle of my sleep. This becomes a routine, and I do not know why I hate myself? But I hate my face when I see myself in the mirror. Please help.",
    "doctor_response": "Hello. All problem you mentioned are core symptoms of depression are sadness, low mood, lethargy, disturbed sleep, low self-esteem, irritability, suicidal thoughts, decreased concentration. I think you should consult a psychiatrist, personally. Usually, there is insomnia in depression, but some time hypersomnia also possible in atypical depression. You do not need different medicine for all of your problem they will be solved just by antidepressant medication. No need to get panic and getting rid of depression is not so severe nowadays. Various new antidepressants and psychotherapies are present. If any stressors present try to remove it or decrease impact in life, improve your coping. Moderate exercise, yoga, meditation may help you. (rule out the medical cause by an investigation like CBC, TSH calcium B12, D3 level).",
    "dialogue_context": ""
  },
  {
    "patient_message": "Loss of appetite, have diarrhoea, blood in stool, had gallbladder removed. Taking lamictol and concerta\n\nHello. I am a 19 yr old female. For the past month, I have had little to no appetite , and when I do eat I have diarrhea immediately afterwards. I sometimes notice red blood on my stool and in the water but not always. Some medical history, I have had my gallbladder removed a year ago, and am currently on a few medications: Lamictol, Abilify, Concerta , and Strattera . I have lost approximently twenty pounds in the last month ( though that may possibly from the concerta). I would just like to be able to enjoy a meal without becoming sick afterwards.",
    "doctor_response": "hi I read carefully all your concerns. Since you have diarrhea and blood  in  your stools  you need to be evaluated with blood work proctologist consult colonoscopyI strongly suggest to consult your gastroenterologist  , you need to be physically exanimated. all the best DR.Klerida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from sever acne. No visible improvement with medication, taking healthy diet. Remedy?\n\nGood afternoon Dotor, I am 25 years old suffering from severe acne from the last 5 months.i consulted a doctor he gave me azithromyin tablet for three days and antoxid hc for 3 months,Seba med toner.But there are no visible improvement. i drink 4 litres of water everyday.i realy take care of my diet with fruts and veggies but there are no improvement on my pimples .",
    "doctor_response": "Hi, acne treatment depends upon its severity whether it is mild, moderate or severe in nature. In other words, it has to be seen what kind of lesions one is having predominantly that is whether you are having more of comedones or papules or pustules or severe nodules cysts and abscesses. The treatment plan changes accordingly. The chances of scarring and pigmentation are more with pustular nodular acne or with cysts and abscesses. In your case, you can continue with tab azithromycin as prescribed, along with topical application of benzoyl peroxide 2.5% in morning and adapalene gel in night.  Use a salicylic acid based face cleanser. Follow this schedule for 3 weeks, if you dont have much of  response, then one can think of adding isotretinoin  or doing chemical peels(glycolic acid or salicylic peels). For the same, you need to consult a dermatologist. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause small lump on neck?\n\nHi, I have recently discover small lumps on my neck, I went to the doctors to find out what this is. She said it s nothing to worry about and since they have gone smaller it is a good sign. However, yesterday I pressed against my neck a little harder and found more tiny little lumps, my neck also feels a bit stiff (I woke up with a runny nose and was sneezing a lot yesterday as well). The lumps were first discovered about 3-4 weeks ago. I have got a blood test coming up soon, should I be worried about this issue or is this a common problem which should go away on its own? Also will paracetamol help? Thank You",
    "doctor_response": "Hi ! Good evening. I am Dr Shareef answering your query.One of the common causes of a generalised lymphadenopathy on the neck region could be a viral fever, mononucleosis, which are associated with a upper respiratory tract infection/symptoms.If the lymphadenitis was due to simple infection, they would subside with the treatment of the infection. If they stay for longer duration, they have to be investigated upon with routine and some special blood tests, and a biopsy either FNAC or an excision biopsy depending on the position and size of the lymph gland for a histopathology.In your case, if you did have any treatment till now, I would have prescribed a course of antibiotics for you initially, and if they do not subside, I would go for all the investigations as noted above to arrive at a diagnosis and further management. Paracetamol might help temporarily for a symptomatic relief only.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is your opinion regarding my medication?\n\nHi doctor,Three years ago, I had a stent in my LAD, which had been 96% occluded. At that time, my cardiologist put me on Plavix for a year and ongoing 81 mg Aspirin therapy. I am also taking 50 mg Atenolol. It was 25 mg until this month and was increased due to palpitations probably stress related. I was also put on 5 mg of Crestor a day. My doctor and I agreed to this, since five men in my family took statins and all had an adverse reaction. Also, two of them were hospitalized due to it. The therapy had been working and my total cholesterol dropped from pre-stent therapy total 219, HDL 140, HDL 44, triglycerides 209 to post-stent with medicine total 138, LDL 71, HDL 39 and triglycerides 141. Over the past one year, I have been doing intermittent fasting. In the past year, have further lowered my numbers to 91 total cholesterol, 48 LDL, 40 HDL, and 61 triglycerides. This latest result has been repeated twice at six months intervals. Now, my GP is skeptical about the low dose statin and wanted to put me back on a blood thinner as well. I cannot get in to see a cardiologist for a month. I am reluctant to be put back on Plavix and I am equally reluctant to change statins and increase the dose. The new GP has kept me where I am with medicines for now. What are my options? It appears with diet and the current medical regimen that I am getting excellent results. Am I mistaken? Are high dose statins required despite the good blood results? Are all statins created equal and are they interchangeable for every individual?",
    "doctor_response": "Hi. Good to know that you are in good control of your lipids. First of all, statins must be used when one has had any heart attack or stroke. The dose of statin is set by the level of LDL (low-density lipoprotein). LDL must be lowered to one half. In your case, Crestor (Rosuvastatin 5 mg) is doing the best. Yes, there are side effects of statins. The most common are muscle pain and weakness. In my opinion, Rosuvastatin 5 mg is the best for you because it is of very low dose. If you change to another statin (Atorvastatin), you will have to take at least 40 mg per day and that may cause side effects as these are common in your family. So, I recommend to continue Crestor 5 mg. You may be thinking that should I quit statin as my lipid levels are quite under control. Remember, the good effects of statins in case of heart attack or stroke is not only through decreasing lipid levels, but there are also many other ways statins benefit patients. So, keep up with your current treatment regimen. Keep your blood pressure under control and do regular exercise of moderate intensity for about 30 minutes a day for at least five days a week. For further information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes feeling of cobweb in lungs?\n\nItit somettimees feels like I have cobwebs in my lungs and a small rattle in my chest.  OI Have bn diahgnosed with astma but what is that cobweb feeling.sometimes get it but not alot. I am not a chronic ashtma patient. I also take vitamin e and seems to help with it.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Since you are having cobweb like feeling in lungs, some rattling (crackling, congestive) in the lungs, we should definitely see for your asthma control. Uncontrolled asthma can cause similar kind of symptoms without cough and breathlessness. So better to consult pulmonologist and get done clinical examination of respiratory system, chest x ray and PFT (pulmonary function test). PFT is must to know the severity of asthma. And treatment of asthma is based on severity only. You may need inhaled corticosteroids (ICS) (budesonide or fluticasone) on the basis of reports. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the recurring infection of the keloid on the chest?\n\nI had CABG 9 years before and there was formation of Keloid on my chest. First 5 years there was no problem and now the place where there is Keloid in chest is getting infected frequently and I am taking anti-biotic medicines to cure the same, every time. How can I get rid of the problem.",
    "doctor_response": "Hi you are either a Diabetic, or some infection is remaining in the keloid and re-surfacing. After an antibiotic course, use magnesium sulphate dressing daily for a week. This will draw out residual infection--regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are injections safe to use for skin itching during pregnancy?\n\nHi doctor, I have\u00a0red bumps on hands, lower back and legs. It is also itching a lot. In some body portion blood patches had happened due to itching. For this itching Estrogen, LCZ and Lobate are used as current medication, but no use. I am going for liver function test as soon as possible.\u00a0Are injections safe to use during pregnancy for severe skin itchiness? Please help me.",
    "doctor_response": "Hi. I have gone through the pictures (attachment removed to protect patient identity). For further information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life expectancy rate for a patient having pancreatic cancer ?\n\nhi, if a 39yr old male was to be diagnosed with acute pancreas cancer , how long should he expect to live?",
    "doctor_response": "hello welcome to healt care magci,this totally depends  ombern tnm classification that is number of metastasis ,i.e the spread of  tumour is in which region ,size of the tumour age of the patient as young cells can resist more than the older ones and history of the patient and so on ,depicting all this can diagnose how long is he expected to live.take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for heart murmur\n\nI am 82 and I have been dizzy most of the time. My doctor sent me to many other doctors for balance evaluation and therapy, heart eval., hearing and inner ear tests and a brain scan. The only abnormality was a heart murmur which I ve had all my life. I ve cut back or eliminated all pills except for a vitamin tablet. My blood tests showed sodium at 132 which is below the range slightly and LDL chol Calc of 125.8 which is above 100. Any ideas?",
    "doctor_response": "hi your murmur cab be only due to cardiac problem, mostly regurgitation murmur. multivitamin therapy is totally a different entity, it does not supress the murmur. this dizziness can be due to uncontrolled heart rate or due to electrolyte imbalance or cervical disc problem. small dose of betablockers like metoprolol if otherwise not contra-indicated can be started to control the rate,which in turn reduces the dizziness. all the best take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough and fever in a child\n\nmy 3 yrs old daughter is suffering from heavy dry cough since last two days. She was having fever also in last 2 days but now it seems normal. Her stools are not clear and normal, sometimes hard and sometimes it is the mixture of hard and soft stool. Pse advice me medicines.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.Cough and cold are viral 95% of the times in children. For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15mg/kg/dose (max ceiling dose 500mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.For cold you can use Cetrizine at 0.25mg/kg/dose every 12 hourly for 3 days.For nasal block, plain saline nasal drops will do, every 4-6th hourly to relive nasal congestion.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Regards - Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get my mother's breathing under control?\n\nMy mom just called and she can't get her heart rate to go down - it is over 100 (she is 67 years old). Her dog is with my Dad as they found a cut on her chest and she is very upset about that. She said it has been this way for a few days though, but is worse right now. She has tried deep breathing, but it is not helping. She also has low blood pressure, which then spikes upward, but is low right now. She is obese and is finding it difficult to get her breathing under control. She does have inhalers, what should I tell her?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, you should tell her to consult emergency room immediately. Breathing difficulty with hypotension (low blood pressure) and tachycardia (rapid pulse rate) are commonly seen in heart and lung diseases. So ask her to visit emergency room and get done 1. Blood pressure monitoring 2. Ecg and 2d echo to rule out heart related diseases. 3. PFT (pulmonary function test) for the diagnosis of lung related diseases (bronchitis). She mayank need cardiac supportive drugs or inhaled bronchodilator and inhaled corticosteroids (ICS) on the basis of these reports. Don't worry, she will be alright with appropriate treatment. So tell her to visit emergency room as soon as possible. Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the causes and treatment for the red rashes that bleed on body?\n\nhi i have been having these red rash circles appear on my body for a couple of weeks now. They red circles that itch and either bleed or discharge clear fluid. They are mostly on my wrists, arms, ankle, and feet. I've looked online for the symtom's but come up with nothing. can you give some insight to help stop this?",
    "doctor_response": "Hello,Thank you for posting on HCM.It seems you are having recurrent attacks of Urticaria or hives. Its an allergic manifestation of skin, where an allergen leads to release of certain substances from your blood, leading to itchy skin rash and swelling over soft tissues. Its proper management requires thorough history, clinical and laboratory work-up.You may have to go for specific tests like patch test, food prick test, IgE antibody levels etc. As for treatment part, best would be the avoidance of allergen as far as possible. Try to eliminate possible triggering foods from diet. I would also advise you various anti-histaminics for long duration( atleast 3 months) with or without oral corticosteroids. For non- responding cases there are many other drugs like dapsone, cyclosporine, montelukast, omalizumab etc which can be used in certain selected cases. Hope this will help you in resolving your query.Thank you Dr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for lack of heartbeat in fetus?\n\nhad a sonogram monday dec.20th and was told my baby has no heart beat. i will be 10 weeks pregnant tomorrow and i am not experiencing any signs or symptoms of a miscarriage. the doctor told me they cant and dont do anything. she wants to see me on the 6th she didnt say why but i thought that when this happens they do a d&c? i am very confused and really feel like i need to get another sonogram,what should i do and is it possible that they just couldnt see the heart beat?",
    "doctor_response": "dearvery sorry to hear about the absent heart beats .Don't worry if you are not having any signs of miscarriage.Nature is a best Doctor, it usually throws out the things which is of no use .Your dr knows the best.She knows when to interveneAll the best Dr. Mira Butani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have lower lip twitching, leg shaking, headaches. Advice?\n\nHi doctor! I am currently experiencing lower lip twitching, and my left leg shaking. I also have experiencing headache after I wake up and eventually gone throughout the day but still comes back during the evening right before I sleep. Just wondering why it happens to me. I used to be so healthy yet a bit stressed up the past few days..What can you advise?",
    "doctor_response": "Hi Your stress appears to be the root cause for this problem. Free yourself from the stress by intentional modes, morning walk, enjoying good company, reading good books, leaving the things to god and ignoring ego. Eat balanced diet avoid lonely sittings and anger. There are meny herbs and procedures in ayurveda which reduce stress. Body massage is a good mode. ashwagandha is a good stress buster and nervine tonic. This will cure shaking and headache.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is cows milk safe for 2 month old infants?\n\nhi i am having twins they are two months old mother milk is not sufficient so doctors advise to use lactogen 1 we use it a one and half month but now we started cow milk the babies are easily disgesting the milk and there is no issue in the health so i wanna ask does cow milk is safe and gain weight bcoz my twins weight is 2.5 kg each",
    "doctor_response": "Committee on Nutrition of the American Academy of Pediatrics discourages the use of cow's milk under one year of age.Younger babies cannot handle the extra minerals, protein, and sodium present in cow's milk.After one year of age you can introduce cow's milk.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could intake of Crestor cause albumin level being 4.8 with having high potassium level?\n\nMy Albumin level is 4.8 according to lab tests. I ve been taking Crestor for several years, does this have anything to do with this? What effect does Albumin have on Kidneys and liver? I also have a high Potassium level (5.3) Are the two connected?",
    "doctor_response": "Hi thanks for posting in HCM I have understood your concern 1.albumin level of 4.8, is normal.2.albumin is produced from the liver3.in case of kidney diseases like nephrotic and nephritic syndromes albumin is lost through urine.4.crestor prevents the loss of albumin in urine along with control of BP.5.high potassium is a side effect of creator but in the case it is in acceptable level.if it is increasing you have to change that tablet.I can suggest you to get done 1. serum creatinine2. serum potassium monthly once3.urine protein creatinine ratio 4.usg abdomenhope this helps you any further questions please let me know thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain due to mental stress, depression, emotional rush. What is the reason?\n\nHelp me stop feeling upset about growing up, every night I sit in my bed thinking about growing up and it makes me feel upset, it also gives me a pain in my stomach I'm only 11 years old and I used to only have one day and then a while later, but now it's every single day! I even think about it sometimes during the day, I even cry about it sometimes, and I turn 12 jn November and it makes me think my childhood is almost over, I can't take it anymore, please help?",
    "doctor_response": "Hello, Welcome to Health Care MagicYou are 11 and going to be 12 in some time but the thought of getting older make you feel depressed with thoughts that your childhood is over. See to some extent this type of thought is seen in a lot of individuals as this is a normal part of life cycle. Every human passes through life cycle from infantile period to childhood to adolescent to adult to elderly stage. No stage is fixed and we are born to get older and to work and to achieve something. So don't take tension of this thing, if the problem is really bothersome then consult with your parents and visit a psychiatrist.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is there dizziness and sleeping problems after breaking on penis head?\n\nGood day, Had sex with the massage girl 2 days ago. Had unfase oral and safe  vaginal sex. near the end of sex craked a thingy which hold my penis head. The penis was in condom. On second morning feel not good . have problems sleeping , feel like a cold. felling dizzy. temperature is 37.5",
    "doctor_response": "Hello, It is not related to your encounter and probably be due to anxiety. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does my WBC, RBC, platelet count amount to? Are they normal?\n\nComplete Blood Picure Haemoglobin : 15.6 gms% RBC Count :5.1 M/cmm TOtal WBC Count : 6,400/cmm Differential Count Neutrophils : 60 % Lymphocytes : 34% Eosinophils : 4 % Monocytes : 2% Basophils : 0% PERIPHERAL BLOOD SMEAR :- NORMOCYTIC -NORMOCHROMIC. PLATELETS - ADEQUATE WBC-WITH IN NORMAL LIMITS The above is the blood test report of mine, please let me know weather the report is normal or any defect is there Thakyou Kranthi",
    "doctor_response": "Hi, Welcome to HCM Every blood report done needs to be corelated with the clinical condition of the patient,and the doctor who ordered it knows best. your Hemoglobin and counts are with in normal limits. But why these test are asked may require a clinical corelation. If there are no major health issues. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low blood pressure along with weakness and frequent urination\n\nI,ve always had low bloodpreasure. I,m 46 yrs old. For the past year I ve had episodes where I feel totally high& I don,t drink or take any kinds of drugs. This last usually a few hrs and then I feel totally wiped out. These episodes happen a few times a week. My diet is healthy. All food groups. But I,ll snack on 3 candy bars a day. Im very active with my business, long hrs. Im 5ft 8 & weigh 135 lbs. For the past year I ve also had frequent urgancy to urinate and the urine smells very foul like that of a outhouse. I,m female and I haven t noticed any signs of menapause and I ve never had children. What s happening with me?\u2026",
    "doctor_response": "I think madam you need a complete evaluation like routine blood investigations, ECG , echo , thyroid profile , urine routine and culture.Madam blood pressure is low when it is lower the 90/60 mmHg with symptoms like giddiness and syncope..If you have such things please work up.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How dangerous is prolonged high BP?\n\nMy mother has had her blood pressure taken today which read 220/120.  Last week it was 200/100.  She has been taking blood pressure tablets for a year or so.  I am concerned that it is so high.  Her doc has prescribed more hypertensive drugs to take alongside the one she currently takes (ramapril).",
    "doctor_response": "Hi, Thanks for your query. Her BP is still high and any reading above 160/100 mm Hg is dangerous. I feel you need an emergency evaluation and treatment. Please visit an ER or a cardiologist at the earliest for further management of her BP. Let me know if I can assist you further.Dr Vishesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can paternity of an unborn child be confirmed?\n\nHii I want to know who will be my baby father ok so I had sex with a guy on June 11 and my period came o June 14 and ended June 19 then I had sex with my ex boyfriend on June 20 and June 27 so now today I\u2019m spotting and that\u2019s a pregnancy sign who would be the fathers child",
    "doctor_response": "Hello dear,welcome to Ask a doctor service. I reviewed your query and here is my advice. The first cycle is finished and no pregnancy concern. The second cycle since is not yet finished so if you are pregnant second guy is father. DNA is only secure way to determine father wood. Spotting you are experiencing is not a sign of pregnancy. Hope I have answered the question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes neck pain near the left shoulder behind the clavicle?\n\nhello doctor i am experiencing some kind of electrical ping on the left side of the back of the neck near the left shoulder behind the clavicle. sometimes when i try to swallow my saliva i will feel the pain. whenever i swallow no thing at certain point at specific angle i will feel the pain.. i am so curious is it something related to nerve disease",
    "doctor_response": "Hi, welcome to our site. I am Dr Saumya Mittal, MD.Read your query. That is a very significant question and i appreciate your problem. I will try my best to answer your queryThe symptoms are quite suggestive of a possible nerve impingement when they come out of the spinal cord through the vertebral column. I feel it can be said that this would explain the cause of all your symptoms. However pain in swallowing cannot be really attributed to it.Short of an examination, I would suggest an MRI of the brain and screen of spine to be sure. I hope this helps you. Inform the reports mentioned above/if any other so I can be of help further. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you. You can upload them on the site.You can upload them with the query, or if you have a problem, send them to attachments@healthcaremagic.com with Sub: ATTN 'Your Name'. Once we receive the photos or diagnostic reports, my team will send reports / pictures to me.Please do understand that some details could be extracted from a detailed history and examination.Please click on Thanks/Helpful if found useful.Please feel free to ask another query. I would be glad to help you. Looking forward to your return query with the details asked so that I can help you further. (If the answer has helped you, please indicate this)Best of luck.Dr Mittal.MBBS, MD (Internal Medicine), CC (Diabetes Mellitus), DNB (Neurology)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Got relief from stomach cramps with rolaids after having dinner. Had some weird sensation in esophagus\n\nAt the start of thanksgiving dinner I felt ok.  Ate several bites of turkey mashed potatoes, stuffing, crescent roll and green beans and suddenly had a stomach cramp type feeling where I couldn't hardly sit up straight.  Like a Charlie horse cramp in my stomach.  I felt some weird sensations also go up my esophagus.  I took 2 rolaids and laid down on the floor on right side after walking around a bit.  It took at least 20 minutes or more before the pain went away.",
    "doctor_response": "severe gastritis due to allergy or hypersenstivity to food in dinner as the acid come up in the throat causing wired sensation in oesophagusneed antacid gelsplenty o fluids non spicy non greesy and non fatty food for some days",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce microalbumanurea level ?\n\nsir, my age is 47. i am having HTN and DM II. My microalbumanurea is 537. Pl. suggest how to reduce it. my age is 47. I am having hypertension with diabetes for 10 years. my microalbumanurea is 539. Please suggest how to reduce it.",
    "doctor_response": "Hi, Your microalbumaanuria is very high,it indicates that due to diabetes kidney is markedly affected. There is possibility that you might have developed Nephropathy. To decrease keep diabetes strictly under control. Strict control of blood pressure. Control of urinary infection which precipitates the condition. you go for serum creatinine and other tests Remain constant contact with urologist,diabetologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for major dizzy spell, irregular heartbeat when taking metoprolol tartrate?\n\nI had a major dizzy spell on Saturday evening. Ended up in hospital, until tonight. Heart monitored, stress tests and dyes. One dr told me not to take metroprol tartrate and one told me I must. Heart test clear. Irregular heartbeat though. I am confused.",
    "doctor_response": "Hi Welcome to HCM.I understand your query and concern.Dizzy spells can be a definite feature of heart rhythm disturbances.Irregular heartbeat is known to alter the blood supply to the brain leading to impaired function in a transient way.Few drugs like beta blockers are certainly known to reduce the heart rate and accelerate the dizzy spells.I advise you to have a complete 24 hr holter ECG which can accurately determine the cardiac conduction abnormalities.Drugs like Isoproterenol will help to increase the heart rate.Drugs like amiodarone can also help to minimise the rhythm irregularities.A 2 Dimensional echocardiography will help to assess the functional reserve of the heart ruling out organic heart lesions.Radiofrequency ablation will also help to eliminate abnormal foci of rhythm.Consult your cardiologist for expert management.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are creatinine level and urea level related?\n\nmy mother is 62 year old, diabetic for 25 years, her creatinine is 5.7 and urea is 120. we observe that when creatinine level comes down, her urea level also drops. are these two related ? is dialysis essential ? she is normal and carries her routine activities",
    "doctor_response": "Hello,Yes urea and creatinine levels are related.Both of them are waste products of protein degradation occuring in body.They both are excreted by kidney. So if kidney is not functioning properly, then the levels of creatinine and urea goes above normal levels.That is why we check serum creatinine and urea to indirectly see the functioning of kidney. Normally creatinine should be around 1.0 and urea below 45.She might need dialysis if the levels keep on going higher because if it goes higher it affects functioning of brain, kidney and lungs.So, if you are advised dialysis by your doctor, its advisable to undergo the procedure. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from hypertension. Arm went numb. Cervical spondylosis diagnosed in x-ray. Prescribed with neurokind and segnoflam. Proper medication?\n\nhi, i have low bp problem for the last 4yrs. last week suddenly my right arm was numb fr few seconds . when i went to doctor. he prescribed neurokind tab n ask me for xray cervical spine . Now the report said i have cervical spondailiysis. n doc gv me segnoflam tab . i i want to confirm whether this medicines are correct. n I m also suffering from severe Headache towards right hand side . which goes till further. N My veins r so prone that time. please advise .",
    "doctor_response": "Hi, Thanks for posting your query. These medication may help in your neck pain and right upper arm pan but never help complete cure. Numbness in arm indicates some sort of neuropathy and you should go for nerve conduction studies. You should also consult with neurophysician and should get pregabalin/ gabaneuron/ oxcarbazepine on written prescription. You should also go for CT/ MRI scan cervicl spine. Thanks , Dr. Mayank Bhargava",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can chest pain be treated?\n\nI am having chest pain on my right side right under my breast. Started about 4 hours ago. I thought it was heartburn so I took tums. Still hurting. Constant pain but will shot a extreme pain every once in awhile. What can I do to make it go away or at least ease up",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Possibility of musculoskeletal pain is more likely. But better to get done chest x ray to rule out lung related diseases.If chest x ray is normal then no need to worry for lung diseases. Do following things for better symptomatic relief in musculoskeletal pain. 1. Avoid heavyweight lifting and strenuous exercise. 2. Avoid movements causing pain. Avoid sudden jerky movements of chest. 3. Take painkiller and muscle relaxant drugs like Ibuprofen and Thiocolchicoside. 4. Apply warm water pad on affected areas of chest 5. Don't worry, you will be alright with all these in 2-3 days. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the Prognosis for the fluid drained from abdomen and legs with edema?\n\nAfter 30 years with hep c, the liver is completely hard---over the past three months fluid has been drained from the extended abdomen--1st 16 litres, 18litres then 20 litres. Legs with edema. Lack of appetite, sleeping from approx. 4pm for the night, weight loss approx. 50 lbs. What is the prognosis????",
    "doctor_response": "Hi,I am so sorry to hear about your condition. It looks like you are currently in decompensated stage of liver cirrhosis (\"hard Liver\"). You are suffering from classical features of portal hypertension (fluid build up in the belly) and other symptoms of liver failure (poor appetite, weight loss, excessive sleepiness, etc). The best available treatment for someone at your stage is a liver transplant. It will completely get rid of the fluid build up although regaining your strength and appetite may take a while. But transplant cannot be offered to everyone and depends most on your current performance status (physical fitness, age, other co-morbid conditions like diabetes, heart problems etc). If it turns out that you are not a transplant candidate, and I presume medications have failed to control the fluid build up, then one of the options to be considered is TIPS. Although it will not reverse the liver failure, it will prevent fluid build up in your belly. Addressing your question regarding prognosis, it again depends on a variety of factors including presence of infection, kidney failure, heart failure etc.I suggest you don t give up and explore all therepeutic options available.Please do not hesitate to contact me for any clarifications needed - rxsuresh@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication to apply on grazes after an accident to avoid infection\n\nHi my14 year old son fell off his bike onto the concrete at a skateboard park yesterday afternoon and has several grazes over his face some more superficial than others. They were cleaned with saline and covered for the night but I removed the dressings this am.Is there anything I should apply to the grazes now to avoid infection?",
    "doctor_response": "hi this is dr. subhadeep thanks for the opportunity to help you.as per your description the matter the injury is not very serious, however the site is face and so chances of infection is a major issue.it will be of immense help if you can send me pictures of those abrasions.first inj. tetanus toxoid 1 ampule should be taken within 24 hrs. if those r only superficial abrasions then you have to clean those wound with gauze piece and beta dine.after cleaning you can either apply mupirocin ointment or neosporin powder.neosporin powder helps in drying the wound fast.once the wound is healed there may be scars for that you can get a dermatologist opinion for creams to remove marks like mender a cream or no marks.first one is more effective.very rarely if it develops a bad scar, plastic surgery excision for scar excision followed by skin grafting can be done.you can use  antibiotics like broad spectrum antibiotics amoxicillin+clavulanic acid combination 3 times for 5 daystablet rantack 150mg 1-0-1x5 dayspain killers 1-0-1 and t. chymoral forte 1-1-1x5 dayshope this consultation was beneficialregards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes reactive HbSAg, high AST and ALT?\n\nmy daughter donated blood at a camp. they sent her a note saying her HbSAg was reactive and her AST was 52 ( the normal level is 5 to 40) and her ALT was 77 (the normal range is 5 to 40) her T Bilirubin is 0.5 (0.2 to 1.3) and Anti-HbC is negative. D Bilirubin is 0.1 (0 to 0.4) T Protein is 7.2 (6 to 8) Albumin 4.4(3.5-5). what does it mean",
    "doctor_response": "Hello,the presence of HBsAg means that an individual has come into contact with hepatitis B virus. There are some rare exceptions to this rule. If the core antibody (anti-HBc) is negative then there are two possibilities. (1) there is an infection that has not yet led to increased antibodies against core antigens(2) there is no infection and HBsAg is reactive because of other antigens that cause cross-reactivity.The second is the most likely scenario unless your daughter had symptoms as well. In any case a repeat and more complete testing for hepatitis is warranted.So, besides HBsAg and anti-HBc, also please include the tests:- HBeAg- antiHBe- anti-HBs- liver function testsDoing them in a couple of weeks would be appropriate unless she has symptoms.If she does, then she'll need to contact an infectious diseases or hepatology specialist to receive treatment.I hope I've helped!If you'd like more information, you can contact me again.Kind Regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling of inguinal lymph nodes?\n\nHello! I m a 24 y/o white, female with, overall, great health. Approximately 4 weeks ago, I noticed the swelling of one of my inguinal lymph nodes on the left side. Recently, two more inguinal lymph nodes have swollen, also on the left side. Along with the swollen nodes, I have lost weight and become fatigued. The nodes feel firm, but are movable and painless. I ve checked my feet/legs for cuts/abrasions, thinking I possibly had some kind of infection, but my skin is clear. My question is, do I have cause for worry? Or should I wait a couple more weeks to see if the swelling goes down before seeing my family physician?",
    "doctor_response": "Hi, thanks for using healthcare magicIt may not be anything significant but you should consider going to your doctor for an evaluation.Normally it can take up to 4 to 6 weeks for lymph nodes to return to normal after an inflammatory response.Since the 4 week time period has gone and you are noticing more than one lymph node, your doctor may need to assess you.This would include history of symptoms, examination and blood tests. The initial blood tests would likely be a complete blood count and ESR (checks for inflammation in the body).I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, irregular periods, thick endometrial wall. Treatment?\n\nhello doctor, I m 28 years old woman and i have completed two years of married life.Before 6 month we leave any precaution but i m not conceive.now I m suffering from priods irrugarties before 3 to 4 month my blooding is also very low and priods delay 5 to 6 day every month.Doctor is this a reason not to be pregnentent.I consult a doctor who suggest me to ultrasound . in my ultrasound report of 9th day of priods endometrial thickness is 6mm doctor i want to know this treatment is right or wrong??? Can i continoue this treatment.other-wise i ll go to thyriod test.Doctor my Doctor suggest me 4 ultrasound in a month i do not understand what is the right treatment for me pls suggest me what i do????",
    "doctor_response": "Hello. Thanks for writing to us. Since you are having irregular periods, hormonal disturbances need to be ruled out like PCOD and thyroid dysfunction. Repeated ultrasound scans help to detect if your ovaries are producing eggs or not. You are getting the right treatment. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for infection of wound post pilonidal cyst removal\n\nHi i just recently had surgery for a pilonidal cyst removal. its been 5 weeks since my surgery and now i think the wound might be infected. i went to urgent care last weekend and they provided me with antibiotics but the infection seems to have worsened. Also i have just gotten sick this weekend with a head cold. Is it urgent that I go to the doctor right now or is it okay if i wait until tommorow afternoon?",
    "doctor_response": "Hi thanks for asking question.You have mentioned about infected wound.Do your CBC to see for actual severity of infection.If neutrophilia along with high total count then antibiotic has to be taken that you already taking.But if fever is above 101.5'f and total count if markedly increased then consultation of doctor is needed.Meanwhile drink more water,Eat fruits and green leafy vegetables.Avoid excess spicy food.Stool softener can be taken.Avoid smoking for few days.If that area severely affected and discharging pus then consult doctor and regular dressing necessary.I hope you understand my concern.thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is fever in the evening with congested chest be a symptom of typhoid?\n\nMy daughter is 3 yrs of late she she getting fever in the evenings and in the morning her fever is little less or normal.some time she says he has a pain in her stomach.her chest is congested.is it typhoid.doctor geve her corocine and asked us to moniter after every 6 hrs",
    "doctor_response": "hi, chest congestion with fever points towards upper respiratory tract infection. In typhoid there is history of fever without any focus, and the fever continues to increase. Without treatment fever increases in typhoid and can cause complications like pain abdomen, pneumonia, hepatitis. Kindly do complete blood count, typhidot IGM hand x ray chest. It will help in ruling out typhoid and chest infection. temperature chart it should be done so that we may know that whether temperature is increasing or not. Review with reports. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Surgery for umbilical hernia, hysterectomy, liposuction & abdominoplasty. Abdominal scan done. Any advice?\n\nHi Doctor! -  I'm angelina.  last October i underwent  surgery for umbilical hernia, hysterectomy , liposuction & abdominoplasty [tummy tucking] . Just 3 months after these operations [done in one day] due to consistent pain i was advised to undergo ultrasonography of the abdomen in july '13 wheren the report states:epigastric hernia & illdefined soft lesion in the umblical region which i fear must have increased by now.  kindly suggest.  thank you.",
    "doctor_response": "Hello ,thanks for your query .As your ultrasound suggests that you have an epigastric hernia and an ill defined soft lesion in the umbilical region which could suggest an incisional hernia following the operations.I would suggest you to consult your surgeon who can evaluate you and plan the further management - surgery at  the earliest . Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have canker sore inside lip and hole in gums where tooth was extracted. Reason?\n\nI had two teeth extractions this past Wednesday. I developed a canker sore on the inside of my upper lip . The dentist said it was caused by the Novocain. Right above where I had my tooth extracted there is a hole on my gums. He had to use several equipments to try to remove the root. My question is, can a canker sore cause a hole on your gums? The hole is pretty deep and it s not white like the canker sore right above it. Could it be from the sore? What caused the hole if not? And will it close?",
    "doctor_response": "Hi, Thanks  for  asking  the  query, Canker  sores  occurs  due  to  physical  or  chemical  trauma . The  hole  in  the  gum  is  due  to  healing  extraction  socket ,  usually  it  takes  8-10  days  after  extraction for  the   socket  to  heal  completely. Maintain  a  good  oral  hygiene  and  prevent  the  site  to   get  infected. Use  chlorhexidine  mouthwash  gargles  twice  daily. Apply  dologel  oral  ointment topically  over  canker  sores. Hope  this  helps  out. Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dry cough?\n\nHi i have a dry cough that makes me gag and wretch, it produces nothing then i need to wet my mouth when i do with saliva, and then swallow, it feels like it has spikes in it and makes me gag and wretch, what could this be and what can i do about it.?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.By your history and description, possibility of throat irritation and related cough is more likely.So better to consult ENT doctor and get done clinical examination of throat.Yoi will mostly improve with levocetrizine or fexofenadine twice daily after some food. Drink plenty of fluids orally and keep yourself hydrated. Avoid oily and spicy food. Avoid junk food. Avoid hard to chew food.Do warm water gargles 5-6 times a day.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes new born baby to cry whole day?\n\nMy 22 days old baby is crying since morning. She is completely on breastfeed but since morning she is not taking the feed properly. She could latch on the breasts but within a minute removing it and started crying. She is passing urine normally ( every 3-4 hrs) and have passed stools thrice since morning . I have tried feeding her by expressing my milk and feeding her, but still she hasn't stop crying. My breast are getting enough milk ( both of them leaking since morning today).  Please advise.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.This is called evening colic and is quite common in this age group. This happens when the baby sucks at the breast very fast and in eagerness to drink milk will gulp in air too. Unless the air comes out like burping or flatus this discomfort will be there and next time check if the baby is sucking too fast and gulping in air too. You will be more convinced. Usually I don't advice any medicines for this as they give only temporary relief.The two best ways to relieve this distress is - 1. Do not put  the baby in lying position after feeding till the baby burps out the swallowed air.2. If  still crying - put the baby in prone position and keep patting the back gently so that the baby passes off the flatus and gets relieved.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain below the ankle bone?\n\nI woke up Wednesday morning with moderate to severe pain in my right foot. It s on the side of my foot, below my ankle bone and in the arch area, but still on the side of my foot, not the top or sole. It hurts to walk or to make circles with my foot. There doesn t appear to be any bruising or swelling but it is very tender to the touch.",
    "doctor_response": "Hi, Tenderness (pain on touch) is suggestive of internal soft tissue injury. So better to consult an orthopedic doctor and get done a clinical examination and X-ray of the foot to rule out any fracture or severe injury. If X-ray is normal then no need to worry much. Take a painkiller and anti-inflammatory drugs like Ibuprofen and Acetaminophen. Avoid weight bearing. Immobilization for few days will also help. Apply warm water pad on affected areas of the foot. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Kaushal Bhavsar, Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for toothaches with pain in the gum.\n\nI have been suffering with toothache for 2 weeks now. I went to my dentist and have been told I need 2 teeth extracted and 1 needs root canal. My problem is I am very scared dentists, I was scared to just visit my dentist even though I new he wasn't going to any treatment.So, he sent a letter of referral to be put under sedation. When I phoned up to book the appointment they told me I could only get an appointment for the 24th May 2012 which is 3/4 months away.Thing is i'm really suffering my gums ache 24/7 and I cant get a sooner appointment at the sedation clinic. Have you got any other options for me? such as could I go to my doctor and get referred else where? possibly sooner? Could I book an appointment with another sedation clinic without going back to my dentist to get referred? sorry - i dont know what else to do.",
    "doctor_response": "Hello!Read your query.You don't need to be scared of dental treatment as dentistry has become absolutely pain free now. You might experience some discomfort of opening your mouth for long,etc.You can take a full course of antibiotics MoxikindCV for 5 days. Analgesics like ketorol10mg D.T for 3 days.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any non-surgical treatment for L4-L5 disc bulge ?\n\nHello Sir/Madam, I am suffering from severe lower back pain since 2 months. Background : ------------------- I took 3 weeks bed rest. The pain reduced for about a month and again the symptoms are re-occuring. Severe pain in lower back (mainly right side) and the pain is radiating to my right leg. I also experience numbness on right leg with difficulty in walking after I sit for 2 hours continuosly. I took MRI scanning and there is disc bulge in L4-L5 and L5-S1 discs which is touching the nerve roots . I was suggested to go for operation in which they will cut the bulged part of the disc. I am not for operation and am looking for non-surgical method to correct the problem. Could you please suggest me, what kind of treatment will suit me. Also the approximate cost for the treatment.",
    "doctor_response": "Hi The answer of problem you have is Surgery no medical treatment only symptomatic treatment is available  but if you believe !!!!!!!!!!!!!!!!!!!!!! then do this Embrocation with Olive Oil on back & right leg before going bed Take a cup of Black tea With sugar before breakfast GOD Bless you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What the chances of pregnancy after consuming unwanted 72?\n\nHi doctor I had sex with my girl friend in 14 Feb and I gave her unwanted 72in just 1hour. And she has also the problem about the period which is not came from last 2month.so pls give me the solution is she will be pregnant or not. And the period not come again then she could be pregnant or not. Thanks",
    "doctor_response": "Hi,Chances of pregnancy are less if she took unwanted 72 in just 1 hour but still to confirm it i want you to do a pregnancy test with a UPT kit . It costs cheap and is available in all pharmacy. The instructions on how to use it  & how to read the test  is given on the Kit Box . Contact us with the test report",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedies for reducing lower lip size\n\nhello....doctor..may i hav ur attention please   my lower lip is bigger in size and it is embarrassing for me in societycan u plz suggest some home remedies or natural therapies so dai size of my lower lip cab be reducedi am 19 years old studying in banglore",
    "doctor_response": "Is the lip swollen up recently or its the same always. if its enlarged by birth means  the best way to cure is to consult a cosmetologist.if its just swollen recently means May be some allergic response or traumatic. try applying aloe vera gel with honey and little rock salt.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Breathing problem while walking,climbing,talking\n\nDear Sir, I am of 28 years old. I have a problem of brathing while inhaling at some times, not continuosly specially when to have a continous discussion & communication with frends and othe people and feel suffocation . Even when to going upstairs of 4th floor apartment. it roots from back 5 years, started, when during teaching, (when i was a teacher), my throat was struk up, so after continous teaching & speaking with students, at the end of night, while going to sleep , feeling to tired off, or feeling imbalecment during breathing , but not much problem. Now i am doing a job in a private industry. i quit teahing since back three years. but have a problem of breathing while, walking, upstainring and to talks and chats with my friends, not continuous but at some times. while talking with my friends, i stop and take long & suffocated breath.",
    "doctor_response": "Hi welcome to H.C.M.Forum, you are having mild gastric complaint, and anaemia. for 2 days you eat only curd and rice. then you stop taking junk foods, spicy food, ristrict chillies, and sour foods and juices. if not relieved you can use PPI, antacid and iron preparations. thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could severe pain and swelling be torn rotator cuff?\n\ncan severe pain and mild swelling with warmth central located in the most tender spot, be torn rotator cuff. and exhibit serious pain 8 months after a serious fall which resulted in a broken shoulder on opposite side. I have unexplained pain 10+ scale. Regular xray yesterday showed no fractures, no arthritis. Can you get a rotator cuff tear and have no symptoms and then with out additional injury or unusually use begin exhibiting pain as severe as the broken extremity from last Halloween",
    "doctor_response": "helloThere is difference in rotator cuff tear and supraspiatus tendinitis,whereas in former the movement of shoulder is impaired especially abduction and roatation while lifting arm sideways, in tendinitis there is pain and movements may be painful and not restricted as such, an MRI may distiguish the two.So consult a shoulder surgeon or orthopedic surgeon. In your case , it may be tendinitis.Take advil thrice a day after meals for 7 days and do hot fomenataion, rest arm in a broad arm sling for 10 days., it may help but if not go to orthopedic doctor for investigation.Also apply anti-inflammatory gel like voltarenthanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does Diazepam show in urine sample?\n\nHOW LONG DOES DIAZAPAM SHOW IN URINE SAMPLE,AS I HAVE BEEN TOLD I HAVE TEST IN APP 3/5WEEKS.AND CAN I TAKE ANYTHING TO HELP CLEAN IT OUT,,I WAS PRESCRBED IT TILL COUPLE OF MONTHS AGO BUT HAD PLENTY TO TRY AND WEAN MYSELF OF, LAST USED LAST WEEK.THANKS",
    "doctor_response": "HelloThe drug isn't detected in urine beyond about a maximum of three weeks once it's discontinued so likely you'll screen negative for it.The are no ways of cleansing the system any faster than your normal metabolism",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cold with redness around the vulva?\n\nDear Dr. my two year old has a number of symptoms that I m not sure are related. She has had a cold which presents as a night cough and generally runny nose for the past two weeks. Today she developed soreness/redness around her vulva (we changed nappy brands so it could be that, she has very sensitive skin). I checked her mouth for white spots in case it was thrush and didn t see any but did notice that her tongue is covered in little red dots. Any advice? The soreness is really bothering her, the night cough too, for that we are using a humidifyer. Regards, Eimear. .",
    "doctor_response": "Hi...I feel by what you quote he should be having a - Hand Foot Mouth disease. This is one viral illness among all other exanthemas which can cause fever followed by rash over palms and soles. It is a self-limiting disorder and itching can be really worrisome. I suggest you use any over the counter antihistamine if you have one with you now. You can use Hydroxyzine at 1-2mg/kg/dose (Maximum 10mg) every 6th to 8th hourly for 7 days. This can even cause some peeling of skin in the next 4-6 weeks and do not worry about it.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a visible bulging jugular vein in my 2 year old a cause of concern?\n\nHi I am curious about a bulging jugular vein in my 2 year olds neck on his left side, this is always present especially visible when he laughs or cries. I laid him on his back with his neck elevated to 45 degrees to see it bulge when he is rested. Should I be worried!?",
    "doctor_response": "HI no need to worry on seeing prominence of jugular vein in semi recumbent position.It is physiological only.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recommend methods for pregnancy\n\nHi iam 27 yrs old. recently married past 8 months. Doc said I have Poly cysts and prescribed Deviry  10mg to be taken for 5 days twice daily. after 6 weeks of my period. Will that tablet  help me to concieve  . plz suggest me what to do for I want to be preganant",
    "doctor_response": "Hi, thanks for writing..Intercourse in and around fertile period helps in getting pregnant. Deviry is a progesterone tablet which helps in getting periods. Until 1 year of unprotected intercourse if you dont conceive, it is called infertility. Get follicular study from day 11  on alternate day till follicle size reaches 20mm which is the time of ovulation..Timed intercourse during this time helps in pregnancy.Hope i have answered your query.. good day..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent yellow stools in a 3 month old?\n\nHi my 3 month old daughter has been pooing 5/6 times a day since 48hrs ago. The colour is yellow which i m told is normal and its not excessively runny but is there anything to worry about. She is sucking her hands a lot which might be her starting to teeth. Should we be concerned yet. We also have been giving her water in between feeds to keep her de-hydrated.",
    "doctor_response": "Hi,You did right by giving her fluids to avoid dehydration. The teething doesn't start except after 6 months of age. So the suckling of the hands is just a habit some kids get used to. Since the stools are not runny then no need to worry, as some babies pass stool with every feed.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Salah Saad Shoman",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for strengthen the neck muscles\n\nmy head shaking is getting much worse. I went to see a nerologist and had an MRI done, he said some people just get this with age, and there was nothing that could be done. I was wondering if weight neck exercises might be helpful to strengthen the neck muscles.",
    "doctor_response": "*1. Since examination [neurologist] and investigation [MRI] is done, and there is nothing to be evaluated as told by your doctor, thus AGE [which is not mentioned] could be a contributory/provoking factor. [some people get this with age] probably senile/essential tremor [ET]2. since MRI revealed nothing conclusive thus, shaking due to parkinsonism, multiple sclerosis or cerebellar disease can be excluded.3. make sure to check with values of blood urea and liver function tests for any hepatic disorder or other metabolic abnormalities.4. make sure it is not due to alcohol/drug withdrawal?5. Drugs used to treat ET, also increases the risk of depression, and since ET is not a life threatening disorder, unless ADL [activities of daily living] like writing/ eating/dancing becomes difficult or it causes disability, so one should check periodically with Neurologist for progression of disease or contact Physiotherapist/ Occupational Trainer.6. since shaking [tremors] are due to problem in the brain, thus strengthening of neck muscles  is of very less advantage. [strengthening is advisable to prevent reoccurence of injury] which is not there.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does clear uterus in USG following positive pregnancy test mean miscarriage?\n\nHi doctor, I am 32 years old, got married seven months back. I had regular 28 days cycle. Two months back, I had amenorrhoea for 40 days followed by urine pregnancy test positive but followed by bleeding and USG pelvis shows clear uterus, after seven days. Following this, I got some brownish discharge like sometimes, increased whitish discharge irrespective of the menstrual cycle. What can I do for this?",
    "doctor_response": "Hi. If the urine pregnancy test was positive then you got bleeding and then, bleeding and uterus empty, then maybe it was a complete miscarriage. Post bleeding, vaginal brown discharge might be infection or remains of miscarriage. To be on safe side have beta hCG and high vaginal swab to exclude infection and pregnancy. Follow with the reports. In case you have pain, immediately report to an emergency gynecologist.  Post-miscarriage or infection. HVS, beta hCG. in case of pain, report to the emergency.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Exhausted. Sleep insufficient. Why am I having mood swings?\n\nI m a 21 year old girl and normally a very happy person and ready to go to my classes (and not waste my money) and wake up feeling good. Lately though i have been feeling like no matter how much i sleep it s never enough i feel so exhausted it s causing me to get to where i just want to lay down and try to sleep and miss class. I m also having mood swings. I never get like that normally. I ll be fine and then bam I m rude or upset. it s stressing me out to where i spilled something on my shirt and cried. that is DEFINITELY overreacting and odd for me, for anyone. I have no appetite and when i do eat it s hardly anything before it starts to make me feel really sick and i have to stop. idk what it could be and it s starting to really bother me.",
    "doctor_response": "hi..well, I think you have undergone through some stress of late..due to that you are facing a depressive episode..for that, there is insufficient sleep and loss of appetite..so please consult a psychiatrist..its curable..you will be fine..thanks..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hi, My Dad has to undergo Kidney Dialysis . Is there any risk? What is the life expectancy after that? Does he need this dialysis on a continue basis? Thanks",
    "doctor_response": "A patient who has reached a stage of ESRD i.e end stage renal disease does require dialysis in either hemodialysis or peritoneal dialysis form for rest of life. the only way to stop dialysis would be to get a renal transplant done. The life span on dialysis is much better now than it was a decade back. although the proceddure of hemodialysis has its complication but all such complication are easily managed in a good dialysis center by a competent nephrologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to stop premature ejaculation?\n\nHi I am 42yrs man . I m losing erraction very soon n m not been able to ejacuate for last two days , we are taking treatment on conciving . My wifes gynac suggested me to tk duphastone 1 tab for 10 days . M wondering how will it help me n is it a right treatment for us. please advise",
    "doctor_response": "Hi, It can be due to thyroid and testosterone imbalance, alcohol, diabetes and stress. You can take hormonal medicines for hormone imbalance. Basically antioxidants and zinc supplement can be taken.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chances of survival when in medically induced coma with kidneys failing and less oxygen level\n\nMy friend has been placed in a medically induced coma, as he has a bad chest infection that has spread to his lungs, he has also been self harming and has very bad wounds that require plastic surgery which are also infected, the toxicology test has also came back with traces of steroids, they are now saying his muscles are breaking up and producing toxins that are causing his kidneys to start failing, what are his chances of survival and how long can they keep him in this coma for before it would start causing irreversible damage, his own oxygen levels in Friday when admitted to hospital were only 3.5%, any information would be gratefully appreciated,kind regards Claire.",
    "doctor_response": "Thanks for your question on HCM.I can understand your situation and problem.Sorry to say but your friend's situation is very very critical.He is having very very less chances of survival.Practically speaking he is having less than 5% chances of survival.He is having septicemia and related complications like hypoxemia, skin and muscle necrosis, brain damage and renal damage by rhabdomyoglobins (secreted from damaged muscles). All these changes are irreversible and lead to MODS (multi organ dysfunction syndrome) and finally to death.So your friend is having very very less chances of survival.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain while urinating with a UTI?\n\nMy grandaughter age 4 1/2 just was diagosed with a UTI....she is on an antibiotic and pyrisium...she took her 1st dose at 2pm of both drugs but she is continuing to have painful urination and passing clots. We cannot get her to drink alot of fluids. Should we take her to the ER for fluids and Iv antibiotics?",
    "doctor_response": "It seems she has pyelonephritis; she need antibiotics as IV for 10 days. I advice to get admitted and get the infection eradicated totally. She may need ultrasound examination of kidneys follows by MCUG and radioisotope scan (DMSA) later dates.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the risk of SCD in a patient with LVH and PVCs?\n\nHello doctor,What is the risk of SCD in a patient with LVH and history of PVCs and possible NSVT? Will simply treating BP reverse any risk? All I have read about this indicates the prognosis is unclear but I am very worried and hope you can shed some light on my situation. I have not had confirmed NSVT but I have felt longer fluttering sensations and have had PVCs for 10 years off and on. I am 23 years old. My stress test was normal. I am on Zio patch now. My echo showed apparent LVH and aortic root dilation 3.8. If I have LVH, does that predispose me to arrhythmias like a hypertrophic cardiomyopathy would, and can it be reversed if I control my blood pressure, which is higher than normal?",
    "doctor_response": "Hello. Firstly, how bad are your hypertension and hypertrophy? Can your hypertrophy be explained by your hypertension? If yes, then it is likely hypertension induced. Hypertrophic cardiomyopathy may cause hypertrophy in young age, but it usually causes severe hypertrophy, with thickness usually more than 15 mm, and can be detected in the echo. Please attach echo report if possible. Also, let me know how much maximum was the BP reading? You have mentioned 145/90 which is mildly elevated. Next, Compared with those without VPCs (ventricular premature complexes), patients with VPCs had significantly higher all cardiovascular mortality, somewhere between 1.5 to 2 times. But, the majority of patients do well and lead a normal life. Also, your stress test is negative ruling out coronary artery disease which additionally contributes to mortality. Also, you should have a treatment for hypertension which should remain under control and strict BP control may reverse hypertrophy and ectopics to some extent but not completely usually. However, you should ask for beta blockers containing medicines like Metoprolol for BP so it will also control ectopics. So overall, the majority of patients do well and there is no need to worry much about it.  For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swelling in wrist & forearm\n\nI fell backwards 2 weeks ago and caught myself with my right hand. My wrist, thumb, and forearm hurt. I put ice on it and wrapped it for most of the 2 weeks. It is still swelling some without using ice and now my wrist on my thumb side still hurts and my hand is beginning to burn at tingle at times. I can move my hand and fingers so I didn t figure I broke anything. Can sprains cause this 2 weeks later?",
    "doctor_response": "hi,thank you for providing the brief history of you.A thorough neuromuscular assessment is advised,Since you had a fall, post which you are having burning and tingling sensation of the hand, i feel, due to the fall on the elbow, there will be a mild injury to the nerve, where there are sensory issues happening. also, the injury dont look that big since your motor functions are normal. For fall, this are common features and recover with proper therapy.I advice you to undergo physical therapy where you will be initially treated with therapeutic ultrasound therapy and TENS therapy. Post which exercises will be implemented to improve the strength in the muscles. Focus more on strengthening the triceps muscle as to improve the elbow mobility and nerve healing. RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is coumadin recommended after undergoing hip surgery?\n\nmy mother recently had hip surgery and is taking coumadin and pain relievers.  she is very neatious and cannot keep anything down.  i was wondering if she possibly allergic to the coumadin.  i think her mother was and i can't seem to find anyone  who remembers.  her mother has been deceased for 17 years.  any thoughts?",
    "doctor_response": "Hello, I have studied your case.Coumadin is given to prevent venous thrombosis after major surgery.Ultrasonography/colour Doppler leg will help I will advise you to do PT/INR.If you suspect allergy to coumadin then you can consult your doctor and change it to say rivaroxaban which is newer.If required you may need to do blood investigation for prognosis and recovery.I will advise to check your vit B12 and vit D3 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for complex regional pain syndrome\n\nI have been diagnosed with Complex Regional Pain Syndrome which I have suffered from for at least eight years. I am unaware of any prominent injuries to my lower left leg and ankle that could have spawned this _____ syndrome. Now that Lortab, a preferred treatment pharmaceutical, is hard to purchase, what are my drug and supplement options? I got good results with Lortab and Gababentin. Now what? I am a healthy 58 year old female. I have optimal body weight and am in good physical shape. Thanks",
    "doctor_response": "Hi, There is no perfect medicine for regional pain syndrome. If Lortab suits you and keeps pain under control , there is no reason to change it. Ask your doctor for other suitable medicines available in your area in case this medicine is not available in your area. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could masturbation cause pimples on face?\n\nhello! docter i am 18 yrs old and i have habit of doing handpractice daily. sometimes when if i see any boy or man is in innerwear ,or standing or sleeping near me in underwear then i get sexual feeling and my penis gets straight my penis also gets straight when i see a girl and suggest me that is pimples in large amount on my face is coming because of handpractice",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Masturbation is a safe way of satisfying your sexual desires and it has no side effects. Pimples are not due to masturbation but normal at this age due to testosterone surge. You can consult a skin SPECIALIST directly for pimples. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes reddish rash under eye in children?\n\nMy 2 year old boy developed redness under his left eye earlier in the day. By tonight the area below right eye became red too. No tearing or discharge, no fever, other rashes, or cold symptoms. Eating well, had a hard time goung to sleep but is sleeping now. Any suggestions and recommendations?",
    "doctor_response": "Hello, I have gone through your complaints and it seems to be eczematous in nature. I would recommend you to apply topical steroid like cortisone cream on the affected areas twice daily for 1 week. This should resolve it. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for back pain and hand pain?\n\nhello, I have severe back pain, which has caused me to stop working after 13 years. I have been diagnosed with a condition that is private and now it has caused me foot, shoulder and hand pain on a constant and daily basis. What do you suggests I take or do. Thank you and hope to here from you soon.",
    "doctor_response": "Thank you for your question.According to your symptoms, pain in several joints may be due to autoimmune disorders. There are many causes which cause joint pains. Complete blood reports, X-rays and physical examination are required to know the exact cause of your symptoms. So, please meet your physician to discuss about your problem.For symptomatic relief you can try ibuprofen tablets twice daily and pantoprazole twice daily. Avoid these tablets if you have renal failure or gastric bleeding.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cstochondritis?\n\nI went to the dr yesterday with really bad chest pain. My Dr did an xray because I had just had an upper resp. infection. He said the xray showed I had Costochondritis. My question is I have had a liver thing going on for the last 3 years. My liver dr said the liver biopsey showed it was either PBC or PSC. Does the Costochondritis have anything to do with either of those?",
    "doctor_response": "Costochondritis, also known as Tietze\u2019s syndrome, is an inflammation of the cartilage in the rib cage. The condition usually affects the cartilage where the upper ribs attach to the breastbone (sternum), an area known as the costosternal joint.Chest pain caused by costochondritis can range from mild to severe.Primary biliary cirrhosis is considered an autoimmune disease, in which the body turns against its own cellsThe bile ducts in your liver are slowly destroyed. Bile, a fluid produced in your liver, plays a role in digesting food and helps rid your body of worn-out red blood cells, cholesterol and toxins.The costochondritis does not cause PBC but it might be associated with it.When costochondritis is associated with liver disease, it is more difficult to treat.So take care and the relevant specialists will advice you further.Thank youDr.JolandaPulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does drinking alcohol vary the liver test results?\n\ndid a liver function test , two days after heavy drinkin, my SGOT is 54 , SGPT 79 an GGT is 97. could this be a temporary spike ? every other entry in the liver function test is in the normal range. I typically drink twice a month - 3-4 drinks. i could have 3-4 nights a year where that could go up to 6-9 drinks.",
    "doctor_response": "Hello,Some people have genetic structure in such a way that low alcohol also cause liver changes like non smokers some times  also develop lung cancers.It may be due to some other reasons also like drugs, infections etc.So for prevention of damage to liver, decrease or stop alcohol.Now it is possible to quit any habit.For that consult your psychiatrist.take care...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my tattooed area having rash and itching all around?\n\nI just got a tattoo on friday, its on my chest plate in between my breasts.There is a rash forming in and around the area I have a few other tattoos so i have a pretty good idea on how to take care of them. Im just concerned because its itching so intensly i want to cry!! burning throbbing itching. what do i do?",
    "doctor_response": "Hi,Thanks for writing to us.You have probably developed contact irritant dermatitis at the tattooed area. To treat the same, take tablet levocetirzine twice in a day and apply a potent topical steroid like clobetasol twice in a day. If the rash does not clear away in few days, please meet a dermatologist.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for multiple bilateral renal cyst\n\ni did a ct it s mentioned that i ve multiple bilateral renal cyst likely of sequal polycystic renal desease for clinical correlation the largest 31x34mm is there any risk n what s the remedy? n also it s stated that i ve a bulky uterus n fibroid for us evaluation",
    "doctor_response": "HelloThanks for query .Based on your C.T scan findings that has been reported that you have multiple renal cysts on both side the larger being of the size of 3 mm x3.4 mmMultiple renal cysts are congenital in origin and in majority of cases detected as a accidental findings when C.T or Ultrasound Scanning is done for  some other illness .They are always asymptomatic and  benign in nature and left alone ..Treatment either marsupulization or laproscopic deroofing is advised only in specific situations when it gets infected or recent increase in size of the cysts Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could lumps in penis suggest?\n\nhi i am 18 and for as long as i can remember i have had a ball shaped lump thing attached to the skin connecting the head of my penis to the shaft (i think its called the frenulum). I am uncircumsised and it is only noticible when i pull back the skin and mostly noticible when i am erect. Any idea what this could be?",
    "doctor_response": "Hi, thanks for sharing your health concerns with HCM!           If I were your treating Doctor for this case of penile lump, I would come up with three possibilities, these include: 1.\u00a0\u00a0\u00a0\u00a0\u00a0a developmental vascular knot2.\u00a0\u00a0\u00a0\u00a0\u00a0The second possibility is of a mucosal tag 3.\u00a0\u00a0\u00a0\u00a0\u00a0The last possibility is of some benign cyst or benign tumor / tumor like condition \u00a0\u00a0\u00a0\u00a0\u00a0Overall, it could be some normal variant and not worry about this but caution and medical examination warranted as this may cause massive bleeding during sex!Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I getting some recurrent swelling in neck that goes away in some days?\n\nHello doctor,For four weeks I had glands in my neck it swells and then recedes, and then returns to swelling again. Chest and backaches or cramps accompany this. Is this hypothyroidism?",
    "doctor_response": "Hello. I read your query and from what you described it appears that you have some upper respiratory tract infection, which could be giving the lymph node swelling in your neck, which is associated with your muscle cramps. These are not thyroid gland swellings according to me because the thyroid swelling does not increase or decrease in size so rapidly. I would advise you to do complete blood count, a urine dipstick test to rule out whether you have any infection and a simple TSH (thyroid stimulating hormone) test that is a thyroid function screening test to diagnose any thyroid disorder. Try to take tablet Paracetamol 500 mg thrice a day for your cramps in the meantime. I hope to see your lab results soon and wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes inability to control walking speed?\n\nMy brother in law, 82, will begin to walk and his walking speeds up to a pace of almost running..he has fallen twice (forward)...he says he cannot control his speed..is this related to a neurolgy issue? he has had a scan and the doctor says nothing show ups you advertise this question to be answered free..yet asking for a payment??",
    "doctor_response": "he is 82 yr old and gait problem and forward falling. probably he has parkinson like symptom. in case of parkinson disease CT scan is normal. parkinson is clinical diagnosis, it occur in old age after 60 yr.tell me about  rest tremor or slowness of activity. if these symptoms are present, he has parkinson. reply me, i will follow you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do feet and hands swell in view of pancreas cancer?\n\nMy father has pancreas cancer( metastatic stage). He was taking all sorts of drugs starting from gemcitabine, gemzar, avastin and morphine for pain. He recently started a new treatment that combine 4 different drugs. He is feeling a lot better, he is not in pain anymore but his feet are swollen and now his hands are starting to do that. What does this mean? Should I be concerned ? Is this just an side effect or does it have a bigger meaning? And what can we do to stop them from swelling more?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your father's situation and problem. Chemotherapy drugs can cause renal toxicity and alter it's function. So renal damage is one possibility for his feet and hand swellings. So get done renal function test to rule out renal toxicity. Another possibility is hypoproteinemia. Pancreatic cancer causes decrease functions of pancreas gland. So absorption of protein from gut is reduced. And hence hypoproteinemia is seen. This can also cause swelling in feet and hands. So also get done serum protein levels. If this is low than he needs additional protein supplements in the form of albumin injections and high protein diet. Hope I have solved your query. Wishing good health to your father. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Risdone 1 (1 MG) posses any side effect?\n\nHi Sir, My self rajender i am eating Risdone 1 (1 mg) from 2006 to 2007, after one i discontinue the medicine, but after the married in 2010, I regular used Risdone 1 (1 MG) what is the side effect of Risdone 1 (1 MG), and what is the effect on my marital life.",
    "doctor_response": "Hi, Yes, it has. Drowsiness, dizziness, lightheadedness, drooling, nausea, weight gain or tiredness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Dizziness and lightheadedness can increase the risk of falling. Get up slowly when rising from a sitting or lying position. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ajeet Singh, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why are the white cells very low even after Pneumonia subisiding and could this be a sign if Leukemia?\n\nHi, My husband has been very ill with pneumonia for the past several weeks. The Dr. says his pneumonia is gone but his white cell count is still very low, 1.5. All of his other tests are back in normal range. Why is his white count still so low? Is it possible the pneumonia is not really gone? Is this a sign of Leukemia?",
    "doctor_response": "Thanks for query.low Wbc is seen in infections as you may your husband had pneumonia.probably that is the reason it takes time to reflect.count 1.5 you mention is it WBC or neutrophil ,is it 1500cells or 150 ?.please provide some details so that I can give you more clarity.regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in hip and shoulder joint?\n\ni am having pain in the right hip joint has been taking glucosamine tablets and shellcal 500 so far no relief, now I am also getting pain in my left shoulder joint, I am a female /Asian origin , have high cholesterol and taking atorin 10 mg daily. please let me know the reason for this pain.",
    "doctor_response": "Hello,The pain in the joints that you have can be related to spondylottic changes or ankylosis. You need to consult an orthopedician and get an MRI scan done to find the exact cause. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "child diagnosed with Typhoid, on allopathy medicines, normal now. What should be done so it does not comes back?\n\nmy son has been diagnosed with Typhoid , he was on allopathy medicines for over a week,then as a friend sugested he moved on to ayurveda medicines...his fever has come down totally to .normal temperature.... he says he feels well too...but my family feels his symptoms are just being numbed for the time being with ayurveda medicines & only allopathy medicines will give a cure for typhoid... am confused... kindly advice email id : YYYY@YYYY",
    "doctor_response": "Hi,Thanks for writing in.Typhoid fever is caused by bacteria salmonella. It is spread through contaminated water and food. Recovery takes time but symptoms can re appear because bacteria can persist in the body. Children should be advised rest and healthy food for a while. They must be told to wash hands before having meals and drink clean water. Less oil must be used in cooking and boiled vegetables are preferable. This is because the intestines need time to recover from infection. Any pain in abdomen and diarrhea must be reported to the doctor.If there is re infection, which is seen in many patients, I suggest another course of allopathy medications and this will cure the infection almost completely.Hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numb feeling on back?\n\nHello doctor. I'm 23 years old, female. For the past 4 days I've been having a weird feeling in my back and lower back, as if i stretched it, but i didnt lift anything heavy and i didnt exercise. Sometimes it feels that my back is numb. There is no pain, fever or any other symptoms. I'm worried of what can it be?Thank you in advance.",
    "doctor_response": "Hi i can understand your concernit could be due to muscle spasm or vit b12 deficiencyplease take tab acetaminophen with chlorzoxzone for immediate reliefvit B 12 for nerve regeneration and to avoid numbnessPhysiotherapy back Hope this helps yougood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes random inflamation and extreme pain all over the body?\n\nI get random inflamation and extreme pain in various parts of my body, 3 weeks ago it was in my elbow and I could not lift or move it, just now I have it in my foot.This causes me to be nearly totally disabled for up to week.Very weird and concerning, local doctor not sure what it could be and generally prescibes anti-inflamatory tablets.What could it be or what steps should i take?",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms seem to be related to rheumatoid arthritis. I suggest to do a rheumatoid factor level and PCR level for further evaluation. Meanwhile,I suggest to continue the use of anti inflammatory medications such as Acetaminophen to relieve the symptoms. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Amoxicillin taken for tooth infection be reused for a   bladder infection?\n\nI was given amoxicillin for an tooth infection , I took it for three days then stop taken it as the pain went away. Now I believe I have what appears to be a bladder infection(frequent and painful urination). will I be able to take the medicine again? I am a 68 year old male.",
    "doctor_response": "Hello! Thank you for your question. I understand your query, however next time you take antibiotic, I recommend you to complete the full course of antibiotics such amoxicillin if given for 7 days should be followed even though the condition has improved to avoid antibiotic resistance. For your frequent and painful urination I suggest you take a urinalysis exam as you may be having a Urinary Tract Infection. If Urinary tract infection is confirmed, you may be prescribed with another round of antibiotics such ciprofloxacin 500 mg 2x a day for 7 days. Meanwhile please do take lots of water.Hope this helps,   A feedback is greatly appreciated.Thank you and God Bless!",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does it take to recover from epiphysiodesis?\n\nGrowth can be stopped by a minor day care surgery procedure called epiphysiodesis. How long does it take to recover from this procedure? Also, what type of surgeons preform this procedure.? And also how does this surgery work? Will they have to open up every single bone in my body and remove every epiphyseal plate? How many epiphyseal plates will they have to remove.? Is it a painful recovery? As you can see I have many questions. Please answer them for me. I really find your knowledge beneficial.",
    "doctor_response": "Hi, It depends upon the age of patient which epiphysis are involved, orthopedics and endocrinologist combine treat such patients, early recovery is usual. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. SHEHLA USMAN, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Aricept have an alternative without side effects?\n\nI am looking for something for my Dad who is 88 with congestive heart failure who is also having trouble with memory. He was on Aricept but the doctor took him off of it because it lowers his blood pressure, therefore I am researching other alternatives.",
    "doctor_response": "Hello dear,You can discuss your physician considering memantine ,which is another good alternative in dementia patients.Blood pressure lowering effects with memantine has been reported occasionally in trials,but no definite incidence.I hope it could be of help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is bunionectomy?\n\nI was told that when I was 21 years of age, I needed a surgery to correct something in my left foot. I did not get the surgery because my husband at the time said we could not afford it. I am currently 40 years of age my issue has gotten worse. I was told when I was 21 years of age that I needed a surgery to pull my toes back to match the ball of my foot and that screws were required to achieve this issue. What is this called? I am planning to make an appointment with a foot specialist, however, I need to know what type of issue this is called. For the life of me, I cannot remember what the doctor said all those years ago. Thank you in advance for your help.",
    "doctor_response": "Hi, Your description is not very accurate but what I could make is that you probably have Hallux Valgus- Deformity of the great toe which bends towards the 2nd toe and the process is very slow growing. If it is Hallux Valgus then only treatment is surgery. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itching, difficulty breathing, sleeplessness.  History of having allergy, eosinophil count 8.3%.  No help from medications.  Help\n\nThank you Dr Grief, 2 months ago my Eosinofil count was 8.3% when I had a blood test. 1 month ago I started having allergy and it has not gone away until now. I have seen a doctor, have been to emergency and have seen a third doctor who is a dermatologist. They have prescribed prednison, benadryl, creams and other I don't remember. My itching is still on me I also feel week, little difficulty in breathing and have not slept enough so feel week.",
    "doctor_response": "Welcome to Healthcare-MagicGreetings of the dayYou could be having Tropical Eosinophilia.Treatment of Tropical Eosinophilia is Diethyl Carbamazine(DEC) for 21 daysIt will also lead to resolution of respiratory symptomsTake careRegardsDr T ShobhaMBBS MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with fatty liver, prescribed livolin forte, aztor ez, taking milk thistle. Will it cause any interaction with prescribed medicines?\n\nhi am 31yrs old and i was told by my doctor i have a fatty liver and my liver function test were as follows HDL 0.83, LDL 2.6, triglycerides 0.5, total cholestrol 3.7, alanine aminotransferase 54.4, alkarine phosphate 73.2, aspartate 32.5, direct bilirubin 1.0, gamma gt 25.8, total biliribin 5.2, my doctor told me not to worry much but recommeded the following medicine livolin forte and aztor ez please advice me if these medicine have side effects or not and i have been taking milk thistle for the last one month can it interact with the medicine am about to start.",
    "doctor_response": "Hi,mwaiantonee, I am looking at your lab results.If the total Bilirubin is 5.2.and the direct bilirubin level is only 1.00 that means there is some degree of destructionbof red blood cells going on.(Hemolysis) Fatty liver by itself can't be causing this I don't think milk thistle will hurt. I would want to know what caused fatty liver. If it is due to overweight you can work on losing weight. If it is from drinking too much alcohol, that should be controlled.The problem of hemolysis should be looked into.May be a consultation with a blood specialist may be helpful. Good health,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get relief from lower back pain which is getting worse after two c-section delivery?\n\nHi there, I've had ongoing lower back pain since the birth of my first child (via emerg. C-section) 2 years, it continued throughout my 2nd pregnancy. Again I had an emerg. C-section with my 2nd child, which was 3 months ago. Pain unfortunately getting worse & am now getting tingling/numbness/pain in both my heels. Have seen an osteopath for last few months but has not given me any relief.Thanks",
    "doctor_response": "Hi there. Your symptoms correlate to disease called Prolapsed Intervertebral Disc...... most probably at the L5-S1 level. Pressure on the nerve is causing the tingling sensation. Kindly get an immediate Xray and MRI of the lumbosacral spine region done. Get it evaluated by an orthopedician.In the meantime follow this protocol :1.  Bed rest.....as much as possible2. Avoid bending forward and avoid lifting heavy objects3. Local heat massage and analgesic gel application4. Painkiller and muscle relaxant medication.5. Pregablin to suppress the tingling srnsationsI hope my advice has helpedGood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the dosage of iron syrup for babies?\n\nHi. My daughter is 10 months old. I was told by her dr. that her iron was low and should give her enfamil iron drops. They have been very constipating even after eating fruit juice, prunes, and lots of vegetables. I bought liquid iron made with ferrochel that is supposed to be more gentle on the stomach. For 1 Tablespoon (15ml), contains 18 mg Iron (as Ferrochel amino acid chelate). It says for child 2 years and up 1/2 tablespoon. How do I convert the dosage for my daughter?",
    "doctor_response": "Dear parent,  the dose for a 10 months old would be 1 and half ml which is equivalent to a quarter of a teaspoon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Unbearable pain in teeth, jaw, ears after taking local anesthesia for teeth filling. Some relief with ibuprofen and acetaminophen\n\nWent to the dentist a month ago for a check up and was having NO pain or issues. He said I had some old fillings that were \"leaking slightly\" (molars) and suggested I get them redone. I agreed to the treatment. Had local anesthetic for the procedure. Since that day, I have had unbearable pain in my teeth, jaw, jaw joint, ear and (at times) up into my cheek and face and down into my neck. I take entirely too much ibuprofen and acetaminophen throughout the day just to make the pain tolerable. I went to the doctor today to make sure it wasn't an ear issue and she said it wasn't. Have called the dentist office multiple times but the secretary insists that fillings will be sensitive and I just need to give it time.  The pain is horrible throbbing and I can literally feel my heart beat in my face/jaw. Eating, brushing my teeth, etc only makes it worse. Help please????",
    "doctor_response": "Hello,Unbearable pain in teeth after re-filling the tooth may be due to-irritant restorative material applied or due to exposed pulp which comes in contact with the restorative material.I would advice you to get a second opinion and x-ray of the tooth to be done.Tooth has to be either root canal treated or re-filled.Infected pulp has to be completely extirpated out.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the red rashes above my eyebrow?\n\nI have some what rash above my eyebrow and in the outter corner of my eyes (little red bumbs) in the corner however not on eye brow . I have had sex and am scared out of my mind in hope I didn t get somthing then it occurred yesterday a day before I was doing some yard work so that lead me to the thought of poison ivy ????? It s trying to also develop on my arm (forearm) and elbow help? What could this be",
    "doctor_response": "Hello,It may be Lichen urticatus. Hypersensitivity to insects may be the responsible cause. Nothing related to sex.Antihistaminic, the oral steroid in tapering doses, local application of mild steroid cream etcetera may be considered. Consult the dermatologist to get proper treatment.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Ilyas Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach pain in the lower right side\n\ndear sir i am suffering from stomach pain on the lower right side my doctor is treeeting me he has given me medicine like cefepime injection, sucral-o and rebekind plus i have taken all this medicine but no releive is there so i want to know what should i do?",
    "doctor_response": "Hai. Welcome to HCM.If you are not getting relived with pain - in this case i would suggest you for an ultrasound scan and rule-out many causes and come to conclusion. if you had already tried for 2-3days then see your doctor again and request for a scan. Hope it help. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will Benadryl help with hives and heavy breathing?\n\nI am 52, 5-5, 165# have taken 1#1000gram Primrose for sleep tonite-  but 10 minutes before had 1 beer with chips. My face when looked in a mirror looks like a mild case of hives and noticed my breathing is a little heavy. This is in 40 min time, will benadryl help?",
    "doctor_response": "hi.welcome to healthcare magic.i understand your problem.my opinion is that,1.dont scratch the lesions.2.avoid contact with the agents causing hives.3.you can take benadryl syrup twice daily.4.you can apply calamine lotion over the lesions.thank you.hope my answer will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any chances of getting pregnant based on the report ?\n\npcod irregular periods 37x31mm cyst in LT ovary on11july its my first day. 7x7mm inRTovary and 11x12mm inLT ovary on22 july 12day. 11x12mm inRTovary and 8x9mm inLT ovary on27july 17day. 1 what does this mean? 2 IS ovulation happen this time? 3 slow and late growth of follicle as in my case .ISany chance of getting preganant? 4 what to do now? 5 plssssssssssss answer soon",
    "doctor_response": "Hello Thanks for query Wait for next cycle ,as  in PCOD sub fertility  occurs ,ovulation is not good ,and there si no dominant follicle. Hope I have answered your question well to your satisfaction. Wish you speedy complete recovery at the earliest.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes prickly heat type skin rash on body?\n\nHi, My 4 year daughter has a skin rash last week she was seen by the gp as she had a cough and he said she may have asthma and a chest infection so she was precribed amoxiclin which cleared up the cough. aweek (wednesday) later i noticed a prickly heat type rash on her ankles over the last few days it has spred across her body up to her cheeks. she is not hot and her eyes are bright still no obvious tiredness and it does not seam to be itching. It looks a little like measles /prickly heat. I have given her prition and keep putting on calamine cream on but im concern what to do. please help thank you Ema ema",
    "doctor_response": "Hi..this could be a rash due to streptococcal infection too. But anyhow you have used the appropriate antibiotic. Another option is that in some typed of viral illness with rash this particular antibiotic can aggravate the rash. You can use Piriton and Calamine lotion....but if its not settling in 48 hours or getting aggravated with joint pains---please consult your pediatrician.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility having patent tubes\n\ni am bharti, both of my tubes are patent, husband semen 56% motility, my age is 29 and my husband age is 30, we got married in oct.2006, 2 ivf with icsi in sir ganga ram hospital delhi. ist ivf positive with blighted ovum, 2nd negative, what should i do now?",
    "doctor_response": "Hello, you need to take it lightly now and get a repeat IVF done as it suits your routineIn case you have any questions in future you can contact me directly on",
    "dialogue_context": ""
  },
  {
    "patient_message": "Wisdom teeth removed, full jawline bruised, swollen. Quick remedy ?\n\nMy daughter had her wisdom teeth out a week ago. She had swelling so bad on her one side we made a trip to the er. Bruising is terrible. Full jawline, (and on the side with extreme swelling bruised eye,and mid cheek to nearly her sternum. She actually has 3 finger print bruises ( still blue) on her upper neck. (The area where he was holding her jaw open.)  Inside her mouth (3 teeth length) in front of her wisdom tooth removal site has running stitches from gum to her cheek. As the swelling has started to go down a hard lump has formed, not near the tooth removal site but on the site where the gum has been stitched to the cheek. She has been taking antibiotics since the removal. I want to know what could cause the need for the extra stitches and if this kind of extreme bruising is normal for this procedure. ( she is on no daily meds and does not normally bruise easy)",
    "doctor_response": "Hi,Thanks for asking the query,According to your symptoms i suppose that you might have developed infection at the site of the surgery, swelling is very common after wisdom tooth removal it subsides in a period of about one week, take lukewarm saline rinses, antiseptic mouthwash gargles and follow complte course of antibiotics and analgesic, ask your daughter to take complete rest and maintain a good oral hygiene.Take Care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore throat and rash on upper arms and chest?\n\nTwo days ago, I started with a sore throat and a fever that was accompanied with chills. The fever was higher yesterday but has since subsided. Today, I have a sore throat and a rash thats mostly found on my upper arms and chest (not very itchy). Can you tell me what this might be?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I have gone through your complaints and it seems to be maculopapular rash. I would recommend you to apply calamine lotion on the affected areas twice daily. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have issues with spine, disc bulge, thecal impression, canal encroachment, transerving nerve roots. Done MRI. What is the cure?\n\nI am 24 years old girl I m also a doctor I m having prb in my spine I have gon for a MRI and the result was that I have a disc bulge at l3/l4/l5 level causing thecal impression and bilateral canal encroachment. The disc is compressing bilateral transvering l5 nerve roots.so now wat I have to do the pain is regular in back n thighs I ll be able to cure or not .",
    "doctor_response": "Exicion of the disc {DISCECTOMY} may be performed by your ORTHOPEDICIAN/NEUROSURGEON TO RELIEVE YOU FROM YOUR PROBLEM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause vomiting, loose motion and mucus discharge?\n\nI have fatty liverfrom month of december.my stomach is also showing like pregnant woman.in the mid of jan i got brown discharge.after some day i got yellow mucus it was rounded,from jan to feb i started vomiting countinuosly.loose motion always irritates me with irritating bowel movements. I took all pregnancies test but results came negative. I am really depress,that really my liver not functioning or may be i m pregnant .fingercross.please help me.",
    "doctor_response": "Hello! Thanks for putting your query in HCM. I am a Gastroenterologist. I will suggest you to get an ultrasound of the abdomen to see whether there is ascites or not and further evaluation and managment according to that if it is there. Also get xray abdomen standing to see any obstruction of the intestinal tract which I presume to be partial in this scenario.I hope I have answered your query and this will help you . Wish you a good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for stomach ailments\n\nMy mom started feeling pain in stomach. We saw some doctors who thought that as an indigestion because of food habits. The tablets given by them didn't work. She got too much pain one day and we admitted her to the hospital. They took Full Abdomen scan in which it was mentioned there is stone formation in both kidney's. But that was not the reason for stomach pain. That is one of the reason because she had pain in the right hip also. Then they took blood sample from her vein and tested it and found abnormality in the Bilirubin level. Then Gastroenterologist asked for one more blood and urine test. After checking the results they told that there is a minor jaundice, but the liver is functioning normal. They told we can discharge the patient and prescribed medicine's URIDIL 300, DROTIN, and PAN-D. They asked us to come back after ten days to have a blood test. In the mean time they wanted a CT scan for Common Bile Duct which should be reviewed by the doctor. Now my mom is at home taking the tablets. Still feeling Tired, unable to have food as usual. Everyone who visits my mom suggests that we have to consult another doctor, because she is not feeling well. What i think is the doctor has prescribed the above said medicine for 20 days so i might have to wait for 4-5 days to start notifying the results. What should i do? I am confused, don't know what is exactly with my mom's health since nothing is confirmed. Help me.",
    "doctor_response": "if the bilirubin is elevated then it has to be evaluate d . don't panic. get CT scan abdomen done.it will help us to get close to diagnosis. pain is because of kidney stone which can be very painful. current medication are proper. if she doesn't take proper food then admit her and get CT scan done. ask doctor about parenteral nutrition if she doesn't eat anything.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes olfactory hallucinations?\n\nHi I have woken up the last 3 nights by the awful smell of burnt toast . Yet no one is cooking at 4am ! Why am I getting this should I be worried or will it just pass and it s just a crazy phase ? Thankyou for any help . I m a bit confused about all the different opinions I googled ! Yvette",
    "doctor_response": "HiI had gone through your query.It is just 3 days so no need to worry.1st thing require to go for routine ENT check up.It may occur in sinus infection or congestion.If it come normal then it may have psychological component.But it is difficult to say because you have it since last 3 days.It may occur in Olfactory referral syndrome or Obsessive spectrum but there are other associate symptoms along with olfactory hallucinations.Need to go for psychological evaluation for this.So consult ENT specialist and psychiatrist if require.I hope i have answered your query.Feel free to ask.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it because of kidney problem that I have burning sensation in my urethra ?\n\nsir, iam 38y old female.i got uti before 1mon.dr prescribe culture. e-coli org seen.i lltake 10days antibiotic course.but no improvement.atpresent i consult MD DGO,she advise citralkasyp,nitrofurantion 100 10days.atpresent i ll taking 5 days.but burning sensation in my urethra .is it kidney problem sir .i am worried ,pls help.",
    "doctor_response": "Hi dear Welcome to HealthcareMagic. Your doctor has prescribed you a good combination of drugs in treatment of UTI.If you can get an ultrasound done to see kidneys , it can be told about the kidney involvement.Its not suggestive that infection is in kidney just because its taking lung to be treated.Symptoms like back pain , intermittent abdominal pain suggest of kidney involvement.Please drink lots of water(upto 5 liters) to fasten the improvement.Please follow the same treatment. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will taking Lutera after 2 weeks of having unprotected sex be effective?\n\nHello, I've been on Lutera for about a month and today I started my first pink pill... I've been taking them at 830 am every single day but I have unprotected sex with my fianc\u00e9 two weeks after I started the pill. Judging by my cycle I am 6 days late, is that normal?",
    "doctor_response": "Hello,I have gone through the query and understood the concern. Though it is claimed that there is no need for additional protection to be used after the first week of the pill use, if you start it from day one of your cycle, it is always wise to use protection for the first couple of cycles. Abnormal menstrual patterns are seen in the initial months and this delay could be one of those. Yet, please get a home pregnancy test with a fresh early morning sample to exclude any failure. Further management can be planned accordingly. Please remember that stress can also delay the cycle. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is sex before a week of the expected period a good time for conceiving?\n\nI got my period on December 12th, I am trying to conceive but not 100% sure if I was ovulating. Had sex from December 19th-30th trying to get pregnant. Its exactly one week before my expected period but I am anxious and curious if it was a good time to try or what I can do for next time. I did experience dark red spotting (which from my research could be implementation bleeding?) but it only lasted 3 days. Please help!",
    "doctor_response": "if your periods are regular, you almost certainly are ovulating.  if you count the first day of your period as day 1, then you usually ovulate around day 12.  if you start having axe at day 10, and have sec every other day until say 20 or so, you should get pregnant.  though sometimes it may take six months or more so don't give up! good luck!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will stopping masturbation help in getting back to normal physical structure?\n\nwell, i read about that masturbation changes body when you do it as an addiction, and i've notice my right chest shrinked and looks smaller than my left chest. i have masturbated for a year and im addicted to it. i just wanted to ask you i i can get back to normal if i dont do it anymore?",
    "doctor_response": "Hey..See dear, Masturbation does not cause any physical injury or harm to the body and can be performed in moderation.Yes, you should not make it a addiction or habit.In my opinion Masturbation has nothing to do with your shrinked and smaller left chest.If your left chest is abnormally small when compared to the right one, then get it examined by a local doctor near you.Also if you are feeling little weak, then concentrate on your diet, drink plenty of water and exercise daily. This will keep your body fit and well.Hope I have answered your question. If you have any questions, then I will be happy to answer them.Take care.Regards.Dr. Surender sharma.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the treatment for a broken back tooth of a 10-year-old?\n\nHi doctor, My 10-year-old daughter's back left tooth completely broke off on her gum, and it was hollow. I believe it is an adult tooth. How would a tooth be hollow?",
    "doctor_response": "Hi. If it is the second last tooth of the last side, then it is the last milk tooth that got broken, as it falls off in between age 9 to 11 years. If it is the last tooth of arch that got broken it is the permanent molar tooth. It is the only permanent molar in arch till 12 years of age. If it is molar, it is some serious issue. Get root canal treatment or filling done because this is the primary molar that will aid in chewing for your daughter's entire life. If it is deciduous or milk tooth then you need not to worry. A permanent tooth from beneath might have given pressure for the eruption, and so milk tooth will be wearing off after becoming hollow. A hollow tooth is caused by cavities or a broken part of tooth. I can tell you a better exact diagnosis if you can provide me with clinical picture of your daughter's teeth. If it is painful right now, you can give simple Brufen syrup (Ibuprofen) 8 hourly for three days. Stay happy and blessed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pruritic urticarial papules & plaques\n\nHello! I suffered with eczema and with what I believe was PUPPs (Pruritic Urticarial Papules and Plaques of Pregnancy) when I was pregnant with my son almost 5 years ago. It is recurring now even if I am not pregnant. I'm not sure of the cause but it started around 2 weeks ago and is getting worse, it's starting to spread all-over my body like before. What can I take/do to make this go away? I would like to stay away from steroids and antibiotics 'cause I used topical I think it is not helping anymore but instead making it worse.",
    "doctor_response": "Hello, I would recommend you to apply moisturizing cream containing white soft paraffin on the entire body 2-3 times in a day and take antihistaminic like tablet cetrizine 10 mg twice daily. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Asmeet Kaur Sawhney",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for back pain with extreme defecation\n\nhi, so this is embarrassing but i have some very intense back pain for the last few days and i have been defecating much more than usual. I m also very weak and tired all the time.I have just returned from a month long trip in Uganda. I was tested for stds about a month ago, but I have not been tested for pregnancy. Other than that I have ADHD, depression, and HSV1",
    "doctor_response": "Dear- thanks for using our service and will help you with my medical advise.The most common reason for pain when defecates is an internal hemorrhoid, specially if constipated and had to make a big effort to move your bowel. However, colon polyps or lesion obstructing the colon canal can be painful too. It is important to have a checkup including laboratory exam, to make sure that you don't have anemia which makes you tired and weak. Your medical conditions are not associated with this complaint although some of the medications for depression and ADHD can cause constipation .I hope that my advise has been helpfulDr.Sara",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does high WBC count in blood result in body ache, nausea and headache?\n\nI have had a high white blood count for 3 months now. Just started having body aches like the flu, vomiting, nausea, headache, fever and chills. Had blood work done that showed no infection. Wondering if you had an idea of what it could be. I haven't been able to keep any solid food down in 3 days.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have leukocytosis, leukemoid reaction, leukoerythroblastic reaction or leukemia.  You should go for ultrasound abdomen, peripheral smear examination and of needs go for bone marrow examination.  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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dry itchy patch on hip and neck\n\nI have a dry itchy patch on my right hip and on the back of my neck that has been there for almost a year...it started during a stressful time and will not go away!  I have been to the doctor, who diagnosed it as psoriasis, prescribed steroids/creams...It cleared up some on my neck but there is still a small spot there...the place on my hip really bothers me, as it is only getting bigger!  It is now as round as a tennis ball in diameter.  It itches and will not go away...please help!",
    "doctor_response": "Hi, For eczema, patch testing is done to rule out other skin diseases. Get physically examined with the biopsy test. Do continue to take the steroids and creams prescribed. You may require oral or injected medications like Methotrexate, Cyclosporine or medications that alter immune response under a PCP. Other treatments are UVB phototherapy, Goeckerman phototherapy, laser therapy, etc. after evaluating disease you have. Eczema is not a contagious disease, it causes patchy dry skin that is itchy, scaly and thickened. There is no permanent cure for eczema but it can be controlled by treating damaged skin. Topical corticosteroid creams and ointments, antibiotics along with antivirals are effective. Phototherapy also works well. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nupur K, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain\n\nHi. I live with my boyfriend. And we are having lots of problems. Everytime we have an argument or he upsets me. I cry and i get chest pains. When I m worried they get worse. I dont know what it can be. If i try not to cry . The pain will increase till ill just put my self to sleep with the pain.",
    "doctor_response": "Thanks for your question on HCM.In my opinion you are having stress associated symptoms. But better to rule out cardiac cause first. As stress also causes cardiac pain.So get done ECG first to rule out cardiac cause.If this is normal than your symptoms are mostly related to stress and tension.So avoid stress, tension. Be relax and calm. Consult psychiatrist and get done counselling sessions. Also involve your partner and discuss your problem and try to sort out things.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could testicle pain be due to masturbation?\n\nI am masturbating from my 16th age onwards... now my age is 25. Recently few month before onwards, my left testis are somewhat mild pain.. in this regards i consult the Urology doctor and he said nothing to worry its just a infection... he gave some tablets... i feel better now... today morning i again masturbate, again the same pain occurred... over masturbation may cause this problem??",
    "doctor_response": "HiWelcomeIn the presence of infection, masturbation can cause done discomfort and pain.I would suggest you to avoid it till infection clears.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does the abdominal pain and enlargement indicate early stages of cancer?\n\nFollowing dinner, I have moderately severe pain in my lower left abdomen. The pain is very centralized in one area and after about 30 minutes, pain goes away.Recent Ultra Sound spleen demonstrates normal echotexture and measures 15 cm and is enlarged.  Does enlargement and pain indicate early stages of cancer.  What further tests would you recommend?",
    "doctor_response": "Hi,I have gone through your query.15 cm size of spleen is moderate splenomegaly(enlargement of spleen). It doesn't indicate that you have cancer. There are various causes of it like:Infection may be bacterial, viral or parasitic.CancerSarcoidosiscystAbscessInfiltrative disease.So the conclusion of being in cancer cannot be drawn now. Further test requires  to confirm the cause of splenomegaly which include Blood tests such as CBC(Complete Blood Count) and liver function tests, CT scan.Do consider a positive feedback as a credit to my work. Let me know if you have any further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for small bumps on the foreskin of the penis\n\nI have small pimples under the forskin and on the penis, they have been here for the last two weeks and it started off with just one but there are about 10 now... I m not sexually active and they do not hurt, they just cause discomfort \ufe0fand itchiness sometimes, what can I do ?",
    "doctor_response": "HelloI really appreciate your concernThis can be caused by number of reasons like dryness of vagina or lack of lubricantions, infection or inflammation of the penis or at times it might be related to allergic reaction.Masturbation may be contributory factor in it.If you can provide me more details like medical history like if you are having diabetes or liver diseaseSimilar complaints in past, I will be able to guide you better.If I were your treating doctor, I would have advised you to keep it clean and apply antiseptic ointment if it doesn't improve or worsens than I would have ordered few investigations like blood for hemoglobin, CBC Liver and kidney function test, blood sugar and urine culture or an ultrasound if need be.you may require a course of anti allergic or antibiotics drugs under supervision of doctor.Thanks for your questionWish you both good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Painful stomach, not appendicitis. Having the mirena taken out. What is wrong?\n\nI went to the doctors last thursday to have mirena taken out as it did not work for me.  I also had been having pains a week before extraction and my doctor thought I had appendicitus so went to hospital and they said no it wasn't but one day after having coil extracted I have been having more pain and lots of bloods loss and clots what is this",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for calling H.C.M,.F. You text says that You had pains since few days, you got mirena removed on last thursday. on friday you had pain and lots of blood and clots. It appears that you have urinary tract infection, which caused pain. on thursday you got mirena removed , probably during the infection which resulted in over bleeding. Even other wise also some times happens like this. still examination is necessory, so i advise you to consult you doctor for diagnosis and treatment . Wishing that everything is fine. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Gardella sexually transmitted?\n\nHi. My doctor just called and said I had a bacterial infection called gardella.she explained that its somewhat like a yeast infection but is a bacterial infection and not related to an std. I forgot to ask her if my boyfriend needs to be treated for the bacteria since we have had sexual intercourse.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Yes, its same as yeast infection but it's caused by bacterial infections.I suggest you to take the medication as provided by the doctor. No its not STD and it will not caused due to sexual intetcourse.But it is better if you can avoid sex during the treatment as it can interfere with the normal flora replacement.Please maintain good hygiene locally as it can be equally help full as treating with antibiotics.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for chronic kidney disease?\n\nMy brother has chronic kidney disease stage 3 almost 4 and it looks like to me that he's addicted to food.  He just loves steak, pasta, processed food, etc.  He has a hard head.  We're all worried about him because we love him.  I think he's in denial and we don't know what to do.  Please help.",
    "doctor_response": "Hello and welcome to HCM.As an Urologist, i must assure you, that chronic kidney disease(CKD), is definitely treatable. There are so many people having similar stage of CKD, on medical treatment.He needs to follow certain guidelines very strictly,  otherwise, he will deteriorate very rapidly.You can send a copy of his latest blood,urine, and scan reports,  with present medication,  here,  in my name,  for an expert opinion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vision problems and dizziness to a 6 year old?\n\nHi,My 6.5 yr old said that today his vision became black at the bottom of his eye but could see at the top part (if that makes sense).  He also said that he felt dizzy.  At the time he was sitting and singing a song in class and looking at the words on the blackboard.",
    "doctor_response": "Hi What you are describing is a very serious symptom.  The first thing I want to rule out is a brain tumor.  I would like you to take the child to an Eye Specialist and a Pediatrician at the earliest.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart ache followed by squeezing sensation?\n\ni have been having heart pains a squeezing sensation on and off for abot 3 months it hurts and i find myself unable to do things and have to rest quite often, especially at the gym i can feel myself getting dizzy when the heart pain starts. do you have any idea what this is? my biological dad died of a heart condition, but i am unsure of what it is as i did not know him well and have no contact with my family. My docter says he is unable to help me because i do not know what the condition it is that my biological dad had?!",
    "doctor_response": "Hi, You need to do further tests to be sure that it is a heart condition, like ECHO imaging to the heart and stress ECG as well, and at the meanwhile, do not try to do so much effort. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painless lump in ear?\n\nHello. I have a small lump which feels a little like gristle but spongy feel in my left ear I noticed this just over a year ago. It hasn t grown in size it doesn t hurt its just noticeably different from my inside right ear. I keep poking and prodding thinking it may be a blocked spot.",
    "doctor_response": "Hello and welcome to HCM,Painless lump in left ear could be due to a soft tissue swelling.A clinical assessment is required to know the exact site of the lesion and its relation to other structures.If the lesion is not clinically fixed to underlying structures, it can be surgically excised followed by histopathological examination.You need to consult an ENT specialist for clinical assessment and further management.Thanks and take careDr Shailja Puri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can one be pregnant if taking oral birth control ?\n\nI restarted oral birth control last month. 3 says before my inactive pills I quit taking the active pills. In addition to this  I had unprotected sex the day I stopped taking the pills. I ended up having my period it was a normal period . I'm concerned that I may be pregnant.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I think you are not pregnant since you had a period and if you finish active pills and don't take pills after or take inactive pills is the same because they don't contain hormones. Hope I have answered the question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I use Kojivit gel to get fair skin?\n\nHi doctor, I am a 22 year old female. I have a dusky skin that is brown skin. I want to become fair. Can I use Kojivit gel? Or any other dermoatology cream can I use? My hands are also brown in color and full of tan. Do you suggest any creams to get fair? I want to become fair as my marriage is going to get fixed by next year. Please suggest me some creams, so that it should not show any side effects. Also, how long I should use it? If I use anything, then will it have any effect in case of pregnancy, etc? Please help me. Thanks in advance.",
    "doctor_response": "Hi. One's skin color has 2 components. First one is genetic, which cannot be changed. Every skin color is beautiful in its own way and we should learn to love our skin color and augment it and not hide or lighten it. The second component is acquired, which is due to the influence of environment, sunlight, hormones, aging, etc. We can only target the acquired component of fair skin color while attempting lightening procedures. I suggest you antioxidant capsules like capsule Antoxid HC (Beta-carotene) and apply sunscreen lotion Lashield gel at 8 AM and 12 PM. Also, you can apply Glyaha koj lotion (Hydroquinone) at night time. Start with an alternate night application initialy as it may irritate your skin a bit and after a week or so, shift to daily night application. Consult your specialist doctor, discuss with him or her and take the treatment with consent. You can go for chemical peeling or microdermabrasion from your dermatologist which will help in exfoliating and give you a clearer skin tone. All these treatments are free of side effects. You may use them for three months. For further information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can salmon oil & Omega affect the role of Petogen 150mg?\n\nGood day Can you please advice if any of the following medication can effect the working of Petogen 150MG: Humulin 30/70 \u2013 28 - 16 Salmon oil Omega 3-6-9 Dolomite Auro-citalopram 2 x 20mg Simvotin 2 x 20mg Adco-antenolol 50mg Prexuim Trusting that you can please help with some advice Thanking you and wishing you a wonderful day",
    "doctor_response": "Hi,Petogen is used for contraception. It helps to prevent development and release of egg from the ovaries during menstrual cycle thus prevents pregnancy. No, Omega 3 fatty acids or other vitamin supplements do not have any interactions with Petogen 150 mg injection. You can continue to take both the drugs.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Saranya Ramadoss, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have indigestion, gastritis, mouth ulcers and wet cough. Please help.\n\nHello doctor, I have indigestion, gastritis, mouth ulcers, and a wet cough.",
    "doctor_response": "Hi. it is generally seen that indigestion causes acidity, gaseous distention, mouth ulcers, and constipation. And indigestion depends on your food habits and lifestyles. If it persists for a long time it causes the above-mentioned issues. Take Liv 52 syrup 10 ml twice a day before food, Kutki capsule one capsule with Trikatu Churna 1 gm twice a day after meals with warm water. Avoid spicy and fried junk foods. Avoid cold drinks, soft drinks, ice-cream, etc. Do regular kapalbhati, mandukasana, and ardhamatsyendrasana.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I give Isomil to my 5 months old?\n\nHello my 5 month old was on nan pro 1 uptill last week,he got diarreahoe so he stop taking tat milk n he had mucus n green potty sometimes wit water n bubbles got his stool test done n according to my pediatrician I shud cage to isomil dunno whether y To switchover to isomil or similac",
    "doctor_response": "Thanks for asking on HealthCareMagic. Formula milk like similar are cow milk based and hence hard to digest for a baby and could cause greenish stools whereas isomil is a hydrolysed formula and easy to digest. If your doctor assumes the cause of diarrhoea to be lactose intolerance or intolerance to milk, it would be better to go for isomil. It is safe and you need not worry about it, it is just not as tasty for the baby.I hope that helps. Feel free to revert back in case of further queries if any.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for a bump and red mark on the scalp of baby after an injury\n\nMy 6 month old daughter fell off the bed and hit the top and back of her head on the edges of a shelf. There is a slightly raised red bump in the back and a scape like red mark on top of her head. She cried for about 20 minutes and then acted normally laughing and crawling. We observed her for a while and then she went to sleep because it was her regular nap time. She is sleeping now but I wonder, should we take her to the ER?",
    "doctor_response": "is she is behaving normally  and there is no loss of consicousness, or vomiting then ER is noy nescessary. jus apply some ice pack on the area and observe for a day... if any new symptoms arise then you can take her to the ER.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruise on arm that stings sometime?\n\nI currently have a bruise on my arm that stings sometimes, I was just wondering what causes that. Background, I have APS, Sjogrens, Raynauds and - most likely Dermatomyositis (I take Warfarin for the APS so the doctors don't want to do the test to determine if I have it for sure). Thank You!",
    "doctor_response": "Hello,In your case bruise is due to the consumption of warfarin.It is quite common for people to have bruises who are on anticoagulants like warfarin.You should get your INR and PROTHROBIN TIME checked and in case they are out of advised  range,then you may need to revise the dose of warfarin.If they are normal,then there is nothing to worry.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure celulitis on left leg?\n\nI was diagnosed as having celulitis on left leg. However now I am beig told it was reaction to betadine/savlon/dettol used at various stages when i was being treated in the hospital.Can reaction to such normal cleaning agents cause reactions like cellulitis?",
    "doctor_response": "Hello,Thanks for the query.Sevre contact dermatitis can cause clinical picture similar to cellulitis.As a first line management, you can apply low potency steroid creams like betamethasone for symptomatic relief. If the lesion persists, it is better to consult a dermatologist and get evaluated. Wishing all the best.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy rashes over legs and stomach?\n\nI have rash-types over my legs and also welt-type rash appears across my stomach or mid section. I think they are hives but one cannot be sure. They come and go but those little red dots on my legs stay awhile. They do not always itch. The ones on my mid devotion do itch. Are these hives?",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your history and would like to make suggestions for you as follows:1. If they itch, possibility of hives is more, however, there is possibility of dermatitis also. Diagnosis of skin condition is best done by direct examination of the skin. Hence a dermatologist would be the best person to identify the type of lesion.2. I usually suggest my such patients antihistamines like cetirizine or levocetirizine for 7-10 days (depending upon response) which treat and prevent itching.3. I would also suggest you to regularly apply calamine lotion or moisturizing cream/lotion over the skin lesions. It will help to recover early.4. please avoid irritating/woolen and tight clothings. Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Routine echo shows moderate pulmonary hypertension. What does it mean?\n\nHello doctor,I had a routine echo done a couple of weeks ago and just got the results yesterday. The sheet says moderate pulmonary hypertension with peak pressure 54 mmHg and central venous pressure of 15.0. Since I only picked up the results no one explained it to me but set up an appointment with lung and heart specialist in six months. What does all this mean? I am a hypertensive and pre-diabetic. Currently, I am on Lisinopril 10 mg.",
    "doctor_response": "Hello. This means pressure in the pulmonary circulation has increased likely due to lung problem (if echo is not showing any abnormalities other than this). Likely this is related to obesity although we need to rule out other causes of pulmonary hypertension by doing CT scan and other few investigations. Do you have shortness of breath, any other symptoms to suggest some cause? You should focus on healthy lifestyle and weight loss.  For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take I pill during periods?\n\nHi, Is it safe to take I-pill (contraceptive pill) during periods. I had unsafe sex(without condom) on 1st day of period and today is 2nd day. If I take I-pill, will any complication arrive in future to conceive. I don t want any complication in future due to emergency contraceptive pill. Please suggest.",
    "doctor_response": "Hi there,After going through your question, I am of the opinion that:1) There is no need to take an I pill during periods.2) Having sexual intercourse during periods does not lead to pregnancy and since I pill is used to prevent pregnancy, no point in taking it.3) I pill does not have any effect on future fertility and can be occasionally used in emergencies.4) However, in my opinion, it is always better to have protected intercourse if you do not want pregnancy and also it helps in preventing other sexually transmitted diseases.Hope this was helpful.Regards,Dr Shikha shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to regrow hair after breast cancer treatment with taxotere?\n\n57 year old caucasian female, no history of hair loss in family or male-pattern baldness prior to breast cancer treatment with taxotere hair was very thick three years after treatment with taxotere hair is extremely sparse and will not grow beyond soft downy stage help please",
    "doctor_response": "Hello, I would recommend you to apply minoxidil 2 per cent lotion on the affected areas of the scalp and take hair supplements like tablet follihair once daily. You need to continue these for 4-5 months to see significant results. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What home remedy can be done to grow hair in chin ?\n\nI M 23 YEARS OLD GIRL....I HAVE THICKER HAIRS ON MY CHIN...BUT I HAVE ONLY SOME AMOUNT OF HAIR...GIVE ME GOOD HOME REMEDIES...REP ASAP... PLZ REP SOON...",
    "doctor_response": "Hi...Thanks for choosing HCM., Thicker hairs on chin, Usually due to 1) Hyperactivity of Hormones.., eg..PCOD, Adrenal gland hyperactivity., Arrenoblastoma., 2) Steroids...excessive use So first evaluate ,to exclude above problems.., 1) simple ,non expensive procedure.... RF- electro...epilation.., 2) Electrolysis.... 3) Chemical epilation.... 4) LASER therapy...expensive but reliable and effective., Diode laser..800 nm., IPL-intense pulsed Light System.., without heat , LHE-400 to 1200 nm..ok good luck.,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have severe distension of stomach, stomach ulcers, constipated. Had colonoscopy. What is going on?\n\ni have severe distension of my stomach that never goes down, i look 8 months pregnant and i am 5:5  140 lbs its been going on for more than 6 months. i am now having sharp pains on both sides and this is new a symptom sharp pain when i eat across the top and both sides. i have had a colonoscopy, came back normal. a endoscopy said i have some stomach ulcers to take prillosec, which i took for a week and quit because it made me constipated. i have even swallowed a camera capsule, came back normal. i had a abdominal and pelvis ct, came back normal. have had one blood test not sure what they checked for but it was normal. and this is a new symptom, i use the elliptical 30 min. 4/5 days a week, last couple of times upon reaching about 20 min i get sharp pains all over my stomach and my toes go numb on both feet.. help please...",
    "doctor_response": "Hi, Thanks for posting your query. With the available described details, there appears to be possibility of dyspepsia with decreased gastrointestinal motility. Dyspepsia is a collection of symptoms consisting of acidic belching, abdominal heaviness and bloating, gargling sound , excessive flatulence. Dyspepsia could be due to peptic ulcer disease, bile reflux disease and functional in nature.You should consult with internal medicine specialist/ gastroenterologist and should go for thorough check up.You should also go for complete blood count, blood sugar, thyroid profile, and renal function test. You should also go for urea breathe test for H. Pylori. If Urea breathe test is found to be positive then you have to take complete eradication therapy for H. Pylori bacteria. Meanwhile, you should also take proton pump inhibitors along with prokinetics and advised antidepressants.Take care, Dr. Mayank Bhargava",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Should I go for rabies vaccination after a minor scratch by a cat?\n\nHi doctor, During my vacation I stayed in a hotel where they had 15 pet cats. I picked up a small cat to play, but she jumped from my hand and it felt like a scratch on my forearm. It was very minor, even not a single blood spot or skin removal present. She was completely normal in behavior. Now, I asked them after eight days. They said they are pet but not vaccinated and also say not harmful. They say none of the cat died but does not look very confident to me because they surely do not have any count of them. Should I go for rabies vaccination? Please suggest.",
    "doctor_response": "Hi. I have thoroughly gone through the photos attached (attachment removed to protect patient identity) by you and understand your concern. For further information consult a general practitioner online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a red inflamed knuckle on the hand?\n\nI have a red inflammed knuckle on my left hand. I am also a breast cancer survivor diagnosed in 2001 (positive receptors-radiation only-arimidex followed) 2010 diagnosed with triple negtive breast cancer (chemo, radiation and left breast mascetomy due to serious infection). Could this be related to cancer treatment and tons of heavy duty drugs taken for infection, plus chemo? Or is it the onset of a form of arthritis. What can I do to slow it down. A few weeks ago, this same condition appeared on my right hand on the thumb side but was more extended toward my arm. Thank you!",
    "doctor_response": "Hello, As this could be the drawback of the trouble due to lack of venous return as the lymph nodes are most times removed during the full mastectomy. I will advice you to get it physically examined if it's a cause of any infection which may not be related to the breast cancer at all. Also using stocking for the upper limb, hot water fermentation and simple upper limb strengthening exercises should help you ease the symptoms. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for typhoid fever and kidney pain\n\nI was diagnosed having typhoid fever last month . I had it two years ago and was treated with antibiotics , but it came back I used antibiotics again , the no. declined from 300 to 80 but I still suffer from the symptoms and having pain in my kidney what should I do ?",
    "doctor_response": "Hi I can understand your concern...Noted you are having typhoid....So because of that you are having muscular pain and so feeling it....Just now consult doc and if needed hospitalisation for 3 to 5 days needed.Take intravenous ceftriaxone for 3 days.Then after take oral cefixime for 10 days.Meanwhile take small diet with frequent interval....Avoid excess oily and fatty food.Fruit juice best one....Soft and bland diet taken....Non veg food avoided....Egg and pulse like protein useful.Take care.Stool culture after treatment should come negative....USG done in your case.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes discomfort while bending after a spine surgery?\n\nyes doctor if one had an operation (spine lower) is it true our bodies heals from inside out so a little discomfort at times maybe too much lifting bending etc. operation was done my name is pay I never received an answer from a few days ago the money was taken from my account but three emails to my pc opened but was blank thank you Dr Andrew I saw your name and photo so this is a another attempt",
    "doctor_response": "Hello!Welcome on Healthcaremagic!Regarding your concern, I would explain that after back surgery you may experience some pain and discomfort in this region. Besides, healing is a long process. It is not really important if the body heals inside out or the contrary, but you should know that the inflammation in this area may persist for a month. Physiotherapy is needed to help improve the posture and reinforce the back muscles. I would also recommend avoiding heavy weight lifting.Surgery can not give you a new vertebral column. The chronic degenerations persit. It just helps improve the pain and movements.  Hope you will find this answer helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rash on face, dry, raised skin, itchy, red. Used expired sunscreen. Treatment?\n\ni have had a REALLY bad rash on my face. very dry, raised skin, itchy, red, red, red. I thought it was from my graves disease being out of control again, but know im wondering if it was from using a sunscreen that contained  avobenezone(3%) which was expired. HELP! i wont even go out of the house its sooo bad. It looks like a chemical burn on my fave.",
    "doctor_response": "Hello,Welcome to healthcare magicThe rash is limited only to the face. So it is unlikely to be due to graves disease.Allergic contact dermatitis to sunscreen is more likely.Use cold compresses and splash the face with cold water frequently. Apply a goo moisturizing cream frequently.You will require a topical steroid cream for the rash. Please get it prescribed by your primary physician or dermatologist. You can also take an antihistamine for the itching.Hope this helpedTake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a habit of finding pleasure by pricking the gums. Will it affect my oral health?\n\nHello doctor, Ever since I was little I would stick sharp, pointy things between my teeth and poke and pick at my gums. It would cause pain but the pain was addictive, it is like I enjoy the pain. When I was a child I would use my fingernails to do it until my gums would bleed. I know that sounds nuts but it is true. As I got older, I started using things like toothpicks. Keep in mind what I am feeling is definitely pain but it is a sensation I like for some reason. I tend to do it between my back teeth. I am worried about my teeth.",
    "doctor_response": "Hello. I have gone through your query and understand your concern. Constant tooth picking leads to gaps between teeth, gum bleeding and gum weakness. Weakness of gums and bone creates more gaps which attract food deposits. These deposits irritate the gums constantly leading to gum and bone infection. This condition is called Periodontitis. Pain, swelling, and spaces between the teeth getting wider are the signs of periodontitis. Once those gums and bone get infected, those teeth will start to shake and become loose in no time. Please visit your nearby dentist and get a scaling and polishing procedure done to remove those calculus deposits. This cleaning procedure should be done once in six to eight months if required, for maintaining healthy gums. And please do try and quit the habit because more than the calculus, your teeth picking habit causes major damage to your gums and teeth. It may even cause multiple teeth decays. To start with, you can try discarding toothpicks and sharp objects from your sight to stop this habit. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painfully swollen foot after being bitten by a bee?\n\nMy granddaughter got stung by a bee on her heel two days ago.  I remove the stinger within 1 to 2 minutes of the incident    However, it is still red and swollen on the foot and her ankle we have treated her with oral Benadryl this is the third day now.  Should we be doing something else or should we be taking her to an urgent care?  I am an RN and I thought I have done everything I should we have applied  cool compresses several times a day and are keeping it clean and dry.  She has been swimming should that be something she should avoid?",
    "doctor_response": "Hi, I am sorry for the bee sting your granddaughter has gone through. It's good you removed the sting withing the first minute. The swelling is due to being stung. Keep applying cold compresses locally to remove the swelling. Apply hydrocortisone cream to relieve redness and swelling. She will be fine in a few days. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Want the name of good doctors for neck pain with cervical spondylitis\n\nhi my name is nitu dawre and i have bad neck pain ... and cervical spondylosis .. i want good doctor to help me out ..in mumbai",
    "doctor_response": "Hi Welcome to healthcare magic forum Cervical spondylosis is a age related disorders. The plan of treatment can be divided into 3 fraction- 1 - need to manage the pain. In this regards proper homeopathy remedies according to symptoms (not just R-11) will be prooved very helpful. 2- supplementation of calcium and phosphorus in homeopathic preparation, 3- some physiotherapeutic neck exercise. This package will be helpful For detail you can contact at multicare.homeo@yahoo.com visit - www.multicarehomeopathy.com ; www.onlinehomeopathytreatment.com Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes foul smell above pubic hair?\n\nim a 17 year  5\"7 inch  and 45 kg   male  masturbating since 5 yrs .currently about 5-6 times a week (once a day)...... sometimes the area above my pubic  hairs (lower waist)   gives a very foul  smell ....... what is he cause and how do i cure it ?",
    "doctor_response": "Hi,The foreskin of penis comes back? If not secretions under the skin can cause smell. Also, try shaving off pubic hair and observe for smell. If it continues then consult your doctor. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. B. Radhakrishnan. Nair",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for breathing difficulty while treating fibromyalgia and diabetes\n\nI have had a bad dose of flu and now have a chest infection. It s been 9 days since start of flu and I am having difficulty breathing, there is a loud rattle when I exhale, also if I lie on my left side it gets worse so I feel it is the left side of my chest, do I need to revisit the doctor? I have diabetes 2 and fibromyalgia so my immune system isn t strong but I never know when I am over worrying?",
    "doctor_response": "Get X-ray chest PA , CBC , ESR ,SUGAR , S.ACETONEgood antibiotics coverderiphyline Nebulizationif not relieved visit Doctor",
    "dialogue_context": ""
  },
  {
    "patient_message": "Facial expression like having a ball in mouth on both sides.  Blood tests normal.   Due to deep fillings in teeth done long back?\n\nHi My family and friends have noticed when I do certain facial expressions that it looks like I have a ball in my mouth on both sides just above the jaw line. I have started noticing as we'll in photos. When I touch it its like there is nothing there just swalllen. I had a blood test and nothing came up in my lymph nodes. I am now starting to think its my teeth I had two very deep fillings done a few years ago maybe I have an infection although I have no pain or swelling in my gum",
    "doctor_response": "Hello,Thanks for writing to us.The appearance of ball in mouth will be due to-Abscess developed either due to re-infection of restored teeth or due to periodontitis.Please do visit a dentist and get a thorough clinical as well as x-ray evaluation done.Root canal treatment has to be done if required.Get deep scaling done.Maintain oral hygiene well.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat painful hematoma on the upper arm, elbow and shoulder area?\n\nYes sir, please.....I was in an ATV accident and have a horrible hematoma on my upper arm from elbow to shoulder.....I had 7oz. Of blood removed from it last Tuesday. It it is still causing me terrible pain. What can I be doing while at home to help ease any pain",
    "doctor_response": "Hello,I can suggest rest to the arm. Ice packs and tablets containing proteolytic enzymes to decrease the swelling. Please don't do any hot fomentation. If you are on any blood thinning tablets, then it will take still more time. The usual time for full recovery is about three to four weeks. Hope I have answered your query. Let me know if I can assist you further.Regards,       Dr. Santosh S Jeevannavar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden panic attacks?\n\nI was woken this morning with what I can only call a panic attack. My heart was pounding and my pulse was racing so much so I could hear and feel it in my throat, ears and chest.I had pins and needles in my feet and was very hot. Very concerning as had to open the windows and took about 2 hours to calm down.",
    "doctor_response": "Helo,This looks like a panic attack but one shoud always try to rule.out a cardiac cause in.first go.Getting an ECG will rule out any related heart disease and if it is normal then it is panic attack for sure.Now, panic attack can occur in association with anxiety or alone. If with anxiety then paroxetine helps a lot.If they come alone and frequency is less- there is no need to start a regular medicine but take clonazepam 0.25-0.5mg in attacks..If they become regular occurance then one must start a regular drug for some time.Donot worry please, you will be fine. It is manageable and do get an ECG first.Hope this reply is useful for youWish you good health!Dr. Manisha GopalMD psychiatry",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to eat food after head injury?\n\nMy 2 1/2 year old fell against the bannister on the stairs, and has a cut along his scalp and two bumps, bruising on his forehead. Pupils are OK. He will need a stitch or two I think - can he eat or drink anything now or should I wait to see how he does?",
    "doctor_response": "Hi, Please wait. We have to check for internal bleeding by doing a CAT scan. If everything is clear, she can get stitches, pain killers and can eat. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Prasanna Lakshmi, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from stomach pain. Took number of tests, all went paradox. Help me find out what it is.\n\nMy father is suffering from stomach pain but no doctor could still diagnose the problem. Most of them said that its due to depression and some said it is a stomach problem. All those doctors took a number of tests but all went to paradox. My father finds himself helpless, week and restless all the time. Please help me out!   Thanks!",
    "doctor_response": "Hello, thanks  for query. You  have  mentioned many things  but not mentioned, what are the problems your's father complaints. You mentioned that there is stomach pain. Please mention that where is pain in the abdomen, sour mouth or not?                                                                                        Nausea Belching or not                                                                                                                                                  Distension or not                                                                                                                                             Age of your's father                                                                                                                                          Tension or not                                                                                                                                                    Working or not                                                                                                                                                            At present one thing I can says that the problem might be a PSYCHIATRISTS  related.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is fusion surgery good for spinal canal stenotic\n\nI have recently had an MRI which shows central spinal canal stenotic at C 5-6 and 6-7, diffuse annular disc bulge posteriorly. Horrible neck pain, headaches, shoulder pain constantly! Over the last 9 yrs. I have had numerous injections, blocks, medications, etc with no relief. I was seen by a Spine specialist who has recommended fusion surgery. Does this sound reasonable?",
    "doctor_response": "hi,as per me I think you need to try out physiotherapy initially with focussed on the Strengthening of the neck, upper back, interscapular muscles and upper limb as a whole. For pain management try out ultrasound therapy and TENS. I have been seeing many patients with same issues but I personally do not recommend them surgery and I have 100% of successful rehabilitation process of their physical status. I wish you try out this whole process of physical therapy, as neck surgery is not always a good option to choose from.god bless you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does sudden, sharp pain in stomach and lower back suggest?\n\nhello i'm 29 years old and last night out of no where i get a pain on my sides the n a really sharp pain in my stomach i couldnt take the pain i cryed and then when i went to sit down i felt the pain on my lower back it felt like there was something inside me. i still feel little sharp pain in my lower stomach as we speak",
    "doctor_response": "Hello! Welcome to HCM.This sudden severe pain (also involving back) suggests a stone in urinary tract, more likely in ureter.Stone causes obstruction to urinary outflow & so smooth muscles in ureter contract excessively to overcome the obstruction, and so is the colicky pain.Many such patients come in my clinic & I advise them ultrasound abdomen & pelvis, X-ray KUB, renal function tests, blood sugar & urine routine.Treatment is done accordingly.Hope this helps.Wish you good health.Thanks.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for problem in toilet training 3 year old\n\nIs it common to have problems toilet training a child who had anal dialation for anal stenosis when they were a baby? My daughter is 3 and very intelligent, but I cannot get her to poop on the toilet. She does alright with pee. I worry that it stems from the stenosis issues-either physically or mentally.",
    "doctor_response": "anal stenos is a recurring problem and dilatation alone is not enough- give some stool softener (babylax) and get ped surgeon to see her for a permanent cure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there increasing amounts of mucus in the feces?\n\nHi doctor, My 77-year-old wife has had constipation issues all her life. This coupled with IBS that generally results in at best small balls of feces. This is day five of no real bowel movement. She had a total knee replacement nine months ago and para-esophageal hiatal hernia repair. Early on use of MiraLax (Polyethylene Glycol) produced nothing followed by two days of Magnesium citrate and still nothing. Finally today, a fleet enema producing small group of balls with mucus. She is currently on Crestor, Tofranil, Fioricet and Lorazepam. Can you share your thoughts regarding this continued bowel movements producing ever-increasing amounts of mucus?",
    "doctor_response": "Hi. The mucus usually results from prolonged constipation and has nothing to worry. She needs to take measures to avoid constipation. Have a high fiber diet. Avoid constipating foods. Take 2 to 3 liters of water daily. You can have low dose laxatives like Cremaffin (Liquid paraffin, Magnesium hydroxide and Sodium picosulfate), Dulcolax (Bisacodyl) and Lactifibre (Lactitol and Isabgol husk) in ascending order as needed. Consult your specialist doctor, discuss with him or her and take medications with their consent. When was a colonoscopy done? If not within a year, you need to consider one. For more information consult a medical gastroenterologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can being exposed to cold lead to skin rashes all over body?\n\nmy elder sister 46 yes female has very itchy rash all over the body except the face which comes on exposure to cold and persist for several days. the rash are red in colour and dry. physician prescribed in. avil , tab teczine and an ethical lotion. wat could be the cause and is the treatment correct",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.It could be Cold induced urticaria or Chilblains. Please wear gloves, socks and woolen clothing. Tab. Teczine is fine and I could not find the actual composition of Ethical lotion. If you do preventive measures for reducing cold induced change, the chances of improvement is more. If you do not get any improvement even after following above mentioned measures, please consult your Dermatologist.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the brain MRI report indicate?\n\nWhat does the following MRI of the brain report mean? There is a small chronic lacunar infarct versus a dilated perivascular space in the posterior left centrum semiolale. A small chronic lacunar infarct in the left thalamus is observed. There is no evidence of restricted diffusion to suggest acute infarction in the brain parenchyma. There is a mildly prominent CSF overlying the cerebral hemispheres secondary to moderate generalized cerebral and cerebellar volume loss rathat than subdural hygromas. The ventricles and basilar cisterns are normal in size.",
    "doctor_response": "Lacunar infarctions are ischemic brain lesions less than 1cm in diameter. The first one described is not sure to be a infarction as it can also be a dilated perivascular space, witch can be be a variation of normal anatomy or changes through a persons life. I don't understand well the sentence before the last, but i suppose it's a brain atrophy caused by an old subdural hemorrhage. You should see a neurologist to value the risk factors for cerebral vascular disease and to treat the patient properly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could lumps in abdomen suggest?\n\nHi,I am having lower left abdominal pain since 5-6 days and 2 days back I found lump in the same lower left side of the abdomen.Today I went to do the doctor and I found out that I am pregnant(4 week).they did ultrasound butthe report has not came yet.Is there any matter of concern due to the lump?Thanks Maya",
    "doctor_response": "Hi maya....U have got done ultrasonogram of abdomen...that will detect any other lump if present...So don't worry till report come...and congratulations.....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Got suicidal tendencies and unable to control anger. What's wrong with me?\n\ni m suffering my anger, and have got suicidal tendencies. i have a gf of 4 years, and when ever i land into any argument with some1 only she is able to calm me down, help me basically. she is like a force who calms me down. i want to know what is wrong with me?? even my parents cant help me nor control my anger. it s like in anger i don t know what i feel or do, its just an instant without conscience..... i also feel like keep hitting things to let my anger out but my gf stops me.",
    "doctor_response": "Hello......... Thanks for your query. On going through your symptoms, it appears you have pathological personality traits. The other alternative could be mild mood fluctuations refereed to as cyclothymia. Hence, i would advise you to undergo a thorough psychiatric evaluation as well as personality profiling so that above disorders can be ruled out. Effective anti-aggression agents like mood stabilisers and beta blockers are available to deal with the condition. Avoid any substances of abuse as they may worsen your state. Wish you speedy recovery. Regards Dr Sundar Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Aspirin safe to be taken instead of Meloxicam?\n\nIs safety coated enteric aspirin 325 mg just as effective as meloxicam 7.5mg ,the meloxicam makes me lighted headed and I live a busy life and do not want to take it .is there an over the counter med that I could take instead ? My body rejects most meds and I would rather take OTC meds anyway .Thank You Theda Smith",
    "doctor_response": "Hello,  Better than aspirin you have Tab Advil or Ibuprofen 400 mg whenever needed. These otcs should be taken after meals and preferably with antacids like Pantoprazole or ranitidine. But in general it's betteur to avoid the frequent of otc, and it's better to get primary problem addressed. Hope this helps you and get back if you have any doubts.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could coughing after recovering from bronchitis indicate upper respiratory infection?\n\nI am wondering why I have another upper respiratory infection?  I was diagnosed with bronchitis this fall and it finally went away after 3 rounds of different antibiotics.  A chest xray was taken and they said it was fine.  Should I be concerned?  It took me almost 3 months to be completely recover from bronchitis.  I am coughing again (not a lot) and have green mucus.",
    "doctor_response": "thanks for your questioni completely understand your questionactually in  chronic bronchitis cough will remain either less or more through outbut if cough with expectoration , that too if sputum is yellow or green in colour or foul smelling that means there is a secondary bacterial infection which happenedit can be associated with other symptoms of fever or breathlessness better to consult a pulmonologist who can start you on antibioticsit will be better if pulmonologist will send a sputum culture and senstivity so that if inspite of the empirical antibiotics if cough and purulent sputum remains accurate therapy can be started cough in chronic bronchitis is a mechanism to clear out excess of secretions that is a normal phenomenon in bronchitis that protects airways to get damaged due to retained secretions , which can lead to infections exact treatment for chronic bronchitis is inhaled drugs that will cause bronchodilatation and ease your symptomsconsider consulting a pulmonologist and disscuss the above treatment and investigation modalities thanks feel free to ask more questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can chronic backache be treated?\n\nI recently had a nerve block as a diagnostic tool preceeding RFI. I found no relief. Can other nerve blocks in different areas be tried. This is my last resort for chronic back pain. I have already had two spinal fusions. I was looking for reviews from patients who had RFI procedures too. YYYY@YYYY",
    "doctor_response": "Dear patient nerve blocks are good measure to reduce pain if other procedures fail. please give detailed history.  why you have undergone spinal fusions on two occasions? at which level it was done? lumbar or cervical? was mri of indicated region done? this history is required  so that I can suggest you further treatment. nerve blocks are given by pain intervention specialist with good results.  patient selection is very important. thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does nightfall reduce testosterone levels and muscle mass?\n\nhi i m 26 year old male..i weight 87 kilos and height 5.10..i m into body building.recently i read that the testostrone levels in the body reduces due to masterbation..so i.stopped it for 5 weeks.buh at the ending day of the 5 the week i experinced.nightfall.does nightfall reduce teststrone and muscle mass and yes by how much? what methods are present to increase teststrone?",
    "doctor_response": "HelloThanks for query.Neither masturbation nor night emission reduce testosterone levels in body.One does not need to increase Testosterone levels in blood by artificial means unless it is shown to be low on blood test.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this chest X ray indicate?\n\nI got the chest x-ray results of my son. Based on the result, he has primary koch's infection suspected. There is bilateral hilar congestion with small hilar nodularities and osseous and other incuded chest are not unsual. May I know the meaning and most understandable explanation for this.",
    "doctor_response": "Hi thanks for asking question.Here in your chest x ray hilar consolidation present.Consolidation means pathological condition in which alveoli filled with pus , blood or cells that lead to opacity in x ray.In tuberculosis along with consolidation cavitary lesion also present in upper lobe.TB can involve hilar node so suscipicion is present.Further study involve sputum acid fast stain and culture.But consolidation also can be present if simple pneumonia is present.So after confirming tuberculosis and with clinical correlation AKT can be given.I hope I have solve your query.Wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Heaviness and numbness on head and cheek. Reasons?\n\nHi, my name is Fidel, 31 years old male. I feel heaviness and numbness on my left head and cheek. I thought that are from my teeth . I did a panoramic exam and nothing been shown. Can I know what are the reasons? could it be from the salivary gland or any other gland? it s necessary to do MRI? Please your response are highly appreciated",
    "doctor_response": "hello and welcome to HCM forum,I would like you to know that pain in cheek and left side of the head may be from tooth infection, impacted wisdom tooth or even from salivary gland .In case salivary gland is the cause, swelling of the cheek will be present but in your case i assume it is not present.One of the causes can be cheek biting, sometimes a sudden cheek bite is also very painful and pain radiated to the same side of the head.Therefore, proper clinical examination is needed .I will advise you to see a dentist soon.MRI is not needed until your dentist advises.I hope i answered your query,i wish you good health,take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the diagnosed complex partial seizure be due to removal of mirna iud?\n\nI have been diagnosed with complex partial seizures.....The neurologist believes it has been caused from an accident I was in when I was 6 or 7....I am now 31 and had 2 of my first ever grand mal seizures in jan 2014....can u help me understand why only now the scar tissue would become problematic? Why not when I initially had the accident? I am now being told I will be an epileptic for the rest of my life on meds 24/7....I can't work drive be alone etc.....I have 3 young children to support and no way of income.....I just had a mirena iud removed 5 mos ago could the mirena have contributed to the epilepsy only occurring now?",
    "doctor_response": "Hi,Thank you for posting your query.It is unfortunate that the scar of your old head injury has led to epilepsy now.It is possible for the scar to remain asymptomatic for several years, and become epileptogenic only after that.It is difficult to pinpoint the exact reason for a sort of \"quiet\" scar in the brain for several years, to covert to seizure-producing scar.However, there is no need to worry about that. If you take good anti-epileptic medications on a regular basis, you would remain seizure-free.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "How safe is giving Panadol for red bump on head due to injury?\n\nHey there, I was just bathing my 4month daughter and as I was getting he out I slipped on the wet floor, causing her to go under for a moment and also unfortunately causing her to bump her head on the bath also. She has a red bump on her head, and is a little lethargic (although she is due to go to sleep as well) Should I keep her awake? or can she go to sleep while I monitor her closely? I have also given her panadol to help with the pain she may be feeling after the bump.",
    "doctor_response": "Hello, First, be reassured that your kid is normal. I will suggest you danger signs of head injury -1. Vomiting continuously2. Seizures3. Watery or bloody discharge from ears and nose4. Unconsciousness5. Altered sensorium or behavior.If none of them are present. I don't think you should worry about his trivial head injury. For pain, you can give oral Paracetamol in the dose of 15mg/kg/dose every 4-6th hourly. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sumanth Amperayani",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of gallstone naturally?\n\nim exel 30 yrs old, 5 5 in height, 50kls, suffering from gallstone, last night i could not sleep because its very painfull i reall dnt know what to do, the doctor advise me to have an operation but we dont have enough money to do so, please help me to cure my gallstone in a natural way . thank u ang more power.",
    "doctor_response": "hi.noted history of gallstones and frequent attacks of biliary colic. diet modification is a very important thing in dealing with gallstones. low fat diet is recommended. but, your condition might have been there for a long time already (chronic cholecystitis or inflammation of the gallbladder secondary to cholelithiasis or gallstone) and is now increasing in frequency of attacks. in this case, diet modification and medication could do the least for alleviation of your symptoms. definitive treatment is still surgical removal of your gallbladder or cholecystectomy. it could be done laparoscopically (goldstandard) or thru open technique.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes foul smelling urine during pregnancy?\n\nHi, may I answer your health queries right now ? Please type your query here... I am 28weeks pregnant and have horrible smelling urine right now. I smell very strong onions while urinating and I m certain its not from any diet changes. Infection maybe?",
    "doctor_response": "Hello,Concentrated urine often smells strong. The smell of onion suggests sulfurous smell and urinalysis should be done to exclude infection, salts and pigments. Please increase the intake of liquids maintain proper genital hygiene. You should also test for albuminuria and get your blood pressure checked regularly. Take adequate rest preferably in left lateral position. Get periodic sonograms. Avoid excess salt. Urinary alkalinizers may be taken if necessary after consulting your specialist. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for right leg injury\n\nI crashed in to a car door and flew about 50 feet away, I got these huge swelled bumps on my right leg, I got this one that is hard on my calf and on my ankle, this morning I was wearing socks and the sock sunk in my skin and now it huts like my ankle is breaking, what do I have?",
    "doctor_response": "Hi, Please get x rays of ankle since there is likely to be a fracture with this kind of fall and injury. Rest of the treatment would depend on X-ray findings. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and stiffness in the lower back?\n\nI have pain in the left side of back since October I also have small lump that developed as well the pain is while bent over or standing for a time stiffness in the lower back I have noticed weekends in my arms and lifting or carrying things that I used to pressure sometime walking for long distances make me sore",
    "doctor_response": "Hello, I have studied your case with diligence. There can be degenerative changes in whole lumbar spine with disc space reduction. There can be degenerative wear of bones, muscles, ligament and facet joint arthritis, due to deficiency of calcium, vitamin D, VIT B12.so supplements of these nutrients can relieve pain.Check your bone strength with DEXA SCAN and you can start medication according to level of osteoporosis,And also check your vit B12 and vit D3 level.I will advise you to do regular physiotherapy and exercises as my patients find much relief by these therapies.You may consult physiotherapist for guidance. He may start TENS, or ultrasound which is helpful in your case you need to take diet rich in calcium and vitamin D.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you find this answer helpful do not hesitate to rate this answer at end of discussion. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to increase the capabilities of brain ?\n\nhi i am male,19 years old .I m feeling weakness in brain nerves ,weak memory the problem get started before 4 years .initially it was started due to stress for 1-2 year but i m unable to recognize it at that time ,but know a days there is no any stress but still i m suffering from this problem .From two years i m under the treatment of a psychiatrist .I am feeling that my brain capabilities get reduced to 50 percent.I am also suffering from digestion problem from 4 years.I am feeling brain empty and very weak.Please suggest me what should i do",
    "doctor_response": "Dear Achalsanghi , Your feeling of weakness in memory/empty brain can be part of depressive symptoms. As you are already under the treament of psychiatrist you can discuss these issues with him and get clearity for your symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing muscle pain after having a spinal surgery\n\nyes, I had spinal surgery in 2011, however don;t think pain is result of only this. pain has gotten worse over time. excreciating over entire body now. is like being sstabbed with hot polker everywhere. all joints and muscles. muscles so twisted and full of spasms they twist everything. effects insides and even skin. skin gets numb, losing feeling, but painful at same time. only relief i get is when laying down. has to be on my back. anything else too painful. no drs. have any answers and seems they ve lost interest, as though it s not as bad as i say. don t know what to do. am desperate. please answer anything you know. thank you.",
    "doctor_response": "Hi Hope this message finds you in good health.I have gone through your complaints and understand your concern.I generally see many cases like this at my clinic.these symptoms are not due to the surgery.it seems u have some sort of hormonal or vitamin calcium imbalance causing the symptoms.get detailed blood investigation done. n let me knowYou should eventually get back to normal in coming few days.Nothing to worry about.\u00a0\u00a0\u00a0\u00a0\u00a0I hope your question has been answered.If you have any follow-up queries,feel free to consult me anytime.Thanks,Take care,God bless.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it fine to consume wine immediately after tendon surgery?\n\nI had tendon surgery and was released 4 hours ago, I have an important meeting with a fortune 100 CEO in an hour I know he will want me to have a glass of wine he brought from his wine cellar is it safe for me to have only one glass? I wouldn t even consider it if he wasn t such an important client.",
    "doctor_response": "HIYou can go ahead and have your wine responsibly. I operate on tendons quite regularly and wine is not a problem to your recovery as long as you drink responsibly",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility\n\nI'm 28 years old. Married for 4 yrs now. Trying for kids but couldn't conceive. I'm 5Feet 3 Inch long weighing  67.5 g. My periods are not regular and my Dr. has diagonized that I have Thyroid & PCOD. I'm taking Eltroxin 50mcg everyday early in the morning and now it is in control. But my Dr. asked me to continue having it till I have my baby. Taking Glucophage 500gm thrice a day. Recently I had undergone HSG Test and the tubes were fine. We have got my husbands spiemen checked and found that the sperm count is low. He is using COQ Forte. I'm under medication since 3 years now but still havent got my pregnancy. Can you please suggest me what to do as we are deperate to have a kid.",
    "doctor_response": "Hello,Welcome to Health Care Magic.Thanks for writing.I am Dr.Nitasha Khan. I have read you question completely, i understand your concern and will try to help you in best way possible.you have thyroid issue and also pcos so both causes chances for low fertility but thr is nothing wrong like both r treatable condition like you are taking medications and it wil be fine you just need to keep faith and be calm and stree free and have healthy diet also you hubands low count kinda makes it double trouble to cncieve but if he is on regular medications he wil be fine and hope fullybyou wil have a baby soon just keep faith and hang in there you wil have good news soon I hope this answered your question.If you have more queries I am happy to answer.Otherwise rate and close the discussionRegards.Dr.Nitasha Khan",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure the recurring back pain?\n\nHi doctor.. Good Morning... My mom is having severe pain in the upper back... treatment is on.. but the time she has the medicine, pain subsudes and then it come back again.. We have received her lipid test report yesterday and below is the observation Total Serum Cholesterol : 196 HDL Clo : 51 LDL Clo104 VLDL Clo :41 Triglycerides : 203.. what does the same signify...",
    "doctor_response": "Hello, I had gone through the case and found that it is almost normal lipid profile only Ldl and total cholestrol is little bit high as normal range Ldl Back pain does not occur due to abnormal lipid profile.For back go for X-RAY of spine and Vitamin D3 blood test.Meanwhile do stretching exercise and calcium rich diet.After diagnosis take treatment.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "My father is suffering from tumour in chest\n\nmy father is suffering from tumour in chest . found the size is 107*74mm by CT Scan . He is felling pain in left arm and less apetatite. Pl advice.",
    "doctor_response": "Visit MEDANTA\"THE MEDICITY\" A super Speciality Hospital In sec-38 gurgaon where U can get Consultation with Dr ashok vaid(world renowned oncologist And Dr tejinder kataria 9world Renowned breast cancer surgeon )........or visit medanta.org or call for assistance 09419191439",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the painful lump above my collar bone after a tdap?\n\nhello, I got a tdap 2 days ago and yesturday I woke up with a knot just above my collar bone, I am assuming it is a lumph node, of course my arm hurt really bad(still) and the knot is still there, doesn't seem as painful today, about the size of a quarter maybe.  is this a normal reaction?",
    "doctor_response": "HI,Welcome  to HCM.Based on the facts of your query,you  seems to suffer from-Reactive lymphadenitis above the collar bone after the tdap,as acellular Pertusis vaccine is known to cause lymphnode swellings after the shot.This is due to the immune reaction in the regional nodes or near by nodes in neck and axilla and is known to occur after tdap shots.Welcome for any further query in this regardWill appreciate writing your feedback review comments,to help the needy patients like you at HCM.Good Day!!Dr.Savaskar,Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent lower pelvic pain?\n\nI have had continuous pain for a month or so in my lower pelvic area. I had a femoral hernia 10 plus yrs ago. it feels sometimes like a burning there. sometimes both sides.. accompanied by right hip/back pain. especially while sitting or twisting to the left.",
    "doctor_response": "Hi, Consult an orthopedician and get evaluated. As of now, you can take analgesics like Aceclofenac or Tramadol for pain relief. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cold\n\nI had PRK surgery almost 5 weeks ago.  I got a bad cold 4 days after the surgery and I was taking Musinex DM and Coldeze.  I got over the cold about 10 days ago and now it seems to be coming back.  I'm back on the Musinex DM.  Is this hurting my healing process with the PRK surgery?",
    "doctor_response": "Thanks for posting your query to Health care magic .It could be of allergic in nature or due to viral infection  so you should avoid exposure to cold and dust . presently you can take Cetrizine10mg with Monteleucast5mg tablet once at night, and Paracetamol 750 mg( Adult dose)  to releive bodyache and fever . Steam inhalation 3 times a day . Mucinex DM is basically releive dry cough so if you are not having such complaint no need to take it .About disadvantage of medicine on PRK consult your ophthalmic surgeon .Hope I have answered your question. If you  would like some more information I will be happy to provide. You can also write a review for me. Wish you good health .Regards,Dr.Manish Purohit",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rapid heart rate, orthostatic hypertension, petachie spots, fatigue, mood swings\n\nI am 20 years old, and have Addison s Disease. Recently I have had rapid heart rate, orthostatic hypertension, petachie spots, fatigue, mood swings, pain in legs, head aches...etc What is most concerning is the high heart rate, it stays in the 80 s at the least at rest. And it is very difficult to get up after sitting, my heart starts racing and pumping harder. Here are some blood test results: at 12:27 PM WBC 4.0L RBC 4.92 Hemoglobin 16.4 Hematocrit 47.5 MCV 96.6 MCH 33.4 MCHC 34.6 RDW 12.1 Platelets 178 Neutrophuls 41.9 Lymphs 43.6 Monocytes 10.3 Eos 3.5 Basos 0.7 Neutrophils (Absolute) 1.70 Lymphs (Absolute) 1.7 Monocytes (absolute) 0.40 Eos (Absolute) 0.2 Baso (Absolute) 0.00 eGFR - unable to calculate due to inappropriate age/gender/creatinine value glucose 76 BUN 14 creatinine 0.9 sodium 138 potassiu, 4.5 chloride 102 carbon dioxide 28 calcium 9.7 protein 7.1 albumin 4.1 globulin 3.0 bilirubin 3.0 alkaline phosphatase 49 AST 13 vitamin b12 487 CT scan recently done with no tumor on adrenals, adrenals actually couldn t be seen due to my lack of fat they say. I take 0.1 fludrocortisone and 30mg hydrocortisone. Any advice would be greatly appreciated, thank you.",
    "doctor_response": "Hello, After going through your medical query I understand your concern and I would like to tell you that predominantly your symptoms are of anxiousness but still I would like to recommend you to get a Thyroid Profile done and consult a physician with reports. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have periods once in two months, runny blood. Trying to concieve. All tests normal. Suggestions?\n\nhi my name is Meagan my period cycle is not good if i miss one month i always get it the next month so im usually 2 months late at the most, sometimes when i do get it, it will last like 8 days and it s blood but its like water has been mixed in with it and its really runny, other times it will be really heavy, and sometimes not all the time i will have big clots of blood coming out of. Sometimes i will have the worse period pain ever esspecially in my lower back and it literally feels like im dying other times it will be fine. Me and my partner have been trying to have a baby for the past 2 years now but we still havnt been able to conceive.Went to the docters they havnt found anything wrong with me so im just looking for other answers you may have for me.",
    "doctor_response": "Hello thanks for your query. You are definitely suffering from irregular periods. That could be a problem in conception. Please let me know what tests and investigations have been done so far, so that I can guide you for further treatment. Common causes of irregular cycles are stress, anxiety, emotional upheaval, frequent travelling, rapid weight gain or loss. Thyroid disorder, adrenal disorder, high prolactin levels should be ruled out. Polycystic ovaries are a common condition which leads to irregular cycles and difficulty in conceiving. Your partners semen analysis should be done. Endometrial lesions should be ruled out. ovulation should be tested by a cycle or two of follicular monitoring. Fallopian tube patency should be assessed. Please consult an Infertility specialist at the earliest, and have a complete work up take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicine to treat eosinophilia permanently\n\nmy wife suffers from isnophilia since childhood and now its has became uncontrollable. She sneezes continuously at times in cold season and dust environment. Doctors say no medicine available to cure permenatly. Is there any solution to overcome this allergy.",
    "doctor_response": "Hello, Thnx to contact us. If I am your treating doctor I would like to advice you that medication only helps to cure your wife temporarily. Only way to get out from the allergy is to find out what is the allergen for your wife. To be away from such a allergen is the final cure for illness. If you have anything else to ask please contact me. Thanx. Dr. Arun Tank",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for anal fissure\n\nI have non-hodgkins lymphoma and was sent for a pet/ct scan to stage. Apart from what was know lymphoma in my face and neck, results came up with lite up in my rectum apparently not lymphoma related. For a few year now i have what i think is a anal fissure would that scat tissue lite up or do you think they are deffinatly thinking a new cancer. i have a referal to a colorectal doctor, the waiting is the hard part so worried I have so far had 1 course of R-CHOP chemo",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, if this is the anal fissure then it may not be due to Hodgkin's lymphoma such condition of anal fissure can be cured with anal dilatation and little surgical intervention, some time medical treatment can be tired, you can have word with surgeon regarding this,  hope this information helps, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painless dark black patch below tongue in children?\n\nMy 3-year old granddaughter saw a dentist yesterday - found a large dark/black spot on back of tongue - were concerned, made appointment for EENT -- mother is my adopted-from-India daughter. This has never been noticed before, no pain, no known injury We re really concerned - should we be??",
    "doctor_response": "Hello there,Thank you for posting your query with healthcare magic,I would like to inform you that unless the lesion(black spot) is increasing in size over years, it is not much of a concern.Also, these kinds of spots are sometimes hereditary and do not cause in problems in future.But only because it was noticed by your dentist and ethically it is advisable to get it checked by a specialist, therefore it is always best to be safe.Kindly see the specialist at your best time, and stay calm.i hope i was able to answer your query,if you have any further questions, kindly feel free to write back.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe shoulder pain\n\nI have pain from my shoulder to my elbow, also on the top of my hand. My shoulder feels like a pull or maybe a tendon. Does not hurt all the time, just when I move it wrong. The top of my hand almost feels like cramp, goes into my 2 fingers. This is all on my left side.",
    "doctor_response": "Hello, I have studied your case. Due to compression of  nerve root there can be pain in your shoulder to elbow.I will advise you to do MRI spineFor these symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.I will advise to check your vit B12 and vit D3 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infection post tragus piercing\n\nI have my tragus pierced and have had it since July. recently it has gotten infected and nothing is curing it. ever since it s gotten infected I ve been sick. running a fever, being super nauseous and my jaw has been sore. do these symptoms have anything to do with this? what are some things I can do to help this infection and these side effects?",
    "doctor_response": "Thanks for your question, I am Dr Asanghanwa. Reading your querry, I would say you have a systemic infection due to entry of germs from the infected tragus wound into your blood - a condition know as bacterial sepsis. I would advise you consult a physician so that blood samples and pus samples are collected and analysed so that appropriate antibiotics and medications are prescribed. Yes your symptoms have a lot to do with your infected wound. I advise that if you in the future do piercings, it should be by qualified and well trained staff who use properly sterilised equipment. Good Luck and get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and tightening of the roof of mouth?\n\nI have an ache and tightening in the roof of my mouth, and also in the center of my chest. aches like a sore throat but at the top of my mouth.  I have just been drinking a republic of tea ginger tea, which I've had before. Also have had a cold since 5/5.",
    "doctor_response": "Hi,Thanks for posting the query,    You might have cause a burn at the roof of the mouth, during sipping the tea or could also be an infection to confirm this you need to get a checkup done, at home take lukewarm saline and antiseptic mouthwash rinses, maintain a good oral hygiene, take multivitamin suplements and antioxidants.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the early signs and symptoms of pregnancy?\n\nCould I be Pregnant? period comes on every 30 days I m 15 years old My last period was april 7th,2010 I think I got pregnant on March 26th,2010 No intercourse around last period ~cramping ~bloating ~Backaches ~ feel movement in your lower abdomen ~Frequent headaches ~Fatigue ~nausea ~feeling moody",
    "doctor_response": "Hello dear,I understand your concern.In my opinion as you got the period on April 7th and later on no intercourse was done there is no chance of pregnancy.Once you get the period there is no scope for pregnancy unless intercourse is done after the period.So do not worry as there is no pregnancy.Even the stress regarding thought of pregnancy also makes one to experience the pregnancy symptoms like nausea,tender breasts ,increased urination etc.So the symptoms which you said might be due stress regarding the thought of pregnancy .Usually the fetal movements start around 5 months of pregnancy.And it is not an early sign.So avoid stress and relax.If you want to confirm you can go for serum BHCG test .But as per your information there is obsolutely no scope for pregnancy.Hope this helps.Best regards....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for an itchy rash near eye,lip and stomach\n\nI have a itchy rash that started with a small itchy spot on my face near my eye. I had some spots on my stomach, butt, and waist. They are not filled with fluid. I was treated with antiviral and steriod pills. The swelling and rash on my face went away, however, it returned a month later near my eye, lip, and stomach. I am once again on antiviral meds and predisone but I continue to scratch.",
    "doctor_response": "Hi Dear,Understanding your concern. As per your query you have symptoms of  itchy rash near eye,lip and stomach which seems to be due to angioedema and because of herpes simplex virus infection as it attacks once immunity of body is poor. Need not to worry. I would suggest you to visit dermatologist or oral physician once and get it examined properly. Go for skin allergy testing to find proper diagnosis. Start with antiviral and steroid eye drops combination is very effective for subsiding lesions. Take multivitamin tablet rich in vitamin B12. Apply lip balm to keep it moisturized always. Apply Zovirax ointment on these rashes and drink plenty of fluids. Ice pack will give immediate effectsHope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluttering feeling in chest and breathlessness?\n\nI have been having a fluttery feeling in my chest on and off today. I have not been weak, dizzy or faint. I have bot been running a fever or sweating. I have however had to stop to catch my breath a few times today after walking up stairs or reading out loud to my class. I have had a cough and cold for over a week now. What could it be?",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!Your symptoms could be related to a cardiac arrhythmia. But a lung infection can not be excluded either, considering the fact that you have been having fever. Coming to this point, I would recommend consulting with your attending physician for a careful physical exam and some tests: -a resting ECG- a chest X ray study and pulmonary function tests- a cardiac ultrasound- complete blood count, PCR, ESR for infection- thyroid hormone levels - blood electrolytes. An ambulatory 24-48 hours ECG monitoring would help investigate for possible cardiac arrhythmia if suspicions are raised by the above mentioned tests. Hope you will find this answer helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is coming back of rash after stopping prednisone normal?\n\nthanks, my doctor put me on a five day course of prednisone for hives that were itching. i did a great job of stopping the itching, but now four days after stopping prednisone, the rash is back and so is the itching though not as bad. is this normal? it was for 40 mg of prednisone for five days.",
    "doctor_response": "Hello, Abrupt stopping of steroids can cause recurrence of the rash. You have to taper the steroid gradually. Consult a dermatologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Ovol be given along with Amoxicillin and Ascoril?\n\nMy 5wks old baby who weighed 8lbs when he was born...keep bringing up his milk and there was sumn like slime or cold came up off his chest with something brown in it.he sounds like they is a cold on his chest ...I was given Amoxicillin and ascoril.. .. while hes taking these can I give him ovol? And is these medications ok",
    "doctor_response": "Hi..you can give Ovol when using Amoxicillin and Ascoril. But 95% of kids illnesses are viral and do not require antibiotics like Amox.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is Sinarest AF and TAXIM-O(Cefixime) unable to treat phlegm?\n\nMy daughter is completing 5 months. She s about 5.8kgs. Recently, she s picked up a cough. She has phelgm-y coughs and the congestion when she breathes is audible. I went to a Ped. and she s prescribed Sinarest AF and TAXIM-O(Cefixime) for a 6 day course. It s been 2 days and the cough/phegm does not seem to let up. Is there anything",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Greetings from Chennai.By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze. I have a few questions for you -Questions:1. How many days per month does she cough or feel breathless?2. How many nights per month does her sleep get disturbed due to above symptoms?3. Does she feel breathless when she runs around or plays with other kids?4. Are the symptoms when there are seasonal changes?5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?6. Is the cough always associated with fever?If your answer is yes for any of the above questions, your kid might be having viral associated wheezing or multi triggered wheezing and I suggest you meet a paediatric pulmonologist who is near your place. No point in using antibiotics every time. It will do more harm than good by increasing bacterial resistance.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure the dry dandruff scalp ?\n\nHello doctor , Am 30 years old woman, and i suffer from dry dandruff scalp. please advice how to get rid of it?",
    "doctor_response": "hi Rajalakshmi, dandruff is very common problem. Apply sebowash shampoo alt day,Use rovate lotion in night time. better visit dermatologist for ruling out other causes of dry itchy scalp like seb ds,psoriasis scalp. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes problem in breathing?\n\nSo yesterday I was babysitting a 3yr old and when I got home I noticed that it hurt to breathe on my right side and that it also hurts to stretch a curtain way....what does this mean? And I can t go the the doctor cause I don t have health insurance or money to pay to go to one either",
    "doctor_response": "Take a muscle relaxant along with diclofenac . This is a muscle sprain which will resolve in a couple of days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe backache be treated?\n\nI am having serious trouble sleeping and back and new pain. I have been seeing a chiropractor and am seeing positive results. In a recent conversation, after discussing my issues, the chiropractor suggesting taking Magnesium Thiconate and provided me with some samples. I am not having side effects and want to order a supply to take regularly. What do you recommend?",
    "doctor_response": "Magnesium L-Threonate is a relatively newer form of magnesium, and apart from helping one with sleep issues, it helps boost cognition and relieve anxiety.It is a safe medication but due to its higher absorptive rate, it is preferable to limit dosage to 300mg/day. As it is providing you with the desired effect and having no side effects presently, you can continue the same.Please note however that if you have a history of cardiac or kidney related problems, this line of medication should be stopped.Also, on account of its adverse effects, if you have any symptoms such as weakness, shortness of breath, or confusion, then stop the supplementation and visit the nearest ER for checking your Magnesium levels and requiring immediate treatment for the same.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is abdominal pain a symptom of hernia?\n\nI am person who has undergone hernia repair (left side inguinal hernia) in the year 2006. That time I could feel and see the bulge when I cough or sneeze. After the surgery it became allright. before surgery I asked doctor to put the mesh on both sides since my abdominal muscles may be weak. Doctor replied that it is against ethics to put a mesh on the side where there is no sign of hernia. when it come that time we can repair. Now for last six months i am feeling a a pain on my right side of the lower abdomen just above penis. I cannot see any bulges on the skin but i can feel something is moving inside when I turn sometimes on bed. So please advise is this is a symptom of hernia.",
    "doctor_response": "Hello! Welcome to HCM.Yes, your concern is very true.Yes, this can be the start of hernia.Initially, there is dragging sensation & sometimes pain.If you have chronic cough or constipation or straining at urination, heavy weight lifting,  again it is more likely that its start of hernia.You havent mentioned your age & weight, as old age & fatty built favour hernia formation.Consult your doctor, once there is obvious bulge/swelling or excessive pain.Hope this information is useful for you.Wish you healthy life.Thanks. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for testicle pain and jelly like semen\n\nhello dr , i got my semen analysis report today..can you please check and let me know if there are any infertility issues with that report?. I have undergone bilateral varicocele surgery 4 years before. I am facing some pain in and around testis and also in the joint connecting abdomen and legs and i am facing this pain especially after every ejaculation.. also my semen is becoming into more jelly one containing more liquid than usual. so i did semen analysis today and got my report as in in attachment. please let me know",
    "doctor_response": "Thanks for asking in healthcaremagic forum   I do understand your concern, but I cannot access your report with your question here.  Varicocele can cause dragging pain in the testicles and varicocele is know to have recurrence. Regarding your semen, the consistency and colour may vary with infection. So, please send your detailed report of semen analysis for further suggestions.  All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stage four gall bladder cancer, large stones in gallbladder duct. Treatment options?\n\nHello Doctor........My mother is 72 years old and she is suffering with Stage 4 of gallbladder cancer , we moved her to  for the treatment but the doctors of the XXXX OF GASTROENTEROLOGY were XXXX. She is also having Gallbladder stone of 26mm located in her duct. Please suggest what to do now as she doesn t have enough strength to go for some chemo therapy.....",
    "doctor_response": "I am very sorry to hear about your mothers condition. Management of stage 4 gall bladder cancer is mainly palliative. If she does not have the strength to undergo chemotherapy, then the main focus of treatment should be pain relief. If the stone is present in the cystic duct (gall bladder duct), then nothing can be done about it but if it is in the common bile duct, then it can be removed by endoscopy (ERCP). Does your mother have jaundice as well? It would be advisable that you meet an oncologist and a palliative care specialist for further treatment. tc",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring staph infections?\n\nHi there,I get staph infections on a fairly regular basis, and it is becoming a big problem for me. I've seen a couple of doctors about it, but they just keep giving me antibiotics. I'm wondering if the fact that I work at a tattoo/piercing shop (so am always around broken skin) is contributing to this, and if I should see a dermatologist.(My info: female, 30, 5'2, 120Lbs, history of skin problems)",
    "doctor_response": "helloyes. being a tattoo artist does expose you to the skin infections like staph and strep. you are therefore advised to take precautions and in case the recurrence in more than twice in a month, then you should consult a dermatologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Has hallucinations. Suffering from paranoia. On zolpidem tartrate. Suggest?\n\nmy mother is suffering from paranoia . she feeling like someone harassing her with sounds and voices. she believing that someone listening her voice and repeating it. if she found any unknown sound around her, she was saying someone doing that sounds to harassing her mentally. we consulted doctor 15 days before , doctor has given 1.prothiaden 75 daily 2 tablets 2.one sleeping tablet( zolpidem tartrate) at night 3. ramipril tablet due to zolpidem tartrate tablet night she is ok. sleeping well. but at morning again she is afraid of unknown sounds and voices. please suggest what i have to do?",
    "doctor_response": "Hi welcome to health care magic forum. As it is a recently diagnised problem it needs some time to get accomedated to these drugs, it is a continuous process of treatment, and she should continue to use the drugs, for life prbably. Dont worry if the drugs are ineffective, she will be cured, by electric shock specially ment for these cases. It is not a shock of electricity but is a medical term. It happens due to auditory hallusination, due to some changes in the brain. I advise you to follow some nonmedical advises to be helpful to her to recover. They are yoga, meditation, reading books, hearing songs and if interested gardening. If not garden pot plants in side the house. she is encouraged to do the work which she can do, like teaching the kids. Wishing for a quick recovery and thanks for calling.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Am I having side effects of Glaucoma drops?\n\nHello, I am using glaucoma drops as a secondary pressure increase following a steroid injection for iritis/uveitis. I m having head rush symptoms when I go from laying flat to standing and sometimes sitting to standing. Is this a side effect of the drops?",
    "doctor_response": "HiMany drug groups are used in glaucoma.Drugs like beta blockers may reduce heart rate and blood pressure causing hypotensive symptoms. Dizziness,fatigue can also occur.Hope I have answered your query. Let me know if I can assist you further. RegardsDr.Saranya Ramadoss, General and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes loss of appetite and back pain along with muscle pain?\n\nI have a loss of appetite,when I do eat it is extremely small portions, lack of good sleep due to my husband snoring, some muscle pain (without any strenuous activity) constant back pain (usually I blame arthritis) I can t wear any clothes tight at the waist without back pain,",
    "doctor_response": "Hi. It's quite possibly due to arthritis plus the fact that u don't sleep well may make u tired in the morning,irritable and cause loss of appetiteI suggest 1 tablet of Muscle relaxant e.g Flexon every day at night just before bed. Start off with 500mg 3-4 times a day and then taper to 250 mg after 2 weeks.Max dosage allowed is 750 mg 3-4 times a dayPlease make sure u don't have liver disease or porphyria before taking the medication",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which medication to be taken for terrible tooth ache?\n\ni have terrible tooth ache and the end of a virus which is now attacking my sinuses. I was taking mucolit (finished last dose this morning.) I have taken ibuprofen but it had no effect on the tooth ache. can i take paracetamol with codeine (combined)?",
    "doctor_response": "HelloWelcome to HCMFirst of all you should know the reason of tooth ache so get your tooth x ray done. IOPA or OPG xray done which will reveal the extent of  infection in tooth or surrounding structures. Meanwhile you can taken flexon A for your pain.Visit your dentist and according to xray report, treatment will be decided. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be done about spasms that occur after back surgery?\n\nI have had 2 back surgeries  and I'm still  having problems  with spasms and and I  can't  stand  for 10 minutes  and I  can't  sit on a couch or my bed and when I  get up it feels  like  my back still in the chair or bed I have gotten  several  injections  and they don't  last. Recently  I went to get a second  opinion  and he said  everything  look good  but I  feel like  I  shouldn't  have  to  live like this, what can you suggest? Please  call me at 919-333-4595,  I  don't  have  a  email",
    "doctor_response": "hifrom your detailed description,my advice would be do back strengthening excercises like suryanamaskar under guidance.Take diet rich in calcium and vitamin D, above all if the doctor says everything look good have faith in his words and leave the bed and start a new life.take care and god bless you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on bruised knee after injury?\n\nI fell onto a tiled floor a week ago today, my right knee is cut and bruised but a lump came up almost immediately. it is still there now at the top of my kneecap, my knee is sore and warm to the touch but I can walk without problem. Just feels stiff but I thought it was because of the grazes I sustained to it. Any ideas?",
    "doctor_response": "Hi ! Good evening. I am Dr Shareef answering your query. You might have got a hematoma of the knee (blood collection) due to the trauma. Walking without problem signifies that the joint ligaments and cartilages are possibly not injured. If there is no fresh ooze, the hematoma may gradually subside with absorption, but it would need proper rest and splintage of the joint. In case the problem increases which interferes with your walk, then you might have to see an orthopedic surgeon in your area, who might advise you for an x-ray/MRI of the injured knee joint. Till that you could start taking an anti inflammatory drug. Further management in that case would depend on the MRI report.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed puss formation inside the big toe nail after its retrieval\n\ni had my big right toe nail removed 4 moths ago due to it being ingrown and infected and everything was fine upto a day ago when i noticed puss stain on my sock, so i looked and it was pussing a little bit, what is happening, do i need to see a doctor?",
    "doctor_response": "Hi, happy to help you on your health concern  on part of HCM!In the present case of wound infection, if I were your consulting physician, I would just advise you to consult your surgeon once more for a physical examination and necessary microbiological culture sensitivity tests for adequate control of infection.Also, it is necessary to find out the cause behind it. For the time being you have to clean the area with antiseptic solutions and keep the area dry. Get a blood sugar test also! ..Hope you got your answer. Please feel free to write to us if any more queries.Wishing you the best health!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does hepatitis C get contracted through kissing? Do I have to get tested for HCV?\n\nme and my freind had vaginal intercourse with a same prostitute using condoms . i had open mouth kissing for just few seconds with her after my friend kissed her. my query is can i contract hepatitis c if my freind or she has hep C in this way. i dont know their HCV status. do i need to test for HCV? i had no oral sore and gum bleeding",
    "doctor_response": "Hello, Hepatitis C is usually spread when blood from a person infected with the Hepatitis C virus enters the body of someone who is not infected. Today, most people become infected with the Hepatitis C virus by sharing needles or other equipment to inject drugs. Hepatitis C virus is not spread by sharing eating utensils, breastfeeding, hugging, kissing, holding hands, coughing, or sneezing. It is also not spread through food or water. So just relax and don't worry. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is vaccinations in a baby safe while having G6PD?\n\nMy 8 week old son has G6PD, I was wondering if it is ok to give vaccinations or if there are any that should be avoided. I ve read something about the link with G6PD and possible Autism due to vaccinations. Also, is there are secondary test that can be done to find out the severity of the deficiency?",
    "doctor_response": "Hi...you can go ahead with all the vaccinations. NO relation of G6PD deficiency and vaccinations or even to autism. Please go ahead with vaccinations and protect your kid.I suggest that you have list of all the drugs which should not be used in G6PD deficiency patients and also mention to the same to which ever doctor you visit to.Regards  - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for cough in children\n\nHai sir Good afternoon. My son has now 10 years old now he is suffering from cough.when I went to the doctor he gave medicine.now he got small recovery but sound is coming when he is breathing sometimes.so what we have to do? Please give me the answer. Thank u sir",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Greetings from Chennai.By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze.THE NOISY BREATHING YOU ARE HEARING COULD BE WHEEZINGI have a few questions for you -Questions:1. How many days per month does she cough or feel breathless?2. How many nights per month does her sleep get disturbed due to above symptoms?3. Does she feel breathless when she runs around or plays with other kids?4. Are the symptoms when there are seasonal changes?5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?6. Is the cough always associated with fever?If your answer is yes for any of the above questions, your kid might be having viral associated wheezing or multi triggered wheezing and I suggest you meet a paediatric pulmonologist who is near your place. Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should the medication be for herniated disc and tear in spinal cord?\n\nMy father aged 70 had a lacunar infaraction an year ago.After consulting a neurologist and taking few pills  he recovered 90 percent.But, he also developed server pain in the lower back and in the legs region, which is  causing extreme difficulty while walking.He however manages to walk a mile per day slowly.After consulting an orthopedican and getting an MRI done, he discovered that there is a disc bulge l4 l5  and thats causing the problem and suggested phisio-therpay as a solution. But phisiotherapy didnot work and he is still facing the same problem.When consulted with other doctors, they are of the opinion that it may be related to the brain or due to lacunar infaraction and not really anything to do with disc bulge l4 l5 ( herniated disc), or wear and tear in the spinal cord which is generally associated with this age. We are a kind of unsure as to whom to contact and how to proceed with medication. Please help as what can we do from here",
    "doctor_response": "I would say that the pain is very unlikely to be related to the lacunar infarct. It is more likely due to degeneration of the spine, which is indeed age related. I would consider surgery an extreme last resort. But if physical therapy didn't work, then medications (like easy-to-tolerate pain killers like Tramadol or Nucynta) would help, as well as likely lumbar epidural steroid injections.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excessive thirst and marks on the legs of a child?\n\nMy son just turned 2yr of age and he excessively drinks at night and urinates at night to the point of constantly soaking his pants and the bed at least 3x a night. There is no HX of Diabetes in the family and he only does this at night time. He also sweats really bad and I keep it pretty cold in the house. He recently started getting marks that look like big circles all up and down his legs but he doesn't itch them and they go away but come back. Can you please ease my mind a little. I am a nurse and have seen a lot so I am very nervous and worried.",
    "doctor_response": "Compulsive polydipsia comes to mind. There is no diabetes or kidney problem in this condition, and the child just seems to WANT to drink more fluids. The other problems that you have mentioned seem to be unrelated to this drinking and urinating problem. Excessive sweating can be a sign of vitamin D deficiency, but can also occur with significant heart conditions. The marks that he is getting on the legs - are they painful? It would be a good idea to send the photos of these marks to someone here through a paid query, so that diagnosis is easier.I am afraid that is the best I can do with this question. Do take him to a pediatrician for a complete evaluation. He is too young to go for counselling, but you can begin to gradually restrict his fluid intake after sundown. Also, wake him up after 1 1/2 to 2 hours after he goes to bed and make him go to the loo. This will reduce the problem of bed-wetting over time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Heart palpitations, running fever, hurts to walk. Had hypokalemia in pregnancy. What is the chance of reoccurring?\n\nmmy 2 yr old has flu type a. The last 2 weeks i have had several heart palpatations. All day today i felt achy and wierd. This evening i am running 102 fever, hurts to walk. I had hypokalemia while i was pregnant with my 2 yr old and was hospitalized for 10 days with it. Oms today fee Never did find out why my kidneys were dumping potassium . Tthese symptoms today feel like hypokalemia. Real weak, hurts to walk....all except the fever. Wwhat is it?",
    "doctor_response": "Dear madamI advice you to review serum creatinine once. Secondly low potassium levels can cause muscle weakness. If you are taking any tablets such as loop diuretics or some drufs which lower potassium can cause the low potassium levels",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rashes near the colostomy site\n\nMy aunt has undergone a colostomy operations 7 years ago. In the beginning everything was fine but for the past 2-3 years she is experiencing severe burning near that area. Red rashes have developed all over her stomach mostly near the operated area which is causing excessive burning. These rashes are like when anyone gets bruised and the top skin peels off leaving the inner red layer exposed. Not only that the whole skin around her stomach has become extremely sensitive. Could you pls suggest a way to get rid of these rashes ????? Pls reply urgently.",
    "doctor_response": "Hello. Thank you for writing to usI suggest a possibility of irritant dermatitis due to digestive juices that coe into contact with skin.Specifically for the rashes I suggest you to use a topical moderately potent steroid e.g mometasone furoate or fluticasone propionate, twice daily for a few days.Topical steroids are anti-inflammatory and would help resolve the rashes. These are prescription products, therefore, I suggest that you talk to your doctor for the needful.Once these rashes resolve, I suggest you to use a barrier cream, containing zinc oxide, dimethicone etc and smear it on skin surrounding stoma so to create a protective layer. That would prevent digestive juices from coming in direct contact with skin.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dull headache and tightness in the chest?\n\nI am a 36 yr old female. I exercise regularly and take 25mg of Atenolol daily for high blood pressure. I am feeling very tired, have a dull headache an there is tightness in my upper chest when I inhale deeply. I took my BP and it reads 107/62 on my home monitor.",
    "doctor_response": "Hi,If you feel the pain during the respiration, then it is a neuromuscular pain. Don't worry, it is not dangerous, it happens quite frequently in young people. Just take Ibuprofen 400 mg. If pain continues, then take Ibuprofen three times a day, for 3-5 days after the meal. Usually a tablet is enough, but sometimes there is a need for taking it for some days.Take careCome back if you have any further questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could pain in gums with bleeding while brushing be due to hit on mouth causing oral piercing touching gums?\n\nMy gums are hurting a little bit. It never happened before. When I brush I bleed from 3 different spots on my gums. It hurts to eat soft foods. I was playing with a dog and he jumped at me and hit my mouth and my oral piercing hit my gums. Did that cause the problem and whats really wrong?",
    "doctor_response": "Hi,Thanks for posting the query,    Yes this could be,  dont worry apply Dologel oral ointment topically over the affected area thrice.At home take lukewarm saline and antiseptic mouthwash rinses.If the symptoms persists or worsen get a checkup done by the Dentist.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Asthmatic, ordered symbicort, feel uneasiness on its intake. Reason?\n\nI am an asthma patient and have recently ordered symbicort from a mail order pharmacy. I received three canisters. After about a week with the first canister I was feeling very short of breath, tired and clammy, and had difficulty preforming my normal exercise...just as I did before being diagnosed with asthma about 6 years ago. I thought maybe there was a problem with the canister I was using, since it felt as though I was completely unmedicated, so I opened another. Within a day or so I began to feel much better and was able to go about my regular exercise without difficulty. That lasted about a week and I am once again beginning to have difficulty. My question is whether it is possible that I have received defective canisters, or are they manufactured in a way that would make that virtually impossible?",
    "doctor_response": "thIS is no defect in can but the inhalers sometime donot suit you have to drink lot of water these can cause acid reflux which causes problems written by you you canchange salts after consultation",
    "dialogue_context": ""
  },
  {
    "patient_message": "My father has B cell lymphoma. What I can do to make him more comfortable?\n\nMy father has B cell lymphoma his white blood count is 67,000 red blood 4.02 and his potassium level is 2 he is taking IVIG treatments his Dr is very good. But I 'm am always with him and can't ask him what to expect and what I can do to make him more comfortable. I am his caregiver and I also a profession caregiver to other pts. Thank you.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Your father's potassium level is very low.  Life threatening arrhythmia can occur with this level.  He should be given potassium supplements for that.  For b cell lymphoma chemotherapy should be given according to stage and spread. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Excessively emotional. Weaned off cymbalta. On prozac. Side effect?\n\nI have come off Cymbalta, because of cost..i was weaned off from cymb 60mg to 30mg 1 a day for 1 wk then, 20 mg of Prozac every other day for 3 days then 1 everyday in am..started crying all the time, very sensitive, that all started july 31 and hv 6 capsuls left as of today,, I am a weepy blatty crying mess..hv called pharmacy, dr who presc. also spoke with family care dr.all advised it takes 4 to 6 wks to kick in..what am I supposed to feel like?  Waiting for Utopia!! YYYY@YYYY",
    "doctor_response": "Hello,welcome to Healthcare Magic.It appear that you have several symptoms of depression. Prozac contain Fluoxetine. It is a SSRIs group of medicine which is used for depression. It usually take 3 to 6 week for medicine to show its effect. So, do not worry and wait for improvement.For long term control of mild to moderate depression following measures are also helpful: relaxation exercise and non drug treatment like CBT (form of psychotherapy).Wish you good health and all the best.Regards,Dr Ashish Kumar Mittalwww.99doctor.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I use Evion 400 for dry skin and hair?\n\nHello doctor, My skin and hair have become very dry. Someone suggested taking Evion 400 capsules orally daily. Can you please suggest if I can take these capsules? Will they help in getting rid of dryness? Are there any side effects?",
    "doctor_response": "Hi. Evion capsules will not help much with the dryness. For the skin, I suggest the following: For the hair, I suggest you try doing the following: Hope all this helps. Do get your TSH (thyroid-stimulating hormone) and fasting sugar levels done. As diabetes and thyroid dysfunction can be a cause for dryness. Take care. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does swollen lymph nodes in the groin with elevated bilrubin indicate ?\n\nhi im male 22 very fit person I have swollen lymph nodes in my groin area ive had blood work done and the only thing that come up was high bilirubin level 49 the number.ive had an ultrasound on stomach and xray of chest all fine.in my bloods they did pick up a virus in the past.should i be worried i think i have some cancer of the lymphs would this have showed up on blood work? I always fell ill my body dosent feel right and sometimes have yellowing of eyes Thanks Yes blood work was 49 normal range was between 1-19 didnt tell me what viruss ive been called in for a second xray now should i be worried?",
    "doctor_response": "Hello There is no relation of groin lymph nodes with high bilirubin levels. The levels of bilirubin you mentioned seems unbelievable in the present context of your symptoms. Kindly verify the levels of bilirubn. You have not mentioned the the virus which was detected in past. The causes of swelling of lymph nodes in groin area are generally because of Infection in feet,legs,pelvic area Hernia Sexually transmitted diseases Lipomas Cancer Normally these swollen lymph nodes disappear in two weeks time however ,if they persist or increase in size or get accompanied by night sweats,fever,weight loss then you should consult your doctor for the investigations. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be concerned with flutter after Catheter Ablation?\n\nI weigh 273 lbs.Iam 5 4 .I just had a Catheter Ablation 6 weeks ago.My EKG this week showed I had a flutter but not Afib.I know it takes about 3 months for scar tissue to form.I am going to have a gastric by-pass as soon as cardiologist gives OK.Should I be concerned",
    "doctor_response": "HiStress echo test should be done prior to your operation, if stress echo is normal ,and no arrythmia is precipitated during the test  then you can go for the operation, in case arrhythmia precipitates then  you have to wait for the  tissue to scar  completely .Stress echo will decide whether you can go for surgery  or not!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes gall stones , vomiting and back pain?\n\nHi I have gall stones and the other day (4days ago) I had extreme pain so I took some panedine forte for the pain and 2 panedine extra since then and I don t know if these are related I have been vomiting I have no desire for food (unusual) I am having difficulty breathing I feel clogged up yet the mucus is clear occasionally there is a hard bright green chunk in it I continuously have coughing fits and am panting after doing the smallest thing I have incredible back pain and I swap from being cold to hot and feel incredibly weak I also have headaches and pain in the back of my eyes when looking any direction but straight Just in case it s relevent I was assaulted a few weeks ago with a cricket bat I was hit in the head 3 times and had a 6cm gash stiched but that has now healed but the headaches started then however the other symptoms only occurred after the gall stone pain which went away within a few hrs then the onset of the other symptoms occurred",
    "doctor_response": "hi.noted history of gallstones and frequent occurrence of symptoms. an acute vs chronic attack of cholecystitis (inflammation of the gallbladder) secondary to cholelithiasis (gallstones) must be considered. it is best if you consult with a doctor, preferably a general surgeon, for physical examination and clinical evaluation. diagnostics (such as ultrasound, liver function tests, alkaline phosphatase, complete blood count, etc.) and management (medical and/or surgical if indications are found) will be directed accordingly. definitive treatment is cholecystectomy or surgical removal of the gallbladder. it could be done laparoscopically (goldstandard) or thru open technique. also, an elective (scheduled) surgery (vs emergent surgery) has better outcomes and less risks of developing post-operative complications. anti-spasmodics may temporarily alleviate the pain. low fat diet is also recommended.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i use derma dew aloe cream for getting glowing skin?\n\nHi Doc, Am kruthi. I work as software professional. mine is a oily n comibination skin..prone to acne and pimples. I wanna day cream which keeps my skin glow during day time. can i use Derma dew aloe cream.or which one you suggest??please help me with this Thanks,",
    "doctor_response": "Hi kruthi,as you have oily n combination and prone to acne and pimples on skin you cant use dermadew aloe cream as it is a moisturising cream. It may aggravate your pimples. If you are going out",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful bowel movements in a child\n\nHi, my baby (now 9 weeks old) has been suffering from painful wind and bowel movements.  I have to sit with her massaging her tummy on the left side which sometimes help.  She has intermittent but frequent pain.  It's exhausting for her and me.  I combine feed her but sure she had it when I exclusively BF her.  She has soft but bitty yellow poo which has been smelling vile sometimes.  Doctor has prescribed calpol and lactulose but this doesn't seem to be helping.  She can scream whether very watery of soft. Some weeks ago I noticed white mucus coming out a couple of times and think that was when she seemed she had diarrhoea.  Please help",
    "doctor_response": "Hello,This is called evening colic and is quite common in this age group. This happens when the baby sucks at the breast very fast and in eagerness to drink milk will gulp in air too.Unless the air comes out like burping or flatus this discomfort will be there and next time check if the baby is sucking too fast and gulping in air too. You will be more convinced. Usually I don't advice any medicines for this as they give only temporary relief.The two best ways to relieve this distress is:1. Do not put the baby in lying position after feeding till the baby burps out the swallowed air.2. If still crying, put the baby in prone position and keep patting the back gently so that the baby passes off the flatus and gets relieved.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sumanth Amperayani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a bump in the gum?\n\nI have an infection in the top of my gum in the inside behind the tooth. I can move the ball which i think is a ball of puss. Ive been taking pennicillin 500 mg for 4 days without any results. Im in terrible pain. I tried sticking a needle to relieve the puss and pain but nothing comes out. No blood or puss! I need help! Im about to grab a pluer and yank my tooth out. My tooth dont hurt but the gum behind my tooth where the ball is hurts. I tried peroxide, salt water, tea bags and nothing works! Please someone help!!!",
    "doctor_response": "Hi,Thanks for posting the query,        This is due to infection in the associated tooth that had spread to the surrounding gums.I would suggest you to get an x-ray done an root canal treatment is required, bump will be reduced after drainage of pus.Continue with the course of antibiotics and analgesics.At home take lukewarm saline nad antiseptic mouthwash gargles.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "How concavity happens on skull?\n\nHi, I am a 55-year-old woman, 158 cm, and 53 kilos. About 2 weeks ago, as i was scratching my head, i noticed that there was a concavity in central part of my skull about the size of a cola cap. The next day, I went for a check-up. After seeing my scan result, my doctor said it was nothing to be worried about. The point is that, unfortunately, he didn t know what could the reason be, and why it happened. I would really appreciate it if you could give me some information about such phenomenon. how it happens? why it happens? is it something to be worried about? and is there any treatment?",
    "doctor_response": "Hi, Concavity can be a normal phenomena. It is related to bone growth. A picture of your skull and reports of CT scan of head will help diagnose it. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sudhir Kumar, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in right upper quadrant?\n\nI have had an ultrasound, cat scan, and hida scan all normal I m still having pain in my right upper quadrant what could it be and also I had my hida scan done this morning but they only did one injection of the radioactive tracer and then made me drink ensure was it done right?? They never did a cck injection is that accurate??",
    "doctor_response": "This is accuratly done of scan. Swallowing of of radioactive fluid which absorbed by veins to be showen in hida scan after certain time of swallowing.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to deal with pain and face dullness associated with Eagle syndrome?\n\nHello doctor, I am a 27 year old female. I have been diagnosed with Eagle syndrome last year. I do not know which type it is, whether it is affecting nerves or arteries but I can feel the pain which is so tough to bear and my face is getting dull day by day. Please reply soon.",
    "doctor_response": "Hello. Eagle syndrome is common in females. There are some medications that can help decrease the dullness sensation such as Neuroton ampoule (nerve multivitamins). I suggest taking just one injection every three days. Anti-inflammatory medicine such as Brufen tablets can be taken twice daily. The second option is nonsteroidal anti-inflammatory injection around the stylohyoid ligament. The third choice is a surgical shortening of the elongated styloid process. For more information consult an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be the number of pus cells in urine ?\n\nwhat is the normal NO OF pus cells in the urine?",
    "doctor_response": "Hello kannappan; welcome to HealthcareMagic The normal number of pus cells in urine can be between 4-6/hpf.Anything more than that with symptoms like increased frequency;fever;burning is considered as infection. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is there bleeding in my gums ?\n\nHello sir/madam I am sharad I have a problem that my gums is bleeding and gums curve not around teeth when I smile it looks very bad so what should I do please help me.",
    "doctor_response": "Hell, Thanks for posting your query. From the details produced,your gums are heavily infected and swollen. Get thorough scaling done. If required,shaping of gums can be done. Rinse your mouth after every meals to prevent plaque accumulation. Brush your teeth twice daily. Use chlorhexidine mouthrinse to gargle. Use soft bristled toothbrush and clean your teeth in back-forth,up-down motion. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could bleeding fresh, bright blood after periods with history of being diagnosed with RA be symptom of lupus?\n\nive been diagnosed with ra few years ago but never treated..recently had a bad flareup.will be seeing specialist next month..ive been researching my symptoms and i noticed the similarities with lupus..tried to donate plasma but my gammas?are too high.few days ago i started bleeding.its fresh blood.bright red.jus had period less than two weeks ago.so am i bleeding from my vaginal walls?is that a lupus symptom?",
    "doctor_response": "Hi and thanks for the query.I am Dr. Alok and very pleased to be assisting you with your health questions today.your high gamma globulins may be due to flare of RA or may be any other immune diseases. Regarding bleeding - this is not a feature of lupus (but decrease platelets (feature of lupus) may leads to bleeding).But  few patients do have overlap of lupus and RA. Your doctor can advice you better after clinical examHope this helps and provides answers to your question.I wish you good health.Dr. Alok",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can bilateral tubular blockage that leads to infertility be removed without using surgery?\n\nDear Sir,I am suffering from bilateral tubular blockage leads to infertility.I want to know whether same can be removed without surgery if so how long it will take to cure .pls reply soon.It is been 3 years after my marraige.I have a keen desire to get prgnant.Please help me...",
    "doctor_response": "hai,the cause and site of tubal block is the deciding thing.surgery is the final option to clear the tubal block.if  it is not cleared with surgery go for IVF.CONSULT AN INFERTILITY specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain and toe nail infection\n\nmy both toe nails were infected.  I got severe pain.  presently i am applying \"SCOLLS NAIL SOFTNER DROPS\".  my toe nails are very thick and hard.  one of my toe nail (left side) got bend but now no pain.  My right side toe nail got severe paid.  what is the treatment.  please help me doctors in chennai, south India",
    "doctor_response": "Hi, A picture of your infected toe nails is needed to give a more precise answer. The very first thing is to determine the type of infection as medications prescribed depend on the type of infection. For this, it is important to know: - if the bed of toe nails are red, swollen and with pus coming out, then, you might need to apply antibiotic cream at the nail bed- if the bed is not affected, but only the toe nail, then, I advise to:wash with warm water and saltapply gentian violet solution on the nail and on the surrounding soft tissue apply anti fungal cream locally. All the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for weakness and body pain\n\nHi my niece is 14 she is overweight a little but she is always feeling weak and has constant body aches she drinks a lot of water and is not a big junk food eater she is pale and she had her iron and theroid checked before and was told ok what could be wrong for such a young person to feel so bad please have u s some help thanks",
    "doctor_response": "HelloWelcome to Healthcare magic.She may have iron deficiency or any hidden infection.Please re confirm with your doctor.May be due to overweight and not eating well due to that reason.Take care...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for brain granuloma symptoms\n\nI am suffering for granuloma in brain 2 years ago ,I am taken treatment by doctor and I am feeling well but last 4 days I am again suffering from same symptoms ,loss eye vision clearly and feeling headache what can I do now plz sir tell me something and say medicine name for cure",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Brain granuloma can be due to many causes but neurocysticercosis and tuberculoma are common. The symptoms are lesion location and size related. You should visit to your treating doctor for re- evaluation and change in medications as required. Details of medications and investigations required to advice treatment. Regards, Dr N Kumar Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rectal bleeding with mucus and blood clots. What is that suppose to mean? Why is there abdominal pain?\n\nFor the past 2 months I have been having rectal bleeding with mucous and blood clots. I have the urgency to have BM s continously thru the day but upon applying pressure its just blood. I am 54 yo female student and have no insurance at this time. I have been taking Miralax daily as well as the probiotics for colon health. I have been experiencing abdominal pain primarily right side radiating to my back along with peridioc colickly abd.pain. Its very bad today should I go to ER.",
    "doctor_response": "Hello! Your symptoms are very serious and a colonoscopy should be done as soon as possible. This might be signs of colorectal cancer and should not be ignored. Abdomen ultrasound or CT should be performed and blood tests as well. Hope this will help Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will the position of testes affect fertility?\n\nsir my right testicle is slightly bigger than the left one, while the skin becomes loose my right testicle is hangging below the left one . i can produse sprem . no pain some times it pains slightly is it normal will it affect my fertility? pl help me out?",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have observed that your Rt Testicle is at slightly lower level than left one and have a doubt that it may affect your fertility.Please note that fertility does not depend upon the level of testicle and both the testicles are never at the same levels in every person ,one is always slightly lower than the other one.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can the lump on penis be?\n\nHi doctor, I have a small lump on my penis. I have not had any unprotected sex and also have a steady partner. I have this for about a month. Please help.",
    "doctor_response": "Hello. It is very difficult to diagnose it without seeing it through photos. Here I mentioned the possibilities, which could be the lump. These are the two main differential diagnoses. Since how long it is on the penis? Is it painful or itchy? Please explain the lesion, duration, symptoms and how it looks. Revert back with the detailed answer to a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for white spots on the scrotum\n\nThis 4th of July weekend, my friends and I did a Slip and Slide, a man made one. Next day I notice that my scrotum looks like a deflated balloon. I observed some whiteness on my scrotum like it was peeling. There is no pain it just looks really weird. What should I do?",
    "doctor_response": "Hi,It may be mild irritant dermatitis. Do not worry, it may recover without treatment. However,you may apply mild steroid with antibiotic cream on the affected area of scrotum. Avoid soap bath. Dettol liq. Amway be used. Keep the area dry. ..okThanks.Dr.Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had wisdom tooth surgically removed, had serious infection in cheek and gum. Given antibiotics. What do we expect?\n\nHello doctor my question is I have had my wisdome tooth surgically removed later July ended up getting a serious infection in my cheek/gum ended up in the hospital 3 times.. all I have been giving is antibiotics it went away slightly but it has come back n its almost the end of September and I'm not giving any awnsures please help",
    "doctor_response": "Hi,From history it appears that after three months there is no improvement it shows that either there might be having root of wisdom tooth remained inside or some part of bone is infected.Consult dentist and get examined.X-ray of this area will give more precise clue about the condition.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the risk factors of sexual intercourse with type 1 herpes patient?\n\nHi doctor, I just recently started dating a man that informed me he has type 1 herpes. I want to know the risk factors and protective measures I can take if I choose to start a sexual relationship with him.",
    "doctor_response": "Hello. Type 1 herpes is a sexually transmitted virus. It spreads with contact with an infected person. It can lead to oro-genital infective lesions. To prevent it, avoid any kind of sexual contact with the infected person especially when the person is having active lesions. If you already had the contact, take precautionary prophylaxis of antiviral medications. Yes, you can have sexual contact with the person but there will be minimal chances of getting infected even if the partner is not running any active lesion. Condoms do not prevent the spread of infection in this case.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes feeling sick and fainting during dinner?\n\nWhen I go out to dinner sometimes I feel really sick and I have even passed out before in the middle of resturaunts. I was wondering if this could be because I don't eat enough food throughout the day and somehow eating a meal latercan cause my blood pressure to drop? If so, is this something to worry about?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Yes, not eating food entire day cant cause such symptoms of fainting down a d feeling sick. You are not taking any food through out the day. This causes hypoglycemia. Brain needs glucose for its normal function. So hypoglycemia will cause shut down in brain function and this will lead to fainting and sick feeling. So better not to fast for whole day. Eat small meals or fruits during day time and take proper meal at night. Don't worry, you will be alright by this. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I start kinprode and Fludac 10 as problem started again?\n\nHi dr. I am taking kinpride tablets 1mg for three months , twice daily before meal and also Fludac 10, once daily after breakfast , according to my doctors advice , now should i continue it as after i stopped it for about a month , the problems started again. Please suggest. . . . Thank you.",
    "doctor_response": "Hello, Fludac is a medicament that you have to use only like your doctor has prescribed. Because of side  effects is better to take an appointment with your health care provider because he knows all the history of your health condition. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ajeet Singh, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy without having ejaculated?\n\nMy boyfriend is circumsiced and last night before we even started i felt some liquid in the head of his penis but at the moment i thought it came from me so we did a little bit without a condom then we used one but today thinking back on it i think it was precum and my question is can i get pregnant from it ?",
    "doctor_response": "Hi and welcome to HCM. The clear fluid  which comes form male before ejaculation is called precum. This precum may contain sperm and you may get pregnant with this. Even few drops of precum may cause pregnancy. I suggest you to take i pill (preferably with in 72 hours of sex for best results) for time being, but it is not safe to repeat this drug every time. If your next period is delayed, please consult a doctor.  Its always better to use condoms as birth control method. All the bestRegardsDr Santosh",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it necessary for my father who has liver problems to go for ANA and ASMA test?\n\nhello doctor, My father is 62. he is having liver problem and is taking medicines. He is non- alcoholic. we got his hepatitis C test done and it was negative. We recently had his LFT done. His report was Bilurbin1.20, Conjugated Bilurbin - 0.70, Unconjugated Bilurbin - 0.50, Total Protien - 6.70, Alumbin - 3.60, Globolin - 3.10, A/g ratio - 1.16, SGOT -67, SGPT - 81 Alkaline Phosphate -134. From last few months his SGOT and SGPt has increased earlier it was normat SGOT 58 and SGPT 63. No one in our family had this genentic disease. doctor has further advice to go for ANA and ASMA and Coesophonal level test. is it really require. kindly suggest and is there any risk facto if SGOT and SGPT level goes higher",
    "doctor_response": "Dear FriendWelcome to Health care magic. I am Dr Charu , I will shortly try to help you with my opinion.I advise you to get also Hepatitis B testing.If it comes negative , you should get ANA , ASMA , to rule out Auto immune hepatitis. However , in autoimmune hepatitis , Serum Globulin levels are raised.Also , get an ultrasound of liver to see for size and echotexture of liver. Based on the available details, this is my best advice for you. You should discuss with your doctor and share my opinion , I am sure he/she will agree to my opinion.Good Luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bloating after first meal. Do i need to worry ?\n\nHi, i m 16 years old and i m kinda stress out because I ve been bloating the past few days. When i wake up in the morning its perfectly fine, but when i eat first thing in a day. my stomach s just begins to bloat and it continuous till the end of the day. I ve been drinking powdered weight gain milks because i m too thin, is that what it cause? Should i be worried about whats happening to me? Please help me.",
    "doctor_response": "Hello.Welcome.milk can cause bloating.You must take the services of a nutritionist for weight gain.He will outline the daily requirement and chart the type and amount of food required by you.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and pain in the knee?\n\nWhen flying this week my knee became very swollen and painful and feels very full above the knee I can bend it backwards but bringing my leg up toward my chest at a 90 degree angle hurts, I want to make sure it is nothing severe before I fly again next week. I travel every other week for work.",
    "doctor_response": "With such presentations in my clinic If I were your treating Doctor for this case of severe pain and swelling i would straight away diagnose it as inflammmotory joint disease and i will start with paracetmol and ibuprofen combination for five days twice a day. as soon as pain and swelling subsides try using knee cap regularly so that it strengthens your knee by preventing it from swelling and also try not to sit down on the floor if you have the habit , as this problem may lead easily to the arthritic changes of knee joint in the future. Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for external hemorrhoids\n\nI am 30 weeks pregnant.....I have an external hemorrhoid that has been bothering me the last few days....It seems really big but I don't usually get them so not sure usual sizes but I noticed today that there are about 3 tiny black spots.......it's also bleeding slightly but not from the black spots....what is this and what should I do?",
    "doctor_response": "Hello You are having small bumps on the outer part of anal opening . You are 30 weeks pregnant .So within next 6-8 weeks you will deliver . Now according to your history having superior, middle and inferior veins hemorrhoids . In my opinion use ANOVATE cream .Apply to clean area, up to 4 times a day ;may be used externally or inserted rectally using applicator .Since fetus part developed very well and this cream is mostly  not for oral use ,so will not develop any harm to fetus .At present you are  nearly on full term pregnancy , so can't take surgical treatment for hemorrhoids .In my opinion this will be useful for you.Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the small and hard lump on the abdomen?\n\nMy teenage daughter has a pea sized hard lump under her skin on her abdomen. It is a bit painful when she touches it or pushes on it, but otherwise it doesn t bother her. What could this be? She is healthy and is a competitive runner and runs 45-55 miles per week.",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. She may have some tumor from fat or muscular origin.  You should go for excision biopsy of that lump.  After that go for histopathological examination to know whether it is benign growth or some other lesion.  Then take additional treatment if needed. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent nightmares?\n\nHello my name is davone i am 22 years old and I really need help , I now this is going to sound strange but I m just so confused about it , its about my dreams ,I constantly dream every night and I mean every night rapidly but not just any dream in the dream I am fully aware and able to control the dream fully i feel everything i am fully aware of everything but the most scariest part is when I m about to wake when I want to awake from my dream at free will I then enter into a weird state where I m back in my bed but can t move and the room is dark please please please help me .. !!! Then when I am awake my mind works a fast pace when I watch TV it s like my brain is aanother person I will immediately mesure everything in the movie as the person height and weight which of their hands are dominate its as if number make up everything if there is any one out there with these conditions please help me",
    "doctor_response": "hi davone,welcome to health care magic,I can certainly understand your extreme suffering regarding your unpleasant experience during sleep. I can explain you that these nightmares are mainly due to imbalance between REM (Rapid Eye Movement) and NREM (Non Rapid Eye  movement) stages of sleep.In general , these two stages maintain sleep balance for its homeostasis, in your case ie in nightmares, the REM activity will be too much than normal, thus the balance is lost. As this is the phase in which the brain is very active, your heart rate will be more, bacause of all these you are experiencing that kind of restlessness.you can get rid of this problem by following strict sleep hygiene ie keeping a regular wake-sleep schedule is very important,which will help  to prevent the sleep deprivation that can bring on nightmares, engaging in regular exercise, which will help alleviate your nightmare if they are due to anxiety and stress,You may find yoga and meditation are also helpful. Be cautious about use of alcohol, caffeine, and nicotine, which can remain in your system for more than 12 hours and often disrupt sleep patterns.Make your bedroom a relaxing place that is reserved for sleep and sex, so that you don't associate it with stressful activities. I would like to know are you taking any medications? as certain drugs like antihypertensives may cause this effect, but very rare. Have you experienced with any severe stress (PTSD) recently? If so, consult your doctor immediately...and get back to me if u have PTSD.Please post your further questions if anyThank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be concerned about the findings in my blood test, after being diagnosed with Hepatitis B?\n\nHi, my name is Elena. I was diagnosed with Hepatitis B and I got my blood work results today. Total Bilirubin is 0.38 Direct Bilirubin is 0.10 AST - 40 H ALT - 57 H Alkaline Phosphatase - 77 Total Protein - 7.0 Albumin - 4.3 Globulin - 2.7 Albumin/Globulin Ratio - 1.6 Do I need to be concerned? Is my liver damaged?",
    "doctor_response": "Dear Friend.Hi , I am Dr Anshul Varshney , I have read your query in detail , I understand your concern.Since you have Hepatitis B infection. We need to find out it is acute or chronic.Your LFT appears to be normal.I recommend you to get investigations to check for chronic hepatitis B.Also , get an Ultrasound Abdomen done.After the reports if it is chronic , you may require a liver biopsy to see for its stage and decision of treating it.If you are sexually active / Married , your partner needs testing too.This is my personal opinion based on details available here.  If you want to discuss your issues further, you may please ask usStay Healthy. Dr Anshul Varshney , MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "How safe is the lithotripsy or lipsotripsy procedure for removing kidney stones?\n\nHi. I have kidney stones and have already passed at least one. The doctor recommends lithotripsy. How safe is the lithotripsy or lipsotripsy procedure for removing kidney stones and what are the after effects on my other organs? Is this the best remedy to get rid of them or keep them from re-occurring?",
    "doctor_response": "Hi Sir,Welcome to healthcare magic,I understand your query and concern.Your symptoms is suggestive of a renal stone located somewhere in the Right lower ureter.For this you need to get him Intravenous pyelography for accurate assessment.I advise you to have Tab Tramadol and Tab.Pantop 40 mg,a course of antibiotic taken under medical prescription to control this pain.Further expert management depends on the outcome of the IVP result.If the size of stone is more than 5 cm then depending on the location of stone Extra corporeal lithotropsy can be done.Meanwhile you need to take soft and less spicy foods.Drink 3-4 litres of water everyday.Fruits,fruit juices,vegetable salads,soups should be taken.Consult your urologist for expert management.Post your further queries if any.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could neurotin 300mg intake cause rash like side effects?\n\nI have been on Neurotin 300mg twice daily for over 2months and within the last week have developed a rash on the inner arms where the elbow bends. It itches and when scratch will get larger in size, but also within the last 2 days having right lower jaw pain. Could this be for the medication even tho I have been on it longer than 2 months?",
    "doctor_response": "Hello,Yes, it may cause  skin rash, fever, swollen glands, flu-like symptoms, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes. This reaction may occur several weeks after you began using gabapentin (neurotin). Please consult with your treating doctor, he will examine and treat you with alternative medication.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy after having tubes tied and while also aging?\n\n12/22/2013: My name is :Mrs. Lisa griffin ,I'm 43 years old , my husband' s 54 years old and can he get me pregnet ? Or  does he have enough sperm to make a other baby ? And I really like the sex too. it feels so good. thanks lisa griffin . We have 2 daughters already ages 3,14.  Just asking. Please email me back. And my tubes are tied too. And I can I still get pregnant still with.or without a condom? let me know. asap.",
    "doctor_response": "Hi,Yes your husband can have enough sperm to make pregnant.Tied tube can very rarely can get recanalization and you may become pregnant, but its very rare. But with condom and tied tubes the chance are very less. So you can have sex and better to use condoms during danger periods.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "When should i go for a pregnancy test?\n\ni think i missed 3 cerezette pills over xhristmas, the days on pack were not matching up so i took the 3 right away that morning i realised i may have missed then and then got back on track after that. the morning i thought i missed them my partner and i had sex... i took a preg test but so far negative how long to wait to take another one? my period is not regular on my pills at all... shall we use a condom even tho i am back on track with the pills?",
    "doctor_response": "Hello,Cerazette is a progesterone only pill. It is common to have an irregular period on this. The protection continues as long as one takes the forgotten pill within twelve hours of forgetting it. The chances of falling pregnant increase if there is a delay of more than twelve hours from when it was due to be taken. Up to two tablets can be taken together if one misses on one day. However, missing 3 tablets puts one at risk of becoming pregnant. It is recommended that one uses emergency birth control measures in such a situation. You could repeat the pregnancy test two weeks after the test that you have taken and tested negative. Or else do a blood test to check for pregnancy hormone level, if you are really worried. Emergency contraception is the other course of action if you realize you have had unprotected intercourse. It could give you 95-99% protection of pregnancy if taken with 72 hours of unprotected sex.Hope I have answered your query. Let me know if I can assist you further.Regard, Dr. Sabina Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest congestion and shakiness?\n\nI have bad allergies and asthma, i sneeze alot and cough from asthma. The past few days days i have been getting pain on the left side of my upper back area and i have been having pain in my chest area and i am very shaky and it  hurts when i breathe. What could be causing this?",
    "doctor_response": "Hello dear,The symptoms as mentioned in your post can be attributed to Acute exacerbation of asthma, secondary to respiratory tract infection.The pain in chest & upper back is due to fatigue/ exertion following attacks of asthma.Management consists of:1. A course of antibiotics based on culture & sensitivity reports.2. Asthalin+ Seroflo inhaler- provide symptomatic relief by causing broncho-dilation (dilating the smaller airway passages, relieving the obstruction & increasing airflow to lungs). So, it can be used during an acute attack.3. Montelukast preparations- used as a maintenance therapy to relieve symptoms of asthma & allergy.4. Antihistamines like Cetrizine can also be used to provide symptomatic relief.5. Also make sure that you are well protected from exposure to cold, dust or other allergens.If symptoms still persist, kindly consult a Pulmonologist for proper clinical evaluation.Wishing a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in the lower right side of the body?\n\nI was laying down last night an I got a very uncomfortable feeling in the lower right side of my body. When I went to sit up the pain became unbearable to the point I went to lay back down an the pain was still there. At first I thought gas could be the issues but now 24 hours later I am experiencing server middle right side back pain. This pain is so server it litterly takes my breathe away. So my question what could be causing this or is it life threatening to go to the er?",
    "doctor_response": "Yeah, could be. without an exam, I can only give general information so, you start with what is in the area of the pain. THe appendix in this case which goes from EXACTLY this sort of pain to LIFE THREATENING within hours. cannot say in your particular case, but generally, this would be a cause for some alarm.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the HBsAg being positive in blood test suggest?\n\nSir, When i went to donate blood to camp on 2-11-2011,Blood screening found that the HBSAg is Positive in it.After that i consulted doctor for monitoring and general check up and the complete tests were done. The HBsAg is positive and the HBeAg was negative as on 18 -12-2011.",
    "doctor_response": "Hi hbsag positive it means you are exposed to hepatitis virus antigen. However its not always that you are suffering from any disease. It may be due to prior subclinical infection or vaccination. hbe suggest infectivity that is negative.  So dont worry.be relaxed. Right now you don't have any intervention needed.thanks for using health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest an antidepressant for a CA patient\n\nHi, I wonder if Citalopram or escitalopram (medication for depression treatment ) can be used for cavanous angioma (in spinal cord ,had hamorrage 2 years ago) patient? will them cause or increase CA hamorrage or bleeding? What antidepresant (treat major depression)would you suggestion for CA patient (18 years old)? Thank you very much!",
    "doctor_response": "I read your question carefully and I understand your concern.Regarding the relation with the cavernous angioma you shouldn't worry much as there is no harmful effect on the cavernoma, no increased risk of bleeding. As for the choice SSRI (citalopram) are a good choice, but they have frequent effects on loss of sexual drive, so a tricyclic like Amitriptyline might be better in a young individual.It should be discussed with a psychiatrist though, especially in a 18 year old, because there is worry about potential increased suicide risk in use of these antidepressants before the age of 21.I hope to have been of help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Gutka eating habit. Unable to open mouth, jaws locked. Possibility of opening mouth after operation?\n\nMyself harish gandhi , i am 38 year old , from long time i had chewing gutka and nuts eating bad habits, as of now i am unable to open my mouth till one finger , my jaw is locked inside . I discussed to some doctor\u2019s in Chhattisgarh in india, ( dental surgan and plastic surgan) According to there advice mouth lips cutting is the only option , there is no other way If i will go through this operation, how much is possible to open the mouth as of now i can open only half finger. Which the best place for this surgery in india , Please send me right doctor name also with contact details As of now i don t have any hard copy of the reports , i will try to arrange it and send you soon Please contact me and help me soon REgards, Harish Gandhi ( ghanshyam 0000)",
    "doctor_response": "hi there thanx for the query first of all your condition is OSMF, which requires cessation of pan gutka absolutely. you need to get your treatment started with your medication and surgical treatment by an oral surgeon as soon as possible.(your condition requires specialist and clinical condition's current status can be only assessed by someone who does your physical examination.) this condition is quite chronic now so make a positive bent of mind and go ahead with the treatment as soon as possible. take care have patience regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome the red spots on my penis?\n\nhi from 5 year i will do penis pump watch regular porn videos previously it was once in a week now a day thrice a day my penis is paining too much but unable to control give gap for 5 or 6 day again the same what to do give me some suggestion going to get married scared what will happen getting red dots on penis also.",
    "doctor_response": "thank you for query.It may be due to friction or fungal infection.Please take following precautions.Use loose cotton clothes.Keep area dry.Apply antifungals like clotirimazole.clean the area twice daily with warm water.consult doctor if does not subside.You can get back to me for any clarifications with the photos.Dr Bharatesh D Basti Dermatologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for breathing problems?\n\nI was recently at soccer practice...I have an inhaler for sports induced asthma but I didn t take it because I went to practice from somewhere else (not my house) so I didn t have my inhaler....so I was at practice and we ran kinda far....and I was just breathing hard like regular...then we did some things like dribbling back and forth and stuff. Then We started to take shots (he rolled the ball and we ran up to it and shot....and all of a sudden my heart was pounding loud (I could hear it in my ears) and I was getting light headed/dizzy and everything went REALLY bright....and when I would blink then open my eyes I would see very bright blotches (my parents also said I was a little pail). So I asked to go get a drink then told my parents and left. I layed down for a while and drank water and it eventually went away. Then that night, out of nowhere I got really cold! And I am the only person I know that actually chatters my teeth when I am cold, and I was, I was also shivering really bad. And i had just been actually pretty hot. So I turened off the fan and went to my room and got under 3 blankets but the chills did not stop...I ended up having these allll night and couldnt fall asleep but eventually I did and later that night I woke up and I was hot (because of the blankets). So I went to the bathroom and splashed my face with water. Then I went to my sisters room and asked her if she could get me a drink because I felt lightheaded/dizzy and thought I might fall if I went by myself. So she got me a drink and and I took an ibuprofen. I stayed awake for a while and eventually fell asleep. I later woke up at 7:30 in the morning and now I feel fine. I guess my question is what happened and what should I do if it happens again???",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.This is an issue of vasovagal shock after certain strenuous activities. Primary care with relaxation, hydration gives best outcome.Prevention requires balanced nutritious diet, proper liquids intake before exertion, deep breathing exercises to make lungs immunity more strong, and deciding the level till which your body can cope up with the activities.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for bruises on lower calf muscles & inside of both knees?\n\ni have had several unexplained bruises that have shown up on my lower calves and the inside of both my knees..also the back of my forearm.I noticed the last few days I have been exhausted my left shoulder is sore and tender. I have a history of values in my legs not working and have had one fixed..I am 48 with nerve radiations down my back sometimes depending on how much I am on my feet,Lymes and have been treated for high blood pressure and anemia..I am concerned that there is something else going on here as I havent dont anything to cause the bruises or be so tired..should i be concerned ,I eat a proper diet and try to move and not just around all day.",
    "doctor_response": "Hi, Unexplained bruises on the body are pretty serious. As you did not mention a history of direct trauma, I assume that these bruises have been developed by themselves. this problem is not related to Lyme, radicular low back pain, increased blood pressure and anemia. This is not a problem that you can ignore or treat by yourself. You should refer to an internal medicine specialist first to check for coagulation problems (disorders that increase the tendency to bleeding.) He/She will order some lab data such as PT, PTT, BT, CBC with Plt and may be Protein S an Protein C. Also, check your urine to see if its color is changed to orange or red. In summary, bruises coming simultaneously in multiple areas might be serious and should be followed up by a specialist. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Hooman Mahmoudi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Tobramycin/Dexamethasone drops help to treat bacterial eye infection in a child?\n\nmy 2 1/2 year old has what appears to be a bacterial eye infection her eyes are not red or swollen. when she wakes up they are caked with dry purulent matter. she doesn t have it during the day just when she wakes up. they run during day. I have an unopened prescription for tobramycin/dexamethasone drops, can I use them on her?",
    "doctor_response": "Hi, By what you say I feel that she is going through simple viral conjunctivitis. This does not require antibiotic or steroid eye drops which you have quoted. I suggest you clean the eyes regularly with clean room temperature water 4 to 6 times per day and they should settle the issue. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes left hand shoulder pain and numbness?\n\nI am the mother of a 2 month old baby , I do a lot of lifting the baby , rocking movements with the baby in my arms , it began as an uncomfortable pain in my left shoulder, now kind of gives me electric numbness kind if feeling at the area between my base of mech and both shoulders , a hot bath or hot water bag gives me temporary relief , but the pain or numbness returns back when I hold the baby etc .. I reckon this has happened after prolonged carrying / lifting baby in the same arm , please advice remedies.what could this condition be?",
    "doctor_response": "Hello, I have studied your case.It can be shoulder rotator cuff injury which may need MRI for confirmation.Medication like methylcobalamine with muscle relaxant and analgesic will reduce pain, you can take them consulting your treating doctor.You may consult physiotherapist for further guidance. He may start TENS ,or ultrasound which is helpful in your case.You may need to take rest for early healing.Also check your vit B12 and vit D3 in your blood.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take careRegards Dr Vaibhav",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for upset stomach in kid\n\nHello, my daughter is 6 and has been compaining of an upset stomach for 3 days. She isn t eating and she is sleeping alot. This morning she started complaining about body aches-her legs, throat, ears, stomach. And she has a low grade fever of 100.2. Is this something to be concerned about?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.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.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can creatinine levels be reduced?\n\nHi, may I answer your health queries right now ?  Please type your query here... My nephew is 23.  His creatine reached 15.8 and his pressure was also very high  195/119.  He was put on dialysis three times a week and was given amlopin 5 mg and concor 5mg twice a day.  He has been on dialysis for 4 months and his creatine has come down to 8 and for the past month his pressure has been normal without taking pressure tablets.  He is a 6 ft tall and weighs 100 kg.  His is on a salt free diet and has limited protein intake.  He mainly has vegetarian food and a hard boiled egg thrice a week.  Can he reduce his dialysis to twice a week? How can he reduce his creatine further?  Kindly give me your advice.",
    "doctor_response": "Hello and welcome to HCM.As an Urologist and transplant surgeon,i can understand your anxiety.Your nephew has kidney failure with H.T.and now on maintainence dialysis.He needs to undergo a kidney transplantation or continue with dialysis.As his kidneys have failed,till a transplant is done,a dialysis is only option.The kidney function is reflected in the creatinine level,so it's done regularly.If his dialysis is reduced to twice weekly,his general condition will worsen.If you've any doubts,send all the reports to me,as a direct question.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat for the white discharge from the fold of breast?\n\ni had breast lift and augmentation 15 days ago. Mist of my stitches cane iut a week ago. Now I have some white discharge coming from the suture line by the fold of my breast. U have been using hydrogen peroxide, but see no improvement. Please help. Thank you",
    "doctor_response": "Hi,It seems that there might be having some infection on suture line giving this problem.Consult your treating doctor and go for regular cleaning and dressing.You might require one oral course of antibiotic as well.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does indentation on back of head post injury indicate?\n\nhello my boyfriend just found a dent in the back of his head and he went to a doctor and she said that he has had a nasty fall in the past and has a hematoma on his head and has to go in for blood tests and she put him on antibiotics, whats happening? Is he going to be okay? i am really scared",
    "doctor_response": "Hello. I have been through your question and understand your concern.You should not be worried about because dents after trauma are very common. Antibiotics are used just for prevention with no real benefit. Indeed, I would not not recommend at all.This situations are self limiting and benign.Hope this helps.Best regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause sudden pain in the lower back on the left side?\n\nI am 21 years old boy. I was playing volleyball yesterday, while spiking there is a sudden pain in my left lower back and I can't straight my back for 10 second, then the pain ocuurs when I bent my lower back sometimes, what is it and how to treat . Pls tell me, thank u",
    "doctor_response": "Hello, You have sprained your lumbar spine. we call it acute lumbar sprain and it is sudden stretch of muscle which is the reason for pain. Treatment is rest for few days and Avoid activities which leads to pain. Tab ultracet p twice a day for 5 days can be taken if pain is severe. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause high SGOT level?\n\nI am 22 years old male I recently had my blood tested for sgot,sgpt and ALP.And the results are: SGPT-19 IU/L SGOT-53 IU/L ALP-138 IU/L I drink bear in moderate quantity but not daily ,I dont smoke either,but I did have a bad diet for past few months and exercised very less What could be the reason for high levels of SGOT?",
    "doctor_response": "Hi thank you for posting your query in HCM.I understand your concerns. SGOT AND SGPT enzymes are the most sensitive indicates of liver cell pathology. Elevated levels occurs in conditions like fatty liver, obesity, diabetes mellitus,  hepatitis A, B, C, D, drug induced toxicity,  cirrhosis, cholecystectomy. I would advise you to quit from smoking,  stop consumption of alcohol. If you are obese plan for losing weight.  Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can HIV enter my body through precum?\n\nHi doctor, Last week, I had a sexual\u00a0encounter with a girl. I did not have any penetrative sex, but I rubbed my penis against her vagina for two to three times. There was no vaginal fluid contact also. I did not have penetrative sex, so I did not use a condom. So, I am worried whether I am exposed to HIV, and I am thinking of getting tested.\u00a0But on the internet,\u00a0I read that the tests are accurate after three moths only. I came to know about HIV RNA test, and I am thinking of getting tested for it. Can I go for that test now? Is a doctor's prescription required? I want to get tested after 10 days. Please tell me if it is reliable or not? If reliable, where should I get it tested?",
    "doctor_response": "Hello. Hope this helps you and get back if you have any doubts. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tenderness in left chest,pain,headache and dizziness?\n\nhi yes i have chest pains headakes and dizzyness that cum an go noww an then also sumtimes my left side of my chest gets really tender wen touched went to my gp he sent me to see a specialist and told me he couldnt find any thin wrong but i no sumuts up inside",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, we should first rule out cardiac diseases for your symptoms. So consult cardiologist and get done blood pressure monitoring, ecg, 2d echo and stress test (trade mill test). If all these are normal then no need to worry for heart diseases. Sometimes, undiagnosed stress and anxiety can also cause similar symptoms. So avoid stress and tension, be relax and calm. Consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic drugs too. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the solution for pimple on penis foreskin?\n\nHello my name is Ernesto and im 17. I wanted to know how to get rid of pimple like things on my foreskin im uncircumcised and its not on the head of my penis but thee skin i just need to know what it might be if you can please answer this im nervous. Ive never had sex but im planning on it with my girlfriend but i need to get rid of these things please",
    "doctor_response": "Thanks for asking in healthcaremagic forum    It may be fordyce's spots. Fordyce's spots are visible sebaceous glands which are harmless. Please visit dermatologist if this is not the condition, for examination and further management. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can incontinence after removal of kidney stones be dealt with?\n\nHi i accidently dislodged my urs stent early at home..I had day surgery yesterday to remove kidney stone at around 10am. I wasnt surposed to dislodge or remove stent till 48 hrs later. It happened last night around 10am. I am continually leaking a far bit. i have total strong incontinence.What do i do now?",
    "doctor_response": "Good Day and thank you for being with Healthcare Magic!When you have dislodged your stent, the bladder end of the stent must be protruding out of your urethra(opening where urine comes out). I would go back to your MD to check the stent and possibly remove it altogether and observe. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at:   I would gladly help you.  Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest methods to handle social phobia\n\nI have a question I believe i have social phobia i have been have trouble with presenting and people in the crowd judging me and i hate using public factilities because i feel people are outside the bathroom door making fun of me, today I was talking to my grandma and she said she had it so what should i do?",
    "doctor_response": "Hi,From what you have mentioned, you seem to have symptoms of social phobia. It is a condition where you are not comfortable in social situations, avoid meeting new people, feel that people are constantly noticing you and fear embarrassment in public.You should seek a psychiatric consultation for initiating treatment. Medications like paroxetine will help. In addition, treatment with psychotherapy in form of cognitive behavior therapy can be opted for. It will consist of sessions which will focus on  relaxation and learning ways to cope up and overcome your fear of public.Hope that you find this information helpful. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes prominent boney lump formation outside the leg?\n\nMy daughter, age 5, has a prominent boney lump on the outside of her leg (at the top of her shin bone). I think there is one on her other leg but not as obvious. She is very slight and her knee joints look big but I put this down to her skinny legs. Are these lumps normal?",
    "doctor_response": "Hello, It could be an osteoma. However other causes must be ruled out. Consult an orthopaedic and get evaluated. An X-ray is required for further assessment. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain beyond the left side of the jaw?\n\nHello.I am having pain at my jaw area, immediately in front of my left ear. The pain is random. Is most painful when I m trying to chew but again, doesn t happen often. It s the kind of thing that if you are on an airplane & have ear pain and you try to yawn to pop your ears, if I try to do that, it feels like it ll get better but I can t achieve the pop that you d get on a flight. My feeling is it is somehow related to sinus but that s just a gut feeling. - thx",
    "doctor_response": "You are very astute to consider sinuses.  You likely have a eustachian tube dysfunction.  The eustachian tubes are located in between your ear and jaw and are responsible for regulating the pressure in your inner ear.  Sometimes from colds, allergies, or change in elevation, the eustachian tubes get tight and fluid from the ear does not drain properly.  This can easily be reversed using medication for sinuses such as antihistamines and nasal steroids.  If you still have the pain, consider getting seen to make sure the ears are looking okay on the inside.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why my 4 years old is feeling rest less and crying?\n\nmy son aditya is a intelligent and sharp boy going to school studying 4 thstd. from november2010 on wards suddenly he stopped going tos chool .he is feeling rest less and stars crying when he hears or thinks about schooll.remaining activities are quite normal kindly guide me in making my child a healthierone",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. There seems something wrong with dates you mentioned. But if your child is afraid of going to school and otherwise he is normal. Take him in confidence and find out what happened at school, visit school and try to find their version. But what child tells you something which is different from school story, I will prefer believing the child. Then accordingly take proper action. Even for future keep conversation open with the child, and believe him, but you should be able to see both the sides. total blind faith in long term may cause problems. As a parent one needs to learn and understand when a child needs help. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest tests to confirm pregnancy\n\nHi doctor, i think i may be pregnant and would love to know when i conceived. i had sex the 9,10 and 17 of july. My boyfriend ejacualted in me the 10th of july at around 6 pm. i took an emergency pill the 11 at around 4 and the next one @ around 4:01. I am not sure if he came out in time the 17th. My period was due the 26th and i am kinda worried. Your kind advice will be greatly appreciated",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options. In a woman with regular periods day 10 to 20 is the most fertile period of the cycle. if your sex activity dates fall in this period , you should be concerned about pregnancy. Your dates fall in this period.Also you have taken emergency pills, if these pills are taken within 24 to 72 hours of unprotected sex act, then they usually protect from getting pregnant.If you have missed your periods, I will suggest to get morning\u2019s first sample of urine tested for pregnancy.Even if you are pregnant, you can opt for termination with medicines safely till 9 weeks of pregnancy.I hope my answer helps you.Thanks.Wish you great health.Dr Purushottam",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could chest pain and shortness of breath be due to anxiety?\n\nDo I need to pay for this service?  I'm a 298 year old woman.  Became obese in the past year - gained 40 lbs.  Having tightness in my chest, and am easily fatigued.  Having some shortness of breath but not bad.  Some heart burn.  My shoulder and neck are hurting.  I've had these symtoms on and off for the last couple of months.  Don't know if I'm just having some sort of anxiety attack as I've been depressed lately.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Tightness across chest, easily feeling tired, having shortness of breath, heart burn and neck and shoulder pain are all common symptoms of anxiety and stress. But they are not the symptoms of anxiety alone. Therefore, it will always be useful and helpful for you to consult a general physician and get advise.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should an anemic patient suffering from hair loss refrain from eating raw rice?\n\nHi, I would like to know what are the side effects of eating raw rice. I have an aunt who is addicted of eating raw rice and she also has other health problems like anemia, hair loss and losing blood. Is all these related? What can be the realm of the health problem? Thanks",
    "doctor_response": "Hello and welcome to health care magic. There is no relation with eating raw rice causing anemia. It's actually the other way round. If you have mild anemia, you may have a peculiar craving to eat certain strange things like raw rice and soil!!  This strange craving seen in anemic people is called pica. May be that's what have given you the wrong impression. My advice is to visit a physician and get your hemoglobin checked. If it's low he will give you iron tablets for 1 month. Make sure to eat more iron rich foods like pomegranate, jagger and ragi. Hope this discussion will be helpful to you. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Z-Pak and doxycycline effective for cold and head congestion?\n\nHi, I am in my 3rd week of head congestion, runny nose, cough and have had intermittent low grade fever (just below 100) for past two weeks. Took Z pack first week, waited a week and am now on last day of doxycycline (whenI started that, I also took a 5 or 6 day steroid pack to relieve the liquid in sinuses. What gives?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Z pack is having azithromycin. It is antibiotic. Doxycyclin is also antibiotic. You need antihistamine and anti inflammatory  drugs along with antibiotics for your cold and head congestion. No need to take oral steroid. Avoid oily and spicy food. Avoid hard to chew food. Do steam inhalation 5-6 times a day. Do warm water gargles 5-6 times a day. Drink plenty of fluids orally. Don't worry, you will be alright in 1week. Anti inflammatory and antihistamine drugs are prescribed medicines, so better to consult doctor for the them. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dog bite\n\nMy name is Isidro, a year and a half ago a dog bit me on my ankle. Currenlty I remain with a sore that will not heal. I have consulted  two doctors on separate occassions but they are not sure why it has taken this long to heal or what to prescribe me. They took an X-ray and found anthing that would indicate an infection.  What should I do next?",
    "doctor_response": "Hi,From history it seems that there might be having chronic non healing wound giving rise this problem since long.As x-ray is normal, possibility of osteomyelitis is ruled out.In my opinion it might require proper dressing done by doctor only so that proper cleaning of slough and necrosis tissue can be done.Gradually wound will be healed up by secondary healing.In some case skin grafting might require.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from premature ventricular contractions\n\nIs it okay to ride a roller coaster if I get occasional pvcs. I have never been able to feel them before and have never felt any discomfort. As a separate question would it be fatal or harmful to ride a roller coaster with the same condition under the influence of marijauna",
    "doctor_response": "HiThanks for using healthcare magicAt low or moderate doses, cannabis leads to an increase in sympathetic activity and a reduction in parasympathetic activity, producing a tachycardia and increase in cardiac output. Chances of PVC, arrhythmia, sinus bradycardia, second-degree atrioventricular block and atrial fibrillation etc could be possible with cannabis use. In your case, PVC could be due to cannabis.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hoarse voice in a child\n\nmy 4mo old son just geiitng over rsv on nebuli abuterol ad amoxil for ear inf and a steroid for the bronc cords now is very hoarse never cries so he did not scream himself that way what can i do or should he se dr again he went yesterday n she secrease breathin treatments",
    "doctor_response": "Hello,By what you say, I feel that your kid might be having increasing respiratory distress. The kid might need medical attention.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sumanth Amperayani",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of levolin?\n\nI have mild persistent asthma and take foracort 200. Recently when I had an acute asthma attack, my doctor has prescribed me with steroids + levolin rotacaps. My steroid dosage is over but when I am taking levolin I am getting stomach upset, diaerreaha, nausea sysmptoms. Can these be side-effects of taking levolin?",
    "doctor_response": "Hello, The following is a list of possible side-effects that may occur from all constituting ingredients of Levolin Inhaler. This is not a comprehensive list. These side-effects are possible, but do not always occur. Some of the side-effects may be rare but serious. Tremors especially of hands, convulsions, Fatigue, urge to vomit, Severe hypokalemia, VomitingDiarrhea, tiredness, Dizziness, Muscle cramps. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Arup Majumdar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bump and soreness on head and neck?\n\nI'm feeling spaced out, light headed, nauseous and have bumped my head twice on Saturday morning and again on Sunday night in the same spot, first bump was quite hard near my temple on the corner of a table. It's Tuesday mid-day now. my head and neck are all very sore too.",
    "doctor_response": "Hi, I have gone through your question and understand your concern. I must tell you that injury near temple can be very dangerous as bone of this area is very thin. For immediate relief you can take pain killers like brufen or voveran but better to consult your doctor to checkout any internal injury as you feel nauseation and light headedness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for intermittent fever\n\nhi, i had fever from 25th june to 13th july on an alternate days. all reports are normal. doctors are not able to find out cause, again i am having fever from 22nd aug.on an alternate day, plz help ferver always occur in afternoon, and goes up to105f .",
    "doctor_response": "Hello, Thank you for your contact to health care magic. I understand your concern. If I am your doctor I suggest you to do blood culture for salmonella, and brucella, and tuberculosis. I suspect you have pyrexia of unknown origin or PUO. Take the treatment of co-trimoxazole for a week under your doctors guidance. Once blood culture report is out you can take the treatment accordingly.I will be happy to answer your further concernYou can contact me. Dr Arun Tank. Infectious disease specialist. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for knee pain\n\nHi I am a volleyball player, yesterday we had practice, and during practice, I went into bump the ball, and fell inwards on my right knee, I am very soar from practice and in a lot of pain! Please help! I want too go back to practice tommorow to get my starting spot! Please!",
    "doctor_response": "Hello, It could be a contusion or ligament sprain. As a first line management, you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist better to consult an orthopedician and plan for an MRI scan. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause pain in arm and shoulder?\n\nMy wife is taking Lupride injections in run up to planned IVF. Our fertilised embryo s are already in cold storage. She is taking these injections for last 10 days and is now experiencing lot of pain in her arm and shoulders. My doctor says its normal and pain is manageable. She doesnt think so. Please help",
    "doctor_response": "Hi, As a first line management you can take analgesics like Paracetamol or Aceclofenac for pain relief. If symptoms persists better to consult an orthopaedician and plan for an MRI scan. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "I feel cold spots between breasts. How can i get away with it ?\n\nI have a what feels like a cold spot inside my body between my breasts, any suggestions? it really feels like i should drink hot water to make it feel good or go away but it doesnt go away.... any help or anyone have the same thing?",
    "doctor_response": "Welcome to Healthcare Magic Your description isn't clear. Are you experiencing any heartburn. Any problem breathing. Any palpitations. You need to stay away from spicy, hot or hard food. Avoid smoking or drinking alcohol. Eat more fresh fruits and green leafy vegetables. Drink plenty of water.If you develop a cough or shortness of breath it would be wise to consult your Doctor immediately.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure rashes on the top of foot?\n\nI have a rash like on the top of foot, started on/by pinky toe.  It has spread over to the middle of my foot, also inbetween toes and bottoms of toes.The symptoms are itchy red blotches.  I use cortizone itch cream works for the itching but not the redness.",
    "doctor_response": "HIWell come to HCMThis could be allergic condition and this can be well managed with Beclomethasone cream, better to have a oral medication too and the drug of choice would be Tab Levocetrizine 10 mg once in day, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for the severe chest congestion?\n\nI have severe Chest congestion, iam a bronchial asthmatic patient, I use nebulizer with duolin to relieve the congestion ,I experience shortness of breath early in the morning. Doctor have prescribed antibiotics brutacef AZ- 500, montek Lc but of no relief .shortness of breath ,can t even walk at slightest movement I feel wheezing.",
    "doctor_response": "Thanks for your question on HCM.By your history I think you are having acute attack of asthma. And infections are the most common cause for this.Better to visit Emergency department , as we need to check oxygen level. If low than you may need supplemental oxygen therapy.Chest x ray is akso needed. And if infective patch is there than we need to start parenteral antibiotics. You may need corticosteroid injection also. As they are potent anti inflammatory drugs and treatment of choice in asthma attack. Injectable bronchodilators like theophyllin group is also useful.So don't wait at hone, rush to the emergency department and start the treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can tardive-dyskinesia with hyperhidrosis be treated?\n\nHello. Can Tardive-dyskinesia cause involuntary smiling and cranio-facial and thorax hyperhidrosis? What treatment would be indicated? Thought about antimuscarinic medication but they have been removed from the market at some point in the past and nothing is available at the time being to treat hyperhidrosis which is my worst problem, although smiling in meetings or when I am very angry is also terrible...",
    "doctor_response": "Hello!My name is Dr. Aida and I am glad to attend you on Healthcaremagic!I understand your concern and agree with you on the fact that autonomic dysfunction is a part of advanced stages of parkinsonism or tardive dyskinezia. I would like to know more about your past medical history. What is your current therapy?Involuntary smiling could be a sign of pseudo-bulbar affect. Regarding hyperhydrosis, I would recommend botox injections. You should discuss with your doctor on this possible treatment option. Kind regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is surgery the right method of treatment for a torn bicep tendon?\n\nHi, I recently tore my bicep tendon at the elbow(6 days ago). I saw my surgeon yesterday and surgery is obviously the way he\u2019d like to go. Unfortunately I am a carpenter and self employed so the idea of not being able to work is a scary one. My surgeon did say that I had great strength and range of motion and that I may be ok if I choose not to do the surgery. My question is: will I experience more loss of strength or supination that has occurred right now, over time? Or is this the worst I will be?",
    "doctor_response": "Hi, If you can do the routine works, no need to go for surgery. If weakness or difficulties are present, better to go with surgery. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I conceive inspite of having tilted uterus ?\n\nHi I m 31 years old and I had an ectopic pregnancy when I was 20. Additionally I have tilted uterus, can I still conceive?",
    "doctor_response": "hello welcome to healthcare magic yes ofcourse you can conceive if u had an ectopic pregnancy. do not worry about the tilted uterus. what treatment was given to u when u had an ectopic pregnancy? anyhow with any treatment given you still have one sided tube and ovary so do not worry. one tube is enough for you to conceive. the only thing you should keep in mind is that you should go see your gynaecologist as soon as you miss your period/pregnancy test is positive so it can be confirmed that the pregnancy is intrauterine as ectopic pregnancy may re occur if u have had one earlier. so just be careful and dont worry it will be fine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for feeling heavy and tired legs?\n\nHi query why i feel so tired and my legs just feel heavy and tired, i have a slight headache feels more fuzzy my ankles swelled a couple of days ago this is not too bad now. I have just finished a four day long stint at work office very warm however not felt this tired before.",
    "doctor_response": "Hello, Consult a physician and get evaluated. We have to rule out possible causes like fibromyalgia also. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for muscle & joint pain\n\nI am active, healthy and strong, just turned 51, female, exercise class twice a week, pretty busy, no allergies or medications. For the past two weeks my muscles and joints are achy and actually hurt. They feel stiff like I did a new exercise and then did not stretch. Have a big red bump that I thought was a black fly bite, it is sore and hard on my shin like I bumped it. Does not look like a tick bite. Any ideas why the aches?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have muscle & joint pain. Well there can be many reasons for symptoms you mention in query like bursitis , gout , infectious diseases , tendinitis or fibromyalgia . I would suggest you to consult orthopedic surgeon for proper examination . Doctor may order certain test like blood test , check vitals , take history and physical examination . Doctor may prescribe muscle relaxant , anti inflammatory along with vitamin supplement and physical therapy .For now take proper rest , apply warm compresses and drink plenty of water . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does shingles require medical attention while on anti viral IV and pain medications?\n\nHi, my husband has a history of CLL and was reciently diagnosed with Shingles. The shingles has spread to other parts of his body besides the nerve path. He is on IV anti viral and a host of nerve blockers and pain meds. He is sleeping a lot and has a steady fever and very nauseous. Blood pressure 129/60 currently. He has been in remission for 10years. Is this a cause for concern? I m not getting answers from the hospital staff. Thanks!",
    "doctor_response": "Hello,Thank you for trusting HCMShingles in an immunocompromised person suffering from CLL definitely require medical attention. However, according to your history, your husband is receiving appropriate treatment with IV antiviral treatment and pain medications. If nausea and vomiting is troublesome I recommend adding 8 mg twice daily to the treatment regimen.His blood pressure is within normal range at present. I would recommend monitoring of blood pressure every 4 hours, and initiate IV fluids if the blood pressure drops down further.Hope this answers your questionPlease let me know if you need further clarificationsRegardsDr.Lekshmi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if the vein is tender, graft pumping well and no blood in coming in the syringe in a dialysis patient?\n\nhi,i am an dialysis patient.i have an av graft in my right upprr arm.went for dialysis,when needle was inserted.was in extreme pain,plus blood clot came out into syringe,nurse tried 4 times ,no blood was coming out,now vein is very tender,graft is still pumpimg well",
    "doctor_response": "Quite likely there is acute clot formation in your graft as its pulsatile and there is no blood flow. In a graft the likelyhood of improvement in that is less although its good to  meet your vascular surgeon at the earliest.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and off balances having inserted 7 stents in the arteries?\n\nMy blood pressure is 106/60. I take 20 mg. Lisinoipril and 9.0 mg carvedilol 2 times daily. I have poor circulation on my right. I m dizzy, off balance. feel week especially after eating. 3 years ago I had 7 stents placed in my arteries to my heart. I have no energy and it is a task to type this simple message",
    "doctor_response": "Hi,You should see your doctor. Your tiredness ans loss of energy can be caused by your medication and low blood pressure, if your blood pressure is usually higher.I would advise you to see your doctor to undergo some blood tests and revise your treatmentWishing you good healthIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for constant urge to pee after gastro-enteritis with the effects of diarhhea?\n\nHi doctor,I have a pretty annoying problem: I constantly have the urge to pee.When I drink much water I have to pee every 15 minutes, the pee is very clear. At night I tend to drink less water because I can't sleep if I have to go to the toilet every 15 minutes. When I drink less I still have the urge to pee, but the amount of pee is a lot smaller, and a bit more yellow. I can hold my pee for maximum 1 hour. When I fall a sleep I wake up every hour with a huge urge to pee, One time I was to late. At night it hurts a bit at the end while peeing, during day it doesn't hurt because of all the water.My guess on this is that it's a urinary tract infection, only my pee is a lot more clear than the normal symptoms of the infection.2 Days earlier I suffered from gastro-enteritis, and I still have some effects of it like diarrhea and cramps. Because of that I don't eat much during day, which could explain why the pee is so clear.Do you have any idea what I could do to fasten up the healing process, I have Zinnit at home and I already took 3 of them, and the effects are slightly less now. Can you perhaps also help with the 'peeing at night' problem, something that could give my bladder a rest at night, and me to :) Some additional information: age:      18sex:       maleweight:  163kgposture: smallextra:  -I am a regular cannabis user, I smoke a little every nights an hour before I go to sleep. This is for non medical purposes except a small headache from time to time.  -I am a skinny guy and I don't eat healthy, but still don't get sick very often, mostly just a cold.I hope you could help me with my questions, I will honestly be very thankful !I know this is a pretty long text, but I wanted to give you as much details as possibly. I'm a student from Belgium, so I'm sorry for my bad english.Thanks again for reading and hopefully helping. Jasper",
    "doctor_response": "Hi Jasper. Nice to see a real good history , gone through and your English is perfectly normal. This is called frequency of micturition. The main cause can be a local infection in the bladder irritating, another is a stone in the urinary bladder irritating a particular part of bladder called a trigone- a very sensitive one. another causes are like diabetes mellitus / incipidious and so on. What you need is to find our th root cause by routine tests of Blood and urine , urine culture sensitivity, ultrasonography of abdomen. This will find out the original cause. Then the treatment really easy. Please do not try anything at home. t looks you have mentioned your weight too much.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for stress?\n\nHi ! i have small cute in the corners of my mouth. I just changed toothpaste brands, this one has peroxide and baking soda in it. And the mucosa feels like its sluffing. I am under lots of stress too. Is this my imagiation or am I lacking a certain vitamin? I usually have a clean diet. Whats causing this?    Thank you",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. About the ingredients of tooth paste, the same tooth paste has been used by so many people and it comes to market after intense tests. You don't have to worry about the allergic reactions. You can consult a physician if the symptoms persist. Stress is different. If you are worried about your stress level, take some days off and go for a vacation. You should not be stressed about the stress itself because it leads to anxiety.You can post a direct question to me in this website. Include every detail as much as you can. I shall prescribe some psychotherapy techniques to control your condition. I am sure that the techniques should be a success.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Soreness in the stomach. Could it be due to binge drinking of alcohol? Liver test suggested.\n\nHi, I am a female, aged 35 and had some blood tests done last week as I had mentioned to my doctor that I had discomfort and some soreness in whole tummy area which seem to be related to odd days where I seem to be constipated (since before xmas). As a precaution, they did blood tests and have asked for a retest for liver . The first test was early Friday morning. I was at a wedding on the Saturday before where I had consumed alcohol (binged) but a 5 full days had lapsed before the first test. I drink quite rarely but do drink usually once every 5-6 weeks where I have a bottle of wine and couple of half lagers. Could the binge drinking at the weekend have affected the results? The doctor wants to do the retest in 7 days time after an alcohol free week. Thanks.",
    "doctor_response": "HiThanks for asking.Binge drinking can lead to the alteration of the liver function tests and most of the times the enzymes remain elevated for few weeks after the drinking.Give at least 3-4 weeks of alcohol free period before you decide to do the liver function tests.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I have a feeling of period pains?\n\nhi im claire i am 31 weeks and 4 days along in my pregnancy so i have only about 8 weeks left before im due, i keep having like period pain feeling comes and goes but is getting worse by the day its been happening for about 4 days but i also feel like a football pushing down on me very uncomfortable but this is my first baby so i dont know the signs??? please help!!!",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the period like pain intermittent needs evaluation.It requires physical examination to rule out any preterm pains.Preterm pains are caused by dehydration,urinary,vaginal infections or any.So you need physical examination and necessary investigations if any.Nothing to worry.Avoid stress.Take adequate fluids to prevent dehydration and urinary infections.Relax.It will subside with treatment.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the complications of spinal fluid in spinal cord?\n\nI was told by my nero-surgeon that they found spinal fluid in my spinal cord, but that he don t think there s any need for concern, I ve also been diagnosed with Cervical arthritis, bone spurs and have numbness, atrophy, and pain in my left arm from the arm pit down to my fingertips.",
    "doctor_response": "Normally spinal cord is surrounded by spinal fluid(CSF).It will be a matter of great concern, if it is not there.The symptoms you have described could be caused by cervical spondylosis with or without radiculopathy. This treatment is being suggested on bases of the information provided.I would like to examine & investigate you in detail.Rule out hypertension, Diabetes or any other metabolic disorder.Any way you may try---.  Dolokind Plus (Mankind) [Aceclofenac 100mg +Paracetamol 350mg] 1 tab.  OD & SOS. X 5days.--. Caldikind plus (Mankind) 1  tab OD x 10days.(You may need help of your local doctor to get these medicines.)--. Fomentation with warm water.--.Sleep on a hard bed with soft bedding.--. Avoid painful acts & activities.-- .Do mild exercises for Back. neck & shoulders.  --.(Take help of a physiotherapist or visit www.drncgupta.com). --. Use no pillow under the head.Do not ignore, let it not become beginning of a major problem.Do ask for a detailed treatment plan.If no relief in 2-3 days, contact me again. (phone.91 9810012688)Kindly make sure, there is no allergy to any of these medicines. (Contact family doctor, if needed).For  emergency treatment visit nearest hospital.-Hope I have answered your question, If you have any further question, I will be happy to help.-Kindly rate the question.-Wish you a quick recovery & good Health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itchy rashes on the arms and lower back. Swelling under the armpits. Need antihistamines\n\nLast night I woke up with severely itchy palms, grew into rashed unp and down my arms and lower back.  I had a big bite (unknown) on my shoulder blade.  Not painful, but itchy.  I have asthma but did not have an attack from this, but I did have severe \"seemed like all over\" itching.  I took my son's Children's Benedryl which seemed to calm things down.  As I was changing my nightclothes just in case it was a detergent allergy, I noticed I had huge swelling under boths armpits.  This swelling has now gone down but not disappeared ( it is 12 hours later).  Is there a better antihistimine I could have in the house to address this?  We live in Tucson AZ and bugs are a fact of life.  Especially when it is hot and we use the swamp cooler.  I just had Terminix here on Monday to spray all entrances, perhaps I scared a nasty bug out of hiding.",
    "doctor_response": "hello,By history this seems to be urticaria of the skin to some insect bite.rash and itching are initial reactions of a hyper reactive skin condition.You're a known asthmatic and prone for hyper reactive airways also when exposed to allergens.Alway have non sedative antihistamines at hand which will prove handy in such situations.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I continue my pregnancy with a high TSH level?\n\nHello doctor, Recently, I got conceived. My latest thyroid profile report showed the T3 and T4 to be normal and the TSH levels were abnormal at 22.96. We have heard that this TSH value affects the brain development of the newborn and also the newborn will not be mentally good. This is bothering us a lot and now we are in dilemma of going ahead or getting it terminated. Please share us your valuable thoughts on this. Currently, I am taking Thyroxine 50 mg.",
    "doctor_response": "Hi. Yes, you are right. Hypothyroidism can affect the fetal brain development, especially in early pregnancy. Thyroid hormone is normally very important for many functions of the body. It helps in the early development of the fetus. The brain is one of the parts of early organ development. In early pregnancy, fetus mainly depends on mother's thyroid level because fetus itself cannot produce up to around 11 to 12 weeks (three months). There is no data available whether you have taken treatment early and adequately. But yes, there is data that hypothyroidism can affect brain development and function in baby permanently and whatever damage occurs is irreversible. If you are taking Thyroxine (Levothyroxine) 50 mg and the level is this high, then you need to increase the dose. And, if you have started treatment just now, then continue and repeat according to the doctor. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is Alice in wonderland syndrome?\n\nhello, i am researching a disorder called Alice in Wonderland Syndrome . i would perfer a primary source for what it is about the disease i need to know. i know that it alters the perseption of an idividual. i also found online that the people with disease don t truely understand that they have or the extent to which they have it? is there something you can tell me.",
    "doctor_response": "Hi, hey wow, thanks for the question!I have only ever seen 1 case of AIWS and it was the initial presentation of a viral infection called the Epstein-Barr virus. It's the same virus that causes 'mono'. From what i understand of the issue, the virus causes inflammation of the blood brain barrier, especially in the posterior vertebral distribution. This has been theorized to cause tiny perturbations in the blood flow through the occipital cortex and THAT causes the visual changes.There have been other instances of AIWS, it's been seen in psychoses especially in the young, it has been related to certain types of illegal drug use, etcThe symptoms are basically issues with the perception of relative size. The patient thinks that they are incredibly small and everything around them is gigantic... or the opposite.. they are the giant and everything is small. It's a distortion of the visual pathway. I'm sorry I wish i could tell you the exact pathology, but i don't know it, and my experience with the syndrome is very very limited. I hope this helps. Thanks for coming to HCM. I hope your research goes well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in getting pregnant after having unprotected sex?\n\nhi i would just like to ask for your advice and what you think,my question today is about fertility, I am 19 years old, and I have always had regular periods since I can remember, when I was 15 I fell pregnant and sadly I had a termination at 10 weeks I had a surgical termination, from then I was on contreception I was the implan as I bleed pretty much all the time with it I had it removed a year and a half later from then I went on the injection nd I bleed all the way through out that aswell so the doctors took me off contreception so they could run blood tests just to make sure everything was alright, everything came back negative so that was good. I have not been on contraception for just over two years now, I use the with drawel method with my partner, nd I no this isn't a effective method but surely it must be for us if pregnancy hasn't occured,I am curious weather I could be infertile and would like your opinion, does everyone get pregnant this way, tho I hav gota say for the first year with out contaception we did have sex quite regulary but now it must b about 3 or 4 times a month. And I do chart my ovulation days only til recently, my concern is do you think I could be infertile or am I just lucky it hasn't occured yet. I have also had a ultrasound and a transvaginal done recently just to make sure everythings ok up there, if that comes back ok, does it mean I'm perfectly ok to have children in the future when I actually try, or could this b a sign that I could be infertile, please help, and also u have never had a std I get checked regulary and I'm perfectly healthy and no problems if that helps.",
    "doctor_response": "as ur usg is ok...now go for serum tsh and serum prolactin den do hsg on day 8th den do follicular study after taking clomiphene from day two den follicle size increase to 18 mm den rupture den iui for early results ......u can get pregnant. ..don't wry",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have inappropriate sinus tachycardia. Should I get a pacemaker?\n\nHi doctor, I had been diagnosed with inappropriate sinus tachycardia nearly two years back. I have\u00a0dizziness, chest pain, shortness of breath, not able to exercise, and anxiety.\u00a0I am currently managing my symptoms with Ivabradine 5 mg, once a day, but the quality of life is very poor due to which I am suffering from depression and anxiety disorders. Sometimes, I feel better and can work off the\u00a0medicines, but as soon as I try strenuous exercises, all the symptoms return. Please apologize for my words, but I cannot even masturbate. My questions to you are, should I consider for ablation? If yes, then what are the risks and success rate? If I have to undergo pacemaker implantation, then what may be the complications and success rate and will I be able to perform strenuous exercises with a pacemaker? Should I consider going for a pacemaker at 21 years of age? Lastly, should I continue with medicines, if there is a possibility of self-healing in the future?",
    "doctor_response": "Hello. Firstly, do not get depressed, this is not a life-threatening condition, and may resolve with time. The symptoms may be troublesome for some time. How much are your resting and maximum heart rate? You should get yourself evaluated by a psychiatrist for anxiety and depression, which I think is causing your poor quality of life. I assume all other causes are ruled out like thyroid, low hemoglobin, and postural orthostatic tachycardia syndrome. The echocardiogram is also normal I guess. Hope this helps you, and get back if you have any doubts. For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a feeling of quivering of heart everyday?\n\nI feel great, I feel strong . I have no problem with a good workout. But my heart feels like its quivering every day. It feels like it beats normal but quivers too. I especially feel it when lying in bed. Makes me think is it always quivering and I only notice it when I am not busy. What's going on with me?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Since your symptoms are only when you are not doing anything, possibility of stress related symptoms is more. But better to rule out heart diseases like arrhythmia (rhythm disturbances in heart) first. Because arrhythmia can cause similar quivering feeling in heart. So get done ecg, 2d echo and Holter monitoring (24 hour continuous monitoring of ecg). If all these are normal then no need to worry for heart diseases. Avoid stress and tension, be relax and calm. Divert your mind from this feeling. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of getting pregnant if the condom breaks?\n\nyesterday i went to the restroom and when i cleaned myself i noticed a light red stain on the tiolet paper, when i went to the restoom again it wasnt there anymore. about 36 days ago my boyfriend and i had sex with a condom but it busted. if there a chance i might be pregnant?",
    "doctor_response": "Hi, thanks for writing..The intercourse during fertile period increases the chance of pregnancy especially if the condom breaks.. If the intercourse has occured during safe period the chance of pregnancy is less. Fertile period in a 28 day cycle is 8-18th day.. Intercorse during this time results in pregnancy.. Hope I have answered your query.. Good day..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why are there red rashes on my glans penis?\n\nHello doctor, I had unprotected sex three months ago. I had all the tests except herpes done and all were negative. About every one to two weeks since the encounter, I have been getting red rashes and red small dots all over my glans penis and foreskin. They are not raised, they do not itch. They are maybe like two seconds a day and no discharge. Although sometimes penis can produce an odor. The dots will disappear on its own usually after three days and can reoccur again after a week or two. There is nothing that seems to be indicative of herpes. Penis also seems very dry and wrinkly at times. All STDs and HIV tests were all negative.",
    "doctor_response": "Hello. Perhaps you have a yeast infection - candida. It can manifest as redness and bumps on the glans. There is usually associated itching. I request you to kindly upload a few images of the affected area so that I am able to confirm and guide you better.  For more information consult an HIV AIDS specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes spreading rash in 8.5 months old?\n\nmy baby is about 8.5 months old, he has a rash the size of a silver dollar on ischest by his armpit, and its spreading across his chest, its also on the inside of his forarm and spreading up his arm..i though it was rignwarm but i went to a pharmacy and they said it wasnt..what do you think it could be...its also starting to flack",
    "doctor_response": "Hi, welcome to HCM. Looks like fungal infection. However, an examination by doctor should be done. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes problems in conception?\n\nHi we, i n my husband, want to concive a baby for last 4 months but could not sucess, what may cause? We both are at age about 34, my weight is 95 pound n my husband's is 180 pound. My height is 5.2\" n my husbands is 5.10\". We both have no poor medical history. My monthly period is of 28 days n normal.",
    "doctor_response": "Hi,I read your query and I understand your concerns.Following is my reply:1) 34 years for a lady is on higher side.2) Get your husband's semen analysis done.3) Get HSG test done for assessment of tubal status.Let me know if you have anymore questions.Regards,Dr. Mahesh Koregol",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of blood pressure ?\n\nMy wife's blood pressure has bottomed out she is laying in tub cool water then hot she is very week. She says she is feeling a little better. She went to the toilet and I've never seen so much poop. She has been sipping water. Very scary for a little bit",
    "doctor_response": "HIWell come to HCMThe symptoms that are stated here are not related with blood pressure but this could be functional problem and may be related with anxiety and depression you have to support her morally and ask her to low down the stress, hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does swollen, tight and achy foot require immediate medical assistance?\n\nI kicked a tire during anger (for which I am seeing a psychologist), and hours later I cannot walk on that foot. Shall I seek medical assistance immediately or wait until tomorrow? The foot is not cold or showing bruising. It is somewhat swollen and feels tight and achy. I kicked with the ball of my foot pretty much on the median line. Thank-you!",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.You may be having early osteoarthritis or vitamin D deficiencies . Exact condition can be judged by x ray and MRI of knee. Till then it is advisable to take rest, analgesic, Diacerine and vitamin D3. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is Mometasone dangerous to use on Face to clear my acne pimples?\n\nHello doctor, I am seriously facing acne pimples problem. Sometimes they occur on my face when I masturbate. If I use Mometasone, it gives a good result. Is it okay to continue this?",
    "doctor_response": "Hello. Acne is a universal issue in the age group of 15 to 25 years due to hormonal changes in adolescents. However, there are multiple effective treatment options depending on the grade and severity of the problem. Mometasone is a topical steroid and is to be avoided strictly on the face and for acne as it can harm your skin in the long run. Acne is dependent on hormones hence excess masturbation may sometimes lead to an increase in the problem. I would advise you to stop Mometasone immediately and kindly upload appropriate images to help us assess your current grade of acne and treat you better. Regards. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for discomfort in throat\n\nPeanut stuck somewhere in throat or wind pipe in 1 1/2 yr son...already seen a doctor ...he told that he cant see anything in throat and advised to have a serial x rays for 3 days...though kid is normal while awake but having difficulty during sleep.WHat to do to comfort him or to dislodge it.",
    "doctor_response": "Hi dear,I understand your concern. I suggest him aurvedic syrup Kuka 2,5 ml twice a  day, it will be helpful for irritation.Wishing your baby good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for itchy small bumps on the penis shaft\n\nI have been facing seviere itching around the shaft of my penis and some small bumps of white colours like small pimples i feel very very itchy on these small pimples like layer around my penis and the skin covering penis is also very itching please provide some tube available for this in india",
    "doctor_response": "Hello dear,The symptoms as mentioned in your post suggest that you might be having fungal infection (Tinea) in the region around shaft of penis.Management includes:1. Keeping the area dry & avoid too much exposure to water or sweat formation.2. Antihistamine preparations like cetirizine to reduce the itching sensation & provide symptomatic relief.3. Application of topical antifungal cream like Clotrimazole to tackle the causative organism.If symptoms still persist or aggravate further, then it will be better to consult a Dermatologist & get a proper examination done to find out the actual cause.So that appropriate management steps could be taken.Also avoid wearing tight undergarments & trousers...as it will cause sweating & predispose to fungal infections.Wishing you a Good Health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce pores on my face ?\n\nhello doctor ..actually i have problem of pores in my face .i had acne before n my face is oily...plez help me to reduce my pores it looks s0 aged on me.thanku",
    "doctor_response": "hi reecha, to start with we have to determine whether you have just pores (dilated hair follicles) or you have developed acne scarring? you may consider sending m,e your pics on my email id or may visit me personally if you are from delhi or nearby. We have developed a specialized treatment protocol for acne scar management of different severities. If you are just having pores, start using deriva MS gel once daily at night.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will foreign bodies cause redness in eyes?\n\nHello doctor, My eye has become red and is watering, I think a foreign object has entered but I am not able to find it. What should I do? It happened yesterday and icing did not help. Currently, I am under medication for high blood pressure.",
    "doctor_response": "Hi. First this to rule out is a foreign body in the eye. For that ask someone to examine your eye with a torchlight and also check the upper lid by everting it because that is the common site for foreign body. Sometimes a very small foreign body cannot be seen with the naked eye and need an eye exam by a doctor. Wash your eye with clean water. If there is no foreign body seen then it is most probably conjunctivitis (that presents with the same symptoms) usually viral conjunctivitis. It usually takes 7-10 days to complete recovery but during this period protect your other eye and other family members because it spreads from one person to another through contact. For symptomatic relief, keep washing your eyes with cold water and do icepacks. That helps to relieve discomfort. Start antibiotic (Moxifloxacin 0.5%) eye drops four times a day to avoid secondary infection. If pain and discomfort are severe consult your nearby eye doctor for a complete eye exam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to remove sebaceous cyst without surgery?\n\nhi, I have a sebaceous cyst on my forehead, and it doesn't pain. But I still want to get it removed. so could you please guide me if it can be done without surgery? I don't want any mark on my face, so worried to go for a surgery. Is there any other method of removing it?",
    "doctor_response": "Hi.Is not this you are asking too much???Dear friend - how is it possible?Do the Doctors be directed like this where you are at the problem end.Well there is no way to remove this without surgery.Yes, you can be helped_ the best surgeon can give you the best scar, may not be visible later on. If the swelling is looking better on the face than the mark- do not get operated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nausea, profuse sweating and dizziness in a diabetic?\n\nMy husband is 66, insulin dependent diabetic and controlled blood sugar who had a 90 minute massage this morning and following the massage, he felt dizzy, was pale, clammy and sweating and felt nauseated. His blood pressure was 148/74 and pulse was 78.",
    "doctor_response": "Hello,From the description, it appears like a fairly severe hypoglycemic episode. Was the blood glucose checked following the episode? Sometimes in patients on insulin and with a very strict blood glucose control, there can be such hypoglycemic episodes. It is better to give a closer look at his diet, blood glucose levels and Insulin dosage. So, as to prevent further such episodes.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Prabhakar Laxman Jathar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the healing time after bone grafting after breaking tibia and febula?\n\nMMy name is manish.I am 22 years old.In 5 september 2012 I broke my tibia and febula falling from bike.Then I went to a oppration.tibia is treated with im nail with four secrews.but there is non union in my tibia.I met the orthopedic doctor.he told me that theu diynamised the tibia.but my tibia still remains non union.after nine month I met another orthopedic surgion.he advised me go for bone grafting and im nail is remove.in the place of nail he oprated with plate with six secrews.the oppration held 9 july 2013.febula is also cut by the doctor.how much time to heal it properly.there is also swelling and pain in my tibia.can i walk properly again.please give me some suggestion how I get well soon",
    "doctor_response": "you will be walking on your feet soon normally but i tell my patients to be patient in case of tibia as blood supply to tibia is very less as compared to other bones that's why tibia heals slowly as compared to other bones. moreover do consult with your physician regarding infection of your tibia. if it is infected then it may take some more time otherwise with plate and screws you will be advised to start weight bearing too",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the difference between IntraLasik and Contoura Lasik technology?\n\nHi doctor, What is the difference between IntraLasik and Contoura Lasik?",
    "doctor_response": "Hi. IntraLasik is a method in which the corneal flap is taken by laser. In regular Lasik, the corneal flap is taken by a mechanical device which has a metal blade. The rest of the procedures are the same. Contoura vision is a personalized Lasik in which the laser correction is done according to the size and specifications of the individual's eye. It is something like getting a shirt specially stitched to the individual's size, whereas regular Lasik is like buying a ready-made shirt.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does my father s prostate and kidney condition need an operation?\n\nmy father had his ultrasound this morning.based from it his prostate gland is enlarged 6.68x6.94x4.44cm volume is 107.7cm. impression indicated the following: infected cyst vs nodule,left kidney, cystitis and prostatomegaly grade 5 with concretions and suspicicous nodules. may i ask if he needs an operation?",
    "doctor_response": "HelloThanks for query .Ultrasound scanning of your father has revealed 1) Gross Prostatomegaly and suspicious nodule in prostate2) Infected cyst or nodule in kidney .Considering the findings in report He has prostatomegaly with nodule which could be a cancerous nodule 2) The cyst in the kidney (Infected ) In a given situation he has to undergo few more tests to establish diagnosis .Please consult qualified Urologist for clinical and digital rectal examination and get following basic tests done to confirm the diagnosis.1) Urine routine and culture.2) Ultrasound scanning of abdomen and pelvis3) Serum PSA.4) Ct Scan of abdomen and pelvis .Further treatment will depend upon result of these tests and final diagnosis.Looking at the large sized prostate he will need to undergo surgery /Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for throbbing back pain\n\nI am a 22 year old female. I felt fine this morning, but earlier today I walked around my office and then sat back in my chair. All of a sudden I got a throbbing pain in my left lower back. I put a heating pad on it and it didn't really make a difference. I took an advil, but then realized I ate it on an empty stomach. I quickly ate some yogurt, but still felt nauseous. I tried to eat chicken noodle soup for lunch but it just made me feel more nauseous. I eventually threw up in the bathroom, probably from taking advil on an empty stomach. I finally took the heating pad off because it was making feel like I had to pee. I went home and tried to sleep it off, but had to keep going to the bathroom because I thought I had to pee. I'm now trying to eat toast that way I can take some meds and not get sick. Where do you think this pain is coming from and will the ibuprofen I'm going to take make a difference?",
    "doctor_response": "Hi,The pain is most probably a muscular pain but however it could be from a pinched nerve too. It should settle using Ibuprofen, but I would suggest over-the-counter Tylenol for the pain as it does not cause the side effects coming from using Ibuprofen. I would however suggest that you not take either of them on an empty stomach. Also it would be prudent that you abstain from alcohol, if at all during the period of your medication. You could also use an antacid before you have some food.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump in the throat?\n\nI ve been going though the last couple of weeks being more conscious of my swallowing than previously. There will be times in the day when I feel like there s a lump in my throat and when I swallow it subsides for a while. I have no pain and there s no coughing or bleeding but there is a recurring feeling of being swollen around my Adam s apple periodically. It doesn t affect my singing as of yet and I can breathe normally but I ve never had this before for this long a time and I m just wondering what it is. Please let me know what you think. I would appreciate a professional opinion because I automatically start fearing the worst.",
    "doctor_response": "Hi.Thanks for your query. If you are a female patient the chances of this problem being globus pharyngeus are the most probable. But to prove this I would advise you the following:::-Laryngo-pharyngoscpy by an NET Surgeon to ascertain about the real presence of any pathologic lump / swelling.-MRI of the neck to see that there is any growth / mass or any other abnormality.If the above tests are normal, it is obvious that the stress and anxiety have taken a toll to give you these symptoms; you can swallow, sing well, there are no other symptoms , why to worry about cancer so much, there may not be any,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen inguinal lymph node after having flu shot?\n\nHad flu shot 2weeks ago after had 103 fever now inguinal lymph noe swollen since two weeks and now another one growing went for cats an they said unclear and ultrasound indicated lymph I'm on amoxicilon and I get very tired not sure what's going on???",
    "doctor_response": "Brief answerAcute lymhadenitisDetailed answerReactive lymhadenitis is common after flu so you need not to worry it will subside in due course of time  within next 2 weeksyou are having a proper antibiotic for that I would like further details to help you better like dosage and side effect if you are facing anyHope this helps you  Thanks for using Health care magicBest of healthRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of abdominal pain?\n\nhii doctor i am 23 yrs old i have pain in my upper abdomen radiating leftwards and at same place in the back and my endoscopy shows no ulcer formation bt i hav this pain from past 2 months i'm sacred of pacreatic cancer as nothing was shown in endoscopy",
    "doctor_response": "Hi.This is good that endoscopy is normal.Secondly do not worry as most of the pancreatic cancers do not cause any pain and does not occur so early.Just to confirm the diagnosis of pancreatitis or so , please go for ultrasonography to start with and CT scan to confirm.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the ability to speak only few words at the age of 6?\n\nA friends son iis 6 nad nnot speaking. despite going to speech therapy, the child only speaks some words and not in complete sentences. Yet he mimics the actions of others well including his older sister. Is there a riisk of autism here or some other learning impairment?",
    "doctor_response": "Hi,Thanks for writing to Healthcare magic.I hope this child has under gone hearing test, and a proper development assessment test by a Pediatric development specialist?If not its imperative that he does undergo it.  Thanks. If you have any more queries I am happy to answer them. Else please rate this answer and close the discussion",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I get chest stabbing even after my cough subsides. Why?\n\nHello doctor, I had a cough since the start this month, but it was just a dry cough. It has got severe when the quarantine started and I could not schedule anymore consultation. I had taken mucolytic which gave me severe coughing but it released a lot of phlegm yellow or greenish color. I tried calling my friends who are nurses and I got a doctor whom I consulted and gave me prescription of Co-Amoxiclav. I had no fever, chills and night sweats. I have a chest stabbing pain for more than two weeks now. Today, the pain level for me is 5-6 whenever I clear my throat or cough a little. I have taken Co-Amoxiclav 625 mg three times a day for the past one week, but the pain did not go away. But my cough stopped and I had just very few episodes of coughing usually when I wake up. My throat does not hurt or itch anymore but I am more bothered by the chest pain now. The inner pain started before just below my breast on the right, but now it is nearly on the chest itself but still on the right. Please advise.",
    "doctor_response": "Hello. The most probable cause for the chest pain, in the setting of the problems described by you, is due to muscle spasm on account of indiscriminate coughing when the infection was present. Now the phlegm is less, signifying decreased infection or healing. What you need are some muscle relaxants and pain killers. Couple this with some balm application locally followed by steam and hot fomentation. Take adequate rest. This shall pass, nothing to worry. If you need any further support or clarifications do not hesitate to contact me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes throat infection?\n\nwhat can i do for my 9 month old baby with a sore throa. her voice is a little scratchy and when she breath, you can hear like she as mucus in her throat. she also cough here and there too. what can i give her to help her throat get better? food, drinks, etc...",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query your baby have symptoms of throat infection which is leading to scratchy voice as well seems to be due to sore throat due to bacterial or viral infection. It is leading to upper respiratory tract infection. Need not to worry. I would suggest you to do warm saline gargles 3 to 4 times a day. Take ibuprofen one tablet twice daily. Milk boiled with a pinch of turmeric taken at bedtime for can be relieving as it has antimicrobial properties. You should avoid spicy food. Visit pediatrician once and get it examined and start treatment after proper diagnosis. Take soft foods to avoid irritation to the throat. Throat lozenges one every 4 hours is helpful. Drink luke warm water throughout the day as it can provide relief. Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant hissing sound in head and in ears?\n\nHi, I noticed 2 weeks ago a constant hissing sound in my head or my ears. Not sure which one. I also have stifness on the right head side of my neck for the last 3-4 weeks. I exercise daily but sitting in front of the computer doesn t help. The stifness remains. Not sure of the hissing sound is related to the stifness in my neck.",
    "doctor_response": "u r having tinnitus. Most of time it is secondary to internal ear problem. if it is synchronous with ur heart beat then get MRI brain done to rule out central cause for these symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in lower right abdomen?\n\npain on lower right abdomen (below navel)my wife is having a charp pain in her lower abdomen on the right side.  much lower than the belly button.  not sure if it's too low to be apendicitis, sinse i understand its located a little higher than the navel.  Her leg is hurting (right) my wife is having a charp pain in her lower abdomen on the right side.  much lower than the belly button.  not sure if it's too low to be apendicitis, sinse i understand its located a little higher than the navel.  Her right leg is hurting left of the hip joint.  she seems to have swelling and tenderness on the spot.  she does seem to have a bit of naussea, but fever and other symptoms are in common with a viral bug currently in south Florida.any idea what this could be?thanks!",
    "doctor_response": "Hi.Thanks for your query and elucidate history.I can think of psoas abscess , the muscle at the back area of abdomen at a point you have explained with the pain in the right leg.Please go for a CT scan and the diagnosis will be clear including that for the appendicitis , inflamed lymph nodes and so. Need a treatment according to the reports one gets.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain on right side of stomach, rib cage,swelling, chest pains. Taking medication, only immediate relief. Any ideas?\n\nI had severe pain on the right side of my stomach and under right rib.swelling and sharp pains in that area.  The pain also comes out the right side of my back at times.I do have chest pains more often now.I have heartburn everyday but now my pain has gotten really bad and I have pain meds but when I take them I only get a couple of hrs. of relief from my pain that's between my stomach and right ribs.Can you please tell me what my problem might be ans should I be concerned about this?",
    "doctor_response": "Hi ! As your pain is severe at times, it needs to be investigated  properly. I think you should get yourself reviewed by your family physician who after examining you clinically, may advise for an ultrasound abdomen to rule out any gall bladder stone/disease, liver diseases, kidney stone, or any other intra-abdominal pathology for further management. Wishing you an early recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How is OCD treated?\n\nif I have contamination OCD that spreads will doing erp really help me? and if ssri's raise serotonin and I have a mutated gene that as a side effect causes low serotonin why not raise it till I come close to serotonin syndrome then just back down from there",
    "doctor_response": "HiThanks for using healthcare magicSerotonin syndrome usually happens at sudden withdrawal or high dose of SSRIs. In your case, chances of getting it is very less, because you have just started the treatment and your dose may be in therapeutic dose. In that case, there is nothing to worry about that. Jut take your medicine and control your OCD symptoms with drug. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe persistent pain at the back of the head?\n\nHi I am 50 years old male suffering a strong permanent pain in my head just on the back taking nurophen tablet to relef the pain but not really help my gp don t know what to do visit more than 5 times on x ray witch he refer me to get it From the hospital the X-ray show on my neck a pression on the Nerf from the disk to the brain I heard the sound of the bones when clicks and the pain on my brain is painfully especially at the night he refer me to a consultant and the appointment is on the 10 th of July any help or advise will be a great appriatiate thanks",
    "doctor_response": "Hello!Thank you for asking on HCM!I understand your concern and would explain that your headache seems to be related to occipital neuralgia. This is an irritation of the occipital nerve from chronic degeneration of the cervical spinal column. An X Ray study is not the best test to determine these changes. So, I would recommend performing a brain and cervical spine MRI study to examine better this region and exclude possible discal herniation. Meanwhile, I would recommend starting treatment with carbamazepine or topiramate for the pain. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for the lump in the vagina\n\nI have an extremely painful lump in my pee hole, and my entire outter vagina is red and swollen, I put basil ine on it and it helps with the redness but it s still swollen kinda itchy and kinda burns. Also my pee hole had white chunks coming out. If you could give me an idea on how to treat it or what it is that would be very helpful",
    "doctor_response": "Hi,It is likely you have a Barthoiln's cyst that has become infected. This is a type of cyst that occurs in this area. It is not serious and can be easily treated. I suggest you bathe the area regularly in warm water to ease the discomfort. See you doctor to confirm diagnosis. You will benefit from antibiotics. I hope this is of help. Regards,Dr K A Pottinger",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for partial seizures despite taking Keppra\n\nMy my daughter is 28 yrs and she start getting light partial seizures when she was 23 and she lost consciousness a couples of times and Doctor put on seizure medicine and she got better for some time maybe getting seizures twice per month , however now she does not loose consciousness and getting twice per day when she wake up or later in the day but they last 3 O 4 seconds and she is aware but I m concern that she getting it more often and feels like a song in her head or something... I m not sure if she getting better or worse since she does not pass out anymore and is able to control it... She is taking Keppra maximum dose!!",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Evaluation like epilepsy protocol MRI for temporal lobe involvement and EEG is advisable. Drugs like Lacosamide or Carbamazepine/Oxcarbazepine should be added to Levetiracetam. Regards Dr N Kumar Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any remedy for late stage 4 colon cancer, profouse and constant bleeding with bad heart?\n\nMy father has late stage 4 colon cancer and is now in a palliative hospital...the tumor is so large that a colonoscopy could not show anything because the scope could not move past the tumor...he is bleeding constantly and had a blood transfusion and then 4 days later need 2 more bags for another blood transfusion....his count is 85 and lost it all right away in those 4 days...other symptoms are bad heart and vascular demitia....so hard to see him like this....what does this mean",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern for your father and sorry to hear that from the history given here, if the condition malignancy in advance stage then nothing can be done I guess he must be on chemotherapy and that is the only hope he has, some time natural remission taking place and patient could complete the average life, hope this information helps you, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair loss\n\nIm 17 years old i had an abortion last year and was taking contraceptive pills also after 3 or 4 months later my hair started To fall and its been a year now im having hair fall In huge amounts my periods aren t normal first 2 days of periods the flow is normal and after that there are few blood spots and they end in 5 days I m Really Worried because of the extreme hairfall please answer this question ASAP.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Irregular periods do suggest you could be having a hormonal imbalance, which further can cause hair fall. I suggest you visit a gynecologist who would ask you to do few hormonal blood tests and also scan your pelvis to visualize your ovaries and uterus. Apart from that: kindly start consuming multivitamins with biotin daily. Increase your nutritional quotient as well. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with cervical and thoracic disc herniation, neural foramina stenosis, shoulder blade osteophyte formation with a ridge, have arm weakness and numbness with neck pain, advised cervical discectomy. Suggestion?\n\nIm43YEARS young and have been diagnosed with cervical and thoraic disc herniatios and neural foramina stnenosis also i ond left shoulder blade osteophyte formation with a ridge. I get left arm weakness ,NUMBNESS and severe pain in neck down my arm. I received 8 epidurals between the neck and thoraic spine with temporary relieve.Im in physical therapy which only provides relief right after they do it. my doc want to do a cervical discetomy is that now the best way to go",
    "doctor_response": "Dear friend , if conservative measures are not helping, modern spinal microdiscectomies come to help. If an expert is advising surgery, then in good surgical hands, at good high turnover centres, discectomies could help, esp. if you have distressing neuro signs. I am not a spine surgeon. but looking at the results of surgeries at our centre, I think they should help you. I would advise you to go by your specialist's suggestion. thanks for being at HCM and hope to keep posted on your progress. good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intermittent squint of eye?\n\nMy 15 month old has had an intermittent squint of only her right eye for the past 3 weeks. It is not associated with anything, and she sometimes does it once, sometimes multiple times in a row. It doesn't appear to hurt her. I took her to a pediatric Ophthomologist, and he did not see any problems, but it continues.",
    "doctor_response": "Both eye coordinatation generally  take time till the age of 3 to 5 years.  If you taken advice from Pediatric opthamolgist. And he said not to worry then i think no to worry",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will kidney problem be related to itching in the hands?\n\nI recently had percutaneous nephrolithotomy surgery to remove around 100 kidney stones from my left kidney after an infection put me in hospital,during this it was found that I have duplex kidneys on both sides and a narrowing of the ureter in the left kidney. The operation was succesful but during that time and ever since the surgery I have had itchy hands and feet during the night. There is no rash,lumps or peeling or any other signs or symptoms other than extreme itching. I am 33 and have noticed since my operation I urinate quite frequently compared to what I did before op,weight loss,tiredness and itchy hands and feet. Also the cause for the stones was put down to the narrowing of the ureter and I have to return for a scan in a few months to make sure the stones have not returned. I was wondering if these symptoms may be related to my kidney problems even though I seem to have no other issues with my kidneys at the moment.",
    "doctor_response": "All those symptoms which you have mentioned in that question,  I don't think related to the surgery... Your itching,  weakness and weight loss is not related to renal stone disease..  If urinary frequency is significant,  can do a uroflowmetry..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do small bumps on penis and around the pubic are indicate?\n\ni am 24 years old.. my height is 5 feet 8 inches and my weight is 63kgs. i hav recently observed small bump on the penis and four bumps around the pubic area. it does not pain,no rash or blister is seen but it itches sometimes. can u tell me what the problem is and which doctor should i consult???",
    "doctor_response": "HiGREETINGS Very difficult to comment without seeing pictures. If it is itching you need to rule out fungal infection.Or else it could be multiple sebaceous cysts on the scrotum.You need to consult a skin specialist. Hope my answer helps you. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication to avoid brain damage when suffering from viral fever\n\nhi my nephew in Egypt has a virus in blood make a high fever and the doctor said no medication except tylonol for fever and he said he can take vitamin omega-3&6 300 ml for brain to no be damage because of this virus what is the best formula of original brain formula I can got him he said over the counter thank u",
    "doctor_response": "Hello,Thank you for your contact to healthcare magic.I understand your health concern, if I am your doctor I suggest you that brain damage only occurs in virus infections when the fever is high. So taking paracetamol will reduce the fever and brain damage. Vitamins will help in reducing damage by antioxidant activity. So prescribed treatment is correct and take treatment accordingly. I will be happy to answer all your future concern. Thank you,Dr Arun TankInfectious disease specialist.Wish you a best health at health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Diogenes syndrome\n\nHi, may I answer your health queries right now ? Please type your query here...My mother in law may have Diogenes Syndrome. Her house has piles of rubbish and items many feet high, with tiny paths between them. He kitchen is squalid and filthy. She is rude and aggressive and has gone to extreme lengths to control her son - mainly financially - only letting him have a cheque book on the family farm 2 yrs ago (he is 46) she screams and shouts at me at any opportunity when I attempt to take him from the home (which she owns and will not relinquish) My husband says it is like abuse in the trap between her and I , what do I do?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. I do not know how you diagnosed your mother in law. Diogenes syndrome, also known as senile squalor syndrome, is a disorder characterized by extreme self-neglect, domestic squalor, social withdrawal, apathy, compulsive hoarding of garbage, and lack of shame. That is a catatonic schizophrenia stage.Here your mother in law is acting just like so many other mother in laws. If your husband is 46, how old is your mother in law? As young and wise person you should understand your mother in law and take her to a counselor.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a numb patch on the shin after a fall?\n\nI fell on my shin a couple weeks ago and a little patch beside the cut is completely numb and when I touch it it feels like I m touching someone else. I put peroxide on it a few times. I picked the scab and it bled for a while but than I noticed it was like a hole and it s still there a few days later",
    "doctor_response": "Hello, Since you have numbness a small nerve may have been damaged. I don't think that there is something you can do for it, it should improve by itself with time. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from esophageal cancer. Finished chemotherapy. Pain in the abdomen, swollen abdomen. Not responding to morphine. Any other options?\n\nMy freind has stage 4 cancer of esophogus he has finished his chemo last september but in last few weeks things have got bad he can still swallow but does not want to eat he is in so much pain in abdomen area his abdomen is really swollen he had doctor in at him early this morning. The doctor said it is fluid inside his abdomen he gave him a injection of morphine as his pain killers were not helping him and a script for oromorph is he in final stages of life",
    "doctor_response": "Hello! Thank you for the query. Abdominal fluid (ascites) is usually an indication of generalized cancer. Therefore he seems to be in the final stages of his life. Usually it takes about 6 months from advanced esophagus cancer diagnosis. The most important for him is to make it as easy and painless as possible. He should receive from his doctor Morphine or Fentanyl patches so he wont suffer pain. For the appetite he should receive steroids (Megace for example). If the esophagus will become narrow so he wont be able to eat, endoscopic prosthesis implantation   should be helpful. Hope this will help. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "what causes metallic taste in mouth while suffering from upper respiratory infection?\n\nI have an upper respiratory infection and my doctor has put me on 500mg of biaxin. I ve been on it for 4 days now and today have a metallic taste in my mouth, plus I just had a spell of jittery anxious feeling. I did have a glass of red wine about 2 hours ago and just had a piece of toast. What is this. The jittery feeling is subsiding now. Should I continue to take this medication tomorrow and call my doctor on Monday or should I stop taking this?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Continue to complete the course as advised by your doctor. Do not have wine as some medicine do interact with alcohol. Also have some antacids as GERD also cause these symptoms.Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Constant lower back pain radiating from buttocks to heels, aggravates on heavy lifting, no relief with exercise. Solution?\n\nGood Morning Sir, Iam Naresh, Age:26yrs, from Khammam, Andra Pradesh. A job holder have no physical hard work. Am suffering Lower Back Pain since three months. As i know lifted more weight causes this pain. Earlier Pain started at right buttock and shifting to left to right day by day. I Consulted Dr.Murali,MD., D.M.( Neurology ),@Khammam. He examined me and replied that it is a disc prolapsed @SLRT45degrees, it is first time na, so am not suggesting MRI and do the small excersize daily you l get relief. But I dont get any relief. Pain some times passes from buttock to leg heal when long sitting. I can walk freely, Can sit & Stand without any help any where but cannot bend forward as like as my earlier days. One of my friend is a Physiotherapist examined me and told me it is look like disc degenaration, or Sciatica . Please reply me and suggest me Sir. What I Have To DO... Naresh.",
    "doctor_response": "Hi Welcome to HCM. It looks like you have cord compression and it is wise to consult a NEUROSURGEON/SPINE SURGEON/ORTHOPEDICIAN. MRI is probably necessary as the pain is getting worse. Get well soon. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause pain in my left heels since 3 months?\n\nHI SIR,my name is sana and i m from pakistansir my problem is that i feel pain in my left foot heel from 3 month now i checked it col doctor adnan qadir in CMH hospital pakistan he advise me 3 medicine 1 cytopan 75 2nd is zyloric-300 3rd is neuromet. what did u say",
    "doctor_response": "hithis can be due to weight, or thyroid problems,calcium deficiency,or any local trauma to that area.all these medicines are fine to help you outcold compression, physiotherapy, limb elevation,crepe bandage will also help.all the best,take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "My brother is severely depressed but he is treated as a mental patient\n\ndear doctor i am really upset .my brother aged 23 is a mental patient and is undergoing treatment for 6 long years without any improvement.....instead his condition is getting worst.he was otherwise a normal person but wrong treatment has made him worst so much so that he is suffering a lot now....earlier he only got depressed but now he hurts him,throws tantrums,once he even bite my mom when he got angry...he is not eating anything and is hurting himself....he has even got a tendency to commit suicide ....we went to Ranchi and Vellore but they said that he is not a mental patient but a patient of severe depression .....please help!",
    "doctor_response": "Hi Saswati, From the symptoms you have given, it appears that he may have something called as \"Personality disorder\" in addition to his mood/depression problems. This kind of problem needs long term treatment and family members will be an important part of this treatment. NIMHANS in Bangalore, Institute of Psychiatry ranchi, CMC vellore.....are few names that jump to my mind which can handle this kind of problem effectively. As I said this will need lot of assessment and therapy is long. Please ask for a \"Personality disorder specialist\" to assess him. With regards to admission, it will be only needed when the risk to himself or others is very immediate or very great otherwise, we always like to manage these kind of problems in their own sorroundings. Management will include medication but psychological/talking therapies play the biggest part and most lasting effects. Bottomline, please get someone more experienced in personality disorders to assess him. Good Luck to both of you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever in children despite taking Paracetamol\n\nMy son 13, had high fever with chill day before yesterday night. He vomitted as well. But the vomit comprised of undigested food of the morning. He had also pain in abdomen. He was given paracetamol. Still fever is being felt soon after ceasing of the effect of paracetamol. Doctor has suspected Typhoid and to go for an widal. May it be malaria? He is having very mild fever for around 20days, though he is active and not caring for that. Pharyngitis like infection in throat with red/white patches are there. We are only feeling the fever. Please advise.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. based on your history fever looking like..viral feverIn vial fevers>>>inter febrile period child active where is in bacterial illness>>child sick look during inter febrile illnessBut your child had fever since 20days better to do some work Up investigations: cbp crp ESR widal complete urine examination. Urine c/s smear for Malarial parasiteUSG abdomen. Please post reports. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach cramps,diarrhoea with low white blood cells?\n\nMy 6 year old has bad stomach cramps, pooped on himself 6 times in 4 weeks, Some BMs hard some diarreah, Stool samples say elevate white blood cells in some samples. blood cbc says low white blood cells. waiting on results for celiacs disease. they are doing more stool samples and also blood in stool samples too on a card.",
    "doctor_response": "Hi, this could be stomach infection or celiac disease. Since, there are more white blood cells in stool sample it points more towards infection. I think till results for celiac disease are awaited, child should be started on antibiotics. I hope this has helped you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for foreskin soreness post intercourse\n\nHusband is type 2 diabetic and uncircumcised. Had balantis in past and used cortisone cream. Left dry patches and when foreskin is pushed back for sex he gets sore in a couple of hours. Also sometimes has problem pushing back foreskin. Any suggestions?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Your husband is suffering from phimosis which is tightening of foreskin over glans penis due to swelling of glans penis due to balanitis or any other infection. Since your husband is a diabetic and he would get this balanitis again and again due to weaken immunity due to diabetes. I would suggest you to get him antibiotics and anti inflammatory for this time  and ultimately get his circumcision done which would be the best option in the scenario. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for colon polyp sever displasia?\n\nI ve been told I have colon polyp sever displasia. I have had two colonoscopies, one in Nov. 2013 and another March 2014. I had another back in Feb. or March of 2012. I am being refered to a surgen now because the GI doctor said the cells are deeper than he can safely remove. My question is how bad can this be?",
    "doctor_response": "There are basically 2 types of colon polyps. One that have a very low risk of turning into cancer and the other that have a high risk. Severe dysplasia is the pre-cancerous condition that precedes the formation of cancer. It always develops into cancer if left to grow. Hence it needs to be removed either endoscopically or surgically. If the endoscopist says that the cells are too deep then you might have to undergo surgery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for beads on scalp and hair loss\n\nI have these white hard tiny beads all over my scalp and I am having ALOT of hair loss its more like shedding but to the point where everyone points out im loosing my hair. I use selsume blue shampoo and head and shoulders conditioner it also itches a lot. what could this be? and how do I fix this? I have already bought a wig cause this is getting so bad. :/",
    "doctor_response": "hi, welcome to HCM,you are suffering from seborrheic dermatitis of scalp & this is causing your hair fall also.rinse your hair and scalp with ketoconazole shampoo (Nizral lotion). apply gently and leave it for at least 5 minutes.apply antifungal, Zoderm E cream at night and wash in the morning. this will clear your dandruff faster.take tab biotin +PABA once daily.this will help you definitely.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the redness in eyes of a 6 month old due to bleach be a matter of concern?\n\nHi we were throwing an empty bleach bottle away when it dropped and fell onto my 6 mths grandaughter s face near her eye. she has a red patch where the bleach landed her eye is slightly red but she isnt upset or cryng with pain we have washed her eye out and her face do we need to do more because of her age?",
    "doctor_response": "Hello,If the bleach didn\u2019t spill in her eyes then nothing to worry. However, if the eye is reddish and watering continuously then you need to consult ophthalmologist.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Khan Shoeb Mohammad Sher Mohammad",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for constant cough increasing at night\n\nhi sir.i have dry cough since 1month.cough wil b more at nite tim nd when i go out..i have used 1ST DOSE t.altrocin500 wid febrex plus 6tabs mrng nd nit.2ND DOSE t.azithromycin500 wid sinus-77.3RD DOSE-t.zifi20010 mrng nd nit wid t.lazine-m nite bt 10TABS.  but i didnt get relief..so ystday i went for diagnosis ESR,CBP,CUE,CHEST X-RAY.ESR- 1ST HR 10mm ,2ND HR 22mm ESINOPHIL-06,,X-RAY P.A VIEW NORMAL.plz suggest me a syrup R TAB ....THANQ SIR",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Coughing at night is mostly due to allergic asthma. Asthma don't picked up by routine blood reports and chest x ray. PFT (Pulmonary Function Test) is must for the diagnosis of asthma.So consult pulmonologist and get done PFT. If PFT is showing obstructive defect then you will mostly improve with inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. A 72-year-old has an uncontrollable shaking of his hand. How can it be treated?\n\nHello doctor, My father who is 72 years old has a problem of uncontrolled shaking of his right hand for the past three years. The problem has increased over the years and now he finds it difficult to hold the toothbrush also. Some works he can do without much difficulty like riding a scooter, sweeping with his right hand etc. But this problem is only increasing. He has consulted a neurologist after my insistence to rule out Parkinson's. The doctor assured that it is not that and gave some medication. This was about eight months back. But, there has been no improvement. My father does not have any other ailments. Of note, he only had a stent operation three years ago. Please let me know what is this problem called, how to treat this and is it curable?",
    "doctor_response": "Hello. Based on the symptoms you have described, your father likely has an \"essential tremor.\" This is a very common neurological condition affecting 4% of the elderly population. Yes, it is not Parkinson' s disease but it has to be differentiated from Parkinson's disease by a neurologist especially who is trained in movement disorders. Movement disorder neurologist is additionally trained in conditions like essential tremor and Parkinson's disease. Please do not hesitate to ask any further questions. For more information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can depression along with appetite loss be treated?\n\nI ve been on trintellix for almost 2 weeks. My depression isn t going away. All I seem to do is sleep, not much of an appetite, constipation and feeling weird in my head. I have no interest in anything. I guess it s all about money, nothings free. Even when it comes to some ones life.",
    "doctor_response": "Hi and thanks for question. u have symptoms of depression and anxiety and u r on treatment since 15 days, i will tell u that psychotropic drug effect start with 10-15 days of continues intake. if  u took for 15 days than i will suggest u take for more 10 days than if it not works than we will start add on therapy or change medication.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headache and stomach ache?\n\nHello, my name is Melissa. My son has been laying around for about 2-3 days and complains of a headache, and stomache ache along with a cough. Plan on bringing to dr tomorrow, but until then what could I do for him? Any sugestions or possible idea of what he has? My son is 9 and weighs roughly 85lbs and im guessing 4ft 5",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query your son is having symptoms of headache and stomach ache which seems to be due to food poisoning/ acute gastroenteritis caused by viral infection and electrolyte imbalance in body. Avoid taking any sharp and spicy food. You should take plenty of fluids. You should give Ibuprofen to child along with proton pump inhibitors as well. Give your child banana on daily basis and light food. I would suggest you not to panic at all. Drink plenty of fluids to rehydrate yourself. Visit general physician once and get it examined. You should go for blood tests as well and start treatment after proper examination. You should start treatment with combination of fluoroquinolones and ornidazole. Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I have periodically recurrent glans penis rash?\n\n26 male. I have a periodically recurrent glans penis rash. It's not disturb me at all, only cosmetically (no pain or itch). Looks like small red spots (1-7) suddenly appears for 6-10 days. First barely perceptible, than color become more intensive & finally disappears. It's not vesicular or peeling. I'd find the same pictures of it in the Internet, but people with the same problem don't get any clear diagnosis at medical forums. It's not looks like genital herpes, syphilis or candidiasis.  The most close is balanoposthitis.",
    "doctor_response": "HIWell come to HCMThe nonspecific skin condition is likely on tentative basis this can be tried with steroid and the best option would be Mometasone, in all the skin lesion clinical examination is must for the diagnosis because this is kind of art of looking and recognize the disease, if symptoms does not improved then clinical examination is must, hope this information is helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can neck pain be treated?\n\nhey I m a 30 year old Women That has been having neck pain for the past 15 years. I ve been having neck pain and was not able to move my neck backwards. 15 years ago someone fell on my neck while I was swimming and since then I have been having this terrible pain and not been able to move my neck backwards. I went to many doctors before but I was sure they didn t know what i had exactly.",
    "doctor_response": "Hi, You need to consult a spine specialist for this complaint. He needs to further evaluate you clinically as well as will advise some scans to get to the base of the cause. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Tejas Killekar, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does smoking weed while taking clomid cause any problems in conceiving?\n\nHi Doctor, thanks for this opportunity, myself and my husband we have been trying to get pregnant for the last 4 months. We did some test and discovered that he has low sperm count. He was placed on clomid, but he smokes weed. Please would this affect the intake of the drug?? Thanks.",
    "doctor_response": "Dear Member,Thanks for writing to healthcare magic.spermatozoa are very sensitive to any oxidants. smoking, alcohol, tight pants, varicocele all cause the low sperm count.I would strongly recommend that all habit forming drugs be stopped and also he should take antioxidants like lycopene, co enzyme q 10. diet should be rich in green leafy vegetables.thanks.dr bhagyashree",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long will eczema in the whole body take to heal completely?\n\nhi, my child is 3yrs old and she is suffering from eczema for the past 2 months.first it started at the back of the knees as thick scales and gradually spreads over her arms,elbows,stomach,back,upper& lower legs as small coin like patches with itching esp at the backof the knees.undergoing homeo treatment.treated with calc sulph,lyco.seems like itz better in some parts and again spreads in some other parts. now is bieng treated with sulphur for the past two days.how long will it take for my child to cure completely?kindly advice.thanx",
    "doctor_response": "HiIt could take several weeks for skin to return to normal since the eczema is more widely present all over the body.Skin disease takes more time to recover since the epidermal turnover or shedding time is 30 to 40 days.I suggest you to wait for 3 weeks for the skin to clear eczema.Hope that was helpful.Let me know if i can assist you further.RegardsDr.Saranya RamadossGeneral and Family Health Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chairi malformation and idopathic inercraniel hypertention\n\nHi ive just recently been told i have a chairi malformation and idopathic inercraniel hypertention in maybibhad decompression sugery that has faild but they dont know what to do next i need an lp but its not safe as my toinsils are still in my spinal cord but im lossin vision in my left eye what would you suggest",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Well you must have undergone posterior fossa decompression with duraplasty which was not so successful for chiari malformation.You may require partial removal of tonsils along with repeat dural repair.Regarding idiopathic intracranial hypertension you require urgent shunt surgery as there is impending vision loss. Hope my answer helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cancer in left vocal cord. Please suggest me right treatment\n\nmy father is facing the problm cancer in left vocal cord 0.8cm bits plz suggest the best treatment age is 45.right now treatment is radiotherphy is the treatment is right in jaipur hospital.plz suggest me right treatment",
    "doctor_response": "Hi, Early-stage invasive glottic cancer, endoscopic surgical removal or radiation therapy are both equally effective with similar functional outcomes. The treatment modality depends on the patient\u00e2\u0080\u0099s wishes and compliance and the surgeon's and the institution's preferences and experience. Transoral laser microsurgery is ideal for the treatment of early-intermediate glottic cancer with or without post operative radiotherapy. Regards Dr. Naveen Kumar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is there any possibility for long sight along with myopic astigmatism?\n\nHello doctor, I am trying to understand my recent prescription I received and no longer can contact the doctor. OD +0.75 -0.50 x070 OS +0.75 -0.50 x010. These are computer reading glasses. Is it normal, if things are blurry at a distance (even three feet starts to look weird)? On reading online, I read this as slightly farsighted with slight nearsighted astigmatism in both eyes. How is that possible?",
    "doctor_response": "Hello,  Welcome to icliniq.com. In the prescription you have mentioned, there are two components, the spherical (+0.75) and the cylindrical (-0.5 at axes 70 & 10 respectively). The important thing to note here is that reading glasses per se are given to people above 40 years of age. In your case, I feel that this power is probably your distance correction. The doctor might have felt that they may be a bit cumbersome to wear all the time, and would have given a small magnitude of power and probably have told you only to put them on during intense visual activities like watching computers, reading books, etc. An accurate way to say whether these were meant for distance or for reading is to recall how you were tested at the doctor's office in the first place. Suppose they made you sit at a distance and asked you to read out the letters on a screen then these are distance vision glasses. If they had tested the power by giving you a book in your hand and asked you to read it, then these would be reading glasses. So, coming back to your question, firstly, reading glasses are meant only for distances around 33 cm from you for the books and around 100 cm for the computers and you would not be able to see beyond this. Second, the far-sighted power of +0.75 is determined by the length of your eyeball. In case of far sightedness, the eyeballs are shorter compared to normal and in near sightedness, they are longer. The astigmatic power is determined by the curvature of your cornea. In your case (myopic astigmatism) the corneas are steeper at axes of 70 and 10 degrees respectively compared to the rest of the cornea. In Hypermetropic astigmatism, they are flatter in that particular meridian compared to the rest of the cornea. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful lump on the armpit\n\nI have a lump on my armpit the size of a kidney bean. It s been there and painless for about 2years. Then just about 7 days ago, I noticed a thick brown pus with a foul odour coming out of it. I pressed it for days now, and it seems flatter but not completely out yet. Please what do I do?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some enlarged lymphnode due to reactive hyperplasia, tuberculosis,  abscess forming infection or some cystic lesion. You should go for examination and if needed go for fine needle aspiration cytology of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can concor be used for high BP in a renal malfunctioned patient?\n\nI m 49 yrs old and having high blood pressure at the same time i was diagnosed with renal malfunction. my doctors prescribed me concor 5 plus. i ve using this medicines for more than a year. my renal problems get worst, i took took a second opinion from another doctor, he advised me to stop using concor 5 plus. he said not good for the patients having renal problems. i m confused now.....",
    "doctor_response": "Hi,Concor is a beta blocker and safe to use in patients with renal problems, so discuss with your doctor to continue it or use combined Alpha+beta blocker like Labetalol.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Wajahat Baig, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for injury to left knee\n\nMy 14 yr old son had an injury to left knee. Went to Erie got immobilizing brace and crutches. Followed up with orthopedic dr. Ordering an MRI , my sons foot and calf are significantly colder than the uninsured leg. Should I be overly concerned ? Should I mention to dr office in the morning?",
    "doctor_response": "HIWell come to HCMKnee joint is very fragile one and highly vulnerable to injury, in my opinion this need to be taken seriously because internal structure of knee joint like meniscus is matter of concern, and for that better to see the orthopedic surgeon, and explain everything in detail, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and palpitations of the heart?\n\nDuring the past few days, I m experiencing dizziness, palpitations, backaches, shoulder ache, chest pain, nausea, cold sweat. I am diagnosed of scoliosis and having hyperventilation during the past year. I am afraid to go to a doctor because my parents might tell me I m exaggerating. please help. im a 15 year old female.",
    "doctor_response": "Hello,All of the problems that you describe may have common and benign sources, particularly at 15. However, if the problems are persistent and bad enough to cause worry, it's worth the visit with your regular doctor.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. James M Wilson",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated heart rate and coughing?\n\nI m a 19 year old male, 163 pounds 6 0 . I take dexedrine 5mg 2x daily(for adhd) and metoprolol half a 25mg pill at night usually(to lower anxiety and hart rate). I went to the cardiologist last year because I thought I had SVT and I had several EKG s, 1 ECG, a 24hr holter monitor and although my heart rate rose up to 168bpm that day, without exercise, the doctor just told me I was an anxious person with very slight mitral valve regurgitation that needed to be on anxiety meds, so I got diagnosed with panic disorder and put on klonopin. I no longer take them as i ve switched to the Tropol(lowers my heart rate & palpitations which is where the anxiety would stem from but that wasn t taken into accreditation which leaves me to believe even more I had a misdiagnosis). I do notice small things when it comes to health issues but i ve noticed now that i m back on my adhd medicine my heart rate tends to always be over/around the 100bpm range resting, and with exercise can get up to 205bpm(that happens anyway with exercise though if I don t take my metoprolol). I ve developed a slight cough that I can t get rid of, I can always see my heart beating out of my chest, sometimes I get a choking feeling or I can feel my pulse in my neck, and my stomach is a little bigger. I go running or biking at least 2 times a week and I eat healthy, so this leaves me to believe I am either psyching myself out or I have a pre-existing heart condition that the doctors have all shrugged off and I should not be taking dexedrine. However I do smoke around 3 cigarettes a day sometimes less. And if that is the case i m really afraid I have heart damage or something with these new symptoms. I don t have insurance as of last month too so I can t go back to the doctor for the time being. I need to know what I should do and what I may or may not have.",
    "doctor_response": "Hi, This a palpitation (increase in heart rate). It will not cause any damage to your heart, but we must work on slowing it down. Take Bisoprolol once again at a rate of 10 mg per day. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to have crowding corrected in 8 months?\n\nDear Dr, i would like your opinion on a braces matter i went for a consultation for ice braces & the doctor told me i will need only 8 months for the braces . i am getting married first of Sep & i told him if i needed longer time i wont be able to do it. he is a very reputable doctor & wont decieve me for the money as he already has a thousands of patients. i am however worried about the 8 months time frame . is it possible to have crowding corrected in 8 months ? thanks alot",
    "doctor_response": "hello and welcome to hcm forum, i would be glad to answer your query, first of all i , with all due respect to you and your dentist i would like to inform you that being a dentist we cannot assure you of the time period a tooth takes to moves from its original position to a new position. you have not mentioned your age here, but i believe you might be older than 20. ideally, orthodontic treatment is done during the growth years (puberty), but in some cases, we do perform orthodontic treatment  beyond that age as well, as in your case orthodontic treatment can be done but the time & the results cannot be decided before. As the teeth and jaws have developed fully, therefore to retain them in a new position , you will need permanent retainers which hold the teeth in an appropriate place, do not worry these are not visible to anyone. i would advise you to get the orthodontic treatment done but avoid unrealistic expectations, just have faith in your dentist. i wish you good health, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes increase in the level of liver enzymes?\n\nI am a 30 year old female. I have depression, anxiety, adhd, and cronic back pain due to a car accident three years ago. I am on a number of medications to help with my issues. I have recently had a blood test to check my liver enzymes, they are elevated. I go see a gastroanteroligist in a week or so. I am worried. What vould potentially be causing the elevation. Help, Tish",
    "doctor_response": "Hello Ms Tish,How are you? My name is Dr Suresh Raghavaiah. I am a Liver and Pancreas specialist and I hope to answer your question today. I am sorry to hear all the problems you are having.Given your situation, I would assume that the elevations in your enzyme levels is due to the medications you are taking. Most commonly NSAIDs take for pain cause a transient elevation of enzymes, which return to normal if you stop taking the NSAIDs. Also some anti-depressants can also cause elevations in liver enzymes.But unless the enzymes are in the 100s, there is no need to panic as transient elevations are very common and return to normal on their own. I am glad that you are meeting with a gastro-enterologist who will be better able to guide you.Hope this helps and hope you start to feel better.Please do not hesitate to write back for clarifications.Dr Suresh Raghavaiah",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the medication to enlarge the penis size?\n\nI would like to know best way to enlarge  my penis, my length is 3.8 inches  in normal state and after erection it is 4.5 inches.  My wife is not satisfied with my length. I would like to know what could be the  best way to improve the length and girth.thanksPOlen",
    "doctor_response": "HelloThanks for query.The length of your penis both in flaccid state and on erection are within accepted range of normal human being.The length of the penis in flaccid state has no significance at all .It is the hardness of the penis that is important for sexual satisfaction of both the partners .If you do not have other issues like Erectile Dysfunction or Premature ejaculation and if she gets orgasm during intercourse ,there is no reason why your wife should  have unhappy with length of your penis. ..Please consult qualified Sexologist for counselling and to convince her.Please note that there are no medicines that can increase the length and girth of penis.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness in chest on exertion?\n\nhi i have had a tight chest for a week now. i went to the gym today and found my chest very tight on exertion and i felt nausea and lost my sight then hearing for a short time. when i got hame i went straight to bed and fell to sleep straight away i slept for about 30mins. i felt alot better after that but i am now still a little tight in the chest with a headache. i am 29 years of age am fit and eat well.",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query thoroughly .Hope this clears your doubt  .Wishing you fine recovery .Welcome for any further  assistance .Regards  take care .Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .*  Though you are fit , but the chest tightness on exertion is due to your    low tolerance level to exercise .Hope this  will help you for sure   .Wishing you fine recovery .Welcome for any further  guidance .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe dizziness and fatigue?\n\nI am suffering with a strange form of dizziness. I had a stress test,a MRI and MRA of my brain , sonogram of my kidney,blood flow to my legs and constant monitor of my BP. I was taken to ER spent 3 days and was discharged, after 24 hours at home I am worst I cannot move in bed and most difficult to go to the John or to any part of my home.i am definitely not doing well .Please assist.Thanks",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. What is the above test reports have shown? what your doctor told? Possible causes like BPPV, vestibular neuronitis or labyrinthitis or cardiac problem or stroke or TIA or hypotension or hypoglycemia etc. Until examination is done it is difficult to say what it is. Please consult your treating doctor he will examine and treat you accordingly. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have a lump on the left side of the rib cage\n\nI have a lump on my lower left side on top of my ribcage. I have been carring my 2 yr old 35lb toddler always on this side. I have no pain and it seems to reduce when I flex my stomache muscles. I have no pain and I think it's part of my muscle tissue.",
    "doctor_response": "Hi, thanks for sharing your health concerns with HCM!        If I were your treating Doctor for this case of painless lump on the left side of the rib cage , I would come up with three possibilities, these include: 1.\u00a0\u00a0\u00a0\u00a0\u00a0a lipoma or benign fatty tumor or neurofibroma2.\u00a0\u00a0\u00a0\u00a0\u00a0The second possibility is of a benign cyst \u00a0\u00a0\u00a0\u00a0\u00a0like bursa or ganglion cyst3.\u00a0\u00a0\u00a0\u00a0\u00a0The last possibility is of some normal / developmental nodule like muscular nodule or just a feeling for you related to sprains/trauma!\u00a0\u00a0\u00a0\u00a0\u00a0Overall, it is benign and not to worry about this but you could go for FNAC test for confirmation if still worried!Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a stomach infection\n\nHi, I have a 4yr old, that had a bit of a stomach flu for a week, wasn t eating much and didn t have a bowel movement and within this last week has been eating more but still hasn t had a bowel movement...he has been struggling all day today and nothing has happend. I have been giving him plenty of fluids, apple juice, blueberry juice water and nothing...don t know what to do??",
    "doctor_response": "HHello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.\u00a0\u00a0\u00a0\u00a0\u00a0I will suggest using laxatives tablets just for this case or Microklist to ease bowel movements. After that, give healthy foods, such as soup, fiber, kiwi, apple/orange juice, fig jam and an abdominal massage would help his bowel movement. Hope I have answered your query. Let me know if I can assist you further.Regards, \u00a0\u00a0\u00a0\u00a0\u00a0Dr. Elona Dashi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is urispas recommended in case of UTI and swelling in gallbladder?\n\nhi , few months ago i was suffering from the urinary infection , my doctor told me that there is swelling on gallbladder . she gave me urispas , aciloc . i took these medicine for 1 week . that time i got recovered from my problem . but after 1 month i suffered from same problem then i visited doctor again that time she gave me zenflox , i recovered but again i am suffering from ther same problem , now u tell me what should i do ?",
    "doctor_response": "Hi,I can understand your problem.You are suffering from two different disease requiring completely different treatment.If you have pain abdomen,dyspepsia with USG showing cholecystitis than you require surgery for gallstone.you are also suffering from repeated episodes of UTI which should be evaluated by USG KUB,urine r/e followed by urine culture and treat accordingly.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nerve damage?\n\nHI!  I have a 5yr old daughter when she was born she passed her hearing test.  Since then she has had 2 sets of tubes placed in both ears.  She just had her second set about 4 weeks ago.  Well she failed her hearing test at school so of course I take her to her specialist and right tube is still in ear and stuck.  So, her second surgery 4 weeks ago was removal of second right tube and 2 new ones put in and she took another hearing test yesterday and she failed again audiologist stated she has nerve damage.  How did this happen?  she has never been in a major accident.  Could this have been caused by the doctor?  Thanks a concerned Mother",
    "doctor_response": "HIThank for to HCM, I really appreciate your concern looking to the history I could say that the child be having congenital condition of partial hearing loss along with the speech difficulty and so why initially test being carried out, the never damage is not iatrogenic, but could be by birth, hope this information helps you, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white rash between the nose and the forehead?\n\nHi Doctor, I notice that between forehead to nose that have a white skin on it. My friend notice that and think I might have a scabies. I check on internet out and see it said red skin, but I don t have a red rash, just white. I did called the doctor by yesterday and set appointment on 19th Monday. Umm, I see the white skin is grow as slow spread not big skin. I search something from the white skin, but I can t find it. Help me to find What title is?",
    "doctor_response": "Hi, It may be hypopigmentation disorder and detailed evaluation is needed to make a diagnosis. Better to consult a dermatologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough and runny nose in baby\n\nmy 4 months old dougher who I am nurssing had her 2nd set of vaccination last on Sunday she started snizzing and on monday she had very light cough and very light runny nose mainly after she sneesed we took her to her doctor and she said very ligh cold or flu noting to worry about, she has no fever and eats normal with normal poops she is feeling better today but has some cough left, however today in two of her diappor one with lots of poop had very small amount of red blood pease and the other had very small poop almost none but had a spote of red blood as well, what would this be casured by and what should we do. as for the cold and the flu she did not have contact with other kids or anyone with cold we keep her worm did not leave the house so why would she come down with cold or flu is it possible that it is an aleargy ever the fact that 4 months is to young. thank you",
    "doctor_response": "Hi, I have gone through your query and understand your concern. First of all be sure that blood in stools has nothing to do with vaccination or flu. Yes its always an alarming sign though.The foremost possibility in a well doing infant like yours is ingestion of blood from cracks around nursing mother's nipple or bleed from infant's nasophrangeal tract. Kindly examine your nipples for any fissures,cracks etc. For conformation stool can be sent for Apt test.Anal fissures, fistula or Milk protein allergy are rare possibilities with this case scenario.May your child be blessed with health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can sperm count be improved\n\nhi i am 35 years old treated for hyperthyroidism 2 years ago for 18 months with carbimazol and after that i had oligospermia although  before the treatment with carbimazol i was well and i have one child 4 years old now the sperm count now is ranging 1.5 -2-3 millions i recieved a treatment with mukti vit and minirals and clomid for about 6 months and the sperm count improved  to 15 millions but after stopping the treatment the count droped again and the motality became worse would you please provide me any advises or treatment i can use to improve the sperm count",
    "doctor_response": "i will advise u to increase your sperm count through ayurvedic and natural treatment.follow healthy diet plan includes nuts (almond,cashew etc) steamed food in your daily food intake.avoid junk ,fried foods,caffeinated drinks.take a pomegranate daily and add more vegetables and fruits daily. - gives u antioxidant property.do walk for 3 to 5 kilometeres daily.Avoid stress and have a sound sleep.oil bath once in a week. sesaem oil.Medication:Ayurvedic prescription:aswaganda choornam- 3g twice a day.goksura(tribulus terrestris) capsules - 2capsules thrice a day.sathavari legiyam- 3g twice a day.tripala choornam- 3 g at time. anti- oxidant property .i will advise yoga for better healthy life.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe abdominal pain below the rib cage\n\nHi I just started taking dicyclomine for severe stomach pain in my upper abdomen just below my rib cage. They can t seem to diagnose what s wrong. I ve taken a number of medications Prilosec Prevacid protonix. They help for a day or two but nothings really worked long term. I started taking dicyclomine the last few days and that really helps with the pain. 10 ml 3-4 times a day. But I m having some really weird side effects. I feel slow minded. I sometimes can t form words feel really dizzy and disoriented. My heart rate was really low then gets really high. I feel anxious. My hands and feet have been feeling kind of tingly and numb and I feel uncoordinated. I don t know if all this is due to the dicyclomine and I do take other medications including Klonopin and Ativan and I wonder if the mixtureis causing some of this. I wake up really anxious with my heart racing and shaking all over. I just feel really weird and disoriented and it s very worrisome.should I stop taking this medication? My doctor is not very available to talk to. Wonder if these are normal side effects of dicycomine and if they will lessen over time. Pit really helps with the pain. But the cognitive side effects are scary.",
    "doctor_response": "hi,thanks for a brief history of you.first of all you have pain in the left or right side. well let's take it in general as the upper abdomen. below the rib cage. few questions to figure out? what is the nature of the pain? are you having any gastric issue? are you facing any trouble with passing urine? have you undergone the diagnostic ultrasound scan for the abdomen region? if not please go for one as it will reveal any issues faced by the systems beneath the abdominal muscles. Now since you take medicine and feel relief it shoes the medicines are symptomatically giving you a little relief. If you have gastric issues, then your metabolism is slow for which you need to boost up your metabolism. now question comes how? the answer is to perfrom some simple core Strengthening exercises. now if you are facing with any urine related issues like low flow or if you consume less fluid in your daily routine? if that is the case kindly drink more water and empty the kidney at regular intervals. now let's come to the pain , since you said it is below the ribs then I will advice you to do some regular deep breathing exercises while placing the hand over the painful area which will also help strengthen the muscles.what your physician prescribed you was for symptomatic relief from pain. But you need to focus on improving your overall metabolism which can be possible by doing regular exercises.to come to a closer diagnosis you need to under go a diagnostic ultrasound scan. which will help rule out something over there.based on that the next step of medical action can be done. so kindly visit a internal medicine specialist and get this done.in the meantime try doing some core strengthening exercises and some deep breathing exercises. your muscles will become stronger and you will find ease of your pain.physician of your must have surely tried to figure out the issue. kindly provide the full cooperation and under go a scan of abdomen.taking too much medicine without medical guidance is not advisable. as self medication on long term always have side effects and it will lead to gastric issues which will also aggravate the pain in the same region.with the grace of God I wish you a speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure a bruise on the mid thigh which is noticed after a hip replacement?\n\nHad a total hip replacement in 2008, right hip is fine. Had other hip done in 2010. I have noticed a dark like bruise on my mid thigh in the last month or so and it burns quiet a bit. should I call and make apt to see ortho surgeon. It can get very sore if on my feet to long",
    "doctor_response": "Hi, As per the history I do not think this should be anything major. but it is always advised to get it physically checked by an orthopedist so if any doubts are there taking to major issue can get removed. Usually bruises might occur post surgery but in the initial stages and not the latter stages. Also, the pain coming depends on the how better the post hip replacement rehabilitation was performed. Sometimes due to muscle weakness some people develop some pain due to wasting of muscles and over strain of it. But again with a physical examination by the orthopedist and exercise things go well. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for stomach pain even after being hospitalized ?\n\nmy husband as a pain in the stomach nearly to liver side he had a fever also then he was hospitalised for 3 days and was discharged even v had taken scan in the stomach but it was normal after 3days he was dischareged when pain was redueced but now he is having the pain again any remedies for this hi my husband freqently tells that he has a pain in the stomach nearly to liver, 2 weeks before he had sever fever and pain and was hospitalised, even scaning was done to the stomach, but the report was normal. after 3days he was dischared from hospital and for few days pain was reduced but from yesterdays the pain has reduece. regarding this plse give us some remedies.",
    "doctor_response": "Hi, Welcome to Healthcare Magic Forum. Get a Blood work up done to rule out any underlying infection and a second opinion from another physician and get a repeat scan done. Let him take his medications regularly and take Tab. Buscopan Plus, whenever the pain is severe. Good Luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will hep B have to be treated for life with Tenofovir?\n\nHi doc, I must have had hep b since birth, am a male ,50 yrs old today. Viral count is 6million, enzymes levels are normal, I am a pre-core mutant - i dont know what this means though. E antigen is -ve, antibody for e is +ve. I feel well all the time, sometimes only a bit tired. Do you think treatment is necessary coz i dont wish to take tenofovir for life! Thanks for your time, regards, shawn",
    "doctor_response": "hi.thanks for posting query at HCM.HBsAg can not be completely eradicated in a patient suffering from HepB.however, complications maybe prevented if proper medication is taken and proper diet plan is followed. Treatment is advised IF high values of liver enzymes AND high viral LOad on a PCR. if HBV DNA count in PCR are not high, Liver enzymes should be monitored regularly while HepB markers maybe checked every 6 to 12 months.hope to answer your concern.wish you good n sound health.regardsDr Tayyab Mali",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for degenerating back inspite of using Narcotics\n\nper my MRI s that have been taken within the last 1 year, from my tail bone to the base of my skull there is not (ONE)vertibray that isn,t affectived by something in my back that is degenerting in my back. In the insurance I have to take through my former employer, (GENERAL MOTORS) our planted closed in 2008. It is a wish of my to not weake up in the a.m. I m 54 years old, and by somehow dieing (to Get ride of the pain I experence all day everyday and have all documentrs. I m seeing a nerosurgon, tomorrow, the second time I,ve him. I have lived a life with monderate pain, as the doctor treated me with NARRICTS plus sent me through all",
    "doctor_response": "I read your question carefully and I understand your concern.These widespread changes are degenerative chronic changes which have happened over many years. So reversing them is unfortunately not possible. What is aimed is pain control and physical therapy to stop progression. Pain control is achieved through over the counter anti-inflammatory drugs such as Ibuprofen as a first step. If that doesn't work then medication for chronic pain such as anticonvulsants (Gabapentin, Pregabalin) or antidepressants (Amitriptylin, Duloxetine) are used. Narcotics are used only as a very last resort.Local steroid injections or surgery may be done only when there is one particular site which is the source of the symptoms, like a bulging disc or bony spur compressing a nerve root or the cord.I hope to have been of help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Teenager.  Allergic cold, runny nose, enlarged adenoids.  Suggested grommet implantation in ears for filled eustachian tubes.  On augementin.  Any home remedies?\n\nMy son is 14 & has had allergic cold & runny nose for 6 months & now he has enlarged adenoids. His eustachian tube had fluid enuf to impair hearing & the ENT suggested grommet implantation in both ears.can i do some home treatments like steam inhalation& feeding spicy soup ,do u think i may be able to avoid grommets? He has taken augmentin 625 for 2 wks alredy",
    "doctor_response": "Hi thanks for usinh HCM. Allergy, cold, running nose, blocked eustation tube and serous otitis media are all due to allergy responce. So only augmentin wont help. You can try out antihistamine like levocetrizine, nasal spray(nasonex twice daily for both nostrils), enzymes like zymogesic plus and montelukast (I prefer Singulair 5 mg) once daily after discussion with your doctor and this will help him along with steam inhalation and chewing gum(to open eustation tube). Get back with the result after a week of using this for discussion on next line of management.Hope I answered your question. Consult your doctor for further examination and management. Feel free to ask me if you have any further queries.Wish you good health. Take care.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Numbness in limbs, swelling and pain in neck, sinus infection, ear infection, tinnitus, floaters. Due to accident or epidural?\n\nHello, i just gave birth to my son 5 months ago and a month after i had him i got into a fender bender. some girl hit me from behind. Ever since then i have numbness in my hands and feet and swelling and pain in my neck. i have also had a non stop sinus infection and two ear infections. also my tinnitus has gotten worse and i have also gained floaters in my vision. i am wondering uf it is the car accident or the epidural is the culprit.... or should i be more worried?",
    "doctor_response": "Hi,Thank you for posting your query.Your current symptoms could be related to the car accident. There could be a cervical spine injury, which can cause pain in the neck and numbness of hands and feet. This can be confirmed by doing an MRI of the cervical spine.Initial treatment would consist of medications such as pregabalin, physiotherapy and use of cervical (neck) collar.Epidural is not the culprit.Regarding sinus infection and tinnitus, please consult an ENT surgeon, as it is an unrelated problem, which needs to be treated.I hope it helps. Please get back if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to cure severe anxiety, nervousness in social situations and sweaty hands\n\nIm having anxiety issues that i can not get a handle on mostly its in social situations and I lose my train of thought and get hot and sweaty hands. I always get a huge pit in my stomach prior to these situations. Also it keeps me up at night frequently and screws me up more the next day. Not sure if there is a way to treat this but it makes it hard for me to work when im claming up from anxiety all the time if feel like a fool.",
    "doctor_response": "Hi,I read you query and can understand the trouble that you are facing. Going by what you have mentioned, you have social anxiety and can be more than that in form of generalised anxiety disorder. However, the good news is that your condition is amenable to treatment. I would recommend you to visit a psychiatrist at the earliest. Had I been your psychiatrist, I would have offered you combination treatment in form of medications with behavior therapy. The initial choice of medications would be from one of the SSRIs like sertraline. Behavior therapy would include relaxation training and strategies to overcome situation specific anxiety for which regular weekly sessions would be required.Hope this information was useful. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure sperm ejaculation while at sleep?\n\nHello Doctor, I am 28-year-old male, I have been experiencing sperm ejaculation while at sleep for the past 10 years. I have not consulted a physician yet. It occurs when I do not practice masturbation. On an average it happens twice or thrice a month wetting my dress at sleep. Please provide me a solution for this, it has been bothering me for over these years.",
    "doctor_response": "HelloSperm ejaculation while at sleep may be due to reasons like over excited state,inadequate emptying etc.You should try relaxation technique and avoid provocative literature and videos.You should try to be calm and go for yoga,mediation.You should try to engage yourself in your job.You will be fine with above mentioned measures.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat cramping rectal pain post ejaculation?\n\nHi I am 45, 69 kg, good health. After ejaculating sometimes, I have a cramping type pain in rectum area. The last time this happened was yesterday. There was no blood in semen and everything else was ok. Is this just muscle spasm or something else? Pain lasted about 15 mins.",
    "doctor_response": "Hi,Thank you for posting your query in healthcaremagic.comThis is Dr. Swarnava dattagupta answering your query.I understand your concern.See, you are quite right about it and mostly it happens due to some muscle or sphincteric spasm. There might be some other causes but they are very rare and are considered only after muscle spasms are ruled out.I would suggest you to take decolic or spasmoproxyvon tablets but it might not be essential because the spasm gets better after some time, when pressure is released.Hope i have answered your question.If you have any further questions i will be happy to help.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having stomach pain and diagnosed as obstruction in lower bowel\n\ni have been so sick i throw up i have bloating like im pregnant but im not my pain is sometimes hot this comes and goes lateley it hasnt left i went to the hospital and they say its a obstruction in my lower bowel but my pain is usually high like right in the middle of my stomach like when they tape measure you at the top of your belly when your pregnant what is going on please give me some answers i go to a gi soon but want to do my own research",
    "doctor_response": "Infection leads to obstruction in the system.In human body after stomach there is long intestine which ends at the anal opening.In any part of this system if there is infection sever in nature can lead to blockage of the system resulting in pain and vomiting.Obstruction if complete it needs urgent medical treatment and hospitalization,I wonder if your understanding is correct, you might have been hospitalized and need investigation like X-ray and ultrasound to confirm and depending upon the severity further treatment can be planned.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen bruised leg after an injury\n\nI was walking and there was some water and I slipped and landed on my knee. I felt like I pushed it up, and now the side of my leg is swollen and bruised. I feel a constant pressure going up and down my leg, my foot is numb and red. What could ve happened?",
    "doctor_response": "Hello, It is quite common after trauma. It is because of the collection of blood underneath the skin after a trauma. As of now you can use analgesics/anti-inflammatory combination like aceclofenac/serratiopeptidase for symptomatic relief. You can also apply ice packs for symptomatic relief.If symptoms persist better to consult an orthopedic and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain below the rib cage\n\nsspeciailists, please mention your problem in as much detail as possible. Do not forget to highlight your Age, Gender, Medical History and Treatment History of the problem you are facing. I recently fell and hurt my knee now when I cough or spit it hurts just below my rib cage on both sides",
    "doctor_response": "Hi.Thanks for your query and an elucidate history. You have a typical history of fall on the knees followed by pain bellow the rib-cage if you cough or spit.This has happened due to the muscles of the upper abdomen start from the lower ribs and it looks they has got sprained a lot while your body tried to balance the fall. I would advise you the following:Take a full bed rest.Take anti-inflammatory medicine like Ibuprofen at 8 hourly duration after food and with Ranitidine.Apply a rubrafacient liniment locally.You can apply an elasto-crepe to the lower chest to support the movement of the ribs. Take laxative to avoid constipation. Let the room be warm. You will be fine soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to get pregnant. White discharge, no cramps before periods. When should I take pregnancy test?\n\nHi doctor! Iam trying to get pregnant from quite sometime. This time, my periods are due from tomorrow  but I have not been getting the usual sharp symptoms. Also I can. Feel. Some dripping sensation, though what is flowing out is a small amount of white discharge. Can it be that Iam pregnant? How soon can. I take a home pregnancy test?",
    "doctor_response": "Dear user, welcome to healthcare magic.We cannot suggest pregnancy by the symptoms you mention because they are non specific.You can have a blood test now or a home urine test after one week.If the test is positive, start taking Folic acid supplements and have a visit to your doctor to do an ultrasound to confirm a healthy intrauterine pregnancy and exclude ectopic.I wish you get pregnant soon. Good luck.Dr. Ahmed Bahaa.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy round shaped red rash on leg?\n\nI have a red rash on the side of my leg above my ankle. It gets darker and round. It itches. I had it in January and the dermatologist thought it was shingles. Gave me Ned s and it went away. Now it is back. Same spot and same type. Can it be a fungus?",
    "doctor_response": "Hello dear,The rash in your leg can be either due to dermatitis or fungal infection (Tinea) in that region.Management includes:1. Keeping the area dry & avoid too much exposure to water or sweat formation.2. Antihistamine preparations like cetirizine to reduce the itching sensation & provide symptomatic relief.3. Application of topical antifungal cream like Clotrimazole or Miconazole to tackle the causative organism.4. Topical antibiotics to prevent secondary bacterial infections.If symptoms still persist or aggravate further, then it will be better to consult a Dermatologist & get a proper examination done to find out the actual cause. So that appropriate management steps could be taken.Also avoid wearing tight undergarments and trousers, as it will cause sweating & predispose to fungal infections.Wishing you a Good Health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high BP when suffering from aneyrysm\n\nMY SISTER IN LAW AGE 57HAD A ANEYRYSM WED. THEY COIL IF OFF WAS DOING VERY WELL FIRST STROKE PATIENCE THAT ACTAUALLY SIT UP IN A CHAIR SUN. WALK 3 STEPS TO THE BEDROOM YESTERDAY AND LAST LIGHT VERY HIGH BLOOD PRESSURE AND IS CONFIDENT. NEED TO KNOW WHAT TO ESPECT AND SHOULD WE START HEADING TO WAKE MED CTR. IN N.C. WE LIVE IN VIRGINIA TAKE ABOUT 4 HOURS OR A LITTLE MORE.",
    "doctor_response": "If blood pressure is high and there is an aneurysm in the brain,medication should be immediately started to bring BP to normal. Any combination containing a calcium channel blocker drug will be good.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lack of concentration and suicidal thoughts\n\nDear Dr. Vasudevan Sir, I am R Venkataraman working in DOEACC Centre, NIT Campus Post, Calicut. I am a psycho patient and was admitted at your clinic on Oct 5 2009. I am having the same problem even now. I was dischrged on 15/10/2009 and the very next day early morning i had to go to my native place were my parents are staying. i came back after one month. The counselling was not done. i am unable to concentrate on my work. please advice me what to do. My problem is very worse. I Feel like to commit suicide. (Though i have not attempted so far) Regads Venkataraman",
    "doctor_response": "HiI had gone through your query.Lack of concentration and suicidal thought may indicate underlying depression.Low mood with loss of interest in activities are other features to diagnose depression.Stress and anxiety can lead to such emotional upset and can affect your daily routines.You have to go for proper consultation and evaluation about your mood/thought process.It can be treated with multi modality approach like medicines , psychotherapy ,counseling and behavior therapy.Medicines like SSRI and other antidepressant will be useful.So consult psychiatrist and get better assistance.Still have query then feel free to ask.You can ask me directly on  you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest possible medication for dog bite\n\nHi, four nights ago, I was playing with a friend's pet puppy. The puppy playfully bit my finger which resulted in a small scratch with very little blood oozing out. Most online suggestions point to waiting for 10-14 days before going for the anti-rabies shot. The dog seems to be fine as of today. What would you advise?",
    "doctor_response": "Hello,Welcome to HCM,Rabies is a disease which is transmitted by the dog, which is 100% fatal but it is 100% preventable by proper and adequate treatment. As you have been scratched by your friends pet puppy. As there was a bleeding from the site of bite it is categorized into Cat III bite according to WHO categories and it is necessary to take both the active and passive immunization with Antirabies vaccine and Antirabies serum respectively. You have to take both antirabies vaccine and antirabies serum, You have to receive all the doses of antirabies vaccine on days 0, 3, 7, 14 and 28 (If the puppy is healthy after three dose of vaccine, you can discontinue the antirabies vaccine) and antirabies serum (Rabies immunoglobulin) on day 0 in and around the wound.In addition to this  you should take Inj TT and antibiotic like tab Augmentin for 5 days. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for sickness in the stomach\n\nhave a friend who had a very painful attack inher stomach and brought up turquoise bile and had a hard time to breath she said she is as white as a sheet the pain is something else she is waiting to go for tests but its a long wait, now she is scared to wait. the pain lasts for about an hr.",
    "doctor_response": "Hi.Thanks for your query and concern for your female friend. Read the history and understood the problem.The most probable cause of such a severe attack can be due to one of the following reasons:-The bile coming in vomiting indicates that there can be an intestinal obstruction-Such a paleness occurs only in few things like- Torsion of the ovarian cyst.Rupture of the tubal pregnancy.Rupture of the ovarian follicle with more bleeding or cyst.I would advise her and you the following:Take her urgently to the ER or the nearest hospital, get her admitted.Keep her nil orally as she may need an urgent surgery.Urgent Standing X-ray of the abdomen and ultrasonography of the abdomen.Surgical exploration may be needed, be ready for this and inform her relatives.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sharp tightening under right rib cage, diarrheo, Hypothyroidism. Problem in Gall bladder?\n\nI have been experiencing frequent, sharp tightening under my right rib cage for about three weeks now. It came on pretty sudden and intermittent and tightens now whenever I move, bend, etc. It has been accompanied by black diarrhea at least twice a day. I have hypothyroidism and don't know if this is related. Could this be my gallbladder? What is the solution?",
    "doctor_response": "Hi and welcome to Healthcare magic.Thank you for the query.It could be caused by gallbladder stones and this is the first thing to rule out. But some other causes may be considered such as hepatitis, gastritis or IBD. YOu need to do abdominal ultrasound first and then further tests if necessary. Till that,try to avoid fatty and spicy food, alcohol and smoking.Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is injecting Emma HMG 75 the right procedure towards infertility?\n\ngud morning doctor my query is i m trying to conceive pregnancy my last LMP is 13/12/13 and on 11th day 23/12/1 my ultrasound has done by my doctor found 10.8 on left 14.9 of right ovary and endometrium size is 5.5 after injecting EMMA HMG75 so suggest me is it the right way i m going through?",
    "doctor_response": "Dear member,Thanks for writing to healthcare magic.The ultrasound shows that there a\"re 2 growing follicles.They have to reach atleast 18-20 mm. The HMG inj helps in their growth. The dose is adjusted till the follicles grow well and endometrial thickness is atleast 8 mm.,ThanksDr Bhagyashree",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mildly high BP?\n\nI am a 34year old female who normally has a perfect BP reading-I have tested myself several times over the last few days. My BP reading has been 120/100 it hasn t got any higher. Should I get this investigated. I do have a family history of hypertension.",
    "doctor_response": "Hi thanks for asking question in HCM.You have absolutely normal blood pressure.If you are suspecting genetic tendency for high BP then it might be elevated until this age.You have 34 and have absolutely normal BP.According to few study it has been shown that with advancing age chances of increasing blood pressure is high.Today patients are suffering from high blood pressure  because of bad lifestyle habits, sedentary life style , smoking , fatty diet etc.So if you have family history of hypertension regularly every three monthly check your blood pressure and maintain healthy life style with helthy diet.I hope my suggestion will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for continuous low grade chest pain\n\nHi, i have just had a ctpa scan which was clear. the doctor at the hospital said to seemy g.p to to diagnose a more minor problem. i have continual low grade chest pain with breathlessness on walking. I don't smoke and not over weight. my doctor seems uninterested and begrudgingly is sending me for a Spirometry test nexy week. any comments?",
    "doctor_response": "Hi There might be chance of early stage of heart failure.Do echcardiography to rule out it.Second possibility is respiratory causes.To rule out respiratory obstructive or restrictive disease spirometry(pulmonary function test) done.According to cause treatment given.For heart failure diuretic helpful like furosemide.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of getting pregnant with irregular periods?\n\nwhat are the chances of getting pregnant if you have irregular periods? i had my period last jan 5, then had intercourse on 14 and 23 (both withdrawal method) then i missed my period this feb 5 (tho i know i am irregular) then had sex on the 6th (unsafe sex) is there any possibility that i could get pregnant in any of those intercouse dates? thanks for your reply! it'll be appreciated much!",
    "doctor_response": "Hi, I think you should do a urine pregnancy test.  There are chances of pregnancy with irregular periods also. So, if test is Negative, you can take some medicines for inducing periods.  If positive consult a doctor.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does it take to recover from throat cancer stage 4?\n\nHow long does it take to recovery from throat cancer stage 4. Had 35 radiation treatments, 6 rounds of chemotherapy. Finished may 4 2011.Have peg tube ,cannot eat solid food.bitter tasting like metal. Does radiation still work for a while when treatment is done.still feel a little lump on neck, will it go away.age 58 male height 5\"11 weight 180. Feel very weak ,",
    "doctor_response": "HIWell come to HCMWith such treatment of radiation and chemotherapy lesion resolves to far extend but due to radiation one can feel some hardening of tissues but this also comes around, one need to be very patience and will power is matters here, hope this information helps, takes care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bronchitis\n\nhi I am girish suffering from bronchitis for 5 years its becoming hell being suffered by this disease whenever season changed. please tell any permanent solution to get rid of. I have to nubilize  myself when got breathlessness. please suggest something effective.",
    "doctor_response": "Hello,Welcome to HCM,Bronchitis is a condition in which mucus membrane of the bronchial tube will becomes inflamed which results in narrowing of the airways in the lungs resulting in cough and breathlessness.Treatment of bronchitis includes 1.Plenty of rest2.Drinking lots of fluids3.Avoiding smoke and fumes4.Bronchodilator cough syrup.5.Oral steroids to reduce inflammation.6. Supplementary oxygen may be necessary.The aforementioned measures helps to improve the condition and makes you comfortable.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain and swelling in the toes\n\nMy husband has been suffering with swollen, painful toes. It is his 3rd and 4th toe on his right foot. He had a plantar wart on the bottom of same foot. The wart is gone now but his toes are still red, swollen, and very painful. He complains that it feels like he is having a charley horse between these two toes. His podiatrist told him to ice it and put 1% hydrocortisone (over the counter). He had been doing this for several days and still no relief.",
    "doctor_response": "Hi In view of the history you have provided In my opinion your husband is suffering from cellulitis of the toes. I Suggest that you start antibiotics, anti inflammatory pain killers and daily dressing with sumag. Keep the limb elevated on a pillow . If there is no relief in 5 days , consult your local doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for knee pain\n\nMy left knee has strong pain when I get up from a chair. Three weeks ago, I got into my sister s big truck and when we were finished with a long drive, I almost could not stand on it. Then pain came on the inside of my knee and back side every time I get up or am sitting for too long. What did I do, and how can I help my knee heal.",
    "doctor_response": "with the information you have provided i would suggest you tab aceclofenac 100 mg twice a day after meals to mask the pain. if the pain doesn't go away after 3 days i would suggest you get an x ray followed by a mri and consult a doctor nearby",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back and shoulder pain\n\nI been having really bad pain between my back and shoulder..I cant really explain the area but its behind my neck on the left side. it hurts only when i sit up straight in a chair and the only way that the pain will go away is if i lay down for about 30 minutes",
    "doctor_response": "Hi,We need to find the cause of the pain and so certain investigation like xray needs to be done. Till then use hot water foementation thrice a day. Don't use mobiles n laptops for long periods and do not read for long periods n watch TV for long use a soft pillow n not very fluffy or thin.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dizziness and nausea after a fall\n\nmy grandma felt and hit her head and threw up for awhile and was unconsions, now she has a soft spot on her head that hurts, she cant move without losing her balance and feels very dizzy. could this be something extreme, what kind of test should her doctor be running",
    "doctor_response": "Hi,Thanks for writing in.Your grandma might have had a head injury which caused her to lose consciousness for sometime and throwing up soon after. Any person throwing up after a fall and having pain in the head needs to be immediately taken to the emergency and tests like CT scan to be done. This will show any bleeding in the brain and fractures. A bleed inside the brain as a serious condition and requires urgent medical attention. She might also have to stay in the hospital for a day or two days. Please do not neglect her condition and take her to a doctor at the earliest. Also please inform the doctor if she is taking any medications for heart diseases that includes aspirin and blood thinners. These might require dose adjustment at old age and after a fall causing brain bleeding. The dizziness also can be due to the fall and any internal bleeds. Please take her to your doctors.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for stress and abnormal negative thoughts\n\nhello doctor im not a troll or any thing like that i need help i think im mentaly ill i some time want to kill lots of people but i do not like the idea of killing i have had lots of stressfull problims my hole life and i have kept them all locked in side my head i see things and hear things i dont like please give me some advce to help me fix my head",
    "doctor_response": "HelloYour description suggest that you have depressive disorder.For its treatment, you can take tablet zosert 50 one tablet every night. Alongwith that, you can take tablet sizodone 1mg every night. You will better in 10days of taking medicines.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the transmission modes of measles?\n\nMy co worker s son found out her son has measles, prior to her knowing about her son she was at work answering phones in the office where I sit. I have a three year old at home and a new born a couple of weeks old, will that exposure affect them. My three year old shots are up to date but the newborn is a three weeks old",
    "doctor_response": "Measles is a viral disease primarily transmitted  from person to person by large respiratory droplets . It can also spread by the airborne route such as aerosols. Infected people are usually contagious from 4- 6 days before until 4 -5 days after  onset of rash. For babies Measles-mumps-rubella MMR vaccine is usually given at ninth month as a preventive vaccination. For your 3 yr old kid kindly make sure he/she was given MMR at nine months of age and another booster is given at 3-5yrs of age. For your 3week old baby if you have had measles before, your baby won\u2019t need any treatment. This is because your antibodies would have passed to him/her in the womb during pregnancy. This gives him/her immunity to the virus for the first six months, and possibly a bit longer.also make sure you are breast feeding your child exclusively.If you have not had measles before, he may be given an injection of human normal immunoglobin (HNIG). Kindly also look in for symptoms like fever, running nose so that you can contact the doctor immediately.Hope this answers your query. Take care.Dr.Riyanka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Lisinopril cause red and inflamed gums and sores in mouth?\n\nI just started taking lisinopril 2 weeks ago.  My gums started getting red, and now are inflamed and I have canker sores all over that side of my mouth.  Now, my jaw on that side is hurting, and my face is swollen.  Could it be the lisinopril causing it?  That is the only thing different that I have done.",
    "doctor_response": "Hello, Welcome, Thanks for consulting HCM,    I have gone through your query , as you are taking medicine Lisinopril , now you have inflamed gums , cancer sore also dont worry it can be due to medication ,     You do can do warm saline gargle two - three times a day    Apply ointment on gums GUM PAINT two - three times a day   Take one capsule Vitamin B complex once daily for 5 days,    For medicine Lisinopril you are taking can consult  your doctor   If you wont get relief then consult dentist also for Oral Prophylaxis Hope this will help you. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is regular menstruation possible while on Duphaston and can endometrial lining be thickened?\n\nhi.. i am 27 years old and i am trying to conceive from last 22 months. i went to doctor and i got checked where i appeared to have no fertility issues besides pcos and hypothyroidism which is usually in control after taking medicines and my husband has a really high count.i tried clomiphene for 6 months and one iui but no luck! Then my doctor suggested me IVF which also went unsuccessful (1 fresh and 1 frozen). Then we took a break of 6 months and tried naturally and went to Kuwait for work . Here we met other doctors who suggested fertiboost and metformin and cabergoline (while proclactin was 25).we tried for 6 months but again no luck! then next month our doctor prescribed us letrozole with trigger shots along with progesterone . AGAIN WE FAILED. This month our doctor prescribed us some fsh shots which are probably used in ivf with duphaston . I started taking duphaston from 14th day (15 july) but i started spotting from 21 july till date (26 july) . Today we did BHCG which was negative . my question is can possible while still start my periods while on duphaston?is there any thing to worry about? for sure i am not pregnant this month olso... Also i would like to add that meanwhile i also did hsg test two months back which was quite ok . my tubes are open and everything seems ok. Also i did one hysteroscopy which was olso normal (while ivf) Now my doctors say that my lining is thin for implantation . what could i do for that ? i mean how could i improve ? what could be the possible reason for this ?",
    "doctor_response": "Hi, Very rare to get bleeding on Duphaston. Thyroid dysfunction along with PCOS could be the reason. Get a checkup with an infertility specialist. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. B. Radhakrishnan. Nair, OBGYN",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent knee aches?\n\nHi I m 52 and am suffering with knee ache -I am not able to walk properly.My Ht is 5.4ft and i weigh 78 kilos.I also take ultroxin for hyperthyroid .This is the first time the pain is sonsistent for 4 months MOVON -p was prescribed and i got temp releif only I got xrays and blood tests ESR 20(mm in 1 hr) and RA 12.3IU/ml,What to do ? I hate to think i am goin to live like this..",
    "doctor_response": "Hi, Do not worry. You are definitely not going to live like this! Although, your long term goal should be weight reduction. As of now, for immediate relief, you can use a hot water bag for about ten minutes, followed by a simple exercise: lie down, roll a towel and place under your knee and try to press it down. Hold this muscle contraction for about five seconds and relax. Repeat ten times. Follow it with an ice pack for about ten minutes. You can also use a pain relief spray / gel. I advise an orthopedic consultation regarding your reports and further medication. Hope I have answered your question. Let me know if I can assist you further. Regards, Shruti Bhave, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can dizziness, often while standing up and high BP along with muscle fatigue be treated?\n\nbp higher in right arm than left . at times 175 /110 in r arm. Dizziness very often when standing up . Extreme muscle fatigue while working in yard . Most times within 10 mins of beginning I have to rest . This is the exact opposite of how i was . I am 57 yrs. old 6 2 and app. 255 lbs.",
    "doctor_response": "Hi, In both the arms the blood pressure varies little and it will be more fluctuating if you go on reading it on your own with associated symptoms like chest pain, difficulty in breathing and fatigue. It would be a matter of concern, and in that case, it is better to consult the physician for exact reading of blood pressure and suggestion. Continuous high reading of blood pressure may be the case of hypertension and it may require medication but confirming a diagnosis of hypertension is necessary. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Met accident, had surgeries, on several pain med, hydrocodone not working properly. Alternative medicine?\n\nhello. I was involved in a vehicle accident 1.5 yrs ago and have had 14 surgeries and on sev pain meds. now iam down to 4 10/500 hydrocodone a day but have been on it for quite some time and think its not really doing its job. going back to my dr and would like to have an alternative to offer up to see what he thinks. I started on morophine and have gotten down this far. but lately seems like skittles as opposed to pain med",
    "doctor_response": "Hi, it appears that you have pain due to the surgeris, and on pain medication.                          I to my patient with such symptoms prescribe, neurotropic injections for 10 consecutive days, and one injection every week.                           Avoid taking potato, other tubers, tomato, egg, chicken, and sea foods. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for insomnia in a child\n\nMy 8 year old step daughter has insomnia any suggestions? She is a perfect angel all day but when night time comes around she fights it says she isnt going to sleep comes in every hour and says she cant sleep. she is on adhd meds and also a sleeping pill at night. I hoestly dont think she is adhd at all i think she cant focus because she is so tired. I am at my wits end",
    "doctor_response": "hi.good day to you.sorry to hear about your step daughter.i think she needs a child psychiatry counselling.insomnia may be due to unknown deep fears or doubts she herself dont realise.try to avoid or minimise  television or internet usage by her to less than 2 hours per day.encourage physical activity and outdoor activity.avoid junk food in diet.encourage plenty of fruits and vegetables.dont let her go empty stomach or too heavy meals at night.try regular bedtime activities.hope u got your answer.take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could renal lesions with high bp and sweating suggest?\n\nMy son is a 50 year old marine veteran, he has been diagonised with a renal lesion, which they say is a cyst. THE v.a. says this is of no concern to them, it is of concern to me and my son. He has been ill for over 6 months, extremely high blood pressure, now under control and weakness aching and sweats.Should we be getting another opinion?",
    "doctor_response": "Hi,welcome to HCM.Looking to your son's history, i as a nephrologist can understand your concern.Cyst in the kidney is mostly benign finding but it require accurate evaluation by CT scan with contrast.Do basic urine report and S.creatinine before that.Control BP toMaintain adequate hydration and control salt intake You can communicate with me furhter with above reports and detailed prescription.I think this would be helpful to you.Best wishes. TC.Dr Jay Patel.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to cure atopic dermatitis\n\nHello Doctor, My 16 months old Kid is suffering with Atopic Dermatitis from last almost 13 months and situation is getting worsen day by day. We have been trying lot many treatments suggested by multiple Doctors but nothing is helping to cure it. He is simply itching all over his body all the time and living a very dis-comfort life in this young age. We are applying lot of Bioline all the time but this only helps for few hours but disease severity is not lowering down. Can you please advise me the best treatment for the disease? Many thanks.",
    "doctor_response": "Thanks for following up. At the first ,you find cause:1. Disbiosis of intestine-check stool culture and sensitivity to antibiotics.2.Helmintiasis -stool for cyst and ova.3. Food allergy-allergic probes.4. Bad digestion of food(stool analysis)5.High level IgE.6.Liver and panreas problems(Ultrasound diagnostics)  For treatment i suggest -Start from Albendazole(Zibend) 5ml once-Next -Enzymes syrup for  1month-Probiotics-enterogerina- 1 sachet once a day for 5 days,then Darolac -1 asule once -for 1month-Anti allergenic diet-Antihistamines -Cetrizine for 1month",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe pain in lower back and hips\n\nI just finished 10 days of levaquin for a sever sinus and lung infection.  I have had a lot of pain in my low back and both hips that started about 7 days after starting it.  can that be caused by the medicine aqnd if so, what is the treatment.  I am having trouble walkind from the pain.  I stayed out of work for last 3 days and rested but still have a lot of pain.",
    "doctor_response": "Hi i am Dr Ahmed Aly    thanks for using healthcaremagic site ,I had gone through your question and understand your concerns ..  Actually rarely levaquin can cause tendinitis and pain in knees and hips but that is very rare and happens only on chronic using or long duration of administration .  In my opinion some times severe lung infection causes bone aches that may subside simultaneously with bed rest and relaxation .  For now you may use advil tab when needed , hot massages with topical gels , B12 vitamin supplementation , muscle relaxants , spinal straightening exercises , physiotherapy will be effective for most of cases . If pain persists i recommend a visit to your physician and MRI to exclude any  spinal injuries or disc herniation for proper evaluation and management . Please click and consider a 5 star rating with some positive feedback if the information was helpful. Wish you good health,Any further clarifications feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a fall on a concrete floor cause synovial cyst and L4 L5 bulging discs ?\n\nCould a bad slip and fall onto a concrete floor cause a synovial cyst and two bulging discs on L4 and L5?",
    "doctor_response": "synovial cyst is caused by repetitive trauma.simply a fall is unlikely to produce it.following fall there may be traumatic heamorrage into cyst  which may bring it into notice.but slipped disc or bulged disc is common following fall specially if the victim is obese and elderly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower abdominal pain?\n\ni have been having lower right abdominal pain that radiates down leg,the left side also hurts but the right side is worse.i also have lower abdominal spasms that feel like bubbles. my abdomen seems to swell after eating,and gets bloated , i have suffered from peptic and rectal ulcers before but this feels different. the pain is constant and is relieved when i do physical work",
    "doctor_response": "Hi.Thanks for your query. The causes of all the symptoms you have mentioned of pain in right lower abdomen, bloating, radiation to the leg, spasms like bubbles, past history of peptic and rectal ulcers can be the following:severe entero-colitis.Tuberculosis of the abdomen. Lymph node masses . I would advise you the following:Tests of blood, urine and stool.CT scan of the abdomen.Upper GI endoscopyPower GI - colonoscopythis will help to get a proper diagnosis and treatment plan.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe loose motions while having fatty liver?\n\ni AM HAVING LOOSE MOTIONS 5 TO 7 TIMES A DAY. iNITIALLY I USED OFLOX-OZ WITH RABI-D. Initially it was ok. It is recurring. Doctor did endoscopy but nothing was found. In scanning it was found Fatty liver. LFT Hepatis C test are negative. Doctors prescribed some medicines for 5 days and if it still persists, he advised to undergo colonoscopy. What might be the reason?",
    "doctor_response": "Hi thanks for asking question.You are taking correct drug for diarrhea.Endoscopy normal means no gastritis or ulcer present...If still no benefit then colonoscopy might helpful in ruling out other causes of diarrhea like inflammatory bowel disease, microscopic or lymphocytic colitis , polyp, growth etc...Meanwhile take more water for maintain hydration.Probiotic taken.Stool exination done for rule out parasite infection and bacterial colitis...Take care Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this MRI report indicate?\n\nLf should dislocation - MRI shows tear of the inferior capsule and large tear of superior labrum, and depressed fracture of anterior inferior glenoid. Follow up apt. is not for 14 days - is it safe to wait that long? Arm has been in immobilizer splint for two weeks already.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have gone through your question and understand your concern. There is injury to shoulder joint with tear of ligaments and support. There is requirement of surgical repair. Delay will lead to fibrosis. Better to get evaluated soon. Regards Dr N Kumar",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long will my face be swollen after a nerve removal in the back tooth?\n\nI went to the dentist to remove the nerve in my back tooth on the right side. after a few hours the numbness wore off but I started feeling pain in my cheek. 2 days later the right side of my face is swollen like a puffer fish. I am taking antibiotics and anti-inflammatory medicine but how long is this going to take before I look normal again",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,   I have gone through your query, as you have undergone dental treatment now you have swelling and pain dont worry , you do warm saline  gargle two - three times a day.   Consult your dentist and go for IOPA xray , if there is any Periapical infection then go for Re- Rct .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen feet while on Hydromorphone?\n\nMy husband has mesothelioma cancer in his right lung. He was diagnosed a year and a half ago. He did 4 Chemo treatments over a year ago, but got too sick. He was experiencing severe pain 2 months ago, and MDAnderson did 10 days of radiation, which shrunk the tumors considerably, but he is still experiencing quite a bit of pain. He takes methodone every 12 hours, gabapentin 300 mg in the morning and again at 3, and 600 mg at 9 p.m. He can take hydromorphone 4 mg if needed, usually takes 1 in the afternoon, and sometimes 1-2 during the night. He prefers to take Tylenol instead, and was taking 8 per day, but Dr. told him to cut way back on that, but he is still taking 4-6 per day. Tonight his feet are swollen REALLY big, especially the right one. I have him soaking his feet in room temp water with some arthritus and sport cool blue ice soaking liquid with alcohol and capsium . what else should I do?",
    "doctor_response": "Hi, The swelling of feet may not be related to intake of Image result for Hydromorphone. This can be related to lymphedema caused by cancer itself or other cardiac or renal causes that need to be detected after proper investigations. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to increase height at the age of 27?\n\nI am 27 years old, my height is 5.2 and i want to increase my height, after seeing advertisement of Dr. ayurveda and stepup herbal body growth formula, i would like to buy but before that i want make sure that it is true at this age i can increase my height, pls. advice",
    "doctor_response": "**1. Height of an individual also depends upon the height of the parents [genetic], if they have short stature, their siblings can/may have the same height.2. No Pharma company will ever describe his/her product not to be authentic, [same is with the product you have mentioned].PS. don't fall for marketing gimmicks.3. There is no such magic Ingredient in any herbal formula which can increase the length of bones  [after puberty is achieved]4. eat a healthy, balanced and nutritious diet and practice pranayam,yogasanas, back exercises that stretches the spine which helps in increasing height by 1\u201d-2\u201d inches.PS. Contact with a yoga expert for various Yogasans which can be adopted and practiced in daily routine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have a hiatus hernia. should I be concerned ?\n\nhi, i have a hiatus hernia , i am 44 years old female, i get this pain quite constant under my left rib cage at the lower end of it, when i draw up my legs or reach for something, got a scan of my liver done results were fine wondering should i be concerned or is it the hernia.",
    "doctor_response": "first, lets be honest.....hiatus hernia dont give pain ....esp under rib cages on left side unless its associated with a partial volvulus of stomach or there is any other issues hiatus hernia are generally graded upto EPITONIM classification, and the managements depends on the grading of HIATUS HERNIA for more email : drtapan@hotmail.com ph: 9925033352",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is 42 years old a problem to get pregnant?\n\nHi I m 42 years old got married in 2012 and not pregnant yet ? could i be having difficulty because of my age? My period started getting weird since the beginning of this year less days than it used to be FYI i had three kids from previous marriage my youngest is 16 yrs old I don t have a health card yet and i don t have a family doctor, do i have to be reffered to a gynaecologist doctor to accept me as a patient or i can be with one directly? Thank you Betsy",
    "doctor_response": "42 yrs age is not a definite cause of not becoming pregnant olden days when contraceptive measures were not used females used to deliver even upto the age of menopause But in modern obstetrics we dont advice pregnancy in this late age usually due to increased chances of congenital anomalies especially Downs syndrome By 40 yrs your cycles may become irregular due to ovarian failure that may be the cause of oligomenorrhoea ie scanty periods  If you are very particular to have a baby you can opt for IVF ie test tube  babies where donar ova  and sperms are used  and embryo can be transfered to your womb But the cost of this treatment is more",
    "dialogue_context": ""
  },
  {
    "patient_message": "History of back injury. Have pain, taken epidural shots. Home cure?\n\nyes you may be able to help.In 1994 I tore my back all up an now with the work I was doing has the cushion between my clavicle bone an my hip bone blown out to where my two bones rub together an pinches the nerve that causes pain you cannot believe(unless you ve had it)I get shots but they don t help.I have had two sets of epidural shots an they didn t even do any good so I was looking for maybe a home cure.HURTING Joseph LaPlant",
    "doctor_response": "Hello. Thanks for writing to us. The pain due to pinching of nerve that you are having is not likely to be relieved with the help of medicines. It is best to consider going for a surgical treatment.I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal ,drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI shows bulge causing foraminal narrowing. Hand pain. Why no relief with medication?\n\nmri scan shows mild posterior bulge along withg postero-lateraL OSTEOPHYTES AT C6-7 CAUSING MILD LEFT FORAMINAL NARROWING. NO NERVE ROOT COMPRESSION OR IMPINGMENT SEEN THERE IS SEVERE IS IN THE UPPER WITH MPAIN MOVING TOWARDS THE HAND THE DOCTOR HAS GIVE PAINKILLERS BUT THE PAIN IS STILL THERE WHICH SPECIALIST DOCTOR SHOULD I CTC AND WHY IS THERE STILL NO RELIEF THE PAIN IS THERE\\FROM LAST ONEM ONTH ALSO MY ESOINPHOLIS SHOWS 12 PLS ADVICE",
    "doctor_response": "Hi,From history it seems that you might be having osteoartheritis in your cervical spines giving irritation or pressure on nerves giving rise to this problem.Consult orthopedic surgeon or spine specialist and get examined.Physiotherapy, short way diathermy and cervical traction will give much relief.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Becomes paranoid with odd things, prescribed Klonopin, doesn't eat . Does this just continue or gets worse ?\n\nMy son (29) has been seeing a psychologist for four years for anxiety.  He has been prescribed Klonopin.  Recently (past year to 6 months) he's become more paranoid with odd things (drones tracking him, etc.) In the past month this has gotten worse and he's quit taking his meds as well as missed his last two months appointments.  He feels the meds are part of consiracy, too. Bizzare behavior has increased (climbing on roof to look for drones, thinking neighbors are NSA, counterfiet money). He's lived in our house alone this winter (we have a second house) and I returned because of this.  I fnally got him to the hospital, where they talked to him  and said he needed to take his presribed meds.  He agreed and he was discards.  Now he won't take the meds., wouldn't go see the pschologist today, and said he can tell I'm lying through his \"eye\" that sees everything.  He won't even eat food I make, thinking it might have drugs in it.  He was tested for illegal drugs and had none in his system at the hospital. So, suggestions? See if he'll go see someone else? Continue to try to get him to take the meds? Wait until another shoe drops and I can get him into the hospital? I had to call 911 and have the police meet me in the parking lot of the hospital.  It took a lot of convincing.  He won't do that again.  Does this just continue to get worse? Or will it clear up eventually? He hadn't been eating or sleeping before I got home.  He's a little better now about eating and sleeping, but still displays odd behavior.",
    "doctor_response": "Paranoid symptoms such as those you have described - drones tracking him/ attacking him - are symptoms of psychosis. Klonopin (clonzepam)  ay have been prescribed to reduce his anxiety and to help him get sleep, but the doctor would have prescribed an anti-psychotic medication (haloperidol, risperidone, olanzapine, etc.) along with it. Has he been taking an anti-psychotic regularly?It is important that you meet your psychiatrist and describe these symptoms to him. He will also interview your son and find out what will help him best. These symptoms, when treated early can improve to a large extent in more than half the patients. Some patients may not respond to the first medication tried, and may need another trial. Do consult a psychiatrist as he will also look for any medical disorders that may be contributing to the illness. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for purple discoloration of the foreskin\n\nWent to the doctor for a four month check up for my son and his foreskin had attached. The doctor pull the foreskin down and bled some around the penis  ,now I am pushing the foreskin down and putting Vaseline around the penis.. He's penis has turned purple is this normal .",
    "doctor_response": "Hi, It may be due to phimosis or local infection or allergy to local application medication. Until examination is done it is difficult to say what it is. Please consult your doctor he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain while urinating?\n\nI had high fever owing to uti infection with too many pus cells and was treated with heavy antibiotics.sonography revealed prostrate to be of 39 gms but ihave no symptoms of prostrate and no residual urine was seen on voiding.I would like to know whether the uti was responsible for the prostrate to be infected or whether the infection was due to prostrate? I am 58 yrs old but this happened all of a sudden with pain while urinating and wbc count went upto 23000.Please explain and oblige.THANKS           Mr.J.M.Dastoor",
    "doctor_response": "Hi,Thank you for posting your query in healthcaremagic.comThis is Dr. Swarnava dattagupta answering your query.I understand your concern.See, with increased age, the prostate generally grows in size, what we call the benign prostatic hyperplasia. But an enlarged prostate will not always present with symptoms. It has to obstruct the urethra to cause difficult or frequent voiding or even residual urine. The residual urine or the obstruction sometimes leads to infection due to stagnant urine. But in general, an UTI is much more common than prostatitis. So, probably UTI was present with a concurrent enlargement of prostate, and UTI could have lead to prostatitis if any, though there was no such symptom.Hope i have answered your question.If you have any further questions i will be happy to help.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and soreness in the legs?\n\nI was put on a course of various tablets including tranexamic acid to stop bleeding in the throat, Since I ve stopped taking the tranexamic acid my left lower leg has been painful and swollen, it started easing off for a while and was just mild shooting pains but the past few days the pain has been constant and really sore, it s been quite swollen for 2-3 days but has started to go down now.. It s sore to move and touch, extreme pain when walking and is still sore to even rest, the right leg is completely fine, not actually sure if it has anything to do with the tablets or such, did suspect it was maybe a pulled muscle or something of the kind but can only pin point it too when I stopped the course of tablets, any ideas or suggestions? Thank you",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. From what you are describing, it points to having a DVT in your affected leg which can be due to your medications. I would highly recommend you to go to ED and get this properly evaluated. If your calf muscle is red, hot, swollen and painful when you touch it please seek immediate medical attention to rule out blood clot.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Samuel Parmar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the white spots on the side of my mouth?\n\nHello doctor, I have these white spots on the side of my mouth. What can this be and how do I treat it? I just found out this week I have vitiligo in my groin area for which the doctor just gave me Protopic and Triamcinolone. Would I be able to use this on the side of my mouth?",
    "doctor_response": "Hi. Well, if you have confirmed vitiligo in your groin area (assuming it has been seen and confirmed by a dermatologist), there is a high likelihood that your light colored lesions over the face are representing early stage of vitiligo, called \"pre-vitiligo\" to be able to diagnose your condition better, I request you to provide me with the following details:  1. What was the time gap between noticing the white patch over the groins and the patches on the face? 2. What is the level of pigmentation of the facial patches, compared to the groin patches? It would be ideal if you send us a nicely focussed picture of groin as well as facial patch or opt for a video consultation where I could see your lesions in real time and be able to diagnose it with much more confidence. 3. Are the facial patches itchy or become red sometimes?  4. Do you suffer from dandruff - moderate or excessive?  5. Do you have history of atopy which means tendency of developing skin and respiratory allergies to dust, breathing problems or frank asthma, recurring cold and cough, sinusitis, etc.?  The above questions are relevant for the following reasons: If the facial patches are only slightly light-colored, they may be due to either pityriasis alba (a benign condition often seen in people with atopy that is tendency of allergies) or due to seborrheic dermatitis (dandruff induced) which may or may not be itchy. Both these conditions will respond to application of Protopic ointment alone - used twice a day for 2 to 3 weeks.  If it is confirmed to be previtiligo, then these facial patches may evolve into full blown vitiligo patches over the next few days. In that case it is advisable to use both Triamcinolone and Protopic for the facial lesions. The protocol for face will be little different from groin. You should use Triamcinolone on face only once a day and that too for 2 to 3 weeks at most, as it is a Steroidal cream and may cause thinning of facial skin on prolonged use. Protopic may need to be continued over your face as well as groin for at least three months. Additionally, expose your light patches to sun-light, 5 minutes everyday. Sun-exposure expedited repigmentation of vitiligo lesions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain. Taken advil. Pink bleeding after urinating\n\nHi I m Carmen and 27 yrs old. Last night I had I very bad pain that made me cry in my left lower back. The pain lasted almost 2 hrs until I had some advil n went to sleep laying on my stomach cause that s how it wouldn t hurt as much. I remember having one good meal and right before the pain I had chips with a really spicy salsa and lime.after that I had an Apple, had some squirt and the pain started. In the morning I went to the restroom and after peeing I wiped myself there was a light pink on the paper.",
    "doctor_response": "Hi, Hematuria or blood in the urine should be evaluated by your doctor. Considerations include infection and genitourinary (for example kidney) stone...most likely.  However, hematuria can be from more aggressive disease such as cancer. Any of these can cause back and flank pain. Please see your doctor for testing and treatment. Best wishes for your health....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain inside of belly button, lump, sore and red, have had cervix cancer, does regular check ups\n\nhello i have had pain in the inside of my belly button for about 4 days and tonight a couple hours ago i noticed a lump on the top of my belly button its red and really sore, lump is about the size of a nickle and i can barley put my finger inside my belly button as it looks like its closing it hurts to laugh bend down or sit would you possibly know what it could be? i have had cervix cancer in the past which the doctor think is all gone i go for regular check ups",
    "doctor_response": "HI thank for asking to HCMThis may be infected boil if it is spurfacial but if is under the peritoneal cavity then you need to go for sonography to rule out the possibility of paraumbilical abscess, the over all clinical diagnosis depends upon the clinical examination and observation, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for restless leg syndrome\n\nMy husband suffers with Restless Leg Syndrome not just at night but anytime he sits for more than 20 minutes or so. He gets some relief from inserting small bars of soap in his socks at night and/or using a homeopathic. If he uses either of these things to often the do not seem to work as well. He has tried calcium, magnesium and a combination of these with no improvement.",
    "doctor_response": "HelloI have read your query. I will advise you vitamin b 12 vitamin D supplements. also increase your fluid and juices intake. Take diet rich in potassium and calcium. I hope I have answered your questions. If you have further questions please feel free to contact us. I will be happy to answer. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes night sweats and shortness of breath?\n\nMy husband has copd. Abuteral 2 times a day and advair as needed. For the last couple of nights he wakes up during the night with night sweats and a shorness of breath.  He het up does his advair and goes back to sleep.  Is the copd getting worse or something else?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Night time sweating and breathlessness in COPD patient is suggestive of worsening of disease. In my opinion, he needs higher and longer acting inhaled treatment for better control of COPD. So get done PFT (Pulmonary Function Test).PFT will tell you about severity of the disease and treatment is based on severity only. He will mostly improve with long acting inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).Don't worry, he will be alright. Hope I have solved your query. I will be happy to help you further. Wishing good health to your husband. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain from upper back into arms,hands and chest?\n\ni have radiating pain from center of upper back progressing into my arms, hands, chest . MRI did not show significant compression some arthritis in C5 and C6. Tried tramodol with no relief, gabapentin some. I am trying prednisone but it elevates my heart rate. Tried PT some results. It has been over four weeks of excruciating pain. I can barely drive. At times I control it by pushing with my back against a corner of a wall. I need to go back to work in a week and don t know what else to do. What else can I do to manage problem and eliminate the cause?",
    "doctor_response": "HiI may suggest a review with a vascular surgeon.A color Doppler for aorta should be done to rule out dissecting aneurysm of aorta which gives similar symptoms.Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and feeling shaky suddenly when i am in toilet?\n\nI woke up this morning and went to the bathroom, when sitting on the toilet I broke out into a random swear and began to go very dizzy and shakey. I was sweating to the point where it was dripping down my chest. This episode lasted about fifteen minutes. What could this be?",
    "doctor_response": "Hi,You have blood pressure drop, which caused such symptoms. It can happen sometimes in the morning after bath or toilet. You shouldn't worry, there is nothing serious, just drink much liquids.Wishing you good healthIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for numbness & twitching in heart\n\nI have been have been havin this numbess twitching heart racing its like when i twitch things try to go numb then ill feel something in my head pulsate now i got headache but different parts parts will go numb like my lips or face but not real bad rite now. And when it happens this cloudy daze comes over me. I got a yr old son and im a fast paced person i stress alot i actually got an anxiety disorder bipolar disorder and ptsd i take3 different meds buts i have been for months nows nothins changed in meds of life",
    "doctor_response": "Your symptoms seem to be due to cardiac manifestations of acute anxiety, however paroxysmal tachyarrhythmia (sudden very rapid heart beating due to a cardiac cause)should be ruled out by getting an ECG during an episode or undergoing ambulatory heart monitoring(Holter).",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to deal with jaundice caused by rcinex used for TB?\n\nmy husband is of 40 years age, he is suffering with testicular TB. in 2002 he taken medication for lung TB. doctors prescribed him Combutol 800, rcinex 600+300, streptomysin injuction, and benodon tablets, he is getting jaundice after usage of rcinex for 4 days, what i have to do? please help me",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your husband's situation and problem. Rcinex is having rifampicin and isoniazid. Both are hepatotoxic and cause jaundice. So better to stop Rcinex in your husband's case. Start hepatoprotective anti tubercular drugs like ethambutol, levofloxacin and streptomycin. Get done liver function tests alternate day. Once liver enzymes and bilirubin are normal, you can start Rcinex. During this period ask him to drink plenty of fluids orally. Avoid oily and spicy food. Avoid painkiller drugs because they can cause liver damage. Give him high sugar diet. Don't worry, he will be alright. Consult doctor and discuss about this modifications. Hope I have solved your query. Wishing good health to your husband. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dry mouth at night?\n\nI have severe dry mouth at night. It wakes me up because it is so painful.i am not on any antihistamines, I have eliminated my night time supplements and it has not made a difference: I am not a mouth breather. I wake up at least 2 x a night to take a drink",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As per your  complain dry mouth can occur due to causes like Severe dehydration, Side effects of medications if you take any, Salivary gland dysfunction, Nerve damage supplying salivary glands, Oral infections like thrush, Sjogren's Syndrome..etc..As it occurs at night it can be commonly sue to mouth breathing habit, and in case if you are not aware of it may be you breathe through mouth while in deep sleep.-For dry mouth chew sugarfree chewing gums..-Drink plenty of water.-Avoid regular mouthwash and use specialized mouthwash that are formulated for dry mouth patients like Biotene..-You can also instil artificial saliva drops..-Suck tart candies as it also stimulates saliva flow..If it occurs at night then you can apply Xylitol patches inside mouth as it helps in maintaining a lubricating layer inside mouth.If does not improve consult an Oral Physician and get evaluated..Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the following pregnancy scan suggest?\n\nhello doctor, i am 20 weeks pregnant and my scan report shows the followingA single, live, intra uterine fetus is seen exhibiting active movementsplacenta; posterior       maturity grade.  1amniotic fluid: adequateheart;150 bpmBpd: 42mmAC: 130 mmFL :28 mmestimated gestational age: 18 w 6 daysestimated fetal weight: 0256 gmsis there  any  problems in this report  and what about the growth ?  it is 1 week lowe than the actual",
    "doctor_response": "Hi there,,This is an absolutely normal findings of ultrasound scan at 20 weeks.The measurements give an estimate of weeks but, a variability from the actually calculated date can be present, as ultrasound only gives a rough estimate.So in effect the ultrasound findings can be plus or minus 1 week in first trimester; 2 weeks in second trimester; and more than two weeks in third.This variability is decreased with newer machines but cant be totally removed.So I would say that this report is absolutely reassuring and you should not worry at all.A good fetal heart rate and a placenta which is only grade 1 maturity indicates that everything is as it should be at this stage.Do not worry.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "18 yr old, on birth control pills. Missed pills, having heavy brown bleeding. What to do ?\n\nHi I am 18 years old and I m taking the birthcontrol pill . I take them everyday at the same time but recently with work I ve missed about 4 days. I started to bleed and I thoughtt or was my period. But it only lasted 4 days. So I took some pregnacy test and they all showed up negative. 2-3 days later I ve started to bleed again but brown and everyday its getting heavier and heavier Ans I need to take my new pack of pills. What should I do?",
    "doctor_response": "Hello,The bleeding you are experiencing is due to the hormone imbalance created by the missed pills. If you have had any sexual intercourse later on in the cycle, you are not protected also. Home pregnancy tests, however, can only read well 3-7 days after the missed period. You should therefore get a blood test for pregnancy and follow it up with a clinical exam and a trans-vaginal sonogram. Once pregnancy is excluded, you can start your new pack of pills. You may also need styptics simultaneously to help arrest bleeding faster. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for pancreatic infection caused due to gallbladder stone?\n\nhi i have pancreatic infection due to gallbladder stone and they removed gallbladder, due to this my sugar level is showing high even after surgery. my sugar level is fluctuating some times very low and some times very high. after my first pancreatitics again after 2 years now i got the same problem and admitted in a hospital for a week. why this is happening again and again. and how to control my blood sugar. i am now taking glugonorm vg1 tablet and obimet sr 500. pls advice",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  You have gall stone and it leads to secondary pancreatitis.  You have gone through surgery for gall stone.  So now no need to worry. Just take treatment for pancreatitis.  You should take a course of antibiotics and fluid therapy.  Regularly check your lipase and amylase level.  You will be fine within short time. You should check your fasting and post prandial blood sugar as well as hba1c.  It will give you exact idea regarding sugar level.  Then you should set the dosage of anti diabetic drug accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for headache and sound in ear due to herpes\n\nmy father age 83 suffered from harpies in June 2011. The harpies was  on head and behind ear one side.  He has consulted the Neurologist and take medicine. Still he has headache and at night he feel some sound in his ear which disturb his sleep. can you please advice me on this matter",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Opioid analgesics can help solve your problem.Pain due to herpes and that is also to late is very serious problem. It will not solve with routine analgescis. This analgesics won't be available with OTC it requires a Doctors prescription.You should also take acyclovir which take care of herpes, neurobion forte for neurological problems.Please take good sleep and do not take stress. This parameters can affect the headaches. Please wear black glasses as it is also helpful in headache.Please maintain good hygiene as this alone can take care of many things same as active drug therapy.I will be happy to answer your further concern on bit.ly/DrArun.Please hit thank you for me if you are helped.Thank you,Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is frequent, watery stools in an infant concerning?\n\nmy daughter is 3.5 months old. normally she passes 3-4 stools a day. from last week every alternate day she is passing 5-6 stools a day.sometimes she passes stool while drinking my milk. sometimes the stool is totally watery. she is oly on mothers feed. her weight is 5.2kg.iss it a cause of concern?",
    "doctor_response": "HiWelcome to the HCMI understand your concerns but don't worry. Infants are prone to  wide variation in frequency, consistency and colour of poops. I appreciate that you have kept your baby on exclusive breastfeeding. So the chances of infective diarrhea is not likely.So, continue with regular feeds and no other treatment  is required. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lactogen 2, constipation, whole milk, gastric problems, suggested baby food\n\nHi. My daugher is 13th month today. she s been drinking lactogen since birth and i only recently started her on lactogen 2 because she had allergy to other formula. but she s been constipating a lot recently and i m starting to wonder if i should switch to another formula since lactogen 2 is only for up to 7 mths. i tried switching her to whole milk but she now gets a lot of gas and i dont know if its because the whole milk is lighter to the formula.. so i m really confused. Please help.",
    "doctor_response": "Hi, Exclusive breastfeeding for initial 6 months is the rule. After that, weaning may be started. Homemade food is the best compared to commercially available products like Lactogen. We usually ask mothers to make simple homemade infant feeds like Ragi malt, sun dried and powdered pulses, well cooked and mashed vegetables and fruits. Please discuss about these with her Pediatrician. Hope this helps. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a knuckle lump caused by injury?\n\nHello, Im a 21 year old girl, and I was in a fight recently. But as I was at the time intoxicated as I went to hit the other person (in defense of a friend) I missed and hit a fence, my hand was badly bruised but nothing seems broken, I havent been to a doctor but now I am worried as between my index finger and middle finger s knuckles, there is a hard lump that hurts to touch and feels like bone, its right up next to my middle finger knuckle. I don t know what to do about it. Thank you in advance for any help you can provide.",
    "doctor_response": "Hi,Dear,Thanks for the query to HCM. I studied your problem in depth and I understood your concerns. Treatment for knuckle lump in throat and headache-Consult ER ortho-surgeon,Elevate and Rest the traumatised  hand.Painkillers and anti-inflammatory-1tab x 2 times  for 5 days Xray of the hand.That is what you could urgently.This advise is based on the facts from the history you give and needs further clinical check.So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you, but just ask a query to HCM and be comfortable to resolve your health  issues.Welcome for any more query in this regard to HCM.Write good resume and Click thanks if you feel satisfied with my advise.Have a Good Day.Dr.Savaskar M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be the normal value for SGOT and SGPT?\n\nGood evening sir, recently i went for normal check up of LFT. The report given a shock to me . In the report my SGOT is 189.4 , SGPT are 94.5 and GGT is 13.5. Ocationally I take alcohol 1 or 2 times in a month. Less consumes Non-veg food, even though SGOT and SGPT levels were increased. Plz suggest the proper medicines. One of dr prescribed URDOHEP 300 for 15 days treatment.",
    "doctor_response": "HiThanks for askingBased on your report and complaints, my opinion is1. Your liver function test is not in normal range.2. SGOT and SGPT should be within 40 normally.3. Since you have a history of alcohol intake, you cab relate these deranged values to it.4. You need to cut down on alcohol intake, and improve your nutrition as well.5. As liver is the site for metabolism, you need to follow your doctor's instructions on medication and nutrition properly.Hope this helpsRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Difficulty breathing, high BP, creatinine level abnormal, blood in urea, kidney issue. What can be done?\n\nHello Sir, my uncle age 57 (from very week financial position) was recently having some trouble in breathing, after some tests dr. told us that as he is having high  blood pressure that was 180/110, and root cause is some problem in the kidney functioning, his blood urea is 80 and Cretan  level is 5.5, we have not started with any medicine til yet, as reports came yesterday only, I want to know what are the chances for him, can he be recovered with medicines or problem has reached to advanced stage. plz plz reply me as soon as possible. I want to know clearly what is his actual position right now and how we can cure him or which way to proceed for better treatment",
    "doctor_response": "Hi the reports do indicate that your uncle is having renal failure. the high BP & breathlessness are due to it. first you need to consult your Doctor and do few investigations like urine routine, sonography of abdomen,blood gas analysis. whether the renal failure is chronic or acute-reversible has to be looked upon. He should be treated with antihypertensives, diuretics to begin with. If breathlessness , urine output does not improve he may require dialysis. Actual prognosis depends on the type of kidney disease. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest methods to attain pregnancy\n\nI am 28 years old\u2026 I got married in Dec 2008\u2026. Now after 2 years we start planning a baby\u2026 My husband is a very shy person and only try intercourse 1 or 2 times in a month from November 2010 and he is very worried that why I am not getting pregnant and said consult a doctor for physical test what is your advice.. I think only 2 times we had successful intercouse",
    "doctor_response": "Hi dear, I have gone through your question and understand your concerns.Regular intercourse, every alternate day, in the fertile period of the menstrual cycle is a must to attain pregnancy.I will suggest you to have regular intercourse for at least6 months before getting investigated for the cause of infertility.Hope you found the answer helpful.Wishing you good health.Dr Deepti Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a shadow on the stress test report indicate?\n\nI had a pet cardio stress test a week or so ago. I spoke with DR. and was told there a shadow on front part of my heart. Doctor said might be some blockage in the heart, or could just be a shadow from my breast. Dr recommends Angiogram going through the arm. Not sure what this really means.",
    "doctor_response": "yes to diagnose cardiac disease better tests are angiography and stress echocardiography...go for these ..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause abdominal cramps and chills after swimming?\n\nYesterday I had a massage. Today I woke up feeling good except in the upper back between shoulder blades. I went outside to skim the pool a d got quite warm. Came i side for water and could not stop sweating. Now have chills and bad cramps in abdomen.",
    "doctor_response": "Hi, * Sudden chills suggest body response to varying temperature of the water pool and outside atmosphere. * Abdomen cramps can be non-specific or certain swimming act related. I would like to admire your further doubts anytime. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a sore inside the left nostril be treated?\n\nI have used a cortisone nasal spray for decades due to severe allergies. In the last 3 months, I have developed a very small sore just inside the left nostril. There was a bit of nasal tissue hanging down yesterday. Do I need to see the doctor or just treat it like dry nasal passage?",
    "doctor_response": "Hi,Thanks for using heathcaremagic.comI have gone through your clinical history and I can understand your concerns.Steroid nasal sprays for long term cause some side effects.As per your description you are having soreness,which is a common adverse effects of such nasal sprays.You can use saline nasal drops two drops four hours apart to get some symptomatic  relief,You can also use cotton dipped in glycerin for the same,but do not push too deep in to nasal cavity.The hanging tissue in your nasal cavity might be a polyp or retention of mucus,you don't need to worry regarding this.I suggest you to consult a general practitioner or an ENT specialist and you need to be evaluated,which include a rhinoscopy (visual examination of nose) rarely a CT scan or biopsy.The doctor can explain you regarding the further use of steroid spray.Hope this information helps.Regards.Dr.Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to recover from the neuroma in the left forearm?\n\nI been diagnosed with a neuroma in my left forearm and it has been giving me a lot of pain. I have numbness and tingling along with burning. I ha have d noticed to lump a few years ago but never botherd me. I had a test done to check for nerve damage. it only indicated slight nerve damage. I have headaches and ringing/fullness in my ears. I have always been physical. I can no longer carry usual weighted items in my left arm as I could before. The dr requested a second opinion. What else wo uld cause this?",
    "doctor_response": "Hello. Thanks for asking from HCM.I can understand your concern. The neuroma occurs after nerve damage to heal the damaged area. So whenever neuroma occurs, it means some nerve damage. It can cause severe burning pain due to abnormal nerve regeneration. Weakness of muscle and sensory loss occurs due to nerve damage. The management of neuroma is either conservative or surgical excision and repair of nerve. Conservative management is indicated: If there is no or mild symptoms: Symptom of burning pain only which is responsive to painkillers like Pregabaline/Gabapentine/Amitryptiline  : Old neuroma of more than 2 years old with complete functional loss. Surgery at this stage usually does not cause any functional recovery.Surgery is indicated if: Intractable pain not responding to painkillers: Neuroma of less than 2 years with functional loss - Excising neuroma and joining nerve ends may lead to some functional recovery. But before deciding for surgery, nerve studies are done to find out the degree of damage, site of neuroma, affected muscle. You can correlate your features and consult neurosurgeon for further management.For headache and fullness in ear, it could be due to ear infection/upper respiratory tract infection, you should consult ENT specialist. After evaluation, he might prescribe painkillers, antibiotic therapy, decongestant, ear drops for 7-10 days.Hope it will help you. Thanks. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain, pain in lower abdomen, vomiting. History of kidney stones. Is this appendicitis or kidney stone?\n\nI am 28 yrs old girl not married i usually hv back pain inthe center of back bone n pain in lower abdomen left side feww  days back had eaten spicey food which caused me the pain in back n lower abdomen frm left side also had vomit doctor said its infection in ependics hw to conform whether itz ependicies or kidney problem ...earlier i had kidney stones but urine test shwedno calcium",
    "doctor_response": "Hello,Thanks for the query to H.C.M. Forum.I would come up with these possibilities for this type of pain in abdomen on LEFT side , these  includes.1 Left renal stone , diagnosis can be confirmed by ultrasound of kidney.As all symptoms are suggestive of pain in the left side of kidney.2 Second possibility may be of peptic ulcer disease ( hyper acidity ) ,diagnosis can be confirmed by upper G I endoscopy.Try raising he head of your bed about 4 inches above with blocks.It might also help to avoid eating or drinking 2 hour before you lie down.To control stomach acid one should not eat chocolate or spicy or fatty or oily foods.Also take some antacid but if symptoms are severe then you may need drugs like proton pump inhibitors.3 Next possible reason may be pancreatitis . Get in blood examination for serum amylase and lipase.As this pain is radiating to the back so may be a pancreatic pain.In my opinion this is not a pain of appendix as appendix is always on the right side ( one to two exception in 1 million cases on left side).In my opinion consult another physician and get his opinion.Good luck.Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain under and around my ribs?\n\nIm having pain under and around my ribs on the right side I dont have a gaulbladder i am having regular bowel movements and passing gas i have vomited the pain is constant with sharp pains frequently that make me unable to stand up all the way i dont know if this warrents a emergency room visit or not",
    "doctor_response": "Hello dear user! and thank you for sharing your concerns with us!I'm sorry for the situation you are in!Pain around and under the ribs may be caused by too many conditions that affect, the abdomen, chest, ribs and muscles etc.It may be caused by, gastritis, peptic ulcers, liver diseases (you say you don't have gallbladder), pancreatitis, cardiac diseases, inflammatory conditions of muscles and ribs, etc.Additional examinations and test are needed to have a better view of this situation.I would recommend you the following tests and examinations:- Chest x-ray- ECG- Abdominal ultrasound- Liver and kidneys function indicators- Complete Blood count, lipids and sugar- Complete urine countAfter you get the results we will be able to have more information of your current health status, and we will find if something is going wrong in your body. After that your primary doctor will give you the proper cure or instructions to pass this condition.Feel free to contact us again for further information and details.I hope you will be fine soon.Take care!DR ERIOL.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does pulsating transfer from one generation to another ?\n\ni have a pulsating that has been going on for a few days in the bottom of my back my father had soemthing similar when he was younger and never mentioned it and he now suffers fro numerous collapsed discs should i be worried I have a throbbing/pulsating sensation in the base of my spine. I am worried as my dad recalls this when he was younger, he is now 40 and suffering with numerous collapsed discs the bottom of his spine! Should I be worried and what should I do?",
    "doctor_response": "Many a times this can be psychologcal also as you have heard all about it and now your father is sick. well have ashwagandha and praval. it will take care of your problems.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in swallowing food while suffering from anxiety?\n\nHi, I have for a long to,me eaten very quickly and never chewed my food enough, swallowing large pieces of food.  After eating, of which I've noticed more so over the past few months, on occasion the food seems to get stuck or go down slowly producing a tightening uncomfortable pain in my chest.  I have a glass of water and each gulp hurts but then five to ten seconds later the pain suddenly goes as though the water has helped lubricate the esophagus.  However tonight, it hapened while i was eating steak and rice, I felt the pain build after a few mouthfulls.  I stood up, the pain seemed to get worse at doing this and I an unusual sensation, as though I was having trouble breathing along with this tight lodged pain!  I had water and within a few seconds the pain had gone.  I am worried I might have a growth in my esophagus that is catching the food as it goes down.  I also suffer from bad anxiety and have had panic attacks in the past.  I definitely eat way way to fast and don't chew enough but am worried its been gradually getting a little worse over the last few weeks/months.  It doesn't happen all the time - I had breakfast and lunch and no issues - just occasionally - three or four times a week.  I'm male, 38 years ols with no knows medical conditions.  Thank you.",
    "doctor_response": "Hello,              You are well aware of your wrong eating style..  All the symptoms you have mentioned are attributed to that only..  First improve these habits..  and see...  if still these symptoms persists then visit ENT surgeon..  to rule out any growth near oesophagus..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful lump on the spinal area\n\nI am fused from c3 to t10 and have hardware placed. I have a very large hard lump around the end of c spine area ending and t spine area starting....the pain is horrific is yhis large lump and pain normal im a 4 time in 16 months spine surgery patient who ended up with alot af neourilogical problems..How do i know you a doctor for sure this is a serious problem i have not a joke?",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You may have some neurogenic tumour like neurofibroma or schwanoma or some other cause.  You should go for fine needle aspiration cytology or biopsy of that lump. 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I was prescribed 3 generic diflucan pills to take one a week for a yeast infection.  I am 3 days late and on birth control.  My husband and I had intercourse 3 times during the week I should have been ovulating and we forgot to use a back up method.  Does generic diflucan affect the effectiveness of my birth control?",
    "doctor_response": "Hello, and I hope I can help you today.The interaction between certain medications and the birth control pill are really theoretical except for a few medications that treat seizures and a couple of very strong antibiotics.  Diflucan is not one of those medications so you do not have to worry about the effectiveness of your birth control method.  So even if you didn't use a backup method it is extremely unlikely you would conceive, as long as you didn't miss any pills.I would recommend doing a urine pregnancy test just in case as your period is late (the pill normally is 99.5 percent effective which means 1 in 200 women a year will get pregnant even when using birth control). But the greatest likelihood is that everything is fine and you and your husband do not need to be concerned.I hope I was able to answer your question today and that my advice was reassuring.Best wishes, Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for poor immune system and frequent allergies\n\nI am wondering if there could be any connection to the symptoms i've been feeling lately.  I've been battling low iron for close to a year now and take daily iron pills, although my iron has come up a little its still very low.  I have been getting sick ALL the time, its seems like my immune system has totally disapeared.  I've developped allergies to foods that i've eaten for my entire life.  I have been recently been dealing with drepression brought on by hard times in my life and I'm exhausted all the time.  I just feel like these are a lot of things to be going on at one time and have them not relate to each other at all?!  Can you offer any advice?",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your history and would like to make suggestions for you as follows:1. Common foods causing allergies are - milk, peanut, tree nuts, soy, wheat, rice, eggs, fish, shell fish. I would suggest you allergy testing for above foods and if positive, I would suggest you to avoid that particular foods.2. I would also suggest you to take a good multivitamin-multimineral supplement, especially vitamin D, E, zinc, selenium and probiotics like lactobacilli for at least 2-3 months.3. I would also suggest you to avoid packed foods, hotel foods and unhygienic foods. Homemade simple diet would be the best. Please take plenty of green leafy vegetables and fresh fruits, if possible. This will help your immune system and depression as well.4. I would also suggest you regular exercises like walking and jogging. 5. Stress can aggravate allergies and also can adversely affect immune system. I would suggest you to be involved in meditation and relaxation program.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for a spine condition\n\ni had spine tb and l1 l2 got totally destructed. While mri shows total resolution of tb and it is 2 months my drug is over and i am hvg side efffects of medicines like spine is not taking my weight, palpitation inthe different places, is it possible to talke on phone, please give my mobile is 0000 rgds amarjit",
    "doctor_response": "Treatment of potts spine is long term at lest 12 to 18 months. It's unusual to get potts spine cured with just 2 maths of therapy with such a destructive lesion  as u have mentioned.  Anyway....continue ATT and wear limbo sacral corset.  Consult neurosurgeon for opinion regarding surgical intervention.Hope my advice will help you.  Take care. Don't forget to rate me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sore groin, no visible bulges, pain during walking\n\nhi my partner has had a sore groin for 2 days. there is no visible bulges round his groin area. He hasn t been doing any exercise but his job requires him to stand for long periods ata time he works in a factory. When he pushes his hand in where the pain is he says it doesn t hurt, but when walking back from work last night the pain started up again and it does intensify the pain at times",
    "doctor_response": "Welcome to Healthcare-magicGreetings of the dayIt would be better if you could be more detailed where exactly is the pan as groin is such a big area. Try keeping the area clean and dry. Consult a General Surgeon.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe cough followed by vomit and chest pain?\n\nhello doctor I am 31 years old, my height is 160cm and weight 70kg. i suffered from esnophilia last year.. i had severe cough followed by vomit, i consulted a pulmologist who diagonised my problem. my chest xray was clear, lungs performance test was good. i took treatment for esnophilia and was alright.. however after that i suffered from frequent cough with loads of mucous in phlegm and would get alright after some days... now for quite some days i am feeling discomfort in my right side of the chest and i would feel better when i cough... my breathing process would be hampered with discomfortness and cough would be triggered and then i will feel comfort... while coughing sometimes my chest pains along with back ache... i am much worried whether these are signs for risky disease like lung cancer.. recently i have discomfortness in left side of my chest and was diagonised by a cardio as gastrities....do that may be the reason for my current problem.... pl advice",
    "doctor_response": "Hi,Dear,Thanks for your query to HCM.Dear I read your query and reviewed it with context to your query facts.I understood your health concerns and feel Concerned about them.Based on the facts of your query, you seem to suffer from-Eosinophilia with Asthma with Gastritis.This HES-hyper eosinophilic Syndrome- mostly is caused from parasitic infestations/ or drug reactions with angioneurotic reactions or Vasculitis from foreign body reactions by the body.Eosinophilic Gastritis is known conditions as is eosinophilic esophagitis.Yes,Eosinophilia is the cause of your health concerns of cough, vomit,and chest pain.Hope this would help you to solve your health issues in the best way possible. Welcome for any further query in this regard.Good Day!!Dr.Savaskar M.N.Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with bipolar & anorexia\n\nMy niece has been diagnosed bipolar just a month ago. She has attempted suicide twice and been hospitalized 4 times in the past 2 to 3 months. She is also cutting and anorexic . She was on a medicine that has seemed to help and recently wanted to Change it due to gaining 5 pounds. She was given the new medicine and 80 pills to help her sleep better. She quickly declined and called her mother to come to her aid. Her mother was on her way to her apartment (30 minute drive)and she decided to take the rest of her sleeping aid (75) pills because she was so upset with herself about going downhill again. Quickly she realized this was so stupid and she had her roommate rush her to the hospital. She is fine and being released today from the hospital. I feel her parents are going to give her an altmatuim and make her move home.mi have asked what professionals have advised and they say they are making the discussion themselves. I am worried that this will put her in a huge tail spin and send her off the deap end. I have asked them to consider a family intervention with a professional to determine what should be done next. Do you feel a person who is newly diagnosed and not yet stable on medication should be backed in a corner? I feel there is so much going on between the parents and her that they need others to help convince her what should happen next. She is 20 and can refuse all help. I feel there is just a small window of time to convince her, before she shuts everyone out. What do you think?",
    "doctor_response": "HIThanks for using healthcare magicI think, she has underline depression or borderline personality disorder which may have been misdiagnosed as bipolar disorder and she needs psychiatrist consultation. She needs proper treatment with antidepressant and with that, her suicidal ideation would decrease. You can also take her of psychologist for cognitive behavioral therapy in her case, that would give additional benefit. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Follicular study shows no free fluid in POD.  Possibility to conceive?\n\nhello doctor, i done my follicular study, the report are11 th day RT Ovary F1:16*13, F2:12*9 MM, LT Ovary 19*13 , ENDo. Thick 6.9 and no free Fluid in POD. 13 th day F1: 17*13, F2:14*12MM , LT ovary 14*11mm and endo 7.5, Decrease in LT follicle15 th day F1:12*11, F2 is not seen, LT ovary13*9 and endo 9.3mm, No free fluidI took hmg inj from day 3 to day 11 and hcg trigger on my 11th day.kindly advice this report is good or bad.Is that only possibe to get pregnant if the fluid is present in pod.",
    "doctor_response": "welcome to HCM!get some investigations done-like serum prolactinserum TSH levelin your case there is no ovulation.once it starts occuring , then you can get pregnant.waiting for the reports",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart palpitations with increase in weight?\n\nI had been using Mintop for 8 months. I did not see any effects of it. But my weight increased about 14 Kgs. I am 28 years old, Male. Now I experience increased heart beat easily with small excursions and easily get tired. Please can any one of you explain what should I do?I  am 176 cms tall and been taking Mirtaz tablets for past 2 years for depression.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Weight gain in depression patients is mostly due to anti depressants side effect or uncontrolled depression itself. You are also having tachycardia. This favours uncontrolled depression more. So in my opinion, you should consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on it's solution. Counselling plays very important role along with drugs in control of depression. Newer anti depressants are more beneficial in prevention of side effects like weight gain. Don't worry, you will be alright with all these. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat swelling of prostate and pain during urination ?\n\nI had Postate Cancer treatment, Brackytherapy in July 2009 all went well untill 2 months ago, prostate swollen painfull to sit, painfull during and after urination, had blood work, stool test, nothing found no infection etc, had urethra scope looked into extremly painfull I cryed out had to lay down to allow nausia to pass. I take Lotrel for hi-blood pressure, viagra and vacuum system for intercourse. We tryed food alegery (acidic foods) Avodart, Uraxatrol, Proposed, Pentoxfylline with no results. Currently on Elmiron, Rapaflo, Phenazopy.",
    "doctor_response": "Thank you for your question. Yes painful urination following prostate cancer treatment is not uncommon however should  be investigated well.1. urinalysis confirm if there is infection.2. CT scan  and or ultra sound of pelvis to check if there is regrowth of prostate cancer.3.PSA level 4. Full haemogram to check for amount of blood and bacterial infection.Treatment Will depend on the results. Consulting urologist and oncologist will be helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can lesion along the lateral wall of the left leteral ventricle identified again be cancerous ? Had brain tumor operated, on oral chemo and radiotherapy now\n\ni am 45 years old,waight 77kg.on February 2009 i had a brain tumor opparation & it was GBM and gread 4.i got radiotharapy and still i was having oral chemo.after every 5 weeks 5 days till May2011.untill march 2011 there was no lesion seen.but in the last MRI on April there is another new lesion seen again.it was 1.3cm.and on26 jun the Finding was :lesion along the lateral wall of the left leteral ventricle is again identified there has been interval increment in size measures 2.0cm.no definite newly developed lesion seen.there are no other significant interval. now i am having oral cemo after every 2 weeks 5 days, i had 4 curcle already. my Question is what should i do now?",
    "doctor_response": "Hi, Sadman, Thanks for query, Not brain tumour but any tumour spreads fast to surrounding parts and lymph nodes and other organs. Radiation and chemotherapy are symptomatic and relief from distress. You continue the treatment as per schedule. ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for the knot under breast in 7 months old\n\nmy daughter is 7 months old and she has a knot under her right breast. last month the doctor said usually they are gone by the time the child is 6 months but as long as it isn t bigger. it was the size of a bee bee last month and this month it is the size of a green pea so i think it has gotten a little bigger. should i take her to a specialist? We have all types of cancer that run in my family and i m a little freaked out now at this point. Thanks",
    "doctor_response": "Hi... I don't think this is related to cancer. Do not worry. Sometimes these things can happen due to hormonal changes and they will settle down by themselves as your doctor has suggested.But I suggest that you get an ultrasound examination done of that region so that we can be sure what it is.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low BP\n\nMy husband has a history of heart disease. He has an ICD . His blood pressure is running 90/66 to 88/57. He is feeling tired and sorta lazy like. Normally BP runs 108/68 to 100/59. His pulse rate fluxes from 70 to 71. I feel his BP of 90/57 is too low. How can I safely raise is a little. JAK",
    "doctor_response": "Hello! Thank you for asking on HCM! I understand your concern, and would like to explain that when facing with low blood pressure values, the two main points to investigate are: (1) cardiac performance (is there a severe left ventricular ejection fraction compromise?); (2) excessive therapy implications (probably, a dose modulation of possible vasodilators  and diuretics should be done).Facing the fact that your husband has an ICD implantation, seems that both the above mentioned point have serious implications on the matter. As I lack more specific information about  actual medical status, cardiac performance and current therapy, I recommend to discuss with his doctor about the above options, and find an optimal strategy to deal with.Hope to have been helpful to you. Greetings! Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible 21 year old could of developed idiopathic scoliosis from having a lumbar puncture performed when she was 18 months?\n\nIs it possible ny 21 year old could of developed idiopathic scoliosis from having a lumbar puncture performed when she was 18 myths old.she had meningococcal septocemia. Doctor is waiting for xray results to confirm scoliosis . Suffering g from back and chest pains for last year. Thank you",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!Regarding your concern, I would explain that the scoliosis spinal column deformation can not be caused by a lumbar puncture even in a very young age. But chronic deficiency of vitamin D or calcium or even a wrong posture can lead to this symptoms. I recommend performing vitamin D and calcium plasma levels to exclude this possibility. A spinal column CT scan would help give more information on the anatomy of your spinal column and possible treatment options. Meanwhile, i recommend correcting your posture and perform a lot of physical activity which is important for the reinforcement of the back muscles. Hope you will find this answer helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sneezing, runny nose, teary eyes after using all purpose flour. Have mild gluten allergy. Can there be allergy to raw flour?\n\nI have noticed that on three different occasions when I'm using all purpose white flour to bake or fry I immediately get a reaction whereas I'm sneezing, runny nose, teary eyes etc for 3 days or so.  Is there such a thing as being allergic to raw/uncooked flour??? I do have mild gluten/wheat allergies.  I have never had this type of reaction to raw/uncooked flour in my life other than these past three occasions.",
    "doctor_response": "Hi,  Allergy is a wide scoped entity ,Any thing&every thing in environment will create allergy to somebody.      It can be food,clothes,cosmetics, toiletories,insect bites, hairs, dust from any source-bed, house, grain,fumes  and so on!The person with allergic tendensy may devolop allergy to newer things in course of time.      The expirience of symptoms on exposure to certain suggests the allergy to that thing.OR you can get yourself tested for various allergens .      Prevention of exposure to allergen is 1st step in controlling. Anti allergic medicines help to control an episode While& desensatisation treatment is curative      Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes clotted blood from gums and sample drawn?\n\nHi ,My brother has got an issue, all of a sudden blood started bleeding from his gums in the form of clots and there are blood clots on his cheeks inside mouth, Can you please let me why is this happening.. and another point is when blood sample was taken for tests, blood has cloted in the place where sample was taken too... Please help me .. let me know if any immediate action to be taken..",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.He may have some clotting disorder. He should go for complete coagulation profile. It will help you to reach the cause. then he should take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any chance of pregnancy if condom broke during intercourse?\n\nLast Friday, I think our condom broke during intercourse. My period was already late prior to that, and I still haven't gotten it. What can I do to make sure I don't get pregnant, or how can I get rid of it if I already am? ( Without Abortion) PLEASE HELP.",
    "doctor_response": "Hi, If you periods are already irregular it's to predict the chance of pregnancy.But if regular , Chances of pregnancy are low in last week of the cycle ( safe period) . Now presence of pregnancy can be confirmed by either simple urine pregnancy test or more confirmatory is Serum Beta HCG. If within 72 hrs of condom failure emergency contraceptive pill can be taken. earlier the better.Getting ride of it means Abortion !",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for clear discharge, tender testicles, no itching or pain while urinating?\n\nThe problem I am having is very confusing, about 2 months ago give or take, I had unprotected sex with a questionable girl, about a week and a half later I experienced mild painful urination and pretty severe itching, I made an appointment at a local hospital and they took some blood for a test and also had me pee in a cup, and I was put and antibiotics for chlamydia and gonorrhea  (I don't remember what they gave me) well about two weeks later I got my results back and I was negative for everything, they told me it may have been to early for the bacteria to show up, so about a week after receiving my results I went and got tested at another clinic, the tested me also (urine only) and gave me a different round of antibiotics which seemed to work, they haven't called me about me results yet so I figured nothing must have turned up, but as of late I'm having small amounts of clear discharge, my testicles are a bit tender but they always have been, there is no itching or pain while urinating, it is quite worrisome that i'm experincing this, i've take enough antibotics to make a person sick, do you have any advice or something, i'm desperate",
    "doctor_response": "HI. You say- my testicles are a bit tender but they always have been// . It is always better to take a 3 week course of antibiotics for Urinary infection to get cured. Drink plenty of water and a clear discharge can be a normal thing coming from prostate.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How much time does it take to recover form laparoscopic appendectomy ?\n\nHi I just had laparoscopic appendectomy last night an I m home already my problem is I have to fly out on thusday an wanted to know if it s ok to do so. Thanks",
    "doctor_response": "After laparoscopic appendectomy, there is no harm in doing normal activities even on post op day 1. But as you are travelling on a plane, you should avoid long distance travels, as if some thing even trivial happens, it will make u very much worrisome. It is advisable to consult your surgeon before leaving, so that he could examine u thoroughly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach ache and flu?\n\nHello,My name is izwin.Me n my 3 boys has been down with flu n cough for 3weeks now. we have been going on the second set antibiotics since yesterday.My main concern is that my 8 yr old and 6 yr old has been having stomach ache vomiting and they wont eat. what do i do? from what i gather is that they r having too much meds to cope with.",
    "doctor_response": "HiWelcome to the HCMI understand your concerns but don't worry. The most likely reason for these symptoms is a viral illness which easily spread amongst children. They do not need antibiotics unless and until blood or culture reports suggest a bacterial infection.Repeated antibiotics should be avoided. The need to development of gastritis, indigestion, antibiotic resistance. I would recommend a symptomatic management including antihistamine such as Chlorpheniramine or fexofenadine along with antipyretics.Give Lansoprazole for stomachache and associated vomiting. Hopefully this will help you.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for fluid discharge from belly button?\n\nMy grandson has an ileostomy. Recently, he had fluid leakage from his belly button. At first it was clear fluid. He was hospitalized in Boston. They did an ultrasound and cat scan but didnt see anything unusual. They gave his high doses of antibiotics and said it was probably a localized infection. Last week it came back only this time it was green fluid coming out of his belly button. After reaching the Boston doctors again, they put him on antibiotics for 10 days. His bellybutton is not infected. It is coming from inside. What could be doing that?",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.The clear history of a clear fluid and then the green fluid from the belly button is suggestive of a condition called patent urachus or patent vitillo-intestinal duct. This is not easily diagnosed on ultrasonography or even a CT scan.I would advise the following in such a patient :Get the examination of the fluid done- the routine, microscopy, culture and sensitivity. Since the antibiotics are not working , it is better to do an exploratory Laparotomy , see for the underlying cause and get a surgical correction for a permanent cure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have itchy red rashes that wrinkled after applying moisturizer. Please help.\n\nHi doctor, I am having a problem with dry skin and rashes. I have a history of atopic eczema on the neck for which I am applying Flutivate cream. 4 weeks back some red rashes started coming up with itching. I thought it is because of dry skin, so I applied coconut oil and moisturizer. The redness has gone, but the skin is wrinkled. On scratching sometimes blood is coming up. Currently, I am taking Losar 50 mg, Nexito plus and Thyronorm tablets. I am attaching the pictures for your reference. Kindly help.",
    "doctor_response": "Hi.  Kindly send me the photographs of your face with a closed eye. Any other medication history, two to four weeks before rash?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can taking the following medicines be safe for triple vessel coronary artery?\n\nMy father in law has been diagnosed with Triple vessel coronary artery disease; he has been on the following medication for the past 3 weeks; and is currently facing unexplained weakness. he is feeling weakerby day. could you please advise on what medication to continue? tab ceruvin A 75- once daily Xtor 20--- one daily at night Cardace 2.5 --- one daily at night Lasilactone 40- once daily after lunch Ranolza OD - once daily at night Tab Ismo 20--- twice daily at morning and evening 4:00 Pantodoc 40---- once daily before breakfast...",
    "doctor_response": "Hello, He needs to use all these medications, and you only can monitor his blood pressure and cardiac frequency, especially when he feels weak, ismo can be once daily, in the evening. I do not see aspirin (acetylsalicylic acid) which is very important, and a possible beta blocker based on the heart rate and blood pressure. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Anila Skenderi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have bodyaches, fever, weakness. Ibuprofen and tylenol taken but no relief. What to do?\n\nhi, my mother has had bodyaches for a week. one day 101 fever. she took ibpr for 3 days and anti allergy followed by 1Tylenol  daily. she does not have feve on the thermometer, but feels feverish and weak. the doctor says that he sees no signs of virus/ infection , she has no cold or sore throat. he thinks its probably exhaustion. what should she do?",
    "doctor_response": "Tynelol paracetaml, ar known to cause allergies withdraw take anti allergics Tab fexofenadine 120 mg bd for body ache use diclofenic and meftal for fever give antiallergics for 10 ndays dont ue paracetamol group in future",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to conceive as i have cyst and irregular periods\n\ni 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",
    "doctor_response": "Hi I think you should go for a 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 clomiphene 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recurring shin fractures.Prescribed Prednisone with Methotrexate and folic acid. Suffering from Lupus. Alternative cure?\n\nThanks for your time. My daughter has had lupus from age 12 and is now 20. We have gone through quite a few different treatments and have had great success.Currently she is going through a year of flares.She plays volleyball on a University team, they look like they will qualify for the NCAA tournament. She is a starter for her team, something she has had to worked hard for this past year.She could not play last year because of a left leg shin fracture. I think it was because she was on prednisone and it weakened her bones. It took her a long time to heal last year. Now she is playing a lot and has started to develop a shin fracture on her right leg. Very painful! She has again started to flare. She had a hard time getting out of bed one day this week. I took her to the doctor and they are starting her on a higher dose of prednisone plus methotrexate and folic acid. She was on cellcept for about 3 year. She also did 4 treatment (one series) of retuxinab (?). I want her to be done with volleyball but she is a determined young lady who loves to play. My question is about the article connecting liver fluke and Lupus. Is this something I should research? Another thought I have had is when she was 5 she got a very bad case of Mono, could this be a possible reason she has lupus? I would appreciate any thoughts for an alternative and/or conventional cure. If I can be so bold to ask for one.",
    "doctor_response": "Dear Madam, I think she should not stress her body unnecessarily and the standard treatment for lupus does not comprise liver fluke . Dr . Shruti",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does fluid in liver cause fever?\n\nhello dr. my dad age 55 yrs. has undergone liver resection before 6 months. since then he is having constant fever. now the reports are showing 3.6 bilirubin. according to our dr. it can be due to cirosis or there may be some obstruction. some amount of fluid is also seen in sonography. can this fluid be a  reason for  100,   101, 102 fever",
    "doctor_response": "Hello and thanks you for your query. I am Dr. Rommstein and I will try to help you as much as I can with my answer.Yes,this fluid may be bile or an abscess and in this case it could be caused if fever,pain and weakness. He should do ct scan and then this fluid can be drained percutaneously or another surgery may be required. Antibiotics may be efficient but if there is no improvement then you should do what I 've mentioned above.I hope I have answered you query. If you have any further questions you can contact us.Kindly regards. Wish you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to determine if pelvic injury has caused conception difficulties?\n\nI had a hammer hit me in my right pelvis area where I imagine my ovarie to be ... I have been married 2 years and no luck getting pregnant how can I get this looked at. Can it make me not get pregnant? How much does it cost for in vitriol or to get my husbands sperm tested",
    "doctor_response": "HI, thanks for using healthcare magicIt is unlikely that this injury would have significantly affected your ability to conceive.There are different reasons for infertility. It can be due to male or female causes or  due to a combination.In terms of your partner, you are right in assuming that he would need a semen analysis. The cost would vary according from one lab to the next. He can either consider speaking to his urologist , speaking to a lab directly to find out the cost.In terms of your investigations, your doctor would need to assess the different aspect of the reproductive system- the uterus, ovaries, tubes, cervixThis would involve both imaging and blood tests. You should consider visiting your gynaecologist or a fertility specialist.Even if issues are found with either of you there are effective techniques available that may be able to help you conceive.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does taking Pravastatin during pregnancy affect fetus?\n\nHello, I recently found out that I am pregnant, of course this was not planned at all.  I was taking Pravastatin 40mg a day.  I stopped as soon as I found out.  Everything I have read is not good.  I'm so worried about what I may have done to my baby.  Is there real evidence that this causes birth defects?  I'm so scared.",
    "doctor_response": "Hi & Welcome.I can understand your concern for the safety of Pravastatin during pregnancy.Pravastatin use is considered contraindicated during pregnancyPravastatin (HMG-CoA reductase inhibitor) is an effective medication to lower the cholesterol level. It has been assigned to pregnancy category X by the FDA.It is  known to inhibit biosynthetic processes necessary for fetal development which may be harmful to growing fetus & which may cause congenital central nervous system and limb abnormalities if taken during the first trimester of the pregnancy.Hence, I advise you to consult your gynecologist for meticulous ante natal checkup which may require serial examination of the fetus by ultrasound scans. Meanwhile, continue to take iron and folic acid as prescribed by your doctor.Hope this answers your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could chronic gastritis and pancreatitis lead to cancer?\n\nhello In 2003 I had pancreotitis. How do I know if I still have it now. Doctors tell me that I have chronic gastritis. I am feeling okay, sometimes no pain at all, sometimes little abdorminal, but not in the back. Could both of these lead to cancer, or am I being paranoid? Thank you very much.",
    "doctor_response": "Chronic pancreatitis and chronic atrophic gastritis are both risk factors for development of cancer. But that does not mean that every patient with these cONDITIONS will go on to develop the cancer. You may undergo a CT scan and UPPER GI ENDOSCOPY regular basis to rule out the development of cancer and rellieve your undue worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on nipple and pain in left rib cage?\n\nHi, may I answer your health queries right now ? Please type your query here... I am a 42 year old male and found a lump on the left hand side of my nipple since last august, the lump is not round in shape more like a small oblong shape. I have have 3 GP s look at it and they said its very unlikely to be anything concening. I also get pain on my left rib cage as well and very worried this might be linked to the lump. I visited my GP again and he referred my to have an ultrasound. Please advice I am worried that I have cancer. The size of the lump has not changed in size since i discovered it",
    "doctor_response": "Hi, Thanks for query to My  HCM virtual Clinic.I studied all details of your query.Your query information is insufficient to comment on whether its cancer or not.In this background I would suggest to consult Surgeon,who would be the right consultant to check and opine about the suspected lump near left nipple and who would treat it properly.If need be he may do FNAC biopsy to fix the cause of your chest lump.In My Opinion you seem to have problem of Confusion and obsession- anxiety of having cancer,and hence the over handling of your so called lump,(which could be Sebaceous Cyst or a  normal fat lump) is giving you lump and the pain in the ribs under the suspected lump.Hence Second opinion from  Surgeon would remove your worry.Hope this satisfies your query.Don't forget to hit thanks and write excellent review comments to help needy visitors at HCM.Welcome for any further query in this regards.Dr.Savaskar M.N.M.S.Genl- CVTS.Senior Surgical Specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are symptoms of carpal tunnel syndrome?\n\nDo I have carpal tunnel syndrome? Last night, I was doing my friendMs hair, and all of a sudden the tip of my right index finger started to feel like it was falling asleep. I ignored it for a while, thinking it would of course go away if it was asleep. But an hour later, it was still there. It felt as if it were falling asleep, but with more of a tingling feeling. My right index finger is the only place on both hands that is having this issue. My parents think I may have carpal tunnel because of teen texting.",
    "doctor_response": "yes your symptoms shows there is a compression of medial nerve but we can't conclude whether it's compressing on the wrist or neck area. we can decide it only with a physical evaluation..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in left side of chest after sneezing and coughing?\n\ni have been having pain in my chest towards the left side when i sneeze and cough....sometimes it is more sometimes less and now it is even there when i am neither sneezing nor coughing.what could it be?i am 45 yrs old,height is5'5weight is 94kgs,recently diagnosed as diabetic and have hypothyroidism",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Left sided chest pain in patient with diabetes and hypothyroidism should be evaluated for heart diseases. So first get done ecg, 2d echo and stress test. If all these are normal then no need to worry for heart diseases. Musculoskeletal pain can be the cause because you are having pain on rib cage movement (coughing, sneezing). So apply warm water pad on affected areas. Take painkiller and muscle relaxant drugs. Take antihistamine for sneezing and coughing.. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have an asymptomatic rash under eye, diagnosed with SLE, high liver enzymes. What seems like the problem?\n\nI have an asymptamatic rash under my right eye, my doctor diagnosed me with SLE because my liver enzymes were up, but I had been drinking 2 days before the blood test was done. Could this be a mistaken diagnosis? I have no other symptoms and again, the red mark is only on one side of my face and doesnt hurt and it periodically gets smaller but comes back to its original size.",
    "doctor_response": "Hi! Welcome to HCM! The diagnosis of systemic lupus erythematosus (SLE) must be based on the proper constellation of clinical findings and laboratory evidence.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Y am i not getting pregnant?\n\nHi! My name is Marissa. I'm currently trying to concieve my first child with my fiance. We have been trying for over a year. I have been taking ovulation tests every month but I get one positive around the 2-4th day of my period and once on my fertile week. Am I not getting pregnant because of that? Please help!",
    "doctor_response": "Hello.I understand your concern.A pregnancy requires a physical and hormonal balance in the body.Infertility needs a workup of both partners (sperm analysis for your husband),along with a detailed medical history and menstrual history. I would suggest you visit an infertility specialist and undergo the tests for checking hormonal imbalances (blood tests), ovarian follicular monitoring(ultrasound) and HSG(for tubes), and others as will be asked for.We need to find out where the problem is- ovulation or tubal factor etc. Treatment will be cause-specific.It is important that you maintain a healthy diet and exercise regime as well.Do not worry.Write in if you have any doubts.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is tenderness in breast and nausea after periods sign of pregnancy?\n\nok me and my boyfriend had sex 2 weeks ago and afterwards the condom slipped off inside me. when i went to pull it out it seemed like all the semen was still in there. but the next day we got the morning after pill and everything seemed fine. now 2 weeks later i started spotting which alternated between being heavy and light bleeding, it lasted about 3-4 days. and now my breast are tender to the touch and im starting to feel a little nasuseated. is there a way i could possible b pregnant?",
    "doctor_response": "Dear Madam,Though slipping or bursting of the condom during intercourse is known to cause pregnancy, you have very rightly and thoughtfully covered this risk by taking morning after pill; which is very effective emergency contraceptive pill. So the chances of pregnancy due to this accident are very low. Morning after pill contains hormones - Progesterone or Progesterone+Oestrogen, which are known to delay periods by few days. Also due to the effect of Progesterone, breast tenderness and nausea may bother. You have got following options:1. Wait for menses to appear for a week after missed period. Mostly they will appear.2. If they do not appear, perform pregnancy test on the overnight first morning urine sample 8 days after missed period. Earlier, these tests may give false negative results.3. Straight a way opt for Beta hCG test which gives reliable results even few days before missing a period. If you are not pregnant and still the periods do not appear, you may take Tab. Deviry for 5 days. 4-7 days later, you should get withdrawal bleeding. If you are not pregnant, nausea and breast tenderness will subside subsequently within few days to weeks. I hope this helps you. Dr. Nishikant",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the mediastynum cyst on the right side of my chest?\n\nHi Doctor. I just got back from my CT scan. 3 months ago they located a 2 cm mediastynum cyst on the right side of my chest. My doctor sent me to get another CT 3 months later to see if it grew. Thy told me that it looks the same and that it is on the right side of my body near my heart. What should I do? And what is it?",
    "doctor_response": "Respected user, hi I evaluated your query thoroughly .* Mediastinal cyst has vivid pathologies ranging from benign neuronal tumors   to malignant ones .* Mediastinal cyst evaluation needs correlation with detailed history of the    patient , clinical assessment , signs elicited by the consultant, exact location    in the mediastinum with in depth analysis of reports , Biopsy of the lesion   giving histopathological evidence of the disease.Hope this helps you.Welcome for any further queries.Thanks for using Healthcaremagic.com & giving me an opportunity to assist you.Wishing you healthy life ahead.Regards dear take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long can Citralka be used once its open?\n\nHi.. we bought the Citralka (disodium hydrogen citrate syrup) for my 11 month child. We gave the syrup for two times before 4 months and we need to give it again now.. so can we give the same syrup even it is already open and its validity for 2 years.",
    "doctor_response": "Hello, One should not use syrup for more than 1 month once it has been opened. Use another bottle. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Loveleen Sharma, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for severe joint pain\n\nmy wife had viral infection which left her with severe aches in all joints she has just been refered to a rheumatologist which will take months on the nhs some days the pain is really bad and cannot walk bloods have been clear,she was given anti inflamatories but these give her severe diarrohea",
    "doctor_response": "helloMultiple joint pains should be diagnosed by a rheumatologist surely, but the GP may suggest certain baseline blood tests like cbc,aso ,esr,anti-ccp,rheumatoid factor etc and make preliminary diagnosis and give medicines which may not produce diarrhea-like tramadol, paracetamol after meals alogwith rabeprazole on empty stomach",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for heart burn\n\nI am 16 weeks pregnant and I had bad heartburn before I was pregnant and drank nexium on a daily basis, but now that I am pregnant I cant drink anything. My heartburn has just gotten worst and worst and it gets so servere that it makes me throw up and doesn t let me sleep. What should I do?",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the heart burn is a routine problem faced during pregnancy due to the influence of progesterone hormone in pregnancy.As you had the gastritis before pregnancy it might get aggravated in pregnancy.But you need not worry as it can be controlled by medicines.The antacids can be taken as first line of treatment.If there is no relief then proton pump inhibitors (PPI) can be tried.Among PPI the omeprazole can be taken during pregnancy.It has good safety profile and is not associated with any harmful effects on the fetus.Nexium is almost similar to omeprazole.So you will get relief from PPI.So nothing to worry.Relax.Also dietary modifications like avoid spicy and oily diet and take food in small quantities every 2 hourly.Take buttermilk or curd daily in diet to decrease gastritis.So check for dietary modifications,antacids and PPI if needed.Don't worry.It will subside.Avoid stress.Hope this helps.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having red sore, itchy spot like bumps on chin jawline. Applied sudo cream which helps temporarily. Cause and cure?\n\nHi I have red sore itchy spot like bumps on my chin and jawline, the dont seem to be spots as i can not burst them, i have 9 in total from one side to the other and well spread out. I dont normally suffer from spots either. I am 35 Male I have tried sudo crem and it helps for a while but the are very itchy and sore when left alone?? Do you have any ideas to what it may be that is causing this?",
    "doctor_response": "HiThanks for your query.You seem to be developing superficial folliculitis.Avoid using oils or moisturizers over the face.Use a topical antibiotic cream over the affected area twice a day.You can take oral antibiotics for the same also.Do not apply any irritants or dettol over the face.Do not use and steroid creams over the affected areas.Hope it helps.DR Geetika Paul",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for rashes due to virus infection\n\nMy 1 year old daughter has a rash on her arms torso back and legs. 2 days ago she was omitted to hospital for tests as she was unable to crawl on her knees as they were a little swollen and red. they took xrays and bloods and said it was all ok and that it was probable a virus. Now one day later she has developed this rash which seems to be spreading rather rapidly. She has no temperature or signs of a fever and seems to be alright. What should I do",
    "doctor_response": "Hi, Perhaps she has a viral exanthem. I suggest you to use a soothing lotion e.g calamine lotion.  In addition i suggest her to take an oral antihistamine e.g either cetrizine of benadryl for a few days.  The rash would dry up and exfoliate in a few days. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Inderal provoke wheezing and allergic episodes in cardiac patients?\n\nHi doctor, I am a senior year medical student in Greece and I would like to ask you a question about my mother. She had a history of hyper/hypothyroidism about 10 years ago, but the last two years her thyroid has been managed and she stopped taking T4. Her cardiologist told her about 10 years ago to start taking Inderal (Propranolol 20 mg per day divided in a two time dose) because she had palpitations and some arrhythmias. She had an echo/ecg about a year ago and her heart was fine and her cardiologist suggested stopping Inderal. But being a very anxious person and having frequently anxiety tachycardias she did not stop it. Which brings me to the present, having been diagnosed the past six months by her pulmonologist with allergic rhinitis/asthma and having frequent wheezing episodes, even though she takes antihistamines when the episodes occur. Shouldn't she change her beta-blocker to a cardio-selective one? She finds herself not being able to breathe while on Inderal, but the symptoms reappear when she takes it. What would you recommend as a cardioselective beta-blocker? Would it be safe to change from Inderal, to let us say Atenolol? If yes, how would she do it?",
    "doctor_response": "Hello. I have gone through the history you have described for your mother. I really appreciate the way you have presented it with all details. It is very important to know the reason to start tablet Inderal at first point. What kind of arrhythmia it was and all in order to evaluate does she really need to continue any beta blocker. As your Cardiologist year ago after cardiac evaluation did not find any reason to continue the medication as per your history. As we see in a day to day practice patients with palpitations just due to anxiety or stress and without any cardiac issue, non-selective beta blockers would definitely aggravate her symptoms. BP you have mentioned in your description is wrong I guess. As it appears to be 12/20 something, might be a type error but looks normal to me. For time being you can change the beta blocker to a selective beta blocker like Metaprolol (12.5 mg) or Nebivolol (2.5 mg) or Atenelol (25 mg)on a very low dose. Get her evaluated again with her cardiac reports whenever possible and if not required better to slowly taper her beta blocker medication and stop as well. Because though cardioselective beta blockers has some or minimal effect on beta 2 receptors as well. Even I would advise to start meditation and yoga to overcome her anxiety issue, that will help her in controlling palpitations if they are related. Would like to review her all previous and recent cardiac records to further discuss and clarify management strategy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is conception possible with PCO while on siphene 100mg?\n\nHello doctor..I need advice as am taking treatment for pregnancy.Got married 6 months before and diagnosed as PCO. As been under mediation of melmet 500 and diane 32 for last months. Now my doctor prescribed me Siphene 100mg from 2nd day of cycle to 6th day.Currently undergoing follicular study8th day- both ovaries showed multiple small follicule with PCO on left ovary. endometrium of 5.8mm10th day- right ovaries with MSF and left ovary - 16x13 mm & 14x13mm. endometrium of 6.8 mmis this normal? When should intercourse be done for getting pregnant.Please advice on supplementary to be had too.Thanks,Priyadarisini",
    "doctor_response": "Hi,Welcome to healthcaremagic.I read your query and I understand your concerns.Following is my reply:1) You are on right treatment.2) Please get semen analysis of your husband and also HSG for yourselfLet me know if you have any more queries.Regards,Dr. Mahesh Koregol",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can LT Paracentral disc extrusion cause pain in ribs and chest?\n\nI currently have a small LT Paracentral disc extrusion with annular tear at T 6-7 and T 7-8. Also minimal disc bulges at  T 9-10, t 10-11 with a broad based disc protusion with annular tear at T 11-12.  I have trouble with breathing sometimes, or any pressure on my upper stomach just below my diaphram. Can this be a factor in that, aside of course from the pain that radiates from my thoracic to my ribs and chest?",
    "doctor_response": "the spinal nerves come from the gap in between the vertebrae.. disc bulges causes compression of the spinal cord and the nerves.. these spinal nerves in the thoracic area will supply your intercontinental muscles   so the pain radiating along the course along with the breathing difficulty is due to that. . since its symptomatic therapy is needed for the disc bulges.. would suggest an orthopaedic opinion..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is laser blast treatment ok for kidney stones?\n\nHello ,         I have a problem with kidney stones .        Right Kidney: pelvis and calcyces  dilated , entire right ureter is dilated 9mm calculus noted at right VUJ.Doctor suggested  for a laser blast treatment , so is that ok please suggest me.Regards,bharat.",
    "doctor_response": "Hi, welcome to HCM.Looking to your history, it seems that stone obstructing the lowermost part of ureter and causing backpressure changes over kidney.Laser treatment can break the stone but sometime it can remove the stone fragments.So, it is advisable in your case to do treatment with endoscopy and remove the stone completely.Maintain adequate hydration.Do basic urine report to rule out kidney infection.I think this would be helpful to you.Best wishes. TC.Dr Jay Patel.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Kidney patient under dialysis, often feel short of breath with cramps, anxiety. Can I take Dixed 50 mg ?\n\nI am kidney patient under dialysis and often feel short of breath sometimes associated with cramps and anxiety etc heaviness in the head as if it is jam, this leads to sleeplessness depression and doctor said it is meantal problem caused by anxiety . I started sleeping pills like anxit .25 later Jlapress 10mg once a day but did not improve except the period its effect remains. Someone a doctor friend suggested dixed 50mg (sertaraline) subject to my physician s nod to it. thats all so far thanks you pkguptya emmail / YYYY@YYYY",
    "doctor_response": "Hi, Thanks for posting your query. Using sertraline in CKD is safe and you can use it without any side effects. Although you should avoid these medication for better life and better compliance. You should also consult with psychiatrist . Get well soon. Dr. Mayank Bhargava",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rashes on the back, chest and forehead of an infant?\n\nHi.... I have a baby girl ! She is 6 months old now n today suddenly she developed rashes all over her back , chest , forehead ( cradlecap) , neck n also just above the neck.... Can I know its cause ? She also fall down from bed yesterday in the morning n developed rashes in the evening... Is her fall n rashes connected? Plz recommend \u263a",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. No relation between fall and appearance of rash. it may be a allergic rash if it is not associated with fever. If there is fever then it may be measles. you need to consult pediatrician in person to confirm it .he may prescribe appropriate drugs for the same . Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful lesions in the gums\n\nI have a few painful holes in my gums around my teeth, and today a new one appeared, rather large on my bottom back gum. Im quite worried, and i have no insurance. I practice good oral hygiene twice a day, and floss before i go to sleep, i brush lightly, and try to get all teeth for the equel amont of time front and back, bottom and top. Do you know what this may be?",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,   I have gone through your query,  as you have painful lesion in gums that can be due to periapical infection or periodontal infection . For this you should consult dentist and go for investigations done IOPAxray if it is periapical infection then go for Root canal treatment and if due to periodontal problem then go for Oral prophylaxis .Do warm saline gargle two - three times a day",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to check if finger is broken after an injury?\n\nI am 11 years old and got my finger sammed in a door at school we have triend icing it and nw have a popsicle stick and tape around it. it is bruised swollen and hurts to touch. the dor completely closed. it is on my middle finger on my right hand between my knuckle and first joint. do you think my finger is broken",
    "doctor_response": "Hi... by what you got I definitely feel that your finger is broken. It definitely needs immobilization and also strapping. I suggest you consult Orthopaedic surgeon regarding this as soon as possible.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for yeast infection\n\nhi i ve been having trouble with my iud i got it last month and the first few days of having it in i got a yeast infection well i became very itchy around my nipples and vigina, with discharge and everything. finally after treating it with over the counter for about 2 weeks it went away. then the next month after a period i got the same symptoms whats going on with my body? will i be getting this every month from the iud?",
    "doctor_response": "thanks for posting your query to health care magic.if you are confirm with diagnosis of repeated  yeast infe.ction of your genitalia . you need to change your IUD . but one more thing is genital infection do not cause itching around breast .it could be due to some other cause .so first examine the vaginal discharge for microbiology lab and confirm diagnosis and then do acccordingly .thanks .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bladder infection. Body resistant to cipro. Reason?\n\nThe doctor's office just told me that I am resistant to Cipro and that is why my bladder infection has not improved.  This is the second round of medication that they have given to me. My bladder infection started over a month again.  Is there any reason for concern that my body is resistant to Cipro and that I have had a bladder infection for this long",
    "doctor_response": "Hi,Thanks for writing in to us.Your doctor intends to inform you that the bacteria causing your bladder infection are resistant to ciprofloxacin. Nowadays due to increased prescribing of antibiotics, the same strain of bacteria which would have been killed by an antibiotic let us say 10 years back, has developed genetic mutation and resistance such that they are able to grow even in the presence of the antibiotic.In other words, the bacteria are becoming more powerful and your antibiotics need to be changed. This is becoming an increasingly common problem in hospitals and you need not worry. The solution to your problem lies in changing over to sensitive antibiotics on your urine culture report. Some of the highly specific antibiotics for urinary infections include nitrofurantoin and newer cephalosoprins. This will be decided by your doctor and you must complete the course for quick recovery.Hope thishelps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the suggested treatment for psoriasis?\n\nI'm only 15 and it's really awkward to talk to my mom about things. I have psoriasis on my scalp and it was diagnosed by my doctor. However, my vagina is weird. I kind of worry i might have psoriasis or even an yeast infection and i don't know what to do.",
    "doctor_response": "treatment for psoriasis will be Puva therapy in which UV rays are used to treat this skin disease.  ointments were available .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. AST and ALT levels are high since the 11th week of pregnancy. Is it alarming?\n\nHello doctor, I am 21 weeks pregnant, and I have all my tests done. All of it seems well. The only concern is the baby is having an echogenic intracardiac focus in left ventricle which was found in anomaly scan following which my doctor prescribed a quad screen test and I did that as well. My doctor is very supportive and understanding, but with both my double marker and quad marker test my chances for Down's syndrome was 1:1071 and 1:1384 respectively, and she keeps saying, she would have been happy if it was 1:10000 and with finding of echogenic intracardiac focus, I am a bit anxious and worried about how to actually take it. I am looking for a strong opinion on your experience. Also, please note, there were two complications I faced. During my eighth week, I had a minor brownish spotting, which was subsided by extra dose of Progesterone and Duphaston and following which I had major itching issues, which when examined found out to be increase in AST and ALT level. All possible tests for hepatitis and ultrasound for liver were clear, and with Udiliv 300 it came back to normal. But my AST and ALT levels were high since the 11th week of pregnancy which according to any doctor is not heard of but it is in control with Udiliv. Other than that, I feel absolutely no physical discomfort or complications. Please tell me if there seems anything alarming.",
    "doctor_response": "Hello. How are you doing? Let me assure you that you and your baby are absolutely normal and will have no problems. Let me explain one by one. A single soft tissue marker like the echogenic cardiac focus is not at all to be worried about. We do not need to do any marker or even a fetal echocardiography. Forget the risk ratio. Even if noted anything above 1 in 250 is not to be worried about at all. Even echocardiography will be normal and post-delivery follow up will be normal. Brownish discharge in first three months of pregnancy is normal. When the embryo implants, the minimal blood which comes due to the burrowing embryo will clot and come out within first three months of pregnancy. Even without the progesterone, the clot will resolve. So do not consider it as a problem. Pregnancy is a cholestatic state and liver enzymes will raise. But that is quite early as you mentioned. Just have symptomatic management. In short, I feel both you and your baby are absolutely fine. Nothing needs to be done. Hope I have clarified your query, do write back if any more queries. All the best. For more information consult an infertility specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy scaly skin patches and leg cramps while having myositis?\n\nplease provide help to assist a family member who is a diabetic with myositis and itchy and scaly skin patches. Also, she has some issues at times with muscle leg/feet cramping; and swallowing and thick saliva. What type doctor needs to be seen for best treatment",
    "doctor_response": "dearthanks for writing to hcmas per the description given the myositis might be the cause of the muscle pain and also difficulty in degluttition.(swallowing)We must review with a neurologist to look after the neuro muscular problem.Hope the sugar levels are within normal level.Mostly the skin scaling,darkening are due to the   chronic elevated sugar levels,we must start  a multivitamin with anti oxidants like antoxid.hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Distention in temporal area, inflamed lungs and asthma. Prescription of Symbicort. Cause High BP?\n\nI was curious and honestly concerned about the distention in my left temporal area. I believe it might be the left branch of the superficial artery . I ve noticed it now for several weeks. It s kind of a long story, but I went to the doctor about two weeks ago with tightness (inflammation) in my lungs. I m an asthmatic and have been since I as three months old. Any how, my doctor gave me an corticosteroid injection and some samples of Advair to get me by until my prescription of Symbicort came in. I went about a month without it and believe it caused quite some problem. Well out of embarrasement, I did not tell him that I also had been taking an L- arginine supplement for about 2 weeks. I should have done some research first, because after the fact I learned that this amino acid can cause inflammation in the lungs. I have been taking my normal medicines theophylline 200 mg tabs twice a day, rescue inhaler Proair as needed, and Symbicort 2 puffs twice daily. I am, however still having that feeling of tightness, like a rubber band around the rib cage. Most of the feeling comes during expiration. My asthma overall is much better in my adulthood as opposed to adolescence . My last severe attach was at age 16 when I was about to be put on a ventilator, but through God s grace was spared. I ve noticed that over the last month my blood pressure has been up and down. I would like to think this is due to all the chemicals (Nitric oxide and L-arginine) in addition to being out of my corticosteroid Symbicort. Needless to say, there is not much research on these substances and their affects on the cardiovascular system. It just baffles me because prior to all of this I did not have any of these problems. My overall weight is proportional to height, I exercise and eat healthy, I do not drink or smoke. Can these factors together be what s causing my higher blood pressure? My doctor as well as I believe that since the inflammation is not caused by an infection that in time the tightness should diminish and hopefully my blood pressure will balance out.",
    "doctor_response": "any vitamin diet suppliments and suppliments trigger allergy as you are knowncase of allergies your allergy is persistence after chilhood without noticedin these paracetamol,ibuprufen vitamins and suppliments increase the alergythese condition is seen in foods which are misdiagnosedget blood serum test for specific antibodies for milk wheat potato chana rice nuts eggeliminate in diet and there will be recoverysymbicort is last choicetake supprtive therapy till the tests and you will be okay after elimination diet after tests",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for lower back pain moving to buttock when bending backwards?\n\nhave had very low back pain for about two weeks now...mostly on left side. Recently most of pain has moved to right buttock, quite severe, specifically when bending backwards.   No initial trauma...started hurting two weeks ago from just bending over and touching my toes! Pain on left side has mostly disappeared. There is also a mild ache center, low back.",
    "doctor_response": "Hi,You may possibly have a prolapsed lumbar disc with nerve compression causing sciatica which would be the pain in your buttock.I suggest you take paracetamol and ibuprofen for the pain. Do gentle, low-impact exercising such as swimming or cycling. See a physio for instruction on building muscles to support your lower back. These are simple conservative measures. If these produce no benefit then you may need to consider epidural steroid injections which reduce the inflammation around the nerve root.Regards,Dr K A Pottinger,MBChB  FRCA",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swollen lips and feet, tingling in mouth, red dots all over body. Taking antibiotics. Recommendations?\n\nAllergic reaction with unknown cause. Swollen lips. Swollen feet. Tingling/numbness in mouth. Have been on bactrim antibiotics for other issue. Have not been exposed to anything out of the ordinary that I am aware of. Red dots all over body. Dots do not itch. Took Benadryl and saw improvements until medicine wore off. What do I need to do? Is there another non-prescription med available?",
    "doctor_response": "Hello and welcome to HCM.Thank you for your query.The first question I would like to ask you is whether or not you were on Bactrim previously? Or is this the first time you have taken Bactrim? Also, if this is the first time, did the assumed allergic reaction occur immediately after the first dose or after a few doses, and which dose caused this? Which infection have you been diagnosed to have?The reason why I ask these questions is because, the rash could very well be related to the infection that you are currently being treated for. This will have to be ascertained by your treating doctor, so please do consult him/her for the same.The next thing is, if this is indeed an allergic reaction to Bactrim, you will have to immediately discontinue this medication. For this as well, you will have to report to your doctor, who will confirm the cause, discontinue the current medication and initiate a substitute.In the meantime, avoid any irritation to the area of the rash, wear comfortable clothing, avoid scratching the region, and avoid application of any unprescribed medication on the region of the rash.Also please drink lukewarm water with a little salt in it, at least three times a day. I am unsure about your infection or other medications, so I cannot comment on other effects you have been suffering. The best thing right now would be to visit your treating doctor.I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications. I would gladly help you.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medication for fatty liver condition\n\nI am rahul. Age 34 i often suffer from fatty liver this is the fourth time why does  it often comes back i also have chronic constipation from years which is herediety currently i have pain on my right side of my abdomen exactly below the ribcage where the liver is situated can you suggest  any permanent relief...i once consulted to gastro specialist.Dr.shankaran a year back who treated me for fatty liver but it seems like it has return back. the pain is  worse after eating",
    "doctor_response": "HiI went through your concern regarding your condition of fatty liver.Fatty liver is a condition in which triglycerides are deposited in liver. And this condition has strong relationship with obesity and other metabolic conditions like diabetes etc.And if inflammation is also present along with fatty liver in the form of raise ALT level in blood then it is called as NASH (non alcoholic steatohepatitis). NASH needs aggressive treatment.Well for your condition you have to concentrate on losing your weight if you are obese by changing your lifestyle n dietary modification. You should start regular exercise and avoid junk foods,  oily foods and sweets. If still your fatty liver condition persists after 2-3 months then you should start capsule ursodeoxycholic acid 250 mg once a day along with Vitamin E 200-400 mg once a day. Combination of these two medications has shown promising effects in clinical trials. Hope you will try to follow the advice. I wish you good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Changed from progesterone pill to combined pill.  Had unprotected sex. Having bloating, cramps. Normal?\n\nAfter stopping breastfeeding changed from a progesterone only contraceptive pill to a combined pill. I had a week break with no intercourse and then also no intercourse for 2 weeks of taking the new pill. 2/3days before my 7 day break I had very light bleed for about a day and have had no period during 7 day break just bloating , mild cramps, is this normal when changing to a new pill?",
    "doctor_response": "Hi,thank  you for your query.Yes the changes you are experiencing are due to the changeover from POP (Progestrone only pill) to Combined pill. because as the pop suggests,it contains only both estrogen and progestrone,hence to body will take time to get adjusted to it.these will last for a few days to a week.If it continues for more than 10days then i would advise you to consult an OB/GYN to change over to a different form of contraception.thank you,wishing you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yellow pus on the corner of toe?\n\nHi, My son has yellow puss on the corner of his big toe, under the skin to the side of the nail on his right foot. The nail dropped off (was black for months) and a new nail has grown underneath however there is now puss near the top right hand corner of the toe and the skin is red around it.",
    "doctor_response": "That unfortunately , does not sound good.You need to get medical attention and you must be started on antibiotics and anti inflammatory. Proper dressing and wound cleaning is advised.Thanks.Let me know how it goes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I ask a doctor to advise looking at the MRI scan report of lubosocral spine ?\n\nHELLO! MY MRI SCAN REPORT OF LUBOSOCRAL SPINE SAYS 1. DISC PROTRUSION NOTED AT C-5,C-6 LEVEL CAUSING INDENTATION OF THECAL SAC . 2. DISC BULGE NOTED AT D10 D11 WHAT DO WE MEAN BY THIS,AND WHAT ECERCISESSHALL I DO SO I COULD GET MY BACK PAIN REDUCED.,, MAINLY PAIN IS MORE IN NIGHT WHILE SLEEPING,,PLS ANSWER ME,,IT WOULD A A GREAT HELP,,",
    "doctor_response": "Hi,From report it shows that you are having degenerative changes in your spines causing prolapse discs causng indentation in spinal canal.This can give rise to irritation or pressure on nerves giving rise to backache, pain in shoulder, neck.consult orthopedic surgeon and get examined.Physiotherapy, short way diathermy and cervical traction will give you much relief.Take calcium, vitamin A and D supplements.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hand tremors, taking Pacitane and Inderal for writer's cramp. Treatment?\n\nMy son 15 years of age a very bright student, studying in 10th std has difficulty in writing fast, complains of mild tremor and not able to hold pen and write normally,tells he has more difficulty in writing tamil and writes keeping the pad over lap,Eventhough he completes exam, he is afraid whether he would be able to get 1st mark.Diagnosed as writers cramp and is on Tab,Pacitane 2mg, Tab. Inderal 10mg and Tab. Clonazepam 0.25mg once in morning. What is the treatment for his problem?He wants to get school first, as he always gets in 10th std also.Kindly give your advice.",
    "doctor_response": "Hello, I have gone through your query. This might happen due to too much writing without break, wrong posture and stress. You need to concentrate on his physical strength too. First you need to correct his posture. He need to work on his endurance of gripping strength. Keeping pad over lap and writing itself is bad practice, so avoid it. consult a physiotherapist nearby for strengthening exercises for grip and posture.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stress after taking Vozet tablet?\n\nHi Doctor Doctor prescribed Vozet tablet to my mother and she is having it from past 2 days. Now she is feeling over stressed after taking this medicine. Please advice still want to continue with this medicine. My mother is a ILD patient and she is under treatment from past 2 years. Thanks, Channakeshava",
    "doctor_response": "Hello,I read carefully your query and understand your concern. Vozet 5 mg is an anti allergic medication. It usually cause sedation as a side effect.So, it does not usually cause irritation at the patient. Anyway, your mother might stop the medication and consult your doctor about an alternative treatment. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dosage got V3 medicine?\n\nMy husband is extremely overweight. He is diebetic and has high blood pressure. His MD said he could take the V3, which I have been taking myself. I gave him one today and he says he does not even feel as if he has taken anything. Should I give him 2 a day,or wait and see if it gets in his system?",
    "doctor_response": "Hello,V3 sounds like a multi vitamin calcium or vitamin D3 supplement. If that is case, such tablets do give required result over a few days. It is safe to give on tablet per day. Doses are always weight based but its better to wait a few days.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Muhammad Faisal Bacha, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get pregnant?\n\nHi , i am planning pregnancy...I had normal check up as pre conception checkup and thryroid and PCOS got discovered in that.Dr has told me to take letroz for 5 days. I only took 2 medicines and then dropped the idea of going on medicines without even trying naturally. Today is my 36 th day since LMP and negative urine and blood test. please suggest what shall I do?",
    "doctor_response": "Hi, thanks for writing..I understand your concern.. Get a urine pregnancy test with early morning sample.. If 2 lines appear on the strip, it means you are pregnant.. If negative take progesterone to get withdrawal bleeding.. What is your age? If you are less than 32, then try naturally for 1 year before taking treatment. If greater than 32 then try for 3-6 months and go for ovulation induction drug after consulting your doctor.. hope I have answered your queries.. Good day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Chlamydia cause a fishy odour post menses?\n\nI once had Chlamydia because I didn't use a condom during sex, I did it again but surely this person I am with doesn't have anything. The smell of fish came back right after I was finishing my period- is this from my period or has Chlamydia come back from my previous boyfriend or do I have a new infection from this partner?",
    "doctor_response": "Hello,I can understand your concern. Fishy vaginal smell is most commonly due to bacterial vaginosis, a bacterial infection of the vagina. It may be triggered by having sexual intercourse with a new partner so that fits your description too. The other possibility is Trichomoniasis. Though it is Sexually transmitted Disease, it is very easily cured. Good thing is, either bacterial vaginosis or Trichomoniasis, the treatment stays same.I would advise you to take Levofloxacin 250 mg (Levoflox) twice a day for five days. The smell should disappear by the time the course is completed.If it does not improve in five days, a gynecologist should be consulted for physical examination and vaginal swab analysis.I hope this information helps. Thank you for choosing HealthcareMagic. Best,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pain in foot and leg?\n\nDr. Grief, Can you tell me anything I can do to help with the pain in my foot and leg. I am 78yr. old in basically good health. My Dr. says the arch in my foot is falling. If I walk I am in constant pain through out my foot and pins & needles and numbmness running up my leg. This has been going on for 2 months. Is there anything I can do to relieve the pains. I have tryed IB, etc with no relief. Thanks for your help, Frances",
    "doctor_response": "hi Frances, You are maintaining well for your age- 78 yrs.You have constant pain in foot with numbness and sensation of pins and needles. In my practice ,with these kind of symptoms I am more inclined to investigate along spinal degenerative disease. I would suggest pain killers , and MRI of Lumbo-sacral spine to assess the extent of disease.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful pulse in chest and upper stomach?\n\nIve recently suffered a neck injury, and took 2 percocet for it. I took the two pills a half at a time cutting them and half and having one in the morning and one at night for 2 days. since then, I ve had a weird slightly painful pulse in my chest and upper stomach. it worries me that it could be something serious cause its in my chest. Im also worried about working out, which i do often and rigorously.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It could most probably due to acidity after taking pain killer. Do not panic. To get rid of any doubt get an ECG done and take expert opinion on it. If ECG report is normal, then there is no need to worry about it and take medication for acidity, which will reduce your symptoms. I hope I have answered your question. If you have further queries, I'm happy to help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yearly hair fall in a particular area of the scalp?\n\nsir i have hair falling once in an year ( for a size of 50 paise coin) on the back side of the head and then after a month hair grows on its own. what could be the reason? Mostly the location of the hair falling remains the same all the times.",
    "doctor_response": "Hi, It seems to be alopecia areata.It is an autoimmune disorder characterized by bald patches in hairy areas of the scalp. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cough in the small baby?\n\nMy little girl is 6 weeks old, she acts like she can t catch her breathe sometimes after she eats and sometimes when she wakes up. Every now and then she will cough and act like something is stuck in her throat. It also sounds a little raspy when she cries. The last few days she will start crying and won t stop, even when we try to give her a bottle when its time for her to eat. She makes herself sick crying also. Will it be ok to wait a few weeks till her appoinment or do I need to go ahead and take her? She also is not eating like she normally does.",
    "doctor_response": "As you have mentioned that she starts coughing on giving feed, it may be due to faulty feeding technique as the feed may get into trachea and she tries to cough it out. Pl check the consistency of milk, temp and the hole of nipple as large hole may thrust initial large amount in mouth. However such a small child should be given breast feed only if there is no absolute contraindication.Also I presume that her upper air way is normal  and there is no such issue as partial choanal atresia. Also rule out gastroesophagal reflux most probably 'H' type which can be the culprit.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have knee pain. Could it be due to wearing of improper shoes?\n\nHello doctor, I am 31 years old. I have pain in my knees especially in the left one. I have not been able to walk for quite long, and sometimes it feels that some fluid is traveling towards the feet and some cold sensations as well. My job profile needs lots of walking. Can the pain be due to the wearing of improper shoes?",
    "doctor_response": "Hello. Kindly give me the following information. 1. Since how long you had the pain? 2. Have you had any injury in the knee joint? 3. What aggravated the pain? 4. Is pain more in the knee or foot? 5. Do you have any back pain radiating down to the left leg? 6. Do you have any other medical problems for which you take medications?",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause of anxiety, menupause?\n\nI am having pms symptoms 2 weeks before my period and its all kinds of symptoms. but i also getting anxiety really bad my chiropractor has said the spleen can have something to do with it. I am 42 and swear its leading up to menapause as i have body tension really bad. what could be the problem?",
    "doctor_response": "hithanks for using healthcare magicIn premenstrual syndrome, anxiety symptoms are common. It happen due to hormonal imbalance. it is very common so nothing to worry abt it. If u r feeling problem, u can start low dose antidepressant with low dose benzodiazepine. consult a psychiatrist for further help.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can high BP medicines result in strange sensations in abdomen?\n\nFor the past 5 days I have been having what feels like a baby moving in my stomach. I only feel the movement on the left side of my stomach at the top of my ribs just below my breast. I know that I am not pregnant, got those parts taken out over 10 years ago. I m 49, 5 2 1/2 , 194 lbs. I currently take 3 different medications for high blood pressure, and hormone medication.",
    "doctor_response": "Hello Thanks for posting at HCM. Your symptoms resemble flatulence or gaseous distention of the stomach. It is caused by gas trapping inside the stomach which forms bubbles leading to such sensation and bloating of abdomen. It can be caused by acid reflux (acidity) and improper eating. When you eat very fast, you tend to swallow air with the food leading to gas inside the stomach. My advice to you is to eat slowly and in small quantities in short intervals. This will decrease some of your symptoms. You should also take a course of antacids for 14 days twice daily before food. Medications and their interactions can also cause such symptoms. So if your symptoms don't subside despite being the above measures, then you must get your medications changed or adjusted.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I increase the dosage of Olmesartan to treat a sudden rise in blood pressure?\n\nHi, I am 82 years old and have always been in good health. My blood pressure was always on the low side. I was surprised when suddenly it was high. My doctor prescribed 0lmesartin 20mg. My blood pressure is still high. can I temporarily increase the dosage until I see my doctor?",
    "doctor_response": "Hello There After going through your medical query I understand your concern and I would like to tell you that if your blood pressure is more than 150-90 continuously then you can increase the dose but is recommended for you to monitor your blood pressure for 1 week.Hopefully this information will guide you properly.Kind Regards Dr Bhanu Partap",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does crystal content in benign epididymal cyst on scrotum indicate?\n\nI was diagnosed several years back with an epididymal cyst on the scrotum, which was benign.  Since then the cyst has increased in size tremendously, equivalent to the size of the testicle itself.  I did get an ultrasound indicating that there are crystals in the cyst itself and was referred to a urologist.  I am patiently awaiting for my appointment; however, would like your opinion on this matter, and what is meant by crystal content.  Thank you so much.",
    "doctor_response": "Hi there , Thanks for your query.Epididymal cyst contains protein, phosphate, glucose, triglyceride and cholesterol along with 99% of water content.so any of the content can undergo aggregation and form crystals.Surgical excision can cure the condition.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Numbness, tingling in different areas of body, needs support always. Diagnosed reversal of cervical lordosis. MS ?\n\nmy 20 year old daughter has been having problems with numbness and tingling in different areas of the body. it has progressed in less than six months to the point where she cannot go up or down steps alone, or get in the tub alone. if she goes out she needs a cane or crutches or another person to support herself. the diagnosis is reversal of the cervical lordosis . her pain management doctor who she saw once said that there has to be something else wrong that they are not finding. could she also have ms.",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern for your daughter unless we go through the clinical examination and some blood work to be done then and then we can be sure about the MS looking to this it may be MS or may not be hope this information helps you have nice day",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in back, flank and calf muscle after passing kidney stone?\n\nI passed a kidney stone over a week ago with staggering pain on my left flank all the way down my leg. I still have terrible pain from my back, left flank and all the way down into the side of the calf muscle. What is the reason and how long will i suffer",
    "doctor_response": "Hello Welcome to HCM. Sorry to hear that from you. Basically you are suffering from renal or ureteric or bladder calculus. Need few details as 1. Is scan done? Usg or CT scan2. Your age Anyway, the complaints that you are telling are true. It happens due to ureteric calculus because various nerves are involved in that process. Depending on the location of stone, you experience pain all the way to thighs and sometimes leg as you mentioned. So do not panic or worry. Please take medications when you have pain. Take tablet ultracet. And you should recover well. Drink lot of water. If pain continues, go for CT or USG scan to know the status of remaining calculus if any. I'm there to clarify all your doubts, feel free to contact me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have deficiency of B 12. What could be the reason for this?\n\nI am from upper middle class. Jain food habit. No junk food, no vices. Have good quality of fresh food only. I m 56 yrs old. Still my B 12 test ( done due to back pain and on the advise of Sr Spine specialist) shows only 218pg/ml and normal range is 211 to 946. 1. What can be cause? 2. What more tests to be done? 3. What steps to be taken to bring it to minimum 400 to 500 pg/ml.",
    "doctor_response": "Go for Vit B1-B6-B12 injections and then tablets. I also strict Jain food. But as a part of medicine we don't have option for any other rich source.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent pain in knees?\n\nHello, Earlier this week, i began having pain in both of my knees. I am a 25 year old female and have not experienced any knee injuries. In the morning I wake up stiff and by the time I go to bed I am in pain, sometimes extreme. I have been trying heat pads with no relief. I have also been off work for the last couple of weeks and have been mostly resting and performing normal activity, nothing strenuous. The pain is persistent and sometimes achy. I have trouble if I sit for too long. I also have troubles sitting in general near the end of the day. It is constant pain. One usually more so than the other. What could this be?",
    "doctor_response": "hi,thank-you for providing the brief history of you.A thorough musculoskeletal assessment is advised.Also, as the pain is in the knee joint which is a stiff kind of felling a clinical Musculoskeletal assessment is advised. post which if needed than the MRI or x-ray of the knee will be advised. Usually, the pain can be due to any factor for which an assessment is needed . Post which, with simple medication and physical therapy you should be back to work.strengthening the muscles are will help improve the knee biomechanics and also help further on a long run.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will frequent ejaculation have an impact on conception later?\n\nwhen i see some hot girt my penis get erected at time then when i go to toilet and thinks more about it and shake my penis it leaves white type thick liquid may be sperms i m 13 my friends told me that by this i may get weekend and by this i looses my energy of last three months and due to this doing again and again i may get too much weekend and will not be able to bring child in future is this all right?/",
    "doctor_response": "Hello Thanks for writing to HCMYou are not rightly informed.This is not related to future infertility at all.Your problem is due to overexcited state.You should try to be calm and don't over fantasize.you should concentrate in your activities.You should avoid provocative literature and videos and try to keep busy yourself in your job.Hope i have answered your query.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sharp abdominal pain and pain in my upper shoulder\n\nI have sharp pain in my back and in front under my rib cage on my right side i am getting dizzy off and on. I think it could be gallstones. Its been almost 48 hours now. I m a 40 yr old female, normal weight and otherwise healthy.",
    "doctor_response": "hi julie welcome to health care magic if you are mentioning about gallstones, then it must be right side,,,? please cross check with your medical history about APD( hyperacidity) and chronic irritable bowels? usualy, the pain gets sorted with basic antacid which helps for gastric emptying and bowel motions, ultimately the gas domb gets relieved and one feels better if it happens regularly, you must rule out the gastric pathology like APD, any liver involvment or even worms menifastation and to rule our gallstones, sonogapphy is must take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why my feet and ankles are swelling?\n\nUpon rising today my bp was 145/80 and resp. was 95    I will be 65 in 2 weeks and I'm  1/2 - 1 pk per day smoker of too many years     recently my feet and ankles are swelling, some days worse than others    I feel sure I should see a dr but can I safely wait until after Christmas or is it urgent that I go now?",
    "doctor_response": "Hello. Thank you for your question and welcome to HCM. I understand your concern. Well, there are several reasons why your ankles can be swollen. First, you mentioned that you have hypertension (high blood pressure). There are some drugs from the dihydropyridine fraction of calcium channel blockers (amlodipine, felodipine etc.) that cause this as a side effect. If this the case, I suggest you contact your physician and change to a drug from an another class of blood pressure-lowering agents. Second, it can be a sign of a failing heart. My opinion is that this is not the case. However, I would recommend an echocardiogram, to assess the motility and function of the heart muscle, as well as the functioning of heart valves. Third, it can be a sign of some sort of damage to the kidneys. Have you ever suffered from kidney stones or other kidney disease? Hereby, I recommend that you get these tests: urea, creatinine, glomerular filtration rate, microalbuminuria. I hope I was helpful. Take care and feel free to ask again. Good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of semen discharge in urine?\n\nI have a problem. It start almost a year ago. The problem is that I have the spem in urine (a big quantity). It happens if for 1 week I dont have a wet dream or ejeculate the sperm then after 7 or 8 days with urine sperm also come out. Kindly tell me what to do. Thanks",
    "doctor_response": "Hi, It can be due to urinary tract infection, prostate infection and orchitis. based on the cause only the treatment can be given. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting, diarrhea, distended stomach and flatulence?\n\nmy 3 yr old son had a virus wher he vomited and had diarhea for a few days. nothing severe but dragging out where he would be fine for long periods of time in between bouts. The whole family had the stomach issues at some point over the last 10 days. He now has a distended belly which concerns me because he is skinny little guy normally. AIt sounds like a lot of gas inside when u tap it. Should i be concerned?",
    "doctor_response": "Hello, As you mentioned other family members also have abdomen issues so it could be food poisoning. It requires an antibiotic course, probiotics, antiemetic, ORS to maintain hydration. If not controlled with oral medications then hospitalization may be required. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sachin Kumar Agarwal, Pediatrician, Neonatology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from pigmentation and dark spots, taking Janumet, vitamin suprative and calcium. Solution?\n\nGood evening doc am suffring from pigmentation a dark spot since 2 years have taken no of treatments but no results am 45 yrs old well maintained, lady i do walking, n yoga , am a diabetic, under went histraktamy, i take janumet 50/500mg n amryl 1mg, for diabetese i take vitamins suprative n calcium n vitamin e regularly.",
    "doctor_response": "Hi, Thanks for writing to us. There could be many causes for pigmentation over face and hence the treatment protocol may vary according to underlying cause. You may follow these general recommendations to help with your concern 1) use a Glycolic acid based face wash like melawash. Keep it over face for two to three minutes then wash off. Little bit dryness is expected 2) use a sunscreen with SPF 30 or above, even if staying indoors 3) take vitamin c, beta carotene and antioxidant supplements 4) apply hydroquinone 4 percent cream over dark spot. Withhold use if redness or irritation occurs. These recommendations might help you out but I would still suggest to meet a dermatologist and ascertain cause of pigmentation. If topical creams alone do not help, chemical peels and lasers can be done to reduce pigmentation. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does yeast infection cause red itchy facial rash and lip blister?\n\nI have a red itchy facial rash for approx a week. Two days ago I developed a blister on my bottom lip and yesterday I started having a vaginal yeast infection for which I took a over the counter yeast infection medication last night. I am  female age 54. 5/4 tall. I have arthritis.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.You should take the diflucan tablet once a week for three months. Please take the drugs under your doctors guidance.Please get your blood sugar done as high blood sugar is the most common cause of the fungal infection in females. Controlling the sugar can prevent the infection from going ahead.Please do not do sexual intetcourse as it can further increases cross infection chance.You can wear condom either while doing inter course.Please maintain good hygiene as it is equally important in prevention of the further infection.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. One side of my face became red and swollen after Restylane.  What can I do?\n\nHello doctor, The one side of my face became red and swollen after Restylane. The vial must have had bacteria in it. I was put on several rounds of antibiotics and the doctor had to finally squeeze the filler out. It is a year later and the entire side of my face is swollen where the infection was. The doctor, of course, claims it was not from that because it is a year later but my face never looked like that. He did Sculptra, putting more on the un-swollen side, but it still does not match. What can I do?",
    "doctor_response": "Hello. Restylane fillers rarely produce infection but may cause a viral infection. One possibility is you would have had a hypersensitivity reaction to some proteins in the filler. But it is very unlikely for it to stay for a year. If there are some localized swelling and induration may indicate a foreign body granuloma or reaction. There are very few options available you could try like dilute steroid injection. But as your doctor has done filling the opposite side seems logical. For more information consult a plastic surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have abscess in gums, discharge, painful. Have mitral valve regurgitation. Worried\n\nI have dr apt tomorrow but am worried.  I have an abscess on my gums which I am draining with pressure and one on my breast nipple which I am also able to drain a couple times a day.  They are both painful but much better now that I can releave some of the pressure.  What I am worried about is why they would come up at the same time within a day. Also I have mitral valve regurgitation so I worry about any infections in my mouth.  Should I be ok till tomorrow or consider going to the er?  no fever",
    "doctor_response": "Hello,Thanks for writing to us.Abscess in gums may be arised due to deep caries or periodontitis.I would advice you to get the abscess drained and curetted.Infected pulp ,has to be extirpated.Maintain oral hygiene well.Take metronidazole along with analgesics.Regarding other concerns,please do visit a general physician.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there anything to worry about the light pink substance located on teeth?\n\nHi. Well I was flossing my teeth and I noticed a weird light pink thing located on one of my top teeth. It is almost like a popcorn kernel. But I have not eaten popcorn recently. I tried to get it off but it seems like it is attached to my tooth. Is it anything to worry about?",
    "doctor_response": "Hello and welcome.Thanks for sharing your concern.please try to understand this fact that the hard substance that appears to be attached to tooth surface could be calculus.(Hard calcium like deposit).Therefore please see your dentist soon and get it removed professionally.If left unattended for long time it will get deposited over almost all teeth surfaces.Therefore please get it examined and treated soon.Hope it helps.Thanks.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower abdominal pain, smaller urine quantity, inflated belly size, urine report showed high ESR, swab test showed pus cells. Diagnosis?\n\nhi i am ansa ,unmarried i visit to doctor with lower abdomen pain there was no other specific symptom swab test show pus formation without any germ . with passing of time i progress symptom of less quantity of urine and report show ESR =70 . belly increasing in size I am very worried about this plz guaid me for diagnosing and medicine",
    "doctor_response": "Hi Thanks for your query Plenty of pus cells without any organism in geberal pyogenic culture in urine indicates presence of sterile pyuria or tuberculosis. You need to start an antibiotic course preferably ciprofloxacin 500 mg twice daily for 2 weeks, take plenty of water around 4 litre/day with an urinary alkaliser. With these you need to have an USG of pelvic organ done to detect any lower abdominal pathology and should consult an urologist to rule out any pathology in the urinary tract. Cystoscopy should be done in refractory casses. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am 54 years old and suffering from chronic kidney disease,i am not on dialysis and i feel very weak\n\nHi Doc, Iam 54 and a half year old man, my height is 5 feet 7 inches and my weight is 75 kgs ,Iam suffering from chronic kidney disease .My left kidney gfr is 18 ml/min and my right kidney gfr is 7 ml/min.Dr Amit Gupta (nepprologist) of PGI lucknow is looking after my case.The relative kidney function left kidney-68% and right kidney -32 % and the impression of the report is -Bilateral small contrated kidneys (right smaller than left)with impaired function and multiple renal scars. my Blood pressure till moring was high-119/low-79.I feel very weak and dizzy all the time .I have turned into insomniac, as i cannot sleep at night. My medicines are-Aplazar,cobadex-z, stamlo,Pentawok 40 mg and ecostrin. my doctor has asked me to visit him in september again.My critinine value is 2.50 and I am not on dialysis .Tell me what are my chances to be lead healthy life and when can i get kidney transplantation done and what can it cost minimum.I am very anxious and worried, help me.Thank you",
    "doctor_response": "Hi, Thanks for query, Reduce your weight, take less protein in diet, Take less fat and carbohydrate,less salt. Keep bp under control,If you are diabetic,keep tight control of diabetic. Go for lipid profile and blood urea. if you full fill these you will have no problem. ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have not had a bowel movement after diarrhea\n\nOkay, so about a week ago, I came down with something. It gave me bad diarrhea, then it went away like a day after, then came back again. I don't really eat anything during the day, but now.. 4 days later, I haven't had a bowel movement. It feels like I need to go, but I can't. I haven't really been eating unhealthy. I was just wondering if there was a way with out over the counter drugs and prescriptions to have a movement. I find it rather irritating.",
    "doctor_response": "better you try to have healthy food .And even try to have more amount of liquid",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bipolar disorder?\n\nMy husband has two distinct personalities. Daily he is fine. The other is triggered when he is excessively tired or if he wakes up shortly after falling asleep. Its an angry, jealous, conspiracy personality. It only happens at night. We ve been together for nearly 15yrs. He never hurts me just angry talk. He never remembers anything about what he says or does. He has a very tramatic past - childhood. Grew up in another country - poverty, abuse, and other things.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The symptoms mentioned here may not be related to bi-polar disorder. Just inquire about his present work conditions. May be he is stressed and anxious. You should consult a psychologist or psychiatrist in person for proper diagnosis.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have weird behavior because of autism\n\nI have a great nephew that was diagnosed with Autism about 6 1/2 yrs ago. For the last 18 months he has been having episodes where he tries to hurt himself by banging his head on a hard service, biting himself, scratching, pinching himself, as well as anyone trying to stop him. Are the episodes typical with children with Autism? He is strong as an ox during an episode. It takes 3-4 adults to hold him down until he is calm again, to keep him from hurting himself.",
    "doctor_response": "HiThanks for using healthcare magicYes, all these self mutilating behaviors are part of autism. Autistic children sometime are impulsive and due to impulsivity, they do all such behavior. In case of your nephew, you should consult a psychiatrist. He needs low dose of antipsychotic that would help in controlling his aggression. In case you need our help, we are happy to help you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes uncontrollable cough after eating banana?\n\nI just had a banana a little while ago which by the way I haven't had in a long time. Anyways I was falling asleep & out of nowhere I started to cough uncontrollably felt like something was stuck in my throat like I wanted to throw up/choking at the same time.. Is it some type of allergic reaction?",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your history and would like to make suggestions for you as follows:1. From your description, I would not think of allergic reaction at first. I would think it as a kind of \"irritating\" cough, may be related to rapidly swallowing of a food or inadequate water intake after food.2. As it happened for the first time, I would not suggest you to think of allergy to banana. Allergy to banana is possible but not that common. In future, I would suggest you to chew banana slowly and swallow it well (avoid fast eating and swallowing) and if possible, have some liquid and stay upright after taking to food.Hope above suggestion will be helpful to you.Wish you the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes non conception even now?\n\nHi.. i m 28 years old and my hubby is 32. I missed 1st prego due to sec's doesnt got heartbit.i have pco and treatment is going on from 1and half year. last b4 2m months i had to be done laprosocpy there found curtain and waste in utures rest is all fine. husband's report somtiems shows abnormal and sometimes normal. my husband taking \"mexoza\" and i m taking \"glacyfage\"500gm 3times a day,follic asid,ecosprin and thyronom 50gm as i have thyroid. still we cannot sucess to conseive. after laproscopy my ist period get delayed to 8 days and now this is second cycle which i didn't geted pregnancy test is nagative. doc suggested me premolute. why this is happening as now all problems are solved.",
    "doctor_response": "Hello, you need to take ovulation inducing drugs as soon as possible to increase your chances of conception and better get an In utero Insemination along with it.In case you have any questions in future you can contact me directly on",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for runny nose and fever in a child\n\nDaughter 2 years old has been having a severe running nose with clear watery mucous for a few days with a mild cough and difficulty breathing (blocked sinus ). Also has a fever that comes and goes that can get as high ~100.5 degrees F. Any help appreciated.",
    "doctor_response": "Hi,From history it seems that she might be having viral infection giving all signs and symptoms.Give symptomatic treatment with antipyretic and decongestant medicines.Give enough water.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can HPV effect the pregnancy?\n\ni got my implannon takin out in august because i want another baby. i have been using ovulation test and this month was the first time i actually got a positive ovulation test so i am just wondering why i havnt got pregnant yet its been five months of trying and it only took us a month to get pregnantg with our first child. Im just scared that i cant have kids because i have hpv and i have had abnormal paps after having my son. yes everything is ok now but im afraid that it might have made it impossible to have kids",
    "doctor_response": "Hi,Welcome to Healthcare magic. I am Dr Ramadevi wani. I will be answering your concernsIt would have been nice if you had provided me some more information like age, BMI, regularity of cycles etc.Among couples trying for pregnancy, 80% of them conceive in the first year and 90% by the end of second year. So don't be worried. You will conceive.HPV does not interfere with fertility. Since you have written about abnormal pap tests, I just want to know, if you have had STD before. If so, then get HSG for tubal patency done ( STDs can cause pelvic infection resulting in blockage of the tube). If you have not had STD before you can try for natural conception for another 6 months. If you do not conceive by the end of one year, then consult doctor and get baseline hormone tests and HSG for tubal patency for you and semen analysis for your husband done. The tests results will help in planning the treatment.To increase your chances of conception maintain normal BMI, quit smoking ( if you're a smoker) and have intercourse at least three times in a week.If you have any further concerns do contact me through Healthcare Magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe asthmatic attacks post Symbicort withdrawal?\n\nI was taking Symbicort for 2 months, and my asthma was the best it has ever been ever. Prior to that I used to wake up every night from asthma having to take my ventolin. I never needed to use my ventolin since I was on the Symbicort which was great. But I was a bit silly and didnt realise my symbicrt inhaler ran out, so my asthma got really bad to the point where I couldn't go to work, and when i took my ventolin it appeared to no longer work on me. Could I be having withdrawals from the Symbicort? Or could it be that I hadn't taken the ventolin for so long that my body doesn't want it anymore?",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your history and would like to make suggestions for you as follows:1. To address your main queries - withdrawals from Symbicort? - one can say that in common man's terms, but actually it is not withdrawal in scientific sense. (as explained in No 2).Body does not need Ventolin anymore - it is not a correct interpretation.2. Asthma is a chronic disorder. Most of the \"controller drugs\" for asthma (such as Symbicort) actually only \"control\" the symptoms of asthma but cannot \"cure\" asthma. So when one stops such controlled medications, one experiences return of asthma symptoms.3. Ventolin is a \"rescue\" type of drug. It is to be used only for symptom relief when symptoms occur. However, frequent intake of such medications is not desirable, so in that case one needs to take \"controller\" type of inhalers on regular basis. This is as happened in your case.4. I usually my such patients to take minimum dose of \"controller\" medications regularly that controls all their asthma symptoms. For example, I would suggest my patient regular inhaler (like Symbicort) and montelukast. In addition, I would suggest him to take salbutamol inhaler on as-and-when-needed  basis.5. Were I treating you, I would also suggest you allergy testing for common air-borne allergens like house dust mites, molds, pollens, insect proteins, pet dander (if you have pet) etc. This will help you identify substances causing allergies to you as well as to know the measures to avoid them.6. Based on allergy testing, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which works gradually on immune system to improve allergy symptoms on a long term basis.7. Regular breathing exercises and a healthy nutrition will also help you in a long run by improving your lung capacity and immunity respectively.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for constipation and blood discharge\n\nmy 2 year old daughter is in the middle of toilet training. she had an accident today, in her knickers. there was a really hard stool, with lots of discharge and a little bit of blood. i find discharge in her stools quite alot, but never blood. have i got a reason to be worried?",
    "doctor_response": "Hello,Hard stool often causes blood in the stool nothing to worry. It is not happening again, give your baby frequent feeds and solid diet to relieve constipation.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Hina Javed",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dry mouth while on Zantac for LPR?\n\nAccording to my ENT Doctor I have a condition labeled LPR. About 30-40-days ago he prescribed one Prylosec each morning 20-30 mins before eating anything. That cleared the condition until 1 to 2:00 pm same day and then it returned. I called him and he prescribe3d Zantac once per day. I had no specific instructions from the Doc but read the meds insert which said if only taking one, take it before bed. I ve been doing that for about 10 days now and am beginning to have serious dry mouth problems. FYI: I am a pretty healthy 80-year old male. What do you suggest?",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .*  There are different  conditions which can give dry mouth for  LPR patient    -  side  effect  of  ranitidne  -  inadequate  hydration  -  excess     perspiration  -  diarrhea  -  others .Wishing you fine recovery .Feel  free  to ask any further doubts .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have 6 months old child, having sex without precautions. Steps to take to avoid pregnancy ?\n\nHi, Good evening I had a 6 months old boy baby. Now me and my husband are having sexual relationship but without taking precautions we did 3 times. But we don t want another baby soon. am getting afraid if i get pregnancy soon. and after delivery i didn t get periods. how i test this and when i will get periods. if i get pregnant what are the steps to be taken to avoid it. please give suggestions. and i had right breast pain while feeding left one. but am feeding both. till i had pain whats the reason for this. waiting for your reply. Thank you",
    "doctor_response": "Hello. Congratulations on your recent delivery. Couples who rely on breastfeeding to prevent another pregnancy are taking a bit of a chance. Many nursing mothers begin ovulating within two to three months of delivery, while others may not ovulate for a year or more. The problem is, there's no way to predict when you, personally, will become fertile again, so you could actually ovulate, conceive and get pregnant without ever having a period. Thus, if you want to prevent pregnancy you should at least use condoms, and you may want to talk to your doctor about other forms of birth control. Now, your breast pain might be a symptom of mastitis, which is a common problem in breastfeeding mothers. Mastitis is caused by a bacterial infection in the milk ducts of your breast, and it can often be managed by simply applying warm packs to the breast. It's okay to continue feeding your baby from both breasts, even if you have mastitis. If your breast tenderness doesn't improve within a couple of days, see your doctor; you might need an antibiotic to get things cleared up. I hope that helps. Enjoy your baby boy!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for pain in the testis?\n\ni ve went to the doctor and the hospital a few times with pain in testes. thy did ct scan and a ultrasound and said that i had a cyst on my left testicle and put me on antibotics. but i dont think that it worked and they wouldnt do surgery because i have had this for a long time .  but it gets painful sometimes and i have this dull bubbly feeling in my left groin area.  would warm compresses help with this?",
    "doctor_response": "HelloThanks for query .You have been detected to have a epididymal cyst (Spermatocele ) in left testicle .It is a benign cyst and can not be cured with antibiotics or medicines .It  needs to be treated in special situation like when it is very painful .Consult qualified General Surgeon or Urologist for clinical examination and get it removed if he feels it to be removed .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from chronic fatigue syndrome, multiple sclerosis. How to overcome this?\n\nHi my name is Sara and I am 17. My mother who suffers from chronic fatigue syndrome and multiple sclerosis is in a constant state of disorganization and clutter that borders on hoarding. I'm leaving for college in the fall and am extremely worried about leaving my mother and 11 year old brother alone as i'm afraid the situation will worsen. How can I help my mother overcome this?",
    "doctor_response": "HI, thanks for using healthcare magicIt may not be possible for you to do that on your own. You would need to employ the help of other family members to help your mother realise that there are areas of concern that need to be addressed.In addition, professional help may be need. This would mean consulting a psychologist who would know how to deal with these issues and best help your mother and therefore allow her to care adequately for your brother.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain after gallbladder surgery\n\nI had gallbladder surgery almost a year ago.  I have been having upper middle doubling up pain that feels sometimes like it is ripping out my spine.  It only lasts about 15  but this is happening 2 or 3 times a day.  I went to a gastrienoligist ? and had an upper endoscopy done.  He said I had mild gastritis and it was probably sludge left over from the gallbladder.  This is going on for almost a year.  Do you have any idea.",
    "doctor_response": "Hi,Post cholecystectomy pain maybe due to stones in common bile duct OR increased fat intake or functional. Gastritis maybe treated by taking Nexium once daily before breakfast for 1 to 2 months. If pain persists you may need to take Famot.My further advice is to get an ultrasound (abdomen) to rule out any stone remnants in common bile duct.- avoid OILY food altogether- avoid eating stomach full and mouth full- avoid spicy food wish you good healthHope I have answered your query. Let me know if I can assist you further. Regards,Dr. Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does a minor head injury require medical attention?\n\nHi Dr I fell earlier this morning and hit my head the soft tissue by the neck bottom I put ice and took Tylenol no bleeding or not thank God it just fills sore did not pass out I am ok with my mind the little table I hit was square will I b ok thank u Patricia",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, if no serious injury is there or no head injury is there then it is nothing to worry, but to get it confirm the nature of injury is matters the great, and it is only possible through clinical examination, patient may not be having any symptoms as long as the blunt injury or head injury is concern but the symptoms comes suddenly so it is the rule to keep the patient under observation in any head neck injury  hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does carotid artery blockage cause dizziness?\n\nIf my carotid artery is blocked, would it cause dizziness when I bend over and come back up? I had testing done with lifeline November 2016 and it showed a mild to moderate blockage in the carotid artery. I started about 4 months ago having dizziness when I bend over to pick up something, empty the dishwasher, etc. It is not every day, but some days it is all day and I have to stop and just lie down. It only occurs when I bend over. It has been recommended that I have a heart catheterization but I would like to have my carotid artery checked out first. Could there be a causal relationship between a partially blocked carotid and this type of dizziness. (The room does not spin, it is lightheadedness following bending over.)",
    "doctor_response": "Hi, The cause of dizziness is likely the vestibular system. Carotid artery blockage may cause dizziness because carotid arteries are important to supply oxygen to the brain. If the occlusion or stenosis is severe (more than 70%) it may cause dizziness or vision problems. Up to 60% occlusions usually do not cause any symptoms. But dizziness while bending is more suggestive of the vestibular system (benign paroxysmal positional vertigo) rather than carotid artery stenosis. You should contact your ENT doctor to check for vestibular causes. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back pain radiating to left leg?\n\nI am a software proffessional. I am suffering from Back pain from last 1.5 years. It started suddenly. One day I got a sudden pain in my stomach and back at a time. That day onwards I am getting lower back pain. If I bend for a short time also I am getting pain. This pain spreads to the left leg if I keep on doing the work. I can not lift weights also. Sometimes If I sneeze or cough also I am getting back pain. Some time I get middle back pain also. Please let me how you diagonize this and what you suggest? which doctor do I consult and can I get rid of this permanantly?",
    "doctor_response": "Hello, Back pain radiating in a limb suggests compression of one of the nerve roots exiting the spinal column. The most common cause for the compression is disc herniation, displacement of one of the cartilage discs located between the vertebrae. Chronic changes to the vertebrae with formation of osteophytes, bony spurs, compression the nerve root are another cause. The best means to diagnose it is a neurological physical exam and a lumbar MRI, I would start with a neurological consult. Most cases improve gradually, but it may be a recurring issue, as our columns continue to age with the passing of the years often it is difficult to get rid of it permanently. Physical therapy is important to prevent recurrences. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Olsi Taka, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itchy rash on the chest, thighs and arms due to the use of contaminated water. What is the treatment?\n\nI have had an itchy rash on my chest ,thighs and arms for the last three weeks until I realised that the water I was using from my roof tank to take showers maybe contaminated. I only applied ice cubes on the affected areas. Could this water be the cause and if so is there any medical product that I can use?",
    "doctor_response": "Hi there. It is very difficult to ascertain sans visualisation or analysis of the water to state that your tank water can have caused this problem. The itchy rash may be unrelated & will require you to visit a dermatologist or /& upload photographs here to help you better. Use a topical steroid lotion such as mometasone furoate twice/daily for the affected areas & see if it responds in 48 hrs together with systemic fexofenadine tablets 180mg taken once/day. Cheers & Good luck!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it to be concerned about the increase in blood sugar and total cholestrol?\n\nMy husband just had some blood work done.  The next day he came down with a cold.  His blood sugars were elevated, his total cholesterol was too.  Triglyercides were good.  Here is his numbers: Glucose 109Total cholesterol 216LDL 151HDL 51.8Triglyrcerides 66He is 45 years old and last year everything was good.  Why the increase?",
    "doctor_response": "Hi,Looking at the clinical history and laboratory reports, I am of the opinion that your husband could be having impaired glucose tolerance and increased lipid levels The cholesterol and glucose changes noticed are due to altering metabolism and weight gain, along with multiple factors.It is still early stages and probably no medication is necessary at present. Lifestyle modifications like  weight reduction, exercises, balanced diet with low carbohydrates and good fat will help him.A repeat test in three months, if done after weight reduction should show normal results, if not it will increase.Any further queries, Happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will high uric acid and calculus have any affect on kidney?\n\nSir, I had a uric acid stone in my right kidney in 2002 and during IVP the stone got flushed. In Sept 2011 I got high fever with severe joint pains. On testing for chicken quinea /dengue virus, the uric acid was 7.3. Immediately the Doc.(MD) told me to take Zyloric tablets for a month. After a month on stopping the Zyloric for 10 days second test was done. There was increase in Uric acid to 8.1 and 2mm calculaus was found in left kidney. He advised to take zyloric for further 3 months and lot of water. Will it affect the kidney in the long run? Should I go to a Nephrologist? Pl advise .",
    "doctor_response": "Hello,High uric acid may cause renal stones and also cause gouty arthritis. It may not cause any damages to the kidney. Do you may take the drug. If you won't take the drug it may cause increase the size of stone lead to kidney problems. Drink plenty of liquids and water. If symptoms not improved please consult with your nephrologist he will examine and treat you accordingly.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible without having ejaculated?\n\nwell my bf is a virgin and while we were hooking up he said he wanted to lose it then and there he unbuttoned my pants and all he did ( i was standing against a wall and he tried to stick it in , he ended up near my clit. and it was for about 2 or 3 min . then i backed away , he said he was barely hard. is there anyway i can get pregnant. ?",
    "doctor_response": "Hi, I think without penetration and ejaculation, pregnancy is not possible. Don't worry about it. hope I have answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it normal to have blurry vision four days after foreign body removal from cornea?\n\nHello doctor, I recently went to an ophthalmologist to have a foreign body removed from my cornea. I have been applying the overnight cream and drops during the day but on day four, my vision appears to be more blurry. Is this a normal part of healing?",
    "doctor_response": "Hello. I have gone through what you have mentioned, new onset of blurring on the day four is not a thing we normally expect. It could be due to a variety of reasons, the most common being increased tearing in your eyes due to inflammation, and the most important being a progression of ulceration of the cornea or corneal edema. My advice to you is to continue using your current medication. and re-visit your ophthalmologist as soon as possible to enable them to have a review.  Measures you can take in the meantime are to wear good quality polarised glasses or atleast your work site safety gear while you are working so as to not let any dirt and debris get into your eye, further worsening the situation. In case you are experiencing difficulties opening your eyes in the morning because they get stuck together, use warm water to clean away all the discharge. Also, always keep your hands clean. Do not rub or touch or do any meddling with your eyes. This can incite a very powerful inflammation once again worsening the situation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking reactin for allergies. Itchy bumps. High eosinophil levels. How to lower it?\n\nI had had allergies reaction since coming back from Mexico 2 years ago...little,red itchy bumps that come and go...it constant itching...and also developed alley to shrimp , but I m ok to eat crab and lobster,,,,my dermatologist says I have hives and there is nothing to,do...right now taking reactin 2 times daily to reduce itching....but it always comes back. And my eosinophils is 0.60 reading ...how do I lower that??? Raf",
    "doctor_response": "hello welcome to HCM as per the details u have submitted u were having a condition called  ALLERGIC URTICARIA DUE TO FOOD ..that means  you are sensitive to shrimp. unfortunately only the remedy avaialable for any food allergy is avoidance of food that causing the hives...i advise you to use anti-histamines with combination of FEXOFENADINE+MONTELEUKAST  and try to avoid the allergans as much as possible... regarding your eosiniphil count, when ever the body exposes to allergans , the eosinophil count increases., so there is no seperated medicine for increased eosinophil count as  in ur case. hope this will help u ..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child taking encorate chrono without elder's consent, behaves strangely. What should be done?\n\nsir, my little brother is about 15 years old . from last month he is taking encorate chrono 500 mg without informing us . from last night he was behaving strange n we are so worried about him , he took 6 tablates at a time , now what can we do now . now i haven t any credit card , so please help me",
    "doctor_response": "Hi, The medicine in Encorate Chrono is Sodium Valporate, which is mainly used for the condition of seizure. Although this medicine is not addicting, but continous used without any prescription is always wrong. It is important to know first that your bother is having any type of condition for which he was prescribed this medicaiton or he himself start this without any consultaltion. If he is taking this medication after some consultation for some conditon, than I would advise you to conslut the same doctor and give him the details of the problem which your brother is right now facing because of overdosing and he may require something to stop this type of impusive behaviour. And if he is taking this medication without any consulation and just for fun than you  can stop this medication and consult and try to find out if he is having some problem or some addicting nature, that may require treatment. Thanks and take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump at anus entrance\n\nI have a small solid pea sized lump right at the anus entrance on the left. It s not painful but other areas are tender on occasion when going to the toilet. I have also had some bleeding but not from this lump but from hemorrhoids that happens from time to time. I ve had a colonoscopy 7years ago and all was well. Should I be worried? what is the lump? How do I treat it? Is it connected? I m a 46yr old female.",
    "doctor_response": "Hi,From history it seems that there might be having external piles called sentinel piles.It is not a pile but indicates that there are internal hemorrhoids inside.Consult surgeon and get examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with hepatosplenmegaly, have irregular lifestyle due to professional constraints. Advisable diet?\n\nI have been diagnosed as having hepatosplenmegaly I have no family history of this.But being a pilot I have very irregular life style,eating at odd hours,having large meal ,then go for hours without food and water.I do drink moderately .I had jaundice when I was ten Years old,if at all i thas any implication on this.Please guide metohave correct diet .Is this condition reversible?",
    "doctor_response": "Hello and welcome to HCM. The causes for hepatosplenomegaly are the following: -Infections (hepatitis, infectious mononucleosis, rubella, etc.) -Blood disorders (anemia, thalessaemia, etc.) -Metabolic disorders -Liver diseases -Portal hypertension and many more. Please note that hepatosplenomegaly is just a symptom, and there should be some underlying condition. Please visit your doctor for a more elaborate examination including a complete blood workup. And yes, this condition is reversible, once the cause is treated this gradually subsides. In the meantime, you should avoid all fatty, oily food, and also meat. I hope this information helps. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tiredness and sleepiness?\n\nHi, I had my blood test done about two weeks ago as I was experiencing hair loss. My ferritin level was 13 and my doctor prescribed me iron table- 200mg to be taken twice a day. Since taking them then i have been feeling weaker, my legs feel weaker, I feel more tired, i can\u2019t sleep more then 2-3 hours at night, and get stressed quickly. What\u2019s causing this? Could it be the side effect of the iron tablets?",
    "doctor_response": "Hello, Please to know from you that you have low ferritin level and probably has low hemoglobin as well. Taking Iron tablet has side effects like gastritis, nausea and low Blood pressure etc. But if I am your treating doctor I advised you to stick to your treatment even though you are facing the side effects. Because in mean time after few months you will be recovered from such symptoms and feels yourself healthy. Thnx",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment to be taken for the lump under left side of neck under ear?\n\nLump under left side of neck under ear,always feeling pressure in that part,Grey or yellowish sputum is produced in throat esp,. after having food. What should be done? Hello Doctor, I have a lump on the left side of my neck, just under the jawbone and my ear.Though its not visible outside, I can feel it when I touch.It is firm and not painful unless I keep pressing on it. I have a pressure feeling in that ear, and quite a lot of sputum(Grey or yellow) is produced in the throat esp, after having food(Sometimes I see blood strains in that).Most of the time I feel feverish and tired.But if I am involved in physical acitivity I feel quite normal. I have consulted lot of doctors with tests like blood,sputum,x-ray,USG. They said the results are normal.But their medication doesn t solve my problem.It s been there for me more than a year now but not getting any better.These is causing lot of mental stress for me so that I can t concentrate on my work.can you please tell me what to do?",
    "doctor_response": "Hi ! Good evening. I am Dr Shareef answering your query. As your history is of a chronic long duration, and all the routine investigations are normal, if I were your doctor, I would go for a FNAC (fine needle aspiration biopsy) under the guidance of a surgeon/ENT specialist after a full physical examination. Further management would depend on the report of biopsy. Till then, you can go for some anti inflammatory drug for your discomfort. There is no need to be in stress at present and be patient.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bruise and swelling in the ankles\n\nBack in June I fell off a ladder and when I landed on the side of my ankle I heard a pop. My ankle immediately bruised and swelled. Was very difficult to walk on for a few days. Months later now I am having a dull ache on the side of my leg from the ankle up on the outside of my leg.",
    "doctor_response": "Hello. You should have gone to ER immediately to rule out a fracture of the lateral malleolus or other ankle bones, and have proper immobilisation and management. It could also have been ligamentous injury and this as well needs expert management. I advise a visit to ER for Xrays, and physiotherapy if there are no fractures. Your ER doctor will be able to advise further. Hope you get better soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high blood pressure.\n\nmy wife is not well for the last 3 weeks. for the last two week she has taken betaloc 25mg, cobadex czs, pansped, thyrowel, domstal and uprise d3 as she was not able to withstand on her own feet from 21st July 2012. That time the measruement of BP was 100/160. But due to no relief to the patient, i have changed the doctor and now he has prescribed Melthix 10mg, Nebula 2.5 mg. and Rabinoc. She is taking those medicines for he last 3 days feeling much better. Please let me whether the treatment is in right direction.",
    "doctor_response": "Hello , ya the medication are perfect and if she is symptomatically better it's ok if she takes the same . Just for your reassurance the newer medications are similar to previous class of medication with just finer change .Let me know if any clarification needed.  Regards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the lower back, neck and shoulders?\n\nI am 45 year old female. I have some nerve damage from a severe mva in 2011. I ve been doing well. I started eating better and losing weight. I lost about 30 lb. This past couple weeks my hands and feet have been very tingly and the bottoms of my feet are getting number. Also, my low back and neck and shoulders hurt.",
    "doctor_response": "Hello, Consult an orthopedician and get evaluated. As a first line management, you can take analgesics like Paracetamol or Aceclofenac for pain relief. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes unusual stool and urination odor?\n\nMy son is 7 weeks old and is exclusively breastfed. He was cranky all day today and I just changed his diaper and I noticed it smelled like fish. There was both poop and pee, so I can't say if it was the urine or poop however, his poop wasn't the normal yellow color, it was more green. It's 1:45 in the morning and I don't feel like it's an emergency, but I'm hoping to get some answers. Thanks",
    "doctor_response": "Greenish stools are normal in infant.they indicate short stool transit time. there is no need to worry. just look for increased frequency or change in consistency to more liquid. any of those with or without fever suggest stomach infection. Keep feeding properly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is bleeding with foul odor, normal post a depo shot?\n\nI want to take the time out to thank you for answering my question. In January of this year I took the depo shot for the first time. The first month it was all good, but then near the end of February I started bleeding and have been bleeding since now I have a weird odor, like rotten eggs or passing gas from my stuff anytime I bleed heavily. My question is there a possibilty I have an infection?",
    "doctor_response": "Hello and thank you for your question. It is normal to have irregular bleeding sometimes for many months after getting a depo shot. However, the bad odor is not normal and can be a sign of infection. Please see a doctor soon for a pelvic exam and testing for infection. I you have fever for pelvic pain go to the emergency room immediately for treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe headache in a child\n\nMy 9 yr old son has been complaining of severe headache for 3 days now, he says it feels like there is water in his head. He cant stand the light either. I am wondering could this be allergy s or something like tonsilitis, which my nephew had about a week ago.",
    "doctor_response": "Hi,Welcome to Hcm,Severe headache is surely mattern of concern especially because its been there for 3 days now. I would like to know more details on it as in where exactly it's hurting in the head and what's the type of pain also is there any factor that would relieve the pain to atleast some extent. Feeling of water in the head can suggest at possible sinusitis which can be secondary to upper respiratory infection and due to blockage of sinuses. As of now, I would suggest that he does steam inhalation regularly atleast 3 times daily. An anti histamine can also help a lot. If nose is blocked , nasal decongestant drops would help further. Hope my advice is of some help. Happy to clear any further queries. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for depression and anxiety\n\nhii,Im tired of writing to docs about my problem, no one ever replies to them, after reading that u have solved over 25000 cases i thought u might b able to help, I'm 22 yr old male.I always had stage fright but then i realised that was not the only thing i had, I have social anxiety i.e. i hate crowded places,i dont get on a crowded bus or a train avoid traveling at peak hrs. I walk most of the time even miles at a stretch to avoid people, i fear them, i would like to carry a knife but im afraid that i might end up hurting myself or probably kill someone when im angry.I'm also depressed since 3 yrs,i have a family but tend to b alone,mixing up wit people is the toughest job on earth for me,i recently moved to a new place but havent spoken to anyone havnt made any frnds wit the fear of rejection,i definitely know they wil reject me, im a bad person,I've started smoking since 7 months coz in the start it helped me wit my anxiety now it doesnt help dat much but sometimes i talk to ppl, once in a blue moon. When im angry i can talk to ppl which i usually avoid at all costs. through reading from internet i figured why i got depression and anxiety, I've a personality disorder - AVOIDANT PERSONALITY DISORDER..I've got each and every symptom it has mentioned.i'm even searching for a book on that subject.i spoke to my parents once in november last yr took them to a psychiatrist,i dont know wat he spoke to them,my dad comes out of the hospital n tells me v knew wat was wrong n walks away. since then we havent spoken about it. i mean we had a fight regarding the medicines i was on but then i had to leave dem i only took them for 15 days.i was on amitryn 10 for 1 month,it helped, i started getting good thoughts,i felt good,i felt normal for the first time in my life but that was only one day, never felt it again.And I havent cried in 11 yrs, cried twice for medical reasons, once for a toothache n once a headache caused by medicines given to me when i was hospitalized 2 yrs ago for dengue. No matter how hard i try i just cant do it. not even after hurting myself,cutting wit a blade,punching walls,bangin my head,extingushing a cigarette on my body,breaking a glass.i enjoy nothing in life.i lie to everyone. watever i have written here is the truth coz i need help,i cannot go on like this,its difficult everyday,some frnds r there but i havent told them , its better that way.recently everytime i travel in buses i wish it would",
    "doctor_response": "Hi,I went through your query in detail and can understand the distress that you must be having. You are definitely suffering from multitude of issues. You seem to have social anxiety which makes you uncomfortable in social situations. In addition, continuity of your problems have landed you in depression which is leading to your being irritable and even trying to harm yourself.I would suggest that you should seek a psychiatric consultation again and get yourself started on medications. Medications like paroxetine or venlafaxine would help you a lot in decreasing your symptoms. You should also make efforts to quit smoking as that will only cause worsening of anxiety in long term. Daily exercise will also help you relax and feel better.You can also consider starting cognitive behavior therapy for yourself. you can discuss regarding the same with your psychiatrist. It will consist of multiple sessions focusing on learning relaxation and changing the maladaptive thoughts that are leading to problem.I do hope I was able to answer your query.Best wishes,Dr. Sunil Gupta",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cough and Cold. Wheezing and sweating. Prescribed with an inhaler. Reason?\n\nyes my 4 month two week sons been having a cough a head cold for a few weeks ive been to his dr 3times she gave me an inhaler said he is wheezing alittle but its not in his chest its just a nasal head cough not much to do becaise no fever however last two nights he has been sweating so much his head back  and body sweating thru his cloths ..? no fever but warm and sweaty should i be very concerned? because iam what can it be",
    "doctor_response": "4 month child is not able to adjust environmental changes you can use antiallergics like fexofenadine 1/2(1`5mg)bd can use syp ventrolin 2.5 ml bd apply neosporin h ee ointment in nose bd sea water 1 drop bd in each nose dont add diary or milk protein in diet for 2 years if added withdraw to clear symptomps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for asthma and breathing problem\n\nI have exercise induced asthma and when I walk up a flight of stairs my heart races but I am not out of breath.  I walk 5 miles a day 7 days a week and my heart does not race and there is no shortness of breath.  I weigh 106 pounds and I am 5 feet 1 1/2 inches tall.",
    "doctor_response": "Greetings Sir/madam. It's appreciable that you are even  noticing some minor changes happening inside you.  As for as exercise induced asthma ,  In exercise-induced asthma, the muscle bands around the airways are sensitive to these changes in temperature and humidity and react by contracting, which narrows the airway. Because people tend to breathe through their mouths when they exercise, they are inhaling colder and drier air.* The symptoms of exercise-induced asthma generally begin within 5 to 20 minutes after the start of exercise, or 5 to 10 minutes after brief exercise has stopped.- If you are experiencing any of these symptoms with exercise, inform your doctor.1. Coughing 2. Tightening of the chest 3. Wheezing 4. Unusual fatigue while exercising 5. Shortness of breath when exercising- As for treatment is concerned,  Bronchodilator medication, after consultation with your doctor inorder to rule out any other cause apart from exercise induced asthma. - Avoid strenuous exercise if it cause you uncomfortable.Hope that helped you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood clots and flesh after the surgery for kidney stone?\n\nMy husband had a kidney stone six moths ago that was to big to pass. The stone was in the ureter on the right side. He under went 3 surgeries to get rid of it. Two laser and sonic wave ( i think ). The last surgery about a month ago being a laser and removal. After the surgery he passed several pieces of the stone and gravle like pieces. A stent was placed and removed about a week later. Scince the last surgery he has had pain on and off and has passed numerous bloodclots and what looks to be flesh. The first surgery to remove the stone was not successful. The dr. attempted three times with different scopes and could not get to the stone. The stone was pushed into the pelvis of the kidney and a second attempt was made a few weeks later with the sonic wave. The third surgery  was successful at removing the stone. Now he is having this pain and clot and flesh problem. It has been over six months and he just wants to feel better.",
    "doctor_response": "helloThanks for query .Your husband who has large stone probably in upper ureter The Urologist attempted endoscopic surgery of URS but could not reach out up to stone at first attempt.This is known problem when the stones are located high up in proximal ureter .Subsequently he could break the stone at third attempt and placed a D.J stent which is a common practice for fragments of the stone to pass down without pain .Now he getting severe pain and passing blood clots and flesh in urine .These are due to infection as a result  of repeated endoscopic intervention .Please get his urine culture done and take appropriate antibiotic .All these issues will get resolved once infection  is well controlled .Ensure he drinks more water .Do ot worry he will recover completely .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of small, painful and moveable lump on the tip of my elbow?\n\nI have a very small, moveable lump on the tip of my elbow. It is causing an amazing amount of pain for such a tiny little thing. I can t move my arm or lift anything without extreme discomfort. My elbow was a bit uncomfortable yesterday but is much worse today, especially if I lean on it or knock it.",
    "doctor_response": "Hi,DEar,thanks for your query to HCM.I studied your query  in depth.1-In My opinion the small  ,movable on your elbow-tip -appears to be mostly -Acute olecranon bursitis - as its movable and painful both.2-Hope this would solve your query.3-Wellcome for any more questions on new or this subject also...Have A Good Day..!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to get pregnant\n\nPregnancy I had a miscarrage in july 2011 & ive been trying to get pregnant ever since  and it seems its not working my periods use to be regular and now there not ive had a miscarrage once before and had 3 boys after my first mc what can i do to get my period regular and what could happen if i start taking clomid without being supervised by an ob i really really want to have another baby....",
    "doctor_response": "HIWell come to HCMFirst of all underlying cause of miscarriage need to be ruled out and treated accordingly, pregnancy is more natural phenomenon than the physiological one apart from the treatment you should keep trying, do not give the hope, compatibility is matter, hope this information helps, have a good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing period like cramps following iui?\n\ndoctor i m 31yrs old.i was given clomid,gonal f 75 for two days followed by hcg 10000 shot and then i had IUI on 17/05/12.my doctor told me on 15th that 2 gud follicles measuring 19,19mm were there on the right side and EM was 9mm.after iui i had cramps on the right side of the lower abdomen till 8th and 9th day after iui.i was also asked to take susten 400 frm 19/05/12 for 14 days.now at times i get periods like cramps.i m really confused.am i pregnant or not..also i have low grade fever ranging frm 99 to 99.6 since last 6 days",
    "doctor_response": "Hi dear, I have gone through your question and understand your concerns. Slight lower abdomen cramps are common after IUI, and if there is no associated bleeding or spotting and the pain is not very severe, then you need not worry.If troublesome, then you should consult your doctor for proper examination, investigations and treatment accordingly.Hope you found the answer helpful. Please do get back for further queries.Wishing you  good health.RegardsDr Deepti Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes congested and sticking out tongue in babies?\n\nMy 8 month old is obviously unwell. He is normally a happy baby but for the last 2 days, he has been off food even milk has a high temperature is congested and sticking his Tongue out. He is teething at the moment so has red cheeks and is drooling. I have given him infant paracetamol and ibuprofen but he refuses any gels. It is as though his Tongue is sore. Is this related to his teething or is there something more serious wrong. He has not slept well and is very restless. Can you help?",
    "doctor_response": "thanks for askingi gone through your question and understand your concernyour 8 month old is having high temperature, and drooling,As per symptom you giving, if i would your treating paediatrician, i would check her throat, . she may have throat infection, for that antibiotics to be given.so your should consult your paediatrician proper check up and antibiotic therapy. hope i answer your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i smoke marijuana while recovering from DVT?\n\nI was diagnosed with a pulmonary embolism from post surgery about a year ago. Proceeded with treatment. About 2 months ago, I was diagnosed with a dvt. Currently on warfarin. Chest is clear but there is still residual clotting in the leg that is clearing up. Can I smoke marijuana?",
    "doctor_response": "Hi, Welcome to Health care magic forum.                      Any smoke, or any tobacco can effect the lungs, fatally. You are not cured completely of the deep vein thrombosis.                       Now it is not advisible to think of the marijuana, especially with the permission of the doctor. D.V.T. is also a result of the smoking , atherosclerosis, and thrombosis.                       If you have it now, the thrombus can be in the heart, or brain.Sorry it is not threatening, it is a fact.                       Take more of green leafy vegetables, pulses, sprouts,and protein rich foods to be healthy.                       Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Twitching in facial muscle. Is it atypical hemifacial spasm?\n\nHi Dr.Samuel, my name is Steve. I'm 21 years old this year. Currently, i'm a college student. I'm not a very active man. A few days ago, my facial muscle near the chin area start to twitch involuntarily. By then it have started to get a bit heavier day by day. I have done some online research and i wonder if i have atypical hemifacial spasm and if it can goes away by itself or do i need to see a doctor? I really look forward for your suggestions. Thank you",
    "doctor_response": "Hi, thanks for writing to HCM.Muscle twitches can happen for lots of reasons, like stress, too much caffeine, a poor diet, exercise or as a side effect of some medications.Although most twitches go away in a few days and are nothing to worry about, some twitches can be caused by nerve problems or other medical conditions. Getting enough sleep, avoiding too much caffeine, and eating healthy foods (like lots of fruits and vegetables), can help prevent some muscle twitches. You should consult a doctor if \u2022 you have a twitch that doesn't go away\u2022 you notice weakness, tingling, or numbness in the area where you get muscle twitches\u2022 it looks like the muscle is getting smallerHope this information is helpful. Good day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is surgery the only option for my lower back pain?\n\nI am ganesh from Mumbai (age 33, weight -78 Kg, Height -170 cm) and suffering from lower back pain. My MRI report says that there is moderate disc dessication at L4-L5 disc causing centoisis impinging. Is the surgery is only alternative for this and if I want avoid it what can else I can do? What is success rate of the surgery?",
    "doctor_response": "mr. ganesh, there is no way except surgery. you will try physiotherapy by a expert but surgery is the final way according to your mri.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Strained lower back, pulled muscle, pain on getting up. History of spinal problems. Treatment?\n\nIt feels as though I have strained my lower back, pulled a muscle. The pain is very bad when I bend down or rise from a sitting position, also when sitting. I have very little pain when I walk. It also feels as if it s moving towards my right hip. I can walk & stand with very little pain. I have had disc problems in the past, but it was very different. The disc problem went on for months & effected my walking (siatica). Do you think this is just a pulled muscle? I am wearing a back brace and using a cane to lean on when I rise from sitting. It has only been about 48 hours after a lot of physical work in my yard & house. Thanks.",
    "doctor_response": "hi cathy welcome to hcm, looks like the old disc problem is back do meet ur ortho u need good rest, muscle relaxants, physio and further examination and  investigation if pain persits after all this do consult a good dr to rule out a slip disc and do avoid bending and lifting weights thx have a great day drdeepak",
    "dialogue_context": ""
  },
  {
    "patient_message": "45 yrs old, have done 2 failed IVF, only have 3 fertilized eggs left. Any chance that third IVF may succeed ?\n\nHi.  I just turned 45 and have done 2 (failed) rounds of IVF.  The RE doctor was able to retrieve 12 eggs initially.  On the first IVF he used 4 eggs - due to my \"old age.\"  After that failed, we did some blood work and found that my husband is positive for T & B Antibodies.  We just did the second IVF attempt - I was given Lipids 5 days before the transfer, and was then on ASA, Heparin, Estrogen and progesterone.  Just found out today that it failed.  The previous lab work etc on me showed that I looked more like a 35yr old than 45.  Since my side isn't too bad off, is there really any chance that a third IVF attempt might succeed?  We only have 3 fertilized eggs left.  Also, when they harvested the eggs origianllay - are there any that are actually left behind that might be grown for a future attempt?",
    "doctor_response": "HelloThanks for your query.If the total number of eggs retrieved, have been used in the previous 2 attempts, and the remainder would be used now, then there would not be any left that might be regrown.You have to have fresh stimulation and egg harvesting.If the lab work showed that you have a good ovarian reserve, do not lose hope , as there is always a chance of conception.All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there something to be worried about flu in pregnancy?\n\nHi i am 9 month pregnant few days back gt viral flu infection with high fever .. Fever is over now so are my antibiotic med but since yesterday i feel like extremly low and sleepy all the time . I am 30 yrz old and also on aldomet 250 twice a day... I hope theres nothing serious",
    "doctor_response": "Hi,Welcome to health care magic.I understand your concern about viral flu affecting your pregnancy. There is no need to worry as flu viruses usually cause upper respiratory and mild GI infections.As you are in your last trimester, less likely chances of any serious side effects due to antibiotics also.Wishing you a safe delivery.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest tips to stop masturbating\n\nhej doctor i masturbate and i feel weak i can hardly concentrate i cant breath good i am very short 5.'6' i am male and i am 18 even my brother who is 14 is 6'2 can you tell me if i can be taller and i want to stop masturbate becouse masturbate had just did bad thinks to me",
    "doctor_response": "Dear user,Thanks for writing to HCM.I understand your concern about possible effect of masturbation on body height, breathing and weakness.Just as sexual intercourse cannot lead to weakness, short stature or breathing difficulties so how masturbation can do it?Masturbation is akin to sexual intercourse. What penis does in vagina during sexual intercourse, same it does during masturbation in your folded palm! This is a natural activity and I would say a 'healthy' activity and does not either affect or deter sexual performance, height, or body structure. It is myth that masturbation causes aging, fatigue, bone problems and memory problems, weakness.Relax and go ahead.Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with low sperm count. Suggested IVF. How can this be increased naturally? Chance of pregnancy with IVF?\n\nMy husband  recieved his test results yesterday, we were freaking out becuase the results stated he has 99% morphology, low sperm count, etc. Basically thripple wammy. They suggested IVF, but I was wondering if thers is any chance to improve this problem naturally, ie vitamins, food, etc. Is it possible that if he re-tests the results may come out different?  What are the odds of achieving pregnancy with ICIS + IVF as a last resport.?",
    "doctor_response": "HelloThanks for your query.Please upload the exact semen analysis report.There are various causes of abnormal semen analysis.You should consult a Uro Andrologist.Some of the causes are treatable , such as infections and blockage,and others are not , such as genetic causes.IT is difficult to say offhand without an examination.IVF _ ICSI reports also depend on the count and other parameters.COnsult an infertility specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Wheezing problem since childhood. Had betamethasone. Difficulty in breathing. Remedy?\n\nHello doctor, I am having wheezing problem from child. My mother also having same problem.. that time we mostly take betamethasone tablets. After, I came to know steroids are not good. So I go to salbutamoland theophylline combination. Now I am feeling diificult in breathe. I feel it is due to gas. Its coming daily..morning, evening, after eating in night.  What is my problem . Tell me remedies ..how to change my daily activities, food..",
    "doctor_response": "Hi Asthma attack can be triggered by pollutants, upper respiratory infections, weather change, stress, allergens, so avoid these triggering agents. and life style modification is must so follow the suggestions strictly Drink plenty of water Boost your immunity by proper diet like having lots of green leafy vegetables and fresh vegetables. Avoid junk spicy foods and carbonated drinks Learn yoga asanas , pranayama and meditation techniques to improve your Lund capacity and for the good. Blood circulation to the chest. Go for chest physio. Avoid exercises Control your stress level by practising regular yoga. Add pepper ,  honey,  ginger and garlic in your diet. Avoid milk and milk products. Take hot foot bath before you sleep for 15 mins. Have good sleep. To avoid excess gas formation do pavanamuktasana to release the excess gas and change your diet as mentioned above take less amount of dhals avoid cabbage, cauliflower, Peas. Drink minty leaf juice added with jeers which will be very effective for your gastric complaints. Hope this answers your query . Take care wish you speedy recovery. Bye",
    "dialogue_context": ""
  },
  {
    "patient_message": "High bilirubin levels. What does it mean? Severe weight loss\n\nHello Doctor,My brother has lost 4-5 kgs weight in last 2-3 months. He is 34 years old. He has undergone many tests like endoscopy, Complete Blood count, Thyroid, stool test for blood loss, blood sugar test and ultrasonography. All results are normal.Today he underwent Liver function test (2 of the parameters are above reference range). Results are as follows (reference range given in bracket):S. BIluribin - 1.5 (0 - 1)D. Biluribin - 0.3 (0 - 0.2)SGOT - 15 (6 - 40)SGPT - 17 (8 - 37)S. Alkali - 102 (36 - 140)Total protein - 8.3 (6 - 8.5)S. Albumin - 4.4 (3.5 - 5)Globulin - 3.9 (2.5 - 5)AG Ratio - 1.1 (1 - 1.4)S. Biluribin and D. Biluribin are slightly above reference range. What does it indicate. Please advise. Are there any more tests needed?Thanks in advance.",
    "doctor_response": "Hello.As you say S.Bilirrubin and D.Bilrrubin  are slightly above reference range. The most common causes of increased bilirubin levels are liver,vesicle or pancreas diseases.For Liver and vesicle, abdomen ultrasound is correct additional test but for pancreas is necessary to request a computed axial tomography(CAT scan).Your doctor,probably,will request because a person with weight loss and increased bilirubin levels,pancreas diseasemust be rule out.I wish you good health.(In case the answer would have been useful please indicate this)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause stomach pain and dizziness?\n\nI have stomach pain not lower part more in the middle and feel dizzy and tired. I also can not stop hicuping not sure if this is related. The hicups have only started today however the stomach pains I've had for 2 days now. I had a bad fall on ice whilst snow boarding recently and not sure If i have done something to my tummy area? or if I have a general problem....",
    "doctor_response": "Hi.Thanks for your query and an elucidate history. The history of fall on ice, pain in middle abdomen, dizziness and tiredness for 2 days and hiccoughs for a day indicate that you have an internal injury, which is causing the irritation of the diaphragm.There  is a possibility of a small oozing in the abdomen due to a small tear any any of the structure. The blood in the peritoneal cavity irritate the diaphragm so much that the hiccoughs start today. Not immediately to due a latent period is always present as the peritoneal fluid dilute the attack. I would advise you the following to be done ASAP as there is a possibility that he may need an exploratory laparoscopy after a CT scan and other relevant blood, urine ans stool tests.  This will help to rule out the gastrointestinal or stomach cancer too.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Had morning after pill and c-section in the past. Will these affect the fertility?\n\nHi, i am 37 and have finally decided for a third baby.  I have two girls 8 and 4 which I got pregnant with first time.  I have taken the morning after pill quiet a lot in the past two years as we weren't sure about third baby.  I also had a c section with my last. We have been trying for past two months and new result.  Is my fertility effected with morning after pill, section etc",
    "doctor_response": "Hi, Before you start trying to conceive naturally, it would be advisable to have a complete evaluation with a specialist who would make sure that you have not developed any hormonal or tubal complications secondary to the emergency pill usage and the caesarean section. if you are found to be normal, it may take sometime owing to your age, but, please allow yourself at least 6 months before you turn to other methods of conception. Wish you good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dark patches on penis\n\nRecently I m having dandruff flakes and patches around and under my pennis area. I used a subscribed cream and it started to reduce a lot. But I found some tan patches on the pen is area near the pubic region and I found it is spreading very very slowly. Can u please help me",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: Are you suffering from psoriasis?Explanation: This type of dried dandruff like material is seen with psoriasis. So, visit a doctor for examination and further treatment.                   It is not a big deal, be cool its not urgent.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower backache and swelling in the legs?\n\nI have lower back pain.Ihave went tothe gynocoligest,nothing going on there,I have went to the chiopractor,lasted only a day,and lastly iwent to have a massageand nothing has helped.My legs are swollen and i only get relief when i sit down.Can you tell me what might be going on?",
    "doctor_response": "Hello and welcome to Ask A doctor Service.  I reviewed your query and here is my answer. Will you elaborate the swelling in the legs? Does it pain when touched? Is it red? Do you run fever? As you said you went to gynecologist,  so there are two differentials for this swelling. It could be deep venous thrombosis if there is also associated hair loss and shiny leg at site of swelling which can be diagnosed by doppler ultrasound of leg and need urgent treatment.  But if you are not bed ridden and don't have underlying blood disorder or not using any OCP's, then it is least likely. The 2nd cause is cellulitis which is more favoring if it is warm, red and painful. And will need aimple pain killers, antiinflammatory drugs and antibiotics. Till that simple elevating of legs will help in subsiding of swelling and need to see a doctor.Hope i answered your question.  Feel free to ask more if you need further assistance.  Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swollen stomach with pain. On morphine. Any other treatment options?\n\nhello, my grandma is in hospital and has been for 2 weeks.  She has been on a drip for most of this time as has not been able to keep down any food and they say her stomach /gut is very swollen and she is in pain.  They surgeon said he cant do anything about this so they want to take her off the drip and then follow with morphin I guess and watch her die.  Is there really no cure for this as she is talking and it doesnt seem right to allow this to happen so easily.",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for calling H.C.M.F. Your description says that your grand mother is at her last days unable to  take any thing in side through the mouth. With out knowing any details of the case it is not wise to comment upon the condition. It may be that she had some problem in the throat. As your doctors advised you can keep her on morphine and let her have infusions with a gap of 3 to 4 days to prevent hyper hydrosis. Wishing her a comfertable time. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if tongue stings as am allergic to nectarines?\n\nI think I am allergic to nectarines.  I have never had a reaction like this in the past. My tongue feels like I burnt it with hot soup.  It's been like this for a week.  I have been rinsing with Listerine and it stings.  Just started taking benadryl.Any suggestions",
    "doctor_response": "HI, thanks for using healthcare magic You may want consider discontinuing the use of the listerine. This would only aggravate any injury to the tongue.You can consider continuing the benadryl. The use of an anti inflammatory agent may also help to decrease any inflammation and discomfort that you are experiencing.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Worried teen, any suggestions or help\n\nHi I'm 18 years old and I have never been to the dentist in my life because I have always refused or said it wasn't necessary, i was scared. I've taken care of my teeth poorly in the past but I have recently been very very good about it. I know I have a few cavities and underneath one, on my gum, is a lump about the size of a skittle. From what i've read online it cannot be good, any suggestions or help?",
    "doctor_response": "Hi, The lump underneath the tooth with a cavity maybe a periapical abcess, ie: pus formation, forming a lump due to infection in the tooth. This needs to be treated along with your other cavities. The abcess suggests that the tooth in question is already dead which needs a root canal treatment to drain the pus, along with a course of antibiotics to eliminate infection. once the pus is drained the lump will resolve immediately. The dental offices are very patient friendly now a days and you should not worry at all. In today's day and age the dental treatment is almost painless in most of the cases. If you are still worried just go for a basic checkup on your first visit and start the treatment in your later visits once you get familiar with the doctor and the clinic. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blisters at the base of penis after using sex toy?\n\nHello. I recently bought a sex toy called Fleshlight and have been using it for about two weeks. Recently, I noticed some blisters at the base of my penis; they are very discomforting. It is not an STD for I  had a clean std exam about 3 months ago, and have not had sex since then. Age: 23. Weight: 200 Ibs, Medical History: nothing significant",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It could be an allergic rash due to the sex toy. Need a direct examination to confirm. Consult a skin specialist directly. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Ear ringing, rolling eyes, shaking, vomiting. Panic attack, low blood sugar or seizure?\n\nI had an episode about a half a year ago. I was in the car with my friends & all of a sudden I heard ringing in my ears & started losing consciousness. I completely blacked out for about 3 minutes. My friends said I was shaking and my eyes rolled into the back of my head. It took 3 minutes to get to my house & on the way is when this happened. I woke up & was clammy & as soon as we pulled into my driveway I got out & threw up, then I was fine. I want to know if this was a panic attack, low blood sugar, or a seizure?",
    "doctor_response": "Hi, Thank you for posting your query. The description of the event sounds more like a generalised seizure. The only other possibility is syncopal attack, which is unlikely to happen in the circumstances you were in. You should see a neurologist and get MRI brain & EEG done for further evaluation. Please get back if you require any additional information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest any medication to avoid full blown cold and cough in kids\n\nMy toddler is going to nursery and often picks up cold and flu bugs. She is again seeming to come down with a cold but I want to nip it before it becomes a full blown cold. Is there some medicine I could give my toddler to avoid setting of a full blown cold and cough. The throat bit I was able to eliminate with a combination of natural remedy - ginger juice honey and lemon and prospan syrup. Is there anything I could do for the cold.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.Cough and cold are viral 95% of the times in children. For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15mg/kg/dose every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.For cold you can use Cetrizine at 0.25mg/kg/dose every 12 hourly for 3 days.For nasal block, plain saline nasal drops will do, every 4-6th hourly to relive nasal congestion.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Vitamin D supplement cause skin problems?\n\nLooking for contraindications of vitamin D. Just read on the internet that skin issues can occur. I take vitamin D (5,000 units in winter & less in summer) along with a SSRI to fight depression. Last summer I became very allergic to UV rays. Other skin issues are occurring. Last summer I had to stop using an anti-perspirant as it caused my underarms to itch. Also, many dryer sheets cause itching. I m 68 & my skin is thinning somewhat due to age, I suppose. Can Vitamin D be causing these skin problems?",
    "doctor_response": "hi sir/madam,Thanks for your question on Healthcare Magic.An allergic reaction to vitamin D causes the immune system to develop a defense against the supplement because of a hypersensitivity to the vitamin. The immune system reacts by creating Immunoglobulin E, or IgE antibodies, that attack the vitamin supplement, according to the American Academy of Allergy, Asthma and Immunology. Various other chemicals are released in the body, causing inflammation in the throat, lungs, sinuses and skin. The primary chemical that causes inflammation is histamine, a hormone that helps fight off infection.After ingesting a vitamin D supplement, hives can develop within minutes or up to two hours. Hives can occur because of too much histamine released in the skin. The rash appears as welts that appear in clusters anywhere on the body. The rash causes the skin to swell and has defined borders, although the rash can appear in any shape or size.Eczema is a chronic skin disorder where the skin is hypersensitive to various triggers, much like an allergy, according to MedlinePlus. If you experience an allergic reaction to vitamin D and you\u2019re pre-disposed to eczema, the allergic reaction can cause an eczema flare-up. Eczema appears primarily behind the legs, arms and on the face in blisters. The rash can crack, weep and crust-over if scratched.Consult your GP for further treatments.hope this was helpful.have a healthy day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the following follicular study report suggest?\n\nhi,my wife had a dominant follicle of 21.9*17and cet 10 at day 13th after hcg injection 5000iu. intercourse took place after 39 hours. she was on letrozole from day3 to 7.she has been taking metformin,cystova,cabergolin for pcos and prolactinoma.her present health condition is normal.is there any chance of gettiing pregnant this time? kindly reply.",
    "doctor_response": "Hello,In your case, everything is fine.So there is high chance of getting pregnancy, until there is unexplained infertility or the tubes are blocked. So you will definitely conceive.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mandavi Rai",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes small lump at the top of my buttocks?\n\nIhave a small lump at the top of my buttocks which is extremely painful to sit on. It is quite hard to touch with a small blackish area on it. I am going away tomorrow and despite it hurting I am not too worried but I wondered if theres anything I can do to calm it. I wondered if it could be a splinter or just some kind of cyst or spot?",
    "doctor_response": "Hi,It seems that there might be having some ingrown skin infection and now forming abscess is likely.go for one antibiotic and anti-inflammatory medicine course for 3-5 days.Apply antibiotic cream locally.Avoid perspiration on the part.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hoarseness while on medication for shingles?\n\nI have been diagnosed with Shingles and have had two rounds of an antiviral medications. My problem now is that I have so much congestion and hoarseness that I can t seem to get rid of. I m going on about 4 weeks of this. Is this related to the shingles.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Hoarseness may be due to herpes infection only. Compilation of shingle only. It is a viral disease causing upper respiratory to lower respiratory tract infection also. Take warm saline water, gargle trice daily and continue the treatment for shingles. In case of wet cough you can take antibiotics. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen lymph nodes?\n\nGood morning, I have had swollen Lymph Nodes s above and behind my left ear and underneath my jaw (left side). My GP checked my throat and ears and there was no sign of infection, bloods were also taken and they came back fine. however, my wisdom teeth are currently pushing through and causing a dull discomfort in the back of my jaw. Is it possible that my incoming wisdom teeth are causing my lymph nodes to swell ?",
    "doctor_response": "Hi thanks for HMC team  well, you shown your Lymph node to G.P. . Blood test are also normal .   But i want to ask some  questions upon your Lymph node like what is the size of node? is it larger than a Pea ? Is it mobile or not? Is it in how many numbers?Do FNAC ( Fine Needle Aspiration Cytology for Lymph node) Test , which will help you to treat your Lymph Node.and show your teeth to a dentist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for CKD(chronic kidney disease)\n\nhi doctor,my dad is 64yrs of age suffering from ckd hes under dialysis from 1 year. his weight is 62kgs.how can he improve his health further. wat al can he eat. his heamoglobon is 9.6 blood urea 67 and creatinine wil vary its 4- 5. then potassium is 4.5.. is he normal is it ok if creatinine and urea differ every month. wat all can he eat. pls suggest. he cant walk always. hel be restless always. pls help.",
    "doctor_response": "hello, thank you for writing in to hcm.chronic kidney disease is a progressive condition. the problems of accumalation of high concentrations of waste products in the blood as the kidney cannot Filter them can cause problems. along with blood pressure maintaining medications and cholesterol lowering drugs, even diet control is important.  restrict the protein in the diet after consulting the nephrologist to avoid accumalation of excessive levels of periodically of protein metabolism.  also fluid intake should neither be less nor to much. usually 1800ml per day is fine. donot take fatty foods. the serum creatinine levels and blood urea levels need to be maintained to slow down the process of damage. regards, dr. riyanka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dry itchy cough\n\nI have a dry itchy cough that leads me to gasping for air. It s been over a month, I use to hear a wheezing, but now that s stopped. It sounds terrible. I can t even laugh hard without having a coughing fit. I literally have to force myself to inhale through the hacking cough. I some times have mucus that comes up with it. Buty throat itches uncontrollably during this time and I have vomited some during these spells.",
    "doctor_response": "What you have got is a post viral cough. It may sometimes be very refractory to treatment and takes a long time to get away.Start seretide inhaler 2 puff 2 times daily and tablet singulair 10 mg daily at night. You should be fine in 4-5 DAYS but continue treatment for 3 weeks Kindly vote thanks if the answer was helpful",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from disentries too often from past months. Is this a liver disease?\n\nHI, I AM SUFFERING FROM DISENTRIES TOO OFTEN. 4-5 DAYS ARE GOOD AND AGAIN I AM GETTING DISTURBED. THIS IS GOING SINCE LAST 1-2 MONTHS. I AM TAKING LIV-52 FOR LAST ONE MONTH. I EAT MEALS REGULARLY THERE IS NO CHANGE BUT GETTING INDIGESTABLE TOO OFTEN. IS THIS A LEVER DISEASE OR SOME ELSE. PLEASE ADVISE. mail id-  YYYY@YYYY",
    "doctor_response": "Hi, Thanks for writing in HCM. I would suggest you to get your stools tested for parasites along with a liver function test. If the stool is positive for parasitic infections then a full course of treatment is a must. But if it happens to be negative then you require to improve the gut function by taking cultures and regularizing your food habits with respect to its content  in a organized manner. This will aid in digestion and improved motility. I hope this answers your doubt. regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any danger if my son used another boys blood testing needle?\n\nhello, my 9 year old son and 2 of his friends tried out another boys blood teating diabetic needle.  Curious and bad choices.  My son says it din't hurt and hea had no blood but his other 2 friends did have blood.  Shoul I be worried and what should we do now?  Very concerned mom.",
    "doctor_response": "Thanks for your query at HCM!I am Infectious Disease Specialist! I went through your query!It is least like ly that he might be infected with needle prick.You must ask your child not to repeat such thing in future. There are many infections which can be transmitted. As they are children less chances of HIV, Hepatitis B or C which are dangerous but no one knows if they are carrier or had received transfusion in past or born to mothers of infected disease.Only test done after few months can prove without doubt regarding transmission.But in your case it seems unlikey. don't worry.Happy to take more queries! You can also write a review for me. If you would like some more information, I will be happy to provide. You can take a follow-up query.Take care!Dr. Sheetal VermaInfectious Disease Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure bruise found on the veins of the legs?\n\nsudden blue bruise on my outer left knee/leg. No injury, it just hurt and I grabbed it and litterally within minutes I saw the bruise travel along my veins in my leg. My husband traced the bruise thinking it was a possible blood clot before bed last night. This AM the very blue bruise has turned very purple and black. It has gone outside the traced outline and looks like its following along my veins lighting up blue...it has now gone past my leg and seems to be crawling up my thigh...any ideas???",
    "doctor_response": "Hello, It can be lymphangitis or thrombophlebitis: It there is any signs of infection, antibiotics may be required. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for down syndrome in a child?\n\nHi, may I answer your health queries right now ? Please type your query here...Hello! I have a six year old son with down syndrome. For the past week to week and a half, he has no appetite and sleeps an unusual amount. He has had a low grade fever on and off but i m mostly concerned about him not eating. Suggestions?",
    "doctor_response": "Dear Parent,Change in the activity and appetite are concerning in your child. It could be a result of underlying infection or a heart failure if your child has been diagnosed with a congenital heart disease which is very common in Downs syndrome. I suggest that you consult your pediatrician as soon as possible who will do a detailed physical examination, do some blood tests and cardiology tests like ECG, ECHO to come to a diagnosis and treat accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stabbing pain in stomach?\n\nI woke up this morning and it felt like I was being stabbed in my stomach. It is now 10 hours later and there is no relief. I ve taken antacids there is no burps or farts. It is somewhat painful to take a deep breath and I m occasionally nauseated. Will it ever end?!",
    "doctor_response": "Hi.This is utterly difficult to understand why the patient is still at home since you are suffering for 10 hours ans you say you have not consulted in ER or a Doctor. The probable reason can be either in the abdomen like intestinal obstruction or lymph node enlargement of a problem in the gall bladder or liver. Another possibility is that you have developed some problem in the pleura - the covering of the lungs as you are giving history of pain increase on deep breathing . Get a clinical examination and investigations to get a proper diagnosis and treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the disorder called which causes walking and talking problems?\n\nhello doc.my daughter is 6yr old.she was unable to walk at the age of2.i took out MRI which says non myelination of peri ventricular white matter at the face of bilateral occipital horns .what this prob is actually called,is it a disorder?now she understands everything can walk but has a prob in talking,does she needs a speech therapy?her paediatric told me to give her this therapy ,what do u suggest.",
    "doctor_response": "Hi, From the history provided, it looks like lesions in peri-ventricular white matter which may be the reason for delayed walking in your child. There are many conditions that may cause walking and talking problem (Global developmental delay) such as muscle related problem, Nerve related problem or could be due to brain injury during birth (perinatal asphyxia leading to cerebral palsy). At present I would advise you to go for speech therapy as advised by your pediatrician and get a baseline hearing test. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nirubhan Bharathy, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for itchy skin rashes in patients post radiation treatments\n\nI developed an itching type rash, seemed like mosquito bites (only on my right arm). If I don t break open from scratching, they appear very bumpy, white and scaley. Symptoms started approx. 1 week ago. I recently had a full hysterectomy (Stage 1 Cancer) and finished 25 radiation treatments. Not sure it there s any relation to my recent symptoms. Should I just apply anti-itch cream?",
    "doctor_response": "Hi, It may be an allergic reaction. As the first line of management, you can apply low potency steroids and can take antihistamines like Pheniramine for symptomatic relief. If symptoms persist, better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for seizures with lesions in brain\n\nMY neice had a seizure at her daughters baseball game and the neuorgeon today said she has leasions on the brain and wants to do a spinal tap. she is also loosing weight and he wants her to have a colonoscopy. She is also have trouble with her balance and has fallen 3 times and He wants her to have her eyes examined.",
    "doctor_response": "seizures with lesion in brain can be treated by antiepileptic medications. phenytoin, valproate, levetiracetam, carbamazepine etc.  are usual medications used for control of seizure. Treatment of brain lesion depend on the cause of the lesion, which can be infective, tumor,stroke related etc",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rapid heartbeat and migraine during pregnancy?\n\nI am researching information for my niece who is pregnant due in april. she is experiencing an increased heart rate and has had a migraine type headache for six days. She is wondering if these are normal symptoms as she didn t experience them with her first child. should she go in to see a doctor at this point?",
    "doctor_response": "Hi.Causes like anxiety, hypertension, exertion, fever, hypothyroidism, etc; can all cause tachycardia (increased heart rate) and so I would recommend an elaborate evaluation to be conducted by your doctor.As for the migraine headaches, they are very common in women mainly because of a hormonal fluctuation, which can occur during the menstrual cycle and also during pregnancy. It can be frustrating, but please support and encourage her so she can get through this.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pelvic and back pain\n\nHi my name is Sandra Iam a 49 year old women in the past week I have had pelvic pain which then lead to lower back pain and currently pain in my left hip . I have been to my GP and currently on antibiotics I also was admitted to hospital Friday morning only to be released and informed to have an ultra sound which I have under gone results of bladder , kidneys and ovaries all showed as normal. I have never had any back problems and always been a strong women, can you help me. The pain has eased but only to return just when I feel Iam recovering.",
    "doctor_response": "HiThank you for asking HCM. As you have done an ultrasound of abdomen and pelvis acute abdomen or chronic kidney stones can be ruled out. Now the conditions we can suspect is problems with spine sacroiliac joints or hip joint.An examination with orthopedician can give clue for that and a X ray followed by MRI might be needed to confirm it.If it is sacroiliac joint arthritis a local corticosteroid injection will give pain relief. In case of problems with spine like osteochondrosis or disc herniation i advise muscle relaxants like cyclobenzaprine NSAIDs like aceclofenac neurotropic drugs and recommend physiotherapy along with this. Hope this may help you. Let me know if you have any further queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does it take to heal fractured ribs?\n\nhow long does it take for 4 fractured ribs to heal?happened 3 months ago- discomfort is more at night when turning in bed-- I fell in bathroom and my whole right side hit the top of the tub, also I have lupus,RA, mixed connective tissue disease,am I correct that it takes longer for me to heal?",
    "doctor_response": "Hi, This treatment is being suggested on bases of the information provided. However, I would like to examine & investigate the patient  in detail. Control hypertension, diabetes or any other metabolic disorder, if there is  any. Any way it may be tried -- Dolokind Plus\u00a0(Mankind) [Aceclofenac + Paracetamol]\u00a01 tablet OD & SOS for 5 days. Caldikind plus (Mankind)\u00a01 tablet OD for 10 days. (You may need help of your local doctor to get these medicines.) Fomentation with warm water. Let the part not be exposed to cold air. Sleep on a hard bed with soft bedding. Use no pillow under the head. Avoid painful acts & activities. Do deep breathing  exercises. (Take help of a  physiotherapist). Do not ignore, let it not become beginning of a major problem. Do ask for a detailed treatment plan. Kindly make sure, there is no allergy to any of these medicines. For emergency treatment visit nearest hospital. Wish you a quick recovery & good health. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nirmal Chander Gupta, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have painful lymph nodes down both arms, what could be the reason for this?\n\nFor seveal months now I could feel swelling in both upper arm not so much the arm pits but below them. Now the lymph nodes are painful down both arms. They are not greatly swollen but I can feel the lymph nodes. Last night my right arm kept me awake most of the night. I always get relieve from an advil but last night the advil did not relieve the pain, although I did get some relief by putting my arm over my head . I have no signs of fever . Any ideals?",
    "doctor_response": "Node found in right arm few weeks back &  few days back have got similar node in left arm exactly in the same place as that of right arm. What could be the reason ?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have peripheral neuropathy. Done laser treatment. Have pain in leg, knee, hip, groin\n\nI have been diagnosed with periferal neuropathy.  I have have laser treatments that cost a fortune and did not help.I have had various foot ointments that have been recommended by a naturopath.  I take heavy doses of various types of vitamin B.  Pain is now in my right leg, knee, hip & groin.   I live in Edmonton, Alberta Canada.  Have another dr's appt  on Thursday and what can I ask for to get me some help or start restoring my nerves.",
    "doctor_response": "peripheral neuropathy u are suffering from is due to which problem.Do u havediabetes?along with B complex tabs ,i suggest you also to have tab prothioden 0ne tab twice daily oratleast oncebefore goingto bed.U are saying that u have pain in right lower limb.Is it associated with back pain?Is there any history of fall/trauma?U may be having lumbar disc disease.kindly consult a near byneurosurgeon for ur problem",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold,cough and severe headache\n\nHiIt is around 9.48 pm (21 april 2011)am going to tell u a brief story wat is happening to me since lst some years..i m regular suffer of cold and cough. arond in the mid of 2008 my mom told me to consult a homeopathy doctor   after taking his medicine  my throat becomed choked slowly  and become to worst choked and then i stoped the treat ment and every thing becomed normal with in some days but the cold and cough still continue .after some month i felt a pain in my head at the time of the movemnt of it, like at the time of praying, to pick som thing from the floor , at the time to tying the lace etc. so i decide to chck the alopathy  doctor . and he gave me some wat of medicine called sinrest  and that helps me alot . i was feel good with in a week ... but the cold and cough was still in my  life in regular basis . in the mid of august 2010 and the previois situation again start . so i used the sinarest medicne as precribed by the doctor earlier  but this time  i take it without the prescription .on 15 the august nite  i felt the worst pain on the front left portion of my head around  11 pm . so my father gave me a medicine called pain kille ( opel) that make me feel better after a hour .in the morning i though that all those thing start because of that sinarest so i stoped the use of it and the pain not occur for a long time of 8 month , now the thing sttarted in the ist week of april 2011 due to some regular up and down fever kinna of condition my doctor consult me to do some  test in whic he found the( EOSINOPHIL   2.0 ) FROM THE RANGE OF .02- 0.50 SO HE  Gave ME SOME MEDICINE OF THAT WITH THE WEEKLY USE OF THAT I FELT THE SAME WORST PAIN OF LIFE AND I HAVE STOOPED THE USE OF ALL THOSE MEDICINE . BUT STILL  THE PAIN IS NOT LEAVING  MY HEAD . AND NOW THE OCCURENCE OF IT DAILY AND SOME DAYS TWO TIME ..  SO PLZ CONSULT ME .. THE AGE OF MINE 25 YEAR WEIGHT 70 HEIGHT 5.6",
    "doctor_response": "Cough, cold and severe headache, need to rule out sinusitis first. Get xray PNS, if no clue, go for ct scan for the same. If ct scan is normal, you need to get MRI brain done. See, history is long standing, so need to be investigated. At times it may be migraine also. Consult physician and if necessary neurophysician for headache.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Possible herniated disc in lower back, painful, buzzing sensation. On prednisone. What is happening?\n\nI am being treated for a possible herneated disc in my lower back, which has caused me pain for the last 4 weeks, ranging anywhere from a 3-9 on the pain scale.  My question is, lately I've noticed that right before my pain elevates to the high end of the scale I experience a vibrating/buzzing sensation all over my body....is this something I should make my Orthopedic doctor aware of?  This has been happening in the last week, after I saw the doctor.  I'm currently on Prednisone & Muscle Relaxers.  Thank you!",
    "doctor_response": "Hello,  Welcome at HCM.I have read complete details of your question.The prolapsed disc does not lead to such vibrating sensation in whole body.These sensation can be either due to deficiency of vitamin B1,2,6,12 or this can be due to stress,anxiety or a generalized neurological disorder.If you are stressed about this then you should first decrease your stress level.For relief from it you may have a preparation like pregabalin or gabapentin.You should consult to a neurologist for this.Hope this all will help you.With best wishes,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is brufen junior medicine safe for kids?\n\nHi,My son is 3 months old and our pediatrician gave him Brufen junior for infection in the eye & ear. But in the product description it is mentioned that it is not safe for kids who are below 7kg or 1 year.Shall i continue with it or stop it? Please advise",
    "doctor_response": "If there is ear pain and not getting relieved with paracetamol , you can use  ibuprofen in proper dosage on sos basis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long will it take to recover after circumcision?\n\nhey hi iam 21yr old, iam thinking to due circumcision surgery. iam thinking to due circumcision so could u plz send hospital name in mangalore?ad send approximation cost for this surgery?ad after surgery how many day it take t cover pain?and in sensitive part how many day it take to cover pain?",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.Recovery after circumcisioon is quick and pain may be felt for few days. all other activities can be done on next day after surgery so you should not be worried about this.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "WBC count, lymphocytes is high. Have a sore throat a few times. Family history has it. Potential virus or lymphoma?\n\nI just returned from a walk in clinic.  My white blood cell count is high and so is my lymphocytes.  I currently have a sore throat and was given amoxicillin 875 mil.  I have had several sore throats in the past, the last time was Dec.  is this normal for a cold coming on?  I'm worried about other potential virus and or lymphoma since my Dad is stage 3.  I am 38 years old, female.",
    "doctor_response": "Hi, There is a chance of virus infection. Anyway, other disease entity like tuberculosis should also be ruled out . You should be cautious about fever, cough any swelling in any part of body. Nothing suggestive of lymphoma still now. The proper clinical examination of oral cavity and oropharynx should also be carried out.Consult your physician for better guidance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do people have severe depression and suicidal tendencies?\n\nmy husband has severe depression and I wanted to know about it and the side effects. My husband has had many anti-depressants with no success. This new one has been given to him in the hospital as of 3 days ago. This is likely his last chance for help. He is also sucidle",
    "doctor_response": "DearWe understand your concernsI went through your details. I am sure that you are much worried and request you to be calm. Suicidal tendency is part of Depressive disorder. Anti depressive drugs help to reduce the depression and they do not cure the root cause of depression. Depression is a habit of the mind. Negative thinking habit. The neurons are habituated to think negatively. We have to change this habit.To change the habit, we need to identify the root cause of the problem. A psychologist can help you in this aspect. After identifying the problem and the understanding depth of  the problem, he will suggest a series of psychotherapy techniques which are to be followed strictly. Then your husband could be saved from this disorder. Believe me. it is effective.For life style counseling, mental counseling, health counseling, psychotherapy treatment and anxiety disorder treatment please visit  this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Not able to conceive. Regular periods. What could be the problem?\n\nHi. My name is Josy from Tanzania. Iam 34 years of age. We got married with my wife since April, 2011, But up to now we do not have a child. My wife gets her menstruation normally, and i ejaculate with no problem. My wife and  i are tired of leaving with no babies. We Consulted several doctors they say we do not have any problem that one day we will have a child. But today i beg if I can contact a specialist to advice and help my family to be happy. God bless you.",
    "doctor_response": "Hello welcome to health care magic regarding your query you both have tried for a baby,but not succesfull,, In majority of cases the defect lies in the female only... Consult infertility specialist and for your self undergo semen analysis..in that they observe the count and motility..both are extremely for fertility.. regarding your wife menses are normal,,,,then hormonal tests,,mostly they were also come as normal...they will do follicular studies.Then they test for fallopian tubes patency test,,if they are blocked or closed,then they will try to open them.. Infertility specialist will help you in this regard.. Hope you are satisfied with my answer.. Have a baby soon Thank you Dr.siddartha",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can low confidence associated with premature ejaculation be managed?\n\nHello doctor, I am male, 26 years old, sex insecure and low experienced, first trauma got 99 during bombing of Yugoslavia, had to get new urinal channel, and product of that is I am circumised. Later in school, I have been bullied for 4 years constantly, physical and mentally by my \"school friends\". Could not get into relationship till 25th year old, had 7 times sex, with 10 seconds each. Troubling to stay erect, fast ejaculation, and even lower self-confindence than before. Now I am troubling and overthinking what will happen next time, will there be next time, although it is hard to get into relationships because of that, cannot stop pressuring myself with being bad in bed and unexpirienced, as time pass, it only gets worse.",
    "doctor_response": "Hello. I am so sorry to hear about your situation, I can imagine how hard it is for you. So you are describing a few things here, when is the problem of premature ejaculation, second is performance anxiety which is making you overthink, third is low self confidence. Probably that came from the bullying and the trauma that you endured. I would suggest you to start therapy sessions to help you build your confidence which will help you in decreasing the performance anxiety and then it will of course improve the problem of premature ejaculation. If the mental health is stable, sexual issues often resolve. Is there some neurological issues you will need to talk to a neurologist or a urologist for that. Try doing kegel exercise regularly which will help you in strengthening the muscle of pelvis which helps in premature ejaculation. Apart from that you will require therapy sessions to work on your confidence building and reducing anxiety. Cognitive behavioral therapy will help you in achieving this.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain and weakness while having vitamin-d deficiency/hypotension\n\nHi my name is Katie. I am 22 years old. I have been in and out of doctors offices since my csection in Feb. of 2009.  I had my gallbladder removed in June of 2009 due to gallstones. My symptoms didn't subside after that/ I still felt the same. Fatigue, Abdominal Pain, weakness etc. I found out that I had vitamin d deficiency (18L). And Hypotension. (Get out of breath, fainting etc)The dr told me to increase my salt intake and exercise more. I did, and it hasn't worked.  During my pregnancy I developed ICP? (high liver enzymes)I had severe itching that didnt subside. Since I had no family history of it, I demanded a Ct scan of my abdomen to check everything visually. My results came back normal. As with all my bloodwork. I am at my wits end and don't know what to do. Do you have any suggestions?",
    "doctor_response": "Hello Katie!Welcome and thank you for asking on HCM!I passed carefully through your question and would recommend checking your adrenal gland function and also your thyroid gland function. Your symptoms could be caused by a hormonal disorder or an autoimmune disorder. For this reason, I would recommend performing some tests: - cortisol and aldosterone plasma levels for the adrenal gland function- ANA, ANCA to investigate for an autoimmune disorder- complete blood count, fibrinogen plasma levels and PCR for inflammation- thyroid hormone levels- a Head Up Tilt test for postural hypotension. A cardiac ultrasound is also necessary considering the shortness of breath when walking. In the meantime, I recommend continuing taking Vitamin D. Hope you will find this answer helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Paralysis due to stroke, diabetes, high BP. Will dialysis be effective?\n\nhello dr my aunt has been paralysed on her left side due to a stoke for 10yrs now. recently her kidneys failed and she has been refused dialysis due to her paralysis and her suffering diabetes and high blood pressure. drs are saying dialysis will not be effective for a patient like her. This doesn't make sense because my mother has the same diabetes and high blood pressure and suffers trachy/brady syndrome and sleep apnea and she was offered  CAPD for her kidney failure..",
    "doctor_response": "Hi and thanks for this query.I a sorry about what your aunt is going through.Dialysis clearly helps in cases of kidney failure. I suspect the doctors think she has many other morbidities that dialysis may not really make any meaningful difference in her prognosis. They may be thinking that there is almost no extra benefit getting her on this procedure.I can only suggest why such a decision might have been made. I think you should consider talking  with her doctor to get specific answers to this question in order to better understand the reasons. Beside, how old is she?I wish this really helps and provide some guidance to you.Wish your aunt all the best.Dr. Ditah",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of dizziness and pinching pain in chest?\n\nhi,for about a month i have been having a sharp pinching pain on the left side of my chest (beside my breast and middle rib)  that last about 5 seconds but usually when i burp it goes away. it is the only symptom i have i dont get dizzy or anything like this. could it be gas related?",
    "doctor_response": "Hello,Whats your age? Most likely it is related to gastritis and acidity. You avoid spicy, fatty, and oily food. Also, avoid heavy meals instead have multiple small meals. Also have some walk immediately after food. Try tab pantoprazole before breakfast once a day for 2 weeks. If it persists after a week then get one ECG done.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fever, flu like syndrome, kikuchi, dejection. Taking HCQS, naprosyn. Lupus symptoms?\n\nMy daughter 25 yrs old was diagonised of Kikuchi in june2012. even now she is getting intermittent fever with flu like syndrome(appro every month). Now she is on HCQS and naprosyn twice daily. her ANA test is negative. Is this kikuchi or lupus?Please tell me what are the conditions that may cause a flare in lupus? is diet responsible? during times of fever she loses her cool and feels dejected. Rest of the month she seems to be normal .Does she need a physchological counselling?Kindly advice.",
    "doctor_response": "hai People with kikuchis like presentation can evolve into lupus but usually they are positive for ANA . Instead of psychological counselling you can give her some peptalks to increase her morale . most likely it looks like a kikuchis only unless she throughs out some new manifestaions later.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I consult the doctor for the throbbing pain in the head and dizziness?\n\nhi well im a teenager and last night i hit my head really hard on my dads trunk door. it didnt hurt as much as i thought it would and i slept fine but im pretty sure my head has a bump on it and it hurts. i also have a throbbing feeling. and im dizzy and VERY worried. should i go to the ER?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern you said here that you had accident that hurt your head, in case of any head injury the 48 to 72 hours of observation is necessary because any thing could happened during this period if nothing is happened during this period then no need to worry about this, if nothing have happened immediately the also nothing to worry, hope this information helps you, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rashes on upper chest, neck, jaw line, itching, burning. Using eurex cream. Cure?\n\nI have a hives type rash on my front upper chest and neck and jaw line. I have had it for a few days and been treating it with antihistimines and Eurex cream. Sometimes it seems to be reducing in severity and then it will flair up again. Should I take different antihistimines. I have loiritidine and piriton and have taken these regularly or more than recommended on the packet but sometimes itch and burn so bad.",
    "doctor_response": "HI I THINK IT IS ACUTE URTICARIA.CHANGE THE ANTIHISTAMINES TO ATARAX AND LEVOCETRIZINE CAN CURE IT,.ADD A SHORT COURSE OF STEROIDS AND CALAMINE LOTION TO THE TREATMENT",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes loss of taste after using Dettol for gargling?\n\nHello Dr I happen to take it upon myself to gargle with dettol. I had a sore throat coming on and thought with my smart self it will kill it in its track. I didn\u2019t swallow just gargle for about 1 to 2 minutes. After that I wash my mouth and gargle with mouth wash. An whala I lost my sense of taste. Everything I try to drink or eat taste like nothing. I am very concern now because it\u2019s been more than 24 hours. Will I get my taste back? Did I damage the senses on my tongue forever?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Loss of sense of taste seems probably due to burning of the taste buds with excessive use of dettol followed by mouth wash. It is probably temporary and will return as the taste buds heal.So my suggestion is to stop using dettol or mouthwash completely. Take Becasule tablet daily. Avoid spicy foods and do warm saline gargles. Just have patience, the taste sensation will gradually return. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hepatitis A infection, high bilirubin levels. SGOT, SGPT normal. Treatment?\n\ni have had hep A in june 2012 and now its aug coming to the end. i am not perfectly alright. my sgot and sgpt levels have become normal but my bilirubin levels remain stuck between 2.4. the doctor said that it is due to some other reason else my hep a is gone if the enzymes are alright what other reason can be that or it is still because of hep a??",
    "doctor_response": "hi, i have gone through your concerns and i feel you need not worry about the bilirubin as long as it is less than four and predominantly indirect bilirubin. please repeat LFT after 1 month  and consult a gastroenterologist . take care bye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for myeloma\n\ni very recently was diagnosed with immunigoblins of 2800 IgG but with all normal blood platelets (of the red sort. or MGUS as a prior state of MEYELOMA, and a suggested bone marrow test in the office of over 3000 IgG. I need a concurrence or a second doctors opinion prior to that test and how it is done.",
    "doctor_response": "bone marrow is needed to see the extent of involvement. if it is MGUS, will not need treatment as well. Bone marrow test is done i=under local anesthesia from hip bone. usually it is with bearable pain and procedure lasts for 5 minutes. have never seen a patient complaining too much pain for it. you can go walking after the procedure. if you are too worried for pain, ask for sedation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it to be concerned about the pain in the upper stomach and rib cage?\n\nI was doing yard work about a week and a half ago and felt discomfort moving large rocks. The next day I had a pain in my left upper stomach to the right of my upper left rib cage. Then a few days labor and currently, I have noticed the pain move to the left of my belly button. I also have felt gas noises and bubbles on the left side now which I have never noticed in my life before. This is not a sharp pain and it seems to get agitated even more upon eating",
    "doctor_response": "Hello againAs per your symptoms there is possibility of  gastritis.I will advise to start antacids [proton pump inhibitors like] rabeprazole 20 mg twice a day.Sucralfate will protect gastric mucosa and will give protective covering.Gases formation can be reduced by eating easily digestible food, stop non veg, drink plenty of water.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can red yeast capsules cause frequent coughing and pain under the breast?\n\nHi Dear Dr. I have been taking red yeast capsuls since last August. During these months I have been caughing continusouly, especially at nights and I feel a pain in my left side under my breast. My question is can red yeast cause thses two? Thank you.",
    "doctor_response": "Red yeast is a herbal supplement. There are no regulated manufacturing standards for this marketed supplements possible side effects of red yeast:upset stomach;heartburn;bloating;mild headache;dizziness,swelling of face lips tongue.continuous cough with chest pain indicates disease related to respiratory system do consult your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are risks of having BP of 140/78 and heart rate of 92?\n\nMy husband has HTN and has tried several meds that have either not worked or had side effects that were not acceptable to him.  He is currently not taking any meds and he has been able to keep his BP around 140/78.  Still too high, but better than the 170's systolic he had before.  This week his BP has been shotting up to the 170's due to stress at work.  Last night he was SOB due to a resting HR in bed of 98 (normally he is in the 60s or 70s).  His BP was 140/78.  This morning his resting HR upon waking was 92 and he still fells anxious and appears SOB.  I cannot convince him to go to the doc.  Is he in any danger that I can relay to him to convince him to go?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Yes, he should visit the doctor and should get medicines prescribed. Currently, his blood pressure (BP) is on the borderline, but he will eventually need medicines.He should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor BP regularly thrice a day for one week then once or twice a week.If BP is persistently more than 140/90 mm Hg, then he should be on medicines for it. He should go for regular exercises like brisk walking, jogging according one's capacity atleast 30 min a day and 5 days a week.He should avoid meat but must have lots of green leafy vegetables, fruits, fish once or twice a week. Avoid smoking and alcohol if any. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painless muscle twitching in foot?\n\nI have a painless muscle twitching in the heal of my right foot. It has been occurring off and on (maybe the past month or so?). I exercise regularly. Drink water (rarely any soda; no coffee) Level of stress on the job has increased dramatically. Should I be concerned?",
    "doctor_response": "hithank you for providing the brief history of you.A thorough musculoskeletal assessment is advised.as you have no pain and other symptoms except twitching of the muscles in the foot, it could be related to muscle weakness in the foot region. Performing exercises for the foot muscles should regain the strength and avoid twitching later on.The twitching occurs due to imbalance in the muscular system and with simple exercises it can be balanced. Exercises includes are - picking the marbles from floor,  picking small bits of paper and walking bare feet on grass.This will provide stimulation to the muscles of the feet and make a Neuromuscular correction in the imbalance in the muscles.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedy for high fever\n\nyes my cousin has been feeling ill since 4am this morning i gave him an off brand medicine (Equate Pain Reliever Antiaminophen) this morning about an hour before he went to school around 2:30 p.m I recieved a call from his school saying he has a temp of 103 I need to know wat can i do for him at home before taking him to the hospital",
    "doctor_response": "hello,,Thanks a lot for the queryyou can take a moist cloth with cold water and keep it on his fore head.dont use tight clothes.give him Tab Paracetamol 650mg thrice dailydo take him to the hospital and evaluate his cause of fever and treat accordingly as per doctors advice.hope he will get well soon",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat thigh muscle pain caused by trauma?\n\nMy 23 year old son Fell down from Bicycle during Army training and he has been advised to take 20 days sick leave for treatment....... There is no fracture of bones... Muscle of outer side of thigh is having pain ... that muscle lost its stiffness. It became loose when comparing the other thigh\u2019s muscle.. He can\u2019t run now... can\u2019t walk comfortably.. When consulted, the doctor prescribed.... EVION LC,.....PRYNERV-M.....AND LIBOTRYP Tabs for 10 days.. My son has limited period of sick leave and has to report to camp after 19 days... there is no considerable relief after taking 4 days medicine..... Due to the limited period of sick leave ,,, please advice whether we have to consult another doctor or to wait ... OR , is the present prescribed medicine will suffice for relief after 10 days... can he continue his training after 20 days ...?????",
    "doctor_response": "Even if leave is of limited period, body takes its own time. Use ice pack 5 times daily for 10 minutes every time. He will get more relief.It would be ideal to get MRi of knee to know what exactly has happened to knee.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain on neck which shoots to the head?\n\nI start with very sharp pain that starts from the back of her neck and quickly shoots to the rest of her head within minutes - 10 pain level ... Lasts about 5-10 minutes and then she loses consciousness for about 2-3 hours ... During which she twitches a lot ... Takes her about 20-30 minutes to wake up out of it ... Headache level drops to like a 3-4 ... Her body is always in pain and she is very fatigued ... All the time ...",
    "doctor_response": "hi welcome to health care magic. after going through your query my opinion is that the patient may have compression of nerve roots in the neck which leads to severe  pain in the head but there might be chances of some pathology in the head (intracranial) for which MRI cervical spine and  contrast enhanced CT is to be performed . visit neurologist and orthopaedician. hope your query is solved. welcome for further queries",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for brain tumor\n\nMy friends son as been given the all clear 3 months ago for cancer of the chest , they have now found a brain tumor no further results as yet but they have also said they have found a shadow on his kidney is it possible that the cancer as spread through his body . Please be honest with us",
    "doctor_response": "Hi, Yes, it is possible that brain tumor can spread all around but probably it is a kidney tumor which may have spread to the brain. So he needs complete work up. I suggest you consult neurosurgeon and nephrologist. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr PANKAJ ARORA, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal cramps, excessive sweating and vomiting?\n\nMy boyfriend currently is having cramping all over his stomach, really gassy (burp wise), heads sweaty but no fever, and he was having nausea and just started vomiting when he tried to swallow two advil cold and sinus pills. Anyone know what it is?? Should we be going to the er? He says it feels like heat stroke but we were only outside for 2 hours today and it wasnt hot out",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Dear he may be suffering from acute gastritis or gastroentritis or food poisoning or Irritable Bowel syndrome etc. Until examination is done it is difficult to say what it is. Avoid spicy food and alcohol avoid smoking and caffeine drinks. Use tablet Pantoprazole before breakfast for one week. Take soft diet, use tablet Sporulac thrice a day for five days. If Symptoms not improved please consult your doctor he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can depression and nausea be treated?\n\nI am a female, aged 63. I suffered a very mild stroke 3 weeks ago. My memory is effected but I have no mobility issues. However, I am depressed, feel nauseous and tired. I would sleep half the day away if I could. All in all, I feel awful. I m eating healthier now than ever before and drinking lots f water but the depression and nausea really bothers me. Any ideas?",
    "doctor_response": "Hello,In my opinion, it is important to rule out low hemoglobin levels, thyroid dysfunction and also very important to rule out electrolyte disturbance. Take mirtazapine and nutritious diet. Relaxation exercise is also useful.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Gayathri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it a good sign to avoid brevactid after 20 days of fertility treatment?\n\nJust started 1st cycle of fertility tx - clomid, puregon, Brevactid. Currently day 20 of my cycle. Blood test yesterday confirmed a 2nd dose of Brevactid was not needed, but unclear whether this is a good or bad sign. Thank you for your help and advice.",
    "doctor_response": "Hi,I read your query and I understand your concerns.Following is my reply:1) You can discontinue brevactid.2) There is no need of it now.Let me know if you have anymore questions.Regards,Dr. Mahesh Koregol",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i give prednisolone to my child for cough and wheezing?\n\nHello doctor, my son is 3 years old and got a very bad cough and wheezing. it got bad in a day. yday he was fine. we went to a doctor and he prescribed Prednisolone(1 tab each for 3 days). my son is on Dipakene for the last two months. is this medicine safe, i dont feel comfortable with this prescription .. please help",
    "doctor_response": "Hi, yes you can prednisolone to a child if wheezing is more and not responding to beta blocker drugs. Prednisolone should be given for a short period of 3 to 4 days and then stopped. I hope this has helped you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Mantoux test is positive. Am I suffering from tuberculosis?\n\nHi doctor, I had pulmonary tuberculosis in my teen age. After a full course of ATT, I was recovered and no findings on sputum and x-ray. Now, I am 30 years old. I have left lower abdomen pain since two to three years. But, it is not severe. The pain is intermittent and often relieved by passing stool. My gynecologist advised me for Mantoux, which came out as positive. I am planning for a baby for three months. My menstrual cycle is fairly regular with an interval of 21 days and I have dysmenorrhea since my menarche. Am I suffering from genital tuberculosis?",
    "doctor_response": "Hi. Mantoux positive is showing sensitivity to tuberculin antigen. It is a screening test and not a confirmatory test. If it comes positive, then do TB PCR (tuberculosis polymerase chain reaction) for confirmation. If that too comes positive, then it means there is a chance of genital TB and you have to take treatment for it for around four to six months accordingly. If TB PCR is negative, then you do not have to worry. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had wisdom teeth extracted. Having pus and pain around the stitches. Normal to have pus at this stage?\n\nHi,I had my  3 wisdom teth extracted 2 days ago. There was a nerve wrapped around my lower wisdom tooth and this is the one causing the most pain.I expected it to be painful but I am worried that I see pus around the  stitches.It also tastes no so good. Is this normal to have pus at this stage or at all.Thank you.Grainne",
    "doctor_response": "thank you friend for the queryhaving an infection or pus in an extracted tooth wound is not normal at all.you please visit your dentist and get the stitches removed. take antibiotics and analgesics for at least 5 days.get your wound clean and also ask him to give you zinc oxide dressings and please try to maintain your oral hygeine and always follow the post extraction instructions carefully.      hope to see you in best of your health and spirits",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do high BP and cold need medical attention?\n\nmy husband had single bi-pass surgery 3 weeks ago. He came home from the hospital 2 weeks ago with a head cold/sinus infection, for which he has been treating with antibiotics for the last 13 days. Yesterday and today, he complained of he head and face feeling like it was on fire, while his arms and hands were cool to the touch. His blood pressure was 161/99 when I took it 30 minutes ago. A home health nurse is due to come again tomorrow morning to check on him. Should I call her now or take him to the ER?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I understand your concern and would explain that your husband's symptoms could be related to trigeminal neuralgia. The blood pressure fluctuations and cold arms and hands are probably related to a normal and physiological reaction to the pain. Coming to this point, I recommend consulting with a neurologist for a physical exam and performing a brain MRI. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is MAI in the lungs?\n\nI am scheduled to have a Bronchoscopy next week with my pulmonologist. She will be doing a lavage, not a biopsy. One of the things we are looking into is the possibility of an MAI in the lung?? Could you please explain this to me? Cancer has been pretty much ruled out and though I m trying to be optimistic, I wonder!! Thank you - Sincerely, Judy",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. MAI means Mycobacterium Avium Infection. It is rare bacteria which infects lungs. It is isolated in BAL (bronchoalveolar lavage) culture.You are can also ask for sensitivity report. Culture report will isolate the causative organism and sensitivity report will guide about effective antibiotic treatment. If BAL is negative then no need to worry for MAI. Usual duration of treatment for MAI is 6-8 months. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Extreme lethargy, tiredness, disturbed sleep, mood swings, sore throat and bloating post stopping intake of antidepressants. Withdrawal symptoms?\n\nHi, The past three weeks I ve been feeling very tired and lethargic, I can t seem to get enough sleep and when I wake up I m still tired. I wake up with a sore throat and it lasts throughout the day. I have been getting dizzy a lot in the past week and my moods have gotten worse. I am very moody and angry. I was taking antidepressants and have stopped taking them recently (without consulting my doctor). I ve had headaches , mood swings, hungry appetitie and am bloated in lower abdomen . Could these be symptoms of medication withdrawals and or something else? Thanks, k",
    "doctor_response": "Hi! How long has there been sore throat and what was the antidepressant you were taking? Why did you stop it? Best Wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes purple bruise below the knee despite taking Advil?\n\nI fell and hit the area beneath my knee very hard. Next day it started swelling and bruising. I am on warfarin and metropolol had surgery a year ago for torn mitrovalve. It has been 4. Days my leg does not hours when I walk. I iced it for 2 days. The bruising had spread down my leg and is swollen but not hurting just a little swore. Have taken some Advil I m resting it tonight it seems to be improving except for the purplness. Any advice traveling on vacation in Ireland",
    "doctor_response": "Hi, Most likely it is only a contusion in your knee so icing and painkillers will help. Any bleeding which has occurred at the time of injury is likely to spread on dependent areas so do not worry about the spread of bruising. It will take a few months for bruising to go down. If pain and instability occur in the knee and then go for MRI. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any side effects of taking zithromax ?\n\nHi I was prescribed zithromax in March for upper respitory problems - I had taken two days and started noticing sever pains my legs and thighs - the thirday both legs were almost giving away for while as I could hardly walk - then I stopped. And the fourth day I was woken up suddenly and my heart was racing I went to bath room several times and was having chest pains etc. 4 times I went to the hospital for same symptoms - they did all sorts of tests and came up with nothing. I used to indian food now I live on cereal and yogurt rice - not bread - nuts no hard food I get stomoch and chest cramping and feel like I will die - will I ever recover? it is almost 9months I am like this.",
    "doctor_response": "Zithromax for 2 days and then these symptoms for last 9 months some how do not show causal relationship. if you have undergone most of the tests and a good consultation then there should be no reason for worry and apprehensions.You should think positive and you shall recover back i think.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with liver problem since months, suggested liver transplantation. Is there any other alternative?\n\nhello! i am Awinash Rai from Guwahati. I have been suffering from a serious liver problem from quite a few months. According to Army Hospital of Guwahati, 80 % of my liver has been damaged & according to them, i ll have to go to Delhi for further treatment. they even suggested liver transplantation . i want to know if you can provide me with some other alternative. please suggest what i need to do as soon as possible. thank you.",
    "doctor_response": "Hi Awinash, If the residual liver function is just 20% then replacement by way of transplantation is the only option. Delhi is the place where the success rate of transplantation especially with the liver is the best. So I would suggest you first consult Dr Soin from Medanta Liver clinic in Delhi and see what he has to say. then take a decision. With regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tooth decay\n\nI have 4 rotten wisdom teeth that gave me n infection in my mouth. I think i might have a gum disease also and im really afraid my teeth will fall out.I work a full time for $8 hr,no insurence, and have bad credit and no cosigner Can i get help?",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. When there is infection in any tooth you have to get it either removed or get it root canal treated, as infection can spread to the apex and cause an abscess or cyst,  which will be very painful, so better you should get it treated as just taking medication can not solve the problem,  so you have to make time for appointment of dentist. Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Want a fresh and healthy skin. Have dark acne spots on face. Which soap should be used?\n\nHi am TJ,have always wanted a freshh and healty skin,I have like a light chocolate skin.I have use some skin lightening skin before,such as plamer s skin lightening complexion tone soap,but I don t want to use any of these skin lightening soap again cos am scared its might damage my skin.so today I searched for a normal soap,that is gonna be cool for my skin,and the soap theo DETTOL SOAP.am not sure if this is the right soap for me,so that s why am asking.I do have some dark acne spots on my face.so what do u think is the best soap 4 me? Is it dettol?",
    "doctor_response": "Hi...dear TJ..., Thanks for choosing HCM.., Soap is not keeping skin fresh and Healthy.., But gives some support.., If U get good selection of soap.., Always look for..., 1) TFM value of soap... TFM means Total Fat Mean Value.., If it is high that soap treated as good soap.., Good soap have minimum  70% TFM value..., So every soap have it's own TFM value.., 2) If soap have low Ph ....treatyed as good soap.., 3) Good soap have loow surface tension and softness., it can give good foam even hard water....High PPF water.., 4) Non-smell, Clolourless, soft and frothy soaps are good ..., ok,..thanQ",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have abdominal flutters and it is painful\n\nI have been experiencing fluttering sensations on the upper right abdominal area behind the rib cage. What is the cause of this? It isn t painful, just a twitching sensation.",
    "doctor_response": "Hi Welcome to HealthcareMagic. Abdominal discomfort , that appears to be , may be due to dyspepsia.Due to increase acidity and reflux , the movement of gas results in fluttering sensation along with burping. Specifically on to the right needs examination to be evaluated. I advise you to visit your Physician and get examined to know the exact cause. Hope this information is useful to you and others. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have a tumor on my right neck and is diagnosed as vallecula epiglottis. Can you suggest a best treatment for this ?\n\nHi! I got a tumor at my right neck and it was there since last one month. I have consulted one cancer specialist in Vizag and he said like it is vallecula epiglottis. He also said this is in stage 4 and this kind of cancer won t spread across other body parts.As part of the treatment, he said he will apply biotherapy, chemotherapy and radiotherapy. Please suggest the best treatment for this and how much it would cost to cure this permanently.",
    "doctor_response": "Dear Rajesh,thanks for query.The treatment can only be suggested by your cancer specialist after examination.Please take a second opinion for your satisfaction then decide one doctor and start the treatment without wasting time,the cost varies from city to city and from hospital to hospital. wishing you speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes delay in periods despite having negative UPT?\n\nHi Doctor,Just wondering im 6 days late on my period which is normally regular. I was using prenatals for 3 month but didnt take it at all this month. I took a pregnancy test last night and it was negative. Me and my husband are ttc and did use the ovulaion period very well. Can i be late due to the prenatals or was it just to early to test.Thanking you",
    "doctor_response": "Hello,I have gone through the query and understood your concern. Prenatal medication does not delay a period. Since you had regular intercourse during the ovulation period, your chances of conception are high. I would ask you to repeat the home pregnancy test. Please do it early in the morning using a fresh sample. You can also go for the estimation of the serum beta-hCG titres. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for endometriosis leading to painful menstruation and bowel movement?\n\nCan you please take 15 minutes out of your time to talk to me for free. I will be thorough and QUICK. I do not have health insurance, i am 28 yrs old working as a Nanny. Ive had endometriosis for many years and saving up for the procedure. My clock is ticking and i am freaking. My horrible pains are not only during menstruation but now having them before and after. Especially during bowel movements which is really starting to worry me and the pain is very bad. YYYY@YYYY",
    "doctor_response": "HIThank for asking to HCMThis type of pain does not need any treatment and this will be fine without the treatment, just keep your stress level low then you will definitely feel good medicine will create some other problem take care and have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat green poop in a 6 1/2 years old child?\n\nmy baby is 6 1/2 month old now. She was born 40 days premature. She is on mother feed, farex 2, cerelac and solid foods. For last two days she has pooped green which is my worry now! what could be the cause of her pooping green. Recently i have switched from cerelac rice to cerelac wheat apple!",
    "doctor_response": "HiWelcome to the HCMI understand your concerns but don't worry. Occasional changes in poops of infants occurs commonly when we change to complementary feeds. You should be concerned about the colour and consistency if:1. There is blood or mucous present which may occur when there is bacterial or parasitic infection of gut.It can also occur in some food allergies.2. Very loose wastooland frequent stools suggestive of diarrhoea.3. Persistent green coloured poops may be due to increased lactose or other sugars in the diet.4. If child has fever along with the changes in poops with poor appetite.At present, I would recommend a proper complementary diet such as mashed fruits, porridge, boiled and mashed pulses, cereal based formulas for complementary feeds. Make sure you take a good care of hygiene.For any further questions, you may contact me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am 10 days late on menstrual cycle but negative for pregnancy. Please advise.\n\nHello doctor, I am a 23 year old female. I have bloated sore breasts, 10 days late on the menstrual cycle, negative pregnancy test, appendectomy on the 20th.",
    "doctor_response": "Hello. Near menses or missed periods can give signs of bloated breasts, the fullness of abdomen, mood variations due to hormones. Have serum beta hCG (blood pregnancy test) to clear the status of pregnancy. If pregnancy test comes negative, you can have menstrual induction by hormones if you want. Some other factors also can delay periods like a strict diet, strenuous exercise, thyroid abnormalities, hormonal imbalance, illness, hormones or medicine intake, anemia, etc. Check these factors as well. If in the coming cycles also you observe irregularity without any reason, then you might need investigations. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for kidney stone\n\nHi my mom has had a surgery on her right kidney 30 years ago. she has had stone in her kidney. now she has pain in kidney and a little bit of skin swallows under her eyes. she has done ultrasound today and according to the report there is a fullness in right kidney as well as extra-renal. what does it mean?thank you in advance",
    "doctor_response": "HelloYour mother findings may suggests fullness of pelvi-calyceal system in right kidney.It is the dilatation of collecting system in right kidney.Extra renal pelvis generally doesn't require any treatment.Fullness of P-C system may be due to many causes like obstruction due to calculus,reflux,PUJ obstruction etc.It is most likely not related to calculus as it is not mentioned in the report.Other causes should be investigated and treat accordingly.She may need IVP(intra venous pyelography) etc.Treatment depend upon findings.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sebaceous cysts all over the scrotum?\n\ni have got sebeceous many cysts all over scrotum(small as hardly 1mm in size but large in numbers abt100-200). i have already undergone surgery for the same. yet new cysts are coming. which cream can i apply on scrotum dat will break cysts but wont harm skin & my sex ability as well?",
    "doctor_response": "Hi,Multiple sebaceous cysts over the scrotum is a rare condition but should be promptly treated if infected to avoid complications that can be harmful to your in the future. Best is to consult a surgeon who can examine you and confirm the diagnosis. Once confirmed, a carefully planned surgery must be done to remove the cysts and then probably reconstruct the scrotum using skin flap surgery. Applying cream may not always help and if ignored then you might end with a potentially life threatening condition which can lead to infections and gangrene of the scrotum. With latest surgical techniques complete treatment is possible.",
    "dialogue_context": ""
  },
  {
    "patient_message": "suggest treatment to save life of baby with three heart chambers\n\nHi. My neice is pregnant with a baby boy due in March. They recently found out that the baby only has three heart chambers and are sending her to Ohio for c-section Feb 5. I don't think she has health insurance, and I am concerned that she and the baby won't get the necessary care to save the baby. I am considering covering the necessary medical expenses, and am wondering what can be done to save this little childs life. Please advise.",
    "doctor_response": "It looks like what in medical terms known as complex cyanotic heart disease....this condition needs cardiac surgery for the child to stay alive... Don lose hope...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pink rashes on the face?\n\nhi doctor, my daughter who is 4months old has some pink rashes on her face. earlier it had come once but within days it had gone.but this time its almost 15days and its increased more.initially it looked like white patch surrounded by pink rash. one of the doc suggested imograf but i felt it increased the rashes.",
    "doctor_response": "Hi... I sympathize with the kid and understand your concern.  The trick of the management is keeping the skin moist and never allowing it to be dry. For this oil massage and lotions like Oilatum will help. Regarding cure options - eczema is a sort of allergy...allergies can only be controlled and can never be cured. But usually kids grow out of it...that is as the age progresses, they become better starting from 6 months.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What precautions should be taken for stones in gallbladder ?\n\nI had a sand size small mobile stone in ballgladder...plz sugest precautions",
    "doctor_response": "hello. Welcome to HCM, Small mobile stones in the gall bladder will probably not cause discomfort or pain, but requires removal of gall bladder. It is not urgent... you can get it removed according to your convenience of time and money. But unattended gall stones may complicate over the years to become symptomatic and then have other superadded problems. In the meantime, make sure to avoid all kinds of fatty and spicy foods. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain during a bowel movement while having a lump in vagina\n\nHi, I have had really painful bowl movements for the last 3 months sometimes I could feel the blood trickling out of my anus. It is horrendous I could scream it is so painful. Gradually it s gotten better. But now I have a lump between my vagina and my anus that s sore and itchy and keeping me up at night, any idea what it is?",
    "doctor_response": "hi.based from your description, it could be a hemorrhoid. it is best if you consult with a doctor, preferably a general surgeon, for physical and clinical evaluation, especially, if you have associated bleeding. high fiber diet is encouraged to help ease your bowel movement. diagnostics (such as proctoscopy) and management (medical and/or surgical if indications are found) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are fluctuating blood pressure levels a matter of concern?\n\nMy blood pressure can be slightly high in early morning, but if I work in the yard or the garden I get really tired and have to take rest breaks frequently.  When I come in the house I feel as if I am dragging.  My lowest reading was 87 over 41.  Even doing little things like washing dishing or sweeping the floor it will drop to around 115 over 65.  Is this something I should be concerned about?",
    "doctor_response": "Hi, If it is creating the doubt for blood pressure disease then it has to be checked with physician if you go on measuring with your own so it will go on fluctuating every time you read it and it is happening due to over consciousness. If you do not have any illness then it is advisable not to measure it like that only, if the blood pressure fluctuating in normal range so it may not cause in symptoms and it can not be low on its own. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Akhtar Husain",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sweating and shivering?\n\nI have been having serious sweating where the sweat rund off me but im then icy cold and shivering.my feet are usually cold .im on levythroxine 100 mcg and last test was normal now .I am very tired all the time fatigued no energy .yet I have trouble sleeping one reason the hot cold all night and day too what do you think it could be thankyou",
    "doctor_response": "this could be hypoglycemia or side effects of levothyroxine, you should maintain your diet properly, and decrease dose of levothyroxine. and share your reports and go for complete Thyroid profile.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if having episodes like crawling sensation all over body, numbness in arms, legs?\n\nI am having more and more frequent episodes of a creepy crawling tingling sensation all over my body.  Some of these episodes last a month at a time.  There is also a numbness feeling in my arms and legs.  These episodes are debilitating.  My family phycision will not even run a blood test on me.  I am looking for a new doctor.  Should I look for an internal med specialist.  I am really scared.",
    "doctor_response": "Hi, Welcome to Health care magic forum.                It appears that your symptoms are probably due to the fibromyalgia, or poly arthritis.                 I advise you to consult an orthopedic surgeon  for diagnosis and treatment.                I usually prescribe to my patient with such symptoms neurotropic injections for 10 consecutive days, and then periodically along with pain medication.                 Avoid taking potato, other tubers, tomato, egg, chicken, and sea foods till the pains are completely controlled.               Wishing for a quick and complete recovery. thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for nausea and abdominal pain after meals\n\nmy daughter has been nauseated after meals for about 5 weeks now, now my second daughter is having the same thing. they both have abdominal pain after meals as well. Their provider is thinking Giardia and has ordered flagyl do you think we are on track? they also both have elevated liver enzymes.",
    "doctor_response": "Hi...there are 2 possibilities here - 1. GER - gastroesophageal reflux -  this will get better with anti reflux medications and life style modifications.2. Worm infestations - needs anti worm medications.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What could this pea sized lump around my scrotum be?\n\nHello doctor, I have been kneed really hard in the groin 10 days ago while playing basketball. The pain is more of an ache that does not last long. There was immediate swelling in my scrotum around the veins and arteries above my left testicle and some minor discomfort but continued to play. I had minor discomfort the next few days while swelling went down. There has been no discoloration. I have been able to go to the bathroom fine. There is now a pea size lump around or in the veins or arteries that causes minor pain when pressure is applied. It is firm but soft at the same time. What could this be? Should I see a urologist?",
    "doctor_response": "Hello. You have had a blunt trauma to your scrotum almost a week back and since then have had a decrease in the swelling and no urinary complaints which are good signs. Was there ever any blood in the urine immediately after the incident? From your description, it appears that what you have is a scrotal hematoma which is resolving gradually. So you need to worry. All you would need is some scrotal elevation which will ease pain and swelling. But I would still advise you to visit your urologist to make sure the pain is just in the scrotum and not involved the testes, which is not possible without a clinical exam. For more information consult a urologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for small bump in gum\n\nI have a small bump on my gum, just above a tooth that previously had an abcess; this tooth has had a root canal. The lump is not painful, just irritating from rubbing against the inside of my mouth. I have an apt to see a dentist in about a month. What could this be?",
    "doctor_response": "Hello,I suspect an active infection from the same tooth. Common conditions include:-inadequate apical seal-additional untreated canal-fracture of rootI recommend taking an x-ray to evaluate the healing process. Antibiotic treatment may help the area to resolve. Amoxicilin is the typical antibiotic of choice. The history of the tooth and events concerning the need of the root canal would be helpful. A very resistant infection may require additional antibiotic treatment. Is this a recent root canal needing more time to heal? Did you take antibiotics and complete the medication as prescribed? You can have resistant infection that may be resolved with antibiotic treatment. The tooth would continued to be monitored at recall visits if it responded well and no other problems were diagnosed. What is the description of the bump? Is it filled with fluid and drains?I recommend rinsing the area with warm salt water and taking anti-inflammatory medications such as Tylenol or Motrin to help resolve the bump until you rturn to the dentist for further evaluation.You may consider an evaluation by a root canal specialist. Some secondary, non-resolving infections require a surgical root canal procedure called an apicoectomy. Thank you for your inquiry. I am available and glad to answer additional questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does TB spread?\n\nI took a neighbor to doctor and they said he failed his TB test, but they do not think it is active. I have to take hime to emergency room in another city. I want to know how can you catch Tubercolosis an I had MYRSA before in hospital. Can I get sick?",
    "doctor_response": "Dear Friend.Welcome to HCM. I am Dr Anshul Varshney. I understand your concern.Tuberculosis spreads by many ways.Most common method of spread of Pulmonary Tuberculosis is through air borne route.If an infected person coughs on you and you catch the infection, then you might develop Tuberculosis depending on the immunity of your body.This is my personal opinion for you based on available details. If you have any further query please ask me.Stay HealthyDr Anshul Varshney, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i take redbull only for today when on pulmison and folic acid for lupus?\n\nI cant find sleep...i woke up at 3 am and i have deadlines to meet but my body is aching....i was diagonised with lupus so i'm on medication of Pulmison 20mg (2 tablets per day, methotrixate( 6 tablets per week),folic acid( 1 tablet per day) and flucoric capsules( 1 tablet evrry monday,wed and friday),purbac ds 960mg( one tablet per day) and altosec 20( 1 tablet before meals).........can i take redbull just for today only. Thank u in advance...Berlinah",
    "doctor_response": "yes, you canbut remember there, too much redbull may be dangerousalso, your sleep is also important in lupustake careDr Alok",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for elevated TLC after DJ stenting\n\nsir My mom blood ureia count is above 100 and creatinine level is above for. They done pcn and dj stanting.after that my mothers both came done but tlc is increasing.....they giving all kind of medicine....i just wana know is there any other treatment is best and my mother is patient of ca carvix and what should i give to eat Please sir help me",
    "doctor_response": "HelloThanks for query.Your mother has cancer of Cervix with involvement of Ureteric Orifices and DJ stent have to be placed to deobstruct her kidneys.Her raised TLC is mostly due to UTI that she has due to obstructive uropathy.Please get her  routine urine test and urine culture done to find out the organisms causing this infection and antibiotics to which they are sensitive to.Please give her  broad spectrum antibiotics like Cefixime along with urinary antiseptic like Nitrofurantoin twice daily and urine alkaliser thrice daily.Later on switch on to appropriate antibiotics as per culture report. Please ensure she drinks more water.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair fall problem\n\nHello Doctor, i am 28 years old male. I have been suffering from hair fall problem for last few years. I had very dense and thick hairs, but now it has reduced drastically. I consulted a doctor and she advised me to use Mintop (5%) foam as I am suffering from male pattern baldness. Kindly suggest whether this line of treatment is ok or not..is it a long term solution to the problem or not?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Mintop 5% will help you but the results will take sometime to be seen. at least a years treatment with Mintop (minoxidil) is advisable. Combining that with PRP (platelet rejuvenation plasma) treatment is doubly beneficial. Here, the doctor takes the patients own blood, spins it in a small machine which separates plasma from RBCs and that plasma if then injected into the scalp area with very thin needles. Also, work on your nutrition level and start multivitamin supplements especially those which contain biotin. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hypertension\n\niI have a hypertension i like to know that is it possibly that i can passed on to my baby . cause he is sweating at nignt. but not the whole night especial when i put the blanket on him",
    "doctor_response": "Hi, Hypertension is passed to children if they have the same risk factors as obesity, sedentary lifestyle, diabetes, high cholesterol, smoking etc. Even in these cases, children of hypertensive may or may not be hypertensive. Otherwise, the child may develop high BP after 35 yrs age if he is to develop it. Sweating is no sign of high BP. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Varinder Joshi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can scheuermann's disease be the cause of back pain?\n\nI am 48yr old man, 21 years ago, fell off a roof.  Last year having a great deal of pain in mid back, mri stated that I have schuermann's Disease, Before my fall I was in construction, framing hotel's, and large building.  Very activity with my family.  Could I have diagnois wrong?",
    "doctor_response": "Your orthopedician should examine the back for preesure tender points, muscle sprain strain,restriction of spine movement etc.besides scheurmanns there is possibility of additional back strain due to any other cause.Take ibuprofen 600mg TID after meal and Chloraxazone 500mg BID after meals for 5 days alongwith pantop20 mg OD on emptystomach",
    "dialogue_context": ""
  },
  {
    "patient_message": "What caused severe chest and arm pain in a child?\n\na student of mine had severe right arm pain about 4 days ago and when he was in karate class he had severe chest pain and was winded and his right arm was in severe pain. He was taken to ER and they kept him in Children's hospital and ran all the test and said nothing was wrong, could this be true?",
    "doctor_response": "Hi...it could be a myalgia or a muscular pain. Moreover when you quote that he is involved martial arts, this carries all the more importance. The hospital would have been doubly sure before clarifying it as normal . So do not worry about it.Paracetamol can be given in the dose of 15mg/kg/dose (maximum ceiling dose of 500mg) every 4-6th hourly that too only if pain in intolerable. I suggest not using combination medicines for fever, especially with Paracetamol.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for muscle pain, bone pain and fatigue\n\nI have muscle aches, bone pain, fatigue and I sleep a lot. I cancel appointments, family and friends functions. I can no longer do house hold chores. This started years ago only a couple times in 2 months, now it has progressed to almost on a daily basis. What specialist should I consult with to help determine what is my problem. I am a 75 year old female. I really need help. Thank you.",
    "doctor_response": "hi,as you mentioned your age as 75, it seems to me more of an ageing factor. why don't you tryout some exercises which will help you built up some strength. make a note here that the exercise will help to improve the metabolism and the immune system as well. you should even focus on your proper and healthy diet as well. drink lot of fluids in a day and exercise regularly. your problem will be solved for 100% sure. I have dealt with many aged people and all does well with exercise and good diet.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can depression and social anxiety be treated?\n\nI am asking about my depression. I was diagnosed with it in the beginning of the year, and I am only a teen. I also took a screening yesterday about social anxiety, and the screening said that I have it. I am scared and I want to prevent this from happening. Help?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Please don't panic. Depression and social anxiety disorders are so common, a psychological problem. If you get alarmed, your worries will trigger the problems and you could feel more helpless. I suggest you keep your calm. Work with your psychiatrist or psychologist for medicines, relaxation therapy, and CBT. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will amantadine fight EBV in the nervous system.\n\nDear Dr. Sumit,My name is N,mn,mla (32 years old).I would be grateful if you could give me an advice.I have a chronic Epstein Barr condition: it causes me hypersomnia, tremors and other symptoms (I'm sorry for my English... I'm Italian).I was wondering if amantadine could fight EBV in the nervous system.Thanks.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.No amantidine is antiviral drug which is helpful in viral infection. But it will not useful in the symptoms caused by the nervous system disturbance.You can visit the neurologist for this symptoms arises because of neurological disturbance.I advice you to take the vitamin B complex treatment. As it can help you relieve some neurologic problems.Please take good sleep, and relieves your stress. As it can help reducing symptoms.Do not worry much regarding infection because much worry can also cause such a symptoms.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause hemolytic anemia and elevated WBC count?\n\nMy mother s wbc is high, bilirubin is high, hgb is 6.8 and falling despite 2 units of blood. Bun was fine but now elevated, Bun/creatinine ratio is now elevated. The hospital Dr dx her with hemoletic anemia. Said it is an autoimmune problem. They Don t know what is causing it. Can you tell me reasons why this could be happening. They have ruled our rx medications, travel, food, and environmental triggers.",
    "doctor_response": "Hello, The body needs red blood cells to survive. They carry haemoglobin, a complex protein that contains iron molecules. These molecules carry oxygen from the lungs to the rest of the body. Some diseases and conditions can result in a low level of red blood cells. There are many types of anaemia, and there is no single cause. It can sometimes be difficult to pinpoint the exact cause. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Esmeralda Sera, Oncologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in scaphoid after falling with outstretched hand?\n\nhi, i went to hospital on thursday fpr an xray as i fell with my hand out stretched, they took xrays and think its my scaphoid but arent sure so they put me in a splint for two weeks then referred me to a scaphoid clinic, it really really hurts... what sort of things will be checked in my scaphoid clinic? thank you",
    "doctor_response": "Hello, After having a fall on the outstretched hand, there will be direct hit over the scaphoid and it may have got misplaced from its original position. It will be suggested to use the splint as this will help the ligaments inflammation to reduce and possibility of scaphoid to get replaced in its position by normal physiological process will happen. After the removal of the splint simple hand exercises will help to regain the hand muscle strength and function. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Diagnosis and treatment of mental illnesses. Could you please answer a few questions?\n\nHello doctor, I am doing research regarding diagnosis and treatment of mental illnesses. Please answer a few questions of mine. What routine medical examinations apart from MMSE and history would you conduct? By this I mean standard routine blood investigations plus other investigations. What clinical signs would suggest performing MRI scan and would you order it with every patient? What clinical signs would suggest performing thyroid hormone tests? Would you do the thyroid hormone test with every patient admitted to the ward? Would it be a standard psychiatric procedure? What neurological and physical examinations would you conduct to rule out any other medical or neurological disorders? Schizophrenia is a dysfunction of brain\u2019s physiology; the functioning through neurotransmitters and through hormones but actually genetic problem is always there; means there is a dysfunction at cellular level. Which neurotransmitters and hormones would be responsible for this dysfunction? What kind of dysfunction of cellular level is that? What does an elevated level of homocysteine found in schizophrenic patients tell the psychiatrist?",
    "doctor_response": "Hi. I have read your queries and shall answer accordingly. Keep in mind that standard procedures for management may differ in different countries. Answers for your questions: All the best for your research. For further clarifications, consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on right clavicle\n\nHi, I am a 20 year old male , 6 foot 180 pounds, physically active, social smoker. About three months I noticed a bump on my right clavicle , approx 5 inches to the right of the throat area, and it is mobile in every direction, painless, and feels like hard rubber under my skin. It is above the bone and under the skin, not deep. I wanted to know if it is something to worry about?",
    "doctor_response": "Hi,It seems that you might be having enlarged supraclavicular lymph node.It indicates that you might be having some chronic infection in surrounding area.Consult your doctor and get examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can there be a recurrence of Meningioma? How can it be diagnosed earlier?\n\nSir,Greetings of the day to you. my mother, 70 years old was operated in November 2010 for meningioma affecting D8 and D9 in the spinal cord. Now, she has the following symptoms: Difficulty in walking straight and steady: tends to fall towards her right. so, she walks touching the wall to her right. Drags her right leg on the floor while walking. Feels heavy in the right lower leg and unable to move it as freely as left leg. But no numbness in general but only when  she gets up in the morning there's a little bit of insensitive feeling for sometime and becomes alright after massaging for sometime.Impossible to sit down and get up using her heels due to severe pain in the right knee cup and moderate pain in the left knee cup while folding the legs fully trying to sit down.No pain in the lower back while sitting on the chair or walking; but severe pain while bending forward at a particular level whereas no pain while bending forward completely.The ortho said that the pain the knees is due to initial stage of arthritis and has prescribed medications. And the pain in the lower back is due to the surgery done in the past and that can treated with some exercises after treating arthritis.Sir, I would like to know from your good self whether there is a chance of recurrence of meningioma. Is surgery the only cure? For, she has become bedridden for almost four months before the last surgery due to delay in diagnosis. And now, I would like to do the needful in time - before she becomes bedridden like last time. I will very grateful to you if you can guide in this regard at the earliest.",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your symptoms. Based on them, we need to exclude a recurrence of the tumor.Yes, meningioma in the spinal cord may recur in some cases.The diagnosis can be confirmed by doing a MRI of spinal cord.Surgery is required if the recurrent tumor is big, otherwise, in some cases, radiation therapy is also useful.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain in the lower back be treated?\n\nI feel as though I may have muscle strain in my lower back, but I really have not done anything to merit it. I also have two thumbprint size bruises that don t actually hurt themselves located on my back directly above the area that hurts. I am constantly exhausted and sleep does not help. What can be the cause?",
    "doctor_response": "tab mahayogaraj gugglu 2bd cap baladi vati 2bd  it will cure your symptoms along with increase your strength and energy",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever and body pain?\n\nHi my daughter is 5 and she caught fever complaining of whole body aching. I gave her calpol 5ml however there was no relief except that she got rid of laziness/ non act ice to active state. Then i gave her bacigyl n 5ml and her fever was gone. I repeated the bacigyl and calpol dose in 8 hours. Any suggestion?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query your daughter have symptoms of fever and body pain. The symptoms you mention in query are pointing toward a condition like viral infection which is due to poor immunity of body , which is making child susceptible to infections . Well this goes away in few days by its own. But if it is getting worse then consult pediatrician for proper checkup. Doctor may order blood test , viral culture test and throat swab test to confirm the diagnosis and rule out causes like scarlet fever or strep throat as you mention in query. Doctor may prescribe anti viral drug , decongestants and mucolytic agent. For now do tepid sponging and take diet rich in liquids. Avoid outside food intake.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does elevated ST in EKG indicate?\n\nMy 16 year old son has been feeling lightheaded when he stands up, so I took him to the doctor.  They took blood pressure laying, sitting and standing; standing is higher pressure, lower pulse.  He isn't running a fever and has experienced no chest pains.  He had an EKG yesterday and it showed an elevated ST.  What does that mean?  I tried to write down what the doctor was saying, but I couldn't keep up!",
    "doctor_response": "hi,ST segment elevation happens in many conditions like Early repolarization common in young individuals or pathological conditions like pericarditis, myocardial injury etc.your physician will Correlate  Clinically and advice further investigation if required.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does migraine and vertigo after hurting the spinal cord indicate ?\n\nMigraine for 5 days now my spinal cord has hurt i have had a migraine for 5 days now my spinal cord has hurt for 3 now i am having periods of Vertigo . i am 19",
    "doctor_response": "Hi, Thanks for query, Headache you are suffering may not be migraine but there may be some infection or impacted wax in the ears. This may be the reason you ate having headache and vertigo. It is also possible that you might acute frontal sinusitis. Consult your doctor and seek advice. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain, drank too much of wine, swallowed almonds accidently. Ulcer or struck almond?\n\ni accidentally swallowed a whole almond one week ago......2 days later I attended a party and drank too much wine.....since that time I've had a stomach ache.....right in the pit of my stomach......could it be the almond stuck or a developing ulcer from too much wine......now I alternate between constipation and the other.....should I be alarmed......I normally drink once glass of wine every evening but have stopped since the stomach ache.",
    "doctor_response": "HYPRACIDITY AND GERD CAUSING THESE AS TOO MUCH INE CAN CAUSE THISTHE ACID PRODUCED IN STOMACH DUE TO HIGH AMOUNTS OF WINE NUTS OILS GREESE IN FOOD COME UP BACK IN THRAT BEHAVING LIKE THIS YOU WROTETAKE METROGYL 200 MG BD FOR 5 DAYSSYP GELUSIL 2 TSF TDS FOR 2 WKLOT OF WARM WATER TO COUNTER AIDITY AND REFLUXNO OILY GREESY SPICY FOOD FOR 2 WKAPLY KENACORT IN MOUTH",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes coughing up blood and black spot vision?\n\nIt's not me who is experiencing any symptoms, it's a friend of mine. She tells me she's coughing up blood, hearing a ringing noise in her ears, and seeing black spots in her vision. I looked it up on Google, and I'm getting results for Brain Cancer or lung cancer.",
    "doctor_response": "These symptoms are surely alarming.She needs immediate medical attention. A complete clinical exam, chest radiograph and an MRI scan of brain alongwith routine laboratory investigations should be done.Please see a doctor and discuss it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Difficulty in breathing during night time.Treatment?\n\nHi, I'm a 24 year Girl.... I feel choked at night and not able to sleep.. I keep coughing the whole night. One doctor asked me to go for endoscopy as he predicted That I could have thick Mucus problem.. but the test came clean and he said its all in my mind... :(But every time during this period of year when the weather changes to cold, I face the similar problem... Please help me as I've my exams next week...",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. In my opinion, we should definitely rule out seasonal bronchitis in your case because you are having symptoms every year in cold weather. Bronchitis is inflammation of airways and this in turn causes bronchospasm and chest tightness, Breathing difficulty etc.So consult pulmonologist and get done PFT (Pulmonary Function Test).If PFT is showing obstructive defect then you will need inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).Don't worry, you will be alright with all these. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cervical cancer\n\nI am 46 years old and have been diagnosed with cervical cancer. I have had a polyp and a cone biopsy done within the past 3 weeks. I have been having a foul smelling discharge from my vagina and am wondering if there is something I can do while I wait for the scans and radiation to begin to help with the smell.",
    "doctor_response": "The smelly dicharge can be to due the disease it self but sometimes a superimpsoed infection may be present. In such cases a course of antibiotics can help along with vaginal douching.Ciplox TZ tab 2 times a day",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in lower right abdomen radiating to right leg?\n\n(To begin, I m under 18, and female, also it isn t my time of month, so the pain isn t caused by that, just in case that comes up.) Earlier tonight, about an hour and a half ago, I was having severe pain that came and went in my lower right abdominals, with accompanying pain in my right leg. I had/have no fever that I can tell, but I had felt like a bowel movement would fix it, and I was shivering, despite it being summer, and not being cold. Since then the pain in my abdominal has mostly gone away, with only a bit moving to my belly button and then to my left side, and my leg did feel like it was numb after the pain, but that went away as well, a little bit after the abdominal pain. (I have had an umbilicoplasty for my outie belly button, I ve since been told it was for a medical reason, not just plastic surgery, and I don t know if that makes a difference in what the pain could be/could have been.) So since then I ve really felt no pain, in either my stomach or my leg, but I became worried, since the pain is similar almost to period cramps, but really was nothing like I ve felt before.",
    "doctor_response": "hi thank you asking HCM. your symptoms are indicative of appendicitis ( acute or chronic.) so please go to your physician adn perform exams like  abdominal ultrasound and blood work. Wishing you all the best. Dr.Klerida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the long term side effects of removing testicular torsion?\n\nMy one year son have testical torsion and removed left testical and stitch the right testies . I am worried for his future he is only one year old is his pubirity come normal ? Does he live normal life ?Does he have children in future ?please help and reply does he have normal testestron ?",
    "doctor_response": "Hello. I just read through your question.With one testicle, your sin will have a normal life. He will go through puberty normally and will be to reproduce and have a normal sex life.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Oxycodone Hydrochloride as effective as Oxycontin CR for backache?\n\nMy pain Dr has prescribed OxyContin CR 10 MG twice daily for me for my back problems. I have been using it at this for over 10 years and at the same strength. Since I am also Retired Military with 60% disability, I can get all medication through the VA at NO COST. The prescription they gave me is OXYCODONE HCL 10 MG SA taken twice daily. How close in strength are these 2 medicines? My pain Dr also prescribed OXYCODONE/APAP 5-325 MG every 4 to 6 hours for break-through pain. How does the break-through pain medicine compare in strength with the other 2?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Oxycodone has a better effect. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain with hard breathing?\n\nHi,I'm a 16 year old girl and I have pain in chest, hard to breathe and sometimes hard to swallow. I also get a weakness in my legs that  I can't walk and I try and hurry to sit down because it feels as I would fall down, can you please help with what's wrong?",
    "doctor_response": "Hi thanks for contacting HCM...Here you have chest pain , dyspnea and dizziness like symptom on walking ....So cardiac causes seems most likely here although you are young ...Investigate with ......1.Blood pressure measurement 2.ECG 3.ECHO 4.If needed chest x ray done ... If your calf swollen and embolism suspected d dimer estimation done for it .....Here cough , fever etc not present so respi causes seems less likely ...But if cardiac causes not present than they are ruled out by chest x ray, spirometry etc ...Avoid stress as it would aggravate condition...Take care .....Consult physician for this.....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Kidney infection, pain in kidney, swollen stomach, taken antibiotics\n\nHi,i have finished antibiotics for a kidney infection,2 days ago.I feel better but still have some pain around the kidney area and my stomach has swollen up again.Should i just hope that everything will settle down in time or should i go back to see my GP.I have had kidney surgery in the past and still suffer from kidney infections quite often,thankyou very much.",
    "doctor_response": "I think you have been suferring from recurrent UTI. I would like to know your age and gender. I suggest followings: 1. Do a ultasound of abdomen with post voidel residual urine. 2. Do urine culture and sensitivity, check your Fasting and posprandial blood suger and serum creatinine. You may requre a prolong course of antibiotics as per culture sensitivity reports.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tooth abscess\n\ni thought this was about ayurvedic medicine helping a tooth abscess.  Can I treat my tooth abscess with ayurvedic medicine to get rid of the infection instead of antibiotics.  If not, then what kind of antibiotic is the least harmful to the gut flora YYYY@YYYY",
    "doctor_response": "Hello,you need to treat the source of the infection. When the source of the infection or abscess is a tooth, it can be treated with a root canal or removal. If the tooth has a gum infection or bone loss causing a periodontal abscess, it can be evaluated by a dentist for possible periodontal treatment or removal. Antibiotics are used to control the spread of the active infection, not a cure for a tooth abscess. You can use Antiinflammatory reducing means to help decrease symptoms, but you can not ignore the source. I prescribe the antibiotic amoxicillin as my first choice. Taking Acidopholus or probiotics help reduce gastric disturbances. Yogurt can be beneficial as well. Not all tooth abscesses require taking an antibiotic. Inquire if your abscess needs antibiotic or can be treated in a timely manner without the need of antibiotics.Thank you for your inquiry. I hope that you can complete treatment with your dentist soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a cramping sharp pain in the abdomen?\n\nI have been having horrible cramping sharp pains in my abdomen . I can t even stand up straight . I ve had this pain for two days now . Monday I came home and ate a bunch of junk food . Right after that I took a nap . When I woke up the pain started and has been nonstop . What does this mean ? Is it serious?",
    "doctor_response": "This is serious.The starting and character of the pain is suggestive of Peritonitis.The probable causes are as follows::Primary peritonitisPerforation of the gastric ulcerPerforation of the small intestine because of Typhoid ot Tuberculosis.Perforated appendicitis. *If the patient is female- Torsion of the Ovarian Cyst, Rupture of the ovarian follicle, Tubal Pregnancy, TO Mass.You need ::X-ray of the abdomen in the standing position for gas under diaphragm UltrasonographyRoutine tests of blood, urine, sugar as as per past history.You Need:Admission in the HospitalIntravenous fluids to replenish the third space loss, electrolyte balance, antibiotics and supportive treatment and consent for Surgery if required.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the red patch of extremely dry and numb skin below my knee?\n\nI am a caucasion 26 year old male.Recently, I have discovered a reddish patch of extremely dry, and very numb skin about 3 inches below my knee. Leading up to my knee from there is skin that is considerably drier than normal, and somewhat numb.What does this mean?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern and looking to the history given here I could say that this could be eczematous lesion and this can be treated with steroid containing cream, and the best option would be \"Mometasone cream\" try this and if the symptom does not improved then you need to see the dermatologist, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pains in upper back?\n\nMy upper back has recently started to have sharp pains whenever I try to sit up straight or do certain movements. It's only on my right side but between my shoulder blade and spine. It's gone on for a day and a half and I havent had any increase in stress. Any help would be greatly appreciated.Thanks,Sydney",
    "doctor_response": "Hi,This could simply be a traumatic problem or an inflammation. It might necessary to note the conditions under which such pains started. Depending on the intensity, simple X rays and measuring the erythrocyte sedimentation rate, ESR, could be necessary to make an appropriate diagnosis, orient further testing and give treatment. Kind regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "When should medicines for osteoporosis be stopped before tooth extraction?\n\nI am a 67 year old woman - I saw my dentist last week with a wisdom tooth that may need extraction.  During our conversation about my current health and meds I told my dentist I had been diagnosed with osteoporosis.  He cautioned me that I should not take certain osteoporosis drugs because of the possibility of severe jaw and dental problems.  I am confused what I should do.  I researched taking Reclast because of the once a year convenience.  I must have the wisdom teeth out should I wait a several months or even longer before taking any osteoporosis meds?",
    "doctor_response": "Hi, Welcome to Healthcaremagic.com.  I had gone through your question I can understand your. Reclast is a bisphosphinate group of drugs called zaldoranic acid. A combination of old age (above 50) and the Reclast drug can lead a disease called Bisphosphinate associated necrosis of Jaw. Which is highly bone infectious disease and can be fetal too. Actually this drug decreases blood flow to the jaw bones, so if any trauma happens to the bone it will not heal easily. If wound will remain there, as in your case tooth socket and will not heal. It is vulnerable to infection and necrosis of bone. Therefore, can be dangerous. So it is recommended that you must stop or complete your treatment of osteoporosis first then go for extraction. Hope you will understand my opinion also provide your feed back and write to us if you need further clarification. Regards Dr Muzaffar",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to avoid pregnancy after having unprotected sex?\n\nhello! i have had unprotected sex with my boyfriend on the last day of my ovulation(most fertile). we used the \"pull out\" method the 1st 2 times and the third time he ejaculation in me.  i this has also been the 1st time out of the month that we have had intercourse. Im not due to get my period until the 1st of January, any recommendations? thank you!",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Do the urine pregnancy test. If you get double lines it is positive. After the day of your missed period as he has ejaculated inside so you may get pregnant.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sheetal Agarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower abdominal pain after hip replacement surgery\n\nHi am 32 yr old male ..recently i have been diagnosed with UTI and few days later i got my Hip replacement surgery done.Now,am having an unbearable pain in my lower abdomin pain in left side..Am not able to stand either..can u please help me understand what is the problem?",
    "doctor_response": "Hi. THe unbearable pain in in left lower abdomen after surgery of hip replacement with prior UTI is indicative of an infection in the operated site. It is possible that you had an active focus of infection which was not under control in spite of an antibiotic cover. I would suggest you to undergo MRI of the operated hip joint along the abdomen to see for the possibility as explained. Also advisable is blood culture and sensitivity, urine culture and sensitivity to get the sensitivity report so that proper antibiotics can be started.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Been stressed, swollen stomach, hands and thighs, uptight feeling, ruled out heart issues. On prozac. Need more rest?\n\nI have a very swollen stomach hands and tighs, feel very uptight. just off 1 x 20mg Prozac a day. Just out of a very stressfull business time nad have a family problem. 3 wks ago was taken to hospital by ambulance, doc though it was heart but that checked out ok, all blood tests ok . sleeping up to 8 hrs at night  yet need to rest most days after lunch,am quiet fit active weight normal age 57",
    "doctor_response": "In my opinion, prozac need to be taken for a longer period. I do not know how long did you take prozacAdditionally, some kind of family therapy / problem solving strategy, which will address the family issues and business issues, need to be added for complete recovery. Or else, alone prozac wo not be sufficient. For this you need to be in touch with a psychotherapist / psychiatristThe symptoms that you are mentioning are quite understandable in the context of stress",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with Moderately Differentiated Squamous Cell Carcinoma. Radiology treatment in oldage?\n\nHello Doctor. My granny has been diagnosed with Moderately Differentiated Squamous Cell Carcinoma Grade 2 , Site: Esopghagus located in middle 1/3rd. She is 85 years old. The doctor has prescribed Radiology treatment. But my worry is the age of the patient. I don t know whether she can go through the Radiology treatment. I wanted to know more about the treatment for this type of cancer . Please do correspond at the earliest.",
    "doctor_response": "Hello Abhiram.ks10, Thank you for posting your query through Healthcare magic.I can understand your concern for your granny. Radiation is the method of treatment of choice for this type of cancers by the conventional medicine. You can ask for the outcome what the doctors expect out of the treatment and the percentage of chances for her to get cured and survive. I am a Homoeopath and so I will be advising you in a different way and it is for you to take the judicious decision about it. According to me your granny must have undergone a shocking psychological conflict at this age almost prior to the development of the stricture of the oesophagus. On examination of the throat for difficulty in swallowing it was found out that oesophagus is having this deformity.   It is said that she had an experience of something that she could not 'swallow'. Now you may go back to her life situations and find out whether she had anything that she could not 'swallow.' Get to know what she felt- whether rejection, indignation, grief, rage, depression etc.- towards this incident. This will tell her genetics. The cause of any cancer is in the mind and is mediated through the brain. Which tissue is to be affected and what should be the type of affection- all these are determined by the 'mind- brain - organ' axis. Give her Homoeopathic constitutional treatment for giving maximum possible longevity of relatively healthful days ahead. Abstain from radiation or any other unnatural surgical procedures.If you so desire, I can help her by taking her case in detail and prescribe for her, her genetic constitutional curative remedy. Give counselling to her in the fashion I explained her disease above and request her to have positive attitudes to the incident and to her present disease condition.With Best Wishes,Dr C. J. Varghese, Homoeopath, drcjvarghese@gmail.com,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for blurred vision and heart palpitations\n\nI ve had off and on blurry vision. On and off hign pulse. But today I have a headache. Stomach is tight and burning. Blurry vision. And overall feel icky. I have lupus so I discount a lot of odd symptoms. But today I m really alarmed. What could it be? Do I call regular dr. Cardiologist or optimologist?",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!Regarding your concern, I would explain that your symptoms could be related to inflammation. I recommend you to closely monitor your blood pressure and heart rate. It is important performing some tests to determine the cause of your symptoms: - lab blood tests (complete blood count, thyroid hormone levels, PCR, sedimentation rate, blood glucose)- a resting ECG and cardiac ultrasound to examine your cardiac structure and function-  a brain MRI. The blurring vision and headache could be related to possible intracranial complications of lupus. That is why a brain MRI is necessary. Hope you will find this answer helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for birth defects in child\n\nMy son was born 6 weeks early, now is 13 weeks old. He has an upper lip tie , a posterior tongue tie, a high palate, a pretty recessed chin, hypospadias, and a shallow sacral dimple. Several people have suggested that I need to look into mthfr and midline defects. Is there something more that I need to worry about with this mthfr stuff?Also at what age and in what kind of practice should we seek treatment for his recessed chin?Thanks!",
    "doctor_response": "For all the problems described a pediatric surgeon shall be consulted immediately. Further investigations will be required to find other anomalies. Depending on the development of child the pediatric surgeon will be able to decide when to go for surgeries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to control your anger n depression ?\n\nHi, may I answer your health queries right now ?  Please type your query here... hello .. this is rhythm here .. well i wanted to ask a question that sometimes we come across such situations in which we feel so depressed n we are totally out of control can do anything daring .. n that happens when our trust worthies don't support us or don't trust us anymore .. :( and even our parents dont support us we might have a quarrel with them only .. so what do we need to do .. n how do we need to control our anger ..  ?? n how can i find out a reason to that problem ..??",
    "doctor_response": "Hello and welcome to health care magic ,take advice from  a psychiatrist usually in these cases we advice to take antidepressant drugs with consultation  from a psychiatrist who can give you speech therapy as well,take tab alprax as it is an anti-anxiety drug when these about to happen ,take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes muscle stiffness after open inguinal hernia surgery?\n\nI had surgery for an open inguinal hernia 4 weeks ago. Since that surgery I have extreme muscle stiffness and lots and lots of pain in my thighs, knees, groin (of course I suppose), upper arms and shoulders. I WAS in good physical shape. I exercise by walking at the gym and used to do weight training. I describe it as feeling like I m turning into petrified wood. I am not running a fever. My primary care doctor ran blood tests of different sorts. They all came back normal. Yesterday I went for a medical massage therapist. This morning I couldn t even get out of bed I was in so much pain. I have type II diabetes and because I have had bad reactions to Crestor and Lipitor for high cholesterol - muscle stiffness and cramping - my Primary put me on simvastatin but has taken me off that for now (about a week ago). We believe that I am having an allergic reaction to the Succinylcholine that was administered during my surgery. I didn t know it at the time, but now I believe that my mother who passed away 9 years ago had this reaction after knee surgery when she was exactly my age - 62. I have a call into a neuromuscular neurologist but their office is closed today. It was suggested to me by the massage therapist to discontinue massage. She also was wondering if maybe I should have a muscle biopsy. I of course think I m headed to a wheelchair - and in my lifestyle, that is NOT an option. Some comforting words of advice before the weekend starts would be gratefully appreciated.",
    "doctor_response": "Hi, I am Dr.Bruno.  I have read your question with care and understand your concerns. Let me try to help you Question : What causes muscle stiffness after open inguinal hernia surgery?Answer : The Most Common Cause of Muscle Stiffness after Open Inguinal Hernia Surgery is Prolonged Bed Rest Question : She also was wondering if maybe I should have a muscle biopsy.Answer : I would suggest you to please wait, and get back to your routine and do simple exercises. It is a high Probability that you would be normal  // I of course think I m headed to a wheelchair // Dear Sir, I do not think So Please wait for a few more daysStart walking a bit and do simple stretching exercises and you must be fine Even if you have problems with Succinyl Choline, they are quite easy to manage Hope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On chemotherapy. Taking Gemceitabin and cisplatin. Also having fever. Worried? Medical cure for this?\n\nmy father is on chemotherapy. Gemceitabin and cisplatin. After ist dose of chemo with the above mentioned drugs. he is having fever since 15 days. Given PULMOCEF tab for 1-5- days. No Relief, THEN Bioper T z injections thrice a day for 5 days. Aslo added amikacin for three days. No relief still 101 fever. Also done AEROBIC AND Anaerobic blood culture. NO AEROBIC PYOGENIC ORGANISM IS FOUND AFTER 48 HRS. INCUBATION. Anaerobic report is pending. From lasT one day he is on NEUROPENAM iNJECTION THRICE DAILY. sTILL FEVER IS THERE.. Kindly Suggest what to do??????????????? We are in pain........",
    "doctor_response": "Hello; Fever in cancer patients taking chemotherapy is not uncommon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do when missed one dose of keppra and depakote ?\n\nMy 27 yr old son was diagnosed with seizures in Dec 2009, but has not had a seizure since May 2010. He takes Keppra 500mg 2 in morning (12 noon) and 3 @ night (12 midnight) and Depakote 500mg 2 in morning and 1 @ night.  He missed his nightime dose yesterday and morning dose today.  At 8:30 tonight he took his morning dose of 2 500mg Keppra and 2 500mg Depakote.  Should he try to get in another dose or just take his doseage as ususal tomorrow starting @ noon?",
    "doctor_response": "HelloNo, he need not worry because these are longer acting preparations and serum level is not going to crash so what he has done is enough.DR SAATIISH JHUNTRRAA",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a blood pressure of 112/68 indicate?\n\nHusband just recently had pneumonia and was in the hospital for 5 day he is now home and hasnt smoked in 15 days yah, his blood pressure is crazy he is on medication and he just took it and its 112 ove 68 is this good or bad, I worry that its to low he say he feels fine, he was taking predisone and antibodicts for his pneumonia and copd, could he be getting sick again ?",
    "doctor_response": "Hi, His blood pressure level with the medication is at a controlled level, and it is important that he'd continue taking the medication to prevent blood pressure elevations, which is not good in the long run. And also considering that he is taking steroids, which are known to have side effects of blood pressure elevations. As to having  COPD, it puts him at higher risk of having recurrent exacerbations, as well as pneumonia, and I would suggest a pneumococcal and flu vaccine which is available with your doctor, to decrease the risk of COPD exacerbations. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Daryl Derick B. Dizon, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do my blood sugar and creatinine levels indicate?\n\nMy mother is 65 yes old.her creatinine in blood is1.42 mg/dl tested on 9th September-2015..blood sugar PP-107.0 mg/dl and fasting 82.0mg/dl ..what is the problem and how it is recovery..my mother is also an ostio arthritis patient..Which department doctor may I consult...",
    "doctor_response": "Thank you for contacting HCM. your mother's blood sugars are excellent. fasting sugars should be less than 100 and post Prondial less than 200 and she is having good sugar control accruing to the information you have provided to us. does your mother have diabetes ? if these tests are done for screening and I do not think she has diabetes. her sugars are excellent as mentioned above, they are falling within the limits. your mother's creatinine is elevated little bit. is this the first time she had these tests done or do have a prior reading. some times we see a condition called chronic kidney disease (CKD) where persons creatinine tends up even with the age. high blood pressures and diabetes certainly worsens the creatinine and thus CKD more quickly. Please reply us back. take care of her.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes my sperm to clump up?\n\nwhat causes my sperm to clump up. it doesn t look any different than normal besides it comes out thick and clumpier than it use too. could this mean i m not as fertile?",
    "doctor_response": "hi.. Welcome to HealthcareMagic forum.. this is normal, it is not anything abnormal.. dont worry u are fertile... thanks,, drbhagwanjindal@gmail.com.. all the best for good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my mother telling absurd stories even after taking shicalm plus for acute mental disorder?\n\nHello doctor, im from burdwan,Westbengal.Im worried about my mother.she is expressing something  with which we can not find any  link.my mother was a patient of acute mental disorder.she had been suffering since 1994. Our grandparents admitted her in a asylum in 1995.after a year treatmnt she got well.since then she was allright.But now all the past symtoms are coming back.a doctor prescribed shicalm plus 5 and my mother is taking it from two weeks.but still now she is telling those absurd  stories.doctor does the medicine allright for her?or should i consult another one?",
    "doctor_response": "HiThanks for using healthcare magicShicalm consists of Trifluoperazine andTrihexyphenidyl hydrochloride. Trifluoperazine is a typical antipsychotic and help in controlling psychotic symptoms. Antipsychotics take two weeks to show response ans right now she is at basic dose. In that case, just wait for few more days for the response. With time by escalation of dose, she would definitely improve. There is no need to change drug or doctor. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there a hole connecting tooth socket to nasal cavity?\n\nHello doctor, I had a molar removed two years ago in the upper right area. Since then the hole has never healed. It goes right up into the nasal cavity. Air passes right through my mouth into the nose. Several sinus infections are there.",
    "doctor_response": "Hi. I got your chief complaint and I have arrived at a conclusion that it is a case of oro-antral fistula which had been caused by traumatic extraction of molar tooth particularly upper molars. Due to either over instrumentation by a dentist. The symptoms of this problem are difficulty in eating food and air passing through the nose. This condition leads to sinusitis which frequently gets infected.  The treatment strategy includes askingyour nearby oral and maxillofacial surgeon to close the defect. It can need a minor surgical procedure. The dentist should have noticed this early and corrected but it seems an error on his part. Though I diagnosed your problem with your history, it would be better if you can tell me precisely which tooth is this or you can send an attachment photograph of the area. Moreover, if you have any radiograph do send me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I having irritation in my penis head?\n\nHello doctor,From the past two days, I am feeling some kind of irritation in my penis head. At a normal time, I felt like something is stuck inside the penis. During urination also I felt itchiness. I observed penis but did not found anything wrong in the tip but saw some small white pimple like swellings in the lower area of the head of the penis. So, I started using hot water to wash but no change. Today I can see the tip of the penis is swollen and a white color coating on the tip. Also same irritation and a foul smell is their. What may be the cause of this disease. What precaution and medicine should I take?",
    "doctor_response": "Hello. Proper hygiene to be taken by both if you are married. Soap and water, Savlon and water. It seems fungal infection (attachment removed to protect patient identity). Fluconazole 150 one per day for five days, capsule Doxycycline 100 once for seven days, tablet Montelukast one at night for itching for three to five days or as required. Locally apply Betnovate N and T-bact OIN (Mupirocin) two times in equal quantity. You can consult a skin and venereal disease specialist. For more information consult an HIV AIDS specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Hodgkin's lymphoma\n\nMy brother has been diagnosed with lymphoma/Hodgkinsons - and he did have glandular fever almost 4 years ago. He saw his GP twice about a lump at the back of his neck almost 6 months ago and they didn't do a bipopsy just a blood test and gave him medication for an ear disorder.  He is only 25 and awaiting a full diagnosis of the stage and type of cancer he has but we're trying to move him to Royal Marsden which is near our home as he is alone in Scotland and family need to be with him- but the hospital is not supporting us and now he is still not had a complete prognosis or any kind of treatment.  What are his survival chances and how can we move him urgently and start the treatment?  Anything will be very helpful tight now",
    "doctor_response": "hello....for hodgekin's lymphoma prognosis is good..he will respond well to chemotherapy(cancer drug regime) and its fully curable. however first the diagnosis should be confirmed early. to start with you should get a FNA done (fine needle aspiration cytology). if it is suggestive of HL,then you need to undergo excisional biopsy of the lymph node. if this turns out positive, immediately take him to cancer institute where chemotherapy can be started. he will also have to undergo USG ABDOMEN LOOK FOR axillary and inguinal lymphnode enlargement to assess the extent of disease.dont worry... it has good prognosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "When can spinal Harrington rods be removed?\n\nSpinal fusion the the T12-L4 levels with bilateral pedicle screws posterior to the T12, L2, L4 segments and bilateral spinal harrington rods. the rods terminate posterior to the L4 level. There is slight straightening of the lumbar lordosis without acute compression fracture or subluxation. Only the L4-S1 discs visualized demonstrating mild annular disc bulging with degenerative vacuum disk phenomena at the L4-L5 level with bilateral foraminal stenosis. Mild left foraminal stenosis at L5-S1 level due to broad-based disc bulging. Sagittal and coronal reformatted images demonstrate levorotoscoliosis with the apex at the L2 level.My question is, can I get the rods removed??",
    "doctor_response": "This mostly of cervical spine sdisorder associated with nerve compression. First some inbestigations like x ray and CT cervical spine should be done. You should start vit. B12 injection once every  3 days and topical and oral non steroidal antiinflammatory drugs 3 times daily for one week.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Would a tear of spleen of about 18cm to grow big cause liver cancer?\n\nhello there, i am a person having hepatites b, and recently my spleen stear to grow bigger till 18cm.i have done endoscoy whic result was like this(Gastro-oesophageal varices, consider propranolol for primary prophylaxis) can you please explain this and can you tell me is there any risk of liver cancer in me. you can tell me, i am strong boy.",
    "doctor_response": "Hi. You have CLD (chronic liver disease) secondary to hepatitis B resulting in liver damage and cirrhosis ( shrinking ) of liver. The dilated gastroesophageal varices are dilated blood vessels under the inner lining (mucosa) at the junction of esophagus (food pipe ) with stomach. Theses varices form due to high pressure in portal circulation due to shrinking of liver. Portal circulation is the blood vessel system responsible for bringing blood from intestines to liver. High pressure in portal circulation also results in splenomegaly (enlargement of spleen due to back pressure).Propranol is given as a prophylaxis to prevent bleeding from gastro-esophageal varices by lowering pressure in splanchnic circulation (vessels supplying & draining blood from gut).Yes liver cirrhosis puts you at high risk for liver cancer. It takes years to develop. I would suggest that you have your ultrasound scan of liver on 6 monthly basis to pick any malignant nodule at an early stage.I hope I have answered your query. Please ask if any ambiguity remains & I will be more than happy to answer. Thankyou for choosing Healthcare Magic for your medical issues.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring eye discharge, fever and cough in an infant?\n\nmy daughter is a year and two months old, she frequently has eyes discharge, fever and cough. we tested her for white blood cells count and results came back with 20000wbc she was treated with Rocephine injection for 5days then Augumentin was given last month. she still has d above symptoms. what do i do?",
    "doctor_response": "Is there any history of allergy in the family it could be hay fever eyes could be allergic conjuction is cough may be asthma the initial high we count is due yo secondary bacterial infection on existing allergic conjuction is the child need anti allergic drops like ketotifen and bronchoscope tor for cough",
    "dialogue_context": ""
  },
  {
    "patient_message": "Took gynera pills, had spots after every intercourse. Side effect? When to start pills again?\n\nI take gynera pills for the first time and tomorrow is my last tablet to take. I was just wondering cause every intercourse we had i have some spot was that the side effect of the pill? And when will I start to take another pill again? Was it after 7 days after my last pill even if my menstruation didn't arrive yet by that time? That was my OB told me. Thanks Doc. Best Regards:)",
    "doctor_response": "HiThanks for your query.Spotting is a common side effect of the birth control pills.Please switchover to another preparation for adjusting the dose if this is very troublesome.Yes , you should take the pill as advised on schedule, even if you do not get your periods.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having heart murmur, panic attack. Occurs while smoking. Solution?\n\nI have a heart murmur & last week I was smoking & I started having a panic attack & passed out I thought I was alright but this Wednesday the same thing happen I started having a panic & called 911, at the hospital they just said I was dehydrated . So I havent been smoking because I have been scared too but yesterday I was just around the smoke & my heart started beating really fast, I am very worried I have a nervous feeling everyday My Question Is What Should I Do ?",
    "doctor_response": "Hello....... Thanks for your query. It is possible that you are suffering from panic attacks. It requires anti-anxiety medication and psychotherapy interventions like cognitive behavioural therapy are useful in such cases. However, you would need to rule out cardiac problems with ECG and thyroid disorders before psychiatric evaluation.  Smoking is not advisable in patents with panic disorder. Hope you found the information useful. Regards Dr Sundar Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do I have gall bladder issues?\n\nI have been diagnosed with acid reflux due to hiatal hernia. Recently I have had discomfort in the upper right abdomen and across the middle of my back. Also reflux has flared up again. Taking Omeprazole 20mg for the reflux. Do I have gall bladder issues also?",
    "doctor_response": "hi.noted history of right upper abdomen pain. yes, it is possible that it may be caused by a gallbladder/liver/biliary tree pathology. other things that must be ruled-out are pulmonary and muscular problems. it is best if you consult with a doctor for physical examination and clinical evaluation. diagnostics (such as ultrasound, alkaline phosphatase, liver function tests) and management (medical and/or surgical if indications are found) will be directed accordingly. if it is indeed a gallbladder stone, a low fat diet is also recommended.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why are my fingertips itching and hurting?\n\nHello doc from last 5 days i am having itching in my fingertips and after itching its start to pain for a while than it transfers into another finger or hand or some time in foots after itching that pain feels when i press my finger however there are no redness dryness or anything so i can conclude kindly put some light",
    "doctor_response": "Hello, The pain and itching in the fingertips can be related to arthritis. This can be associated with swelling of the knuckles. Any fungal infection in the area also needs to be ruled out after proper examination. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive.  Have regular periods. Have sex regularly. Food, any medicine that can ensure medicine?\n\nGood Day Doctor, my husband and i have been trying for a baby for the past 4 years, and nothing has happened. I would like to know of any medicines or any foods or activities that can ensure pregnancy. W both seem fit and i ovulate on time every month and my cycle comes on time every month. we have sex regularly. we are both 26 years old. Please assist.",
    "doctor_response": "hi dear ....first thing is to exclude any pathology in male or female ..... semen analyses in male in obs ultra sound in females are important ...next thing is natural methods ....ensure you know about days that are important ....from day 12 to day 16 of menstural cycle are important .....if fail ,then take tab clomiphen 50 mg on day 2nd to day 6th and have an ultra sound on day 12 ....if still fail , then better to concern infertility specialist ....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Selzic 150mg safe for convulsion in a child?\n\nMy Son who is 4+ years old. On 27 th March 2011 night he became senseless and started vomitting. I consulted child specialist and according to him it was convulsion. He prescribed Valparin 200 to be given for 3 years (5ml twice) non stop. I also consulted neurologist and he prescribed Selzic 150mg(1 tab in the morning and 1 at night) for 1st week and thereafter (1 tab in the morning and 2 tab at night). I am now confused which medicine to give to my child.",
    "doctor_response": "the selection of the anticonvulsant is based on the type of seizures, age and EEG findings I recommend to follow a pediatric neurologist who will monitor the effects of the drug , the side effects and the level of the drug in the blood stream most neurologists will not treat the 1st seizure and will not request an EEG either , but will do so of it happens more than one time , and usually the drug is given over 2 years I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes spiratical bleeding and frequent urination?\n\nMy son has been spiratically bleeding and having to pee all the time.  We have had drug issues with him and we are just curious what could be the problem.  He sniffles a lot, which he says is allergies and he has had allergies before.  I mean like his knee was bleeding and he said he did not know why.  I woke up this morning and their was a tissue with blood on it.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Your son has multiple problems. He may have some urinary tract infection or stone or some other kidney disease. He should go for complete renal function test with ultrasound abdomen. He should also go for allergy test and coagulation  profile. Consult your doctor and take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could lump under jaw bone be cancer?\n\nI have a hard lump under my left jaw bone, below my molars. It feels like a cheery pit, and I can not move it. It does not hurt unless I mess with it. The dentist could not find anything on the x-rays. I see a ENT next week but I am worried. Could it be Cancer?",
    "doctor_response": "Hi,Dear,thanks for the query to my HCM virtual Clinic.I studied your query in depth.IN My opinion -this lump is not a Cancer-as its tender to pressure handling.Its mostly a infective lump-AS the dental xrays are normal, its not-Chronic Apical Abscess.Diagnosis-Hence mostly-its-left-Submandibular sileadenitis/ or could be  Furuncle/folliculitis early stage of cellulitis? General / or ENT- Surgeon consultation would be the right step in your case.Hope this would resolve your query.I would love to help you for more queries.Good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have a L5 S1 disc herniation and a bruise/tenderness at the site of the herniation. Can a disc herniation cause external bruising? I don t use a heating pad and I haven t bumped it. The tenderness has been there since I herniated the disc, the bruising is just showing up to my knowledge",
    "doctor_response": "Hello, I do not think there will be any bruise due to L5-S1 disc herniation. it might be due to something else. But I would like to ask you, are you having excruciating pain in the region of the bruise? Getting it Physically examined by a physician will be always advised as ignorance cannot be benefitted. You should take Physical therapy to help reduce the pain for the disc herniation. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does \"straightening of lumbar curvature due to muscle spasm\" mean?\n\ndear sir, i have back pain in lower left portion for the last two weeks. The X-ray says, \"straightening of lumbar curvature due to muscle spasm\". Every thing else is OK. What does it mean? how i can get rid of this pain. it disappears for few hours but come again? My email is \" YYYY@YYYY \"Thanks",
    "doctor_response": "Hello Thank you for using healthcaremagic I read your question and understood your concern This is muscle spasms of paravertebral muscles as a reaction of your organisms to protect your spine from moving too much.The initial treatment is with muscle relaxant medication and nonsteroidal antiinflamatory drugs from mouth and locally for few weeks.Then if your pain persists you should get an MRI of the spineI wish you quick recovery Dr. Selmani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from foul-smelling greenish discharge from my nose. Please help.\n\nHello doctor, Seven days back, I had flu-like symptoms with very mild fever (max 99 degrees) and little body ache, which lasted for a day or two. However, I did not get any sneezing or cough to date. At present, there is no fever. But after then, my right nostril is consistently producing foul-smelling greenish color mucous, and it is so repulsive as if something rotting inside. I doubted it is sinusitis and took Augmed 625 for three days (six tablets completed). The feverish feeling, body aches, and weakness resolved. However, this smelly mucus discharge, which is nauseating me 24 hours, is not getting cured. I am taking steam vapor twice a day along with Otrivin drops to relieve the congestion. While my left nostril is often transparent and occasionally produces normal white phlegm but right nostril is the culprit here. I am also getting headaches on the right side as if deep inside the skull and right jaw above the molar teeth. I consulted an ENT. She changed my antibiotics to Florenza 325 (twice a day) and also gave Mucolite SR tabs. I have already completed three days of this new regimen. But nothing seems to improve. She examined and said I do not have any visible Nasal polyps. My query is, does this sound normal to you? Does this sinusitis take very long to cure in spite of antibiotics? If it does not seem to be improved in the next two days, what would you suggest as the next course of action? The smelly discharge is nauseating me. I did not notice any blood in the phlegm. I keep blowing out the mucus and more seems to keep forming inside and occasionally drips down to the back of the throat. My tonsils are fine. I have no cough or sore throat or heaviness in the lungs. I am looking forward to the best remedy to get rid of this smelly mucus.",
    "doctor_response": "Hello. You defaulted on the course and dosage of Augmentin 625. It was supposed to have been taken thrice daily for at least five days. With the regimen that you made, I doubt if any bacteria would have got killed, but you would have most probably resulted in a resistant strain of bacteria inside your nose. Complete the second course of antibiotics as told by the ENT. If there is no improvement, give the mucus for culture sensitivity and take the right antibiotic. Additionally, take some antihistaminic and montelukast combination. Avoid excess steam if you are in polluted areas. Do not smoke or drink. Drink plenty of warm fluids. Get back to us if you need it. You may need a radiological investigation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for mental health problem\n\nhello doc i have undergone a breakup because of family reason frm my boyfriends side...i have accepted everything but  since dat day I did'nt got a  single tear in my eye's,which is making me restless,my brain nerves are bursting...please suggest me some ways to have tear's",
    "doctor_response": "hi dear,sometimes due to shock it happen not to have tears.and due to that you are not able to express your feeling and feelings hidden inside.due to that you have restlessness and your nerves are bursting.so consult psychiatrist for detail counselling and medication.sometimes it resolves it self and sometimes it turns in to depression.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for adult AHAD\n\nI have been on Vyvanse for about 1 month now because I have been diagnosed with adult adhd...It has helped me a lot in my job. When I started taking this medication I was 205 and now as of yesterday I'm 186.  I have lost my appetite I do have a healthy breakfast in the mornings before taking it but then after that I do not eat just about a good 8 bottles of water I have to force my self to eat at least a fruit or a healthy snack bar but never get to half of it... would I be loosing more weight if I continue on this medication?",
    "doctor_response": "Hi dear. I had gone through your query. Vyavanse can reduce apatite and also reduce weight also.But change is only transient. You can gain weight after reduction in medicine. I appriciate that you take proper food.Eat high calories and monitoring weight regularly. Consult psychiatrist and get help. Still if you have a query then feel free to ask. Happy to help you. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can painful blisters on the tongue be treated?\n\nI have severely painful sores and blisters all over my tongue and on the inside of my gums and mouth. I have found eating and drinking impossible due to the pain it causes. I have tried the Lidocaine 2% Visc mouth rinse with hardly any relief. What can I do to get rid of the speeds PR at least help with the pain?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As per your complain it seems that painful sores over the tongue and other parts of mouth seems to be due to Apthous Stomatitis leading to inflammation inside mouth and along with it there seems to be apthous ulcers or canker sores.It can be due to causes like deficiency of iron and vitamin B12, stress, physical trauma to the tongue, allergies, acid reflux , side effects of medication etc..I would suggest you to consult an Oral Physician and get evaluated and a thorough clinical evaluation and investigations like blood tests can help in diagnosis..Treatment of underlying cause will relieve the symptoms..As of now you can start gargling with a numbing mouthwash containing Lignocaine to relieve the symptoms.You can also take a multivitamin tablet daily..You can take anti inflammatory painkiller like Ibuprofen..Suck ice and do cool water rinses..Avoid spicy food..Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does TB have any effect on IVF?\n\nHi, I got my Montoux test done which came 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?",
    "doctor_response": "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 xray 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 it's 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could enlarged blood vessel on tongue indicate?\n\nI have a blood vesel on the side of my tongue that enlarges from time to time, usually when my head is lowere than my heart (like cleaning around the toilet).  Today, I noticed that the vein is enlarged, almost thrombosed.  No pain, just enlarged and I am very aware when I talk or lick my lips.  Anything to worry about?",
    "doctor_response": "Hello,This may be part of your anatomy and more pronounced with increased pressure.Please make sure to monitor your blood pressure and rule out high blood pressure that requires medical attention. Consider mentioning this to both your physician and dentist at your routine visits. Most likely this condition is of no great concern. Monitor for changes.Stay well hydrated and make sure that you do not have any vitamin deficiencies or imbalances.A clinical exam of the condition would provide the best diagnosis. There can be certain conditions such as a vascular malformation, deposits on vessels restricting bllod flow, tumor or cyst. Do you have any habits that may contribute to this reaction in so far as being an irritant?Try some anti-inflammatory medication to reduce discomfort. Tylenol or Advil should offer some relief. Avoid irritants such as smoking, alcohol and acidic foods as well.Thank you for your inquiry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sharp pain in arm while bending neck with sore chest and numbness in right hand\n\nI have a sharp pain that shoots down to the. Middle of my right arm when I bend my neck back. My arm hurts certain ways I move it I have a sore mild feeling in my upper right chest area and for the last to days my thumb and pointer finger. On my right hand has been num.",
    "doctor_response": "Hello As you explain the history it seems like a neurologic problem.Discuss with your doctor. Regards Dr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for Asthma leading to chest tightness,back pain\n\nI was recently diagnosed with asthma. I am a 43 year old female. About an hour ago I began having trouble breathing, chest tightness, back pain, and stomach quizziness. Why am I having back pain and quizziness? I took symbicort this morning as I do everyday twice a day. At 5pm I took Ventolin pump and just took it again at 5:50pm.",
    "doctor_response": "asthma is mostly allergies as these medicine will control not help to cure in my opinion you may get allergy test getting  eliminating avoidable allergens and doing sublingual immunotherapy for an avoidable allergens will help you along with supportive medicines in my opinion",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes choking on thick vomit?\n\nHi! My granddaughter, Niah, is 16 months old. The other night my daughter woke up and Niah choking on thick vomit. My daughter said the thickness and texture was that of a cat s hairball. This isn t the first time she has choked on her vomit, but when my daughter took her to the doctor, she said this is normal? We are both worried - I have never heard of this happening to anyone else before? Any idea what would be causing this or if it is serious?",
    "doctor_response": "Ya your doctor  was right,  this is Many times normal,  as thick vomit cantik brought out at this age It tends to choke as the age increases It wil subsidegive her more of solid food than liquids",
    "dialogue_context": ""
  },
  {
    "patient_message": "Duodenal erosion, pylorus inflammation. Taking omeprazole. Gall bladder removed. Normal symptoms?\n\nhad an endoscopy today and the report finding was: duodenal erosions in duodenium first part and the pylorus was also swollen and inflamed. i was taking Omeprazole which never helped with the pain and now recommeneded course of treatment is Ranitidine . If my symptoms continue to persist after this treatment what else can be done. I had my gallbladder removed on 23rd Feb asthey thought that was causing my pain (gallbladder had 3 stones in it) and since that was removed i have additional pain in the gallbladder hole area. Is this natural as well. Any advise will be greatly appreciated",
    "doctor_response": "hi thank you asking HCM you need  treatment  with omeprazole  6- 8 weeks  after that  you will do control  upper endoscopy and I belive that  your erosions  will be dis appeared. wishing you all the best Dr.Klerida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of high temperatures after a microdisectomy?\n\nI, aged 47 yrs., had L5/S1 microdisectomy done on 11.09.12 byspine surgeon. I was discharged on 13.09.2012. After 5 days frommy operation I started to have fever ( oral temperature 99 F to 100 F)usually fever started to come within 10am. to 10.30 am. and continuedthroughout the day and in the morning again it became 97F--98F. This isstill continuing. I visited one medicine doctor as per surgeon`s advisethrice during the period, he prescribed me initially tab. LOXOF 750 mg.one tab daily for 10 days. Later tab. Oratil 500 one tab. twice daily for10 days. Later tab Urispas & advised to take plenty of water With this mytemperature started to appear in the evening & continued till night.Followup visit was made with my surgeonon 10.10.2012. His report goes:-\" 1 month postoperative- the patient is doing well. However she is havingpersistent evening rise of temperature. On examination- SLR normal,no gross neurodeficit, ROM full, no tenderness, scar healed. CRP( 2 weeks back ) - mildly positive ( 1.5 times positive), Urine C/S- no growth.\"But evening temperature was still continuing . He advised me to seesee physician for body temperature .Again medicine Dr. advised me to stopto take medicine except 650mg. paracetomol on SOS basis.Now againI am having temperature as before. I am running such temperature for last 1& half month . When tem. comes I feel headache & scorching my eyes. I havestill pain in my back but I can walk to some extent.Can anyone help me inproper diagnosis? My present Drs. perhaps do not know the reason formy temperature rise. I also feel chills. Can anyone guide me? It is alsoobserved that when I get up from sleep my temperature becomes normal.",
    "doctor_response": "Hello Thank you for trusting HCM Dear most of the postoperative fever cases after spine surgery have no identifiable infectious focus and develop mainly in older patients with anemia and inadequately controlled HbA1c. A meticulous investigation of the source of fever including laboratory and radiological studies remains essential. Early mobilization is recommended for individuals undergoing lower spine surgery in order to decrease bacterial contamination from the gluteal cleavage.Uti, pneumonia, wound infection to be evaluated. Chronic fever surgery to be ruled out tuberculosis, pyrexia of unknown origin and immunocompromised stats. Please consult your doctor further evaluation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have lower abdominal pain, hurts to sit or walk. Help\n\nI have severe lower abdominal pain . It hurts to sit or walk, touch and go to the bathroom. It starts off mild then gets bad for about six days then goes away. This is the sixth or 7th time but its been 18 mths since the last occurrence. The previous times were more frequent. I m at the end of day 2 of the bad days but felt it start on Saturday. It s not a cramp . It hurts to touch inside and out, from above and below. it hurts all the time but gets worse when I m standing. Like my insides are swollen and something is pressing on my insides. I can t figure if its food related because I hadn t eaten anything unusual. I did just have a 2 month long period but can t remember if I had the previous times.",
    "doctor_response": "Welcome to Healthcare-magicGreetings of the dayMay be you be suffering from pre-menstrual syndrome. Take some analgesics and that will give you much needed relief. Also get a Urine examination done to rule out Urinary tract infection.Take CareRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can knee pain be treated?\n\nI have pain in my knees (R L) upon standing up or sitting down, and especially when climbing up or down stairs. I am a 60 yr old female, diabetic on insulin. I have recently lost 30 lbs., but pain has not improved. No injury to knees that I am aware of. No redness or swelling. Suggestions??",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Knee pain while climbing steps may be due to patellofemoral pain syndrome or chondromalacia or osteoarthritis or iliotibial band syndrome etc. Until examination is done it is difficult to say what it is. Avoid climbing steps, take rest, use cold and warm compression. Use tablet Aceclofenac (don't use in case of kidney failure). If symptoms not improved please consult your orthopedician, he will examine and treat you accordingly. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please help with my headache and double vision.\n\nHi doctor, I am having\u00a0headache and double vision. My body is vibrating. I am feeling sad and could not concentrate on anything for the past 15 days. Since a few days, I feel like vomiting and heartburn after having food. Please help.",
    "doctor_response": "Hi. Revert back with the results to a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itching due to allergy. Taking romilast, stopped, itching reoccurred. Safe to continue?\n\nI am an asthma patient and i have little allergy also with some itching and rashes . My physician prescribed me romilast 10 and i had been taking it once daily for more than two years. Slowly i reduced it to 5mg. I want to stop this medicine now. So i tried by missing a day s dose. But the next day itching started and i had to take the tablet. So my question is it ok to continue with the tablet lifelong?",
    "doctor_response": "yes you can continue for life you can add fexofenaine 120 mg if itching occurs and lcal antiallergic ointment on skin for itching but taking antiallergic continously ill prevent asthma and itching you can increase or decrease dose according to your conditions of asthma and skin allergy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dry itchy scalp, flaky, patches on back. Tried ketaconazole shampoo, condition worsened. Suggestions?\n\nI am 34 yrs old. I am female wieghing 77kg and height 165cm. I have had dry very itchy scalp extending to the back of ears and inside as well as forehead. All very flaky. I also have these patches on my back. feels like something is moving in my head. I am not on any medication and have no past health problems. I have tried ketaconazole shampoo, but it seems to be worse. My scalp getsbeven more tighter and dryer.",
    "doctor_response": "the fungal infections of skin can behave like this and fungus increases very fast in other areas due to touchif you have no allergies it is fungustake forcan 150 mg once a wk for 6 weektake ebastine 10 mg od for 3wkuse nn toxic soaps shampoo and creams on scalpuse flucort(antifungal lotion)on whole scalp at night and wash with candid tv shampoo in morningyou can do daly or thrice a wkit wil take 4-6 wk to go awaycn apply candid on lesions of back",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could it be if having swelling in the outside of knee which grows when running, sitting?\n\nI have an odd swelling in the outside of my left knee. It tends to get larger when i run, but it does not really hurt. It can often swell just while sitting at my desk or at a restaurant for a couple of hours - when I get up it feels really tight tna there is a bit of soreness. When I reach down, I can feel a larger bump than usual. If I sit and cross my feet so my left and right feet cross under the chair the bump goes away almost completely. I have been told it could be an aggrivated IT band or hamstring but no one has been able to provide a firm diagnosis and hence no firm treatment except expensive Chiro that does not seem to be helping. Thanks, PDC",
    "doctor_response": "Hello,The swelling on the outside of the knee that grows on sitting can be due to an inflamed bursa. You need to get an MRI scan of the knee done for a proper diagnosis.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cramps, tireness, passing blood clots. Stopped birth control pill, had sex\n\nI think I may be miscarrying but I didn t know I was pregnant. I was having sex with my boyfriend regularly and using Microgynon birth control . I attended hospital for a pre op assessment as I am having knee surgery and the nurses told me that I had to stop using the pill that day for the operation to go ahead. So I stopped it about 28 days ago, the day after having sex and my period came about 3 days ago. My period normally lasts 3 days max and is very light, passes with no pain, only an increase in appetite but for the last 3 days I have been experiencing excruciating cramp and I have been very tired. I normally pass one or two little clots of dark blood but today and yesterday I have passed no less than 15 very large clots. The period blood I normally have is red but slightly gunge like and sticky, this time the blood looks exactly like if you were to bleed after cutting your arm (just normal blood). What should I do?",
    "doctor_response": "Hi thank you for asking HCMI have gone through your query. It is usual to get irregularities in menstrual cycle or a break through bleed when you suddenly stop contraceptive pills. But if bleeding is more then better to go to ER.ultrasound examination will be needed to find out the status of uterus. Progesterone or a D & C might be needed to control the bleeding. Hope this may help you.Let me know if you have any further queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes forehead and head to be hot in an infant?\n\nMy child age is one year weigh around 9.5. Sometimes his forehead and head is very very hot when i check the temparature through armpit it is normal. It is hot especiallay morning 3.00 AM to 10.00 AM. During this period if he had milk his forehead will start becoming normal slowly.",
    "doctor_response": "If forehead temperature is less than 99 F and feeding well nothing to worry..you should give antipyretic only if its more than this and surrounding environment also effects on body temperature so if surrounding is hot , don't dress him heavily",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for diarrhea and vomiting in my child\n\nMy 15 month old has had bad diahrea for give days. It s clay colored and coming in massive amounts. He there up a couple of times. No fever. Took to dr and waiting on stool culture. Also has ear infection. Tonight I noticed 5 large hive looking bumps on arms and his stomach seems hard and bloated. I stopped amoxicillin dr put him on in case of allergy until I see dr tomorrow.",
    "doctor_response": "Hi...it couldbe drug allergy and the diarrhea also could be because of antibiotic assoiciated diarrhea.  Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron (as prescribed by your paediatrician).Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing pain in the lower ab\n\nWas climbing other day and slipped and caught myself with arms and felt bad pain burning. Since than can t do sit ups hurts when sneezing and pulling down. TThe pulling down cripple s me. All pain is around lower right ab. Hurts to touch right below around groin",
    "doctor_response": "Hi,From the kind of fall you had it seems you have injured an internal organs or pulled an abdominal muscle. If the pain is sever associated with distended abdomen and painful movements you need to show to a nearby GP. He might suggest certain blood test or an MRI or the the movements are only painful and pain gets subsidised on rest and applying hot packs then most probably it's a pulled muscle. You can take a muscle relaxant like meftal or diclofenac gel like volini. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Jenis Bhalavat",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I had unprotected sex and took ECP tablets. Why am I not getting periods?\n\nHi doctor, I had unprotected sex with my fiance. After sex, within 48 hours, I took two ECP tablets. After taking it, bleeding started for two days. My menstrual date was a week back but I did not get it. Also, I face some kind of a different taste in my throat, have a headache and troubled heart. In every month I take one dose of ECP and every time when I take ECP, bleeding start for two days and I successfully get my periods. But now after sex, I took ECP and the same bleeding started for two days but I did not get my periods. Is this any sign of pregnancy or any infection or whatever?",
    "doctor_response": "Hi. Your periods can become irregular after taking ECP (emergency contraceptive pill). It may be early or delayed by one week. You may also have spotting. You have taken medicine correctly. The urine test will not pick up early pregnancy. Please do serum Beta hCG blood test now to rule out pregnancy confirmatively. I would like you to start on monthly contraceptive pills, to avoid such situations in the future.  For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low back sprain and painful bending\n\nI suffered a low back strain/sprain while playing shuttle cock. it occurred when i bend forward to take a drop and i felt a sudden severe back strain. I was unable to continue play and the pain became so severe now that I was hardly able to move, bend or even walk. Plz give me a reply",
    "doctor_response": "Hello, As per your history, it may be due to muscle sprain. For that you can take tablet acetaminophen. Apply diclofenac gel or ointment locally. Heating pads also helps. Do regular physical therapy. In case of not getting relief you may require MRI back after orthopedician consultation. Avoid forward bending. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mild joint pain and strained muscle in the shoulders?\n\nGood evening... I am writing about a systemic problem I am having with mild to severe join pain. Originally, this began in my left shoulder, and was presumed by the physician to be a pulled / strained muscle. The problem not only persisted, but began spreading, first to the opposing shoulder, then to the left elbow, wrists, left hand, then the lower back, and finally to the hip / groin area and finally to the backs of the knees. It was found I had a highly elevated white blood cell count, coupled with high inflammatory readings, VERY dark urine, and severe joint pain. The condition persisted, not always as bad every day as the last, but in my shoulders, never unnoticeable. I continue to this day with these symptoms. Upon recollection, I remember joking with my wife that a small, 2-dot red mark on that same shoulder (left) was a spider bite, and that maybe that s why the pulled muscle wasn t healing. I then remembered recently I had been under a trailer a week prior to noticing the marks doing plumbing work. After SOME research on spider bites, many of my symptoms resemble a brown recluse bite. My physician seems doubtful, but these are present in our area, and he cannot account for all of these persistant symptoms and is ready to send me @ 50 miles south to a contagious disease testing facility if he has no answers by this Tues. How common are spider bites such as this and do my symptoms fall within the range of being that?",
    "doctor_response": "hiAs of now you must be given prednisolone tabs and allegra ,an anti allergic and safe pain medicine like accelofenac to minimise symptomsyoumay consult a rheumatologist also who may get arthritis profile of blood done and auto immune,immunological tests also.platelets count is very important, alongwith ANA,IGg!IGm etc.if your doctor recommends quarantine suspecting contagious disease,follow it but certain tests must be included to diagnose conditions which can cause similar symptoms besides suspected infectionyou may discuss what i suggest here with the treating doctor who may agree to investigate other possibilities or at least rule out",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fatty liver\n\nHello Doctor,Per recently screened tests, it was found that i have a fatty liver condition. I am a non alcoholic person. Dietary habits is predominantly vegetarian. My Question is, can Jaundice have any role in this, as there was an occurence of Jaundice in my adolescent  years.",
    "doctor_response": "Hi Thank you asking HCM.with regards to  fatty liver you can start  to use sylimarine and  vit E. it is not associated with jaundice. wishing you all the best dr.klerida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in rib while sneezing ?\n\nThis past Sunday, while battling chest congestion, I sneezed and felt severe stabbing pain in the left side of my rib. As of today, when I cough there is a strong pull on that side. How long before that would go away? I am thinking it was a muscle pull.",
    "doctor_response": "Hello, Your symptoms seem to be related to a muscle strain. I suggest using anti-inflammatory medications such as Ibuprofen to relieve the symptoms. I also suggest using Voltaren gel for local application. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a correlation between hydrocodone and kidney stone?\n\nHi i had a devastating work injury back in August that required surgery. I was prescribed hydrocodone and took it as needed even up til now. I was diagnosed with a kidney stone in late November. Is there a correlation between the hydrocodone and the kidney stone?",
    "doctor_response": "No. .they don't had relationship, stone may be due to u did nt take plenty of water or change in your food habits",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can allergic rhinitis be treated?\n\nI have been non stop sneezing all night and I to the second day now. I have been helping a friend remodel their home. During the cleaning stages, bleach was used and ALOT of it. What can I do to get relief from this after I suppose was inhaling the bleach fumes. I'm miserable, please help!",
    "doctor_response": "hi sir/madam,Thanks for your question on Healthcare Magic.As per Ayurveda, Allergic rhinitis is compared with Vata- Kaphaja pratishaya. The concept of Ama, Asatmya and virudh aahara also predict the allergic conditions.Ama is the product of impaired digestion and metabolism. It affects Rasa and Rakta Dhatu leading to manifestation of Pratishyaya. Wrong food combinations (Virudh aahar) having antagonist properties like fish with milk, fruit juice with milk, clarified butter with honey, ice cream after night meals, etc. leads to allergy.Ayurvedic line of treatment:-If the symptoms are severe and in chronic conditions, Vamana Panchakarma treatment, followed by Virechana is administered. This helps to relieve Ama and balance Tridosha.In some cases, where the patient has normal digestion strength, Nasya treatment (nasal drops therapy) is administered with herbal oils such as Anu taila or Shadbindu Taila. After the above Panchakarma treatments, Ayurvedic medicines are administered to improve respiratory immunity and strength of upper respiratory tract.The medicines given for allergic rhinitis are:-1. Nimbarajanyadi tablet \u2013 Contains neem and turmeric as main ingredients.1-0-1 after food.2. Chavikasavam \u2013 Fermented Ayurvedic liquid, also used in urinary tract disorders.10 to 15ml with water 3. Mahalaxmi Vilas Ras \u2013 Also useful in the treatment of skin diseases, diabetes, Sinus, non healing wounds, etc.1-0-1 after food.Diet to be followed are:-1. Take Light food, lukewarm water, Kapha nashaka foods like little spicy food, saindhav salt, legumes, soups etc.2. Avoid heavy food, fermented food, congestive food, too hot or too cold food, soar food, non vegetarian food, sweets, banana, curd, yogurt, ice creams, deserts, cakes, yellow grams, etc.3. Avoid Alcohol and cold beverages.Lifestyle improvement:-Use mask while driving vehicle or going through public places.Always take warm water bath.Do not expose to hot sunrays.Regularly take inhalation of steam.Regularly go for morning walk in warm weather.Do sufficient exercise.Do not reside in dark or dump places. Get fresh air.Do not get sleep at day time or immediate after dinner.Take sufficient rest.Yoga for rhinitis:-1.Ardha chandrasana2.Veerabhadrasana3.Salamba sarwangasana4.Setu bandhasanaHome remedies:-1.Take half liter water, add 20 gm salt, one teaspoon turmeric, boil it for 10 minutes and take it repeatedly.2.Take six cloves add six black pepper and one teaspoon of turmeric make powder and take it with honey.3.Take",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can slimquick diet pills cause false positive on pregnancy tests?\n\nI was on Birth control for five years. My periods grew to be about two weeks apart, and I was being made to switch brands repeatedly. I have not gotten pregnant since I stopped using it about 9 months ago, and recently started taking Slimquick diet pills and got a positive test. Could the Slimquick cause a false positive pregnancy test?",
    "doctor_response": "Hi, I would say it is highly unlikely that SLIMQUICK would case a false negative pregnancy test. SLIMQUICK does not mention all the active ingredients and concentration and it has been changing over years; it will be difficult to rule out its effect completely. If you were my patient, I would suggest you to consult an obstetrician. Also would suggest against herbal medications like SLIMQUICK as there is documented evidence of liver toxicity with its use. I would rather recommend diet and physical activity for weight loss over such supplements. Hope this helps you. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high bp, depression and anxiety after having mirena?\n\nI had my Mirena placed in January and since then, have been having extremely high blood pressure 165/110, depression and anxiety.  Is there a chance this could have been caused by the Mirena?  I am currently on 200mg of labetalol and 20mg of prozac.  Neither of which seem to be helping much and my blood pressure spikes almost daily.  Thanks.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Mirena (levonorgestrel-releasing intrauterine device) is a form of birth control that is indicated for intrauterine contraception for up to 5 years and for the treatment of heavy menstrual bleeding in women. Mirena is a hormone-releasing system placed in your uterus to prevent pregnancy for up to 5 years.The problems you are mentioning may not be the side effects of mirena alone. I think it is due to anxiety and stress. May be PTSD. Associated with the stressful situations around January. Rewind and find out. Another possibility is (you did not give your age though, so assuming) menopause. Anxiety and depression are possible in that instance. The medicines should help you along with psychotherapy. I shall help you in that matter. 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.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest recovery time post rotation surgery on femur\n\non june 23rd i got internal rotation surgery on my femur and had a titanium rod put in. they cut my bone and inserted through there. i cant walk anymore and im trying very hard to figure out watch the recovery time is til i can walk again or even bear my own weight",
    "doctor_response": "Dear Patient, Welcome, and thanks for sharing your concern I went through your query, and want to know for what reason was this surgery done. I feel if surgical cut is made and fixed with intramedullary nail than weight bearing at least partial can be done early if fracture is stable. if there is any instability than weight bearing is differed till union signs are seen which means about 2 to 3 monthsI hope my advice would have been useful, in decision making regarding your treatment, still if you have any clarifications or doubts feel free to contact back.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest solution for premature ejaculation and erectile dysfunction\n\nhi doctor its me muhammad actually i have a 1 problem for last 8 years but now my problem is very serious doctor my cock is not good working its too small and its very week some time its working for only 2 or 3 minutes and some time its not working so i am already married i have a 2 kids but i am yong now my age is 28 years old can you tell me pls solutions of this problem. i shall b very thankfull to you for my assist. my email id. YYYY@YYYY",
    "doctor_response": "Hello,You are having erectile dysfunction and premature ejaculation problem as per history. I suggest you rule out hypertension, prostate problem, high lipid level, obesity like cause for your problem. You should get checked your blood pressure and blood sugar level first. Additionally ultrasonograohy can be planned with special emphasis on testes and prostate. Avoid smoking if having habit of it. Serum testosterone also need be checked. Revert back with reports once done Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the chest while breathing?\n\nyesterday i've been throwing up due to a stomach virus going around and now 24 hours later everytime i breathe in deep my chest hurts the pain is occurring in the middle of my chest!! i am a 20 yr old male,,im 5'7 150 pounds.. im very healthy so please help!!!",
    "doctor_response": "Hi thanks for contacting HCM...Noted you have viral flu of stomach....Here are possibility....-Reffered chest pain from viral infection of stomach-muscular pain by unaccoustemed activity.Here are some advise....Take pentoprazole for two week.Avoid excess spicy and fatty food for few days.Green leafy salad taken more...Avoid smoking ....and alcohol....Cooked oatmeal rich in selenium , thiamin , fiber , vitamin E .. So sooth stomach...Kiwi , avocados , berries like fruit useful.Avoid excess tea and coffee....You will recover in few days....If any unsual symptom like cough , fever, chest pain occur then further work up needed.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I developed itchy and dry skin after dyeing hair in salon. Can you have a look?\n\nHello doctor, I have a question about my skin condition. I have developed a really itchy and dry skin after I dyed my hair. Here are the symptoms. I do not know what the condition is as my appointment is months away. Can I attach pictures?",
    "doctor_response": "Hi. I have seen your query and examined your given picture (attachment removed to protect patient identity). It seems you have developed allergic contact dermatitis to hair dye. Though you may not have had this on your previous exposure, now onwards you may have a severe reaction to the dye. You can use topical 1 % Hydrocortisone cream local application twice daily and take tablet Levocetirizine once daily for one week after consulting your dermatologist. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are frequent UTIs in a 4 year old a concern?\n\nMy Grandaughter is experiencing a lot of urinary track infections. She is only turning 4 in Jan. My Daughter - in - law told me that she might have some kind of reflex disease. They are or will be running tests. Is this rare for this age group and what causes this to happen?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Less that ten % of young girls can have vesicoureteral reflux.  This is when urine in the bladder refluxes, or travels out of bladder into the ureter, and back up toward the kidney.  The ureter is the tube-like structure that normally takes urine from the kidney down into the bladder. In these young girls the attachment of the bottom of the ureter into the bladder is abnormal and allows the urine to leave the bladder and go back up into the ureter. Depending how severe the reflux, the urine can go back up into the ureter and into the kidney. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Ppd test positive, rifampicin, feels dizzy, allergy, anti allergy medicines\n\nhi..i have ppd positive test and the pulmonologist advice me to take combined rifampicin and inh for 4 months,for 14 days of taking it i experience dizziness then at 15th day i started to have allergy all over my body,and he prescribed anti allergy medicines..still i have some allergy even i am taking this anti allergy..my question is do i still need to continue this medications?",
    "doctor_response": "YOUR MEDICINES ARE CAUSING ALLERGYTHERE ARE 2ND LINE AND3 RD LINE AND OTHER MEDICINS IF YOUR DOCTOR WANTSHE CAN CHANGE TO OTHER GROPDS AND OTHER SALTSBUT IF YOU STILL WANT WITH THESE TAKE ANTIALLERGIC WHICH GIVE YOU RELIEFLIKE FEXOFENADINE EBASTINE LORATIDINE HICH CAN BE TRIED HESE HAV TO BE TAKEN CONTINUOUSL LONG ITH OTHER ANTI TB MED",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child had low blood sugar, elevated WBC, no urination after a seizure and breathing difficulty. On beta blockers, Was diagnosed with HCM as an infant. Is low blood sugar level related to HCM?\n\nMy Niece, who is almost three had a seizure and stopped breathing last night. She was diagnosed with HCM at three months and has been on beta blockers ever since, three times a day. When she arrived to the hospital her white blood count was elevated, blood sugar level 19, and not urinating. The previous two days she had a severe case diarrhea . She is on her way to Stanford children hospital rite now. I just wanted to see if there was any ideas of why she had such low blood sugar , and if this could have something to do with her HCM.",
    "doctor_response": "HIThank for asking to HCM I really appreciate your concern for your niece looking to the given history here I could say that in this case the complete medical history along with the investigative reports needs to come on any decision to advise in better way but if the child is under the care of best pediatric unit then no need to worry bout this you can discus with the doctor for prognosis, hope this information helps you, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Aspirin an effective alternative for Plavix?\n\nIn 2013 and 1 yr later, in 2014, I had a TIA. As a result, after the carotid artery check, my doctor put me on plavix 75 mg and lipitor 10 mg. My GI doctor asked me why I was on the medication, and when I told him, he suggested I could accomplish the same thing with a daily aspirin. Is that correct? Secondly, while applying to change my Medicare Supplement coverage, I was turned out because I take Plavix, which I m told is new and industry-wide. Can you advise on this issue?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. In case of TIA Aspirin is the best medicine, it is the alone is enough for that, still the underlying cause of TIA would be matter of concern Aspirin can only prevent the further even but not for sure, some time the TIA might not be due to disturbances in hemodynamic system but it could be due to other etiology. Hope I have answered your query. Let me know for further assistance if needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for an infection in the stomach\n\nHello, good, the first thing to ask for excuses him since I am speaking to him across a translator since I am A SPANISH contact with you because I am slightly worried since I have enough indications of small quantity has consumed gas of the burners approximately 6 months ago, nowadays I am not badly in general, algun small, prick in the zone of the bladder or in the mouth of the stomach, but very slightly and during a little time, some time ago if me dolia but not tape-worm either vehicle or means to go to the hospital in this moment and the following day I was perfectly and I was not, wise either that I tape-worm this substance inside. Nowadays I have a small sapullido in the low zone of the gut, and one in the neck, and the hunger like that it is mas long, thank you very much in advance and wait for reputtings, One",
    "doctor_response": "Hi.I would first recommend a deworming course of either albendazole (400 mg orally, once; followed by another tablet in 2 weeks time) or mebendazole, which ever is available in your region. The next thing I would recommend is a course of antibiotics. I too apologise as the translator was not effective enough and I could not understand your query clearly enough.In antibiotics, I would prefer the use of ofloxacin 200 mg oral tablet, to be taken twice daily for the next 10 days. You can also use either ranitidine or omeprazole tablets 15 minutes before each meal for 10 days.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluttering in stomach and chest and breathlessness?\n\ni am a 44 yr old male pack a day smoker, no family history of major health issues, i do not drink or do drugs, i am on my feet 8-10 hrs a day, ive never had any health issues and i dont exactly eat the way i should, i am around paint and some chemicals on the weekends and i dont have a doctor that i see.every now and then i get a thump or fluttering in my stomach and chest area and i cant seem to exhale and for a second i lose my breath entirely and honestly it really scares me. any thoughts on what may cause this and am to young to have developed emphasema pr to old to develope asthma ? please help",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, possibility of arrhythmia (rhythm disturbances in heart) and COPD (chronic obstructive pulmonary disease) is more. Fluttering sensations in chest are mostly due to arrhythmia. And arrhythmia is common in smokers. So consult doctor and get done ecg, 2d echo and Holter monitoring (24 hours continuous recording of ecg). If all these are normal then no need to worry for arrhythmia or other heart diseases. You are also having breathlessness. So chances of COPD (emphysema or bronchitis) is also high as you are active smoker.Smokers are prone ti develop emphysema after the age of 40 years. So at 44 years of age, you are at risk of developing emphysema.  So consult pulmonologist and get done clinical examination of respiratory system and PFT (pulmonary function test). PFT will not only diagnose COPD but it will also tell you about severity of the disease and treatment is based on severity only. You will improve with inhaled bronchodilator and inhaled corticosteroids (ICS). In any case, quit smoking as soon as possible. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nausea after taking Meizitang?\n\ni recently started taking Meizitang, a weight loss sofft gel capsule. Yesterday i was nauseous and was vomiting every 10-30 minutes, and easing around lunch time. Today i feel just as bad, if not worse and it has just occurred to me that maybe this pill doesnt sit well with my birth control pill. Could i be pregnant?",
    "doctor_response": "Hi, Okay. Cannot comment on the possibility of pregnancy. Without an exam, I can only give general information. First, you have no guarantee there is anything in these unregulated pills. If they have what they say is in them: cassia seed is a digestive irritant. That is what it does.Many Chinese medicine things most of which aren't even for weight loss in Chinese medicine. Various drugs, mostly dangerous, have been found when reputable labs have analyzed it.St. John's wort NOT supposed to be in Meizitang, DOES lower the effect of birth control pills so herbals can do this. No idea if this one does, but then, as mentioned, it might or might not have enough ingredients to do anything. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sameen Bin Naeem, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen vein in a child\n\nMy 5 yr old has a swollen vein on his left cheek inside his mouth. He s been to the dentist recently and they saw nothing. She thinks he may have a canker sore or something. This pain has been bothering him on and off for a yr now. I don t think it s an abcest tooth because his dentist would have seen that on X-rays. Is there anything else it could be?",
    "doctor_response": "HI...it could be a hemangioma of the cheek. But one thing which is not falling into the groove is that there is pain which is not usual in hemangiomas.  I suggest you consult a pediatric surgeon and get a bisopsy done. We will know the diagnosis confirmedly.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does chemothrapy done for stomach cancer lead to constipation and back pain?\n\nhi my brother has stomach cancer and has had an op to help him eat his food as his food pipe was making him sick he than had six sessions of chemotharpy and when he had his scan they said that it was not working and have gave him four months to live the whole family are devastaded he now is suffering from stomach pain and and constipation his back is also in pain and he is only 45 years old please could you write back to help me help my brother",
    "doctor_response": "Hello dear. I appreciate your concern.  I have gone through the details. Your brother requires best supportive care at this stage. The cause of constipation is the pain killers which he must be taking for the pain. Your can use dulcolax tablets. lactulose syp, or proctoclysis enema for constipation. For pain if not controlled by usual pain killers, narcotic drugs can be taken. But these drugs must be taken after consulting a physician. Hope that makes it clear. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cracking and peeling of skin due to allergy from ring. No relief with eucerin and steroid creams\n\nI initially developed some cracking and peeling in the skin near my ring on my inner finger. It was diagnosed as an allergy to the ring (which I have worn for many years). I then developed a patch on the palm of my right hand, followed by small finger on my right hand and a few minor spots of peeling between several fingers. I was prescribed a gel/cream containing a steroid. I then consulted with a pharmacist who recommended a Eucerin cream. Nothing has worked thus far.",
    "doctor_response": "HIThank for asking to HCMThis could be eczema, and this condition gives good response to steroid preparation, and matter is choosing the right  steroids if I would be your doctor then I would prescribe the following preparation,1) Hydrocortisone with Benzyl benzoate cream base apply this three times I dayI hope this agent will relieve your allergic problem, take care and have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are high sugar and raised liver enzymes side effects of Protonix?\n\nHi doctor, I have been taking Protonix for almost three weeks for acid reflux. I had some blood laboratory work done and it showed my AST 812 and ALT 1,115. Could this be a rare side effect of Protonix? My glucose also went up to 192 and lipase is 72. I do not drink, smoke or use drugs. My doctor ran more tests the next day, but has not gotten the results yet. So, he has not prescribed anything yet for my sugar levels. She knows that I have not been feeling well for the past three weeks. I just stopped taking Protonix from yesterday. Also, I discontinued my regular Plaquenil before three months, which I used to have for the past 20 years for fatty tumors in my arm. Is there anything I can take to bring both the liver function and sugar down?",
    "doctor_response": "Hello. Is this the only liver function test you have? I wanted to trend it. Plaquenil (Hydroxychloroquine) and Protonix (Pantoprazole) both can cause elevated liver function test, but it is relatively rare with Protonix. I also want to make sure that you are not using Aspirin, Tylenol or cholesterol medications, since they can have direct effects on the liver. Another important point is that the slight elevation of lipase and blood sugar can happen in pancreatitis, which again could be a rare side effect of Protonix. But, this point goes against the fact that the elevation of blood sugar is out of the proportion to the lipase levels. A person, who has prediabetes, may develop full blown diabetes transiently under physiological stress. I was trying to understand if you had been tested for diabetes ever and if this blood sugar was obtained in fasting. For high blood sugars, I would suggest that you try to avoid high carbohydrate diet, soda, bakery products, white bread or pasta and juices. Hydrate yourself with plenty of water. Can you please share your symptoms and for how long did you have them? Please also share if you have been worked up for lupus or autoimmune hepatitis and your entire medication list if you can? Revert back with the details to an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My hemoglobin count is low. Is it due to iron deficiency?\n\nHello doctor,I had my blood testing done yesterday. Rest all reports are good except for my hemoglobin count. The following pointer is highlighted:Hemoglobin- 8.4 g/dL.Eosinophils- 7.4 %.Monocytes absolute count- 0.14 x 10^3/ul.Basophils absolute count- 0.01 x 10^3/ul.Hematocrit (PCV)- 32.6 %.Mean corpuscular volume (MCV)- 71.5 fl.MCH- 18.4 pq.MCHC- 25.8 q/dL.RDW-SD- 51.6 fL.RDW-CV- 20.3 %.PDW- 7.5 fL.PLCR- 11.5 %.Considering above test results, is there anything serious to be taken care of? Is it just due to iron deficiency? How should it be prevented? Could you suggest what could be done for the same?",
    "doctor_response": "Hi. Your Hb level is low and blood indices also low. Your serum iron level as well low. Hence, it is suggestive towards iron deficiency anemia. For further workup, peripheral smear examination and serum ferritin investigation have to be done. You need to have a prescribed iron tablet that contain good elemental iron like Orofer XT like tablet containing Ferrous Ascorbate with elemental iron 100. This tablet can be taken until bone marrow iron storage gets normal. That is why I recommend serum ferritin testing as well which reflect iron store. Take care. For more information consult a hematologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the swelling and pain in my left wrist?\n\nHello For the second time in two weeks I have a swelling & considerable pain in my left wrist. The first time I felt that a vein was blocked so took Aspirin 3 times that day. The swelling started to go down within an hour & then progressively got better. It wasn t 100% but not so painful. I have the same thing again now & feel it is a blockage. I am sure you will recommend getting it checked however is a blocked vein an urgent problem or will I be given anticoagulants anyway? Leanne",
    "doctor_response": "Hello, Looking at your details it does not looks to be vein blockage.Such pain with swelling can be due to:-Synovitis of wrist-Rheumatoid arthritis-Gout-InjuryI shall advise you to have a complete blood examination including CBC, serum uric acid, ESR, RA factor to rule out problem. At this time, taking preparation containing indomethacin or salicylic acid on prescription will help you. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mukesh Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tiny white raised rashes on arms and cheeks?\n\nMy 14 month old has a rash on her arms and her cheeks. They look like tiny white or skin coloured raised dots. I see her scratching her arms but not her face. Her cheeks are just red. Could it be worms? Does she need deworming? Or what else could it be?",
    "doctor_response": "Thanks for your question. It seems she has allergic dermatitis. There are different causes of allergy:-worms;-dysbiosis;-malabsorption;-high level of IgE;-lack of enzymes;-liver problems and etc\\I suggest-check stool for cyst and ova,stool culture,stool analysis, blood test:-albendazole can be used for worms; -hypoallergenic diet(avoid chocolate, nuts,semolina(sudgi),tomato soup,carrot;-antihistamines(Cetrizin );-darolac-1 capsule once for 1 month for normal intestinal flora-use child's soap,avoid flavoured, wear cotton clothes  Take care   Best regards   Dr.Svetlana",
    "dialogue_context": ""
  },
  {
    "patient_message": "What information can be gathered from a semen analysis report taken after a vasectomy?\n\nI had a vasectomy in early december 2010. I just got the semen anlysis report. The gross examination is as follow: color normal, volume 1.5 ml, blood trace and ph 8.0. Viscocity - decreased Turbidity- normal Progression- no motil Motility- initial to 4hrs @ 0% Count - 2.0 Morphology - normal 100 Whats the verdict? Thank you for urr time XXXX.",
    "doctor_response": "Hello, The count and motility is very low. Pregnancy is not possible according to this report. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Got wisdom teeth removed and stitched sickets. Healing well but flap on gums has got bigger. Normal?\n\nHi, 3 days ago i got all 4 wisdom teeth removed as 3/4 of them where impacted. If it matters i am 18 and the surgeon stitched the sickets with dissovable stitches. They are healing well but since yesterday i noticed a small flap of gum on 3 of the areas where my wisdom teeth where removed. Each flap has gotten bigger today (its possible that theyre just swollen though). The problem with this is each flap has grown over the tooth next to them, so im basically chewing on them throughout the day. Will this cause any problems? What should i do? And why are those flaps there? They seem to be mostly secured by the stitches",
    "doctor_response": "Hi,Thanks for aksing the query,A complete healing after wisdom tooth removal occurs upto 3 months, whereas pain swelling subside in 10-15 days.According to your symptoms i suppose that you hve developed inflammation and swelling around the healing socket.You just follow the post operative instructions given by the Dentist properly.Take complete course of antibiotics and analgesics.Take lukewarm saline and antiseptic mouthwash rinses.Avoid eating of hot and spicy foodstuffs.Avoid smoking and alcohol consumption as this may worsen the condition.Hope this helps out,Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the severe head trauma have caused calcified lesion?\n\nGood evening Doctor Rynne. My wife recently had a CT scan due to chronic sinus infections. The CT identified a calcified lesion in the frontal left lobe. It was 1.8 cm. In 2000, she was involved in a horrific vehicle accident and sustained extreme head trauma. Would this be the most likely cause? If so, will this lesion get larger and cause problems in the future?",
    "doctor_response": "Hi, I am Dr.Bruno.  I have read your question with care and understand your concerns. Let me try to help you The 1.8 cm Calcified Lesion can be (a) Meningioma which has undergone calcification(b) Healed Granulomas (c)  Other Lesions which calcify Since there is no specific complaints pertaining to the Lesion, I would suggest that you do a repeat CT Scan after 6 months In Most Cases, you will find the lesion in the same size and not causing any problems in future It is very rare for a Calcified Lesion to Grow. Very Few calcified Lesions Grow. Most Calcified Lesions just remain in the same size Hope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the seriousness of C2 level cancer cells?\n\nMy sister was diagnosed with thyroid cancer this past Summer, she had surgery to remove her thyroid in Aug and we were told that it was caught in time and it had not spread nor was it in her bloodstream. Well she had her annual pap and now they are saying they found C2 level cancer cells...she is only 30 years old. They haven't said were the cancer is, but how serious is C2 level and could this in any way be linked to the thyroid cancer?",
    "doctor_response": "Your sister probably has a condition called CIN2 which is a condition of the cervix (the last part of the uterus) which if left untreated can progress in half the cases to cancer of the cervix. you have 2 options. Either get a PAP smear repeated every 6 months to see if the CIN2 is progressing. Or, she can undergo a colposcopic examination done along with biopsy of any suspicious area. This will ensure that she does not have anything sinister. Also, this has nothing to do with her thyroid cancer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling at ankle\n\nmy mom has just started with multaq 400mg 12 days ago. she had swelling at the ankle. others, she got pradaxa 110mg, diabetmin 500mg and perindopril 5mg at the same time. we will go travel early of Nov 2012 for a week and when we return home she is advice to do eletricity pump to restore the normal rhythm. pls advise",
    "doctor_response": "Homeopathy can treat the case with greater degree. Apocynum can , ledum palasture are few capable medicines to reduce ankle swelling",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dark lips\n\nhello i need answers and what i can do; my daughter 7 yrs old has a very dark upper lip that is discolored almost black looking i have tried all kinds of creams and chapped sticks but still will not go away. what is it and what can i do to get rid of it? concerned mom..",
    "doctor_response": "Thank you for query.The natural color of skin is the best.it is better not to alter it for whitening.Cosmetics do more harm than good. So stop all cosmetics.You can use antioxidant and vitamin tablets.Then advise your child to not lick the lips too much  or cause irritation to it which can cause darkening.Treat if any infections or deficiencies are present.You can get back directly to me for any clarifications with the photos.Dr Bharatesh D Basti Dermatologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can varicocele be treated or controlled by yoga?\n\nHello doctor, I have the right varicocele, which is 4 mm in size due to which I have very mild pain in the right testis. Do you think this can be treated by yoga in any way or if yoga can help in controlling this?",
    "doctor_response": "Hello. First of all, you need to undergo examination and need to take medicine for the immediate arrest of the problem. You can try yoga asanas like suryanamaskar, bridge pose, straight leg raising, dhanurasana in a slow manner. Deep breathing exercises and pranayam can help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I getting recurrent cold attack in the last 3 years?\n\nHello doctor, I am suffering from a cold for three years until now. I think it is due to a dust allergy. Please help me.",
    "doctor_response": "Hello. The long-term cold is suggestive of allergic respiratory tract infection. You need to investigate with allergic testing for further work up. The causative allergen needs to be avoided like dust, mite, pollen exposure, cold atmosphere, etc. The Levocetirizine or Fexofenadine like anti-allergic medication can be prescribed for your case. Immunotherapy is also beneficial in such cases.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of cancer?\n\nHiy,  masyu I w your health queries right now ?  Please type your query here...my husband was in ER this past Friday and had a scope put down his throat to dislodge a piece of food.  dr said the opening was the size of a straw.  and significant scarring (has acid reflux).  waiting on biopsy results.  could it be cancer?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your husband's situation and problem. Yes, this can be due to cancer. Chronic acid reflux causes constant, persistent inflammation in esophagus. This can lead to metastatic changes in esophageal mucosa. And this causes mass like lesion with narrowing of the esophageal lumen. So his endoscopic finding like straw sized opening and fibrosis can be due to esophageal malignancy. Biopsy isn't needed for confirmation. So collect biopsy report. Also get done CT scan. This will also tell you about  size and extend of the mass if present. Hope I have solved your query. I will be happy to help you further. Wishing good health to your husband. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back pain?\n\ni have been suffering from lower back pain for 3weeks now. the doctors have first thought it was kidney stones as there was blood in my urine but the scans didn t show anything. they then diagnosed me with a muscle spasm but the pain doesn t seem to be decreasing.",
    "doctor_response": "Hello, I have studied your case. I will advise you to do MRI spineDue to compression of this nerve root there can be back pain associated with it.For these symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.Core stabilizing spine exercises will help.I will advise to check your vit B12 and vit D3 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of GMH injection?\n\nI want to get pregnent for second child. I had three abortion earler after one child.Two abortions due to improper growth of fotus. & one was our decesion. Now I want second kid. But we are not getting success .. Our doc has suggested some GMH injection . I want to know the side effects of the same.",
    "doctor_response": "Hi, Common side effects of GMH Injections include injection pain, local abscess, allergic reaction, headache, abdominal pain, Nausea, vomiting and ovarian hyper stimulation syndrome. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ajeet Singh, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms and treatment for bone cancer?\n\nI have intermittent bone pain in 5 specific areas. It has been going on for over a year but seems to be getting more intense and more frequent. The bones affected are my right ulna, left humorous, right femur, left foot and pelvic bone. It is stabbing, sometimes throbbing pain that can be very intense and then it just goes away. i had a terrible ear infection recently that took 6 weeks to heal. We finally figured out that the infection likely started in my in my mastoid bone. I was treated for mastoiditis and have no idea if that is related or not. I am a 37 year old female that is otherwise in good heath. I have 5 children and am very active. Two recent blood tests showed elevated bilirubin and blood in my urine but a liver work up showed nothing. That was about 10 months ago.We recently moved to a new state. The bone pain is getting worse and I would like to see a doctor. I am worried I may have bone cancer or something serious. I don t want to go into a new doctor and demand testing, but what is the best way for me to encourage my doctor to rule out anything serious?",
    "doctor_response": "Hi,Thanks for writing in.Bone cancer might involve any bone and rarely also affect multiple bones. The usual signs of bone cancer are swelling which is sudden in onset and rapidly progressive with pain in the region. Some bone cancers can also cause signs of inflammation in the region.Since you have been diagnosed to have mastoiditis therefore it is almost certain that your condition is infective in nature. Mastoiditis occurs due to chronic infection of the middle ear which involves the mastoid bone. Treat with medicines is recommended and in some patients surgical treatment is required and it is not a bone cancer.. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could pineal cyst be the cause for headaches and imbalance?\n\nIn 2010, I had a MRI of the brain with and without contrast and nothing abnormal. July of 2014, I had another MRI of the brain with and without contrast. The result was that I have a pineal cyst 6 mm. My neurologist and family doctor say in 6 months to do another MRI. However, I believe I need to be followed by a brain surgeon because I have some serious symptoms such as, legs becoming like jello after waking up from a nights sleep, so I fall to the floor because I feel nothing in my legs; I have headaches but to get rid of the headache is the struggle, but after a headache, my head is so sore and tender all over; I use to have 20/ 20 vision, know I wear glasses and the eye doctor says it is stigmatism; then i have fibromyalgia and focus, fatigue, steep, and blurry vision occurs daily. I have spinal issues (disc bulges, mild degenerative changes, a tiny posterior annular tear; mild bilateral hypertrophic degenerative facet changes, spinal canal stenosis. I weight 318 pounds, and I had the gastric bypass surgery of 8/2013. I have lost 115 pounds. Everything is worse, the pain and my thinking and thoughts are somewhat hard to get out. I have depression, anxiety, and short term memory loss. I meet with a spinal surgeon this Friday. I meet with a brain surgeon on 18th of aug. I am meeting with the surgeons for 2nd opinions because I need to know what my future goals could or need to be done. I want to live and I want to get better. All this stemmed from a car accident, other than the pineal cyst. My question is how do I decipher what symptoms go with what diagnosis because it appears that the same symptoms can either be from this illness and that illness? I done a lot of pineal cyst research, of what is out there.",
    "doctor_response": "I don't think the pineal cyst is responsible for your diagnosis. It's of a small size and there is no reason for it to cause any symptoms, pineal cysts are found by coincidence in many people. As you yourself said many of your other medical issues can cause overlapping symptoms and justify your complaints, but I don't think the pineal cyst has to with that and I agree with your neurologist's recommendation of leaving it as it is and have a control MRI, perhaps even later than 6 months, say in a year.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Upper abdominal pain, bloating, extreme burning sensation, vomiting, profuse sweating, have cold. What does this mean?\n\ni have been having pain and bloating in my upper stomach several times a week. extreme pain with these attacks. bloating, and extreme burning occur in the stomach. is only relieved by vomiting which occurs after suffering with nausea with this as well. i sweat from head to toe when these attacks occur, and have passed out with these attacks at times. i experience cold,and shake while attacks are occurring.",
    "doctor_response": "Hi thanks for your question.Most probably you are suffering from APD that is acid peptic disease.APD is due to increased acid output in the stomach due to variety of causes. Common being ,cigarette smoking ,alcohol, spicy foods and infection of stomach by a bacteria called as H Pylori.APD causes severe gastritis, that is inflammation of stomach, which give rise to burning pain abdomen, nausea and vomiting .The sweating after vomiting followed by cold and shivering is due to vagus stimulation, which occur due to vomiting and is normal physiological process. Stop any of above mentioned acid stimulant if you are using. You can take antacids, Proton pump, inhibitors like pantoprazole.Consultation with a physician is advisable who may be able to perform an upper G I endoscopy on you to determine cause of you symptoms and may prescribe you appropriate treatment. You may also need ultrasound abdomen to determine cause  of your symptomsHope this answers your question",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for carcinoma cancer\n\nMy dad is 70yrs, he has got carcinova cancer on naval cavity and he has given radiation of 30 sittings. I heard there is good medicines for cancer in sidha... I want to know how true is this and is it advisable to treat him with sidha in this age as he is  weak..",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  He has nasal cavity cancer.  Treatment depends on type and stage of cancer. In early stage surgery can be done to remove cancer tissue.  In later stage surgery will not helpful.  Radiotherapy or chemotherapy is the treatment of choice.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to deal with a person who is violent and angry due to cancer pain?\n\nhi my father law 82 has stage 4 cancer of the prostate ans he was in a lot of pain so the Dr put him on a fenal patch for pain he is acting very angry and iractional toward the family and is getting violent with us. what can we do to help him but keep are sanity.",
    "doctor_response": "Ok, first alert the doctor. There can be a large number of potential causes of that. The fentanyl can cause lack of oxygen and that is corectable. It can also directly cause changes in personality which reverse with lowering the dose of the fentanyl. Or it could be depression associated with having a painful fatal disease.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Entice be replaced with liv,52 HB for high SGPT?\n\ni am pesent of Hbsag -B My report of HBVDNA Virul load of 12 Cror,  i give tablet of Entica 0.5 ( Entecavir ) But Not Confidence. So please give Suggestion , It possible to Stop the Tablet of Entica  & Give  LIV 52 HB its  Better for Us Ple give Your Suggestion  ( My id   YYYY@YYYY  )  & making of Report of SGPT 55\"  Ple Help for That.",
    "doctor_response": "You should definitely continue with Entecavir. Please dont stop it as stopping it might cause a flare in your hepatitis. There is no evidence to use LIV 52 HB for the treatment of hepatitis B. Please consult a gastroenterologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe abdominal cramps and back pain after a Depo-Provera shot?\n\nI have been on the Depo shot for over a year now... I usually only spot, but I ve been bleeding off and on for the last 2 weeks and now I m having severe cramping and back pain that feels like someone is stabbing me in my lower back. Is there a possibility that I could be pregnant or could it be the depo not agreeing with my body anymore?",
    "doctor_response": "Hi, I think it can be a side effect of depo or it can be due to vaginal infection also. Do a urine pregnancy test at home to clear the doubt.  But pregnancy is very unlikely. Get yourself examined by a gynecologist.  you can take some medicines like Tranexamic acid to stop the bleeding. You may need some antibiotics.  Hope I have answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chronic abdominal pain after eating?\n\nSomeone I know has had severe chronic abdominal pain for the past 6 months or so. She is a vegetarian. Most every time she eats, she gets a sharp and very severe pain near her stomach area. Once the pain peaks, she usually vomits. We  have been to the emergency room before but they sent us away after giving her temporary medicine. What could possibly be wrong with her and what can I do to help?",
    "doctor_response": "Hi, Welcome to the HCMAs I have gone through the history , it might be gastric ulcer , which causes these kind of symptoms.My suggestion would be first get an endoscopy done to rule out any ulcer and then you may discuss with gastroentrologist .Unless it is diagnosed , avoid spicy and fried food and dining outside.Hope my answer will be helpfull.Regards, Dr.Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mild pelvietasia noticed on left kidney\n\ni was born with 1 kidney ...enlarged on the left side.last week  im experiencing urine incontinent..before i reached the bathroom..i already passed some urine..and i need to go to the bathroom at least 3 times in an hour to passed urine ...then finally  i  then i had a flank pain on the left that i decided to have a  renal ultrasound.the technician told me that i had a mild pelvietasia...official result will come out after 3 days..I had U & E...and my crea shows 85..my last urea taken last month was only 65.I only had one kidney...thats why im so concern for further distruction..How i would treat this mild pelvietesia and how do i take care of my kidney? thank you so much. Im 45 years old . Im 5'1 in height and weight 62kg.Im hypertensive taking daily hyazaar 50mg..and for my flank pain...i take 1 gram tablet of paracetamol..because i exeperience some chills and severing..even though i dont have fever.I came from a family who all died from hypertension...my dad died from heart attack and a diebetic.",
    "doctor_response": "Hello and welcome to HCM.As an Urologist, i can fully understand your concern.Many people are born with a single kidney, which doesn't cause any health problems, if it's normally functioning. It's usually slightly larger in size,compared to a normal kidney.You should get examined by an Urologist,urgently, as you've symptoms of left flank pain with chills,frequency, and have a family history of Diabetes,and are hypertensive.As your scan shows mild pelviectasia, You should get certain tests done, like 1.Blood routine,2.urine culture,3.FBS and HbA1C,4.CT-IVP.After showing the reports to Urologist,proper treatment will be started. Till reports come,you may start, Tablet Ciprofloxacin, twice daily,with the Paracetamol650mg,twice daily and 10-12 glasses water daily.You may send reports to me, as a direct question,for an expert opinion.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can formula feed be introduced in 3 weeks old baby?\n\nI have a 3weeks old baby who only feeds on breast milk. Am worried because she looks dehydrated, tiny and malnourished unlike when she was born. She cries often and seems not to be getting enough breast milk. What do I do, do I introduce formula feed.",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. You should be worried but not too much. You should introduce NaN or other if you would like and if baby don't gain weight. Start from 30 ml,add every  day 30 ml. Give 90-100ml for 1 feeding. You can give NaN 1-2 times .Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does it take to get pregnant after a miscarriage?\n\nHi, my name is Tracy. I have a 16 yrs old daughter and after several years of trying to have a child with my husband. I got pregnant and did not know and took a drug which caused miscarriage. Is it possible to get pregnant after a miscarriage??? And how long does it takes?",
    "doctor_response": "Hi Tracy,I'm sorry about your miscarriage.Yes, it is possible to get pregnant after miscarriage. How soon you get pregnant depends on your age, how soon you start ovulating. Some women get pregnant in the next cycle after miscarriage, some take a few months.If you are planning to get pregnant, start taking Folic acid and Vitamin B12 supplements.Hope I have answered your question!All the best!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, severe lower back pain since earlier delivery. In case of positive pregnancy how can the back pain be diagnosed?\n\nHello doctor. I am 34 years old , i have a 6 year old daughter. I am planning for the next child. After delivery since 6 years i am having back pain while doing any work for which i have to bend forward. Hence i used to just avoid to bend forward. But since last 5 days i am having extremely seviour lower back pain, i can t able to move also . I have to take pain killer pills to do my day to day work. Doctors prescribe me to do x-ray . But i have a doubt of pregnancy, so avoiding the x-ray and having the pain killer pills. My question is if i got +ve pregnancy, then how could i diagnosed my lower back pain , as i cannt do x-ray. please advice me. thanks minakshi",
    "doctor_response": "hi meena, first thing you need to do is confirm your pregnancy with urinary pregnancy test kit which is available over the counter on the pharmacy. Both x rays and painkillers could be harmful in pregnancy so you need to confirm the test before going for the same. In case if it is positive and you still want to continue it there investigation like MRI and few blood test like cbc, esr, sr calcium, sr vit d, to rule out sinificant causes of back which could affect you in the pregnancy. if your pregnancy test is negative then you  can go through all investigations as adviced by your orthopedic doctor before planning a pregnancy",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does possibly non-malignant lump on neck indicate?\n\nhi doc. i feel a lump on my neck.. First check up, ENT made an ultrasound to check if there is lump inside my throat, but nothing seen and prescribed to take clindamycin for a week, but i still feel the lump..I went to another doctor for a check, he prescribed to take clariget because during that time I have also sinusitis. Then after a week, i went back to the doctor because i still feel the lump, and  he advised me to undergone biopsy, the result is negative for malignancy..he just told me that this is due to inflammation....but a month after the biopsy, there still the lump..can anyone advise me what might be the problem? or to what specialist i need to go to check it up?? thanks.",
    "doctor_response": "Hi.Thanks for your query.I would have been happy to know whether you are a male or a female patient.Well the history is very typical and occurs usually in the female patients.Is there any history of ::-Pain-fever-difficulty in swallowing-You have not mentioned anything ike this , and if not present you need not worry.-Was there any incidence of any death in family or someone near and dear has a cancer ? If yes this may just be globus hystericus as you have already been seen by Doctors.I can set this as a diagnosis only after 2 tests - namely:-CT scan or MRI of the neck and whole pharynx-Endoscopy of the area to find out is there is any lump or not. If both the things are negative , please request your Doctors to add on a medicines for anxiety / depression.If there is a positive finding, get a reference of an Onco-surgeon for further management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes continuous ejaculation?\n\nDear Sir, I'm really very pleased to see u.I'm South Indian. I'm facing different penis problem.I have continuous ejaculation just little bit hot. For example, if i talk with my girlfriend normally, ejaculation is continuing. Now what can i do & what is the name of problem?",
    "doctor_response": "Hi, The ejaculation you are mentioning here is called being \"horny\". that is a normal sign and there is nothing to worry about it. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe hair loss\n\nDR, I am S.killivalavan, 29 years old. I am suffering from hair fall problem for the past 10 years. Now the number of hair falling is gradually increased and my forehead in clearly showing that i am on the way to baldness. what is the permanent cure . Is there any permanent cure? please let me know. Thank you.",
    "doctor_response": "Hello,Thank you for posting on HCM.I appreciate your concern regarding hair fall. Hair fall is usually ascribed to multiple factors like diet and nutrition, hormones, stress, cosmetic products etc.From your description, it seems you might be having Male pattern hair loss or Androgenteic alopecia, which is due to male hormone, testosterone. If i were your dermatologist/trichologist, i would like to take through history including family history, history of recent major trauma/illness/stress/medications etc, and recommend some basic investigations like CBC,blood sugar, Thyroid function test.There is only one permanent solution to androgenetic alopecia i.e Hair transplant. Other treatment options only work to give results as long as you use them.I would suggest you a course of oral tablets containing biotin and other essential vitamins and minerals for minimum 3-6 months. Also, would put you on solution containing 10% minoxidil once a day  and a hair serum containing peptides for hair growth at night.(Q sera etc). Finateride can be used in selected patients after thorough counselling and checking your liver function. Finasteride, inhibits metabolism of testosterone at hair root level. It sometime leads to embarrassing side effects like impotency, decrease in semen volume but which are totally reversible on stopping the drug.I would advise you use of gentle shampoo and conditioner on regular basis and use of coconut oil twice a week.Avoid combing in wet hair and let them dry by wrapping in towel. Avoid blow dryers and hair-color/dyes. Take plenty of fresh fruits and vegetables in your diet and try to de-stress your routine life.Hope your queries are resolved and wish you best of health.Thank youDr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain and shortness of breath\n\nI am 22. About 90 lbs. 5 1 . I have for awhile now have gotten chest pains on my left side. They come and go throughout the day lasting only a few seconds.I feel short of breath occasionally. Never cough (unless I have a cold). Sometimes my heart beats fast and I get dizzy when I stand I have had 4 migranes within the last month always with aura. I have smoked since I was about 15. Average 1/2 pack a day. I recently had EKG, Chest x-ray, blood work. All came back normal. But I am worried I have a heart disease or lung cancer. These are the only symptoms. I have had three children (2011, 2012, 2014) all healthy normal pregnancies. No other known health problems. Have generalized anxiety and bi-polar. Should I ask my dr about lung cancer because I smoke?",
    "doctor_response": "Hello dear, thanks for your question on HCM.In my opinion you should consult pulmonologist and get done PFT (pulmonary function test) to rule out bronchitis as it is common in smokers and cause similar symptoms.So get done PFT. It will also tell you about severity of the disease. And treatment is based on severity only. You may need inhaled bronchodilators too.And quit smoking as soon as possible as it will only harm you. If PFT is normal than mostly you are having anxiety only, because other investigations (blood report, chest x ray and ECG) are normal. So better to avoid stress and anxiety. Be relax and calm. Consult psychiatrist and try to discuss all your symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sore and painful hole above gum. Had sore throat. How to get relief?\n\nHow can I get relief from the sore spot - a small crater like hole above the teeth gum ? I have a sore spot in my far upper right gum (above the teeth gum.) I just discovered that its actually a small crater like hole. about the size of pen point. I ve had a sore throat for the 2 weeks especially at night and that spot has been very sore for about some days now,and also i am starting to feel pain there",
    "doctor_response": "hello and welcome to HCM forum, i would like to inform you that the pin point size hole is normally present on both the sides of your upper back teeth region, if pain and swelling are associated with it then it needs to be checked . In your case, i believe you will need to see an ENT specialist for sore throat. i advise you to perform warm saline rinses(3-4 times/day) for 3-5 days. if the problem does not resolve then kindly visit an ENT doctor. i hope i answered your query, i wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain and stiffness in knee post a knee replacement surgery\n\n5 weeks ago I had a knee replacement I am still experiencing pain and stiffness when should this subside. I am doing exercises 4 times a day, but not getting to the 90 degree . Should I be walking more to build strength. yesterday I stood for a length of time and feel like I lost any progress I have made. Help me to get on the right track karen",
    "doctor_response": "Brief Answer:Most likely require manipulation under anesthesia (MUA) by orthopedic surgeon.Detailed Answer:Warm Welcome. I appreciate your trust in HCM and assure you are on best portal on the globe for expert online medical services.I have thoroughly reviewed health query you raised, and well realize all of those concerns. Being your physician, I will take care all of them today and will extend my expertise to solve the problems.Painful stiffness after knee replacement is frustrating not only for patients but for us too. It is noted to be most common local complication after surgery. Usually the knee should gain its function by the end of 4th week. Based on what you said, you will most likely require manipulation under anesthesia by orthopedic surgeon. A revision surgery may also be planned instead but MUA has found to be most effective within first three months.You may take tab. naproxen 20mg once a day for your pain. Physiotherapy should be continued as advised and it is also mandatory after MUA.Hope I addressed all the concerns you have. Let me know if you have further questions. I will be more than happy to clear any doubts. Keep a follow up to see how you doing.Regards!Dr. Ali Raza",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe pain and infection in tooth\n\nI have infection in my tooth and it's giving me severe pain. My dentist prescribed me Clarithromycin (antibiotics) today and I have taken 2 pills today - one in morning and one in evening. But tooth pain is very severe and unbearable. Can I take tylenol (Acetaminophen 500 mg) to releive the tooth ache? Would it have any side effects with Clarithromycin.",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain in case if you have infection in tooth for which you have been advised antibiotic Clarithromycin it will resolve infection grdually but to relieve pain you need to take higher painkillers and you can although take Tylenol without any problem but it will resolve only mild pain..But in case if pain is severe you can take Tramadol or Ketorolac..Although it will resolve pain and gradually as the infection will reduce the pain will become less but it can be temporary and can relapse..So my advise would be to get an x ray done to rule out the exact cause of pain..In case if tooth can be saved you can get  root canal treatment done to get permanent relief..In case if tooth cannot be saved extraction is advisable..Hope this information helps..Thanks and regards..Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent cough ?\n\nI have a persistant cough for the past 3-4 months. I was tested and cleared of having whooping cough. I had other health problems in the past 6 months including a white tail spider bite, and a lump removed from my foot. My doctor said to come back if the cough did not clear but I am sick of taking antibiotics. What can be the cause of my cough. It keeps me awake at night.Regards Marie",
    "doctor_response": "Hello dear, thanks for your question on HCM.I can understand your situation and problem.You are having chronic cough, which is not responding to the antibiotics.So we need to rule out following possibilities.1. Chronic infection like tuberculosis2. Bronchitis.So better to consult pulmonologist and get done1. Chest x ray2. PFT (pulmonary function test).Chest x ray is needed to rule out infections like tuberculosis.PFT is needed to rule out bronchitis.So I advice you to first diagnose yourself and then start appropriate treatment.Haphazard use of antibiotics should be avoided as it can delay the recovery and increases drug resistance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can intense pain in the heels be treated?\n\nHello. I have intense pain in my heels.  I\u2019m on my feet all day long.  There are mornings it\u2019s sombad that I have to lean on furniture and such for help to walk to the bathroom. In an hour or so they feel better but. It great. By the end of the day 6/7 o clock they are killing me again. What do you think it is and how can I fix it",
    "doctor_response": "Hi, The symptoms are suggestive of plantar fasciitis. As a first line of management you can try analgesics like Diclofenac or Tramadol for pain relief. If pain persists, you have to consult an orthopedics and consider steroid injection which has got good results. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I take ovulation induction drugs to get pregnant ?\n\n29yrs,pcod,irregular periods, taken three month course for pcod after that two months past doctor take USG but not found any major follicle in this. now she recommened another three month course. what would you suggest? another doctor recommend ovulation induction drug i.e some clomipine type.?IS this safe for me i am confused .which doctor i had to follow? i want preg soon. if i choose induction drug method Is it solve my problem .otherwise one more month would be wasted.and then i have to follow three month course.",
    "doctor_response": "Hello Thanks for your query. PCOD causes sub-fertility ,not infertility ,so you can get pregnant. Do regular exercise ,aerobics,long walks , you have already taken the drugs for three months ,so go for  ovulation induction \u2018Hope I have answered your query well , I will be available to answer your follow up queries, \u201cWish you Good Health and trouble free speedy recovery\u201d",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child diagnosed with food allergies, stomach pain, nausea. What are the treatment options?\n\nI have a 4 yr old whoum wasnt diagnosed with so many food allergys till about 2 with many demanding cause theres a family history of digestive issues. his diet consists of fruit vegitables chicken soy or almond milk and neicate splash as a meal supliment..dispite staying away from other foods he still is sick. syptoms: stomach pain with nausia somtimes vomiting ..loss of color and lips turn white..lathargic and weak all this comes on with out warning is seconds & lasts about 20min somtimes on and off in a day",
    "doctor_response": "hello dear, your child must undergo few blood test regarding esinophil count and endoscopy for sure diagnosis.advised to consult pediatric gastroenterologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having loose motion as a side effect of Pantocid HP? How to stop it?\n\nHi doctor. I had Pantocid HP after doctor advice and had loose motion 4-5 times. For stopping loose motion what shall I do? For past six days I am taking Pantocid HP kit. No problem except loose motion of about 5-6 times and some weakness. I am taking Bifilac HP one tablet daily and a vitamin capsule. How long loose motion will happen as it is a 14 days course. I know this is a side effect. Can I take electrol powder (ORS) and coconut water? Should I follow any food restriction except spicy food?",
    "doctor_response": "Hi. I have seen your reports (attachment removed to protect patient identity). Pantocid HP kit contains Pantoprazole, Amoxicillin and Clarithromycin and is used in the treatment of gastritis by Helicobacter pylori bacteria. Pantoprazole reduces acid secretion while the other two kill bacteria. Loose motion is a common side effect of Amoxicillin and Clarithromycin. I will suggest you to take Bifilac (probiotic) 3 times a day. That may prevent loose motion from antibiotic and also to replenish your gut flora. Take this after consultation with your physician. You can take ORS (oral rehydration salt) and coconut water. I also suggest you to take Imosac M (combination of Loperamide Hydrochloride and Simethicone) and Racicadotril to stop loose motion till you consult your doctor. Avoid spicy food and take a light diet that your body can digest easily. For further information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Panic attacks post appendectomy. Marijuana smoker. On medication. Reason for panic disorder?\n\nHello, In October of 2002, I had a trans abdominal, left appendectomy. There was a tumor the size of a grapefruit engulfing the gland, so the gland had to be removed along with the tumor. Until recovery, I had never experienced anxiety or panic attacks, and I was an avid user of Marijuana and occasional user of psychedelics. In my entire life I had never had a panic attack or anxiety attack. After the surgery, I developed SEVERE panic disorder, but not until I stopped using the prescribed pain killers I was on. 11 hours to the hour of stopping my pain medication intake, I had my first post-surgical panic attack. It sent me to the hospital. I may point out that I may have had an adrenal spike 1 week into my 2 week surgery window, which ramped up my schedule by 1 week. I blacked out, and awoke several seconds later in convulsions,  making it very difficult to walk or even raise my arms, it was as if I had no strength at all. Yet, upon arriving at (yes, I went to the ER), they found nothing wrong with me. Then surgery, then recovery, which included an epidural and anesthesia, followed by an 8-day morphine drip (I had never been put under nor taken morphine), and then 1 month of Hydrocodone for pain. It was not until after stopping my Hydrocodone intake that I developed CONSTANT symptoms, that have not gone away to this day. After many trials of antidepressants, none of which alleviated symptoms, I was prescribed xanax, which works. I now take 4mg's a day to keep symptoms at bay. This has been my life for 11 years now. I am also a marijuana smoker, but I find it increasingly harder to smoke it as it now agitates my symtoms. Any ideas as to why the SUDDEN change from no history of symptoms, to surgery, to MASSIVE attacks? I am 6'6\" tall, no stranger to trauma, I have a strong stomach, Ive had multiple compound fractures with bone sticking out of my skin by inches and not been bothered by it. I am a lifelong martial artist, so why the flip? I do not believe this is a psychological condition but has definitely created psychological dependance on my 2 medications, xanax and metoprolol tartrate (beta blocker for tachycardia). Am I nuts or have I been miss-diagnosed? I may also point out that I have constant heart palpitations without the beta blocker. My surgeon suggested that I may have a damaged beta receptor on my heart. Funny, it was not there before, and upon consulti",
    "doctor_response": "You have mentioned your symptoms and clinical history in great detail. I understand that you developed panic attacks only after your surgery and not before that. Did you have abdominal cramps, churning sensations or diarrhoea as part of your panic attacks or did these occur even prior to the surgery? How was the tumour around your appendix suspected or why did you get investigated in the first place and how did the tumour come to be diagnosed? What symptoms did the tumour cause? I am asking these questions because there are certain rare tumours (carcinoid) that arise around the appendix and can cause panic attacks especially with abdominal symptoms and diarrhoea. The reason for your current symptoms can be:1) Use of alprazolam. Alprazolam is a wonderful drug for panic attacks. However, it is very short acting. Once its effects wear out after 4 to 6 hours, the panic attacks come back with even greater severity. This leads to an increasing use of alprazolam over the years. (You might have started with 0.25 to 0.5 mg per day and now you are using 4 mg). It does not help the root cause of panic attacks - which need other types of drugs. 2) A more serious concern however is you may be having some more tumours lurking in your body. The group of neuro-endocrine tumours are a set of rare tumours. They are usually small (I suggest you look back at the surgery notes and biopsy report of the surgery you have undergone and have a consultation with an endocrinologist to rule out this possibility. Meanwhile you can also consult a psychiatrist who will help you get off alprazolam with another drug that is easier to taper and stop. If the above medical possibilities and hyperthyroidism are ruled out by your endocrinologist, you may be having panic disorder which is a treatable condition.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from abdominal pain, vomiting and dizziness during pregnancy\n\nam pregnant and been having constant lower abdominal pain and constatly vomiting/nausia, constant dizzyness..for the past 2 weeks should i be consern and worried. i vomited one morning and there was a small trace of blood too. i havent gotten money to go get checked so am worried. what might i have and can it be dangerous.... am 18, female, my medical history that involves with this is: i have h-palorie virus(stomach virus) and ive had irregular menstrual periods and bad craps during my menstrual period. thats all i know about my medical history",
    "doctor_response": "Hello, Nausea,vomiting and dizziness is commonly seen in the first trimester.You may even have some cramps but you also need to be careful that you dont miscarry.You need to rest as much as possible,dont do heavy lifting.Any cramps increasing in intensity,you need to get an ultrasound asap.The H Pylori can cause some gastric irritation and you may have some flecks of blood in your vomit.But you need to see a doctor immediately if this occurs again.Any bleeding see a doctor immediately.You should get a full ante natal check up done if you havent already.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How reduce spinal pain after surgery?\n\nI am a 57 year old female with a history of four back surgeries including fusion in the L-5, L-6 area. After 3 surgeries, including the fusion surgery, I saw a spinal surgeon in the Twin a Cities who, following a discogram, said my problem was several tears in the disk above my fusion. He recommended fusing all my disks together. I m not sure I would have done that but it was a moot point as my insurance changed and that doctor is now out of my network. I returned to my regular surgeon who tried removing my rods from the fusion...which helped somewhat but my spine still hurts almost more than I can take...can you help me. My surgeon says everyone has these tears in their disks and that they shouldn t be the reason for my pain. He has left me high and dry! HELP",
    "doctor_response": "Hello!Welcome on Healthcaremagic!I understand how you feel and would recommend trying a medical treatment for the chronic management of your back pain. In this regard, I would recommend trying amitriptyline or pregabaline. Physiotherapy may also help improve your back pain and the movements of the spinal column. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could eye swelling and itching be due to allergies?\n\ni woke up this morning and my right eye is swollen and itchy but its not red or pink. i suffer from eye allergies but my lower eye lid has never swollen like it is now. i was wondering if it is my eye allergies or somehting else and what to do for it",
    "doctor_response": "HI, thanks for using healthcare magicAllergies would most commonly involve both eyes rather than just one but this can vary from one person to the next.\\Since it is itching, allergy is the most likely cause.The use of an oral anti histamine would help as would the use of a topical allergy drop to the eye.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for the habit of eating raw rice\n\nHi am rubi ,my bad habit is I used to eat raw rice always. Am 19 years old girl. I want to leave this bad habit. I can t tel to my parents about this. So what I have to do now. N what s the reason of am eating raw rice without washing it . Plz help me doctor",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much in this regard. Weird eating habits are common and this happens due to some nutritional imbalance of the body. If body needs some extra nutritients which it is starving for, you start craving for that nutrition. Salt eating, mud eating, kerosene, chocolate are some examples. In your case, eating raw rice is also common and most probably it is happening because of iron deficiency, Please consult your doctor for some iron supplement.Hope this answers your query. In case you require more of my assistance in this regard,  please post a direct query for me in this website. I am happy to help you.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for seizures\n\nMy sister-in-law had surgery on her back 4 weeks ago. She has been rushed back to the hospital with Seizures: her right arm shakes, her eyes roll back, she loses time does not remember having a termor/seizure and has to wait until she can speak again. Several visits later - the last one On friday , October 3rd , 2014 in which she had in front of the Dr. they got her to a neurologist & they did a weekend analysis (Head items on her head) and told her 4 = 6 weeks until results. They have no idea what is causing this and are not ready to say seizures and or termors at this point. Im very frightened for her,",
    "doctor_response": "I read your question carefully and I am sorry about the you sister in law's troubles.Seizures are not usually related to back issues. They can have many diverse causes like infections, stroke, brain tumor, metabolic alterations of blood and tissue components (electrolytes) etc. So many exams are often needed to find the cause the cause like head CT or MRI, EEG, blood tests, cerebrospinal fluid tests and according to their results the cause is treated. Of course seizure treatment can be started rightaway without waiting for the results of all the tests, there are many drugs available (valproic acid, carbamazepine, levetiracetam, phenytoin, etc) which I am sure the neurologist knows, but while they're important to control the current situation, to make a prediction about what to expect in the future depends on what the cause is which must be evaluated with the above mentioned tests.Hope things work out for the best. Don't hesitate to come back for further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Gums sore and bleeding, front tooth sore. Remedy?\n\nMy gums have been sore and bleedings when I brush them the past few days and for the past few months my front tooth will sort of feel a bit sore and I suppose it feel a little looser or something. It feels weird then I put direct pressure on it from the front but not the back. I don't know it actually feels loose or I am just thinking that.",
    "doctor_response": "Hi,From history it seems that you might be having acute gingivitis or developing Pyorrhea.Due to infection and infalmed gums, teeth become loose due to loosing support from gums.Consult Dentist and rule out pyorrhea.If gingivitis is there, with regular treatment with antibiotics you will be alright.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the extreme pain in the lower back?\n\nMy wife has lower back pain on the right side.  She says that it is a burning sensation.  It also causes her extreme pain when I gently stroke her skin.  There is no redness, swelling, or any other visible alterations.  What could it be and should she see a local doctor. (we don't have insurance)",
    "doctor_response": "Hi, welcome to our site. I am Dr Saumya Mittal, MD.Read your query. That is a very significant question and i appreciate your problem. I will try my best to answer your queryI think you need to see a doctor. Backache with hyperaesthesia (increased pain on touching) , means that there is some problem going on inside the back that may be affecting the nerves arising from the back. The compression of the nerves can cause severe pain, that often radiates to the lower limbs. Or may cause tingling or numbness.She may need an MRI and followed by physiotherapyI hope this helps you. Inform the reports mentioned above/if any other so I can be of help further. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you.Please do understand that some details could be extracted from a detailed history and examination.Please feel free to ask another query. I would be glad to help you. Looking forward to your return query with the details asked so that I can help you further. (If the answer has helped you, please indicate this)Best of luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Am i have klinefelter's syndrome?\n\nSir, I am a 19 year old male. My voice has been high-pitched since puberty, am 6 feet but very thin with negligible muscle, and also my body stores more mass around my hip region. I also have smaller penis.However, I have facial and body hair, good in studies and a good IQ. I also used to have nightfall and my sexuality is fine. But socially awkward.So sir do I have Klinefelter's syndrome? If so can testosterone therapy get me to a normal level??",
    "doctor_response": "Hi, No, these manifestations could all be normal and is not necessarily a genetic disorder. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Melek, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to make sure baby if unharmed after falling?\n\nMy 6 week old fell off the couch. After a few seconds of crying he started falling back asleep. I started feeling parts of him to see if he d react like he was injured but he didn t. He just went back to sleep. What else can I do to make sure he s ok? Is it ok for him to be sleeping now?",
    "doctor_response": "hi, in cases of head trauma there is high chances of brain injury. There are some symptoms which are found When brain injury occurs like persistent crying, seizues, persistent vomiting, bleeding from mouth or nose. If above symptoms are not present, then most of the times child does not have brain injury. However, it is better to get the child examined by a Neuro surgeon, and if required a CT scan of head should be done. I hope this will help you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "History of small bowel obstruction. Have CHF. Caused by soluble or insoluble fiber?\n\nI have had numerous episodes of small bowel obstruction which the doctors say is probably caused by ruptured appendix surgery when I was 3.  I am now in a 70's with CHF and would  like to know what type  of food I should be eating.  I have been told by every physician I have consulted that it  does not matter what I eat but I am sure it is related to the amount of fiber I consume.  Is soluble or insoluble fiber causing this ?  It seems to be related to fiber and I have tried to reduce my intake but it  is difficult since I am then prone to constipation and hemorrhoids.  Any advice would be appreciated. Thanks.",
    "doctor_response": "Hello,If it is a post surgical obstruction then it may due to adhesions in the lumen of the intestines.Fiber diet is very important in your age because it prevents constipation, hemorrhoids, hyperlipidemias, heart blocks and even colonic cancer.The only thing is that the diet should be easily digestible.So cook the fiber well(Vegetables, greens).Preferable you may take soluble fibers.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to reduce pain in my shin muscle\n\nmy shin muscles are paining n getting tightened if i do regular walking, im doing stretches n walking though its not helping giving icemassage evernight to releie pain its not working any special stretches or treatment for my shin muscle to walk longer distance without discomfort? my age is 30 male",
    "doctor_response": "Hello, I think you these are related to your shoe or footwear and the medium u walk. Correction of gait and also having flexible footwear should solve your problem. Your endurance levels look good by history only thing is troubling which I see is the footwear. Try walking barefoot and see if the pain comes. If pain doesn't come then your footwear has issues. And if comes then the foot muscles need some exercises. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can surgery for gallstone removal be done by general surgeon?\n\nhi, i am a diabetic type ll. I am having many other unrelated medical problems & my GP has not been helpful at all. I have had to appointments made by me to specialists in the areas I have problems with. I have to have gall bladder surgery for removal of gall stones & bladder, I have a 9.? x a 9.? cm ovarian cyst that requires surgery & a couple small things that need to be addressed & taken care of as well. My question is, do I get a general surgeon or do I get an OBGYN & an GI Dr. to try to take care of these 2 surgeries or do I get a general surgeron or do I need to push my GP into taking charge of this entirety?",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, actually this is surgical team work being done altogether if this work to be done for gall bladder, ovarian cyst, and this is the way things being done, hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes loneliness, tension, and laziness?\n\nI am 34 years o ii  ld .My problem is i cannot stay alone if my husband has to go on tour. I feel very lonely . I get very badly tensed if i have to do even a very simple work.I am completely not confident about myself.Ialways feel very lazy.I always want someone to be with me. what is my problem. please help me on what to do.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Loneliness is not only your problem. So many married women across the globe are troubled with it. Those without children feel the pinch more. Even those with children, feel loneliness when their children leaves for jobs. As this is very common among women, they themselves found the remedial measures according to their styles and attitudes. Someone prefers hobbies like rearing pets. gardening etc. Some people select jobs suitable for them. Some women learn some work at home like embroidery, painting etc. The decision is to be taken. IDLE MIND IS DEVIL'S WORKSHOP. You cannot leave it like that. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for knee pain?\n\nBoth my knees grind and pop and have sharp pain when walking up and down stairs.  Sometimes when walking my left knee feels as though it pops out of place and then back into place.  I can not do squats or lunges. I feel as though the cartlidge may be completely gone.  What are my options to fix my knees?",
    "doctor_response": "Hello,Since there is grinding and displacement of knee followed by relocation,it suggest-knee arthritis with ACL and medial meniscus tear.A MRI will \u00e7onform the findings.Line of treatment will be based on findings-if the tear is of grade 3/4 then a operation is required and with a tear of grade 1/2 conservative management with physiotherapy can be done.Till then you need to take rest and avoid movements at knee as it will further worsen the condition.A knee brace will prevent reccurent dislocation.Hot packs will reduce pain to some extendHope you find this helpfulThank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat Idiopathic thrombocytopenia with heavy bleeding?\n\nHi. i am 42 years old. and 2 years back after i stayed in hospital to help someone suffering from dengue.. i am having serious health concerns.. the heamo told me i have Idopathic thromocytopenia. Now since two months i have heavy bleeding..1st it started on 29th august ( after 1 month gap in july where i did not get periods) it was v heavy  and went on for 12 days until  i went to gyneac she gave me pause mf . again  the bleeding started on 22nd sept and is still going on. the dr told me to take harmone tab which i am very reluctant to do so.  but  i am at loss what should i do.. today i took pausemf again to stop bleeding. thou it is not very heavy. but still so many days .. i am worried.. what should i do. ?",
    "doctor_response": "hi, you may haveb itp plus some othe problem also. definitly you bleed more with itp. but itp bleeding generallly not stopped fully with pause mf tablets. for itp steroids or Iv Ig is required. moreover tell me what is your platelets count. so consult gynecologist to search cause of your heavy bleeding. if they find any other cause then take treatment of that. and if only itp i there then start treatment of that according to your doctors advice.thanks for using health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for breathing problem?\n\nHi My Mother is 57 years old and she has breathing problem i mean difficult breathing. Carried out some tests, in Renal function test Blood urea is 126 mg/dl and serum Creatinine is 2.1 mg/dl also Serum Electrolytes sodium is 118 mmol/L and Potassium is 6.9 mmol/L what i can do best plz help i am too much worried?",
    "doctor_response": "Thanks for your question on HCM. I can understand your mother 's situation and problem. By her reports, in my opinion she is having breathing difficulty due to renal (kidney) failure. All the reports, high urea, high creatinine, low sodium and high potassium, favour possibility of renal failure. In renal failure, ability of kidneys to excrete water and other harmful substance is reduced. So there is metabolic acidosis and fluid retention in the body. This fluid can accumulate in lungs and pleural cavity. These causes Pulmonary edema and pleural effusion respectively. Both these cause breathing difficulty. So better to consult nephrologist and start appropriate treatment for her renal failure. Hyperkalemia (high potassium) can be fatal due to cardiac side effects, so immediate treatment is required for this. Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking antibiotics for kidney infection. On microgynon. Taking a herbal supplement for stress. Will it affect the pill?\n\nHi I currently take Microgynon 30 contraceptive and have recently had a short curse of anti biotics for a kidney infection would this affect my pill as the doctor did not mention it? Also i have just started taking a herbal remedy called kalms as I was feeling stressed at work I have been taking them for 3 days, will these affect my pill?",
    "doctor_response": "Your pills are not likely to get affected ,however your kineys may get affected adversely by herbal remedy.Suggest you stop taking this & start a homeopathic drug for stress after consulting a homeopath.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can abdominal bloating along with nausea and stomach ache be treated?\n\nMy wife has been sick to her stomach for a few days. Her abdomen seems very swollen. She is feels very full, making it difficult to breathe. Some nausea, She doesn't want to eat because it make her stomach hurt. Very concerned. She is 70, recently treated for bronchitis antibiotics and prednisone, also taking albuterol from a nebulizer or inhaler. Her abdomen is very swollen, looks like she did when pregnant many years ago. Any suggestions?",
    "doctor_response": "Hello,Take her to the emergency room, as swollen abdomen is making breathing difficult, indicating urgent clinical evaluation, examination, and investigations like X-ray of abdomen and chest, ultrasonography, and tests of blood, urine, and stool. This may be due to the intestinal obstruction which may need urgent surgical intervention, to release the problem and/or get further investigations like CT scan of abdomen, colonoscopy, and biopsy to know further diagnosis like ruling out colon cancer and get treated accordingly. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. T Chandrakant",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for blocked tubes in kidney\n\nI AM FROM SRI LANKA AND HAD CHECK UPS AT YOUR APPOLO SEVERAL TIMES.BUT MY PROBLEM IS REGADING ONE OF MY GOOD FRIEND WHO IS HAVING SOME URINARY PROBLEM THAT IS THE TUBES BETWEEN KIDNEYS AND BLADDER ARE BLOCKED.HERE FOR TEMPARALIY A DEVICE HAVE PUT INSIDE AND TEST ARE BEING DONE TO FIND OUT THE REAL COURSE. BUT I AM NOT SATSFIED WITH THESE AS I KNOW SEVERAL MESSED UPS. PLEASE ADVICE ME",
    "doctor_response": "HiFrom the information provided I understand your friend has had stents placed in the ureters. He will need further tests to find out the cause including CT/MRI of abdomen and he might need ureteroscopy which is camera inspection of the ureters. Unless we look at your old records and scans done previously we cannot comment on it futher.There are multiple causes for the blockage including stones, blockage by birth called PUJ obstruction, growth within your abdomen or growth within the ureters, scar from previous operations, etc.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain with gas problem\n\nGood morning. My boyfriend is experiencing stabbing chest pain on his left side. He is under 25yrs and an everyday smoker. Besides his smoking he is a well nourished adult. He joggs at the park occasionally and is usually pretty active. He kind of wolfs down his meals. I told him he may be experiencing some gas issues. However we are not sure.",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your boyfriend 's situation and problem. In my opinion, he is having GERD (gastroesophageal reflux disease) due to smoking and poor eating habits. But better to rule out cardiac cause first for his left sided chest pain. So get done ecg. If ecg is normal then no need to worry for cardiac cause. He is having GERD mostly. It is due to laxity of gastroesophageal sphincter. Because of this, the acid of the stomach tends to come up in the esophagus and cause the symptoms of burning and stabing chest pain. Smoking further damages the sphincter. So first of all ask him to quit smoking. Avoid stress and tension. Avoid hot and spicy food. Avoid large meals, instead take frequent small meals. Start proton pump inhibitors. Don't worry, he will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chronic back pain?\n\nHi , I m 32 year old a girl . I am not married and I never have any sexual relationship in my life. I am a virgin .  I have a chronic back pain for ten years  and my Orthopedic doctor told me that the pain can be caused by Pelvic Congestion and it can be treated by making a massage for the private sensitive area the genital area, \"the Pubic\", specifically \u200b\u200bthe Clitoris as a remedy for the congestion.He said that this way is a medical scientific treatment for pelvic congestion?? Is this true?? Sorry for asking this embarrassing question but I do not know if what he is saying is right or not ?? I hope that I find your reassuring answer . Thanks",
    "doctor_response": "Hi,Thanks for your query. After going through your query I came to know that you have chronic bachache . Your orthopedic surgeon has said pelvic congestion as a cause of it  and suggested massage private sensitive part specially clitoris as a remedy for it.I have not knowing  as per my medical knowledge such treatment. May be your doctor true. But I have heard many community person whenever a young girl has constant backache, suggesting marriage as a solution. You can discuss with your treating Doctor about it. I do hope that you have found something helpful. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have anger outbursts, pulls hair from head and is suspicious. On medication. Alternate treatment?\n\nHi! I have a friend who is a mother of 2 & had been physically abused by her mum since she was a baby. This friend has been pulling her hair (literally) from her head, brows, lashes & has anger outbursts, is suspicious, fears her husband will leave her etc. She was prescribed Citanew 10mg, Tryptinol 25mg for a week & then 50 mg after that & Tab Dosik 1.5mg. She says that she is not functional now & is always sleepy. Is there something that can be done for her without the meds or should there be other help along with the meds?",
    "doctor_response": "Hi there, thanks for asking. Pulling hair from the head and eyebrow is called trichotillomania and it is often accompanied with anger bursts as you mentioned. Citanew and Dosik are good medications for such a condition which are commonly prescribed by doctors. I am sure that her doctor has prescribed Tryptonil for a special reason. In most of the time it can cause sleepiness during the day, since it remains in the body for long hours. She can talk about this issue with her doctor and she may decrease or discontinue Tryptonil to see if her sleepiness is improved. Her condition may become quite satisfactory after several weeks with just Citanew and Dosik. The response time for trichotillomania (pulling hair) and its related symptoms is longer than depression and is almost like the time needed for obsessive compulsive disorder (about eight weeks). I wish the best health for her.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there pregnancy chances with non penetrative sex?\n\nhey there m a medical student me and my girl friend had sex 15 days ago we did not have intercourse i just fingered her but wat i thought is that my finger was not wet with sperm i m so confused i didnot penetrate it my finger just reached clitorius is there any possibilty of fretilization??",
    "doctor_response": "Hi, I think there is a little chance of pregnancy if semen has come in contact with vagina because sperms can swim up until the uterus. So, if her periods get delayed, do a urine pregnancy test.  If positive consult a doctor if you don't want pregnancy.  If negative wait for your periods.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes random rise in WBC levels?\n\nMy mom is loosing weight 8 9 lbs in 6 months, loss of appetite also. Her cbc was normal 7 days back but 4 days back wbc was 17000 and 2 days back it was 15000. No fever no signs of infection, what could it be? How can one s wbc increase within 1 week?Worried!",
    "doctor_response": "Hello,I understand your concern.I am Dr Arun Tank, Infectious diseases specialists, responding to you.There are many causes of rise in WBC count. Infection is one amongst them. There is possibility of leukaemia also.I suggest you to keep continuous watch over WBC count. If you feel feverish or some kind or infection related immediately contact the nearby doctor. At this phase nothing more is required.I will be glad to answer your further query. Thank you for your contact to health care magic.Wish you a best health.Thank you,Dr Arun Tank.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling at the site of circumcision\n\nHi Doctor.. I had my circumscion done in 3days now..the swelling is getting worse everyday..there was some bleeding on the surgerated area on my right side..I ve washed it accordingly to how they instructed me..I have no antibiotics at all..they didn t give me any at the hospital where i was circumsiced..I went for check up today and they told me that I must wear shortpens or jockeys and my penis must always look up at all times.. 3days after i removed the bandage I noticed some swelling but it doesn t hurt that much..and I dont have trouble Irinating...what I do need to know thou is how long will it take for the swelling to go away and what procedures must I follow??",
    "doctor_response": "Hi thank you for querry.As you mentioned you are worry about your inflamation on circumcision site.its better to start local antibiotic cream like polyfax skin ointment twice per day to prevent infection amd swelling.Follow up with your dr after 1 week.Hope the answer will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does sensation in one side of brain with making sounds in sleep imply?\n\nHello. I fee burning (warm) sensation in the left side of the brain with nick stiffness. Also Yesterday I walk up speaking jeberesh (sounds not words) not sure if there is an correlation. Could you please help me decide if there is something to be concerned about?",
    "doctor_response": "Hello. I have been through your question and understand your concern.According to my point of view  you are experiencing some episodes of confusional state. It has many causes with most of them being benign but you should see your GP to start at least with a complete blood count and have you have a objective exam.As I said these are generally benign situation and you should not worry, but neither you should neglect this.Hope this helps. Please feel free using HCM again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having abdominal pain?\n\nThe past 3 days my son who is 9 has complained of abdominal pain. No  fever, no constipation, no diarrhea. He's been ok most of the day and now back to hurting. I have gave him chewable peptones tabs and he seems to feel better when he passes gas, but then he's hurting again but he's going to the restroom fine. What can b wrong?",
    "doctor_response": "NamastheWelcome to Healthcare-MagicGreetings of the dayTwo most common cause for pain in children are1. Constipation2. Worm infestationGiving him Bisacodyl suppository and deworming him with albendazole will give him much needed relief.Hyoscine Butyl bromide which is antispasmodic will also provide him much needed relief.In case you need any further assistance, will be glad to assist you.Wishing you happy and healthy lifeTake CareBest RegardsDr T Shobha DeepakMBBS,MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does robaxin 5oomg help in feet pain?\n\nlast 2 weeks I have mild (tolerable) pin pricking pain below my toe ( not the heel part) on both my feet. I stand 5-6 hours a day at work and it does not help. I am not diabetic and I am 60 years old,male. No other symptoms. I had 2 robaxin 5oo mg left from my back pain (2 years ago) and I took 250 mg twice a day for 2 days and for 3-4 days I did not have any pain at all?????",
    "doctor_response": "hi,Thanks for providing the brief history of youSince you mentioned your symptoms you have and you have to stand for 5-6 hours a day, also you tried self medication which didnt work.What it looks like to me is the nerve getting irritated at the lower spine region for which you are feeling this symptoms of pin pricking. And also you had the back pain issue in the past as well which is making me think this.Since the symptoms are not to big and tolerable for you, i think you can be fine with some exercises for which you can meet a physical therapist and learn from him.Or either you can do some exercises for strengthening the core and the spinal muscles. by this the symptoms should stop.Also, whenever the smallest things starts from the spine, one should keep continuing the core strengthening and spine strengthening exercises for long term to avoid major injuries.feel free for any more queriesRegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and weakness?\n\nMy grandmother feels weak and dizzy every morning. She is not a diabetic. We have taken her to the hospital four times. I had them take her off her lisinopril for fainting. She is on ASA,MVI,Metoprolol ER,Prevacid,Evista,Levothyroxine,statin,recently put on celexa and sinemet(for shaking). I think parkinsons or other medication causing problems. I asked for a holter monitor. They ran every test available(EEG,CT,ECHO,TILT TEST,ALL LABS,A1C AND ENDOCRINE(ALSO PER MY REQUEST). Then the rest of the day she is fine.",
    "doctor_response": "Hi, I agree with you that one of the medicines may be causing these side effects, as all her tests have come out as normal. Try stopping Sinemet and see if she feels better. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sudhir Kumar, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes flank pain?\n\nI have had right flank pain for over a year now. I have ruled out kidneys and ovaries, but the pain is pretty much consistent and comes like contractions. I use a heating pad just to ease the pain, not really easing just more manageable at times. What other areas should i consider looking for relief and answers to this pain?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Flank pain could be due chronic pancreatitis, chronic cholecystitis, inflammatory bowel disease.Get a CT scan abdomen which will diagnose most organ pathology. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am gay but want to be straight. Please guide me.\n\nHi doctor, I am a 29-year-old male, working in IT firm. From my childhood, I am very soft and gentle. When I was 12, I fell in love with a girl. But, she changed schools. So, when I was 15, I started having sex with boys. After she left, I felt love towards boys and was sexually attracted to boys. I do not feel anything even if I see a girl in nude. I used to masturbate twice a week, by thinking about males. If I see a girl's nude picture I am not feeling anything. I am not a smoker or drinker. So, I think I am gay, but I do not want to be a gay. I want a straight man's life. I wanna be a manly man. I should feel sexually attracted to girls. Help me take a good path in life.",
    "doctor_response": "Hello. I completely understand that you feel concerned about your altered sexual preferences. It is generally due to past negative experiences in life as you mentioned about the early sexual interactions with the same gender partners. Since your first early interactions were with the same gender, it usually becomes a habit or the sexual preference/ orientation. Are you currently engaged in homosexual activities? It becomes difficult to alter your sexual preference if you are engaged in sexual activities with the same sex. Since you are highly motivated to make changes in your sexual preferences, it is the first step towards betterment. Intentionally involve yourself in activities which would help you find interest in opposite gender. For example, Intentionally avoid sexual interaction with the same gender so that your sexual needs find satisfaction with the opposite gender. You may feel disturbed as you do it. Learn to deal with your emotions and state of mind. Suggest positive affirmations for you at the time of disturbance such as I am doing it because I want a straight man's life, I choose to be sexually attracted towards girls, and I like to be a heterosexual (opposite sex) partner. These are instances from what you have already mentioned. Find more positive affirmations for you which will help you become what you want. Make these affirmations a routine in your self-talk. Practicing it daily will gradually make it automatic in your mind, and your brain will start working on the way you want it to be. I hope this is helpful for you. Best Regards. For more information consult a psychologist counsellor online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of fever?\n\nhi doc my son was having fever & loose motions from last sat ,it persisted for 3 days after which we did cbc as per doc advice.doc had also given some medicines for same as per cbc typhi o figure is 1:160, others are negative, his fever has subsided & he looks ok do we need to worry about this pl reply to YYYY@YYYY",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern looking to the history given here I could say that if this was the typhoid fever as detected in the blood test and given a right treatment and patients became afebrile and asymptomatic the no need to worry about this, every thing would be fine soon take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My crossed eye treatment was not a success. Can I get the surgery done again?\n\nHi doctor,I have crossed eyes since my birth. I got operated 4 years ago, but the problem was still there. I mean the operation was not 100% successful. Can I redo the procedure?",
    "doctor_response": "Hi. Revert back with the answers to the above questions to an eye care ophthalmologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause of numbness in hand and arm after drinking alcohol?\n\nIm very concerned....i am experiencing numbness in my left hand and arm. A little bit in my face as well. I did consume alcohol last night....this.also occurred the last time i had alcohol. Never before has this happened though, even though i have drank on & off for over 7 years. Please help!",
    "doctor_response": "Hello,I am Dr Mittal.I have read your message.I think I can help you.This may definitely be a neuropathy.Many compression neuropathies occur like this, especially under the influence of alcohol. You need to test an NCV or nerve conduction study of both the upper limbs and face.This can be done at most hospitals where there is a neurologist available. If found to be present, you will need to get admitted to the hospital for treatment with injectible steroids, pregabalin and other supportive care inclusive of physiotherapy. I have tried to make it as simple as possible. Feel free to contact me for any further clarification.Best of luck,Dr Saumya Mittal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hives or allergy of a 5 yrs child, kindly suggest\n\nHelp Please. My 5 yr old broke out in hives for the first time 11 days ago, they seem to get worst rather then better. she has them in most of her body including swelling of hands, fingers, toes, lips, and around eyes. They eventually fade away and appear in different areas almost immediately. She took oral steroids for 6 days, and steroid shot 3 days ago. She takes benadryl , zyrtec, advair, and singular every day. She is asthmatic & allergic to milk protein & soy. She had a piece of pizza the day she broke out, but the doctor believed she had overcome the allergy since she was born. So I gave her milk products gradually. Can that cause hives for this long? Could she possibly be allergic to something else? Her hive are horrible even in her private areas and itch very much so. Please help...",
    "doctor_response": "Dear Mirna ji In all such cases the cause of allergy can be external or internal. You have noticed external causes as allergic to milk products or soya but rule out internal causes where intestinal worms are major factor. Get her stools examined. Increase the immunity of the baby to prevent recurrent attacks with Swamla i tsf bd. to cure hives Ayurveda offers cure with Haridra khand 250 mg. and tab . gandhak rasayan 1 bd.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of spasms going from rib cage down to the hip,can it be due to some problem with an organ?\n\nI am having spasms on my midsection below my right side rib cage down to my hip on my right side. It catches me so severely to make me wince and cry out. I have to catch it and bend. I wonder if it is a muscle problem? This is the second time in the last month that it has happened. I have taken pain relievers to make it subside a little. I hope it is not a problem with any organ.",
    "doctor_response": "Hi you have spasms on your mid section below rib down to hip on (R) Side .the pain is severe and you have to take painkillers for it to subside. In my opinion this kind of pain originates on having stones in kidneys or ureter and the pain in this is spasmodic and very severe. I suggest you take plenty of water , anti spasmodic medicines and get an ultrasound of abdomen to diagnose stones.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shingles\n\nMy doctor has diagnosed me with shingles. Do I need to quarantine myself from everyone? I only have a rash on the left side of my forehead and no blisters. The rash first occurred last Friday. I have been taking Panadol for the pain but today the pain is very mild and I dont feel the need for pain relief.",
    "doctor_response": "Your question is shingles transmittable? To those you have never had chicken pox they can become infected with the virus from the blisters. If you keep the area covered and do not let susceptible people contact the bandages or clothing you do not need to isolate yourself.I hope this answers your question. if you have any further questions please contact us again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump at the base of my shaft\n\nHello, i noticed a kind of lump at the base of my shaft where it meets up with my scrotum, its under the skin and you cant see it. the thing is i can ONLY feel it when i have an erection. and im not sure if it was there before. is this something i have to look up ?",
    "doctor_response": "Hello...The site u mentioned is a quite unusual site for any lump... it may be sebaceous cyst....U can consult family doctor for check up for confirmation",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump in the elbow\n\nHi, I have two lumps on my right ulna near the elbow. They re hard and painful if a lot of pressure is applied. Otherwise, I have a dull ache that never goes away. Other symptoms that I ve noticed are feeling chilled and having a bad Kung infection that is really hanging on. I ve also had little interest in food which is unusual for me. Should I be concerned? What type of doctor should I see?",
    "doctor_response": "it is possibly a benign lump like lipoma or neurofibroma not to worry much!in worse case it could be some parasitic cyst also!please consult a general surgeon if you wish to remove it.all the best.........",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure catarrh in throat and white coat on tongue ?\n\nI have cattarrh in the throat and my tongue has a white coating that comes off and does not hurt and feels like mucus is there any way to solve the problem as it has been a while?",
    "doctor_response": "alex this could be due to chronic common  cold, if you have cold for long better to consult ENT doctor. for time being you can do steam inhalation with tincture benzoin to limit the problem",
    "dialogue_context": ""
  },
  {
    "patient_message": "Histroy of ruptured brain aneurysm. Life expectancy?\n\nI suffered a ruptured brain aneurysm 10 years ago.  I returned to work after about 6 months and had no deficits.  I also quit smoking at the same time.  I just lost my job and I'm trying to get health insurance.  I was denied due to the aneurysm.  I'm wondering now what the insurance companies use as far as life expectancy after an aneurysm and what medical studies they use?",
    "doctor_response": "Hi,Thank you for posting your query.If the aneurysm was treated (clipping or coiling) and the aneurysm got obliterated, as checked by an angiogram, you could expect an almost normal life span.However, if it was not treated, the risk of re-rupture is about 2% per year, which could reduce the life span. Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can lower back pain be treated?\n\nHello, I have been having back problems for years now and i have tried EVERYTHING, doctor put me through therapy and also gave me muscle relaxers and they dont help at all, also gave me 10m oxicodene and that doesnt help just put me to sleep. Is there anything else i can do or take. The pain is in my lower back and at night when trying to sleep it all in the middle? Please help",
    "doctor_response": "Consult a spine surgeon for diagnosis.a physical examination and MRI scan are required to evaluate pathology before specific treatment is givenUse spinal brace for lower back,avoid heavy objects lifting",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will taking Potassium chloride be safe for controlling BP?\n\nI live in Canada - a recent blood test reveals I m borderline in my potassium level 3.3 (range 3.3 - 5.1) I m a senior 79 years old - only medication is a water pill 2.5mg daily for blood pressure problem - last reading 130/78 and an adult coated aspirin 81mg taken daily. My doctor has suggested I take 1 x APO-K - Potassium Chloride - Slow-Release 600mg tablet daily - I would like your opinion.",
    "doctor_response": "HI,  thanks for using healthcare magicThe potassium level is just within range. It is possible that it may remain in this normal range but with the use of the diuretic (the water pill that you mentioned), it may go below normal.You can consider the use of the  potassium replacement therapy but  it may not need to be taken daily eg alternate days may be enough.Your doctor should also monitor potassium to make sure it does not go above the upper limit.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having asthma. Feels like having hives, bronchitis. Using nebulizer and inhaler. Any home remedies?\n\nI think I have hives from taking hydrocodone . I didn t notice really until after I had stopped taking them. How long after taking the rx do they normally appear and how long normally to go away. Is there anything I can take to speed it up. Also I have asthma and have felt like bronchitus was coming on. I have need to use my nebulizer and my inhaler alot. Today is better but still nasty. What can I do at home or over the counter?",
    "doctor_response": "Stop taking the products you seem to increase allergies After leaving it take 3 week to subside Stop taking milk and diary as it increases the mucus stop taking mustard coconut walnut ground nut almonds and soya oils use olive for cooking and application",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for vomiting in a child\n\n7 year old son has been throwing up at night on and off for a few months now. Once he has thrown up, he goes back to sleep and is fine. He was put on a once a day fibre in a glass of juice close to a year ago now, because he was badly constipated. Should I be taking him in to see the Dr.?",
    "doctor_response": "Thanks for consulting at Healthcare Magic.An overdose of fiber supplements can provoke nausea and vomiting. These symptoms may indicate a fiber blockage in your intestines. A ball of the supplement, called a bezoar, may form in stomach and provoke nausea and vomiting. A fiber bezoar is most likely to form if children do not drink enough water when taking fiber supplements. Slow gastric emptying increases the risk of forming a fiber bezoar. Since your son is suffering from these complaints since few months, I would suggest you to consult pediatrician for detailed clinical evaluation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to extract wisdom tooth when on Orencia?\n\nHave RA..take Orencia infusion. Last infusion was June 12th..is it okay to have my wisdom teeth extracted tomorrow? What do I need to do or what exactly should I tell dentist.  What are the risks?  I was scheduled for another monthly infusion but I waited.",
    "doctor_response": "Yes it is safe for you to go for a wisdom tooth extraction. Just inform the dentist that you are taking medicines for arthritis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the esr reading in my report indicate?\n\nMy CRP Cardio is 20.5 with an ESR reading of 22. However, my concern is heart attack, stroke, or heart disease. I do have Diabetes type 2, and high blood pressure. In addition, I take atenolol for my arrhythmias. My previous blood test showed a WBC count of 16,000, abs Neutrophils of 10.7, and the abs Lymphocytes at 4200. I\u2019m trying to figure out if this is a serious cardiac problem or an inflammation in the cardiac region.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. No need to worry for heart diseases or heart inflammation. Your raised ESR (erythrocyte sedimentation rate) is mostly due to elevated WBC (white blood cells) count. In WBC s, you are having neutrophilia, this suggests bacterial infection in th body. This infection is the reason for your elevated ESR. Since you are diabetic, we should rule out urine infection, lung infection and abdominal infection first. So consult doctor and get done clinical examination, urine microscopic examination, chest x ray and ultrasound examination of abdomen to rule out common infection in the body. Nothing to worry about cardiac inflammation. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of oral cancer?\n\nHi My name is abhijit and am from India. I have a mouth ulcer inside my cheeks, close to my upper right cheek. It looks like a slight hardedned layer which does not pain. The ulcer has been there for 3-4 weeks now, i have also visited my office doctor and another physician, they had put me on to folic acid and vitamin b12 tablets and it turned out i have vitamin b12 deficiency my readings show below 159 and the average is between 230 and 900. After it was diagnosed i have been taking b12 shots, have been told to take 5 continous shots and after that once a week for 5 weeks. The ulcer remains the same and also I have a soreness in my cheeks on the same side, it feels like a set of hard lines on the inside of teh cheeks. I used to smoke earlier but 1-2 cigarettes a day, i have quit since a month. I had even spoken to the doctors about oral cancer, they ruled it out saying its a zinc, iron/b12 vitamin deficiency. Can you help me out with what it could be as am in a lot of stress and keep thinking about this..",
    "doctor_response": "Hi,Thanks for writing in.The symptoms of oral cancer includes the followingWound in the mouth that doesn't heal.Swelling, lump or thickening of the skin or lining of your mouth.Presence of white or reddish patch on the inside of your mouth.Loosening of teeth.Poorly fitting dentures if you wear it.Tongue pain.Pain in the jaws with inability to open the mouth without discomfortDifficulty or pain during chewing.If a doctor has examined the mouth ulcer you have been having for 3 to 4 weeks and diagnosed it as a vitamin deficiency feature then you should take medicines and get your condition reviewed. The ulcer might take sometime to heal. Stress can also cause ulcer.Please be relaxed and take medicine and observe for healing changes in the ulcer. If the ulcer remains unchanged over a month then your doctor might refer you to a specialist for evaluation and diagnosis. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do I get some weird thoughts and numb feeling?\n\nHi doctor, Nine months before, I had to break up with my mom's house. Then, I found that she passed away. Since then, I am really numb without any feelings. I have been crying non-stop for her, because she was my best friend as well. Also, I am not able to explain my feeling. In the past one and a half weeks, I am constantly getting angry, snapping at my children and partner and feeling very on edge. I cannot stand any noise and I have all weird thoughts in my head. One, for instance, I cannot get into the car unless I can see the air bag sign as I am scared that we are going to crash. If my kids or partner goes out, I always think something bad is going to happen to them. Also, I am unable to go out alone. I could not answer the door or eat or sleep. I just do not know what to do anymore. I do not want to go to a general practitioner as they think I look like an idiot for saying all of the above. What can I do now? Please help me.",
    "doctor_response": "Hi. I can understand your feeling. Please do not worry and do not scare about your symptoms. For further information consult a psychologist counsellor online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dizziness, headache and fluctuating heart rate\n\nI have been feeling very ill for sometime now I have had out of control blood pressure high and low dizziness dehydration headache heart rate problems sitting up iam dizzy standing iam dizzy I have pressure in my eyes and head I have been to the er 5 times my family doctor is not doing anything",
    "doctor_response": "Hi,I can understand your concern.I want to know 1) Your Age.2) Any associated diabetes, blood pressure or cholesterol problem, heart disease.3) Current medicines if any.4) Habits like smoking, alcohol, any substance abuse.Your problem may be due to-1) Cardiac arrhythmias abnormal electrical activity of heart.2) Postural Hypotension (Blood pressure drop in response to standing)3) Decreased blood supply to brain either due to heart problem or blockages in brain arteries.4) Effect of some drugs are you taking if any.You should consult cardiologist.There is need for 1) Clinical examination, assessment of hydration.2) Check blood pressure for any postural drop.3) Detailed neurological examination.Depending on it there may be need of 1) ECG, Holter's monitoring, Electrophysiological study of heart, 2DEcho of heart.2) Blood test like CBC, Kidney and liver function test, serum electrolytes.3) Thyroid function test.4) Brain imaging like CT or MRI of brain with angiography.Till that time maintain adequate hydration, avoid staying alone.Hope I have answered your question.If so do vote.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for itchy palate\n\nFor the last two days the inside of my mouth has been itching. It started on upper roof of mouth near the hard palate I have not eating anything hot or spicy or any citric fruits. Now I'm having a issue with my tongue irritating and my upper lips is very chapped it looks like a rash but not signs of sores. What could it be?",
    "doctor_response": "Hello,You may have an oral fungal infection. Try some acidophilus and continue to avoid acidic and spicy foods. Rinse your mouth with warm salt water to soothe and cleanse. If you do not get relief or feel your condition is worse, see your dentist for an evaluation. A prescription anti fungal medication, Nystatin, may be required to treat a yeast infection. Other possibilities include viral infections will take time to heal. You should continue to avoid all irritants including smoking and alcohol.Consider your sleeping habits and congestion causing you to breath through your mouth. Any sinus concerns? This can dry out you palate and cause dry lips. Keep well hydrated.Any recent food changes? An allergic response could be responsible for this condition. Antihistamines can offer relief. Itching can be treated with Benadryl. I hope that my suggestions are helpful. Thank you for your inquiry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe tailbone pain\n\nI recently did something stupid with my grandkids. I took a ride down the stairs and my tailbone has been killing me. The last few days it has started really hurting in a in a v shape on both hips,lower back. Is anything I can do for the pain until I call my doctor next week",
    "doctor_response": "As you alluded to, you appear to have bruised your tailbone, or \"coccyx.\" The first thing to do is to apply ice, in this case by sitting on an ice pack, 20 minutes on, 20 minutes off, as often as you can. This will reduce inflammation, and will help numb the pain. Additionally, topical anti-inflammatory creams, such as Aspercreme, will help with pain. Finally, Naproxen/Alleve by mouth twice per day with food can help greatly with inflammation and pain. You will also need to find a good cushion or pillow to sit on for cushioning.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain due to appendix infection. Surgery scheduled. What would be the cost?\n\nDear sir one of my relation she was suffering from stomach pain, so we consuled a doctor near by our area and took a scan, and it appears staing stage appendix, doctor said surgery is needed to remove apendix, sir please can i know what is the details of it and main thing i want to know how much it will be cost for surgery?",
    "doctor_response": "hello , welcome to hcmagic well mohan, appendectomy is the surgical removal of the appendix,a piece of intestinal remant,which is non functional in humans. When an appendix is removed laparoscopically, it only needs 3 holes to put in abdomen.Surgical instruments are inserted through the incisions and are used to remove the appendix. if  laparoscopic appendectomy is done, recovery is faster and are in less pain as compared to traditional open surgery. Additionally, they will spend less time in the hospital since the incisions are likely to heal faster. so it is advisable to dolaproscopy for your relative and the cost of appendesectomy is usually cheap,in our country, it varies based on the institution ,i wont reveal the exact about here,but it is affordable to an average person. hope helped your query dr.surendiran hcmagic",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could increase liver enzymes apart from hepatitis in pregnancy?\n\nLast Tuesday I had vomitting, diarrhea, and stomach pains. (I was 27 weeks currently 28 weeks pregnant) they gave me an IV so I could be hydrated, and said my liver enzymes were high. My OB is having them retested. Other than hepatitis (I've had my prenatal panel) is there anything that could cause the increase in liver enzymes?",
    "doctor_response": "HIThank for asking to HCMThe disturbances in parenchymal cells, like inflammatory process, destruction,necrosis, and these can happens due to infections either viral bacterial parasitic, trauma  could also does the same thing to cell either exogenous or endogenous, these are the likely causes responsible for liver enzyme elevation, it is wide gate open pathology for liver cell it is very fragile, hope this could help you clearing your doubts have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to increase testosterone levels from 150 inspite of injections?\n\nMy husband testosrone levels keep going to around 150. He has been getting the injections every 2 weeks over a year now very unsuccessful in getting these levels to where there to be? He is also taking suboxone, atenolol, celexa, clonzapam, adderral, and gout meds.",
    "doctor_response": "HiGreetings. I believe your husband is taking few medicines which may be decreasing his libido. BUT need not decrease testosterone .we have to find out why he is having low testosterone. There are so many causes for decreasing testosterone. so unless we find out and if treatable causes are there has to be treated first.Or else has to repeat the injections .I don't know whether 1000migm injections are available in your country. If so that can be given and need to take once in 3 months.I would like to do a hormonal analysis to find out the cause for low testosterone and then supplement. hope my answer helps you. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should anti rabies vaccine be taken again if previously vaccinated?\n\nHello,         I was bit by a local dog and took 3 doses of rabies properly as per schedule. Since the dog was not rabid and was fine, I did not follow up on the remaining 2 doses. now a puppy's teeth scratched my skin and it looks as infected. Do i need to take anti rabies shots again?Thanksjaya",
    "doctor_response": "HiAs you were not fully vaccinated previously, you need to be vaccinated again fully. But if you were fully vaccinated previously, you needed only 2 shots now on days 0 and 3.Hope my answer helps.Thank you for contacting healthcare magic",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for urticaria\n\nHello doctor, my 5yo daughter had an urticaria allergy. Once she had when she s 3yo, give celestamine for 4 days and it healed. But now it s past a week and still there and spreading. My house doctor added Lameson. And still not healed. A friend told me to use Cetirizine, but i doubt it cause i ve never tried. Is it better then celestamine??? Which one is better? Thnx.",
    "doctor_response": "HelloYes i agree for cetirizine you can use it but about the dosage you should consult her pediatricianRegardsDr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there any side effects of taking Roto syrup ?\n\nhello, my baby is 2 months old and she got rota sirop as prevention of not getting rota virus, now  from that sirop her poop was really hard in shapes of ping pong balls, from that there was a little blood on side of her poop how dangerous is that and what should i do?",
    "doctor_response": "Hi,Thanks and welcome to healthcare magic.Rota virus vaccine is given in 2 or 3 doses at an interval of 4-8 weeks to prevent diarrhea due to Rota virus.If the child has constipation try Lactulose syrup 2.5 ml twice daily to regularize the bowel movement.I do not think there is any relation to Rota virus vaccine and constipation.Hope this reply is OK for you.PLease feel free to ask further queries if any.Dr.M.V.Subrahmanyam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart raising, severe sweating and wrist pain? ?\n\nlast night I was drinking I only had three bottles and half a vodka and when I went out for a cigarette I felt I was going to collapse so I sat down and then had to go inside but I felt sick and was sweating profusely with my heart racing. I took me shoes off and put my head as low as possible to try to help. This also happened to me on monday not drinking but I had smoked a little bit of weed. This time I had to lie on the floor. Also happened me around 2 weeks ago and I was drinking on this occasion again I had to lie on the floor. Apparently when this happens my lips go blue and all colour goes from my face. I have collapsed with a hangover one day also and almost twice when working out. I have pins and needles very regularly of late and lots of headaches - with some back neck and wrist pain. Do you have any idea what this could be??",
    "doctor_response": "HelloThanks for posting at HCM. I have gone through your description. I eould have been able to help you better had you provided your age. Your symptoms need urgent attention and investigation. It may be a vasovagal syncope. But since there have been multiple episodes of it, you must get investigated. These symptoms can also be caused due to heart issues and blockage of the neck vessels which supply blood to the brain. I recommend a ECG, 2 d echo, carotid artery Doppler and x ray of chest and cervical spine. Also please get your blood tests -CBC, vit D, vit B12, and fasting and post lunch blood sugars.Please revert with the above test results. Please also measure your BP regularly. If all these tests are notmal, an MRI +MRA brain should be done. Please refrain from any alcohol, tobacco and weed. Wishing you good healthRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "If the battery of pacemaker is not changed cause any side effects?\n\nIf a pacemaker battery needs to be replaced and the patient does not want to go through that procedure because of their age, what risk is there in a leaving a nonfunctioning pacemaker in the person? This pacemaker has not been needed since it was activated. (7 years)",
    "doctor_response": "Hi, Having a pacemaker with discharged battery is like not having the pacemaker. I hope it was put as he must be having low heart rate with symptoms like syncope or giddiness. Complications of not getting the battery changed are the same which is persistent giddiness or loss of consciousness when heart rate becomes very low. The pacemaker interrogation will tell whether he needed the pacemaker in all this time. If no, I hope he will do fine without the pacemaker too. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sameer Maheshwari, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could i be pregnant as i am taking thyroxin for thyroid problem ?\n\nI have thyroid 5.90 I have been told to take thyroxine25 half tablet a day,I got my periods last month on12th june,i had ealier done a coursr of diane35,after the course i got my perios 4days late,this month i have not yet got it at all,i have also done pregnancy tesy,its negative,I want to get pregnant ,me&my husband have started planning,I want your advice whether thyroxine tablet is correct and should I start taking folic acid,if so then what tablet to take for folic acid,I m very worried what to do for my periods,help me,im nt able to sleep in the night as well.i am taking thyroxine also regularly.i have yet nt got my periods,what to do to get it and what medicine should i take for folic acid",
    "doctor_response": "Welcome to Healthcare Magic You can wait for 7-10 days late for periods to come as periods can delay even with stress. Firstly get your thyroid hormone levels checked. If it is normal or you have hyperthyroidism also you can have irregular period or missed period like this. But since you are taking Thyroxine you should rule our Prolactin hormone elevation and Polycystic ovarian disease by thorough checkup by Gynaecologist if your periods do not come. If Pregnancy test is negative, no need to take Folic acid but if you are planning for pregnancy you need to have regular periods first which ca be done by contraceptive pills provided by Gynaecologist advice only. Get thorough checkup by Gynaecologist to rule out any hormonal or ovarian problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cough and difficulty in breathing?\n\nHi. I have been sick for about a week, my sides hurt from coughing and I am having a hard time breahing, and when I breathe in it feels cold, I havent ate in four days and I have been couhging to the point of throwing up and I am weak and have been coughing so bad I feel like I am going to pass out. I have the shakes and I am freezing but my temperature is at 38.4Celcious. I have been to the emergency in my town and they sent me home and siad it was nothing, any suggestions?",
    "doctor_response": "Thanks for your question on HCM.I can understand your situation and problem.In my opinion you should immediately consult pulmonologist and get done1. Clinical examination of respiratory system.2. Chest x ray3. PFT (pulmonary function test).There are few possibilities in your case. Like1. Lower respiratory tract infection (LRTI) like pneumonia or tuberculosis.2. Bronchitis.So, chest x ray is needed to rule out lung infection.PFT is needed to rule out bronchitis.So better to first consult pulmonologist, diagnose yourself and then start appropriate treatment.Don't worry, you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat cold with occasional coughing up of blood associated phlegm?\n\nI had a cold a couple of days ago and since then I ve ocassionally coughed up phlegm with tiny specs of blood In it. I quit smoking a couple of months ago and smoked for approx 5 years at about a pack a week. I m 28 years old with no other health problems.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. You are having hemoptysis (blood in sputum). Since you were a smoker, hemoptysis is commonly seen with bronchitis, lung infection and lung cancer.So better to consult pulmonologist and get done chest x ray, PFT (Pulmonary Function Test) and CT thorax.Chest x ray and CT thorax are needed for lung infection and cancer. PFT is must for the diagnosis of bronchitis. You may need antibiotic or inhaled treatment based on diagnosis. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. A 21 year old male fainted suddenly after a party. Please guide us.\n\nHello doctor, This query is regarding a 21 year old male having no health complications in the past who suddenly fainted after a party. We took him to our GP for the check up. The GP found nothing wrong and advised rest. However, we went to the lab on our own and carried out CBC. WBC count was high in the first report - 11,300, lymphocytes 4,500, and RDW 16 which was indicated as high in the report. The peripheral smear showed:  RBC: Normocytic normochromic with mild anisocytosis. WBC: Absolute lymphocytic leucocytosis. Platelets: Adequate.  We then went for one more blood test in the following week. This time the WBC was 7100 and lymphocytes 5100. The morphology report says:  RBC: normocytic normochromic. WBC: within normal limits. Platelets: adequate on smear. Impression: normal peripheral smear. No hemoparasites seen.  The boy has lost some weight. A mild night sweat is there. Please guide us.",
    "doctor_response": "Hello. The diagnosis in your case is lymphocytosis. The underlying cause for the lymphocytosis should be searched for. For that, a detailed physical examination should be done and liver, spleen and lymph nodes should be palpated. Infectious mononucleosis, viral influenza, hepatitis, lymphoproliferative disorders, syphilis, etc., are some of the causes. If any specific clinical complaint is present than provide history regarding that for further discussion. You investigate further according to need like influenza antibody testing, SGPT and SGOT, HIV testing, etc. Your peripheral smear examination reports are normal and are not showing any specific abnormal cells. You have to repeat CBC (complete blood count) again after a week. If lymphocytosis persists for more than three to four weeks then flow cytometry investigation should be done to rule out monoclonal nature of lesion. For more information consult a hematologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tiredness in a 20 month old?\n\nmy son is 20 months old and is usually very rambunkshish. today he woke up normally, happy ready to go and at about 11 climbed up on my lap and has slept on and off all day long. no sign of fever. when he wakes up it is for 5 to 10 minutes at a time he drinks and eats a few things then goes right back to sleep. I am really worried and dont know what to do",
    "doctor_response": "Hi... this is a sign that his central nervous system could be affected. There need not be fever always. I suggest you get him examined by a pediatrician or physician as soon as possible. It could be a initial symptom or Encephalitis.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itchy rashes around bikini area,thighs and pubic area. What should I do?\n\nI have extremely itchy rashes around bikini area,thighs and pubic area. Had been to my GYN, he did tests for east infection, it came out clear. Blood tests for diabetes and thyroid also came clear. He said it might be a cause from detergent, but i have nat changed any brands in the detergent or toileteries. This is the second time I m getting this. First time was last month which ended with painful boils. Please help.",
    "doctor_response": "hello, im dr satya. itchy rash around pubic area, thigh, and bikini area, common causes of itch aroud this area is candidiasis, fungal infection or also called tenia, alleric dermatitis, id reactions, parasitic infestations such as scabies, and some rare disorders. before concluding that you have something serious i would suggest that you follow a good hygiene and consult a dermatologist for a better evaluation. thank you dr satya ,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain in ribs and spleen be treated while suffering from myeloproliferative disorder?\n\nim a 45 year old woman,who suffers from myeloproliferative disorder and been having lots of pain ,under my left rib ive been told that they can feel my spleen,im waiting 2 have a scan and 2 c a consultant im on alpha interferon on for the myelo but now im very worried about the pain im getting ,its getting worse and im having a bad feeling about this ,wot will happen .",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Myeloproliferative disease is a kind of blood cancer (malignancy involving blood cells). This can spread to flat bones like ribs, scapula and also in abdominal organs like spleen and liver. So in your case, we should definitely rule out spread in ribs and spleen for this pain. So get done CT scan or PET scan as soon as possible. For pain relief, you can do following things. 1. Apply alternate ice packs and warm water pad on affected areas. 2. Avoid movements causing pain. 3. Avoid heavyweight lifting and strenuous exercise. 4. Take painkiller like ibuprofen. If spread is there in ribs and spleen then you might need chemotherapy and radiotherapy. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is IV iron only solution for IDA due to Menses?\n\nHello I have been DX w/Iron Def Anemia. I am 43 yo. Female. I had two very bad experiences with IV Iron last August. I have been on oral iron now since Septmber of 2010. I recently had another round of bloodwork done, and have my results. My Heme Dr. seems to be overly aggressive to me suggesting IV Iron all the time. I am wondering if I shared my lab results with you, that you could tell me whether or not, in your expert opinion, I would need IV Iron. It has been determined I have IDA due to Menses, and the use of Librax for IBS.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have iron deficiency anemia due to excessive blood loss in menses.  You should consult gynecologist for that. As far as iron treatment is concern, it depends on your hemoglobin, ferritine level and serum iron level.  Oral iron takes more time then intravenous iron. But if you are not ok with intravenous iron then you can go for oral iron and in emergency you can go with blood transfusion.  Consult your doctor and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swelling and blackness in the toe of 21 month old\n\nhello - my 21 month old son dropped his full sippy cup right on his big toe this morning. The toenail is now black, and he has been whimpering, crying and uncomfortable all day. He won t let us touch the toe, and it is swollen a bit but he was able to walk on it. However tonight he does not want to walk on the toe, although he does not flinch or cry out when we touch the tow itself. Should we do anything to alleviate the selling or address the toenail being black now?",
    "doctor_response": "Hello, thank you for posting your question.Blackening of a toenail after an injury is most likely due to local bleeding. In this case associated swelling and pain may also be there. Here painkillers and rest should relieve the condition in a few days.Another rare reason that could cause blackening of the toe is the arrest of the blood supply to the tip of the toe, due to the injury. In this case pain would be severe and your child would be completely unable to move or use the toe. This should be considered as an emergency and be attended immediately. In any case attending a doctor would be the next logical step.If you need any more assistance kindly write back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hairfall\n\nhello sir my problem is my hairfall . some says that i am anemic, so , thats why i have hairfall. itry many medicines , oils, hairgain shampoosetc , but of no use. on the front of my head, my skin seems to be without hairs . if i wash my hair regularly then no oil comes on the scalp but if i wash after 2 days , my scalp seems oily and much thin har. please",
    "doctor_response": "Hello,Thank you for posting on HCM.I appreciate your concern regarding hair fall. Hair fall is usually ascribed to multiple factors like diet and nutrition, hormones, stress, acute or chronic medical conditions,drugs,cosmetic products etc.From your description, it seems you might be having Telogen Effluvium, which is hairfall secondary to stress.In your case anemia is one apparent cause of hair loss.If i were your dermatologist/trichologist, i would like to take through history including family history, history of recent major trauma/illness/stress/medications etc and recommend some basic investigations like CBC,blood sugar,Thyroid function test.Some other special investigations like trichogram and dermoscopy and further aid in diagnosis and prognosis.I would suggest you a course of oral tablets containing biotin and other essential vitamins and minerals for minimum 3 months. Also, would put you on solution containing 5%/10% minoxidil once a day and a hair serum containing peptides for hair growth at night.(Q sera etc). I would advise use of gentle shampoo and conditioner on regular basis and use of coconut oil twice a week.Also enquire from your dermatologist about upcoming treatment options like mesotherapy and platelet-rich plasma.Avoid combing in wet hair and let them dry by wrapping in towel. Avoid blow dryers and hair-color/dyes. Take plenty of fresh fruits and vegetables in your diet and try to de-stress your routine life.Hope your queries are resolved and wish you best of health.Thank youDr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Methodrone be used to relieve breathing problems?\n\nmy mother is currently with hospice they sugjested to use methodrone for helping her breath is this true,something about opening her tubes to help her breath better .she is in conjested heart failure,any more alternitives shes allergic to pennicillan,",
    "doctor_response": "Well come to HCMThank for asking I really appreciate your concern, if this is the congestive heart failure and it is the cardiac component is there then the drug for this is regime like bronchodilator, digitalis, and diuretic this is the  regime being tried globally, in severe condition oxygen is second line of management, besides this nothing much can be tried, if infection is there then for that antibiotic can be given,  hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for chronic bad breath\n\nextreme bad breath for many years. people back away when i talk to them. They can get no closer than 4 feet without reacting. not my imagination. have gone to pcp ent gastro. nothing helps. it comes from my tongue and scraping wiping brushing rinsing does not help. can you please help me",
    "doctor_response": "Hello,The bad breath could be because of the deposits over the teeth causing gum infection, Or it can be because of the fissured tongue, or it can be because of the pus discharge secondary to gum or tooth infection or any respiratory tract infection.Consult an oral physician and get yourself examined to rule out these conditions. If it is gum infection get the teeth cleaned once, and maintain oral hygiene after that. You can use mouth wash. If it is tooth infection get the tooth restored.If it is a fissured tongue, you can use topical antifungal agents like candid mouth paint. If it is respiratory tract infection consult a pulmonologist.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Mahesh Kumar T S",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for scabies infection\n\nHi, may I answer your health queries right now ?  i have symptoms of scabies infestation since sunday. small bumps on face, hand, body, legs, inner thighs, scrotum. used dettol, hyd peroxide to clean up.  still feels itching what is the immediate treatement i should do",
    "doctor_response": "Hi & Welcome.I can understand your concern.The most common treatment for scabies involves the use of 5% permethrin cream or 25% benzyl benzoate lotion.The cream or lotion should be applied to the skin of all of your body. Before you apply it, make sure your skin is cool and dry. Don't apply it after having a hot bath. Clean clothing should be worn after treatment.Skin sores that become infected should be treated with an appropriate antibiotic prescribed by a doctor. For the treatment of itching oral antihistamine like Levocetrizine can be taken.Bedding, clothing, and towels used should be decontaminated boiling in hot water or by dry-cleaning, or by sealing in a plastic bag for at least 72 hours.Since this is a highly contagious disease, all members of your family including recent sexual partners if any should be treated at the same time as you, even if they don't have any symptoms.Repeat the treatment process 7 days after the first application to ensure it's successful. The second application will ensure any mites hatched from existing eggs are killed.Because the symptoms of scabies are due to an allergic reaction to mites and their feces, itching still may continue for several weeks after treatment even if all the mites and eggs are killed. If itching still is present more than 2 to 4 weeks after treatment or if new burrows or pimple-like rash lesions continue to appear, retreatment may be necessary.Hope the suggestion given above could be useful in getting the treatment prescribed by your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for fungal infection on the body post pregnancy\n\nHi, i am having fungal infection post pregnancy. I am taking FZHH 200mg tab once in a week and using tyza ointment. Infection fails to cure and it is spreading on my face. Can I use tyza cream on my face? Please suggest if any solution for this. I am breastfeeding a\u00f1d this skin problems giving me more physical and mental stress",
    "doctor_response": "Hi, Dr Purushottam Neurgaonkar here. I welcome you to HCM VIRTUAL CLINIC. I have gone through your question, and I think I have understood your concern. I will suggest you the best possible treatment options. 1 )  Please maintain good personal hygiene. 2 )  Use Tab Fluconazole 150 mg twice a week for 4 weeks .  Cloben G ointment twice a day for 4 weeks on the affected area.  Use Tab Celin 500 mg twice a day for 15  days. I hope this answer helps you. Thanks. Dr Purushottam Neurgaonkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i stop clexane of my patient before operation ?\n\nexcuse me im a nurse and i want to know, shoud i stop clexane of my patient befor operation?",
    "doctor_response": "Hi,you know clexane is anti platelet drug.Normally before any surgery this kind of drugs are not given.In some cardiac procedure this is not withheld.It is better to you please ask the in charge physician about this.thanks and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes warm sensation on feet?\n\nMy 11 year-old healthy son has been having a periodic warm sensation in his foot, just above his 3rd & 4th toes. It isn t painful, it comes for a few seconds, and then disappears again. This has been happening for the past 2 days. No other symptoms. Thanks for any info.",
    "doctor_response": "Hello. I just read through your question.Sometimes this can happen when a small, even unnoticed, injury happens to the area. It most likely is a small pull in the muscle around the area. It typically resolved after a few days and is nothing to be overly concerned about.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Done fertility test. Taking CoQ and fish oil. Help?\n\nHello \u2013 my wife and I have been TTC for a little over a year now with no success. We decided to go to Fertility Center of IL; her results all came out positive, even tho she has one ovary (left one). My results came from the SA test were 47.7 Million (Count), 62% ( Motility ) and 2% (Morphology) \u2013 I was told my sperm morphology is low as the avg is 14%. I was also told to take CoQ-10 and Fish Oil. Would this really improve my Morphology? And if so, how long until we would be able to conceive? I would really, really appreciate some answers!! Thank you!!!",
    "doctor_response": "Hello Thanks for your query. Sperm morphology \u2014 the size and shape of sperm \u2014 is one of the things checked in a semen analysis for male infertility. Sperm morphology results are reported as the percentage of sperm that appear normal when semen is viewed under a microscope. Normal sperm have an oval head with a long tail. Abnormal sperm have head or tail defects \u2014 such as a large or misshapen head or a crooked or double tail. These defects may affect the ability of the sperm to reach and penetrate an egg. However, having a large percentage of misshapen sperm isn't uncommon; in fact, if your sperm sample contains only 4 percent \"morphologically normal forms,\" it's considered normal. Morphology is just one piece of a fertility analysis and, by itself, does not determine fertility. Other important factors checked in a sperm analysis are: Semen volume Total sperm number Sperm concentration Vitality of sperm Motility of sperm If a semen analysis shows irregularities in any of these areas, a wait-and-see approach is generally tried first. Another semen analysis is usually done after four to six weeks to see whether sperm quality has improved on its own. If there are still abnormalities, tests may be necessary to look for an underlying problem. Common causes include Infections High fever Usage of illegal drugs Alcohol consumption Congenital testicular abnormalities Varicocele \u2013 Enlargement of veins within the scrotum Toxin exposure causes reduced sperm motility Cigarette smoke causes abnormal morphology Organic solvents causes coiled tails An assessment by a Urologist is a must for diagnosis and treatment. Even with abnormal sperm morphology, motility problems or a low sperm count, it's important to remember that an abnormal semen analysis does not mean you are infertile. Many men with low semen analysis values are still able to father children. It just may take longer, a year or more. If you and your partner aren't able to conceive through sexual intercourse, assisted reproductive technology such as in vitro fertilization may be an option.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for constant headaches, dizziness and double vision\n\n14 year old girl with constant headaches, feeling sick, dizzy & faint. Last week she started getting double vision & her eyes have been turning in. Optician was concerned so at hospital Had MRI scan which was clear apart from small growth on Sinus. Waiting on blood test results. Please can you give your opinion.",
    "doctor_response": "Hi...all the symptoms you quote are fitting into a space occupying lesion in the brain. But I am glad that the MRI has come out as normal. But we need to keep the kid under follow up.The only other possibility I could think of is non-organic or functional disorder as the MRI is completely normal.I suggest you see an ophthalmologist - to check the fundus of the eyes and if that examination is also normal, I suggest you see psychologist too.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a piece of skin hanging in the vagina during pregnancy indicate?\n\nHi Doctor, I am 10 weeks pregnant and since 2 weeks, I have been observing something hanging in my vagina, feels like a thick skin attached to inside of vagina. Sometimes, when I wipe, I notice some blood(only when I wipe). Can you please confirm what it can be? It s not painful and hardly felt during the entire day except sometimes when I go toilet. I am going for my first appointment with my midwife on 23rd May so will sort it out then too but still would like to know what it is. Thanks in advance.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. According to your description the possibilities are : -Remenants of hymen. -Thickening of vaginal mucosa. -Rarely cervical polyp. By clinical examination the exact cause of the problem can be identified. If that tag is of only superficial origin that can be removed by clamping and cutting and if needed suturing. If it is a polyp, the origin should be identified by ultrasound and treatment should be planned accordingly. Deeper cervical polyps may need be treated conservatively as you are pregnant now. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is life expectancy with low heart and kidney functioning?\n\nHi my dad is in hosp and they tell us he has only 20% of his heart working, his kidneys are also not doing the correct job, but no need for dialosis yet, what ar his chances we are a long way from them and I dont know wather to go home now or not, thanks",
    "doctor_response": "Hello, After going through your medical query I understand your concern and I would like to tell you that with 20% heart function life expectancy is very poor and unpredictable. He can go home on medication and you have to see a cardiologist nearest to your place so that in an emergency you can take him immediately. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to remove ascites\n\nRespected good evening. .... My father 71 yr old .He had pseudo maxima peritonie with ascites. .In oct 2013 he operated in tata at Mumbai. .and they removed ascites with exp.laprotomy. ...After 4 chemo also finish...With palatine care.....but tdy we did ct scan nd again we found ascites in large amount.....so pls with humble request would you like to tell me what can i do......Pls. .....",
    "doctor_response": "Hi,Thanks for writing in.Ascites is the term applied to collection of fluid in the abdominal cavity. In certain conditions as your father, there is excessive collection of fluid in the abdominal cavity. In smaller amounts such fluid can be allowed to get reabsorbed on its own. However when the fluid collection is high, the chances of it getting reabsorbed is less.For excessive ascitic fluid, doctors usually prescribe a diuretic pill and that helps to drain the fluid. In large collections, the medication might not give the adequate response and in this case ascitic tap has to be placed. This is a slightly thick needle inserted in to the anterior abdominal wall and connected to a tube. The fluid is allowed to slowly drain out over hours or two days. Sudden decompression of the fluid might lead to distress and should be avoided. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How safe is using Flomist nasal spray for adenoid and tonsils?\n\nMy kid is a female, 4yrs 3months old, having continuous throat infections. recently came to know she is suffering with an adenoid n tossilitis problem. Her ENT has sugegsted for 6 months she should take a tablet once a day MONRAIR 4mg) and every alternate night Flomist nasal spray in each nostril..... I have come to know flomist is a steroid will it harm my child who is schooling now? She is also having bronchial problem for which her paediatrician has put her on Tritofen syrup 5ml twice daily continuously. Taking all this medication she is still suffering colds, coughs and fever frequently. She has also taken pneumoccocal vaccine and the influenza, but no change since past 3 months. Kindly help. My email id is YYYY@YYYY and contact no.+0000",
    "doctor_response": "Hello, I feel that what she is having is because of recurrent allergy and not an infection. Your pediatrician is appropriately treating your kid. Vaccines will prevent only bacterial pneumonia and invasive pneumococcal disease and the influenza vaccine will prevent against influenza virus and not allergies. I suggest you follow your Pediatrician's advice. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain post wisdom tooth removal?\n\nHello,I had 4teeth pulled last Thursday, 3 lower rear & 1 encisor. The dentist had a HARD time getting the lower rear out-think it was what they call a wisdom toot. I just know he had every tool imaginable in my mouth -even  small sawzall I call it. He said he finally got it, sewed me up & gave me a script for 325/10 mg. Hydro for pain. I did not fill it, I told him I already took 30 mg Ovycodone & my ins. would not cover it. Now the problem I am hurting BAD! Is it possible I have a dry socket?",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concern...As per your complain it is about 6 days that you have got extraction of teeth done with difficulty in removing wisdom tooth and as if now the pain is so severe then there is a possibility that you have developed a \"DRY SOCKET\"I would suggest you to consult an Oral Surgeon and get evaluated and a thorough clinical evaluation and investigation like x ray if needed can be done for diagnosis and treatment can be done accordingly..In case of dry socket you will be given sedative dressing in the socket  that will reduce pain and also initiate healing..As of now you can take Tramadol or Ketorolac to relieve pain and do cool compresses over the cheek..Hope this information helps..Thanks and regards..Dr.Honey Nandwani Arora..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be the reason for occasional back pain?\n\nOn several occasions when the adrenalin glands kick in, I have experienced lower back pain. It doesn t last very long, but It never happened untill about a year ago. I don t have all the symptoms of Addison s disease, I do have some of them. I do have heart palpitations, but I had them checked out by a doctor and he said my heart was good. I have restless leg problems when i try to sleep. I do have muscle twitches in my eyelids and other larger muscles. After searching on the internet, I have seen where many people have the same pain during adrenalin rushes. There are alot of theories, but no one seems to know the answer. Any information would be greatly appreciated.",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, such pain could be due to muscular spasm and nothing to take any thing with adrenaline, stress could be the reason for this,   hope this is information helps, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and discomfort in the wisdom tooth?\n\nok i have all my wisdom teeth my teeth are tight, uncomfortable, and painful.my top two wisdom teeth are really rotten.im pretty sure a have an infection or gum disease.my jaw comes out of place and i grind my teeth so are all kina loose.i need help asap but i dont have enogh money bad credit and no cosigner.what should i do this problem really controls my life.",
    "doctor_response": "Hi,Thanks for posting the query,  I would like to tell you that wisdom tooth is the last tooth to errut in the oral cavity and is often tilted in postion or impacted this region is difficult to clean so there is often food accumulation leading to inflammation, pain, swelling, Pericoronitis, i would suggest you to get the tooth examined by an Oral Surgeon get an OPG radiograph done and plan for its removal...Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to fantasize about older women?\n\nIm 27 years old, and Im completely attracted by middle aged woman who are around 40-60 years old and look very plumpy. This feeling has been there in my mind since my teenage, ( I fantasize a lot about only fat and middle aged woman, but not with a normal girl irrespctive of her beauty) Could anybody tell me is it normal or a psyco disease??",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Every person has his own personality, behavior and liking patterns. Some like dogs, some cat, some horse etc. Likewise, like towards opposite sex, same sex etc are also common. In your case, fantasy about older women are efinitely not a psychic disease but an obsession arised due to non-awareness about sex. Fantasy about old ladies are just fantasies, not reality. Reality shall enlighten you when you get married. Till then, please enjoy your studies, areer and of course, fantasies.In case if you need more of my assistance in this matter, please post a detailed direct query to me on this portal. I shall help you with psychotherapy tips to overcome your problems.Hope this answers your query. Available for futher clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes continuous sneezing?\n\nhello there, My nephew's sneezes are not stopping from last 55 days. The frequency of sneezes is approx. 1 per minute. Actually the problem started in January 2011 but it stopped after a month and it occured again after one month to last for another one month. We have gone to a number of Doctors and they prescribed some nasal sprays and medicines, but it seems nothing worked. Most of them say that it might be physchological but we feel that theres some problem as sneezing stops when he goes to sleep and comes back as soon as he wakes or we move him in sleep. Kindly suggest me whom should we take him to in AIIMS. I mean which Doctor or Department.",
    "doctor_response": "HI, thanks for using healthcare magicYou should take him to see an allergist to determine if he is reacting to a particular allergen.The allergist would be able to do allergy testing to pin point the source of the problem. If it is identified then hopefully his exposure can be reduced or eliminated.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I use Brite cream to whiten the face? Any side effects?\n\nHi All, I am male, 27 years old. I have normal color (not so dark). So can I use BRITE cream from WALLACE company to get fairer face. 1. Can it be used on face? 2. Can it be used by men? 3. Will it cause any side effects in future? 4. What precautions do we need to take while using it. Please clarify the above points.",
    "doctor_response": "Hello Thanks for posting your query You said that you are not very dark. My suggestion is only to apply a good sun screen half an our before you go out.  That will keep your skin texture intact and will prevent from sun tan and darkening. Creams like Brite contains hydroquinone and has only bleaching effect. It is like going to a parlor. It is not a permanent remedy and you may have to apply continuoulsly. It definitely produces side effects in the long run especially reddening of face and the steroid will produce increased facial hair  under the eyes. Retinoic acid produces burning sensation when you go out in sun light. As no medication can change the texture permanently and without side effects it is better to accept our own color and be with it. have a nice day pvs prasad",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this angiogram report indicate?\n\nMy mother has cardiac problems. Her Angiogram report says \" LAD -Type III, good size vessel having 40-50% stenosis at its proximal & 70-80% stenosis at its mid segment. D1 has got 95% stenosis at its proximal segment. D2 has got 30% stenosis at its proximal segment.LCX: Dominant, good size vessel having 95-98% stenosis at its mid segment.RCA: Non dominant vessel having 60-70% stenosis at its proximal segment. What does it mean?",
    "doctor_response": "Hello. Thank you for your question and welcome to HCM. I understand your concern. This angiogram report indicates that this is a three-vessel + secondary vessels, coronary artery disease. As it happens only in 8% of people worldwide, the left circumflex (LCx) artery is the dominant artery. This is only statistics, and it is a normal variable. Now, usually, the treatment recommendations vary from one clinic to another and from one country to another. If she was my patient, and if there was acute ischemia, I would treat only the culprit artery of the heart attack in the first time, with a angioplasty and stent placement. In a second moment, i.e. two weeks later, I would treat the two remaining blockages, the one in the mid-LAD and the one in D1 with stents, if suitable and if in a favorable position. If there was no acute myocardial infarction, and the three arteries would be suitable targets for stents, I would treat them with stents all at once. Even with all these said, there is no invasive cardiologist in the world that would be sure without seeing the angiogram film. There are detailed things that should be best discussed with the operator that carried out the procedure. There is one sure thing: the recommendation is that something should be done about this three-vessel coronary artery disease, whether it is angioplasty+stenting, or coronary artery bypass grafting. I hope I was helpful. Take care. Regards, Dr. Meriton",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy if had unprotected sex and took Postinor?\n\nHi,am 15,I had uprotected sex with my bestie,and few hours later that day I took postinor 1,an overdose,1 and half tablets,am supposed to have my pd from 17th-21st of this month and I haven't seen it,could I have possibly gotten pregnant?or is it a side effect? What should I do?",
    "doctor_response": "Dear member,Thanks for writing to healthcare magic.Delayed period following unprotected sex can be sign of pregnancy. Please  do a blood test or urine test for pregnancy.If negative then please wait till next period.ThanksDr Bhagyashree.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Wobbly upper front teeth due to injury, four teeth are loose, cant eat solid food\n\nMy daughter is 4 years 4 months old. 2 months back she bumped in the centre table but there was no bleeding in her mouth . Later that day she told that her upper front tooth was wobbly. I went to the dentist . But they said keep an eye if color changes. It has been 2 months already the color has not changed but now all four teeth in the front of the upper gum are loose. Appointment is not available at the moment. The teeth are hurting because she is not able to eat even a biscuit. Just soft food. I am really worried. Is this some sort of deficiency? Please help me. Regards",
    "doctor_response": "hi. welcome to HCM of course everyone matter for their childrens. actually the dentist advised you for colour changes were meant that your daughter's tooth might have got infection aur may have lost its blood supply. but if for 2 months if there are no colour changes then it means there is nothing to worry about. now your concern about the loosening of the upper four gums is a natural process leading to the appearane of her permenant teeth. it is normal for this age and all her teeths will be replaced by the permenant ones. however she is in a growing age so she may need calcium supplement to enhance her growth process. meanwhile use soft diet which can readily swallow. thanks with regards dr.ishfaq",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My vagina is sore after intercourse with expired condom. Is this thrush or symptoms of pregnancy?\n\nHello doctor, Last week I had sex with a guy with expired condoms. I saw the packets only after sex and found that they are expired. Is this a problem? Could I be pregnant? Also, I am not sure if this is linked or not but three days ago, I had a really sore, stinging and itchy vagina. I have had thrush before and do not know if this is what it is? I got Canesten thrush combi internal and external cream packet and have been rubbing some cream on my vagina for the last few days. It does not feel as weird burn as much as the first day but still feels weird. About half an hour ago, I inserted the internal cream. My vagina has been feeling really weird, but it feels like a urine infection in a way but does not burn to urinate. I do not know if this is thrush or an infection like a sexual infection from an expired condom? I have not gone to the doctor. When I did put a finger inside the other day there were some white bits on my finger. My opening to the vagina hurts and is sore when I try to finger myself. Could I be pregnant? Or could I have got a sexual infection due to an expired condoms? The soreness started a few days after the sex with expired condom. I feel uncomfortable and do not know what to do? Is it true that once period comes it clears up? Please suggest.",
    "doctor_response": "Hello. If the condom is expired it means it may break easily if it has not had breach then it is as safe as normal condoms. According to your information, three months have passed after this incident and during these three months did you had normal periods? Normal period means no pregnancy. The symptoms you are mentioning are suggestive of thrush and oral Fluconazole 150 mg one tablet daily will take care. The ideal thing would have been if you had uploaded an image so that one could see what is there. And yes, you have to avoid sex for a few days until soreness settles.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does chest pain with bp 124/82 suggest?\n\nyes iam 24 years old and weigh about 300 lbs. For the last two weeks i have been having a little pain in my left chest.  So i went to my doctor and he ran EKG and blood test and he said everything was fine. But i have been known to experience some anxiety .  my blood pressure was 124/82 and heart rate was 88. The pain isnt real painful just a little tight sometimes do you think im okay?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. First of all no need to worry for major heart related diseases for your chest pain because your ecg is normal and your age (24 years) is too young for heart diseases. Sometimes, uncontrolled anxiety can also cause chest pain and chest tightness. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on it's solution. You may need anxiolytic drugs too. Don't worry, you will be alright. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain\n\nok so i had protected sex within the past couple weeks, however i got my period, a little early.  For the first like 4 days it was very very light then about 2 or 3 days it was a little heavier but still light.  Also, the past couple days, when I wake up in the morning, I have a complete food aversion and a middle ground between a stomach ache and nasea.  Today, I also noticed some very liquidy discharge that was clear and had no smell. Is it likely I'm pregnant?",
    "doctor_response": "Hello and thank you for your question. It is possible that you are pregnant so if you miss a period please check a pregnancy test. It is a little early to be feeling pregnancy symptoms however so you may also consider getting checked for a sexually transmitted disease. If you have abdominal pain and a positive pregnancy test you should go immediately to the Emergency Department to make sure that you do not have an ectopic pregnancy (pregnancy in tubes) which can be an emergency.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for burning sensation in shoulders and back with high BP?\n\nPost triple by-pass surgery 7 weeks. Been getting burning sensation at night while sleeping upper shoulders across back, wakes me up Goes away after approx. 5 min. but by this time I am quite anxious and BP goes up and heart pounding . Settles back down after getting up. Any ideas",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!I understand your concern and would explain that your symptoms seem to be relate to gastro esophageal reflux. I recommend consulting with your GP for a careful physical examination, and some tests:- resting ECG and cardiac ultrasound to examine your cardiac structure and function-blood lab tests (complete blood count, cardiac enzymes, inflammation tests, liver and kidney function tests, blood electrolytes). A fibrogastroscopy is necessary for the diagnosis. I would recommend starting omeprazole or lansoprazole. If your symptoms improve by these drugs, the diagnosis of gastroesophageal reflux would be much probable. Hope to have been helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had breast cancer. Taking Tamoxifen. Now diagnosed with large endometrial polyp. Is follow up necessary? Is it cancer?\n\nI was diagnosed with stage 1 breast cancer in 2009 and I have been on Tamoxifen since I had surgery. When I started Tamoxifen, I was  premenopausal (age 44), but my periods became irregular. Just found out that I have a large endometrial polyp. Obviously, I am now concerned about the possibility of endometrial cancer. How should I follow up?",
    "doctor_response": "Hellowelcome to health care magicFor your breast cancer you are using tamoxifen since sugery,,Tamoxifen is used in the treatment of estrogen receptor positive breast cancer..But that tamoxifen has side effects like it causes endometrial  polyp,endometrial hyperplasia and endometrial cancer..Endometrial polyp causes slight bleeding..some of the polyps are carcinogenic..so better consult Gynecologist and remove it by simple curettage..and the removed mass send to histopathology..If cancerous cells are present then you have to undergo hysterectomy that is complete removal of uterus...as you are near menopause so no problems..Hope you understand my suggestionThank youDr.siddartha",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get pregnant?\n\nHi, may I answer your health queries right now ?  Please type your query here...i m meenakshi 25year old 3years of marriege wanted to get pregnant my doctor said i m ovulating but he think may be my fallopian tubes blocked what should i do ...i want  baby  what should i do ... i m taking ayurvedic baba ramdev s medicine to concive. i need u r help plz help me out> thanks",
    "doctor_response": "Hello,Thanks for trusting Healthcaremagic!I have gone through your query and I can understand your concerns.As per your description it seems that your Fallopian tubes are blocked. Obstructed Fallopian tube is a common cause for infertility among females. You don't need to worry as it can be completely cured with timely treatment.Do not go for unscientific treatment and magic healers, you may lose your money and time.Consult a gynecologist specialized in infertility treatment. You have to do a test called \"hysterrosalpingogram\" to locate the level of the obstruction. Once the location and extent of the problem has detected,surgical correction is required to correct the defect. Nowadays, laparoscopic methods are preferred.Wishing you good health.Regards.Dr.Shana",
    "dialogue_context": ""
  },
  {
    "patient_message": "I suffered a miscarriage in my first pregnancy and my husband recently had an Epstein-Barr virus infection. Should I delay my next pregnancy ?\n\nhi, am laila and am 28 years old with a regular periods.i had an abortion in 15 march 2011 at my 7th week pregnancy with no need for D&C. a 15 weeks after that, my husband had an EBV infection for the first time (primary infection not activation). shall i delay my next planned pregnancy, if yes, for how long? or what shall i do concerning pregnancy plan? thanx doctor .",
    "doctor_response": "welcome to HCM. Minimum 6 month gap should be there after abortion.EB virus is not in active stage then it is not that serious.I would recommend you try and get yourself as fit and healthy as possible before you concieve.Start nutrients including zinc,folate,b complex,Vit-c and iron.Eating right,avoid stress,yoga and doing regular exercise are also helpful.Consult your gynaecologist for better planing.Best wishes....Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it dangerous if isnophillia count is 11?\n\ni am CABG surgery patient age 48. i did a surgery befor 2 years. Once in six months i did a check up, in this time isnophillia count was 11. is this any dangerous and how can i reduce. And also when i tensed or stress or intercourse, my bp range was 155/120 like that, is this also any dangerous.",
    "doctor_response": "Hi, your eosinophil count is definitely high. There are many causes of high eosinophil count. They are allergy, autoimmune disease, parasitic infection, hypersensitivity etc you need to search the cause and take treatment. it is not danger. so don't worry about that. your blood pressure is also slightly high consult physician for that.and go for regular check up. Thanks for using health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I always dream of wearing a diaper?\n\nUh can I ask a very personal question anonymously. So like, I have been night-time incontinent for the past there years and often my dreams involve... wearing a diaper. I don t know if this is a sexual innuendo or some comfort thing but I m really not sure how to act upon it because this urge has been going on for the past 8 years and from research i ve done it never gets better, only worse, up until the point at which it is solved. i really need some advice here because although I am 18 I am somewhat afraid to tell my parents even if i m moving out soon. Can I please get some real advice here on how to go about this.",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: I am not clear for what are yu incontinent- Bladder, Bowel or semen?Explanation: Bladder incontinence or bed wetting at this age is certainly abnormal. If you are suffering from bed wetting please visit a neurologist as early as possible.                  If you are having wet dreams/ejaculation while sleeping then it is entirely normal at this age. Dreaming of wearing a diper if  is giving you enjoyment then there is no problem. Unless anything harms you or others there is no problem.                   Visit a psychiatrist regarding this for better advise. Good luck enjoy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. On progesterone injections. Ultrasound shows immature follicles. Treatment?\n\nI have had three miscarriages in the last year, after having a successful pregnancy in 2009. The first 2 miscarriages were early on at about 6 and 8 weeks. The last one was in April and we were monitoring very closely. Before that we had discovered that I had low progesterone and so I was doing progesterone injections twice a week as soon as I found out I was pregnant. I still ended up miscarrying around week 10. This month I did a sono series so that they could observe ovulation , and the doctor told me today that I had immature follicles. Everything I am reading is talking about immature follicles and infertility . I have had no problems getting pregnant. Every time we try, I get pregnant. When an immature follicle ruptures does that mean that I have an immature egg and so it is just not sufficient for sustaining a pregnancy?",
    "doctor_response": "Hi, Thanks for query, You have miscarriage at 6-8 & 10 weeks period.this indicates that your fertilisation process is OK but your implantation process rather attachment of fertilised ovum to uterus wall by plecenta doesn't maintained. This is a complication of frequent mis carriages.Just wait for some cycles  time for preparation of your endometrium for fertilisation.You may get result. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling bloated, unprotected sex, stomach pain, headaches, sickness. Pregnant?\n\nI had a period on da 18th of this month which only lasted one day which was hevery but normally it last about a week Is dat my period or could I be pregnant also I had unprotected sex a week before my implant was due to come out now I'm feeling bloated getting tummy pains n  headache but not not the sytoms of needing the toilet or feeling sick could I be pregnant even tho 3 pregnancy test come bk netgive.",
    "doctor_response": "Hello,Here, you can undergo one blood test for beta-HCG to rule out pregnancy confusion.Other reasons are hormonal imbalance (most common) due to effect of implant, stress, irregular food habit, over weight or loss, thyroid disturbance, increased prolactin level, ovarian cyst etc.In exclusion of pregnancy, you should consult with your gynecologist for clinical examination & relevant investigation (like pelvic USG, hormone assay etc). Take suggestive measures accordingly.Take healthy diet with vitamin & iron supplements, avoid stress by meditation/ yoga, control body weight, maintain genital hygiene & take sound sleep.All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Headaches and stabbing pain in back. Have degenerated discs. Hypertensive. Tried all alternate medicines. Surgery only option?\n\nI am a 63 year old married woman, I have 3 deteriorated disks in my neck, have headaches and get dizzy also feel like electricity in the back of my head feels like there are 3 lines across the back of my head and I have to massage it hard for circulation, my blood pressure went to 189 over 103, and also have degenerated disks in my lower lumbar. I am in constant pain day and night. What can I do? Is operation the next step. I had physical therapy, aquatic therapy, epiderals and pain tablets, natural medication help but pain goes from 4 to  10 constantly. Please help me out , I will appreciated verymuchhhhhhhh I will wait for your answer. Thank you very much!!!",
    "doctor_response": "HiHigh blood pressure is the main cause of headache so you should consult your physician for treatement of high blood pressure. Other thing is disc degeneration but i dont know mri cervical spine findings but if pain radiating down in upeer limb and constant pain you can take short wave diathermy and cervical traction. If that does not work you can take epideural injection if it still does not work then you should go for surgical modality.Hope your doubts are cleared.Thank you.Get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain on my tailbone\n\nHello. I m a 20 years old girl. One day more than a week ago I believe I sat too long on a bicycle with a very hard seat and after I started feeling a bit pain on the tailbone area. But I didn t pay much attention to it and I continued using the bike maybe twice more. But 2 days ago I was in a lot of pain and when I checked it out in the mirror I saw that I had a bump on the right cheek of the butt (above the anus, near the tailbone area). Its not much red or irritated but it seems swollen and like the size of an almond and it does not look like it has created pus. Yesterday I started using Advil for the pain and it was effective, then the pharmacist gave me Eudorlin which I tried but it had no effect whatsoever for the pain. So today after a night with no sleep I went back to Advil. I m really nervous cause I can barely walk, I can t sit, and I m not at all comfortable laying down, (so I m not getting much sleep ). Right now I am not in the position to go to the doctor so I really hope you can help Sorry for the long post.",
    "doctor_response": "hi,i appreciate your concern.it seems you have coccyxdynia,due to injury on hard seat while cycling.there seems to be injury to last fragment of tailbone,causing irritation and swelling.i usually advice my patients to take sitz bath ie sitting in lukewarm water in a wide utencil,for 5-7 days,take some safe painkiller,use sponge cushion for sitting,apply locally pain killer creams,use anaesthetic cream/gel in anus to help to pass faeces.get an x-ray done for pelvic area after consulting ortho expert.thanks i will be happy to answer further any query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be the cause of neck pain and heaviness in head?\n\nHI, I AM 37 YRS OF AGE AND HAVING BP FOR LAST 10 YRS.....NOT HAVING ANY MEDICINE BUT NOW I HAV STARTED TAKEN AMLOKIND -L 5 MG TWO TABLET IN A DAY...MY PRESSURE IS ALWYS LIKE 165/100 SOMETIMES IT DOES UP ......AND NOW I AM HAVING MY NECK PAIN , HEAVINESS IN HEAD...HAVING DIFFICULTY IN MOVING MY NECK AND SHOULDER.....",
    "doctor_response": "hi your headache is related to high blood pressure.( uncontrolled) please get evaluated  with a the cardiologist with an ecg, chest x-ray, 2d-echo,ultrasound abdomen, x-ray neck (to rule out spondylosis/ compression),if required ct brain to find out the possible causes change of lifestyle &  destressing yourself will help a lot. all the best take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain and left side pain\n\nI recently start getting either back or long pain on my left side. I hurts so much that I cant even sleep. Trying to get of bed was bad. The pain was less when I start moving. I also noticed that when I move my head up and down my it hurts again. It feels like a knife sensation. it does not hurts when I breed but I feel a little disconfort. I had this for the last two days.",
    "doctor_response": "Dear ; I understand your concern. It looks that you are having a pinch  nerve . You can try an antiinflamatory and if no improvement, you should have a MRI to check for spinal stenosis or buldging disc.Dr Sara",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the home remedies for chalazion?\n\nHello!my son its got a chalazion..i have bene to THE dr nd grave me tobradex drops and maxitrol..but it didnt go Away..i want to ask u what i can do to go Away without surgery????is Any natural way to make it go Away?i read that HOT compres with HOT green or black tea helps..what to do?",
    "doctor_response": "HelloAs per your query your kid is suffering from a skin disease called kshudra Riga in ayurveda , this is happening due to vat a vitiation and can be cured by treating vat a only. For that you need to consult an ayurvedic physician nearby or contact me with complete history at drjasmeetdhami @rediffmail.com. For the time being bring pippali ( piper longum) , crush it to powder and take 1 gram daily in morning empty stomach and apply mustard oil to the affected part (it will start improving)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had bladder & prostrate cancer. Now have tumors in lungs, neck. Pain in right leg. What are the risks of delay?\n\nsymptoms of femur fracture.My husband has bladder cance and prostate cancerand now has metastatic tumors in his lungs , right neck, lower right back and upper right back.He has just gone through 10 radtiation treatments to his chest.His right leg gave out on him and he is suffering from acute pain in the right femoral area.refuses to see emerg. as he is scheduled for a full ct scan...in 3 days.I want him to go to the emerg now...this happened last night (Friday)CT Scan scheduled for Tuesday.He can barely walk and in severe pain.25 radiation treatments in February of this year for prostate cancer.Previously BCG chemo therapy for bladder cancer.What are the risks of delay?Thank you.",
    "doctor_response": "Hi,Thank you for your question.From the history and description of the pain your husband is in, he may have fractured his femur. Therefore, I would strongly recommend that he consults a doctor urgently. If he has fractured his femur and leaves it too long before treatment then the operation may be more complex than necessary. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes depression with severe mood swings in a 15 year old?\n\nI am 15 years old. I m 5 5 and 117lbs. My mother has been diagnosed with depression and my dad is an alcoholic. I have not been diagnosed with anything other than the odd leg injury as I am a dancer. So for about 2 years I have been feeling really weird. For around 1-2 weeks, I feel insanely happy and hyper. I do not need much sleep and manage to get lots done in my day. I talk fast and am much more social. But I m often irritable and fight with people for no real reason. The next 1 to 3 weeks I feel super depressed. I find it hard to focus and get any work done. I often think about suicide at these times or make plans to die. I cry all the time. I sleep for about 13 hours a day but wake up about 5 times during it and find it hard to get back to sleep. I also SI. I usually don t eat much and take time off school so I can try to sort myself out. I am constantly tired and people notice that I m slowed down. Am I going crazy or just being a teenager. Please help.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  From the description, it is clear that you do suffer from Bi-polar disorder. But there is another possibility that you are trying to lead me into the diagnosis. For a teen aged person highs and lows are normal. These happens due to disappointment. Because teenager needs to identify his/her role in family, school, society, career, future etc, disappointments are common. To diagnose your mental health disorder, please undergo a psychometric test administered by a trained clinical psychologist / psychiatrist.  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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could chest pain post quitting smoking suggest?\n\nI was a smoker for about 12years :( I quit for 5 months now , 2 months after I quit I had chest pains a really really slight coughs so I got scared and went have like 3 chest x-rays and a ct scan and thanks god Im ok, now it's been 5. Months and The chest pains here again I'm scrared :(",
    "doctor_response": "Hello dear , hiWarm welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  There are different  possibilities  for  the  same  as    -  bronchitis  -  emphysema  -  stress induced  -  others .Hope this may help you .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can the penis foreskin be brought back to proper place?\n\nHi doctor, Yesterday my penis foreskin suddenly moved back and did not come back to proper place. Glans is still open and pain is there. Please suggest the way to restore that. Please guide me on how to pull it back.",
    "doctor_response": "Hi. This condition is probably paraphimosis and it needs urgent treatment. If you are not able to pull back it by yourself then consult a surgeon or doctor as soon as possible. He may correct it immediately as of now and may recommend surgery for further depending on the severity. For more information consult a sexologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath and fluid in lungs?\n\nhi dr, my cousin has had breast cancer, what type, im not sure. Her breasts have been clear from cancer for the last year, but she started to get shortness of breath, went to doctor and is in hospital now, has a lot of fluid on her lungs. She is awaiting cat scan, how serious could this be, doctors are not telling her a lot but they said the lungs have a lot of fluid and more than likely cancer is back. She has just got fluid drained. What do you think. Thankyou.",
    "doctor_response": "Your concern about your cousin is justified. The collection of fluid - what doctors call pleural effusion, can be due to many causes. But in the setting like that of your cousin, it is most likely due to invasion of cancer cells. As the fluid is drained, its laboratory examination and the CT scan will give you the definite answer.Hope I have answered your question. If you have any further questions I will be happy to help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a blotchy rash on arms and legs after taking a meth injection?\n\nName: Taylor Romero: PT HISTORY: I am a Recovering Heroin addict recieving Methadone Treatment, and also take a multi Viamin, Aspirin (81mg 1xDaily), Vyvanse (50 mg 1xMorning), and today I made the mistake of doing about .3 Gram of Crystal Meth Via IV, and now I have this rash all down my arms, and legs, looks similar to blochy red lines everywhere, and also, on my right wrist (right Forarm) is the place where I did my shot of the crystal, and about 4-5 hours later, my right palm and thumb turn blue and is swollen, I also missed a tiny bit of my shot when shooting into my right foerarm, I was wondering if this is some kind of allergic reaction or am i just being paranoid?",
    "doctor_response": "Hello, Your symptoms seem to be related to an allergic reaction. I suggest using antihistamines such as Cetirizine. I also suggest using Calamine lotion for local application at the rash area. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could pus and blood filled lumps in armpits be a precursor of cancer?\n\nHi. I am a 34 year old female, and cancer runs in my family. My Dad died with prostate cancer, and my Mom currently has ovarian cancer. Now, to my question. I my left armpit, I have lumps that come and go. Well, they've came back, and been back since May 1st. This time, it feels like at least 3 of them. I noticed today, that my armpit is now leaking pus and blood. What could this be, or what should I do? West Virginia",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have enlarged axillary lymphnode due to some acute inflammatory lesion or tuberculosis.  Or you may have some abscess forming infection.  Chance of cancer is very low.  However you should go for fine needle aspiration cytology or biopsy of that lump.  It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for systemic lupus , fibromyalgia and arthritis\n\nI was trying to get to my doctor who has all my info not that she keeps up on it. My problem is systemic lupus, fibromyalgia, arthritis, nueropathy, and a host of other conditions. Very bad knees, bone on bone (been getting shots) but not helping lately. Bad feet & toes, prolapsed mitro valve, dizziness and falling a lot. The past several months I have trouble to be walking on my legs & feet more than 10 minutes. Today I got up and could not hardly walk; felt like I had crushed bones in my legs. I have been dealing with a lot of these illnesses since 1982.",
    "doctor_response": "Hello,Welcome to the magical world of health care, I went through your query, and your concern need a multi speciality approach to deal, a rheumatologist, a physiotherapist, and cardiologist will make a good helping team.  I hope my advice would have been useful, in decision making regarding your treatment, still if you have any clarifications or doubts feel free to contact back.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for depression and stress\n\nHi im 14 Im very depressed at the moment and im not sure why ive always had self hatred and no confidence but now I always want to cry and I never cry when I want to and ive got a heavy feeling in my chest at night usually every night Im always thinking and worried and if its a night before school its very heavy and I want to cry alot. I think its stress but im not sure what is wrong with me?",
    "doctor_response": "Hi,I can understand the distress that you might be facing with your current set of symptoms. From what you have mentioned, it seems that you might be having a depressive episode. I would recommend that you discuss regarding your symptoms with your parents without any further delay and seek a psychiatric consultation. You will benefit from treatment with anti-depressants like escitalopram. In addition, it would help you relax if you start exercising daily.Hope this information was helpful. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having nausea, backache, diarrhoea, no apetite, knee pain. Problem with liver?\n\nI have been experiencing a lot of nausea the last few months and now I have a dull ache on the right side of my mid back, can t tell if it is internal or muscle related. I have been alternating between full blown diarhea and chalky grey stools for the last week, I have virtually no appetite . I m 29 and was a moderately heavy drinker up until about 2 years ago when my daughter was born. I don t tolerate NSAIDS well so I take quite a lot of acetaminophen to deal with chronic knee pain and almost constant upper back, neck pain and headaches. The knee pain is from a fairly recent injury but I have had the upper back pains since I was in junior high. I attribute this to a very bad fall (almost 20 feet, i landed on my shoulders) i don t feel like the injury was ever properly diagnosed, I recieved no treatment other than an xray . I take about 3 grams a day(16 waking hours) about 20 days per month. I never use to take acetaminophen when I was a drinker. Do you think I need to be concerned about my liver health? I don t really want to see my Dr. if I don t need to. I think he believes I m a hypochondriac or a drug seeker because I talk to him about my back problems most visits. I think he believes I am to young to have chronic back pain and doesn t take me seriously, he prescribes me naproxen almost every visit even though I tell him every time that it makes me sick!",
    "doctor_response": "Hi  I have read carefully all your concerns and I am sorry for experiencing such sad situation. with regards to your diarrheaI recommend you to  use -plenty  of  fluids -tasectan with a glass of water- hydraminIf it still persists please you should do coproculture ,  fece analysis like candida, ova and parasites,  abdominal ultrasound and blood work.with regards to your pack pain, I belive it may be real, so you can do:- massaging -you can use some times opiod analgesics like tramadol,-avoid stress as it possibile  with regards to your liver and acetaminophen use , it is toxic for the liver . you take 3 grams a day for 20 days per month, it a high  and toxic dose for liver, so you should do balance biochemistry.So I recommend you to stop use of acetaminophen ore decrease the dosage all the bestDr.Kleridap.s. if you have further concern, do not hesitate to contact me",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pus cells in urinalysis during pregnancy?\n\nHi, I am a female aged 31 years old. I am 21 weeks pregnant. I went to the prenatal clinic two weeks ago and the results of urinalysis indicated that \"pus cell seen\" I have been experiencing pain on my right pelvic bone that does not seem to go away. at time its even difficult to stand while i was sitting. please help am i in any danger?",
    "doctor_response": "HiPus cells on the urine indicates urine infection. For that drink lots of water .After 12 weeks of pregnancy uterus start growing in to abdominal cavity. All  the pelvic muscle and ligaments start stretching. Because of that lower back pain and pelvic pain will be there.Don't worry it will come down.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to relieve stomach pain and possible constipation in 5 year old?\n\nmy 5 year old son has had tummy pains that have been coming and going .. he feels like he has to poop but he sits there and nothing comes out i took him the hospital cause i thought he might have appendicitis but blood and ultrasound and xrays came back just fine so could he be constipated if so what can i do for him?",
    "doctor_response": "Hi.  You can include lot of vegetables and fruits in his diet. Dates and prunes are especially good for constipation. He must take around 1 litre of water per day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart perpetuation?\n\nyesterday I hadheart perpeation for nearbour 5 min..  due to which I felt weekness and there was dueto which I had pain  in chest..... I dont know whether it was through irregular heart beat or what...i had taken warm water and glucose  which result in vomitting and I felt relieved...this happened thrice...asitsan extreme cold herein India",
    "doctor_response": "It can have different reasons, some of them; low sugar,low or high temperature, alterations in thyroid like hyperactive thyroid,dehydration,high fever.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal for children to giggle without reason?\n\nHi, may I answer your health queries right now ? Please type your query here...My son is 5 yrs. He has a history of acute manengitis when he was only 15 days. He survived miraculously. He had undergo a shunt-surgery at an age of 1 and 1/2 yrs. His activities has been delayed. Now at an age of 5 he goes to a play way.Sometimes he starts giggeling without any reason otherwise he follows everything. Is it normal or what to do? Kindly suggest.",
    "doctor_response": "is there any delay in his achieving milestones like sitting,standing,walking,speaking. does he also mutter when he giggles or seems as if ge is talking in himself. if yes he may either have some intellectual disability or another psychiatric illness. if all above questions answers as no then it may be normal also. i would suggest you to get him checked if there is any doubt",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump in the vaginal opening indicate?\n\nI have a fleshy lump on the front wall of my vaginal entrance that covers most of my vagina, though there is a hole at the bottom underneath that can be accessed easily when I m lubricated, it now also has a little white bump on top of it. I m worried this could be something sinister and am debating going to my local GUM clinic to get it looked at but would like to know if it s just something normal and will go away with time or is actually supposed to be there.",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .*  This  seems most likely to be bartholin or sebaceous  cyst  .    Should  get  examination  clinically  and  if  necessary  ultrasound     evaluation for definite  management  guidelines .Hope this  will help  to clear your doubt   .Wishing you fine recovery .Always welcome for any further assistance anytime .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath and feeling of muscle cramp in the chest?\n\nI went to the dr and then emergency tuesday, I thought i was having a heart attack, They did an ekg and said that i wasen't. Why do I have shortness of breath and it feels like my heart or surrounding area, is in a charlie horse feeling??like a bad muscle cramp?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. First of all, no need to worry for heart diseases because your ekg was normal.Sometimes stress and anxiety can also cause similar kind of symptoms. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic drugs (propranolol and flunarizine combination) too.Don't worry, you will be alright with all these. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does depo injection harm unborn baby?\n\nhi, i was on a pill that you didn t take a 7 day break, went and got the depo injection. the doctor told me to continue taking the pill for a further 7 days as well which i dd. i think that i may be pregnant and was wanting to know if the depo injection can do any harm on unborn baby??",
    "doctor_response": "HiSince you have taken depo injection and oral contraceptive pill, it is highly unlikely to get pregnant. Depo-Provera is considered a Category X drug by the FDA, which means that the medicine has been shown to create problems with the fetus. There's a risk of harm to the unborn baby with using Category X drugs during pregnancy, and most doctors agree they should be avoided whenever possible.Hope I have answered your query. Let me know if I can assist you further. RegardsDr.Saranya Ramadoss, General and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for pain in testicle.\n\nMy balls hurt sometimes especially the left one. This happens after one time in the middle of my sleep my nut got swollen I couldn't even move literally. So now I have a little ball next to or on my left nut it hurts very often sometimes not so much other times alot I feel like I'm gonna throw up or something. Can someone please tell me what this is or why it happened. Thank you very much for all the help.",
    "doctor_response": "Hello,The testis inflammation need to be ruled out here. I suggest you investigate with testis ultrasonography for primary work up. If testis inflammation present than anti inflammatory drug and antibiotic course need to be prescribed..Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does low blood count suggest?\n\nHi there,  My dad did his knees replacement within the last six months. He appeared to be healing well, however the doctor diagnosed him with a low blood count very recently. He was at 109 and dropped to 98. I am concerned...What can he do to fix this..",
    "doctor_response": "Hello,You dad has anemia and the commonest cause is iron deficiency for which an iron supplement is sufficient to correct the problem. Serum Iron and Ferritin estimation will confirm the diagnosis. Since he is a senior citizen check his kidney functions also. Impairment of kidney function can produce anemia not corrected by iron supplements and will require other treatments.I shall be happy to answer any further query you may have.Dr. Noble Zachariah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Non hodgkin s lymphoma, heart valves replaced with titanium valves, damaged mitral and aortic valves, diagnosed COPD. What now?\n\nI am trying to find the right specialist for my sister for when she is released from a rehabilitative hospital in MI.  She has had non-hodgkins lymphoma for about 12 years.  She was diagnosed with COPD a few months ago and last week had two heart valves replaced with titanium valves because the doctor who gave her a port  to remove fluid buildup failed in her sanitary procedures. The infection that resulted caused damage to both the mitral and aortic valves and possibly brought on the COPD.  My sister never smoked.",
    "doctor_response": "Hello and welcome to HCM,Your sister is suffering from three different disease processes.The first is Non- Hodgkin lymphoma. Chemotherapy is the main modality of treatment.i guess she might have had the cycles of chemotherapy.Secondly, there is damage to the cardiac valves. The damaged valves need to be replace by synthetic valves. Your sister has had the replacement. There are certain precautions which one has to take after valve replacement since the patient becomes prone to various infections especially infective endocarditis and sub-acute bacterial endocarditis. These two conditions are characterized by infection of the artificial valves by bacteria entering from oral cavity, some focus of infection in the body, etc.Thirdly, COPD. The management of COPD depend on the predominant disease process- bronchitis, asthma, emphysema, bronchectasis.Cigarette smoking is am important risk factor for COPD but COPD can occur without any prior history of cigarette smoking.Treatment depends on the predominant entity affecting the lungs.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dark spots within the wound on knee?\n\nI had a wound on my knee about the 3/4 inch in size and its healing. It took bout a week or two for it to completely dry off as a clear liquid used to seep out. now with the scab gone, the wound is pinkish but has dark spots within the wound. Is that normal?and why does the wound spot?",
    "doctor_response": "Hello,I understand your concern.I am Dr Arun Tank, Infectious diseases specialists, responding to you.The wound that you described is normal. It is normal healing procedure. The black spot will disappear by its own. Though it takes some time. But till that time you have to be patients.I will be glad to answer your further query. Thank you for your contact to health care magic.Wish you a best health.Thank you,Dr Arun Tank.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes watering of eye and drooping of mouth?\n\nI have noticed in the last few days that I have had an onset of bells palsey my right side of my mounth is drawn and my right eye is watering I am 56 and I am diabetic now the other time I had this happen I was 21 and I was not a diabetic then but I went to a dr when I was 21 they told me nothing was wrong so It did eventually went away I dont remember how long it took but I was just wandering if you could tell me how long it may take for it to go away?",
    "doctor_response": "Hello dear,I understand your concerns but please be reassured.If it is definite diagnosis of bell's palsy,long term prognosis is good and in more than 90 percent of the cases complete recovery can occur within a few months(maximum upto 1 year).If it is of few days,I suggest you to visit a neurologist so that he may prescribe you a short course of oral steroids and ensure your proper physiotherapy for facial muscles.It will increase the rate of recovery.Meanwhile,eye patching and lubricants in the affected eye will prevent corneal injuries.I hope it helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a drooping eyelid be treated?\n\nHi Dr Rynne, I have a 42 year old daughter who has an upper eyelid that has recently dropped & is obvious in pictures. She has seen her optometrist who is referring her to an oculoplastic surgeon in Atlanta (where she lives). My concern is whether her brain should be scanned before just treating for cosmetic appearance. What do you think? Thank you, concerned mom Janice Forrest",
    "doctor_response": "Hello!Welcome on Healthcaremagic!You are right to think that other disorders should be excluded before discussing about surgery. It is true that a lot of neurological disorders may lead to such clinical situation. For this reason, I would recommend consulting with a neurologist and performing a repetetive nerve stimulation (ENG) to exclude myastenia . A brain MRI may be needed too. Hope you will find this answer helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having hearing problem only in the left ear. Why?\n\nHi doctor, For the past few days, I am not able to hear properly through my left ear and it is almost down to 50%. I have consulted an ENT specialist and they suggested for a CT scan. Everything is fine in the scan. Sugar and BP levels are normal and they injected some steroids for two days. Still, I am not able to hear and the same situation continues till now. Will it lead to permanent hearing loss? Do you have any suggestion of what could be done? I am 28 years old and the problem is only with my left ear. Audiometry is also done where the right ear is fine and 50% reduction in the left ear compared to right. Currently, the doctor is advising some medicines for vitamin improvements. Please help.",
    "doctor_response": "Hi. I understand your concern and you have developed sudden hearing loss in your left ear for the last few days. For further information consult an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I get a mild case of chicken pox from the shingles?\n\nI have been diagnosed with shingles, just have itching right now. But the lesions seem to be spreading up my back and down my leg, not typical of the dermatone location. Most of the outbreak is on just one side of my body around the waist. Could I get a mild case of chicken pox from the shingles?",
    "doctor_response": "Hi, If you have had chicken pox in the past you can not develop that infection again, it causes long life immunity. Because you are having widespread shingles you will need to probably take some oral antiviral like acyclovir to help it heal quicker. You will need a visit with your doctor to confirm this diagnosis and take the prescription with acyclovir if it is needed. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Antoneta Zotaj, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pain in back after down fall from stairs?\n\nTeenage girl fell down a flight of carpeted stairs this afternoon. She blacked out for a little while, woke up, and couldn t catch her breath. She took anti inflamatories, hot bath, then iced it. It s now midnight and her back is in a lot of pain. Should we go to the er or wait to see if things improve by morning?",
    "doctor_response": "Hi, thank you for posting.I have gone through your query and I understand your concerns.Her symptoms are related to muscle contusion(bruise). The treatment of muscle contusion contains non steroidal anti inflammatory medicines, rest, ice, compression and elevation.You should take her to Emergency Room for a bruise harm score.X-ray and complete blood count are necessary in these cases. Complete blood count will show if she has internal bleeding.Contact an orthopedist.I hope I answered your question.All the best.Dr. Behar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abnormal activity with lot of anger\n\nDear Sir, My wife is very arogant, Becomes angry every times and when she is angry she can do anything, she can pluk her hairs, beat me, my daughter, beat the mate servant, tells slangs, beat her mother even tries to suiside also... But when she is good (which is a rare situation) or if somebody outsider meets her cant understand anything.. she is a housewife , not much educated, she have a brother who is a brilliant student. Her parents always campares her with her brother and made her feel bad about that. After we got married, mu mother also reacted badly with her and didnt try to fulfill the place of her mother. we are basically from West Bengal but stay at bangalore..I took her once to the mental doctor, but there she acted like she is very normal as I tols you earlier. Doctor have asked for family therapy. What happens in this family therapy? Is this curable? How can I get my wife back and lead a good life??? I want to visit you also if required...Please help me....",
    "doctor_response": "Hello; thanks for the query & I feel sorry to hear your state of plight. Based on your description; your wife seems to have some set of personality disorder (PD) most probably cluster B (emotionally unstable, borderline type). PD per se not an illness cured by medications but a form of extreme behaviour defying societal norms, causing distress & dysfunction for patient himself/herself & family members. PD is usually treated by talk therapies known as cognitive behavior therapy (CBT). Additionally, considering that your wife has endured a lot of adverse conditions at her parental home & with mother in law; family therapy (FT) was advised to you. FT is also a talk therapy; where a set of desirable & undesirable behaviors; contingencies for family members; behavior modifications etc. are suggested. Additionally, if your wife is suffering from mental health problem like depression; that too can be diagnosed & treated. Since you live at Bangalore; you can visit NIMHANS Bangalore for all these therapies or revert back to me for further help. Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I use Kojivit gel to get fair skin?\n\nHi doctor, I am a 22 year old female. I have a dusky skin that is brown skin. I want to become fair. Can I use Kojivit gel? Or any other dermoatology cream can I use? My hands are also brown in color and full of tan. Do you suggest any creams to get fair? I want to become fair as my marriage is going to get fixed by next year. Please suggest me some creams, so that it should not show any side effects. Also, how long I should use it? If I use anything, then will it have any effect in case of pregnancy, etc? Please help me. Thanks in advance.",
    "doctor_response": "Hi. One's skin color has 2 components. First one is genetic, which cannot be changed. Every skin color is beautiful in its own way and we should learn to love our skin color and augment it and not hide or lighten it. The second component is acquired, which is due to the influence of environment, sunlight, hormones, aging, etc. We can only target the acquired component of fair skin color while attempting lightening procedures. I suggest you antioxidant capsules like capsule Antoxid HC (Beta-carotene) and apply sunscreen lotion Lashield gel at 8 AM and 12 PM. Also, you can apply Glyaha koj lotion (Hydroquinone) at night time. Start with an alternate night application initialy as it may irritate your skin a bit and after a week or so, shift to daily night application. Consult your specialist doctor, discuss with him or her and take the treatment with consent. You can go for chemical peeling or microdermabrasion from your dermatologist which will help in exfoliating and give you a clearer skin tone. All these treatments are free of side effects. You may use them for three months. For further information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood on panties and fever thereafter?\n\nMy child woke up with some dried blood on her panties on Thusday she is Five. Saturday my child went to a swim party came back so tired wouldn t get out of bed from 5:00pm on had small fever then Sunday went to swim park and she started freezing it was very hot outside she complained her head was hurting. We took temp it was 101.3 gave advil didn t go down for a while. Woke up Monday morning seems okay.",
    "doctor_response": "Dear friend,This is a highly unusual symptom in a five-year old child. I mean the blood on her panties, unless she hurt herself there while playing. Do take a look at her private parts, both the front and the back under a good flashlight illumination. If in any doubt, take her to her pediatrician. There does not seem to be any relation between the blood on her panties and the occurrence of fever. The latter seems to have subsided anyway, but still, you should get her looked at by a pediatrician.Dr. Taher",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Excedrin be taken for sinus congestion, fever and cough?\n\nMy 73 yr. old has a deep cough, ache all over, 102.7 fever, no appetite. He went to walk-in clinic yesterday. He was given something called Zpac (started yesterday). He thought it was sinus as his eyes were running, stuffed head (he has a lot of sinus trouble). Today he is much worse. Just lied in bed all day and didn t want to eat or drink. He just took an Excedrin. I m worried his temperature is too high. Thank you.",
    "doctor_response": "Hello,The amount of underlying infection is substantial giving high grade fever.Excedrin drug can be taken 2 to 3 times a day after meals along with antacid preferably later after 24 hours of intake, if fever persists, you should consult treating physician.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to swim for a patient with a pilonidal cyst on the tail bone?\n\nI have a pilonidal cyst on my tail bone and I also have an abscess on my down stairs area on the right lip they were both lanced. They are both closed up well the abscess is I don t know about the cyst. Anyways am I safe to go swimming in a lake or a pool?",
    "doctor_response": "Kindly donot go for swimming with abscess anywhere in the body.It is neither safe for you nor for those who share the pool with you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bilirubin result abnormally high, indication of Gilberts Syndrome. No prognosis?\n\nI have had two recent bilirubin test results that are abnormally high.  The first, part of a liver function panel, was 1.6.  The second was a total and direct bilirubin test.  The total was high, 2.0.  The direct was at the upper end of the standard range, 0.2.  My doctor said that these results indicated Gilberts Syndrome, but she minimized its significance.  She said that nothing needed to be done about it.  She said that it was hereditary.  She didn't indicate any prognosis.  What can you tell me about this?",
    "doctor_response": "Hi,Thank you for getting back.Gilbert syndrome causes mild yellowing of eyes due to increased bilirubin.It occurs due to deficiency of one liver enzyme.In this syndrome there will be no symptoms except for jaundice.Situations like fasting may elevate the jaundice.The prognosis is excellent and no treatment is required.Hope I have answered your query.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the risk of spinal cord injury?\n\nWhat is the risk of spinal cord injury in a person with a unilateral fracture of the left facet of C-6? 2 years ago I suffered this injury in a mountain biking accident. No surgery was required. I returned to work 8 weeks after the incident. Presently have no pain and a slight rotational deficit at the limit of turning my head. I wish to begin cycling again but am concerned about re-injury or worse suffering a spinal cord injury from another fall. I am a 6 tall male 200#.",
    "doctor_response": "hi,thank-you for providing the brief history.As the C6 fracture cannot lead to long term spinal cord injury. There may be a possibility of having nerve root impingement in the future if the neck muscles become weak.I will advice you to undergo and thorough clinical examination and an MRI of the neck. Also, with physical therapy you can regain the strength in the neck muscles and keep the normal anatomical alignment of the bony structures in the cervical spine and you can avoid nerve root impingement.Using a collar while your sports is important to avoid any injury to the neck muscles and even can avoid the malalignment of the cervical spine.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "I would like to know about experiences of others with Retro peritoneal Sarcoma, about Traditional medicines that may help and basically anything that anyone would like to share. B/rgds Pradeep Chawla",
    "doctor_response": "My mom has this. Very serious form of cancer, she has had it 4 times in 5 years. Surgery is often the answer but is highly agressive and may need radation and chemo... Cancer comes back, and no dr's seem to know a lot about it... it's scary",
    "dialogue_context": ""
  },
  {
    "patient_message": "Done surgery for scheuermanns disease. Feeling popping in spine, numbness in back. Something to worry about?\n\nHi I am 19, i recently had a surgery for Scheuermanns Disease fusing from my T-2 to my L-1. it is a little over 4 months since my surgery and I am feeling a poping along the sides of my upper spine where the metal rods and fusion is. I have numbness in the area and had other people feel my back. They say the feel something pushing up. Is this something I should worry about?",
    "doctor_response": "Hi, it appears that the feeling of some thing pushing up, and numbness to touch may be common, for some more time, but it is prefered to consult your operated surgeon, when you have even a small doubt.                   I advise you to avoid weight lifting, and hard work for some more time.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause kidney pain?\n\nstarted to have pain around back right side basically where kidney would be . pain is basically onstant, nagging or like a burning sensation. noticed urine smells stonger, and also left side back is tender. no burning when urinating. no fever, no nausea",
    "doctor_response": "back pain may or may not be kidney related. most of the time it is due to problems of spine, slipped disk, postural pain etc.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain after a serious kidney infection?\n\nI was recently hospitalized for a serious kidney infection and likely sepsis with 5 days in the hospital after a kidney stone got stuck in my ureter and got infected. This was 4 weeks ago. I have been very slow to recover. I have been pain-free, other than mild pain, for the last week and I do feel my energy start to come back. I have 4 more stones in my left kidney (two are 5 mm and 6 mm and the other two are small). I have been off all antibiotics for over a week. I just saw my urologist and my UA showed 1+ WBC dip, trace protein, hemolyzed trace blood dip, 10-20 WBC micro, 5-10 RBC mico, but no bacteria. Does this indicate any kind of infection? My urologist didn t say anything but at my visit before this (two weeks ago) my UA was similar and he said it was still ugly. I was still on antibiotics at that time. Also, I had a very serious episode of pain one week ago, but my urologist wasn t concerned as I didn t have a fever and the pain went away, although I was about to go back to the ER. It felt very similar to the level of pain from when I was in the hospital. My fianc\u00e9 wants to get a second opinion. Any information or advice you can provide will be very much appreciated. Thank you!",
    "doctor_response": "Hai,so now ur problems are-left renal calculi with pyuria(pus cells) & hematuria..u can now do a repeat renal function test,urine culture & CT KUB(plain) that will guide further treatment",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can stomach and breasts that seem to sag be dealt with?\n\nHello Dr. Rangadhar,I am 32 yrs old, (male), and am slim but have a funny big sagging belly and sagging nipples. The combination looks so crazily funny that I feel ashamed to go out in public. Kindly tell me how I can look normal.thank you in advanceShyamal",
    "doctor_response": "Hi there,I had gone through your query and understand your concern.Yoga and excercise can help to tone the body to some extent but if the problem is very unconfortable or disturbing the daily routine life,I suggest to see the Plastic Surgery who can examina the extent of the condition & advise surgery if required.A lot of individuals theses days opt for cosmetic surgery if this kind and best Specialist Surgeon to advise is Plastic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain and headache?\n\nHi, I suffer from back pain since having my second child but has been getting worst, my nan had this crumbling spine  and im worried I may have it as well. I have been getting really bad headaches and feeling slighty sick as well over the last month. Do you think this is something to worry about?",
    "doctor_response": "you haven't mentioned your age build weight etc which are important for suggesting something, no back pains don't usually run in families. try a course of tab Lobak twice daily for a week with local application of Mykolayiv ointment",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it safe to take Gelusil and Emeset when pregnant?\n\nHi doctor, My wife is 7 weeks\u00a0pregnant\u00a0now. Currently, doctor has suggested some tablets and her reports are attached for your reference. From yesterday, she feels gas and wants to take Gelusil. Is it safe to take Gelusil with these medicines?\u00a0She also complains of vomiting sensation especially in empty stomach and takes tablet Emeset only on alternate days. Previously, she used to feel her appetite as heavy even after food. But, after this\u00a0gas issue she takes less food. Please guide me how to take care of this situation?",
    "doctor_response": "Hi. I went through your prescription (attachment removed to protect patient identity) and your query. I will try and make things slightly simpler for you. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning in the heart in spite of stunt placement?\n\nHi Sir, Recently my mother had heart stroke and joined in care hospital and doctors confirm that 1 vein is blocked and immedetly they put stunt .. After 4 months my still facing the problem of heart burn.. and doctor confirm that once again angiogarm be done ..pls help in this regard why my mothe facing the same problem again is this critical to her pls advice",
    "doctor_response": "Hi,Atherosclerosis is a disease, which affects arteries (vessels). In your mother case it affects heart arteries and cause narrowing abd blockage in arteries. A stent was put in one of her arteries, but heart has more than one artery, and as the disease evolves, other arteries may be affected and there may be need for intervention in other arteries. We prescribe medications to prevent the blockage of remaining arteries, but still there is no 100% guarantee, that there will be no further blockages, it is individual.Hope this was helpfulTake careCome back if you have any further questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bleeding in the lips?\n\nLast week, the inside of my lips starting bleeding on both lips and it looked just like I had eaten a red popsicle. After a few days of that, it stopped bleeding but now some yellow ish crush forms where the bleeding used to be. It also looks like there are tiny pinkish dots on some parts of my lips. There hasn\u2019t been any itching, burning, just a little bit of pain when it was bleeding. I was thinking it was an allergic reaction, since I started being super conjested and sneezing a lot since it started. It\u2019s lasted for exactly a week. I don\u2019t know how to make it better!",
    "doctor_response": "Hello,You have symptoms of bleeding in the lips which seems to be due to an allergic reaction and could be due to loss of the natural moist layer of lips.Need not to worry. I would suggest you apply benzyl benzoate lotion in 25% quantity and apply cold compresses to lips. You should avoid hot, sharp and spicy food substances. Visit oral physician/dermatologist once and get the complete examination done and take the proper course of antibiotics. Avoid repeated touching or pricking of lips. You should apply cold compresses on lips. Avoid applying any cosmetic product on the lips. Hope I have answered your query. Let me know if I can assist you further.Regards,      Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce stress?\n\nHi there i have been drinking a lot of water and my acne got less, but then i started to stress about my girl friend, she was very sick and almost died then i started to get sad, and since i was getting to stress and getting sad my acne was getting more and more and more, and yea i eat 2 minute noodles and bread a lot, sins i have been stressing, what do you think maybe the problem, please help",
    "doctor_response": "hello, irst and foremost stress is necessary for life up to some extent for one's progress as well as alertness which is called eustress.However when this stress is more than require4d called distress and affect overall physical and mental health.You didn't mention causes for our stress otherwise I can tell you specific measures.In stress many persons eat mores as appetite center gives pleasure and reduce stress however if it is continous it leads to obesity and secondary complications.So it is wrong cope up mechanism to figh stress.Overall lifestyle changes are necessary to reduce stress like regular proper nutritious diet on time,regular adequate sleep,regular physical exercise(simple walking 3-5 KM 5 days a week suffice) and/or yoga.And specific measures depends on your causing factors of stress.Reduction of stress s necessary and must as stress is respooonsible for current lifestyle diseases kike hypertension,heart disease and dibetes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do the eyes started ticking?\n\nMy 5yr old daughter out of the blue today spiked 103.5 fever, she had fallen asleep and woke up when her dad come home said one thing then her eyes did this wierd ticking thing for about 5 seconds then she went back to sleep. She has since perked up and is playing but im wondering what would have caused the ticking and should I be worried? It almost looked like she was having a sezure but it was just her eyes",
    "doctor_response": "Yes it is a siezure, they can be of various presentation like ticking of eyes chewing of mouth flickering of face deviation of face even pain abdomen and frank siezures. it occured after onset of high grade fever disappered and child is alright sensorium wise after siezure. you have  to control the fever in this case and further fever episode. the illness is known as febrile siezures.  it is seen in childten between 6m to 5 years age group and disappear usually by age 6.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rubbery painless lump on the neck?\n\nI have a rubbery painless lump above the hairline on my neck. It started at the base of my skull. I took a round of PCN and it got smaller & moved down to my neck between the 2 bones at the base of my skull on the back of my neck. It is not moveable. I ve had it for 4 mo.",
    "doctor_response": "Hello and welcome to HCM,The lump that you having in the neck between two bones can be the same lump that you had previously or it could be a newly developed lump.A X-ray of the lump is required to look for its origin - whether bony or from soft tissue.If the lump is arising from soft tissue, an aspiration of the lump is required.In aspiration cytology, cells are aspirated from the lump, spread on a slide and stained with appropriate stains.The stained cells are studied to look for the origin and nature of the lesion.Thanks and take careDr Shailja Puri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I continue medication even after there are no seizures?\n\nI fell down in office and got a minor external injury on my head. I was unconscious for couple of hours and got to know that I suffered partial seizures after I fell down. I was taken CT & MRI scans and was assured that there was no seizures defect in my brain or nerves. I have been using Levipil 500mg in the morning and Levipil 1g at night. When there is no Seizures defect should I continue using medicine? If yes, how long?",
    "doctor_response": "Hi, Thank you for using Health care magic.I can understand your concern about course of anti-epileptic medicine.Most of the Doctor prefer 3 to 4 year of anti-epileptic course after last seizure episode if no causative factor had been found for seizure.As you said, after fall and injury you had seizure but no defect seen in brain imaging you will be also considered in above said situation.It is also important to withdraw medicine slowly means reducing the dose of medicine gradually over time.Your treating physician will be in a best position to guide you in this course of anti-epileptic medicine.Hope you will find this healpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be concerned as my feet and palm gets very hot?\n\nThank you, this is fantastic, I am impressed for such service. My concern is during night my feet(soles) and palm of my heands get very hot and have a funn sensation in them. It wakes nme up in the night and fell like but dont have swelling in my feet. Am quite worried about this. Thank you Tazim",
    "doctor_response": "Hello, As having a burning sensation in the feet and arms can be due to disturbed physiology. Having a uric acid test done will be good. Post which if the test turns out positive then medicine for the same will be advised. If the test is negative then try doing static neck exercises, upper limb strengthening exercises, core stability, and hip muscle strengthening exercises. This should relieve pain. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are cough and nasal mucus normal after tonsillectomy?\n\nMy 5 year old daughter is 5 days post tonsillectomy. After the surgery she seemed to have a lot of nasal mucus and developed a cough that is very wet. I can hear the mucus in her chest. She keeps wanting to cough but says she can t. Is this normal after a tonsillectomy?",
    "doctor_response": "Hi...This is not normal after tonsillectomy. I do not think the tonsillectomy is related to this cough and cold. it could be viral. Cough and cold are viral 95% of the times in children. For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. For cold you can use Cetrizine at 0.25mg/kg/dose every 12 hourly for 3 days.For nasal block, plain saline nasal drops will do, every 4-6th hourly to relive nasal congestion.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes liver enlargement in the fetus?\n\nhi Doc, I am 29 years old and weight 95 kgs. I had a baby last month and she died soon after the birth due to the liver enlagrement that is what my doc says. My due date was 12 may and i got operated on 16 may i dint get and pains for delivery so i got operated. when the baby born, baby had passed stool inside my womb ans it has already drank. please i want to know the reason for its death... and the reason for the liver enlargement. please reply me doc i want know will it effect the 2 nd kid..?",
    "doctor_response": "hi!! I can understand your concern. in my opinion you had a post dated pregnancy which might be the reason for passage of stool in utero. but that is not necessarily related to the liver enlargement that your doctor mentioned. liver enlargement could be a congenital problem which needs proper investigation. there is a risk of recurrence of this issue in your next pregnancy so I would advise you consult your doctor in your next issue.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blue veins all over chest and shoulders?\n\ni have been having blue veins all over my chest and tops of shoulders,and also down the side of my tummy for 8 months now, and they seemed to come up overnight. the only other time i had this is when i was pregnant. but i am not pregnant now, so what else could cause this i was on the pill but have not been taking it for 7 months now, and i am also very bloated all the time, any suggestions?",
    "doctor_response": "Hi,Prominent blue veins on the chest can cause psychological distress because of their unsightly appearance. Blue veins on chest causes include normal aging, genetics, hormonal changes, or even rapid weight loss.Those suffering from liver conditions such as cirrhosis can be especially susceptible to the development of blue veins on the chest. Other conditions that involve the accumulation of fluid in the abdomen or an enlarged abdomen can lead to blue vein development.The cause should be identified. Sclerotherapy and Laser therapy are available as treatment options.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Saranya Ramadoss, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I having indigestion, incomplete stool evacuation and abdomen swelling?\n\nHello doctor, I am 28 years old male and unmarried. For the last two months, I feel some gastric problems which include incomplete evacuation of stool at morning properly, abdomen swelling, numbness in feet, low energy in legs, low hunger, food not digested properly, slight pain in right side under ribs, and very rarely heart side. I have also gone through ECG but the doctor told that it is perfectly fine in ECG. So, I took some Probiotics, antibiotics like Ofloxacin, Ciprofloxacin, and Librax, but did not solve my problem entirely. Then I consulted a doctor. He told me that I have liver enlargement and told me some medical tests and ultrasound. Then I found liver enlarged, high cholesterol, and some other issues. I used to drink alcohol for four years very much, then moderate. I started smoking eight years back. I masturbate a lot, which I think make my body weak. I tried to control very much but I think I am addicted to it now. I have strong will power but my strong urge and anxiety lead again towards it. I used my type multivitamin for some time which includes Revital mainly. I used to drink water a lot nearly 6 to 7 liters daily. A few months back, I came to know my vitamin D is also low. I am a vegetarian. I have multiple kidney stones (5 to 6) in both sides. This is the fourth time of formation. In the LFT test, OT and PT are very high. Please prescribe some medicine for fatty liver, cholesterol and other problems you find from my history and blood test.",
    "doctor_response": "Hi. You need to modify your diet and lifestyle consistently and avoid all medicines and foods which can potentially damage the liver. You need to be on a diet high in protein and low in fat or carbohydrates. You should have regular physical activity. Regarding medicines, I need to see the liver function tests to comment. Can you give the exact SGOT and SGPT values?",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can one confirm the presence of impetigo?\n\nI have had 5 boils each appeared at different times since 20 yrs old, I am now 28. The first one appeared a year after my 104 degree fever bronchitis/namonia... first on my left buttocks... after it bursted it healed... then another appears above it on the right side of my waist on the back... it too bursted and healed... then another appeared on my left forearm... it too bursted and healed... then I got one on my left check... i expirence my lower check/chin line swell up like a baseball... it was the first time i was treated with antibotics this time after going to the hospital er... two days later it finally bursted... it too healed... months later a boil formed above my left eye also with fever... it too bursted and healed... i now have an infection on my face that appears like impetigo and i am currently treating it with antibotics... no boils this time but during a short lived fever a lymph node on the front right side of neck the size of a pea... my infection is going away but this painless pea sized ball is still like so. Some kind of blood cancer runs in my family, my grandfather had one form and his sister, my aunt who had passed from it after fighting it with treatment... i also just learned that their father, my great grandfather had passed from a cancer of the blood... when I went in for a blood test at the er, they said I had a high white blood cell count, but I just assumed my skin infection/impetigo was to blame... are these symptoms of a blood cancer or lymph nodes, I m also have a poor appetite, lack energy when I used to run 3-6 miles 3 times a week, I am losing a lot of weight... average was 105 now I m 95lbs... and i don t work out as much.",
    "doctor_response": "Hi, welcome to HCM, You do have impetigo. Rest of your symptoms are also due to that.Most common cause is Diabetes. But in some of my patients it has been due to deranged liver functions. Please check both and if blood sugar is normal, a course of liver supplements and B Complex with vitamin and C for six months does help. regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could painful lumps on penis foreskin suggest?\n\nHi I have found a lump on my foreskin at first I thought it was just a spot because I squeezed it and it did pop however it has not gone down and now appears to be a small lump which can move around if I squeeze it. it isnt painful and doesnt feel uncomfortable do you know what this is ?",
    "doctor_response": "Hi,Dear,Thanks for the query to HCM. I studied your problem in depth and I understood your concerns. Cause and plan of Treatment-In my opinion on the given data,you seem to have Epidermoid or the mucoid cyst of the penile foreskin, which is painless as is your case.Don't guess more. I would advise ER Surgeon Consultation to avoid further complications with it.Hope this would resolve your issues.Act fast.So keep cool and Consult your ER Surgeon, if need be , who would treat it accordingly.So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you, but just ask a query to HCM and be comfortable to resolve your health issues.Welcome for any more query in this regard to HCM.Write good reviews and Click thanks if you feel satisfied with my advise.Have a Good Day.Dr.Savaskar M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing soft gum after teeth extraction\n\nI had 5 teeth extracted 2 weeks ago the extraction went well, however after the swelling went back down I'm now left with a part of my gum that is ultra soft to touch almost as if it's sort of sinking in. This is causing me some discomfort with my dentures which seem to be rather ill fitting",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,     I have gone through your query, as you have mentioned that you have undergone extraction 2weeks ago now you have swelling and discomfort may be due to proper healing not occured ,    Proper healing after extraction take 15 to 20 days now you should visit dentist and get oral examination done    Do warm saline gargle two - three times a day  Hope it will help you.    Wishing you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Discomfort in stomach when interacting with people with a tendency to hurt myself. What does this indicate?\n\nRespected sir,I am Anitha, of 36years. I have a sort of tickling problem inside my stomach while walking and talking with someone. So at this time of tickling i couldn't stand individually i need some sort of support like either leaning on the wall or hurting myself like pinching my fingers and biting my lips so to avoid this i used to go off without talking with friends. But before i had this problem in my eyes at the age of 23 i couldn't see my friends or any one else and talk with them properly and at this time too i used to injure myself . Then i wanted to let you know one more thing that's by birth i could not talk with my parents by catching there hands and this tickling used to come in the stomach while playing, jumping etc. Then while entering into the shop or anywhere else i couldn't stand there properly and some thing happens inside my body. I have this problem by birth and now my age is 36. Sir am suffering from this problem for a long time when ever i visit a doctor i couldn't explain them and they too don't understand what my problem is. So sir kindly please check out about this tickling problem in my stomach. Am shedding tears each moment so please kindly take this matter seriously and send the reply. I think this problem in there only for me in this world cos non of my friends or people surrounding me have this problem,So please do take it into your attention sir. Awaiting for your reply.",
    "doctor_response": "Hi It is phobic anxiety which is with you .Good news is that there are treatment available in form of drugs; behavior therapy, cognitive behavior therapy relaxation; yoga and others. Please go to Psychiatrist ;after taking short acting anti anxiety drug(say drug by generic name Alpazolam 0.25 mg =1/2 tab )  as you find it difficult to talk to doctor because of your anxiety ;after taking the anti anxiety drug you may be in a better position to talk with doctor as it will reduce your anxiety  ;talk to him about your problem ; You can approach a clinical psychologist also for Behavior therapy .Such patients are benefited by treatment ;Of your own you may start yoga ;and relaxation ;",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen lymph node after eating solid food?\n\nOnly after eating solid foods, my lymp node on right side of my neck swells up (lump).  It goes away in about an hour afterwards.  I am not alergic to any food that i'm aware.  31 yrs old , 5 feet 7 inchs, 170 lbs.  This has never occured before and only started a day ago.  Help!",
    "doctor_response": "Hi,DEAR,Good Evening,Thanks for the query.Bump cause on your rt.neck-is due to the Siale-lithiasis obstructing the Sublingual Salivary Gland below yoru jawline on rt side.The eating reflex stimulates salivery secretions in your sub-lingual Salivary Gland on your rt side, but due to the ductal blocage by Siale-lithiasis-i.e.ductal stone- it gets pent up and gland swells and gradually get discharged due to partial obstructing duct of  salivary gland.Hope this would help you to plan the treatment with your doctor.Wellcome for any further query in this regard.Wishing you good health.Good Night.Dr.Savaskar M.N.From INDIA.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On birth control pills.  Occasional periods.  Black, brownish bloody discharge.   Reason?\n\nHello Doctor,I'm on the pill and have been for about 9 months now it is the mini lower dose pill, in the last 3 months I've had a period 6 days after I finish the pill packet,then 6 days before I finish the packet and now I'm 17 days into this packet and I have dark black/brownish blood yesterday for a little while then again tonight what could it be? Thanks Richelle",
    "doctor_response": "Hello:If you are in a progestin only pill (mini-pill). The bleeding pattern that you are describing (scant infrequent bleeding) is something expected to happen.If this is not bothersome, you can continue taking the pill.If you fill that you are bleeding too much, maybe it is time to consider switching your birth control method.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to be satisfied and happy with present situation?\n\ni am 25 years old lady. i am doing my engineering in computer science from india. i am in my 3rd year of this 4 years course. but i alwayz wanted to be a doctor. now i want to give the admission test for medical entrance. is this healthy thinking to plan for another 5 years again ? or i should console myself and wll try to be happy with what i have?if i go for medical classes then i wll have to study with 9 years junior students than me. plz suggest soem practical solutions.",
    "doctor_response": "Hi,I think you need to ask yourself the reason for the strong desire to change your career at this time when three years have already passed in this course. If this is something due to your dissatisfaction with your course and what you are learning, let me tell you, you are likely to feel the same in a medical course as well. Think about your reasons clearly before deciding.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cure for the Hiatal hernia with a fibrotic ring and H Pylori?\n\nHi I have just had an endoscopy done and found that I have haital hernia with a large fibrotic ring I was also diagnosed with h pylori for wich I have had two courses of treatment.I have a lot of phlegm build up and have difficulty swallowing.Is ther any cure for this.Thankyou",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn Short: There is solution for every problemExplanation: AS you have already taken anti H-pylori kit, I dont think medication is again required for that. Consult surgeon for hiatal hernia. Hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for ductal breast cancer\n\nI was diagnosed with Stage1 Invasive Ductal breast cancer grade 3 triple negetive Brca1 and 2 negative. My tumor was 2mm. Very small my doctor said chemo wasn t needed due to the size..did lumpecty along with 33 radiation treatments. I done a lot of research on triple negative always chemo..what are your thoughts",
    "doctor_response": "In patients with Infiltrating Ductal Carcinoma - Triple Negative type, chemotherapy is almost always needed. However as the size of the lesion in your particular instance is less than 5mm (size mentioned is 2mm) chemotherapy may be avoided. It may bet better for you to have a medical oncology consultation with all details being fed to Adjuvant Online! to find out the benefit of chemotherapy in your particular scenario. Other relevant history like family history, age and other parameters will also have a bearing on the final treatment decision.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling on foot?\n\nHi, I got ankle sprained 3 days ago, got X-ray, it is not a fracture but high ankle sprain. I could walk little with limp. Swelling is there on ankle but OK. and I could bear the pain while little walk. Question is- why I am having a swelling on front foot after ankle, I had elevated the leg while sleeping and this swelling is there from 2nd day of injury. There is no pain in the swollen area. doc have given following tabs- celin-100,nucoxia,pantocid and started taking these from 3rd day of injury.",
    "doctor_response": "Hello, What I can infer from your history is that you have an ankle sprain; that is simply you have got a ligament injury which will take about 3 weeks to heal completely. As advised by your doctor, continue the medications. I would also suggest you to use a crepe bandage to give mild compression at the ankle joint; this you can use throughout the day and not at night. I would also suggest you not to take part in any sports and avoid twisting your ankle for 3 weeks. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Santosh S Jeevannavar, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen and painful lump on the rib cage\n\nI have a knot on my left side on my rib cage and it is very swollen and painful. It has been there since before Christmas and I have had multiple tests run and they all came out negative but the know is still there and super painful and swollen. I am female and 18. The past few days it has been worse than usual and my body has been having shaking episodes, like vibrations in my hands and feet and mouth and head. My doctors don t really want to help me. Any idea what it could be?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. By your history and description, possibility of either osteomyelitis or herpes zoster infection is more. Herpes zoster is skin infection common in chest area. I causes painful lump. Osteomyelitis is bone infection common in ribs because ribs are flat bones. So better to get done clinical examination and ultrasound examination of local part for the diagnosis. You may need antibiotics and antiviral drugs according to the etiology. Warm water pad application on lump is advised and will reduce your pain. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment to get pregnant?\n\ni started my periods on the 7/7/10 and finished on the 13/7/10 and i started ovulating on the 17/7/10 and i have been having intercourse with my partner as we are trying for a baby but on the 6th day of me ovulating i started bleeding is it normal for this to happen if i am trying for a baby please help",
    "doctor_response": "Midcyclic bleedig can occur . it is normal in some cases. do not worry about it will watch for the next a few months.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal of monitoring blood pressure by resting on bed?\n\ni have recently carried out 24 hours BP monitoring by attaching the equipment with my upper arm. The variation during 24 hour cycyle was huge like 100/45 and 157/87. i am a bp patient and have been having Telma 40 and metpure Xl 60 for the last two years. I was not convinced by the explanation of my doctor. The monitoring was mainly done on resting on bed. can you please let me know whether it is normal or not. Mind you sir that I had stopped medicine one day prior the test.",
    "doctor_response": "Hi,During 24 hour blood pressure monitoring it is affordable to have such variations, especially among patients with high blood pressure.Blood pressure can increase during the day, after eating, after some physical activities. And it is decreased during the night, when one sleeps. So we can have such variations.Hope I could help youWishing you good healthIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to know ovulation date when on infertility treatment?\n\niam following folecular study,my egg size is 20mm and my docter advised to take Life 10000 injection that night.i taken that ,ihad sex that night andthe next day idont have a sex,and day afterday i had a sex.my question is when iam ovulated and there is a chance to get prgnancy for this month",
    "doctor_response": "hi thanks for writing to ususually after the injection the egg ruptures in 18 hoursfor definite signs of egg rupture , a ultrasound is neededhope for the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will taking Lagap Doxylag while trying to conceive cause any problems?\n\nDear Doctor, I m taking lagap doxy lag 100mg on alternative days,for my scalp problems. at the same time i m planning to conceive on this ovluation cycle(it will be between 21-26).Our doctor advised me to consume the tablet till December 1st week.If i m conceiving during this perid will it affect the fetus health?",
    "doctor_response": "Hi , Doxy belongs to the family of Tetracyclin.Use of these drugs are better avoided during pregnancy , unless the infection is so serious & life-threatening. Better to avoid pregnancy till medicines are over. The anomalies caused by medicines cannot be corrected.So I would advise you to delay pregnancy till medicine is overAll the bestDr.Balakrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Semen analysis showed nil sperms even after homeopathic treatment. Suggestive treatment?\n\nI have done my semen analysis several times 1st time - Nill sperm ( Pus cells:12 ~ 14) 2nd time - Nill sperm (Pus cells:11 ~ 13) Started homeo treatment 3rd time - Nill sperm (Pus cells:10 ~ 12) 4th time - Nill sperm (Pus cells:8 ~ 10) 5th time - 20 Mill sperm count (Pus cells:2 ~ 4 & Epithelial cells: Nill) 6th time - Nill sperm (Pus cells:3 ~ 5 & Epithelial cells: 1~ 2) Please guide what to do",
    "doctor_response": "Hi, your semen report suggests some short of infection by presence of pus cells . Absence of sperms demand a clinical examination by a surgeon . Please get a check up and get tests done as suggested . persistence presence of pus cells require to be investigated by semen culture and treatment accordingly . please discuss with doctor the course of investigations and treatment available .Testicular biopsy will indicate further line of management . A PRELIMINARY CLINICAL EXAMINATION IS ESSENTIAL FOR FURTHER ADVICE . Please get a check up and be guided . With best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does excessive masturbation leads to infertility in men?\n\ni have been masturbating since my 10 grade and now its been 11 years since then.many time i have mastubated 4-5 times a day.i want to know that whether excessive masturbating does any harm to male productivity in future?",
    "doctor_response": "Hi well come to HCM. No it will not have any bad effect on male productivity, but if you are involved too much you will disturb your routine activity and your education too will be affected. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain in the legs be managed?\n\nI fell back in November at work, my left leg went between a dock plate and a trailer backed up to the dock. My doctor has released me from his care to go back to driving. I am still having pain in my thigh and in my knee but he says he can not see why. What are your thoughts on this? Thank you.",
    "doctor_response": "Hello, It may be due to some ligament or tendon injury sustained during the fall. You can consult an orthopedician and get an MRI scan done to look for any possible ligament or tendon involvement. As of now you can take analgesics like Ibuprofen or Diclofenac for pain. You can apply Diclofenac ointment for symptomatic relief. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for tightness in chest muscles with dizzines\n\ni have tightness in my chest and my musles hurt in my chest sinus infection and upper respitory infection back to back for about 3 months dizzyness and pressure in my head ,shakes,upset stomach,sore all over,had ct scan chest x ray x ray on my sinuses and blood work everything comes back normal but symptoms still there they come and go all day",
    "doctor_response": "Hi. I can understand your concern.  Chronic cough is commonly seen in bronchitis and lung infection. Since your chest x ray is normal, no need to worry for lung infection. Possibility of bronchitis is more in your case. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of bronchitis. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid (ICS)Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower pelvic and back pain after a hysterectomy?\n\nI have a history of suffering with endometriosis I have had two surgeries as a result of this disease. I had histerectomy in 1993 since that time I had a surgery in 2003 and 2016. It has been attached to my bladder, appendix, Colon. It caused my lung to collapse, removal of some of my colon, removal of my appendix and I didn\u2019t have a clue to what was going on inside my body. I feel like something may be going on now my symptoms are lower pelvic and back pain",
    "doctor_response": "Hello, I have studied your case with diligence.At old age there can be degenerative wear of bones, muscles, ligament and facet joint arthritis, due to deficiency of calcium, vitamin D, VIT B12hysterectomy can aggravate osteoporosis..so supplements of these nutrients can relieve pain.Osteoporosis may be associated leading to diffuse pain in back.Check your bone strength with DEXA SCAN and you can start medication according to level of osteoporosis,I will advise you to do MRI spine to see for any disc bulge or spinal canal stenosis.And also check your vit B12 and vit D3 level.You can reduce flare up by doing regular exercises and medication.You need to start supplement of calcium with vitamin D, vit B12, and if osteoporosis is severe then bisphophonates can be started.I will advise you to do regular physiotherapy and exercises as my patients find much relief by these therapies.You may consult physiotherapist for guidance. He may start TENS, or ultrasound which is helpful in your case you need to take diet rich in calcium and vitamin D.If not relieved you can take epidural injection.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you find this answer helpful do not hesitate to rate this answer at end of discussion. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are varying blood pressure a cause for concern?\n\nhi there, I just went to the pharmacy and did a blood pressure test, first time was 130/95 second time was 120 90 and the third time was 120/88. The day before I did a test and was 140/97. I'm 42 and was 120/80 just four months ago. Should I be concerned?",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern. You should not worry. I'll try to explain you something and give you my opinion. You should know that blood pressure fluctuates in different situations and this is quite normal. It changes during emotional stress,  physical activity and different situations of our metabolism like eating,  sleeping ect.We talk about hypertension if we have mean value that exceeds 140 / 90 mmHg.A person might have high value during emotional and physical strees so its mandatory to judge on mean values. So to clarify this situation, if I was your treating doctor I would recommend some examination like a cardiac echo to evaluate heart function and walls,  a full blood analyze and a holter pressure monitoring to evaluate your values during day and night. After all this we can judge if we are dealling whith hypertension and how to treat it. Hope I was helpfull. Best regards, Dr.Ervina",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking medication for pollen allergy. Dizziness, vomiting followed. Tablet reaction? Diet to follow?\n\nHI SIR,SINCE I HAD A SLIGHT DIZINESS TODAY MORNING & EVEN VOMITED PITHAM KIND OF FLUID,I AM TAKING MEDICINE FOR POLLEN ALLERGY NAMED SINGULAIR ....CN YOU PLS ADVICE ME ,THE REASON FOR THE SAME??? IS IT ANY REACTION OF THAT TABLET WHICH I AM TAKING & WHAT ARE ALL THE DIETS WHICH I SHOULD FOLLOW ?WOUD APPRECIATE UR ADVICE...THANK YOU",
    "doctor_response": "Hello, Singulair tablets are usually meant to be taken at night due to the side effects of drowsiness. Occasionally the drowsiness could relate to a feeling of dizziness, but not vomiting unless you had exceeded the dose. Singulair itself is unlikely to be effective for pollen allergy unless you combine with an antihistamine like fexofenadine. There is no special diet for pollen allergy; but addition of a nasal spray will help with the symptoms of rhinitis (sneezing, runny nose, white discharge, blockage). Best Wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for itchy bumps on toes in a child\n\nim 13 and i have these like little tiny bumps on my toes and theres like alot of little bumps on my toes and they itch really bad and it first happend when i got new shoes but that was last year and they went away within a week or so, this has been on my toes since chritmas break. what do i do?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Regards - Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat loose motion and vomiting on kids?\n\nHi, may I answer your health queries right now ? Please type your query here... i am from nasik my child , 2 year old, suffered from Severe Fever last week ,after that doctor admitted him for 6 days ,after discharge now he is suffering from loose motion & Vomitting, but there is no smell in motions or vomit can u suggest sm medicine so , that his motions were quickly stop",
    "doctor_response": "Hello dear!please provide the details of medicines given by the doctor during hospital stay.It could be due to lack of useful bacteria vanished away by antibiotics use. Also it could be post infectious IBS.i would recommend to start giving home made probiotic composition that is home made yogurt mixed with rice and lentil cereal(with minimum salt).It acts as a natural probiotic.Also give fluids especially ORS after every stool and for vomiting give rice water(water that we normally throw away when we boil rice-it has starch in it),its v effective for vomiting.If it doesnt settle with all this ,start syp. metronidazole 200 mg/5ml(5ml thrice daily) for 7 days and syp. zinc 5 ml once daily for 10 days.Hope it will help. Be blessed :-)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is my angiography report normal?\n\nHi doctor, One year ago, I had chest pain. I thought that it is may be due to some excessive spicy food I took the last night and also I did not sleep till late due to some work. So, I just ignored it and left for my work. That day, I had to go somewhere driving myself and I thought it as just a minor chest pain and will go away eventually. Hence, I left with my car driving myself.\u00a0That pain did not go away rather stayed with me the whole day and by afternoon, it became worse. That day I was so busy and I was almost with empty stomach. So, I had some food and thought it would go away. I felt a little better for some time, but the pain was still there.\u00a0At evening, I had to admit to a hospital and they gave me medication like Sorbitrate, etc., but the pain was there. I was not fainted, but I felt that I am going to be. The hospital suggested for ICU and when they were taking me there, I suddenly felt fine. The pain went away out of the blue; I sat up on my bed from lying down and was feeling that I can go running now, just like nothing happened to me.\u00a0Still, doctors suggested an ICU and I got admitted. They did all tests in the next two days and discharged me with a suggestion of an angiogram. I got angiogram within a week and the report came normal.\u00a0Now, my problem is, sometimes I feel very little chest pain, which is usually sharp. But, it is sometimes vague in various areas of my upper body. I do not know what my problem is. Can you please check my reports? That incident occurred one year back and I just recently did some usual basic tests. Please tell me your suggestion. Thank you.",
    "doctor_response": "Hi. I want to assure you, do not worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case, reports (attachment removed to protect patient identity) and can well understand your genuine health concerns. 1. You have got a normal coronary angiography report. Nothing found abnormal in it. 2. There is nothing serious seen in echocardiogram attached here. 3. Your blood work done recently has been totally unremarkable and there is no harm seen. No lipid profile derangement to pose a cardiac risk. 4. But, you had supraventricular tachycardia of unknown origin with chest pain one year back. Such a pain is usually seen in young adults who remain busy in their daily life routine. This is the disease of the modern era. 5. People have more stress at work, take very less rest, take little quality sleep, do not exercise, take a junk diet and take less nutritious diets. Fluid and electrolyte imbalances and nutrient deficiency leads to muscular weakness and the ache. 6. Undefined painful chest areas are also a problem with smokers and alcoholics. If you take alcohol, smoke or use any other illicit drug, please try to leave that. I want to run a battery of some tests that are necessary to be done right now. Once you get the reports, upload in a follow up. HBSAg (hepatitis B surface antigen), Anti-HCV (hepatitis C virus), vitamin D levels, vitamin B12 levels, LFTs (liver function tests) and RFTs (renal function tests). 1. I suggest Excedrin (combination of Acetaminophen, Aspirin and Caffeine) daily after breakfast for three days. Then, take it only at the time you feel pain. Try to avoid as much as you can but if unbearable, then it is fine to take. 2. Citrucel (Methylcellulose) dietary fiber supplement. 3. Tablet Surbex-Z - multivitamin once daily and continue for a month. 4. Start jogging; 10,000 steps daily at a healthy pace is your goal. It gives endurance, muscular power and many more benefits.  Consult a specialist doctor, discuss with him or her and take the medicine with consent. Revert back with the reports to a cardiologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fibroid operation done. Ultrasound results show uterine micro fibroid masses, no ovarian disease, pelvi collection. Can I get pregnant?\n\nAfter a fibroid operation, these are the results of a scan I had five monthes later- ( 1) There is an anteverted uterus, measuring 8.9cm x 4.5cm x4.8cm, without signs of endometrial decidual reaction. (2)There are few intramural/sub-mucous micro-fibriod masses, with the the largest measuring 2.0cm x 1.7cm. (3) There is no ovarian cyst or pelvic collection. (4) The urinary bladder is normal. CONCLUSION. Apart from uterine micro-fibriod masses, there are no sings of ovarian disease or pelvic collection. I want to know what could be wrong after fourteen months I am yet to be pregnant , moreover my husband s sperms test is confirm ok.",
    "doctor_response": "Hi Wino These microfibroids don't cause an problem in fertilization, sometimes,may cause problem in implantation of fertilized ovum. Means,they don't cause any trouble in getting pregnant,but chances of miscarriage increases. So,hope for the best& try to conceive Thank You",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is oxygen level affected due to weaning off steroids?\n\nI have a question about my mom. It started off with a biopsy of her lungs which this Dr. went into her lungs through her back. He then put a tube in her lung ,and told the nurses to take her to ICU they took her to a regular room and there the tube fell out of her lung causes them to do cpr on her for hours. well we made it through that and they told her when the results came back she had IDIOPATHIC PULMINARY PYBROSIS. THEN SHE GOT INCEPHALITIS IN HER BRAIN, tTHE DR, AT kEESLER AIR FORCE BASE GOT THE RESULTS ON HER BIOPSY AND TOLD HER SHE HAD A YEAR AND A HALF TO LIVE, WELL SHE HAS BEEN IN OUT OF THE HOSPITAL FOR ABOUT 14 MONTHS, THE DR. AT KEESLER SAID HE WAS GONNA DO A BIOPSY WITH HIGH RISKS THAT THE TUBE HE IS GONA PUT DOWN HER THROUGHT MIGHT HAVE TO STAY. HE DID THE PROCEDURE AND FOUND OUT SHE HAD VASCULITIS. WAS PUT ON STEROIDS AND SEVERAL ANTIBIOTICS. THEY STARTED ABOUT 6 WEEKS AGO TRYING TO WEEN HER OFF OF THE STEROIDS. TONIGHT SHE COULDNT BREATH AND MY FATHER TOOK HER BACK TO KEESLER HOSPITAL. HER OXYGEN LEVELS WERE 79 AT THE OXYGEN ON 4 BUT IT DIDNT HELP. SO THEY PUT IT ON 9 AND HER LEVELS WHEN UP TO 100% THEN HE CALLED ME AND TOLD ME HER OXYGEN HAD TO BE PUT UP TO 15 AND THEY WERE PUTTING HER IN ICU. DO U THINK THIS HAPPENED BECAUSE THEY TRIED TO WEEN HER OFF OF HER STEROIDS? WORRIED AND SCARED",
    "doctor_response": "Hello,Sorry for the continued medical problems your mother is facing. Steroid is the major treatment after continued inflammatory disorder with unknown cause. Steroids cannot be taken for a longer time as it suppresses the immune system leading on to infections and other systemic disorders. I strongly doubt weaning through steroids could have led to the present position, rather a progression of the disease could have caused it.Hope i have answered your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any relation between yeast infect and bell's palsy?\n\nHello doctor, recently I was diagnosed with a yeast infected. I took canesten oral and used the cream as well. A week later I ended up with Bell's Palsy. Is there any connection between the two? I want to make sure there isn't an underlying illness/disease that I am not being treated for. Thank you.",
    "doctor_response": "Hi,There is no connection between yeast infection and Bell's palsy.both are different entity.Continue with antifungal oral and local treatment.Consult neurophysician and get examined and investigated for Bell's palsy.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do we need to take medicine for uric acid for a person having lower lumbar sacralisation?\n\nhi, i am 27yrs old female. for the past three years i have been suffering from lower backpain. recently i went to an orthopedecian and he took my lower back radiographs. he found ut that there is lower lumbar sacralisation. also he got my blood tests done. my RAF is normal, but Vitamin D is 5.2 and uric acid 6.1doctor has prescribed vitD supplement . i want to ask if i need to take medicine for uric acid also.thanks& regards",
    "doctor_response": "Hello,I had gone through the case and found that your uric acid is in normal because normal range isSo you need to take precaution in the diet like avoid Purine rich food like mutton and some kind of fish variety, whole grain cereal and wheat bran.Take green vegetable , fruits, low fat milk and yogurt.Follow the diet and find the normal level of uric acid.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in left chest\n\nGOOD MORNING SIR, IAM SURIA  FROM KUWAIT I AM SUFFERING FAST5 YEARS IN LEFTSIDE CHEST PAIN . I CAN NOT WALK 5 MINUTES CONTINUE , 1 YEAR BEFORE I WENT TO CHENNAI  TAKEN X RAY BUT THEY TOLD NOTHING  BUT I FEEL STILL PAIN  WHEN I AM WALKING . PL HELP ME",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Since you are having left sided chest pain especially on exertion (walking), we should first rule out heart diseases like coronary artery disease (CAD). So consult cardiologist and get done 1. Ecg 2. 2d echo 3. Stress test (trade mill test) 4. Coronary angiography (if required). You may need anti anginal drugs and other cardiac supportive drugs. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for dry cough and congestion in lungs\n\nI am a female of age 52 years. Having dry cough continuously. Observed slight congestion in the lungs Also having varicose veins on the right leg due to surgery .I am a renal donor with hypertension and diabetes. Suggest suitable drugs for the above and also do s & don ts for this complaint.",
    "doctor_response": "HI, thanks for using healthcare magicPersistent dry cough is most commonly related to : (1)post nasal drip- this is the most common cause.In some cases persons may not know that the drip is present and may only present with the cough.Treated with topical nasal sprays such as nasonex, nasocort, flonase, rhinocortOral antihistamines would also help(2)asthma - this is also a cause for persistent cough which tends to be worse at night(3)GERD- gastroesophageal reflux is another cause of chronic cough. The other reflux symptoms may or may not be presentYou can consider treating for post nasal drip since this is the most common and there are no other symptoms pointing to reflux or asthma. If after a 1 month to 6 week period the coughing persist then treat for asthma or gerd.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for painful lump in armpit\n\nI have a huge lump in my ampit, it came on suddenly about a week ago... it's so painful i've lost mobility in my arm... if i raise my arm It hurts down to the bone.. it's really hot and firm... and theres no pus or even a visible like starting point... I need to do something cause i can't work like this... any ideas?",
    "doctor_response": "Welcome to health care magic. 1.The history suggest an infective aetiology - either an abscess, hair follicular infection or bony pathology.2.If you are my patient i would have examined and ask for a ultrasound examination and a x-ray involving joint and bone AP/LAT.3.Ultrasound - gives me the nature of the lump, its source and extension.4.X-ray will give me the characterisation of the lesion if its bony source.5.Further if abscess or infective collection - incision and drainage followed by a course of antibiotic will be given.6.In case of bony after characterisation depending on findings treatment involves. Good luck.Hope i have answered your query.Any thing to ask do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain caused by an injury\n\nHello I was recently hit in the stomach on the left side about 2 in he's below rib. I have some bruising on my stomach. The pain felt like it traveled toward my lower back.but now it has moved to my left lower abdomin. I feel as though I bruised my intestines. Have been constipated lately",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query.Considering your symptoms following a trauma, I would refer you to a general surgeon who might after a general physical examination specially of the abdomen go for an ultrasound/CT scan of the abdomen to rule out trauma to the internal organs of the abdomen. It might not be possible to opine on your problem without a thorough physical examination.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will sperm motility increase after hernia operation ?\n\nMy husband had two sperm tests done. First one was 4 million with 20% motility and 2nd was just 1 million with 10% motility. He recently had a hernia operation and could that improve the count now? Also it looks like I have pcos and am currently on clomid but we are now on the list for ivf. What chances do you think we have of conceiving naturally? I am 30 and husband is 42",
    "doctor_response": "there are some chances to become pregnant your husband can take makardwaj vati 2tab 3time &drink cows milk with cows ghee in it.you can take garbhchintamani ras 2tab 3time,for some time .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Dihydrotestosterone blood test help to predict androgenic alopecia infection?\n\nI ve experienced thinning weakening hair since a very bad case of the flu 18months ago I had a comprehensive blood test four months ago that showed I had problems with my thyroid TSH was elevated although t4 was normal range. I am trying to find out if I am experiencing hair thinning due to androgenic alopecia ... Would a Dihydrotestosterone blood test tell me if this is the case",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.In my opinion, the cause of your hair thinning is due to thyroid problem. Androgenetic alopecia is a clinical diagnosis which does not require blood tests. Please treat your thyroid problems first which will improve you hair problem. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes contractions during pregnancy?\n\nhi doctor .. my name is akanksha ..m at my 24th week of pregnancy ..frm last few days was feeling some contractions so doctor asked me to take duvadilan - 10 mg (twice a day) ans susten 200 ..after dat there was relief ..but frm yesterday in site of taking regulat medication i can mild contractions which last for fraction of second. Is this normal ?",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, if this is the symptoms then it need to be brought to investigation and in my opinion better to get done the ultrasonography, you can not take this as granted because of medicines,  hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of body tremors?\n\nMy father is 65, for the second time in a few months he has been suddenly throwing up, being very pale and shaking uncontrolably, and saying that he  has a tender stomach. The last time after maybe 4 hours he was feeling somewhat better but continued to feel drained for days. We have no idea what is wrong.",
    "doctor_response": "He is either suffering from an infection, a metabolic disorder of his electrolytes, liver, or kidney enzymes, or dehydration.  You should strongly advise him to seek out a doctor right away by way of his own primary care specialist or take him to an Urgent Care or ER.  Sounds like he needs labwork and perhaps some IV fluids to pump him up a bit. Please rate this a 5 STAR ENCOUNTER and write me at: www.yyy.ly/yyyyyyyyyyy with more questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. l got a sore hard lump after the removal of wisdom tooth. Is it normal?\n\nHello doctor,I just got one side of my wisdom teeth removed both upper and lower six days ago, and I have another one scheduled after two days for the left side. The upper is 100 % fine, which they pulled. The lower they pulled the tooth without removing the root because it was too close to the nerve. I do have some stitching in this area currently on the lower cheek. Noticed a hard lump about 1 inch between my lower jawline and cheek area. Is this normal because of swelling or something else. Currently taking Amoxicillin 500 mg and Ibuprofen 600 mg. Please let me know what this hard lump is, also generally on the lower side where this lump is, remains sore.",
    "doctor_response": "Hello. The lump is mostly a hard swelling which forms postsurgical removal of the wisdom tooth or maybe even by swollen lymph nodes due to infection. It takes a week or two for the swelling to subside. Sometimes, if the root is still inside, the infection may be remaining there causing swelling. Get an X-ray done to find out the exact problem and stronger antibiotics like Augmentin (Amoxicillin and Clavulanic acid) along with a painkiller for a week. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes needle pain while coughing in a bronchitis patient?\n\nI have bronchtis.A few days ago, when I cough or sneeze, my whole upper body gets extreme burning and needle pain that is intolerable. I have been taking ibuprofene every 2 hours to try to remedy it, but does not always work.Started the same day I started on the antibiotic.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Chest pain (needle type) on coughing in bronchitis patient is mostly due to pleurisy (inflammation of pleura). And most common cause for pleurisy is infection. So possibility of lower respiratory tract infection (LRTI) is more in your case. So get done chest x ray to rule out LRTI. You may need antibiotics too along with ibuprofen. Better control of bronchitis is also needed. So start inhaled bronchodilators and inhaled corticosteroid (ICS) for better control in bronchitis. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the uneasiness on my feet with panic attacks?\n\nI have had three panic/anxiety attacks in the last three days. Trembling, shaking, hyperventilating, uneasiness on my feet, crying uncontrollably and the feeling of crawling out of my skin. What is this? I am on depression and anxiety medication but that doesn't seem to help right now...",
    "doctor_response": "Hi and thank you so much for this query.I am so sorry to hear about these repeated panic attacks and these crippling symptoms that you have reported. I will suggest that you get your medications evaluated because they seem not to be working appropriately. Also, you may need to try behavioral psychotherapy measures in addition to drugs to make the treatment more effective, learning coping strategies is very vital in the being able to deal with these attacks.I hope you find the above useful. Feel free to request fr more information if need be.Thanks for using our services and I wish you well.Dr. Ditah, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best medication for dementia?\n\nMy mom has dementia and was displaying aggression. She was prescribed Zyprexa two weeks ago without consultation with the family. In reading information online, I have a number of concerns and I am wondering if perhaps there is a different/better medication for her",
    "doctor_response": "HiI understand your concern.Zyprexa contain olanzapine and it is only useful to control behavior problems in dementia.Dementia is irreversible type of memory loss and we can not revert back what had already damaged.But we can prevent it from further damage by medicines like donepezil and memantine.Donepezile is the 1st choice if diagnosis is dementia and memory loss is significant.Consult psychiatrist and get evaluate properly.If she is not having behavior problem then do not require to give zyprexa.Zyprexa has nothing to do with memory.I hope i have answered your query.Still have query then ask.Happy to help you.Thank you.Regards.Dr Vishal Garala.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling dizzy, headache and cramps. Due to depo shot?\n\nHi. I have had my tubes tied for 2 years and ever since then my periods have been every 29-31 days. I recently decided that I wanted to get on depo because i have heard of  cases of pregnancy with your tubes tied. I had my depo shot on March 27 and was due for period anywhere between April 10-12. Around that time I had cramping like i was going to come on my period but it never came. Could that have been a side effect of depo? Also this morning i was really dizzy and I had to sit still, now I have a bad headache because of the dizziness. could that be a side effect of the depo also?",
    "doctor_response": "Hi,Your symptoms could be due to the effect of the depo shot since you did not time it with your cycle. Your period may get delayed or may not come at all as happens in some people. The headache and dizziness could be related to the effect of the hormone and you should get your blood pressure and other vital data checked to see if you need any medical assistance. If you continue having persistent discomfort you should report to your consultant and switch to some other contraception. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is gabapin 100 a safe drug ?\n\nIs gabapin 100 a safe drug",
    "doctor_response": "Its is advisable to continue or discontinue any medication only under medical supervision. No drug is absolutely safe or unsafe as it depends on the nature of illness and the biological constitution of the patient.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could the rash on ankles and legs be?\n\nI have this rash that is on the tops of my feet and has spread to my ankles and legs. Mainly small dark brown spots but some have merged into dark areas of skin. They do not itch or hurt at all but my feet are now starting to swell and I don't know if they are related.",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, if this is not itching or any discomfort, then this could be due to some systemic disease and diabetes need to be ruled out, as matter of fact skin lesion demands the clinical observation and this is the only way of clinical diagnosis because this is kind of art of looking, so better to get done the clinical examination to ruled out the possibility of diabetes induced skin lesion, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can infertility be treated?\n\nI have irregular periods problem.my last periods date was 11july.my all hormonal test are normal. Plz tell me what is the problem my pregnancy test also negative i want baby but i cant canceive i have also face once three month miscarriage in july last year.",
    "doctor_response": "hello user.please do follicular study to know exact time of ovulation.keep relationship around ovulation or do iui for early results.thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lump in throat, unable to swallow, cant cough it out, ball of phlegm. History of seasonal allergies. How can I cure it?\n\nYesterday,before I went to sleep ,I felt this lump in my throat which feels like a ball of phlegm .I can barely swallow & I can still feel it even when I m just sitting here,not talking or swallowing .I went to bed,hoping it d be gone in the morning.However,it wasn t.I tried coughing it up but barely any,if any at all,came up;it feels as if it s too far down in my throat to cough up.I m drinking tea right now to see if that will melt it away,but it doesn t seem to be helping. I should probably mention that I have seasonal allergies ,which are active currently,but my allergies have never caused me to have phlegm before,so I don t think the allergies are causing it.Besides trying to cough it up(which doesn t help anyway),what else can I do to try to dissolve it or push it down?",
    "doctor_response": "YOUR ALLERGIES HAVE INFECTED THE SINUSES AND IS CONVERTED TO ALLERGIC SINUSITISPOST NASAL DRIP OF MUCUS OF SINUS GIVE THISADD DOXYCYCLINE 100 MG BD FOR 5 DAYSAS THESE ARE FASTEST CLEARING IN SINUS INFECTIONTAKE MONTEELUCAST 10 MG BDADD BRONCHODILATOR SYP FOR COUGHADD ANTACID GEL TDS TO CLEAR THROATAPPLY NEOMYCIN H EYE OINTMENT IN NOSE BDSEA WATER 2 DROPS AT NIGHT EACH NOSE TO CLEAR BACK OF THROATADD DICLO SOS FOR PAINCONTINUE 3 WK",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is alcohol consumption advisable prior to tooth extraction?\n\nDear Sirs,I have a situation with my partner who is classed as an alcohol dependant consuming three bottles of white wine per day (Now reduced to 8% wine) to keep her withdraw symptoms under control.  She is currently waiting to detox as she  has been trying to stop for a while.    She has reduced her intake substantially but cannot stop.   She needs a tooth extraction or canal root treatment (If we can save the tooth) and is absolutely terrified of the dentist and has bad gag reflexes, therefore she will need to be satiated for the required treatment.   I have tried to research this topic and all i seem to find is advice not to drink before or after treatment but nothing concrete advising of what to do if you are an alcoholic and cannot go without a drink prior or after treatment.    Please could you kindly let me know what options are available and if the dentist carrying out the proceedure will still go ahead and if so, how will this affect the patient?",
    "doctor_response": "Hello,Yes, it is true that alcohol consumption is not advisable prior to dental procedure and it is advisable to stay alcohol free for at least 24 to 48 hours and even more if possible.If there is anxiety then anti-anxiety medicine like Valium can be given by your Dentist but even before that you should be alcohol free and in her case she is taking relatively toxic doses so she should be detoxed.So, please consult your Dentist and get her evaluated. But do not proceed for any dental procedure or taking medicine along with alcohol intake as the outcomes can be fatal.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat sperm thinning?\n\nI am boy age of 30,but my sprem is thin'i want thick sperm'i face problem when I watch any sexy movie I get wet' because my spram come automatically come out of my piens'kindy tel me any fruit or food which help me.l am poor I have no money to snd you'",
    "doctor_response": "DearWe understand your concernsI went through your details. Please stop worrying about these sexual matters because all these are normal. Sperm thickness or color is not the determining factor of your fertility or your ability to produce children. On an average, semen is almost 95% water. Therefore don't be anxious about it. When anyone watch porn movies, their penis discharge a liquid called pre-cum which is used for lubrication during sexual intercourse. This is also normal. I suggest psychological counseling to you.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tremors in the body while sleeping?\n\nI am a 35 year old female and for the last few months I have been having myoclonic like jerks. The only problem is I don\u2019t have only have them when I\u2019m falling asleep. I have jerks in my hands, neck, body etc. any time I\u2019m tired. It\u2019s so bad my 9 year old son asked me why I was jerking so much. Also I am tired a lot so tired I could almost fall asleep standing up. It is almost impossible to keep myself awake. The worst times are early in the mornings between 8 and 11 and early evening between 6 and 8. Then I can\u2019t sleep. I am up half the night sometimes until 330 am. Also when I\u2019m driving my brain will just zone out. I half to shake my head to refocus or pinch myself. Recent labs including electrolytes and vitamin levels is fine. I don\u2019t know what the problem could be and I dislike going to neurologists.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I have noted your symptoms and they are suggestive of myoclonic jerks. Even though you dislike going to neurologists, there is no other option. You need to see a neurologist and undergo EEG test. If there are epileptiform discharges, you would be started on anti-epileptic drugs. The best drugs are sodium valproate or levetiracetam (for myoclonic jerks). Proper treatment can bring about a positive change in your daily life. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to get pregnant, hsg test shows tubes open, HPT negative, no periods yet. What to do?\n\nhi doctor, I am 26 trying to get pregnant for a yr.i had a hsg test on last month 22nd my tubes were open now.this mnth my menses delayed so i had a pregnancy test bt it came negative . still my period doesnt start yet. please help me what i have to do.",
    "doctor_response": "Hi,Welcome to HCM.Home pregnancy test (urine test) can come negative in early pregnancy. Kindly do one blood test (beta HCG), which will confirm OR rule out pregnancy with 100% confidence. In case it comes negative, still you need not worry as occasional period can delayed in normally ovulating woman.Wish you good health.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest alternate medicine for insulin dependent type 2 diabetics\n\nSir I have been suffering from Insulin dependent type 2 diabets for the last 6 years and my age is now 46 years. I am taking novomi 30/70 initially i have taken glycypage sr 500 three times a day but during last 8 months i have stopped glycyphage and took some ayurvedic sugar control medicine and insulin i have continued 20 units only in the night time i have developed uti and epithleal cells and frequent urination every hour for 24 hours and like that for 6 times in 2 months doctors advised me to take Onglyza 2.5 mg tablet one time daily and i have started taking onglyga since 25 days and severe urination stopped but scanning in Feb 2014 revealed that Gr.I prostatomegaly and pvr urine is 28.7 cc and when i have consulted urology in KhammamDist AP India, i am advised to take Uromax 0.4 mg and frequent urination symptoms which generally start in the evening at 430 pm disappeared and i am now comfortable now that severe thirstiness and continuous urine flow controlled please advise me whether uromax 0.4 tablet is ok for UTI i have taken norflox 400 mg for 7 days daily two tablets with uromax only this excess urinaton symptom got controlled and so far only 2 days i have taken uromax can i continue the same without any sideeffects. whether this frequent urination in the night is only due to gr.i prostatomegaly please reply",
    "doctor_response": "Hello and welcome to HCM.Frequent Nocturnal enuresis in your case is mostly due to uncontrolled Diabetes and also Benign Postate Hyperplasia (BPH) .BPH can cause difficulty in passing urine as well as frequent Urinary tract infections due to retention of urine in the bladder .Urimax is the choice of drug in grade 1 BPH and can be continued by you as it helps in improving the proper flow of urine .It has no significant side effects .Norflox is an antibiotic given to control the Urinary infection it should not be continued unless prescribed by your doctor .You can not substitute Insulin with any Homoeopathic remedy straightaway , It would be advisable to consult a senior Homoepathic consultant in your area for a detailed case history and then proceed with the medication as per the consultant's guidance.Regular check ups and follow ups are must .ThanksDr Preeti Chauhan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mildly enlarged liver with generalised fatty changes, mild hepatomegaly. Treatment ?\n\nhi & regards,my liver is mildly enlargewith generalised fatty changes,vertical span of rt.lobe is 15.07cm(normal 14cm) gall bladder ,hepatic and portal veins,cbd, pancreas , spleen ,kidneys, urinary bladder ,prostate all are normal in ultrasound.the impression is mild hepatomegaly with fatty changes,associated git problem. in lft test serum bilirubin 0.8(normal 0.2-1.20) direct bilrubin 0.5(0.00-0.40) indirect bilrubin 0.3(0.10-1.20) sgot 50(10-40) sgpt 88(10-40) alkaline phosphtase 126 (34-94) protien7.4(6.0-8.0)serum albumine 4.0(3.7-5.3) serum globuline 3.4(2.3-3.6) blood uria 56 (10-50) serum creatinine 1.8(0.6-1.2) serum uric acid 8.0(3.4-7.0) calcium 9.6 (8.4-10.2) sodium 141.7 (135-155) potassium 3.98 (3.5-5.1) one year ago i suffred from this desies at that time my doctor gave me ursocol 300, antoxid,ec350 but now the doctor has been shifted to another place now a new doctor gave me viboliv 500 and febuget 40 for uric acid .i an alcoholic with intake once a week one peg and non vegitarian ,i dont smoke. i shall be highly oblised if u help me. thanks",
    "doctor_response": "Hi, Welcome to Healthcare magic! The cause of fatty liver in your case is alcohol intake. The liver enzymes are only mildly raised. Abstinence from alcohol will reverse the condition. If you are obese, weight reduction is necessary. If you are a diabetic or if you have high cholesterol, those issues should be treated as they can also contribute to the development of fatty liver. Continue taking ursocol and viboliv.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Took allopathy medication to treat hypothyroidism. Willing to start homeopathy treatment. How to proceed further?\n\nsir i am hypothyroidism patent the problem is detected by me on nov 12 i started allopathy   medicine on feb 13 and after 30days i stopped it my self, because i thought i have to take homeopathy treatment, but at present my age is 26 yrs, weight is 89 kg ,height is 167 cm,report of blood test is t3-42.06,t4-1.75,t.s.h-286.467, i am confused now what to do now at present i am in thane,Maharashtra.please help me.",
    "doctor_response": "hi i had gone through your query and understand your concerns.first i will appreciate you for want to take homeopathic treatment,because homeopathy is the only system of medicine which follows the NATURAL LAW OF CURE.the cure of hypothyroidism is permanently cure only with homeopathic medicines only.i see similar cases among peoples especially women s who visit my clinic ,and previously they are taking allopathic medicines,some are under controlled, some are not controlled of TSH levels. but complaints are due to hypothyroidism arenot controlled in all patients.after starting homeopathic treatment in all patients without any hormonal tablets their complaints are not only decreased but TSH are also become normal.consult your local homeopathic physician for correct diagnosis of the case and remedy to fit your complaints. or mail me at drravib4u@yahoo.co.inI hope this is helpful for you, thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for continued depression and symptoms of bipolar disorder\n\nHi I m not sure if I have bpd, though i do exhibite traits, I have had clinical depression for many years and had many forms of treatment including sleep therapy & ECT , all without success. Include in that many many forms of medication. I have been with my current phyc for nearly 10 years. I wonder am I on the right track ? Cheers gidday2u..",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. You should know that these problems are not mental diseases, but are mental disorders. Many researches and researchers confirm that medicines alone cannot cure mental disorders. Life style changes, change in thinking pattern, relaxation etc are as essential as medicines. Psychotherapy can help you changing your lifestyle and thinking patterns. Yoga and meditation help you to streamline your metabolism and neurological balance. Please consult a psychologist for further information.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL.  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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can lactogen be given to a two weeks old infant?\n\nHi, may I answer your health queries right now ? Please type your query here...hello doctor my baby is 2 wks old.since im having large breast whenever i try to feed him he sucks a little and leave due to difficult to breath.but i keep on trying.i feel my breast milk is not enough.so i have started lactogen1.i need to know how long it takes to digest 1 scoop of lactogen.",
    "doctor_response": "Hi, Welcome to HCM. Can understand your concerns. Breastfeeding is best for baby. A child should be given exclusive breastfeeding till 6 months of age. If however, if you feel that breastfeeding is not sufficient then formula milk like lactogen 1. Lactogen 1 takes upto 3 hours to digest as compared to 2 hours in breastfeeding. I hope this will help you. Wishing your child good health. Take care. Regards Dr Deepak Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for conceiving\n\nhi i am on clomid from 2-6 day of my cycle, alongwith i am taking ovacare, ecospirin and blong-f. on 11th day of the cycle i ovulate which i know thru folliculometry, from that day itself i use to take progynova for seven day but i am not concieving. I am on this cycle since 6 month. what to do",
    "doctor_response": "Hi , What are you doing ?All the medications you are health supplements , except Tab. Clomid. May I advise few investigations to see for any hindrances in your getting pregnant. Do have those tests which you have missed. Husband- Semen analysis at least 2-  done 4 weeks apart preferably in an infertility center ( examination done by andrologist), Blood sugarsWife - Blood Sugars, Thyroid profile Ultrasound scans to evaluate Uterus , Ovaries & adnexa          Confirm tubal patency- most important- Tube is the connection           between uterus & ovaries( the bridge where sperm meets the egg &           forms a baby) this is size of hair follicle & cannot be seen on scans.           So check with HSG( Xray with dye), or SSG ( Scan with dye) or           LaparoscopyIf all this done & found normal , nothing can stop a pregnancy with God's willHope I have clarified all your queries , do let me know if you have any more queries. All the bestDr.Balakrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and tenderness on the right forearm?\n\nI have been having pain and extreme tenderness to the touch on the right inside of my right forearm just below the elbow. I have only experienced this type of pain and sensitivity once before, and that was about 30 years ago but the pain was in my big toe, and it was diagnosed as gout. I also have bursitis and arthritis in my hips and shoulders, but this is the first time I\u2019ve ever had this pain in my arm.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Yes, it is possible that gouty arthritis of elbow or tennis elbow or pulled muscle etc. Until examination is done it is difficult to say what it is. Take rest , use cold compression and painkillers support. If symptoms not improved please consult your orthopedician, he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Liver transplant, history of anal cancer. How many chemo treatments can the body survive?\n\nLiver transplant patient ( out 6 Years). In 2111 had anal canal cancer. Radiation , Chemo . Successful, but meanwhile a cell escaped to new liver. Half consumed ( squammous cell ) Back in Chemo toshrink , if possible. First treatment, low platelets requiring two units. Red cell to 6 , 2 units. I wish someone would give me at least some kind of prognosis since he has 5 more chemo treatments scheduled, and I know this happens every time. How many times can the human body take these counts, withour death?",
    "doctor_response": "Hi there, The benefit versus toxicity of chemotherapy is always a debatable and difficult situation and naturally brings anxiety to care givers and physicians alike. If we were to not give chemo then disease will progress relentlessly and he would be suffering from disease progression. Chemotherapy may cause low red cells and low platelets but thankfully we have medical measures for them and can support the body Also according to side effects, oncologists would adjust the dose. No one can tell how much chemo human body can take as many times patients are given third line or fourth line chemo, it really depends on the bone marrow reserve and the general condition of the patient. Have a clear discussion witn your oncologist and be realistic. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach cancer after having keyhole surgery?\n\nHI , my friend has recently been diagnosed with stomach cancer ( malignant gist) , she has just had keyhole surgery to remove an additional tumour that was blocking oesophagus, this was benign, since returning from hospital post surgery, she has been having seizures , she has had four. Can you offer any advice on these & what may be causing them ? Thank you ...",
    "doctor_response": "Hi,Thanks for writing in.It is not the key hole surgery which is causing stomach cancer. The reason is that there might have been a tumor in the abdomen which caused the benign tumor and some of the cells were still inside after the key hole surgery. With time these cells transformed to malignancy and therefore a malignant gist was formed.The seizures cannot be ignored if she had 4 attacks. A CT scan brain is required to evaluate the brain for any new metastatic transformation. The malignant gist tumor can become aggressive and then this causes secondary deposits in other organs including brain, liver and lymphnodes. It is urgent to do a CT scan brain and look for disease spread. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes semen leakage during a bowel movement?\n\ntwo days in a row I had what appears to be some semen leakage while having a bowel movement. I do not know what is causing this. I am worried it could be a prostate problem; however, I do not have any pain or discomfort deep in the rear area. what could this be?",
    "doctor_response": "Hi, When you defecate, feces move through the rectum and out of the body.  Therefore, it is conceivable that the pressure and straining from a bowel movement, especially if you are constipated, could press on the prostate. Passing stools through tectum in few people may gives sexual pleasure lead to semen leakage. Also check for prostatitis or urinary tract infection may also present like this. Please consult your physician/neurophysician they will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu",
    "dialogue_context": ""
  },
  {
    "patient_message": "On Adderall since long. Side effects? Does it cause kidney stones?\n\nHi, just wondering if there were any studies that supported adderall as a cause of kidney stones. I've been on adderall for at least 10 years, and only just started getting the stones about 2 years ago. But since then they're very frequent.  However, when I went off adderall I noticed they lessened significantly, and have already increased tenfold in the week since I started taking it again. When I was off adderall,  I was off for about 6 months. One stone was analyzed and the results were indeterminate origin, or something similar to that, I can't remember the exact way it was phrased. The first stone I had was excruciating, however,  after that, the others don't seem to be as painful, even though sometimes they do look bigger. I don't know if this is a sign of something bad either, but I hope not.A year ago, my kidneys were tested and were functioning fine, despite the stones.I hope you can put all this info together and maybe help me out a bit.I will talk to my doc in June,  but right now I'm out of the country and would just like some quick advice! Thanks!Katie",
    "doctor_response": "Greetings !Welcome to the site.Well it is unlikely for Adderall to be the reason behind your kidney stones since it is not associated with this as a side effect. The fact that after discontinuing Adderall you noticed a decrease in the frequency of stone formation could be best described as a chance finding as kidney stone formation in the body is very random and not dictated by any regular timing / interval and so this very nature of kidney stone formation justifiably explains the frequency decline which coincided with Adderall withdrawal.So to summarize---- Adderall is unlikely to be the cause for your kidney stone formation.-- You shall continue taking Adderall as per the guidance of your doctor.-- As for kidney stones you should keep yourself well hydrated by drinking lots of fluids including water, lemonade, cranberry juice, coconut water.I hope this allays your dilemma regarding Adderall's effect on your condition.Wish you all the best.Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Shall I take Tadalafil tablet to maintain erection?\n\nHello doctor, I am 32 years of age weighing 76 kg and my height is 5 feet 6 inches. I am unable to maintain erection. I have been experiencing this since a year. Prior to that, it was all fine and great. I have not had any other health issue and my BP, sugar levels, cholesterol are all normal. I exercise three to four times a week. I have attached my test reports for your reference. Please advise whether I can take Tadalafil tablets.",
    "doctor_response": "Hi. You can safely take tablet Tadalafil (10 mg or 20 mg) half an hour before sexual activity. It can be taken on alternate days if needed because the effect lasts for two days. You could also take tablet Tetrafol plus (combination of Levomefolate calcium, Pyridoxal 5-phosphate and Mecobalamin) one tablet daily for three months. It is helpful in erectile dysfunction. For further queries consult a sexologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for vomiting while on anti-depressants\n\nI HAVE A FRIEND who is getting her tattoo removed on her lower wrist it seems every time she is doing this with in 24-48 hours she is vomiting and running to the bathroom she is also on anti- depressants should she be worried as she is unable to eat anything or to keep it down is this a side affect of the treatment",
    "doctor_response": "Dear, We understand your concernsI went through your details. This could be natural allergy reaction to the \"removal-of-tattoo\" process. These nausea and vomiting do happen in such allergy conditions. You should have mentioned what is the anti-depressant your friend is taking. Usually anti-depressants do not act negative in 24 - 48 hours. Do consult a psychiatrist.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in a spot in jaw, cant open my mouth, cant swallow. Reason and treatment?\n\nhello, my right side of my jaw is in so much pain just started yesterday, when i open my mouth i can not open it all the way, i can turn my head, i can swallow jus hurts a little and when i touch the spot where the pain is located it hurts extremely bad, the whole upper right of my neck is swollen compared to the left side?",
    "doctor_response": "hi. You have not mentioned the area of the spot but after hearing your symptoms i am quite certain that the problem is related to your wisdom tooth which is either errupting or else is tilted in the wrong direction. it happens as food gets lodged in that area and its difficult to access it with a brush resulting in infection. this infection in turn causes discomfort in the surrounding gums and also results in mild swelling in the area. warm saline gargles may help and i would recommend you to visit your dentist who can give medication as well as can clinically see the problem. regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat adrenaline?\n\nfemale who recently became engaged on the 21st of last month . That week I was on such an incredible adrenaline high female who recently became engaged on the 21st of last month . That week I was on such an incredible adrenaline high ....................................",
    "doctor_response": "hello,thanks for ur query, that feeling common for all.enjoy.all d best.take care.hello,thanks for ur query, that feeling common for all.enjoy.all d best.take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the numbness at the back be a symptom of lyme's disease?\n\nOn Sunday I was bitten on the back by a horse or deer fly. On Monday night my body started feeling numb. I haven't lost any muscle strength, it just feels numb. Yesterday my throat felt kind of tight, but since has gotten better but the numbness is still there. Would this be lyme disease or just an allergic reaction to the bite?",
    "doctor_response": "Dear patient, this is most likely some kind of allergic reaction to the bite, not typical fpr lymes disease. Should get better by itself, best regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes discomfort/tightness in lower back\n\nI have discomfort in left side lower back which tightens and makes my legs jerk. I have constant leg pain in different locations\" knee, foot, ankle. Does this sound like a spine? age 62 height 5'4\" weight 190 I take mirapex for restless let symdrom",
    "doctor_response": "Hello, I have studied your case. Due to compression of this nerve root in spine there is pain in your thigh and leg.I will advise you to do MRI spineFor these symptoms analgesic and neurotropic[pregabalin] medication can be started.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.I will advise to check your vit B12 and vit D3 level.Till time you can continue your medication.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing pain in my testis up to abdomen?\n\nYes, within the last hour or so, I have developed a mild pain that radiates from my R testis into the R abdomen. I can't say that there is any swelling in the scrotum, however there does appear to be a small lump above the R testis. If I had to describe the pain, it feels like the pain after you have been kicked in the nuts.",
    "doctor_response": "Hi.Thanks for your query.Good description.The pain looks more due to the right ureteric colic.Get an ultrasonography of the abdomen and the scrotal area done to get a proper diagnosis. The treatment will depend upon the findings.Till then take plenty of water orally and an antispasmoidic tablet.Visit a Doctor",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in knee?\n\nSo, I have some knee pain. I am 21 years old, and I have no swelling in my knees. Both knees feel pretty sore right now, my left more then my right. It does not hurt to walk ect. The only real PAIN I feel is when I m walking down stairs. The pain is very mild. Otherwise I just have minor discomfort. I work a job in retail, and I have to crouch down sometimes. The pain began after the superbowl and I worked the previous day and we were busy. I also ship out to bootcamp in 18 days. It has now been about two weeks of discomfort. Do you think this could be a serious injury? Or should I continue to ice/OTC meds/rest?",
    "doctor_response": "Hi, In my opinion, this could be chondromalacia patella, so I recommend taping the patella, strength your adductors and internal rotators. Hope I have answered your query. Let me know if I can assist you further. Regards, Ayman Darrag, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high temperature and loss of appetite in a toddler?\n\nHi, my little girl of 2 years 5months has been getting sick on and off for the past two months. I m in Ghana a tropical country and the most common disease affecting babies here is malaria fever. My girl has been treated of this and was a was ok for some few days but went back to the same symptoms again. Normally the symptoms shown are high temperatures, especially in the night, cold and cough, cartar, lost of appetite vormiting of mucous. What could be the possible reason for her ailment. Doctors only did one thorough test on her which proved to have malaria parasites to which was treated. However, after being well for only two weeks the symptoms are back but all the malaria treatments given only stop the disease for about a week and comes back.",
    "doctor_response": "Hello, This might be viral illness as your kid has already been treated for Malaria which is endemic there; 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 a viral illness and it doesn't require antibiotics at all. Once the viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does OCD person have a habit of disturbing others at odd hours?\n\nI have a neighbor that has OCD.  He is obsessed with moving around furniture at very late times, like 12-2 am. in the morning. We all live in a very small apt building and his neighbor downstairs has to put up with him literally slamming the furniture around!!  The walls are very thin in this building.  Does OCD have a side effect that gives him the \"out\" for SLAMMING stuff around at ungodly hours and disturbing other people??",
    "doctor_response": "hithanks for using healthcare magicOCD is a chronic illness and in OCD it is very difficult for patient to control there obsession. When ever they try to control these obsessive thoughts, they feel anxiety symptoms. U decrease anxiety, they have to follow their thoughts. Sometime even on treatment it is difficult for them to control symptoms. It is not his fault. What he is doing , is because of his illness. Try to cooperate with himThanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will taking Vitamin B tablets for rickets be effective?\n\nMy 15 month old son has a bow leg more severely on his left leg and was diagnosed with rickets and has been given vit D supplements for a 6 week course...He also seems to be having an in-toeing on his left feet..what are the long term effects of his condition?",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, if the disease diagnosed early, and give appropriate supplement of vitamin D and calcium then prognosis would be excellent but will leave the bony defects as it is, only in sever case it may need surgical intervention, hope this information helps you, take care and have a nice day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My p-ANCA is 202. 55 U/ml and c-ANCA is 40. 74 U/ml. What does the report mean?\n\nHello doctor, I am a 47-year-old female. I started to have severe joint pains and inflammation around three weeks back. Then one day as I was giving a presentation, my team members noticed that I was bleeding profusely from my nose. The in-house nurse was called and I was found with high pressure of 210/120 mmHg and was subsequently hospitalized for a day. After extensive blood tests, I was found that my ANCA-MPO (p-ANCA) is 202.55 U/ml and ANCA-Pr3 (c-ANCA) is 40.74 U/ml. What does this mean? I was prescribed Imuran 50 mg once a day.",
    "doctor_response": "Hi. I have gone through your query. I need to clear a few doubts before giving you the final answer. I understand you had some problem which started three weeks back with joint pains followed by high blood pressure causing a nose bleed. I would like to investigate why you had sudden blood pressure rise? Is it due to inflammation in the kidneys or some other reason if previously things were normal? Do you have any history of fever, recurrent nose blocks or hearing loss? Were the other blood tests done like CRP (C-reactive protein), urine routine, chest x-ray, ESR (erythrocyte sedimentation rate)? As per the results, these are the markers for vasculitis. So we need to be sure these are the ones that are causing your joint pains or high blood pressure. Because the management will change if there is renal involvement and Imuran alone would not be enough. 1. CRP. 2. ESR. 3. Urine routine. 4. X-ray chest PA (postero-anterior) view. 5. CBC (complete blood count), LFT (liver function test) and serum creatinine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if having hemangioma in liver and kidney that is growing?\n\nRespected Sir, My close relative , at age of 76yrs.(Male), residing at Calcutta, is suffering from hemangeoma in liver and also in kidney since last few years . Doctors advised for operation in 2009 but during operation they found the condition of the hemangeoma was such the they could not do any operation and stopped there itself. Since then he is surviving on medicine. These hemangeoma is further growing and creating problem for him. Can we expect  valued advice from you so that we can save his life.We will be tankfull to you for ever. We will be waiting for your early reply. my e-mail address is   YYYY@YYYY / YYYY@YYYY With best regards, p.sarkar",
    "doctor_response": "Hello Mr Sarkar,How are you? I am sorry to hear about your relative's condition.Hemangiomas of the liver are fairly common condition diagnosed by ultrasonography. In the majority of the cases these do not cause any symptoms to the patient and are detected by scans done for other reasons. But when they start growing or when they become blocked they can cause pain. They can also rarely start bleeding when emergency treatment need to be initiated. when they do become symptomatic, the best treatment would be to surgically resect (\"cut out\") the hemangioma. This severity of the surgery will depend on the size and location of the hemangioma, the physical condition of the patient and also his liver function. The same applies for the kidney hemangioma also. But as I understand, your relative has undergone an attempt to surgically remove the hemangioma. But what is not clear is why the surgery could not be completed. In this regard if you can provide us the operative reports, Imaging (CT scan, MRI, Etc) and the discharge summary of the previous hospitalisation, it will be a great help in guiding furteer course of action. If surgery is indeed not feasible, then there are treatment options available which can be explored like percutanous sclerosant injection or blocking of the feeding blood vessels to decrease the size of the hemangioma.Please do let us know the previous treatment reports. Hope this helped and hope your relative feels better. Please do not hesitate to contact me for further details - rxsuresh@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do spinal stenosis - lumbar region and spondylosis - cervical region suggest?\n\n1. Lumbar bulging disc 2. Spinal stenosis lumbar region without neurogenic claudication M48.061 ( Primary 3. Spondylosis without myelopathy or radiculopathy cervical region M 47.812 4.Radiculop lumbar region M5416 .what typ1e of treatment is recommended",
    "doctor_response": "Hello, Report says you are suffering from lumbar spondylosis without involvement of spinal cord and nerve roots. So physical therapy with regular exercise may be useful. Please consult your neurosurgeon he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for thigh pain and red patches\n\nOk my daughter is 13 amd was at field hockey camp. When she came back she came back sating her thighs hurt and were burning. There are red patches and a little bumpy. I think maybe thighs hitting together when running but not sure. Please help anything i can do",
    "doctor_response": "Hello, It might be due to underlying Muscle injury. The red patches & Swelling could be Ethythema and sudden sprain at the thigh area. Treatment- 1. Ice Pack Application (Twice/Thrice a Day) 2. Rest (For a couple of days) 3. Avoid Sports/Strenuous Activities 4. Loose clothes to avoid Wear & Tear of sore area. 5. If the pain persists for another 2 days, then take these Medicines- Tab Signoflam - 1BD, Tab Pan 40- 1OD (Empty Stomach), Tab Enzomac - 1OD (Empty Stomach). Take these drugs for 5-7 days. 6. If the Symptoms persists even after 1 week of the treatment, then visit a local Orthopaedics Specialist and might go for further Investigations. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Saurabh Singh Rajan, Sports Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for upper abdominal pain\n\nDear Doctor, I am 30 years old married housewife, having one son of 8 years old. irregular mensturation. now I feel pain in my upper abdomain after taking my food. it happens just after half an hour of my regular intake. please suggest what can i do? My hight 5.4ft weight 55Kg.",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Abdominal pain after food intake is due to duodenal ulcer.2. You will require treatment with proton pump inhibitors and H2 blockers.3. Reduce stress, and spicy items. Avoid NSAIDS painkillers.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it positive report to pregnant my wife ?\n\nhi please note below my semen analysis below i want to know i can pregnent my wife with this report is it possitive for pregnent my wife.... volume- 2.0 ml pH - 8 colour - opaque liquefication time 20 minutes total sperm count - 38 million active - 15% sluggish- 05% dead - 80% Pus Cells - 2-4 RBC - 1-2 Epi cells - 0-1 clumps - +",
    "doctor_response": "Hello Mr.Mohd.Yasin; welcome to HealthcareMagic Sorry to say but the semen analysis you have posted is not good and the main part to worry is the active sperms and the motility where you should have more than 50% motility and more than even 50% active and normal forms of sperms.Please consult a Urologist/Andrologist for opinion and treatment as you surely need to get treated if you want to be a father. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stiff neck followed by dizziness and slow speech?\n\nThe other night, I got some stiffness in my neck and got really dizzy like I had been drinking but I dont drink. Then I got slow of speech and started smelling old engine oil. what could have been the problem? I had the stiffness in my neck and head all day.",
    "doctor_response": "Hello!Welcome on Healthcaremagic!Your symptoms could be related to chronic degeneration of the cervical vertebral column. Anyway, it is really hard to connect all your symptoms together with a neurological disorder. The dizziness and neck stiffness could be related to chronic degeneration of the cervical column. But the weird smells does not seem to be related to such issues. Anyway, if the problem persists, I recommend performing a brain MRI and a Doppler ultrasound of the cervical arteries. Hope you will find this answer helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "How contagious is shingles for a person in remission from cancer?\n\nWe have some friends coming to visit. One person has come down with shingles. Both my husband and I have had the shingles shot. How contagious would this be to us and what are some preventive measures we could take? My husband is in remission from stage 4 lung cancer, would this be a threat to him?",
    "doctor_response": "Hello ,I understand your concern. I am Dr. Arun Tank, infectious disease specialist, answering your concern.Yes it is threat to your husband.Shingles usually appears on persons having low immunity. If your husband is having stage IV remission, he must be taking the anti cancer drugs. Such drugs causes immunosuppresion.Shingles is a risk for such a person. I advice you to start with anti shingles drugs like acyclovir for your treatment. It will prevent you from getting infections.Glad to answer your further concern contact me on bit.ly/DrArunWe wish you a best health at healthcare magic. Thank you,Dr. Arun TankIf you are satisfied with my answer rate me as five star and close the answer",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to improve penile size?\n\nHi sir ,Next year I am going to marry.I am 30 year old male. But About one thing I am somewhat worried that my penis size is very small and thin .So I am really scared that I can satisfy my wife or not. So is there any treatment available for this kind of problem??",
    "doctor_response": "Hello, SIZE, THICKNESS AND HARDNESS of penis never matters in a sexual intercourse. Love and passion matters and determines the sexual pleasure. Usually, in flaccid condition, the size will be less than 2 inches. Average size of erect penis is 4 inches. But even a two inch erect penis can satisfy any woman across the world just because, woman sexual nerve endings which are the reason for pleasure for women, are available only up to two inches from the opening of vagina. Therefore, please don't worry. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. K. V. Anand",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high fever\n\nMy 4 year old had a high fever today after a nap it went down considerably after he got up moving around he has since had spikes the rest of the day and is currently hot again he has no other symptoms of anything his pediatrician said to give him motrin.  Is there anything else i should be looking for?",
    "doctor_response": "Hello. I just read through your question. The most likely diagnosis for fever with no other symptoms in a 4 year old is a harmless viral illness. Typically, the fever lasts 2-3 days and resolves. I agree to treat with Motrin. However, if other symptoms arise (ie: ear pain, throat pain, vomiting, etc...), or the fever lasts beyond 2-3 days, he should be examined.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for appetite loss in a child\n\nhi, my daughter is 18months old. previously she used to eat food properly, but now she is not at all eating any solid food, only juices ,she is preferring. wat ever liquid food we will ive , she will take. is it good for health that only taking liquids...",
    "doctor_response": "Hi...giving only liquid diet is not going to give adequate nutrition for the kid. I take this opportunity to tell you certain scientific facts and relieve your distress - 1. An active is a well kid even if she/ he is not eating well. 2. Development of a kid is as important as or I would say even more important than growth alone.3. As the kids grow their interest in food decreases and interest in play activities increases so that they eat small quantity and run away to play. As parents we need to be more patient and feed than less quantity but more aliquots per day.4. This age rather than the quantity of the food I suggest you concentrate more on the number of times you feed her and also make whatever you feed her calorie dense by adding good amount of ghee to it.5. I suggest you not to use appetite stimulants on long run as they may cause drowsiness.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes muscles spasms around the neck long after having a surgery?\n\nI have neck spasmens that go all the way around my neck in a circle. I previously had two neck surgeries about 20 years ago. I just had surgery on my back for a cyst in the thoracic part. I am 62 years ago, not in real go shape. The emergency doctor said I should be checked for Lyme disease but I don\u2019t think I have that. What do you think?",
    "doctor_response": "Hi, Consult an orthopedician and get an MRI scan done to look for conditions like cervical spondylitis. As of now, you can take analgesics like Acetaminophen or Tramadol. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause severe pain in foot, recently suffered from Chikunguniya?\n\nGoodevening.. My name is manoj.I have been suffereing from lot of pain in my foot since last 3 months.I suffered from Chikanguniya 3 months back,but after that the pain in foot remained,making it difficult for me to stand evenly and walk properly. Can u suggest the reasons for this pain?",
    "doctor_response": "Hello,It may be due to chickengunia. For pain you can take tablet acetaminophen. As it's viral infection, there is no need for antibiotics. Keep your self hydrated. Take balanced diet. Hope I have answered your query.. Let me know if I can assist you further. Regards, Dr Shyam Kale Family and general physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medication is suggested for swollen lymph nodes on the right armpit?\n\nI have two swollen lymph nodes at my right arm pit. They are not soft, but not fixed either. One has been there for 2-3 months...the other popped up a couple of weeks ago. They are not painful, nor have I had any infection or illness. What are the chances they are cancer?",
    "doctor_response": "Hello, Your symptoms seem to be related to a reactive lymph node. This is one of the common causes of swollen lymph nodes. I suggest doing a complete blood count for further evaluation. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does sharp abdominal pain along with nausea indicate mono?\n\nHi, I got my blood results back yesterday and my lymphocytes have increased from 34% to 55% in under a year.I've also been having sharp pains in my left abdomen. Nauseous and no appetite. Constantly tired... And I have many swollen balls on one side of my neck. Is this mono?",
    "doctor_response": "Hello,It could be mono but you need to see a doctor and be sure. It could also be something more serious. See a doctor for an exam and evaluation as soon as possible.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump on the inner foot indicate?\n\nMy husband has been doctoring with a pen orthopedic physician who is putting him in a walking boot and custom orthotics for plantar fasciitis, however, he has about a 1 inch lump protruding from the bottom of the of his inner foot right where the heal and arch would meet. He has extremely flat feet from working on concrete floors for almost 30 years. He's had an MRI and X-rays but there's no real answer for what that protrusion could be.....any ideas??",
    "doctor_response": "Hello, Since your husband is a known case of planter fascitis the lump of 1 inch in size at a point where the heal meets the arch can be due to fascitis itself as MRI could not show this separately. Must be a fibrosed part of fascitis. The best treatment for such a case is as follows and I am sure may help your husband. Prepare a water solution super saturated with common salt as much as would allow immersion of of above ankle area in the tub. Make this warm and test with flat of palm for temperature. This hot fomentation twice a day will him a lot. Surely the orthopedic boots and such things too help maintain the normalcy but you have to check whether this is a proper fit or not. A course of an anti-inflammatory medications and steroids too help a lot in some cases. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the use of dentures cause pigmentation change in my mouth?\n\nThe inside of my mouth is no longer pink but more like color of flesh.   Sometimes it seems to be a little pink but definitely not has changed color.  THe under side of my tongue is lighter than it used to be.   I got a full set of dentures about 7 month ago.  Could that have caused pigmentation change in my mouth?   This is not a coating, this is the entire inside of my mouth has changed color.",
    "doctor_response": "Its absolutely normal. Your mouth being a living tissue undergoes changes secondary to denture wearing. But watch out for any signs of pain burning dryness of mouth. Please remove your dentures at night and store in water.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to improve children's concentration level?\n\nMy name is Ashim Nayek residing at Durgapur and I have two children and my elder son aged 17 year who is very absentminded and can not concentrate in his academic studies normally. His patience is very little and erratic in nature. He did very worse in his recent school final exam ( Class X exam.) due to his unmindful nature and he also involve himself in smoking cigarette seperately. He frequently behave very eratic with his perents. So please advice me how I tackle my son in coming days. thaking you, ASHIM NAYEK VILLAGE AND POST.- GOPINATHPUR DURGAPUR - 713211 DIST.- BURDWAN WEST BENGAL MOBILE : 0000.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  Your son is adolescent. Adolescent nature is always like what you described. This happens due to hormonal and body changes. They feel that they are matured and indulge in risk taking behavior. They ignore and behave erratically with parents and elders when they are advised because they never want to listen to advises. But you should not worry. Within some tow or three years, his behavior shall be good. For the time being, be his friend.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My platelet count, uric acid, SGOT, and SGPT are deranged. How can I be treated?\n\nHello doctor, I am a 29-year-old man and I weigh 115 Kg. My preventive health checkup results show\u00a0the following irregularities:\u00a0Mean platelet volume 12,\u00a0CHCM 31.8, mean platelet volume at 12, total cholesterol 200.6, serum uric acid 7.8, globulin 3.7,\u00a0SGOT 93.27,\u00a0SGPT 213.87, and vitamin D total 25- hydroxy at 5.05. Kindly advise me on the lab results.",
    "doctor_response": "Hello. I will explain the\u00a0above one by one. Regards. For more information consult an\u00a0internal medicine physician\u00a0online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain and muscle weakness while having dextroscoliosis?\n\nHello Doctor, My name is Rowena, 38 years old, married with children. I have a dextroscoliosis, i experience on and off back pain, when my back is in pain for a week , I alwys experience mild chest pain and muscle weakness of my left upper and lower extremities, Sometimes i m afraid i have a problem with my heart but my ECG is normal. Is it related to my dextroscoliosis Dok? please explain. Thank you!!",
    "doctor_response": "Hi, Yes, it is really related to your dextroscoliosis. It is a disease that causes myocytis, it is a common complication. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump below the knee indicate?\n\nI fell on the rocks while fishing and got a knot on my leg below the knee. There is a scrape but no bruising While sitting it feels fine but when I stand it hurts but only after a few steps it subsides. It s been a week and the knot is still there Any suggestions",
    "doctor_response": "Hello, my name is Dr.Dorina Gurabardhi. I understand your concern. A knee lump can represent :-a joint deformity due to a chronic inflammatory condition such as arthritis -deformity that arises following any kind of injury to the joint-infections Some advices that I can give to you are :-Do not squeeze, scratch, drain, open (lance), or puncture the lump. -Keep the area clean by washing the lump and surrounding skin well with an antibacterial soap.-Apply warm, wet washcloths to the lump for 20 to 30 minutes, 3 to 4 times a day.Hope my answer was helpful, if you have any other questions I'll be glad to help, thanks!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be concerned for the pus formation in wound even after taking antibiotics?\n\nmy son met with an accident 3 wks back. got a ddep gash upto his bones on the knee joint. had antibiotics for12 days and is getting dressing done every alternate day now. the wound is healing but he still has pus formation. should it be acause of concern ?",
    "doctor_response": "HelloWelcome to HCM. Thanks for posting your query in HCM.I understand your concerns.Pus formation in the wound signifies that it is not yet in the healing condition.The wound appears to be deep.So it needs thorough dressing with debridement so that all pus is cleaned off.Taking antibiotics for 12 days and presnece of pus still signifies that your son has developed resistance to the antibiotic.So i would advice you to do culture and sensitivity of the pus and to take appropriate antibiotics depending on the organism present in the pus.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest diet to gain weight in a baby\n\nMy 6 month baby girl weight is 6.02lb and at her birth time her weight was 2.90 lb. she is not gaining her weight . I started solid food from 5 month. I give her Breast milk and formula as well.suggest me some diet chat so that she can gain her weight.",
    "doctor_response": "Hi,Thank you for asking question on health care magic.Your baby as per birth weight is VLBW baby(very low birth weight baby).She needs Dexolac speccial care formula to accelerate the growth velocity,milk cereal mixture like cerelac, smashed potatoes fruit juices and vegetable soups and breast milk can be continued as far as possible.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower right rib pain in diabetic patient?\n\nI have been having lower rigt rib pain for 3 years. I am 55 Have type 1 diabetes x 43 years, Gastropareses,and fatty liver. Iv had all the tests ct x ray bone scah all are normal. My primay is sending me to a pulminary doc. Why would that be.Thanks Mike",
    "doctor_response": "Hi thanks for contacting health care magic.Noted you are having fatty liver.So first possibility is it could be reffered pain from liver or gastric cause.Second pain could be muscular because of muscle strain by heavy exercise, heavy weight lifting or any unaccoustemed situation.Third pain could be by costochondritis like condition.Take rest.Analgesic for pain.Avoid heavy work for few days.Hot compress can taken for pain.You will recover within few days.If still complaint increasing then x ray done to rule out rib fracture like condition.I hope your concern solved.Take care.Dr.Parth goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have OCD, trouble reaching orgasm. Taking anafranil. Dosage increased. What can be done?\n\ni am a 16 year old male. I have been taking a drug called anafranil for ocd. I have been taking it for about a month. every week the dosage was increased. i am now trying to get off the drug by decreasing the dosage until i don't take it at all. what i have become aware of is that i have had trouble reaching orgasm. i'm afraid that this is permanent or that if it does get better that i will still be affected in some small way. Please tell me if it will get better and how much better.",
    "doctor_response": "Hi there ~ If your problem is the ability to not get orgasm and feel like that is related to anafranil it might be wise to go off of the medication.  However I assure you that you will get better and reach orgasm when you stop taking the medication.  I however feel like there is more to the story than just the medication.  You should consult a psychiatrist who can take a complete history and make your problem better including your ocd.  I hope this helps. Take care and have a lovely day !",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Which specialist should I consult for one side headache?\n\nHi doctor, I have been suffering from one side headache since last 10 years. I was diagnosed with paranasal sinuses. I am taking medicines for sinus problem and a few periods for migraine. But no results found. Please guide me. Which department should I consult and get treated?",
    "doctor_response": "Hi. Your description fits into migraine headache. Migraine headaches occur usually on one side of head and have severe throbbing sensation associated. They can be accompanied with vomiting, photophobia (severe sensitivity to light) and phonophobia (fear of noise). You can see a physician who deals with migraine cases and even you can see a neurologist for the purpose. A neurological examination and fundus examination are must to rule out any other neurological problem. If required your doctor will also post you for CT scan and MRI brain. Treatment for migraine headache would be with the drugs like Flunarizine, Propranolol and Amitriptyline. In case of acute pain drugs like Sumatriptan and Ibuprofen helps to terminate the attack. For further information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anal pain\n\nHi for the past few hours I have this weird throbbing pain in my anal area shooting up to my abdominal area it s very discomforting when I sit down on the toilet it s worse and while having intercourse it s uncomfortable so i have to push my partner away we had intercourse the other day where my partner accidently went into my anal and I had a tear which has been nipping now it s away today these pains have started can you please tell me what this could be?",
    "doctor_response": "Hi, , your problem could be an anal tear, fissure or a small abscess. Please use a local preparation with antibiotic, local anaesthetic and soothing agent three times a day. Also use a stool softener. If you are not better, you need to show a proctologist. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to workout while suffering from a mitral valve prolapse?\n\nSir i have diagnosed first degree av block and mild anterior mitral valve prolapse and trivial regurgitation and i have no symptoms of the chest pain shortness of breath or fainting so in this scenario can i continue running and gym and do push up either this gonna my case more worst for future and how much chance of Increase in prolapse and regurgitation my echo report was lvid-d 47mm lvid-s 32mm la 36 mm Ao 32mm Rv-d 18 Ivs-d 9 Lvpd 10 arotic valve 1.3 m/sec pulmonary. 6m/sec",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. After going through your medical details, I understand your concern and I would like to tell you that aerobic exercise is good in mitral valve prolapse as it strengthens the heart muscle but intense workout is generally not recommended. Kindly consult a Cardiologist personally so that he can evaluate extant of prolapse and a cardiologist can advise you for right exercise routine to follow . Kind Regards Dr. Bhanu Partap",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long will it take for liver enzyme levels to become normal?\n\nHi, may I answer your health queries right now ?  Please type your query here...My daughter had recently got TB Infection for which she was prescribed AKT4 medication. After a week her SGPT/SGOT LEVELS were very high. Now a week later they are still high. How long does it take to come back to normal. is any restricted diet required for this",
    "doctor_response": "Hi welcome to health care magic.... You have not mentioned your sgpt and SGOT report values.... Before coming to conclusion on akt drug induce hepatic damage,  viral hepatitis should be ruled out.. For that hbsag detection and anti hcv estimation done by ELISA.... In your akt isoniazide and rifampicin is yes potentially hepatotoxic drug... So if needed all drug should stopped and non hepatotoxic drug given including ethambutol,  streptomycin and ofloxacin....Than primary akt started in gradually manner... Take careAdvise : Consult your treating doctor or physician for examination and further work up according to the need.... Hope this will help",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of blisters on jaw ans back bone and lump on penis ?\n\nHi,I had a unprotected sex with girl at 12/01/2012. I have tested HIV 1 + HIV 2 negative at 12/06/2012 at five months. From the five months I have been suffering from symptoms like blisters on jaws  and back bone. And a painless lump in penis. Please suggest what to do? And please suggest where to treat in kolkata.",
    "doctor_response": "Please see a Surgeon who can examine you. Without examining it is very difficult to comment as to what it is. It is unlikely to be due to the sexual encounter but still better to get it checked and treated. Both the problems also could be unrelated but can say with surity only after examining you. So my advice is that dont delay it and get yourself checked soon.Take care. Dr Rishi, New Delhi, India.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be concerned of sore, stiff and painful knee cap?\n\nI had a knee replacement  12/2012 and developed non hodkins lymphoma in May 2013. I have had 6 chemo treatments. My knee has become sore, stiff and painful above the knee cap. Are these items for concern or should go away after completion of chemo and stem cell transplant?",
    "doctor_response": "hii am sorry to hear about prolonged illnessi guess bad news keep on coming in a bundle when they start comingalmost like long phases of bad news intersprersed by short breaks of good newsthey may go away with the completion of chemotherapyhowever it may be a good idea to get the xrays of the affected joints againthat way we can be more sure as to what exactly is going on in that jointhope that helps and answers your querybest of luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have I damaged the wrist by throwing punch on a piece of wood?\n\nI was really mad and punched a piece of wood several times with my knuckels. I have bruises on my knuckles but they don t hurt at all even when I touch. The only thing that hurts is closer to my wrist which feels more like a brusie when I touch it. Should I be worried?",
    "doctor_response": "Hello, Take tablet serratiopeptidase to reduce the swelling. Do check nearby orthopaedician for further follow-up. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parkavi Gunasekaran, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes joint pain and numbness of hands with negative rheumatoid factor?\n\nI have joint pain and numbness in both hands when I wake up . I have not had a diagnosis yet but all tests for ESr etc and rheumatoid factor were negative. All joints hurt and my shins have started hurting in the last week like the bone hurting. I am 58 and past menopause and have cholesterol of 8.6 and on atrovastatins 40mg but had pain before started them, my joint pain been going for 5 yrs now and not getting better.",
    "doctor_response": "Hi you have joint pain for 5 yrs and numbness in both hands when you wake up. ESR And RA Factor are negative .You had pains before starting statins. In my opinion Since you are 58 and post menopausal, the cause of your pain could be osteoporosis / osteomalacia. I would recommend you start taking regular calcium ,Vit D3 and get Bone Densitometry, Se Vit D3 Estimation .Also let me know how are your knee joints particularly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe headache,nose bleed and pain in mid lower back and abdomen?\n\nI had a heart attack Nov 17th 2012 at the age of 45. I had a 100% block LAD. It was stented. Since then I have had 5 stents place. 4 in left side of heart. and one in my left subclavinal artery Lad restented and subclavin steel syndrome.. I recently had a heart ablation due to Svts where they appilied 9 lessions and had to stop due to the pherenic nerve. my B/p goes from 70/40 and will rise to 160/114 with a heart rate up to 158. never below 90bpm since the ablation. But at least now it will be as low as 90bpm, before it was always over 100.. Now I am having headaches and sever nosebleeds that happen when b/p is over 130/94 heart rate 110 Pain in mid/lower back and abdomen. slight edema in feet and face. I am already on Lasix and heart medication. What would cause the nosebleeds and pain??? Please help!!! Thank you!!!",
    "doctor_response": "As angioplasty is done, you might be on blood thinners. Get blood investigations for coagulation done. Also see ENT doctor for nose examination, to rule out local pathology. Keep your bp under control.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of bumps below chin while suffering from tuberculosis?\n\n30, 177 cm, 68 kgs, i am suffering from TB told by my doctor. There is two bumps (with swelling) just below chin. Done biopsy needle last 10 days and given tablets like R CIN, RANIDOM, CIBA, COMBUNEX. I have been using for last ten days but there is no cure in it what i have to do next. Please help on this issue.",
    "doctor_response": "hi. Welcome to HCM.If those swellings are because of TB then these will subside over time. You will have to take anti-tuberculosis treatment for 6 month if you had not taken previously. New cases are initially treated with four drugs: isoniazid, rifampin, pyrazinamide, and either ethambutol or streptomycin. After 2 months, they are then treated with a continuation phase of 4 months with isoniazid and rifampin.Generally tuberculosis infection takes time to respond.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is Mometasone dangerous to use on Face to clear my acne pimples?\n\nHello doctor, I am seriously facing acne pimples problem. Sometimes they occur on my face when I masturbate. If I use Mometasone, it gives a good result. Is it okay to continue this?",
    "doctor_response": "Hello. Acne is a universal issue in the age group of 15 to 25 years due to hormonal changes in adolescents. However, there are multiple effective treatment options depending on the grade and severity of the problem. Mometasone is a topical steroid and is to be avoided strictly on the face and for acne as it can harm your skin in the long run. Acne is dependent on hormones hence excess masturbation may sometimes lead to an increase in the problem. I would advise you to stop Mometasone immediately and kindly upload appropriate images to help us assess your current grade of acne and treat you better. Regards. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My kid has little bumps on her finger. Is it an insect bite?\n\nHi doctor,My daughter is 2 years and seven months old. From five days, she has little bumps on her finger and she is having an itching sensation especially during nights. This happened after she played with clay in the garden. I am assuming it to be some insect bite. I am not sure though. Please advise.",
    "doctor_response": "Hello. Yes, there is a strong probability of some sort of insect bite. I suggest giving her syrup Atarax 2 ml (Hydroxyzine) twice a day for two days. Keep watch, she might feel sleepy after Atarax. Apply calamine lotion locally. If the swelling does not disappear in two days, she may require antibiotics to prevent infection. As of now no need. It may be painful, give her syrup Ibugesic 2.5 ml twice a day morning and evening post meal. All medicines to be taken after doctor's consent. For more information consult a paediatrician online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the ideal time to have sex if planning for pregnancy ?\n\nWhat Was The Best Sex Schedule If I Want To Get Pregnant If My Period Starts On 15th Then Last 22nd? my fianze only have two weeks vacation and we both decided to make a baby...",
    "doctor_response": "Hello. Thanks for writing to us. The best time would be day 9 to day 14 of your cycle if you have a regular cycle of 22 days. You must have sex at least once in 24 hours. It depends on your ovulation. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drtayalrakhi@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause hard lump on the side of jaw?\n\nI had medullary thyroid cancer and a thyroidectomy 2 years ago .(Men 2b , multiple endocrine neoplasia ]. I have had an infection of saliva glands 2 times now . The hard lump on the side of my neck under my jaw is hard and the size of a dime . I am 58 years young and am wondering if this could be just a growth or cancer of the lymph nodes ? I also had a complete adrenalectomy 2 years ago and have put on a lot of weight from the prednisone .I am a school bus driver and cannot afford lots of tests . Thanks for any input on my condition ,Kathy",
    "doctor_response": "HI,Thanks for the query to HCM.Treatment for hard  lump on side of jaw-In my opinion,its a lymphadenitis with infection from salivary glands mostly.As you had old thyroid cancer,your apprehension could be reduced by arranging a Antibiotic trial with your ER Doctor,as you are short of money.If it responds and reduces-then forget it.If not you need to consult Surgeon and treat it after FNAC Biopsy.Hope this would help you to plan treatment with mammography and ER doctor.Welcome for any further query to HCM.Hit thanks.Good Day.Dr.Savaskar M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rapid heartbeat\n\nI am 28 male. Professional. I had feeling that I can feel Some fast heart beat. and I get some Air Passed from mouth at frequent interval. This will happen, only at Night ( after Dinner) This normally continues up to 30 mintues. and Air Realesed from my mouth at 5 mins interval. this was contiuned Daily at night. What is the Problem? please suggest me to solve it? Is it related to Heart Problem?",
    "doctor_response": "Hi, After going through your medical query I understand your concern and I would like to tell you that most likely your BP goes on lower side after meals which is causing you rapid heart rate and heavy meals are causing more if gastritis which is why you are passing air from your mouth. It's recommended for you not to take heavy and spicy meals in the night and take tablet Pantocid before breakfast for 10 days. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr Bhanu Pratap",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for reddish spots\n\nMy son 5 yrs old has developed some kind of reddish spots on the body which keeps appearing/disappearing at different body parts mainly around the waist. We tried Allegra, omnacortil syrup and some creams to be applied on spots.As long as we give medicine, spots are in control, once we stop they start appearing once again mostly in early morning and late nights.What you can suggest / possible causes/ disease/infection?",
    "doctor_response": "Your child is developing urticaria-hives in common language. He can be given antiallergics from time to time and a monteleukast. Deworm him .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest a treatment for the torn meniscus in knee\n\nI think I tore my meniscus (not sure which) in the left knee; firstly about four months ago, it s stayed sore for a short while then got better with a little soreness here and there. Secondly, one month ago my left knee popped out of place during a sport activity and has been randomly feeling of set when in squatting position to standing position then replaced with a little adjustment. Today it is now filling with fluid and hard to walk on. Will thus go away or do I need surgery?",
    "doctor_response": "Dear patient First of all we have to confirm the diagnosis.  Are you having  symptoms of locking  and inability to put weight on left knee? If yes there is possibility  of meniscus tear.you have to go for mri of left knee to look for exact site , type and which meniscus is torn.  Visit radiology  center nearby you and get it done.  Tears which requires  surgery  are 1. Bucket handle  tear 2. Complex tear 3. Anterior or posterior horn teat with instability.  You need to consult expert arthroscopic surgeon nearby you with report and get yourself examined.  All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful redness on the roof of mouth?\n\nMy husband has an area on the roof of his mouth that is very red and some of the skin looks almost like a blister has burst there.  It's close to his teeth but he says the actual tooth does not hurt.  It's very painful and made worse by eating or drinking anything hot or cold.  He's had it about three days and its gotten progressively worse.",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC.As per your complain painful sore and inflamed area at the roof of the mouth can be due to causes like formation of an ulcer that has been traumatized and inflamed..It can also be due to biting something very hard causing injury to the mucosa..Another cause can be burning of the roof of the mouth with some hot foods or fluids or chemical substances..I would suggest that he should start applying numbing gel over the sore area to relieve pain especially before meals to make eating painless..Do cool compresses or suck ice pops..Avoid spicy and hard foods and take a soft bland diet..Take  Ibuprofen to relieve inflammation and pain..Do antiseptic mouthwash gargles..Hope this helps.. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medication should I take to remove blood clots from leg as it is very tender to touch ?\n\nHi, I m a 20 year old male. I had a blood clot in the leg ( dvt ) about a year ago I quit taking my thinners about 9 months ago and i believe I m having the same symptoms as then. My left calf is tender to touch and when i point my toes up. If dangle my leg it throbs. When i stand it throbs but worse when i unlock my knee! Should i go to the ER? i have no family physician.",
    "doctor_response": "Hello, Welcome to Healthcare Magic forum. The symptoms you are having do resemble that of DVT and if untreated there is a significant risk of thromboembolism, gangrene and pulmonary embolism. It is advisable that you visit the ER at once and get the doppler test to confirm the diagnosis and start appropriate treatment. Try to avoid any tight dressing on the affected limb and maintain circulation of the limb. Drink plenty of water and avoid any sudden movement of the affected limb. Wish you a speedy recovery. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest permanent remedy for skin rash\n\nSir I am diabetic person, FBS IS 150mg/dcl I have skin allergy having reddish skin and rashes. Where allergy appears I will take two 5mg citizine tablets, it will not appear for two days, again after two days it will appear. once again if I take two 5mg citizine tablets it won t come for two days. It is happening for me from the past six months. What is the permanent remedy",
    "doctor_response": "Hi,It may be chronic urticaria. Consult the dermatologist for the perfect diagnosis and proper treatment. You may go for allergy test. The triggers may be found out. It may be either contactant or dietary factor. That should be avoided. And continue taking cetirizine for more than 6 months even after control. Hope this helps.Dr.Ilyas Patel,Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent dry cough?\n\nHi, my husband keeps coughing a lot. Its more of a dry cough. He was on madication which reduced his coughs, however its back again. The doctor said that this is to do with some rashes on his through. However, this time when he checked he said its not the rashes too. How do we understand the exact cause of this cough.",
    "doctor_response": "the various reasons for dry cough which persists more than 3 weeks and not associated with constitutional symptoms like weight loss or fever, include:Allergic rhinitis causing a post nasal drip at the back of your throat( check with an ent specialist), gastric reflux, drugs like enalapril and ramipril, and prolonged viral infections due to immune deficiency states like B12 deficiency. Would suggest you have your nose and throat evaluated by ENT surgeon, take a course of Pantop with domstal for gastric reflux and check for vitamin B12 deficiency. you might also want to check for cough variant asthma by pulmonary function tests.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does it take to clear sludge from kidney?\n\nHow long can it take to clear sludge from a kidney? My grandson is 8 and had surgery for a blocked ureter (it was a vein) twice. Now almost a year later he has similar pain. An ultrasound shows no frank hydro nephrosis. Surgeon suggested it is sludge. Can a CT scan show the presence of this?",
    "doctor_response": "Helloya CT can show it but u dont need to go for CT unneccesarily for any so called sludge..had the sludge been in any significant amount it would have appeared on ultrasound itself",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have pain in the eyes and severe headache. What could it be?\n\nHello, When I see any object, I feel like I can see only half of it and after that I experience\u00a0pain in the eyes. I also have severe\u00a0headache\u00a0soon after that. What could it be?",
    "doctor_response": "Hi. These symptoms indicate migraine headache. These vision related symptoms are present in aura (temporary visual disturbances that precede the migraine headache). The treatment of migraine headache is by use of analgesic drugs in acute episodes and by use of prophylactic drugs like flunarizine to prevent recurrent attacks. Consult a general medicine physician online for further investigations and treatment -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes paralysis after removing the clot from spine?\n\nmy brother-in-law has just undergone emergency surgery where a clot was removed from his upper spine. it appears that he has some paralysis in his arms and legs... has only regained limited function of one hand. my sister mentioned that he has already begun physical therapy (surgery was just yesterday) ...does something like this usually result in some kind of permanent disability? (she said at this time he can't even answer a phone)",
    "doctor_response": "The paralysis can come from the compression of the spinal cord from the blood clot.This can cause the spinal cord to have a \"stroke\", and can cause damage to the spinal cord.There can be some improvement over the first few weeks and months, up to a year after surgery, so rehabilitation is important.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for acid reflux?\n\nI have been seen in the emergency rooms a few times for what I thought were cardiac episodes.  each time I was checked out and told that it was acid reflux that was causing the symptoms and sent on my way.  The last two-three days I have felt shooting pains in left arm, shoulder and chest.  My breathing is really heavy and I feel nauseous, could this all be from really bad gas? I am 31",
    "doctor_response": "Hello,If you had similar complaints in the past, many a times , and you have been evaluated completely by cardiologist with an ecg and echo , and if they were normal, then yes it could have been acid reflux which is causing the symptoms for you ( sometimes the symptoms are not typical of the condition - like yours which is atypical ), hence if you continue to have the symptoms , since how long? Check if they are related to food intake,  any specific kind of foods ( such as spicy, fatty, coffee,tea, alcohol, smoking) that are causing the symptoms , and please consult your Gastroenterologist and get yourself evaluated and get an upper GI endoscopy and treatment can be given by your doctor Depending on the findings .Hope i could help you.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do severe central canal stenosis and mild ligamentum flavum thickening suggest?\n\nLumbasacral spine transitional vertebral body is labeled L5. L1-2 severe central canal stenosis due to a central left paracentral disc protrusion-extrusion and probably congenitally short Pericles. L2-3 moderate central canal stenosis due to a broad based disc bulge, mild ligamentum flavum thicening, mild facetarthropathy and congenitally short Pericles. The lower pole right kidney has a10mm T2 hyper intense mass which may represent a cyst. What does this mean. I have no insurance and had to pay cash. When I came back foe this report they said they could not help me and I should go to the county hospital.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. There is a disc (fibrous tissue) between two vertebra. Behind the disc is normal spinal canal through which spinal cord and nerves are passing. Due to a number of causes, this disc can get displaced from its normal position and cause compression on the canal/cord which an result in pain. You report is telling these compression at L1-2 disc & L2-3 disc. Ligaments along these areas also get thickened and cause contribution in causing the pain. Cyst is a fluid filled cavity. Normally it causes no harm until or unless MRI indicates any abnormality in the  cyst. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medication or injection need to be taken after a dog bite?\n\nDEAR DOCTOR, THIS MORNING ,ONE OF MY RELATIVES GERMAN SCHEPARD DOG ,TRIED TO ATTACK ME, AND SCRATCHED ON MY SHOULDER WITH ITS NAIL ,STARTED BLEED, MYSELF APPLIED DETTOL AND CLEANED THE SPOT, BUT AFTER THAT,I FEEL LIKE HEAD ACH,FEVER AND MY BODT STARTED GETTING TRUMBLING AFTER THAT,AND I FEEL A KIND OF FEAR IN ME, MY FRIEND INFORMED THAT , THE DOG WAS VACCINATED AND NOTHING TO WORRY.BUT STILL I FEEL SOME THING HARD. WHAT MEDICINE OR INJECTION SHOULD I TAKE AT THIS SITUATION ,PLEASE ADVICE ME. THANKS .vasu from chennai",
    "doctor_response": "Hello,Welcome to HCM,Rabies is a disease which is also transmitted by bite of the monkey, it is a 100% fatal disease but it is 100% preventable by proper and adequate treatment.As you were scratched by your relatives German Shepard dog on your shoulder which has led to bleeding and the dog was vaccinated against the disease rabies, according to WHO categorizes it has been categorized into Cat III. Cat III requires both active and passive immunization. Active immunization with antirabies vaccine on days 0,3,7,14 and 28 (if the dog is healthy you can stop the vaccine after the third dose). The vaccine should be taken to the shoulder by the intramuscular route.You need to take a shot of tetanus injection too.The aforementioned treatment will protect you against developing the disease rabies.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cold and sensitivity on the penis?\n\nmy penis is cold and feels very senitive ,i have been on clorom tablets,and diclac tablets,it started 3 weeks ago,frequent urination,on comfortable to wear underwear it rubs..i do smoke but never had this problem before..i have been to my gp ,he has ruled out serious problem,has it something to do with prostate trouble?",
    "doctor_response": "Hello, I suggest you not to worry. Your GP has made it clear that you do not have a serious problem. Prostrate issues do have other symptoms which your GP will identify. For confirmation, you may consult a urologist. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain from hip to fingers?\n\nAfter having my first child via hysterectomy 42 years ago I have been complaining with pain, stiffness and swollen lymph node in my right hip. For years I was told nothing was wrong. As it progressively got worse as I aged, and the pain started in my foot big toe and knee, I was then treated for a pinched nerve. This did give some temporary relief. Now the pain has gotten worse from my hip to my foot and my big toe is spreading apart from the rest of my toes. I am also loosing muscle tone in the other toes.",
    "doctor_response": "Hello, I have studied your case. Due to compression of this nerve root there is pain in your hip to toes.I will advise you to do MRI spineFor these symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.I will advise to check your vit B12 and vit D3 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mild to moderate diffuse cortical thinning\n\nI was diagnosed with mild to moderate diffuse cortical thinning laterally. My kidneys are normal size. My creatine levels are normal. And my EGF are is 59. I m confused about my diagnosis. I don t know what it means to have cortical thinning. How serious is this? I m 47 with hypothyroidism but other than that I m healthy or do I thought",
    "doctor_response": "Hi,As an Urologist, I can understand your anxiety. Cortical thinning is suggestive of reduced kidney function, probably from UTI. Normal GFR should be above 90ml/min. An isotope renal scan shows accurate kidney function on each side. Moderate and diffuse cortical thinning occurs from recurrent UTI. You'll need to do urine routine and culture,blood creatinine, RBS and LFT. You can send me a direct question to clear doubts, with an expert opinion.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Matthew J. Mangat",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for allergic cough and running nose with chest infection\n\nHai doctor,for my 1year 3 month old son .always he is getting allergic cough and running nose and gradually going to chest infection and some time fever and chills . I am mother and I have history of allergy to dust .for my son dr.priscribed moticope suspension ,how long time he must take this medicine ?and what are the precaution to avoid this allergic .what kinds of food item to avoid.? Kindly answer for me",
    "doctor_response": "As per your history, your son is probably suffering from Allergic rhinitis & your doctor has appropriately prescribed Monticope (Montelukast + Levocetrizine) for him. Duration of this treatment  is usually 6-8 weeks, then doctor should re-evaluate the response and treat accordingly. An alternative to this treatment is inhalational corticosteroid by inhaler. People are sometimes afraid of inhalers, but no need to worry, it is only a targeted drug delivery method to reduce side effects of drugs. Your next query was what food to avoid. Generally brinjal, egg, prawn, some types of fish, some variety of nuts, milk, soya are common causes of food allergies. However, to know for sure, I would recommend for Allergen Specific IgE Testing for your child.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to recover from peripheral neuropathy?\n\nI am suffering from peripheral neuropathy caused by chemotherapy for treatment of multiple myeloma. I have quit taking the prescribed drugs because of the destructive effects on my body...reduced strength, almost no endurance, limiting mobility. Quality of life is more important than dealing with diagnosis. oncologist said, initially, that he was 99% certain I was MGUS , not full-blown multiple myeloma. Free light chain blood test changed his mind. what can I do to cleanse my body, recover from the neurophathy caused by 2 months chemo?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I would explain that neuropathy is not always reversible. But, I would recommend taking some supplements containing alpha lipoic acid, coupled with vitamin B complex and performing a lot of physiotherapy. If you have numbness, burning sensation or pain, I would recommend taking Pregabalin or Gabapentin. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could back pain with burning skin suggest?\n\nI have a really bad middle back pain that hurts when I move. And very sharp pains when I take deep breaths. I m able to walk but very slowly as the pain is sharp and hurts a lot. I ve also had a head ache since thurs and since then too I ve also not been able to hold food down. If I eat a meal it feels stuck on my chest and I cough and vomit it up. I was told last year that I had copd and just wondering of any of this is related. I ve been in bed since thurs. Attempted to work today but couldn t stand it. I m also freezing and shivering but my partner says my skin is burning Should I go to hospital",
    "doctor_response": "hiYou must visit hospital as pain in the middle, vomit and other problems need attention of doctors with few  xrays of chest and back.An upper gastro-endoscopy for food pipe and stomach and upper bowels may be required, chest x ray for COPD issues, and spine xray?MRI for disc related lesions.You will be given anti-emetic to control vomitting,antacids/PPI inhibitors or acidity controllers and some pain medicines.Complete assessment is the necessity as of now.Endoscopy rules out food pipe lesions,stomach lining issues,ulcers etcBest wishes,Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which inhalers or tablets can suitably treat mild wheezing ?\n\nFor mild and rare wheez which is better inhalers or tablets?",
    "doctor_response": "its necessary to know  exact cause of wheeze---its just symptom not disease .......inhalational drugs are always better than their similar counterpart  oral drugs as these act directly at desired site and skip the unwanted sideeffcts eg tremors with oral salbutamol",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is yeast infection related with itchy redness around frenulum with bleeding?\n\nI am a 74 year old male with a recurring (2 years+) redness of the frenulum.with some itching and some occasional slight bleeding. The area affected in  the right side , about 2 cm long. I have been using Moninstat but the symptoms keep on reappearing. My, GP has indicated that I have a yeast infection. Any suggestions?",
    "doctor_response": "According to your history it seems to be a case  of  fungal (yeast) infection. If it is recurring you need to undergo blood sugar tests. moininstat cream is not the right treatment for this infection. You need to apply some good antifungal cream and keep the area as dry as possible.Also avoid using soap on this area.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pains in back, MRI shows an incomplete delineation of a cyst. What could be the problem ?\n\nHi, I went to the doctor for pains in my back and an MRI was ordered. I got that done 2 wks ago and went to the Dr. yesterday for the results. Nothing wrong with my back, but an nimcomplete delineation of a cyst was seen, I believe he said 3.3mm. So another MRI has been scheduled for my pelvic area. I had a partial hysterectomy years ago leaving my ovaries. Do you have any idea what could be the problem?",
    "doctor_response": "Hi, great question Based on what you have reported, it is difficult to come up with concrete information. Sounds like your doctors do not yest know what is going on. When a back MRI is done, a scout film or localizer is acquired. A pelvic lesion was probably seen on this localizer or even on some of the other cuts. However, the back images are usually not accurate enough information to establish a diagnosis of a pelvic abnormality. There are so many possibilities.  Get the pelvic MRI and THEN from there start figuring out with your doctors what needs to be done. Best of luck,,,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What could be a bump at back of the throat with postnasal drip and GERD?\n\nHi doctor, I wanted to ask a question about a bump at the back of my throat. It is like a bone. I went to a Local ENT, and he told me it is normal, sometimes it shows to some people. I just wanted to ask what is it?",
    "doctor_response": "Hello. I have seen the picture. (attachment removed to protect patient identity).  Do you have symptoms like pain or itching in the throat? It looks like granular lymphoid tissues of the posterior pharyngeal wall or it could be a small cyst of the posterior pharyngeal wall also. Did you take any treatment for the swelling? If not you can just do Chlorhexidine mouth gargles three times daily for a week which will reduce inflammation and you can take an oral antihistamine like Fexofenadine which will take care of the allergy part (sometimes lymph nodes are enlarged secondary to allergy). If you have more queries please revert back.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Yellow seamen, had gas problem, taken medicine. Suggestion?\n\nI am 21 yrs male. I am noticing since few days that my semen is a little bit yellowish in color !!! It has never been like this!!!! I took few medicine a few days back as i had some gas problems , after taking those medicines although my gas problem is solved but im noticing yellowish color in my semen!!!! Plz tell me if therez anything serious and what should i do to get rid of this color!!!! Thanks@Regards Akash",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have noticed colour of your semen has changed to yellowish since couple of days.This is most likely to be due to presence of infection either in seminal vesicle or prostate. Please get your routine urine test and semen culture done to find out the organisms causing this infection and antibiotics to which they are sensitive to.You need to take antibiotics like Doxycycline twice daily for 3-4 weeks to combat the infection completely.Repeat semen examination after the completion of course of antibiotics.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing back pain, puffy face, limbs, diarrhea, nausea and unquenchable thirst?\n\nReoccurring systems over last year. Pain on my left side in back, around ribs. Doesn t feel muscle related. Puffy face, hands, feet. Diarrhea, nausea, constant, unquenchable thirst. Last two days back to normal. Occurs again every other week. Very tired during bouts. 42 yr old female 5 6 120 lbs",
    "doctor_response": "i think you may be having some harmone related disorder. You have to go through a urine examination. There is a disease known as SIADH which an cause these symptoms, curable after treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with allergic reaction on face, itching, burning on using cream. How can I get rid of it?\n\nI am having an allergic reaction on parts of my face. I think it is from my limictal or this face med I take. The allergic reaction is bothering me. I keep touching and itching my face. If I put cream or other stuff on it, my face will start burning and stinging. I am gonna look for a Dermotoligist in a few days. What can I do so I will stop touching and itching my face till I find a Dermotoligist?",
    "doctor_response": "Thanks for writing in HCM. You have to avoid the cosmetic creams or other cosmetics which may cause allergy on your face.   Wash your mouth three or four times in a day with water. Don't use excessive cold or hot water. Itching may be at least partially controlled with the use of low-sedating antihistamines . You can use alovera, it will reduce the burning sensation of your face.  Protect your face from direct sun light and dust. Avoid traumatizing the skin by keeping fingernails short and hands clean to avoid scratching and infecting the skin. Wishing you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a persistent cough with an ear infection be treated?\n\nMy 10 month old daughter has been sick for the last month now. I have taken her to her pedi 3 times now, and I still don t feel she has gotten any better. It started as a normal cold that seemed to have gotten better after about a week then about 2 days after that got worse in a matter of overnight, so I called the Dr. and they saw her and said it was probably just post nasal drip, again after a few days seemed to be a little better, and within a few days after that got worse again. I took her in again to find she had an ear infection. The Dr. put her on augmentin which she had a reaction to which gave her a terrible diaper rash so I called once again and they changed her med to azithromycin and probiotics. I still see no change in her cough..it is a frequent cough that at times gags her. I am very concerned that she should have gotten better by now. What should I do?",
    "doctor_response": "Hello and welcome to health care magic..From your history I concluded that your baby has upper respiratory tract infection.Azithromycin is a good choice and complete a five day course.Meanwhile remedy for cough must be done.I suggest Citrizine (rigix) a non sedative anti-allergic. Ivy leaf extract ( Dr Koff). & Syrup Terbutaline ( Britanyl).Hope you find this answer satisfactory.Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is severe heartburn with pain in abdomen normal during pregnanacy?\n\nmy wife is in her third trimester and has been having severe UPPER abdominal pain for the last couple weeks. it just recently got worse the last couple of days. doc says its heartburn but i have never seen heartburn like this in my life. any suggestions?",
    "doctor_response": "HI,    I understand your concern.    Heart is not normal in pregnancy. it's because of over streching of cardiac sphincter of stomach, allowing acid gastric juice to regurgitate in esophagus It can be managed well by few lifestyle change -    - raise your head end while sleeping,don't sleep immediately after food.Do not take water or liquid before going to sleep.     -Avoid forward bending.    -Instead of eating two meals.. have small multiple servings of food. avoid spicy food,    - Avoid sour drinks,soda , coffee, alcohol.   *  Antacids / proton pump inhibiters will help in controlling severe symptoms.   Thanks.   -excessive burning can be relieved with freeze cold milk.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for difficulty in breathing while treating fibromyalgia\n\nI have been diagnosed with fibro and other health related problems. I ve had an MRI and a body scan. I was asked if my feet hurt me but never given any answers from the body scan. I ve also had the needle nerve test with no answers. I have started having problems swallowing so I wonder with all the other problems if I have MS. I haven t talked with my Dr yet but plan to on my next visit.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. According to the history scleroderma should be excluded in your case. For this you should consult a rheumatologist specialist. Please discuss with your doctor for this. Regards, Dr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic neck and shoulder pain in kids\n\nMy daughter has had chronic neck and shoulder pain for 3 years. Yesterday she got an MRI and was told she has spurs circling her vertebrae and some nevers are being pinched, and they told her to do these exercises that she had done before and didn t work. Can I send the MRI to anyone to get an independent analysis? My daughter is with Group Health and can t go outside that system.",
    "doctor_response": "Dear Sir/ Madam,Thank you for posting your query at healthcaremagic.comYou may send the MRI reports to me, if you want with her age.But I advised your daughter to continue exercises and streches prescribed and  also life style modification.1. Avoid lifting heavy weight2. Instead of back up she can use the trolley school bags.3. Looking down and reading the books should be avoided, instead a rise reading desk / stand can be provided, that will maintain the distance and also forwarding bending.4. Prolong concentrated work to be avoided, intermittent breaks will increase efficiency in her work and will reduce the  stress for her.5. Hot water fermentation will provide her relaxation to her.Hope you find my answer informative.Your vote of thanks will be very much appreciated!With best wishes,Dr, Vishwanth Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for muscle spams with twitching in arms\n\nHi I ve been experiencing daily head and ear pressure , lots of mucus in throat and my throat feels like it s closing. Also body aches, twitching in arms and legs and muscle spasms. Fatigue. I ve been tested for allergies and had a catscan for sinuses and all clear. Seen an ent multiple and he s saying anxiety but that s not the case",
    "doctor_response": "Dear Patient,your history looks like sinus involvement, but you say your ent doctor has ruled out any pathology. there, so  there are two options, either you see some other ent doctor or you can take an opinion from a neurologist. I hope that helps you ,Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in toe tips in left foot?\n\nWhy do the tips of my second and third toe on my left foot go numb, tingling and experience minor pain? Thid has been happening about 3 weeks now, just those toes. Diabetes runs in the family, but I have been recently tested (3mo;s ago) and have no flags un my bloodwork. The endocrinologist insists on me taking Metformin to prolong any onset of diabetes. Could this medication be causing this numbness? It happens no matter what type of she I wear, so he can t be the shoes.",
    "doctor_response": "Hello, Thanks for writing to us, I have read your query,Toe numbness can be due to pinched nerve in spine.Due to compression of nerve root there can be tingling numbness in your foot.I will advise you to do MRI spine and EMG-NCV [Nerve conduction study] and consult to orthopaedic surgeon.Peripheral numbness is common in diabetic but incidence is low in prediabetic.          Change your diet and remove inflammatory foods such as citrus fruits, dairy products and wheat that may aggravate peripheral neuropathy. Simultaneously increase your intake of potassium and calcium-rich foods such as bananas and avocados and green leafy vegetable.Vitamin B12 is important in the maintenance of health and normal functioning of the nerve tissue and deficiency of it can lead to numbness. You can increase B12 level by taking meat and fish, or you can take Inj methylcobalamine.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood in urine, yellow urine and pain in right side?\n\nhi doctor,i am having a yellow ,smelly and sparkly urine after that i suffered a kidney pain two months ago;i did an ultra sound and the result said that i ve got 29 mm sediment inside a bag in the middle of my right kidney and i did urinate some blood during those pains",
    "doctor_response": "Hello....As per your history mentioned by you...u seem to have renal concretions or renal stone...it may be associated with infection of urinary tract...and also a bit damage to ur kidneys that may lead to blood in urine...You should take tab.Diclofenac 50 mg twice a day for pain relief along with meal...if u have fever or burning micturition start antibiotics along with that... preferably Tab.Norfloxacin 400mg twice a day...Take plenty of water daily....Repeat ur ultrasound after 21 days...if concretions or stone size is steady or increasing active removal of stone is necessary by mean og non invasive procedure like ESWL.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does tender bruise on wrist bone indicate?\n\nI have a very tender - feels bruised - spot between my first finger knuckle and my wrist bones.  There is no bruise and I don't recall hitting it.  It has persisted for a few days and doesn't seem to be getting any better.  It only really hurts when pressure is put on the spot.",
    "doctor_response": "Is there any history of trauma? It may be sprain or strain. Ganglion  Is a swelling situated near wrist and it becomes prominent on flexion.                                      Therefore it may be an inflammatory lesion. It is better to take anti inflammatory drugs along with hot fomentation. Rubifacients may also be applied locally on the affected area.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen lips?\n\nmy lips are swollen and burn i dont think it is an allergic reaction to food because it happened the day afert i had gotten into the sauna in the gym its been 2 days and they really burn especiallly in the morning when i wake up they are really swollen and dry what can this be??",
    "doctor_response": "Apply vaseline gel on your lips twice daily. This will soothe your lips and decrease burning sensation. Take Vitamin B complex/folic acid supplement daily for 10 days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Colon cancer, metastasis in liver, diabetes. Have yellow eyes. Done Chemo therapy. Should I worry?\n\nHello....I was diagonised with stage 4 colon cancer which had metastasis to the liver ...they removed the signoid colon in June 2010...at that time they said my liver was too far gone to do a resect...and chemo would not prolong my life...I do not have good insurance,so have been seeing my GP,who is helping with my pain...at present my diabetic numbers r increasing,though my diet is the same...alos I have no yellowing of eyes or skin...but my pain seems to be increasing....Is there anything new or hopeful in the past 2 years?  I feel blessed for the good days i have had.    Sorry to have taken your time.Do not have finances to pay at this time..Things have been very hard financially . This is a good site for people who can afford .May all of you be Blessed with your help for others.",
    "doctor_response": "Hi and welcome to HCM. i am sorry about this serious diagnosis but I see you are a fighter and this is a good sign. In these cases blood sugar isnt something that determinate your life expectancy. Also it can be pretty easily managed by certain medicines. Only important findings are liver function tests and liver morphology. So you will be fine till your liver works good enough and it means that there should be more than 20% of normal liver tissue. It is obvious that all you need is palliative care and sometimes GP can be more helpful than any insurance or institution. You just need to use adequate painkillers, prevent ascites accumulation and prevent weight loss. Everything else isnt in your hands.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump on the breast\n\nI have a dime-sized hard pink lump that might be an insect bite. It s at the top of my right breast, so it is in a very sensitive spot. I m thinking it is an insect bite, but I ve never had one that has been hard like this one is. Should I be concerned, or see a doctor? It has been 3 days. I also had 2 on my back, and and another one on the back of my neck at my hairline, but they seem to be going away.",
    "doctor_response": "Hi, welcome to HealthCareMagic. An insect bite usually causes local cellulitis and it may present as a lump with pain. Please take a broad spectrum antibiotic like Tab. Amoxycillin + Clavulante 625mg three times a day with Tab. Metronidazole 400mg three times a day for 5 days and pain killers. Don't wear tight brassiere over the breast till it resolve. Hope you will get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Persistent red, itchy liquid filled rash on upper chest, used neosporin, hydrocortisone cream, zpack\n\nI have had a red, pimply, itchy rash on my upper chest x3 days. When i scratch it seems as though the vesicles are filled with a clear fluid and weep......i have tried hot showers, antibacterial soap , neosporin , aloe vera lotion, and hydrocortisone cream. It has become very dry, thick and leathery on my chest. I went in the sun hoping to dry it up without success. Last night I started a zpack I had had at home. I am 47 yr old white, female, 5 5 . 140 , no known health problems....can you please advise. I have no insurance.",
    "doctor_response": "Hi, welcome to HCM. Please, avoid self medication it is sometimes harmful. You need to stop all types of medication and go to a Dermatologist for proper management Or You could apply a muporicin preparation e.g.Bactroban cream/ointment twice daily for 1 week. Visit/ consult land/online dermatologist 1 week later. Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is swelling and swishing noise while movement of knee normal after knee surgery?\n\nI recently had knee surgery (loose body removal), now whenever I bend my knee, or flex, I hear a swishing noise. It sounds like fluid is moving from space to space. This is my third surgery (same knee) and least invasive. It s been three days. Anything to worry about? Or is it normal swelling?",
    "doctor_response": "Hello, It is quite common after knee surgery. It is due to the entrapment of small debris or foreign particle after the procedure. Nothing much to worry and it will settle by itself. If symptoms persist you can consult an orthopedic and plan for an MRI scan. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What would be life expectancy for stomach cancer patient?\n\nHello, My father who is 80 yrs old had stomache cancer, tumor was removed but now, 5 mos. later his stomache cancer returned. Now, he has two small dots on his liver.  He wants no treatment.  What is life expectency for him? We are truly devestated.",
    "doctor_response": "Hi,Thanks for writing in.It appears that your father has stage 4 cancer of stomach. After cancer was operated in the stomach the disease appeared in the lever to cause metastasis. The survival of stage 4 cancer patients is 2 years after detection. This is not a fixed duration but if aggressive chemotherapy is given then he might survive longer.To extend his survival he must be counseled to take chemotherapy and this can slow the disease progression and keep him comfortable. There are new techniques like chemoembolization and radiofrequency ablation which has successfully delayed the disease in many patients. He should also be given enough pain relief because cancer patients have lot of pain and this causes their general condition to worsen. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for constant high temperature ?\n\nHi,My son is 14 yrs old and weighs 85kgs.He has fever for the last 6 days now.When i gv him a paracetamol it comes down to normal from 101 or 102.His appetite is fine,and even studies when the temperature is normal.There are no abdominal cramps and no loose motions or constipation.Now from the 6th day temperature is shooting up to 103 also.Please help and suggest what should be done??",
    "doctor_response": "Hi and thanks for the query,The commonest cause of high temperatures is an infectious process. however a proper clinical evaluation is needed. A complete blood count, a C reactive protein measurement and a clinical review is important. I suggest you consult your primary care physician. Kind regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat microvascular ischemic disease?\n\nI am a 60 year old male, 5'9\" tall, 155 lbs. Only significant history is a diagnosis of prostate cancer, believed contained to the prostate at this time. Seeing a doctor for ringing in the left ear, recently had a MRI to check for tumors/irregularities of the ear canal. The MRI report reads, in part,\"Axial T2 and flair sequences demonstrate small punctuate T2 and flair hyperintense lesions within the deep white matter bilaterally.  This likely represents microvascular ischemic disease. Everything else in the report appears normal, I think. They did administer contrast and identified no abnormal areas of enhancement. The reading doctor's impressions are: 1. Small punctuate T2 and flair hyperintense lesions demonstrated within the deep white matter bilaterally. These likely represent small foci of microvascular ischemic disease. No confluent signal change suggestive of mass lesions or infarct is identified. 2. No abnormal areas of enhancement are seen.No mass lesions are identified.3. Grossly normal internal auditory canals. No mass lesion is seen. No abnormal fluid collections are present. I realize this is probably good news as far as the ear problem, but I'm a bit concerned with the microvascular ischemic disease part. Your opinion will be appreciated.",
    "doctor_response": "Hi,Thanks for writing in.Microvascular ischemic disease is a common condition found after 60 years of age. It happens due to the mildly decreased blood flow to areas of the brain. This is not a serious condition and more like an aging change and seen early in people who are having diabetes, high cholesterol and hypertension.Observing a healthy lifestyle and eating a nutritious diet helps prevent progress of this condition. Please take vitamin B12 supplements and this is a neuroprotective medicine. It will help in growth of damages nerves. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Fertomid 50g the right medicine to get pregnant?\n\nhello Dr. my name is Cynthia.I have been u family planning for more 10 yrs after the birth of my son.bt I stop now I want other baby I went to the doctor she give me fertomid 50g .I want to know that its gonna take for how long to be pregnant. after week I went for pregnancy test bt its negative",
    "doctor_response": "Hi,Just taking Fertomid will not help you get pregnant.You need to try for 6 months without any medications and you should be able to get pregnant.May I know how old you are and also what method of family planning were you using?Fertomid is only given to women who have ovulation problems. Please do not take them with out a proper evaluation of cause of infertility.I would not even think that you have a problem, unless you have tried to get pregnant for at least 6 months to 1 year.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain, mucus and flatulence, loose stools, reflux and indigestion?\n\nI had left lower abdominal stinging pain that ranged from low- just above the pelvis almost to my waist. It was strong and persisted for about 4 hrs until I tried Ibuprofen and it felt somewhat better. It worsened when I walked and it radiated to the left side of my back. I am regular in my bowel habits - every morning and lately it seems I am having maybe 2-3 small BM s in the day. I do not have any bleeding but, there is often mucous present now and gas 3-4 times a day - usually before BM. I did have my gallbladder removed about 5 yrs ago and never had any of the horrible side effects after (I d always heard about diarrhea or difficulty w/bowels after surgery). In fact, I have been very regular each morning. But, only occasionally have loose stools - never diarrhea. The pain has been better today. The other sx I have is reflux and indigestion almost daily for about 3-4 weeks.",
    "doctor_response": "Hi.The cause of your abdominal pain, mucus in stool, flatulence and gases before BM, loose stools re-flux and indigestion can be due to severe form of colitis as per the history provided by you. As per your history I can think of Cancer of the colon - hence causing the severe pain due to obstruction; passage only of the gases before BM; loose stools ; Get a CT scan of the Abdomen, Colonoscopy and related investigations so that the proper diagnosis can be made and treatment planned accordingly- whether Surgical or medical. Cholecystectomy ( gall Bladder Removal )5 years back may not be the reason for all the symptoms you have.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can swelling on the collar bone be treated?\n\nmy right collarbone has a lump, where it begins, and the whole bone is swollen, so it is larger than the collarbone on my left...my left collarbone is normal.....i have no pain.....i fell down some stairs a year ago and was in severe pain in my left shoulder, arm and hand....hydro and physical therapy helped,and i thought i had recovered.....until i noticed the swelling about 2 months ago.....it looks like i have osteoarthritis....i have arthritis in my hands and knees.....and i think in my neck from the fall ...my neck is always painful when i turn my head.....i am 81 years old.....my question is what , if anything, can i do about the swelling in my collarbone, as it is very noticable....",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Probably you had fracture of collar bone when you had a fall and now it's healing hence the bump. kindly take X-ray. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hardening of the heart arteries\n\nI have been put on Imdur 30mg,the heart dr. said i was born with the muscle in front was on top of two arties, but then my family dr, said his report said I have the same thing as sports players fall dead with, something about hardening of top of heart..I really wonder what I should do, I have alot of pressure with pain at times especially when I get to tried",
    "doctor_response": "hello.I have gone through your query.Thanks for using HCM.I actually need to know your exact diagnosis before i can guide you,I presume that mostly you may have Hypertrophic cardiomyopathy.kindly provide me with detailed reports to get proper guidance,My best wishesDr.Rajesh Teli,MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will there be any side effects of taking 1000mg of Zeptol for seizure?\n\nI had a surgery for occipital meningioma 15 years ago. I was prescribed 200 mg Zeptol CR tad. Due periodic occurence of seizure, Dr gradually incresed it to 400 mg in the morning and 600 mg in the night to control occurence of seizure. I would like to know what are the side effects of 1000 mg of this medicine per day. I am 73 yrs of age and otherwise lead a normal life. How should I minimise the side effects if any. Thanks, R K Mathur 550 Kailash T0wer III, East of Kailash, New Delhi 110065 India",
    "doctor_response": "Hello, I would explain that 1000 mg of Zeptol is not a high dose. Anyway, I recommend checking carbamazepine blood plasma levels in order to be sure that this dose is not toxic for his body. You should know that this drug can cause gait imbalance or interact with high blood pressure medicine and cause high blood pressure if present. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does elevated CRP level indicate?\n\nI am a 42 year old female with no major health problems, but have not been feeling well over the last few years (since having kids). I recently had blood work done because I have been fatigued and achy and short of breath.  It showed my bilirubin was slightly elevated and a positive ANA (they mentioned a slightly high RNP or something like that). A couple of years ago, by CRP levels showed up as elevated.  What could this point to?",
    "doctor_response": "Hi, Unfortunately, the information you 've provided is not enough. A positive ANA test may mean nothing. Many autoimmune disorders - even minor or unimportant ones - may cause an elevated ana titer. Whatever is lower than 1:80 is too low. Bilirubin levels may also indicate anything between serious liver disease and the harmless Gilbert's syndrome. C-RP levels may be elevated for far too many reasons to list here but in most cases, it is caused by some sort of inflammation (infectious in origin or not). Therefore, more information is required to get a more clear picture of your current status. Clinically important information includes any symptoms you may have (in detail) and the test reports (a scanned copy). Without the actual values, the rest of the test results (what other tests you've done) and a complete clinical picture it's too risky to draw any conclusion. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Panagiotis Zografakis, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for stickler syndrome?\n\nHello! Mother of a son four years old which was diagnosed Stickler syndrome. Until a year ago he was led by Pierre Robin sequence, and then the doctor asked for the genetic analysis of the stickler ... They are still waiting for genetic analysis but the doctor is confident that it stickler, and the more I read the more convinced I am that ... She would like you to explain to me what the problems we encountered, cleft palate surgery, we passed the same as glaucoma surgery ... the things that should pay more attention to him and can olakasati some of the problems they will encounter ... thanks you in advance ... greetings from Croatian",
    "doctor_response": "Hi,I had gone through your question and understand your concerns. Maintaining a healthy lifestyle by exercising and avoiding negative  smoking  by surrounding relatives can help prevent fractures. Treatment may include care of broken bones, pain medication, physical therapy, braces or wheelchairs, and surgery. A type of surgery that puts metal rods through long bones may be done to strengthen them. Tentative evidence supports the use of medications of the bisphosphonate type. Please click THANK YOU and consider a 5 star rating with some positive feedback if the information was helpful. Hope the above information helps you, Any further clarifications feel free to ask.Regards,Dr. Ahmed Aly Hassan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruises post heart surgery?\n\nMy husband had open heart surgery over 19 years ago! The two scars where they had the tubes in are bruising real bad they are almost black and feel like they is a hardness behind the bruise of one now! He takes blood thinner every day to regulate his blood for the mechanical valve he has! Any ideas as to why this is happening?!",
    "doctor_response": "Post surgical wound healing can lead to such blackening. ... and due to blood thinner more prone for booking",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and numbness in my arm?\n\ni am having slow breathing sometimes my stomache stops moving up and down when i sit stand or lay down and very short breathing before was uncomfortable but now don t notice it and now having pain and numbness in arm but it could be the cause of my hand infection i am having now i had severe pain for two days in my right arm i hardly breathe through my noise",
    "doctor_response": "Dear Sir/MadamI have gone through your query and read your symptoms.In my opinion, first and foremost what hand infection are you having as that can very well cause pain in the arm and numbness. take care of that first. better consult a Hand Surgeon for your infectionI hope that answers your query. If your want any more clarification, contact me back.Dr Narender Saini",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a grey bruise on the leg after a fall?\n\ni recently fell on stairs; 9 days ago. I have three bruises on my right leg. One bruise is casing me concern due to it s shape ( about a 3 inch circle, a grayish and hard center). It appears to be getting better but it looks terrible. Should I go see a dr just for a bruise?",
    "doctor_response": "Hello, As most bruise resolves with time. But on a safer side, I will advise taking an x-ray if any bone Injury is present. Also, do hot water fermentation so the vascularization improves and the dead cells move out. Simple ankle toe movements will be of benefit as well. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the hard lump on the lower neck which does not move?\n\nI have a hard lump in the lower neck front near the middle of the clerical its in the shape of a tear drop, 1 inch wide by 2 inches long. Not painful, at times a little ache. Does not move when swallowing. What could it be? I have had other symptoms but not sure if they are connected.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Your hard lump on the lower neck may be some soft tissue tumour like lipoma, neurofibroma or dermatofibroma. Or it may be enlarged lymphnode or lymphoma mass. You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact idea regarding diagnosis. Then you should take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes anxiety and chest pain?\n\nI keep feeling will anxious and have been like this for a while now and I can t seem to stop worrying and its starting to make me feel really down. I ve also started to get chest pains, other aches and pains and feel tense all the time aswell so thats also making me worried but I don t know if there is something wrong with me.",
    "doctor_response": "Hello and ,Anxiousness and associated chest pain raises possibility of cardiac or heart disorder.It is important to consult a cardiologist for complete cardiac check up and investigations to rule out cardiovascular diseases.Ischemic heart disease causes chest pain which is associated with anxiousness, sweating and breathlessness.If no cardiac disease is detected, further investigations are needed to look for the cause of these symptoms.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for asthma\n\nI am 27 years old and with a 5 yr old kid, I am having Thyroid (8+) and a mild PCOD and i am taking thyroid Tablets (100 mg) anf taking treatement for it.. and i am having Asthma Problem and Using Inhaler as my surrounding is covered with total dust Pollution.. Give me some Permanent Solution for these Problems",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your history and would like to make following suggestions to you:1. Were I treating you, in addition to inhalers, I would add regular montelukast in your treatment.2. I would suggest you allergy testing which may help you identify the substances you may be allergic to and also to know the measures to avoid them.3. In general, I would suggest you to avoid exposure to dusts, smokes and air pollution.4. I would also suggest you regular breathing exercises ans a healthy diet which will improve your lung capacity and immunity in a long run.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low blood iron levels and WBC count?\n\nI m 49 and for the past two months I ve been having strange health problems. My iron level dropped to 14 with a saturation of 4, low wbc - 2.0, ,mono level was above 600. They ve given me 2 iron infusions and b12 shots which has helped. Also I ve lost a lot of muscle tone in my left buttocks. I do not have a GI bleed and the doctors aren t giving me any reasons as to why all this is happening. Can you help me figure this out?",
    "doctor_response": "If you have a combined Iron and Vit B12 deficiency, there may be a pathology in your gut that may give rise to both these. It will be wise to consult a hematologist, and get yourself examined. In due course, you may be required to have a endocscopy (upper GI and Colonoscopy) done to have a look at the gut and for any likely pathology.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for red bruise on knee\n\nI fell 3 days ago and have a red bruise on my knee. When I returned home it did not appear to be an open wound ( no external bleeding) But over the last 3 days the centre of the bruise is becoming yellowish which appears to be pus. I've been applying antiseptic cream even though the wound is not open. My question is: Can I apply ice to the bruise if there if pus there? And - how did pus get in there if the would was not open? Any advice would be appreciated.",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain a red bruise at the site of injury is due to ruptured blood vessel caused by trauma leading to spillage of blood into soft tissues..It is not a serious condition and will get resolved gradually as the blood will disintegrate..As the area has become yellow with pus in it there is a possibility that there has been infection in the area along with pus formation..As  the injured area become weak the bacteria present in blood or from mild laceration from the skin can penetrate the area of injury and cause infection..I would suggest you to consult a General Physician and get evaluated and he can advise you to take antibiotics like Sulphamethoxazole and Trimethoprim, and anti-inflammatory painkiller like Ibuprofen..You can also be advised to apply antibiotic ointment over the injured area..In case if there is excessive pus accumulation Incision and drainage can be done..Hope this information helps..Thanks and regards..Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i rub vicks vapor on chest for cough and chest pain?\n\nI have a 79 yr old mother and she has very bad cough and chest pain from coughing so much ishe was given zythromax which she finished now she has cough syrup to help her sleep with codeine now she has 102 fever and I gave her Tylenol but I was wondering where she has heart disease can I rub vicks vapor on her chest and back",
    "doctor_response": "Thanks for your question on HCM.I can understand your situation and problem.I advice you to take her to the hospital and get done chest x ray and ECG.In old age, lung infections are very common . And high grade fever (102) with vigorous coughing with chest pain can be due to pneumonia.So chest x ray is needed to rule out pneumonia.ECG is needed to rule out cardiac cause.So consult doctor and discuss all these.Rubbing Vicks will not help her. It is just superficial cream.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can you Please suggest some medicine for my stomach pain?\n\nHi doctor, I am having stomach pain for the last two days with loose motions. I took medicine to control loose motions. But, I am using bathroom for every four to five hours. I feel some heavy pain in stomach and feels like going bathroom. The motion is not loose and not regular too. It is dark and greasy. When I press the stomach I feel the pain. Please advice some medicine. I am fasting all day due to the festive season and having heavy food late night. I had a heavy diet with chicken before two days and since then it has started. I can feel the pain over the stomach and sometimes in the back too. Please help.",
    "doctor_response": "Hi. It is really a troublesome situation you are facing nowadays. I feel sorry for this health issue. But do not worry. With care and lifestyle changes you will get better soon. Ask your local physician for a prescription of Metronidazole (or) Rifaximin to be taken orally and Imodium (Loperamide) for the loose motion. Mainstay of management is taking a lot of fluids, including Pedialyte to replenish fluid loss. Avoid fried and fast foods, spices and stuffy meals. Remain as light as you can. For further information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump on the thigh indicate?\n\n31 yr old male. Wrestler and jiu jitsu practitioner. Never had any significant health problems. I found a quarter sized lump on my inner thigh a couple inches south of my groin. It is firm, painless, slightly purple with a black dot on the top. You can move it under the skin. I've attempted to puncture it with a needle and squeezed it pretty hard to see if pus would come out. Only blood. I now have some fluid build up around the lump (what I get for being a DIY doctor, right?) It hasn't gotten any bigger. I started doing jiu jitsu again about 4 days a week for the last month. Only after I started jiu jitsu did this lump come up. Any ideas what it could be?",
    "doctor_response": "Hi there - Lump on the thigh could be a number of things.  Given your history of Jiu Jitsu and wrestling, the most common thing is a hematoma (old blood clot) under the skin.  Another cause could be a lipoma (basically, a benign fat ball).  Neither of these is cause for concern. Another more concerning cause could be an enlarged lymph node, which can be caused by a benign infection and in rare cases, malignancy (cancer). I certainly don't mean to scare you, and the other causes I mentioned are much, much more likely. I'd recommend you not stick any more needles in it for starters, and ask your doctor for an ultrasound. If there's any question, they can biopsy the mass and find out what it is.Hope this is helpful, feel free to contact me if you have any further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medication for pain on the left side of the rib cage\n\nI need to give you a little history.  On holidays left home last week driving 10 hrs first day.  Started off good then winded up with very uncomfortable pain on my left side which radiated to below my rib age .  Tylenol didn't work neither did bengay.  Ended up with a very flush face that night and prickly heat.  The ache wasn't as severe on the right sideSleeping was no problem.  This continued for the next 4 days.  Good in the morning and as soon as I started walking it became unbearable.  Bengay seem to help.  Lots of belching going on as well.  Got to our destination and went for a massage.  There were definitely some knots that needing working on.  I was still sore walking so taking it easy.  As was the case no problem sleeping and woke up feeling good.  I didn't have to use the bengay till last night the pain in my upper right shoulder  to my spine I had excruciating pain lying down walking didn't matter.  It felt like a vice being squeezed on my upper right side.  We applied the bengay but it wasn't doing its magic at all.  Sharp twinges into my abdomen.   When I get that pain it's usually on my leftside.  It seem to go downhill after having a hamburger for supper.  I took some tums.  Kind of helped.  Not such a good day today . Woke up with pain.  Haven't a clue what's going on.  My temp is ok 99.  As I type this it's easing up again.  Who knows it might disappear again.  That excrutiating pain I was talking about is a familiar pAin to me.  But comming more often  Thanks Denise",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. In my opinion you are having mostly GERD ( gastroesophageal reflux disease ). But better to rule out cardiac cause first. So get done ecg and 2d echo to rule out cardiac cause .If both are normal then no need to worry for cardiac cause. GERD is more in your case. It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms. Stress is the common worsening factor for GERD. So try to follow these lifestyle modifications along with drugs for better symptomatic relief. 1. Avoid hot and spicy food. 2. Avoid stress and tension. 3. Avoid large meals, instead take frequent small meals. 4. Start Proton pump inhibitors. 5. Go for walk after meals. 6. Keep 2 - 3 pillows under head in bed to prevent reflux. 7. Loose weight if you are obese. 8. Avoid smoking and alcohol if you have these habits. Don't worry, you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for itching and swelling in foot\n\nI had a full thickness skin graft 2 years ago on my foot. It has become very itchy and when i scratch becomes raw and swollen. As soon as it heals, the whole process starts over again. To make things worse i am a Type 1 Diabetic. Not sure what to do about the itch and swollen foot",
    "doctor_response": "Hello,In case of diabetics it is necessary to keep your diabetes under control.There are increase chances of infection in such cases.You should do following to have relief:- Keep your blood sugar under control.- Some time such itching can happen due to blood stagnation. Apply a compression bandage from below upwards. In case of resting position keep your limb elevated on a pillow.- Take an anti itch preparation like levo cetirizine on prescription.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mukesh Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tightness at base of throat, breathing difficulty after eating biscuits. Was it allergic reaction to gluten?\n\nI recently read the book Wheat Belly and decided to go on a gluten-free diet . I am 47 years old and have had issues my whole life with diarrhea or at least very loose stools nearly every day and have sufferred severe stomach cramps and pain. I also have had nausea more days in my life than I haven t. Over the years, I ve had every test you can imagine starting when I was 10 years old. Nothing has ever been found. In fact, my parents were told that I was creating my symptoms for attention since my only other sibling has cerebral palsy . I even had a specialist I was referred to for fatty liver disease tell my the pains in my stomach were psychosomatic. After 3-4 days of no gluten products, I began to feel better. No diarrhea, no nausea, very little stomach pains. Yesterday I ate several biscuits with no other gluten in the entire day. About an hour after I ate the biscuits, I began to feel a tightness at the base of my throat. I thought it was heartburn, but there was never any burning and antacids didn t help. It continued to get worse and I felt that I had to consciously take deep breaths to get enough air. If I sipped on ice cold water the symptoms would subside for a few minutes - maybe 3 minutes then immediately return. I became concerned this was an allergic reaction to the gluten. I have no other allergies other than seasonal and Sulfa medications. I took a 25 mg Benadryl which did nothing. Two hours later, I took some pseudofed, the only other allergy medication I had on hand. I seriously considered going to the ER but the symptoms reached a certain level and stopped progressing so I did not go. It was 6-7 hours before the symptoms finally went away. I have always eaten a lot of bread and flour so I find it hard to believe that these three biscuits could have caused these symptoms, but I didn t have anything else that I haven t ever had before and this is the only thing I have eaten in a week that had any gluten in that I m aware of. Does this sound like a gluten allergy?",
    "doctor_response": "yes definately gluten is one protein and this is found in wheat there are many proteins in wheatyou hitory suggest that you have allergy to glutn or wheat wholeu need to blood serum test for wheat specific antibodies if you have stopped the food for many days even a small one amount can lead to severe allergies even anaphylaxis. one timer exposute can lead to problem for 3 wkit is good you have controlled with antiallergics and the antiallergics are requiredi suggest to get serum tests and eliminate diet completelyyou need to take immunotherapy so that you can take it again",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does having Implanon cause changes in pregnancy test?\n\nI have been feeling like I am pregnant. I ve had the implanon in for 2.5 years and I feel movement in my stomach and I have gained at least 5lbs. I m shocked because I work out at least 3 times a week. My last menstrual cycle was the 24th of July. I know it may be soon to tell but I just have a strong feeling. I have done 4 pregnancy test and they all came out negative...is there a possibility that I may be pregnant?? Can the implanon give multiple false negative??",
    "doctor_response": "Hello, and I hope I can help you today.If your pregnancy tests are negative, then you are not pregnant.  The Implanon will not cause a false-positive pregnancy test.  However, the hormone in the Implanon, called Progesterone, can cause many similar symptoms to pregnancy, because the same kind of hormone is produced in your body by pregnancy.  So feeling bloated, having breast tenderness, spotting or irregular periods and weight gain can all just be side effects of the Implanon.  Many women think they feel fetal movements, but most women don't feel fetal movement until they are at least four to five months pregnant, so you are likely mistaking the movements of your intestines for fetal movement.I suggest you discuss your situation with your healthcare provider, as you may prefer to try an alternate method of birth control which may not give you these symptoms.  Your Implanon will need to be replaced at 3 years anyway, and other hormonal contraceptives that are not systemic, like the hormonal IUD, can give long-term pregnancy protection without as many systemic side effects.I hope I was able to adequately answer your question today and that this information was helpful.Best wishes,Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long is Reese advisable for thread worm infection?\n\nHi! I thought I had a yeast infection for two weeks, only to later figure out I have pinworms. I took Reece medication a week ago, and although I have had some improvement- symptoms persist. I know it is recommended to take a second dose next week. I kept feeling something so I re-did a tape test to only to find an actual threadworm! Grossing myself out completely. How long does Reece take to eliminate this problem. Do I need to get a prescription strength medication?",
    "doctor_response": "Hi, Thanks for posting in HCM. I understand your concern.pin worm infection is common now a days.Reece is the only remedie for the treatment of pin wormit should be taken for 2 weeks if you have mild symptoms..it can go upto 6 weeks if you have severe symptoms.along with Reece strict hygiene measures should be taken till your treatment period to avoid re currency hygiene measures like..1.washing your bed sheets and pillows daily2.cleansing the toilet room each time 3.cleaning your nails each days if you scratch your anal/vaginal area as eggs are layed typically i that region. Hope the information provided would be helpful. All the best. Regards,Dr.sameena",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the liver function test results a cause for concern and suggest diet plans?\n\nhello doctor, myself Ranjith Shetty, on 13th of thismonth i got my liver blood test -in that SGOT =61 ,SGPT=121 ,then as per doctors advice i stopped all sorts of junk food and started to take Liv-52 syrup twice a day  . and on 17th of this month the level of SGOT=50 and SGPT=117, now my question is 1) is this a dangerous  2.) how long it will take to cure  3.) what food should i eat 4.) whether medical science treats this as dangerous or mild?",
    "doctor_response": "Hi I can understand your concern.....You gave elevated liver enzymes.Let me know you mostly you have fatty liver or gall stone like condition.....This condition is not dangerous.Fatty liver take approx 10 month to resolve...Here are diet suggestions .....Take low fat food.Trans fat food like butter , cheese , meat , baked pestry , cheese avoided.Avoid alcohol.Fruits and green leafy veg more...Regular exercise done...Refined food not taken...Continue taking ursideoxy cholic acid syrup.If still liver enzymes continue to be increased then viral marker study done to rule out viral hepatitis like condition..I how your concern solved.Happy to help  you further.Dr.Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a wet feeling on the cheeks while suffering from diabetes?\n\nI have a lot of health issues I had a stroke at 25 and I had two heart attacks at 45.  I am also an uncontrolled type two diabetic and have high cholesterol and blood pressure All of a sudden in the last three weeks about six or seven times a day my left cheek feels like it is very wet. I rub my cheek to make sure it's not wet and there is nothing there... any advice??",
    "doctor_response": "Hello,It may be a symptom of TIA (Transient Ischemic Attack) the so-called mini-stroke. As it is a neuropathy feature. Please keep your blood pressure and diabetes under control.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Varinder Joshi",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat abdominal pain and loose motions in a 43 old female?\n\nHi,My mother is 43 years old , she is suffering a lot due to stomach pain and we consulted doctor for this. Doctor suggested her take PAN 40 tablet and gelusil syrup to recover from this.She has continued this for 2 months, during this time she was feeling ok with it. From Yesterday she has stopped to having tablet and syrup , due to this suffering a lot by having loose motion and heavy stomach pain.Could you please suggest us the treatment to be taken for her?Thanks in advance,Hari",
    "doctor_response": "HIThank for asking to HCMI can understand her problem, if I would be her doctor then I would definitely treat her with the following medicine,1) Tab. Dicyclomine with Acetaminophen one tab. three times in day2) Tab. Ciprofloxacin 500 mg twice a day for five days I hope she would get lot of relief with these regime, take a good care of her, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes spots on abdomen?\n\nMy 9 year old daughter has bruise-like spots on her back (spine) & abdomen. They 1st appeared around November 1st 2009 on her back and now have spread to her abdomen. What could it be? Her doctor gave us ointment that didn t work and now they are sending us to a dermatologist.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is memory loss post massive heart attack, a disability?\n\ni had a massive heart attack in 2008 there for i had to have 2 stents placed in my heaart i work in a really high stress job and of late my memory as i was told i lost some short and long term some times i forget what i was doing when doing it anyway i am wandering if i would qulify for the disability",
    "doctor_response": "Hello, I would explain that memory loss is not related to coronary stents. It could be a sign of dementia. For this reason, I recommend performing a brain MRI and consulting with a neurologist and performing some cognitive tests in order to investigate this possible issue. Regarding disability, it is important to evaluate the severity of your memory problems, in order to judge the degree of disability. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause a bruise followed by a numb feeling in the finger?\n\nMY NAME IS CHRISTINA AND MY QUESTION IS, KNUCKLES ON MY HANDS 1) RING FINGER YESTERDAY HAD A BIG BRUISE ON IT JUST ALL THE SUDDEN AND THE TIP OF MY FINGER WAS GOING NUMB & TURNING YELLOW; I MASSAGED IT & GOT COLOR BACK & TODAY BETTER SWOLLEN WITH BRUISE 2) NOW ANOTHER ONE APPEARED ON POINTER FINGER ON DIFFERENT HAND TODAY I DID NOT HURT IT IN ANY WAY TO HAVE THIS HAPPEN - GETTING CONCERNED ABOUT THIS STRANGE ACCURANCE- DO YOU KNOW WHATS HAPPENING?",
    "doctor_response": "Hi i am Dr Ahmed Aly    thanks for using healthcaremagic site ,I had gone through your question and understand your concerns ..   In my opinion that could be a kind of arthritis either gouty or rheumatoid       , usually these symptoms may come from cold weather .    For my patients i suggest some lab investigations like urine analysis , ESR (erythrocyte sedimentation rate ) , ASOT (anti streptolysin O titre )   , Rf  ( Rheumatoid factor ) for proper evaluation and management of the underlying cause .  You may use painkillers like NSAIDs like advil tab when needed , hot massages with topical gels , high fluid intake and low protein and salty meals till the results come . Please click and consider a 5 star rating with some positive feedback if the information was helpful. Wish you good health,Any further clarifications feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stage 1V lung cancer, 400 mcq per tablet. How many mcq s does it take to come up to 1 mg?\n\nim going to be starting chemo in a couple weeks for stage IV lung cancer.  i will be having port placement on the 4th.  so far they have given me B12 infusion which they will repeat every 3 weeks and told me to get folic acid on way home today.said i could get it @ drug store over the counter with no prescription & I'M to take 1 mg a day starting now.  problem is bottle says 400 mcq per tablet.  I've never seen mcg for dose.  how many mcq\"s does it take to come up to 1 mg?",
    "doctor_response": "1 milligram = 1000 micrograms So u need to take folic acid tablet 2 and half tablet per day.Since it is stage IV lung cancer the doctor may be planning chemotherapy with agent called pemetrexed which is used in subtype of non small cell lung cancer called adenocarcinoma.Vitamin B12 and folic acid are needed to prevent pemetrexed toxicity such as anaemia and low platelet .Regards and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower right pain in back under rib cage?\n\nI have lower right pain in back under rib cage with burning sensation in front lower right rib cage now I am also feeling a popping there too. I am a 33 year old female. I have had my gallbladder tested and that is okay, but seems to be getting worse, it is especially bad when sitting and standing to much.",
    "doctor_response": "thank you for posting your query,the pain you described just seems neuromuscular type of pain. if it severe you can take anagesics like ibuprofen or muscle relaxant like aceclofenac + chlorzoxazone + paracetamol. otherwise physiotherapy and exercise will help you a lot. style of working and posture is of much important.so care about it should be taken that it will not hurt again.hope this answer will be helpful to you.for more queries plz don't hassitate to ask.get well soon dear friend",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to calculate chances of getting pregnant?\n\nI'm planning for pregnancy, I'm undergoing regular follicular scan, yesterday I had a follicle measuring 15x18mm, its 21th day of my cycle, I'm having regular intercourse, so I want to know the chances of releasing the egg and getting pregnant this month.",
    "doctor_response": "Hallow Dear, I can appreciate your keenness in getting pregnant. If the egg is around 18 mm in diameter, you do stand a good chance in ovulating in next 24 hours. So utilize these days for sexual relations maximum.If this cycle it does not work, please follow my advice.From day 9 onwards, submit yourself for ultrasonography for ovulation monitoring till the evidence of ovulation is noted. In this monitoring, please note the following conditions:1. Note the size of the follicle just before the ovulation. Follicles of diameter between 18 mm to 21 mm in size release the best quality eggs and have the best of the chances to get fertilized and complete a successful pregnancy. 2. Note the thickness of the endometrium (uterine lining). Endometrium of 9 mm to 14 mm thickness is most conducive for successful implantation of the fertilized egg (blastocyst). The life of an egg is 14 hours while the sperms are active for 72 hours. Keeping these facts in mind, you may plan your sexual relations. Around the day of ovulation, have intercourse at least alternate day.I hope this helps you. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe abdominal pain?\n\nI am 29 years old and having severe abdominal pain so they sent me to have a colonoscopy done yesterday it all came back good but yesterday I had a couple of bowl movements and it was pure blood and then this morning I wake up and my face is swollen also I have chills and I feel so bad is this normal after a colonoscopy?",
    "doctor_response": "Hi, Blood you experienced is indicative for hemorrhoids or any possible anal fissure, especially when your stool was hard. Having a swollen face is not related to colonoscopy. Depending on your actual age, it might be due to:- kidney problems (e.g. infection)- changes in blood pressure- medications you might be currently taking. I advise to get an emergency appointment with your physician for further evaluations and adequate treatment. All the best!Dr.Albana",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Taken I-pill on the second day of my period. Are there any chances to get pregnant?\n\nHi doctor, I had unprotected sexual intercourse on the day 1 of my period, and the penis was rubbed against my vagina. But we have not done penetration. I was worried due to precum. So I took an I-pill on the day 2 of my period within 13 hours. Should I be worried? When should I expect my next period since I took the pill on day 2 of my period? I have my cycle for 24 to 26 days. Should I expect withdrawal bleeding in this case? And what can I do to get my regular periods? Are there any chances of getting pregnant?",
    "doctor_response": "Hi. As you have taken I-pill early on the day 2 of your cycle, you may or may not get a withdrawal bleed. The chances of pregnancy are minimal as you are in your safer period with regular cycles. If you do not have a withdrawal bleed, then get a serum beta hCG test done after eight days, to rule out pregnancy. If it is negative, wait for your menses, which may be delayed this time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart fluttering?\n\nI'm very worried about my heart health. I was experiencing heart fluttering for about 4 days, and finally went to see my doctor. My heart flutters every once in a while, but has never before lasted for days, and was intermittent but consistant. My doctor performed an ekg which said t wave changes in the septal lead borderline abnormal for age and gender. I'm a 31 yr old female in good health. My doctor order a thyriod test. Can some please tell me what the cause could be?",
    "doctor_response": "Hi,Don't worry. Women frequently have some ECG disturbances without any abnormality.Just do the thyroid test, if it comes back normal, you can undergo a stress test, if it comes back normal as well, then forget about ECG changes.Take careCome back if you have any further questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedial measures to stop masturbation\n\nHi, I have been mastrubating for about 6 years now on a avg once a day...The frequency has reduced now but the occasional urges are stronger. I heard that the habit will reduce the quality of the brain and drains the body of essential nutrients and stunt growth.. Is it true...? In any case i want to badly stop doing it..Please suggest me some remedial measures. Is it even possible to stop it through sheer will power or is it genetic..?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. These are all myths about masturbation that it will stun the growth and it will have effects on the brain functionality. The only side effect of masturbation is that the body gets used to take all the pleasure from masturbation and libido towards sexual intercourse is reduced, another cause of decreased libido is that when a person masturbates on regular basis his sperm count will reduce and body will make more sperms this will direct most of the testosterone towards sperm formation causing decreased libido. Yes masturbation can be stopped by will power and there is no genetic involvement in the habit of masturbation. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a hard lump on the rib cage\n\nHi I think my xiphoid process is swelled up its between my ribs when I am lying down its tender to touch it s a big hard lump and doesn t move when I touch it and makes me get gas trapped in my stomach and it causes bad heartburn I also get pain in my mid back any ideas? Thanks in advance",
    "doctor_response": "swollen hard xiphoid process can be an osteoma. its a benign condition. Heartburn may be due to acidity. Get an ultrasound of abdomen to rule out other causes. if the heartburn persists an endoscopy may be needed. Also get an EKG",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the white patches on the inner side of the mouth?\n\nHi doctor, There are white patches on the inner side of my mouth. There is irritation while taking chilly and hot food. I am consuming a non-tobacco pan masala for six years.",
    "doctor_response": "Hi. You should stop taking pan masala. The white patches look like leukoplakia (attachment removed to protect patient identity). You should consult an oral surgeon and get evaluated. A biopsy can be done. For now, apply Kenacort ointment (Triamcinolone). For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicine to improve sperm count\n\nHello Doctor, I am 33 Year old, no child, doctor advice me to take UBI Q 300 to improve my fertility, I am consuming this tablet from last 1 year, still My sperm count is not improving, now doctor suggest me to take HI Q plus 500 tablets, so I am very confused to choose this tablets. please suggest me which one is better",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I would like to see your semen analysis report before prescribing you any medication. If you would have come to me i would have ordered some investigations before starting ant treatment which would include serum FSH , serum testosterone and serum prolactin levels along with testicular doppler ultrasonogarphy to rule out varicocele. Moreover to increase sperm count i mostly recommend my patients cap.evion once daily and tablet tamoxifen 20mg these drugs have shown excellent results in my patients. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sneezing and allergic cough, severe nocturnal leg cramps, prescribed banocide forte, have severe chest pain, diarrhea following intake. Help?\n\nam 25 yrs old.suffering from sneezing and allergic cough since 10 yrs.am having severe nocturnal leg cramps for the last 1 yr.1 month ago i underwent myomectomy due to uterine fibroid .2 days back an orthpaedic Doctor prescribed me tab. banocide forte 100mg when i complained of leg ache. after taking banocide am having severe pain across the chest, diarrhoea, nausea,dizziness. what should i do",
    "doctor_response": "this is allergic symptom get xray pns done maximum painkillers when taken during allergy increase the allergy symptom .The safe painkillers are diclofenec, meftal and tramadol for any kind of pain. avoid taking paracetamol,ibubrufin , Stop all milk products and dairy products including creams and soaps. Avoid using mustard oil. Start taking tablet methotrextate 2.5 mg once weekly dose(latest treatment). Take tablet grisOD once a day . tablet montair Fx twice a day syrup tosex half tsp at night do for three weeks. get your blood serum test for milk, wheat, potato specifi antibiodies dont take any vitamin, steam post again after getting the results",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My mother has CKD with creatinine level 6. 3. What has to be done?\n\nHello doctor, My mother is 56 years old and she is having CKD with creatinine level 6.3. Her BP is around 130/80 mmHg and blood sugar below 150 mg/dl for the past three months. Kindly guide me.",
    "doctor_response": "Hi. BP and sugar are in normal range. What questions do you have regarding creatinine? For more information consult a nephrologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizzy spells along with heavy head and partial vision loss?\n\nI had 2 episodes of dizzy spell last sat, one in the morning one late afternoon. Went to emergency Sunday. Was told it is Peripheral Vertigo. Doctor sad it will come again in the future. I m still filling dizzy especially in the morning, it is weds afternoon now. Light headed had headache yesterday. My head fill so heavy, having heart palpitation and losing bit vision from time to time. Not steady on my feet. Keep tripping as I walk and going sideways. I do have fibromyalgia and chest pain in the morning some times. Please help. Maria.",
    "doctor_response": "Hi, I am Dr.Bruno.  I have read your question and understand your concerns. Let me try to help you Question : What causes dizzy spells along with heavy head and partial vision loss?Answer : There is a problem in your posterior Fossa. It can be reduced Blood Flow or a Space Occupying Lesion. Please consult a Neurosurgeon at once Please note that partial vision loss is not that common in Peripheral Vertigo. The symptoms of Partial Vision Loss has to be given more importance and hence I suggest you to consult a Neurosurgeon immediately Hope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does a delayed period indicate an ability to get pregnant?\n\nHello. My name is Wendy. I am a 30 year old mom of 3. I have a medical concern. I had my last child in 2006 and had a tubal ligation. Then in December 2009 I had to have a endometrial ablation done because of my problems with my period.. Got my period started back in January and since every 21-22 days for 5-7 days.Then this month I havent had one since May 27 So now I am worried..I was told i wouldnt be able to have anymore children so what to do..??I am worried..",
    "doctor_response": "once you are located you cannot get pregnant however only 1% chances are there of ligation faliure. don't worry just wait and watch for your periods. if they delay then there can be other reasons  which can only be ruled out through proper consultation from a gynaecologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can any online doctor advise me on the liver function tests ?\n\nWhat is the stage of disease and condition of liver the following values BILIRUBIN 0.19 mg/dl BILIRUBIN 0.6 mg/dl BILIRUBIN (INDIRECT) CALCULATED 0.41 mg/dl ASPARTATE AMINOTRANSFERASE ( SGOT ) 53.7 U/l ALANINE TRANSAMINASE (SGPT) 65.8 U/l ALKALINE PHOSPHATASE 121.6 U/l GAMMA GLUTAMYL TRANSFERASE (GGT) 30.8 U/l PROTEIN - TOTAL 7.45 gm/dl 6.0 - 8.3 ALBUMIN - SERUM 4.25 gm/dl 3.2 - 5.0 SERUM ALBUMIN/GLOBULIN RATIO 1.33",
    "doctor_response": "hello. welcome to HCM.Your total bilirubin levels are within normal range, as are alkaline phosphatase, gamma GT and total and differential proteins. however, the direct fraction is a bit more than indirect fraction, whereas it should account for nearly one third of total bilirubin. Also, there is a mild elevation of hepatic enzymes- SGOT and SGPT. the cause fro these could be alcohol/ drug related. In case you are asymptomatic, you just need to wait and watch by abstaining from alcohol and discuss with your clinician regarding any medication which you are on. You can get your enzymes and bilirubin tested after a month or so. However, if you are presently or in the past have been symptomatic with jaundice/ previously documented abnormal LFT, you need to have additional investigations (viral markers) and ultrasound of the hepqatobiliary region. Based on results of these, the further course of action will be decided. Hope this helps. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes black particles in urine, sore kidneys and difficulty in walking?\n\nI have recently had black particles in my urine when I have strained it.  It looks like black pepper.  Urologist said it was not kidney stone because he did not see any on CT scan.  What is it? Kidneys have been very sore.  Could hardly walk, stand, or lift anything.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Did you have any recent trauma? or kidney stones in the past? Minimal bleeding into the urinary tract can cause this. Or you must have passed out the stone in the urine. Sometimes a condition called papillary necrosis can cause this.check you blood sugars. Keep drinking min 3litr of water and fliuds. Difficulty in lifting and walking are due to problems in the back muscles and bones. Maintain a good posture and get those checked once. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it safe to get my son's dental treatment done under GA?\n\nHello doctor, My son, 2 years and 10 months, has been suggested RCT (pulpotomy). Background: My son is breastfed and still feeds during sleep. He has complained of pain once or twice in the last three to four months. His oral habits are not good. He cries his heart out when we brush his teeth (normally once a day). He likes shakes and juices. He is on an antibiotic and analgesic course currently. He does not speak much. So, communication is a problem for him. Questions: Should we go for RCT directly after the first round of complaining and medication or should we wait and see? What alternatives do we have? Is GA safe for such young kids? Does it have any impact on his future teeth? What can we do to improve his oral health irrespective of whether we opt for GA or not?",
    "doctor_response": "Hello. I have seen the image sent by you (attachment removed to protect patient identity). Formore information consult a paediatric dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes edema in hands and feet, shortness of breath and red dots near toe ends?\n\nedema in hands and feet morning...shortness of breath not all the time..lots of cramping in calves. my left foot also has flat small red dots just at the end before my toes. Went to er lungs sound clear ekg normal but he had mentioned blood clot but he only said leg pain and I didn't even think about swelling as I was there because I felt like I wasn't breathing. Also lots of anxiety my sister killed herself dec19 so they chalked it up to anxiety.",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.It could be possibly a panic attack. This is a disorder of anxiety and occurs cause of imbalance of certain neurotransmitters in the brain. especially serotonin, nor adrenaline,  and dopamine to some extent. Medicines are the best options to take care of these symptoms. Paroxetine is the the most popular medicine and my drug of choice. I generally prescribe my patients 12.5 mg per day at night which takes care of anxiety symptoms. Also certain medicines like propranolol and clonazepam can be give as required when there is a panic episode or expected situation where panic attack can appear.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/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lump on the neck.Cause?\n\ni have a small painless lump on the left side of my neck its soft and i found it about a month and a half ago, but just remembered about it right now it has stayed the same size. It only hurts if i pushdown on it.it goes away & comes  back,been to two MDs & they both said not to worry,its a muscle.",
    "doctor_response": "Welcome to Health care magic.1.It could be a muscle as your doctor said.2.Possibilities of lymph nodal enlargement can not be ruled out.3.I would recommend to get an ultrasound neck none to evaluate the nature of the lump, its source, nature and extensions.4.Lymph nodal enlargement is seen after any infection / inflammation local or systemic.5.VAscular cause also one of the possibilities - gets scan for confirmation. good luckHope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will Naturogest 300mg help to get pregnant?\n\nsince 7 years of marriage and i had conceived once and had a miscarriage, now i am on a treatment with a bfamous doctor, they have done iui and asked me to take natugest 300mg through vagina twice a day for 15 days. do u think that it will help me to become pregnant.",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.1] Naturogest contains hormone progesterone; which helps support pregnancy.2] It is given after IUI in a view to support the pregnancy ,if it happens after IUI.3] Sometimes, pregnancy does not grow due to less progesterone support and to avoid this situation NATUROGEST is given.4] it does not help to get pregnant but helps to support and grow the pregnancy if it is there.I hope my answer helps you.Thanks.Wish you great health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes small lump in area of shot after wisdom tooth extraction?\n\nI have a small ball inside my cheek after a wisdom tooth extraction. I believe it is in the same place that one if the shots were given because I experienced very sharp pain at the time. It's been 3 and a half weeks since the surgery and I am getting concerned. Do you know what this might be?",
    "doctor_response": "hello thanks for your query, i have gone through your query.the small ball kind of tissue could be a fibrosed injection site, where the tissue becomes firm or hard. the pain will be there at the site of injection for a week. nothing to worry about it. you can use topical anesthetic and analgesics like anabel gel. apply 3-4times daily. do saline gargling.i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Eyes are blood shot, heavy with moisture. Got Autism. Related to sympathetic discharge of autonomic nervous system?\n\nMy son is autistic.  His eyes are often blood shot.  We wonder if it is due to allergies but we note that one day they are not bloodshot and the next day they are.  He does not cry, ever, but I noted today than upon his mother being away for 2 days that tonight his eyes are blood shot and heavy with moisture.  It makes me wonder if his eye condition is related to sympathetic discharge of his autonomic nervous system.  If I had his problems related to autism I believe i would be crying a lot. Thank you for any insights you might have regarding his condition.",
    "doctor_response": "Hi,Thank you for posting your query.First of all, I would like to reassure you that his redness of eyes are not related to any abnormalities in the sympathetic or other parts of nervous system.These are most likely due to allergies, as you suspected. Allergies need not occur everyday, and it is fairly alright if his symptoms are intermittent. He would benefit from treatment by an ophthalmologist, so please consult an ophthalmologist.I hope it helps.Please get back if you require any further information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes early progesterone spikes post IVF?\n\nMy wife and I are seeing an RE, and have tried multiple IVF cycles. Most recently the conclusion seems to be that her egg quality is being affected by an early spike in progesterone before her eggs are fully mature on a lupron protocol (10 iu daily) that should be suppressing the progesterone. The level jumped from 1.7 to 3.5 between days 7 and 8 of her last egg retrieval cycle.. My questions are: 1) what type of testing could be done to try to determine the root cause of this early progesterone spike? 2) is there any other way to regulate this type of thing through diet or medication? 3) any other recommendations on how to approach this problem? Thank you so much for your time!",
    "doctor_response": "Hello, you need to start higher dose of leupride and recombinant FSH for induction of ovulation so that there are no LH levels in the bodyIn case you have any questions in future you can contact me directly on",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in left hamstring radiating to inner thigh?\n\ni am experiencing pain in my left hamstring, and after a short period the pain resonates on my inner thigh up just below my groin area. this occurs whenever i am driving for any amount of distance. i try to adjust my driving position, or use a lumbar pillow or a pillow under the knee nothing seems to help. if i stop the car and get out and walk for a minute then the pain goes away. then i am able to continue driving and finish my trip. also the left side of my knee starts to throb and feels sore to the touch. but again once i walk for a minute i get relief any suggestions?",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, this could be due to compression and this might be compressed the sciatic nerve, you need to maintain the good posture if this is cause too much pain then better to avoid the car driving, in such case decompression gives good results, hope this information helps, take care, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take vigamox for staph infection?\n\nMy 5 week old baby has a staph infection in eye and was prescribed vigamox on Mon. She has had 5 total drops..... 1 Mon. night, 2 yesterday and 2 today. Her eye looks red and swollen and is still infected. Are the drops not working? When should it start to clear up?",
    "doctor_response": "HI, thanks for using healthcare magicIt may take a while for an improvement to be seen but normally changes should be visible by day 3 to 4.If she still has the same amount of discharge and swelling then she may need to be reassessed. It is possible that she may not be responding to those particular drops.Her doctor may want to consider taking a swab of the discharge. This can be sent to the lab for them to determine which medication would work best.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high BP\n\nHi, my name is kashif and I am 26 year old living in pakistan. I have blood pressure problem some time my blood pressure shoots very high and It causes severe pain in my neck and some time my blood pressue lows down like 51/100. More then one year I am experencing blood pressure problem. It also cause redness in my eyes and irritation. Now I also experience severe pain my chest aswell. My ALT test is normal However in my chelostrol test HDL is little bit high.",
    "doctor_response": "Its a great problem to treat someone whose blood pressure is not steady,,ups and downs....monitor your blood pressure every day for a week,,if still high consider visiting your doctor",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red spots on chest and chest pain?\n\ni get red spot on my chest and when they appear i am also having chest pains that feel like a throbbing to a stinging. also when this is happening i have shortness of breath. sometimes stress sets them off and some times when i am upset. but most the time i am just working or at home just sitting down when they hit",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Red painful spots on chest are commonly seen with herpes zoster infection. Stress and anxiety are common cause for recurrent herpes infection. So better to consult dermatologist and get done clinical examination of skin lesions. You will need acyclovir oral tablet, antihistamine and anti inflammatory drugs. Also check for diabetes as herpes infections are common in diabetic. Wash your clothes thoroughly in antiseptic solution. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden heavy bleeding along with stomach pain during pregnancy?\n\nI am 10 weeks pregnant and last sunday had a sudden gush of blood and bled all day along with some really bad pain in my stomaChe, it quit the next day. I have not started my appointments with a midwife yet. Every hospital told me they Could not get me in fast enough to just go to the ER. We live over an hour away so i didn t go. I am still waiting anxiously....Do you think I am alright sinCe the bleeding is gone now? Or should I still go to the ER?",
    "doctor_response": "Hallow Dear,Heavy bleeding with abdominal pain at 10 weeks of pregnancy  is not a good sign. There is a great risk that baby might have been jeopardized.  If you have not expelled out the baby during the bleeding you had, you should confirm its safety by ultrasonography. Usually, early pregnancy bleeding - diagnosed as threatened abortion is very difficult to salvage when associated with pain. Urine pregnancy test will not give any information about viability of the baby since it requires about a week or more for these tests to become negative after the baby has become non-viable. Please report to your Obstetrician or Emergency Room ASAP. If you cannot do that, please get ultrasonography done to find out the status of the baby. Till that restrict yourself to the bed. If the baby is non-viable, you may have to undergo termination of pregnancy without delay to prevent complications like infection, heavy bleeding due to clotting defects (DIC) or due to incomplete abortion, etc. Waiting anxiously at home is not going to help you, it may worsen the situation. I hope you got the message.  Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does an infected bump on the tailbone take to heal?\n\nhi, i had a bump on my tailbone and it has been hurting for three days. today morning it leaked and puss has been coming out. it has been 8 hours there is some puss it has been coming out. so can it be healed by itself and how long the puss will still come out?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As per your edit is obvious that the lesion is infected. You have to start antibiotic. Start a short course of antibiotics like Ampiclox or Amoxicillin/Clavulanate for five days. Apply topical antibiotics like Mupirocin after cleaning with soap and water. Generally it will heal with in four to five days. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the lump on the left side of the shoulder?\n\nI have a lump on the left side of my shoulder a little near my neck inside the collarbone. When it first happened 3 days ago my collarbone and my neck hurt...I wonder where it comes from and there is not any more real pain but I take ibuprofen....What should I do??? It seems like it will go away but I don t know.",
    "doctor_response": "Hi ! Good afternoon. I am Dr Shareef answering your query.From your history, I feel that possibly you have got a lymph node inflamed in your neck region, which could be due to any infection in the drainage area of the lymph node. If I were your doctor, I would do a general physical examination of yours with special attention to your head and neck region along with the oral cavity, and would consider advising you for a short course of broad spectrum antibiotic along with an anti inflammatory drug.  This might resolve the problem.Otherwise I would consider referring you to a general surgeon/ENT surgeon, who might advise you for an FNAC(fine needle aspiration cytology)/excision biopsy of the lesion to arrive at a definitive diagnosis for appropriate management of your problem.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lymphadenitis of left cervical region\n\ni am found to have reactive lymphadenitis of left cervical region along with that i have pain in left shoulder and mild fever in d mornings.My age is 21, weight 62kg and heigt 160cm. I have been on metformin and OCPs for past 4 year since i have PCOD.",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Reactive lymphadenitis is possibly due to infection in the draining areas.2. Cervical region surrounding areas, needs to evaluated for infection..3. Sputum examination and complete hemogram is necessary4. However, if there are no areas of infection, it would be prudent to wait for 2-3 months, as lymphnode to reduce in size will take a longer time. Fever in the mornings if present indicates possible infection, daily evaluation is necessary, if fever is present. More details necessary for further opinion.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for fever?\n\nMy 5 yr old daughter has run a fever for 5 days, as high as 103.8, went to ER & she was diagnosed mid ear infec. 5 dayhs later after on antibiotics she is still running low grade to mid range fevers and is now complaining of extreme pain in her legs and extrimities...should I take back to ER for blood work, what may this be?",
    "doctor_response": "Dear parent,Looking at your description of symptoms, there seems something else is also a problem besides middle ear infection. my suggestion is to visit ER again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe stomach pain\n\nhi, my daughter is suffering severe pain in her stomach, near enough daily now, usually sick aswell, sometimes dioreah, we are waiting for a peadiatrician appointment and the dr asked for a urine sample, it came back that there was puss in her urine. what does this mean?",
    "doctor_response": "Hi.The pus in urine is suggestive of an Urinary tract infection. Your daughter has UTI. I would advise: Blood- complete blood picture, kidney functions tests, blood sugar fasting and post-lunch, Urine- routine,microscopy, culture and sensitivity ( before start of antibiotic)Ultrasonography of abdomen.After the urine is sent for culture, antibiotics can be started immediately- Added Amikacin in proper dosage can work wonders, The most important point is there may be a root-cause for UTI in such a small child and if required CT scan of the abdomen is needed to get the cause and treat this too to avoid recurrence.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could erection problems be due to typhoid?\n\nhi, my husband had typhoid 3 weeks before for which he had taken the complete treatment. but now he has sexual problem like weakening in erection which was never before. Is this due to typhoid? when it was corrected and we gain our normal sexual life?",
    "doctor_response": "Hi, Typhoid is not known to cause erectile dysfunction. The sudden ED could be due to psychological problem like stress or depression. So just take next two week break. Give him more fruits and healthy diet. After next two week of still erectile dysfunction persist than you should consult him to nearby psychiatrist for counselling. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for essential thrombocythemia\n\nI have seen 2 hematology/oncology Doctor s; who both diagnosed me with essential thrombocythemia and tested positive with jak 2 mutation. I am no seeing a 3rd hematologist who says I have Thrombotyosis. I take 81 mg aspirin daily. The Doctor stated my bone marrow is overactive. I was also told this can go into Leukemia. My question is: are the 2 diagnosis the same and is this cancer. When I looked up ET it was notated a blood cancer. I am a bit confused; and really worried about my health. Thanks, Christine",
    "doctor_response": "Hi, dearI have gone through your question.I can understand your concern.You have essential thrombocythemia. It is chronic myeloproliferative disorders. But it can turn into acute leukemia. It is called one type blood cancer. But it chronic disease and prognosis is better. Regular phlebotomy is required to control red cell mass. Aspirin and other blood thinner are also useful. Consult your hematologist and take treatment accordingly.Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can gallstones be the reason for lower back/abdominal pain?\n\nI have pain in my lower right back/abdomen. Recently had 2 cats cans and ultra sound. Only issue was gall stones in gall bladder. Can this be causing this pain? I have trouble standing up straight. Hurts when I breath in. Constant pain. Referred to urologist but cannot see for another week. Wait to see him or other? I am 60 yr old male Thanks",
    "doctor_response": "Hello! Thanks for putting your query in HCM. I am a Gastroenterologist (DM). Yes gallstone can cause pain in either locations you have mentioned. So I will suggest you to visit a surgeon for evaluation and managementI hope I have answered your query and this will help you. If you have any further query  I will be happy to answer that too. Remain in touch and get-well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Blood in urine. Urinalysis showing high WBC. KUB ultrasound shows mild caliectasis. Treated by medication?\n\nhello, im 34 years old, female. I'm having blood in my urine early this morning, i went to a laboratory for a urinalysis and cbc, my albumin result is 2(++), pus cells 57-50, red blood cells 12-15 and i have an abundant bacteria, my WBC result is above the normal range normal is 10 mine is 15.8, i was advised to have an KUB ultrasound and the result is i have a mild caliectasia having a slight dilatation of the left calyceal system is seen but no apparent  mass or calculi...my question is..if this condition can be treated by medicine or what are the other remedy for this condition?thanks, hoping for your urgent reply..god bless",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum. Hematuria is condition in which  blood passes in urine. May be due to stone ( calculus) in urinary tract system ( kidney, ureter, bladder, urethra). may be due to infection, cancer, tuberculosis. Please don't be in panic ( I mentioned the causes). In your case it seems there is  heavy infection of kidney that's why there are pus cells in urine  with bacteria. red cells are also present . The cause of concern is ALBUMIN ++ in urine Mild  increased white blood cells,due to infection. Yes  this  condition will be alright with medicines. Consult a physician and get  his opinion. Before this if possible upload the report of Blood urea, uric acid, serum creatinine .Kidney involved but  treatable so at once get treatment. Hope I have answered your question. If further any question I will help. Get well soon. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there something to worry about gram negative bacilli?\n\nHi, my seven month old son had high fever since last 3 days. His doctor suggested to go for urine test and culture. His report is in and having gram negative bacilli. Would like to know is this a serious report? Or can be under control with antibiotics.",
    "doctor_response": "HiWelcome to the HCMIt seems that your child is suffering from a gram negative bacterial urinary tract infection. I would recommend you to take a complete course of antibiotics according to the culture and sensitivity pattern of urine. Usually if properly treated with compliance, it will be fine.Also, since this episode has occurred so early in life, the cause and it's effects on the urinary system needs to be thoroughly investigated. Ultrasonography KUB should be done soon after the diagnosis of UTI. The MCU is recommended 2-3 weeks later, while the DMSA scan is carried out 2-3 months after treatment. Hopefully this will help you. In case of any further questions, you may contact me.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had viral hepatites. Did health check up. Showing mild hepatomegaly with fatty changes. Problem?\n\nHI, I had viral hepatites in 2004. When i got my general health check up in 2011 2 parameters in LFT were abnormal,  i guess SGPT. And an US scanning reveled a mild hepatomegaly with fatty changes. Later i consulted a doctor(gastro) he tested me for Hepatites B and other test and said its ok and nothing to worry. now i want to know if it may give some problem in future?  Vijayakumar.",
    "doctor_response": "Hi and welcome to Healthcare magic. You didnt mention which hepatitis idi you have. If it was C or B then you are probably still infected and virus can be activated at any time on your life or never. YOu should do frequent LFT check ups and liver ultrasounds. Fatty changes arent caused only by virus.  The most common liver disorders is fatty liver which can be found in healthy people, but usually is resulting from elevated blood lipids, overweight and elevated blood sugar. YOu should treat it by changing dieatary and lifestyle habbits. Do exercise, avoid alcohol,smoking, fats,fast food and carbonated drinks. Eat more fruit and vegetables, boiled meat and follow some of hepatoprotective diets. Findings usually improves on such measures. If not, then some medicines can be presribed. Wish you good health. Thank you for your querry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could sore, inflammed skin on penis be due to excessive pulling of foreskin during sex?\n\nI have inflamed skin slightly raised on either side of my penis where the foreskin meets the shaft. Not a lot of pain just soreness. I just recently became sexually active and the first time i didnt use a condom and had some problems with complete insertion initially with the forskin. could these lesions be caused by excessive pulling on the foreskin (beyond its limits)",
    "doctor_response": "Hi,From history it seems that due to new experience you might be having some problem while insertion producing some soft tissue damage might cause this problem.Avoid sex for few days.Take anti-inflammatory medicine for 3=5 days.Apply antibiotic cream locally.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for purple area on the tongue with headache and metallic taste in the mouth\n\nI have a pea size purple area on the right side of top of tongue as well as a yellowish looking sore on the end of my tongue that doesnt look very well ... as well as a a yellow pimple looking area on gum on the left side upper....  Today I woke up and feel terrible . headache...fatigue ...nausea.. Metallic taste in mouth... What am I dealing with",
    "doctor_response": "Hi,Thanks for asking the query,    This could be an infection a bacterial and viral.Take a course of tab amoxicillin TDS, tab aceclofenac TDS for three to five days.Apply hexigel oral ointment topically over the affected area.At home take lukewarm saline rinses and antiseptic mouthwash rinses.Avoid spicy, hot foodstuffs.Take multivitamin suplements.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is fever and headache a symptom of meningitis?\n\n\"my 9 year old son has a fever of 100.6 and vomiting and a headache. His neck is not stiff. Could he have meningitis?  Last week he had a stomache virus which lasted 24-hours and the week before that he had fever and headache.  we've been to the doctor.  they did a flu test and the results were negative.",
    "doctor_response": "HI, thanks for using healthcare magicHeadache can accompany viral infections such as the common cold or viral gastritis.It is not only present in infections that directly involve the brain.His doctor can examine him to determine the exact source of infection and treat appropriately.Viral gastritis is treated with mainly fluid replacement . I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI shows hepatic cysts in liver, kidney. Father died of kidney cancer. Any solution?\n\nI have a MRI report done that says I have Hepatic lesions compatible with cysts.  When the MRI was done they also found an oblong parapelvic cyst of the lower left kidney measuring up to 2.8cm  They also say there are a couple of subcentimeter probable cysts of each kidney.  I have known for 7 years I have multiple scattered hepatic cysts in the liver.  I am concerned because this is the first time anything has shown up in the kidney.  My father died of kidney cancer about 7 years ago and that was the time they showed multiple liver cysts when I did my colonscopy thenThis MRI was done because there were cysts showing up on the liver when they did a CT virtual colonscopy",
    "doctor_response": "hi thank you for the querysir I have gone through your query and understood your concerns..sir a parapelvic  cyst of the kidney is realtively common problem encountered in urological examination...but rarely need treatment...unless it is presented with symptomatic renal stones, pyelonephritis and back discomfort...how ever considering your family history of renal malignancy I would like to advise you appropriate diagnostic measures and follow up regularly...and coming to your liver cysts ..common causes of hepatic cysts found to be  simple cystsneoplastic cystsPCLDhydatid cystsliver abscessget liver function tests done and appropriate diagnostic procedures to rule out neoplastic liver cysts after consulting your Gastroenterologist...hope I have answered your querywish you good healththank you follow up queries will be welcomedregardsDR Alekhya",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have drymouth and halitosis. Nose gets blocked. Am a mouth breather when asleep. Visit Dentist. Saliva overproduce. Tongue with halitosis?\n\nHi,  I am concerned about drymouth and halitosis when I wake up.  I believe I am a mouth breather when asleep, because my nose when lying done tends to be blocked on which ever side I sleep on.    When I go to the dentist I tend to overproduce saliva?     How do I prevent dry mouth at nite and coated tongue with halitosis???I am over 70, take no meds, very healthly except for a higher BMI than I would like.",
    "doctor_response": "Hello,Thanks for writing to us.Halitosis usually occurs due to poor oral hygiene maintenance,sinusitis.I would suggest you to get a thorough scaling done.Use Chlorhexidine Mouthrinses to gargle.Dry mouth may occur due to decreased salivary production.If necessary,salivary substitutes has to be administered.Take plenty of fruits as well as fluids.Habit breaking appliances can be used to prevent Mouthbreathing habit.Also get Malaligned teeth corrected through appliances.Also visit an E NT specialist to treat nasal blockade.I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes addiction to mint when suffering form anemia?\n\nI have all symptoms of intrinsec factor anemia I got iron inyections for long time and it did not help me much now I am getting so bad that I can not function I have ann appt with an hematologist en few days my concern is ... Why I am so attracted to mint that is becoming like an addiction? Is there some spetial prpperty in the mint leaves that could cure me Thank you",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Iron deficiency is known to cause pica.2. In this condition, patients are known to ingest paint, varnishes, mud etc.3. Mint could be due to pica. 4. On correction of deficiency, mint addiction should go.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful lump under the chest near the rib cage?\n\nim female 23 with a history of depression. i got attacked in september and have been taking 8 doses of solpadol to relieve the pian, only 8 months later i cant stop taking them. recently the last 2 months ive had a terrible pain where i have recently found a lump and am very worried as its painful. its directly underneath my chest in the center of my rib cage, its very painful, what could it be?",
    "doctor_response": "HI,Dear,Thanks for your query to HCM virtual Clinic.I studied your query in all the details put forth by you.I understood your health concerns about the Cause of itchy painful lump on your shin.Cause of the Painful lump under chest near ribcage-You had a history of attack/assault 8 mths back,due to which this pain started and still recurs, and for this reason you need to take Tab Salpadol.-Since 2 months,you have found a lump with terrible pain near the center of your rib cage under the chest.With this history,it seems that you suffer from -Epigastric Hernia with obstructed contents,mostly pre-peritoneal fat with necrosis, causing sever pain.ALERTS/Caution-AS this Lump would complicate to recurrent obstructions going in to strangulation and would cause more serious pain and abdominal emergency,I would suggest you to consult ER Surgeon ,who would give his Second opinion also and would treat it accordingly.This Epigastric hernia occurs in your case due to the trauma 8 mths back,which has increased the silent weakness or hole.Since last 2 mths you noticed this lump, by chance,when its contents got obstructed and only by severe pain you are worried  about it now.-As the its with very small duration, I would suggest you to Consult a ER Surgeon and get the physical examination and his Second Opinion on it.This would help you to plan treatment with your ER surgeon.Hope this reply would satisfy your query and worry with itIf you feel satisfied with this reply,don't forget to hit thanks and write excellent review comments,which would improve my rating for new needy visitors to HCM.Welcome for any further query in this regard to HCM.Have a good day.With Regards,Dr.Savaskar M.N.M.S.Genl-CVTS,Senior Surgical Speciailst",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest better treatment for rheumatoid arthritis\n\nhello doctor,, its sid frm chennai my mother got diagnosed rhemotoid arthrities before a year in her left foot..from that onwards we used some kind of tablets like(transdol,odis etc..)and one injection which is a steoroid.but stil my mother having pain so please suggest me i am confused about what i have to do... please",
    "doctor_response": "Hi, To give you proper medicine for rheumatoid arthritis we need to have your test reports like anti CCP, CRP, CBC,ESR. Please get those reports done and till then take over the counter pain killers. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Jaideep Gaver, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for gallbladder problem\n\nI found you on world internet in health magic the reason I am writing this to you. I feel pain right side near liver or pain could be Gallbladder. I went to hospital explained to the doctor he checked & got me ultra sound he did not find any thing, then I got pain after few weeks I went again he suggested me that you need MRI, he scanned my body with two injection in different timings he did not find any thing I ask him where the pain coming from? He did not say any thing My pain appears in the night around 3.30 or 4am. During the pain I stood up and walk to the bath room and come back to bed & pain disappears. You are experienced doctor would you please tell me what kind of problem is this. I have excellent health I don\u2019t smoke or drink I am 54 years old. What is the best way that I will take care in early stage before it goes worst I would very appreciate if you suggest me as you are experienced doctor. I will be very thankful to you. Regards, Jamal Abro Chicago Illinois Ph. 630-945-6727",
    "doctor_response": "Hi,You may have an endoscopic examination to rule out any lesion in esophagus or stomach or proximal duodenum. However, MRI must have excluded all possible and common causes of your pain.Hope I have answered your query. Let me know if I can assist you further. Wish you good health!Regards,Dr  Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does diabetes causes bruises on the right arm?\n\nI was diagnosed with type 2 diabetes earlier this year. My doctor wasn t happy that my A1C number only moved down .2 and started me on medication to lower my A1C more quickly. However when I finished work on Saturday, my upper right bicept was hurting and felt hot. Now I have a long bruise from the under side of my upper right arm to going to the top side of my lower right arm. Is this related to my diabetes or the medication to lower my A1C?",
    "doctor_response": "i have not seen such side effect of any antidiabetiac drug ...it has relation to exertion at workout ..please see orthopaedic at the earliest",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a shoulder pain after holding an electrical wire?\n\nI grabbed an electrical cord in the attic by accident. I couldn t let go, not sure how long I held on. Had left shoulder pain immediately & down my arm. I now have shoulder pain that isn t going away. I ve tried ice & Motrin. What should I look for as critical symptoms or should I be going to see a dr now?!",
    "doctor_response": "Hi, Possibly you have injured some shoulder muscles during electric shock. Start pain killers and physiotherapy and if there is no improvement in 2-3 weeks, Get an MRI of the shoulder. Showing a doctor is always better. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and pain on the toe?\n\nI have two questions - one, my large left toe swells up occasionally. It becomes red, swollen, is painful, and is warm to the touch. Do I have gout? Is it really concerning? #2 - My doctor says I have calcium levels that are a little high - 11.1. What can cause this and what is the significance?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The most likely diagnosis for your symptoms be gout. Gout typically causes pain and swelling in the big toe. However we have to rule out other conditions also. Get your serum uric acid level analysed. Consult a rheumatologist and he will direct you accordingly. As of now you can take analgesics like ibuprofen or Diclofenac for pain. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest discomforts, joint pain and headache?\n\nhi. 3 years ago i went on a night out with mates and took cocaine. the day after i got chest discomfort, nausea lightheaded i went to the hospital who done a ecg, blood test water sample and chest x-ray of which all come back normal. i have been in and out the hospital the past 3years they have never kept me in over night. my chest discomfort is not as bad as what it was i had it constanly when it first started now it comes and goes. i also get pain in left arm and jaw pain in both legs headaches dizziness do you think its heart related or anxiety",
    "doctor_response": "Hello, I understand your concern and would explain that your symptoms seem to be related to anxiety. Nevertheless, I would recommend consulting with your attending physician and performing some tests in order to exclude other possible causes: - an exercise cardiac stress test - complete blood count, PCR, ESR for inflammation - blood electrolytes for possible imbalance - thyroid hormone levels for thyroid gland dysfunction. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Due to rectal bleeding, I end up in anemia. How long can I take iron tablets?\n\nHello doctor, My height is 5'7\" and I weigh about 159 pounds. I am a male with anemia. I got a colonoscopy but they could not stop the bleeding, so I got a transfusion, and I also got another colonoscopy to make sure that the bleeding stopped. I have to get another colonoscopy between 3-6 months from the first colonoscopy. I went to see my primary care doctor and they gave me some iron pills to be taken for three months which are over the counter called Ferrous Sulfate. I went to see the gastroenterologist last month, and they told me to come back this month to make an appointment to get another colonoscopy. I cannot get in touch with my doctor right now because of the COVID 19. I wanted to know that if I still have symptoms of anemia, could I take some more iron pills or three months is enough?",
    "doctor_response": "Hi. You have mentioned that you had bleeding per rectum and you had gone for the colonoscopy. Can you share the report of colonoscopy so that I can know what was the cause of bleeding? It is perfectly safe for you to continue the iron medicines until the time you get an appointment with your regular doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cure for grand mal seizures with a history of HSV and partial hysterectomy?\n\nI have had at least 3 grand mal seizures in the past month and started Keppra after the first seizure and had a dosage increase after the 2nd seizure. No prior hx of seizure for me or my family,. I drink an alcoholic beverage about 2 to 4 times a year . I do have a hx of HSV 2 and partial hysterectomy. I am 46.",
    "doctor_response": "HI THANKS FOR POSTING YOUR QUERY.LET ME FIRST TELL YOU THAT THERE IS  VERY  CLOSE ASSOCIATION BETWEEN HERPES SIMPLEX VIRUS HSV2 AND GRAND MAL EPILEPSY.HSV IF INFECTS THE BRAIN CAN CAUSE HEMORRAGHIC  ENCEPHALITIS OF TEMPORAL LOBE WHICH CAN BE FORERUNNER OF A SEIZURE/CONVULSIVE ACTIVITY.SUCH SEIZURES ARE WUITE RESISTANT TO ANTI EPILEPTIC MEDICATIONS.ALCOHOLIC DRINKS ARE WELL KNOWN TO INCREASE THE SEIZURE ACTIVITY UNPREDICTABLY.I SUGGEST YOU GRADUALLY REDUCE THE CONSUMPTION OF ALCOHOL.IT ADVICE YOU TO GET AN MRI BRAIN-FAST SPIN ECHO BASED TO RULE OUT ANY ORGANIC LESION AS IT EARLIER MENTIONED THAT POSSIBLE WITH HERPES.CURRENTLY YOU ARE PLACED ON KEPPRA WHICH IS AN ADD ON DRUG FOR GRAND MAL SEIZURES.YOU NEED TO HAVE A BASELINE/FIRST CHOICE DRUG CALLED VALPROATE SEMISODIUM TO TREAT THE SEIZURE ACTIVITY.THE BEST POSSIBLE DOSE TO CONTROL THE SEIZURE ACTIVITY IS CHOSEN.SERUM DRUG MONITORING CAN BE HELPFUL.ONLY ADD ON DRUGS MIGHT NOT BE EFFECTIVE IN YOUR CASE AS IS EVIDENT FROM RECURRENT SEIZURE ACTIVITY.INCASE IF YOUR CSF TESTING/MRI REVEALED THE PRESENCE OF HSV,THEN ANTIVIRAL THERAPY WITH ACYCLOVIR HAS TO BE INITIATED PROMPTLY.YOUR BLOOD PRESSURE SEEMS TO BE IN NORMAL LEVELS,BUT CONTINUE RECORDING YOUR BLOOD PRESSURE AT FREQUENT INTERVLS.CONSULT AN EXPERT NEUROPHYSICIAN TO TACKLE YOUR ROBLEM.THANK YOU",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is diarrhea and blood in stool normal after antibiotic and pain medications?\n\nmy daughter had her wisom teeth pulled a week ago and was prescribed pain meds and antibiotic. She did ok with procedure took all of antibiotic and pain meds for 4 days. She has since had alot of stomach pain diarrhea and blood in stool. Is this common and how long will it last, she had these symptoms for 3 1/2 days.",
    "doctor_response": "Hi, Diarrhea is common side effect of antibiotic. But blood in stool is significant condition that we have to take seriously. Take Albendazole tablet and anti-diarrheal measures like ORS powder in boiled and cool water. I would suggest to meet your pediatrician to achieve these. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Pramod Kokare, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could swollen foot at the bottom with a knot and red streak coming from swollen area indicate?\n\nHi my name Angie. My friends left foot is swollen on the bottom were his toes are and it has a knot on it and a red streak coming from the swollen area. The red streak is about inch long and is getting bigger.Please  help any info will be helpful. Thank you",
    "doctor_response": "Hi angieFirst thing is to show to an orthopedist doctor.if there\u2019s history of injury must be questioned with patient.An X-rays or MRI may be advisable.Taking Motrin tabs thrice post meals daily and application of thrombophlebitis gel is indicated.keep foot elevated and avoid walking,use walking stick in opposite arm to take weight off the affected side.If it\u2019s post injury,hematoma formation is likely which should be aspirated and oral antibiotics must be takenSee a doctor he\u2019ll help with diagnosis and treatment wear elastic crepe strapping",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Had removal of myoepithelial carcinoma before three years. Can I have a recurrence of it?\n\nHi doctor, I had an extraction of two tumors of epithelial-myoepithelial carcinoma with a prominent dedifferentiated (high-grade transformation) myoepithelial component extracted from my nasal cavity before three years. MRI scans were performed to look for recurrences. In my previous MRI, I had a perfusion curve showing ascending plateau. I have significant weight loss for the past seven months. I have occasional nosebleeds with pain. I also have fever, sensitivity, and bleeding in the mouth palate occasionally. Currently, I am taking Iscador P series II injections three times a week, painkillers, and supplements. Please advice.",
    "doctor_response": "Hi. Please give your queries and concerns on pointwise. So that, I can answer them for you. I will point out the abnormalities present in the scan soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pimples under nose when having cold?\n\nMy child has a cold and doesn t wipe/blow her nose that well or thoroughly. She has suddenly developed a number of little pimples under her nose - surely there is a connection between these? Seems too big a coincidence. She is only 7 - she doesn t get pimples!",
    "doctor_response": "Hello. I just read through your question.The area under the nose often gets very dry during colds. This gives bacteria an opportunity to cause the pimples. I recommend using a moisturizer in the area, especially during colds. They will heal on their own.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is cyst of size 3mm a cause of panic?\n\nOur 23 year old grandson just told us he has a cyst in his throat - It is 3mm - How big is that ? and - since he is having check-ups once a month - I guess they are on top of it !?? His Dad (our 57 yr old Son died of lung, brain , kidney cancer on Christmas Eve last -- We are concerned.",
    "doctor_response": "Hi and welcome ot HCM. this is very small cyst and if this is not growing rapidly, then you dont need to be worried at all since malignant tumors at this age is rarity.  WIsh you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a painful hard lump inside my bottom lip?\n\nI am 19 years old and have been a smoker since i was almost 16. i have noticed over the past couple months a hard lump inside my bottom lip. its not sticking up like a pimple or anything but if you squeeze it on both sides you can feel it. my cheeks have had a lot of pain lately and my gum line has been bothering me. just wonderin if you could help me out with any good news thank you!",
    "doctor_response": "Hi Dear, Welcome to HCM.Understanding your concern. As per your query you have painful hard lump inside bottom lip is mainly because of frictional keratosis and perioral dermatitis of oral mucosa due to continous irritation from smoke fumes. I would suggest you not to panic about it. Stop smoke immediately to prevent exaggeration of symptoms as it could convert to a malignant oral lesion as well. Maintain oral hygiene by brushing and flossing daily. Do listerine mouth wash rinses.  Your symptoms will redolve in 10-14 days.  Drink plenty of water and have diet rich in multivitamins. Avoid hot, sharp , spicy food. Take ibuorofen if it is tender to touch. If symptoms keeps on persisting visit oral physician once and get it biopsied and examined.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is reason for getting cancer?\n\nMy wife had skin cancer and was sucessfully treated for that. The next cancer she got was colon cancer and she was sucessfully treated for that one. The next cancer she got was a Brain Tumor and she was treated for that one and it went into remission but came back about 4yrs later and she past away from it. Why did she get so many cancers?",
    "doctor_response": "These series of cancer suggest the presence of a cancer syndrome either cowden syndrome or lynch syndrome other wise know as hnpcc.These syndromes lead to improper dna damage  repair which  leads to cancer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant drooling and cold sores after a tongue-tie?\n\nHi there! My Grandson is two years old and his tongue is tied. He drools constantly and has frequent outbreaks of cold sores. He is easily understood when he speaks, but we all are wondering if we should get the surgical procedure done to release his tongue. What in your opinion is the easiest and least traumatic procedure for his age?",
    "doctor_response": "no need to worry, its a commen problem, if tonge tie doesn' t interfere with speech, and tongue comes out normally , no need of any operative  procedure",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes continued low grade fever in a child mean?\n\nmy 9 year old daughter has been running a low fever 99/100, off and on for 3 weeks. she s tired more then shes not. no other symtoms except mentioned pain in stomache once and a headache once, in this last 3 weeks. took her to the doctors, he said lets wait it out, may be a virus, but to call if the fever gets 101 or more. should I be concerned and what could this fever be from? thank you",
    "doctor_response": "Hi,If she is otherwise okay, we need not worry. Usually viral fever should resolve by 5 days, but occasionally do persist for 2-3 weeks, as in conditions like IMN (mononucleosis). Still, if I were your treating doctor, as it is already 3 weeks, after a detailed examination to look for enlargement of lymph nodes, spleen or liver, I would prefer to get a complete blood count and a peripheral smear get done. This will help us to be sure that there is nothing else going on. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam T. K., Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I cannot remember anything that I study. Is it a psychiatric problem?\n\nHi doctor, I am a male, who is studying medicine. From childhood, I was an average student. I got good marks in the 10th standard, but in the 11th and 12th standard, I got very bad marks. I do not know what happened, although I study for a long time. Still, I am not getting good marks. I got admission in a medical college, and my parents had to spend a lot for my admission. So, I thought to work hard and score good marks, but again the same thing is happening. I study full day, but I cannot remember anything. Even if I remember what I study, I am not able to recall it during exams. I get tensed when my teacher or friends tell me to explain some topic. Although I study it well, I cannot explain what I read, and I make many mistakes when I explain. Sometimes, when my teacher asks me any question, I get tensed and go blank. I cannot even answer basic questions. I failed in all internal exams, and only a month is left for my final exams. I doubt that I have a physiatric problem or this course is not fit for me. But, I want to be a doctor, but my\u00a0condition is bad. I do not know what to do. I feel that I have a poor IQ. These things happen only in studies. My personal life is super cool. Due to this problem, I am slowly losing interest in my studies. Can you please help me?",
    "doctor_response": "Hi. I read your query and understand your concerns. I hope this helps you.\u00a0Thanks and regards. For more information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can physiotherapy cure slight tear in anterior talo fibular?\n\ni am 17 , i m 170 cm tall and weigh 60 kgs . The question :- i sprained my ankle a year back and probably tore a ligament.At that time i couldn t get a specialist , but my family doctor advised me to take rest and do simple exercises which never helped.eventually the swelling came down and i started playing (basketball again) , after 9 months a visited a specialist and he asked me to start physiotherapy.After i finished my physio i had a little pain in my ankle. My doctor advised an MRI and an xray. The Xray said my ankle s normal but the MRI said that there was a tear in the anterior talo fibular. the doctor said its not a complete tear but if i did physio therapy it would rejoin it. The ankle still have a little swelling and it feel very uncomfortable when i walk fast.what should i do?",
    "doctor_response": "Hello, Minor tear will resolve with physiotherapist and immobilisation. Large tears may require surgical correction like arthroscopic repair. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain, General & Family physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pelvic pain, feels weak. Cervical cancer?\n\nHello Doctor..............I am suffering pelvic pain since a week..............i feel weak all the time.............i took morning after pill abt a month ago..............n most importantly i am 17 yrs old............is there a chance that i am suffering frm cervical cancer?? i dnt have multiple sexual partners........n my partner is nt suffering frm any sort of infection............pls help...........!!!",
    "doctor_response": "multiple sexual part is one of the risk factor for cervical cancer particularly when sexual activity started at earlier age as in your case. general symptoms of the cervical cancer is inter-menstrual bleeding per vagina(bleeding in between cycle of menses), post-coital bleeding( bledding immediately after sex not related verginity) discharge from vagina, pelvic pain, back ache. so in your case you should consult gynecologist and get your pelvic examination(PV/PS) Done to rule out cancer cervix. the fundamental thing now a days is HPV Virus as etiology of cervical cancer which is sexually transmitted disease from male to female.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling under armpit while having gland tuberculosis\n\nI am 34 years of age and recently diagonized with a gland tuberculosis. I had swellings under in left armpit for about two months now. What kind of medical intervention will help me? what caused in the first place? and what shall I do? Pls help me understand it better. Thankyou very much!",
    "doctor_response": "Hello and Welcome.Thank you for your queryAs you were recently diagnosed with gland tuberculosis,I am sure you are under treatment for the same.Regarding your worry about the swellings under your armpit,they are nothing but the swollen or enlarged lymph nodes due to tuberculosis.A lymph node is an oval-shaped organ of the lymphatic system, distributed widely throughout the body including the armpit and stomach and linked by lymphatic vessels.They become inflamed or enlarged in various infections and diseases,for example in your case,in tuberculosis.I recommend you to complete the course of your tuberculosis treatment,and check for the decrease in the size of those swellings. But if they still persist,you need to check it with your doc,he may recommend a biopsy for the same.Thank YouStay Healthy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can red rashes on knee and vertigo be symptoms of valley fever?\n\nI live in Tucson AZ and had valley fever about 15 years ago.  One of my symptoms was vertigo.  I now am having symptoms of vertigo (if I look up on straight down).  I also had a red, bumpy rash (not itchy) on the front of my legs below the knees.  I also feel fatigued, and malaise.  Could I have valley fever again?  I've heard you can get it again.",
    "doctor_response": "Hi I did review your concern. Tucson AZ is place where valley fever can occur. It is caused by Coccidiodomitis fungi. It generally presents as respiratory disease with fever.Vertigo is generally not seen with this infection. If you are experiencing vertigo I would recommend you to get yourself evaluated. Vertigo can occur due to inner ear or cerebellar or heart issues(light headedness). A neurologist needs to investigate your condition for that. The bumpy rash below your knee can be a manifestation of valley fever known as erythema nodosum. It can be confirmed by a punch biopsy.I hope this helps.Let me know if you have any more questions or concerns.wish you a very healthy life ahead.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a red rash on the penis be treated?\n\nHi Doctor, three months backs i got little bumbs in the base of my penis. I did research and kind of convinced that it is genetal warts. I applied tea tree oil and it was removed. After that i got a small red patch in the head of my penis (inside the skin) i applied tea tree oil there too. The thick red color become less, but visible. And i get little uncomfortable while peeing and little irritation. What to do?",
    "doctor_response": "Hi, Presence of irritating while passing urine if often indicative of urinary tract infections. It is also possible that tea tree oil acted as irritant to the urethral mucosa leading to inflammation. In my opinion it will be right to visit a doctor without delay for proper examination and treatment. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower abdominal pain\n\nI STARTED OFF WITH BAD STOMACH PAIN IN MY LOWER ABODMEN THAT LAST FOR LIKE A MONTH. THEN THE STOMACH PAIN TURNED IN TO FEELIN LIKE GAS BUBBLING BUT I DIDN T HAVE ANY GAS AND THAT LASTED BOUT THREE MONTHS. NOW IT FEELS LIKE THERES MOVEMENT IN MY STOMACH. I VE BEEN TO THE EMERGENCY ROOM TWO TIMES BECAUSE I M VERY CONFUSED BUT EACH TIME I HAVE WENT THEY HAVE SAID I M NOT PREGNANT. I M 22 YEARS OLD AND HAVE SICKLE CELL ANEMIA. I BEEN STILL GETTING A PERIOD BUT EVER SINCE THESE SYMTOMS I HAVE TOLD YOU ABOUT IT HAS NOT BEEN NORMAL IT HAS BEEN EARLIER THEN NORMAL. THEY ONLY LAST BOUT 3-5 DAYS BUT RESENTLY IT HAS LASTED 9 DAYS AND STILL GOING. LOOK I NEED SOME KIND OF ADVICE HERE. BECAUSE MY STOMACH HAS ALWAYS BEEN FLAT AND NOW I HAVE THIS GUT THAT CAN FROM NO WHERE. COULD I BE PREGNANT OR COULD SOMETHING ELSE BE WRONG AND DOCTORS ARENT LOOKING AT THE RIGHT THIS.",
    "doctor_response": "According to your complaints you might be sufferring from irritable bowel syndrome of some  kind of food intolarance to you. You can become pregnant.it has no relation with you abdominal complaint.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it to be concern about child yawning often?\n\nmy 5 year old boy started yawning several times during the day about 6 months ago. we initially thought it was just a tic and that it will go away, however, he still does. we also thought he needed to go to bed earlier, but that has not stopped his constant yawning either. i do not think this is normal and i wonder if i should take him to a pediatrician. any advice? thank you very much",
    "doctor_response": "Hi, this is a habitual thing, you need to counsel the child that he should not yawn repeatedly. As child grows this yawning will decrease, don't be too angry on child and counsel him with tenderness. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have decay in tooth, soreness and swelling in jaw. Taken amoxicillin. Will ice help tone down swelling?\n\nI have decay in my tooth. I cannot have it extracted until my INR is within range. I took ten days worth of amoxicillin and finished about a week ago. The tooth is extremely sore and the jaw is swollen below the tooth. I will be seeing the dentist tomorrow with the latest report on my INR. Meanwhile, OUCH!  Would ice be good to help the swelling go down? I don't know if I can stand the cold on the site.",
    "doctor_response": "Hi,Thanks for asking the query,Tooth pain indicates infection in the tooth, such type of infected tooth needs to be treated with Root Canal Treatment to save it permanently.I would like to tell you that antibiotics and analgesics will give a temporary relief, Drainage of the abscess is required.I would encourage you to visit to the Dentist and get the checkup an x-ray done, once the abscess is drained the swelling will be reduced.Hope you find this as helpful,Regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is knee replacement surgery recommended in case of cold and cough?\n\nI am due to have a total knee replacement tomorrow. I have a cold at present which is resolving slowly although I have started to cough ove the last 3 hours. I am 68 and otherwise in good health. BP 145/85. Cholesterol 5.1. Should I go ahead and have the surgery?",
    "doctor_response": "Hi, Knee replacements are done under spinal or epidural anaesthesia,cough and cold doesn't pose a problem for these type of anaesthesia but as a precaution we avoid doing replacement while the patient is having any sort of respiratory infection, so as to prevent the situation in which we need to intubate the patient with respiratory issues in case of complications arises. Secondly, there are high chances of lodging of infective agent at knee implant so it is always better to postpone surgery till the time infection subsides. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Rohan Shanker Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bleeding of gums?\n\nI am 23 old female ..doctor,while brushing day before I saw blood in my spit ..someone said it may be due to acidity but today again the same thing happened .. what can be the reason doctor ..??? and as far as my health is concerned I am perfectly fine",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your query blood in spit on brushing can be due to causes like gum infection and inflammation leading  to Gingivitis..As you brush your teeth the gums gets stimulated leading to bleeding.. This can be the most common cause..If it would be due acidity then it can be associated with other symptoms like heartburn..I would therefore suggest you to consult an Oral Physician and get evaluated and a thorough clinical evaluation can help..In case of gum infection Scaling of teeth followed by gum paint application can help..Do warm saline gargles..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I hit my forehead against a wall and got a scar. Can I treat that scar?\n\nHello doctor, I hit my forehead against a wall and had a small cut on my forehead and now it has healed and it looks like a scar. Will I have a permanent scar?",
    "doctor_response": "Hi. First, you need to understand that scar treatment depends on its depth and lenght. Whether your scar is permanent or not, it is very important to evaluate it. Mostly scar lightens and becomes equal to the surrounding skin with passage of time. However, scars which are deep becomes permanent. Such scar will not go away with any creams or gels. Best treatment for permanent scar is reversal by plastic surgery or it could recover to some extent with C02 laser.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for pain in the left iliac region\n\nhi. i m 31yrs female. i hv pain in my left iliac region which is dull n heaviness like n severe in evening. it is since abt 4-5months n nw it is localised .i hd LSCS 5yrs back n hd wound infection also. my usg n CT r normal except for minimal free fluid. kind adv diagnosis n treatment.",
    "doctor_response": "You must go for some exercise like pelvic briding .lower trunk rotation abdominam setting and stretch your hamstrings ,iliopsoas and glutes.Do iceing 10 min 4 time a day along with any calcium plus vitamin d tablets",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe peanut allergy, carbon monoxide poisoning. Related symptoms?\n\nHello, Just recently my son was admitted to the hospital with a severe peanut allergy reaction and at the same time they detected a very high level of carbon monoxide poisoning in his system. We had the apartment tested and there were no signs of CO in the apartment. They then said that there was probably a miss reading of the level of CO in his body, however how is this related to the severe allergy reaction that he had with the peanuts?",
    "doctor_response": "Hi cia-fmly, Thanks for writing to us, Generally there is no relation between CO level and peanut allergy you have stated above, The symptoms for peanut allergy could be different for different persons, An allergic response to peanuts usually occurs within minutes after exposure, and symptoms range from mild to severe. Peanut allergy signs and symptoms can include: 1)Skin reactions, such as hives, redness or swelling 2)Itching or tingling in or around the mouth and throat 3)Digestive problems, such as diarrhea, stomach cramps, nausea or vomiting 4)Tightening of the throat 5)Shortness of breath or wheezing 6)Runny nose. 7) sometimes it may lead to anaphylaxis Carbon monoxide level in the body could have increased due to exposure to pollution , since our blood absorbs more % of CO than Oxygen easily . But since you have said that there  were no chances of such , I think the report has to be reevaluated . I hope this was informational and wishing a good health to your son, Dr.G.Gayatri devi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the bend in penis be due to excessive masturbation?\n\nsir due to masterbaton before marriage my penie is bend is any treatment to sraight the penie my married life is good and also have child but i have promblem that my penie is not hard during intercourse and i get discharged in 5 to 10 stocks i cannot do sex morethan one minute sir iwant to increase my sex time duration so pls help suggest me any medicine or technique",
    "doctor_response": "Hello, Masturbation considered as the last cause of bent penis or early ejaculation or erection issue. It can be due to hormonal issue, varicocele or anxiety. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "With the below kidney ultrasound report what could be the cure for blood in urine?\n\nTHE RESULT KUB ULTTRASOUND: The kidney are normal in size and echotexture, with good cortico-medullary defferentation. the right kidney measure 10.5 x 4.9 cm, with a cortical thickness of 1.3 cm. the left kidney measure 11.5 x 4.9 cm, with a cortical thickness of 1.1 cm there is moderate dilatation of the left pelvocalyceal system and visualized left proximal ureter. The right pelvocalyceal structure are intact, there is small exophytic cyst in the inferior pole of the right kidney measure 2.62 cm in diameter. No lithiases or solid masss demonstrated. the right ureter is not dilated. The urinary bladder is minimally-filled with no intraluminal echoes. Prevoid urine volume: 10cc IMPRESSION: MODERATE URETEROPELVOCALIECTASIA, LEFT - SUGGEST CT STONOGRAM SMALL RENAL CORTICAL CYST, RIGHT KIDNEY What is the possible treatment to cure my blood in urine?",
    "doctor_response": "Probably you are suffering from obstruction in ureter. cause for obstruction could be stone stricture or compression from outside. You should undergo CT scan for further management. But mostly your condition is curable . all the best. If you have any questions feel free to contact me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Want lower molar, front lower teeth replacement. Is there any non-invasive, non-surgical method of replacement?\n\ni have my I lower molar of both side and front lower teeth except canines missing since 1 year when i got them extracted due to severe caries. i showed to may nearby dentist for the replacement but either they suggested me for the fixed or implant treatment. but i dont want any invasive procedure. when think of removable, its very cumbersome to adapt and adjust that initially. me confused, is there any other option available apart from this becoz i really need immediate replacement that too non invasive and non surgical. plz help",
    "doctor_response": "Hi The number of missing teeth are more than what would be advised for a fixed partial denture. ideally implants would be the best solution for your problem. with newer techniques the implants are placed witha simple punch cut in which only the spots where implants have to be placed is punched out. Extraction on the other hand is a much bigger and traumatic procedure than this. Still if you do not want implans then you have only 2 options: flexible dentures and cast partial dentures. Flexible dentures are easy to adjust but cast partials are more stable and better for the health of the remaining teeth in the long run. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for loose stool\n\nHello , my baby is 14 months he has an The common cold , runny nose ,occasionally febrile ,loose stool for a week now. He just started the nursery , I want to know what I can do to help with his loose stool? He is not lethargic, well hydrated, still has a good appetite , fever reduced with paracetamol. He as two to three soiled diapers a day with loose stool which is sometimes green and very mal odorous . What can I do to help with his loose stool?",
    "doctor_response": "Hello. Thanks for asking Healthcare Magic. It seems that your baby has got infection of the gastrointestinal tract. I would suggest to start with an antibiotic like norfloxacin/metronidazole 100/120mg per 5ml. 2.5ml two times a day and lactobacillus sachet two times a day for 5 days. Oral rehydrating solution throughout the day in small sips. Hope this helps. Thanks and Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Increased bone pain, weakness and PSA level. Suffering with prostate cancer. Using Honvan. Suggestions?\n\nDear SirMy Dad is suffering from Prostrate Cancer from the year 2008. My Uncle , a doctor, had kept him in good condition by the medicines Kalutite , now replaced by Honvan .But todays PSA test shows around 850. .Last week he had severe bone pains and tremendous weakness.We are monitoring his food completely with more fruits & vegetables, green tea, Parsely ,carrot juice etc.Is there any way now to reduce the PSA level? Please help me out sir",
    "doctor_response": "Hello.Unfortunately PSA levels are very high.These levels of PSA with bone pain probably means that his father has multiple bony metastases. Besides of hormonal treatment- is right the drug that you refer-it is important  use of opiates derivatives to control pain . Please consult your local doctor for a prescription. In this case, because of their very high levels of PSA,the treatment is only palliative,is not curative. I wish you good health. (If the answer has helped you, please indicate this)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bleeding through hard palate\n\ngood night doctor. I'm a dentist, general practice from indonesia.  Before I'm sorry if my english not good. I want ask about bleeding from hard palate,it will be difficult for respiration while patient got torus palatinus operating procedure. how to manage the bleeding? thank you for your answer. drg.sayid azhar from ugm yogya.",
    "doctor_response": "Hello, thank you for consulting with HCM.there are many ways to control the bleedingfirst you can apply a cotton of anestesia.second you can use medications like streptochrom local application, ethymsylate and trenemesic acid.these you can use with a gauge and even you can use suture also.Hope it will help you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is a PCOS patient noticing blood on inserting finger though missed period?\n\nHello doctor,I have not had periods in three months due to PCOS (polycystic ovarian syndrome). Recently, I had a burning sensation while I urinate. I had couple of pictures taken and I realized I bruised myself while showering because my nails are long. Yesterday, I had some cramps like period cramps, checked for a period, there was none. I used my finger to check and saw blood, so wore a safety napkin throughout the last night while asleep and woke up with nothing on it. Inserted my finger again this morning and I still see little blood. What is the issue?",
    "doctor_response": "Hi. I have read your concern. I presume you already know that PCOS causes your irregular menstrual cycle. And it can also present like very scanty bleeding or just spotting today then nothing at all the following day, it is called oligomenorrhea and it is part of the PCOS. However, with the history you have told, you have long fingernails. It is also possible that you have caused a little scratch to the vaginal mucosa that would have caused the mild bleeding. I suggest you set an appointment with obstetrician and gynecologist to prescribe you with pills to regulate your menstruation. In the meantime, if the bleeding is just mild, you need not worry about it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe abdominal pain on the lower right side\n\nMy daughter is 12 and has been suffering with what the gastro doctor calls IBS (only with constipation) for the past 2 years. She goes through bouts of severe abdominal pain which always goes undiagnosed at the hospitals. The doctors always send her to the ER for possible appendicitis. It never is. Well now she is suffering abdominal pain in her lower right side of her abdomen and in her back in same general area. It hurts to stand, cough, lift her arms, bend over and the pain is constant over the past two days. She feels it is getting worse. However, she is still eating and has no fever (two symptoms the doctors at the ER said she would have are fever and loss of appetite as well as pain so bad she can t sleep). She slept last night although she said she woke a few times but went back to sleep. My question is, should I take her to the ER again or wait to see if she gets a fever? I never get answers at the doctors or hospital as to diagnosis, so I only know what it has NOT been in the past, and she has never had appendicitis.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. IBS (irritable bowel syndrome) is a functional bowel disorder. That means there is no underlying pathology detectable in bowel but bowel isnt functioning well. It may be due to abnormal sensitization to normal bowel function and may be it is recognized as painful by brain wrongly. The child needs change in diet in form of increasing fibers in diet i.e. roughage and increasing physical activity and outdoor sports. Avoid fast foods and unhealthy ready made food. increase salad and fruits in diet. Adequate water intake should be there. Please do ask your doctor for dietary counseling. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bed wetting\n\nHi doctor,My son is 13 yrs old.he is suffering from bed wetting since birth.he feels thirsty so he drinks lots of water in day & night too. what to do.pls guide me. Regards . Rekha",
    "doctor_response": "Hello, Welcome to HCM,I understand your concern.Bed wetting at the age to 13 years is not normal and we have to do something for that.You should start with home measures initially.Ask your son not to drink fluid, water, caffeine containing drinks like cocacola, thumpsup, pepsi, tea, coffee two hours before going to sleep. Ask your son to empty bladder before going to bed.Some children exhibit some sign just before wetting the bed like restlessness. If you pick up this sign during night, wake up him and take him for bathroom.Never scold your son for wetting the bed. Bed wetting may be a sign if the child feels emotion or social insecure. Take your child in your confidence. Tell him that bed wetting is not good and you are going to help him get rid of this.During day time, ask your son to hold urine as long as he can and than go and empty bladder. This kind of \"bladder exercise\" will enable him to control bladder.Try these measures for 2-3 months. If they are working, go ahead with them.If they don't work, You should consult psychiatrist or pediatrician. Medicines are available for bed wetting like Imipramine & desmopressine and they are highly effective but they can only be prescribed by a doctor.I hope this will helpful.All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for throat cancer?\n\nDear Doctor, i am an 18 year old female. I do not smoke ciggaretts, however i occasionally smoke black and mild cigars.i smoked my first one back in november ( about 4 months ago) but i didnt smoke them a lot until a couple of months ago. not every day. maybe 2-5 a week. and not every week. i do inhale them though. ive recently decided im not going to smoke them any more because im terrified i have developed throat cancer. ive had a very sore throat the past few days. and ive been getting headaches. my neck is very stiff and sore. my glands are swollen. i went to the doctor and she said i possibly have a sinus infection and put me on an antibiotic, im hoping this is what i have. my good friend also has mono, she said i could possibly have that, but it is too early to tell. what i am wondering is since i do not smoke very often, is it possible i have throat cancer? or another type of cancer?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some upper respiratory tract infection with enlarged lymphnode.  At your aga throat cancer is very rare. You have history of smoking but with this short history of smoking it will not cause cancer. You should take a course of antibiotics like azithromycin or amoxiclav. Don't worry about cancer. Just be relaxed. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dark patches under armpits, between thighs. Temporary relief from ketoderm gel, pevaryl emulsion. Solution?\n\nGood evening doctor I have dark patches under my armpits and between my thighs specially during summer when I sweat. I ve been using Ketoderm gel and pevaryl emulsion from time to time. The patches diminish but they come back after a certain time. Someone advised me to take terbifin tablets. Can i take them because I have stomach upset (acidity). Can u please help me . Thank you. From Anne",
    "doctor_response": "hi Anne..thanks for your query If you suspect fungal infection happening repeatedly, it is important to do a scraping and culture to confirm the diagnosis and know the exact type of fungus .Terbinafine is not effective on all types.Although not common, it might cause diarrhea, stomach upset, or temporary change or loss of taste.Possibility is of : -T.versicolor, also a fungal infection.This is more common in hot, humid climates or in those who sweat heavily, so it may recur each summer. -Intertrigo is a yeast infection of skin folds caused by Candida albicans. In areas of the body that have skin touching skin such as the armpits, groin and under breasts or fat folds the environment is warm and moist.Intertrigo is characterized by an  red, macerated patch with scaling on the edges.Repeated infection might give rise to brownish post inflammatory hyper pigmentation. Hope this is helpful to you..Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tightness in chest\n\nHi, for about 4 days to a week I have had a tight chest and a cold feeling in the back of my throat. The chest tightness moves around or even goes away sometimes but for the most part it in the base of my lungs or sometimes a bit lower than my rib cage. Right now it's directly in the centre of my chest, It also feels like something needs to be cleared from deep in the back of my throat every so often when I breathe in. I do or did smoke. I've made a conscious effort to stop but it's only been a couple of days. I'm worried it's something very serious. I have suffered from anxiety for over a decade but I'm well attuned to that to identify that it isn't the issue here. At least I don't think it is. This has kind of sprung out of nowhere as I was fine a week ago. I'm not under any stress. I thought it might be reflux but I don't know. I do suffer from that also but have never experienced anything remotely close to this. Any help would be greatly appreciated.",
    "doctor_response": "Respected user , HiThanks for using Healthcaremagic.comI have evaluated your query thoroughly .* This is in relation with underlying bronchitis .* Suggestions for better recovery -  X-ray chest with primary laboratory work up of complete blood counts    with ESR .-  Proper antibiotics with decongestants to clear the respiratory tract from   mucus plugs -  Strict dietary regimen  -  Avoidance to excess cold -  Inhalation of vapors of boiled water with added tincture benzoin  with     blanket over the head -  Use of corticosteroids , bronchodilators in selected cases -  Life style modifications  as    Walking in fresh air , avoidance of smoking, alcohol    Deep breathing exercises , YOGAHope to clarify  your query Welcome for further assistance Thanks for using Healthcaremagic.com & giving opportunity to assistWishing fine recovery Regards dear take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can social anxiety disorder be treated?\n\nI know I have social anxiety disorders. not because some or a dr. has told me so but I pretty sure I know how I fell in certain situations around people or public events. I m 46 years old and I have live a pretty well life on my own but always hiding behind my true emotional problems and seems like the older I get the harder my feelings are . but I need serious help with my disorder now and wish I didn t but don t know what to do about it. I m married, with no children but suicidal thoughts have always been there but seem be to more now, but only because it doesn t seem to matter at age any more, is there real treatment out there that doesnt cost an arm and a leg that won t discourage me from seeking advice. I do have insurance",
    "doctor_response": "Dear userWe understand your concernsI went through your details. Social anxiety disorder is a chronic mental health condition in which social interactions cause irrational anxiety. For people with social anxiety disorder, everyday social interactions cause irrational anxiety, fear, self-consciousness and embarrassment. Symptoms may include excessive fear of situations in which one may be judged, worry about embarrassment or humiliation or concern about offending someone. Talk therapy or psychotherapy and antidepressants can help increase confidence and improve ability to interact with others. I suggest online psychotherapy and counseling. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the treatments post surgery for Chari malformation ?\n\nHello, my name is Cathy. My son had Chari malformation and had to have surgery because the form he had was blocking the flow of his spinal fluid. My question is would he be able to lead a normal life? He wanted to join the Navy but is have such a hard time because of the surgery.",
    "doctor_response": "Hi, Welcome to HealthCareMagic.com  I am Dr.J.Mariano Anto Bruno Mascarenhas, and I am here to help you. I have read your question with care and understand your concerns.  Once the Obstruction has been relieved, those with Chiari Malformation would be able to lead a normal life and even join the Navy and serve the nation. Hope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.Best Wishes for Speedy Recovery Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for abdominal pain\n\nHello my name is Crystal and i have been having pains in my stomach in the middle where my ribs are and it can really hurt and right before i almost fell asleep it felt like somebody shoved something there and it got stuck then i rolled on my back and i was fine i have a little pain on the left but more on the right can feel sharp i had my gull bladder taken out a year ago and my heart rates sometimes as if its pounding almost out of my chest and it really only seems to bother me a lot when i lay down most of the day i'm fine can someone help me???",
    "doctor_response": "Hi Crystal.Thanks for your query. Read the history and understood the problems. You have a typical history of severe pain in the abdomen where the ribs are. As if somebody shoved something and it got stuck there, got alright when you rolled back. Pain is more on the right side where your gall bladder was and has been removed 1 year back. The probable cause of sudden and such a severe pain can be due to Volvulus of the StomachBile duct stonesIntestinal obstruction.I would advise you the following:The only specific investigations which can help you are:Barium studies for the stomach in head-low position to see for stomach volvulus.Upper GI endoscopy can helpColonoscopy and CT scan of the abdomen are done to rule out other probable causes. If volvulus of the stomach, simple stitch to fix the stomach to the anterior abdominal wall can help you the best and on permanent basis. Rest of the treatment depends upon other probable diagnosis if made.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could a lump in armpit mean?\n\nHi, I am a 23 year old male in good health.  Recently i noticed when I lift up one of my arms and feel around my collar bone near where my trap would be their seems to be an elongated lump on both sides.  It doesn't feel like any lymph nodes I have felt in the past because they are both long and pretty skinny.  I cannot feel either lump if my arms are hanging down, only when they are elevated even with or higher than my shoulder.  I was just wondering what this may be.  Thanks.",
    "doctor_response": "Hi,Dear,Good Morning from India.Thanks for your query to HCM Virtual Clinic.-I studied your query in depth.I understood your concerns.-In my opinion-you may be suffering from -anxiety and obsession for the armpit lumps.-From the facts given from your query,I feel your armpit  is normal and healthy-as claimed from you.-Still to remove the worry-I would advise you to consult your doctor who would clinically check up the probabilities of the lumps you suspect.Hope this would help you to discuss with your doctor on your visit.Wellcome to HCM again for any more queries.Have a Good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause cold hands for a person having heart arrhythmia?\n\nI am 64 no medical conditions, I don t drink alcholic or take caffine I am not over weight and not smoked for 14 yrs. I have been having very cold hands for many months, developed heart arrythmias about two months ago intermitently But now having palpations of the heart at all the me.",
    "doctor_response": "Sometimes when you have arrhythmia,  in some variety there is decrease in effective  blood pumped from your heart and decrease perfusion of your hands and feet resulting in cold hands.  It is important to know what type of arrhythmia you have,  a simple ekg and sometimes a 24 holter test is required to know the type,  after the results you should be put on specific drug to prevent the arrhythmia and henceforth your palipation Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swelling in finger\n\nMy right index finger has been swollen for a last 3 month now. the knuckle is painful to the touch, but i m not able to bend it. Any ideas what it could be?? i also had a X ray but nothing came out of that. I went to a Bone specialist he recommended me to take IBUPROFEN thrice a day for 2 months. Is it the feasible option?",
    "doctor_response": "hello,I have studied your case .You can take brufen for pain relief but i think you should reach at some diagnosis also. I mean you should not what is the cause of this and then you can treat the root cause.   Most probably it is tenosynovitis or trigger finger. An good orthopaedic surgeon can examine this and confirm the diagnosis. I hope then you can take treatment in form of steroid injection. I hope this answer will be useful for you.Let me know if there is any other followup questions.'thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having pain at the base of my tongue where it attaches to the front of lower jaw?\n\ni have pain at the base of my tongue where it attaches to the front of the lower jaw. the soft tissue there. as if i had stuck my tongue out too far. which i didn't do. it just started out as a simple soreness to now it bothers me all the time. it's been several days now. i thought it might be a canker sore but i don't see it.",
    "doctor_response": "Thanks fro writing to Health Care Magic...!I would firstly recommend to perform a radio graph (IOPA / OPG) to understand the underlying pathology. Instead of providing you with various simple to complicated reasons and confusing you more.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome nervousness and lack of confidence?\n\nHi, I am Haran (24 years old) doing MBA at Bangalore. I feel that I am running low in self confidence and self worth. I feel that I do not have any attitude at all and tend to forget what I am going to say when sit for interviews due to nervousness. What can I do ?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Self Confidence, as you already know, cannot be purchased. Also no body can give you self confidence. What we can do is to motivate you. Even if somebody motivates you, you should be able to take the positive points out of it and become self motivated. I mean to point that self motivation is always key for self confidence. You are actually fearing your inability. You are over seeing your abilities and worries about those inabilities which should be made abilities if you try to make it should be made. You have all the abilities and you just have to know them Introspection should help you.If you require more of my help in this aspect, Please post a direct question to me in this URL.  Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain after having intercourse?\n\nhi, i have been having really bad abdominal pains since saturday morning, and it started the day after having intercourse, its not constant but comes and goes, but when it starts its extremely painful and because its been four days im getting a bit concerned about it! is it normal?",
    "doctor_response": "Hi.Thanks for your query. The pain in abdomen has started after intercourse.The most probable causes are :-Ovarian and /or Fallopian tube problems.-PID-Pelvic inflammatory Disease.-Intestinal obstruction.-Cystitis with urinary tract infection.I would advise in such a patient the following:-First of all consult a Gynecologist for per-vaginal examination as this physical Ultrasonography of the abdomen-X-ray of the whole abdomen in standing position.-examination by a Doctor can get far more information than any investigations;-Tests of blood, urine and stool.The treatment will depend upon the diagnosis hence made. Till then take plenty of oral fluidsNo sex related activities till you are diagnosed and cured.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why my gums are inflamed, red and painful post tooth extraction?\n\nI had tooth #30 extracted 4 weeks ago and since then I have been in a lot of pain. The dentist cut the tooth out and had a hard time doing it. I was put on antibiotic of clindimyicin . Now where the tooth was cut the gums are inflamed red and painful. I also have bad ear pain and headaches. What is wrong?",
    "doctor_response": "Dear user,Thanks for using healthcare magic.I had gone through your query and understand your concerns.Don't worry it can happen sometime,it may be dry socket,You should gargle with salt water,and clean the wound,it help wound heal proper,You should take antibiotics and painkiller,and don't be stress,You need to visit your dentist,so he or she assign you proper treatment,wish you good health,'Hope I have answered your query. If you have any further questions I will be happy to help\". Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment should one take to get rid of dark circles ?\n\nMy skin colour is dark and also have dark circles my age is 18 i need glow and fairness in my face",
    "doctor_response": "Dear Prince, Thanks for choosing HCM the causes of dark circles are different from other pigmentations on face. the common causes are stress, lake of sleep, excessive sunexposure, uses of glasses etc. so to overcome from this problem, you have follow some common intructions along with medications 1. sleep cycle shd be proper 2. change life style - exercise, stressfree life 3. Kojic acid application at night 4. morning sunscreen hope this will help u",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause and remedy for positive HBsAg post treatment ?\n\nhi!i am having hepatitis B since 1994.Ten months back i started allopathic medicine Tenvir.After treatment my viral DNA & HBeAg are negative but HBsAg is still persisting.Two months back I also started LIV 52 Hb along with Tenvir but HBsAg is still positive.I am 43 yrs & having no general problem.My LFT remains normal.I take alcohol thrice a week.How to get rid of HBsAg.Due to TENVIR i am suffering from muscle & joint pains frequently.Should i stop Tenvir now & continue liv-52 Hb.Please advice me.I am worried now about liver cirrhosis etc.",
    "doctor_response": "Welcome to HCM Dear THE surface antigen remains positive for long periods , and if you keep on taking alcohol it will be very harmful for hepatic cells HBeAg [envelop antigen] may become  negative but you still have hepatitis virus in your blood , you did not write that what was your viral load prior and after treatment with tenvir you can take dry extract of Phyllanthus amarus [trade name Nirocil] in dose of 1 tab tid if you want to shun tenvir it has been proven with modern study that it has got anti viral activity and it chek the replication of viruses By Ayurveda it can be treated with very good results Aim of treatment in Hepatitis -B is two folds 1 neutralization of toxins secreted by viruses along with stoppage of viral replication 2- Regeneration of hepatocytes with herbs witch contains growth factors as well as anti-oxidant effects some of Ayurvedic herbs contains interferon which is strong viral inhibitors and there is not intolerance as compared to synthetic ones DR SHAILENDRA NAITHANI www.ayurvedadivine.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for difficulty in concentrating despite taking Vyvanse\n\nI can not concentrate in class or while doing my homework. I was prescribed Vynase (sp?) 30mg. It worked at first but for only a couple of hours. I believe my adhd is more severe than I originally thought. I am 44 female weigh 180 and am going back to school for my bachelors degree.",
    "doctor_response": "Dear userWe understand your concernsI went through your details. Lisdexamfetamine is a prodrug of the central nervous system stimulant dextroamphetamine, a phenethylamine of the amphetamine class that is used in the treatment of attention deficit hyperactivity disorder and binge eating disorder. I think you are troubled with ADHD. Treatment for attention deficit hyperactivity disorder (ADHD) has two important components \u2014 psychotherapy interventions (for both the child and the parents; or the adult with ADHD) and medications. There is a significant amount of research demonstrating that medication alone won't help address all of a patient's attention. So Psychotherapy is needed.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Tramadol a good medication for lower back injury with sciatica?\n\nIs tramadol a good medication for lower back injury with sciatica, I guess it would be chronic, since it has been almost 7 months now. I have been to phys. therapy, and also a Functional Recovery Program that deals with chronic pain. I have been prescribed Norco originally up until I started FRP. My new doctor frowns on the narcotics, and has prescribed various meds to deal with the pain and sciatica, Flexeril, Celebrex, and now Gabapentin. None of which works for me as well as the Norco. I just want some relief, I can t stand being in pain all the time. Can you give me any suggestions?",
    "doctor_response": "If you have tried those medication . I think now you should try tab piroxicam od . as i t is long acting medication a well it not metabolised by kidney . this is good for chronic pain becoz you have to take this once a day. Along with this You can take caps flupirtine  three times a day.This medicine alter the pain perception centrally .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain, feeling of fullness, hiccupy belch. Suggestion\n\nMy daughter is 16 years old and has been suffering from upper abdominal pain, sometimes right in the middle of her abdomen and sometimes under the ribcage. Her discomfort/pain ranges from a feeling of fullness which includes feeling like she has alot of trapped air or gas, to more of a sharp, stabbing pain. She tends to get this feeling more after she eats. She also has been having a tendency to emit a sound that is as best I can describe as a loud and forceful \"hiccupy\" belch. I have asked her about the appearance of her stools and she says they seem normal in consistency and color. She has been to her doctor and he put her on a generic prescription of Prevacid as he thinks it may be some sort of reflux condition and she has been taking it for about 3 weeks with no noticeable improvement. Her doctor also ordered an abdominal ultrasound and the results came back normal with the exception of a polyp on her gall bladder which the doctor's office said was nothing to worry about and would not be contributing to the symptoms she's experiencing anyway. I should mention also that although she has not had any vomiting, she often feels queasy (especially in the morning) and her appetiite has diminished somewhat. Our next step is to have her get an upper GI to determine what is going on. Could you please give me your professional input as to what you think her symptoms are pointing to?",
    "doctor_response": "Hello ronniekay,When the complaints are in the abdomen, you think that the problem is in the organ level. Very often it need not be the case. You have not mentioned in the long letter, since how long your daughter is having pain in the abdomen. This is an important missing link to connect her present symptoms to any possible cause.After all possible investigations also, if you find that nothing is evident to produce this pain, then also such pains and belching are possible. Since she is a very young girl, a lot of sensitivities are possible both in the mental and physical levels. In my practice a number of children have come with similar abdominal problems after being ridiculed publicly in the school by teachers, after failing in exams which they thought would win, after losing a close friend either by transfer or death and after innumerable emotional conflicts of similar nature. You have not given the details about her mental make up, her peculiarities in the mental level, her reactions to her life situations etc. which are essential to analyse her problems. In Psychology such abdominal complaints occur if she has a problem in the mental level that she cannot 'digest'. You have to probe whether she was abused by somebody immediately before the onset of her problems.Therefore my advise is to take her to an expert Homoeopath who will take her case in detail, analyse her symptoms in the light of her mental and physical make up and find for her the genetic constitutional remedy which will not only remove her present symptoms but also will keep her free from such sufferings in similar circumstances in future. Any amount of investigations need not always give any evidence for the pain. Please do not give her any more chemical drugs to relieve the symptoms of pain, belching etc. without understanding the totality of her problems. My best wishes for a rapid cure through the safe and simple medicines of HomoeopathyDr. C. J. VargheseHomoeopathdrcjvarghese@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can nestum be fed despite loose motions?\n\nMy 5 month old son is passing loose foamish green motion since 10days for nearly 4times every day..my doctor earlier prescribed colic aid and prowell..Since there was no improvement,she suggested for stool test and gave Taxim O to start..The stool report shows presence of mucus and puss.the Dr has told to continue Taxim O.though the color has changed from green to yellow,it s still watery.The dr has prescribed to continue Taxim O and also give Nestum( food supplement)is it ok to give Nestum to my breastfeeding 5 month baby at this time ?will it make the stool semi solid?",
    "doctor_response": "Hi dear Welcome to the HCM,Yes! Nestum can be given during loose stools, it helps.Stool culture is the best investigation to get the exact bug causing problem,accordingly antibiotics are given to get the proper relief in symptoms and also eradication of the infection.Taxum O is a good antibiotic for the dysentery, but it self it causes some loose stools.Hope the loose stools will be better after the antibiotic is stopped.Along with the Nestum baby can be introduced some rice dal water during such situation. thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Ranitidine good for high blood pressure?\n\nI want to know if ranitidine is good for high blood pressure treatment? My mom has high blood pressure but tabletes like captropril cause headache and nausa, but she face to none of these side effcets when using raninitine ( of course she take ranitidine for stomachache). Many thanks",
    "doctor_response": "Hello dear and thanks for posting your query here.Ranitidine is not for high BP, it's for acidity that's why your mother is feeling better with this tablet for her headache and nausea.But is she has high BP, then she must take some medicine for lowering it. For this, please see your doctor for some BP lowering medicine other than captopril.I hope this information would be of help to you.Thanks and all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to get pregnant after an abortion. Taking primolut. No periods. Can I take clomid?\n\ni had an abortion 4months back after 21wk of conception. Now i'm desperate to get pregnant and went to a doc and was adviced to take primolut for 5days and then wait till i see my periiod and take clomid after the third day of my period. I haven't seen my period 2mnth and still not seen it. I discontinued the 5days primout regimen in 3days hoping to fasten things a bit. But no period still. I was wondering what would happen if i take clomid with out expecting to see my period.",
    "doctor_response": "Hello. Thanks for writing to us. Since your periods are delayed, there is no use of starting with clomid now. You need to have a regular periods or at least a withdrawal bleeding to start with clomid from day 2 of your cycle.I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal ,drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for constant cough at night\n\nmy 6 yr old son has constant cough at night, which we believe is triggered because of acute gas/acid formation in stomach. Cough subsides after constant rubbing of back to get burps. He vomits sometimes which gives him relief from the cough. Which speacialist should i consult for treatment?",
    "doctor_response": "Hi.... nocturnal cough is usually suggestive of wheezing. At this is this age could be a starting stage of asthma. I suggest you consult paediatric pulmonologist regarding this.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I tell my parents and doctor that I have been suicidal ?\n\nHow can I tell my parents and doctor that I've been suicidal ? Latley I've been having suicidal thoughts for over a week now. This isn't the first time. It's happened months back and it's only gotten worse. I've been laying around in my bed trying to sleep to make the day go by faster. Some days I over eat and others I don't eat at all. I used to be a obsessed with my phone and the internet. I barley go on them anymore. I've found a method to commit suicide and I wanna get help before it worsens. I've been emotionally abused for a year now by my ex & it's continued. Other problems in life have developed into a big picture and I can't cope with anything anymore. I just need some way I could tell my doctor and my parents. They've made me stop talking to my ex months ago but I did it behind their back. Will I be able to confide in a psychologist if my doctor refers me to one? How can I tell my mom that I need to see the doctor? Do I tell her It's private? I'm embarrased to tell my doctor.",
    "doctor_response": "hey dear world is beautiful....just always spend time wid ur friends...try 2 enjoy ur life at fullest wid friends...n m sure d thoughts of suicidal will go......n always think positive..... about ur ex he wasnt worth u. dont ever talk wid him...control urself.....n always keep smiling...be happy.....",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for chest pain?\n\nHi I am 38 year old male I have been having chest pain .and also tenderness in my ribcage I have had stress test ,X-ray,ecg,and echo testThank god these all came back normal but I still get a lot of chest pain .I have been told it Is muscular .is that normal for something that's been going on for a year or more. (also seen gastroentarologist. (slept wrong:)) that was normal also",
    "doctor_response": "HiIt might be a fibromialgia.Try Ibrufen twice orally for a week and you will feel better.Take careDr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for enlarged prostate\n\nMy father is suffering from enlarged prostate and doctor suggested Tamdura and Afdura. Now my father is on CRT and doctor said to continue with it for 2 weeks. If it does not get cured, it should be operated. When should it be operated ? Cant it be cured with tablets? Plz helpl me",
    "doctor_response": "HelloThanks for query.Your father has been diagnosed to have obstructive urinary symptoms due to Enlarged prostate .The modality of treatment in enlarged prostate depends upon following factors.1) Size of the prostate gland and the volume of post void urine residue detected on Ultrasound Scanning .2) Severity of symptoms and impact of these symptoms on quality of his life.3) Getting repeated episodes of UTI due to enlarged prostate Continue taking medications like Tomsulosin and Dutasteride .However if there is no satisfactory improvement in his symptoms It is better to get endoscopic resection of enlarged prostate (TURP)done.This will give him permanent relief from symptoms.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any permanent treatment for type 2 diabetes?\n\nI have type 2 diabetes and I was wondering what the normal level.  Mine can range from 120 to 245 on any given day.  There are several articles that they say their system can cure the diabetes with in 17 days to 6 weeks for ever.  Is there any truth in this? YYYY@YYYY",
    "doctor_response": "HIWelcome to H C M Keep your Blood Sugar your blood sugar  report is 245  -is HighNo permanent treatment . You can maintain at normal level with proper medicine,diet.Follow the instructions of your doctor.Take your medicines regularly.To avoid ComplicationsMaintain your Blood Pressure at -Keep Hb1c at 6.50 Percent(indicate 3 months blood sugsar level) Avoid sugary,salty,fatty foods.Alcohol,Smoking.Take plenty of water, leafy vegetables,fresh fruits (No fruit juices)Exercise regularly High risks Factors are-High pressure, Family History of Heart Disease,Diabetes,Thyroid.Maintain your weight. Consult Eye Surgeon for Fundus Exam  to rule out Retinopsthy.  yeary.Discuss your doctor for teary check up & for vaccination.Thanks  & Relax,DON'T EXPECT MIRACLES.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What could be the reason for mild high frequency hearing loss in my daughter?\n\nHello doctor, My 9-year-old daughter has recently been diagnosed with a mild high frequency hearing loss in both ears. Her hearing levels are only very slightly below normal and it is not impacting her day to day in a noticeable way so, for the moment, the audiology team are just monitoring it. My worry is that I accidentally caused it when she was a baby. There was one time when she was a young baby (maybe 2 months old) and she was in a rear facing car seat in the front of my car, i.e her ears were near the speakers at the front of the car. I turned the engine on and the radio blasted out really loud, I think it was probably on volume 12 or 13. I turned it down straight away and she did not cry but now I feel awful that I may have damaged her hearing. Please could you tell me how likely it is a one-off incident like this would have caused it?",
    "doctor_response": "Hello,  Welcome to icliniq.com.  I understand your worry. I would say it is possible to develop such a hearing loss due to what we call acoustic trauma, noise-induced. However, we can never be sure whether the loss is due to that incident or due to some other or if the loss was congenitally present. What you can do to prevent further deterioration is prevent her from listening to loud music, keep her away from loud sounds, try and use noise isolation buds when there is excessive noise outside, eat a healthy diet and meditate. Rather than worrying about what could have caused the loss, I think it will be prudent to prevent any further damage to the ear and guide your daughter on the right path to achieve what she wants to.  I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dark pigmentation, prominent around eyes and mouth, skin lightening treatment medsoglow, alternatives to it\n\niam 41 yrs old recently the dark pig mentation around eyes and mouth are very prominent. i consulted kaya skin clinic they suggested skin lightening alternated with mesoglow treatment once amonth for 4months. but they gave partial success in the whole process.iw ould like to go for second opinion. is there any other alternative procedure for my problem.",
    "doctor_response": "Hi, Visible pigmentation in human results from the synthesis and distribution of melanin in the skin, hair bulbs and eyes. Hyper-pigmentation can result from excessive sun exposure, use sunscreen with SPF 30. Some natural remedies are- mixture of lemon juice and cream; apply on face. Put lemon juice onto basil leaves. This is great for getting rid of pigmentation marks and dark circles that may have been a long-time problem. Apply lime (nimbu) to the affected area, and after 15 minutes wash it off. This needs to be done on a daily basis. Other remedy is Kojic acid cream which lightens up the dark spots but takes some time. However, mesoglow is a facial treatment using Vitamins and Mineral injections to add that healthy glow to skin which radiates energy and vitality.Subdermal vitamin injections rejuvenate the cells, making them more active and thereby stimulating the production of collagen and elastin. Overall it reduces dark spots; effects seen faster than kojic acid. You can continue same treatment for dark spots along with natural remedies and sunscreen creams. Take care. Best regards, Dr. Neelam.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does iron deficiency cause a pain around the belly button?\n\nHello doctor,A few days ago one of my female friends had pain around the belly button. She went to a physician and was told that it could be because of a decrease\u00a0in iron in the blood. Does iron deficiency relate to pain near the stomach? What can be the other causes?",
    "doctor_response": "Hello. Yes, it can be related. One of the causes of a low hemoglobin count is low iron in the body, which may occur either due to inadequate diet or excessive loss from the stools or menstruation. There are multiple causes, and we need to confirm it by hemoglobin level, serum iron studies, and stool for occult blood testing. If bleeding occurs due to acidity and gastritis, especially if associated with nausea, bloating, burping, pain on eating, sour water feeling in the throat or chest burning, then she should: If she is bleeding due to a worm infestation, then she should have tablet Bandy plus once at bedtime, to be repeated after two weeks. To confirm this she will need stool routine examination. Hope this helps. Get back if you have any doubts. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes black discolouration in teeth while using Fluoridex toothpaste?\n\nI have been using Fluoridex tooth paste after deep cleaning and my teeth are now turning very dark-almost black- between the teeth and small areas where teeth are slightly chipped. I discontinued this toothpaste after using it for two weeks twice daily. Any ideas?Thank you, Jack",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns.As per your complain Flouridex toothpaste contains main ingredients as Potassium Nitrate and Sodium Fluoride and is an effective anti cavity dentifrice/ toothpaste..Although such kind of side effects are not commonly observed after using it and blackening between teeth  can be due to staining of teeth that is a normal process if brusing is not proper while some individuals are more prone to develop staining due to rough teeth,..Chipping of teeth is due to attretion and abrasion..I would suggest you to consult an Oral physician and get evaluated and a thorough clinical evaluation can be diagnostic..Scaling can be done to remove stains along with demonstration of proper brushing technique..For chipping of teeth the exact cause like teeth grinding habit or other causes like physiologic abrasion can be checked for and treated accordingly..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for constant water flow from mouth after neuro attack while having diabetes and high BP\n\nHi could you please help me my father is suffering from diabetis and high b.p. recently he had a neuo attack.from last some days water is running continously from his mouth . please suggest what shall we do and to wat specialisation doctor we sahll consult.",
    "doctor_response": "Hello!My name is Dr. Aida and I am glad to attend you on Healthcaremagic!I would recommend consulting with a neurologist and performing a brain CT scan to exclude possible stroke. The water running from his mouth could be related to facial palsy and the inability to swallow or close his mouth. You should discuss with his doctor on the above issues. Hope to have been helpful!Best wishes!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is dizziness and blackout normal in teenagers?\n\nMy 15 year old daugther told me that she had experienced dizznes and black vision when she gets up in the morning, she also experiences the same symtoms when sitting in the couch and gets up is ths normal for a teenager? Really appreciate your thougts, thanks",
    "doctor_response": "Hello dear,The symptoms as mentioned in your post can be attributed to pathology in the Vestibular Apparatus in inner ear (it is associated with maintenance of body posture & balance) most probably Labyrinthitis or Benign Paroxysmal Positional Vertigo.Symptomatic relief can be obtained with intake of Vestibular sedatives like Betahistine or Cinnarizine preparations (to be taken only under the guidance of a Physician).If it still persists, then she needs to consult her Physician/ ENT Specialist & get a complete clinical examination done.Investigations like estimation of blood pressure, blood sugar levels, serum electrolytes & vestibular function tests will be required to rule out any pathological cause for the symptoms.There is no need to worry, your daughter will be fine.Till then, maintain adequate hydration & proper nutrition status and avoid stress.And she should also take precautions of getting up from bed slowly & avoid sudden head movements.Wishing her a Good Health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On COQ, addyzoa, carnisure. No sperm. Proper treatment, advise?\n\nHello, we are trying to have baby from last 2 yrs now and visited one infertility speciatlist and he advised me to take some medicines like 1 ) COQ 300 , addyzoa  and carnisure 500 daily as hwe found there is no sperm found in my semen test. i want to know how far is this medcines will benefit to me in having my own baby as the doctor i'm dealing he told me to go for donor sperm which i don't like to go for.please advise",
    "doctor_response": "You have azospermia and the web is full of information about your condition. Sadly medicines that you are taking has no approved therapeutic effects. Azospermia is broadly categorized whether the cause is from obstruction in the passages or failure of the testes to produce sperm. That being said you have to worked up to determine the cause of your azospermia.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How safe is taking T Udilive 300mg for Hepatitis E?\n\nHi... i have been suffering from Hepatitis E since april 2014. Doctor advised me to take T Udilive 300 mg. I have been suffering from 5 to 6 times motions after taking this dosage. Is it react my body. Plz. suggest me should I take this medicine or not?",
    "doctor_response": "Hello,      I read your question carefully and can understand your concern very well.      I would like to tell you that udilive tablet contains deoxycholic acid, which is bile acid and useful in liver diseases, where bile production is hampered.       I would also like to tell you that loose motions you are suffering are due to hepatitis E and not because of udilive, so don't stop this medicine. Also take plenty of liquids and sufficient amount of glucose salt water to avoid dehydration.      Don't worry, it will be fine within few days. You should avoid eating outside food and traveling.       Hope this will help you and feel free to ask any of your further follow up questions directly to me, i will be happy to answer you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Depression with varied mood swings. Hypersensitivity to smell and sound. How do I solve this?\n\nMy son has never been in trouble he turned 18 last Christmas and decided to try weed.  He now smokes and recently got in trouble.   Problem is he was depressed prior to all this. Had ups and downs in his mood.  During argument about using my car he said some very dark things against my husband and I he repeatedly kept saying he will kill himself.  Things he said were very graphic.  He is refusing help from a doctor, I feel lost like there's nothing we can do.    What are my options?  He is destroying himself and we can't do a thing.  He has bouts of anger.  He in hypersensitive to smell and sound.",
    "doctor_response": "I am sorry for all the trouble you are suffering. Your story is heartbreaking. The first priority is to determine if he poses a physical threat to himself or others. Physical safety is at risk.It is imperative that you discuss this with a mental health professional, even without your son. An experienced clinician will recognize these symptoms and know exactly what to do. i wouldn't waste any time as I am concerned for all of you. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent cough and shortness of breath\n\nHi, may I answer your health queries right now ?  Please type your query here I am 65 years old and for the past 12 months I have had a persistant cough that is quite forceful. It makes my ees water and I am quite short of breathe for a period of time after.  The secretions I clear and thick with bubbles in it.  I am also very tired.  Please can you give me some insight?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Yoi are having chronic cough, expectoration which are difficult to cough out and breathlessness. All these symptoms are characteristic of bronchitis. So get done chest x ray and PFT (Pulmonary Function Test).Chest x ray is needed to rule out other lung diseases. PFT is must for the diagnosis of bronchitis. You will mostly improve with inhaled bronchodilators (formoterol or salmeterol), N acetyl cystine (NAC) and mucolytic with expectorant syrup.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lowering of pod beta HCG value during IVF?\n\nGood afternoon. We are married for ten years and still expecting a child. My wife had one early abortion and 3 IVFs. All unsuccessful. Earlier she had an ectopic pregnancy, which got aborted normally. In one of the IVFs there were excess frozen Embryos and so she had two FETs. In the second IVF and 1st FET the 16 days result was positive. The third IVF, which is recently done had initial positive result and on 23 pod Beta hcG is again 13.59. We are lost. Can you help us",
    "doctor_response": "Hello sir, in my opinion she needs thrombophilia profile testing and pregenetic analysis of embryos in next cycle.Also both of you should get a karyotypic analysis done.In case you have any questions in future you can contact me directly on",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pins and needles sensation in abdomen and upper arms and legs?\n\nAt night I am getting a pins and needles sensation. At first it was just on the ab and back but now I am experiencing it on my upper arms and legs. Certain fabrics seem to irritate it more. . Coolness lessons the feelings. In order to sleep I have to distract my mind by concentrating on other things. I have noticed it some other years but never as bad as this winter. there is no pain except a burning that some times i think is the pricking feeling. it is such now i can no longer ignore.",
    "doctor_response": "This sensation is mainly due toneuritis. Synthetic fabric ma induce allergic reaction. Stop using such fabrics, use soft cotten fabric. Take neurobionfort tablet daily. If it is dry skin then use good body lotion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for heart palpitations with chest tightness\n\nhello i suffered with heart palpatations about a month ago but after cutting caffine down they are gone, now i have a tight chest with little pain sometimes and i get shakey with feeling sick i have no stress or worries at the moment this has been happening for the passed week ?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. In my opinion, we should first rule out arrhythmia (rhythm disturbances in heart) for your palpitations.So get done ecg, 2d echo and Holter monitoring (24 hours continuous recording of Ecg).If all these are normal then no need to worry for arrhythmia or other heart diseases. Sometimes stress and anxiety can also cause palpitations, shaky feelings , chest tightness etcSo better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic drugs too. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Primolut help in getting pregnant?\n\nHi, may I answer your health queries right now ?  Please type your query here...i have been trying for a babay for 5 years now had ivf for three times all failed, a friend asked me to take primolute that it will help me concive, what is does primolute do",
    "doctor_response": "Hi, primolut is a progesterone which helps in getting your periods if they get delayed or it helps in stopping the bleeding if it is in excess. It can't help you in conceiving.  Other progesterone like duphaston or susten is a better option.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffer from chronic urticaria. Food allergy test advised. Vaccination suggested. Curable?\n\nactuly m facing chronic urticaria problem from past 7-8 months....first i consulted to a doc he did several food allergy test...he suggested to take vaccine for allergy... i was not satisfied with that so i consulted some another doc. who has given me some medicines. here i want to ask only one que that i have to suffer whole lyf with this allergy or it is curable?",
    "doctor_response": "IF YOU CAN GET BLOOD SERUM TESTD FOR COMMON FOODS LIKE MILK WHEAT AND POTATO OR COMMON FOOD YOU EAT YOU WILL GET RESULT AND ELIMINATION DIET WILL CURE YOUINJECTION OR VACCINATION IS NOT GURANTEEYOU HAVETO INJECT THREE VACCINES OF HISTAGLOBE AFTER 1 WK INTERVAL FOR ONE SET AND THIS SET TO BE REPEATED AFTER 3 6 9 MONTHS FTER TO HAVE FULL IMMUNITY BUT NO GURANTEEWITH MEDICINES YOU CAN ONLY SUBSIDE BEST IS TO GO FOR ALLERGY TSTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is lamictal safe for depression and anxiety?\n\nHi.mydaudgter has special needs and takes lamictal she has been depressed and had a lot of anxiety she is also non verbal. Very prone to violent  tantrums,1 week ago she started taking paxil 10 ml 1 time a day . Moods has been great. But very nauseous and. She stares a lot, is this normal?",
    "doctor_response": "hithanks for using healthcare magicLamical in depression acts like a mood stabilizer, but it does not have good effect on anxiety symptoms. Paxil 10 mg would help her to control both depression as well as anxiety symptoms, but initially it could cause a little bit nausea which would improve with time. Rest u can consult to treating psychiatrist.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Shy person, have extreme anxiety before presentation speeches, feeling of heart in the mouth, get blank that reflects on the face and makes the situation worse. How can I tackle this?\n\nHi, I am 28 years old and working as a software professional in Bangalore. My work profile requires me to give frequent presentations before my team. I have very bad speech anxiety , which has only been getting worse year after year. I am also a very shy person. My anxiety level is so bad that I can literally feel my heart in my mouth, not to mention that I go completely blank, and everything reflects on my face which makes things even worse.Please help me to tackle this problem.",
    "doctor_response": "hi..performance anxiety or social anxiety disorder is what we may call it is to be tackled by counseling..some bahavioural modification needs to be done..also some medication may be required prior to your presentation for the initial days of therapy to tackle anxiety..so pls consult a psychiatrist and then a clinical psychologist..have a good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes weight loss while suffering from hole in the heart?\n\nHi, my friend is 20 years old and is having hole in her heart. SHe was suggested to go for an operation, but since last month, she has started losing weight tremendously as she is not able to eat anything. Whenever she eats, she goes for vomitting 15-20 times. Her weight right now is 30 Kgs. Does it can risk her survival also or its just a normal symptom?",
    "doctor_response": "sir I think if she is recommended surgery for ASD or VSD then go ahead for that .If still you are on doubt take second opinion and if she is loosing weight and vomiting are there , she requires urgent attention by physician .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high level of carbon dioxide in blood?\n\nA couple things. Just received blood test results and I seem to have a high level of Carbon Dioxide in my blood. I m at 30...range 22-29 mmol/l. Would this be indicative of asthma syptoms? Could burning wood in a fireplace also cause this result? 57 years old female diagnosed with Asthma at 3-about years old. No symptoms since.",
    "doctor_response": "Hello and welcome to HCM,High levels of carbon dioxide in blood are due to disorders of respiratory system.In case of hyperventilation, there is increased accumulation of carbon dioxide in blood.Asthma can lead to complications associated with respiratory systems.Thus, elevated carbon dioxide can be due to asthma.You need to consult your pulmonologist for clinical assessment, relevant investigations and thus management.Thanks and take careDr Shailja Puri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should vaccine be taken after a rat bite?\n\nHi Doctor, i got bitten by rat on left foot at little finger on 10th Feb night ,It was bleed and i washed it and applied soframycin and i got vaccinated on 11th Feb morning.... but i dont know which vaccine dose doctor gave me ....as of now i dont see any bad effects of rat bite apart from swelling around wound...do i need to confrim from doctor with which dose i have been vaccinated?do i need to go under any vaccine course after bitten by rat?Can i apply soframycin on wound site till it get healed?",
    "doctor_response": "Rat rabies has been reported but it is extremely rare. It is not necessary to take rabies prophylaxis in bite cases by house rats. However, rabies prophylaxis can be taken when bitten by wild rats. One dose of the rabies vaccine is administered on days 0, 3, 7, 14 and 30 intramuscularly into the deltoid region. Mostly your doctor must have given Tetanus vaccine if it was single dose. You can confirm from your doctor. If rat was domestic then there is no need to take rabies prophylaxis. Only wound care is need:For this you can take amoxicillin 500 mg every eight hours for 3 daysWash the wound with betadine three times dailyYou can apply soframycin cream locally every 8 hours for few daysIf rat was wild then you have to take rabies prophylaxis also.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this kidney functional test result indicate?\n\nHi Doctor, In my recent report, it shows cortical echoes are increased. Both kidneys are normal and differentiation present in cortisol medulla. Pelvicalyceal system is not dilated and no calculi. Please advice on this report. If there is any treatment to be taken.",
    "doctor_response": "Hi, Findings suggest  renal parenchymal disease.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Indu Kumar, Radiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain near the sternum?\n\nHi, Im 22 and have recently had chest pain on the right side of my sternum. The pain at first was quite mild and have experienced it before and it would come and go but today it got much worse. The pain was very sharp and localized to about 1 rib. The area around it was tender and upper body movement would sometimes relieve or increase the pain. The pain hasnt spread to any other areas and Ive found shallow breaths helped lower the pain. I havent had any injuries or incidents which could have caused any broken/cracked ribs.",
    "doctor_response": "The characteristics of the pain you describe are compatible with musculoskeletal pain. It is characterized by a localized pain  that can be exacerbated by cough, respiratory movements of the chest wall, movements of the superior  members and palpation of the painful point, which will present with tenderness and, eventually, with a muscle node. Musculoskeletal pain varies in intensity and duration. It can be mild or very intense with impairment of daily life activities. It can last a few hours even if untreated or last many days, weaks or months. A localized, long lasting musculoskeletal pain that does not resolve after the use of traditional analgesics and anti-inflammatory drugs is classified as myofascial pain syndrome and frequently requires multidisciplinary intervention.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My father is diagnosed with viral fever and had delirium after consultation. Please advice.\n\nHello doctor, My father is 57 years old. He is having 102.3 fever and also some confusion and disorientation. The physician he consulted did blood work and concluded it to be viral but the delirium started after the consultation. Getting worried. I can send the blood reports across. Please help.",
    "doctor_response": "Hello. If he has a fever and is delirious, it is not something that should be managed at home. Delirium can be due to toxic reasons (toxins can be substances released by microorganisms during an infection, prescription medicines or illegal drugs) or metabolic reasons (low or high blood glucose, electrolyte abnormalities, etc.), ischemia (lack of blood flow), etc. So, I suggest that he should be seen again by his physician. The alternative would be to get him hospitalized. In the meanwhile, give him Acetaminophen (Tylenol) to keep the fever down. 650 mg can be given four to five times a day. Temperature itself can cause delirium. Please upload the blood work, so that I can take a look at them as well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any chances for getting pregnant without ejaculation?\n\nMy boyfriend and I had sex last night and for the first few minutes he didn t wear a condom. He put one on and proceeded, then ejaculated. The condom didn t break. My concern is those first few minutes. I took an ovulation test and I am ovulating. Is it pointless to buy plan b?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. I think there is no use of buying plan B, as the period during which he was unprotected is the duration during which there was no expulsion of semen or sperm at all. This in my opinion does not warrant any cause for concern.Hope I have answered your query. Let me know if I can assist you further.Best wishes,Dr. Shoaib Khan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can an unusually large tailbone cause a callus?\n\nI have always had an unusually large tailbone but recently,a patch of hard skin has developed which is pressing on the bone when I sit.It is similar to a callus.Could it be caused by pressure of the bone on the skin which is possibly thinning with age? I am a 75yr old female .",
    "doctor_response": "Hi and thanks for the query,It is very difficult to associate the callus to the large tail bone. this would have manifested itself earlier enough. However, if the tail bone compels a particular sitting position, this could be a probable explanation. If not, something else should be considered. kind regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a constant sore throat with lymph nodes enlargement. Should I be worried?\n\nHello doctor, About two months ago, I developed a sore throat. It was mainly on the right side. I went to urgent care, and they did a quick strep test, which came back as positive. I also had a little bit of a stuffy nose, and mainly the right ear felt full or plugged. I went home with antibiotics, and after like four days, it seemed to be subsiding. Then on about the eighth day of the pills, it started to come back. By the time the antibiotics were gone, it was back. I went to urgent care, and again they did an actual culture that you grow in a dish. It was negative for strep, so they said it was a virus. My throat was still red, and the ear was congested. Then I waited. It would seem to get better and then would come back. Every time it came back, it hurt worse. It might be gone for a day or two or twelve hours. I started having a tickle in my throats and a cough. About eight days ago, it came back in a big way. I never ran a fever at all, which makes it seem weird. A few of the glands on my neck seem larger. There is phlegm coming from somewhere, and I cannot tell if it is from the sinuses or not. I always have to clear my throat. There is now some sinus involvement, as my cheekbones are aching. My voice feels scratchy. It does not hurt more to speak or eat, but it is annoying to do both, as it all feels tired and raw. I hate to make a big deal out of nothing, but looking things up online is telling me it could be bad. Can you give me any insight?",
    "doctor_response": "Hi. Revert with more information to an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and swelling in left scrotum?\n\nRes sir i have been left scrotal pain for last 1 year left scrotal swelling for last past year Report scrotal USG Left sided varicocele along the posterior and lateral aspect of testise Doctore advise me a tablet 1: FLOTRAL-ALFUZOSIN HYDROCHLORIDE 10 MG 2: TO WARE SCROTAL SUPPORTER BUT NO CHANGE",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: You can go for surgery if its too huge/painExplanation: Varicocele if mild need no treatment/surgery. If its causing continuous pain/infertility then you may go for surgery. Otherwise not required.                  Swelling may not get reduced from support, its for reducing pain and to make you comfortable.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if 87 tr old broke her pelvis after falling on tailbone and is in unbearable pain?\n\nmy 87 year old mother broke her pelvis. while in convalescence at home with my wife and me she then had a subsequent fall landing square upon her tailbone. i have no car at this moment, my wife is away and am located in a very rural area. she is now suffering SEVERE..UNBEARABLE pain. from all research i have conducted her symptoms indicate her pain is due to some sort of trauma to her sciatic nerve. i am a retired psychologist and have more than just nominal medical knowledge. i am quite certain that some sort of surgery will be needed to correct this. but.. my question is: what can i do NOW..i mean right NOW, as she is in dire pain to give her SOME degree of relief. Would an injection of novocaine to the area offer her temporary relief? if so, would it be available should i call 911 and have her taken to a trauma center.[i really don t even know of one nearby] she is VERY stubborn and would refuse any prolonged stay. considering the information provided, and the circumstances what would you recommend i do? she does have strong narcotic pain medications [oxycontin] but oral administration of them proves futile at any dosage. again let me reiterate: i am very sure her pain arises from some sort of pinching or damage to her sciatic nerve. please advise. thank you, alex smith",
    "doctor_response": "Hello, Consult an orthopedician and get evaluated. Surgical correction may not be possible at this age. Consult an orthopedician and plan for conservative options like splinting or skeletal traction. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it advisable to take ayurvedic medicine for PCOD while on Eltroxin?\n\nHello doctor, I have hypothyroid and PCOD. I am taking Eltroxin 100 mcg. I have been put on Deviry tablets a few times to regularize periods. I am looking for a permanent cure for PCOD. I read from your posts that kalarchi choornam is effective. Can I take them along with thyroid Eltroxin tablets? Or will there be any interaction? What is your suggested treatment for my PCOD?",
    "doctor_response": "Hello. You have hypothyroidism and PCOD (polycystic ovarian disease). You are not trying to get pregnant now. So, it is time to take strict Siddha medications to get a complete cure from PCOD. I advise you to continue Eltroxin tablet. During your regular visit, the physician will regulate its dose based on hormonal values. So, you no need to worry about that. In many people, Siddha drug renders the possibility of reducing Eltroxin dose. For PCOD, please follow the following medical advice. a) Kumari legium (Van kumari legium), take 2 gm (one spoon) in the morning and evening before food or Aloes compounds two tablets in the morning and two in the evening after food. b) Tablet Chithira moola kuligai one tablet in the morning and one in the night after food. c) Kalarchi chooranam 1.5 gm in the morning and evening after food with hot water or milk. If you do not get this drug in the market, you can prepare as follows:  Kalarchi (Bonduc nut) seed (remove outer shell and use only the inner kernel) - 100 gm Black pepper - 10 gm Asafoetida (fried) - 10 gm, Keep these in a mixie jar and make a powder. The drug is ready. Store in a container. d) Malai vembathi thailam or Kalingaathi thailam (both or same) 5 ml daily during the night before bed. After some days, you can increase its dose a few drops. Continue all these drugs. Within three months, you will get periods. Then also during menstrual bleeding days, stop all drugs. Again, start from day fifth of the bleeding day. Continue for six months. Your uterus and ovary will become normal. Suppose, if you do not get bleeding, but only few spots, then consider it as the bleeding. If you do not get even a spot, then do not worry, you continue these drugs for six months. Tender arasam leaf (peepal tree), collect the tender leaves. Grind three leaves and mix with milk (like milkshake). Consume this in the morning. Continue this daily morning until you become normal. If you get more tender leaves at a time, dry them and powder it. Then take 1 gm and mix in milk. If you do not like milk, then use buttermilk or water. This is another important home remedy for PCOD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and burning sensation in the ribcage?\n\nI am having rib pain, it is more in my left side but it is also in right side. I have burning sensation.and my ribs are sore to touch. Pain increases when i lie with back touching the bed and even when i sut and back is touched with chair. Arm movement also increases pain",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Rib pain may be due to costocondritis or pleuracy or herpes zoster infection early stage or vit D deficiency with multiple rib fractures etc. Until examination is done it is difficult to say what it is. Use tablet Tramadol and paracetamol twice a day for five days. If symptoms not improved please consult your doctor he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a small white spot on the roof of the mouth?\n\nOk I have a small white spot looking thing on the roof of my mouth it's been there for about a month a little tender to touch but I've had no other symptoms of anything and doesn't bother me if I don't poke it I did have oral sex just over a month ago",
    "doctor_response": "Hello, Thanks for your query.Small bumps on the roof of the mouth should be checked by a doctor. This may be a result of a food or medication allergy. Fever can sometimes cause bumps in the mouth as well.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe left arm pain\n\nHi, Im a 17 yr old female and for the passed 2 days, my left arm has been hurting really bad! The pain is throughout my whole arm, however, it hurts worse around my wrist and upper arm/ shoulder area. I dont have any other symptoms and I haven t done anything differently lately. Thanks!",
    "doctor_response": "Hi, As a first line management you can take analgesics like Paracetamol or Aceclofenac for pain relief. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have stomach ulcers, acid reflux, memory issues, depression, bad tremors. Had Guillain Barre. On nerve pills. Suggest\n\nI had Gullian Barre at 8 years old. I am now 50. After I left the hospital all those years ago, I was a totally different person. So nervous all the time and just didn't feel like the same person anymore. Doctors put me on nerve pills then and I have always had to take them. Course my body is so adapted to them they just don't work anymore and my anxiety has hit a whole new level. I have bad tremors and my thoughts are jumbled. I have stomach ulcers and severe acid reflux. I stay sick and so tired, but yet I can't sleep. I can't drive anymore or leave my house anymore. This is getting so much worse with age. They say I am depressed and suicidal,and I agree with that, but the reason is because I am so sick and nervous all the time. It has put my life to a complete stop. I don't know what do to from here. My memory is getting worse everyday. At this point, I am not living, I am just existing. I am also extremely nauseous and have started vomiting on a daily basis. I have restless leg and have been told I have possible blockage in my neck that can lead to a stroke. I really need some answers. I just don't have the proper insurance to have the test that I need. Can a neurologist find out why I am so nervous (physically)?",
    "doctor_response": "These are all psycho-somatic manifestations.You consult a Psychiatrist,then you will be alright.Take ALPROZOLAM 0.25mg one tablet at 8 pm daily as well as one   NEUROBION tablet once a day after lunch along with one MVT tablet once a day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for blue bruised ring on my elbow\n\nHi I fell on my elbow a week ago hard enough  to break the skin. It iced over completely where I live the same night so I never went to a doc. now a week later I have a purple and blue ring around my entire elbow.. about the size of an orange and my forearm/elbow/shoulder all are killing me.. my doc cant get me in so debating whether ER is necessary.",
    "doctor_response": "Hi, there!It looks like You have elbow bursitis and punction is needed to aspirate liquid.I am not sure, if ER will do this, because Your condition isnt life threatening, but You can try to go to ER and ask them.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is my stool test result showing?\n\nHello doctor, I just got my stool results, and I would like to ask a doctor to interpret it for me. Lysozyme * 674 \u2264 500 ng/mL, Butyrate\u2021 4.5 0.8 \u2013 4.0 mg/mL, Total SCFA's\u2021 17 5.0 \u2013 16.0 mg/mL, Occult Blood Positive Negative.",
    "doctor_response": "Hello.  What are your symptoms? What was your dietary intake in 1-2 days prior to test? Amy family history of major gastrointestinal diseases? Now stool SCFA and butyrate are slightly out of range which is fine to have. Also, lysozyme is slightly elevated and it is a marker of inflammation in bowel which may be due to multiple reasons like IBS, IBD or diarrhea, etc. So it' is a nonspecific marker.   But important factor is stool for occult blood, which is positive. So there is some minor bleeding is going on within a bowels. This is the abnormality which should be evaluated further. This has multiple causes ranging from IBD to polyps, etc. However, some dietary factors like some fruits, vitamin C, iron supplements, nasal bleeding, hemorrhoids, etc, can give positive results.  Now, we would like to get total of 3 samples for occult blood testing and if it remains positive subsequently then needs endoscopy, or even if having symptoms then still need endoscopy. So, the concerning factor is stool for occult blood, rather than rest three, and needs further evaluation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe shoulder pain\n\nI am in need of a ortho to access my physical abilities for my ex-employer. I was getting long term disability from their insurance(cigna) and they cut my benefits until I have a doctors assessment of my ability or inability to do my job there. i had two rotator cuff surgeries on my right shoulder and i still cannot use it 100 percent and am in constant pain. I cant afford my doctor who did the surgery because my benefits did not include health insurance. I just need a doctors opinion on my restrictions so that I may start receiving my benefits from cigna again.",
    "doctor_response": "hi,thank you for the brief history of you.As you mentioned you had two RCI surgeries, I am actually not happy to hear this. RCI does not need surgery and if needed it is not performed twice.. There is something which went wrong. Let's figure out this. Hope you will cooperate and provide the details.How many rotator cuff muscles were ruptured? what surgery was performed?Did you perform physical therapy before and after the surgery?what was the muscle strength before and after surgery?Well this questions decide the prognosis of the patient with Rotator cuff injury (RCI)Also, I have been seeing RCI patients with 2 out of 4 muscles rupture. Can say a 50-50% cases. All have recovered well. Neither a cortisone injection nor a surgery was done post physical therapy. Patient is above 65 and can perform all ohyscual activities without any hesitation.As I think now you have undergone two surgeries , you need a good physical therapy which can help you regain all functional movements. Also, performing surgeries back to back is not good as it may lead to scarring of the tissues.I advice you to do 12-16 weeks of proper physical therapy to get optimum results.Any more questions, you can ask me personallyRegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can taking multiple antibiotics cause redness and dryness of vagina?\n\nHello doctor, Ever since being on multiple antibiotics for a persistent UTI a year ago, I have had vaginal problems. It was first a bout of yeast infections and then BV. I have tried many pills, external and internal creams, home remedies, and diet changes, but still, I have redness and dryness externally. I have tested negative for yeast and BV, but nobody knows what is going on.\u00a0Is it possible that I am just totally out of balance? I have been taking probiotics daily, but it does not seem to be working. I am desperate for help because I am literally at my wit's end.",
    "doctor_response": "Hi. How are you doing? Sorry to hear what you have been through. Hope I have been of help to you, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do tablets Endogest 200 and Lupi hcg 5000 help in conceiving?\n\nHi...now i am 22...i get married at dec,13..then am getting period regularly..i am trying to get pregnancy....we consult the doctor she prescribed me to {Evion 400mg,Ebexid,M2 tone syrup}when i take this medicines i got 3 days later about my period...again we consult our doctor with my scan report......doctor says scan reports are very well..then she prescribed me to{Endogest 200 for 20 days,Lupi hcg 5000}now i get this tablet.its sure to give any positive results for us?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. The fact that your doctor has commented that your scan reports are good means that you are ovulating regularly. Endogest is a natural micronized progesterone preparation. After fertilization, progesterone is required to stabilize the pregnancy. This progesterone is released by Corpus luteum. If corpus luteum is weak, the pregnancy may not continue due to shortage of progesterone. Therefore you are given these pills. Moreover, Inj. hCG helps strengthening of corpus luteum. So it will be useful when the fertilization has taken place. If you miss the period, perform your pregnancy test on the overnight morning first urine sample, earlier the test may report false negative results. Alternatively you may perform Beta hCG test on the blood 10 days after the last unprotected intercourse. Now that the other medicines like Evion, Ebexid, M2 are not continued now, we need not discuss on them. Moreover, if you are ovulating naturally, you do not need these medicines. I hope this explains you about your medicines. Hope I have answered your question. Let me know if I can assist you further.Regards,Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swelling in leg, on comprssion stocking. History of having blood clot after vein procedure, positive factor V leiden. Ideas?\n\nI had a blood clot in my leg after a vein procedure with laser in March.  Subsequent tests showed I am positive for Factor V Leiden.  I still have a lot of swelling and continue to wear a compression stocking.  I can't figure out if the swelling remains from the vein procedure or the blood clot and I'm afraid that I will have to live with this kind of swelling from now on.  Is that the case for Factor V?  Is this continued swelling to be expected?",
    "doctor_response": "Hi,Thank you for your query on Healthcare Magic.Positive for factor V Leiden people are prone for clots formation in the blood circulation system.Symptoms will depend on the site and extent of involvement.Continue to wear stockings.Prophylactic use of anticoagulants like aspirin, warfarin may be required to prevent further clot formation.Prolonged sitting or lying on bed further increases the risk of clots formation.Consult the doctor for further advise on management.Hope I have answered your query.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should I do after my wife has taken more sleeping tablet?\n\nToday early morning my wife take more sleeping tablet. its for my moms tab. The tablet name is risperidone tab 2mg & imiz -2 . she take each 8 tab. i m given some salted water. then she take vomit. but she getting sleepy and very tired. what i do next treatment.",
    "doctor_response": "Hello,She needs to be sent to the hospital for at least two reasons.One is that she will need good monitoring to rule out poisoning and serious problems related to this. She may have ingested even a higher number of tablets.The second reason is related to possible suicidal ideas, plans and actions. She may be having severe depression which may be causing her suicidal attempts. This is an emergent situation and needs prompt and fast intervention.I hope this answers your query. I remain at your disposal in case further medical assistance is needed.Regards,Dr. Antoneta Zotaj,General and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for numb leg, back pain and constipation\n\nHi my name is wayne for the last 18 munths ive had all tipes off simptums it started with nume left leg wiche made me fall over one morning after geting up burning on back off left hand spech prob stuter swolowing then for about 4 weeks a bad head wich ran down my neck some gate problems constapation 6 weeks electric shock wich came after bending foword it ran strate throw me the syrangerst feelling yet lasted seconds since then my legs are hevy all the time night cramps in borth cafs bad back pain high eye presher have nit had a full night slep for mounths just dx with cough syncope so lost my hgv still in work but finding harder each day",
    "doctor_response": "Hi, Welcome to HealthCareMagic.com I am Dr.J.Mariano Anto Bruno Mascarenhas. I have gone through your query with diligence and would like you to know that I am here to help you.Your symptoms require in person detailed clinical examinationThis cannot be managed onlinePlease consult your family physician at the earliestHope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in HealthCareMagic at  Best Wishes for Speedy Recovery Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pus-filled boils all over the body?\n\nHey... I've been getting these pus-filled boils all over my body... Especially in my thigh region and the pain is unbearable. Besides that, they leave dark brown marks in the area and I really want to get rid of them fast... Ive been applying a paste of neem leaves which has kind of helped reduce them but the marks that I have already got are not going and I think it's folliculitus:..",
    "doctor_response": "Hi.Thank for your query and your diagnosis of folliculitis,..Well You need a proper course of antibiotic and supportive medicines. Apply liquid povidone iodine (betadine) to the affected are twice a day to kill the skin bacteria. The skin takes 3 months for the regeneration- that is the minimum time the body will take for the marks to go - if you stop fiddling with them .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in my left testicle after sitting for a long time?\n\nMy left testicular hurts normally after i have been siting down for long periods of time, and sometimes my right one hurts as well. I have a lump just above my penis on the right side and it hurts nearly all the time. My doctors gave me Antibiotics too see if there is an infection there but could you diagnose my condition please? Daniel",
    "doctor_response": "Hello, It's not possible for me to comment on your lump if its infectious or not without looking at it. However your doctor did the right thing to give a trial of antibiotics beforehand. Testicular pain might be due to excess pressure over testis while sitting. It can be relieved by wearing loose fitted clothes and underwears. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr SAMEEN BIN NAEEM, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rash on inner thighs and red scrotum?\n\nHey, I have a rash on my inner thighs round my groin area, my scrotum is also red. The rash has spread to both sides of my belly! Noticed it just over a week ago but didn't think nothing of I untill I noticed it has spread from my inner thighs to both sides of my belly. Any suggestions of what this is???",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms seem to be related to a fungal infection. I suggest using Clotrimazole cream for local application. I also suggest using Diflucan for three days.I suggest to maintain a good hygiene. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can anemia and low blood count be the reason for me not getting pregnant ?\n\nHad two successful pregnancies and now I m trying for a third but I m having difficulties. Doctor told me I m anemic and have low blood count. Could that be the reason?",
    "doctor_response": "Hi Lulu, Welcome to Healthcaremagic, Being anemic or having low counts is a symptom rather than a disease. This may or may not be reason of your secondary infertility, but I think Ist step now is that you get yourself investigated for cause of anemia. The cause may be dietary eg., iron deficiency or folic acid deficiency or malabsorption (in intestine), to bone marrow level. You should consult a physician. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are some common causes of one-sided SI joint pain?\n\nWhat are some common causes of one sided SI joint Pain that comes and goes? I'm 25 and just had a baby (naturally) 10 months ago. Back pain started at 8 months Postpartum .",
    "doctor_response": "There are various causes of SI joint pain which range from: Considering your history, it appears more likely due to pregnancy and incorrect posture. It is imperative to know if you are able to fold your legs , any pain in bending forward or backward, any issue in walking. Mild SI joint pains can get relieved with exercises. Severe may require SI joint injections Please let me know if something else is required With regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for headaches and pain in brain\n\nhello doctor, past 3 years i am suffering a lot from my personal life and for this , for me my parents are suffering more. i don t want them to suffer anymore. i am surrounded by lots of problems and i couldn t even share it with any one. everything is just inside my heart and my mind.24 hrs i have headache and some strange pains in my brain. i even went for checkup my parents took me.they said, while taking of lots of alzolam 0.5 regularly my brain nerves started drying, and then they prescribed me some other medicines. doctor i just can t live my life anymore and i don t want to give any more tensions to my family which they are suffering for me. so i just want to finish up my life. after which i will get relief from my life , my pains, my sorrows, my problems and everything. and then everybody will be free from me and my tensions and can move on in life. suggest me a medicine please doctor",
    "doctor_response": "Hello, According to the history you mentioned, looks like you have Depression , which may be endogenous( without any reason) , or reactive ( with some reason). Whatever please do not become addicted alprazolam which is not the solution for the problem. Hope the doctor whom you have consulted has evaluated your headache,if required a head scan. If that is normal, then kindly consult a good psychiatrist and counsellor, various good treatment options are available currently which can really change your life. There is no need to worry as your  problem can be definitely treated. Better your parents and family member also attend the counselling. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. MOHAMMED ASHRAF",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant cough and abdominal pain?\n\nI have two unrelated problems: I have been coughing for over 2 years, its productive and the mucus is clear and sticky. It sounds bronchial however I am negative for asthma, have a clear chest xray and have many airborne allergies. i have tried ventalin,flovent,flonase to no improvement. My blood pressure is elevated from the constant coughing and I find it sometimes difficult to breathe or go long periods of time without coughing as I feel as if there is a constant pool of fluid in my throat. I also have frequent headaches that I believe to be related to this.And my second problem, unrelated is regarding a sharp pain i've recenntly developped in my left lower abdominal region. I'd guess around my ovaries or kidneys. It is only present during sexual intercourse or after achieving climaxes. It is pretty recent and has been since the start of my last menstrual cycle about three weeks ago.",
    "doctor_response": "Hello Thank you for trusting HCM Any cough more than 8 weeks called chronic cough May be your suffering from chronic allergic bronchitis :in this condition airwaves inflamed due to certain air born allergen produce cough. Other possible causes 1.post nasal drip2.GERD with laryngopharyngeal reflux 3 . cough variant of bronchial asthma4.drugs like ace inhibitor and etc. 5 . infections 6.occupational lung disease  Treatment :avoid allergen, avoid cool drinks, tab. Moterleukast twice a day may help Post intercourse pain may be due to Pid or dryness  Or simple muscle pain. Please consult your doctor if symptoms not improved.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Instant schizophrenia, sadism, urges to kill. Symptoms disappeared post head injury. Treatment?\n\nI was diagnosed with light insanity schizophrenia and sadism but with self control i never harmed anyone Last week someone ran into me and i hit my head really hard and now its all gone the voices the urges to kill all of it i know it should like a good thing but i cannot handle it its like im someone else and its scary i dont know what to do.",
    "doctor_response": "Hi. It is not clear from your statement that you have undergone required investigations or not. If not than it is required to get investigated by neurologist as such symptoms , just not get vanished by head injury. If you got investigated and all is well and you are not having your previous symptoms than you must be feeling all this due to sudden change in your baseline behaviour. As you are not use to such self you are feeling not being your self. All you will need to visits a psychologist who  will help you with therapy to deal with this change . With in some sessions you will be able to see the difference in your situation. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to manage the severe pain caused by an ineffective Isotope treatment for multinodular thyroid cancer?\n\nhi im a 32yr old female that had ineffective i131 isotope treatment for multi nodugler thyroid cancer about two and a half yrs ago now when i eat it hurts so bad i cry the pain runs down my arm left side only and nt past my elbow sometimes i even taste blood im tired of choking please help. thanks cristina",
    "doctor_response": "Hi, Welcome to Health care magic forum.                       The  sudden onset of blurred vision may be due to the retinal detachment, injury, or neuritis of the optic nerve.                       I advise you to consult a ophthalmalogist for diagnosis  and treatment. You may need to have the M.R.I  of the eye for confirmation.                       Take more of green leafy vegetables, pulses,sprouts, andprotein rich foods,fruits and juices to act on the nerves.                        Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "White patches developed on cheek. Tested negative for fungus. Safe to use flutivate cream?\n\nHi... Recently some small white patches developed in my right cheek. However they are not itchy and i tested for fungus under doctors supervision and no fungus was found either. He suggested me to apply flutivate skin cream of GlaxosmithKline.However Its been a week with no particular improvement. he asked me to visit after 2 weeks . should i continue with the cream?? PLS HELP...",
    "doctor_response": "Hi Sourav , Thanks for the query. The condition you are suffering from can be polymorphic light eruption,P.alba etc. As the fungal infection is ruled out you can safely apply Flutivate cream. It is safe steroid and you can use it for 15 days. Improvement is usually slow. Visit your dermatologist after 15 days. Hope this helps. Regards. Dr Sudarshan MD Dermatologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause stomachaches and fatigue when suffering from Melkersson-Rosenthal Syndrome?\n\nMy wife was diagnosed with Melkersson-Rosenthal Syndrome Abound 35 years ago the first full syndrome in a hundred years Over the past years she has suffered stomach pains which last for some time this also leaves her severely fatigued. Is it possible that the syndrome is causing inflammation of the bowel",
    "doctor_response": "Hello!Welcome on Healthcaremagic!You should know that it is not typical of this syndrome to affect the bowel and cause inflammation. But sometimes this syndrome (considering the fact that is really rare) could be confounded with Crohn disease, which is an inflammatory disorder, affecting the bowel and causing similar lesions in the orobucal region. For this reason, I recommend performing a Gastro-intestinal endoscopy and probably biopsy to exclude this possible disorder. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I experiencing dizziness, abdominal pain and weakness?\n\nI woke up this morning and found that I am very tired and have a lack of energy I am finding it hard to walk for short distances with out loosing my breath. I also am experincing dizzy spells and some times black outs I have stomach ache and even if I eat a lot they wont go away!!",
    "doctor_response": "Hi.Thanks for your query.The history of pain in abdomen, much tiredness, lack of energy, finding it hard to walk for short distance, black-outs, loosing breath, dizzy spells, all indicate that you are very much sick and should report to the ER or nearby Hospital urgently for checking the vitals, getting investigated and treated symptomatically to star and then the definitive treatment on physical examinations and reports of the investigations of the blood, urine, stool, X-ray chest and ultrasonography of the abdomen.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent pain and redness in arms,knees and lower leg?\n\nI am experiencing aches and pain generally in my arms, knees , lower legs which show redness . Seems like flu symptoms and tiredness - this has lasted few months & doctor has taken blood tests four seem ok but the problem is ongoing. I am a 64 lady who has always been quite active but have now this constant achiness- can you assist with any suggestions to ease my problem",
    "doctor_response": "Thanks for contacting healthcare magic. You have problem of pain swelling and redness at knee region that may be because of rheumatic arthritis. Bursitis may cause stifness and redness around knee region.Gout may cause swelling and pain because of accumlation of uric acid crystal. Ct scan is helpful for further diagnosis. Consent a physician for further diagnosis. Proper physical examination and history give exact idea. I hope my guidance is helpful to you. Take care. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause positive hepatitis B after taking vaccination?\n\nsir, my family (my self wife son ) taken 3 doses of hepatitis b vaccination. After some time when i was sick , had blood test and my self tested +ve for hepatits b hbs ag but my wife and son are -ve and my hbe ag is -ve and hcv -ve what is my condition . if i had sex with a lady is there any chance of transmitting the virus",
    "doctor_response": "Did you check for hepatitis B before vaccination? In all probability you were already positive at the time you took the vaccine. You need to check Hepatitis B DNA viral load. If it is high you might transmit the infection during sexual contact. If your sexual partner is vaccinated then the has negligible chance of getting the disease.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I had oral sex with a sex worker. Is there any chance for me to pass herpes to my wife?\n\nHi doctor, I was on a business trip and my friend and I went to a high-end brothel. My friend hired two girls and brought them back to the hotel. He had to take a phone call and while the girls were waiting for him they performed oral sex on me for a few minutes without a condom. They had no symptoms in their lips and facial region. I am worried, I contracted herpes. I got tested for chlamydia, syphilis, gonorrhea, hepatitis, and HIV and they came up negative. It has been four weeks since the incindent and I have no herpes symtomps. What are my chances of having herpes? I know people might not show symptoms. I am married and I felt very guilty for what I had done and told my wife. We are planing to have kids. What are the chances of her getting herpes and passing on to our baby? I appreciate all your help with my concerns.",
    "doctor_response": "Hi.  I can understand your concern. There are very fewer chances of you having herpes since four weeks have passed and you have not developed any symptoms. But yes, herpes can even occur as sub clinical infection without presenting with any signs and symptoms. I would recommend you go for an ELISA (enzyme-linked immunosorbent assay) test for herpesvirus that is HSV 1 IgG and HSV 2 IgG and HSV 1 IgM and HSV 2 IgM. These tests are confirmatory in herpesvirus infection. These will tell your herpes status. If positive there are chances of passing the infection to your wife but not very high since you are asymptomatic. I would recommend you to first get the tests done and find your status. Then we can discuss further possibilities. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a constant feeling of nausea and pain in the abdomen?\n\nI have constant feeling of nausea, and pain in the upper part of the abdomen with bloating feeling after each time I eat, I did a complete blood picture , and micro urine analysis which showed everything to be normal only for the epithelial cells to be many instead of few What is my condition and would the high number of epithelial cells be dangerous if everything else showed to be normal?",
    "doctor_response": "Hi ! Good evening. I am Dr Shareef answering your query.If I were your doctor, I would advise you not to eat from out side to avoid any kind of intestinal infection creeping in . After a clinical assessment, I would go for a stool test for ova and cyst, a urine routine/microscopic and culture sensitivity test to rule out a UTI, and treat it if found positive which should relieve you of your problem. In addition, an ultrasound of abdomen would help us in ruling out a gall stone disease which not infrequently would give rise to pains and bloating feeling after meals specially a fatty meal. Till these reports are available, I would advise you for a proton pump inhibitor, a probiotic and an anti spasmodic drug if need be for a symptomatic relief.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can dementia be cured without medications?\n\nHi with stage 4 aids which it has been only discovered when the toxoplasmosis and tumors in the nose and pancreas were found, the cd4 cells are now at 150. will they go up again once in one month they will operate on the pancreas cancer? the nose tumor has been removed alreadyand its fine. the lesions provocked by the toxo are still there they menaged to get rid of the infection but the demages are hard to cure , will they cure? without medications, dementia takes over the mind, will that cure? movements walking is very slow. will this go back to normal?? thank you in advance. i know it is a lot of questions i hope u can help me",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  Many researches and researchers confirm that medicines alone cannot cure mental disorders. Life style changes, change in thinking pattern, relaxation etc are as essential as medicines. Psychotherapy can help you changing your lifestyle and thinking patterns. Yoga and meditation help you to streamline your metabolism and neurological balance. Please consult a psychologist for further information.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest discomfort and difficulty in breathing?\n\ni have had chest discomfort for over a month now. It has affecting my breathing significantly. i do have asthma but it has never really affected me before. this is a constant tightness in the chest in conjunction with difficulty breathing at times. during this period i have not had a legitimate asthma attack where i am gasping for breath. before the month that i had this i sinusitis. also about a week ago i was on a course of levaquin and 40mg of predison for 5 days then a weaning dose of 20mg for 5 more days the antibiotic was for all 10 tens. to an extent it has helped and today i feel a bit better but im just curious as to what could be going on as my dr is rather vague. also there is a small chance i was exposed to black mold. thank you.",
    "doctor_response": "Hi. I can understand your concern. Asthma is most common allergic disease which is not a curable disease but definitely controllable, by controlling the same you can lead a symptom free life. Usually presents with cough, wheezing, difficulty breathing and chest tightness. If not treated appropriately can be life threatening.So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed 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 bronchodilators and inhaled corticosteroid (ICS)Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain, nausea, flank and back pain. Single hepatic hemangioma in liver, cyst in right kidney. Causes ?\n\nLymphnoma Cancer - Grandfather died from. A. In formalin labeled duodenum , second part are multiple irregular fragments of tan/pink soft tissue measuring up to 0.4 cm in greatest dimension. All blocked and labeled as A1. B. In formalin labeled stomach,body are four irregular fragments of tan/pink soft tissue measuring up to 0.1 cm in greatest dimension. All blocked and labeled as B1. Liver has tiny single hepatic hemangioma , likely congenital? Cyst in right kidney None of these should cause stomach pain, nauseau, flank pain and back pain?",
    "doctor_response": "lymphoma of the gastrointestinal tract can present with above symptoms. may also be associated with B symptoms like fever, night sweats and weight loss. the lesions are seen in different parts of the gastrointestinal tract which may be suggestive of systemic disease like lymphoma. rarely it can involve the spine and casuse back pain. so these lesions should be biopsied with histopathology and immunohistochemistry to come to a final diagnosis. cysts in the liver and kidney may be benign!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes irregularities in heart beats?\n\nhi my name is angel and i have a question!! for the last couple of months ive been having this irregular heartbeats my heart beats and stops and i gasp for air and then it beats slow and it keeps repeating i feel like im out of breath everytime it happens and my heart stops",
    "doctor_response": "Hello, After going through your medical query I understand your concern and I would like to tell you that it can be due to heart arrhythmia which is why breathing difficulties with skipped heartbeats. It\u2019s recommended for you to get a basic cardiac evaluation done which includes ecg, echocardiography and a HOLTER (ambulatory ECG) done and consult with reports. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can my semen count be increased ?\n\nRes.Sir My age is 44 year old. I was marriage in1996 but my wife is not con sip any ones my semans count & motile is very low pl z. any suggest.me madicen for growth my semans and motile . I am very upset and desperation science last 2 year",
    "doctor_response": "Hi welcome to HealthcareMagic Only good Nutrition will promote the production of the sperm and semen, Avoid frequent Hot water bath, which will decrease the growth of sperm, testis are out side the body in order to maintain lower temperature lower than the body temperature, follow this for a month then you will see improvement.. there are no medication especially for production of semen...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bad odor through the genitals?\n\ni am an obese male. i shower everyday 3 times, but have a problem with odour from my genitals. it is embarrasing as i work in a government building and speak with at least 1000 peole a day. i know people have noticed it, but havent said anything to me. i have changed soaps, body wash, laundry detergent. nothing works",
    "doctor_response": "Hi, It can be due to bacterial infection, take local antibiotics to recover as soon as possible. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of getting pregnant if the intercourse is on the day of egg rapture?\n\negg raptured on 15th april, we did intercorse on 13,14, 15 and 16th april. i have regular 24-28 cycle. today  is 29th day of my cycle, hpt is negative, AF still didn't come. i am taking progestrone suplement( 200 mg once in a day) after 17th april regularly.",
    "doctor_response": "Hi,If you are young couple with normal semen analysis and normal fallopian tubal patency test your chances of getting pregnant in this cycle are about 25%.Do a blood  test for beta HCG. That will clarify things.The delay in your period could be due to the progesterone you are taking.If you have any further concerns do contact me through Healthcare Magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for a bruise on the face caused by hitting\n\nMy nine month old son must have hit his head sometime to day, didn t cry or anything for me to notice when it has happened. He went for his mid day sleep and has woken up with a egg in between his eyes more to the left side with a light blue tinge bruise over his left left eye. Should I be worried??",
    "doctor_response": "Hi.... Please do not assume that he might have sustained an injury at such a rare place. This could be spontaneous bruising and the first and foremost sign of bleeding disorder. I suggest you take him to the pediatrician and get him evaluated.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for knee pain\n\nhi my age is 26 yrs.i have done my thyroid t3, t4 &tsh test the result are - 122 ng/dl,10.10 mg/dl, 5.10 mIU/ml. Commets: suggesting Thyronormalcy. I am having knee pain from past 2 months. So i would like to know about my report and further treatment for my joint pain",
    "doctor_response": "Hello, As there are changes in the thyroid levels there will be kind of fatigue to set in the muscles. So by having fatigue which is a physiological process, there will be the weakness in the knee muscles leading to knee pain. Doing strengthening exercises to improve the endurance of the muscles of the knee it will be helpful to avoid knee pains. Like doing walking, reverse walking, static Quadriceps and static hamstring should help you avoid knee pains. Use icing as help for reducing the pain. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of bleeding after taking bromelain?\n\nI got mixed messages on Bromelain before face fat transfer.. if I took one 500 mg bromelain but have been taking vitamin k for two weeks and about to take pharmaceutical grade vitamin k tomorrow and the day before surgery, will I still have a chance of bleeding too much?",
    "doctor_response": "Hi,Bromelain is an enzyme obtained from the pineapple claimed to be effective for relieving sinus problems, reducing inflammation, and improving digestion. However there is no proven clinical study to support these benefits. Its common side effects include indigestion, nausea, diarrhea and abnormal uterine bleeding. Vitamin K is commonly used to reverse the bleeding caused by the blood thinner warfarin it does not prevent the abnormal uterine bleeding caused by bromelain.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI shows degenerative changes in the spine. Advised to undergo back surgery. Opinion?\n\nMy mom s MRi report shows degenrative changes in the spine . Transitional vertebra at lumarosacral junction with sacralisation of L5 vertebral body. Also its mentions posterocentral and paracentral disc protusion at L5-l4 with minimal cranial migration causing identation of thecal sac and narrowing of bilateral lateral recess / foramen compressing exiting nerve roots. Doctors in India have adviced undergoing an back surgery with 50 -50 percent chances but we are a little concern about undergoing a back surgery. We are not sure about the chances and also recovery time needed. Your advise will be greatly apprciated.",
    "doctor_response": "Hi,Thank you for posting your query and MRI spine findings of your mother.The decision to operate would depend not only on the MRI findings, but also on the clinical symptoms and examination findings of the patient.In general, only about 10-20% of patients with these findings would require surgery and the rest can be managed with medications and physiotherapy. In operated cases, the success rate is more than 95% cases, if the case selection is correct. I would request you to get back with patients symptoms and examination findings.Best wishes,Dr Sudhir Kumar MD DM (Neurology)Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high BP with strep throat?\n\nI went to the Dr. on Saturday for a sore throat which was strep. my blood pressure was 140 over 106. I had not taken my bp meds in a few months and thought I felt fine. my bottom number has never been this high. A few days before the drs visit i did have a tooth pulled by a dentist. I didnt know if this was just a one time incidence or if I have something causing this to happen.",
    "doctor_response": "Hi,Any type of mental or physical stress on body may associated with fluctuation in blood pressure which may be high or low BP.In your case there might be following causes for high BP-1) Part of your high BP problem for which you were taking medicine previously but stopped since few months.2) May be due to present infection.I want to know-1) Since how many years you had BP problem and taking medicine for it.2) Which medicine were you on for high BP.3) Have you stopped BP medicine by your own or after consultation with Doctor.4) Have you regularly checking BP after stopping medicine.5) Presence of illness like diabetes.6) Family history of BP problem.I will advise you to monitor your BP regularly and consult your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it normal to feel heartbeats in the stomach?\n\nHello doctor, I can feel heart beats in my stomach and it is moving like the heart is beating. This issue I have from more than a few years, but I am feeling it more and makes me nervous. While having this issue, my stomach is getting bigger, more bloated. Please do not suggest me going to doctor, I need a way to lower the heartbeat that I feel in the stomach.",
    "doctor_response": "Hello. Firstly, I guess you do not have any other symptoms like shortness of breath or chest pain. It is worthwhile to get yourself auscultated by a local doctor to rule out structural heart disease, although that appears to be less likely. You should avoid fatty, oily and spicy diet. Have some walk after having food instead of taking rest. Have regular sleep habits and avoid stress. Avoid smoking and alcohol if any. You should get prescribed tablet Pan DSR (Pantoprazole and Domperidone) 40 mg or Esomeprazole-Domperidone combination before breakfast once a day for two weeks. Also, you should get prescribed tablet Etizola beta (Etizolam and Propranolol) 0.25/20 mg bedtime for two weeks, if the heart rate is at least more than 65 per minute. This may cause slight sedation. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Also, try to divert your mind to other activities and do not think much about this to reduce the anxiety and nervousness. Because, the feeling of heartbeat does not mean you are suffering from disease, and one can feel it normally as well. Hope this helps you and get back if you have any doubts. For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having painless, oval lesions on tongue. History of sinus problems. Prescribed fungal medicine. Should I go for dentist advice?\n\nThank you. I have two painless, indented, oval lesions on my tongue . I have also suffered with sinus problems for a year. I have used a steroid nose spray in the last week when the lesions appeared. My doctor prescribed a. fungal. med. but said that I should also see a dentist . I am a 50 year old woman. What do you think? Thanks.",
    "doctor_response": "hi mam i have read your query dental advice is very important  to check the nature of lesion like color scrapable or not origin induration oralhygiene status after assessing it then taking appropriate medication will help u thanks dr.karthikeyan virukshaa dental care coimbatore",
    "dialogue_context": ""
  },
  {
    "patient_message": "My friend has Systemic lupus erythematosus and is on steroids. How can she stop the steroids ?\n\nHi, my friend had problem of SLE(some red spots).This spots is to appear on her legs.After many treatments doctor adviced her to take steroids(wsylon).This is 10 years back.intially dose was 20 mg then 10mg and now she is taking 5mg regularly.Other than this she is normal.If there is extreme pain in her leg she takes 1 pain killer nice.If she stops wyslon she gets pain in her body,feels tired.she is married now.Will she have problem in conceiving.And if she conceives will the baby be normal.How can she stop this medicine.?please help. Age:29 weight:47 gender:Female",
    "doctor_response": "Thanks for the query It is very difficult to say if she in particular will hav trouble conceiving but yes patients with sle can have a complication during pregnancy but some do fare well if she is following up with doctors regulary She is on the right track of treatment, she should not stop wyselone on her own Have a healthy living",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I not drink the coffee if I am scheduled for a stress test?\n\nI have a stress test scheduled for tomorrow morning and I m concerned that I forgot that I was not supposed to have caffeine and had a cup of coffee. Do I need to cancel? They re expecting me at 8:30 a.m. tomorrow morning. Thank you! YYYY@YYYY",
    "doctor_response": "Hello dear,Coffee contains caffeine which acts as a stimulant.So, there are chances that it may interfere with the interpretation of the results of stress test.Effects of caffeine reaches its peak by 30-60 minute of consumption & then starts decreasing thereafter.So, it is better to have a gap of 24 hours.Kindly discuss regarding this with your treating doctor.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain and shortness of breath in teens\n\nMy 13 year old sister has been having symptoms of strange behavior that started with her having chest pains and saying she can t breathe. My parents took her to the er where a brain scan was done and also a look at her heart. Everything came back normal. Today she is acting very slow and strange. She can t sleep. She says she s too hot one minute and then she gets cold a little while later. She says her feet and hands feel like pins and needles and that light is too bright and that her hair is too heavy. She talks slowly and can t seem to think clearly and answers to questions are unorganized or not relevant to the question. I am very scared for her. I asked my parents to take her to a psychiatrist but they are waiting to see if she gets better. I don t know what to do.",
    "doctor_response": "Your sister is likely suffering from Conversion Reaction. This is common in this age group specially in girls. Something has happened which is sub conciously causing problem to her. She is not able share the problem to any one and that is increasing her distress. There may be any problem starting from onset of periods, any bulling or teasing in school, any love issues... any thing. Ask your parents to talk to her regarding any problem giving assurance that they will be by her side. Once she starts communicating things will resolve. . Tab clonazepam can give her some relieve. As weight is not mentioned cant give you the dose. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How the lump under skin can be treated?\n\nI have a pea size lump way under the skin on my bikini line. It has been there a few moths now. Often times the swelling in it dies down to virtually nothing, but sometimes (often when I'm on my period) it increases is size again. It isn't always painful but sometimes it is.",
    "doctor_response": "Hi! Thanks for writing to us and sharing your health concerns regarding a pea size lump way under the skin on your bikini line.When a person comes to my clinic with such skin nodule first of all I examine him/her and then if not confirmed about a possibility, I go for FNAC/BIOPSY TEST from the nodule!In such cases I think of few possibilities like:1. a reactive lymph node that gets enlarged with reaction to local infection2. a sebaceous cyst getting infected intermittently3. some benign skin tumor like lipoma, neurofibroma or dermatofibromaTherefore you must see a doctor for a clinical assessment! Hope you got the answer. Please revert back to us if any more queries.wishing you good health!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Missed taking loette pills. Bleeding started. Can I take primolut?\n\nI accidentally missed taking a Loette pill a few nights ago, then started bleeding, so am taking  Primolut to make it stop. Is it ok to keep taking my Loette pills at the same time as taking Primolut 5mg? Or should I cease taking the Loette until the end of this cycle? I still have 10 active Loette pills left in the tray. Thanks in advance.",
    "doctor_response": "hi.. thanks for using HCM..you are taking oral contraceptive pill.. missed taking the tablets..you have not mentioned the reason for taking the tablet?if it is for contraceptive?... wait for 5 days for bleeding to occur, then start with the new pack of pills from 5th day onwards..primolut will not help to stop bleeding..all the very best..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump in ears?\n\nhi, i have a problem with my ear, i always have, as a child i had to have gromits when they were taken out i constantly suffered from earaches and infections.my ear has always had a yellowy/green substance which smells come from it a few months ago it stopped and then i found a lump in my neck to which i have been told by my gp to blow holding my nose and unblock it, but when i do this there is a very loud screeching noise, my ear then feels very full and itchy and i can then get a little of the fluid that is in there what could this be",
    "doctor_response": "Hi there,It looks like you have got infection in ear, may be ASOM (acute suppurative otitis media) a bacterial infection, or may be there is perforation of ear drum due to chronic infection,you are required a local examination and a course of antibiotics to cure it,please visit a near by ENT doctor.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ankle pain\n\nLast night i was at cheer practice and while I was tumbling, i landed on my ankle/leg weirdly. It hurt a little whenever i landed, but the pain was not too bad. I kept practicing and my whole leg would hurt when i would do certain things, but it was not too bad. By the end of practice, i could not walk on it at all without tons of pain. I iced it this morning, and last night and also took advil this morning and last night. Today my ankle, knee, and thigh area are swollen. I can put some weight on my leg without too much pain, but I can not walk normally without TONS of pain. I have had problems in the past with patella tracking, but it has not bothered me recently.",
    "doctor_response": "Hi there thanks for your question. If you have any pain when  you stand or walk on your injured ankle, it suggests severity of injury and warrants further  work up whcih wil include a X ray at the least. Ice and rest usually give relief in pain and swelling over the first two days. But you are not expected to have pain on standing or walking in mild injuries.Such pain should suggest you to take your injury seriously to avoid long term ligament related pains. Hope this helps All the best. Regards.Dr.SBK",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and weird feeling in forehead?\n\nHi, I have a bit of swollen forehead and general awareness of my forehead area. I was working hard yesterday in our crawl space to deal with and clean up a water issue. I noticed that I was sneezing some in the evening but thought it may have been some dust, etc. I was not in the space for many hours, perhaps an hour total over the course of the day. It was the hottest day we ve had thus far in Raleigh, NC at 98 degrees. I have also been somewhat prone to dehydration over the years. I am 45 and am a professional engineer in the office most of the time. Should I just rest, get water? No significant pain just a full type feeling in the forehead area along with the visual. I m not sure if it feels warm but maybe a bit. Any advice greatly appreciated. Thank you.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have swelling and weird feeling in forehead. Well there can be many reasons for symptoms you mention in query like viral syndrome , occipital neuralgia , sinusitis or migraine , high blood pressure or cervical spondylosis .  Such symptoms can also appear due to allergic reaction or sun stroke . I would suggest you to consult neurologist for proper examination . Doctor may order certain test to confirm the diagnosis like CT scan MRI . Doctor may order blood test along with checking vitals . Doctor may prescribe antiviral like acyclovir along with anti inflammatory ,vasograin , beta blockers , furosemide and physical therapy of neck . Doctor may also refer you to ENT specialist for sinusitis like problem . For now take paracetamol along with taking proper rest .Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dry cracked skin near the tailbone of a newborn?\n\nmy newborn has something that looks like dry cracked skin right where the tailbone would be. Its above the folds in the buttock area but still in the area covered by the diaper. what treatment should I use I don t think its diaper rash its more cracked looking not red. I put aquaphor on it today when I noticed it.",
    "doctor_response": "Hi,Is the area erythematous? From your description, it may be caused by skin dryness- in this case, you can continue the same moisturising cream twice daily for 5-7 days to see the response. Keep the area clean to avoid secondary infection. If it is not getting down by 3 days, or the area becomes red / swollen / tender / blistering, kindly get it examined by your doctor to rule out other important causes like skin infection.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam T. K., Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the survival rate with adenocarcinoma and enhancement on the brain?\n\nHi my mom is a 68 yo diagnosed w signet gastric adenocarcinoma, more thn 2 inches and bleedingwith cavity lymph nodes affected. Contrast mri shows enhancement on the brain. She has lost brain functioning in. the past 3 dzys, aphasia and cannot communicate but seems to understand and recognize.Dizzy and Sleeps all the time for past 2 weeks. What are the possible treatment s and how long would she have with them?",
    "doctor_response": "Hi, dearIhave gone through your question. I can understand your concern. Your mother is suffering from stomach carcinoma.  She has metastasis in the brain.  So it is already stage 4 carcinoma.  Treatment of choice is chemotherapy and radiotherapy.  Prognosis is very poor despite of treatment.  Life expectancy is very low. She has not much time.  Sorry to say but it is fact. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain from the right shoulder to the ear?\n\nI just learned I have a multi nodule thyroid goiter. I have to make an appointment with a specialist. My right shoulder up to my ear hurts and there is a little swelling in my shoulder. Could this be due to the goiter. It hurts worse since the ultrasound on this past Saturday?",
    "doctor_response": "Hi, It is not related to goitre. As the first line of management, you can take analgesics like Aceclofenac or Tramadol for pain relief. If symptoms persist you can consult an orthopedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is liver cancer curable ?\n\nMy Brother in law is suffering from liver cancer; he is living in Lahore Pakistan and just 34 years old. All best doctors of Pakistan have refused to take his case as they are saying it?s not curable! But one doctor (Breg:Naeem Naqi) from CMH Lahore has started chemotherapy and after taking two injections he is now having jaundice also. Now chemotherapy is stopped due to jaundice and they are not giving any medicine for jaundice....needs your opinion, is there any hope!",
    "doctor_response": "Hi.. Stage 4 is an advanced stage of the tumour and it cannot be cured.. You can get a second opinion from one of the oncologist available on this web site.. The\u00a0 link is as follows  Chemotherapy drugs are hepatotoxic and that is the cause for the jaundice. You may have to wait till the jaundice reduces and treat the complications if any that may develop.. There are few other treatment options available.. An oncologist would be able to explain this better...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should an asthmatic patient suffering from lightheadedness and anxiety worry about cardiovascular disease?\n\nHello Dr. Grief. I have a problem when laying down on my stomach, and lifting my head (watching tv while laying in bed) my ears swoosh, and I feel lightheaded like I could pass out if I don t change position. The same thing happens if I am standing, and contract my shoulders, and look up to get a good stretch, and correct my posture. I also feel numbness from the outside of my left shoulder down to the back of my hand, and also a little on the left side of my face/cheek, it is very mild, and doesn t affect function at all. It is annoying, and worrisome though. This has been going on for about 2 years now. I have been diagnosed with anxiety disorder for about 4 years now, but I have only the occasional mild symptoms of anxiety for which I take a small piece of an Alprazolam pill, and I am ok. I used to get heart palps often, but hardly ever do anymore, and I don t worry too much about them because I had a nuclear stress test a year ago that was all good. I have asthma, and take fluticasone twice a day, and singular 10mg at night, along with albuterol as needed. This winter has been the worst ever for my asthma, as my airways are almost always agitated. I exercise 3 times a week, a combination of strength training, and brisk uphill walking. I am a 38 year old male, normal weight, and composition, actually in pretty good shape. Any idea what this could be? I worry about cardiovascular disease because I smoked for 9 years, but I haven t smoked for almost 10 years now, and I only rarely have alcohol, and only in moderation, less than 2 drinks. I had high LDL/ and low HDL cholesterol, but got that under control with exercise, diet, and Testosterone therapy. Any help would be appreciated.",
    "doctor_response": "You have to check your asthma control. In asthma , chronic hyperventilation with disturbance of arterial blood gas exchange can lead to light headedness. Check your blood pressure in lying and standing position to rule out postural hypotension",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking Simvastatin for elevated cholesterol. Have diabetes type 2. Medication causing elevated liver enzymes?\n\nI was dx with elevated cholesterol and placed on simvastatin. About six months later my liver enzymes were and still are climbing, and I have been dx'ed with diabetes type two. Could this medication cause such sx?  Along with these problems, i keep having urinary infections, dry and peeling skin that does not respond well to moisturizers. If I eat, my blood sugar goes up, but falls quickly and causes clammy sweats and nervousness. Anything I should do ? I went to the ER because of pain in mt back and anxiety like nervousness with rapid heartrate. They said it was because my serum potassium was low and prescribed 500 mg of pot,chloride bid. Last labwork one month ago shows my K levels normal, but liver enzymes still climbing. I don't know what to do because my Dr. Keeps saying he is going to research my problem, but I have not heard from him.",
    "doctor_response": "Hello,Statins like SIMVASTATIN is known to cause elevation of liver enzymes.It rarely causes problem to the patient or liver damage.Although you have not mentioned the levels of your liver nzymes,It is very rare that drug has to be withdrawn because of liver toxicity.Mild elevations are ignored but if the values are above 10 times of normal upper value or if patient develops symptoms,the drug is withdrawn.Either a different statin like pravastatin or fluvastatin is given or a entirely different drug belonging to other class like EZETIMIBE can be given.Other most important factor is the control of your diabetes.An uncontrolled diabetes can also result in high liver enzymes.Stop your SIMVASTATIN and see th response in next 1 month.If liver enzymes become normal,then we know the culprit and can think of starting EZETIMIBE.Keep control of your sugar level by medications,appropriate diet and regular aerobic exercises.I hope it helpsThanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for alzheimer s disease\n\nMy husband is 65 years old with Alzheimer s disease. Ironically, he was a family practice doctor, until 4 years ago. Yesterday, his right eye began to bother him. Redness on the lid, rim, and eyeball itself. Today, I noticed that the eyelid was not closing completely. His smile is crooked. He is unable to answer my questions about numbness, pain, etc. He has always had excellent health except for the Alzheimer s. No high blood pressure. Low cholesterol. Only taking RX for enlarged prostrate. I am trained as an artist. Thank you, Kay E. Peterson Woodburn,Oregon",
    "doctor_response": "Hello Kay!I read your question carefully and understand your concern. I think that your father may have a peripheral facial palsy, which in most of the cases is caused by a viral infection or the cause is not found. I would like to know if he has had problems with expressing himself and answering the questions before , from Alzheimer disease , or it has started now with the face problem. Does he have a slurred speech or he can't express words.A peripheral face palsy can be caused by a possible stroke in the brainstem , but it is not associated with difficulty expressing , only with slurred speech from the dysfunction of the muscles involved in speech. Other symptoms like paralysis or dizziness would be present in case of a possible stroke.  So, I would advise you to consult with a neurologist, have a good physical examination . If it is just a peripheral face palsy no other examinations are needed and he can try treatment with steroids and antiviral therapy for some weeks if no contraindications. If other signs are present a brain MRI would be helpful to exclude a possible stroke. Hope to have been of help!Thank you for using HCM!Greetings!Dr. Abaz Quka",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring seizures after pneumonia with history of Stroke?\n\nMy dad suffered a hemorrhagic stroke 4 yrs ago and is on a peg and has a trach,but still going strong. This week he suffered a double pneumonia and a Uti . Today I noticed him foaming at the mouth. What could be the underlying cause? He had several small seizures lately as well. Thank you",
    "doctor_response": "Hello, His symptoms could be caused by seizures, probably related to the brain damage from the previous hemorrhage. You should also know that every infection (UTI or pneumonia) leads to seizures exacerbation. For this reason, it is important to treat as soon as possible the infection and take regularly anti-epilepsy drugs. Hope I have answered your query. Let me know if I can assist you further. Take care. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for viral influenza\n\nMy baby had a high fever ,39.5 degrees, today , I go to baby hospital ,we have a blood test and doctor confirm my baby got Viral influenza,doctor give us some Antipyretic and other medicine. Then we get back, and take medicine follow up the instruction, first up fever back to 38 ,but few hours later, it back to 39.8,amlost 40. So what can i do, please kindly give a hand !",
    "doctor_response": "I understand your concern. Viral influenza takes 4 to 7 days to completely settle so the fever will take another few days to go away. More important is how your baby is feeding, if she is breathing very fast or finding it difficult to breathe. If any of those are present, it is important that you get back to your doctor and request admission if she is breathing too fast or not feeding enough. I would like to know the age of your baby so that I can guide you on how to check her breathing, whether it is faster for her age so that you can take her to the pediatrician if needed.Do let me know her age, about her feeding and breathing pattern(if she s working very hard to breathe with indrawing of the chest) so that I can guide you better.Hope this helps and she gets better soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for difficulty in conceiving\n\ni am 28 yrs old and married.My marriage was on Sep 08 and has intercourse weekly thrice till March 09.My Husband left to Nigeria by April 09 and I joined him by October 09.For the past 5 months trying to have baby but all in vain.I am taking folic acids tablets for past 2 months.I have regular 29 days period. The sexual life is very much satisfactory and we had not come across any medical examinations on this regard.Kindly advice for getting pregnant",
    "doctor_response": "Hi, I think you can try naturally for 6 months more. be in contact with your husband every 2 to 3 days after your periods stop.  It will increase chances of your pregnancy.  If it doesn't work, then you can go for evaluation.  Do a thyroid profile and prolactin levels and a ultrasound for your uterus and ovaries.  You can track your ovulation by repeated ultrasound or ovulation detection kits.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have pain and tiredness due to hashimoto s\n\nHello. I have Hashimoto s. I feel best on 3 grains of NDT. My TSH is .005 at this dose. My endo lowered my dose and now I am tired, and in more pain plus skin conditions that had resolved have returned and my BP is rising. I want to bump the dose back up.",
    "doctor_response": "Hello,Welcome to HCM,Hashimoto's disease or thyroiditis is an inflammation of the thyroid as a result of an immune attack on the thyroid.Now usually in about 95% of the cases, Hashimoto's results in an underactive thyroid or hypothyroidism. In a very small percentage of patients that have Hashimoto's antibody the thyroid becomes overactive. But this is very rare and I must say that we rarely see it. I can say that your symptoms (Pain,excessive tiredness,profuse sweating,palpitations,anxiety and irritability ) are very indicative for Hyperthyroidism. It would be helpful if you send me a copy of your blood test report so I can evaluate the results and to know which tests you have already done. A diagnosis of Hyperthyroidism Can be confirmed with blood tests that measure the levels of thyroxine and TSH in your blood. High levels of thyroxine and low or nonexistent amounts of TSH indicate an overactive thyroid.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Am I entitled to claim DLA for osteoarthritis?\n\nI have severe pain in both ankles due to osteoarthritis.I have had an ankle fusion in one foot and waiting for a fusion in the other foot.I have had steriod injections and various tablets over the years.I have had this for 12yrs.Im thinking of claiming dla.would I be entitled?",
    "doctor_response": "Hi, Any person who has limited motion and mobility issue due to illness is entitled for disability living allowance whether he works or not. So you can also claim DLA. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jayesh Vaza, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the ways of birth control for a woman without any side effects?\n\nhi i was on depo shot but i got off if as i was putting a lot of weight on my periods are all werid and sometimes i never get them i am worried about getting pregnant or if i even am??? i need to protect myself without gaining weight as this is a huge issue any suggestions?",
    "doctor_response": "Hi dear and thanks for your query.If you do not want hormonal methods of contraception you have another methods such as:Cooper IUD tubal ligation They have no side effect like weight gain,headache ect.All the best",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the X-ray with suspicious densities in upper lobe indicate?\n\nHi... I would like to know if i have lung problems since one of the findings i had during my x-ray was \"suspicious densities are found on the upper left lobe\".  I was asked to have apicolordotic view tomorrow.  Let me as well share this, 7 years ago, I was diagnosed to have PTB but i took some medications for 6 months and completed it.  I went back to my doctor and he told me it was treated already...  I'm worried because I am planning to go abroad and work there...  Please help... Thank you.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Your current x ray findings are suggestive of old fibrotic lesions due to previous tuberculosis. Tuberculosis lesion in lungs heal with treatment. And this chealing process develops fibrotic lesions. These lesions are static and seen through out the life. So for your employment query, we should prove that that these lesions are inactive, scarred lesions. For this, you need to consult pulmonologist and get done CT thorax and bronchoscopy. If both these are normal then you can argue with visa authorities. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can taking the following medications be safe for conception?\n\nHi! We have been married for 4 yrs now and yet I have not been able to concieve. Currently taking the treatment for the same. Also my husbands sperm motilility rate is verly low - Rapid linear Progressive 10% , PH7.5 Vol 3 Ml - even after taking certain medicines such asCarnitor 500mg, Ecozyme, Beco Zin , Native C for last 56 months. My montly cycle is 27 days and it is regular. I have also gone for 3 IUI's but no success. I have been taking following medicines - Evion400, Ecosprin, Trental 400, Glycomet 500SR, DHEA and Folvite. We are planing for 4th IUI. Kindly provide your opinion.",
    "doctor_response": "Hello,Thanks for sharing your health concern with us. As per your description, it remains to be seen if your husband's sperm count shows any improvement after treatment. With the lower progressive motility, IUI also may not always be successful, especially if the timing with ovulation is missed. If you also have ovulation defects, it is better to go for IVF techniques. Hope you find this information useful. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat excess spinal fluid on spinal cord?\n\nMy daughter is 16 with back pain, hip pain and some numbness in feet and hands. MRI shows excess spinal fluid on her spinal cord. She also has a vertebra that that did not separate. We are being referred children s hospital. Just want to know what could be wrong and what to ask dr. Only lower back MRI was done and X-ray",
    "doctor_response": "Hi, welcome to our site. I am Dr Saumya Mittal, MD.Read your query. That is a very significant question and i appreciate your problem. I will try my best to answer your queryI will suggest an MRI Brain with spine screening as well. Here is why-The fluid is produced in the brain. Ideally it is meant for the cushioning effect. In certain conditions called hydrocephalus, 1 of the 2 things may happen (Or both)-1. the fluid produced is too much2. the fluid is not sufficiently absorbed backThere is a possibility that the same high levels of fluids may be present in the brain. Now you have said she has upper limb issues as wellSo there may be a problem in her cervical bones too.So an MRI brain with screening of spine would be my choice of investigationI hope this helps you. Inform the reports mentioned above/if any other so I can be of help further. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you.Please do understand that some details could be extracted from a detailed history and examination.Please feel free to ask another query. I would be glad to help you. Looking forward to your return query with the details asked so that I can help you further. (If the answer has helped you, please indicate this)Best of luck.Dr Mittal.MBBS, MD (Internal Medicine), CC (Diabetes Mellitus), DNB (Neurology)Consultant Physician and DiabetologistJS HospitalEx Apollo Hospital, DelhiEx Kailash Hospital, Noida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could a lump under the chin be?\n\nI have a hard lump under my chin seemingly attached to the right side of the chin bone. It is a very hard, immobile bump about the size of a marble. My chin does not appear swollen at all but my skin is noticeably lighter where the lump is and no hair grows on it. does this sound like something serious?",
    "doctor_response": "Hi Dear ,Welcome to HCM.Understanding your concern. As per your query you have lump under chin which is immobile and hard could be due to enlargement of submandibular lymph node or due to inflammation of submandibular gland. It could be due to cystic lesion from thyroid gland as well. Need not to worry much. You should go visit general physician once and get it examined. Get ultrasound done to find out exact cause and extent of etiology. You should go for fine needle aspiration cytology as well. You should take proper antibiotic course along with anti-inflammatory medications. Drink plenty of water and diet rich in multivitamins. Start treatment after proper diagnosis.Hope your concern has been resolved. Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for heart palpitations\n\nHI I ve been having heart palpitations for 2 days - they are constant throughout the day. I don t have any caffeine in my diet, do not take any drugs or medications, do not have a very stressful job. Is this cause for concern? When should I see my doctor?",
    "doctor_response": "Hello, I would explain that your symptoms could be related to possible cardiac arrhythmia. For this reason, I would recommend performing a resting ECG and a cardiac ultrasound. Some blood lab tests are necessary too (complete blood count for anemia, thyroid hormone levels for thyroid gland dysfunction, blood electrolytes for possible electrolyte imbalance). An ambulatory 24-48 hours ECG monitoring would help examine your heart rhythm trends for a prolonged time and exclude possible cardiac arrhythmia. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain with history of kidney stones and gastric?\n\nI have pain in my back. Yesterday it was at the shoulder blade and now today it s lower. Only on the right side. I ve had gastric bypass and kidney stones in the past and I m scared to death it s another stone. Or if it s something with my liver since I drink quite a bit. Help?",
    "doctor_response": "HelloRenal stones can cause pain radiating to back. You also consume alcohol and you have had gastric bypass. I would advice you to go for ultrasound abdomen to diagnose a liver pathologgy and renal calculi.Visit your physician.Hope this helps.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have facial swelling after taking penicillin and pain medicine for toothache?\n\nI called my dentist monday because I had been having a toothache so he prescribed me some penicillin and pain medicine and he is going to see me next tuesday. so that means I will have taken the penicillin for a week. I didn't have facial swelling until my third day of taking the antibiotics. Is that normal?",
    "doctor_response": "No...that is not at all normal...discontinue the medicine and show to a physician at the earliest...Dr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can high fever and pink spots on the neck, ear and stomach in a 3-year-old be managed?\n\nMy 3 year old son had high fever for 2 and half days. No runny nose no cough no sneezing. No pain. Which all came down with meds. The highest was 104.7. Just once it went there. Then on the 3rd day it went up to 103. I gave meds at 2 oclock pm. After that the fever just kept going down. When fever goes down he plays and acts normal. Just tired and ask to aleep a few times. Today 4th day his temp it in the 99. 99.8 to 99.2. And he developed a few pink spots on him.maybe 6 On his stomach some by his neck and ear, only one or two on back. Is this a viral rash?",
    "doctor_response": "Hello, By what you say I feel that this could be a simple viral illness only. Even the Rash could be a viral exanthem but unless I see the rush it is difficult to exactly opine upon it. I will explain you how a viral illness behaves so that you can be more confident. 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. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will using vitamin c be safe for pigmentation & dark patches around mouth?\n\nHi, I'm 21 year old girl, i have wheatish complexion and i have pigmentation around my mouth and dark patches on the corners of my lips. A dermatologist recommended me to use Pure Vitamin C cream. Is it going to work effectively? Can I use Vitamin C on my lips too?",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,   I have gone through your query, as your doctor has recommended you a vitamin C cream yes you can apply it but you should consult with your doctor for recomendation .  Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i meet spine specialist for spinal arthritis, degenerative discs and annular tears?\n\nI have spinal arthritis, degenerative discs and some annular tears in my spine.  I have been in pain management for almost 3 years with numerous series of epidural and facet injections and even nerve ablation therapy.  Nothing works.  Would you suggest that I seen a spine specialist?",
    "doctor_response": "Hello!Welcome on Healthcaremagic!I would like to review your spine MRI report for a more professional opinion. I would also recommend starting preventive therapy for the chronic management of the pain. In this regard, I would recommend starting pregabaline or amitriptyline. You should discuss with your doctor on the above treatment options. Physiotherapy can help improve muscle spasms coupled with a muscle relaxant (Flexeril). Hope you will find this answer helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a painful lump on the buttock\n\nHi for the past year I have had the area of the crease of my butt about an inch of it is white/grey in colour. At first it was like a bad in h which would then turn into a slit cut and it would be really painful. I noticed I would get it when the area became abit moist. What is this condition?",
    "doctor_response": "hi.based from your description, it could be fistula-in-ano, anal fissure or abscess formation. it is best if you consult with w doctor, preferably a general surgeon, for clinical evaluation and physical examination. diagnostics (such as proctoscopy) and management (medical and/or surgical) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatments for Jaundice with bilirubin level 17.5\n\nmy brother is suffring for joindise fo last 25 days the bilrubin count is 17.5 at this time he is in icu room at base hospital in delhi  the doc say some water  in his liver the blood turn into water what is the best treatment and best hospital in delhi",
    "doctor_response": "dear, there are various causes of jaundice which further divide into obstructive  and non- obstructive causes based on the site of disease in liver itself or in blockage of biliary drainage which can further be divided into painless or painful it help in diagnosis at this bilirubin level  biliary drainage must be done either internally or externally based on the cause or feasible route no hospital is bad or good , a doctor where be he is in private or government put their full effort to cure his patient you can try in  Institute of Liver and Biliary Sciences (ILBS), aiims ,medanta medicity , delhi  all are good option",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long can a patient of hepatic encephalopathy live?\n\nHI my father has hepatic encepalepathy and he is very sick and weak and has lots of bed sores too. Right now he is on meds to control the high amonia level in his blood. But how long can the meds help? and how long can a patient live with this condition?",
    "doctor_response": "Hi thanks for contacting HCM...Here your father is very sick and having encephalopathy....So as he has chronic liver disease and elevated ammonia , prognosis is poor here ...Take prescribed drug like neomycin or lactulose etc....Meanwhile more fruit juice and green leafy vegetables given...Spinach and carrot juice given...One tsp cumin seed with water can be taken..Ultimate treatment for liver chronic disease is liver transplantation....In severe case 5 year survival rate poor.Take care....",
    "dialogue_context": ""
  },
  {
    "patient_message": "70 years.  Recurring swollen face, near jaw line.  On medication and lipitor for high BP, smoker.   Guide\n\nMy husband has had three incidences of a swollen face, in the last month.  First, a lip, then the right side, a couple of days ago, the left side.  It's the lower portion more by his jaw line.  What could this be? The last two times it only lasted a day.  This one is already into the second day.  He is a male, 70 yrs old, smoker, and on high blood pressure pills as well as 40 mlgs of lipitor.  Thank you for your input/",
    "doctor_response": "hi,this may be the sign of allergy for something which he is eating, try to corelate what he ate on those days or previous to those days. wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can persistent oral thrush be treated despite taking Nystatin suspension, Diflucan and Clotrimazole Troches?\n\nI have had oral thrush for 10 mon and have been using Nystatin swish and swallow, chlortrimazole troches and several rounds of diflucan without total clearing. Am considering gentian violet and have seen clear gentian violet mentioned on a couple of web sites. Is there such a thing? If so, any idea where I can get it?",
    "doctor_response": "Hello maam! I do not know about gential violet stain but I definitely have a treatment here for you that will work for sure!- Tab. Fluconazole 100 mg (thrice in a week, EOD;  Every Alternate Day) for 14 days - Nystatin mouthwash- you can continue using your Nystatin swish and swallow- every day for 14 days- Clotrimazole Lozenges. - Rabeprazole 20 mg B/F in the morning for 7 days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes neck and scalp pain while facing nerve issues?\n\ndoctor, i have neck nerve problem .feeling touching some were and coming sound moving both side i went before nuerolagist he tolled me neck nerve touching that affected your neck so small vein blood circulation stopping some time that time coming neck pain and scalp pain",
    "doctor_response": "Hi, In my opinion, occipital neuralgia should be considered as a possible condition in your case. I think that is necessary a cervical spine MRI first. NSAID drugs and physical therapy of the neck are treatment modalities in the first stages. Discuss with a Spine Specialist for these issues. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for rash on cheek near infected wisdom tooth?\n\nHello I went to the dentist because it felt like my wisdom tooth was infected...however i recieved meds for that and the tooth doesn t hurt anymore however it seems that I have some kind of rash or something on my cheek near where the tooth is but the tooth is under the gum and require surgery to pull it....I can barely chew food and it hurts very bad...what can I do for this?",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,   you said that you have wisdom tooth under gums, actualy it is partialy erupted you have  problem of pericoronitis , do warm salinre gargle two - three times a day and apply ointment on cheeks where you feel rashes Mucopain 2 - 3 times a day you get relief. Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes extreme tiredness, dizziness and short of breath inspite of having multiple health issues?\n\nI have been having extreme tiredness, dizziness, short of breath etc for months. My DR said that my last labs show kidney slowing and heart something or other. I have a multitude of health issues such as fibromyalgia, chronic fatigue syndrome, severe muscle spasms in my nevk and only have 25 perceny of my intestines left. My question is, what dr should I see next? Im so exhausted that more than not will fall asleep talking to someone, or eating etc. My dr wanted to hydrate me, but can t get a vein. I drink tons of water and urinate just fine. What do you suggest?",
    "doctor_response": "To be frank after rulingout major organ illness better to consult psychiatrist as all these things could be part of somatoform disorder or depression. Best of luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lumps on the neck after a bee sting?\n\nMy 17 yr old son was stung by a bee on the back of his neck 2 days ago. He noticed 2 lumps on his neck about 2 inches away from the sting. They are sore when pressed on. I thought they would have gone away but haven t. I m going to call the ped in the morning. Do you think these lumps are from the sting?",
    "doctor_response": "Hello ,I understand your concern. I am Dr. Arun Tank, infectious disease specialist, answering your concern.No it has no relation with the sting.Sting only causes reaction at the sight of the bite. It never causes sting away from the sight.Secondly it also causes reaction immediately. It never causes reaction after two days.It is likely to be some kind of infection.It requires further confirmation to do treatment.I will be happy to answer your further concern you can contact me here or you can contact me on bit.ly/DrArunWe wish you a best health at healthcare magic. Thank you,Dr. Arun Tank",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i walk on toes after getting a surgery on foot with foot cast?\n\nhi. i just had surgery on the right side of my right foot the week before christmas and after the sergury they put a splint on it i think for aweek and on the 27th i went in to get my foot cast and i get it off on this coming up wendsday,.,.,.,.,.,.what could of happend if i have walked on my toes a few times or my foot fell on the floor a couple of times?",
    "doctor_response": "Hello, You should not walk on toes after major orthopedic surgery. It will affect the healing process and improper weight bearing as in case of toe walking can lead to unwanted complications like malunion and decreased joint mobility. You can consult a physiotherapist and he will direct you to various rehabilitation options. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in my neck down to my arm?\n\nHi I have serve pain on my left side from the neck down to my arm and on the right side also, it hurts to left a glass of water. Or to left anything up I have had neck surgery n lower lumbar surgery twice I really need help with this pain. My meds aren t working at all and I don t know what to anymore! So sorry but I don t any money at the moment I did t know I had to pay",
    "doctor_response": "hi,thank you for providing the brief history.As per the history it appears to me as a recurrence of the disc compression on the nerve root leading to symptoms.I will advice you to undergo physical therapy like therapeutic ultrasound therapy & TENS therapy. Pain and inflammation need to be controlled and both physical modalities can perform well if taken in a correct dosages.Also, strength training for neck and back muscles is important to avoid the recurrence of the pain and other symptoms.precaution needs to be undertaken by sleeping on a hard surface, neck collar, avoiding long bumpy travels, sudden jerky movements etcIn my clinical practice most sever cases with neck and back injuries are treated well with physical therapy as recurrent Operations are not healthy. Pain control should happen with natural way as too much pain killers can damage the kidneys and physical therapy is a good option.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is my lymphocyte level always increased?\n\nHi doctor, I got my CBC report. It was normal, but lymphocytes were 3.04. Then again I tested after two days, everything was normal, and the lymphocytes were 2.57. I asked a general physician. He said, they would fluctuate every hour, and the doctor saw my latest reports and told everything is normal and healthy. I am a fearsome person. So I tested for blood smear. I read that the blood smear will show abnormal cells. If you have any blood disorders, the report will show you. The reports came in which RBC, platelets are adequate, and there is no hemoparasite found but, it says mild lymphocytosis. My general physician says there are no abnormal cells like blast cells or anything found. So it is normal. Can you tell is this normal? I am getting feared and worried. I tested because of my fear of getting cancer. Please help.",
    "doctor_response": "Hi. I have reviewed your query, and I will surely help you to remove your fear. The mentioned history does not suggest any abnormality, and you have lymphocytosis only. As per the reports you have attached (attachment removed to protect patient identity) abnormal cells like blast cells, prolymphocytes are not seen. So, leukemia is not present. In leukemia, the total count will be high, which is not present in your case. So do not get worried. You can attach your reports so that I can also check it. For more information consult a hematologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sever stomach pain in autistic children?\n\nHi, I have an autistic son ,aged14 . He is taking sodium valproate for subclinical seizure and Propranolol for stomach migraine. Even after on medication for one year ,he is having severe stomach pain and becomes violent. Recently I observed his underwear getting wet due to small urine leaking out.What can be the cause? What tests I have to perform?,",
    "doctor_response": "Hello and welcome to \" Ask a Doctor\" service.I have read your query and here is my advice.Urine incontinence is mainly caused by seizures, so, it is necessary for a reevaluation for the seizures medication.Discuss with the Neurologist for these issues.Hope this helps.Feel free to ask if you have further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes slight heart murmurs?\n\nIs there a way i can tell if my mild/moderate pectus excavatum is decreasing my staminia when doing physical activity. I am fifteen, and my doctor says i have a slight heart murmur. he sent me to get a ultrasound and said it is probably nothing to worry about.",
    "doctor_response": "heart murmurs are of two types ...some murmurs are due to disease and other murmurs are found in normal people ..as your doctor says it is nothing to worry about ..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in abdomen & anal canal post sex?\n\nMe and my boyfriend were having sex doggy style when he hit something hard, i think it might of been my pelvis. It hurt both of us. And for the past 2 hours i have been having throbbing pains in my lower abdomen and my anal canal. It hurts to fart. But he did not insert his penis in my anis.",
    "doctor_response": "If you did not have anal sex and it was vaginal sex in doggy style then nothing much to worry. Take a medicine with mefanemic acid with acetaminophen. Usual market brand available is Meftal plus. You take this medicine twice daily for three days and you shall be fine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe hairfall\n\nI'm a having a severe hair fall.. i was not like this before.. even if im not brushing my hair still hair keeps on falling.. when i say severe hair fall it means as in more than 100 hairs a day. I have thick healthy hair, i eat fruits and vegetable and i even take Vitamin E every night for my skin.Do I have cancer?age: 25weight: 156 poundsmedical hx: unidentified PID, UTI",
    "doctor_response": "Hello. Thank you for writing to us at healthcaremagicHair fall can be due to various causes. Common causes being androgenetic alopecia and telogen effluvium.Androgenetic alopecia is associated with gradual receding hair line in males as well as thinning and hair fall from frontal and crown part of the scalp.Family history is usually positive in androgenetic alopecia. Telogen effluvium on the other hand is due to shifting of hair follicle from anagen(growth phase) to telogen (shedding phase). Once hair enters teolgen it will be shed over the next 2-3 months.Various triggering factors responsible for shifting hair from anagen to telogen are either dietary like deficient Iron stores; preceding illness like dengue, malaria, jaundice; preceding surgery; post-partum etc.Treatment would vary depending on the diagnosis. Treatment options include topical minoxidil and Oral finasteride for androgenetic alopecia and topical minoxidil along with biotin supplement for telogen effluium.I suggest that you seek an appointment with a dermatologist in your region for the needful.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore lump on testicle?\n\nHi, i have found a lump on my right testical, that i have noticed this past few months, its attached to the side of my testical and is about a pea sized lump that is sore to touch.. it is only felt, you can not see it sticking out of my sack. Somedays it hurts without it being touched. I researched cancerous lumps, and they seem to be small numerous lumps that are visible to see sticking out the sack. Should i get this checked? I have a recent history of cancer in my family, could this lump be cancerous? Thanks",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern.  You may have some epididymitis or orchitis. You may have abscess forming inflammation or some cancerous lump.  You should go for ultrasound examination.  If needed go for fine needle aspiration cytology. Then take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy gums after cleaning teeth and eating chocolates?\n\nAfter having my teeth cleaned I had itchy gums, this has now been ongoing for 3 months and is even worse when eating chocolates or drinking sugary drinks or eating fruits. But other than that it is constant and nothing seems to help. Can you help please?",
    "doctor_response": "hi i would suggest get an OPG xray done there might be chances of u have gum related problems (periodontal pockets) and once u get your opg done visit an periodontist.regards Dr Rakesh Mishra",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fluttering feeling in the upper abdomen after gall bladder removal. Worried\n\nI have no gallbladder, taken out last year, I've heard you can have \"phantom pains\" and until last week didn't think much about that but once last week and again this morning felt a \"fluttering\" feeling on the upper right of my abdomen and got worried, suggestions? I know i am relying on my liver but wonder if its serious or what to do next....please any suggestions?",
    "doctor_response": "Hi,                                   Yougot your gall bladder removed last year, you heard of phantom pains, last week and this morning you had pain in rt upper part of abdomen.                                   As you are in a view of phantom pain you are thinking of it.                                   Other possibilities are gastric pain, due to irritation, indigestion, ulcer etc.                                    Dont worry you will be fine with PPI, and other medicines.                                    Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can infertility as a result of azoospermia be treated?\n\nI have been battling infertility for the past five years as a result of azospermia, I have done varicocele surgery and I have taken a hand full of treatment and yet no improvement. I don t have money for IVF and my marriage is at the verge of collapsing. Is there any hope for me",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Unfortunately, the only hope is that you consider ICSI cycle accompanied with testicular sperm extraction procedure. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for lung infection?\n\nMy husband has broken his shoulder but they have been unable to to operate due to a lung infection. Whilst waiting for the op he has fallen on his shoulder burst open the swollen area and for 4 days it has been leaking nasty yellow brown gooey fluid. The medics keep changing it but its no sighn of stoppping leaking. He is awaiting bed for shoulder op any day now. What is this stuff leaking ??",
    "doctor_response": "This is likely pus from an infected wound. He should seek medical attention immediately. This will require antibiotics at the least, and may require surgical debridement of the wound as well. I hope he does well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get pregnant?\n\nI came off the pill 2 months ago. My last period was 3 weeks late and only lasted 4-5 days. My period would noramlly be due on the 28th of this month and I have had brown discharge for almost a week now, what is going on with me, I am trying to get pregnant, should I go and see my doctor?",
    "doctor_response": "Hallow Dear,The last period you had 3 weeks after discontinuing the pills for 4-5  days was normal.If after that you had no period for 7 weeks, it indicates you could be pregnant. However, you are having brown bleeding for last week. This could be missed abortion. Pregnancy immediately after discontinuation of birth control pills do have a risk of spontaneous abortion. Please report to your Obstetrician for correct diagnosis. You may need surgical evacuation if the abortion is not complete. This could be incidental abortion and need not repeat again in future. Hope this helps you.Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for mild dull ache in left leg\n\nI have a continuous throbbing in my shin area of my left leg. Is not painful. Went to the doctor who suggested Magnesium 2 - 3 times per day. I have been taking magnesium but is not helping. I have only been taking twice a day. Do you think the 3rd dose may do the trick? or can you suggest something else I might try?",
    "doctor_response": "Thanks for keeping trust with us. ..as per your history u r taking magnesium twice a day to controll symptoms. ..In my opinion more than that can increase serem level of magnesium that can create additional problems ....so better to consult your physcion before you increase the doses. ...at present to releve symptoms u can a start a calcium supplement and a analgesic like tab tradmadol 50 mg sos basis. ..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Ear ache while smoking. what should I do to treat this ?\n\nWhen I inhale smoke or talk on the phone my right ear starts to really hurts what do I do ?",
    "doctor_response": "Hi, How long are u getting this type of pain? Is there also hearing problem in right ear? You should see an ENT specialist to find the cause and get treatment accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the suggested medications for swelling in hip joint?\n\ni have pain in my left hip area i have consulted an orthopedician nd in xray found a swelling in my hip joint his medicine is effective for a few hours but i have been taking medicine for 10 days and the pain increases in i cough sneeze orlaugh loud...plzz help",
    "doctor_response": "Hi, Whats your age? Have you done any blood test only x-ray is not sufficient to make a diagnosis of hip pain without injury. Get these investigations done. HGM with ESR, CRP, montoux test,  TB gold, Anti-CCP, MRI hip with contrast and then review. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jaideep Gaver, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for fever in toddlers\n\nMy daughter is 4.4 years old, 21.8 KG weight. she has fever of 102.3, and my doc has prescribed Lariago 10 ml 2 times for 3 days, and Meptal-P 8 ml twice a day for next 3 days. We are in Hyderabad, India. I had malaria symptoms and undergoing treatment for the past 3 days, had high fever - 104, 184 was my sugar level, and low BP too. Since today evening my daughter who is very close with me, has been developing fever, and hence the medicines. Pls advise what would be the best way forward on my daughter s health.",
    "doctor_response": "HI...if your daughter is developing fever in being in contact with you, then it is not malaria and mostly it is viral illness. Viral illness spreads by close contact and malaria spreads by mosquito bites.Now in south India, Dengue is in full swing. I do not recommend the usage of Meftal-P which has the side effect of dropping platelet counts, because as such in any viral illness, there can be drop in platelet counts.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 15mg/kg/dose every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes my mother's obsession with suspicion?\n\nHelo doctor, I am Sivaprasad 25 yr old guy and i m asking question related with my mother, She is 54 yr old and living with us, our family is a small family, father mother sister and me. My mother is suspicious about everything especially things related with father. Some times it will lead to huge quarrel between father and mother, Father was trying to lie many things from mother because of this problem. This lead things more complicated. How can i overcome it?",
    "doctor_response": "HiThanks for using healthcare magicIn that case, you should consult a psychiatrist to rule out psychosis. May be she has underline psychosis and due to this, she suspects on your father. In that case, she needs mental evaluated and for that, better to consult a psychiatrist. If she has underline psychosis, then you would improve with antipsychotic. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sore irritating socket area post tooth removal\n\nI had a tooth pulled and ended up with a dry socket.  I took antibiotic and the dentist put medicine in the area three days.  I went away after that with pain medicine and antibiotic.  I noticed in front of the socket I have a hard bump and the socket area is still sore not painful but irritated.  What could be wrong?  Am I healing?",
    "doctor_response": "Thanks for your query, I have gone through your query.Since you are telling you had a history of dry socket, it takes litle time to heal, the hard lump can be because of the inflamation. nothing to worry it will heal completely in 10 days duration. mean while you can do saline gargling.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pregnant. Have liver enzyme. Prescribed with Udiliv, Duvadilan retard, Astymin forte. Are these medicines safe?\n\nHI Doctor my wife is 32 week pregnant now. She has been suffering from Liver Enzymes recently. Her SGOT - 470, SGPT - 640, ALP -490 . She has been given Udiliv 300mg twice daily by her gynec . She has been advised for checkup next week. The following medicine has given - duvadilan retard - twice daily, astymin forte - twice daily.",
    "doctor_response": "Yes these medications are safe they would enhance your liver functions as well as reduce the levels of enzymes and prevent heatotoxicity.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of postinor?\n\nHi, Since i started taking postnor some years back, i experience these pains/cramps that lasts between 20 to 30minutes some days after i take it. Now i have stopped taking postnor but i still get these pains some times. I am getting worried. I dont know what to do.",
    "doctor_response": "Hello,I read carefully your query and understand your concern. Postinor can cause cramps as a side effect.I suggest using magnesium for muscle relaxation. If the symptoms continue, you may also use a spasmolytic such as Buscopan. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is elevated levels of LDL in blood dangerous?\n\nMy HDL is 2.42 and LDL 2.77 ratio total to HDL 2.5  and Triglycerides 0.4  how concerned should I be  about the LDL it seems just a little high and what about 0.4 triglycerides - the range on the lab report says risky if below 1.5 . My reading seems much lower?Total Cholesterol 6.1 mmol/L (all above measures in mmol/L obviously except the ratio)",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.LDL is bad cholesterol responsible for heart disease.HDL is good cholesterol it protects you from heart disease.As your LDL is high you have to take proper care to reduce it. Reduced cholesterol helps protect heart disease.You can start exercise, diet control etc to reduce the LDL and cholesterol.Some lipid lowering drugs available in the market which reduce the lipid. Simvastatins reduce the cholesterol.I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for typhoid fever\n\nHello Sir, It was yesterday when my blood test showed that I have typhoid .. S Typhi O Positive upto 1/40 .. S Typhi H Positive upto 1/80 .. S Pratyphi AH & BH are Negative in all dilution. Since past week I had fever 100+ headache weekneas and loss of appetite. Currently I am on Homeopathic Medicines, Please let me know is Homeopathic write decision or I must go to English Medicines. And how long will this typhoid remain ?? I am really suffering very much.. Please suggest the best possible way.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice. If in Widal test dilution is 1:160 or > then it is considered as a positive test for typhoid fever. In your case both dilutions are below than normal, so not positive.100+ fever may be due to malaria, flu, common cold, without complete history it is very difficult to establish any diagnosis mere on the basis of this query.Homeopathy or allopathy all depend on mind and disease and belief of patient, you are better to judge which therapy you prefer.Good luck.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Het Ram Bishnoi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What shall I do to regularize my periods?\n\nHi doctor, I have been\u00a0having PCOD since last 14 years. I started treatment before four years with Bigomet SR 1000. After continuing it for eight months, I had periods with more gap compared to earlier. Then, I had periods only with the help of medicine and so, I left the treatment. I started my treatment again before nine months and had regular periods. I dropped the treatment again. I have to regularize my periods now using medicines as I am planning for pregnancy. I am taking Myotol-F and Folvite for the last one month. During this period my doctor gave me three tablets and said after 10 days my periods will occur. Now, it is more than 10 days and no periods yet. I have attached my laboratory test reports for your reference. Is there any other problem?",
    "doctor_response": "Hello. I have gone through the reports (attachment removed to protect patient identity) and in your case, PCOD (polycystic ovarian disease) is not a problem for delayed menses, but high prolactin levels due to hyperprolactinemia. PCOD can be controlled with diet, exercise and weight loss and even with Cyproterone oral contraceptive pills, but menses would not regularize and ovulation would also be irregular if the prolactin levels are not under control at all. I suggest you dopamine agonists like Cabergoline, twice a week for three to four weeks to bring down the prolactin levels. Presently, I believe you have been given progesterone pills for initiating withdrawal bleed, but just mere 3 pills of even Primolut-N are insufficient to initiate a bleed. Hence, you have not received a withdrawal at all. Wait for another five days and if menses do not occur, then you should be started on Primolut-N 5 mg twice a day for five days at least and then withdrawal should be expected in the next 5 to 7 days from the day of the last pill intake. Consult your specialist doctor, discuss with him or her and get the dose altered. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for child having spots on face, hands and around eyes\n\nmy sister is suffering from skin problems from last 7 years...every time it goes off then again comes back..it basically appears at the joints of hands , legs , couch area...there are shiny spots on her face around her eyes....we went through many skin specialist..but it returns again and again...generally it appears during rainy season....skin starts with rough reddish brown color and ends with black big area...kindly suggest",
    "doctor_response": "Hi,Can you send me a picture for a better assessment?From what you said, this may be a manifestation of skin allergy (atopic dermatitis), which can have intermittent exacerbation depending on climate and environmental allergens. This is a chronic disorder which is difficult to cure completely. Applying a moisturising cream regularly after bath will offer some help. During flareups, this will need topical steroids and anti allergy drugs for few days. Kindly keep regular followup with a dermatologist.Sometimes, an allergy skin test followed by desensitisation or avoidance of the particular allergen if feasible will offer longterm remission.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam T. K., Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does viagra posses any harmful impact on fetus?\n\nHi, My name is Mr Emmanuel Asante, I am a regular user of Viagra pills during sex with my wife, I would love to know if I pregnant my wife while using viagra on sex with her , will there be any affect to my child health as a course of the use of the sex drug , I hope to hear from you pls",
    "doctor_response": "Hi, Not a bit or there would be a lot of birth defects. It isn't really known about the effects if the WIFE took it, but there are no reasons for her to take it and it does not work much on women. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from UTI. Frequent urination.  Sonography showing kidney stone. Taken ciprofloxacine. Further medications?\n\nHi .I ve been suffering from UTI for the past 48 hours.I ve used Phenazopyridin to stop the pain but not useful much -I ve also done the kidney Sonography and they suspect of kidney stone in size of 3 mm.I also used ciprofloxacine sine morning but every 2 minutes I need to urinate -Is there any other medications to make the situation better till I visit my nurologist ?",
    "doctor_response": "You should get a urine re/me and urine c/s test done to know the organism causing the infection and the antibiotic it will respond to. In the meanwhile, since you have already started taking ciprofloxacin, you may continue it morning and evening, take meftal spa or dicyclomine for the pain, drink plenty of water and take alkasol syrup. You must consult you urologist as he/she will advise you further on kidney stones also.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause TB?\n\nI am in the US, but my friend lives in Rishikesh and she was diagnosed with TB. She was told she has a closed TB and nothing can be seen on the x-ray. She is now on her 3rd month of medication and was told to take it for a total of 10 months. I am very concerned about her and have several questions.",
    "doctor_response": "Hello ! Can you please mention in which organ in the body your friend was diagnosed to have TB ? Coz TB can affect any organ  n from head to toe . Since  u mentioned X ray , I presume you might be speaking about Pulmonary TB . For diagnosing pulmonary TB clinical (patient's presentation symptoms and signs), radiological (Chest x ray, high resolution CT appearance), microbiological (sputum AFB, sputum CBNAAT testing ) findings need to be correlated.  The common symptoms suggestive of TB are cough for more than 2 weeks duration not subsiding with routine antibiotics, fever with evening rise in temperature , bloody sputum (henoptysis), loss of appetite n loss of weight.  Did your friend have any of these symptoms ? If yes then definitely investigations to rule out or rule in TB have to be proceeded with . Also two things need to be kept in mind.  One , not always chest x ray show some abnormality in TB.  If there is minimal lesion then only a HRCT chest can pick it up and it can be missed on chest x ray.  Two, Since TB is common in India, at times , other diseases are wrongly diagnosed to be TB . Hence it s essential that you get the consultation with a qualified physician to ensure that diagnosis is correctly arrived at.  As far as the treatment for TB is concerned , if this is the first time your friend is taking anti- TB medications then he/she has to take it for 6 months.  If this is second time then the course will be for 8 months",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long can daxolac be continued in a 2 year old?\n\ni giving my son Daxolac from his birth, as my wife milk not available from after one month of birth. Now my son is 2.5 years and using Daxolac 3 Number. please let me know any side effect of this Milk (Daxolac 3) if any. Can i continue to give this. He is now eating everything but without milk not sleeping. please suggest",
    "doctor_response": "Hello,There is no major side effect of Dexolac; the only thing is your child is not getting adequate nutrition. You need to give him balance diet.You can continue Dexolac after taking care of overall nutrition but giving fresh food is more preferable than canned powder.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Priyank Ghanchi",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed fatty liver.  Prescribed Ursocol 300.   Is this curable?\n\nHello Doctor, I underwent a master healthcheckup and found out that I have fatty liver issue. My doctor advised me to take Ursocol 300 for the next 3 months. I am really worried now. Is the fatty liver a major issue and also want to know whether this is permanently curable. Do we need to follow any specific diet for this ? Pls advise",
    "doctor_response": "Hello,Normally some fats is present in liver but if this fat increases more than 5 to 10% of weight of liver,then it is called as fatty liver.Fatty liver is broadly either alcoholic or non alcoholic.Alcoholic fatty liver is caused by excessive consumption of alcohol while non alcoholic fatty liver can be caused by high cholesterol or high triglycerides,diabetes,pre diabetes,malnutrition,weightloss,certain medications etc.Fatty liver is totally reversible if the offending cause is identified and removed.Quit alcohol if alcohol is the cause.Control cholesterol,diabetes,if they are the cause.Reduce weight Reduction of intake of saturated snd trans fats,sugary drinks,junk foods etc.As far as medicines like URSOCOL is concerned,many gastroenterologist do prescribe this medicine but their role is controversial.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are sore throat, neck pain and earache symptoms of throat cancer?\n\ni have had a sore throat for over 2 months, also neck pain, and earaches. A doctor i saw 2 weeks ago thought it was sinusitis, prescribed a antibiotic which did not help. I am very concerned that i have throat cancer. My sore throat gets worse then better, even in the course of a few hours but never leaves.",
    "doctor_response": "If you are having fever and a throat swab test as well as a sputum culrture test is required. If not meet a surgical oncologist and get a consultation . he/she can decide the need for aa endoscopy of you air passages.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of pain in foreskin ?\n\nyes initially i had a itchy in my foreskin and after ward my foreskin started to drowning, i took the medicine and applied the lotion. since for three months i avoid the sex also. now my foreskin cannot strecht and its painful when i get erect pls help",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have itchy foreskin and painful on erection.This could be mostly due to Muco Cutaneous Genital Candidiasis (Fungal infection) which is common in person with diabetes.Please get your blood sugar tests on empty stomach and 2 hours after lunch done to rule out/confirm  the same .If positive you will need to take medications to control your diabetes.Take anti fungal medication like fluconazole with topical anti fungal  cream for local application.Get the prescription of medicines from your family Physician.Ensure to wash your genitals with warm water twice daily .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes body chill when suffering from heart disease?\n\nMy 86 year old mother in law just called me saying she just woke up from a nap but felt cold inside her body...strange feeling....she has atria fib and a weakened heart muscle working at about 1/3 capacity is this feeling cold inside something that is real and should I be concerned about it?",
    "doctor_response": "Hello, thank you for putting your trust in our site, my name is Dr.Soliman and I will be glad to answer your question.this feeling of cold inside her body considered a common symptom of atrial fibrillation for females above 60 years old like your mother in low and it happens due to decreased cardiac output to the whole body, so you should not worry about this complaint and assure her that this feeling is normal with her condition and she should be covered while sleeping and wear more clothes.I hope this answer fulfill your query and if you are satisfied with the answer please consider giving 5 star rating,wish you a good health with regards,Dr.Soliman",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath , leg pain and stomach pain?\n\nSeveral questions been going on for over 7 years 1. pain in right upper stomachs and radiating to r shoulder and mid back - deep 2. Legs feel tight aches and are shiny 3. Become bloated no matter the food and constant stomach pain 4 bowel movement is mustard soft most of the time 5 shortness of breath starting to occur Before and After gallbladder removal - have had many test, everything comes back neg.",
    "doctor_response": "Hi Dear !! Thanks for your query to HCM .Read and reviewed your query and health concerns. IN the given situation of Yours, seem to suffer from-Post-cholecystectomy Syndrome(PCS).Stomach pains are from bile induced diarrhoea, and gastritis.Shortness of breath is from-GERD with lower esophagitis, and is due to esophageal irritation and inflammation.Leg pains seems to be with Bloated stomach compressing Sciatic nerves.Hence theses test done to fix cause of these complaints come out normal..Other causes of stomach and leg pain like-IBS C with ano-rectal piles, fissure in ano,Crohn's disease ,Gall stones with post-obstruction hepatitis,,need to be ruled out.Second opinion from Surgeon / Physician need to be taken to resolve these pains.This plan would reduce your dilemma pain with nausea in lower chest and back .Hope this would help you to plan further of this complex illness of yours.If need be, update any health issue 24 x 7 by a direct question to ME, at following HCM link-Dear, if satisfied,Don't forget to close this query with YOUR pleasing feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at HCM services.If you want to update more details and ask more update queries ,You are most Welcome herewith !!Good Day!!Wishing Good Healthy Life in time to come!!Dr.Savaskar M.N.Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medicines and measures should I take for my 8 year old son having low body weight and diagnosed with asthma ?\n\nHi sir, Sudarshan here, my 8 years male child having weight 18 kg and ashthma problem. Now his blood /urine report is as follows. Test Result Normal value HB 12gm/dl 12-18 gm/dl TC 7750 cells/cumm, 4000-10000 cells/cumm Polymorphs 66%, 45-75% Lymphocytes 31%, 30-45% Eosinophils 3%, 1-6% E.S.R 25 mm/1hour Male: 5-10 mm/1hr ALBUMIN TRACE SUGAR NIL BILE PIGMENT NEGATIVE BILE SALT NEGATIVE PUS CELLS 8-9/HPF 0-0/HPF RBC NIL/HPF 0-0/HPF EPITHELIAL CELLS 15-16/HPF 0-0/HPF Please give ur valuable advice and medicines and remedial action",
    "doctor_response": "Hi Sudarshan, . Your Son has a Infection and Inflammatory Process going on inside his Body. What exactly are his Other Symptoms? Take him to a Pediatrician as he needs a complete evaluation so that Proper diagnosis can be arrived at after looking at his test report. He may need antibiotics and anti asthmatics. Medications cannot be prescribed without Proper physical examination. Good Luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My USG shows complex heterogenous hyperechoic cyst in upper pole of kidney. Please explain this.\n\nHello doctor, Yesterday, I had an ultrasound of my abdomen. They gave me the report online and I am not sure how to read it. The things I am looking up are extremely worrisome. It is all saying cancer. I am going for a CT scan within a week. It is without contrast because I have myasthenia gravis and the contrast really affects my breathing. Will contrast make a huge difference? Below I have pasted the results and it says: Normal liver and gallbladder. Left renal calculus. Complex heterogeneously hypoechoic cyst in the upper pole of the left kidney for which further imaging is recommended. Also, I have been urinating almost every hour and it feels like my bladder is never empty. I have had a kidney stone four years ago. But the part about the complex cyst on my kidneys is troubling me.",
    "doctor_response": "Hi,  Welcome to icliniq.com.  I understand your concern. So, you have a cystic lesion in the upper part of your kidney. First of all, you are only 28 years old and at your age, I would favor many benign lesions over malignant ones. If they are not talking about solid components of the lesions, it again favors benign lesion. Let them do CT (computed tomography) with i.v. (intravenous) contrast, if possible share both ultrasound images and CT images with me. One more thing, if you do not have any sign of night sweating, weight loss or redness in your urine, again malignancy risk is too low. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in arm and back?\n\nI woke up this morning around 1:30 to use the bathroom and after returning to bed, became restless and had trouble falling back to sleep. I got up before 6 this morning to get ready for work and had a mild headache, so took my thyroid medicine, showered and then took 2 regular Tylenol. I noticed that my right arm was aching since I got up and also had pain and discomfort in my back between my shoulder blades. I have been experiencing this arm pain and back pain all day. I have since taken more Tylenol. I also have Ulcerative Colitis and am taking Asacol daily, Rowasa enema at night, a blood pressure medicine (forgot the name) usually take around noon. I m also taking Remicade infusions. I ve had 2 treatments so far...my next one being July 10th. I guess I m wondering if this is a side effect of the Remicade, which I don t see that it would be, or something else. How serious could this be?",
    "doctor_response": "Hi, Medications currently have a lousy sense of direction and side effects from them have to occur everywhere not in one spot. Overall aches from immunologicals? sure, one spot. doubtful. Then, the larger question is what's the cause of the pain! Cannot say in your particular case, but generally, you start from what is there. The nerves run from the neck down the arm. Shoulder is not a perfect spot unless it is along the top. AND moving the neck usually triggers it. Joints give pain with moving the joint and this is quite likely in this case. Arm attachments are a bit complex. Then there is the muscles. these generally hurt if pressed. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can ashwaganda brahmi combo cause anxiety symptoms?\n\nI've tried ashwaganda brahmi combo and the first week I felt so much better,had more energy ...etc,then when I got my period had very intense anxiety simptoms.Do you think this might be do to those supplements.I started those to help with stress!Thank you",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. As per ayurvedic texts, ashwagandha is used for anxiety and brahmi as brain tonic. Earlier the combination is usually prescribed for anxiety. Now a days it is not followed because it is not that effective. But it is your duty to consult a doctor before taking any medication. Never have self diagnosis and jump into trouble. Anxiety and stress are not diseases but are state of the mind and they are completely curable just with the help of simple life style changes and some meditation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest a remedy for a tear on the frenulum\n\nSo yesterday I ripped my frenulum there was a lot of blood. The bleeding had stopped completely but the tear still hurts. Let me mention that it was torn to the point where there is only a tiny piece left intact. Well I have been cleaning with peroxide to make sure there is no infection. What I wanted to know even if there is only a small piece left will the tear still reattach and should I really be cleaning with peroxide or is it a bad thing. P.s. I am not able to pull back foreskin over my head without pain.",
    "doctor_response": "Hi,Thanks for writing in.The tear in your penis may get better without treatment. Avoid sexual activity until the tear has healed. Once it has healed, you can try using a lubricant during sex to prevent the problem from happening again.It is not a serious issue and might take 2 weeks to heal. Right now you are required to keep your genital clean and dry. Please wash with warm water twice a day to avoid any infection. You may apply neosporin ointment over the torn frenulum. Please take oral pain killers for 5 days.Since the bleeding seems to have stopped, you do not need surgical suturing. It may happen that a scar might form in the area, if this happens then there is shortening of frenulum and might be released by minor surgery . This cannot be known now and will be obvious only after one month.Please wear loose inner clothes and maintain genital hygiene. Avoid masturbation or sex for two weeks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should I wait to have sex after starting new pack of pill?\n\nHi I m currently on the combined pill. But last month I was in hospital for 2 days with a kidney infection, during this time I had high temperature and was vomiting. I was on the pill and I finished the pack. After pack was over I had my period as normal. I am now back on the pill and have been for 2 days. I was wondering do I need to wait the 7 days before having sex or will I automatically be protected?",
    "doctor_response": "Hello dearUnderstand your concernAs you took pill whole month and period is already came and you also had started again new pack last for 2 days.You have not wait to sexual intercourse and you are already protected.But you have to take remaining tablet on sane time every day for effective prevention of pregnancy.So no need to wait for 7 days, Enjoy your sex but do not forget to take your pill on same time everyday.Hope this may help youBest regardsDR. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Small bruise, severe pain in incision area after removal of appendix. Could this be possible blood clot?\n\nHi, had appendix removed laproscopically a week ago & although I expect to be in pain, the incision on my left side is absolutely bringing me to tears. I have a small bruise there. Even a regimine of Tylenol every two hrs then Percocet every two hrs will assist me in doing taks related to this area. I called the on-call-nurse last night and she said something about chockers & tubes used during surgery and that this could be a blood clot that my body needs to absorb. Is this something to just work through, or to perhaps have the ER investigate?",
    "doctor_response": "HiThanks for writing in The information provided does point to some form of inflammatory reaction at the local siteIt would be better if you get an ultrasound done as the pain is not bearableA complete blood count will help rule out any infectionDo write back in case of concern",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the Norovirus with symptoms of vomitting and diarrhea elevate the readings of liver function test?\n\nhello Dr. Grief - I just had norovirus last weekend which lasted about 48 hours(horrible thing). I was due for a blood test which I get every 4 months to monitor liver function because of my medications for RA. I went the morning following the virus for no particular reason except it was a convenient day to do a fasting test along with the other requested tests. My liver readings were elevated and I was wondering if vomiting, diarrhea, and not eating or drinking normally could skew the test results? If you do not have enough information I can call my doctor s office tomorrow to ask, but thought I d check here now.",
    "doctor_response": "Yes a norovirus infection can cause raised liver enzymes.What I would do is repeat the liver enzymes two to four weeks after the infection has settled to see the trend of the liver enzymes.If the liver enzymes are settling then I would not worry and would attribute it to the viral infection and this is not something to worry about.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Cipralex safe to take during a pregnancy?\n\nHi I am Immortal from Saudi Arabia I have been on cipralex 20 mg for about 2 years and still feeling like I need it.... I would like to ask you about the safety of Cipralex during pregnancy as I am planning to get pregnant? and if it is safe.. what is the allowed dosage please...",
    "doctor_response": "it is not advisable to take dis anti depressants in late pregnancy n during feeding...but in my opinion u should stop taking it frm d time of conception. ..n resort to yoga meditation fr anxiety n depression. ..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Elaborate on significance of platelets\n\ni am very anemic and have had all tests showing no bleeding anywhere i am female 70 yrs old have had 2 mini strokes and had a stint put in the neck artery feel fine have gained 12 lbs am very active and now am told something about testing for platelets that i dont understand could you tell me about platelets",
    "doctor_response": "Welcome to H.C.M.I appreciate this thing that you are active in this age after being anemic. Your doctor is advised Platelet count because you has suffered 2 mini strokes. High platelet count also can cause such stroke due to make a thrombus so follow your doctor advise and go for testing of platelet counts.I also suggest you take diet rich in iron to improve in anemia including iron supplements.Thanx for query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medication is to be done to reduce the pus cells in the semen?\n\nMy sperm analysis shows that i have 5-10 fph pus cells in my semen which is an indication of an infection. Which antibiotics can i take to reduce the pus cells in my sperm? Which medicine can i continue taking to increase my sperm count from 21million to beyond",
    "doctor_response": "HelloThanks for query .Your semen analysis has revealed presence of 5-10 puss cells which strongly suggest infection of either Seminal Vesicle or Prostate and needs to be treated with appropriate antibiotic .Ideal approach is to do Semen culture to trace out the organisms causing infection and the antibiotics to which they are sensitive to so that one can take appropriate antibiotic to target the infection .However it is normally a combination of Trimethoprim and Sulfamethoxazole or Doxicycline  twice daily that is being prescribed by most of the Physicians .The sperm count will automatically  increase once the infection is well controlled .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal cramps during pregnancy?\n\ni am 39 weeks and 2 days pregnant many times i get menstrual cramps and suffer from lower back pain so is it that i am in labour and if it is so then y i am not getting it properly and is it that i need to have artifical pain or what other things should be done in order to induce labour pain",
    "doctor_response": "Hi there,The last few weeks of pregnancy are the most uncomfortable and also filled with anxiety and stress. And as the baby grows larger compared to the womb you can feel tightening and pain which can be mistaken for labour pains.You need not worry, as some women may get into labour by 42 weeks, that is 2 week after their due date and this is absolutely normal. You are still at 39 weeks and should not be worrying.A true labour pain will be increasing in intensity and length of time and will be from loin to groin and is usually accompanied by bleeding or breaking of waters.Do not worry, if you dont get labour pains by 42 weeks then induction of labour will have to be considered.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this X-ray result of back indicate?\n\ni am 24 year old and have lower back pain in low temp., had meet with doctor and he suggested to take X-Ray i did the same and doctor also advised me to have a medicine called \" Cyclobenzaprine \" but still same problem and X-Ray Result was \" everything was normal but only one thing was not good and that was \"straightening of spine is seen with loss of normal curvature suggestive of muscle spasm\" what that mean i dont know. please help me to resolve this problem.thank you",
    "doctor_response": "Hi,Showing loss of curvature and straightening of spine in elderly might be due to degenerative and osteo-artheritis in spines.But as you are young this might be due to faulty posture of sitting.This can be due to long time sitting in front of computer or table work.Correct your posture.Sit straight and avoid bending from back while doing work.Go for back extension exercises daily.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long waist belt should be worn for anterior wedge compression?\n\nSir, Iam 49 years old working a teacher.25 days back i fall down in badminon court. my hips dashed hardly. Here is my MRI report --- anterior wedge compression of L1 vertebral body with fracture showing hypo intensities on T1 and hyper intensities on STIR images........ s/o probable post traumatic changes. 2) Degenerativde disc diseage at D12- L1, L3-4, L4-5 and L5 -S1 levels. 3) Bilateral para central disc bulge of L4-5 and diffuse disc bulge of L5-S1 showing encroachment on neural foromina. Above is MRI impression . My Dr recommonded waist belt and rest How long i have to use the belt ? How long i have to take rest ? Is there any neurotic problems will happen in future ? Shall I travell or attending my routin duties ? Please answer me. There are 6 members are depending on me. Thanking you sir",
    "doctor_response": "Hello,Eight to twelve weeks will be the recommend period. You can start physiotherapy and weight bearing after that. Consult a physiatrist and he will direct you accordingly.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have been feeling tired the whole day. I do not really want to do anything and I do not know why.\n\nHi doctor, I am an 18 year old female. I weigh 110 pounds, and I am 5 feet tall. I have been feeling a bit weird lately. I have been feeling tired; like no matter how much sleep I get, I still feel so tired. And when I eat any sweets, I feel weird. I do not know how to explain it. I feel like my heartbeat gets faster sometimes, but when I check my pulse, it feels normal. But today when I ate some chocolate cookies, I laid down because I felt tired and weak. My left arm felt really weak. Then when I got up, I got really dizzy, like more dizzy than I usually get when I wake up, and I had to wait a few seconds so that I can go downstairs without falling. And I always just want to lay down. I always feel so lazy and do not really want to do anything, and I do not know why. Should I be worried?",
    "doctor_response": "Hi. No need to be worried, but yes you need to get evaluated for the cause of your problems because at the age of 18, tiredness all the day and weakness is not common. Your problems could be due to low hemoglobin, vitamin D or B12 deficiency, or due to thyroid problems or diabetes. I advise you to get the following tests done:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i change immobilizer to allow bending after undergoing knee surgery?\n\nQuestion about knee. I had knee surgery (meniscus repair and plica removal) a week ago. I can bend my leg fully as diagnosed by my doctor. I was wondering if I am allowed to change my immobilizer to allow me to bend? If so what degree should I set it to?",
    "doctor_response": "Hello,You should not bend or walk without consulting your doctor.Sequential walking and weight bearing will be better for full recovery. Physiotherapy can help to attain full range of movements.Consult a physiatrist and he will direct you accordingly.Hope I have answered your query.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for multiple meyloma\n\nMy husband is 77 yrs old and was diagnosed with Multiple Meyloma 1 year ago and had a liaison on his right hip and a small one on is L5. Has not taken chemo since June, but several radiation treatments. He is again having more pain in his hip and is taking some oxycodine for pain, do you have any other suggestions?",
    "doctor_response": "Hi madam. Please consult an oncoulogist. Better idea will be to start chemotherapy. Because radiotherapy he has taken and it has not much worked so we need to change the treatment plan.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in the upper back , shoulder and chest\n\nI woke up with pain in my upper back - between the shoulder blades - and in my chest. The pain is worse when i turn my torso or neck. it feels best when i am sitting up in bed on one of my sides. my back pain worsens when i lay flat on my back. i usually sleep about 6-7 hours a night, but last night i slept for 9 and woke up much later than i usually do (at 1:30pm rather than 7:30-8am). im a 25 year old female, nonsmoker, irregularly exercise, eat relatively healthy. Ive had a history of mild GERD, and stopped taking birth control pills last week because it was causing my resting heart rate to increase. Any idea what is causing this pain?",
    "doctor_response": "You could be having muscle spasms. Hey an Xray of the spine in that region. Apply hot packs. Take pain killers for 5 days. Avoid turning to side and lifting weights. Consult your Orthopaedic surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for recurring cellulitis due to MRSA\n\nLooking for a Infection Disease Specialist in Durham region, ON. Thanks.I am a senior citizen, among other issues, I am suffering from recurring Cellulitis since early 2013. My GP (in Ajax, ON) referred me to AJX Hosp Emmergency, leading to a specialist in Infection Diseases. First, I started with IV for first two wks (can t tolerate because of simultaneously on both arms, started getting swollen arms). Orally, I have been using Novo-Lexin, 500mg, 4xTabs a day, each batch 7 days x 2wks. The problem will disappear, and after a short time recur.During the last visit to the Hosp/Doc, he mentioned that he has done all he could and that I should continue the treatment through my GP.I understand that if this matter is left untreated, the spreading bacterial infection may turn into a life-threatening condition...because Cellulitis may affect tissues underlying skin and spread to lymph nodes and bloodstream. I believe my situation could be MRSA carried by Bed-Bugs .I wonder if there is an ongoing research to look into the MRSA matters. If not for me, I would like to see other can benefit in this case? Many thanks, and God bless.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.You should first investigate your staphylococcus aureus by culture and sensitivity.This will diagnose sensitivity pattern of the organisms.In case of MRSA it will be resisitant to the routinely prescribe d drugs. In such case treatment according to sensitivity pattern can cure you. Please remember that incomplete treatment can create in necessary resistant in the bacteria making the treatment more difficult.Once your cellulitis us stopped you should swab your nasal septum, groin, umbilicus for MRSA screening.If the MRSA is still detectable than you should treat it with mupirocin complete treatment with mupirocin ointment can clear MRSA from your system.Please adopt good handwashing practice. It plays half role in your treatment.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest antibiotics for klebsiella infection\n\nI have klebsellia, I look after a six bed group home I need to know if I need to have everybody tested I also need to know which antibiotic is the best one to use it it was tested in my urine I have had sharp headaches and I have serious memory issues and I have had bowel problems for about a year",
    "doctor_response": "dearAs rightly thought off klebsiella infection can spread through body contact or linen in house.Please take care of the regular hygiene,cleaning,disinfection,sterilisation of all lenins and clothes.More over a prolonged levofloxacin or cephalosporin group like cepepine,ceftazidime are usually prescribed depending upon severity and symptoms.If indicated injectables like pipperacillin tazobactam are also given.How ever please have a constant consultation with your treating physician about the drugs during use.hope this helpsmost welcome for further queries",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from severe pain even after a week of wisdom tooth extraction. Why?\n\nHello doctor,I had my lower wisdom tooth extraction last week. I had bone cutting and stitches. Today is the sixth day of surgery, but I have severe pain even after taking pain killers. But there is no adequate response. I had five days of antibiotics too. Please suggest me what I should do?",
    "doctor_response": "Hello. Your medications are fine, are you taking Cataflam still or stopped? Did you follow all the do's and dont's your dentist had suggested you after extraction? As wisdom tooth extraction is in itself a complex one and any manhandling makes the patient suffer a lot. For now, do warm water and salt rinse slowly not so harshly, and water should not be hot, only warm, be careful about that. Secondly, you need to visit your dentist who did the extraction as soon as possible, to look for any bony spicules remaining or if stitches are healing correctly or not. Clot rupture, delayed healing. Oral examination. Dry socket. Stitch removal, check for bony spicules, and irrigation. Avoid eating especially hot on the affected side. Follow-up after having word with your dentist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes wetness feelings after urination?\n\nHi, my 8 yr old daughter wipes herself about 15 times after urinating and will not stop with out a fight. She is hurting herself down there. She tells me she feels wet and it will not go away. What do I do? The bathroom is a major production for her, so she will hold it for a long time. Mary",
    "doctor_response": "Hi,This may suggest urine collecting inside vagina / vestibule due to improper positioning while urination, which then dribbles after getting up. Make her to sit with thighs widely apart while urinating (for this, inners are preferably removed). Squatting position, if feasible will also help. Also, we have to council her that holding bladder is not at all a good habit, as it will lead to problems like recurrent urine infection or bed wetting.If these measures do not help, kindly take her to doctor to look for any other underlying cause like labial adhesions or ectopic urethra.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam T. K., Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes skin rashes on the back and knees?\n\nDaughter has flesh colored skin rash in various places. Patch on back and one behind her knee. Slight itching which abates during the night. The rash appears in different areas then goes away and appears in other areas. No other symptoms. Only change in her life is that she returned to work just before rash appeared.",
    "doctor_response": "Hi, The rash is most probably due to urticaria (hives). Common causes are food, drugs and environmental factor. Ideal treatment is finding and avoid the aggravating factor along with antihistamine tablet. You can take an antihistamine tablet. If you do not get any improvement in a week, you must consult your Dermatologist as soon as possible. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Siva Subramanian, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for valley fever\n\nMy daughter got sick on August 25th.  She tested positive for strep and was put on penicillin on August 29th.  She hasn't gotten any better.  She is in Arizona, so I'm worried she has Valley Fever.  She has been to three doctors, the last one told her she was homesick so didn't take her questions about Valley Fever seriously.  What should we do?",
    "doctor_response": "Hello,Welcome to HCM,As your daughter is known to have valley fever, which is a disease caused by a fungus that gets into the body through the lungs. It will make her feel like having cold or the flu and may cause a rash.In rare cases it can be deadly even with a normal immune system. Valley fever can spread from the lungs to other parts of the body. There is no medicine to prevent valley fever,but to stay away from areas where valley fever is common.Anti fungal drugs is very helpful in patients who are more likely to have the disease spread to other areas of the body.The follow up of patients with  chest X-ray and blood test helps to make sure whether she is getting better.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fluctuating blood pressure levels. On Lasix, Amlodipine. At end stage renal failure. Can this medication affect kidney more?\n\nMy blood pressure ranges from 138/98 to 165/111 and I am currently on Lasix , amlodipine 5mg so I have been taking my b/p am s pm s and at least 3x each to get an average, since I am at end stage renal failure I know this can damage my kidneys . Also I am cycling at least 30 m. a day and have a very strict diet, what else can I do.",
    "doctor_response": "The blood pressure varies from time to time in a day. The target blood pressure should be-between 120/80 to 130/85. You need to increase the dosage of your BP medicines if you cannot achieve this target. You also need to decrease the protein loss in urine if any and control phosphorus level and Hemoglobin. Also if you are nearing end stage renal failure you should start planning for the type of renal replacement therapy you would opt.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medicine should I take to reduce my weight and conceive ?\n\nHi Doctor , I am 25 yrs old and married since 5 months.I have PCOd.When consulted my Dr. she gave me Glucophage 500gm and informed me it will also helps in reduction in weight.I took it for 1 month but my weight got increased,so I changed my medicine to Glycomet .I want to reduce my weight so that I can conceive fast.Please tell me which I can go ahead Glucophage or Glycomet . Please advice.",
    "doctor_response": "hi,thanks for query.Both drugs are same,only brand name is different.This medicines is used for treatment of PCOD and in most of the patients reduces weight,but still it is not the major effect,it is only a beneficial by product.Please continue with either of them.Apart from this please talk to your doctor about other help for reducing weight like diet planning and regular exercise. wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart pain when taking deep breath?\n\nim 18, 5'4 and weigh about almost 100 dont have medical history. im wondering what does it mean when you take a deep breath my heart hurts well right in that area. its not constant its just really random, ill be laying down or just sitting and it would hurt out of no where. what does this mean? i havnt been to a doctor yet.",
    "doctor_response": "hello,   Mostly it's a acidity and reflux disease. Do you have upper abdominal pain, nausea, bloating, burping, increase in pain on food, sour water feeling in throat or chest burning, if yes it further supports the diagnosis. You should avoid fatty, oily and high calorie diet. Have some walk after having food instead of taking rest. Have multiple small meals instead of heavy meals. Have regular sleep habits and avoid stress. Lots of green leafy vegetables, fruits. Avoid smoking and alcohol if any. You can get prescribed tab Pan DSR 40 mg beforebreakfast once a day for 2 weeks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does it take for egg rupture after injection?\n\nHi doc i am on 16 day but still not ovulated. My right overy size is 24 n letf is 16. ET is 9.6. Right now i am on my way to get injection to rupture my overy. Can u plz tell me Post injection how long it takes to actual rupture n when should i have inetercourse",
    "doctor_response": "Hi,Thanks for writing to HCM .Once you take injection for rupture of follicle it takes average time between 6 to 36hrs to rupture.  So I generally suggest to have intercourse from 12 hrs after injection to 48hrs later. This is the ideal period. And the sperms have the capacity to survive in uterus for 2 to 3 days . So no need to have very frequent intercourse. Instead you can plan once in 12 hrs. This increases chances of conception. Hope I have been helpful .RegardsDr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain and headache while recovering from dengue fever?\n\nHi,My mother was having High Fever, Chills, Severe Headache,Joint Pain, Low Blood Pressure and Low Platelet Count. She was discharged from hospital after the fever went down and the pressure and the platelet count has increased. She was diagnosed with the Dengue virus.  After coming back from hospital she is really weak and is having severe abdominal pain. She is also having headache. Is it that the Virus is still there and she is not completly cured? Should we transfer her back to hospital for furher treatment. Please help.",
    "doctor_response": "You shoud watch for fever by measuring fever at home by thermameter and also watch on platlet count.it should not go down.maintain adequate hydration of pt. You can consult your dr for follow up.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for epilepsy?\n\nhello sir/mam-my brother was suffering from Epilepsy at a age of 12 now he is 26 yrs.with time his disease showed different symptoms like telling i am having aids etc.but now since 2009 he is diagnosis as epilepsy with pyschosis.how is having procy ,sizodon,oxetol,progen,sonazep,and haloperidol injections .his condition is not gud now he is atacking the family members,not eating medicines etc please kindlyyyyyyyy help .thank you in advance",
    "doctor_response": "Hi dear,epilepsy with psychotic symptoms is very difficult to treat and for better control of your brother first of all admit him in psychiatric nursing home.also do MRI of brain if possible.aggression is common in patient of epilepsy so if you control epilepsy many of psychotic features controlled own his own.Consult psychiatrist or neurologist.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a large lump on neck indicate?\n\nI just found a large lump at the top of my neck that pops out if I tilt my head back and is movable.  I took a bad fall about 6 weeks ago hitting the base od my head on the seat of a chair.  I have an appt tomorrow now with my dr.  Just wondering if it could be injury related.",
    "doctor_response": "Hello!Thank you for the query.Yes, it can be injury related. Injury can cause blood collection under the skin. It is called hematoma. If its large enough, wont go away by its own and should be drained. Such lump can be also a sebaceous cyst or even a lymph node.Doctor consult is a good idea. In case of doubts, ultrasound of soft tissues can be done.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Regular severe back pain. History of both femur injury. How to get relief?\n\nhi im darrin having really bad back problems i was in a bad car wreck when i was 11 crushed both of my femurs i know a little pain goes with this but im 24 and i am in so much pain on a daly basics that really i cant do any thing and i was wondering it there was anything i can do to get some relief... thank you Doc.",
    "doctor_response": "hi, U had crush injury bilateral thighs 13 years ago. U had not mentioned what type of treatment U had taken at that time. Now at this time it may be chronic osteomylitis bilateral femur. Is there any discharging sinus present? for confirming ur diagnosis there should be xray bilateral thigh & some blood   investigation & after that planing of treatment can be made.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bump on shoulder in kid\n\nIm trying to figure out what to do about my 6 year old daughter has an open wound on her head on the top i have put peroxide and triple antibiotic ointment on it and it was getting better, but I looked today and it looks worse then it did. It almost looks like a hole and it is got mucous and blood. Then she has a bump on her shoulder that looked like a pimple so i squeezed the puss out and its getting bigger and redder and i keep having to squeeze the puss out.",
    "doctor_response": "Hi,Dear,Good Morning and Thanks for your query to my virtual Clinic At HCM.I studied your query in depth and understood your concerns .Causes for lump on shoulder in your kid as follows-Mostly they are -Chronic Scalp wound infection with boil on shoulder with pus discharge.Treatment-Tab-NSAIDs -like VoltarenTab-Amoxycycline 250 mg x three times a days Dressing for the Scalp infection andSurgical I and D for Boil with abscess on Shoulder.Check with ER  Surgeon and check your fbs and pps,and plan for Excision Biopsy of the lump to resolve the worry.Don't worry of them,as they could be relieved with proper treatment.Hope above reply would help you to relieve of the issue you have.Welcome for any further query to ME and HCM.Wishing you a Fast Recovery.Write Good review for the benefit of my new patients.Click thanks ASAP after this.Have A Good Day.With RegardsDr.Savaskar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in passing stool after taking Dexona shots?\n\nHi, can I answer your health question? Please type your question here...sir 4 days ago a bee was sting at my tongue and reation in all body then fail dexona and prima code enjection enject to my body ...from that time toilet is not coming proper and something pain in back side ....",
    "doctor_response": "Hello,Constipation from Dexona drug is due to altered gut flora mechanics and water absorption from intestine as side effects of the medication.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Purva Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Heard a popping sound due to pressure applied on knees\n\nI Was playing basketball and went up for a layup and as I came down I heard a loud pop. Now my knee is in a lot of pain but I can still walk on it and play basketball on it. It feels like its going to give out at any moment as well. Whats wrong with my knee? Is it a torn ligament??",
    "doctor_response": "Hello, It could be a ligament tear or locked knee. Consult an orthopaedician and plan for an MRI scan for further assessment. Hope I have answered your queries. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dry lips\n\nHi, My lips seem to be constantly irritated for the past 3 months. I believe it started as an allergic reaction (I had weeping, crusting, swelling) but now its cheilitis. My lips are often dry and peel frequently. They have red blotches on vermillion boarder.. At times the outline of my lips go red then subside. I tried every cream possible... they all have short-lived effectsHELP PLEASE",
    "doctor_response": "Hi,You seem to have chronic cheilitis.There may be erythema, dryness,mild scaling, fissuring and crusting. You might have mild pain, burning and itching. There may be some cause. Lip licking might exacerbate the disease. Sunrays exposure, cosmetics,lipstiks tooth paste, dusts...etc might be resposible. Vitamin B complex deficiencies,anaemia or nutritional inadequacy might cause the disease...You consult dermatologist for firm diagnosis and perfect treatment of its cause.Have blood tests to rule out any internal disease or vitamin deficiencies.You may take folic acid 5 mg thrice a day with iron tab. Antibiotics may be needed if there is secondary bacterial infection. Apply antibitic cream with mild steroid like mometasone. You avoid soap,cosmetics and lipstik for good and fast result. Avoid bad habit of lip licking,if it is there. Do not prick the lip skin with your nails.You might get good result after few weeks. I hope this would help you in your treatment.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause prolonged abdominal pain?\n\nIm a 21 year old male just got out of the army, Ive had abdominal pain for over 16 months now, frequent bright red blood in my stools. Ive been diagnosed with crohns and IBS. I just started a new workout regiment for the first time and I had alot of blood in the stool again for the first time for over a year now. Ive takin pregnosone and been on humira for several months. Wondering if this is cause for concern.",
    "doctor_response": "HI.Thanks for your query.As per the history you have provided you are already suffering from IBS and Crohns- It may be either of it.You are bleeding in intestines in spite of the medicines means you need to get a review.I would advise you the following:Get an appointment with the Gastroenterologist Get a colonoscopy and biopsy to prove what exactly is the problem. Histopathological diagnosis is very important as the treatment of both the diseases is different. I would advise the following investigations and treatment in a such a case:Investigations:*Routine blood investigations like Complete blood picture, blood sugar, urea, creatinine, liver function tests, thyroid function tests.*Urine -routine and microscopy*Stool: routine, microscopy, occult blood, culture and sensitivity.*Ultrasonography of abdomen,*Colonoscopy All these investigations should be within normal limits for one to say you have IBS.Treatment:''STRESS'' = stress is the most important cause of IBS. Please remember and you must have observed that when you do not have stress your problem with IBS is reducedChange of lifestyle.I think 'may be' you are not coping with something. Vacation outside of your area, mobiles phones to be off.You must have noticed already that these changes help a lot. Try to avoid anything which you are / have to do against your will and wish. Getr into the hobbies which make you forget the world around you. Life comes only once, boss.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach pain, drowsiness followed by vaginal bleeding after taking postinor 2.  Delayed periods.  Possible pregnancy?\n\nI had sex with my fiance right after her period. And 2 days later she took postinor 2, she complained of stomach pains and drowsiness a day after then 5 days later she had vaginal bleeding. She is supposed to see her menses on the 28th but still hasnt seen no sigh of it. Is she pregnant? or just side effects of the drug?",
    "doctor_response": "Hello, I would be happy to help you with your question.The initial bleeding followed by the delay in her period is almost certainly related to the medication that she took.  While it is very effective, it is not 100%.  She should expect a week or two delay in her period, but should also check a pregnancy test weekly for at least a couple of weeks to rule out pregnancy.I hope that this helps and good luck!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the purpose of taking humog injection ?\n\ni want to know the purpose of taking humog injection ... and also i want to know the best gyneocologist in XXXXX",
    "doctor_response": "Hello. Thanks for writing to us. Hucog injections contain human chorionic gonadotropin and are given to help the matuire follicles to rupture. Once the mature follicle develops in an ovary in the mid cycle, this injection helps in the folicle rupture and release of the egg. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes choking in sleep?\n\nmy 6 week old woke up choking and not able to catch her breath she appeared to be choking on a bubbly slimy clear like saliva i suctioned what i could out and patted her back till she was able to breath better. this has happned once before she gets red and her eyes get really watery",
    "doctor_response": "Hi..sometimes kids with a retracted lower jaw (retrognathia) can have this problem. The other possibility though remote which I could think of is that it could have been a seizure. I suggest you take her to her pediatrician and get her examined to rule out these possibilities.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatments for irritable behaviours\n\nMy husband is a very moody person.  One day he is fine and enjoys doing things with me and our kids and the very next day is can be VERY moody--will not speak to us at all and is very irritable.  It seems like this happens every month right before I am about to start. It seems as though it gets worse the older he gets! Is there any kind of medication that he can get from the doctor for this?",
    "doctor_response": "Hello,The symptoms are indicative of a possibility of mood disorder: bipolar? but to pin point the diagnosis one has to interview him in detail to know the reason of his up and down behaviour.You may better take him to a psyciatrist and Im very hopeful that after drugs are started he will feel much relaxed and your family will be at peace and will enjoy life in a better way.Usually, we use a mod stabilizing agents like sodium valporare or lithium or oxcarbazepine in suh cases depending on several other actors- like presnece of hypertension or diabetes or some other comorbid illness.Also you must get his baseline blood tests like TSH, lipid, liver and kidney, blood counts,  ECG test before proceeding for any medicine.Wish you good healthDr. Manisha GopalMD Neuropsychiatry",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent vomiting and joint pain\n\nmy husband is 24 he has been experiencing moderate hurting in his joints and chilling with vomiting for weeks he hasnt been able to keep anything down for the last few days and seems to just keep getting worse as time goes by his lips turn blue everytime he vomits its not flu because its been like two months",
    "doctor_response": "I would suggest please visit a gastroenterologist as soon as possible. It might be something siniste which need to be investigated",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fungal infection in the groin area\n\nHi, may I answer your health queries right now ?  Please type your query here...DearDoctor, i am having a fungal infection in and around the grion areas and thighs, it itches a lot and i was recommeded to have terbest 250 mg tablets,it got cured with that but after a period of time it recurrs, pls suggest some remedy",
    "doctor_response": "hi dear,please try to avoid tight clothing.sprinkle clotrimazole powder around groin area and take oral tablet of albendazole once in a weak.thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can follicular maturity be increased?\n\nhello doctor: i have 35 days cycle. the result of TRANS VIRGINAL SCAN shows that my follicles are immature. On day 12th, these are less than 5mm and on day 19th, these are 11mm. what should i do to increase my follicle? And my endometrium is not thickening. Doctor suggested me to take neodipar. I do not know what to do. Am i ovulating or no?? with 35 days of cycle, when i will be ovulate? please help me and suggest some medicines",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.As you have 35 days cycle and eggs dont mature then  i would suggest medicines that stimulate ovaries like clomiphene. Ovulation generally happens 14/15 days before your menses starts means 35-14 so at 20/21 th day.So consult a gynecologist and he/she will advise you medicine after some basic reports and also give medicines to mature uterine wall.Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sinus infection\n\nI am confident I have a sinus infection, but I live out of a metro area and cannot reach my doctor.  I was recently treated for an upper respiratory infection with a z pack and cough medicine which has improved; however, I awoke two days ago with pain in my neck that has now settled in my head, behind my eyes.  The pain is such that I have severe nausea and am dizzy.",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concern..As per your complain the symptoms seems to be due to Frontal Sinusitis leading to headache and pressure behind the eyes and nausea and dizziness can be due to infection and pain..I would suggest you to take a course of antibiotics like Augmentin, anti-inflammatory painkillers like Ibuprofen, decongestants like Pseudoephadrine or Sudafed, steam inhalations, saline nasal irrigations and using a humidifier can help..You can also do steroid nasal sprays and nasal decongestants like Xylometazoline..For nausea you can take Domperidone..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain\n\ni have been having lower back pain especially since having my child who is now two weeks old, i had an xray done and the radiologist said i had bilateral pars defect a L5 S1 with grade 1 anterolistheis on L5 S1, what does this mean and is this the reason for my continuing lower back pain and how can this be fixed",
    "doctor_response": "HiWelcome to healhcaremagic After going through your query I concluded that you are having chronic backache. On X ray you are found to have pars defect at L5,S1 with anterolisthesis of grade 1. It means that you were  having developmental defect in formation of part of vertibra. It later displaces under strains of life and manifests as backache. Grade 1 anterolisthesis means L5 vertibra is displaced anteriorly in relationships to S1 which is less than 1/3 of vertibral body. Its treatment is either wearing lumbosacral belt and avoid strenuous activity and analgesic. Second option is operative in situ fusion. You can discuss with your treating Doctor about it. Hope your query get answered. If you have any clarification then please don't hesitate to write to us. I will be happy to help you.Wishing you a good health. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "High BP. Started intake of Liinopril. Healthy lifestyle. Suggest diet plan and recommend to reduce BP\n\nHi!  I'm a 59 year old clinical psychologist.  I'm very healthy, average weight, eat healthful foods, exercise, don't smoke, rarely drink, etc, etc, i.e., your ideal patient.  EXCEPT that I've suddenly ended up with high blood pressure!  I was at my dentist's office last week, and during a routine PB check, my BP was somewhere around 140/105.  Scary!  Especially for me, who's always in perfect shape.  So I had it checked again today, at a friend's office (he's a surgeon buddy of mine) and it was about the same.  (About 30 minutes later, my BP had calmed down to around 145/85, but that's nothing to brag about, of course...)  So my friend Eric prescribed 10mg of Liinopril (it's what he takes).  And I've just taken my first med, as of an hour ago.  No side effects, but I hate being on a BP med!  I want off ASAP.  So here's my question (sorry for the long intro!):Since I'm already doing so many of the things you would characteristically recommend for naturally reducing BP, what do you suggest?  Also, I'm not sure how to go about reducing the med slowly, as I attempt to change a few lifestyle habits toward the healthier side.  In other words, how do I \"test\" whether my BP is coming down in independent relationship to the med?  As of the first high reading of a week ago, I immediately cut, cold turkey, all caffeine, alcohol, and salt, and I started eating more potassium-rich foods.  (I do understand, by the way, that I now need to limit my intake of potassium, so I guess I need to cut down/out bananas, spinach, etc?)  I am practically in a panic, because this is literally the first conventional med I've ever had to take.  And we all know that calmness is key here, so HELP!  Thanks so much, Denise D.",
    "doctor_response": "Hello,Thanks for your query.As you already know that calmness is the key so just follow that. Stress itself can increase your blood pressure more.Start doing meditation. Relax yourself. Do things which you enjoy.Make certain dietary changes which you had already started. Include potassium in your diet. Potassium lessens the effect of sodium & thus help to normalise the blood pressure.Decrease salt intake in diet.Eat more of fruits, leafy vegetables, high fiber diet.If you are overweight. Decrease your weight.Start brisk walking daily for 20-30 minutes after consulting your doctor.Stop smoking & drinks that also help to decrease the blood pressure.Follow all this life style modification. Presently you can continue lisinopril.Regularly check your blood pressure thrice a week at same time & keep a chart of all blood pressure readings. Depending on your blood pressure response, lisinopril dose can be decreased gradually or even stopped.I hope i have answered your query.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for rashes in chin\n\nI have a burning red rash located below my chin and on my right side of my neck. It get's worse if I have foods I'm allergic to, but the burning sensation never goes away. I also have a pinched nerce in my C-5 vertebrae can this pinched nerve cause this rash?",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, this could be due to hypersensitivity and this could be best treated with local as well as oral medication as given bellow.1) Tab Beclomethasone cream2) Tab Hydroxyzine 10 mg three times in day hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Teenager.    Occasional headache,   blurry vision,   temporary memory loss,   weird posture.     History of minor concussion.   Recommend\n\nHi so im 16 in july and lately ive been getting headaches mostly in the morning but also throughout the day.  Durring these headaches i sometimes loose my side vision and my vision becomes blurry. in addition to this my mom keeps telling me that she has told me things that i really dont remember her saying at all along with my coaches and friends doing the same thing. Also my arm sometimes like will like move a little without me trying to move it.  Cancer runs in my family like to the point where all most all of my relatives who have passed away have died from cancer.  There has been some other symptoms that have been freaking me out for the past 6 months or so but those are the main ones i can remember.  Also, my mom keeps telling me that im acting weird with like my movements and posture and stuff.  Im hoping its nothing of corse but im getting really worried i was wondering what u think could be going on.  Also i suffered from a VERY minor concussion around a month or so ago.  When i went to my pediatrician she said it was nothing to be worried about (i barely got hit but my mom kinda freaked out)  Also the symptoms started way before the concussion so i dont really think its that anyway if you have any idea what it could be or any advice to get rid of the symptoms that would be awesome thanks.",
    "doctor_response": "Hello,welcome to Healthcare Magic.Your headache is appear less likely due to concussion, as you had headache even before the mild concussion. Headache can be caused by several medical conditions. Common causes for headache:-infection in ear, nose or throat-Stress and anxiety-High blood pressure-Eye problem-Migraine-Neurological problem: like brain tumorBefore making any assumption, it is better to get yourself evaluated by general physician to rule out above causes of headache and then seek consultation according to their recommendation.Wishing you good health and all the best.Regards,Dr Ashish Kumar Mittalwww.99doctor.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen lymph nodes?\n\nI am a 40 year old female (5'4\", 135 pounds) with a swollen, non-tender lymph node on the right side of my neck, which I just had a CT scan of today.  I also have a low WBC that needs to be rechecked in 2 weeks.  Extreme fatigue and an unexplained rash.  Any thoughts?",
    "doctor_response": "Hello. Thanks for writing to HCM.I read and understand your question very well.I try my best to help you in this.As you have lymph node  in right side of neck, there are many cause for it.Like acne face , infection in mouth , ear infection , tooth problem , gingivitis , tonsillitis , sore throat ,tuberculosis , lymphoma , metastasized cancer  etc.You have also fatigue and unexplained rash   and low WBC , Gone for CT scan. I suggest you to consult a good physician for this.I hope my advice will help you a lot.Thanks and Regards.Dr Vijay",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for jaundice in a child\n\nmy brother baby is 5year old.he is suffering from jaundice on that time he is 4 day and in very critical situation on that time doctor change his full blood of body after that he is felling well but not properly now he is 5year old but her body not having any moment he is proper in bad he is week please advice me or suggest what can i do.",
    "doctor_response": "Hi,Thank you for asking question on health care magic.Severe jaundice,particularly uncojugated hyperbilirubinemia,if more than 10 mg/kg needs exchange transfusion.Please follow your doctor's advice,exchange transfusion reduces serum bilirubin immediatelyHope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. On using Epiduo for acne, my skin burnt terribly. Why?\n\nHi doctor, I am using a treatment on my acne called Epiduo which was prescribed by my doctor. My skin has very bad hyperpigmentation and acne. I have been using the treatment for three days and on the second day it itched and burnt a little and I thought it was just working and all was fine. But on the third night I put it on and my skin began to burn terribly and it was unbearable. It blocked me from breathing and I nearly passed out. I did not wash it off because I found when I did that on the second night it made it worse and when I woke up today I had terrible chemical burns all over my face. My hyperpigmentation and acne had become worse and it is causing immense pain and discomfort and it really does look terrible it is similar to the worst kind of sunburn ever and the skin is plastered and dry too. I do not know what I can do? Is there some sort of treatment I can do in a cosmetic skin clinic? Or something I can use on the burns and the acne and the hyperpigmentation?",
    "doctor_response": "Hello. You have developed contact dermatitis to this Epiduo (Adapalene and Benzoyl peroxide) which you were using for treatment of acne. Now your skin has two problems. It needs to be treated in two steps. First, we have to treat contact dermatitis. Do not use Epiduo now. Wash your face with mild soap and water. Take tablet Azithromycin 250 mg twice daily for the first three days then on alternate days for three weeks. Apply sunblock of SPF 60 (sun protection factor) from morning till evening. Use good moisturizer four to five times a day. When your skin improves from this contact i.e. burned condition then, step two of treating acne and leftover pigmentation will be done Contact dermatitis and acne vulgaris. Apply a sunblock of spf 60. Take Azithromycin 250 mg bd for the first three days then on alternate days for three weeks. Apply moistuerzer four to five times a day. Wash face with mild soap and water. Avoid using Dettol and other irritants. Avoid scratching or pricking up the leison. Follow up at three weeks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is anti-RNP and leukopenia?\n\nThanks. I was finally diagnosed 7 yrs. ago with Lupus from a Bone Marrow Biopsy. I now have Mixed Connective tissue disease, with a spectrum of choices. My blood has feel affected for almost 10 yrs., however now it s traveling thru my organs. I ve had acute chronic pancreatitus for 3 yrs., High Blood pressure & heart rate for 4 yrs., now I have Lupus scaring my lungs & a blockage in my Lungs. (I also have a thyroid nodule which I m not concerned about.) I just notice from my rehmy drs. paperwork today that I tested positive for myalgia & myositis. My question is that in Jan, I tested positive anti RNP and leukopenia. What is that? Oh I also have Ostopenia & RA.",
    "doctor_response": "Hi, I will answer your first question which is about RNP. RNP is ribonucleoprotein. Antibodies against RNP are suggestive of a disease called Mixed connective tissue disease. To put it simply this is a group of diseases where the normal immune system of the body which in health protects us, now starts to attack us . This is called immune mediated disease . There are Five major diffuse connective tissue diseases : systemic lupus erythematosus (SLE); scleroderma (Scl); polymyositis (PM); dermatomyositis (DM); and rheumatoid arthritis (RA). A sixth disorder, Sj\u00f6gren\u2019s syndrome. Mixed connective tissue disease has a combination of the above. Regarding your leukopenia, this means that your white blood cell count is low. This is also a feature of the above immune mediated disorders. You may get a complete blood count and peripheral smear done along with blood sugar, urea and creatinine,Liver function tests. It is important to follow up the status of your kidneys as Lupus is known to affect kidneys also. Regular follow up is essential with an immunologist. There are several methods of treatment based on the severity of the disease process. Treatment includes short courses of oral corticosteroids. severe disease requires immunosuppressive drugs such as azathioprine . Therefore my advice is to get a review with an immunologist or rheumatologist with the tests that you have done. I presume that you done many tests already. Mixed connective tissue disease involves different types of immunological diseases such as polymyositis, lupus, etc . It is called an overlap connective tissue disease. What is important that you must get a regular follow up and medication according to the severity of your disease. There are several new drugs available and these diseases are manageable.. It is important to keep a positive outlook as this improves your overall sense of well being and your ability to cope and manage life effectively. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How do you remove the shell of sunflower seed stuck in the throat?\n\nI was eating some sunflower seeds and I accidentally swallowed the shell and it is not stuck in my throat stabbing me when I swallow but when I eat anything it does hurt  I need help trying to get it out without going to the doctor I\u2019ve tried yogurt bread and it will not come out",
    "doctor_response": "Hello, You need a laryngoscopy directed removal. Consult an ENT specialist and he will direct you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Nupur K, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any side effects for iui and microgest?\n\ni did an iui on 9th jan & my dr has put me on microgest, last time when i was on microgest i was feeling sick but this time i have none of the side effects i had last time jus the white discharge & that also not as much as last time Do youthink i could be pregnant??",
    "doctor_response": "Hello,IUI may present like symptoms of pregnancy like implantation bleeding, menstrual delay, tenderness in breasts, nausea, fatigue, cravings and aversions. Consistently high body temperature may also observed. Please mention your symptoms. White discharge not a symptom of pregnancy.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does purple vein appearing on chest of an infant mean?\n\nMy 27 month old has these dark purple veins that go all across her chest. They are so dark and her skin is so white that it so visible and people always ask what s wrong with her!! She was not a chubby baby, she was breast fed exclusively for 5 months and then introduced to food but still breast fed until 16 months. It almost looks like she is wearing a giant necklace with lots of chains. Is this a sign of some kind if disease?",
    "doctor_response": "hi..just visible veins in a fair and thin child is common. it is not a matter of concern, unless there is  facial swelling or problem during sleep. nothing much to worry about it.kindly upload the photos and i can clarify your doubts.regards-Dr.Surendra",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have black spots appearing on my head. What is causing it?\n\ni have black spots appearing on my head that has never been their before. what is causing it and is it something that i need to check out and what is causing it?",
    "doctor_response": "hi it may be blach heads or pigmentation. whts ur age? it look like tiny spot? have over face?",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can you deal with sluggish feeling, tiredness and breathlessness?\n\nHi my name is Rosa and I am 57 yo with history of diabetes, high blood pressure, have had 4 mini strokes, seizures, heart problems due to strokes. I have been feeling sluggish, tired, out of breath, even just walking from my lving room to bedroom, calmy and do not feel when I have abowel movement. This has been going on four 3 days now.",
    "doctor_response": "Hi, As you have diabetes and blood pressure. Firstly u should monitor both blood pressure and blood sugar levels ..and check if they are in normal limits .. and correct them if they are not in control. And as your having heart disease it might sometimes lead to heart failure and symptoms causing tiredness and breathlessness. Hence i suggest u to once consult cardiologist and get your 2D echo done once and take further treatment. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tickling sensation in the lungs and persistent cough?\n\nI've had a sore throat for 10 days now.  Also, I've had a peristent, nagging cough for the last week now.  I get very little sleep, as I constantly have a tickling sensation in my bronchus/upper lung, which drives me crazy 24 hours per day!  I can not go very long without coughing, which only gives a very temporary relief, before the tickling starts again.  I've been hacking up dark green sputum, sometimes bloody at night, from excessive coughing, which may be due to irritated throat tissue?  It is also painful when I cough at the bottom of my throat and in the top of my lungs.  Often when I cough, i get a sharp pain in my head just above my right eye.  Also my ribs are quite sore from all the coughing.  Went to hospital and got on Penicillin 6 days ago.  Has not helped at all.  This bug is likely a virus.  Can't go on like this much longer and am punch drunk from lack of sleep.  Is it possible that I have pneumonia?  Is there anything that I can do to suppress the tickling sensation in my lung?",
    "doctor_response": "Thanks for your question on Health Care Magic.I can understand your concern. By your history and description, possibility of post infectious bronchitis is more. Pneumonia can also be the cause. Both these cause similar symptoms. And he both are common after viral upper respiratory tract infection (URTI). So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. PFT (Pulmonary Function Test) 3. Chest x ray. PFT is must for the diagnosis of bronchitis. Chest x ray is needed to rule pneumonia. You may need inhaled bronchodilators and inhaled bronchodilators and inhaled corticosteroid (ICS). 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for kidney condition\n\nWhat I m inquiring about is I ve just been diagnosed with secondary raynauds and auto immune disorders. I have also had a big problem with tumeral calcinosis in my elbow and had several operations to remove them. Is this all tied in together. Also I have nephritis of the kidneys",
    "doctor_response": "Hi,Thanks for writing in.Auto immune disorders cause significant deterioration in kidney function and this leads to pain and discomfort from the effect of deposition of immunogloulins in the kidneys. These changes take place at the microscopic level and a renal biopsy usually proves the cause for the symptoms.If the diagnosis is confirmed then treatment is by a combination of immune modulators and steroids. Chemotherapy and anti metabolites might also have to be prescribed for this purpose. The treatment might take 6 to 8 months with proper treatment and follow up. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "3 years old with swollen gums and purple tongue\n\na 3 year old has red swollen gums a purple tongue and black stains on her teeth and runs a high fever everyday",
    "doctor_response": "purple tongue is due to heart or lung problem,black stain is du to tetracyclin drug side effect refereed to pediatrician.....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Allergies. Took treatments, allergies repeating. Any top ranking allergist for treatment?\n\nMy husband has numerous severe allergies ranging from pollen to bees/honey to polyester.  He went through one sent of sensitization treatments here in Greenville SC which helped some of the pollen allergies, but he keeps having allergic reactions unpredictably and has been in the emergency room several times this year.  I'm looking for a top ranking allergist to get more specialized treatment.  Can you refer me to a good place?",
    "doctor_response": "Hi Kindly mention the your place you are reciding here to suggest top ranking allergist at your area to get more specialized treatment.The permanent cure is to avoid allergen. I advice your husband to wear full sleeve cotton dress and glouses to avoid any contact with allergen, daily wash the dress with hot water and sun dry them. Also the area you are staying should be dust free (Daily mopping). With these you can try montelukast 10 mg and levocetrizine when required (For symptoms). You can apply topical mometasone furoate cream, this will help in preventing the rashes to occur. In severe symptoms take salbutamol inhaler and ask your husband to carry the inhaler always with him.Hope this is more informative and helps you.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a bruise near the ankle?\n\nThis evening I noticed a \u201cbruise\u201d on my leg near my ankle, no soreness. Within a couple of hours of noticing it, the size has increased to a little larger than a half dollar and has changed from blue to a bright red, no soreness, no fever. I returned from Europe yesterday and was on the plane about 10 hours. I am 72 years old. Am I dealing with a blood clot?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As per your history, it may be due to injury or blunt trauma to that feet. Kindly do x ray of ankle to rule out possibility of fracture. you can apply crepe bandage. You can take tab. aceclofenac after consultation. Apply trombophob after consultation. Continue physiotherapy as advised. Take care. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause small reddish bumps between eyes and bridge of the nose?\n\nI have small reddish bumps between my eyes and bridge of my nose, (closer to my eyes). They don't hurt unless I rub my eye, even then it's not really a pain it's more of an irritation. I've had them before but shrugged it off, they go away after about a week, but come back, randomly. I thought it was my make up, however I have since quit using make up after the second time they appeared. They don't really look like blisters or warts or anything like that. They look more like irritation and swelling due to a clogged tear duct, and I don't think they are styles, as I have had those, however I have no idea that's why I am here. They don't have any fluid in them that I can see or am aware of. What are the most common possibilities of what it could be, what causes it to happen,and how to treat/prevent it?",
    "doctor_response": "welcome to hcm,             Nothing to worry about. These small reddish bumps may be due to some infections. the best thing for you to prevent such episodes is avoid using more creams in the face. and wash your face with luke warm water regularly and have a massage starting from the place of the bump to the lmiddle part of your nose both sides on regular basis. this will prevent further episodes.hope this explainswith regardsDr.Amarnath",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have pain in stomach while passing stool, also randomly. Had small ovarian cyst, was told will regress. Cyst growing?\n\nI have been having pain on the right side of my stomach every time I push to, well poop. Then at random moments I get a sharp pain in my abdomen area on the left and middle. They past year I had an ovarian cyst but I had a ultrasound in october and they said that I had a very small cyst, but it would just go away. Could it possible that the cyst is growing?",
    "doctor_response": "Hi welcome to Health care magic forum . You had pain in the stomach on right side when you go for stools. you also have pain on left and middle of stomach. previous year in october you had ovarian cyst, doctors said that it is small and it will go away. It is painng when you go to stools,so more possibilities are there for intestinal infection, I advise you to consult a physician for diagnosis and treatment, with this treatment , if you get complete relief , it is well and good other wise you have to get tested for urinary tract infection, or enlarged ovarian cyst. Wishing for a complete relief, and thanks for calling H.C.M.F. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Where can I have my father checked for L2 bone suppression ?\n\nmy father's backbone L2 bone hasbeen supressed.some doctors saying this case related to neurology or orthopaedic respected sir my father s backbone L2 bone hasbeen supressed. and having so much pain . i m in delhi, but my family living in panna m.p., so i havebeen checkup him in jamdar hospital jabalpur . but pain is continue.this problem came when he was sitting on last seat in the bus before three and half month.some doctors saying this case related to neurology or orthopaedic.please give your suggestion, where should i checked up him,and also give me contact address of that hospital. my mail id is: rajcba129@gmail.com. thankyou",
    "doctor_response": "Your father require thorough investigation as ct-scan and MRI. After the correct diagnosis usually it seems that your father will require treatment from both orthopedic surgeon and neurologist/neurosurgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated CRP levels?\n\nwhat is elevated c r p  noted .ferritin  is  not good index or iron stores in presence from inflammation illnessiron                                                                                                                                                                                         transferrinsaturation ferritin  looking for simple ans",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. High CRP level is suggestive of inflammation.  In case of inflammation s ferritine is not a good indicator of iron store.  You should go for serum iron level. 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling sensation in hand?\n\nYesterday afternoon I managed to get pricked in the hand by a thorn bush and since I woke up this morning said hand has been experiencing a tingly or pins and needles sensation for quite some time. (I cleaned out the wound, which is relatively small, with soap and water and but antibacterial ointment on it after it occurred) I also received a tetanus shot within the last 4 years so I m not as worried about it being that. Thank you for your time!",
    "doctor_response": "Hi,Thanks for your question on HCMI do understand your concernAs per your history it designates some  injury to nerve so dress the wound by a doctor and take a full course of antibiotics, if there is any pain you can integrate Ibuprofen and paracetamol coalescence with any PPI. Do take rest for sometimes.Hop that helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for weak gum and teeth\n\nHi I am 40 yr old male. I have dental problem; before start explaining my problem, let me give some introduction: My mothers teeth are not good. So my teeth. The front teeth were projected out and the gum was not strong. Gradually the gum started disappearing and now i have very little gum on my teeth. Because of that my teeth have started moving. I can not byte or chew even banana. So i would like to go for artificial permanent teeth which i need not have to remove everyday while sleeping. Please suggest me what type of treatment i should undergo and its approximate cost.",
    "doctor_response": "hi.... many times dental problem comes in gene. so before i suggest you treatment i will tell you some options. one option is fixed bridge but for that you need mesial and distal very sound teeth which will give support to your missing teeth. other option is implant in which no natural teeth support is needed but for that bone should be there for placing a implant. so go to nearby dentist he will examine your case and tell you the best option for you.....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment for tiredness and painful lump on anal area\n\nhi i have been feeling very tired for a few days and i also keep getting big red hard blistery like spots apearing and i also have a very painfull lump around my anal area,it feels like alot of pressure around my anal,also keep seeing blank spots apear sudden but dissapear so quick,heavy headed can you help.",
    "doctor_response": "hi.it is best if you sought consult with a gastroenterologist or a general surgeon for physical examination and a possible proctoscopy to check on your anal area. this is an outpatient examination. possibilities of these perianal lesions described are hemorrhoids, perianal abscess, fissures, fistulas or infectious causes.if you have difficulty in bowel movement, you might want to modify your diet to a high-fiber one as a start.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. The girl I am going to marry is 33. Is it alright to wait for two years to plan a baby?\n\nHi doctor, I am 31 and I am going to marry a girl who is 33 years (two years elder to me). If we do not want to plan for a baby for one or two years after we get married, will she face any problems during pregnancy as she will be above 35 years? Also, will the baby have any problems growing up?",
    "doctor_response": "Hello. I went through your query and understand your anxiety. Actually, the chances of conception and having a healthy pregnancy decrease after the age of 30. After 35, the risk of having babies with Down's syndrome increases significantly. So it is best advised medically to conceive sooner. Both your health and medical parameters will be able to establish better on your chances of having a healthy pregnancy later on. Personally, I have had patients conceive naturally or with minimum medical help even at 35 and 40 and have had successful pregnancies and healthy babies. But, statistics do show that as the quality of sperm and ovum decline with age, so does the chance of conception and healthy pregnancy. I hope this information has been beneficial. Let me know if I can help you in any other way. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for child suffering from fever and stomach pain\n\nMy 4 yr old daughter has had a fever for two days not breaking with Motrin and Tylenol. Just going from 103/104 down to 100/101. She says her stomach hurts really bad. Especially the left side and her back a little. She has bad smelly gas but regular bowl movements. She never complains of stomach problems. Unsure what to do. Most pediatricians act like the fever is no big deal. She has had her tonsils and adenoids out and still 9 ear infections. Just moved to Nevada. No pediatrician I like yet and no insurance. Can you help?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.Fever of 2 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 15mg/kg/dose every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat enterococcus infection?\n\nI'm finishing up a ten day course of ampicillin for an enterococcus infection. I started feeling I'll three days ago, but what bothered me the most was that I could smell and taste blood. Yesterday I came down with flu-like symptoms (hot flashes/chills, weakness, sore throat), and this morning my gums and the roof of my mouth started to bleed. Could this be a reaction to the ampicillin? In the past I've developed reactions to other antibiotics I've taken (sulfa drugs, macrobid, etc.). I only have two doses left. Should I take them?",
    "doctor_response": "Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.In my opinion it is not the reaction to drugs.Reaction to drugs appears immediately. It appears after a weeks period.In my advice continue and complete the treatment as per the schedule.I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes decrease in S-Ferritin level?\n\nI'm 49, obese and putting on more weight by day.  I'm getting headaches in the night when I've had read meat for dinner... patalogy test showed that I do not have any allergics.14 June 2010:  S-Iron  3.8 mol/L  &  S-Ferritin 9mg/mL I've used an prescribed iron supplement.25 January 2011 : S-Iron6.8mol/L  &  S-Ferritin 7mg/mL According to the South African pathology report Normal S-Iron levels must be between 9.0 & 30.4mol/L  &  normal S-Ferritin levels must be between 15 & 160mg/mL How come the iron level picked up but the ferritin level went down?",
    "doctor_response": "Hello and welcome to HCM,Serum ferritin is the storage form of iron.The level of ferritin decreases in case of iron deficiency.Initially there is depletion of serum iron followed by ferritin.Thus, Thus, low ferritin implies low storage form of ferritin.Iron supplement will correct the iron deficiency and also the depleted ferritin levels.Once the iron level improves, the ferritin level will also pick up.Do not worry and continue with iron supplement.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Constant pain over appendix area, weight loss, nausea, tests show high bilrubin, normal CAT, ultrasound. Cause?\n\nMy daughter has a pain that is constant right over where her liver/galbladder/appendix is. She has had catscans and ultrasounds of the area and nothing has shown anything unusual. She has experience weightloss, nausea and blood tests only show an increase in her billirubin. It has spiked to 2.9 and is currently at 1.4. Any ideas on what it might be?",
    "doctor_response": "HI Only rise in bilirubin does not explain her pain it is imp to know if her bilirubin is direct or indirect hyperbilirubinemia if indirect bili is normal then poss it is Gilberts syndrome if her CT scan is normal then it is possible that she may be having functional abdomainal pain syndrome talk to her observe he if she has stress or has pain durng stress these sympt are common in teenagers",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is it shaky and awful feeling sometime after taking the doses?\n\nHi.. I suffer from Chronic pain.. I have had 4 shoulder repairs,, 2 bancart (sp?) and 2 decompressions.. all on the same shoulder,, needless to say I am very closely doctored as even though I am reasonably young(37) I do suffer extensively. SO my daily dose of pain medication is 4 tablets of 4mg hydromorphone twice a day. I have been on this dose... or recommended dose for 3 years;.. somedays i take less sometimes i take and extra tablet or two depending on my pain for the day.. i work full time at a very demanding job and i also have 4 kids at home. So my question is... tonight when i took my regular dose i suddenly got really -high- at least i think thats what happened. I was just so shakey and so awful feeling for a couple hours. Why would this happen? I have never felt this way before and there was 9 hrs from when i took my first dose to when i took this one. Thanks in advance Courtenay",
    "doctor_response": "Hi Hope this message finds you in good health.I have gone through your complaints and understand your concern.u seem to have got gastritis or some sort of body reaction to the medicines which is quiet common.Try to avoid as much tablets as possible and keep the dosage to minimum.Nothing to worry about.\u00a0\u00a0\u00a0\u00a0\u00a0I hope your question has been answered.If you have any follow-up queries,feel free to consult me anytime.Thanks,Take care,God bless.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cramps in the feet and ribcage?\n\nLately I have been experiencing painful cramping. The odd thing that it is in my feet, ...arches and outer toes. I also have severe cramping in the middle of my rib cage, on both sides. I take Calcium/Magnesium, and Potassium supplements and fish oil. Any clues what I am going through ? The foot cramping occurs only at night......",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The cramping and pain can be related to osteoarthritis changes, low calcium levels and disturbance in electrolyte levels or poor fluid intake. I hope this information has been helpful for you. Regards, Dr. Praveen Tayal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will taking cetirizine and allegra cure severe headaches, sneezing and sore throats caused due to sinus infection?\n\nI am suffering from Sneezing, sore throat and severe headache from last 3 yrs. I thought I have sinus and allergy because I get sneezing with dust and old cloths and weather change. But recently in diwali vacation in my home town, I went to one shoes shop and when he kept Agarbatti and switch on fan, I started coughing and was feeling so much disturbance in my chest and it was not stopping even I came out from tht shop. So I went to pathelogy and met with consultant docotr, he asked me to take cetrizine so I took Allegra which was with me tht time. After 10 mins I felt comfortable and I gave my blood for allergy test and after tht we went to lungs specialist doctor. he did some my test using mouth air and he said tht u have allergy induced Asthma and he has given Montair-fx mediicne one time in a day, Forecort inhaler twice in a day 2 puff and one nasal drop.He asked me to take these medicine one month and after tht meet any lungs specialist in Pune. After second day when my allery test report came, it was normal so we asked doctor so he said tht u have asthma. I am taking this montair-fx medicine from last 24 days and I can say I didnt face any trouble, I got 100% relieve. now i dont scare with cold waves and cold things. I have stop taking nasal drop after 10 days and for puff I m not regular but medicine I m taking regularly. So now again I have to consult with one doctor. I stay in Pune, please suggest me one good doctor in Pune. But I m worried becuase I m not able to understand which disese i have now if my allergy test is normal and after taking this medicine even I didnt face any sinus kind of headache.",
    "doctor_response": "Hello,thanks for your query.1.from your history it is clear that you do have allergy induced asthma.2. you have been taking antiallergic(allegra),and steroid +bronchodilator puff.this opens the air passages (narrowed by body reaction to allergy) and you can then breathe easily.3.season change,dust,perfumes etc will worsen breathing problems .sinusitis will worsen by exposure to cold .avoid such situations 4.keep up a regular routine of mild exercise(yogasanas) to improve lung capacity .5.ask your doctor to shift you from steroid to long term nonsteroid prep for asthma to reduce steroid related side effects .6. visit a chest physician(M.D.chest) wh can guide you better .stay healthy ,happy to help",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat skin rash on elbow?\n\ni have a skin rash on my elbow;s nowhere else just the elbow's... i have had them for few years noe their white lumps and sometimes red the rash has got worse... i have seen my doctor and he did,nt have a clue what they were.  He gave me cream it has'nt touched it",
    "doctor_response": "Dear, welcome on HMC, Rashes may also be associated with skin conditions, such as eczema, psoriasis and impetigo. The elbow is a common location for psoriasis eruptions, which cause scaly white spots and inflammation. Some chronic skin conditions may flare up for a time, then resolve. Other causes of rash include autoimmune disorders that occur when the body is attacked by its own immune system, which normally serves to protect it from foreign invaders (antigens) and  can be treated with medications, including over thecounter creams and ointments containing the steroid hydrocortisone (for example, Cortizone-10, Cort-Aid..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for muscle spasm in the bottom of my foot?\n\nI was in a recent car accident and I remember when I got out of the car, I slipped but a firefighter caught my arm and I didn t fall to the ground. I keep thinking I had a muscle spasm in the bottom of my foot, which I am more prone to get. A week later the bottom of my heel still hurts with certain pressure on it. ????",
    "doctor_response": "Hi, It is quite possible that you had an ankle sprain during being pulled out from the car. Use pain killers, ankle brace and local heat for about 2-3 weeks. If it does not heal by then MRI will be required. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Gopal Goel, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excruciating pain on right side of the stomach and testicles?\n\nMy boyfriend woke up 2 days ago with excruciating pain on his right side, stomach, back and testicle area. His face and lips became numb a few hours later while I was taking him to the hospital and he kept feeling too hot, then too cold. They took a urine sample to detect whether he had kidney stones, but today they said the test came back negative. He s taking some medication right now, but I m really concerned as to what might be the cause to all of this?",
    "doctor_response": "Hi.The pain yo described - the excruciating in the right aide with normal urinalysis is suggestive of a right Testicular Torsion. He needs urgent ultrasonography  and color Doppler examination of the scrotal area and surgery to reverse back the torsion to save testis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of pain in hands, wrists and neck?\n\nMy 30+ y/o niece suddenly developed very-painful hands recently, plus horribly aching wrists, and neck. Sometimes when she is driving, she can hardly control the steering wheel the pain is so pronounced. What does this sound like to you? I am so worried about her. She is trying to home-school three children, and has done a great job, b/c all three test yearly about 2 - 4 grades above public school children of the same age. She is so worried that she will have to give up the home schooling. Thank you!",
    "doctor_response": "Dear patient she may be suffering from.nerve compression at the wrist likely which is leading to radicular pain in both upper limbs and hands. Sudden onset pain and associated neck pain likely explanation is disc disease with nerve compression. Diagnosis can be confirmed by mri of the cervical spine.Please get it done form radiology centre nearby you. Meanwhile start tab pregalin x 75 mg one at bedtime with tab ultracet twice a day. You need to consult neurophysician with report.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes spreading rashes?\n\nMy daughter is 4 years old she started out with rash on her legs then it went to her arms then to her belly now it s on her groin area and now tonight it s on her privates. It all started out as tiny raised bumps on her her no color to them then she would wake up the next morning with scratch marks all over her cause of the intense itching. I had taken her to the doctor they said it could be poison ivy or something so they gave me benidril and cortisone cream; been using that for about a week and it still the same. She has had the rash since about the 1st of the month. What could it be? Also noticed she is bruising easier than normal.",
    "doctor_response": "Hi...by what you quote it seems to be an allergy of the skin commonly called urticaria. Sometimes it can as long as 14 days to settle and sometimes within this time period it can completely subside and come again as a second crop. Benadryl and cortisone cream are good for this condition. If it is persisting even after 2 week or she is developing blood in urine or motion and intense pain abdomen - seek immediate medical attention. Otherwise you can wait.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with stage IV lung cancer metastasized to iliac bone, on chemo, have swollen feet. What is the prognosis?\n\nMy husband was diagnosed stage iv lung cancer metastesized to iliac bone on 4th round chemo . Dr only checks ankles for edema . Tonight feet are swollen. Dr seems to be a little nervous--maybe because I work for nephrologists he knows. Sometimes his answers don t make sense and he definitely is not wanting to talk about prognosis . How do I get better answers?",
    "doctor_response": "Hello Very sorry to learn about your husband's condition. Lung cancer bone metastases are all too common with lung cancer, affecting 30 to 40% of people with advanced lung cancer. In addition to causing considerable pain and discomfort, bone metastases can result in fractures that interfere with daily activities and lessen your quality of life. The median survival \u2013- that is, the amount of time after which 50% of people are alive and 50% have passed away -- is sadly less than 6 months. Survival is somewhat higher for women, those with adenocarcinoma, people with only one bone metastasis, and individuals who do not have any fractures. That said, some people have survived and done well for many years following a diagnosis of lung cancer with bone metastases. Best of luck Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to overcome depression and pain after chemotherapy ?\n\nmy wife gone through kimo & now ca125 report show ok result but she is going through depression and pain in body",
    "doctor_response": "Hello ! Dear Arun Mehta , the pain ,restlessness are due to the side-effects of chemotherapy, you can give her Cad. Sulph. 30 a dose early morning empty stomach once a week, but it would be better to take homoeopathic medicine under supervision of a good homoeopath ,please find one around your place, you can depend on Homoeopathy . take care have homoeopathic medicine stay healthy .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shaking and feeling cold?\n\nLast night, while on the computer, I began shaking uncontrollably. I then took a long hot shower and went to sleep with a heavy headache and twisting stomach. During somewhere in 12 am, I urinated and felt just a bit better but all I have now is a small headache and unatural skin. Last night, after taking my shower, I stopped shaking but my room was 82 degrees and I was still cold.Whats wrong with me???",
    "doctor_response": "Hello,Your symptoms could be related to an infection. Have you measured your body temperature? Do you have fever? If you do not have fever, I would recommend consulting with your attending physician for a physical exam and some lab tests (complete blood count, PCR, ESR, urine analysis, thyroid hormone levels, blood electrolytes).Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Several open pores, acne scars, pigmentation on one side of the face. Treatment?\n\ni have a little bit skin problem on my face.... i have sooo much open pores on my face and red marks of pimples .....my pimples are healed but marks are there also i have smaall light black dots on one side of my face but these dots aree nott seein bye normally if i carefully see my face my face has become black in one side of my face please help mee out to rid of this problems",
    "doctor_response": "hi nitesh thanks for your query on healthcaremagic forum. The problems you are talking about are Acne , Blackheads , dilated pores and scars after healed acne. Typically, people with oily skin tend to have enlarged pores that secrete excess oil, or sebum. Larger pores are also more likely to get clogged with dead skin cells, dirt, and bacteria. Dermatologists generally treat acne-related conditions with topical antimicrobials that help disinfect the skin, and topical retinoids to help unclog pores and prevent white or blackheads from forming. For more moderate or severe cases of acne, an oral antibiotic like erythromycin, tetracycline, doxycycline, or minocycline may be prescribed. The fact is you can\u2019t get rid of your pores, or even shrink them, but you can cleanse and care for your skin in ways that make pores less visible. And that includes staying out of the sun as too much sun exposure reduces the amount of collagen in our skin, and that also causes pores to expand. Laser Treatment for the scars of acne as well as pigmentation may be helpful to you as well .(Fr Erb Glass Laser). Avoid oily foods and oily cream applications on your face and have plenty of water. God Bless",
    "dialogue_context": ""
  },
  {
    "patient_message": "How safe is angioplasty or bypass for LV dysfunction and pumping rate of 24%?\n\nHello Doctor,Its regarding my friend health problem. Recently we noticed a cardiac problem i.e., MULTIPLE BLOCKS in his heart. (through angiogram)Till now we did not even noticed any sympom and even he is not having any health complaints like BP or Sugar.But unfortunately we noticed that by birth he is having only one KIDNEY.The doctors told that we could not do anything as he is suffering with severe LV dysfunction and the pumping rate is only 24percent.so they cant go for either ANGIOPLASTY OF BYPASS.They just preferred to go with MEDICAL MANAGEMENT and there is no life gaurentee.could you please suggest us how to face this abnormal situation. Is there any possiblity for his life gaurentee?.",
    "doctor_response": "Hello,  Since his heart function is low, and also he is having only single, both bypass and angioplasty are risky options. But in order to prevent further fall in heart function, he should have either of two. Bypass is a better option but has more risk. So you need to take the risk and go ahead with either procedure.   He must be on multiple medicines like Aspirin clopidogrel statin like atorvastatin beta blocker like Metoprolol and ace inhibitors like ramipril. All these should be continued. Get his repeat echo done to see if any improvement in function. Hope this helps you and get back if you have any doubts.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Yellow blister on small palate due to low immune system. Solution?\n\nHi I have had a small yellow blister on my small palate now for about three months and my doctor said its nothing but my dentist said its because my immune system was low as I had been on triple antibiotics because I have h pylori . That was about 5 weeks ago and it still hasn t changed really, maybe a tiny bit smaller but that s all. Appreciate any help thank you. I am a 25 year old male and it is only sore if I drink hot things but even then it s not bad",
    "doctor_response": "Hello Welcome to HCM I would like to tell you that canker sore can be due to:- -stress problem -vitamin deficiency -trauma or injury while brushing It can be treated by:- -multivitamin treatment -taking natural milk -avoiding spicy food -applying dologel Consult your dentist for further query. Take Care Regards Dr.Neha",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does addiction to masturbation cause weight loss and reduced physical growth?\n\nim 19 year old boy .iam thin guy with 5.11 inches and 57 weight..my problem is like i masturbate everyday when im alone and my cheeks have been reduced badly.is this for masturbation or for anyelse? please help me and give me an advice to stop masturbation.please",
    "doctor_response": "Hi, Welcome to Healthcaremagic.com. I had gone through your question I can understand your concern about habit. See this is not the case of your low weight body of reduced cheeks. A person is married at an age of twenty and has sex daily for years if he doesn't feel any health issue why will you,  there is only one difference that is of intercourse , it is normal. At your age it will not affect you health wise. In case you want to check your habit, you need to have a room partner who will be with you most of the time and will check your loneliness. Keep in mind partner must be the one in front of him you may need to think. Hope my answer will help you and provide your feed back and visit us again in case any further help is needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can tonsillitis be treated?\n\nI ve had tonsillitis for a month now it started in my left tonsil where there was pus and my doctor gave me erythromycin. It cleared up and a half week later my right tonsil became swollen but no pus. I ve had CBC tests done WBC counts done and swabs done everything has come back negative. The pain was bad I ve been in and out of the hospital and doctors. I was put on azithromycin 3 days ago and had some side effects and was taken off my doctor called me today to discuss the results and said i shouldn t be on antibiotics because my WBC was about normal. He thought i could have oral gonoreah so we did swabs and I m still awaiting results. I saw a net at the hospital who did a ultra sound in my tonsil to check for a abscess and she said she couldn t see any puss inside, which made me feel better at the time. They then also discussed a possibility of a oral std and gave me a antibiotic via injection and benadryal at the same time in case i was allergic to the new antibiotic. They also gave me oral steroids and the next day the pain was do able. As the day went on the pain began to come back. I am so confused is this a viral infection? My blood tests which ive now done many and swabs have come back negative for any infections or bacteria. The doctor at the hospital said my monocytes were high on the CBC then she did a further test and said they were not actually high. The pain is still here its very frustrating i down know what to do my doctor has stopped my antibiotics the azithromycin until further notice on the oral gonoreah test he said if it were to be positive he d put me back on it. I m pretty scared at this point i feel like i will never get better i feel doomed and i don t know what to do now",
    "doctor_response": "In my opnion for your query the expert you visiting is not wrong and it is very important for you to stay calm. Ask you expert to kindly serve you with symptomatic management(pain relief). Wait for the result of the test. I would recommend you to perform luke warm salt water gargle thrice a day. There is a procedure of tonsillectomy which could be performed but for that your expert is trying to rule out all causes of infection. Have patience and don't give up. I am sure you will be well soon. Take Care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will oxygen therapy help to cure saliva gland cancer?\n\nHi, friend was just diagnosed with saliva gland cancer , they want to give him radiation and chemo. He is 64 otherwise in good health, good weight. Do you think that oxygen therapy would help ? Also, heavy doses of beet juice ? My Mom passed away one year ago today of this cancer and it took her in 4 months. So time is of the essence but she was 83 and not in great health. I wanted her to get hydrogen therapy and oxygen but she was not in a good place. Would you recommend them ?",
    "doctor_response": "First of all, the ideal treatment for salivary gland cancer is surgery and if required, to be followed up with radiotherapy. Surgery is not done only in cases where the disease is too advanced and cannot be removed. In such cases, radiotherapy and chemotherapy are given. Hydrogen or oxygen therapy has no role in curing any type of cancer anywhere in the body and i will strongly advise you against wasting precious time in this line.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. A 68-year-old diabetic woman lost most of her teeth. Is dental implant suggested for her age?\n\nHello doctor, My mother is 68 years old. She lost most of her teeth. Our doctor suggested full mouth dental implants. My mother has diabetes, and she is worried about the surgery and pain. I would like to know if she can go ahead with full mouth dental implants at this age? Will her diabetes create any issue? I have listed the last three blood sugar levels taken two months before. Fasting 73.8 mg/dL, after meals 124.5 mg/dL. Fasting 278.9mg/dL, after meals 206.2 mg/dL. Fasting 175.5mg/dL, after meals 109.2 mg/dL.",
    "doctor_response": "Hello. One can go with full mouth case with dental implants when the underlying bone conditions are ideal, which means patient's boney ridge should have adequate height and width. As per the age, there should not be any bony resorption. Bone conditions are important for implant stability. Systemic conditions like blood pressure and blood sugar levels should be under normal levels. After going through your given reports, patient's blood sugar levels are not constantly under control. So, need to check HbA1C (glycated hemoglobin) and follow up with diabetologist for strict diabetes control. Blood sugar level is important for the proper healing of bone during the process of implant placement. It will be beneficial if you upload image of an OPG (orthopantomogram), or give further details about the bone condition for proper treatment planning and management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best treatment to remove kidney stones?\n\nHelloI have right side kidney stone, what is best solution for take it out stone ? I been drinking too much water still problem with kidny stone. One and half years ago I had both side kidny stone , it is come back again. Please advise how to stop kidney stones?",
    "doctor_response": "Hello, Go for a CT scan to assess the size and location of the stone. Depending on which you can opt for various treatment options like ESWL or PCNL. Consult a urologist and he will direct you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes increasing white blood cell count?\n\nHi, i am 27 yr old female. I have recently found that my white blood count is increasing. It is now at 17,000, i am extremely exhausted, loss of appetite, moody and just alll around do not feel well. I have had mastitis in my left breast for almost 2 yrs now that has not been treated...could this be the reason? My dr is sending me to an oncologist for further testing but didnt go into any detail on what she thought the problem could be. Help!! This waiting and worrying is really stressing me out emotionally.",
    "doctor_response": "Hello! Thank you for using healthcaremagic. There are various reasons for increased white blood cells count. The history of mastitis suggests an underlying infection which could lead to increase in the white cells count. Probably the referral to an oncologist is just to rule out leukemia as this could also result in high white cells count. Also, is there any lump in your breast or is it only the mastitis? I suggest you look into that as well as soon as possible.Do feel free to ask any other queries regarding your condition.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sore in the lungs\n\nIm 35 male, quit smoking a month ago will help from Chantix. The last few weeks my right lung is sore, I can feel it through my chest, side and back. Also, it cracks or pops sometimes when I breathe in. I had a CT scan 3 or so months ago and had some small nodules all under 6mm so I don t think it can be cancer. I ve also notice both ears are full and I can pop them at anytime, which I ve never been able to do before. No coughing or any other sypmtoms",
    "doctor_response": "hi,it your small nodule is not cancer,it can be benign lesion or may be by some infection.the fullness in the ear also suggest some infection too.i suggest to take antibiotic full course (amoxy. clave 625 mg TDS  or other group suggested by your doctor)to get rid of the symptoms.  after the course of antibiotic if symptoms persist, further level of work up shluod be done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can alopecia areata causing hair loss and scalp burning be treated?\n\nHi doc m 25 year old girl and hairsutisim lead me to discover that i am suffering from PCO's and taking its medication(metmorphin, diane35 n multivitamin) from almost 14 months now. from last 2 months i discovered a alopecia areata patch on the scalp and a scalp burning 2 to 3 cm under the patch. i had 3 such patches when i was 14 years old but they recovered back themselves in 7 to 8 months.because of PCO's i am left with 1/4 of my hair i have following questions to ask of you 1. can i have the same hair strength as i used to have before PCO's (i mean i wana know if the folicals remain alive ) 2. how can alopecia areata can be recovered",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As per your case history of alopecia aerata and hairfall, my treatment advice is - 1. Take good nutritious diet full of green leafy vegetables and milk. 2. Apply a tacrolimus 0.03 %ointment twice daily on affected part.3. Take an iron supplement and vitamin b12 supplement once daily for 3 months. 4. Other treatment options are mesotherapy and injectable multivitamins given only after consulting a dermatologist. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does small tender lump behind the nipple and tender armpit mean infected cyst?\n\nMy 27 year old son has a small lump and tenderness behind his nipple.  He has been treated for 10 days with flucloxicillin but still feels unwell.  The breast area is tender and there is slight tenderness under the armpit.  His symptoms generraly appear flu like. His doctor has said it may be a cyst which is infected.  He has now finished the antibiotics and is going back to see his GP early next week.  Do you have any advice.  Elaine",
    "doctor_response": "Welcome to Health care magic.1. The history suggests that it can be infected cyst or an abscess or infective collection under the nipple.2.If the antibiotic course has not helped - then needs further evaluation.3.An ultrasound will be best to assess the pathology - it will help in analysing the nature of the lump , its source and its extensions. At the same time axillary tenderness also can be assessed.4.Axillary tenderness will be probably muculo-skeletal pain radiating or an lymph nodal enlargement due to localised infection. 5.In this case of infective collection the treatment of choice will be - small incision and drainage followed by course of antibiotics will be helpful. Good luck.Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can any online doctor help me with the sperm test results?\n\nHello Doctor, Please have a look on my semen analysis report PHYSICAL EXAMINATION -------------------------------- Collection Time        :  5.25 PM Receiving Time        :  5.40 PM Volume                    :  1.5 ML Liquefaction Time    :  45 Minutes pH                            : 7.5 Color                        :  White Opaque MICROSCOPIC EXAMINATION ------------------------------------- Sperm Count           : 115 Million MOTILITY DURING FIRST HOUR ----------------------------------------- Rapid Progressive        : 35 Slow Progressive          : 25 Very Slow Progressive  : 10 Non Motile                     : 30 MORPHOLOGY -------------------- Normal Spermatoza             :   70 Abnormal Spermatozoa       :   30 Viability                                :   35 Leucocytes                          :   1-2 / hpf Erythrocytes                        :  0-1 / hpf Sperm Cells                         : Occassional / hpf Epithelial Cells                     : Occassional / hpf Sperm Agglutination             : + ----------------------------------------------------------------------------- Because of abnormal semen liqufaction time of 45 minutes and semen volume 1.5, I did a semen culture test and the results shows TEST                                                     RESULT                                                          REFERENCE RANGE S: SENSITIVE                              MS:MODERATE SENSITIVE                                       R: RESISTANT Could you please tell me, this is normal or having any infection and required any medicine to rectifye the same ? with the medicine how much time it is required to be normal.",
    "doctor_response": "Hi,.Your semen analysis report is absolutely normal & you need no extra test for that. Liquifaction time of 45 minutes is normal. Volume of 1.5mL is also normal. You have not posted full semen culture report. Kindly upload it for further interpretation.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for trigeminal nerve disease\n\nMy brother has trigeminal nerve disease. He has visited all the ways he may be affected. My question is about the results of long term use of an anti-eppilectic, ativan, hydrocodone, and a very strong acyclivir. If the pain is too much, he will have a drink and then falls into his soup bowl Are there any articles you know that I find and learn more. THank You!!! Iris",
    "doctor_response": "Dear Iris, Thank you for asking on Healthcaremagic!I understand your concern and would explain that all these treatments are symptomatic. Besides acyclovir, which is an antiviral agent, used  against herpes infection, all the other drugs are symptomatic treatment for the pain control. Antiepilepsy agents can be used for years, to reduce the severity and frequency of pain attacks. I would  not recommend taking ativan and hydrocodone for a long time. Hydrocodone can cause addiction and tolerance. A brain MRI is necessary too. Other treatment options would be local infiltrations of the trigeminal nerve or other antiepilepsy agents. You should know that during antiepilpsy treatment, it is necessary to periodically check up their plasma levels and also complete blood count and liver and renal function tests. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I feel full quickly and I am tired very much. How can I be treated?\n\nHello doctor, I am a 39-year-old female. I take Nature-Throid for hypothyroidism and Wellbutrin for anxiety. I have recently been feeling full quickly and tired. My blood work came back normal. An abdominal CT scan was clear and a vaginal ultrasound was clear. What could be causing this?",
    "doctor_response": "Hello. I have reviewed your health query and can understand your worries. Hope this helps. Please feel free to ask more if you have queries. For more information consult a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest natural tips or food to avoid pregnancy\n\ndear doc, u gotta help me...i have no one , an orphan since 16yrs of age. married at 22yrs, now 32yrs.have a girl of 9yrs. in laws & hubby want a boy and are pressurizing me for one. my physical condition is very weak and after 9 yrs i am not at all mentally prepared to go for 1 now doc. i cannot tell them these reasons, have told before, they ignored & threatened me. so i am asking you to give me a solution.pls give me some natural tips to avoid getting pregnant.or some foods which i can take to defer pregnancy for months without anyones knowledge.please doc help me.can i take pills without getg caught,incase i hav to go for some blood test etc?help help.i dont want to get pregnant.....it will effect the future child also",
    "doctor_response": "I can understand your problem and it is a wise decision on your part to avoid another pregnancy when you are not physically fit. Unfortunately there are no foods which can avoid conception. You can go for sterilization as a permanent solution. If that is not possible, then there are contraceptive injections which can be taken at the doctor's clinic and one injection lasts for about 3 months. Consult a gynaecologist as you will need a prescription for that.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the prognosis for kidney tumor with brain metastasis?\n\nTHANK YOU SO VERY KINDLY. MY QUESTION IS RELATED TO MY GODCHILD 10 MONTH OLD BABY GIRL WHO HAD A KIDNEY TUMOR SURGERY (DOC. CLAIMED IS A RARE TUMOR OF THE KIDNEY), AND IS NOW IN CHEMO THERAPY TREATMENT,HAD A SMALL TUMOR IN THE BRAIN AND THEY ARE DRAINING THE FLUIDS IN THE BRAIN, A LOT IS GOING ON, DESPITES OF DOCTOR S HELP TO SAVE THE BABY, BUT THE PARENTS DO NOT REALLY UNDERSTANDING THE TRUTHFULNESS OF THE SITUATION. WHAT CAN YOU ADVICE THAT WE ASK THE DOCTORS RE: BABY S PRESENT HEALTH STATUS? PLEASE HELP US.THANKS",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Treatment and prognosis depends on type of cancer. Your baby has kidney cancer with metastasis in brain so it suggest poor prognosis irrespective of type. Complete removal of cancer cells from body is the keyIin treatment. Prognosis and life expectancy also depends on grade, stage and other co morbid condition and overall health status.  Consult your doctor and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat abdominal pain followed with vomiting and diarrhea?\n\nI have been having episodes of extreme upper abdominal pain. The only thing that relieves it is vomiting and I also have diarrhea at the same time.  I have noticed that prior to the onset of pain my stomach becomes distented and I begin belching which smells like rotten eggs. Please advise",
    "doctor_response": "HI. Your history is very well suggestive of an intestinal obstruction for which you need a clinical evaluation by a Surgeon, a standing x-ray of abdomen when you are in pain. Stop food , go for liquids only till you are well investigated. Go for surgery if advised.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nose bleeding and fatigue?\n\nMy 5 year old son has been having several bloody noses within the last few weeks, he is fatigued, threw up a few times the day before last, he wants to sleep on the floor, I find him on the floor in the mornings. He looks so tired and a little pale or even jaundice.",
    "doctor_response": "HelloThank You for contacting HCM.Due to multiple bleeding episodes he could have become anemic which could be the cause of fatigue. As he is also having jaundice so i would suggest you to take him to hospital where he would undergo lab investigations including CBC & LFTs to determine to extent of anemia and jaundice. Further treatment would be carried out on the basis of results.In the meanwhile you can put ice pack at his nose. It will decrease the bleeding episode.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the solution for excruciating pain in tailbone after falling down from stairs after painkillers, pain patches have failed?\n\nI fell down a flight of stairs 10 days ago and the pain in my tailbone is excruciating. It hurts all the time, but It brings me to tears to do any barely lifting, standing on one leg (dressing), sitting, standing or walking for prolonged periods of time. I've tried ice/heat and ibuprofen.  I've also tried pain patches, but I have a bad rash from them. Is there anything else I can try?",
    "doctor_response": "HIThank for asking to HCMI can understand your problem even slight hair line fracture could cause such pain and this could be long lasting and you have to be patience and need to increase your pain bearing capacity, this may take at least couple of week, meanwhile you can take the \"Diclofenac\" 50 mg sustain release tab. this will give excellent result, nothing to worry about this, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any chance of pregnancy?\n\nobgyn help pleasei had a baby boy january 17 2012 amd when i did my 6 week checkup i got the merina iud put in. well everything was great and i was having my period the 13th of every month until sept. my last period was aug and i havent had one since. now i am feeling exactly how i felt when i got pregnant. headaches, lower back pain, tender breast, constipation, heartburn, sick at random times through the day, and slight movement in my lower abdomial area... oh and three days ago i started lactating... when i took a pregnancy test over a week ago and it was negitive but now my sympthoms are worse... am i pregnant... what should i do since i have the iud insert??? please help",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As per your history, as your last UPT test was negative, kindly repeat test after 8 to 10 days, in between you can do ultrasound abdomen and pelvis for confirmation after gynecologist consultation. Take care. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can strep B infections, cause foul smelling watery discharge?\n\nAt my annual checkup (about a month ago) my gyno said I tested positive for Group B strep.  I'm prone to yeast infections because I always have sugar in my urine, so I thought that maybe I've been getting a yeast infection, but today I had a dark watery discharge that smelled really bad.  No pain, no itching, just the one bout of discharge and a continuous foul odor.  I started birth control about a week and 3 days ago.  What could be the cause? Could it be Group B strep related?",
    "doctor_response": "Thanks for posting your query to HCM. Streptococcal infection do not cause foul smelling discharge . but associated infection along with Streptococcal infection like  Yeast infection , Trichomonas infection or some other parasitic infection may cause foul smelling discharge .If you are having persistant discharge with foul smelling , do for examination of your discharge for Microscopic examination to Microbiology lab to know type of infection .then your gynec surgeon will be able to treat you accordingly  .take care ,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes smell in urine and stool of a child along with fever?\n\nmy 19 month was running a high temp all day yesterday it finally broke around midnight, yesterday he had mushy dirty diaper and it smelled like her diapers when she was a baby and had rotavirus...her pee is also smelling like rotavirus dirty diapers. Today she woke up congested and had a fever no dirty diapers but she isn t wanting to eat, we are keeping fluids in her, she has had horrible gas today that smells like the rotavirus diapers. I just want to know if she could be fighting off a small bug or is it possible to have rotavirus without the diaherra?",
    "doctor_response": "Hi, probably your child has stomach infection, i don't think it is due to rotavirus as fever is also present. You need to do a stool routine microscopy test and the child will probably need antibiotics like oflox syrup for 3 days. Since, drugs in children are given according to weight so you need to take the child to local doctor or revert back with exact weight of child. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could recurred lump on neck with itchy freckle indicate?\n\nI have small freckle on my neck and it was itchy a few nights ago - That same night a lump appeared under it but went down the next morning and returned to normal  Now a few days later the lump is back (I had been checking it so maybe irritated it).  it has not gone down and I am worried it may be modular melanoma.",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You may have some reactive lymphnode hyperplasia.  So it disappear itself and then reappear.  Don't worry about malignant melanoma.  Malignant melanoma don't have that characteristics. Just consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hives on back and stomach along with wound itching?\n\n76, 5ft 9 in , 189 lb, aortic insufficiency controlled with quinapril, Norvasc, Sept 1 direct inguinal hernia repair (ok so far)This AM my wound itched (unusual) Wife detected hives on back,  belly, much of body  New Sheets stored in original plastic container for 2 yrs. First use last night.A highly spiced indian dish last night; unexpectedly hot, slightly beyond my comfort zone.Took claritin plus 2 Ty;lenol last night. (not first time.)  for sleep purposes.Inclined to think Indian dish, but it could be sheets contaminated with plastic stabilizer or coating on sheets. Macy's brand \"dorm HQ\"",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms seem to be related to an allergic reaction. The allergen is unknown and can be any of the factors mentioned in the query.I suggest using antihistamines such as Cetirizine 10 mg daily.If the symptoms continue, you may need steroid shots.Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe dizziness and nausea?\n\nhello...I have had 3 or more times of having dizziness,extreme on-come of sleepiness,nausea and fainting...what could this be ...I have been hospitalized 2 x s for this already with many tests done and the doctors are at their witts end for and answer for this???",
    "doctor_response": "Hello!Welcome on Healthcaremagic!I understand your concern and would recommend performing a brain EEG to exclude possible vertigo epilepsy seizures. A brain MRI coupled with thyroid hormone levels are necessary to exclude other possible causes that may trigger this clinical situation. Hope you will find this answer helpful!Wishing good health, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there no withdrawal bleeding after 10 days of taking Unwanted 72?\n\nHello doctor, I had sex with my fiancee 10 days back but the condom got ruptured during the process. She had taken Unwanted 72 within 12 hours. She has not got her withdrawal bleeding yet. What should I do?",
    "doctor_response": "Hi. Withdrawal bleeding may be late or may not occur until next period. She took the pill within 12 hours. So, the chance of pregnancy is almost nil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat elevated heart rate and dizzy?\n\nhi the other day my heart felt like it had stopped then started again very fast about 5 times staight after it went back to normal i went very dizzy and hot only lasted for seconds went straight to hospital who did an ecg and it was fine and got sent home since then havent been feeling to good what can be wrong",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!Regarding your concern I would explain that your symptoms seem to be related to anxiety or a panic attack. Did you feel other symptoms like difficulty breathing, shortness of breath, fainting, etc.?Anyway a cardiac arrhythmia can not be excluded even with a normal ECG. I recommend consulting with your attending physician for a careful physical examination and some tests : -a cardiac ultrasound to examine your cardiac function-an ambulatory 24-48 hours ECG monitoring to examine your heart rhythm trends during the day and exclude possible arrhythmia-blood lab tests (complete blood count, blood electrolytes, thyroid hormone levels, fasting glucose, kidney and liver function tests, etc.). I recommend you discussing with your doctor on the above tests. If all the above mentioned tests result normal, the main cause of your symptoms would be just anxiety. Hope to have been helpful!Feel free to ask me directly at any time for any other uncertainties. Best regards!Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "On dialisis for kidney failure. Able to pass urine and feels hungry. Is it possible to undergo stem theraphy?\n\nGood night Doctor.My mother is on dialisis for kidney failure thrice in a week.I want to know if it is possible for stem cell theraphy for failur of kidney.She is 50 years old.as of now she is able to pass urine and feel hungry.Is it possible for my mother to undergo stem theraphy? Any where in India especially hyderabad.is it possible",
    "doctor_response": "As of now the stem cell therapy is only experimental with not so good results. Also most of the studies are in early CKD and not end stage disease disease. It would be better for you to continue on dialysis or think of a transplant if possible.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the lump on my left lower back?\n\nHello, I've recently started suffering from lower back pain, the pain itself gets worse and shoots down the left leg. I've discovered a small lump to the left of the lower back, it's inside and seems to go up and down, any advice or news is appreciated?",
    "doctor_response": "Hi,Dear,Good Evening from INDIA.Thanks for the query to HCM.I went through all the details of your query. on the details given by your query,In my opinion you suffer mostly from-fibrositis ? neurolipoma?I would advise CT spine with CT Guided FNAC- to rule out bony /intra-spinal lesionConsult a Orthopedic Surgeon.consult ER doctor for the script of drugs.Hope this would resolve your query.Welcome for any more query to HCM and ME,in this regard.Wishing you fast recovery.Write review ASAP with strong recommendations for HCM and for ME,for the benefit of other new and old patients.Have A Good Day.With Regards,Dr.Savaskar M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and soreness in hands?\n\nhello this is in regards to my 6 yr old son.We went to the water park all day Sat. for ten hrs. We ate there and it was very hot outside. We gave him as much liquids as we could. He woke up yesterday and he said his hands hurt. They were sensitive to the touch,little pink,some were kinda hard. He was tired through out the day and even took a nap which was not like him. We thought he was tired from Sat. Late last night he had a low fever. We gave him med for the fever and the pain in his hands. Today he woke up with a low fever but he didn t have it after that. His hands still hurt. So I took him to the doctor and she didn t know what it was. Do you happen to know what this is?",
    "doctor_response": "Hi...by what you say I feel that it could be viral myositis or inflammation of the muscles in the which can occur after exertion or after viral infection or viral illness and fever.If it doesn't subside in another 24 hours or his urine output is going down then we need to consider viral hemorrhagic fever and I suggest you take him to the nearest emergency room.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden hair loss and small white spot on the face?\n\nhi... my son is 6 yrs old and suddenly i noticed some hairloss , not much but there is a small white spot on his face which he scratched today and the skin peels like dandruff... he is an asthma kid since birth... he is on seretide inhaler twice daily n montelukast tab 5mg ones a day.... just wanted to know",
    "doctor_response": "From what you described I feel the hair loss or alopecia as in medical jargon is a result of dandruff and intense itching. The spot on face which peels like is also seborrhoeic dermatitis , all these are usually associated in a child who is atopic. The same explains his atopic asthma.Atopic dermatitis is the most common form of eczema. It often affects people who also have:Asthma or hay feverFamily history of eczema, asthma, or hay feverDefects in the skin barrier, allowing moisture out and germs inAtopic dermatitis usually begins during infancy or childhood. But it can strike people at any age.Treatments for atopic dermatitis include:Products to lubricate and moisturize the skinSteroid creams and ointmentsDrugs that control the immune systemAntibiotics to treat infectionsUltraviolet light, alone or with a drug called psoralenI have explained all these for your information. You can review with your doctor for appropriate suggestion,. Take care, regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower abdominal cramps and leg cramps\n\nI am having leg cramps all the way into my toes. I am also having cramps in my ruq abdomen and lower abdomen area. They are related, because it all started friday 3 days ago. They are not constant, they are intermittent mostly at night or positional for my abdomen. Could it be low potassium? I have had low potassium before, but I have been eating bananas. Should I call my doctor for a blood test?",
    "doctor_response": "Hi! Good morning. I am Dr Shareef answering your query. It is unlikely to have abdominal cramps due to low potassium. If I were your doctor, I would advise to avoid eating from outside if you do to prevent GI infections creeping in from most of these unhygienically prepared food items. I would also advise you to go for a roughage rich diet along with plenty of liquids as improper hydration could also give rise to the leg cramps. However, in case the intensity and frequency of these increase, I would advise you to take appointment with an internist and get  yourself clinically assessed along with any related investigations for a proper management. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could smoking after inguinal hernia surgery cause severe pain in stomach?\n\nHi, i had gone through Inguinal hernia surgey more then one year back and later again i started smoking cigrets after three months or so i din t have any problem till now but day before yesterday i took epsom bath i mean just hip bath, and later i started feeling diffrently and yesterday i had gone for a trip and i din t have my breakfast but i had one tender coconut, and i smoked cigrets without lunch and laer i ate in night that too chicken and farm quil now i am feeling excruciating pain i can t control lease suggest me what should i do and please do tell me is taking epsom salt bath a good thing. Thanks and regards",
    "doctor_response": "HI.The smoking after a long history alone can not be the reason for pain in abdomen. Your history of cigarette and chicken and quail can suggest that the pain can be due to infection in the intestines or got Irritated due to its contents. Hernia surgery is not likely to cause pain as also the epsom bath . Get an antibiotic, probiotic and anti-spamodic course. If the pain does not subside go for further investigations",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I wait for 3 weeks to undergo Thyroid cancer?\n\nHi Doctor yesterday my doctor told me that i have Thyroid cancer but i have to wait about 3 weeks for the operation and about 3 years ago i had breast cancer too but it was just a small lump i am ok about that what you think is 3 weeks to long to wait thanks doctor Joyce.",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, either this is secondary or primary malignancy if this is not severe enough or does not have any metastasis, and other vital organs are intact then you can wait for 3 weeks its okay, malignancy is very slow progressing disease, sudden onset of emergency is very rare, hope this information helps you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for restlessness and stomach pain in a child\n\nHi,my baby is 1month old and I find she is very restless . I have a feeling that she has got stomach pain. She stretches a lot (while she is asleep and awake) and vomits most of the milk she had. she make a cough kinda sound also . My mother advice me to give his bonnisan as she used to give it to me when I was a baby. But i m confused whether it s safe, if so what dose should I give her. Please advice. Thank u",
    "doctor_response": "Hi, 1 month old infants usually suffer from colicky abdominal pain  partly due to constipation caused by breast mik and parly due to gaseous distension. It usually requires no medication, just good burping activity of the child and keeping in mind not to give anything else to the baby except mother milk.But if the child is restless and irritable, Syrup Colicaid 5 drops twice a day can be given. Vomiting the feed is considered normal if the child does it intermittently and vomits out thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "My doctor attempted to fit me with the mirena coil a couple of days ago and couldnt do it due to it being too painful to complete the fit. since then I have been suffering with really bad lower abdominal pain and cramping but no bleeding although heavier than normal discharge. will this settle down or should I seek medical advice ?",
    "doctor_response": "Yes you should. The discharge also neds to be checked to make sure there is no infection. Take antispasmodics for pain relief, and meet your doctor at the earliest.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My wife is suffering from PCOS. What is the german homeopathy treatment for it?\n\nHello doctor,My wife is 24 years old she is suffering from PCOD disease since last 10 years. Earlier she used allopathy she wants cure from german homeopathy. Please suggest treatment.",
    "doctor_response": "Hello. The Homeopathic remedies I have had the most success with for PCOD (polycystic ovarian disease) are, 1. Natrum Muriaticum, 200C, take two separated doses daily until symptoms improve for yeast infections, skin breakouts, and PMS disturbances. 2. Sepia, 200C, take two separated doses daily until symptoms improve for yeast infections with dryness and tension of the vagina. 3. Lachesis, 200C, take two separated doses daily until symptoms improve. Excellent for troubles with circulation, no periods or heavy periods with a reddish, warm face and cold extremities. She can try the remedy for the symptoms that most closely match her case. It would be helpful to have a thorough case history taken by a Homeopathy to find the very best remedy for her particular symptoms. Deliverance Kit PCOS Formula by a company called Biogetica. This combines Homeopathic remedies with Ayurvedic herbs. She should try for weight loss and eat whole grains for her starches. Don does not eat too many carbohydrates such as bread and cereals in one meal. Spread carbohydrates out throughout the day, so her blood sugar does not spike. It is best to stay away from sweets and pasta as much as possible. She should try to drink eight cups of fluid without caffeine, and eat plenty of vegetables and fruits. Exercise is helpful, along with managing stress with meditation, taking walks in nature, and she can try yoga. If she is experiencing infertility, that is highly frustrating and difficult for both wife and husband. You can take a look at my article on infertility for some effective natural ways to conceive. I hope this helps your wife. Please let me know if I can be of further help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluttering feeling at the bottom of the rib cage?\n\ni have a fluttering/pulsating type feeling at the bottom of my left rib cage.  it seems like i can feel something sticking out at the bottom of the left rib cage where I get this feeling.  It is also burning a little..off and on.  and sometimes feels like something contracts or gets hard",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Chest discomfort with fluttering feeling in chest is commonly seen with arrhythmias. These are diseases of heart rhythm.. So better to first rule out cardiac arrhythmia in your case. So get done ecg, 2d echo and Holter monitoring (24 hour continuous monitoring of ecg). If all are normal than no need to worry for heart diseases. Sometimes gastritis can also cause similar symptoms. So take proton pump inhibitors (antacid). Don't worry, you will be alright, but better to first rule out arrhythmia. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the safe and natural way to prevent acne ?\n\ni have small pores all around my face and wrinkle and a scar and few black spots what is the safer effective cheaper treatment without any side effects and what about its cost kindly guide me i am thinking of herbal peeling how about its result does it have any side effecte",
    "doctor_response": "THanks for the query Glycopeel and Micro derma ablations are cheap and effective options for acne scars. The cost will depend on how deep and how extensive the scars are. in bangalore it will cost you between 15k t0 30k. For now you could apply tomato or stawberry juice on your face. It helps. Have a healthy living",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dizziness, fever and cold sweats\n\nHi, Please can you help ? I keep going dizzy as in the room is spinning when sitting worse when i stand. It's been happening most of today. I also keep spiking a temp of 38.1-39.3 I've been having cold sweats and keep going clammy. Can you please advise me on how to stop this feeling many thanks.",
    "doctor_response": "Hello,The dizziness with the room spinning is called vertigo.Most commonly it is related to the inner ear. It can also be related to an acute infection such as cough/cold or sinusitis. This may be case for you since you also have a fever.The most common inner ear causes are- BPPV (benign paroxysmal positional vertigo), Meniere's disease, and vestibular neuronitis. None of these are life threatening, just difficult to handle as they occur.You should consider seeing your doctor for assessment to determine the cause for you. Treatment varies.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Michelle Gibson James",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can steroid eye drops raise the blood sugar levels?\n\nHello doctor, My father had cataract surgery yesterday. His sugar levels were fine before surgery. Today he was given a Dexa injection 2 ml in his eye due to inflammation. After that the sugar levels have stayed between 280 -300 through out. Just before dinner, his sugar levels were 300 mg/dL. As advised by our doctor have gave him 16 units of Mixtard instead of 14 which he takes regularly along with regular sugar medicines. My questions are: Does Dexa injection increase the sugar so much and when will the effect go? In addition, he is also putting one drop of steroid eye drops Predmet every hour. From tomorrow, it will be once every three hours. Can this also increase the sugar level? From tomorrow how should we manage the sugar levels? Will the effect of steroids go away? Please see the attached prescription of all the eye drops after cataract surgery. He is taking Mixtard Insulin 30/70 - 50 units in the morning,14 units in the night, Glycomet GP2 1-0-1, Linagliptin 5 mg 1-0-0, Fibator 10 mg -0-0-1, Metolar 25 -1-0-0, Dynapres 0.4 - 0-0-1, Arreno 1-0-1, Ecosprin 75 1-0-0, Thyronorm 25 mg one tablet from Monday to Thursday and two tablets from Friday to Sunday, Cap Uprise once a month.",
    "doctor_response": "Hello,  Welcome to icliniq.com. I just read your query and from what you have mentioned it appears that your father\u2019s blood sugar has increased because of steroids. As for your questions let me answer them one by one. Yes, Dexa injection increases the sugar so much and it will have decreased effect once your father is off steroids completely. Yes, steroid eye drops Predmet (Methylprednisolone) can also increase sugar level. Regarding managing the sugar levels, if his fasting is above 250 then increase his evening dose of Insulin by adding two more units. If his dinner blood sugar is 250 mg/dL above then add two more units to his morning dose of Insulin and continue monitoring accordingly. If drops to 200 then do not increase his insulin at all and maintain at that dose of insulin. Keep following his blood sugar closely and watch for any signs of hypoglycemia as well like increase sweating or shivering or headache or hunger or cold skin, etc. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "GERD Child having breathing difficulty. Xrays normal. Diagnosed allergy. Given Fluticasone nasal spray. No relief. Recommendation\n\nHi, my 5 year old son keeps taking deep breaths as if he was exerting himself running. He does it on and off and he says \"it's hard to breathe\" but it happens even when he's resting. I took him a couple of months ago to his pediatrician and she requested chest X-rays that came back ok. She said it could be allergies and prescribed fluticasone nasal spray but that hasn't helped. What could it be? He had GERD until he was 24 months approx.",
    "doctor_response": "Hi welcome to Health care magic forum.                              Thanks for choosing H.C.M.Forum.                              Your son of five years age is taking deep breaths, on and off, even at rest, Xrray was normal, pediatritian said it may be allergy, and prescribed fluticsone nasal spray , but not helping. he had GERD, upto the age of 24 months.                              It may not be related to either of the diseases you are thinking to be , breath lessness, or G.E.R.D.                                  I think it might be a psychological , may be related to gastritis, due to lactose intolarance, or indigestion.                              I advise you to consult a psychiatrist, with this you can have a god result.                              Besides i advise you to avoid milk and milk products .                              Wishing him a quick and complete recovery.                              Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can smoking olive oil fumes cause pain?\n\ni inhaled a lung full or 2 of fumes from bubbling olive oil and now my lungs hurt a bit im pretty sure it was not smoking but 'fumes', there was no black smoke coming from iti guess the whole of the inside of my lungs has been coated with a fine layer of olive oil, and lungs regenerate so i should be good in the morning right?im not sure whether its placebo or not but my lungs seem to hurt a little more now its very late / early here and i cant sleep because of it, i went for a pee and it seemed a slightly painful like between my lower organs and lungs, have decided to drink lots of fluids and had a slice of bread pains just below my rib cage and behind my rib cage higher up (like where my lungs are)thank you, im getting quite worried now",
    "doctor_response": "The inhalation may have irritated your airways (bronchi). If your symptoms do not resolve in the course of a day then you should see a doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to have rods in fusion on c-7 T-1 ?\n\ni had surgery on Oct. 15,2011, went in for my check up today and i was told my fusion didn t take and this is surgery number 5 that i had and my dr. wants to go back in and put some screws and a rod in by my last fusion which is on the C-7 T-1 and i refused what happens now will it affect me in the long run",
    "doctor_response": "Hello, As surgery is not always a permanent cure. it can only help to provide the joint stability by which the pain symptoms can be reduced. I don't think you will have any major issue if you reject the next surgery to be taken. As whatever could have done, it's done to a good extent. For now, avoid surgery and try doing hot water fermentation and simple exercises which helps improve the muscle strength and stability of the cervical spine. Gentle kneading massage if you have too much muscle spasms. You can take the help of a physiotherapist and see if you get some good results to avoid the surgery. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for the fever due to enlarged spleen and lymph nodes?\n\nMy 32 yr old son has been running fever for 3 months, been hospitalized for 5 days, dismissed for 6 days.  All we know is he was anemic, enlarged spleen, with some mildly enlarged lymph nodes in abdomen.  Found nodule on his thyroid while looking for enlarged lymph nodes in his neck.  While in the hospital the gave him intravenous antibiotics and he never had a fever.  I have Hashimoto's, and told his doctors.  They are wanting to remove his spleen as they suspect some type of lymphoma.  They did a bone marrow biopsy in the hospital which showed nothing abnormal.  Could he possibly have hashimoto's ?",
    "doctor_response": "Hi, Welcome to HealthCareMagic.com I am Dr.J.Mariano Anto Bruno Mascarenhas. I have gone through your query with diligence and would like you to know that I am here to help you.Please repeat the bone marrow biopsy after three weeks and then decideHope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in HealthCareMagic at  Best Wishes for Speedy Recovery Let me know if I can assist you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does this MRI report of spine suggest the need for surgery?\n\nI am 56 yr old female and have been diagnosed with moderate discogenic and spondylotic changes in the lower 2 lumbar levels greatest at L4-5 where there is a grade 1 degenerative listhesis with rather severe central canal and lateral recess narrowing bilaterally. there is broad-based posterior disc protrusion at this level. There is moderate left and mild right foraminal narrowing. Also at L5-S1 there is facet arthropathy w/a broad based right paracentral and foraminal disc protrusion w/moderate right lateral recess and mild right foraminal narrowing. Left neural foramen and left lateral recess and mild narrowing. There is overall mild facet overgrowth at L3-4 with mild central canal and lateral recess narrowing. Question: Will I need surgery?",
    "doctor_response": "I read your question carefully and I understand your concern.The decision to undergo surgery though is not taken solely on your imaging results but also on what symptoms do they cause and their intensity. Also usually conservative treatment and physiotherapy is always tried for some months first.If you have intense pain which hasn't responded to physical therapy then I believe surgery for the changes in L4-L5 with severe canal and lateral recess narrowing. At time if the symptoms do not correspond to compression at this level nerve conduction studies are done beforehand to make sure which level needs to be addressed.I hope to have been of help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe back pain after treatment for clostridium difficil\n\nSure I had a Percutanious Discectomy on Feb 7th this year,I left the Hosp and within 1 day had non stop Diharea and was dehydrated.went to the ER and found I had C Diff.(stated it was from Keflex)Was put on 12 days of antibotics and felt better until finished then excruciating different back Pain present ever since.",
    "doctor_response": "Hellowelcome to hcmwell your back pain in most probabilities is not related to clostridium diff and is most probably due to spasm of back muscles which in turn can be due to sprain or disc prolapse...you should take following medicines for 5 days n if the pain still persists then get a MRI OF LUMBOSACRAL REGION...take these medicines(1) TABLET IBUPROFEN 3 times a day(2) TABLET CHLORZOXAZONE 3 times a dayregardsdr rahuk",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. 2. 5 year old suffering from stomach ache. Which medicine has to be given?\n\nHi doctor, My son is 2.5 years old. For a week, he is complaining of stomach pain. After farting he is fine. Our family doctor recommended one antibiotic for five days and a medicine to avoid vomiting. He had small vomits twice, but later it was fine. Now, after completing the course of medicine he again complaints the same. His diet is almost nothing and he is not ready to take any food. He just has few mL of milk. He does not have fever. His stool was watery, but it is normal now. Can you provide any recommendation on diet and medicine? Please give me a solution to the problem. Thank you.",
    "doctor_response": "Hi. I can understand your concerns. Complain of abdomen pain with vomiting suggests that your child probably has acute gastroenteritis or food poisoning. Since, antibiotic is already given and now there are no loose stools or vomiting, there is no need to give antibiotic again. For abdomen pain, you can give syrup Cyclopam (Dicyclomine hydrochloride and Paracetamol) 5 mL on SOS basis (as and when required) that is when abdomen pain occurs. Whenever a child becomes sick, there is decrease in his appetite which improves as child recovers. Now, you should give him all the foods that you were giving him earlier. If he is not eating then you can start Glucon-D in water thrice a day for one or two days. Start a multivitamin like syrup Bevon 5 mL once a day for 15 days. Keep patience. Child will eat properly now as he has recovered from illness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with stage 4 cancer signet ring cell carcinoma of stomach\n\nmy brother has been diagnosed stage 4 of cancer Signet ring cell carcinoma of the stomach as he very week and loosing weight doctor don't want to treat him with chemotherapy as being too week is their any other form of medicine that may help him to gain strength and then be able to receive treatment",
    "doctor_response": "There is no medicine that can improve his general condition to an extent where he can tolerate chemotherapy, but improving his calorie intake by parentral nutrition can improve his generel condition.You can  consider radiotherapy to control his disease locally and palliate any symptoms he has. There are Biological drugs used in cancer treatment, please enquire the same with your oncologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Has fever despite ibuprofen and paracetamol. Monocytes high. What is wrong?\n\nMy 13 month old has had a fever more than 39 for 10 hours despite ibuprofen and paracetamol . She is flat. We took her to the hospital and she had a cxr which was normal and blood tests and were sent home to wait for the results of the bloods. I had been waiting a number of hours and called the lab and her monocytes are high andcrp is 24. We cannot find the paediatrician he is not answering his phone. Should I take her to a different hospital or wait?",
    "doctor_response": "thank you. it is just 10 hours have passed.it is not possible to reach a diagnosis from this result.you can use paracetamol suppositiry & sponge the baby with warm water to normalize temperature.it may be viral fever.wait for 3-4 days,if condition not improving then consult a paediatrician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for low energy, headaches and rashes on arms\n\nMy daughter is 14 and in 9th grade. Over the break she has not felt well. About 7 days ago she was in bed/couch for 2 days with no energy and a headache. She appeared to get better, but when she went to a work out she felt faint and came home early. She fell a asleep for a few hours. She continues to have low energy , sometimes a headache, and just yesterday she started having a red bumpy rash on her arms...",
    "doctor_response": "I would suggest some test and exam for your daughter. Weakness headache and rash are not normal. However you didnt mentioned any fever. But still you should visit a doctor.Meanwhile you should give her fluids and ORS to prevent dehydration.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes wheezing while breathing through mouth?\n\nHello, I m having difficulty breathing through my mouth after I sneeze or cough. I feel my chest tighten and then I start wheezing. I have seen my doctor and he said it was bronchial asthma. He prescribed some medication for three days with an inhaler. I finished taking the medication and only took the inhaler one time (four times that day, as prescribed). I later went back and he said everything was gone and now have tracheitis. I had another appointment with him today and he said that I now have a cold and what I am feeling is coming from my throat. Should I be worried? As I explained to him again and again... every time I sneeze or cough or even laugh (hard) I end up with a wheezing (while breathing in through my mouth).",
    "doctor_response": "Your symptoms are suggestive of bronchial asthma and you have to take inhalers on a regular basis especially the controller ones like seroflo or foracort. Consult your local physician for correct dosage and technique of taking inhalers.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can I do to have a healthy heart?\n\nI am 53, have taken treatment for high blood pressure for years, have high cholesterol and my father died at 51 of coronary occlusion. I have recently had a few chest/epigastric pains and had a clear ECG, electrocardiogram and a good 24 hour BP monitor-average 119/68. I have lost a stone in two months, walk for 30 minutes at least 4 times a week and have reduced my dietary fats-also take Benecol. However I am terrified of having a heart attack-is there anything else I can do-I do NOT smoke!!",
    "doctor_response": "Hi, You should maintain your blood sugar, lipid profile and blood pressure under control. Continue what you are doing. In addition, avoid day to day stress. Try meditation, relaxation techniques as deep breathing exercises. Do not take stress, if you keep your risk factors under control, there is a little risk of a heart attack. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Varinder Joshi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for lower back pain and nausea?\n\nHi, I hope you re well. My boyfriend is in severe pain. It s his lower back, and he says it s some of the worst pain he s ever been in. He s also nauseous but the nausea seems to be coming from the pain. Earlier the pain started with a head/neck ache which went away with excedrin and a nap. He felt normal til a few hours ago when the back pain started. No fever but he is freezing and it s not that cold. I just don t know what to do. He s taken one more excedrin and I m keeping heat on his back.",
    "doctor_response": "Hello, I have studied your case. According to your symptoms this looks as acute lumbar muscle sprain in your lower back.Another differential diagnosis can be lumbar disc bulge leading to sudden onset of pain.Intervertebral disc compresses spinal cord and leads to back pain and shoulder pain.Muscle spasm should recover with in 2 weeks, as it has not recovered you may need further investigation.When such patient comes to our hospital we usually do x ray to rule out any nerve compression.MRI spine will show any disc bulge is there or not.And when muscle sprain is confirmed muscle relaxant, analgesic and neurotropic medication can be started consulting your doctor.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you find this answer helpful do not hesitate to rate this answer at end of discussion.Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could cervical spondylosis be a cause of tooth pain in the jaw? I saw an endodontist and he could see no reason for the pain I have in #20 tooth lower jaw that has a valid root canal. He showed me a diagram of the nerve root in the jaw and thought possibly the pain came from there? Thanks, Kathleen Andersen",
    "doctor_response": "hello thanx for consulting at hcm..usually tooth pain caused by infection like deep dental caries involving pulp or from periodontal causes such as calculus,,if tooth causes are ruled out for teeth pain then systemic causes can be looked into..do u have cervical spondylosis?? usually spondylosis causes tmj problems so kindly have a check up with oral physician..hope it helps,,take care,,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes insensitivity in hands and tingling in feet?\n\nI m,13 and my 36 yearold mom is loosing feeling in her hands to the point she can pop and twist them and mot feel it. She also has tingly feet. Please tell me what I can do or what she can eat. She did have diabetes during pegnacy and diabetes run in the family.",
    "doctor_response": "Hello, Your mom is showing signs of peripheral neuropathy. In this condition, the nerves of the arms and legs get damaged. Diabetes is the commonest cause of neuropathy. Other causes include vitamin B12 deficiency and thyroid disease. Once the cause is identified, it can be treated with proper medications. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sudhir Kumar, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it advisable to travel after brain surgery and series of small strokes?\n\nI do have a question...my father in law had brain surgery for a brain bleed in March 2011....he had many issues, including a series of small strokes, congestive heart failure and also had surgery for a large blood clot in his leg...he is doing much better and wants to take a 14 day pretty intense trip to Italy....we are concerned not only with the flight, but the intense travel with the tour...",
    "doctor_response": "Dear user, thank you for your answer, great that your dad is doing better, best thing is to  have him visit his doctor and do a medical check up on his situation, if his doctor after examining him allows him to travel then it will be ok. Meaning is a doctor has to examine him to make sure he is fit for traveling. best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does microvascular ischemic changes suggest?\n\nI had an MRI of my brain done, my doctor thinks I may have multiple sclerosis. The MRI reports early microvascular ischemic changes. I have what I call episodes . I get numbness, tingling, and a feeling of nausea and syncope. Does this mean I may in face have MS?",
    "doctor_response": "Hi, First of all, Multiple sclerosis cannot be diagnosed by microvascular ischemic changes in the MRI. These changes means you could have vasculitidis (an autoimmune disease affects the blood vessels), SLE, Sarcoidosis or ischemia. Therefore, you should ask an immunologist for help. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mustafa, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white discharge from the penis?\n\nHi,i am 26 years old with a height of 6 feet and wieght around 75 kgs.from past 2-3 days my penis is paining and then i noticed that an infection has on the tip of it.and also a white like liquid is discharging everytime with a very bad smell.please help me out.",
    "doctor_response": "Hello, Since you didn't provide your sexual history. If you have recent unprotected sex we can think of STI. If not it can be a simple bacterial, fungal infection local application of antibiotics, antifungal can help you. Mild painkillers will also help you reduce inflammation. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe back pain?\n\nwoke up one morning 3 wks ago turned head to left and felt a sharp burning pain radiate down from base of neck into left shoulder blade area.  Two days later it happened again when waking up.  Still very painful and worse after having an adjustment with my chiropractor a few days ago.  What could this be?",
    "doctor_response": "Hello, I have studied your case.According to your history and complains yes such kind of pain can due to compression of nerve and muscle sprain due lifting of heavy weight or heavy exercises.Another differential can be nerve compression due to disc bulge which may need MRI for confirmation. Some time CT contrast may not show minor disc bulge. If clinically vascular status is feeble colour Doppler may help to look for vasoconstriction.Medication like methylcobalamine with muscle relaxant and analgesic will reduce pain; you can take them consulting your treating doctor.You may consult physiotherapist for further guidance. He may start TENS, or ultrasound which is helpful in your case.You may need to take rest for early healing.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take careRegards Dr Vaibhav",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the growth in wisdom tooth extraction site?\n\nI had my wisdom teeth out 5 weeks ago, they havent healed well and my surgeon put me on penicillin on monday, he stated that although he could not see an infection, things dont seem right. I now have this bloody growth at one of the extraction sites. I am going to book an appointment asap with my surgeon, but what could this be?",
    "doctor_response": "Hello,  Thanks for consulting HCM,  Read your query, as you have undergone extraction of wisdom tooth see what happend is healing of wisdom tooth socket takes time if it is surgical extraction or traumatic extraction dont be worried so much this growth can be the clot formation on the extraction site or it can be due to deposition of food debris in clot it look like growth at extraction site. Consult your dentist and follow post operative instructions and take proper course of antibiotics , take proper rest , take soft diet .Hope this will help you. Wishing you good health.Regards, Dr. Priyanka tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pneumonia?\n\nMy dad is 79 and in February was admitted to hospital with Pneumonia. Unfortunately he had prior for many years had problems with swallowing and choking. He now has a gastrostomy tube and is nil by mouth as his Epiglottis is not working correctly. Is there anything that can be done we don t seem to be getting any answers",
    "doctor_response": "Thanks for your question on HCM.I can understand your situation and problem.In my opinion, your father is having aspiration pneumonia mostly.He is having following risk factors for aspiration.1. Old age2. Difficulty in swallowing3. History of choking4. Non functioning epiglottisAnaerobic infection is most common cause for Aspiration pneumonia. So better to get done sputum culture and sensitivity to identify causative organism and start appropriate antibiotic therapy.Just make sure that his antibiotic regimen contain anaerobic coverage.So discuss all these with his treating doctor and start proper treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain,cold,infection,on tylenol. Suggestion?\n\nHi, I've had a dull pain in my left side for the past 4yrs when I lie on my back. I have to sleep on either side, because the pain can be unbearable when on my back.  I had a very bad cold that lasted about 4weeks about 4 years ago. and feel that maybe this is what caused my problem.  May there was an infection at the time, and I should have looked in to medical attention and possible antibiotics.  I am not a smoker.  I do not take drugs... just Tylenol to ease daily pains.  I am a 47 year old female in good health.  Please help!",
    "doctor_response": "Hello,Thanks for posting to HCM,Taking too much of Tylenol may cause sever liver disease.For cold take tab. wikoryl twice a day.For back pain take cap.secode oil. once at night in a day.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be done after molar fall out with tiny bit still intact?\n\nDentist help! My molar fell out I am experiencing no pain or bleeding what should I do? I can't make it to a clinic until Monday. If my gum isn't bleeding am I going to get dry socket. There is a tiny bit of tooth that I can see but the rest is just a hole",
    "doctor_response": "Hello,The remaining part of the tooth could be a left out root piece. Nothing to worry consults an oral physician and takes a radiograph to rule out the presence of a root piece. If there is a root piece, then get it removed under local anesthesia. Nothing to worry about dry socket, it will not occur when there is still a root piece inside.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mahesh Kumar T S",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to control blood pressure\n\nI just took a blood pressure reading that was 152/61 and I am experiencing a queasy feeling in my chest like I can feel my heart beating but no pain. I am 62 and have never been diagonosted with high blood pressure in the past but I have had this feeling in my chest before. It comes and goes but most noticeably after I eat or drink. Any ideas?",
    "doctor_response": "hi,    your blood pressure reading is normal, you should get an ekg done, if ekg is normal your symptoms could be due to esophagial reflux problem which can be solved by antacid medicines.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can an infected wound on the toe be treated?\n\nI smashed my big toe from about the knuckle toward the tip and it kind of leaked from around the nail cuticle for a few day then stopped. Well I\u2019ve been noticing a foul smell about two weeks later and desided to cut some of the toenail off when it wasn\u2019t attached and it is black and smells horrible under there. I can feel the whole bottom of that toe but not the top. I\u2019ve rinsed and ligjtley scrubbed the smelly tissue off but the rest of the nail is attached still. What do I do?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.I think you should go to surgeon and he will cut and remove the infected part , he  will cut,the nail , and clear the wound. Maybe he will give you antibiotic ointment to put in.If he see it necessary oral antibiotics may be needed. Take care. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for disturbed night sleep\n\nhi,i have a son 13 months , he just recovered from herpesangina and had fever for a week. he was on amoxycillin and meftal-p for a week..now he is ok but he now wakes up at night 2-3 times and he is teething as well..his night sleep patterns are disturbed..any help would be appreciated...thanks..",
    "doctor_response": "Hello. Thank you for your query. In order to relieve his teething pain you can buy some teething gel and put it to babies gum every night before sleep. If the baby has persistent pain you can give him some Acetaminophen syrup. Also as a Sleep Baby Consultant i would suggest you to keep up the good routine. If you still have difficulty on your baby's sleep contact me and we can do a Sleep Training.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Doxinate have side effects?\n\nI was taking emesat-8 for nausea and vomiting for pregnancy on SOS basis. Y day Doc asked me to take Doxinate as well as I had to take an exam and did not want any problems. Now I have not felt vomiting for more than 24 hours. Is there something wrong by taking Doxinate?",
    "doctor_response": "Hello,Doxinate can cause excessive sleepiness and fatigue and thus it is not recommended for long term use. You can continue emeset or domeperidone.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rash and flakes on both sides of the nose and forehead. Is it the side effect of taking Tetralysal ?\n\nHi I hope someone can help me, Basically about two weeks ago I started getting a rash type thing on both sides of my nose , and forehead , its made my skin red around my nose and get very flaky around the area and it becomes soft and grey when ever I wash my face, I dont know what it is but I do have acne and my doctor prescribed Tetralysal for it so it could be a side effect to that? I avoid touching the area as I hoped it would naturally heal, but all that happens it the flakes build up so I m forced to clean it, Its really starting to effect myself confidence, please help what is this? and is it treatable!?",
    "doctor_response": "Hello I would be pleased to answer your question Skin around the nose getting flaky and red is a sign of a side effect of the cream or face wash . You should a mild steroid prescribed from your GP . You should use a mild cleanser called Cetaphil Cleansing lotion . It is a temporary flakiness which would surely go away with the steroid cream . Thanks and Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for draining abscess pocket on ascending colon\n\nI have a drain coming out of  an abcess pocket on my ascending colon.  It has been there 5 days and is still draining some.I'm also on antibiotics for another week and am supposed to have the drain for the week as well.  I noticed the tube seems to have loosened a little - maybe a half inch and a little fluid came out - due to the bag(bulb) hanging down.  The stitches that were put in are sticking out more.  I'm sitting down and it is not dripping now.  Its Sat night  and I'm wondering if I can wait til Monday to see the dr.",
    "doctor_response": "Hello,Thank you for your contact to healthcare magic.I understand your health concern, if I am your doctor I suggest you that nothing to worry about in your case. If you are worrying about infection you can get antimicrobial sensitivity done. And start treatment accordingly. Rest discharge for some times is common and nothing more intervention is required.I will be happy to answer all your future concern. Thank you,Dr Arun TankInfectious disease specialist.Wish you a best health at health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and blurred vision after an ankle injury?\n\nI feel pretty hard and hurt my ankle, right above where I ve broken my foot before. I went to the hospital and they did and X-ray and said it was just a sprain. That was two days ago. Today, I ve been lethargic, dizzy, and my vision has been blurry. Is it related? Should I be worried?",
    "doctor_response": "Hello!Welcome on Healthcaremagic!Your symptoms are not related to the sprain in your ankle. Have you taken any painkillers or opioids for the pain during these days. This situation could be related to your therapy adverse effects. I recommend you to monitor your blood pressure and heart rate and take plenty of water. If this situation persists, I recommend going to the ER for a physical check up and some tests : complete blood count, PCR, sedimentation rate. Hope you will find this answer helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause for sudden pain in the neck of the child?\n\nmy almost 4 year old has complained about a pain in the back of her neck which seems to occure maybe once a month for duration of 30 seconds. This episode makes her cry for the same duration and she stops. she has an MRI scheduled for October 17th, do you think it is something serious?",
    "doctor_response": "Hi dear,I understand your concern. It seems she has not correct position of spinal cord. She should sit and walk properly.Use small pillow. I suggest-Apply Diclofenac gel twice a day,rubber gently with massage.-Do exercises for neck, back daily.-Swimming.-Compress with Camphora to affected area.Hope it helpsWishing your baby good helth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should I use medicines for high BP?\n\niam adinarayana, 8 months back suddenly my relative expired. i shocked and tension. 10 days regularly bad thinking and depressed. once i went to doctor, he checked my BP. i was suffered hypertension. doctor told me that use tablets daily, tablets are 1.repace-h, repace-50 and dilzem-90.daily i use 3 tablets. now iam able to perfect. i checked daily my bp. now 125/75. daily i go to walk. my age 35, weight 74. now my problem is that- can i with draw these tablets. or use lifelong. please suggest me sir. thank you.",
    "doctor_response": "if you have hypertension are you should get medicines adjusted by your physician and you should not check your blood pressure Delhi I will you should get it when you go to your physician or get it when you only have some problems checking BP to offer and can make you can only show that pretty sign of anxietyOnce the medicines are a set tender digested by your physician they must we continued all the time of the BP but if the BP's law you can always try if the blood pressure is low then you can always try going without medicines for a while if the BP comes back again that means you have to take medicines all the time this account Lord is this a consultation I hope I help you thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "How an air bubble in the plural cavity be treated for a new born?\n\nMy question is very similar to the preceding post which hasn t yet been answered. We have a newborn (yesterday), 7 lbs, 9oz, full term with air bubble in the pleural cavity (I think...the best I understood was between the lung and lung lining). Baby has been transported to ICU unit at nearest big city hospital. What are we facing?",
    "doctor_response": "Air in pleural space is pneumothorax. It could happen due to trauma to the chest wall or as a result of in appropriate ventilation/ infection. Newborn's lung compliance is less and hence minor injuries result in air inside pleura",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for heart murmur, leaking heart valve and hole on heart?\n\ni have a heart murmer a leaking heart valve and a very small hole in the heart .doctors dont seem to be to worried about it  mind u havnt seen a doctor in 2 yrs as been feeling well. but now i keep feeling dizzy and feeling sick thou i dont be sick i also have a slight low blood presure do u no what makes me feel so ill",
    "doctor_response": "The small whole that wasn't a concern in the past doesn't become one when you feel different. There isn't enough information to be certain of the source of your symptoms. If persistent, its best to see the same doctor who has seen you before.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nerve pain in head and legs along with exhaustion?\n\nHi sir/madam, feeling severe nerve pumping in head , and some time at legs, mostly in the afternoon to evening time, and after that exhaustion and calming down , other times feeling good but once in while keep getting also when ever remembering about the situation getting this , some time unbearable especially when at work",
    "doctor_response": "Hello ! Thank your question  ! In my opinion this is just psychological and physical stress  causing these troubles to you. The pain in the legs is caused by muscular contractions , especially after physical exercise. It is typical after a day work in the afternoon or evening. The feeling of the nerve pumping in the head too. It may be caused by the muscular contractions in your scalp, but t may also be explained by vascular disorders inside your head. You should just relax, and do not think about it . It is nothing serious! If you are getting these troubles more often, you should see a doctor, and have a good physical examination . Hope to have been helpful! Thank you for using HCM ! Dr. Abaz Quka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment needed after illeostomy\n\nMy husband has had an illeostomy and is due to see an oncologist on Nov3 for review as to Chemo as he has a positive in 3 of 9 Nodes. We have been doing the MMS protocol hoping to avoid Chemo or at least to lessen the treatment. Can he take the tea? He is a very healthy 72 but is not and never has been on anything other than Fish oil, Multivitamins and CoQ10 but has Cholestreol of 6.2 for wich he will possibly take medication after all this drama is over? Thankyou",
    "doctor_response": "hi, It is good yo know that your husband enjoyed 72 years if his life without any ailment. However now this dieases is here, which appear to be a bit advanced as nodes are involved. As MMs protocol is not a conventional medicine so it will not be possible on our part to comment on its safety and interaction.These days many gentic test are availale to be done on the tissue to know the aggresiveness of disease. Moreover todays chemo are usually well tolerable and the dose can be modified based on the tolerance.It will be my personal as well as scientific request to go ahead with chemo. Th choice of chemo depend lot on his general condition.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for loss of appetite and lethargy after a dental surgery\n\nI had all four of my impacted wisdom teeth surgically removed four days ago and I am still suffering from loss of appetite, weakness, nausea, and itching, most likely due to the Vicodin I was taking. How long before the symptoms wear off and what to do in the menage time?",
    "doctor_response": "Hello,  Thanks for consulting HCM,  Read your query, as you have  loss of  appetite , lethargy , nausea , weakness this can be due to side effect of local anaesthesia , nutritional deficiency ,drug induced , traumatic extraction or loss of blood during extraction. For this I will suggest you to take proper sleep of 8 to 12 hours , dont take stress , take proper nutritious healthy diet , take soft diet , you can also start with vitamin B12 , folic acid supplements by consulting with your doctor .  If your weakness , nausea and itching continues for more than 24 hours you can report back to your  doctor to evaluate for heamoglobin , malnutrition.Hope this will help you.  Wishing you good health.Regards, Dr. Priyanka tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "High BP patient, LFT test shows high Gamma GT, alkaline phosphate. Reasons ?\n\nHi, My mother(age=55) is high BP pateint and taking BP medicines since last 6.5 yrs, recently she had LFT test, she had Gamma GT =192 & alkaline phosphate =143, rest all results are in rages.she also had hepataitis test and that test is also clear Please guide me what could be the reason fort high gamma Gt & alkaline phosphate?",
    "doctor_response": "Hello Bushra, Nice to see that you are concerned about your mother's health. The common cause for a high level of gamma GT is related to alcohol intake. But other causes related to increase levels could be due to medications ( reason why her BP medicines should be checked again by her prescribing doctor, hepatitis/liver diseases such as cirrhosis ( which must not be necessarily of viral origin; so wish to know what hepatitis tests were done and if an abdominal/ liver scan was done. Biopsy could be helpful) and also some cardiovacular diseases such as myocardial infarction (of course she would have presented with a heart attack, so this is ruled out). Non the less it is better you get to an internist for further review ( so he can relate the cause of the elevated enzymes). Above causes can also raise the alkaline phosphatase and also bone diseases need to be ruled out. First of all if your mother is a heavy or moderate alcohol consumer it is high time she quits, if she is not, then other causes could be investigated. Cheers and wish your mother a better health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What combination of diet and exercise can cure face acne ?\n\nhi iam 18 year please tell me solution anyone cant tell me solutions i have pimples on my face that disturbed my life please tell me solution dont coment tell exat solution tablets,exercise, yoga ,pranayam,food also if possible tell solutions for ED and glow on face",
    "doctor_response": "Hello shubham; welcome to HeathcareMagic Acne are common for your age and they increase with dirt;pollution so first you need to clean your face with soap and water you can use Dettol soap.Secondly you need to differentiate the pimples whether they are simple or big;pink and hard which are called acne rosecae.If it is acne rosecae then you can use ointment called Treclin it is a ointment with antibiotic and will help treat it but there is no complete cure as it will keep on coming till a certain age.As for food avoid excess oily and spicy food and you should be fine. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cramping, bleeding after having sex. Taken progesterone. Going to have areola reconstruction. Pregnant?\n\nI had my cycle Oct 16th 2011 was sexually active around 28 Oct unprotected and started cramping w/ heavy bleeding around the 11th Nov. Missed period for Dec, Jan, Feb. Took 1 round of progestrone mid Feb for 10days, but no period. Waited a few weeks took another round of Progestrone for 10 day mid March got period for 1 day. Have taken several HPT (hone pregnacy test) which were all negative. Have had 2 urine pregnacy tests at GYN doctor s office which were also negative. Was prescribed BC patch which I was on for 2 weeks until I started having severe dizziness and vomiting . stopped the patch and had a period. Haven t had a period since. My stomach has been swelling and I m experience movement. I haven t gained weight, but I ve haven t been able to lose weight even though I ve reduced my calories to1200 daily for the past 3 months combined with 4 days a week exercise. All my weight is in my stomach area (very full from under the breast area and down). I ve tried wearing a girdle to restrict my waist area but I m starting to experience pain in my stomach and lower back. I ve had testing for all my organs (pancrease, gallbladder , and liver function and they all came back fine). I m concerned because I had sugery March 30 for areola reconstruction. Is there a chance I could be pregnant? I have a retroverted uteris with fibroids .....",
    "doctor_response": "hello,.There are several reason of missed or delayed period. First exclude pregnancy and you also get negative results several time.Those are like hormonal imbalance,PCOD,over wt,Psychological upset,Eating habit disorder,stress, thyroid problem etc.So need some investigations like USG lower abdomen,LH/FSH,PPBS,Thyroid profile,Blood estrogen and progesterone level etc.Then consult with gynecologist with all reports and take advice accordingly.Control body wt,avoid stress,take healthy diet and need proper sleep.Be well.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. l got a sore hard lump after the removal of wisdom tooth. Is it normal?\n\nHello doctor,I just got one side of my wisdom teeth removed both upper and lower six days ago, and I have another one scheduled after two days for the left side. The upper is 100 % fine, which they pulled. The lower they pulled the tooth without removing the root because it was too close to the nerve. I do have some stitching in this area currently on the lower cheek. Noticed a hard lump about 1 inch between my lower jawline and cheek area. Is this normal because of swelling or something else. Currently taking Amoxicillin 500 mg and Ibuprofen 600 mg. Please let me know what this hard lump is, also generally on the lower side where this lump is, remains sore.",
    "doctor_response": "Hello. The lump is mostly a hard swelling which forms postsurgical removal of the wisdom tooth or maybe even by swollen lymph nodes due to infection. It takes a week or two for the swelling to subside. Sometimes, if the root is still inside, the infection may be remaining there causing swelling. Get an X-ray done to find out the exact problem and stronger antibiotics like Augmentin (Amoxicillin and Clavulanic acid) along with a painkiller for a week. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are there good chances of recovery after an open heart surgery while suffering from diabetes?\n\nMy husband was admitted today with afib. The Dr said the top of his heart was racing to fast and the bottom could not catch up. He has had open heart surgery and apacemaker since October of last year. he is 82 and diabetic. Are his chances of recovery good?",
    "doctor_response": "Hello!Welcome on 'Ask a Doctor'!Regarding your concern, I would explain that his symptoms could be related to atrial fibrillation. I would like to directly review his cardiac ultrasound and ECG report in order to give a more professional opinion. Hope to have been helpful!Wishing good health, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pet dog be kept at home after undergoing liver transplant?\n\nMy had a liver transplant in 2010, and the doctor said that she could be around pets because of their shedding hair. But sometimes she s around pets and nothing happens. Me and my sister wanted to get a dog, and a Chihuahua doesn t shed a lot like the other breed. But were not sure if it would be okay for our mom.",
    "doctor_response": "Hi. It's true that pets are contraindicated at immunocompromised patients homes I say i.e the transplanted persons, but if you can control the pet vaccination and health rigorously with your family veterinary then we can speak of a relative contraindication. So, you can keep pets, but strictly under vet control.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it dangerous to have GGT level of 160?\n\nI have raised levels of ggt of 160 my doctor tells me it has been raised for over 2 years, I drink very little alcohol and have a connective tissue disorder I take paracodine medication 45/500 mgs 4 times a day is this a dangerous level? my doctors says it is a 'fatty liver' and need to lose weight I an 54 years of age, female and weigh 10 stone",
    "doctor_response": "HelloHigh GGT may indicate liver injury.It may be due to many reasons like hepatitis,alcohol intake,altered lipid profile,medicines,auto immune causes etc.It is important to know other parameters like SGPT,bilirubin,alkaline phosphatase level.You may need few investigations like routine hemogram,random blood sugar,lipid profile,complete liver function test,ultrasound of abdomen.You should avoid alcohol completely.I suggest tablet ursodeoxycholic acid 300 mg twice daily for three months to my patients.It helps in regeneration of liver cells.You may need to take few more medicines after full investigations.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need home remedy for cold sore with mucous in the eyes.\n\nHi,I have a cold sore, which usually comes with mucus in my eyes so I can't see well, as I have now. I also have a new pain in the roof of my mouth and have developed a cough. I've been taking lysine and ibuprofen, but am not getting better. Usually I can ride it out, but am getting worse. Is there anything I can do at home to help.Thanks,",
    "doctor_response": "**1. going by your history: symptoms are worsening and not getting better, it requires an Examination with Oral Surgeon /Dentist/ [roof of  mouth], ENT specialist [since cough has developed] to look for any hidden/underlying pathology, [oral hygiene, blood test for infection, appropriate X-ray], and so in best Interest prior to have an appointment with them, at home, the case can be managed on the basis of stomatits. avoid food that contain acid [citrus fruits], also nuts, chocolates. stop Irritants like NSAIDs [pain killers]. take a cotton swab and soak it in any type of raw liquor, press it directly on the sore for about 2 minutes.. eat ripe pomegranate.. mix honey in cold water and gargle with this [three times a day], or you may use mouth rinse with baking soda in it.. avoid: black gram,milk,yogurt,jaggery,dry/heavy food,day time sleeping, sleeping in prone position.. You may suck 'Khadiradi Vati' as Lozenges",
    "dialogue_context": ""
  },
  {
    "patient_message": "How is chronic appendicitis treated ?\n\nHi, i am 27 years old and i have been experiencing lower right abdominal pain for about half a year. The pain is constant and it becomes worse after i have any form of bowel movement or bending movements. I did an ultrasound scan and nothing wrong was found with my reproductive organs. Subsequently, i saw a colorectal specialist who initially thought that my constipation problem is causing the pain. However, after being on mild laxatives for 3 weeks, the pain did not improve of go away. The doctor says he is unsure of what is wrong with me. I have also sought help alternatively from Traditional Chinese Medicine who has diagnosed me with Chronic Appendicitis . Basically, he identified this condition by first pressing on the lower right quadrant of my abdomen (where the pain is). After which, he lifted up my right leg and pressed on the same spot again and that set me off into a yelping pain in which i literally jumped up a little from the bed. Hence, i will like to seek other opinions as to what can be causing this constant lower right abdominal pain. Is it indeed a condition of chronic appendicitis? This is bearing in mind that the pain intensifies after bowel movements or during any bending motions. Thank you very much for your kind help and time.",
    "doctor_response": "Hello. There is such a thing as chronic appendicitis. This usually occurs when fecoliths (small rock-hard pieces of stool) get inside the appendix stump and cause inflammation. The pain you described with right leg flexion is characteristic of a \"psoas sign\" which helps support this diagnosis. In \"chronic\" appendicitis, the omentum (a curtain of fat overlying the gut) will usually start sticking to the inflammed portion of gut, causing more discomfort that can be constant. Alternative diagnosiis would include diverticular disease, irritable bowel syndrome, functional constipation, or ovarian pathology. The most usefull test in this case would be a Cat-Scan of the abdomen and pelvis with PO/Rectal and maybe IV contrast. If normal, I would then order a colonoscopy. If it is chronic appendicitis, this could be potentially dangerous. It usually responds to a long coarse of antibiotics, which can also be considered empircally if you dont have access to testing.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could white substances in stool during pregnancy suggest?\n\nConcerned: I am currently 14.5 weeks pregnant (first pregnancy) and for about a week now I have had BM once a day except for the fact that it s accompanied by a small amount of what looks like white matter. Stool is of normal color and solid but accompanied by white matter with BM that ll either float or sink in water. I pushed it down with a tissue to see if its hard to soft and it seems like soft tissue. It doesn t come attached to stool either. No cramps or blood. I ve researched a lot online but no solid answers. Help?",
    "doctor_response": "HiWelcome.I have gone through your query.I would have asked for stool routine and based on the report, I would have decided on the management plan. See OBG specialist for examination and further help.Hope this helps.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any chance of getting pregnant even after using condom and taking pill?\n\nhim 20 year old.i hd sex on 13 of last month.my partner used condoms and in the next morning i took unwanted 72.my due dates are 30-31or many times 1st.bt dis tym i missed my dates.is there any chance of me getting pregnant?.if no then y my periods not started yet??",
    "doctor_response": "Hi,Thanks for the query. As your partner used condom and as you have taken emergency contraceptive pill, the possibility of pregnancy is less in your case. Emergency contraceptive pill can alter the menstrual periods depending on the time of the menstrual cycle when that was taken. For more details :  emergency pill can be one cause for your problem. Repeated intake of emergency contraceptive pills can make the cycles more irregular. So, consult gynecologist once, get evaluated and take tablets for withdrawal bleeding. Better to use some regular contraceptive method. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the live52 Ds Himalaya herbal tablet effective in treating diabetes?\n\nI am a Diabetic last 12 years and on Metformine sr 500 bd with Glipizide completing 75. HBa1c is raised ton8.00 sept 2014 report. Recently I have started taking 1 piece of ladies finger  veg.  okra.fasting and post  lower down. Can I take live 52 Ds Himalaya herbal  tablet along with above medicines as my digestion system is not proper having mucous and often gets loose motions followed by foul smell.suggest.",
    "doctor_response": "dear friend, liv 52 ds is herbal product having hepatoprotective properties against chemically-induced hepatotoxicity. it is good for liver health, increases appetite and improves health of digestive system. so you can take it simultaneously with your medicines for diabetes. there is no problem. you said that you having complain of mucous and loose motion, in this you can use 'diarex' tablet which is also a product of himalaya helpful in acute and chronic diarrhea,and as an adjuvant to the treatment of irritable bowel syndrome (IBS).hope this answer will be helpful to you.for more queries plz don't hassitate to ask.get well soon dear friend",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mental stress, anxiety, gained weight, blood pressure problem. Itchy face\n\nhello..i am 29 years old.i recently lost my father. due to lots of mental stress and anxiety i am not able to sleep at night. i wud be awake till 3/4 am and my mind wud be over active, i don t know how to block unwanted things out of my mind. i have gained weight alot in the past year. now i am having blood pressure problem as well. And recently i have experienced something i don t understand, i fell like drinking my face toner so i wud keep staring at it. Then the other night my face was itching and i wanted to scratch it and write/colour it with a ball pen, Kindly help me please.",
    "doctor_response": "hello first of all, relax and don't worry As per your description, you are experiencing depressive symptoms which may be the continuation of grief reaction and for that u need some antidepressants/antianxiety drugs as well as psychotherapy. So i advise you to consult a psychiatrist soon and your problem will be easily solved Your weight gain or blood pressure problem may be linked to depression or there could be some other medical etiology too. So you should also consult a general physician. Good Luck Thanks...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is circumcision needed for foreskin covering head of penis?\n\nI am 27 yrs old.. I have query about the foreskin of the penis..when the penis is erect, the foreskin rolls over the head of the penis butdoes not go beyond that as on the below side it is connected with the head of the penis.. should i need a surgery",
    "doctor_response": "Hi, You are having a phimosis problem according to mentioned history. You can try topical steroid cream to be applied over that. If no help with steroids than circumcision operation needed. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should the braces be used to keep tooth in line?\n\nHi Doctor, I have zigzag tooth and iam 25 year old, I like to go for a treatment to make it order.How long i should put the tooth braces and some of my friends saying that after the treatment is over if i remove the braces the teeth may come forward. Please suggest ... Thanks in ADVANCE",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,    I have gone through your query, as you have mentioned that you are 25 year old now , if you go for Orthodontic treatment this time, treatment given to you is most probably Fixed Orthodontic treatment , so it takes time of atleast minimum one year ,   For this I will suggest you to go Orthodontist and ask for treatment plan, Orthodontist will guide you in best way ,  Hope this will help you.   Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fear of HIV contraction post encounter leading to depression. Had negative test results. How can I get over this?\n\nHello nice people,please iam living in hell since almost one year,help me please,since one year i had a risk with a woman,i gave her oral sex ,i tested after that risk for 6 months anti HCV and it came back negative,i repeated the same test after 3 more weeks and it came back the same,can i move on and forget everything?",
    "doctor_response": "Hi there, you can stop worrying and live your life to the full. Is it hepatitis C that you are worried about or is it something else? Usually seroconversion takes place by 6-8 weeks after exposure and you would test positive for the infection after that so as the episode occured an year ago and you have tested negetive on two occasions it is unlikely for you to have got infected during that episode. In the future you would like to be a little more careful and spare yourself this mental trauma. For now you can be rest assured that you are fine if you have not tested positive on two tests even after an year of exposure. For the future take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lipomas and cysts in breast\n\nI began noticing lipomas ( that's what the dr said) at about 24 yrs old. I have had several removed, but they are everywhere! I do not go for mammograms anymore ( now I'm 41) because I have cysts and lipomas in my breasts.I have had biopsy after biopsy and no more. Some lipomas are pushing on nerves and now a couple fingers go numb. A little over the past year, I hurt all over now! I tried getting a massage, and once it started I jumped and screamed in pain. (muscle and bone pain) as an RN it's started to interfere in even getting out of bed to go to work. Any suggestions?",
    "doctor_response": "Hi,Any lump in the breast should not be neglected.Go for Mammogram and go for diagnosis.They might be Fibroadenoma of breast or multiple cystic lumps due to hormonal changes.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning sensation around the anus during a bowel movement?\n\nHey,I am having some itching and burning sensation in my anus after the stool pass especially more if I eat any spicy food or if the stool is harder.i am feeling some small pimples around by anal area when I touch.this is started after I recently had an Ayurvedic oil massage in an authorized Ayurvedic hospital three months ago",
    "doctor_response": "please get examined by a doctor or surgeon as they appear to be piles according to your symptoms ...it may be warts .....please avoid constipation ...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for growing lump on front of leg below kneecap?\n\nI took a fall on a rough gravelly surface 4 months or so ago. I had to dig a couple of small pieces of gravel out of the wound but I believe I got them all. A small soft lump remained after the wound healed. It is not painful to the touch but kneeling on it is painful. Over the last couple of months it has increased in size. Overall diameter is the size of a half dollar and it is raised at the center point approximately 1/3 of an inch. If I am sitting in a chair with my feet on the floor, the lump is on the front of my leg just below the kneecap. It is not particularly uncomfortable but the fact that it is getting larger is giving me pause. Any thoughts?",
    "doctor_response": "Hi,Thanks for writing to HCM.I think that you missed one small piece of gravel inside.That may be causing foreign body granuloma. So better show it to a surgeon for a physical examination and get it removed.Dr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could ultrasound finding of thinning of kidney lining indicate?\n\ni went in for an ultrasound for gullblatter and they noticed both kidneys has thinning of the linning of the kidneys just want to make sure that its something i shouldnt have concern about and should i follow up on this im 29, 198,5'6 Fale. im adopeted dont know any background info. any info would be much appreciated. its been about a year to a year and ahalf since the utrasound. i did have my gallblatter removed",
    "doctor_response": "Thinning of your kidney s may be due to stones in your kidney or some other tumour in th e ureter, u should immediately go and consult nephrologist, or giv complete kidney details to me, u ha ve to think about the problem as u are very young.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffer from low hemoglobin count, giant cell arthritis. Normal colonoscopy. Is vasculitis the cause?\n\nMy wife has Giant Cell Arteritis and has recently being diagnosed with having a low haemoglobin count. The count has dropped as follows...112 in February, 102 in March and 87 in April. Upon attempting to source out what these numbers mean I cannot find any reference save and except to grams per deciliter or grams per 100 mililiters such as for women being 12-16 grams pers deciliter. Can you explain what the above numbers (112. 102, 87) mean and how do I convert such numbers to deciliter or milimeters.  Further, she has had a gastoscopy and colonoscopy performed and each have been normal! If there is a slow bleed, where could it be or what other suggestions could be offered. I have also read that vasculitis could be the cause of lower haemoglobin levels. Thank you .",
    "doctor_response": "Divide by  10  the  HB  in  decilitres  is  obtained.  the  readings  mentioned  by  you  are  in Gms/litre  and  usual  lab  readings  are  reported  in  gms/DLLow  hemoglobin  can  follow  vasculitis  and  prednisolone (Cortisone)  may  be  needed along  with  iron  supplementation  as  drugs,  and  iron  rich  diet",
    "dialogue_context": ""
  },
  {
    "patient_message": "Low blood platelet count. Waiting for bone marrow test results. Solution?\n\nhello doctor ive been told I have very low blood plaes.  What can I do to build them up.?  Can anything at the health  food help me i had a bone marrow test done didnt get the results yet.  please help.  my name is Barbara Canady   Iam sorry Iam on ssI I don't have enough to take me the doctor tomorrow.  Thank you for being there.",
    "doctor_response": "Hi! welcome to HCM! It is important to note that, even though, the platelet numbers are decreased in thrombocytopenia, their function usually remains completely intact. The treatment of thrombocytopenia is largely dependent upon the cause and the severity of the condition. In general, platelet transfusion is not necessary, unless an individual with low platelets (less than 50,000) has an active bleeding or hemorrhage, Sometimes, transfusion may be recommended without any bleeding if the platelet count is less than 10,000. If a drug is thought to be the cause of low platelet count, then it may be discontinued . In auto-immune thrombocytopenia or ITP, steroids can be used to weaken the immune system in order to impair the attack on platelets. Take healthy well balanced diet with plenty of fluids and wait for the B.M result. Hope this helps you! Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are hepatitis B vaccines and how do we know they are effective ?\n\nmy brother has taken 4doses of hep b vac..how should i know it has working or not...and how can we find useable and unusable vac..is there any changes in liquid..?",
    "doctor_response": "Hello.Welcome to HCM forum.Only three doses of vaccine are given at 0,1and 6 months.Whether your vaccine is giving you protection or not can be found out by measuring ant-HBs and not HBsAg.The values of anti-HBs should be more than 10 IU/ml.Any person who is previously vaccinated is found to have anti-HBs less than 10 IU/ml should be given a booster dose of HEP-B Vaccine.Don't use the vaccine if found to have some suspended particles or if it's color has changed.Thanks and good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat hyper pigmentation ?\n\ni have a hyperpigmentation over my face and i consult with Dermatologist and he advise me apply melaglow and tablet vit c and to apply sunscreen .now it has almost one month and i don t see any difference.please suggest me what should i do?",
    "doctor_response": "Hi, Thanks for writing in. Hyperpigmentation can occur due to a variety of causes like endocrine disturbances, exposure to sunlight, drugs like antibiotics, antiarrhythmics, and antimalaria drugs and in post inflammatory states. There are a few things that I would like to clarify here. First of all, the sunscreen that you are using should have a 50-60 SPF and should cover both UVA and UVB. This needs to be applied 20 minutes before stepping out and every 2 hours thereafter. Further, you should also use an umbrella. Other drugs which are used for treating hyperpigmentation include creams which contain tretinoin, azelaic acid and  hydroquinone. Procedures like glycolic acid peels are also used sometimes. These are prescription drugs and you would need to see a dermatologist for the same. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause delay in periods after taking an Ipill?\n\ni get my regular date on 1 dec then on 7th cec we had sex without precaution  than i took ipill than date came on 22th dec but now i did not get my regular date which should come on 25th dec as regular period but now its over to one month from today but i tested my pregnancy by pregtes kit that was negative but now im very tense about my date when it will come. please tell",
    "doctor_response": "Hi,thanks for writing..I understand your concern.. I pill has a high dose of hormones. so the common side effects with it is delayed periods and intermenstrual spotting. It will get normal after this cycle. you can wait for a week . If still no periods, repeat preg test and if negative take progesterone for 5 days to get periods. hope i have answered your query. Good day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for pain relief from cancer?\n\nMy mother in law who is 86, about 80 lbs. has multiple myeloma.  She has had radiation for the tumor on her sacrum, she also fractured this area and now has developed a huge bedsore on that spot..she is on 75mg of a pain patch, oral pain, and morphine as needed...she had started on chemo, and she almost died...now she is doing nothing to prolong her life...about 3 weeks ago she was really bad, she called for her sons and the priest and has now been really responsive...bored, as she calls it, and totally with it...we are not sure what to make of this...would you have any answers for us. Thank you..",
    "doctor_response": "Your mother can continue tab morphine 10 mg four times daily after food.If pain still persist then she can try BUVALOR TRANSDERMAL PATCH.It contains Buprenorphine.This works for 7 days continuously and u need to change patch after 7 days.RegardsDR De",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rashes on the vaginal labia?\n\nmy daughter has rashes in external labia for a week ive been trying all kinds od idaper rashed, putting it on air, but its worst after she poops, i just changed her formula to milk based for pat two weeks initially she is in soy based bec. of eczema ,do you think the ash is bec. of milk based formula?",
    "doctor_response": "Hello, As per your history, it may be due to dermatitis. You can apply hydrocortisone ointment, give her syp citrizine in case of itching after pediatrician consultation. It may require further evaluation, for that blood investigations, complete heamogram, blood culture should be done after detailed medical examination and pediatrician consultation. Till then keep the area dry and clean, maintain proper hydration and hygiene. Hope I have answered your query, let me know if I can assist you further. Regards, Dr Shyam Kale,  Family and General Physician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will there be difference between sonogram calculator and LMP for conception?\n\nI was very desperate for a job and had unprotected sex with a guy who promised me a job on the 7th of March 2014, I took morning after pills on the 8th March, first day of my last period was on 16 March (of which I was convinced the pill worked). I then had unprotected sex again (after my period) with my boyfriend several times but don t recall the dates (somewhere from March 10) . I found out I was pregnant on the 10th of April and went for an ultrasound on the 30th of April, my Doc said I am 7wks 5dys preg. How accurate could that be as I believed at the back of my mind that I am between 5-6wks pregnant. Could it be possible that the pill didn t work? I m scared and confused that it might not be my boyfriends. Please help. I am losing my mind and can t seem to not stress about this mess I put myself in. I also have one more concern please, my period was normal as it lasted for 4-5days, *sigh* my boyfriend and my mother know about the pregnancy as we (my boyfriend and I) were pretty much planning to have a child together but the ultrasound dates just really gave me a huge slap on my face. The ultrasound based on the measurement of the embryo showed that my due date is on December 12, 2014 (my doctor didn t ask me when my last period was) I am also a bit confused about two other things as well - the first one being when I use the due date calculator by sonogram (reverse calculation) it says that I conceived on March 21, (how long does it take to conceive after sex) then the second calculation based on my first day of LMP which was March 16, shows that conception date was March 30. Am I chasing empty pavements or none of this changes anything? I had a miscarriage last year and really wanted a baby but not that of a man I don t even love.",
    "doctor_response": "DearWe understand your concernsI went through your details. Sperm life within moist vagina is upto 48 hours. If sperm cell could not find a way into the ovum, within this 48 hours, the sperm cell dies. Sonogram shows the growth of the embryo and it could be possible that the embryo had grow a bit more faster than usual. That happens in many cases. The tentative delivery date is calculated based on the general arithmetic and assumption, but there are techniques like this too. I don't think you have anything to worry about the current scenario. Doctor said 7 weeks and your calculation is 6 weeks. The matter of 7 to 10 days tolerance is normal. Note that almost every pregnant women give birth at least a week or more before the tentative delivery date. Don't worry. You may talk to your doctor in detail. Don't be shy and afraid to talk to your doctor and clarify your doubts. Take care.If you still need my assistance in this regard, please use this link.  Please remember to describe the whole problem with full detail.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in opening mouth?\n\nDear Sir,   My wife is unable to open her mouth fully. she is not eating supari or pan masala now but in their school days she use to eat supari very much. we have taken treatment  in bhopal dr. gives lots of injuctions inside the mouth but their is't any progress please guide us",
    "doctor_response": "Hello dear,First of all be relaxed and calm. I will provide you with my best possible advice.As you mentioned that she was eating eating supari very much previously, most probably this will be the reason for reduced mouth openingAccording to the symptoms and the treatment she had undergone, it seems that she is suffering from oral submucous fibrosis(OSMF). Its specific treatment depends on the degree of clinical involvement Visit Dental surgeon as soon as possible so that the severety of the disease can be determined and prompt treatment will be initiated.Here I am advising few things for her which you can start immediately- AVOID CHILLIES-Eat lots of green vegetables- Eat 2-3 raw tomatoes daily as it is rich in antioxidant known as LYCOPENE.- Use Tess or kenacort gel inside the cheeks thrice daily over the thickened area of the cheek.- give her Lycospring or SM Fibro softgels once daily- Mouth Opening Exercises like blowing out cheeks as the maximum extent hold for 2-3 seconds and then relax, and other exercises as told by the dentist.  Visit you dentist immediately for further exact guidance, support and treatment.Hope this will help you.Thank You.Take Care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does prolonged usage of tobacco cause mouth cancer?\n\nhello dr, my husband is having a habit of eating rajnigandha regularly. some time ago he had left rajnigandha but now again he start eating it again . I want to enquire about the side effects of rajnigandha masala. I heard that it is not good for mouth and causes mouth cancer . Is the information true??? please tell me as soon as possible. thank you Mrs. Priya Rahul Sharma",
    "doctor_response": "Apart from areca nut, rajnigandha contains several toxic and harmful chemicals such as Eugenol, N-Nitrosamines, Sodium Carbonate, Ammonium Carbonate, Ammonia, etc. Apart from these, they contain high levels of heavy metals such as lead, arsenic that cause cancer, organ failure, and various nervous diseases.The Indian Institute of Environmental Medicine estimates that on an average, tobacco contains at least 19 known carcinogens and at least 30 metallic compounds comprising heavy metals. Further, the Cancer Tobacco Research Institute (affiliate of the Indian Council of Agricultural Research) estimates that the popular brands of gutkha and pan masala, such as Manikchand, Rajnigandha, Chaini Khaini etc, contain nicotine.Gutkha, or chewing tobacco, is a known carcinogen and it is known to cause oral cancer and cancer of the esophagus, pharynx, larynx, stomach, and pancreas. Apart from cancer, tobacco also results in various health problems such as Gum Disease, Peripheral Vascular Disease, Hypertension, Peptic Ulcer Disease, and Coronary Artery Disease.RegardsDr De",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is there any cream to treat wrinkles of skin in hands and feet?\n\nHello doctor, I am 21 years old but my skin is very loose and it looks very old get wrinkled on the upper part of my hands, feet and also in some other parts. Some areas are too stiff. I never get exposed to the sun. For these, I am using Nivea SPF30. I take proper diet with fruits and vegetables but my problem is not solved. I have consulted a lot of dermatologists but there is no improvement. I do not want any wonder results but I need some improvement. I was very depressed by this condition. Please suggest any lotion or cream to solve my problem.",
    "doctor_response": "Hello. This is genetic and you cannot do anything about it with lotions and medicines. There is a temporary procedure called dermal fillers which will give fullness and youth to your hands and legs but that is not cheap and the results last for nine months to one year. If you are interested in these procedures you can meet a cosmetic dermatologist or plastic surgeon who does fillers.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible despite negative pregnancy test results?\n\nHi it the last 3 weeks I am after bloating up as if I'm pregnant I have been on the pill this last year never missed a period the last one i had was only 2 weeks ago.i have had 3 pregnancy tests  and are coming back negative.could it possible to be pregnant .",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I don't think you are pregnant since you used contraception pills and tests are negative. Maybe is just bloating. Hope I have answered the question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump in the armpit indicate?\n\nHi I'm 55 yrs man with a bluish sort of lump just below my armpit it never hurts me but time and again around it gets filled with pus with bad smell i squeeze that get some relief but time and again same procedure what do u suggest me surgery or else hope u suggest a cure",
    "doctor_response": "Hello,Since how many years or months, you are having a lump in the armpit? Is the lump soft or hard? Most of the times soft lump is usually lipoma ( a benign fat tumor). Presence of pus in it usually indicates sebaceous cyst which got infected. I advise you to consult a general surgeon and go for simple excision of the lump along with a course of antibiotics. Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Siddartha",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated WBC count of 28?\n\nmy mother is in the hospital and her white blood cells are elevated to 28 and antibiotic does not seem to be helping. she originally was admitted for chest pains and abdominal pain and was also treated for uti which has been clear, but her white cells are elevated and geting higher. numerous test has been done in search of any other infections but nothing has been found. should i bee concerned",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  Your total wbc count is high.  It is either due to infection or due to sime other cause like leukemia. Please send me your complete blood count report.  It will help to reach 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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What increases the sexual stamina at the age of 35?\n\nHi, am 35 years old and have been married for 8 of these. For some years now, I can hardly do more than one round of sex. Only one and I cant get it on again. I think my wife is not happy, she would like to have two or three rounds as she tells me her friends do. Infact last night she asked me if it is my body, if am sick, weak or simply not interested in her as much as in the past? Personally, I always thought we had no problem in that department? What is wrong with me?",
    "doctor_response": "Hi, Regular exercise, physical games and yoga can help you. Along with then you can take home-cooked meals, low-fat food. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does abdominal pain and melaena in a thalassaemia patient indicate infection?\n\nI have thalassemia, in my case I have blood transfusions along with iron infusions with dextran about once every three months. I produce kidney stones constantly so I am losing blood that way also. I have had abdominal pain for the past 5 days and black tarry stools. Hemoglobin was 9.1 1 month ago. Could this just be an infection in the body? I have more aches than normal.",
    "doctor_response": "Hello,abdominal pain and melaena usually indicates upper gastrointenstinal bleeding. This is a serious and urgent situation and you should get to the emergency room as soon as possible. Since you already have a low hematocrit and \"sensitive\" blood, you should be more concerned!Till then, avoid eating and drinking (including drugs).I hope everything goes well for you!Kind Regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes weight loss and BP fluctuation after gall bladder removal?\n\nMy friend had gall bladder removal over 4 weeks ago. she is losing weight rapidily though eating and keep getting dehydrated though she is drinking several water bottles per day.  her blood pressure is fluctuating from 127/85 to 90/60 through out the day. she has been to the hospital numerous times. what could  be causing this. also dizziness, nausea, dry heaves, constipation..",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.First, blood fluctuations cant be related to gallbladder surgery and this is separate issue which should be evaluated by cardiologist. The other issue may be sign of postcholecystectomy syndrome syndrome which has all these symptoms and this occurs in about 5 to 40 percent of patients who undergo cholecystectomy, usually can be transient, and rarely persistent or lifelong. Symptoms include Dyspepsia, nausea, and vomiting, Flatulence, bloating, and diarrhea, Persistent pain in the upper right abdomen. Some individuals may benefit from diet modification, such as a reduced fat diet, following cholecystectomy since it may be more difficult for digestion of fatty foods. Postcholecystectomy syndrome treatment depends on the identified violations that led to it. Typically, the patient is recommended dietary restriction table with fatty foods, enzyme preparations, antispasmodics, sometimes  oral ursodeoxycholic acid can alleviate the condition.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can lower back pain and leg pain be sciatica pain?\n\nI am 61, 105 lbs, ehlers danlos and sarciodosis in the chest - recently a two week episode causing severe pain the the lower back due to two upslips, sacrum shifted in off position and lower vertibrate subluxed. it has been corrected every other day - and in this time period, needed help with pain so have been using ketamine trouche. only .5mg. I have now had issues with the bowels barely moving despite using my myralax (sp?) I am wondering if the bowels could be shutting down from the meds or could it be from the severe pain in lower back and down the right leg with the siatica pain?",
    "doctor_response": "Complete bed rest for a certain period of time is the initial mode of treatment in low back pain. Pain can be controlled by medication, exercise, weight reduction, lifestyle modification etc. take paracetamol 1 gm twice or thrice daily as required initially for some days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain on left side\n\nI m 30 years old. 6 2 200lbs I ve been having chest pains on the left center heart feels like it skips I get kinda dizzy short of breath I m an active man still doing back flips and running with kids and dogs as well as exercising I do smoke half pack a day and drink heavy once a wk my pulse is 107 I sweat like crazy at night",
    "doctor_response": "Thanks for your question on HCM.In my opinion you should get done investigation s to rule out cardiac and pulmonary causes.So get done ECG and 2D ECHO to rule out cardiac cause.Get done Chest c ray and PFT (Pulmonary Function Test) to rule out pulmonary causes.Your heart rate is very high. Ideally ot should be less than 90. Smoking and drinking habit is injurious to health. And cause cardiac and pulmonar causes.So consult your doctor and discuss these.Please quit smoking and drinking as soon as possible.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes air bubble feeling and pain in the lower back?\n\nThis morning I was just standing up doing my makeup, and I felt this sort of air bubble in my lower back. I felt a piercing pain afterwards and it took a while for it to fade although it still hurt to stand up and do certain things. This pain has been going on all day, what is this and what can I do?",
    "doctor_response": "It looks like a muscle cramp.I would recommend a pain killer like acetaminophen. Warm compresses. Avoid massaging.If the pain persists, visit a doctor and get it examined.Hope this answers your question, thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Burning sensation in abdomen, discharge from abdomen. Had C section. Incision closed with staples. What can help?\n\nI had a c section 3 months ago. Healthy baby. The incision was closed with staples on the inside that dissolve.  Some of the staples worked themselves out.  This was painful. There are still almost all of the staples still in. They are still whole and very painful.  The outside is completely grown together ( not pretty). The staples are trying to push out.  The do not appear to be dissolving.  I have a constant burning pain in my abdomen.  I am also no heavier but much puffier than after her birth. I wear supportive garments and still have trouble getting up. This is my second setction and third delivery.  This is the hardest recovery. My temperature has maintained at 96 degrees. I had a discharge from from my belly button a few weeks ago and that went away. I sweat often, feel fatigued and occasionally get very physically overwhelmed. The newest symptom is pain around my ribs on my right side.",
    "doctor_response": "Hello and welcome to HCM, The staples used to suture the wound (surgical wound in your case) are metallic in nature. They do no dissolve and have to be removed few days after adhesion of the wound edges. Pain is usually present post-operatively. pain killers are prescribed in the post-operative period. However, if the pain is constant not relievd by common pain killers, there can be a possibility wound infection or wound dehiscence. Wound dehiecence is a condition in which the deeper layers of the wound give way. It is associated with oozing out of blood and serous yellow colored fluid. Burning pain in the abdomen can be due to nerve injury during surgical procedure. Heaviness and puffiness that you are experiencing is due to baby weght that you have gained during pregnancy. Consult your doctor for clinical examination of the wound to look for features of wound infection and/or wound dehiecence. Thanks and take care Dr Shailja p Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medication for severe pain in the neck muscle\n\nI had severe pain in a neck muscle last night as I tried to go to sleep.  I am a 43 yr old female, in good health, non smoker, non drinker, slightly elevated cholesterol (not on medication).  I switched positions and it would come right back.  It's on my right side of what I think is my carotid artery.  I get regular massages, so I don't think it's a muscle issue.  It felt like a tight spot in my artery.  I actually got up and tried to take aspirin, thinking it was a heart attack symptom.  We didn't have any on hand though.Any thoughts?Stacey R.",
    "doctor_response": "Hi, I am Dr. Ramez Mohammed. I had gone through your question and understood your concerns. I think you suffer from inflammation of the origin of the sternomastoid and trapezius muscles  caused by inflammation in the cervical nerves that have been affected by some inflammation in the cervical spine. You may suffer from pain when you move your neck. So I advise you to use NSAIDs topical gels and anti-inflammatories, muscles relaxanrs tbs. and multivitamins with muscle massage in one direction & Compresses warm water to get the full comfort. Hope above information helps you. If you have additional or follow up questions then please don't hesitate in writing to us. I'll be happy to answer your questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high fever\n\nMy 3yr old has a very runny nose, a high temperature, cold feet, aching arms, and stomach pains she is also complaining her eyes hurt. She is very lethargic  .She hasn't been eating properly for over a week now either only eating very little. Please help",
    "doctor_response": "Thanks for consulting in Healthcare. It seems your daughter has acute viral infection, acute rhynopharingitis, she feels pain in gurgle, her appetie decreased,thats why:1.Try to keep her with plenty of water  or ginger, lemon and turmeric powder tea2.Cut onion, leave with a water near her bed, fitoncids will kill viruses, you can drop onion water in nose 1 ml 4-6 times, very effective3.Drop  nose with saline and nasal drops , especially before sleeping4.Use calpol syrup from temperature or adol suppositories 250 mg if she can not drink5.Tulsi juice 5ml 2 times will help to decrease temperature6.Sualin 1 tab 3 times for resolution with anti inflammatory effect7.Physical methods:cover her wet sheet or take a bath with usual hot water and her temperature will decrease after 2 min8. For increasing immunity and decreasing temperature Vitamin C 500mg is also helpful, give during 5 days9.Multivitamins-zincovit 5 ml 1 time 1monthRecovery soon",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a knee knot post injury?\n\n2 questions I was fishing and when I was trying to jump to a diffrent rock I slipped and hit my knee on the rock there s a big knot how do I heal it. I was on the swing and it broke and the chain hit me on the head and there is a knot on my head how would I heal that? This Happen in same day Bad day",
    "doctor_response": "It is not a knot May be you have broken the knee and your head too with a crack fracture, how do you want to get well without being a Dr? ! if all want to be Dr's without studying no Chance. Get examined & get treated as well",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bad left tooth with pain. Tooth surface gone, shallow, slowing decaying, braces, back tooth suffering. Dentist?\n\nI have a bad tooth on my left side that is really causing me severe pain. The surface of the tooth is gone and the tooth is slowing decaying, I believe. I had braces and my back tooth suffered. I  believe it is causing my left side to become swallow. I am unable to concentrate on anything because it is that bad. What should I do. Should I wait to call my dentist on Monday?",
    "doctor_response": "Hi welcome to Health care magic forum.                           Thanks for calling H.C.M.Forum.                           You had a bad tooth on the left side, causing you so much pain and swelling on that side .This could be deep dental caries leading to peri apical abscess.You should surely visit a dentist for this since your tooth is  infected the infection should be controlled with medicine .The reason for having such a severe pain is pressure that built with in the tooth because of the inflamation. The infection control together with pressure relief will help you to get relieved of the pain.Based on condition of the tooth your dentist will decide if you can go with a root canal treatment or you have to get it removed.                           wishing u a good recovery.Have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can i stop masturbation, increase body weight and improve memory power?\n\nHi Good afternoon. This is Maddy(name changed) and my age is 21.I m masturbating from last 4 years so how to stop masturbating because my weight is just 50kg and i m losing memory power... So how to increase body weight and also memory power.....Thank you",
    "doctor_response": "HelloYour main questions are ,1 How to get rid of masturbation ? 2 How to increase weight ?3 Increase memory power?More or less all these problems are related to each other .Answers ,1 Consult a psychiatrist and get his  help as this is not a disease , rather this is a habit . Either control yourself or consult a psychiatrist .2 For weight , eat high fatty food with high carbohydrate , this will increase weight . While high protein diet will increase the mass of muscles.3 As far as concerned about memory power . It seems that you are having somewhat depression so get the help of psychiatrist .Good luck.Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes discomfort in throat and issue in breathing?\n\nHi, my name is Mary. My mother who is 49 years old, has been feeling a scratchy throat and then feels some trouble breathing like her chest is pushing weight on her and then she feels a bit claustrophobic and her heart starts beating faster. She's never been diagnosed with any problems and i don't know what could be triggering it or how i can help.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, possibility of heart or lung related diseases is more in your mother's case. So consult doctor and get done 1. Ecg, 2d echo and stress test to rule out heart diseases like heart failure or coronary artery disease (CAD). 2.  Clinical examination of respiratory system and PFT (pulmonary function test) for the diagnosis of bronchitis. She may need cardiac supportive drugs or inhaled bronchodilator and inhaled corticosteroids (ICS) on the basis of these reports. Don't worry, she will be alright. First diagnose her and then start appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling and numbness in hand and fingers?\n\nHi, I am a 39 yr. Old Male. I ve been experiencing tingling and numbness in my left hand and fingers for about a year now and a few months ago felt a hard lump on inner part of my upper left arm between my elbow and armpit. It s not painful, but what I due notice is I can only feel it when my arm is fully extended. When I bend my arm i can t find it. What could this be?",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.You are likely to be having soft tissue swelling which may be pressing one of nerves supplying hand. It can be lipoma, cyst, neuroma etc and may require excisional biopsy. MRI of left arm will be helpful in confirming diagnosis. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having depression and anxiety. How to treat it?\n\nHello doctor, I am a 16-year-old female. I have mental health issues. Here in my country, there is no priority to this problem. Rather they just see it as an illness, and they think I am going crazy. I honestly think I might be. I have been trying hard to ignore my feeling and honestly, think that I am doing well. But could not control my feelings. Everyday seems to be harder, and I get so anxious. My insecurity feel is getting worse. I am not happy and tired of being sad. I do not know what to do more. I think I am losing hope. I need help but do not know where to find one. I feel like losing myself any time soon. I do not know if I can, but I think it is the only way. Please help.",
    "doctor_response": "Hello. I understood what you are going through. But you should appreciate yourself for finding the strength to be able to ask for help. That is half the battle. Depression can be handled in two ways: 1. Medicine, for that, you will have to consult a psychiatrist because these medicines cannot be prescribed online. 2. Psychotherapy, i.e., talk therapy, which is counseling in common terms. You should start it to understand your subconscious negative thought patterns, which are making to feel this way and keeping you anxious and sad. You should start cognitive behavioral therapy, which is highly effective in treating depression. Consult a therapist in your place or just start a session here. On your own, start with journaling and start writing down your thoughts. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swollen ribs\n\nTwo months ago I had a fall down stairs and injured my ribs back. Black and blus swollen etc. all subsided, Now two months later the same spot on my back I woke to yesterday have a Grapefruit sized lump that feels like silly puddy. No discoloration???? What could this be?",
    "doctor_response": "Hello, It is necessary consulting with your attending physician for physical exam and an ultrasound of the lump, in order to determine its possible nature. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for getting pregnant\n\ngud evning sir,i had already 3 missed ab.my last 1 was on 1st feb now its already 4 months passed away.today my dr advised me to go 4 two opt. either i should go for natural pregnancy tht contain risk of missed ab. too or go for ivf.can u suggest me wht should i do",
    "doctor_response": "Hi, I think you should go for evaluation first.  Do a thyroid profile and APLA profile too. Talk to your doctor regarding this.  These tests can help you know the cause of abortions.  You can take some extra medicines like progesterone, aspirin and heparin as soon as you get to know about your next pregnancy.  You can conceive naturally. In IVF, they will know about the quality of embryos, so chances of abortions are less. But you can give a try to conceive naturally also. Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever,nausea,body aches,headache and swollen glands?\n\nI've been feeling nauseus for the past week, but yesterday I was really sick and feverish and my left gland has swollen up. Today is much the same, my body is aching, my head is sore, my glands are swollen, and I'm incredibly nauseus. What could it be?",
    "doctor_response": "Dear Friend.Welcome to HCM. I am Dr Anshul Varshney. I have read your query in detail. I understand your concern.You might have developed an acute viral infection superceede by secondary bacterial infection.I would advise you to get examined by a doctor and take appropriate treatment.Till you get a medical help, observe following:1. Tab Paracetamol as on when required basis.2. Warm saline gargles3. Anti allergic like Levocetrizine once a day. This is my best opinion for you based on available details. If you have any further query please ask me.Stay Healthy.Dr Anshul Varshney, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does one gradually get worse with polymyositis?\n\nmy husband died after having polymyositis for eight years it affected his lungs and he had pulmonary fibrosis and copd thought we would grow old together but one night he just stopped breathing could we have prevented his death or do you gradually get worse with polymyositis",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.Polymyositis is connective tissue disease.It affects almost all organs of the body especially lungs.It is incurable and progressive disease.With treatment, we can reduce the rate of progression but we can revert it.Pulmonary fibrosis in Polymyositis patients suggest worse prognosis.Usual life expectancy after diagnosing fibrosis is less than 4 years.So this disease usually get worse over time.Hope I have solved your query. I will be happy to help you further. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should valprol cr 500 be continued?\n\nI am sunil, taking a valprol cr 500 since last 12 years. in starting it was taken by as per advised by a neurologist from varanasi because i fetched a attack in 2002 ten went to doctor. but could not visit him regular basis as per schedule date provide by him but continued taking this medicine because whenever i tried to get rid off this medicine i faced some problem. what should i do now? i am working in ludhiana as a IT support engineer.please advise me ASAP",
    "doctor_response": "I am glad you have stuck to the advice of a neurologist and continued the medicine. Before thinking of stopping the medications, it is important to see if you are therapeutically covered by the amount of drug you are on . Also investigating for seizure activity in the brain would help. To this end two tests would help 1. Valproic  acid level in the body 2 EEGStopping this drug can be thought about definitely as you don't seem to have had an attack since 2002. You could get more advise once the two reports mentioned are done and  conveyed .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with intestinal tuberculosis. What is the treatment and diet regarding the same ?\n\nI am diagnosed with intestinal tuberculosis in July 2011. I suffer with regular upper abdominal pain . Please refer me relevant treatment and diet regarding the same.",
    "doctor_response": "Hi Welcome to HCM Read your prob, treatment of intestinal TB is 4 drug combination of AKT which should be taken for 9 month. along with it you should take antacid n tab omeprazol 20mg empty stomach. you should avoid spicy n fatty food ,take fibre riched diet. they helps in avoiding your symptoms n abdominal pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "When will be my ovulation time as I have PCO's\n\nmy doctor adviced me dimet 500 thrice a day..i was done fasting insulin test which was 156.3(after 100 gms) for one hour insulin and my 2 hour insulin was 199.8 which was twice the normal range..im having pco and doctor told i have problem in ovalution..will dimet 500 help in ovaluting??im 27 years old and 57 kg with normal height..having this tablet for past 2 months but could not conceive.my periods are regular as im given duphuston..i had a miscarriage 7 months back..anticipating your answer",
    "doctor_response": "HI,\u00a0\u00a0\u00a0\u00a0 The Dimet500may not help ovulation,but it will reduce your insulin resistance there by reduce your Wt.& remove basic cause of anavulation in PCOD.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Only thing is you have to increase your physical activities to get maximum effect of drug .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen lymph nodes in the groin?\n\ni had a c-section 11 days ago. the other night i felt 2 lumps on my groin and my GP said it's just swollen lymph nodes. he is not concerned since i don't have fever or any other symptoms. now, the lump is bigger and there is more than two. should i be concerned?",
    "doctor_response": "Hi! please don't worry but take care; there might be wound/vaginal infection!Well, this is very very common post-operative complaint that some females get enlarged inguinal lymph nodes following caesarean surgery; we have seen so many cases but fortunately all were reactive or related to recent minor infections, wound infection, hair follicle infection etc. in recent past. Rarely some lymph nodes turn into abscess that needed surgical drainage/antibiotics.Therefore, you also need to see your doctor for a detailed examination and if necessary needle biopsy/ultrasound to relieve your concerns.regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the purpose of mycoplasma and ureaplasma tests during pregnancy?\n\nhi dod good evening! I am 6 months pregnant and they did urine culture, The test shows I have 18 pus but bacteria was not identified.. but during my urine sample collection, i touched the sterile part of collection cup.. My doctor advised me undergo mycoplama and ureaplasma test. What is the indication for this.. Thank you",
    "doctor_response": "HI.They are infection-causing organism which could be the cause for the infection. But as you mentioned, I would recommend a retesting of the urine culture and sensitivity.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back injury, radiating pain, vertigo. Suggestions?\n\nHi I fell down the stairs 5 days ago. I slipped fell back and landed on my back the step hit me at the top of my back my head jolted backward with the force but itdid not hit anything. for the first two days I hurt everywhere and was very sore gradually all my aches are dying down but the pain in my spine is bad it feels a lot worse today it is located in the area where I hit it and it is radiating up through my neck. I am also having episodes of vertigo which started yesterday and are quite scary. My gp couldn't see me today. I was wondering if you think it is anything to worry about.",
    "doctor_response": "Hi,Thanks for the queryBased upon the symptoms, you do not have any major neurological problem. But I feel that you should better get examined to rule out pinched nerve so that we can treat you accordinglyPlease get back if you need any additional informationBest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What treatment is advised for post-ejaculation muscle spasms and nerve irritation?\n\nHi doctor, I have been struggling with chronic prostatitis or CPPS for the past five months. A big issue I have been having is the post-ejaculation muscle spasms or nerve irritation. I am currently in physical therapy to work out the muscle tension or spasms and hoping that helps with the nerve irritation. Unfortunately, a new and frightening issue has emerged, which is what my question to you here is related to. A month back, I masturbated to ejaculation. The ejaculation was very painful, specifically in the perineum area. After that, from the next day to the month end, I had no erection whatsoever at any point. The whole pelvic or penis area felt kind of just dead or numb. It is very unusual for me to go that long without ejaculating and especially without so much as an erection. When I woke up the next day, I had an extremely weak erection and it was a little bit painful. It was at this time I noticed a bend curve to the left near the top. This was extremely alarming and scary for me to see. I decided to masturbate that night. The whole time the penis was very numb and had very little sensation. It was erect, but there was no pleasurable sensation, and the curve to the left was still very alarming (pictures are attached). When I ejaculated (first time in two weeks), the ejaculate fluid had some trouble coming out. It made it out, but it kind of just leaked out (as opposed to shooting out) and there was absolutely no pleasure or sensation with it. It was less sensational than urinating. I still had a feeling. I could feel something was happening but it was very dead or numb feeling. Another piece just to throw in here, whenever I get aroused, but do not get an erection (so pretty much always), I have a very uncomfortable tingling in what feels like my perineum (although it is a radiating type of tingling, so it is possible it is coming from somewhere else in the same area). This tingling is relieved if or when an erection occurs. So my point is that I am very concerned about this leftward bend near the top of the penis. I have never had this before. I have read about Peyronie's disease. It looks to me from a visual standpoint that that could be it. However, I have to say that I am having a difficult time feeling or identifying any plaques or bumps or anything of that nature. The only thing of interest, which I believe you can see in the pictures, is that there is a big",
    "doctor_response": "Hi. I have gone through your query and the images that you have sent (attachment removed to protect patient identity). There is definitely a curvature that is appreciated on the images, but I cannot confirm whether it is Peyronie's disease without actually examining you myself. It is however among the few possibilities that can cause your present condition. I would like to know a few more details about the last time you masturbated. Did you find any sudden loss of erection or swelling of the penis after ejaculation? Did you feel a popping sensation in your penis at that time? Immediately after did you have any partial erections, and were these erections painful?  The usual cause of this type of problem is a tiny injury to the layers covering the penis which give it stiffness. This could also explain why you did not have erections for sometime immediately after. The important thing is to rule out Peyronie's disease which can be progressive, the others are not. If it is just a curvature, without Peyronie's, it is necessary to check whether you are able to have normal erections, from the images it does appear that your erections are normal (needs to be confirmed during an examination). If it does not interfere with penetration, then usually we do not intervene unless the patient specifically requests for cosmetic purposes. So, to summarize, it is not likely to be Peyronie's, but I would definitely want to rule out with an examination and maybe an ultrasound if necessary. Such a slight curvature would usually not require any further treatment unless it interferes with penetrative intercourse.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause a stiff neck and arm that restricted movement?\n\ni went to the doctors today I have trouble with my neck this is the 4th time I get pain down my arm and I have been taken to hospital because I could not get out of bed I could not move now last visit to the doctors they told me I have a pulled muscle at the top of the spine I feel its a pinched nerve but it is coming around to frequent and I don t know what to do",
    "doctor_response": "HiYou may have an orthopaedic opinion for this..an x-ray/MRI of neck should be done for diagnosis.Meanwhile chloraxazone and advil tabs after meals should be taken, and also use of cervical collar,hot fomentation and application of voltaren gel.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest ways to deal with anxiety\n\ni think i have anxiety if i dont what do i have?in yr 6 i was walking home from school, we left at 3:35 I was about halfway there to my house it was 4pm and there is a path which leads the shops and the shops lead to my house but in the middle of the path were 2 teens the teens were smoking and i was scared they'd kidnap me so what I did was I sat on my bag for an hour until they had gone but i think they left before cus my mum came and the boys werent there and i didnt have my phonenext day, there was the same path, and there was a man walking his dog and i thought he wuld grab me so i did like that fast walknext one: 2 teens behind me, I ran cus i thought they would run and kidnapp me!!I have sucidial thoughts, self harmed before with my teeth (bit myself)I had a rough past, given alchohol by my dad when i was 3, dad used to abuse my bro, bro was involved in a gang and they would use to throw rocks at our windows, Once i was in my room and a person threw a rock in the window and i was young maybe 5,6,7 or 8 and it nearly hit me luckily it didnt.What do I have ? anxiety,worry anything else? could my past could of caused this?I sometimes hesititate to ask a question, it might be because im shy but i have noticed my confidence has defintaly boosted.I sometimes speak my mind depends on who im with.Im always thinking in bed and since im thinking so much its harder to go to sleepThanks.",
    "doctor_response": "Hi,well, from the complaints you have presented here, it is suggestive that you are having an underlying sense of insecurity.There are various things that needs to be considered here, such as level of functional impairment, associated symptoms, age, social environment and detailed past history.These complaints are more suggestive of neurotic conditions.My advice to you would be to consult a local psychiatrist, as a detailed clinical work up would be required to established a diagnosis, and attention to your suicudal thoughts warrants a psychiatric help.welcome for further suggestions.Regards,Dr Pankaj Borade",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diabetic, metal taste in mouth, buzzing ears, dizziness, electrical shock feeling, allergic. what is this symptoms all about?\n\nI am type 2 insulin dependant diabetic, currently with BG over 250. I have the taste of metal in my mouth, also buzzing in the ears, dizziness , sudden movement of the head increases buzzing and dizziness and causes vision changes. i have electrical shock feelings, similiar to that as if you put your tounge on a 9 volt batttery, in my head. I have allergies as well, and have some thick mucus. I don t kow if i have a pinched nerve in my neck, a blood clot in my neck, a sinus infection ( no facial tenderness or sinus pressure) or if this is from elevated blood glucose. I have experienced this before, the metalic taste is new. some times the floor feels like it is moving up, spacial relationship is all wrong",
    "doctor_response": "tHE BLOOD SUGAR levels can cause all these problems and sometimes the medicines(insilin )or ther oral medicines cause allergies to increase and some of the symptomps are of diabetic neuropahy The metallic taste can be due to more acid formation in the stomach which overflows in mouth sometimes or the post nasal dripping of sinuses also give such taste you can differentiate by doing xray pns,,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in groin and tightness in hips flexor muscle?\n\nHello....I have had burning sometimes searing pain in both groin. Now it s more on the right side and my hips flexor muscle become very tight and becomes hard to walk. all blood work thru the years are negative for any prostate problems. Seems to get worse when sitting or sleeping, movement seems to help, I have been diagnosed with RA two years ago even after 10 blood panels came back negative for RA, but they are treating me as if I have RA with the methotrexate weekly. I have read that it might be my siattic nerve because sometime I get real tender from my groin to my big toe.....any thoughts please",
    "doctor_response": "helloi may suggest to consult another rheumatologist and fresh anti-ccp and rheumatoid factor, CRP should be done.do hot fomentation of flexor area in groin and take muscle relaxant tabs like chloraxazone in consultation with an orthopedic doctor. Do hip movement exercises daily under a physiotherapist.Review of  medicines and diagnosis by seconf rheumatologist may be helpfulbest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can i do for high blood pressure?\n\nMy husband is 35 yrs old and high bp patient from last 2 yrs , I  m not satisfied from dr. because the Dr.prescribe the medicine that can't the pressure repace h , repace n and 2 medicine other and now Dr. Gave today Oslo-tel2.5, ltd 12.5, etizolam 0.5 what can I do now today pressure of my husband is 160/110 and before 1 week it was 170/110",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. His blood pressure is very high.  He should take salt restricted diet and anti hypertensive medicine. Many options are available.  Losartan is the drug of choice.  Calcium Chanel block like nifedipine or beta blocker like atenolol can be used in combination according to need.  All are prescription based medicine so consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Had an unsuccessful implantation. Is it a sing of infertility?\n\ni think i had an unsuccessful implantation i heard that when that happens your normal menstrual period comes as well. Is my next period going to be on my normal cycle days or do i base them on the last menstrual period. My period is every 40 days. I want to have a baby do you have any tips? is unsuccessful implantation a sing of infertility? and why does it happen?",
    "doctor_response": "Hi Welcome to HealthcareMagic Yes you are right when implantation is unsuccessful menstruation follows. If you have not taken any treatment in this cycle then your periods will come as usual but if u have taken treatment then your cycle may vary and timing of periods may change. Yes unsuccessful implantation is sign of infertility. There are various known and unknown factors which leads to implantation failure. You need to be evaluated thoroughly and then treated . Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pain behind knee cap after hip replacement?\n\nI had an anterior mini hip replacement 6 weeks ago. I am still having quite a lot of pain around the wound area (not the wound itself). I have just been advised by physio to start some shallow squats, but I get sharp pain behind the kneecap. What should I do?",
    "doctor_response": "Hi Sharp pain behind the knee cap could be a referred pain or due to direct involvement of knee joint. Take pain killers and start exercises as suggested. Get an X ray of knee to grossly rule out any knee pathology. Your pain around the hip is likely to reduce over a period of time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes inflamed tonsilitis and headache in my daughter?\n\nmmy daughter is7years she had inflamed tonsilitis complained of headaches stomach aches she was tht on antibiotics zocin which helped but now she has flu and complaining of headaches and stomach aches she plus high temperature.the symptoms are the same as before what could be the problem?",
    "doctor_response": "Hi,Welcome to Hcm,I'm glad to hear that your child's tonsils have become better following antibiotic therapy. Now the symptoms you mentioned seems to me due to viral infection which can be just upper respiratory infection or if you live in a dengue epidemic area,possibility of dengue needs to be considered. As a remedy at home, child has to take plenty of liquids, paracetamol in case of fever and ssevere pain and rest. Hope this helped. Happy to clear any further queries. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is the lump on anterior tibia mid shaft due to fall rising towards ankle ?\n\nHello. My husband had a large piece of plywood fall on his anterior tibia mid shaft about a month ago. It bled of course, then seemed to heal. He has since told me that a lump rose up and traveled distally towards his ankle (very near the maleolus) I am concerned it may be a clot that may dislodge and cause problems.",
    "doctor_response": "Hello,I have studied your case and I think that your husband may be having collection of blood in the shin.This get accumulated under the skin and causes hematoma. It is not a serious situation and it will dissolve by its own. I would recommend you to use hot water fomenatation and volitran ointmnent.     I hope this answer will be useful for you.Let me know if there is any other followup questions.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes unexplained bruises on inner thighs?\n\nMy 2 year old son has unexplained bruises on his inner thigh, he has had diarreh with alittle blood and a 102 fever for the past 2 days. I called a nurse on-call and she told me to him to the er. When I got there the Doctor didn t seem to concerned about the burises and the bloody stool he told me that my son was just teething. I am consured so I m asking for a second opinion. Please Help",
    "doctor_response": "hello XXXXXX as a paediatrician i am much concerned with the diarrhoea with blood ( called dysentery) it may be of bacterial origin (want more details to conform it) because child may have dehydration and loss of electrolytes from the body . start the child immediately on ORS (take care mix the whole packet in 1  L of water or it may worsen the diarrhoea) as much as child can take , syrup zynconia(zinc)5ml oral once a day, and    lactobacillus (sporolac) twice a day   and i have some other questions reply me weight of the child stool - colour smell composition , frequency, duration fever - continuous or  intermittent high grade or low gradeany other symptoms like cold burning micturationsend the these details i can help u better..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain while sleeping at night?\n\nRecently I have been suffering from back pain at night, particularly when trying to turn over. I know that I have very mild scoliosis but apart from this and very occasional muscle spasms in my back (one per year if that) I haven't really had any problems before. I think it is worse if I lay on my back or front but am not 100% sure - I normally go off to sleep on my side but often find I have moved onto my back or (less often) my front in my sleep. It's bad enough to wake me up but doesn't trouble me at all during the day. I'm 46, female 54 kg, 5ft 5 and run 4 times per week (currently about 30 miles per week) with a small amount of yoga and pilates in between.",
    "doctor_response": "Hello, Thanks for your query. After going through your query I came to know that  you are suffering from chronic backache. I t may be due to vitamin and trace element deficiencies specially vitamin D and vitamine B 12. Back exercises, Cartisafe D once daily, NUROKIND GOLD ONCE DAILY and analgesics (DICLOFENAC 100 MG SLOW RELEASE TABLETS) give relief. Sometimes vitamin D deficiency can aggravate  this so serum vitamin D test is advised if it is low than vitamin D supplementation will be required. Avoid  long continuous standing. Sit in a straight posture. Eat milk, fruits and green leafy vegetables daily. You need to done MRI TO RULE OUT other causes. You can discuss with your treating Doctor about it. I do hope that you have found something helpful and I will be glad to answer any further query. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I continue taking Crocin, Erithromycin and Cetrizine for congestion, dry cough, light fever and body pains?\n\ncongestion in lungs with dry cough.with light temparature and body pains,  it must be due to taking watermelon four days back in this winter season. I am taking crocin, erythromycin and citrizen for the past three days.  whether it is ok and to continue. Pl. help me.",
    "doctor_response": "If you hav no symptoms at present then its ok to complete the total treatment for 5-7days.. However if you dont feel any improvement then its better to get done Xray chest and you need to visit your family physician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. After joining professional course, I do not feel like mingle with people. Why?\n\nHi doctor, I am a 19-year-old female doing MBBS. Everything is really good in my life, but I certainly do not understand the chit chat going on in my mind all the time. I do not feel going when I meet people, I do not like noise, parties and going out. But this was not the case earlier, I like dressing up and going out for shopping, now I do not feel like doing these things. I just like studying and following my normal routine, I do not want to be like this. Please help. I am very anxious about my face as I have acne scars, so I am always very conscious about them. I just take medication for it, I often have severe headache attacks, probably migraine, especially when I go out with my friends or hear a very loud noise.",
    "doctor_response": "Hello. I am sorry to hear about your situation, I can see that you are under a lot of stress. what you are describing looks more like anxiety disorder, it is possible that because you have been under a lot of stress for a long time. MBBS is a very tough field and even though you must be a good student it does take a toll on your mental health. With chronic stress problems like severe headaches, migraines social avoidance can occur. I would suggest you to talk to a counselor and they will help you find out the negative thoughts which are causing this anxiety and this type of behavior and they will help you to cope up with them and be able to enjoy your life again. Either find a local counselor or you can opt for online counseling sessions with me via icliniq. If these are severe you might require anti-anxiety medications, but as you have mentioned that you are able to function well, I think they might not be required. The counselor will evaluate you and take a detailed history and advise you accordingly. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Kind of blisters that ooze water when scratched, keeps recurring. Is it skin disease ?\n\ngood day' i have this kind of blisters and when i scratch them they become bigger , and i found some water came out from blisters when i try to scratch it. And now they are wounds and it gets bigger and bigger . I have suffered this last summer and until now i still enduring it. It keeps on coming back to my skin even though some other wounds healed already. I don't know what it is, but when we go to the doctor, she said that it is an allergy and recommended me to take some medicine that she suggests to me. I did what she say's to me, but nothing was changed to my skin. I'm worried cause it's almost 5 months but it is still on my body . Please help me to determine this kind of skin disease. Thank you.",
    "doctor_response": "allergic dematitisthe medicines are of help to subside the symptompsthe main concern is to know the causes of allergyit can be drugs taken for other ailmentsit can be due to soaps shampoooils cooking oil and creams hena dyes and other body application materialsit can be any fod stated giving allergyyou have to correlate and find cause to cureyou can use antiallergic tablets for itchingcap doxycycline 100 mg bd for 5 days to heal the woundslocal antibiotic and antiallergic ointment mixtureand calamine lotion locallyno toxic soaps shampoo oils and creams",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in top of head between ears with normal MRI?\n\nhello, I have had extreme head pain located on top of my head between my ears, went to the hospital and had an MRI that came back clear, temp is normal, BP is normal, I was taking 4- 222 tablets to help with the pain and it wasn t working very well, I was given a shot and a pill in emergency, they kept me there to see if I would have side effects and didn t, So I was prescribed APO-TRAMADOL HCL 50MG APX and APO-KETOROLAC TROMETHAMINE 10MG APX , these help me cope with the pain as just a bad headache, I can at least get a couple hours of sleep, if I sleep more than 4 hours, when I wake up the pain is unbearable, its the pain that wakes me up, feels as if someone hit me with a hammer, when they told me they were doing an MRI, I thought it would give the cause but puzzled the poop out of me instead, I don t know what to do, is there anyone who can help me ????",
    "doctor_response": "As you mentioned that its the pain in head, which wakes up you, and your MRI Brain is normal. So there can be few possibilities which also need to be considered. 1) Cluster headache2) Idiopathic intracranial hypertensioncluster headache is a clinical diagnosis and for IIH, need to do lumbar puncture and see the CSF pressure",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have an uneven skin tone on my face. How to get an even skin tone and glowing skin?\n\nHello doctor, I am 24 years old. I have an uneven skin tone on my face. Please advise for an even skin tone and glowing skin.",
    "doctor_response": "Hi Uneven skin tone is caused mainly by: To prevent and reverse dullness of skin and to improve your skin tone:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and swelling in the collar and shoulder bone?\n\nI am a 45 yr old female in good health but I do smoke. I woke up on a Saturday about 3 months ago and had pretty substantial pain in my left shoulder and collar bone. I had not sustained any injuries or strains that would have caused the pain. I just woke up and I hurt. I have the pain everyday now. Some times it s a lot worse than others. It is always much worse at night. It is more in my shoulder but it does move into my collar bone. Now it is moving up my neck, down my arm and into my ear. The back side of my collet bone next to my shoulder is swollen. I don t have any tingling or numbing.",
    "doctor_response": "Hi, your symptoms are more like a muscle sprain especially of the trapezius muscle, as your shoulder and clavicle has started paining suddenly. you need analgesics, and good physio, but before that an MRI of the shoulder joint can be helpfull.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do hypertension causes kidney failure?\n\nmy nephwe is suffering from hypertension since 16 years and recentely i came to know that he is advised dialysis for kidney failyre. do hypertension cause kidney failure?",
    "doctor_response": "Yes, hypertension which is not controlled or not treated properly can treat kidney failure. So it is very much necessary for your blood pressure to be controlled.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from cough & fever\n\ni am in argentina and got a few mosquito bites on each of my upper arms.. 2 were weeping and area swollen.. i applied anti histamine cream and tee tree and the swelling has gone as has the weeping.. this afternoon i have developed a tickley cough no fever.. is this relevant ?",
    "doctor_response": "Yes, sometimes it can be relevant. Just got a chest xray done & consult your doctor , he will see xray & would guide you further..",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the the sore lump caused by a crash on the leg?\n\nI crashed my lower leg into a metal beam about 4 weeks ago.  It hurt like heck, enough to be fractured,  but I ignored the injury and used my legs as I normally do.  A large, normally-flesh-colored lump about the size of a lemon remains, and is sore at times.  I assume it is a left over hematoma that will gradually dissipate.  Are there any concerns I should have about this? After how long should I be worried if it is not gone?",
    "doctor_response": "Hi there. Looks like your injury is taking a long time to recover. I would suggest you keep an eye on for the swelling to increase in size or become suddenly painful. There are instances where an underlying tumor of the bone manifest after an episode of trauma. So you need to watch out for the same. If it is a hematoma with a fracture associated with it that is getting neglected, you will find difficulty in weight bearing and walking on the affected leg and you will need to get an x ray of the involved region for the same and get treated appropriately.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to improve my mother's condition after stroke attack?\n\nHi doctor, My mom is in her early 60s.\u00a0She has had type II diabetes for more than ten years, and she has also suffered from the stroke in the past.\u00a0I want a doctor's opinion about her current situation. Her present situation is as follows:\u00a0Paralyzed on the right side of her body.\u00a0She cannot stand or turn. She needs help to sit. She sits for not more than five minutes before asking to be made to lay down. She has lost her continence. We buy for her adult diapers.\u00a0Nowadays, eating has become a problem for her. It is very hard for her to chew and swallow. We force her, but it is becoming harder from day to day. When the last time she got hospitalized, her condition did not improve. It cost us the little we had to keep her there. Now, she is back at home.\u00a0It is very hard for her to speak. At times, she might intend to say something, but she can hardly pronounce a word.\u00a0She spends the whole day laying down. This can go for week and months as this is the only position she finds comfort in. Do her illnesses giving their last blows?",
    "doctor_response": "Hi. I have gone through the provided details and understand your concerns. Revert with the details to a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching & red patches in knee?\n\ndoctor plz help me out about 3 yrs ago my legs below knee started itching and red patches i consulted the doctor he gave me cosvateg cream i applied n they went back in normal position but after 3 yrs i came back wid same problem in major condition swollen red patches n cracks n alot of pain also i applied cosvateg cream again with calak lotion but this still a major problem for me so plz doctor help me out",
    "doctor_response": "Hello,The symptoms seem to be related to dermatitis or eczema. Cosvateg cream is used to relieve the inflammation. I suggest to use this cream or another steroid cream such as Betametasone cream.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for the lump in the buttock?\n\nHello, i am worried about my lump in the right side og my buttock. It is red andvery painfull. Its running 4days now. I had this before and it was small i thought its just pimple i press it and there is something smelly white thing cames out after that no more i didn t touch it anymore but the lump still there. Now its getting bigger and very painful if i touch it. Its red and pain when i sit and lay in my right side. Please help me. Thanks",
    "doctor_response": "Hi,From history it seems that you might behaving forming abscess on that area.Due to friction or lack of hygiene due to not reachable for cleaning there might be having ingrown hair infection.Go for one course of antibiotic medicine course for 3-5 days.Apply antibiotic cream locally after proper cleaning.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can amusement rides cause any danger with mononucleosis infection?\n\nMy son has been diagnosed with mononucleosis.  He has already finished his course of antibiotics and told to avoid contact sports for at lease 2 more weeks.  We are going to amusement park in 1 week.  Is it safe for him to do amusement rides ie. roller coasters or is this dangerous to his health?",
    "doctor_response": "Hello and thank you for your question.The reason for avoiding contact sports with mononucleosis is the danger of spleen rupture. Rides that are high velocity like roller coasters are probably not a good idea until the 2 weeks is up.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause vibrating sensation in chest?\n\nThe past couple weeks I have noticed a faint vibrating sensation on the left side of my chest.  I'd only noticed it a couple times but it is happening a lot today and yesterday.  I havent been concerned about it but as it has become more frequent, I have also been very sick to my stomach and can't keep anything down for the past 12 hours.  I'm female, 44 with no diagnosed major health concrns.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.Vibratory sensations in chest are commonly due to stress and anxiety. But we shall definitely rule out arrhythmia (rhythm disturbances in heart) first.So get done ecg, 2d echo and Holter monitoring (24 hours continuous recording of Ecg).If all these are normal then no need to worry for arrhythmia or other heart diseases.Avoid stress and tension, be relax and calm.Take pantoprazole and levosulperide combination twice daily on empty stomach for your gastric trouble.Avoid hot and spicy food.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sore stomach, gas, hot flashes, cold sweats. Acid reflux, hiatal hernia. Help?\n\nI have acid reflux and a hiatal hernia . My stomach has been really sour lately after eating, lots of gas and belching . My GI doctor suggested changing my meds and if I don t improve, do an upper scope again (it s been 4 years.) Last night I got hot flashes and cold sweats and was headachy and nausous. Went to primary care doctor this morning who ruled out the flu or another type infection. Said I may be working on an ulcer? Have you ever heard of an ulcer causing hot flashes (not heartburn , more like a hot flash across my chest and upper back/shoulders)? Was given somethng for the nausea but that s all she could recommend.",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for calling H.C.M.F. As you describe there is hot flushes, (hot flash across chest and upper back.)cold sweats , head ache an nausea. As you have hiatus hernia, and G.E.R.D. also when it is more it can elicit like this also, due to hyperacidity. Ofcourse it is also possible when there is fever associated with gastritisi it can be confirmed if you get fever in next few hours. Other possibility is jaundice confirmed by yellow urine and yellow eyes. But as it is mostly suggesting gastric symptoms i advise you to consult a gastro enterologist for diagnosis and treatment. You may have to go for gastroscopy besides other routine tests for confermation. Wishing for a quick recovery. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of chemotherapy?\n\ni have been off chemotherapy for about 2 months and have all sorts of aches n pains.. Is this just my body getting back to normal and is this usual as hospitals only ever give you side effects of being on chemotherapy not side effects of coming off it!!",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have side effects of chemotherapy. Chemotherapy is very toxic drugs.  It destroy malignant cells but along with that it destroyed some normal body cells also.  So it leads to weaknesses, pain, low blood count, hair loss, frequent infection etc. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then feel free to ask me. I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful ulcers\n\nhi , my wife(31) is suffring from mouth ulcers from 4 years .any time they come up ,lasts for 7-10 days and then goes back. some times they are very painful that she cant even eat properly .we have taken so many tmts.like dentist , desi , aayurvedic , physician , ent , homeopathic etc but no relief .please guide us what should we do",
    "doctor_response": "Hello! Welcome to HCM.You did not mention if she is under any medication for general health like hypertension.Many of the drugs can be causing this.In that case she can consult the physician for a change in the prescription.A clear cause for ulcers has not been given yet,however poor oral hygiene, stress, deficiencies can attribute.She can use a lignocaine based gel like GUMTONE before food(this makes the area little numb, so that she can eat).Gargle thrice daily with warm saline water.Use a soft tooth brush.Have a stress free lifestyle.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be done to treat infertility despite taking Rejumet for PCOS?\n\nHi, im taking rejumet tablet for pcos  past 6months, this tablet is advised by gynaecologist, im trying to conceive, this tablet im using along with clomophine for 5 days and rejumet  for twice and folinext once in night, but still now i didnt become pregnant, but this month also i took tablet regularly without fail, but still now i didnt get periods, and i dont have any pregnancy symptoms im in confusion now, whether taking rejumet for long time  will have an side effects, usaually i will get my periods 2, 3 days difference as 14th day of my cycle doctor will do folicular scan and she will give iNj. HCG  so i was getting periods correctly, this month she told ovaries are not formed good so didnt give injection, on 17th day of my cycle the ovaries are 16-18 mm, my LMP = 17-12-13, pls advise what i need to do further",
    "doctor_response": "we need to know status of sperm count of ur partner.than only line of treatment can b decided.after few cycles  dose of clomifene to b increased to 100 mg /day starting from 5th  day of cycle.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in abdomen and eyes in a toddler?\n\nHi, my son is 3, he has a temperature of 39 degrees (since last night) and is complaining of a stomach ache and that his eyes hurt! His eyes are slightly blood shot and his lips are very red. Do you know what could be causing this? I can t think of anything which he could have eaten that might have upset his tummy.",
    "doctor_response": "Hello, Look this might be prodromal symptoms for some infection: viral /bacterial? At the same time   Some Allergic reactions also? You please just don't get panic and just ensure proper diet,  hydration n complete rest. There are multiple reasons for Abdomen Pain in kids. So as of now, I would suggest you deal symptomatic way : Just give Paracetamol for pain and fever. And monitor temperature 4 hourly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ajaygupta009, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is recurrent swelling in the toes a matter of worry?\n\nMy 27-year-old daughter, who has Down Syndrome, has puffy toes with purple areas on the tips and top surface. They are also cracked. I don t think she has this in warm weather. She says she feels no discomfort. Last winter, her doctor had her feet scanned for circulation problems and found none. Is this recurring condition anything to worry about?",
    "doctor_response": "Hi, It could be small hemorrhage from the veins. Can happen in certain diseases like Renauld's disease (a type of peripheral vascular disease). I suggest a consultation with a surgeon ASAP. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the solution for frequent horrible nightmares?\n\nI have been having horrible nightmares very frequently for a few months now. but I have suffered on and off throughout my life. I remember these dreams in great detail. and awake feeling very fearful and i usually stay that way sometimes for days. Sometimes i cannot even go outside after dark.  I also have episodes where i know i am awake and i can hear everything going on around me but i cannot move or open my eyes for quite sometimes. Why?",
    "doctor_response": "HIThanks for using healthcare magicNightmare is usually related to unconscious mind and content in night mare shows the response of our mind. If you have any stress, then that would show in your dream. In that case, either you can try some relaxation exercise or some low dose benzodiazepine to get sound sleep. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can removal of IUD cause harm to fetus?\n\nHello Doctor, I am having 15 month old baby and i was using IUD (Copper T 380A) Birth control. But i got pregnant now,. My GP prescribed Ultrasound last thurday and the result was, my IUD is in Cervix and Baby is in uterus and Baby is 7 weeks and 4 days old now. I am going to OB tomorrow afternoon to remove IUD. Will that be too hard ? Can you please What about the chances of Miscarriage?? I dont know, whether I have to be happy or worry as Copper T is in my cervix... Can you please shower some light on my confusions Doctor??? Thanks heaps in advance???",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your query, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.First of all do not panic.If your IUD is totally lying in the cervix, it can be safely removed out. It will not cause any harm to your baby.If removed from cervix it has no chance of causing any infection or even there are no chances of miscarriage.You should be happy that IUD is in the cervix, and is away from the pregnancy and bag of membranes. I will suggest use of Micronized progesterone as a support -200 mg 2 times a day for a week.I hope my answer helps you.Thanks.Wish you great health.Dr Purushottam S Neurgaonkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bulging disc?\n\nI was diagnosed with a bulging disk at the L-3, L-4. I had pain in my back and pain that went down my right leg on the inside part of the leg NOT the back of the leg down to the knee. No pain below the knee. I am much better. Did my bulging disk receed back into place?",
    "doctor_response": "Hi I did review your concern. Herniating or bulging disk is a disease of unknown cause that causes the disk pulp to force through surrounding tissue and press on nerve roots as they come out of the spinal cord.It causes the severe pain like you are having and depends on which nerve roots are being irritated.It precipitates with increase pressure on vertebrae and with rest and relief of pressure, the disk pulp moves about and stops irritating causing relief of symptoms.It does not mean you cant have it again, once it happens, you are predisposed to it and it can happen again.I hope this helpsLet me know if you have any more questions or concerns.Wish you all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to prevent hair loss\n\nsir as i am suffering from hair fall there is heavy loss in my hair, i feel sad to say this so plz help me from hair loss, i do not know hair specialist so i need treatment. so what kind of treatment shall i take kindly give me about this information",
    "doctor_response": "Hi, It may be alopecia androgenetica most probably. Consult the dermatologist for the perfect diagnosis and proper treatment. I would recommend you to take Finesteride tablet daily for few months. I would also recommend you to take tablet Biotin daily along with cap Vitamin E. Apply minoxidil 10% solution on the scalp twice a day. Anti -dandruff shampoo may be used if you have dandruff. Avoid worries and anxiety related to hair loss. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilyas Patel, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the chances for survival when having stage 4 cancer?\n\nDon't know where to start; have had burgers for 20 years, lost my toes (both feet) and have went on.  Just got the infor that I''m on stage 4 (something esophageal cancer) and I have been to the VA where all the long, short & mediam coat drs are fighting over me.  I opted to stop chemo and I'll start here. Can you give me an idea who/how/what to ask - eg. time line etc. just want to get this over with but don't know what to do or ask. Dr. Perrin MD in Ft. Dodge is what I guess my primary Dr. along with HOSPICE AND GOD KNOWS ABOUT THE VA? 'An and all infor or suggestions would be helpful.  i'V NEVER DONE THIS BEFORE.  tHANKS  *HELP INFO - i DON'T DRINK, SMOKE AS OF 20 YRS AGO SINCE MY DIGANOISE OF BERGERS.  THANKS AGAIN",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.You have esophagus cancer. It is stage 4 cancer. Surgery is not useful in this stage. So treatment options are chemotherapy and radiotherapy. But it will not cure the disease. It just works as palliative therapy. Despite of all treatment prognosis remains poor. Life expectancy is not good. Sorry to say but it is fact.Consult your oncologist and plan accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can I prevent getting vaginal tear during sex?\n\nHello doctor, Everytime I have sex I get a vaginal tear. I did not have sex or wear a tampon for 10 weeks to let it heal. I had sex again last night and it tore again. I do not have an issue with lubrication, so I am not sure what to do.",
    "doctor_response": "Hello. Vaginal tears after sex are mainly dependent on several causes like vaginal dryness, chronic skin conditions such as eczema, psoriasis or lichen planus, etc., and sometimes it may also be caused by the use of recreational medicine like Viagara by the partner. Vaginal tears could be superficial and deep. Superficial tears usually result after having sex and they usually heal by themselves in few hours to 1 to 2 days and then usually do not bleed heavily. Deeper cuts usually occur during childbirth.  As you mentioned that it took 10 days to heal your previous tear then it sounds alarming. Was there any heavy bleeding or pus coming through it? And how long have you been facing this problem? Can I have a look at any picture of tear? I would suggest you that if you do not have any issues with lubrication (which is the most common cause of vaginal tear during sex) then you must get yourself assessed by the local doctor and get tear examined to determine the actual cause and appropriate treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anxiety, lack of sleep/appetite and nervousness\n\nfeeling anxious , cant sleep , not eating right , thinking about dying all the time but I dont want to die , nervous ness that comes off and on all day today whats wrong with me Ive been worried about my boyfriend being out of town and I do go out alot with friends to drink so I dont know if its the alcohol what should I do",
    "doctor_response": "Hi.I had gone through your query. It may symptoms of depression anxiety. Low mood with nervousness with sleep problem can be due to depression. It can be treated with a SSRI and benzodiazapine. In SSRI sertraline / escitalopram will be useful. But consult psychiatrist for proper evaluation and choice of this medicin is depend upon you clinical details and history. Exercise and meditation can be useful. Proper sleep and diet can help. Do stress free activities yoga, relaxation. Do your hobies and music.Keep your self busy and never let yourself alone. Consult psychiatrist and get help. Still if you have a query then feel free to ask. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fallen down stairs, painful lump, breathlessness. Xray required?\n\nHi, I fell down some concrete/metal stairs about a month ago. I had been inebriated at the time so I didn t feel any pain initially. Later that evening, I began to feel sharp pain in my back but (having forgotten about the fall) just chalked it up to my history of carrying a lot of tension in my back (as a violinist). By the end of the week, I was in pain no matter what I did. Sitting, standing, laying down, fetal position-- nothing helped. Hanging myself over the back of a chair (balance point being my middle/low stomach) helped a bit, but otherwise it was intense radiating pain. A relative of my friend with some experience in massage therapy took a look at my back. There was a large hard lump in the lower-middle of my back (among the highest lumbar vertebrae ) that I had thought was just part of my spine (seeing how hard it was) but which she said was definitely not supposed to be there. Massage helped relieve a lot of the pain, but the lump was still there, though smaller. My back remained generally stable during the next week (unless I carried a backpack in which case I would be in immediate intense pain and would remain in pain for the rest of the day). By the end of 7 days, though, the massage had lost its effect and I was in pain again. I received another massage that alleviated pain for about a week before I was in a lot of pain again. Sometimes the pain would just return of its own accord-- always radiating. Sometimes leaving me breathless . In the past 5 days or so, on a few occasions when my back has started hurting, my fingers, hands and arms have started ticking/spasming. Sometimes violently. Decreased some with advil . The lump is still there and pressing it is uncomfortable and gives me a sensation similar to free-falling. Should I go in for an x-ray or do you have an idea of what the injury might be?",
    "doctor_response": "Thanks for the query. Injury to your back can cause muscle, ligament sprain or bony fracture. The lump may be a haematoma in the soft tissue. It may indicate significant injury to spine. Its better to get the xrays of the spine to rule out fracture. In case of back injury rest is the only way to relieve the pain. If you consider taking rest for few days, you will definitely feel better.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had vomiting and diarrhea. Could it be because of any allergic reaction?\n\nHi, I have had vomiting and diarrhea every 2 weeks for over 2 months now. It lasts for a couple of hours each time. Apart from the very first time all i can link it too is fish. The last time i was sick i had a tuna sandwich and within 2 hours i was being sick and had diarrhea. Does this sound like an allergy? I am 31 years old and this started happening beginning of december.",
    "doctor_response": "yES THESE CAN BE ALLERGIC SYMPTOMPS aNY FOOD CAN CAUSE ANY TYPE OF ALLERGY AT ANY AGE THIS IS FOOD ALLERGY yOU GET YOUR BLOOD SERUM TESTED FOR FOOD SPECIFIC ANTIBIOTICS FOR MILK WHEAT POTATO NUTS FISH EGG YOU WILL GET IT",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for diabetes characteristics\n\nI was electro shocked held to unconciouness afib for two days till medicine got me back rate as high as 180. I am 49 years old male 160 lbs 6 foot. could this cause me to have diabetic carrectoristics or even be dibetic after? also could it cause a small almost insect bite like rash above both anckels about 4 inches? blacking out and hard to focus with eyes though eye doctor says nothing wrong with vision?",
    "doctor_response": "Hi,Sorry to hear about your medical condition. There is no correlation between an electro shock and you having diabetic symptoms. Diabetes is a disease process that takes years before it even manifests as symptoms.When were you electro shocked? And what was the exact medical condition that you were told to have regarding the heart. Also could you please tell me more about the blackouts. Do there occurs immediately on standing up from a lying position? Do they occur after a walking for a while or they occur on exertion? Are you a Hypertensive? If so I think you should have your supine and standing BP checked?And finally what medications are you on right now? And finally could you describe more about the rash above both ankles. Is it red or is it elevated? Does it look like it could have occurred due to physical friction with another object recently?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Hepatitis C?\n\nYes Dr. Grief, My name is Ruth and i have Hep-c. The virus has been in my system since 1995 i know for sure.  What i don't know is when i became infected. I haven't experienced any dramatic system yet, so can u tell me what symptoms i should be looking for and also what type of therapy is available for Hep-C? I thought it wasn't curable. I am a female 58 years young.",
    "doctor_response": "hepatitis C is curable. there are actually new medications that came to the market at the end of 2013.Treatment will depend on the specific type of hepatitis C (there is type 1,2,3,4,5,6!) and treatment duration and medications chosen may vary based on this.The classic treatment includes an injection given once a week (pegylated interferon) plus pills taken daily. Duration of treatment vary between 12 weeks to 48 weeks! The new medications are approved to be given together with the interferon injection, however in certain cases it can be given without it (the injection is the one with the most side effects).Hepatitis C won't give you symptoms until your liver is significantly damage, or cirrhotic, reasons why it is important to treat it before it is too late.Talk to a gastroenterologist / hepatologist for the necessary blood tests and then treatment options",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause hallucinations, forgetfulness and abnormal behaviour, taking host of medicines for various conditions?\n\nMy dad is 57 he lost his brother a week ago, shortly after that we had to call an ambulance for him. It was like my dad lost his mind he lost all reality, he don't rember any thing that he done for 4 days. He was shooting people with his fingers, pulling on his clothing, sound sensitive, thought people was going to hurt him would jump when you touched him, praying, mixing past with now and refused to eat for 3 days. The hospital tolled us he had an allergic reaction to a steroid he was on and they released him 2 days later. He was good for a day but now keeps slipping back to being lost and asking many questions. He keeps thinking that we are all trying to make him crazy , he thinks that the kids are testing him but there just playing like little kids, he gets confused really easy and even gets mad for no reason. He's on over 12 different meds for back pain, diabeties, heart problems, and depression. This is not the first time its happened. Its happened once before and they gave us no diagnosis then either. He's had a cat scan and it showed nothing, his blood test only showed a low electrolites and they said it was from a sinous infection. Is it some thing we should be worried about or get a second oppionion on, are they missing something?.",
    "doctor_response": "HiThanks for using healthcare magicI think your father has acute transient psychotic episode for which he needs a antipsychotic drug rather than antidepressant. Low electrolyte could be due to antidepressant side effect. You should consult a psychiatrist for his proper evaluation and in case you need our help, you can connect us.RegardsDr. Abhishek Kapoor",
    "dialogue_context": ""
  },
  {
    "patient_message": "Done MRI for pancreatic cyst. What should my next step be?\n\nI had a MRI done to look at a cyst that was found on my pancreas on a previous MRI. I am a 42 year old woman. I understand that it has gotten a little smaller but I do not understand the rest of the results. Could you help me and advise me as to what my next actions should be if any? Results= FINDINGS: Correlation is made with the previous MRI examination dated05/03/2012.There is motion artifact on these examinations limiting evaluation.The extrahepatic common duct and visualized intrahepatic bile ducts areunremarkable without filling defect, stricture or abnormal dilatation. Thevisualized pancreatic duct is unremarkable. These findings are similar tothe previous study. A lobulated cystic mass is again identified within theregion of the uncinate process of the pancreas which demonstrates cysticcharacteristics on all pulse sequences without enhancement. The overallsize appeared slightly decreased compared to the previous study currentlymeasuring a maximal transverse dimension of 1.2 cm compared to 1.6 cm onthe previous exam. There is suggestion of a cystic duct remnant which isnot optimally visualized due to motion artifact. Also, there is asuggestion of an accessory bile duct supplying the right hepatic lobearising from the extrahepatic common duct.The visualized portions of the liver, spleen , adrenal glands and kidneysare unremarkable.IMPRESSION:PERSISTENT CYST IN THE UNCINATE PROCESS OF THE PANCREAS SLIGHTLY DECREASEDIN SIZE COMPARED TO THE PREVIOUS EXAM.SMALL CYSTIC DUCT REMNANT.Findings suggestive of an accessory bile duct supplying the right hepaticlobe arising from the extrahepatic common duct.",
    "doctor_response": "Hi and welcome to HCM,thank you for your query.at this point it doesnt require any treatment since there is no growth or obstruction of main pancreatic duct. Also,there is no risk of malignancy.So if you dont have symptoms you dont have to be worried since this is just benign pancreatic cyst which is common accidental finding.   All you need is frequent follow up. Wish you good health. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for red bumps near scrotum\n\nHi, I am 15 years old, I shave my Testicles, And I have Red bumps in one area on my scrotum, Just one area. They are not big, But can get itchy sometimes. I never had sex Before ever. Friends say its because i didnt shower in like 5 days because of plumbing?",
    "doctor_response": "HelloWelcome to health care magic. I appreciate your concern.Looking at your description it seems that you might have injured your scrotum during shaving, if possible upload a photograph and write back to me Meanwhile wah it with antiseptic soap or solution and apply antibacterial ointment to avoid infection.if it doesn't subside in a day or two than you should see you family physician or GP for physical examination, you may require a course of antibiotics.you can take acetaminophen or ibuprofen for pain relief.Maintain good hygieneBest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I be pregnant after spotting ?\n\nbeen off the depo for about 9/2010 and have not started my period on 06/29/2011 spotted for a day and on 07/02/2011 had unprotected sex and 2days later i start spotting again can i be pregant",
    "doctor_response": "Hi Welcome to HealthcareMagic. it takes time for periods to resume after removal of depo.  However during this time contraception is not achieved.  There could be chances of pregnancy.I advise you to visit your gynecologist and get evaluated for your periods to start.  you can also get pregnancy test done. Hope I answered your question.If you need more information feel free to mail me. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back pain while on steroids?\n\nMy father has been experiencing lower back pain and cramping in his hamstrings (both legs) upon changing from a seated / lying position for more than 2 weeks now. He can barely walk. He wen to the doctor about 5 days ago and was given muscle relaxants and steroids. There has been no improvement. He is a long time type 2 diabetic so I am concerned about his circulation and possibly his kidneys. I am trying an electrolyte drink with no sugar to see if that helps him but I am doubtful.",
    "doctor_response": "Answer: Hello,Thank you for using Healthcaremagic.I read your question and understood your concern.I think your father has diabetic neuropathy which can be stopped but reversal is difficult kindly do whole body physiotherapy exercises every 2 hourly for better circulation follow diet advices and control blood sugar and steroids should be given only with physician advice .Dr. Sandeep patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the right scrotum?\n\nMy right scrotum was in pain since last week but yesterday I was shocked to find a hard lump attached to the ball inside the right sack which pains a lot. It pains even more when touched or pressed. Please help cure this or suggestion on how to sure it.",
    "doctor_response": "Hello Thank you for trusting HCM Dear possibly your suffering from epididymitis. Have you suffering from any Stds?? Other causes for Testicular pain  hydrocele, inguinal hernia, kidney stones, spermatocele, orchitis etc. cap. Doxy 100mg twice a day for 1week consult your doctor he will examine and treat you accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am 51 years being treated for coronary ectasia and hypertension. Can I take Viagra for erectile dysfunction?\n\nHi doctor,I am 51 years being treated for coronary ectasia and hypertension. I am taking the following medicines now. Tablet Clopilet 75 mg, Warf 2.5 mg and Nebicard H. Can I take Viagra for erectile dysfunction?",
    "doctor_response": "Hi. The drug Viagra (Sildenafil) can cause potential side effects alone and certainly in combination with the above drugs. It can cause hypertension and even the heart attack also. So it is not safe in the asked context.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the reason for blurred vision and sensitivity to light?\n\nHello doctor, I was born half blind in one eye. I have been through a stressful few months and it has all caught up with me now with headaches and anxiety-like symptoms, etc. I noticed during this time, that my \u201cgood eye\u201d became hazy/blurry and became quite sensitive to light. This has gone back to normal vision. I noticed that it is now affecting my \u201cbad eye.\u201d I woke up a few days ago quite dizzy and did not know what was going on. I am wondering if it happened then? As I have gone my whole life like this so maybe my body is confused? I am also worried because I am unsure of whether the vision in the \u201cbad eye\u201d will return to its normal state. This makes me dizzy at times and I think it gets worse when I am nervous about it which might be why I get dizzy?",
    "doctor_response": "Hello. The symptoms of photophobia and blurry vision points out to the following possibilities:  Given that there is a history of congenital impairment of vision in one eye, this tips the diagnosis towards glaucoma or corneal dystrophy. But to diagnose them with certainty you will have to undergo tests like: Until then, I suggest you start Carboxymethylcellulose plus Naphazoline eye drops four times a day. Nepafenac eye drops every morning. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. For more information consult an eye care ophthalmologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to wean off a toddler from formula milk?\n\nhi dr,,Im a mom of 2 years old boy hes a bottle feed since birth and until now hes depending on the formula milk.And about his intake of solid food its very ok especially his snacks and i gave him some yogurt drink regularly.And he can drink 210 ml 6-8 bottle in a day.He s weight is ok and it seems that hes becoming heavier everytime that i carry him i can feel some backpains on my back especially my mother.So my question is that when he will depend on milk??I want him also to eat rice like us.He can eat rice but not too much rice in a meal.He prefer to drink his milk.Thank you",
    "doctor_response": "Hi...1. Too much milk will cause constipation and anemia.2. Only milk will not suffice for all the nutritional requirements of the kid at this age.3. Gradually will reduce the milk and increase rice and cereals and pulses.4. He should be eating rice like all of us at this age.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for paralysis of hands & legs?\n\nMy Sister and Kidney and Paralysis problem. She got first paralysis attack 6 years back. After that she has paralysis attack 3 times. (This was mostly in WInter season) Which was on her legs and hands. Her creatine level is 2.8. Yesterday She had 4th Paralysis attack. Please suggest us what to do. we are in tense",
    "doctor_response": "Hello,Thank you for your question.From the explenantion that you give it looks like a central neurological problem in year head.It may from many causes such as encephalitins , meningitis, stroke, aneurism in the brain , tumor, epilepsy etc etc.Also another cause my be from kidney problem that you have since kreatinin level is high.I recommend you to see a specialist in neurology and he will order blood tests and imaging test such as CT scan , MRI , ultrasound of kidney etc.If neurology specialist clears your sister he may send you to nephrology specialist to address the kidney problem.wish you quick recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the pelvic area spreading towards the left testicle?\n\nI have had pain for a few months on the left side of my pelvis just under my underwear line.  I thought it may be a hernia and i also cut my dairy as when i was gassy it made it worse.  a few times the pain went into my left testicle only.  i also take lithium 1200mg and lisiniprol 20 mg.",
    "doctor_response": "Good Day and thank you for being with Healthcare Magic! Pain in the left testis could be varicocoele. This is located on the area that you have described. This is can be confirmed by a Doppler ultrasound of the scrotum or if it is severe then by physical examination. This is felt like a bag of worms in the spermatic cord or the cord that connects the testis to the body.Other conditions could still be an inguinal hernia, a kidney stone ( radiated pain ) or a testicular tumor. Regards,  Manuel C. See IV, M.D. DPBU FPUA",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can my acute pancreatitis become chronic?\n\nHello doctor, I had acute pancreatitis three weeks ago (probably due to too many drinks on a Saturday although I am not a big drinker generally) and since then struggled with digestion. I am very worried as some of my stools are pale yellow and I have terrible fatigue. My blood tests are now all fine and the CT scan (taken five days after admission to hospital) were all good. My symptoms have changed and are mostly very painful referred pain after eating and fatigue. I am very worried about chronic pancreatitis. My question is, is my system still recovering and could I have these symptoms whilst the pancreas heals without it being now chronic?",
    "doctor_response": "Hello. Generally, it takes time to recover after acute pancreatitis. I suggest you stop drinking alcohol, absolute cessation of alcohol. You are at a risk of developing repeated episodes of pancreatitis and chronic pancreatitis if you continue to drink. Please start enzyme supplements. As the CT is normal, you may not be having chronic pancreatitis but an endoscopic ultrasound is a better investigation to know if you have chronic pancreatitis or not as the CT is normal. For more information consult a surgical gastroenterologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to relieve lower backache\n\nI have been suffering with lower back pain for about a year now. The pain shoots into my legs, feeling like toothache in my bones. About a week ago the pain has moved further up my back and when I lay down it feels like my lungs are bursting out of my chest. I can not get a good nights rest as the pain wakes me up.",
    "doctor_response": "HiI can understand your problemLooking at your symptoms it seems to be a case of degenerative disorder of disc.Please consult your doctor for detailed examination and a battery of tests like RA factor HLA B27 testing ESR and an X ray lumbosacral spinemeanwhile have tab acetaminophen  for pain reliefvitamin B 12 to avoid nerve damagePhysiotherapy Hope this helps yougood luck take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to remove cyst on buttocks\n\nMy mother has a cyst on her right butt... It happened after my eldest sister was born 30 years ago... It came out little and afterwards, it became bigger and bigger as a size of a baseball ball.. I wanted to ask for help on how to get rid out of it and also if it is cancerous?.. Thanks for the immediate response",
    "doctor_response": "Hello and thanks for your question.With a cyst this big it will need to be removed surgically. There is no way to tell if it is cancerous or not with out doing a biopsy or removing it.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes spots all over the buttock area extending to the thigh?\n\nhello my 2 year old son has spots all round his bum area and come down the inside of the top if his thighs. its dont look like nappy rash, because hes had that and its never looked like this. the spots are raised and bumpy, a bit like chicken pox but without the heads. what do you think it is?",
    "doctor_response": "Hi,Is he having any other symptoms like fever? Are the lesions itchy?If no fever, raised lesions which are not fluid filled can suggest an urticaria (will be itchy), a contact dermatitis or a purpura. Urticaria will respond to antihistamines, calamine lotion and occasionally steroids. Purpura need further evaluation to rule out conditions like HSP (Henoch-Schonlein purpura). Kindly show it to your pediatrician.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam T. K., Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Epileptic, on medicines for bipolar disorder, suffering with forgetfulness, difficulty in recognizing people, events of the recent past. Help?\n\nrespected doctor, i am an Indian girl ,aged 22,pursuing my education in dentistry ......I am having epilepsy and even on psychiatric medication for bipolar disorder ...Sir, i am continuously forgetting things.I dont remember what happened in my life in last few years and even some people.......I dont understand what to do.I told this to some people close to me like my to-be-husband,but he laughed out on me and said that I am acting..How to make him understand.I am not able to recognise people around me and even dont remember the events which took place in my life since 2002.This forgetfullness is increasing day by day........sir, please tell me what should I do and how to make him understand. Yours sincerely, U.K.Alam",
    "doctor_response": "Hi, Thank you for posting your query. You are suffering from epilepsy and cognitive disturbances (secondary to epilepsy and medications). You need to consult a neurologist for evaluation and treatment (correct choice of drugs and dosage). Next time, when you visit your doctor, take your fiancee along with you, so that the doctor can explain regarding your illness to him. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes slow resting heart rate in an infant?\n\nHello. I recently gave birth to a beautiful baby boy. He s perfect but I am really concerned that he has a slow resting heart rate it could go all the way to 65bpm when sleeping.. When he is up it goes up to 110. He was in the nicu for about 3 days. They were monitoring his heart and they did a EKG on him and said his heart rhythm was normal so they decided to discharged him with no diagnosis. I am so concerned i don t know if to take him to another hospital for a second opinion or to just let it go. He was put on antibiotics due to an infection I had. I m not sure if that s what might have cause it to slow down or what.Could it have been the antibiotics?",
    "doctor_response": "Hi,Thankyou for your quiry.Brief...He needs to be evaluated throughly for different factors causing slow heart rate.Detailed answer...Since normal heart rate in new born is 125 to 150 and below that heart rate may need throughly for different factors.For example..Congenital systemic lupus erythromatosus,cardiomyopathy,some medicines used by mother like tetracycline,and some genetic problem like long QT syndrome.For that he needs second opinion by cardiologist.Hopefully my answer is helpfull.Regards,Dr.Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low BP\n\nI am 55 5 10 @ 192 big bone structure... perfect blood panel... non drinker 16 years, non smoker 14 years, have an auto immune disease, every disc in my back is degenerated with several bulges, ruptures, Double Widow Maker survivor (2 hrs 100% occluded) two stents... BP averages 112/68 p 60 s ... last couple days I have been mid 90 s/low 60s... as low as 86/47 p 72 trying to sleep",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. After going through your medical details I understand your concern and I would like to tell you that low blood pressure can be because of anti-hypertensive drugs, dehydration, any blood loss or sometimes after Angioplasty. Kindly stop taking hypertensive drug if you are taking any, keep yourself hydrated and personally consult a Cardiologist if you are experiencing any dizziness, palpitations or nausea kind of symptoms. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for spider bite\n\nI had gotten a spider bite a few day ago on my finger. It had swollen and a red line started tracking up my arm. The doctors dripped antibiotics in me through I v and prescribed me Clindamycin. This morning I got another bite which is as well starting to track. Will the Antibiotics I am currently taking be affective on this new bite or will I need to go to back to the hospital ?",
    "doctor_response": "HelloWelcome to HCM,Spider bites are actually rare occurrences and bites from most spiders cause local redness, irritation and pain that usually can be treated at home.These local reactions usually resolve without treatment over a period of 7-10 days.I would suggest you to followWash the site of the spider bite well with soap and water.Apply a cool compress or ice pack over the spider bite location.Over the counter pain relievers may be used to relieve symptoms.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treating for bronchitis. Pulmonary specialist found having asthma attacks. On nebulizer. Have wheezing, musty smell in nose\n\nI have a couple of problems.  For the last 3 weeks my family doctor has been treating me for bronchitis.  I went to a pulmonary specialist this past Friday and found I have been having asthma attacks.  I am now on a nebulizer every 4 hours.   The wheezing is driving me crazy.  I also have had a musty smell in my nose for the past year or so.....Help...I am going crazy",
    "doctor_response": "Hello, Thanks for the query  to H.C.M. Forum. I would come up with these measures  for  asthmatic patient , these are.1 Avoidance of  mite , dust, hay , pollen , sudden fall & rise of temperature  , fine dusting powder ,mold , fine cotton fibers will help in an asthmatic patient .2 Nebulizer helps but temporarily, so in my opinion consult  one more specialist  and get his opinion . As in this type of patient I , usually prescribe  antihistamine + bronchodilator .3 Musty smell is actually due to allergy to certain allergens , which  are responsible for asthma.In my opinion consult a pulmonologist and get his  opinion ( 2nd).Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can hallucination be treated?\n\nHello . My husband had hallutination problem . 5 yrs back . Treatment was going on in mumbai. Again started the same problem . But my husband is not in mumbai now and he is not ready to come out of that place bcoz of afraid. As somebody wants slap him and etc etc . He is not eating and sleeping . Could you please suggest what to do",
    "doctor_response": "Dear userWe understand your concernsI went through your details. Hallucinations are where someone sees, hears, smells, tastes or feels things that don't exist outside their mind. They're common in people with schizophrenia, and are usually experienced as hearing voices. In your husband's case you should consult a psychiatrist near your home at the earliest. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shoulder after having alcohol?\n\nHi. I have experienced aches in my right shoulder every time I drink, which is not that often. It usually last about 5 mins. I dont experience anything else with consuming alcohol and I don t have the fever, night sweats, fatigue, or enlarged lymph nodes. What could be causing this achy pain?",
    "doctor_response": "HelloI have read your query. There is possibility of nerve compression leading to pain in shoulder. Saturday night syndrome is common in alcoholic leading to pain. Neurotropic medication like pregabalin and methylcobalamine can be started consulting your doctor. I hope I have answered your questions. If you have further questions please feel free to contact us. I will be happy to answer. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hematoma in head\n\nMy baby is 18 days old, I pushed for 3 hours, then they used a vacuum suckshion to help pull him out. He now has a hematoma on the right side of his head. I am very concern, It's the size of a walnut in shell. Is there anyhing I can do to help it go away?",
    "doctor_response": "Hello, Congratulations for the baby. The problem you mentioned is very common whenever people applies the suction cups for baby. If I am your treating Doctor I would advice you not to worry. The hematoma you have mentioned is disappear in due course of time. Only thing I advised you to have relax. hematoma is gradually absorbed by the body circulation. I would also like to ask you if you find any other signs of great injury to baby like scalp injury, eye injury, ear injury? If it is present than the problem is serious. Ask me if you are in further querry. thnx",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are night terrors suggestive of PTSD?\n\nHello. Sometimes my husband wakes up scared and stands up hyperventilating. It s usually triggered by a light touch, such as my hair landing on his arm, etc. Once he realizes he is safe, he goes right back to sleep. Could this be a sign of ptsd? He s never had an anxiety attack, that I m aware of.",
    "doctor_response": "DearWe understand your concernsI went through your details. First of all I wish to know why are you Asking \"Could the sudden wake up from sleep be a sign of PTSD?\" without any other additional symptoms in itself proves the problem is not PTSD. PTSD comes after a traumatic experience or event. It could mild, moderate or severe. Just startling is not a significant symptom in the case of PTSD. The significant symptoms include Feelings of intense distress when reminded of the trauma, Intense physical reactions to reminders of the event (e.g. pounding heart, rapid breathing, nausea, muscle tension, sweating), Avoiding activities, places, thoughts, or feelings that remind you of the trauma, Increased anxiety and emotional arousal etc. Does your husband experienced any traumatic events in the past?If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have constipation and no bowel movement, had chemo for lung cancer\n\nMy boyfriend has been diagnoses with stage 4 non small cell lung cancer squeamish cell second round of kemo not succesful so he just finished more radiation.  Has matastisised to brain which is in remission.  1st question last chemo was like six weeks ago he has constipation still hasn't had a bowel movement in six days now and dr keeps giving him meds but all they seem to do is give him pain and bloating.  He also is not scheduled for a ct until feb 17 and follow up with oncologist a week later to set up next round of chemo  he has just recently had a new onset of coughing up blood.  Should I call his oncologist or may bee even get a second opinion?",
    "doctor_response": "Good day there! Constipation with associated malignancies and chemo rounds is very understandable and needs monitoring and reajustment of doses with monitoring and symptomatic relief. You should call an oncologist and yes you can have a second opinion with seeking gastroenterologist help. Meanwhile Increase fluids and electrolytes replinishment with fibrous diet and some laxatives are advised. Good luck and take care of your boyfriend.regardsS Khan",
    "dialogue_context": ""
  },
  {
    "patient_message": "When is it safe to run after having hepatitis B +ve?\n\nGood morning doctor, I'm a 32 yr old female was suffering from jaundice n diagnosed for hepatitis B +ve. I've recovered from jaundice fully i.e. billirubin count was 0.8 last i checked on 4th of october.My doctor is saying we'll get the HBsAg check done 0n 15th of next month. He is quite +ve it'll come negative. I used to run at least 6 to 7 km everyday before jaundice now I've started going for walks in the morning. But getting temped to run a bit. What will u suggest. With regards n thanks....",
    "doctor_response": "Hi I appreciate your concern regarding healthy life style adopting after positive for hepatitis b.Yes usually after getting acute hepatitis b infection approx.90 to 95 %patient recovers.Only 4 to 5 % can be carrier or chronic hepatitis.So continue with healthy life style until viral marker comes negative.Instructions for you.......-omega 3 fatty acid oil can used in meal like sunflower or olive oil-avoid refined food and sugar-avoid smoking and alcohol-fruits more -green leafy veg useful-avoid trans fat like cheese, burger, meat , butter etc...Continue regular exercise.Cumin seed with milk taken daily.Papaiya seed with lemon juice can also be good herbal remedy.Mostly your report will be negative.If HBSag comes positive then repeat after 6 month.if it comes positive after 6 month then carrier state is present.I hope your concern is solved.Take care.Dr.Parth goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for itchy scrotum which bleeds at times?\n\nI have a really itchy scrotum. My Dr has prescribed steroid creams in the past but they are not very effective so I stopped using them. For a while, I was slathering myself with vasoline which seemed to help for a while.but then the itching resumed so I have discontinued. I do hope you can help with this problem as i often scratch so hard that i bleed so this makes infection a hazard. Thank-you",
    "doctor_response": "HelloThanks for query.The itching of scrotum seems to be due to fungal infection Use topical anti fungal ointment like Meconazole twice daily.Ensure to wash your genital area with warm soap water twice daily before applying ointment .Ensure to wash your inner wares in boiling hot water mixed with antiseptic solution like Dettol .Ensure to use loose inner wares .This will get cures within 5 days.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can asthma due to allergy be treated?\n\nHAI DOCTOR GOOD EVENING I AM ZAIN FROM MANGALORE, I AM HAVING ALLERGIC PROBLEM  OF SNEEZING   ASTHMA PROBLEM COULD NOT ABLE FIND OUT REASON FOR ALLERGIC  HOW TO FIND THE REASON FOR ALLERGIC ,IS THERE ANY FRUITS CAUSE ASTHMA ATTACH PLEASE GUIDE ME DOCOTOR",
    "doctor_response": "Hello Zain,Thank you for asking at HCM.I went through your history and would like to know more about you like - a. Since how long you have allergies and asthma? b. What is the frequency of your asthma episodes? c. What are your nose symptoms? d. What are the best and worst seasons for you? Above details will help me more to guide you better. At present, I would like to make suggestions as follows:1. Were I treating you, I would suggest you regular montelukast and levocetirizine for at least 2-3 months.2. I would also suggest you to use salbutamol inhaler on as-and-when-needed basis for asthma symptoms/wheezing/breathlessness.3. I would suggest you allergy testing which will help you identify the substances causing allergies to you and also to know the measures to avoid them.Common asthma-allergy causing substances are air-borne substances like house dust mites, cockroach proteins, molds and pollens in your environment and animal proteins (if you have pet/s).Based on the allergy testing, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which works on immune system to gradually improve allergy symptoms in a long run.4. In general, please avoid exposure to dusts, smokes and air pollution.5. Regular breathing exercises (including Yoga & Pranayama) and a healthy diet rich in vitamins & minerals (adequate amounts of green leafy vegetables, fruits, sprouts, etc) will also help you in a long run by improving lung capacity and immunity respectively.As you have asked about fruits, usually asthma is caused by many factors acting together, so any particular food is less likely to cause asthma. Of course, asthma attacks can be triggered by cold foods, cold drinks and some fruits.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling in fingers?\n\nHi Dr. Grief, My name is Al and I have been experiencing tingling in my right fingers andlike my fingers are going to sleep. It happens mostly when I go to bed or sitting still. When I exercise it does not bother me or play golf. I started wearing a support glove brace at night and seems to help sometimes. I also have a video for capal tunnel which includes exercises but I only used it for a short time. I quit but should probably start back. I am considering going to a hand speciallist.",
    "doctor_response": "hi,thank you for providing the brief history of you,A thorough neuromuscular assessment is advised.Based on your symptoms, what i feel is, you need a thorough neuromuscular assessment. As your history indicates the tingling of fingers, it can be due to two factor - 1. carpal tunnel syndrome or 2. cervical spine disc degenerative changes. Since you mentioned when you play gold your tingling is not evident it appears to me more of a sports related injury. May be your physician can recommend the NCV test first to rule out the carpal tunnel syndrome and later an MRI of cervical spine to rule out the soft tissue injury.Once diagnosis is made, you will be directed to physical therapy for proper retraining of the muscles of the neck or the forearm as per the requirements. Usually patients recover in 2-3 weeks of time in my clinical experience.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes one to faint while coughing?\n\nI have anemia, thalassemia minor and Thrombocytopenia. I had an episode when I passed out last January. I am having cough since last 2 days and today while I was coughing I almost passed out . can you please tell me the reason or suggest me the treatment?",
    "doctor_response": "Hi, There is a medical condition called cough syncope which means that a person passes out (loses consciousness) when they cough very forcefully or become spastic in their coughing (one cough after another without being able to stop). What happens is that there is pressure inside the head that is built up with the cough (or series of coughs) that prevents blood from flowing through the carotid arteries into the brainstem itself. When blood flow to the brainstem is interrupted in this way a person can temporarily lose consciousness. In your case, you didn't quite lose consciousness because there wasn't enough pressure to completely stop all blood flow to the brainstem. The treatment is to discover what is causing the cough and to treat that entity.  Eliminate the cough...or cough spasms... and you won't nearly pass out. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the extra piece of skin on anus in kid?\n\nMy daughter who is 2 1/2 years old has some sort of thing on her bottom.. i noticed it while ago but it seems to be getting bigger and when i wipe her bum after she has a bowel movement she says ouch that hurts .. thought mabey it was a skin tag but im not sure.. its kinda like an extra piece of skin right on her anus... could anyone answer what it might be?",
    "doctor_response": "Hi Dear Welcome to the HCM,It could be sentinal tag, can be easily removed by the surgeon.Hope the query is answered.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI shows L3-4 disc desiccation, right foraminal annular tear and mild diffuse disc bulge. Effects on body ?\n\nwhen an mri report is done and the result shows L3-4 disc desiccation ,ritht foraminal annular tear and mild diffuse disc bulge. No central canal or foraminal stenosis . 2. L4-5 left foraminal protrusion with mild impingement of the exiting leff L-4 nerve roots. what are the effects on my body. and i have tried just about every medication for the pain that i have been feeling before doing this mri report. what can be done to help my situtation",
    "doctor_response": "Hi, Thank you for posting your query. Your MRI of the lumbar spine (lower back) shows bulging of discs (soft tissue located between the bones) at two levels and mild compression of the nerves that exit from there. This can lead to low back pain and pain in the legs, along with tingling and numbness of the legs. Specific medications that may help you are pregabalin or gabapentin capsules. In addition, physiotherapy would also be useful. If you do not show adequate response to these, epidural injections may be given. Please discuss these with your doctor. Wishing you good health, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe pain and swelling in shoulder\n\nMy wife of 63 had rotatory cuff repair operation two years ago. Last week she woke up with intense pain in her shoulder and a pocket of what seemed like fluid in it on top of the shoulder. Not like a blister under the skin but a bit deeper. As it persisted the shoulder became more red and painful. Antibiotics don t help and a sonar showed fluid in the soft tissue above the joint but none in the joint or tendon. She has severe pain and fever an no one knows what to do. The shoulder is now severely inflamed and swollen and no pain killers help any more. I have resorted to administering Morfeen orally to help her cope with the pain and it helps, but the second course of antibiotics finishes tomorrow and has had no effect. She was also not bitten by something.",
    "doctor_response": "Hello, Thanks for writing to us, There is possibility of internal muscle injury around shoulder.Shoulder problem should be diagnosed with MRI and arthroscopic repair if required will give good results.Physiotherapy will help for early recovery. Physiotherapy like USG and TENS will help.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tiredness and chills?\n\nHi, I feel really tired and get chills. This happens every 2/3 days. I'm fine one minute and then then the next minute I'm absolutely shattered. I'm 43 and a female. Also I keep forgetting things and say the wrong things eg 'turn the volume down on the gas'! Recently had shingles in my head on the right side but the memory loss and tiredness/flu like symtoms were before I had shingles",
    "doctor_response": "HelloSince you are 43 years old and feels tiredness, chills , shattered , forgetfulness .All these symptoms are off and on ,  may be due to these reasons :1 Perimenopausal syndrome , just before onset of menopause the levels of estrogen and other hormones starts decreasing , so this may be the main reason. Diagnosis can be confirmed by blood examination for estrogen , androgen , progesterone . 2 Anxiety or tension ( stress )  is another most common reason of such symptoms .3 Thyroid hormone imbalance . Diagnosis can be confirmed by blood examination for T3, T4 , TSH . As I have noted due to imbalance many patients feel such symptoms .So deal as mentioned above , consult a primary care physician and get his opinion .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for headache and constant dizziness.\n\nHi. I m a 33 year old female who 8 weeks ago fainted in work whilst having a migraine. This has happened before so I was not that concerned. However, roughly 4 weeks later, I fainted again. This time no migraine. I assumed due to it being around my period, it was due to that. However the last two weeks I ve had constant headaches at different places on the head. I ve been constantly dizzy and on times almost fainted. I ve been to see my doctor who s sent me for blood tests and an ECG. All tests came back fine. He did say my blood pressure was low but it always has been so didn t think that would be anything to do with it. I ve suffered with migraines for about 6 years but never had headaches or dizzy spells as bad as this. For the past 4 days I ve nearly blacked out every day and the back of my neck and bottom of head feel like there s loads of pressure. This feeling of nearly blacking out happened in front of the doctor and he said that it could be because the room we were in was really warm, that I was dehydrated. He also said that I maybe suffering with vestibular migraines. I ve looked up the condition and the blacking out every day and I m still not sure that this is what I have. I m concerned about the headaches and the constant dizziness which has just appeared all of a sudden.",
    "doctor_response": "Hi, Please get a brain MRI done to exclude other causes. In the meanwhile, start preventive migraine therapy, with Topiramate tablets to prevent repeated headaches. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sudhir Kumar, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic asthma\n\nHello doctor, mu mum is a patient of chronic asthma and Hypertension . she takes losartan potassium 50mg 1times daily and amlodipine 5g 2 times daily.if she takes the drugs her BP remains 130/70. to control asthma she takes Seretide Accuhaler 50/250 puff 1times daily and sulbutamol inhaler 3 to 4 times daily and montelukast 10mg 1 times. my mum is 66 yrs old. my question is that. is it safe to take montelukast 10mg for long term use? as i see if she takes that medicine her asthma is controlled better . please give me some suggestion",
    "doctor_response": "Hello,Thank you for asking t HCM.I went through your history and would like to make suggestions for your mother as follows:1. Regarding your main query, montelukast 10 mg is usually considered very safe for long term use. Common side effects are nausea or stomach upset. If she is not experiencing such side effects, I would suggest her to continue it as it helps to control her asthma.2. However, salbutamol inhaler is a \"rescue\" type of inhaler, which should be used only for asthma symptoms like wheezing or shortness of breath. If she needs to use it 3-4 time daily, it means her asthma is not well controlled and she needs to upgrade her controller medications.3. Her controller medications are - montelukast and Seretide 50/250.So I would suggest her to upgrade dose of Fluticasone component of Seretide after consulting her doctor as daily use of salbutamol inhaler is not desirable. 4. I would also suggest you to make sure that the technique of using Accuhaler by your mother is perfect. If it is not perfect, there are chances that adequate amounts of drug might not be reaching to lungs. So please get her technique reviewed by her doctor.5. I would also suggest your mother regular breathing exercise and a healthy diet which will improve her lung capacity and immunity respectively.Hope above suggestions will be helpful to you and solves your query.Should you have any further query, please feel free to ask at HCM.Wish your mother the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are painful post auricular lymph nodes concerned for cancer?\n\nHello doctor, I am a 22-year-old male. I do no substance abuse, alcohol, and smoking. I have a painful post auricular lymph node swelling for four days. Yesterday evening one more post auricular lymph node was noticed which is swollen, sudden in onset and painless. I am taking antibiotics Augmentin duo (Amoxicillin and Clavulanic acid) and painkillers for three days. I am worried because one more lymph node started swelling and I even worried about cancer. Please help. Blood test was done lymphocytes - 55% and neutrophils - 30%, rest all values are normal.",
    "doctor_response": "Hi. Your complaint is suggestive of some ear or scalp infection, as it is painful. Please send a picture of the lesion, as it is possible that what you think is the painful lymph node is actually folliculitis and the painless thing is actually the real lymph node. In that case, the antibiotics that you are currently taking are appropriate. The dose should be Augmentin Duo 625 (Amoxicillin 500mg and Clavulanic acid 125 mg) twice a day for five days. Do not stop before five days. Take tablet Combiflam (Ibrufen 400mg and Paracetamol 325mg) twice a day for two to three days. Regarding the risk of cancer, size of the painless lymph node is a very important parameter in deciding further investigation. If the size is more than 1.5 cm then FNAC (fine needle aspiration cytology) of the lymph node is usually recommended. This test needs to be done if after taking the above-mentioned treatment for five days the swellings continue to persist. Gram stain and culture of any discharge. Acute lymphadenitis. Lymphoma. Folliculitis. Continue antibiotics to complete total of five days. Painkillers as required. Hot and cold fomentation. Maintain scalp hygiene. Followup is must if the swelling persists more than a week. Follow up with pictures both before medicines and after a week.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having developed a large boil containing fluid below the knee\n\nI had a radical hysterectomy for endometrial cancer done 3 months ago.I had swelling on my feet.and about a week back I had a road accident.I have developed a large boil containing transparent fluid on my leg below the knee .there is no fracture or dislocation. Is it normal?what is the remedy?",
    "doctor_response": "HI, thanks for using healthcare magicBullae can sometimes form as a result of trauma to an area.It would be best to leave the lesion. It will likely burst on its own. If you try to puncture it on your own, it may introduce infection.If it is increasing in size or associated with signs or symptoms of infection then you may need to see your doctor for assessment.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can unprotected sex without ejaculation inside vagina cause pregnancy?\n\nHello doctor,My wife had her last periods 15 days back. The period lasted for about four days. We had a sexual contact a week later. She had her periods completed on Tuesday, and we had this on Thursday, and it was not intercourse. I was not able to penetrate her and was only sliding against the outer lining. Since it was unprotected, so as soon as I got the feeling of ejaculating, I withdrew. After that, I ejaculated outside. But I have a little doubt that maybe a drop or so might have come out when I felt like ejaculating and may have got on her outer vagina or slightly inner vagina. Are there any chances of getting pregnant? I doubt because of a drop that might have come out. She has a regular cycle of 28 to 30 days.",
    "doctor_response": "Hello. There is almost no chance of pregnancy in your case if you are sure that the drop of semen just touched the outer vagina. Pregnancy happens only on penetration intercourse with some volume of semen ejaculated inside into the vagina. Practically, I feel there is no chance of pregnancy. Also, the time period that you had intercourse is her safe period and not the fertile window which further reduces chance of conception. There is no need to worry regarding pregnancy or even take a contraception. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for discharge from infected tooth\n\nI had pulp extirpation on an infected tooth last Tuesday, following an emergency.  It recovered well but since yesterday has started throbbing. Is this normal? I have an appointment to have the tooth extracted next week - I have a long history of problems with it and have agreed with my new dentist that this is the best course of action for me.",
    "doctor_response": "HelloIf there  is throbbing pain associated with that tooth, it might be due to blood clot formed inside the pulp chamber when pulp was removed or some remaining  pulp which is causing the irritation. It will go when you extract it.It is normal.Thank  you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does solid mass in liver, bilateral renal cortical cysts, mild prostatomegaly indicate?\n\nSir,As per my recent scan report of my father - 85 Years , Pls let me know your comments and criticality of the issue.Scan report follows,1. solid mass in right lobe of liver2. left renal calculi3. bilateral renal simple cortical cyst4. mild prostatomegaly Thanks and RegardsM SundaramoorthyBangalore - India",
    "doctor_response": "hi.noted ct-scan results. first, your father has an enlarged prostate (mild prostatomegaly). this usually happens as male population age and if the patient has a history of benign prostatiic hyperplasia. second, your father has kidney stones (left renal calculi) and third, simple cortical cyst in both of his kidneys (bilateral renal simple cortical cysts). the most important thing to note about these two are the sizes and if they are causing obstructive symptoms in urination of your father. the last and probably the most concerning finding is the solid mass in the right lobe of his liver. what are the characteristics of the lesion and how big is it? is your father experiencing any symptoms such as weight loss, pain, jaundice, fever? it is best if you bring him to a doctor, a general surgeon and a urologist, for complete physical examination and clinical evaluation. other diagnostics (such as liver function tests, bilirubins, tumor markers, blood exams, etc.) and management (medical and/or surgical if indications are found) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain under right rib cage?\n\nI fell and hurt my ribs on the right side. I don t think anything is broken,but something isn t right. It s been a week. most things don t hurt but some things hurt alot. I m afraid to get an x-ray because its over my heart. Most of the pain is when I lay down, it hurts more when lying on my right side.Sometimes when i get up it just feels like things are squished! The question is how long would bruised ribs hurt, and what else could be causing the pain.",
    "doctor_response": "Hi, It may be due to minor contusions that have developed following the fall. Nothing much to worry and you can take analgesics like Tramadol or acetaminophen for pain relief. If symptoms persist, you can consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain and sensitivity in forearm\n\nI have had for 2 days sharp pain in my forearm area, 3/4 up my arm, in the tendon muscle area, when I push in that area sensitive -- no idea why, sharp acute pain comes out of nowhere - also knuckles hurt and wakes me up - 62 yrs old, excellent shape, good over all health, but that same hand s thumb is arthritic so it might be connected?",
    "doctor_response": "Hello, Cannot say in your particular case, but generally, localizing pain to what is painful is the first step. a classic way to differentiate heart from muscle pain is if the muscles are sore to touch or movement then not the heart. We generally are NOT aware of stresses that cause pain later on in tendons and joints. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am gaining weight. Should I increase dose of Eltroxin?\n\nHi doctor,I am 58 years old. I have been diagnosed with hypothyroidism 20 years ago. I am on Eltroxin medication since then, 100 mcg daily and twice a week 150 mcg. My T3, T4, and TSH are normal as I do blood analysis every six months. I noticed I am gaining weight from three months although my diet has not changed. Should I increase the dose?",
    "doctor_response": "Hello. Since your thyroid test results are normal and considering your age, it is not advisable to increase the dose of Eltroxin just because you are gaining weight. If a person does not exercise much and after a certain age, he just keeps adding the weight every year just because aging slows the metabolism naturally. So, instead of increasing Eltroxin (Levothyroxine), I would recommend that you try to walk every day and control your diet. For more information consult an endocrinologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any side effects from using Obimet SR and Ovacare and Nurac HR for PCOD?\n\nI have slight PCOD. I am 37 years. Doctor advised me to take Obimet SR 500 mg twice a day alongwith Ovacare and B vitamin tablet Nurac HR. What are its uses. Do they have any side effects. Doctor has advised me to use for months together. Please advise me.",
    "doctor_response": "Hello, Since you have been prescribed Obimet SR, you have type 2 DM for which you have been given this medicine. (you have not mentioned here that you have diabetes). Ovacare & Nurac HR are commonly given to women who are trying to conceive. These are given to support ovarian function & restore the menstrual cycle by correcting anemia. Yes, all the medicines have side effects so take medicines cautiously and as advised. You may experience side effects like nausea, vomiting, headache, dizziness, rash , etc. If you get uncomfortable you should report to the treating doctor immediately. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Nupur K, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for appetie loss in a child\n\nHi .....my 4 yr old grandson has been sick for 2 weeks he feels bad off and on isn t eating much has seen MD 3 times and been to er they can t find anything wrong but he has fever off and on......but tonight when he vomited it was bloodand i Am really afraid for him any ideas what it might be?",
    "doctor_response": "Hi,   I understand your concern.   -. First  keep a record of his temperature reading  of the fever by using thermometer for 2 days every 2hourly.Sometime body gets warm,because of weakness,still temperature remains normal. - If you find definite  rise/fall in temperature, your child needs an expert child specialist's consultation, needful investigations & specific treatment. - The blood in vomit must be due to starving out of loosing appetite. Offer him cold milk( not freezed)/non spicy food to avoid it, Consult your doctor for use of Ranitidine syrup., in case it repeats. - For lac of appetite, mild rise in body temperature- he needs-   -    Rest, easy to digest, nutritive diet that  he likes.( Chicken soup/boiled egg, Fresh fruits/juices)in multiple small servings   - Vitamin( specially B complex )supplements help in raising appetite level.Ideally lacto bacillus containing tonic help.  - Protect him from extreme weather/ allergens/ unhealthy food till he regains his resistance.   He should be all right within 15 days.  Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for diarrhoea in a child\n\nhi, my child is 19 months and is having cough. now she has has developed loos motions. when ever she is coughing she tend to wet her pajamas with very small wattery loos motion. out doctor advised sporlac powder. can we give he some other medicin for stopping loose motion",
    "doctor_response": "Hi...It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron (as prescribed by your paediatrician).Regarding diet - You can use cerelac...any flavour will do. Avoid fruit juices as they might aggravate diarrhea. You can give zinc supplements & ORS apart from normal vegetarian porridges & soups.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have irregular periods. Have pcos and taking oosure, pioz. Is there chances for pregnancy?\n\nhi... i am diagnosed with pcos... and i am taking now oosure and pioz... i was suppose to get my periods on 8th but got it by 14th of this month.. i have irregular periods... but i started my oosure and pioz last month and without taking any other medicine i got my periods now... can you tell me when i will get pregnant... and is there chance for my egg to mature",
    "doctor_response": "Hi, Thanks for your query. Oosure(myoinisitol) is using for ovulation at 14th day of menstrual cycle and induce ovulation also because in PCOS cycles are generally anovulatory. Pioz(pioglitazone is antidiabetic drug use to decrease the symptoms of hyperinsulinaemia which is present in pcod. Because with these two drug symptoms of pcod decrease and chances of ovulation increased or cycle become more regular and chances of pregnancy increased. GOOD LUCK.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I had a blood transfusion and was detected as hepatitis B positive now billurubin and Liver enzymes are normal. Is it a acute or chronic infection ?\n\nHello I am 26 years old, i had a blood transfusion in Aug 2010 and detected as hepatitis B positive in Apr 2011 when I got hospitalized because of jaundice . It took six weeks to recover from jaundice. Now my billurubin and Liver enzymes are normal. Please tell me whether is it acute or chronic infection (as most probably I got infected at the time of blood transfusion)?",
    "doctor_response": "welcome to healthcare magic .... If you are HBsAg Positive for more than six months after your diagnosis of Hepatitis B then you are considered to have Chronic form of Hepatitis B. If your HBsAg levels are negative with in 6 months of your diagnosis , then you had an acute form of Hepatitis B infection. Just check your HbSAg levels i.e HBs Antigen levels by september 2011 and if you are positive - you are a chronic carrier else you had an acute episode.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in lower left abdomen, spreading to lower back and hip bone, constant back pain. Reason ?\n\nhiii....its about a month ago...i wake up in the morning and had pain in my lower left abdomen that spread to my lower back and hip bone....since then i am having on and off pain in abdomen that is very low and i cant even feel it some times..but back pain is constant...which is not severe but i can feel it....i also have headaches some times...what could be the reason?",
    "doctor_response": "Hi,Thanks for posting your query.It could be due to muscle spasm , bowel or renal pathology. Thorough examination and ultrasound is required to diagnose the condition.I suggest you to consult your doctor for examination and treatment acc. to that.Hope this will helps you. Feel free to ask me if you have any further queries. Wish you good health. Take care.RegardsDr Saurabh Gupta",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for kidney, gall bladder problems\n\nI've been in the hospital several times this week in the emergency room for Kidney problems then the ER Dr. prescribed some antibiotics for my kidney, I took this medication and it made my body hurt so much, a lot of pain, I went to another Dr. and that Dr. told me that he thinks the pain may be a cause of my Gall bladder. my enzymes were very high from my liver. My body is very itchy and under my skin it hurts everywhere and if i itch it makes it worse and I begin to break out in blochy red sores.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have gall bladder problem, high liver enzymes and itching. Your symptoms suggest gall stone with or with out cholycystitis. You should go for ultrasound abdomen and complete liver function test. It will give you exact diagnosis. Then you should take treatment accordingly. Chronic calcular cholycystitis can be treated by surgery or conservatively. Consult your doctor and take treatment accordingly.Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back pain, sore throat and itchy eyelids?\n\nI have a relative that has the following symptoms - these symptoms may not all be related but this is what he is experiencing - 1)  falls asleep standing up, 2) frequent lower back pain on lower right side of back, 3) frequent/daily heartburn, 4) trouble urinating - feels like he has to go but can't right away - 5) itchy eyelids( under rim of eye) (occasionally), 6) complained of sore throat recently",
    "doctor_response": "Hi, welcome to health care magic.after going through your query my opinion is that your relative is suffering from urinary tract infection. due to it he cannot take proper sleep that lead to day time sleepiness. take analgesics, antibiotics, antacids and increase daily fluid intake. visit opthalmologist and gastroentrologist, and urologist. get sonography of whole abdomen done. Hope your query get solved. Welcome further queries. .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of the slipped disk problem?\n\nHi Doctor, I am having slipped disk problem because of which my entire right leg is paining. I consulted a physio in Fortis hospital, bangalore and took the treatment for around 4 days but did not help much. Can you suggest me what to do to overcome from this issue ?",
    "doctor_response": "Hello, As any slipped disc will take some 4-6 weeks of time. Undergoing, 4-5 days of physiotherapy session will never be helpful. You need to continue for some time and post that management of the same. In my clinical practice of over 12 years, most slipped disc requires 4-6 weeks of the time of therapy. It pain level is high then therapeutic ultrasound therapy and TENS therapy for reducing inflammation and pain. Post which exercises like - core stability, spinal muscle strengthening exercises, hip muscle strengthening exercises, straight leg raise, static quadriceps, static hamstring and ankle toe movements.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nerve pain while suffering from paralysis?\n\nMy aunt is partially paralyzed and she experiences various kinds of nerve pain, she is currently taking several medications to control those pains, my question is what other forms of pain or illnesses should she expect? She has been paralyzed since 2010 and was never prepared or spoken to about what to expect with her condition.",
    "doctor_response": "Hi, She may be having fibromyalgia or regional pain syndrome. Both are chronic pain conditions and are quite difficult to treat. She can take analgesics like Tramadol or Gabapentin which can provide symptomatic relief in these patients. If pain persists, better to consult a pain physician and get evaluated. Emotional support is also very important in these conditions. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for elevated Low-Density Lipoprotein?\n\nI just had a CMP - all results were normal, except that I have elevated LDL. I do drink alcohol and I have read that too high of an HDL level can be a sign of alcohol related problems. Also, my AST/ALT ratio is 1.6. However that being said, those numbers are very low at 24 and 15. Does my liver seem to you to be healthy? My bilirubin, etc. were all normal.",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. ALT, AST levels are within the normal range. Its good.2. If the ratio is more than 2, then liver problems can be thought of. At present, your liver is healthy.3. Take low fat diet. Along with it moderate exercises will help in improvement. Elevated LDL will reduce.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the cervical lordosis be the cause for headaches and back pain?\n\nHello. I was the driver in a car accident. The other car hit the front left of my car. I was driving a small jaguar and hit the side of my head on the drivers window. My car was totaled. I went to the hospital and they did a ct scan w/o contrast on my head and spine. The findings were.... There is mild reversal or normal cervical lordosis. Strain-cervical. Closed head injury. The therapist I ve been seeing said my range of motion has been affected. Extension 31%,Lexion 42%,left rotation 64% and right 48%. my neck hurts all the time and makes noises when I turn my head either direction. The wreck was 3 months ago and I have had a head ache almost every day, confusion and back pain. My question is....is the cervical lordosis the cause of my problems and could it have been caused by the wreck. I don t seem to be getting any better and I m worried if I settle what are the long term effects this can cause me? My dr hasn t even mentioned this to me I saw it on the hospital report. Any info u can give me I would greatly appreciate.",
    "doctor_response": "Hello!Welcome on HCM!Regarding your concern, I would explain that cervical spine trauma can lead to chronic headache, especially in the back of your head. This is caused by the muscle spasms in the neck, which extend to the back of the head. It can also lead to irritation of the occipital nerve, which lies in this region, causing this type of headache. But, a long time has passed from the accident and you should feel better now. As your troubles persist, I would recommend consulting with a neurologist for a physical exam and a cervical spine CT scan or MRI. You may need to hold a cervical collar if evidence of cervical disk protrusion are revealed in these tests. If this test result normal, you should consider post-concussion headache as a possible cause underlying your troubles. In such case, an antidepressant would help relieve your symptoms. Hope you will find this answer helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the sudden deterioration of the femur bone?\n\nthe top of my left femur disappeared over a 3 mo. period and am told I have necrotizing faceitis...due to possibly a fracture that was found.recently a dr. told me it may have,and most likely was caused from a bed wound that exposed my spine....can someone tell me what really caused my bone to deteriorate that quickly?I also was ending chemo for ovarian cancer when all this began last year.",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern. Hip bone is reabsorbed following fracture neck of femur. It may have possiblity that that following fracture neck of femur many times head and neck get absorbed. So I see most likely cause of your bone disappeared following fracture neck of femur. Other less likely cause can radiation which you get following your cancer treatment.You can discuss with your treating Doctor about it.Hope I have answered your query.If you have any further questions then don't hesitate to writing to us . I will be happy to help you.Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could pain and swelling in knees after an injury indicate?\n\nHi , I banged my knee badly on a water slide on Saturday , it didn t swell up but it has been causing me some pain ever since , I can bend the knee but walking and driving hurts and any pressure to the top of my knee hurts quite a bit . What should I do ?? Ibuprofen doesn t seem to help at all !",
    "doctor_response": "Hi, I think you should visit a hospital ER and get an x-ray of the affected part. Even if there is no fracture, you should have plaster cast for 3-6 weeks along with paracetamol and multivitamins. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nirmal Chander Gupta, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the semen analysis report 4% less than the normal morphology having 3 kids?\n\nhigh dr im a physcion i have 3 kids before last one sience 15 years my wife do all investigatios it was normal as well folliculomerty for ovulation normal fo each cycles ,when i do semen analysis for sorry i discover less than 4% in normal morphology ,count was 100milion,more or less normal motility NB i was smooker but now i stopped also potentially diabetic under control (just mild impaired GGT) and also in mypast history i received interferone injection for ttt of epatitis c sience 4 years, also ihave mild lt varicocle without reflux effect plez  till me the ideal solve in your openion  and why i complain now although me having kids before",
    "doctor_response": "Hello and .As an Urologist, i can fully understand your concern.Your semen analysis test must be done after 2-3 days without sex.If your last semen test was done more than 3 months back, repeat it.You should get blood male hormone tests like, testosterone, FSH, LH, PRL,and HbA1C, done. When and how many Interferone injections have you taken.  Kindly send your reports with scan, in my name, as a direct question for an expert opinion.Wish you well.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Disabled, pain in umbilicus, red line from navel to right side, stage 3 rsd. Advise?\n\nI have had severe pain in belly button literally feels like tearing inside and a very red line from inside navel to almost quarter inch to RT side by where scar was from aperoscoot from iver five years ago...ain s barbaric and I have stage 3 RSD so that says a lot...really scaredThanks for zero,am on DISSABILITY and live alone,cant drive and can't afford.s much for caring DRS",
    "doctor_response": "THIS CA BE DUE TO SOME MEDICINES TAKING FOR YOUR DISEASESPAIN KILLERS CONTAINING PCM BRUFEN VITAMINS DIET SUPPLIMENTS AND OTHE CAN CAUSEGET INTENSION TO SALTS OF MED YOU ARE TAKING AKE NON OILY NON FATAND NON SPICY DIETLOT OF WARM WATERLIQUID ANTACIDS TDS AFTER MEALS AND MEDICINESAKE EBASYNE 10 MG BD OR OD LONG TILL YOU GET DIAGNOSIS AND SALTS OF MED CAUSING THISAPPLY LOCAL ANTIALLERGIC CREAM OVER SCAR AREAMEFTAL SPAS SOS FOR PAIN",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever in case of TB in spleen and liver?\n\nhi..i'm 23 yrs old.i have been daignosed by T.B in spleen and liver. i had liver test for medicine side-effects and had infection so taking oflox medicine.i've been taking its treatment for 5weeks but i still have fever around 100 degrees with oflox and paracetamol.For how long fever will remain and start getting down?I feel alot of weakness and had typhoid before.Why do i hv such low immunity?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.Yes, you are right, this is really sign of weakened immune system especially in your age and this is really serious issue which require intensive measures. Fever is sign that infection persist despite antibiotics and you need to repeat CAT scan and see if abscesses resolved or not. If not, then you may need surgical drainage of abscesses and then repeated antibiotic treatment. At same time you should evaluate imunse system to see if there is some specific immune disorder. I hope I have answered your query. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am scheduled for a joint block injection in my right foot due to arthritis pain. Will it pain a lot?\n\nHello doctor, I am scheduled for a joint block injection in my right foot due to arthritis pain. Will I be able to drive home myself from my appointment or do I need to take someone with me?",
    "doctor_response": "Hi. The injection given for the joint block for arthritis contains some local anesthetic. So, you may not feel pain at least for half an hour to one hour. You will be able to drive the car. But as soon as you reach home, keep your leg elevated and apply some ice packs as it may bother you that evening. Hope it helps. For further clarifications consult an orthopaedician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please give a second opinion regarding my knee surgery.\n\nHi doctor, I am a 31 year old female. When I met with an accident before six years my left leg below knee got injured and the doctors has done wrong surgery. Please help me.",
    "doctor_response": "Hello. Revert back with reports and more detailed history to an orthopaedician and traumatologist online.---->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a bad odor from the mouth\n\nI have a really strong odour that comes from my mouth. It always has different smells like poo or somthing dead. ive been to the doctors dentists.  Had a gastrophase been tested for so many things.  When cars drive past there heads turn like they smelt me. Everywhere i go people cough around me like they gag. I dont no what to do and i hate to say it but im close to giving up. Every second of every day is uncomfterble. It started when I was about 18 and slowly got worse and worse and im 21 now",
    "doctor_response": "Hi in regard to your query, you have mentioned that you had visited doctors and dentists but you have not mention what did they say.Basically bad odour from mouth is of many reasons either 'coz of poor oral hygiene or any systemic diseases like diabetes, liver insufficiency, kidney diseases etc... since you have mentioned something like dead i would suggest you check your diabetic status since you are healthy with your gastric status.I would suggest you to undergo complete health check up with your systemic status and make sure you are healthy and go for dental check upp to confirm that your oral health is good tooo. Hope this is helpful.Without treating the systemic cause treating the only oral causes will not help.Hope this is helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can any online doctor tell me about my mother's kidney condition and am i going in the correct way of treatment ?\n\nHello - My Mom 76 years old has been suffering with phylonephritis for a while and her creatine levels have been fluctuating from 3.1 to 3.4. She is 5 2 and because of the water retention now weighs 198 (regular weight is about 175). She is diabetic (insulin dependent 12 units NPH in the evening and 22 units in the AM), has high blood pressure and stage 5 kidney disease. Her last visit to the nephrologist revealed that her creatine level went up to 3.9 (the highest it has ever been). To keep her from dialysis , the doctor gave her Metolazone 2.5 mg to expel the excess water from her body. This medication which she just started to take yesterday is to be taken 1/2 hour before her regular diaretics Furosemide which he increased from 20 to 80 becasue of her recent retention of fluids. Will this new medication help to keep her off dialysis if her creatine levels should go down (at least for a while). When would she need to definately go on dialysis (what would her creatine levels be?) What can I do to keep her off dialysis? Your assistance/guidance is much appreciated. If I am a match for her, I would like to give her one of my kidneys should dialysis be necessary. Thank you for your advice in advance",
    "doctor_response": "Thanks for the query. it is hard to predict when she will go on dialysis. If she is expelling more than 900 ml of urine per day then she might not be put on dialysis, dialysis is one of the best mode of treatment for chronic kdney disease, she will feel good immediately after dialysis as all the excess water will be removed. Dont shy away from it or be scared of it. have a healthy living",
    "dialogue_context": ""
  },
  {
    "patient_message": "Took shock treatment for mental disorder. Can you help me find a doctor?\n\nHi, this is roshan. My sister during her initial state of mental disorder, she used to murmer on herself. My father found this unusual behaviour in my sister and took to a doctor, where she underwent shock treatment for 3 months. For my sister we had treatment with phyciartist in anantapur district of AP. She is not so active as she is before. We want to meet a phyciartist in Bellary. If possible please provide me the good phyciartist details in Bellary.",
    "doctor_response": "Hello  She had complaints of muttering and unusual behavior. She was most likely suffering from some psychotic episode and possibly schizophrenia. Shock therapy or ECT is very nice modality of treatment which is devoid of major side effects and is effective in acute stages of illness. But it should not be used solely for maintenance purpose. For medicines you should consult her psychiatrist again for detailed evaluation. She is not active like she was before, this might be due to her illness only and negative symptoms of disease. Regarding Psychiatrist in Bellary, you can visit medical college and hospital for expert opinion. Thanks Dr. Seikhoo Bishnoi, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are my right knee and hip pain due to osteoid osteoma?\n\nHello doctor, I am suffering from right knee and hip pain, for more than one year. My MRI reports showed a right femoral neck stress fracture with surrounding edema and osteoid osteoma. The doctor saw my blood and MRI reports and suggested taking capsule Sunbless 60K, tablet Ezorb forte, and tablet Voveran 50 gm.\u00a0But I am not feeling any relief, in fact, the pain is going from severe to unbearable.\u00a0The doctor asked for a PET scan. I am very desperate due to this problem. I have attached my reports, kindly help me. What should I do?",
    "doctor_response": "Hello. I understand your concern and would like to help you with it. I have seen your reports (attachment removed to protect patient identity). Feel free to discuss further. For further queries consult an orthopaedician and traumatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need treatment for sprain in the ankle and lower back after falling down.\n\nHello~ I was Dx a year ago with RSD after a fall where I severely sprained my left ankle and lower back. I do experience all the symptoms however it is not isolated to my foot. At times the entire left side of my back swells up as well as my leg. When I go for my checkups the doctor only concentrates on my leg and not the complaint of my back? Could there be something else going on? Thanks, Maylene M.",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. With your given history of reflex sympathetic dystrophy, it is a clinical syndrome of many unknown causes like minor traumas, infections, surgeries, with an unclear course of pain attacks, vasomotor dysfunction, strokes, characterized by pain, swelling, and vasomotor dysfunction of an extremity. So don't worry this syndrome is a bit rare, your back pain and swelling is co-related to your ankle trauma. I don't think there are another complaints. If you early diagnose the RSD you may ask your physician about a sympathetic blockade with anti inflammatory drugs as a first line of treatment. Sometimes surgical sympathectomy is needed if there is spinal injury  for your back swelling and pain. If you are unable to do your usual normal activities or reached late stages which I think and hope you are not you may use spinal stimulation ( Epidural implantation of a spinal cord stimulator which has been shown to provide significant, prolonged pain relief and functional improvement) only if needed or after at least 6 month of chronic pain.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Ahmed Aly Hassan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes flu symptoms, joint pains and fatigue?\n\nMy teen daughter has fatigue, flu like symptoms, slight depression, joint pain and general feels bad. she spent time in the Yukon last year and has not been the same since. she came back with lots of mosquito bites and tick bites. Could she have something because of this....",
    "doctor_response": "Thanks for posting your query to health care magic.yes offcourse insect bie can leads to transfer of some kind of parasitic or viral illness .flu like symptom may be due to some influenza like viral illness .you need to undergone some investigation to make diagnosis :Peripheral blood smear examination for parasite 2.Complete blood count .presently you can give her paracetamol 500mg for fever and pain  with water as and when nedded or 8 hrly after meal .review me after investigation report .Feel free for any further query.Regards,Dr.Manish PurohitInfectious disease specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes burning while urination in a 3 year old?\n\nMy daughter is three years old and she told me it burnd when she peed l and she started weting her pantys so I put her back in pull ups and took her to the dr and they done urin test they all came back negative for infections but there was traces of blood in her pee so they are sending us to a uroligist and im worried bout what it could b causing this and what will be the treatment! Thank you!",
    "doctor_response": "Hi....by what you quote I feel that it could be a viral associated cystitis or inflammation of the urinary bladder.As she has got blood in the urine we need to check her blood pressure too. If it's normal- most probably it is cystitis. But if blood pressure is high then we need to consider renal and glomerulonephritis as cause for blood in urine.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hypothyroid taking 50mg thyroxine, hairloss, pricking sensation in eye. Can it be Candida?\n\nhi there, i m 43, 5ft 7, 9st 7... I am hypothyroid taking 50mg thyroxine . I have had hairloss now for 21 months, also i have developed an annoying pricking sensation in the eye ... any ideas on the hair and eye? I m wondering can it be Candida? I am on iron tablets and Vit D .... still struggle with tiredness and depressive tendencies .... ?",
    "doctor_response": "Hello, welcome to Healthcare Magic. It is difficult to comment about cause of hair loss and eye irritation in your case. But one thing is clear from your description that your weight is very less. Malnutrition can lead to hair loss, dry eyes and depressive symptoms. In your case, it is better to get investigated for low weight. Same time start healthy diet and weight monitoring. Wish you all the best. Regards, Dr Ashish Kumar Mittal www.99doctor.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for heart palpitation and chest pain\n\nHi, I am a 27 year old female, 5'7\" and 306 pounds. I have a history of anxiety and panic attacks and heart palpitations. However today I have been having palpitations since about 9 am, they come and go but hav been getting a pain in the middle of my chest(sharp) when the palpitations happen. I am also a smoker. What is going on?",
    "doctor_response": "Hi welcome to HCM. I understand your concern.Well there can be few causes of palpitations. I would like to know have you ever had an ECG done for your palpitations? Any past consult for these palpitations.It can be because of increased consumption of alcohol, caffeine, anxiety itself, deranged thyroid hormone levels, some underlying heart conditions not previously known causing irregular beating of the pump.Usually taking a dose of beta blockers can help provided there are no contraindications to their use e.g asthma, Diabetes etc.I hope my consult proved of some help.Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does brownish or pinkish discharge after intercourse indicate pregnancy?\n\nMy period ended 2 weeks ago. I have been having unprotected sex with my Husband for a week now. 2 days after the first time we had unprotected sex i have a brownish discharge. then it changed to pink. Yesteday after we had sex again watery pink discharge was coming out. Could I be pregnant? I don t want to take a test yet because I feel as though it is too early.",
    "doctor_response": "Hello,If you have regular 28-30 day cycles, it is likely that you were during the ovulation period when you had the intercourse. Fresh spotting can sometimes be seen during ovulation. Brownish discharge suggests old bleeding and can be due to some breakthrough bleeding. Other local causes that need to be excluded are erosion of the cervix, vaginitis, cervicitis, polyps of the cervix and uterus. Pregnancy tests cannot be done so early. A sonogram, local exam are helpful. A blood test for pregnancy can be done after a week. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had biopsy of prostate done. Had septic shock and high fever. Has blood infection. On respirator.\n\nHI MY DAD HAD A BIOPSY OF HIS PROSTATE AND WENT HOME FINE THE NEXT DAY HE HAD A SEPTIC SHOCK 104 FEVER THEY SAY ITS DUE TO THE BIOPSY HE HAS A BLOOD INFECTION AND IS ON A RESPIRATOR AND ALL TEST HAVE CAME BACK GOOD THEY SAY ITS A BACTERIA BUT THE INFECTION IS NOT GETN BETTER ITS NOT GETTING WORSE BUT HE IS STILL N ICU TOMORROW THEY ARE SUPPOSE TO REMOVE HIM OFF THE RSPIRATOR SO HE CAN BREATH ON HIS OWN WHAT KIND OF QUESTIONS SHOULD WE BE ASKING AND IS THERE ANYTHING U CAN SUGGEST TO MAKE HIS HEALING PROCESS BETTER?",
    "doctor_response": "HI, thanks for using healthcare magicI am sorry that your father is so unwell. The chances of sepsis following prostatic biopsy is low- 0.1% to 0.3%. Normally antibiotics are given prior to the procedure to reduce the chances of infection but in persons who develop sepsis it is suspected that the bacteria involved is resistant to the antibiotic that is commonly used- ciprofloxacin. Your father may have been given this antibiotic.This resistance is the most common reason for sepsis.You can consider enquiring whether this is the case in your father's condition.In addition whether the bacteria is still present on blood culture or are the cultures now clear of bacteria.His prognosis and course of recovery expected.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are fever and red color in leg due to TP?\n\nHi, may I answer your health queries right now ?  Please type your query here... my mom is suffering from filaria from last five year  and some fungal infection at the knee in same legs, now she is geeting attack after 1 week daily fever and all leg become red ,home time dr says that we have tp operate this",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Redness and swelling is due to filariasis.  Because filaria block your lymphatic vessels. You need to take treatment of that. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then you can contact me atbit.ly/DrsanghvihardikThanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swollen fingers. Suspected Eczema, treated with neoderm. Now fingers turning dark and dry. What should be done?\n\n3 months ago my finger were swollen itchy and rashes appear.a doctor said it was eczema.I was treated for eczema with steroid cream (neoderm).after the swelling gone i stopped for a few days.now my fingers become dry and getting darker and appear a bit swollen on before the nailbed part..why and what should i do to make it look back to normal.? Pls reply.thanks",
    "doctor_response": "Hi,Welcome and thanks for posting your query to Healthcare Magic.After reading your query it appears the possibility of \"lichenification\" with \"post inflammatory hyper-pigmentation\" over your fingers.It is a common process on the skin to get thickened after any chronic process such as eczematous condition over it. As you suffered from eczema so due to this the skin may get thickened and then it becomes darker due to the over activity of the color giving cells known as melanocytes.For the prevention and betterment kindly follow the suggestions below:-You can do warm water compresses to reduce the intensity of itching and improving the hydration of the skin over hands.-Do not scratch or rub the skin as it can lead to further aggravation.-You can take oral anti histamine like loratadine or levocetrizine under medial advise.- You can apply Fluticasone or mometasone cream under dermatological guidance which are mild potency steroid cream than neoderm. DO not apply any steroid cream beyond 3 weeks without your doctor's advice.- Apply plane white petroleum gelly for 5-6 times a day o whenever you fell dryness of the skin.By doing above measures you would be benefited in next 3 weeks of the period.Hope these informations will help.\"With good health wishes\"Dr Sanjay Kumar KanodiaMD (Dermatology & STDs)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring pain in lower back?\n\nI am a 23 year old student. About 3 months ago, I experienced a sharp pain in the lower right back. I went through tests for any kidney stone, but they were all negative. I also went through X-rays, MRI and a few blood tests. MRI and X Ray reports revealed no problems. However, my Vitamin D count was extremely low. It was 5 and according to the report normal range is 30-100. I am currently taking Vitamin D supplements. Its been a month now. But I started experiencing the pain again in the lower right back again. Please advise. Thank you.",
    "doctor_response": "HelloI can understand your concerns. You must continue with your vitamin D supplements and keep a frequent check on blood vitamin D levels.For the back pain, i have some suggestions for you:Avoid sitting for more than 30minutes at a stretch. Take a walk around in your room for 5-10 minutes.Keep your posture correct.Take a pain killer tablet when needed. Apply analgesic ointment over the painful area.Consult a physiotherapist to learn back strengthening exercises.Hope this helps.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take Virohep for Hepatitis B?\n\nHello sir , i am in complte state of shock as yesterday only i came to know thea i have hapetites b postive,, my famly phiscian advsed me to see gasto specialist immediately, i am a 24 year old working professional and lives in mumbai, having made an intensive search about the hapetites b in the interet i know that it cant be fully cured and the cost of treatment in allopathy is almost unaffordable for me which also has lot of side effects, i have come to know about the drug named\"virohep\", could u please advise me what should i do now, its jst the beginning of my career and i have caught this deadly virus which is goin to remain with me forever....pls help",
    "doctor_response": "Hello,Please don't panic , I can understand your apprehension,  Hepatitis B virus,  if you have gained it,  then first please get your family members checked (if it is negative for them, then ask them to get vaccinated immediately, available everywhere,  but anyone of them is positive,  they should go about the same way as I'm going to tell for you), first of all please consult a Gastroenterologist, so that few tests are done to see if the infection is active or not, if the viral load is high or not and the to check for the liver status,  not all Hepatitis B virus positive patients require treatment,  evaluation is a must,  and once you know if your disease is active and your viral load high, then you will be started on treatment (treatment at affordable prices are available,  and Govt also supplies medication for this- please consult), but if you have inactive disease with undetectable viral load,  then you will just be on regular follow up to see if the virus is present/ not present,  active/ not active and if the viral load increased,  so please don't panic, ( Hepatitis B spreads thorough sequel contact - please be careful until your doctor says), Hope I could help you.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is intake of Siphene 100 safe?\n\nHi Doctor I want to know, for many consecutive cycles siphene 100 mg tablet can be taken? does this tablet have any side effects? I have been taking it since 9 months. Can i continue the tablet for more cycles or can it impact if i continue for long?",
    "doctor_response": "Hi, Thanks for writing to HCM .I suggest you to discuss with your doctor as routinely if 3  cycles of siphene fails to conceive IUI should be done for 3 to 4 cycles. If still you won't conceive then siphene should be stopped and alternative ovulation inducing drugs to be used. Before switching to another drug I advice you to get your follicular study to know whether you have started ovulating normally. IUI is intrauterine ingestion of sperms . It will increase chances of pregnancy.  There are side effects of siphene like cervical dryness, headache, weakness, depression etc but these are minor and can be ignored.If you have following then you should stop siphene immediately and consult your doctor like leg swelling, breathlessness , abnormal and multiple enlargement of follicle .Hope I have been helpful .RegardsDr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shortness of breath after treated asthma\n\nHi, may I answer your health queries right now ?  Please type your query here... I have asthma, I use albuteral, symbicort and theophylline, still feel short of breath all the time, peak flow is good, can breathe in deep, just feel pressure ...Dr thinks its just an allergy..",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your history and would like to make suggestions for you as follows:1. I would almost agree with your current treatment. Were I treating you, I would add montelukast in your treatment.2. I would suggest you allergy testing which will help you identify the substances you may be allergic to and also to know the measures to avoid them.Based on the results, an Allegist-Immunologist may prescribe you allergen specific immunotherapy which works on immune system to gradually improve allergy symptoms over long term basis.3. In general, I would suggest you to avoid exposure to dusts, smokes and air pollution.4. Regular breathing exercises and a healthy diet rich in vitamins & minerals (adequate amounts of green leafy vegetables, fruits, sprouts, etc) will also help you in a long run by improving lung capacity and immunity respectively.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of potential pregnancy?\n\nim 18 yrs old and usually my period comes on the 28th or 29th but lately its been a little irregular but not by more than a few days. This month it came october 16th. I had unprotected sex the days that i think i was ovulating. Now I have been experiencing cramping and some light spotting(only when i wipe) for about two days now on and off 29th and 30th. I have also been extremely tired lately all i wanna do is sleep and im a tad bit nauseous but it may be in my head, and im having weird food cravings and increased need to pee!! could i be pregnant? or what is going on with me?",
    "doctor_response": "Hello dear,I.understand your concern.In my opinion as you have irregular periods the ovulation cannot be predicted.The spotting can be due to some hormonal imbalance due to stress or any.As you have irregular periods I suggest you to get evaluated for thyroid abnormalities,   PCOD , overweight, obesity ,stress etc.The first sign of pregnancy is missed period.If at all the expected period is missed I suggest you to go for urine pregnancy test after a week of missed period.The symptoms of pregnancy like nausea,vomitings,increased urination ,sore breasts start 2 weeks after missed period.So it is too early to feel any pregnancy symptoms.The thought of pregnancy also makes one to feel the pregnancy symptoms.So avoid stress and check for the period.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have tightness in chest. Is it start of a heart attack?\n\nHi doctor, I am suffering with cold and cough. A week before I had cold, I felt some tightness in my chest that was aching. It was associated with some burning sensation on top of my back and around my shoulder blades. Since I had cold, the condition has got worse and has remained for few days constantly. It is slightly painful and causes discomfort. I get quick sharp pain while stretching or lifting. The pain gets worse when I am standing. I have chest congestion and off late been coughing up yellow phlegm. My chest feels tight when I cough. I have been having neck pain too. I am very much worried and concerned about my heart. I will be flying for a few days so, now it is giving me a huge concern. I would like to know, is it the start of a heart attack? Please help. Thank you in advance.",
    "doctor_response": "Hi. I have thoroughly gone through your case and can understand your genuine concerns. 1. Muscular spasm for example: respiratory muscles like diaphragm, abdominal muscles, chest accessory muscles of respiration and back muscles. 2. There is an aching lung tissue because of bad cough. 3. Chest infection (respiratory tract infections). 4. When you cough on already aching muscles you will have chest tightness. This is known as the guarding reflex of the body. I would suggest you to start with these medications after consulting your cardiologist for physical examination. 1. Tablet Azithromycin (Zithromax). 2. Tablet Ebastine (Ebatrol). 3. Tablet Ibuprofen (Advil). 4. Start having a good cough syrup. 5. If you are not allergic to vicks, then apply vicks vaporub over the chest and neck to get better relief. 1. Start using a nebulizer. 2. Use vicks warm mist humidifier. In case you are allergic to vicks, then use only plain water in the humidifier. 3. Drink lots of fluids and take good rest. 4. In order to prevent constipation, take lots of fiber rich foods and whole grain containing healthy foods. 5. Avoid processed foods, coffee, tea and energy drinks. For further queries consult a cardiologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does consuming crab drip cause bruise on the face?\n\n13 year old grandaughter suddenly has unexplained brusing appearance starting from the corners of the lower lip corners decending doward to just under her chin. THIS STARTED A FEW HOURS AFTER EATING CRAB DIP. NOT SURE THE DIP HAS ANYTHING TO DO WITH IT.",
    "doctor_response": "Well it may have caused by allergy to some ingradient in crab dip and likelihood is much.Anti allergic medicine will help it.More so if you take Haridra capsules and neem capsules 1 BD ( Himalaya co.) and sugarcandy powder for few days it will go. These are turmeric herb and neem plant capsules pure herbs. No side effects. May add Haridra Khand - an Ayurveda medicine ( not tasty) 1 tsp BD for enhanced advantage. May ask Ayurveda doctor near you.Be sure it will help your daughter.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can infertility be treated?\n\nHey there, my name is Amber and me and my boyfriend have been trying for a baby for the last few months now and nothing... I was just wondering if prenatal vitamins would help increase my chances of getting pregnant? And what are some things that I could do to increase my chance",
    "doctor_response": "Hello,Infertility has so many causes. The problem may be in either of you or in both. When it comes to a male person, hormonal imbalance may lead to insufficient sperms or immotile sperms.For female issues can be many. Hormonal imbalance including thyroid FISH, LH, uterus (womb) and ovaries and tubes morphology, any abnormal menstruation.In the query, you didn't mention about periods, whether they are regular, in a cycle or not. My suggestion is please consult fertility specialist or consultant and make sure these tests for you. Thyroid profile, ultrasound abdomen, LH and FISH, tube patency and so many tests. And for your husband semen analysis is a must and should.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Siddartha",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high BP while suffering from arthritis and Alzheimer s disease\n\nMy mother is 91. I was testing my blood pressure with a new home machine and took hers, too. Mine was fine, but hers is 172/113! She has had high bp and is currently taking Triamterene W/Hctz 37.5/25, 1/day, as well as Amlodipine 5mg Tab 1/day. She is mostly physically inactive each day as her knees and back bother her from arthritis. She weighs approx. 170-175 and is about 5 6 and has been diagnosed with early alzheimer s. Should I be rushing her to the hospital for nitroglycerine or something?",
    "doctor_response": "hello,   It's not an emergency, but her bp medicine needs to changed. I would have increased the dose of Amlodipine to 5 mg twice a day. Or triamterene is not a effective antihypertensive so it can also be changed to telmisartan if bp is high. So you can discuss these issues with your local doctor.    She should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Get her lipid profile and sugars tested once..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is feeling intoxicated after waking up a symptom of chronic Epstein-Barr?\n\nI have tested for epstein barr in 2006-07and it came back with high numbers very high, Very Positive I am trying to find out if waking up feeling like I am intoxicated is a symptom of Chronic Epstein Bar. I tend be unable to function and leads to almost 5 days of sleep with getting up to use the restroom but other then that I m asleep. Also currently I can look awake do everything normal and I won t remember the day and will fall asleep and feel like I m missing days",
    "doctor_response": "A feeling of lethargy can mean a viral infection. If you are prone to EBV, you must approach your healthcare provider/family physician and get it tested.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is stomach distension a good sign after having an embryo transfer?\n\nI had my embryo transfer done on 14th sep2012,seven days ago.two fully fertilized eggs were inserted successfully as said by my doctor.i do not have any such symptoms only my stomach seems to be bigger in size than normal.is this good or bad sign?will i get positive or negative result",
    "doctor_response": "Hi,I guess your concern is about, is stomach distension is a good or bad Doncaster having a embryo transfer, right. My straight forward answer is IS NOT AT ALL A SIGN RELATED TO EMBRYO TRANSFER. You told that you are having stomach distension after embryo transfer, this distension is usually due to the drugs which are prescribed during the whole cycle of embryo transfer. It's not at any good or bad sign which decides the success of embryo transfer. With the above information you can try out my suggestions.1. RELAX...NOTHING TO WORRY. It's not the thing which decides your success of embryo transfer.2. If you are still worried then feel free to ask your treating gynecologist or infertility specialist. He /she can help you.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Sudha Rani Panagarregards- Dr sudha rani panagar(i pray the God that ur embryo transfer will be successful n u blessed with a cute n healthy baby...hopefully TWINS)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for pain in small intestine leading to diarrhea ?\n\nPain in small intestine which leads to diaherea",
    "doctor_response": "Dear hariprakash your few symptoms may be symtoms of Chrons Diseases but it is chronic disease.. but it may be worm infestation problem. please had a Stool examination and confirmed. consult your doctor for details of your complains take care thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it normal for my stomach to make squeaky sounds a few years after hernia surgery?\n\nHi doctor, Is it normal for my stomach to make squeaky sounds a few years after hernia surgery?",
    "doctor_response": "Hi. The squeaky sound might be due to two reasons: Most common cause of this is IBS (irritable bowel syndrome). This has a history of constipation and alternative episodes of diarrhea, with or without pain. If you have these symptoms, then it is IBS. Fibre-rich diet and medications should be taken. There are rare chances of it being an obstruction, secondary to surgery. In this case, you have to get an ultrasound abdomen scan done. Revert back to a medical gastroenterologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes red rashes around cheek and neck which looks like bumps?\n\nHi my daughter is almost three weeks old, and this morning I noticed she has developed a red rash around her cheeks and neck! little red bumps that look like they have a white head, can you tell me what this is or if there is something I can use to get rid of it? thanks for your help!!",
    "doctor_response": "Hi... I sympathize with the kid and understand your concern. The trick of the management is keeping the skin moist and never allowing it to be dry. For this oil massage and lotions like Oilatum will help. Regarding cure options - eczema is a sort of allergy...allergies can only be controlled and can never be cured. But usually kids grow out of it...that is as the age progresses, they become better starting from 6 months.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "When should the bandage around an infected finger be removed?\n\nI had a very bad infection on my finger.  I went to the ER and the doctor made an incision and drained it.  It's been bandaged now for 3 days, but hurts a lot.  Should I remove this bandage and clean it and re bandage it, or just leave the bandage on?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.You should :-remove the bandage-clean the infected finger with peroxide hydrogen-apply an antibiotic ointment -cover it with a clean badageRepeat the same thing every day for at least a week.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to stop infection due to wound caused by rusty nail?\n\nMy granddaughter just stepped on a rusty nail and her foot was bleeding and my daughter doesn't know if she ever had a shot for tetanus.  My granddaughter is 6.  What should she do? If I have to pay for this service I can't afford it and my granddaughter lives in another state.  Please help me!",
    "doctor_response": "Hello and thank you for your question. Your granddaughter needs to be taken to her doctor right away. It is very important that she get a tetanus shot if she is not up to date on that vaccine. The wound should also be cleaned and examined for signs of infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bumps on the lower lip\n\nHi I have two tiny bumps on my lower lips. They are colorless and I did not notice them until I scratched my lip and nicked them. I have mono and I have never had a cold sore or a canker sore. I was wondering if these two small bumps were cold sores? I do not have a history or those and they are not blisters nor or they red but I am freaked out. Also, I go to the tanning bed so I did not know if it could be a burn",
    "doctor_response": "Hi..Thanks for the query..Two tiny bumps on the lips that are painless and colourless does not seems like cold sores as cold sores commonly appear like fluid filled blisters..They are probably appearing like fordyce's spots that can be due to hypertrophied sebaceous glands or oil glands..So my suggestion is to consult an Oral Physician for a clinical examination so that the exact cause of the bumps is ruled out and  treatment can be done accordingly..In case if it is fordyces spots generally no treatment is needed until they are  unsighty..In that can laser removal of the glands can be done..Hope this helps..Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in jaw/mouth?\n\nthe left side of my jaw/mouth is in pain, i dont know if its to do with a toothache, my actual jaw, muscle or an ear infection. i cannot open my mouth wide or close it to the full without pain occuring. I've tried cracking my jaw, force a yawn, popping my ears and eating food and had no success.",
    "doctor_response": "Hi,Thanks for consulting HCM Read your query,as you have pain in jaw , popping of ears dont worry this can be due to carious tooth ,  impacted tooth, or due to temporomandibular disorder . For this I will suggest you to consult dentist and go for oral examination and examination of Temporomandibular joint for pain and tenderness of masticatory muscles . In meantime do warm saline gargle , avoid excessive mouth opening , take soft diet , do hot formentation .Hope it will help you. Wishing you good health.Regards , Dr. Priyanka tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the slowly growing bump on head?\n\nI have a small bump on my head. I have had it for a few years now and when I first noticed it it was about a fourth of a inch now it s been about 3 yrs and it s about a inch in diameter. It s not painful but it s slowly growing. Do I need to get it checked out since i ve had it for so long or is it something I don t need to worry about. I mean I have been putting it off for so long i don t want it to grow anymore but i m nervous of what it could be",
    "doctor_response": "Hi ! Good morning. I am Dr Shareef answering your query.From your history, it does not seem to be something to be scared about.  In any case, if I would have been your family physician, I would have referred you to a general surgeon for a clinical examination followed by a FNAC and an excision biopsy if considered appropriate by him for a definitive diagnosis. Further management if any would depend on the reports of investigations of all these tests.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Gall Bladder removed. Extreme pain in upper stomach area, terrible burping and gas\n\nhi m y gallbladder was removed 18 years ago never had any problems after that whatsoever.....the past week however I have been getting extreme pain and bloating in the upper stomach area, together with terrible burping and gas.....happens especially after eating anything and during night as well........have been taking Gaviscon and it seems to help sooth the pain for a while.....",
    "doctor_response": "Hello, Thanks for the query to H.C.M. Forum. I would come up with these possibilities for these symptoms , these includes.1 The first possibility is of peptic ulcer disease ( hyper acidity ) . Diagnosis can be confirmed by Upper G  I endoscopy . Try raising the head of you bed about 4 inches with blocks. It might also help to avoid  eating or drinking for 2 hours before you lie down.To help control stomach acid  one should  not drink alcohol or drinks with caffeine in them or eat chocolate or spicy or greasy foods. Gavison only help to some extent. But in your case symptoms are sever so you may need drugs like proton pump inhibitors.2 Indigestion may be the next reason , diagnosis can be confirmed by clinical history of illness by a physician, particularly after gallbladder removal.3 Tension or anxiety develops such type of symptoms .In my opinion consult a physician and get his opinion. Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the lower abdomen on the right side. Nausea and fatigue with pelvic pain. No appendicitis. What else?\n\nI have pain in my abdomen on the right side sometims left it swells up and I am unable to lean to the side that is swollen. I become nautious and tired. this happens every month around ovulation and is starting to get worse. It is also accompanied by pelvic and groin pain. I have been to several doctors no appendicitis or kidney infection or gastrointestinal problems. Pain is becoming severly worse to where at times it hurts to move,.. Do you have any idea of what this might be? please help",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for choosing H.C.M.F. According to your description the pain is there only during the ovulation period and it is going to be worse upto the period (i have assumed) As you said there is no appendicitis or kidney infection, or gastro intestinal problems. So it appears that you are missing gynacologist , The pain appears to be dysmenorrhoea due to pelvic inflamatory disease, or p.c.o.d.etc. So i advise you to consult a gynacologist for diagnosis and treatment. You may need to have trans veginal ultrasound scanning, besides other routine tests for confermation. Wishing for a quick and complete remission form the disease. I welcome to call me for any doubts in this matter. best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for chesty cough\n\nHi, i have a random chesty cough that lasts for about an hour and can come on late at night or early in the morning. It ceases after about and hour and can ocuur again 3 days later, the enxt day or a wekk later. It has been on and off for 3 weeks now. Im 38 5 feet 8 and a half inches tall and 11 stone. I used to use a whizzer for allergies when i was young and suffer from hayfever.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Since you are having past history of wheezing and allergies, we should should rule out asthma and bronchitis for your current symptoms. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. PFT (pulmonary function test). PFT is must for the diagnosis of bronchitis or 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 salmeterol) and inhaled corticosteroids (ICS) (budesonide or fluticasone). Oral combination of antihistamine and anti allergic drug is also beneficial in your case. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lateral herination in thecal sac\n\nAt C5-C6, there is a small right lateral herniation, causing ventral impression on the thecal sac without cord or nerve root impingement... (from MRI report). Could this be causing my head to hurt on the sides and back and top when I bend over, cough, or sneeze, etc. What is the treatment?",
    "doctor_response": "You should go for intermittent cervical traction for 15 min and followed by shoulder bracing and shrugging exercise along with isometric neck exercise .atlast interferential treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on bottom of proximal phalanx?\n\nAfter I had fractured my right index finger a couple months ago, when it had healed it left me with a tiny lump on the bottom left of my proximal phalanx. The lump is only visible when my finger is bent, when it is straight nothing can be seen. I m not sure what it can be. Thanks.",
    "doctor_response": "HI.Thanks for your query and an elucidate history. The small lump on the bottom of proximal phalanx can be due to the following factors:-Callus, the bone's effort to heal the bone properly- sometimes takes time to get re-modelling or resorption. - Tenosynovitis on the tendon or the capsule of the joint van be prominent as you have mentioned. I would recommend the following: Take an anti-inflammatory tablet in proper duration and proportion. Hot water bath to the affected area were , the water being a strong solution of common salt, use the same solution again and again in spite of being  dirty later.  I hope this answer helps you get a clearer picture , proper diagnosis. This leads to a proper treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the frenulum to harden and the foreskin to toughen?\n\nWhat causes the frenulum to harden and the foreskin to toughen, thicken, and have a burning sensation when pulled back, causing the outer layer of skin to tear? Drug and still free. Worried about other types of infection, or posable diabetes (not diagnosed as a diabetic)",
    "doctor_response": "HelloThanks for query.You have not mentioned your age in your query.Difficulty in retraction and thickening of foreskin can be due to Diabetes or Phimosis..Please get your blood sugar level estimation done to rule out the same .Please consult qualified general surgeon for clinical examination If required you may need to get circumcised .Dr.Patil.If",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause sores in nostril?\n\nmy 5 yr old daughter has sores in one nostril crusty and yellowish, a cough not productive and an itchy anus keeoing us up at nite shes been treated with threadworm treatment 5 ml twice daily for 3 days to no avail what could it be or are these alll sympyoms of one thing",
    "doctor_response": "Hi.... Itchyanus could be due to thread worm infestation. But I do not relate the crusty nasal discharge and other symptoms your daughter is having for the same. These symptoms could be related to viral illness or acute bacterial rhinosinusiti. I suggest she may need antibiotic treatment. I suggest to consult your pediatrician as this might require prescription drugs.Regards - Dr.Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for allergy towards certain food\n\ni am suffering from food alergy. i try to know which food make me to suffer this but don't get idea. like before some days i ate pizza my skin was full of red spot. yesterday i ate tomato and i again felt the same.. please suggest me any medicine or treatment",
    "doctor_response": "HI, thanks for using healthcare magicBased on your reaction to the pizza and then to the tomato the next day, it is likely that you may be allergic to tomatoes.To find out if you are allergic to any other agents then you may want to have allergy testing done by your doctor.This can be in the form of skin tests or a blood test which can identify specifically what causes your allergic reactions.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are causes of elevated liver? I took ibuprofen about 9 hours prior to blood test. Does tylenol also have an effect on the liver? My cholesterol was also a little high, at 228. My doctor had me repeat my blood test and I am waiting for result. Thank you.",
    "doctor_response": "Hi,Thanks for writing in.Elevated liver enzymes has many causes. It can occur in infections of the liver and intestines. It can also be seen in those who have regular alcohol intake. Taking pain killers for long duration also causes elevated liver enzymes. Treatment medications for some chronic diseases also causes increased liver enzymes. Your test report needs to be discussed with your clinical problems as 1% to 9% of people without symptoms have elevated liver enzymes.You may need evaluation for hepatitis, cirrhosis, or fatty liver disease among other conditions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for panic attacks while travelling\n\nI was in a car accident on 9\\9\\14 I was the passener in the car we were coming out of a slight fog bank at ten thirty pm and we hit a very large cow that was standing accross the road totaling our car, when we came to a stop i couldnt get out of the car and paniced i kicked the door open. Ever since that night I am very afraid to ride in any vehicle. Driving im not so bad because i have some what of control but being a passenger scares me i get very tense, anxiety sets in, im jumpy, I am afraid to be on freeway or around a lot of vehicle, the rain or just darknes scares me especially now fog. I make the drivers i ride with nervous or mad, im deathly afraid of being in a accident and i dont know what to do, or who to see. i panick when just getting in a car. my body tenses up and wont relax. i live in everett wa.",
    "doctor_response": "HelloWelcome here.I think you have developed phobia of riding in the car after accident. This phobia precipitates anxiety attacks when you travel in the carI would suggest you to take tablet propranolol (prescription drug) half an hour before travelling. This will help to control anxiety.Also, psychological treatments like behaviour therapy and biofeedback will help you to overcome your fear.A psychiatrist will help you in this.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pain in calf be related to trapped nerve operation or valve replacement?\n\nI am on warfrin as I had an aorta valve replacement 7 yrs ago a week ago I started having sharp pains on my outer right calf it lasts for a few minutes then disappears . Further to this I had a back operation 6 years ago for a trapped nerve could the pain be related to the nerve?",
    "doctor_response": "Hello, As due to valve replacement this symptoms are very uncommon and cannot be considered as one them. If the pain is tingling, numbing, burning, radiating etc than this could be related to the nerve entrapment in the lumbar spinal column. Due to ageing and degenerative changes, these pains are common. I will advise to do McKenzie maneuver and see if the pain is reduced while performing the one. The McKenzie maneuver can be found online. If the McKenzie maneuver is positive then it can be a nerve entrapment. Exercise will be guided accordingly for strengthening the core muscles, spinal muscle, static hamstring, static quadriceps and ankle toe movements. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes foul smelling stool in an infant?\n\nmy son is 22 months and has had foul smelling stool for a few months now. they have always been soft - i don t think he has ever had hard stool yet. the color has been consistently been a orange/light brown , the smell is enough to make me gage , smells like rotten egg.",
    "doctor_response": "Hi! soft and foul smelling stools can be a sign of fat malabsoption.  since it is recent onset it is most likely some infectious cause. make sure your child is dewormed. also get stool test for fat globules",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes large amount of thick phlegm during night?\n\n85 year old female, 85 lbs, 5' 4\"only diagnosis is Parkinsons for 10 years.What causes large amounts of thick white Phlem that only happens after going to bed for a person with parkinsons? What can be done to elemenate or decrese this problem. Her Dr. says drink a little lemon water before going to bed and keep head elevated 45 deg. which we do.Thank you,  Sherrie",
    "doctor_response": "Hi thanks for contacting HCM...Noted you have white phlegm ...If congestive symptoms like runny nose associated then decongestent like antihistaminic drug given...Here bronchitis has to be ruled out...For that chest x ray needed....If needed antibiotic given....If congestion more steam inhalation can taken...Avoid smoking if habit....For congestion Galic cloves one or two added in cup of milk boil and cooled...then taken...Turmeric powder in milk also useful.Consult pulmonologist for detail examination...Take care.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Weakness, tiredness, trembling. Detected elevated white blood count. On tricort since a year. Side effects?\n\nBeen on tri cor for about a year. in the last couple months Ive been experiencing noticing weakness and feeling tired on occasion. My Dr. said my white blood count was elevated a little and checked it again. Still was a little high. Wants to re-check in couple months. Last 2 weeks been experiencing more weakness and trembling and very tired. Could this this attributed to TriCor",
    "doctor_response": "Hello,Thanks for the query to H.C.M. Forum. Since, you mentioned that you are taking Tricor ( TRIAMCINOLONE) from last one year. The side effects of Tricor are swelling  over face , osteoporosis, peptic ulceration, hyperglycaemia . Due to depletion of calcium you feels tiredness and weakness. In my opinion consult your treating doctor and discuss about  this . Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to wean off from Xanax?\n\nMy son lives with me (I m 76) he is 48.... he is on Keppra & Depakote 500mg takes each Bid, on Gabapentin 300 mg Tid, Cyclobenzaprine 10mg Hs, Diclofenac 75mg Bid, Ambien 10mg Hs, Xanax 1mg Bid, question is: on 10/31/16 he had first apt with pain management. The doctor added Percocet 7.5/325mg Tid and Ativan 50mg 1-2 tab twice day as needed. He was told to wean off Xanax at present he s been on 1 per day. On 11/7/17 I will begin half Xanax per day. With all the above heavy duty meds, when or how to time-wise give last two. thanks for advice.. Ps I dispense meds, He is so confused he goes into his room comes back hour later then he has been debating with me that He didn t get pills. I m a nervous wreck",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. He is on Xanax. Xanax or Alprazolam is rapid acting and it better to reduce the doses over 4 weeks to prevent withdrawal. The dose can be reduced to half for a couple of weeks followed by 0.25 for next two weeks followed by complete stoppage. The dose reduction in this manner will not cause any withdrawal. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can cough suppressant be taken to cure bronchitits?\n\nI have had bronchitis for 5 days.  Yesterday my cough was completely gone while the next morning I woke up with a horrible wheeze and had a strong cough all day even after taking gallons of water and only eating soup.   Could I take a cough suppressant.  Benzonatate is very effective for me.",
    "doctor_response": "Hi thanks for contacting HCM...Noted you have diagnosed with bronchitis ..It might be viral or allergic...If cough is troublesome and dry then dextromethorphan like cough suppressant can be taken....For wet cough ambroxol like mucolytic drug needed....If allergy is due to allergy take antihistaminic like benadryl...If nasal blockage present then nasal spray can be taken of oxymetazoline to relieve congestion....If you are living in cold climate humidifier can be used....Take care.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain on penis tip?\n\nI am 51 yes old. I have a pain in tip of my penis that run down to my testicles to Mr rectum. It started with a small bump on under foreskin of my penis . it burns sometimes when I urinate. I have been on antibotics -cipro and doxy .doesn t seen to be working . can you tell me what s wrong.",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: May be infectionExplanation: As you have pain continously, you may be suffering from urinary tract infection. Please visit a doctor and ask him for urine and other tests. Hope this helps youo. Please let me know. COntinue antibiotics till then as advised b your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Has long term CVA. Taking Ceftriaxone and Clindamycin for fever. Mental status not good. What to do?\n\nExcuse me Doctor, I have a patient who is a known case of CVA for 10 years duration. she developed fever a couple of days ago and I started Ceftriaxone and Clindamycin iv. Now after 8 days her fever is flactuating but has not been stoped and her mental status is not so good. What should I do for her now and what is your advice.  Thanks a lot",
    "doctor_response": "Hi, fever is a symptom of some infection of URTI, LRTI, UTI, enteric infection, so accordingly tests are to be done and treated, get the tests TC, DC, ESR, QBC, WIDAL, PLATELET COUNT, etc done and treat accordingly. Usual cause may be urinary tract infection, i in such situationprescribe cifixime 200mg, BD                           To improve the resistance give her green leafy vegetables, pulses, sprouts, and protine rich foods. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can fatigue and elevated blood pressure levels be treated?\n\nHi, I have bene having fatigue, and my blood pressure readings are pretty high. I work as a hotel room attendant and its pretty tiring and stressfull, my family has a history of high blood pressure, but this time my whole body feels weak and tired, and about 5 hours ago my blood pressure readings were165/112",
    "doctor_response": "Hi, I understand your concern and would explain that straining physical activity and daily stress can lead to uncontrolled high blood pressure values. Nevertheless, I would recommend consulting with your attending physician for a physical exam and some tests to investigate for other possible causes underlying high blood pressure: - Complete blood count, PCR, ESR for inflammation - Thyroid hormone levels for thyroid gland dysfunction - Blood electrolytes for possible imbalances - Kidney and liver function tests - Cortisol and aldosterone plasma levels for adrenal gland dysfunction. If all these tests result normal, I would recommend discussing with your doctor on the possibility of starting anti-hypertensive therapy, to help maintain your blood pressure under control. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes randomly occurring sharp pain in body?\n\nHi I m Vanessa and I m 17 years old. Ever since I was in middle school, I have been experiencing random sharp pains, but I can t tell exactly where it s coming from, but it feels like it s coming from inside my butt. I would get it once in a blue moon before, but I ve recently been experiencing the sharp pain a lot more often. When I ll get the sharp pain, it ll feel like a shock, and I have to stay still for a little while because if I move the pain will get worst. I don t know what it is and I was hoping that you could help me.",
    "doctor_response": "Hi, The location and movement of a pain gives clues as to what is going on, If it is always in one spot and internal, then an internal congenital bone abnormality AND, at the base of the spine is one of the MOST common places for this to occur. An internal tail. Non-fusing of the spine (spina bifida), bone spur abnormality. The spina bifida can cause paralysis if it is a BIG gap in the spine and the spine gets injured. This is actually one of the more common congenital bone abnormalities. Mild ones are 1 in a hundred (formerly. those prenatal vitamins are given mainly to prevent THIS, so that 1 in a hundred number from 40 years ago is likely much much smaller). AND see if it is only when you sit on that spot in which case there doesn't have to be anything else wrong at all.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for semen leakage, memory loss and erectile dysfunction\n\nhi sir am 26 years old .am suffer from  semen leakege during night  .i doing  masterbate from age of 15 .i need some home  remedy to recover  from  this problem  please  help me.i have lots of problem memory loss,body weak erection dyfunction  so please  i want imediate ans from u.",
    "doctor_response": "Dear, We understand your concernsI went through your details. You don't have to worry about your masturbation habit. Masturbation is normal and natural. Masturbation cannot cause any physical or mental problems if your habit is within limit. Semen leakage during night (night fall, nocturnal ejaculation) is also a normal and automatic process. This process is natural and automatic and therefore you cannot control it. But again, there is no health issues regarding your semen leakage. It is just the accumulated semen, that is leaking. These two issues, masturbation and semen leakage cannot cause any memory problems, weak body, weak erection etc.But if your knowledge about the above facts are wrong, you might have anxiety related symptoms and that is what you are suffering now. Please consult a psychologist for counseling.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Happy New Year. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hello.....Women on both of my parents' sides have had breast cancer for years, and on my Dad's side, cancer runs very high....my Dad just passed away from brain cancer, and his two sisters have had breast cancer, only 1 of them died from it.  My mom gets benign breast cysts all the time.  Also, my maternal grandmother has just been getting treatment for uterine cancer.  Are my chances very high of getting some form of cancer?  Should I get a DNA test done?",
    "doctor_response": "Hi Welcome to HCMI have gone through you query and  found  your concern about chances of getting some form of cancer? Dear,  It is not mandatory that if some one has family history of cancer ought to get infected . Chances can be there .  You have to have  stronger immun system to be free of the disease.You have to be aware of the fact that everyone has cancer cells in their body, so why does one person never get diagnosed with cancer and another person is diagnosed with cancer? Because  ---Nasty microbes and parasites get inside of the organs and make their homes there . The cells in the organ become weak due to the activity 0f microbes  and weaken the immune system & cause  growth of cancer cells indicriminately ,The cancer will not come back as long as the patient watches their diet and strengthen their immune system , so that it can fight out the microbes and parasites  causing cancer or  other diseases . If you think you may be at risk for cancer, you should discuss this concern with your doctor. You may want to ask about reducing your risk and about a schedule for checkups.Meanwhile , for your imun system  I would like to suggest you to Adopt regularity in your life style . --Simple, healthy nutritious food including more of fibers , protiens , vitamins & minerals than starches like rice , potatoes . Also avoid tea ,coffee ,alcohol fried and fast foods PROPER regular EXERCISE , WALK,YOGA, pranayam-deep breathing proper rest HELP YOU TO STRENGTHEN YOUR IMMUNE SYSTEM and help you lead disease free life .Turmeric powder a Tspoon with a cup of hot milk before bed time help many types of bacteria under control .A Tspoon of fenugreek seed powder with water in the morning to control sugar level .Antioxidants like raw garlic ,ginger , onion in every meal .Use of lemon in water befor meals and butter milk in lunch help the body keep going Mixture of extract of Lemon ,Garlic, Ginger , Vinegar of Coconut water  Bark of Moringa tree  & Homey  , Take  25-35 ml  for 21 days to 41 days  ,with equal amount of water  for 3-4 days and pure mixture for rest of the days .PROPER regular EXERCISE , WALK,YOGA, pranayam-deep breathing proper rest HELP YOU TO STRENGTHEN YOUR IMMUNE SYSTEM and help you lead disease free life .All the above is full of antioxidendants having no side effects giving you immunity to live life without such disease and can go with any therapy . Condition is to be regular with this regimem .You can advise this regimen also  to your mom  , grand mom o",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause seizures in right hand,mouth and eye in an infant?\n\nMy son is 2 1/2 years old, he got seizures in his right hand,mouth and eye(as the movement is there in these parts) while he was sleeping.He is very active and no complications during pregnancy or at delivery time. Did CT Scan, EEG(15 mins)- reports were normal. Used Eptoin Syrup 5ml for 1st 1 week(TWICE) and then 2.5 ml for the second 1 week (TWICE) and next 1 week only ONCE and stopped. For 2 nd opinion, we went to another DR. he said to have EEG for 1 hr after which he said - there is no problem but have some minor things and asked us to use Trioptal syrup for 1 atleast year. I m worried about the sideeffects and my son s growth in terms of mentally, physically. Is there any chance to get the seizures once again? Pease help!! Thanks, Srilatha",
    "doctor_response": "Hi dear,I had gone through your question and understand your concern. You can not see on the CT scan detail brain structure, you should perform MRI brain with epilepsy protocol .Focal seizures can not occur without causes .There are next causes of Focal seizures:-trauma;                -structural problems of brain;                -infection.Focal seizures are usually treated during at least three years. Don't stop treatment. Better use Carbamazepin syrup, discuss it with your doctor.Medicines can cause delay development :cognition or motor.It depends from person to person.Hope i answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "When is circumcision surgery needed?\n\n...With in next three months I am going to get married, Right now my pennies with foreskin. Now I do masturbating with foreskin with out any problem, but after marriage, will it give any problem for intercourse with my wife. Will I satisfy my wife with foreskin pennies? My question is whether I need to do circumcision surgery or not necessary. That is must or not. Please give me answer. Thanks",
    "doctor_response": "Hi, It's not necessary to get circumcision surgery for you. You just need to learn to open you foreskin backwards to uncover the head of your penis. once you get that done, you won't find any difference between a circumcised penis and a normal one. And you can very well satisfy your wife. Take care. Hope I have answered your question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Blood report of a 2 year old showing RBC exhibits mild microcytosis and mild leukocytosis. Hemoglobin electrophoresis noted. What does it mean?\n\nMy 2 yr son got his blood report which indicates Red blood cells exhibit mild microcytosis Mild leukocytosis with absolute lymphocytosis is evident, occasional activated lymphocytes are seen. Advised :Haemoglobin electrophoresis. his neutrophils are low -15%,his MCV-75.9 fL ,MCH-24.3 pg .please tell me this what it means......",
    "doctor_response": "Thanks for your query. Microcytosis means his red blood cells are a bit smaller in size than usual & the common causes are iron deficiency & thalassemia trait ( both are common non-serious conditions) Mild leukocytosis means the white cells ( White blood cells, or leukocytes are cells of the immune system involved in defending the body against both infectious disease and foreign materials) are increased in number . lymphocyte is a type of white cell. Lymphocytosis (increased lymphocyte count) & activated lymphocytes are commonly seen in viral infectios in children. Hemoglobin electrophoresis will confirm the thalessemia trait if that is there. There are no reasons to worry and should wait for electrophoresis report. Hope you find the explaination useful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower back pain?\n\nSuddenly yesterday afternoon my lower back starting hurting and I couldn't sleep last night. I do stand and walk alot at my job and I am also riding on a school bus for about an hour bouncing around on the seat. I also have a small ranch and have chores to do where I have to bend down and over. I haven't experienced this kind of pain before, what do you think could have caused this. I am 5 ft tall and about 110 lbs. Never mind, I didn't know I had to pay to ask a question, cannot afford this. Thank you anyway.",
    "doctor_response": "HiThank you for asking HCMI have gone through your query.Your problem is most likely a strain of back muscles.It can happen while assuming into a awkard posture or lifting some thing or while climbing stairs.It is better to have an orthopedic examination to rule out other conditions effecting spine like disc herniation.For back strain i advise my patients with a short course of NSAIDs like Aceclofenac and Muscle relaxant like thiocolchicoside.For some i give Gels with NSAIDs like diclofenac and caspascin for local application.Hope this may help you.Let me know if you have any further query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for skin rash in a child\n\nHi my daughter is 11months old she has a bug bite looking rash that keeps coming up on her legs and arms we ve been to the dr and they had never seen anything like it. Nothing is wrong with her at all no fever we went to dr. For an ear infection she was put on amoxicillin and 4days later had a rash on stomach. Took her off amoxicillin put her on Benadryl. 5 days later rash appears on arms and legs looks like Mosquitos bit her 30 times on each limb. Put her on medicine 2 weeks have passed now spots are coming back?",
    "doctor_response": "your child seems to be suffering from atopic skin problem . use good moistuerisers for along duaration .follow this step by step . apply liquid parrafin all over the body half hour before bath ,give bath with mild warm water ,use TEDDIBAR soap after bath apply good moistureir all over avoid talcuam powder after bath",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicine to improve complexion\n\nHi , this is Manjot, I have brown skin and I want to improve my complexion , I want to try some whitening pills to minimize melanin level in my body , do they really work ??? Is there any medicine which can make my complexion light and glowing ????? Thanks .",
    "doctor_response": "Thank you for query.Natural color is the best color.it is always better to have natural color than go for whiteners.dark skin have melanin which protect you from various skin cancers.So please avoid any fairness/cosmetic creams.I do not advise use of any cosmetics for becoming fair. Cosmetics do more harm than good .wash face regularly atleast 2 times a day with gentle cleansers like cetaphil.do not rub or use harsh soaps.If you still persist  use sunscreens in the day time at least 3 -4 times a day which also helps in preventing sun tanning. Sunscreens protect from pigmentation if used atleast 2-3 times per day.Mild keratolytics like salicylic acid can be used if need be under supervision of dermatologist.You can get back  to me for any clarifications .Dr Bharatesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does my nose look really big?\n\nHello doctor, I am 18 years years old and just wondering if my nose is average or actually big.",
    "doctor_response": "Hello. I have seen the picture (attachment removed to protect patient identity). Firstly, I would like to assure you that you are just perfect and nothing needs to be done cosmetically. Secondly, if the structure of your nose is causing you any physical ill health, you need to consider a surgical procedure. A deviated nasal septum is a state where there is a tilt in the nasal bridge more than usual. It is nothing serious and a majority of the people do have it. Sometimes, this causes frequent allergies, cold and sinus problems or it interferes with the daily activities. This is the only scenario where you need to consider consulting an ENT specialist in person and follow their advice. As of now, presuming you have no such problem, you are good to go. For more information consult a family physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does anechoic cyst at the right renal upper pole suggest?\n\nA recent Sono showman anechoic cyst at the right renal upper to mid pole measures 4.2 cm. Right renal parenchymal thickness and echo texture otherwise appears within normal limits . There is no evidence of right sided hydronephrosis or renal calculi. Last Nov, the cyst measured 3.1 cm looks like and increase Please advise on this condition. This is a follow up from the Dr s orders. Please advise as to what questions we should ask regarding the findings.",
    "doctor_response": "HelloThanks for query .Based on the facts that you have posted you have been detected to have solitary cyst in upper pole of your right kidney .These cysts are benign in nature and present since birth .Normally  no treatment is required.  Treatment is required in special situation when there is sudden increase in size of the cyst giving rise to severe pain in loin or it gets infected .The size of the cyst that you have need to be monitored every year and active intervention ( if needed) can be considered if there is persistent increase in size of the cyst .There are no specific questions to be asked for apart from size of the cyst and need for its removal  Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can hcg diet cause red rash?\n\nThis is for real, an on-line doctor to answer questions?  I should send to my college daughter just in case, right? I do have a question.  I am 56 years old.  I am doing the HCG diet.  I notice a red \"rash\" on my chest...no itching, nothing...but it just showed up.  Can this be HCG or HCG detox?",
    "doctor_response": "Thank you for your question!The rash that you describe does not belong to the most common side effects of HCG diet.Anyway there are less common or rare side effects which is the allergy and rash on different areas of the skin, and sure this could be your case.If the rash bothers you, and the symptoms like itching and swelling will be present, it is necessary that you stop the hcg diet.I hope this helps!Feel free to contact me if anything is unclear.Good health!Dr.Migena GEGA",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shoulder and chest pain along with heart burn?\n\nI keep feeling a dull aching pain on my left shoulder blade & it radiates to my chest. I do have problems with heartburn. But I'm beginning to think it may be something serious. Could it be a heart attack coming on? Please help. I am very worried. Thank you.",
    "doctor_response": "age, high blood pressure, high cholesterol, smoking? are  these symptoms occurs on exertion.symptoms are suggestive heart disease or acidity problems. if above risk factors are their then needs to be evaluated for heart problems like ekg or stress test.anyway get your blood pressure checked and get blood sugars,lipid profile, hscrp tests done",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in upper right arm and between shoulder blades?\n\nI am a 65 year old woman, 5 2 175lbs and nonsmoker. I had pain in my upper right arm. It moved to the back, in between the shoulder blades. The pain is unbearable and now I am seeing localized bruising in two areas on my lower right arm. The only thing that 70% helps is a cold pack on my back, but it is still painful. What do I have?",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.It is most likely muscular pain. Treatment of it is rest and analgesic such as ibuprofen for pain relief. If not relieved by it then strong analgesic such as tramadol can be of use. For further investigation of pain you require x Ray and MRI of the region. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does SGOT-22,SGPT-45 and LDL-119 suggest?\n\nmy age is 39 years, i tested my blood last week, it show, SGOT 22, SGPT 45, Triglyceride normal, LDL 119. Please advise, what does it mean, as my weight is 65kgs. I am doing exercise daily for 30-40 minutes (tread mill ). Can I continu my exercise or to stop it so to avoid any complication. what type of food i have to avoid. please advise.",
    "doctor_response": "hi.thank you for posting query at HCM.LAB values are normal.you may continue to exercise.however, its better to take all your current blood results to treating physician.wish you good and sound healthregardsDr Tayyab Mlaik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had unprotected sex 5 times. Was on pill. Found slight brownish discharge. Any chance I am pregnant?\n\nHi. I am 22 years old I am on the pill for about 2 months now and I have had unprotected sex with my boyfriend 5 times. He has pulled out every time and the one time I was worried I too a plan b pill. I have a slight brownish discharge a few days before I'm supposed to get my period and both pregnancy tests I took were negative. Any chance I am pregnant?",
    "doctor_response": "hello As you didnt mention the due date of your menses , so it cant be said that what is the chance of pregnancy at present. though you have negative pregnancy test that means at present you doesnt have pregnancy. but you should wait for your due date of menses , if it doesnt occure on or with in one or two week you should repeat the pregnancy test and make it confirm. if there is menses on time then all is ok ok Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does having mumps affect the menstrual cycle of a woman?\n\nGood morning. My wife is 10 days late in her menstrual cycle. We were using condoms as birth control. She had a severe case of the mumps last month. She has taken three home test pregnancy tests and all are negative.Could the mumps have delayed her cycle.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.No mumps won't do delay in the cycle.Mumps can affect on the salivary gland it won't affect on the menstrual glands nor dose it affects the hormonal values in the blood so it won't affect menstrual bleeding.You can either check the pregnancy test after few days or you can wait for some day to menstrual bleeding to come.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is addiction to cremaffin harmful and how long can it be taken?\n\nMy child - 6 year old is having severe constipation problem. He was initially took to pediatrician and then to pediatric surgeon. Pediatric surgeon suggested Cremaffin which we are using for the last 3 months and worked well. However, the child got addicted to it and without cremaffin he is not having bowl movements. We also find gas formation. Should we continue with cremaffin. If so - how long we can continue?",
    "doctor_response": "Hi,Long-term use can make your body depend on the laxative for regular bowel movements, damage the bowel, cause malnutrition and fluid and electrolyte changes. You need to slowly withdraw the drug by using it on alternate days and then completely stopping it. Increase fibre in diet and adequately hydrate your child.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Saranya Ramadoss, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness in neck muscles?\n\nHad a pacemaker replaced in March of 2010. For past 6 weeks I have had tight muscles on left side of neck, shoulders and down left side of back. Try massaging, ibuprophen and it only somewhat released tightness for a short time. Is this muscle tightness caused by the pacemaker electrical impulses or maybe by the pacemaker being a foreign object on that side of my chest?",
    "doctor_response": "Hi, As such pacemaker is not known to cause as any pain or muscle tightness as per the distribution and type of pain it appears more to be arising from some sort of cardiac ischemia. You need to get cardiac workup done before thinking about anything else. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Rohan Shanker Tiwari, Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in my big toe and a bump behind the mid joint?\n\nMy right big toe is numb and has a swelling, soft bump just behind the mid joint. It is not a hard deposit and it seems to be filled with a fluid substance. It can produce discomfort when I wear shoes. I also have diabetes but I only take metformin. Thank young",
    "doctor_response": "hi,thank-you for providing the brief history.As you have diabetes and this lump which appears to you like a fluid accumulation along with numbness in the big toe I will advice you to undergo a thorough clinical examination and the blood sugar test. Some other blood test might also need to check if any infection is there.This kind of lumps in the feet is supposed to be not ignored as it maybe due to some abnormality in the tissues leading to the same. Also checking the uric acid levels is Advised.Based on the clinical examination and diagnostic tests the medical management can be initiated. Also, since you are diabetic you should improve your physical activity to keep the blood sugar levels in controlRegards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the procedure for self hypnosis?\n\nI am trying to learn self hypnosis and meditation since last 3 years but still I am not expert in doing this.I know that if some one hypnotize me and say \"whenever you say READY in your mind, you will instantly go in deep trance and now whatever you say in your mind will go to your unconscious mind\" then this will really work.      I have tested it with my friend and brother by hypnotizing them.But there is no one here to hypnotize me to program my mind to do self hypnosis or meditation.I want someone to hypnotize me.Could you please help me to learn self hypnosis?",
    "doctor_response": "Hi dearI understand your concern.Hypnosis is unconscious process and only 6o % in the world hypnotize by someone.It is not possible to hypnotize everyone.And among them self hypnotize is so difficult because ewe know our thought processes and suggestion in them is difficult.So if you want to hypnotize then contact expert near by.But self hypnotize is not possible in some extent.Still have a query then feel free to ask.Thank you.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is anti rabies injection necessary if bitten by vaccinated dog?\n\nhi, i was bitten by our pet dog in my palm, it doesnt bleed but i was worry for the bite leaves a red mark. our dog was being injected by an anti rabies vaccine. do i need to get vaccinated asap? are there any chances that i'll be infected? thanks,. answers will be a big help. thanks and godbless",
    "doctor_response": "Hello dear ,I read and understand your concern.I am Dr Arun Tank, infectious disease specialist answering your concern.No, there is no chance of rabies if the dog is vaccinated. You should not worry as your dog is vaccinated. But if your dog is not vaccinated and you have given the vaccine to it after the bite than you wont be covered with the anti rabies effect of the vaccine.Please take good care of the wound with the frequent cleaning and dressing. avoid further injury to the bite mark.you can take the aceclofenac tablet if you are having the pain with bite mark. please take the drug under your doctors guidnace.You can ask me for further clarification here or you can ask me on bit.ly/DrArun.Thank you,Dr Arun TankInfectious Disease Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can 2 slipped discs in the lumbar part of my back cause pins and needle sensation in my feet ?\n\nI have pins and needles sensations in my feet every morning when I get up could this be from my two slipped disc in the lumbar part of my back.",
    "doctor_response": "hi,yes it can be due to slip disc,u can also have numbness or tingling sensation in feets.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe back pain in kids\n\nI am an 11 year old girl and i have been exsperiencing bad back pain (not like stich), it is very uncontivable it has been happpening now for about 3-4 months ?? what do you think is wrong i though (and my mum thought) it was sleeping wrong but my mum checked on me and thats not true soooo ......",
    "doctor_response": "May be you might have sprained your back muscles due to bad posture in sleep and just have some hot fomentation for a couple of days and you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes involuntarily shaking of head and twitching in a child?\n\nMy daugher is 8-months old and just started shaking her head side to side almost involuntarily and twitching. She is on her 2nd dose of medicine for a double ear infection. She was on amoxicilian but is now on augmenten (3 ml, 2x/day). Is this her attempt at shaking the fluid? She hasn t been sleeping well and wakes up crying. she s also teething.",
    "doctor_response": "Hi...by what you say I feel that this could be a symptom or self satiating behaviour due to double ear infection. If she is feeding well and is not having fever and not irritable or having a normal sensorium then you need not worry. But if she is having this symptom for more than 24 hours I suggest you consult your pediatrician regarding this.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for severe constipation\n\nMy 4yr old son suffers from constipation to the point of bleeding when he finally does. It has been four day and even though he take Miralaz daily and we gave him Castor Oil he is still not able to. I believe he affiliates pain with pooping. How can I help my son?",
    "doctor_response": "HI , First try to give your child plenty of fluids, high fibre containing vegetables,fruits and start usinga laxative like lactulose for 1-2 mnths.Also get examined by a child specialist for presence of any anal polyp/ulcer",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for eating problem in 7 month old\n\nOur 7 month old babu refuses to eat anything but breastmilk. He weighed 6.2kg at 3-4months but now weighs 5.5kg. We have tried all sorts of things, milk, cereals, but he just doesn t seem to like them. We are worried about his weight. Could it be worms, teething, as some have suggested to us? Thank you.",
    "doctor_response": "Hi...At his age interest in play increases and interest in food decreases. This is quite natural. If he is active and playing around you need not worry. This age rather than the quantity of the food I suggest you concentrate more on the number of times you feed her and also make whatever you feed him calorie dense by adding good amount of ghee to it.PLEASE DO NOT GIVE ANY SO CALLED APPETITE STIMULANTS AS THEY ARE NOT VERY SCIENTIFICALLY PROVEN AND THEY HAVE THE SIDE EFFECT OF EXCESSIVE DROWSINESS.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of masturbation?\n\nhelo sir, i am a 19 yrs old guy.my problem is that i used to masturbate for last 2 years.now whenever i see any porno pic ,erection happens in my genitilia and semen comes out in just a minute .i am very much worried.and i also want to leave masturbation .please help me.",
    "doctor_response": "Hi, The masturbation is a safe and pleasure-giving procedure. So you may need not to worry about that. The ejaculation within a few minutes is common at such a young age. I suggest you restrict masturbation frequency for two to three times a week. Try to watch fewer porn videos and try to avoid to remain alone in room. Yoga, meditation will be beneficial to you. Just now make goals in the study and it will help you to get rid of excess masturbation habit. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the causes & treatment for recurring lumps in elbow?\n\nHi there, for the past 5 years I've had reoccurring lumps at the back of both of my elbows. They don't hurt, sometimes they are itchy. I've asked my doctor and all he can say is for my not to eat foods such as seafood alot.. He gives me this cream to put on it. The past years the cream worked but it keeps coming back. Now it is more worse then ever and bigger than ever - the cream is no longer effective. Please, please help me I am desperate for a long term solution! Here are some photos I just took:  WWW.WWWW.WW  WWW.WWWW.WW",
    "doctor_response": "Hi ! Good evening. I am Dr Shareef answering your query.Even though there is no photograph seen with your question, it seems that you have got a chronic dermatological problem which might not be diagnosed properly without an appropriate physical examination and related investigations. Therefore, I would advise you to see a dermatologist in your area for an appropriate diagnosis for proper managemnt. Till that, please take care not to scratch those and avoid any pressure over the lesion.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the fingers?\n\nthe thumb of my right hand hurts when i grap something in a certain way. this morning my pinkey hurts when a use it a sharp pain runs to my wrist. it also hurts to the touch on my hand on my pinckey side, right above the wrist. bending my hand back hurts today also. What is this and what can i do?",
    "doctor_response": "Hello, Pain in the fingers & wrist can be due sprain, strain, fracture or compression of the median nerve(Carpal tunnel syndrome). Visit ER, get physically examined & get X-ray & nerve conduction tests done. 1. Avoid over-extending your wrist. 2. Take Acetaminophen(Tylenol) or Naproxen to reduce inflammation & pain. 3. Steroid shots are also effective(to be taken under a Consultant). 4. Usage of wrist splints is effective. 5. If median nerve is affected you may need surgery. 6. Get evaluated and treated for OA/RA. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Nupur K, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Kidney stone stuck in the urethra. Tingling feeling. Any other treatment options than surgery?\n\nHi ,my name is Natalie, I,m a 40 years old female, and I have one kidney stone (4 or 5 mm) stuck in my urethra tube right in the end for 3 month now ,I can feel it tingle and only ones I felt real pein. I refuse to go to surgery and I been taking cranberry juce,water,limon etc...please let me know if there is any other way to get it out! Should I wait longer to see if cames out by it self or this can be a danger to me, and damage my urethra?. Help me pleeeeeeeeeeease !!!!!!!!!!",
    "doctor_response": "hello Natalie, please dont worry. If i read you correctly you are talking about urethral stone and not ureteral stone. Urethral stones are placed in the passage leading out of the body from the urine bladder. i think u are taking too much trouble. these stones can be easily removed by cystoscopy (the operation that you fear). there is no cuts and generally the pt can go home in 1 day. i think you should follow the advice of your doctor and get it removed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suspcion of Gilbert's, normal urobilinogen. Will that rule out the chances?\n\nMy gastroenterologist suspects Gilbert s. My total bilirubin is 3.2. My direct is 0.44 (normal is up to 0.4). No bilirubin in uring. Urobilinogen is 1.0 (which is the upper limit for normal). I read that in Gilbert s patients, urobilinogen is typically subnormal. Does my 1.0 rule out Gilbert s? (Note: I eat a banana every day, including in the days prior to the urine test. For the urine test, I simply provided one sample at the doctor s office in the morning. That was my second urinatination of the day and was of low amount. All my other serum tests are normal.)",
    "doctor_response": "Hi,If you have no other symptoms, and no common bile duct stones, then it certainly sounds like Gilberts syndrome.  Gilberts syndrome is simply a laboratory finding that doesn't have any significance on your health. I see patients all the time who are sent to me with Gilberts syndrome from other doctors, and I wouldn't worry one bit about it. I hope I have answered your questions. Please feel free to contact me if you have any further questions or if you feel I haven't addressed your question adequately.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it normal to have engorged penile vein?\n\nHi doctor, I am 29 years old man, currently having issues with my penis. So it has been exactly one week where I was doing foreskin stretching while erection during taking a shower three days straight, due to a very tight foreskin. I noticed very dull pain the second day which went from the front left side of the penis head to back pelvic floor area. I also noticed the veins on my penis is inflamed swollen. How can I cure this soon? I was concerned and decided to masturbate to check my semen, which was good (no blood). The penis skin is good and no bruising showing, just the swollen veins. I was forcing the foreskin back and do not know if I hit the vein, or etc. Please help.",
    "doctor_response": "Hi. I can understand your concern about your symptoms. Since it is an acute one, it can be due to phimosis. Do you have any of the following issues: Itching, any discharge, pain, swelling, irritation, redness, disruption in the flow of urine, difficulty passing urine, irritation while passing urine, painful masturbation. Kindly send a picture for better understanding. At present, painkillers will help you. for further management, share more details.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can stem cell therapy regenerate synovial fluid in toes?\n\nMy RA has attacked the synovial fluid in my big toe causing the bone on bone. I had bunion surgery year and a half ago and this has cause a shift and daily discomfort. Can stem cell therapy regenerate the fluid between my toe thus causing my toe to shift back in correct alignment?",
    "doctor_response": "Dear patient  There are no studies in literature  that supports use of stem cells in rheumatoid arthritis  affected toe joints. Also  toe deformities cannot be corrected by just replacing synovial fluid and synovial cells. Since rheumatoid arthritis is disease of synovial joints it will affect regenerate cells.  You have undergone  realignment surgery and that is helpful in deformity correction.  For pain relief arthrodesis is helpful. You need to visit your operating  surgeon with report.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have epiretinal membrane and floaters and flashing in eye. Is surgery necessary?\n\nHello doctor, I went in for a regular eye exam and told I have an epiretinal membrane. Last year I had floaters and flashing and went to a specialist who said all is fine. I went for new glasses and they told me I had an epiretinal membrane. I have an appointment next week with the specialist, but so worried I may need surgery. My husband passed away recently and a few weeks later my mother also passed away. I did the eye graph exam (from internet search and there is no distortion). Is this something I can live with or shall I have the surgery next year? I have no one to help me and may have help next year.",
    "doctor_response": "Hello. The epiretinal membrane will decrease you. There is a jelly-like substance in the eye and as age progresses it starts to liquify and you start seeing floaters. You should go to an ophthalmologist immediately in case if there is an increase in the number of these floaters or if you are seeing flashes of light. Because these are the signs of retinal detachment. Get your retina checked at least once a year. Right now you have to ignore the floaters and you will get used to it. The surgery is only necessary if you have difficulty in seeing or retinal detachment or cataract. You can talk to your doctor about it and tell you are not comfortable going for surgery until next year. Next time you attach the reports given by your doctor it will be helpful for me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for tuberculosis?\n\nHello Doctor, My father is hospitalized for more than 3 weeks in Chennai... He is struggling to breathe and has other problems like BP, TB(which has been found now). He is in ventilator . Since it is more than 15 days Doctors done Tracheostomy treatment. It happened 5 days before. Still he is not able to come out of ventilator. Please suggest how long it would take for him to come out of ventilator. Also he has lung infections which has been recovering now",
    "doctor_response": "Unfortunately tuberculosis can be a very severe infection. It is treated by usually 4 medications at a time. If he is sick enough to require a ventilator, the medications are often done intravenously to ensure they are reaching his lungs quickly and reliably. The duration of treatment for TB is many many months depending on h is clinical course.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What causes painless black crack inside cheek in a smoker?\n\nHello doctor, I have a black type of a crack on the inside of my cheek and lips, no pain, a bit of irritation, and kind of like a small bump. I am a daily smoker and drink occasionally. I noticed it only a week ago. I have been smoking for five years and drinking ocassionally these years.",
    "doctor_response": "Hi. That is an ulcer caused due to biting (attachment removed to protect patient identity). Apply Orafast gel on that and it will heal in 3 to 4 days. That is not an issue but please do not smoke. You know the complications of smoking. It is hard to stop a habit but if we try nothing is impossible. Take care and please inform me if your ulcer is healed or else we will go into the next level of medication.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have enlarged tonsils with lump and fever. What could it be?\n\nHello doctor, Three weeks ago, I noticed my left tonsil seems slightly enlarged and I have a lump with white head right behind it. A little background for the past six months, I have been experiencing daily low fevers and severe night sweats which are undiagnosed. My PCP told me it was just a tonsil stone but I am almost positive it is not. It looks nothing like any that I have seen in my research. I would love to submit a photo for a second opinion. I will eventually make it to an ENT if needed but with the coronavirus, I would like to wait if it is nothing to worry about. Most labs (done prior to lump) looked normal except I had a positive ana with a low titer 1:40. My CRP was considered normal but 5.1 which says I am high risk for heart disease. I am a pretty active, healthy 34-year-old so while considered normal, it seems off to me. Chest x-ray looked normal. TB test negative.",
    "doctor_response": "Hello. You are right it is not a tonsillolith, it is a tonsillar cyst. Indeed, it is nothing to worry about and such a small may not even need any treatment. Furthermore, your tonsils are not that grossly enlarged or even congested to give you the spikes of fever. Low-grade fevers and night sweats need to be evaluated for other more important causes like tuberculosis. Have you done any serological tests and baseline blood tests?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I take Morphine instead of Dilaudid for broken discs?\n\nback in 1998 I broke my c6 and damaged my dic between c 6 c5 for 3 years I was bed ridin chronic pain 2002 they put me on dilaudid 2mg 4 tm dy which made some diff then added 25 mcg fen now I am at 175 mcg fen one 100 and one 75 also dilaudid 4 mg 4 times day now my doc for trial they want me to try drop the dilaudid and try 30mg of morphin 3 times aday the fen stay the same which would work best or a complete revamp I need to get some life back I am 71 and my name stuart",
    "doctor_response": "Hi Stuart,Dilaudid contains an opioid hydromorphone which is an effective analgesic like morphine and is expected to have lesser side effects than morphine. So if your doctor wishes to shift you from dilaudid to morphine, in my opinion, it will be better to ask him clearly what his reasons are for advising the change. If you were comfortable on the previous regimen, then there is no point in making any change.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bumps, itchy red rashes in legs, thighs after having protected sex. Possible cause?\n\ni did sex with women with condem but i did kissing with her, i think same days i got bumps in my butt and it removes with 1 within then i got bumps in leg and it is also remove in 4 days, but i am feeling itchying in my tigh area and red rashes came there, so little bit worried, i never got bumps in my life before or rashes",
    "doctor_response": "hi..thanks for your query. You might be suffering from Folliculitis on the buttocks and legs .IF so,It requires oral anti biotic therapy.There is a possibility of eczematous eruptions as well like Prurigo or acute urticaria. you should visit a dermatologist and get medicated.Meanwhile you can use Oral anti- histaminics to reduce itching. Hope this helps.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take flagyl for bacterial vaginosis and dehydration?\n\nHello,   I had a sexual encounter back in July where the condom had come off. I believe it came off as he was pulling out but not to certain if it came off due to the friction i felt while having intercourse. About 5 days later, i woke up with severe diarrhea that I've never experienced in my life that had went away the next day and i also had a loss of appetite and the food i did attempt to eat that next day, had a strange metalic taste along with spotting....I've taken several pregnancy tests and after taking them, i had all negatives. The spotting had continued along with thrush and I've never experienced that along with the metalic taste which can also be caused from the dehydration however, the diarrhea is what scared me. When I went to the er, The Dr. did a pelvic exam and drew blood and I was told i had bacterial vaginosis and prescribed flagyl. Two weeks prior to that, i had started a new diet consisting of fish and high in vegetables however i had very little bowel movements...I'm unsure as to whether that could be typical ARS symtpoms, from the diet, or food poisioning? Since that incident four months ago, I've experienced muscle twitching in my lower back that has happened within the past two months, sensitivity to the light, pelvic pain. Does this sound like typical ARS symptoms? I spoke with the guy i had intercourse with and he told me he got tested after i asked him about it and he also got tested about 2 weeks ago and he tested negative for everything. I've also been experiencing severe fatigue, muscle aches, difficulty sleeping at night, some instances where im hot which has been ongoing for two months now and more painful periods. Does this sound like ARS symptoms or could this all be related to stress....I've also had a dream about 2 weeks ago where i was tested in the dream and told i was HIV positive along with very vivid dreams. Does this sound like typical ARS symptoms?? Please help as im worried and worrying has taken over my life",
    "doctor_response": "Hi,Welcome to HCM.I understand your concern.The only way to confirm your HIV status is to test your blood sample for antibodies against HIV 1 and 2 by ELISA. This test will relieve your anxiety and stress. The symptoms you have mentioned in your query are not of ARS.Bacterial vaginosis is caused by anaeorobic bacteria which are usually commensals of the genital tract and you have been correctly treated by flagyl.I suggest you undergo the HIV test and confirm your status instead of imagining the worst and worrying unnecessarily.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest natural remedy for photomelanosis\n\nHi Dr. Samuel, this is Upender Due to photomelanosis, I am prescribed to use Triglow cream (Glenmark). As soon as I stop applying the cream, my problem again continues. I am looking for a remedy other than applying alopaethic creams and something in natural ways. Please suggest me regarding this.",
    "doctor_response": "**1. Photomelanosis/hyperpigmentation: is increased pigmentation due to sun exposure on exposed area particularly face-neck-limbs. 2. Initially contact a  dermatologist, who will clinically evaluate [who will differentiate it from sun burn (tanning) or post inflammatory hyper pigmentation due to secondary disease] and help you.3. avoid the sun by using sun-protective clothing and sunscreen to decrease the likelihood of pigmentary changes induced by UV light.PS. whatever improvement you get with peels and lightening cream, it should be maintained by regular skin care and avoidance of sunlight as much as possible. Sunscreen should be a routine for the rest of your life.4.  In Triglow [Fluocinolone,hydroquinone, tretinonin],side effect of hydroxyquinone itself is hyper pigmentation thus could be cause of your recurrent problem. [On its prolonged use it can cause thinning skin with red irritated skin or even hair growth]5. chemical peel which are affordable/effective and can be made/use at home are: with the help of tomato, orange peel paste, sandal wood paste, fresh milk, honey with curd , rose water and banana paste.6.you may go for combination peel which are safe on skin and give excellent cosmetic results.7.  A face wash containing glycolic acid will help in decreasing pigmentation.PS. . reduce your consumption of fats,sugar, salt and preservatives, all of which have a drying effect on the skin. . Remember to drink at least eight glasses of uncarbonated, unsweetened water every day, or substitute for green tea, which delivers both hydration and antioxidant power.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain and swelling in wrist due to an injury\n\nDuring a boot camp session 2 hours ago i hit the floor with my wrist and straight away a lump come up on my wrist and it was blue.you could also see the vein was raised.I have applied ice and swelling has gone down but it is still blue and very painful.i have pain across my wrist,down the inside of my thumb and strangely up towards my elbow.I can move my wrist although its sore,i can grip and move my fingers.I feel sick with it but although paiinful i can cope with it",
    "doctor_response": "Hello, I think you might be having a hairline wrist fracture. I would suggest you get x-rays of the wrist joint. It will confirm the diagnosis. If there is any fracture then you will need splinting. You have done the right thing by applying ice over it. Do not massage or move it. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Naveen Kumar Sharma, Orthopaedic Surgeon, Joint Replacement",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a pain in lower-right flank indicate for a diabetic patient?\n\nhave t2 diabetes w/ elevated blood sugar.  Over past 4-5 weeks have developed a dull pain in my lower-right back. (Flank).  Is this the start of my kidneys startingto fail, or is it a sign of something else?  The last blood test I had about a month ago-everything came back within range.  Please advise, K",
    "doctor_response": "Hi,Flank pain is a relatively common condition that can have a lot of possible etiologies and a number are commonly seen in urology. Anyway I want to say that this is not a sign of diabetic kidney disease because or diabetic nephropathy do not cause pain. So, don't worry. In diabetic nephropathy the filters of the kidneys, the glomeruli, become damaged. Because of this the kidneys 'leak' abnormal amounts of protein from the blood into the urine. This is the main sign that the kidney is starting to fail. Possible causes of your dull right flank pain can be urinary tract infections like Cistitis or pielonefritis or renal calculi.I suggest to consult an urologist to investigate about your flank pain (urine test, blood test, ultrasound etc) and if you find the cause ,you can have the right treatment.Hope I have clarified your doubts. If you have further queries, feel free and ask. Regards,Dr. Elona Xhardo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to consume alcohol when diagnosed with coronary disease?\n\nhi doctor I had MI before 3.5 years . I TAKEN HYPERTENSIVE MEDICINES + blood thinner REGULARLY. I suffered nasal bleeding also and was critically cared also. finally I deed angiogram , result is no blockage & minor coronary disease. now I have been prescribed nicorandil 1-0-1 atorvastatin 10mg - 0-0-1 aspirin 75 mg - 0-0-1 Can I take beer drink if yes ...wht shld the limit ? what is the risk & benefits ?",
    "doctor_response": "Hello, You can drink a beer time after time, but I would not recommend excessive drinking as it may be toxic for your brain and lead to chronic arterial hypertension and chronic changes to the blood vessels, increasing your cardiovascular risk. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the back pain and trace of leukocytes in my urine?\n\nI went to an Urgent care today because we just moved out of state so I don t have a pcp yet, but they said that I have a trace of leukocytes in my urine and I have been having bad back pain and side pain and nauseous especially after eating...they drew my blood and said that its not a virus and that they are sending it out for gull bladder testing....do you think it could be a kidney infection.",
    "doctor_response": "Dear friend,from my clinical experince I am telling you there is a good chance that you have urinary tract infection.again urinary tract infection can be due to kidney infection or obstruction in the way of urine excretion through bladder.your back pain and leucocyte in urine compells me to say this.hope an adequate amount of antibiotic will help you to get cured of this infection.wish you a healthy life.thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling inankles and feet?\n\nI have recently been placed on blood pressure medication, about 4 months ago. Starting about a month ago my ankles and feet have been swelling by the end of the day, almost double. Sometimes they go down by morning and other times they don t. What could be going on?",
    "doctor_response": "Is the anti hypertensive medication a calcium channel blocker like amlodipine? Calcium channel blockers have a side effect of causing pedal edema. If you're using it please consult your physician and consultant will stop the drug and switch to some other medication. Caution to be kept in mind as it is not the only cause of swelling it could be due to hypertensive nephropathy or other diseases affecting kidneys which has to be evaluated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain with constipation?\n\nMy daddy has abdominal pain for 3 days and occasionally has vomitting of black substance. His doctor prescribed only senokot and simeco for indigestion since he is also constipated. Also, his stomach has become big. What would be the causes of his pain?",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.The causes of constipation, abdominal distension, vomiting black colored substance is suggestive of the following::-Intestinal obstruction of whatsoever cause. -Fecal impaction.-Uremia.I would advise you the following::Take your father to ER / Hospital.Get an X-ray of the abdomen in the standing position. Blood for CBC, urea, creatinine , liver function tests, sugar, electrolytes.Urine : routine.There is a possibility of a mass / Cancer ; this has to be ruled by a colonoscpy after a preparation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for kidney problems after surgery for squamous cell carcinoma?\n\nI had surgery November 20 for squamous cell carcinoma on my right cheek. Two weeks ago, it became infected and found a small hairlike substance  in the wound and was treated with Keflex. Today, found wound infected again and went to the doctor. They cultured wound, guessing now is MRSA, and gave me Antibiotics. Now, found letter in mail saying my doctor wants new labs as my kidney function showed concern. This is the second time post surgery, my kidneys showed something high (I forgot what) after surgery. I am 48. I am an athlete and health care professional. You may speak in medical terms. Thank you.",
    "doctor_response": "Hello and welcome to HCM,The squamous cell carcinoma is not directly related to the kidney function tests.Kidney diseases do not show up early in the course of disease because the kidney compensates it. The normal kidney takes over the functions of diseased kidney tissue.The renal function tests turn abnormal only when the disease becomes advanced.You have mentioned that you acquired wound infection for which you took some antibiotic.There are some groups of antibiotics which affect the renal functions.The compromise seen in renal functions could be due to these antibiotics.You need to consult your doctor for management of the compromised renal functions.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore foot with swelling on the top?\n\nHey,I have had a sore foot for a couple of years now and I notice a swollen spot on the top of my left foot I would not say a bump or a knot it s sore to the touch and it will not allow me to bend my foot all the way down like I usually can,and it hurts pretty bad to walk on it ,it will come and go,what in the world is this?it is right below the bend of my foot,on the top.",
    "doctor_response": "hi,thanks for briefing your history. if you have persistent swelling of the feet than you need to check with vascular surgeon and get your vasculature checked. this can be done by Doppler scan. it will help to look into the veins and arteries to see any possible blockage for swelling. along with this you can try doing hy water fermentation and do ankle toe movements as well which will help reduce swelling. after hot water fermentation I recommend to keep the leg above the level of heart over the pillow to drain the metabolics. Also an x-ray if guided to be taken for any possible old fracture if any Present. with the grace of God I wish you a speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen and painful lower back and buttock after injury?\n\nHi, I feel down on stairs yesterday. between my lower back and buttocks is swollen and painful when even the lightest pressure is applied. My mid spine also hurts but not unbearable. my neck is also slightly swollen and painful. should i be concern. I took pain killers (advil) and applied muscle rub",
    "doctor_response": "Hello,Swelling on the low back and neck suggest a fracture.Due to this you are having sore upper back.An X-ray is required to confirm the diagnosisYou need to avoid spinal movementsA lumbar belt would be good to provide back support and movement restrictionsIcing will help to reduce the swelling.Depending upon the kind of fracture treatment will be decided (conservative or surgery)As in conservative approach you will require to were a brace or a lumbar support.Physical therapy rehabilitation is required for complete recovery.Hope this helps youthank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness, nausea and mucus in throat?\n\nHi I am having dizziness for nearly 10 years can t sleep well at night there is a lot of fluid came out of my mouth when I sleep at night and I feel there is a lot of fluid at the back of my head and in my ears and mucos on my throat all the time and nausea .already have a MRI for my head an have a lot of test for nose and throat at ent hospital and everything seem to be normal.",
    "doctor_response": "Hello!Welcome on HCM!I carefully read your question and would explain that your symptoms could be related to sleep apnea. For this reason, I would recommend performing a Multi Sleep Latency test to help investigate for this possible disorder. I would also recommend performing thyroid hormone levels, as thyroid dysfunction could lead to similar troubles. Hope to have been helpful! Wishing all the best, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the pain in left breast be muscular pain?\n\nI have had pain in my left breast on and off for around 2 months now. Sometimes it would radiate up into my left shoulder, and my loser back on the left side would hurt. For about the last 2 days it has seemed to be all of the above plus chest pains, sort of like muscle pain. What do you think it could be?",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .*  There are different  possibilities for this  issue  as    -  ligament  sprain or strain  -  muscular  pull  -  neurovascular  bundle    related  -  internal organ pathology including  lung parenchyma  , pleura    or  others .*  Should  be  examined with clinical signs  eliciting  thoroughly , necessary    work  up  of  x-ray  chest  or  others  .Hope this will help you surely to understand  the  issue .Wishing you fine recovery .Feel  free  to ask any further doubts .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes variation in the HB and hematocrit values?\n\nhad a cbc done on 9/28/2010 showing rbc 5.37, hb 14, hematocrit 40.5, mcv 75.4, mch 26.1, rdw-cv 14.5 and these numbers have been pretty consistent based upon 3/2/2010 & 5/10/2010 cbc's. Then on 12/21/2010 same test with corresponding values rbc 4.61, hb 11.3, hematocrit 33.5%, mcv 72.7, mch 24.5 and rdw-cv 15.3. Just wondering if could give some insight on what would cause this type of variance?",
    "doctor_response": "Hello,there are a lot of critical details missing from your description but I'll try to give you some direction.A decreased hematocrit with lower than usual mcv and higher rdw usually suggests iron deficiency although this is not 100% certain. Ferritin levels can help estimate the iron stores of your body. Clinical details can be very helpful as well. Any blood loss can cause a drop in hematocrit. This includes menstrual losses, gastrointestinal bleeding, hematuria etc. Decreased iron absorption is another possible cause. It usually has to do with very low meat and fish consumption. If you've had an infection, a drop in hematocrit may happen due to increased red blood cells destruction (mostly).I hope I've helped!If you'd like a more specific and detailed report, please ask again but mention all the details of your medical history this time!Kind Regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What relieves the pain in the hip caused due to a fall?\n\nHi, well, first of all, it has been pretty rainy today, and I was wearing shorts to play soccer. As I was turning with the ball, I slipped and fell on a concrete thing (where the shed used to be) and my hip has been really painful ever since. Is there any quick relief techniques?",
    "doctor_response": "hi,thank you for providing the brief history of you.A thorough neuromuscular assessment and musculoskeletal assessment is advised.As you had a fall on the concrete on your hip, there can be a possible of muscle injury at hip or a soft tissue injury in the spine. After a thorough assessment the diagnostic may be advised. Post which with simple medicine and physical therapy you should perform well.Also, since the pain is more, you can use icing for the region. but post which the very next day you need to get assessed as prevention is always better than cure. Never take any sports injury as smaller one. It can affect the sport performance later.In my clinical practice I see sports injury cases and with precise assessment and use of best diagnostic procedure we come to the root cause and plan the rehabilitation. We are able to make 99% of output on field. RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat hernia?\n\nhi i am a 28 year old male that does very hard construction work 40 to 80 hours a week. I have had this hernia for a bout 7 years.  I went to the dr about 6 and a half years ago and he told me it was just cosmetic and needed no further treatment.  I did not agree.  At  the time that i went to the dr it was about the size of a very small grape and very painfull.  Now it is about the size of a golf ball. Sometimes it gets very hard and tight and is really painfull. and sometimes it is soft and causes mild discomfort.  Most of the time it is painfull.. What type of dr do i need to see and how long would i be out of work and how much do you think the surgery would cost ballpark.  What might I do to take care of it untill i can get to a dr.  Thank you so much!",
    "doctor_response": "Thanks for contacting HCM with your medical concernsI assume that you are concerned about a hernia in the inguinal area which is in the groin. A hernia in this area does require repair. I would recommend you seek a general surgeon for consultation and surgery.If this is an umbilical hernia, one from the middle of your belly button then this is less of an issue. It does not usually require repair but if it does cause significant pain and discomfort then I do recommend consultation with a surgeon for repair. The repair is more difficult to preform if you are over weight.The time off from work with both procedures could take 4-6 weeks.Hope I answered your question. Please feel free to contact us again for you medical concerns and questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "How safe is taking brufen for heart diseases?\n\nHello father is a patient of Chronic Kidney Disease. He is undergoing Haemodialysis twice a week since Oct 2008, which started when he was admitted to hospital after Heart attack, which was followed by Angioplasty. This resulted in steady increase of creatinine and dialysis started then onwards.LAst week, his upper hand swelled enormously due to ( i think) blood oozing out and accululating inside his upper arm) just above the fistula) from fistula due to accidental wrong way of puncturing the needles of the pipes for haemodialysis (during one of the dialysis sessions).  Thereafter he was prescribed Bruffen 200 mg thrice daily after food for 5 days, with application of ice pack on the swelled hand( we can see clotted blood and his hand has become violet because of that). Is this okay for him and his heart and can taking Bruffen be detrimental/fatal to his health/heart. We are from India, Kolkata. He is 66 and with hypertension with medications and diabetes from long years. What can be effective now?? Or is continuing medication advisable.He is on medication like, Nikoran 10, concor 5, zytanix, rabicip, He is having breathelessness at any minimum exertion. Please help - A Biswas +91-0000",
    "doctor_response": "Hello , As such Brufen is strictly to be avoided particularly in heart and kidney patients as it can cause per say increase in Creatinine and when you are on Ace inhibitor / Arb for Blood pressure and strengthing  the heart , Brufen has unfavourable interaction which may harm the kidney furthur.  So per say I would advice you to avoid Brufen if possible.  As he is already on dialysis,  so a short course is so.ethimes sometimes of to take , however I would suggest that it is taken only if plain paracetamol 650 mg is not effective.  Regards Dr. Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pressure in the head?\n\nI have a strange pressure on the right side of my head, above my ear. Almost at my temple. It hurts slightly now, and I had it last night too without pain. I take 20mg Cipralex, however I haven't taken it yet today. Could it be a withdrawl symptom or an anxiety thing? Thanks.",
    "doctor_response": "Thanks for your question dear first please mention your age and second that you are adict to what??  Now causes include there is due to tention  injury medication alcohol",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause dull pain under the rib cage?\n\nI have been experiencing a dull pain in the upper right side just under the rib cage. My stomach is very bloated and fat. I am constipated. Sometimes I feel a hardening or lump at the top of my belly. My right side from head to toe gets the pins and needle effect. I recently had a severe case of positional vertigo (probably not related).",
    "doctor_response": "I think you need to get ultrasound examination of the abdomen that will confirm if there is any abnormal swelling in the abdomen or a lump. This will also show if there is enlarge liver or gall bladder than can also give rise to similar complains.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes black line veins breaking the skin around shaft of penis?\n\nhi, i noticed a couple months ago that i have a couple areas around the shaft of my penis where there are very small black line veins breaking the surface of my skin.  they don't get bigger. It appears to be in the area where i was circumcised as a child.  Is this normal.  Im 40 years old.  No discomfort, no swelling, no fluid.  Also I can only really see it when I spread the skin apart....very hard to see.",
    "doctor_response": "DearWe understand your concernsI went through your details. Appearance of black / dark veins around the penis shaft is quite normal and there is nothing to worry about it. In all males this blood vessels are seen on the surface of penis.The shape and pattern may be different in individuals but it is normal.In flaccid stage these veins are not prominent.When one gets erection the blood flow the penile vessels increase.This leads to filling of them with blood and they become prominently visible.In fact it is the blood flowing that is responsible for erection and its maintenance.In my opinion what you have is normal and there is no need to worry.However, if you are anxious about it, local examination by your doctor is the only option. You need treatment which will not be possible without your local doctor examining you.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent chest pains ?\n\nI often have chest pain through my back up into my jaw. I ve seen a dr and was diagnosed with ulcers w/o an ultrasound or scope. It s gotten a little better, however, it occurs wherever. ..after meals, before meals, after drinking water..my mom and my brother have both had their gallbladder removed, should I get a second opinion? I am a 40 yr old female",
    "doctor_response": "Hello dear, thanks for your question on HCM.I can understand your situation and problem.In my opinion you should first rule out cardiac cause for your symptoms. So get done ECG. If ECG is normal than it is mostly GERD (Gastroesophageal Reflux Disease).It is due to laxity of gastroesophageal sphincter.Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms.But better to consult gastroenterologist and get done upper GI Scopy to diagnose this.You should also rule out H.pylori infection. As this can also cause similar symptoms.Try to follow these steps for better symptomatic relief.1. Avoid hot and spicy food. Avoid large meals.2. Avoid stress and anxiety.3. Take proton pump inhibitor.4. Go for walk after meals 5. Keep 2-3 pillows under head in bed to prevent refux.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the kidney permanently damaged due to low potassium level leading to emergency dialysis ?\n\nmy mom suffers from angina, had emergency dialysis because potassium level read 8.1, kidneys failing, then pace maker put in. Now she is having breathing problems at nights. Is the pace maker too much for her heart and did she suffer from permanent kidneys damaged.",
    "doctor_response": "Hello and welxcome to HCM.As an Urologist, i can fully understand your anxiety, for your mother.The dialysis was done as high levels of potassium( >7), are abnormal.It's safest to bring it down to normal levels,by doing a hemodialysis.High potassium levels causes problems on heart function, detected on an echoscan and ECG. A pace maker is needed,if there's a block in rhythm.The pace maker helps in maintaining heart rhythm. The kidney function is checked with blood urea,creatinine and electrolytes level,which indicates, if dialysis is needed.Dialysis helps in kidney function.If you've any other doubts,send it as a direct question to me.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes foul vaginal smell in children\n\nHi my daughter (5) has an aroma of fish around her, we checked andits coming from the vagina area. My wife has taken her to the doctors and they took a wee sample. They tested it ?? and sai one of the 3 tests was positive and it normally isnt in a child of that age. I am not in the country at the moment and the doctor told my wife it was POSITIVE and nothing else i.e never elablorated on what was positive Can You assist as im away for another 3 weeks and am clearly concerned as a dad.",
    "doctor_response": "Hi...by what you say it could be urinary tract infection or a fungal infection of the vaginal area. Both are easily treatable and I have a few questions for you. Kindly get back to me so that I can guide you better.Questions - 1. Has there been any fever?2. Does she handle the genitals frequently?3. Do all of you - adults and children use same linen and towels after bath at home?4. Is there any itching or redness in the local area?5. Is there any vomiting and pain abdomen?You can approach me at the following link.Once the page opens there will be an option below my image as \u2013 ASK ME A QUESTION \u2013 click on it.Please find the link below - www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have gallbladder inflammation, cough, mucus filled, discomfort in rib area. Done liver functioning test. Further?\n\nHi yes do I have gallbladder probs? Constant coughing with mucus lots of trips to the bathroom ... Bowels , slight discomfort in rib cage right side area, wind ( both ends ) burps constant , fatigue, general feeling of unwellness. And occasionally my ribs feel locked up on right side if bending to put shoes on! Like a muscle had contracted and stuck! Going to docs tomorrow for a liver function test and will hopefully find its inflammation in gallbladder. / not hopefully / just hope nothing worse ... Thank you",
    "doctor_response": "this seem to be gall bladder as the disease has explaination of all the symptomps written by yoyas the gall bladder is inflamed and blocked the fatty oily food is not digested and cayuses the diseaseget diagnosed it is not serious as many persons have this disease and it can be treated by surgical intervention",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take instaflex for diabetes patient?\n\nHi Dr, I have a small query My Mother is suffering from Severe Joint Pain and also she has Disbetes. Is it safe to consume Instaflex for her? will the Blood Sugar gets increased because of Instaflex ? Please confirm its a matter of my Mother..who is everything for me..",
    "doctor_response": "Hi, Yes, it can be taken safely while having diabetes.Instaflex is a dietary supplement used to treat joint pain associated wit osteoarthritis and other such conditions. Although it contains glucosamine, a type of sugar however it does not affect the blood sugar levels hence can be taken safely while suffering from diabetes. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mohammed Taher Ali",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for fever and body aches\n\nI have a mechnical heart valve and I have been sick with a bad cold or flu. I had a fever, the body aches, runny nose, head ache and cough. I still have weakness runny nose and a severe cough. What is still wrong. I have no health insurance due to cut backs at work what can I do.",
    "doctor_response": "hi sir, its a viral fever.. benedryl cr syrup 10ml thrice a day.. dolo650 tab thrice a day, after breakfast, after lunch, after dinner.. extracef plus tab after breakfast, after dinner... xyzal m tab once after dinner... follow the treatment for 5 days... dont take cold drinks, oranges, grapes, fridge items etc... thank u, have a nice day..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the ASO test indicate?\n\nhi,i1m 20 year old girl.my ASO test is positive about 400 dilution b4 1 week .wat does it show?i dont have any joint pain or any other disease when i hav done that test. b4 2-3 weeks i had a pain on my knee, but it was gone after 2-3 days without taking any medicine. is there any problem with me?",
    "doctor_response": "Hi thanks for asking question.Here you have high ASO titre and then after 3 week knee pain.So you might have sore throat infection with streptococci and then after 3 week you have arthralgia.Because you have high ASO titre you should take antibiotic for that.If infection not controlled and if you have poor  hygenic condition or low immunity then chances of rheumatic carditis are there.So just now  it is better for you to do your ECG and CRP level to rule out cardiac involvement.Take antibiotic to treat condition.I hope you will understand my concern.thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a white spot on chest x-ray suggest after taking TB treatment?\n\ni just wondering how do i now that i already cured about minimal ptb... i don't have cough. or any signs right now.. i already take medicines a year a go when i diagnose that i had tb. but when i have my x-ray lately still have a little white spot.. how do i know if it is inactive..?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. This white spot on chest x ray is mostly due to healed tb lesion. Tuberculosis after treatment heal by either fibrosis or calcification and both these appear as white spot on chest x ray. But to prove that this lesion is inactive, you need to consult pulmonologist and get done 1. CT thorax with Contrast 2.  Bronchoscopy and BAL (bronchoalveolar lavage) analysis. If both these are negative for tuberculosis or other infection then no need to worry for active lesion. So consult pulmonologist and discuss all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes anxiety and depression after treated for lumbar fusion?\n\nhi doctor,I had a lumbar fusion on March 10, I was on dialudid until March 21.  I'm  experiencing lots of anxiety. is this related to opiate saturation? what can I do (I am taking xanax to help me get through it). How long should this last? Also I regularly take 10 mg of lexapro for anxiety & depression, should I increase that to 20 mg?",
    "doctor_response": "It is for sure that the opioid saturation can cause anxiety. But even your neurolgic problem have helped in causing anxiety. In my opinion you shouldn't take xanax for long period. As for lexapro you need see the doctor if he is going to make it 20 mg.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will masturbation lead to infertility?\n\nLast 3 months we are trying for child. But we are not able to conceive. In my young age i was involved in mastrubation. Is it the cause. Because i have tested my semen its normal only. And my wife's test are also normal. Please suggest me how to get conceive.",
    "doctor_response": "HaiAs per modern science masturbation didn't lead to infertility.So no need worry about this problem furthermore. As your semen test and your wife reports are normal you can try for another 2 to 3 month.I suggest to visit a infertility specialist for counselling about intercourse because some technique will help that you may not be known.hope i answered your query.Thank youhave a cheerful life",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are lump in jawline and swelling in gum related?\n\nI just noticed a soft lump along my lower jawline right along the top of my neck. It s towards the left side and is movable. I just noticed it and am worried. Also the gum around my left upper molar is swollen. Does this have anything to do with the other?",
    "doctor_response": "Hi..Can understand your concern..As per your complain a soft movable lump along lower jaw line that is movable is most commonly a swollen lymph node which can be due to infections originating from teeth,gums,salivary glands or any other nearby or distant structures of the body...A lump along the jawline can also be due to swelling in the salivary gland but a movable round lump is commonly a lymph node swelling due to infection..In case if you have swollen gums around upper left molar there can be a chance that there is a deep seated infection in the gums or deeply infected tooth and both these conditions can lead to swollen lymph nodes..I would suggest you to consult a dentist and get evaluated and get treated for the infection in the gums and in tooth (if infected) and as the infection will subside there are very much possible chances that the swelling in the lymph node will also subside..Hope this information helps..If you find the answer helpful kindly write a positive review and click on found this answer helpful as a token of appreciation..Thanks and regards..Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Could past history of STD cause infertility?\n\nHello doctor,I have been very stuck in the past few years. About four years ago, I was in a long term relationship with a boyfriend of mine. And during that time, I became sick and did not know what it was. Came to know that it was an STD (chlamydia). I was cleared after being in the hospital for two days. I have recently been with my current boyfriend for four years now and soon to be engaged.We have tried conceiving, and nothing works. I believe I may be infertile due to what happened to me, but I did not think so at first because I thought the doctors during my hospital visit would have explained that something else was wrong. I have not gone to the gynecologist yet nor have got my concern about this checked because I am terrifyingly nervous of the outcome as I know it is severe. I need some help on any natural remedies if this is the case.",
    "doctor_response": "Hello. Chlamydia is an infection which appears very mild and may be asymptomatic, but the damage it causes is quite extensive. The main risk is of damage to the inner lining of tubes and also the structures surrounding the uterus. It can create a block to the movement of the sperm, egg, and embryos.As you have been treated in the hospital, the infection has been handled thoroughly and adequately. You can find out if there has been any damage to the tubes, the bridge between ovary and uterus, where the egg and sperm meet to form an embryo. Either have an HSG (hysterosalpingography, X-ray with dye) or laparoscopy to clear any adhesions. If this path is clear, then there is nothing to worry, and you will surely get pregnant. Quality and quantity of eggs are affected by these infections. At this age of 20 years, you can get pregnant. There could be many other reasons for no pregnancy. 1. Have your partner's semen, blood sugar tested. 2. Have your blood sugar, and thyroid tested. 3. Has an abdominal and pelvic scan done to rule out any abnormalities? Out of these tubal patencies is most important. Worst scenario if the tube is blocked, it needs to be cleared by hysteroscopic tubal cannulation, or if the damage is not correctable, then IVF (in-vitro fertilization) is the solution. I hope I have clarified your query, do write back if any more questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain between shoulder blade and spine?\n\nI have pain between my shoulder blade and spine. It feels like muscle pain and pressure seems to be the only relief I get. Stretching hurts and my husband said that he feels a bump when he puts biofreeze on it. If I take a deep breath it also hurts. What could it be?",
    "doctor_response": "Dear Patient,I feel your pain is not muscular and its origin can be from the internal organs of our abdomen, namely gall bladder, pancrease, or liver.Getting an ultrasonography or contrast enhanced Ct can be very helpful to rule out any internal organ problem,I advice you to see a general surgeon and get investigated.things will improve for the good.Hope i could aid you in understanding your symptomsThanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe throat pain\n\nHi Sir my daughter is 2years 8monts now she is having pain in throat from last night, yesterday she haved some patato chips so i think because of chips she must have got throat infection, I have given her 5ml Althrocin 125mg syrup today morning becz she was complaing of sever throat pain. so I want your advice what should i do.",
    "doctor_response": "Hi...potato chips won't cause throat infection. This could be a viral or bacterial pharyngitis. I do not approve of using over the counter antibiotics. I suggest you go ahead and do a rapid antigen streptococcal test and a throat swab culture after consulting your pediatrician. If any one of these is positive, then we are justified in giving an antibiotic.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a cyst in left breast be cancerous?\n\nI was diagnosed with a cyst in the left breast 2 years ago. I have recently had a mammogram and ultrasound. the new radiologist does not think this is a cyst and wants me to have a needle aspiration biopsy to check for cancer. I am getting a second opinion and having another ultrasound done first. A cyst cannot turn cancerous right??",
    "doctor_response": "Thanks for your question on HCM. Breast cysts are usually benign in nature.But can turn into malignancy in future.  Though the chances are very less, but possibility can not be denied. That's why follow up mammography is always indicated for early detection of cancer.So new radiologist might find something unusual in cyst appearance,  so he order needle aspiration to rule out early malignancy. So in my opinion you should get done Needle Aspiration to rule out malignancy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could head heaviness after exertion be due to cervical spondylosis?\n\nI am 67 years old. I suffer from heavy head (not headache) after doing exercise. I have mild cervical spondylosis . After 45 years of age I have suffered from hypertension and had been for medication for High Blood Pressure. From 3 years I have been taking anti-asthmatic inhaler and continue to take it as of today. My Blood Pressure stays normal 80/120 these day but still I feel heavy head after exercise. Is it due to cervical spondylosis or due to any neurological issue. Can anything be done since I am keen to continue my exercise routine.",
    "doctor_response": "hello!!Dear,Thanks for referring to HCM !!I have been through your query and  completely understand your concern .*exercise does increase your blood pressure to a certain extent. It would be good if you measure your B.P during such episodes of headache. If you notice that B.P is above 160/90 then certainly it is a cause for concern.* If the B.P doesnt rise to such level then the reason for your headache could be strain to your neck muscles. spondylosis aggravates the headache.Hence try to avoid such exercises which put lot of stress. Try doing neck exercises which relieve spondylosis.You shall be fine sir/madam.Hope i have helped you. TCthanks.with Best regards Dr.Suhas Chauhan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sore throat, redness, tonsils with tiny red veins, dots on tonsils, allergy ?\n\nMy 5-year old son complained of a sore throat (no other symptoms). I looked inside his mouth and his tongue looks fine but the back of his throat is red. His tonsils have tiny red veins running through them and the tonsils have round crater-like dots all over them. They are not tonsil craters (I know what those are) but are almost more like polka dots on his tonsils. They are not blisters or filled with anything; they are red and about the size of a pencil eraser. Could this be allergies? Hand/foot/mouth? Thank you",
    "doctor_response": "Hello Dear. Welcome here on Health Care Magic Dot Com. I am very much concern of your problem. I think I will certainly able to help you out of this condition. In my view You have a bad habit of treating yourself by yourself. And you are not a doctor. So some procedures must be left for the trained doctor. So I will suggest To visit your family doctor and he will take care of everything. Good luck. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure cough and cold?\n\nMy 7 year daughter had a cough & cold about a month ago. She had taken amoxicillin, prednisolone & robitussin as prescribed by the doctor. It took longer for her to be free from this cough w/ phlegm. After 3 weeks, she had again cough, but this time its dry, hard & w/ nose bleeding. What causes this and pls advise. Thanks.",
    "doctor_response": "Hello, The symptoms of your daughter seem to be related to an upper respiratory tract infection. I suggest using Dexometorphan for the cough. I also suggest to drink liquids and eat a healthy diet. If the symptoms continue a recommend the second cycle of antibiotics. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for loss of appetite and vomiting after intake of Azithral\n\nhi, my daughter is almost 4 years old .we wear in india for 2 months. we got back from india day before yesterday. she had abad caugh the before we get on the plane. so the doctor gave her azithral 200 twice daily for 6 days. today is her last dose. it seems doesnot work at all. now she lost her appetite and seems throwing lot. at this point what to do?",
    "doctor_response": "The common side effect of azithral is nausea , loss of appetite and diarrhea that is gastric upset. Now that the course is over her appetite should come to normalcy in few days. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be done for red and swollen bump under the armpit?\n\nHey so i have this condition under my armpit where i have like this 2 inch bump and it s red and swollen and full of puss. i also have mini giles in my armpit where pus randomly comes out from. then on my other armpit i have this pea sized open sore. what should i do?",
    "doctor_response": "Hi, Kindly go to a doctor and drain your pus or chances of infection will be more. This might have happened due to the shaving of your hair in armpit which might have been infected. Kindly drain the pus as soon as possible and once it comes back to normal, whenever you shave use an antifungal cream to avoid future infections. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jilu Joseph, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain, abdominal pain, numb left leg. Taking medication for PID. What should be done?\n\nam julie, last week i was diagonised with pid n i was given levofloxacin 500mg for one month, metronidazole 400mg for two weeks and clotrimazole pessaries for six days.now am on the medication but my worry is that the left lower back n abdominal pains are causing my left leg to become numb. could there be other caused of the pains? should i continue with medication n can i use over the counter pain killers for the pains?kindly advise",
    "doctor_response": "Hi Julie, welcome to Health care magic forum. Thanks for asking a question to H.C.M.Forum. You had P.I.D. and using levofloxacin,metronidazole, and clotrimazole pessaries. Now you are also having left lower back pain, and abdominal pain, your left leg is numb. You are getting treated for P.I.D.and it is O.K., there appears to be some orthopedic problem like  sciatica,arthritis of the hip joint. I advise you to consult an orthopedic surgeon for diagnosis and treatment.You may need to have M.R.I. besides other routine tests for confirmation. Wishing for a quick and complete recovery. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest me the treatment for low sperm count and motility.\n\nDear Doctor my age 28 yearsheight 6 fitweight 58 kg i have TB in my past Presently iam healthy seminal report is quantity 20mlcolour milky whiteconsistency thick liquidreaction alkalnePH 70 total cout of sperms 10 million Dear Doctor my age 28 years,height-6 fit,weight 58 kg, i have TB in my past Presently iam healthy seminal report is quantity 2.0ml,colour-milky white,consistency-thick liquid,reaction-alkalne,P.H-7.0, total cout of sperms 10 million/ml of semen Motality after 1/2 hours total motile-10% active motile-10%,moderatelymotile-10%,sluggeshly motile-20% ,non motile-60% after 1hour total motile-8% active motile-5%,moderatelymotile-10%,sluggeshly motile-25% ,non motile-60% after 4hour total motile-2% active motile-00%,moderatelymotile-5%,sluggeshly motile-15% ,non motile-80% micro scopic morphology-10 to15% immature forms 08 to 10% tail less-02 to 04 %,pin head 01 to02%,W.B.C-4-6/hpf,R.B.C-no found, epithelial cell-not found,trichmonous-not found so pls tell sir i can be a fatheror not if not treatments are avilable for me. and duration as per abnomality which shows in my report. so taking medicine after showing doctor he gave me siphene-m and carnisure 500mg tablet and advice it to take two months so tell sir/mam it is right treatment for me and i will be father or not if yes how much time it will take.",
    "doctor_response": "HELLO WELCOME TO HCM YOUR SEMEN REPORT IS NOT NORMAL . SPERM COUNT AND MOTILITY IS LESS. SO YOU HAVE PROBLEM TO BECOME FATHER . GIVEN TREATMENT IS RIGHT. IF NOT RESPOND THAN THERE R SO GOOD MED IN HOMOEOPATHY FOR INCREASE SPERM COUNT. FOR THAT WE REQUIRED MORE HISTORY PLS. MAIL ME MORE DETAIL drvipul2001@yahoo.com there are so many techanic also availble now a days so don.t worry you will get result for your problem.. best luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach pain in kid\n\nMY daughter is 5 years old with a sever stomach pains, has had the runs since 1pm this afternoon its now 12:30am and its still going.. she started vomiting around 730pm while having the runs at the same time. the vomiting stopped at 9pm.. but she still awake and in pain, going to the washroom every 10 minutes, do i take her to the emerg or let it play out.",
    "doctor_response": "Good afternoon..!!Yes, it's better to visit pediatric ER for further evaluation and management.Thank you, have a nice day..!!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Done ultrasound for abdominal pain. Longer menstrual bleeding, no pain. What is the condition?\n\nHi doctors. I m 21 years old. i was admitted last Mar 31,2012 due to abdominal cramps, they thought it was appendicitis but it is not bouncing pain and my appendix was not visualized in the ultrasound. so it was ruled out as UTI. My ultrasound conclusion was, normal sonogram of the liver, gallbladder, common bile duct , pancreas , spleen , abdominal aorta , both kidneys and urinary bladder; non visualized appendix; thin-walled non septated cyst, left ovary consider follicular cyst. Since April 2012, my menstrual cycle takes longer. Before i had only 1-7 days of menstruation but since discharge from the hospital i had almost 1 to 2 weeks of menstruation, 1-4 days of my menstruation is heavy to moderate and it s my normal menstruation while the succeeding days is like moderate bleeding to spotting and it s painless. Can you help me doctors about my condition? Thank you so much.",
    "doctor_response": "Hello! Thank you for the query. First of all an explanation for you.  Appendicitis can not be ruled out by ultrasound. Especially if the doctor who has performed the ultrasound didn't find the appendix. It simply means that your appendix could not be found with ultrasound. So if it was not found, it`s inflammation cannot be ruled out. Moreover about 50% of appendicitis is treated with antibiotics with very good response. But such inflammation can recur. So it is possible that you have the appendicitis again. This  should be checked as soon as possible. So you should have abdominal ultrasound and fool blood work, liver and pancreas tests, urine analysis. Such symptoms can be also caused by mentioned by you uti or kidney stones, ovarian inflammation, ovarian cyst rupture, pregnancy or even endometriosis. It is strongly advisable for you to visit gynecologist and have transvaginal ultrasound performed. Hope this will help. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes soreness in the jaw joint after having upper denture?\n\nI got a new upper denture when I try to chew my jaw in the joint gets really sore also my cheek bones my lower natural teeth get really sore on the outside edge and the ridge of my upper jaw (where the teeth were) the lower teeth feel like they are biting on a flat surface",
    "doctor_response": "Thanks for your query, i have gone through your query. the pain or soreness in the joint could be because of the new dentures. it can be because of sudden change from edentulousness to dentures, or any high points or fault in the denture. the soreness over the ridge could be because of the sharp edges of the denture impinging on the ridge. consult a prosthodontist and get yourself examined and correct the problems. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes eating and breathing trouble due to dentures?\n\nhad to have all upper teeth removed.  Had temporary denture made and am waiting for healing to get 3 more implants to snap into new denture without the palate part.   I already have one implant but unfortunately while waiting for everything to heal is now falling out.When I put the temporary dentures in - I feel like  my breathing is blocked and I have extreme nasal drip down the back of my throat.  Why is this happening?  I have had the dentures since last November - they still are horrible and I cannot eat.   What is causing all this?   Is there a problem with my sinus?",
    "doctor_response": "Hello I think your temporary dentures are over extended just get them rechecked with your dentist this a common problem faced by patients when the denture extension is beyond specially at the palatal region extension. So don\u2019t worry get them corrected u will feel better\u2026regards Dr Rakesh Mishra",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should Xyzal be taken to cure allergies?\n\ngood morning i just went to see the dr. about my alergies and she gave me xyzal 5mg i just want to know should i take this forever cause i do get my allergies bad and i also get sinus bad.  please let me know if that is also going to help me with my sinusitis. thank you",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your history and would like to make following suggestion to you:1. Drugs like Xyzal (antihistamines) treat symptoms of the allergy, not the allergy itself. Hence as long as one has allergy symptoms, one has to take them repeatedly.2. Common side effects of Xyzal (& similar drugs) are sedation, drowsiness, poor concentration, etc. If you are not experiencing such side effects, you can take it for long duration as it usually does not have long-term side effects.3. Yes, allergic rhinitis and sinusitis are closely linked. So Xyzal can improve symptoms of sinusitis.4. Were I treating you, I would also add montelukast in addition to Xyzal.5. Personally I would suggest you allergy testing which will help you identify what you are allergic to and how to avoid them. 6. A balanced diet rich in vitamins & minerals (adequate amounts of green leafy vegetables, fruits, sprouts, etc) and avoidance of exposure to dusts, smokes & air pollution will also help you in a long run.Hope above suggestions will be helpful to you.Wish you the best of the health.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take Remeron and ellbutrin for depression and anxiety?\n\nI am 42 and am 6 weeks pregnant. I was on Citalopram HBR 40 MG but stopped when my therapist put me on Remeron 15mg and Wellbutrin 300mg for depression and anxiety. I stopped celexa one day and started the wellbutrin the next. I was told to stop the wellbutrin and remeron the day I found out I was pregnant which was last week. I am so tired but when I go to bed in the evenings I seem to panic and get up and pace. I finally fall asleep on the couch in an upright position. Even then it is only for a few hours. I desperately need help with known what to do to sleep and to go back on my meds. My husband said if he would have known this we would have never tried for another one. We have a 3.5 little girl. I have to stay busy during the day so that I am not crying all day and I panic when there is nothing to do.",
    "doctor_response": "HI, thanks for the query. As such no drug is entirely safe in pregnancy & both mirtazapine (rameron) & bupropion (welbutrin) are no exception. Both fall under FDA category C i.e. to be used only if benefit outweights the risk. Hence you should consult your Psychiatrist & your Ob/Gynac doctor before continuing these medications. Secondly, considering your symptom profile; welbutrin is not a good choice as welbutrin itself causes flare up of anxiety & panic attacks. Single drug use Mirtazapine between dose 15-45mg per day (all dose taken at night) is an excellent anxiolytic & will take care of all your symptoms. As you are preganant & wont be safe to use SOS anxiolytic like clonazepam, etizolam; hecne also consult a Psychologist to learn relaxation exercise, cognitive behaviour therapy (CBT) where you will learn exposure & response prevention (ERP), autogenic relaxation training etc. Supplement all of this with yoga & pranayam & you will soon get well. Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am a mouth breather. Will this cause health problems later?\n\nHello doctor, I am 19. I am partly a mouth breather since childhood. I mean, I breathe through my mouth only while sleeping. Is it harmful? Will I get sleep apnea? I am a thin guy with no snoring issues.",
    "doctor_response": "Hello. I just read your query about mouth breathing. I would like to say that yes, eventually it causes enlarged tonsils as well as adenoids, and causes a nasal obstruction leading to obstructive sleep apnea. It can happen in any body type. If your nose is blocked because of nasal polyps or a hypertrophic nasal mucosa leading you to breathe through your mouth, then you must visit an ENT (ear, nose. and throat) specialist to correct the issue. Hope you find my advice of some benefit. Good luck. For more information consult a general practitioner online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Would a vasectomy done to avoid pregnancy leave a scar or mark?\n\nHi Doctor, I want to stop my sperms coming out. I am 46, married a have 2 daughters. But i have family pressure on me for a son (3rd child). But i not for it. I want to stop sperms when in sex with my wife. Whats the best way. I know vasectomy can help, but will it leave any scar or spot. Because i don t want my wife to know about it. Or is there any other way which can stop these sperms like some injection or drug.. please suggest thanks XXXX",
    "doctor_response": "Hello, * According to my surgical experience, there is a discrepancy between the heading of the question and detailed narration below. * If the family wants a 3rd child and you are not ready, you have to discuss the issue thoroughly with all the members taking them in confidence, rather than searching the ways of stopping sperm production which can have very much other effects over your psychology. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Bhagyesh V. Patel, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes diarrhea with watery stools?\n\nhi. Dr. my grand daughter had diarrhea after the typhoon last week she is 1 year and 3 months old..i gave erceflora twice then pedialyte 30 and stop giving milk.after 2 days she is ok. and i start give milk...but she still water stool after drink milk so i decided to went in lab test for her feces the result was negative (blood gross) soft : consistency. other: yeast cells few....",
    "doctor_response": "Hi,Thank you for asking question on health care magic.Presence yeast cells suggest that it is fungal diarrhoea.Antifungal drug like Nystatin may help.Better consult pediatrician.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I go to the emergency room for back pain when tilting head forward?\n\nmy back hurts really bad when i tilt my head forward, it is breath taking pain. steady ache when i try to relax, bad enough i am considering a trip to the emergency room. i have a pretty high pain tolerance but this is hard to take. it gets just a little better in certain positions but not enough to relax.",
    "doctor_response": "There is no such need of hurry to go to the emergency for back pain. You should avoid forward bending, weight lifting., squatting. Take hot compression Volini spray for local application.take pain killer and ppi like pantoprazole for 5 days.By this time you should do a Digital X-ray of L/S spine and consult sn orthopaedic Dr.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the possibility for developing a blood clot without hormonal or other risk factors?\n\nHello doctor, I was wondering if I need to be concerned, or what is the probability if any, would I have at developing a blood clot if I have no blood clotting genetic issues (factor v, etc), not on any hormones (was on birth control pills for 12 years but been off for almost four years), no recent surgery, do not and have never smoked. I am just going to be moving 12 hours away and someone I know developed a blood clot in their leg after a 12 hours drive and did not have any risk factors (smoking, hormones, etc) to their knowledge. I got a little nervous about this possibility because I had a friend who died of a PE. Also, should I take Aspirin before the trip and wear compression socks or would that help? I am a 31-year-old female who only takes prenatal vitamins, Vitamin B12 1000 mcg chewable, Citalopram 10 mg, and occasional Excedrin as needed. Thanks.",
    "doctor_response": "Hi. I can understand your concern. Before I can answer your question, you mentioned that you are taking prenatal vitamins. Just curious if you are pregnant or plan to do so? Do you have previous unplanned or accidental abortions? Please let me know.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication to stimulate hair growth in moustache area\n\nhiI was diagnosed for facial Seborrheic dermatitis which caused some hair loss in the mustache area just above the upper lip and was advised to use mometasone furoate solution which has treated the condition, but i have a tiny bald spot where i was affected. The doctor had told me to apply a certain tincture to stimulate hair growth in the affected region after ten days of applying the mometasone furoate solution. Unfortunately, my wife lost the prescription and I dont know what kind of tincture was prescribed. I currently reside in different city and I cannot consult the doc again, and neither can call the doctor cause I do not have the doctors phone number.Therefore, I'd really appreciate if you could please advise me as to which tincture I should apply.Regards,Rick",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I have gone through your complaints and would recommend you to apply folifast hair tincture on the affected area once daily at night. This will help in improving hair growth. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is Mometasone dangerous to use on Face to clear my acne pimples?\n\nHello doctor, I am seriously facing acne pimples problem. Sometimes they occur on my face when I masturbate. If I use Mometasone, it gives a good result. Is it okay to continue this?",
    "doctor_response": "Hello. Acne is a universal issue in the age group of 15 to 25 years due to hormonal changes in adolescents. However, there are multiple effective treatment options depending on the grade and severity of the problem. Mometasone is a topical steroid and is to be avoided strictly on the face and for acne as it can harm your skin in the long run. Acne is dependent on hormones hence excess masturbation may sometimes lead to an increase in the problem. I would advise you to stop Mometasone immediately and kindly upload appropriate images to help us assess your current grade of acne and treat you better. Regards. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does suggested Hb electrophoresis in view of low MCV and high RBS count mean Thalessimia test is required ?\n\nHi, my 12 year old daughter s blood report says - SHOW MILD ANISOPOIKILOCYTOSIS, MAJORITY ARE MICROCYTIC HYPOCHROMIC CELLS WITH OCCASIONAL OVALOCYTES AND SCHISTOCYTES. NO HEMOPARASITES SEEN. It also says - SUGGESTEd HB ELECTROPHORESIS IN VIEW OF LOW MCV & HIGH RBC COUNT TO RULE OUT THALESSEMIA TRAIT . Do we need to take her for Thalessemia test?",
    "doctor_response": "Hello, The blood smear report does, in fact, suggest that she would be best tested for THALASSEMIA. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat hives like swollen lump?\n\nhi im leigh 16 from GB,now i have had a rash for two weeks i have been to hospital and doctors and they game me steroids and 120mg auntiestamine but it has failed to work . But now it has come back twice as worse and so painful and really swelled lumps like hives but they can not do anything else im wondering if you can help?. Thank you .",
    "doctor_response": "Hello, Antihistamines can be updosed and a different antihistamine can be added to the existing one. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Kakkar S., Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for sperm motility and size ?\n\nsir, my husband is 30 years old. he is suffering with low sperm count 2-3 million/ml having with left sided varicocele 1. most of the sperm are abnormal in shape and non motile , what should we do to get a child",
    "doctor_response": "Hi Welcome to HealthcareMagic Your husband can undergo a minor surgery to correct varicocele and take vitamins and antioxidants. Get his semen culture done to rule out infection, if found he need to take course of antibiotic to clear it. Treatment for few months may improve results. Once sperm counts, motility and morphology are good you can conceive naturally or through Intrauterine insemination (IUI). If semen parameters doesnt improve ICSI (IVF) is the option. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can't blood clots be dissolved completely ?\n\nHI, My mother is suffering from weakness in right leg, hand and arm since 6 days, also only 20% movement was possible then. First 48 hours we could not find any root cause of this sudden illness. However, on third day after MRI we came to know that there are blood clots in the arteries leading to brain . (no clots in brain). I am not able to understand exact reason for this clots. Doctor is giving 2-3 injections everyday since then so as to liquefy the thickness in blood. Now there is 50-60% improvement in physical capabilities on my mother only in right side of body, face is alright. But doctor said, that he cannot dissolve the clots completely. And only 70% recovery from paralyzed leg and hand is possible, even after physiotherapy . So is it real, that blood clots cannot be dissolved?, Also, can my mother recover 100% from this ? and can u please help me interpret meaning of 70% recovery on right hand side?..left side is alright.",
    "doctor_response": "Hi, Through arteries blood clot might have traveled in the brain causing this problem. Now as treatment for clot and making blood thin are going on so do not worry. But as doctor says 100%improvement is not possible it means due to clot some part of the brain area is damage due to cut of blood supply during initial period before treatment is started. you continue the treatment and physiotherapy more improvement may be there. ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is the speed of my ejaculation reduced with age?\n\nHi there up to about one year ago, when masterbrating the ejuclate would travel about 18 inchs. Now that i'm 47 years old my ejuclate  travels only about and inch and no more. I'm in good health, no heart or any other problem that i'm aware off, is this age related or should I be worried. Thank for any advice.",
    "doctor_response": "Hello,Your problem is age related. The semen might not be ejaculated with force like that of young age. You may need not to worry according to my opinion. Don't worry.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever?\n\nGood day my 70 year old mom has fever for 4 days now, her KUB ultrasound is normal, chest xray is normal too, creatinine as well is normal but she has 1-3 white blood cells and 25-30 red blood cells in her urinalysis, what could be the problem and what should we do to rule out the cause? thank you",
    "doctor_response": "She is suffering from urinary tracks infection. Get her urine culture and sensitivity done. Till report comes you can start with broad spectrum antibiotic.add urine alkaliser. Acetaminophen can be given as required. After the culture report suitable antibiotic can be given.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in top of leg and hip after climbing stairs?\n\nMy son picked me up on Oct. 19th and I went home with him to help with the Grandkids, as his wife was on a business trip. As I was going upstairs from the basement, I had a camera case on one shoulder and another case on the other shoulder, which contained all my supplies, such as makeup, hair dryer and other heavy items. As I reached the second step, I guess the heavy cases pulled me backwards and I fell. My son helped me up and asked if I could put weight on my leg and I could. I stayed the week, taking the girls to school each day and other places, I was very sore and going up and stairs was somewhat difficult and my top of leg at my hip turned every color, I did not go to the ERdown in Raleigh. I thought it was better until I rode home on Oct. 24th, but it started hurting after the ride home. I decided to go to the ER on Sat. Oct, 25th for x-rays as I was scared of a blood clot. I do have a Hematoma on my leg just below my knee. The ER Dr. At Northern Hospital in Mt. Airy, NC ordered x-Ray and and MRI. They do not have MRI service on Sat, so I think it was another test she ran as she put warm solution on my legs and looked for blood clots with an object she moved back and forth, starting at my crotch. I have continued walking everyday I can, and it has not bothered me, as a matter of fact it feels better after I walk. Yesterday, I walked on mt treadmill for 20-25 minutes. It is very sore today and hurts some and I still have the knot and have been putting an ice pack almost every night to cut down on swelling. I have heard of a bone bruise and have read about them on the I-Pad and it says you need to rest and take pain meds. I did not follow up with my primary Physician as I was instructed as I figured I had gone for test that he would have sent me for. Should I go back to emergency room for more test and also quit walking till all is healed? Thank you, Betty Midkiff",
    "doctor_response": "Thank you for using HCM. Its advisable not to strain yourself further until the hematoma is healed. Continue pain meds and do follow up. Also better consult your physician regarding calcium and vitamin D supplementation as in elderly osteoporosis is common.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for foot injury\n\nHello, I work at a horse barn. One of the horses there stepped on my foot. I did not think it stepped on it that hard but a spot on my foot is bruised. It kinda hurts to walk on and it hurts to touch it. This happened yesterday and I cant wiggle my toes on that foot as well as I can on fingers. What should I do? Any information would be great. Thank you :)",
    "doctor_response": "In my opinion you should do a simple x ray to be safe , although it seems like nothing ,also use anti inflammatory like alphinturn untill thenGood Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause sharp chest pain with episodes of heart flutter?\n\n28 year old female. chest pain left side front now last night it was a sharp pain when I took a deep breath in my back on the right side upper back. Occasionally I have episodes where my heart will flutter and beat fast then feel like it suddenly stops for a second and it makes me cough to catch my breath. I have never had this checked out but was told this weekend I could have a form of heart disease...is this true?",
    "doctor_response": "Hi thanks for contacting HCM....Noted your symptoms suggesting toward some form of cardiac cause....As you complaining flutter like sensation so first arrhythmias has to be ruled out....Second it could be ectopic or premature beats like problem....So consult doctor without delay for auscultation of heart sound and check murmur ....Measure your blood pressure...ECG and echo useful for correct diagnosis.Causative treatment done...Take care.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with benign neoplasm of pituitary gland and craniopharyngeal duct. Have headache and memory loss. Guide?\n\nHi, I have been diagnosed with a benign neoplasm of the pituitary gland and craniopharyngeal duct..The size of the tumor is 1.4 cm. I'm afraid the result will be surgery. What do you think? I meet with a Opthomologist tomorrow to have a vision screening done b/c my vision is blurred. I have extreme headaches and so much memory loss. I will be seeing a neurosurgeon as well ASAP. I'm scared.",
    "doctor_response": "Hi,Thank you for posting your query.Yes, your guess is correct. Most likely, your neurosurgeon would advise you for a surgery. However, there is no need to worry, as the tumor of pituitary is most often benign (such as pituitary adenoma or craniopharyngioma). Once they are operated, you would improve for good. The most likely cause of your headaches and memory loss is the tumor.Also, in most cases, the pituitary surgery can be done through nose, without opening the skull. I hope it helps.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My platelet count is abnormally low after a week of fever. Could it be something serious?\n\nHello,  I am writing to ask about some symptoms I have been experiencing. I am 57 years old. For almost a week I havehad persistent low grade fever (never more than 100.5). After the end of the week, today I no longer has a fever. We did a blood test and found abnormally low amount of platelets: 127 Thousand/ microliter. When we did the blood test six months ago, it was at normal level of 166 thousand/ microliter. During the fever I had no other symptoms,: no cough, no throat pain, no runny nose, no breathing issue, etc. Even though the fever seems to be gone since today I am very worried as to what may have caused it, if it could be linked to a serious disease. So far the platelet count is the only abnormal thing showing up in the blood test. Thank you.",
    "doctor_response": "Hello, Keeping into the current circumstances , your fear is completely justified. Good thing is your fever has subsided Excellent is not having any Upper respiratory tract symptoms during the febrile episode Now coming to low platelet count medically known as Thrombocytopenia , your count that is 1,27,000 /mm3 falls in mild range [1,00,000/mm3---1,50,000/mm3] which can happen due to multiple reasons 1]Lab Error 2]Pseudothrombocytopenia due to the anticoagulant used [EDTA ] Low platelet count is considered , when associated with Bleeding symptoms like spontaneous or easy bruising , petechial rash ,bleeding , gum bleeding etc You have none , hence i foresee it to be a lab error /EDTA induced Further , if you are worried , you can get that rechecked by going for reanalysis of platelet count in Heparin or Sodium Citrate based collection or Peripheral smear I can assure you [with the history of your current illness provided ]that your health is safe and sound and all is well Eat well, Sleep well , Stay safe Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can painful and swollen glands on the neck be treated?\n\nHi, I am a 21 year old woman and I am experiencing painfully swollen and enlarged glands on my neck and behind my left ear, sensitive skin across large portions of my face, along with small rashes scattered across my forehead and scalp. Also, it hurts to open my jaw because it feels muscles there are slightly swollen, though it could be connected to my ears, because it is just in front of them... Should I be worried or is this something that will pass with time?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I understand your problem. You may have your parotid gland enlarged (parotitis). It may be due to bacterial or viral infection. I suggest you to go to an ENT specialist as there is a facial nerve which goes through the parotid gland which can get affected. if you didn't treat this. So to avoid problems to facial nerve you should go to the doctor. Hope this will help you. Thank you and get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes episodes of numbness and tingling in right side?\n\nI have a c1-2 bone spur. I am experiencing right sided numbness. No pain, just tingling and numbness. From my lip to my foot. The numbness and tingling is intermittent with problems with coordination in both right arm and leg. Nothing in particular exacerbates. Just comes and goes. Lasts from a few minutes to a few hours. No discernable pattern. Should I just continue to deal with this even though it is beginning to affect my job performance? Or should I get a second opinion? Diagnosis was made by X-ray and followed with CT of head and c-spine. First episode at age 42, and 6-10 episodes yearly. Episodes becoming more frequent and more aggravating depending on activity at time of episode.",
    "doctor_response": "Thank you for asking Healthcare majic. My name is Dr Ehsan Ullah & I have gone through your query.All the above mentioned complaints are due to prolapsed disc compressing nerve roots in cervical spine along with bone spur...    Kindly get MRI cervical spine with brain cuts and consult near by neurosurgeon...Meanwhile take some analgesics,muscle relaxants and pregablin 75mg one tab at night.Hope this may help you. Let me know if anything not clear. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes constant upper right back pain with elevated liver enzyme levels?\n\nI have had an issue with back pain since 2015. At that time I had mildly elevate liver enzymes and fatty liver. Had an ultrasound which showed possible stone at the neck of the gallbladder and a dilated common bile duct. My Physican suggested loosing weight to possibly decreasing the enzymes. I am a very busy person and almost 9 months later I returned to see him. During that time I have intentionally lost 30 pounds with low carb diet. I have been having consistent right upper back pain which will on occasion come to the front of my chest. With a stabbing sensation. Last week I repeated my labs and my ALT was 165 Ast was 65. Really concerned with this pain. Saw NP and she wanted me to return in 4 weeks to repeat labs. My alkaline phospatate was 65. I do have a history of drinking beer. Do u feel this could be my gallbladder. My biggest concern is that I am having all this pain and she wants to wait.",
    "doctor_response": "Hello,I can understand your concern.I agree with you that this may be a gall bladder issue but i strongly believe that there may be other abdominal causes as well that can cause these symptoms and derangements,especially causes related to the liver.You need to consult a good hepatologist and get a CT contrast abdomen or an MRI abdomen for deciding the further line of treatment.Hope this was useful.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having abdominal pain, swollen abdomen. Have 2 slipped discs. History of hysterectomy and endoscopy done. Any advice?\n\nhi i get alot of abdo pain on the left side of my abdo after i have eaten i also get swelling around my abdo i am about 10 stone 11 and am not unhealthy i swim play sports but i always get this bloating swelling when i ve eaten. i do not always eat healthy but 7/10 i do i had hysterectomy 12 years ago and an endoscopy 2 years ago and i also become very very tired this has been going on now for about 10 months i do have 2 slipped discs that cause me problems i have just had 3 months off work so i am on regular tramadol about 200mg a day i am also 42yrs young any advice would be good thanks ruth",
    "doctor_response": "Hello,The abdominal pain seems to be due to gastritis.Gastritis may have been induced by painkiller drugs.It is advisable to stop taking painkillers oral and shift to patch application.A repeat endoscopy is recommended.Consult your doctor for more help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How lymph node TB with liver infection be concurrently treated?\n\nhi my mother is diagnosed with lymph tb, she is started using atk4 medicines for one month, suddenly she got liver infection, her bilirubin and sgot and sgpt levels are too high, they stopped her medication except rmp, etm, and few antibiotics, now they started with inh and her sgot and sgpt levels are elevated within one week, now they stopped inh,  how long this may continue , she is 65 years old",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.She has lymphnode tuberculosis. But INH is hepatotoxic drugs and she can not tolerate INH. INH causing liver damage in her. SO she should take 2nd line or 3rd line anti tuberculosis treatment. Consult your doctor and take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does reticular infiltrate in lungs mean?\n\nI had a pulmonary function test recently and part of the results said: ....there is a reticular infiltrate present in both lungs unchanged from the previous chest. I don t know what this means. Could you please explain in words that a sweet little old lady can understand?",
    "doctor_response": "Thanks for your question on HCM. Reticular pattern on chest x ray can be seen in1. Interstitial lung disease (ILD)2. Interstitial pneumonia (viral)3. Old healed scar etc.Since your reticular pattern on chest x ray is static with comparison in previous x ray, no need to worry.  As this must be old healed scar lesion.As ILD and pneumonia will worsen if not treated. So static reticular pattern suggest healed lesion only.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for Psoriasis on 1 year old baby\n\nDear Sir, My sister daughter of 1 year 3 month old is suffering from severe Proriasis (full body including head ) and she first got Proriasis when she is 45 days old till then she getting treatment but not cured. She taking ACROTAC and OMNACORTIL, for the past 2 months but no improvement\u2026whether this medicine is really useful? any side effects will come? How long it will take for cure. Please advice if any other good treatment is available. please help us....",
    "doctor_response": "hello.. welcome to health care magic forum.. psoriasis is an auto -immune disorder.. one has to take internal medicines to ensure recovery... taking steroids like omnacortil n other allopathic drugs will only help temporary.. and it will lead to further supression of the diseases.. only to aggravate later.. the best way to treat it is by using homeopathic medicines.. it takes time n patience to be healed.. do not use any topical creams.. for the itiching and dryness olive oil is best to use.. avoid harsh soap use a glycerine, moisture soap.. avoid direct exposure to sun rays, tangy things, wear soft cotton clothes.. avoid synthetic n linen wishing u good health..",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat lump inside the skin of ear lobe?\n\nI have a small lump inside the skin of my ear lobe. I have never had earrings, and when i squeeze the lump, it hurts and can be crushed inside my ear. It swells up and turns very light red, but not noticeable or even relatively close to blood color. What do I have?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  You may have sebaceous cyst.  It is very common in that area.  Excision biopsy is the treatment of choice.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having urine retention?\n\nMy step daughter is having urine retention. She is 30 years old never any problems with her kidneys in the past. What could be causing this. They have placed her in the hospital and given her a CT. We have just been told that her kidneys are not functioning properly. Why?",
    "doctor_response": "Hi,There can be many reasons for urine retention in a your daughter.Mechanical/anatomical causes include urethral stenosis, foreign objects, bladder stones, constipation, urethral cancer, uterine fibroids, bladder-neck obstruction, pelvic organ prolapse, cervical cancer and anti-incontinence surgery.Functional or neurological causes of urinary retention in women include cerebral and spinal cord diseases which can be congenital, neoplastic, degenerative, inflammatory, vascular or traumatic, e.g. spinal cord injury (suprasacral), multiple sclerosis, Parkinson\u2019s disease, cauda equina syndrome and Fowler\u2019s syndrome.It is important to know what is the diagnosis made on CT scan stating that the kidneys are not functioning properly.The problems with the kidneys might have arisen due to obstruction in the flow of urine from the urinary bladder to the exterior. If there is persistent obstruction to the flow of urine then there are back pressure changes from the urinary bladder in to the kidneys. If such an obstruction continues for more than 10 days then permanent damage to kidney function is possible and this is called obstructive uropathy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tooth sensation\n\nI have sensation in my tooth covering my right side head where the tooth is, the doctor has advice me to have Tegtarol 200mg two times Gapathy M  one times  and Ezat 120gm one time dentist has said it is nero problem so the nero has advised me advise me further",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have tooth sensation due to infected tooth. Well there can be many reasons for symptoms you mention in query like tooth abscess , pulpitis or gingivitis. Need not to worry.  I would suggest you to consult dentist and get complete examination done. Doctor may perform oral prophylaxis . Doctor may order x-ray of tooth to confirm the diagnosis . Doctor may also check the tooth for tenderness and check level of infection . If infection has already affected the pulp then doctor may recommend root canal therapy along with crown on it . For now do warm saline rinses several times a day and maintain proper oral hygiene . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for conception\n\nHi Doctor... I am 27yrs old.I have got married before 2yrs.Now i have plan to conceive baby. before 1 month i was trying to get pregnant but it show negative. My period cycle is on 16th of every month. Please suggest me the actual timing to get pregnant. there is no problem  in period cycle. suggest me pls...",
    "doctor_response": "HiGREETINGS Hope you have done your husbands semen analysis. If not get it done at the earliest. The ideal dates in case her periods are regular is 10 days from first day of periods till 20th day.Daily or alternate days intercourse and you should not get up for 30 minutes after discharge. Hope my answer helps you. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in stomach, penis and testicles when being sexually excited\n\nHello Doctor, I\u2019m having pain in stomach abdomen near to penis area, Sometime testis (balls) are paining. This is my 4th time getting pain like this.. I have to masturbate to release the sperm then abdomen & testis pain will go away. I\u2019m 27 years old guy. I don\u2019t have any bad behavior. I won\u2019t smoke, I won\u2019t drink liquor, and I\u2019m still virgin never had sex with any women. I have plan to get marry coming 2016. If I have any serious problem I want to fix it before getting marry. I realize this is happening while I\u2019m sexy talking to my girlfriend via phone or sms. Please advice about this problem. Thank you!",
    "doctor_response": "thanks for your query in HCMyou are having pain in testis and abdomen.probably there may be varcicocele or epididymal cyst in scrotum. please get an ultrasound scanning of your abdomen and scrotum. if the report is normal, nothing to worry.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest management for Ewing sarcoma with metastasis\n\nHello Dr. Samuel N. Grief, my 22 year old cousin has Ewing Sarcoma and is being treated at U of M right now which resides in Ann Arbor Michigan. It has metastasized. She went in with a pneumonia and her lungs keep feeling with blood. I m trying to look for other test she could possibly have to help her overcome this terrible Cancer. Her family is desperate for answers and so am I. I m in Medical myself and want to do everything I can for her. She doesn t deserve this.",
    "doctor_response": "Hi dearI have gone through your question. I can understand your concern. Ewing sarcoma with metastasis can be treated by chemotherapy and radiotherapy. Treatment depends on which organ is affected by metastasis and size and location. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for weakness?\n\nI am a 38 year old female with an ileostomy due to Crohns ...i have recently been sick with a stomach virus.I went to the doctor and my potassium level was a 3.2 i am weak ,having problems with my nerves,and dizzy. He gave me potassium pills but i know they did not dissolve properly ...what should i do ?",
    "doctor_response": "Workup should be done to investigate the cause of your weakness.Serum electrolytes, and not just Potassium, should be requested. Also, blood sugar and.other parameters should also be done as to investigate on the cause of your weakness. And proper management and treatment should follow.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can depression along with anxiety and ADHD be treated?\n\nHello. My son is 12 and has been diagnosed with many mental health disorders including: Major Depression, General Anxiety Disorder, ADHD, Frontal Lobe Delays, Executive Delays and also has an undiagnosed mood disorder. He is also soon to be tested to see if he s in the spectrum. He has extreme behavioral issues, is extremely fatigued and has always had a hard time sleeping, as well as highly uncoordinated. I came across some information about Wilson s disease, and based on the symptoms it has made me curious if this may be the culprit? And looking at his eyes, I am wondering if he has Kayser Fleischer rings. I have a picture of his eye that I can send to you. We have just come to terms with all of these seemingly separate illnesses, but starting to wonder if they all just point to one thing. Thank you so much for your time!",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Mood stabilizers may help control ADHD symptoms to a little bit. Low dose antipsychotics may also help. Behavioral\u200b issues might also get reduced. Regarding Wilson's disease, consulting a physician as early as possible is the best thing. Measurement of copper levels helps in diagnosis. I hope I have solved your query. Feel free to ask further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for sprained ankle\n\nYes, my daughter sprained her ankle Friday night;she went to the ER and was told that it was sprung and that a blood vessel. The ER wrapped it, but she has been in such much pain with sever burning sensation and also she has a blister on the same foot; the foot is cold to the touch. She went back to the ER again last night and on her way back again to night. What can we do for her?",
    "doctor_response": "Hi...the treatment for sprained ankle is complete rest and a POP (Plaster of paris) cast or a crepe bandage keeping the ankle in the correct position of comfort. When the bandage or POP is too tight then the symptoms of blistering and cold limbs occur. I suggest you get back to an orthopedic surgeon and get the bandage loosened appropriately.Regards - DR. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from stage IV esophagus and stomach cancer, metastatic cancer in liver and lymph nodes, have deterioration with each chemo treatment, want to stop it. How long can I live?\n\nMy husband has been diagnosed with stage iv esophagel and stomach cancer . He has had surgery to remove the large mass in his stomach. He also had metastatic cancer in the liver and lymph nodes. He has undergone 7 treatment of chemo and he is getting worse(sicker) with each treatment. I know his prognosis is not good. He now whats to stop treatment and just live his life without being so sick. About how much time does he have in your estimation?",
    "doctor_response": "when treating the stage IV cancer patient,the aim  of the treatment will be different from the stageI cancer . The aim of the treatment is try to  decrease his sufferings from the disease and disease caused problems. this approach is called palliative treatment.There is always debate when to stop the treatment and leave him without any cancer treatment. Carcinoma esophagus is different from the cancers of the other areas. the starvation will take upperhand and most of the patients will suffer because of this one than the cancer itself.  As Physician i will not give any treatment which will give him more harm than help. Giving more chemotherapy, now will come under this category. It is fact that our aim now is to give more comfort to him by looking after his food intake, and also to see  how he should be comfortable in all aspects. if his general condition is good, the survival may be months ,otherwise in weeks. To me it is reasonable to tell you to be strong and to prepare yourself for the worst thing within short period. i am sorry to be like this. you and physician aim at present is to give possible  comfort,less pain to him until he stays with us.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for frequent sublux of the shoulders?\n\nhello. i am a sophomore in high school and am an athlete. last year i played football and subluxed my right shoulder twice. after the second time i went and got surgery. after months of rehab i went back into physical activity. i started training for wrestling season over the summer. in July my left shoulder subluxed. i rehabed it and felt fine for the next few months. two days ago my left shoulder subluxed again and i dont know what i should do. im a varsity wrestler and im just stuck. my shoulder is hurting. do you have any suggestions for me rehabilitation wise? or anything i can do to eliminate the pain? thank you.",
    "doctor_response": "Hello, Surgery may be needed for your left shoulder. The pain will relieve after putting your shoulder in the right position. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "hep c symptoms involving blood found in both vomit and fecal matter, please suggest me\n\nhep c symptoms involving blood found in both vomit and fecal matter. im a 39yr old male who is hep c positive and currently still active in my addiction of meth. I have recently, 7 days ago to be exact, started having sharp pains in my liver which brings on bouts of extreme nauseousness. When i do vomit from the pain theres been enough blood in it to cause me huge concern. the same in my stool but only the past 3 days. what should i do?",
    "doctor_response": "Do talk to your doctor about cirrhosis of liver and other conditions as well. Hepatitis C is known for that.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for persistent dizziness\n\nI m feeling dizzy for the last couple days. I haven t slept well for a few days. Could that be a factor? I do take synthroid for my thyroid. Could it be time to change the dosage ? Or my blood pressure medication ? I do have my yearly physical this Monday so I ll talk to her about this. Was looking at this site for possible clues. Thanks",
    "doctor_response": "Hello!My name is Dr. Aida and I am glad to attend you on Healthcaremagic! Your symptoms could be related to different possible causes: a thyroid hormone imbalance, lack of sleep or blood pressure fluctuations. For this reason, it is necessary to measure your blood pressure values frequently during the day and checking thyroid hormone levels.It is also necessary trying to regulate your sleeping hygiene in the next days. You should discuss with your doctor on the above issues. Kind regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any possibility of brain getting affected or bleeding in head if fell down on floor?\n\nHi doc. I just want to ask if there is posibility that affect my brain or bleeding on my head if i fell down on the floor  and knocked my chin and get blue black and showlend...but when i fell down i feel something just like an electricity that goes up on my head but i never get dizzy and  i monitored my self i did not get boumiete ..",
    "doctor_response": "Hi,Dear.Welcome to HCM.If you fell down on your chin then the vibrations of the impact can reach to the skull bone and caused you sensations as well as when ever there is a hurt on a nerve it travels up to its origin.so do not worry about it.If you are not feeling dizzyness,vertigo,headache,loss of sensorium,eye or ear ache within 24 hrs of hurt that means there is no injury to your brain.And as you are telling that you dont feel any of the thing i think there is no brain injury.so stay stress free and rest properly.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a rash on my face that has come back more aggressive than before. Please help.\n\nHello\u00a0doctor, I am 20 years old and suffering from a rash on my face. The first breakout was around five weeks ago. I noticed a red spot above my left eyebrow after hearing a\u00a0stressful news and eventually it spread to my chin and above my lip. I was at the beach and after around three days, the rash hardened and left. The skin was kind of dry. The rash has a blister look to it up close and is red. It looks like a ton of little pimples and some of the spots even have what look like whiteheads. It is not painful\u00a0but does itch somewhat. One week later, the rash came back and I decided to see a dermatologist. The dermatologist said I had seborrheic dermatitis, but did not take a sample to have a lab test or anything. She basically just looked at my face and told me what I had. She prescribed me Ketoconazole for two weeks day and night. It kind of came and went. The Ketoconazole cream I guess worked because I did not break for around two weeks. Well, I just stopped the Ketoconazole five days ago and today, I woke up to the same blister-looking rash again. This literally happened overnight. It has just gotten worse throughout the day. Now I have it above my left eyebrow up onto my forehead, the bridge of my nose and around my right eye, chin, above the lip, and some on the right cheek. I need help. Was the dermatologist right when she said it is SD? Or could this be something else? I know they say the skin is scaly with SD but I am not sure my skin has a scaly look. It is more like pimply. To be honest, my skin most resembles a heat rash in the pictures. The pictures do not do it justice.",
    "doctor_response": "Hello. It could be seborrheic dermatitis or photodermatitis. Allergies may be playing a role. All these are visual diagnosis and the lab tests or biopsies have limited or no role. Seborrheic dermatitis is more commonly present with dandruff and similar rashes on the neck and sometimes upper chest. Photodermatitis would be present over the sun-exposed areas. In all of these conditions, a mild steroid cream would be useful if applied for a few days. You can apply Hydrocortisone cream mixed with Ketoconazole for 10 days, twice daily and then switch to plain Ketoconazole for the next 10 days.  An antihistamine, like tablet Loratadine, can be taken 10 mg twice daily. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. A sunscreen is very important to decrease redness. Apply your sunscreen at least twice daily for example at 8 AM and 12 PM. If dandruff is present, a Ketoconazole-based shampoo may be used twice a week. You can follow up after two to three weeks. Good luck. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could elevated alkaline phosphatase levels suggest?\n\nI have been nausea for a little over a month, everyday. I had blood drawn and my alkaline phosphatase level was elevated to 139. My Dr. wants me to wait another 2 weeks and have blood drawn again. I do have pain on my right side but it is not constant. Any insight you can provide? I want to request a CT scan because I think it is my gall bladder.",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I understand your concerns and I will try to help you as much as I can.Yes, this may be gallbladder issue but if only ALP is elevated then I dont think that urgent measures are required. If other liver markers are fine than it may be just small gallbladder stone that passed so only lab follow up in few weeks is required. You can do ultrasound to see if stones are present, but CT scan is not necessary. You need to change your dietary habits first.  Need to avoid fried food, carbonated drinks, coffee, alcohol and spicy food. You should eat more milk products, vegetables and boiled food. SOme other causes are less common and include biliary tree pathology, but this is not likely at this point if no symptoms are present and liver markers are fine,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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dizziness and anxiety\n\nI've been getting lightheaded a lot lately sometimes followed by a bowel movement. The feeling gets strong like the feeling going to faint or die sometimes feel like I need an ambulance. People tell me it's just anxiety cause I did lose my job and have been worrying about bills. About to start a new job now I'm worried it's going to happen at work. It happens sometimes when I go in stores, happens after I get mad sometimes. I got a blood pressure machine and constantly check it, and always it's around 117/68 and pulse is around 80. The feeling scares the hell out of me. Went to the doctors they say it was vertigo but it wasn't. I guess, nothing is spinning just feels like I'm going to faint or die, I drink a lot of water and it takes about an hour or so for it to go away. I don't lay down when it happens cause I'm scared I won't get back up. Thank you for any info you might have.",
    "doctor_response": "Hai,With your clinical profile , it appears to be Panic attack.Its a Anxiety related disorder . It will get improve with Cognitive Behavioural Therapy & if require Antidepressents . Get a nearest Psychiatrist opinion for further help.ECG,THYROID FUNCTION TEST & SOME OTHER INVESTIGATION MAY BE REQUIRED TO RULE OUT ORGANIC CAUSES                                            THANK YOU",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat loose motion in an infant?\n\nhi, good day! i have a 9 months old baby and suffering from loose motion right now. she has taken to a doctor yesterday and test her stool. examination shows plenty of fat globules. the doctor gave her oral rehydration, vometa (for vomiting) and erceflora and continuous in take of e-zinc. she also has a slight fever last night, until today. would you think that the medicines given to her will stop the loose motion? could you please advise what would be the best foods to be given to her to removed the fats? thanks!",
    "doctor_response": "Hi,This indicates acute gastro enteritis. Most cases are caused by viruses, and need only supportive measures, as already given by your doctor. This is enough to control loose stools, although it may take 5-7 days for motions to normalise. You need not worry.Meanwhile, give frequent sips of fluids like ORS after each stools to avoid dehydration. Avoid fruits, juices and sugary items as these may exacerbate diarrhea. Fat globules is stools need not be worried- just indicates incomplete digestion due to decreased transit time, and need no intervention.If fever persists after 2 days, she becomes lethargic, not taking feeds, or stool becomes blood stained, kindly take her back to doctor, as this may need addition of an antibiotic tooTake care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam T. K., Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ankle sprain\n\nHi. I sprained my ankle 10 days ago and it was put in a cast for 7 days. I have been using an ankle brace for the past 3 days, There was minimal bruising, i.e. only 3 really dark purple bruises and some discoloration on the sides of the ankle, but quite a bit of swelling. The swelling has gone down almost all of the way. I still have pain in the evening when I go to sleep. I am going on a 10 hour flight on Saturday and my question is, should I inject myself with Fragmin, or would taking an Aspirin and wearing compression socks be enough. As a side note, I bruised really badly when injecting the first 4 days, there was intense pain for about half an hour after each injection and there was a dark red circle around the injection site. The pharmacist suggested that I stop injecting and use aspirin.",
    "doctor_response": "dear friendi have not understood the need to use dalteparin that is fragmin and aspirin in a case os simple sprain ankle which has been adequately immobilized by a cast. Do you hav any co existing disease due to which this was indicated, in normal course the bruises resolve on their own in time it does not need any rigorous intervention.as regards to you need for travel is concern , if you are mobile and can walk, periodic walk down the aisle and keeping hydration should be adequate to prevent stasis induced DVT in long flights. all you need is to keep flexing your toes and contracting your calf muscles when seated for a long time.in case you do have clotting condition then use of aspirin is a good idea but still the former two ie fluids and walking still stay as use ful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "3 year old girl baby have a 10-12 pus cells in urine. is it normal or high infection ?\n\nSir my 3 year old girl baby have a 10-12 pus cells in urine is it normal or high infection the doctor gave us tab mox kid, tab ozalab dj, candid cream, t bect cream. Please suggest me what to do ?",
    "doctor_response": "hi sahin.welcome to HealthcareMagic forum.pus cells are more than normal.but you should follow the respective doctor without thinking much.above mentioned treatment cover almost every thing.must do follow up.take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes one to see unusual pictures and faces and which is leading to a deterioration in the health?\n\nDear sir, Since 2 months my wife is facing a peculiar problem.she gets afraid very frequently.she says that she often sees a very unusual picture/face which other people dont see who are with her at that very moment.her health is deteiorating.please suggest what could be the reason and remedy for the same. Regards Neeraj",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. The symptom you are mentioning is a clear case of illusion / delusion. Usually happens to depressed or schizophrenic patients. You need to have good psychiatric treatment and please consult a psychiatrist as soon as possible.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have intermittent, dull, chronic left abdominal pain below ribcage. Can Pradaxa intake cause this?\n\nHello doctor, I have been experiencing upper left abdominal pain just beneath lower ribcage and on the opposite side in the back. I have intermittent, dull, and deep chronic pain. I am 43 years old, nonsmoker but consumes alcohol (not for the last four months). My blood pressure is 120/80 mm Hg. I am currently on Omeprazole 20 mg daily (one month). I am diagnosed with pneumonia and pulmonary embolism. It is confirmed by chest CT. I was prescribed Pradaxa for three months (stopped taking medication on Mark 26). I have a history of acid reflux, sleeps on a 6-inch wedge pillow to manage the symptoms. Tests I underwent are: Abdominal CT with contrast: unremarkable, mild diverticulosis, not considered relevant to pain. Chest CT with contrast: unremarkable, PE and pneumonia cleared. Blood tests all normal, no sign of pancreas or kidney trouble. My primary care physician suggests pain is associated with PE. My pulmonologist says it is very unlikely to be associated with PE and recommends to confer with a gastroenterologist. Could this be an ulcer or some other issue within the stomach or GI tract? Perhaps caused by the Pradaxa medication? Would the abdominal CT have uncovered peptic cancer or other serious GI issues? What further testing would you recommend? Should I wait to see if things get better or act soon? If it is safe to wait, how long should I give it?",
    "doctor_response": "Hello. I must appreciate the detail history you provided which is very helpful in diagnosing your condition. After reviewing your history, in my opinion, this pain is not related to pulmonary embolism. It looks like to be associated with some gastritis and stomach issue. Now coming to your queries, the CT Abdomen has ruled out serious abdominal issues such as malignancy but it could not rule out peptic ulcer disease. You can just wait for it and take the medications which I am prescribing. I do not think that waiting is going to cause any further issues as it does not look like to be something serious. Take the following treatment for two weeks and if no improvement then we can consider EGD. None at the moment. Gastritis. Peptic ulcer disease. Esophagitis. Gastritis. Continue Omeprazole but increase it to twice daily before meals. Syrup Gaviscon (Alginate) 10 ml three times daily after meals. Both these for two weeks. If no improvement will consider EGD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does recurring rash on hand indicate allergy to cleaning agent?\n\nHi, I have a recurring rash on my hand. just 2 spots- between my thumb and forefinger and a smaller one below my forefinger. It started about 4 weeks ago , and in between it almost goes away but when I do a lot of housework it flares up again. Any chance I could have developed an allergy to the dish soap?",
    "doctor_response": "Home Remedy-Make a oil after boinling neem leaves in mustard oil till all the leaves become black then filter it and apply that oil on affected partTreatement- 1-Take panchnimbadi churna 1-1 tsf with water twice a day..2-Take pranacharya allergin capsule 1-1 twice a say...3-Take pranacharya charm vikarasav 2-2 tsf with water twice a day....4-Apply marichyadi oil on affected part.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is vomiting and fainting normal during pregnancy?\n\nhi doctor...am now in my sixth monthy of pregnancy..i am taking tablet for thyroid,metformin for insulin resistance and all other vitamine tablets like iron and calcium. nowadays  i am having vomiting and fainting.. not daily..i did my 22nd week scan and everything was normal..blood pressure ws also normal.now i am having little emotional stress..",
    "doctor_response": "Hello dear,I understand your concern.Iam happy to know that your BP is normal.In my opinion the vomitings might be due to gastritis.Avoid spicy and oily diet.Take antacids and antiemetics.Check for any fever associated with vomitings.If fever is there along with vomitings then the cause of fever needs to be evaluated.But as per your information there is no fever so need not worry.Regarding fainting I suggest you to get a HB done to rule anaemia.Take food every 2 hourly to maintain blood sugar levels constantly because low blood sugar can also cause fainting.Low BP can also cause fainting but as your BP is normal it might not be the cause.Take adequate fluids upto 3 litres per day,coconut water,fruit juices  to combat dehydration caused due to vomiting.Nothing to worry.It will subside.Hope this helps.Best regards....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I workout regularly,but not able to lose weight. Please help.\n\nHello doctor, I eat healthy, I workout, but I am not able to lose weight. I am really worried about my health. What can I do?",
    "doctor_response": "Hello. I want you to understand how metabolism plays an important role in weight gain or weight reduction. An increased metabolism will lead to more energy burning which will help you to reduce weight. How to increase metabolism? Regarding exercise: Stay healthy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Has back pain, went to chiopracter, arms numb. Polymyalgia Rheumatica. On pain pills. Have swelling, cramp. Vit d given. Treatment?\n\nmy husband 72 years old, in good health until 4 weeks ago, when his back started to bother him, went to chiopracter and then his arms were going numb, so went to Doctor who took him off his colestral  medicine.  Another week, arms still hurting so go back.  Did blood tests and Dr. gave us a sheet on Polymyalgia Rheumatica.  Started him on predisone and pain pills.  Pain still unbearable, but arms have stop hurting and swelling, but pain is in his right hip and leg like a severe cramp that won't let go.  Went back to Dr. took more blood for Lime disease, which came back negative.  Today he is lots of pain even with the pain pills, called Dr. office, said to go and get some vitamin D and call back in Monday.",
    "doctor_response": "Hello,Thanks for writing to us,According to your history it looks like there is lspinal disc bulge compressing your spinal nerves .I will advise you to do to do x ray spine and MRI spine.You may need muscle relaxant with analgesic,and neurotropic medicine.lumbar corset and hot fomentation will give faster relief.Physiotherapy like USG and SWD will give quick relief.Yes vit D levels will help in treating cause of pain but its defficiency will lead to diffuse whole body pain.I hope that I have answered your query. Let me know if I can help you further. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for productive cough\n\nour 16 year old with cerebral palsy, started with a bad cold virus on 12/9...I passed it on to her and it lasted at least 3wks before I felt better. She can not blow her nose well, so she coughs hard enough to get rid of phlegm. She is still coughing up a little phlegm. She sometimes coughs hard enough to cause her to vomit (if she has food in her stomach). She is not nauseous. She does not have a fever. Her cough is productive, but I am concerned how long it has been and that it is such a strong cough. We have not had her to the doctor, but I am feeling I should call on Monday",
    "doctor_response": "thanks for consulting in Health care. It seems Your daughter has acute bronchitis. You should start to give her :1.Cough medicine for  loosen mucus in lungs and make it easier to cough up. Ambroxol 1 tab 3 times will help to her.2.Cefpodoxime- antibiotic 200 mg 2 times for profilaxis of pneumonia3.Vibrating massage of her back relieve your child's cough. Ask your doctor about nebulization. It is very effective.  You can do inhalation with salbutamol and ambroksol4. At home you can do steam soda inhalations5. If you see obstruction, respiration rate 40-60 in min, then you should use Inhalers: salbutamol will  help him breathe easier and cough less. Recovery soon and visit your doctor",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for dry mouth, peeling skin on lips, and cracking corners of mouth?\n\nYYYY@YYYY   I have dry mouth.  I have the skin on my lips peel off.  The roof of my mouth behind my upper front  teeth is very sore. I have whitish bumps around the nostrils, and the same at the corners of my mouth the corners of which crack.  I would appreciate any help or advice you can give me.  Thank you.  Betty Jane Porter   YYYY@YYYY",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. As you are mentioning that you have noticed dry mouth,  sore roof and cracks at the corner of the mouth,  it looks that you have fungal infection of mouth,  as all the symptoms match to it.Better once you should visit your dentist get it completely examined and then start with the treatment,  also get a complete blood picture done. Hope it will help you. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes soreness in my lower rib cage along with a lump?\n\nI have been feeling very sore in my lower left ribcage under my breast.  I have checked for bruising since it's tender, but there is nothing on the surface of my skin.  I noticed yesterday that there is a horizontal hump/bump from under my left breast to the sore area of my ribs.  What could this be?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  You may have breast lump, muscular pain or ribcage problem.  You should go for x ray and mammography.  It will clear all doubts.  If it is breast lump then go for biopsy. It will give you exact diagnosis. Then you should take treatment accordingly.  If it is muscle spasms or pain then take muscle relaxant.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for abnormality in heart beats and difficulty in breathing\n\nIn the past I have had an issue where my heart beats really fast for a few seconds (and feels like it is beating really hard), then skips a beat then goes back to normal. It happens (at most) once a day and I have had it all checked out and it is quite normal apparently and nothing to worry about.Over the past few hours at work I feel like it has happened maybe 5/6 times. It is a little off-putting and I am not sure if there is anything to worry about. I almost feel like it is a little harder to breath (not a lot though)...your thoughts?",
    "doctor_response": "Hello, When our heart starts to beat up very fast or notably, this is because heart itself is trying to fix that has been wrong. When heartbeats are associated with difficulty in breathing then it's time to run a few diagnostic tests to determine the cause. So to me you should consult with your cardiologist and run a complete cardiac checkup: EKG, echocardiogram, Holter monitoring to check it out. There are various causes but first should check your cardiovascular system. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Albana Sejdini, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in left arm and hand?\n\nI am having numbness in my left arm and hand. I have a history of neck problems. I jammed my head into a low hanging pipe at work this week sending my head between my shoulders. My previous diagnosis was a strained muscle. I get pain in my neck about 2-3 times a year that starts around the big knot in my upper neck.",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms seem to be related to a pinched nerve in the shoulder. I suggest using anti inflammatory medications such as Acetaminophen to relieve the pain. I also suggest to maintain the arm and hand immobilized to prevent further damage. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from erectile dysfunction due to atherosclerosis. Is it manageable through siddha medicines?\n\nHello doctor, I am suffering from erectile dysfunction due to atherosclerosis causing less blood flow to the penis, this may be due to family history of high cholesterol. The allopathy medicine suggested for this is Tadalafil 5 mg every day (vasodilator). Is it manageable through Siddha medicines? I am 33 years old. My height is 176 cm, and I weigh 76 kg. I have borderline high cholesterol, and I do not have high blood pressure or diabetes. I do not have the habit of smoking or drinking. Please go through my blood reports.",
    "doctor_response": "Hi,Welcome to icliniq.com. I have gone through your reports (attachment removed to protect patient identity). As per your blood report, your cholesterol profile is above the upper limit. This might be the cause for the penile artery blockage (atherosclerosis plaque). But, I think the other possible reasons for erectile dysfunction may be: For cholesterol, you consult a general physician and they would prescribe Simvastatin. This will reduce your cholesterol and reduce the plaque. If you wish to have sexual intercourse, on that day, take one tablet of Tadalafil before sexual activity. Otherwise, do not consume it regularly. It has many side effects. In Siddha, cholesterol, trauma or unknown cause induced erectile dysfunction can be treated using the following drugs: Last two drugs can improve the vascularity to the penis and reduce further worsening of atherosclerosis complications.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the required qualities of sperm to be fertile?\n\nHi doctor,we have stop planning & planning for a baby.We are trying to conceive last 4 months but the result has come negative.I did my semen analysis and came to know that my sperm count was on border line.The doctor has given me medicine on it and so i am regularly taking it..I need to know how exactly the semen quality should be for positive conceive.",
    "doctor_response": "HiGreetings You should share your semen analysis report. If it is normal get a direct check up with urologist or andrologist to find the cause.Then only you should take medicine.Feel free to ask your doubt with more details Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sternum pain\n\nMy 18 year old son is having pain under the sternum and it gets worse when he eats or even drinks water He woke up in the middle of the night when it first started and this is day 5. Went to Urgent care Friday night, says if is costochondritis but does not improve with ibuprofen. Has tries softer foods but still has pain when eating.",
    "doctor_response": "Thanks for your question on HCM. Since he is not improving with pain killers,  I think he is having GERD ( Gastro Esophageal Reflux Disease ) associated pain. It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms. So central chest pain under sternum can be due to GERD only. Ask him to follow these steps. 1. Avoid hot and spicy food. 2. Avoid large meals, instead take frequent small meals. 3. Avoid stress and anxiety. 4. Start proton pump inhibitor. 5. Go for walk after meals. 6. Keep 2 - 3 pillows under head in the bed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does citrobacter amalonaticus mean?\n\nHello,My doctor called and said I had citrobacter amalonaticus but didn't know anything about it......I was hospitalized in ICU for two weeks. I have lived with ankylosing spondylitus, asthma and tachycardia,for which I am at 540 of tiazac. I have lived with diarrhea for 4 weeks now, then the head was hurting,back of neck, stomach pain, then some fever added to it just lately. I also found out near the end of my stay b12 was down so I had to start taking injections and my thyroid was chaning in my tests. I have been losing strength alot that I fell bedridden. I am really not one who likes hospitals. I have lost alot of trust here in Canada, it is just the way it has become here....    THANK YOU FOR YOUR TIME.",
    "doctor_response": "HiThanks for your query at HCM.I understand your concern and situation. I really feel sorry for your situation. But no need to worry.Take the treatment for your problems. As far as citrobacter infection is concerned it can sometimes be seen in patients who are immunocompromized. If this bacteria is found then I suggest you to take antibiotics based on culture and sensitivity results.Hope I answered your query.Dr Sheetal Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can alcoholism and aggressive behaviour be treated?\n\nSir my brother is 34 years old. He is a drunkard and taken its treatment 2 times. He have some mental problems from childhood. He doesn t go for any work or we have to force him to go. He will leave the job within 2 weeks and take rest for more than 3 months at a time. He talks bad words about woman. Our father left us after disposing their property at his age of 23.He is very rude to his mother. He is now saying that some people followed him, tried to kill him etc. But such a thing hasn t happened. Is he lunatic",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.In my opinion, it is very important to take a detailed history of alcohol use. Alcohol can cause suspicious NES and aggression too.It is very important to detoxify him from alcohol use and treatment with benzodiazepines and thiamine.Later on to de-addiction treatment can be carried out. If suspicious NES is persisting, then treat him with antipsychotics drugs.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Gayathri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could horrible back pain and cramps be due to labor?\n\nHi. I think I might be in labor. I m 38 weeks and 5 days. I m having horrible back pain and cramps similar to menstral cramps. I m been timing my contractions for about an hour, and they are about 6 to 8 minutes apart. The contractions themselves are not painful, but I m in pain in other areas (like I said the cramps and back pain). The pain is pretty continuous. Am I in labor?",
    "doctor_response": "hi,  Thanks for the query. Labor pain is uterine contraction with severe pain, that tightens your abdomen & the pressure is going down wards. It comes intermittently( The gap between two pains being surprisingly painless), the gap between two pains go on decreasing & the pain time goes on increasing.   You have constant pain in back ( due to loose pelvic ligaments being stretched by down ward movement of fetus)along with mild cramps & uterine tightening.. to push the baby down in pelvis... as a preparation of child birth.   You will have true labor pains within a week or two.   Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for headache, lump on forehead after injury?\n\nmy son was playing soccer yesturday collided with another player he has huge lump on forehead woke up this am and had some blood black and red in his spit that he coughed up. has head ache lump down a bit but bruised other kid stitches should be cocerned",
    "doctor_response": "HI,greetings from HCM.From history he must have injured his nose and forehead after collision with another player.with probable injury to anterior cranial fossa.this will result in huge lump in forehead and coughing out blood.you have to report to neurosurgeon urgently and get a cat scan of the brain to diagnose the exact problem",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abscess tooth, swollen gum, tooth infection\n\nI have an abscess tooth and ive been to a dentist and currently on meds for the infection but the gum around my tooth is really swollen. I have a date tomorrow nite at six thirty and need swelling to be gone by then which is about 23 hrs from now. What can i find around my house that will get rid of the swelling? Help! And can i spread my tooth infection to my bf by kissing him?",
    "doctor_response": "hi, i read your problem,there is an infection in the tooth at that area because of that there is abscess and swelling...... for infection it is must to take medicine which you have taken......... but you did not tell that you are going for root canal treatment or extraction.......... these medicines are for infection not for swelling....... swelling will need drainage.......... after drainage swelling will disappear...... and this will not spread by kissing......... take care Dr.Gunjan Gupta",
    "dialogue_context": ""
  },
  {
    "patient_message": "How safe is giving Chloramphenicol for 11 month old due to conjunctivitis?\n\nhi my baby was diagnosed with conjunctivitous and i was given icare chloramphenicol and on the leaflet inside it says do not use on children under 2 my baby is 11 months i have given him the drops but after reading the leaflet i am reluctant to give him them as it says it causes grey baby syndrome which i am just wondering if my concerns are justifyed or am i just being silly thanks for your time",
    "doctor_response": "dear parent, did you get the drops on your own? better consult an ophthalmologist, don't try medicine s in such a small child. especially antibiotics. if it's prescribed by a qualified doctor, please consult him/ her again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms and treatment for autism?\n\nim 18 years old, im 5\"9, about 75 kilos.im writing because i have taken a lot of online aspergers tests and i always seem to score highly on them like 170/200. I think  it runs in my family because my cousin has been disgnosed with autism since a very young age and also my aunty aswell. i know you cant believe online tests but i do fit all of the criteria and since starting university this year i have noticed im different. for example im extremely gfood with computers and can spend hours on them ata time everyday. i dont really enjoy interacton with making new friends and social enviroments i find it awkward and think people dont like me etc. id much prefer to talk directly over an online chat with a doctor",
    "doctor_response": "I'm glad that you understand that online tests are not authentic. Many times we believe the things we want to believe and ignore the facts. For instance, I would want to believe that I did not score well in an exam because the paper was tough and not because I did not study. Similarly, maybe you're depending on the information that autism runs in your family and you have autistic traits. It is possible that you don't like social interactions because you're an introvert which is completely normal. I'd suggest you to not believe information provided on the net because one cant detect how true it would be. Kindly consult a doctor and don't shy away from sharing your problems with an expert. A psychiatrist/psychologist will clear all your doubts and give you more clarity by studying your genetic history. Incomplete knowledge is dangerous knowledge!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with OCD, habit of washing hands frequently. Am I liable for treatment?\n\nHello doctor. I am a girl of 23 years old and live in Mauritius. I have been suffering from OCD since 2-3 years and am not following any treatment. I came to know about my problem through this website itself but i can`t follow any treatment since my parents are not supportive. They know that am doing all those rituals like washing hands etc and taking long hours of bath because i feel that am dirty.They know the reason why i behave like this but they do not accept that am suffering from a problem. They scream everytime and say that one day i`ll definitely kill them with the way i behave. Am really fed up and i feel my life has become like hell. My parents always scold at me and they say all this is in my mind and i must know how to fight with it. I wanted to consult a psychologist without letting my parents know about it but since am not working i depend upon them and i was waiting for the day when i get a job to start a treatment. I always cry when they scream at me and now they have started to keep a watch on me when i have a bath etc but i feel more stressed with their attitude. Yesterday my mum was so angry with me that finally she contacted a psychologist.She did this only to make me fear but actually am happy that finally i`ll be able to go and consult a psychologist. But what is making me worried is whether the psychologist will understand my problem?Will my parents understand me after that and try to atleast support me?",
    "doctor_response": "Hello and welcome to Healthcare Magic. Thanks for your query. I understand that you must be going through a difficult time trying to deal with your obsessive-compilsive symptoms. I'm sorry to hear that your parents are not being understanding and supportive to you regarding this. Unfortunately, many people have a poor understanding of psychiatric disorders and some even have a negative attitude towards them. Anyway, it's good that you have got a appointment with a psychologist. Don't worry, psychologists are well-trained professionals who will be able to explore and ascertain your psychological problem. They will also be supportive to you and advise you and your parents on further management of your problems. Once your parents are able to understand the nature of your problem and that it requires professional help, I'm sure they will be more understanding and supportive. Wish you all the best. Regards, Dr. Jonas Sundarakumar Consultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic cough and severe back pain\n\nHello, the X-ray of my girlfriend done in November 2014 revealed suspicious densities in the right parahilar area of her lungs. She told me about that only recently so I suggested to her to have X-ray done in June 2015 again which turned out with the same result. The apicolordotic view done on the following day concluded unremarkable . However, Im very worried cause in November she experienced cough which continues from time to time; she suffers from back pain, she does not have taste for food and she lost much of her body weight. Im suspicious about TBC cause she lived in the same boarding house with a couple who both had cough and her problems began shortly after she had moved there. Moreover, she comes from the Philippines. Thank you.",
    "doctor_response": "thanks for asking your question I completely understand your question cough of long duration that is more than two weeks can be tuberculosis .u need to get a fresh chest xray and consult a pulmonologist .he ll request for a sputum smear examination for afb for confirming the diagnosisbackpain in tuberculosis can be due to tb spine also that is potts spine and she needs to be evaluated for that also by a xray ls or dl spine .pulmonologist ll fully examine her and tell you the investigations which needs to be done to diagnosedont panic but these things needs to be done early, because if she ll be diagnosed as tb early treatment will cure her and ll decrease the spread of infection alsothanks/ regards feel free to ask more questions may god bless you with good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes low grade fever and asthma in a 19 year old?\n\nI am a 19 yr old college student. I'm about 5'5 or 5'6 and have asthma & some allergies... I've been running a low grade fever for the past 2 weeks on & off. I haven't been having any other symptoms. Ocassionally i'll have a runny nose or a scratchy throat, but other than that I have no other symptoms. I'd just like to know what could be causing this.",
    "doctor_response": "yes there is a possibility you might be suffering from sino-rhino-bronchial allergies. with kind of mixed secondary infection so take tab.Linox 600 for 7 days after food.tab. alex cold one tab per day after dinner for 5 days.take nasal spray Duonase one spray per nostril",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I take Olanzapine. Why am I having headache, cramps, nausea, and bad morning sickness?\n\nHello doctor, I have headache, cramps, nausea, bad morning sickness, back pain, hunger, feel light headed. I am taking Olanzapine and Zyprexa.",
    "doctor_response": "Hi. The symptoms that you mentioned are common side-effects of Olanzapine (Zyprexa). Please, do your best to tolerate the side-effects especially in the beginning of therapy (if you just started taking the medicines) as in some situations the side effects decrease in intensity by time. I strongly advise you not to stop this medicine or skip doses as it is extremely important to stick to its dosage and continue to follow up with your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Insulin needle harmful to child if put in mouth?\n\n16 month old opened drawer and pulled out a fist full (maybe 4 or 5) of insulin needles used on my dog. He had one in his mouth, but we didnt see any punctures, and dropped one on top of his foot, punctured but no blood. My husband, and I live alone and he was Visiting with his family. He seems fine, should he see a doctor?",
    "doctor_response": "hi dear, thanks for your query.Insulin needles can puncture the skin or oral mucosa with or without bleeding. Because they are used, they may transmit infection from your dog to your child like rabies. If your dog is vaccinated for rabies than no need to worry otherwise you should consult doctor as soon as possible.regards- dr deepak",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair fall\n\ni was suffering frm typhoid fr some 10days i ws down wid fever..after tat i recovered quickly...bt since den i hve lost volume of my hair..i hd tremendous growth of hair,great volume,curly hair...bt now m worried coz my hair has bcum thin also..so can u plz help me out wt treatment should i take",
    "doctor_response": "hi there.1. your concern is acute telogen effluvium.2. it's a recoverable hair loss.3. you can try anaboom shampoo weekly twice, use drinking water for washing the scalp.4. have trichogro hair supplements daily one after breakfast.5. try them for 3-4 weeks, if no response start grocapix spray, daily night 3-4 sprays into the scalp.this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How should the lumps be treated?\n\nhi i am concerened about three lumps i have,they are 1.5 cm in size roughly,1 on my arm 1 on my bottom and 1 on my back,the 1 on my arm is more pinky with a brown spot in it and sometimes get twinges in the area around it on my arm,my doctor told me they are cold spots but im not sure can you help please i am 28 and 12 stone",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have multiple lumps.  It can be multiple lipomatosis, neurofibromatosis or some other mass.  You should go for fine needle aspiration cytology or biopsy of one lump. It will give you exact diagnosis. Then you should take treatment according to diagnosis. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Anxiety, arm numnbness, low blood pressure, nausea, fatigue. Taking Xannex medication. Causes for symptoms?\n\nI was wondering what would be the cause of my symptoms I ve been having for about a week now. I was diagnosed with anxiety , and am currently taking 0.25 Xannex .. I have a doctors appt. tomorrow, but figured I d ask you guys now considering my symptoms feel worse today then any other day. SYMPTOMS : Numbness from my hands to the very top of my arms on both sides. Low Blood Pressure yesterday it was 89/71 and today its 100/73. I feel tired all the time. And this morning I feel nauseous. I work for a pharmaceutical company, and my job is not easy, because I have to use my arms. I am tired on the jobs, and its stressful to me while these symptoms have accrued. Please tell me what I should do?",
    "doctor_response": "Hi All your symptoms like numbness in hands, low blood pressure , tiredness, nausea and your feeling that job is stressful point towards anxiety. Is it present only for 1 week and you were perfectly fine before that or the problem has worsened in the last week? If it is present only for the last i week, there could be some issues worrying you for which you should consult somebody you confide in or else professional help from a psychiatrist. Whatever, this problem should soon be over and you will be fine. Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "On Accutane course, LFT showed spiked ALT and AST. How dangerous is this?\n\nI am on Accutane 3rd month- 60 mg/day and 145 pounds. My baseline liver test was ALT and AST 25-20 pre accutane and after one month the went to 235 after two months on accutane. How bad is this? My doctor did other blood tests and ruled everything else out.. I don t drink, I m healthy? Just confused... How abnormal/dangerous is it for it to spike like that?",
    "doctor_response": "Hello, I have gone through your problem. You have been using Accutane since 2 months and now your liver enzymes had shown a spike. First you need to know that any drug we take will be excreted either by the liver or by the kidney. And many of the drugs will have adverse effects on these organs. They can be Hepatotoxic (injurious to liver), nephrotoxic (injurious to kidney) or Neurotoxic (injurious to brain and nerves). If the drug is Hepatotoxic, there will be rise in the ALT and AST values. You have taken Accutane and after that the liver enzymes got elevated. So it had an adverse reaction on your liver. If you continue the drug there is every chance for the liver enzymes to get elevated further. My advice is to stop the drug immediately and consult your physician. You need to get an Liver function test done after few days to make sure that the liver enzymes reverted back to their normal levels. Also you can ask your doctor to prescribe an alternative medication. good luck to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back and stomach pain. Gas? UTI can cause this?\n\nhi, i have this horrible feeling of gas.. everywhere..lower abdomen and lower back. on the sided of my lower body as well.. it feel better when i release air, but my back hurts like crazy! what do i have? any other helpful infor is that i currently have a UTI and my period is coming in abut 4-6 days. i am also sexually active",
    "doctor_response": "Hi, Thanks for posting on HealthcareMagic. After reading your symptoms i feel your pain is due to 3 reasons: - Amoebiasis : It causes pain in lower abdomen and back along with gas which eases off after the gas is released. - Pre menstrual back pain : Before Menstruation certain patients get cramps leading to back pain - UTI : As you know that you have UTI, It also causes pain in lower abdomen and back. I would strongly recommend you to visit your physician as he will confirm the diagnosis after clinically examining you and getting your stool test for the presence of amoeba. He may also give you muscle relaxants for pre menstrual pain and antibiotics for UTI. Meanwhile, you must avoid eating junk food and oily as well as spicy food. Your doctor will prescribe medicines accordigly. Wish you a speedy recovery. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat hanging skin flab outside tooth?\n\nHi, my wisdom tooth started coming threw on my top right hand corner about 4month ago and has not gave me any problem, but about 2weeks ago i noticed a flap of skin hanging down from the outside of my tooth and im not sure what it is could you tell me please?",
    "doctor_response": "thanks for your query, the hanging flap could be an inflamed gum around the erupting tooth called pericoronitis. nothing to worry consult your oral physician and take a radiograph of the tooth, if the tooth is in proper alignment and has sufficient space to erupt then get the hanging flap removed or if the space is insufficient and tooth is in abnormal position get the tooth removed...do slaine gargling and can take antibiotic course after consulting your physician. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for anxiety and heart problem\n\nmy husband  who WAS chain smoker but has left completelyage 63 years had a  heart attack a year back and was treated fairly with medications but due to the allergy he has when using any kind of dye, he hasnt gone through angioplasty,  since than he's suffering from anxiety, now he has stopped taking the medications except for asprin , but he walks 1 hour  a day n does some breathing exercises  and looks after his diet. do you think its enough what he is doing n what measures should be taken for his anxiety",
    "doctor_response": "no I think medicine should not be stopped. all heart medicine should be continued in addition to other measures which he is doing. Patient should counselled for anxiety and assured regarding the health . he ll need counseling session and anti anxiety medicine for some time which you should get prescribed from local doctor",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause bump on leg?\n\nI had a bump on my leg that was bothering while I slept. It hurt when i touched it. I went to the Dr. and he thought it was a cyst so he opened it up to drain it only nothing came out. He then removed a small piece of white bone like cartilage that was there and could not figure out what or where it had come from. Have any ideas????",
    "doctor_response": "Hi.Thanks for your query.The white bone like could have been the dead bone called sequestrum.Proper cleaning, antibiotics for a long time will help a cure. I would advise you to go for CT scan or MRI of the area to help the diagnosis.Also I would send the material for histo-pathology examination.The further management would depend upon the response to the medical management and reports of MRI.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes unwanted erection of penis?\n\nI am male and I had an unwanted erection in front of a female ultra sound tech while testing the location of my pubic area. I am in my late 50's and I am embarrassed I couldn't control myself. The tech patted me and said not to worry that this was normal. Is this a natural physical response or did I lose control because the tech I observed to be young and pretty?",
    "doctor_response": "DearWe understand your concernsI went through your details. You are unnecessarily worrying. Female ultra sound techs and other hospital staff working with male always sees such erections and for them it is quite normal. Please understand, erection happens due to three states. One due to sexual arousal, two due to controlled urine and three due to anxiety. You had an anxiety related erection. She knows it and therefore she did not care about it and you need not be embarrassed. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to for my son whose chest seem to be full with mucus?\n\nHi. My son is 18 months & has a very horrible time sleeping & eating & his chest sounds like its filled entirely with mucus, my mom told me it was bronchitis & his doctor is rarely available so I can't get him checked out any time soon, should I take him to the hospital?",
    "doctor_response": "HI from your query, I understood is, you are getting a sound - wheeze with increased breathing na. If this is causing him to wake up and difficulty in taking feeds , please take him to a hospital for getting some nebulisations/medications to relieve and also get an X-ray done tor/o bronchiolitis/pneumonia",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes brown colored semen after masturbation?\n\nhi am santosh from india.i hav pumped my testis many time and all the the time semen has came out but yesterday i pumped my testis now also semen came but my ptestis colour hav been slightly changed to brown.i want to know the effects of pumping testis in hand n do i became a father if i hav sexual contact with my wife.",
    "doctor_response": "Hello, Blood in the semen, or hematospermia is a cause for brown ejaculate. Minor tear is small vessels during ejaculation can be a cause. In most cases it will settle by itself even without any treatment. If symptoms persists better to consult a urologist and get evaluated. In that case we have to ruled out infective causes like prostitis. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a red bruise near the elbow of an infant indicate?\n\nmy 7 month old baby had a bruise near her elbow, except it was dark red! the colour of port red wine? she hasnt fallen or hurt herself. now that it has gone we can see a small dot where it was, so im thinking she was bit by an insect? she never had any unusual symptoms of any sort.",
    "doctor_response": "dear parent,  being dark red and then resolving to only small dots are the normal stages of healing of any bruiseif this is a one tine incident then there is no need to worry,  but if the unexplained bruises keep occuring then you might ned to investigate the possibility of a bleeding disorder",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is Coarsened Hepatic Echogenicity, compatible with a component of Hepatic steatosis in a scan report?\n\nHi, can you please help me to understand what this means it came up on a scan after being test for my Gallbladder to be removed. What does this mean Coarsened Hepatic Echogenicity, compatible with a component of Hepatic steatosis or other Hepatocellular disease",
    "doctor_response": "Hello Thanks for writing to HCMLiver is normally homogeneous in echotexture.Coarse hepatic echotexture indicates liver parenchymal disease.It may be due many reasons like excessive fatty deposition,cirrhosis etc.You need proper clinical examination and investigations.Investigations include routine hemogram,RBS,LFT,RFT,Lipid profile,elastography. Further investigations can be done if needed.Proper treatment depend upon clinical examination and investigation reports.Hope i have answered your query.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dry cough\n\nHello last time I had intercourse was in January and I ve had a normal 5 day period since then but this months the first to days were normal but the rest were light. Also around the time of my period I was on antibiotics and had a allergic reaction to it then I was given another antibiotic but was sick to it as well. Now I m having dry cough and throwing up. Am I pregnant? What could be wrong with me?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. No, I don't think you are pregnant. Possibility of viral infection is more likely which is causing cough and vomiting. So drink plenty of fluids orally and keep yourself hydrated. Do warm water gargles 5-6 times a day. Take levocetrizine and paracetamol combination twice daily after food. Take antacid (pantoprazole) and anti emetic (domperidone) combination on empty stomach twice daily.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",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Am I suffering from any neurological disorder?\n\nHi doctor, I am a 30 year old male. I am suffering with the below symptoms which feels like a disorder. I have this disorder running in my family. A few of my paternal uncles also have them, but in a mild form. I had these symptoms since childhood, but it was very mild at that time. I had ignored them previously, but over the course of time this has got severe and now it has started to concern me. The symptoms are severe anxiety, panic struck, sweating palms, facial sweat, getting nervous, trembling hands and legs, voice breaking down, throat gets dry, extensive sweating of palms and sweat starts dripping from palm within a few minutes (hyperhidrosis). I am\u00a0having the above symptoms when I\u00a0attend any public or office meetings where I have to speak in front of a crowd, in\u00a0any social gatherings where I feel I am at focus and when I\u00a0face any adverse condition or under mental stress due to work pressure.\u00a0However, I am perfectly normal when I am alone or relaxing at home, having no sign of anxiety or sweat. I have tried a lot to keep my anxiety under control before going out for meetings, but these symptoms appear involuntarily and starts making conditions worse for me. This is making my life difficult and I have started avoiding meetings or gatherings.\u00a0Am I suffering from any neurological disorder? If yes, please suggest what kind of treatment I should undergo to bring my life back to normal.",
    "doctor_response": "Hi. I have read your question with care and understand your concerns. For further information consult a\u00a0neurologist online\u00a0-->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for the presence of staph in semen?\n\nHi, I am in need of help as it seems that my world is coming to an end.I contacted staph.aureus sometime in 2004 and i cant seem to get rid of it.i have tried several drugs but to no avail and just last month i went for a lab test as i can feel the symptoms,i did semen analysis as the normal test is not showing anything and i am shocked with the result.The result stated that i have moderate growth of staph with sperm count of 15million and mortility rate of 40% and also i have only 30% of normal sperm.please i need your help and need to know how i can get rid of this and boost my sperm please.",
    "doctor_response": "Use count plus granules one tablespoon with luck wram milk and Satawar+Ashwagandha mix powder 1 tablespoon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mouth ulcer and swelling in mouth?\n\nmy 5 year old son has mouth sores / mouth ulcer since yesterday morning and was not able to eat all day. he was drinking enough fluids though. last night he had a slight fever so i gave him paracetamol before he went to bed. This morning his face is swollen on the side where there there is a mouth sore is. He has no fever at all and his appetite has gone back to normal. I am still worried about the swelling though. He has no food or allergic reaction to medicine. I have also not introduced any new food so im confident that it is not an allergy and might have to do with his mouth sore. I am hoping to get an explanation about the face swelling.",
    "doctor_response": "Thanks for your query. I have gone through your query. The mouth ulcers can be a apthous ulcer secondary to stress or anxiety. You can take topical analgesic like choline salicylate and topical anesthetic like lignocaine. The swelling in the mouth can be because of the tooth or gum infection which has led to cellulitis. Nothing to be panic, consult a pediatric dental surgeon and get it evaluated. Mean while you can take a course of antibiotics like amoxicillin(if you are not allergic). If the diagnosis is confirmed as tooth infection, then the tooth has to be treated.I hope i have answered your query. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lumps in body?\n\nAbout a week and a half ago i got a little lump under my armpit after shaving and the next day it started to hurt i squeezed it and puss came out the next day i ended up with 3 then 1 more then the day after that 2 more but they all went away and now i have 1 and its big it feels like a ball and i need to know how i got them could it have been my shaving cream? p.s i got them on my legs when i started to use nair my doctor gave me some pills and cream and they went away! that was a year ago now this ! im not sexually active im still a virgin so its not a disease",
    "doctor_response": "Hi,Welcome with your query to HCM virtual Clinic.I reviewed all the details of your query,in context of the of the painful aftershave armpit lumps.Based on the facts of your query,You seem to have Boil in armpit- post-shaving, and is not related to  your sexual activity,as you are virgin.Its not from the shaving cream,but is from the skin bacterial flora in the armpit which infects the shaved hairfollicles to cause it.Don't squeeze it ,as recurrence is due to it also.Consult your family Gp doctor who would treat in the best possible way for you.Hope this reply would help you to plan treatment with your doctors and resolve your worries.Will appreciate writing excellent review comments to help the needy patient visitors like you at HCM.Welcome any further query and information in this regard.Good Day!!Dr.Savaskar M.N.M.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lack of orgasm during intercourse in a 16 year old?\n\nHi Doctor, I'm a 16 year old boy (I'm about 1,80 meters and I have no medical history concerning medicins or whatsoever) and recently had sex for the very first time. It felt great, and my girlfriend enjoyed it too, but I didn't have an orgasm and/or ejaculation. After this first time I haven't had an erection just by thinking about sex and before my first time this was very easy. I do masturbate once a day  and I move my penis pretty fast and hard when I masturbate. Also I do smoke 1 maybe 2 cigarettes a day. Hope you can help me, A normal boy",
    "doctor_response": "Hello,You are very young aged boy and at this age, there is usually no any erectile dysfunction occurs. One time failure of ejaculation or achieving orgasm cannot be considered abnormal. The achievement of orgasm is learnt after few sexual attempts usually. I suggest you stop smoking because it have multiple bad effect in body along with affection of sperm count also.You should also focus on study at this young age. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Symptoms of mouth ulcer due to tobacco. Solution to leave habit of chewing tobacco?\n\nHi sir/madam, I am Mani. I used to shewing tobacco product (Packed PAN MASALA) for past 2 years. Now i am afraid of Mouth Cancer. I am trying to get away from this habit. But i couldn t. Is there any solution to leave shewing Tobacco Product? what are the symptoms of Mouth cancer by chewing Tobacco product? Thanks.",
    "doctor_response": "Hi thereThanks for asking your queryChewing tobacco leads to many side effects from sataining,gums recession,bone loss to much serious problem like leukoplakia(white sores) and precancerous conditions which can cause cancer of mouth,throat and oesophagusQuitting his habit is quite difficult but not impossibleFirst you have to make a mind that you really wants to get rid of itThen in start reduce your daily chews quantity Reach for your chew alternatives when you feel the urge to have something your mouth. Eat as much as you can.Stay active. Working, running and exercising can help distract your mind and body from cravings.Hope this will helpGud luck and thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe anemia\n\nHallo, My friend (age 29) for over a year has severe anemia, but at the moment the doctors don\\'t know what it is. At the beginning they suspected the myelodysplastic syndrome. The bone marrow biopsy made 3 times, didn\\'t reveal any abnormalities. Lymphoma, leukemia, cancer and proxysmal nocturnal hemoglobinuria, celiake and ednocrine diseases have been exluded. Gastroscopy, colonoscopy and abdominal ultrasound also came out in ok. Viscerial arteriografia also unchenged, thickening of the iheum and jejunum was only noticed.My friend has a low level of iron and potassium but the intravenous administration minimally raises the hemoglobin level. It was initialy enough to roll blood once every 3-4 weeks, but since 3 months administration of two units of blood rises hemoglobin for only 0,5 while it can decrease during the day even by up to 1. My friend occasionally complains of pain in the lower spine and kidney area. She also suffersasthma and is allergic. Today the doctor told her that he could only give her blood and iron and wait as the illness developes. If it\\'s possible, I\\'d like to consult. I can send a mail with the results.Best regards Justyna from Poland",
    "doctor_response": "Hi I did review your concern. Can you please send me a direct question with  the complete details of her lab reports. I can answer better. i am thinking of possibilities like enzyme defects or hemoglobinopathies. sideroblastic anemia and other rare causes of anemia. Waiting for your reply.good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a large painful lump on the nose\n\nI have a large lump onon my nose in between my eye and the bridge of my nose. It feels like a hard water balloon. It doesnt give me much discomfort but i believe that is still growing, and is causing sinus pressure. It started to present itself about 4 years ago when some debris got blown into my face at a boat yard i worked at. I had a stye but when it went away i thought it was all over. Any help will be greatly appreceated thanks",
    "doctor_response": "Hi,Welcome to HCM Virtual Clinic.I reviewed your query in context of all the facts of your query.Based on the facts of your query,the lump between your eye and bridge of nose,seems to be lacrimal duct Cyst/or Epidermal Inclusion Cyst or Sebaceous Cyst,after the trauma from debris to your face with resolved Stye after the debris trauma to face area.Duration of 4 yrs restricts the lump  cause mostly to Epidermal Inclusion Cyst or Lacrymal duct Cyst.Dermoid Cyst possibility is ruled out as they exist since birth and more in the middle plane.Treatmetnt-Second opinion needed from your ENT/Opthalm and General Surgeon,who would treat it accordingly.USG /Sos CT skull would fix the cause of the painful nose bridge lump as above.For the cosmetic correction Excision and hpr study by Team of -doctors,for the nose  lump under antibiotic, is suggested under guidance of your Surgeon.This would help you to plan treatment with your doctor.Contact with Premium question to ME,if need be.Will appreciate your Hitting  thanks and writing  excellent review comments to help needy patients like you. Welcome with any other further query in this regard.Good Day!!Dr.Savaskar,Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there swelling in neck behind ear and a swollen tooth?\n\nHi doctor,My father is having a swelling in the neck behind the ear. Also, he is suffering from a swollen tooth. He is now taking treatment of root canal. Can you please suggest the reason for swelling in the neck? Is this a serious disease like cancer? What to do for this swelling?",
    "doctor_response": "Hello. I would like to know few details like: There can be a few reasons for this swelling. Like: What I will advise you is complete the treatment for swollen tooth and also take a course of antibiotics for the same. Of still, the swelling is persistent then you need to get it checked. Best is to show a physician who will examine in detail and also to get basic blood tests like CBC (complete blood count), ESR (erythrocyte sedimentation rate), LFT (liver function test) and X-ray chest. He might also need an FNAC (fine needle aspiration cytology) depending on how his symptoms and reports are.  For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure side effects caused due to the intake of formula milk?\n\nHi, my son is 5 days old. Every time he drinks his formula milk he always poop. I try to test his poop. And here is the result. Fecalysis result: Color: yellow Consistency: watery to mucoid Pus cells: 1-2/hpf Rbc: 0-2/hpf Others: bacteria: many Fat globules: many No ova or parasites seen. Hope for your soonest response. Thank you, M.franco",
    "doctor_response": "Hello.  I just read through your question. There is nothing abnormal about a 5 year old having a bowel movement every time he eats.  This is called the gastrocolic reflex and is normal. The only important tjing is that he is comfortable.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rapid heart beat and painful breathing?\n\nI went to my doctor a few months ago told her I have problems exercising with out my heart beating fast and making it difficult and painful to breathe. Now I notice a popping in the right side of my chest underneath my breast in between this little area that feels like a bone it feels like there s a lot of pressure in my chest that s almost really painful. What could this be my doctor says she doesn t think I have asthma and if I increase my exercise it will probably get better but I haven t told her about the popping noise and pressure in my chest yet.",
    "doctor_response": "Get done ECG . Check ur blood pressure. Get examined when u have such complains. What's ur age? R u having thyroid problem?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to control blood pressure\n\nI am 39 years old and recently been diagnosed with high blood pressure (BP daily average ~ 140/100). I got my blood/urine work done and following were the alarming indicators: 1) Serum Creatinine - 1.35 and 1.54 mg/dl (from 2 tests, one week apart) 2) eGFR (non african) - 66 and 56 (from 2 tests, one week apart) My Doctor suggested to have another blood work done in a week to check if these level return to normal, otherwise she would recommend to see Nephrologist.. Can someone tell me how bad these numbers are from Kidney function point of view? Thanks.",
    "doctor_response": "Hello! Thank you for asking on HCM! Seems that your kidneys are not functioning so well. A moderate renal function lowering is present and you need to be very careful in the future. First of all, you need to treat your high BP properly (calcium channel blockers, centrally acting drugs,etc may be useful  in such conditions), a probable diabetes, any urinary obstructions or infection, etc.) A close follow up by a nephrologist would be necessary.Hope to have been helpful. Greetings! Dr. Iliei",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Phimosis\n\nHi docI am a male, sixteen years of age, and me and my girl have hit the mark where we are considering taking it further.I have already told her and she is fine with it,That i suffer from phimosis. I cannot retract my foreskin WHEN ERECT. Easily when flaccid,But near impossible when erect. I have done some research and gathered that my phimosis isntThat bad, because most people say thry can hardly see any of the glans, but i can retractAlmost halfway. What i would like to know is the best metbod of practice to solve this problem, via stretching,And roughly how long it would take.Cheers :-)",
    "doctor_response": "HelloThanks for query .You have Phimosis and unable to retract foreskin over glans penis on erection .It is utmost important for foreskin to get retracted completely and freely mobile over glans penis to have enjoyable sex without pain ,Since you are unable to retract foreskin over glans penis The only best treatment option is to get circumcised .This is a simple surgery done under local anaesthesia as a out  patient procedure and offers permanent cure and helps to have enjoyable sex for rest of the life.Please note that any other modalities like stretching foreskin does not help to resolve the issue. Dr.Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the swelling in parotid gland be due to viral infection?\n\ni have problem before 12 day ago with swelling left paratid gland  first 8 day pain full now no pain , swelling bit of but am have swelling wen am eating after 4 min   eathing  again swelling going of bit my blod test lok like viral infection paratoit am on antibiotik thanks and sorry for my pore english",
    "doctor_response": "Hi..Can understand your concern..As per your complain Parotid gland is one of the major salivary gland and is present in front of the ear one on either side.Any infection in the gland or obstruction in the ducts of the glands can lead to swelling in the gland..As per your symptoms the swelling increases while eating clearly indicates that there is obstruction in the ducts of the salivary gland leading to swelling..The obstruction occurs due to formation of crystalline stones within the ducts of the gland from minerals present in saliva leading to blockage of ducts and the formation of stones known as SIALOLITHS can occur secondary to infection in the gland..When the duct is partially blocked and there is increased saliva flow during eating the saliva flows back to the gland and causes swelling..You should consult a dentist or an oral pathologist and get evaluated..In case of sialolith you should take more of sour candies and lemon drops as they will increase saliva flow and small stones can get flushed out along with the saliva..In case if the stones are large a dentist can palpate the superficial stones along the duct course and push them out of duct..In case of stones in deeper locations of duct and large stones surgical removal is done..A technique known as Sialoscopy which is an endoscopy technique can be done to locate the stones and subsequently removed..Hope this information helps..If you find the answer helpful kindly write a positive review and click on found this answer helpful as a token of appreciation..Thanks and regards..Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are intramural uterine fibroids?\n\nHello doctor, Multiple intramural uterine fibroids 30, 20,12 and small interior wall 30, 25, 12 mm posterior wall. Right ovary 37*33*12\u2019mm volume 8.2cc. Left ovary 38*25*15 mm irregular cyst. Kindly advice.",
    "doctor_response": "Hello. I have gone through your query and reports. The size of the fibroid is very small and negligible, and there is nothing to worry about. Please repeat the scan after three months to know if there is any change in the size. However, if you have a doubt, then get back to me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and numbness down the back of the legs and near temple?\n\nI am having pain and numbness down the back of my legs to my feet as well as in my temple and behind my right eye.  The leg pain began only on the right side but yesterday moved to the left as well only not as severe.  The pain in my head and temple has occurred upon waking up in the morning but today is the first day it has not gone away.  Didn't know if the two are related or could be a more serious underlying condition.  Thank you for your help.  I don't want to go to the doctor and seem like a hypochondriac, I was there two weeks ago with pneumonia.",
    "doctor_response": "your symptoms sugggest you could be having vitamin b12 deficiency please start on meconerv 500 mcg daily meanwhile get your B12 levela done and get back",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause green mucus in sinus and chest, loss of voice and cough?\n\nI have had a head cold for a bout two weeks, which seemed to be getting better, except for having lots of green mucus in my sinus and a bit on my chest. However this evening I have now suddenly lost my voice down to a whisper and am coughing. What s going on please.",
    "doctor_response": "Hello,It is an infection and needs antibiotics. Please consult your doctor.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Jnikolla",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for asthma and severe lung infection\n\nI was just released from hospital.  I have asthma and had a severe lung infection.  The doctors immediately decided that it is due to the fact that we have 10 parrots, one being an umbrella cockatoo, one African grey and various others.  They want me to get rid of my birds.  I am having a great deal of difficulty facing that possibility and need more information before going that route.  I have not been home since it was thoroughly cleaned as my husband was trying to minimize the dander/dust as much as possible.  Any suggestions about getting better but keeping our parrots?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, possibility of hypersensitivity pneumonitis (HP) is more. And most likely cause for this is exposure to allergen. Common household allergens are dust, mites, animal dander, fur etc. Best treatment for this is avoidance of allergen. If you do this, no treatment is required. Pneumonia heals by itself once we remove the allergen. So in my opinion, you should definitely remove all the birds (suspected allergens) from you home. You will definitely improve once you remove them. You might not need medicine also. So there is no alternative to this. This is for your health. No way it is possible to keep birds in home and you getting better. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the use and intake method of susten tablets ? How does it help ?\n\nhi, I am 33 years(female), 50kg,my doc advised to take susten 100 as its my 25th day, i want to know how to use suten100, can i have sex while using it",
    "doctor_response": "hi u should use it once daily or twice a day. u can sex while using it mainly it is use for safe pregnancy ask ur doc why he has given it. its progesterone tab.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for anxiety and depression?\n\nHi I havent been able too use or feel my legs in 2 months now. The docs and neurologist say there is nothing wrong with me but i still can't use or feel them. I have had a long term anxiety disorder wich my doctor changed my meds a month ago from xanax to clonazepam 1mg/day. Which hasnt helped my anxiety attacks. And I have gotten very depressed from being stuck i a wheel chair so the E.R. doc put me on prozac 20mg/day. I have been on these new meds for 3 to 4 weeks now. And its as if i'm getting worse. I hurt very bad conctantly and my depression is worse. What should I do?",
    "doctor_response": "Hello,Look like fluoxetine (prozac) is not helping you but actually increasing anxiety. Prozac is notorious for increasing anxiety in many patients and in such cases it should be stopped and you should be put on either venelafaxine or paroxetine.they are proper SNRI and very useful in cases like yours.so, talk to your doctor regarding the change in medicines and im sure you will feel lot better in few days of starting them.prozac can simply be stopped. There is no need to taper this medicine. Already you are on lowest dose of it.as your anxiety and depression will improve-so will your motivation and strength to move around.get your B12 level and TSH levels done and correct them if they are disturbed.wish you good health.Dr. Manisha GopalMD Neuropsychiatry",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does andractim gel effective for Gynecomastia ?\n\nHello sir my problem is i am suffering from gynacomastia from past 7 years, i heard that andractim gel(dht) will help to get rid off it. So shall i use it or not. And also inform me about its side effects. Recently from one year i am having hair loss. My age is 22, height is 5.6 feet and weight is 63 kgs.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Andactrim (Dihydrotestosterone) gel is widely used for gynaecomastia in patients not willing for surgery. It shows some results but not hundred percent effective. Surgical removal is the best possible option and Andactrim is used only in patients who are not willing for surgery. The possible side effects are due to hormonal imbalances and it includes acne, mood swings, blackening at the site of application and weight gain. You can consider it in case you you do not want to go for surgery. Wishing you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore throat after eating almonds?\n\nHello:After eating almonds, raw, I have a sore, irritated throat which lasts only about 15 to 20 minutes but I cough and hack the entire time as if it was some kind of common cold irritation.  Short lasting, but fairly sever. What is happening?  Do I give up almonds!  (Say No)Thank you.",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your history.I would like to ask you more questions about your symptoms after ingestion of almonds. However, at present I assume you are having only sore, irritated throat and you never have had any nose symptoms, eye symptoms, skin rash, edema, gut symptoms as well as wheezing/breathlessness after ingestion of almonds.With these assumptions, I would like to make following suggestions to you:1. You can try almonds after thoroughly washing them in water. This may remove some chemicals/substances which may be irritating.2. You can try almonds after removing their peel. This may remove some proteins/substances in peel which may be the cause.3. You can change the source of almonds you are getting from. This also may help.4. If above measures do not help, an allergy testing for almonds will help to know whether this is a true allergy or something else.If any time, should you develop other symptoms mentioned above, I would suggest you to consult an Allergist-Immunologist.Hope this will be helpful to you.Wish you the best of the health.Should you have any further query, please feel free to ask at HCM.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should i wait before seeing a doctor as i hurt my knee?\n\n999 Generating utilization of the ideal traveling purses will be sure which the gadgets you will have could possibly be secured until such time as you obtain into your spot. The new selection characteristics Sprouse s legendary graffiti in the process to be a digitized rose, like totes, satchels, louis vuitton wholesale belts wallets, louis vuitton wilshire mm scarves, louis vuitton handbags sale bangles and footwear. red bottoms shoes for cheap [url= WWW.WWWW.WW cfm]red bottoms shoes for cheap[/url]",
    "doctor_response": "Hi...If I would have been in your place...I would do the following before visiting the doctor1) Ice up the painful area of the knee.. frequently2) Keep it compressed with crepe bandage or compression bandage..3) As pain permits I would stretch front thigh muscles...back thigh muscles..calf muscles..4) Give less activity to my knee and avoid painful activities untill pain gets comfortable..for 2 days atleastHope this is helpful..Revert back with type of pain.. how far you can move your knee.. what gets the pain..and what relieves you the pain...how frequent you experience it... incase you need precise answer..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Have my gums receded because of placing smokeless tobacco in the same spot for years?\n\nHello doctor,I am a 32-year-old male. I have used a smokeless tobacco called Swedish Snus for going on four years now, always in the same spot. My gums have severely receded in this area. I am otherwise healthy. I recently made an appointment with a periodontist but I am terrified I may have gum cancer. I noticed about a week after I quit putting smokeless tobacco in this area the gums became extremely sore, and are still sore two weeks later. I do not see any lesions in this area of my mouth, but the gums look 'pickled' is the best way I can put it. I do not know if the soreness I am feeling is from the gum tissue or exposed roots in that area of my mouth.",
    "doctor_response": "Hello. I have gone through the images posted (attachment removed to protect patient identity). You have to change your brushing technique as soon as possible. Brush in an up and down motion without putting too much pressure on the teeth and gums. The recession is definitely not any type of cancer. It seems to be a side effect of intense to and fro brushing. Use a soft-bristled toothbrush. You can consult a periodontist to find out ways to regenerate or surgically stitch back the gums to its old position. For more information consult a periodontist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the jaw to slide forward along with pain and headaches?\n\nwhen I sit forward my jaw seems to be sliding forward, like it isn t being held in place by the muscles like it should be. This is a new symptom for me. I normally have a normal bite, but if I sit forward, like looking down at a tablet computer in my lap or sitting at a desk working, my jaw slides forward creating a significant underbite; I noticed this because it causes great pain and headaches.... I don t know what to do?",
    "doctor_response": "Hello,In my opinion, it could be a sub-laxation of the TMJ disc,  so you just need to see a TMJ doctor for a quick reduction that takes a few movements. Until then, open your mouth and measure The height of the mouth opening,  it should be 3 fingers. Push your lower jaw backward with your hand towards your neck. This can help reduce your symptoms. Hope I have answered your question. Let me know if I can assist you further. Regards, Ayman Darrag, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of genital herpes?\n\nI think I have Genital Herpes...... I haven\u2019t been able to get a hold of my doctor since it\u2019s the holidays...... I first got one bump on my vagina lips Friday and now have about 7 or 8 that are extremely painful and whenever pee comes in contact with them it\u2019s extremely painful...... the bumps are red and some look like there open.....",
    "doctor_response": "Hello and welcome to HealthcareMagic! The classical sign and symptoms of herpes are painful vesicles. Vesicles are tiny rashes containing a transparent fluid. They usually start small and then increase in number. This seems like what you are describing. If this is so, I will advise you to see a doctor immediately. Firstly, you need to test for other sexually transmissible infections like hepatitis B, syphilis, HIV and chlamydia. Secondly, you need to start treatment with the antiviral Acyclovir and a strong analgesic (Tramadol). It is important to start a corticosteroid (Prednisolone) to prevent postherpetic neuralgia and an antibiotics therapy (Amoxicillin) to prevent infections in case you have an ulcer. Hope that clarifies you concern. Thank you for the query. Take care Regards, Dr. Chobufo Ditah, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes flakes on the scalp leading to hair loss?\n\nHi. I have some fluids coming out of my scalp. Also scalp forms skin bits that later get caught in the comb and come out together with the hair - now there is very little hair left. I would like to identify what kind of desease/virus I have ; what causes it and to find solution. Thank you in advance.",
    "doctor_response": "Hello,Welcome to healthcare magic,From your description it could be scalp psoriasis. You should consult a dermatologist for clinical examination and diagnosis. Scalp psoriasis can be very well controlled with treatment. I donot think that it is because of any viruses. Hope this helped, Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for head cold & diarrhea\n\nMy 12 month old granddaughter has been sick with a headcold for a couple weeks now and just the past four days she has lost her appetite and has developed diaharreah. My daughter told me she gave her some wheat pasta to try the same day her diaharreah started. I noticed today my granddaughter s belly seems to be swollen. She is fussy and won t eat much at all but does drink some of her formula during the day although she is only consuming about half of her norm. We are concerned about the swollen belly. She does sleep good through the nights but she always has. During the day she is fussy. She is also teething and doesn t handle the teething well. Just concerned about her belly mostly.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes body pain in a diabetic?\n\nmy mother is 55yr aged,she is diabetic and on dialysis,she is suffering from body pain and weak muscles as she is not able to stand on her own legs and her haemoglobin level is 9.5,so i request u to give some suggestions about her diet,curing of t.b,and how she can walk?",
    "doctor_response": "Hello, It could be peripheral neuropathy. As first-line management, you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the oral alternative of amikacin injection?\n\ngood day doctor,  I am 29 yr old female.I am suffering from a UTI which is a reoccurence after5 months. the symptoms are frequent urge to urinate, pain while urinating,little vomiting sensation.Four months ago i got a urine culture & a vaginal swab test done.while the urine culture didn't show any bacterial infection swab test did come up with E-Coli infection. was adivsed by the consulting doctor to take Amikacin for 5 days but due to certain conditions i was unable to take it.at present i am on board a ship in vietnam as my husband is marine engineer.so i am unable to take amikacin at this moment as well as it comes only in the form of injection. Plz advise alternate medication which can be taken orally.plz advise more than one trade name .Also plz advise if URISPAS will be helpful or not?Thank you.KIM",
    "doctor_response": "Hello I hope you are not pregnant now. After observing your test reports , I suspect you were suffering with uncomplicated Urinary tract infections .if you are my patient I would advice you to take Macrobid 100mg twice daily for 7daysMacrodantin100mg 4times foe 7daysFuradantin 100mg 4times for 7days. Also use  urispas tablet for 7days twice daily.it will relieve the spasmic pain during voiding.I hope you are satisfied with my clarification. Wish you good health.  Rate my answer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. A patient has hydrocephalus associated with many other problems. Kindly advice.\n\nHello doctor,I am an occupational therapist, and my client's mother would not let me talk to her neurologist even though I need to script some equipment. So I wanted to ask general questions, the client is 12 years old and has hydrocephalus and had many many surgeries as her shunts keep becoming blocked. She now has the most significant possible VP shunt in her brain, and recently (a couple of weeks ago) had a bleed after surgery, but that has been treated now, and she is going well.The client also has uncontrollable absence seizures, a chromosomal disorder, intellectual disability, connective tissue issues, hand deformity, and recently diagnosed tuberous sclerosis (skin and possibly in the brain). The client's mother would like me to complete a funding application for them to get a hospital bed at home, as the daughter (client) is currently sleeping upright with pillows.She said sleeping upright helps the shunt drain. I have not been able to find any research around this, and have also read about something that says over drainage can be an issue. Did you have any thoughts about this issue? Or if it is really client specific and I do need to contact her neurologist or neurosurgeon.",
    "doctor_response": "Hello. I read your question carefully and would explain the upright position (head of the bed 45 degrees) can help reduce the intracranial pressure. So, I agree with the patient that she feels better in this position. Regarding the medication, I would recommend Diamox and Furosemide to help reduce intracranial pressure. An anti-epilepsy drug is also needed for her seizures. I would suggest Valproate or Levetiracetam. I hope you will find this answer helpful. I remain at your disposal for any further questions whenever you need.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tibia and chronic back pain?\n\nHi doctor,I have pain when I touch my tibia and chronic back pain.I am diagnosed with vit.d deficiency.earlier it was 25 Bg Ol and now after taking calcirol sachets once a month for 6months,it has increased to 65 ng/mol.but the pain is still there.what should I do?",
    "doctor_response": "Hello, The pain could be related to local inflammation. For this reason, I recommend checking inflammation tests (complete blood count, PCR, ESR) and performing an X-ray study of the tibia. It is also necessary performing an X-ray study of the lumbar spine, in order to investigate for possible chronic degenerations of the spine (a bulging disc), which can lead to pain in this region. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lumpy mole in armpit which oozes brown stuff?\n\nI have a Lumpy mole in my armpit, been there since a child. It has been sore a larger than normal with a small pin point black head. Today I sqeezed it and A large amount of brown stuff came out along with what looked like black fuzz. Should I be alarmed? This has never happened in 30 years.",
    "doctor_response": "As your description goes it is dermoid cyst though it can only be confirmed after examination of the same. Currently it is infected and hence needs treatment , kindly consult a surgeon at the earliest.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swollen gum around lower wisdom tooth that is painful and hard to eat or drink\n\nMy gum is swollen around my lower wisdom tooth. It is extremely painful and hard to eat or drink. My dentist gave me antibiotics which I have used for two days with no improvement. I keep having really thick saliva as well and generally do not feel well",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,    I have gone through your query, as you have swollen gums around wisdom tooth , dont worry it happens during eruption of wisdom tooth that is Pericoronitis .  It happens when tooth is erupting that is Partially erupted or Impacted .  You do is warm saline gargle two - three times a day.  Consult dentist and go for Scaling and currettage of tooth .   Take one Tablet Painkiller Diclofenac sodium twice daily for symptomatic relief .  Hope this will help you.  Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Using dermaroller to treat acne scars. Can I use vitamin c serum after roller?\n\ni bought a dermaroller 0.5mm from a clinic here to treat my acne scars (those pitted ones) and for active acne. When i asked doctor he told me to apply clyndamycin phosphate after rolling when you sleep. But some sites say that anything u apply after the rolling penetrates deep in the skin and show awesom result. so can i use vitamin c serum immediately after derma rolling my skin?",
    "doctor_response": "Hi..dear kiran.., Thanks for choosing HCM.., Dermaroller...... are used for a treatment process called micro needling or skin needling. It is a form of collagen induction therapy...,It will increase 4% to 87% absorption of skin and hair products by the blocked pores which stimulates hormones effectively & naturally without inducing hyper pigmentation and sun sensitivity to the skin. Dermaroller improves blood supply on scalps, face, neck, skin and throughout the body irrespective to the nature of the skin.., RESULTS are depend upon...the experience, skill and technique ., of the Doctor...So it is not handling by U without knowing anything.., about these...Hence consult good dermatologist..ok thanQ",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a protruding vein on the temple and mild eye pain?\n\nI am looking for information about the brain and a definitive explanation of aneurysm how it occurs and what are the triggers. Is it stress, or something more? Symptoms are bulging vein at temple and dull pain behind eyeball with occasional tearing of the eye...thanks! In Service,",
    "doctor_response": "Hi, Brain aneurysms are formed mainly because of high blood pressure. Genetic factors that result in weakened connective tissue also contribute to aneurysm formation. Symptoms you describe are not typical for a brain aneurysm, these symptoms indicate more a type of primary headaches (cluster headaches) Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numb feeling in the left area of my lung, dizziness and light headedness?\n\nSo for the last week I have had this tickle numb feeling in the left area of my lung and my back area where my lung would be located at. I don t really feel out of breathe. Sometimes I feel light headed or dizzy. I checked my blood pressure which was normal and my heart rate was around 90. Anyway it s really starting to worry me. Any clue or suggestions?",
    "doctor_response": "Hello, I think that feeling dizzy sometimes is not related to numb feeling on your back and is not an important thing. The numb feeling on your back may be a pinched nerve. Anyway, getting it evaluated by your doctor may give more information about your condition. Hope you found the answer helpful. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white crusty stains?\n\nHi just wanna ask i have some white stains on my underwear after i got a mild erection.However, after 1 hour, the same stain appear again on my new set of underwear. They dry up and feels crusty on my underwear.  I wonder if they are just pre-cum or infection. The last time i am sexually active is 3 months back and I was clear by local medical doctor for STI ( they say i got NGU and I was cleared by them during that time).",
    "doctor_response": "HelloI appreciate your concernLooking at your description this could be related to infection leading to urethral discharge or may be precum when you get sexually excited with prnography.In my opinion you should go for certain invesgations like blood for hemoglobin CBC or liver function test and urine culture and sensitivity testYou may require a course of antibiotics under supervision of your doctorMeanwhile maintain good hygieneHave healthy and nutritious foodAvoid smoking and drinking Please revert back to me if anything is not clear I will gladly answer you Best wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for ankle and knee pain\n\nI had a knee replacement March 201, all was going well then I started gtting pain in the knee. I returned to the surgeon and a scan said that the joint was inflammed. I am still waiting to hear back from them as to what is the next step. I now have persistant ankle pain ine the same leg. Any sugg estions.",
    "doctor_response": "Hello, As you have ankle pain I will advise you to follow the post TKR rehabilitation program of exercise which can help the muscles to be stronger and allow the joint stability. Also, use the balance board training which is on the best scale of exercise platform post TKR but used very rarely in some. This helps to stabilize the ankle, knee and hip. Also, improves the muscle imbalances in the lower limbs. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for continued fever, headache and mild chills and cough\n\nmy son aged 17 years is suffering from fever accompanied by headache for the past 4 days he has been given ciprobid but fevefr does not seem to go.he has chills but very mild at the time when his temp rises.he has cough too but little cold .what should be done?",
    "doctor_response": "Hello,Welcome to HCM,As your son is having fever for last 4 days for which your doctor has prescribed antibiotics for your son and the temperature has not come down yet. Other symptoms are suggesting me that he is having upper respiratory tract infection.I would suggest you to wait for another 2-3 days by that time your sons symptoms will come down. If the symptoms are not coming down even after this duration you need to test for blood culture to find out the organism and treat them appropriately.So wait for some more days the symptoms will come down, in addition to the antibiotics you can give him Tab Paracetamol and Mucolytic syrup.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Within a week I had nightfall for about 5 times. Will this affect my health?\n\nHello doctor, I am 20 years old.\u00a0I have never had sex. But within a week, I had\u00a0nightfall for about 5 times. Will this affect my health?",
    "doctor_response": "Hello. Since you are 20, you will obviously have higher testosterone levels. If you do not masturbate, your body needs a way to get the semen out and hence occurs nightfall. Nightfall is nothing but the involuntary ejaculation of the semen from the penis during sleep. It is healthy and there is nothing to worry. I will advise you masturbate may be twice a week, as it will also enhance healthier semen formation.  Consult a sexologist online for further query -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for phlegm from severe cough and breathlessness\n\nHi I have been coughing up a lot of phlegm and it's foul tasting and has a bad smell to it, it's very thick also. Its really painful when I cough and I have been sleeping so much the past few days. I have a few health problems and i'm on a lot of pain relief, I also have asthma. I have never been so tired before and have no energy. I keep getting breathless too",
    "doctor_response": "montelucast 10 mg bd bronchodilator syp tadsPCM plus codeine allergic cough syp tads and addition of antacid gel will help you in this case",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Intravenous therapy help to diagnose cystic acne ?\n\nHi i am inquiring about my son, i have took him to dermatologist blood doctors and a blood specialist here in elizabethtown ky and louisville ky but none of them can find an answer to what is going on with him. He has knots all over his head three of them are the size of ping pong balls i would say all together he has 15 knots on his head, they are on his back also, i have been told they are what is called cystic acne but none of the treatments have worked. They are very painful, have foul oder, and he is now getting light headed and having head aches , please help! He has been on interveinious therapy , accutane, he is 19 and no other health problems that we know of. Please help !",
    "doctor_response": "Hi,Judy, Thanks for query, It seems that due to some infection on scalp spreaded all over scalp in the form of small abscesses causing pain and foul odour. Remove his hairs and clean with betadine lotion thoroughly and apply betadene cream. Do the dressing regularly. Take care that there is no flies touching scalp,if they put eggs on it will give big problem. Take long antibiotic course. Consult dermatologist . Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. How can i track cervical fluid when having sex? Getting confused with cervical mucus and semen?\n\nHello...I just finished charting my first cycle yesterday.  My husband and I are trying to get pregnant. I am 30 years old and my cycles tend to be 31 days long.  In looking at my chart, it looks like we missed my fertile time this past month.  My question is how do I track cervical fluid when having sex regularly.  I think I am confusing cervical mucus with semen on the day following intercourse.  How should I address this?  Thanks!Diane",
    "doctor_response": "Hello DianeThanks for writing to us.Cervical mucus would be long and stringy during the ovulation period, as you obviously know.It would coincide with rise in body temperature.Semen would liquefy minutes after intercourse, so it would not be stringy and would not elongate like a thread between your fingers, but would be runny like water.The smell also is distinctiveAs you are eagerly trying to conceive, I would advise the use of ovulation detection kits or follicular monitoring by ultrasound.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to do surgery for nerve problem in the back?\n\nMy father,58 years is suffering from nerves problem in the back. Doctor has advised him three tablets for 1 month.Zymoflam-D, Rablet20 and Fibrogesic. Doctor has told if these medicine works then its fine otherwise only options that would be left is Operation. Is it safe to get operated at this age or is there any after effects. Please respond its urgent. What is the success rate for this opertaion.",
    "doctor_response": "Hello! thank you for writing us here.Well, a possible case of nerve compression at the back region. That's your concern right? If the medications doesn't make any difference, an operation would take a couple of hours to perform.they would remove some part of vertebrae which won't compress the nerves anymore.he'll get quick relief after the operation and success rates are high. Pain would be present for few weeks at the site of operation but it would subside with NSAIDs the doctor would prescribe. Rest the chances of relapse are low. best regards,Dr Gunjan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe tooth ache after filling\n\nI'm a 46 year old man, had a terrible toothache after filling.Had the tooth extracted and prescribed CLAVAM 625 mg and meftal 500.  Two days into taking these had diarrhea, what really causes this and also have tight stomach muscles and feel ridged on my waist.I'm also not having an erection.",
    "doctor_response": "Hi Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concern...Toothache after filling can be due to many reasons1. when a filling is done near to pulp tissue (which is present deep in tooth), it causes inflammation & necrosis of pulp causing severe pain2. Sometimes a tooth is asymptomatic, but still has infection in it due to deep caries. In these tooth due to large cavity infection has a way to get out. but after filling , The way for infection to get out is blocked & this causes severe pain by increase in pressure inside the pulp.                     If you have diarrhoea , you could take probiotic medicines Visit your dentist if problem persistDon't worry you would be fineHoping your query is solved.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Syncope, vertigo negative, eye sore, teary, muscle weakness, BP drop\n\nI ve experienced syncophe 4 times already. I consulted with my ENT to check if it s vertigo but after several tests, all are negative. He then referred to an Optalmologist for my eyes sore at times and is teary, but after the test, he got negative results as well. Since Ive mentioned that I sometimes passed out, my muscles weakens and that my BP drops down dramatically he said it is syncophe and should try consulting a cardiologist . Now, I had undergone holter monitoring and stress test, both are normal. The cardio then asked me again to have a complete blood work out, ECG , and 2 d echo. I really dont know what s happening, even the doctors are asking questions where is the syncophe coming from? Is it really not vertigo?",
    "doctor_response": "Hello welcome to HCM forum Get your CT head done Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough with phlegm\n\nHi there. So i am 19 years old and in college. I got sick 3 weeks ago, i feel better now but my cough is still here. I had phlem well i was sick...which has decreased but now i have noticed a weird breathing feeling, like a grumbling in my chest/lungs...What is up!?",
    "doctor_response": "Hello ! you seem to have developed post infective bronchial hyperactivity , which means to say , in some patients ,  the respiratory tract infection causes the airways to construct temporarily for few days . This causes difficulty for air to enter and exit through the airways causing the grumbling sound .The good news is this is a temporary phenomenon .Get a chest x-ray done . Ensure that you complete the course of your antibiotics . and also take Inhaled bronchodilators like Foracort , Budamate or Duolin inhalers for few weeks until your airways get back to their normalcy and your breathing is at ease .Avoid exposure to cold and dust m Hope my reply is of help . Do drop in your valuable feedback.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Shall I take Amoxicillin for cough?\n\nHi doctor, Four weeks ago, I had a cold and chest infection. I self-treated with Amoxicillin and it was resolved. Now, I am getting cough with\u00a0slight wheeze. Also, it is a productive cough with green sputum. Shall I try Amoxicillin again? I am regularly on Citalopram and Micronor.",
    "doctor_response": "Hello. 1. Sputum for AFB (acid-fast bacillus), gram staining, culture and sensitivity and GeneXpert. 2. Complete blood count. 3. Urine routine examination and culture and sensitivity. 4. Serum creatinine and electrolytes. 5. Chest x-ray posteroanterior view. Consult your doctor, discuss with him or her and take the medicine with consent. 1 Tablet Co-amoxiclav 625 mg three times daily for seven days after meal. 2. Capsule Omeprazole 20 mg two times daily for 15 days, half an hour before meal. 3. Tablet Paracetamol 500 mg three times daily for 10 days. If the temperature is more than 102 degree Fahrenheit, then take two tablets immediately. 4. Syrup Bromhexine three teaspoons thrice daily for 15 days for cough. Drink hot water, mix salt with hot water and gargle twice daily. Revert back with the reports to a family physician online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does kissing person with history of TB spread the infection?\n\nHi Doctor I am Vijay Munni, I am just married my wife suffered from TB  2 years back for wihich she had taken the treatement for 9 months and got cured. I had doubt if i kiss her I that I will be having TB. I am not worried for this but just thinking of taking preacution.",
    "doctor_response": "Hi thanks for asking question.Now your wife has been cured from Tb infection with completion of AKT.So no chance of getting infection right now.But yes TB can be transmitted through aerosol spread.So while kissing , aerosol route can spread TB organism.But acquring disease is depend on your immunity.I hope i have solve your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe leg cramps?\n\nHello Dr: I m 55yr old, diabetic, but under control, take insulin as well as metformin, & crestor. At least 2-3 times a week while sleeping I have to get out of bed because of extreme painful leg cramps below the knee. But they are not strained muscles related but more tendon like. Its as if my leg, can be one or both are locked in an unusual position that requires me to stand and force the relaxation of the leg by stretching or massaging for at least 1/2 hr or more. Any guidance would be appreciated. Richard",
    "doctor_response": "hi,thank you for providing the brief history of you.As you mentioned about the muscle cramps, it could be related to diabetes as some people report the same symptoms. Depending upon the history of the diabetes like how long it is persisting can help assess better. Also, are performing any regular exercises for controlling the blood glucose levels. If not then exercises are a must for a diabetic, not just only walking. As due to diabetes there is a possibility of the freezing of the nerves and muscles which leads to the abnormal cellular metabolism and lead to muscle cramps. Also, you can check the lumbar spine assessed with the MRI scan to rule out any degenerative disc pathology. as even with the possible of the degenerative disc pathology the cramps are possible.Treatment will be guided based on the diagnosis. Also exercises are recommended in both of the cases for better cellular functioning and metabolism.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high blood pressure even after taking medication?\n\ni am 62 yr old male, iam taking medition for hbp from last 30 years   last few days ago my doctor told me that i have 180/90 bp and he gave me medicine, i am taking this medicine in the morning, when i take reading in noon the bp is 120/80 but at the night the bp is 170/92 why it is happening?",
    "doctor_response": "most likely your doctor have given you a suboptimal dose of the medicine i.e a dose lower then the prescibed dose to maintain its level for 24hours..every medicine when taken reaches to its peak level after some time ....and after that our body starts clearing that drug ...so a dose is prescribed in such a way that a particular level is maintained for 24hours to avoid fluctuation of bp.as you have not written about your prescribed medicines i would recoomend youtab losar h once daily in moringtablet amlodipine 5mg in eveningmonitor your bp every three days both the drugs are first line drugs used today doses will be adjusted after 7days thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and numbness in the thumb?\n\nI had my thumb fused and carpal tunnel release 3 weeks ago. I have been having an increase in burning pain in the thumb and some numbness recently. The pain used to be at night, now I am experiencing it all day. The extra strength tylenol, 6 per day, doesn t seem to be helping the pain. I can t take NSAIDS due to stomach issues. Any comments?",
    "doctor_response": "Hello,I read carefully your query and understand your concern. Your symptoms seem to be related to carpal tunnel syndrome. I suggest to continue using Tylenol to relieve the pain. I also suggest using cold compresses for local application. I also recommend to maintain a splint to prevent further damage. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is surgery required for kidney stone?\n\nHi Sir, I have had a kidney stone (4.6mm) since September 6, 2014. The pain has stopped and just light headedness and a bit of nausea. The urologist called and said he can perform a surgery. What are the pros and cons of doing such a thing and what are your thoughts?",
    "doctor_response": "Hellostones of size less than 10 mm can be treated usually by medicines only and dont require surgery....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the variations in blood pressure be a matter of concern?\n\ni just went for a blood pessure test at my local drugstore and my first reading was 151/101. they made me si for 10 minutes, second reading at 148/101, waited 5 mites, and my third reading was 134/95. she advised me to go the he hospital tonight. Should I go? Is this really bad? I'm a 25 yo female",
    "doctor_response": "HelloConsidering all the facts and your young age there is nothing wrong with you. Always get your bp checked only after taking rest for 20 mins. Follow healthy lifestyle habits, do daily morning walks, take less salt in diet and you will be fine.No need to go to hospital you are fineTake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can we give coriminic qr syrup for 4 months old baby?\n\nHi, My son, 4 months old, has been suffering from cold (runny nose, sneezing) since last ten days and pediatrician has given coriminic qr syrup, .5ml three time. I wanna know that whether this syrup can be given to three months old baby or not. Thanking you.",
    "doctor_response": "Hi...Coriminc contains Pseudoephedrine. This is not a licensed drug in this age group. I suggest you not to use it in this age group. Cough is a protective reflex in this age group. This is how the phlegm is coughed up and swallowed and this will come out in vomiting or motion. I do not suggest any medicines except for saline nasal drops in this age group for relief from nasal congestion.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen lymph nodes in neck\n\nhi.my name is judy, 22 years old,63 Kg.i have two swollen lymph nodes on my neck 1 week after i got stung by a bee on the neck. they are not tender and move when i touch them. are they swollen because of the sting or should i get tested for something else?",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain swollen lymph nodes in neck seems to be most probably due to infection and inflammation in the areas drained by those particular group of lymph nodes..As you have got a bee sting on neck the swollen lymph nodes can be due to allergic reaction to the toxic substance released by the bee sting..As the lymph nodes are mobile they does not seems to be due to any serious cause..You can take a short course of antibiotics like Amoxicillin, anti inflammatory painkiller like Ibuprofen, do warm compresses over the lymph nodes..In case if you do not find improvement in 2 weeks consult a General Physician and get evaluated and a thorough clinical evaluation and investigations like Biopsy or FNAC can help in diagnosis and treatment can be planned accordingly..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low Hb and septicemia in a child\n\nmy baby is 2 mnth 2day old. . Delivered by cs 23rd day befre edd. . He had septicemia and under t/t frm 11 dec upto 24 dec. Recevd vancomycin , aztreonam and metron tazobactem cefepime. . Bcz he had cellulitis of rt thigh bcz vit k inj at wrong site and superfcly. . Now he hav hg% 8.3gm only. . Plz sugest t/t?",
    "doctor_response": "your child has been  given antibiotics with all possible pathogen for septicemia, but to be more specific you can go for blood culture and sensitivity testing ... this will guide you for antibiotics..and ya after he is out from any infection you can start iron and vitamins drops which will take care of hemoglobin but if hb falls down rapidly during illness he may need blood transfusion..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances to conceive after breaking of a condom while having sex and later taking birth control pills ?\n\nhi, i was just wondering what the chances were of becoming pregnate if a condom breaks and you take birthcontrol every night and have never missed a day?.... thanks:)",
    "doctor_response": "hello welcome to healthcare magic. if you have been taking birhtcontrol pills regularly without even missing a single dose, then the chances of you becoming pregnant are almost nill. which phase of your cycle are you in, as in what day of your cycle? a lot depends on that also",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can male infertility be treated?\n\nHello sir, Iam anand, age 25 yrs my sperm count is 105 M/ml active motility is 10% moderate motility is 42% sluggish motility is 24% Immotile is 24% Normal form is 5% head defects is 75% neck defects is 12% tail defects is 8% i am not able to became a father after 1.5 yrs of marriage. Pls guide me what I had to do? Thanks.",
    "doctor_response": "Hi, I have gone through your question and understand your concerns. Your semen examination shows normal sperm counts but the motility and morphology of the sperms are not normal. Such situation occurs when there is infection in the genital tract or there is some obstruction in the genital tract. Abnormalities in morphology and motility of the sperms are a major cause of infertilityI would suggest you to consult a urologist and get properly examined, investigated and treated accordingly.Hope you found the answer helpful.Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat severe stomach pain and constipation after an enlarged liver and gall bladder?\n\nI am a 43 year old female. I went to the Hospital er last night due to Pain in My stomach , My stomach is swollen with severe pain and tight. makes it dificult to breathe. I have consipation then lose stools. I am getting ready to undergo treatment for Hep-c. They did a CT scan and found no blockages however my Liver and Gallbladder were enlarged. I am going to a Gastro Dr on the 24th Of August. My question is there anything that I can do before my appointment to help with the swelling and pain.",
    "doctor_response": "Hello, To decrease pain and swelling suitable over the counter anti inflammatory drug can be prescribed. In addition antacid also can be prescribed. Until you consult gastrosurgeon, I suggest you to take soft and bland diet more. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having acne scars. Any home remedy?\n\nHi , i used to have pimples when im @16-21, now pimples are completely gone, bt during that time i used to press those pimples to take the pus out. So small holes formed on the cheeks of both side. So please let me know do i need to compulsory go for a surgery or any house remedies are there to get rid of them? I want them this to be happen in a period of 3-6 months as my marriage is going to fix....Thanks in advance",
    "doctor_response": "Hi, Treatment of acne scars depend upon the severity and depth of scarring. Chemical peels, microdermabrasion, manual dermabrasion, dermarollers, acne surgeries like subscision and in severe cases lasers are the options to treat acne scars. A proper treatment of your scars can only be done, once your skin has been analysed by a dermatologist. In the meanwhile you may begin with daily application of Glycolic acid 6 percent and retino a cream over your scars to improve them. These two would only be useful, if scarring is mild and superficial. Hope that answers your query. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes slightly high temperature during nights?\n\nHi. For as long as I can remember in the evenings I feel my body get hotter and my temp will be about 98.9 to 99.3. Upon waking it is usually around 97.5 to 98.1. Lately I have had increased anxiety and also waiting to talk to my doctor about an elevated thyroxine level. Is my nightly temp a concern? I do not know if I'm noticing it more based on my increased anxiety but for the last week it has went up every single night. I",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Yes, it looks like that its thyroxine.Thyroxine causes a same symptoms as you are having.Elevated level of thyroxine can cause higher catabolism and makes brain hyperactive.I suggest you to take your thyroid function test done. It consist of T4 T3 and TSH. According to laboratory results various treatment modalities can be adopted.Various anti thyroid drugs are available and treatment can be adopted based on the laboratory reports.If necessary thereafter iodine thyroid scan can also be done.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to know sprain or broken ankle?\n\nMy wife hurt her ankle dancing, she twisted her ankle, she twisted it under her when she fell down, it hurts a lot and is making her feel like throwing up, she can move her ankle up and down but not side to side, she can put any weight on it, is it sprained or broken?",
    "doctor_response": "Hello, This sounds like an ankle sprain. Taking an MRI will be of good choice to understand the grade of injury. Stabilize the ankle in ankle brace. Allow the healing to occur. Try out balance board training exercise which will help stabilize the ankle joint and improve the muscle imbalances. She should be able to dance again. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having noticed a uncomfortable feeling on the left side of head\n\nHi thank you for your interest in helping me. I have been having an uncomfortable feeling on the left side of my head, my left arm and left leg, (feeling you have when sleep on a limb for too long). They did a CT scan, MRI and said everything is normal. The neurologist said it is not a stroke. The only thing they found is cervical spondylosis on my neck which gives me some neck discomfort. I have this feeling mostly at rest, I had pain at the back of my left shoulder went to the ER they did EKG and said it was normal. I m hypertensive on treatment with Losarta, Hydrochlorothiazied, and Potassium. The doctor recommended physiotherapy what could be wrong with me? Please I need help .",
    "doctor_response": "Hello!Thank you for asking on HCM!I am glad that your MRI have resulted normal. This means that there is no infection, stroke or tumor. So, all serious conditions are excluded. Coming to this point, I would recommend performing an EEG to exclude partial seizures. I would also recommend performing thyroid hormone levels for possible thyroid dysfunction, blood electrolytes for possible electrolyte imbalance and HbA1C for diabetes. If all these tests result normal, I would recommend continuing physical therapy. A cervical spine MRI would help exclude possible myelopathy, although your symptoms are not typical of cervical spine compression. You should discuss with your doctor on the above issues. Hope to have been helpful!Kind regards, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for recurring muscle pain in the arm\n\nHi My name is Amy. I woke up with muscle pain on my arm since this Monday. I also feel tingleing from time to time also my right hand hurts. I been taking tylenol it helps but after the effect the pain comes back. This happen since the weather change from hot to cold. Also the pain come to my shoulder and neck",
    "doctor_response": "Hello,Due to compression of this nerve root there is tingling numbness in your arm and pain associated with facet arthropathy. I will advise you fresh MRI cervical spine for better diagnosis.For these symptoms, analgesic and neurotropic medication can be started. Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief. I will advise to check your vitamin B12 and vitamin D3 level.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Vaibhav Gandhi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for anxiety?\n\ngoodnight doctor, my name is donald, i am 62 years and was diagonised with high blood presure and hypertension. i am presently on meds hydro chlorothiazide and lisinopril. howeveri still have anxiety problem and not sure what i should be doing again... help",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Anxiety is a disorder and not a disease. Organic diseases require medication to get cured. Disorders normally do not need medicine because they can be cured just with the help of some life style changes. You are suffering with anxiety and at 62 you should have known how to change life style to get rid of it. Anxiety is the after effect of apprehension of a fear creating situation. Means you are imagining fear and your body produces symptoms of fear when there is no reason for fear now. Psychotherapy and relaxation techniques can surelyt help you.Please post a direct query to me with all details in this website. I shall prescribe some psychotherapy techniques suitable to you and I am sure that your problem can be cured.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes white spots on tongue in a child suffering from cold?\n\nOk so here s the deal my daughter has asthma and Everytime around the winter months she gets sick with cold viruses sometimes pneumonia, but not so far this year. Her pediatrician and allergy Dr has her on a couple of steroids and when she gets a cold I give her albuterol too. Well my questionvis she gets these white spots on her tongue whenever she gets these colds. First I thought they were coming from the steroids she s inhaling because I read somewhere that this is where the spots are coming from...her Dr gave me the name of the spots when a child gets them when they have a virus...but can you tell me what this may be or if the steroids are causing them to appear...sorry so",
    "doctor_response": "Hello,The most likely cause of the white spots, especially since she uses a steroid inhaler, is thrush. This is a yeast infection in the mouth. Steroids and antibiotics make parts of the body susceptible to yeast infections. These white spots cannot be removed with gauze or a washcloth. To decrease the chance of her getting these spots have your daughter use water to rinse and gargle her mouth right after using the inhaler. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Arnold Zedd",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does Systalic heart rate:130,diastolic:94 and Pulse:47 suggest?\n\nI have a systalic heart rate of 130 and a diastolic of 94 and a pulse rate of 47.  I take correg for high blood pressure. My doctor said to dcrease my correg to 3.25 in the morning and 3.25 in the evening.  What happens to the 94 diastlic rate since that is not being addressed/",
    "doctor_response": "dear , i think you mean ( systolic pressure 130 / diastolic pressure 94 ) , heart rate 47 the normal systolic blood pressure is between 110-140 , and diastolic one is 60-90 .. the normal heart rate is 60-90 at rest .so , you seem to have a mildly elevated diastolic blood pressure and low heart rate , the most common cause of elevated diastolic pressure are obesity , smoking and alcohol intake . I see that you should stop Coreg as it is a betablocker which decrease the heart rate evermore , and fix your life style . Also you should measure your blood pressure by a different set and in many different times through 3 days .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any side effects of burning on tongue and gums after mouth washing with Dettol ?\n\nHi,I mouthwashed with about 20ml of dettol and I seem to have had a burning on my tongue and some gums. My tongue went somewhat numb and I'm pretty sure it burned my taste buds. I have no severe side effects. Only side effects are those said before and the obvious burn identification on the tongue. After some research on the topic, I found out that the numbing of the tongue should ease up in about a week and taste buds should regrow. Do I have anything to worry about?",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,   I have gone through your query, as you have numbness in your tongue and problem with taste bud now dont worry but dont do this in future .  You can take ointment Mucopain or Dologel apply it on tongue twice daily that will give you releif.   Take one capsule vitamin B complex once daily for 7 days Hope this will help you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have missed my period after having Meprate. Is there a chance for me to be pregnant?\n\nHello doctor,I have missed my period even after taking Meprate. It has been eight days now, what are the chances that I might be pregnant although I have not done penetration tests?",
    "doctor_response": "Hello. Firstly, did you have had emergency pill post intercourse? Was there any menstrual irregularities before this like delayed menses and all. If you have had an emergency pill, then the likelihood is very less as these are highly effective. In this situation, since you have missed the period, pregnancy cannot be ruled out and need to do a urine pregnancy test. So get this done on an urgent basis. I hope this helps you and get back if you have any doubts or more information to share.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling of right spermatic cord and burning in right testicle?\n\nHello, Whenever I sit my right spermatic cord swells and becomes really thick. This goes away when i stand or lie down. I'm also experiencing burning/cold/tingling pain in my right testicle. There doesn't appear to be any lumps on my testicle although I'm still scared it might be cancer. I've had ultrasound twice, and it didn't show anything, and when I said that my right spermatic cord swells when I sit the doctors had nothing to say. I believe I should also point out, for relevance, that my right testicle has gone into my groin twice, and i've pushed it back down again. I've also had 2 left side varicocele surgeries, and it has returned again, but I doubt there's a link to the current problem. I have another appointment on 12th May but it's so far away , and I would apprecieate another opoinion.Best wishes",
    "doctor_response": "Hi, It can be due to infection - urinary tract infection, prostate infection. Doing urine culture can help diagnose the cause. We can think of cancer now. Since you already did scan twice. It can be a complication of surgery - neuropathy. Doing a blood sugar can help you. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "sharp pain in lower abdomen. What could be the reason for pain?\n\nIv been getting sharp pain in my lower abdomen on the left hand side.. Iv noticed it flare up a few times in the last couple of years but only on the left hand side.. While I'm walking I feel it most or when coughing.. I have to bend over and push my lower abdomen in to try to stop pain when I cough.. Do u have any idea what this could be.. Iv never been doctors about it but it's started happening again so I think something is wrong",
    "doctor_response": "hello there!  I read your query and i want you to know that there could be multiple possibilities for the left iliac fossa pain (left lower quadrant).And it needs a clinical correlation with your basic history physical examination and some workup to rule out different etiologies and Differentials.large bowel , rectum and sigmoid colons may be affected from diseases like IBS inflammatory bowel syndrome or diverticulosis or Chronic constipation or any condition of large intestine.so in nut shell your gastro intestinal tract needs workup.gynecological causes can be the reason for that too ( sorry but i cant see the gender or name while answering the question)You need to see a gastro enterologist and mean while continue good bowel habits. Here are someIncrease fluid intakeincrease fiberEarly break fast 10 minutes after it for 10 minutes on the toilet.regular excerciseavoid stimulantslose weightHope you will find a reliefregardsDr S Khan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain , abdominal pain and heart burn\n\nAbout 1 1/2 mos ago I had severe heartburn, abdominal pain, back pain. The heartburn traveled from my chest to my navel to my right side. Had all tests for female heart attack including catheterization and all came back negative. Last week I had another episode, not quite as bad, but needed to take another nexium at night and tums during the day. I have reflux disease and IBS. Had colonoscopy and endoscopy 2 years ago and tests in 2012 (MRI, etc) since I have constant abdominal issues. I am taking carafate before meals. I am usually taking amitryptaline for intestinal spasms but stopping for now. What could possibly be wrong, and how do I get this to calm down? Help!",
    "doctor_response": "Stop every medicine for few days and try to bear the pain. Heavens will not fall. Your tests are normal.For heart burn, take small qtys of cold milk every two hrs with a biscuit or half slice of bread. Avoid spicy food. Do not take dinner late. If you can get, find Liqorice powder ( glycrrhizia glabra) with honey. If still problem please add Avipattikar herbal powder 2 gm twice a day.For IBS take Ayurveda's Panchamrit parpati 1/2 gm finely ground, mixed in curd and roasted, ground cumin seeds approx. 1 gm. Twice daily for 4 weeks.Totally safe. May ask any Ayurveda doctor for further guidance if needed. This slow process will manage your problems effectively. Pl try to communicate after four weeks.Hope it helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I feel sleepy during office hours,even after 8 hours sleep at night. Please advice.\n\nHello doctor, I am a 24 year old working woman. I feel sleepy during office timing, even though I have 8 hours sleep during night. Please advice.",
    "doctor_response": "Hello. Feeling sleepy during office timing is most commonly caused by absence of a sound sleep at night. Sleeping for 8 hours during night not always means that you are having a healthy sleep. A healthy sleep is determined by the following factors: As you told that you are sleeping for about 8 hours at night and your age is 24 years, this is an adequate sleep at this age (6-8 hours). However if you still feel sleepy during your office hours, this can be due to inadequate sleep in terms of quality of sleep. Besides this, few other things also hamper sleep quality such as: I would recommend you a few changes that you can make at your work place such as make your work area more stimulating, work in chunks, take breaks in between your work, do not work for long hours at a stretch, drink water in between, avoid too much tea/coffee in order to work continuously, get involved in conversations in between for a while to refresh yourself. Also try and maintain sleep hygiene at bed time. Besides this if you continue to have this problem, seek an opinion from a sleep medicine physician online, get yourself evaluated for any of the above causes for sleep disturbances -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long I have to wait to get pregnant after the surgery of hysterolaparoscopy ?\n\nHello Doctor , I had a surgery of hysterolaparoscopy on 31/jan/2011 n i got ma periods on 2/02/2011 n again in the same month i got periods on 15/02/2011 n i z waiting to get pregnant but on 26/03/2011 i got periods..... how long i have to wait to get pregnant????",
    "doctor_response": "hI; Welcome to healthcare magic; You have not mention your hysterolaparoscopy report;assuming your reports are normal you can wait for around 6 months to get pregnant. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Possible aspergers syndrome, numerous mental health issues. What can be done?\n\nI am guardian and grandmother of a 22 year old female.  She has been a special needs child throughout her lifetime.   She was under the care of Dan Coury @ Nationwide Children's Hospital for years.  She now lives with me and my husband.  She definitely needs an evaluation and diagnosis (we suspect Asperger's Syndrome) - does she need to see a psychiatrist for this? or?]I have called numerous mental health svcs in Columbus, OH and keep getting referred to others -  Any assistance as to how to get a diagnosis from a reputable psychiatrist would be appreciated....tk you",
    "doctor_response": "You need to go to the web site of the psychiatric association of your country / province. For example, if you are located in America, go to \"american psychiatric association\", then you will be able to find a good child psychiatristI feel, you need to have opinion of multiple specialists like pediatrician, pediatric neurologist etc before coming to a definitive diagnosis. This is common. therefore do not worry for multiple referrals. Rather make a sense of these and go aheadI. genuinely, appreciate for taking care of the child in special need",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatments for AR and PH\n\nHi This is Jeeva from Bangalore. I am rhumatic heart patient since 1987 onwards. Recently I came to know I have sivere AR and PH. But day to day life and sexual life is normal. I am doing excersie and yoga. Shall I go for operation or medication is enough for this. Please advise me. Severe AR is there since 2007 onwards. due to my life sytle and yoga I am feeling good.",
    "doctor_response": "Hi, You need a surgical intervention when you have cardiac symptoms. tiredness, breathlessness, chest pain, difficulty doing routine work, frequent lung infection and there is increased pulmonary congestion. Also, check for Ejection Fraction in the echocardiogram report. less 45 % means you are going for cardiac failure - needs surgical attention. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for bruising in the hand due to cut?\n\ni punched something hard several times and I have like 4 very tiny cuts. not even deep just like scrapes. it was very red a painful but the next morning it was very red an puffy with bruising. the bruising is a little on the knuckles but a big circle on the top of the hand. and it hurts to make it totally flat since my hand was in a punching position. I can open it but not like totally flat. I don t want to tell my mom what should I do? is it broke, just bruised im not sure.",
    "doctor_response": "Hello.  It's likely this is just a hand contusion but if the pain and swelling don't improve greatly in the next two days you really will need x-rays to check for fractures",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a viral infection\n\nI went to the er running a 103 fever they said they thought it was pneumonia they did a chest x ray and blood work when the blood work came back my white blood cell count was 25000 instead of 10000 like they said it should have been, but then he said he was not sure if it was pneumonia or not but that i had a \"spot\" on my lung that worried him. He admited me into the hospital for pneumonia but my family dr came in and said he did not think it was pneumonia and tested for flu it was negitive too. they did more blood work and said my levels were back down to a good rate after one day and he discharged me from the hospital after one day with me feeling worse than i was. he said he thinks it might be a viral infection. what could the \"spot\" be and everyone is worried bout my levels being so high then dropping that fast",
    "doctor_response": "Thank you, pleased to answer you.WBC and granulocyte counts are clear evidence of the bacterial etiology of respiratory infection, but low or normal values do not rule it out. Lymphocyte counts are of no value for distinguishing between viral and bacterial infections. Nodules can be scarring, granulomas, infection, fungus, virus, and cancer. Here in Morocco, nodule let us always suspect tuberculosis caused by Mycobacterium tuberculosis agent, but there are others mycobacterium type less agressive than mycobacterium  tuberculosis but they can give such things like Mycobacterium avium. I formally propose that you have a mycobacterium types (not tuberculosis type), but you need some specific test of tuberculosis.high WBC dropping fast is extremly suggestive of infection response to treatment",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Motrin 800 be taken for anti-inflammatory purposes while taking Xarelto?\n\nXarelto and Motrin 800. Can they be taken together? Tweaked my back this morning and took 800 Advil, saw chiropractor and got treated. She knows about Xarelto that I take once a day at night. She told me to take 800 Motrin tonight for anti-inflammatory purposes. Just took Xarelto and Motrin 800 before I thought about checking. YYYY@YYYY",
    "doctor_response": "Consult an orthopedic doctor for back.Tylenol 650 or500 is safe to take.Take rest,apply voltage gel after fomentation",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes amenorrhea?\n\nI am 32 year old. 162 cm hight and 65 kg weight. i had surgical removal of a cyst in fron of my thyroid about 8 years ago. My problem now is that i did not get my period for about 8 months! i was under stress a i started my postgraduate studies 10 months ago and i am not sure if this could be a factor for my case. I am worry that i had problem in my thyroid or even something worse related to the missed period! what would be the worst of not getting the period that long?",
    "doctor_response": "hai, First don't get worried and stress out Because stress may also influence your menstrual cycle.As you got a history of thyroid cyst kindly go for a thyroid profile test because amenorrohea is common in of thyroid problem. as in certain condition premature menopause and  certain drugs will also cause amenorrohea.Kindly visit a gynaecologist with your thyroid profile report for further treatment and management.Thank youhope i answered your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Laproscopy can be done after failing to conceive with clomide?\n\ni am apcod patient..trying to conceive from past one year..i am taking clomide but there is no sucess..its almost 65days since i got my last period.my doctor adviced me to take regestrone for 7 days and then go for lyproscopy after getting period...should i go for it...",
    "doctor_response": "Hi, I think you can go for laparascopic ovarian drilling.  It will help in treatment of pcos. You can try naturally also after that. Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does hemangioma on left lower side of L2 vertebra mean?\n\nOn my lumbar MRI it is showing a hemangioma on the left lower side of the L2 vertebra on the right image of the L2 it is showing the hemangoima to be presenting superior at the center of the L2 vertebra body, does this mean that the hemangoima has grown throught he vertebral body?",
    "doctor_response": "HelloHemangioma on left lower side of L2 vertebra mean hemangioma in left side of L2 vertebra in lower region.It is present inside the vertebral body.Vertebral haemangiomas are most common benign vertebral neoplasms. They are usually asymptomatic and incidentally detected during imaging for other reasons.It usually doesn't require any treatment. Treatment is indicated if there is neurological deficits or severe pain.In symptomatic lesions,treatment options are radiotherapy,balloon kyphoplasty or transarterial embolisation.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for constant cough and breathing difficulty\n\nJust to let you know I have been previously diagnosed with cough variant asthma. On Friday night I started coughing and did a breathing treatment with a steroid and another drug that gets rid of inflamation. I did not sleep at all that night and I woke up Saturday morning and did a breathing treatment. I kept coughing throughout the day and did three more breathing treatments, used my inhaler about 20 times, and took a perscription and over the counter cough medicine. I continued to get worse, not better. I was also running a fever and had horrible body aches. On Sunday morning, I woke up, did a breathing treatment, and went to Care Now. They said I had asthmatic bronchitis and reactive airway disease. They gave me a cortisone shot and an antibiotic. My oxygen levels were normal however on the peak flow test, I was only 50% of what I needed to be so they did a breathing treatment on the spot. Also, my blood pressure was higher than normal. That afternoon I was much better but by that night, I got bad again. I did not sleep at all last night. My heart was racing and I could not breath laying down. I would also get dizzy if I stood up. I got up this morning and did a breathing treatment. My mom suggested that I go to another doctor, so I got an appointment. He listened to my lungs and he said they sounded fine but he did a breathing treatment on the spot just in case. My oxygen levels after the breathing treatment improved greatly. He said that because I was feeling so bad, he would do a chest x-ray just in case. That was late this morning and he still hasn t called with the results. Since then, I have gotten much worse even though I am following all of my doctor s orders. I can barely get a word in between coughs and I am having trouble breathing. Do you recommend that I go to the emergency room?",
    "doctor_response": "Hello,As you explain the history, you should do Arterial blood gases, chest x-ray and a spirometry test with bronchodilators.  Hope I have answered your query. Let me know if I can assist you further.Regards,     Dr. Jnikolla",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat accelerated pulse rate?\n\nI was sitting in class when my pulse suddenly started to accelerate and i got light headed my nose started to run I became extremely uncomfortable and I wasn't able to sit still. My hands are quaky and I feel like I just got punched in the stomach. What could this mean?",
    "doctor_response": "Hello!Thank you for asking on HCM!Your symptoms seem to be caused by a panic attack. I would like to know your age. Have you experienced other similar episodes before? I recommend consulting with the GP for a careful check up (physical examination, a resting ECG, a routine blood test, blood pressure monitoring, thyroid hormone levels, blood electrolytes, blood sugar, kidney and liver function tests). If all the above mentioned tests result normal, the most probable cause would be a panic attack.Hope to have been helpful!Greetings! Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What ayurvedic medicine can be given to my little one to increase her alertness?\n\nHello doctor, This is with regards to my daughter who is 2 years and eight months old. I have noticed that she is slow in activities. She is very laid back and relaxed. I have a feeling that she has an imbalance of vata, pitta, and kapha. I mean if she can be either low on pitta or vata as per my understanding. One ayurvedic doctor did give her a medication for one\u00a0month. She took it in the last year for one\u00a0month. She is otherwise healthy and normal. Could you suggest a safe medication\u00a0without side\u00a0effects\u00a0for this age group to increase her alertness and for balancing of the doshas?\u00a0Kindly suggest any\u00a0foodstuffs too.",
    "doctor_response": "Hello. Please provide me these details. Revert with more information to an\u00a0ayurveda specialist\u00a0online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for vaginal soreness with itching\n\nit has been years since I have had this problem but I recently finished a round of antibiotics and am experiencing vaginal soreness and itching. It reminds me of a yeast infection and monistat sounds like a product i used before. would you recommend this. this is not severe, the burning mainly only upon urination and itching on and off.thanks",
    "doctor_response": "thanks for posting your query to hcm . if there is yeast infection , it will not be cure of antibiotics. yeas infection require antifungal medication locally and systemically .I suggest you to consult a gynecologist for proper examination.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes genital warts in men?\n\nhi doctor im 24 years old male i got genetical warts and the doctor prescribed me to take imiquimod 5% and asked me to the test os hiv and vdrl and im scared and dunno what to do also i used the imiquimod yesterday and now i feel so tired and dont feel like eating any thing can you help me please",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Warts in genital area is STDs or sexually transmitted disease.It causes infection via sex. If the opposite partner has infection of HPV virus than it can transmits to you.Yes, your doctors is right and you should take imiquimod. There are some side effects of the imiquimod but you should take it till you are cured.Other STDs are usually associated with it. Like HIV, syphilis and others so testing of it and exclusion of it should be done.You should avoid sex with partner until you are cured. If your partner is affected than you should both take the treatment.There are other methods of treatment also available but it will be clinically evaluated. Modalities are phenolic cauterisation, laser excision, cold gas excision and others. But each method should be applied after your proper clinical evaluation.So you should ask your doctors for other therapies.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in stomach and legs in a child\n\nMy 3 year old has been complaining about her stomach hurting and leg pains and crying about it. She has no symptoms of a cold or anything else and she plays and runs around just fine. There s a lot going on with the family and what not so could it be anxiety? She does it mostly at bed time or when were leaving to go somewhere. A few times it has been just laying there watching TV or coloring.",
    "doctor_response": "Hi...by what you quote I feel it could be growth pains. But stomach pain is unusual. Limb pains are common. But if I were your pediatrician, I would like to get her vitamin D levels checked and proceed further based on that.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for red spots on body\n\nHi Doctor my name is Ela. I have a questions to you. I was chatted with my sister in Abu Dhabi just few hours ago. She told me she got allergies on her skin and its red color. She said once it healed it turn black color, and couple days later it will came back again. She has a lot of red spot on her butt. I m so worried about her health. Do you have an idea what kind of allergies she d got? Im very much appreciate it, if you can help me answer my question. Thank you so much",
    "doctor_response": "Hi.As per your case history you are having allergic dermatitis.My treatment advice is \u2013 1. Avoid using any new products like soap or perfume.2. Apply a mild antibiotic plus steroid cream like fusiderm-B cream twice daily on it.3. Take an antihistamine like levocetirizine for 7-10days .4. Other treatment options are oral steroid and hydroxyzine given only after consulting a dermatologist.Thanks.Dr.Harshit Bhachech.MBBS, DDVL.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Back pain, increases after bowel movement, soft stools, subsides later. Solution?\n\nI have severe back pain in the morning when I wake up. The back pain increases during and after a bowel movement . My stools are soft. The pain fades away after a few hours and it only re-occurs the next morning. The back pain is in the lower back making it difficult to stand or sit. It subsides a bit when lying down on my side.",
    "doctor_response": "Thanks for the query. Back pain could be a referred pain from the bowel problem. As you said its related to your motion so first is to rule out any rectal, colon or anal problems which can give rise to back pain. Get examined by a general surgeon to rule out this problem. If that ruled out then we need to rule out spinal cause and in that case we need to spine x rays. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes soreness in throat of a child?\n\nMy 7 yr old started complaining about her throat being sore on Sunday. Monday she wasn't feeling well I thought it was her allergies. Her dermatologist gave her a script. On Wednesday she woke up complaining about her throat being sore on one side and she had a fever at. 100.4. I took her to primary care who said it's probably a virus she'd should start coughing in a few days. It's something going around. Well she has 103.4 fever. At 830 she received the wrong amount of motrin and I gave her the difference about an hour ago. Should I take her to the er. What should I do",
    "doctor_response": "Hi,From history it seems that this can be viral infection but seeing the throat soreness a bacterial infection should be ruled out.She might require one antibiotic medicine course like Azithromicin for 3-5 days.Ask her to do warm water slat gargles.Avoid giving cold drinks, junk food.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Irregular periods. Taking glucophage and duphaston. What could be wrong?\n\nhi Dr.. I have a baby of 2.5 yrs. now iam trying for new baby. But my period was iregular.when i consult a dr she give me glucophage for 1 month ang next month clomid with glucophage.but unfortunately no intercourse and cycle was 29 days. next month on the same medicine and have blood spotting after 33 days. But negative pregnancy test .Then Dr give Duphaston for 5(*2) days.It was before 12 days.Still I didnt get a period. May i hope your help Dr ?",
    "doctor_response": "Hello. Thanks for writing to us. Since you did not get a withdrawal bleeding after taking duphaston, you need to get your urine tested for pregnancy. The delay in having periods , if the pregnancy is ruled out can be due to a mild hormonal disturbance which can be treated by your gynecologist. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of Betacap and Tryptomer?\n\nHello Doc, I am suffering from chronic migrane from past approx 10-12 yrs. I am taking betacap tr 80 once in a day and tryptomer 10mg. but some times i used to miss the tryptomer at night. is there any side effects of these medicines. can you tell me the best way to cure the migrane.?",
    "doctor_response": "Hi, Tryptomer (Amitriptyline) can cause various side effects. Some of them are: CV: Orthostatic hypotension hypertension tachycardia palpitations arrhythmias ECG changes CNS: Confusion hallucinations disturbed concentration decreased memory delusions nervousness restlessness agitation panic insomnia nightmares mania exacerbation of psychosis drowsiness dizziness weakness emotional lability numbness tremors extrapyramidal symptoms (eg, pseudoparkinsonism, movement disorders, akathisia) seizures DERM: Rash pruritus photosensitivity reaction dry skin acne itching etc. The prophylactic treatment of migraine include Propranolol (Betacap ) and Amitriptyline (Tryptomer). The probability of success with any one of the anti-migraine drugs is 50\u201375%. Many patients are managed adequately with low-dose Amitriptyline, Propranolol. Many patients are able to discontinue medication and experience fewer and milder attacks for long periods, suggesting that these drugs may alter the natural history of migraine. Hope my answer was helpful. If you have further queries feel free to contact me again. Regards, Dr. Tushar Kanti Biswas, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a hard lump near the ear?\n\nI have a hard lump in front of my ear on the right side, it feels like bone and as if it s attached to my jaw bone. I also have toothache and have had some welling in a lymph node in my neck on the same side. I had my lower right wisdom tooth removed 2 months ago.",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. It can be possible that there might  be some  infection still left in the jaw bone after wisdom tooth extraction,  which is causing all these problems. To confirm the diagnosis you have to get a full mouth x - ray done which will show the complete infection. Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there irritation in the stomach while eating and gas troubles?\n\nHello doctor, I am working in a software company. I have a gastric problem, stomach gets big and tight when gas occurs. Below are a few symptoms. When gas occurs, irritation in stomach above the belly button and just below rib bone (little right), releasing more gas when I go to the bathroom, if I eat anything spicy, irritation in the stomach at the time of eating, below right rib, no heartburn. I met a doctor, who gave Nexium 40 1-0-1 and Sucrafil 1-0-1. It was good for two hours after food, but later gas forms, feeling stomach has increased its size. So, met a Gastroenterologist, who checked and gave, Deltone 60 1-0-0 and Lafaxid 10 0-0-1. But the same issue, after eating food, nearly two hours later, gas forms, irritation at the point comes. At weekends, when I am at home, I used to eat biscuits, fruits often, so 90 % I do not get this gas problem. My weight has increased to 8 kg in the last six months.",
    "doctor_response": "Hi. You have to modify your diet and lifestyle. Try to avoid or reduce the amount of gas forming foods in your diet. Also, reduce excess spice and masalas. Add more of salads. Try short frequent feeds rather than heavy food or meals three times a day. Keep yourself well hydrated with two liters of water daily. Avoid carbonated drinks, excess coffee and alcohol if any. Have regular aerobic exercises. Follow these measures consistently for a month and see the response. Regarding medicines, Nexium (Esomeprazole) is a good choice. Can have for 2 to 3 days whenever you have excess symptoms. An endoscopy and ultrasound scan of the abdomen, if not done, is highly recommended.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness and tingling sensation in my hands?\n\nHi,i keep getting numb and tingly hands. this has been for a while now that i think about it. At times some or all of my fingers go white, ice cold and numb for no appaent reason. right now they are swollen and tingly. i am very fit and healthy 32 year old woman ?",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your symptoms.Based on the description, we need to exclude peripheral neuropathy and Raynaud's phenomena.In peripheral neuropathy, nerves of the hands are affected either due to compression of the nerve at wrist (such as carpal tunnel syndrome), or due to infections, vasculitis, etc. This can be confirmed by doing nerve conduction studies.In Raynaud's disease, the artery gets narrowed at times, resulting in symptoms that you described.Please discuss with your doctor regarding both.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen and painful gums?\n\nMy gum is swollen and painful on the top right side, near the back where my wisdom teath used to be (they were removed 18 months ago). The glands in my neck on the same side are also slightly swollen and it aches a bit round my right eye. Do you know what this could be?",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,  I have gone through your query, as you have swollen and painful gums dont worry  it can be due to inflammation in gums due to periodontal problem or due to molar tooth present that is second molar may be carious or periodontal problem.  May be periodontal abscess or periapical abscess is there . You can do warm saline gargle two - three times a day. Apply Stolin gum paint on painful seollen gums two - three times a day Consult dentist and go for investigations and oral prophylaxis .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for  cough and vomit in the night\n\nGoodday, I have a \"productive\" cough. I have been coughing for 5weeks now. Although I cough during the day, it get terrible at night and I cough till I vomit. I vomit up mucus/spit though. This cough was not caused by the flu/cold or anything, it just started with an irritation in my throat and has gotten worse. Please help with a home remedy. No money to go to doctor or buy medication! I am in south africa, female, 24.",
    "doctor_response": "HI, thanks for using healthcare magicThe most common causes for persistent cough are: (1) post nasal drip- this the most common(2) asthma(3)GERDIf there is a history of asthma this would need to be assessed and controlled.It is possible that your symptoms are related to post nasal drip since it started with an irritation of your throat.This is normally caused by an allergic reaction to a particular trigger.It would be treated by avoiding the allergen if known. In addition the use of  a topical steroid nasal spray and oral anti histamine would help.If there is a history of GERD, this should be treated as well.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is Savella prescribed for?\n\nHello Dr., thankyou for your time and expertise. I hae been diagnosed with Chronic Fatigue Syndrome and 4 mnths later with s every Chemical senitivities along with non0Aids or other retro-virus related low CD -4 cells (have had a abone marrow and many other expensive ongoing blood test over a few years period. The number has fallen from 550 at first testing to 109 very many years later. My healthhas declined greatly even snince first diaganosese,but my present pain Dr. athe head of duke apin clinic in Nc, gives little attention to CD-4 cells or Chemical sensitivities and is contantly almost forcing me to try yet anti anti-depressant (savella) though I ve tried 14 others with very bad results over the tears. He threatens to stop prescribing properly taking morphine which controls my pain if I don t take a new $410.00 per month drug not even meant for CFS but is an anti-depresant (he agees I; m NOT depressed nor do I have fibromyalgia, the two things the drug is for. Should I go through further misery and take another drug that I react badly to and can t afford (my total income is $1315.00 per month and rent alone is $124.00 per month. or chance drugs that work being taken away? Stressed in Chapel Hill",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It is true that Savella is not approved for CFS but at the same time it is also true that it is potential medication for CFS. Your doctor is doing his best to protect your health with use of medication which causes least number of side effects in compare to current medication (morphine). In my opinion there is nothing wrong to trey a new medication with potential to treat CFS when 14 other medications failed despite the years of effort. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be the reason for pain in the abdomen and back?\n\nhi i am 38 years old, female 124 lbs. I have my urine tested and the results are as follows: pus cells 6-8/hpf, red cell 0-1/hpf, protien trace, leukocytes trace, epithelial cells +++. my hematology result that is not normal is neutrophil 56. i feel some dull pain in lfet lower abdomen and some pail on my lower back. with some feelings of wanting to deficate.I dont have fever, just the pain i mentioned.",
    "doctor_response": "HI.Your symptoms are suggestive of left sided colitis and a course of an antibiotic and supportive medicines will help a cure. You can certainly go for a CT scan of the abdomen as you have multiple problems and CT  scan helps differentiate all with the help of other tests like colonoscopy and a good physical examination by a Surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Blood pressure, want to conceive, eslo2.5mg and telmikind40\n\nmy wife have bp problem and she want concive ,her treat by a gyine but main problem bp so suggest a mediceni for bp contol.at this time she take eslo2.5mg and telmikind40 but she not feel good",
    "doctor_response": "Hello. Thanks for writing to us. The medicines she has been prescribed are to lower her blood pressure. If the blood pressure is not getting adequately controlled or she has some other related symptoms then she needs to consult a physician for a re- evaluation.I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL  Regards, Dr. RakhiTayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat heart valve problem?\n\nhi my mom is 81 years old and has two bad heart valves the aortic and the valve in the left side is also really bad she has afib and scar tissue on her lungs how long can u live like that her doctors wont operate because she wont live threw the operation",
    "doctor_response": "HiThank you for trusting and asking HCMI read your query and understand your concern Unfortunately at such ages it so difficult to resist big surgeries like heart surgery It is recommended that conservative treatment is the best option Cardiologist depending on the severity of valvular dysfunction should decide the dosage of diuretics, inotrops and anticoagulation Patient treated in the right way may stay safe for a long time Hope my answer will help you Stay healthyRegardsDr DrilonaCardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to deal with pulmonary hypertension?\n\nl am a 51yrs old sudanese schoolteacher 5 ft six inches of height 55kgs weight diagnoesd in Kuwait chest hospital in 1989 as a vsd sevesre pulmonary hypertension and not indicated for surgery i got married in 1998 with three duaghters 12_10_8 .l know my case very well and l ve heart disease history a younger brother had died of heart failure and four youger brothers died in their baby hood they were likely have the same disease .my parents are close relatives and they still alive with reasnable health according to thier age.l was hospitalised in1986and 2006 for haemoptasis. I have been suffering recently from feet swelling and neck and shoulders stiffness specially when l carry any something over ten kilos of weight accompanied with a high fever and l feel the area very hot a two days ago echo showed that the case is normal a chest xray showed in the day that heart is not enlarged but not in good health other lab results 2days ago esr 8 mm/h.hb119.5percent uricacid 6.0 my question is what are the exepected symptoms and comlications in this case and how to deal with them.email: YYYY@YYYY cell 0000",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You are having pulmonary hypertension (PH) due to valvular heart disease (VSD). Surgical correction is the best treatment at the time of diagnosis. I am still surprised why surgery was not advised in 1986. Anyways, future complications for PH with VSD are 1. Right sided heart failure 2. Congestive heart failure 3. Arrhythmia 4. Uncontrolled hemoptysis. So to prevent all these, you should definitely get done 2D echo regularly. Avoid excess salt and water in diet. Start Tadalafil or Bosentan for PH. Do chest physiotherapy and deep breathing exercises. Start low dose diuretics. Hope I have solved your query. I will be happy to help you further. Wish you good health! Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bronchitis and osteoporosis\n\nHi my 62yo brother in law is ill. He started with bronchitis 10 months ago followed by ?rib fractures. Then started with vertebrae compression fractures. Visited osteoporosis Clinic. Discovered severe osteoporosis with non-detectable vit D and low calcium. Further work up showed elevated gamma lamba labs. Sent to hematology/oncology MD. Bone scan normal, hyponatremia in 120 s, ?mult myeloma mentioned. Going for MRI of left humerusthis week. He had fluid 12oz drained from lung pleural space that came back benign. MD states so much arthritis, scarring and old fractures in bone it s hard to make conclusive diagnosis. Any ideas?/",
    "doctor_response": "Hello, Bronchitis is a chronic respiratory problem that can be controlled with proper antibiotics and steroids. Osteoporosis needs regular calcium and vitamin D3 supplements along with bisphosphonates. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Groin pain alleviated when walking. No swelling or redness. Hernia, appendicitis or stones?\n\nhi, my boyfriend is having severe pains in the groin area. it alleviates when he walks. there is no swelling or redness. He does not have any fever. It is mainly in the right side but he says it originates in the lower groin area and irradiates upward, staying in the right quadrant. i can see a possible hernia , appendicitis or possible stones. Would you have a better idea?",
    "doctor_response": "Hi friend Welcome to Health Care Magic Hernia can be seen or felt. Better on walking means less likelihood of Nerve or Muscle pain Absence of swelling and redness ia against local inflammation. Appendix pain starts in mid-line ad then localises to right lower quadrant/ fever is usual. Stone is most likely  but urinary symptoms will be there sooner or later. A number of possibilities...!  Repeated examination / may be tests / and time will tell. Take care Wishing speedy recovery God bless Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Blood in stools, severe constipation, irritation in passing stools on eating spicy food. Taking Pilex tablets, bland food. How can I cure this permanently?\n\nSir, I am 34 year old male from South Indian. From the childhood i am unable to eat Chilli food item even very low amount of chilli. Hence now a days i am eating food without ZERO amount of chilli. if i add very little amount of chilli in food, it will very irritation while going to pass stool . Also, in last 3 years, i am facing daily constipation and for release of constipation, i am drinking warm milk while going to bed at night. it will give some relaxation for constipation. In some time, i have a problem for stool with bleeding . For this i am taking Ayurveda medicine like PILEX TABLETS & PILEX OINTMENTS. but still i have a problems OF STOOL WITH BLEEDING. So please help me.",
    "doctor_response": "1. you have only mentioned about constipation and use of medicine to relieve your constipation and blood in stool, but nowhere it's mentioned that what is/was the cause of bleeding?? 2. Bleeding indicates disorder or disease of digestive tract, so what was the source of bleeding: upper GI (esophagus,Stomach,duodenum) or lower GI (colon,rectum,anus)?? 3. going by your history, it seems that 'blood with stool' indicates hemorrhoids unless proved otherwise. 4. rule of thumb is:constipation causes hemorrhoids( due to over straining) and hemorrhoids causes constipation (due to fear of blood), thus vicious cycle goes on. For Constipation: i.any history of anemia, prolonged fever, IBS?? ii. use of laxatives with Aluminium, prolonged use Iron,calcium, Anticholinergics?? iii. Thyroid Function test (under active thyroid?) iv. any Psychological cause: depression,Personality Dysfunction,Physical Inactivity?? Reason/Cause of blood in stool has to be evaluated by general surgeon by doing suitable tests and P/R Examination., whether due to gastritis,piles,ulcer or any infection? .In the mean time you can follow the following regime: .regular bowel habits with attempted bowel movements 15 to 20 minutes after breakfast, when the gastro colic reflex is strongest. . fiber rich diet . because constipation leads to Urinary tract infection:adequate fluid intake, at least 8 glasses/day. .drink luke warm water during morning hours,getting up from bed. . drug of choice acting both on constipation and blood in stool is 'Abhyarishta\", take 3 spoon with equal amount of water three times a day,after meals. . Avoid over straining, don't sit too much on hard surface, and take warm SITZ bath. . Yogic postures like Vajrasan, Trikonasan,Parshvakonasan are useful alongwith abdominal massage.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can infected uvula and infected sinuses be treated?\n\nI HAVE A UVALA WHICH GETS INFECTED QUITE A BIT AND THEN I HAVE TO BE INTUBATED 5 TIMES SO FAR I HAVE BEEN THINKING OF HAVING THE UVALA REMOVED EVEN THOUGH MY PROBLEM IS INFECTED SINUSES WHICH I BELIEVE IAM THE ONLY PERSON DOCTORS HAVE HEARD THAT I GET ANDEODEMA FROMI NEED TO THINK ABOUT THIS OPERATION AND ITS SIDE EFFECTS COULD YOU PLEASE INFORM ME WHAT IAM LIKELY TO EXPECT",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: Uvula helps in voice production. No need to remove it. You are not the only person to get angioedemaExplanation: Take precautions to prevent angioedema, and get treated yourself for sinusitis with antibiotics and anti inflammatory drugs. Please consult a doctor before doing anything on your own. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for gallstone\n\nI have a 4 cm gallstone.  Should it be taken out if I don't have many of the usual symptoms.  I am 65 and my dr. says that I have probably had it a long time.  I don't hurt when I eat a fatty meal or a big meal.  Right now I keep having a pain just about the area of my right bottom rib cage.  It has been there for about 4 months. I weigh 150 pounds and am female.",
    "doctor_response": "Hello and thanks you for your query. I am Dr. Rommstein and I will try to help you as much as I can with my answer.If there are no symptoms then this is called asymptomatic cholelthiasis and surgery is not necessary especially if there is large single stone as in your case. However,if symptoms occur then surgery is recommended to prevent I inflammation and pancreatitis.Till that,try to reduce fats intake and alcohol.I hope I have answered you query. If you have any further questions you can contact us.Kindly regards. Wish you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excessive heat and sweating in the body?\n\nI am curious to why I am HOT all the time?  I just turned 37 years old, and have been experiencing this now for almost 5 years.  I am hot and sweating, where only a tank top and everyone else in the room is fine and wearing long sleeves and jackets?  Would could be my problem?",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.There is one clinical condition named as hyperhydrosis. In this condition patient is suffering from more of sweat.The treatment for this condition is not known but you can take parasympathomimetic drugs under doctors guidance. This drugs can decrease your sweating. You can use it only when you have to protect yourself from sweating.For further protection you can use cotton clothes and cotton undergarments, loose clothes,.Some times only you can use antiperspirants. Please do not use it for long period. Because prolong suppression can cause skin disease.Avoid going in the area of dense population.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for soreness and tingly feeling in knee\n\nI twisted my knee about 2 weeks ago and it has been sore for the entire time. It is starting to feel better and I m able to bend it more and more, however, last evening my shin bone below my left knee started to feel numb. I can walk just fine, but anytime I touch it it feels tingly.",
    "doctor_response": "Hello, As post-injury, there will be pain and inflammation due to which there will be changes in the body biomechanics and this may have led to changes in the gait cycle leading to abnormal stress and strain over the muscular system . Once the normal biomechanics changes there are expected to be changes in the symptoms. Doing correction of the knee biomechanics will help reduce the other symptoms. Do the exercise for improving the Range of Motion of the knee and strengthening the muscles of the thigh and legs to stabilize the knee joint, improve muscle strength and correction of the gait cycle. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for numb face with irritable white bumps due to nerve damage during dental surgery\n\nHello i had surery done for my wisdom teeth. Now i think it s called paralysis which to me is a part of my fce is numb due to nerve damage. Now i have these white bumbs that are irritable on the areas that are numb. It s been about a year and a half since the surgery",
    "doctor_response": "Hello!Welcome on HCM!Regarding your concern, I would explain that the white bumps could be related to an infection. Anyway, I recommend consulting with your attending physician for a careful physical exam and some tests: - a panoramex (teeth x ray study to exclude possible residual peaces of teeth compressing the nerves from the surgery or for a possible infection)- a brain MRI to exclude other possible causes of face numbness - some blood lab tests (complete blood count, PCR, sedimentation rate for inflammation). You should discuss with your doctor on the above issues. Hope to have been helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of day dreaming?\n\nhi doctor...i day dream a lot,i waste much of my time in thinking abt different things lyk my future,friends etc etc and all the non sense crap,i think it started 2 years back when I was in 11th and it greatly affected my results... I cannot concentrate on studies and waste my study time in dreaming abt things...m in 1st mbbs right now and it is really affecting my studies...i am not sure if I can clear the final exams",
    "doctor_response": "HIWell come to HCMWhether is night time dream or day time dream this is physiological phenomenon and not the disease that can be treated and this is nothing to worry if you are not comfortable with this then stop sleeping in day time, hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is nestle nido milk powder safe for a 2 year old?\n\nHello doctor My daughter is 32 months old. Her birthweight was 2.8kg. Now her weight is 11kg and height is 87 cm. I am giving her Pediasure twice daily and cow milk (full fat) once daily. I wanted to know whether her weight and height is normal or not. She is a hyperactive kid. I am planning to switch to Nido milk powder, what do you suggest.? Pls advice Thank you",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. For her age, her height of 87 cm places her between the 15th and 20th%tile for healthy girls age. Her weight of 11kg places her between the 15th and 20th percentile for healthy girls her age. These are normal percentiles. You should compare her measurements with those of you and her father. At her age why do you feel see needs an infant formula?  Unless there is something significant in her history that I do not know, then the normal milk for a healthy child her age is whole cow's milk. I hope this is of help to you. If you want additional information, please come back to our website.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is shortness of breath and chest tightness related to pneumonia?\n\nI have had shortness of breath and a tight chest. I also have been very slowly getting over pneumonia. I also have 6 heart stents. I was very active until pneumonia started in Feb. Is this a condition of my heart or pneumonia. Not all the time just at night.",
    "doctor_response": "HelloUsually pneumonia is a condition that after treatment passes.It might be from heart problems in my opinion.Consult your doctor.RegardsDr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having pain behind breast that is radiating to underarm. Please help.\n\nHello doctor, I have undiagnosed chest or back pain which over the last 4 to 5 months has been getting increasingly worse. Full spinal MRI performed, have not seen the report but was told by the doctor that there was nothing there that would account for the pain. I would really appreciate a fresh perspective. Pain (4 to 7/10) behind left breast and radiating around the side and underarm. Not affected by posture or activity but unable to breathe deeply. Episodes last from 90 seconds to 4 to 5 hours, some days it only happens 2 to 3 times, other up to 20 times. Sometimes, the pain will wake me at night. This pain is different from other episodes in that it is much sharper (10/10) and makes lying down impossible. Cardiac causes and blood clots have been eliminated. Nuclear bone scan showed a hot spot at L1, which prompted a lumbar CT. From that, I was told that I have severe arthritis in the lumbar with possible nerve impingement. Advice from spinal MRI was no nerve impingement. Previous history: Have confirmed the diagnosis of DISH in the neck (C3 to C7) and possible diagnosis of ankylosing spondylitis (being treated with Humira, which helps immensely). No problems with any other joints. Current medications: Mobic 15 mg once daily, Humira 40 mg fortnightly, Targin 40/20 mg twice daily, Endone 5 mg as required, Sevikar HCT 40/5/12.5 once daily, Thyroxine 200 mcg once daily, Oestradiol 2 mg once daily. Comments: Have lost 5 cm in height in the last 5 to 6 years. Probably not relevant to my thoracic pain, but when I go to the toilet, most times I have severe lower back pain for some time after, and occasionally pain down the back of both thighs.",
    "doctor_response": "Hi. Following is the reply after viewing your images (attachment removed to protect patient identity).  Review of cervical spine MRI. In C2-C3 disc level, there is a mild left neural foraminal compromise. In C3-C4 and C4-C5 disc levels, there is minimal right and mild left neural foraminal compromise. In C5-C6 and C6-C7 disc levels, there is a minimal bilateral neural foraminal compromise (left greater than right). The features of DISH are persisting. Therefore, it is likely that the pains you are having on the left are due to mild neural foraminal compromise in the above cervical levels. There is mild fluid in C3-C4 and C4-C5 disc levels. There is no significant spinal canal stenosis. Review of thoracic spine MRI shows no significant disc bulge or neural foraminal compromise. Review of lumbar spine MRI and CT. There is no obvious disc bulge but the changes in the vertebrae and the intervertebral facet joints are moderate in nature. There is thickening of the flavum ligamentum in L1-L2, L2-L3 and L3-L4 disc levels causing thecal sac compression and impingement of nerves in the lumbar spinal canal. There is lumbar spinal canal stenosis in many disc levels and is prominent in L1-L2 disc level. There is a moderate bilateral neural foraminal compromise in L3-L4 and L4-L5 disc levels. The increase in pain during bowel movements is likely due to dynamic neural foraminal stenosis. The CT scan shows significant degenerative bone changes and facet joints are showing sclerotic changes in multiple levels.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen lymph node on back of the head\n\nI have a swollen lymph node to the back of my head that seems to swell more during times of stress & when my BP is elevated. It is very tender @ times & sometimes not enlarged, but never completely goes down. I have had this problem for about three years and did receie workup to check me for lymphoma years ago.",
    "doctor_response": "Hello,This sounds more like a sebaceous cyst than a lymph node. A biopsy could be done to see if it is a lymph node or cyst. In either case it could be removed if it is bothering you.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could lumps on the head and throat suggest?\n\nMy friend has a painful red lump on back of head just above her right ear,a doctor vist and doctor said oh you were bitten by a bug and gave her a salve to put on it.no sign of a tick,redness larger than a half dollar and she can not bear the pain,tender to touch,doctor ruled out things other than a bug bite. now she complains her whole head hurts,she also has a small lump now on the throat below her chin?? any thoughts ??? thank you",
    "doctor_response": "Hi,Dear,Thanks for the query to HCM.I studied your problem in depth and I understood your concerns. Cause for the lump in your head and throat-In my opinion both these lumps are differrent-One on the head above right ear-is diagnosed by your doctor as but bite-and is being treated accordingly.The bite seems to be  infected with secondary infection.Hence I suggest it to consult ER Surgeon, who would treat it accordingly.Other lump -on the throat-is a seperate lump and is not causing the headache you have.Headache you have is due to the infected bug bite and needs to be treated by antibiotics with your ER Surgeon.For Final Diagnosis and treatment  needs clinical data from a Doctor.Its not thyroid as you think -otherwise Your doctors would have asked you to do USG and other tests to rule it out.and Hence for further treatment I would advise you to Consult ER Surgeon , who would treat it accordingly.This advise is based on the facts from the history you give and needs further clinical check.Hence I would advise you to check with ER Surgeon.So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you.Hope this would relieve your problem.Welcome for any more query in this regard to HCM.Write good resume and Click thanks if you feel satisfied with my advise.Have a Good Day.Dr.Savaskar M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can I do to reduce shoulder pain that is slowly spreading towards the arms?\n\nI ve had a knot in my back near the shoulder blade that s been lasting now for 6 weeks. I also have pain that goes from my shoulder down my arm into my fingers mainly the index finger but also the thumb and middle finger. Most of the time it feels like the muscles are just tired like I ve worked using them for a long time.",
    "doctor_response": "Hello, The symptoms seem to be related to a pinched nerve in the shoulder. I suggest using anti-inflammatory medications such as Acetaminophen to relieve the symptoms. I also recommend avoiding movements that can trigger the symptoms. If the symptoms continue, I suggest consulting a neurologist for further evaluation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause 3-year-old to continuously pass stool?\n\nMy 3yrs old girl has been stooling continously for about a week now. She can stool for as much as 9 times a day. We had visited the hospitan and she was given Cefamor after careful evaluation. Today, she had completed the dosage yet the stooling continues and is now blackish in colour. This tool even comes more after eating, it is so bad now that the girl is trying to avoid eating.",
    "doctor_response": "the frequency of the stool indicates there is diarrhoea even if the consistency is not watery, giving an antibiotic will increase the problem because most of these antibiotics can cause diarrhoea as a side effect and killing the beneficial bacteria in the intestines. the fact that ( stooling  ) occur after eating indicates that this child has what is called exagerated gastrocolic reflex , which is a normal physiology but increased by the hyperactive bowel from an offending agent .I recommend doing a stool analysis and culture to exclude bacteria or parasite .in the mean time you need to increase fiber diet to bulk the stool, and water to prevent dehydration , you can use smecta sachets which can decrease the amount of stool .I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of lump on inner cheek of butt?\n\nI have a lump on my inner cheek of my butt. Noticed about a week ago size of a grape now its the size of a golf ball. just popped this morning red milky stuff came out put its still about half the size. Should I be worried about this. Also its painful to walk or sit. Thanks",
    "doctor_response": "it is just an infected sebaceous cyst or a folliculitisjust go for surgical removal after a course of antibioticsall the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in the chest?\n\nI am a 24 year old female, I had pneumonia six months back. but the shadow on my x-ray is not completely gone and I had occasional chest pain. I have no fever or cough. But the chest pain has increased a lot since last two days. Is there something wrong again? I would like to mention that i also am a smoker. Is it affecting me?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Yes, your smoking habit is the likely cause for this chest pain. Pneumonia causes inflammatory changes in lungs. So post infectious bronchitis is very common after pneumonia. And chances of bronchitis are even more when patient is an active smoker. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (pulmonary function test). PFT will tell you about severity of the disease and treatment is based on severity only. You will need inhaled bronchodilator and inhaled corticosteroids (ICS). Smoking cessation should be done as soon as possible. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can nerve damage in the foot causes tingling and numbness in the foot?\n\nHi I had a discetomy l5 s1 3 years ago I have some nerve damage a drop foot left side . My drop foot has improved about 80% Any way I feel on my butt a few days a go and now I feel some more numbness and tingling pain in my left foot Should I be worried?",
    "doctor_response": "Hi..The pain what you described is basically from a nerve damage..it may be a small comprehension or may a irritation..I recommend you to take Investigation to rule out nerve root impingement...if there is disc iritation. then you can try with McKenzie program...and core and glute stability exercises...Since you already have a foot drop...it is very important that you take early intervention..Hope this is helpful for you...kindly revert back in case you need any further help...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cold sore after bite by spider\n\nI had a cold sore about two months ago. I treated it with abreva. It healed but left a red mark (bottom lower lip). About 3 weeks ago I was bitten by a venomous spider and went through an antibiotic treatment. During the time I was being treated for the spider bite, the area where the previous cold sore raised again. I now have a bump in the area that is pink and raised. It is not painful but does not seem to be getting better. Should I be concerned?",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.No, you need not to worry.It will go with its own. Redness in the wound is probably because of infection. If you continue with the antibiotics taken for the spider bite the swelling will go with its own. Please maintain good hygiene as it is equally important for constraining the infection as equally as drugs do.Applying antibiotics ointment like polysporin can help you prevent infection. Taking cetrizine can help you from getting itching.I will be happy to answer your further concern on bit.ly/DrArun.Please hit thank you for me if you are helped.Thank you,Dr Arun TankInfectious diseases specialist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best option to get relieved from kidney stones?\n\nI think I may have a kidney stone, what is the best option for pain relief or should I go to er if pain gets u nbearable? I read about a tea you can drink, the Neatle tea leaf where can I find this? And if I am passing blood does that mean I am In the process of passing the stone?",
    "doctor_response": "hello, I suppose you are having pain in flank region as you have not specified correctly. i would suggest you to get a USG scan of abdomen to look for presence of kidney stone. If at all its present, the size of the stone, number of stone(s), site of the stone all this information we can get and which can help for proper diagnosis and treatment for the same.  Regarding the question about blood in urine, if stone is present and if its eroding the wall of kidney, ureter or bladder it can cause blood in urine. So to get answers to all this question i would suggest you to get a USG scan of abdomen and follow as per the report. Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from malaria fever\n\nHi, I am a dinesh patwa and i have a problem of malaria fever and pain in the stomach from 10 day and doctor give me the VIZYLAC capsule but i have not relief then after they give me a ZOFER MD4 Dr. Told that you have a problem in a KIDNEY, So tell me what i can do. Tommorow the DR. give me a AMLODAC 5 tab. Can iget relief after this tablet.",
    "doctor_response": "Hello Mr. Dinesh,Welcome to HCM.I understand your concern.Sadly none of this tablet is a treatment of malaria. Vizylac is vitamin supplement along with lactic acid basillus to correct disturbed intestinal flora. Zofer is for vomiting. Amlodac 5 is for high blood pressure.If you have already done PS for MP (blood examination of malaria in blood) and found it positive than you must take full course of antimalarial tablets  depending upon the type of malaria (P. falciperum or P. vivax or other).If you are suffering from P. falciperum than you need to take Artesunate tablet, sulphapyrimethamine tablet along with primaquine tablet.If you are suffering from vivax malaria, you need to take chloriquine and primaquine tablets. This is as per the latest Indian guideline of malaria treatment.But you haven't seem to taken this treatment so I would recommend you to contact a physician and get the full course of treatment.Hope this will be helpful.Do ask if any further clarification is needed.I am available at  Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain, headache and vomiting?\n\nLast Wednesday I woke up with chest pain; i ve had previously and they said there was something wrong with my liver but then it suddenly went away so I didn t go back. With that symptom I also had major headache and I was throwing up constantly and my all my muscles ache so that was Wednesday, thursday I had all the same symptoms, still throwing up, friday morning I woke up and had bruises all over my body all down the back of me down my legs my arms everywhere and then I also have another symptom which is itching, all symptoms are pretty much still there today except for I m not throwing up anymore. You know what this could be?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. By your history and description, possibility of liver disease is more. Because liver pathology causes high bilirubin and high liver enzymes(SGOT and SGPT) . These can cause itching, vomiting and skin rashes. So better to get done ultrasound examination of abdomen to rule out liver disease. Also get done serum bilirubin, SGPT and SGOT to know about severity of the disease. You may need injectable drugs because you are having vomiting. So consult doctor and discuss all these. First diagnose yourself and then start appropriate treatment. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat penile injury?\n\nHai sir my name is kumar iam doing sex with my girl friend he donot opening his pussy clearly my cock is not entering in to his pussy I pussed my cock very hard in to his pussy my cock is injured skin is cuted blood also camed sir any problem is there sir plz give me answers plz",
    "doctor_response": "HelloThanks for query .You have sustained injury to your penis while attempting forceful entry of your erected penis in vagina ,This is mostly due to one of the following reasons .1) You are unable to retract your foreskin over glans penis 2) Her vagina is narrow or may not be adequately lubricated .Please consult yourself to General surgeon and her to Gynecologist for clinical assessment and further treatment..Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes trembling sensation inside the chest?\n\nI am in menopause for 4 years now and last June i had a panic attack and around that time i started to have sensation of trembling inside my chest. I say sensation because nobody can fell these trembling, even not my doctor with the stethoscope. These trembling are \"all the time\" but when i move it doesn't really bother me, although they are there. But when i sit to eat, watch TV, or go to bed...it is very annoying. I listen relaxation music every night to relax. Sometimes it wakes me up at night and have had time to fal asleep again. I have had blood work done several time; they only find that i am vitamin D deficient and take supplement since October, but still trembling. I started hormone (patches) 3 weeks ago to see if this would solve my problem...not as of now anyway.  My husband and I are retired...this can't be stress !!! Any help would be very appreciated.",
    "doctor_response": "Your symptoms are suggestive of panic/anxiety disorder. If your doctor has found no underlying physical correlate to the symptoms, it doesn't mean there is no source. Panic/anxiety disorder is a real medical problem and there are several treatments that are very effective. Discuss this option with him or her. A trial of non-habit forming anti-anxiety medicine may prove informative.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Thinning of hair, weight gain, short feeling of detatchment suggesting possible hyperthyroidism.  Blood tests normal.  Guide\n\nI have several symtoms which suggest cyclical hyper thyroidism but blood tests do not confirm this diagnosis (symptons: hair thinning, weight gain, odd attacks which occur every 28 days - these are not really panic attacks, but a feeling of detachment which last about 30 seconds and continue for about half a day). I am due to have a MRI scan shortly.",
    "doctor_response": "Thinning of hair and weight loss might suggest hyperthyroidism. Weight gain is usually seen in hypothyroidism. However, you have mentioned that blood tests (including thyroid functions) are normal. Your feelings of detachment lasting 30 seconds may be an epileptic phenomenon and an EEG will be more useful than an MRI. Do these monthly episodes occur around the time of menses? You may consult a neurologist or neuropsychiatrist for your symptoms to make sure these are not panic attacks. Further investigations will be advised by him.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I conceive naturally after endometriosis surgery?\n\nHi doctor, I am a 30 year old female. I have been\u00a0trying to conceive\u00a0for a year with endometriosis on ovary. My husband is 32 and normal. My AMH is 1.85. I am planning to get laparoscopic surgery. Can laparoscopic surgery reduce my AMH further more? What should I do?",
    "doctor_response": "Hi. The laparoscopic surgery will definitely reduce your symptoms and the endometriosis of the ovary will be taken care of. Since AMH (anti-mullerian hormone) is a hormone, post surgery the effect of it would be a little difficult to state now. Please get your surgery done and then repeat the test. Once the problem is solved, the body will take care of the hormone. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does a pineal gland cyst cause superficial numbness and dizziness?\n\nHello. I am 43 years old and 130 lbs, 5'7\".  Two months ago I was diagnosed with 15.8 X 12 X 9.7 mm pineal gland cyst.  I have constant low-grade headache, extreme eye sensitivity to light, constant dizziness, and mental fogginess.  More irritating to me, however, is that I have superficial numbness in all four extremities, legs much worse than arms, a deep constant feeling that my legs are falling asleep, pain in legs, and a feeling of needing to move my legs constantly, resulting in twisting movements of ankles while awake.  The numbness started in my left lower extremity and has progressively worsened and spread upward over the past two months.  Additionally muscles feel sore and like they have been strained while at rest. Pain is unrelenting. Please help if you can. Thank-you.",
    "doctor_response": "Pineal gland cyst don't cause such symptoms. Probably you are having Restless leg syndrome. Try tab Pregabalin 75 mg at night and also do Serum ferritin and TIBC. Hope my answer will help you. Take care.dont forget to rate me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to deal with abnormal behaviour of a teenager?\n\nMy 20 year old daughter does not communicate well with us. She says we think she is an idiot. She was raised in a functional, Christian home, and is a third year college student with no major. when we try to talk to her about college grades and majors, she becomes irrational and has outbursts of unkind remarks toward us, her parents. what have we done wrong, and what can we do to change her attitude. She is very pretty.",
    "doctor_response": "Hello thanks for asking from HCMShe is 20 and is showing complaints like not communicating well with you, she has ideas that you people consider her idiot, she becomes irrational and she show outburst of unkind remarks or anger. Such symptoms should not be ignored. She is in twenties and this can be considered as normal teenage behaviour but her anger outbursts and irrational thinking points more towards some other cause.Underlying conflict and depression may also present with such symptoms. Her ideas that she is an idiot could be a feature of depression. Anger outbursts, irrational thinking etc can occur due to bipolar disorder or some psychotic disorder. From the symptoms you have mentioned it is very difficult to make a proper diagnosis. I would advise you to consult a psychiatrist and get her evaluated to make final diagnosis.Thanks, hope this helps you. Take Care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on the side of shin bone?\n\nSure. I just noticed a lump on the side of my shin bone about 4 below the knee. It is about 1 1/2 long by 1/2 or so wide, running vertical along the inside of the bone. No pain. I can t really tell if it is soft or hard, as it could be just as hard as the fatty deposits get. Any ideas?",
    "doctor_response": "not to worry much as this is benign condition like lipoma, sebaceous cyst, a bursa or just a neurofibroma! if really worries you can go for an FNAC test for confirmationall the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes significant bruising and bleeding with any injury?\n\nhi I am 39 yrs of age i have a blood dissorder which causes me to have significant bruising when i get a injury and I tend to have a lot of bleeding. I was benging down to pick up something and struck my forhead on a metal bar. Ihave had some tingling in my face and speech interuption headach ect. should i be worried aboutsubdural hematoma?",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. If you are having a clotting disorder, which increases risk of thrombus, any injury, however mild needs to evaluated with caution.2. If you have hit metal bar harder and if you have neurological symptoms, internal bleeding or thrombus formation requires evaluation along with possible hematoma evaluation. CT/MRI is necessary.3. Meet your doctor and watch out for dizziness, severe head ache or loss of consciousness episodes. Neurological symptoms are not good for your, go to your doctor at once.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in chest while breathing?\n\nHi my name is Courtney and I am 21 years old. About 4-5 days ago I started to notice this pain/pressure in my chest around the sternum area. At first I thought it was heartburn then I started to notice every time I ate, drank, burped and occasionally while breathing I would have a sharp pain in my chest. No of course I really didn t think anything of it and figured it would pass. Now it is getting worse and I barely want to eat because it hurts too much. Do you have any idea what could be wrong?",
    "doctor_response": "Thanks for your question on HCM. Your all symptoms are suggestive of GERD (Gastro Esophageal Reflux Disease).It is due to laxity of the gastroesophageal sphincter. Due to this acid of the stomach tends to come up in the esophagus and cause the symptoms. Treatment of GERD is as follows.1. Avoid hot and spicy food.2. Avoid heavy meals, instead take frequent small meals.3. Avoid stress and anxiety. 4. Take proton pump inhibitors. 5. Go for walk after meals.6. Keep 2-3 pillows under your head in bed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to remove gall stones\n\nI have gallstones. Should I get my gallbladder taken out? I have only had the one attack (which landed me in the ER). I have heard so many \"horror stories\" about the surgery that I am afraid to have it done. Can they do the laparoscopic surgery on me if I am overweight? I watched the procedure being done on youtube and I noticed that they place three clamps on the duct before cutting it loose. Do these stay in the body or are they removed? How risky is the surgery and what are the possible complications? How long is the recovery time because I have a two year old son to care for?",
    "doctor_response": "hi.thank you for posting query at HCM.i thoroughly read your query and understood your concerns.Gallstones are small stones that form inside the gallbladder.Gallstones pain (Biliary colic) usually is usually 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 with 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 ( UDCA) for a period of 12 to 24 months. UDCA 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 in size ( 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. Clamps are withdrawn as the duct is cut loose. 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.regardsDr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Allergic, difficulty breathing,Diprospan, pels\n\nAllergic, my nose not breathenk and my eyes is rad... Before I did Diprospan inside my nose but it was in Ukraine. Now I live in Australia but here dont practec this treatment ... they sugest only pels but it doesn t work for me...",
    "doctor_response": "Hello, Welcome to Healthcare Magic forum. Diprospan nasal spray contains betamethasone a corticosteroid  which can be used for severe cases of alergic rhinitis. Corticosteroid nasal sprays such as Nasonex and Rhinocort can also be used to relieve the symptoms of sinusitis, hay fever, allergic rhinitis and non-allergic (perennial) rhinitis. However,they can cause side effects such as headaches, nausea and nose bleeds.Hence their use should be limited and only on prescription. For symptomatic relief you can alternatively use anti histaminics either nasal sprays or oral pills available freely on prescription and over the counter. In Australia sprays like Telnase (Triamcinolone acetonide) and livostin (Levocabastine hydrochloride) are the popular products  on the market and are available over-the-counter. Please understand that allergy is best prevented than treated.So do consult an allergist for long term relief rather than repeated selfmedications providing temporary relief. Wishing you good health, Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could lumps on skin in pregnant woman suggest?\n\nHi, my wife is 5-6 weeks pregnant, and has just noticed two medium sized lumps superficial to the skin, minor pain, 2 inches apart on the inguinal line that runs superior from the vaginal opening to the iliac crest. Signs started 2 days ago. No vaginal cramping or bleeding. No abdominal pain. Possible infection of the lymph nodes?",
    "doctor_response": "Hi,It seems that this is enlarged inguinal lymph node.It shows that there might be having some infection in lower genital parts.If infection is there, go for one antibiotic medicine course after consulting your Obst.Keep local hygiene hygiene proper.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have GBS-CIDP. Taken Medrol. Harmful when taken long-term? Have throat and toes infection\n\nHi  I am Sanv was patient of GBS-CIDP & need to discuss that-1)at initial statge IVUG was given to me but that treatment was failed i n my case so ther after i have beeen given steriod and i am still taking Medrol teblate as advised by doc.--is it harmful for me to take for long time..?2) due to less immunity cos of steriod i am suffering some kind of infaction like in throat & toes infaction-what is your views..?3)I am 95% revovered from GBS but i am very afraied of as this deciease might come again so what precaution should we take after full recovery from GBS i.e what should we avoid in food or in travelling out door.4)when i was admitted into hospital coupls of months back,my blood got tested thru HIV as well but it was negative.is there any link between HIV & GBS..? should i get checked my Blood again for satisfaction or it is fine..?5) I was habitual of smoking but During GBS period i dint skmoke but now i again started to smoke,kindly advise me how it is harmfull for this kind of patients.i am very scared of this kind of deciease and i want to  save by life for better living.pls help me...i am waiting for your respoce...kindly repy point wise.",
    "doctor_response": "hi sanv..gbs is an auto immune disorder,in which body produces antibodies against our own neural tissue cells,triggerd by some infections(like campylobacter ,cytomegalo virus.mycoplasma,)causing progressive muscle weakness,starting legs migrating up involving hands resp.muscles,sometimes neck muscles cranial nerves..the condition may last from 4  wks to 6 months usually....the main treatment modality is supportive,immunoglobulins and plasmapharesis if reqd........gbs recurrences can occur but rare.......more than 90% of pts recover significantly or totally by 6months with out long term problems....but pts have to continue rehabilitaion physiotherapy,muscle and breathing exercises...usually steroids donot help much in gbs,but in cidp whih is a variant of gbs steroids have a signicant role,,recurrences can occur .with varying severities and are unpredictable..your doctor might have put based on your  clinical condition..long term steroids should not be used as can cause some problems like infections,reduce immunity bone and joint problems..as stated hiv -ve do not worry..,,consult your doctor(as he is the best person knowing your health status,response to treatment and side effects) regarding slowly tapering steroids and adding mild immunosuppressants which are helpul in your condition ,avoid infections,stay healthy eat healthy,continue physiotherapy and breathing exercises..,,,as gbs can affect breathing system better you totally stop smoking take care of infections use antibiotics as required..best wishes ,take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Test reports normal, pregnancy test negative, irregular periods. Is it safe to take duphaston?\n\nhi , i m trying 4 baby from past 2 month. but i m not able 2 conceive.. i have done all the test n all the reports are normal.this time i have tested for pregnancy but its negative and my periods are also irregular. my doctor suggest me to take a medicine name DUPHASTON after 14 days of my periods.is it ok to take this medicine? or is it harmful for conceiving. please suggest me . thanks",
    "doctor_response": "hi, duphaston is progesterone, which will help in regularizing the periods and if pregnancy occurs it will help in implantation and also in maintenance of pregnancy, so you can use it, it can cause some side effects like nausea etc but they can be tackled with medication, try to trace your ovulation and plan intercourse on that period which will improve the chances of pregnancy. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bronchitis\n\nI have been sick for almost two months now. It started as what I thought was bronchitis. Dr. put me on antibiotics and cough syrup, and while it helped, symptoms didnt go away. I have terrible body aches cough and a sore throat. I was also placed on steriods and an inahler, and while there steriods helped, after they were done i felt bad again. I am 29 and have smoked for 15 years. I have quit for a week now and still feel terrible every day",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.In my opinion you should definately consult pulmonologist and get done PFT (puomonary function test).PFT will tell you about severity of the disease and treatment is based on severity only.You will need newer long acting inhaled bronchodilators (indacaterol and glycopyrollium).Chest physiotherapy in the form of deep breathing exercises and incentive spirometry is also advisable.Dont 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Biopreg-f tablets be taken safely during pregnancy?\n\nhi i am 24 year old women, i m planning to have my first baby. i visited a gynecologist she advised me to take biopreg-f tablets on a daily basis. it contains biotin 5mg and follic acid 5mg but i have read that follic acid intake must not exceed 1 mg for women and it might also have side effects such as \"irreversible nerve damage\". how safe it is to continue this tablet. will it have any side effects? please help.",
    "doctor_response": "Hi, there are no side effects of this tablet. A 5 mg folic acid absorption is much less in the body. So, the bioavailable or active part of folic acid will be less than 1 mg. You can take these tablets. Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can whiplash occur when one is stationary?\n\ni am a bus driver i bwas at work the other day when another bus backed into mine while i was stationary is it possible i could have whiplash as find it hard to move my neck and my left side i have been told you cant whiplash when stationary and if you no the impact was about to happen.",
    "doctor_response": "hellothank you for contacting HCMno in your case whiplash injury is unlikely to occur. you are having muscular spasm due to sudden jerky movement. i would suggest you following things:> take proper rest for 2-3 days> take hot water in rubber bottle and place against your neck and back. it will give soothing effect.> take naproxen 500mg one at night for 3 days. it will relax your muscles and reduce pain.hope this answers your question.wishing you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in lower annuls and down left hip/leg?\n\nI have numbness lower annulus and down left hip/leg to toe big.  also have numbness cervical neck.  I have had a MRI lower back and a MRI contrast .  Im numb at back upper neck.  They have told me they have found something however im waiting for may10th to discuss with doctor ,  Could this be MS",
    "doctor_response": "it could be MS. it could also not be MS and be many more diseases like lumbar canal stenosis or some other disease of the peripheral nervous system. what you need is a thorough clinical examination by a neurologist and tests to figure out your diagnosis",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath while talking?\n\nMy speech is extremely nasal and i amnhaving difficulty speaking normally without having to pause intermittently to catch my breath. I also have difficulty chewing normally as i have to keep my mouth open and fight to move the food around in my mouth.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. By your history and description, possibility of Upper Airway obstructive lesion is more likely. You are having difficulty in speaking (more nasal voice), chewing and swallowing.So possibility of abnormal upper airways like epiglotis, pharynx, larynx is more likely. So consult ENT doctor and get done endoscopic evaluation of upper airways. If there is any obstruction then surgical correction is needed. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best medicine to reduce sudden itching ?\n\nSir, my mother 67yr old suffering suddenly itching 3day ago . I have given first aid for medicine of CETRIZEN control but again itching start.before I have suffering this problem and my wife also this problem but both of then take CETRIZEN cure the problem. My mother not feel so good above medicine.what shall I do or prescribe any good medicine .soap use continous use Dettol and not use any cosmetic item. Thanks for your kind co-operation.",
    "doctor_response": "HelloThank You for contacting HCM.From the symptoms i think you most probably suffering from scabies. It is a skin disorder in which there is itching spread in whole family. Is itching sever at night and between fingers? I would recommend you to visit a dermatologist to confirm the diagnosis so that treatment can be started immediately. Although it is not life threatening but may spread to people around you. Once again this disease would be confirmed by examination. I have concluded from the description you gave.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. Wishing you all good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for rashes in hips & waist\n\nMy son developed a red rash with welps beginning on his hip and now around waist line, other hip & beginning behind one knee. Took him to doctor who said it was a heat rash & to try corn starch & if that doesn t help then to begin steroid treatment. Does this sound correct? He does sweat a lot bc he is in welding school. Suggestions?",
    "doctor_response": "Hi, Your symptoms seem to be related to heat rash,I agree with your doctor.I suggest you to clean and dry the area frequently.I also suggest to use antihistamines daily and calamine lotion for local relief. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Upper stomach pain, cold hands. Symptom of gallbladder stones or heart attack?\n\nperson has possible gall bladder stones...hasn't had all the tests. had upper stomach pains lasted more than 2 hours (now gone) and very cold hands (normally is very warm). no fever, but felt cold.  b/p normally 110/70.  presently 127/77.  are the cold hands normal with a gall bladder attack? or are cold hands a possible symptom of a heart attack?e-mail:   YYYY@YYYY",
    "doctor_response": "Namasthe Welcome to Healthcare-MagicGreetings of the dayDiagnosis of both requires good clinical examination and assessment. It definitely calls for Bedside ECG to be done, along with Ultrasound of abdomen if the patient is stable.Take CareRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for frequent bowel movement in child\n\nMy baby 1 year old just recovered from high fever. Since then stool he been producing odd stool color and very frequent bowel movement per day. Yesterday it was 10 times. Stoll color yellowish with some white and this past 2 days it was grayish clay. Is it something that we need to worry about?",
    "doctor_response": "Hello, It seems your kid is having viral diarrhea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain at the xiphisternal region after having meal?\n\nDear Dr, I have recently been diagnosed with Gastric mucosal prolapse @ OG junction. With a history of Grade 2 Reflux esophagitis 6 years ago. In recent visits with my doctors are confusing me rather giving solutions. My general complaint is: 1. Diffuse pain at the xiphisternal region after having meal(especially in sitting posture) I must confess that i was a avid spicy(fat) food eater until a month back. Thanks in advance for your reply",
    "doctor_response": "Hello, It is due to severe acid reflux and gastritis.As first-line management you can take antacids like omeprazole or pantoprazole for symptomatic relief.If symptoms persist better to consult a gastroenterologist and plan for an endoscopy.Avoid spicy foods also. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is warfarin advisable having a history of blood clots?\n\nMy husband has a history of blood clots and is on Warfarin. His level is safe between 2 & 3 and he has been staying right there for over a year. He just had a blood work up and the level increased to 3.5. We have been racking our brains trying to figure out what foods we have eaten that could have affected his level. These are the only things we can think of that we don t normally eat. We had a tuna fish sandwich for lunch one day. He had quite a bit of sunflower seeds last weekend, we had some canteloupe and maybe went over our egg limit when I made some egg salad. Other than this, we cannot think of anything at all that he has done differently. Our doctor s office hasn t called back and this is driving us insane. Can you help us out? Thanks, Karen & Robin Kelly",
    "doctor_response": "Hello, Yes, it is a blood thinner. The formation of a clot in the body is a complex process that involves multiple substances called clotting factors. Warfarin decreases the body's ability to form blood clots by blocking the formation of vitamin K\u2013dependent clotting factors. Warfarin dosing is highly individualized and not based on a patient\u2019s weight. Warfarin requires regular monitoring to ensure that blood clotting time or prothrombin time is within the correct range. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. AJEET SINGH",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are Budesal and Duolin safe to be given for chest congestion?\n\nMy baby is 3and half year old .she chest congestion last 10 day , doctor has put on first on duolin after 3day she put on her budesal.5mgfor another 3 day . I have given 2day but she has now stil, should i give more days or should i mixed budesal with asthin or duolin then give plz suggest",
    "doctor_response": "Hello,May be your daughter has asthma, so in case of asthma you can't discontinue your Medicine without doctor's permission.You should ask your doctor for discontinue. Otherwise she may get another episode of cough.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Priyank Ghanchi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump in lower back?\n\nI had a lump on my left lower back and went to the doctor. It moves around a little bit but is very tender. The doctor said it was scar tissue because it was too hard to be a lipoma (which run in my family). Since then (2 weeks ago) I now have gotten two more, one about an inch lower and another on my right lower back. Two of them run more horizontal and the other is more vertical. So I m not buying the scar tissue answer. any suggestions of where I should go to get a second opinion? Thank you so much",
    "doctor_response": "HI,Welcome with your query to HCM.Based on the facts of your query,after its review,In my opinion you need to have Second Opinion from Surgeon,who is the right doctor to opine on it. In my opinion it could be mostly a NeuroLipoma or a dercums Lipoma with multiple lipomatosis ,which runs in your family.But the its multiple occurence questions on its being infective boils,which needs to be ruled out by physical check from Surgeon.Antibiotic regression would prove that they are boils and not Lipomas.But for this you need to have Second opinion as rightly thought by you and advised by Me in the beginning of this reply.Hope this reply resolves your worry with your queries.Will appreciate writing your feedback review comments,to help the needy patients like you at HCM.Good Day!!Dr.Savaskar,Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to completely cure ADHD in a 20 yr old boy?\n\nIs it possible to completely cure ATTENTION DEFICIT HYPERACTIVITY DISORDER in 20 year old Boy ? Help me ...give me tips I read at your site in one of the replies that Disorders happens due to state of mind and state of mind always alter according to experiences and circumstances. Change your life style and circumstances and the problem goes away.",
    "doctor_response": "HiThanks for using healthcare magicYes, with age, ADHD gradually subsides. In that case, treatment depends upon the severity. If ADHD, effecting maintaining daily function, then there is need to take medicine like methylphenidate. If he has mild ADHD, in that case, nothing to worry and with time, symptoms with subsides. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "On depo shot. Irregular periods. Reason?\n\nI started the depo shot june 2012, i had my lost shot dec 13 2012. I didnt have a period the whole time i was on the shot. I started my period jan 2013 had regular periods after that. Well recently on april 20 2013 i started my regular period, stopped bleeding on april 27 2013. I then started bleeding again on may 4 2013. A week after stopping. What could be causing this??? If age matters i am 23 years old",
    "doctor_response": "Hi.Thanks for asking in Healthcare Magic.Although highly effective, Depot progesterone is not suitable for young girls like you as it can either cause irregular bleeding, excessive bleeding or absence of regular periods. These complications increase when you use it frequently as your case may be. Depot progesterone  is indicated only for those who are most unlikely to use other contraceptives effectively.It appears that your cycles are disrupted. If the bleeding pattern continues to be irregular, you should consult a gynecologist for necessary guidance. Drugs like Tranexamic acid may be helpful but check with your Dr before you start any medication as it can be taken only after your Dr's advice.I hope this is useful to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vaginal bleeding during pregnancy?\n\nHi I am 33 years old pregnant 6 weeks ago.yesterday I was ar doctor clinic and everything was great I also heard the heartbeats of the baby.i am an A negative blood type.today in the morning I started bleeding red it's like the first day of the period and even blood is somehow not much liquid.i have no pain anywhere.doctor asked me to make prolaton depot 500 mg as injectioncould it be im loosing my baby? Or is it bcoz of my blood type???? Pls answer",
    "doctor_response": "Hi, Dr Purushottam Neurgaonkar here. I welcome you to HCM VIRTUAL CLINIC. I have gone through your question question, and I think I have understood your concern. I will suggest you the best possible treatment options. Please do not panic. Your blood group has nothing to do with your present bleeding condition. The bleeding that you are experiencing is called as threatened abortion.I will suggest you to take bed rest. Tab Pause 500 mg 3 times a day for 5 days.Tab Vitamin C 500 mg twice a day for 5 days. Injection of natural micronized progesterone 200 mg  or  injection of hydroxy  progesterone  500 mg once a week, till 14 weeks of pregnancy.  Repeat USG if necessary after 2 weeks or at 12 weeks with NT  scan.I hope this answer helps you. Thanks Dr Purushottam Neurgaonkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes general weakness and muscle pain while having seronegative arthritis?\n\nHi, I am Milind, diagnosed sero negative arthritis,with Rh factore positive.ANA TEST IS NEGATIVE.I am on celecoxib 200 1bd,Leflunomide 20 1 od & Hydroxychloroquine 200 1 bd. My overall condition is stable & without pain episode ever since medicine started 5 month back. HOWEVER, I am fealing weakness & mascular pain on stress. My physician has given Myoril 4mg 1 bid for week. HOW long these medicine will continue? Do you suggest any other reasone for weakness & mascular pain. I am non diabitic, no history of hypertension,lipid profil, LFT, RFT & BIOOD PICTURE REPORT NORMAL. AGE 53Y MALE, WT 90KG HT 165 CMS.",
    "doctor_response": "Hi,Thank you for providing the brief history of you,Since you mentioned about you have been diagnoses with Sero negative arthritis and on medication which is helping is a good news.As you mentioned about your symptoms of muscular weakness and weakness, this are a part of the RA symptoms.What you need to come out of this symptoms is indulging yourself under a physical therapist who will help you learn how to make the muscle stronger and balance your functional activities without losing more energy.Since you have a pathology, the body mechanism will be running out of energy to support the needs of the cellular mechanism.Undergoing physical therapy session will help your muscles to become stronger, improve the metabolism, improve the fatigue levels to lower down, and overall body conditioning .After all, exercise is the natural way of healing the body as post exercise the body produces its own medicine to heal the body.I recommend you to learn the exercises from a physical therapist.Important note :RA should not travel towards the joints of the ribs. As it is painful and may lead to trouble. For which i will highly recommend to perform regular breathing exercises.With the grace of God i wish you a Good health.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of worsening exhaustion with elevations of liver enzymes?\n\nHello, I have had slowly increasing mild elevations of liver enzymes over the last 9 months when they were initially discovered.I had taken venlafaxine 300mg and mirtazapine for 20 years for severe OCD. The previous 5 years I have had chronic fatigue syndrome which has been incapacitating for the last two years in particular with symptoms of ibs symptoms, extreme fatigue, mental fog and back pain.Depression and OCD has worsened also.Since the elevation of the liver enzymes I have changed medication to fluoxetine as venlafaxine was believed to be the cause of this but mental health is worse and no improvement in liver tests I am a 40 year old woman with pcos.My current alt levels are around 70, ggt 180,alp 134 and have had slow steady increases. Ultrasound showed only slight fatty changes.Do you think my worsening exhaustion could be partly related to liver?Should I have any further investigations for this before change in meds? Thank you.",
    "doctor_response": "Hi,His light fatty liver changes are a normal finding after an age of 40 years. So don't worry a lot about them. Though liver function tests  are deranged, yet they are not that deranged that they cause fatigue. Fatigue and feeling of exhaustion are because of Fluoxetine which you are having for your ocd.Abnormal liver function tests were most likely because of Mirtazapine. Dont go for any further medication just ask your pychiatrist for few latest ssri's like Paroxetine which are much safer and have significantly less toxic effects. Liver rejuvenator like Sylimarin can be taken for 3 months to improve liver functions.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ramesh Kumar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Mild pain in lower back, taking Motrin, had cough and pain became severe. Solution?\n\nI fell down four steps on Saturday, February 23. I had mild back pain in the lower back, right side that was controlled with Motrin. I coughed this morning and something happened in my back and now it hurts very bad in the mid back area on the right side. This pain is a bit higher than the initial pain (it feels to be just below the rib cage).",
    "doctor_response": "this looks like intervertebral disc prolapse , this as to be evaluated and mostly can be managed with drugs",
    "dialogue_context": ""
  },
  {
    "patient_message": "Allergy on head, lozisoft\n\nmy daughter(5 months old) having some allergy on head.for that doctor suggest LOZISOFT.when ever apply that one.she have immediate cold .is it safe for my baby please tell me",
    "doctor_response": "Hello, Welcome to Healthcare Magic forum. Allergy only on head (I assume scalp) is not a very common condition.I assume that the doctor has provided you with a diagnosis like Atopic dermatitis.Infants having scaly, itchy lesions in scalp can also  have a seborrhic dermatitis or some infection like fungal or bacterial. Lozisoft lotion is just a moisturiser containing liquid paraffin and aloevera and is safe for infants. It is usually given for dry skin conditions or atopic dermatitis. However if your baby is not responding well to it , she can possibly have an allergy to any of the ingredients or fragrance used in the lotion.Also if her scalp lesion is not resolving then please consult your doctor again for reviewing the diagnosis and providing an alternative medication. There are many similar emollients or moisturisers available of different brands like aquasoft, calosoft, nmf_e, etc Your doctor may prescribe an alternative for solving your problem. Wishing your daughter a speedy recovery. Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lichen planus?\n\nA year ago, I started to get some rashes in my mouth and tongue (I have root canal treatment done) and my dentist said it is lichen planus and there is no treatment for this condition. He also said it might stay for few years and then will disappear by itself. Now I have noticed that these rashes has almost gone, but slight discoloration (light black) on the tip of my tongue and one or two red spots on the tongue remains. What is this lichen planus ? Is there any treatment for this ?",
    "doctor_response": "Hi, Lichen planus is an immune related disorder. I would recommend you to apply triamcinolone acetonide gel on the affected areas twice daily. This will reduce the marks.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it safe to take Mobizox for foot pain?\n\nHello doctor, My brother, who is 36 years old, has a lot of pain in the ball of right foot.\u00a0It is like a sharp pain both on the foot as well as in the toes.\u00a0He is overweight with 98 kg and he is of height 5 feet 7 inches.\u00a0He is taking NAC 75 painkiller.\u00a0But, the pain comes back once he stops eating the painkiller.\u00a0What can be done for this pain? What could be the cause? Also, his uric acid is high at 10 or 11. Please suggest some measure. Thank you.",
    "doctor_response": "Hello. Revert back with the answers to the above questions to an orthopaedician and traumatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to deal with difficulty in understanding everyday conversations?\n\nMy name is Megan, I am an 18 year old female that has migraine headaches everyday sometimes all day for the past two years. Sometimes with the headaches I get dizzy light headed and nauseous causing me to be unable to stand up or walk. I also noticed that lately have had troubles thinking of the words to say when having an everyday conversation with friends or family and I have troubles understanding people when they are talking to me. I have been to see a brain doctor (couldn t think of the word) and he isn t available to often and is making no progress to finding out what causes them or how to prevent them. I have tried medications and nothing is working. The doctor also tried switching my depression medication and that also didn t work. I am becoming very concerned with this and would like someone else s opinion. Please and thank you.",
    "doctor_response": "Hi Megan,I read you query and can understand the distress that you might have been facing due to your symptoms. The symptom of difficulty understanding conversations can be due to anxiety or remaining preoccupied with certain things. I would have liked to know about the medications that you have taken earlier and the medications that you are currently on with the duration of treatment. It is possible that initially the anti-depressants don't show any response. Change in medications might be required. I can't comment on it until I get to know what medications have you already taken. Medications for migraine will have to continue. In addition, I would also recommend you to start exercising daily. You can also start meditation. That will help you relax and control your anxiety.Hope this information was helpful. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from gout, unable to concentrate, difficulty walking, overweight. Treatment?\n\nHI ALL, I AM XXXXX. I AM SUFFERING FROM GOUT FOR THE PAST 10 YEARS AND MY AGE NOW IS 33. I HAVE DIAGONISED THAT I AM SUFFERING FROM THE DISEASE JUST 5 YR BACK. I AM VERY MUCH DISTURBED BECAUSE OF THIS GOUT.I CANT WORK PROPERLY / CONCENTRATE OR EVEN LOSE MY CONTROL SOMETIMES. I WEIGH 95KG. I SOMETIMES HAVE SOME SMALL SCAR ON HEAD AND FACES. I FOUND WHENEVER I GO WALK I FEEL PAIN. PLEASE DO HELP ME TO REDUCE MY WEIGHT AND COME OUT OF THE GOUT and OTHER ASSOCIATED DISEASES. EXPECTING YOUR ANSWERS. THANK YOU. MY MAIL ID YYYY@YYYY .",
    "doctor_response": "Hello sir /madam,I understand your agony. First of all ,you need to reassess your serum uric acid and accordingly get  treated with hypouricemic drugs .You need to reduce weight and that can be accomplished by strict life style changes. Brisk walking, reducing your calorie intake would help. You can get a lot of information on which foods have to be avoided over the internet. Also a holistic approach towards your problem would be to do some yoga and meditation .hope i was of help",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swelling in the leg\n\nmy servant is suffering from tubercloysis of right leg.her leg is swallon and filled withh water . my orthopedics doc is recommending operation vd oral medicines oflox 300 twice daily and topfanac twice daily.please help her as she s very poor and I want to help her",
    "doctor_response": "Hello, I agree with her doctor that surgery coupled with antibiotics is necessary to help her recover from this situation. Unfortunately, a long time of therapy is important. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic viral fever in a 4 year old child\n\nhello i have a 4 year old and he was running a fever yesterday, i took him to the hospital, his fever was at 102.5 when i got him there, mind you the only thing he did was sleep and drink, he would not eat anything but a little bit of eggs, the doctors at the hospital say he had a summer virus, and to give him fever reducer med. they gave him motrin at the hospital and he broke his fever, this morning he woke up running a fever again and it was at 101 this time so i gave him some fever reducer med. that seem not to help so i went and got him some motrin and made him drink gatorade. he broke his fever and around 6pm he spiked a fever again and again it was 101.5. i was wondering if i should go get a second opinion or just wait it out since i gave him more motrin",
    "doctor_response": "HiWelcome to the HCM I have gone through your question and understand your concerns. But don't worry. Most common cause of fever in this age group is self limiting viral infections. They usually last for less than a week. There is no use of going for blood or other investigations so early unless and until the fever is associated with any other symptoms or finding.At present, I would recommend you to give him Syp. Paracetamol for fever spikes at 15-20 mg/kg ( max. 500 mg) and repeat the dose at 6-8 hours interval if fever persists or recurs. It's better than Motrin for fever relief.Also, keep him well hydrated by regular feeds and fluids.Hopefully this will be helpful. For any further questions, you may contact us.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Which method of abortion is better for 5 weeks of pregnancy?\n\nHello doctor,I am pregnant. The ultrasound shows five weeks \u00b1 two weeks of pregnancy. My symptoms are fatigue, emotional,\u00a0indigestion, and anger. I am on Pantocid for five days. I want to abort my pregnancy. Please tell me which method is better - surgical or medicine?",
    "doctor_response": "Hello. If your ultrasound scan shows five weeks of intrauterine pregnancy, then you can go for a medical abortion by taking tablet Mifepristone 200 mg orally stat and after 48 hours of taking this medication, you can take tablet Misoprostol 400 micrograms orally and repeat the same dose of tablet Misoprostol orally after six hours of taking the first dose of Misoprostol or you can use tablet Misoprostol 800 micrograms vaginally as high as possible before going to bed. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Do not take the above medication in case: You may experience bleeding per vaginam which is little more than the usual periods. But, in case if it is heavy and not stopping after two to three days, kindly contact your nearest gynecologist immediately. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hand tremors after a stent placement and bypass surgery\n\nI have had severe hand tremor, since 1972 when I was in the Army. I did not go to Vietnam did however spend 3 years in Germany. can can only fill a cup or glass half full or I will spill it. the Army did several test but let me out in 1977 even typing this i hit the letters two or three times instead of one. had a minor head injury - n0 stitches or medic called; did not lose conciseness. Trying to get help from the VA now, they are baffled and are saying possible. PTSS. I am disabled for Cardiac Vascular decease, I have 12 stints and have had a double bypass . Don t rely care about the money just need the medical care as I am only 59 and cannot get medicare for 2 more years Any suggestions would be greatly approached. Thanks my e-mail is YYYY@YYYY",
    "doctor_response": "Hi, The most common cause of hand tremors is \"Essential tremors\" (ET). People with ET respond well to propranolol tablets. So, you can try it under the guidance of your GP. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sudhir Kumar, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a large lump between the vagina and anus?\n\ni have noticed a large lump between the vagina and anus more to the left side, i am very worried as it has become very swollen/painfull and have noticed part of it has turning a blackish colour. I first found the lump 3 days ago, 6 days ago i had sex and used the morning after pill, please help!!!!!",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have hemorrhoid ( piles ).  You should go for per rectal examination to confirm the diagnosis. Drink plenty of water. Avoid constipation. Take high fiber diet.  Surgical excision is the permenent treatment. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a bruise on the back?\n\nHi,Hi, my name is Derek and I am 23yr old  male,I have found a bruise on my lower back right in the center of my spine. Its purple with a bit of red dots. I dont know how it got there but I didnt have it yesterday. It doesn't hurt at all, should I be concerned?Cheers",
    "doctor_response": "Hi,As this appearance of bruise is of very recent origin, there might be having some thing bite or some friction bump due to sleeping for long time in same position.Take antihistamine like Cetrizine for a day or two.Apply Vaseline or calamine lotion.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I suffer from premature ejaculation and poor erection. Please advise.\n\nHi doctor, I suffer from premature ejaculation and poor erection. While intercourse the semen has ejaculated within seconds. I have advised to take Nanoleo, Ultra D3 and Uphold for the night and Spem cure and Ultra D3 for the morning. While taking night set of pills, I woke up at midnight with heavy sweating, nervousness, and indigestion. Then I stopped all the pills. Please advise me can I continue with the pills or go for other treatments? I had a semen test and it has 60 million with 30 % motile.",
    "doctor_response": "Hi. Take tablet Uphold (Tadalafil and Dapoxetine) one hour before intercourse. Do not take it on regular basis. It is for erectile dysfunction. Take tablet Duralast (Dapoxetine) 30 mg one hour before the intercourse. It is for PME (premature ejaculation). Nanoleo is ayurvedic preparation, commonly prescribed for low sexual desire patient. So no need of it. Ultra D3 is Calcium tablets. You can take it if you want. Sperm cure (Coenzyme Q10, Lycopene, etc.) is also not needed daily. Take a healthy diet. Do regular exercise. Do you have any anxiety or depressive symptoms? Review after 15 days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can an infection on the knee be treated?\n\nMy daughter recently had a shave biopsy done and got an infection on her knee. She was on bactrim for 3 weeks and they just changed it to a different antibiotic. She now has a red streak ring around one of the spots. The biopsy came back as mulloscum virus. Should i be concerned or just keep giving her the antibiotics?",
    "doctor_response": "Hello, molluscum is a contagious viral infection. specially among children. you can continue the antibiotic for the priscribed duration to prevent developing Resistance.      You don't have to treat molluscum lesions unless they are in face and neck, or you are at the risk of spreading to others. Some times people who have contacted titi's needs treatment for mollucum. Treatments are lasers curettage and using certain acids and and chemicals to burn them.     usually patches  would go away on their own in 2-6 weeks. even if we leave them for that period. Hope this helps. thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pus formation at tooth extraction site\n\ni had my wisdom teeth removed a week ago, my mouth swelled to the size of a tennis ball so i went back to the dentist 3 days later and got antibiotics to help the swelling, now there is pus coming out from where my bottom wisdom tooth was removed and a hard tender spot of my cheek where if u press it very painful and forces pus out of the area where my wisdom tooth was, is this normal and what do i do about it, thanks",
    "doctor_response": "HiThank you for your query with HCM,as such when your wisdom tooth was removed one cannot expect pus discharge from the socket since everything will be curretted after extraction if there is an periapical infection.As you describe that there is tender spot on chhek there might infection on the gums /soft tissue.Nothing to worry about since you are already on antibioticsI would suggest you to visit your Oral Surgeon for need ful and thorough examination.Hope i have answered your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Cowart lotion or Hair4u lotion or Topsor lotion best for hair growth?\n\ncowart lotion, hair 4 u lotion, topsor lotion consists of what ingredients and which of them is better for decreasing hair fall and improving hair regrowth .can u suggest any best option of them or any new option so I can regrowth my hair back but should be no side affects.. Do i need to be on a special diet or something.",
    "doctor_response": "Hello,Welcome to healthcare magic,Topsor lotion is a topical potent steroid lotion usually given for allergic disorders or steroid responsive dermatitis eg: psoriasis etc. It can also be given for scarring alopecia and alopecia areata which are types of hair loss disorders.I do not know what is cowart lotion but coverit solution is minoxidil. Hair 4 u is also minoxidil. Minoxidil is an approved treatment for baldness.Hair fall is an umbrella term under which there are so many conditions. A consultation with a dermatologist is essential to make a diagnosis of the type of hair fall you are having. The treatment varies with the condition.Hope this helped,Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling after tooth extraction\n\nHi I went through a root canal procedure, It started january This year and then with four procedures i sometimes forgot to go back to the dentist the last june 6 I got this very painful attack from te tooth and that there sems to be a very hard part showing in my lower jaw. It started to be very painful so I was given antibiotic and that the tooth was extracted after two weeks of antbiotics the swollen part is not completely gone but I cannot any feel pain up until now there is still a hard part and but it is slowly going away I wonder what this is. I am afrdaid of surgery so what is the best thing to do?",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.The swelling will reduce gradually ,if it persists or increases please get it checked by the dentist .Meanwhile you can continue doing salt water gargling and gently massage the external surface.If pain you can take paracetamol.Hope this was helpful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How effective is venlafaxine for long term hot flashes?\n\nI was prescribed venlafaxine hel er tabs to treat long term hot flashes. I have been taking it about 3 yrs. These disturb me daily - day and night - and have been ongoing for 20 years (I am 68). I haven t had any success controlling them since stopping hrt many years ago. I have always had trouble staying asleep and this has gotten worse. I am not and have never been depressed, rather upbeat and active. I was told to take the RX before bed. Any suggestions?",
    "doctor_response": "Hi, Welcome to Health care magic forum.                    The hot flashes might be due to the deficiency of the estrogen, H.R.T is discontinued due to some reason.                      There might be some other reasons, for hot flashes,may be underlying feelings of deficiency of estrogen, deficiency of vitamins,some chronic infections.                    I advise you to consult a physician for diagnosis and treatment.                    Take more of green leafy vegetables,pulses,sprouts,and protein rich foods to have blood,general health and resistance against infections.                   Wishing for a quick and complete recovery. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain and cough in case of lung collapse\n\nSir, I am suffering from lung collapse, since last four days I have a high pain in left chest and cough also some time dry or some time other type. Please tell me about the treatment and duration of treatment with precaution.Is it serious or not? Thanks",
    "doctor_response": "Hello,If its lung collapse the you must go for treatment.It might a mucus plug which blocked your lung, you must get rid of it.Have any mucolytic and bronchodilator drug.still not resolved with that go for Bronchoscopy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes diarrhea and dizziness while on BP medication?\n\nFemale 55 over weight by 50 lbs.... takes 50mg bp med.... diarrhea for a week now....can\u2019t control it...dizziness can\u2019t walk few feet with out getting out of breath vomating ....blisters in mouth...blood pressure 126/76...has a appetite....history of drugs......any idea what\u2019s wrong",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Her symptoms could be related to an infection or drugs adverse effects. For this reason, I would recommend consulting with her attending physician for a physical exam and some tests to investigate for the possible causes: - Complete blood count, PCR, ESR for inflammation - A stool analysis - A resting ECG - Kidney and liver function tests - Blood electrolytes for possible imbalances. In the meantime, I would recommend avoiding taking blood pressure medicines and consume plenty of fluids and rehydrating solutions (electrolytes) in order to avoid dehydration or any electrolyte imbalances, which may be life threatening. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Ovisterone 25 mg a contraceptive pill?\n\nWhen we tried for IVF, egg ovelatted naturally one day before the egg collection.  The doctor had adviced me to take tablet OVISTERONE 25 mg twice a day for 60 days.  My tubes are normal there is no block.  It has been 12 since we got married.  When I take this tablet, can we try naturally or this tablet is a contraceptive pill.  I am 36 years old.  Kindly advice",
    "doctor_response": "Hi, Thanks for posting in HCM. Composition of Ovisterone is 'Dehydroepiandrosterone' (DHEA).  It is a naturally occurring hormone produced by the adrenal glands and reproductive organs in the body. DHEA is converted in the body to androgens & estrogens. Hence, its intake is known to improve ovarian reserves and response to ovulation induction. Thus it improves conception rates and minimizing miscarriages, thus increased pregnancy outcome. It is not a contraceptive pill. Since the doctor has advised you to take this medication, you can clarify whether to try naturally or is there a plan to go for next IVF cycle. Hope the information provided would be useful. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had gall bladder surgery. Pain in stomach just below ribs and on the back right side. Comments?\n\nHi. I had gallbladder surgery two and a half weeks ago and am still having pain at the same levels as pre-op - in my stomach area just below ribs and often on the back right side as well. I ve been careful of what I ve eaten and haven t eaten much at one time. Sometimes the pain occurs perhaps a half hour or so after eating and sometimes it seems unrelated. I m supposed to fly to Sarasota from MN Wed. to see my mother and am getting a bit nervous. Comments?",
    "doctor_response": "Hi and welcome to HCM,thank you for your query.It can be postcholecystectomy syndrome which is common complication of gallbladder surgery. but also there could be stone in choledochus duct or pancreatic duct. Or your preop. pain was initially caused by something else,pancreas or stomach issue. However, you should follow hepatic diet and drink plenty of fluids till you find the exact diagnosis. Also,take some antispasmic medicines.if that helps,it may be stone in bile ducts.Wish you good health. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high blood pressure\n\nI went to the V.A. hospital today. They said my b.p. was 192/126. I had ran two and a half blocks after parking to make it to my appointment on time. At the end of the appointment it was 146/84. I am 55 yrs. old, non-smoker or drinker. Should I worry?",
    "doctor_response": "Hi thank you for querry,Yeah one reading too high indicate hypertension you must check you blood pressure and its still on higher side for at least 3 occasions than you should start medication.some patient have high blood pressure in hospital setting so ambulatory blood preasure monitoring is best to diagnose it mean when you are at home and relax.In younger age group ACEI like Enalapril or Ramipril is a drug of choice its started from 5mg and tiitrated accordingly.Calcium channel blocker is a second choice like amlodipine.Life style modification also help like exercise,diet,reduce salt and fat,reduce smokin alchohal and anxiety and stress.hope the answer will help you.wish you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause pancreatitis?\n\nMy husband is 47- experienced first pancreatitis 4 years ago. Had gallbladder removed, became diabetic following year. Was able to control with diet until last year. He is now taking Januvia as of last month. He started on mertformin and that actually caused his numbers to rise. He had a flare up that was managed at home in June of this year, and accute attack in August, and another flare that we are managing at home this month. We are seeing a gastro dr, specialist in Dallas, and our local family dr. He's had a biopsy of the pancreas and it was benign for cancer. We are going back for more tests in a few weeks. We are following low fat diet as well. He does not drink or smoke...so far there are no medical answers for the cause of the pancreatitis. In your experience, are we doing all the right things? Would a Mediterranean diet help considering diabetes an pancreatitis?",
    "doctor_response": "Hi,Antidiabetic drugs by themselves can cause pancreatitis.  Since alcoholism and gall stones are absent then antidiabetic drugs can only be the possible offending agent.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for itchy red bump on my toe\n\nhi I had a red bump on my toe that itched at first I thought it was a bite but as the days went on it got harder and bigger so I thought something was stuck in my foot. I wear sandals all the time so I thought maybe a small piece of glass or something. I went on to carefully try to take it out but I didn t see anything there I put antibiotic on it and left it alone but when I woke up it was swollen and infected",
    "doctor_response": "HelloIt may be due to allergy or infection.Swelling and redness may be due to infection more.Please apply antibiotic cream and leave it open so it will heal fast.Take pain killers like tab ibuprofen or tab paracetamol will also help in relieving inflamations.Prevent it from water.If not cured, consult your doctor.Take care...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Upper right molar extracted, advised to stop smoking\n\nhello, i had my upper right molar extracted on Friday afternoon. My dentist placed a few stitches and I was advised to use gauze for a couple hrs after. As a smoker, I was advised of dry socket and to avoid smoking at all cost . Bottomline, when is the earliest that I may be able to smoke again?",
    "doctor_response": "hi after extraction, its best to avoid smoking for atleast two weeks or untill the socket is properly healed. so your dentist have advised you right. for speedy recovery do warm saline rinses and gargle after eating anything , so as to avoid food being stuck in the extraction site, though such thing happening in your case will be rare because of the stitches. but still , why to take chances. and if possible, stop smoking for the betterment of your and your family's health. wishing you speedy recovery With best regards Dr Ankit Aggarwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for a tooth condition\n\ntoday I had temporary veneers fitted before I get the permanent ones in three weeks. Whilst i like the front 4, the ones on the incissors are bulky and i was just wondering firstly if this is what the permanent ones will look like and secondly if it is possible to get them filed down",
    "doctor_response": "Thanks for your query, I have gone through your query.Regarding the temporary veneers, usually the bulk of the temporary veneers will be bulkier than the permanent one. The temporary veneers are not esthetically acceptable, nothing to worry. The permanent veneers will be just like your neighboring teeth. D o not be panic, be cool. If you are not happy with the permanent veneers, then you consult a esthetic dental surgeon and get it corrected.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes period symptoms and discharge despite being on implant birth control?\n\nI don t normally Have a period. I have an implant (birth control) in my arm. In the past 3 weeks I ve had off and on days with a light period symptoms and with a milky discharge. It last a day or two. This is the first time I ve had bleeding in 2.5 years. I m not sure if I should think it is serious or not. I know girls should have periods it s just not what my body normally does.",
    "doctor_response": "Hi,There is nothing to worry to about. Its usual not to have periods if you have implant on. Since your using it for 2.5 yrs so your bodies hormonal system is altered. The irregular periods might be due to any drugs you are taking. If you have post coital bleeding then it is alarming otherwise it is not serious.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Shajia Zafar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to give carnisure for hypertensive patient?\n\nMy mother is a newly detected hypertensive on telmisartan 20mg hs.she is also on nevibilol 2.5mg am od n on atovastatin 10mg for dyslipidemia.srecently she hd a NSTEMI following an emotionl upset.he hs bilateral varicose veins since 10years.she oftn complains muscle cramp in her legs, chest n back.is it safe to gv her carnisure?My dad also hs the same problm..muscle cramps in his legs esp at 4-5am.he is a known case of type 2diabetes/hypertension/dyslipidemia/benign prostatic hypertrophy on medications including aspirin.kindly advise.",
    "doctor_response": "levocarnitine as such as no proven role for muscle cramps pain relief. as the pain here is due to varicose veins, treatment should be towards varicose vein. leg elevation, compression stockings till thigh, varicosectomy surgically or with laser may help. levocarnitine may give effect of well being. your mother should take aspirin too to prevent deep vein thrombosis. your dad may have diabetic neuropathy and pain may be due to that. control of diabetes and dyslipidemia is of utmost importance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the busting of the veins in the penis be the cause for loss of erection?\n\ntwo weeks ago I woke up with an erection like always my penis curved a bit to the left and I would enjoy grabbing it and curving it the opposite direction a bit, well this morning I did this and I heard a pop, it did not hurt, my erection went away I jumped out of bed noticed it was changing color. went to hospital er right away, Dr told me that I busted a vein and to see if I get a hard on that night in my sleep, I did. two weeks later the bruising is going away and my erections hurt and seem smaller and there seems to be a knot where it busted is this true? and will it go back to normal state like it was before? what is that knot on the side?",
    "doctor_response": "Hi, it could be a burst vein but it could very well be a penile fracture in which part of the Corpora cavernosa gets injured. All your symptoms point towards that. I suggest you get an Ultrasound done for the penis and the Radiologist would be able to tell you whether there is any injury to the organ. If there is it might require repair. If not, then need not worry and it will recover over a few weeks. Take care and feel free to contact me by leaving a Direct or a Specialist query.Dr Rishi, New Delhi, India.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Blood test shows low potassium and electrolyte level. Feel weak, nauseated, dizzy, muscle cramps. Help\n\nI recently got a call from my doctor about blood work I had done this morning and they say my potassium levels and electrolytes are dangerously low. I have been having kidney issues, take a prescription dose of potassium 1500mcg per day and its still way too low. I have stopped the diuretic the urologist gave me and I have trippled my dose of potassium per doctors request. I wanted to know what is normal and is there anything I can eat that would help raise my levels faster. I am weak, nauseated and very dizzy.. muscle cramps ..and feel aweful..I will do anything to get to a better place but I need to know what the normal level is to get myself back to the safe zone.",
    "doctor_response": "hello.yes your symptoms are typical of hypokalemia.diuretics and few other drugs cause or worsen hypokalemia.what kind of kidney issues you have?and how old are you? it is very important to get yourself thoroughly evaluated and investigated as there are very rare diseases which give rise to low potassium levels but your case looks as if the cause is diuretics which is a very common cause provided your previous potassium leves were normal. persistent vomiting also causes such symptoms. normal potassium levels vary from lab to lab but any level below 3.5 mEq/L needs evaluation and if grossly low between 2-3 or less might even require parenteral correction. so it is important to know the levels and corelate with your symptoms. severe hypokalemia can be fatal. all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on the anus?\n\nI have a pea sized lump on my anus i believe is a hemorrhoid(spelling) and it has a purple / blackish area on one side. what should i do about it? i would like to not have to go to a doc if possible. is it ok to just leave it alone? it is only a minor discomfort, and doesnt seem to be very bad.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have hemorrhoids. You should take high fiber diet with plenty of water.  Avoid constipation.  It will decrease the pain.  You  can take local anesthetic gel like lignocain.  If you have bleeding and pain then ultimate treatment is surgery.  For that you have to consult doctor. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can cyclopam suspension, econorm and zinc dry powder be given together?\n\nDear sir, my daughter is suffering from motion with mucos and she is crying, i think due to stomach pain or worm, i have visited a pediatrician he has given medicines cyclopam suspension econorm zinc dry powder for suspension can i give all these at a time.",
    "doctor_response": "Hi DEar welcome to the HCM,The child has got stomach infection probably dysentry.Requires stool routine examination and culture/sensitivity.Stool culture will tell us about the exact bug causing infection and also the exact drug needed to eradicate the infection.Mentioned drugs can be used for the symptomatic relief of the problemHope the query is answered.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tooth to fall off with bleeding gums?\n\nwhy did my mother just have half her front tooth fall off and my gums bleed after taking certain bp meds I am so fed up with all these meds and would like the truth.will not give credit card number so sure you will not help there has to be someone out there thar cares. and that knows these answers.",
    "doctor_response": "Hello! Read your query.You did not mention the medicines you are taking for hypertension.Some medicines like calcium channel blockers and blood thinners will increase gum bleeding rarely.A poor oral hygiene will increase this incidence.You must get scaling done once every 6 months.Follow  a oral hygiene routine of brushing(twice daily),flossing(once daily) and mouthwash(thrice per week).If this bleeding is significant , you must check with your physician for a change in the medication.Reg. your mother, a poor oral hygiene reduces the gum position.This further reduces levels of bone attachment. This can be prevented by following a proper oral hygiene with good blood sugar levels.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lumps on back of the calves after surgery\n\nI am a 66 year old male who is in relatively good health. following kidney stone surgery to break them up and a subsequent stent for 1 month, I have developed knots in the back of both calves, both ham strings, and both deltoids. The pain has become quite debilitating and is made worse by sitting, especially in the car. The best way to describe the pain is like a lactic acid build up after strenuous exercise. I do have a factor five blood clotting disorder that I have never had any effects from previously. Would appreciate any help as I am grasping at straws!",
    "doctor_response": "hi.thanks for the opportunity to help you.from your description it looks to me like thrombophlebitis of the veins in the calf,hamstrings and buttocks.this has happened as a result of prolonged immobilization due to kidney stone surgery and stent insertion for 1month and as you have factor 5 deficiency you have tendency for hypercoagulability leading to clotting of blood.thus stasis due to prolonged bed rest,old age and factor 5 deficiency leading to hypercoagulability and clot formation can lead to thrombophlebitis.however we should rule out DVT which is a life threatening condition in which there is formation of thrombus in deep veins.these thrombus can dislodge and block pulmonary vessels leading to pulmonary embolism and death.though from your description it doesn't look like DVT.kindly visit a surgeon and get a venous doppler of lower limbs and get a coagulation profile , venogram, Radioactive,I125 fibrinogen study done.if it shows thrombophlebitis,oral antibiotics,thrombophobe ointment for l/a and t.chymoral forte 1-1-1x5 days can be taken .if however DVT is diagnosed by doppler of venous systems inj.low molecular weight heparin followed by warfarin as per surgeon's advise.if surgery is required.these methods to be considered in case of fixed thrombus.in case of  free thrombus fibrinolysins,thrombectomy using fogarty's catheter or IVC filter can be used.surgical options are:-1)palma operation for iliofemoral thrombosis2) May husni operation for popliteal thrombosis.t.dafflon 500 mg 1-0-1x3 months to reduce viscosity of blood and congestion of veins can be use prophylactically in cases of both thrombophlebitis or DVT.hope the consultation was beneficialregards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Grade I fatty liver, normal LFT, want to burn the fat to ensure upcoming ultrasound is normal. Measures?\n\nDear Doctor, I am 27, weight around 65kg and am 178cm tall. I have been diagnosed with a Grade 1 Fatty Liver . However, my LFT is perfecty normal. I don t smoke , I have never touched alcohol or non-veg food. I have a critical medical exam in around 6 months from now where an Ultrasound would be taken. Aprt from regular exercise (12-15km walk / jog everyday, 10km cyling) and a healthy diet (chapathis, raw vegetables, lack of fried or fatty food), what else could be done to ensure that the Ultrasound does not reflect a fatty liver? I would like to request you to kindly let me know what could be done to burn the fat and ensure that the Ultrasound is normal. Kindly help me out as I need to find a solution to this problem nd get rid of the same in a month from now. Is one month a realistic target? Please let me know. Thank you. Good day.",
    "doctor_response": "Dear Sriram! many thanks for the query. I have gone through your mail in detail and could grasp the contents. Firstly , your weight is just fine for your height. Actually you are a bit underweight. A grade I fatty liver on an ultrasound does not mean anything at all. fatty liver with raised liver enzymes will require attention and sometimes medication. Otherwise it doesnt mean anything. You keep up with your regular exercise and diet and nothng else is necessary. A grade I fatty liver in a medical examination will not disqualify an individual from any fitness test. regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Started vomiting periodically. Was constipated. Has nasal allergies. Related?\n\nMy 11 month old son has started vomiting periodically. This has been going on for about 3 days. He acts perfectly fine, plays, eats, drinks, nurses. Doesn t have a fever , doesn t seem to be in pain, has had normal diapers. He was constipated, but I made sure he was eating more fruit and veggies, and the constipa tion resolved a few days before this started. I also gave him 1/2tsp. of Benefiber in juice twice a day f or the constipation . He has nasal allergies and gets stuffy at night, so I m wondering if it s just postnasal drip causing him to gag. I can t tell if there s bile in the vomit, but it smells AWFUL, very \u201dbarfy\u201d.",
    "doctor_response": "it is coomon pleasse read milk theorychild needs breast feed only till 2 years and after that no milks definately to happen as these are animal proteins which are not competible with human proteinswe cann add vegetable fruits cereals and other food except if  you add milk before 2 years it idefinatele to happenstop extra milk aand diary and child will recover in 2-3 wkcontinuw with supportive therapy for 3 wk till you get withdrawl effects",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does washing hair everyday lead to hairfall?\n\nhi....i am from india . i take head bath daily using herbal powder. is it good to take head bath daily. i am loosing lot of hair. And i also cannot quit it as here there is lot of pollution and sweating. Does daily head bath increases hairfall? I loose about 50-60 Hair daily.",
    "doctor_response": "thanks for asking,normal hair fall 50-100 per day, as you are losing 50-60 hair per day then it is normal.yes, it is good to take head bath daily. you can use volumizing shampoo (X gain)shampoo three to four times a week. herbal powder should be avoided in hair. regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dark skin behind the neck and the ears?\n\nMy son is 15 years old, he has been getting dark skin behind his neck and behind his ears.  It looks like he has not washed his neck in weeks.  It is not itchy.  Now he has two round spots on either shoulder.  I have put on lotion with vitamin e for 3 days twice a day and 90 % is gone...but it will come back if I do not put lotion on for awhile...it looks horrible ..what is causing this?",
    "doctor_response": "Hello and welcome to healthcaremagicI would keep a possibility of Pseudoacanthosis Nigricans as the reason for the dark patches around the neckPseudoacanthosis Nigricans is a skin disorder in which there is darker, thick, velvety skin in body folds and creases. The skin becomes dark, velvety and thick in areas such as back and sides of neck, armpits, thighs, elbows and knees.Acanthosis nigricans usually appears slowly and doesn't cause any symptoms other than skin changes.It typically occurs in individuals younger than age 40, may be genetically inherited, and is associated with obesity OR endocrinopathies, such as hypothyroidism, acromegaly, polycystic ovary disease, insulin-resistant diabetes, or Cushing's disease.The majority of cases of acanthosis nigricans are associated with obesity OR are otherwise idiopathic. This is likely because of insulin resistance, and more likely to occur in darker-skinned persons. This is also known as Pseudo-Acanthosis Nigricans.Acanthosis nigricans is likely to improve in circumstances where a known cause is removed. For example, obesity-related acanthosis nigricans will improve with weight loss.People with acanthosis nigricans in general should be screened for diabetes. Weight loss and controlling blood glucose levels through exercise and diet often improves symptoms.Topical tretinoin 0.05% cream once daily at night helps to lighten pigmentation along with weight loss, exercise and diet management.Alpha-Lipoic acid ha been shown to increase insulin sensitivity and thereby reverses the pseudo-acanthosis nigricans which arises as a result of insulin resistance states e.g Obesity and diabetes. It is commercially available for prescription in acanthosis nigricans.regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for difficulty in breathing\n\nHi, I have hard time breathing sometimes. I wouldn't be doing anything I'd br sitting down watching tv and my heart starts pounding really fast and I feel like I can't breath any more. I get up to get a drink of water and I start feeling light headed, I told my doctor but he didn't say anything was wrong with me. I have low blood and low iron and I'm not sure if that's the problem. I take vitamins and iron pills but I'm not committed to them. I'm 16 turnig 17 next month. Can you please help me?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.Lethargy, breathing difficulty, palpitations etc are symptoms of anemia.You are not taking iron and multivitamin pills regularly. So your anemia will not improve and your symptoms will persist.So better to take your iron and multivitamin pills regularly as per directions of your doctor.Eat more fruits, green leafy vegetables and pulses.Don't worry, you will be alright once your anemia is cured.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is valparin safe in cancer bladder?\n\nMy husband is taking valparin chrono200 for the past one month. He is hving ca blader with bone mets under gone partial cystectomy and now chemo. He has been priscribed with valparin along with some other pain removers from the pain & paliative clinic. Is it really necessary?",
    "doctor_response": "Hi,Thanks for writing in.Valparin chrono 200 contains sodium valproate 200 mg, valproic acid 87 mg which is a medicine to treat seizure, mania, migrain, epilepsy and related conditions.It is to be given carefully in patients with liver problems. In the first 6 months after starting treatment the liver function tests are to be closely monitored. If the liver function test is normal for 6 months of regular treatment then there is no serious concern. Urinary bladder cancer with bone metastasis is not a contraindication for treatment with this medicine. If pain isnt severe then please discuss with the doctor. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high BP,protein and bilirubin?\n\nmy 18 year old athletic son went to the doctor for a migrain, doctor said his blood pressure was 150/100. protein and billirubin was found in urine.  upon return of blood tests, liver enzymes are high and they will do a ultrasound on the liver. what can be the problem?",
    "doctor_response": "Hello welcome to the health care magic Based on this finding liver or kidney pathology can be most likely (liver pathology most likely among this two) Your work up done as follow.... _serum bilirubin _urine urobilinogen and bilirubin estimation _USG abdomen _serum urea,  creatinine _HAV like viral marker by ELISA if bilirubin high According to this report cause can be diagnosed and accordingly management decided Take care Hope your concern solved",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tan colored bruise on ribs in a child?\n\nthey are side by side on each side of his ribs.... I read online that it could be a sign of leukemia for children! He is learning to walk in is using your Walker I thought maybe the Walker band did something and it could be a minor brain doesn t look like a blue bruise it s more of a tan color bruise with the red ring around it! Can you please help tellif this is something I need to worry about",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically. I am asking this so that our team can help you in a more efficient and scientific way than out of imagination.Hope my answer was helpful for you.  I am happy to help any time.  Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can herpes be cured with herikind 800 medication?\n\nSir, I am a agriculture scientist, I am having some pastule  in few spots on our head, that is quite pianfu. It was from last 5 days.To-day I go to my family physician He told that it is Herpes nad gane herikind 800  4 tab./day. Is it correct medicine",
    "doctor_response": "Hello,I read carefully your query and understand your concern. Heroes can be cured with Acyclovir cream for local application. I also recommend using Acyclovir tablets three times a day. I recommend using Cetirizine 10 mg for the itching. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can hepatitis c cause warm feeling and red cheeks?\n\ni have recently been diagnosed with hepatitis c. I have noticed lately my cheeks get red and i kind of get a warm feeling on my face. I am 23 yrs old and most likely contracted the virus in the last year. Are these symptoms possibly related to the virus and should i be overly worried?",
    "doctor_response": "Hi there,Its unlikely that hepatitis C would cause liver failure that quickly.  I wouldn't be overly worried. I'd make sure you have your liver enzymes checked regularly (every 6 months). You should also make sure you get a liver ultrasound, and an alphafetoprotein (AFP) level, every 6 months as you are at increased risk for liver cancer. I hope this answers your questions. Please feel free to contact me should you have any further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are soft red squishy lumps above the groin area hernia related?\n\nI am an overweight (220lbs)18 year old women in college and I noticed a pain under my stomach that didn t seem to be a big deal at first. It s a small squishy/soft bump in line with my lower stretch marks, above my groin area. It s red in color with purple at the peak of bump about the size of a dime. There s another small squishy bump next to it as well. I notice whenever I wear underwear I feel mild discomfort and irritation. Even without immediate contact it is uncomfortable. I looked only and saw mention of a hernia? But I don t want to jump to conclusions",
    "doctor_response": "Hello, As per the narration of red squishy with a tender area of the lump, it is not related to hernia for sure. Either it can be post inflammatory lump or pimple with infection. If you can provide a photo picture of the same in follow up a conversation if there is no objection, I can further focus precisely on this issue to guide at my best level. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for feeling sleepy and tired after getting malaria fever?\n\nHello Doctor,Recently, i have started feeling sleepy and sometime runs tired easily. i have treated malaria fever in the last 3 weeks with coaterm (aletermineter and numerfantrin). at work i feel easily sleepry, please help me for recommendationmy age is 34,height is about 1.73M and weight about 79-80KG, Medical history - My father has high Blood Pressure but is been managed",
    "doctor_response": "Hello,Welcome to HCMI understand your concerns.You are suffering from post fever tiredness and fatigue.It takes 2 -3 weeks for you to get rid of these symptoms.As you had fever 3 weeks back,it would have decreased your body's immunity and it takes about 3 weeks after fever to boost up the immunity.So,i would suggest you 1. to take good rest and sound sleep2.Eat lots of fruits and vegetables which are rich in vitamins3.Eat dry fruits like dates, pista and badam,that will help up to increase the haemoglobin levels.Hope i have answered your query.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain and blurring of vision?\n\nOver the past 24 hours I ve been suffering with pains in my chest while I breathe and worse if I cough, now feeling dizzy and my vision is a bit blurry with blotches in the corners of my eye. I have a pain very subtle that aost feels in my heart. Do I seek medical help?",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Symptoms are severe, medical help is necessary.2. ECG evaluation necessary to rule out anything serious. Also biochemical enzymes study will also be necessary.3. If ECG and biochemical studies for cardiac enzymes is normal, then will need further clinical history about previous symptoms. If cough is present since long, which could be causing low oxygenation and breathing difficulty, then salt water gargling and linctus codeine syrup will be beneficial to suppress cough. For pain, ibuprofen will be helpful. 4. More clinical details along with ECG needed for further opinion. Better to seek medical help now.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the problem in getting pregnant?\n\nHey, I am a 29 year 5.9 240 lbs I am 12 days late from a normal 30 day cycle. I have had 5 neg test. My husband and I are trying for another child. I am cramping like I am fixing to start my period and had light pink on my paper when I wiped once 10 days late. I have NEVER been late before on my period but I had my thyroid taken out almost 2 years ago and still I have never been late. I am taking 150mg of synthroid a day. Please help as i am praying I am pregnant..",
    "doctor_response": "Hi, I think you can take some progesterone like duphaston for 10 days. It will support the pregnancy if in any case you are pregnant.  If you are not pregnant, you will get your periods within 1 to 2 weeks after stopping the tablet.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can be the reason to get clots after taking 2 doses of MTP pills?\n\nHello doctor, I had recently used MTP pills, and it is day 4. Day one I took 1 tablet of 200 mcg, the second day I took 2 tablets each 200 mcg. I did not take rest two pills, due to heavy bleeding. Also, I had got a lot of clotting, though it must be cleared now. On the fourth day, I did ultrasonography and found still a few clots were present. What is the best solution now? Will it clear automatically after a few weeks or should I take rest two pills now? Please help. Also day 4, the doctor suggested that I need to go for dilatation and curettage. I need your suggestion. Should I do it immediately? I am not in a position to do it now. Can I do dilatation and curettage after some time of around two months? Please suggest. I have attached my laboratory tests for your reference. Thank you.",
    "doctor_response": "Hello. Considering the USG (ultrasonography) scan report (attachment removed to protect patient identity), there are still retained products of conception inside the uterus with clots. Ideally, you can take the remaining two doses of tablet Misoprostol and allow the bleeding to continue further as with medical abortion the bleeding may last for at least 7-10 days. Repeat USG scan ideally after 2 weeks to check for retained products again. If the products are still retained then dilatation and curettage would have to be done without delaying it further as you said till 2 months. Delaying can lead to endometritis or uterine infection which can be harmful to future pregnancies.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does eating of spring greens cause headache?\n\nEating Spring Greens (a variety of dark cabbage) and or cabbage, causes me wild headaches.  Would it be the oxalate?  Today, I've finally nailed it that it's the cabbage we put in our raw juices, giving me an unrelenting wild headache until the transit time clears it out of my system.  Any ideas?",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your query, and would like to congratulate you for your keen observation. Such observation of self is indeed a path to health!Yes, spring cabbage can trigger headache in those who are prone to. In some persons, it can trigger even migraine-like headaches. However, culprit may not be oxalates (oxalates are related with kidney stones) but may be other contents like n-hydroxytryptamines or such others.Were I treating you, I would suggest you take a multivitamin-multimineral supplement. Vitamins such as B6, C and other minerals aid in metabolism of biogenic amines. After 2-3 months of supplementation, I would suggest you to \"try\" eating small quantity of spring greens, if tolerated, gradually you can increase consumption.Hope above information will be helpful to you.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes left sided cramps after laying down?\n\nI'm 9 dpo I have been having pinching like sensation in my sides when I lay down. One night I layed on my left side and started feeling mild cramps that lasted all but a minute. I started a headache about 5 dpo off and on I usually don't have headaches when my period comes. I have cold like sytmpoms stuffy/runny nose, drainage and sneezing plus tired but can't sleep at night. I'm constantly hungry but really don't have an appite. Last night I got bright yellow discharge no smell, ictching or burning when I pee it was just there when I wiped. I am getting for urine track infection but this is the first time I've seen yellow discharged. Could I be pregnant.",
    "doctor_response": "Dear patient thank you for your question.Let me start off by saying that change in the colour of urine does not occur in pregnancy and the only way to know if you are pregnant is to take the pregnancy test.Your query is quite correct. It is quite rare to see a yellow discharge in pure uti infection.One explanation i have is that is quite possibly a trichomonas infection of the vagina which has now involved the uti which explain your itching, discharge and burning urination",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does mild temperature and headache after treatment for typhoid indicate a relapse?\n\nHi, may I answer your health queries right now ?  Please type your query here...hii... my uncle had typhoid last month..about 2 weeks after discharge he is now suddenly having low grade fever(99-101C) from noon to night..it starts at around 12pm and leaves by 12am..he also has headache at the time..couldit be a relapse?His blood culture was normal at the time of discharge",
    "doctor_response": "Hello, thank you for posting your query here. Did your uncle take the complete course of antibiotics for typhoid ?From the symptoms you be described with low grade fever and headache, my opinion is that he is having a viral illness now. You can ask him to wait for 2-3 days, and if fever persists, to do a blood culture and start on a course of antibiotics (what he took last time for typhoid). Importantly, ask him to take a vaccine for typhoid a month after recovery, as infection with typhoid does not protect against typhoid recurring in the future .Hygiene and hand washing before eating food, after using the toilet is to be stressed upon. As is drinking boiled water, avoiding juices and uncooked food outside as much as possible. Hope he gets better soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain and dizziness?\n\nI'm 19 years old and 175 lbs...I recently lost about 30 lbs (through diet and exercise) but I don't know whether my weight loss could be the cause of my symptoms. I've been having difficulty breathing with minor chest pains. I also experience dizziness, although not very frequently, and I've noticied a change in my appetite. I don't know whether this could be a factor, but I was diagnosed with latent TB about 2.5 years ago and I've had yearly chest x-rays and took the prescribed medicine for 9 months after my initial diagnosis.",
    "doctor_response": "Your weight loss is not due to TB.If you are concerned you can get T-spot test (blood test) to rule out TB infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am lonely and continually depressed. Please help me.\n\nHelIo doctor, I am a 17 year old girl who through a series of mistakes has pushed my friends away. School is a constant battle and I feel alone and defeated. I am lonely and continually depressed. Please help me.",
    "doctor_response": "Hi. From the available description, it appears that you need to manage stress appropriately. Mistakes are a normal part of our life and there is no point in regretting them. Whatever might be the situation, you need to move forward. Identify the problems in school and start working on them, one by one. Once you identify the problem, it will be easy to make a list and solve the easiest first and then proceed further. At the same time, it will be appropriate if you can talk to your old friends. Saying sorry and admitting mistakesmelt almost all the problems in buddies and I am sure they will embrace you with the same warmth if you move a few steps towards them. Having said this, take the help of elders in your family because they can provide valuable advice. I can assure you at this stage that you are not alone and help is available. Whatever comes to your mind or whatever problem you face, do not hesitate to write back to me. I will be glad to assist you. If you find any difficulty in handling such situations, you can write back to a psychologist counsellor online with specific details for further guidance -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Allery with blocked nose and itching of eyes and throat\n\nHi, I am 30 years old and have very bad allergy from last 3 years but it have got worse this year. My nose is blocked all the time, my eyes, ears, throat itches me most of the time. And some times I keep sneezing or watery eyes. I use histal dc and otrivin drops, vitamin c 500 regularly and I get immediate relief . Is there any thing else that I can do? And is there any side effects of using histal. I am planning for my second baby too.",
    "doctor_response": "IF YOU HAVE TRIED ALL THE ABOVE MEDICINE THE TAKE INJ HISTAGLOB 1 AMP  S.C. EVERY WEEL FOR 3 WEEKS THAT IS  DAY NO -1 ,DAY NO- 8 , DAY NO-15 . TAKE MEBEX TWICE DAILY FOR 3 DAYS TAKE UNICARBAZAM FORTE 1 TAB DAILY FOR 15 DAYS GET EOSINOPIL COUNT DONE",
    "dialogue_context": ""
  },
  {
    "patient_message": "How many pills of clomids should be taken for infertility?\n\nHi how u doing? just want to know i been trying so hard to have a baby for the pass 2 to 3 years and it didnt work for me. I have place in a order for clomids it takes 10 to 25 business days to reach. I just want to know how many pills do i take each day?",
    "doctor_response": "Clomid contains clomiphene. Is used to stimulate the follicles of ovaries.So follicles increase in the size and get mature for ovulation and they help in fertilization.Idly this drug should be started on 3rd day and continue for 5 days. It can be given as 50 mg od to 100 mg od. If 50 mg doesnt work then dr can increase the dose.So it is better to consult a gynecologist after his/her advise take this medicines.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What cause lower abdominal cramping only throughout the night?\n\nI have been having lower abdominal cramping only throughout the night its not very painful but uncomfortable enough that it keeps me up at night. This cramping is associated with lower back pain and i have been staining throughout this time. What can this be?",
    "doctor_response": "Hi.Thanks for your query and an elucidate history. Cramping in the lower abdomen only during the night , enough to keep you awake with backache and staining through-out this time can be due to mild for of menorrhagia, which you may not be noticing due to being busy throughout the day. I would advise you to have a direct examination by a Gynecologist and have abdominal and per-vaginal ultrasonography to get a proper diagnosis. Proper treatment would help you. IF required the curettage and biopsy may be needed to rule out cancer of the uterus .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent fever\n\nMy daughter is 6 years old and has been running a high temp for 3 day. So far the highest was 104.1. No other symptoms and she s acting herself and playing. I took her to doc. They said maybe coxsacki virus. I don t see anything on her hands or feet. Maybe one dot on her throat. Should I be concerned and take her to her regular doctor?",
    "doctor_response": "At least it seems that she has a virus. You can keep giving her paracetamol for her fever and sponge her when her temperature crosses 101 F. Give her plenty of liquids and a light, easy to digest diet. If she breaks out into a rash elsewhere, or has new symptoms, take her to the doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is wrist pain after an injury normal?\n\nI broke my wrist 9/1/11. I had a cast on for four weeks. I have terrible pain in my wrist, and sometimes up to my elbow. Is this normal. I have trouble with fine motor now. I wore a soft brace for a short while after the cast came off to try and help with the pain. I have an appointment to go back in two weeks, should I keep it or is this normal. If it is normal what can I do to strengthen my wrist?",
    "doctor_response": "Hello,I read carefully your query and understand your concern. After\u00a0the\u00a0cast\u00a0is\u00a0removed, it's normal for the\u00a0wrist\u00a0to be stiff for 1 to 2 months. It I still be advised to\u00a0wear\u00a0a soft\u00a0wrist splint\u00a0at night for 1 to 2 weeks\u00a0after\u00a0the\u00a0cast\u00a0is\u00a0removed\u00a0to stabilize the\u00a0wrist.Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain. Taking birth control, not pregnant. Family history of stomach ulcers. Treatment?\n\nI m having a lot of middle abdominal pain ulcers run in my family it hurts so bad I cry and cry I can barley walk and I know I can t be pregnant I m on birth control and it also feels like contractions I just had a baby almostseven months ago I can t handle this pain its been going on for about three days now and I ve been able to bear it until now please help me!",
    "doctor_response": "Hi. If this is really such pain then you need to do gastroscopy and other endoscopic procedures. If it is associated with fever, fatigue and muscle guarding then go to ER. Try to avoid food that triggers pain. It can also be gallbladder disorder ,not just gastritis. You should do US of abdomen to rule this out. There is no need to suffer. Intensive,persistant pain is a sign of something,especially if regular analgetics didnt help. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes ankle pain despite no blood clot while having endometriosis?\n\nHi, I have endometriosis and ovarian cysts and have developed pain in my ankle and sometimes upper leg (currently both ankles). My normal dr checked me for a blood clot due to where pain was but there was none and an X-ray was done and no fractures. Could the pain be related to my other issues?",
    "doctor_response": "Hi, There could be many reasons for ankle pain. most common in elderly is posterior tibial tendon dysfunction. Don't go into details what is this. Just learn intrinsic foot exercises and try it for 6 weeks. I hope there would be some relief. Next time please mention your age in query. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Anuj Gupta, Spine Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long do braces need to be worn for straightening teeth?\n\nhi doctor iam31 years old.i was wearing retainer for along time.but now if I don't wear it teeths moving to its position..and it hurts.i want to put on braces now.i don't need much straightening.but just want to fix my teeths in same position.my question is how long I need to wear braces ? and how much will be the cost.?can cost vary with a simple straightening?",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,     I have gone through your query, as you have mentioned that you have Retainers for, many years now you are mobility in your teeth , You should go to orthodontist and get proper treatment course done otherwise your teeth wil again come in there previous Alingment,     Treatment plan for orthodontic treatment is long procedure so it will take time , so better option is that you go to Orthodontist and get proper schedule for it,   Hope this will help you.    Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be concerned as i am having fluid filled bumps on my penis?\n\nI get tiny little fluid filed bumps on my penis that itch and looks and itches like poison oak, when I pop them they usually dry up and go away, I just get them occasionally, what can it be. Please help, thanks Greg. My email address is buzzy45@  WWW.WWWW.WW",
    "doctor_response": "HelloThanks for your query,You have not mentioned anything about your sexual activities whether you got these bumps after having a unprotected sex or otherwise. Based on the facts and description of the lesions it appears that you have Genital Herpes 2 infection.Please get swab tests of a fluid from the cysts done to confirm the diagnosis and start taking anti viral medications like Acyclovir twice daily orally and topical anti viral cream like Acyclovir for local application Ensure to wash your genitals with warm water twice daily and avoid sexual encounters till it gets cured completely.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Weakness, weight loss, sharp head pain, rapid appetite change, blurry vision, hearing problems, balancing problems, memory loss. Advise?\n\nI have been feeling very weak..I have lost a lot of wait..I have had pretty bad sharp needly pains in my brain..It starts in my eyes, then goes to my temples, then shoots to the back of my head.my appetite rabidly changes.. Blurry vision, hearing problems, loss of balance, memory loss.. I have all of those symptoms.",
    "doctor_response": "hiwelcome to health care magic the symptoms u hav been experiencing like headache ,weakness ,loss of weight and appetite change can be symptoms of hyperthyroidism i.e increased function of thyroid gland or chronic infectionsbut blurring of vision ,hearing loss and memory loss are significant symptoms .you must undergo an MRI BRAIN  as lesions in medial temporal lobe can cause these symptoms mainly if it is an infectionkindly mention your age and duration of illnesshope u find this helpful",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hashimoto s thyroiditis and COPD\n\n67yo woman recently diagnosed with Hashimotos and COPD. Quit smoking 15 yrs ago have been very active biking, hiking, walking. About 9 months ago I sarted noticing a slight shortness of breath. Now I have severe trouble breathing when I Stand up and try to walk. Two months ago I was walking around a little slower but still had quality of life. due to feeling tired I went to a dr who did a blood test and discovered the Thyroid problem. I was put on 50mcg of Levothyroxin. I had two stents put in ten years ago.EKG 2mos ago showed a normal heart for my age. 81% on the Bruce Protocol. Over the last two months my breathing has worsened to the point that I can t take more than 2 steps without severe loss of breath. As soon as I lie down I can breathe again. Have very little appetite and have lost 25 lbs since May.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. You are having weight loss and breathlessness on minimal exertion. All these indicate worsening of underlying COPD in you. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. PFT (Pulmonary Function Test). PFT will tell you about severity of the disease and treatment of COPD is based on severity only. You should start inhaled bronchodilators and inhaled corticosteroid (ICS). Enroll yourself in Pulmonary Rehabilitation center where chest physiotherapy and deep breathing exercises are done. All these are important in COPD patients. They will improve lung functions and reduce symptoms. So consult pulmonologist and discuss all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does sharp pain inside the elbow joint get cured on its own?\n\n7 Months ago I cracked the Lateral Epicondyle and Olecranon in my left arm in a RTC. My arm is fully healed up now and I ve got full mobility but ocasionally when I straighten and twist my arm at the same time I get a very sharp and immensely painful stabbing feeling inside of my elbow joint, where it was broken. Is this the sort of thing that will just go away with a bit more time of healing, or should I get it checked out again?",
    "doctor_response": "Hi, The pain may last for few weeks and settle by itself. You can take analgesics like Diclofenac or Ibuprofen for pain relief. If the pain persists for long despite taking analgesics, you can consult an orthopedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a treatment for the penis enlargement?\n\nhi,iam male not married yet age 29,ht 5.3inch,my penis is small,when i masterbuting its size will inc upto 4 inch.my worry is how much size should i need the intercourse,my sexual feeling is also very hi please suggest if any medicine available for increase my penis,i would be highly thankful to u,my mail id is  YYYY@YYYY",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Four inch penis size is enough and don't worry about that. In sexual intercourse female get sensation and got pleasure by friction of penis in initial two to three inch ares only where g spot is present. So you do not need to increase your penis size and don't take any medicine or oil as per my opinion. Masturbation is safe and pleasure Giving technique and during high sexual  desire it can be tried. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest dosage of Remicade for burning abdomen with gas\n\ni just had an introvenious iv of remicade. the nurse wasnt sure of the dosage so she gave me three vials. whatever that is .  I havent felt well since. I was awake alle nite and had a burning sensation in my abdomen and lots of gas. it feel like i didfnt get the proper dosage.  what is the proper dosage for a 5'8\" women?",
    "doctor_response": "Hi.Thanks for your query and understanding the problem correctly.The recommended dose of REMICADE \u00ae is 5 mg/kg given as an intravenous induction regimen at 0, 2, and 6 weeksOne vial contains 100 mg So if your dose is correct if your weight is  around 60 kg ..The dose depends upon your weight. Please discuss this with your Doctor next time you are going to have Remicade and take at the stipulated time.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lungs tuberculosis\n\nI hav been detected with lung tb coz i used to smoke ,i am on medication now n will complete my 6 month course as reccommended by my doctor on aug 19th ,my age 25 and im a female n a flight attendant by profession , but i hav been told that my tb mark wont go for 2 years atleast and this would be an obstacle for my career, plz advice",
    "doctor_response": "Hello, thanks for using Healthcaremagic. i had gone through the dtails you have posted. tuberculosis commonly infects lungs. it produces pneumonia if not treated at this stage it prodeuces cavitation and then heals by fibrosis. if fibrocavity or fibrosis is establisted it wont go off totally. so whether you have this fibrosis or not we need to have a look at your chest x ray. though fibrosis is seen on chest x ray you will be cured for tuberculosis...Hope this helps..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe nose bleed and dizziness\n\nHello I normally do not have nosebleeds. And the last 4 days I ve had for bloody noses. These are concerning to me because I have a hard time to get them to stop bleeding. After many attempts with a cold pack on my nose with my head tilted forward it takes about the over 30 minutes to get the nose bleeds to stop. But after many blood clots and lots of blood later they finally stop. Now my face is feeling numb I m kind of dizzy and very very tired",
    "doctor_response": "You must go to an ENT specialist to rule out any local trauma & for management which may include cautery to stop bleeding & nasal packing.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What happens when the enamel of the tooth falls off ?\n\nHello i am a 22year old female with no health problems.When i woke up this morning the white bit of my tooth ( Enamel i think) at the front fell of and underneath is a brown/reddy coloured tooth with a sharp end and it looks like the root off the enamel is still there the back side of my tooth is fine.What could it be?",
    "doctor_response": "hi.from ur history it appears that there is chipping of enamel from the anterior region, due to which ur underlying dentin and pulp is exposed, which is appearing as brownish red in color.go to ur dentist, if it is only superficial chipping, light cure composites can be used to build the tooth.if there is pulpal exposure then u need to go for rct and ceramic crown.wish u good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for bug bites\n\nbug biteI was in hawaii a week ago and on a night tour I got a bug bite. It was itchy for a day or so and then stopped. But where I got the bite there is a loony sized white spot. my whole back tanned except for this bite spot that is still white. for the last week I have been very tired and feeling ill. I've vomited a few times, and have felt very weak. could this be from the bite? Why do I still have the white spot and should I look for more help with this?",
    "doctor_response": "Hello dear,You should definitely look for more help.From your symptoms,it seems like a spreading infection from the bite site.And ,features like extreme tiredness,vomiting may indicate systemic nature of the infection(Although you may be having a simple infection like an urinary tract infection,since these symptoms followed the bite,we have to take some precautions).Your doctor will guide you further depending on the examination findings.I hope you will find this information useful.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment options for disc bulge\n\nSir am arshad 22 yr old a small village frm Shimoga district, Karnataka State, India, 1 yr Before i got left leg pain nd back stifness nd legs stifness ... Nd back pain, My MRI Report Shows its D4 D5 small disc bulge causing indentation of thecal sac....!! Dctr seggest to spinal card surgery....!! Nd 10 day back i met chiroprocr psyothropy nd he said get well soon bt am nt satisfyd with dis treatmnt bcz no changes in my body...! Sir hav any tretment for it without surgery....???? Sir how i get well sir...????",
    "doctor_response": "Answer: Hello,I have studied your case.I will advise to get surgery soon if u take physiotherapy for 3 months and no relief occursor if pain increases in between this duration which it severly affects your daily activities Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does high blood pressure cause bleeding from nose?\n\nsoory for my bad english.My father is 58 yrs old. One years ago suddelny blood is coming from his nose. After treatment from local doctor blooding was stopped after 10 min. But after 2 hrs. there is blooding again. After first add my father addmitted into hospital. After nose endscopy and some sholdring in nose my father come back home. But after one day there is blloding again from same side. After that we consolt to another doctor. He said that it s due to High BP. After that since last year there is no problem. But now again same problem occurs from same side one at morning and second at evening next day. I check BP but it s normal. but doctor s again said that it Due to BP. Can any one help to What is actual Problem? Doctor s write some test also but every thing is normal.",
    "doctor_response": "Higher blood pressure surely causes bleeding from nose.  So try keeping in under control by taking proper medication.  Even it increasing temporarily will result in nasal bleed,  if the blood pressure is normal throughout the episode,  the next is local cause should be ruled out as it is the same nostrils that always bleed s.  If all normal a blood doctor (hematologist)  should be consulted once in life to make sure he doesn't have any problem there (low platelets, coagulation disorders) .  Lastly I would like to assure you that if blood from nose is not very significant and self subside.  Not  to very much if all cause s are ruled out",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in my right side if abdomen?\n\nHy I have some pain in my right side of the abdomen, the pain is not excruciating but it s there for two weeks now. Also i have a pain in my left hip, for at least two months, I don t know if those two symptoms are related! I am generally constipated. thank you for answering me, my concern is the colon cancer.",
    "doctor_response": "Hi.Thanks for your query and an elucidate history..Yes, you are right , the concern of cancer of the colon has to be investigated immediately by having colonoscopy after a good preparation and also to have the CT scan of the abdomen and hip joints to whether the to problems are related or not. It is possible that the cause of the pain in the right side of the abdomen be due to colitis or co. Pain in the left hip looks to be a different problem as it is there for 2 months. A good physical examination by an Orthopedic Surgeon and a CT or MRI can help to get a proper diagnosis. During such a problem it is always better to have an early diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could continued itchy rashes on ribcage, inside leg and elbow of a child be viral rash?\n\nMy son is almost two, and 3 weeks ago he caught a slight cold and then a rash, but he still had the rash all over his rib cages, inside of one leg and inside one if his elbows and is super itchy. Took him to the dr a week ago and said it was a viral rash but it doesn t seem to be getting any better, what might it be?",
    "doctor_response": "It might be a fungal rashes in the folded areas of the body that is elbow.back of the knee joint and rib cages,u can use an antifungal soap and cream with oral anti histamines.Novalle soap, Telekast-L kid tab twice a day for 5days after food and Lobate cream twice a day for local application.he will be fine",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest me for what aliment entecavir tablets is given.\n\nHi,Doctor iam male 39 years in recent test i came to know that iam hbsag+,,,,IgG antibody to hep c virus is non reactive,,Hep Be antigen negative,,,PCR assay is 5,634,946,    PT INR 1.3,,,,,Doctor suggested me to take ENTECAVIR tablets,,,Iam worried of my life kindly suggestme.",
    "doctor_response": "Hi,Thanks for asking.Looking at your query, my opinion is as follows:1. You are suffering from acute hepatitis B.2. Do take Entecavir tablets until liver enzymes levels come down.Nothing much to worry now. Watch out in future for any jaundice and get your regularly tested for any liver conditions (cirrhosis, hepatitis, carcinoma). Avoid blood donation and use protection.Be careful.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I regularize my periods in order to conceive ?\n\nhello doctor i need gynocologyst im 9 weeks pregnant my LM i m 21 yeas...married life spoans 1.2 years..i had irregular periood after marriage and when examined it was suggesootive of pcos and hupothyroidsm i had tablets for 3 months and my thyoid level was likely to be normal and dr. cut down dosage but i didnt test for pcos nw last two months i got my period regulr and now i m 10 days late..what o i want to do to regularise and to concieve??NB. i m with my hus for two concecutive mnths for the first time now after marriage",
    "doctor_response": "hi,     You have taken treatment for Thyroid ,you have regular periods &you are with your husband for last 2 mths,-all these factors favour chances of pregnancy.     If you aer 10 days late. urine preg. test would confirm the pregnancy.In case it's +ve get your thyroid treatment adjested earliest. &don't bother for PCOD. But if the test is -ve,go for PCOD treatment. Thznk you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for nerve damage in both the legs\n\nblocks in back i have arthritis in my lower back.i was going to a pain clinic and they were giving me 12 shots at a time in my lower back along my spine..now another dr says i need both hips replaced..can the blocks do that damage to my hips? and now i have nerve damage in both legs.",
    "doctor_response": "Hi, If you have severe enough arthritic degeneration to affect the lower spinal column then, there is a good chance that the hips will also be involved by the same process. The shots will not have caused your hips to deteriorate rather the same arthritic process. The nerve damage you perceive to be in your legs most likely is due to the same arthritis affecting the lower spine which is compressing lumbar nerve roots L4 and possibly L5.  That's where the problem likely resides. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I use Kojivit gel to get fair skin?\n\nHi doctor, I am a 22 year old female. I have a dusky skin that is brown skin. I want to become fair. Can I use Kojivit gel? Or any other dermoatology cream can I use? My hands are also brown in color and full of tan. Do you suggest any creams to get fair? I want to become fair as my marriage is going to get fixed by next year. Please suggest me some creams, so that it should not show any side effects. Also, how long I should use it? If I use anything, then will it have any effect in case of pregnancy, etc? Please help me. Thanks in advance.",
    "doctor_response": "Hi. One's skin color has 2 components. First one is genetic, which cannot be changed. Every skin color is beautiful in its own way and we should learn to love our skin color and augment it and not hide or lighten it. The second component is acquired, which is due to the influence of environment, sunlight, hormones, aging, etc. We can only target the acquired component of fair skin color while attempting lightening procedures. I suggest you antioxidant capsules like capsule Antoxid HC (Beta-carotene) and apply sunscreen lotion Lashield gel at 8 AM and 12 PM. Also, you can apply Glyaha koj lotion (Hydroquinone) at night time. Start with an alternate night application initialy as it may irritate your skin a bit and after a week or so, shift to daily night application. Consult your specialist doctor, discuss with him or her and take the treatment with consent. You can go for chemical peeling or microdermabrasion from your dermatologist which will help in exfoliating and give you a clearer skin tone. All these treatments are free of side effects. You may use them for three months. For further information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can food intolerance cause pain underneath breastbone?\n\nI sometimes experience a tight knot-like sensation in the stomach area, in the gap just underneath the breastbone, which often results in me having slow, uncomfortable breathing, and feels like slow suffocation. Is it likely to be food intolerance as it often happens after eating cheese or chips, which I now try to eat in moderation.Your opinion would be appreciated.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Yes, it could be most probably due to acidity. You need to avoid those foods that exacerbate the symptoms and hot, spicy foods. Eat meals regularly every day, drink plenty of water, take medication for acidity if necessary. If you have further queries, I'm happy to help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause continued pain in abdomen of a child?\n\nHi I have a daughter aged 7.5 years who is having abdominal pain for last 1.5 years or so and now since dec the pain is severe have done sonography, blood test, urine test etc and all the reports are normal. Right now giving her homeopathy medicine, the pain has reduced but still the pain prevails and it is severe sometimes",
    "doctor_response": "Hi... I have just read through your question. Whatever you are describing is called Chronic Pain Abdomen in medical terms.The differential diagnosis of abdominal pain in children varies with age, gender, genetic predisposition, nutritional exposure and many environmental factors. The causes are many including - constipation / acid peptic disorders / inflammatory bowel disorders / irritable bowel syndrome / worm infestation etc.I suggest you see your pediatrician or a pediatric gastroenterologist for this.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Regards - Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain during H pylori infection?\n\nI ve completed triple therapy for H pylori bacteria, but I still feel a stinging pain from time to time in my stomach and chest area. My doctor started me on Protonix which seems to help but by the end of the day I still feel the pain and uneasiness. Stool test showed that H pylori was negative.",
    "doctor_response": "HelloThank You for contacting HCM.Welcome to Health Care Magic.My name is Dr Muhammad Ahmad & i will look into your problem.I have gone through your query and would try to help you in the best possible way.Stomach has such a strong acid in it that if you fill a drum of this acid and throw a cow in it ,kit would disappear in one hour,,,,that's our mucous membrane and protective layers and mechanisms saving us from this acid and Hpylori disrupts that protective layer and when this acid touches and burns our stomach wall it hurts us...   That's the reason when we treat H.Pylori we give antibiotics but we also add acid lowering drugs with it as well because the ulcers H.pylori has created are so dangerous that your own acid can burn you and dissolve you like chicken curry you ate last night in Johny's party :)Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. Wishing you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with typhoid and blood infection. Undergone medication. Undergone some tests. Fever and cough. Suggest?\n\nHello , My sister is 26 years old. She was diagnosed with Typhoid 2 months back.She got treated for that with heavy doses of oral and inject-able antibiotics.  After that she got diagnosed with some blood infection. She got treated for that. From last 2 months onwards she is on antibiotics and heavy doses of anti allergy medicines. But still she has fever up-to 99C and Cough.Yesterday she had her tests again. Chest X-Rays are clear. LFT is normal. TB test is negative. But in her Urine test WBC Count is unlimited/Uncountable. ESR ratio in blood is 91. What problem she might have? We are really very much tensed about her. Please suggest what should be next step?",
    "doctor_response": "SOMETIMES WHEN YOU TAKE MORE ANTIBIOTICS THERE CAN BE ANTIBIOTIC FEVER STOP ANTIBIOTICS WHICH HAVE BEEN TAKEN IN EXCESS START WITH ANTI ALLERGICS TAKE ALLEGRA 120 MG BD SYP TOSSEX 1/2 TSF BD SYP GELUSIL 1 TSF TDS SYP CITRALKA I TSF TDS AS URINARY TRACT ANTISEPTIC LIQUID WHICH WILL CLEAR YOUR URINE WBCS TAKE 2-3 WK TAKE MEFTAL SOS FOR FEVER",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing hair loss?\n\nHi I am 29 years old last year i had lot of hair fall when consulted doctor he suggested using Hair4u Lotion. Since 1 year i am using it and now again the severe hairloss has started is it because the lotion is not being effective now does these lotions have a time frame which would make them ineffective on the hair.",
    "doctor_response": "Hi,It may be telogen effluvium or androgenetic alopecia. You have not mentioned your gender. Believing that you are male, it is likely to be androgenetic alopecia. You may apply minoxidil 10% sol twice a day with oral finesteride 1 mg daily for few years.If you are female, most probably it may be telogen effluvium. There may be some cause like anaemia,vitamin deficiencies,thyroid dysfunction,stress or some internal disease. I would recommend to take tab biotin 10 mg thrice a day for long time with mild steroid lotion application daily at night. Mild shampoo may be done alternate days.Thanks.Dt. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does presence of mastoid air cells in periventricular white matter mean?\n\nI just had a MRI w/wo contrast showing mastoid air cells that are opacified bilaterally and also changes in the periventricular white matter. I had a non malignant tumor removed 12 years ago with alot of problems now. Autonomic Dysfunction Disorder, gait disorder, memory loss, tremors and more.... Should I be concerned?",
    "doctor_response": "Hi,Thanks for writing in to us.Bilaterally opacified mastoid air cells mean that the air containing spaces within the petrous temporal bones which are located behind the ear are showing some fluid collections. This can happen when there is an ear infection which causes seepage of fluids into these mastoid ear cells. It requires an examination by the ENT specialist.The details of your tumor surgery would be required to know if the autonomic dysfunction disorder, gait disorder, memory loss, tremors are due to after effects of the surgery. Periventricular white matter is the white matter areas in the brain which is found next to the ventricles or fluid containing spaces. This can mean that there is seepage of the cerebrospinal fluid in to the white matter and if you are an elderly person then this is acceptable. It is a variant of the degenerative changes in the elderly people.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for small lump on lower back\n\nim 37 yr 165 lbs male i have a small lump on my lower back on the left hip side. It is not paining much, but once in a while I feel small pinch. This small lump was there for almost 3 years. I remember I was playing Tennis in hot sun in Arizona one day and was dehydrated and got this lump the next day and it stayed there. Was this lump due to the muscle spasm or anything else is I am worried of. Please let me know. Thank you very much.",
    "doctor_response": "Hello and welcome to HCM,A lump on lower back on left hip region is most probably due to soft tissue swelling.Muscle spasm is unlikely to cause a lump or swelling.Imaging of the lower back will help to determine the relationship of the swelling with the bony structure.Imaging can be followed by aspiration cytology of the swelling.In aspiration cells are aspirated, spread on a slide, stained with appropriate stains and studied microscopically.This investigation will determine the origin and nature of the swelling.Management of the lesion can be done after this investigation.Consult your primary healthcare provider for clinical assessment, investigations and thus management.Thanks and take careDr Shailja Puri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i use 1gaine hair solution and tab folgroom for controlling hair loss?\n\nHELLO DOCTOR AFTER MY SECOND DELIVERY I AM FACING HAIR LOSS PROBLEM. YESTERDAY I WENT TO ONE DERMATOLOGIST, HE GAVE 1GAINE HAIR 5% SOLUTION FOR MORNING ,2 HAIR ACTIVE SERUM GEL FOR NIGHT, 3 TAB FOLGROOM,4 TARITOP SUSPENEION, 5 SEREN HAIR CONDITION. SO I CAN USE THIS MEDICENS DOCTOR,",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Hair fall after pregnancy and delivery are extremely common due to hormonal changes. The medications seem fine to use. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why people drink more water in chronic mercury poisoning?\n\nHi doctor, In the case of chronic mercury poisoning,\u00a0is there an increased consumption of water? The same question, for chronic fluoride poisoning. Please guide.",
    "doctor_response": "Hi. In chronic mercury poisoning, it binds and stops the functions of SH (sulfhydryl-containing enzymes). It also gets deposited and causes cellular toxicity. If the toxic pathology happens in the gastrointestinal tract (GIT), then the patient feels burning inflammatory sensation in the GIT. In order to cool it, he consumes more water. This concept is mentioned in Indian Traditional Siddha Literature. But, no modern study is available on this concept. It also says that even a person become psychotic. In chronic fluoride poisoning, there are no such symptoms as the fluoride target calcium sites like teeth and bones. It also has other effects in internal organs. Many geographical areas are contaminated or rich in mercury and fluoride. The groundwater (or drinking water) is rich in mercury or fluoride. The same water is used for agriculture. Thus, people tend to consume mercury and fluoride through drinking water and vegetables. Fish (from mercury-contaminated sea) consumption also leads to mercury poisoning on a chronic basis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes raised blister like area on eyeball?\n\nI have a clear sack or raised blister like area on my eyeball It's confined to sclera and does not pass over cornea. It is causing discomfort, I have had no recent eye infection or injury but I do wear contact lenses. What is wrong and how do I treat this? I am 26y and healthy.",
    "doctor_response": "Hi,From history it seems  that there might be having,Irritation on  sclera due to lemses orstarting of Pterigium.Consult ophthalmologist and get  examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes slight elevation in blood sugar?\n\nI am a 65 yr old male.  I had a hip replacement 12/30/14 and recent hand reconstruction 4/1/15.  I have re-cooperated from my hip but a couple wks before my hand surgery I was ill vomiting, seats, chills fever.  I think it was the flu.  The last couple weeks I have been fatigued and for the last 7-8 days I have been low grade fever, coughing, shortness breath, bad sweats and chills, no appetite.  Went to dr last Wednesday Apr 29th and chest X-Ray showed no fluid in lungs and white blood count showed little elevation in sugar but dr said normal.  Any suggestions?He prescribed augmented and a cough syrup.  My cough is better but I have all of the other systems still.",
    "doctor_response": "FBS 110-126 mg/dl =prediabetic FBS=> 126 mg/dl = Diabetic.Have a low calorie deit and keep yourself active.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is recurrence of synovial cyst of spine a possibility?\n\nI am a 70 year old woman who had a synovial cyst of the spine about 5 years ago. The only symptom I had was leg pain. The cyst was diagnosed after doing physical therapy and when that was unsuccessful having a MRI. Recently, a similar pain has begun in the same area as when I experienced the synovial cyst. Is it possible that a cyst could reoccur in the same location?",
    "doctor_response": "Hi there. Thanks for your question at HCM. Synovium is the normal covering of joints which help in production of joint fuild and smooth functioning of joints.Synovial cysts are fluid filled lesions, arising from synvium of joints which have worn out. Age related arthritis in joints of at th eback of your spine ( facet joints) can lead to synovial cysts whcih can manifest with pain in the lower limbs( since these joints are pretty close to your nerves in the spine. As long as the joints are still present ( that is no fusion or fixation surergy done for these joints) these cyusts can persist and can recurr. So the answer for your question is , yes it is possible for it to reccur in same location, if that particular joint was not fused last time around. If the pain is bothering you , the best way to confirm this would be a repaet MRI of your spine. It os best that you see your doctor and confirm that your current symptoms are matching the findings of spinal involvement and get fuirther evaluated. Hope this helps. All the best . Regards. Dr.SBK",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is laparoscopy?\n\nThis is general question. what is laparoscopy? Why it is done? Any risks?",
    "doctor_response": "Laparoscopy is a surgery that uses a thin, lighted tube put through a cut in the belly to look at the abdominal organs or the female pelvic organ. Laparoscopy is used to find problems such as cysts, adhesions, fibroids and infection. Tissue samples can be taken for biopsy through the tube. In many cases laparoscopy can be done instead of laparotomy surgery that uses a larger incision in the belly. Laparoscopy can be less stressful and may have less problems and lower costs than laparotomy for minor surgeries. It can often be done without needing to stay overnight in the hospital. Laparoscopy is done to check for and possibly take out abnormal growths such as tumors in the belly or pelvis, check for and treat conditions such as endometriosis, ectopic pregnancy or pelvic inflammatory disease, find conditions that can make it hard for a woman to become pregnant, do a biopsy, to look whether cancer in another area of the body has spread to the belly, check for damage to internal organs, such as the spleen, after an injury or accident, do a tubal ligation, fix a hiatus hernia or an inguinal hernia, removal of  organs, such as the uterus, spleen, gallbladder, ovaries and appendix. Partial removal of the colon can also can be done and also to find the cause of sudden or ongoing pelvic pain. Risks include bleeding from the incisions, infection and damage to an organ or blood vessel. This may cause more bleeding that needs another surgery to repair.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for slow heart beat and weakness\n\nHi ...my mother feels very week now days. She wakes up at 3:00 Am daily and feel her heart is going to weak. She cries sometimes and feels like no one is for her in this world.She does not eat as she should. She is looking do weak. Pls suggest what is this and what we should do. Thanks",
    "doctor_response": "Hello. Thank you for asking on HCM. I hope I can help you.Weakness of cardiac origin can be elicited by low blood pressure or slowed heartbeat/conduction disturbances. If you can, please tell me, has she had any episodes of fainting with or without loss of conciousness? Does she take drugs that lower blood pressure or slow the heart rate? My opinion is that she should do an EKG and be put on a 24-hour Holter rhythm monitor. Also, an echocardiogram should performed, to assess heart muscle and valve functioning. After these tests are done, we can judge if this problem is of cardiac origin and, if it is, proper measures of treatment must be undertaken. I hope I answered your question. Feel free to contact me again. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be causing dizziness and stomach pain simultaneously?\n\nI have been feeling dizzy lately and throwing up in my mouth. My stomach has been hurting. I have been drinking lots of water. trying to eat healthy and working out. I just don t feel like myself. Do you know what this could be? stomach gets cramps, wake up with my head hurting",
    "doctor_response": "Hi,Thanks for writing to HCM.As for your stomach pain...you are having gastritis with reflux...GERD...and for that you need to be started on a ppi and prokinetic combination like pantaprazole and levosulpride, which i prefer for my patients. But for the prescription you need to see your local doctor.And your dizziness can be due to stress by the pain and that should go by the above treatment, but still when you go to your local doctor, do get your blood pressure checked as low bp can also cause that.Dr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the effects of reactive lymph nodes in the submandibular regions?\n\nWhat does this mean please.  I have a growth on my jaw and have got the results of my ct..  it says there are a few small subcentimetre lymph nodes noted in the submandibular regions which are likely reactive in nature.  Some of the submanidbular lymph nodes lie close to and medial to the mandible.",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,  I have gone through your query,  see lymph nodes enlarges when there is infection in oral cavity . So this enlarged lymph nodes can be due to periodontal infection or periapical infection also in oral cavity . For this you should consult dentist and go for examination of Oral cavity and Examination of lymph nodes . If possible go for FNAC of lymph nodes. Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "seven and half months baby not able to lift his head\n\nmy seven and half month old son is having these symptoms please help me to cope with the situation.his weight is 8kg now and born with 3 kg of weight and cried immediately after birth. 1 not able to react on any sound (bera done, report showing severe hearing loss in both ear, VEP is normal) 2 still not recognizing mother or any kin (head size is little bit bigger but MRI read normal,EEG normal,Echo normal, 3 not able to lift his head while lying on back. but can lift head while in prone position 4 not able to sit, if we try to get him sit with support he shows stiffness,some time he sit for a while otherwise  try to stretch on bed.he truns on bed himself 5 he is crying like a normal baby but not laughing some time smiles Transthoracic Echo Doppler Report says: No structural heart desease No evidence of any hypertrophy of ventricles Normal ventricular function and dimension please suggest me what to do now. all other activities are normal (eating,sleeping,passing stool,urine,can lift his both leg and bring leg near his mouth, licks his both hand and catch any article with both hand) waiting your valuable suggestin please",
    "doctor_response": "Dilated ventricles mean ventriculomegaly and this could be either due to hydrocephalus, increase water content of ventricles, and a measurement of head circumference would tell you whether he  this condition or not. The very fact you say that he is unable to lift the head; I have a strong suspicion that this could be because of that I mentioned and I recommend to take your child to a neuro surgeon immediately.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of dark spot on the face?\n\nMy 2 month Old daughter has a dark spot on her face (left cheek) about the size of a half dollar coin. She wasn t born with it, it popped up on her face when she was about 3weeks old. Also some days it looks like its clearing up, some days it looks dark. What could it be?",
    "doctor_response": "Hi...by what you quote I feel that if could be a transient fungal infection. But, skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes waist rashes with itching and pain?\n\nHI, I have a painful rash on my waist area. I have used gold bond powder for soothing the rash but it is not working. I am wondering if it has to do with my briefs that I wear. Should I switch to silk or a different fabric? During the day, it doesn t irritate my skin as much but at night is when I get the sensation to itch the area. I have betamethasone valerate lotion that I have applied to the area. It doesn t give me any relief. I also take cetirizine to help me sleep a night and for the pain. What would you recommend?",
    "doctor_response": "Hi, The rash could be a contact dermatitis or a fungal infection (Tinea cruris). The drugs given for both the conditions are entirely different and if not given properly, it could worsen the disease. So, I request you to consult your Dermatologist to arrive at a final diagnosis and to initiate apt treatment. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the prognosis for secondary bone cancer?\n\nhi.  my mother has just been diagnosed with secondary bone cancer. She is 80 next month and has been admitted to hospital due to the pain. She had breast cancer 5 years ago and had a full left mastectomy but was found to be lynph node positive.  She is very weak and tired and has eaten very little for the last 2 weeks. Please can you give me your honest opinion of the prognosis.  thank you",
    "doctor_response": "Hi,Thanks for writing in.Many patients get secondary bone metastasis from breast cancer that is treated even more than 5 years back. It is important to know which bone is affected and what is the extent of the bone lesion. Since she is elderly, it is important to provide her with adequate nutrition.A patient like your mother with post mastectomy and a bone spread might survive till 2 years after detection of the secondary bone cancer with good treatment and care. If she is not eating then the survival more than 6 months to a year is difficult. If she has dehydration then it is important to give her fluids and fresh juices. Eating is an important part of management and even if her appetite is reduced you should convince her to eat smaller meals at regular intervals every 3 to 4 hours. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for flank pain, abdominal pain, headache and fatigue\n\ni had my gall bladder out about 4 years ago. i also had a couple of stints installed after the fact because i continued to get gall bladder like attacks. i has been about 2 years since the last surgery. i now am having alot of pain on my right side (flank) and some abdominal pain in the same area where i had my pain for the gall bladder. i have no fever, no blood in my urine, i m have had some fatigue and a headache ever now and then, but other than that i feel ok",
    "doctor_response": "Hi.Thanks for your query.Read the history and understood the problems.You had your gall bladder removed and put in the stents. This indicates that there is a problem in the common bile duct, which carries bile from the liver to the small intestines. Now you have similar pain in the right flank, no blood in the urine and no fever. I would advise in such a patient the following.MRCP to start with and before the ERCP is done.ERCP and Endoscopic ultrasonography will give a proper diagnosis. Further stenting, or surgery may be required to get a permanent relief.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for itchy inflammation on butt region\n\nI have tears in my butt crack that are very painful and taking a long time to heal. I think that I had yeast in the area because it was red, inflamed, and itching and burning really bad. The redness and inflammation above the tear is better, but the tear is still there. Do I need to be seen by a doctor or can I treat it at home.",
    "doctor_response": "Hello,Welcome to HCM,Your history and symptoms are suggestive of fungal infection and it is more common in this area, as these are the normal comensals of this area which will be kept under control by helpful organisms.Whenever there is a imbalance in the environment it will multiply and produces its symptoms.I would suggest you to follow1.Keep the are clean and dry2.Topical application of anti fungal cream like Ketcanozole cream3.Oral single dose of Tab Diflucan, 150 mg.4.Oral anti histamines.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling of face and tooth ache\n\nMy boyfriend was complaining that his partially capped front upper tooth was hurting him the other day. He said cold makes it feel alot better. We noticed a little swelling in his upper lip last night. Today he woke up and his upper lip is now severely swollen along with the left side of his face from his lip up to just under his left eye. He said his tooth still hurts alittle but not a ton. He is having trouble chewing.  I saw pictures of a abcsessed tooth and dont see any signs of one on him. He is also not allergic to anything that we kno of and hasnt eaten, drank, or taken anything odd.",
    "doctor_response": "hi,I have gone through your query , you confirmed that their is partially caped tooth. Can I know ?? For what reason caping was done? as you described of swelling with little pain this case seems of Periapical Abscess with related to the tooth. you should take antibiotics as early as possible other wise your problem will increases by time.Thank youDr. Hariom Sharma MBBS, MS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can conception be attempted despite mass in fallopian tube (pelvic TB)?\n\nhi i am subha.now i am taking pelvic T.B. medicines since 9 months.my fellopian tube is infected and there is a mass in my left fellopiantube.after completing medicine also it's not completely wentout.but now it's size is very less comparing before.now should i try for normal pregnency?",
    "doctor_response": "Hi, I think if your tubes are patent and your periods are regular , you can try naturally for 6 months.  Be in contact with your husband every 2 to 3 days after your periods stop. It will increase chances of your pregnancy. Hope I have answered your question.Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for constant high BP\n\nAt what point should a person go to the emergency room for high blood pressure? My boyfriend has hugh blood pressure and was started on Diazide caps just this morning by his Dr. he just took several readings about ten minutes apart on our digital meter and its consistently around 170/106. He also took some aspirin. Any advice, he s concerned he may need to go to the emergency room?",
    "doctor_response": "Hi, I don't know much about your boyfriend past medical history or his age, but I recommend you to not read BP every 10 min, but every 1 hour or 4-5 times a day would be enough. These are high values and maybe he need to add other medications, but need to do some routine blood test first if he has not done yet. Hope I have answered your query. Let me know if I can assist you further.  Regards, Dr. Anila Skenderi General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the belly button to go in and out while sitting or laying?\n\nmy son josh is 10 years old and in the last week I have noticed the center of his belly right where the belly button is going in and out he will do while sitting laying and its happening more often now I took him to our family doctor and he had xrays done but we go on Friday and get the results my son has never done this before till now when I watch his belly just the center goes in and out the belly button goes all the in and then come out could you please tell me what this iam a very worried mother please let me know how we can treat it thank you so much",
    "doctor_response": "Hello dear,welcome to health care magic forum.The condition suspected in such a situation is umbilical or paraumbilical hernia. In such case,there will be bulging out during coughing.This is easy to diagnose with a simple abdominal examination with an ultrasound if needed. If confirmed, can be corrected with a minor surgical procedure.Kindly follow up with your doctor.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it possible to get anaphylaxis if stung by bee frequently?\n\nHello doctor, Few months ago I got stung by a bee in arm. It is not the first time I was stung by a bee, but this time 30 minutes after it happened, I got swelling under my eyes, on my cheeks and it was getting bigger as time passed. I went to ER and they gave me Corticosteroids IV. Now, I was wondering if this means I am allergic to bee stings and if in future I get stung by a bee again does it mean anaphylacic attack can develop?",
    "doctor_response": "Hello. Yes, that is correct. It seems you are allergic to bee sting. For an allergic reaction to develop, initial exposure must occur in order for your body to create an immune response to it. This might have happened a few months ago when you were stung before. Since there was already an exposure and established immune response, subsequent exposure may result in allergic reaction. Severe allergic reaction resulting in anaphylaxis may occur but most of the time allergic reaction is mild and not life threatening. Symptoms such as excessive skin reactions, including hives and itching and flushed or pale skin, low blood pressure, constriction of your airways and a swollen tongue or throat, difficulty breathing, weak and rapid pulse, nausea, vomiting or diarrhea and dizziness or fainting warrants immediate consult. I hope I was able to answer your concern. Is there anything else I can help you with?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can abortion during first pregnancy hinder the other pregnancies?\n\nmy name is vani. I am 37 year old. I got married in 2009 oct. In 2010 may 25th when i am 10 week pregnant i got abortion due to genetic problem. mine blood group si b negative that i came to know when i am 2nd month. Now suggest me when i can plan for next pregnancy, and i am working engineer travel in bus in morining and evening for 40 minutes. what are the precautions i must take. please suggest me.",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the miscarriage in first pregnancy might not always hinder for further pregnancy.There are various causes of abortion.And as per your information the miscarriage was due to genetic problem.Usually after miscarriage a gap of atleast 3 months is essential to plan for next pregnancy.As it was genetic problem you both the partners might need to undergo karyotyping to rule out any chromosomal anamolies.If you both are normal and that problem might not recur in furthur pregnancy.Also take folic acid tablet daily one starting from one month before planning the pregnancy.Nothing to worry.As most of the genetic anamolies does not recur .And abortion is the natural way of termination of abnormal embryo.So consider getting done karyotyping for both of you and start folic acid prior to planning of pregnancy.And a gap of 3 months is needed.Bus journey daily might not effect.But once the pregnancy is confirmed avoid physical strain.Hope this helps.Best regards....",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes thick whitish vaginal discharge during pregnancy?\n\nIm 37 weeks pregnant. I keep getting thick white toothpaste looking discharge when I wipe. It feels like rubber. Every time I lose more and more and every time it causes severe back pain. Today the pain isn't getting better only worse and I had clear fluid in my pants.",
    "doctor_response": "Thick white discharge can be due to candida infection.However the pain can be due to pregnant uterus but if it is becoming more than it can be labor pains.You need to put candid V 6 vaginal pessary pv for 6 nights.You should consult doctor in case of increase in abdominal pain, bleeding or leaking per vaginum or decreased fetal movements.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for high GGT levels in pregnancy\n\nHi there- I had been having blood tests for other things earlier in the year and came back with a GGT of 39. They checked it every few weeks for awhile and it slowly went back down to 29. Now, I am 6 weeks pregnant and new blood work shows a GGT of 43. All other liver number are fine. I m a social drinker (not anymore since knowing I m pregnant!) and I ve been taking omeprazole for the last 10 years for relfux-- I have a weak value between my stomach and my esophagus causing inflammation. I ve switch to pantoprazole a few days ago after find out about my pregnancy, as it is a B grade drug rather than a C. Please let me know what you think is causing the liver problem, as what, as a now pregnant woman I can do.",
    "doctor_response": "Hello, and I hope I can help you today.Many people have one mildly elevated liver enzyme value that is unexplained. GGT is a marker for acute liver damage and is frequently elevated with alcohol consumption, however other things can also affect the levels of this enzyme in your blood. There is even a possibility that the omeprazole that you have been taking could be causing this elevation as a side effect.As long as you've had tests to rule out a medical cause, such as hepatitis or other chronic liver disease, the mildly elevated GGT is not dangerous for you or the baby. Furthermore, it may go back to normal once the omeprazole is out of your system.So there may not be a way to know what actually has caused this laboratory abnormality for you, but as long as it does not get worse during the pregnancy and that you have been evaluated for any type of dangerous liver diseases or problems, it will not pose a risk for you or the baby.I hope that I was adequately able to answer your question today, and that this advice was helpful.Best wishes for the rest of the pregnancy,Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in heart and irregular heart beat\n\nGood morning.. I was born with a heart valve that was not perfect.. most recently I have had serious problems with my heart so I went on to see the public hospital.. they gave me pills for my blood pressure later to find out the pills they gave me was for 60 year olds.. I am now 22.. Every day I get palputations when I get the slightest excited or tensed.. I am now on a new chronic medication coralyn.. seems to work for the blood pressure but not the irregular heart beat.. It carries on for hours some times till I get relaxed.. but then there is pains in my heart witch goes to my left arm.. not Hectic pains.. But the palputations is keeping me from having a normal day.. what can I do?? I was already at the cardiologist but he wants to see me next year..",
    "doctor_response": "Hello, For this reason, I would recommend performing an ambulatory 24-48 hours ECG monitoring in order to examine your heart rhythm trends for a prolonged time. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of the bumps around spider bites?\n\nHello, I recently got 2 spider bites, I don t know the type of spider. Two bites are extremely swollen and blistered open, but then I have 5 or 6 other large, hard under the skin bumps right around them. All located in my right armpit, and one goofball sized under the skin bump also complete opposite from the bites but still so severe? I want to drain the bumps but wasn t sure if it was lymph nodes and if that s not okay?",
    "doctor_response": "HI, thanks for using healthcare magicIt would be best to see your doctor for drainage if this is needed.This would ensure that an aseptic technique is maintained and reduces the chance of further infection.In addition, antibiotics may be needed as well especially if the lesions are large.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a stomach virus with fever be treated?\n\nHello,my son is about nine month old and had very high fever before two days, it was about 105, the doctors in the hospital reduced the fever and they discovered that he had a virus in his stomache. I am concerning now because my baby is not playfull as much as before and he sleeps more than before. Is there any risk or side effect might affect on him? or this is normal reflection in the recovery time.",
    "doctor_response": "Hi, it seems like your baby might be suffering from Acute gastroenteritis. Are there loose motions? If yes, the there is high possibility that child is dehydrated. kindly take him to medical facultyDisclaimer\"This provisional advice provided by me stands subject to the patient undergoing a physical examination and is based entirely on inputs provided by patient/attendants. The patient is advised for physical examination at earliest\"",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can using a knee brace cause swelling in ankle?\n\nCan using a knee brace that is too tight on my left knee which I had a meniscus repair on two months ago cause swelling on my left ankle I put it on tight and bowled 5 games there is no pain but definitely edema of. The right side of the ankle and slight swelling above the ankle.",
    "doctor_response": "Hii there,Yes the knee brace that you are using might be too tight that is causing this pressure symptoms at ankle as swelling which is due to disturbance in circulation.Kindly get another brace with one size bigger.And you need to remove the brace at night time As you underwent meniscal repair i advice you to take rest and avoid sports and strnious activity.Hope this will solve your problem.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and wheezing in a child\n\nMY BABY IS 2 YEARS OLD,HE HAVING VEEZING TROUBLE,& ON SEP HE HAVE VEEZING WENT TO DOCTOR,ON THAT TIME HEGOT PNEMONIA &HE SUFFER WITH FEVER FOR 1 WEEK &DUE TO HEVY FEVER HE GOT FICKS ALSO .NOWHE HAVING MILG FEVER WITH MILD VEEZING WE ARE GIVING ASTHALIN.PLS ADVICE US ANY UPDATE",
    "doctor_response": "Hi, Please continue the same medication and you can give the fever medicine also an appropriate dose. Fever of a 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 a viral illness and it doesn't require antibiotics at all. Once the viral fever comes it will there for 4-7 days. So do not worry about the duration if the kid is active. He may also be having simple febrile seizures, from which he will gradually grow out of by 5 to 6 years of age. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had impacted wisdom teeth removed. Taking Tylenol. Had cold. Have yellow pus in mouth, foul odor. What is this?\n\nHi, I had 4 impacted wisdom teeth removed about 2 months ago. I am just getting over a bad head cold that has made the left side of my upper mouth kill. Tons of pressure, very uncomfortable. I ve been taking Tylenol at night which helps a little. Last night while laying in bed, I felt this insane amount of pressure, then almost like a birth of yellow/ green puss filled my mouth. This happened to more times. I m nervous but I don t want to rush to the dentist over every little thing. Oh also, it smelled terrible and tasted just as bad. I floss every day and brush twice a day. Am I broken? Should I run or walk to the dentist? Thank you for your time. Amysue",
    "doctor_response": "Hi, Thanks for asking the query, I would like to tell you that wisdom tooth extraction is not a simple extraction, it is somewhat a complicated procedure and there are many postoperative complications like pain, swelling, prolonged numbness, difficulty in mouth opening, fever, malaise. You dont worry about the symptoms, headache can be due to use of antibiotics and painkillers prescribed to you. Yellow liquid oozing out can be because of abscess formation there could be a chance of some broken tooth piece left in the socket to rule out this, Visit the concerned dentist and get a checkup done. Follow the postoperative instructions given by the Dentist properly, take complete course of antibiotic and analgesic, take lukewarm saline gargles 3-4 times a day to give a soothing effect, use antiseptic mouthwash gargles twice to promote healing and prevent infection. Hope this helps out. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cannot concentrate on work, self-esteem issues. What is wrong?\n\nHi, My name is mark. I am 25 years old, I am a web developer. From my childhood i was very good in studies even when i not study well i still do very good in exams. It was till about 16 years of age. After that I understand that i need to achieve something in my life so i decided to work hard on my studies and became a very good software engineer. But don t know now i started showing bad results in exams while i study day night and work hard. In this way i completed my degree 3 years ago it was recession period and i not able to find good job. So i started with small one and i got success and open my own software company. But i don t know now i have to work hard to get my company to top. I am not able to focus on my work. I continuously play games and watch movies on my notebook instead of doing my work. While i know i am doing wrong, but i can t help it my mind just stop working and force me to these stuff. Please help me what is wrong.... I also want to tell you my family history and about my personal life may be it helps. My father was from a joint family. He get married to my mother and they live together with my grand father, and my father s other brother and sisters. My father is the oldest one in all. But no body respect him because i also found he is bit lazy and don t know much family relationship. My father s brother and sisters hate my mother while my mother do all good for them. So after facing much torture from them my parent get separated. My parents love me a lot and upto 10 years of age of mine they try to provide me everything i wanted. But after that i realize financial state of my family is not good at all. So i started saving money. From my childhood i keep having long discussion fights with my mother, but i love and respect her from my heart . I am not much good looking, so i keep distance from girls from i was a child. From about 12 years of age I mostly like to be in my room. I don t like to go out, may be i afraid from getting disrespected or ignored by other, as i don t like this. Now I am living a life just equal to prisoner always in my room in-front of my notebook, in this way i have lost my company. Have worked on 2 of my own websites, which developed taking very long time and much of time i wasted in playing video games and watching movies. Please i want to know why i do wrong while i know i am doing wrong and why i keep myself in my room only don t want or afraid",
    "doctor_response": "Hello and welcome to Healthcare Magic. Thanks for your query. Your symptoms could be indicative of a mood disorder. However, you need a detailed psychological assessment to make a definitive diagnosis. I would advise you to consult a psychiatrist for a detailed evaluation and further treatment.  then there are effective treatment options available - in the form of medication or counselling / psychotherapy which will help him overcome your problems. Wish you all the best. - Dr. Jonas Sundarakumar Consultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe muscle cramps\n\nhello, my fried has muscle cramps so bad that for a couple days after, he is in pain. he is 54, had a heart attach at 48, is diabetic and takes shots twice a day. he drinks a lot of water so i know the dehydration cant be the problem. how can i help him",
    "doctor_response": "Hi,Thanks  for  your query.After going through your suffering, it seems you have developed muscle spasm (cramp).The cramps are caused by hyper excitability of the nerves that stimulate the muscles.  Drugs given for asthma, anginaand Parkinsonism also lead to cramp. A simple way to prevent cramp is-1. Warm up and stretch your calf muscles before running stretch your calf muscle before going to field 3-4 times and each time holding for 10-15 seconds. 2. Talk to qualified trainer for proper running form and footwear.3. You may run in a heel-toe pattern and avoid letting the balls of your feet hit the ground first.4. Stay properly hydrated before, during and after you run and eat a balanced diet with adequate minerals, particularly potassium and magnesium. Taking a multivitamin can also helpI do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat leg pain?\n\nI have been having pain in my leg starting in my pelvic and moving to my knee and then my foot along with some swelling and random bruising. Some bruises are big and purple but most are small and yellow and disappear after a day. I also have extreme fatigue to the point where I have trouble staying awake. I was disagnoiced with IC and high blood pressure both of which I am on medication for.",
    "doctor_response": "Hello, As a first line management you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist better to consult a physician and get evaluated. We have to rule out possible causes like a peripheral vascular disease. An ultrasound Doppler is required. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could heaviness in chest after exercising be broken rib?\n\none week ago i was using a crow bar working in the yard and i pulled back with the crow bar expecting to pull back hard to get it wedge out of its area, it came out much easier than expected and i brought it back hard onto my right side of my chest bone ... i immediately felt like i hurt myself but continued on in the yard... not for too much longer though, that night it hurt any time i bent over, im assuming the blood flow threw off my equilibrium or something ... now just breathing, sneezing, blowing my nose, opening a jar ... sleeping ... feels like a heavy weight ON my right chest- no bruising. i am a 41 yr old - good health- female. could i have broken a rib? -",
    "doctor_response": "Hello,Your symptoms seem to be related to a pulled muscle. I suggest using a muscle relaxant such as Baclofen three times a day. I also suggest using magnesium supplement for muscle relaxation. Warm compresses can also be helpful.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I having abdominal pain after taking Gestorin 200 tablet?\n\nHi on my 20th day my follicles got ruptured after taking HUMOG injections(measures 18x16mm and 19x15mm previous day) and left ouvary has 21x15mm ad 19x16. Doctor asked me to have intercourse for 2 days and advised to keep the Gestorin 200 tablet for 15 days for vaginal use. now for the past 3 to 5 days am having stomach ache like getting periods. please advise me whether i can get pregnant with PCO problem.",
    "doctor_response": "It can be side effect of drugs but also it can be typical gastritis or bowel issue. You need to do gastroscooy and switch to another medications.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could a migratory tender lump, moving from armpit to elbow, indicate?\n\nI have a small pea sized lumb that started under my left arm pit but has migrated down my arm to just below the elbow. It is moving steadily toward the hand at about an inch per day.It is a little tender to the touch. It seems like it is in the vascular system. What might this be?",
    "doctor_response": "Hi,Dear I went through your  query.1-By the facts placed by your query,I feel it to be- a lump  due to spreading thrombo-phlebitis, or  lymphangits- as its tender and moving down the elbow to the forearm2-It could be due to some infection in boild and or due to insect bite,which started this migrating lump.3-Better consult your family doctor immediately as its alarming and needs doctors help 4-Hope this would solve your query,5-Thanks for your query to the Health Care magic. You are wellcome for any further treatments if required.I would love to help you out of YOur lump .Thnks.Wellcome.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in lower back and stomach below ribs. Better in sitting position. Guide\n\nI have been experiencing alot of pain in the lower part in the small of my back as well as in the stomach area just below my ribs and it seems to be worse when i lay down i have actually be sleeping sitting up over the last few nights I was wondering if you might know if you could explain what could be happening or what the diagnosis might be",
    "doctor_response": "Hi,Thanks for posting your query.From description it seems to be due to muscle spasm.You need stretching exercises to relieve the spasm. Doing hot fomatation and applying muscle relaxant gel will be helpful.Hope this will helps you. Feel free to ask me if you have any further queries. Wish you good health. Take care.RegardsDr Saurabh Gupta",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Inspite of having Zovirax, rashes on my penis has not subsided. Why is it?\n\nHi doctor, I am a 30 year old male. I got\u00a0rashes on my glans penis after sex with my wife. I have consulted a doctor and he suggested to use Zovirax 200 mg four times a day for one week, thinking that it is herpes. But, I think it is not. I have used it but no improvement at all.\u00a0The rashes getting disappeared within a week when there is a gap of intercourse. After sex, I am developing rashes again and as there is a gap of one week, the rashes getting disappeared. This has started only one month back. No pain, no itching, the rashes look red.\u00a0I think it may be fungal or bacterial infection. What medicine shall I use?\u00a0When I used Candid dusting powder, the rashes are getting cured. Kindly suggest.",
    "doctor_response": "Hi. Revert back with clear pictures to a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will i get pregnant due to PCOD problem?\n\nHi this is akshaya 26 years old. Got married before 3 Years. I have PCOD Problem taking OBIMET 500 MG. getting Regular periods for more than a year. this month discontinued OBIMET and Taken OVACARE  AND FOLIC ACID TABLET ovulation not happened and not ruptured till 20th. Doctor adviced me to continue with OBIMET and folic acid Tablet. After 2 Months she will give some Tablets to STimulate. Actually want to know whether will i get preganant",
    "doctor_response": "Hi, I think you can get pregnant.  You have to take medicines like clomiphene 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.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can backache be treated?\n\nI m 50 yrs old. I am currently taking pain medication for back pain etc. . Today I was trying to move Dresser over a little bit, I heard a loud pop in my lower back. I immediatly layed flat on my stomach to try to relieve the pain. That didn t work so I tried to make out of the bedroom to the couch. Well, I didn t make and this time I laid on my back. The next thing I know my better half is really upset. I asked her what happened and she said it look like was having seizure and that had stopped breathing. She called 911. I talked with EMTs and recommended I should And at least get an MRI. I told them that if need be and I don t feel better Iwould go to the Hospital ..After they left my better half asked if I had wet myself, I felt around and sure enough I had,which basically means I had lost body functions. I hope you since of what I ve typed. Thanks",
    "doctor_response": "I would make sure you get a MRI of the lumbar spine.This will evaluate you to see if you have a herniated disc in the lower back, which can cause back pain, leg pain, and bladder issues.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does tubal flushing help in conceiving?\n\nHi, i went for tube flushing last month June 28,06,2017 had intercurs all through my ovulation period missed my period which was surposed to come 18 of July , but did not til now had some terrible cramps went for blood text 6 days after my period and is Negative but still my period has not come could I still be pregnant no pregnancy symptoms",
    "doctor_response": "Hi I think you should wait for the periods for one more week and repeat the test. If negative, you can take some medicines like meprate or deviry for inducing periods. It can happen due to some stress factor or hormonal imbalances also. You can try ovulation induction with timed intercourse for 3 to 6 cycles for conceiving. Hope it helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat pain in an old person arising out of recovering herpes?\n\nMy mom got diagonised with Herpies a month back. Now it is subdised almost 75% however, she is under severe pain and not able to tolerate the pain.....what should i do.....she is 70 years old...and pain killers are not much helpful.....thanks in advance for your advice",
    "doctor_response": "Hello, Welcome Thanks for consulting HCM,   I have gone through your query, as you have herpes infection dont worry as you have said it is painful , yes it is painful, for this you should consult Physician and go for Antiviral drug course .  Drink plenty of water with liquid supplement Electrol .   Take one tablet multivitamin once daily with antiviral drug .  Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be done to wean off Clozapine without which vertigo starts?\n\nI have been taking .05 Clozapine twice a day for a year to treat Vertigo which was quite severe 3 years ago. Meclizine did not help but Clozapine does. In addition to that, I take Ambien 2-3 times a week for sleep. I was also drinking 2-3 ounces of Vodka nightly which I have discontinued. My plan is to wean myself off Ambien but am not sure about Clozapine because when I don t take it, my head starts spinning again.",
    "doctor_response": "Hello, If you have vertigo that has never been evaluated as to underlying then, I suggest you see a neurologist or if possible a NEURO-OTOLOGIST. There must be a reasonable explanation for why you have such symptoms that can only be cured with clozapine. You should be screened for what is known as VERTEBROBASILAR INSUFFICIENCY which is a reduction or lack of good perfusion into the vascular tree of the brainstem which could be critical. It should not be masked by something like clozapine but rather identified and addressed. Perhaps, it is something simple such as BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV) which can also be quieted down by something like clozapine but never cured as well as either the Brandt-Daroff exercises or an Epley Maneuver. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat nightfall causing fatigue and hair fall?\n\nHi i am ja ,makash. i am suffering from Nightfall problem since last 7 years. it occurs 3-4 times a month. Due to this problem i am facing many problems like fatigue and my face is also becoming dull like my cheeks are pressed and i have hair fall problem also. Request you to please suggest me some good medicines.Thanks",
    "doctor_response": "HI Thank for asking to HCMI really appreciate your concern looking to the given history here I would like to ask you that you used the words \"Night fall\" did you mean \"Nocturnal ejaculation\" if this is right then let me tell you that this is physiological phenomenon and not the disease but this is great myth, so need to worry about this it wont cause anything, hope this information helps you, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with lupus, had Vitiligo , spots on body. Treatment?\n\nI was diagnosed with Lupus when I was 19 years and have been in remission for 23 years.I have had vitiligo for almost 30 yrs. It was just a spot on each arm up until 15yrs ago.The spot on each arm grew bigger. 4 years go, I began getting spots all over my body.Mainly, underneath my clothes but in the last year,it is visible on arms and legs. I don't want to wear make-up it would take hours. How can I speed up the process?",
    "doctor_response": "Hi ! Thanks for you query . Both lupus and vitiligo are diseae that belong to autoimmune category although many other etiologies are suggested for vitiligo it is possible to see them both in combination. For vitiligo control many options are available but since you suffer from lupus i would suggest you consult a dermatologist and rheumatologist both before starting any therapy because PUVA therapy is not recommended in patients with lupus as it uses UV rays which are a known causative factor for lupus and thus exacerbate the existing disease leading to flare. Plus you must be taking some drugs for lupus they need to be assessed , organ involvement and disease activity must be determine before taking any decision . Till then skin camouflaging creams can be used in consulatation with skin specialist which seems to be the best option considering that it will not affect lupus in any ways making it the safest way out. Take Care. Thanks a lot for choosing HCM for you query. Dr. Shruti",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do the findings of sperm analysis suggest and should I consider treatment for successful conception?\n\nHi, I am Sagar, Below are details of my Report, 1) Method Of Collection Masturbution 2) Spillage Nill. 3) Self liquefaction : N 4 ) Appearance : N 5) Viscosity : N 6) Odour : N 7) Volume : 1 ml 8) pH : 8.0 9) Sperm Count/ml : 4 million/ml 10) Sperm Count per Ejaculate : 4 million/ml 11) Immobile Sperm :75% 12) motile with no progressive forward movement : 05 % 13) Slow forward progressive movement : 20% 14) Moderate forward progressive movement : 00% 15) Rapid forward progressive movement : 00% 16) Total Motile Sperm Count per ejaculate : 1 millions 17) Fructose : Present 18) Live sperm (Supra - Vital Stainig) result : Most sperms are DEAD. Please let me know the outcome of this test, what are chances of getting baby, if any treatment required?",
    "doctor_response": "Hi,Welcome to HCM.Your sperm count appears to be too low to allow natural conception. Kindly confirm the same with a repeat semen analysis after 7-10days with 2-3 days of sexual abstinence. If repeat semen analysis shows same count, you need evaluation in the form of some hormonal evaluation like FSH, Testosterone, TSH & Prolactin and one evaluation by urologist/andrologist. If anything treatable is found, count can be improved. Otherwise option for conception will be ICSI (test tube baby).Wish you good health.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and swelling in lower side of the mouth?\n\nHello, my name is Raychalle. i had my 4 wisdom teeth extracted on April 24, 2014 and ever since a week and a half ago i started feel discomfort on the bottom left side where my wisdom tooth was extracted. I now have aches and pains on the lower left side of my mouth. Also it swelled back up and my glands are swollen as well. does this mean i have an infection ? what should i do ?",
    "doctor_response": "thanks for your query, i have gone through your query. the pain and swelling could be because of tooth infection or gum infection. consult a oral physician and get a radiograph done to rule out any remnents of roots of wisdom teeth or any infection in the adjacent or neighbour teeth. take a course of antibiotic and analgesics and treat the teeth accordingly. the enlarged lymphnodes could be secondary to tooth infection. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes the elevated level of Bilirubin in urine?\n\nHi, I just got my lab results back for a C/C urine and the results were that I have a large amount of bilirubin in my urine. I asked my PA what could be causing this and she said she didn t know. She ordered a liver panel and those tests came back normal. Do you know what can be causing this?",
    "doctor_response": "Thanks for posting your question on HCM.Age, gender, alcohol intake not mentioned.Information is incomplete like do you have yellowish discoloration of the skin and the eyes or the pain abdomen or loss of appetite, itching etc.Normally urine does not contain BilirubinIncreased levels of bilirubin in the urine may be due to:Hepatitis (inflammation of liver), obstructive jaundice (impaired flow of bile into the intestine) cirrhosis of liver, gallstones in the biliary tract, tumors of the liver and gall bladder.You are advised to consult your doctor to conduct clinical examination and to find out the exact cause of elevated level of bilirubin in your urine.Take care of your health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I had mutual masturbation. Do I need a PEP being a hepatitis C patient?\n\nHello doctor,I am a 31-year-old male with a history of hepatitis C on Harvoni. I was with a lady doing mutual masturbation. I then placed my fingers on her tits and played with them. I then sucked her tits. I have traumatic oral lesions. My concerns that if she has HIV and then I got it to my fingers then to her tits and then to my mouth. That happened two hours ago. Do I need to get PEP?",
    "doctor_response": "Hello. You had negligible to low-risk exposure in this scenario. Mutual masturbation and playing with tits involves no risk. I guess there was no discharge from tits. If there was no discharge, again this was a negligible risk. You had traumatic oral lesions, which was a source of risk to the other person.If you do not know her HIV status or if she is HIV infected, in both situations, your concern of HIV acquisition is unwarranted as HIV cannot be transmitted by touching. Because of no to negligible risk, PEP is not warranted in this scenario. In case, the act was more than that you had described, or there was also fresh cuts or oozing wound on the tits, or you had sucked secretions from the breast, kindly revert. Take precautions in the future. I hope your query is answered, but if you still have any other question, please revert.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen and painful arm\n\nI fell on ice and braced my fall with my hand. I have swelling at and above the arm end of my collarbone. The swelling fills in the normal dip and forms a raised lump in that spot between the collar bone and shoulder. I have very mild aching discomfort in a resting position. I only have pain in the swollen area when I raise my arm sideways, not forward or backward. The swelling has increased since I fell five days ago, but the pain has decreased. Any ideas?",
    "doctor_response": "You have symptoms of swelling of area between collar bone and shoulder as well you have pain at the same area and the arm. Here one thing is good that your pain is reduced from the time of fall in 5 days but there is swelling which is increasing is not a good sign it shows there is inflammation increasing.Here I will suggest to visit ortho doctor and take x ray to see there is nothing major damage in your soft tissue and bone. Now here ortho will also check with some physical test and then based on report and diagnosis for minor to moderate issue he will suggest for physio treatment and conservative management. You can also use cold pack to swollen area to reduce inflammation.For any thing major damage ortho doctor will suggest for either pop plaster or surgical correction in case if there is damage to bone( fracture) or soft tissue injury ( major cut ).Till the time you consult doctor I suggest to take some conservative steps like immobilise your shoulder close to body that means do not move up and down or stretch out side for time being and keep using cold pack frequently to reduce swelling.Along with this you will have some pain relief but do consult a doctor for proper diagnosis and treatment.Here I have given you general guideline on treatment I suggest follow it step by step and I am sure this will be helpful for you.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have a bump on the backside of the roof of the mouth. What could it be?\n\nHello doctor, I have a bump on the right backside of the roof of my mouth. It is right next to the tooth that is farther back. It has pain when I brush my tongue over it. Also giving me a slight headache and earache. I recently went to the dentist for a cleaning, and they said my wisdom teeth were not even showing so what could this be?",
    "doctor_response": "Hello. I read your query, and it seems that the bump which is painful and which gives radiating pain to ear and head is because of your third molar and this tooth is infected as the food gets entrapped between the tooth and soft tissue covering that tooth. For this, avoid eating too hot or too cold. Wash out oral cavity after every meal with mouthwash and warm saline. Do not apply external heat to that area, especially keeping your hand on that area. Also, take antibiotic and painkiller. Antibiotic you can use is Amoxicillin and Clavulanic acid combination in 625 mg dosage bd. Painkiller can be Ultracet ((tramadol and acetaminophen) thrice a day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes enlarged liver?\n\nHi, may I answer your health queries right now ?  Please type your query here... my niece get an extremely swollen tummy after eating, huge really.  An ultrasound found she has an enlarged liver.  Waiting to see a GI specialist, any idea what this could be?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.There are several possible causes and additional tests are reuqired for diagnosis and the treatment depends on exact cause.  if this is caused by diet, obesity and diabetes then dietary and lifestyle changes will be beneficial in every case. Alcohol and viral hepatitis are most common causes and in this case medical evaluation is required.Also if there is infectious disease or biliary duct disorders then he needs to do some tests to rule out more serious issues which require specific medical treatment.Wish you good health. Kindly regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a treatment to increase the size of the penis?\n\nDear Sir, My penis size is 3-3.5 Inches while its fully erected. I had sex with my girlfriend and soon we are getting married. firstly the erection is not good. 2nd size is small which doesn t feel pleasure and my girl want to make it big with good girth. So I request you to please suggest me what to do to increase penis size and girth size. Thankyou In advance. Hoping for your early response.",
    "doctor_response": "HHi dear. I had gone through your query. Sorry to say it is not possible in any mean.Be realistic. Can we increase size and girth of our finger??It is god gifted and no treatment can help.Yes there is a treatment for good erecttion.Medicines like sildenafil/tadafil can help to maintain good erection. You both require mutual understanding and acceptance that you have.3.5 inch is a good size for ppenetration and female vagina is highly sensitive up to 3 inch.You can make her more excited by manual or clitoreus stimulation. Feel free to ask. Accept the fact and  enjoy.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from cough with mucus. Been a heavy smoker. Throat feels constricted. Suggest\n\nI gave up smoking about 11 years ago having been a very heavy smoker for about 12 years. I then took up running. It took a long time to get my lungs back in order (about two years) but I finally reached a decent level of fitness.What has always bothered me though is that I regularly cough up mucus/ phlegm. This happens throughout the day.When running, it is quite a problem as my throat feels constricted and I am coughing up phlegm even more.A running friend suggested I might be slightly asthmatic. Is this likely? My sister is asthmatic but there is no other family history that I am aware of.",
    "doctor_response": "you may be allergic to somethingif you have left smoking it is not likely to have effect after so many yearsbut as age goes the immune system goes down and many allergens in environment start reacting with body and causing mucus and phlemtry this avoid using mustard coconut walnut groundnut almonds and soya oilsuse olive for cooking and application take lot of warm water in morningapply neosporin h eye ointment in nose bdsea water drops 2 drops at night each nostrilcontinue these preventers for 5 -6 monthscan add singular 10 mg sos if more secretions of mucustry and if not cured can post for further guidence",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sensitive skin, rashes on body, feeling light headed, irregular periods. Reason for rashes?\n\nhi there. I am a 30 year old woman, and out of nowhere, i ve had a rash since March 2012. The severity changes by the day, sometimes i m covered, sometimes just small patches . This is a sudden onset. Now, i ve always had sensitive skin , and i ve recently had an allergy patch test which showed hair dye, nickel, disperse orange 3 textile dye... but, the rash is continual, is there any chance this could be a sign of something going on internally? I m also light headed frequently, along with fatgue, irregular periods and abdominal issues. My rosacea flares to extreme in the off time of the rash. It s always something. My self confidence is at an all time low.",
    "doctor_response": "The symptoms mentioned may be due to thyroid disorder .go for thyroid profile and get treated accordingly.use regular moisturiser and antihidtamine",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can helicobacter pylori cause testicle pain and difficulty in urination?\n\npain in left testicle and when urinating chest pain in left side mainly and stomach pain/tightness, diarrhea starting after taking omeprazole after doctor thought it may be acid reflux however side effects were bad, currently being tested for heliobacter pylori",
    "doctor_response": "Hello, Thnx to contact us. If I am your treating doctor I would like to advice you that Helicobacter pylori is limited to stomach only it has nothing to do with testicle pain and pain while urinating. Yes diarrhea may be possible that to also with the side effect of the drug. But do not discontinue the drug because of diarrhea. ESO Kit might help you, discuss this drug with your family doctor. If you have anything else to ask please contact me. Thanx. Dr. Arun Tank",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does one treat bad breath and gum bleeding?\n\nDear Doctor, My son will be almost 11 in coming August.  He has bad breath inspite of brushing his teeth twice a day.  Also sometimes while brushing teeth bleeds.  We consulted a dentist and he recommended scaling and also advised to apply quadragel for 4 days to take care of gingivitis.  This was done 2 weeks ago but the problem still persists.  Please help. Thanks Leena",
    "doctor_response": "HiWith your query, generally bleeding from gums is due to inflammation of gingiva coz of accumulation of plaque/caluculus/food debris.In your case you have already visited your dentist and the primary treatment was done so nothing to worry.I would suggest you to visit periodontist specialist to rule out the exact cause. Since your son 11 yr old we cannot suspect any systemic complications/disease but is your son having any food regurgitation since bad breath is due to many reasons no need of any local factors it could be systemic diseases like ENT problems/sinusitis/ liver and kidney diseases etc.... so kindly if no systemic diseases are not present then throughly get his teeth checked for any pockets or periodontal diseases.Hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bleeding gums\n\nHi. Im having some problems with bleeding gums at back of mouth when brush with constant taste of blood  for about two weeks and have bad breath. For last couple of days suffered with earache.. Ive always looked after my teeth. Gums still pink. Not sure whether i have my wisdom teeth. What could be the problem. ? Victoria . Age 41",
    "doctor_response": "Hi,Thanks for posting the query,    According to your clinical symptom,s i suppose that you are suffering from gingivitis, i would suggest you to go for complete mouth scaling and polishing. Brush your teeth twice daily with soft bristle toothbrush.At home take antiseptic mouthwash and lukewarm saline rinses.                                Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nosebleeds with clots after dental surgery?\n\nMy daughter had general anesthesia a week ago for dental surgery. They placed a breathing tube in her nose. She had a nosebleed right after surgery (which I expected) but she is still getting nosebleeds a week later, with large clots in her nose. Is this normal?",
    "doctor_response": "HiNose bleed (epistaxis) is normal 8-24 hours after surgery/removal of tube .If it is exceeding the same you should refer to your doctor and i would not hesitate to give you some outline of the procedure that might be done . Your doctor will identify the source of the bleeding . The source of most anterior bleeds can be identified using a headlight and adequate suction.Once the bleeding point is identified, cauterization\u2014either chemical (silver nitrate) or electrical (hotwire or bipolar cautery)\u2014usually provides definitive treatment. If cauterization is unsuccessful, anterior nasal packing is the next step.Nasal packing is the placement of an intranasal device that applies constant local pressure to the nasal septum which works by direct pressure, reduction of mucosal irritation, which decreases bleeding. hope this will be of some help to you . take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my baby not taking food feeling unsettled?\n\nour 13day old baby has been very unsettled today will not be left on their own in moses basket must be on either me or my partner to sleep and is not having feeds an when he does whimper for food he s not drinking it just having a couple of mls an no more not sure what it could be?",
    "doctor_response": "Hi....this could be an initial stage of starting of sepsis in such a tender age. Usually refusal feeds and feed intolerance are first and foremost symptoms of sepsis in this age group. I suggest you take the baby to a physician or Pediatrician and get the baby checked once.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fatigue, malar rash, sores in mouth, suspects lupus. Remedy for fatigue?\n\nI am experiencing extreme fatigue that is unrelenting.  I have an appt. to see a Rheumatologist in October as my primary care MD suspects lupus.  Alng with the overwhelming fatigue I have malar rash, open sores in my mouth, and trouble thinking clearly.  The only way I can make it through the day is by taking 40mg of Prednisone;  nything less is like drinking water.   What if anything can I do to get more relief from the debilitating fatigue?",
    "doctor_response": "Hello,Sores in mouth can be due to A p ht ho us s to ma tit is.I would advice you to avoid spicy,salty foods.Maintain oral hygiene well.Vitamin be cos u l es as well as iron supplements has to be administered.Continue with your corticosteroids .Also monitor your blood-sugar levels.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hearing problems, neurological problems, on Neurobion Forte, Stemetil, Vitamin E Acetat, no help. Permanent cure ?\n\nHi .. I need helps from you. My father is suffering from some neurological problems. He is 72 yrs of old. He had Hearing problems since the last 5-6 yrs and then slowed down in all his activities,movement etc. Eventually, he stopped interacting with the outsiders. Then we felt worrying and consulted with the Neurologist in New delhi, India. Last year Aug (2011), I consulted with doctor and the doctor has informed that my father is suffering from Debantia, a neurological desease. The doctor prescribed Syndopa Plus, Aricept 5mg, Avion,Sea code plus. Since the last one year, my father is taking those medicines. The condition is still remain same (although not detoriating more). Since the last 2-3 months, he is feeling headache and one of his eyes close quite often. Then I discussed one of the doctor and he offered few medicines ( Neurobion Forte, Stemetil MD, Vitamin E Acetat). Now he feels little better since the last 2-3 days. My father is now become irritate since he has to take a lot of medicines on daily. So, could you please suggest how to control this neurological desease or is there any medicines available for permanent cure? Regards, AAAAA",
    "doctor_response": "Permanent cure at this age is bit difficult Actually he is suffering with dementia U should continur the same treatment and with regular follow with neurophysican Just have on ct scan head of ur father And few routine investigation renal function test ECG",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this liver ultrasound report indicate?\n\nRespected Doctor My father age is 69. His Left Lower Lobectomy Lung with Mediastinal Lymphadenectomy done under general anaesthesia on 10.10.2014. His HPE Report is given below: A) Left Lower lobectomy + B) Mediastinal nodes - Adenosquamous carcinoma; 10.5 cm; grade 2; pT3N2M not applicable; Margins uninvolved by tumor; closest bronchial cut margin 0.5 cm; lymphovascular invasion presenr; lymphnode metastasis present (2/10). Please inform me that is he need Chemotherapy ? Waiting for your reply.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Your father's report indicate that he has adenosquamous carcinoma. it is a type of lung cancer. It also spread to the mediastinal lymphnodes. His two lymphnodes get the cancer spread. so he needs chemotherapy also. Consult your doctor start chemotherapy accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a sudden rise in the heart beat?\n\nI ve recently become concerned about my heart. I m a 21 year old, 5 8, 175 pound woman and consider myself decently healthy. I eat well when I can although I do make poor food choices. I am also not very active as I work at a call centre and sit at a desk all day. I don t drink as much water as I should. I have also been smoking marijuana consistently for 6 years, mostly through a glass bong with at least 1 perculator. Within the last 2 years I have been smoking something called poppers , which is a layer of tobacco from a cigarette with a layer of marijuana smoked through a bong. It creates a strong headrush and intense feelings of relaxation, causing me to want to lay myself down as if it was overwhelming my body like heroin (I have never done heroin but I have seen people react that way to it before) I know it is very bad for me because the carcinogens from smoke is obviously bad, especially cigarette tabacco that s mixed with marijuana and only filtered through water, but I want to know what it s doing to my organs and body functions in the long run. The problem is that I don t think there have been many studies on poppers because it is a relatively new and still underground method of smoking marijuana so its hard to find reliable information. Recently my heart has been occasionally feeling strange. I will be relaxed either sitting or standing and breathing and I will breathe out slowly, then feel my heart almost lump up and beat in my throat, it scares me and I take a deep breath in to counteract it, and for a second I almost feel like its going to stop beating. Then its all good again. What s happening to my organs and why is my heart doing this? Thank you for taking the time to read this and reply!",
    "doctor_response": "Hello , The heart beats you are feeling is because of the ill effects of poppers on your heart as the tobacco would make the heart pump stronger and faster giving you the symptoms you have described.  As you have truly said that the effects op poppers haven't been studied however all the ill effects  of tobacco applies here ranging from hypertension , stroke , heart issues , lung damage to various cancers . Also the effect is compounded by weed . It's not wise to use poppers as the sudden surge in body metabolic is not good . Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest a substitute for espogen\n\nhi..my husband's creatinine is 2.7 and he also has cirrhosis of liver...he is 51 yrs.....initially his nephrologist put him on espogen 10000 once a week and has now reduced his dose to 4000 weekly....but in the guld espogen is not available...any other substitute for espogen.",
    "doctor_response": "you can use any erythropoietin generic compound like WEPOX OR ZYROP 4000 unit instead of espogen.you can use darbopoietin alpha generic compound also in 25 mcg subcutaneous weekly dose.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicine for wisdom tooth pain\n\nHHi! My name Nima.age33.I am 5 ,onto pregnant and having pain in my wisdom  teeth. I have shown my dentist she said just gargle with salt water, and can take panadol.  so pls advise as I'm still having pain what can I do? Or any tablet better than panadol can I take for relief. Thanks",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.During pregnancy,it is advised not to take a lot of medicines keeping in mind the effect it will have on the fetus.I would suggests you to carry on your dentist instructions of taking Panadol,as other pain tablets are not advisable .You can take the Panadol six hourly.Do salt water gargling.You may require a dose of antibiotics like Amoxicillin ( if you are not allergic to any medicine and is also safe during pregnancy) on prescription from your dentist. Hope this was useful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain\n\nHi, my mom is suffering from back pain. She is in treatment for the past 1 year..Now she has pain in her thighs and could not move around. we consulted a ortho surgeon yesterday and she is presscribed with tab.myospaz and lyrica for 2 weeks. Can you please let me know what are these tablets for and also it has be 24 hrs now and she is nt releived from the pain yet.",
    "doctor_response": "the tablets are for muscle relaxation and pain relief. i believe you must visit your physiotherapist as soon as possible. it would give her deep heating modality called SWD and TENS for pain relief after which she can follow the protocol for exercise for permanent resolution. medication can only make you pain free temporary if you wish to have right solution then visit your physio ASAP.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stiffness in the neck from sleeping wrong?\n\nI ve been suffering From,what I thought, was a stiff neck from sleeping wrong.Then after a day my ear,jaw and surrounding area became sore I couldn t chew.Then onset of incredibly debilitating headache, on only same side.My right. Now I just was laying on stomach playing with son and .....VERTIGO,Nausea and complete loss of control over eye movement so I had to hold them closed,off&on for a few minutes until things started to ease up. My husband was ,luckily,here yet he was in awe as my eyes darted back and forth with my complete loss of coordination ! I do have heart disease.. Accompanied with mild STURGE-WEBER symptoms...(directly on neck.Thats where PortWine stain is)of veinous issues&lymphatic problems..I.E.HYPOTHYROIDISM. COULD I be heading for a full stroke! Been having weakness &dizziness for close to a month before this started and headaches don t ease up At ALL,LATELY,even with RX for that.please give me advice.!.as I m a bit scared of what just happened.If I had been in a car I would have undoubtedly crashed.",
    "doctor_response": "Hello, It is just a contusion or sprain. Nothing much to worry ma you can try analgesics/antispasmodic like Aceclofenac/Baclofen for symptomatic relief: Generally, the symptoms will settle in a couple of days without complications. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is reason for child s body not accepting medicines for leukemia?\n\nMy nephew is 4 yrs having lukemia found in October 2010. His treatment of Chemo started and now Doctor said to stop the chemo of medicine currently giving after he see a report which is due to methotrexate, and will start again the chemo after 1 week. What would be the reason child s body not accepting this medicine?",
    "doctor_response": "Hi, I have gone through your question and I understand your concerns but chemotherapy is basically a cytotoxic medication that could lead to rejection of therapy in a large percentage of children. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cough , tiredness and soreness in the chest?\n\nI have symptoms of being tired,chest is sore and once in a while I feel like I have to cough to catch breath,like a spasm or something in throat area.also sometimes feel fluttering in belly.....when I was walking this past winter I cold I felt my chest getting very sore while walking...now the weather is warmer and I still feel it,but not as much....lately I feel post nasal drip also",
    "doctor_response": "HelloThanks for your question, I will definitely help you in best possible wayChest pain and shortness of breath is a matter of concern which may be related to heart or lung disease I would like further information to help you betterYour age and relevant medical history?Does it associated with sweating or palpitations?Since how long you have this problem?If I were your treating doctor I would have advised for a battery of tests like blood for hemoglobin,CBC, ESR, liver and kidney function test and an X are chestYou may require a course of antibiotics preferably penicillin group of drugs if you are not allergic to this.You should do gargling with warm saline water or antiseptic mouth washcough syrup with anti acidity and anti emetic drugs are required for symptomatic reliefYou should take deep breathcomplete bed rest,Hope this answers your questionplease feel free to ask for more assistance I will be happy to help you wish you good health and speedy recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat horsefly bitten area?\n\nI got bit by a horsefly yesterday. The area immediately swelled and turned red. After a few hours it looked like it was getting better but last night it got swollen and was swollen down to the middle of my calf. Today no swelling on the calf but still about a baseball sized redmond got area around the bite.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Horsefly bite is going to be heal soon as indicated by decrease in its size. I advice you to take care for wound in means of hygiene, please do dressing and frequent cleanliness.You can take ceteizine and prednisolone under your doctors guidance. It will help your wound to get clear earlier. Because it contains some antigenic material which will be cleaned by antihistaminic drugs.You can use polysporin ointment over the wound. Betadine ointment can help prevent I infection you can also use it.Please avoid injury to the wound part to get it clear early.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does COPD affect pregnancy?\n\nhi i was just wondering my mother is 46 years of age nd thinks she mite be pregnant but is scared that her copd she was diagnosed 9 years ago nd has only had one bad experience with it nd that was when she was diagnosed with it will this effect her pregnancy??",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Yes, COPD (chronic obstructive Pulmonary disease) can affect pregnancy. COPD is chronic, progressive inflammatory disease of lungs. It causes breathlessness, recurrent lung infection, heart failure, arrhythmia, Pulmonary hypertension etc. And all these can worsen in pregnancy. So control of COPD is must if patient is planning for pregnancy or already pregnant. With controlled COPD, normal pregnancy can be achieved. So no need to worry much for pregnancy with COPD if COPD is fully controlled. So be cautious while having pregnancy with COPD. Strict control of COPD is needed to achieve normal pregnancy. Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain when moving. Taken ibuprofen. Difficulty in lowering the head\n\nHi there, I wonder if you could help with my back pain I have been experiencing for about 6 weeks now, lower back pain when moving, not sore to touch, I am pretty fit, have done yoga to see if it eases, I have to take lots of ibuprofen before and after any exercise, even if I rest it hurts, I am 43 years old, I surf, run, go to a gym regularly, and swim and do yoga, anything I do hurts at the moment, when I lower my neck there is an excruciating pain in my lower back. Any help would be great, thanks",
    "doctor_response": "Hi, Dmorgan, Thanks for query, It seems that you are having some degenerative changes like osteoartheritis changes in your vertebral column giving rise to this problem. Go for x ray lumbo sacral region and find out the cause. If there is osteoartheritis then consult orthopedic surgeon and seek his advice. Physiotherapy will help a lot. Ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a knot in the chest close to the breast?\n\nI am 22 years old and I have a knot on my chest next to my left breast.  I have had it for well over a year but sometimes when I do certain things it hurts. At first I thought it may be a calcuim deposit but then I wasn't sure if they form there. I am lactose in tolerate so I dont drink and eat milk products as I should. Also a little over a year ago I started drinking pop again. I drink  way too much mountain dew and plan to stop drinking pop after the new year. I wasn't sure if this could have something to do with it or not.",
    "doctor_response": "Hi,Dear,Thanks for your query to HCM.Dear I read your query and reviewed it with context to your query facts.I understood your health concerns and feel Concerned about them.Based on the facts of your query, you seem to suffer from-?Fibrocystic Adenoma in axillary breast.Mostly from MOuntain Dew,high content bromine intake.Some report confirm correlation in these 2 and hence I  would suggest you to stop pop which leads to Mountain  Dew in your case.Hope this reply would help you to plan further treatment with your family and specialist doctors there.Take care and get healthy and avoid bad food to live long.Welcome for any further query in this regard.Good Day!!Dr.Savaskar M.N.Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How is an electrophysiology study done for arrhythmia?\n\nA friend is experiencing arrhythmia and is scheduled for an EP study to determine whether she needs another ablation.  The left ventricle is the source of the arrhythmia.  What kind of study is an EP? I don't have enough firsthand INFORMATION TO GO FURTHER.  tHANKS-",
    "doctor_response": "Hello, Yes, an electrophysiological study was done for arrhythmia. In this study, local anesthesia is given and the catheter is inserted. The electrical conduction is studied on the computer. Palpitation is induced and the patient is asked for where is the pain. If the arrhythmia is found then they will do an ablation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Penchila Prasad Kandikattu, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in right side of abdomen\n\nI woke up this morning with pain in my right side, abdominal area, it is very extreme when I take a deep breath, cough, sneeze, or laugh. It is tolerable when I am sitting, but it is very painful when I stand or walk and somewhat more painful when lying down. I have had my gall bladder removed already and I know from recent blood tests that I have a very fatty liver that I m awaiting to see a specialist for. Should I go to the ER? Or should I just call my doctor tomorrow morning?",
    "doctor_response": "Hi.Thanks for your query.You should immediately go to ER.The pain in abdomen which increases on all the activities you say is an indication that there is a severe process of inflammation going on either in the abdomen like appendicitis, right kidney abscess or some problem in the lower lung or pleural cavity. You need urgent investigations:\"*Hemogram, urine tests.*ultrasonography*X-ray of chest.You need an admission:Intravenous fluids and antibiotics. Proper diagnosis And treatment as indicated by the investigations",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause for the outbreak of molds?\n\nin the past 90dys.molds just poped up all over my back,face, and neck ;they are getting worse each day and my hair fell out completly and will not grow ive used all types of hairgrowth products.my question is what causes such a outbreak of molds to appear on my face and back so rapidly and what can I use or do to get rid of them.",
    "doctor_response": "Hi,Welcome to HCM.Fungal infections of face, neck and back are commonly caused by dermatophytes and are termed as tenia or ringworm infection. These infections are easily treatable by very good antifungal medications available now a days. I suggest you get those rashes examined by a skin doctor for confirmation and get a fungal culture done. Get a prescription for antifungal drugs which should be taken for at least 6 weeks to 12 weeks. Fungal infections of skin are more common in persons with unmaintained personal hygiene and also in chronic illnesses. If you feel that fungal infection is getting worse then causes for immunocompromise like diabetes, prolonged illness, malnourishment and HIV have to be ruled out.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for malocclusion of teeth in a child\n\nMy daughter is 5 years & six months old. Last week we saw a new teeth growing at the back of one of her lower milk teeth. i took her to clinic and they moved it out. but the new one is  not at the right place. so waht would u advice me to do to make it grow in a proper place. thanks",
    "doctor_response": "Hello,Often the lower front adult teeth erupt behind the primary teeth. The position will change as the teeth fully erupt. The jaw continues to grow as the teeth are developing. Children can have an early orthodontic consult with a specialist for evaluation for the need of braces. There are interceptive treatments that include placement of a bar to guide bone growth or retainers to guide teeth. The orthodontist will advise and keep your child on a recall for the best timing of placing braces if needed. In general, braces are not placed until the primary teeth are gone and adult teeth are present. I am glad that you are aware of your child's tooth development. You should plan on routine visits with your dentist for your child. I monitor tooth development and eruption sequence for my younger patients. When I see misalignments, I will suggest an early visit to the orthodontist.Thank you for your inquiry. I hope my explanation is helpful to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for spherocytosis\n\nI have a 13 year old girl who has been recently (December 2010) diagnosed with spherocytosis, multiple stones in the gallbladder as well as a large spleen ( 15x6.4cm) by ultrasound. Various doctors in Cyprus advised us that these two organs need to be surgically removed where as other doctors advised us that removal of the spleen would not be necessary. We already went ahead with the removal of the gallbladder in February 2011, however we are now in a dilemma on how to proceed with the  spleen. 10 days ago we checked the spleen (by ultrasound again) and the result showed that the spleen is now 18cm and increase of her liver to 16.2cm.",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Splenectomy is the specific cure for spherocytosis. Removal of spleen reduces hemolysis and there will be usually no more complications2. No, there are no other methods at present.3. Yes, it is possible, based on how much it is congested with RBC4. She will require capsulated organisms vaccination. Otherwise, she can lead a routine life.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent right sided pain below the ribs?\n\nfor the last 2 weeks have had a nasty sharp pain just under the right side of my rib cage. Pain constaint at about a 4-5 with spikes up to 7-ish. Hurts no matter the position my body is in. I have been fighting with a nasty case of bronchitis but this seem to be separate.",
    "doctor_response": "Hello,I have gone through your questions.if you have a bronchitis in past than kindly have an opinion from your doctor about this right side pain.it may be due to pleaural effusion or pleuritis.Have a better health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain with a lump post surgical abortion procedure?\n\nI just had a surgical abortion around 10am this morning. After the procedure is have had mild lower stomach cramps. About 2 hours ago the pain worsened and shot to my lower left quadrant above my hip bone. There is a large lump present that can be felt by touch and is visible",
    "doctor_response": "Hi.Thanks for your query.Noted the history and understood your concerns.As per the history your have provided, surgical abortion may not be directly related to the lump that has formed. This is a very very rare occurrence and hence needs to be addressed immediately by a CT scan of the abdomen and the abdominal wall to see if this is hematoma that is spreading from the operation site or a hernia that was not recognized and so on.Pain in abdomen that is spreading to the left lower quadrant can be due to the same reasons. Further management may be an emergency matter hence stop anything orally till advised by your Doctor or nurse.Take pan-bed rest till well diagnosed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes neck pain, continuous shaking of neck and vertigo?\n\nI have been experiencing vertigo for the past 2 weeks. I was given antivert and took it for nine days. My primary physician suggested not to take the meds when I returned to work to see what would happened. After 4 days, the vertigo returned. I had a cervical fusion in 05, including a plate and several screws. I believe there is a relationship between my neck pain I'm  experiencing (due to the surgery) and vertigo. Please help me. I'm a 53 year-old teacher. My neck is constantly moving from left to right, up and down. Should I seek a neurologist? Thanks, Cheryl from Euclid, Ohio.",
    "doctor_response": "Your symptoms are likely to that of BPPV. You should consult a physiotherapist and learn some exercises to prevent BPPV.  An MRI gives a detailed view of it.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is Mometasone dangerous to use on Face to clear my acne pimples?\n\nHello doctor, I am seriously facing acne pimples problem. Sometimes they occur on my face when I masturbate. If I use Mometasone, it gives a good result. Is it okay to continue this?",
    "doctor_response": "Hello. Acne is a universal issue in the age group of 15 to 25 years due to hormonal changes in adolescents. However, there are multiple effective treatment options depending on the grade and severity of the problem. Mometasone is a topical steroid and is to be avoided strictly on the face and for acne as it can harm your skin in the long run. Acne is dependent on hormones hence excess masturbation may sometimes lead to an increase in the problem. I would advise you to stop Mometasone immediately and kindly upload appropriate images to help us assess your current grade of acne and treat you better. Regards. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have light and short menstruations, kindly help\n\nSince august I have light and short(1-2 days) menstruations.But this month I had heavy menstrual bleeding all five days.My menstruations are so painful. Now im under stress ,I have depression . So doctor, can stress and depression to be reason of heavy menstruation this month? What natural home treatment can you to recommend me for painful menstruation , heavy menstrual period? What natural treatment for depressionn and stress do you know and can to recommend to me ? Thank you for your help",
    "doctor_response": "Take Tab. Restone (maharshi Ayurveda) 1 tab thrice a day Syr. Amycordial 10ml thrice a day for 3 mths Your problems will be solved",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe weakness and typhoid fever\n\nI suffered from typhoid 20 days ago.it was cured and I began to work as per my daily routine. I didn t felt weakness for 15 days but I got fever again and felt weakness to the great extent.now I am not able to get up from my bed but not getting any fever. Plz suggest if there is any concern and the period for weakness??",
    "doctor_response": "Hi thanks for asking question.You are recovering from typhoid fever.Total improvement sometime takes 1 month.The antibiotic course should be for complete duration.In between proper nutrition has to be maintained with more fruit juice and semisolid diet.Take small meal with frequent interval.Avoid outside food.Avoid excess spicy food.Drink more water.Food with high protein helpful like egg.You just check  that cefixime like drug taken for minimum 10 days or not otherwise incomplete therapy may lead to carrier stage.For relief from weakness maintain healthy nutrition suugested above.Dont worry.If still no improvement then carrier stage has to be thought.I hope you understand my concern.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat lesions on face,body and scalp?\n\nDear Dr I am a patient of PV for the last 3 years with hypothyroidism for the last 6 years. I am presently on 15mg Predesolone+100 mg Azithroprine+188mcg thyroxine+1 shellcal + Multivitamin+ Vitamin E + VIT D weekly. 3 years before when I was diagnosed PV I was given 32mg Methylpredesolone which was tapered from time to time over about a year and when completly stopped it relapsed after a fortnight. Again I was restarted with 48 mg Methylpredesolone which is now tapered to 12mg + 100mg Azithroprine (50mg morning& evening). At 8mg methylpresolone+ 100mg Azron my I did not get any lesions for about a month but all of sudden there were several lesions on face, body & scalp. Then I consulted other Doctor who administred me 140g IVIG. After IVIG my lesions were reduced, my skin health improved and itching disappeared altogather. After about a month of IVIG again 7-8 lesions appeared and was put on 30mg predesolone {instead of Methyl)+100mg Azron which is now tapered to 15mg Predesolone+100Azron. I am not getting any lesions now for about 2 weeks and my Dr is suggesting to taper it to 10 mg which I am doing from tomorrow. He is also suggesting 2 infusions of Retumbix 0.5g each over a gap 15 days each & thereafter 1 more infusion of IVIG ne month thereafter. Now I request you to please suggest the best course of treatment. I am 60 yrs old male with 5 -2 height & 72 kg body weight, with hypothyroidism. With regards skk",
    "doctor_response": "Dear SKK, its really a pressure upon you to gulp so much of medicine, which I would not like my patients to continue for such long, lifetime.You can't stop it either. I would rather suggest my own such patients to get support of pure herbals to gain some resistance against disease. To start with Turmeric, Holy basil leaves, Manjishtha, Neem powder, Amalaki and Guduchi alone would help you a lot. But may be its slower in action. But what did you gain after getting so many fastest acting medicine. Even if you have to take slow medicine for life, what's the harm when there's no side effect, no interaction with drugs. But you will find in few weeks what benefits you will gain in few months ahead.If you are in India, you get all the herbs at some Pansari shop i.e. herbal grocery shop. Get all these - clean, grind and mix in equal ratio. Takw with pure honey if not diabetic. Otherwise with water. We may also help you in getting these if you so desire. Globally you may get capsules of many cos containing extracts or powder of these herbs. I prefer Himalaya's pure herbs series.For any other query, pl write direct question. I want that you must start taking support of these herbs. In few weeks you will start realizing the benefits. These all will not only detoxification, cure but also raise your immunity.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does in wrist & jaw with rise in CRP levels suggest fibromyalgia or arthritis?\n\nIn the past 6 months I have experienced bilateral hand pain and wrist pain. In addition, I have long term shoulder pain, jaw pain, and some knee pain. Rheumatologist said I had fibromyalgia, but i fear it is really rheumatoid arthritis. RF, CCP, ESR, LUPUS ARE NEGATIVE. slightly elevated CRP now and in the past. I feel lousy!! any thoughts? 63 yr old female",
    "doctor_response": "Hello,I can understand your concern. As your tests show negative for RF, ESR, CCP, Lupus, you do not have rheumatoid arthritis. I can describe you how you can differentiate between arthritis and fibromyalgia. Arthritis is a degenerative joint problem associated with the aging process. It is related with the bone pain. So if you think that the pain you have is increased while having joint movements or the joints make sounds while moving them, then you have osteoarthritis.Firbomyalgia is a disorder associated with muscles. Joints or bones are not involved in this pathology. In addition, this disorder is associated with sleep problems, excessive fatigue, and specific trigger points which will start or increase pain in the muscles. In addition, if you will stay inactive, sit in a place for a long time or after waking up from sleep, you will feel the joints are unable to move and then eventually it will improve.However, both diseases will require long term analgesics to control pain. You can visit a pain clinic or neurologist for alternate ways to manage pain.I hope this information helps. Thank you for choosing HCM. I wish you feel better soon.Best,Dr. Viraj Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "One pupil larger than the other, have had costochondritis, been stressed. Cause?\n\nHi. I only noticed about 2 weeks ago that my left pupil is larger than my right pupil. I have had costo chondritis, fibre maliga since 2010, just had a stress test and heart alright. I haven t been able to read signs unless ontop of them or read tv guide on tv, or see peoples features since last April. The pain from these costochondritis attacks almost cause convulsions. Medication changed and pain better now, but do the difference in pupils relate to any of the above or what is the cause? Thank you",
    "doctor_response": "Hi there ~ A difference is the size of pupils is not uncommon.  It is also not affecting your vision and so I would advise to stop worrying about the size of your pupils.  I am sure it has also not come up in normal conversation.  I am glad that your stress test was negative and your costochondritis is also better.  If your fibromyalgia is giving you problems, I would advice you to see a qualified psychiatrist.  Deep breathing and relaxation exercises are helpful in these situations. Take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest methods to control blood pressure\n\nMy husband has had a whipple operation in the last four years and has passed several kidney stones and had kidney infections.  Today he is feeling lightheaded and his blood pressure is 111/63 and pulse is 69.  Is this an ok number for a 63 year old man>",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!Regarding your concern, I would explain that these blood pressure values are quite normal.Anyway, it is normal to have a lower blood pressure after surgery, due to the bleeding or lack of physical activity. Anyway, if his blood pressure values keep dropping in the next days, I would recommend consulting with his doctor or going to the ER for a complete blood count, to exclude possible anemia. Meanwhile, it is necessary having some rest and take plenty of fluid to stay well hydrated. Hope you will find this answer helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having spotting randomly every few days after abortion. Please advise.\n\nHello doctor,I had an abortion four months back. My period returned seven weeks later and ever since then I have been spotting randomly every few days. I was 13 weeks pregnant at the time of the procedure. Is this normal? If not, what could it be? There are no other symptoms aside from very very light cramping. Previous history of the same issue: I did have the Nuvaring before I got pregnant and was taken off of it due to an estrogen-induced stroke. I then tried the mini pill. Current medications: Sertraline.",
    "doctor_response": "Hi. Please ensure if you had a complete abortion or there are still bits of retained products of conception in your uterus by doing a transvaginal scan. Since it was a second-trimester pregnancy, there may be chances of RPOC, which can lead to irregular spotting or bleeding. In such case, you may need a D and C (dilatation and curettage) to get rid of RPOC. Secondly, Sertraline reduced the efficacy of birth control pills, and hence failure rate increases. So ensure to take additional precaution using condoms, if possible.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pinched nerve and degenerative disc disease\n\nI have been told that I have spurs in my back as well as degenerative disk dieses, as well as several pinched nerves. I have been told that I need a doctor of my own however I have no insurance. I have a hard time standing for a long period of time, I cant get comfortable to sleep. I am at the end and cant deal with my pain. what can I do?",
    "doctor_response": "hi,thank-you for providing the brief history of you.A thorough neuromuscular examination is advised followed by an MRI of the spine.As you have severe pain which is due to nerve impingement I will Advice for a thorough neuromuscular examination and find out what muscles are weaker.Usually due to the weakness of the muscles in the spinal column the vertebral bodies leaves it's anatomical position and leads to compression on the disc and the disc inturn will lead to compression on the existing nerve roots.Along with simple pain killers and physical therapy you should respond well. In my clinical practice most patients are referred to physical therapy for nerve impingement and along with therapeutic ultrasound therapy and TENS therapy there pain levels and inflammation is reduced. Post which exercises are implemented leading to strength in the spinal muscles and core muscles. This helps to avoid the compression and also the anatomical position is back for the vertebral bodies so the compression from the nerve root is relived.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bruises on the thigh\n\nhi I m a 16 year old girl I ve been battling a cold for the past 4 days with dry cough, little sore throat and hoarse voice. I recently noticed two circular bruises on my left thigh near my knee. They re dark purple and the size of a dime. I don t remember any possible way I could ve gotten them. One of them hurts like a bruise but one of them doesn t hurt at all. I m just a little worried because I have been reading so many things on random bruises and it s scaring me. should I consult a doctor right away? Or wait? And if I do wait when should I go see one for sure? Thanks",
    "doctor_response": "Hello, I have gone through your query and bruises could be due to some unnoticed trauma. Keep them under observation. If it recurs then consult a doctor and get it evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Asmeet Kaur Sawhney, Dermatologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having abdominal pains for a long time. Now getting worse. Feels very hard inside. Critical?\n\nEver since I can remeber I used to complain about upper somach and abdominal pains. They can get worse sometimes, but now they are bad. My stomach has been hard for a while. IT feels as if i have little rocks inside and a big rock or something hard sprt of popping out and as i press my stomach its hard. Is this something critical? Or what can I do to help myself?",
    "doctor_response": "Hello, Thanks  for the query to H.C.M. Forum. History is  not clear. Pain in stomach with pain in abdomen from long time.But from , how many years ( as you mentioned that as you remember).Age, gender,tests reports , if any, However as  you are  complaints this pain may be due Hyper acidity and gastritis. Worm infestation,Amoebic colitis , are the other causes of pain abdomen.Consult  a physician and get in complete examination as ULTRASOUND, blood, gastroscopy. Physical examination by  a consultation will reveal many things. Hope I have answered  your question. If further any question I will help. Best wishes, Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling pain in penis and difficulty in getting erection?\n\nFor some reason last night I had a hard on. I was lying on my bed ready to sleep when out of nowhere I felt a slight tingling pain in my penis and it just went limp. After noticing that I could not get an erection anymore I stood to check and to my surprise no matter what I did, I could not stand. I have been depressed the whole night and I could not sleep because I was so worried. I am only 20 years and I have never had sex, I just want to know what is going on with me, if it is Erectile Dysfunction or just me tired of masturbating. I do masturbate a lot about 2-3 times a day almost everyday. I just want to know what is going on and please any suggestions to get myself to better health again... thank you",
    "doctor_response": "Hello welcome to Health Care magic.1.Not to worry at all, does not feel like a serious issue.2.Its no erectile dysfunction because you are giving history of masturbation.3. The above things might happened because of your excessive masturbation, out of stress.4. If you still feel discomfort and things repeating - go for checkup.Like to ask ? Do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for Microvascular ischemic disease\n\nMy daughter is 41 & was just diagnosed with Microvascular ischemic disease. Where do we go from here? She isn t overwt, doesn t drink or have any other diagnosis. Her cholesterol has always been WNL s. She was to her primary care provider because of headaches for the last 2 months.",
    "doctor_response": "Hello, Microvascular ischemia is a radiographic finding that shows as very small \"dots\" or \"spots\" on the image of a brain scan which is usually an MRI. Such a condition is NOT UNCOMMONLY seen in normal subjects without any history of medical problems or complaints just based on normal aging (20-35% in HEALTHY SUBJECTS). It represents the aggregate result of microscopic blood vessel deterioration causing the tiniest amounts of deprivation of oxygenated blood to brain tissue. This is generally NOT A PROBLEM and is not likely to lead to what most people understand as SERIOUS STROKE unless being caused by things which can lead to strokes if not truly controlled such as HYPERTENSION, DIABETES, SMOKING, etc. There are multiple associated conditions with this entity (aside from what I just mentioned) such as high cholesterol, aging, atherosclerosis, heart disease, atrial fibrillation, and the list goes on and on. There is no definitive treatment.  Neurologists tend not to get terribly excited when this read is made since treatment is generally directed at RISK FACTOR CONTROL or the condition is SEVERE in its amount of brain territory covered (which the radiologist will usually say in the report). I try not to prescribe anything for the most part since there are risks to taking things such as aspirin, Plavix, or Aggrenox (the most commonly used agents) and again, if the person is otherwise healthy and the finding was incidental I simply educate the patient as to what it means and how best to control associated risks as those listed above. Here's a nice little article you may find helpful  Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes atherosclerosis?\n\nMr. T., a 45-year-old black male employed as a midlevel corporate manager was seeking a physical examination. He appeared somewhat overweight. He denied taking any medications or smoking, but admitted drinking alcohol. His father and older brother have hypertension, and his paternal grandfather experienced an MI and a CVA at a young age. Mr. T. stated, \u201cA year ago at a health fair, my cholesterol was tested. I was told later by mail that my cholesterol was 250.\u201d What lab tests are indicated? What other questions should be asked of this patient? What are Mr. T\u2019s risk factors for hypertension and coronary artery disease? If Mr. T. showed a high level of intellectual curiosity, and kept asking questions, how would you explain the pathophysiology of hypertension and coronary artery disease to him? How does atherosclerosis develop?",
    "doctor_response": "Hello!Welcome to Ask a Doctor service!I understand your concern and would explain that atherosclerosis is a gradual process. Arterial hypertension and dyslipidemia are independent risk factors for atherosclerosis, which increase its speed of development. From the other hand, atherosclerosis can lead to gradual blockage or the coronary arteries and brain arteries and increase the risk for coronary artery disease or stroke. That it why it is necessary to periodically check your blood lipid profile, a resting ECG and Doppler ultrasound of the carotid arteries. Hope to have been helpful!Wishing good health, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to use combitied inhaler when having MVPS?\n\nHi, I am diagnosed with MVPS and I am taking Ciplar LA 40 (once a day). For the past 4 - 6 months i had wheezing periods once in 2 months.I had been consulting a Asthma specialist who tried lot of treatment and atlast he prescribed me with Combitied 250 inhaler. Is it safe to take the inhaler as I am having MVPS",
    "doctor_response": "Hi,ToIt is not safe to use combitied-250 inhaler while one Ciplar LA-40. Based on the history the symptoms of wheezing seem to be due non-selective beta receptor blocker Ciplar. If you start using Combitied inhaler while on Ciplar you may not get relief from wheezing. So, ask your doctor for an alternate effective but a safer medicine for MVPS instead of Ciplar so that wheezing will not occur.Hope I have answered your query. Let me know if I can assist you further. Take care.Regards,Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any medicine for facing puss discharge problem from left scrotum?\n\nhello doctor I am facing puss discharge problem from my left scrotum since last one year of my operation. Recently i am facing problem with right scrotum which became hard due to infection. doctor stating me to go for surgery is there any medicine which can avoide surgery yogesh",
    "doctor_response": "Hello,Thank You for consulting HealthcareMagic!Physical examination is mandatory to assess this since there are variety of other causes that needs to be ruled out. Infection can be managed by broad spectrum antibiotics but to assess the need to surgery, actual diagnosis needs to be established for which investigations like ultrasound are necessary.Stay healthy and thank you for consulting! You can contact me again anytime, if you need clarifications or further assistance in future. Kindly rate the answer if you are satisfied.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does my chest hurt on moving my torso?\n\nMy chest hurts a lot, if I lift my hands or move my torso it hurts like muscles are tearing apart surrounding my ribcage, also if I push the upper central part of my sternum its similar to the pain but slightly less hurtful, what seems to be the issue here?",
    "doctor_response": "Thanks for your question on HCM.In my opinion you are having musculoskeletal pain only. But as a rule in chest x ray we have to rule out cardiac cause first. So get done ECG to rule out cardiac cause.If this is normal than it must be musculoskeletal pain only.Try to follow these for better relief.1. Avoid strenuous exercise. 2. Avoid heavy weight lifting.3. Avoid bad postures in sleep.4. Take good painkillers and muscle relaxant.5. Apply warm water pad to affected area.6. Wear chest belt for minimal mobilization of painful site.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for abdominal bloating\n\nFor the last two days I've had considerable bloating, mainly in my lower abdomen with some upper too.  I have not felt nausea just pain from bloating.  Every move I make hurts my stomach and feels like a knife jabbing at me.  I've noticed my stools are light in color and loose but only once a day.  I've taken simethicone with little relief.  I'm also experiencing a yeast infection.  What can I do to get rid of this pain?",
    "doctor_response": "Hi! Good morning. I am Dr Shareef answering your query.If I were your doctor, I would advise you not to eat any outside food specially the fried, oily, spicy and fast food kind of food as these might bring in intestinal infections giving rise to your symptoms, apart from your intestinal mucosa being sensitive to many constituents of such outside food. I would advise you for routine stool test for ova and cyst to rule infections out, and treat them if positive. Apart from that, I would advise you to add more of roughage and enough liquids in your diet along with a routine moderate exercises depending on your physical fitness.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting after eating?\n\nHi...My daughter is 11 months old. Since yesterday night she is vomiting what ever she is taking in ..including mother s feed.Doctor has prescribed Zinconia 2.5 ml ...we have given 1 dose but the same is not helping and she is still vomiting anything taken.She has also got loose motion now.Looks a little feverish too.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron (as prescribed by your paediatrician).Regarding diet - You can use cerelac...any flavour will do. Avoid fruit juices as they might aggravate diarrhea. You can give zinc supplements & ORS apart from normal vegetarian porridges & soups.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for chest pain and fatigue after radiation therapy?\n\nmy spouse had stage 3 thymoma resection in july with radiation therapy and was feeling little better. for three weeks now he has been experiencing the constant chest pain, shortness of breathe, fatigue just like when the tumor was discovered. His radiation oncologist doesn t seem concerned however it went from stage 2 to stage 3 mastatis in four months. How concerned should we be of this reoccurring or moving to another location while we are waiting to get his routine ct scan? I have been told that it can move to the brain and he has been experiencing more than normal memory loss for a 49 yr old men.",
    "doctor_response": "Hi,Thanks for writing in.It is unfortunate to know about the disease progress and discomfort in your spouse. Thymoma responds the best to radiation treatment and he is getting treated regularly. It is important to know the field of radiation and any chemotherapy that was given to him during last few months. There are certain medications that are toxic to the lungs and might cause lung fibrosis. A CT scan is a must to assess any lung changes due to chemotherapy and radiation. Any spread of disease must also be evaluated in detail.It will help if he also gets a brain scan to know if there is any condition that is causing loss of memory.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of the anxiety?\n\nThank you doctor, and I appreciate the quick response. Like stated earlier, I ve always had a fear of the doctors. Whenever something I thought was seriously wrong I always confided in my mom, and she would always reassure me that I would be ok. She was right 100%. Now that she is no longer here, I have nobody to go to, so I appreciate you understanding where I m coming from. Four years ago I was diagnosed with a slight thing of anxiety. My doctor prescribed me alpralozam. The pills expired in 2012. They helped cause they just took the edge off. My grandmother, grandfather, uncle, and mom have passed away within these past 3 years. It s too much to handle all at once. They all went into the hospital, and never made it out, so that s the way my mind thinks. I think if I go into the hospital, that I ll never make it back out. Yes, I know it sounds crazy, but that s how I think. About a month ago I had this slight pain between my thumb and index finger. Again, nothing serious, probably just a bruise, but I took it to the extreme. First thing I did, was search up online if there are glands in your hands. Of course there are, so right away I think it s a swollen gland and something is wrong. I worried about that for a couple days, and must have tensed myself up so bad that my fingers started to ache and hurt. So, right away I start thinking the worse. Why are my hands and fingers hurting now. I worried about that for a week. Sure enough the pain between my thumb and finger, went away. This brings me up to now, where I must ve worried myself so much about my fingers and hands that it cause what I hope is anxiety. About a week after all of this happening, I woke up last Saturday and stood up and felt like I was off balance. Nothing serious, figured it was just allergies. It got better throughout the day, and would come and go. Again, thinking crazy, got it in my head that it was something serious, like a brain tumor, brain hemorage, etc. I would constantly search up symptoms of all those things and worry myself day in and day out. This past Monday, 2 days after this occurred I sucked it up and went to the doctor. She checked me out. My BP was 115/75, my lungs and heart both sounded good. I explained this situation and she said to just relax myself. Once I left that doctors office, I didn t feel a thing. I felt like myself. Sure enough, as time went on, that feeling came back. It sucks and I hate it. That s how this whole past week ",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. I can see that you are suffering from health anxiety disorder, referred also as hypochondiasis. You are obsessed yourself with health problems as you are already aware. But you can also notice that these obsessive thoughts comes only when you are not busy. Once you are busy, you do your job, not thinking. You shall need occupation therapy and Cognitive Behavior Therapy and your problem is hundred percent curable. Understanding life and learning how to enjoy life are the keys. You can learn these by observing your past experiences, elders, surroundings etc. You can also visit a psychological counselor for further advice.If you feel that I can be of help to you, feel free to post a direct question to me and am obliged to serve your cause. I shall prescribe Cognitive Behavioral Therapy techniques tailor made for you to clear your problems.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of getting breast cancer after milk ducts removal?\n\nHi, may I answer your health queries right now ?  Please type your query here... I have the milk ducts removed from my right breast 4 years ago because of a bloody dishcarge, then 2 years ago I had a bloody discharge and lump in my left breast and then had a mastectomy.  My question is - can I get cancer in my right breast now that the milk ducts have been removed",
    "doctor_response": "Greetings. I appreciate your concern. If the earlier diagnosis was of cancer then there are chances that u can get a recurrence of cancer. Otherwise there is little or no risk of getting cancer. So you need not to worry.regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedy for cough and cold during pregnancy\n\nHi,My wife is 9 month and 14 days pregnant and from today morning she is having cold and cough. We would like to avoid taking medicine and we are looking for some alternative home therapy that can be given at home for this cold and cough.Please suggest! She has border line high BP also, currently under medicine. Not sure if this information would be relevant for above issue.",
    "doctor_response": "hai,for common cold and cough depending upon the severity medication is needed.if she feel severe nasal congestion and persistent cough medication is much needed one. try with following home remedy:\u2022 Two tablespoons of fresh ginger extract added to hot water and consumed frequently helps  cold and sore throat, symptoms. add lemon juice too.also1 gm of pepper(stimulant) with honey (natural cough reliever) will give you cough relief.Add plenty of liquid daily.If the severity is not improved consult the physician to treat the condition.Borderline high BP is okay as of now.(physiological)thank youHope i answered your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pus filled pimples on my wife's forehead?\n\nIts about my wife. A couple months ago she had an injury after getting a microdermabrasion treatment on her chin. The injury became infected and she was prescribed antibiotics. This seemed to be clearing things up. But over the last week or so it seems to have come back. This time its not only on her chin but on her forehead, back, chest arms, legs.  There are a bunch of sores which first appear like pimples but then turn into open sores with puss that bleed. What could this be? She will see her doctor Monday but we were just dismissed outright at a dermatologists office and the diagnosis - picking and scratching. The dermatologist however, did not know about the original injury and infection from med equipment because he would not let my wife explain. Was he correct?",
    "doctor_response": "this is the classic case of staph skin infection on the skin. you need to check her vitals like temperature and heart rate. if they go up then it means the infection has spread and immediatly needs hospital admission and intravenous course of antibiotics. conditions like these are commonly seen in dermaabrasion treatments.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does pulmonary tuberculosis with cicatricial changes rule out physical fitness parameters for employment?\n\nMy xray result is Suggested pulmonary tuberculosis with cicatricial changes. Are still fit to work? Is it curable? Xray says there are minimal fibrotic and coarse reticular opacities in the left upper lobe with associated slight superior traction of the hilar structures Rest of lungs fields are clear Heart not enlarged Trachea is midline Costophrenic angles and hemidiaphragms are intact Osseuos structures and sift tissues are unremarkable The impression is suggestive ptb with cictricial changes. Correlate with clinical and lab parameters",
    "doctor_response": "Hello,As per x-ray report tuberculosis is present. For its confirmation, I will advise investigating with sputum examination acid-fast bacilli (AFB)stain and culture for tuberculosis confirmation.If tuberculosis confirmed, then AKT needs to be started for six months. Consult pulmonologoist for examination and start AKT accordingly than after. Hope I have answered your query. Let me know if I can assist you further.Regards,\u00a0\u00a0Dr. Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for chest discomfort,palpitations and discomfort\n\nI started taking a beta-bloker (for almost 1year and half) due to some frequent premature atrial contractions. Lately I'm feeling lighteaded, dizziness and tired, any activity like climbing stairs or even some emotional stress are the perfet trigger to some chest disconfort, palpitations and exhaustion. Do I need to go to the doctor? Can this be a side effect of beta-bloker? Can this be just anxiety?",
    "doctor_response": "Hi There\\Yes lightheadedness, dizziness, fatigue these all could be due to low blood pressure which could be caused by the beta blockers.Yes palpitations can very well be triggered by emotional stress.Its advisable that you should consult a cardiologist personally and get yourself properly evaluated.I wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sting like pain and blue discoloration at joint beneath toe?\n\nsudden sharp pain like wasp sting or spider bite. shoes on at time,  dark blue discoloration of toe at joint beneath toe gradually spreading to neighboring toes as if briuised  - pain was transitory not due to impact or stress, not tender to touch, no visible punctures, not distended or firm,",
    "doctor_response": "Pain and dark blue discolouration of toe suggests decreased blood flow to that part and as a result poor oxygen supply to the nerves and tissues there. It may be triggered either by exposure to cold (Reynauds phenomenon) or a peripheral arterial disease fi you have risk factors like diabetes, hypertension/chronic smoker. Both of this needs complete clinical evaluation and you need to meet a doctor and might have to do some tests",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and swelling in the arm?\n\nEarlier today i was at work spraying sanitizer out of a spray bottle when my middle finger on my right hand got locked down and it was really hurting my arm. i tried and tried to move my finger up and it wouldn\u2019t work. i had to forcefully open my finger with my left hand. and when i looked at my right arm it was really swollen. the swelling has gone down but when i make a fist with my right hand it hurts my whole forearm, what is going on?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The pain and swelling in the arm can be related to local inflammation like tendonitis or a muscle spasm. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can swelling in the ankles be reduced?\n\nAfter traveling for 13 hours, flying and driving for 6 hours, my ankles are very swollen. I have had long days of traveling before; however, this swelling has not happened previously. Other than elevating my feet above my heart what would you suggest to reduce the swelling. It is now 24 hours after the traveling. Thank you.",
    "doctor_response": "Hi, It is quite common after prolonged immobilization. You can apply compressive stockings during flight. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the painless lump on the tailbone?`\n\nI had fallen off my horse two weeks ago, ended up having x-rays swelling was extreme around my tailbone and the bruising it caused was massive, again two weeks ago, bruising is gone, just about but I have a lump which doesnt hurt if pushed on but is located around my tailbone probably the size of a half a grapefruit, is this water and will it go away given time... or do I have to have it drained possibly... My ex-rays showed no chips, or breakage...",
    "doctor_response": "Hello!Thank you for the query.This lump is probably a hematoma. Due to injury some blood has accumulated under the skin in the soft tissues. Such blood collection if large can not get absorbed or disappear by itself. That is why you should consult a surgeon and have it drained. In case of doubts, ultrasound should be done.Hope this will help.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness with pinkish rash on the body?\n\nHello I have been feeling very dizzy for a few months now, aswell as being very tired all the time no matter how much sleep I get. I also have a rash that started a few months ago and is now spreading. They are pale pink blotches scattered around my body. Do you have any idea whats wrong and should I be worried?",
    "doctor_response": "Hi, You could be having an underlying disorder and I feel that the skin lesions could be a manifestation of underlying disease. I advise you to visit your Physician immediately for proper diagnosis and treatment. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On IVF recently. Having breast tenderness, headaches, no periods. Reason?\n\nHi. I was on an IVf cycle recently, Period started Jan 12th, Meds began Jan 14th. I was put on a hold (stop meds) as my estrogen wasn t rising according to the doctor. My cycle is always 28 days. so it was due on Friday. I have been having breast tenderness and headaches for the last week. My meses has still not started, not am I having an pain or cramping as usual. Any insight?",
    "doctor_response": "Hi,Your symptoms are not specific for an early pregnancy; they could be premenstrual as well. You may wait for your cycle for a couple of days and then go for a pregnancy test or if you wish for an earlier confirmation, go for a serum beta-hCG assay and a trans-vaginal sonogram after a couple of days. Please contact your consultant for further suggestions. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which cream should i apply for scar ?\n\ni am 20years old female.i want to know the name of scar cream plz do tell me and m a medical student,i had allergy once and then there are too many scars on my body...plz do help me n tell me the best ointment in PAKISTAN which removes all my scars..i will be thankful to you",
    "doctor_response": "hello welcome to healthcare magic. there is no medicine as such which can remove the scars completely. however there are certain ointments which can make the scar less visible(make it lighter). also there are some lasers( an expert dermatologist can help) you can try an ointment called contractubex or myderma cream, but remember they will only lighten the scar. also they show there effect in a few months only.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe pain in liver while having NAFL?\n\nI have been diagnosed with NAFL (by CT Scan) and I have had high uric acid w/gout for 3 yrs. I have pain, sometimes severe, in liver area especially after eating. I also take Protonix for GERT. Blood test are normal. I am 25 lbs overweight. Due to pain in stomach have not been exercising. Can not find out what is causing the pain and losing weight has been impossible. What should be done to determine the cause of the pain now?",
    "doctor_response": "Hi there,Given your problems of pain after eating, the most common cause of your pain is likely stones in your gallbladder. The easiest way to diagnose this is to get a right upper quadrant ultrasound to look for stones in your gallbladder. If you do have stones, and you can continue to have pain after you eat, the treatment is to have your gallbladder removed by a general surgeon, which is usually an outpatient procedure.  I hope this answers your questions. Please feel free to contact me should you have any further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent urination and lower back pain?\n\nI am experiencing frequent urination. I have checked with my a specialist but everything seemed perfect. I suspect it has something to do with my lower back ache. Or could it be due to bacteria? or does it soemthing to do with my lower back ache? Tq. my email:  YYYY@YYYY",
    "doctor_response": "Hello,I had gone through the case and found that there might be many cause like urinary tract infection, diabetes or any pressure on bladder.So go for ultrasound of lower abdomen, blood sugar  and urine culture.After that take proper treatment.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can I heal the scar on my face caused by spectacle lens?\n\nHi doctor, I got a laceration scar on my face by a cut from my spectacle lens. The scar looks bad. Please help me to get rid of this scar entirely as soon as possible. I am using Mupivate and Mupirocin ointment. I am using it for many days. But it does not work.",
    "doctor_response": "Hi. What is the duration of the scar? Can you please upload a few pictures? For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could a bump in knuckles suggest sprain?\n\nHi! My cousin kicked my middle knuckles of my second and third finger about 3 weeks ago, since then there has been a a bump in between those knuckes and i cant bend my fingers back like i can with my other hand? Do you think it is sprained or just needs more time to heal?",
    "doctor_response": "hi,thank-you for providing the brief history.As per the history it look more of a sprain of the ligament near the phalanges. Still I will recommend you to take an x-ray to rule out any bony injury.Once It is ruled out, I will advice you to undergo physical therapy , with some proper physical therapy guided EXERCISES and myofascial release technique you can get rid of the lump and regain the full functionality of the hand and fingers.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had pains and jaundice, ultrasound showed gallstone, MRI showed that the stone had passed, advised gallbladder removal after recovery. Do have symptoms after months. Should I go for surgery?\n\nin January I had pains and was jaundiced, a gallstone was seen on my ultra sound and the following day I had an MRI which showed the stone had passed. I was told i needed the Gallbladder removed but i had to wait untill my bloods were normal it has taken 5 months for my bloods to clear I have had no other attacks and I am almost back to normal but the hospital still want to remove my Gallbladder do I need this surgery or can i leave it and have it if the symptoms come back",
    "doctor_response": "Hi Jackie Thanks for posting your query. Ideally you should undergo surgery to remove gall bladder. Gall bladder dysfunctioning causes gall stones to form. And even though gall stone may be removed once, the diseased gall bladder is still present in body, which may cause new gall stones to form. It is seen that once a patient has had severe episode of gall stone disease, such patients have increased chances to suffer from more such episodes in future. Hope this helps. Dr. Rajat Gupta",
    "dialogue_context": ""
  },
  {
    "patient_message": "It is possible that Hepatic Hemangioma is pressing on my lungs and on my stomach?\n\nI was diagnosed with a DVT and then a few days later they found I had multiple Pulmonary Embolisms.  I have had trouble breathing for a couple of years and it continues to get worse.  Lately I feel very bloated after eating or drinking just a small amount and worsening acid reflux.  An upper GI showed no GERD.  A barium x-ray showed some reflux.  I am currently on Warfarin.  Today I was told that the CT scan also showed a hepatic hemangioma. It is possible that the Hepatic Hemangioma is pressing on my lungs (causing shortness of breath) and on my stomach (causing the fullness and bloating)?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. No, hepatic hemangioma is unlikely to press lung and stomach and cause symptoms. Hepatic hemangioma is actually accidental finding in most of the time and it is asymptomatic. Rarely large hemangioma can cause pressure symptoms. So if the size of your hemangioma is less than 5 cm than it is unlikely to cause these symptoms. In my opinion, Pulmonary embolism and warfarin are causing all these symptoms. Pulmonary embolism causes restrictive lung disease and this is the likely cause for your shortness of breath. Warfarin is known to cause severe gastritis and bloating. So hemangioma is unlikely cause. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a hard lump on gum?\n\ni had a hard lump in left side of my lower gum in my molar,it does not hurt,when i touch it,or push it softly. It is a damaged tooth. I am worried about it,what should I do? Does the dentist pull my damage tooth,even if it has a hard lump under it? Please help me.",
    "doctor_response": "helo thanks for consulting at hcm,,it could be abscess frm periapical or periodontal etiology,,it could be due to swollen lymph node b,cz of infected tooth,,plz get an iopa radiograph and a check up with ur dentist,, do salt water gargle thrice daily, take analgesics and antibiotics if requd with a prescription,,hope it helps,,tc",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in the ribs and shoulders\n\nFor probably 10 years I have had pain in my ribs and shoulders (Or under my shoulder blades really). My ribs feel like they are too small for my body! I feel I have to pull them out with my fingers and sometimes it feels like the bottom ribs poke things when I lay down. I feel pressure all over my ribs. I have pain under my shoulder blades that drives me nuts. I have talked to my doctor more than once and still no idea what is wrong, but I am going crazy! Some other symptoms that may be related are my undiagnosed daily stomach aches and extreme gas pain. I also am recovering from depression and anxiety. I have patella femoral in both knees. My hips pop when I walk and are often quite sore. I m generally sore and tired most of the time and pain is not limited to these areas. Sometimes I get unexplained stabbing/ burning pains all over my chest. My doctor last suggested fibromyalgia and gave me a medication to try, but it isn t qorking. Can anyone please help me?? :(",
    "doctor_response": "Hi, It's a very common phenomenon to have pain in ribs and shoulder blade. This is basically because of the weakness of muscles and the point where it is attached at ribs and other bones, it gets pulled and there is inflammation. So there are two parts of treatment. One is to get relief now. For that you can start with ultrasonic therapy and if no relief then laser therapy. If still no relief then you can get trigger point injections from any pain specialist or orthopaedic surgeon. For long-term relief, you need to build up your muscles. For that start with walking daily and regularly and increase distance gradually till you reach up to 4 km. Then start brisk walking and continue it. It will take around 5-6 months for muscles to strengthen. In between when pain increases, get those injections again. These injections are totally safe. but don't stop walking. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Anuj Gupta, Spine Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the stomach, feeling cold. No fever. Any idea what it is?\n\nHello Doctor, I got up with lot of pain in my stomach at around 2am. Took Digene Immediately coz it has helped me before. But this time it was of no help....did go to the toilet around 3times, tried to walk around nothing helped. Suddenly I started feeling very cold tried to keep myself warm .....the thermometer showed that I didn t have fever . Finally tried some home remedies like soda and water, lime with black pepper powder, cumin powder and black salt the paindid not subsidise....I forced myself to throw up, with this the pain reduced and happen to sleep for a while...but the pain still exists...please advise.",
    "doctor_response": "Hi. It sounds to me like gastritis attack especially if this already happened. You can do gastroscopy to evaluate how serious it is. Till that just avoid hard food and alcohol, coffee. Eat milk products and fruit. Also lay with your upper body elevated. You can try taking some other antiacid drugs such as pantoprasole or antacides. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should I do to treat swollen gum and throat?\n\nhello, yesterday the left side of my gum started to get swollen and now the left side of my throat is swollen. Im using some sort of sore throat relief spray but it seems like its not working at all, in fact the pain is getting worse and I think im getting a fever. what should I do?",
    "doctor_response": "HiThanks for writing in.Swollen gums occur due to deposition of calculus.Go for scaling of teeth.Complete course of antibiotic.Do warm saline rinses.Visit your dentist for further treatment plan.RegardsDr. Neha Sumra",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest opinion on medicines to conceive\n\nI am 27 yrs old and my wife is 24 years old,we are single family ,we are tried to our 1st conceive .1st my Dr. suggested me for tablet DOXY-1LB 100mg 14 tab(one tab. daily after food from D1)and Fertomid50/Clomipure 50mg 10 tab(2 tab. daily from D3) and Duphaston 10mg 10tab(1 tab. daily from D16) but no conceiveafter that my same Dr. againt suggested me for tablet Ecosprin 75 mg 90tab(1 atb at bed time daily for one month) and goodova plus 50mg 10tab(2tab. daily from D3) and GestofilSR/Sustan SR 200mg 20tab.(2tab daily from D16). please helf and guide us.",
    "doctor_response": "You have not provided me with other necessary information. How long have you been married? Are your wife's monthly periods regular.You need to do semen analysis. Your wife needs to do hormone tests .If you are trying and not conceived since two years then your wife needs to do a test to confirm the patency of Fallopian tubes.Have you people done all this. I understand your wife took medications  to induce ovulation twice.  Was there ovulation as evidenced by ultrasound or serum progesterone test.If all your tests are normal and there was ovulation with medication continue the treatment for at least six cycles. Don't be anxious. You are a young couple and have a very good chance to conceive. I would also wish to advise regarding the following facts which are important.Your wife should take folic acid 5 mg dailyIf you are smoker you should cut down on it.If your wife is obese she should reduce weight to improve chances of conception.You should have regular intercourse 2-3 times /weekGood luck. Keep me updated about the treatment",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the side effects of getting sterilized at the age of 24?\n\nI am almost 24 years old and I would like to get sterilized. I am married now for two years and me and my husband are 100% positive we do not want children. He tried to get sterilized but his doctor said no because we are too young. I am tired of having to remember taking pills and the pills have really affected my mental health. They make me depressed and they have also caused weight gain. Is it possible to find a doctor who would sterilize me at age 24?",
    "doctor_response": "Hello,Thanks for sharing your health concern with us. In the current scenario, I would ask you to go for some other mode of temporary contraception, like an implant or an IUD. This is because, if your thoughts change in future and if both of you wish to have children, you still have a chance. You need not continue with the oral contraceptive pills if you find it difficult to use them. I am not sure any competent doctor would agree for such an early sterilization, without any children, for no medical reason. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for hiccups\n\nMy husband had a cortisone shot in his right hip three days ago and now for two or three days he has gone into hiccups and I understand this could be a side effect of the shot. Is that true, and since we have not had success totally by giving honey, sugar on the tongue or swallowing ice chips, what can I do to get these stopped. Thanks for your help. Mrs. S.",
    "doctor_response": "Thanks for your question on HCM.Hiccups has no specific cause.But the most widely approved theory is irritation to phrenic nerve. Others are dehydration, pharyngitis etc.Treatment is also not specified anywhere.Drink plenty of fluids, keep yourself hydrated.Take antihistamines. Beclifen is the drug commonly used in hiccups. So you can try this beclofen if hydration does not give you relief.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get relief from muscle spams and burning pain in back after falling from stairs?\n\nslipped down the stairs the other day and was very painful with lots of muscle spasming similar to when I compression fractured my L1, L2 in spine 9y ago. Took me a long time to get adjusted on the stairs into a position which was the most comfortable and then was able to crawl back up the stairs and into my bed on 1 side only as the other side or on back was too painful. Now two days on I can walk but get severe burning pain in back on right side at back and still get spasming if I move into wrong position. it is better as I can get around better although still painful. I feel the bruising in my mid back on right side of spine where the stair lips hit my back as I slipped down and that is very tender. any suggestions? Update:  had xrays but nothing obvious.   Still get red hot pains in my back right side above the hip with cramping / light spasming?    Taking slow release ibuprofen,  oxycontin and paracetamol also propam for muscle relaxation but sharp burning pain from right hip/buttock between hip and spine going up back not touched by pain medication so all I can do is lay down in a comfortable position,  leaning forward or trying to sit up etc very painful with the burning pain like a red hot knive big needle going up back. not sure if this maybe pulled muscle if it didnt show up on 3 xrays taken but sent off for further review just in case ER Doctor missed anything.  Not sure what to do other than continue the treatment and hopefully it will get better but considering the level of pain relief I have available its not doing much. Thank you so much for advice,  I felt quite lost when nothing was found on xray in local small hospital er. Kindest regards and happy new year",
    "doctor_response": "Hi there. A fall of such a nature is not good for you as you already have had compression fracture in the past. First and foremost get an Xray done immediately to rule out any fractures.  The muscle spasms could be due to these fractures. Secondly ....please take complete bed rest and avoid bending your back forwards. You need an anti inflammatory along with a muscle relaxant like tablet Nucoxia - MR twice daily. Apply ice packs to the tender area along with diclofenac gel application.  Avoid applying heat altogether. Tablet ULTRACET ( tramodol) can be taken if pain is not relieved by the above. I hope my suggestion was helpful. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is injection necessary for pregnancy?\n\nhi , i had abortion in 2005 that time i didnt check my blood group later i came to my blood group is B negative . i told that about it she told me to have an injection if not geting pregnacy is difficut but some problem i didnt have that injection but know i want a baby what to do please tell me",
    "doctor_response": "Hallow Dear,First get Rh group of your husband done. If he is also Rh -ve, there is no necessity for you to get the injection as there is no risk of isoimmunisation.Usually, Rh negative person does not have the antibodies in the blood against Rh positive antigens by default. When the blood of such individuals comes in contact with the Rh positive cells, the body develops antibodies. Therefore, during first pregnancy, the baby has usually no risk. However, this baby if Rh positive, can be responsible for initiation of Rh antibody formation in mother's body. This usually happens during delivery or abortion. These antibodies in subsequent pregnancy may cause harm to the baby. Therefore, immediately after delivery, the injection is given which prevents the antibody formation in the mother's body. Now, since you had not taken such injection, you can find out whether such antibodies are formed in your body by performing a test called as Indirect Coomb's test on your blood.  If there are no antibodies present in your blood, your next baby is spared of the mishap. However, after next delivery do not forget to take the injection. If the antibodies are formed in your blood, the effect of baby will depend upon the concentration of these antibodies. Accordingly baby may require blood transfusion either immediately after delivery or even during pregnancy lest the risk to the baby's life due jaundice as a result of blood cells destruction. I have tried to make these very complex things as simple as possible for you. You may contact me by asking me a Direct question after you get your blood tested for antibodies. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having a functional cyst in left ovary, what should I do to treat abdominal pain?\n\nhi... sir..iam mn,ma,age:19yrs. this is the second time iam suffering from stomach pain. for the first time i get rid of it after a lot ofsufferings i had 4 times vomitings. again now iam facing the same situation  again.it will suffer me for 3-4 days after that i getting everything out. i do have a functional cyst left ovary.  suggest me what to do now..??",
    "doctor_response": "Hi thank you asking HCM with regards to your stomach pain  you can start to use antacide, omeprazol. To my opinion you need to be diagnosed correctly, so you should  perform exams like  abdominal ultrasound and upper endoscopy. after that  you will get  the proper treatment. wishing you all the best Dr.Klerida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and shortness of breath due to a fall?\n\nMy son had a fall dwon on stairs, the back pain was recovered in three days, but he always feel pain and short of breath in his stomuch when he try to sun or jump. He had no pain doing deep breath, X ray showed no fracture on rib and spine . What could hurt his stomuch? is it possible there is bruise on his stomach cuase by hard falling? How to help recovering ? thanks",
    "doctor_response": "Hello, Consult a physician and get evaluated. You have to get an X-ray chest to rule out possible rib fracture as it can present with similar symptoms. As of now you can use analgesics/anti inflammatory combination like aceclofenac/seratiopeptdase for symptomatic relief. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for high fever in a child?\n\nHello, my 6yr. Old son (55-58# s) has had a high fever of 102.8 - 102. His cheeks are hotter then his forehead & red. Should I keep him awake till his fever goes down (only right after taking tylenol, it drops a couple degrees). I m worried about a fever having a long term negative effect. What point do I take him to E.R?",
    "doctor_response": "Immediately give antipyretic combination such as paracetamol+ mefenemic acid, PCM+ ibuprofen, kept in minimal clothing, don't cover body with blanket, sponging the baby, keep a watch for mental status of baby.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain and bloating?\n\nMy dad was diagnosised with end stage cirrhosis about 8 months ago.... He has varices bleeding and has had banding done on those.... he recently has another bout with varices bleeding and was passing it in his stool also... they banded again... now he has some stomach pain and feels bloated... is his disease getting worse...",
    "doctor_response": "Hi and welcome ot HCM. it can be caused by several causes. in most cases this is related to diet so he hould eat less irritative food. also this can be sign of gastritis gerd or hiatal hernia or obd and ibs. to rule these out her should do gastroscopy ad colonsocopy. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does head injury with no symptoms need medical attention?\n\nHi, may I answer your health queries right now ?  Please type your query here...My 2 year old banged his head on sunday I put a cold compress on the area and no bump came out just red spots. He did not vomit or show any symptoms of concussion, sleepiness etc. He has been well since. Should I still take him to a and e ?",
    "doctor_response": "Dear parent,I understand your concerns but  you should monitor the child for a whole 24 hours after the injury. if the child experience dizziness or vomiting or headache then take the child immediately to the hospital for an urgent ct scan. if the child didn't experience any of these symptoms in the 24 hours following the injury then no need to worry. I hope I answered your question",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes black colored blood?\n\nHad blood work done yesterday It has been many years since I have had any done Right away the nurse and I noticed it was very black in color and very thick. And that was all she said. Then about 30 minutes later they wanted me to go back and have a pint of blood removed. Which I didn't do because by then it was  after my doctor was available & I would have had to go to the ER.  What is all this a sign or symptom of?Thanks for any info. Stacia",
    "doctor_response": "HI DearI have read your query and by the \"black colored and thick blood\" i understand that your blood has a higher level of hemoglobin.Normally hemoglobin should be in the range of 12-14gm%. A little more than that upto 16gm% would not harm you in any way. But a significantly higher Hb level more than 16.5gm% or even higher may be of concern.Higher Hb levels are known as polycythemia which can be due to various reasons ranging from benign to malignant(cancerous) conditions.The doctor had asked to remove some amount of blood, that is known as phlebotomy.If i were your doctor, i would have asked you to do the following lab tests:1. CBC with PBS (routine blood count with peripheral blood smear)2. Serum erythropoietin level (if decreased, a malignant condition would be suspected and next panel of tests would be advised)).Please share the reports once it is done.Follow up questions will be appreciated.Thank youRegardsDr Pallavi Jain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for low blood pressure and pain in stomach\n\nmy father is agastic pacent sences 6 month. he take medicines r  RAZZ 20 &GUTREX.  but now he is suffering with low blod pressure i.e110/70.and aiso stomac pain at the time of eating i.e at dinner and meal time. can u give me simple rutin of eating food?how low blod pressure remove?",
    "doctor_response": "Hello, The problem with your father is, he had low acid secretion. and when Doctors give them a drug for it, as a effect of drug your fathers blood pressure reduces. If I am your treating doctor I advised you to take drug along with some ORS or something like that. It will increases your blood pressure. thnx",
    "dialogue_context": ""
  },
  {
    "patient_message": "History of sacrococcygeal teratoma. Painful coccyx. Alternative to removal of coccyx?\n\nLast October I had a large Sacrococcygeal Teratoma removed surgically, and I have an appointment later this year to see if it is returning. My coccyx is painful when I put pressure on it, and I am worried the teratoma may be returning. I also have mild spina bifida, and am not in a wheelchair. The MRI showed that my coccyx is deformed, and I am looking for alternative ways to eliminate the teratoma, before there is any chance of my coccyx being removed - although if this is the last resort, then it has to be done. Is there any alterntives?  <",
    "doctor_response": "Hi, Thank you for posting your query. There are good chances that your sacrococcygeal teratoma has not recurred, as there is no visible swelling or lump in the area. Pain can also be due to other causes. However, if it has returned, then surgery is the best option to prevent it from recurring in the future. I hope it helps. Please get back if you require any additional information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nausea in a child?\n\nMy 2 year old threw up twice this afternoon and hasn t done anything since. She says she feels good. What could it be .. Do you think it would be a stomach bug if nothing else happens, It never fails that I alway get the stomach bug when she gets it and I really don t want it",
    "doctor_response": "Hello,It seems like one episode of food indigestion. No need to worry. Observe him if no episode happened again stay relax. You can deworm the baby by giving Vermox for three days.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Hina Javed",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain?\n\nI am Bethany 14 years old I am hurting in my right side of my stomach really bad. It hurts too breathe in worse than what it does when I'm doing nothing. It has been like this for 2 days now. I am very active I don't know if that would have something too do with it but it might. What is wrong with me and what do I need too do!  I need all the answers I can get. THANKS!",
    "doctor_response": "HI. You are too young to know this.  I hope your parents do know about this. As per your history - I would like to suggest you to go for an urgent ultrasonography and / CT scan to if there is no appendicitis , tubal / ovary problem. The reports will indicate whether you need a medical and/ or surgical treatment. Visit ER",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can I do away with the frustration of having a baby ?\n\nhello sir, I am a 26 year old married man. we have got married in 2007. first 3 years our bed life was really awesom but now a days for last 6-8 months my wife is not comfirtable with me on bed. she don t like all these things. she even don t want to to talk about this matter. because of all these things i became very frustrate , I can t concentrate in my professional life. I am not able to understand why she is behaving like this. Please help me. Actaually after 3 years of marriage i want a baby desperetly, but she even don t want to ta;k about this. after Marriage she got pregnent 2 times, but at that time we have not continue those issues. I feel very sorry for that step. Please help me. I am in Delhi.",
    "doctor_response": "Hi! Welcome to healthcaremagic.com.What about a child is your wife worrying??? extra responsibility? additional loss of freedom.talk to her openly and nicely what exactly she is feeling? Is she depressed? does she work outside or homemaker?Do take a second honeymoon away from your place if possible for a week or so,the change of place may do some good and encourage her to talk freely as to what is troubling her.If nothing works may be she requires some counselling .Do the needful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excessive sweating and shortness of breath along with stomach pressure?\n\nYesterday when I was walking to my car from grocery shopping by the time I got to my car I could barely breath. I was sweating something awful. Before I could even begin to take any groceries out the car I had to sit down and rest. It took me 30 min to get the groceries in the car cause I had to keep stopping to sit down in the air conditioner. Made me shake a lot. I ended up having to call my sister to come drive me home. Feels like something heavy is sitting right above my stomach and when I press down right below my rib cage between them it hurts and feels like a lump is sitting above my stomach.",
    "doctor_response": "Thanks for your question on HCM.In my opinion you should immediately consult cardiologist and get done1. ECG2. 2d echo to rule out cardiac cause.Your symptoms like sweating,shortness of breath and chest heaviness are seen most commonly in congestive cardiac failure or myocardial ischaemia.So get done above mentioned investigation s to rule out these.If both are negative than no need to worry much for cardiac cause.This may be due to acute gastritis also. So avoid hot and spicy food. Take proton pump inhibitor. But first rule out cardiac cause. So consult cardiologist and discuss all these.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is my husband taking right medications for brain tubercloma and how long does he have to continue ?\n\nHi My husband is suffering from Tubercloma in the brain(right side of brain). He underwent Biopsy couple of times. Now he is under treatment and taking anti-tubercloma medicines (Encorate,Levipil,PZA,R-Cinex 450). Recently the doctor changed the medication from Encorate to Divaa OD 250mg for which he started having seizures consequtively for 2 months. The medication was re-visited and changed from Divaa OD 250mg to Encorate and Eptoin . Can anyone suggest us if he is under proper medication and what are the things he need to avoid. How long does he need to be under medication. His lesion size is of 1.8cms. Please do suggest us. Past 6 months he is taking his medicines regularly and his age is 30years. Please do help us.....",
    "doctor_response": "Dear Mrs Ravijyotsna I have reviewed summary given by you  and there are two inter-related issues i.e. tuberculoma of brain and seizures. a) For tuberculoma, he needs to take antituberculosis drugs for atleast for one year. Reasons for repeated biopsy is not clear and also about initial size of lesion and description of MRI findings have not been provided by you b) If change to Divaa OD was 250 mg once a day, it was inadequate and need to have full dosage. The dose of encorate will be from 750-1500 mg /day based on body weight and level of control of seizures. Addition of eptoin is not clear to me with available information. c)  Suggest to have a repeat MRI study if not done recently to assess size of lesion and consult a neurologist near to you regards pratap",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I go to ER for a pus filled insect bite?\n\nhi, my two year old had what seems like a puncture bite from an insect. I went to change her pullup and noticed that there are two bites now and they both have pus in them. they are hard to the touch and cover about a nickel size area. I squeezed one. should I head for the er?",
    "doctor_response": "HI, thanks for using healthcare magicShe may not need to go the ER as an emergency but she should see your doctor.You can schedule an appointment.If the appointment is too far away (more than a week) the she may need to go the ER so that she can be seen sooner.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain, increasing in intensity, vomiting, fever. Non-diabetic, not asthmatic. Cure for pain?\n\na 26 years old male was working when he experienced gnawing abdominal pain which gradually increase in intensity, sometimes being on and off associated with vomiting and fever. patient is a non-diabetic and Non-asthmatic. No food and drug allergies . Patient had the following vital signs-Bp-120/80 HR- 95/min RR- 26/min T: 37.9C Abdominal Distended, (+) direct tenderness of all quadrants (-) rebound tenderness , ill-defined masses on all quadrants.",
    "doctor_response": "Dear sir/madam. These symptoms and signs seems very serious and evaluation shoud be done as soon as possible. Ill-defined masses on all quadrants?? What did doctor that diagnosed it recommended? This kind of pain associated with fever is a sign of intraadbominal infection and some of imaging tests should be done,US or CT scan. You need to do inflammatory markers. vital signs are ok but it sounds like intraabdominal infection( appendicitis, colitis, diverticulitis, abscesses,tumors) and surgical and gastroent. work up should be performed. Wish you good health.Dr. Ivan Romich",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump behind the ear indicate?\n\nHi, my three year old daughter had a pea sized softish lump behind her ear a while ago and I have recently noticed a similar lump on the back of her neck this weekend. She also has little nose bleeds from time to time too...I have a apt at docs in two weeks but am concerned...should I seek earlier apt?! Many thanks",
    "doctor_response": "This can be lymph node enlargement associated with ear and nose infection. Does the child have recurrent rhinitis? It may lead to epistaxis.If epistaxis is significant then you should visit a pediatrician earlier.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do fibrotic strands in a chest X-ray report signify?\n\nGud day! My husband had his cxr last wk,and advised for ALV.. the diagnosis was fibrotic strands found in his repeat x-ray,and was advised to see a pulmonologist...Is this a something to worry about? 2 months ago,he had undergone lap chole,is this somewhat related? He s a non-smoker and a healthy living individual....Pls advise... Worried wife",
    "doctor_response": "Respected user, hi I evaluated your query thoroughly .* Fibrotic strand signify any type of insult to the lung tissue through any    means .* Vital information needed here that was X-ray chest carried out as a part of   pre-operative work up for cholecystectomy and was there fibrotic strands    in  that ?Kindly provide these details to correlate in a sound pattern .Hope this helps you to some  extent .Feel free to ask any further health related questions .Thanks for using Health care magic .Regards dear take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain in the upper back?\n\nI am having sharp pains in my upper back on the left right below my shoulder blade.  I have heard that in women this could possibly be signs of a heart attack.  It comes and goes but has been consistent for the last hour or so.  I am a 68 year old female.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice.Pain in left shoulder and arm, might be caused from heart or from neuromscular problems.To determine if this pain is related to heart problems, it is needed a more detailed history of the symptoms, and a physical examination.If the pain gets worse with movement is generally related to neuromuscular problems, but it should never be ignored, so I highly recommend you to consult a cardiologist.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can being overweight be related to palpitation and dizziness?\n\nI had a palpitation yesterday and then felt very very dizzy.  It lasted all of 5 sec.  I went to urgent care.  They took my BP (167/94) and my heart rate was 101.  I am on Lisinopril/HCTZ (20 mg/12.5).  My BP last month was 128/78 and my heart rate is usually in the 70's.  The doctor said the EKG looked ok but my heart was beating a little fast.  He said I should follow up with a cardiologist, which I am going to do.  He said it was difficult to determine what happened.  I don't smoke, I am overweight, I drink very little caffeine.  Any ideas?",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!I passed carefully through your question and would explain that your symptoms could be could be related to a cardiac arrhythmia. Of course, being overweight, drinking coffee and smoking can trigger this clinical situation too. But, I would recommend performing some tests to investigate for cardiac arrhythmia, before concluding that nothing serious is going on: - a cardiac ultrasound- an ambulatory 24-48 hours ECG monitoring- thyroid hormone levels for thyroid dysfunction- complete blood count for anemia- blood electrolytes for possible electrolyte imbalance. If all the above tests result normal, there is nothing to worry about. Reducing caffeine intake and avoid smoking will improve your situation too. Hope you will find this answer helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having allergic reaction, eyelids puffy, tiny hives on face. What could be causing this issue?\n\nI am having an allergic reaction....eyeslids are puffy and scaley, tiny hives on my face and my tounge feels funny. Over the last few weeks I found green tea was the culprit and stopped drinking all tea, was pretty cleared up and then yesterday I ate some soy beans and I am broken out again badly. I found on line where both green tea and soy beans can cause exzema and hives on the face....have you heard of this and do you know of anything else that could be causing this issue?",
    "doctor_response": "Hello welcome to HCM. ALLERGIC reaction occurs when your body system reacts to a foreign substance such as certain type of foods like fish,milk or pollen or dust etc.IT depends on the individual whether you will have an allergic reaction to a substance or not. SO to prevent it there is only one option ,ie to avoid contact with which you have allergic rection.KINDLY MAKE A NOTE OF FOOD STUFFS YOU ARE ALLERGIC TO..AND IF YOUR ALLERGY IS SEVERE CONSULT A GP. FOR MILD ALLERGIES,YOU CAN TAKE ANTI HISTAMINES LIKE TAB.CETRIZINE. OK AND TAKE CARE..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have itching and a pimple-like stuff that is bleeding a little in my scrotum. What could it be?\n\nHello doctor,I am a 29-year-old male. I recently realized that my scrotum is itching and there is pimple-like stuff that is bleeding a little. There are reddish black spots on my scrotum, but it is not the area that bleeds. The area that bleeds looks like a ring-cut.",
    "doctor_response": "Hello. I understand your concern. The black, reddish papules may be angiokeratoma which bleeds when you scratch that, but that is not the cause of itching as such. I am prescribing you medications for itching and ring-shaped erosions. Kindly consult your doctor to discuss the suggestions and take the treatment with consent. 1. Tablet Fexofenadine 180 mg twice a day. 2. Tablet Ivermectin 12 mg today and after a week. 3. Cream Flutibact (Fluticasone Propionate, Mupirocin) cream twice a day for a week.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic pneumonia\n\nHi, I m a 55 yr old white female, 5`4 , 180 lbs. I had childhood asthma and bronchitis, and were given steroids frequently. I seemed to grow out of it at age 17. During the last 14 yrs I ve developed Fibromyalgia/Chronic Fatigue, RA, for 14 months my SED rate stayed at 53-108 and they could not find out why, Cushing s Syndrome, neuropathy of the feet, and most importantly - Hypogammagobulinemia. I rec d IGG iv s monthly for 4 yrs, then lost insurance 6 yrs. ago. I m disabled and on Medicare, I haven t rec d IV s in 6 yrs. During that time I ve had pneumonia 17 times, once was septic pneumonia, constant sinus problems, PCP infection and a rare form of arthritis associated with the hypo (the Dr. couldn t tell me the name of it). I have contacted Medicare, foundations and pharm companies trying to get help to start treatment again. Reaching out to any possible help has been met with apathy and no one would try to point me in the right direction. I m really worried and would like to know my chances of surviving if I can t get the IGG treatments. Thank you very much for your time.",
    "doctor_response": "Hello, The cause of chronic pneumonia is mandatory to be evaluated here with culture of bronchial lavage fluid, CT scan of the thorax and other supportive evaluations. Unless the root cause is identified, one cannot get the complete management chart. Hope I have answered your query. Feel free to post further doubts. Thank you. Regards, Dr. Bhagyesh V. Patel, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause a severe asthma person to throw up and become unconscious?\n\non Friday, I had a severe asthma attack and saw my lips turn blue, called 911 but by the time they got to me I was unconscious; they said my oxygen level was under 50, but didn t tell me I threw up till later on. I was too out of it still to ask then, but I am curious as to why I threw up at that point, and if I should do anything. I am on medication now, and still kinda dizzy. but it s better then I was. but why do your bodily fluids release at that point ? i also bit my tongue at some point when I was unconscious, is that a sign of anything?? my family said it could have been a seizure",
    "doctor_response": "Thank you for asking Healthcare majic. My name is Dr Ehsan Ullah & I have gone through your query.your 1st concern is know about the lowering of oxygen level during the severe asthma attack and2nd concern is regarding tongue bit.regarding your 1 concern , the body's oxygen level falls drastically when there is either obstruction in the air way or reduced air entry to the lungs or reduced lung capacity to transfer oxygen from the lungs to the body parts where it's needed and in response to such situations , lips turn blue as a signal.turning of lips blue in patients with long lasting chest disease (chronic obstructive pulmonary diseases {COPD}) represents a condition called Chronic bronchitis in which air pressure in blood vessels (Partial pressure in arterial blood) is reduced and there is increase air residual volume with air trapping in the lungs. you need to continue with prescribed medications and do regular follow up.regarding your 2nd concern;biting tongue is although occurs in seizure attacks but in cases where you get unconscious , it can be because of accidental trauma to the tongue. if you have family history of seiures , or noticed such incident then you need to consult your physician .Hope this may help you. Let me know if anything not clear. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can breast cancer have metastasis to the back?\n\nMy sister in law had breast cancer and finished treatment about 6 months ago with herceptin the final stage.  She had had a bad back for a few weeks and has had a scan and been told that she had cancer in the back - not sure where else.  She is very private - acts as though all is ok - however I fear the worst - on this limited info can you give me some guidance please?",
    "doctor_response": "Breast cancer most commonly spreads to bones. Her attitude \"all is ok\" , is good, having a positive outlook for a cancer patient gives them a very good quality of life.Evalauting further with a PET scan can give information on if it has spread elsewhere.Second line Chemotherapy is available and bisphosphonates are also recommended.If the pain in her back is worsening after the above options , she would need a surgical assesment for stability of the affected region, followed by radaition for pain control.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump in the center of chest?\n\ni have a lump in the center of my chest. it has been there for 1 week. no pain .it doesnot feel hard. i can see it in the mirror when i stand up , but it doesnot feel hard. when i lie down i donot feel anything.age 58, weight 152 5 ft., donot drink, smoke, i take no medication. no heart problems, no hypertension.",
    "doctor_response": "hi.it is best if you consult with a doctor, preferably a general surgeon, for medical and physical examination. based from your description, it could be a cyst (a sebaceous or a keratinous type), a fibroma or a lipoma. these lesions can occur anywhere in the body and have the tendency to recur.  management (medical and surgical) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy if fooling around without penis entering the vagina?\n\nWhen I was 16 years old I got pregnant and had an abortion. I got pregnant without going through the act of intercourse. My boyfriend and I were going to have sex then at the last minute I chickened out, his penis was on the entrance of my vagina, but I pushed him away at the last minute. Can you please tell me where I can go to find this information so I can explain to my children how importance of protection? Every where I go, the answer is no you can't get pregnant unless the penis is deep inside the vagina. I am proof that that statement is absolutely not true.",
    "doctor_response": "Welcome to HealthcareMagic,It is true that pregnancy results form sexual intercourse where the penis has to entire vagina and ejaculation should take place. But even if the male partner withdraws his penis and ejaculates outside it may result in pregnancy rarely as the pre-ejaculation fluid may contain sperms. Another situation is when the ejaculation is done on the vagina, very rarely it may result in pregnancy. But as I already said these are very rare possibilities. Hope that answers your question.Regards, Dr.Imaad.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain and feeling of passing bowel movement?\n\nApprox. 3hours after eating I experience mid abdominal pain, like a dull ache, and feel like I have to have a bowel movement. Usually, if I stretch out the pain will eventually subside and by morning I am better. If I have a bowel movement it is often better. This does not happen all the time, just occasionally, like once a month perhaps. Any thoughts as to what is happening? Thank you.",
    "doctor_response": "welcome to hcm,          if it occurs rarely once in a month there is nothing to worry. Feeling of the bowel movements rarely like once in a month is normal. but if it is associated with pain you may need oral anticholinergic drugs . discuss about this with your treating physician. any way i want you to have adequate fiber rich food, Drink adequate water have regular bowel habits.hope this explainswith regardsDr.Amarnath",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does intermittent pain in toe require medical treatment?\n\nLast night I experienced paid on the top of my big toe. It wasn t ask often as a blood plus but was often about every 10 seconds. Woke my up about 4:25 AM. I do not have diebeties. (misspelled) Had a physical in January and blood sugar is good. Should I call my doctor? Off and on today I feel the same pain.",
    "doctor_response": "hi,as you mentioned you have pain the great toe, there seems to be two chances as per my understanding of your pain.one, it can be high levels of uric acid two, due to nerve impingement in the lumbar spine.for checking the uric acid levels , urine test will be done and for lumbar spine nerve impingement , MRI will be good.As to rule out first preference is uric acid test, if this comes normal then the next iw MRI if spine.usually by precision of the exercise planned with medication helps to recover upto 99% of the cases.with the grace of God I wish you a speedy recovery",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chest paining after hitting football with orange poop so should I be concerned?\n\nOkay so my son was playing football and he got hit in the chest area, he said he has pain on the left side of his chest. He also said that his poop has been red for about 2 days and the day he got hit, his poop was orange. Should we be concerned about this?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your son's situation and problem. Your son is having blunt chest trauma due to football hitting. Usually this does not cause any major internal damage. But since he is having reddish stool, we should rule out internal damage like stomach injury or lung injury. So better to get done chest x ray to rule out lung injury. If chest x ray is normal than no need to worry for lung injury. Get done stool microscopic examination. If it is positive for red blood cells than he needs upper GI scopy for the diagnosis of stomach injury. If stool examination is normal than no need to worry much. Hope I have solved your query. Wishing good health to your son. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for lumps in the neck?\n\nHi, I have 2 lumps in back of my neck on on top left one on top right. The one on left is big and tender where the right on is small and doesn't hurt. I have also been feeling dizzy for a month now and last week started to feel short of breath. I am a vagetarian and my gums are white so I think I am anemic, can you help as to what is wrong with me. Thanks",
    "doctor_response": "Hello, Thanks for consulting HCM I have read your query . As far as lump in neck is concerned this can be enlarged cervical lymph nodes due to infection .  For this I will suggest you to keep watch on lump . If it increase in size or you have symptoms like pain or fever then you  should consult physician for clinical examination of lump and if needed go for investigation like biopsy . Hope this will help you .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had gall bladder removed previously. having slightly high bilirubin levels. Serious?\n\nhello...... bilirubin was 1.3 this week....All other Liver tests normal. my last physical 12 months ago was 1.0 and my labs 6 months ago were .9. Again all other over tests normal, no symptoms. Dr said I have Mild elevation. I was also sick with bad cold at blood draw , silight fever........ what is consider High vs Mild, as I m heading for a retest monday. I also had my gall bladder taken out due to tones when I was 43. I m 51 now in good health, active and take Crestor, Benicar . I friend of mine is a GI Dr and said I had a fatty liver about 5 years ago but not to worry as he saw on CT. Again just wondering how high is 1.3 since my lab report says mile elevation. FYI, my blood counts were normal 12 months ago, so doing a retic count monday. thanks",
    "doctor_response": "Hi, If your  other liver enzymes are normal then you need not worry . You need to start a course of liver tonics for a period of 4 weeksand the repeat liver function tests and ultrasound of the upper abdomen. Gall bladder surgery may not affect the bilirubin after such a long period without associated symptoms. I hope this answers your querry. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for acid reflux\n\nAbout a week ago, I experienced acid reflux while sleeping, which caused a mild wheezing in lungs for a day. Since then, for the first time, I have experienced a persistent, mostly dry cough, clearing of throat, and strange, metallic, burnt taste in the back of my throat after coughing. I used to suffer from asthma but have not had any symptoms for the past four years.",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your history.Were I treating you, I would suggest you 4-6 weeks treatment with a proton pump inhibitor drug such as omeprazole or pantoprazole, half-an-hour before meals.I would also suggest you to avoid hot and spicy foods, alcohol and caffeinated beverages. If possible, a brief relaxing walk after evening meal will also help.Hope this will be helpful to you.Wish you the best of the health.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. l got a sore hard lump after the removal of wisdom tooth. Is it normal?\n\nHello doctor,I just got one side of my wisdom teeth removed both upper and lower six days ago, and I have another one scheduled after two days for the left side. The upper is 100 % fine, which they pulled. The lower they pulled the tooth without removing the root because it was too close to the nerve. I do have some stitching in this area currently on the lower cheek. Noticed a hard lump about 1 inch between my lower jawline and cheek area. Is this normal because of swelling or something else. Currently taking Amoxicillin 500 mg and Ibuprofen 600 mg. Please let me know what this hard lump is, also generally on the lower side where this lump is, remains sore.",
    "doctor_response": "Hello. The lump is mostly a hard swelling which forms postsurgical removal of the wisdom tooth or maybe even by swollen lymph nodes due to infection. It takes a week or two for the swelling to subside. Sometimes, if the root is still inside, the infection may be remaining there causing swelling. Get an X-ray done to find out the exact problem and stronger antibiotics like Augmentin (Amoxicillin and Clavulanic acid) along with a painkiller for a week. For more information consult a dentist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe cough?\n\nHi.I m 30 years old.From last 2 years I often had cold n cough.I use to take medicine from local Dr.But now from last 2 months I had severe cough which was not going after taking many medicines.My Dr suggested to do blood test.N it shows diabetes 147 while fasting n average is 7.4.n was having high bp.From last week having severe headache.dr suggested MR I n XT scan.report says extensive polyp oil inflammatory soft tissue is seen I bilateral maxillary,ethos, frontal n spheroid sinuses.so now Dr is suggesting surgery.wat shudder be done.i want a 2nd opinion",
    "doctor_response": "Thanks for your question on HCM.In my opinion, you should definitely get done surgery for nasal polyps.No medicines or treatment other than surgery will be helpful in your case.Following are the indications of surgery in your case.1. You are having multiple polyps.2. Bilateral polyps3. Symptomatic (coughing) since 2 years.So, all these favour surgical treatment in your case.So get done surgery for symptomatic relief.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can OCD be completely cured?\n\nHi doctor, my name is Jack and i have ocd, i have no recurring symptoms for about a year now and am cutting down on my medication slowly now... i am currently at 30mg a day. Is there any chance that my ocd can be completely cured ?And is there any way to certify that ? because i want to join the arm forces and i am afraid that my history of mental health will affect this. Even if a mental sickness is cured already, will it be considered during the hiring process ?Thanks so much doctor !",
    "doctor_response": "Hi,Fortunately it is one of a few psychiatric conditions that can be managed w/o medications. Slowly cutting down while working on controlling the compulsive acts via various training methods you must've been taught. It can go into remission but complete cure, is rare. As far as the hiring process goes, you would need to check with appropriate authorities. hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain with high BP\n\nI am a 20 y.o. female. I weigh 114 lbs and am 5 foot 3 inches. I have had chest pain now consistently for about 12 hours. Well, I wouldn t exactly call it pain, but definitely severe pressure with intermittent pain. It does seem to have gotten a little better since it started, but earlier today I was very short of breath and it felt like there was air or something in my lower throat. It also felt like something was pushing against my trachea. I have been slightly tachycardic and my BP was 139/92. I can also feel pressure, maybe almost tingling in my upper left back muscle, like it s been pulled or something. I m worried because I know unrelieved chest pain is a problem. I m also worried because I ve been on Adderall XR 40mg for about 4 years now, and I know there are a lot of heart conditions associated with that. I plan on going to the Dr. tomorrow morning if it hasn t subsided but I m honestly a little worried to go to sleep if it s something more serious.",
    "doctor_response": "Hi dear though you are just 20 but as you are on amphetamines for 4 years a probable cardiac causechas to be ruled out,amphetamines can cause ischemia,cardiac ischemia(less blood supply) is a very common side effect of using amphetaminesThey can also cause lung condition like pneumothorax which also presents with the same symptomsamphetamines can also cause severe gastritis and heart burn which also can present with the same symptomsi would suggest you to go forEcg2d echochest X ray PA view this will help you to reach a diagnosis that what is the exact cause of pain and medication can  be taken accorfing to diagnosisthanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest consequences with high SGOT and SGPT levels\n\nHI I AM 32 YEARS OLD MALE. MY SGOT IS 47 AND SGPT IS 54 AND IS FROM ALMOST 2 YEARS.I SMOKE AND DRINK ONCE OR TWICE IN A MONTH.I AM STRESSED DUE TO THESE  RAISED LEVELS.KINDLY HELP ME.                                                                         THANKS",
    "doctor_response": "Hi.Thanks for posting query at HCM.Usually ALT or AST values higher than \"two times the upper normal limit\", is considered abnormal ( in some countries, ALT or AST values of more than 100 are considered abnormal). Value of AST or ALT greater than 85 or above maybe investigated further.Alcohol ingestion and obesity are common causes of fatty liver disease.advice for fatty liver:- abstinence from \"Alcohol\" - LOW fat diet should be followed, AVOID junk food and beverages- decreased oil consumption (oily food)- NO red meat- green vegetables should be ingested daily- use lemon juice (lemonade) once in a day- reduce weight if overweight/obese-\"recheck liver enzymes after 6 to 8 weeks\" and/or ultrasound.any further questions are welcomed.hope to answer your concern.wish you good health.regards,Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are red sore & swollen legs side effects of chemotherapy?\n\nMy wife's cousin, who also happens to be her best friend has developed pancreatic cancer which has also been found in her liver. She had 5 chemo sessions after which she felt much better and from this she was informed that the tmour (tumours?) were shrinking be it ever so slightly. She was then afflicted with red, sore and swollen legs which will not go down. Her chemo has been stopped (before Christmas) because of this which she finds disappointing as she felt the benefit of it.",
    "doctor_response": "Dear sir, yes this can be the side effect of chemotherapy, but we can't say about the diagnosis without looking at it. in fact i would like to emphasize upon an important diagnosis that it could be Deep vein thrombosis, whose probability is higher in pancreatic cancer. doppler study of leg veins confirms it. it can be treated with medicines. so i would suggest you to have a consultation with oncologist regarding same and get the treatment started.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever, appetite loss, sore throat, vomiting and a palate sore?\n\nyeah my five year old daughter, has 102.0 temp., loss in appetite, sore throat,chills and vomited once today. she also has a sore on the roof of her mouth, but not sure it that has anything to do with the way she is feeling. see has no front teeth and i think the sore is from chewing hard foods in that area the is no color to the sore. Don t really know if i should bring her to the er or just wait and see.",
    "doctor_response": "You should consult your clinician and get checked... As symptoms are suggestive of acute pharngitis or tonsilitis",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itching, red spots, bleeds all over the body except face. Taken Cipra 500 and doxy bid. Remedy?\n\nFirst just itchy very all over body like I had something crawling on meTiny red small pimple like bumps appeared Started on my legs from the knee upA few on my back and Butt as wellNone on my face but I feel like something is crawling on me all the timeNow I have some on my arms and two or three on my handsThey don't se to be fluid filledAnd when they dry up they are scaley and if scratched bleedAlso both of my elbows are red and scaley The first month I only had a few mostly on my legs up from the knee. This is the third month and I recently noticed some on my lower part of my legs. I think the second month I wasn't that itchy but now 3rd month extremely itchy again.I took 4 days of cipro 500 mg bidNow I'm taking doxy bid. Both antibiotics I had from previously having bronchitis and doxy for my boyfriend took for an large pussy ingrown hair on his thigh",
    "doctor_response": "Hello,Welcome to healthcare magicFrom your description I am thinking of insect bite reaction. Watch out for bed bugs and mosquitoe bites. Ciprofloxacin and Doxy is not indicated in itchy rash. Kindly consult a dermatologist to confirm diagnosis and to start  topical steroid cream for the rash.Hope this helpedTake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fingers tremor with nerve weakening sensations?\n\ngud morning! am vicky,i started masturbate since 4 years back now am 22,now i have feel my fingers are shivering if i do any work,i think my nervers are weak,now i giveup masturbate,what shall i do?this cause any other side affects..like sexual dysfunction",
    "doctor_response": "Hello, Masturbation is not the cause for your weakness and other problems. May be you are feeling them in your mind. Therefore I suggest consulting a neurologist for physical examination, diagnosis and treatment. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. K. V. Anand",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can intermittent lower back pain caused due to long hours of sitting be treated?\n\nSaw my doctor about 8 years ago and mentioned my lower back hurting and she said age. I am now 37. Well it is local to one spot and comes and goes. Back side on the right about an inch from my spine just above buttox close to hip line. Pain appears to be muscle or tendon related with pain extending into the buttox at times. I always assumed it was from sitting on my wallet and have carried my wallet in my font pocket for over 7 years now. Not sure what aggrevates it. Pain is about one inch wide and two inch tall area. When it is bad it has put me to my knees but most times lately it just gets achy for several days. What your recommendation?",
    "doctor_response": "Hi, The lower back pain after sitting for long hours is mostly posture related. You need to have regular stretch breaks during the work, follow office ergonomics and do regular back strengthening exercises to help. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with epilepsy. On Oxetol. MRI normal. Talks to herself, sleeps, laughs the whole day. Having psychological problem. Solution?\n\nhi! i have an elder sister who is of 36 yrs and been sufferring from various problems from about 20 yrs. we have not got a proprer solution regarding her problem ,so can u please hepl us with it.She has been taking the tablet OXETOL 300 mg for the past 20 yrs but still ther has been no improvement .since some yrs she has been becoming worst. she is suffering from something called as the EPILIPSEY but all her reports are normal,we haveeven done her MRI but that also was normal.she keeps on talking to her self the whole day but we dont khow excatly wht she talks.she does all her day to day work properly.she eats well sleeps on tme evrythng but does not do any household duties at home.for more than 10yrs she has been treated from BANGLORE THE NIMANS HOSPITAL.but still there no such improvements in her yet. the doctors there have told us that she is having a phycho problom and so has to be treated under a phsyciatric.she is on OXETOL 300 mg RESIDONIA PLUS . She has become very agrrogant these days.she only sleeps laughs and talks the whole day.kindly help us with some solution or help us with the best doctors for consultation. this is my email idso indly send in ur reply to the YYYY@YYYY or call on MR.RATNAKAR AMANNA at 0000. thanking u.",
    "doctor_response": "Hello and welcome to Healthcare Magic. Thanks for your query. From the descripion of your sister's psychiatric problems, it appears that she may be suffering from a psychotic disorder, probably schizophrenia. Schizophrenia is a chronic pschiatric illness where the patient can have hallucinations (like hearing voices - the \"talking to self\" is actually the person's response to hearing voices), delusions, deterioration in personal, social and occupational functioning, etc. In addition to the anti-epileptic medication (Oxetol), she has been put on an anti-psychotic medication (Residonia Plus). If her psychiatric symptoms are still not controlled, then you have you go for a follow up, to see if medication has to be increased or changed. It is important to understand that since this psychiatric problem is a chronic one, treatment can only control or decrease the symptoms, and not cure the illness completely. So, regualr medication and follow up is a must continuously. Wish you all the best. Regards, Dr. Jonas Sundarakumar Consultant Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes child to pass big stools?\n\nHi, may I answer your health queries right now ? Please type your query here... my 5 year old niece has hugh bowl movements (4 inches in diameter) that will not go down the toilet and stuff the toilet. She experiences no pain and is healthy otherwise. Is this something anyone has seen before?",
    "doctor_response": "Hello, If she is healthy otherwise and growing well, you need not worry about it. It might be physiological for her constitution and body.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sumanth Amperayani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe abdominal pain and acid reflux\n\nI took my boyfriend to the ER the night before last for uncontrolled abdominal pain with no relief of using pepto bismol, tums and Tylenol. He is also nauseated, headaches come and go and has really bad acid reflux. The doctor diagnosed with dyspepsia, She gave him reglan, protonix and a GI cocktail. The doctor did say that his WBC was elevated It has been two days and he continues to have discomfort/pain , acid reflux, nausea and abdominal pain. He has had no vomiting and diarrhea ... His follow up appointment with PCP isn t for a few more days. He isn t eating but one small bowl of broth a day and is drinking sprite and water throughout.",
    "doctor_response": "Hi.Thanks for your information about your boyfriend. The picture of raise WBC indicate that there is n inflammatory process going on in the stomach and it can be appendicitis presenting with the symptoms you have suggested. I would advise you to take him back to the ER and get a CT scan and other tests done to find out the cause and get treated according to the clinical picture and the reports of investigations.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swelling in the upper lip and sore in the inside of the lips after a fall. Pus formation. What to do?\n\nI fell on a sidewalk three days ago and  landed on my face. The swelling on my upper lip has gone down but there is a huge sore on my inside upper lip and it seems to be torn by the impact of my upper teeth during the fall. I have been washing it with salty water several times a day but it is still present and when I  put a tissue on it and apply light pressure, a yellow \"pus-like\" smelly effusion comes out. Not much. But should I go to a dentist or doctor if if continues much beyong this weekend? One other thing, I am diabetic so the mouth  canker-like sore is of especial concern to me.",
    "doctor_response": "Hi !Thank you for your query.Dear sir,You seem to have an infection that has been superadded over the wound you got by falling over the upper lip.Since you are a diabetic the tendency of getting infections is increased and there is delayed wound healing. You should check with an endocrinologist for this immediately so that he can monitor your sugar levels which is essential for effective recovery and plus start with an appropriate antibiotic coverage to heal the wound.If you have any further queries feel free to ask.Wish you good health.Take care.Dr. Shruti",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring seizures?\n\nMy son is 35 years old. 2 years ago he had his first seizure. 1 yr later he had his second one. Now six months after that he just had one today. He has had test done and they say he is clean. There has to be something wrong. What other kind of test should he have to find out what is going on?",
    "doctor_response": "Hello, Recurrent seizure in an adult may occur due to Hypo- parathyroidism leading to hypocalcaemia, Drug and alcohol related, infection / trauma / tumour of brain, metabolic causes leading to low blood sugar / sodium or high blood urea may aggravate seizure frequency. So go for investigations like serum electrolyte, blood sugar level, electro cardiogram, lumbar puncture test, Electro encephalogram, CT & MRI of brain. Consult a neuro physician for physical examination and further evaluation.Thank you for consulting HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI of lower back showing narrowing of the thecal sac, disc fragmentation and disc herniation. What does it mean?\n\nI just had an MRI a few weeks ago on my lower back and I finally just got my results and I was wondering if you could tell me what it means. It says the Central disc L4-L5 is noted as well, there is a slight narrowing of the thecal sac with AP dimension of 8.6 mm at this level, it was 9.8 on the prior exam. The impression states: from exam dated 9/10/2012, there have been large reabsorption of significant disc fragment at L5-S1, mild central disc herniation remain. There is mild central disc and 45 which is narrowing the AP dimension of thecal sac from prior examination. If you could please tell me what this means that would be great and thank you for your time.",
    "doctor_response": "Hello,The spine as you know is a set of small blocks of bones arranged one on top of the other to form a pillar support for the body. Now these blocks of bones and connected to each other by spongy cushions called discs between them. At the posterior part of the pillar and behind the discs we have the spinal cord running down from the neck to the tail region.In your report, the disc at L4-5 (lower back) is showing some degenerative changes. Further there is a slight increase in the posterior transition of the disc at that level.At L5-S1 level, the disc might have got fragmented due to degenerative process.For you it means that if the pain is severe and unbearable, please let your doctor know and they will guide you towards a pain free future.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of chronic obstructive pulmonary disease?\n\nplease tell me if profuse almost nightly night sweats are a symptom of copd...emphysema? My guy has copd but has bad night sweats and bad dreams...not restful. Please help...he also wheezes during the night and coughs in the morning...He is trying to quit smoking - down to 3-4 daily.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Yes, night sweats, bad dreams and wheezing are symptoms of COPD. But better to rule out heart diseases and depression as both of them can cause night sweats, bad dreams and both are seen in COPD patients. So get done ecg and 2d echo. Consult him to psychiatrist and get done counselling sessions. He may be need anti depressant drugs too. Smoking cessation is the priority. Inhaled treatment (formoterol or salmeterol or tiotropium) are treatment of choice to control COPD. Don't worry, he will be alright. Hope I have solved your query. I will be happy to help you further. Wishing good health to your guy. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat swelling of the left ankle after an injury?\n\nI hit my ankle bone on the inside of my left ankle on metal pipe at the park it instantly swelled and bruised and couldn t walk on it good. The next day I could walk on it but still swollen and hurt to touch. Now it s a week later and it s still swollen and bruised black and blue and hurts to touch should I be concerned?",
    "doctor_response": "swelling and pain of your ankle needs a better attention. you need to rest your ankle by avoiding or reducing weight bearing. you can keep your leg elevated above your heart level and apply ice packs over swollen part to reduce swelling. you can do gentle ankle up and down movements which is part of functional rehab now. you can take some analgesics if not contraindicated for pain. if your pain and swelling didn't reduce with these measures in one week you need to consult a orthopaedician for ruling out any Hair line fractures",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for allergic cough\n\nSir my 2.5 yts baby have alergic asthma . He got many cough within a day after normal fever. Now i m using srp . Asthalin,srp defcort, srp AB phyllin And for fever - ibujesic plus and wikoryl And giving inhalation with duolin and Budecort . He is now fever free but still have more cough plz help sir",
    "doctor_response": "HelloThank You for contacting HCM.His throat needs to be checked for throat infection. Most of the times children do cough because of chest or throat infection. For cough you can give him Diphenhydramine + Acefyllin Piperazine. If problem continues then i would recommend you to visit a pulmonologist for detailed checkup followed by lab investigations to rule out the cause and permanent treatment of baby.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. If you do not have any clarifications, you can close the discussion and rate the answer.Wishing him good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Started on ICSI, but cancelled as eggs were not mature. Periods are overdue. Thick white discharge occurring. Suggestions\n\nhi, i started on ICSI but it was cancelled as on day 13 my eggs were not mature so all medication was stopped. my periods are now 8 days overdue and i get cramps as if i am going to have periods but instead a thick white discharge occurs. can anyone tell me what i should do as i tried contacting my doctor but i am not getting any response.",
    "doctor_response": "Hi,Thanks for your query. I read your query and I understand your concerns. Following is my reply:1) The discharge is not related to cancelled ICSI cycle.2) If discharge continues, please get examined by a gynecologist and get medicines for the same I hope I answered your query. I will be available for any follow up query you have.Regards,Dr. Mahesh KoregolIVF & Infertility Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is BPT and aloe arborescens effective for cancers caused by pathogenic microorganisms?\n\nIs Dr Isaac Goiz Duran biomagnetic pair therapy an effective therapy for cancers caused by pathogenic microorganisms? The same question for the aloe arborescens. And How more effective would they be if applied at the same time. I will greatly appreciate your profesional input. Thank you very much.",
    "doctor_response": "treatment is allopathy. must be supported by randomised trials. no data is of any value without scientific evidence. they are no randomised trials that are practise changing on the herbs you mentioned. they might have medicinal value but are of no use in cancer if used alone",
    "dialogue_context": ""
  },
  {
    "patient_message": "Allergy, congested, runny node, sneezing, increased heart rate. Taken allegra tablet and nasal spray. Cause?\n\nHi, I was at my allergist today and was very congested, runny stuffy nose, sneezing as a result of being off my Allegra for four days prior to the subdermal allergy testing she did today. I showed no reaction to any of the environmental allergens tested for, but to help me out she gave me a small cup full of liquid prednisone , an Allegra tablet and some nasal spray (she said earlier would not aggravate my existing benign heart irregular beat I get from time to time.) That was at noon today. Then tonight at 5pm I started suddenly getting an increased heart rate along with bad irregular beats (PVCs I believe from past experience). Three hours later I am still getting them. Can these be a result of the prednisone the allergist gave me? I told her I had a history of benign irregular heart beats and couldn t take any nasal sprays that had a decongestant effect because of my heart. That is why I m surprised she gave me prednisone which I just read online can cause palpitations and rapid beat. Do you think the one dose of prednisone caused this fast beat and irregular heart beats and, if so, will it subside soon or by morning? Thanks.",
    "doctor_response": "Hello, There is in fact very little evidence to suggest prednisolone can set off premature ventricular contractions; but certainly can set off palpitations if the dose was higher than required. Some patients with adrenal insufficiency who require steroids for life also feel the same once they start and novice patients will feel more of the effect. You have not mentioned the dose you had, or whether you took it on an empty stomach or without PPI cover. Gastritis is a problem when taken on an empty stomach, and that set off palpitations. It should subside within 24 hours, but if you still feel unwell, I would suggest you get seen by a physician as soon as possible for an ECG and a thorough evaluation. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does my kidney reports indicate?\n\nWhat does this mean: in my left kidney there is a superior pole cyst measuring 3.1x2.x3. Cm. With a possible punctuate peripheral calfacation? They found a trace of blood in my urine that i beleive the arkerwith the blood testwvas 9. I was hospitalized this past december with hemmorragng out blood from my mouth. Then the doctors ruled it pnuemonia.....then i had a colapsed left lung atthesame time. The specialist could not find the leak so he put a clamp on the vein that had the highest fgure i leaking. Whie doing up labs to check on my blood count from the pneumonia, is how they found i had blood in m6 urine....jut trying to figure out the cause of the. Leeding etc. And the first qestion?",
    "doctor_response": "Dear patient,I suggest to do ANCA test (IF and ELISA) to rule out vasculitis. Did you do a CT scan of the chest (in particular HR CT)? Please let me know about these data and renal function +urinalysis.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy if having fluttering in stomach while on birth control?\n\nHi I m feeling little flutters that feels like little locking in my stomach it just started to today but I am kind of scared. I am on birth control I just got off my menstrual a day ago so I don t think and hope I am not pregnant. What else could this be ?",
    "doctor_response": "Hallow Dear, Birth Control Pills contain Oestrogen and/or Progesterone hormones containing medicines. These medicines increase the stomach acidity and also cause nausea due to their metabolism in the liver. These things ultimately lead to indigestion and/or gastrointestinal upsets. This causes flutter like feeling you are having. To control the gastritis, please take some proton pump inhibitor acidity controlling medicines like Pantoprazole. Also take some carminative like carminative mixture or Gasex or plain soda. These will give you relief from your symptoms. I hope this helps you, Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for myxofibrosarcoma on chest wall\n\nHello. I was operated for swelling on right chest wall mass on 30th Aug.2010. The Histopathology report of the hospital was Pseudosarcomatous myofibroblastic proliferation. While I gave the slides & the excisioned sample given to other Lab reported that it is Low Grade Myxofibrosarcoma (low grade cancer). It has again started growing and am advised MRI done. So kindly give your expert opinion as to why it has grown and will surgery needed again? What precautions to take. What is the final remedy to get out of it permanently. I am Mr. Mehta from Mumbai, India, 58 yrs, Male and have no other health problems. I chew tobecco and smoke 1/2 loose ciggaretts daily. Pls reply at your earliest",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have low grade myxofibrosarcoma.  You have gone through surgery.  But recurrence in very common in almost all sarcoma.  So you should go for surgery again.  Wide excision surgery with negative margins are the most important. If needed go for radiotherapy or chemotherapy according to need. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes body temperature increase with weakness?\n\nHello Doctor. My husband's has been feeling really weak and his body temperature increases rapidly and then reduces after half hr or so. He does not have any other symptoms of fever like runny nose or watery eyes. We saw a doctor and he put him on an antibiotic for 3 days assuming that it is fever but the problem still appears. Can there be other reasons for increase in body temperature?",
    "doctor_response": "Hello, Fever with weakness omif not resolved by antibiotic course than you can rule out hyperthyroid by serum TSH estimation for primary work up. It's advisable to investigate with CRP estimation, Elisa test for hiv and hepatitis profile, widal test etc for further work up. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and tightness in chest?\n\nlast night about 2:30 am I woke with extreem pain in my chest. It was a squeezing tightness but at the same time SO PAINFUL! It lessned a LITTLE when I sat up but just a bit. Laying intensified it, espically if I turned to my side (which was unbarable)... The 'attack' feeling lasted about 25 min and I was able to get back to sleep not long after but I still could not lay on my sides or breath deeply. This morning/today I had pain if I: took a deep breath, bent even just a little ways forward, turned my body quickly, walked up the stairs...shoots of tight PAIN... and I also feel like I was beat about the chest all night and have a heavy internal bruise today... Does this sound heart related or heartburn related? It would be like no hearburn I've ever had before! but that is what is coming up in my online searches... The reason it seems it may not be heart related is because the pain is present in the morning instead of only during the episode.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.Sudden onset chest discomfort at midnight should always be evaluated for heart diseases.So first get done ecg, 2d echo and stress test (trade mill test).If all these are normal then no need to worry for heart diseases.Sometimes pulled muscle during sleeping because of awkward position of sleep can also cause similar kind of pain which continue in morning also.So avoid movements causing pain. Avoid heavyweight lifting and strenuous exercise.Apply warm water pad on affected areas.Take simple painkiller like paracetamol or ibuprofen.Don't worry, you will be alright but first rule out heart diseases.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent urination with bladder pain?\n\nI am constantly having to go to the bathroom to pee. About ever ten minutes I have the urge to go and sometimes my bladder still hurts and I still need to go. It doesn't hurt when I pee but it's getting old real fast having to go this often. The only things that have changed lately is with me is I started taking methadone a little over a week ago and I have been drinking a little more fluids throughout the day.",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, it is the symptom of poly urea and most likely cause of this could be infection, bladder stone, and diabetes all these needs to be ruled out, some time it could be due to too much water intake so I would advise to reduce the water intake if this is too much, second get done the urine test just to rule out the infection and diabetes (Presence of sugar) some time it may needed x-ray of lower abdomen  hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for panic episodes\n\nThere are times that i feel all of a sudden as if the world paused around me and feel like i am about to faint, It last seconds and then i feel blurred vision and confused and want to drop to the floor. it is scary but after battery of tests the doctors cant find anything wrong. However i do have those scary episodes?who should i go to?",
    "doctor_response": "HelloYou have sudden onset symptoms like you are about to faint, blurred vision, as if world has paused. The possible reason could be Anxiety disorder and panic, some cardiac pathology especially Angina attacks, or some CNS like Partial seizures etc, Endocrinal abnormality like Hyperthyroid states etc. But as all investigations came normal so there is no need to worry, most likely these symptoms are due to Panic Disorder a type of anxiety disorder. The disorder occurs in episodic manner.Consult a Psychiatrist for expert opinion. Medicines like Paroxetine, Sertraline etc result in improvement. In attacks of severe anxiety then drugs like low dose benzodiazepines can be used. Low dose benzodiazepines like Clonazepam, Alprazolam help in relieving symptoms in times of severe panic attacks.Relaxation exercises, breathing exercises also help in decreasing the symptoms.Thanks, hope this helps you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which medication is most suitable to treat PCOD ?\n\nHi Doctor , I am 25 yrs old I have PCOd.I got metformin tablet ysday ,I asked for glucophage but they gave me Glyciphage ,which one is the correct medicine to go ahead.since I am trying to conceive,Please advice",
    "doctor_response": "hi welcome to healthcare magic forum glyciphage and glucophage both contain metformin . so dont worry ,both are same medicine but from different company . you can continue with glyciphage . i hope i have answered your question.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is severe abdominal pain after taking perssery following severe thrush episode concerning?\n\nHi I took a pessery following a severe thrush episode and experienced significant abdominal pain four hours later and have experienced right abdominal pain all of today. I would appreciate your advice. Is this something I need to worry about and could this cause pelvic inflammatory disease? Thank you.",
    "doctor_response": "Hi. This sort of a problem is not really encountered , but in medical practice anything is possible.It would be wise to consult a Gynecologist for clinical examination , ultrasonography and additional investigations which may be thought by Her.It is possible that thrush only caused the pelvis inflammation and co-incidentally pessary was also used. Of course , stop using pessary. Continue other medicines as advised by your Gynecologist. You are free to take second opinion of a Surgeon in case you are not satisfied.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for gynecomastia\n\nHi ... I'm 27 years old with slim body, male and have like a women boobs on my chest . after some research, I've come across it may be gynecomastia. Other details; plaese give some tips for helping me get rid of them. Please help out, they are very embarrassing and make me feel very self-conscious.",
    "doctor_response": "Hi, If it is related to hormonal issue - need to see a endocrinologist and work it out. If no hormonal issue, you need to see a plastic surgeon for reconstructive surgery. Simple method is regular exercise and meeting a physical trainer. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can rashes, bumps and itching be treated?\n\nMy mother is 63 and had extremly itchy palms and itchy feet with bumpy rash for about 4hours last night. And after that she has vomit 3 times and continues having nausea. She feels hot and then she shivers as if she has temperature. Does not have a thermometer. What can be happening?",
    "doctor_response": "Hi, It can be an allergic eruption. Consult a dermatologist and get evaluated. As a first line management, you can take antihistamines like Pheniramine for symptomatic relief. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause blood in the phlegm?\n\nI got a cough 2 weeks before and my doctor precribed a antibiotic and a Dry cough syrup.. after week the cough did get cured so he gave another syrup with some allergic tablet. But last 2 days i am getting blood in my phleym in the morning alone and still the cough is there.. i feel a irritation in my throat and feel some thing is struck in my throat.. Can any one help me..",
    "doctor_response": "Hi welcome to HCM...Here for your cough you are given antibiotic.But blood present in phlegm so digital chest x ray should be done to rule out any lung infection or bronchitis if present ...If needed sputum cytological examination done for further work up....(if x ray suspicious or showing consolidation )Excess coughing and bronchitis like infection also lead blood in cough...If x ray shows fungus ball and sputum shows fungus than antifungal drug might needed...If pneumonia or TB suspected sputum cyto and culture will be useful....Meanwhile avoid smoking ..Avoid excess spicy foods ...Take care ....Advise : pulmonologist consultation for examination....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pregnancy happen after touching of breasts?\n\nwhen i went for a movie someone pressed my breast for a fracwhen i went for a movie someone pressed my breast for a fraction of seconds,but i was fully covered.this happened before 3 months and i am having this doubt for past 2 and half month.can i be pregnant?",
    "doctor_response": "Pregnancy does not just occur because one gets her breasts fondled.However, excessive and repeated breast stimulation may lead to milk let down from the nipple which may in turn cause a woman to miss her period even when she isn't pregnant.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am suffering from vaginal spotting and swelling of leg after C- section. What is the treatment?\n\nHello doctor, I am a 32-years-old female. My second baby was delivered by LS/CS method before a week after completing 36.5 weeks. Doctor also removed my uterus as I had been suffering from a complication of central placenta previa with increta/parcreta. And I had even bled a few little clots during 29th week. During the above operation, I lost heavy bleeding about 4.5 liters, for which six units blood and four units plasma were transfused and was admitted to CCU for ventilator support. After a few days, I was discharged from the hospital with a stable condition before four days. After arrival at home, my legs started swelling and also releasing vaginal blood spottings occasionally. Besides, my above C-section was performed with a large cut than my previous cesarean was done before five years, and the doctor has advised visiting for stitches (sutures) removal. Please share your opinion and advise me over the above case, including swelling, blood spottings, large cesarean cut, and future complications on account of above issues.",
    "doctor_response": "Hello. Placenta previa with increta is a severe condition, so uterus has to be removed due to bleeding. Swelling may be due to anemia or blood transfusions. Take tablet Lasix one tablet once a day, it will cause frequent urination. Blood spots will disappear after a few days. Take a rest. What about the baby? The cut was large because surgeon first done lscs (lower segment cesarean section) then because of bleeding decided to do a hysterectomy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure sciatica nerve pain in leg?\n\nHi.. My mom (58 years old) is suffering from Sciatica Nerve Pain in Right Leg. Very difficult to walk and sometimes in the night, pain starts. Lots of medicines had already taken but no relief. Her weight is 80 and height is 5 8 . No High BP, no Sugar, Uric Acid under control, No chronic disease.",
    "doctor_response": "Hello,Welcome and thanks for your query.She has a pinched nerve from the disc pressing on the sciatic nerve. It would be good for her to lose weight and to have an anti inflammatory pain reliever.She can use Neurontin at bed time to give her pain relief and better sleep.Do get back to me if you have further queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever and constant cough with redness and watering of the eyes?\n\nHi My 8 year old daughter has a temp of 38.5. Panadol will bring it down but then it just goes back up again. She has a constant cough, red watery eyes and generally doesn t feel or look well. She also doesn t have much of an appetiete. My 5 year old son has had croup but i have questioned that maybe it is whooping cough. Thankyou",
    "doctor_response": "HelloIt can be an impeding bacterial infection as well.  A good look at the throat should be able to place in a better condition to answer that as ur younger child has recovered fro infection.Are ur kids vaccinated",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can you tell me if there are signs of cancer in my mother's MRI?\n\nHello doctor, I need to have my mother\u2019s MRI read by a radiologist. Her doctor ordered her to have an MRI done and she had one done yesterday. My mother has had neck pain for at least a year now and her doctor believes the problem is arthritis, but not sure. My mother went to a physical therapist and had several shots in her neck for pain, but that did not solve the problem. I have sent the files of the MRI.",
    "doctor_response": "Hi.I have read through your query in detail and have gone through the MRI (attachment removed to protect patient identity). Please find my observations below. In conclusion, pain in the neck is possible with this kind of an MRI finding and might be considered a finding that is to be managed medically. Surgery is not required in this case as the findings are mild.Physiotherapy and nerve pain relief medicines are the first treatment of choice.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for fever , vomiting and diarrhea in a child?\n\nMy 5 year old has had a fever that comes and goes for almost two months now.  It gets as high as 104.  She is very tired and has lost 6 to 7 pounds in this time.  She complains that her tummy hurts.  The episode before this current one she was vomiting for a day and had very bad diarrhea the next day.  She is usually sick for a couple days and then normal for a week or so.  Her blood work showed low hemoglobin.  Another catch is her older sister caught it this time so it must be contagious.  Any ideas?",
    "doctor_response": "Hi I am sorry to hear that your 5 yr old child been unwell for 2 month with on and off fever,weight loss and tummy ache.She definitely needs thorough evaluation including examination,blood test and further investigations based on the clinical and blood test findings.I hope this helps.If you need further information please don't hesitate to contact me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain & difficulty in breathing?\n\nHello, My mom has lung cancer and is currently on  chemo shots, she is 66 and has had her fluid drained from her lungs three times. She is currently having a hard time breathing and severe back pain. What I have read online so far is that it may have spread to here bones. Is there any other possible reasons for her pain and shortness of breathe?",
    "doctor_response": "HIWell come to HCMI really appreciate your concern for your mother if this is malignancy and developed metastasis in lung tissue then such breathing difficulty is very likely, symptoms can be treated accordingly else nothing much can be done, better to have opinion from expert oncologist, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in throat to shoot pain to heart?\n\nI need to ask a question for my husband... he has been having a sore throat for a few days now... now he is saying that the pain in his throat is shooting pains to his heart..., he don t seem to think he needs to go to the er but im worried that he might... can you please help?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Actually that isn't that rare of a pattern. Just that it isn't the usual sore throat! An irritation of the esophagus often/usually causes chest pain even though it is the throat. (it's a much lower down throat than the usual cold!). Colds also can sometimes do that. Of course having a cold does not mean that someone cannot have a heart attack. Without an examination, I can only give general information. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Semen analysis showed low sperm count, prescribed Biophene, Lenova, Exart5. What are the functions of these?\n\nactually i went one of the doctor regarding we need kid purpose, we done all tests. when i given my speram the report showing very small count. but i given my speram 2days without intercourse. the doctor suggested some tabletes. 1. BIOPHENE 2. LENOVA 3.LINEATOR 4. EXART 5. H1Q 300. so i need what purpose we need to use the above tablets?",
    "doctor_response": "Hi, your semen report is abnormal . you have mentioned about count but not about motility. count should be above 20 million /c mm and motility 60%active motility even after 6 hrs . in case of oligo astheno spermia medicines are prescribed hoping improvement of semen quality both in count and motility. semen analysis to be done after 3 months to see the result . it will be good to attend infertility clinic and evaluation of both the partners to be done . Treatment of infertility is a continued process and to be taken till get the result . Please discuss with your doctor and a check up to be done to exclude presence of any condition like hydrocoele,varicocoele etc that may require surgical treatment",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason behind cheek pain, tooth and nose pain with salt like taste persistent in mouth?\n\nI have been having pain on and off for 6 months lasting over a month at a time. Pain changes places but usually starts in the ear. Then teeth start to hurt. Its now moved to the cheek and the side of my nose. Its only occuring on the left hand side. Been to the docs and they have loomed in my ear and theres no infection and my throat doesnt hurt. My neck is tender but nothing swollen. Suddenly had strong salty taste in my mouth for the last 3 days.Particularly bad in the night and I wake up with painful teeth, thought it was bruxism so bouggt a mouth guard but it doesnt help. The pain is driving me nuts. When I get rid of it it just comes back a month later.",
    "doctor_response": "Hi,Thanks for asking the query,This could be due to infection in the tooth.Get an x-ray done of the tooth.A root canal treatment has to be performed.Take a course of antibiotics and analgesics.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the hard lumps on the neck?\n\nMy boyfriend has a hard unmoveable lump at the base of his scull and neck connect, it does seem to change in size at times depending on his stress levels and then while rubbing his neck and shoulders I found another lump in his shoulder mucle near the spine. I dont know what kind of doctor to take him to or what it is.",
    "doctor_response": "Hi! thanks for writing to us sharing your friend's health problem and giving us an opportunity to discuss once again on the occurrence of hard, fixed lump on the nape of the neck region.I usually consider few possibilities in such cases, as per my experience of fine needle biopsy reports and these are as follows:1. lymph nodes due to certain chronic or acute infection in the surroundings like scalp, ear, neck etc. 50% cases2. benign cystic conditions sometimes getting inflamed 30% possibility3. benign tumor or tumor-like conditions like neurofibroma, lipoma or dermatofibroma etc...20% possibilityTherefore, this is not a thing for mush worries but should be properly investigated; please see a general physician first for confirmation of the diagnosis and then move to specialist according to the diagnosis.regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will lysol help to treat rashes on feet/hands of a baby?\n\nMy 18 min old grandbaby has hand foot and mouth...... She has the rash on her feet, hands, a couple places on her mouth nose area and rash on her bottom. I have her for the night, will Lysol work to spry everything down with to help keep it from spreading to my other rand child and daughter?",
    "doctor_response": "thanx for posting query .hand , foot and mouth disase is a viral disease and it is a mild disease and it will be cured by itself in due course of time . lysol does not have any role in treating it or preventing it. you can give PCM for fever, and antihistaminic in case the baby has itiching . rest assured your baby will be fine",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recommend treatment for mouth ulcers\n\nI brushed my upper gums with a toothbrush.  Gums around teeth are fine this is the upper part of the gums and now i have what almost looks like ulcers where I brushed and they are very painful and my face is swollen on the worst side.  What can I do to alleviate this?",
    "doctor_response": "Thanks for your query, i have gone through your query. The ulcers could be a traumatic ulcer caused by tooth brush. the swelling could be secondary to the trauma to the gums leading to cellulitis or it can be a angioedema secondary to the tooth paste or any food items. consult a oral physician to rule out these two conditions. if it is traumatic ulcer you can take topical anesthetic and analgesics like anabel gel. if it is a cellulitis, then you have to take a course of antibiotics like combination of penicillin and metronidazole(if you are not allergic). if it is alleric or angioedema, you have to take antihistamines like cetrizine. consult a oral physician and follow his instructions. i hope my answer will help you. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe depression on the death of grandparents?\n\nafter the death of two granparents and a close friend of 16 having a stroke my daughter 16 is scared to sleep without her mum convinced her mum is going to die it has now been 18 months how can i help i have taken her to a hypnotist and she has had therapy the doctor just seemed concerned of she was ok at school andnot jealous of her brother she is fine at school and adores her brother, when she did not cry on  the second session the doctor declared her ok but she is still scared, daytime she is fine and enjoys school and life has lotsof friends and loves sport how can i help what else cani do?",
    "doctor_response": "HIThanks for using healthcare magicSuch kind of behavior is usual in children and in that case, better to consult a child psychologist. Your daughter need some supportive therapy with reinforcement. That would help to come out  of above symptoms. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain and tingling in the lower back, swollen lips and tongue. Had surgery on spine. Twisted nerve or ligament?\n\nim a 35 yr old female..I have had surgery on my L4 and L5 in 2005..I recently started gyming and working on my upper body. four days ago during a shower I seemed to have twisted my nerve or ligament in my lower back giving me shooting pain..since then..I have my back is stiff and have had tingling sensations..even if I cough my lower back seems to hurt..that doesn t seem t worry me as much as my swollen lips and tongue I have had since the episode. three days in a row I have woken up with swollen lips and tongue.. I am not sure if these two incidents are related..I have taken anti histamines one tablet a day it seems to get better during the day an when I sleep the next morning it seems to get worse. Do I need to go to an ER?",
    "doctor_response": "Hello, Thanks for posting your query. As you have had sprain/strain on lower back, it is possible that strained muscle has irritated some vessels or nerves. It will go away with time, you can take muscle relaxants. As far as your swollen tongue and lips are concerned make sure what drugs you have been taking recently, usually it is caused by drug reaction or food allergy. Relieve from anti histamine suggests you have got allergic reaction. Contact your doctor and notify your reaction and drugs you have been taking. Hope it helps. Take Care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get pregnant while suffering from pcos?\n\nhello doctor, pcos detected at the age of 19. My doctor prescribed ovral-l and i took it for 3 years. I got married at the age of 24. Its 2 years since marriage but no child yet. Doctor prescribed me ovacet with metformin and i took it for 6 months but no improvement. I am bit overweight but not obese only belly has more fat. Please tell me will my condition improve and what should i do? I am very tensed because of this.",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.As in pcod polucystic ovarian disease, mutiple small follicles are there, which not mature upto the size.In pcod insulin resistance develops so sugar level in blood remains elevated.Androgen excess in pcod cause hair problem on face.I would advise to Reduce weight, it helps in reducing insulin resistance, avoid butter, cheeze, oily diet,  and take follicular stimulating drugs like clomiphene which stimate ovaries. Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i take combo of dicynone+ponstan forte for normal period?\n\nHi dr. I am on a mirena 20 days ago.It was inserted in the first day of my period to reduce very heavy menstrual bleeding. I am 48 years old with a fibroid (2-2.5) at the center of the uterus in addition to hyperplasia.Suffering from a severe anemia , I am taking 2 tablets of maltofer fol daily . The first 5 days of my period i took 2 tablets of ponstan forte +2 tablets of dicynone (250mg) and everythingis OK.My 2nd period came earlier and i wonder if i should take the comb of dicynone+ponstan forte again.now and how often.",
    "doctor_response": "Hello, Nothing much to worry and your treatment is in the right track. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is sharp pain in the spot of scar where there was large gash serious?\n\nI hit my head resulting in a large gash, 7 staples, 5 months ago, right above my hairline onthe left fron/side of myhead. The scar is semi-raised, and is tender to the touch, and often feels tight. I sometimes have sharp pain and discomfort at the spot of the scar, and occasionlly headaches, although it does not feel as though my brain hurts, moreso my skull. I laid down on my right side last night and got a shooting pain at the spot of scar. Please let mek now what you think this soudns like? Thank you.",
    "doctor_response": "Hello,Most likely there was subsequent nerve damage (scalp nerves). You can try simple painkillers (paracetamol, ibuprofen) or you can apply anti-inflammatory cream on the area. Discuss with your Doctor for these issues.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having cough and clogged ear. Had cold. Allergy? What could this be?\n\nHi,  I caught a cold, or I thought it was only a cold, exactly two weeks ago.  It knocked me out for two days then i started feeling better.  I have been continuing my normal activites and  exercise since last Saturday but my throat never stopped hurting although it is not as bad as it was the first few days.  I would compare it to allergies.  My concern in that I still have a cough and now I have had a clogged ear for two day?  What could this be?",
    "doctor_response": "you must hae took medicines for cold decongestants paracetamol and antibiotics cause this or if you neglected again this can happen the mucus fills in sinuses leading to post nasal drip and hence the symptomps writen by you develop pnd iritates the thrat leading to swelling and pain and pnd falling in trachea leads to cough take anti allergic singular 10 mg bd tab fexofenadine 120 mg od syp tossex 1.2 tsf night syp gelusil 1 tsf bd put sea water drops in nose 1 drop bd to clear throat take for 3 week to complete recovery and to prevent recurences",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are Hyospasmol tablets advisable while trying to conceive?\n\nHi Dr. I was having stomuch pains and took the hyospamol pills and planning to fall pregnant I m on my ovulation days can this affect my chances of becoming pregnant as I have been trying for almost 2 Years to fall pregnant after my 1st child.. Thanks",
    "doctor_response": "Hi, As you already had a successful pregnancy, you  have a very good chance to get pregnant again.It is always better to avoid painkiller if trying for pregnancy. It may stop the egg from coming out of the follicle.i would advise you to have a tubal patency test done. Tube is the bridge between uterus & ovaries , where the egg & sperm meet & form the baby. It's very thin , size of a hair. It cannot be seen on scans. You never know if it is clogged or blocked. Have a HSG ( X-ray with dye ) or SSG ( Scan with dye ) or laparoscopy. These tests can also open a blocked tube.Also have husband's semen tested . If all fine  you should be pregnant within a month or twoAll the bestDr.Balakrishnan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anorexia and bulimia\n\nMy niece suffers from anorexia and bulimia. She has a blue blotchy appearance on her stomach. She has is the last two years self medicated pharmacy laxatives and then progressed to eating foods that are a super fibre such as a kilo of blueberries in one hit - thus getting the same effect. She is telling family that it's a burn but due to the lack of skin lession and the area involved it would seen odd  Area is from below breasts taking in the entire trunk to the pelvis full width. It's as if say you have no fat what so ever and you ate a bunch of blueberries and your skin is transparent showing your inners pattened almost like coloring in say a spiders web every second or third section. She exercises to excess every day and displays the hysteria self centreredness obsessiveness classic to these conditions. Thank you",
    "doctor_response": "It seems it is anorexia nervosa rather than bulemia. Require treatment in indoor and supervision. Treatmnt include drug therapy n councelling. Pharmacotherapy n rehab will help. Contact psychiatrist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes head pain and cough in a child?\n\nHi, my 34 months toddler has a cough. This morning, while being in the middle of playing he all of a sudden put his hand on the back of his head (where the head connects with his neck), and started crying, saying that his head hurts. He stopped in a minute and said he was feeling normal again. Is this something I should pay attention to, or ignore? In the last few days his heart has been racing after he used an inhalator to stop cough.",
    "doctor_response": "inhaler use can cause increased heart rate due to beta agonistic action regarding headache Its causes can vary from benign causes to danger causesthis differentiation can be made only after examining the child",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could asthma with diarrhea symptoms suggest?\n\nHi i have had numerous and variuos minor issues with my health i have recently been diagnosed with asthma.  i have recently had diahorrea for about a month culminating with three of toenails falling off and over the last 36 hours an unexplained fever with flu like symptoms but no flu!  Am i mad!",
    "doctor_response": "No you are not mad.Asthma and other disease may coexist.If fever and diarrhoea persist even after proper antibiotic course consult your physician...as diarrhea may  be a symptom of many medical problem like hyperthyroid .So need a careful examination.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to regain libido and penis erection?\n\ni am sixty. years old having height of 5ft-11inches with 58 kg of weight.two grown -up and healthy children.recently,i have started losing libido and stiffness in penis during ejaculation. i would like to know the best tested oil or cream which can create stiffness in penis.",
    "doctor_response": "Hello,As per your history to increase libido and stiffness during ejaculation that is for erectile dysfunction and premature ejaculation, I will suggest you to take tablet Uphold 10 mg after sexologist opinion.Before starting this medication, you have to confirm that there is no history of liver, Kidney, heart Disease or stroke recently. You have confirmed it by blood tests after consultation.You can take this tablet generally one hour before sex. So, I will suggest you to consult with the sexologist.Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I having nosebleeds and dryness?\n\nHello doctor, I am a female, 22 years old, 110 pounds (50 kg), and height 160 cm. I rarely have nosebleeds, but I had one two days back and again this morning. It woke me up before work. The last lasted for 10 minutes (it seemed like a normal nosebleed). The one this morning lasted around 45 minutes and I have felt a trickle of blood going down my throat all day. I do feel dry (weather). I am not taking medications, except for iron pills (I have an iron deficiency).",
    "doctor_response": "Hi. Mostly the bleeds are due to dryness. Since you have iron deficiency you must be more careful. To stop nosebleeds pinch the nose for three minutes gently so that it gets occluded. Apply ice packs in either side of nose while keeping your nose pinched. Elevate head end of bed in night while sleeping. Check your vitals and BP (blood pressure) should not be high. To prevent this apply some lubricant cream inside the nose to keep it moist. Keep some steamer inside the room to produce enough moisture inside the room. If using air-conditioner keep the temperature at a moderate level like 23 to 26 degrees Celsius and make sure the air is not dry. It should be moist.  For more information consult an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to lower sgot and sgpt levels?\n\nGood Afternoon Doctor, My name is Anand Vijayan 19yrs. Today i checked my liver function and bilrubin in urine. I got the result , in that Sgot-45 Sgpt-96 and bile salt and bile pigment is negative. could you please suggest any mesures to decrease my sgot and sgpt.",
    "doctor_response": "HelloIncreased SGPT may indicate liver injury.It may be due to many reasons like hepatitis,alcohol intake,altered lipid profile,medicines,auto immune causes etc.You may need few investigations like routine hemogram,random blood sugar,lipid profile,viral markers,ultrasound of abdomen.I suggest tablet ursodeoxycholic acid 300 mg twice daily for three months to my patients.It helps in regeneration of liver cells.Further treatment depend upon investigation reports.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes double and blurred vision along with numbness in the tongue?\n\nI m 29 yrs old. I been having a double blurred vision for past 4 years now, with a numbness on my left side of tongue, both symptoms tongue numbness n double blurred vision starts at the same time n it lasts up to 3 minutes, then a bad headache and feeling of nausea starts after that, I m worried. I need the answer please and thank you",
    "doctor_response": "Hi, You need to see a neurologist for a full and complete workup but you may be suffering either from some type of seizure disorder, sudden restriction of blood flow to the brainstem or these could be aura symptoms to ocular migraines. Otherwise, look up a local friendly neurologist or even headache specialist.  They will work you up and get some concrete answers for you. I agree that you need to get to the bottom of this...very important. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for pain in gums after quitting tobacco\n\nmy name is Vishnu Prasath.S, since my age of 17 am addicted to this Guthka,now i am 24 yrs old ,am 6'1 inches tall with a weight of 79.5kgs,i have quit the habit of chewing tobacco or gutka or any of its form,its not been long jus few days ago i quit ,now i am facing pain in my gums , this makes me feel restless, what should i do ,kindly guide me pls,thanks in advance",
    "doctor_response": "Thanks for using health Care magic.Read your query.Good ,you have stopped taking Guthka, as it would have have harmed you .It causes sensitivity and gum problem.I would advice you to visit your dentist and get your teeth cleaned  and follow the correct post maintenance instructions.Don't restart the intake of the tobacco products.Use a desensitizing paste for a while.Do salt water gargling.If pain is too severe ,you can take paracetamol and get your teeth checked for any decay.Hope this was helpful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Painful lump on palm, pulsates on applying pressure, intermittent tingling in fingers. What could it be?\n\nHi there, I have a painful lump on the palm of my right hand , it isn t solid and cannot see that the skin has been broken, as thought maybe a splinter or bite. The lump is in the centre and feels like its the vein as pulsates when pressure is applied to it. I have had intermittent tingling in my fingers. I have had this now for two days and doesn t seem to be improving. Can you shed any light as to what it may be or should I see my GP?",
    "doctor_response": "Hello,the commonest swelling on the palm are due to palmar space abscess due to infection. But your history is not in favour of any abscess. But it appears to be likely a neurovascular lesion because of pulsation and tingling.You may have to consult your doctor and get it evaluated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes an elevated liver enzymes?\n\nwhat does it mean when your billirubin is elevated, fluid in the bowels, alsowhat does it mean when your billirubin is elevated, fluid in the bowels, also liver enzymes elevated as well? I know that's a lot of questions at once but that was the way it was presented to me.",
    "doctor_response": "Hello! Thanks for putting your query in HCM. I am a Gastroenterologist (DM). It may suggest cirrhosis of liver or Liver failure. To confirm few more tests are required like ultrasound abddomen to know the liver echotexture, portal vein diameter, size of the spleen. Some blood tests like serum albumin, prothrombin time.I hope I have answered your query and this will help you. If you have any further query  I will be happy to answer that too. Remain in touch and get-well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizzy spells and numbness of the gums?\n\nI have had several dizzy spells today and with the worst one my gums and around my lips on only the rt side became numb and tingly. Also was off balance for a time. could it be vertigo, as my dr. suggested when I called. I was not hyperventilating at all and am not given to panic or anxiety attacks. thank you",
    "doctor_response": "Hello and welcome.Thanks for sharing your concern.The numbness mentioned here in the history is not related to teeth or gums.it has underlying cause.please visit your physician in this regard.you can start with vitamin B complex.Avoid all sorts of stress and take care.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will pain in the wrist due to myomectomy heal by itself?\n\nHi. I had a myomectomy 3 weeks ago. There is a pain on my left wrist (The IV was on the left). I have a painful and raised vein on my wrist. From what I have read on the intrnet, it could be Phlebitis. Is this going to correct itself, or do I need to go to the doctor? If so, Do I go to the OBGYN, or to my primary care physician?",
    "doctor_response": "Hello, It is nothing but phlebitis( inflammation of the veins). Nothing much to worry as it is quite common after IV line insertion and blood draw. As a first-line management, you can apply over the counter available heparin creams (thromophobe is a popular brand) for symptomatic relief. Nothing much to worry and it will settle in few days. OBGYN has nothing to do with it and you can consult a physician if symptoms persist. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling tired, easy bruising, dizziness and darkening of vision. Anemia? Advised to get tested for leukemia. Why?\n\nWhy am I having so many problems with my body? I keep bruising easily, I am easily into pain, I am always tired, I experience bouts of dizziness and vision darkening. I know it is anemia, but what could be causing the anemia? I eat (in every meal) plenty of iron. I am on iron pills every day, yet I still become anemic. My doctor has tested me for leukemia, and I don't have it....any solutions? I am a male. 13 years old, I am 5.4. and I am 83 lbs.",
    "doctor_response": "Hello friend,Your question is very important -= 'why am I having so many problems with my body?'This cannot be answered in the way you searched. You are over weight. You get bruised easily. You feel pain more than reasonable. Feels dizzy . You explain everything as because of anaemia. There you are wrong. Then naturally you say: 'I am taking Iron tabs regularly' as if iron will take care of your anaemia. You are lost to find reasons for your sickness.Conventional medicine cannot answer your question.I am a Homoeopath and in Homoeopathy we have answer for your questions but it cannot be given through this forum. Your case has to be studied in detail. Your parent's history, their disease tendencies, your intra uterine life, your past history, treatment history etc. become important. While taking your case in detail we will concentrate on your genetic constitutional dispositions to find out your remedy. This can be done by a very detailed case taking and analysis by an expert Homoeopathic physician. Therefore my advise to you as a young friend is to tell your parents to take you to an expert Homoeopath who can help you to make you free from several physical ailments you are suffering and you will suffer in future if not taken a corrective treatment at the earliest. Your letter does not at all give any details about your mental make up which is very important for a Homoeopath to reach at the right remedy.With best wishes for speedy cure through Homoeopathy,Dr. C. J. VargheseHomoeopathdrcjvarghese@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of pregnancy?\n\nhi i am 21 years old and started feeling sick on thursday night, i have had this feeling ever since and have actually been sick but only a couple of times cant seem to shake this feeling off, also feeling very tired and have sore nipples together with a egg white like discharge down below, is this a sign of pregnancy?",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the tiredness and sickness can be the signs of pregnancy.But the pregnancy is confirmed by urine pregnancy test.The test need to be done a week after missed period for accurate results.The first suspicion of pregnancy occurs with missed period.The symptoms of pregnancy like nausea,vomitings,sore breasts ,increased urination start around 6 weeks of pregnancy.I suggest you to do a urine pregnancy test and confirm.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How can I remove dark patches due to jock itch?\n\nHello doctor, I had jock itch six years ago over the groin area and lower abdomen. It was completely cured then but has left dark patches. I have been suggested by a dermatologist to use Glycolic acid 6 % cream, which does not seem to be working. Suggest an effective ointment to clear the dark patches completely.",
    "doctor_response": "Hi. Infections of the skin usually heal with hyperpigmentation. This post-inflammatory hyperpigmentation is tough to resolve and would take years to go completely. However, creams containing Kojic acid do help to quicken the recovery twice daily for three months. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest solution for problem of loosing grip while writing\n\nI am Datta Padulkar, 41 years old. My problem is not too serious. I just can not write properly with my natural right hand. While writing I fee as I am losing grip of pen & paper. I have no other problem except this. Shall I consult a doctor or any exercise will help me out.",
    "doctor_response": "hi,thank you for providing the brief history of you.A thorough neuromuscular assessment is advised.As you have facing difficulties while gripping this could be related to the neuropathic issues or some motor control issues. getting an assessment done by a specialist like a. neurologist will help provide more inputs. Also, an MRI of the cervical spine or may be of brain will be required to understand the soft tissue pathologies involved.As most cases recover with simple medication and physical therapy. I will advice you the same.In our clinical practice we find such issues arising due to neuropathic factors in the cervical spine. and by motor relearning program they respond well.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headache and neck stiffness?\n\nI have had a headache that wouldn t go away for over a week. Now on top of the headache I have stiffness in my neck. No matter which way I turn my head (up, down, side to side) there is a fizzy noise. Sounds like the carbonation and the fizz of a soda pop. In 2006, I ve had major head concussion due to an accident. Is this something I should be extremely concerned about?",
    "doctor_response": "Hello! I read your question and understand your concern. I think that your headache and neck stiffness may be related to muscular contractions in your neck and back of the head . It may be related to degenerative changes of your cervical column. The sound during your neck movement is another argument in favor of this diagnosis. I would recommend you to consult with a neurologist and have a good neurological examination , a full blood work to exclude a possible infection and a cervical column xray . Other test like a cervical column CT scan may be necessary to examine better your column and intervertebral disks. Hope to have been of help!Thank you for using HCM!Greetings!Dr. Abaz Quka",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bleeding in the stools?\n\nHi, my 5 year old daughter had soft red poo (she also ate loads of strawberry jelly that day) for a couple of days. Took her to the doc the same night but she couldn t see bleeding coming out of her anus. After a couple of weeks (again she ate strawberry jelly) she had soft red poo for a couple of days. A month later she had a tummy ache during the night and went to the toilette a few times with runny dark brown poo. She is like this for a week now and she had a little bit of black runny poo . Am worried but also have made an appt with her GP next week. Please help !",
    "doctor_response": "red stools could be due to eating ref colour substances. but as you told it is associated with pain also, frequent, so could be due to polyps, dysentery, fissures due to hard stools.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shortness of breath\n\nMy husband is almost 68 years old and over weight. Recently he has been getting shortness of breath whenever he walks just a short distance (I m talking a few feet) His blood pressure is pretty normal 130/68, but his pulse has been high for him. It s been running between 75 and sometimes 110. What can be wrong? Do you think it s just because he s over weight? Thank you for your advice.",
    "doctor_response": "Thanks for your question on HCM.I want to ask one thing. Is your husband smoker?.If yes than he is at risk for cardiac and pulmonary causes.Shortness of breath can be seen in both causes.So we need to rule out cardiac and pulmonary causes first.Get done ECG and 2 D Echo for evaluation of heart function.Get done chest x ray and PFT (Pulmonary Function Test) to rule out pulmonary causes.If all are normal than obesity must be the cause for his symptoms.  So strict dieting is needed for weight loss.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever with headache and body ache\n\nHello Doctor, Im Rani 30 yrs female living in kuwait. Past 4 days i have sever bodayache and fever . Went to clinic, they gave Brufen,Amoxcyllin and Actified tablets. they also gave me a injection to redu ce the temperature. it was fine for a night and next morning the same problem started again. So today i have fever, headache, body pain and sore throat as well. Please advice any medication and food intakes during fever.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have fever with headache and body ache along with sore throat this seems to be viral fever or flu. Need not to worry. I would suggest you to 1) Take anti-inflammatory medications such as Ibuprofen to prevent fever and body-ache.2) Drink plenty of fluids, have proper rest.3) Do warm saline gargles.4) Take analgesic such as Flexon and take light diet.Your symptoms will resolve in 3-4 days. If symptoms keeps on persisting visit general physician once and get it examined and start treatment after proper examination and prescription. Go for blood tests a s well. Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have depression and suicidal thoughts. Please help.\n\nHello doctor, I have depression, feeling of failure in life, no more attraction to live life. Sad, anxious, or empty mood. Loss of interest or pleasure in activities. Thoughts of death or suicide, including suicide attempts.",
    "doctor_response": "Hello. I understand what you must be feeling right now. Depression is a serious but treatment illness. I can see you have thoughts of suicide and suicide attempts are also there which indicates that your depression worsened now. But do not worry, there are various treatment options available, with which your condition can be improved. Depression is a biological illness just like diabetes. It is neither your fault nor your wish to be in the pain that you are in right now and you cannot overcome these feelings and thoughts. Every disease needs appropriate treatment. I would advise you to consult a psychiatrist online or offline as soon as possible. Remember help is there please avail it. I would require more details about your problem. Thyroid function test, serum B12. May require inpatient care, medicines, therapy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does \"PTB right upper lobe\" mean in chest X-ray?\n\nhello doc.i had a chest x-ray the result is minimal ptb right upper lobe what does it mean? what are the symptoms because i don't feel anything or something wrong with my health. but last month i was confined with a tonsillitis? i want to know is there a relation the result of my chest x ray now?",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .*  The x-ray results suggests Pulmonary Tuberculosis , which can be    old chronic infection of past or recent development .*  Must seek advise of physician for further management though you have    no problem at present .Wishing you fine recovery .Feel free to ask any further  queries .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had severe stomach pains. MRI,X-ray, medicines tried. Still have pain. On aspirin. Suggestions?\n\nI have had tremindous stomach pains.  I have had MRI, X-Rays, tried new meds and I still suffer from the same pain. To me it feels like it is getting worse but my dr. keeps saying nothing seroious. I went to an abdominal dr. also and he said just to keep on taking the asprin I was taking to help the pain.  What else Can I do?",
    "doctor_response": "Hi,Thanks for writing in.I suppose you have stomach pains for a while now and started taking aspirin for it with some ?new drugs. MRI and X rays have been done for abdomen or any other part is not clear from your query.With this information, I would like you to stop taking aspirin for stomach ache. You may take proton pump inhibitors (pantoprazole, omeprazole ) and some anti spasmodic medication. Aspirin may worsen your pains by causing gastritis and that might exactly be happening with you.As investigations, I suggest you to have complete blood tests and ultrasound scan abdomen. A gastroduodenoscopy (oral endoscopy) might be done if necessary.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest therapy for rapid heart beat & palpitations\n\nI am 21 yrs old, overall pretty healthy. 5 2, 105 lbs. I learned I have heart palpitations and a rapid heart beat a little over a year ago. In the past 3 months my blood pressure has gone up along with my heart rate. For the most part, we got my blood pressure under control but my heart rate is slowly increasing. Sitting it s normally around 100-110. Walking around home it can get up to about 140. Sometimes I feel like my heart is beating very hard and fast. It is very uncomfortable at times. It makes me very tired. I have learned I have a B12 deficiency about a month ago and the B12 vitamins aren t helping. Could my B12 deficiency be causing my heart to do this? Or could there be something else causing this? I have had a stress test, and an echo with a bubble study and everything came back fine. Please help!",
    "doctor_response": "Hello, Most of the time fast heart rate are caused by stress, anxiety & tensions. It is triggered by the stimulants that you might be taking like caffeine, nicotine, alcohol, entertainment drugs, smoking etc. Avoid it. Hormonal changes due to contraceptive implant(Implanon) or other contraceptive devices or pills, thyroid dysfunction, congenital heart disease or heart conditions like arrhythmia, sinus tachycardia, atrial flutter or atrial fibrillation may cause heart palpitations & discomfort. You are suggested to get physically examined by a heart specialist & get CBC, Urinalysis, ECG, Echo, X-Ray done to rule out any developing heart disease. If you are obese, get a lipid profile done. Take home made food avoid eating junk food, stay well hydrated. Dehydration also causes palpitations. To regular exercise and stay away from stress. Your treatment will depend upon the severity of the disease detected. Maintain weight as per BMI. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nupur K, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could swelling and redness in ankles, feet, arms followed by severe pricking pain and numbness indicate?\n\nRecently whenever I am up moving around or sitting for 10 minutes or longer my feet and ankles begin to swell and get reddish. I can feel in my forearm and wrists swelling as well occurring, and it becomes very painful trying to even move them. After about 20 minutes of the swelling has occurred I feel a very painful feeling of needles puncturing my skin in my feet , ankles, and upward. I get so numb that I can not even stand or walk. I m not sure what to account this all to?",
    "doctor_response": "HiThis may be due to vasculitis..you must consult a rheumatologist or a physician for tests of blood, color Doppler testing, blood factors,CBC,CRP,etc.Prednisone tabs. are often a remedy after confirmation of diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain, chest pain. Gallbladder removed. Have had pancreatitis. Help?\n\nI ve had pancreatitis before and they took out my gallbladder , just the other night I had a severe attack and I couldn t even take my self to the Er, emsa had to come and get me, I m also getting pain in my left side of my chest on into my shoulder blade, they did a ct scan and blood tests and nothing came back, they released me with unknown abdominal pain , I go to a specialist Thursday, any ideas what s happening? I m getting real tired of these pains!!!",
    "doctor_response": "Hello! Thank you for the query. Upper abdominal pain and left chest pain radiating to your shoulder blade can be caused by heart problem. And this should be ruled out at first. To do that, heart ECG and heart enzymes should be checked. It is also possible that there is a stone in your bile ducts and it is causing your pain. Usually gallstones are invisible in the CT, that is why abdominal ultrasound should be done. Do not know what blood tests were performed but you should have GGTP and AP checked (usually elevated with bile ducts stones). Upper GI endoscopy should be also done to rule out peptic ulcer. If no findings in ultrasound and blood tests, ERCP procedure should be also considered (to contrast pancreas ducts and bile ducts). Hope this will help. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes memory loss, tiredness and agitation while on Levonelle?\n\nHi, I took levonelle about 4-5 weeks ago, only about 4 weeks after having a termination (I know, I ve sorted contraception now), but I m having terrible hormonal side effects. My skins broken out, I feel hormonal and stressed, tense, my memory s awful, I ve lost about 9lb in 3 weeks, I m tired and feel restless and agitated. I m also angry and weepy. I m pretty sure it s from both of these things but I need to know what s going on with my hormones.",
    "doctor_response": "dear,sudden stoppage of hormaonal pills have invoked a withdrawal symptoms in your body.your body mechanisms would need time to tune itself in absence of hormonal supplements to function, which may take couple of months around.A gradual tapering off of the hormone would have prevented it.a setting up of secondary depression is quite evident.I would like to advice you to undergo a course of anti-depressant for couple of month.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chronic back pain, scoliosis, severe pain. on Methadone, Any advice?\n\nI have had chronic back pain due to scoliosis for years now...I have had the back surgery to \"fix\" the problem and now have 2 rod and 32 screws in my back and the pain has increased 100%! I barely can walk, have had a second opinion and was told there was nothing he could do for me...my neck just isn't ready for surgery yet. Now my question...my pain management doctor has been pushing Methadone on me fo....r months now! Should I try the Methadone before I get an opinion on the pain pump! I am afraid to use Methadone and don't like the stigma associated with it! What should I do, try the methadone or go straight for the pain pump?",
    "doctor_response": "methadone can only subside not cure it will work till you takeyou can follow other procedures for trials if something helpslike pain pumpphysiotherapy rehabilitation exercises",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the likelihood of diabetes reversal in a person who is exercising regularly and maintaining a healthy weight?\n\nHello-I am under my dr\u2019s care for a recent (February) type 2 diagnosis.  I am not overweight and I do not drink alcohol.  I changed to a LOW carb diet, no sugar.  I take 1000 mgs of metformin per day.  I am two weeks in on a everyday lap swimming regimen of 2/3 mile.  My blood sugar 3 hours after a meal is 116.  Is it possible to soon go off meds?  Before starting exercise I got my a1c down to 6.5 from a February number of 10.5.  What is the likelihood of diabetes reversal?Thanks for your help.",
    "doctor_response": "Hi, Diabetes mellitus was initially thought to be an irreversible condition, however recent knowledge has shown that weight loss can reverse the changes. Data has shown that losing 10 kg of weight reverses diabetes in 2/3rd of patients if done earlier. So you are right, you should focus on diet and exercise to reduce weight. And if your sugar levels are good, you can always stop drugs. However regular follow-up of blood sugars is necessary. Please do not stop medication without the advice from your doctor. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Muhammad Zahir Shah, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for back pain\n\nI am a 46 yr old female who's had back pain for years.My symptoms are sore left hip, tailbone cracking,bottoms of feet hurt, upper thighs REALLY hurt and have \"dents\" in the muscles,im fatigued most of the time and also have tiny  muscle twitches all over. My knees also crack. Sometimes to get any relief at all i lean back on my butt while holding my knees until my tailbone cracks, usually 3 or 4 times. Help :(",
    "doctor_response": "Hi , Welcome to HCM.Reading your query it seems that you are suffering from osteoarthritis(age related arthritis). The treatment of this includes Diacerine50 mg+GLUCOSAMINE 1500MG daily and diclofenac sodium 100 mgslow release tablets daily if pain is there.It can be supplemented with vitamin D (if level is low) and calcium.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why has my lower lip become pink?\n\nHi doctor, I am a male and half of my lower lip color has changed to pink and it\u00a0looks bad. I want to bring it back to normal color. Please help.",
    "doctor_response": "Hello. Thank you for your query on this platform. It may be initial phase of vitiligo a hypopigmentary disorder. Avoid smoking and taking very hot food or drinks. Avoid biting or licking lips often. Take antioxidant tablets. You can try initially with a steroid cream like Fluticasone and Tacrolimus ointment after consulting your dermatologist. Consult your dermatologist for examination and management. For further information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medicine for MS and prolapse disc in back\n\nHello doctor, I have been on baclofen for two weeks first in tablot form and now liquid, I am taking 5ml once a day. Which other pain tablets can I take with this for the pain I suffer with MS and prolapse disc in my back. I also experience a lot of pain in my legs and back. Also if I came off the baclofen would It be alright to come off in just taking less over a a few days? I am not sure the baclofen is helping, but ai do want to give it more time. Thank you very much val wheeler.",
    "doctor_response": "Hi, it is very common to have aches and pains in MS due to spasticity. Baclofen definitely helps you relieve stiffness which in turn reduce pain. but have to follow certain exercise regiem to stretch your leg muscles with help of a professional and also work on your back. It can be tackled easily",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does porn addiction and intense anxiety have any correlation?\n\nHello doctor, I am 36 years old. I have depression, illness, and taking treatments for about 16 years. Now, taking Veniz XR 37.5, Thyronorm 50 mcg, both in the morning and Veniz XR 37.5, 75 both are evening. Feeling fatigue and anorexia. I do not like doing work, feel restlessness, and intensely angry. These symptoms are feeling compulsive looking in the smartphone, porn sites, and porn stars detail, and masturbate two to three times daily. Now, while looking on erotic porn stars videos, heartbeat and anxiety are high. Is it porn addiction? And what are the symptoms of porn addiction? Porn addiction and intense anxiety have any relation? Please answer me.",
    "doctor_response": "Hi. When we are in anxiety and depression, our mind is stressed, it needs something which could increase secretion of a chemical called dopamine in our brain. This chemical uplift the mood. Doing masturbation or any kind of sexual activity increases this chemical in the brain. It is the same as people start drinking alcohol more or smoking more in anxiety and depression and subsequently develop substance use disorder. I would advise you to consult psychiatrist so that your medications can be adjusted. Once you are better you would automatically decrease all these increased sexual behavior. Thyroid stimulating hormone. Medicines need to be adjusted. Sleep well, eat a healthy diet, follow a routine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for cough and cold in a child?\n\nMy 7 year old boy has had a manageable cold with some coughing over the past few days. But tonight he suddenly complained of itching and we saw patches of rash all over his body. It came up out of the blue. He does not have a fever and his energy level if normal",
    "doctor_response": "Hello,Children are very sensitive to any small change in weather (like cold) or environment around them. As they are in the process of developing immunity to many things. The kid got a cough and cold which is manageable as you said but still, it needs proper treatment or else chances of recurrence increase. So make sure you are giving medicines as per your doctor's advice for a cough and cold. Because sometimes it seems like a cough and cold is gone or suppressed for some time, but if it is treated insufficiently, then it comes back again.Here is syrup that can be given for now it will provide some relief-Allegra(suspension)- As per the weight of the kid (do consult a pediatrician in person for proper dosage according to the weight of your kid you have not mentioned the weight here as its necessary to calculate the dosage)About the rash, does the child has any known allergy to any food or substance? Any family history of allergy to some substance or food or medicine? It has happened for the first time or any similar incidence happened previously. As the rashes are very itchy, check if the child has been bitten by some insect that went unnoticed and that resulted in the appearance of rashes. If it's an allergic reaction to anything like food or some chemical or some insect bite, then I would suggest you take the child to the emergency room as soon as possible. So that immediate medical attention will be provided. It will help to reduce the uneasy feeling and also further complications can be avoided. Always seek medical help for any illness in kids even if you can deal with it at home. Also, make sure the child is receiving all the vaccines that he or she should be receiving as per the regular vaccination schedule up to the age of 10-12. It's a necessary thing which should be done on time because it helps for the normal and healthy growth of the children and keeps them safe from life-threatening infections.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Manisha Auradkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes an elevation in the liver enzymes?\n\nI am a healthy 52 year old women and I just had my annual check up and my doctor called me and said my liver enzymes were high. My GGT is 203, AST is 43 and my Alkaline Phosphate is 203. I am going back for another blood test, she is checking for Primary Biliary Cirrhosis. I don t know anything about this disease and the info on line was pretty scarey. What else could cause elevated enzymes? What do you know about PBC?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have elevated GGT and alkaline phosphatase levels.  It suggest cholestasis.  Some injury or stasis in biliary tract can leads to this. In primary biliary cirrhosis there is bile stasis and cirrhosis. you should go for complete liver function test with ultrasound abdomen.  Search for the cause and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the pea sized lumps on my shoulder and back?\n\nHi. Last month i felt a small peas like on my underarm. I didnt pay much attention until this morning. I was worried when i stretched my skin on my right shoulder and i saw multiple peas like on my skin. While im having my shower this evening i also felt the same way when i palpated my upper back. Im so worried. Could you please give me some advise on what to do?",
    "doctor_response": "Hi ! Good morning. I am Dr Shareef answering your query.It might not be possible to reach even at a approximate diagnosis only with your history over the net. I would suggest you to please visit a general surgeon in your area for a clinical examination and further management of the problem to avoid any related complication.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat knee pain with swelling?\n\nTwo weeks ago I bent down on my knees to get a can of coke. When I got up I got a slight pain in my knee which left shortly later. The back of my knee begin swelling. Soon taking over my whole knee. Each day the swelling gets bigger and it had moved to the front. It's huge. I cannot walk on it without pain",
    "doctor_response": "Hi,I recommend you go for an x-ray, MRI, physical examination by your specialist for fissures or fractures. Sometimes its a muscular tear or a ACL or PCL minor tears are suspected especially when swelling persists and increases that is dangerous. You may start to wear a knee support, hot fomentations followed by topical gels is effective. Maintain your leg straight as you could and avoid bending it or any vigorous actions. Elevating the foot over a pillow also helps with your swelling.Analgesics such as Acetaminophen (paracetamol) and NSAIDS are often recommended. Chymotrypsin, trypsin and Diclofenac are also recommended. Try not to be late to visit your physician to make sure your knee is safe and doesn't need any intervention. Hope the above information helps you. Any further clarifications feel free to ask.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Ahmed Aly Hassan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are ovulation induction drugs effective ?\n\n29yrs,pcod,irregular periods, taken three month course for pcod after that two months past doctor take USG but not found any major follicle in this. now she recommened another three month course with duloute -L and ebexid. what would you suggest? another doctor recommend ovulation induction drug i.e some clomipine type.?IS this safe for me i am confused .which doctor i had to follow? i want preg soon. if i choose induction drug method Is it solve my problem .otherwise one more month would be wasted.and then i have to follow three month course.",
    "doctor_response": "Hi Welcome to HCM Read your prob,if your follicals are not maturecomplete then you should wait for another month also. as when they get their full size then there is more chance to ovulate if in case they cant rupture ,you should get injection of ovarian stimulant for rupturing them. you can also start clomifen tab after your period as per advise ,so that you can not be late for a month.it has no side effect.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can infected urine cause infection in an amputated leg?\n\nMy husband who is 69 and weighs 190 lbs. recently had a below the knee amputation.  Within one month the lower limb was infected and he is now in the hospital after they did an above the knee amputation.  I have a couple of questions.  First, the surgery was done this past Monday late afternoon and when I left today which is three days later he still did not have any bandages or wrappings covering the incision/staples and a small open area for drainage of blood.  After the first amputation the doctor had specific wound care orders which was dry dressing to be checked every day and changed every day.  This time...the doctor signed off the case within 24 hours and left no wound care instructions.  I have been asking the nursing staff, the hospitalists, etc. why the limb is not covered and today my answer from two doctors and a wound care nurse is that it is better for it to be free from dressings and just be open air.  I told them I didn't agree and that did not go over well and was told when I receive a medical degree or nursing degree then I could voice my opinion.  I am extremely concerned about infection as his first amputation was infected and is still on IV antiobiotics for treatment of the infection.  He has had periperal vascular disease for 15 years and the amputated limb has an old graft that took three angioplastys to open the blockage for the first amputation.  My husband has had a Urinary Tract infection since the first amputation up to today.  They had to drain his bladder twice because the readings were showing urine retention in the 700 range.  I mention this because one of the doctors who is refusing to bandage his upper limb says if the urine should get in his open new wound it could not cause an infection?  I also questioned dirty sheets being placed on top of the wound, my husband touching the wound with dirty hands and just plain old germs that are everywhere in the hospital.  Isn't a Urinary Tract Infection mean there is bacteria in the urine.  Because he has had this UT Infection he has been using a urinal and it spills all the time.  The would and open incision are very close to his penis and the urinal is touching his limb all the time.  Should I be worried about infection without this wound/staples being bandaged and the fact the urine is getting on the open wound area.  The lower limb was so badly infected that it had turned black and their was no choice but to amputate highe",
    "doctor_response": "Thanks for consulting. I have carefully worked through your case, and I can realize your health worries. Being your physician, I assure you not to worry as I will take care all of your medical concerns.your husband must have got the urinary tract infection when he was put tube for urine first time. following an amputation for an elderly person the chance of infection are high so that's why he was given an IV antibiotics. that too if he is having diabetes the chance of infection are even more high.kindly take care that by no way his urine comes in contact with the amputation wound. the mater of content is not that your husband having urinary tract infection. the normal urine itself is full of germs. hospital is the worst place to manage the amputated wound like this. hospitals is full of bad and strong germs. MRSA is a night mare and is common in hospitals. My advice will be you personally learn from the health professionals and get your self trained in cleaning the wound and you do it every day from your home. also it is better to keep the wound open rather than keeping it closed as the temperature inside a closed wound becomes favorable for germ to grow. in open wound the oxygen in air and cooler temperature becomes unfavorable for the germs to grow. but extra care must be take to keep the bed and bed sheets clean.keep a check on the sugar levels and keep it controlled in normal range. Hope it helps. If you need further, detailed and quick assistance related to any health issues in future, feel free to 'ask me a question' directly from my profile.Have a wonderful time ahead. Best Regards!Dr. Arunmozhi varman",
    "dialogue_context": ""
  },
  {
    "patient_message": "Itchy eyes, red spots under eyes. Histroy of allergy in eyes. Suggest\n\nHello.I have recently made a huge mistake. Being stingy I used daily contacts for more than one day and washed them with water to out in my eye. I went to the doctor and he recommended some anti allergy drops. The matter has now been solved but unfortunately my eyes still itch sometimes and I am starting to get these red spots underneath my eyes. I'm also worried because it might be an STD as I read something about it on a symptomps page. I appreciate your helpKind regardsNik",
    "doctor_response": "this is no history of std AS THERE ARE SOME LESIONS ASSOCIATED WITH STD THIS IS ALLERGY ONLY AND ALLERGY TAKES 3 WEEK TO GO TAKE ANTIALLERGIC ALLEGRA 1`20 MG OD FOR 3 WK APPLY NEOSPORIN H EYE OINTMRNT OVER EYES PUT CHROMAL FORTE EYE DROPS IN EYES BD DO FOR 3WK EVEN IF THE SYMPTOMPS SUBSIDE BEFORE YOU CONTINUE FOR 3 WK THIS WILL GO AWAY YOU CAN ALSO WASH WITH WARM WATERI",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stage 4 breast cancer\n\nHello, My mother has stage iv breast cancer, she was diagnosed about 6 years ago and after treatment everything was looking good, however last year she began suffering pain in her back and was continually misdiagnosed until august when it was confirmed that the breast cancer had spread to her bones, after extended periods on chemotherapy, in february this year she had to stop as it was affecting her Heart, since then she has started to suffer from nauesia and headaches and so she was given an MRI three days ago, today the results show she has LOTS of brain tumours, the biggest being 2cm so they are going to start radiation therapy. I am currently working away and in three weeks i am going to be home before going away for another month. Should I be planning to organise some time off work? Im worried that she will really start to go downhill quickly.",
    "doctor_response": "Good morning. Treatment in a case of metastatic breast cancer depends upon the receptor status and the areas of metastasis. Receptor status like ER PR and HER-2/nue rectpor. Depending upon the positive receptor, drugs are chosen. Similarly if the disease is only in the bones and breast, drugs acting on ER receptor like tamoxifen(oral drug) will help in early stage and no need for chemo in the beginning. IF HER-2 is positive then a targeted agent for HER-2 is added(trastuzumab drug). For bone strengthenng another agent like bisphosphonate or denosumab is added. So you need to know her receptor status before planning out the treatment. Radiotherapy will of course required for brain metastasis.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Regestrone effective in the treatment of infertility?\n\ni am trying to get pregnant and my last periods was on oct 11th. i got some spots on 5 th nov and 6th nov, tested for pregnancy but it was negative. So doc advised to take meprate 5 mg for 5 days, but i didnt get periods, so doc again advised for regestrone 5 mg. i am taking this tablet and excepting what will happen. please advice on this situation",
    "doctor_response": "HIWELL I HAVE GONE THROUGH YOUR CASEWELL REGESTRONE DOESN'T HELP TO CONCEIVEBUT HELPS IN MAINTAINING PREGNANCY ONCE YOU CONCEIVEJUST WAIT FOR YOUR NORMAL MENSES, IF NOT KINDLY DO HORMONAL PROFILE AND BASE LINE USG PELVIS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause painful lump on inner chest?\n\nI am a very active and healthy 21 year old.I was working out yesterday. I do very explosive pushups and pullups and olympic weightlifting. I wokeup today and noticed a pea size lump by the insertion point of my inner chest on my right pectoral, it is very painful. Is it a ruptured vein possibly? Or should I go to the doctor to see if it s possibly worse?",
    "doctor_response": "hi,thank-you for providing the brief history of you.A thorough examination of the chest and costochondral joint is advised. An x-ray or MRI will help much to understand.It looks more of a costochindritis and needs to avoid exercises for time being which aggrevates the inflammation of the costochondral joint.Also, doing breathing in that duration of rest while placing the hand on the painful area will help strengthen the muscles. As intercostal muscles are smaller and needs a thorough understanding and proper exercise a physical therapist should help better.In my clinical practice most cases respond well to physical therapy guidance.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure cough with chestpain and back pain ?\n\nhi sir am suffering from cough for a long time and also i am suffering from chest pain and upper back pain through the cough . what is the solution to cure these problems ? and please inform me to my mail odela_raju2007@rediffmail.com please inform sir",
    "doctor_response": "Hi Odela raju Welcome to HealthcareMagic. What other symptoms do you have ? Do you have excess belching , bloating?Do you have any fever ? I sthere any sputum when you cough, if so what is its colour? Please rule out a reflux disease and then get a chest x ray. Please answer these question so that I can help you better. The treatment plan depend s on the cause of these symptoms. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain while standing after sitting for some time?\n\nI am a 57 year old female. When I sit for any length of time, whether it be 5 minutes or 5 hours, I have difficulty walking. I also get a lot of pain on the outside of my right leg. Another thing, when I sit or lay down, shocks bounce back and forth all over both legs and feet constantly. It never stops until I get up and move around but the second I lay back down, it starts again and is continuous. Do you have any idea what could cause this?",
    "doctor_response": "hi,thank-you for providing the brief history of you.As per your age there are possibility of having degenerative changes in the knee joint and also the lumbar spine.The knee joint pain can be due to early osteoarthritis changes in the knee and the shocking like pain in the legs is due to nerve pinch in the lumbar spine.I will advice you to undergo a thorough clinical examination and an MRI of knee and lumbar spine to u understand the possible soft tissue Injury.Treatment:Physical therapy in my clinical practice has successfully reuslt on patient with similar complaints.Physical therapy includes - Therapeutic ultrasound therapy, TENS therapy and exercises.I expect you will recover in 2-3 weeks of time.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for shortness of breath and chest discomfort\n\nI went to the ER for a little chest discomfort last night. EKG was normal, but blood work was a little off. My Sat oxygen was 90 and my d-dimer was high so they did ABG blood and a CTA. The CTA was negative, and the doctor said everything was good. They did the SAT oxygen and it was 96. This morning I got my labs for the hospital and the ABG levels do not look good to me, the po2 was 35. I do not nor have I had a trouble breathing. Could those numbers be false, and why would the doc say everything was negative with numbers like that? I am 41 male, ex-smoker, I quit 2011, over weight by 25 lbs",
    "doctor_response": "thanks for your question I completely understand your question if pao2 was 35 that is very much decreased but spo2 of 96 % does not match with it .probably it was a venous blood , this is the only possibility if doctor said every report is normalif you have doubts you can have a repeat abg done or you can ask the doctor to tell you the reportsspo2 of 96 % is perfectly normaland regarding copd you can consult a pulmonologist to evaluate and guide youthanksfeel free to ask more questions may god bless you with good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What do you suggest for a white lump on my penis shaft?\n\ni have a very tiny white pearl looking thing about 1/3 way up my penis shaft. im embarrased to go to the doctors and i have had these in my ear lobes before..... took long time to go away. should i be worried about the one on my penis? what can i do to get rid of it?",
    "doctor_response": "Hi. This white pearly looking small lump can be due to very small cyst as you already had it on ear lobes too. There is nothing to worry about and just forget about this. You can not do anything to get rid of this. It may go away on its own.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bruise on skin after a dog bite\n\nI got jumped on by a dog and scratched. I don't think it cut the skin but it was pink, then in a day it bruised. Now a few days later it's bruised dark in a circle. Will this go away on it's own or should I get a medication. I'm 23, 115 pounds, 5'8\" and don't have any medical problems. Diabeties does run in my family.",
    "doctor_response": "Hi,Nothing to worry, from history it seems that there might be having small scratch might have leading to minor blood leaked forming small bruise.Apply ice pack for 2-3 days.Gradually it will be absorbed.go for tetanus toxoid shot.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain with nausea\n\nI have upper abdominal pain with nausea and increased salivation when pain is at its worst. Some vertigo duing a bad attack. Seems to be triggered by food - nuts, little oil, very little onion or garlic or even high fiber, sometimes. Symptoms have gotten gradually worse over 6 months or so and now are significant at times. I am a vegetarian; I eat very little (lowfat) dairy. When I eat eggs, it is only egg whites. I have been supplementing 2+ years Bs, D, C, magnesium and take anti-inflammatory Zyflemend (rosemary, tumeric, ginger, oregano, green tea). BMs are regular. I have chronic lyme disease and finished intense 9-month antibiotic/anti-viral treatment approx 10 months ago. I am not currently taking any treatment.",
    "doctor_response": "Hello....(1) u r suffering from  APD i.e ACID PEPTIC DISEASE with GASTRIC ULCERS (2) take these medicines for 3 weeks without skipping any dose - (a) TABLET RANITIDINE 2 times a day (b) CAPSULE PANTAPRAZOLE once daily before breakfast (c) TABLET DOMPERIDONE 10mg 2 times a day (d) SYPUP DIOVOL-LA 4 teaspoons 3 times a day (e) SYRUP SUCRALFATE 2 teaspoons 3 times a day...(4) avoid spicy food/fried food/alcohol/smoking....follow this advice and it will do magic to your problem :-) take care....Dr Rahul",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sarcoidosis\n\nI have Sarcoidosis and have been perscribed Lamisil for a fungus problem in my fingernails and toenails. I was first perscribed a laquer and drops for this condition, which has been working. My immune system is real bad and my body does not like RX drugs. I am nervous about taking this med. Do you have an opinion?",
    "doctor_response": "Hi I did review your condition.Sarcoidosis is intially treated with steroids like prednisone 40 mg and this is titrated with the problems and severity of your problem.you need to discuss the starting dose of this medication with your doctor and need to take them regularly.abrupt stopping after once started can create problems.I hope this helps.wish you all the best.thank you for choosing healthcaremagic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for weak bones\n\nbuilding up to much mucus in my chest cause me to have short of breath . every time i take calcium I have a hard time to breath and i can not get air in mine lungs so i stop take it . I need to take something for my bones I m small and my bones are weak what can i do please help me. Fara",
    "doctor_response": "Hello Fara. Thank you for writing us here. I would suggest you to take Bromhexine twice a day so you don't have too much mucus formation and also it would melt the mucus which is forming giving you clear airway and would help with your symptoms. Also consult your physician to reduce the dose of calcium supplements and instead you should take more amount of milk and have sun bath more often for getting strong bones. sunlight is very important for this and It would also help you to get better skin and little tan which is beneficial for your overall health.best regards, Dr Gunjan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause for abnormality in blood test report?\n\nI just got my blood work results back and my blood platelets are at 119 with my bili total plasma at 3.2. Everything else is normal. I m a 31 year old male who has had a history of IV drug use and alcoholism. I have almost 8 months clean. I had a hep c test and hiv test about 7 months ago with negative results then. What could be the cause of these abnormalities in my blood work?",
    "doctor_response": "High bilirubin along with the past history of alcoholism and I/V drug intake indicates liver involvement. To confirm it you should get examined alkaline phosphate, SGPT and SGOT levels. Your platelets are 1.19 lac which is normal and does not signify anything. Bilirubin levels also become high in jaundice so I will advise you to get complete workup done from your physician. I also will advise you to quit alcohol and drugs as they are affecting your health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Meaning of MRI showing diffuse brain parenchymal atrophy?\n\nMy sister aged 46 years had an MRI today and the impression is showing - diffuse brain parenchymal attrophy. she is under medication (anti depressants) She is under deep sleep for the last 12 hours same like coma BP, Pulse, ECG, Blood sugar all normal",
    "doctor_response": "This finding is coincidental.due to the effect of antidepressants she is asleep.brain atrophy does not cause this condition",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I had my periods before 50 days. Will Kalarchikai induce my periods in a week?\n\nHello doctor, I am an unmarried woman. I got periods before 50 days. I am having kalarchikai from yesterday. Will I get periods within a week? Five months it is was a regular cycle the sixth month is like this. It was irregular now again same. What to do?",
    "doctor_response": "Hello, Welcome to the icliniq.com. You have the delated period problem. If you have any history of unprotected sexual intercourse than rule out pregnancy by urine hCG card test. If the pregnancy test is negative than rule out thyroid issue by serum TSH estimation. You need to investigate with ultrasonography of abdomen and pelvis with particular emphasis on the ovary to rule out the ovarian problem if present. If you have gain weight recently then also it can be the cause. For that, you need to lose weight. You can consult a nearby gynecologist for your detailed pelvic evaluation. I hope I have answered your question. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Focal fits and temporal horns in brain\n\nHello Doctor , For the past seven years I was suffering from focal fits and temporal horns in brain with mild dilatation. Now i m taking mazetol 100 mg tablet for 6 years. Past one year i have not taken the tablet, few weeks back i suddenly got fits. I have to continue the tablet fo all my lifetime. Is there any cure for this ? Please advise me im going to be married with in three months.",
    "doctor_response": "Hello,from what i could gather is that you were prescribed this medicine and without the doctor's knowledge you stopped it abruptly and most probably that was the reason you throwing fits again.See you have to gauge risk to benefit of the medicine taking it for long time.If you are supposed  to take it and that too in a particular dose but you are not having it/taking lesser dose of same, in that case there are increased chances of having a fit. So it is always better to abide by what your neurologist has prescibed you and am sure that he will, in time taper off the dose as required.And as regards cure for this, if you take the medicine regularly there are fair chances you getting rid of the ailment for good.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a small lump on face indicate?\n\nHi, today I woke up with a dime-sized lump on my face. It s on my cheek bone, below my eye. It is quite painful and squishy, I ve been told it may be a cyst. I have to go to work daily and cannot have this on my face while working with customers. What is it? What should I do? Thank you!",
    "doctor_response": "Hi.Thanks for your query.A dime sized lump can not be a cyst if it has appeared overnight. The site bellow the eye on the cheekbone can be swollen die to insect bite, again to say so because it has appeared in a short span, is painful and squishy.Get an antihistamine ans a short course of oral steroids. I hope it will be fine. Please do not fiddle with it, as this area if skin is very sensitive and the edema increases very fast even on a slight handling. Give it some time , it will heal nicely.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for weak heart\n\nHello. I have this friend who I actually met on the internet...well we ve been really close and she is almost like a sister to me. But...well she sort of has this condition with her heart, and I dont want to ask her about it cause I know she will just get sad. I was told she only has a few months left. But she was born with a weak heart. She went into operation for a pacemaker I think and it didnt really work out and I just have some questions...",
    "doctor_response": "Hello, Her situation could be related to heart failure. I would like to review her cardiac ultrasound report if possible, in order to give a more professional opinion. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swelling and pain in wrist\n\nI have a weak wrist as for the past 2 years have managed to fracture the same one! Last night I helped lift a heavy rabbit hutch when I felt something go in my wrist, it was very painful, I took ibuprofen did the ice and elevation trick but this morning my wrist is very swollen and badly bruised?",
    "doctor_response": "Hi, you need screening of your wrist, and the first step out is to get an X Ray done, once its clear that there is no bony injury, the treatment becomes very different, but if you have any bony injury than usually the treatment is surgery and the period of rehabilitation may extend to months, usually 6 to 8 months.Do not delay, as delaying not only lets change in the treatment but the results of treatment also becomes poor.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes ear pain after putting ear drop?\n\nMy daughter is 10 years old. She got ear wax removed by ENT doctor on Thursday - 2 days back on her 2nd visit after use of ear drop based on 1st visit. From Friday night she complained about pain in ear and followed by mild fever. During weekend pain increased. Today her ear started bleeding. Is this because ENT ruptured her ear drum? I took her to urgent care today and the doctor treated it as if there is nothing serious and gave antibiotic. I am worried about loss of hearing.",
    "doctor_response": "Hi,It seems that there might be having some irritation and soreness due to removal of wax giving this type of pain.Nothing to worry, pit antibiotic ear drops for 2-3 days.It is less likely injury or rupturing of drum.If pain persisted or increased then  you might require one ocurse of antibiotic medicine for 3-5 days.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for allergic rashes on the body during pregnancy\n\ni have been getting allergy to beef (i think) since childhood like red raised bumps allover body can be any where really itchy and then i have ayrtec and the itchiness goes in 30-45 mins and the bumps in like 3 hours...i m tired of it and now pregnant so what should i do? i avoid beef but lately it has occurred despite my not having beef ..it happens like any time sometimes not for weeks and sometimes for 2-3 days but zyrtec is my saviour",
    "doctor_response": "Hello dear,I understand your concern.In my opinion the best  treatment for allergy is avoiding allergy causing agent.The antihistamines like cetrizine and chlorpheniramine maleate can be taken during the pregnancy and they are safe.Usually a few pregnant woman complain of itching due to hormonal changes.So nothing to worry.Use moisturizer daily.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for dust allergy\n\nHi, I have had a bad dust allergy, symptoms-running nose, watery eyes, sneezing and heaviness in chest, with slight feverish feel thats gone now,with sem medicines but i have a heaviness in my chest, slight running nose and watery eyes sometimes still, nose is blocked during sleep what medicines can i take, this happens with the onset of Oct and stays long i am from Mumbai and the pollution is too bad suggest a medicine pl",
    "doctor_response": "Hello dear,The symptoms as mentioned in your post can be attributed to Allergic rhino-tracheo-bronchitis.Presented with similar complaints, I usually treat my patients with:1. Tablet Allegra 60 mg twice a day or Tablet Levocetrizine 10 mg in the evening.2. Tablet Montelukast 10 mg in the evening.3. Grilinctus syrup 5 ml to be taken 3 times a day.4. Voice rest- avoid talking in loud voice & for a long time.5. Stay protected from exposure to cold, dust & other allergens.6. Steam inhalation.7. Avoid smoking, cold food & drinks, maintain adequate hydration & take soft, non-spicy foods.There is no need to worry, you will be fine.Wishing you a Good Health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications for patchy and itching skin\n\nMy mother has started severe itching on her body. she has taken many medicines through many dermatologists but no relief. the skin becomes patchy red. Firstly she feels as if some worm is crawling & then the itching starts. the doctors always give her steroids. Can u pls help me with this?",
    "doctor_response": "Hi..the condition you described is known as urticaria.You should consult a dermatologist to know the exact cause for it. Get her few investigations done like absolute eosinophil count and serum IgE levels done to have an idea about the ongoing allergic reaction in the body. Start giving her tab levocetrizine 5 mg at bed time and calamine lotion for topical application.Post her investigations report so that i can guide you further regarding the management.Hope this post is helpful to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes an urge to frequently urinate and a sharp abdominal pain?\n\nHello, For the past 2-3 weeks I've been having more frequents trips to the restroom (urinating), I am hungry shortly after a meal, sharp abdominal pain, if I eat a lil more the area around my bellybutton hurts, do you know what this could possibly be? I hope you can help me.",
    "doctor_response": "Hi,You are mostly suffering from gastritis and urinary tract infection.Get a routine urine test done and show it to a physician if anything abnormal is there. And drink plenty of water.Also start a course of antacid like omeprazole or pantaprazole for your gastritis.Avoid tea, coffee and soda drinks.RegardsDr. Ashish Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for wheezing cough after treated streptococal infection\n\nHi Doctor, Im being treated for Veridians Streptococcus. Have been for over a month now. At first I was given 5 days of Amikacin in injection form 1gr/per day. I had no signs of improvement and was then prescribed Cefalotin for 5 days, injectable 1gr per day. I completed three days of this and went back to the doctor because this also had no beneficial effects whatsoever and I was prescribed 10 days of 750mg tabs of levofloxacin. Im five days into treatment and yet again no signs at all of improvement. I went to another doctor today to get a second opinion and he told me to discontinue use of levofloxacin and start with a 5 day treatment of ceftriaxone injections at 1gr (which I havent done yet) At this point Idont know what to do or who to believe.... My symptoms are not severe or very discomforting in terms of pain, difficulty swallowing etc.... In fact if I hadnt looked in my throat about a month ago and seen the white lump on the side of my throat I would of never suspected I had Strep, as it only tingles a bit here and there. During this time it has niether spread, or become bigger/smaller. The only new symptom recently is a sporadic wheezing cough. I would l really appreciate any input that could lead to finally getting rid of this.",
    "doctor_response": "Thanks for posting your query to HCM.no need to be worried I can understand your concern and guide you about treatment as I understasnd it is a upper respiratory tract infection (URI) .white lump is not always a Streptococcal infection it could be due to some other infection or may be  tonsilolith .first  you need to do :Culture and sensitivity examination of your throat swab to microbiology lab  .It will guide you about exact cause for your URI .presently you should satrt1. gurgling with POvidone iodine gurgle 3 times per day .2. Take Vitamin C 500mg daily.3.Multivitamin and zinc tablet .presently stop taking antibiotic.along with this can consult to ENT surgeon for examination undergo examination .hope this information will be sufficient for your query .rate me if you are satisfied with my answer .feel free to ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Getting shooting pain in abdomen. Sonography and OGD scoppy done. Not cured by ursocol 150. Any more treatment required?\n\nLast One month i am geting shooting pain in abdomen and it starts early morning at 3.30 to 4 am. Dr asked me to do sonography and OGD scoppy. It is done and observations are : Fatty lever and gastritis/ lax cardia . Dr. has prescrived ursocol 150 and rabonik and sparacid, i am taking all these medicines but no relief yet, any more investigations required ???",
    "doctor_response": "Hello,Gastritis will take some time to settle.Due to lax cardia there may be gastric regurgitation and you problems.You may continue the medicine and wait for some more time before going for any further investigations.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat grade 4 brain cancer?\n\nmy mother is suffering from glioma of brain cancer grade 4 she is on bed she is not taking her right side hand is paralised due to left side glioma we r operated in j.j hospital on 28 th january12 she is on liguid  tata hosp given 10 continues radiation now that tumur ariesesto 5cm what can i do ?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern for your mother looking to the history given here I could say that, there you are in best place for the cancer patients, and no need to worry about the line of treatment what ever might be suggested, as long as the glioma is concern you better have a words with the medical team for prognosis, hope this information helps you, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Dubagest safe during pregnancy?\n\nI am 6 week pregnant n my transvaginal ultrasound only a sac of 6 mm is visible nothing else and yesterday morning I also had 4-5 drops of bleeding.Is there  anything to worry or everything will be fine?My doctor also suggested me to take dubagest sr 300.. Is it safe?",
    "doctor_response": "Hi there,,Yes Dubagest which is a progesterone is absolutely safe in pregnancy especially in the first trimester where it given to continue the pregnancy if we are suspecting threatened abortion.So please do not worry about the medication and take it as advised.It is common in early scans for the sac to be empty, on repeat scan after 10 days the fetal pole and fetal heart can be seen .Any early pregnancy has a 1 in 6 chance of miscarriage and usually after fetal heart is seen the miscarriage risk decreases to less than 5%.Hope this helps.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can fibroid be treated?\n\ni have a subserous fibroid about 3.1*2.9cms in the fundus with bulky and retroverted and cervical nabothian cyst of about 12mm is noted in my uterus. i want to know how can it be treated? and is it something serious? and there is mild fatty changes in my liver. so how can this be treated.",
    "doctor_response": "HiDont worry.fiboids are most common benign lesion of uterus.subserous fibroids usually not much problomatic unless pedunculated.these lesions usually regress after menopause.if it is causing any problem to you then requires treatment  otherwise doesnt require treatment.fatty liver is most commonly due to excessive carbohydrate deit intake, PCOD, diabetes etc..best is life style modification.exercise everyday.fatty liver is reversible.so dont worry.Thank u With best regardsVasundhara",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does low protein in LFT indicate?\n\nI had done my LFT (liver functioning) recently. Though everything was normal, protein content was found less than normal. 4 months ago I had severe diarrhea for about one week. After that I used to feel pretty  week and less hunger. But now since one month or more I am feeling quite healthy, feeling enough hunger, taking milk every morning and eating other healthy foods. Still protein level was found less than normal and albumin, globulin were found in range but near to the lower one. Is it any kind of abnormality or disease or normal? Please help.",
    "doctor_response": "HIWell come to HCMThe actual report of Liver function test is not given here but this nothing to worry because the clinical symptoms are very important than the report if you do not have any symptoms then no need to worry about this, hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have been bleeding for two weeks, and I feel the symptoms of anemia. What to do?\n\nOk so, I'm a 20 yo femal, for 5 years I've had inconsistent periods, I would bleed nonstop for 3 months, then go for 4 or 5 without a single drop, I've had normal cycles (as in a 6 days cycle normal flow) only a couple of times in my life, I went to 3 different obgyns did ultrasounds and everything looks normal, they would just tell me that I'm still young and that my hormones are just all over the place, I'm sure if my anemia wasn't as severe, they would just brush me off, but they give me pills (I really don't remember the names) that would work for the 6 months that I'm on them, and the sec the treatment finishes, everything goes back to usual. I don't get cramps, like ever, and I get blood clots and obviously really really heavy flow (pad change every 30 mins) It seems to be triggered by anxiety attacks or just depression episodes. Now, I've been bleeding for 2 weeks and I already feel the symptoms of anemia, and with covid19, I can't go to a doc, pls help I feel like I'm losing my mind, and blood.",
    "doctor_response": "hi !! welcome to iclinq... what you're going through is just the hormonal imbalance.... for a perfect normal monthly cycle the hypothalamus, pituitary, and your ovaries should work in coordination..... that cordination takes few years and varies with individuals...... as of now correct your anemia with hematinics ...would give a prescription on pills.. continue the pills everyday for all 21 days without fail ,at the exact time without missing it...generally bleeding stops by second or third day once you start the tablet....... that would stop the problem.... anxiety / depression / diet u consume also regulate the quantity of flow. .. no worries hormonal/ stress HB, TSH pcos hormonal ocp, hematinics iron rich diet u need take the pills for two cycles and review",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden fainting in a child while eating an ice cream?\n\nHi, I have a similar case to this one, in a 5 years old:my 3 year old child fainted today. she was outside in the hot sun and was eating an ice popsicle. she suddenly cried out. walked 2 feet to where her mother was and fainted. i picked her up straight away and she awoke. when asked she said she had a pain around the nasel area but does not remember fainting .any clue?I suspect vaso-vagal fainting due to the cold popsicle She had a similar case 3 years ago, which ended in pre-syncope. (she didn't faint as happened today...)In the last 3 years she has eaten hundreds of ice popsicles and ice creams, nothing happend....Thanks.",
    "doctor_response": "It might still be a vasovagal attack. Has your child any dental problems like fillings, etc.? Because the raw nerve roots at the base of the teeth are connected to the vagus nerve. When these nerve roots get irritated, she might experience a short period of fainting, but when they are not irritated, she might eat her entire ice cream without any problems.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for asthma\n\nHello, male 53. In 1993 I breathed in smoke of a combination of styrene monomer and organic peroxide. I have been to see specialists who have concluded I have mild asthma. I am on Singulair 10mg, Symbicort and Ventolin.Once or twice a year I catch a cold, which goes directly to my lungs. I am now on Zythromax and Prednisone.I know it's hard to tell from this little info, but does it sound like I'm being treated correctly?Is it possible I had the celia in my lungs burned away by the chemical inhalation?",
    "doctor_response": "U r on the right treatmentI doubt u have celia in your lungs.You should probably get at least baseline PFT, allergy testing",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for nausea while on medication for congestive heart failure\n\nMy husband is on AMOXICILLIN post oral surgery. He has PHENERGAN for nausea but, it inhibits him from urinating properly. I've given him some peppermint tea and crackers for the nausea, . What else can he do to eliminate the nausea he has so he doesn't have to take the PHENERGAN? My husband is 65 years old WT 170 lb. He also takes medication for congestive heart failure.",
    "doctor_response": "Hello!Welcome and tank you for asking on HCM!I carefully passed through your question and would recommend taking metoclopramide instead of Phenergan. This drug does not cause troubles with urination and is well tolerated in congestive heart failure. Hope to have been helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluid in sebaceous cyst removal site?\n\nI had a sebaceous cyst removed off my back 6 days ago and when my wife presses it the same white fluid comes out. It is not infected and im on antibiotics. Should it still have the white fluid in it after being removed? And should I continue to press the fluid out?",
    "doctor_response": "Hi, thanks for writing to HCM.Well, I'm really sorry to inform you that there must be something wrong with your discharging wound!In my opinion there are two possibilities:1. the sebaceous cyst has net been completely removed 2. some smaller cyst in the surrounding or early infection in the woundYes, a whitish discharge could be contents of a sebaceous cyst / lymphatic cyst or some thin pus!I also suggest you to go for a microbiological/cytological test of the secretion  for confirmation and to relieve your concerns!Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Would liver damage shown up in endoscopy?\n\nI am a 53 yr old male, 5ft 8in, I am not sure about my weight but I wear 34 inch waist trousers and med size shirts(not over weight) I had an endoscopy in October which showed a hiatus hernia and Barrett's Esophagus . The question I have is would liver damage have shown up in the endoscopy?",
    "doctor_response": "liver damage would not show on an endoscopy, as you can't directly see the liver with this camera.you could see indirect effects of chronic liver damage through an endoscopy particularly on the esophagus and stomach (such as esophageal and/or gastric varices) but these varices are only seen on advanced liver disease.imaging studies, laboratories and ultimately a liver biopsy are better to check on the status of your liver",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can one get rid of big and painful pimples on the face ?\n\ndoctor i am a 24 years girl and i have been troubles by the pimples i got on ma face since 2 years now. i tried ointments..tablets.. parlor.. herbal treatments but of no use. I did not have pimple problem in ma teens also but now all of a sudden.. it is big and painful..and mostly around my mouth. what should i do?",
    "doctor_response": "Hi..dear beenu., Thanks for choosing HCM., PIMPLES...since 2 months.., difficult to contrlo.., Only solution is.., 1) COMEDONE EXTRACTION... by RF., it must be done by..Dermatologist.., 2) Tab..Isotretinoin 20 mg daily for 2 months., 3) Tab.Azithrmycin..250 mg daiy for 1 week., 4) Take plenty of green vegetables and fresh fruits., 5) frequent washes with Triclosan soap., 6) Topical Clindamycin 1% 2 time sdaily ., ok..thanQ",
    "dialogue_context": ""
  },
  {
    "patient_message": "What precautions to take to reduce wheezing in children?\n\nhello doctor, Our 8 month old son had a bout of bronchiolitis around three months ago.He was admitted and treated with nebulisation using asthalin, budecoert and ipravent. He responded well to the treament and was discharged after a week.  The doctors advised us to use levolin and budecoert with an inhaler. Ashvath, our son is prone to cold and this aggravates his condition resultingin wheaziness.  What precautions  should we take and should we continue using the inhaler? regards, preeti and vijay t",
    "doctor_response": "Bronchiolitis is inflammatory condition,and was treated well.but the usr of steroids budecort is controversial.However budecory must be tampered but must not be withdrawn abruptly.Hence refer to pediatrician to stop drugs.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long to use the movicol?\n\nMy 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.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. 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 (fibre diet) appropriately?You can get back with answers at the following link - www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696Suggestions:1. 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 Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the advantages of laser surgery for adenoidectomy?\n\nHi Dear Doctor My little brother is going to perform adenoidectomy soon as it causes problems in his breathing. However, doctor suggested that a laser surgery would be good. Is it so? Is there any side effect of laser surgery or what advantages it has than any other processes? Regards",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Laser surgeries are newer surgical technique in which NdYAG laser is used for tissue cutting. Advantages of laser surgery are 1. High safety. 2. Less chances of bleeding, intraoperatively as well as post operatively. 3. Precise tissue cutting is possible, so less damage to the surrounding vital structures. 4. Less Surgical time is required so less anaesthesia dosage is required. So laser surgeries are more safer and less time consuming than conventional surgeries. The only drawback is cost. It costs almost double as that of conventional surgery. Hope I have solved your query. Wishing good health to your younger brother. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the severe pain in my left lung?\n\nThank you- just want I had hoped for- I have developed a fairly severe pain in my left lung- it is at its worse when I cough (even slightly) and my left rib at the bottom is also painful. I have no history of previous lung infection. I stopped smoking, must be 23 years ago. My aga is 76 (Just!) and I livev iive in Thailand. Over to you Doctorif I may please!",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Chest pain on coughing is mostly due to lung diseases like pleural effusion and pleurisy. So better to get done chest x ray first. If chest x ray is normal then no need to worry for lung diseases. Sometimes simple musculoskeletal pain can also cause similar symptoms. So apply warm water pad on affected. Take painkiller and muscle relaxant drugs. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my stomach feeling strange and pooped some blood?\n\nHey this is fairly embarassing but I pooped blood the other day and I'm freaking myself out. My stomach has been feeling strange ever since then. I'm not really in pain or anything, and It may all just be in my head, but I'd really appreciate some expert thoughts on the subject.",
    "doctor_response": "Hi there,If you had blood in your poop and it is dark brown or black in colour then you do need to visit a doctor and get yourself evaluated especially the upper part of your GI tract i.e stomach, oesophagus and Duodenum. If what you pooped out was red colored fresh blood then most probably you had hemorrhoids which you would have injured while straining to pass poop. This can be treated by having plenty of fluids and fiber in diet alongwith applying hemorrhoid cream to your inflammed area.Thank you for your query,Dr Arun A",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to stop masturbation?\n\nHello doctor! I am suffering from the aftereffects of overmasturbation. I am 22 years old and i masturbated for 9 long years continuously. A year back i started feeling many problems due to this addiction and i started trying to quit masturbation but u know that addictions aren't easy to get rid of quickly. Finally almost after a year now i haven't done it for 20 days now and i am planning not to do it ever again but the problem is that i am not recovering. I haven't noticed much improvement in the past 20 days. I just need to know whether this damage can be fixed by refraining from masturbation or not. Tell me about any specific diet that i need to take and any specific routine or rest schedule. Following are the major symptoms: - My pelvic muscles have become weak. I feel light pain in my groin, lower back, theighs etc. - I feel tired and feel lack of stamina. I get tired after 5 minutes of running spree. - I have weak erections and even when i get erect it lasts for just a minute if i stop touching my penis - I don't have morning erections as i once used to have. - The size of my penis has been reduced when erect from almost 7 inches to like 5 inches. the girth has been reduced as well - My penis is no longer that sensitive to touch. I have to struggle to get an erection. - I have also developed concentration problems like lack of focus, loss of memory - I also have an inconvenient feeling in my prostate region and i heard that overmasturbation causes enlarged prostate. Kindly tell me what to do besides refraining from masturbation. Just to let u know that physically i look healthy but internally i am sexually and psychologically exhausted. In the past 20 days of abstinence i had WET DREAMS twice. Tell me how to stop wet dreams and don't lose any further energy. Thankyou in advance. God bless you!",
    "doctor_response": "Hello dear,Masturbation is a normal phenomena, and does not have any side effect on body or mind, unless you get addicted to it.Since you are feeling that masturbation is interfering with your normal functioning, you can try out the following measures:1. Improve your social life by spending more time with friends and relatives.2. Keep your mind active and busy at all times either through curricular or extra-curricular activities.3. Have a diet rich in fruits, vegetables, fish, nuts & honey.4. Avoid fast foods & lipid containing diet.5. Avoid smoking & alcohol.6. Keep away stress, think positive.7. Exercise regularly & practice meditation.These measures will be helpful in improving your health & build up the confidence level.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bad smelling white stuff on tongue, dark brown colored saliva, mouth doesn't seem fresh even after brushing. What is the white stuff?\n\nhello, I keep getting a white stuff on my tongue .It generally occurs after eating however i do have it when i wake up in the morning.I can scrape it off with my finger and doesn t smell to nice.Plus my mouth never seems to feel fresh, even after brushing my teeth sometimes.What is the white substance? Also my saliva seems to appear a dark brown colour too.",
    "doctor_response": "HI, your tongue gets the coating very fast and that coating smells bad. this is normal but amount of coating depends from person to person. I suggest use tongue cleaner regularly two times a day along with brushing. for fresh breath use mouthwash at the interval of half an hour from brushing. Thanks, Dr. Vishal Jain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for headache and shortness of breath\n\nMy 10.5 years old boy has been complaining since a year from pain in his right side of the head when he hits a ball with head or sometimes when he hits his head while sitting in the sofa he says that pain fades under the eyes. Recently since a month he started to complain from difficulty in breathing but the doctor said it is 100 % phsycological. He is atheletic . He is practicing swimming n running since he was 4 years old.",
    "doctor_response": "Does your son hit soccer balls with his head?  If so, he could be getting a low grade chronic concussion.  His symptoms do not sound psychological.  His breathing may be due to exercise induced bronchospasm or stress but his head symptoms warrant investigation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lump on mid-section of back has resulted in severe pain all over body. Is it because arthritis has remained untreated?\n\nI have two problems which may or may not be related. 1.) For the last 15 months i have had a small, gulf ball size, boney lump in the mid section of my back. It does not move nor relieve pain when rubbed. I have psoriasis which i developed when i was only 12 years old and was first treated for arthoritus when i was 18, currently untreated due to income. The pain has grown so bad that it is now traveling down my left buttocks and knee throbs, to the point of staying in bed often and unable to stand nor straighten out my body when i first wake up. 2.) The past 9 months but seem to become more extreme the past two months is more of a sickness type pain which comes with a beefy list. -Sweating always, even more so when i sleep, i wake up in a puddle with wet clothes and bed sheets every night even when its 60 degrees in my home. - lost of weight, it flexes from 79-95 in amatter of a week or so, and extreme hunger and thirst, then feeling like im going to throw up when im finished. And never satisfided. -Blur vision, to the point i havent driven in 2 wks, and survier eye pain. (Often cold rag on my eyes tends to relieve the pain only while in used) -Whole body aches and pressure headachs from ears forward that dont let up. -The past 2 weeks to seem to be in the bathroom peeing every 10 minutes or so, a large amount of pee even when i havent drank alot of fluides. Pee seems to be strong dark and in large amounts. -Septic fumes traveling up my throat into my mouth with hardly any relief. -Ringing in ears every once in a while the past few days mainly left side and loudly. - a few times these have even came along with a bad fever over night but doesnt last long. -2 months ago was tge first time my first three finger on both hands but worse on my left went numb. Feet are the same but travels past my anchels. -I have a long history of kidney infections and uti. -Sometimes my neck is stiff but that maybe from being in the bed all the time -right before my current spell of all these symptoms i had the biggest flare up of psoriasis patches i have ever have, almost over night, which now covers 80% of my chest, stomach, hips, back and but. Traveling up my neck. - and to top it all off i am loosing my hair i believe is due to lack of food in fear of getting sick. I have these spells for over 9 months on and off but this current one seems to have taken ov",
    "doctor_response": "Hello. Thanks for writing to us. The presence of lump on the back can cause a severe pain due to its position. It can cause a nerve root compression. Ankylosing spondylosis is another common cause.I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal ,drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pressure with a history of angioplasty?\n\nHi, may I answer your health queries right now ?  Please type your query here..i got angioplasty for LAD and LEFT MAIN OSTIAL IN april 2009.in january 2010 THALIUM TEST show mild to moderate blockage in anterior wall.now since last one month i am having mild pressure in chest.",
    "doctor_response": "Hi ThereAfter going through your query I understand your concern.I would like to tell you that Left Main Ostial is a point of major concern in itself. Generally Left main disease is to be corrected by open heart surgery rest depends on the condition.If your thallium test was positive for moderate blockage and now you have developed symptoms then you should personally consult with your cardiologist and get a evaluation done. You may require an angiography for a proper evaluation of the evaluation.Hopefully this will answer your query.Kind RegardsDr. Navneet Mahajan",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of vitamin d deficiency?\n\nI have just found out I am vitamin D deficient and had an iron level of 6.My doctor has prescribed ferrious sulphate and Aciferol D3 20,000 unit tablets twice weekly.I have been taking them for a week and feel worse,my legs and arms ache and shake and I have a constant headache,are these symptoms of these conditions and will they feel better over time?Thank you",
    "doctor_response": "Hello again,You may be having severe vit D deficiency and you may need to repeat supplement. You may need 2 more doses at interval of 4 weeks.Effect of this dose of vitamin D will take 2 to 6 week\u2019s time to show results.Physiotherapy sessions may help to reduce pain, so I advise to take physiotherapy.You may need to continue iron supplement.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you find this answer helpful do not forget to rate this answer at end of discussion.Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes palpitations and a blackout spell?\n\nHi, I m an (almost) 18 year old female and last night, I woke up and my heart was beating faster than normal. When I got up and walked to the hallway, I suddenly starting hearing this really loud ringing noise that overpowered everything. I felt disoriented and dizzy as well. My vision kind of blacked out - I couldn t see anything but I was conscious. I also felt extremely nauseous. I sat down and after a couple minutes it all went away. I still feel a little out of sorts now. What s your best guess as to what happened to me..",
    "doctor_response": "Hi, If this happens the first time, so now it is to be kept under observation, else it might be due to some nightmare, dizziness. Lightheadedness must have been due to hypotension, happened due to a sudden change of position from sleep to sitting or standing, for safe side cardiac and cerebral test can be thought. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Akhtarhusain, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Would herpes infection affect the window period of HIV 1 and 2?\n\nHello doctor, I have a question regarding co-infection of HIV with various other diseases like syphilis, herpes 1, herpes 2, gonorrhea, hepatitis C, hepatitis B, chlamydia, CMV, HPV, and molluscum contagiosum. Some time ago, I had a paid unprotected oral sex encounter but vaginal sex was mostly protected. I say mostly protected because the condom was very loose due to my erectile dysfunction. I received oral sex from her without any protection. Please take into account that prior to this episode I have been experiencing chronic penile sores and burning in urethra supposedly due to my established herpes infection (earlier tested positive for both herpes 1 and 2). I also have a weak immune system because I suffered from malnutrition while growing up. I have four questions that I want to ask. Would my herpes infection affect the window period for HIV 1 and 2? Would the window period for any of these aforementioned diseases be affected in case of pre-existing or simultaneous co-infection with another STI? Also, would my herpes infection increase the likelihood of getting infected with HIV or any other STI? Lastly, please advise when should I get tested for all these STIs in order to have conclusive results.",
    "doctor_response": "Hello. No, herpes does not affect the window period for HIV 1 and 2. Yes, it could be if the immune system is compromised. The term window period is used mainly with reference to HIV. Herpes infection per se does not increase the chances of an STI. But the mode of transmission of herpes is similar to the mode of transmission of other STI diseases. So the risk of exposure to all STIs is the same.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Lactitol Monohydrate syrup be safely taken for constipation?\n\nhello doctor. my son just 70 days old and he is suffering in constipation from last 7 days and this is the second time it is happen.his dr. prescribe him latitol monohydrate syrup.is it safe for my son?kindly advice.regards, ashish debnath kolkata",
    "doctor_response": "Hi...giving lactitol is not advisable for constipation at this age. You can give him some warm water and he will definitely pass. Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for loss of mmemory\n\nmy grandpa has been shaking uncontrollably and can only eat things like yogurt and apple sauce. the nurse called my grandma yesterday and they told her that before she left he wanted to go to the door and watch her leave and started crying. and his memory is ok but after about an hour he forgets it. Is there a symtom name for that",
    "doctor_response": "Hello, It could be an age related senile dementia or Alzheimer\u2019s disease. Considering his age prognosis will not be that good. Consult a neurologist and get evaluated. Drugs like donepezil will be effective. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does cancer treatment cause goiter?\n\nmy question is : can cancer treatment chemotherapy cause thyroid glad/goiter disease? Is chemotherapy causes not interest for sexual intercourse? when will stop te falling of hair which caused by cancer and healed after taking chemotherapy treatment. still there is many hair are falling with my wife comb? Thank you very much! all doctors who participate for answering my questions",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Gone sexual desire and hair loss are known side effects. Good part is that they will go with time after completion of chemotherapy.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. B.dinesh",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes loose motions and vomiting in toddler?\n\nhello doctor, my daughter is 16 months old. since last night she has been suffering from acute loose motions and vomitting. whole night she was crying. she has already 7 teeth and when she plays she tries to put anything which she is playing with into her mouth. she is crying and i cannot tell you if she has stomach ache or not. what can be the reason and what steps to be taken to get her alright?",
    "doctor_response": "Hi, I understand your problem. First, I want to know about number of episodes of loose motion and vomiting. she had fever or not? In this case I will check her hydration status, respiratory rate, Temperature, do her chest auscultation. After that we can do probable diagnosis and can prescribe medications for your child. If probable diagnosis is acute gastroenteritis then I will prescibe Syp. Metrogyl, Syp. Ondem, Syp. Mintagesic P. As these are prescription medicines So better  you consult with pediatrician for further management. I  think this will be helpful to you. Review back. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I plan for baby while having Gland Tuberculosis?\n\nHi doctor,I am 26 years old married man.I am suffering from gland Tuberculosis as detected by FNAC and same is also confirmed by Mantoux tuberculin skin test.I am taking AKT-4 medicine from the last one month.Now My Question is : Can I safely intercourse with my wife as we are planning to have a baby now as its more than five years since our marriage.And will there we any chances of deficiency if my wife gets pregnant in the baby?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  You are suffering from tuberculosis in lymphnode and you are taking anti tuberculosis treatment.  You can plan for baby.  There is no problem in conceiving or no any chance of infection to your wife or baby.  You can plan it. There is no harm in that. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to deal with rashes,redness in inner eyelid and headache?\n\nI have a rash everywhere it's getting better now but just this morning I noticed redness on my inner eyelids then I'm getting headaches. Ive had this rash for over a week but it's finally getting better now this eye lid headache deal is killing me. Could this just be an allergic reaction?",
    "doctor_response": "HelloThank You for contacting HCM.Yes it could be allergic rash. Allergic reaction takes few days to resolve completely. I would recommend you following things:> Take acetaminophen for pain twice a day> Apply tobramycin eye drops twice a day in eyes.> Take levocetirizine one at night for 5 days in case of itching.> Wash eyes with tap water 2-3 times a day> Avoid dustReport to hospital if:> Condition remain same after 2-3 days> Any unusual symptom appears> Condition deteriorates.> There is difficulty in breathing.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from PCOS. On clofert. Not able to conceive. Ovashield prescribed. What is the drug action?\n\nI am 26 years Old,167cm,60Kg. I am having PCOS and TTC from 1year, i was on Clofert-50mg for 3 cycles and in the 4th cycle i had HSG as suggested by Doctor. Fallopian tubes are proper as per the report. When i was on Clofert i ovulated in every cycle on 17D but was not concieved. Also when i had HSG on 11D of my cycle, next cycle started 10days late. Now my doctor told to take OvaShield(5th Cycle), please let me know whether these tablets are helpful for me in concieving. Also any suggestions on the food i should take, intercourse with my partner?",
    "doctor_response": "Hello. Thanks for writing to us. Since you are ovulating in every cycle, there should not be any difficulty in conceiving. You can start with ovasheild as suggested by your doctor. Do have regular intercourse during the fertile days of your period. I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL  Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard muscle under scar after appendix removal?\n\nMy daughter had her appendix removed 4 weeks ago..she practiced just a bit with her basketball team on Friday and as of Saturday, when you push a bit down on one of her scars, you can feel her muscle very hard, but it is just under her scar..Do you think she ruptured her self by playing basketball?",
    "doctor_response": "I see no reason to suspect ruptured sutures from your discription  check for any haematoma (red or blue color ) good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy a possibility here?\n\nhi doc !!! my age is 28 yrs and my weight is around 56 kg my height is 5'2 and i am suffering from thyoroid and pcod.my period are very regular and even after doing the relation between 13 20 days of my monthly cycle. I had not concieve. doc has advised me to take Corian 5000 on Day 11for artifical rupturing as size of ovary was (21*23 mm). I felt cramping in stomach on Day 13 and sonography reports showed that egg was ruptured and fluid found in POD. we had relation on Day 13 alost 48-50 hours after taking the injection. Whether making relation 48-50 hours after the injection is right window for concieving. but my cycle which was due on 18 th june 2011 before that i am feeling same symptoms of getting period , still is there any chance of getting pregnant.",
    "doctor_response": "i think you are pregnant. you can go for urine pregnancy test at home  by kit easily available in the market. i wish you are going to be a mother soon. hope my answer helped you. take care. do not forget to give ratings to the answer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in back around waist?\n\nI am having pain around my waist in the back area only. Not front. I am a diabetic and have had a kidney infection before that I did not know about and it spread to my L5-S1 and I had to take 6 weeks of IV antibiotics. That was 7 months ago though. I just started with this pain. Never had it before. Pain 7 on a scale of 1 to 10. Sed rate is 52. CRP 1.4. Could this be related to my previous kidney infection? Have never had this pain before.",
    "doctor_response": "Hello, I have studied your case. Yes this can be due to kidney infection.Usually nerve compression cant be seen on x ray you may need MRI for this.I will advise you to do MRI spineTill time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and interferential therapy will give quick relief.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain and pressure in chest\n\nI did go to a doctor this morning with serious chest pains...there was lots of pressure...and every few min I experienced very, very sharp pains (stabbing pains) 8 on a 1-10 scale of pain.  I'm only 28...I have been involved in a work-out class the last 10 weeks....they did an ekg, said normal - and they took blood and labwork came back fine (it doesn't appera that I have any blood clots), no family history of heart problems in my family - what could be wrong with me?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.There are different diseases that can cause these pain, and they are very serious diseases.A doctor should rule out these diseases before saying that it might be just a muscular random problem. You are a young patient and your doctor has ruled out an acute myocardial infarction and blood clots in your lungs.I suggest you to do a chest x-ray to rule out a possible pneumothorax, and possibly an angio CT scan of the aorta to exclude aortic dissection. Take care of yourself until doctors say you are OK.  Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Anila Skenderi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shivering in hands and legs?\n\nhi. im a 22 year old girl. i experience shivering sometimes in hand and legs when i lift heavy objects(even 3 kgs for 5 to 10 mins) or if i strain myself doing heavy work. when i consulted a nearby doctor, she prescribed me iron tonic, with iron+protein tablets since me Hb is 10.2. but i fear whether this may be a nervous problem. pls suggest me a solution",
    "doctor_response": "Hello, Thank you for trusting HCM.muscle twitches are normal after strain, threshold varies between individuals based on their fitness level. Your doctor was right prescribing iron based on Hb level and being a lady, plus you can add some multi vitamins with vitamin b complex in them but refer to your doctor always before taking any new medication even multi vitamins, and remember to drink enough water. i dont think its a nerves issue. hope that helped.Best regards,Dr. Nazzal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of survival after bowel surgery and delirium?\n\n86 yo male had bowel surgery for early stage cancer. Been suffering delirium since surgery 5 days ago. In surgery now because of probable gas that I suspect is gas gangrene. He is frail, smoker and under weight. What are my father in laws chance of survival",
    "doctor_response": "HIThanks for using healthcare magicDelirium has high chances of mortality and at age of 85, chances are very high. In his case, survival chances would depend upon his physical condition and nursing care. If physically he is not well, then it would take more time to come out of the delirium. Sometime, due to underline dementia, patient does not get 100% improvement. Better to consult a neuro-psychiatrist for further opinion. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain, low vitamin B-12 levels and hairloss after diagnosed with transverse myelitis?\n\nI have transverse myelitis my have every other month have will bad chest pain the heart doctor said my heart is good do transverse myelitis cause your chest wall to hurt. my B-12 level will not maintain in my body i take shot every week this been happen a year. My hair was to my shoulder but it real short like a man hair cut.",
    "doctor_response": "Hello, If you used corticosteroids for transverse myelitis hair may be weaker. Other symptoms are justified by transverse myelitis and low vitamin B12. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking elina 10mg for allergy. Is it safe to apply flutivate cream to reduce marks on skin?\n\nHello Doctor, I had allergy for few months.. Now I am little bit fine and taking elina 10mg alternative day...along with this doctor gave me flutivate cream to apply. I dont have rashes now. But I have marks on my skin due to fact I had scratched rashes earlier when I had allergy. With applying Flutivate cream, can it reduces marks on my Skin?",
    "doctor_response": "if you contrl your allergies and have no further allergies and dont scratch continuos application can reduce marks also avoid mustard coconut walnut groundnut almonds soya oils use olive for cooking and application you will be better ealier",
    "dialogue_context": ""
  },
  {
    "patient_message": "Red pimply rash in left toe, spreading across foot, slightly paining, discoloration. Something fell on foot. Suggestions?\n\nDry skin red pimply rash started at my left small toe and spreading across top of foot.  Thought athletes foot at first but spray did not work.  I slightly recall dropping something on foot (doing yard work) but not exactly sure.  At base of small toe on top could be a bug bite but again not sure.  Also there is a small amount of pain when pressure put on small toe.  Some discoloration (black n blue) but that goes away.   Any suggestions?",
    "doctor_response": "Hi,It seems that the rash on left toe would be either acrodermatitis or allergic contact dermatitis.There may be some cause.It may be dust,grass,fertiliser,soap,water,leather,plastic or other.Steroids in tappering dose,antibiotics and antihistaminics would behelpful to improve the disease.Local steroid witH antibiotic cream may improve the lesions.Doubtful cause should be removed.Avoid soap contact.Avoid stress.You will get improvement.Still, consult dermatologist.I hope you got my answer.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic fever in a child\n\nSir, my daughter age 10 and my wife age 33 are suffering from fever for past one week. All blood test has been done. All is normal. They get intermittent fever and in night also temperature increases. Had 3/doses of amikacin. What to do further for this fever. What can be the cause???",
    "doctor_response": "As a pediatrician I would like to examine patients and want to go through reports... Details needed for further comment",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain and persistent cough?\n\nI have a pain in left lung for a couple of months , also a persistent cough and only recently coughing up a brownish substance  which has me concerned. I don't feel unwell but get tired quite easily. I I am a 47 yr old female. My GP said he couldn't hear anything going on , and it might be muscular ?Kind regardsL. Mc",
    "doctor_response": "Hello,You have brown sputum expectoration in form of cough since many months. So, it should not be neglected. Your work up is needed in form of chest x-ray.If chest x-ray normal, then no need to worry and bronchitis can be the possibility for which antibiotic course prescribed and symptomatic management done. Provide your reports for giving more comment.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Parth Goswami",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes gallbladder to shrink?\n\nMy girlfriend went to the Hospital  the other day and they said her gallbladder is the size of a fart. but it may be because she had just ate 2 hours before.. What causes gallbladders to shrink? And she thinks that it isnt her gallbladder at all and is her kidneys because the pain is now moving to the back near her kidneys but still in the original spot with stabbing pains near her gallbladder. What do you think?",
    "doctor_response": "Hi and welcome.Gallbodader shrinks during the day and it depends on meal that person has taken. fats may cause gallbladder enlargement and fasting may cause shrinkage. Pain is usually caused by gallbaldder stones and this should be seen on ultrasound. So if there are no stones then pain is caused by something else.Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach has been hurting in the middle. Worried ?\n\nMy stomach has been hurtibg go three days now and it sometimes stops but then it come back and it hurts real bad. When I eat it will start to hurt again. It hurts in the middle of my stomach. I m getting kin of scared right now because it won t go away. I ve also have been taking tums. I don t have to puke or any of that. Please help!!!",
    "doctor_response": "Hi, You have gastritis. It occurs due to hyper acidity, or taking hot spicy food ,smoking taking alcohol any pancreatic disease or duodenal ulcer etc. Take light food without oil & chilly. Take more milk. Avoid smoking or alcohol. An antacid will help. A proton pump inhibitor medicine is required if not controlled by above measure. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat pain in coccyx due to pain?\n\nI have had for some time a small hole on the skin about at the tip of the coccyx, last week I fell and sice I've been haping a lot of pain when sitting, I am 19 years old. What could it be? Could it be serious? What kind of specialist should I go to?",
    "doctor_response": "Hello, I have studied your case. Due to fall on hard surface sacrum may be injured. Due to microtauma there may be fibrosis formation.Do hot fomentation over sacrum. It will take weeks to months to subside.Use ring cushion and take sitz bath [sitting in lukewarm water for 10 min]Take analgesic like nucoxia 90 once daily along with tab methylcobalamine 1500 mcg once daily consulting your doctor.If not relieved with all these methods then local injection may be required. You can take this consulting your  orthopaedic doctor.Clinically spinal origin of pain needs to be ruled out, if required MRI spine can be done. You may need to rule out pilonidal sinus.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on roof of mouth?\n\nI have a red lump on the roof of my mouth, it kind of looks like a spot that you would get on your face, this is on my right hand side on the roof of my mouth towards the back. i keep on accedently rubbing my tongue along it, and it is becoming very irritable, i does not hurt its just when i rub my tongue along it is when i can feel it.",
    "doctor_response": "Hi,Dear,Thanks for the query to HCM.I went through your query and understood your health concerns.In My opinion- that lump on roof of mouth could be due to -cyst of the tiny salivary / mucous gland on the roof , may be caused from eating food trauma/ viral infection.-Plz show it to Dental surgeon and he would treat it accordingly.Your main worry is for the cancerous lump in the roof of mouth.-No need to worry as its retention cyst of the salivary glands mostly.-Hope this would help to resolve your worrysome query on your next visit with your family GP doctor.Wellcome for further query to HCM in this regard.Wishing you fast recovery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in right side when exposed to bright light?\n\nI am having Right side head ache, accompanied with right eye, right forehead, right neck pain...can you please suggest whom do i contact...either neurologist or ENT specialist or eye specialist. what is the cause of this pain?triggering pain...when exposed to bright light, loud noise, strong odor, tention",
    "doctor_response": "Hai, mayb ur suffering from migrane ar sinusitis. Pls meet an ent surgeon first rule out sinusitis, then a neuro physician. Ur problem will be solved",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. 2. 5 year old suffering from stomach ache. Which medicine has to be given?\n\nHi doctor, My son is 2.5 years old. For a week, he is complaining of stomach pain. After farting he is fine. Our family doctor recommended one antibiotic for five days and a medicine to avoid vomiting. He had small vomits twice, but later it was fine. Now, after completing the course of medicine he again complaints the same. His diet is almost nothing and he is not ready to take any food. He just has few mL of milk. He does not have fever. His stool was watery, but it is normal now. Can you provide any recommendation on diet and medicine? Please give me a solution to the problem. Thank you.",
    "doctor_response": "Hi. I can understand your concerns. Complain of abdomen pain with vomiting suggests that your child probably has acute gastroenteritis or food poisoning. Since, antibiotic is already given and now there are no loose stools or vomiting, there is no need to give antibiotic again. For abdomen pain, you can give syrup Cyclopam (Dicyclomine hydrochloride and Paracetamol) 5 mL on SOS basis (as and when required) that is when abdomen pain occurs. Whenever a child becomes sick, there is decrease in his appetite which improves as child recovers. Now, you should give him all the foods that you were giving him earlier. If he is not eating then you can start Glucon-D in water thrice a day for one or two days. Start a multivitamin like syrup Bevon 5 mL once a day for 15 days. Keep patience. Child will eat properly now as he has recovered from illness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Underweight, fatigue, feeling of sadness. Suggestions?\n\ndocter i think i hav sum prob with me.... frm my childhood i m soo tired nd energyless.. i dnt feel like doin any work and 2day in my collage my teachers told me do u take drugs.. which was really hurtin i dont hav such habits... but i b like ppl who take drusg :(  m sooooo  tired nd energy less nd m 17 years  my weight is oli 48  ppl think i take drugs so i am like this... plz tell me wt is wrong with my body :(",
    "doctor_response": "Hello....... Thanks for your query. Based on your history i would initially like to rule out the following: 1. Thyroid disorders 2. Anemia 3. Other endocrine causes If the above disorders are ruled out, a thorough psychiatric evaluation would be required to rule out: 1. Dysthymia/ chronic low grade depression 2. Depressive disorder 3. Personality disorder This can be followed by suitable psychotropic medication or psychotherapy techniques like CBT/ Cognitive behavioural therapy as required. Active lifestyle, healthy diet and meditation might be beneficial. Wish you good health. Regards Dr Sundar Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes right sided chest pain with vomiting?\n\nI have had pain in my right side of chest, above breast but pain goes down right breast and into my right side under arm.  I have had lap banding (vbg) about 6 years ago and have kept the weight off.  I have trouble keeping food down and have been vomiting it up to relieve some of the pain.  I also have a large hernia (from the surgery), which took over 200 stitches to close.  I am just wondering if I have caused some problem to my chest or throat from all the throwing up I have done.  I do this at least once a day if not more.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Since you had banding surgery possibility of spasm of lower esophageal sphincter is more likely. This sphincter plays very important role in swallowing. If this sphincter doesn't work properly, chest pain, vomiting, pain relieved by vomiting is seen.So better to consult gastroenterologist and get done upper GI (gastrointestinal) scopy with manometry (pressure monitoring).Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is mepivicain recommendable while having adrenaline allergy?\n\nHi , I got pt stated that she has allergy to adrenaline, she need tooth extraction which may be required surgical removal, so shall I use mepivicain (without adrenaline) or that will not be effective for longer procedure ( if end up surgical removal). Many thanks Jena",
    "doctor_response": "HIMepivicaine without the adrenaline should be fine for the procedure and a second injection can be used if the procedure becomes prolonged",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suspecting psoriasis. Advised to take Tricort 40 injection. Should I take injection?\n\ni have been adviced to take tricort 40 injection tomorrow. I have recently developed skin boils and reddish scars on hands and now increasing on legs. I think they have suspected psoraisis.. Should I take this injection. In addition to this the doctor has perscribed Aceret 25 mg 2 tabs at night and Tab Atarax 10mg. Please advice",
    "doctor_response": "Hi, Thanks for writing in. The condition your wife is suffering for can be folliculitis or furuncle. You can use Tbact cream cream over the affected area twice daily . Also you can use a good antibacterial soap like SOAPEX soap for bathing. Inj tricort contains steroid which may worsen the condition and psoriasis also. Better avoid the injection. Acetret is good for psoriasis you can take it.Atarax is for itching and its safe. Few prescription drugs and antibiotics can help a lot in cure of this problem. Hope this helps. I encourage you to visit a qualified dermatologist for confirmation of diagnosis and prescription medicines. Regards. DrSudarshan MD Dermatology",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have been on anti-depressants for the last two months nearly as i was diagnosed with clinical depression and very much on the brink of suicide. Although there has definitely been an improvement, generally (e.g. interacting with friends and social events, smiling/happier, not on the brink of tears etc.) However i keep having very vivid dreams; planning my death, previous death of relatives and of an old friend with took their life recently, and other scenarios such as my boyfriend being unfaithful, and other events like that (e.g. arguing, deaths of others), this has also lead to me talking, shouting and even on one occasion screaming. I also find it extremely hard to get a substantial amount of sleep (this has always been a problem). For example the night before last i could not get to sleep till 3am and i (had to) got (get) up at 7am for college. I don t know what to do.",
    "doctor_response": "Hi! Welcome to HealthcareMagic! Dear, psychological problems are difficult to diagnose & treat. For example, in your case, antidepressants are not having good effects completely even after 2 months. I think your psychiatrist might had discussed this with you but again you need to be emphasized. In most cases, its your willpower & internal resistance which will help you. Most psychotropic drugs have delayed therapeutic effects. Antidepressants start their effect after 3-4 weeks and full effects take still longer. Meanwhile, side effects of a drug may cause insomnia (sleep problem) as in your case and may lead to non- or poor compliance. An antidepressant is usually evaluated for 8-12 weeks at full doses before stopping, if not having effect. I think you discuss your problem with your psychiatrist again-- you might require dose adjustment as well as short term addition of an anti-anxiety drug. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain with normal ECG\n\nI am from Bangladesh. I am in a private service in Dhaka. I felt chest pain for last six months and so i we went a cardiologist in SQUARE Hospital in Dhaka. He gave me some test like ECG,ECHO, blood tests and ETT. All other tests except ETT was found normal. I was for 9 and half minutes in excercise tolerance test. I didn t feel bad. But the cardiologist told me that he found some significant changes in third stage of test. So, he stopped the test and he advised me to do an angiography for better result. He suspected that there may be block. Then I went to another cardiologist in National Heart foundation of Bangladesh and he advised me not to do angiography right now. He prescribed me some medicines like Anclog plus, Anzitor, Ecospirin and advised me to walk an hour every day. By this time I talked to my sister in USA. She consulted with a doctor there and the doctor said if ETT test is positive it will be better to do an angiography. Then I went to another cardiologist for third opinion. I went to Prof. Dr. Afzalur Rahman, MD (Card), Phd (card), FACC (USA), FRCP (Edin), FRCP (Glasgow), Fellow in Intervention cardiology (France & USA), awarded CRT2009. He also checked my tests and advised me to do an angiography as soon as possible to be risk free and to know the actual result. So I did Coronary angiography under him at Square hospital. My CAG report was normal. There was no blockage in heart as per result from CAG. He advised me to feel free and stopped all medicines. He told me that the cause of the pain might be from muscle strain or Gas. Still I feel chest pain and it seemed at middle of chest and sometimes from middle to left or right. I feel tired sometimes. I have my CAG report and CD with me. I need your suggestions and advice",
    "doctor_response": "Hi, If your Coronary Angio report is normal than you should not worry from the cardiac point of view. Their are many causes of chest pain. Yours can be due to musculoskeletal pain or due to costochondritis (it is an inflammation of joint between bone and cartilage of chest). Both are benign conditions and can be easily treated by a pain killer. Positive ETT can be false as it has a sensitivity of around 70% but Coronary angiography is the final test and if that is normal then there is nothing to worry. So relax and don't worry about it. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sameer Maheshwari, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Ciprofloxacin change the consistency of semen?\n\nA physician prescribed a 28 day supply of ciprofloxacin for my chronic prostatitis. After 3 weeks, I still do not have relief. Also, the consistency of my semen has changed to a thin watery fluid. Is this a sign a other issues or is it a result of the antibiotic?",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: No, ciprofloxacin cannot cause this.Explanation: Prostatitis can itself can bring changes in semen consistency so, as your taking antibiotic for its cure it will cure your prostatitis but will not harm you.                    So, continue it as advised by your doctor and meet him once. Till then be happy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "IVC filter placed in the abdomen after brain injuey. Having pain in the abdomen. See the doctor?\n\nyes what are symtoms of a problem with a ivc my husband had one placed in lower belly area on 19th of dec. to help with blood clots in both legs that formed while in hospital from brain injury , he has been home 1 week and started to complain of a funny pain in lower belly , they did not tell me what signs to look for if something happened to the ivc he seems to have a small area in his lower belly that feels like a small round ball . im not sure if i should take to er or just watch to see ?",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for choosing H.C.M.Forum. Your husband got an I.V.C filter fitted in inferior venacava to prevent thrombus from his legs to enter into the heart, to prevent any thrombo embolism . Now he is having funny pain lower belly. that feels like a small round ball. There are so many side effects some common are 1. fracture of ivc, or perforation into duodinum. Now it appears that none of these is the case. It may be the thrombus lodged in the IVC and causing obstruction to the flow of blood.Don't worry it could be a psychological feeling also. What ever may be the cause any abnormal feeling should be reported to the concerned doctor. So immediately report to your doctor about this. Wishing for a quick and complete remission from the complaint. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bipolar spectrum disorder\n\nI had a aneurism in 05 they coil it. Have bipolar ptsd.I was on clonadine. They took me off it 3day ago cos my bp was low. It run 98/57. My nose bled today took my bp its 104/87 pulse is 114. Should I go get checked. Oh I had seratona syndrome about a year ago. I m scared and kinda panic I feel ok till I had a small nose bled. And took my blood pressure",
    "doctor_response": "Dear patient, Thanks for being concerned about your health.Welcome to Health Care Magic.Clonidine is a centrally acting drug that is used for lowering your BP. It can also be used in many different illnesses including drug abuse (in particular).The tablets come in 100 millionths of a gram dosages. I will directly answer your question by stating that clonidine, when taken regularly in high dosing can cause hypotension to occur in a person. In your case, your BP was 98/57, which is a result of that medication. The reason your BP has shot upto 104/87 is that you must gradually stop taking clonidine. You must taper it off under medical supervision, else you get rebound hypertension. Please see a psychiatrist as regards your BPAD and PTSD, and voice all your concerns. This might help you.In every other way, you are quite fine and healthy. Feel free to repost on this forum. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lethargy after hip and rotor cup replacement?\n\nHi I have several replacement both hips, & 1 knee & rotor cuff tear repair & a donor bone in my back. Are there any diseases or blood disorder or sickness I could get from all these surgerys. I stay tired and no energy, and aching in my left top back of shoulder. Thanks",
    "doctor_response": "HiThese surgeries are quite safe. Yes long term you can face problem of implant loosening or wear. Pain in shoulder can be due to rotator cuff involvement so get an mri done and start physiotherapy for that. Lethargy feeling can due to low haemoglobin or some other generalized cause. So get investigation done and consult for the same With your local pphysician.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a lump in the testicle be treated?\n\nI m 66 year old male, good health, non smoker. Had a small lump in testical sac for long time. In past week this small lump has grown to be like a large marble or little larger and painful to touch and irritable all the time. Don t have any signs of fever.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Most of the times small testicular swellings are harmless as they are spermatocele which is the swelling of testicular tube, but if the swelling has grown in size and changed its consistency then it would bother me. If you would have come to me, I would have done your testicular ultrasound and If it showed any solid mass or calcification, I would have done testicular biopsy as well to rule out testicular cancer. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will i conceive after taking sectum in uterus out?\n\ni am married for 10 years i dint concieve the time i got married finally after 10 years i planned for laproscopy and i came to know that there is tb in my uterus and there was a sectum in the uterus and my doctor has taken out the sectum now i am on akt 4 can i become pregnant",
    "doctor_response": "Dear Madam,Tuberculosis of the reproductory organs does lead to problems in conceiving. It seems, there were some adhesions in your uterus due to the involvement of the uterine lining. Breaking the adhesions or removing a septum does not assure pregnancy. The extent of involvement of uterine lining plays a great role. You will have to undergo treatment for genital tuberculosis which is for minimum 6 -9 months. Then if your uterine lining regenerates healthily, you have some chance of pregnancy. Sometimes, along with the involvement of uterine lining, the fallopian tubes also are involved by tuberculosis and get blocked. Even though the block is removed, the tubes become spastic, lose their motility and thus cannot propel the egg to the uterus. In  such case, natural pregnancy is almost improbable. If the uterine lining is normal, then test-tube baby (in vitro fertilization and embryo transfer) may work. I feel you should plan as follows:1. Get tuberculosis treated first.2. Get yourself thoroughly investigated for patency and mobility of the tubes (by hysterosalpingography and/or laparoscopy) and status of uterine lining (by hysteroscopy and ultrasonography). 3. Find out whether you form eggs regularly (by ultrasonography, ovulation monitoring kit or hormonal profile)4. Get your husband's semen examined. All these investigations can give you idea whether you can conceive or not. Of course, they have to be carried out only after your full treatment of tuberculosis is over; i.e. after 6 - 8 months. Take care please.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lumps on butt cheek\n\nI am 21 years old female about 220 lbs. Its been a few days now that I have this golf ball size lump on the inside of my left butt cheek and it hurts so much i cannot sit properly or walk. Everytime i go to the bathroom and wipe myself i always hit the bump/lump and it hurts. What should i do? This is the second time, same place this occurs...",
    "doctor_response": "thanks for sharing your health concern with us!well, it is just an  infected sebaceous cyst or could be lipoma also!not to worry much for this. you continue  to press ice-cubes or cold compress and if not relieving within 7 days then consult some surgeon for aspiration of the material inside; never poke it as this may invite infection! all the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in multiple lymph nodes?\n\nAfter giving that stuff a try I too also felt like my heart was going to beat right out of my chest, but when i woke up the next morning i noticed swelling in multiple lymph nodes. Do you know of any other cases of this? and how can i get the swelling to go down?",
    "doctor_response": "Hi & Welcome to HCM.I appreciate your concern for the multiple lymph nodes enlargement.Incomplete data like age, gender, duration of your problem, any associated symptoms like fever, weight loss, loss of appetite, pain in the lymph nodes, etc.The features described in your query are suggestive of generalized lymphadenopathy which can occur due to inflammation, infection ( viral, bacterial or parasitic diseases) or malignancy.You have to consult a physician for proper clinical examination and work up like blood tests such as CBC and ESR, Chest x rays, FNAC or biopsy of the enlarged lymph nodes to come to a diagnosis.Hope to have answered your query.Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Persistent sharp abdominal pains, backache after UTI treatment. How can I relieve it?\n\nHi, two weeks ago a reported to my doctor about sharp pains I felt on my right side and severe backache , and she tested my urine. She told my that there were numerous pus cells found and it indicated that I had a UTI . she gave me antibiotics but I still feel the pains as before. Kindly tell me what could have gone wrong. Thank you.",
    "doctor_response": "Hi, IT WILL BE BETTER TO GET EXAMINED AND TESTS DONE . GET AN URINE C/S . A COURSE OF ANTIBIOTICS MAY BE REQUIRED AS PER URINE C/S REPORT. FOR THE TIME BEING PLEASE TAKE PLENTY WATER.IN SEVERE PAIN MAY TAKE SOME PAINKILLERS LIKE DICLOMOL TAB MAY BE REPEATED 3 TIMES . A PLAIN X=RAY ABD K U B MAY BE HELPFUL TO RULE OUT URINARY STONE THAT MAY GIVE RISE TO SEVERE PAIN . HOPE YOU BE ALL RIGHT SOON",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a cold sore on my gum?\n\nI am in my 30s, and I recently noticed a small pimple-like bump on my upper-left gum. It has a tiny coldsore on it, it does not hurt but is quite worrying me. I take good care of my teeth by brushing and at least once a year prophylaxis but I am not taking VitC pills. Anything I should take to diminish the bump? If it bleeds and I accidentally swallow it, would it infect me?",
    "doctor_response": "Thanks for your query, I have gone through your query.The cold sore can get aggravated secondary to the stress or tension. Nothing to worry, you can take topical anesthetic and analgesics like anabel gel. apply 3-4 times daily before food. If it comes again next time, as soon as you notice the blister or ulcer, you can take antiviral drugs like acyclovir, since the antiviral drugs are effective within 24hours of onset of the lesion. Nothing to worry it is a self limiting condition. do saline gargling.I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on top of mouth with sore throat and temperature?\n\nI had a stomach virus two weeks ago that had a fever of 102 for 2 days after that I started having a stuffy nose that went into my ears and my eye look like it had an infection. I ran a fever of 99 for about 2 weeks. I now have a very sore throat and my temp is still 99 and I have a lump on the top of my mouth towards the back. Is this something I should go have looked at or could I be at the end of what ever bug I have",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.  You have infection in ear, sore throat and fever.  You may have upper respiratory tract infection like granular pharyngitis which give lump like feeling.  You should go for examination.  If needed take a course of antibiotics like azithromycin or levofloxacin according to your doctor's advice. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does lump on inner thigh indicates?\n\nI have a baseball sized lump on my left inner thigh, and I noticed it yesterday. It is firm, warm, and tender to the touch. There is no discoloration, and it is not swollen large enough to be visibly noticed. I am a 24 year old male, 5 ft 10 inches, 300 lbs, and currently taking citalopram.",
    "doctor_response": "hi.it is best if you consult with a doctor, preferably a general surgeon, for medical and physical examination. based from your description, it could be a lipoma (fatty deposit), a fibroma or a cyst (a sebaceous or a keratinous type). these lesions can occur anywhere in the body and have the tendency to recur.  management (medical and surgical) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can allergic cough be treated?\n\nI am very allergic to chemical fumes of all kinds. I accidentally breathed in spray paint fumes and my throat became immediately raw. It has been three days and my throat is the sorest today and I ve developed a nasty cough as well. I feel generally ill and depressed today. I was exposed at work where an individual went outside to spray paint a small piece of plywood and then came in with it before it had dried and may have given it a few touch up sprays inside as well. I am not sure how to prove to the individual at work and my boss that my extreme discomfort was caused by their extreme disregard for safety. Any professional advice for me?",
    "doctor_response": "Good Evening,Thanks for given information,carefully I have considered your allergic cough symptoms,here I suggest you some medicine might be helpful to relief   Tablet Montelukast 10mgTablet.   levocetrizine dihydrochloride 5mgsyrup. Acephylin piperazine       helpful for your allergic coughThanks for consult              Regards,                         Dr,Naeem.MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have rash like spot on the thigh. No itching or no burning. Could it be ring worm infection?\n\nI had a white pimple looking spot on my thigh and I popped it, it whelped up and went away for a week w a scab where it popped. Nothing came out. A week later I have a red circle that does not itch , burn , or bother me in any way. It also has irregular boarder. I m not sure how to treat it not knowing if it s a ring worm , which it s not the classic case or a bite of some type.",
    "doctor_response": "Hiya there. From your description it does appear to be one of the 'gyrate' erythematous skin conditions. More often than not, it could be a 'reaction pattern' following some sort of insect bite reaction as if it were fungal origins, there would have been some discomfort. Might i suggest using a topical combination cream of a hydrocortisone & antifungal applied twice daily for a 3-5 day period. It should clear up completely. If not, then you need to fix an appointment with your nearest dermatologist & have it biopsied if only for academic interest. I envisage no problems & nothing serious to write home about. Good Luck & Godspeed!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest traetment for pus on gums\n\nI have pus coming from my gums on my top left side and it fall down on my tongue along with a substance that feels like sand.  Ending is a paste like substance on my tongue that keep my tongue burning and my mouth dry email  YYYY@YYYY",
    "doctor_response": "Hi! Welcome to Healthcaremagic.I read your query. Is this pus in only limited part of gums as you mentioned or is it generalised? Do you notice any cavity in tooth near pus area?If there is, this pus can be due to dental infection, for which you need to visit a dentist.If there is no cavity, then this pus can be due to gum disease. Is the tooth in that area mobile, calculus deposit or gum receding?You need to visit a dentist. Get an x-ray done if required. In case of gum disease, you will be given an antibiotic course. If there is not much bone loss and tooth firm, scaling and curettage will help in removing infection.Maintain good oral hygiene. Do warm saline rinses. Use chlorhexidine mouthwash twice a day. Massage gums using gum paint. Take healthy diet and multivitamins. Have regular oral prophylaxis. This require good and sustained oral care.Hope the answer helps you. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to stop vomiting from nostril?\n\nhello sir,my 5 years old girl has been vomitting through her mouth and noustril since she was 4 month.the sight is really scary for us as parent because she gasps and bulges her eyes finding it difficult to breath during vomit.what can we do to stop the vomit through her noustril.pls help",
    "doctor_response": "HI, thanks for using healthcare magicSince there is connection between the mouth and the nasal passages, vomitus can sometimes be expelled via the nostrils.It does not mean that she has any abnormality.Vomit may be expelled in this way particularly if there are copious amounts.There is no treatment. If she has a history of frequent vomiting then she would need to be assessed for this.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. One of the hairs in eyebrow has changed to blond. Is that normal?\n\nHi doctor, I am a 24 year old female and weighs 64 kg. I am not on any regular medicines. I am a healthy woman. I have one hair in eyebrows grow long to around 3 cm and changed color to blond. My natural hair color is black. Is that normal?",
    "doctor_response": "Hello. In your paternal family, is there any history or case of vitiligo in which a person develop white patches or graying of hairs? Right now, I can say that you can get it trimmed for now. If there is a genetic history of vitiligo in your family, then there can be many chances for you to develope such thing and do notice it next time on all your hair growing area. For now, you can take tablet Follihair (Biotin) multivitamin tablet take it once in a day for one month and get your CBC (complete blood count) done. For further information consult a hair transplant surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tingling and numbness from hip to knee?\n\nI had a vasectomy yesterday. All seems fine and have limited pain, but I have some tingling and numbness from my hip down to just above my knee on both sides. I am normally not one who lies on back for extended periods so am assuming I pinched a nerve, but have been up for a couple of hours and it doesn't seem to be getting much better. Do you have any recommendations?",
    "doctor_response": "Hi,I understand your concern and would agree with you in the fact that your symptoms could be related to a pinched nerve. But this is a short time to notice signs of improvement. I would recommend performing some physical activity (stretching, yoga, walking). If your symptoms do not improve in the next days, you should consult with your doctor and perform a nerve conduction study. Hope to have been helpful. Let me know if I can assist you further. Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for the pain in the right lung after the removal of Ureteric calculi?\n\nhey doctor im dewan from bangladesh. recently i have had my ureteroscopy for removal of left ureteric calculi. after having surgery i am feeling pain where right lung is situated. this pain is moderate. i was given cef 3 200 mg(1+0+1) for seven days,tab.pantolok 40 mg(1+0+1) for 15 days,tab ucol 2 mg, tab urokit and neofloxin 500 mg. what can i do reducing my pain in right lung",
    "doctor_response": "Hello,      After having ureteroscopy as per your statement, which might be urethroscopy i.e per urethra examination and removing visible calculi through urethral route and after such procedure you are having pain in right side chest wall, which you are calling Rt.lung pain, it has no any relation with the above urethral procedure , therefore you don't co relate these two together but you should go for fresh check up of your chest problem by undergoing X Ray chest and ECG check up and consulting any chest physician. In between you can take any analgesic or Pain reliever drug such as Tab. Diclofenac sodium + Paracetamol 2-3 times a day. Good luck and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does my follicular study indicate?\n\nmy age is 27 years weight 56. I am undergoing my follicular study for monitoring of ovulation. On 10th day Endo echo (mm) was 6.2. on 12th day it was 8.6 and it is showing 13*13 and 13*12. what does it means plz tell me whether the follicles are good or bad. i am trying conceive baby this month",
    "doctor_response": "HAIWELCOME TO HCM Your endometrium is good.follicles are not growing ,so you need to take clomiphene from next cycle to grow your follicle or hormone inj to make it grow.consult an infertility specialist to conceive soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat red, hot rashes on face after intake of coffee with chicory having history of being allergic to rag weed?\n\nI figured out that the alternative herbal coffee I was drinking, Teeccino, has chicory as the main ingredient, after I broke out in a serious rash on my face that is super red and very hot.  I looked up chicory and found that it's a relative of rag weed, which I am highly allergic to.  I stopped drinking the tea, but the rash has been going on for a couple days now and it hurts.  What can I put on it to calm it down and not make it hurt worse?",
    "doctor_response": "Hi,Dear.Welcome to HCM.When a patient comes to me with the same problem i usually advice him to apply HYDROCORTISONE 1% ointment twice a day and Tab.ALLEGRA 120 mg once in a day for 5 days.You will be fine very soon.And ALLEGRA may cause a little drowsiness so avoid driving while you are taking the medicine.So take care.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed with non obstructive azoospermia. What are the treatment options available other than ICSI?\n\nMy husband has been told he has non obstructive azoospermia . he had a biopsy and they retrieved sperm, i wonder how it s possible for him to have no blockage but have sperm. is there anything we can do other than ICSI to become pregnant. We ve had 5 ICSI s and 2 frozen transfers using his frozen sperm from biopsy but none were sucessful, we were told his sperm were good quality when retrieved.",
    "doctor_response": "Hello, Welcome to HCM, I am Dr Das Look, there is problem in the microenvironment. That means, in testis, for production of sperm, a special microenvironment is essential. When there is any problem, then the production of the sperm is hampered. In these condition, non obstructive azoospermia can occur. So, there is really no treatment available except the ICSI.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having acute bronchitis. Prescribed inhaler. Feeling pain. Remedy\n\nAfter having a case of acute bronchitis my lungs have really been aching, especially my right lung. It's gotten worse and starts to really ache and throb when I lay down or bend over to pick something off. I've been to the drs 3 times already and all they prescribed me is an inhaler so I'd rather not spend a fortune going back unless I absolutely need to.",
    "doctor_response": "you are having allergies inhalrs can only subside not cure acte bronchitis tretment led to this as ust have taken antibiotics take tab singular 10 mg bd tab allegra 120 mg  bd syp ventrolin 1/2 tsf tds syp gelusil 2 tsf tds take for 3 week but if you have recurent alergies go for allergy tests and desensitoisation therapy you will be fine",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes small white spot with pus at tip of tongue?\n\nI have a ver small white spot appeared to be pus filled on the tip of my tounge . It appeared  4 days back when i was eating mango and suddenly chewed my tongue .It has decreased in size.. i have no pain in ear,neck,swallowing..But when i touch dat white spot it hurts very little.....Is there any thing to worry ????",
    "doctor_response": "Hello,  Welcome to healthcare magic. As you have small white spot on tongue dont worry it is due to traumatic injury to tongue during chewing dont worry for this you can do warm saline gargle two - three times a day.  Apply ointment Mucopain or dologel two - three times a day on tongue . Take one capsule vitamin B complex once daily for 15 days If you wont get relief then go to dentist for examination .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Generalized body itching. Taken antihistamine. Have stomach trouble, cramps, nausea, concentrated urine\n\nI am awake at 4am because of a total body itching. Hands feet everything. It started yesterday morning and I took and antihistamine and it went away for a few hours but came back with a venegence this am. It seems like internal rather than external cause. I have been having stomach issues for the last couple months, with some cramps and nausea . Thought it was the flu but still feel slightly nauseous after I eat. Have noticed my urine is concentrated in the morning as well. Have had a few headaches in the last few days.",
    "doctor_response": "Hello, It is possible that you are having infection-related urticaria (urticaria is red itchy weals that come and go; triggers: infection, stress, autoimmunity and most are spontaneous). You will need a complete blood count, CRP, LFTs, urine c/s, stool c/s (if still having abdominal pains) to exclude an infection. Appropriate antibiotics and long-acting antihistamines such as fexofenadine 180mg once daily for a week is required to control this. Sometimes you may need to continue on the antihistamines for longer. Best Wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does spondylotic changes at mid- lower cervical spine mean?\n\ni have recently been told i have spondylotic changes at the mid - lower cervical spine with osteophytic spurring and mild disc space narrowing at c5/c6. What doe this mean? i have a lot of pain in my neck and suffer from pins and needles in my hands, especially the right hand.",
    "doctor_response": "Hi, thanks for posting your concern in the HCM. Simply speaking, cervical spondylosis refers to a condition in which there is mechanical wearing of the intervertebral disc cushions due to lose of hydration and elasticity.  The surrounding ligaments also lose their elasticity. There is biomechanical incompetence.  The joint space narrows down, annulus bulges forward and facets override.There may be abnormal growths or spurs on the bones of the spine.Gradually one or more nerve roots are compressed resulting in radicular pain, tingling, numbness in the distribution of the affected nerve.For rehabilitation and conservative management, immobilisation of the cervical spine is the mainstay of treatment.  Traction may be applied although it has no proven benefit in cervical pain. Superficial and deep heat therapy to the local tissue may help. Analgesics and muscle relaxants may also be taken. In case of progressive neurodeficit, intractable pain or documented compression of nerve root(s) surgical intervention may be needed. For any further questions, please write back to us. Regards.Dr. Kaushik",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a lump on bottom of head indicate?\n\nI just noticed a small lump or nodule of the back of my sons head like at the bottom of where the hair ends. It s between .25 and .45 in in diameter. Also found two other smaller bumps on the other side of his head. When I touch it he doesn t wince like t hurts but I m very worried. He s 20 months. My dagger passed away from lymphoma but I m not sure it s connected. Also he scratches the back if his head a lot - it thought it was just his eczema but maybe it s related. I m going to make an appt with a pediatrician but I have to find one. We just moved to a new state about 5 weeks ago.",
    "doctor_response": "HI...please do not be worried. The swellings you are palpating are just enlarged lymph nodes and in the area you are mentioneng the most common reason for them to get are seborrhea/ dandruff or small injury to the scalp. If there is nor chronic fever and weight loss, or sever pallor you need not be worried about them. But I suggest you get him evaluated by a pediatrician.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What precautions should be taken to avoid recurrance of TB?\n\nHi, I am 21 year old female.I was diagnosed with intestinal Tb in july 2012. I had symptoms of extreme pain in abdomen sometimes which grew more both in intensity and in frequency, specially after the meals. More intense pain also resulted in vomiting many a times. I started avoiding food as it caused pain. I was already underweight (39 kgs), and then my weight loss became more severe. Also i had coughing problem from many months but it is prominent only in morning time. Doctors said it is allergic cough and has nothing to do with the problem of TB.They even saw the reports of my digital xray and said i have no infection in lungs. The CT Scan reports revealed that i was having some obstruction in the ilio cecal junction. I was given a treatment of intestinal TB for 9 months. My treatment ended in March 2013. After that the pain went away. I also regained my appetite. But still i face the problem of coughing in morning and also i have a problem in digesting vegetables with seeds like brinjal,lady finger etc. What are the possible reasons for this? Also what are the precautions i should take that this disease does not occur again.",
    "doctor_response": "Dear Friend.Welcome to HCM. I am Dr Anshul Varshney. I have read your query in detail. I understand your concern.If you have taken full course of Anti tubercular drug, and you have been declared as cured then you don't have to do any particular thing to prevent the recurrence of Tuberculosis.Since you are having cough now, just get :1. Xray Chest2. Sputum for AFB3. ESR.This is my best opinion for you based on available details. If you have any further query please ask me.Stay Healthy.Dr Anshul Varshney, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic back pain along with painful joints\n\nim 41 suffered a sliped disc 4 yrs ago, had surgery to remove disc, it caused damage to the spinal nurve, I have been left with numbness to right thigh, tinglin to right leg and left leg, I have also now got pain around my chest lick a tight belt, I have pins and needles in my face up to my eye and forhead and it can b left and right periodically, painful joints stiff joints, pain in my muscles, periodically,tinglin in my feet and numbness in my heal to right foot, depression, sight blurred at times and pain behind my right eye, I can have a good day then 2 days feel fatigued and in pain, ,I still have cronic back apin as I have a bulges in l5 s1 of my spin, and a bulge to the 4and 5 disc in the thoracic area, my arms can suddenly spasm and I drop things and my legs go numb and heavy makin walkin hard, I no I have nurve pain as I get it down my buttocks and the back of my legs,i have fit like movements which I have medication for, its like a fit uncontroable movements in my limbs, its quite complex painful joints achin muscles, lack of use in my right hand, night time I wakewith pins and needles in my arms and legs. this has been ongoing for about 5 yrs, do I have M S if only someone would tell me, im with a nurologist pain clinic drs ect but I don t think anyone wants to commit themselves please help",
    "doctor_response": "Hello Thank you for trusting HCM Your suffering from multiple levels of compression of spinal cord which will lead to compressive myelopathy with sensory motor involvement. According to your history your suffering from cervical compression also. Bandied like sensation due to thoracic nerve root compression. You suffering from flexor  spams also. Please consult your neuro surgeon for further assistance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause muscle jerking in arms & legs in elderly males?\n\nHello I have started having muscle jerking in my arms & legs. I am 77 years old. A little over weight. I have neuromas in both feet & neuropathy in my feet & legs. I don t know if this has anything to do with the jerking. I am also a diabetic. Healthy & strong until the last 10 years. I have had 3 surgeries on my feet for the neuromas but keep coming back. I have a difficult time walking & standing because of the pain caused by these things. Any suggestion you could make would be welcomed. Mary Bryan",
    "doctor_response": "Hi mary bryanHope this message finds you in good health.I have gone through your complaints and understand your concern.I guess the neuromas are the root cause of such jerking because they are attached to muscle. There is no specific treatment that will cure it permanently.U need to keep  watch on its progress,stay healthy.Nothing to worry about.\u00a0\u00a0\u00a0\u00a0\u00a0I hope your question has been answered.If you have any follow-up queries,feel free to consult me anytime.Thanks,Take care,God bless.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there itching with pain while retracting foreskin?\n\nHello doctor, My husband is 44 years old and taking no medication but only anti-fungal cream. He has a lot of itching and his foreskin does not go back without pain. Please help.",
    "doctor_response": "Hello. From your history, it seems the skin is inflamed and cannot be retracted, this is called balanitis. There is a possibility of phimosis (tightness making it difficult to retract and painful. I am not sure of his personal hygiene because if he is not cleaning it properly, it can cause some pus like particles smegma which can provide medium for infection in it.  What you can do is use Augmentin 625 mg bd for 10 days, use enteral antifungal Fluconazole 200 mg daily for 10 days, tablet Ibuprofen 400 mg BD for six days. You can get triple action cream (contains combination of Corticosteroid, Antifungal and Antibiotics) that will help too. Permanent treatment for this problem is to see a doctor and get circumsicion that will solve the problem once and for all. Fungal and bacteria infection, poor personal hygiene. Swab for microscopy culture and sensitivity. Paraphimosis. Balanitis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Ibuprofen be taken while on Naproxen?\n\nI am naproxin 500mg (440mg) twice a day, 8 hours apart. This is for a fall I had yesterday. I fell backwards on my pelvic area and now have pain there and upper buttocks. I went to Urgent Care and have no fractures. The naproxin only decreases pain for 3 hours. I would like to take 600 mg of ibuprophen in between. How would I schedule the 2 medications? Thank you",
    "doctor_response": "Hello, You can safely take ibuprofen and naproxen together. Keep in mind that you may experience severe gastritis while combining the drugs together. You can take drugs pantoprazole to tackle gastritis related side effects. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Could radiation therapy cause T-wave inversion?\n\nHi doctor, The patient is a 65 year old, hypertensive and diabetic female with T-wave inversion V1 to V6 on ECG. ECHO and TMT have done to evaluate further, which was reported to be normal. The patient is on Metformin XR and Tazloc-H. The patient is asymptomatic. Six months back, ECG did not show these changes. She is hypertensive for 15 years and diabetic for the last 10 years. What could be the cause of these changes? Please advice.",
    "doctor_response": "Hi. Global T-wave inversion carries a very little significance (attachment removed to protect patient identity). I would suggest repeating the ECG again in six months if the patient is asymptomatic. If otherwise, you can get a CT coronary angiography to rule out any CAD (coronary artery disease). For further information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for flatered area in forehead due to head injury\n\ni have a 10 months baby(male) 2 days before by mistaken i threw my mobile in anger and it hit my baby on his forehead, i took him to a doctor he said everything is normal, baby behaves normally, but the area on his forehead has flatered, will that flat surface will come out in time or i will have to take him to doctor for further treatments. my mail ID is  YYYY@YYYY",
    "doctor_response": "Dear parent, this indentation will eventually come back to normal. you need to apply a hemoclare ointemeunt to avoid bruising and you should monitor the baby for the next 24 hours if he suffered vomiting or dizziness. then take him to the hospital",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is severe coughing harmful during pregnancy?\n\nHi, I am 21 wks pregnant and I have a chesty cough.last night I was coughing alot and today I can barely walk with the pain in my side.Is this dangerous for my baby, am I after doing damage cos when I cough it really hurts and I need to hold my belly?",
    "doctor_response": "Generally, no. Coughing during pregnancy does not hurt your baby. You should be evaluated, though, to see if anything can be done for your cough to help you feel better. As long as you are not experiencing vaginal bleeding or abdominal cramping with the coughing, the baby should be okay. If you notice these things (Cramping or vaginal bleeding), it is worthwhile to be evaluated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had Root Canal treatment. Given ciplox and Imol plus. Why do I have dizziness and discomfort?\n\nHi, I had a Root Canal treatment (1st Sitting) done. Doctor advised to take Ciplox-Tz along with IMOL Plus. From the start of the medicine course, I have been experiencing dizziness and discomfort. Online research suggest that Ciploz-tz (Ciprolfloxin) and  should be not taken with and NSAIDs like Imol plus. Please suggest if this is correct.ThanksAnil",
    "doctor_response": "Hello and welcome.The medication that your doctor had prescribed are correct and they are usually given for short duration like three to five days.This reduces the infection and pain.Therefore the root canal procedure can be done successfully.However if you find discomfort after consumption of medication then you can definitely speak to your doctor regarding change of drug.An alternative drug should solve your problem.Hope it helps.Thanks.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp stabbing pain under right breast?\n\nhi i had the flu it lasted nearly 2 weeks but a few days after i developed a sharp stabbing pain under my right breast when i cough or breathe deep ( feels like something is tearing apart ) i went to my gp & my chest is clear & was told its likely a viral infection this has been over 10 days ... i dont feel sick or no temperature",
    "doctor_response": "Hi, Breast pain can happen after an episode of fever. You can take analgesics like Paracetamol or Acetaminophen for symptomatic relief. Nothing much to worry and it will settle by couple of days. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. An inflammed tissue in the right side of my throat is irritating. What could it be?\n\nHello doctor, For the past seven months, I have been having the following symptoms. They have gotten progressively worse, until the point where it is severely affecting my quality of life to where it is hard to function in a normal lifestyle. I have this really irritated, inflamed, and damaged area of tissue on the right side of my throat. The area is white, and it is covering the bottom half of my vocal cords. I taste blood and pus. I have an earache in one ear, the same side that the throat irritation is on. I feel weak, faint, and dizzy. My nostrils are blocked. I do not have a runny nose. I do not have a regular stopped up nose either when I blow my nose nothing comes out. It just feels like the back of my nostrils are blocked. I have a lot of trouble breathing, which causes my heart to beat very fast. I breathe through my mouth, but it is not the same. I have no heart condition, and my pulse never raced before this started happening. My blood pressure is fine. I have tried nose sprays to open up my nose, sinus congestion medications, allergy medications. I do not have any allergies. When the symptoms first started they were not bad, but only got progressively worse. I went to my primary care physician. I was put on antibiotics. While I was on the antibiotics and for about a week after my symptoms disappeared, but then they came back. I went back to my primary care physician. He said that since the antibiotics helped the first time maybe another weeks worth would make the symptoms go away permanently. The same thing happened. While I was on antibiotics and about a week after my symptoms disappeared, but only to reappear again. I went back to my primary care physician. He said that he could not put me on any more antibiotics. He did a blood test to see if I have an infection, the blood test came back negative for infection. He sent me to an ear nose and throat doctor. The ear nose and throat doctor did a fiberoptic laryngoscope. He found the severely irritated spot in my throat. He said it was probably acid reflux. He sent me to a gastroenterologist. The gastroenterologist performed an upper endoscopy. He did not see any signs of acid reflux, except for the severely irritated spot in my throat. I do not have any of the symptoms of acid reflux, even before I started taking Protonix. He put me on Protonix. I have been on Protonix for two months now. The symptoms have o",
    "doctor_response": "Hi. I went through your symptoms and pictures. (attachment removed to protect patient identity).  Your fiber optic picture indeed shows some amount of changes of laryngopharyngeal reflux. So even though you do not have acidity and reflux you still have some laryngeal reflux for which you will have to take a proton pump inhibitor tablet Pantoprazole 20 mg twice a day for one month. The white area in your throat needs to be investigated by a throat swab for culture and sensitivity to know if it is actually a bacterial infection. Regarding nose block, have the ENT surgeon done a nasal endoscopy in your nose. If yes, what did he say? If not done I will suggest go for a CT (computed tomography) scan PNS (paranasal sinus), axial and coronal view to be done to rule out sinusitis, as if sinusitis is too much even then you have these symptoms. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can non-penetrative sex cause HIV infection?\n\nhi i had sex with a sex ,well i put a condom on but cudnt get an errection after i put it in her vagina so i took the condom n masterbated can i get hiv from that? i have had flu like sypmtons and a sore throat and white dots on my toungue and throat please help its been 3 weeks since this happened",
    "doctor_response": "Hello As you mentioned that there was not penetration , so no chance of any HIV infection. As  far as concerned about sore throat , white coating on tongue , flu like symptoms may be due to viral infection or allergy ( cold ) . So take some tyleno, 10 mg /kg body weight whenever require . In my opinion  no need of any tension about HIV .It will take some 7-10 days for complete recovery .Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can itchy rashes caused by Alendronate Sodium be treated?\n\nI have had reactions to a pill I have been taking once a week for nine weeks..it is Alendronate Sodium 70mg. I have had Hives, swollen legs, ankles. very itchy skin, and now today a swollen upper lip... My Dr. told the Nurse to tell me to take Benadryl every 6 hrs till medication is out of my system... does this sound ok???",
    "doctor_response": "hi sir/madam,Alendronate Sodium is also called Fosamax.Fosamax can cause irritation, inflammation, or ulcers of the esophagus which may sometimes bleed.Taking Fosamax exactly as your doctor prescribes can help lower your chance of having esophagus problems.If you get chest pain, new or worsening heartburn, or have trouble or pain when you swallow, immediately stop taking Fosamax.direct consultation is required with your symptoms with all detail reports.hope it was help ful",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could it be if husband has a painful lump on breast?\n\nI am very much worried with my husband who complain of having a lump on his right breast which is painful when pressed which is located just beside his nipple. On the same day he is also suffering from sore throat. Also, a week from that he also complained once of having blood discharge while bowel excretion.He is 32 years oldd and a heavy drinker. He is also a smoker. Can anybody tell me what might be the cause and what possibly is his illness might be?",
    "doctor_response": "HiWelcome.I have gone through your query.It is difficult to comment on it without examination, so I would either suggest you to see doctor for examination and for exact diagnosis or upload the pictures here, I'll go through them, and provide you with specific advice.Hope this helps.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tooth and gum ache?\n\ni am 18 years old and used smokeless tobacco frequently. My lower gum on the right side started to recede causing pain in those teeth and that area. Between the two teeth there were 2 tiny black spots tht have disappeared. saw a GP nd said it was fine just a small infection i quit  have been using a new tooth paste nd OTC mouthwash that has peroxide in it for about 5 days. Now suddenly my top left gum began to hurt yesterday way in the back of my mouth. There is a black spot on my upper tooth on the last molar however the pain starts at the tooth before and continue to the first tooth in front of the molars. My gum has a texture, is inflamed, and feels very warm. the pain seems to be in the upper gums.",
    "doctor_response": "Hello, Thanks for consulting HCM Read your query , as you have pain in tooth having black spot this can be due to your tooth is carious causing pain and gums are receding due to gingval inflamation may be due to improper oral hygiene , deposition of subgingival calculus causing gingival recession dont be worried I will advise you to consult your dentist and go for examination of tooth with black spot and if needed go for Iopa xray of tooth if it is deep carious discuss with your dentist and go for Root canal treatment , and for gingival recession you should go for scaling and root planing . In meantime do warm saline gargle , for pain you can take analgesic like Paintol or Diclomol by consulting with your doctor and go for its treatment as early as possible .Hope this will help you.Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for orange color semen discharge?\n\nMy  man was over seas and now he has orange color semen. He is super worried about it!  And it happened for the first time tonight he has been back for over 6 months and has had 2 full check up blood work and std checks, all clean so what could have caused it to turn orange?",
    "doctor_response": "Hello, It may be due to infective causes like prostitis or infection of seminal vesicles. Some times stone disease can also cause similar symptoms. A semen analysis is required to make a diagnosis. If there is signs of infection, antibiotics must be started and most cases respond well to antibiotics. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for fatty liver\n\nHi Doctor, i was suffering from liver pain(pain at right bttom of chest and sometimes at center of chest. currently i m in chennai. i feel breathing trouble and when i drink water or take food, after taking it gives severe pain. i obsever no other symptoms other than this. and when i keep my hand on my chest i feel some hot temperature. can i know the best doctor in chennai. i feel very very uneasy. i went to a doctor and taken scan, only fatty liver was observed ans no other symptoms like kidney stone, stomach pain was observed",
    "doctor_response": "Hi, How are you? My name is Dr Suresh Raghavaiah. I am a Liver and pancreas specialist and I hope to answer your question today.Fatty liver can be caused by excessive alcohol intake (Alcoholic steato hepatitis, ASH) or due to excessive fatty food intake and sedentary life style (Non-alcoholic steato hepatitis, NASH). ASH is usually the beginning stages of alcohol induced liver damage and is completely reversible if the patient refrains from alcohol. NASH is being much more commonly diagnosed currently owing to poor dietary habits and sedentary life styles of people. High caloric intake, high fatty food intake and poor exercise regimens lead to deposition of fat goblets in the liver tissue leading to fatty liver (which shows up as increased echo texture on USG). This is also completely reversible in the initial stages if caloric intake is limited and exercise regimens are adhered to. If left un-checked, patients usually become obese, diabetic and in final stages may lead to cirrhosis of the liver which will necessitate a liver transplant.I would suggest a healthy diet and exercise regimen. Although there is no time limit on when to get a repeat scan, I would suggest one, once you have succeeded in losing some weight.Chennai does have a number of excellent hospitals  (Apollo, Global etc) which should be able to evaluate you and guide you further.Hope this helped and hope you start to feel better. Please do not hesitate to contact me for further details.Have a great day.Dr Suresh Raghavaiah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I not able to conceive as we are trying for a baby ?\n\nmy helathe is fine i run everyday i eat helath and fatty foods hi there me and my boyfreind have been trying for a baby 4 a year but nothing is happening i have done ovilitoin test and i do a pergence test every month as we want 1 so much can you help me please",
    "doctor_response": "Hi! welcome to healthcaremagic.com.Since you are not able to conceive after 4 years it is better you undergo thorough medical evaluation for both of you to ascertain the reason of non conceivement.Do ultrasound serially to check if ovaries are releasing egg normally.Also a dye test to confirm patency of tubes.Blood tests like blood profile,Lh,Fsh,Thyroid,Prolactin,Sugar profile.And his side semen analysis will suffice.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I opt a chiropractor treatment as I am not relieved from my pain in physiotheraphy?\n\nHello doctor,I have been seeing a physiotherapist for 10 sessions now, and during the sessions, I have been doing exercises and getting needling in around, and undead left shoulder blade to try to relieve the pain, but it still feels bruised under it. I have had some massages previously, which reduces the pain temporarily, but the pain comes back. I was wondering if a chiropractor could help as maybe something needs an alignment?",
    "doctor_response": "Hello. As with history, I can speculate that you are having trapezius. As the pain around the shoulder blade is due to the inflammation of the insertion of the trapezius muscles. As per my clinical practice of I do not think that dry needling and massage are the more extended term relief. I will advise that you should do hot water fermentation over the upper back and neck region. Post that, myofascial release, correction of the posture, and strengthening of the trapezius muscles.  This issue is commonly arising due to bad posture and the cervical spine IVDP (intervertebral disc prolapse). But for the cervical spine IVDP we need an MRI to understand the nature of the soft tissue injury. I understand that doing hot water fermentation, myofascial release, correction of posture and trapezius strengthening has helped my patients relief of the pain. I request you to look for one and let us see after a week. I assume things should get correct soon with the mentioned treatment plan. Regarding the chiropractor, I do not think it is needed for now so soon. If you have any more queries, please feel free to contact me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is white fluid comming during urination?\n\nI m 28-Male.White like fluid coming during urination. Kindly advice whats the problem",
    "doctor_response": "Hi,Welcome to HCM.White discharge while passing urine may be normal semen discharge. In that case there is nothing to worry. If you have history of sexual contact, then it would be a good idea to get blood test done for sexually transmitted diseases.If the whole urine is white in colour (like rice water) then it is a condition called chyluria, for which you will have to consult an urologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the rashes my grandson is having on his face and torso?\n\nMy baby grandson appears to have two different rashes on his face an torso. Started with what looked kike nappy rash. Then developed red blotches on his toso. This was followed by what looks like nettle rash. He s no sick but obviously uncomfortable and not sleeping well.",
    "doctor_response": "Hi.... I love to see the photographs and then answer you queries more precisely. If you can kindly upload the photos on this website and I would get back to you. By what you quote at this point of time, I suggest he might be having - 1. Infantile eczema.2. Erythema neonatorum3. Nettle rash.I wish your grandson a speedy recovery. If you need any future medical consultation and suggestions, I will be glad to help. You can approach me at the following link. Please find the link below.www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there a rise in my creatinine level?\n\nHello doctor, My creatinine level is 1.9. What should I do? My BP is normal. I am currently on Zyloric 100 mg thrice daily, Atorvastatin 10 mg, and Eltroxin. I have done an ultrasound. I had a USG done with no abnormal findings.",
    "doctor_response": "Hello. This rise in creatinine levels is usually related to a kidney dysfunction. For this reason, I suggest performing further tests to investigate your kidney function like creatinine clearance, a urine analysis, urine microalbuminuria and consult with a nephrologist. It is also necessary performing a urinary tract ultrasound. Chronic hyperuricemia can lead to chronic damage to the kidneys. Anyway, I reviewed all your performed tests and would explain they are normal (normal blood lipid profile, complete blood count, thyroid function, fasting glucose, uric acid levels). For more information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tooth ache\n\nHello, My name is Amanda Petti and I have a question. I got my wisdom teeth out over a month ago which was on October 6, 2010. For about a week now my left bottom side of my mouth is in a lot of pain. The pain goes from the back of my mouth all the way to the front of my mouth and also down my neck. I touch back there and kind of press down and I can feel where the pain is starting. Would it be a dry socket even though its been over a month or is it something with the nerver? What do you think it means? Thank you!",
    "doctor_response": "Thank you for posting on HCMI suggest pain is related to nerve irritation & hope it has resolved now considering the tooth was extracted in 2010.If any swelling is persistent - I suggest you need a visit to dentistHope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is 9 year old crying when tries to wake up from sleep?\n\nI have a 9 year old client who cries in the morning when her mother wakes her up. Daughter says she is crying because she is crying. Daughter is doing well in school, has friends, is from a caring family. She is the youngers of 3. She is very intellegent, does well in school, is active, healthy.",
    "doctor_response": "DearWelcome to HCMWe understand your concernsI went through your details.  There is an old saying which goes as Crying children do better in academics. This 9 year young child is doing the same. You must inquire for how many days the present behavior is present and what is the frequency. At what time the child is woken? What are the waking methods? Do the parents force? Do the child fear studying immediately after waking up? I am sure there is a missing link. Talk to the parents and child. Child may not be able to provide more information as of now. But once you build rapport with her, she will divulge more. Just use simple counseling methods of reassurances and calming. I don't think behavior modification methods are needed here. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in back on right side after waking up?\n\nHi. I recently started waking up in the morning with achy pain in my lower back/side - right side. I have had back pain before so know it's not that. It's not anywhere near the spine (more on the side) and above the real lower back where I have had back pain in the past. I'm sleeping in the same bed so that has not changed. I believe it's my kidney. It hurts and aches but then goes away after an hour or so after waking. What might this be?",
    "doctor_response": "Hi welcome to hcm,I understand your query and concern.As per your clinical description of pain,it usually points to renal stone located somewhere in the lower ureter.For this you need to have a CT scan of the abdomen for accurate assessment.Gelusil cannot control this pain.I advise you to have Tab Tramadol and Tab.Pantop 40 mg,a course of antibiotic taken under medical prescription to control this pain.Further expert management depends on the outcome of the CT scan result.If the size of stone is more than 5 cm then depending on the location of stone Extra corporeal lithotropsy can be done.Meanwhile you need to take soft and less spicy foods.Drink 3-4 litres of water everyday.Fruits,fruit juices,vegetable salads,soups should be taken.Post your further queries if any.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe pain and bruise in the buttock\n\nAfter riding the Lawn Tractor over very rough terrain. When I got off the Lawn Tractor I immediately had a pain in my Right Buttocks . I realized that my wallet had been pounding on that area during the time I was mowing. There is no obvious bruise and it only hurts when I stand and walk. It get worse the more I am walking. Sitting and lying does not hurt at all. What is it? I think it is an inflamed bursa. What should I do to get some relief?",
    "doctor_response": "yes, you are absolutely right.its a aseptic inflamed traumatic bursitis of gluteal muscle . it may be due to  localized pressure given by purse to the buttock muscles.Rest, icing and anti-inflammatory such as ibuprofen will give  immediate relief. Hope this helps.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of blood in stools?\n\nI noticed when my daughter pooped, if I leave the stool in the toilet bowl the water around the stool turned red, like blood seeping out from the stool. Is it normal? Because when I tested by leaving my stool in the bowl for a while, the similar redness around the stool appears. Please help",
    "doctor_response": "hi,the redness appearing around stool may be blood or related to the food you both are taking. i assume that there is no complaint of pain while passing motion. there is simple test [stool for occult blood] available to check whether it is blood or just coloration due to diet. if blood is present, a pediatrician consult will be required.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in head while coughing\n\nI coughed and extreme pain raidiated throughout my head increasing on every heart beat once I laid down the pain diminished but when getting up and walking up a flight of stairs the extreme intense pain came back just as in the initial incident but each day the pain decreased I don t what it is or what to do",
    "doctor_response": "Hello,Regarding your trouble, kindly consult a physician and get an ECG done. Along with this it is important to know your lung function so kindly gwt a lung function done. Sudden increase in intensity of pain may hint towards Angina pain. The main priority is to immediately  consult a physician for cardiac funtion tests.If you are a smoker kindly quit smoking.Regards,Dr.Riyanka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take Formonide 200 and NecMonto-L for long periods ?\n\nI have been asked to take two puffs / twice a day of Formonide 200 and one tablet a day of NecMonto-L EVERY DAY for asthmetic phlem problem. Please explain how these drugs works and is it safe to take them for long periods. Age: 67 Gender: Female. History: Wheezing and breathlessness and Phlem since more than 25 years",
    "doctor_response": "I understand from the background you have given that you have asthma. Here, your airways tend to over-react to triggers like dust, cold air, strong odors, smoke, etc. which cause the airways to narrow temporarily. After the triggers are gone, the airway returns to its normal size. But over a long term this repeated narrowing and widening can lead to loss of their \"elasticity\" and permanent narrowing. Asthma is an airway problem that can be controlled but not cured. The most important medicines to relieve and control asthma are those that cause widening of the airways and those that prevent permanent damage. In your case they are Formoterol and Budesonide respectively (contained in Formonide). Since these medicines act for a maximum of 12 hours you need to take these medicines twice daily EVERY DAY. Together they control your current episode AND prevent further episodes. The dose may be reduced over a period of time if you show good response and withstand reduced dose ONLY IN CONSULTATION WITH YOUR PULMONOLOGIST during REGULAR FOLLOW-UP. Regarding side effects - since these medicines are inhaled and taken to the lungs where their action is required, they do not reach other parts of the body in significant amounts to cause significant side effects. When compared to oral and i.v medications used to treat asthma, the inhaled medications are far superior w.r.t their side effect profile. If you have allergy of the nose - runny nose, sneezing the Montelukast-Levocetrizine combination(NecMonto-L) will help. Regarding this your pulmonologist will decide the ideal time to discontinue.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can i do to gain sensation back after losing tissue?\n\nWhat can I do to gain sensation back after loosing tissue? I have had two colposcopys in the past 4 years and it just doesn t feel the same at all. The first time you would have thought it was a LEAP the doctor took so much tissue and there was more bleeding than the second...",
    "doctor_response": "Hi, Unfortunately, loss or lack of sensation following colposcopy is a recognized complication which (if after 2-4 years) is likely going to remain permanent. It is a very uncommonly reported complication of the procedure but can happen based upon scarring of the biopsied area and other uncontrollable factors. With the loss of sensation in that area, you may wish to talk to your doctor about other possible sidelight causes for numbness in that area unrelated to the biopsy procedure since other things could also be causing the problem. So check with them as well and see if they can re-examine you to see if there may be a simple explanation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dark silvery patches on fingers, suspicion of psoriasis. Which medicines should be taken?\n\nI am suffering from bad silvery/dark patched in my fingers since past 4/5 years. Local homeo doctor opined it as psoriasis . Kindly suggest me internal and external medicines for remedy. for some days I have taken Betnasol tabs and having good result. But somebody suggested me discontinue it because it is a steroid group of medicine. Please suggest. S. Bandyopadhyay YYYY@YYYY Male, 57 years, Indian.",
    "doctor_response": "please try clobet ointment, and evion cream. regarding internal medicines it is best if you have some tests done before taking a few medicines",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms and treatment for vertigo?\n\nI have been having dizzy spells, not sure if it is vertigo. My doctor gave me Meclizine but it does not seem to be helping. I made an appointment with and ENT but I have to wait 1 more week to see him. In the mean time I have to deal with the dizziness.",
    "doctor_response": "Meclizine is poorly effective for the majority of cases of \"dizziness\" yet it is prescribed with what I refer to as \"reckless abandon\" at times from ER's, etc.  First, dizziness has to be defined as either VERTIGO or not and then, the UNDERLYING cause needs to be sought and discovered.  Medication (meclizine or not) is not going to resolve problem if the vertigo is because an inner ear problem, a circulatory problem, or a brain problem.  Your next best move is to see a NEUROLOGIST or if possible a NEURO-OTOLOGIST.  The time of 1 week to see a specialist is not bad at all.  If you wanted to be seen sooner then, you could try a CVS pharmacy Minute Clinic but typically those are staffed by Nurse Practitioner and from what you're stating I don't think it's likely that you would get much more than either the meclizine back at a higher dose or something else geared toward just treating your symptoms without looking for a cause.  Please rate this a 5 STAR CONSULTATION and write me at: www.bit.ly/drdariushsaghafi for more questions or comments.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can painful stiffness in the neck caused by cervical arthritis be treated?\n\nYes, my son is active Army and he is presently completing his packet for commissioned officer. He was experiencing neck pain, i.e. a stiff neck for approximately 1 week which he treated a over the counter Rd and moist heat. He had to see the Army Doc and was ordered X Rayss which showed he had Arthritis of the neck C 3 4 &5. He is scheduled for an appt w the ND next week and is afraid this may prohibit his completing Officers Training. He is 34 years of age. Played basketball for app 14 years in schoo! And college. What would his best course of treatment be as far as Rd and would this prevent him for furthering his Army career? Thank you",
    "doctor_response": "Hello, Physiotherapy is the  best option for cervical spondylitis. For symptomatic relief of pain ,combination of muscle relaxant and NSAID( Paracetamol+Chlorzoxazone  and or Diclofenac) for a short period with antacid like Pantoprazole oral is usually effective. Let me know if I can assist you further. Regards, Dr. Tushar Kanti Biswas, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have PCOS. Family history of ovarian cancer. Had tubes tied. Why am I in pain?\n\nI have PCOS , family hx of my maternal grandmother died of ovarian cancer . Is it true that ovarian skips a generation? I have been having painful, heavier cycles monthly. I had an u/s this morning and the tech told me she was going to label the cyst that I had now a complax cyst. I know there are several types. I ve had 2 removed August 2011 and felt pretty good afterwards but it continues to stay on the right side for the pain. I m scared that it may turn into something worse. I m 39, overweight (215) and 5 3 and have high b.p. My dr. told me to lose weight and get my b.p. under control and grow older and we may talk about a partial or full hyst later on, but not now. I had my tubes tied and and finished with children. I m doing just that but am concerned about the pain. I don t want to do b.c. pills. Any suggestions? Thanks ---Lisa",
    "doctor_response": "Hello and welcome to HCM You have a family history of ovarian carcinoma. It is true that ovarian carcinoma has a genetic basis. It is a familial occurrence. The presence of PCOS does not increase in the incidence of ovarian carcinoma. Presence of cysts is a normal finding in ovaries. The thing of concern are the presence of high blood pressure and obesity. The presence of high bp and high weight increase the risk of endometrial carcinoma. These parameters need to be kept under control and prophylactic hystrectomy done since you have completed your family. Thanks and take care Dr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had hysterectomy and bladder surgery. Getting metallic test in mouth, sore stomach. Took laxatives. Is it normal?\n\nI had a hysterectomy and bladder surgery a week ago. For the last two days I have had a metallic taste in my mouth it is accompanied with indegestion or sour stomach . I did have to take laxatives for 4 days. However I did not take it today because I thought they may be the cause . The taste makes me very nausea . Is this normal and is there anything I can do to get rid of the taste?",
    "doctor_response": "Hello The symptoms point towards the side effects of the medicines you might have taken or may be still taking after the surgery. Just wait for the course of medicines to finish . For sour stomach ,you may take some antacid like pantoprozole 40 mg daily on empty stomach for few days. Do inform your treating doctor. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for phimosis\n\nHi, I recently participated in sexual intercourse and I seemed to cut my banjo ( i don t know the proper name for it) and I can t pull my foreskin all the way back because it hurts. I also had pink like semen for a while, and now it s starting to get white again but now I ve got jelly like crystals coming out as well, I m really concerned",
    "doctor_response": "Hi.I had gone through your query.Phimosis is only corrected by surgical methods.Circumcision is the choice of operation.Indication of surgery are pain, difficulty in sex or urination.It is very short operation and can be done under local anesthesia.Consult surgeon for better evaluation.No need to worry you will be fine.Glad to help you further.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for tooth infection\n\nHi am suffering from pain in my wisdom tooth, I have visited doctor yesterday. He said I got foul wisdom tooth and suggested me for extraction in two days. Meanwhile he asked me take antibiotic pills. But now am suffering very badly with pain. Can you suggest any tips or tablet for my pain.",
    "doctor_response": "Heloo pt-The problem you are facing is because of the tooth infection.nothing to worry about you  i just suggest you etorica120 for 3days ,flagyl400,and hyclav625 for 3 days.if any queries are there reply me back.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What remedy is suggested for bruise like lumps?\n\nAbout seven days ago I noticed a purple bruise on the underneath of my 6 year old daughters arm as the days have went by the purple has spread to about the size of two fifty cent pieces it has a hard white lump to the one side it is not centered but it does almost seem like it is coming to a head.",
    "doctor_response": "Hi,Dear,Thanks for the query to HCM. I studied your problem in depth and I understood your concerns. Treatment  for bruise -like lump underneath of arm-Your daughter had -boil underneath the arm which developed in to abscess in it with cellulitis around it.Antibiotics /anti-inflammatory NSAIDS/ and Surgical drainage by ER Surgeon would resolve your issues.This advise is based on the facts from the history you give and needs further clinical check.So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you, but just ask a query to HCM and be comfortable to resolve your health  issues.Welcome for any more query in this regard to HCM.Write good resume and Click thanks if you feel satisfied with my advise.Have a Good Day.Dr.Savaskar M.N.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to determine hand foot and mouth disease at an early stage?\n\nmy daughter was at a birthday party yesterday afternoon, one of the girls this morning was taken to see a doctor because of a rash and fever and as it turns out was diagnosed with hand foot and mouth disease. My concern obviously is for my daughter (who is 4) but also myself as I am 37 weeks pregnant. What should I keep an eye out for on her, or should I send her to stay with relatives so that I don t catch it?",
    "doctor_response": "Hi...hand foot mouth disease is not a very dangerous viral illness. If it has already got contacted you daughter may have some itching but it is self limiting. it will not bother adults as much. If a pregnant woman gets hand, foot and mouth disease (HFMD), there\u2019s normally no risk to the unborn baby, as complications are rare.Hand, foot and mouth disease is rare in healthy adults, so the risk of infection during pregnancy is also very low. But a very remote possibility of miscarriage exists.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and vomiting in kid\n\nHi, my 10 year old daughter has had a fever of 102-103 for about the past 12 hours. I gave her ibuprofen a few times, which reduces the fever for a short time, then it goes back up. She vomited twice today, both times shortly after trying to eat something. Is there any reason for concern?",
    "doctor_response": "Hi welcome to HealthCareMagicfever , vomiting  is usually viral in nature  and resolves in 2-3 days.You need to concern if child is  dull,poor oral acceptance,headache not releived with medicine, severe headche , vomiting not responding to medicines, fever not coming down after 2-3 days,high fever.Hope I answered your queryfeel free toask if any other querythanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in leg?\n\nright leg is swollen on one side...went to dr. had ultrasound done of my leg to check for blood clot and its nothing. Im currently almost 10 weeks pregnant with my second child. My right leg was swollen yrs ago, same spot, same leg, and ultrasound showed no blood clots. I am on my feet at work and constantly moving around. I am worried that this is something serious even though ultrasound showed no blood clots",
    "doctor_response": "hi,as you have mentioned the little of the history and diagnostic procedures performed. I feel you should try doing leg exercises. try dipping the leg in warm water for 15 minutes then Keep the leg over the pillow while lying on your back. that means the leg is elevated above the level of heart to get venous drainage. also perform some simple exercise like ankle toe movements and straight leg raise. during pregnancy swelling is common and can be avoided by some simple exercises. I don't think there is serious issue where you have to worry. if the symptoms persists talking to a gynec or a gynec physical therapist will be of great input.thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Infected by hepatitis B, stress, fatigue, pain in the liver area, increased weight. Take liver function test anually. Suggession?\n\nI am 28 years old and working in private company i had been infected by Hepatitis B since 9 years until now i hadn t faced any problem expect stress and fatigue and occasional pain in right side (liver portion) ,but there has been increase in weight . annually i take LFT ( liver function test ) what would you suggest me",
    "doctor_response": "Dear Friend.Welcome to HCM.It seems you have been suffering from Chronic Hepatitis B. I would suggest you following:1. Anti Hbs Antibody2. Ultrasound Abdomen.3. HBV DNA.You require treatment for this.Stay Healthy",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to improve a baby s skin complexion?\n\nmy daughter complexion is dark,though she is very pretty,the indian mindset is biased towards fairer babies.I am wheatish in colour,my face is dark but my body is wheatish,my wife is very fair,my son who is 9 years now is wheatish all over.My baby is 1 and a half years now,i have noticed she undergoes different complexions in a day,my face is wheatish but her back and legs are very dark,how to know her correct complexion and can you suggest measures to improve her complexion.I love my baby very much and hence concerned about racial discrimination by others at later stages of her life.",
    "doctor_response": "Hi, complexion of skin of baby depends on colour of parents. This can't be changed. There are no medicines for this. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes erectile dysfunction?\n\nHi. About 2 months ago my penis became very red and swollen along with being realy itchy. After seven days I came to the conlusion that it could be a fungus infection so I put some cream on it that would help. The swelling and redness reduced, but it still looks wrinkly and now it seems very dry when I get an erection. I thought it might be chlamydia so I got myself tested, but it was negative. What do you think it could be?",
    "doctor_response": "Hi, If you had unprotected sex - need to rule out sexually transmitted infection chlamydia test alone won't help you had unprotected sex - you need to do a panel of sexually transmitted infection tests. It can be due to fungal - few days treatment won't help, you need to take treatment for at least 4-week continuous with appropriate antifungal cream. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in dry socket of tooth, brown discharge. Paste put in for pain. Treatment?\n\nI have dry socket from a wisdom tooth extraction a week ago, the dentist put paste into it for pain, there is brown stuff in the socket, my dentist didn t tellme to remove anything.... should I remove what s in there? I have an appointment in a day and a half and its been a couple of days ? Is it cotton or part of the paste",
    "doctor_response": "dry socket is because after extraction  the blood clot got dislodged from the socket. so ideally the dry socket should be curetted which means it should be cleaned & irrigated with medicine & obtundent dressing which is already given to you must be placed. the brown discharge or paste is the dressing. it will take around a week for the pain to subside. you should go for regular dressings, & maintain that area clean. food lodgement in the socket can again cause infection & give more trouble. use betadine mouthwash twice a day to help in healing. betadine should be diluted with equal amount of water, & after rinsing with it you should not intake water for atleast 20  mins.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How many hair follicles do I need in the donor site to go for hair transplant?\n\nHello doctor, I recently had a meeting with a hair transplant clinic and they told me I needed 3000-3500 follicular units (8000 follicles). Attached is a photo of my hair loss, is this overkill? I am afraid of running out of the donor area.",
    "doctor_response": "Hello. It is androgenic alopecia (male pattern baldness). It is a genetic, sex hormone imbalance disorder. There is a shortening of hair growth cycle and delay in new hair growth (increase in dihydrotestosterone-DHT). Causes in our case can be hormonal imbalance, insufficient protein intake, iron deficiency, hair procedures, rough handling, stress, and drug-related. Treatment: Minoxidil 5 percent lotion 1 ml at night for 30 days (on hair thinning area). It slows hair loss and grows new hair. Nizoral Shampoo twice weekly for six weeks. Laser therapy (low-level laser therapy) to stimulate the growth of follicle. Hair transplant last modality of treatment. Eat oranges, avocado, carrot, yogurt, sweet potato, salmon, spinach (vitamin A, folate, iron), green leafy vegetables, eggs, chicken. Drink lot of water. Drink green tea. No caffeine, tea, soda. Eliminate stress. Stop smoking. Scalp massage, aloe vera gel, onion juice extract as a home remedy. Try this before thinking of hair transplant.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could pain be caused by facets?\n\nin august I was stopped at the rotary and another care hit me from behind. I felt a pain to left of l4 l5 and it shot to straight across to left of my lower back and stopped. it felt like an electrical shock. two days later when I sat down the pain was horrible. I was diagnosed with lumbago and a S1 ligament/joint strain. my mri revealed an asymmetric disc bulge to left at L4-L5 which contacts descending left L5 nerve root in the lateral recess and also results in mid left foraminal narrowing at this level. I have a had two epidurals and one trigger point injection. trigger point injection had kenalog, which hurt like a bee sting and continued to hurt for weeks. this area sometimes still feels like a bee sting. now my back doctor wants to give me facet injections at L4 to S1. pain is really bad to left of L5-S1. pain radiates down to tailbone and both sides of sacrum can hurt. sitting and bending backwards can really hurt. the area can feel like a rug burn. pain from bulging disc no longer goes down left leg. Also I no longer have pain to left of L4, but my doctor wants to put a facet injection in this area. I a very fearful of these injections. I also have mild diffuse degenerative disc disease thoughout the lumbar spine without central canal stenosis and facet arthropathy at L5-S1 resulting in mild bony foraminal narrowing. my back doctor thinks MVA jumpstarted facet pain. could pain be caused by facets?",
    "doctor_response": "Hello There ! Its good that there is no radiating pain from the disc bulge. Facet  pain could be one factor , however there could be pain originating from other aspects too in your case like ligaments , due to the mva. If there are no motor and sensory defects , like muscle weakness , numbness  or sensory loss ,my suggestion would be to give a try to conservative pain management remedies. a PHYSIOTHERAPIST has a host of tools to manage your pain and can also assess where it comes from . Kinesiotaping , Ultrasound , TENS etc and gentle manual therapy  as indicated can be applied with excellent results for  pain in low back and sacral areas. Be aware of your postural habits though , some lifestyle changes could be suggested by your physio to help you correct your body mechanics and  manage pain better. tc",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the meaning of free fluid in the pouch of Douglas?\n\nwhat is the meaning of free fluid in the pouch of douglas,and what is the side effect on me trying to conceive 35,fola,female, My scan shows i have a free fluid in the pouch of douglas,i want to know the meaning,the cause and what treatment measure to take,Dr mohammed Tauseef,gave me a reason to smile when he answered my question.",
    "doctor_response": "it is the infection around  the  uterus, which does not cause failure in conceiving if you want detail information visit this site:",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to control vomiting after feeds in a child?\n\nMy Baby is 8 months old. I started giving him cerelac right after six month. His teeths are coming. From last 2 days he is vomiting after I give him meal he vomits that. What should we do so that he does not vomit. He is very weak. He weighs only 6.5 kg. He does not eat well.",
    "doctor_response": "with hold cerelac for one or two days and restart in small amounts.if still he continues to vomit start tab junior lanzol 1/2 once a day early morning for two weeks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a small pea sized nodule on knees indicate?\n\nhey i'm 21 , male from indiaI have this small pea sized nodule in the right side of my left knee ... im just worried what it would be ... i once fell on my knees and got a cut on my knees! the wound healed and was clumpy for a while ! and now its gone and i have got this nodule recently .",
    "doctor_response": "It could be a hematoma or a lump with collected blood from the injury, but since you say it has come up recently it could be something else. It would be difficult to say without examining. So I suggest that you see your Doctor who can examine you and advise accordingly. If not, then send us a picture of the lesion on 'Ask a Specialist' section of the website and then we can help you better.Take care,Dr Rishi, New Delhi, India.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am suffering with headache, sweating, uneasiness.\n\nI was taking szetalo plus (1tab/day) since 2yrs and just 1week back, doctor sugegsted me to take szetalo 10mg..when started taking it, i am not comfortable. i am suferring with headache , sweating, uneasiness. please let me know if this is common symptom while reducing the dose.",
    "doctor_response": "hi! it does happen at times    what we call drug withdrawal effects  well seen with these antidepressants   dont worry  you just discuss these with your psychiatrist / physician   he will certainly adjust a better regime for  you  along with some anxiolytics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedy for burning sensation in the stomach\n\nMy husband is suffering from gastric problem. Now he is taking high dose of  antibiotics like  cap.,amoxycillin,tab klarion,tab tinidazole &tab pantocdac from 4 days. He  is 35 yrs old, wt is 60 kg,ht 6\". He is taking soft diet only. last night he is suffering from sever  burning abdomen what can i do for relief him from burning abdomen at home",
    "doctor_response": "Hai,I advise you to take honey or yogurt  frequently in small quantity.Avoiding taking dry and spicy protein diet.take rice gruel add with salt and ellachi will soften your abdomen from the burning sensation.drink cold water for temporary relief from the burning sensation.Thank youhope i answered your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do i need a vaccination again for dog bite if previously vaccinated?\n\nRabies and vaccine hello my son was bitten by our neighbor s dog.he received 3 doses of rabipur , the dog is doing well so that the doctor discontinue for the 4th dose, after 12 days after the last dose he bitten again by another dog...i ask that the current vaccine is still active what we can do?",
    "doctor_response": "Hello,Welcome to HCM,As your son was given post exposure prophylaxis with three doses of anti rabies vaccine on days 0,3 and 7. Remaining two doses was not given as dog was available for observation and it is healthy after 10 days of observation.As he was bitten once again, according to WHO categorization of animal bite, he will be categorized into Re- Exposure category.The Re-Exposures should receive two doses of anti rabies vaccine on days 0 and 3. So your son should receive two shots of anti rabies vaccine.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a red line under the tooth?\n\nI am a 35 year old female and I have recently discovered a red line under one tooth on my gum. What could this be? I can not get in to see my dentist until next week. I am very worried about this and can't help but think this is some type of oral cancer. Please help!!",
    "doctor_response": "Hi,i went through ur queryReasons for red line under the tooth can be many but considering ur ageIt could be due to Dental abscess, It could also be due to injury to ur gumsOr sometime it can be caused due to hormonal changes tooAt present with limited amount of informationU can 1. Apply ointment TESS twice daily         2. Do warm Saline Gargles         3. Maintain Oral hygiene by brushing twice dailyHope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen lips and cracks in corners of the mouth?\n\nmy 10 yrs old son is having major issues with his mouth.he was being treated for what they thought was gingervitis but over christmas break it escalated and his lips cheeks and gums are so swollen and he constantly hurts.we are waiting for his labs to come back and they just did an oral biopsy on him.he also has cracks in the corners of his mouth  and none of the ointment is working..do you have any suggestions on what can be causing this and what i can do to help him..the kid already has a speech problem and now its 10x worse",
    "doctor_response": "Hi dear, I had gone through your question and understand your concern. You should be worried, but not too much. Cracks in the corners of the mouth and gingivitis are symptoms of iron deficient anaemia. I suggest-check iron,haemoglobin, RBC to exclude anaemia;-follow iron enriched diet:spinach, sesame seeds, pomegranates, dates,apple,etc;-take multivitamins: Zincovit for 1 month;-it could be necessary to take iron syrup;-apply Pantosal.Hope I answered your question, if you have any further questions ,please don't hesitate to contact us. I am always happy to help",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have had two periods in the same month. Why?\n\nHello doctor,I have had two periods in the same month. The first one was for five days and this one has lasted for six days, but I am still having some blood when I wipe. I do have PCOS and I understand that the period issue could be a result of this. I am feeling unwell and constantly have a headache. The first period was on the 5th and the next one was on the 26th.",
    "doctor_response": "Hi. Irregular cycle is a common manifestation of PCOS (polycystic ovarian syndrome) and it is due to hormonal disturbances inside you. You need some medication to control your cycle as well as your bleeding. Medications are different according to your need. If you do not want to conceive, a combined hormonal pill is ideal. But, if you are suffering from subfertility, an ovulation induction with a medicine called Clomifene is ideal. Consult your specialist doctor, discuss with him or her and start the treatment with consent. PCOS. Medication. Weight loss. For further information consult an obstetrician and gynaecologist online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How does clogged blood in the head cleaned naturally?\n\nhow can clogged blood in the head be cleaned naturally ?",
    "doctor_response": "Hello. . Clotted blood anywhere in the head is very unlikely to get cleaned naturally.It has to be removed surgically or if it remains there it is may get infected or resolve on its own in a long passage of time. Get an MRI done to see how big is the clot and where is it. Dr. Rakhi Tayal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could pain on back below the shoulder with tingling and numbness in right arm indicate?\n\nI have pain on the right side of my back just below my shoulder. I can t lift weight with my right arm, certain forward movements cause sharp pain, overuse causes it to ache. I also have tingling and numbness and feel fatigued. The pain has been there for about 3 weeks now.",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It seems you have impinged nerve at the neck level which is causing you the pain and tingling and numbness . so do care about your neck positioning and try to sleep straight . No sidelying position and apply hot pack twice a day. Use cervical collar while travelling will help you in relieving your symptoms. Avoid fried items in diet and eat lot of green veggies with lot of fluids, vit b 12 supplements may help you out (as vit b 12 is considered as nerve tonic). Avoid any overhead activities and travel with less luggage if your work requires you to travel.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Harsh Swarup",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden pain and burning sensation in the lungs?\n\ni was washing my dog and was in a head down position with my knees agains my chest for about 10 minutes when a burning pain in my lungs hit me and i was out of breath as if i felt as if i just ran a marathon. When i breathe there was gargling sound. I got hot in an instant and my face, eyes and ears got red and hot. i feel burning in my lungs and throat with every breath, i just drank some water with baking soda hoping its an acid reflux- i never got one not sure how that feels. Thank you.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. No need to worry for this as this is normal. Normally our lungs are in upright position (standing) or in lying down position (supine). But when our lungs are placed in upside down position, blood supply of lungs suddenly increases and this gives symptoms of breathing difficulty, pain and burning sensations. If this position is for short time like for few seconds, these symptoms won't appear. But if upside down position is for longer duration like 10 minutes in your case, these symptoms appear. So no need to worry much. It is normal, not indicative of any disease. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anxiety disorder and depression\n\nI m either super depressed or overly happy. I m insecure, paranoid, unable to trust literally anyone, constantly anxious, have daily or more panic attacks. Can be extremely happy and the smallest thing sends me into a hateful rage. I m controlling and a perfectionist. I can t stand people yet I love everyone. What it wrong with me? My brain never stops and I seem to always think everyone is I guess conspiring against me.",
    "doctor_response": "DearWe understand your concernsI went through your details. To be frank, how are you able to do so many emotional obsessions? Don't you have anything else to do? That is the question. If you are engaged from morning to evening in your job or profession, the come back home and relax and do household duties like rearing child or gardening, you will be kept busy and such thoughts will come only occassionally. If you do not have any such thing to do, naturally, ''dle mind is devil's workshop''. Please understand. Still I suggest you to consult a psychologist for mental health screening test and diagnosis. Take care.If you still need my assistance in this regard, please use this link.  Please remember to describe the whole problem with full detail.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pressure in back of head, herniated disc in neck, shrinkage in front of brain. Due to trauma?\n\nHI, MY NAME IS CYNTHIA, AND I HAVE MS AND I HAVE ALOT OF PRESSURE IN THE BACK OF MY HEAD AND I HAVE HAVE A HERTNATATED DIC IN MY c5-c6 in my neck,know I have shrinkage in the front of my brain.can I get this from a lot of truma to my head.",
    "doctor_response": "Hello and welcome to HCM,The problem that you are facing pertains to the cervical spine.The cervical vertebrae are seven in number and these vertebrae are separated by intervertebral discs.These discs act as shock absorbers and allow frictionless movement of the vertebrae.There is protrusion of the intervertebral disc between 5th and 6th vertebrae.The protrusion of the disc can compress the nerve roots emanating from the spinal canal.This can cause pain in the region supplied by the particular nerves.The management of this problem is conservatively initially.If the symptoms do no disappear after conservative measures, surgical methods may be required.Shrinkage of brain substance can be due to vascular insufficiency, age related changes etc.Trauma to the brain substance can also cause shrinkage of the brain parenchyma.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed popping like sensation near the ribs due to an injury\n\nI went to an amusement park with my daughter. I weigh 95 lbs and she weighs 180 lbs. The ride tossed her too my side and I got squished by her and I felt a rib pop. Since then, it has been popping under my left breast and it hurts to breath sometimes and it hurts when I laugh and REALLY hurts when I sneeze. Everything else is fine though I dont have pain when I reach for stuff, but it hurts a lot at times. Is it broken do ya think? And if it is, what should I do?",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. You are having blunt chest trauma. And following are the possible complications of blunt chest trauma that can cause similar symptoms like you have. 1. Rib fracture2. Pulmonary contusions3. Pneumothorax4. Muscular injurySo get done chest x ray first. If chest x ray is normal then no need to worry,  you are having mostly muscular injury. So follow these instructions for better symptomatic relief. 1. Avoid heavyweight lifting. 2. Avoid strenuous exercise. 3. Avoid bad posture and movements in sleep. 4. Start painkiller and muscle relaxant. 5. Apply warm water pad on affected site. Don't worry, you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had D & C. On puregon injection, clomid. Time to mature follicle?\n\nHi, today is day 9 of my cycle.I had 5 injections of 150 iu puregon, and 5 days 150m clomid this cycle alternatively (tomorrow is the last clomid day). I did Scanning today (D9). but my biggest follicle was 8*8 others were 7... . my dr gave me 3 more injections for day 10, 11 and 12, and another scanning for day 13... do u think is there any hope to get mature follicle? How long I have time to grow the follicle? can they grow till day 13 or 14 also? and also the endometrial thickness was only 4! I had D&C on 1 march...",
    "doctor_response": "Hello, Thanks for posting your query on health care magic. Follicles grow at a rate of 2mm/day. 8mm on day 9 is a good size. There are chances that follicles grow at-least to 18-20mm. Ideal size of dominant follicle at the time of rupture is 18-22mm. Endometrial thickness of 4mm is not ideal for conception. Anyways, nothing is impossible. Wish you good luck. regards, Dr Nilofer",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a long lasting Insulin dose for elevated blood sugar levels advisable?\n\nMy sister s Blood sugar is 201.I have given her a long lasting dose if insulin 2 hours ago..Is that still too high and what should I do? Also she has issues with high blood pressure and her heart Her vitals are ad follows 101/71 and her heart rate is 67 Is that ok?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. From your description, I can deduct that 201 mg/dl is not a fasting blood sugar result. (because she had a long lasting insulin injection 2 hours ago.) It is not too high, don't worry. This result is not dangerous for your sister. My advice is to increase 2 UI her insulin doses (you can start tomorrow with the increased dose) and to check her fasting and post prandial (2 hours after meals) blood sugar again. If the result do not return to \"normal diabetic range\", I suggest to consult her treating doctor because your sister may need to change her insulin schedule to control her diabetes. About her vitals, her blood pressure is \"a little bit\" low, but is can be normal for the females. Anyway, if she take anti hypertensive drugs, I suggest to lower the doses of the medication. Her heart rate is OK. Hope i have answered to all your questions. If you have other doubts,feel free and ask.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there accumulation of water in spite of stomach dialysis?\n\nHello doctor, My sister is undergoing stomach dialysis treatment for the past one month. Now, she has developed water in the lungs. Due to that, there is breathlessness, no appetite, no sleep, water retention in feet, and stomach. The doctor has removed 1 liter of water from the lungs, but second day it is accumulating. What will be the treatment?",
    "doctor_response": "Hello. Your sister is undergoing peritoneal (stomach) dialysis. Now, she is having fluid retention in her body. This can be either due to change in her fluid intake habits wherein she has now increased fluid intake, another reason may be that the dialysis technique is not resulting in an adequate water removal from her body as well as poor clearance of toxic material (which may account for her poor appetite). We also have to see if the medicine fluid which we install in her stomach is going into her chest cavity. Having excluded the later condition, I would suggest her to have a PET test which will give an idea of how her stomach surface membrane is working. This will give an idea as to how we can tailor our dialysis schedule for her (number of sessions per day, duration of each session, the concentration of fluid to be used, etc). I hope I have helped you. For more information consult a nephrologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is this pregnancy normal based on the ultrasound report?\n\ni m 8 weeks pregnant and my symptoms (nausea and extreme fatigue) have just disappeared over the past two days. i did have an early ultrasound last week and they said they found a heartbeat but i m a mother of 4 so i m pretty experienced with the way the whole pregnancy thing works and these symptoms don t usually clear up till closer to 12 weeks. i m usually not this neurotic, but i did have a miscarriage in may so...should i be worried?",
    "doctor_response": "Hello dear,i understand your concern.In my opinion the symptoms of pregnancy like nausea,vomitings, increased urination,sore breasts start around 6 weeks and persist till 12 weeks usually.But it might be variable in different pregnancies and in different people.So nothing to worry.As the ultrasound is normal the well being of pregnancy is confirmed.So just relax.Avoid stress regarding anything.Hope this helps.Best regards...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes neutrophilia?\n\nHey there! I would like to ask something with regards to neutrophilia. I ve got a friend who just had a physical examination and she is kinda troubled as it was reflected in her CBC that she has one. May I ask the reasons why such condition happens and how to deal with it? Thanks and more power!",
    "doctor_response": "Hello,Thank you for your contact to healthcare magic.I understand your health concern, if I am your doctor I suggest you that neutrophilia has many reasons which include most common infections  particularly bacterial, blood malignancy etc. In most of the people low grade neutrophilia is associated with infection, which I suspect the same in you.I will be happy to answer all your future concern. Thank you,Dr Arun TankInfectious disease specialist.Wish you a best health at health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for striking pain in brain\n\nmy boyfriend had brain sergury may 10, 2010 to remove a frontal lobe tumor. since then he has stricking pains in the top & front of his head after making love. He has seen mant Doctors in aour area. He has so many types of medication that doesn t, please help us",
    "doctor_response": "Hello, His symptoms could be related to orgasmic headache, which is a rare type of headache. I would recommend trying propranolol to help prevent this type of headache. A new brain MRI is necessary too, in order to exclude any possible tumor recurrences or increased intracranial pressure. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the reason for pain in lower abdomen, bleeding during intercourse, clotting and cramps?\n\nI just recently received an ultrasound and the findings were that I have subcentimeter ovarian cysts and a 1.6x1.26x2 cm right sided fundal fibroid. I have had this very painful dull pain in the lower right side of my abdomen, sometimes I bleed when I have intercourse, I have very painful periods with alot of clotting and severe cramps. I have incontinence issues and the list goes on and on. One of the PCT from my gynecologist office called me and said everything is fine. How can that be when I am in SO MUCH PAIN?",
    "doctor_response": "Hi. You are absolutely right , everything is not fine. The bleeding during intercourse can be coming from the uterus or there can have a lesion on the cervix. Fundal fibroid can cause the pain and bleeding if it has eroded the internal wall of the uterus ans clots and cramping. Ovarian cysts of this small size usually do not cause problems. I would advise you to go for another opinion. Possible chances of betterment are from Laparoscopic diagnosis and removal of the fibriod if there is a facility nearby you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is talking imaginary things a symptom of Parkinson's disease?\n\nMy father is 70 year old and is suffering from Parkinson's disease since 7 years. He used to take Syndropa CR, Ropark 0.5 and Parkin 2mg and Entacom as medicine. For last few days he has development a new symptoms of talking wrong imaginary things. Is this common to parkinson disease.",
    "doctor_response": "there are 2 possibilitiesa. this may be a part of the dementia. the dementia may make the person talk irrelevently. the dementia is present in a large number of patients and often it comes late. b. may be an effect of the medications, the dopamine based medicines may have simlar effects. it is known to cause such symptoms.best to meet a neurologist for the readjustment of the dose.Best of luckDr Mittal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having asthma and sinusitis, taking clarinase tablets. Sinus pain in half of the face. Feeling breathlessness. Is it a side effect?\n\nHi thereI am asthmatic and sinusitis. And last week my doctor gave me clarinase tablets cause I had Sinus pain, the pain was exactly on have of my face (left). two days after I was on clarinase I noticed that I was not feeling well. A very bad cough started, And noticed that I couldnt start taking breath easily. for example when I go up one storey. I could notice that theres something bad with my breath. On the side effects I found that while take clarinase It can cause coughing,dizzyness, and narrowing of air pipes. What probility it will be? my asthma was triggered or just a sideefect,Best RegardsTiziana",
    "doctor_response": "Hi, Thanks for using HCM.I advice you to stop any antihistamine like clarinase in asthma. This may help you for sinusitis in reducing the secretion but in asthma it dry up the bronchial secretion and can cause more problem. You can take montelukast (Singulair 10 mg OD) which will help in both asthma and sinusitis. Do steam inhalation 3 times a day. Since you are developing sinus pain take acetaminophen for pain and to prevent inflammation and you may require antibiotic. This will help you. Hope I answered your question. Consult your doctor for further examination and management.Feel free to ask me if you have any further queries.Wish you good health. Take care.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes continous low grade fever?\n\nlow grade fever always of my eleven year old daughter from last 3 months together .She is suffered from viral hepatitis and she is fully treated as doctor said and doctor suspected typhoid again full antibiotic course completed already but still no fruitful result please help",
    "doctor_response": "hi,Just read through your details .Viral hepatitis as i understand can cause fever but it will be good to know what is the state of her liver functions.you can help the doctor in diagnosis in many simple waysLow grade fever in a 11 year old can be due to so many causes.Record her temperature for 2 full days without giving any fever medications .show this temp record to your doctor ,Write down and tick after all symptomsthere are tests that can tell whether it is typhoid or not.Before treatment test blood for typhoid,test urine for infection,blood again for liver functions ,ultrasound scan of abdomen .if fever is low grade ,better to start treatment after the results which will be available in a day .I am sure with specific treatment her fever will subside ..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can recurrent high fever in old people lead to any serious issue?\n\nHi doctor, My father suffered from high fever over last week and he was alright. But today again he is feeling a mild rise in his temperature. Is this anything serious?",
    "doctor_response": "Hi. I want to assure you that do not worry as everything is going to be fine soon. I have thoroughly gone through your case and can well understand your genuine concerns. Fever is just a symptom of other illnesses like infection, inflammation etc. So, we have to rule out some basic infections possible in him. Also some background of your father's overall health is needed.  Please answer the following questions to assist him in the best possible way:- 1. Does he have or had any of the following symptoms in the last week, the symptoms include sore throat, neck glands enlargement or enlarged lymph nodes? 2. Did he experience any painful urination, frequent urination or urge to urinate even after coming from restroom, all time feeling of bladder fullness as if he needs to urinate? 3. Are there any symptoms of constipation, vomiting, nausea, diarrhea, abdominal pains, cough with/without sputum, nasal discharge, flu, eye redness, etc? 4. Does he have any skin condition/disease? 5. Is he diabetic or hypertensive? Whether he takes any regular medication? If yes, then please mention it. 6. Is there any allergic history for food or medication? 7. Is he a known hepatitis patient? 8. Does he have any gallbladder issues or history of kidney stones? Treatment will be decided with follow-up details.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering with Sjogren's syndrome, lupus, has nerve pain from labia to rectum. Is it related to Sjogren's?\n\nI have a friend with sjogren s syndrome and possibly lupus . She has had intense nerve type pain (burning radiating) from her labia to the rectum for months which is incapacitating at times. Is it possible this is nerve pain related to damage from Sjogren s - has already been too gyn, rhematologist, PCP, GI with next stop being a neurologist. Would love to help her. No offense, but it seems many doctors know little about Sjogens and I m not sure her symptoms are being taken as seriously as they should be.",
    "doctor_response": "yes it is a possibility as sjogrens may be associated with peripheral neuropathy vausing burning type of pain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Flat, circular, red blotches in pubic area above penis. What could it be?\n\ni shave my pubic area and recently noticed a few flat, red blotches just above my penis .they seem to be somewhat circular. i have only had sex with my girlfriend for the last 2 years and she is clean plus we use condoms . any idea what this is?",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have shaved your private parts recently and have noticed red circular spots on pubic area ..Most likely this is due to allergic reaction to the chemical or soap used while shaving.Do not worry just wash your genitals and private part with warm water twice daily and apply anti allergic steroid cream.This should get cured within a week.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stomach Xrays showed inflammation, have burning sensation, reflux symptoms and gas. US of gall bladder is normal. What must be wrong?\n\nOver past year I have experienced episodes of my upper stomach feeling as if it too large for my body , I went to my doctor and had ultra sound of my gall bladder ....pictures were good ... The feeling has come and gone consistently over past year..... This past Friday I woke up with the feeling within a short time of waking I had severe cramping in lower stomach centre and left side .... I  waited for an hour before going to hospital   During that time I tried walking , which I couldn't do standing straight .... I did have a bowel movement  during this time At hospital I was told I had  a inflamed stomach ...X-rays showed my stomach had gas as well as some stool left in my Colin   Dr suggested tetra 1x for 8 weeks ... Ps I have never experienced  pain, burning, or reflux symptoms .... I'm not a gasy person .... I eat healthy and I seldom drink .... Any suggestions?Thanks Lori",
    "doctor_response": "Hi Lori Gas is common troubling symptom for patient .Please give a trial to hot bottle fomantation to abdomen  when you feel pain next time .it should not be very hot Aboid burning youself In  my opinion walking may not help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high levels of SGOT and SGPT?\n\nMy one year-old baby presented SGOT 96 and SGPT 100. He is allergic to diary and egg and he is still breast fed. The ultrasound findings showed his liver being a little larger (right lobe 10 cm) for his age (15 months) and weight (10 kg). The examination for hepatitis ws negative. Thank you",
    "doctor_response": "Thank you for query.elevated enzymes indicate hepatitis.but for now, keen observation maybe required.are serological tests for hepatis A,B, C done?are there any other symptoms.regards,.Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does chest pain with cough & chills suggest?\n\nI have a lot of left side chest pain that radiates to the back. I also have a cold, cough with some green sputum. Additional I have chills and am slightly nauseous. I called my doctor back in michigan (I m out of town right now) and he called in levoquin for me. I didn t start it right away because I didn t feel that bad until today when all the above symptons came on. I m concerned about my heart. Do you think it s heart related or something else?",
    "doctor_response": "I think its a lung issue.get done Chest x ray. Take levoflox 500mg tablet for 5 days.cough chills n fever suggest some lung infection",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing palpitation with chest and back pain and excessive sweating. Is it due to anxiety?\n\nI'm 30 year old male with a family history of heart disease. For the past two or three weeks I've been experiencing mild chest/neck/ back pain that comes and goes. Occasionally I will have palpation s along with a warm sensation in  my heart. The left side of my upper neck also has a small knot in it. I've also been having drenching night sweats, I'm always tired and I have a felling of not being well. I also have a couple rotten molars  on the top and bottom of my mouth I'm not sure if they could be part of the problem too. My Dr. Thinks its anxiety and and its all in my head. At the er they did blood work an EKG and chest xrays which all came back fine but my bp was 170/90 and she said it that I needed to be on bp meds but my doc said I'm fine. I swear I'm on the verge of dying. Could it all be in my head or could it be more?",
    "doctor_response": "Hello you are young to have hypertension, however with our changed lifestyle and the stress of professional life I am increasing seeing patients in your age to have hypertension. Considering this as newly detected BP, from today itself you should start on lifestyle modifications like cutting salt in your diet to less than 3 gas, bringing regularity in life and exercise, atleast 45 mins 5 times a week. Keep on tracking the pressures at different time on different days. See what is the trend. At the same time get yourself evaluated for secondary causes of increased BP and if founded treat the cause. If this doesn't help a single anti hypertensive in small dose should do the trick which at later stage we can gradually decrease and wean off if possible. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of anxiety?\n\nThe last few times that I ve smoked pot, I ve had very weird attacks. After the first couple hits of weed, I feel fine. But when I smoke a little more, my jaw starts to feel kinda funny, kinda like it s numbing. Then after a while, I start focusing on every little pain in my body, and it feels horrible. When I get too cold, it just feels like I m becoming numb, thus thinking I m dying, thus causing crazy bad anxiety. I shake a lot as well. This never used to happen, and for a while, I would just get really depressed when I smoked, but now, it spirals into really bad anxiety, and a feeling that I m going to die. Does anyone know exactly what I may be experiencing, and maybe a way I can make it stop ? Because smoking used to definitely make me happier and calmer, but now it just makes me shake, and scared.",
    "doctor_response": "Hello, thanks for the query. One of the side effects of smoking cannabis (pot, weed, marijuana) is occurence of cannabis induced panic attacks or also known as bad trips cahracterised by symptoms of intense anxiety, palpitations, feeling weird, numbness, intense fears of death. People have acted crazy, even done homicides (run amock) under influence of cannabis induced panic attacks. As cannabis is fat soluble & slowly cleared from body; these attacks can occur for a few days even after stopping smoking. Hence best way is stopping cannabis smoking altogether. As there are other health hazards like Psychosis after cannabis use; its prudent to stop using cannabis. You can use sos etizolam, clonazepam (benzodizepines) as anxiolytics to control these distressing symptoms. Hope this helps. Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Took medroprogesterone and clomid. Pregnancy test negative. Should I take the medication again?\n\nhello, I took medroprogesterone on May 15 through may May 24. I finally had my period June 5th and started taking clomid 50MG on June 9th which was day five of my period and finished the clomid on June 13. Today is now the July 4 and is day thirty of my last period and I took a pregnancy test but it came back negative. Does that mean I am not pregnant and should take another round of medroprogesterone?",
    "doctor_response": "Hello. Thanks for writing to us. Right now it is too early to say that you are not pregnant. You should wait for at least ten days for your periods to start spontaneously, retest your urine for pregnancy after that and then if it is negative, start with medroprogesterone. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can body naturally ovulate without having the hgc injection during superovulation?\n\nHello, I am a 36 year old woman, 5ft 3 and about 9 1/2 stone.  Over the past few years I have been trying to conceive with my husband with no result.  We have recently just started our first cycle of superovulation and I just had a question to ask.  During superovulation can your body naturally ovulate without having the hgc injection.  It's just i was due to take the injection and i felt some pains as though i was starting to ovulate.  I have now taken the injection and i am still feeling the pains.  Does this mean i might be ovulating now (at my normal time) and not 36 hours or so after the injection was taken.  It's just that i want to get the timing right and as it is a bank holiday weekend i am not able to ask my clinic for a couple of days.  If this is the case and i am ovulating now, how long do i have in order to fertilise the egg.  Thank you",
    "doctor_response": "HiIn many cases of ovulation induction we don't even prescribe Hcg injection as most women ovulate even without it. The reason the injection is prescribed is to make sure that you ovulate. So it is very much possible that you ovulated before the injection. It is generally said after ovulation the egg remains fertile for 24 hrs. Let me know if you have any other queries. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tonsils, sneezing, eye redness, difficulty breathing. Taking mox-500. Cure for symptoms?\n\nDear Sir, I am suffering from tonsil problem after every season change, morning sneezing , redness in eyes and my family doctor used to give me Mox-500 mg and some other medicine but yesterday night i was suffering from the same issue but i had some problem with breathing and some noise also came from neck i am very afraid kindly help me",
    "doctor_response": "Hello Dear Thanks for your query. Did you have such attacks before ? You are having attack of bronchoconstriction. Are you having fever too? May be you are having bronchitis.You will need antibiotics as well as bronchodilator to relieve you from the respiratory distress if its so. Take CoAmoxiclav 625mg thrice daily for five days. If there is no fever and only respiratory distress then may be it is due to allergic reaction and no need to take antibiotics in that case. Take 2 puffs of Salbutamol inhalation during acute attack. If the breathing problem persists and continues for days then it is better to shift to salmeterol fluticasone combination inhalation twice daily. For the allergic reactions you mentioned you can take levocetrizine 5 mg twice daily. Get a clinical checkup from your doctor and dont take medicines without his prescription. Hope this helps. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe pain in the left side of the abdomen. Infection shown in the blood test. What can be done?\n\nhi Doctor, i am having severe pain in left side of my abdomen my all reports were normal i was also been hospitalized as there was infection in the blood the counts were more. But even after that the pain is the same. i am suffering from this pain since last 2 months and its so much that i cant even sit properly YYYY@YYYY",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for calling H.C.M.Forum. You have got left sided pain abdomen since 2 months, and it is unbearable. If the pain is in left upper region, it could be of gastric irritation, or pancriasitis,  in the middle may be of worms or stones in the upper urithra, or kidney. if in the lower may be of urinary tract infection, stones in the lower part of urithra, amoebic colitis, or if female pelvic inflammatory disease. I advise you to consult a surgeon for diagnosis and treatment. You may need to go for M.R.I.besides other routine tests for confirmation. In the mean while you can use anti spasmodics for temporary relief of pain. Wishing for a quick and complete relief of pain. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does hepatitis virus stay dormant in the body after infection or get cleared?\n\nHello doctor,I have been given hepatitis B blood test that showed the HBsAg negative and the hepatitis B core antibody image as positive. I am currently getting labs done for hepatitis B Surf Ab Quant, HBsAg screen, hepatitis B virus profile, and panel. I am getting conflicting information on websites and from healthcare professionals that hepatitis B does not ever leave the body but I also read that 98 % of the people who get it cleared the disease from the body. My question is what is the real answer, can I beat the virus and remove it from my body completely leaving only anti-bodies?",
    "doctor_response": "Hello. You have positive HBV core IgM which means one of the following: Do you have any symptoms of active hepatitis, like jaundice, or painful liver? I strongly recommend that you perform the whole hepatitis B tests and provide me with the results in order to reach the accurate diagnosis. For more information consult a general medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly explain my dad's echocardiography report and further treatment.\n\nHello doctor, My dad underwent echocardiography. The LVEF % which used to be in the range of 45 % earlier has dropped to 30 % to 35 % range. He had an\u00a0episode of VT before two years and had ICD embedded. I am attaching his earlier and latest report. Please explain.",
    "doctor_response": "Hi. I have gone through his reports (attachment removed to protect patient identity). Wall motion abnormality is seen in the echo report of your father. The heart is supplied by three arteries LAD, RCA, and LCX that is, left anterior descending artery, right coronary artery and left circumflex artery respectively. Any obstruction in blood supply in these vessels will cause decreased blood supply to a particular area of heart (which is supplied by that artery). As blood supply is compromised the muscles in that part of heart will not get proper nutrition and will start degenerating, which is medically termed as regional wall motion abnormality (RWMA). A coronary angiogram should be done to rule out coronary artery disease (blockage in the coronary artery), which is the main reason for RWMA and decreased ejection fraction. My advice is to get a coronary angiogram to rule out the blockage in the coronary artery. For further information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for allergies and asthma\n\nMy 8 yr old son suffers from allergies and asthma.  He has been on Predisone 3 times this year for flare ups 40mg daily for either 5 or 7 day treatments.  He takes Claritan , Singular and Nasonex daily and his Dr just added Symbacort inhaler daily.  He also has an albuterol inhaler. He is having a flare-up now with lots of wheezing so his Dr put him on the 2 inhalers. I am just concerned that he is taking lots of steroids.  Is there any other options.",
    "doctor_response": "Hello.Thank you for asking at HCM.I went through your son's history and would like to make suggestion for him as follows:1. If your son has frequent flare ups and needs oral steroids (prednisone) 3 times a year, that means his asthma is not under good control.I understand your concern about steroids, and would like to mention that, I have no concern about inhaled corticosteroids, but I do have a concern about oral corticosteroids.As inhaled steroids work locally, they are least absorbed in body and mostly have local side effects. But frequent oral steroids are not desirable, although they have to be given when they are needed.2. So I would like to first get reviewed your son's technique of using inhaler in presence of a doctor. This is most important as if it is not proper, there are high chances that he may not be actually getting enough drugs into his lungs.3. I would like to step-up his controlled medications of asthma.4. I would suggest you to get his allergy testing done. This will help him identifying the substances causing troubles to him and also you will know how to avoid them.Also, an Allergist-immunologist may prescribe him allergen specific immunotherapy based on the allergy testing, which works on immune system to gradually improve allergy symptoms.5. Please try to avoid exposure to dusts, smokes and air pollution as much as possible to him.6. A healthy diet rich in vitamins & minerals (adequate amounts of green leafy vegetables, fruits, sprouts, etc) will improve his immunity in a long run.7. There are other options like Ayurvedic medicine, homeopathic medicine, herbal medicine, etc. Please consult alternative medicine experts for information about these therapies. Hope above suggestions will be helpful to you.Should you have any other query, please feel free to ask at HCM.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which test confirms dementia?\n\nI have a friend whose sister is dealing with a sort of dementia she doesn t remember who she is at times and wonders off and gets combative at times she has had a nervous breakdown in past and her dad died from alzhimers deases im trying to lead them in right direction sheonly has il. Medicaid the doctor has done scans but I think she needs to go to someone who deals in these arethe scan doesn t show signs of dementia so they say but she deffently needs help",
    "doctor_response": "hello, dementia is a chronic irreversible memory loss which i can say your friends sister is not suffering from. Since she has past history of nervous breakdown, and her father has died and may be her childhood experiences are not good , so the chances are high that she is suffering from \"DISSOCIATIVE AMNESIA\". there is no such tests which can confirm that she has dissociative amnesia except history and clinical examination. In dissociative amnesia, due to some past bad experiences , patient sometimes completely forgets who is he/ she? may forget her family members as if she has memory loss but sooner or later she will start recognizing them. In CT scan , the report will be normal.In Dementia , lost memory is mot regained cognitive imapairment is irreversible as i have alredy mentioned .You should consult a good psychiatrist. I hope this answer helps you. Any more queries , You are most welcome.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can abdominal pain, diarrhea with colon flatulence be treated?\n\nmy son is 6 and had severe abdomial pain, diarrhea and lots of gas in his colon. His pediatrician said he has constipation and jus gave him suppository. He is still having pain from massive amount of gas but his dr. said gas-x wont help since it s in his colon and not his stomach. Is there any thing he can take to speed up the gas process because right now it is trapped in his system. If he can t take any thing, how long will it take for gas to eventually pass?",
    "doctor_response": "Hello, Probably your child has a giardiasis or amoebiasis as suggested by abdominal distention or bloating gassy abdomen, cramps. He needs to be examined for giardiasis by doing a stool test, then he needs a course of oral metronidazole three times a day for five days. Or oral Tinidazole twice a day for five days give him this drug with an antispasmodic drug like dicyclomine to relieve the pain and spasm. Metrogyl causes a metallic taste in the mouth. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr ASHWIN BALIGA, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Regular periods after taking Aldactone, have PCOS. How to conceive normally?\n\nI have been diagnosed with PCOS in 2003. I was on medication (Diane 35 for 5 years and aldactone for 9 years). I was told to continue aldactone. In Feb this year I found a breast lump which was diagnosed as fibro adenoma . The doc said the lump may be because of aldactone. I have stopped all medication since Feb 2012. I had very irregular periods (once in 15 days). After stopping aldactone, I am getting almost regular periods. I have been TTC since Nov. 2011 and still no success. I am 26 years old now. BMI is 24.6. What steps should I take now to conceive normally?",
    "doctor_response": "Hi, Most important step is lifestyle modification: Healthy diet + at least 30min. of sweat inducing exercise daily. Since you are having irregular periods, you are not ovulating regularly for which you can take simple tablets after consulting you doctor. Another way is Laparoscopic ovarian puncture, which will resume ovulation in about 50% cases. But as laparoscopy is invasive operation, its better to go for simple treatment first unless laparoscopy is indicated for other reasons.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower back pain in an elderly person\n\nHello, I am a 62 year old white male. I was checked about a year ago by a neurosurgeon regarding md to lower back pain. Symptoms from that were exacerbated from lifting any type of weight. The pain would go down the back and seemed like it would terminate in my left testicle. The surgeon said he did see some changes but n the spine, but nothing requiring surgery at this time. My symptoms now seem to radiate from my back towards my stomach on my left side. I recently was placed on a high cholesterol med. other wise only other thing I am taking is a baby aspirin, a daily multivitamin, and cinnamon.",
    "doctor_response": "Hi,In my opinion the pain to your testicles was only a radiating referred pain of renal pathology which happens commonly with a renal stone or a gravel in a ureter I don't think the medicines you use are the reason for your pain I think you may need some lab investigations like SUA, ASOT, urine analysis, U/S abdomen and pelvis to exclude any underling renal pathology.  For now I recommend for my patients hot foments with physiotherapy and massages with topical gels ,painkillers like NSAIDs, muscle relaxants will be  effective otherwise you may ask your neurosurgeon for further evaluation on your vertebral column. Please consider some positive feedback if the information was helpful. Hope the above information helps you. Any further clarifications feel free to ask.Regards,Dr. Ahmed Aly Hassan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take Lutegin 5000 injection during pregnancy?\n\nhello mam, i m in first trimester and during my first month i would hav stomach pain as tat we get during normal menstrual cycl so had consulted Dr , now every week am adviced to tak 2 injection every week ,, the name of injection is lutegin 5000 ,an harmone injection could u please let me know if it is safe to continue,,m continuing it it noww, please do advice me ,, thanks,,",
    "doctor_response": "Hi,   Thanks for the query under health care magic platform.   I understand your concern.   Lutegin 5000 is a human chorionic gonadotrophin...a pregnancy hormone essential for maintenance of pregnancy. It is given  in first trimaster to maintain pregnancy & avoid abortion/ it is supplemented in assisted conceptions for good results./ it is also given to avoid abortion in case of history of abortion in past. . It is very safe in pregnancy. Please don't worry & take it as advised by your doctor.    Thanks..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes paralysis after cardiac ablation procedure?\n\nI recently had m 3rd cardiac ablation procedure that took 8 hours, in recovery the hospital staff tried to wake me but I was unresponsive. I could hear everthing around me but I was paralyzed in my own body. After several hours I started to regain my limbs and nuero deficits were gone. What might have happen to have caused this situation?",
    "doctor_response": "Hello, I would explain that this situation could be caused by an overreaction to anesthetic drugs. There is no reason to panic. I would just recommend checking your liver and kidney function tests and performing a brain MRI. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the small spot on the testicle be due to cancer?\n\nI found a really small spot like thing located on my testicle, its roughly 1mm in diameter and is at the top of my left testicle. im a small bit worried as my brother had testicular cancer a few years ago. i am 18 years old. any information would be great?",
    "doctor_response": "Hi, It can be due to bacterial or fungal infection or bacterial infection. It can also be due to std if you had unprotected sex. Rule out std from a panel of tests. If your not recovered by these medicines it can be cancer, for that you can do biopsy. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have allergy & too much pain in body, kindly help\n\nHi i have allergy i am 26 f my allergy now is 230 in my blood i have to much pen in my body",
    "doctor_response": "hi welcome to hcm thanks fr the query the best way to treat allergy is avoid the allergen to which you are allergic during symptomatic phase you can take antihistaminics like levocetrizine take care.wish you a good day",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will emergency pill work if taken 12 hours after sex?\n\nHello sir good morning. My wife had took first tablet of emergency pill {prostinor 2}. After taking first tablet we are again did unprotected intercourse. As per instruction she took second tablet after 12 hours. Now my question is - emergency pill will work? Thank you With regards Rashid. From dhaka city of bangladesh.",
    "doctor_response": "Emergency pill is effective when taken within 72 hours of unprotected sex.So yes, the pill will work if she has not already ovulated.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes breathlessness after running?\n\nMy husband isn t a jogger and tried jogging today. That was around noon today and his breathing has been off since. He says, it s like not being able to take a full breath. He looks a little pale too. He just used a nebulizer and it didn t seem to help much. He s trying to sleep now and I m just a very worried wife. Do you think we should see a docor now or is it possible to wait until Monday?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.Breathlessness on exertion is mostly seen with heart and lung diseases.So better to take him to hospital and get done ecg, 2d echo and stress test (trade mill test) to rule out cardiac diseases.He will need PFT (Pulmonary Function Test) to rule out bronchitis (lung related disease).So better to consult doctor and diagnose cause for his breathlessness.He might need cardiac supportive drugs.Hope I have solved your query. I will be happy to help you further. Wishing good health to your husband. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if having hematospermia after drinking which is brownish and causing no pain, clear urine?\n\nI have hematospermia after a heavy night of drinking. I also drink protein shakes and creatine, but make sure to drink lots of water/orange juice as well. The first time it was mostly dark red, but the second time it was a bit brownish. No pain and urine is clear.",
    "doctor_response": "Good Day and thank you for being with Healthcare Magic! how old are you? if you are more than 45 years of age I would suggest having your Prostate checked to rule out cancer that may have caused your Hematospermia.Otherwise if you are still young then majority of the Hematospermia are usually self-limiting and caused by inflammation. It will go away on its own in a few days without treatment and is not a cause of worry. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at:   I would gladly help you.  Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe fluctuation in BP and facial swelling when there is a drop in temperature. How to manage this condition?\n\nI experience facial swelling, mucus in my throuth,and severe allergy when the tempeture drops or when it cold. I am also in and out of the emergency room because my b/p goes from 100/60 to some timesway over 280/120. It getting worst every winter. I am take several b/p meds to control the problem. I have had no peace for the last 4 years. I do have year round allergies, but it's severe when it's cold.",
    "doctor_response": "fluctuation u hv stated in BP r very rare, whether it is self recorded or rec by physician.when u have got attack of asthma than temporarily bp may rise..which should settle with dpi/mdi inhaled medicines.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What dosage of cypon should be given to a 8 year old?\n\nmy daughter 8 years weighing 22kg , was prescribed cypon - she gets very hungry good thing , but she seems too drowsy and at times excited...., what is the right dose anyway and should it be given just before meals or what, and how long? thanks, irene, nairobi, kenya",
    "doctor_response": "the dose for cyproheptadine(cypon syp) is 2mg/day, can be increased to 8 mg/day in 4 divided doses. give your child 2-4 ml 6 hourly . its side effects include neurological like tremors excitement, nervousness, sleepiness, constipation, dry mouth etc. give it over a period of 3-4 months and then slowly reduce the dosage to completely stop it. the reason for slow taper is the withdrawl CNS symptopms seen after stopping this drug suddenly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Baseball size infection of arm. Had breast cancer\n\nMy mom was admitted into the hospital tonight with a baseball size infection in her left arm by her armpit. She had breast cancer 2 years ago and a left myscetomy of the breast, also had about 27 lymph . Nodes removed from the same arm. Hospital said this infection is so bad it is life threatening, and could be an abcess... what is your opion?",
    "doctor_response": "Hi, Thanks for the query. Infection is invariably very common in cancer because of decrease in immunity. Lymph nodes could be due to infection or metastasis. This can be confirmed by investigations, antibiotics need to be given on the basis of microbiological studies. Your Physician will look into all these and prescribe appropriate antibiotics. These infections are treatable and hence not life threatening. Kindly take the opinion of treating doctor and give proper medication. The surrounding area of infection needs to be cleaned using either Spirit or Dettol/Hydrogen peroxide. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated ALT level?\n\nI had a blood test which included a CBC with Differential /platelet. three results came back slghtly high . my RBC was 5.39 hemoglobin 16.00 and Hematocrit 47.6. also included was hepatic Function Panel(7) where my ALT came back 10 points over the normal range. My AST came back normal. Should I be very concerned with these results?",
    "doctor_response": "Good morning I understand your question Asymptomatic elevation of alt just above normal (ten points up that normal)  is commonly due to either drugs you might be taking, hepatitis c or fatty liver and each one of them need to be investigated and treated separately If you drink alcohol you need to cut down to a lower limit I would suggest you repeat lft after 4 weeks to check the trend of alt again I hope this will help in answering your question I would like to answer your future queries if any",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do removal of Adenoids affect physical features?\n\nHi Dr, my daughter has been diagnosed with inflamed adenoids and the ENT had recommended surgical removal of both the adenoids and tosils. she is 10yrs old. i had also been reading articles on its affecting physical features and it scares me, but at the same time, am also currently reading articles that do not encourage the surgical removal of the adenoids and to look into other more conservative and non-invasive now available treatments. to this, i am also in doubt as to how effective these 'non-invasive' treatments would be, and at the same time, my preferrence would hopefully be not for surgery. Hope Dr could advice me on matters. Am a Malaysian Chinese. Thank You.",
    "doctor_response": "no, no, it is good decision, you shoud remove adenoids, because it is not nice when girl opens mouth every time and blood circulation to brain worse when children have adenoids, they study not well. You should remove adenoids earlier , non -invasive are not effective if she has 2-3 stages and decompensation",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness while having high creatinine level?\n\nI am just getting retested for high creatine. I don t know my last level but it has increased and my family doctor is sending me back to my kidney specialist. I have had unexplained dizzyness and I am starting to loose my balance. Could this be due to my creatine level.",
    "doctor_response": "Hi Yes creatine elevation has caused your dizziness.Serum creatine tells the condition of your kidneys and with declined your kidney function you have creatine accumulating in your body.Please do visit your family doctor and consult your nephrologist with your complete blood report for further treatment and investigations if required.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "What makes me sneeze in the morning and have red and swollen eyes?\n\nHello! My name is Hrishiraj and I am 35 years old.  I am from Guwahati and have been suffering from allergy since past 15 years.  Earlier it used to be seasonal but it now occures throughout the year.  I sneez a lot at morning or whenever it starts.  It is followed by a running nose with very diluted discharge from the nose.  My eyes also itch a lot which is followed by reddening & swelling up of the eyes.  There is continuous flow of water from the eyes.  Please suggest how to get rid of this chronic problem.",
    "doctor_response": "HelloThese symptoms may be due to these reasons , these include.1 Allergic rhinitis  , nasal itching , watery rhinorrhea, conjuctival symptoms, eye pruritus, sneezing, post nasal drainage .Other sign & symptoms are headache , nasal obstruction , impaired smell morning cough .All these symptoms are a characteristic feature of allergic rhinitis.I want to tell you that allergic rhinitis is a precursor of asthmatic allergic bronchitis or asthma.Avoidance of , dust , mites , pests ( cockroaches ) pollen , molds , sudden rise and  fall of temperature , fine dusting powder .These are predisposing factors of asthma as well as allergic rhinitis . When such patient visit my clinic I prescribe them to take monteleukast+ fexofenadine combination tablet once or twice in day.Steam inhalation also help .2 As I mentioned above this ( as you are a chronic patient of these symptoms from last 15 years , so may turn into asthma . Wheezing , cough , shortness of breath, whistling sound are characteristic feature of asthma . When such patient visit I advise them to take monteleukast + bambuterole once or twice in day . Beside avoidance is important .3 Bronchiectasis is another such cause because you are passing plenty of mucus through nose . So get in sputum examination as well  Xray chest for confirmation.Deal as above mentioned , this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Spine twitching, dizziness, fatigue, lightheaded, anxiety, rapid heartbeat. History of PVC. Have DDD\n\nI am having twitching near the spine.   Dizzy, fatigue, lightheaded, anxiety, and hard heart beat.   Have a history of PVC'S.   I have been to the ER and chest CT scan and X-ray were good.  All blood work was normal.   Have degenetative disc disease in L-4 L-5 and S-1.  Twitching and slight pain comes alittle higher around the kidney area.",
    "doctor_response": "Hi, Thank you for posting your query. Twitching and back pain may be related to L4-5 and L5-S1 disc prolapse with compression of the lumbar nerves. You may benefit from gabapentin capsules, in addition to back extension exercises. Please get back if you require any additional information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the abdomen and hip. Blood in urine. Kidney stone found. Suggested to see a gastroenterologist. Why?\n\nIm having extreme lower abdomen right hip pain for the last two weeks.I thought it was a female issue so I went to see my GYN he found a little blood in my urine tol me to see my urologist . I went he found a kidney stone in my left kidney and this is not causing my pain. I have made an appt to see my gastroenterologist . I dont know which way to go now. any advice.",
    "doctor_response": "hello.sometimes its difficult to say on clinical examination which organ or syatem is exactly causing the problem due to close proximity different organs. your lower abdomen pain could be due to kidney stone but some stones do not cause much pain and your urologist must be thinking in the same lines afterall i believe  he examined you and then advised to see a gastroenterologist. a gastroenterologist will look for GI tract causes for abdominal pain, may advise few tests or investigations. so you have advised a correct tract and its worth seeing a gastroenterologist if urological cause is ruled out. all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for night fall.\n\nhello Dr.i am 22 yr old male. i am suffering from nightfall problem due to hand practice from when i m 16 yr old now i have only 1 or 2 minute libido. n which day i have not make hand practice that night i have nightfall what is the solution for this problem . pls suggest me YYYY@YYYY",
    "doctor_response": "DearWe understand your concernsI went through your details. Your night fall problem cannot be due to your masturbation habit. Please understand, night fall (nocturnal emission) cannot make your body weak. Your body produces semen whenever you are sexually excited. Produced semen is stored within your body and is a waste product. That waste product is ejaculated when you indulge in sexual activities or when you masturbate. If you do not do this, body finds its own way to throw the waste product out. Body does it through nocturnal emission or through urine. This cannot affect your health. To prevent nocturnal emissions, please start masturbating or indulge in sex twice a week. I also suggest you to consult a psychologist for counseling.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bleeding with pain, painful breast and nausea after being off nuva ring?\n\nI got off birth control oct 2013(Nuva ring) I had no period at all until May I had spotting then I started bleeding July 5th and have not completely stopped I was out on meds to stop that made me sick and it was intolerable I have been to the obgyn 5 times complaining of horrible pain they did an ultrasound along with blood test(those were fine) but my uturine lining measured 22!! I go in sept 4th for a DNC and h-scope...why are my breast severly hurting?! I m exhausted all the time some days nauseated and some days could eat everything in site. I jut want to feel better :(!!! What s going on with my body!! I m 27 btw I have a 6 year old we are getting ready to Ttc again help please - hurting worst then after or during pregnancy -",
    "doctor_response": "Hi Hope this message finds u in good health.I have gone through ur msg and understand your concern.it may be due to some sort of hormonal imbalances or variations in the body,though there may be other reasons as wellNothing to worry about, You should eventually get back to normal.Take multi vitamin and calcium supplements Do consult a gynecologist if symptoms worsenGet back to me for any  FOLLOW UP QUERIES anytime.Regards,Dr Mahaveer Patil...(MBBS,MS,Mch)",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of pregnancy?\n\nI had my periods on December 23rd .I am 30yrs old.For the past one week,I have symptoms of Vommiting,tiredness,Legs paining as if I am going to get my periods,morning sickness.Feels very hungry.getting Distrubed from sleep,Getting so irritated.Is it signs of pregnancy,if so,when should I test .",
    "doctor_response": "Hi dear, I have gone through your question and understand your concerns.The symptoms you have described can be present both in early pregnancy as well as in premenstrual period.I will suggest you to wait for the periods, if delayed then get a urine pregnancy test done to confirm the diagnosis.Hope you found the answer helpful.Wishing you good health.Dr Deepti Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid the cough?\n\nMy son has been having a cough for almost 2 weeks.I took him to the doctor and since his regular doctor wasn't there the doctor on call said it would go away by itself but this was last Tuesday and he still has the cough.is there anything I can give him to help him?",
    "doctor_response": "Hello,Welcome to HCM,As your son is having cough for last two months the cause for the cough should be found out and it is important to know whether it is associated with sputum or not.As he is having cough for more than 2 week it is important to evaluate your son to find out the cause. I would suggest to undergo1. Sputum smear examinations2. Routine blood investigation. 3. Chest X ray.For the present symptoms I would suggest your son to take antibiotic like Bactoclav and antitussives like Syp Bricarex.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is green yellow bile alcohol poisoning?\n\nMy teenager son drunk too much vodka last night and is suffering still today and still being sick, is green yellow bile is this normal or should I get him checked out? He can't keep anything down and has been like this since 10.00pm last night.  Is it bad alcohol poisioining?",
    "doctor_response": "Hi,Thanks for posting your query.I am Dr.R.K and I am pleased to assist you.There are two possibilities which can explain his symptoms which occurred after drinking too much alcohol . One is alcoholic gastropathy in which the inner lining of stomach is inflamed and the second is pancreatitis in which pancreas is inflamed.Persistent vomiting can lead to dehydration and electrolyte disturbances.I would advise you to take him to a doctor immediately for examination and treatment.I hope that answers your question.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can acne and pimples be treated ?\n\nhello doctor, am 15 years old. and i have had severe pimples .. and i still have them, mostly on my forehead , and cheeks . It is very embarassing for me. i cannot concentrate on anthing. i also have acne scars on my face . mainly in my forehead and cheeks. How can i get rid of them quickly?",
    "doctor_response": "Hi....., Thanks for choosing HCM.., Why U are worrying this.., It is common in Ur age..., If U take care of Ur  Skin.., It will conrol easily..., This is called..ACNE VULGARIS...., It is due to Hormonal action....ok., 1) Frequent washes with Triclosan soap... 2) Tab Isotretinoin 20 mg daily for 2 months.., 3) Topical apply ZYCLIN-NANO, or CLINXOL.., 2 times daily.., 4) Take plenty of vegetables and fresh fruits..., ok...good luck..,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Cypon be given to manage poor appetite in an infant?\n\nMy daughter Is one year 6 month old very very fussy in eating not even one time meal per day she eats and I have often admitted her in hospital and given her drips due to dehydration every time she gets fever she stops eating and leads to dehydration or infection with vomiting leads to dehydration again plz advice me can I give cypon at least for a month or so and what shud I give drop or syrup and how much ???",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Yes, cypon is prescribed as an appetite stimulant but please get her checked once for her symptoms because there can be other causes of irritability and decreased appetite which need to be ruled out. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does high SGOT and SGPT mean?\n\nmy daughter had high fever on and off and her full blood count revealed a platlet drop it droped to 116,000 and picked up now but her sgpt and sgot is 256 and 104 her dengue antegent was negative and antibody g was positive what is the reason for elevated sgpt and sgot",
    "doctor_response": "Hi, SGOT and SGPT  are sensitive indicators of liver damage or injury from different types of diseases or conditions, and collectively they are termed liver tests or liver blood tests. So the next step is to look for certain liver damage and the most common cause is fatty liver disease. It should be confirmed by ultrasound. Other causes are viral hepatitis, cirrhosis, medications, alcohol intake or autoimmune diseases. To verify the exact cause, US, bilirubin levels and tumor markers should be additionally done Then appropriate treatment can be started. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ivan R. Rommstein, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of Alzheimer's disease?\n\nI am 71 years old (female) and recently I have been forgetting names of things and peeople. If I leave it alone I eventually remember. I also feel as if I am stumbling sometimes and am slightly unbalanced. I guess I fear Alzheimer's ... and also worry I may have a brain tumor.",
    "doctor_response": "HiI understand your concern.Prime symptoms of Alzheimer is forgetfulness or amnesia.It is like unable to remember or register new events.Recent memory affect the most.Remote memory can affect but occurs after long duration.If you have problem in remembering thing in day to day activities then need to asses mental status.MMSE means mini mental status examinations tool is very useful to screen it it is available on net.If Alzheimer dementia diagnose then need to treat in early phase for better outcome.it can be treated with medicines like donepazil or memantin etc.Consult neurologist for further assistance.Thank you.Get well soon.happy to help you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe back pain\n\nback question  hello my my,name is Audrianna in 21 and 145lbs and im 5'4.  I have serious pain in my back I've been through physical therapy and tried medication like gabatin  or mobic which hasn't helped. Sometimes the pain shoots down my legs and hurts in my hips as well it hurts to bend down to pick stuff up and I cannot sleep at night. I have been back to the doctor and they can't seem to do anything. I've had mri and other imaging done they told me I had bulging disks and degenerative disk disease and my sciatica nerve \"acts up\" if you would call it that.  I've asked for some other type if pain medication but they don't wantbto give me narcotics because of my age but my point is if it will help me and give me some relief then why not? I need some kind of help I'm in pain everyday and im tired of hurting I need advice on what I should do...",
    "doctor_response": "Many interventional pain procedure like Transforaminal epidural steroid injections, nucleoplasty, intradiscal water cooled RF, ozone discectomy etc. these procedure are cost effective , avoids surgery, avoids incision, avoids anesthesia and are usually day care with quick relief. If you are not benefiting from drugs like gabapentin, tramadol etc you should consult a pain physician for above treatments. Opiods are not given as they have lot of abuse potential due to chronic nature of your problem and it is medico legally not right. Do consult a pain physician to avoid surgery and getting quick relief .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does delayed periods after being off birth control indicate pregnancy?\n\nHi I had my copper coil out on the 4 th of oct my last period was the 12 th sept I was due on yesterday but not had anything yet and I'm normally like clock work and alwaycome on two days early we have had unprtected sex 4 times  the week before and 2 since it was out has having the coil out messed up my system I have not took a test as don't think by the dates that I am pregnant or is it possible to still get pregnant ?",
    "doctor_response": "Hello, and I hope I can help you today.Removal of the copper IUD makes you immediately able to conceive, as the IUD does not affect your hormones in any way.  So if you have been having unprotected sex and your period is late, you are at risk for pregnancy.  Your cycle should also not be affected by removal of the coil, so it should not affect your cycle.However, if you are deliberately trying to become pregnant or are worried about pregnancy, the stress from worrying about it may actually delay your cycle further.So I recommend performing a urine pregnancy test and if it is negative, retest in one week if your period does not come by then.  If you continue to have irregular cycles, and do not conceive, you may want to see your GYN doctor back for a hormonal evaluation.I hope I was able to answer your question adequately today, and that my advice was helpful.Best wishes,Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for high creatinine levels\n\nMy creatinine levels are high, and have been for years. I don t know the numbers. The doctor just says hmmmm, we should try to figure that out, but does nothing. Should I be concerned? WHAT A LOAD OF SHIT! WHY DONT YOU TELL PEOPLE FROM THE BEGINNING THAT THERE IS A CHARGE.?? Typical, money-hungry doctor that doesn t tell you jack-shit, just gets you further in debt.",
    "doctor_response": "HelloThanks for query .I can understand your feelings and concern about your problem .High creatinine levels in blood (You have not mentioned the present value of your creatinine ) is mostly due to Chronic Renal paranchymal disease and needs to be investigated .Please consult qualified Nephrologist for clinical examination and get following basic tests done to confirm the diagnosis.1) Urine routine and culture.2) Ultrasound scanning of abdomen and pelvis3) Renal function test 3) Serum proteins 4) Excretion of proteins and creatinine  in 24 sample of urine Further treatment will depend upon result of these tests and final diagnosis.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for extreme depression?\n\nhi iam always deprested because i have my body i have tryed to cumit suside 2wise i wont a boob job but dont have a job i cant take it no more i have been bulleied all my life i just wont the body i have always wonted what can i do i just cant take looking at my self no more???? please help",
    "doctor_response": "Hi dear. I had gone through your query. I understand your concern and emotional problem. Depression require proper assessment and treatment. Suicidal thoughts indicate severe depression. It cab be treated with different modalities. Depression with suicidal thought require emergency consultation to psychiatrist. ECT means electro convulsive therapy is the choice to treat it but for that you need proper assessment and consult psychiatrist. Anti depressant like sertraline / escitalopram will be useful. So consult psychiatrist and get help. Happy to help you further. Thank you.  Get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing pain & trismus on the left jaw\n\ni had a toothache on my 2nd and 3rd molar on the right.when i visited my dentist and she gave me antibiotics, but 2days after taking the antibiotics- the original pain went away but now im experiencing trismus and the pain is on the left jaw, i cant even insert a thin cracker in my mouth. what should i do?",
    "doctor_response": "Thanks for using Health care Magic.Read your query.I would advise you to continue the medication,also do warm saline gargles.Revisit the dentist and get a checkup done (maybe on the left side your third molar will be having a problem which is causing the trismus and pain).Get the needful treatment done .Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I use mouth rinses daily as a routine along with brushing ?\n\nI have a doubt regarding the mouth washes. I brush my teeth 2 times a day. I just want to know whether i can use mouth rinses daily as a routine along with brushing. Is ther any harm in using these kind of mouth washes daily",
    "doctor_response": "Hi, Chlorhexidine mouth washes are prescribed for 3 weeks. If used more than 4 weeks it can cause staining of teeth, stenosis of parotid duct, burning sensation of mucosa.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause back pain in patients with lump in spine & history of endometriosis & ovarian cyst?\n\nMy 19 yr old daughter experienced a sudden onset of lower back pain yesterday that radiated to her hips and she found it difficult to walk and was in a great deal of pain thru out the day. Tonight however she says she cannot stand up straight or bend over....she has an approx 5 range of motion but she also has a very hard lump to the left of her spine (L3-5?? area). It doesnt hurt to touch and doesn t move. It is 930 pm on fri. night....should I be taking her right in to emerg tonight? history of endometriosis and ovarian cysts.",
    "doctor_response": "Dear patient Sudden onset of back pain  with lump in lower back  is mostly haematoma. Muscle spasm due to haematoma leads to stiffness and restricted movements. Other rare possibility  may be psoas  abscess. She should be investigated  with 1.ultrasound  of  abdomen 2.  Xray of lumbosacral spine anteroposterior and lateral views  to confirm diagnosis.  Visit expert spine surgeon with report.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from persistent cough & tingling in hands & feet\n\nI have had asthma for most of my life and have had no problems, but as I started running it started to act up and soon I was constantly coughing and clearing my throat throughout the day...it feels like I constantly have to cough. A few days ago I couldn't breath and my chest also felt really tight, but the weird thing was the tingling in my hands and feet. I just started on a new Qvar inhaler...could it be side effects?",
    "doctor_response": "HI, thanks for using healthcare magicThe clearing of your throat during the day is likely related to post nasal drip which is also one of the common causes of a persistent cough.Post nasal drip would contribute to your difficulty in controlling your asthma.It would be treated by avoiding any known allergens and a topical steroid nasal spray. An oral antihistamine may also be needed.There are some persons that have exercise induced asthma and this may be the case for you.If this is the case then the use of your reliever medication shortly before exercising would help.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause a lower abodominal pain?\n\nMy boyfriend just got back from seeing the doctor ..he has lower abodominal pain..came back from work..that's how much it hurts..the doctor took bloodtest said everything was ok..must be stomach flu..but he's not sick....he is still in pain..I think the doctor could of took an ultrasound at least...what do you think it could be...",
    "doctor_response": "it could be uti or gastritis duodenitis gall bladder or hyperacidity does not come in blood testsneed ultrasoubd with urine examination to find the cause and traet mean time can use antispasmodic sos with antacid gel tds for few days",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty in conceiving?\n\nI've been trying for a year to get pregnant me and my soon to be husband really want a baby but can not seem to get pregnant people have told me not to try so hard so for awhile I stopped trying hoping it would happen I take lots of vitamin because my vitamin counts have always been low I feel like I need more than vitamins and fertility drugs to help us and I just want to have a baby my cycle is about every 45 days and I keep track of it on my phone can you help me? Please and thank you",
    "doctor_response": "Hi,Thanks for writing to HCM .Your cycle lenght is 45 days . It is not a good sign. This means you are mostly having anovulatory cycle means each cycle your egg wont rupture and you get your next cycle.I suggest you to get urself evaluated. You should undergo your follicular study which will help you in telling you ovulate or not and if so time of ovulation.  Along with this you should get your thyroid profile done and serum prolactin, fsh and Lh levels. If these hormones are raised treatment should be taken .If they are normal you can start with ovulation inducing drugs. You can discuss this with your gynac doctor. Also get your husband semen analysis which is equally important.Hope I have been helpful .RegardsDr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having low BP. Blood pleasure  90/49 left arm, 92/59 right arm, temp 97.5. What do I need to take?\n\nMy father n law is 98 yrs old he is not on any meds but iron pills. He got up off the couch with my husband help & fell while my husband turn to get his cane, No bruises r broken bones. Check his blood pressure it was 90/49 P 65 left arm & 92/59 right arm P64 temp 97.5 R 16. What do I need to do r give him, if B/P is to low.",
    "doctor_response": "Welcome to healthcare magic. There are many causes of such a incidence in this old age. Some baseline   investigation inv. are needed to find out the cause. particularly rbs,ecg,renal function,cbc have to do to exclude some common causes. the common causes in this age are tia,hypoglycemia,autonomic neuropathy,cardiac conduction defect etc. it is better for him to consult a doctor. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could the reason of having lower back ache and nausea with irregular bowel movement\n\nI have not been well since October last year, I have left lower back ache and nausea , I get dizzy and nausious I have a sick feeling in the abdo and need to go to the toilet sometimes I m constipated and sometimes loose.",
    "doctor_response": "thanks for choosing health care magic. You seems to very much anxious and concerned.Just relax take light diet,more of liquids,eat well and sleep well.Avoid eating junk foods,too much of soft drinks.And see your doctor for evaluation of your symptoms.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes vomiting in a child while feeding?\n\nMy baby is 15 months old. Sometime she doesn t chew the food and take it in as it is, sometime she started coughing and then vomit while feeding. Our dr has suggested to use junior lanzol 15 once in a day. She is having some cough too so i am little worried whether she vomits is due to cough or something else is causing this. Any help or suggestion would be of great help for me to understand the problem.",
    "doctor_response": "it may be GERD .continue junior lanzole.it will help.do barium swallow to rule out GERD.GERD- Gastro esophageal reflux disease",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for carcinoid Syndrome\n\nI have Carcinoid Syndrome with Neuroendocrine liver cancer. I have problems with high Seratonin levels. I need to find a medicine and herbal checker that will help me regulate these high Seratonin levels to keep them low to help with severe anxiety. Also a good diet and vitamin regime, to naturally keep my Seratonin levels safe. My heart rate is fast, I have attacks, when I have physical stress, sometimes emotional, with severe sweating, weakness, wanting to faint. My past bad reactions to medicines are, anti depressants, Celexa, Effexor,Prozac, Seraphine, Buspar, Trazadone, Zophran, and more. How can I find more information on controlling my Sereatonin levels?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.The only medication which can help in such conditions is Octreotid which will reduce serotonins levels produced by pancreas and intestines. However it may not be enough to remove completely symptoms of carcinoid syndrome and th eonly curable solution is to do liver resection surgery if this is resectable. It means that metastases should be limited to one liver lobe. Your medications may have its own side effects and it should not be related to Neuroendocrine tumor, but you take bit too much medications that affects your psychological functions.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe arm pain\n\nI have a severe pain in my outside forearm when i try to rotate my arm or twist my wrist such as opening a door knob. I can move my arm up and down with no pain and flex my arm with no pain, only the twisting motion causes it. I noticed the pain almost immediately after lifting weights. What is causing this horrible pain?",
    "doctor_response": "Hi there, thanks for your question. Pain on the outer aspect of your forearm specifically on rotatory movements, suggest a pattern of pain similar to that seen in tennis elbow. Due to repetitive stress of such rotatory movements , suttle micro damage happens to the flexor muscle attachments in outer apsexy of firearm.Test, Ice and analgesics help relive the pain. I would suggest you to strictly avoid rotatory or screwing movements of your forearm. You can use a band similar to tennis elbow band, applied about 2 inches below your elbow, where you can see the main muscle mass. Doing this over 4 weeks , you il have significant relief. If the pain still persists or the pattern changes. you need to see your physician for further tests.Hope this helps.All the best.Regards. Dr.SBK",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for low hemoglobin and hematocrit\n\nI am a male, 63 years old. I just had a lab test two weeks ago and the result shows that my hemoglobin and my hematocrit are both low. How can I get them at a normal level? What vitamin supplement can I take that I can buy over the counter? I can go to my doctor to get medicines but If I can just buy one, I will. (I had prostatectomy five months ago.)",
    "doctor_response": "Hello,This means you have anemia. If there has been a drop in the hemoglobin from your last reading, it requires to be investigated at your age.  A man who its a wide variety of normal foods usually does not become anemic.  Do you have any abdominal pain, irregular bowels or do you pass black colored stools? Have you lost weight? If any of these is present, you would require to be investigated. If you only have been a poor eater or on a restricted vegetarian diet, then it is probably iron deficiency due to food deficient in iron. In such a case you can take a supplement which is rich in iron and vitamin C as vitamin C promotes absorption of iron. You had a prostatectomy . Have you checked your kidney functions? If they are abnormal, that can also be a cause of anemia in which case iron supplements would not help. If you were my patient, I would advice a kidney function test, serum Iron and a stool examination for occult blood as primary investigations.You are welcome to do these and get back to me and I shall be happy to be help.Have a good day!Dr. Noble Zachariah",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blister spots on hands of babies?\n\nHi, My baby of 17 months has recently had the sickness bug, she has been sick free for 2 days now and is eating and drinking as normal. Tonight for no reason she developed little pinprick blisters/spots on her hands, it look like nettle bites?? Any idea on what they are would be much appreciated",
    "doctor_response": "Hi, By what you say I feel that this could be hand foot mouth disease or any other trivial viral exanthem. But please do remember that skin conditions are always best diagnosed and treated after seeing them directly and hence I suggest that you upload an image here so that we can guide you better. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for knee pain in kid\n\nMy 9 year old son has been saying his knee hurts for a few months now. At first I was thinking it could be growing pains but now im not sure as he is saying it hurts more often. It hurts more when he bends it or turns a wrong way. Most of the pain is on the knee cap.",
    "doctor_response": "Hi,You should get an x-ray done, and consult a orthopaedics. It might be due to injury or vitamin D deficiency.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Narendra Maurya",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are painful lumps on back of neck and on head serious?\n\nI can not turn my head to far to the left for about 6 days now woke up yesterday morning feeling a lump on back of my neck to the right side were my neck and skull meet and now another lump showed up hurts to touch it or even brush my hair how can I ease the pain and do you think it is serious?",
    "doctor_response": "Hi,These may be lymph nodes that have enlarged due to infection. They can be tender when inflamed. Take paracetamol and ibuprofen. If they are still present in 3 weeks you should see your doctor for investigationsRegards,Dr K A Pottinger,MBChB  FRCA",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sore leg muscles\n\nmy dad is 66 years old, he had a knee surgary about 6 months ago, now his leg has very sore muscles on the back of his leg and sharp pain at ankle , also numbness at ankle. it has been like that 4 weeks now. the pain is just grownig, nothing help so far.",
    "doctor_response": "Hello, As he underwent knee surgery post there will be a weakness of the knee muscles leading to change in the gait mechanism. Due to which there will be changes in the alignment of the spinal column leading nerve entrapment. Doing exercises for strengthening the knee muscles and core stability along with the hip muscle will help improve the knee stability and spinal column stability. By this, the pain and aches will be reduced. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chills,fever and nose congestion?\n\nMy 9 year old son woke up with a headache this morning which then developed into a fever 101.4 . Tylenol only helps until 30 minutes before his next dose. Then it goes back up. He has the chills and a fever and a stuffy nose. What could it be? Mono? Influenza? Sinus infection?Thanks, Worried Mom",
    "doctor_response": "HiWelcome to the HCMMost likely it seems to be a self limiting viral illness. Don't worry they are usually common in the kids. You can take the following measures to help him:1. Give him acetaminophen (Tylenol) or ibuprofen tablet for pain relief and fever both. You may repeat the same dose after every 6-8 hours interval if required.2. Use an antihistamine such as Chlorpheniramine or fexofenadine for stuffy nose. Also vapor rub will be helpful.3. Use steam inhalation 2-3 times a day for decongestion of sinuses.There is no need to have antibiotics or laboratory work up at present.Hopefully this will help you. For further questions, you may contact me.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does using Isoniazid tablets cause seminal problems?\n\nI am a 36yr old man, 5'11'' tall, 154 pounds weight. Does going through treatment of inactive TB using Isoniazid 300mg tablets cause harm to semen and can we plan for a baby while going through the treatment or do we have to wait till 9 months for completion of treatment? Please advise.",
    "doctor_response": "Hello Thanks for writing to HCM.I read and understand your question.I try my best to help you.As you are on isoniazide tablets and there  is no known effect by isoniazid  on male fertility or semen production. You want to plan baby than go for it.This isoniazid not effect on that.I hope my advice will help you a lot.Thanks and Regards.Dr Vijay",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain when i work hard along with heavy shoulders?\n\nI have severe pain around pelvic for several yrs diagnonisrd ovarian cyst after using antibotic now say its gone but still my back aches when l work always tired my shoulders feel heavy can not lift hand for few minutes now l m on myospaz 2x3daily n meloxcam 1x1daily help doc",
    "doctor_response": "here after going through your explanation i suggest you have weakness of your spinal muscles. There may be problem with your spinal curve as well for certain level at disc issues also. As a treatment i suggest to visit orthopaedic doctor and if needed do a mri scan, now you can plan your treatment as per report of mri scan, suppose  there is too many problems at spinal disc lavel then the orthopaedic doctor will suggest you for surgical correction if it is manageable with conservative medical and physiotherapy treatment then you need to visit a physiotherapist.Now hear the physiotherapist will give you some physiotherapy treatment which will help to relax your soft tissues as well as to have healing effect in your soft tissues it will also help to relieve pain at your back. At your home i suggest to use hot and cold pack to relieve some pain by relaxing you are soft tissues and having healing effect on it. Also take a complete spinal exercise program from your physiotherapist which will help you to improve strength and stamina of your spine and the spinal muscles.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had wisdom tooth out, stitches, have an infection, swelling, painful jaw, chin and tongue. What is going on?\n\nHi, I had 3 teeth taken out on Friday (a few days ago). One wisdom needed to be cut (top left) with stitches as it was not out yet. Another wisdom tooth was partly out  of the gum (top right) and was taken out. The bottom right tooth (molar) was a crown/root canal tooth. It costs lost of money to have work on the molar, but they said there was an infection or something that showed up on the x ray so they took it out as well. When I got all 3 teeth extracted  I had to IV Injection (drip) in hand, and not much swelling, but my right bottom gum and side of face hurt after the numbing wore off. It's a lot worse 3-4 days later. My teeth on the right all hurt, so does my jaw/chin/under my tongue. I have a sore mouth, and back/neck pain (probably from truing to sleep on my left or on my back). My ear ties to unblock, but it feels like an ear infection. I asked the dentist if I needed a script for antibiotics, but he just gave me a script for Endone/oxycodine(which I don't like, it makes me very sleepy and my heart race, it wears off after 3 hours). I've been taking ibuprofen and panadol/paracetamol. It's hard to eat and swallow and I have an unpleasant taste in my mouth (even with salt water to gargle). My dentist is off for another 2  days. Should I get antibiotic tables from my normal GP? Thank you.",
    "doctor_response": "Hello,Thanks for writing to us.Since you have got all the 3 teeth extracted at the same time,the pain,swelling and metallic taste is common post extraction.To prevent development of dry socket at the site of extraction,clean the socket using gauze soaked in betadine solution.Rinse mouth after every meals.Maintain oral hygiene well.Avoid stressful works.Take complete course of antibiotics after consulting with your dentist.Take rest for another 4-5 days.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will AZO yeast treatment interfere with the drugs which i take regularly?\n\nContemplating taking AZO yeast tablets for a yeast infection which has been treated with fluconazole, which did not cure the burning sensation and redness in the area/presently my gyno has suggested oatmeal sitz baths which I am doing 2 x daily ..........most on my mind besides getting some relief is if AZO yeast treatment interferes with Rx drugs I take regularly:  lipitor, bisoprolol and HCTZ",
    "doctor_response": "Hi,Welcome to HCM.I understand your concern that antifungal therapy has not been very successful, but fungi now, most commonly yeasts are also showing some resistance and need to be tested for antifungal susceptibility. I suggest you get an antifungal susceptibility testing done for your infection and get appropriate antifungal prescription. AZO yeast is a homeopathic medicine most unlikely to interfere with your present treatment but I would still suggest you go for change in antifungal prescription rather than AZO yeast.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of internal scar tissue occurrence post knee replacement?\n\nI had a full knee replacement 4 months ago. I am know dealing with internal scar tissue around or under mt knee cap. My doctor suggest that surgery might be needed. However this would be done after it has been a year from surgery due the risk of infection. If this done what keeps me from getting internal acar tissue again,",
    "doctor_response": "Nothing but activity and preventing infection..Maintauning the full range of motion soon after the surgery .And the quality of the material from whivlch the joint done..Avoiding overweight and doing physiotherapy .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I get tested after having unprotected sex?\n\nHello, I had unprotected sex on friday unfortunately, the condom i was wearing broke, then we just decided to have sex without a condom. My penis started hurting a couple days later mostly on tuesday & wednesday. My penis is pretty sensitive around the tip, & a little red, around the hole where urine comes out. I dont know if its from hard penitration, she CLAIMS she is clean of diseases, also it doesnt hurt to pee or anything. What should i do? Or be worried about? Should i get tested?",
    "doctor_response": "HelloThanks for query.You had unprotected sex few days back and have pain in tip of the penis .In view of unprotected sex and being unaware of STD status of your female partner it is safe to get basic screening test for STD and urine culture done to be rest assured of acquiring STD . Please get your routine urine test and urine culture done to find out the organisms causing this infection and antibiotics to which they are sensitive to.Please take broad spectrum antibiotics like C ef exine along with urinary antisept ic like Nitrofurantoin twice daily and urine alkaliser thrice daily.Later on switch on to appropriate antibiotics as per culture report.Get the prescription of medicines from your family Physician.Ensure to drink more water.To keep your urine dilute This will help to control dysuria.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from wheezing. Taking flomist nasal spray, lasma, forocart. X-ray shows enlarged adenoids. Treatment?\n\nhello Doctor. My daughter is 9.5 years old. From 2009 january she started wheezing . Before that she s very normal. After consulting a paediatrition dr. advised her to start sereflo 200. 2-0-2. Flomist nasal spray , lasma 5mg. After regular treatment they reduced the drug and now she s using forocart 200 1-0-1. Before starting the treatment they advised to take x-ray. Report is enlarged adenoids . But dr. told that is not a problem. But she had attack again two days back. I am very much confused. I am scared that whether she should take inhaler life long? Please tell me whether adenoid and wheeze have connection. Tell me the remedy.",
    "doctor_response": "Adenoids are nothing but lymphoid tissue in the back part of nose. They are more active in children and defend against infections traveling in air breathed in through nostrils. In the process, they become swollen. Your daughter is suffering from allergy. It is most likely related to dust, pollen etc. The child is suffering from allergy i.e. bronchial asthma. Enlargement of adenoids is also due to allergy and occasional infection. Adenoid enlargement will not influence bronchial asthma in any way. Your child's bronchial asthma will usually reduce in frequency and intensity as she grows older. Though she may not be absolutely free from asthma, she will surely have less and less of it. Prevention of exposure allergy causing agents like dust, pollen, dry weather, some foods like eggs or fish (if applicable) and undue strain, eating very cold foods etc should be avoided to prevent attacks of asthma.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly suggest a medicine for quick relief of stomach pain and vomiting in a child.\n\nHello doctor, My daughter is 6.5 years old complaining of stomach pain. She vomited once. What medicine should I give for the quick relief?",
    "doctor_response": "Hi. I understand your concern. Most common abdominal pain in children at this age is due to worm infestation and indigestion. If deworming is not done, do it with Bandy plus syrup (5 ml is equal to 400 mg Albendazole and Ivermectin 2.5 mg). Give 5 ml once in the night. If indigestion is there, symptomatic treatment is required. Syrus Emset (Ondansetron) 5 ml twice a day to be given. Any history of fever? If the pain is persistent, you need to do USG to rule out other causes and can give Cyclopam 2.5 ml once.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump on the right side of the pelvic area?\n\nI have a lump on the right side of my pelvis, it doesn't really hurt and goes away and comes back on and off. It's been there for months now, i thought it was a fatty pocket as i was alot heavier when i first noticed it. but now i've lost alot of weight and it's still there.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some soft tissue tumor like lipoma, neurofibroma or dermatofibroma. You should go for fine needle aspiration cytology or biopsy of that lump.  It will give you exact diagnosis.  Then you should take treatment accordingly.  Surgical excision is the treatment of choice. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sponge like ball right on my spine?\n\nI have a small sponge like ball right on my lower spine, that can move slight when i touch it , there is no pain, but I've had various back problems and pain including scoliosis, and a blood patch due to a epidural gone wrong that caused spinal fluid to leak from my brain.",
    "doctor_response": "Hello! Welcome to HealthcareMagic! Your symptoms could be related to different possible causes: a lipoma, a cyst, inflammation, etc.. Coming to this point, I would recommend consulting with your doctor for a physical exam and an ultrasound of the soft tissues in this region. A spine MRI in this region would give more information on the nature of this lesion. Hope you will find this information helpful! Best wishes! Dr. Aida Quka, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "My brother is admitted with Taenia soliun, what could be going wrong. Please help\n\nMy brother is currently admitted in hospital with Taenia soliun which is a form of tape worm they say that has gone to his brian. He is being treated for that, at the moment he is paralyzed on his right side and I am very very worried what could be going wrong. Please help.",
    "doctor_response": "Hi Nina, cysts of tenia solium can go and impanted in brain which may leads to continuos pain with paralysis, it can be treated with medication and steroids but most of the cases recovery is good after oedema subsides Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can we have kids after a testicles surgery?\n\nyes my boyfriend was hit in his testicles @ 19, he had to have surgery one of them was removed, could he ever have children",
    "doctor_response": "Hi Tammy! Welcome to HCM.As long as the other testis is normal,and the sperm counts ,motility,quallity etc..are normal you should'nt have to worry about conception. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for hives apart from Keflex and Doxycycline\n\nI took two days of keflex two weeks ago for a bacterial infection from a splinter. The dr. changed my antibiotic to doxicycline. 4 days later another big rash on my belly. It has been two weeks and I still have hives everyday. How long can this occur? They gave me a steroid but it made my bp go up. Plus, I already have high bp ( treated though) Thank you.",
    "doctor_response": "If you are having rashes two weeks after stopping the medications, then it is unlikely that it was related to them. Is there anything else that you could be having an allergic reaction to? It may also be worthwhile to see a Dermatologist to help diagnose the cause of the rash. I hope it resolves soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having restless leg syndrome, fibromyalgia and neuropathy with high sedimentation rate. Do I need to see neuromuscular neurologist?\n\nI currently have restless leg syndrome, fibromyalgia, and neuropathy.  Symptoms have been getting worse. My new PCP checked my sedimentation rate and it is 51, which he said is moderately high. I am getting an MRI and another EMG.  He said there may be an underlying problem causing these symptoms and pain and conditions but the test just indicates inflammation somewhere in the body but getting the rate is a start.  Why would I need to see a neuromuscular neurologist?  I also have epilepsy and have a epileptologist.  Why do I need a neuromuscular neurologist for what is going on now.",
    "doctor_response": "HIThank for asking to HCMIf you are not taking Gabapentine, then I would suggest this medicine first before going to see the neurophysician this will give you good result try it, have nice day",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the cough related to a chest infection?\n\ni have had a chest infection for the last 3 weeks i have just finished a 7 day course of anitbiotics but i am still coughing upgreen gunk . the only prob is now all i can taste is salt . my saliva is salt the gunk im coughing up is salt , everything i eat . its driving me mad",
    "doctor_response": "Dear FriendWelcome to HCM. I am Dr Anshul Varshney. I have read your query in detail. I understand your concern.I would advise you to first investigate the cough.You should get the following as you have cough from last 3 weeks:1. Xray Chest.2. Hemogram with ESR3. Sputum for AFB.4. Sputum for Gram stainThis is my best advise for you based on available details. If you have any further query, please ask me.Stay Healthy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am experiencing pain in right side of stomach, and feeling like vomiting, kindly help\n\nhello doctor , my age is 50yrs, i got sonography test, which is showing that my liver measures 18.3 cms in cranio-caudal dimensions and appears bright in echotexture. i mpression: grade 2 fatty liver with mild hepatomegaly . significant post void residue. i m experiencing pain in right side of stomach, and feeling like vomiting. i hv diabaties post eating 240 and bp 150 and cholestrol, for which i will get it checked today. and wbc count 12100, pls let me know my situation of health. dr is telling that this is due to diabatees or cholrstrol. rgds Anita",
    "doctor_response": "Hi Anita! Welcome to healthcaremagic.com.Fatty liver is due to high cholesterol.Pain in the stomach area and vomiting is called gastroparesis.The most common cause of gastroparesis is diabetes. People with diabetes have high blood glucose, also called blood sugar, which in turn causes chemical changes in nerves and damages the blood vessels that carry oxygen and nutrients to the nerves. Over time, high blood glucose can damage the vagus nerve.Treatment includes medication , dietary changes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could loose stools, ALT 41, AST 80 while being on dianbol mean?\n\nHello, I am 31 male who about a year ago started taking dbol (dianbol). It is an oral anabolic steroid that is hard on the liver. I only took it for a week because I started experiencing negative side effects. The main side effect was loose stools which I still have. I recently had some bloodwork done and my alt was 41 and ast was 80. I will be following up with a doctor but everything is taking so long to schedule. I was wondering if you could tell me what your opinion is on what it could be. Thank you.",
    "doctor_response": "Dianbol is well known to have the side effects above mentionned by you in the liver and less in the bowel habits. Anyway the best you have done is to have stopped it immediately and without heavy left problems then time \"will heal\". I'd recommend just some Probiotics for a while to regulate your bowel habits. I hope to have answered your question and I' ll be open to more discussion in case you need it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in stomach, water in abdomen, CT shows its getting thick, What could be problem?\n\nHi, My mom has pain in stomach she went to doctor, they said that there is some water in ur abdomen and there might be possibility of having appendice, they gave some medicine to dry that water now after CT Scan it found that water is getting thick and no doctor is doing any treatment they are suggesting to consult to some other doctor. She is in Nagpur now. Can anyone suggest to what is the problem and which doctor she should consult to.",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for calling H.C.M.F. The  fluid in the abdominal cavity is called ascitis. and is caused by either secondary to liver disease, or Intestinal, or gynic problem. Thick fluid suggest malignancy, or some thing of that sort I advise you to consult a general surgeon, For diagnosis and treatment. You may                                                                                                                                          need to have M.R.I. examination of the aspiration liquid, besides other routine tests for confirmation. I advise you to consult a surgeon at a multi speciality hospital, so that the doctors in case of doubt can refer to oncologist in the same hospital, or may treat in combination of the other doctor. Wishing a quick and complete recovery. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking eptoin for years. MRI nad EKG tells no definite electrical signal in brain. Suggest?\n\nI am taking eptoin 100mg for a long 35 years.from my child age I got injured in the back side of my head several times. 3-4 times convalsation took place at the age of 6- 14 years. Now for the last 6 years I am facing panic attack as told by a psychiatrist . MRI and EEG reports tell that there is no definite electrical signal in the brain.and as per the advice of a neurologist I stopped eptoin 100mg. one interesting thing that panic attack symptoms started since 2006, when I was using eptoin 100mg daily one tablet. But panic attack, fear, death tendency , insomnia , constipation are stil present. pl. give me advises. Yours truly Dr. H.K. sarma, Assam, India email: YYYY@YYYY",
    "doctor_response": "Hello. From your description it appears that convulsions that you had in childhood were totally different from the 'panic attacks' that you are having now. And in that your neurologist is right in stopping medication. The normal MRI and EEG also is a good reassurance before stopping drugs for convulsions. Very rarely convulsions may appear like 'panic attacks' and in that case it is best to have a recording of the EEG during the attack preferably with a video (Video EEG). Once diagnosis is settled, psychiatrist will be able to guide you regarding further treatment. For such problems usually a combination of medications and behavioral therapy is needed. So speak to your neurophysician and decide further. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could impingment syndrome cause weakness in shoulders, back and neck?\n\nI was diagnosed with impingment syndrome in my shoulder, physical therapy was going well until one day even touching parts of my shoulder, upper back or neck area caused me to become lightheaded, sick to my stomach, weak and dizzy. I m 25, 6 foot 2 inches and about 200 lbs.",
    "doctor_response": "Hi you have impingement syndrome in your shoulder and one day you had light headedness ,sickness in stomach weak and dizzy. In my practice I would diagnose  this is Vaso vagal Syndrome where pain sometimes causes these features . If problem comes  again then i would recommend thorough medical check up.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best medicine for kidney infection and back pain?\n\nHi, may I answer your health queries right now ?  Please type your query here...I have been on Cipro since Monday for a kidney infection. Fever was gone yesterday, but today I'm back up to 99.8. Should I call my doctor back or give the antibiotics more time? Still have back pain, too.",
    "doctor_response": "HiWas the cipro started presumptively or based on urine culture report.If fever has recurred despite being on antibiotics then the possibilities are a bug resistant to cipro in urine or you have develoed a complication secondary to the kidney infection. Hence please contact your doctor urgently.Meanwhile keep drinking plenty of fluids. Back pain secondary to urinary infection can take few days to resolve after infection is completely treated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have a painful enlarged gland under jawline. Getting toothache. Should I take antibiotics?\n\nI have a painful enlarged gland? under my jawline and pain that feels a bit like toothache but radiating along my gums top and bottom.  thought maybe an abscess in my back tooth but not sore when bite together or eat or anything.  had bites on my stomach that became infected so got antibiotics for them, could it just be a swollen gland due to other infection being fought although it has been more painful at times than the infection on my stomach",
    "doctor_response": "Hi there,           Thanks for asking your query,First let me tell you diagnosis and treatment in dentistry is related to photographs and x-rays(since it involves hard tissue).They may be lymph nodes which are swollen. When the body goes through an infection or illness, the lymph nodes tend to become swollen, including those located around the jawline. Being an integral part of the immune system, these lymph nodes work in overdrive when the body is under attack by creating beneficial antibodies, and they can become swollen since you had bites on your stomach.(or)  it can be abscess associated with your back tooth.Please visit a dentist for the needful ,or he might refer it to a physician.get well soonregards,dr.naveen",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i get pregnant even after taking unwanted 72,and what should i do to avoid pregnancy?\n\nmam/sir, today i had unprotected sex (around 3pm) with my boyfriend, he came (ejaculated) in me. Nearly after 3 hours(5:45pm) i took unwanted 72. I took it for the first time. After sex i also went to toilet to pee and washed a little bit. I am in very much in tension now. 2 hours later i also had headache. Should i be worried? I dont want to become pregnant. What should i do now. What care should i take to not to become pregnant. Normally my period was about to start on 4 april and its 28 march today. please help me. If this pill fails, what will happen?, How will i know?,and what shoud i do to avoid pregnancy? Please someone help me as soon as possible.",
    "doctor_response": "Hallow Dear, Unwanted 72 is a very reliable emergency post coital contraceptive when taken within 72 hours of the unprotected sexual intercourse. You have taken the pills within 3 hours of the sex. So you should not be concerned about the pregnancy. Usually, a few days after the consumption of these pills, there is some amount of bleeding for a day or two. Not an issue to be worried about. Even the following menses may get delayed by few days to a week or so. This is a known phenomenon. I feel, you should not be worried about pregnancy. Stress also delays the menses. If your menses are delayed for more than a week, you may perform pregnancy test on overnight early morning first urine sample. If at all there is pregnancy, it can be easily terminated by Medical methods up to 9 weeks of gestation. I hope this removes your stress. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to take zocef in pregnency ?\n\ni am 5 weeks pregnent. according to urine test my doctor notice some urine infection. I have no burning sensation at the time of urinating but sometimes it smells odd. Doctor prescribed me zocef 250 for a five day course. is this safe?",
    "doctor_response": "Hi,Anindita, Thanks for query, During first trimester you should avoid taking Zocef unless it is a must. But as your doctor has prescribed,discuss with doctor. Consult your Obst and seek his advice. ok and bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "80yr, had mastectomy. Having pain, purple bruise in the right arm after bumping onto something. Solution?\n\n80yr old female, history of breast cancer with right side mastectomy , recently bumped right arm just above right elbow and at first asymptomatic . 2 days later entire right arm +2 pitting edema from upper mid arm to fingertips, right arm is also a dark purple and mid upper arm is firm to touch. Her radial pulse is +2 and her lower arm and hand is slightly cool to touch and upper arm is warm. She is very confused but does grimace with pain when manipulating right arm. recent xray of shoulder and elbow show nothing broken. Could a contusion to the upper arm region cause bleeding inside the arm that would turn the entire arm dark purple all the way to her fingertips. She is not on blood thinners of any kind.",
    "doctor_response": "HiPost mastectomy,there is chance of lymphoedema of corresponding upper limb with swelling and pitting.IF it gets infected,it will become red or purple with local rise of temperature.Please give her good antibiotics,if possible two,anti inflammatory medicines .She should keep her limb elevated.It will come down.But,the edema if at all due to breast cancer will be there .You should see that no injury occurs in that as it may lead to infection.Wish her speedy recoveryRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain and pressure?\n\nhi, mi kid has chest pain and pressure, he was at his bed playing to his cell and the he feel a pressure in the chest and some difficult to breath, he is shaking a little and sweating, his in a good mood, actually he are smiling, no blurry vision, no headache, no pain in the stomach, no dizziness and walk normal, he feel a little scary about the pressure and now can t go to sleep, can you tell me if this is a emergency and need to be carried to an hospital . thanks",
    "doctor_response": "may be only myalgia chest. there is no history of cough. Needs chest support by elastic bandage. To be reviewed  after about a week.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause partial facial numbness with continually watering right eye?\n\nMy upper lip/mouth on the right side feels somewhat numb, as if I was numbed by a Dentist.  When I smile, only my left side looks normal.  My right eye also is continually watering.  I've had seasonal allergies all my life but this doesn't appear to be a result of allergies.",
    "doctor_response": "Welcome to Healthcare Magic!Do you have weakness in any other parts of body? It looks like Bell's palsy.Facial nerve gets compressed or damaged, which leads to facial palsy. It is a reversible condition. You should consult your doctor. With steroid medicines in tapered doses, it responds well. Doctor can also rule out any other cause for it.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of taking ayurvedic powder for allergy?\n\nHi doctor,my husband is taking aurivadic powder for allergy.he is taking this for one year.Now,he is saying that iam feeling laziness .Actully he is very active .and iam noticing that he has some black spot on his finger joint not on other area of body.doctor please help me. I m wating for your answer.thanx.",
    "doctor_response": "Hello,Dark spots on the finger joints are indicative of the side effects of the medicines your husband has been taking. You have not mentioned for how long he has been taking it. However, it can also be due to some underlying pathology which needs to be detected & treated. Like developing diabetes, joint damage, blood pressure issues, depression, fear or stress.You are suggested to help him take adequate rest & stay away from stress, give him home made nutritious food, rich in protein, iron, calcium & minerals. However, he should get a complete medical check up done. Get blood tests, urinalysis & imaging tests done. The treatment will depend on the pathology detected & treatment will be done accordingly.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Nupur K, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How deviry help to treat infertility?\n\nHello DR. Samuel. I have been taking Deviry 10mg from last 6 days after consulting doctor and he recommended it. Before that from last 3 months i did not have my periods and i want to get pregnant. His Taking Deviry will help me in concieving. I am really worried could you please guide me It would be of great help",
    "doctor_response": "Hi ,Welcome to HealthcareMagic .Divery is progesterone.  It induces period by causing bleeding . Once periods come then infertility treatment can be started. Directly divery don't help for conceiving.  Hope I have been helpful .RegardsDr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible for a toddler to exhibit different levels of prader willie syndrome?\n\nI have a grandaughter who just turned 3 and weighs 55 lbs. I have been researching Prader Willie Syndrome and I am pretty sure that is what she has. Is it possible for kiddo s this young to demonstrate different levels of the disease? ie; she is not short in statue but was slow to feed; had several weight checks and failure to thrive up until she was appx 15 months, now she is OBESE and can t stop eating. I have had to bring this to our Pediatrician s attention?? Her LDL-C is 142? I just don t know where to turn.",
    "doctor_response": "I suggest you to consult your doctor for this obesity. obesity in children have many causes and it may not be prader willie syndrome. most common cause of obesity is overnutrition, which is suggested by overgrowth in both hight and weight. we consider other cause if child has short stature, mental retardation or  other endocrine abnormalities",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get off ramipril and other BP medicines?\n\ni stoped taking the lipitor prescribed to me 3 weeks ago due to muskle and joint pains and tingling numbness. i now also want to stop taking ram-ramipril and another bp medication . it has made me unable to work and i get fatigued walking a few steps .",
    "doctor_response": "hi firstly the fatigue is because of the medicine lipitor lipitor us a statin and one of the most common side effect of statins ard Myalgia ,severe fatigue as you have already stopped lipitor the fatigue and weakness will go off in few weeksif you want to stop ramipril and other medicines then stop taking one class of medicine every week ,for eg if you are taking three medicines write now then take only two next week sudden removal of medicines can cause rebound hypertension so its better if you taper off the medicines start regular exercises for atleast 45minutes a dayavoid salty foodadd fibres to your diet this will naturally bring your bp downdont worry fatigue will go away in 4,5 days and please keep a record of bp while tapering medicinesthank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat fragrance allergy?\n\nI developed fragrance allergies at a new work place.  I get dry eye symptoms, nausea, headaches and dizziness.  This got worse and I have been in this environment about 3 months.  Recently, I noticed my sense of smell has diminished and I don't smell very well any more.  what is happening?",
    "doctor_response": "Hi , thanks for using healthcare magicAllergies can sometimes result in enlargement of structures in the nose called nasal turbinates. If enlarged, they may cause nasal obstruction that may reduce smell. In addition , nasal polyps can also cause a reduction in smell.You can consider the use of antihistamines to help with your allergiesYou may also want to visit your doctor or an ENT doctor for assessment of your  ability to smell.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes intermittent hot sensation in the abdomen?\n\nI am have intermittent, very intensely hot sensations across my abdomen.  They are painless.  I have had hot flashes before while on fertility medication - they feel similar to that, but are concentrated in my abdomen only and as I said before, are painless.  Could it be stress/anxiety related?",
    "doctor_response": "Hi.Thanks for an elucidate history and your query. You have rightly noticed such symptoms to be due to hormonal changes. The stress and anxiety too are directly related to the hormonal changes a woman gets from time to time. So please there is nothing much to worry about the hot sensation across the abdomen. Take a rest, change over to other situations like may be outing/ vacation  or so and you would be fine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long will it take for the stitches to dissolve after surgery?\n\nI had emergency surgery to remove my appendix it was open surgery the stitches are dissolvable how long before they disolve? Also my external stitches have tape over them when does this come off my bandage has been removed also I had a drain tube out of the wound which was removed after 3 days? its now been 11days since op? I'm 15 years old and do sports 5 times aweek so want to know how long before I can swim and do my judo training again.",
    "doctor_response": "Hi and welcome to hcm. External stiches should be removed after 14 days. internal stiches dissolve in 3-4 months.but it doesnt postpone recovery. You should start with normal activities after 1 month.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does a hard lump below the rib cage indicate?\n\ni have a hard marble size lump on the left side below my rib cage I also have been getting Charlie horses and the sensation that my stomach is turning inside out. I am also have lower Back pain that can get very severe.putting me on my couch with heating pad for most of day and over course of sleep. This has been going on for approximately 2months. I am a 32 stay at home mother of 3 please help",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some soft tissue tumor or lymphoma or some other mass.  You should go for ultrasound test first.  If needed go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for muscle & vein problems\n\nhi doctor, i am suffering pain past two years (times only) and consultant or tho he advised this is L4 & l5 PROBLEM muscle & veins comes outside.. you go to physio therapy like I.F.T, Traction etc.. right now which type of treatment can i follow? pl advise me ..",
    "doctor_response": "Hello, From the symptoms you have provided it appears to be  not a muscle or vein problem,this is simply a case lumbar nerve root compression,but your history and complaints are quiet insufficient to reach towards a definite diagonosis. I would like to advise you to go fo a xray of your lumbar spine,flexion and extension views,and if possible get sn mri lumbar spine with screening of whole spine. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Rohan Shanker Tiwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause penile bleeding?\n\nmy father is 81 yrs old & was bleeding heavily from penis. went to er & ct scan showed mass on r kidney. stopped bleeding next day & it has been 2 wks. went for ct scan w/ contrast last week. waiting for results. cystoscopy being done this week also. what could this be?",
    "doctor_response": "HelloThanks for query . Your father who is 83 years old had episode of gross hematuria and have been detected to have mass in his Rt kidney .This is most likely to be a Renal Cell Carcinoma and needs further evaluation to find out extent of disease ,spread of the disease to regional and para aortic lymph nodes , perinephric tissue and distant locations like lungs ,liver etc .Further treatment will depend upon result of these tests and final diagnosis as regards the extent of disease .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "TIA, have numbness on face, eyelid drooping. MRI showed issues with cerebellar tonsils. What other than chiari malformation can it be?\n\nHello, my name s Michele. I was in the hospital for three days last week with what the doctors told me was a TIA. The left side of my face was numb and I was having issues with moving the left side of my mouth and my left eyelid was drooping. They performed an MRI and a CT scan and when I was being discharged they told me I had some issue with my cerebellar tonsils, though I don t remember what the doctor said. For years I have had a lot of problems with my balance, I ve had horrible headaches and dizziness along with fainting spells. Everything I have wrong focuses on my left side. I have had issues with numbness and tingling in my left hand and left foot along with pain down the arm and leg. I have chronic back and neck pain that never seems to go away. I don t know exactly what s going on but I was wondering if it could be something other than a chiari malformation?",
    "doctor_response": "Hello, All of your symptoms can occur in Chiari malformation. Rather this constellation of symptoms would strongly suggest such malformation. Along with the chiari malformation of the brain there may be bony abnormality of the craniovertebral junction which can cause some of the symptoms like neck pain. Cerebellar tonsils may be herniated and causing pressure on structures of brain and spinal cord. MRI is the best and reliable investigation for chiari. good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Mifepristone cause long term damage to the baby?\n\nI took mifepristone [just those three] and it didn t work I went to the hospital and they did a ultra-sound and blood test and said every thing went fine. Do you think there is any lasting damage done to the baby from taking this drug? I am now thinking about keeping it but I m not sure because of that..",
    "doctor_response": "Hallow Dear,Tab. Mifepristone is usually followed by Tab. Misoprostol.  The abortion process usually starts within 24 hours.If the medicines fail to terminate the pregnancy, then there is a risk of abnormal development of the baby; hence it is not advisable to continue the pregnancy after failure of these medicines. It is better you inform your Obstetrician about the consumption of the medicine for termination of pregnancy and then get the termination done by surgical evacuation of the uterus. I hope you got the message. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain, dizziness, loss of breath, back pain. Is it due to physical exertion?\n\nHi, Iv been experiencing lower back pain on the left hand side for quite a while now, I have also noticed that i seem to be very unfit (i am a health 18 year old male and i play a lot of sport) which i shouldnt be. I have noticed I get dizzy went I become short of breath and I lose my breathe very quickly. I seem to get the back pain very bad when I'm tired for example at the end of a training session or game or if iv been standing up for a while.",
    "doctor_response": "Hello Sortness of breath at the age of 18 year is not good sign, the cause of sortness of breath can be ruleout after examination . usually the sortness of breath is associated with Cardiac problem or Respiratory system problem. so i will advise you to consult a doctor. i wish for your better health ok take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of potential heart disease?\n\nHi, last night my chest felt very heavy when I lay down. I wouldn t call it pain, it was more like something was was sitting on my chest. It got better when I sat up and better still when I stood up. I had asthma as a child that I more or less grew out of (if that s possible). I only have issues with it about 2x a year due to allergies. The sensation didn t feel like asthma, but maybe the symptoms change with age? I m 32. This sensation in my chest happened about a month ago and I saw a doctor. CMP, CBC, TSH all came back normal and H. Pylori test came back negative (I also get a gnawing pain in my stomach that comes and goes, but this doesn t happen during the chest episodes) . I m concerned this could be a heart problem. I think that thought is causing me to lose more sleep that the discomfort in my chest. The heaviness was gone when I woke up but it feels like it s coming back. Should I be in the ER now? Have my doctor do an ECG? I m a 32 y.o. female, BTW. Sorry for the lengthy query...",
    "doctor_response": "Hello, I would explain that your symptoms are really atypical of any cardiac disorders. Anyway, I would recommend you to closely monitor your blood pressure values and heart rate. In my opinion, there is no need to go to the ER. Anyway, if these episodes repeat, I would recommend performing a resting ECG and cardiac ultrasound. An exercise cardiac stress test would help investigate for coronary artery disease. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is air travel safe in a person treating for myelodysplastic syndromes?\n\nMy Mom has MDS. Currently only affecting her red blood cells. She receives 1 unit of blood every two weeks. The day before her transfsion, her RBC is usually around 84-85. She would like to take one last vacation to the Carribbean for one week. I would travel with her. Question: would it be safe(r) for her to fly if she has a transfusion the day before she boards the plane and returns a week later?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.She has myelodysplastic syndrome. She is taking blood transfusion. If her other parameters are normal then there is no harm in air travel. She can go for it.Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer.Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the use of quadruple marker test?\n\nHello doctor, My wife is 18 weeks pregnant with twin gestations. She has conceived through IUI treatment. We want an urgent and detailed feedback regarding her quadruple marker report. How authentic are the report findings, considering there are no other marker tests done before, like double marker?\u00a0What could be our next steps? I have attached the quadruple marker\u00a0report. Thank you.",
    "doctor_response": "Hi. I have gone through your question and understand your concerns. I have reviewed the quadruple marker report (attachment removed to protect patient identity). For further information consult a fetal medicine specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can low iron count and HB being 7 cause smaller myloid cells?\n\nI just had a bone marrow biopsy. They did this because when doing a cbc they found that my myloid cells were small. Other than CML is there anything that can cause them to be small. A little history I have been anemic and on iron most of my adult life. My iron count was 2 and my HB was 7. I was given 2 units of blood and iron iv. My b-12 was also low but i dont kow that number. I am tired often but work 12 hour days and have contributed my fatigue to that. Since i recived the blood and iron i feel as if i have a cold. I am sore and ache and tired. I am suposed to go back to work tomorrow. What do you think? I guess there are 2 questions in there",
    "doctor_response": "Hello and welcome to HCM,Low hemoglobin level is often associated with fatigue and tiredness.A hemoglobin level of 7 has to be managed by blood transfusion as well as iron supplements.Presence of small sized myeloid cells is not characteristic of CML.CML is characterized by increased white blood cell count, increased number of precursor myeloid cells.Constitutional features of fever, fatigue, enlarged spleen are also present.Since, the cause of anemia is iron deficiency, you are advised to take iron supplements for atleast 3 months and then get blood iron levels re-checked.Thanks and take careDr Shailja Puri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for leg injury\n\nI was in a car accident two days ago and the only injury I sustained was in my legs. The upper part of my shin, right under the knee cap is rather painful. I pushed on the knot and felt something move and then was extremely painful. What is the best answer for this?",
    "doctor_response": "Hello, Consult an orthopaedician and plan for an MRI scan. We have to rule out possible ligament or tendon injury. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach flu\n\nJust getting over the Stomach flu. When to the bath room and noticed I am bleeding some when I finished my period last Wed. It is not bright blood but it is there. When I was sick I vomited quite badly. Should I worry yet? This is the first time this has happen. I am 44 years old.",
    "doctor_response": "dear,regarding ur stomach flu, hpe its cured now and regarding ur blood ..since ur age is 44 so its a menopausal period and irregular bleeding with irregularities ibn cycle period is very common, if its a slight streak of blood ther is no need to worry but if it continues  , go for a consulatation wid a gynec. and if possible than fr a pap smear.thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yawning while crying or participating in some activity?\n\nHi there, why does my 4yr old yawn when she cries or is at a swimming class? She gets 11.5hrs sleep and doesn t behave in tired manner. Sometimes she says she s tired when she needs to participate in an activity such as tennis or playball, which I might add her instructors say she s incredibly talented for her age. Is she just being lazy, seeking attention, has a medical condition or being a typical 4yr old?",
    "doctor_response": "hi this is quite normal in kids to yawn during activities, there is nothing to worry about. just see that she gets continuous sleep in the night from 8pm onwards and don't allow them to watch tv in the night.hope this is helpful to you, rate it if you like it. take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the neck, shoulder and stomach. Diarrhea. What is wrong?\n\nI have been having pain in the left side of my neck and shoulder I can t turn my head now tonight I am having a terrible stomach ache so bad that I can t stand up straight and I ve been having diarrhea . What is going on with me? I just got my tubes tied 3 weeks ago the doctor had to almost do another c-section on me to do the procedure.",
    "doctor_response": "Hi, Thanks for posting your query. With the available described symptoms, there appears to be possibility of acute viral gastroenteritis. Presence of diarrhea and neck pain suggest the diagnosis. Myalgia is a prodromal symptom of viral infection. As such there appears to be no correlation between past c-section and tubes ligation. You should consult with internal medicine specialist and should go for thorough check up. You should avoid milk and all milk products. You should take complete antibiotic therapy, probiotics, antispasmodics and muscle relaxants. You should also apply hot soakings in neck for soothing effects. Take care, Dr. Mayank Bhargava",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes loss in body balance?\n\nI can t keep my balance when I close my eyes, and sometimes loud sours can cause my balance loss, and other times I feel movement in my brain. I had neurologist tell me there s nothing wrong in my brain. But I have a herniated disk that is pressing against a nerve in my spine. ENT doctors say I need a test of my inner ear.",
    "doctor_response": "Hi,Thanks for writing in.Balance mechanism of the body is maintained by the cerebellum in back of the brain and vestibular apparatus in the inner ears. Since you have consulted your neurologist and made it certain after clinical examination and CT scan or MRI scan therefore the cerebellum should be normal. I feel your vestibular apparatus in both inner ears require testing just as your ENT doctors have said. It might help if you get Electronystagmography (ENG) or videonystagmography (VNG) done to record abnormal eye movements while your head is placed in different positions or your balance organs are stimulated with water or air.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I substitute Suboxone instead of Percocet for chronic pancreatitis?\n\nI have been taking Percocet for a decade for chronic pancreatitis. I have stopped taking the percot since sept16. They have given me 4 mg of suboxcen. Although the pain level is under control. I would say 75 percent of the pain is relieved. But there are some days that the pain is intense. I do not take percent for fun or a high. I take it after having seen drs is mass ,Florida, and California. I have seen gastroenterologist and been referred to pain clinics which all say they can t cure this chronic pancreatic and the final result each time is to mama get my pain with Percocet. I took it into my own hands went to rehab for7days. And have been actively participating in a five hour a day. M-f. I am in a lot of pain right now. I took 4mg of suboxin and I found a 5 milligram percot and I really am debating whether to just take it to relieve this pain. I read side effects and seems like a low dose should be ok. Can I take this pill to get past this pain",
    "doctor_response": "HelloOne Percocet right now may not cause you too much discomfort, but there are two points here--1) With the opiate receptor blockage from the naloxone in the Suboxone, there wouldn't likely be any pain relief.2) You could have some opiate withdrawal symptoms if you took the PercocetSo my advice is to forego the Percocet",
    "dialogue_context": ""
  },
  {
    "patient_message": "I had my wisdom teeth moving, please suggest me remedy\n\nI had my wisdom teeth out like 4 years ago. The last week i noticed my teeth, (the four in the front bottom) started to feel like they were being pushed like they did before i had my wisdom teeth out. like 2 years ago, for a checkup, the dentist noticed a spot on my Xray, below my bottom front teeth and had asked if i was having problems. i wasnt. it was news to me actually as the previous dentist never metioned a thing. They said it could just be an artifact. Well, now i am having discomfort as i did before and in the same area where there was something showing on my xray. Any ideas what this could be!? i am kinda worried!",
    "doctor_response": "Hello Amanda, The spot under the bottom front teeth may be due to the periapical infection arised from trauma,decay or periodontal infection. Pus may be accumulated beneath the tooth. It has to be drained and curetted thro' root  canal treatment procedures. Take antibiotics after consulting with your dentist. Maintain oral hygiene well. Rinse frequently using warm saline and betadine. The dark spot will gradually vanish,once the treatment procedures are undergone. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of dizzy spells?\n\nI have been having dizzy spells , bad headache I collapsed on the train the other day and went to hospital but hey couldn't find anything in my blood or brain scan the headache has been coming and going for about one month but te dizziness only started three days ago",
    "doctor_response": "Hello!Welcome and thank you for asking on Healthcaremagic!Your symptoms could be related to low blood pressure or orthostatic hypotension. An inner ear disorder can not be excluded too, considering the dizzy spells. For this reason, I would recommend first consulting with an ENT specialist for a physical check up and labyrinthine tests. Other tests to consider would be a Head Up Tilt test for orthostatic hypotension, especially if your blood pressure values drop during standing up position. Hope you will find this answer helpful!Best wishes, Dr. Aida",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can 'arkamin' and 'minipress-xl' be taken after renal transplant?\n\ni am 38 yrs (female) & undergone renal transplant in 2003. i was on hypertensive drugs for last 8 years. i was on drugs aten50 BD, Dilzem 60 BD, Losar 50 BD for hypertension. my regular levels of blood pressure was maintained at 140 to 150/ 80 to 90. for last 4 months my BP levels have shot up to 180 to 185/ 80 to 90. Doctors have asked me to stop Dilzem 60 & Losar 50 & added new drugs arkamin 2 tablets thrice, minipress xl 5mg BD & also added Asomex 5 mg once a day in morning. i want to know if this conbination & drugs are OK for post renal transplant patients like me. Please advise.",
    "doctor_response": "hi noted all your details dearthe combination given to you by your doctor is  perfect one for renal patientsyour target bp should be 130/85mm of hgcalcium channell blocker amlodipine is highly safe in renal patient try to avoid  a prescription of losar  by any cardiologist in future as  often in renal patient with deranged lidney parameters  at 1 antagonists are not indicated you current nmedication is a good onetake your bp  every third day and maintain its recordstry doing regular exercise 45 minutes a dayavoid too much fat and oily foodtxhave a good recovery",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain with vomiting?\n\nHello, I am wondering what is going on, I was having severe abdominal pain last night followed by black chunks in my vomit.  I've been having many problems with severe abdominal pain, vomiting and terrible diarhea daily but this was the first time I had black vomit.  Do you have any answers to why this is going on?",
    "doctor_response": "this is possibly altered blood in the stomach due to bleeding  from gastric ulcers!have anti-ulcer medicines and upper GI endoscopy to confirm it!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My girlfriend has breathing problems, throat and chest pain even after taking antibiotics. Why?\n\nHello doctor, My girlfriend had mucus, throat pain, shortness of breath, tiredness, chest pain, and a build-up of snot. She had two doses of antibiotics for a chest infection. Done a chest x-ray, it was clear and normal. She was asked to take antihistamines to stop mucus from the back of the throat, but all symptoms remain. It is happening for two to three months. What is this? Is there any possible prognosis or cure? Please help.",
    "doctor_response": "Hello. From your history, it is evident that she has picked up an allergy, which is constantly leading her to develop mucus, and hence, her entire chest is getting congested. Ideally, there is only one thing you can do, and that is to change her atmosphere so that she is not exposed to the allergen. May be she can consider wearing a mask while working. Just an advise long term prolonged allergy like that can lead to asthma in the future. I will suggest the following medicine till she recovers. 1) Tablet Montek-LC (a combination of montelukast and levocetirizine) one tablet before she is about to go to work. She may feel a little drowsy, so ask her to take adequate precautions. Montelukast is a good drug for chest congestion and helps in relieving the allergy. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can i go on 'general motors diet' to lose weight while trying to get pregnant?\n\nHi Doctor, i am 28 years old and trying to concieve my first baby. I am 5 feet 4 inches tall and weigh 69 kgs. I want to lose a little weight and at the same time cant wait to get pregnant. Can you please suggest if its ok for me to go on general motors diet for a week or two..thank you! Shweta",
    "doctor_response": "see have green tea and high protein diet...do serum tsh and serum prolactin den do hsg on day 8th den do follicular study after taking clomiphene from day two den follicle size increase to 18 mm den rupture den iui fr early results. ..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Treatment for high BP, chronic fatigue and spondylitis\n\nI am a month away from 26 never had issues with blood pressure normall run 117/82. At the store today after waliking around for awhile I ran into a bp machine it said 172/108...last week I had a really bad headache and had one of the people I work with take my bp it was 154/101. I have chronic fatigue and spondylitis. I go to the doctors this wednesday. I feel fine, other than allergy symptoms like my head is a small balloon.",
    "doctor_response": "hello,   First thing, for blood pressure, you need to buy a bp apparatus and monitor your blood pressure.    You should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day for one week and make a chart, then once or twice a week. If your bp is persistently high more than 140/90 then you should have medicine.     Regular exercises like brisk walking, jogging according your capacity atleast 30 min a day and 5 days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn't abdominal fat deposition or obesity. Get your lipid profile and sugars tested once..      For spondylitis, you should first x ray, may need mri if x-ray could not a diagnosis. Treatment will be according to your symptoms, medicine like pregabalin, physiotherapy, traction and last stage is surgery.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain and numbness in chin and lower lip after root canal. On Clindamycin 150mg, numbness still present. Healing time?\n\nHello, I had the last appointment for my root canal on number 29 last friday. The next day i developed pain, numbness in my chin and lip lower left side. I went to the Dentist he did not know what was wrong did Xrays did not see anything. The next day which was Tuesday I went to an Endodontist who told me I had an infection below the root canal tooth . He did Xray and also said I was swollen He perscribed me Clindamycin 150mg 3 times a day for 5 days. I started this Tuesday night, today if Friday so I have been taking antibiotic for almost 3 days. Pain is much more tolerable but still very numb and tingly. How long does this last? Will the numbness go away once infection is gone???",
    "doctor_response": "Hi, Thanks  for  asking  the  query, After  a  successful  Root  Canal  Treatment  the  canals  are completely  devitalised  ,  disinfected so  there  are  no  chances  of  pain . Pain  can  be  due  to  incompletely  done  procedure,  re-infection , accidentally  left  unexplored  canal ,  Take  an  x-ray  which  will  show left  remnant  pulp  tissue  and  periapical condition . Take  complete  course  of  antibiotic  and  analgesic . If  the  pain  is  tolerable  ,  you  dont  worry  about  the  symptoms  it  will  take  some  days for  it  to  subside . If  it  persists  for  more  than  a  month  you  can  consult  the  Dentist . Hope  this  helps  out. Regards....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is a huge difference between systolic and diastolic dangerous?\n\nMy mom s blood pressure is currently 123 over 62. Is it dangerous to have such a large delta between systolic and diastolic? She is also experiencing intense pain on her left side, no tightness in her chest or lightheadedness though. Her father had many strokes and heart attacks before he died.",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. Blood pressure 123/62 is perfectly normal for the age. A gap between systolic and diastolic BP is perfectly normal and natural. Her chest pain can be a stable angina, and should not be neglected. Keeping the fact in mind you have history of strokes and heart attacks in your family. Hence I would like to suggest you initially few basic tests of cardiology to rule out angina in her case. 2D echo is required to see blood supply of heart, and tread mill test to see if blood supply is maintained during stress also.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Rini",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain, numb upper legs and difficulty in standing. What is the cure?\n\nHi.. I have been having some strange issues going on this past week.. My lower back so been hurting and when I go to stand up its almost like my lower back, butt, and upper legs are numb and wont support me. it causes pain when this happens and its hard for me to straighten my body up. the longer I sit the worse the pain is when I stand. when I bend over my upper legs try to give out on me. this has never happened before and as I don't have insurance I'm hoping someone can give me some insight as to what this may be and what I should do",
    "doctor_response": "your symptom suggestive of  acute disc prolapse. for this symptom i prescibed  rest, thiocolchicoside tab 4mg twice , methypednisolne tab 4 once and methycobalamin 1500mg once daily for 10 day and like to review after 10 day.contact your physician for prescribing this type of treatment",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes skin rashes and sweating after consuming alcohol?\n\nHi I am from Asia, male and of age 34. My wt is 68kg and ht is 1.65m, with no known health problems.My issue is my allergy reaction after drinking alcohol. I have rashes on my back, the rear of my arms, my torso and back of my neck. These rashes are small little red dots, and they are really painful when I sweat. Typically takes about a week before I get well. I came across articles on miliaria and after seeing pictures and reading of symptoms, sounds exactly like what I have! So question is if miliaria can indeed by triggered by consuming alcohol? And if indeed so, can I conclude I am actually not allergic to alcohol, but merely that my skin was unable to handle the heat involved with drinking, or that my pores are clogged? I'd like to know that these rashes are limited to my skin and not a symptom of some bigger problems internal to the body. Lastly, please do advice if there is something I can do to prevent these rashes.. They are rally painful (like needles poking) when I sweat, which is really often here in hot and humid Singapore.Thanks for all your kind advice.Alex",
    "doctor_response": "Hi,This reactions is known as alcohol flush reaction.When we consume alcohol, it gets metabolised in body by liver enzymes into acetaldehyde and then into acetate.Alcohol causes vasodilatation of small blood vessels and capillaries and some times bursts this capillaries under skin leaving behind broken capillaries and red spots.Also,alcohol causes diuresis by suppressing vasopressin release from kidney leading to extra work to the kidney and by this water comes out in bladder leading to depletion of water in body leaves skin dry,rough and itchy.This all is direct effect of alcohol in body when consumed in excess,you can consider it as a allergy.The best way to cure allergy is avoidance of contact with allergen rather than taking antiallergic drugs like steroids or antihistamines.Some people(commonly Chinese,Japanese)have inability to convert this excess acetaldehtde into acetate leading to accumulation of this acetaldehyde into blood causing blood vessels to dilate more.And because of this,our skin turns red and slightly burning to touch till this substance clears from the blood by kidney.Best treatment is to curtail this alcohol consumptions.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever\n\nMy daughter is 14 months and last night she got a low fever of 100.4 around 6 pm so I put her down to sleep because I felt sleep would help her fight it off. She woke up around 10:30 vomiting in her crib so I took her out and took her temperature again and she was at 101.4. Her behavior was normal other than vomiting. She was taking liquids and running around as usual. I m mostly worried since she vomited. She woke up with morning with a low fever again.",
    "doctor_response": "Hello. I just read through your question.The symptoms you describe are consistent with a stomach virus. In these cases, as long as she remains well hydrated she will be fine. The fact she is taking fluids and is active tells is she is well hydrated. If the fever lingers beyond 2-3 days, I recommend consulting with your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having pain in kidney after taking Avas and Vogs. Are these related?\n\ndear sir,               I am shefali and taking last two days Avas-5(1 tab.) with break fast and in the night  having 1 tab. vOGS-M 0.2 but last 1 day I have in pain in kidney, so you suggest me what problem? I am also hypothyroid(TSH) 14.02 and fasting 199.",
    "doctor_response": "HiThanks for your queryThe use of these pills is unlikely to cause pain in the kidney.If you have persistent loin pain I would recommend a USG of the abdomen and Urine R/M. These will tell us if you have any kidney problem.Hope this helpsGHood luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nausea and lightheadedness on waking, arm numbness and chest pain?\n\nWell for about 4 days now I have been getting nauseous and at first I would wake up and could not think at all it felt like I was half asleep could not answer any questions at work right and it would last a good 4 to 8 hours after I woke up before it would go away. Then four days ago I woke up really light headed and nauseous and regardless I went to work and as I drove to work I got a sharp pain in my left armpit and my left hand went numb so I ignored it and it slowly went away and the next day It came back and did the same thing. It is not hurting in the armpit anymore but hand is still going numb and different parts of my chest tend to hurt and go away right now I am light headed and feel really hot despite it being only 60 degrees in here and its almost below zero outside. Also whenever I am home I sneeze alot mostly at home but whenever I am out my nose is stuffy and usually can t smell out of it. Would appreciate any help thanks.",
    "doctor_response": "Hello dearWarm  welcome to Healthcaremagic.comI have evaluated your query in details  .*  This is due to underlying pathological condition giving pyrexia with     systemic manifestations ; reason has to be evaluated in terms of     respiratory infection with or without enteric fever via basic lab tests .Wishing you fine recovery .Feel free to ask any further  queries .Regards  .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and pain in face and lymph nodes on neck?\n\nI am having quite a bit of pain and some swelling on the right side of my face, just in front of the tragus. My ear does not hurt at all, but the lymph nodes behind my ear are swollen and sore as well. This morning, the lymph nodes on my neck decided to join in with swelling and pain too. I have not had any trauma since this all began, except for a bug bite above my right eyebrow, which has been swollen and sore. Any ideas what is causing all this? It has been persisting for about 5 days now, and just getting worse. In the last few hours another bump has formed on my scalp, just above my right temple.",
    "doctor_response": "Hello,I have studied your case and I think that your neck pain and enlarge lymphnode can be due to infection in the body. It can be a dental infection or it can be a throat infection. I would recommend you following.1.Meet a ENT specialist and get examine your lymphnode. 2.He will advised you to take antibiotics for some time may be five to seven days.3.if there is reduction in swelling than its pk other wise you need to get a FNAC .  I hope this answer will be useful for you. Let me know if there is any other followup questions.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the MRI report indicate?\n\nHi,The MRI report says \" Although non specific, the predominantly posterior periventricular and left parietal T2/Flair hyperintensity is likely the sequela of chronic small vessel ischemic disease.Other than minimal maxillary mucosal sinus thickening, no cause to explain the patient's headaches",
    "doctor_response": "I read your question and I understand your concern.It would have been useful if you had included also your age and medical history.That report indicates narrowing of the small vessels in the brain which causes changes in the brain due to insufficient blood supply. I mentioned your age because it is a common process with aging so it could be considered normal if your age is advanced. It is not directly a cause for a headache.In order to limit its advancement you should pay attention to risk factors for blood vessel impairment like high blood pressure, diabetes, smoking, high cholesterol and address them.If you are young then other causes must be considered like connective tissue disease, hereditary conditions etc.I hope to have been of help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be concerned as i am having abdominal pain?\n\nI went to the bathroom to remove and change my tampon. I had extreme discomfort when trying to remove it (which is uncommon). It took a few tries to fully pull it out and found there were two tampons instead. I'm having a lot of abdominal pain. Should I be worried?",
    "doctor_response": "Hi. Is it possible that one of the tampons was lying there for lot of days? If yes this can cause infection spreading to uterus and pelvis. It is unheard of to have a pain in abdomen on removing tampon. There can be other reason too. Better to get the examination done and may be some investigations if the pain does not subside on its own.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is is there an average amount of time before things get even worse?\n\nHi my father in law in currently in the hospital after his 6th heart attack. Heart function is down to 27% . Cardio MD says there is nothing else they can do for him. Question is is there an average amount of time before things get even worse? Right now he is comfortable and I am just unsure of what to tell family members who live out of town who are asking if they should come see him.Thank you in advance.",
    "doctor_response": "Hello Thanks for posting at HCM. I have gone through your description. You have not provided information about how is his current health status, like if he is in the hospital, is he on ventilatory support or oxygen requirement or if he is in the icu or wards. So it is very difficult to comment on the life expectancy now. Since he has suffered multiple heart attacks and his EF has dropped to 27%, it is classified as severe LV dysfunction. But some patients with severe LV dysfunction do very well on optimised medications. He has to be on diuretics( water pill), beta blocker medications and other medications which prevent remodeling of the heart. Also he must be on blood thinner meditations, cholesterol lowering medications ( statins) and anti anginals. He must be very regular with his meditations and daily food intake should be restricted to 1-1.2 liters per day. If he gets discharged in a good health and he continues on above medicines and restrictions, he should do well. Otherwise he may have repeateded episodes of heart failure requiring hospitalisation. Wishing him good healthRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe pain in the stomach. On medication. CT scan shows some type of cellulitis in the stomach. Treatment?\n\nMy lipase is around 600 and my stomach hurts. I go to the hospital all the time and now the doctors think I am a drug seeker. I am already on pain meds but I am in pain regardless. I also had a CT scan and it show some type of cellulitis on my stomach. I left the hospital because of how I was being treated. Should I find another hospital or just deal with it at home?",
    "doctor_response": "may be linked with food allergiesmilk or wheat or potatoget blood serum tested for milk wheat and potato specific antibodies in your bloodafter that go for elimination diet you will be okcan do desensitisation therapy laterand after that you can add your food after desensitisation therapyif you want you can also food specific antibodies in your blood for other common foods which you take in routine like nuts rice egg",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rash on groin, hips, back, stomach. Using benadryl, baking soda bath. Due to meth usage?\n\nMy 23 yo son has a rash on his groin , hips, back, stomach and bends of his knees...he describes the itch as a feeling of fiberglass insulation on his skin, he also has a sore throat (for 3 days), he is a user of meth and I am trying to figure out if this is related and there is any treatment if this is caused from drug use? He has been taking benadryl and soaking in baking soda bath",
    "doctor_response": "Hi the rash cannot be drug rash as it is located.it can be due to soaked baths which causes excess moisture.whatever the reason can be first treat the condition with atarax 25 mg at night.alaspan in the morning and application of calamine lotion.if the lesion is erythematous annular lesion with central clearing try to rule out fungal infection.if it is so use antifungal cream twice daily",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest suitable therapy for high BP\n\nI am a 35 year old male, recently diagnosed with systolic heart murmur and mitral valve leaflet prolapse. My DR has prescribed Atacand for slight blood pressure elevation (although he only took 2 successive readings 5 minutes apart because I hot and cold attacks and he said this is due to high blood pressure. Is this appropriate treatment?",
    "doctor_response": "Hello There After going through your medical query I understand your concern and I would like to tell you that mitral leaflet prolapse need not urgent management but healthy blood pressure maintenance.It\u2019s recommended for you to continue with anti-hypertension drugs for better health care.Hopefully this information will guide you properly Kind Regards Dr Bhanu Partap",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes two holes in back of mouth with tooth like color?\n\nI have two small holes in the back of my mouth where my wisdom tooth might be coming in it doesn't hurt and I kinda see a tooth like color in it also can feel it is hard. Could this be my wisdom tooth even though I'm almost 26. Also I've had an olcer on and off for the past year in the same spot. Please help.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern.Thanks for your query . The hard structure you mention in query is nothing but erupting wisdom tooth (as you also mention in query ) . But this wisdom tooth is impacted means partially erupted . This impacted tooth make space for lodgement of food derbies and bacteria , which make gum to swell on that site .That inflamed gum usually get bitten during eating which form ulcer . this condition is called 'PERICORONITIS' .iI would suggest you to :-- Do betadine rinses several times a day otherwise the pericoronal flap get badly infected .- Take  Advil ( if not allergic) or paracetamole for pain and swelling .- Do hydrogenperoxide rinses mix with equal amount of water once .Consult dentist for proper examination . Doctor may take X-ray to see the root position and and relation to bone .Doctor may prescribe antibiotics (amoxicillin) , Surgically cut the pericoronal flap if it become problematic.Doctor may also recommend you to get the wisdom tooth extracted . If doctor think the it will be problematic in future due to lack of space in arch. hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of constant sneezing and runny nose?\n\nhi doctor iam from ap ,studying here iam having problem that continous fall of water from nose & sneezing so having dis problem iam unable to study ,previously i consulted a pulmonolgist doctor in ap he suggested  rotocaps & inhailers ,am  having dis problem form 2005 onwards so,still i am struggling with dat so suggest me doctors",
    "doctor_response": "First of all u consulted wrong doctor for your problem. Rotacap or rotahaler is not the treatment for running nose and sneezing. U should consult ENT specialist.here I will give u some tips to relieve symptoms. Avoid unnecessary contact with cold water,steam inhalation twice a day,antihistaminics can be taken as they are the safest drugs but after ENT specialist examination",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for filaria\n\na female 62years old,suferring from filaria since 6 to 7 years.chief complains are-swelling  whole body,pain, oozing is stop now ,dyspnoea, ,unable to walk,but when oozing stop the condition of patient  worse with fever,n etc.  now she is not taking any treatment .plz suggest us what should we do?",
    "doctor_response": "Hello, Thanks for asking the question. You will need to get a test for microfilarial worm, which is done at night after 12 am as it enters the blood during that time. You might need to use Hetrazan drug which treats filarial worm for about 3 weeks. Please consult your doctor for more information.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having pain in belly button while coughing. Hurts while leaning back. Should I be worried?\n\nI have an acute pain about one inch down and one inch to the left of my belly button it doesn t hurt when I push on it but when I cough and sometimes when I lean back it hurts in an area about the size of a dollar coin I am a male 43 years old no surgeries. It came on suddenly and I have been experiencing this for about a week now. No pain unless I cough",
    "doctor_response": "hi,thank you for your query.abdominal pain in the left lower quadrant can be due to1.inguinal hernia2.diverticulitis3.muscle pull4.gasyour complains point towards Inguinal hernia.This condition usually entails part of the intestine protruding through a tear in the lower abdominal wall. Severe pain in the lower left side of the abdomen generally occurs when coughing, lifting, or bending over. A bulge is generally noticeable near the pubic bone where the protrusion is, and there may be a heavy sensation in the groin. Men sometimes experience swelling or pain in the scrotum as well.kindly contact your doctor for a physical check up for precise treatment of the pain.thank you,wishing you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Constant kidney cramping and pain, history of stones. Low RBC, G1,G3 are dysmorphic. Should be concerned ?\n\nhistory of kidney stones since the age of 13, female now 29. constistantly on a 4-5 times per week basis over the past year getting kidney cramping and pain but never enough to warrant a doctors visit. low rbc (about 40) in msu but about 30% are g1 and g3 dysmorphic (i just checked myself as in micro lab). have had scans during this time (ultra sound and xray) and all show no stone. there is a about 6cm mass off the kidney at an old nephrostomy site that has always been said to be no worry. So question is... are the dRBCs of a concern?",
    "doctor_response": "The findings you have described need to be evaluated further.Investgations like Urine-24 hrs  protein,albumin quantification,KFT,Ca,P,uric acid etc need to be done,so that further work up can be plannedDysmorphic RBCs are always significant.I suggest  get yourself thoroughly evaluated by a Nephrologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "How effective is Plan B emergency contraceptive in preventing pregnancy?\n\nWe had sex and the condom broke but I pulled or before I came but we still ended up getting plan b 38 hours after the sex. It s 2 days after she took plan b and she is peeing a lot. Her period was supposed to come today but it hasn t yet. Could she be pregnant",
    "doctor_response": "Hello. Effective plan B for contraceptive preventing pregnancy very high.If you take it within 72 hours after you've had unprotected sex, Plan B One-Step can reduce the risk of pregnancy by up to 89%. If you take Plan B One-Step within 24 hours, it is about 95% effective.Do not warry its gonna be OK",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for pain and spasms in foot\n\nI twisted my ankle a week ago and experienced swelling around the ankle bone and the front of the ankle and part of the top of the foot. I did the R.I.C.E. and the swelling is virtually gone. I can walk on it without too much problem. However, my little toes and part of the outside of my foot feel a little numb/tingly and I have occasional spasms of pain throughout my foot. Is this normal? If so, how much longer will it take to fully heal and can I do anything to help it heal?",
    "doctor_response": "you probably had a ankle sprain, and healing with RICE did well. now you will need a X ray to see if there was accompanying injury to the fifth toe bone at the base. it that comes out to be normal, then you should not worry and should give yourself some more time to heal.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the natural or herbal remedy for treating cough due to acid reflux?\n\nHi, I suffer severe cough due to my acid reflux. My GP has put my dose of Omperazole to 80mg until my cough calms down. Is there anything more natural or herbal i can take. I was thinking of buying some Probiotic pills from a health shop. I take Manuka Honey it doesnt help.",
    "doctor_response": "I h v read ur problem  n  there are effective herbal remedies for  ur case ....1) drink cold milk with a 2 gm of  mulethi powder in it empty stomach2) eat  5 munnacha dipped in water for  12 hrs  every nit sleeping time3)  Take 2 gm aanvala ( emblica )  with 2 grm of mishri  powder 5 min before  every meal4)  HIMCOCID SUSPENSION 2 TSPOON  AFTER every meal .Avoid curd  rice  beans  pulses like Rajma  urad, kulath, red spices junk food .non veg 5)  dont drink too much water during mealSleep at proper time  at nit but keep a gap of 1/2 hr btween meal n sleepBest of luck ..come back to me if u feel anything to tell...i will be happy to help u thnkssss",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to improve sperm motility ?",
    "doctor_response": "Hi,Welcome to HealthcareMagic ForumFollowing measures will help you:1) Have a healthy nutritious diet comprising fruits, veggies, salads etc. 2) Take a Zinc, selenium, l-carnitine, vitamins C and E supplementation once daily for few months.3) Abstain from smoking and alcohol.4) Do some form of exercise daily.Wish you Good Health, www.99doctor.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness being in crowded place?\n\nHi um. So I m at Disneyland with my friends been around a crowd for 12 hours and I was fine but then at the end I started to feel really dizzy and disconnected from my body. I went to the doctor and nothing was wrong. Then I went to the mall and was a around a large crowd and then started to freak out because I Felt the same feeling! And then I went to a concert with my parents and it was around a large crowd and it happened and I had short of breath and felt faint so dizzy and disconnect from body and my mom said it was a pannic attack then it happened again at a padres game! I feel like I can t do anything anymore, like go to a concert, or a padres game, or even to Disneyland and I m so scared to be in large crowds I start to think about it and it happens! I want it to stop! I m 13 been to Disneyland 6 times and grew up around large crowds this never happened to me before! I just wanted it to stop please help!",
    "doctor_response": "this phenomenon is known as claustrophobia. its treatment is exposure and relaxation. patient feels uneasyness in crowded places",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent cough despite taking Combivent, Advair and Cetirizine?\n\nI have been on Combivent and Advair inhalers for about 20 yrs. Now that I m 77 and have gained weight (from less exercise and overeating) my peak flow meter reinforces my hunches about my capacity dropping 50 points. My pulmonologist insists I haven t grown immune to my asthma meds while the Walk-In clinic believed its possibility and reason for trying Symbicort and Proair HFA on me...(to no avail). I ve increased my short term Combivent puffs to 3 instead of 2 twice daily as prescribed, although I still need to take my evening puffs earlier. Have also had a wet cough over 2 months despite Cetirizine, Metoprolor .5 mg + Montelukast 10 mg RX. Any thoughts?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. In my opinion, your lung disease have worsen because your peak flow reading has been dropped and you need more rescue inhaler. So better to consult pulmonologist and get done PFT (Pulmonary Function Test).PFT will tell you about severity of the disease and treatment is based on severity only. You may need newer ultra long acting inhaled bronchodilators (indacaterol and glycopyronium).Deep breathing exercises and incentive spirometry are also beneficial for lung functions. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated blood pressure?\n\ni m 27 year old female, my blood pressure is 138/90, normally its around 113/80. i m currently taking propanolol 80mg for a tremor, so should the blood pressure be this high? only had my blood pressure taken because i ve had stabbing pains in the bone behind my ear. but they said my blood pressure, although high wasn t a result of my head pain, can t help but think it may be related?",
    "doctor_response": "Hi, Propanolol 80 mg should be adequate to keep BP below 130/80 mm Hg. If not, you need to undergo an investigation to rule out any secondary cause hypertension, particularly reno-vascular in view of your young age. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Tushar Kanti Biswas, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pains and dizziness?\n\nMy 15 yr old daughter has pains in her heart that's the word she describes best for it ,now and again while been stood felt  dizzy and fallen to the floor , I've been to the doctors who sent us for an ECG this test came back fine so what else could it be?",
    "doctor_response": "Hello. Thank you for your question and welcome to HCM. I understand your concern. EKG is a test that refers mostly to the changes in heart electrical system, caused by the heart muscle. My recommendation is that right now you should proceed to do an echocardiogram to assess the heart muscle and the valvular apparatus function, also. Although, this is a harg age when she can be subject to a lot of stressful events during a day. The episode of falling to the floor, w\u0131thout losing consciousness I assume, is probably a sudden drop of blood pressure due to brisk switching positions, usually from lying or sitting down to standing up position. However, I suggest you to proceed to echocardiogram, in order to clarify the very little amount of suspicion I have. I hope I was helpful. Take care. Kind regards, Dr. Meriton",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for hip pain\n\nI am 57 years old, 5 feet tall, 150 lbs. I have fibromyalgia, but my problem is I get catches in my hips, when that happens it is excruciatingly painful and I can hardly walk. This time it lasted for two days, most times it might just last a few hours. I usually will lay down for a while and it will go a way, but sometimes it is worse than others always. I had an mri on my hips and my low back, they were negative.",
    "doctor_response": "If MRI are normal then it is advisable to rest and analgesic such as ibuprofen three times a day for few days",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for strained muscles\n\nI have severe pain in my hamstrings and I also feel like I am going to collapse while I am walking, and it hurts me to walk. I have just consulted with my doctor and she thinks it is strained muscles, but I know that I have not strained any muscles as I do not play sports. I am having a hard time believing this.",
    "doctor_response": "Hi,Thanks  for  your query.The symptoms you have described are more likely to be symptoms of muscles strain.To get relief from the pain and for quick healing:1. Do hot fomatation at the site.2. Apply local anti-inflammatory gel 2-3 times a day.3. Take anti-inflammatory drugs like Ibuprofen to reduce pain and local swelling or inflammation.4. Do not put weight or try to do exercise that involve painful muscles. Give proper time to heal.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for stomach cramping and enlarged prostate?\n\nI have a pain related to cramping on my stomach about 7 inches left of belly button. I am also experiencing symptoms of UTI for the past week of which have diminished without antibiotics through herbal teas and cranberry, additionally my physician has told me my prostate is slightly enlarged. The cramp however is persistent",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.The cramps could be a manifestation of urinary tract infection. Manytimes the bladder infection can lead to this kind of problem. You can get a fresh urine test done to identify the same. 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, or want any further details about this same issue you can use the below mentioned link:bit.ly/dr-srikanth-reddy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a mini stroke be detected in an MRI ?\n\nI have been having the symptoms of silent migraine although they never last more than 1 hour. A friend has mentioned TIA, which I have now researched. The symptoms all match, including the length of time they last. I have however, had an Mri 3 months ago which came back all clear. Would TIA have been picked up on the MRI? Donna",
    "doctor_response": "Dear Donna, Thank you for choosing health care magic. It would be helpful for us to analyze if you describe your symptoms in detail. If you think your symptoms are fitting in TIA( Transient Ischemic attack of brain) you have to undergo stroke work up to know the exact reason for symptoms. MRI can pick up TIA s but not all the time. So I would advise you to see a neurologist at the earliest and have a full stroke work up to prevent further stroke. Usually they will investigate you to know the source of your problem with carotid doppler( to rule our carotid stenosis), echocardiogram( to rule out any cardiac source - blood clots from heart travel to brain and can give you stroke). Apart from the investigation it is very important to control your risk factors like hypertension ,diabetes and hyperlipidemia if you have any of these conditions. Visit a neurologist at the earliest.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are blurbs that form in the lungs?\n\nwhat are blurbs that form on or in the lungs? why is part of the lung removed when blurbs are found and when the bad part of the lung is cut out bc of blurbs will that part be biospy? what exactly is a blurb and how does a blurb cause a hole to form in the lung and is there any treatment to keep blurbsfro m coming back.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. These are small cysts in the lung apices, which upon strong forces may blast and cause pneumothoraces. It's treated surgically. Hope to have been helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe muscle cramping and inability to walk?\n\nOur daughter has been on Lamictal for approximately 5 years for bipolar disease. Very recently she experienced severe muscle cramping and inability to walk. The symptoms went away that day but recurred a few days later. My husband is concerned about rhabdomyolysis (he is a retired cardiologist and was previously an internist).",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have severe muscle cramping and inability to walk. Well there can be many reasons for symptoms you mention in query like vitamin or mineral deficiency , nerve compression or inadequate blood supply . I would suggest you to apply warm compresses to legs and site of muscle cramps , do light exercises like yoga and stretching to boost blood supply and take proper rest . If condition doesn't get well then consult orthopedic surgeon for proper examination . Doctor may order certain test like nerve conduction test to confirm the diagnosis . Doctor may prescribe multvitamin supplement , muscle relaxant , anti inflammatory along with physical therapy . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for extreme sharp chest pain\n\nheart pounds with chest pain hello im a 22 year old female. for the past 2 weeks I've been having extremely sharp chest pains. my hearts tends to pound, and sometimes speed up. the pain varies, sometimes it last 2 minutes and sometimes 20. but for the first time last night the pain woke me up out of my sleep. the pain travels through out my body sometimes... to either my arm, back or neck. I've been researching it but my pain gets worse by the day. I don't wanna go to the er if its not necessary but I don't have insurance to see a doctor. so I've just been in pain, hoping it goes away.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. In my opinion, possibility of stress and anxiety related symptoms is more but better to get done ecg to rule out heart diseases because heart diseases can cause similar kind of pain. If ecg is normal then no need to worry for heart diseases. Stress and anxiety appear more in your case. So avoid stress and tension, be relax and calm. Consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic drugs too. Counselling plays very important role in control of anxiety along with drugs. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the cure for numbness in head, face and hand with weak convulsions?\n\nHello doctor, I quite often suffer from feeling numbness in the part of my head, face, and hand. I also quite often feel something like weak convulsions in the head. Those are very often with a headache. I am also very sensitive to the light and temperature changes. Those very often cause very strong headache and tearing. When there is cold outside, for it becomes difficult to speak. While walking sometimes for me it is very difficult to keep the coordination. I often feel trembling and weakness in the face and hands. I have visited neurologist a few years ago and magnetic resonance tomography was indicated. However, I have not gone for this medical examination. I have just started taking indicated medicines Tanakan. It helped me a little bit, but all those symptoms have stayed. I live with it for quite a long years. What illness it may be? What treatment and indications would be in this case?",
    "doctor_response": "Hello. I read carefully your question and would explain that your symptoms could be related to different possible causes like fibromyalgia, vitamin D or vitamin B12 deficiency, tension-type headache related to psychological stress, multiple sclerosis, small vessel disease of the brain, etc. Tanacan can help improve blood circulation in the brain. I would like to know your age and past medical history. I also agree with your doctor on the recommendation for a brain MRI, as it is very important to exclude some of the above possible causes. I would also recommend performing some other blood laboratory tests like complete blood count for anemia, vitamin D and vitamin B12 levels, plasma levels for possible deficiency, PCR for inflammation, thyroid hormone levels for thyroid gland dysfunction. You should discuss with your doctor on the above tests.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated SGPT level?\n\nhi doc i'd got my lab results regarding my sgpt and the results was 229 u/l. What is the cause of this and what medicine i have to take? Im maintaining medication of ascorbic acid and fiber supplement before undergone lab test, is ascorbic acid and fiber supplement contribute with this?",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. Your sgpt level is high. It is a liver enzyme. Its level increase in liver damage.  Hepatitis, alcohol or drug may leads to this. You should go for complete liver function test. Then start treatment accordingly. Continue with your ascorbic acids and fiber supplements. It has no relation with your sgpt.Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for facial eczema\n\nI can you please help .. I have eczema on my face . I take dicxycycline one a day .. I take it in the morning . I use a cream on my face called eucerin. I get it form Wal-Mart. . I feel it s not help I ve been on this medcation for about 2months .. I feel I need to be on my old one tetracycline.. Please help me.. What cream should I be using for my face .",
    "doctor_response": "Hi, my query, who duagnose for you eczema in face ??You are using different type of product in face, some are antibiotic.You should be carefull for using any medication in face , specially like steroid.dont use self medication.As soon possible you meet with a dermatologist about the diagnosis of your facial eczema and its proper treatment.thanks, best of luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of vulvar cancer?\n\nI am 27 yo female, otherwise healthy. I just noticed a 1inch cord-like, hard mass under the left side labia minora skin that lies parallel to the vagina, near the bottom of the vaginal opening. It started as an itchy area on Saturday, then this Sunday a palpable pea-marble shaped mass was felt under the skin. Now the mass has extended in a tube-like shape all the way to the bottom of the vagina. What could this be? It doesn t seem like a bartholin cyst, I have never had one before but the shape of this mass is not characteristic of a cyst. Could it be vulvar cancer?",
    "doctor_response": "HiVulval cancer presents with bleeding and white discharge from vagina.pain abdomen , loss of appetite and weight loss can also happen.RegardsDr de",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am a transgender female. Are there any markers in one's blood that indicate their sex?\n\nHi doctor, I am a 65 year\u00a0old transgender female, and I have been on hormone therapy for the past two years. I have had an orchidectomy but not gender reassignment surgery. I recently donated blood, and on the questionnaire, it asked for my biological sex. The person there said that because I was born male, my biological sex would always be male. Are there any markers in one's blood that indicate their sex?",
    "doctor_response": "Hi. Hope I have answered your question. Any further comments and questions are welcome.\u00a0Regards. For further queries consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in triceps while lifting the left arm?\n\nhi, my tricep is paining while lifting my left arm sideways. but while stretching straight no pain. also when i fold my arms and touching shoulder left position is not coming properly and paining. this pain i am experiencing for past 1.5 yrs. in gym i am not able to do the shoulder workout and experiencing heavy painwhile pulling the bar down and touching shoulder. how to get rid of this pain.",
    "doctor_response": "Hello, This is due to the wrong exercise and also a weakness of the shoulder girdle muscles. Need shoulder stabilization first and then other exercises for the upper limbs as a whole. In case the pain is radiating in nature then it could be neuropathic and using Cervical collar and MRI should be performed for the neck to find possible causes. Take an MRI if the pain is radiating in nature. Like sharpshooting or numbing or tingling etc. If not the above one then performing shoulder stabilization exercise before doing any other upper limb exercises should be good to get results. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does the arm hurt?\n\nWhat does a bat bite look like?  I was bitten by something, while walking in my neighborhood yesterday.  It was 12:00 PM.  All of a sudden I felt something bite me.  I looked at my arm and there were two tiny holes.  My arm hurt for about 1hr.  No other symptoms. No swelling redness ect. I live in Lake Jackson, Tx. Is it possible to be bitten and not know it?  I did not see anything.",
    "doctor_response": "Hello,Yes, it is possible. Sometimes it happens a bat may bite like it, and you may not know if the bat flies right after the bite. Vampire bites do the same, but in the day time, it is less likely (not impossible though). Bats are usually nocturnal but may come out in the day for food. You need to keep the wound clean with pyridine and look for any secondary infection by bacteria.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Muhammad Hanif",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could difficulty in twisting wrist be due to fracture?\n\nTwo days ago i was running with a dog while I was running the dog ran in front of my and triped me. I fell onto the road and skidded. I got some scratches on my face. But about 30 minutes ago my wrist started to hurt. It hurts to twist it did i break it?",
    "doctor_response": "if you fractured your wrist, it should be deformed, swollen and terribly painful (in this case go take an xray). most likely, you sprained wrist ligaments or the triangular cartilage (a meniscus-like structure of the wrist). ice rest wrapping and local nsaids. if it doesn't pass in 15 days, take a wrist rmn to better understand the damaged structure and plain a possible surgical repaor",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I consult a doctor for headache, fever and sore eyes in a child?\n\nMy 8 Year old Son has had medium to high grade fevers for three days now 37.7-38.8 0C he is complaining of a headache and sore eyes. he complained that his eyes were burning 3 days ago, now he is light sensitive and to look down hurts. Should I have him see a DR or wait another day or two?",
    "doctor_response": "Hi, This seems to be a viral illness and as such there are no dangerous symptoms here which should make you approach and Emergency Room. Fever of a 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 a 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 the duration if the kid is active. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can i do to increase WBC count?\n\nI have had a low WBC and Neutrophil counts since radiation therapy in Feb. 09.  I had some blood work done last week and my WBC is 2.6 and my Neutrophil count is 1.0.  I can only assume the radiation therapy (for breast cancer) caused this.  What do you think and is there anything that I can do to raise these levels?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern for your health I would like to say you that because of the radiation therapy such blood picture is common and this would come around as soon as the effect of radiation eliminate from the blood, otherwise there is no way to increase the WBC, I hope this information helps you, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful lump in neck\n\nMy 12 year old son just found a small lump on the right side of his neck. Dependent upon how it is touched it hurts a little. We didn t realize it this morning when he had his physical exam. Should I be concerned? If he lifts his neck up the lump is visible.",
    "doctor_response": "hi.based from your description, it could be a possible cervical lymphadenopathy (inflamed lymph node) probably secondary to a recent upper respiratory tract infection; a possible lesion of thyroid or salivary gland in origin. thyroglossal duct cyst and other considerations like fibroma, lipoma or cystic formation must also be ruled-out. it is best if you consult with a doctor for physical examination and clinical evaluation. diagnostic examinations such as neck ultrasound, ct-scan or x-ray, thyroid function tests and tissue biopsy may be recommended as needed.  subsequent management (medical and/or surgical if indications are found) will be directed accordingly.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if expired ultrafen suppository is given to a child?\n\nI gave my 4 years old son (40 lb) an Ultrafen (iBuprofen) 200mg suppository (to treat 38.8C fever). After one hour he got a rash all over his body and I discovered than the medicine was expired (12/2010). His temperature is down now and the rash is gone.Is there anything I should do now? I gave him one (from the expired suppository) yesterday too.",
    "doctor_response": "Hello, Precaution is better than cure. Always read Exp date before giving medication. Now that its already administered, kindly keep watch for any new symptoms. If there is visit your doctor.Disclaimer\"This provisional advice provided by me stands subject to the patient undergoing a physical examination and is based entirely on inputs provided by patient/attendants. The patient is advised for physical examination at earliest\"",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on right chest after treated costochondritis\n\nnoticed a small tender lump about 1.2 inches down from my clavicle on my right chest also the vein passing in this area is raised and noticeable both down into my right breast and up to my neck this does not usually show. I have just come out of hospital as an emergency admission last night for central chest pains. The hospital have diagnosed viral chostochroniditis. I also have bilateral tender lymphadenopathy of the submandibular glands a sore throat and a cough which produces green phlegm and causes a great deal of pain.This lump was not present during my stay in hospital. I am still feeling very unwell with the virus and I am taking regular paracetamol for the chest pain and temperature. Highest temp 37.9. I get tired really quickly and feel out of breath when walking also the chest pain increases on walking etc all of which the hospital where aware. The hospital discharged me saying to take regular parcetamol (very sensitive to aspirin and nsaids cause severe stomach pains) and bed rest until I feel better, I am also sensitive to penicillan (rash) oxytetracycline (rash) erthromycin (shortness of breath) Clindamycin (tongue swelling). Do I need to see my GP regarding the newly noticed lump or is this part and parcel of chosttochronditis? Thank you for your time.",
    "doctor_response": "Hi,Dear thanks for the query.The lump down the right clavicle-mostly due to the viral clavicular-arthritis along with costo-chondritis.Still I would advise second opinion from orthopaedic -doctor from your area.Hope this would resolve your query.Thnks.Wellcome to HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe depression\n\nhello doctor my husband is suffering from severe depression but he dont accept that he has any disease ,so me and my 6 yrs old son face many problems due to to him. all the time he feel tired, insecure, upset without any reason . please tell me what should i do.",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. How you diagnosed that your husband is depressed? He could just be stressed, disappointed with normal life situations. Situations arised out of job are always stressful. You need to talk to him. That is your duty as his wife and home maker. A good relaxing chat with you should clear some clouds from his mind. Do it every day. Support him. If need be, consult a psychologist.If you require more of my help in this aspect, Please post a direct question to me in this URL.  Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for high BP and airline fracture in Chennai?\n\nmy father fell down,he is 68,and he also has high bp,for which medication is undergoing,now the Dr has said that he has suffered airline frature in his 5th spinal bone,and the medication for which ic rest.what i want to know is any Dr in chennai,and speedy medication for recovery.iam his son m p rajesh.my email id is  YYYY@YYYY",
    "doctor_response": "HIThank for choosing HCMI can understand your worry, let me inform you if your father fall down because of accident and not due to neurological illness or changes like happening in TIA (Transient Ischemic Attack) it is mostly happening in hypertension, then it is nothing to worry, now for the hair line fracture it may not need any specific treatment in absence of medical symptoms, so no need to worry about this such fracture could take few weeks for healing, hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What makes the child of 4 years to talk with the help of nasal?\n\nMy grandaughter is 4 years of age and in my estimation has a speech problem sort of talks nasal. you can understand her but must listen very carefully especially with s however problem quite normal at that age. She is going to a learnin center however I feel her problem is more speech related. Can you suggest a Dr in the hamilton Burlington Stoney Creek, area that she could go to. Thanks Dale Byers YYYY@YYYY",
    "doctor_response": "your 4 yr old child is probbally suffering from DNS abnormality which can be corrected by ENT surgeon,",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat infection due to mosquito bite?\n\nI got bit on the eyelid by a mosquito two weeks ago. Went to doctor because eyelid was swollen shut. It was infected and they gave me antibiotics and steroidal medicine and antihistamine. It is much better after going through the antibiotics. But now it s been itching again (not swollen) and there is a pustule still there on the corner of my upper eyelid just above the eyelash line. What should I do?",
    "doctor_response": "Hello, Thnx to contact us. If I am your treating doctor I would like to advice you that the bite may be infected I advice you to change the antibiotics and continue with rest of the drug. I advice you should think of antibiotic cefixime. Also start ciprofloxacin eye drop it will cure you in a week. If you have anything else to ask please contact me. Thanx. Dr. Arun Tank; Infectious Disease Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath and dry cough?\n\nmy mother just had chemo for her lymphoma out of remission after 16 yrs. She is 86 yrs old. She had her first round of 6 cycles and she gets short of breath and has felt her air is shut off. Her cxr shows no chf or pneumonia and they says she has the heart of a 20 yr old. At times will have a drey cough. What could be causing this",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. In my opinion, we should first rule out bronchitis in your case because bronchitis is common after chemotherapy and it causes breathlessness and coughing. So consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT William also tell you about severity of the disease and treatment of bronchitis is based on severity only. She may need inhaled bronchodilators and inhaled corticosteroid (ICS). Don't worry, she will be alright. Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain post a hip replacement surgery\n\nI had a hip replacement two years ago and now I find that my lower back hurts on the opposite side when I get up in the morning,  I purchased a new mattress but that does not seem to help.  Is this something related to the hip replacement.   I am a side sleeper.  The pain goes away after I start moving around.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.In my opinion that could be a kind of joint stiffness due to the compensating effort done to withstand the new hip joint from the opposite side.I recommend hot gentle massaging with topical anti-inflammatory gels, physiotherapy, B 12 vitamin supplementation, muscle relaxants, and painkillers like Advil tabs, when needed, will be effective in most of the cases.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Ahmed Aly Hassan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have pain in liver area and getting worse. What do you think?\n\nHello there Dr my name is Kelly, I recently turned my life around by eating better and changing my lifetyle from pretty bad to awesome with Dr Cabot and Bowel food and a great eating habit for the last 3 weeks, my problem is I am experiencing pain in my liver or gaul around that area and is progressively getting worse. I havent had panadol, I want to monitor it. What do you think ? :D",
    "doctor_response": "Hi. Such pain is usually caused by gallbladder stones. It doesnt matter which food do you eat now because it could have been formated already. If you feel crampy paind son after meal it is definitely it. Also you can try to take painkillers because it wont be very helpful in biliary colicae. So this is the way to check it. Spasmex or similar drugs would be helpful. If you rule this out the some more other diagnosis can be considered such as hepatitis, gastrits or IBD. SO I suggest to go step by step. Do ulrasound and liver enzymes and then plan further examination. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for infertility problem\n\nim 32yrs old married for 5yrs having pcod with f.tubes normal in hsg. undergoing fertility treatment since 4yrs starting wit tabs first then with ovlation inducing inj  n iui. no result. went thru ov. drilling n endo biopsy for pcr n culture. tested tb pcr positive, AFB neg, culture negative. taken Akt4 2mnths,Akt3 1mnth . planning for ivf suggest if to continue tabs for another 3 mnths or goahead with ivf.",
    "doctor_response": "Hi, first complete your ATT course then go for IVF. mean while try to reduce weight so IVF drugs work well. AS you are taking treatment along with that you go for IVF test also so your time is not getting waste . Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Flat spot on the penis, pain in lower abdomen, testicle and penile pain, tingling sensation while urinating post sexual encounter. Reason?\n\nHi Doc, it has been more than 3 weeks now since my last sexual encounter and i noticed that my lower abdomen and testicles hurt. I have a tingling sensation sometimes when i urinate and occasional pain inside my penis i hardly even notice. I noticed a white flat spot on the top of my penis head (near the hole) that is sometimes not even visible. (i wear tight jeans most of the time). what could be the reason to this?",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have developed UTI and prostatitis following sexual encounter .Please get your routine urine test and urine culture done to find out the organisms causing this infection and antibiotics to which they are sensitive to.Please take broad spectrum antibiotics like Cefexine along with urinary antiseptic like Nitrofurantoin twice daily and urine alkaliser thrice daily.Later on switch on to appropriate antibiotics as per culture report.Get the prescription of medicines from your family Physician.Ensure to drink more water.To keep your urine dilute This will help to control dysuria.Since prostatitis takes long time to get cured you will need to take medictions for 4-6 weeks.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had a premolar tooth pulled. Having intense pain, bad smell from the site. On narco, ibuprofen. Treatment?\n\nI had a premolar tooth pulled on Friday- it is now Monday and I'm still experiencing severe pain in my gums and I have horrible smell coming from extraction site.  I won't be able to talk to my dentist until tomorrow.  I have been taking narco along with ibuprofen to ease the pain- but it doesn't completely relieve it.  What can I do in the short term to make this better?",
    "doctor_response": "hi...as answered by other doctors... it seems to be dry socket... visit your dentist again, he will irrigate and clean the area and will place medicated gauze in the affected area...take care...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do misaligned teeth cause biting of inner cheeks?\n\nHello Doctor, I've been diagnosed with LPR which is acid reflux of the Larynx. Over time LPR can affect your teeths enamel due to high levels of acid. Along with LPR I developed dry mouth and a tongue coating which is normal with LPR. I noticed for a while that my inner cheeks are a little puffy. No pain or anything, it feels as if I'm bitting the inside of my cheeks. My teeth are misaligned as well due to two inpacted wisdom teeth that arent removed as of yet. Could the misalignment be causing me to bite differently, which is causing the puffiness? Or is this from the dry mouth/ LPR? Thank you",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.Misalignment of teeth can cause the cheek bite .Since you have not mentioned your age ,it is not easy to suggests any treatment plan.I would suggest you visit your local dentist to plan a treatment to correct the misalignment of the teeth .Also for the cheek bite you have a night guard done.Keep your hydrated for your dry mouth .keep sipping fluids or you can have sugar free chewing gums.Hope this was useful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing my daughter's chest pain and shortness of breath?\n\nYes I have a daughter that is 18 years old and has been in the hopital ER twice this week with shortness of breath and  chest pain she has even been admitted to the hospital on the second ER vist. they ran blood work, X- Rays, ecocardio gram, altrasound on veins and pelvic also a MRI and she has been see by a Gastorologist, and a Cardiologist.  Both doctors say they feel that her problems don't have anything to do with them.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern. Since all her reports are normal, no need to worry for major heart or lung related diseases for your daughter. In teenagers, stress and anxiety can also cause similar symptoms. So better to take her to psychiatrist and get done counselling sessions. Try to identify stressor in her life and start working on its solution. She may need anxiolytic drugs too. Don't worry, she will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wishing good health to your daughter. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for typhoid fever?\n\ni have 4 days of high feaver , and other sysmptoms related to typhoid , the test has come today and widal test shows positive also frontal headache , gut symptoms match typhoid.kindly suggest medicine to be tacken immediately as i could not reach a doctor today.",
    "doctor_response": "Dear FriendWelcome to HCM. I am Dr Anshul Varshney. I have read your query in detail. I understand your concern.Only rising titres of Widal test are important.I would advise you to get Blood Culture for Salmonella Typhi.Treatment includes antibiotics like Cephalosporing and Macrolides.This is my best advise for you based on available details. If you have any further query, please ask me.Stay Healthy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes difficulty breathing after a sore throat infection?\n\nMy son is 7 years old. He had sore throat 4 months ago. After the infection, he frequently take deep breath in every 8 seconds. Now, he frequently take deep breath every 30 sec follow by a cough. I am vey worry. What is his problem? He had bronchitis when he was 5 years old.",
    "doctor_response": "thanx for  choose hcm.as per  given history,  he will  be suffering from  asthma, bronchictasis.for diagnosis do some investigation  xray chest, cbc, esr  to rule out diagnosis.if more than 3week he have breething problem , TT investigation required.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in shaft of penis?\n\nabout a week ago i started a small intermittent pain in my penis shaft ,after that i faced a urine frequency with a little turbulence  and then i went to doctor and got UA test, there were nothing but a trace amount of blood and only RBC .doctor prescribed an antistone drop and anti- inflammatory  pill but after that my pain is continuing and spread from my abdomin to my gorin and testicles.please help me and guide what should I do, what is this?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You need to rule out infections in genito urinary tract or renal and ureteric stones. Need a direct check up with urologist. Very difficult to comment without seeing directly. Consult an urologist. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does \"faint cortical calcification in kidney\" seen in CT scan mean?\n\nPrior CT examination demonstrated a tiny nonobstructing right renal calcification. Right kidney demonstrates a few tiny nonobstructing calcifications measuring up to approximately 7 mm. Lower pole small cortical cyst is seen measuring up to 11 mm. There is a 9 mm nonshadowing vein nodules associated with the right kidney lateral cortex. Although sonographic appearance suggest possible angiomyolipoma, this is not seen on CT examination. This could represent a faint cortical calcification.  This is from a ct in October.  What does it mean?  I have not heard back.  I have another test 2 weeks ago and I will send it to you\u2026.thanks Pam 2 weeks ago obular contour is seen in the inferior aspect of the< right kidney. This could represent a lobulation, although the lesion is not excluded. Please correlate with CT when appropriate.",
    "doctor_response": "Hi, The CT scan result is suggestive of small calculus (stone) that is not obstructing your ureter or draining system of your kidney. Angiomyolipoma is not likely. If you have symptoms like abdominal pain, you can plan for the removal either by ESWL or endoscopy, otherwise no treatment is required. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Partner taking prezolon for arthritis. Will it affect the sperm?\n\nHello dr,My husmand has an autoimmune disease (arthritis) and he is on prezolon 2o mg per day from february 2013.  We are trying to conceive, does prezonolon have side effects on his sperm? He controlled his sperm last year and it was normal(count 60mil/ml, total number of mot.sperm. the 1st hour 30,6 mil/ml, total motility 1st hour 51%, totaal count 90mil, normal morphology 17 % (normal:  more than 14%) .He should control his sperm again or there is no need to do that?  How much does prezolon coyl affect his sperm? We will be able to conceive? Than you very much for your attention",
    "doctor_response": "Hi, Thanks for your query. Your partener is on prezolon since feb.,because its a steroid and study shows that it affect sperm count. In semen analysis motility should be more than 60%,analysis varies from lab to lab. I think you should consult a doctor for preznolone use,because it affect sperm count. You are able to concieve with under supervision of a doctor. So don't worry. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat the swollen knee caused from a fall?\n\nI was in car accident and fell out of the car 4 weeks ago leg was bruised and swollen. Now there's a bump on a leg by my knee and I pushed the bump and it moved. I can move it around in my leg. Feels like a fatty thing. I have no idea. There's a few of the little pieces in my leg that I can move around.",
    "doctor_response": "Hi, there!Your complains and symptoms lea to think about posttraumatic synovitis.MRI scan will be the best option to reveal injured knee joint structures.Joint punction will be usefull to aspirate liquid/blood and cure pain/limited range of motion.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain between shoulder blades\n\nhi i am only 20yrs old and a female and have been having off and on mild pain between my shoulder blades for about week now. one day i also had pain under my breasts in my ribs when i would inhale deeply as well as pain in both sides of my lower abdomen what could this be??",
    "doctor_response": "Hello, As a first line management, you can take analgesics like paracetamol or aceclofenac for pain relief. Consult an orthopaedician and plan for an MRI scan to rule out ligament or tendon involvement. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the best way to control psoriasis?\n\nHi, I have been suffering with Psoriasis for the past 6 years. Have taken lot of medication in the past for no use. However, am able to reduce it through Yoga and stress management activities in the recent past. What is the best way to control it or atleast ways to reduce the flare-ups in the Skin ?",
    "doctor_response": "Hello,Welcome to healthcare magic.Psoriasis is a chronic disorder with remissions and relapses. As you might be aware, it can be well controlled with treatment, though there is no definite cure for it.The management depends on the extent of psoriasis.Some ways to prevent newer lesions would be to keep the skin moisturized, cut down stress levels, prevent infections and to stop alcohol consumption.Moisturization plays a key role as dry skin tends to worsen psoriasis. Dry skin could be itchy and psoriasis tends to spread on areas of trauma (from scratching).Moisturize often especially at the beginning of winters ( when psoriasis could flare) and also if you are in an air conditioned atmosphere.Stress has found to have a direct role in relapses. Do continue yoga and other stress management techniques which will help in preventing relapses.Infections, especially throat infections could lead to flare ups. Treat an infection promptly.Alcohol has also found to have a direct correlation with psoriasis. Try to cut down or stop alcohol consumption completely to prevent flares.Hope you find this helpful.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes an open sore on an incisional scar long after a heart surgery?\n\nok thanks my mom all of a sudden has an open sore that was infected on a scar where she had heart surgery years ago it is now open about a quarter inch deep I can look in it to you may not be scary to me it is it is healing don t have a picture to show have been looking for one but cant find on here",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I would like to tell you that it open sore can be because any bacterial infection which will require a course of antibiotics and dermal application. Kindly consult your treating Cardiologist for physical evaluation of the wound. I hope this information will answer your query. Kind Regards Dr. Bhanu Partap",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain, cramps and pink color stool to a 3 year old?\n\nMy 3 yr old had a tummy ache last night, i assume she was cramping, and when going to the bathroom, she all of a sudden wanted to go in a diaper and there was a pinkish color in her mushy stool. is that pointing to an irritable bowel? She is acting normal and seems to have slept really good.",
    "doctor_response": "She might have acute bacillary dysentery.she has to be given cefixime or other antibiotic for that. Give her lot of fluids. If her stomach pain is severe and continuing , u have to do ultrzsound abdomen for intessusceptipn...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in upper back while bending?\n\nI have been hurting in my upper back for a day, or two, when I bend over to pick up something or get a pan out of my cabinet, the pain is like a stabing, or shooting pain around my upper torso. I went to the doctor for this same pain back in June and ask could it be gallbladder, she examined , and said it was sore muscles, go home and take muscle relaxer. I havn t been working hard enough for my muscles to hurt. This is pain, not soreness. Do you have any ideas on this?",
    "doctor_response": "As per your complaint of stabing pain it seems like a muscular pain only. So you should consult orthopedics.Take pain killer , muscle relaxant .Consult physiotherapist who advise you muscle strengthening exercise which could help you bettter.Get well soon..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for getting pregnant\n\nHi..I take ovralg to get my periods..I have son 4.5 year old through IUI and now I want another child and I m still taking ovralg...do I nees to go through the same process again or is there any chance I can conceive naturally...will 14 th day formula apply on me as I read that first day of ur last count 14 day if you will do then can get pregnant as i get my periods through ovral g so will this work for .please assist",
    "doctor_response": "hello..thanks for trusting the healthcare magic doctors for ur health related queries.I guess ur concern is about..remedy for getting pregnant...right.well..there plenty of remedies in the present world. one of them u have already tried during ur first baby..right.as u told that, u r taking ovral-g, it's given for regularization of menses. once periods will regular,chances of getting pregnancy is increased.that's why ur treating doctor prescribed u.lastly want to say that, YES..there is chances of getting pregnant with natural formula, as u know 14th day formola. it is also called fertile period( it is from 10th to 16th day of cycle) during this period chances of getting pregnant is high.because on the 14th day ovulation occurs(follicle rupture n ovum comes out),so that we doctors advice to do coitus from 2days before n after this 14th day,so that sperm can fertilize the ovum n pregnancy will happen.with the above discussion u can try out my suggestions-1. DON'T WORRY..RELAX, u can get pregnancy with natural methods. there is chances.2. once ur menses will regular,chances of getting pregnancy will increases spontaneously.so regularize the menses then try the 14th day formula.3. if u r in hurry then visit to nearby infertility specialist.he/she can help u out.regards- Dr sudha rani panagar( i pray the God u can get ur second pregnancy as soon as possible.)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of brain death while in coma after surgery?\n\nHi there! My four year old daughter was in a car crash on Sunday. She was taken into surgery right away and due to complications, the surgery took longer. She is now in a coma. I was wondering if there was a chance she might become brain dead/ flat line and never wake up.",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.Children always have a better chance of recovering from coma.But comatose patients are at high risk for secondary medical complications such as pneumonia,skin infections,sepsis. Brain death occurs when a critically ill patient dies sometime after being placed on life support, that's why  I don't think that her brain is dead.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing your daughter speedy recovery",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in the uvula while suffering from panic attacks?\n\nI am curious about something that s happened a few times to me now. This is embarrassing, but I really want answers so I m asking here. My uvula will sometimes swell to the point where it can lay down on my tongue. I don t suffer from any anxiety disorders, but each time this has happened, I ve had a panic attack and hyperventilated. In my head, I KNOW I m not suffocating/ choking, but the constant swollen pressure inside my throat makes me agitated, sweaty, and manic. It s like my body is in terror, but my mind is saying There s nothing to worry about. It feels like I can t breathe (which ironically makes me hyperventilate) and it triggers my gag reflex. It s incredibly stressful. I start to shake, hyperventilate, gag, sweat, and experience panic despite the head knowledge that I m really not in danger. It s hard to explain what it feels like to feel your uvula touch multiple sides of your throat. It feels like my throat is clogged (because the contact is the circumference of the uvula) and I unconsciously swallow to clear the obstruction , which only makes it worse. If it matters, the sensation feels like I ve got thick mucous on my uvula, so I feel the need to repeatedly swallow. I suspect the swallowing inflames my uvula which makes it grow WAY bigger. Then it becomes hard to swallow and the sensation of having something stuck in my throat makes me feel like I m choking. In reality, I can still breathe, but it certainly raises all the alarms physiologically that I am choking/suffocating. I m a normal weight (170 lbs, 6 foot tall, 27 year old male). The panic attacks only ever happen AFTER my uvula swells. The uvula swells over the course of hours then stays swollen for hours more. At a certain critical mass, I feel the sensation of having the uvula down my throat which feels like I m choking. Additionally, my saliva glands go into overdrive. Since I can t really swallow, I m left leaning forward over a bowl and spitting to keep my mouth from filling with spit (which only exacerbates the sensation of drowning/ choking/ suffocating). Leaning forward also keeps the uvula from going down my throat though, feeling it lay on my tongue isn t exactly a huge improvement. This only happened 4-5 times in my life and all within the last 3 years. The first three times this happened, I ve gone to an emergency room. Each time, steroids reduced the swelling. I ve been referred to an Otolaryngologis",
    "doctor_response": "Hi, Panic attacks come under the anxiety spectrum of disorder and need to be treated fast. Due to anxiety, several neurotransmitters start malfunctioning. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lower back pain\n\nI live in Wichita, KS and am having severe lower back pain down my right hip into the right leg.  I have had several injections but it has only given me temporary relief.  Whom would you recommend would be the best adult back physician/surgeon specialist in Kansas or any neighboring areas?",
    "doctor_response": "hi you have possibility  of sciatic in this also   pain is same as like you tell you must take physiotherapy to relief pain and use hot pack to relief pain and back strengthening exercises that will relief your pain . wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for sharp pain in lower right side of abdomen\n\nI have sharp pain in the lower right side of my abdomen. Under my belly button and to the right. Feel nauseated, no appetite, had a temperature of 101 last night - none today - and when I sit down my rectum throbs at the initial sit down. When I go to the bathroom if there is any pushing or pressure it s very painful, doesn t matter if urinating or the other.",
    "doctor_response": "Hi,    Thanks for posting your query with healthcaremagic.   According to your symptoms it looks like some sort of infection in the lower abdomen. Commen causes of pain in this area are  appendicitis, lower ureteric stone or urinary tract infection. As you have not mentioned about any other symptoms it is difficult to give a correct diagnosis. Pl consult to a nearby physician and get one ultrasound abdomen done. As your symptoms are not severe there is nothing to worry. Get a proper treatment and you will be alright soon.        Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for chest pains\n\nMy name is Jaclyn, I am 23 years old, 5'5\", 195 lbs, and have a clean medical history other than year round allergies. However for the past 2 days I have had chest pains that are causing different(faster) breathing patterns and both my hands are really red, buring hot, and itchy all over. I dont know why this is happening but I would really like too. Thank you.",
    "doctor_response": "Hello Jaclyn!Welcome on HCM!Your symptoms seem to be related to an allergic reaction or inflammation. I would exclude any possible cardiac disorder, related to this symptomatology. Coming to this point, I would recommend consulting with your attending physician for a physical exam and some tests to investigate for the possible underlying causes: - a chest X ray study and respiratory function tests- complete blood count, PCR, ESR for inflammation- Rheumatoid factor for possible arthritis- ANA, ANCA for possible immunological disorder. You should discuss with your doctor on the above issues. Hope to have been helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for hepatic encephalopathy?\n\nfemale patient of age 25 years has jaundice with malaria and typhoid progressed to hepatic encephalopathy.what is the treatment ?",
    "doctor_response": "hi she has serious condition better to admit in hospital let doctor check all parameter and decide  which treatment needed she has complication due to jaundice,malaria and typhoid. she need intensive treatment",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes altered mental status in an adult male?\n\nMy Brother In law age 40 years married blessed with a girl child doing nothing remains at home his attitude towards his Parents and Spouse is quite questionable and does not allow anyone to express there feeling towards him neither they are able to give any suggestion .Typical Attitude problem , Speaks filthy and absurd language,Use to throw away things when he gets angry ,Eats a lot, Shouts on everybody, Use to do things to get attracted towards him,he doesn't know what is write and what is wrong.Kindly suggest where to go as he will not be able to visit the doctors place as he always tell that I am fit and fine does regular GIM excercise also.AMit 0000",
    "doctor_response": "DearWe understand your concernsI went through your details. Definitely your brother is troubled by mental disorder associated with his previous experience and attitude. Proper Diagnosis needed for proper treatment and cure. Seems like schizophrenia but clarity needed. Consult a psychiatrist.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes enlarged kidneys in a 5 week old child?\n\nHi -my son is 5 wks old (approx 4.5kg) and has a marginally enlarged kidney which is making me worry about giving him gripe water for his tummy problems. I gave gripe water last night and it worked wonders so I would love to keep giving it rather than have him suffer in pain and cry for 3hrs in a row at night.  The bottle warns about giving it to anyone with impaired kidney function - does this include my sons problem or do they mean some more sever kidney problems instead? Mia",
    "doctor_response": "Hello Mia and welcome to HCM. As an Urologist,i can understand your anxiety.The mild enlargement of kidney,isn't anything to worry about.This is considered as normal,up to a difference of 2 cms, between the two.Kidney function is tested by doing a blood creatinine test.The enlargement seen on an ultrasound scan,is of no consequence.The scan and creatinine,need to be re-checked after a month.If you've any doubts,send me all the reports,as a direct question.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden pain under the ribs after a gall bladder surgery?\n\nI had my gallbladder removed at the end of July beginning of August. I've been healing very well until these last couple of weeks. 3 Weeks ago I had a horrible pain under my ribs where my gallbladder used to be. I literally thought I was having a heart attack and I'm only 20 years old. My mom told me she thought it was an air bubble or gas just stuck so she was patting my back and eventually it went away. This past weekend it happened again as well as today. These are horrible attacks, like I said I feel like I'm having a heart attack. I am prone to anxiety attacks as well. But what could this be?",
    "doctor_response": "hi.thank you for posting query.presentation of post cholecystectomy pain.differential: surgical incision pain, fat intolerance or stone remnants in common bile duct.ultrasound abdomen maybe done to rule out stones in common bile duct and to see the tissue underlying incision .advice:- take pantoprazole 40mg once daily before breakfast (for the rest of your life)- discuss with treating physician- also get a complete blood cell count(CBC) test- avoid OILY food and FAT diet altogether- avoid eating stomach full and mouth full- avoid spicy food wish you good health.further queries are welcomed.regardsDr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a colicky baby with gasping be treated?\n\nhave a 6week old granddaughter she seems colicky she was breast fed for about 4 weeks then to formula similac then to a soy formula and now nutrimigen been on it for 7 days still quite cranky and she does the little squeaky noise like gasping quite frequently any suggestions? her older sister had to go on nutrimegen also but in a week she was great",
    "doctor_response": "HiThanks for writing to health care magic.Gastica drops can be given at 5 drops thrice a day .Colic pain may last for few months before settling.Ensure proper burping after each feedWishing your child good healthRegardsDr Arun",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes redness in arms and legs?\n\nmy daughter is 5 years old, she s being having fever for two days and I ve being giving her childrens motrin for the fever but today in the morning she woke up with redness in her legs and and knees but right now she has it in her arms and neck and legs she doesn t have anything in her back or face. I asked her if she was itchy or she had pain in her rash but she says she doesn t. should I take her to the hospital?",
    "doctor_response": "Greetings.... i think your child is suffering from viral fever. There are many viral infection which are associated with rashes which tends to go away with time and you dont need to bother... But if you live in Dengue infested areas then you should rule out Dengue by doing a complete blood count and NS1 antigen test in a hospital... Post the picture of the rash if possible.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is placenta fundal posterior maturity, grade III a normal finding at 38 weeks of pregnancy?\n\nPlease explain about below Report: Single Viable intra Uterine foetus in cephalic presentation, oblique lie. Corresponding to 38 Weeks gestational age. Plecenta fundal posterior maturity, grade III . Fetal Heart Rate : 154/min Amniotic Fluid Adequate . Cord around Neck: Absent",
    "doctor_response": "report is normal suggestimg normal foetus having his head towards the vaginal opening corresponding to 38weeks...u can have labour pains anytime..everything is ok",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in upper right leg and hip?\n\nI had a tummy tuck 3 weeks ago and now I have pain in my upper right leg for 2 days now. I m not sure what to do it feel like a Charlie horse however the pain radiates to my hip. If you have any suggestions please help! I did also have lipo on my thighs.",
    "doctor_response": "Hello, As any pain radiating in nature from back to hip thigh leg is indicative of the lumbar Radiculopathy. Getting an MRI scan of the lumbar spine is advised. Post which, the possible soft tissue Injury is figured out. Doing core stability exercise, spinal muscle strengthening exercises, hip muscle strengthening exercises and lower limb as a whole on both sides will help reduce the symptoms. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Focal nodular hyperplasia lesions on liver. Blood work shows low creatinine levels. Cure?\n\nI have been diagnosed with having several focal nodular hyperplasia lesions on my liver . I sometimes experience discomfort in that area. I recently did some blood work for insurance purposes and my results show my creatinine level low at 18.7 and my protien creatinine ratio at 0.22. I am concerned, can this indicate something serious? Thanks!",
    "doctor_response": "Hi there,Thanks for your query.Firstly, you seem to have mixed up creatinine and creatinine ratio values. Hence, I cannot offer any comments.Life is incompatible at Blood creatinine level of 18.7!!As far as the focal nodular hyperplastic lesions are concerned, are they ON the liver or inside the liver. BOTH are different conditions with different interpretations.Please re-post your query in full details and correct values. Or, consult your doctor who will examine you and prescribe appropriate treatment.In case of any further queries, revert back to me THROUGH DIRECT PREMIUM QUERY (Paid), addressed to me personally. You will receive- almost immediately- my response in great details.If you find my response helpful and informative, do not forget an \u201cexcellent\u201d (5-star rating)  to my answer, to ENCOURAGE all doctors- engaged in social service- to render sound advice to the FREE queries. Fond regards and have a nice dayDr. Rakesh Karanwal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes body tremors after an accident?\n\nHello I developed a body tremor after a car accident that get worse with rest. I was referred to a neurologist. Had an mri with contrast dye nd a ct scan and everything was normal. My neurologist said she has no idea what it it is. I have no anwser yet, can you please help me",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. You do blood tests for evaluation of the deficiency of vitamins, calcium, etc. If there is vitamin B12 deficiency, then take injection/tablet. If calcium deficiency is present, then take calcium tablets. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for infertility problem\n\nHi. Me and my husband are trying to get pregnet for six years and still no luck. I have a regular 28 day mestural cycle and I ovulate on time I also get ovulation cramps and my boobs get sore but I don't get that streatchy clear discharge, the fertile discharge can that be one of the reason why I haven't got pregnet? And if there's anything I can use or take to increase my discharge? Thanks",
    "doctor_response": "Hi, Welcome to HealthcareMagic. Confirm with follicular study that you are ovulating normally.  If you are ovulating normally then no need to increase discharge and it is not cause of infertility.  I suggest you to discuss with your doctor regarding use of ovulation inducing drugs like clomephine . This will help multiple follicles to mature and rupture . Thus  increasing chances of pregnancy. Hope I have answered your query. RegardsDr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes feeling of burnt smell after brain aneurysm surgery?\n\nI have been experiencing a phantom smell for about 2 1/2 months, something like burning peanuts. I had surgery for a brain aneurysm a little over 5 years ago. My ethmoidal nerve was severed during this surgery and since then I have not had a sense of smell. I have had very little sense of taste as well, but lately, everything tastes burnt or bad.",
    "doctor_response": "Neurosurgical operation of aneurysm with nasal approach may lead to injury of olfactory nerve and it's twigs. Sometimes patient has this phantom feeling of abnormal smell. As taste also depends upon smell, it may also be abnormal. Some relief may occur with time. Wish you good recovery and health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause of pus filled pimples on testicles?\n\nI woke up this morning with two pus filled pimples on my testicles. I haven't ever had any before. I am not sexually active,nor have I been for over a year. Again this is the first time. I do not think this is an ingrown hair. Plus I haven't shaved down there.",
    "doctor_response": "HelloI share your concern Pus filled pimples on the testis can be caused by infection from urine or stool and can be allergic as wellIf you can upload me a photograph and answer my these questions I will be able to help you betterYour age and relevant medical history if any?Have you ever had similar problem in pastIn my opinion you should see your doctor for physical check up and investigation to rule out infective  conditionMeanwhile you can apply antibacterial or antiseptic ointment like mupirocinMaintain good hygieneKeep your public hairs cut and cleanHope this answers your question Thanks and regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for getting pregnant\n\nhi doc. My name is t n im marid im 21 n when i was 18 i got miscourage it was 6 month n the second one was 3 month, my hubby has a child from previous merige. We r trying to hv a baby n my gynaecologist has recomend some clomid for me n got my period n i realy need a baby but he cant recomend anything to us.",
    "doctor_response": "Hi ,   Thanks for the query. I understand your concern.    You seem to have some problem with menses (probably pcod) .It needs detailed examination &few investigations followed by specific treatment. It would help you.   Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bulge on wrist on 3 year old?\n\nLately I have noticed a small buldge on the right wrist for my 3 year old son. Please can you tell me the cause and affect. Do we need to undergo an operation. weight : 13 kgs.",
    "doctor_response": "Hi,The information you provided is not adequate to comment on anything. If I were your pediatrician, I would like to know how big is the bulge? where exactly its located on the wrist? How long has it been there and is there any increase or decrease in size? Is the bulge mobile, painful ??A bulge in such a location Can be a nonspecific bony deformity or fat accumulation also which needs no treatment. So better its seen by a doctor to make a confirm assessment. You might need to get an xray as a part of evaluation. Hope this advice helped. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does getting hit by ball on penis stop ejaculation?\n\nHi im a 12 yr old boy and i was really silly doing PE without a sports cup. Today my friend threw me a cricket ball in PE but it bounced off the floor through my hands and knocked me in the privates. It hurt me really badly and i felt sick. Could this knock damage my privates and stop me ejaculating? And will it ever stop hurting down there?",
    "doctor_response": "Hello, You can take anti-inflammatory and analgesic medication for that life paracetamol or Brufen for five days. It seems to be blunt trauma by ball and will be resolved in few days. However, if you have swelling in private parts than it's better to consult nearby doctor for detailed evaluation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could white colored tongue be due to candida infection?\n\nI have a white covered tongue for four weeks now, after taking antibiotics for a skin infection. I am on treatment for oral thrush for two weeks (1 week Amphotericin oral and 1 week nystatin oral) and on candida-diet but doesn't improve. I have had no pain at all and the white thing is not brushed off by toothbrush and does not bleed.Is this really candida?",
    "doctor_response": "Hello,Welcome to HCM,I understand your concern.White patch on tongue which cannot be brushed nor scraped, suggests it's a leukoplakia(refers to a condition where areas of keratosis appear as firmly attached white patches on the mucous membranes of the oral cavity).It is a diagnosis of exclusion(once all other causes are ruled out). Oral leukoplakia more commonly occurs in those who smoke,chew tobacco. Leukoplakia is a premalignant lesion, i.e. \"a morphologically altered tissue in which cancer is more likely to occur than in its apparently normal counterpart\". But the vast majority of oral leukoplakias will not turn malignant.If thats the case it is recommended to recommendation that possible causative factors such as smoking and alcohol consumption be stopped.If the size of patch increases in size, has to br reviewed by physician.Hope this information was useful. Good Luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cure for fused cervical spine and pain in mid back?\n\nMy total cervical spine is fused, rods and screws. Been having pain in mid back.  MRI shows Multilevel disc desiccation and osteophytes reflecting multilevel degenerative disease.  There is desiccation of virtually all thoracic discs with multilevel anterolateral marginal osteophytes reflecting degenerative disc disease.T3-T4  2-3 mm right paracentral protrustionT5-T6 2-3 mm thickness central right paracentral disc herniation resulting in dural impression without cord impingementT6-T7 2-3 mm thickness L paracentral disc herniation resulting in dural impression without cord impingement.Should I go see my neurosurgeon?  I've had Pain Management shots in my bacg prior to this MRI, but they didn't help.  They DID give my husband diabetes when he had them for his back.  My GP put me on Gabapenton 10 days prior to the shots beginning to keep the diabetes from starting hopefully.  It did.",
    "doctor_response": "Hi,Thank you for posting your query.I have noted your complaints and the MRI spine findings.There is no need to go to the neurosurgeon now, as your thoracic spine abnormalities are minor and do not require surgery. Management would consist of using medications such as pregabalin or gabapentin capsules, and physiotherapy.There is no risk of getting diabetes with above medications.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes small sized penis with full erection?\n\nmy penis is small and i cant obtain a full erection. it has been years since i could feel a solid erection ( i feel it is that way becuse i have had a serious masterbating problem for over 4 years and it seems to be gettin softer and smaller. and i tend to orgamum a lot faster) and i want to know how to fix that. Furthermore my scrotum sags very low. infact lower that my penis most times. how can i fix this?",
    "doctor_response": "Hello,The size of penis cannot be reduced to masturbation. The masturbation is safe and pleasure giving procedure. Kindly mention size of penis during erection state. The initial few centimeter of vagina is sensitive for intercourse sensation feeling. So bigger size of penis more than 5 inch is not needed in erection stage.Hope this provided information will be useful to you. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the cause for sever pain and numbness after root canal treatment?\n\nHi I had a rootcanal  in the morning I woke up with a lot of pain and than I felt numbness on my lower right side lip chin and teeth went to hospital because if severe pain I was givin injection and narcotic pain killers second day went to dentist he took the filling out pain got better still numb oral surgeon took a ct he said showed nothing went back to dentist he put filling he pain again he took it out and cleared the whole tooth was referred to a nerve specialist what can I do what's going on 2 months passed by still numb",
    "doctor_response": "hi, tanks for your query.There are several different issues that can cause your lip, chin, or jaw to be numb after a root canal procedure. The first is that, in the process of filling the space normally taken up by your tooth pulp, the dentist has used too much filling material. Doing this sometimes results in the material penetrating to the main sensory nerve and chemically burning it. It is very common for overfill in rear teeth to cause lip and chin numbness. Once infection is present from perforation, however, medications may work, but if the problem gets bad enough, extraction might become necessary for you, just as it is with infection from underfilling. visit endodontist for this.hope this is helpful.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest natural remedies to grow hair\n\nHello sir .my name is ali ,age 27 from india, i m suffering from baldness or hair loss for six year . I have lost my hair from front and back side mostly nd in middle less hair.. Is im suffering from androgenic alopecia or other? I went to doctor for checkup he told me it is androgenic alopecia. Then what should i take except minoxidal nd fenasteride .plz can u tell me any herbal effective medicine. What can u say about segal solution of canadian product. Plz tell me some natural product to regrow my hair .plz plz plz plz help me",
    "doctor_response": "once baldness occurs it is difficult to regrow the hair.in ayurved we  use hasti danta mashi for it.the other help ful treatment is gunjadi taila,it will at least keep your remaining hairs intact.avoid food with lot of salt for eg papad, pickles.etc .also spicy food,nonvegiterian diet should be avoided.shiro dhara will also help",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could the blister behind wisdom tooth be?\n\nI have a blister like structure behind my wisdom tooth, on my gums. It is painful, and is sensitive to touch. The pain and sensitivity extends beyond the structure, and includes sensitivity in the jaw region and also in the throat, near the structure. What is it and what should I do?",
    "doctor_response": "Thanks for your query, I have gone through your query.The blister behind your wisdom tooth can be a pericoronal abscess or it can be a mucocele.The pericoronal abscess occurs secondary to the gum infection around the wisdom tooth and deposits around the wisdom tooth.The mucocele can occur secondary to any trauma like biting over the gums from opposing tooth or tooth brush trauma. Consult a  oral physician and get it evaluated.If I am your treating doctor, If i diagnose it as pericoronal abscess i would have prescribed a course of antibiotics like amoxicillin 500mg and metronidazole 400mg tid for 5 days (if you are not allergic). Then i would have suggested to go for aperculectomy or extraction of wisdom tooth.If it is a mucocele i would have suggested you to get it treated by surgical excision. I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cold sensations in the abdomen and back while having pneumonia?\n\nMy husband, age 63 is feeling cool on his abdomen and back while the rest of him is warm...currently sleeping. Last week was diagnosed with pneumonia...had a period last week when he was so cold, couldn t get warm so we went to the hospital. He says he is feeling fine and feels OK to work everyday (does construction work outside on a normal basis). Should I be concerned tonight that part of him feels cool even when under covera for an hour or two Thanks so much",
    "doctor_response": "Hello and thank you for asking in HCM I can understand your concern Don't worry so much. Your husband is under treatment for pneumonia according to the history and he has had fever several times.Now he feels better but he is not completely asymptomatic which means that the feeling he had might be due to an episode of temperature not so high .This shows that the treatment is doing well. But he has to be careful with the treatment to be correct as the doctor has prescribed ,no smoking and not to work in dust environment ,a lot of liquids too.Take careWish a fast recovery for your husband. Dr. Jolanda Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bad reaction to Mirena, blurred vision, flashes in eyes, weight gain, hair loss, anxiety, insomnia. Suggestions ?\n\nI had the mirena only for a month and had a bad reaction to it, I got blurred vision, saw flashes in my eyes and gained weugh and lost my hair and my anxiety went out the roof. Had ti takem out had panic attacks, I broke out in a rash, had flu like symptoms and drenched my bed, I  have insomnia and have heart palpitations and have gone pretty much hyperthyroidism, my insides hurt from this, it was awful!!!!!! Has ruined my life until I can get my hormones back how do you suggest I do that?????",
    "doctor_response": "Hi there, thanks for asking. You can have hormonal balance with taking pills which is named as oral replacement therapy. You can also take herbal supplements which have feto esterones. They are weak esterogene and they do not have any side effects. They can be found in some foods like soy bean, etc. I wish you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Jaw pain in lower right side, swollen face, gums. Root canal done. Cure?\n\nHi there, i am having pain in the lower-right jaw, i only feel the pain where i push and the bottom-right part of my face is a bit swollen. The pain seems to be somehow under the teeth , and the gums are swollen over ~3 teeth in that area (and hard when touched) I went to the dentist 1 week ago to have a root canal on the opposite side of the mouth, and to my knowledge i don t have any problematic teeth on the side it hurts now. Also, when tapping the teeth or eating i feel no pain whatsoever.",
    "doctor_response": "hello and welcome to hcm forum, i would like to inform you that pain with swollen gums is something which is following infection, which either may be from a decayed tooth or infected gums. If the tooth is not hurting on chewing food or on tapping then it is most probably gum infection, Thorough cleaning (removal of tartar ) will help resolve the infection. But in order to confirm the cause, a dentist needs to examine the oral cavity thoroughly, i will advise you to see your dentist soon. Until then you can perform warm saline rinses( 3- 4 times.day) to relief pain and swelling, use an antibacterial mouth rinse(twice/day), Do not apply any hot compresses over the swelling. i hope this answer was useful, i wish you good health. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Chronic acne on face, chest, back, cystic pimples, folliculitis. Cure for symptoms?\n\nHi, I had severe acne in my early teens, that only lasted about two years (12-13). It was on my face, chest , back, behind and even thighs. Slowly but surely, the acne on my face, chest and back subsided, but never fully on my behind or legs. I was then told what was on my behind and thighs was folliculitis . Now I am in my early 20 s and have broken out on my face again. This time, there are no cystic pimples , but small bumps with no white or black heads ALL over my face. It started on my forehead , with lots of itching, and within a week was all over my face and neck. What happened? And why hasn t the follilculitis gone away yet?!",
    "doctor_response": "Hi, Welcome to Healthcare magic. Your skin condition is most likely Keratosis pilaris with or without acne. It is a familial skin condition which appears usually at upper thighs and upper arms but may be at back shoulder face and some times generalized. You can use the following though treatment is not always required- 1. Capsule- Tetracycline 500mg (or doxycycline 100 mg / minocycline 100mg ) twice daily  for 1-2 months orally. 2. Tretinoin cream or gel/ Adapelen cream or gel- you could apply twice daily on trunk and extremity and once at night on face for 1-2 months 3. Follow up needed after end of 1-2 months. With regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to maintain sperm count through treatment?\n\nHi doctor, I am suffering from hypogonadotropic hypogonadism. I am taking HCG 5000 and HMG 150 injection twice a week. My sperm production has started from azoospermia. We have done IVF and it was successful. My doctor asked to take testosterone injection, but if I take this my sperm production will be stopped. I want to know how to keep sperm production active. Please let me know the available option to maintain the sperm. I heard about Clomiphene citrate 50 mg or Enclomiphene citrate 25 mg treatment. Please help me with that.",
    "doctor_response": "Hi. HCG (human chorionic gonadotropin) and HMG (human menopausal gonadotropin) are excellent choices to ensure a good sperm production, which is needed for fertility that you have achieved. However, this treatment combination rarely leads to normal testosterone levels, which is needed for good muscle mass and general well being. Testosterone injections will be ideal for the same, cheaper and easier to take. Yes, it will reduce your sperm count, which is reversible once it is stopped. Hence, unless you want to have a second child soon, there is no rationale to continue the difficult regimen of HCG and HMG injections. You can conveniently switch to testosterone injection now. Then a few years later, we can stop the testosterone injection and go back to HMG with HCG if you plan a second child. Clomiphene citrate will not help in hypogonadotropic hypogonadism. For further information consult an endocrinologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I experiencing high enzymes in liver and pancreas?\n\nI have experience high enzymes in liver and pancrease I've had severe back and left side pain since January it has gotten worse in the last three weeks. I've been through mri, ct scan ,colon test,endoscope and now a mrcp test can you give me some suggestions",
    "doctor_response": "hi.noted history of elevated liver and pancreatic enzymes. did they found anything significant in your imaging studies? it is best if you consult with a dcotor, preferably gastroenterologist or a general surgeon, for physical examination and clinical evaluation. hepaticopancreaticobiliary tree pathologies must be ruled-out. one of the primary concerns is pancreatitis. other diagnostics (such as blood count, liver function tests, etc.) and management (medical and/or surgical), will be directed depending on the findings.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat fungal sinus infection?\n\nMy husband has had sinus and allergy problems for over 20 years....has been to Mayo numerous times...seen various doctors and most recently an ENT.  Last year, a sinus culture revealed a fungal infection in his sinuses.  He also had a sinus scan a few weeks ago and the ENT said there was nothing shown on the scan and didn't seem concerned about the fungus.  Is there a specialist who deals with fungal infections?",
    "doctor_response": "Tanks for posting your query to HCM.ISolation of fungus from sinus culture is not confirmative as sinus infection .repeated isolation of same fungus is considered as infection because fungus is most common contaminant of clinical specimen . you need to undergo histopathological examination to confirm diagnosis . You should contact to Infectious disease specialist or to a ENT specialist who will take care of your case .",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a small lump on the abdomen be treated?\n\nSo I have a small lump on the right side of my abdomen, just above the hip bone and it's beginning to freak me out a little. I've had it for around 2 weeks, I had gotten a knock in that area playing football and there was and is still to an extent bruising in the exact area the lump arose, but it didn't appear until a week or so after this happened. Should I be worried?",
    "doctor_response": "Hello,This is a small hematoma (post-traumatic). Usually, it is a self-controlling phenomenon but should take of the following care for better early recovery. \u2022 Apply ice 4 to 5 times a day \u2022 Keep the part clean with antiseptic liquid\u2022 Avoid direct/indirect pressure or itchingIn our clinic we recommend cephalosporin group of antibiotics (to prevent secondary infection) and anti-inflammatory agents to resolve it faster according to the case evaluation. (I can guide if you upload the photo.)Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am bleeding after a positive pregnancy test. Is it due to the miscarriage that I had last month?\n\nHello doctor, I have been trying to conceive for four months now. Last month, I got two positive pregnancy tests followed by some bleeding a week after the test. I bled for about a week. And this month, I also got three positive pregnancy tests. I got a positive test two days before my missed period, but the periods followed, which was very dark. Is it possible that this is still the first pregnancy or is it more likely that this is a new pregnancy? Thanks in advance.",
    "doctor_response": "Hi. How are you doing? Hope I have clarified your query, do write back. All the best. For more information consult an infertility specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and a dominant red lump after bitten by a horse fly?\n\nI was bit by something. I believe it was a horsefly but the reaction was not like normal ones I have encountered before. Like this others, this bit was a small red bumps but then a day or two later the area swelled and a target like effect (such as the \"bull's eye\" when bit by a deer tick with lyme disease). What is going on? What could the problem be?",
    "doctor_response": "Insect bite generally induces allergic reationAdvice1.\u00a0\u00a0\u00a0\u00a0\u00a0Cold fomentation with ice pack2.\u00a0\u00a0\u00a0\u00a0\u00a0Dexamethasone 0.5 mg twice daily per oral for 5days3.\u00a0\u00a0\u00a0\u00a0\u00a0Levocetirizine 5 mg daily per oral for 5 days4.\u00a0\u00a0\u00a0\u00a0\u00a0Ibuprofen 400 mg thrice daily if pain occurs 5.\u00a0\u00a0\u00a0\u00a0\u00a0Ranitidine 150 mg twice daily for 5 days if you are taking ibuprofenThanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest ways to increase penis size\n\nDear Doctor , I have small penis and I need penis like a man . I am not asking very big penis but it should be like a man with proper fatness as well as my testis are also small. so it it possible to have a big and fat penis. money is a major problem but I will afford if there is any hope. Please do reply if it is possible with the expenses required for surgery or treatment course along with your fee. Regards Sanjeet Jain",
    "doctor_response": "Thanks for asking in healthcaremagic forumIN short: There is no way to increase the size of penis(except implants)Explanation: The size does not matter, if you are having normal erection and able to satisfy your partner then its normal. Please do not fall into any ones hand who just try to get money out of you saying he knows how to increase the size of penis. Hope your understand. Stop thinking about your penis size.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have stents in leg, blocked artery. Done surgery for blood clots. Taking Plavex, baby aspirin. What to do?\n\nHi: I am healthy, not overweight, not a diabetic but arterial problems run in the family. I have 4 stents in 1 leg & after only 5 mo. the artery is blocked again. I had emergency surgery 5 mo. ago because I developed blood clots between 2 of the stents so now I take Plavex along with 1 baby aspirin. The pain is severe because of the PAD. I'm not sure which direction to go in at this time. .",
    "doctor_response": "HIThank for asking to HCMI am really sorry for hear about your peripheral arterial disease, if you are smoking then quit it, if not then it could be genetic in origin, you better consult to some very competent peripheral vascular surgeon,, Medicated stent could help you it does not get block early, always keep your leg elevated while sleeping, Have nice Day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is evion 400 mg safe to treat acne ?\n\nhi i m asad 24 yearsof age i have acne problem now i am using evion 400mg capsules twice.but i want to ask that can evion be taken with milk what will be its benefits plz ans",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.This is a safe drug and can be taken with or without milk. Make sure you take only as per your doctor\u2019s advice, not on your own. This helps in cases where there is deficiency of vitamin E and problems associated with it. Wishing you a good health.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Pragnesh Vachharajani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have bipolar disorder. What are the lifestyle changes I can do to improve my mood?\n\nHello doctor,I am a 35 year old male. I am suffering from a bipolar affective disorder. Currently, I take Magnesium Valproate 400 mg BD with Amisulpride 100 mg HS. My overall mental health remains stable with the\u00a0above-said dose of medicines. But, in spite of that, I have had anxiety in the\u00a0past. I always want to be in bed, talk as less as possible with my family, and remain busy with my gadgets. I do not get actual sexual pleasure despite having erotic thoughts all day. My motivation levels are low. I do\u00a0not spend quality time with wife any longer. I have been\u00a0taking medicines\u00a0for\u00a0the last six years. If this dose is changed, I have so many other problems. So, I stick to this, so that my sleep and appetite remain good. Please suggest me the needful.",
    "doctor_response": "Hello. I can understand your concern. You are suffering from bipolar disorder and are on Magnesium Valproate and Amisulpride. Thanks and take care. For more information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could high level of leukocytes be due to UTI in an infant?\n\nMy daughter is 15 months old and has a history of one UTI prior to 12 months of age. She had an ultrasound after the UTI but no VCUG. Twice since then she has developed fevers and had her urine tested both by dipstick and by microscopy. In both cases she tested positive for leukocytes but negative for nitrites, RBC and no bacteria were found. The dipstick test for leukocytes was +++, I m not sure what the numbers from the microscopy were. Her paediatrician said that the white blood cells were probably there from an infection elsewhere in the body (she did develop a cold). I am still a little concerned however as I thought this level of leukocytes in the urine was abnormal, and read that leukocytes can also indicate inflammation. Is there another possible problem here (another kind of inflammation?) or is UTI the only possible concern?",
    "doctor_response": "Hello,It is not correct for me to guide you based on this information alone. But at the same time, by what you say, it looks like a complicated Urinary tract infections (as it is multiple UTIs).I agree that WBC increase in non-infective inflammation also. But if you can upload all her reports of urine routine and blood CBC, I may be able to guide you better.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sumanth Amperayani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pressure pain in bladder\n\nHi, may I answer your health queries right now ?  Please type your query here... my bladder feels really full n got a real pulsating pressure before n after i pee n stomach pains like period pains as soon as ive been toilet i get the pressure pain like i need to go again",
    "doctor_response": "Hello and thanks you for your query. I am Dr. Rommstein and I will try to help you as much as I can with my answer.This is suggestive of uroinfection if you are female or prostate hyperplasia if you are male. You need to do urinoculture and basic urine a analysis to rule this out as well as kidney ultrasound. Also,you should drink plenty of fluids and raspberry juice to promote urination. If there is no improvement you may need urinary catheter.I hope I have answered you query. If you have any further questions you can contact us.Kindly regards. Wish you a good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the best things one can do to get pregnant?\n\nHello doctor, What are the best things one can do to get pregnant?",
    "doctor_response": "Hi. As with anything, having a planned pregnancy has a better outcome than an unplanned pregnancy. For both partners, adhering to a healthy lifestyle in terms of diet, fitness, stopping smoking and alcohol, and stress management are important. For the woman, in particular, we check blood count, rubella immunity, thyroid levels, sugars if indicated, and advise folic acid supplements to prevent certain neurological defects. If you are at the age of above 35, or having irregular cycles, endometriosis, or have had pelvic infections, you may want to visit your gynecologist to avoid wasting precious time. If your partner smokes or consumes excess alcohol or diabetic or above age 40, it is better to get a semen analysis done. You can calculate the fertile period of your cycle and try to make use of this period. All the best, hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the MRI brain show?\n\nyes doctor. thanks.my sister is having paralysis on right side. she can't speak.according to her reports, she is having large acute nonhaemorrhagic infarcts noted in left basal ganglion, left frontoparietal periventricular white matter with compression on the left lateral ventricle but no middle shift.patchy acute non haemorrhagic infarcts noted in left frontotemporo occipital cortcal infarcts.according to mra study of brain, left mca is thin with poor flow signals in it.. according mr angiography of neck, both vertebrals arteries are thin and hypoplastic. plz doctor tell her actual situation in comprehensive language and possible treatment.",
    "doctor_response": "Hi,Thank you for posting your query.I have noted the details of your sister.She has a large brain stroke on the left side of brain, resulting in paralysis of right side of body (arm and leg) and loss of speech. Speech area is also located in the left side of brain.The bad news is that there is no treatment to fully cure her. If she had a smaller stroke, and she was seen in a hospital within four hours, she could have received thrombolytic (clot buster) therapy, which leads to good outcomes.At this stage, she would get supportive treatment (physiotherapy, nutrition, BP and sugar control). In addition, physiotherapy and exercises would be started.With good treatment, she can recover part of speech and weakness.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am having diarrhea, severe headaches, and fatigue after contraceptive pill withdrawal. Why?\n\nHello doctor, Since I came off the pill 14 months ago, I have had lots of issues: black, brown, smelly spotting, irregular periods, severe pain, severe fatigue, been to the emergency department many times with different issues (stomach bleeding, severe stomach pains, lightheadedness, back and neck ache, etc.). I developed a headache about 6 months ago, MRI showed a pituitary microadenoma, have been to endocrinologist but he has ruled out hormonal reasons and sent me away saying another MRI will be done in 6 months and have referred me to a fertility specialist. I cannot live like this, severe stomach issues, cannot eat properly, diarrhea, severe headaches 2 weeks leading up to periods, have lost 5 kg within 5 months, severe fatigue, no energy for anything, palpitations, any exercise makes me very lightheaded. Someone please help.",
    "doctor_response": "Hi. In your description you have mentioned lots of issues that needs to be investigated and sorted out in detail individually. Microadenoma and hormonal imbalance are two separate issues actually those can cause different symptoms, need different investigations, precautions and treatments. It would be better if you could send me your detailed reports. Adenoma related issues need to be consulted with endocrinologist on regular basis. For rest of the medical issues need to be consult with consultant general physician to sort out for every symptom. Have some counseling sessions with pshychaitrist to help feel emotionally balanced. For irregular periods have transvaginal scan and blood tests on day 2 of periods (testosterone, progesterone, prolactin, insulin, FSH and LH , thyroid function tests), high vaginal swab, cervical smear. Collect all laboratory tests and discuss here. Have combined oral contraceptive pills for 3 cycles to have hormonal support and regulate periods. After collection of swab from vagina, have injection Ceftrioxone 500 mg intramuscular once. Azithromycin 1 gm per oral once. Tablet Doxycycline 100 mg twice daily and tablet Metronidazole 400 mg 8 hourly for 14 days. Have balanced diet , weight and BMI. Complete treatment of any health issue you have. Have daily walk, exercise and yoga. Have recreational activities and quit recreational drugs. Have cold milk at bed time and after waking up before breakfast.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for difficulty in breathing\n\nrestriction in right lung when inhaling which is causing breathing problems.  have had chest xray and is all clear.  I take symbicorte preventer medication for my asthma morning and night every day and have been using my ventolin inhaler more often due to shortness of breath",
    "doctor_response": "HiProbably steroids nebulizer might help you better for this.Try this you will feel better again Regards Dr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am taking dental pain medications also, but still have pain , please suggest me what should I do ?\n\nI had a caries of tooth from 6 days. I used to take pain medications and the pain used to come out. From 2 days i noticed that my cheek started becoming big. There was lot of pain also. I started getting fever also. Is ther any thing wrong. Iam taking pain medications also, but still the pain is not coming down",
    "doctor_response": "First of all, with all the symptoms you have stated, i guess you have got infection and caries since months, but u noticed it 6 days back. Analgesics (medication which subside pain) is not treatment, its just temporary relief to buy some time for you to get complete treatment. so, its not going to solve your problem. Your cheeks are swelling thats is due to Infection, aerobic as well as anaerobic, and the fever is due to the infection. And just pain killers arent going to solve your problem. You need to consult your dentist and he or she will take a Radiograph or X-ray, and will advice you treatment, mostly extraction or Root canal treatment, but in few cases, incision and drainage is also needed if the infection is very much spread. But from your case presentation, i guess your swelling will be subsided with the help of Antibiotics which cover both aerobic as well as anaerobic infection, (dont try to self medicate yourself, consult your dentist) and pain killers, they will act efficiently when you are taking antibiotics alongwith it. For any other querry, you can contact me anytime at Dental Care Forum and you can get some insight and information on different dental care procedures on my Dental Care Blog. Regards, Dr. Shoeb Ansari B.D.S.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does problem straightening leg after football injury indicate?\n\nI am 21, 5ft 6in and I hurt my knee about a month ago playing football. It was a sudden impact type of injury but it was never swollen just very sore and it still hurts and I can not straighten my leg fully. It is just unstable sometimes and I can t jump. Do you think there is something serious wrong?",
    "doctor_response": "Hi there . Thanks for your question at HCM.It is possible that your symptoms are caused by a mild meniscal tear. Meniscus is a disc like cushion between the two articulating surfaces of your knee joint. Two menisci in each knee work as shock absorbers during bending and twisting movements of your knee. When it is injured this shock absorbing function is lost and it can get caught or squeezed between the articulating surfaces. This can cause pain on movements like bending, squating, geting up from a chair, twisting movements associated with going up and down stairs.In more severe forms it can be associated wity stiffness of knee wity inability to bend fully, giving way or popping sensation and more severe pain.If you cannot manage your daily routine without pain, it will be prudent to meet a sport physician and let her/him evaluate your knee. Also pain while going up and down the stairs can suggest some injury to associated ligaments of the knee. Hope this helps. All the best. RegardsDr.SBK",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for chest pain and blood taste in the mouth?\n\nHello my name is Martha, I'm 21 years old and on April 30, 2009 I had surgery, under my sternum, I had a tumor removed, now I'm have surgery to have the wires removed, six months after my surgery I started having chest pain again but now everytime I have chest pain I have a bloody taste in my mouth and its a very strong taste and I feel it more the deeper I breathe",
    "doctor_response": "Hello dearWarm welcome to Healthcaremagic.comI have evaluated your query thoroughly .*  This seem sin relation with regurgitation of stomach acid  into esophagus    and  throat  most  seemingly .*  Needs  evaluation with upper  GI  endoscopy  and  further  managementHope this will help you for sure .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest ayurvedic remedies for irregular periods and problem in conceiving\n\ni have irreguar period cycle. it results me in my pregnancy,therefor i consult a doctor since 2008.no improvements.last year i had an operation called mini lap + OD =DT did not work out yet..now i have started to take ayurvedic medicine. I am 26 years now.Will I get pregnant soon?",
    "doctor_response": "Hi,I understand your concerns.Following is my reply:1)\u00a0\u00a0\u00a0\u00a0\u00a0It is better to start allopathic treatment.2) Please get husband's semen analysis done.You can contact me anytime directly to ask question by pasting following link in your browser:XXXX",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high SGPT and cholestrol\n\nhi doc, my mom is 71 y/o, just had her labtest this morning and the result of her sgpt/alt is 106.4, according to the blood chem result normal value should be 4-38 IU/L. could you please give me the answer to her lab. result?by the way here are the results of her other labtest: FBS 103.9, cholesterol 202.4, triglycerides 64.4, HDL cholesterol 72.5, LDL cholesterol 117.0, BUA 7.4, creatinine 1.3.  Thank you so much.",
    "doctor_response": "Hi thanks for contacting HCM...Noted liver enzymes value high....Your mom's  total cholesterol high...But triglyceride within normal limit and LDL mild elevated....But your HDL that is good cholesterol are high.So regarding cholesterol no need for much worry....Investigate your mother case with USG to rule out gall stone or steatohepatitis like condition if present....If your mother having positive cardiac history in past then it also can lead elevated enzymes.Malabsorption syndrome by celiac diaseasr and muscular problem also can be cause...If needed and vomitting , malaise , headache , fever like presentation viral market study done to rule out viral hepatitis....Take care....Consult gastroenterologist with keeping this in mind...Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is asthma permanently curable and how to prevent it?\n\nMy daughter is 4 year 6 months old and she has started having breathing trouble for last 6 months. She has got severe  wheezing problem three times in last 4 months and we have consulted the near by pediatrician who has suggested nebulization with astalin and budecort. Both myside and my wifeside has history of Astama and I have minor breaching issue though I have never got a  severe astama attack till now. Given the frequency at which my daughter is getting the wheezing problem and astama attack, we are worried about her education and other activities. We stay in Bangalore-East and looking for a good pulmonologist who can suggest how to control our daughter astama problem. Please suggest how we can control the astama issue of our daugher and whom can we consult(preferably in Bangalore-East). Is Astama permanatly curable or preventable?",
    "doctor_response": "HiAsthma is preventable. If we avoid allergen responsible for it as it is a allergic responce. Even if we identify the irritant and avoid those we can prevent it.For permanent cure we need to identify the allergen by sensitization test and by immunotherapy we can cure it.Asthalin nebulization should be given as required and budecort daily to prevent the occurrence of symptoms. If not controlled then consider adding plain montelukast 4 mg (till 5 years). These will help her.In bangalore Dr.H Paramesh from lake side is the leading pediatric pulmonologist. You can get help from him.Hope this information helps you. Feel free to ask if any further queries and I will be glad to answer them.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for muscle pain and fatigue?\n\nI am a 55 yr old female looking for someone who is familiar with the e-coli strain 0157, shiga toxin (STEC). I had this in Jan. 2003 (bloody diareah and treated with ciprfloxacin) and feel this has been the on-going cause of my muscle pain and fatigue. I believe I was noticing muscle pain before the end of the year. I am discouraged with the medical field, my doctor only checking my muscle enzymes in 2011 and she didn t follow through to tell me they were elevated till my next physical 1 1/2 yrs later. She was wanting to treat me for fibromyagia, but I question that as I believe elevated muscle enzymes is not common in Fibro. At my last appointment she was steering towards depression. I couldn t believe it! I switched doctors in Mar 2013 and he orders bloodwork for my CK every 3 mon. My creatine kinase numbers have fluctuated between 137 (Jan 2011)and 419 (Apr 2013). My latest test in Feb 2014 was 226. I have also gone to several natural health practioners with their own ways, but it wasn t till Mar 2013 through my own research that I was aware the e-coli strain I had was Escherichia coli 0157. I have recently seen a naturapath who thinks I should consider IV treatments of ozone, hydrogen peroxide and Vit C. I have been on a for better health for a good 9 yrs. It has consumed my life and mind. I had been an active healthy woman prior to this bacteria. What is your input? Thank you. Cecile",
    "doctor_response": "Hello, Consult a neurologist and get evaluated. A detailed evaluation is required to find out the exact cause. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is Ecosprin 75 tablets used for?\n\nI am 32 year old women from kuwait,and i didnt conceive for two years and when i went to india now for gynaecologist check up.Both my husband and my reports are normal and told to take Folic tablet and Ecosprin 75 tablet for me and Speman tablet for my husband and also told cycles to take ovulation test on 14th day...I want to know What is Ecosprin 75 tablets for???",
    "doctor_response": "Hi,Ecosprin-75 tablet is given to improve blood circulation to the fetus and hence to maintain normal pregnancy. The main purpose of giving Ecospirin-75 during pregnancy is given to prevent stillbirth, fetal growth restriction, preterm birth, and early pregnancy loss and preeclampsia. Continue taking it as prescribed.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my infant s bilirubin level increasing?\n\nMy daughter had a baby 5 days ago and he had jaundice. He was placed under blue bili light. Within 24 hours his bilirubin level went from 19 to 12. They were sent home but had to go back for bilirubin level today, and it was 14. Why did the level go back up? He is eating well and passing meconium stools.",
    "doctor_response": "Thank you for sending us your query. The baby is has physiological jaundice, which is a self remitting condition. it usually persists for first 3 weeks of life.  However if the symptoms persists then congenital hyperbilirubinaemic conditions, such as Crigler-Najjar syndrome or Dubin Johnson syndrome or Gilbirt's syndrome or Rotor's syndrome may be considered. In such scenario, you should consult a paediatrician to pin point the exact cause. In most of the cases no active treatment is required and patient leads a normal life. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for immunodeficiency disorders\n\nMy daughter has this disease and the Doctors are having a difficult time trying to control the disease, she is going from the ICU to the ICU Acute care back and forth. She is doing the IVIG for the second time now and I hope she has some results this time but if not they are planning nto rest her for a week before doing the Plasma treatment again? Is there something other than those treatments that can be tried ???",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Your daughter is suffering from immunodeficiency disease.  But treatment depens on type of disease.  There are many kind of immunodeficiency disease.  Iv immunoglobulin and plasmapheresis is useful in almost all immunodeficiency disease.  Still specific treatment depends on exact type. Find the exact type of disease and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have back pain and lump on abdomen. Had tumor removed from abdomen and thyroid. Cure?\n\nI have had many tests done and no real answers, lower back pain lower pelvicarea pain and large lump on my lower right abdomen, pressure almost constant that feels like labour pains right before pushing. have had hysterectomy 10 years ago. tumors removed 6years ago from the right side of abdoman and tumor removed from thyroid 2 years ago. checked for chrones, colitis , and many other things and all negetive. am at the point i am at wits end from the pain, pass out it gets so bad at times",
    "doctor_response": "Hello. Thanks for writing to us. Since no pathology has been detected after various investigations, it seems to be a nerve related pain. This can happen due to nerve root irritation or compression. You can consult a neurologist for proper evaluation. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes involuntary twitching and short term memory loss?\n\nAbout 6 mo ago my 15 yr old son suddenly started stuttering and having involuntary twitching, usually in one of his arms. There has been no change in the stuttering but the twitching has gone from 2 or3 episodes per week to about ten per day.he says it isn t painful but that he has no warning and no control over them.the twitching usually only lasts a few seconds and he is otherwise completely normal and healthy. One more strange thing is that he seems to have some short term memory loss. Lately, he has been repeating the same story or asking the same question that some one just answered an hour before",
    "doctor_response": "this is called abscence seizure....its a type of seizure that happened in children and adolscent....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does flotral taken for enlarged prostate cause mouth dryness?\n\nI am a male , age 71, and have been taking flotral 10mg since 3 years. I take it at night after meal. The mouth is dry when I wake up. What is the best time to take it and is there any other medicine to reduce enlarged prostate? My PSA is 1.8Thank you for the immediate reply.",
    "doctor_response": "Thank you for being with healthcare magic!  Flotral or alfusozin doesnt cause mouth dryness. If you are snoring when you sleep then that is the cause of your mouth dryness when you wake up. If you have a prostate size more than 40grams then you can take a medicine to reduce the prostate size (finasteride/dutasteride).  I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at:   I would gladly help you.  Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain. MRI showing herniated disc. Suggested surgery for vertebrae fusion. Second opinion?\n\nI have been having lower back pain for 5 yrs , had MRI in 2007, showed herniated disc between L4&L5, Dr suggested therapy , had therapy for the last 5 yrs, last couple months, gotten worse, another MRI, Dr Suggested surgery to fuse vertebras together, I Can t decide what to do, is fusion safe, will it deteriate other discs, because of more stress . I need some help to what to do?",
    "doctor_response": "hi ,there are basically two kind of surgery done for chronic disc problems i.e. only decompression -when the leg pain is more than back pain  and decompression with fusion when backpain is equal or more significant than leg pain   Any chronic disc problem should treated with surgery only when all option of conservative management are exhausted i.e. taken lot of analgesics continuously for more than 6 weeks , exhausted with physiotherapy.It is true that other disc are at increased risk but it takes quite a long time for the other discs to degenerate.fusion is more of concern only in young age and obese individuals",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in the ankles and sleeplessness while on a CPAP machine?\n\nI have recently developed swollen ankles. I had open heart surgery about 10 years ago with great results, quad bypass. Also a cardiac stress test with (medicated) heart ultrasound about two months ago. Results were also good. Restarted compression stockings yesterday, didn t help much. Last night removed stockings, overnight most of swelling receeded. Wearing the stockings again today, and for the most part, swelling has returned. Very busy person, but in the evening when i have time, watching TV with feet elevated above heart. Will try sleeping again with stockings removed. I am also on a CPAP maching. Have not been gettinc adequate sleep lately. Going for sleep therapy session(s)starting this Friday at Henry Ford Hospital in West Bloomfield Michigan. Should I be concerned? Are there are other possible problems which may have excasperated the problem? Thank you. PS, my BP is averaging about 140/75, pulse stable at about 55bpm.. HDL AND LDL are under control with meds.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. One of the reasons for swelling in the legs may be due to your hypertension medications especially if you are taking calcium channel blockers like Amlodipine or Nifedipine. Talk to your doctor and see if the medications have to be changed. Consult your cardiologist and get your heart checked with ECG, ECHO, TMT etc. Get blood tests done. See if your kidney is working well with renal function tests like- urea, creatinine. Seek emergency medical care if you have leg swelling and any of the following signs or symptoms, which may indicate a blood clot in your lungs or a serious heart condition: i. Chest pain ii. Difficulty breathing iii. Shortness of breath with exertion or lying flat in bed iv. Fainting or dizziness v. Coughing blood Certain medical conditions can also result in a swollen ankle or leg. These include: i. being overweight ii. venous insufficiency, in which problems with valves of the veins prevents blood from flowing back to the heart iii. rheumatoid arthritis iv. blood clots in the leg v. heart failure vi. kidney failure vii. leg infection viii. liver failure ix. lymphedema, or swelling caused by a blockage in the lymphatic system x. previous surgery, such as pelvic, hip, knee, ankle, or foot surgery To treat a swollen ankle or leg at home, remember the acronym RICE: i. Rest. Stay off your ankle or leg until you can get to the doctor or until the swelling goes away. ii. Ice. Put ice on the swollen area as soon as you can for 15 to 20 minutes. Then repeat every three to four hours. iii. Compression. Wrap your ankle or leg snugly, but be sure not to cut off circulation. Support stockings may be an option. iv. Elevation. Raise your ankle or leg above your heart (or as far above your heart as possible). Two pillows will usually give you the correct elevation. This encourages fluid to move away from your leg. Regards Dr Sanjay Kini",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedies for sinus infection\n\nI have had a cold/sinus infection going on a week now. It is clearing up now but I noticed white on my tongue. It's not creamy or anything and feels dry. I did burn it slightly the other night but I am worried and don't have money for the doctor but this is uncomfortable and I want it gone. I'm 21 . 5'3\". 104 lbs. I smoke off and on but this is overnight and I have quit. What is it and what are home remedies?",
    "doctor_response": "Take hot water vapour  inhalation.add pinchof turmeric powder to it.once a day for 3 days.u wil get relief.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have GERD and feel a lump under Adam's apple. Is it serious?\n\nHi doctor, I am 32 years old. I have GERD since a few years as the doctor told me after a diagnosis where he took the camera inside the food pipe. Anyway, I used to smoke then I quit but recently I smoked a bit when I was in holiday, after coming back from holidays I am getting a lump like feeling under my Adam's apple, just where the neck and the chest meet when I swallow food or saliva. It is very disturbing. I went to the doctor and he told it is maybe because of inflammation of the food pipe and gave me to do an ultrasound but everything went well. Nothing was found. But the feeling of something stuck is making me worried. Should I be concerned?",
    "doctor_response": "Hi. The lump feeling is most probably due to reflux laryngitis. It is a manifestation of GERD (gastro-esophageal reflux disease) higher up near the larynx (Adam's apple and voice box). Smoking aggravates the same or can be a trigger for it. The reflux symptoms may also be voice change, hoarseness, difficulty swallowing, increased throat mucus and frequent clearing of the throat.  You will have to take some proton pump inhibitors (Pantoprazole, Esomeprazole or Lansoprazole) twice daily for few weeks and then take once daily for a week and stop. Have Gavison syrup (Sodium Alginate and Sodium bicarbonate) after each meal. Follow all precautions for GERD as your doctor would have told you before. If the problem persists and does not resolve you may have to repeat the endoscopy and this time we will have to do a video laryngoscopy along with the UGI (upper gastrointestinal) endoscopy. If there is excessive mucus you may need a mucolytic medicine and an anti-allergic tablet as well. Do let us know the progress. For more information consult an ENT otolaryngologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for erectile dysfunction\n\nI HAVE NEVER ENJOYED SEX IN MY LIFE.I AM 41.MARRIED AND FATHER OF A SON AGED 7 YRS. MY TESTTOREN LEVEL IS LOW.I HAVE BEEN ABLE TO SATISFY MY WIFE VERY FEW TIMES . AFTER A VERY GAP BETWEEN INTERCOURSES  I FEEL SOME SORT OF EXCITEMENT.BUT I AM NOT ABLE TO ENJOY FREQUENTLY.I FEEL SHORTAGE OF SIMEN IN REGULAR INTERCOURSES. SOMETIMES EJECTION PROBLEM PERSISTS.ABSENCE OF HARDNESS IS THERE.",
    "doctor_response": "Hello, Consult a urologist and get evaluated. If there is any fall in testosterone level, it must be supplemented. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could abdominal pain be due to food poisoning?\n\nMy stomach has been harting since i got home and i thought it just might have been the dairy that i ate last night or the yogurt but then i started throuing up survierly and i just literly trough up like 10 times in a row and it was like water and spit and i took medasin and that helped but like i said i through up again but when i did my stomach was not hurting at all i just want to know what it might be and my friend thinks it might be food poisining and she also has a case of stomach problems but she dosent no what it is she is going to a gi spechialist but she dosent through up like i do.",
    "doctor_response": "Hello. Thank you for your question. based on your description, it is very possible that your stomach pain was due to food poisoning. I am glad that your symptoms disappeared after you vomited. That is very common. As long as your symptoms do not come back, you do not need to worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain after eating meal\n\nI was eating chicken and rice last night, After I finished the meal, I got a pain in the middle right part of my chest, I thought it would go away but the pain is still here after waking up, It isn t a constant pain it comes and goes like a stabbing sensation, Should I be worried ? I swallowed some rice made into a ball shape to help dislodge whatever it could be but the pain is still there, I don t have money to go to hospital at the moment I am in the middle of the month , Please help",
    "doctor_response": "Thanks for your question on HCM. In my opinion you are having GERD ( Gastro Esophageal Reflux Disease ).  Since you are having pain after eating chicken and rice, possibility of GERD is more. It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms. Try to follow these steps for better symptomatic relief. 1. Avoid hot and spicy food. 2. Avoid large meals, instead take frequent small meals. 3. Avoid stress and anxiety. 4. Start proton pump inhibitor. 5. Go for walk after meals. 6. Keep 2 - 3 pillows under head in the bed. 7. Avoid smoking and alcohol if you have this habit. 8. Loose weight if you are obese.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What's causing nervousness, dizziness, nausea during any serious situation like interview, exams?\n\nDear doctor,My anxiety problem started after losing a job in August 2013. I worked for 4 years in a tiring and stressful position and put up with a lot of unfavourable conditions then I lost my job because of no fault of my own. About 1 month after the job loss I went for an interview and during the interview I felt extremely sick. My heart started to pound, my head went dizzy, I felt very nauseated and afraid. I lost that opportunity. I went for another job interview and the symptoms were even worst. They have continued up to the present time. I am still suffering from the same symptoms only in serious situations which requires a lot of concentration such as during a job interview and at school ( I study part-time at university) during the exams I feel the same. I feel very nervous and sick. What seems to be the problem?Thank you for your response,Maryam Erfani",
    "doctor_response": "HiThanks for using healthcare magicI think, you have performance anxiety. In that case, you should consult a psychiatrist for proper treatment. You need low dose antidepressant and benzodiazepine. That would help to control the anxiety symptoms, You can also do some relaxation exercise to control underline anxiety.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain on knee while running even after meniscus surgery?\n\nI had menicus surgery a year ago on my right knee. It was torn and I have some arthritis also. Some bone on bone. I am 61 and play soccer. Why does it still hurt when I kick the ball and run. It hurts under my knee and below to the left. I am really disapointed. Do you have an answer/",
    "doctor_response": "Hello, I have studied your case. There can be associated chondral damage.I will advise you MRI knee again.Cryotherapy Light compression wrap may help.Strengthening Exercises: Do quadriceps strengthening static exercises, Straight leg raises, hip adduction and abduction, \u00bc and/or \u00bd squats Active assisted ROM stretching, emphasizing full knee extension (flexion to tolerance) Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes headache and diarrhea while suffering from shingles?\n\nI have shingles. Now I have headache and very liquid diarrhea for about a week. Just some info on me, I have psoriatic arthritis, idiopathic intracranial hypertension, empty sella syndrome and type 2 insulin dependent diabetes (there are more but those are the main, my health is not the best). My main question is with the diarrhea. It is very dark and foul smelling. Even if I eat nothing but crackers. I will be calling my doctor at 11:00 tomorrow but for know was just wondering if you had any ideas on the subject.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I advice you to do Consume plenty of liquids  in form of boiled water , lemon juice , coconut water ,home made juices , organic  tea , coffee , butter  milk  etc .Prefer soft , light  , bland , vegan  diet  with fresh  curd  preferably .Avoid  all types of  oily , spicy , non veg , hot beverages , junk foods , dairy fat ,milk  , aerated drinks  till recovery .Intake of PPI  ( as omeprazole ) , antibiotics  ( with metronidazole on pack ) ,Racecadrotil as an anti secretory agent , antispasmodic  agent as dicyclomine help faster recovery , whichrequires prescription with your doctor. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am on treatment for psychosis and depression. Will nicotex interact with my medicine?\n\nHello doctor, I am suffering from psychosis, anxiety, depression and panic disorder which used to be at its peak before few months. I used to smoke seven to eight cigarettes a day. I visited a psychologist counselor and she told me to quit smoking by using nicotex every two hours. But I am scared because I am having disturbed heartbeat. My ECG is normal, but I have a headache and other symptoms. Can this be any interaction of nicotex with medicines? And also I want to know how to use nicotex? I was recommended to take after every two hours gap, but I want to know for how many minutes it should be chewed? Will this be helpful?",
    "doctor_response": "Hello. Now, have you been diagnosed with psychosis, anxiety, panic disorder, and depression? What were the other medicines apart from nicotex gums which were prescribed to you? Was any improvement noted after taking those medicines? Now, solving your doubt. Nicotex can be taken as many times as you would take a cigarette or whenever you had a desire. Cigarettes contain harmful chemicals apart from nicotine whereas, nicotex contains only nicotine which is not so harmful to lungs. You can safely take nicotex gums. If ECG (electrocardiogram) is normal then no major issues with heart are likely. Your symptoms appear to be because of anxiety more than due to nicotine. You chew nicotine as long as it loses its taste. Let me know about your symptoms more so that I can help you more.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is there nothing that can be done about the pain from scoliosis and hypermobility?\n\nHello doctor, I am a 26 year old female. My height is 5'1\" and I weigh 53 Kg. I have had pain in all joints. I also experience pain in the spine between shoulders and down to my tailbone since 2010, on and off. I have finally seen a rheumatologist. The doctor said I have scoliosis, minor spondyloarthritis and hypermobility. She gave me Sulfazine that did not work and instead I developed nausea. Hopefully in a month, I can start taking an injection which the doctor told will only help with the arthritis pain. I was also told that I need to learn to live with pain and nothing can be done about the pain related to the other disorders. The doctor also asked me to keep taking Ibuprofen. Is there nothing that can be done about the pain from scoliosis and hypermobility? Do I need to learn to live with pain that restricts me from doing any physical work (even cooking and cleaning)?",
    "doctor_response": "Hi. Hope this helps and revert back to a rheumatologist online for further follow up -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for candida esophagitis\n\nHi, may I answer your health queries right now ?  Please type your query here...I had been diagnosed with candida esophagitis, I had been on prilosec but it wasn't helping. I took week of diflucan but as soon as I was off it, the pain can back,  took prilosec but no help.    The dr came me some more diflucan but started having this back pain.  Got off it.I am now taking acidophilus, enzymes and some    licorice, but still having pain which radiates from my back.   Any suggestions.",
    "doctor_response": "Hello and welcome to HCM!I read that you took prilosec (omeprazole), in order to reduce the pain caused by gastric acid. And then you took diflucan (fluconazole) but the symptoms got back once you stopped it. I would suggest to try taking itraconazole, which is the choice if fluconazole didn't work. However, ask your doctor if you can tolerate itraconazole. The standard regimen is 200 mg/day for about three weeks.Hope it helps and I wish you a quick recovery!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Umbilical ulcer, painful across belly button. What now?\n\nHi I have an umbilical ulcer and it causes me great pain a few times per year, it also feels like my tissue is separating like a band width wise across my stomach from my belly button, and it does protrude about an inch from inside belly button, I was wondering if and when I should get surgery to fix this? Can it just keep getting worse?",
    "doctor_response": "Hello! Thank you for the query. If no discharge from the belly button, most likely you do suffer from umbilical hernia. The main problem with such hernia is that the hole in the abdominal wall is usually small so the intestine can stuck in it what usually leads to bowels obstruction or intestines necrosis. And you never know when will it happen. So if it gives you pain I suggest you to get scheduled for surgery and do not wait anymore. Hope this will help. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medication for swollen optic nerves\n\nMy 10 year-old daughter has swollen optic nerves. She had clear results for her brain and optics MRI and negative for ANA. Her C-reactive protein test and other blood tests including TSH, HT1, 2, 3 and 4 are normal. The neuro opthalmologists here could not determine the cause. I am afraid that she might lose her vision. She was given oral steroids but her vision has not improved significantly.",
    "doctor_response": "Hi...by what you quote I feel that your daughter is having optic neuritis...considering the age and gender of the kid the most important diagnoses to be ruled out is autoimmune phenomenon which the doctors you are consulting have very well done already. Sometimes it can be idiopathic too...this means for which no cause can be ascertained. But the steroids will definitely help prevent complications. If her vision has not improved significantly, I suggest going ahead with a pulse dose of methylprednisolone and then followed  by oral steroids. Sometimes it can take some weeks to recover the eye sight. So we need to wait and watch. I feel that the evaluation and management of the case is going in the right direction.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in right bicep\n\nI have had pain in my right bicep that feels like excessive gym work and started two days ago. I have not exercised or lifted anything heavy so am surprised about this. Today I now have the same pain developing in my left bicep and left lower arm. Should I be concerned?",
    "doctor_response": "no don't worry,,Is there numbness or tingling ? neck pain ?You should receive Non steroidal drug (meloxicam 15 mg once daily after meal),muscle relaxant once daily before sleep  and topical massage cream .You also can use warm fomentation the next two days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "White patches on skin.\n\nHi, I am 15 years old and I have had these white patches on my neck,arm, and mouth for about 2 years now. There are two spots on my skin where the white patch is about 6 inches long and its really embarrassing epically around my neck. Ive been on Vitilax,Antivitiligo, and vitamin pills for these pass two years and my white patches are slowly healing. There are little dots of my real skin around the white patches and im really happy but at this rate, its going to take like 20 years for it to be completely healed. Maybe because the white patches i have are really huge i dont know. If theres any other medication to quicken the procedure, please help!!",
    "doctor_response": "I think you have some thing called Vitiligo which occurs due to less of melanin pigments in the body. You can get it treated. See a good dermatologist or cosmetologist to treat your white patches. There are many recent therapy in the hospitals. You can get it checked with your Dermatologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can be the cure for the break outs around my groin and vagina?\n\nHello doctor, I am breaking out around my groin and vagina. I\u00a0have never had an unsafe sex. So, I do not think it can be an STD. I am on a birth control pill. I have attached images for your reference. Kindly suggest treatment?",
    "doctor_response": "Hello. I understand your concern and I have viewed the images\u00a0(attachment removed to protect patient identity). Regards. For more information consult a\u00a0dermatologist\u00a0online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes an ear growth with neck glands and lymph nodes swelling?\n\nWhen I look in my 4 yr olds ear with an otoscope he has a black hair like object. Its texture looks like a stitch. What would that be? For at least six months now he has had swollen glands and lymph nodes throughout his neck, is there any connection between the two?",
    "doctor_response": "Hello, A child with swelling in the neck suggests of lymphadenopathy or lymph node swelling. Does he have a fever, significant weight loss? does he have any other complaints like hearing loss on that side of the ear? He needs a few investigations of the blood like total and differential counts and the lymph nodes need to be evaluated by both general physical exam and probably a lymph node biopsy. The black mass in the ear needs to be examined by an otoscope and removed by an ENT Surgeon. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr ASHWIN BALIGA, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat cavity in molar tooth?\n\nHi Dr. Gupta I have 1 and half year old son and he has cavity in one of the left molar tooth what treatment can be done and how can I save other teeth. He brushes at night although when he goes to sleep he drinks his last milk and then go to bed. Please advice what is best treatment for him. Nurjahan Ajanee from Dhaka, Bangladesh",
    "doctor_response": "Thanks for your query, I have gone through your query.The decayed tooth can be treated by restoring with glass ionomer cement if the decay is not involving the pulp. If it is involving the pulp, then it can be treated endodontically (pulpectomy). Consult a Pediatric dental surgeon and take a radiograph to rule out the above said conditions. Get it filled as early as possible to prevent further complications like pain, swelling. I hope my answer will help you, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the signs of having OCD(obsessive compulsion disorder)?\n\nin the daytime its not as bad, but as soon as it gets dark I am paranoid that someone is in my house and that they are trying to kill me. I always check everywhere to make sure nobody is there. I usually stay up late so when I walk into my room for bed it's pitch dark and I will check everywhere to make sure nobody is there. I won't enter a room without turning on a light cause I am afraid of people killing me. If I am in my bed and I have to go pee I will grab a light and check everywhere on my way to the bathroom. I also always have a blanket, I feel like it's a shield incase someone comes and try's to kill me.. when I turn corners I pop my head to make sure no one is there in my house.  Do I have OCD?",
    "doctor_response": "Hi dear,what ever you described is not suggestive that you are suffering from OCD.according to your history you might have psychosis or anxiety .but one can not say without face to face consultation and history.so as early as possible consult psychiatrist.have any suspicious or any hearing of voices ?is there any abnormality in your behavior and speech? thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child suffering with rash following fever. Rash turned to sores. Can he go back to day care?\n\nHello my son was sick and running a fever, then he ended up with a rash. I thought it was a fever rash at first but my sons buttocks was really bad that he had open sores. I took him to the ER and the doctor wasn't able to tell me what the rash was exactly. Of course by that night it was irritating my son and hard for him to sleep. I have been use Balmex, he has been doing naked time, and I've been changing his diaper constantly. My concern is should I get a second opinion regarding this rash and should I take him back to daycare with this rash. The Doctor stated to give him 1 day but I'm not sure if that's enough time",
    "doctor_response": "Hello,Thanks for the query,Probably he has developed chicken pox.It is better to avoid day care till the time the rashes dry up.Please apply an antibacterial cream on the rashes.This will prevent secondary bacterial infection.Also give him an antihistamine syrup.This will give him some relief.Please meet a dermatologist for exact diagnosis.Let me know if you have any other doubt.you can ask a direct question to me on this forum, following the below link.  you a good health.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for disc bulge at L5 position\n\nHi doctor i am having Disc bulge L5 position . My age is 23 . Doctors have given me Pysiotherapy exercises and tablets . Will this work out. some people say i can take d3 rise sachet 16000 units which will be much more effective. what should i do? how long will it take to get rid of from the disc bulge?",
    "doctor_response": "Hello Thanks for writing to usAccording to report,you are suffering from degenerative disc disease of lumbar spine.Degenerative changes occurs in spine due to aging and development of weakness in annulus fibrosis.Findings are early in your case.1.At L5 level,there is  disc bulge.Satus on nerve compression is not mentioned in your query.Majority of the cases of degenerative spine disease are benefited by physiotherapy,so physiotherapy should be tried first.Surgery should be the last option. There are also medicines like capsule pregabalin available for pain relief. D3 rise tablets are vitamin D tablets.It can be taken empirically.However,ideally serum vitamin D3 level should be evaluated priorly.Treatment can be planned after consultation with neurologist.Get well soon. Take Care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dry cough with feeling of fullness in chest?\n\ntwo months a go i started having an annoying dry cough and now have chest fullness like there is air and i belch a lot. at first i thought it was from wating but i do it even if i don't eat or drink anything. I feel palpitations like a heavy abnormal heartbeat and i hooked up to an ekg and when i feel full or air i have bigeminy and then belch and it feels better for about 30 seconds and then comes back.  can't lay on left side because i feel the same heartbeat feeling on that side. always have to lay on back or right side. goes on all day long. I am 44 about 150 pounds and no other history of anything.",
    "doctor_response": "there are several conditions associated with lungs and heart that may lead to dry cough-1-asthma -it is usually result of an allergy2-acute bronchitis caused of infection of bronchi3-pneumonia 4-less commonly- congestive heart failure.i would suggest you to get your chest x ray done .meanwhile you should take following medicine-tab levofloxacin 500mg once daily for 15 days.tab pan 40 once daily before breakfast.take adequate amount of fluid and stay hydrated.    thankyou and take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the solution for pins and needles feeling in neck, face and arms\n\nit starts like pins and needles at my neck area then moves to my face and arms, i get red and blotchy with a burning feeling, after it goes away my eyes are swollen and feel itchy, my little finger has pins and needle feeling all the time, it,s like it has a mind of it,s own. i am scared something is happening to me, i have never had this before. thank you",
    "doctor_response": "hai,pins & needles sensation  can be due to various reasons ,added with burning feetit can be due to diabetes melliteus,thyroid  hormone variations,peripheral neuropathy,nervous disorders, anaemia,vitamin b12 deficiency,injury to the nerveendings,calcium deficiency,& psychogenic causeplease evaluate for your sugarlevels,thyroid levels,haemoglobin,serum calcium to rule out all the above problemstake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can a person having  diabetic and on dialysis do kidney transplant?\n\nMy father was just rejected for kidney transplant as he is diabetic and on dialysis. The rejection was due to his heart being too weak at 35 percent function; he had congestive heart failure last year. He is 78 years old, but seems strong to me. What would be average expectations?",
    "doctor_response": "Hello, for a person to undergo renal transplant, tha patient should be fit for the surgery to undergo. For that his diabetes should be well controlled, if hypertension is there then the BP should be well controlled. As for his heart condition where you specified his EF is only 35%, it is quite low. In surgery some time bleeding can occur in which state the patient undergoing surgery should have a heart strong enough to handle the blood loss and decreasing volume. As your father's EF is only 35%, his heart wont be in condition to handle any situation occuring during surgery. So even if he appears to be fit to you, seeing his heart condition it will be inadvisable for him to undergo the transplant.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause elbow pain?\n\nHi, i am experincing a dull ache on the outside part of my elbow (thumb side) there is also a small vein that has popped up above my elbow joint going horizontal and its about two inches in length. I am a professional body builder and the pain didnt start until about two days ago during an excersie i was doing. During the day the pain is more of a dull ache but during workouts there s been iinstances where the pain is so bad i cant even lift more than twenty pounds without feeling pain",
    "doctor_response": "this is probably Tennis elbow ( inflamation of common extensor orginin , is i am correct pain should increase if you close your fist rest + NSAIDs (alphinturn) +physical therapy is recommendedHope i was of help Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the small pus filled lump in the groin?\n\nI have a small lump in my groin area between my testicles and anus it did not hurt like a pimple however when I squeezed it it popped but it wasn't puss that came out it was blood what could this bee? I'm 27 never had anything like this I am around 260lbs",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have perianal abscess formation. You should take antibiotics like cephalosporin or amoxiclav. If it doesn't respond to treatment then you should go for culture and sensitivity test. And then take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for staph infection\n\nMy dad is 71 years old and he had a knee operation that ended up with a staph-infection and this has been going on now over 2 months in and out of the hospital my question is how many of these operations can his frail body handle and what can i do to bring him home?",
    "doctor_response": "HelloWelcome to Healthcare magicFind out from lab test that staph infection is MRSA or non MRSA. For MRSA, choice of drugs are linezolid, vancomycin etc. For non-MRSA, clindamycin, cifazoline, nefcillin etc are choice of drugs.Thank you for contacting us.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for h.pylori\n\nhello guys i am from east africa i stay in india for 5 years and 6 months then i went to usa as soon as i reach us i got stomach problem then i did blood test they found h.pylori +3 ,i took medicine but didn't work thriple therapy - tetracycline ,bismuth , and omeprazol (for 14 day)qudriple therapy - clarithomycine , metronidazole , amoxiline and omeprazole none of it work i think i got the h.pylori from hyderabad indathank you",
    "doctor_response": "Hi DearI appreciate your concern towards the ineffective treatment for H pylori.If you were my patient with the blood test of h pylori +3 , I would have begin your treatment as follows:The triple therapy ( Two antibiotics of different groups and one PPI)Clarithromycin with Metronidazole to be taken for two weeks onlyAlong with the above antibiotics Omeprazole once daily  but for 6 weeks duration. This regimen is found to be effective.By the way Helicobater pylori is universal in nature, not confined only to the Indian city of Hyderabad.Besides the medications, to enhance the healing process avoid taking hot and spicy food, alcohol and alcohol containing beverages, coffee, smoking, stress. etc.  I hope your doubts have been clarifed.Take care of your health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high WBC level?\n\nHi, my white blood cell level is high(12). It is supposed to be between 4-10. My red blood cell level and hemoglobin level is normal. Will there any problems due to the high level of my white blood cell and is there any remedy or treatment for my ailment? Thank You",
    "doctor_response": "HiThanks for your query.Based on your query and reports am of the following opinion.1. High WBC count is usually due to infections- bacterial/ viral/ parasitic.2. Other causes being leukemia, leukemoid reaction.3. Since your count is high, infections need to be ruled out. If you are having any symptoms related to airways/ GIT/ urinary tract, antibiotics can be started.4. If asymptomatic no need to panic, get a peripheral smear examination done to check for abnormal cells if any. Hope this helpsRegards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is surgery recommended for a deep tissue hematoma post accident?\n\nIn August, my friend was involved in an auto accident. She sustained a deep tissue hematoma that failed to resolve. Doctors have tried draining, but this has not reduced the area. She was informed of a possible need for surgery, and that this syndrome could be life-threatening if not treated. Is there a syndrome that describes this condition?",
    "doctor_response": "HiHope this message finds you in good health. I have gone through your message and understand your concern. such kind of unresolved hematomas can lead to cellulitis and pressure symptoms on the surrounding soft tissue structures. there is no such syndrome to describe this kind of unresolved hematomas.CT guided aspiration and drainage is recommended follwed by histopathology study of the lesion.I hope your query has been answered. Feel free to consult me anytime.Thanks. Take care. God bless",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Syncope, blackness of vision. EEG shows spikes while sleeping. What does it mean?\n\nmy 17 year old daughter has has a few episodes of sycope lately and blackness of vision . She is otherwise healthy and an athlete. We were advised to see a neurologist whohad her undergo an Bloodwork-clean, MRI- clean, EEG-some spikes while sleeping. He says she could be prone to seizures but not really What does that mean?",
    "doctor_response": "Dear parent, Thanks for your query The problem that your daughter has is common complaint and answer lies in history and not in investigations. Thus first let us see what your daughter has. We may not conclude it as syncope and let us consider as a paroxysmal event Now what all happens before during and after event is of prime importance. What are the preceding complaints and what is her motor status during the event. How long or short duration are the events and at what level of consciousness is she at time of event is very important Now coming to investigations - EEG showing spikes is not epilepsy. The spikes in EEG could be a hereditary trait. There are lot of normal variants which could cause spikes I think you she may also require a TILT TABLE TEST which if positive can clinch diagnosis",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is tight, swollen hand and feet after childbirth a cause for concern?\n\nI am one week postpartum and all of a sudden I noticed my hands and feet felt tight like swollen but don t look swollen except my right ankle which isn t terrible just uncomfortable. I ve also had muscle pains throughout my body including calves. I was concerned it being a bloodclot. How do I know if it is? This was my 3rd child, all vaginal births with no complications of any kind during pregnancy and births and no history of blood clots. No high blood pressure or any other concerns.",
    "doctor_response": "Madam its highly unlikely that venous blockage occurs in all four limbs. Moreover venous blockage causes swelling that is evident, and not felt. Your symptoms seems due to postpartum phase. Do not panic keep mobile and see if this settles.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching bumps on the outer lips?\n\nhello doc, last week i started to notice some itching in my outer lips and it started to form little bumps, like an allergy. the problem is that this allergy is lasting too long, and its a little swollen, what could it be? it itches a lot, but there are no other symptoms, thanks",
    "doctor_response": "HelloThank You for contacting HCM.This could be allergic response may be due to insect bite or dust. I would suggest you following things:> Don't touch that area with dirty hands.> Apply polyfax plus ointment over it twice a day> Wash hands before and after applying ointment> take cetirizine one at night for 4 days. It will reduce itchHope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen, sore and sensitive penis?\n\nYesterday poured undiluted savlon on my penis for cleaning 3-4 times. it was red, swollen, painful and burning for the whole night. I took an antibiotic and anti-alergic in the morning and went to sleep. Before I went to sleep I had washed it many times with cold water. Now there's almost no pain and burning but the foreskin is badly swollen and is sore and sensitive. Is this anything serious?",
    "doctor_response": "HelloThanks for query.You have developed swelling of the foreskin due to allergic reaction to Savlon,You need to take broad spectrum antibiotic like Ciprofloxacin to prevent  along with anti inflammatory drug like Diclofenac twice daily.along with topical steroid cream Cartisol cream  twice daily.Ensure to wash your genitals with warm water twice dailyEnsure to avoid sexual encounters till it heals up completely.Do not worry your problem will get resolved within a week.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Toddler with periventricular leukomalacia, has affected vision, limps and eyes not in tune, taking stramonium. Can I give cicuta virosa with stramonium?\n\nHello, I have a son 2 years old with periventricular leukomalacia . Among others affected his vision . He has taken stramonium 12 ch for one month now and he will continue for another one. It seems that his perception is doing better but his limps and eyes seem to be detuned. So can I give him cicuta virosa together with stramonium?",
    "doctor_response": "PVL is sequle of hypoxic/ischemic insult to brain during birth and I disagree with the improvement you had noticed after using  stramonium - the process of delayed myelination in your child seems non progressive and has tendency to improve in course of time, by itself, little by little although not totally. Moreover, datura is relatively a poisonous substance and I had seen in India doctors prescribe in higher doses to patients which we neurologists strongly disagree . A regular physiotherapy with combined occupational therapy programme is all that is needed and don't ever go for non-scientific ways of treatment which are not yet proved to be beneficial.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of fordyce spots on testicle?\n\nHi, on the ballsack I have fordyce spots which i know are normal. Sometimes I pop them and a white substance come out. However I have a few that are not massive but just a bit big which won t pop. I shave down that area often. I also have very small hardly visible ones on my penis which pop with a white substance too. Does this have any affect? And how can I remove them?",
    "doctor_response": "HelloThanks for query.You have Fordyce's spots over scrotal sac,The scrotal skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin.Normally they fade away without treatment however they need to be treated if increase in size or get infected.Please consult qualified General Surgeon for clinical evaluation and further treatment.If needed some of them which are bigger may need to get excised in Toto (Completely along withthe sac) Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe hair loss be managed while experiencing stress, financial strain and weight loss?\n\nI am 45 years old and experiencing a dramatic change in my hair texture within the last 6 weeks. It has begun to fall out in handfuls, well over 300 hairs a day, has dulled in texture, feels chalky and I ve lost weight. I have been under increased stress due to job loss and financial strain, unable to afford healthcare and losing weight.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Hairfall can occur due to a number of causes like Androgenic Aloepecia caused due to sensitivity of hair follicles to androgenic hormones and genetics while other causes can be  fungal infection,nutritional deficiency, stress, long standing illness, side effects of medicines..Also if there is weight loss then probably stress is a cause however you also need to get your thyroid and blood sugar levels checked..You should consult a Trichologist and get evaluated and he can advise you investigations like hormonal assy, blood tests, trichogram, done to rule out the exact cause of the problem and treat you accordingly..You can be advised to apply 5% Minoxidil lotion over the scalp..You can be advised to take Biotin and multivitamin supplements..You can also be advised to take Finesteride orally if there is androgenic aloepesia as it suppresses androgens..You should massage the scalp with warm coconut oil..You should take a nutritious diet and drink plenty of water..Also add more of proteins, nuts, green vegetables and fresh fruits in diet with milk and clarified butter  in diet and regular exercise to gain ideal weight.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest possible medication for typhoid fever\n\nmy baby at about 6 years for infected typhoid fever for last one year. After consult with the doctor and after advise of the doctor get regularly medicine, but after one/two month again affected the same disease. last one have been passed but no permanent solution is found. please advice for proper care of my child.",
    "doctor_response": "Dear Sir/ Madam,Thank you for posting your query at healthcaremagic.comSince it is prolong and recurrent, please do repeatedly blood analysis including culture and sensitivity for antibiotics.Many cases, there are drug resistance typhoid. Even today ideal drug is standard one. Keep the child well hydrated with plenty of fluids in the form of fresh fruit juices, simple light food in the form of porridge, milk, etc.Since it is the disease of the gut (intestine) patient should be carefully monitored not to give heavy and spicy food.Following this patient should be vaccinated with anti-typhoid vaccine.With this child will develop immunity again typhoid and relapses.Wishing your child a speedy reocery!Your thank you note is appreciated! Looking forward.With best wishes,Dr. Vishwanath Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could bumps on tongue indicate cancer?\n\nI had two red small bumps removed from my tongue last week and when I got home there was quite a lot of bleeding - I am okay now but felt unwell and sick.  I am awaiting the results of my biopsy but am very worried as the bumps had been there for a while",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Lump n the tongue can be squamous cell cancer or some benign lesion.  Just wait for biopsy. If it is benign lesion then no need to worry. If it is cancer then you need further treatment like chemotherapy. Wait for the biopsy results. Then plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes green stool and stomach pain despite giving Azithromycin?\n\nMy 6 month old baby is having green poop, with stomach pain for last 20 days. I consulted a pediatrician, she first gave him ciprofloxacine syrup for 7 days, it was cured bt again after days stool was green. Went to the doc once again, she now suggested azithromycin syrup. Bt still he is having green poop. No improvement. Stool test says plenty pus cell and mucus present. What can I do ? Why is this happening?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry.There is no need to use antibiotics (especially broad spectrum antibiotics like ciprofloxacin and Azithromycin in such an young baby) unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.I strongly suggest that you stop the antibiotics.I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron (as prescribed by your paediatrician).Regarding diet - You can use cerelac...any flavour will do. Avoid fruit juices as they might aggravate diarrhea. You can give zinc supplements & ORS apart from normal vegetarian porridges & soups.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Regards - Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Frequent ammonia smell when breathing, stage four of chronic kidney failure. Advise?\n\ni have chronic kidney failure and am currently at stage 4, and expecting to soon need dialysis or hopefully a transplant. My question relates to an amonia smell I get evey now and again. I had it a phew months back but only when breathing hard, my consultant said at the time that he didnt think I should be noticing that given my stage of failure. Past couple of days have noticed it again but only when breathing normally this time? Do you think I should be raising this with my consultant at this time or wait til my next scheduled appointment in mid May 2013?",
    "doctor_response": "HiThanks for the query.Ammoniacal smell to breath is seen in advanced stages of kidney failure.So you need to check your urea and creatinine levels and discuss the results of the same with your physician.Depending on the results and after examining you the physician will decide if it is due to kidney failure or some other cause.Hope this helpsGood luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes face, lips and tongue swelling?\n\ni'm a male 53. using high bp medicines since 12 years. i'm using telsartan-h 80, minipress xl 5mg, revelol xl 100, amlosafe 5, tonact tg. i'm also taking razo-20 and lesuride. for last 2/3 months i'm facing swelling on my lips and tongue. it becomes normal after 12 hours. is it due to medicine reactions ? if yes, then which medicine i have 2 stop or change ? plz suggest ....",
    "doctor_response": "HIWell come to HCM I really appreciate your concern, it could be allergic condition but it may not be due to anti-hypertensive medicine still if is doubtful then you can discuss this with your physician but to stop the medicine without any clinical evidence is not advisable but better to think about the differential diagnosis beside the allergic condition  hope this information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for vomiting and diarrhea in children\n\nMy 2 year old had a stomach bug on Wednesday where she threw up for about 3 hours every 15 minutes. She had some diarrhea. Then she went 24 hours with no vomiting. She then vomits one more time and that\u2019s it. Then tonight nearly 48 hours since she last threw up she vomits again and it smells like yeast. She hasn\u2019t run a fever with any of it. She\u2019s been mostly drinking water, some Gatorade with no sugar, and some grape juice. Is this something I should be worried about?",
    "doctor_response": "Hello,Deworm him. Give syrup Vermox. 1 tsf daily for 3 days. Also go for stool examination. And give syrup Entamizole 1 tsf twice for 10 days. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Hina Javed",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and swelling in ankle post an injury?\n\nI fell in my driveway the week after thanksgiving I. Felt a burning situation. In my ankle and was not able to put weight on it. It was very painful . The next day I was able to walk but. Not without a little pain and swelling i. The ankle and. This has continued. I decided to wrap it and were a ankle brace is there a need to go see me doctor?",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain it seems that there has been ankle sprain due to sudden twisting leading to inflammation of the soft tissues in that area and the pain and swelling is due to it..As you are able to walk, there does not seems like any bony fracture and mild pain and swelling is not abnormal and you need not to worry about it..You can apply cool compresses over the ankle..Apply analgesic and muscle relaxant gel over it and put ankle brace..You can also elevate your leg while lying down..You can also take anti inflammatory painkiller like Ibuprofen..Avoid excess walking and straining..In case if it does not resolve in a week consult an Orthopedician and get evaluated..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath and wheezing?\n\ni recently started having shortness of breath and wheezing maybe about two weeks ago. the wheezing isnt really bad its really soft but really high pitched and annoying(i dont get the wheezing all the time it comes and goes) also i  have shortness of breath and its hard for me to sleep because it doesnt feel like any position is good to get enough oxygen in.",
    "doctor_response": "Hi,Shortness of breath and wheezing is generally because of underlying chest infection or because of a blocked nose. So get some drugs like nebulizers and anti allergic (monteleucast) with a antibiotic. Do some tests like C x-ray, X Ray PNS, blood counts and a 2D Echo. You will be fine soon.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Sameer Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Please suggest a remedy for black facial spots\n\nFor your kind information I have black spots of pox on my face, which I wish to remove through some ointment,cream or gel permanently, but those are deep enough and due to thiese black spots I look ugly. Please help me out, becaue I do not want to go in for PLASTIC SURGERY.",
    "doctor_response": "HelloThank you for posting on HCM.From your description, it seems you are having atrophic scars due to chickenpoxScars are pretty challenging to treat and treatment comes with variable results. More importantly the fact is no topical medications are going to help in removing scars. Only tretinoin or glycolic acid based creams can help to some extent but the results are very subtle and unpredictable and works for very mild scars only.Therefore, I would suggest you to go for laser therapy (Fractional Co2 laser, Non-ablative RF etc) as it has the best results of all other treatment modalities. Moreover, if additionally treated with dermaroller or 100%TCA peel (CROSS technique), pretty appreciable results can be achieved. Hope this will take care of your query.If you wish to contact me in future for any query kindly use the following link: you best of health.Thank youDr Hardik PitrodaM.D Dermatology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for high BP\n\nGood morning Dr. Chetna.My name is Saswati Patnaik (F / 31) , house wife, lives in Bangalore. I am suffering with high Blood pressure Generally in between 150/100 to 240/ 120) I am taking Amlong tab 5mg every day morning as suggested by a Doctor. My both the parents has same problem above mentioned. My mother died 2 yrs back due to Breast Cancer and she had BP and Blood Sugar as well. I am afraid I might landed up the problem which my parents are suffering. Can you please help me out.Saswati Patnaik. Bangalore(Karnataka)",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern. I will try to explain and give you my opinion. You should know that when we treat hypertension our goal is to keep mean blood pressure values below 140 / 90 mmHg.I must say that values between 150-200 mmhg are pretty high and we should not leave them like that.But you should not worry about it. Hypertension is a chronic disease,it has hereditary factors but  you just have to find an adequate treatment and every think would be ok.In my opinion amlodipine 5 mg is a very smoll dosage for your high values.If I was your treating doctor I would recommend some examination like a cardiac echo to evaluate heart function and walls,  a full blood analyze to chek renal function and a holter pressure monitoring to see your mean blood pressure values during day and night. After all these we can better jude what to do whith your medical treatment. We can rise the amlodipine dosage up to 10 mg and add othe class of medicament like a ce - inhibitors,  b-bllocker ect according to your previous examinations.Hope I was helpfull. Best regards, Dr.Ervina.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing severe cough noticed during night\n\nHi i can not stop coughing and its worse at night feels like i have something stuck in my throate, and then when i wake in the morning i cough and feel really warm and keepcoughing loads of green stuff up been like this for 2 weeks, im taking cough medicine and sucking strepsills.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your situation and problem. Coughing at night time with greenish mucus expectoration is commonly seen in bronchitis. So we should first rule out this. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x ray 3. PFT (Pulmonary Function Test). Chest x ray is needed to rule out other lung diseases like lung infection. PFT is must for the diagnosis of bronchitis. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid (ICS).Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe abdominal pain?\n\nI am now experiencing severe cramping (lower abdomen the spreads through my entire stomach up to my diaphragm. stomach pain. Started last night. The pain comes and goes but when I feel it, it is the most painful feeling I felt. Lasts for a few seconds. Pain also radiates on my left shoulder. Feels like. I need to pass air but I can t. Please help. Thanks",
    "doctor_response": "Hi.With the history you have provided the spasmodic pain in the abdomen with a referred pain to shoulder is suggestive of the peritonitis part also . I would advise you to go to ER/ Hospital immediately. Be nil orally, do not  take anything orally.You need the investigations of :: X-ray of the abdomen in the standing position to see for the gas under the diaphragm. X-ray of the chest.Ultrasonography for fluid in the peritoneal cavity. If you have a perforation you may need urgent surgery. If there is obstruction and causing secondary peritonitis , conservative treatment can be tried.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is surgery necessary for following cardiac angiogram result?\n\nHELLO DEAR DOCTOR. SIR OR MADAM MY MOTHER HAS A HEART PROBLEM. SHE 69 YEARS OLD AND I DID THE CARDIAC ANGIO.THE RESULT IS 1:HUGE CALCIUM BURDEN IN ALL CORONARY ARTERIRES. 2:MILD TO MODERATE DISEASEIN LAD AND DISTAL RCA. 3:MODERATE TO SEVERE DISEASE IN MILD TO DISTAL CX. 4:CORONARY CALCIUM SCORE=1679 PLEASE INFORM ME IF IT IS TREATABLE AND WHAT MEDICINE TO USE.IN PESHAWAR THE DOCTOR HAS TOLD ME FOR THE SURGERY. I WILL BE THANKFUL TO YOU IF HELP ME.",
    "doctor_response": "If  the disease in distal cx is >70%, and the vessel is not too small, the lesion should be treated with stenting or surgery. It's very important that you see a cardiologist soon, to prescribe a good therapy and decide if it's necessary to do pCI or surgeryBest regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes right-sided back ache and pain around the vulva?\n\nRight side, back area..right above waist..Painful...had several infection (Bladder,,now started bleeding by the Vulva area..Pain to go and find it sometimes hard to start to go...Dr. Gave me some special cream to put a dab their of Estrogen..Whoa did I get sick...It was made with no preservities in this cream...I will be 83 in a few mo s...Dr. Said I urinate so much,,up every hr and thirty mimutes thru the night, exhausted that I have irratiedthis area,,,He has also ordered a tens Unit to start next week when it comes..Sometims a lot of Pain..Any Ideas so I can sleep...Just went in remission for my Beast Cancer,,,,I have HER2positive. Thank you..",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I have understood your problem, see naturally when we are active and Young, our enzyme and hormones are powerful so due to strong immunity, we can fight with many infection, but as the age progress, and inactivity and sedentary life style and other Physical morbidly as you said breast cancer, so ultimately immunity decrease, and from genital areas protective secretions decreases. So ultimately at present you need to take lots of water in morning and evening not at bed time. have a lot of aloevara juice, turmeric milk, continues the prescribed medication. need to engage in daily basis of walking. do some breathing exercises. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "High WBC due to upper respiratory infection. Elevated ferritin levels. Hemochromatosis?\n\nMy white blood cell count 12/24/12 was 13.7, however I was experiencing an upper respiratory infection at that time. Then I had the bloodwork done again 1/24/13 the WBC was at 15.0. My Dr. does suspect Hemochromotosis due to the fact that ferritin was elevated in both blood draws. My question is would Hemochromotosis cause an elevated WBC count? Obviously I m concerned with Leukemia?",
    "doctor_response": "Hi and thanks or your query, Hemochromatosis could be suspected although the clinical evidence in your case is very much lacking. Its a normal reaction for the white blood cell count to rise with a respiratory tract infection. Hemochromatosis has nothing and is not related to the white blood cell count. Leukemia would require an excessive rise in white blood cell, usually accompanied by anemia, pain, an infectious syndrome too. I think its really too early to think of a leukemia n this case. Doing blood haptoglobin levels could help. Diagnosis of leukemia usually warrants a complete blood count and a bone marrow aspirate, but really do not think you need it. Consult and internist for a proper evaluation. thanks and best regards, Luchuo, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Naturogest and vaginal pessaries prescribed for increasing the chances of conception. How are the pessaries used? Any side effects?\n\nHi Dr. Lundi, I ve just undergone an IUI . My doctor has prescribed naturogest 200 (micronised natural progesterone ) vaginal pessaries for me, as a follow up to the procedure, to increase chances of conception . I am supposed to use these pessaries twice a day. I just wanted to know whether these pessaries have to be inserted as close to the cervix as possible or just simple vaginal insertion is enough. Also, do these pessaries have any undesirable side effects? Thanks, Monica",
    "doctor_response": "Hello Thanks for your query. The pessaries should be inserted as high up in the vaginal canal as you can, because the chances of their being effective increases. Also, it is a normal pregnancy support, commonly given after IUI, as progesterone supports the early pregnancy during development. there are no gross side effects, you might feel vaginal itching and discomfort. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Which crown should I wear for a RC treated tooth?\n\nHello doctor, My lower front tooth broked in an accident. I visited the dentist here in my place and he suggested RCT. My first session of RCT has been done 11 days before, and the last session was two days back. I want your advice on steps after RCT. Is laser filling possible for such tooth break or crowning is the only option? Which type of crowning is most suitable for it? Please help me. I am waiting for your valuable advice.",
    "doctor_response": "Hello. Crowns are best after RCT. Best crowns are zirconia. They are metal free, and they have good strength than other crowns. Other than that is CADCAM crowns. They are 3D porcelain metal crowns and have good strength. They come with a warranty. Both look very good and have exact teeth color. Filling of teeth will be done on the last day of RCT. Ask for post and core if possible. But the crown is important in everything. I wish you good health and happiness. Keep me updated with the improvements.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause tenderness in lower abdomen?\n\nI have left lower abdominal tenderness to touch, feels like a tightness. Relieved with positioning, better if lying on left side. Moderate relief after taking motrin. Have history of consstipation. Took a dulcolax suppository, senna 2 tabs with only small results which were followed by small loose stool. Initially when I stood straight it felt like stretching, then that resolved. Now tender to palpation on left lower abdomen, very localized.",
    "doctor_response": "Hi, thank you for asking Healthcare Magic.With this presentation, some information (like your age and sex) is needed because it would help in the diagnosis. If that cannot be possible, then I think it could be a case of intestinal obstruction or a disease called diverticulitis. A gynecological problem could also be evoked if you are a female. A thorough clinical assessment associated with some tests is needed to determine the cause.I would suggest you see an emergency room doctor for proper assessment and management.I hope that answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. We will be delighted to answer more questions from you.I wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest alternative to Mestinon and CellCept for myasthenia gravis\n\nI am a 73 year old woman. I was diagnosed with MG six years ago. I am on Mestinon and Cellcept. I get apheresis every other week, I am not getting any worse and I certainly my not getting any better. I heard that there may be some chemotherapy drugs that doctors are trying now on some MG patients and they are doing fairly well with it. Have you hear anything regarding any new drugs that are being offered to MG patients?",
    "doctor_response": "Hello, Immunosuppressive drugs in treatment of Myasthenia Gravis (MG): Mycophenolate mofetil has become one of the most widely used drugs in the long-term treatment of MG, because of its effectiveness and relative lack of side effects. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Tushar Kanti Biswas, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of deviated septum of nose in a child post injury?\n\nMy 14 month old son tripped and fell face first on hard tile....he hit his nose primarily....there was a small streak of blood with the snot that came out of his nose as he cried very hard and swelling of the bridge of his nose. I took him to the pediatrician right away and while tough to examine him because he was fighting her she said she didn't see any blood pooling or a deviated septum. What are the chances these could develop over the next few days and should I have him double checked by an ENT?",
    "doctor_response": "Hi...I suggest that you get him evaluated by an ENT surgeon and get nasal X-rays too to be doubly sure about the septal deviation. But if you get it evaluated after the swelling comes down then it will be even more easier and authentic.regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause severe pain in back and abdomen, awaiting ultrasound report?\n\nI have been getting pain in my abdoman and back and have had an ultrasound today, i noticed that the person taking the ultra sound spent alot of time in my right rib area and whn I looked at the screen I saw what appeared to be a red dot on my liver or pancrease, I am scared to go back to the dr as i am not sure what news i can expect, hel please?",
    "doctor_response": "Hi, thank you for posting.Severe abdominal pain causes are different. From what you refer I think that you have gallbladder problems.Gallbladder is affected by different infection(bacterial and parasitic) that causes a gallbladder bulge. Gallbladder blockage causes severe abdominal and back pain, nausea.The second cause is gallstone.These causes are treatable and you don't have to worry.To diagnose your problem you need:-Abdominal ultrasound(that you've done).-Abdominal Ct scan.-Fiberoptic gastrointestinal endoscopy.-Blood test, blood sediment rate.-Liver function test.You should contact a gastroenterologist.Dr. Behar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What steps should I take for serotonin syndrome?\n\nzivox triggered serotonin syndrome I have been taking zivox for at least 2 wks, and now I have at least 3 symptoms of serotonin syndrome as listed by pubmed and Mayo clinic websites. symptoms such as over active (loud) bowel sounds and spasms, diarrhea, tachycardia, headache, and diaphoresis. what steps should I take now that I have this knowledge, is emergency intervention necessary?",
    "doctor_response": "Hello,I will suggest you to stop using zivox. Take oral rehydration salts mixed with drinking water. If you can't drink enough, then you can visit your nearest doctor to help you getting rehydrated.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Muhammad Faisal Bacha, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath?\n\nHave been diagnosed with mildly inflated lungs some 4 years agony.I can run 5-9k withou a problem ,, latest lung test gave a reading of 2.9 , I am 51 years of age .Why am I recently short of breath( walked through a construction site full of dust last week).",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. In my opinion, you are mostly having bronchitis due to exposure of dust. Dust is irritant in nature and can cause inflammatory reaction in airways. So patient feels breathlessness. Same thing is happening in your case. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test) for the diagnosis of bronchitis. You may need inhaled bronchodilators and inhaled corticosteroid. Don't worry, you will be alright with this treatment. Avoid exposure to dust, smoke and pollution. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. There is a neck swelling and Mantoux test shows 15 mm raised surface. Can it be TB?\n\nHello doctor, My mother has gone for the Mantoux test and the report stated 15 mm raised surface. There is a swelling on the left side of the neck near the shoulder. Firstly we went to a homeopath because we thought that it is a stone. After 3 to 4 days it started paining after that we went to the mentioned doctor. He has given those medicines and has written some of the tests. And now he has written a new test called FNAC (which I do not know). So today my mother has gone for the test and yet the report is pending.",
    "doctor_response": "Hi. I have reviewed your query and here is my advise. The swelling could be due to infective enlarged lymph nodes, reactive node enlargement or tuberculosis. You cannot rely on the Mantoux test. It is not the test for tuberculosis. To confirm tuberculosis and to rule out the nature of lesion you need to investigate with fine needle aspiration cytology. In this investigation, a needle is inserted into an enlarged node and material taken outside over slide which is stained and examined under the microscope. It is five minutes OPD procedure, so do not worry about that.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will Ubi Q100 help to increase sperm count?\n\nHi Doctor, Am 25 years old ,and my husband is 35 its been one and a half years after our marriage and we are tryinf for a baby. I am having PCOD and recently we came to know that my husband is having thyroid problem (TSH 11, is high other factors is normal)and his sperm count is very less .5 millions/ml and is having premature ejaculation and am having Diamet500 (Metformin) tablet and my husband is having Ubi Q100 and Evion Fort and for thyroid Ebexid 15mg all med one daily for three months (just now only we started medication) Dr, is these medicins help us us to have a baby or is there any side effects for is medicines and this Ubi Q100 how it help to incerase count",
    "doctor_response": "Hello, these are simple routinely given medicines and are very good for semen quality.keep taking them as advised and these are safe medicines so nothing to worryIn case you have any questions in future you can contact me directly on",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there irregularity in cycles after one tries for conception ?\n\nHi We live in abroad we have got married in feb 2009 just after a month got pregnant which we initially did not plan for so we got to abort it on pills and after that we got it checked the doc said it is clean nothing s left so now it s been 2years since our marriage so now we are ready for kids .from may 2011 we started having unprotected but after that i have noticed my period started to skip earlier my menstrual cycle was regular never a day late but from may 2011 it started to skip so I am so freaked out at this point we are so desperate to have kids please help me .",
    "doctor_response": "Hello Thanks for your query. it is good you are planning for kid & started having unprotected sex,Due to unprotected sex your periods have become irregular or skip.There is nothing much to worry ,continue trying.& consult gynec for investigation of both of you.First investigation is husband semen analysis.if that is o.k. then start you test to find the cause. \u2018Hope I have answered your query, I will be available to answer your follow up queries, \u201cWish you Good Health and trouble free speedy recovery\u201d",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from Jaundice\n\nOur grandson is 4 weeks old, had jaundice as a newborn, and has some boil-like eruptions on his bottom near his anus. He no longer appears to have jaundice. Each time one of these has burst, a day or so later, a new one forms. The mum is using breast milk sometimes, as well as calendula oil in a warm wash. What should she be doing?",
    "doctor_response": "HI baby might be having boils due to stool passage which contaminates that area. Please apply a cream with zinc oxide after every stools and keep the perianal area dry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Ultrasound shows gall stones. Options other than surgery?\n\nI have had three doctors recommend gall bladder surgery.    Somewhere I read that Gall bladder surgery is the second most common unnecessary surgery.   Sometimes, according to material I have read, there is not another incidence of gall stones.   I am seeking a second opinion.    I have had two ultrasounds that show gall stones, a blood test, and a one-time incidence of  gall stone pain.",
    "doctor_response": "hi,gallbladder surgery is mandatory if you are symptomatic like...pain abdomen,abdominal distension,fever,jaundice(yellow skin,yellow urine) and loss of appetite(hunger)take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bluish brown spots on the legs, arms, neck and back. Numbness in the mouth. Feeling anxious. Due to hyper pigmentation?\n\nI have had for the last two years brown to almost a blue color spots on my body. Legs, arms, neck, back ect. Every once in a while I break out into red places and my mouth tingles kind of numb and the brown blue places get red around them. It last for about 2 days and when over I new brown blue places. I have around 10-12 total now. I also feel very anious and nervous when the outbreaks happen. I am a 65 year old female. I have been to a doctor and a dermotologist both said it was hyperpigementation. I went to my doctor recently with an outbreak and he looked at the new red spots. Some are small some the size of palm of hand. He said now he does know for sure what it is. He ran blood work and did a chest x-ray. Still did not know.",
    "doctor_response": "Most probably u r suffering with senile purpura . It is normally after the age of 60 at traumatic and pressure sit .Initially it is red than become biuish than black than brown and than go. If ur blood biochemistory is normal than don't worry take tablet of vit C daily for 3 months.For confirmation of diagnosis skin biopsy shd be done and go to dermatologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightening in the middle of the torso?\n\nI just had tightening in the middle of my front torso, right below the chest bone that's in the middle.  It lasted about 10 minutes and now it has subsided.  I have never felt anything like that before.  Any thoughts? I'm 46 yo female with no health problems that I am aware of.",
    "doctor_response": "Hi.The feeling of tightness i the mid-chest can be secondary to esophageal problem like esophagospasm. On a safe side ECG should be done as the heart attack can present in the same way.If the problem repeats it is better to g for upper GI endoscopy also. Take a PPI, antacid gel. If there is no relief you have to visit the ER,..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for bruise on toe post injury\n\nHi. Two days ago I was reaching for a can on the top shelf at the store and another one fell on my foot. It hit right below my last 3 toes. It is pretty sore, it s slightly bruised but mostly very swollen. I m not sure if I should go in and get it checked out. Definitely can t wear a closed toe shoe. Only been able to wear flip flops. Any advice?",
    "doctor_response": "Hi,Thanks  for  your query.From description it seems to be soft tissue injury . Swelling might be due to haematoma formation(collection of blood).You need an x-ray to rule out any bony injury. I suggest you to consult an orthopaedician nearby for a detailed examination. You may get the X-ray of the area affected under his/her guidance. Beside icing and elevating it, you can take anti-inflammatory drug like motrin to reduce pain and inflammationI do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of survival with leaky heart and two holes init?\n\ni have just received news that my 69 year old uncle has a leaky heart with 2 holes ?The doctors werent going to op as he also has something wrong with his liver.He is not very strong at the moment as to why he cant have surgery.Please does he have a chance of survival.",
    "doctor_response": "hello,Chances depends upon whether he has any shortness of breath or not, his heart function in percentage. Both things are fine and liver is not severely damaged then he has fairly good life expectancy.Holes could also be closed with angiographic techniques as well, depending upon the size and location of holes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for angiokeratoma of vulva\n\nI m suffering from angiokeratoma of vuvla. . My doc prescribed me daflon 500mg twice a day n enterogermina empty stomach Early morning. since then i m going through loose stool or soft stool .. urination n pain in left side of my lower abdomen.. is it common?",
    "doctor_response": "Hi,Medicines usually do not work on angiokeratoma, it has to be removed by laser or ELECTROFULGURATION.Hope it helps. If you have any other question please do not hesitate to contact us.Regards,Dr. Atishay Bukharia",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in the left shoulder\n\nI have left shoulder pain. It hurts really bad when i let my arm hang at my side. I also feel it going all the way over to where my neck is. It hurts when i cough and sneeze. If i lft my arm up by my side and reat it there, it relieves the pain. My shoulder is also swollen. I also have my left thumb that twitches at times.",
    "doctor_response": "hi,thank you for providing the brief history of you.this looks like more or a nerve entrapment. why don't you meet up an ortho specialist and get assessed and even can undergo an MRI which will be of help is it anything with the disc issue.also to mention that the neural symptoms like tingling, numbrness, weakness, pain, twitching etc are related to nerve directly at times.also get assessed your shoulder because at times when there is a shoulder injury involved then there will be a weakness and swelling of the shoulder and also a chance where the muscle entraps the nerve and provides unusual symptom.try doing hot water fermentation for shoulder and neck region.also to mention, you can take a help of a physical therapist to help you with therapeutic ultrasound therapy and TENS for your pain and swelling.also the physical therapist will assist you in getting back the strength in shoulder and neck muscles.when the muscles are weak the anatomy of the body changes and the physiology of muscles do not run proper.with the grace of God you will be fine and at good health in future",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this lab test using spinal tab method indicate?\n\nHello!  I just had a spinal tap done. My Dr is looking for MS or another issue that could be causing my symptoms. My test results are. Glucose CSF (67), Protein CFS (31.0), Tube Number (4), Color and Clarity is Colorless and Clear, White Blood Cells CSF (3), Segmented Neutrophils CSF (1), Lymphocytes CSF (85), Monocytes (14). Everything else was a 0 so I didn't put them down. What can cause the Lymphocytes to be so high? Will MS cause this? Thanks Christine",
    "doctor_response": "I read your question and I am sorry about your concern.Those results show an elevation of the protein and the lymphocyte count. Before continuing I must point out that the White Blood Cells (WBC) count must be mistaken because the WBC include all the neutrophils, lymphocites, monocites so number can't be lower as it's their sum.Regarding the question on multiple sclerosis, well yes, it can show high lymphocyte and protein numbers. On the other hand they can change from other causes as well, like from central nervous system infections. So the diagnosis is directed by the history and clinical exam.However usually to search for the diagnosis of MS, the spinal tap is obtained more for the purpose of testing for what are called immunoglobulins and the presence of oligoclonal bands. I don't know if those have been tested, the rest doesn't help much for the diagnosis of MS. Usually the diagnosis of MS if put by MRI, and spinal tap is obtained if in doubt to search for oligoclonal bands.I hope to have been of help. Feel free to ask further questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for nose injury in a child\n\nHi, may I answer your health queries right now ? I have a 5 years old son, fell down 3 days ago and his nose was crooked. He had small nose bleeding and not much problem in breathing. The X-Ray showed no break in his nose, but the doctor says the internal bones are displaced and need to be fixed. Please guide me if it is necessary or may cause any risk for my son.",
    "doctor_response": "nasal injury should be talen care if there us displacement of nasal bones ..it is eother fone before appearance of swelling or agyer the swelling dosappears ...yes it is rewuired to be done as displaced nasal bones give rose to cosmetic deformity..till then child is to be given simple pain killers and antibiotics ..in the mean while please donot manipulate nose yourself",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having pain from minor disc bulge and it is intolerable\n\nIve Had lower back pain for two years and have to now have epidurals For the pain As the pain is so bad. My last Epidural was on was dec 22nd. For five weeks my left knee has been very painful for no apparent reason and now I ve got severe pins and needles and weakness down left leg all the way to my toes and my back is killing me. Please help. I m 37 female and noone seems to be bothered! I ve done Physio, chiropractor , acupuncture etc. I can t live with this pain. MRI two years ago said minor disc bulge but nothing major.",
    "doctor_response": "hi madam, the pain you are suffering might be do to bad body posture while working , sitting or sleeping as your MRI is normal. nothing will help you except for good back strengthning exercises. you initially require a through evaluation and if functional requires some medications to ease your stress. consult an expert orthopedician to solve your problems",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain on the legs,fingers and toes after having a decompression surgery?\n\nhad decompresion surg on L4 and L5 in dec...then infection 10 days later not merca they cut me open cleaned it out 8 days in hospital 6 weeks at home iv bage now 4 months later still crazy pain in back legs calfs ...fingers toes knees im 43 male and active also did 8 weeks physcal theropey ready to move on will this pain get better or will it be with me for life...my dr says im doing good and it will take a year to get better no mri or cat scan or xrays sence infection i wonder what kind of damage i have giving me all this pain i run heavy equetment for a living and need to go back to work",
    "doctor_response": "Hi!Thank you for writing to usThere are chances that some neuro muscular pain is because of neuropathy, i would suggest a neurologist consultation.if i were to treat, i'd like to see a new mri and neurophysiological tests done, An Emg study as well and advice for blood sugar tests., if its neuropathy then pregabelin, methycobalamin, vitamin B1+B6+B12 injections would be preferred.Please consult your doctor and if he agrees, proceed for further evaluation as suggestedThanking youBest wishesDr sunil srivastava",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and tendinitis in arm?\n\nI have had a M.R.I it showed I have Tendinitis pain in my arm. I have been treating this with ice. I also have Calcium in my shoulder. Can that cause the pain and Tendinitis in my arm? I have had Fibromyalgia for many years. I m 87 years young, I live in assisted living, because of the Fibro. I get around very well, I do a lot of walking. Sincerely Beryl Small.",
    "doctor_response": "hi,Thank-you for providing the brief history of you.As you mentioned you are 87 years old and have tendinitis in the shoulder. I Will recommend you to undergo physcial therapy. As with the use of the therapeutic ultrasound therapy and TENS therapy the pain and inflammation can be reduced. Post that, an exercise regimen will be initiated and it will help you to regain some strength in the shoulder girdle. Also, from mild to moderate exrrcises will be made perform with the physiological limits of the pain. So pain should not restrict your exercise plan for regaining strength.I have personally been dealing with geriatrics above 80 at least 10 patients a day. We follow the slow and steady protocol, and we have achieved 90% of the shoulder functions with 99% reduction in pain.I am sure you will be benefitted by the physical therapy. With the grace of God I wish you a healthy life ahead.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I have sex while I am pregnant?\n\nHello doctor, I am 11 weeks pregnant. I had unprotected sex with my husband. Is it safe to have sex during pregnancy?",
    "doctor_response": "Hello. How are you doing? Hope I have clarified your query. Do write back. All the best. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for difficulty in getting erection after using penis extender\n\nhi im 18 years old an i was using a penis extender, i stopped using it after about 2 weeks because a vein was going thru my penis that i never seen before and also i couldnt get erected which i can always do. im scared an just wanna get it back please help me",
    "doctor_response": "DearWe understand your concernsI went through your details. usually mechanical penis extender may not cause any harm to your penis or can cause Erectile dysfunction. The vein you are talking about was there before which you did not notice earlier. Now you noticed because, you started worrying and being anxious about the penis extender and its effects. Nothing to worry. Stop being anxious. Consult an urologist for clarity.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, PCOS. Follicle study done, still could not conceive. Suggestions?\n\nI have been tying for a baby since 5 months, had a thyroid issues, it got controlled five months back, then got to know have mild PCOS ...since then takig treatment, last month had done folicile study, the result was good enough as it ruptured at 22mm on 17th day however cudnt concieve. Doctor said once again go for folicile study. but some relative of mine is saying that i should get HSG checked this month...wat should i do? as the doctor has said i cant go for both the test together....please suggest?",
    "doctor_response": "Hi, If you want to get the tubal patency test done, you should better avoid follicular study in the same cycle as there will be delay in the study owing to the timing of Hysterosalpingogram, as it is done during the follicular phase of the cycle. So, you can ask your doctor to suspend follicular studies in a cycle and go for a HSG test if he finds it reasonable and if you want to get it done. It is always good to exclude problems of tubal patency. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the natural supplements for clearing the arteries?\n\nHi,My pulmonary doctor read my echocardiogram and said I have a hardening of the heart wall.  He asked how long I had high blood pressure, but usually my pressure readings have been low.  Since I had to take Prednisone and antibiotics for shortness of breath (two separate doses of each since October 20th) my blood pressure is up in the 140/78 range more often than not.  What can I do with diet or natural supplements to help clear my arteries and make the wall normal again.Thank you",
    "doctor_response": "**1. Prednisolone causes fluid retention and increases blood pressure, while most oral antibiotics do not raise blood pressure, which means that apart from alternate medicine, you should also seek consultation from your pulmonary doctor regarding the dosage of Prednisone and also the offending antibiotic .2.Since your doctor interpret the findings as hardening of arterial wall, thus  also check with lipid and blood sugar profile, and in Ayurveda treatment is given on the line of 'dhamni pratichya' as a five step approach:i. Exercise: .brisk walking for 45 minutes every day, at least 5 days a week.. Yogasanas: to relax and stretch various muscles, which should be learnt under the guidance of an expert, and also after discussing with the physician as to which exercises and asanaas are permitted to specific heart conditions.. Pranayama: In its simplest form i.e. deep breathingii. Stress Management: Meditation for 15 minutes everyday i.e. positive thinkingiii. Low fat diet:Avoid: butter, ghee,cheese,unskimmed milk,saturated oils,deep fried foods, alcohol,caffeine,tobaccoTake: more of soups,plenty of salads of uncooked or boiled vegetables, sprouted pulses, more of bhajis with minimum oil,skimmed milk, onion,garlic, soya bean, curd of skimmed milk,apple.iv. Elimination of known risk factors: like smoking, weight reduction if obese, strict control of diabetes and cholesterol levels, avoid mental strainv. Drugs: You may ask for prescription medicines like: Tab Abana, Mukta Vati, Arjuna arishta, sarpagandha ghan vati, and have emergency medicines at hand [in bedroom,at the office, in travel kits]",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can antibiotics be taken while on infertility medication?\n\nI m currently using an antibiotic and a conception tablet at the same time, i m trying to get pregnant as i am close to my fertile window. I just want know the effect of the antibiotic on the conception tablet and i hope it wont prevent me from getting pregnant?",
    "doctor_response": "Hello,Thanks for trusting us with your health concern. Since you are on medication to induce ovulation, you should take the advice of your consultant if you wish to add any other medication. Though there is no proven evidence of antibiotics affecting the ovulation inducing agents, precaution is needed. Hope you find this information useful. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach pain?\n\nHi Doc, I been having stoch aches and I do not have any idea what is happening, I have not change my diet, wich consist mostly of vegies and protein, very little carbs, because my sugar is a little high, I am trying to controlled with diet and exorcise. Thanks",
    "doctor_response": "welcome to Health care magic.1.There are several causes for your stomach ache.2.Your symptoms are more towards acute gastro-enteritis.3.Other causes could be cholelithiasis / cholecystitis / renal calculus / bladder infection.4.If you are my patient i would first examine and then ask for an ultrasound abdomen, depending on symptoms the treatment depends upon.5.I would recommend you to get an appointment and do needful investigation as your doctor asks.Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I see the dentist as the tooth fell before the permanent filling?\n\nI just 3 of my teeth crowned, two on top and 1 right under them on the bottom left side. They're temp crowns until 2 weeks when I get my permanent ones. The bottom one fell off, it's under 2 other temp large crowns; and now it's exposed but doesn't work. What should I do? The dentist is closed for 2 days including today",
    "doctor_response": "Thanks for posting your query to HCM.You don't need to worry, just visit your dentist after 2 days who will cement the temporary crown again.Just take a precaution of not biting hard from that side as the tooth is weakened by crown preparation to prevent fracture of tooth.Hope my answer will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest home remedy for the swelling and pain in sentinel pile\n\nHi i am 25yrs old female .I have a sentinel pile , its been paining since past 3 days , it is little swollen since yesterday, today morning I observed the pain increased I lil n swelling tooso I looked in the mirror. Wen I moved it little to the left observed a small pale swelling on the right surface of swelling . I think it got infected. What should I do . I am worried. I am unmarried and I am worried abt this . Wat should I do now. Any home remedies",
    "doctor_response": "Please do not worry. You will have to manage to keep the stool soft at any cost. Take high fibre diet and avoid red meat. Take isabgol husk or fibre supplements regularly at dinner. Sitz bath will be immensely helpful. Add a small amount of antiseptic lotion to a big pan of lukewarm water (as hot as your skin can take) and sit on it with the portion of your anus/rectum dipped in it. Do that for 20 mins a couple of times a day and you would be relieved.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Prescribed vicodin for pain after falling into manhole. How to overcome panic attacks having at night?\n\nI am looking for a pain management Dr. about 3 years ago i fell into a manhole at night, I sued, and ended up setteling for an amount that at the time was fair. I just thought the pain would get better. Went to a really good doctor in S.F. She prescribed me vicodin. About 3 mo. after that I started having panic attacks at night- I'm afraid to go outside and im afraid to drive. Now i'm having hard time ansewering door etc. But she then perscribed me antivan( only for sleep though) She also prescrbed me S Ci",
    "doctor_response": "Hello.Lorazepam addition, it is important the prescription of aeffective antidepressant for panic attacks for example  Paroxetine.I treat my patients with Paroxetine 20 mg per day+Lorazepam 1mg thrice a day when Panic Attacks is the diagnosis.Please consult your local doctor for a prescription.I wish you good health.(If the answer has helped you, please indicate this)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can cause foul smelling dark patch on forehead?\n\nHi doctor, I have a dark\u00a0patch on my forehead\u00a0which smells bad. For this, I have tried laser treatment as well. But, it did not work. Please help.",
    "doctor_response": "Hi. Revert back with the information asked above to a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for vomiting with diarrhea with runny nose and cough\n\nMy son is almost 7. Very high functioning autism which is only important in this situation because of his non-compliance with continuing with tylenol and his refusal to have blood draw and the labs quick reply that I should bring him back when he is ready to comply. He s been sick now for about 3 weeks. Started with 48 hours vomitting...then about a week later diareha, pooed himself while asleep a couple of times...then just seemed to be brewing a cold that never broke until last week he was pretty much lethagic, curled up in a fetal position with head on my chest...sleeping, much decreased apetitie and fluid intake. Had been able to get him to take tylenol intermittentl because he seemed to be feverish. He s had a chest x and its clear. green fluid stool is at the lab pending results for O and P (I think). But has refused blood draw, despite very heavy incentives. Still runny nose and cough. What do you think could be going on?",
    "doctor_response": "Hello! Welcome to HealthcareMagic! One should be concerned in such situations. The condition seems to be due to transient low immunity. But in this case, things have extended pretty long. It will be better if you stay in touch with pediatrician rather than keep giving him Tylanol. The doctor may prescribe other symptomatic treatment for the relief. Once reports are received medicine can be prescribed accordingly. Take care Regards, Dr. Ratna Mulay, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for heart palpitations?\n\nIs a resting heart rate of 43 beats per minute too low of a heart rate? I am 19 years old, 3rd degree black belt martial artist, run cross country, and participate in rigorous Marine physical training. However, I do not run faster than a 20 minute 3 mile. 20 minutes in 3 miles is somewhat average at my age I believe and I have never trained for or ran a marathon. Very respectfully, Patient C",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand you concern but you don't have to worry. This is quite normal.It is quite known for us in cardiology that young, well trained people does have lower frequencies. We call this \"athlete hearts\". This does nt mean that you have to be an athlete. As you do regular physical activity, like martial arts and running this means that you are a well trained person and it is quite normal that your heart is adapt and has lower frequencies, even below 50 beat for minute.Only if you ever feel very tired, if you feel lightheaded or you loose your sense and you find low heart frequency we should worry and make any examination.Other wise, this is quite normal.So my opinion as a cardiologist is that you should keep on training. I encourage and complement you.Hope I was helpful.Wish you good health. Best",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain and swelling?\n\nMy lower back is swollen and hurting bad. It's been slowly getting worse over the past 4-5 weeks, Started with a knot of some kinda and now this. I never hurt it that I'm aware. You can see the area on my back looking in a mirror and it seems like it's purple looking. What could this be?",
    "doctor_response": "Hi, Thanks for using HCM.In my opinion all you need to do is give you back a little rest. For immediate relief have some pain killer along with a muscle relaxant and have proper bed rest for 2 weeks. Do not lie down on soft mattress use hard one instead, do not sit for longer durations and do not travel long distance for 2 weeks . You can also apply some good anti inflammatory pain killer gel on your back. If the pain increases do some hot fermentation locally. After 2 weeks start with some back strengthening exercise. It will help you build you back muscle and you will be able to continue with your routine works  in few weeks with no pain at all. But do not over look at the symptoms right now. As it is still early days for you and you can be fine and back in action with these small things. Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this blood test result indicate?\n\nMy name is Tina I m 199pounds and I m 32 years old I had blood work done and can t figer it out if my results are normal White count was 10.4 and hemoglobin is 12.3 Hematatrit was 38.2 Platelet count was 299,000 Sodium 137 Potassium was 3.8 Chloride was 102 Carbon dioxide 27 Anion gap was 8 Buns was 7 Creatinine was 0.79 Calcium 9.1 Bilirubin was 0.5 Sat was 39 Alt was 47 Alkaline phosphatase was 69 Protein 6.8 Albumin was 4.1 Was negative for salicylates and acetaminophen and alcohol",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Your all investigation reports are normal.  You should nt worry about that.  If you have any symptoms then consult your doctor and take treatment accordingly.  Otherwise no treatment is needed from your reports. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health. Our",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for allergies during spring\n\ni HAVE BAD SPRING SEASONAL ALLERGIES AND IN THE PAST WHEN IT RAINS I WOULD FEEL GOOD BUT i NOTICE WHEN IT RAINS RECENTLY I SEEM TO BE GETTING REALLY SICK INSTEAD OF FEELING GOOD LIKE IN THE PAST. MY ALLERGIES ALSO SEEM TO BE LASTING LONGER THAN USUAL.",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your history and assume that you have nose symptoms of allergies - nose running, sneezing, nose obstruction, nose itching, lacrimation, etc.I would like to make suggestions for you as follows:1. I would suggest you to use montelukast and levocetirizine or cetirizine or fexofenadine for relief of symptoms.2. I would also suggest you to start regular montelukast 2 weeks before anticipated bad season and to continue it through out the bad season (in your case, the spring and rainy season)3. I would suggest you allergy testing for pollens, house dust mites and molds. This will help you identify the substances causing allergies to you as well as to know the measures to avoid them.4. Based on allergy testing, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which gradually improves allergy symptoms by working on immune system.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health ahead.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for severe mouth ulcers\n\nHi, I had severe mouth ulcers around 3 months back begining from throat till the lips. several tests including Liver function test, Kidney function test, HIV, CBC wtc were done and results were normal. I was put on for 10 days and saw relief in the condition. However, after 2 days of completing the course of medicines, i had the same ulcers developing and within a day my entiore mouth region was severly ulcered.. Pl suggest as to what diagnose test needs be done and what should be teh further steps...?? Thanks Santosh",
    "doctor_response": "Hi. Welcome to Healthcaremagic.I read your query. Oral ulcers can be a manifestation of several things like stress, anxiety,underlying diseases like gastric diseases, blood disorders, hormonal problems, medicine side effects, etc.Is your Hb level fine? any history of infection or medication?What is tha usual location of ulcer. Check if the size is small 1-2 mm, round margin, does not change shape.. these could be apthous ulcers.Take healthy diet incluting vitamin c, iron etc. Take multivitamin mineral tablet one per day.Tylenol or ibuprofen can be taken for pain relief. Apply anesthetic oral gel like Mucogel etc before eating anything to avoid burning. Maintain good oral hygiene. Avoid stress. Take proper rest and sleep. Check for indigestion or acidity and refer a physician. Take lots of fluids.If the antibiotics helped you, chances are there is some underlying infection. Refer a physician for Gastrointestinal check up.Hope the answer helps you. Thank you!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Nasal congestion. On allegra, nasonex and antibiotics. Chest x-ray showing granulomas. Taking prednisone. Any suggestions?\n\nI have had bronchial and now nasal congestion on and off since the end of December. I was put on antibiotics which didn t do much. I saw an allergist who performed the skin test and no allergies showed up. It is not asthma. I was put on Allegra and Nasonex , which didn t help much. I had a chest xray which only showed some granulomas but nothing significant. I was most recently put on prednisone and a stronger nasal spray to reduce inflammation and dry up the nasal passages. However, I am done with the prednisone and today I am still congested. My next step is to get a sinus cat scan. WHAT ON EARTH IS THIS??? I often cannot fully speak because there is so much snot and phlegm in my nasal area. It s gross!!",
    "doctor_response": "Hello,Granulomas in the upper airways (nose) or lower airways (lung) needs proper evaluation.The differential diagnoses:1. ANCA positive vasculitides - that require exclusion with ANCA, MPO PR3 blood tests, urea creatinine. If PR3 is positive, Wegener's granulomatosis is a distinct possibility.2. Sarcoidosis - ANCA is negative in this condition where granulomas form, and ACE levels (blood test) can be high in some patients. Steroids with immunosuppressive drugs are the treatment options.I hope that was useful.Best Wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for upper left side chest pain when under stress\n\ni get sharp upper left side chest pains when I get stressed, smoke, and sometimes randomly. smoked for 23 yrs a pack a day. they last about 2 to 3 seconds but sometimes sharp enough to grab my chest. im also experiences tingling in my left shoulder blade that last about a minute. My resting heart rate also sits at 110.",
    "doctor_response": "welcome to hcm...pain lasting for 2 or 3 sec is not cardiac disease ..it is not cad ..coronary artery disease..but as you get pain also when on stress and you are smoker ..please get ECGand chestxray and BP measurements ...please cut down on smoking and decrease weight if you are overweight...if all tests come normal please undergo stressechocardiography ...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly explain about the best medication for major depression from SNRI group?\n\nHello doctor, I need help for my 19-year-old son. He has tried SSRI's which did not work (Then we had the Gene testing done and it showed that he should not be on the one that he was on) and seemed to make him worse. He is now on an SNRI, the same one that his mother is on and that is not working as it should either. We have tried the Ketamine treatments and they seem to help short term (a couple of days). We stop those treatments when he was hospitalized at the end of last year. He was required to be hospitalized to be observed for ECT treatments which were started. We saw a great improvement with the ECT and after about 7 treatments, he was backed off to once a week which seemed to work okay, with only one bad day. Then he was moved to every two weeks and it got bad again. We got him in a few days before the two weeks were up and he still had some very bad days. He is a psychiatrist but my son is not honest with him because he fears being locked up again. I guess my question is this. What medication in the SNRI class have you found to work the best for major depression? (I know he has been labeled treatment-resistant but the anxiety medication he takes seems to work). Is there another class of medication that you would suggest we try?",
    "doctor_response": "Hello. Firstly sir, it is just a brief labelling to broadly differentiate classes, but many people who do not respond to one SSRI/SNRI, will do well with another drug of the same class, so cross switching between classes is also done. Among the SNRI, my personal experience as well as the literature, supports the use of Venlafaxine as superior compared to others. Lets assume that we are going to use Venlafaxine as a primary drug. In non responders or resistant, usually augmenting agents are given. I do not know what agents have been tried for your son so far. But normally, SNRI with mood stabilizer like Sodium valproate or Lithium, or SNRI+low dose second generation antipsychotic, or SNRI plus combinations of mood stabilizer and low dose antipsychotics can be used. Apart from this other classes of drugs can also help such as Mirtazepine, Bupropion, and as and when needed temporary use of low dose Benzodiazipines and Propranolol can also be added.  The goal here will be remission of symptoms or atleast reduction to an acceptable level. In patients with resistance, usually 2 or 3 drug combinations will be needed. Also many psychiatrists do not reach the maximal dosage recommended of most drugs and that also needs to be tried out. Apart from this, you should consider getting 6 to 8 sessions of cognitive behavioural therapy from a clinical psychologist. It will also help and add to the effect of medicines.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes involuntary movements in legs and feet?\n\nmy brother started having movement in his legs and feet after chemo treatment for throat cancer... Dr did a spinal tap to figure out what is wrong...Dr says he has a possible viral syndrome I do not know how to pronounce it or write it testing to discard leukemia... do you know what s the name of this syndrome ?",
    "doctor_response": "Hello, His symptoms could be related to Chorea or Dystonia. Anyway, I would recommend performing a brain MRI, in order to exclude any possible brain lesion. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could itchiness in whole body easing with benadryl indicate seasonal allergies?\n\nI have two qustions. One is my husband has extreme chaffing between his thigh and scrotum. What should he use to promote healing? Second is I have all over body itch ,i think from seasonal allergies. It eases some with benadryl. What else could I do or could it be?",
    "doctor_response": "HI, thanks for using healthcare magicYour husband would need to reduce friction , heat and moisture.This means using cool clothes, keeping the areas separated as much as possible, using barrier creams between the affected areas.In addition, he may need  a short course of a topical course of an antifungal and mild topical steroid (to reduce inflammation).In terms of your itching, it may be related to seasonal allergies. The oral anti histamines should help.Other causes of generalised itching are: liver disease, allergies to medications, thyroid disease, infections such as scabies.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do I need a dental surgery for lower gum and cheek swelling and pain while also taking naproxen?\n\nHi and thank you.  I ate hard granola, hard cookies and now I have pain in my lower right gum and my outer cheek is swollen.  Pain goes away with Naproxen.  But swelling is there.  Could I have injured something on the hard stuff?  I might add I had that dental surgery on that side 3 years ago.",
    "doctor_response": "Hello and welcome.The cause for present swelling appears to be mild to moderate inflammation.you can take anti inflammatory tablets for three to five days.The swelling should reduce by then.If the inflammation does not subside within three to five days, it is best to see your dentist for clinical examination.Hope it helps.Thanks.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can bruxism be treated?\n\nHello, I am 71 years old.  Two years ago, my upper left wisdom tooth was extracted by a general dentist.  Since then I have been hearing a loud thumping, wooshing noise.  The noise is consistent 24 hours a day.  It happened right after the extraction.  I have had numerous of scans, xrays, mri's, and tests, etc. I have seen ENT's, oral surgeons, etc. And they keep confusing my condition with pain, or hearing loss.  I have neither, it's just a loud noise! no pain at all, unless I press firmly at the place where the tooth was extracted.  I am so depressed because no one knows what I am talking about.  I just want this noise to go away. Do you have any idea on what might have happened to cause this noise?",
    "doctor_response": "hellooo....so .you have no pain and no hearing problem....so y getting worried!!!cheer up....there is nothing to worry in this case..in my opinion.the sound can be due the joint problem...tthat might have caused excessive straining to your joint while extraction....usually some people experience pain some dont..you are lucky in that case....so its just due to excessive opening of your mouth while extraction of the tooth....it will be alright soon...have soft diet...try not to open the mouth too wide during yawning...reduce the opening....dont have too big jumbo burgers...and have soft diet for few weeks....moreover be happy and smile...it can heal everything..hope you got the rply...have a nice day!!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Brain CT scan says cerebral parenchyma shows calcified shadow in the occipital region. What does it mean?\n\nCT SCAN REPORT  Axial CT examination of brain was carried out taking contigous 5mm thick sections in posterior fossa and 10mm thick sections in middle and anterior fossa.  Cerebral parenchyma shows calcified shadow involving righ occipital region. Sulci/gyri are normal. The internal capsule and caudate nucleus appear normal. Both lateral ventricles appear normal is size & appearances. Both sylvian fissures appear normal. The basal cisterns are not affaced. Bony window apper normal.  POSTERIOR  FOSSA The cerebellum shows normal shape, sizes and tissue attenuation. Its folia are normal. The cerebellar vermis is in midline showing normal appearance. Fourth ventricle is normal. The pons and mid brain appear normal. The cerebellopontine angles are free.  IMPRESSION:- C.T.  FINDINGS REVEAL-- -- SMALL CALCIFIED SHADOW IN RIGHT OCCIPITAL REGION. can u pls guide me on this",
    "doctor_response": "Hi Mr Manish, Thank you for sending your CT scan report for opinion. As per CT scan report, there are no significant abnormalities in the brain. There is a small calcified area at the back of your brain. The commonest cause could be a healed tapeworm infection of the brain. As of now, no treatment is necessary for the same. However, the definitive diagnosis and treatment would depend on your symptoms, and examination findings. Please get back if you require any additional information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website:   My email: drsudhirkumar@yahoo.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having random blood blisters on hips, pain in legs. Is it signs of cancer?\n\nHello, I ahve been experiencing random blood blisters on my hips. Me and my family are concerned that I might have cancer . Due to blood blisters and have been experiencing pain in my legs. Though we are not sure what might be going on and I am trying to see my GD soon. But what are some of the signs of the different cancers that I might be worried about?",
    "doctor_response": "Hi, what is your age? blood blisters may be from some hematological disease. may occur due to some clotting factor deficiency. anyway blood cancer may also has similar signs. but not to be worried too much, because detailed history and clinical exam is mandatory. no of lesion, size, appearance,margin everything to be looked at. consult a hematologist probably a complete blood count to be done then if indicated other exam like bone marrow biopsy may necessary.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to drink after LFT is normal ?\n\nhi i have recently had 2 lft tests under taken,the first test my ggt was 900,got my second test 6 weeks later and my lft results were back to normal.i was drinking spirits and beer every day for 10 years,and after my first liver test i reduced my alchol down to 2 shandies a week,and my lft was back to normal,is it still safe to drink a couple of shandies per week.im 44 years and 10 10 high and 11 stone.thanks stephen..",
    "doctor_response": "Hi Stephen, Welcome to HealthcareMagic Forum. The normal range of GGT is  0 to 51 international units per liter (IU/L). It could be raised in condition like liver and bile duct diseases. Since your GGT was 900 earlier, what is the recent blood Report of GGT? If you say it has come down to normal, it could have been elevated due to congestion of the bile ducts, which is called cholestasis. Kindly stop your Alcohol intake as you may end up having Liver Cirrhosis and Hepatitis. There will be chances that you may increase your dailyalcohol intake day by day. Join a Alcoholics Anonymous group where in you will meet, men and women who will share their experience and help each other so that they may solve their common problem and help others to recover from alcoholism. Practice relaxation techniques like Yoga and Meditation, Exercise regularly and maintain a healthy weight. Avoid high calorie foods and eat healthy nutrtious balanced diet which should include fresh fruits and Green Leafy Veggies. Wish you Good Health, Take Care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be done to to treat the shakiness and pressure in the head after pain under the ribs?\n\nI saw my doctor FRIDAY after intense pain in my right side under my rib he has referred me for a scan of gallbladder which I am waiting to hear a date for the pain has got better but I m still uncomfortable when I sit or bend this I can cope with but Ive had this shaky feeling all over and pressure in my head since the pain first started which I m finding hard to deal with should I contact my dr again, what s causing it and is there anything I can do to releive it I ve already gone on a low fat diet and been exercising gently",
    "doctor_response": "Good day!  Once gall baldder etiology is ruled out which i am sure it wont be as such presentations are classic for galbladder issues like stones or infection. Relux and pancrease infection also present this way. f all clear it will be simple spasm of muscles and will resolve with some antispasmodicsgood luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sudden dry cough attack with allergies\n\nI am a 45 year old man ,in 22 year age i had go throw diagnostic check for allergy and found that allergic with dust , smell and potato , i have taken many times common allergic treatment for relieve. but now from last 4-5 years , I have experienced that no cold and no fever ( As earlier ) but sudden dry cough attack for one or half hour ( When I came in touch with dust or smell or weather change), than I feel very dull and week, Please suggest me the medicine and preventive majors.",
    "doctor_response": "Hi  . As per your clinical history it appears as you are having allergic rhinitis.If I were your treating doctor, I would advice you  Steroid nasal spray , saline nasal drops & steam inhalation .Also use warm water gargle when cough start.Use mask in polluted & dusty environment , Plenty of fluid.Hope this information helpful to you, take care and have a nice day.Regards - Dr KK ( Karade )",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medications to treat high blood pressure\n\nI take Captopril 25 mg & Metapropol 25 mg twice daily, my BP usualiy 145/30 or a little lower times. the last two days my BP is at 112/60 - 120/70 . Ocassionaly my BP drops too low 85/45 after eating breakfast. Should I keep taking my meds even tho my Bp is lower than normal?",
    "doctor_response": "Hi,I would advise you to omit your Captopril dose when you have blood pressure equal or less than 120 mm Hg, if you notice it raises, then take the tablet.Wishing you good healthIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for blood in cough\n\nHiI am having blood in my cough from last 3 days...although not that much severe ..but m too worriedwhat could have been the reasons behind it ,,... and how serious is it???I have taken some painkillers last week as i felt severe headache..doctors said it is migrain pain and i was given some antibiotics...pls suggest",
    "doctor_response": "HelloI find your concern very important.If you are sure that the blood comes from coughing despite from  your clinical situations you should have some examinations as follows:Blood countChest CTFibrobronchoscopyPPD testSputum smear for tbAccording to the above tests  results it will be and the diagnosis and treatment too from a lung diseases.Wish you good healthDr.JolandaPulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had wisdom tooth extracted, put IV on arm, large purple bruising noticed. Is this normal?\n\nOn Saturday I had all 4 of my wisdom teeth extracted...I was put to sleep during the procedure, so they put an IV in on my right arm (right below my elbow )...the following day I noticed a large purple bruise where the IV was placed...it s now been 5 days & the purple bruise is gone but now a blue, black, purple bruise has replaced it & now takes up a large amount of my arm...it seems to have spread & have gotten darker with time...is this normal?",
    "doctor_response": "Hello there and welcome to HCM, Your extraction of wisdom teeth is no where related to the bruise on the arm.As you have described purple reddish bruise  i can suspect formation of hematoma on the arm due to long placement of scalp vein or misplaced scalp vein. i suggest you to visit a physician and get it confirmed. If it is hematoma it will resolve in few days with proper medication . dont worry but see a doctor before the condition gets worse. get well soon and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does fluctuating blood pressure indicate?\n\nMy dad\"s blood pressure has been fluctuating too much day to day. One day it will be 160 over 102 and the next day it is 102 over 60. What does that mean when the systolic and diastolic readings flip flop day to day in such a drastic way? Is this something very serious?",
    "doctor_response": "Blood pressure recording should be done in a repetitive pattern and not sporadically. Single measures should not prompt concern. Decisions are best made from an average value from a two week span. Record his blood pressure on a schedule every day. It should be taken seated after a 10-15 min period of relaxation. The two week average is the best way of gauging concern.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does my hubby need to go the the ER immediately as he hit his head?\n\nMy husband hit his head hard several times while in a small plane experiencing turbulence last night.  Now it's been about 30 hours later and he is complaining of being very sleepy and feeling nauseousness all the time. Does he need to go the the ER immediately? What about in the morning? Would an urgent care clinic suffice?",
    "doctor_response": "Hi, thanks for using HCM.Your hubby's symptoms could be due to effect of flight travel or head trauma.Better to consult doctor in ER to get examined to rule out any head trauma. Not to worry, but better to get checked .Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Remedy for lumbar spondylosis, diffuse bulge with right lateral protrusion as shown in MRI\n\nsir, from mri scan following impression : lumbar spondylosis, diffuse bulge with right lateral protrusion of L2-L3 IV disc, compressing thecal sac & exiting nerves on right side with left neural framinal stensis, diffuse bulge of L3-L4& L4-L5 discs causing B/L neural foaminal stenosiskindly help me , two neuro surgnes advised me to go operation  for which i dont want pse give me advise of what is the remedy. if i dont do go for operation what will be the effect in future and now I am taking german (indian) homopathy medicne for time being pse sir help me  thank u",
    "doctor_response": "Hello welcome to HCM, Surgery for herniated disc is absolutely indicated if 1.You have weakness in your legs( inability to move any part of your legs). 2. You have problem with passing urine or stools.3.your pain is unrelenting and non responsive to conservative measures which include bed rest,physiotherapy , nerve numbing medications and anti inflammatory medications all tried for a period of 12 weeks.If any of three conditions   apply to your condition and it is affecting your quality of life and your job, getting the surgery done at the earliest  is advisable. The source of pain can be inflammatory or mechanical. during the initial few weeks sine the pain is related to inflammation it has more chances of getting resolved on its own , but once the pain is related to mechanical pressure it is unlikely that your pain will resolve without relieving the mechanical pressure by surgery. If the pressure is due to inflammation you might do well even without surgery , whereas if it is due to mechanical pressure it is likely that your symptoms will progress if not operated.Hope this answers your question.With Kind regards,Dr. Shashidhar.B.K Spine surgeon Bangalore",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does S shaped scholiotic curvature of the spine and Medial tilting of the superior pole of both kidneys indicate?\n\nI had a Cat Scan report stating I have S shaped scholiotic curvature of the spine and Medial tilting of the superior pole of both kidneys that could be seen with horseshoe kidney also mildly increased uptake left lover lumbar spine at L3-L4 facet joint.....I am just researching What does this mean .... I am considering having a nuerostimulator implant due to all the spinal issues....but I now see this on my report.....Is this related to arthritis of the spine, sciatica and neuritis and fibromyalgia?",
    "doctor_response": "Hello, I have studied your case. This can be arthritis of spine due to deviation in mechanical axis.There can be associated disc Protrusion leading to neuritic pain.You may need MRI spine to get detail diagnosis.For symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for cold , flu and non itchy rashes on neck\n\nHi I had a cold or flu which I m over now but I developed a non itchy rash on my neck shortly after. This has happened efore after I had a cold. The rash on the side of my neck is spots, about 8 of them red slightly raised with no head. Just wondering why this happens?",
    "doctor_response": "HelloLooking at your history this could be viral exenthema due to viral infectionif you can upload me a photograph i will be able to guide you betterIn my opinion you should consult your doctor for examination and a battery of tests like blood for hemoglobin CBC CRP ESR liver function test you can take acetaminophen with anti allergy drugs like levo cetirizine for cold and fluas such it is selikely limiting disease which will subside as time passesThanks for using our servicesregards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can HCG cause tumors on your liver? I went on the HCG diet for 43 days FEB. 2010. Went in for a ct scan for something unrelated and they found a growth on my liver. The size of a large orange. The doctor does feel that it has been there for a long time. Just wondering if the HCG could have made it bigger. I am getting a MRI next week. Hopefully it is not cancerous.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. HCG doesn\u2019t cause any liver problems. The tumor may be benign most often probably an adenoma or hemangiomas. Get an MRI done and I\u2019m case of any diagnostic confusion, better to get a liver biopsy done. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is this dosage of Percocet safe to be taken for body pain?\n\nI am currently taking 10 mg Percocet after being on Lortab and Norco 10 mg for over 32 years. My Doctor wanted to see if the oxycodone would give me better pain relief. I seems to be helping somewhat more, but not a whole lot. I was taking 6 Norco per day and now am taking 5 Percocet. I want to know if Percocet comes in a stronger dosage than 10mg; and if not, what we be the next step from 5 Percocet per day. Thanks",
    "doctor_response": "The narcotic in percocet does come in higher doses BUT with higher doses than this there is a very real risk that 1) if you stop you will feel quite bad for 1-2 weeks (withdrawal) and 2) this is starting to be a bad pattern of use (addiction).But then, it depends a bit on the type and aetiology of the pain. if something goes in the pathway of a nerve, then that is the nerve involved. Nerves are long and the pain is in a belt-like long pathway. Smaller areas are smaller nerves. This also tends to say what might  be going on. Obviously if there was an injury to the area and then there was pain outward from it \"hit a nerve\" would be a possibility. Sick nerves are MULTIPLE areas and tends to be the TIPS of the nerve not the whole nerve. And the point is that nerve pain can also be treated by nerve pills like anti-epileptics.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for acute pain in left side of chest\n\nhi i m kuldeep, today I had acute pain in left side of my chest, my ECG is normal as per doctor, they advise me to go thru tests etc... but I feel normal right now.. I am smoker, carstrol problem and obesy.. do you thing I should go thru these tests.. please advice",
    "doctor_response": "Hello, Since you have a history of smoking, are obese and have Cholesterol with pain in the left side of your chest, you should visit ER, or a Cardiologist & get physically examined. For pain you can take Acetaminophen (Tylenol) & PPI's like Propantoprazol, one sos when pain. Get all investigations, CBC, Urinalysis, Lipid function tests, X-Ray, ECG, Stress test, (CT & MRI if required) done to detect any developing coronary artery disease. Your treatment will depend upon the pathology detected. In the mean time stop eating oily-fatty food with trans-fat, red meat, avoid alcohol intake, stop smoking or addictions if any. Stay away from stress & take veggies, berries, fruits & home made food. Hope I have answered your question. Let me know if I can assist you further. Take care. Regards, Dr. Nupur K. General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of an abdominal pain?\n\nI have been having a pain in my right upper abdomin for the past two months that is progressively getting worse. I work in a lab and had a cbc done with an elevated neutophil count, AST and ALT. Should I be concerned about possible liver issues. I do not have any jaundice.",
    "doctor_response": "Hi! Good evening. i am Dr Shareef answering your query. The investigation reports shows the cause to be of infective origin with an elevated neutrophil count. If I were your doctor, after a detailed physical examination,  I would advise you for an ultrasound whole abdomen and a CT if need be for proper evaluation of the intra-abdominal viscera. Further management would depend on the reports of the investigations and examination findings. Till then, I would advise you for a proton pump inhibitor, bland diet, and an anti spasmodic if the pain is unbearable.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for an infection in a baby?\n\nHello doctor my ten months old baby has some infection and admitted to the hospital .but last Wednesday she was discharged the doctor was gave some antibiotics to have but now she is watery loose motion nine to ten times I am not feed her any solid I am only feed her lots of water and milk but she feel very weak and not stop the motion what can I do please help me doctor",
    "doctor_response": "Hello,Some antibiotics like Amoxicillin can cause diarrhea. Give ORS solution to your baby. If she is not vomiting, then probably she would not need intravenous fluids. Limit milk and feed more semisolid cereals. Milk can aggravate diarrhea. Add probiotic sachets like Reflora-R. Make sure baby is not having a fever, abdominal pain, bloody stools, or baby is becoming lethargic. Under such circumstances, you will need to admit baby.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Khan Shoeb Mohammad Sher Mohammad",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is early stage of lichen plasus pigmentosus curable ?\n\nHello sir, I am 24 year old and diagnosed with lichen plasus pigmentosus. It is at its early stage with few spot on neck and face . I have family history of this disease. I am prescribed with skinlite cream containing hydroquinone . I want to know that whether my condition is curable and how long it will take to cure. Please help me out.",
    "doctor_response": "Hi! neha, Welcome To HealthcareMagic forum, Neha ,LPP  is a chronic problem and sadly its response to the  treatment is very variable.I am sure your treating dermatologist would have told you. It appears as ash colored patches over flexures of body and chest. You can apply skinlite if you want ,but the more specific medicine is oral vit A .We usually give it for 2 weeks ,once a month and then repeat it next month too. Similarly we can 3 such cycles .In resistant cases even oral retinoids can be tried .But for that you should consult a good dermatologist .Also before giving retinoids one needs to undergo certain blood investigations and take specific precaution (esp in females).So discuss the possibility of retinoids with your treating doctor.Its a excellent tablet for pimples ,but works good for pigmentation too. If you are using skinlite over exposed areas of body then don't forget to use a good spf sunscreen in day time. I hope this answers your question ,if you have any further query you can write back to us. regards, Dr.chawda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dry cough and sharp pain in the right chest\n\nFor the last 3-4 days, I get sick in the evening. I j=have a hacking dry cough with extreme spasms, a sharp pain in the upper right chest (rightly the middle of the ribs) which is poking out (not a stabbing pain), dizziness, discomfort. I am very a active 68 male usually excellent health.",
    "doctor_response": "Hello dear , hiWelcome to Healthcaremagic.comI have gone through your concern in depth .*  This seems  in relation with irritation of pleural surface through     underlying  bronchitis .*  Suggestions for  better  recovery-  Antibiotics , decongestants , bronchodilators  , analgesics with  or     without  steroids  as  per  the  clinician  concern .-  Deep breathing exercises , YOGA will recover  faster .-  Avoid exposure to dust , pollen ; if needed use triple layered face mask-  Maintain hydration with plenty of liquids .-  Balanced nutritious  diet .-  Avoid smoking , alcohol if using .Hope this clears your query .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does abdominal pain lead to black outs?\n\nMy daughter is experiencing abdominal pain that was kind of burning right in the middle of her stomach, under her ribcage.    She also is light-headed, and she has these involuntary twitches or shakes through-out her body.  She does not have a fever.  She has been eating differently lately....salads and fruits, and smaller portions and very little bread.  She has lost a lot of weight within the last 3 months...maybe 20-30 pounds.  She looks great now, and exercises a lot.  She was running today, and almost blacked out.  She just took pepto, and now that she is laying down...she is doing better.  Should I be highly concerned?",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.Yes , This is of a concern and I think needs to be investigated for the sake of ruling out any underlying problem / Medical condition which should not be missed out.I would suggest the thorough medical / physical check-up by a Doctor. Thorough Clinical examination can either declare this as an incidence or can lead to further investigations.Sometimes it is better to observe such child for psychological changes - they are so prone to. A good clinician also takes care of this too .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is throat cancer,related with swollen tonsils and spots on throat?\n\nMy 18 year old daughter has a really nasty looking throat. It comes and goes but never completely goes away. It is full of holes and white looking deposits. Her tonsils swell up to almost touching. She never runs a fever and it only gets sore sometimes. She does lose her voice once in a while. And it always looks like hamburger even if its not bothering her. One doc says its normal. One doc said look into throat cancer. What is your opinion. Please help us.",
    "doctor_response": "Its not a cancer its probably related to URTI and tonsils are infected and enlarged. with proper treatment of antibiotics for 5 days with salt water gargling this will improve",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can one prevent the chocking effect during a panic attack?\n\nHello, i get panic attacks where it feels like im chocking when i swallow food causing me not to eat. How do i stop that chocking feeling? Also, I hyperventilate when i have panic attacks and was wondering if inhalers help stop my hyperventilating and calm me down ?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. No, inhalers will not help you to stop hyperventilation. Your all symptoms are due to uncontrolled stress, anxiety and panic disorder. In my opinion, you should definitely consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on it's solution. Along with counselling sessions, you will also need anxiolytic and other supportive drugs. With proper treatment, your symptoms will subside and you will remain calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chronic venous insufficiency?\n\nHi, I am asking a question for a friend. She is 60 and has recently been diagnosed with chronic venous insufficiency and is having a blood test to see if she may have an inflammatory arthritic condition that is causing pain in her hands.She also has fairly high blood pressure for which she is taking medication.She has finger nails which are paler at the nearest point and pink/ red at further up the nail. Some of the nails are half and half , and on some it is a strip of colour.She has read that this can be a sign of kidney disease and is very worried. Naturally she will make an appointment to see her doctor but I am wondering how likely this is to be kidney disease  or if it can be connected to her other problems or just be a sign of ageing,Thank youKit",
    "doctor_response": "Thanks for your query...her symptoms do fit in one and half syndrome category but it is very rare syndrome. ..sometimes half knowledge causes considerable distress..she has already been checked for inflammatory arthritis which may cause kidney disease too...Please advuse her to consult a physician and not worry too much.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a painful lump at the base of the neck?\n\nHi! I am a sixteen year old girl about 140 pounds. I have a pretty big lump at the base of my neck, the top of my back. It feels a bit like bone and hurts when I press down on it. My back's been hurting a lot lately and I'm afraid it might be because of that, even though I've had it all my life. My parents don't want me to get it checked out because they think it's just fat, but it feels like more than that. It makes me feel really self conscious and it hurts a lot.",
    "doctor_response": "Hi.Thanks for your query and an elucidate history.I can understand why your parents do not want the lump to be shown. They may be fearing the scar if the surgery is required. I would advise at least to go for ultrasonography and FNAC to know whether this is just a diffuse lipoma or something else.You are 16 years old and a long life in front of you. If the lump grows more and more the scar of surgery will also be more. Since it is hard like a bone chances of a lymph node or some other problem is more. Yes, this can definitely cause backache is the nerves supplying the lower area are pinched / entrapped. Please insist parents to go for investigations .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy skin post intake of Quinine, Zantac and Penicillin?\n\nI just had two teeth pulled from an infection in the gums.  I took the penicillin at 4:30 at the dentist office.  Then again before bed at 9pm as instructed, along with tylonal and advil.  I also took my nightly medication of zantac, along with vitamins.  Everything was fine until I drank quinine soda for leg cramps and then I began to itch everywhere.",
    "doctor_response": "Hi..Thanks for the query..Well, itching all over the  body is an indication of the most common cause that is an allergic reaction..As it has happened after taking the drink then it is probably an allergic reaction to any of the ingredient of the drink..However it can also be a delayed allergic reaction to the antibiotic that can very much begin after 2-3 doses of the medicine..So my suggestion to you is to as of now take anti allergics like Benadryl, Levocetrizine, Allegra etc..You can also apply Calamine lotion to sooth the skin..In case if still there is no improvement or you continue to get the symptoms then consult an Emergency room or your Dentist and get evaluated so that he can change the antibiotic..If still the symptoms persist get an allergy test done to rule out the exact cause and avoid exposure to the same to avoid allergic symptoms..Hope this helps..Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for disc desiccation at T12-L1 and L4-L5 levels\n\n1.Moderate degree of disc desication noted at T12-L1,L2-L3,L3-L4 and L4-L5 levels. 2.Broad based posterocentral and right paracenral herination of L4-L5 disc causing compression of transversing nerve roots at Right lateral recess and right neural foramina. Kindly suggest what is the action to be taken. Regards, Rachana",
    "doctor_response": "Hello, With my clinical practice of 12 years most of the cases with disc herniation, disc degeneration, disc prolapse have responded well to a physiotherapist. As mentioned by you about the MRI report but the main thing which is missing is the clinical symptoms like - pain in lower limb/s, tingling, numbness etc. As MRI is a diagnostic procedure and not a diagnosis we need to compare the clinical symptoms with the MRI reports. If there are no clinical symptoms the MRI cannot be considered as a diagnosis. It is a diagnostic tool to correlate the clinical symptoms. If you have any of the above mentioned clinical symptoms than the treatment part will be this way. If the pain is radiating in nature then first need to try out McKenzie maneuver which you can find online, as this maneuver helps to centralize the pain and thereby stopping the radiation of the pain. Post acquiring the McKenzie maneuver position one needs to use hot water fermentation over the lower back to provide the soothing effect. Post which once pain level falls below the level of 5 in vas Scale of 0-10 where 0 is no pain and 10 is maximum pain. Exercise the core, extensors group of muscles of the spine, hip, thigh, leg, in short, the whole lower limb. In case you are non-diabetic then using icing post-McKenzie maneuver position will also be okay and rest steps as mentioned above. In case you trying for the first time and not getting an idea of how to perform in accuracy than taking guidance from a physiotherapist should be helpful. My experience of 12 years has produced a maximum recovery with the equal support of the patient for this condition. Most of them are now playing squash, marathon runners, mountain climbers etc. A normal life and more than that can be achieved is a good interest is provided in the case. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness,tiredness and BP at around 130/50?\n\nthe last few years my blood pressure has been running at around 130/50. my blood pressure use to be about 110/70. I also developed many PVC/PAC s and heart palpitations. the cardiologist gave me a 24 Holter monitor and an electrocardiogram and found nothing, but I still feel like something was missed. the spacing between the diastolic and systolic is worrying, I can t handle physical activity like I use to, and I get dizzy when I get up from sitting or laying down....any ideas?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Since your extensive work up for heart diseases is normal, no need to worry for major heart related diseases. Sometimes, hypothyroidism, anemia and vitamin B12 deficiency can cause similar symptoms. So get done thyroid function test, hemoglobin estimation and vitamin B12 level. You may need drugs or supplements on the basis of these reports. Don't worry, you will be alright. Avoid stress and tension, if you are having stressful life. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for high alkaline phosphate\n\nhi! i recently had Liver Function Test. In my test report everything is normal but Alkaline Phosphate is high. Its range is from 35-104 and i have 267 in my blood report. Could you please tell me what is its role and what precautions should i take and is there anything serious?",
    "doctor_response": "Hello! Thanks for putting your query in HCM. I am a Gastroenterologist. Until it is three times elevated it has got no significance especially when it is increased in isolation.I hope I have answered your query and this will help you . Wish you a good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cystic pimple under eyebrow, swelling, tried popping it, infection. Cure?\n\ni have a cystic pimple just under my left eyebrow. it is common for me that when i get a pimple near my eye it causes the area to swell some. this pimple had been growing for a couple of weeks and was not coming to a head so i finally decided to try and drain the fluid out of it but when i woke up this morning it just seemed infected and my eyelid is so swollen i do not want to go into work today - it looks awful",
    "doctor_response": "Hi, Thanks for writing in. Acne is caused by hormonal imbalance. Blockage of sebaceous glands causes papules and pustule and cystic acne. Acne is treatable now.With correct treatment all your pimples , scars and dark spots can be treated. To start with you have to apply Brevoxyl cream twice daily . Also you can use anti acne face wash like Brevoxyl face wash. For swelling you can take tab ibuprofen.Also you can apply neosporin ointment over the area. Discuss the option of Isotretinoin with your dermatologist.It will have rapid effect. Hope this helps. Regards. dr Sudarshan. MD dermatology.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I recover from back pain without surgery?\n\nI am 32, 5'5 120 and I got an MRI for back pain. The results said I have L4-5 mild bulge and moderate annular tear. L5-S1 moderate disc extrusion, facet djd is mild bilaterally. Moderate to severe left stenosis and moderate right lateral stenosis near SI roots.  I am scheduled for epidural next week, but want to know if I can heal from this or is surgery the only option",
    "doctor_response": "Hello, I have studied your case.Your MRI says foraminal protrusion causes foraminal stenosis which leads to compression of exiting nerve root which later on supply right lower limb [leg].Due to compression of this nerve root there is tingling numbness in your leg and pain associated with it.Medication like methylcobalamine with muscle relaxant and analgesic will reduce pain; you can take them consulting your treating doctor.You may consult physiotherapist for further guidance. He may start TENS, or ultrasound which is helpful in your case.I will advise to check your vit B12 and vit D3 level.As MRI shows disc compressing on nerve root then surgical decompression is permanent solution.Epidural may give long term pain relief.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is cough on chest a symptom of primary complex in 3 year old?\n\nhello sir my son is 3 years old. he was suffering from cold and cough since august 2013 and after treatment of 10 days he get relaxed but after that he was suffering with the same as the weather conditions change. Dr. told that it is seasonal cough and cold. but when X-ray was taken (March 2014) on the recommendation of one of the doctor cough is deposited in his chest. i want to know that is it primary complex / TB. thanks",
    "doctor_response": "Hi,It seems that he might be having allergic bronchiolitis giving this problem.Exact reading of x-ray will be more helpful for any doubt about primary complex.To rule out primary complex some other investigation might required like,Complete blood checking like TC, DC, ESR etc.Montoux test.Weight loss.After all reports we can have clue about his diagnosis.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest an alternative remedy for infant viral fever apart from Levolin\n\nhi, my baby is 11month old, suffering from viral fever & cold,cough from three days, i am giving levolin from three days, but still cough is not gone, sholud i cahne the medicine like ascoril or continue with levolin , also pls tell anything else i can do for his throught as he is only taking milk due to this problem,",
    "doctor_response": "HelloPlease continue with levolin(levosalbutamol a bronchodilator).Ascoril contains terbutalin(also a bronchodilator).I dont think ascoril is needed as already you are giving levosalbutamol.You amy give some antiallergic like cetrizine for better effect.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could fever in toddler be due to swelling of adenoids?\n\nmy three year old child has had fewer three times in the past one year and two times we were told by our doctor that it was due to swelling of ADENOIDS. can you please clarify more. why does this do occur . how to take preventive measures and what should be the diet followoed during such perriod",
    "doctor_response": "Hi, if you want me to answer your question directly if adenoids can cause fever I would say yes because they can be a nidus of infection. But at the same time, the most common cause of fever in young children is not adenoidal hypertrophy but it is a simple viral illness. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can IVF treatment be undertaken when suffering from TB?\n\nMy name is Poonam. My age is 36 and weight is 58 Kg. I have taken ATT treatment at the age of 32 years. Now,  I am going for IVF treatment from AIMS Hospital.  Doctor advised to go for Blood Test of various Tuberclosis tests but they were negative.  Then as per the advise of the Dr., II went for PCR for M. Tuberculosis (Sample-EA) from AIMS Hospital.  The result of this test is Positive.  Now, sir, please advise me whether to go for IVF Treatment or first to take course of medicines for Tuberclulosis treatment?",
    "doctor_response": "Hi Poonam, i will be answering your question, hope this will be helpful to you.First you should finish the ATT and then go for IVF, i will not suggest you to undergo IVF while you will be taking ATT as there will be risk of failure of IVF or else there might be some defect due to ATT.Take proper nutritious diet and take medicines at time. dont miss ATT, even a single tab.Get well soon.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes electric shock sensations in head followed by fainting?\n\nI was laying down and I felt like my head had an electrical current running through it, then I passed out. This happened 3 times. You should also know I have heart issues, an AICD and pacemaker, ejection fraction 30%. Is this a symptom of something I should be concerned over? I have passed out before and they believe it was orthostatic hypotension. I have been under a lot of stress lately.",
    "doctor_response": "I think you may be having this manifestation due to heart problems. Low ejection fraction and malfunction of pacemaker may cause transient hypoperfusion of brain presenting as loss of consciousness. If seizure was also present with unconsciousness then it may be stokes Adam syndrome. You need to consult your cardiologist for checking pacemaker. An eeg of brain and neuroimaging may be done. Hoping you recover early.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest therapy for high BP followed by headache & dizzy spells\n\nHello. I am only 19 years old but my blood pressure tends to run really high. It generally runs around 150/100. I also have been having a lot of headaches lately and dizzy spells. I won t be doing anything and I will out of nowhere feel intense dizziness and vertigo for a few seconds, and then it goes away. This happens at least once a half hour. I m not overweight. What do you think? I m trying to get into the navy, so I don t really want to go see a doctor about it until after i get in, but I don t know how serious of a problem this is or if it can wait that long. I do have a history of high blood pressure in my family.",
    "doctor_response": "HelloTaking into account your family history of high blood pressure and your current symptoms, I think you really need to see a cardiologist as soon as possible.We should rule out cardiac issues first. Perhaps you might have inherited heart defects since birth which are giving symptoms at this point of life.I am really sorry you need to see the cardiologist as soon as possible. Should correct the high blood pressure. Even if you go in navy, they will check your blood pressure. If they find it high, then they will ask for cardiologist appointment.Hope you'll do the right thing.Dr.Albana Sejdini",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why am I suffering from mood swings and memory loss?\n\nConfusionLately ive bin suffering from terrible mood swings,memory loss,confusion,lack of concentration.I hav checked my diet to see if im eating anything different but nothing i can put my finger on.Ive started taking vitamin D an cod liver oil along with a multi vitamin,has that got anything to do with d way im feeling",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. First of all you should ask yourself, why you started vitamin D,cod liver oil along with a multi vitamin. Was these prescribed by a doctor? If yes, you should consult your doctor appraising him of the symptoms. If NO, that is the reason for your confusion. You are worrying too much about your health. Morbid anxiety about health and serious diseases is called hypochondriasis. You shall need psychotherapy treatment for it.Thoughts are there to come and that is the duty of the brain. let the thoughts come. You need to divert the thoughts to more priority ones. Means be busy and divert thoughts. Relaxation and meditation plays an important role in controlling OCD. Plenty of water, oxygen and exercise most important. For more psychotherapy techniques, You can post a direct question to me in this website. Include every detail as much as you can. I shall prescribe some psychotherapy techniques to control your condition. I am sure that the techniques should be a success.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes c3/c4 spinal cord compression?\n\ni had a mri in 2010 that showed abnormal t-2 cord weight. 2011 mri that showed signal alteration in the odontoid process, 2011 2 level acdf, 20113 mri abnormal signal and 2014 degenrative signal alteration in the anterior/inferior corner of the c-3. i currently have c3/4 spinal cord compression and facet overgrowth, what might be going on with me/",
    "doctor_response": "u seem to have CV junction anamoly. In such cases surgical correction is needed if there is weakness of limbs or urinary problems.if disease is not involving spinal cord.....then no need to worry.....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest alternative medicine for panic disorder\n\nGood day doc,I been takin rivotril for maintenance  sometimes 1/4 now 1/8 tablet for almost 3 yrs now as for my panic disorder, how can i stop this med gradually? Is there an alternative natural way? coz my sgpt is153 last month, my doctor advise to take silymarin and now my sgpt is 83",
    "doctor_response": "Hi Dear I understand your concern. Panic disorder can be treated  with SSRI. SSRI is the choice for panic attacks and anxiety disorder. Peroxetine is choice among SSRI. Combination of peroxetine and revotril can be uaeful Do take advise from psychiatrist. Still have a query then feel free to ask. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is left basal pneumonia contagious?\n\nis left basal pneumonia contagious? i had may chest xray last saturday for my employment but the result was \"left basal pneumonia is not ruled out.\" the doctor said since i have cough that would be the result. i lost my job because of that. is it possible to have my xray again after a week?",
    "doctor_response": "Hi,Dear,Thanks for your query to HCM.Dear I read facts of your query and reviewed it in context to your query health issues.I understood your health concerns and feel Concerned about them.Based on the facts of your query the reply of your query is-If its  TB with basal pneumonia on left side-it  would be contagious and carries social risk of spread of TB and affection of colleague employees. dangerousJust check up with family Physician and Chest Physician to  rule  out above possibilities.Many other problems need to be ruled out, which could occur from left basal pneumonia, in not isolated from working place.Do's-Start treatment with Cap-Augmentin  1 x 2 times / Brohchodialators / 1 x 2 times a day x for 10 days time.Repeat X-ray Chest with recheck from Second Radiologist, after a week is not going to help Much.Support treatment with High protein diet / Vitamin Supplements/ enough fluids and Rest would help you to recoup fast.Before starting Antibiotics,Get Sputum AFB and LCr test of sputum  and IGRA blood test to fix the diagnosis and cause of the Left Basal Pneumonia .This would help  to assess  the extent of the damage in the lungs and the possibility of spread  to contact people around.Other causes  needs to be ruled out by Consulting Chest Specialist.Don't be callous to get examined with your doctor.Just don't worry and be patient and co-operate with your doctors,till you verify with your attending doctors.There is Need to Check with Chest Physician , if things don't recover.-Other causes need to be verified with your  Specialist doctors, as the facts may be different what you submitted.-For this Second opinion from Consulting Chest Physician-is needed who would do proper investigation after proper physical assessment to resolve your health issues.-for early recovery-please follow above do's which would resolve your complex health issues.Hope this would help you to treat your health issues in the best way possible. Welcome for any further query in this regard.Good Day!! Dr.Savaskar M.N.Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for skin rashes\n\nskin rashes hi I am a 30 year old female. I've been having these rashes that look like  mosquito bites for one week already. I've taken benadryl and got an allergy shot at work. I've washed my clothes and cleaned my room. I've tried calamine lotion to soothe the itchiness. it seems to be most intense during the night. what could it be?",
    "doctor_response": "Hello,Thank you for posting on HCM.It\u2019s very difficult to approach conclusive diagnosis unless for proper physical examination, anyways from your description it seems you are suffering from scabies.Scabies is a contagious disease caused due to mite and it spreads among people who are in close physical contact and by use of common household articles.Treatment is pretty straight foreword. Firstly, i would suggest treatment of your secondary infection (if any) with oral and topical antibiotics.The key to successful treatment of scabies lies in treating everyone simultaneously in the family and others who are in close physical contact. Your doctor would prescribe oral drugs like ivermectin which will kill the parasite. You might also be advised application of permethrin 5% cream and a corticosteroid with fusidic acid cream. Apply the medicated creams exactly as advised by your doctor. Take antihistaminics as advised to relieve itching and irritation. Avoid sharing of clothing and toiletries and launder all you bedding and clothes in warm water.Hope this will take care of your issue.Wish you best of health.Thank youDr Hardik Pitroda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had tooth extracted, led to dry socket. Why do I have fever, nausea and stuffed nose now?\n\nI had a tooth extracted which led to dry socket. The dentist treated it w/ antibiotic and it sealed up. Quickly after I got a cold with the most rotten tasting/smelling mucus (so bad other can smell it) accompanied, by intermittent headache, slight fever, nausea (from swallowing it I anticipate) & stuffed up nose only in the nasal passage over the tooth extraction site. OTC meds only make me feel better for a little bit at a time. HELP!",
    "doctor_response": "hi. once the tooth has been taken out of the oral cavity and any complication like dry socket, if develops and heals successfully, then, it has absolutely nothing to do with any sort of cold/ fever or headaches. it may be most likely a coinicdental problem. moreover if you still suspect, the tooth to be a reason for all this, you may ask the dentist to take a Xray of that area, to make sure, nothing remians inside the extraction socket. Now Foul smelling mucus and stuffed nose can be treated with inhalation of steam along with warm saline gargle and antibiotics for a few days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain after running?\n\nmy son is 13 years old, he has coloboma. For the past year or so he has complained of chest pain after running. He has had chest x-rays and an EKG and they showed nothing wrong, he has not been diagnosed with asma.. Would a stress test show if there was something the x-rays can t see?",
    "doctor_response": "coloboma some times accompanies what is called CHARGE syndrome which the letter C refers to coloboma and H refers to heart defects .ECG can role out the electrical and functional abnormalities of the heart , but it doesn't show defects or structural abnormality .so a echocardiogram is the gold standard method to diagnose these defects which some times can present with chest pain or exercise intolerance .I highly recommend doing ECHO to this young man  , and I hope he doesn't have any defects and this pain is a musculoskeletal pain .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the 6 mm mole on the side of my head?\n\nHello doctor,I recently discovered a mole on the side of my head which is less than 6 mm in diameter and looks irritated. I would appreciate having someone look at it to further determine if I should have it looked at in person. I have had the mole my whole life. However, I do not remember it appearing the way it does today (I feel that the color has changed).",
    "doctor_response": "Hi. The mole certainly looks irritated and red (attachment removed to protect patient identity). Perhaps it is due to trauma. Trauma is the most common cause of a mole becoming inflamed or irritated. I suggest you use an OTC (over-the-counter) topical antibiotic like Neosporin ointment or Mupirocin 2 % cream, twice daily for a week or 10 days. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for nausea and dizziness due to prolonged use of computers\n\nHello, I work on computers all day and toward the end of the day lately I have been feeling dizzy and nauseous. I thought I was hungry but I eat and its still there. I try to drink plenty of water. Could it just by my body telling me to stop looking at the computer.",
    "doctor_response": "Hi,Thanks for writing in.Sitting on the computer for prolonged periods involves strain to many parts of the body including eyes, brain, hands, wrists, neck and back muscles. This can mean that the posture while typing is not correct or your computer and eyes are not aligned at the same level. It might also be that you do not blink your eyes frequently or are not breathing normally when sitting at the computer. Please take regular breaks and drink adequate fluids when at work. This will also prevent dehydration and electrolyte imbalance. If you still experience your problems even after following measures to control them then please consult your doctors.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Detected with non hodgkin's lynphoma. Took six cycles of chemotherapy. Treatment for the findings?\n\nHi...my father was detected wid non hodgkin's lynphoma last february...after dat he tuk six cycles of chemotherapy and is nw on maintainance treatment fr two years frm nw...recently he gt his blood examination done which showed a high SGPT(45) and an elevated ESR count...wat might b the cause according to u...cn u plz tel....",
    "doctor_response": "I want to know the what type of maintenance therapy he is on? Is it rituximab, once in 2 months. If this is the drug, he is on, usually, it doesnot cause this type of elevation. And moreover, levels mentioned by you are not alarming and hence to keep regular check.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this chest X-ray report indicate?\n\nincreased bronchovascular markings in right lower zone and paracardiac region This is a chest X-ray report please explain what does this means and also I have been a patient of pnemothorax in 2012 but now I am having dull achy pain under my lower breast kind of rib pain ?",
    "doctor_response": "Hello,Increased bronchovascular markings may be a sign of pulmonary or cardiac disease as well as a common finding that have no meaning. I don't think it has to do with the pneumothorax of the past. I suggest you to take a complete blood count to see for a possible infection and echocardiography to exclude a cardiac problem.Hope I have answered your query. Let me know if I can assist you further.Regards,  Dr. Anila Skenderi",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the bump inside the mouth which is hard and painful?\n\nHey, I just found a bump on the inside of my mouth, it is above my teeth in the right side of my mouth. It is hard and somewhat painful, I did just get done eating a somewhat hot slice of pizza, so that might have something to do with it. Do you have any Idea what it could be?",
    "doctor_response": "not to worry much as this is benign condition like infected cyst or a peri-apical abscess of the tooth due to some injuries while taking food! antibiotics can be of help! if really worries you can go for an FNAC test for confirmationall the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to check out for possibility of pregnancy without tests?\n\ni think i could be pregnant. the first day of my last period was march 19 2010. i havent had my period this month and i m having all symptoms of it except a positive test and severe pain. i ve taken tests online and they all say i may be. how can i really find out without getting a home test?",
    "doctor_response": "in delayed cycles sometimes urine test is delayed positive. to confirm it go for serum beta Hcg a blood test.if Hcg test negative then you are not pregnant.symptoms can be due to hormonal imbalance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of excessive masturbation?\n\nhi i am 22 year old, i masterbating regulerly from 4 years ago. now i realise that i cant concentrate on studies and anything else. i am living in my own thoughts. i physically present but not mentally.my thinking power ,analytical power is become very poor . how can i recover the loss happens to my brain. how can i get my concentration back ???",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, although masturbation is natural instinct and physiological phenomenon and of course this may cause physical and mental trauma if care being not taken, it has to be some limits and with well mental balanced, no stress, no functional conditions, it is advisable to stop this for some time before this could cause maniac disorders, hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the difference between Telma 80 and Telma AMH?\n\nWhat is the difference between telma 80 and telma am h and telma h Initially I was taking Telma AMH 40 MG later I found Swelling in my foot doctor has changed the medicine telma h Feeling very much uneasy after taking the second telma h 80 mg then doctor changed to telma 80 mg",
    "doctor_response": "hi ,i m happy to see your curiocity about the drug .telma 80 contains telmisartan which is antihypertansive,working as ARB,wher as telma AMH is combination of thyzide and amlopidin.amlopidin known to cause ankle swelling.thanks. any future quary is welcomed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes increase BP?\n\nI am taking amlodipine since Sept 9 this year but recently my blood pressure is elevated. I had hip surgery in August but BP was okay but recently spiked various time of the day and I am doing 4 readings since I had low sodium level but fine now. I am alarmed about the high BP i.e. 173/92 or 176/110. Yet other times it will 144/94 or 155/89. What causes this as I did not have issues when I was on Verapamil for several years. I was switched to amlodipine cause it did not affect my heart rate. I always had low heart rate but was told the new medication does not affect the heart rate. Advise why a spike in BP? I advised my doctor but haven t heard back yet",
    "doctor_response": "Hello Thanks for posting here. I have gone through your description. Your BP seems to be persistentlu higher despite taking amlodipine daily. Verapamil is a stronger blood control medication than amlodipine. But one of its effects is lowering the heart rate, which in your case was lowered too much hence stopped.. The amlodipine you are taking is not enough to control your BP and hence it must be changed. If you were my patient, I would start you on tablet Telma AM which is a combination of telmisartan plus amlodipine which would be an ideal combination for you. It does not lower the heart rate and has beneficial effects on the kidney and heart. The brand name telma AM may change from country to country, but telmisartan 40 mg plus amlodipine 5 mg combinations are available worldwide. You can take one tablet of Telma AM in the morning. It will definitely help get your pressure under control. If despite this your blood pressure remains high  (after two weeks of starting Telma AM) you must undergo a 24 hour ambulatory BP monitoring which records your BP every 15-20 mins while you go around your daily routine activities. It gives us an idea of your pressure control, effect of medications, time of day when pressure is high and also we can correlate high blood pressure with the activity you were doing at that time. So to proceed further, please take the telmisartan amlodipine combination i have adviced for two weeks and then follow up. Wishing you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sperm release problems, ejaculation of small amounts, low pressure. Cure for condition?\n\nive been facing some problems with sperm release for about one month. Before, when my sperm ejaculate it goes for a long distance with a high pressure and a big amount. Now, when my sperm ejaculate it only goes for a too short distance not even more than 5cm with a low pressure and short amount of sperm. why is that happening, and how can i cure it and become like i was?",
    "doctor_response": "DearWe understand your concernsI went through your description. I suggest you not to worry much. You should not worry much about such things. Ejection length depends on just one factor, and that is the viscosity of the semen. If the viscosity is less, or semen is watery, it ejects for a long distance. If semen is thick, it is sticky, it travels lesser distance.Along with age, the quantity of semen and viscosity decreases. Emotions, anxiety, stress, fatigue etc are also other factors. Bur there will not be any problem for the effectiveness of semen. I sincerely advice you that you have nothing to worry.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abnormal heart beat?\n\nmy heart is always beating around 100 times per minute and never get less than that,when i go to sleep i feel thrue my chest heart beating and it doesnt even slow down when im laying myself down,i sleep really bad usually waking up at least 5-6 times from 00:00-07;00 sometimes it also feels like its stops for 1-2 secons and starts beating again,i noticed also heart is beating fast after i finnish to eat,what could be wrong ?",
    "doctor_response": "abnormal sensation ofheart beats are medically termed as  palpitationsheart beat normal range is from 60bears per minute to 100beats per minute your heart beat as told by you is a  it on higher normal rangewhen heart produces fast regular heart beat its called as sinus tachycrdiatachycardia means fast heart rate,if heart rate is fast but regular we call it sinus tachycardia..it can be because of abnormal thyoid status ,or anaemia most commonlyif heart beat is irregular or regularly irregular they are called arrythmia ...much more dangerous then sinus tachycardiai would suggest you to go for following investigation initialllyECGComplete blood profilet3,t4 and tshvitamin b12 levelsyour sleep is bad as you said ...raised anxiety level ...overthinking ..obbsessiveness can also lead to palpitationsas you finish eating the demand of blood in your digestive system increases so heart has to beat faster to pump more blood in that area from the short history of your anxiety or anaemia needs to be ruled out firstthanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes nose bleeds, shortness of breath and low pulse rate\n\nMy mother is experiencing water retention, nose bleeds, shortness of breath, low pulse rate...she had 5 bypasses back in November. Any suggestions of what may be causing this? Her heart doctor doesnt seem to have any answers. The nose bleeds were going on before the bypass surgery. She is 68 years old, 5 ft 3 inches, weighs about 200 lbs.",
    "doctor_response": "i would recommend a few blood tests like renal function tests and liver function tests. Also get an echocardiograph to know her heart function.A diagnosis can be made only after the results of theses tests.Hope this answers your question, thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chestpain, metallic taste in mouth, coldness and shivering?\n\nI ve just returned from a holiday and while on holiday I had a cough and some chest discomfort which got worse over the past few days. Since the flight yesterday the chest pain has got worse and there s a metallic taste in my mouth and for the past couple of hours I ve been feeling cold and shivery.",
    "doctor_response": "HelloYour history suggests that chest pain,cold and shivering may be due to lung infection.You need proper clinical examination and investigations.Investigations include routine hemogram,random blood sugar,chest X-ray (PA view).You may need to take antibiotics after evaluation.Proper treatment depend upon clinical findings and investigation reports.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible that lbm is triggered by hepatitis b?\n\nI was diagnosed with hep b 3 years ago.  With the medicine  ( baraclude ) that my doctor prescribed my liver tests became normal . Last night I started to have lbm and I can't think of anything that I ate that would cause the lbm. Is it possible that the lbm is triggered by my hep b?",
    "doctor_response": "Hi thanks for contacting HCM....You have now normal liver function after diagnosed with hepatitis b infection 3 year ago ...But you can be carrier ...So confirm your negative infection by viral marker study by ELISA.Anyway here your irregular bowel movement could be by eating outside food or excess fatty meal or excess spicy food.It could be from gastroenteritis like  infection also by virus or bacteria.If diarrhea with mucus or blood present or fever start antibiotic....If muscular spasm more dicyclomine can taken.Small meal with frequent interval taken.Avoid alcohol , smoking etc.If problem more USG done .Take care.Consult gastroentetologist if not improving.Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard heart beats and difficulty in breathing?\n\nHi. I feel like my heart is gonna come out Of my mouth. It's beating really hard and I can literally feel it thru my chest. Should I be concerned?  I also feel like I can't breath and that I'm lacking oxygen. I can't seem to get a deep breath  and I'm getting very impatient cause I'm afraid of what can actually happen.",
    "doctor_response": "Hello and thank you for using HCM.I carefully read your question and I understand your concern.You shoud not worry. I will try to explain you something and give you my opinion. This had  to do with a heart rhythm issue.You may have this sensation like your heart is going out of chest for different reasons. it might be a simple sinus tachycardia.This mean that your heart beats over 100 beat for minute.It might be another arythmia like atrial fibrillation.It means that your heart rhythm its not normal but beats in a chaotic way. Or it might be an extra sistolic beat, a premature heart contaction. All this rhythm issues makes you feel palpitation, feeling like your heart is racing or gooing out of chest,difficulty in breathing deeply like the air is not enough. There are different causes of this rhythm issue like simple stress , coffee and alcohol consumption. Also pathologys like anemia,  hyperthyroidism or ischemic heart disease might be other causes. So ,if I was your treating doctor I will recommend some examination like an electrocardiogram,  a cardiac echo, a full blood analyze, your thyroid hormones, a holter rhythm monitoring  and a stress test. Only after this we can judge what we are dealling whith and how to treat it.It might be just a stressed period and it will pass.Hope I was helpful.Wish you good health.Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Are the white and sore blisters in genitals due to herpes?\n\nHello doctor, I am 21 years old, girl and I think I have genital herpes. I am full of white blisters that are very sore and burn. My lymph nodes in my groin are swollen and tender too. I generally have been feeling very poorly for the last few days. I am extremely uncomfortable. I am taking contraceptive pill.",
    "doctor_response": "Hello. It is better to confirm that it is herpes by having one local examination by infectious control specialist and to have high vaginal swab or biopsy from lesion to check in laboratory. If it confirms, you can have tablet Acyclovir 800 mg five times a day for 10 days but only after confirmation. Have complete treatment of any health issues you have. Have recreational activities and quit recreational drugs. Have balanced diet, weight and BMI. Have a strict hygeine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for fungal infection\n\nHi Doc... I am a male of 40+ years. I have a fungal infection and a doc prescribed a Mycoril Cream 1%. However, it seems not to be working. Its now over two months since I have been applying this as well as maintaining good personal hygiene, such as abstaining from sexual contacts",
    "doctor_response": "Dear FriendWelcome to Health care magic. I am Dr Anshul Varshney , I will shortly try to help you with my opinion.For fungal infection, i usually advise my patients oral antifungals like fluconazone/terbinafine for atleast 2 weeks.For topical application, you may use miconazole/sertraconazole cream.You may take antihistaminics like levocetrizine in night time for itch.Keep the area clean and dry.Based on the available details, this is my best advice for you. You should discuss with your doctor and share my opinion, I am sure he/she will agree to my opinion. If you wish to discuss the problem further , you may please  ask.Stay Healthy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and pressure in the chest?\n\nTeen daughter texted saying her chest hurts and feels like there is a lot of pressure on it. feeling a bit shaky. Ate food 1/2 hour ago after only eating a bagel and cream cheese at 1 pm. I heard cough a bit this morning and blowing her nose. Beginning of a cold I would say? The heaviness on the chest makes me wonder. keep an eye on that?",
    "doctor_response": "Hi Regarding your concern, I would explain that the heaviness on the chest could be related to a respiratory tract infection. Gastritis can not be excluded either. For this reason, I recommend consulting with her attending physician for a physical exam and some tests: - A chest X ray study - A resting ECG - Complete blood count, PCR, ESR. You should discuss with your doctor on the above tests. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feels lazy, depressed, stressed and alone in the world. What should i do?\n\nI don t know what to do anymore. It feels like I am 15 going on 50. I feel like I never want to do anything, and I don t like school or my friends anymore. Little things that never bug me, make me want to burst into tears now. I can t even look at my body in the mirror, due to the fact that all I see is pure ugliness. I feel useless and that my life is just one repetitive nightmare. My sister s hate me, my brother is too focused on drugs, my mother is too lost in her own world and my father is dead. I feel alone and so messed up.",
    "doctor_response": "HI  katrina. THANKS FOR YOUR QUESTION. HOW LONG YOU HAVE THIS SYMPTOMS? YOU HAVE SO MANY CHRONIC STRESS AND NOW YOU HAVE FEATURE OF DEPRESSION LIKE-LETHARGY, WORTHLESSNESS,GUILTY FEELING,PROBLEM IN SLEEP. SO PLEASE VISIT A PSYCHIATRIST AND DISCUSS YOUR PROBLEM HE WILL HELP YOU BY EITHER GIVE YOU MEDICATION OR WILL DO COUNSELLING THAT WILL HELP TO SOLVE YOUR PROBLEM' BEST WISHES DR SOURAV GANGULY",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain while eating, aching jaw, headache, fever, wisdom teeth coming through. Cause?\n\nHi, so my wisdom teeth have been coming through for a few months now. The pain was particularly back on Wednesday night but it was a public holiday so I went out. We all drank a fair bit. The next day I assumed good Hurt my stomach because of alcohol. It's not 4 days later I still get pain everytime I eat , feel nauseous , have no appetite, aching jaw , headache and fever. Is my teeth making me sick?",
    "doctor_response": "Hi, Thanks for writing, Yes definitely, these can be the symptoms caused by erupting wisdom teeth.  Headache, fever and even jaw aches are common. You need to visit a dentist and get antibiotics and anti inflammatory analgesics prescribed for yourself. This will reduce the symptoms to a great extent. Use warm saline rinses to get symptomatic relief till you visit your dentist. Also a antiseptic mouthwash 2-3 times a day would be helpful. Maintain good oral hygiene. Stay healthy, Thank you, Dr. Tarush Thakur",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for the nerve pain in both feet, sciatica and on the left hip?\n\nWhat are my options for nerve pain in both feet, siatica in left leg hip and buttocks and herniated discs L4,L5, and L5, S1. I have had 2 rounds of physical therapy and 2 rounds of epidurals. Nothing works very well or for very long. My neurosergeon says my herniation is small and chronic. Microdisectomy only has a 60% chance to help the siatica only.On Tramadol. There has to be something out there that I am not aware",
    "doctor_response": "Hi,For my patients I suggest surgery after 4 months of epidural shots failure after that decreasing weight and spinal straightening practices followed by surgery for unilateral sciatica involves the removal of part of the disc, which is known as a discectomy. While it results in short-term benefits, the long-term benefits appear to be equivalent to conservative care  like NSAIDS, steroids, muscle relaxants, physiotherapy and massages with topical gels and even Yoga is helpful. Treatment of the underlying cause of the compression is needed in cases of epidural abscess, epidural tumors, and cauda equina syndrome. Nowadays stemcell implantation and other minor endoscopic interventions are madeHope the above information helps you. Any further clarifications feel free to ask.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Ahmed Aly Hassan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does intensive chemotherapy cause walking defects?\n\ni had intensive chemotherapy including burkitts non hodgins lymphoma over the last 10 years ive had 78 sessions of chemo therapy the original chemo therapy has left me with a very bad walking gait drop foot and altered nervee sension as if i am carrying a bag of potatoes in my right tighe have you come across these sympthoms before i cant walk more than 100 yards",
    "doctor_response": "Hi,Thanks for writing in.Our gait is controlled by the cerebellum which is in the brain and the middle ear balance mechanism. If you have had chemotherapy sessions with medicine that can cause damage to the brain and nerves then having a gait problem can be explained due to chemotherapy.The damage is slow and 78 sessions of chemotherapy is significant when we talk about side effects of the medicine. The nerves might have developed paraesthesia and this causes you to have abnormal sensations. It is also important to know if you are getting your regular supply of vitamins and this can also cause nerve related symptoms. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can tricompartmental degenerative joint disease be treated?\n\nTricompartmental degenerative change most severe involving the medial compartment with chronic maceration and tearing of the medial meniscus, full-thickness articular cartilage loss, and marrow edema. Mild to moderate joint effusion what happens next",
    "doctor_response": "Hi, As the first line of management, you can take analgesics like Tramadol for pain relief and exercises for symptomatic management. If symptoms persist, you can consult an orthopaedician and plan for joint replacement. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can testicular failure causing infertility be treated?\n\nDear Doc, I am 38years old male and trying for a kid. i could find very low sperm count in siemen analysis. have gone through a testicular biopsy and result were found normal. Recently dure TESA procedure no sperm could be aspirated and i was told by the treating doc about testicular failure. All of my hormone levels are normal. Can u help me in getting some remedy.",
    "doctor_response": "HelloWelcome to HCM.I understand your concerns.The treatment for oligospermia and testicular failure is cumbersome.I would suggest you to take tablet fertisure-M. This a nutritional supplement which is said to improve sperm count.Take one tablet daily for 3 months. You can then go for a repeat semen analysis followed by TESA.Consult an infertility specialist and discuss this.Hope this helps.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could lightheadedness, rapid heart rate and shivers be symptoms of heart attack?\n\nwell i was rushed to the hospital thursady after noon at work i was not feeling well i felt light headed ,i felt like i  couldnt think clearly all day, i sat down at work all of sudden my body start shaking going numb my heart kept racing i couldnt slow down ,i thoughjt i was having a heart attack or stroke thank god i work at a nurseing home the nurse took my blood pressure it was 200 she called 911 for me the doctor at the hospital got the blood pressue down  had stress tests done that came out normal,blood work done normal finally discharged me after day and half put me on tenormin atenolol  diagnosis was chest discomfort hypertentension anxiety gerd  i am only 46 years old it scared me pretty bad i dont want to die i am very scared right now because the doctor didnt or doesnt know why this happened to me i have never had this happen before, i was thinking can menpause cause  this also i have been letting things bother me also i cant relax either i feel like i am losing it",
    "doctor_response": "Hi There After going through your query I understand your concern.I would like to tell you that lightheadedness with palpitations with shivering can be because of heart rhythm disorder , acute stress , panic attack and other various conditions. As in hospital you were diagnosed with hypertension and anxiety , so symptoms can be because of that too but too. But to avoid underlying life threatening cardiac rhythm disorder further evaluation should be done.Kindly continue with beta blocker and get a HOLTER monitoring for 48 hours done to evaluate heart rhythm disorder and consult with a cardiologist.Hope to have been helpful.Kind Regards Dr. Navneet Bansal",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itching vagina after stopping birthcontrol?\n\nI recently stopped taking birth control and have itching inside my vagina, no discharge or smell. I thought it was a UTI, because it burned when i peed, but then i thought it may be a yeast infection. is it possible that me quitting birth control could have caused this itching?",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern looking to the history given here I could say that if you are taking hormone containing pill for contraceptive purpose then such itching symptom is common and this would come around as soon as you stop the pill, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes adenoid and wheezing in children during winter?\n\nhi, my 7byear old son,height 4.1 and weight 33kg.for last 3 years he is getting frequent cold and cough.and he is detected by adenoid and he is also having wheezing problem in the night.specially he will get in this winter season.am really worried doctor,what problem he is having?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Greetings from Chennai.By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze. I have a few questions for you -Questions:1. How many days per month does she cough or feel breathless?2. How many nights per month does her sleep get disturbed due to above symptoms?3. Does she feel breathless when she runs around or plays with other kids?4. Are the symptoms when there are seasonal changes?5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?6. Is the cough always associated with fever?If your answer is yes for any of the above questions, your kid might be having viral associated wheezing or multi triggered wheezing and I suggest you meet a paediatric pulmonologist who is near your place. No point in using antibiotics every time. It will do more harm than good by increasing bacterial resistance.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lumps on the back of the tongue?\n\nI saw my dentist today  who said he has never seen lumps like the ones I have at the back of my tounge.  They are not red or painful, just raised.  I do have acid reflux and take prilosec daily.  I have had a lap band for 5 years and have had 2 endoscopies in the past 6 months.  I have a bitter tast in my mouth that never goes away. I am 50 years old.and am in menopause.",
    "doctor_response": "Hello, Thanks for your query.Bumps on back of tongue are known as papillae & they are natural. In case they are painful & inflamed,then it can be due to various reasons:- -trauma -allergy -canker sores -throat infection -leukoplakia -scarlet fever You need to rule out the exact cause by visiting dentist & get it treated accordingly. For temporary relief you may apply topical anesthetic gel like dologel 2-3times a day. Consult your dentist in case problem persists.I do hope that you have found something helpful and I will be glad to answer any further query.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can high BP be the cause of nausea?\n\nI am 57, 5'2\", 138 lbs. recently had very high blood pressure ,at peak 170/102, found what appears to be a lump in middle of upper stomach, below chest bone, painful when pressed. Never had BP that high, and BP went down in few hours. Already on BP meds for BP and was controlled, little nauseated some days.",
    "doctor_response": "Hello!Thank you for asking on HCM!Regarding your concern, I would recommend performing further tests to investigate for secondary causes of high blood pressure: - complete blood count- inflammation tests (PCR, sedimentation rate)- thyroid hormone levels for possible thyroid dysfunction- kidney and liver function tests - blood electrolytes- fasting glucose and HbA1C for diabetes- a chest X ray study for your lungs- an abdominal ultrasound to examine also the lumg in the middle of upper stomach. A CT scan may be needed. The charachteristics of the lump that you describe seem to be related to inflammation. If all the above tests result normal, you should consider making some changes in your antihypertensive therapy (as your actual blood pressure values are really high) in order to have a better control of your blood pressure. You should discuss with your doctor on the above issues. Hope to have been helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause leg pain?\n\nThe only way I know how to describe the pain I am having sounds silly but it feels like someone has a voodoo doll and is stabbing me on no regular basis in my upper outer thigh right leg and above my ankle in my left leg. I am 76 years old and take thyroid medicine and blood pressure medicine.",
    "doctor_response": "hi,thank you for providing the brief history of you.A thorough neuromuscular assessment is advised.As you mentioned your symptoms and age , two things come in mind. either the pain can be due to any vascular insufficiency or either it can be a neuropathic pain.For this, a thorough neuromuscular assessment is advised. Also, you may have to take a diagnostic test like Doppler scan of the lower limbs for vascular insufficiency or an MRI of the lumbar spine for the neuropathic symptoms.As the treatment will be totally based in the Diagnosis post the Neuromuscular assessment and diagnostic tests.For vascular insufficiency, the treatment plan will be conventional - rest, medication and physical therapy, home care advice, do's and dont's etcFor the neuropathic pain, - medication and physical therapy like - Therapeutic ultrasound therapy, TENS therapy & exercises like - core stability, pelvic floor Strengthening, spinal muscle Strengthening, lower limb strengthening will be advised.But prior to any treatment plan, the Neuromuscular assessment is a must. also, as per your age there will be a degenerative changes in the lumbar spine which may lead to this kind of pain and post assessment can be helped by planned therapy.As in my clinical practice on a geriatrics , the rest, medication and physical therapy has given us 88% success rate to help them get rid of symptoms and a better life. I wish the same from you.RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could you suggest some medication for Spasticity causing lack of strength in legs?\n\nMy wife is a paralytic patient of left side.the main problem now is the spasticity due to which she is not able to work with the left hand. She also has pain on the left knee. There is a general lack of strength in the legs. Kindly suggest medicine for these problem. H.m.Dayal YYYY@YYYY",
    "doctor_response": "Hi spasticity due to paralysis  can be reduced by aggressive physiotherapy and antigabanergic  medicines.Kindly take tab baclofen and tab Valium and do physiotherapy.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Other than seeing a psychologist, are there any ways of treating Trichotillomania?\n\nHello doctor, I wanted to know how to cure an OCD specifically Trichotillomania? Other than seeing a\u00a0psychologist, are there any way of treatment?",
    "doctor_response": "Hi. I read your query\u00a0and understand your concern about treating obsessive-compulsive disorder\u00a0(OCD) without visiting a psychologist. For further information consult a psychologist counsellor online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child diagnosed with jaundice. Given diet and asked to rest. Is normal but urine color is darker. Suggest?\n\nHi, My Son is three years old and diagnosed jaundice last Sunday 15th Sept ,we have given ample rest and put on diet from start. His Total Bilurbin count was about 4 at that time.After few days of diet and rest he feels good. He is now active but his urine colour is still pale yellow from dark yellow. Does normal urine takes its time or should we have to take some treatment.",
    "doctor_response": "Hi and welcome to HCM thanks for the query.Urine color is darker several days after bilirubin levels stabilize so you dont have to be worried. wait for at least 5-7 days and then repeat LFt to see is there improvement or not. most causes of jaundice in his age is benign and usually it is some congenital liver enzyme defect or systemic infection. He should continue with hepatic diet and rest for 2 more weeks. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mild hypertension?\n\nI am 56 years old with mild hypertension and I experience vision loss and almost blackout during mild exercise, cutting the lawn. During a walk this spring I had an event and went to the ER, they did a heart cath and found only mild blockage, 20 to 30% and gave me blood pressure med and after 60 days I still have the same issue, what could be the problem?",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service.  I have reviewed your query and here is my advice. Is your echo normal? During black outs did you experience any fast heart rate, were you dehydrated, working in hot environment, or are you diabetic? Please get back with these answers. Also monitor your blood pressure and increase fluid intake. Avoid standing for long time or working in hot environment for long time. This can be most probably vasovagal syncope. Also get lipid profile tested once.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to place a dental bridge on the lower teeth?\n\nIs it possible to place a bridge on lower teeth, 23,24,25,26 using existing teeth 22 and 27 as anchors ? Our dentist wants to have implants on 22 and 27 but  we are concerned the implants are expensive plus what if they get infected and need to be removed. The patient has down syndrome.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Putting a bridge for 4 teeth with support of just 2 teeth, which are also weight bearing areas as used for chewing, can cause weakening of the supporting teeth also.Secondly, if the supporting teeth which in your case are 22 and 27 are already having some bone loss or weakening then they are not appropriate for taking support.So first of all, please send me x-rays of your teeth so that I can see if the teeth are healthy for support or not.Also implant is an option and if done properly, it will not get infected. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can aspirin and plavix be taken prescribed for heart issue after being diagnosed with bleeding in brain?\n\nMy father was on aspirin and plavix - he fell and hit his head, he was diagnosed with a bleed on the brain. We asked his primary to consult his cardiologist who put him on the aspirin and plavix. We understand that he can NOT be on any blood thinning medications, we just wanted the cardiologist who was treating his heart issues aware and give his input. However the primary refused to consult him and then told my father that plavix is not an antiplatelet. A neurosurgeon was consulted in and he recommended no blood thinners, repeat CT in one month ( after the 2nd one showed an increase in the bleed and another small area of bleed). We asked for a neurologist to see my dad and again we were refused. What resources do we the family have when the doctor will not work with you?",
    "doctor_response": "Hi,Thank you for posting your query.Aspirin and plavix (clopidogrel) are both anti-platelet agents and would increase the chances of bleeding. They are both contraindicated in patients with recent bleeding in the brain.On the other hand, if we do not start the anti-platelets, then, there is a risk of getting heart attack.So, the benefit of using plavix should be weighed against the risk of bleeding.In patients with recent bleeding in the brain, it is generally safe to start plavix or any other anti platelet agent after two weeks. However, I would advise to use only a single one, and not a combination of plavix and aspirin.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY:  BLOG:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for mouth ulcer with bleeding ?\n\nmy husband has been suffering with mouth ulcers and they have also been bleeding very heavy but just today he pulled out this big thing it was full of blood out of his ulcer can you please explain what this could be thankyou.",
    "doctor_response": "Dear friend. Thanks for sharing your concern. According to the history given,it appears that your husband has  apthous ulcer.It is caused due to vitamin deficiency, especially vitamin B. Also stress is the aggravating factor here. Do not worry .Ask him to take tablet becasolues for a month. Locally apply dologel for relief. Avoid stress and hot and spicy food stuff. Hope it helps. Thanks. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the chances of getting HIV after unprotected anal sex?\n\nHi doctor, I had an unprotected anal sex for a small duration with a guy before two days. Now, I am worried about HIV and other STD infections. So I would like to know about the chances that how could I have gotten HIV infection from him if he was positive? When can I have my tests of HIV and STDs done?",
    "doctor_response": "Hi. Unprotected anal sex carries a high risk of acquisition of HIV. You are still in the window period, where the post-exposure prophylaxis can be given as it can be initiated within 72 hours of last exposure. HIV test can be done now. This will help you to know about your pre-existing status. Get the first test done at four to six weeks of the last exposure. For more information consult an HIV AIDS specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I want to delay my periods as I will be travelling. When to start taking the pills?\n\nHi doctor, I am 21 years old. My date of period is 16th and it got over on 20th. I need to travel. If I start taking pills 15 days prior to my date, will it delay my periods?",
    "doctor_response": "Hi. In case you want to postpone your periods, then start taking the medication a week before your scheduled periods and then you can postpone the periods. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tampon went missing in vagina. Nauseated, tired and skin more sensitive. TSS?\n\nOn tuesday -5 days ago, I went to take out my tampon , and it wasnt there. I dont know if it came out when I did a wee ( but i m not sure I did one). I put it down to stress making me forgetfull. Now 5 days on I am feeling nauseous, tired and lightheaded and my skin feels a bit more sensitive than normal. I dont have a temperature, and dont have a rash , but do you think I may have TSS? I dont have a discharge or any smell, and have tried to look for a stuck tampon but cant find one. What should I do? Or could the worry of thinking I have a lost tampon make me feel like this?.",
    "doctor_response": "Hi, Thanks for query, The tampon if not inside vaginal vault then it must be come out as it cannot pass cervix to go to uterus. Check your vaginal vault if not there it must came out. If you have still doubt you may check it with Gynec. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sharp pain after getting the contraceptive implant. Is this normal?\n\nI have had the contraceptive implant inserted two days ago and while lifting something heavy I felt a sharp pain that felt like the implant had snapped or the wound through which is was inserted opened- I have checked the wound and it s fine but the rod I need to feel for seems split and not like the full rod that it originally felt like, could my implant have snapped and what are the consequences of this?",
    "doctor_response": "Hello,Thanks for posting your query on health care magic.There is possibility of trauma at the site of implanon insertion.I suggest you to get it examined by a doctor.Other possibility could be due to ligament tear or tendon injury.Hope this helps.regards,Dr Nilofer",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could lumps with in fibrocystic breast females suggest?\n\nFor many years I have been diagnosed with fibrocystic breast. I get mammograms each year but for the last few months I ve felt a new lump in my my right breast it feels different from my normal cyst it moves but it concerns me. I m on birthcontrol pills have been since I was 22 when I got married I m now 43 yrs old should I go to doctor?",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query. If I were your doctor, after a general and local physical examination of both side breasts, I would advise you for a FNAC (fine needle aspiration cytology) of the newly developed lump. Further management would depend on the cytological report of the FNAC.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed red semen while ejaculating\n\nHello docs n experts, Since yesterday I m ejaculating red semen. I noticed it yesterday while masturbating, even today I seen same thing when I was trying to confirm was it a normal one day case or a serious issue. Now I think it is a serious problem for me. Please help me.",
    "doctor_response": "Thanks for asking in healthcaremagic forumIn short: Hope you did not use any sexual gratification instrumentsExplanation: Blood in semen is not normal. Injury or infection in urinary tract can cause this. So, make sure that it was from inside your urinary tract and visit a doctor for examination.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe back pain?\n\nHello, I awoke one morning with the area around (what seems like) my tailbone hurting a lot. To the point where it is extremely difficult to walk (as in excruciatingly painful). I m not sure if it is the bone itself that hurts or it is the muscle around it. When I lay down for extended periods of time, it restores minimal movement but soon after getting up, the pain is back to the usual level of extreme.",
    "doctor_response": "hellowelcome to hcmyour symptoms points towards a clear cut diagnosis of DISC PROLAPSE i.e bulging of intervertebral discs from their normal position...you should get a MRI OF LUMBOSACRAL SPINE and consult a orthopedician for prescribing you the required treatment....for immediete relief you shoul visit a physiotherapist for SPINAL TRACTION and other modalities which will provide instant relief from painregardshcm",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat cellulitis infection and high ggt?\n\nrespected doctors,my age is 36 i have celulities infection in my left foot from 6 years for a couple of timenow i got my blood tests and the tests show that my ggt is high (65) i also have history of gestional diabetes nine years beforeplease can you kindly tell me any curation of my diseases",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Cellulitis of the foot requires a antimicrobial therapy.I suggest you to take a cefixime 200 mg tablet for foot infection three times a day under your doctors guidance.You can also take paracetamol and diclofenac tablet under your doctors guidance for pain and fever.Please maintain good hygiene by frequent dressing and cleaning. This will equally cures you rapidly as do antibiotics do.Raised GGT indicates some liver pathology. I suggest you to get your all liver function test done. If you have this high GGT is because of hypertension than treating the hypertension will treat you with high GGT.Please control your sugar if your sugar is high than controlling the sugar also cures your infection.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from lower stomach pain and discomfort ?\n\nHi Dr. I m 23yr old unmarried girl, For the past 1-2 months, i m having pain and discomfort in the lower stomach region and also often constipation and feeling pressure over there. the pain will last for around 1-2hrs. Nowadays i m feeling very much tired.Kindly guide me to diagnose the problem and to find a solution. Awaiting for your response.",
    "doctor_response": "Hi! Welcome to healthcaremagic.com.Any abdominal pain lasting more than 3 weeks should be investigated .Starting with please take an ultrasound of pelvis to see any ovary cyst,bladder-cystitis etc,Which may be causing these symptoms.Let us know.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest therapy for high BP\n\nMy name is Mr. Murlidhar Shandilya from Sagar,Madhya Pradesh and I am 75 years old.I am suffering from high blood pressure since last 2 years and I have been taking NUSAR-A.M. but from last 2-3 months I am finding problem in walking and other activities.When I tested for T.M.T it came out to be positive.The local doctor has prescribed me with a number of medicines and at the same time he has prescribed me to go through angioplasty but I want to get well through medicines and without going through any surgery.So please suggest me the way to get well as soon as possible.",
    "doctor_response": "Hello, I would like to review your cardiac tests in order to be able to give a more professional opinion. In the case of suspicions on coronary artery disease, angioplasty would be the golden standard test to examine the blood flow in your coronary arteries. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Red spots after acne cauterization\n\nI got acne cauterization on my nose but now it leaves scars and there are red spots on my nose, what to do? is there any meds you d suggest in order to help with the discoloration?",
    "doctor_response": "Hi, Welcome to Healthcare magic forum, when did u underwent cauterization? For first few days the red spots will be there and disappears slowly, if still persists then meet ur dermatologist for treatment. Hope I have answered ur question, Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the lump in shoulder?\n\nI have a lump on my back shoulder blade that I got an incision on, but was to deep for the doctor to know what it was. No pain and it has grown a little over 9mos. No puss came out when the incision was done, and had like a light red to light purple color to it. What could this be?",
    "doctor_response": "Hi ! Good morning. I am Dr Shareef answering your query.As the lump is a slow growing one, it seems to be benign as per your history. If I were your treating physician, I would have referred you to a qualified general surgeon to deal with the problem, who after a clinical examination and some routine investigations might go for a FNAC (fine needle aspiration cytology) followed by an excisional biopsy depending on the situation as judged by him. This would confirm the diagnosis and also would help in further definitive treatment if need be.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sharp pain in left abdomen\n\nHi, about four hours ago I got a sharp painful stabbing pain in my left abdomen which has become worse since. Ive just lied down a felt what I can only describe as a pop in area of pain. Can you suggest anything. Taken pain killers and used heat bag but np relief......",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query.If I were your doctor, considering no relief by the pain killers, I would refer you to the ER of the nearby hospital so that apart from a clinical surgical assessment, investigations like CBC, serum amylase, serum lipase, along with an ultrasound of whole abdomen could be performed to arrive at a diagnosis. A plain x ray of abdomen in upright posture could also be done if need be after a clinical assessment of the abdomen.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dental abscess\n\nHi. MY boyfriend had an abcessed tooth and he had a hole on his jaw/check where puss was coming out. The problem is its been about a year and a half and the hole (with a bump on the jaw) and the puss is still there .Could you help? -worried",
    "doctor_response": "Hello,Thanks for consulting HCMRead your query as your friend  had abscess in tooth this pus formation can be due to carious tooth or due to poor periodontal condition . If pus formation is due to carious tooth then treatment can be done is root canal treatment and if pus formation is due to periodontal problem then go for scaling and curretage .  I will suggest you to do warm saline rinses 2 -3 tiime a day , brush your reeth twice daily and consult dentist for oral examination and treatment. Hope this will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause a large bump under the tongue?\n\nA week ago I had a large bump under my tongue along the skin ridge connect tongue and mouth. A few days ago it appeared to turn into a blood blister so i attempted to drain the blood. Now I have a large white triangle shaped flap where the \"bump\" was. What might it possible be and is there anything I can do to get rid of it?",
    "doctor_response": "Hello,I am happy to assist you. My initial question to a patient in my office would be as to the source of the bump? Was it trauma? If so, it sounds like the pocket of blood was formed and you drained it. Now you need to give it more time to heal. Rinse and keep the area clean. Warm salt water may help. If it continues to be an annoyance to you, you can have the extra tissue reshaped or removed. Dentists can use lasers, electrosurgery machines or a scaple.If you are concerned that this may not be healing or have not had a recent dental visit, this would be a good time for a dental check up. A clinical exam would give you the best information on your situation. I hope you find this helpful. I would be glad to answer any additional questions or concerns that you may have.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for continuous cold\n\nDear SIr, I am suffering from continuos Cold for the last 12-13 years. I m  30yrs old now. There is a continuous flow of mucos from the back of my nose to the mouth. I didn't feel headache, cest pain, sneezing. But for the past 1 week I was feeling pain around my right eye. there is no family history of Asthama and TB. Doctor saw my  CT scan and said that there is no need of sugery and can be cured by medications. If it is not cured in 1 month he will give me steriods. The medicines he gave for 1 month are below : (1) Mucolite SR (2 dose/day) (2) Montek LC (1 dose/ day) 3) PAN-D (combination is:ENTERIC COATED PANTOPRAZOLE SODIUM AND DOMPERIDONESR CAPSULES)................ I need you help whether he has provided me correct medicnes ?? Or wht is you suggestions., you can also advise me on  YYYY@YYYY  in advance.. :)",
    "doctor_response": "Hi i did review your concern.Your condition could be due to allergic rhinitis, chronic sinus congestion or It could be due to deviated nasal septum.I would recommend consulting a ENT doctor and get yourself evaluated. A nasal examination and if required a Paranasal sinus xray or CT scan may be required.Meanwhile I would advice you to use otrivin spray for nasal dripping and congestion.I hope this helps.Wish you all the best.Thank you for using healthcaremagic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from bilateral lung cancer and breast cancer. Spread to lymph nodes. Had diarrhea and vomiting. Prescribed with phenergan suppositories\n\nMy mother in law has stage VI bilateral lung cancer and breast cancer that is in the lymph nodes. She has been placed in hospice and last week she had diarrhea and clear vomitting. she was feeling better but then yesterday she started throwing up brown diarrhea looking stuff. She said she is having normal bowel movements. I had my husband call her doctor and they gave her phenergan suppositories and said if she continues to vomit to take her to ER for IV fluids. I am wondering if she has a bowel obstruction?",
    "doctor_response": "For diarrhea your mother in law can take tab reglan 10 mg thrice daily before food.For diarrhea T.Imodium 4 mg stat then 2 mg 2 hrly till motion stopsDo a straight x ray of abdomen to rule out sub acute intestinal obstruction.If diarrhea still persist then inj Octreotide 150 mcg subcutaneous thrice daily for 5 days along with T.Ciplox TZ twice daily after food for 5 days.Regards and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Wheezing problem, cold, hereditary, allergic, prescribed laveta m. Wahts the side effect?\n\nMy daughter has wheezing problem when she gets cold. Doctor said it is heriditary and caused due to some allergy. She got it thrice. She is 1.9 yrs old. Doctor has prescribed laveta m as preventive...wanted to know abt the side effects due to long term use...doc said for a year ...or should I look at some naturopathy? Pls suggest",
    "doctor_response": "hello dearthanks for your query at HCMlaveta m contains montelukast it is luekotriene antagonist this is very safe drug produce few side effects like headache and rash. eosinophilia , neuropathy, psychiatric changes and churg strauss syndrome are reported in very very few cases according to literature.you can use this drug .no need for naturopathy which has unknown results on improvement.regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am 13 days pregnant and experiencing pain in lower abdomen and thighs. Why?\n\nHello doctor, I am a 23-year-old female. I am 13 days pregnant and currently experiencing a pain that feels like I have been exercising for a long time. The pain is in my thighs and the lower side of my abdomen. I currently take Metformin 2000 mg per day and folic acid also.",
    "doctor_response": "Hello. I hope you did not have any extraordinary activities to cause the pain around the thighs and lower abdomen. The pain we are to worry about is intermittent pains, that come for a few seconds, just like the pain in periods and then disappears, and come back again later. This may be associated with discharge from the vagina, with or without bleeding or spotting. If anything of this sort, do meet your doctor immediately and you may need medications to make the uterus quite. It could also be an infection in urinary bladder with a burning sensation while urinating, increased frequency of urination, and feverish feel. This also needs a consultation with the doctor to confirm the infection and using antibiotics. Untreated urinary infections can further lead to pain in the uterus, It could also finally be an infection around the uterus if you had intercourse recently. This also can be cleared with antibiotics. Anyway, nothing to much worry about, as you do not have any bleeding or spotting. Simple course of antibiotic, in case of any infection and hormonal support can relieve you of the pain and more important can make your baby safe. Drink a lot of water, avoid intercourse, any sort of mental, physical stress, and rest well. Kindly do not delay to visit your doctor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this EKG report indicate?\n\nThx. I am 58 year old female who 3 weeks ago had flu, but took Tamiflu and still has sob. But dramatically better. Started on prednisone. On ekg- sinus rhythm negative precirduak t-waves within normal limits. Do I need to worry? What does this mean? I m healthy, with hypothyroidism, take synthroid daily.",
    "doctor_response": "Hello and welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. There is slight changes in few of the EKG waves, those are not significant and doesn\u2019t indicate any cardiac abnormalities or angina.If in case of symptoms like ches pain, you can go for blood tests like troponinI to rule out angina. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Delayed periods. Pregnancy test negative. My chart shows ovulation time. Can I become pregnant now? Have faint redness when wiped.\n\nGreetings! I'm in need of your help! I had a cycle on the 4th and 26th of May but NO CYCLE in June at all!!! It's now the 2nd day of July with STILL no cycle and I've taken 2 pregnancy tests that BOTH said negative. My calendar and charts show that I'm gearing up for ovulation starting on the 4th through the 7th of July, which is this week. Can I ovulate even though I didn't have a period in June? Also, when I wipe, there is a pinhead size of faint redness. Can I really be pregant because not enough hcg is showing in my urine?",
    "doctor_response": "Hello,Here, you need to undergo one blood test for beta-hCG and TVS scan to rule out possible conception. Early home pregnancy test is less significant.After that, you need to consult with gynecologist for examination and other relevant tests if needed. Other reasons of late period are obesity, ovarian cyst, hormonal imbalance, high prolactin level, hypothyroid state etc where improper ovulation may occur. Take suggestive treatment according to test report.Maintain genital hygiene properly. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Undergone utz of abdomen, having echogenic structure at the mid segment of the kidney. What medecines should be taken?\n\nI have undergone utz of the whole abdomen , and was seen to have 2 tiny echogenic structure at the mid segment to lower pole of the left kidney measuring 0.40cm and 0.42cm, with renal parenchymal calcification . what should I do? Hi! I have undergone utz of the whole abdomen and was seen to have 2 tiny echogenic foci at the mid segment of the left kidney measuring 0.40cm and 0.42cm, no caliectasis was demonstrated bilaterally, but with renal parenchymal calcification on the left kidney was noted. What are the treatment options for this? do I need to take medications? if yes, what meds will I take. Thank you",
    "doctor_response": "Hello,Thanks for visiting healthcaremagic.Since you have NO problem so far,no immediate intervention is required. Based on the single test you had done it is not able to do anything. You must undergo blood glucose, sr.creatinine,uric acid,and MRI . tHEN CONSULT nephrologist.Thanks,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the pea sized lump between my lower ribs?\n\nI have found a small lump between my lower ribs, I have a constant dull achy pain and tightenness a bit light indigestion. I had a baby September 2010 and thought the pain was related to the muscles being weaker and not regaining their orginal structure, but I recently found a peas sized lump .",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query. Although it needs a physical examination of the lump, from your history, it seems to be an epigastric hernia, which is protrusion of a small amount of preperitoneal fat through a week point in the liniea alba, which might have been caused by the stretching during your last pregnancy. This herniation could give rise to the lump along with the dull achy pain in your case. The treatment of this conditoin would be a small surgery. However, this has to be examined physically by  a general surgeon who would then decide on the course of action and proceed accordingly. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will I be able to conceive after taking Duphaston?\n\nIhave conceive problem so doctor first done HSG test report is Ok then ask to Do LFT and Creatinine, Urea, test that also OK, except one Alkaline Phosphatase whose value is 377 against normal range of 80-315. Now doctor prescribed me UDILIV 150 twice daily for 15 days and if period starts then take D3-D7 :Letoval 2.5 mg and Duphaston 10 Mg during D19-D25. and also keep trying in the mean time. Name: Minarva Das Age:   27 Gender: Female. YYYY@YYYY",
    "doctor_response": "Hi, I think you can conceive by taking letoval and duphaston.  Letoval is given to increase the growth of your follicles.  You can track your ovulation by repeated ultrasound or ovulation detection kits.  Duphaston is given to support the implantation.  So, these medicines increase the chance of pregnancy.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for lumps\n\nhi! for three days now i noticed i have a lump on my face.first, it was located just above the right side of my eyebrow.i thought it was an insect bite after touching it for several times i felt it moves to the center of my eyebrows above my nose area.it disappear overnight, but a lump appears on my right forehead.for the second time around it disappear overnight.on the third time i noticed a small lump above the chin area on the left side below my lips.it's slightly painful when i touched it, what could it be? pls help me thanks!",
    "doctor_response": "HI,Good Evening.Thanks for your query.I studied the query in-depth.I understand your concerns.My diagnosis-?Acne /?  mild regressing-pimples / or? Urticaria--Treatment for this multiple moving and  re-appearing lumps on your face--Tb-Antihistaminic- / with Hetrazan-Antibiotic for 5 days.-Tb-NSAIDs.Hope this would releive your query.-Wishing you early recovery and good health.Wellcome again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the reasons for having chills in head while hearing music?\n\nHi, doctor.. I am at the age of 23 and will soon be 24 soon. I am very emotional about music, movies, concerts, etc. Whenever I listen to my favorite music/songs i get this chills around my head but i don't feel cold. I would like to know if this could cause brain tumor?",
    "doctor_response": "Hi,Thank you for posting your query.First of all, Let me assure you that your symptoms are not suggestive of brain tumor, and listening to your favorite music would not increase the risk of getting brain tumor in the future.These are non-specific symptoms and are not suggestive of any disease.I hope my reply has helped you.I would be pleased to answer, if you have any follow up queries or if you require any further information.\u00a0\u00a0\u00a0\u00a0\u00a0Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,For DIRECT QUERY to me:   My blog:",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have chronic pancreatitis. Lower abdominal pain. Ultrasound shows abdominal ascites. Cure?\n\nDear Doctor,My father is an patient of chronic pancreatitis but don't having sugar at present,he having an continous pain in the lower abdomen,and in ultrasound their is an ascites in the abdomen,doctor took out the sample of the fluid in the abdomen sent it to lab to test,then they found it an abdomenal TB case,they give the medicine for TB, after 15 days as well my father is having pain sometimes in the back  & sometimes in the Abdomen ,and after taking the meal in the morning  he having very bad pain,and it subsides slowely after 2 hours, my father already taking the digestive enzymes  tablets with the meals. can you please  help me what we should do to cure all this.waiting for your reply. regards pankaj( YYYY@YYYY )",
    "doctor_response": "Hello, Thanks for the query to H.C.M.  Forum. Ascites fluid  is due to tuberculosis abdomen. Treatment of tuberculosis is continue, so a good thing. Still pain present as note down , why?Abdominal pain is the major symptom of acute pancreatitis . Pain may vary from a mild to severe , constant & incapacitating distress. Pain in the abdomen is due to pancreatitis . 2nd reason of pain is due to anti tubercular drugs as these develops hyper acidity and gastritis. Consult your treating physician & another physician and get 2nd opinion also. Good luck. Dr. HET",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stones in prostate after being treated for cancer\n\nIS THERE A PROSTRATIES CURE OR TREATMENT I HAD PROSTREATE CANCER AND HAVE HAD 62 SEEDS PLACED IN THE PROSTRATE AND A TURP AFTER THAT THE SEED PLACEMENT WAS 2 YRS AGO AND TURP WAS A YEAR A GO.  ALSO I NOW HAVE PROSTRATE STONES AND GOING TO HAVE THEM REMOVED IN 2 WEEKS.",
    "doctor_response": "Hello, Surgical removal of the stones will be the treatment of choice. Consult a urologist and he will direct you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for persistent cough\n\nMy name is Haley and since Saturday evening I ve had a terrible cough. I went to the doctor yesterday and he said it was Croup and gave me steroids for it. I was just wondering if it was normal for my back and chest to be sore when I breathe in today since I haven t been coughing nearly as much as I was.",
    "doctor_response": "Brief:Things are expected to get better soon.Detailed:HelloThank You for contacting HCM.Welcome to Health Care Magic.My name is Dr Muhammad Ahmad & i will look into your problem.I have gone through your query and would try to help you in the best possible way.Things you can do:      There can be few things you can do to effectively control you cough.1-Using a mask to avoid allergen entry to respiratory tracts.2- Steam inhalation.3- Using antihistamin like allegra-D4- using a cough syrup.5- some times cough can aso be caused by stomach acid refulx in this case you have to deal with it to by using antacids6- stay away from cold air.Sore Chest:   Yes it is normal to have a sore chest in this case because inflammation and coughing makes it sore, you can just wait for some days, using your meds and things will get better with time. Its a good news already that you are coughing less now.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. Wishing you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness with loss of balance?\n\ngood day i am a 29 year old female mother of two. my two year old daughter had a near death experience which shock the hell out of me. from then i realize that i found out that i have this faintish dizziness come over me, recently i now realize i am loosing my balance. What is happening to me",
    "doctor_response": "Hello, Nothing serious is happening to you, it is stress and anxiety after that episode that is causing your issues. So, just peace your mind and don't worry about. If the problem persists, get evaluated by a Psychologist for Posttraumatic stress disorder. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "What course of treatment should be done for pseudotumor cerebri and migraine?\n\nHello, I ve been diagnosed with psuedo tumor cerebri and migraines by my neurologist just as a brief background. I have had a migraine now for three days with auras, dizziness, vomiting, hard time being in light and dealing with sound and I am very easily agitated and an extremely painful itchy rash that has completely taken up one side of my body. I called my dr she prescribed me sumatriptan injection and Tramadol tabs and so far it has done nothing at all and she hasn t said much about the rash, I m not sure what to do",
    "doctor_response": "Hi, If your diagnosis is pseudotumor cerebri or IIH as it now called Idiopathic Intracranial Hypertension then, the treatment of choice would be to first identify possible underlying causes such as obesity, overuse of Vitamin A, or the use of certain medications such as Antiglaucoma, Carbonic Anhydrase Inhibitors, Loop diuretics, Cardiovascular, Corticosteroids, Beta-Blockers, Tricyclic Antidepressants, or Antiepileptics. If any of these medications you should ask your doctor if you could go on a trial without them and see if things improve.  Otherwise, the definitive medication of choice would be to start with something such as Diamox or topiramate and then, consider other solutions as needed. Your rash may be a reaction to the Sumatriptan or Tramadol (BTW, I'm not a fan of the Tramadol for treating headaches...not terribly effective and risky in terms of side effects AND high percentage of patients have allergic rashes to the drug). Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in hematoma\n\nMy blood pressure is normally 12/72ish. I have a preexisting (old) subdural hematoma to left posterior upper hemisphere (parietal lobe?). I was in a heated arguement approx 6 hours ago, felt a sharp pain in area of hematoma and my BP is 164/82 with manual cuff and automated cuff. Am I in trouble or should I do anything?",
    "doctor_response": "Transient rise of blood pressure may occur during exertion, tension or anxiety . Headache may occur with much rise in blood pressure which is holocranial. Unilateral headache may be due to some other cause like migraine or cluster headache. In your case persistence of headache and vomiting or focal limb weakness may be indicator of serious problem and then should be evaluated. For now you need to relax and monitor your blood pressure regularly and consult if progression or new symptoms appears. Be healthy and jolly",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain to touch in right lower back.  Have Celiacs disease with history of gallbladder removal.  Is this serious?\n\nBruise like feeling to the touch on my right side lower back above my hip but below my right ribcage. I had my gallbladder removed 5 years ago and have Celiacs Disease. After I touch the spot, it hurts a good amount and then fades over the next 20 minutes. Could this be serious given my past?",
    "doctor_response": "Hi, The pain you are having could be related to: - appendicitis - possible kidney or urinary tract infection - liver/pancreas/bowel problems. So, I strongly suggest to consult your GI specialist as soon as possible to rule out appendicitis (as emergency) and other conditions. I also advise to: - do abdominal ultrasound - do urine analysis - do complete blood profile - check your liver enzymes in blood All the best! Dr.Behar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could recurring perirectal abscess be due to fistula?\n\nHi, may I answer your health queries right now ? I have a perirectal abscess and it ruptured two days ago and now is filling up again, I have an appointment in 2 days with a colorectal surgeon. Does this mean I have a fistula, this is the third one in 2 months.",
    "doctor_response": "Hi thanks for asking question.You have perirectal abscess which burst so ya chances of fistula is there.For that rectal examination has to be done by proctoscopy.And you mentioned that this is for the third time.So it is better to get examined proctoscopy.I hope you have no further query regarding approach for your case.thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can chronic cold with a running nose be treated?\n\nHelo Dr. My 10 month baby suffring from cold with runny nose from last 7 days. Doctor prrescribed me sumocold syrup initially with antibiotic and later changed it to histakind syrup ..m giving him histakind syrup(2ML) twice a day with antibiotics for 4 days ..but still he is having cold.plz tell me the best cold syrup for him. Is it seasonal change or some other reason? Can i give him saline nasal spray but there is no chest congeation.. tell me the correct the correct tratment for running nose. Thanks.",
    "doctor_response": "Hi welcome to healthcaremagic,Common cold , running nose is self limiting illness , it usually resolves in 7-10 days.One can give antihistminics ,paracetamol , and if there is nasal block ,you can use saline nasal spray (it can be used as and when required, saline nasal spray is safe to use for prolonged time and as many times as required.).If baby is well,not febrile , accepting feed well , no rapid breathing , no respr distress , you need not worry , it will resolve .But if it persists than allergic rhinitis and secondary bacterial infection needs to be  ruled out.Hope I answered your querythanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rash with fever?\n\nMy daughter woke up with a rash on the back of her legs .. So I went get some calamine lotion and some cortisone 10... The next day the rash was all over.. She had a fever.. She had an piecing on her her that was infected.. So I brought her to the emergency clinic yesterday .. They gave her an antibiotic and and steroid shot.. Today the rash don t look as bad but it still everywhere.. What should I do? The rash is just bumped no puss or leaking, red, itchy, and it hurts her.",
    "doctor_response": "Hi dear,I have gone through your question and understand your concern. She has allergy to metal or some chemical agent. I advice- Fexofenadine or Allegra 120mg 1 tablet once a day.-Chloropyramine 2 ml intramuscular during 3-5 days.- Charcoal 3 tablets 2 times for 5 days for absorption of allergensHope it helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on head of penis\n\nHello, I am a 46 year-old male. I have a type of lump inside the head of my dick. The pain associated with this condition is minimal, more of an irritation. This sensation is not constant. There are not any other symptoms, no burning while urinating, etc...",
    "doctor_response": "HI,Welcome with your query to HCM. Based on the facts of your query,you seems to have Globus Pharyngeus. Treatment- Surgeon's Second Opinion to fix causes of Painless Lump in the head of th penis- He  would investigate your by physical examination and by FNAC Biopsy to rule out the Cancerous Growth of the penis. UroSurgeons help in diagnosis and ruling out other causes of such a penile growth is also needed. These doctors would fix the diagnosis and would treat it by needful surgical treatment as need be. This would help you to resolve your worry. Welcome for any further query in this regard Will appreciate writing your feedback review comments,to help the needy patients like you at HCM. Good Day!! Dr.Savaskar, Senior Surgical Specialist M.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for kienbock s disease\n\nI have Kienbocks disease. I had my R wrist fused 4 years ago, still have pain up forearm. However, I am currently having investigations on L wrist(dominant hand). Has progressed v quickly, characteristic same symptoms as before. Have been signed off work for month. Have had bone scan, and will have MRI next week. I am struggling with everyday tasks and my work is nigh on impossible. Can it be classed as a disability? Thank you",
    "doctor_response": "Dear Patient,this probably is keinbocks in the next wrist also, MRI will confirm the stage of the disease, and will further help us to provide you with treatment options, now a days depending on the condition, radial shortening osteotomy,, JESS distraction and Proximal Row carpectomy are good options .I feel if your work profile does not involve heavy work than movement preserving procedures must be tried first. this is due to the fact that your one wrist is already stiff, moreover the operated wrist needs to be X rayed, and see if the union of fusion aimed has been achieved or not.I hope that helpsThanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bleeding from cut on penis\n\nI am a male of 17 years old!i have got a cut on my back side of the Penis, i think a cut or breakdown of a nerve or something i am not sure!!it bleed-ed last night and i am very scared what all can happencurrently i am applying neosporin powder on it !plzz help me and whom should i consult, which specialist?",
    "doctor_response": "Hello dearUnderstand your concernYou should consult the general surgeon or urologist. It need proper examination as chance of cutting veins on the back side of penis. Take following advice: apply pressure on bleeding side, apply neopsorine powder, wear loose undergarments, do not apply bandage, do dressing with betadineHope this may help youBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rash on the torso following flu treatment. Is it related to flu?\n\nMy nephew recently had the flu which lasted about 7 days. He now has a rash COVERING his entire torso. His only known allergy is a peanut allergy which has never caused a rash. He hasn t eaten anything new/different. The only change is some new pajamas for Christmas, but the rash is localized to the torso, and a few splotches on the face, but nothing on legs or arms. Could this be related to the recent flu virus? He currently has no fever and no other complaints other than some itching",
    "doctor_response": "the antibiotics and vitamins given in flue can cause thiss even pcm brufen anddisprin orfever cause thiswithdraw all medicinesgive warm watergive aniallergic ebastine 10 mg night for 3 wkapply calamine ltion on rash area it will take 3 wk to subside after the stop of flue medicined",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for chronic pain in the neck and back\n\nI am a 49 year old female with degenerative disc disease throughout my entire spine along with scoliosis in my thorasic and severe rotoscolosis in lumbar and an overcurvature in my neck which causes daily headaches. My bone denisty has gone from a T score of -2.1 to -1.7 in three years with osteoarthritis. I have severe chronic pain throught my neck and back which is now radiating down my right arm and into my left leg. I have been taking norco 10/325, robaxin 750 and fiorecet for years which helps make the pain tolerable. Could you please suggest a doctor who will be able to treat both the pain medication and normal issues such as sinus, bronchitis, blood pressure issues?",
    "doctor_response": "Dear- I reviewed your medical question in detail and will give you my advise. First of all, any primary care doctor as family practice or internal medicine can help you with back pain and regular illness as sinus and blood pressure. However, if your back pain is severe and is getting worse, you will need a reevaluation with MRI of lumbosacral to see if you have spinal stenosis or bulging disc with nerve trapment. In this particular situation, a back specialist is better trained for the treatment.You should take calcium supplements to help your bones,I hope that my advise has been helpfulDr.Sara",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My intraocular pressure is getting high in the last six years. Why?\n\nHello doctor,Over the past six years or so, my intraocular pressure (both eyes) has risen to 16, to 19, and now to 21. Will it continue to increase still? Kindly help.",
    "doctor_response": "Hello. As you might have been informed, increased eye pressure is mainly associated with the disease called glaucoma. This chronic symptomless disease is very drastic to the optic nerve and might lead to irreversible damage, and in the end, cause blindness. However, this eye disease is never diagnosed or established based on eye pressure measurements and requires a detailed and comprehensive examination including many diagnostic tests like, visual fields, gonioscopy, OCT (optical coherence tomography), multiple measurements of eye pressure during at least three consecutive days and these tests might be repeated twice and even thrice in the first year and then every six months if the only suspicion remains. If you have not undergone these tests, please do, and if you require a second opinion, please upload the results of all these tests and I will gladly provide you with my opinion.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for chest tightness?\n\nI have been suffering with a tight chest that feels as if I have a heavy weight on it.  This started last year with me waking up occassionally with a shortage of breath and an indegestion type pain.  The tightness has become more regular up until a few weeks ago when I did some physical work in the garden.  I suffered heavier than normal pain which eased after a rest, pain killers and a hot bath.  The tightness is now with me nearly all of the time and I now get a twinge across my chest a few times a day with pain or numbness in my left palm.  Over the past month my lower eyelids have begun twitching, starting with the right and now affecting both eyes and is very irritating.  I probably don't hacve the best diet in the world and do have quite a stressful job and 2 small children.  Is this something that I should worry about or do you think that it will clear up in its own time?",
    "doctor_response": "Hello dearWarm welcome to Healthcaremagic.comI  have evaluated your query  thoroughly .*  Suggestions for better recovery-  Maintain hydration with plenty of liquids .-  Avoid smoking or alcohol if using .-  Regular walking in fresh air , deep breathing exercises , YOGA .-  Avoid stress , anxiety .-  Regular sound sleep of 8 hours .-  Consult later doctor if required .Hope this will help you for sure .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes ear discomfort in a child?\n\nto me this is gonna sound foolish but here it goes. my son is having problems with one of his ears. tugging it, trying to stick his finger in it, and other such things. he is two but this is not normal for him. we went on vacation a week or so ago and it was warm at the cabin we stayed at so we left the porch doors stay open so the kids could play outside on the enclosed porches. our son started crying one night and tugging on the ear and we washed it out with some mineral oil. the next night we used sweet oil. we can not see anything oursleves but i did notice while we were at the cabin that the wood roaches were crawling about outside. well, duh, i know it s a cabin and it s in the woods so that is expected. his ear has never bleed or anything but he has been having a lot of wax coming out of the ear and tugging on it more thatn he has ever done before so i think there might be some kinda of bug in it. my husband wants to get it out ourselves if there is one there but to be truely honest....I don t feel safe about it. We are going to buy the octoscope that is sold in the stores and see if we can see anything today. I have almost made up my mind to just take him on to the doc monday. I am so scared, I don t want to damage my son s hearing with trying to get one out if there is one there. To be honest I am gonna feel like the world s worst mother if there is a bug in it. i guess what i m asking, is if i am right in just wanting to take him to the doc and let them get it out?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.I recommend to visit a doctor in order to rule it out, an otorhinolaryngologist for children. Does your child cry when you put pressure in the tragus (the part of the ear that is near the cheek)? Does your child has temperature? If there is a bug and the tympanic membrane is okay, if you drop some water inside the ear the bug will come out. But, it also can be an ear infection. So, as I said before better visit an ORL pediatric doctor.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Emilda Belortaja",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for pain in groin and numbness in leg after sustaining a fracture in hip and sacrum?\n\nejected from vehicle in 7/31/13 had hip fracture in 2 places and fracture sacrum.still have pain in groin area feels like I am sitting on a golf ball. cant sit or ride long , left leg is numb and tingles like its a sleep. I limp most time and in pain all time cant sleep or get no relief in hip and leg.",
    "doctor_response": "Hi you had sustained Fracture in hip and sacrum  and still have pain in groin. I would like to know if you were operated and what was the nature of operation. In my opinion from  your description , I think that probably sacrum has malunited ( united in different position) . The nerve - Sciatic nerve passes very close to sacrum and hip and it might have been damaged partially. I suggest get an X Ray pelvis including SI joints and both hips and NCV Studies  for both legs. Start painkillers , Pregabalin and Spinal Extension exercises at present.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can chronic backache be treated?\n\nMy husband has a chronic lower right back pain. He does get some relief with Advil, but this problem has persisted for years. He will not take Advil daily or weekly for that matter. Has had digestive problems all his life, from irritable bowel to duodenal ulcers 20 years ago. He has had numerous abdominal ultrasounds in the past. Had his gallbladder removed 4 years ago due to a non-functioning gall bladder diagnosed with a HIDASCAN. This pain was relieved post op for almost a year, but has since returned. Seems to disappear when he lies down on his back. His concern is his kidneys. Doesn t feel like muscle strain or spine problem.",
    "doctor_response": "Hi. I understand your question I will help you to know what you want.. IF I were treating such case in my clinic ,firstly I will reassure the patient and expecting one of 2 conditions: Firstly I suggest doing X Ray and MRI  lumbosacral spine to exclude any bony or soft tissue changes that result in this back pain. second possibility that this back pain is due to his bowel problem as It may cause discomfort in the back due to abdominal distension.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for diarrhea and vomiting\n\nmy son is 17 months old and has had tan colored diarrhea for almost 3 weeks now. He has about 4-5 bouts a day. He has thrown up maybe about once a week or less. I took him to the doctor and they are doing stool samples but i just want to know what s going on.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron (as prescribed by your paediatrician).Regarding diet - You can use cerelac...any flavour will do. Avoid fruit juices as they might aggravate diarrhea. You can give zinc supplements & ORS apart from normal vegetarian porridges & soups.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe tooth pain and jaw pain\n\nHi, I have jaw pain. It has slowly gotten worse throughout the day. Both sides of my mouth and jaw hurt. If I put my teeth together my teeth even ache and hurt. I took (2) extra strength Tylenol and it helps a little, but I feel like I need to put ice on it. I have had TMJ...a long time ago. It feels like it but I do not remember my teeth hurting.",
    "doctor_response": "Hi Dear, Welcome to HCM.Understanding your concern. As per your query you have severe tooth pain and jaw pain . The symptoms you mention in query are pointing towards a condition known as bruxism that is clenching of teeth at night , which occur due to may reasons like TMJ problem , impacted tooth , misalignment of teeth , TMJ dislocation  or psychological problem . I would suggest you to consult oral surgeon for proper diagnosis . Doctor may examine physically , movements of TMJ , order CT scan and MRI to find out exact cause . Doctor may prescribe muscle relaxant along with anti inflammatory ( sometimes disc of TMJ get inflamed due to som reasons like injury ) or refer you to orthodontist for alignment of teeth . For now start stretching exercises of TMJ and physical therapy of TMJ .  Try to do yoga and meditation , which are essential for whole body relaxation .Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the following pregnancy scan suggest?\n\ni am pregnant now and the scan report shows single intrauterine gestation sac and the sac is normal in size and shows fetus with normal yolk sac.52mm corresponds to 11 weeks and 6 daysfetal cardiac activity 154/minnormal placental formation seen posteriorly , lower end touching the internal OS.cervical measurement 3.1 x 2 cm .internal OS closed.Please answer if my pregnancy is normal",
    "doctor_response": "Hello, and I hope I can help you today.This report shows normal placenta, gestational sac, yolk sac, and a fetus of approximately 11 6/7 weeks with a normal heart beat.  There is a mention of the lower part of the placenta is touching the opening of the cervix on the inside, but this really is not relevant in the first trimester.  Your cervix is also not dilated, which is normal in pregnancy until the baby is full term.An ultrasound in the first trimester cannot tell if the baby is physically or genetically normal. This is determined by blood tests that will be performed on you late in the pregnancy, and a detailed ultrasound that looks at the baby's body when it is a bit larger, usually around 18-20 weeks gestation.So, in summary, for now, you have a completely normal-appearing live first trimester pregnancy.  I recommend drinking lots of water, taking a prenatal vitamin supplement daily, and a healthy, lean well-balanced diet.I hope I was able to adequately answer your question today and that this information was reassuring.Best wishes for the rest of the pregnancy,Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to control hair fall?\n\nHi, i,m having hair fall and have been prescribed with adgain capsules and tugain and salfin lotion to be applied.but i have lot of white hair for which i'm applying hair dye and the dr has advised me not to use it for some days.But working in a professional firm i cannot do that !! can i use henna instead?",
    "doctor_response": "HIWell come to HCMYour basic information is missing here and that is your age and gender, if you are male then the treatment which is given to you would work partially, it is better to stop applying the hair color, you do not have any other option if ou need good result, take care, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes elevated ALT levels in LFT?\n\nHi, may I answer your health queries right now ?  Please type your query here...Hi,I am a 41 year old normally healthy female who recently had a baby 6 weeks ago. My ALT levels are normally fine but I was concerned so my MD ordered a liver enzyme test. The number was 64 U/l which according to palo alto medical foundation us WNL. Other labs report this value as high.During my pregnancy I was put on low levels (50-100 mg ) of labetalol, and after my c section was put on percocet and then vicodin. I also continued the Labetalol. This was my second C section. Post Op I had some cellulitis  and problems with my incision thus the reason they contiued me on vicodin. I no longer need the pain meds and do not take anything now for pain. I also am nursing. I do not drink anything alcoholic, do not smoke and am gradually losing the pregnancy weight (I gained 30 pounds).My QUESTION: Is the value of the ALT test alarming and should I question PAMF's upper limit of normal value? Again, my number for the ALT is 64 and 29 or 30 I believe for the AST.Thanks",
    "doctor_response": "Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I understand your concerns and I will try to help you as much as I can.I don\u2019t think this is related to your pregnancy. AST (SGOT) and ALT (SGPT) are reasonably sensitive indicators of liver damage or injury from different types of diseases or conditions, and collectively they are termed liver tests or liver blood tests. So the next step is to look for certain liver damage and most common casue is fatty liver disease. It should be confirmed by ultrasound. Other causes are viral hepatitis,cirrhosis, medications, alcohol intake or autoimmune diseases. To verify exact cause, US, bilirubin levels and tumor markers should be additionaly done Then appropriate treatment can be started.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is runny nose, cough, dizziness, fainting and low appetite after being on Tylenol concerning?\n\nDaughter 14 had temp of 102 yesterday, runny nose, coughing, we think flu,  today this AM normal. laying down yesterday to rest, took Tylenol last night, before bed at 6:45 PM, this AM got up walked from one room to another distance maybe 15' stood in front off mirror and felt light headed and fainted, then walked back to bed, is thirsty, has not eaten much , never had any fainting before, we think it is just lack of eating that much since she is not feeling well maybe she is weak.  first time in along time she has ever been sick, she plays soccer, basketball and is always in good health -- do you think we should be concerned",
    "doctor_response": "HelloYour daughter is having running nose , cough ,fever took tylenol and fainted next morning after she wake up .Faintness may be due to these possibilities , these include : 1 Side effect of  paracetamol , some times few patient feel such type of dizziness after tylenol. This is very common and not a cause of concern.2 faintness may be due to fever or cold or sore throat , this is also common.3 Hypotension due to fever and sweating ( dehydration).Faintness is very common and not a cause of concern particularly when your daughter is a soccer player , so all these are common ( faintness ).But if fever or coughing remains after 3-4 days  then consult a physician and get his opinion, at present not a cause of concern.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can asymmetric to the left superimposed uncovertebral disease be treated?\n\nI had an MRI of my cervical spine done last Friday. Part of the report states that at C4/C5, irregular degenerative ventral disc/osetophyte complex notes asymmetric to the left superimposed uncovertebral disease. Partially effaces the ventral subarachnoid space. The only thing I understand is the part about the bone spurs and that uncovertebral refers to C3-C7",
    "doctor_response": "Hi, In between the vertebra (bones in the back), there are discs.  Degeneration of the vertebra usually implies that there is arthritis of back. Osteophytes occur in arthritis. The spinal subarachnoid space is space in the spine which contains CSF. The imaging suggests that it is mildly affected. You should consider speaking to your neurologist or orthopaedic surgeon. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Period missing after taking pill, Pregnancy test negative, want to conceive\n\nHi my name is nicola, need a answer for what I m going to ask you. I came of my pill last year in may 2011, I didn t come on my period until 6 months later in november, but after that I haven t come on since, I m not pregnant, I ve done home pregnancy tests and all negative. I m really worried something might be wrong. And me and my partner want to try for a baby. What could be wrong, to why I haven t come on my period?",
    "doctor_response": "Hi Nicola, Thanks for writing to us. You should consult a gynaecologist for urine, blood test and ultrasonography to rule out the cause of delayed period. Get your hormonal profile done sometimes pills changes hormonal level. If you want to get pregnant your regular period is very important. Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy swelling on palms & soles?\n\nHi Dr, My palms and soles are itchy and swollen, It paints when i walk. now its combined with sore throat, I have red patches on my both palms, I have pain in my fingers as well. I am not understanding whats happening, The couple of doctors i met suggested its a food allergy, and gave me medicines which didnt help. One doctor gave me steroid tablets which gave me temp relief. But the problem still persist, does anyone  have any idea what is it ?",
    "doctor_response": "HI, thanks for using healthcare magicIt is is possible that it is a type of eczema possibly dyshidrotic eczema which can affect the palms and soles though there are also other causes.It may be affected by allergens so you can consider an allergy test to try and determine if there are any particular irritants that cause your reaction.In addition to avoiding these allergens, the use of topical steroids and oral medication may also be needed.You may want to consider a dermatologist.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for tingling sensation and pain in the rib cage\n\nI have a tingling feeling and at times a sharp pain about an inch and a half below my right front ribcage and about three inches from the center. Tingling comes and goes all different times of the day and while sitting or walking. I now have a small lump now",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have tingling sensation and pain in the rib cage. Well there can be many reasons for symptoms you mention in query like muscle spasm , chest infection , acid reflux and heart problem like angina . I would suggest you to consult cardiologist to rule out more serious condition first . Doctor may order ECG , TMT , troponin t test and complete blood profile . Doctor may prescribe isosorbide nitrate , aspirin along with diuretic and sedative . Doctor may also refer you to orthopedic surgeon for muscle problem or gastroenterologist for acid reflux . For now apply warm compresses and eat light and non spicy specially at night . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes depigmented and shiny penile tip?\n\nHi sorry for directness, but the skin on the tip of my penis has gone shiny and light colour. it becomes itchy some times and the rest of the times its fine. my skin also cracks when I have sex. I have tried anti fungal creams but no result. can you give help?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It may be candida balanoposthitis most probably. Consult the dermatologist for the perfect diagnosis and proper treatment. I would advise to take proper antifungal like Itraconazole. Apply antifungal cream like Clotrimazole cream. Cleanse the prepuce and glans penis with diluted Dettol liquid. Improve hygiene and immunity and also the partner should take proper treatment. Hope this helps. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could consanguinity causes mental issues?\n\nHi, my boyfriend has some problems with sex, he can\u00b4t be loyal to me because he needs to sleep with other women frequently and I m starting to think he is mentally ill. I recently found out his parents are cousins. Could consanguinity cause this type of mental issues?",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. I sincerely do not agree with your theses. consanguinity cannot cause this type of mental issues but causes normally physical problems. In your friends' case, if you do not like his attitude, desert him. If he really loves you, he should change himself and come back in search of you. Other wise, simply he is not suitable for you. Leave him and be happy.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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dark circles under eyes in an infant?\n\nMy one month old has really dark circles under his eyes. When he was born I notices he was chocking like on fluid and his eyes were realy puffy. As if they didn t suction his pasage well. Well now the puffiness is gone but the eyes are darkend and sometimes he still gags and chokes. Should I cotact an ENT specialist for help?",
    "doctor_response": "Hi.... I understand your concern. If the baby's weight is normal then I don't think you should worry. But if he is not gaining weight appropriately, then I suggest you consult with your pediatrician first and then on his advicee consult other Specialist.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do swelling near the incision after removal of appendix and stabbing pain in the lower abdomen need immediate medical attention?\n\nHello, I am a 20 year old female and have been getting stabbing pains on the lower right side of my abdomen everyday for about 4 weeks now. I know it cant be my appendix for it was removed in 2010. I have noticed that above the scar of my appendix removal the area seems risen, and beneath the scar the area is flat. Should i be worried and seek further help?",
    "doctor_response": "Hi, Noted the history of appendectomy in 2010, but there is now pain in the scar which is elevated.This can happen due to the following reasons as per the short history that you have provided.Incisional hernia that can develop in the scar, this may be the reason for elevation and the hernia causing compression or stretching over a nerve that gets you the sharp pains.Hence I would advise you the following in such a situation:Consult a General Surgeon for clinical examination, see for cough reflex that is whether the scar elevates or the lump enlarges on coughing and is reducible, this confirms that this is a hernia and needs surgery.Also needed is to see for the nerve that is affected and to get it free for the pain to be controlled.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. T Chandrakant, ENT & General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the sperm count normal?\n\nhi i am manoranjan patra my semen volume-2.0,viscosity-normal,colored-white total sperm count-110 million, normal spermatozoa75%,abnormal spermatozoa 25%, total modility- 90%,active motile 80%,sluggishly motile 10%, non motile ( dead)10 %,pus cell- 1-2, redblood cells - nill, Testicularcells- nill Please answar me is this normal? can i be a fathher",
    "doctor_response": "Hi Mr Patra,Yes you can be a father. The semen analysis result is normal. So you should not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should i be concerned about my father s painful knee and foot inspite of an injury?\n\nMy son was tackled by another child and hit his shin on the cement curb. His knee and leg down to his foot is very painful. There is no swelling but he can t straighten his leg and can not put any weight on it. Besides a sprain what else could it be? There is no redness or heat in the areas either. Thx!",
    "doctor_response": "In my opinion your son may have hurt his anterior cruciate legament or meniscus i recommend an MRI to be safe",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain, heart palpitation, weight loss, abdominal pain, shivering, felt during weather change. Reason?\n\nHi Doc, Iam a 29 year old unmarried guy.I m suffering from some health issues.It s been more than 12 years suffering from the problem.My problem is more prominent when the climate changes from winter to summer than summer to winter.symptoms includes: 1. Fatigue 2. Unpleasent taste in mouth 3.Lower back pain 4. Heart pulpitations 5.Unexplained weight loss 6. Abdominal pain and indigetion 7.sometimes fever 8.Headache 9.Low sex desire 10.Feel shivering even in the month of March(summer) These symptoms lasts for about 2 months and none doctor told me what it is exactly.So could you please help me out wit this problem?",
    "doctor_response": "Hello. Thanks for writing to us. The symptoms you have mentioned may be related to chronic fatigue, hormonal imbalance or cardiac disorder. A detailed physical examination and few investigations under the guidance of your physician will help in proper diagnosis and specific treatment. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal drtayal72@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness in legs and pain in groin area?\n\nGood afternoon. I am concerned about what is going on. I m making an appointment with my doctor, but my right leg has been generating unexplained bruising that is getting worse, I am experiencing numbness in it and my groin area on that side keeps hurting. Just wondering what it could be?",
    "doctor_response": "Hi Hope this message finds you in good health.I have gone through your complaints and understand your concern.I generally see many cases like this at my clinic.The first thing we do at our clinic is to find out the exact cause of the pain and numbness. We get an xray and if necessary an mri done to find out the root cause.In your case,there are 3 possibilities-POSSIBILITY 1. Soft tissue swelling- there may be no bony component,only the soft tissues around the region might have been swollen causing the symptoms.POSSIBILITY 2. Nerve involvement- there may be a partial or complete compression of one of the nerve that arises from spinal column,that might cause reduced nerve supply to the concerned partsPOSSIBILITY 3.muscle involvement- in some remote cases,the muscles in the region might get stiff causing fibromyalgia like symptomsBut i assure one thing, even if it is either of the above 3,all have a good prognosis and you should eventually get back to normal in coming few days.Nothing to worry about.I suggest you should get an mri done to come to a diagnosis.Do get back to me after ur mri reports are ready.\u00a0\u00a0\u00a0\u00a0\u00a0I hope your question has been answered.If you have any follow-up queries,feel free to consult me anytime.Thanks,Take care,God bless.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is chest pain related to a heart dysfunction?\n\nI am 62 years old and otherwise in good health. I just took a nap lying on my back. I do not normally sleep on my back, but rather, on my side. Several times lately I have napped on my back. I feel mild, but annoying pain on my chest as I awaken and it lasts until I stand upright and start walking around. Again, this is not a one time thing but a pattern that follows only this particular napping posture. Is this a heart condition?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. After going through your medical details I understand your concern and I would like to tell you that your symptoms can be due to underlying heart disease. Considering your age and symptoms it can be a heart failure which requires proper evaluation and treatment. It\u2019s recommended for you to consult a Cardiologist personally for physical and diagnostic evaluation. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes left side abdominal pain after childbirth?\n\nMy wife gets these bad abdominal pains on her left side and in her back ever since child birth. They don't happen all the time, but whe it does she's bent over in pain. She's gone to the er a couple of times but all tests come back inconclusive. So now she's afraid to go to the doctor. Please Help!!!",
    "doctor_response": "Hi.Thanks for your query. The problem of pain in abdomen after a childbirth can be a serious problem.You have not mentioned whether this was a normal delivery or by a Caeserian Section (operation).If going to ER is not helping Her, I would suggest you the following:Consult a Gynecologist or a General Surgeon for an internal / per-vaginal examination. Clinical examination is very important as it gives the information that no tests can give. Go for the investigations as suggested , which may be :Ultrasonography of the abdomenColonoscopyCT scan of the abdomen if there are positive findings on USG or need further evaluation.Psychological evaluation is there is a chance of post-puerperal psychosis.The treatment will be according to the investigations reports and clinical judgment of the Surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause loss of feeling in a hand, blood pooling around thumb while diagnosed with cancer in abdomen?\n\nA friend of mine has developed no feeling in her one hand and it extends up her arm to near the elbow. It looks like some blood is pooling along the thumb. She has cancer in her abdomen and will be starting treatment again tomorrow. The ends of the other fingers on her right hand are just starting to do the same thing.",
    "doctor_response": "Hello, Thank you for your contact to health care magic. I understand your concern. If I am your doctor I suggest you it must be a metastasis to the finger that has caused a blood to store there. It is the malignant metastasis that has caused you such a symptoms.I will be happy to answer your further concernYou can contact me. Dr Arun Tank. Infectious disease specialist. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is shingles the causes for lower back pain?\n\nI have had a acute case of low back pain which has immobilized me. i was just getting over a cold when i started Having symptoms of nerve pain in my right leg and an outbreak of shingles at the top of my right buttock. I have never attributed low back pain like this to shingles, but I am beginning to think that maybe that is the cause. I am wondering whether I should be getting an immunization vaccine for shingles. I am 61 yrs. old.",
    "doctor_response": "Dear patient shingles may be reason for back pain. Shingles is caused by varicella virus which mostly is seen in children but may be seen in adults. in many patients when their immunity is supressed virus which is dormant in body gets activated and reflects as intercostal pain and back pain. Treatment  is to start acyclovir and tab diclofenac for pain relief. please get yourself examined by skin specialist as soon as possible.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for alopecia on head\n\nHi, may I answer your health queries right now ?  Please type your query here...hi:),,i am suffering from alopecia on my head(hairline),,,things started when i suffered from chicken pox about 9 years ago,,went in for medications but without any improvement,,went in for lot of humiliations due to this,,lagged behind in studies,no career,no self confidence,, cant afford huge medications,, female,,aged 26,, response will be appreciated,,tku",
    "doctor_response": "hi there.1. we can help you in further preventing hair thinning and making it better.2. you can try rogaine 2% lotion, apply 20 drops once daily bed time for 3 consecutive months.3.have adgain capsules daily one after breakfast.4.use scalpe shampoo weekly twice for head bath, use only soft drinking water.don't worry they are easily available medication and cost effective.you will be fine.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for calico in kidney?\n\nHi, I am 48 years and my hight is 177 Cm & weight 73 Kgs. In last 3 year I noticed 2-3 times Urine & Kidney Infection & treated for the same. Suddenly from last weak I feel regular back pain in left side & pain in urine discharge. last year in my ultrasound report some calicos around 4.5mm were found in my left kidney & gall bladder. What should I do and what is the right treatment?",
    "doctor_response": "HelloThanks for query .Pain in left side of back is mostly due to calculus of a size of 4.5  mm in left kidney .Normally the stone of a size of less than 7-8 mm pass out through urine spontaneously and does not require any active intervention .take following treatment to help to pass out the stone at ease and quickly 1) Drink more water to pass 2 liters of urine in 24 hours 2) Get your routine urine test done to rule out any infection 3) Take antibiotic like Norflox as a prophylaxis to prevent infection 4) take Tomsulosin once daily .This will help to dilate the ureter and there by to pass the stone early and without pain .As regards stone in Gall bladder .If there is no pain in abdomen (Silent stone)it can be left alone and take a call for removal by Laproscopic surgery at later date or get it removed now . Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will Depakine and Tegretol increase my mental ability?\n\nHello, i am 27 years old, i suffered from 10 years from increasing in electric power in the brain, i take a medicine called Depakine & Tegretol , and i feel that i have a lake in logical thinking and mental health. I need for a treatment that can boost my mental and thinking, it is urgent please. Thanks",
    "doctor_response": "Dear User,Thanks for using health care magic.As per your query it appears to me that you are taking tegretol and depakene for seizure disorder which is associated with increased current in brain. I like to inform you that both these medicine are first line drug in seizure disorder because of their effectiveness and low cost in compare to new generation medication.In case you are not feeling well there is option of shifting to newer generation antiepileptics like levetiracetam, topramate or zonrsamise among others. Please talk to your doctor at next visit about side effect that you are experiencing with current medicine and hopefully he will change to newer molecules for your seizure disorder.In case that is not possible due to efficacy issue he can add some mood elevating medicine like modafinil or armodafinil.'Hope I have answered your query. If you have any further questions I will be happy to help\".Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart palpitations with fainting episodes?\n\nAbout 2weeks ago I nearly fainted and today I woke up feeling like i was up all night and hav'nt slept for days.I keep taking deep breaths to see if it will keep my heart from beating in my throat.thats what it has felt like all day since I woke up. I have'nt done any thing to my heart rate up. What is this I'm feeling?",
    "doctor_response": "Thanks for your question on Healthcare Magic. In my opinion, we should first rule out arrhythmia  in your case. Arrhythmia is rhythm disturbances in heart. It can cause palpitations, chest pressure, tightness etc. It also causes decrease blood supply to brain. And this causes fainting episodes. So better to consult cardiologist and get done 1. Blood pressure monitoring 2. Ecg 3. 2d echo. 4. Holter monitoring (24 hours continuous monitoring of ecg). You may need anti arrhythmia drugs too on the basis of above reports. 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dry and sensitive skin, tried different creams, but no results. Suggestions?\n\nHi ,I have a dry and sensitive skin, none of the market available mosturising cream suites me.Sometimes wrong use of cream leads to dry patches and many small small pimples on my face.I am fed up of trying new creams  suggested by someone or other every time. Currently I am using Curatio fash face wash , Evion mosturising cream and suncros aquagel sunscreen which is again not having a good result still I can sometimes see dry patches on my face and my skin getting darker slowly. Please help me as for my marriage 3 months is left and I want to look best on my day.",
    "doctor_response": "Hi Ankita Welcome to the forum.You should not be worried about the simple problem of your skin. What you are suffering from is quite common condition in people with sensitive skin condition which some times behaves both as dry skin and oily at places.The very first thing you should do is avoiding direct sunlight exposure to the skin. Even if you are avoiding the same then also there is exposure of UV radiations from computers and other artificial light sources, so should also take care of the same. the best avoidance is never at all by sunscreen but is by personal protection by clothes and umbrellas.Contact with Cell phone on facial skin (because of radiation and heat )also make the skin sensitive.Secondly you should start up your day drinking water and make it a routine to drink more than 10-15 glasses of liquids/day.Start eating a lot of Vitamin C and A containing fruits ( all yellow and sour fruits will do).Avoid waking till late night, take good sleep of 8-9 hours.Finally what you are using is fine, the only thing is don't rub your face wash excessively and  more than 3 times a day. Use your moisturizing cream immediately after washing your face when it is still wet in minimum possible amount otherwise it will lead to eruptions on the face in this summer season. Your sunscreen is fine. Try to avoid touching your face bare minimum as give dark patches because of irritation and avoid stress.By following above things slowly your skin will follow a normal course in few weeks of time.Best of luck for your marriage.With best regards,Dr Sanjay Kanodia",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the painful horizontal line on the side of my lower back?\n\nHello. A week ago I fell on my wood steps and landed on my left side of my lower back right above my butt. It bruised severely bad. But Now there is what seems to be a horizontal line that is really hard, painful when I touch. Should I get this checked out or any idea what this is?",
    "doctor_response": "good morning. it is better if u are examined and get an x ray done. as ur symptoms are not so severe i hope u need not worry. hard and painful as there is inflammation. what are u using",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe toothache due to infection\n\ni have had a severe toothache for about 3 weeks.  I know i have a severe infection because the pain is so intense.  The problem is i did not have the time to change my dental insurance so im stuck with a plan that most hospitald wont take.  Dental care in New York are very expensive and i really dont want to pwe anybody for years to come.  But this pain is so severe at times that i think my hea will explodde.  I get the worst headaches and i cannot eat anything without fear that i will cause my mouth to hurt.  While at work i take at least 7 or eight ibuprofen for the pain. And at home about the same or more so that i can sleep.  My ear hurts all the time, and sometimes feels clogged.  My face burns sometimes, tingles and even feels sore and numb when the pain is at its worst.  For the last two or three days not even an ibuprofen seems to be helping.  After about 10 minutes the pain returns.  It builds up like a contraction during childbirth and then at it its worse when i feel to faint it subsides.  I cant take this anymore and now its the weekend.  I need to go to an emergency dentist to get some teeth puled, if not tonight then definetly Saturday morning.  What can i do to help the pain, will an emergency dentist in a local hospital see me even if they dont take my coverage?  Please help feels as if i will die.",
    "doctor_response": "helloo..read thru ur query..i must say that it an be a periapical abscess(infection beneath the root).u have to take antibiotics (amoxicillin+metronidazole) for 5 days then infection will subside so will the pain..taking ibuprufen alone cant do much reduction as it can just be effective for sometime...after that if u want u can meet an endodontist and see if it can be filled(rootcanal treatment+crown) and saved..saving a tooth is most important than plucking it away..but as ur having problem with insurance yes u can meet a dentist and get it extracted....its better to take antibiotics and reduce infection and going to dentist as with infection dentist wont be able to extract on same day as it may cause more pain to u..do nice salt water gargle as many times as possible..try not to bite with that side..and meet ur dentist..be cool and happy..it reduces pain...peaceful mind can be best medicine..hope ur benefitted something from this reply..have a healthy day!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having pain in lungs\n\nwhen i beathe in i get a pain in my back both sdes as if ir was my lungs,when iam in bed and i move i can feal the pain and its quite bad, pain killers are not working any ideas",
    "doctor_response": "hey jemma u might have pain in ur chest muscle which while moving and during respiration u r feeling the pain ,remember u have not got any type of trauma to ur back and chest muscle ,dont take pain killers on regular basis .this will go off gradually .if the pain is unbearable then only take pain killers .rest urself ,take hot water bath ,restrain urself from activity which increases ur pain .bottom line is need to give rest to ur muscle which are strained.take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed rashes as eczema. No relief from itchy rashes on cheek bottom. How to cure?\n\nhi i have been having problems with my skin for about six months i have seen a skin specialist and he said that the rash on my body was exma and he gave me treatment for this which has helped but not cured.since seeing him i have had this itchy rash between the cheaks of my bottom for the last 6wks i have tryed over the counter creams but these are not working",
    "doctor_response": "Hello.itchy rashes on chin bottom is due to xerosis of skin.apply moisteriser along steriod cream for 10 days.regular application of moisteriser  may prevent recurrences",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for itchy breast inflammation\n\nLately my breasts are itchy, especially around the nipple area, and on one of them there seems to be a slightly inflammed montgomery gland with redness around it...is there a natural remedy?  I don't want to take antibiotics.  I also have an antibiotic cream that has some cortizone in it as anti-itch for exema that was on my arm, can I put this on  it?",
    "doctor_response": "Hi,It seems that there might be having some local skin infection like dermatitis giving this problem.due to itchinmg there might be having some bacterial infection as well.Apply the cream you are having for few days.If pain or swelling and redness persisted then you might require one course of antibiotic medicine.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am having some pregnancy symptoms with a negative result of prega news. Is it reliable ?\n\nI am 25 years old female married for 6+months my LMP IS 8/6/2011 i have not yet got my periods but today i took the prega news pregnaancy test at the evening and it turned out to be negative is this test is ok for confirming that there is no pregnaancy or is it possible that i will get my periods in 1-2 days my periods are almost regular and i have a 32 days cycle should i do take the test again with morning urine or not i have no other syptoms expect i got some dizzy spells yesterday evening and i think i am urinating alittle bit more also there is an increase in discharge from my private part please suggest me in right direction",
    "doctor_response": "Hello richi ; welcome to HealthcareMagic Sorry to correct you but your LMP shoud be 8/5/2011 and as a 32 day regular cycle the expected date should be 9 or 10 of June.The periods can get delayed due to hormonal imbalance also and the delay can be even for a week.But the main thing is that you had few dizzy spells and the urine frequency also seems to be increased so I would suggest you to wait for another 3-4 days and then repeat a urine pregnancy test and if that is positive you are pregnant.The reason for the wait and repeat is that many times it happens that the conception is late;so till you repeat pregnancy test please don't take any unnecessary medicine as you may be pregnant. All the best. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does symptoms like sore throat, cough with phlegm, ear pain and ringing indicate?\n\nHello doctor, I am a 16-year-old female. I have been sick lately (sore throat, coughing up yellow, green stuff, etc) but this morning I woke up with my cough worse and my ear aching and ringing and throbbing. Anything I can do to make it stop?",
    "doctor_response": "Hello. This appears to be an upper respiratory tract infection leading to throat congestion and blocked eustachian tube leading to symptoms. You should have Augmentin 625 mg (Amoxicillin and Clavulanic acid) three times a day along with some antacid like tablet Pantoprazole 40 mg before breakfast once a day for five days. Also, have Betadine gargles four times a day. For cough, you have syrup Ascoril two teaspoon whenever needed up to three times a day and also have anti-allergic tablet Allegra 120 mg once a day for three to four days. Also, have decongestant nasal drops Xylometazoline drop two times a day for two to three days. For pain, you could have tablet Acetaminophen 500 mg whenever needed. Have steam inhalation three to four times a day. Avoid cold food items. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I be concerned for a knot on the brow bone?\n\nHi my son fell and hit is head about 30 minutes ago. He has a big knot on his brow bone. Its a little purple not bad though. Its the hard knot that worries me.and he still has the imprint of the counter top.. he is acting normal but all of a sudden he is saying he is cold. Is this normal? Or do u think he needs medical attention?",
    "doctor_response": "Hello,Thank you for contacting me at \"Ask a Doctor\". I will try to answer your question to the best of my ability.It sounds as though he has a local contusion to the area. apply some ice, and give him some ibuprofen or Tylenol.  If he has any signs of concussion such as dizziness, nausea, vomiting, drowsiness, etc., then you need to take him to the emergency room. I hope this information is useful for you. Please do not hesitate to message us back if you have any further questions.Best wishes,Adrian Rawlinson MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will a possible stress fracture in the base of toe heal on its own?\n\nI have a possible stress fracture in the base of my 3rd toe. MRI and X-ray showed stress reaction. I don t know if that means full stress fracture. I ran a marathon last week and it is actually feeling Okay. I saw the Dr. yesterday and he sayss that I need to rest it if it is ever going to heal. He said that he could put me in a hard sandal or I could just wear my shoes with orthodics. I prefer not to use the sandal. I teach P. E. and I am on my feet all day. How long will I need to back off from running. I also teach spinning classes and assume that I can continue to do this.",
    "doctor_response": "Hi, Your doctor is right. You have to rest your leg, it will take a couple of weeks to one month for complete recovery. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Took unwanted 72 after unprotected sex. Had late menses with severe pain and heavy bleeding. What medicine should be taken?\n\ndr. before two months ago , i made a unprotected sex two time with my wife.first Monday and i gave her unwanted 72 on Wednesday.second time Friday in same week and unwanted 72 gave her Sunday.after that she told me that menstrual cycle not come on time and when it come then sever pain & more bleeding occurring . i am very afraid of this , please suggest me some medicine and ideas.i will highly obliged.",
    "doctor_response": "HelloThanks for writing to us with your health concern.IT is not recommended to take unwanted 72 so frequently.It causes menstrual irregularities.It can cause withdrawal bleeding and spotting alongwith pain and cramping.It can prepone or postpone your normal menstrual cycle by a week, or more.Hence what she experienced is pretty normal, after the emergency contraceptives.Right now, please do not take any more medications.It will worsen the problems.You should be taking regular contraceptives.Emergency contraception is not a substitute for regular contraception.You can start birth control pills from second day of cycles.It will regulate cycles also.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and itching in hands after flu?\n\nI am recovering from the flu. I was very sore all over, feverish and bed ridden for 2 days. Today I'm eating solid foods and feeling no pain, except in my hands! It started with my fingertips, and now my whole hands are itchy and really painfully sore.",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, if this is flue then this couple be self limiting condition may not need any treatment, you need to be in bed for couple of days, drink more water, and stop worrying about this, this would be fine soon, hope information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pregnant, drop of blood comes out after urinating. Ultrasound shows mild dilatation of pelvocalyceal system in right kidney. Meaning ?\n\ni am 27 weeks pregnant, and had a history of UTI during my first trimester, and now, the problem i have is when after i urinate,a drop of blood comes next. I thought i was having some vaginal bleeding , but when my OB doctor checked on me, the blood was not from my cervix . I did KUB ultrasound and they found out that i am having a mild dilatation of pelvocalyceal system in my right kidney. but not demonstrable stone was seen. There is also a fullness of the right ureter . they found out also that there is urinary bladder sediments. and urinary retention of 21%. what does this means. thank you!",
    "doctor_response": "hi there, blood in urine indicates injury or infection any where along the urinary tract starting from the kidney to the urethra. As your pelvicalycial system is dilated along with right ureter fullness it indicates obstruction at the level of ureter most probably due to stone or stricture.Some amount of urinary retention is acceptable in the 2nd trimester as the uterus is pressing on the bladder and hinders in complete evacuation. The dilatation of the ureter and the pelvicalyx should be taken care of . As you are 27 weeks pregnant, you may take the advise of a urologist whether it can be taken care of now or you need to wait. Usually 2nd trimester is a good time for any surgical intervention if requried but at your stage the attending urologist will be the best judge along with your obstretician. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am affected by kidney failure and criatinine, please tel some ideas\n\nsir I am affected by kidney failier and criatinine 4.3,nitrogen 40[blood] and also diabetic patient stil i'll prepared for Balanced Acu treatment please tel some ideas about this treatment [age]47",
    "doctor_response": "Kidney failure is a result of uncontrolled Diabetes. So it has become a complication now. At this young age, I would recommend you to take the opinion of a good Nephrologist, as there are many key things that you should do in the form of diet, medicines, lifestyle.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had embryo implantation. Progynova and femoston prescribed. Will these drugs help?\n\nHiI had my 5day transfer today and my DR  told me to continue with progynova , femoston inserted in the vagina, progesterone injection 60mg everyday, today after transfer she added duphaston 10mg twice a day.  She advised me to continue with my iron supplements.  I am would like to know how these drugs help my embryos implantation.  Something I didn't quiet understand on my last ultrasound my endometrium was 8.6 and that's 5 days ago and today during the transfer the doctor said it was a bit thin measuring 7.  Is it normal for endometrium to decrease? It's kinda worrying me.",
    "doctor_response": "Dear user, welcome to healthcare magic.Femoston contains estrogen which helps make your endometrium thicker in order to enhance the possibilities of implantation.Progesterone is necessary after ovum pickup to support the luteal phase, till the beginning of the forth month where the placenta develops and takes over.The difference in endometrial thickness may be interobserver variation no more so don't care about this.I suggest you take your medications and don' worryI wish you get pregnant soon. Good luck.Dr. Ahmed Bahaa.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there a remedy for constipation, undergoing dialysis and has low BP?\n\nMy mom is not able to pass stool from last 4 days. She had taken looz syrup for 3 times. Also dulcolax suppository twice and evacoul granules but not helped. Given cremalax tab  2 hrs back but not useful. Is there any medication . She is on dialysis and having low BP.",
    "doctor_response": "Looz syrup 30 ml for every 30 min till she pass stool. other option being she can take PEGlec. Consult gastroenterologist for prescription of PEGlec. Apart from medications give her plenty of fibre diet like fruits and leafy vegetables.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can h.pylori occur with a negative blood test?\n\nI had a blood test negative for H Pylori. Then I had a EGD that showed erythema, congestion and mosaic appearance in the antrum and stomach body compatible with gastritis (with biopsy). Biopsy is not back, can it be H Pylori even with negative blood test?",
    "doctor_response": "Blood test is not a definitive test for H pylori detection, urea breath test and biopsy reports will also help in the establishment of final diagnosis",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for persistent sickness\n\nMy four year old son is sick at least once a month. Jan -11 just started coughing and has green snot. December - Flu November- Ear infection October - Cold, ear infection, ect. I fell awful that he is sick all of the time. I want to know what I should or could do to help him stay healthy",
    "doctor_response": "Hello,Upper respiratory tract infections could be due to tonsils or repeated allergic infections. Uncured infections of throat can lead to repeated ear infections.Start Augmentin now, I do not know the wait but start in paeds dose for 5 day with syrup Rigix 1 teaspoonful (tsf) twice a day for 5 days and give Brufen in pain and fever and also, avoid cold and sour.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Hina Javed",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could lumps on breast suggest?\n\nHi Dr. Manjunath.About three days ago my daughter was resting her head on my chest. She jerked her body and her head hit my left breast really hard. I immediately felt pain. My breast is still hurting, and I can feel a hard lump above my nipple area. What is this lump? Could the lump further develop into something serious? Thank you.",
    "doctor_response": "Hi,From history it seems that there might be having some blood collection and induration due to hard blunt hit.Apply ice pack for few days.If swelling and pain increases, consult your doctor.You might require one course of antibiotic and anti-inflammatory medicine course.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for getting pregnant\n\nAge-28,Height-5.5,weight-73,i miscarage of 2 months in Jan 10 due to not aware of such.Planning for last 6 months but not yet conceive.Periods are regular cycle of 30 days consulted doctor this month itself she has prescribed the Folic acid and productive F to me and productive M to my husband.Plz help would this will result in positive and i conceived this months or what treatment i should go for.",
    "doctor_response": "Hi, I think you should take some medicines like clomiphene for the growth of your follicles and track your follicles growth by repeated ultrasound. Only productive M and F and folic acid will not work.  When follicles reach a size more than 17 mm, take injection for rupturing the follicles.  Be in contact with your husband for next 2 to 3 days.  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. You can do a thyroid profile and prolactin levels just to rule out any other problem. Hope I have answered your question.  If you have any other query I will be happy to help. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Stage four bowel cancer, chemo no help. Swollen feet, is it due to tumor or circulation?\n\nHi my mum has stage four bowel cancer which has spread to the liver and to the peretoneum. Operations weren t an option as the cancer has spread too far, she tried chemo back in November but was no point in continuing as the pain and after effects were too horrific. She is doing really good seeing as her oncologist said she should be dead by now, mum feels it is the supplements that are helping to boost her immune system . Her feet have become quite swollen the last few days, is this from the tumours and part of the body breaking down or is it more circulation and she needs to try and move her feet more? thank you",
    "doctor_response": "Hi and welcoe to HCM. I am sorry that you re confronting with such serious disease,but I am glad that your mum feels good. It is always hard to predict every malignant disease. Swollen legs can be caused by tumor pressure on pelvic veins,and this isnt uncommon. But also you should look for heart and kidney disease because both can cause swollen feet. Whatever it is she should lie with elevated leg,can put some pillow undernetah and do feet exercise. For the beginning blood pressure and echocardiography and basic labs would be good to evaluate kidny and heart function,although those swelling arent gonna hurt her very much if this isnt exreme. Wish you good health and good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Kindly comment on my psoriasis prescription.\n\nHi doctor, I have been suffering from psoriasis in my palm. When I was 12 years old, I had this disease for the first time. After taking some medicines it disappeared. But, it used to come on and off. In the past one year, I have faced this problem quite often. In between, I had homeopathy. As it cannot be cured, I shifted to allopathy again. A local doctor prescribed me some medicines for psoriasis and I want a second opinion about the prescription.",
    "doctor_response": "Hi. Yes, your treatment is right. But, do not take Folitrax for long duration (Methotrexate) as it can adversely affect your liver and immunity. For further information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could excess fluids in the abdomen suggest?\n\nHi my son has fluid in his abdomen. He has been sick to his stomach and not been able to eat. He has been getting very shaky and not sleeping. Not sure if he has been throwing up for he is in Florida and I am in Tennessee he has just been admitted to hospital for further testing. Can he have cancer (I pray that is not what it is) he is 23 years old.",
    "doctor_response": "hi,Dear,Thanks for your query to My HCM Clinic and understood your health concerns.Excess fluid in the abdomen is due to many reasons-Commonest-is Ascites / due to the liver cirrhosis from Viral hepatitis / alchoholic hepatitis.-Dont worry till you get definite reports from  the treating doctors.Talk to the hospital to get the right information.Relax till then.Wishing early recovery to your son.Wellcome for further queries in this matter.RegardsDr.Savaskar /India",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, taking Glycomet, follicular study shows non-progression. Can I conceive?\n\nI am trying to conceive for the last 1 year and 6 months. My periods are highly irregular. My gyn has put me on Glycomet SR 500 mg twice a day. Follicular study showed non progression. Now I had my periods on 29th July 2012. my gyn has put me on clofert 100mg for 5 days and asked for a follicular study from 8th Aug. please suggest, can i conceive",
    "doctor_response": "Hello. Thanks for writing to us. Since no active follicles could be seen with 50mg of clofert, yopur gynecologist has increased the dose to 100mg,. The formation of follicles is necessary for the release of ovum and conception. You need to follow the treatment as suggested by your gynecologist. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is there any abnormality in my semen report?\n\nHi doctor, I have been married for two years now. We have been\u00a0trying for baby since last one year, but not getting any positive result. We used to intercourse as per ovulation calculator, but my problem is that I can ejaculate only when she is on top. But, I failed to ejaculate in another position. Otherwise, I suddenly lose my erection within 50 to 60 seconds. Is there a chance to get pregnant when women on top? What should I do to increase my stamina and how to overcome sudden erection loss while intercourse in the missionary position?\u00a0I have attached my semen report. I am on Fertisure M and my wife is taking Ovacare.",
    "doctor_response": "Hi. I read your query with keen interest and reviewed the attached reports (attachment removed to protect patient identity). For further information consult a sexologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for bloated stomach\n\nhi, i have chronic ibs,im in pain with it24/7,lately i have been having fellings in my upper abdomen of fullness and winded, it feels like ive been puntched in the stomach and it gives me goosebumps all over,it lasts between half an hour to 45 imns,is this comman for chronic ibs?  joanne",
    "doctor_response": "Hi Joanne.Since you are a known patient of chronic IBS, it is possible that you are having more stress and / or anxiety at the moment. This is the most important cause of increase in your symptoms of feeling of full in the upper abdomen and feeling wind. The feeling of abdomen being punctured and and goosebumps all over can be due to intestinal infection.I would advise you the following :Take a 5-day course of an antibiotic, metronidazole.Continue probiotic for a long time.Stop all the foods and beverages that increase your problems. Control of the stress / anxiety by yoga, naturotherapy or medicines if needed. If there is no response go for the investigations of the blood, urine, stool, colonoscopy and CT scan of the abdomen to find or to rule out any probable causes of your problems.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I take emergency contraceptive again after taking it, having periods and unprotected sex?\n\nHi am 23 years old,68kg height 5 4. I took emergency contraceptive pills 7th of march and got my periods which started on16th of march,I had unprotected sex on 28th of march,is it advisable to take emergency contraception again?is my cycle back to normal?what should i do?",
    "doctor_response": "Hallow Dear, Emergency or post-coital contraceptive pills give protection against the pregnancy if the pills are taken within 72 hours after the unprotected sex. These pills do not offer any protection against pregnancy from the unprotected intercourse performed after the consumption of the pills. Hence for such intercourse after the pills, the dose of the emergency contraceptive pills needs to be repeated within 72 hours of that sex. In fact, emergency contraceptive pills should be taken only in an emergency situation and its routine use as a regular contraceptive is not advised. If you are engaged in a regular sexual activity, I would advise you to adopt some regular routine safe and reliable contraceptive method like condom, oral birth control pills or condom. I hope this clarifies your doubts. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe head jerking in a child?\n\nhi my child was in hos last month they said he suffering with anxiety nbut i think its much more she is head jerking really bad and its getting worse by the day she falls asleep during the day a lot to im sure she has conntacted something after having pandemrix swine flu jab can i be right",
    "doctor_response": "Hi dear,I had gone through your question and understand your concern, jerking of head can be sign of epilepsy after infection. I suggest- perform EE G;-MRI to exclude changes in brain tissue;-contact to neurologist.Hope it is answer to your question.Wishing your baby good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to stop hair loss?\n\nhi, i am swati kumari, my age 27 , i am a indian, live in bihar ptna, my challange is hair remove in head in mid centre skull 3cm squre area. i some hospitals go & for treatment some paste tacrolimus ointment tecrosis-f  & tabblets bioshel composition is biotin 5mg , vitamin e & excipients q.s. give. what i doing.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As per your case history you are having alopecia aerata. My treatment advice is - 1. Take good nutritious diet full of green leafy vegetables and milk. 2. Apply a Tacrolimus 0.03 % ointment twice daily on affected skin. 3. Take an iron supplement and vitamin B12 supplement once daily for 3 months. If problem persists then consult a dermatologist. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can hemorrhoids affect the tailbone and be the cause of severe pain while sitting and getting up?\n\nCan Hemmorhoids affect your tailbone, it s hard to get up and feels like a hard knot maybe, it hurts to sit most of the time, after I go to the bathroom #2, it stops hurting, for awhile, then starts back hurting, sometimes it feels like its burning and going to rip toward my upper crack, very painful to get up and sit.",
    "doctor_response": "Hi, Hemorrhoids usually give local pain.They don't cause pain in the tailbone. So, I don't think that your symptoms are related to hemorrhoids. I suggest you to do an X-ray of the tailbone for further evaluation and treatment. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes depression and lack of appetite?\n\nmy daughter is 20 years of age and she is losing weight suddenly and she's feeling depressed off and on and she can't keep a job and she feel sick off and on and on I think it's her thyroids but I am not sure I am going to have her check what do you think.",
    "doctor_response": "depression in this particular age of your daughter is mostly due to social and inter personal relationship related stressors, and due to poor coping abilities of individuals to deal with those. Very common and very curable, if properly managed. However, a proper assessment of severity of symptoms can only be done by through history and examination that warrants in personal presence of a psychiatrist, for which a psychiatric consultation is highly advisable here. A psychotherapy sessions and A course of antidepressants like escitalopram can be considered.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have hpv. Colposcopy and biopsy confirmed cancer. Removing half of cervix required?\n\ni have hpv and just wasnt feelin normal after some yrs i had a colposcopy and then a biopsy which came back cancerous. my doc said remove half cervix but i m hearin a hysterectomy is usually recommended? i meet with doc tmorrow mornin whats my mmost important questions to ask. and will my vagina still feel tight?",
    "doctor_response": "treatment of cancer cervix depends on the stage of the disease. early stage tumors are treated with radical surgeries plus or minus radiation, later stage tumors are treated by radiation in combination with chemotherapy. you need to discuss with your doctor the complete treatment plan and adverse effects of treatment. your vaginal tightness depends on your plan of treatment",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for soft spot on head due to hit on tile\n\nMy son had a fall a few days ago and hit the right side of his head above the ear on the hard tile - he is 11 months old. All the normal crying and fussing then he returned to normal after a few minutes and has been completely normal since. He does now have a large soft spot on his head where he struck the tile - but there is no discoloration at all - it does not hurt him at all when I press on it and he is acting completely normal. There does appear to be a ridge to the skull around the area that is swelled. Should I do anything?",
    "doctor_response": "Hi...this seems to be a soft tissue swelling due to the trivial injury. You need not do anything for it. It will settle in 2-3 weeks times. No need for ay medicines or ice application also.regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my 5 year old have abdominal pains?\n\nmy child has been complaining about tummy aches for the last week and sometimes feels sick.She is not eating much at the moment and she is goinng for a poo more often but normal consistency of the stools.not sure what is wrong with her,She is 5 years old",
    "doctor_response": "HI.The commonest reasons for tummy aches in 5 year old child is tummy-tonsils, meaning enlargement of intra-abdominal lymph nodes. These give typical symptoms like you described. Another possibility is appendicitis.In both the conditions patient has similar complaints. The best way to rule out is to have high resolution ultrasonography. Consult a Pediatrician or preferably Pediatric Surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain on lower back and waist?\n\nI had a very sharp pain on my lower back/ waist were i coulndt walk anymore and my sromach was tendee and rwal bloated it look like if i was pregnant but i had a massage and im barely gettn better after 5 days of pain im doin a lil better i can bend now n stretch wat was the cause for that",
    "doctor_response": "Dear friend, we have a got a nerve which starts from our lower back area to the legs.so if we cause our back bones or pelvic bones to work or bend more then it causes sudden  severe pain.also we have a cushion like structure between our vertebral bones.if this structure gets damaged due to overwork of backbone , nerve in between this vertebral bones feels pain.so that is precisely what happened in your case.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could the facial lump with hardness be?\n\nHi, I have a small lump on the side of my face, a bit like a small cyst. I have had these behind my ears also before, but they had gone within a few weeks. This on the otherhand, has been on my face for about 3 and half weeks now. What could this be? It is hard to touch but not painful. Thank you. Anita",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query facial lump with hardness could be due to draining abscess of underlying tooth as it is not painful. It could be due to stone in salivary duct, infection of oral cavity, lipoma and lymph node inflammation. Need not to worry about it. I would suggest you to  consult an ENT specialist and get it examined. Physical examination is very important to find out right diagnosis. Doctor may need an X-ray and an biopsy of the lump to figure out exact diagnosis. Maintain hygiene of oral cavity. Avoid sharp, spicy food substances as it will exaggerate your symptoms. Drink plenty of water.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness when I bend?\n\nI am feeling dizzy mostly when I move quickly or bend over. I recently started using a nicotine patch. I am taking medication for high blood pressure and I have taken my blood pressure two days in a row and it is around 107 over 70. Low for me even with the medication.",
    "doctor_response": "Hello!Welcome on HCM!I understand your concern and would explain that your symptoms are related to low blood pressure or orthostatic hypotension. Considering your complaints, I would recommend discussing with the prescribing doctor on the possibility of reducing the dose of your actual therapy, in order to avoid low blood pressure. Hope you will find this answer helpful!Kind regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Which medicine can be used to normalize my BP?\n\nhello doctor,my misses is having more blood pressure,it is equal to nerarly160/110 affter using revelol xl 50 tablet.it will not come down to normal level.we are some what feeling tention about that much of BP.kindly prescribe me better medicine to normalise the BP.",
    "doctor_response": "hi, you have realy high blood pressure. and at this blood pressure anything can be happen. you may have stroke or coronary events with this blood pressure. go to the doctor urgenty and take medicine. you can take losarton, B bloker or calciuum channel blocker according to your doctors advice. just go to the physician and take treatment accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe thigh pain\n\nHello Doctor. I m a 33 year old woman in good health. Tonight I began having pain (tender to the touch and constant) in the outside part of my right thigh. There is no redness, bruising or swelling. Just concerned because it was a sudden onset and I don t recall bumping my leg or etc. Blood clots run in my family so that is my first thought :/",
    "doctor_response": "hi,just relax acute pain could be due to overstretching of muscles at night while sleeping and this is common if you do not exercise regularly.  for the present take a few days rest till your pain is gone, then start gradual exercises, and see the difference.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest ways to improve immune system in children\n\nMy kids are very skinny and one is prone to infection. How can i help his immunity fast and then help him to gain some fat. He has always been so skinny since he started school was fine up till 5-6 age. But has always caught strange infection. No docs r helping and am stressed out. Hes always ill.",
    "doctor_response": "their are no medicines to improve immunity. It is Innate and hereditary.proper nutrition is the best way to keep the immunity going. Help your child with a lot of anti oxidant like fresh fruits and fruit juices. Also give a lot of fresh milk and other dairy products. Certain immunity boosters and provitamin preparations are available in the market which u can try(although not of much help).probiotics for proper digestion, good amount of proteins in form of meat and cereals, proper carb diet will help him gro strong internally. your child will acquire weight and height later on which we sometimes call as Catch up growth.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes poor memory along with dizziness and excessive sleepiness?\n\nThe last few months my head feels strange,I hear the sound when people talk I just can t seem to understand what they are saying. I have had some memory problems and dizzy I have fallen 3 times in a couple of weeks.I am extremely sleepy. I have always been a very active person. I don t understand?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. These symptoms can be caused due to wide range of problems like neurological, endocrinal etc. Consult a physician. Get your sugar level and blood pressure checked. Once your symptoms will resolve your memory problem will resolve. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pinching pain in lower abdomen?\n\nI m a 27 year old female and my husband and I are trying to conceive for the first time. We have been trying for 5 months, I have had a constant light pinching pain with spasms for weeks now and sharpe pinching pains at least a couple times a day all in my lower left abdomen. About two weeks ago I had a positive At home PT in the morning, went to the doctor that day and got a blood test, which came back negative, then the next week was told to come back. And do another blood test and it was negative all the while I have been having this pinching pulling spasms and full feeling but hungry so I m. Dry confused and worried. I have had normal stools, but very short periods for the mast two months (2 days long) which is not normal at all! Worried its tubular or ectopic or what? Help",
    "doctor_response": "Hi.Thanks for your query.Tubular or Ectopic pregnancy is a possibility and confirmed by ultrasonography and per-vaginal USG. If in doubt, diagnostic laparoscopy can be confirmatory as well as therapeutic . The pinching pains can be due to any other problem including the stress, anxiety and mild IBS. Get examined by Gynecologist again. MRI of the pelvis is more of value in doubtful cases .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is dark green stool normal after starting nan pro1?\n\nHi Doctor, My son is 4 months old and from 2 weeks we started nan pro1 then after he stopped taking my milk, from few days he was having greenis..but today he had dark green color stool having little bit yellow spots and it was lil bit greasy.....Please advise what to do...Is it normal or some intestinal.",
    "doctor_response": "Hi...it is  quite normal after starting a new formula feeding. Some times it can even result in constipation too. It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of potential pregnancy?\n\nHi Sir/Mam, My period normally starts from 25 or 26 of each month and stays for 3 days. I had unsafe sex with my Boy somewhere in 10July to 12July. After that I had my regular/normal period for the month of July and August. However, now my period is 10days over for September month. Am i pregnant???",
    "doctor_response": "Hello, and I hope I can help you today.Contrary to popular belief, many women can miss a menstrual cycle once in a while for reasons other than pregnancy. Stress, weight changes, differences in your daily schedule, and even worrying about pregnancy can delay your cycle and sometimes even make you skip your period.What I can say for sure, which I hope you find reassuring, is that there is no way that you could be pregnant from an encounter that happened before you had to normal menstrual cycles. However, if you had have sex since your last period, I would recommend performing a pregnancy test as the most common sign of pregnancy is a missed menstrual cycle.What I suggest you do at this time is, if there is no possibility of pregnancy, just try to wait and see what happens when you're period would be due this month. If you miss another menstrual cycle, it would be prudent to see a doctor for evaluation, as other hormonal problems and medical issues can also be a reason why your menstrual cycle skipped.I hope I was able to adequately answer your question today, and that my advice was reassuring.Best wishes,Dr. Brown",
    "dialogue_context": ""
  },
  {
    "patient_message": "Laproscopic surgery suggested for endometriosis. Can it be cured by Ayurveda or homeopathy?\n\nHi..im veena...im 23 yrs and my hus 28 yrs..im tryng to conceive for 7mnths.i have consulted a gynecologist and she diagnosed condition as endometriosis.left ovary 6cm and right 8 cm....they suggest laproscopic surgery...i want to know is it curable by ayurveda or homeopathy as im feared of surgery",
    "doctor_response": "Hello and Welcome to HCM, I had gone through the case and found that it is cured by homoeopathic medicine.You must give all the detail of grade of endometrial thicknes along with other associated problem like menstruation and leucorrhea etc.After getting the detail, we can start the medication.Hope you find the answer of your query.Thanks,Dr.Soni VermaHomoeopathic Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for palpitations and breathlessness\n\nHi i  had the second from the back top tooth taken out a week ago. I am getting a little pain, although day by day that is subsiding.  My problem is that i keep getting palpitations and feelings of breathlessness - i've never had this problem before and im a little worried. What do you think this might be",
    "doctor_response": "DEAR USER,THANKS FOR CONSULTING WITH HCMI UNDERSTAND YOUR CONCERN BUT REMOVAL OF TEETH IS AS SUCH NOT ASSOCIATED WITH PALPITATION OR BREATHLESSNESS UNLESS AND UNTIL YOU ARE ANXIOUS ABOUT ITI ADVISE YOU TO GO FOR A ECG AND ECHO IF REQUIRED AFTER CONSULTING THE CARDIOLOGIST SO THAT HE CAN DIAGNOSE THE UNDERLYING CAUSE IF ANYHOPE I ANSWERED YOUR QUERY. YOU CAN MESSAGE ME FOR ANY FURTHER CONCERNS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for frontal lobe encepholomlecia along with memory loss\n\nI have frontal lobe encepholomlecia and I m tired of the depression and memory loss. I am currently taking Effexor to stabilize my mood and Aderal for ADD. Are there any other meds that would work to relieve the symptoms? I m thinking that Aricept my help?",
    "doctor_response": "Hello,Thanks for using healthcaremagic.In my view you can try piracetam and citicoline which are nootropic medications. Unfortunately Aricept did not show any improvement in frontal lobe symptoms and not recommended.I mustt inform you that both are prescription only medications and you need to discuss with your doctor before making any such decision.Other than this it is required to practice yoga and meditation as they are effective in controlling few symptoms of frontal lobe damage.Thanks and regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What should I do to reduce my OCD?\n\nHi doctor, I am observing obsession since last two to three years. I discussed my symptoms with a doctor at icliniq and he told me it is due to OCD (obsessive-compulsive disorder).\u00a0Firstly, I have this problem if a topic or matter emotionally bothers me. I keep calling my mother frequently on phone and start talking for long duration. I cannot be without calling as we both stay in different state. If I do not get a chance to call my mother then I call to any of my friend and talk about the same topic. When a topic or thought rotates in my head my focus tends to go there only so current work gets disturbed. I do will start cooking and then forget and go to other room to start another work. Even though in office I always works good, recently observing that my focus is diverting from my work to other work where my mind tends to stay. Because of this, my current task is getting affected. Secondly, I am very absent minded at home. In office also I sometimes forget to attend daily meetings where all project teams come and give updates regarding their progress of tasks. I also forget sometimes to check fingerprint in office which is for security purpose. I have stopped taking care of myself.\u00a0My life is not routine oriented at all. I am poor in time management also. When I am at home, I generally walk and keep eating something. In office whenever I call mother from my mobile I cannot relax or stay at same area and I keep walking and talking over phone.\u00a0Please guide me. What should I do to reduce my OCD, absent mindedness, anxiety and restless nature? These are immensely bothering me.\u00a0Do you offer psychotherapy online for these? What is the procedure to attend psychotherapy sessions online? Please guide. Thanks.",
    "doctor_response": "Hi. I read your query with keen interest and agree with your doctor who suggested OCD (Obsessive-Compulsive Disorder) for current symptoms. In addition, it appears to me that there is secondary depression. So, your diagnosis for current condition can be called OCD with secondary depression. Regarding treatment part, both psychotherapy and medications are effective for control of symptoms. I do offer psychotherapy for OCD and depression on weekly basis lasting for 10-12 weeks. Majority of the patients get benefited with psychotherapy of such duration. In addition, few patients who have moderate to severe symptoms need medications in addition to therapy. Revert back with the detailed information to a psychotherapist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive, had sex on seventh, eighth and ninth and experienced vaginal cramps, sour milk discharge. Problem?\n\nHi Doctor. I have been trying to fall pregnant for the past 6 months, I had my period on the 2nd of this month which lasted for about 3 days. I had sex on the 7th,8th and 9th then started experiencing viganal cramps that lasted for about 3-4 minutes. on the 10th my discharge had a sour milk smell to it... What could it be?",
    "doctor_response": "Hello,thanks for using health care magicIt is possible you have a genital tract infection.Genital tract infections could be sexually transmitted or promoted by sexual intercourse. More so, following menses, it is very possible to have germs grow on bits of menstrual blood that are in the genital tract.The best thing to do would be to meet a doctor for detail examination and for a vaginal smear to be done and examined for an appropriate diagnosis of the causative agent.Best regardsDr Achuo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in right lower abdomen?\n\nHi, may I answer your health queries right now ? Please type your query here...i had an abortion where the fetus was removed at 5months,and iv been having pain on my right lower abdomen since then, i was diagnosed with pid a year ago.could my fallopian tubes be blocked?",
    "doctor_response": "Hi! Good afternoon. I am Dr Shareef answering your query.The pain on the right side of abdomen could be due to a persisting pelvic infection, or could be due to a urinary infection after exclusion of any chances of appendicitis by a physical examination. If I were your doctor, I would have advised you for a urine routine/microscopic/culture sensitivity test, an ultrasound of abdomen and routine blood tests like a CBC and ESR. The status of the tubes could be known by a radiological investigation like an HSG (Hystero salpingogram) by an experienced gynaecologist in association with a radiologist. Till the reports are ready, you could go for an anti inflammatory along with a proton pump inhibitor drug for a symptomatic relief.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes grey discoloration on the body while on Benadryl and Tylenol?\n\nAn 18 month old boy ran a fever every day last week. Also runny nose, cough,malaise. Augmenting started Wed. Fri woke up covered in rash. ER said allergic to to augmentin. Yesterday facial edema and still fever, pediatrician said benadryl and tylenol. Today in the bath he became blueish grey all over. Now back at DR waiting to be seen. Any ideas?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It could be a fixed drug eruption to Acetaminophen. But skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically. Please revert back to me with images so that I can guide you better. Regards, Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fluid in lungs on chest x-ray and swollen neck lymph nodes?\n\nHi, my husband has been though much testing in the past 2 weeks. It all started with a swollen supraclavicular lymph node. Then a week later one on the other side became enlarged. After a week, he went to the doctor who put him on amoxicillin. During this stage, he got extremely tired, and began running low grade fevers. After the 10 day regime with no results, he went for blood work, which all came back normal. Next, a chest xray, which showed fluid in his lungs and something in his chest. A ct scan revealed the swollen lymph nodes in his neck and either a mass or swollen lymph nodes in his chest. He went to get the fluid drained off his lung. They took a gallon off and said they would take the other gallon within a week (he has an appt. Monday). This fluid was tested and lymphocyte cells were present. He had a biopsy of the first swollen lymph node a couple of days ago and they said the results would be in within 7-10 days. The doc. said something about a type of lymphoma after the initial look at the biopsy. We now have an appt. with an oncologist this week. I feel like we are not getting enough info. They say whatever is in his chest is pushing on an artery, which is causing the fluid. I don't understand why no one knows what this is. If this is lymphoma, is there any insight as to what type it might be? Is this something where he will need his lung drained every week? He has been feeling short of breath with back pain due to the fluid. He is 32 years old and other than this has always been in great health. Any detailed info. would be appreciated. Thanks",
    "doctor_response": "Hi Dear !! Thanks for your query to HCM .Read and reviewed your query and health concerns. IN the given situation, You seems to have suffered from-NHL Lymphoma with Mediastinal Lymph nodes with supraclavicular nodes first on one side and then on the other side.Other possibility could be-TB lymphadenitis with glandular lymphdadenitis / and Sarcoidosis.But in view of the lymphocytes in the pleural effussion, chances of NHLymphoma and or TB Lymphadenitis.Chances of NHLymphoma are more in view of the supra-clavicular lymphnode swellings.Hope this would help you to plan further of this complex illness of yours.If need be, update any health issue 24 x 7 by a direct question to ME, at following HCM link- if satisfied,Don't forget to close this query with YOUR pleasing feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at HCM services.If you want to update more details and ask more update queries ,You are most Welcome herewith !!Good Day!!Wishing Good Healthy Life in time to come!!Dr.Savaskar M.N.Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for itching ringworm infection\n\nI had what was told to be ringworm on my arm/ side of elbow...which has spread to my back, Both sides of my thigh and a patch on my back leg and on my neck..it inches so bad that I scratch and it spreads and never goes away... What can I use and What should I do",
    "doctor_response": "Hello,Welcome to HCM,The ring worm is caused by a fungus. They thrive on moist surfaces due to sweat formation, they infect that area and the infection spreads if not treated. Wearing wet clothes and not wiping that region completely dry creates a favorable condition for the fungus to multiply. Ringworm infection needs to be treated with antifungals.You can apply clotrimazole cream or terbinafine cream. Either of these has to be applied twice a day. They have to be used for two to four weeks depending upon the area infected.I would advise you not to use clotrimazole combination with steroid cream since it basically masks the infection. You should use a plain clotrimazole cream.If the infection is not controlled by application of cream for a month then oral antifungal might be needed.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a swollen hard stomach?\n\nbloated jard stomach hi i have had a swollen hard stomach for 3 weeks and my breasts hurt I was 12 days late for my period before i had my period I had 3 days of brown discharge then a 2 day clotted bleed had blood and iron test came back Meh yet my belly is getting bigger and harder with slight pains on my rite side what could this be",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern looking to the history given here I could say that the chances of flatulence may be there and could be due to some intestinal infection and this could be protozoa infection and this could be treated with \"Tab Metronidazole 400 mg twice in day for five days, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do I have Lymphoma?\n\nI have been feeling sick lately, with more and more symptoms showing themselves. After googling my symptoms I learned that I have almost all of the symptoms of a person with lymphoma. The only symptom that I can say I don't have is weight loss. I am not jumping to the conclusion that I have lymphoma, but I would like to know what type of doctor I should go to in order to receive tests that will tell me what is happening with my health. Do I need a blood test?",
    "doctor_response": "You have not mentioned your symptoms in detail. Do you have any lymph nodes palpable in the body. What about fever, night sweats.I would suggest that you see a GP (General Physician) for your detailed history, clinical examination and baseline investigations before any specialist consultation.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart palpitations?\n\nMy heart has been racing for a couple weeks now. Heart rates ranging on average from 111 to 122. I do nothing to cause this. It is like this even while sitting down doing nothing. Along with this and for even longer my left arm has felt like it has a rubber band around it cutting off circulation or something. It sometimes gets so painful i can not hold it up to wash my hair or even put it in a pony tail. Well now the last few days I ve been having an issue with my neck. It feels as if the main arteries (or at least the largest ones) on both sides are a out to explode. It mainly feels like this if i move in certain positions, do any kind of work and most definitely cough. Coughings the worst. It also feels as iff the sensation may be starting to go down into my right shoulder a bit. What is going on and how worried should i be? I ve told two of my doctors about my heart rate and my arm and they just brush it off.",
    "doctor_response": "Hi welcome to hcmI understand your query and concern.Irregular heart beat in your case are suggestive of any arrhythmias of heart which means abnormal conduction abnormality of heart.I advise you to get an ECG,2 D Echo of your heart immediately to confirm the diagnosis.I also advise you to get lipid profile,complete blood picture,chest x ray immediately as a part of routine check up.Drugs like Amiodarone,Betaloc,Pantop 40 mg will be helpful in your case.Avoid stress and anxiety.Avoid smoking ,alcohol,fatty foods.Abnormal lipid profile if present in your case should be treated with atorvastatin.Monitor blood pressure and heart rate immediately.EP study and radiofrequency ablation will be the procedure of choice.Consult your cardiologist for expert management.Post your further queries if any,Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "36 year old with sickle cell anemia. Feeling breathless on climbing stairs. Due to poor level of fitness?\n\nI am 36 yr old, african american female with sickle cell anemia, type SS. I notice that i am quite breathless after going up 2 flights of stairs (12steps each). Is this indicative of my condition or can it indicate a poor level of fitness that i should address? It takes me 10 -15 mins to recover breath. I live a lightly active lifestyle. Exercise once per week",
    "doctor_response": "Hellowelcome to health care magicThanks for your queryYou have been diagnosed as sickle cell anemia..sorry for thatsickle cell anemia is a hereditary condition in which red blood cells are sickle shape rather than normal shape..these sickled cells undergo clumping in low oxygen states and leads to luminal obstruction of smaller vessels..Their life san also reduces and undergoes hemolysis leading to anemia..Because of low hemoglobin you may feel tiredness on simple work..In the query you didn't mention about the hemoglobin level..depending upon the level of hemoglobin,,the treatment for this varies ranging from folic acid to blood transfusion.Take medications like hydroxy urea,,it will reduce the sickling..Consult hematologist for more suggestions.. Hope you understand my suggestion..Thank youDr.siddartha",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to manage the fatigue caused by the medicine Montek?\n\nI have am taking montek lc, 1tablet everyday for alergy and wheezing. If I dont take the tablet even one day, I will be sick, with wheezing also. Its like I am addicted to it. I am always tired when i take the medicine. How can i stop taking montek lc.",
    "doctor_response": "You are saying if you skip montek, you get sick with wheezing. It basically doesnt mean u r addicted to it, it means without taking it you get the problem of wheeze. So I would say dont stop taking the montek without your doctor deciding to stop it. You have to consider taking care of wearing a mask while driving or gardening etc and prevent allergens getting into your lungs, along with taking your meds regularly. As you get better with time, your doctor may decide to stop it. Until then follow what your doctor has prescribed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Test showed mild enlargement of liver. Should I be worried?\n\nHi I m 38y male and recently did a master health checkup. I m 83kgs / 180 cm in height and have a normal exercise body. I m non smoker and non-alcoholic. The observation in my USG scan mentions a very mild enlargement of liver (mild hepatomegaly ) and my family physician says it s very mild and nascent and nothing to worry. TMT , Pulmonary , ECG, Echo Doppler tests was perfect with no abnormal findings. My blood esr is 30mm/hr: RBC 11.9 gm/dl: MCV 63.19 fl : MCH 20.66 picograms. LDL Cholesterol : 127 mg/dl Serum Uric acid : 8.1 mg / dl SGPT/ALT : 64.1U/L Liver Enzyme (Billirubin counts, SGOT/AST, Alkaline phosphatase) - are all in perfect normal range. Is the condition Mild Hepatomegaly, a serious thing to worry. Should I go and take further advise from a Gastro-enterologist. I know liver is an intelligent organ and it can sometime come back to normal size. Appreciate an expert advise on this. Ganesh",
    "doctor_response": "Hi Nothing to worry. By your name,it is evident that you are from a Tropical country,where infections like Malaria,Hepatitis,Amoebiasis etc are common.So,Mild hepatomegaly in your case is just an incidental finding or any previous infection might have lead to hepatomegaly. As you are Non alchoholic,Liver function tests are normal,no need for further investigations. There are no lesions in the liver like abscess,Cyst etc . Eventhough if it doesn't come to normal size,no need to worry. It has excellent capacity of regeneration.Eventhough 75% of liver is lost due to trauma,it can regenerate into whole liver. Please stop worrying. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is involuntary thumb movement related to seizure?\n\nHi doctor,I am taking antiepileptic medicine Selzic 300 for three years now, and I have a\u00a0problem with involuntary thumb movement. My doctor suggested Clonazepam along with Selzic, to control this thumb movement. From the last three years, I am fits free, and at the age of 5, I had meningitis. Please tell me if I am at a risk of getting fits.",
    "doctor_response": "Hello. You are saying that you are fits free for last three years. I need more detail. Revert with more information to a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the glass like substance near lung in x-ray?\n\nMy brother in law had shoulder x ray done for upcoming surgery, the X-Ray showed glass like substances on part of the lung that showed in the x ray, he smoked many years ago, and over the last 3 weeks got a cold like illness, coughing, running low grade fever, what can cause this he was never knowingly exposed to asbestos",
    "doctor_response": "Thanks for your question on HCM.I can understand your situation and problem.In my opinion your brother is having infection in lung either bacterial pneumonia or tuberculosis.Because the glass like opacity in lungs on x ray is known as consolidation.He is also having low grade fever, cough since 3 weeks, so possibility of lung infection is high.So I advice you to consult pulmonologist for your brother and get done1. Chest x ray2. Sputum examination for AFB to rule out tuberculosis.3. Sputum culture and sensitivity to rule out bacterial pneumonia.Consult pulmonologist and start appropriate treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes coughing and vomiting?\n\nMy son has the cold. He got up coughing so I gave him pedia care cold and allergy. A few minutes later he was still coughing. I encouraged him to drink water. I made him some chamomile tea and soon afterwards he vomited due to the coughing. He seems better and stop coughing. I evelated his head with pillows and he sleeping. I hope he okay. Should I watch him further for another hour?",
    "doctor_response": "Hi, thanks for using healthcare magicThe most common cough of acute cough is viral upper respiratory tract infection ( common cold). The coughing occurs due to post nasal drip of secretions and also due to irritation and inflammation of the airways.By elevating him you would help to decrease the backward drip of secretions and should decrease the coughing.He should be ok. It can take 1 to 2 weeks to recover completely.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes abdominal pain upon standing from sitting position?\n\nI ve noticed lately that in the afternoon, after having sat in the recliner for a while with my husband, when I go to stand up there in a sharp pain in my lower left abdomen area, near my hip and front side. I never have a nagging pain throughout the day; like I said, it only really hurts when I stand up after having sat for a bit.",
    "doctor_response": "HI.This type of pain is typical in a sense that it increases only when you stand up from a sitting position. This indicates inflammation of the ilio-psoas muscle. You need to undergo CT scan to confirm about the likely problem with the ilio-psoas muscles. Take a medical treatment if there is no abscess or so. If there is an abscess, you have to to get it operated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness in the knees post knee replacement procedure?\n\nI had total knee replacements, both knees, approximately two years ago with great success. Today, however, I am experiencing a tightness and some pain in my knee joints. Is it possible to experience gout in prosthetic joints, or what other ailment may be the culprit?",
    "doctor_response": "Hi,GOUT IS NOT CULPRIT BUT LACK OF PHYSIOTHERAPY IS.ALSO GET XRAY OF BOTH KNEES STANDING DONE IN AP AND SEND ME THE REPORT.IN ADDITION TO PAINKILLERS ADD amitriptyline tab.SO DO PHYSIOTHERAPY DAILY.THANKS.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Taking birth control. Had periods, belly looks bigger. Pregnancy test negative. Suggestion?\n\ni was on birth control and at the end of july i started feeling like i was pregnant and my belly got bigger so i stop taking them well i had two period in sept and i missed last month and i have started yet i took home pegnancy test and it said no but i look like im pergnant and im sick to my belly and i done this with my last one can u help me",
    "doctor_response": "Hi,If the pregnancy tests are negative and and if you are getting periods there is no possibility of pregnancy.There are two reasons why your belly may be looking big.1. What is your age? May be you are putting on belly fat. In that case, you need to exercise well.2.Please get an ultrasound done. Sometimes the presence of ovarian cyst or fibroid uterus( smooth muscle swelling of uterus) can cause the belly to look bigger.I hope I have answered to your satisfaction.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does masturbation cause chest pains?\n\nAbout 2 weeks ago, I was shovelling snow and developed chest pains. I went to the emergency room and my EKG/etc were fine. I have reflux and raking/etc has triggered it in the past- it s just never lasted 2 weeks. It could be a severe muscle strain. My question is about masturbation. It seems to make the pain worse. I went a week without doing it, the pain was easing up, so I tried it and- bam it s back. I ve gotten chest pain from masturbating before. What is causing this? If I can t get some release from time to time, I may as well shoot myself!",
    "doctor_response": "Hi, Your words indicate that this chest pain comes every time you are in stress, snow shoveling, masturbation....etc., so you need to do what's called (stress ECG), to exclude heart problem. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Salah Saad Shoman, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the reason for weight loss and hair fall after craniotomy surgery?\n\nHello doctor, My sister is having a craniotomy operation. MRI before surgery and post-surgery are attached. Biopsy report is also attached. So, kindly help me to understand the biopsy report. Current medications are Encorate Chrono 500 mg twice daily, Thyronorm 50 mg. Current problems are weight loss, severe hair fall, less appetite, weakness, not able to eat or smell non-veg items, no hunger.",
    "doctor_response": "Hi. The biopsy report and MRI findings are suggesting astrocytoma which is kind of cancerous brain tumor. Post operation MRI is showing that the tumor is not fully removed in surgery. That usually happens in these kinds of tumors because it is sometimes not possible to remove the whole tumor. Please consult with a good radiation oncologist to decide radiotherapy if not yet given. Hair loss is because of Encorate. Restoring the symptoms should be taken seriously and a repeat MRI should be considered after consulting with the neurosurgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure sore blisters on penis?\n\n..Doc i have sore blisters in my penis ,they come and go when they appear i normally visit my GP and he will give a cream and pills,i asked him to test me and the results came im fine .i am fraid when they come back coz they are painful.plz help.",
    "doctor_response": "Hello, Here are some of the home remedies which you can do to prevent sore blisters. Wear loose-fitting, breathable underwear and pants in soft fabrics. Apply a gentle moisturizer, petroleum jelly, or aloe vera to the skin of your penis as needed. See your doctor if your skin's draining pus. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr SAMEEN BIN NAEEM, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to shake/shiver before climax during masturbation?\n\nHello, I m a 14 year old male and have been getting wet dreams since i was 13. But i never really masturbated to ejaculation. When i masturbate and feel i almost cum i start shaking and i stop wanking and still shake for a minute or so ( my hands and legs mainly). So my question is if this is normal, thanks.",
    "doctor_response": "Hi,Thanks for writing.Shaking or shivering at or just before climax is experienced by few people. This can be due to exhaustion, muscle spasm and tiredness. This is due to the intense contraction of muscles in different parts of the body. This usually happens when deeper orgasms are experienced. There is nothing to worry as it happens only momentarily for a minute. It might be the result of a more focused masturbation leading to greater excitement, especially if your feet are off the ground.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do if having lupus and swelling in sternum from where pain radiates?\n\nI have lupus and take several medications. Today I went in to the hospital with chest pain which tested negative for anything heart related. I do have swelling along the sternum and the pain radiates from there. It a result costocondritis is suspected. What can I do for relief until I am able to see my family doctor?",
    "doctor_response": "you can take NSAIDs group of medicines like ibuprofen, naprosyn like medicines for short term, but I advise you to see a rheumatologist to rule out TB also in sternum, which is some time seen in lupus patients",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does lumps in leg with bent knees suggest?\n\nHi I am 19 years old, and I have a lump on my lower left leg about 5 inches below the knee on the left side, but I can't feel it unless I am kneeling down where both my knees are completely bent, that's only when I can feel it...almost as if it only popes out when doing so..is this at all serious? please help",
    "doctor_response": "Hi,DEar,thanks for your query to HCM.I studied your query  in depth.1-In My opinion the the leg lump 5 inches below your left knee,hope it comes on the left back of the left knee on kneeling only,in that case -most probably it is MB cyst-Bakers cyst / or could be -Saphenous varicose vein- lump-which is  a possibility. 2-Hope this would solve your query.3-Wellcome for any more questions on new or this subject also...Have A Good Day..!!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is sleep test required for breathing difficulty while walking?\n\nI have had breathing problems come up in the past month & 1/2 when doing much walking & small things. I have shortness of breath where I have to breath through my mouth to get enough air. I went to a heart Dr. & he said all sounds good then he had me go to a lung Dr. that now wants to have me do a sleep test. I only had about 5 of the sleep questions in minimal & that s only because I have a bad hip that wakes me up at night. I told her this but she still wants the sleep study. I want a second opinion, am I wrong ?",
    "doctor_response": "Hi, In my opinion, you should not get done sleep study first. Better to first rule out lung related pathologies for your symptoms. So consult pulmonologist and get done clinical examination of the respiratory system and PFT (Pulmonary Function Test). PFT will not only diagnose bronchitis but it will also tell you about the severity of the disease and treatment is based on severity only. You may need inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone). Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Kaushal Bhavsar, Pulmonologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does enlarged or low red blood cells cause low back pain?\n\nHI, I was wondering if you know anything about enlarged or low red blood cells in relation to low back pain in males. After having a bone marrow test, the white blood cells either became low or high. This is for my friend s Dad so I don t know the details, but everything is checking out fine everywhere else....Kidneys, colon, liver, spleen are all okay. I know this is really vague, but any hunches you might have would be helpful and appreciated. Thanks.",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. I see similar cases amongst young people who visit my clinic. In the first meeting, I advise my patients to go on lifestyle modifications for three months. I retest them again after three months and if they continue to be in high range then I advise them to go take many physiotherapy modality like IFT and SWD OR TRACTION therapy by which we control the pain of lower back but there is no relation between back pain and low rbc values.... in fact due to some jerky movement and muscle spasm he may have this type of pain...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have pernicious anemia. History of colectomy. Taking iron supplement. How to get more energy?\n\nI have been diagnosed with pernicious anemia due to my Crohn s I had to have a total colectomy 5 years ago. I now have absolutely no energy and feel lethargic. I just purchased iron liquid supplement with all the B s and other important vitamins . How do I get more energy and does this progress into a more serious problem if my body isn t producing the proficient amount of RBC s to give oxygen to my blood. What else can I do to help with getting more energy",
    "doctor_response": "HiWelcome to HCMAs you have pernicious anemia, you are already taking supplements. So no need to take more pills. You should get few investigations- Serum Fe, B12 and folate levels; as sometimes the supplements are not reabsorbed properly by body. In that case you can get injectables. Moreover, you should take healthy food for more vitamins, minerals and proteins for more energy and also should do some exercise. If your body isn't producing efficient amout of RBCs, anemia can progress and can lead to symptoms like pallor, breathlessness etc.Thanks..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back pain and pins and needles sensation in legs?\n\nI recently visited Ghana, Africa on a school trip and have been taking doxycycline as anti-makarial tablets. Just after a week of returning I ve been have strong pins and needles in my legs and some soreness in NY lower back. I didn t know if this could be related or if I have something else, or if I m just over reacting?",
    "doctor_response": "If I were your treating doctor, I would take these symptoms seriously.New onset low back ache with background of pins and needles sensation in the legs can suggest pinching of the nerves in your spine. It will need further evaluation in the form of X-ray and MRI. Further management will depend on findings in these investigations and how your symptoms respond over next few weeks. Wishing you best of health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why does my toddler have rashes on back of leg which seems to be spreading?\n\nRough rash on toddlers back of leg it has spread to his foot and thigh in past week. Does not appear o bother him at all. It is less noticeable with application of cortisone cream. It also is not red or scaly, more like bumpy roughness on the skin.",
    "doctor_response": "Hello,Welcome to healthcare magic,It seems like child is having atopic dermatitis(eczema). Atopic eczema is associated with red itchy rash usually over limbs,face, neck(mostly over skin folds). Atopic individuals have sensitive skin which will develop eczema due to a lot of external and internal triggers. The triggers might be dust, extreme heat or cold, certain food stuffs, woolen clothes etc. The barrier function of the skin is not normal. A moisturizing lotion (for eg: cetaphil moisturizing lotion) is a must on a daily basis and reapply it 2-3 times according to the dryness. It helps to restore barrier function. Use very mild cleanser for bath like cetaphil sensitive cleanser. Topical steroid cream might be indicated to bring the eczema down if it is severe. Cortisone is a mild over the counter steroid and you may use it.Hope this helped Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for high Blood Pressure?\n\nI have been on blood pressure medicicne for a months or so. I have been running high BP usually in the > 120-142/>77-88 range. Pulse is usually between 60 and 80. however, for the last hour my bloop pressure has been 106/66-77with a pulse of 95 -109. this seems very dramatic change should I be concerned",
    "doctor_response": "hello. blood pressure is not a constant value. it changes with activities we do.exercise, smoking, caffeine, sexual intercourse can all raise BP physiologically while BP lowers when we are resting, sleeping, meditating, etc.blood pressure may vary between two readings taken few minutes apart.best time to check your BP would be in early morning after you wake up.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have nausea while taking placebo pills of birth control. Normal to skip period?\n\nHello, I just started my first pack of a low dose birth control pills this month. I am now on the placebo pills, almost finished with them and no period. I feel horibly nauseous. I took a home prego test and it is negative. Is it normal to skip the period all together the first time? Can skipping your period cause you to feel sick? Can the pills cause a false pregnancy test? We used no protection during this first pack of pills either.",
    "doctor_response": "Hi thanks for the query.You may be having nausea either due to high progesterone levels in premenstrual period or due to iron in placebo pills of your pack or a combination of both these factors may be causing too much nausea.This is not normal to skip the period although, the period may be delayed.These pills can not change the results of pregnancy test. You may be feeling sick because of premenstrual period.Hope this information is helpful and informative to you.If you have further queries you can directly reach out to me on the following URL:",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lack of semen discharge during orgasm?\n\nI am 54 years old. One day while having a shower, I felt retraction of my penis so I pulled it out and I felt something has happened, now I have some narrowing on the sides of the middle of my penis and no semen on the moment of ejaculation but little secretion later on. What is my problem and I can get it treated?",
    "doctor_response": "DearWe understand your concernsI went through your details. You need to understand the process well. You are 54. Quantity of semen is determined by so many factors like the interest in sexual act, water content in your body, physical and mental stress, age and so many other factors. Anxiety is also another cause. The retraction you felt could be a natural feeling during a shower. Still, I advise you to consult a physician for your satisfaction.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How safe is taking Parkin 2mg for Psychosis?\n\nhi sir my father is suffering from psychosis the doctor has given them parkin 2 mg tab and serenace 5 mg tab but my father was suffering from epilepsy from past 17 years. the doctor had recognised that he had depression from NIMHANS HOSPITAL. currently he is ok but some times he talks some things he sees or hears some thing but doctor said that it is not schizoprenia but it is psychosis. sir so please guide me and he has also diabetes they have given him glucobay M-25 and he is taking epilepsy tablests like M-TOIN 100 mg and ATEN 25 mg and MAZETOL 200 mg. sir please guide me. i am from country india my state is karnataka asia continent and my city is bangalore we live in area chamrajpet. sir you all might be knowing the bangalore city because it is world's fastest growing city so only in our city we have many diseases which are also fast sir please guide me about this my email id is  YYYY@YYYY  thank you sir please reply me and please guide me.",
    "doctor_response": "Hi..Thanks for the query. Firstly Parkin (Trihexphenidyl...abbreviated THP) is a drug which is given to control trembling of hands (also known as extra-pyrimidal side effect or EPS) caused by serenace (haloperidol). Haloperidol/Serenace is the antipsychotic or main drug which is being used to treat Psychosis by your fathers doctors. Since he is also suffering from epilepsy; giving Haloperidol/serenace might not be a very good idea as certain antipsychotics increase the risk of having a seizure episode. Hence antipsychotic agent Quetiapine (brand names Quel, Quetipin, Quetan etc.) might be a better option for your father as this drug has a very low propensity of causing seizures. Lastly, all antipsychotic drugs including Quetiapine, Haloperidol do cause some worsening of Blood cholesterol & sugar levels. Hence strict dietary management, physical exercise along with regular monitoring of blood sugar, cholesterol & appropriate medications for diabetes & hypertension should keep your father fine. Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes crackling sound coming from lungs?\n\ncrackling lungs I am a thirty yr old female who is 21 Weeks,pregnant. I am having done crackling in my lungs and i can here it When i breathe. I do not smoke, am not sick and have no sob. I was wondering if its something i should be worried about?",
    "doctor_response": "thanks for asking your question I completely understand your problem in pregnancy there is increase in intra abdominal pressure and intra thoracic pressure due to growing foetus .some of the abdominal contents are pushed inside the thorax.no need to worry this is common with pregnancyif u  experience it more and the symptoms increase then u can consult your gynaecologistthanks/ regards feel free to ask more questions may god bless you and ur child with good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I donate blood frequently. My hemoglobin level has come down. What am I to do?\n\nHi doctor, I am a 21 year old female. I have donated blood twice (in December and March respectively) and my hemoglobin level was 12.1 g/dL. Yesterday, I had gone to donate blood. But, I was not able to do so because of my low hemoglobin level (9.5 g/dL). I am just wondering if the drop in my hemoglobin level is because of my periods?",
    "doctor_response": "Hi. Hemoglobin (Hb) level does not drop down during your periods unless you have abnormally excessive bleeding. It could be a result of frequent blood donation. Maybe your body did not get enough time to regenerate the lost blood. So, give some time for your body to regenerate the lost blood. Take Iron supplements and VItamin B complex for six months. Repeat Hb check after six months. Once your Hb level is back to normal, you can donate blood again. Before you donate blood the next time, check your Hb level and consult a gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lupus test required for arthritis and hoshshemoto hyper thyroidism.\n\nI arthritis and hoshshemoto hyper thyroidism and I need to be tested for lupus I don't have any medical coverage as of 02-13. I didn't read all the information before I asked the questions I don't have money to pay sorry I wasted your time im on line looking for a free clinic.",
    "doctor_response": "Hi,First and most important test for lupus is ANA test.If it is negative, chance of lupus is less than 1%, but if positive, it doesnot mean that you have lupus",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe leg pain when diagnosed with a blood clot\n\ni was recently diaginosed with a popital blood clot on left leg. placed on xarelto. My leg is swollen severely down to my foot with excessive pain and hot to the touch. yesterday in the er the dr said the blood clot is gone , which of original finding was march 10, they then tell me I have a bakers cyst in the same area. the problem is now i have an infection that has spread over my body causing red blotches and hot to touch. the leg is so painful i have to use a cane to walk. and it is hard ...its been like this for almost 2 weeks and i am extreme pain. what can this be and what can be done",
    "doctor_response": "Hello, It would be better if you can send me pics of your legs and also tell me what all medications you are taking and at what dose. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Anuj Gupta, Spine Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can OCD and depression be treated?\n\nhello ,sir .. i am suffering from mental disorder since last 18 years and is looking for right treatment. i have rumination ,ocd , depression and mood problems . i also face lot of problems in thought process and cognition also and face paranoid thoughts as well . currently i am on Desvenlafaxine(100mg)and Apriprapazole(30 mg) . please help me sir.",
    "doctor_response": "Hi, Desvenlafaxine is a good antidepressant drug but if the problems are OCD, rumination and mood issues then other drugs like Fluoxetine or Clomipramine or Paroxetine, etc., should be kept in options. These drugs have great efficacy and have good actions in controlling the OCD symptoms. You can talk with your psychiatrist for these drugs. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Seikhoo Bishnoi",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reactivate dead sperm?\n\nHi Doctor, I did my Semen Analysis in which i found that my Sperm was active 40% . How can i reactive my dead sperm. Report like that Semen Analysis Volume: 2.5 ml                Viscosity: Normal Count: 70 Million/ml Microscopic Examination Sperm Motality Active 40%       Sluggish  10%      Non motile 50% Sperm Morphology Normal: 70%       Abnormal:  30% Pus Cells 08-10 Please Help me how to reactive my sperm..",
    "doctor_response": "Hi,Welcome to HealthcareMagic . I would suggest you following treatment . It takes time for increase in motility and also there is no 100% success.-start multivitamin with zinc and lycopene combination  for 3months-reduce weight-quit alcohol and smoking. -avoid trauma to testicles-have healthy diet and be stress free.Repeat semen analysis after 3 months. If there is no improvement then next option will be IUI.  Here healthy sperms are placed in uterus .Hope I have been helpful . RegardsDr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for small red lumps on the thigh\n\nI have two small reddish purple lumps on my left inner thigh. They look like mosquito bites almost. I don t know how long they ve been there, but it s been a month or two. They re only itchy if I irritate them, scratch them first. They re the only two. No more have ever popped up. I m an 18 y/o female",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have folliculitis, acne or some other pathology.  You should go for examination by skin specialist or send me image so that I can help you further. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does the mild angina curable with medication?\n\nHi, I have been diagnosed mild hypertension a year ago &put on medication viz: Ridaq 25mg daily po. I used this medication, then I experienced sharp throbbing pain radiating to the left arm, which I explained to my physician same day when consulted, tht I have something like angina symptoms which he confirmed is a mild angina. I m currently using atenolol,amtas5, disprin 150mg daily together with Ridaq 12,5 mg daily, the pain is still there but am also using Isordil prn,which has a good effect on pain. I want to know, is the angina going to stop/ is it like the chronic hypertension?",
    "doctor_response": "Hard to say. New onset angina would be a reason for a lot of interventions like cardiac catheterization to see if there are blockages. Sometimes the pain isn't from the heart but mostly it would be and mostly it would be chronic.The situation is dynamic though. and will tend to get better or worse with a significant risk of heart attack and heart problems.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is taking Sinarest safe while having sinus pain?\n\nHello, I am a 40 year old male - having cold since 4 days (I stay in Bangalore, India). I started taking Sinarest twice a day for the past two days. Now, the running nose is OK but I have a sinus pain - on the left cheek (just above my upper teeth). Is it recommended to continue taking Sinarest? I have a history of Sinusitis. Requesting suggestion.",
    "doctor_response": "HI, thanks for using healthcare magicYes, the sinarest can be continued, it contains a mixture of a decongestant, antihistamine and pain killer.In addition the use of warm compresses to the face may help to reduce drainage and reduce your pain.Fluids and rest are also important.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "De-sensitizing agent applied to tooth, jaw pain, irritability. Dolo 650 taken. Cure for pain?\n\nHad a sensitive tooth coated with some de-sensitizing agent this evening, now 8 hours later I seem to have major pain starting from that tooth and emulating to one side of my entire upper jaw, the pains causing alot of irritability and is not letting me sleep. Its 1 AM and now and I obviously cant go see a doctor now, any temporary relief methods for the pain ?? Tried a tablet of Dolo 650 seems to have taken 0 effect. please help ?",
    "doctor_response": "take capsule proxyvon & tomorrow get a x-ray done for that tooth.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump on the penis shaft\n\nHello, i was recently masturbating last night for the first time and i orgasmed and then ejaculated.About 20 mins later i checked out my penis again, to find that there was a lump on the shaft of my penis (left side) it stung when i pressed it in at first but a day later i went to school and when i came back i checked to see if it was better (and it was)then i pressed it in again and it dident sting at all.If you need my age i am 12Also there is some tiny pimples on my penis going all the way to the top, they do not hurt or itch in any way so im not really bothered in any way.I do not want to see any doctor.",
    "doctor_response": "Welcome to Health care magic.1.Its infective cause in the subcutaneous plane / under skin with collection within.2.First thing you have to do is - do not touch or press or scratch the lumps / lesions, in that way you are only complicating the condition.3.Mean while you maintain local hygiene, clean the area with the antiseptic liquid, avoid clothing that can cause irritation to that area, use soft clothing until it heels.4.If possible a course of antibiotic would help. If you can see your GP that will be fine.5.If things not getting better, than needs examine and treatment accordingly. Good luck.Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe pain in lower right abdomen. Having kidney stones. Options for stone removal with minimal surgery?\n\nHi, my wife (25yrs) has stone in her right kidney of 9mm size. This was diagnosed 4 months back by ultrasound. That time she was not experiencing any problem. Doctor told to let it there and suggested some do s & don ts. Yesterday, she had severe pain in her lower right abdomen. Local doctor given some injection to relieve. I wanted to know, what are the options for her kidney removal with minimal surgery. Thanks in advance!",
    "doctor_response": "Hi, Thanks for using HCM.Q. what are the options for her kidney removal with minimal surgery?Shock wave lithotripsy. It uses sound waves to create strong vibrations (shock waves) that break the stones into tiny pieces that can be passed in your urine. This can cause moderate pain, blood in the urine and discomfort as the stone fragments pass through the urinary tract. If not successful then surgically can remove stone using small instruments inserted through a small incision in your back. Discuss with your doctor for the same. Hope I answered your question. Feel free to ask me if you have any further queries. Wish you good health. Take care.RegardsDr. Lohit",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure ventricular tachycardia?\n\nHello , I am a 24 years old guy . I was diagnosed with Wolff Parkinson White Syndrome four years ago . I have experienced few Supra-ventricular attacks after the diagnosis, And sometimes I feel premature ventricular beats PVCs . But recently I realized that my heart beats began to change in terms of intensity and smoothness . Today , for the first time in my life I have felt many strange consecutive beats lasted up to 20 seconds , Those beats were more likely PVCs . I was confused but conscious and I hastened to the clinic in my school where my heart was monitored by ECG . ..I am afraid that my heart began to develop Ventricular Tachycardia especially after taking into account the fact that my recent ECGs showed a more widened QRS complex - about 125 mm - and obvious Delta wave. Apparently I need radio-frequency ablation ,is this procedure available at your medical center ? ... How much does it cost ? Thank You",
    "doctor_response": "Hello, After going through your medical query I understand your concern and I would like to tell you that for recurring episodes of palpitations in WPW setting you should consult an electrophysiologist for treatment options. To avoid any life-threatening episode RFA is the treatment of choice. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhanu Partap, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest permanent solution for e-coli infection\n\nHi Sir / Madam, My Dad (Mr. Maruti M.Shirodkar) is suffering from Parkinson since last 10 years, however along with PD he is going through a rough patch of having E-coli bacteria in urine at regular interval. We had operated him for prostrate twice, however have noticed that he is not able to pass his urine completely and because of this bacteria (E-coli) is found in his urine. Intake of antibiotics help to reduce the count of bacteria, however after a interval this antibiotics become resistance to it. Please suggest in this scenario which doctor I need to consult a urologist or a nephrologist, also is there a permanent solutions for the same. A urologist also said that his urinary bag in body may have got weak because of which he is not able to vacate urine completely Regards, Ameet Shirodkar",
    "doctor_response": "Hello there,I am dr.milan an infectious disease specialist answering your question.I feel that better you consult an urologist. You can consult nephrologist also no problem in that also.Now e.coli is most common infecting organism in urinary tract.Problem is right that bladder is weakened and prostate is operate so normal urinating mechanism is compromised now so it is the reason why recurrent infection is happening. Everytime you go for culture & sensitivity test and we need to follow sensitivity pattern. Long term uses of one antibiotic can cause resistance so we need to change antibiotic according to report. But you need to be vigilant when there is infection showing by increase in frequency, burning, pain, fever or any other symptoms.Hope i have given appropriate guidance to you.if you have any query you can consult me anytime.Give me star rating according to your satisfactory level.Thanking you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause for the lump on the top of the nose?\n\nI have a sore lump at the top of my nose in the corner of my eye so its more ornless we re my eye brow starts its very big and very sore I did have a ganglion on my hand its its not their eny more could this be the problem its causing me alo of hed pain ?",
    "doctor_response": "Hi ! Good morning. I am Dr Shareef answering your query. The sore lump on your nose could be an inflammatory lump giving rise to the pain and tenderness at that site. And yes ! this could give rise to referred pain in your head. If I were your doctor, I would prescribe you a broad spectrum antibiotic and an anti inflammatory drug with a proton pump inhibitor which would relieve your symptoms. In addition,  I would also advise you not to prick or fiddle with it to avoid it flaring up more.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why there is pain under my right shoulder blade?\n\nYes hi have apain 4 3days the pain has been under my right shoulder blade, to day it has migrated to the fro t of my chest to include the lower sternum and the short ribs on right side I have n clue as to what started this I am a 61 year old dissabled. Vet. Any how hurts to take deep breaths and moving a d bending those areas of the body are to die for!",
    "doctor_response": "hi,thank-you for providing the brief history of you.As you have pain beneath the shoulder blade I will advice you to take a cardio examination along with x-ray due to your age factor.Once the cardiac clearance is found then this pain looks more of the pinched nerve in the cervical spine or trapezius inflammation. for which a thorough clinical examination is advised.Also, most cases have muscular pain and are treated successfully with physical therapy in my clinical practice.Regards Jay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any chance of pregnancy after an egg rupture?\n\nHello doctor i want to get a pregnant .i got period March 14th. After 10 days my egg is not rupturing. so doctor gave me injection to be rupture. After 31st i went to clinic . An egg (cyst) ruptured. From that day i have taken duphaston for 10 days 2 times which is given by doctor. she told me that after 10 days stop duphaston and wait for one week then if you r not get periods come and see me . April 9th my 10th day over. from that day i stoped to take dupalaston. But today April 13th. today i felt that i got periods. But it is not like that. only one drop blood was there. after that nothing was there. i dont know what happened. i m always checking i got period i got period. plz advice me. what should i do. doctor told me to come 14th. i will pray to god for good news. i got period March 14. my egg rupured on March 31th. tomorrow 14th. we can find out that am i pregnant. plz reply me.........",
    "doctor_response": "Hello. sometimes this does happen that when u expect periods u see just drops esp. when u are taking menstuation regulating drugs its because ur endometrium has not shed properly.u may need withdrawal bleeding with other drugs before u start for this menstrual cycle infertility treatment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on knee?\n\nI m 19, 5 8 , and 140 pounds. I have a lump above my right knee that feels slightly smaller than a golf ball. It is not visisble, but you can feel that it is there. I visited the doctor and when my doctor couldn t figure out what it was she got another doctor to take a look. He was also unsure as to what it was. They said it was to hard to be many of the things they had suspected. It also did not appear on any xrays. They ordered an MRI with contrast, which should happen in the next couple days. I am a little worried, and wondering what it could possibly be???",
    "doctor_response": "Hi.Thanks for your query.Noted your history of lump above right knee. It is wonderful that golf ball is not so small that someone can feel and a Doctor is not sure about it. If it is so, it is possibly a cyst of synovial origin and hence can appear in a particular position and not in other of the knee. Get an opinion of an Orthopedic surgeon along with MRI of the knee in that particular position that shows the lump otherwise it will be false negative.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is MPV level of 6.8 a cause for concern?\n\nI have been very fatigued. It is not me at all. I had blood work done and the only thing abnormal was MPV of 6.8. My father had Multiple melanoma and Leukemia. He passed from massive heart attack though. I have a TBI, Subdural hematoma, subachnoid hemorrhage followed by multiple stokes in 2013,. I have struggled since. I have had a digestive or gastro problem for 3 years now.",
    "doctor_response": "Hi, dearI have gone through your question.I can understand your concern.If your all other parameters are normal then only MPV has no significant effect. It is mean platelets volume and it indicates size of platelets. Don't worry about MPV.Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Based on my follicle study will I be able to conceive now?\n\nhelo doctor, i had my ovulation study done.on 15thday my follicle size were 30 and 24 mm.i took 1000mg injection to get egg ruptured.doctor told that 30 mm follicle is ruptured and another 24 mm is now 26mm so will i be able to conceive if i will have sex today",
    "doctor_response": "Hi, if your eggs has ruptured, be in contact with your husband atleast today. There is a chance of pregnancy.  Take progesterone for next 2 weeks.  Talk to your doctor regarding this.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Got stent removed, pain in lower abdomen. Is the pain normal? Healing time?\n\nI am having lit pain in lower abdomen ( kidney ) area. I have gone through stent removal process 2 days back  which was inserted to create passage in urator since I had kidney stone of 3 mm size, stone was also removed 2 days back. First process was done 15 days back.Is the pain normal ?If yes, how long it will take to normalize ?",
    "doctor_response": "Hi, Based from the information provided you have undergone the process of stent placement and stent removal so that the stone can pass from the narrow tube known as URETER. 1) YES - the pain is normally felt at the sight of instrumentation and the pain in the lower area of kidney is a referred pain and it occurs in such cases of kidney stone. 2) These is a minor operative process will usually take about 10 days from the closure and removal of the stent to heal completely provided the healing was with out any complication. Hope this answer may fulfill you need. Dr. JAY PATEL.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for erectile dysfunction while trying to conceive\n\nDear sir, i am having a very big problem and that is why i am trying to do sex with my wife in night my penis doesn t stand and in case if it stands it just goes down in 1 minute and we just unable to do sex and this is very disgusting. we are having this problem for a long time and this is so bad. So please help me sir its been 1 years since i have got married and we trying to have a baby but without sex how could we able to have a baby so please help sir",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. 1. If the main can obtain an erection on his own by masturbation, but not with his wife during intercourse or cannot sustain it, then the cause is definitely psychogenic. 2. Other causes which need to get evaluated as the probable or hidden cause of ED are: - Any use of hypertensive or psychiatric drugs - Any medical condition like overweight, diabetes, high blood pressure/cholesterol] - Any psychological issue [stress/depression/anxiety] - Any substance abuse [adddiction] Please consult a Urologist for necessary examination Serum Testosterone and FSH/LH level] and investigation, till then: (i) start with perineal exercises: while urinating, stop the flow of urine, start again, stop & start again 4-5 times. (ii) Take: milk and milk products, ghee, cheese, curd, black grapes, pears, raisins, dates, almonds, walnut, pomegranate, carrot, banana, apricots, muskmelon, amla, coconut, pistachio, turnip, potato, onion, lady finger, radish, old brown rice, peas,garlic, bottle gourd. (iii) Avoid sour and cold substances, tobacco [in any form], brinjal, tandoori roti, red chilies, heavy and food which require long hours to digest, jaggery and its items, deep fried food. Before prescribing medication especially for ED, the patient should be evaluated for any cardiovascular diseases, thus have an appointment with a Cardiologist for any potential risk of a cardiovascular event. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Munish Sood",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My son is having nasal blockage and fever. How to cure him?\n\nHi doctor, My son is six years old. He has nasal blockage for the past two weeks. Now, he has developed a fever. His throat and tonsils are swollen. We took him to a doctor. The doctor prescribed him Benadryl 5 ml and Crocin DS 7.5 ml. He has not given any antibiotics. Is it fine? Please suggest.",
    "doctor_response": "Hi. Do not worry. You can give Augmentin DDS syrup 5.4 GM by 30 ml (Amoxicillin with Clavulanic acid) twice a day for five days along with the above-given medications.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing abdominal cramping?\n\nMy period went off about 2 weeks ago and like i had sex last Friday and like yesterday and today I have been really tired and my back has been killing me and my stomach has been cramping like crazy i cant lay on my stomach because it hurts i feel like bloated and the cramping is hurting real bad like im about to be on my period again.. Idk what it is Could you tell me... Could it be Pregnancy?..What have I done..Nothing yet because i am not sure what to do i was going to try and take a test next Friday I guess",
    "doctor_response": "Hello! Welcome to HCM.You havent mentioned about fever, if any.This can be musculoskeletal pain or due to stone in urinary tract.As the severity suggests & back pain is also there, it is more likely stone related pain.Stone in ureter (tubes connecting kidney & urinary bladder) causes obstruction to urine outflow from kidney to urinary bladder.Smooth muscles in ureter contract excessively to overcome this obstruction by stone & cause severe colicky pain.Temporary treatment to relieve pain includes smooth muscle relaxants & pain killers like drotin, voveran, tamsulosin etc.Many such patients come in my clinic to whom I advise ultrasound abdomen  & pelvis, X-ray KUB, renal function tests, urine routine.Treatment is done accordingly.Consult your doctor for medicines.Hope this information is useful.Wish you healthy life.Thanks.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is galvas Met safe to take while having diabetes and on BP medication?\n\nI am advised Galvas Met 500 today. My sugar level is 197 before fast and 298 after two hours of breakfast. Hb 1 Ac was 12%. I was on medication for BP since last 10 years. Though with home remedies I am able to bring down fasting sugar to 150 with home remedies. Is new medicine is ok for me",
    "doctor_response": "Hi, Based on the history you seem to have uncontrolled diabetes for which your doctor has prescribed Galvus Met. Galvus Met is a combination of two anti-diabetic medicines Metformin & Vildagliptin. Metformin works by lowering glucose production in the liver, delaying glucose absorption from intestines and increasing the body's sensitivity to insulin. Whereas Vildagliptin works by increasing the release of insulin from the pancreas this reduces both fasting and postmeal sugar levels. Together, Galvus Met provides better control of blood sugar. Generally it is well tolerated by most patients however it may cause abdominal cramps, diarrhea, metallic taste and sometimes decreased blood sugar level. These side effects usually subside over a period of time. Continue taking Galvus Met and have regular follow up lab tests as advised by your doctor. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had rubbed penis tip inside vaginal lips. Could residual semen on penis cause pregnancy?\n\nMy partner rubbed the tip of his penis inside my vaginal lips, but there was no penetration. I'm almost certain there was pre-ejaculation and I too was very wet. He did not ejaculate anywhere near my vagina, but on his body. He wiped off the semen from his penis with a dry tissue. Would there be residual semen on his penis that could cause pregnancy if we repeated the same act later in the day, no penetration but rubbing around the vagina? Could I become pregnant from the first action described?",
    "doctor_response": "Hello,In above type of sexual activity, chance of being pregnant is quite less. Though it depends on fertile days or ovulation time.Precum or ejaculatory fluid on tip of penis contains small amount of sperm and may cause pregnancy in some percentage of women.Here, you need to wait for next coming period. If it is delayed more than 7 days, you need to undergo one home pregnancy test to be sure.Practice safe sex in future. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could a lump in between breast?\n\nHey, I am 16 years old and quite awhile ago I noticed a small hard lump in between my breasts, I decided not to do anything about it or tell anyone because it wasnt hurting and it seemed to dissapear. But the past few weeks i have noticed it abit more from time to time it can get abit sore, when i run my finger across it, its feels soft and abit hard it is around the size of a thumbnail i would say. I am really worrying what could it be?",
    "doctor_response": "Welcome to health care magic. 1.The history suggest me that it could be ductal dilatation or cystic changes.2.Cyclical cause are seen during the periods time / menstrual. 3.Confirmation can be done by an ultrasound examination.4.An ultrasound will help to identify the nature of the lump / lesion, its sours and extensions.5.Depending on the findings if its a mass - FNAC - fine needle aspiration cytology to assess the type of cells involving. Followed by needful treatment. Good luck.Hope i have answered your query.Any thing to ask do not hesitate. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump on inner thigh?\n\nI have a hard lump on my inner thigh next to my testicles with a sort of trail coming from it like a tunnel under the skin that I can feel is hollow as if it's been eaten away almost. The skin feels really thin along this trail and the lump is purplish and sore to touch",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You may have some soft tissue tumor like lipoma, neurofibroma or hemangioma or other soft tissue tumor.  Chances of benign lesion is more.  You should go for fine needle aspiration cytology or biopsy.  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 health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent swelling and pain in leg after accident?\n\nHi... I got into a car accident about a month ago, walked away with just a few bumps and bruises. But while everything else healed up within two weeks, my right leg is still swollen and I m having a little pain as well. I can still walk just fine i was just a little concerned.",
    "doctor_response": "you should see sportsmedicine  specialist and some physical therapy will help.Also xray of leg may help to rule out any bone bruising or crack fracture.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the spot in the lung a scar tissue from the injury?\n\nAbout a year ago I broke 2 ribs. The x-ray showed a spot on my lung at the area of the broken ribs. A follow-up x-ray showed that it had been just a bruise. A ct can today shows a nodule on the same lung. Is it most likely scar tissue from the injury?",
    "doctor_response": "Thanks for your question on HCM.I can understand your problem and situation.By your description, it seems mostly fibrotic scar lesion.The reason for this is as follows.Any lung Insult whether tuberculosis or pneumonia or lung confusion, heals by either fibrosis or calcification. And these appear as scar lesion on chest x ray and CT thorax.Pulmonary contusion is common after rib fracture. So it is normal to have scar tissue on lungs at the site of broken rib.So due to healing, scar tissue is seen at the site of rib injury.No need to worry much for this. Follow up CT is needed after 6 months to see the status of the lesion.If scar is of same size than no need to worry. It is inactive, healed scar only.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause a marble sized lump with pain ans irritation on right cheek?\n\nMy 7 yr old son has a marble size lump on the outside of right cheek. It moves up and down but is not painful, more irritating. I am unsure how long the lump has been present. I felt the inside of his mouth and could not find any cheek bite. Is this serious? What should I do?",
    "doctor_response": "Hello, Thank you for consulting with HCM.As you are mentioning that you have noticed a lump in your sons cheek, it looks that it is a buccal lymph node which is palpable.As lymph node is a normal finding it is situated in different parts of the body. They are situated inside the skin, firm in consistency, movable and marble sized.So there is nothing to worry about it you just notice it and if it starts becoming painful or increasing in size then consult a physician.Hope it will help you.Thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal for placental thickening during pregnancy?\n\nHi, I am 32 years old and weigh 77 kg, this is my first pregnancy, i am into 14 weeks of pregnancy, placental thickening noted in anterior, low lying reaching and partly covering internal os. Is it safe for me and baby. Doctor suggested to avoid intercourse",
    "doctor_response": "Hi, As your placenta is low lying you need to take bed rest and avoid trauma and intercourse. But nothing much to worry as placenta grows upwards in most of the cases. You can confirm it by serial ultrasounds after 1 to 2 months or at 32 weeks. You need to be alert, if any bleeding occurs immediately contact your doctor.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Khushboo Priya",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of pregnancy after unprotected sex?\n\nI'm 23 years old. I'm a girl. My boyfriend and I had unprotected sex 13 days after the first day of my last menstruation. He ejaculated inside but I was able to squeeze some of his semen. Could I become pregnant? I don't have a regular menstrual cycle, my longest cycle takes 31 days and the longest is 28. When do I need to take a pregnancy test?",
    "doctor_response": "Hi, I think there is a chance of pregnancy.  You should do a urine pregnancy test as soon as your periods delay. If negative, no need to worry. If positive, consult a doctor if you don't want pregnancy. Hope I have answered your question.  if you have any other query I will be happy to help. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it possible to do icsi treatment if the sperm count is zero?\n\nhello Dr i am a 40 years ,wt 82 kg, old man my sperm count is zero i had consulted to many expert they suggested me that i have to go icsi treatment,can it possible ,i it possible please tell what is success rate ,cost of tretment and best icsi centre near bareilly(up) thank you",
    "doctor_response": "Hi, Not generally with the zero counts. One couldn't get enough sperm to be able to do anything in the test tubes. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can an alcoholic develop shadow on an adrenal gland?\n\nmy 52yr old husband, an alcoholic with alcoholic hepatitis, gross ascites, jaundiced. clotting screening normal, hyponatraemia and raised total bilirubin (was 300 on admission, now under 100). recent 11week hospital admission following collapse and confusion, weight loss and poor balance. He had an Abdominal CT scan which revealed a shadow on an adrenal gland. what would this indicate? would it be related t his alcoholism? I remain uncertain re his prognosis and extent of liver damage.",
    "doctor_response": "Hello,1) He might be suffering from acute hepatitis on background of end-stage liver disease due to alcoholism2) Prognosis is depend upon liver functionality to produce proteins and clotting factors; level of bilirubin, ascites3) According to his laboratory data as written here roughly, he might have moderate-to-severe type of liver damage which has 2-year life survival 40-60%.4) Shadow on adrenal gland might not be associated with liver disease and possibly due to benign adrenal tumor.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes brown discharge from nose after root canal treatment?\n\nhi i wanted to know whether i am in serious danger here. i recently had a root canal and a lot of fluid went into my nasal cavity[i think] and for the past 5 hours my nose has been letting brown stuff out.. and when i lay down i feel a nasty liquid being swallowed. I should add that i was in a weird position that forced those liquids to end up there.. what can i do to get rid of this ??",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.It is very unusual for the fluids used in the oral cavity during the root canal treatment to enter the nasal cavity as you have mentioned.Even if the root of the tooth is in close proximity of the sinus or have a direct access, small amount of solution used should not cause any damage.If there is sudden increase of swelling and pain ,report back to the dentist and have it checked. Careful monitoring may be required followed by a dose antibiotics, nasal decongestants and more required treatment.Hope this was useful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the growth on my collarbone?\n\ni have a hard growth on my collarbone near the centre of my chest, pain is extending from the area throughout my chest and shoulder and sometimes makes me lose my breathe...i had seen my GP last week and i had xrays..they said there are no breaks and no bone abnormalities...she just said she dont know what it is but since i seen her this past monday the pain seems to be moving. Is it something i should go see her about again or just go back in a couple weeks like she said? thanks",
    "doctor_response": "hi you have swelling on your collarbone near center of chest and pain sometimes causing you to lose your breath. Your  x rays are normal . In my opinion you have synovitis of Sterno- clavicular joint and since sometimes it affects your breath also I would recommend immediate CT Scan to assess the condition. You should visit your doctor sooner than next appointment.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of zavolis 50 mg?\n\nsir, I am using diavista30mg but when i consulted a doctor for review he changed the medicine as it is causing burning sensation of urinary tract, and prescribed zavolis 50 mg it is costlier and whether it has any side effects or it is safe to use please let me know",
    "doctor_response": "Hello Zavolis-50 is commonly prescribed alone or along with metformin to treat diabetes. As compared to diavista-30 it is quite safe however it may cause delayed stomach emptying, nausea or flu like symptoms. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mohammed Taher Ali",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can taking Insulin, Janumet and Metformin together cause swelling in the breasts and ankles?\n\nHello, I am a black female who is 54 years old. My symptoms are breast heaviness, ankle swelling, a smelly discharge from my vagina and a bloated belly. I am also a controlled diabetic 2, active and I eat healthy. Never use alcohol nor cigarettes, and I still have a normal period every month. Is it possible my meds are interfering w/ me? I take insulin, janumet, metformin, and linzess for chronic constipation. I had a period over 2 wks. ago, yet, my breasts are still full and I have the bloating. I truly hope this is a benign condition.",
    "doctor_response": "Hello, Metformin can cause abdominal bloating; flatulence etc as side effects. However, none of the drugs mentioned is known to cause breast heaviness, ankle swelling. Insulin though can cause weight gain. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Tushar Kanti Biswas, Internal Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause blisters on the hands and feet of an infant?\n\nMy 6 month old has blisters on her hands and feet. I cannot see any in her mouth but she doesn t cooperate with me looking there. she has no fever, feeds well but has been vomiting clear liquids once a day for 3 days. She is playful, has not lost weight and appears well!",
    "doctor_response": "Hi,\u00a0\u00a0\u00a0\u00a0\u00a0Welcome To Healthcare Magic.I can understand your concern regarding to your child\u2019s health.Having blisters on hands and feet is reason for some allergic reaction. So, consult dermatologist to rule the reason for it. Till the time, for blisters you should give liquid Levocet (if no allergy) 2 ml, daily at night for 3-5 days. For relief in vomiting, you can give her liquid Ondem (if no allergy), 2.5 ml, 2 times in a day at the interval of 12 hours for 2 days.After doing these,  I hope your child will get well sooner and please share your review about my answer on healthcare magic.Take Care,Thank You.From:- Dr. Nupur Shah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does elevated BP and cholesterol cause fatigue?\n\nI'm a 60 yr old , female in good health except for HB and H cholesterial  which I take meds for I sleep way to much I amm exhausted at the end of my work day usually eat dinner and fall asleep on the couch wake up and go to bed I'm just tired all the time.",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!Your symptoms could be related to blood pressure drugs adverse effects. Are you taking any betablockers? They can cause chronic fatigue and low physical performance. But, I would also recommend consulting with your attending physician for a careful physical exam and some tests to investigate for other possible underlying causes: - a chest X ray study- an arterial blood gas analysis- complete blood count for anemia- thyroid hormone levels for thyroid dysfunction- blood electrolytes- kidney and liver function tests- blood electrolytes. If all these tests result normal, I would recommend performing a multi latency sleep test to investigate for possible sleep apnea. Hope to have been helpful!Wishing all the best, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is recurring pain in right shoulder a cause for concern?\n\nI have this pain in my right shoulder that is pretty persistant. I also keep having these attacks where the pain worsens, i have trouble breathing, my heart flutters, and i get severly nauseous. I have had blood tests, EKG, CT scan on head and everything is fine. I need to know if i should be worried. I have been to the ER three times and everything is fine. Please help me!!",
    "doctor_response": "Hi, Yours is a right shoulder pain so its unlikely to be related to a heart condition.But on the other hand you have breathing difficulties,with palpitations and these should not be ignored as rarely even right shoulder pains may be from cardiac causes. You may have had some tests which seems fine but you definitely must go to a more advanced  center for determine the cause for this. Meanwhile you can take pain medications combined with a skeletal muscle relaxant for pain relief,pain patch application. Once you have ruled  out a heart problem then you can proceed for further investigations like an MRI to check for tendon inflammation or injuries. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. George Verghese",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have small testicals, erectile dysfunction, pain in testes. Concerned\n\nim 27years sir my testis are both very small and left was too small compare to right testicle and and my penis not getting good erections even in sleeping also. and my scrotum is hanging too much and my testes are paining frequently particularly left which is too hanging of testicle. and i want to know my sexual strength and sperm count with action positions etc...",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have small testicles with problem of erectile dysfunction.This could be due to hypogonadism .However this has to be ruled out by clinical examination by a qualified Endocrinologist and following tests.1) Detail Hormonal assessment like Serum Testosterone ,Growth hormone ,LH etc .2) Ultrasound scanning of Scrotum.3) Colour Doppler study of scrotum.(To rue out varicocele on Lt side)As regards your sperm count get your semen analysis done to know more about your sperm count and morphology of sperms.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shortness of breath?\n\nYes, I m a heart patient, and now im having shortness of breath when taking little steps or getting up or showing, I have a pacemaker and i m not sure if I should go to the hospital. I was there is february with congestive heart failure so I m not sure what is going on now.",
    "doctor_response": "Hello and welcome to ask a doctor service. I reviewed your query and here is my answer.As you said you have a pacemaker and congestive heart failure. So getting shortness of breath of this severity is not a good sign. It means either you ade not taking your medication properly or your medicationa are no more sufficient for your congestive heart failure or there may be lungs problem. You need to go to a hospital and see a cardiologists for this.Hope i answered your question.  Feel free to ask more if you need further assistance.  Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Burning sensation in mouth with pain\n\nhi.About 5 days ago I had the usual sorethroat/headcold one gets.The last 2-3 days the upper back of my mouth where you would get postnasal drip burns so painfully it is driving me insane.It is painful to swallow;it is somewhat helpful to drink cold,ie yogurt/icecream or hot chocolate also gives some relief but it only feels better for a very short time.The pain when swallowinf is NOT in my throat.I don t drinkor smoke,not diabetic,56yr-old female....what do you think??",
    "doctor_response": "Hi, The pain which you have described can be due to a residual irritation of the area after the earlier sore throat. You need to do the regular warm saline gargles 3-4times/day for a couple of days so that the tissue is healthy again. If the pain persists that means the infection is still present and further antibiotic course has to be taken along with mild pain killers under the guidance of your attending doctor. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for typhoid infection\n\nHi, Just now I came to know thay my mother aged 50 is suffering from typhoid ( 1: 140) . She has problems with antibiotics. Is there any other way of treatment. How to take control over vomiting? She has very bad sensation. Could you please suggest essential fluids for it so that I can provide time to time.she is too weak.",
    "doctor_response": "Hello,I understand your concern for your mother.If her widal O titre is 1:160 and she is having fever, then it is Typhod.Typhoid can only be treated with antibiotics. Because she is weak and vomiting, she may require to be admitted.With proper treatment, Typhoid is cured easily. Without treatment it can be dangerous with dangerous complications.So you should take your mother, at the earliest ,to a specialist in Internal Medicine and have her treated well.Wish her a quick recoveryDr. Noble Zachariah, Kuwait",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low sperm count\n\nHello,I am a am of about 50 yrs. I have had 2 children before now. 5 yrs after my last child and after trying for almost 2 yrs to get my wife pregnant, i went for semen analysis and it was discovered that i have very low sperm count of 2million/ml. What couls be the cause and what is the type of treatment that will be most effective?",
    "doctor_response": "Hi  ...Your sperm count is very low suffering from severe azospermia ...The cause has to be ruled out ....If you are taking antihypertensive ,antidepressants ,cytotoxic drugs then such problem can be there ...Excess radiation exposure can be cause ..Smoking and alcohol can lead testicular dysfunction ....Rule out diabetic by random blood sugar.Rule out thyroid problem by serum tsh ,t3 and t4 estimation...Excess stress , coccaine abuse , steroid can be causative ....Your testis also has to be examined for varicocele..Get your fructose test done that able to distinguish obstructive or less production from testis ....Obstructive cause include chalmydia or gonorrhea infection that lead obstruction by fibrosis....If FSH,LH and Testostetone all low cause can be at hypothalamus and pituitary ..For which CT scan can be done....If all three normal obstructive cause there...Prostate examination also done ....You can given hey fort tablet and causative treatment done. ...With keeping these in mind consult surgeon or psychiatrist for that ....Take care ....",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why the bone in the forearm is paining and the elbow to finger tips goes numb if leaned on it?\n\nThe bone in my forearm (the bigger one) is very painful at my elbow, when i even slightly lean on it my arm, from elbow to finger tips goes numb and doesn t regain feeling for quite a while after? The bone in my elbow sticks out a lot and you can feel it when you touch the area it is without applying pressure. My other arm is not like this. What could it be? Im 21, 5ft5 and don t know my exact weight. Around 160lbs.",
    "doctor_response": "Hello,I read carefully your query and understand your concern. The symptoms seem to be related to a pinched nerve in the elbow.I suggest using anti inflammatory medications such as Ibuprofen to relieve the pain. I also suggest using gentle stretching exercises.Cold compresses can also be helpful. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side-effects of the hair-loss medicine, Keragole?\n\ni need information about the usage of the drug keragole forte and i also need that taking this drug may also lead to ageing of the skin or not my age is 20 actually my hair loss promblem started by intaking of the drug called saw palmetto and then i am now using keragole forte need an answer immediately pls.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Keraglo forte is a hair nutrient tablet which is to be taken once a day for a minimum of 2-3 months for good results. Unfortunately hair fall or hair loss is not cured by one factor only. You will have to do adjuvant therapies like hair PRP - platelet rejuvenation plasma treatment, where plasma from your own blood is injected into your scalp with the help of tiny needles. This plasma is rich in growth factors and platelets which further strengthen your follicles and promote new growth. Also I suggest you start with topical Minoxidil 5% once daily for at least 6-7 months for good results. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in ribcage, chest and breast?\n\nhello im a 38 year old female i get a burning horrible ache that flares up in my ribcage and ribs get very sore, the ache then goes to my left breast and my back aches and get sharp pains in my chest when i turn a certain way or pick things up  what could it be?",
    "doctor_response": "HIWell come to HCMI really appreciate your concern, most probably such symptom could be due to hyperacidity, second muscular spams may be the cause and this could be due to poor posture, I my opinion condition can be well treated with \"Tab Omeprazole 40 mg and Tab Domperidone 30 mg once  in day for few weeks, for the poor posture you need to maintain it, else this is nothing to worry, hope this information helps, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is normal blood pressure and pulse rate?\n\nhi there i am a first year medical student int he Fiji school of medicine and i am doing MBBS1 programme,,,, my question is that,,can anyone explain what you would expect the pulsr rate and blood pressure of a student to be after several days stranded compared to the normal values and the reasons for any differences",
    "doctor_response": "Hello, Thanks for your question. Been stranded can lead you to be depressed but does not cause hypertension. May only worsen a poorly managed hypertension. Warm regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes brown discharge after IVF cycle?\n\nMy first IVF cycle, have been administering 10 units of Lucrin since 6 Sep, 150units of Gonal since 29 Sep. Scan 2 days ago showed 15 follicles (6 - 11mm), todays' scan showed 26 (7 - 15mm). Dr thinks I should be ready for ET next Wed. I found brown discharge today. I'm also having sore back, sore knee and ankle for 3 nights.  Is this normal?  Is this OHSS?  During the consultation this morning, I was told i have higher risk of OHSS. What will happen if I have OHSS? Do i have to abort this cycle???",
    "doctor_response": "hi healthcare magic user, your risk of OHSS can be prevented with proper stimulation and dose of medications. now a days  antagonist protocol with GnRH agonist trigger is safer way to prevent OHSS. since you are already on agonist protocol you can try for embryo transfer  but their is high risk for hyperstimulation. if their is hyperstimulation you will feel bloated, pain in abdomen  heaviness, in sever cases their would breathing difficulties. If you conceive after transfer  sometimes their are increased chances of hyperstimulation. risk of abortion  is low if managed  properly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for itchy,dry scalp and hair loss\n\nHELLO DOCTOR, SINCE 2010 I AM HAVING SOME KIND OF SCALP PROBLEM WHICH IS STILL GOING ON, I AM HAVING HAIR LOSS SINCE THEN. I KEEP ON WASHING MY HAIRS DAILY BUT BY THE EVENING THE PROBLEM STARTS AGAIN. ALSO AT THE CENTER OF MY SCALP SOME PIMPLE TYPE PART OCCURS AGAIN AND AGAIN.  I HAVE CONSULTED MANY DERMATOLOGISTS, TRIED VARIOUS SHAMPOOS AND MEDICINES BUT DIDNT GOT THE SOLUTION. INITIALLY I HAD ITCHING ON MY SCALP BUT THESE DAYS I AM FACING WITH ITCHING ON MY OTHER BODY PARTS ALSO. BY THE EVENING MY SCALP STARTS SMELLING VERY BAD. AND DUE TO ITCHING VERY POWDERY SUBSTANCE GETS ACCUMULATED ON THE SCALP MAY BE ITS WORST DANDRUFF. I WANT TO KNOW WHETHER IT IS RELATED TO DRYNESS OF SKIN ?WILL PANCHKARMA BE THE SOLTUION? PLEASE SUGGEST ME SO THAT I CAN GET RID OF THIS HAIR PROBLEM...",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Persisting itchy scalp can be dandruff or scalp psoriasis. Scalp psoriasis is a skin disorder where dry flakes are found on the body even the scalp and they do bleed occasionally. The psoriasis is a long term disorder with remission in between. For scalp psoriasis coal tar and ketoconazole based shampoo lotions are prescribed which are to be used twice or thrice a week till remission. I suggest you visit a dermatologist for review of your lesions and exact dosage for the treatment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Smruti Pevekar",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat chronic costochondritis?\n\nHello I suffer from Chronic costochondritis and I m comming up for 16 in may.. I was on the strongest ibuprofen allowed by law and it done so much damage I also take omeprazol and have recently been moved off the anti inflamitries as they are doing my body damage and I ve become immune to them.. I m going to get an electroscan (12 point ecg) and an echoscan because during the latest diagnosis the doctors found a clicking and murmering noise from my heard which may be MVP, I really need some form of pain relief and I know the story with costo but there s talk of cortisone injections to ease pain on some sites including wiki bit each time I ask for a solution I get no reply the doctor acts like I never asked the question ..what can I do I have tried everything and there has been no progress, they seem more concerned about my heart than my costo but I can t go on with such pain this is barbaric and the only thing keeping me from suicide is the girl putting up with me through all this, what are my rights, options and ways to go about this because NHS treat me horribly, what can be done ??",
    "doctor_response": "Hello,I read carefully your query and understand your concern. Your symptoms seem to be related to a costochondritis. I suggest using anti inflammatory medications such as Acetaminophen to relieve the pain. I also suggest gentle exercises. If the symptoms continue, I suggest using prescription painkillers such as Oxycodone. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for severe back pain?\n\nI have been having a strange feeling in the center of my back...spine about chest high. there is no pain or tingly feeling, just a strange feeling that i can notice that is hard to explain. its not a big deal during the day, but when i lay down to sleep it is noticeable and hard to not think about. when i stretch that part of my back or crack it, i get a weird feeling in my chest and it makes me cough sometimes. there is also a bubbly feeling that occurs in my chest often.. almost like a small pop you get when you start to burp on purpose. i do not experience any pain unless i run.. then it feels like someone is stabbing me in the chest. also, sometimes when i take a deep breath it feels like i was just swimming and it makes me cough. any help would be appreciated. thank you!",
    "doctor_response": "Hello, I have studied your case.I will advise MRI spine to see for any nerve compression leading to upper back pain.Medication like methylcobalamine with muscle relaxant and analgesic will reduce pain; you can take them consulting your treating doctor.You may consult physiotherapist for further guidance. He may start TENS, or ultrasound which is helpful in your case.I will advise to check your vit B12 and vit D3 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it safe to take antibiotic for Klebsiella infection during pregnancy?\n\nHello doctor, I am 15 weeks pregnant and have been suffering from urinary tract infections on and off for the last month. I gave my urine for culture and it showed up Klebsiella one lakh count. My gynecologist advised to take Norfloxacin 400 mg twice a day but the internet has a mixed review of the same with concerning how it will affect the fetus. Is it safe to consume the antibiotic?",
    "doctor_response": "Hi. I went through your query. Norfloxacin can be given in the second trimester of pregnancy that is after 13 weeks. Your urine culture report shows that it will be sensitive to Norfloxacin. Klebsiella is a very resistant bacteria. You will need a prolonged treatment with Norfloxacin. Also, please do ensure to repeat the culture after treatment is complete to make sure that the bacteria is completely gone because at times it needs extended treatment to completely cure the problem. Complete eradication is necessary as Klebsiella in pregnancy is not a good thing. It can cause abortions and pain.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for tired and lethargic behavior after taking Prozac\n\nMy daughter is 22 and was prescribed 20 mg. of Prozac and 5 mg. of Zyprexa for depression. She took that for about 6 weeks. Felt great the first 2 weeks. Then began to feel lethargic and sad. By the 4th week the doctor doubled her Prozac to 40 mg. and increased the Zyprexa to 7.5 mg. After 5 days of this a different psychiatrist took her off the Zyprexa and kept her on the 40 mg. of Prozac. The first week she felt much more energetic but had some difficulty sleeping. Now she has been on the 40 mg. of Prozac for 2 weeks and once again tired/lethargic/no energy or motivation. Should she reduce her dosage of Prozac?",
    "doctor_response": "HiI admire your positive outlook and congratulate you for the attitude. Now I guess she has depression and it could be due to some stress in her personal life. In that case, you need some help.However let me give my opinion here. I think a combination therapy of antidepressant and low benzodiazepine would help her. In antidepressant, she is already on prozac (fluoxetine). Better to keep her on same medication and gradually she would improve. She can try some relaxation exercise like JPMR or deep breathing exercise. That would keep her calm and relax. In case, you need further help, you can ask. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain between the left breast and collar bone?\n\nI am experiencing a sharp pain between my left breast and collar bone, it is worsened by deep heaths sometimes, moving sometimes and even when I stay still the pain becomes sharper, it shoots up towards my shoulder or stays between breast and collar bone. What could this be? Should I see a doctor?",
    "doctor_response": "Hi I did review your concern.Such a sharp pain that worsens with deep breath can be due to musculoskeletal cause or pleurisy or pericardial cause.I would advice you to go see a doctor and get your self examined. At the basic he will do an ECG and get a chest xray done to find out more about the pain.I hope this helps.Wish you all the best.Thank you for choosing healthcare magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do you think I need to see a psychologist for this? This happens a few times a week. I am sitting at the computer looking through local news or google news and then I see information about a car accident. Of course, being the idiot I am, I click on the link which gives information about the car crash and information on the victims. Of course, the victims are usually in my age range. 15-21. I look at the victims pictures and go into deep though. Wow, did they know they were going to die at that last second? They don t look like the type of people to die. Did they get hurt? Were they well known? Usually, at this time it s about 10:30-11:00. I of course become ridden with anxiety and don t go to bed for another 3 hours. I can t even go to the college I want because of the fear of car accidents. I was going to go visit a college a few days ago with my mom, I told her I wanted to go to a college here, which was a lie. I just didn t want to take the risk of dying on the interstate to the cities. I just have this feeling I m going to see someone, know someone or be in a gruesome car accident. I can t watch local news anymore because I don t want there to be anything about car accidents. Especially about highschoolers in my area. I just wish people cared more about how they drive! Drive for yourself and others. I don t want to be split in half.",
    "doctor_response": "Hi, Welcome to HealthcareMagic Forum With your description it is clear that you are some form of anxiety disorder. It may be generalized anxiety disorder, OCD or phobia. These disorders are best treated with combination of CBT (cognitive behavior therapy) and medicines. Help from psychiatrist and psychologist will definitely help you. I hope this information has been both informative and helpful for you. Wish you Good Health. Regards, Dr. Ashish Mittal eashishmittal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excess of wax in ear and high body temperature?\n\nMy baby woke up this morning with a lot of wax around her ear, she has been irritable for a few days, crying, sky high temperature and i put it down to her teething as she had really rosy cheeks. Could she have an ear infection and have burst her eardrum? What shall i do? My doctors said to get something from the chemist but my babies in a lot of pain.",
    "doctor_response": "Dear parent, I understand your concerns but it seems that your child has caught an ear infection. this requires ear drops as otrivin together with an antibiotic for 10 days. to relieve the fever and pain you can use acetaminophen or ibuprofen syrup every 8 hours",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat Myotonic Dyphropy in a 11 year old?\n\nHi I would like to know of a doctor who specializes in pedriatrics of muscle diseases-I guess a neurologist-in the Middletown NY area? My 11 year old niece has been diagnosed with myotonic dsyphropy (not sure of the correct spelling, sorry). Any help you can give me would certainly be appreciated. Thank you.",
    "doctor_response": "Hi,Thank you for asking question on health care magic.Myotonic dystrophy is a complex disorder involving multiple systems.Neurologist,Physiotherapist, reabilitation specialist, ortho pedician, ophtholmologist Cardiac phsician and a pulmonolgist to function in coordination for better out come.Patients survive full and successful life if treated in a correct institute.Inability to relax muscles be trated witha drug such as Maxiletine.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for hip pain after falling down\n\nA week ago I trip backwards landed on my buut and hiting my head now my back hurts the same day I also steeped Into a little hole which hurt my right side of my hip. So what should I do my back hurt realty bad even to sit up as well my right side of my hip. How long will I be in pain and what did I do",
    "doctor_response": "Hello, An x-ray of the hip and lumbar spine is advised. As this matter looks to be related to the bony injury or soft tissue injury in the lower back due to fall and having an injury is common in that region due to the impact. Post an x-ray is no fracture found then low-intensity exercise for the core, spinal muscles, hip muscle and lower limb is advised. Doing hot water fermentation will help relief of the pain for now. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the severe cough and pain in my ribs?\n\nI think I might have whooping cough and have been coughing very hard recently. I now have a pain in my right side around my 11th and 12th ribs. It feels partially like muscle because it hurts when I walk or move that side of my body, but it is also very painful to the touch on those ribs. Could I have cracked my ribs?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.Vigorous coughing itself causes musculoskeletal pain.So we should first stop your coughing.So get done chest x ray. If chest x ray is normal then no need to worry much. Take antihistamine (levocetrizine or fexofenadine) for coughing.Apply warm water pad on affected areas of chest. Avoid movements causing pain. Avoid heavyweight lifting and strenuous exercise.Take painkiller and muscle relaxant drugs.Don't worry, you will be alright with all these in 1 week.No need to worry about fracture rib.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. A part of my anal skin has come out and not going inside. Please help.\n\nHi doctor, A part of my anal skin has come out and is not going inside. What should I do? I have tried putting it inside but it pops out again. I have applied coconut oil as well but nothing is happening. As such, there is no pain in that but it is not looking nice as well.",
    "doctor_response": "Hi. This is likely to be a prolapse, either an anal or rectal prolapse or prolapse of hemorrhoids. Definitive treatment is the surgicalcorrection if it is severe. Otherwise, you should put it inside manually after passing stools. It may come back again during straining at stools. So every time it comes out, you need to put it back.  I guess you do not have any bleeding. The most important thing to prevent its progression is to avoid excessive straining at stool. You should avoid constipation, so if having constipation should have a laxative like Cremaffin plus syrup. So, visit the surgeon once to get it confirmed and for its severity.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hard abdomen?\n\nHi, My 12 month old boy has been crying uncontrollably for the last few nights. he seems to have a hard abdomen. His stool tonight when it eventually came was 3 different colours. Black green and brown and had quite a solid texture. he is on aptamil number 2. His crying stopped as soon as his bowels moved. Should I see a doctor",
    "doctor_response": "Hello,Functional constipation is normal in this age group which can lead to a hard and painful abdomen. You can treat by lactulose syrup, or simply a small amount of olive oil added to his milk. Organic constipation ruled out if he is having a normal appetite, not having vomiting, thriving well, having normal shaped stools. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Omaira",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am suffering from a severe depression and i am only 18\n\niv asked questions here before. sometimes i received good answers, many times i received not good ones such as See a doctor . so im not expecting the best from this but id like any advice anyway. im just so desperate. im 18, iv had some severe depression for about a year or so now. i feel like i cant tell anyone about it. i havnt told a soul so far. its basically just literally ruining my life and almost every relationship iv created in the past (i mean friends or just any kind of relationship, even ones i formed back when i was really young) have seemed to dissipate inside of me. to all them they dont know because iv hid it. but inside i feel like i dont even know my life long friends anymore. iv been feeling like i cant even turn to my family anymore. everyones becoming so distant from me and i feel there s no where to turn. im living in some kind of empty void now. does anyone have ANY kind of advice for me???? besides from the too often repeated stuff (see top)",
    "doctor_response": "HI well come to HCM. It seems you are not happy if we ask you to see your doctor.But when question is asked should provide enough material to conclude the thing, every thing can not be judged by merely history, at times clinical examination and invetigations are needed  before giving medical advice.WE have our limitations to answer you.At present it looks like you are suffering from depression. You got to help your self. Start thinking positive.Involved your self in social activity.Attain gathering and start mixing well with people.Select activity of your choice and keep busy in it. Make newer friends. All this will give you inner pleasure and will help you to come out of depression. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment to reduce dark spots on face\n\nhello sir,I have oily skin. there are many pimple and their black spots on my face also my face also my skin is getting dark as I was using multiple creams suggest me some medic if u can which can make my skin fair and vanishes the dark spotplease sir help me",
    "doctor_response": "Hi,From your question I can make out that you are suffering from Acne and one of its side effects ie black spots (also called post inflammatory hyperpigmentation). I would 1st prefer to treat your pimples. once they get cleared, the dark spots can be taken care of.you can also use facewash solution in the morning and evening folloewd by application of adapalene 0.1% cream at night and clindamycin gel in the morning over the pimples for about 1 month. once your face is cleared of pimples, you can apply kojic acid containing cream over the dark spots twice daily and a broad spectrum sunscreen gel (not lotion as you have an oily skin) half an hour before getting out into the sun.Thank youtake care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest gum treatment\n\nyes u can i have twothe first one is if i have two cycles a month evry month since march is it possible that i may have a std? the second one is i have recently had a infected tooth pulled out and bit of the tooth are still in the gum is the infection going to remain there",
    "doctor_response": "hello thnks for consult at hcm..the remaining tooth fragment has to be pulled out once the infection comes down,, u can take antibiotics and analgesics if u have not taken earlier,,plz consult a dentist for tooth problem, regarding two cycles a month does not suggest std either ways plz consult ur gyneacologist ,,hope it helps ,,tc..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pins and needles in fingers and face and swollen eyelids after taking nitrofurantoin for cystitis\n\nI am a 55 year old woman who was prescribed nitrofurantoin for cystitis . I stopped taking it after 2 days because of pain in legs. 24 hors later I started having pins and needles in my fingers and my face and this has continued for 2 days . My eyelids are also swollen. Will this get better on its own or do I need to see a doctor?",
    "doctor_response": "Hello, It seems like hypersensitivity to Nitrofurantoin. You have to take loratadine 10 mg for some days, do not use anymore this medication,  and consult with your doctor for another antibiotic to treat UTI. If you have difficulty breathing go to ER. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Blerina Pasho, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does delay in periods with scanty flow and discharge post periods with negative urine pregnancy test mean pregnancy ?\n\nhello doctor,i am 18 and we played on 20th jan..but didnt do any sex...after that i got my periods late for first time in 7 years..its was heavy flow for 3 days then suddenly stopped and some brown discharge for next 2-3 days..i had 3 urine pregnancy test that time all came negative..last test i took was 6feb,and also ultrascan but nothing found,now i feel bloated and my nipples tip have some burning sensasation but breast not paining,even i m having constant lower stomach pain and also vaginal pain,last period i got was on 8 feb,dis time too i am not getting 2day its 7 march.should i again take test? i dont want to b pregnant,if its positive can i abort without any doctor consultation?plz reply.",
    "doctor_response": "Hello, Thanks for posting your query. There could be many reasons for delayed periods other than pregnancy, like stress, anxiety, hormonal imbalance, illness etc. Regarding your symptoms of heavy flow followed by brown discharge this can occur in times of stress or if you are anemic or ill. You can take some iron supplements like Fefol Z capsules one daily for three months and add plenty of green vegetables and milk in your diet. If your period is delayed by more than a week then you can get tested using a home pregnancy kit. In case your pregnancy test is positive and you choose to go for an abortion, please consult your gynecologist who will guide you. This is important as any self methods could be potentially harmful to your health. If you continue to have delayed heavy flow every month, Please consult your gynecologist who will examine you and give the appropriate hormonal treatment to regularize your flow. Hope I\u2019ve answered your query. Regards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Should I get jaw surgery done to treat open bite due to tongue thrusting?\n\nHello doctor, I have an open bite due to a tongue thrust I have had since I was a baby (I am 22 now). It is affecting the way I talk, eat, and I sometimes find myself gasping for air when I sleep. I have been looking into ways to correct it and also close my bite. Will corrective jaw surgery help with my tongue placement as well as close my open bite?",
    "doctor_response": "Hello,  Welcome to icliniq.com.  As per your description, you having open bite and tongue thrust. For correction of open bite the exact cause must be ruled out. Tongue thrust is the cause and is also aggrevatinng factor. Also, if corrective jaw surgery works or not or whether any skeletal jaw problem is involved can be suggested only after clinical examination. If there is growth direction of Maxilla or mandible is altered or there posterior vertical maxillary excess and etc., is there then that have to be ruled out before planning for corrective jaw surgery option. First Tongue thrust should be taken care with help of habit breaking appliance and then malocclusion should be corrected with Orthodontic treatment,provided skeletal factor is not involved. Again I would like to see images of your concern area and teeth for detailed diagnosis and management of problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dementia\n\nMy father is 86 years old and is in an assisted living facility. He has dementia, however, I don t know what stage, it is beyond initial and has elected to not take meds for it. He has been losing weight over the past 2 months, is gradually slowing down, and now nods off to sleep whenever he s sitting. Are these typical signs of demential progression?",
    "doctor_response": "Hi and thanks for question.these r typical sign of progressive dementia. u have consult psychiatrist or neurologist for problem. in dementia, person gradually forget thing, food taken or not, routine activity problem, than close relatives name . if he was not ready than a patch for dementia treatment is also available u can use them.thsnks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and cough\n\nHi, I am glad for this service of consultation you are providing. My 18 months old son has been with feeling regular the past 4 days with not very high fever of 99 - 100 degrees. Today he started coughing as a barking old dog that sounds very scary. His coughing is getting more and more frequent during the night and sounds that he is having problems to breath. What should I do? Thank you so much for your help.",
    "doctor_response": "Hi,It seems that your son might be having viral infection producing productive cough and fever.Possibility of having bacterial infection is also there.In this situation one course of antibiotic medicine is advisable as there are chances of pneumonitis is there.Consult your doctor and get examined.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and tenderness on left side of body?\n\nThe whole left side of body and the left side only is swollen and tender especially the upper left quad. I had the left medial head of my clavicle surgically removed. Do I need to have my lymph nodes checked. I have very large cyst in L breast. I just had chest xray due to the chemical levels of my uterine fibroid no results yet. I have gained weight and I feel fatigue.",
    "doctor_response": "Hi there. a clavicle surgically treated can definitely hamper the function of Thoracic outlet (mainly circulatory system). Breast cancers lead to blockage of lymph nodes and channels. Aditionally, hormonal imbalance in the body leads to weight gain due to fluid retention. Clinical examination and correlation is required though.",
    "dialogue_context": ""
  },
  {
    "patient_message": "PCOS, trying to conceive, had miscarriage. Using Clomid with no help. Any solution ?\n\ni am 30 year old, married for 5 years now. trying to conceive from ldast 2 years.diagnosed with PCOS 2 yrs back . but no cysts in the ovaries. with symtoms irregular periods, acne, abdomen fat, hair loss and unwaned hair. besides this i had a miscarriage last year. I exercise regularly with no refined carbs, high protein and fiber and lots of fruits,vegetables and nuts. and also i used clomid for 9 months with no success. all the symptoms were subsided during clomid use and again came back after stopped using it. please help me on this problem and to conceive and have successful pregnancy.",
    "doctor_response": "Hello,It is quite possible that you may not be ovulating even after taking CLOMID.In such cases,the dose of CLOMID is increased and it can be increased upto 250 mg.You must also check for prolactin levels in blood as hyperprolactenemia can result in situation where CLOMID doesn't act.Other methods for improved ovulation chances are..Regular exercises and reduction of weight.It is said that a mere reduction of weight by 10% can help achieve ovulation.Use of drug called as METFORMIN 500 mg twice a day for atleast 6 to 9 months.It helps in reduction of insulin resistance and achieving ovulation.Please consult your doctor and discuss about it in detail.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedies for a child swallowing a chicken bone\n\nI have a child that is almost 3 years old that was eating a chicken leg. Upon examining his plate to see if he needed anything else I realized that there was part of the chicken bone broken off and missing. When I asked him where it went he said it was in his mouth and he ate it. He had already swallowed the food so I don't know exactly how much he swallowed or if it was a small broken piece that he possibly chewed. Do I need to take him to the emergency room?",
    "doctor_response": "taking a child to emergency room depends when your child ingested the foreign body , where it is located in gut and what type and how large was the foreign body.in your case child ingested a chicken bone , it is  small in size can be sharp or blunt, has not caused any symptoms like vomiting , pain, or difficulty in swallowing at any time. so its not of emergency.  but position of chicken bone has to be looked in gut by a chest and abdominal x ray. if it is still (after 2 hours of ingestion) in upper gut esophagus it has to be removed by endoscope. if it has not crossed stomach after 3 days it has to be removed . if it has crossed stomach it will pass by itself in stool. So please get the xrays done.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What else can be done if a third of brain tumor could be removed and the rest is not dying?\n\nHi there My husband has a brain tumor, it is very rare and is called Condrosarcoma. In May 2011 when it was diagnosed it was as big as my fist. A local Neurosurgeon took a biopsy and could only remove a 3rd of the tumor. He had radiation for about 2 months every day, but it does not seem like the tumor is dying. It has gone into every little opening expl his sinus openings ext. Is there anything that you can do for him?",
    "doctor_response": "Hello, Since the tumor is expanding the best way for your husband is to undergo a more aggressive surgery. There are serious risks also that you should consider. Take a second opinion from another Neurosurgeon in your country. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "kidney selling in need of money, please help\n\nif any one want to sell one of his/her kidney.... how sud he/she can sell it plz reply?",
    "doctor_response": "Hi Welcome to health care magic It is an offense under law in India ,don`t try it ,you may face many future problems. \u2018Hope I have answered your query, I will be available to answer your follow up queries, \u201cWish you Good Health and speedy recovery\u201d Disclaimer",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe stomach pain?\n\ndiagnosed with H. Pylori. Taking amoxicillin, clarithromycin and lantoprozole. I am having severe stomach pains. should I be taking these medication with severe stomach pains. Is there another medication I can take? I think the pain is more from the clrihromycin.",
    "doctor_response": "helloH pylori treatment is done for 10 to 14 days usually and if pain is severe,your doctor may add anti-spasmodic sos.unless there is itolerance to clarithromycin, this drug is preffered as is curative, yes adding probiotics and lactobacils may be additional help .Consult your doctor if changes are necessary for pain.Some doctor substitute metronidazole also if some drug is not suitingbest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lipomas, shivering limbs. Father has lipomas. Sarivadyarishta, kanchanaraguggulu, homeopathy medicines taken. Can they be cured?\n\nsir i am 20years  male and my father have multiple lipomas over the body but they are not much noticable but i got nearly 50 lipomas on my both hands and some of them on my body and thighs many of the doctors says that they are not curable sir i need the perfect answer whether they would be cured and also good homeopathy doctor should look after my condition for a perfect medicine??  they are increasing day by day....i used some ayurvedic medicines like saribadyarishta and kanchanara guggulu for nearly 4 months but no use also used some homeopathic medicines but cant find any result ,i will drink much coffe and tea and i have general weakness like shivering hands and legs when tensed and no other problems.....please help me sir",
    "doctor_response": "Hi friend, Welcome to Health Care Magic Was biopsy done and the diagnosis confirmed? IT IS NOT CURABLE...NO SYSTEM OF MEDICINE CAN CURE Only cosmetic improvement is feasible by surgical removal You also have Anxiety - could be reaction to the condition...? Psychological assessment and assistance can help You want a perfect answer and that too for free! Only physical sciences like Physics or Mathematics can give perfect answer... No biological science can give perfect answer - only statistical probabilities... Take care Wishing speedy recovery God bless Good luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can i increase my result?\n\nmy first 'echo' gave me a result of 60,, which my doctor told me was good.  However 3 weeks later it is 50-55.  My doctor said this is still normal.  (i have undergone chemo/radiotherapy for cancer)  I have another echo in 7 weeks time.  How can i increase my result please?",
    "doctor_response": "hello, I have gone through your query .Thanks for using HCM.Basically normal EF is above 55%.so figure of 55 or 60 is considered normal.In your case our goal is to look for side effect of chemo on EF.I think next assessment after few weeks will give you right information.if it is around 55 ,nothing to worry.My best wishesDr.Rajesh Teli,MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes shaky body in children?\n\nmy eight year old grand daughter starts shaking for no reason... like shes freezing... gets real weak... sugar has been checked and drs cant figure it out subsides after a few minutes.. my daughter says she acts like shes not as focused about her school work .. says shes getting dumber? drs keep saying I need to see her do this... well thats kinda hard because it doesnt last very long.. but the attacts seem to be getting more frequent.",
    "doctor_response": "HiThanks for using healthcare magicI think, he may have pseudo-seizure due to school stress. In that case,you should consult a psychiatrist and psychologist for his mental status examination. That would help to make a proper diagnosis. Treatment in his case depends upon the reason that lead to pseudo-seizure. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Liver function tests showed bilirubin, serum alkaline phosphate content. Had Gallbladder removed by laparoscopy. Suggestion?\n\nmy gall bladder was removed 6 months ago by laproscopy.my blood picture was normal at that time.a few days back my liver function test results are: serum bilirubin 1.41, serum alkaline phosphase 435, serum ALT(SGPT) 77,serumAST(SGOT)54, GGTP gamma glutamyl transpeptidase 528,serum globulin3.9, albumin-globulinserum ratio1.0. all other values normal. i am male 78 years,indian. i have no symptoms at present. what are the likely causes and .remedies.",
    "doctor_response": "Hi,Welcome to HCM,You are asymptomatic and undergone laparoscopic cholecystectomy 6 months back.These liver function test show high level of alkaline phosphatase 435 and GGTP 528 and other enzymes are borderline raised.Indicative of cholestasis  you should get a fresh ultrasonography of abdomen and visit the surgeon and Physician for proper treatment which depends on cause.GGTP ( gamma-glutamyl transpeptidase ) could also indicate alcoholic injury to liver so by chance if alcohol use is there please stop. Many cases of minor injury to the common bile duct can be managed non-surgically.Please take care.Good Luck.Dr.Akhilesh Dubey M.D.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the following blood test result indicate?\n\nMy daughter has been have the severe abdominal pain attacks for well over a year now. (She is 14 years old, weights 80lbs., is 5 1/4 tall.) They come on suddenly and last for hours. With each episode she can experiences the uncontrollable shakes, cold clammy sweats and nausea (sometimes even vomiting). We had blood work done a year ago (two days after the episode), blood work done last week during an episode and repeated blood work four days later. My questions is with the blood work done. These numbers stand out to me and wondering if I should be concerned. My daughter had surgery 7 years ago to remove a benign tumor (chondroblastoma) from her ankle. Now wondering if these episodes can be related. 8-13-13 9-21-14(during an episode). 9-25-14 WBC 4.8 6.6 4.6 Neutrophils. 53.2 85.8 41.9 Lymphocytes. 38.3 7.1 43.5 Monocytes. 5.7 6.1 9.7 Eosinophils. 2.1 .6 4.5 Basophils. .7 .4 .5 Alk phosphatase. 219 310 257 Total bilirubin. .5 1.4 .3 Thanks, Christina",
    "doctor_response": "Hi I did review your concern.very characteristically there is neutrophilia when your daughter has an episode of severe abdominal pain and mild increase in bilirubin too. i would advice you to get a CT scan with contrast of her abdomen to see for any inflammatory lesions causing this. Sometimes angioedema can cause these attacks and lesions like appendicities can also cause. For this we need to know where exactly she feels pain and has she noticed any changes in her bowel movements,i hope this helpsWish you all the best.Thank you for using healthcare magic!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why is my abdomen hurting around the navel?\n\nI have had abdominal pain for two days. It seems to be unrelated to foods I have eaten. I have gone to the bathroom normally. It hurts when I press on it.  I am able to function and do normal daily activities. I finished my menstrual cycle two days ago.  The pain is more of a discomfort, not quite as bad as cramps. It feels similar to eating something that didn't agree with me, but I have no other symptoms to indicate that.  I have also had a migraine for five days, which is also typical around my period. When I press on my stomach it hurts more around the belly button area-above and below it.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. The presentation of narrated symptoms suggest that it is related to intestine colic from various possible reasons as early appendix inflammation or others. I would suggest an ultrasound of the abdomen and pelvis for further proceedings. Thanks. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe sore throat, cough and nausea?\n\nI was fine yesterday, i woke up this morning about 10'oclock was completely fine, went back to sleep because i was feeling drowsy woke up about 12.30pm i had a sore throat didnt think much of it, now i am coughing so bad it makes my stomach like crunch up. It feels like when i cough all my effort is going in and its making me go weak. I can't eat neither i did earlya and it made me worse. The smell of food is making me sick. What is this?",
    "doctor_response": "Hello dear , hiWelcome to Healthcaremagic.comI have gone through  your concern in depth .*  This is in relation with acute respiratory tract infection with systemic      manifestations .*  Needs immediate assistance with your family doctor to get the vital    parameters checked  and  get  treatment  in accordance  with  that .Hope this clears your query .Welcome for any further guidance .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sharp pain in elbow after falling down?\n\nHi I fell today on tiles at a swimming baths and I landed on my elbow. After that it was sore and then the pain wasn t so bad. It s bruised the tinniest but that s it and now and again I get sharp pains. I don t know if I have a maybe fractured it? But I think I m exgaggarting? Can you help?",
    "doctor_response": "HelloI have studied your case. There is possibility of fracture around elbow. you may need clinical examination and x ray to confirm diagnosis. Till time take rest. I hope I have answered your questions. If you have further questions please feel free to contact us. I will be happy to answer. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to shiver and feel cold after angiogram?\n\nMy partner had an angiogram yesterday  and this eving she has been shivering and her face is white and she feels cold and has a temperature of 37.6 even though she's taken paracetamol. The angiogram was normal. Is it normal to have shivering and slight fever start 24 hours afterwards?",
    "doctor_response": "Ya you may have some feverish feeling with shivering post angiogram ,  not always but frequent as for an angiography a dye is used,  your partner had delayed reaction to the dye.  Take plenty of liquids and the dye will be flushed out of the system through urine in 24 hours.  You need not worry for the same and it's just mild reaction to the iodinated  dye. .Wishing you best of health.  Regards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What does abutment of the nerve root mean?\n\nHi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for\u00a0annular bulging and tear?",
    "doctor_response": "Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am not able to maintain an erection even after taking Tadalafil. Why?\n\nI am 32 years old healthy male without any relevant medical history. I am married since 2 years and do not have kids. Till 3 months ago I used to have weekly sex with my wife but now since last 5 months I have been staying without her in some city so meet her only once a month. I also masturbate once a day mostly. In last 45 days we have met three times but I felt less confident in maintaining erection enough to have sex, so I had 5 mg tadalafil and did intercourse comfortably. But yesterday I had to to take 10 mg tadalafil and then also I was under confident. Kindly suggest: 1) if I have erectile dysfunction and need to take medicine 2) If it is just psychological condition and need not worry 3) Or keep consuming 5mg/10 mg tadalafil every time having sex. But I am afraid this will be habitual and long term usage for next 15-20 years shall have side effects on my body and family planning 4) Or whatever you suggest is right Thanks a lot.",
    "doctor_response": "Erectile performance and ejaculation can be influenced by many factors, if you are anxious, sad or stressed this can get lower performance, if you are relaxed and happy you will have better performance because it is affected by neurotransmitters, which is influenced by mood, stress level, etc. the more relaxed, happy and stress free you are the more levels of these neurotransmitters and better performance, it's also influenced by emotional factors with your partner, if any problem between them can lead to psychological erectile dysfunction which is common in young couples. and when partners stay away they are not doing sex often and they get distanced in emotions and some level of anxiety builds up when they perform.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it to be concerned about the minor pain in the chest?\n\nI am experiencing minor chest pain on the upper right side of my chest.  I had coffee earlier and I just worked out pretty strenuously which I do 5 to 6 times for at least an hour every week.  I am in good shape and eat very healthy.  I did however have about 5-6 beers last night and smoked a cigar.  Any ideas on what it could be and suggestions for the future?",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. No need to worry much for your mild right upper chest pain. Possibility of musculoskeletal pain due to strenuous work out is more in your case. So avoid strenuous exercise and heavyweight lifting for 1-2 weeks. Apply warm water pad on affected areas. Avoid movements causing pain. Avoid bad postures in sleep. Take painkiller like ibuprofen. Don't worry, you will be alright within 1 - 2 weeks. For healthy future, better to quit smoking (cigar) and Alcohol (beer) as these are not good habits. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from Psoriasis, scalp infected, uneasy to apply propysalic ointment. Any liquid based ointment?\n\nhello doctor, i have been suffering with Psoriasis for almost 15 years. In fact, it started when i was in 3rd standard, but now , i still have it in mild stage. i mean, i am still suffering with it on scalp . i use propysalic nf ointment, but its uneasy to apply over scalp, so can u please recommend me any liquid form of ointment for scalp.thanks and regards,kumar.",
    "doctor_response": "Hi.yes there are main lotions to apply on scalp .it can be clop-s nano lotion.propysalic is also available in lotion form.kersol-c lotion.halox lotion etc are available.use a coal tar and salcyclic acid shampoo weekly twice can cure it",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pigmentation on cheeks, brown skin due to pollution. On vitamin tablets, supravet cream, kojivit gel. How to regain fair skin?\n\nHi, I am XXXXX, I got the pigmentation on my cheeks and got bit brown skin as I was fairer before but harsh condition in XXXX ruined my face complexion . Now a month before I consulted a doctor and he gave me vitamin tablets, supravet cream, kojivit gel with some alovera moisturizer but even after using it I didn t found any favourable result even I thought my skin got more brown and darker. He prescribed me to apply those creams twice a week for one hour and tablet everyday for 20 days with a gap of 10 days after taking 10 tablets. Please tell me how do I get my fairness back and want to get rid from this pigmentation with further fairer skin. with regards",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice. The condition you are facing can be melasma, PIH, etc.Without actual visualization of the skin, it is not possible to comment on nature of pigmentation.Sun protection is most important for any cosmetic treatment.Use good quality sunscreen.Avoid sun exposure.Use brevoxyl face wash.Apply depiwhite cream at night.Take lot of vitamin C in diet.Visit a dermatologist for proper examination and diagnosis who can also provide you some clinic based procedure like chemical peeling and laser.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sudarshan",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am suffering from stomach and digestive problem.I always take medicine for digestion.When I leave the medicine, Gastric trouble,constipation and pain in stomach starts.",
    "doctor_response": "You have chronicaly been consuming the drug. Due to chronic use your body has started to show physical dependency on the drug. Now you will have to get rid of the habit in order to stay drug free in future. Gradualy decrease the amount of the drug consumption along with practice of other natural methods to avoid your gastric trouble.",
    "dialogue_context": ""
  },
  {
    "patient_message": "MRI of cervical spine showing loss of cervical lordosis and mild scoliosis. Moderate bulges indenting the subarachnoid space. Any future complications?\n\nI have done a MRI test of cervical spine(3Telsa) Conclusion of the report- *Degenerative changes of cervical spine with loss of cervical lordosis and mild scoliosis with convexity towards left. *C4-5 and C5-6: Moderate bulges indenting the anterior subarachnoid space and exiting nerve roots on both sides. I am 41 yrs male and my profession is pharma sales. Please tell me how it has happened at this age and what problem can arise in future due to this.",
    "doctor_response": "Hello, The changes that your MRI shows are suggestive of cervical spondylosis. With age almost all people will have these changes but you have developed them a little early. If these degenerative changes progress then problems like, neck pain, restriction of neck movements, arm pain, arm weakness etc can occur. The possible causes could be prolonged unhealthy neck postures for e.g. sitting for long hours before computer which is not at level with eyes etc. You can incorporate some of these life style changes and learn physiotherapy of the neck which will help you in the long run. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of breast cancer ?\n\nI am 20 years old and have a two year old son. I have a petite body build and have not gained much weight lately. I got one lone stretch mark on my right breast while pregnant and it hasn t bothered me until recently. It is extremely painful and seems to be getting larger; it is hollow-like and looks bruised. My right breast hurts pretty much all the time but every now and then, I will get a sharp stabbing pain where the stretch mark is, sometimes it s so bad I almost cry and can t breathe. When I think cancer, I think of a tumor, so I have no clue what this hollow spot could be!! Please help..",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. No need to worry much for cancer.  As your age is too young to have cancer. Cancer lumps are generally not painful so again less chances of malignancy in your case.In my opinion you should first get done mammography of right breast.This will tell you about your breast lump. I think you are having abscess or infected cyst which causes so much pain.So no need to worry for cancer just get done mammography and start treatment accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can itchy rashes on the body be treated?\n\nMy daughter, who is 43 years of age and generally in good health , developed a rash all over her body, approx 10 days ago. This rash initially presented itself as hives (pink and a little swollen) with moderate to severe itching. She was given both antihistamines as well as topical dream, without any improvement to her condition, although there was some improvement to the redness, initially. Through constant scratching, her body is now bruised in many areas and today, following a bad night of severe itching, she is now experiencing \"pins and needles\" sensation all over her body. We are very concerned as to what this can be and what she should do next.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. According to the history, it would be better for her to be examined by her doctor to find the exact cause of the allergy and then it would be the treatment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long will it take to clear fluid from lungs?\n\nMy 69 year old Mother was just discharged from the hospital after spending 5 days there for pneumonia.  She has no spleen and was admitted Sunday because of fluid in her lung and was almost septic Monday.  How long should she wait before getting on an airplane?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. It is advisable to take at least 2-3 weeks of rest after pneumonia. She is also having pleural effusion (fluid in lung) and septic, so possibility of severe pneumonia is more. In this situation, it takes almost 2-3 weeks for complete resolution. Air travel in plane is not safe because of low oxygen saturation at that height. So possibility of breathing difficulty is high in pneumonia patient in the plane. So better to take proper rest at home for 2-2 weeks atleast. Get done repeat chest x ray and clinical evaluation after 2-3 weeks. Hope I have solved your query. Wishing good health to your mother. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing miss beating in my heart?\n\niam 43 year man and from 10 day iam feeling miss beating in my heart iam daibitic and hypertensiv too and i have psoriasis my blood pressure is under control but my sugar is not in under control i regularly exercise 40 mintue on cycle tell me the cause plz",
    "doctor_response": "Hello!Thank you for asking on HCM!I understand your concern, and would explain that your symptoms may be related to a cardiac arrhythmia. Based on your cardio vascular risk factors (hypertension, psoriasis and diabetes), a cardiac check up is necessary. I recommend consulting with your attending physician for a careful physical examination, a resting ECG, a chest x ray and some blood lab tests : - complete blood count- fasting glucose and HbA1C- PCR, sedimentation rate- kidney and liver function tests- blood electrolytes- thyroid hormone levels, etc. An ambulatory 24 -48 hour ECG monitoring and a cardiac ultrasound are necessary to rule in/out a possible cardiac arrhythmia. Hope to have been helpful!Best regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for hepatitis E\n\nI was  recently suffering from Hep E & was on medicines for 4 months. Now bilirubin level is below 1 but Globumin is 4.5 & Albumin does not cross 3.5. I have done blood check up. Hb is 9.9 ,Platelet is 116 WBC 3900, RBC 3.21 Monocyte 14. what would you recommend. Dr adviced Serum B 12 test. Guide. Deepak Lad 58 yrs",
    "doctor_response": "Dear Friend.Welcome to Healthcaremagic.Hi, I am Dr Anshul Varshney , I have read your query in detail , I understand your concern.Hepatitis E is a self limiting condition.You have recovered from it as your reports suggests.You have 1 main issue that is anemia.I would advise you to get evaluated.Get following:1. Complete Hemogram2. General blood picture.3. Vitamin B12 assay.Review with reports.This is my personal opinion based on details available here.  If you still have any other query, you may please ask me.Stay Healthy. Dr Anshul Varshney , MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bubbling sensation and pain in groin area\n\nI have had pain in groin area- left side for about a month that is painful at times and then seems to go away.  at times radiates into left leg and now I have a constant vibration/ bubbling sensation in left side groin. no lumps though like a hernia ??",
    "doctor_response": "Hello,The possible causes are:1. Anxiety may cause twitching of perinium muscle lead to bubbling or vibration sensation2. Nerve compression of perineum3. Femoral Hernia with a small part bowel in it4. Perineal injuryTake rest, do yoga, meditation, and regular exercise. Avoid alcohol and caffeinated drinks. If symptoms not improved, please consult your physician, he will examine and treat you accordingly.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Penchila Prasad Kandikattu",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes unexplained bruises with low hemoglobin levels?\n\nMy son had a liver transplant almost 7 years ago. He is immune-suppressed and is on aspirin and his hemoglobin and platelets are low, so he bruises very easy. However he has a bruise on his lower right side that has a knot underneath and I am wandering if this is something I should take him to the dr over?",
    "doctor_response": "Hello and welcome to HCM,Low hemoglobin levels suggest anemia.A complete hemogram and peripheral blood smear examination has to be done to know the cause of anemia and thus its treatment.Low platelet count occurs due to either decreased production in the bone marrow or increased destruction in the bone marrow and in peripheral blood.Drugs are common cause of destruction of platelets on peripheral blood smear and your son has s history of intake of immuno-suppressants.Since, there is increased bruisibility on the body, coagulation tests also need to be performed to know the status of coagulation factors.Consult your hematologist for the problem, diagnosis and thus treatment of the condition.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a kidney disorder\n\nMy nephew aged 12 years is facing kidney problem due to eating sweets supari. As per SUIT doctors, his one kidney is not functional whereas in another kindney stone is found. During last week, SUIT doctors wash the first kidney. Please help me what I do?",
    "doctor_response": "Hello and welcome to HCM.  As an Urologist,i can understand your anxiety.A non-functional kidney,with less than 10 % GFR,must be removed.A kidney stone must be treated,depending on it's size.Stones less than 6mm size,can be treated medically.Treatment is medical dissolution drugs and drinking 3 liters fluids daily.Larger stones are treated by lithotripsy,with ESWL,RIRS or PCNL.If you've any doubts,send a direct question to me,in my name.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will deformed testis low down my sperm count?\n\ni have 2 deformed testis of which have been checked and all ok 1 of them according to the consultant appears to have grown in on itself.  i am now 40 what are the chances of having a low sperm count i have had 4 operations down they 1st time to have my testis dropped and the other have been to remove cysts",
    "doctor_response": "Hello and .As an Urologist,i can understand your concern.If the testis are deformed,semen test must be done, to know sperm count.After 2 days abstinence, semen test should be done, for accurate report.As surgery has been done on the testis,a scrotal doppler scan, must be done.Also,if the scan and semen test are abnormal,hormones should be tested.If you've any doubts,send it to me,as a direct question,with reports.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to enrich body weight in infants?\n\nHey... my little girl is 15 month old and weighs only 7.5 kg.born only 2 kgs.I give her pediasure with milk like 2 to 3 oz. But some times she wont drink.and i tried rice..eggs.chicken.bread.chapati.khichdi.every thing but she would take only 2 bites and then refuses. She is hyper active. What should i do for her weight gain?",
    "doctor_response": "Children of this age group are difficult to feed. So try to enrich every food items he is taking with butter ghee oils. As the fat content of the food increases, even small amount of feed carries good calorie. Also try to give him food from family pot, children prefer tasty food not the bland smashed boiled things.Give her syr Cypon 3 ml once daily for 15 days. it will increase appetite.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest a herbal tea that is safer for a person suffering from asthma and bronchial breathing problems\n\nHello.Dr.Grief.I have been suffering from asthma and broncal breathing proplems for quite some time now. My current Doctor has me on a Inhaler and Nebulizer,I am really tired of using them, since they are making my heart rythm beat faster than normal at time.Please tell me if there is a Hebal Tea that is safer for me to use.Thanks dp",
    "doctor_response": "There is no herbal tea but ginger and tulsi also help in addition to the inhalers The main stay of managment is inhlaers to control the chronic inflammation",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does eating red meat cause abdominal bloating, light headedness and headaches?\n\nhi, i havent eaten red meat for 3 years and started a couple days ago.the problem is that on the  next day a feel bloated in the abdomen and lightheaded or light headaches, and feel a little  out of it.tires and distracted. can it be the red meat and how can i change this symptoms?",
    "doctor_response": "HI, thanks for using healthcare magicSince you haven't used red meat for 3 years, it likely that this is the cause of your symptoms.It is possible that with continued use, as your body gets use to the red meat that the reaction would decrease.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lightheaded and shaky feeling?\n\nSo about 20 or 30 minutes ago I felt lightheaded, Cold sweat, and a slight shaky feeling (Which I think was caused by me panicking over the sudden lightheadedness) it lasted about 7 or 8 seconds and went away. After it went away my mouth felt very very dry and sticky. So I drank a bottle of water and as I was drinking it I started feeling 100% normal again. I have done a bunch of research and so far I think it was dehydration as I have not drank anything at all today besides a coke zero. Everyone else is telling me its dehydration and all the research I have done so far has led to that. As of right now 30 minutes later I feel perfectly fine I just want to get your opinion. (SIDE NOTE: I was up all morning and drank a lot of water between 1:00am and 3:00am yesterday morning. During those times I urinated about 7 to 10 times, and have gone all day today since about 5:00am without drinking any water till midnight the next night. which was just moments ago)",
    "doctor_response": "Hello, Consult a physician and get evaluated. We have to rule out possible causes like anemia and thyroid dysfunction. As of now, drink plenty of water to keep yourself hydrated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair whitening and loss of hair\n\nHi Doctor, I had undergone hair straightening and colouring sometime back. Because of this my hair has got completely damaged. I am losing a lot of hair and hair whitening has also become common. My hair has become very frizzy and looks lifeless. What should I do to get my healthy hair back?",
    "doctor_response": "Hi Dear,Understanding your concern. As per your query you have symptoms of hair whitening and loss of hair which seems to be due to compromised immunity of body, stress, systemic conditions, improper hygiene, fungal infection and hormonal changes.Need not to worry. I would suggest you to - Take diet rich in supplements like Vitamin A ,Omega-3 and Vitamin E.- You should avoid using shampoos that contain excessive chemicals. - Take protein rich diet and healthy food intake on daily basis. - Do massage of hair scalp on daily basis.-  Avoid covering your hairs with cap/hat or longer duration.If symptoms keeps on persisting visit dermatologist once and get it examined and start treatment with antifungal medication and shampoo. Go for blood tests to check any underlying systemic pathology.Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower backache while suffering from gallstones?\n\nHi, I had a gallbladder attack 3 days ago and turns out I have small gallstones. The only pain I m having now is a dull aching pain in my lower right side of my back. I can t bare the thought of surgery. I heard about a medication Ursodiol (Actigall) or Chenodiol (Chenix). Would this help to dissolve the stones? And am I able to purchase it over the counter? I am a 56 yr old Fem. CBD measures upto 3.4 mm, not dialated....what does this mean? It was in my paperwork from the ER.",
    "doctor_response": "Hi, For gall bladder inflammation you can complete the course of prescribed antibiotic for seven days. I suggest you take anti inflammatory medication as well for five days. You are right. The ursodeoxycholic acid tablet can dissolve gall stone but not in all case. You can take it for one or two month. If you have repeated gall stone induced pain than you should undergone operation to remove gall bladder laproscopically. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Serum after popping a pimple on penis. Why is it scaly and dry now?\n\nI had a small white bump on my penis , i popped it and white sebum came out but then it did not bleed , instead it sealed itself up and had inflamed under the skin, its quite painful to touch and after a couple of days of popping it, it seems to be slightly spreading with other small white bumps under the skin spreading also, and the surface has got slightly dry scaley skin, i hope its not and infection or doesn t turn into one, please answer asap. Thank you! P.s. its happened before but not this bad, the skin eventually flaked off until the bump was gone.",
    "doctor_response": "hi i think serum after popping the pimple is due to scab formation which is scaly and dry,it is not infection it is only compensatory phenomenon.once serum comes out it subsides.if still present apply moisteriser along with mild steriod which cures the disease",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heart to skip beat and shaky legs?\n\nHello, this evening, for the 3rd time in about 2 months it felt like my heart skipped a beat, like a thud and took my breath away, afterwards I felt really shaky, legs went like jelly and generally felt terrible for the next hour or so. I've had a unltra sound on my heart etc all seems fine, just wondering what it could be and is it anything to worry about, I've noticed quite a few people discussing PVC, just wondering if that's possible and what I could take to help make sure it stops happening. Thank you. Mark",
    "doctor_response": "Skip beats coming frequently ...then do holter...so it will help us to decide any medication require for same ..I also would like to advice blood investigation like sr K and sr CA++",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes incoherent and unmanageable nature of a person?\n\nMy father, aged 62, has been under psychiatric treatment for 6 years for Recursive Depressive Disorder. During this period he was cured for nearly 2 years. However, though for the last 4 \u2013 6 months he is free from depression he has been found to become increasingly nagging and later in-coherent. For the last 1-2 month we have found him talking to himself or others, completely incoherent. He suddenly lies down on the floor, starts running(with small steps), hugs anyone who is around him, shouts(either someone\u2019s name, or just blabbers incoherently or the words:\u201cminor aberration\u201d). He was admitted in a psychiatric facility for last 1 month where initially he was given no medicines to eliminate the case of drug reaction. Following this when his actions became more uncontrollable(he started jumping and falling face first on the bed, banging an open door, hugging people more, running) pathological test were done. Urine Culture, Chest X-ray, USG(whole abdomen) showed everything to be clear. However the C-REACTIVVE PROTEIN was found to be 51.1(However, the psychiatrists and neurologist finds one things very puzzling and completely reverse to his diagnosis. My father has periods of high confusion when he presents typical symptoms of dementia and very high delirium(all above abnormal activities included), But he too has periods when he is lucid, completely coherent, aware, sharp memory and defies any signs or symptoms of dementia. According to the psychiatrist in lucid times also there should be at least some baseline cognitive deficit no matter how less, and hence the doctor too is at a loss. When he is normal he says that sometimes he has a squeezing sensation inside his head, which is soon followed by confusion and worsening of the squeezing sensation. Soon it becomes intolerable and he loses control and as we see he loses full cognition. If at that time we talk to him he hears but cant comprehend. So we give him Haloperidol drops when he feels the squeezing sensation or as soon as we detect he is starting to get confused. His present medication includes: \u2022\u00a0\u00a0\u00a0\u00a0\u00a0Donepezil (10mg at morning) \u2022\u00a0\u00a0\u00a0\u00a0\u00a0Risperidone(2mg at night) \u2022\u00a0\u00a0\u00a0\u00a0\u00a0Quitipine (150 afternoon + 150 night) \u2022\u00a0\u00a0\u00a0\u00a0\u00a0Haloperidol oral liquid (10 drops SOS) \u2013 generally 50 \u2013 90 drops per day My question: \u2022\u00a0\u00a0\u00a0\u00a0\u00a0Is the Diagnosis correct? \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 If so then why is he so incoherent and unmanageable at times(nearly 8-10 hrs a day). Also how can he be so cohere",
    "doctor_response": "hi, I can understand the stress you must be through currently. From his complaint, it appears to be a case of psychotic disorder overlapped with an episode or two of delirium, considering his high age.The symptoms of muttering to himself. talking irrelevant and disorganised behaviour, all suggest a possible psychotic disorder. For further diagnoses of its subtype I'll need to know a complete elaborate history and progression of symptoms from you.the medications appear to be going inadequately the doses can be adjusted. I would suggest considering stoppage of one of the drug.Ill need to know his CT brain findings.welcome for futher consultation.hope to have satisfied your query.thanks Dr Pankaj Borade",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can asthma along with chronic cough be treated?\n\nHi, I was diagnosed with asthma about 2 years ago. I currently use Advair and Singular as well as an ibuterol inhalor. However for several weeks now I have had an increase in asthma symptoms. I used an entire rescue inhalor in a period of 2 weeks (usually I can go several months before needing to replace) I wake up at night short of breath and wheezy. I have a fluttery feeling in my chest as well as some soreness. I have been coughing up brownish-yellow phlem and have has a low grade fever for several days now. I am also experiencing increased overall fatigue but have been able to sleep due to constant coughing and shortness of breath. In addition I have had a headache for several days as well as a sore and stiff neck. Thoughts about what could be going on?",
    "doctor_response": "hi sir/madam,Thanks for your question on Healthcare Magic.As a ayurvedic doctor would recommend you ayurvedic medicine which are best will give you good results too.please note down these following medicine:-1. Vasarishta :- 15 ml should be mixed with equal quantity of water and taken after meals twice daily.2.Haridra Khand :- One tea spoon of haridra khand should be taken with a cup of warm milk at night before going to bed.3. Talisadi Churna :- One tea spoon of talisadi churna mixed with ginger juice and honey should be taken three times in a day.4.The combination of Sitopaladi Churna+Pravala Pisthi+Rasa Sindur:-Take 2 gm of Sitopaladi Churna, 200 mg of Pravala Pisthi and 100 mg of Rasa Sindur to be taken with ghee three times in a day.These medicine doesnt have any side effect as its made by herbal drugs,you can find these medicine very useful in respiratory problems.I hope i was helpful for you.Have a healthy day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symtoms of border line personality disorder?\n\nI am currently supporting a person, full time, in my home, who has a mental health disorder.  She has never had a formal diagnosis and I'm suspecting that she may well be boarder-line personality disorder and wondered if you could shed some light on this situation for me.  What are some of the signs/symptoms of a boarder-line personality disorder?",
    "doctor_response": "Hi,A person with borderline personality disorder often act impulsively without thinking about consequences. He/ she usually complains of feeling empty and the mood frequently fluctuates. Such a person often show anger outbursts and have unstable relationships with others. A borderline person have a tendency for showing self-destructive behavior (suicide gestures and attempts). Such behavioral pattern is usually present for along duration of time and manifests  in multiple situations and not just in a single setting.It is highly recommended that you fix a consultation with a psychiatrist for confirming the diagnosis.Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does cortisone shot cause swelling?\n\nHi, Three weeks ago I had a cortisone shot to help with a tendinites problem, a few days later I noticed a slightly swollen area above my right hand side collar bone, it is soft and painless, could this be related to the cortisone infiltration or not? Thank you",
    "doctor_response": "Hi Steroids reduce inflammation and swelling.It is unlikely to cause swelling.Any swollen lymphnode or abscess should be ruled out.Any history of fever should be ruled out.Visit your physician immediately in case of increased swelling or redness or fever.Hope that was helpful.Let me know if i can assist you further.RegardsDr.Saranya RamadossGeneral and Family Health Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had intercourse. Have excessive bleeding, late period, dizziness, headaches, loss of appetite, milky vaginal discharge. Suggest?\n\nHello doctor good morning I had periods last 6 th august.due to oveebleeding and stomach tablets I taken some stomach pain tablets and doctor gave me birth pill.I taken only for 5 days and stopped.2 days I got my period and stopped.again 19 20 I got brown vainal discharge.25 26 27  we had intercourse the upcoming days I felt dizziness,headache,loss of appetite,frequent urination and vommiting sensation and I first got milky vaginal dicharge next day egg watery elastic discharge and yesterday watery discharge.today is my period date and I having no stomach pain.my vagina is dry.did am having delay in periods",
    "doctor_response": "Hi,Thanks for writing in.This irregular intake of birth control pills has probably disturbed your cycle. This may be a delay in your periods or a new period date will set now. Nothing can be said for sure. Better to wait & see. Meanwhile, you may try home pregnancy tests after every few days until you start your period.Avoid irregular intake of hormonal pills in future to avoid period irregularities.Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the stinging of meatus of penis with redness and occasional inflammation?\n\nItching and slight stinging of urethra/meatus of penis, with some redness and occasional inflammation.  There is neither discolored discharge nor any other symptoms to speak of. Only said risk is from sexual intercourse with an supposedly STI-free woman in which a condom broke roughly 14 days ago.",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have developed urethritis after unprotected sex with a woman whom you suppose to be STI free.Since there is redness and stinging of external urinary meatus possibility of STI has to be ruled out by swab test of the discharge from the meatus to be rest assured yourself to be about free from STI .You need to take broad spectrum antibiotic like Cefexine along with anti inflammatory drug like Diclofenac twice daily.Ensure to wash your genitals with warm water twice dailyEnsure to avoid sexual encounters till it heals up completely.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is acute viral hepatitis?\n\nI am a 22 yr old female weighing 40 kg and 1.53 m tall. I was recently diagnosed with acute viral hepatitis and now also suffering form jaundice. Although my vomiting have stopped but i burp alot even when i have not eaten anything. is this a serious problem or will it go away with time?",
    "doctor_response": "HiThanks for your query.Incomplete data regarding the type of virus responsible for your illness.Viral hepatitis is an infectious disease caused by hepatitis viruses (most commonly being A,B,C,...subtypes).Hepatitis A Virus spreads by drinking contaminated water or eating improperly cooked foods, etc). Hepatitis B & C Viruses spread by sharing the injection needles, blood transfusion or from mother to new born babies.Hepatitis A virus infection is characterized by loss of appetite, vomiting, abdominal pain, jaundice, etc. It usually subsides in 3-4 weeks of time and confer a prolonged immunity.Since it affects the liver hence symptoms like vomiting, burping, indigestion, heartburn are common which gradually disappear over a period of time.Meanwhile avoid hot and spicy foods, fatty meals, drugs, etc.Hope this answers your query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pregnancy be delayed after marriage?\n\nhello dr !!! i am a girl of 25 yrs n looking fr getting married by this year... as per discussion with my future husband we were thinking about baby ...as per him he wants a gap for 3 years aftr marriage ...will it be ok to and safe if we think to have baby after 3 years..??",
    "doctor_response": "Hello dearI understand your concernNo problem in taking the gap of the three year.After three year you will become 28 year and it is reproductive age group for you.No worry, you can become pregnant after 3 year or as per your decision.Till enjoy marriage life, avoids stress, take healthy diet, drink plenty of water, do regular exercise.Hope this may help youAll the best for marriageBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pain in the tailbone be treated?\n\nI have fallen twice onto my tail bone in the last year, no immediate pain, now I am having great pain in the tail bone area when I sit and lay down. What specific type of Dr should I see? My PCP doesn t seem to be concerned thinks I have Arthritis there now.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.It seems that you have a chronic inflammation at tail bone.I would suggest you to get an x ray done to rule out a fracture.Sitz bath will help.You may need local steroid injection shot.Consult an Orthopaedician.I hope I have answered your query. Let me know if you have any further questions. Regards,Dr. Mahaveer Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and elevated bilirubin in a child\n\nHi, may I answer your health queries right now ? Please type your query here...My baby s age is 10 days..serum bilirubin 15.6mg,direct 3.6mg,indirect 12.0mg..having fever at the time of 1pm to 3pm at around 100 degree day time after that gradualy reduced everyday..what is remady.. YYYY@YYYY",
    "doctor_response": "for fever use acetaminophen 3 times dailyfor high bilirubin,  you have to increase the amount of fluids the baby takes..try to give him a breast feeding or a bottle very hour.. and foolow up the test every 2 days.. if the levels is decreasing then continue.. if the levels are increasing then go to the hospital,  the baby may need to be subjeted to special type of light that breaks bilirubin in blood",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat lumph in the right side of breast?\n\ndear sir, i am reema. My age is 26 yrs. 4-5 months back docters diagnosed me as a TB patient. I have a lumph in the right side of breast and it pains sometimes. I also have continue stomach ache.I feel very fatigue and also have lost my weight. Are these really sympyoms of TB?",
    "doctor_response": "Hi.First of all- the breast lump is most probably a fibroadenosis and nothing to do with TB.Secondly all other symptoms are in favor of TB, but with the proper treatment you should have an improved appetite, weight , feeling good/ better than before.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for e coli infection\n\nhello sir, i am suffering from e coli for last 1 year. I have completed my antibiotic course for 3 times in this duration. but all in vain. I feel burning sensation, sometimes low and sometimes high. very rare but i feel pain while urinating. But there is no frequent urge to urinate. no any prob with my appetite and no sign of fever. please suggest me some useful and helpful home remedies and help me out of this problem.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Recurrent UTI or urinary tract infection should be investigated.You should do ultrasound examination of the abdomen particularly kidney to find out the obstructive causes of any UTI like stone and other.I also advice you to do urine culture and sensitivity testing. When you take the drug according to the report your urinary tract infection can be cured easily. Please take the completed schedule of the drug. Do not discontinue the drug. Drink plenty of water which h can flush out the bacteria from the system.Mainyian good local hygiene by frequent cleaning this will help cure the UTI at earliest.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can be done for vertigo with bilateral hearing loss?\n\nHello doctor, Suffering from vertigo from past two years. Diffuse narrowing of basilar arteries. Bilateral ear loss 60 percent.",
    "doctor_response": "Hello. I understand your concern and would explain that your symptoms could be related to an inner ear disorder. When did you perform the brain MRI? Your symptoms are not suggestive of stroke, but if you have not performed a brain MRI recently, I recommend performing it. Regarding your therapy, I would recommend using Mannitol IV for a short period of time, to help with vertigo. It is also important for taking daily baby Aspirin to prevent stroke and continue Stugeron for vertigo. I would also recommend performing a cervical spine MRI study in order to exclude possible bulging discs in the vertebral column, which may trigger your symptoms. I remain at your disposal for any further questions whenever you need. Brain and cervical spine MRI, ENT consult.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could the eye pain be due to head injury?\n\nthis evening my daughter (8 years old) school bus had an accident...i wasn t home at thy time but her father was..she came home being frieghting and cried..she wouldn t talked so my husband took her to thy store to clear out her mind of thy accident..so then i guess she told him that her eyes hurted from flying off her seat to the front seat of her..she didn t feel it at first but i guess afterwards she starts feeling thy pain..so i m just waiting til she gets up in thy morning to hear the whole story..i don t know if i should take her in tomorrow to check it up, nor waited til i talked to the school?...the school did leave a message on the phone stated that if we parents have anything to say we can contact them in thy morning...with thy accident i don t even know how i m going to say nor do.. help?...",
    "doctor_response": "Hello,It can be due to concussion. Fracture of orbit or facial bones is an another possibility. As a first line management you can give her paracetamol syrup for symptomatic relief. Ice packs can be applied over eye. If symptoms persist better to go for a CT scan of head.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for the symptoms of leprosy\n\nhello sir i am sooriyakumar. in 1990 i take treatment in st thomas leoprosy center(chetpet,thiruvannamalai dt).but last two year i am in chennai.i find some symptums of leoprosy in my hand.so i have to take treatment near by my area.now i am in kilpauk.where to take treatment i don't know,pls help me sooriyakumarage 27",
    "doctor_response": "Hello sooriyakumar,          With reference to your concern.If u had taken treatment for Leprosy previously and u think that your symptoms are the same as how when u were diagnosed in 1990. I advice you to take the previous hospital records, and get a consultation, with the DERMATOLOGY (Leprosy Clinic) doctors at Rajiv Gandhi General hospital (which opp. to chennai central) which would be nearer to your location.Hope, this helps you.Thanks, Good Health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes high blood pressure, headaches with body aches and pains?\n\nHi my blood pressure reading yesterday was 139/99 is this too high? ive been having lots of headaches and feel sick when i try and read as well as lots of aches, pains, night sweats and so tired!!! I'm usually fird and healthy, i'm 32 with no other health problems. This tiredness and night sweats has been going on for a few months and pains in my arms, legs and back getting worse,",
    "doctor_response": "hello.. greetings.. i have gone through your question. 139/99 does sound pre hypertension but a single BP recording cannot be used for establishing a diagnosis of hypertension. it invloves a number of factors.. including the time of the day, any acticity prior or during recording, dietary intake etc. it also depends on whether you have a family history of hypertension. So first of all we need three BP recordings one reading per week for three weeks.. if all these readings are persistently high.. then we need to work you up for hypertension. Going by your age and symptoms, i would recommend you to get your vit D, vit B12 levels tested along with a complete blood count.. proper diet, balanced sleep, stress relief and exercise will also help get over these symptoms.. please revert with the above. thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe dry mouth while on Lomotil be treated?\n\nHello, I recently had my colon out and was given Lotromil for diaherra. Within 4 months the dry mouth was so bad my teeth with decaying and falling out. I did not know what was causing it b/c I have MS and was on several other meds but my mouth was not ever dry like that until the ileostomy. So I stop taking it and no more dry mouth but I eat anything and it goes right to the bag, which means I am not getting much nutrients from what I eat. Any suggestions?",
    "doctor_response": "Hello,Dry mouth can occur due to a number of causes like Severe dehydration, Side effects of medications if you take any, Salivary gland dysfunction, Nerve damage supplying salivary glands, Oral infections like thrush, Sjogren's Syndrome etcetera.Damage to teeth is due to dry mouth as the flushing action of debris and bacteria is reduced due to reduced saliva causing increased decay of teeth.-For dry mouth chew sugarfree chewing gums.-Drink plenty of water.-Avoid regular mouthwash and use specialized mouthwash that are formulated for dry mouth patients like Biotene.-You can also instil artificial saliva drops.-Suck tart candies as it also stimulates saliva flow.If does not improve, then consult an Oral physician and get evaluated. You can be advised medicines like Pilocarpine for improving saliva flow.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Honey Arora",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for multiple ailments\n\nI had laproscopic supracervical hysterectomy a year and a half ago. Following surgery I had a lot of pain along the incision on my left side but I didn t follow up with the surgeon. Since then I ve had repeat UTI, Yeast and eColi infections, problems with edema and generally feeling unwell. Last summer I developed heat intolerance, and periodic purpuric rashes and worsening edema and painful inflammation. Then everything went over the top a few months ago after a yoga class - after hte first class I developed severe Pelvic pain and and severe inflammation then severe low back pain. I developed breathing problems and a CT showed scarring, mild hyperinflation and collapsing of previously healthy lungs. A PET showed increased uptake in spinal column. A PAP showed candida again, and obscuring inflammation. My urine output has quadrupled since last summer. My blood tests are going off the normal scale, high hemacrit and hemaglobin and I m told that inflammation shows in my liver (equal ratio in liver blood test) Now I have awful chronic diahrea, nauseau and stomach pain. I can t sleep on my lift side due to torso pain. An MRI of my pelvis raised some questions so I had a pelvic ultrasound. The radiologist reported a hydrosalpinx but the technician performing the ultrasound also showed alot of concern over something high up past fallopian tubes close to my (now irritated) scar from lap surgery. I ve been on one antibiotic after another and get some releif immediately after, but then everything comes right back worse then before. The gyn I m seeing wants to perform a salpingectomy and describes it as a small swollen watery mass in my fallopian tube. I can t imagine this tiny little mass can cause all this disturbance in my body a year and a half after my partial hysterectomy. I m very reluctant to take time off from work as my boss is irate over my being absent so often due to sickness and my gyn want me to take a week off followig surgery. On the other hand if this is the cause of all the problems I know I SHOULD DO IT! I keep questioning if this can be possible though?",
    "doctor_response": "Welcome to HCM. Probably I agree with her. Only thing is can she do this laparoscopically? That would be nice decreasing the recovery time so that you can go back to work soon. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to improve chances of fertility with irregular menstrual cycles?\n\nI have a question for you... My husband and I have been trying to get pregnant for 2 years now and nothing has been happening. I kind of am starting to worry we won't be able to have kids? What steps can we take to try and become pregnant? Is there pills that will help me to become ovulated and get fertile to be able to have children? I am 20 years old, and am just looking for some answers.. Am I not ovulated/fertile yet to have children? I also only do get my menstrual cycle every 3-4 months, would that have something to do with it? and would getting on Birth Control possibly help the situation?",
    "doctor_response": "Hi dear. you have so many queries. Don't be so anxious. If you are already having periods after 3-4 months, did you ever get your scan done and is it polycystic ovaries. If so you need to get a consultation from a gynecologist and work step by step to acheive pregnancy.First get semen ex. of husband. what about your weight and BMI.Get ovulation study done to see whether the cycles ovulatory or not.get hormone profile done.Don't get disheartened. You are only 20 years old and take proper guidance.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What dosage of Tylenol is advisable for an infant?\n\nMy infant son had his two month checkup today. He was given three shots in the leg and was recommended to take infants Tylenol. They did not provide a dose recommendation and he is only 8.14 lbs. I bought infants Tylenol from Walgreens and the box says it s 160 mg per 5ml. The syringe starts at 1.25 /2.5/3.75 up to 5 ml.",
    "doctor_response": "Hi...Paracetamol can be given in the dose of 15mg/kg/dose (maximum ceiling dose of 500mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.For your kid's weight and for the strength of the medication (160 mg per 5ml) you are having, you can give 1.5ml per dose.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this chest X-ray report indicate?\n\nI have RA and went off plaquenil due to side effects now I have been diagnosed with asthma and chest xray shows left hilum calcified lymphnode and calcified graniola in my left lung last week. My grandmother had lymphoma and my grandfather had RA, is this something to check further? I have appointment with my RA doc next month.",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.Yes, you should definitely get done CT thorax.Rheumatoid arthritis (RA) can involve lung and cause nodules cavities, fibrosis.Chest x ray is screening tool for lung diseases.Since you have Calcified nodule and lymphnode on chest x ray, CT scan is needed.CT scan is 3 dimensional imaging of lungs and have better quality and interpretation about lung lesions than chest x ray. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for paralysis on left side\n\nhello sir,my mom .about 55 yrs old. is suffering left sided paralysis for 4 years .on that time clinical reports shown it thrombosis due to high b.p.now she moves inside the room as toddle walk.but lt hand light move with light sensation.ur advice to improve my mom",
    "doctor_response": "Hello, In such cases, some degree of paralysis is permanent. Improvement is usually not complete but is possible. Physical therapy and guided exercises are necessary for this purpose. Care should be shown for the blood pressure control in order to prevent any recurrence. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Erion Spaho",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in my right rotator cuff\n\nI recently have pain in my right rotator cuff for about a few months. There are still some kinks in the right arm. I am concerned that recently I noticed a soft raised mass at the base of my neck on collar bone. It doesn t really hurt, so what could this be",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. There might be possible ligament injury in the rotator cuff. Most often it might be a contusion only developed due to excessive use. As of now, you can take analgesics like Ibuprofen or Diclofenac for pain. Avoid physical exertion and apply ice packs. If pain persist, better to take an MRI scan to look for any ligament injury. Wishing you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "On warfarin for blood clotting.   History of having MTHFR factor allergies  and upper respiratiory infection.   Advice\n\nI take 7.5 ml of warfarin because of  blood clotting  . I have a form of the MTHFR factor.I have allergies, and a friend said that her Dr said she could take an allergy medication as usual, but when she feels a sinus infection coming she could take Aleve-D so it doesn't get any worse. I had an upper respiratory infection at the end of May, and I have the same symptoms again.",
    "doctor_response": "sinus infecion recuryou have to get xray pns waters view and treat according to allergy guidelines t present can take metronidazole 200 mg for 5 days and sos in future as these clear the sinuses fastcan take fexofenadine 120 mg bd and not any decongestants take anti allergic syp odand add antacid sypapply neomycin h ointment in nose bd sea water 2 drops at night in each nose continue 3 wk and sos ill you consult your doctor",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent pain and burning sensation in the foot despite being on opioids?\n\nI had a fatty tissue tumer removed from my ankle ad arthritis removed from big toe resulting in a fusion. I don t walk to much because I have spinal stenosis and other sppine issues. the foot from the two surgeries has always hurt and I am on opioids . They still work for the spine but the foot is in constant pain burning numb etc.",
    "doctor_response": "Hello, These symptoms are due to nerve dysfunction in the lumbar spine due to the spinal canal stenosis. As it's very common that the level where the stenosis does trouble the nerve, the possible dermatomes and myotomes are affected. Doing core stability exercises are a must to improve the stability of the spine and also avoid certain compression happening over the nerve root or the spinal cord due to stenosis. With core stability exercises you will be benefitted for the symptoms to reduce as well. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Burning in the tongue and lips. Took cephalexin. Persisting symptoms. What to do?\n\nI gave rimming and almost 2 weeks later my lips and the tip of my tongue have been constantly burning, I have been to see a doctor but forgot to tell about the rimming. He did prescribe me a course of cephalexin 500mg 2 tablets twice a day this was a 10 day course to which I've now finished though still have a burning sensation to my lips and the tip of my tongue, could this be a std or something more serious?????",
    "doctor_response": "Hi, Thanks for writing, I recommend you to visit a general physician and tell in detail the cause of your problem. There are many different diseases which you may be at a risk of. Even though cephalexin was prescribed, but doctor might have prescribed it for skin and soft tissue infection. See, almost all std's are curable. You just need to have the right drug combination for the right disease. A more detailed clinical examination and details of your history are must for a clinician to diagnose your problem. Only then can he prescribe better and specific drugs. Stay healthy, Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should be the dosage of ofloxacin and metronidazole for baby?\n\nHi, My 1 year 1 month baby is having loose motion.Gave ofloxacin and metronidazole suspension 2.5ml at noon.After that she passed motion 3 times making a total of 7 times today.She is 8 kg .Can i give her the same medicine at night .What is the dosage.Please answer.",
    "doctor_response": "Hi, Oflaxacin is not advisable for young children. Because of its harmful effects in growing children's bones, Oflaxacin should not be used in young children. However, Metronidazole can be given safely to your baby in the dose of 100 mg equivalent to 2.5 mL three times daily. I also recommend oral rehydration solution like Relyte for the correction of dehydration and probiotics to reduce the frequency of loose motions. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can montelukast sodium oral granules be mixed with liquid?\n\nI am giving Montelukast sodium oral granules 4mg to my son who is 3&half year old. Doctor told me to mix the granules with water and drink it, but as per instruction in the internet say don t mix with any other liquid. From past 4 months i am mixing the granules with water and drinking. Is it any harm in doing so???",
    "doctor_response": "Hello, Mixing with liquid might affect its efficacy. You can crush the pill and ask to take orally. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Blood report shows cholesterol 235, HDL 36, LDL 139, SGOT 50, SGPT 67.  Advice to control cholesterol and liver disorder\n\nMy blood reports are asUric Acid  7.1Cholesterol 235HDL 36LDL 139Triglyceride 522Total Billionaire  0.9SGOT (AST) 50SGPT (ALT)  67Alkaline Phosphates 67Kindle advise diet and medicines how to control Cholesterol  and Lever , plz also tell me either lever readings are harm full",
    "doctor_response": "Hello.Elevations of liver enzymes(SGOT and SGPT) and cholesterol are not worrisome,but triglyceride levels probably should  be treated with medication by mouth (fenofibrate is the most commonly used drug for this condition).About the diet you must avoid intake of alcohol and fat products (bakery products, fried foods,pastries, red meat).Please consult your local doctor for a prescription.I wish you good health.(If the answer has helped you, please indicate this)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will she get pregnant by inserting finger that had pre-cum?\n\nme and my girlfriend were messing around and i fingered her we never had acctual vagianal sex but im scared she might be pregnant before i fingered her i let her touch my penis and i never came but some precum got on her hand she went to wash her hands and the little amount of precum on my finger i wiped off after she came back it was around 20 to 25 minutes before i fingered her all i did was finger her we never had sex and i never ejaculated that night just a little precum can she get pregnant from this?",
    "doctor_response": "Hallow Dear,1. You had fingered her vagina. Fingers never ejaculate semen. So there is no possibility of pregnancy due to fingering. 2. She had handled your penis which had some precum on it. However she had washed her hands after that. So there is no possibility of pregnancy due to that also. 3. You had wiped off your fingers which had some amount of precum on it. Then after about half an hour you fingered her. Again, there is no possibility of pregnancy due to this act. So rest assured. She will not be pregnant due to any of these acts. I hope this gives you peace of mind. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have i lost my mental status?\n\n52 y/o WF - began having confusion,irritability,  Difficult  multi tasking and remembering and forgetting .  Nursed 30 years began having difficult and feeling unsure of myself. Back pain,blurred vision,numbness, H/A - Dx years ago with Fibromaligia but more concerned its MS. MRi moderate scattered non enhancing foci of white matter signal abnormality most likely related to chronic micro-vascular ischemic changes.",
    "doctor_response": "Hi,Thanks for writing in,Based on your symptoms, it is advisable to consult a qualified psychiatrist. Multiple sclerosis might have psychiatric manifestations, particularly mimicking fibromyalgia and depression.Hope this helps.Dr A Rao",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this spirometry test report indicate?\n\ni Just had a spirometry test with results of prebronchldilator revealing severe obstruction with fev1 of 35% of predicted or 1.18 liters. fev1/fvc ration is 51% erv is 62% oximetry is 92% . spirometry reveals severe obstruction fev1 increased from 35% to 43% and fef25-75% increased from 17% to 30%. What does all this mean?",
    "doctor_response": "Hello and welcome in HCMThis result mean that actually you have a low lung function.After the prove with bronchodilatators the lung volumes are relatively improved which means that you probably may benefit from  their use.Your doctor will probably prescribed them.Take careDr.Jolanda",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for breast cancer\n\nI am undergoing testing for breast cancer. On 01-27-14 the doctor removed my nipple, areola and some tissue under the skin. The results showed cancer. Another surgery on 03-10-14 resulted in removal of lymph nodes and a lumpectomy and removal of additional tissue. The surgeon thinks it is early stage 2. I saw an oncologist today, and we are planning a Pet-scan. She said I have lobular breast cancer. I also discovered a small lump on my left breast, and 2 different colleagues concurred that there was a lump. Depending on the outcome, maybe mastectomies on bone breasts followed by chemotherapy. A lot to take in one sitting.",
    "doctor_response": "Thanks for your question on HCM. Lobular carcinoma of breast is notorious to spread in opposite breast. So better to get done biopsy from left breast lump too, to rule out malignancy. And yes PET scan is needed to rule out distal metastases. As bones are most common site to metastases. In early stage 2 breast cancer treatment of choice is enblock resection of breadt tissue with resection of involved lymphnodes.Post operative chemotherapy and radiotherapy is necessary if lymphnode s are positive for malignant spread.Also get done ER (Estrogen Receptor) and PR (Progesterone Receptor) study to guide hormone therapy (tamoxifen). So discuss all these with oncologist.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What medicine is preferable for erectile dysfunction?\n\nDear Doctor, i gave a 40 yr old man  with mild hypertension  120/90mmhg, Telvas -H(telmasartan/ hydrochlorthiazide). However 6 months on the drug he complained of erectile dysfunction which is progressively worsening. He's blood pressure is still high at 110/90mmhg. Should i change the drug? What should i do for him.",
    "doctor_response": "HelllloThanks for query .At the outset I would state that the problem of ED that your patient has can not be due to mild hypertension that he has ,He needs to be investigated on following lines to rule out any organic cause for his ED ,1) Blood sugar levels to rule out Diabetes 2) Thyroid Hormone assessment .3) Color  Doppler Ultrasound Scan of penis .If there is no organic cause for his Ed it can be considered to be Psychogenic in origin and guide him to Psychiatrist for counselling .You can try and prescribe him Sildenafil (Viagra ).This may resolve his problem of ED.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes green coloured loose stools?\n\nI am Revathi from Tamil Nadu,India.My Son who is 3 months old doing loose motion which is green color and sometimes yellow color fluid id leaking frequently...i am giving Vibact sachet and T.septran for 4 days ..till now he is doing loose motion in green color",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service.I have reviewed your query and here is my advice.Green colored stools in a baby are usually due to decreased intestinal transit time after any diarrhea resulting in non-transformed bile to appear in stools.Bile is released in the upper intestine which is usually transformed into yellow pigment and giving the stools their color when the function of the gut is normal. Green colored stools are not a concern.At 3 months rotavirus diarrhea is the most common culprit for diarrhea which does not need antibiotics. Feed your child normally.Diarrhea usually takes a week or two to settle. A probiotic like Lactobacillus rhamnosus gg is usually recommended for diarrhea. Your baby is quite young, therefore please consult a pediatrician regarding the same.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Aftab Anwar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My father has a problem of shaking hands. What is causing it?\n\nHi doctor, My father, who is 71 years old, has a problem of shaking hands for the past 4 to 5 years. It is gradually increasing. What is the cause and how to get the treatment? We met a neurologist and she prescribed some medicines for two months, but things have not improved. Shaking hands is mostly below the wrist. It is more in the right hand when compared to the left hand. He finds it difficult to hold things, to brush, etc. He had a stent operation 2 years back and has asthma. Apart from that, there is no other health issue. Please advise.",
    "doctor_response": "Hi. We are here to help you. Revert back with the reports to a neurologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it necessary to continue with biopsies for enlarged prostate?\n\nMy age is 66, height 6'2\", weight 215.  I have two health issues high blood pressure and an enlarge prostate.  Prostate treatment to date has been a PSA test every year for the past 8 or 10 years and 2 biopsies.  The biopsies have been negative.  Should I continue with biopsies, they do cause some uncomfortable recovery situations.",
    "doctor_response": "only if your psa jumps a full 3 points higher than it has been.Please rate 5 Stars! I strive to provide the best answers to your questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How much meftal-p should be given to a child for fever?\n\nDear Sir, my son is 1 yr 9 months and body wt is 12.5 kg.For last two days he is having fever with highest score 101.00(only once today morning) and average of 100. With 5 ml dose of crocin he feels better for 2-3 hr but again rolls back to 100. His activity is absolutely normal and he is fully active. Should we go for meftal-p if yes then whts the dose? Please suggest.............Thanks in advance.",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query your child has fever which could be due to bacterial or viral infection and due to poor immunity of body. Need not to worry about it. You can start with Meftal P. Monitor dosage for child. You should keep child dehydrated always. Give mild dose after every 4 hrly as Meftal-p contains mefenamic acid and paracetamol. You can give crocin syrup 5ml 4-5 times a day depending upon fever. If fever increases do tepid sponging as well with cold water. Visit pediatrician once if symptoms keeps on persisting. The most common side effects of Meftal-P are gastritis, abdominal discomfort, bleeding, so it should not given on empty stomach and the duration of treatment should not be long.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can extraction of tooth be related to recurrent sinusitis?\n\nDear DoctorI am Sabu, 27/male from Kerala. I had a right side molar tooth extraction 3 years ago and then I had recurrent sinusitis. I felt pus coming out of my nostrils and got bad smell of the pus. When that happened I took some antibiotics and it was subsided. It happened a  couple of times. Then in January 2010(after 2 yrs of extraction) I had the pus formation and bad smell and I met an ENT. They took scanning and some other tests and told me that I have to undergo FESS. So I underwent FESS in February. After 35 days of FESS, I had the pus formation again and that time I consulted an Oro Maxilo Facial surgeon . he did many x rays and found out that there is an Oro Antral fistula , which was the cause of the recurrent infection and PUS formation. So I had to undergo cod wel luc surgery and they close the fistula by flap. After 5 months of the surgery now, I again felt some pain over the flap and some blockage of nose. But this time I did not feel pus or bad smell. What comes out of nose is clear mucous. I again met the doctor and he told me that the pain is because of the inflammation on the top layer of flap due to the common sinusitis. He gave me augmentin 625 mg for 5 days. I am worried if the infection will become any serious trouble in future. Should I undergo any checkups again, or to take any medicines? IS the sinusitis I feel now is common?? Will it affect the flap adversely? Please let  me know as early as possible.Thanks doctor.",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.Yes, An oro-antral communication is a potential complication of an upper molar extraction. Since you have already undergone a successful closure operation, the mucus discharge should be of a regular sinusitis.If it is persistent and is getting infected regularly, please visit your oral and maxillofacial surgeon and have the antral communication status reviewed.Continue with the antibiotics and medication for sinusitis as prescribed.Hope this was helpful.Thanks and regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest ways to deal with body rigidity caused by Parkinson s disease\n\ndoctor, my mother 80 years was daignosed for parkinson. she is taking syndopa CR125 thrice a day, but still she has got lot of rigidity in her body which makes her difficult to walk and stand. Her hands are shaky but can still hold the glass. Lately she has developed allergy to some medecine and got red rashes in her hands and legs. Her face and legs have swollen a bit. Kindly suggest me what is to be done to take her out from this condition.",
    "doctor_response": "hi,thank you for your help in providing the brief history of your mother.since it's parkinson and she is already seen by a neurologist who has advised to take syndopa. it is a symptomatic way of dealing. Since you mentioned about the rigidity she has is not loweing down, why don't you take a discussion with a neurologist and take some guidance of having physcial therapy for your mother. Most of the patients respond well with physical therapy and gradually the rigidity and tremor comes down.I have seen many parkinson cases getting helped by the physcial therapy. So the first line after syncopa I prefer to advice for physical therapy.with the grace of God I wish your mother a speedy recovery",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is Mometasone dangerous to use on Face to clear my acne pimples?\n\nHello doctor, I am seriously facing acne pimples problem. Sometimes they occur on my face when I masturbate. If I use Mometasone, it gives a good result. Is it okay to continue this?",
    "doctor_response": "Hello. Acne is a universal issue in the age group of 15 to 25 years due to hormonal changes in adolescents. However, there are multiple effective treatment options depending on the grade and severity of the problem. Mometasone is a topical steroid and is to be avoided strictly on the face and for acne as it can harm your skin in the long run. Acne is dependent on hormones hence excess masturbation may sometimes lead to an increase in the problem. I would advise you to stop Mometasone immediately and kindly upload appropriate images to help us assess your current grade of acne and treat you better. Regards. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the meaning of fluid in right adnexa on an ultrasound?\n\ni want to conceive a baby now as me and my husband just planned for baby...i went to doctor to get myself diagnosed...she advised me to do ultrasound to find if both ovaries are working properly ...after ultrasound i found that i had mild free fluid in right andexa around right ovary....what does it mean?",
    "doctor_response": "HAI WELCOME TO HCM THAT could be an paraovarian cyst . if its big you need to remove it through laparoscopy.CHECK YOUR DAY 2 FSH,LH ,PROLACTIN AND RHYROID.SEMEN ANALYSIS should be done. ovulation induction with follicular monitoring will help you to conceive.",
    "dialogue_context": ""
  },
  {
    "patient_message": "When will SGPT and bilirubin levels be normal after taking ursofalk?\n\nMale, 49 years old, 62 kilos in weight,  SGPT 103 , total billirubin 5, direct billirubin 4.6  ... diagnosed with hepa A 2 months ago, had been taking ursofalk, sylimarin, vit b12.  ... is there any cause for alarm considering the length of time to normalize the levels of sgpt and billirubin?",
    "doctor_response": "Hi thanks for contacting health care magic....Noted you have hepatitis A infection....Here 2 months has passed ...What was your previous report???Sometimes hepatitis A takes 3 to 4 month for full recovery...If it seems condition not improving and needed by gastroenterologist then short term steroid given....Meanwhile take low fat diet....Avoid alcohol if have habits.Green leafy vegetables taken more....Excess fried food and non veg avoided....Fruits like papaiya, apple taken more....Sugar cane juice and apple juice helpful......In dinner grined spinach and carrot juice taken along with food....One tsp licorice with honey can be taken....Take care,....If still condition not improving consult gastroenterologist for proper examination....Take care...Dr.Parth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the success rate of iui?\n\nHi I m aarti n my age is thirty five I hv to come to india to do treatmrnt for my baby my husbanD stays in jakarta sowr deposited his sperm counts r not so gud my husband cnt try intercourse at all nd he is diabetic I hv tried many iuis but it is coming failure I cnt afford ivf cn I get a success frm iui pls advice my reports r ok Dr told",
    "doctor_response": "Hi,It is common to get failed in initial trails with IUI. Try one more time you may get pregnant. Before IUI get thorough examination of your body like all the possible tests that prevent pregnancy from your side like patency of Fallopian tubes and other hormonal imbalances. Hysterosalpingography is the test to know the patency of the tubes. If the tubes are blocked IUI will fail.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Vidya Jyothi B",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for lower back pain?\n\nHi doc...symptoms started as low backache 2 months back and now the backache is gone but I have  pain in my right leg which i get after getting up from my seat after sitting for sometime. It feels like the pain is starting  from my hip bone. Can u tell what it could be ?",
    "doctor_response": "Hello,I had gone through the case and found as per your symptoms it might be sciatica pain.So go for MRI of lumbosacral region to find the exact cause.Do back and leg stretching exercise. If pain is unbearable then take physiotherapy massage.Hope my answer will be effective for you.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to recover from the spine deterioration?\n\nHi. I have had two Kaiser opinions from the ortho spine clinic. Have deteriorated spine x 30 yrs. Last 10 months with two herniated bulging discs L5/s1. Suggested only foramenectomy (fusion) and one said from the back the other from the front. What is the difference? The front surgeon said it would save damage over time disrupting other discs I already have and may need fusion down the road.",
    "doctor_response": "hi,thank you for providing the brief history of you.A thorough neuromuscular assessment is advised.Since you have herniated disc at L5 - S1 level and you have been advised for surgery? I wonder if you have tried physical therapy . As it is non invasive and can help recover if proper therapy is applied. Also, surgery is made to choice by surgeon is you have severe neurological symptoms of controling the lowerrl limbs during movement .In my clinical practice most patients don't need surgery and all recovered well almost 99% with physical therapy. Also, the area L5-S1 is a crucial area as it is a weight bearing joint, so as u have the maximum mobility and weight bearing at that area, dealing with a proper surgical procedure is needed.Depending upon how your muscles are before and after the surgery by the help of a physical therapy.Also, I had a case with 3 levels disc protrusion and a old fracture of 4 vertebrae but surgery was not needed. with proper assessment and guided physical therapy patient responded well and surgery was never done till date..RegardsJay Indravadan Patel",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sacroiliac joint pain radiating to the leg?\n\nI have had two prior surgeries. the first in august 2009 and the second in march 2011. Li and l-2 in 2009 and l-3, l-4 amd l-5 in 2011. Back never recovered after 2nd surgery. As I stand up my back loclks up and feels like bone on bone scraping. The pain is intense and makes it hard too breathe. Both SI joint areas hurt as it alternates from one side to the other with the right side being the constant area where I get hip flare ups, pain down leg and down to my big toe. I have had multiple MRI s and at one toime in 2014 was told by surgeon I needed surgery as the disk was chipping on opposite side of where he had performed prior surgery. He decided as I waired for wifes insurance to kick in and he changed his mind. I went to new surgeon in the same office and he saw nothing on the same MRI that showed a problem in 2014 and didn t think the current MRI warranted surgery. The pain is incredible about 5-7 months out of the year and not so bad the rest of the time though I am on opiates for pain and they help keep the pain to a dull roar during the better months. Nothing helps much when I have the stabbng sensations like I am feeling at the present time. There seems to be no particular thing that sets it off. I had been seeing a pain dr up until the first surgery and even for 2 years after the second surgery. Trigger point shots stopped helping at all. Is there any type of surgery, such as cageing mt lower vertabre, which would help or will this continue to get worse as time goes by? Setting upright seems to put a lot of pressure on lower back and exacerbates the problem.",
    "doctor_response": "Hello! Welcome to HCM! I have studied your case.You may need to do MRI spine again with contrast to see for nerve compression. If your new MRI shows disc bulge with nerve compression then surgery may help.Due to compression of this nerve root there is tingling numbness in your leg and pain associated with it.For these symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, sit with support to back. You can consult physiotherapist for help.Physiotherapy like ultrasound and TENS therapy will help.Yes your symptoms may increase with age and instability with associated nerve compresssion.  Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.  Take care Regards, Dr. Vaibhav Gandhi, Orthopaedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful, itching sore on the buttock accompanied by bad odour?\n\nHi I have a red,flat, round, sore in my bum cheek. Prior to this stage last week it was really really itchy! And was so sore even when I sat down on the toilet to pee cause it caused my cheeks to separate making it hurt. And dreaded going poop knowing I had to wipe which relieved the itch but hurt badly after wiping! Along with theses symptoms there s this really bad order. (Only thing to describe as if like something crawled up in and died) I ve had this since November 2016. On and off with those same symptoms... Never had this before and not sure what it can be. I do have genital heperes but my outbreaks are low like 1-2 times a year.... but it never smells like how my bum does if it s is herpes on my bottom. After my first born I did have hemroids and still have a skin tag hanging on my bum hole.....after my natural birth. Any thoughts and ideas what this may be? Please help 38 year old Mother of 2 children Thank you",
    "doctor_response": "hello,This sounds like a sebaceous cyst. They form when a hair follicle or oil glad gets blocked and forms a small cyst. The fluid in them is thick and smells bad. If it has been there that long you may need to see a doctor and have it removed. Sometimes soaking in warm water will help it open up and drain but if it keeps reforming then the cyst capsule may need to be removed by a doctor. This can be done easily in the office.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is brownish discharge a sign of infection?\n\nI was on antibiotics last month and got my period as normal which lasted from the 4th of October to the 9th. I started back on the pill on the 7th but had intercourse on the 8th but he didn't cum inside me.  On the 14th I got a once of very light brownish discharge in the morning and it went away after that and then last night on the 17th when I went to the bathroom and wiped myself it was a very very slight bright red discharge and it's gone now. It's only when I wipe myself though, could It be an infection",
    "doctor_response": "Hi,   I understand your concern.   I understand your query.  - Light bleeding with infection would have other signs like vaginal discharge, back ache, burning in urination,You do not have any of these, so mostly you don't have infection.  - certain type of contraceptives can produce occasional spotting in between two periods. It usually stops on it's own.The pills should be continued without break.     The spotting should not last for more than 7 days/should not be vigorous bleeding.- If it is so- doctor's consultation is indicated to exclude   some other causes of such bleeding needs to be excluded-( cervical errosion, cervical polyp, PCOD,fibroid uterus)  Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get rid of redness underneath the head of the penis?\n\nI am 16 years old and I am not circumcised at the tip of my penis under the skin and underneath the head it is red it has never once hurt or itches but I am concerned because it is red I don't know how to get rid of it I clean twice a day but doses not take it all away what should i do to make it go away ?",
    "doctor_response": "Hello, Please consult a dermatologist/skin specialist for the same. It needs to be checked up thoroughly to exclude presence of any sexually transmitted disease. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr SHOBHIT KUMAR PRASAD, Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruised and tender neck?\n\nI have bruising on my neck (mostly one side but on both) it is bruised where my neck and shoulders meet. The side that is the worse is tender to touch and feels harder than I think it should be. Also there's seems to be swelling but very little pain and no injury. Thx",
    "doctor_response": "Hi welcome to the health care magic You are having unilateral bruise near neck area If you post photo then better idea can be there History of trauma needs to be ruled out It might be muscular injury induce bruise or costochondritis of clavicle Naproxen or ibuprofen can be prescribed for that for five days If no improvement then x ray should be done and local area examination and palpation needed Take care Hope your concern solved",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the relation between trichophyton,candida and epidermoph ?\n\nmy grand daughter has been tested possiviive for the TOE alergens, trichophyton-candida-and-epidermoph, but my resurch has come up with very little. why are these grouped together, skin fungal and an internalyeast bacteria? what is the relation/link between the two?",
    "doctor_response": "Hi there! There are broadly 2 kinds of fungi which could infect skin. one type needs keratin to grow like Trichophyton or epidermophyton because of which it tends to grow on Skin Nails n Hair where Keratin is abundant. These do not grow inside the body. While Candida can grow on skin and inside the body too. Mostly moist areas like Groin, Vagina etc. For nail infection especially toe nails the medication needs to be taken for a long time because the drug concentration patterns in these areas need them to be so. Hopefully this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could be the reason for having pain in the left side of my face and in front of ear in the top jaw?\n\nHiI have had pain in the left side of my face for a week now. I have been to my dentist who put me on a 5 day course of Amoxicillin 500. I feel quite sick and periodically feel as if I have a temperature. Today  the pain is just in front of the ear in the top jaw. Also my head feels really fuddled.Any ideas?Linda",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. As you are mentioning that you have pain in the left side of the jaw in front of the ear, then there can be two possibilities for it-First is there can be any infected  tooth in the upper jaw which is causing this problem. -Second is may be your joint of jaws (Temporomandibular joint ) of left side is creating the problemIf the problem is of tooth the the dentist must treat the tooth as only antibiotic will not solve the problem. And if the problem is arising from your joint then antibiotic have no role in it, as it will be relieved by some muscle relaxant. But for both the conditions you should visit your dentist again and get it confirmed with detailed examination with x - ray of the tooth and joint, Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is severe pain in back with feeling of pinched nerve serious?\n\nI believe i have a pinched or compressed nerve in my back. Is there a chance i can just take it easy and let itheal? Or is a doctors visit needed. Pain level is a high 10, couldnt stand for 45 minutes after i felt it and cant move fast or pain is too much to handle.",
    "doctor_response": "HI,THANKS FOR POSTING YOUR QUERY. IF PAIN LEVEL IS UNBEARABLE I SUGGEST YOU TO SEE AN ORTHOPEDICIAN TO RULE OUT OTHER MEDICAL CAUSES OF BCK PAIN. AN INITIAL X RAY MAY REQUIRED TO FIND OUT ANATOMICAL CHANGES.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest and arm pit pain\n\nI am a 23 year old  male and have been having a few issues the past couple weeks. I'm in pretty good shape (5' 7\" about 150 lbs). My left side of my chest has been having this awkward discomfort like my heart area is being pushed/squeezed. It would randomly cause a bit of discomfort underneath my left arm pit and inner arm. If I press on the inner arm it would send an even more awkward pain. I haven't really been under any different stress then usual. I haven't been sick or ate any unusual foods that I can recall.Unfortunately I do not have health insurance and am hesitant to go to the ER and just be told it's nothing.Any information? If I can include anything else please let me know.",
    "doctor_response": "at your symtoms please get BP..chest xray and ecg done to rule out major problem ...other possibility is anxiety",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes cold sensation in the chest and heart palpitations?\n\nI am having a cold sensation in my chest. I have heart palpitations, feel out of breath, easily winded, and sometimes feel intoxicated even though I m not. I stopped taking my vitamins because I thought maybe I had taken too many. I was on a multi vitamin, magnesium (for constipation), Vitamins C, D, and B12 complex.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. After going through the medical details provided by you I understand your concern and I would like to tell you that it can be because of anemia, dehydration, underlying heart disease. If you're feeling reckless with palpitations then it should be evaluated for underlying heart disease or lung disease then it should be evaluated for underlying disease or lung disease. It\u2019s recommended for you to get an ECG and an ECHO-cardiography done and consult a cardiologist or a physician personally for proper evaluation and management. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr Bhanu Partap",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe itchiness on the scrotum\n\nI have raised like skin irritation on the sides of my scrotum. One side more that the other. Was tested for all stds, which are negative. Finally took a biopsy and gave a general diagnosis of eczema. I was given everything from higher dose of steriod creams to ani fungal cremes nothing helped. This has been with me for years.",
    "doctor_response": "hi dear,welcome to healthcare magic.i understand your problem.my opinion is that,1.dont scratch the lesions.2.maintain good hygiene.3.apply mometasone cream twice daily over the area.4.take levocetrizine tablets twice daily for 7 days.thank you.feel free to write your questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What herbs should i take for elevated autonucleic antibodies?\n\nWhat herbs should i take to address elevated autonucleic antibodies levels, with a Rheumatoid factor present?  I am Pitta / Vata.  Noticing: rapid aging of the skin.  Poor memory. geographic tongue. Flighty nervous system - difficult to ground (all my life).  Strong aversion to sun.",
    "doctor_response": "Hai,I am sure you would have consulted your doctor with the FANA test report. I would like to know the sub-type of ANA in your case. How long has the symptoms been there?As a Homeopath i would suggest a suitable potency of medicine Natrium Muriaticum. A detailed case study is required for the prescription for which you can consult an expert.Hope my answer helped,Wish you good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the appropriate dosage of folic acid while attempting pregnancy?\n\nHi Dr. I 'm a 25 yr old woman got married 6 months back. I am planning get conceive a baby,i want to know whats the dose of folic acid that i should take prior to preganacy ? when it shold be taken and for how long? My body weight is about 75 kg...",
    "doctor_response": "Hi, thanks for writing..Take folic acid for 3 months prior to conception.. This prevents nueral tube defect.. If you are not immunised against rubella and chickenpox get vaccination done. Avoid pregnancy for next 3 months after the vaccination.. Any infection should be treated prior to pregnancy.. Take lots of fruits, green leafy vegetables and lots of water..  Hope I have answered your query.. Good day..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes soreness at the tip of the tailbone?\n\nI have been experiencing a soreness in the tip of my tailbone for months now, just recently I have been experiencing a burning sensation in my lower back and a grabbing in my buttocks and right leg hamstring. I am a landscaper and very active and my job involves a lot of bending and lifting",
    "doctor_response": "Welcome to healthcare magic! You have mentioned that your job involves lot of awkward postures. So it may be prolapsed intervertebral disc. When disc irritates or compresses nerve roots, you experience numbness, burning sensation in that area. It is advisable to get your MRI of lumbosacral spine done. Consult orthopedic surgeon. Learn right work postures from physiotherapist. NSAID like ibuprofen should be taken after consulting doctor. Take rest for few days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Swollen gland on neck, pressure in head, no cold, sinus infections. Cancer?\n\nHi for a couple of weeks I feel that my gland on my right side is swallon and feels tight. Also inside my lower mouth on the right side i feel soreness but no pain. I have pressure on my right side of the head but no pain. No fever. I have not had a cold or sinus infections in months. I am a smoker and concerned. I m not sure if it could be. Should I wait it out with home remedies or see a family practicioner, or an ENT. Should I first be looked by a dentist to make sure it s not from any dental issues? Just not sure what step to follow and this is kinda scary since cancer is the new killing machine..thank you",
    "doctor_response": "HI DEAR gland on right side of your neck are swollen and tender and you feel soreness inside your mouth,dear this can be an op thous ulcer inside your mouth which is infected and has resulted in enlargement of lymph node on right side of you neck,you can apply local analgesic and antiseptic agent to the ulcer and also take a course of antibiotic,you can consult an ENT surgeon or dentist,to decide whether this is a cancer or not,which can be decided by biopsy of the ulcer .however thee are less chance for it to be a cancer",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes excessive sweating in a child?\n\nMy 3 year old son has always been very hot natured and sweats when participating in physical activity. He recently had his tonsils out so we have been sharing a bed and I have noticed that he excessively sweats during sleep to the point where he drenches his pillow or anything that he comes in contact with. While his body is sweaty, he mainly sweats alot from his head. No excessive urination though. Thoughts?",
    "doctor_response": "hi, its a very common problem with kids and its usually seen that its due to low calcium levels , i would suggest you give him Syrup Calcium once a day for 2 months. his sweating will reduce down. do proper head wash to prevent infections in the head due to sweating.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is an effective alternative for milk while taking antibiotics?\n\nMy boy  yrs old is suffering from cold since a couple of days and has fever since yesterday..i met the doctor today and he prescribed amoxylin powder to be mixed with water to be given twice a day for 5 days..he gave crocin and alex a decongestant too..my boy likes milk and asks for it... i generally switch to isomil when he has episodes of diarrea..as i am not getting isomil can i use neusobee till his course of antibiotics or give him general milk...he has been prescribed anitibiotics for the first time",
    "doctor_response": "HiWelcome to the HCMI understand your concerns but don't worry about it. If your baby has had a severe case of diarrhea, his body may temporarily have trouble producing lactase, and he may have symptoms of lactose intolerance for a week or two.For respiratory tract infections, Syrup Amoxicillin, Alex and crocin are fine. a humidifier in the room will be of help.Antibiotic induced diarrhoea can occur in some children after long term use because of gut flora affection. You can give him probiotics such as enterogermina if it occurs. There is no need to switch to lactose free formula at present.For further questions, do contact us.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for runny nose and sore throat?\n\nI am 27 weeks pregnant.  I had a runny nose and sore throat last Friday.  The sore throat went away, but my nose completely clogged for 5 days.  I took a benadryl but it is still clogged.  I used Afrin once, but it is still clogged to the point where I haven't tasted food for 5 days and I can barely get any mucous out when I blow it.",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain it seems that you have upper respiratory tract infection also known as Common cold that is viral infection and as you are pregnant you can take only limited medications.Also viral infection is self limiting and resolves within a day..You can take antibiotics like Amoxicillin to prevent secondary bacterial infection.Take tylenol for pain..Do warm saline gargles, steam inhalations, saline nasal irrigations and use a humidifier in your room to breathe moist air and it will soothe the nose and throat..You can take plenty of warm fluids and take sufficient rest..Do warm compresses over the chest and around the nose..avoid chilled and spicy foods..Hope this information helps..Thanks and regards.Dr. Honey Nandwani Arora.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for swollen and painful nipple\n\nI noticed some pain in my right nipple yesterday. It is painful to the touch around the nipple itself, but not further out towards the breast area. The area is swollen and puffy with some redness around the nipple. It seemed to appear out of the blue. There was no chaffing from clothing or trauma that would have caused this. I am aware that, although rare, men can also get breast cancer, but it sounds like it involves a painless lump and some discharge. I am hoping I can get some insight here. I am a 34 year-old white male in average shape. Help!!",
    "doctor_response": "Hi.I would in such a scenario recommend 2 things:1. Check with your doctor all the medications you have taken or been taking, as some can cause increased sensitivity or even gynecomastia (e.g. cimetidine)2. Check on your hormone levelsBest wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Every time I eat spicy food, I poop blood. Why?\n\nHi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy\u00a0food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I\u00a0do not have a\u00a0family history of colon\u00a0cancer. I got blood tests done last night. Please find my reports attached.",
    "doctor_response": "Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for pain in the tooth\n\nHi ~ Had orthognatic surgery - lower jaw only to correct overbite. It s been 8 months now and I am still feeling a terrible burning sensation on lower lip and chin. Feeling is coming back but skin is extremely hipper sensitive. Teeth hurt when chewing and muscles feel very tired and tight when talking. Can this burning sensation be something permanent? How long could it take to do away? I ve heard all sort of answers from if it hasn t yet it never will to it can take up to a few years -2,3,4 or so . Thank You",
    "doctor_response": "Thanks for your query, i have gone through your query. The burning sensation can be because of the nerve injury during orthognathic surgery called hypersthesia. The recovery time may vary from months to years. But cannot predict exact duration or time of recovery.If i am your treating doctor, i would have suggested you to take nerve regenerating drugs like vitamin B6 and B12.The pain in the jaw and muscles is not related to the surgery. It can be because of any maloclusion or TMJ disorder.Consult a oral physician and get it evaluated and treated.I hope my answer will help you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have chest discomfort with upper and lower back pain. Please help.\n\nHello doctor, I have chest discomfort and upper and lower back discomfort since yesterday. I passed stool twice today and the last one was cloudy. I am a 32-year-old male. My height is 5'6\" and I weigh about 77 kg.",
    "doctor_response": "Hi. I reviewed your history. Do you have a burning epigastric sensation? Difficulty in breathing? Do you have hypertension or diabetes? What is your last meal? All these significant history points are important to exclude any cardiac problem or any gastric problem.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Tonoferon safe for babies?\n\nHello Doctor,My baby is 5.5 months old now. My doctor suggested Tonoferon ,Zincovi and calcine P drops. My baby takes calcine and zincovit without any problrm however he throws out(vomit) entire tonoferon whenever i tried to give him . He does not like taste and smell of tonoferon at all. Should I check the medicine or generally babies do not like tonoferon? Thanks in advance!!",
    "doctor_response": "Hi,Taste of Tonoferron is not good as it is an iron containing medicine.So it might not accept by children.You can mix drops with water and dilute while giving.Give her after feeding.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can an infant be administered with oflox drops for cold?\n\nHi I'm a mother of an 8 month old baby girl, the peadiatrician prescribed to use oflox drops in her nose for her cold to reduce the bacteria. I would like to know if it's safe to do so I'm a bit worried as the drug is only used for the ear and eyes. Please help. Concernd mom.",
    "doctor_response": "HiWelcome to the HCMIt's not advisable to go for ofloxacin drops for such treatment. Most of the cold in this age group are due to self limiting viral infections. They respond very well to just symptomatic management. So, I would recommend you to give her an antihistamine drops at recommended dose as per weight and age along with regular feeds and fluids to maintain hydration.Also, you may use normal saline nasal drops regularly as they are the safest for clearing blocked nose.Use a room humidifier while sleeping if the weather is dry.Hopefully this will help you.I will be happy to help you in any further questions.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Red blisters on the roof of mouth and throat, swollen tongue with whitish film, breathing trouble. Relief measures?\n\nI m pretty sure my daughter has herpangina (?sp). She has red/white blisters on roof of her mouth and her throat. No hand/ foot sores. Her tongue is pretty swollen and is covered in a whitish film. She s saying she feels like she s having trouble breathing almost like when she s coughing but she doesn t need to cough. Do the sores spread down the throat enough to cause breathing problems? I know this is most likely viral therefore antibiotics won t work but is there something that can be prescribed?",
    "doctor_response": "Hi, Thank you for the query. Herpangina is a acute febrile illness assosicated with small vesicular or ulcerative lesions on the posterior oropharyngeal  structures. The lesions are whitish gray i color and lead to pain and itching  in the oral cavity, difficulty in  swallowing . This can be treated by  a course of antibiotics  and analgesics  and betadine gargle and application of topical anaesthetics will help in taking food and give relief from pain. Hope this information helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it to be concern about the child hitting the head?\n\nHi my daughter hit her head when she fell of the bed she is 9 months old and she has a red spot where she hit but no bump she is the same height as the bed n cried for all of 5 mins and is playing and seems to b ok should I take her to the emergency room anyways",
    "doctor_response": "There are few danger signs post head injury which parents need to watch for, to take children to emergency room for further management:(these are the children who would need  a CT head scan within 1 hour of the risk factor being identified:)1.loss of consciousness after the episode and persistent vomiting after the impact.2.Post-traumatic fits but no history of epilepsy.3.On initial emergency department assessment, GCS less than 14, or for children under 1 year GCS (paediatric) less than 15.(GCS means scoring for consciousness with maximum being 15 and for parents symptoms will appear like excessive sleepiness at home in unsual hours)4.Suspected open or depressed skull fracture or tense fontanelle, detected by experts at emergency.5.Any sign of basal skull fracture (haemotympanum, 'panda' eyes, ,translucent fluid /blood leakage from the ear or nose, Battle's sign).6.Focal neurological deficit(not able to move one of the limbs/affected speech/vision)7.For children under 1 year, presence of bruise, swelling or laceration of more than 5 cm on the head.As a precaution,because your child is less than 1 year,it is advisable to go to emergency be seen once by a emergency physician first.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Cozaar the right medicine for high blood pressure?\n\nI am a reasonably fit 52 year old man who cannot climb any stairs, even a relatively short 5 steps or so, without feeling lightheaded 20-30 seconds after completing the climb. I have been diagnosed with high blood pressure and take Cozaar in the morning. I ve never had a low blood pressure reading. This effect is much stronger after eating. Is this a heart problem, or something else?",
    "doctor_response": "Hello Sir , Considering the age of 52 years and as the symptoms occurs characteristically on exertion ie. When you climb stairs , heart as the cause should be ruled out on priority.  A baseline 2 d echocardiography and if nomral , a treadmill stress test is the best way forward as here you would no if any symptoms,  ecg changes and blood pressure response on exercise helping us make a diagnosis.  Regards Dr Priyank Mody",
    "dialogue_context": ""
  },
  {
    "patient_message": "Engaged in foreplay. Rubbed penis on vagina. Ejaculated outside. Took contraceptive pill. Pregnancy chances?\n\nhi. i wanted to know if i could be pregnant. i had my first day of period on 17th feb 2013. on the 7th march 2013 i had foreplay with a guy. i gave blow job to the guy and he ejaculated on the floor. 10 mins after ejaculation ,we both got naked and he started rubbing his penis on my clitoris and vagina and ejaculated on my breast i wiped it off immediately. i could feel he was little wet and even i was. we rubbed for 2-3 minutes. it was 18th or 19th day on my cycle when this happened, and my cycle is usually 28 or 30 days. when i went home i washed my vagina with water, 1 hour later i saw traces of blood on the undergarment(i usually spot during ovulation ). and i consulted a doctor and 4 hours after the act, i took a emergency contraceptive pill. are there chances of me getting pregnant. we din not have any penetration or intercourse. please reply.",
    "doctor_response": "Hello, I would be happy to help you with your question. Given the lack of vaginal penetration AND the fact that you took emergency contraception, then the chance of pregnancy is small ( I hope that this helps and good luck!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can prolonged stress causes coma?\n\nMy nephew collapsed- both his breathing & heart stopped. CPR revived his heart befor the ambulance came but he is still in a coma (drug induced) and not breathing on his own. In what time frame does the brain damage occur after the heart stops beating? Closest guess is it took 5 - 10 min....Also can sudden cardiac arrest be caused by long term stress?",
    "doctor_response": "you are correct it takes approx 5 minutes for the brain death due to reduced blood supply that causes asphyxial brain injury.. cardiac arrest could be due to high cholestrol levels or hypertension or any structural defect of the heart.it will take some time to get overcome from coma.so take care of him.hope my answer helped you. plz rate the answer.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes fever, joint pain and dizziness after vaccination for shingles?\n\nOn Thursday afternoon I received a vaccination for shingles, a subcutaneous injection. The first 24 hours I had no reaction, then later that evening, I developed a fever of 100.8, felt achy in all my joints, a little dizzy and developed a redness at the sight about the size of a deck of cards. I went to bed, took an 800 Ibruprophen, lots of water and woke up this morning with a normal temperature and feeling fine. The redness was still in my arm and it is sore to the touch. I took it easy during the day, but tonight I have developed the same fever. The injection site is sore and very tender to the touch and the same size. I am concerned because I am hosting my 1 month old grandson next week and he has not had his vaccine for chicken pox that I know of. Will I be contagious to him?",
    "doctor_response": "In my opinion you should contact your doctor immediately because these side effects are considered sever ( not the normal side effects )you should  not be worried yet since rash did not spread away from injection sitebut better safe than sorry .Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is causing a bump at the site of last tooth?\n\nI'm a 18 year old female, and I have a bump right at the end of my lower jaw, behind my last tooth. It's enough space to accomodate a tooth, but not sure whether that's really what is causing the bump. It's not too hard either. The tooth right above it causes a lot of irritation when it comes into contact. What could it be?",
    "doctor_response": "Hello, thank you for consulting with healthcaremagic. Actually 18 year is the age of eruption of last molar, it can be possible that your wisdom tooth is coming in the mouth, but it will take little time.Just observe it for few days, at least a week,  if then slso , it is not coming or creating some problem, then you should visit your dentist and get an x - ray done which will show the condition. Hope it will help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes unresolved pericarditis?\n\nI am 17 years old, 173 cm high, 72 kg weight. The problems started 10th of January when i felt strong pain in my chest, followed by temperature the next day. For 20 days I suffered without anyone knowing what's wrong with me, and then, finally, I was diagnosed with pericarditis. My CRP was 174 then. I took Longacef for 7 days, it seemed OK, but after 3 days it came back. Then they gave me Prednisone with Aspirine wich I took for 15 days. I was fine for the next month, and then it came back again, with CRP 214. Prednisone with Longacef for 10 days, and now I've been taking prednisone for 2 months, with decreasing doses for up to 5mg. Yesterday my doctor cancelled the steroids.",
    "doctor_response": "hi, Pericarditis is caused by many agents.. but at your age, most common causes ate viral infection, rheumatic pericarditis or immune related.don't worry. just follow with your doctor and things should get well soon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does prominent cervical lymph nodes on MRI suggest?\n\nRecent MRI indicates numerous prominent lymph nodes are seen throughout the bilateral cervical chain including mildly enlarged bilateral level IIa lymph nodes measuring up to 2.1 cm there is also a slightly prominent 1 cm left supra-clavicular lymph node. What does this mean?? Should I be concerned?",
    "doctor_response": "Good day and thanks for your question.Yes, you should be concerned. Lymph node enlargement suggest something going on, either an infection or a cancer.Please kindly see your doctor for further full blood check (full blood count), investigations for tuberculosis and an Endoscopy.Hope it helps.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have pimple-like bumps in my pubic area. Could this be an STD?\n\nHello doctor, I am a 25 year old male. Over the past two\u00a0weeks, I have been having pimple like bumps in my pubic area. When I noticed the first one, I tried popping it, and it did not disappear, in fact, it got worse. Two more bumps appeared, less than a week after I tried popping the first one. Then I accidentally scratched those, and they started to bleed. I am wondering the cause of this. I am worried that it could be an STD. I hope it is only an ingrown hair, but I do not understand how they appeared altogether. I have not been sexually active for the past three months. One of them is on my penis shaft skin, but none of it is on my penis. I have attached a picture for your clarity. I have been masturbating a lot these past few weeks. Could it be due to that?",
    "doctor_response": "Hello. From your description and pictures (attachment removed to protect patient identity), you seem to be having folliculitis. It is a bacterial infection of the hair follicle. I suggest taking a course of an antibiotic, Cephalexin 500 mg, twice daily for five days. You could also use Mupirocin ointment over the lesions, twice a day. In addition, you could add betadine solution to your bathing water for three days. Avoid shaving the region till the lesions heal. Hope this helps. Take care. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for problem in breastfeeding the baby\n\nI have a month n a half old baby.. She is not latching on to my breast, initially I had a flat nipples so as per doc s advise I fed her with a help of nipple shield. Now when I try to feed her directly she s not accepting.. When I try it rigorously she cries a lot.. I feel so helpless n frustrated using this shield..",
    "doctor_response": "Hi,Now she is used to of having feeding with nipple shield she may not like to feed with nipple directly as due to having flat nipple she feels inconvenience.Do not leave trying for nipple feeding.While feeding keep your two fingers around nipple and with fingers help put nipple in her mouth.Observe that her nostrils are not blocked due to breasts.Initially she will be hesitated but gradually she will be used to it.Try to make nipple erupted with help of breast suction pump.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I felt lightheaded and like my heart stopped. What should I do?\n\nHello doctor, I am a 74 year old\u00a0male in excellent health, and I am not on any medications. Recently, I had a strange chest sensation. It felt like my heart stopped or skipped, and I felt lightheaded like I might pass out. I had an EKG, echocardiogram, and a Holter test done. The EKG results were normal. In the echocardiogram, I\u00a0was given a reading of 77 % and was told that my heart was in a very good condition. Holter tests showed supraventricular tachycardia but not extreme. I have only seen the physician assistant as the cardiologist is too busy. I would like to send my Holter test reports to you and get an opinion. I have cut back on caffeine and alcohol, which are the only measures I have taken so far.",
    "doctor_response": "Hello. I understand you are a little worried about your heart and have been on the Holter monitor for a while. I appreciate that you have uploaded the reports in full for my consideration (attachment removed to protect patient identity).\u00a0 Hope this helps. For more information consult a cardiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does brown discharge/ spotting with nausea suggest pregnancy?\n\nI m 20 years old, on the contraceptive pill, me and my partner have sex often but after the 1st march (which i confirmed was my first ovulation date and I missed three pills previous), I ve been having brown/clear discharge which I guessed could be spotting? I ve also felt really hungry to the extent that I am constantly nauseous however I m concerned that its too early to tell if this could be symptoms of pregnancy or not? My period is due 11th march. Thank you.",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.1] If you have missed your pills, please get urine test done if if you have crossed your dates.2] If test is negative, you can get periods earlier or some unusual bleeding because of missing the pills.3] if test is negative and you get regular periods, then please use the pills regularly without missing them.I hope my answer helps you.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes continuous chest pain and blood discharge while coughing?\n\nHi, My husband is having continous chest pain since couple of weeks. Since last week he also had cold, cough & fever for 2- 3 days and while coughing during the morning he saw some blood content as well. What would be the cause for all this? Could there be something really serious?",
    "doctor_response": "Hi. I can understand your concern. Ideally ecg and 2d echo should be done first in your case. If both are normal than no need to worry for heart diseases. also get a chest x ray done as it can be due to lung infection also. Consult a pulmonologist for the same.Don't worry, he will be alright. I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to prevent redness of eyes in vernal conjunctivitis?\n\nHello doctor, My son is 8 years old and sometimes he has bloodshot eyes. This allergy was started when he was one year old. He has been diagnosed as vernal conjunctivitis.",
    "doctor_response": "Hello. I reviewed your history. Vernal conjunctivitis is a chronic condition and requires treatment for a long time. It usually decreases in severity by 15 years of age. The treatment mainly involves the use of antiallergic drugs like Olopatadine with steroid eye drops in acute and severe cases. Since the treatment is required for a long time the treatment needs to be done under the supervision of an ophthalmologist. Hence, I advise you to consult your eye doctor for examination and treatment accordingly.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cancer in neck and chin\n\nMy friend had papillary Ca of thyroid with metastasis to lymph nodes & total thyroidectomy with removal of lymph nodes ,now again detected with Ca at base of neck and chin . Please advice on course of action ,treatment , suggest best oncologists in mumbai.Male,20yrs.",
    "doctor_response": "hello,as in case with any cancer, there will be spread of cancerous growth to other parts of the body..so also is in this case,Ca is a short form for cancer and not for calcium in this case,i would suggest you tata memorial hospital",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Whenever it is cold, I cough. Can you tell me what the problem is?\n\nHello doctor, I am 26. I had dry cough from the 10th of last month and it did not go away completely. I was a smoker until the 2nd of last month and then gave up. I smoked for five years. Within the last few weeks, I must have smoked 10 cigarettes. My issue is whenever the temperature is cold, I cough and when it is sunny, I would not. I do not cough too much. It is once or twice in the morning and whole day nothing. Clear mucus and no medicine is required. I just drink hot water and everything becomes fine. Can you tell me what the problem is? I have no chest pain or throat discomfort. No weight loss. Whenever my stomach is gassy, I cough. Please help. I have smoked for five years. What is my cancer chance?",
    "doctor_response": "Hello. As you said that you have been smoking for five years and now have cough with clear mucus expectoration, it is most likely due to bronchitis. It is very common to have cough if you smoke more than five cigarettes per day. Also, because of cold weather, it gets aggravated and takes longer to heal. So, better is to stop smoking as you did rightly and take a good expectorant like syrup TusQ-X 10 ml (combination of Ambroxol, Guaifenesin, and Terbutaline) three times a day. Continue with salt water gargles and steam. It will help to loosen and liquefy the cough. If there is no relief even after seven days, better get your chest X-ray done from your family doctor and get treated accordingly. Usually smoking for five years at this age does not cause lung cancer but you should stop smoking. Smokers' cough because of bronchitis is very common. For more information consult an allergy specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for severe chronic pain\n\nI suffer from severe chronic pain and have been prescribed hydrocodone since I was 22, I am now 52. Less than a year ago my doctor of twelve years sent me a letter telling me he would no longer prescribe narcotics and was also declining from being my PCP. I was shocked and hurt. Confused. I called and asked why and was never given a reason, even when I went to administration and risk management. I am now in foreclosure of my ranch as I can not function and perform my chores involved for me to make my living. Any speculations you may have would be appreciated.",
    "doctor_response": "Hello, In many countries narcotics are legally regulated and that may be the reason for with holding the pain medication in your case. However, you can try analgesics like Gabapentin for symptomatic relief. You can consult a pain physician, he can legally prescribe narcotics for you. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for fever,pale skin and dark circles under eye\n\nGood evening, my daughter is 4 years old and for the past two days has had a fever from 99-102, difficult to get to stay awake, complaining of being tired and not being herself, pale skin and dark circles under her eyes. This all started the day after she finished biaxin for an ear infection.",
    "doctor_response": "Hello, By what you say I feel that this could be a simple viral illness. Fever of a 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 a viral illness and it doesn't require antibiotics at all. Once the viral fever comes it will there for 4-7 days. So do not worry about the duration if the kid is active. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain and tightness with psoriatic arthritis?\n\nI ve been having chest pains for a couple of hours now. I am 30 and I ve had some issues with chest tightness due to psoriatic arthritis. I did start synthroids 50 mg today. My blood pressure is normal 126/76 Are there any signs I should look for about this pain to know if its not just the arthritis?",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Psoriatic arthritis can cause lung complications like bronchitis and lung fibrosis. Both these cause chest tightness and chest pain. So better to consult pulmonologist and get done clinical examination of respiratory system, chest x ray and PFT (Pulmonary Function Test). Chest x ray is screening tool for lung fibrosis. PFT is must for the diagnosis of bronchitis. If both these are normal then no need to worry for major lung diseases. Take simple painkiller and muscle relaxant drugs. Apply warm water pad on affected areas. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rashes in chin, cheeks, neck caused by synthetic fur pillows. How to make them disappear?\n\nI am 15 years old, female, and I woke up with a rash on my chin, cheeks (more on one side), and a bit of my neck. It seemed to spread a bit through the day (could be caused by me frequently touching it, being anxious and checking if its diminishing or not). It may be caused by some new synthetic fur pillows that I bought and slept with, but why would it be just on my chin? What can I do to make it disapear?",
    "doctor_response": "hiThanks for asking query on HCM.it seems to be contact dermatitis, probably it started on the side where your face is in touch with the pillowAvoid the synthetic pillow which is suspected to be the cause of this rash.Apply calamine lotion to the affected part 2-3 times dailyTake Allegra (phexopenadine) 60mg tablets twice dailyusually it disappears within 3-4 daysOtherwise  better consult a dermotologistHope this answer serves your purposeDr.M.V.Subrahmanyam",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is radiation effective for pancreatic cancer stage 4?\n\nhi I m wondering if radiation for stage 4 pancreatic and liver cancer would be beneficial. the patient is already taking strong chemo and a lot of herbal supplements. Feels good except after treatments. What pills and treatment would you suggest Thank u",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. Treatment of pancreatic cancer depends on type and stage as well as spread of cancer.  In early stage surgery is useful. In late stage chemotherapy and radiotherapy remain mainstay in the treatment. Radiotherapy is useful in some types of pancreatic cancer.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could fever and shaking a warning symptom of febrile seizure?\n\nMy 22 month old daughter just woke up from sleep and had a fever of 102.3.  I gave her 1 tsp of childrens advil (per my doctors advice) but was wondering why when she awoke and had fever (and still for a few mins after taking medicine) she was shaking a little all over.  My son at 20 months had a febrile seizure, and i'm familiar with what seizures in general look like, this was not one, but is it a warning sign of one?",
    "doctor_response": "Dear Sir,Shaking that your noticed probably is due to high fever also called as chills & rigors.However, a child can have febrile seizures, try to keep her temperature down to normal limit. You may give here paracetamol for high fever under your doctor's guidance. Also you can do cold sponging.In case you notice apart from shaking , teeth gindering , tounge bite, frothing , uprolling of eyes, rush her to ER , that is a seizure.Consult your doctor for appropriate treatment for the cause of fever.Wish her good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause grey, pasty stools in an infant while having cold and mucus in cough?\n\nMy son is 7 months old and had a gray paste bowel movement, he s been vommiting on and off for last 3 hours.. He s getting over a really bad cold that lasted a week but he s still has a lot of mucus in his cough, so when he coughs up the mucus he starts throwing up",
    "doctor_response": "HiWelcome to the HCMYour child seems to be suffering from a viral gastroenteritis episode alongside the respiratory infection. In my opinion you may try the following measures:- keep him well hydrated by regular oral rehydration therapy I.e. ORS, Lemonade, Buttermilk etc- Syp. Ondensetrone or domperidone can be given to relieve vomiting.- Syp. Chlorpheniramine will help him in cough and also help in sleep.-In case the stool has blood or mucous present, then start antibiotics such as ofloxacin-ornidazole.- Syp. Zinc at 20mg once daily for next 2 weeks will help him in recovery.For further questions, do contact us.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have painful lump in my armpit. Please help.\n\nHello doctor, I have a painful armpit lump. Please suggest.",
    "doctor_response": "Hi,  Welcome to icliniq.com.  It is an infection. Take tablet Cefixime 200 mg twice daily for five days, Mupirocin ointment daily for five days. Take antiseptic soap for bathing. Tablet Aceclofenac and Serratiopeptidase once daily if there is pain. Review after five days. Infection will subside, if lump remains it need to be removed surgically.  Send a photo after five days. Bacterial infection. Fasting blood sugar.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I feel I may have a neurodegenerative disease. How to determine it?\n\nHello doctor,I feel as if I may have a neurodegenerative disease. My symptoms are as follows:More forgetful than normal.Battle to find the right words.I get very bad pains and pressure in my brain.When driving, I battle with judging my following distance.Please, could you provide any tests that I could take? If it is a neurodegenerative disease, what is the progression rate, that is, the timeline between each stage?",
    "doctor_response": "Hello. First, only based on these symptoms, it is difficult to say with certainty. I would like to ask if you have any medical problem as of now, and taking any medicine, or using any substance of abuse. These symptoms could be due to: So, to reach a diagnosis, you need to undergo few investigations including full blood count, blood sugar, thyroid function test, B12 and folate level, CT or MRI brain, liver and renal function test. There are psychological tests such as MMSE (mini-mental state examination), or Hamilton depression rating scale (to find the level of depression), ADAS - Cog to find the level of cognition. I recommend that you consult a psychiatrist in person for a detailed evaluation. The timeline for neurodegenerative diseases is different for each disease and also vary considerably in different people, like Alzheimer disease progresses in 5 years to a decade while prion disease progression is very rapid. Similarly, neurodegenerative diseases secondary to medical conditions are reversible or at least stagnant once appropriate treatment is taken. For more information consult a psychologist counsellor online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lower right stomach pain, mood swings and acne?\n\ni have lower right stomack pain mood swings and really bad acne my flow is ushely heavy but this time it was 4 days early and extemly light i have for 4 dYs its been 7 days and to top that out of the blue ive gone up one cup size and crave cheese and hav gained weight",
    "doctor_response": "HI.Thanks for your query and an elucidate history. The symptoms of right lower abdominal pain, changed uterine flow, acne, increase in size of breasts as you have explained all are suggestive of the following:Ovarian Dysfunction causing hormonal changes causing all the symptoms you have.-I would advise you to consult a Gynecologist for clinical examination;-Hormonal assays;Ultrasonography for ovarian evaluation to see for PCOS and other related problems of uterus and so on. To get started with treatment as per the investigations.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the life expectancy having bile duct blockage and severe jaundice?\n\nSunday, October 10 - my 77 year-old mother visited us and we noticed that she was turning yellow (skin and eyes).  She said it had been that way a couple of days. Monday, October 11 - my mother called and scheduled an appointment with her doctor. Tuesday, October 12 - saw the doctor and had an ultrasound and a blockage in the biliary duct was found. Friday, October 15 - met with a GI doctor. Monday, October 18 - had a scope procedure through her mouth, took a biopsy, and placed a stent in a biliary duct. Wednesday, October 20 - diagnosis of biliary duct cancer. Friday, October 22 - had a CT scan. Monday, October 25 - met with surgeon and had an MRI. Tuesday, October 26 - surgeon called at night and stated that per MRI cancer is only in one side of biliary duct and he would perform surgery. Wednesday, October 27 - called doctors office to schedule surgery...surgery still not scheduled but was informed the earliest would be November 10 (2 full weeks). The stent is not working to drain the bile and my mother is extremely yellow and feels very weak and lethargic...says she has never felt this bad in her entire life.  She was very active and is now getting very feeble. My questions are: How long can she survive with severe jaundice?  If they cannot operate for 2 weeks and she gets extremely bad, should we take her to the emergency room? Is there any dialysis-like treatment that can be done to clear up the jaundice?",
    "doctor_response": "Hi and welcome.Jaundice with obstruction is serious issue and it should be deblocked as soon as possible to prevent li er failure. People may live for even for 2 months with jaundice but yu should not wait this since liver damage may happen and then surgery may not be sucessful. so you should insist on earlier termin for surgery. Wish ou good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Child complaining of stomach ache, cramps. Took medicines, better with vomitting, diarrhoea. Cramps, aching persists. Solution?\n\nHello doctor, My daughter is 7years old and she has been complaining about stomach ache and cramps past 20 days .From the last 10 days she was suffering from vomiting and loose motions about 3-4 times a day.We did consult the doctor and there are no signs of food poisioning or appendix. The stool( fungal culture) test has been done and it shows candida species(+) other than C. albicans isolated in culture. Ultrasound of USG abdomen has also been done and it shows Mesenteric lymphadenitis. She is been taking MYCOSAT( Nystatin ) -1ml and Flagyl S. - 1tsp and Dompy ( domperidone ) - 1tbsp before food.She is little better with vomiting and loose motions but she s still suffering from cramps and aching once or twice a day. The doctor has asked me to see a surgeoen and I need your suggestion for the same as I am very much worried. Thanking you with regards,",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for asking a question to H.C.M.F. Your child of 7 years had pain abdomen since 20 days, and vomitings and motions since 10 days. U.S.shows mesentric lymph nodes. Culture showed candida species other than candida albicans. Used mycostat, and flagyl. s , domperidone. She is better but still complaining of the cramps and aches ones or twice. It appears to Be the chronic infection of the intestines, needs to be treated in a general way of treatment with mixed drugs and anti spasmodic drugs. It will definitely give relief , then you can repeat the tests to see whether the previous infections cleared or not. Wishing for a quick and complete recovery. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Kidney stone blasting done, on medicines, feel light headed, weak. Used to take Benazepril earlier. Remedy?\n\njust has a kidney stone blasting one week ago,was in hospital for 2 days from excessave pain. when discharging me the hospital drs. put me on cozaar 50mg, lopressor 25mg and norvase 5mg to help blood pressure. My family dr had me taking Benazepril 20mg 2x a day for several months but it would still get high. Im so confused and don't know whose advice to follow. I do have a nagging bronical cough. Feel light headed and a little weak also.",
    "doctor_response": "Hi,You got kidney stone blasting done one week ago, was in hospital for 2 days due to pain, you have bronchial cough, feelig light headed and week.                          The blasted stone peaces will be causing irritation of the ureters and infection, you will be fine soon.                           Regarding family doctors prescription you can withhold for few days, then you can continue again. Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of Omnacortil syrup?\n\nMy son is 3 Years and has been diagnosed with Nafrotic Syndrome with Minimum Change. He has been prescribed 30mg per day Omnacortil syrup for 4 weeks and then subsequent reduction of the doze. What will be the side effects of this Steroid ? Please advise as I am really concerned about the consequences.",
    "doctor_response": "HiWelcome to the HCMI completely understand your concern regarding steroid use for Nephrotic syndrome in your child. But don't worry as this is the best first line treatment for minimal change type of nephrotic syndrome. The side effects are not common during the treatment that your child is receiving at present. Long term therapy with steroids may lead to increased appetite, cushingoid features, impaired growth, behavioural changes, gastritis, salt and water retention, hypertension and bone deminerali-zation. If on prolonged treatment with corticosteroids, the child should be monitored for steroid toxicity. Examination for cushingoid features, monthly record of blood pressure, six-monthly record of height and weight, and yearly evaluation for cataract is recommended.Hopefully this will help you.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain the poisonous effect of phenol ingestion.\n\nHello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect.",
    "doctor_response": "Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Are they ways to get rid of masturbation habit?\n\nHi Doctor, My name is Arsal & i am from Pakistan i live in Islamabad the capital city of Pakistan .I am 17 years old & i want to quit this addiction of masterbation & i am actually on my way to quit it but sometime this urge makes me crazy.How can i cope up whit this urge ?",
    "doctor_response": "HelloMasturbation is practiced by many males but its obsession is bad.It is good that you are concerned about your problem and try to get rid of it.You should avoid provocative literature and videos.You should try to be calm and try to engage yourself in your job.If condition persists the you may need psychological counselling.Get well soon.Take CareDr.Indu Bhushan",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from Asthma for the past 8 years and put on Seretide inhaler 4 times\n\nMy niece of 8 years has Asthma . She was put on Seretide inhaler as well Asthavent 4 times . I was under the impression that Asthavent was a short term relieve to sudden attacks.",
    "doctor_response": "hi welcome to healthcaremagic Asthavent's half life is 1.6 hour so u need to take for 4 times or as u required,it's use for short term becouse of its short half life and its quick mechanism of action. thank you",
    "dialogue_context": ""
  },
  {
    "patient_message": "Do birth control pills cause brown discharge through the vagina?\n\nI am on the birth control pill ortho tri cyclen lo, I ve been on it for nearly three months, I have the last hormone pill tonight. Today i started experiencing a light brown discharge that has a bad odor. I am sexually active but always wear a condom. I haven t experienced this before and I m not sure what to think. help.",
    "doctor_response": "Hi, I think you should consult a gynecologist.  It can be due to some infections.  You may need some antibiotics.  Hope I have answered your question. Regards Dr khushboo",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe hip pain?\n\nI have two Tarlov 2 Tarlov cysts. Right side at S1 neural foramen is 1 cm and a 2 cm cyst on right at S2 neural foramen. I have had 2 back surgeries and neck surgery. Neck surg in 2000, 1st back in 2002 and 2nd back in 2010. I also have new bulging disc at L2-3. I have bad right hip pain. What would be systems at this location? Thank you so much!",
    "doctor_response": "Hello, Most cases managed conservatively with drugs like gabapentin. Surgery is limited to severe cases only. Consult a spine surgeon and he will direct you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hand, leg paralyzed, unable to speak after brain stroke. Blood clots in brain. Treatment?\n\nHello, could you please give me right direction. my father got sudden brainstroke, his left side leg and hand got paralysis .Also he is not able to speak.still 15days left, he take food through pipe and also urinal pipe connected.he iz 76yrs old.As per doctors advise more than 6to 8 months urinal pipe and feeing pipe required for my father. As per Doctor L D Padhi, Doctor- Kalinga Hospital, BBSR: 1/4th part of leftsite brain got blood clots.he cant give me right duration when my father got well( means he can take food through mouth, for urine urinal pipe not required) please suggest me for my fathers well treatment.",
    "doctor_response": "Dear Mr Patra, Usually after an ischaemic stroke, the part of the brain that has been completely destroyed because of lack of blood supply does not recover its funcion. It is the surrounding areas of the brain which will need to take over the function of the affected part. This will take time and especially in an elderly gentleman like your father, it may not happen completely. Therefore it is possible that he will be left with some extent of permanent paralysis. Once he has come out successfully from the acute hospitalisation he will definitely improve, but the improvement will be gradual and most likely incomplete. Eventully, the doctors will attempt to remove his feeding tube and urinary catheter, ut when it may happen is difficult to predict. I gwould assume that the side of paralysis is Left sided arms and legs? This is because his left brain is affected and this controls the opposie side arm and leg function and the speech in right handed individuals. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes frequent stone formation in Kidney?\n\nDear Doctor, In the span of last month i am going for second time for kidney stone laser treatment.And the growth of the stone is little high rate.I did my first treatment in Nov 2013 .During that we crushed the stone and passed through a stent .It was of the size of 2 CM and recently report says that i have a stone of size 1 cm.Why this is happening frequently .what will be cause and how can i restrict kidney issue or stone formation from re occurring .I any of these case i didnt felt any pain Thanks Ras",
    "doctor_response": "HiSome people form stones again and are called recurrent stone formers. The most important thing in preventing stone formation is not to leave any fragments of stone behind at the operation. I would advice the following tests once the stones are clear         - blood tests- serum calcium, uric acid         - Urine tests- 24 hour urine collection to check as a minimum for pH, urine volume, creatinine, calcium, uric acid/urates, oxalates and citrates. This will tell us the cause for recurring stone formation and we can institute further treatment. Meanwhile drink adequate fluids to make urine colourless, avoid eating red meat and reduce salt content in diet.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is sinus tachycardia infection caused by virus?\n\nI have a 16 year old daughter that has been having sinus tachycardia with symptoms of chest pain, dizziness, and heart rate up to 200.  This has been happening since having an upper respiratory and sinus cold in December.  We are now being told that the tachycardia could be caused from the virus in December.  Is this possible?",
    "doctor_response": "hi,Thanks for writing in to hcm.Yes sinus tacchycardia or arrythmias can be caused due to severe viral infections. In such cases usually the virus affects the heart muscles causing weakening of the muscles and disruption of the electrical activity of the heart.Your child may be treated with medications that reduce the risk of heart failure and diretics which prevent oedema and medications that lower the stress on heart.Also a low salt diet is advisable to maintain Blood Pressure.Regards,Dr.Riyanka",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having stomach pain, blood in stool. History of carcinoid tumor. What could it be?\n\nHi I have recently in the past few weeks been getting really bad stomach pains after I eat anything, I can be really hungry and eat the smallest amount and still get a pain in the stomach and need to go to the toliet, I have also had some blood in my stool . I had a carcinoid Tumor in my appendix nearly two years ago and was wondering if it has come back or is there something else it could be",
    "doctor_response": "Hi welcome to Health care magic forum. As you describe you had bad stomach pain after eating anything, and an urge to go to stools, and there is blood in stools. There is a history of carcinoid tumour, of iliocecal junction. It appears to be irritable bowel syndrome , or amoebic colitis for which it is to be treated now. If there is no responce, you have to consult a gastro enterologist for screening about the relapse of the cancer. First you consult a physician for treatment of commen causes. I advise you to follow some diet recommendations as avoid taking more of spices, junk foods, and oily foods, to minimise the irritation to the gut. Wishing for a quick recovery. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump in testicle?\n\nI have a small pea size lump in my left testical. It has a sharp like littel peddle. Ha dit checked out 30 years ago when it was hard to find. Felt more like a tiny little sharp pointe pebble. Doctor said nothing to worry about than. Over the years it had become a bit bigger, more like a tiny pea. No pain or swelling. Should I have this checked out again after so many years?",
    "doctor_response": "Hi,Dear,Thanks for your query to HCM.Dear I read your query and reviewed it with context to your query facts.Based on the facts of your query, you seem to suffer from-Lump due to hydatid Cyst of Morgagni of Testes-which is a vestigeal Appendage / also known as Appendix of testes -present on top of testes.USG would confirm or rule out this lump cause.Other causes could be Spermatocele/ Vasectomy lumps etc. and would suggest to have Second Opinion from Surgeon who would physically examine and verify other possibilities of such  a painless lump in testes.Hope this would help you to plan further treatment with your family and specialist doctors there.Welcome for any further query in this regard.Good Day!!Dr.Savaskar M.N.Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the possible treatments for mild prominence of left pelcicalyceal syatem ?\n\nMy report says mild prominence of left pelvicalyceal system. Left kidney (size measures 11.0cm in length and 1.2 cm in parenchymal thickness) normal in position, size, shape and echo pattern. Corticomedullary differentiation is maintained. No definite renal calculi. Prominence of pelvicalyceal is noted. Ureters is obscured by bowel gas",
    "doctor_response": "HIThank for asking to HCMThis is the anatomical structure of kidneys here the urine collected drops by drops, in your case this  becames prominence, means obvious, this is only happens in obstruction ahead, but nothing such obstruction detected, so nothing to worry about this, have nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can groin area dryness with sensitive skin and itching be treated?\n\nHi, may I answer your health queries right now ?  Please type your query here... below my penile side my both sides of skin becomes dry and become very senstive i apply itch card the itching cream but it is not working its become very senstive and my skin colour change into red and black kindly tell me what is the problem",
    "doctor_response": "Hello. Thanks for writing to us at healthcaremagicMost likely it is a fungal infection; fungal infections are common at sites such as groin folds because the fungus gets a chance to proliferate in the moist, humid conditions that prevail in the folds, specially in hot and humid weather conditions like tropical countries.If I was the treating doctor I would have asked you to use a topical cream containing antifungals like either Sertaconazole Or Luliconazole Or Bifonazole, twice daily for 4-6 weeks.I normally also ask my patients to take an oral antifungal because the condition may not respond adequately to just topical antifungal creams. Oral antifungals like Fluconazole, Itraconazole are faster acting and therefore rapidly effective in this condition.An OTC oral antihistamine e.g cetrizine 10 mg once daily will provide you symptomatic relief from itching.I would suggest that you visit a dermatologist for a confirmatory diagnosis as well as appropriate prescription.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to cure infertility?\n\nhi, I am 33 years old, had laproscopy done in october2009 (left tube tortuous) My husband's semen's count and motility(active 10% sluggisg 55%) is pretty low.now doctor told left tube blocked.normally egg formation in leftt overy normal.3month before tb pcr detected positive in mensual sample.after that i m on AKT3 .one time conceive normally & one time with iui (both lasts only for 45 days) please sugest the treatment and doctor in gurgaon delhi",
    "doctor_response": "Hi, I have gone through your question.Since your one fallopian tube is blocked and your husband's semen parameters are deranged, conceiving naturally is difficult.In your case, you should undergo at least 3 cycles of IUI followed by in vitro fertilization or ICSI (intracytoplasmic sperm injection ), if IUI fails.I would suggest you to consult an infertility specialist and take any further infertility treatment after completing the course of antitubercular treatment.Hope you found the answer helpful.Wishing you good health.Regards,Dr Deepti Verma",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and pain in the calf muscle?\n\nMy 56 yr old husband who has A-fib, is on coumadin and INR is in therapeutic range, struck his left calf on a lawn chair about ?5 days ago, and is now complaining of pain. (we were at a concert last night, and he was standing a for a few hours). It is NOT warm, no redness. The left calf is swollen, it was about 1 inch larger than right last night. He has been off his feet today, sitting in recliner, and ice pack to injured calf intermittently. No SOB, no Chest pain. I am an RN, and fairly confident it is a muscle injury, or ? tendinitis. We will see his reg MD tomorrow, but thot I would ask your opinion about waiting until tomorrow am. Onset of pain was last evening. He says it feels better now that he has been imobile, and ice packs.",
    "doctor_response": "hiicing is good .give some tylenol and ask him to keep leg elevated .it is good idea to visit a doctor for assessment physically as some history suggestsbest wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "Cause of a painful bump in the throat\n\nHi I just sneezed and heled it in a little bit i think, but now my throat feels as if their is somethign stuck inside of it like i bump or lump it doesnt hurt when I drink but it irritates my throat like the bump i rubbing against something, I have never held my sneeze in before but I think i may have on accident causing this pain in my throat can you please help?",
    "doctor_response": "sneezing mean allergic this may be acute alergic sinusitis or chronic which can be confirmed by getting xray pns waters viewntinue 3 week hich is minimum course in allergy the allergy causes mucus to fall down in throat as post nasal drip which causes the same explaind by youcan take doxycycline 100 mg bd for 5 daysadd antiallergic fexofendaine 120 mg bdantacid gel as pnd causes gerd apply neomycin h eye ointment n nose bd and sea water 2 drops at night each nose to clear back of throatcntinue 3 week as it is minimum course in allergy",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any vitamin or massage for facial seizures?\n\nMy brother suffers with uncontrolable facial seizures. He started taking botox but it had bad side affects to it but it controled it for a short while. I would like to know if there is a vitamin or massage to his face or something that would relief him of this.",
    "doctor_response": "Hi no there are no vitamins and massage for facial seizures to control it.It can be controlled by antiepileptics .Medicines used are tab clobazam, tab gabapentin,tab levepil.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lump on back of heels\n\nI have a lump on my back that feels like a large air pocket, it isn t swollen nor does it hurt, no crackling sound when touched, and is about the area of a tennis ball or smaller. the lump doesn t feel like it contains a fluid, just air like. i do have pain to the left of the lump or swollen area, but it feels like a tight muscle. any ideas?",
    "doctor_response": "Hi,Dear thanks for the query to HCM virtual clinic.I studied your query in full details updated from you.I understood your health concerns.Based on your query data, In my opinion ,Dear You seem to suffer from Back Lipoma mostly as its non-tender and is common site for Big Lipoma.Sebaceous Cyst needs to be ruled out by USG study of the lump and by a Second Opinion from Surgeon.If the lump is on the heels as said in the heading,  which exposes the confusion by oversight/or typing mistake.Still if it is in the back of heel, TendoAchilles Bursa needs to be ruled out, from ortho Surgeon.Treatment-Would vary depending on the cause of the lump on the back  or on the back of the heels.Surgical excision if it troubles you is advisable.Else it is a benign tumor and need not worry unless its of cosmetic or pressure symptoms,for which I would suggest you.Hope this would resolve your query and worry and Anxiety accompanied with it.Welcome for any further query in this regard to ME.I would love to help you out.Awaiting for any further query.Wish you fast recovery from this intriguing health problem.Have a Good Day.Dr.Savaskar M.N.M.S.Genl-CVTS -Senior Surgical Consultant",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes lump above ankle?\n\nI have developed a small lump, about an inch in diameter, several inches above my ankle. It is soft and when I touch it there is a slight burning sensation in the skin. Also I have a slight dull ache that fades when I am standing, but runs thought the entire leg. I am only 26 and have an appointment in the morning, but am having some anxiety. Any ideas what may cause this?",
    "doctor_response": "Hi,Dear,Thanks for your query to HCM.Studied your query in full depth of its details.Reviewed it in context of your health concerns.Based On the facts,You seem to suffer from-Varicose Veins with Incompetent perforator vein just above ankle,with slight burning sensation due to Sural Neuropathy from Cellulitis of the leg tissue around the long saphenous tract,along which the sural nerve passes down the leg.Color Doppler Study of the Deep and Superficial Long and Short Saphenous Vein would confirm the accompanied DVT with incompetent perforator vessel causing the soft sore lump in the leg above.Thus the cause of this lump could be due to DVT  of the Deep Popliteal Vein with Varicosity of the perforator vein.Pain throughout the leg on standing, indicates the Short Saphenous Varicosity .Hope this reply would satisfy you and would help you to plan further treatment with your doctor there.Welcome any further query in this regard,which would be replied in next session..Good Day!!Dr.Savaskar M.N.Senior Surgical SpecialistM.S.Genl-CVTS",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it good to take siphene 50 mg while trying to conceive?\n\nMadam, I am Smitha, married last yr ( now 1yr) . For 6 months we are in planning. But now we want a baby. My height is 150 cm. weight 78.  US report PCOD. FSH, LH, Prolactin, TSH are normal. Now Metformin tablet is used regularly. One Dr. prescribed siphene 50 mg. is it good for me?",
    "doctor_response": "Dear Smitha, Polycystic Ovarian Syndrome (PCOS) is a condition which is characterised by infertility due to non release of the eggs (anovulation) from ovaries. Along with, there are high levels of Insulin and Androgens. Siphene contains Clomiphene citrate as an active medicine. This medicine helps inducing ovulation. Since the Insulin levels are high, adding Metformin helps success to Clomiphene citrate by reducing Insulin. There is another view that Myo inositol reduces both the Insulin and androgen levels and hence has better success than Metformin. Clomiphene citrate should be tried for not more than 6 cycles. If it fails, then some other medicines like HMG/hCG combination should be tried. You seem to be rather obese. Obesity also is a classic feature of PCOS. Please modify your diet (high protein, low fat and low carbohydrates) and start daily exercises to bring down your BMI between 18 and 23.9. All your other reports are within normal limits. However, please get your husband's semen also tested in a laboratory. I hope this provides you some guidelines based on your brief history. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchiness after eating seeds and nuts?\n\nMy fiance is 78 and he is allergic to soy. He gets itchy after eating seeds and nuts and some fried foods. My question is what is the best to use for frying? I use vegetable oil most often. I don t fry many foods. Is shortening a better choice? What works best on the itchy rash that he gets? Thank you",
    "doctor_response": "Hello,        The frequent itching after eating seeds and nuts and other stuff indicates allergy to that food and allergy leads to a reaction which may cause rash, itching and burning sensation in skin etc. symptoms. So try ti*You can use olive oil, sesame oil,coconut oil, butter etc. for frying instead of vegetable oil for frying.*On itchy rash apply lactocalamine lotion as it will help in soothening of skin. Also give him anti allergic tablet too after getting a rash, you can give him a tab. cetrizine in a stat dose.*If problem is troubling him more then do visit a nearby dermatologist.*I hope you find my answer helpful.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes discomfort in the right foot long after treating plantar fasciitis?\n\ni have discomfort in my right foot in the arch area that stops me from aerobic exercise (bouncing). I have had planters faciitis in the past but it does not feel the same now. I have gone to two doctors and one gave me a cortisone shot that really hurt and the other took an xray and said nothing was wrong. It is very frustrating as it limits my ability to work out. Every day since I sit at a desk every day it does not seem to bother me. On weekends when I am on my feet all day it throbs at the end of the day.",
    "doctor_response": "Dear patient if pain is at the arch of feet and occurs on increased walking reason may be flat foot. In this condition there is loss of normal arch of medial side of feet. It may be mobile or rigid. Diagnosis can be confirmed by clinical Examination and weight bearing lateral xray of the feet. treatment is shoes with medial arch support. You can take tab diclofenac sodium 50 mg twice a day for pain relief. If xray is abnormal please consult foot specialist around you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Will Kalarchikai cure multiple ovarian cysts in PCOD?\n\nHello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well.",
    "doctor_response": "Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Any suggestion for severely swollen hip from hip injury?\n\nMy boyfriend was in a motorcycle accident a year ago. He hit his hip very hard when he went down and the injured ared was at least 10 by 10 inches and was Severely swollen. Dr s told him it would go away in a few months but it hasn t. What kind of Dr. should he see to address this continuing problem?",
    "doctor_response": "Hello, It might be a contusion or fracture. Consult an orthopaedician at the earliest and get evaluated. An MRI scan is required for further evaluation. As of now, you can use analgesics/anti-inflammatory combination like aceclofenac/serratiopeptidase for symptomatic relief. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of back pain?\n\nDear Sir, My age is 31 years. I am suffring in back pain (upper side of back near neck). The pain starts at midnight and after this I cannot sleep easily. I am regularly using Diclofenace Sodium 100mg two times daily and Mecobalamine 500mcg three time daily. Please help me I am in Pain.",
    "doctor_response": "Hello, Thnx to contact us. I understand your concern. If I am your doctor I advice you to do physiotherapy exercise to strengthen your back muscle. Analgesics you can take as and when required but it is not he definative treatment. You should also think of getting X-ray chest and neck for vertebral abnormality. You can also think for heat therapy to reduce pain. In long duration of treatment exercise is the only way of reducing your back pain. Please do Serum Vitamin B12 and Vitamin D level to check for any abnormality.I will be happy to answer more of your concerns, kindly know me,Wish you a very good health at health care magic. Dr. Arun Tank. Infectious Disease.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why have I missed my periods this time?\n\nHello doctor, Three months ago, I had sex with my partner. Fourteen days later, I had my normal periods. But now two months have passed by and I have not got my periods. Moreover, I have used home fertility kit and that has shown negative results.  Am I pregnant?   What is the reason for my missing periods?",
    "doctor_response": "Hello. If you had a period after intercourse which is totally normal like the ones you had before, in terms of flow and days, it is highly unlikely that you would be pregnant. Also, you have stated urine pregnancy test is negative. So that goes against too. There could be many reasons for a missed period. I suggest you try a simple progesterone, Medroxyprogesterone 10 mg daily after food for five days. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. You should expect your period to come after completion of the doses between 48 hours to seven days. If you do not get it even after that, it is better to consult a gynaecologist physically to rule out other causes as well. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair loss and dandruff\n\nhello doctor am karthik am facing problem from hair loss and too much dandruff which was oily and my hair is losing in a pattern from front side can u suggest me to restore my hair lost and to reduce dandrufff.   my friends told that if we use helmet then hair loss will be increased how much is it true can any one give me",
    "doctor_response": "Hi,You seem to have seborrheic dermatitis on scalp. There may be flakes on scalp. It is an inflammatory skin disease. There may be some triggering factor. Stress,anxiety,sleeplessness,yeast like mellassazia on scalp..etc might trigger. It may be responsible for hair loss.You consult dermatologist for firm diagnosis and treatment.I would like to suggest as follow...- apply mild steroid with salicylic acid lotion on scalp at night.- cleanse the scalp with ketoconazole with salicylic acid shampoo alternate days while bathing- tab ketoconazole daily for 2 to 3 weeks- tab biotin 10 mg daily for few months to control hair fall- avoid stress and worriesI hope this would help you..Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment should I take for swollen in Shoulder and pain?\n\nI am due to have a total shoulder replacement on May 12. At this time, my shoulder is very swollen and I ice it but the swelling continues to reappear and it is very painful. I do take pain medication but it only relieves the pain for short periods. My concern is the swelling and it is often very warm where it is swollen. Should I be worried? Could there be an infection? I have had 11 screws and a plate removed from my shoulder and it began to fall apart. There was a significant amount of arthritis that they scraped out. But right now, I am very worried about the swelling. Thank you for your time, Robin.",
    "doctor_response": "there is very high chance that it can be infection and so you need to go to doctor and do some blood work. If there is any suspicion and blood work shows some positive results then you need to take antibiotics as per your consultant's advise.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chest pain?\n\nThe center of my chest popped and pain is coming and going. Feels like i cracked my chest plate and its kind of hard to breath without feeling some pain. Im very worried because im uninsured and cant afford to go to the hospital. What is wrong? Is it serious? This has been happening for about a year or 2 and gets worse as years go by..",
    "doctor_response": "Thanks for your question on HCM.I can understand your problem and situation.Since you are having problem since 1 year, I think you have anxiety and related GERD (gastroesophageal reflux disease) associated symptoms.But better to get done ECG to rule out cardiac cause for your problem.If ECG is normal than no need to worry much for cardiac cause.Anxiety related symptoms are more suggestive in your case. GERD is due to laxity of gastroesophageal sphincter. So acid of the stomach tends to come up in the esophagus and cause central chest pain. So treatment of anxiety is needed to control GERD symptoms. So avoid stress and anxiety. Be relax and calm. Avoid hot and spicy food. Start proton pump inhibitor. Don't worry, you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes coughs after orgasm during masturbation?\n\nHello. I m 21yrs old and have just started masturbating, I have observed that I end up in short series of coughs after an orgasm, and this has continued for a few months, could you please tell me what reasons could imply to this and if there is anything to worry?",
    "doctor_response": "DearWe understand your concernsI went through your details. Masturbation is not an unhealthy habit. Masturbation is normal and natural. There is no reason to get short series of cough after masturbation. But you must address two things. First, masturbation do consumes energy and therefore you strain much during masturbation. This strain always could interfere with respirator organs. You should consult a physician to assess the possibilities of respiratory problems.Second, apprehension and obsession related to anxiety can cause repeated symptoms. Whenever you masturbate, you are expecting these cough because you had it last time. Such expectation can cause the cough itself. You may consult a psychologist for further advise. If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tingling in right side of head, hot flashes in face and right ear, nausea, pain in right ribs with headache.  History of AVM on right side of brain in childhood.  Connection?\n\nI have been having these symptoms for over a year now. It usually starts by having chills or a tingling sensation on right side of my head, and then usually the right side of my face feels hot including my ear. I get nauseous, I go to the restroom and go to the sink but when I gag nothing comes out. I have been getting sharp pains in the right side under my ribs out of nowhere. There was this only one occasion that I had blood in my stool. After I have these \u201cHeadaches\u201d my head just feels like it\u2019s bruised or swore, it\u2019s a weird sensation that I really cannot explain. They come like the rhythm of a heartbeat. I have tried Tylenol for many times but it\u2019s a disappointment, it usually does not work so I try to sleep it away. When I was at the age of 6 I had a Brain AVM (arteriovenous malformation) on the right side of my brain. Last month on the 11th I went to the doctors and had a UTI (urinary tract infection).What I\u2019m trying to find out, if these \u201cheadaches\u201d are normal I guess for a person like me who had an AVM, or is there something I should be worried about.",
    "doctor_response": "the most common diagnosis with these symptomps are sinuses and as theyare nvolved here are recurences of symptomps off and on andheadaches like thissuggest you to get xray pns waters view and get consultation from doctor and treat accordingly",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dehydrated, given I V fluids, experiencing severe lower abdominal pain, stool black . Does this have anything to do with dehydration?\n\nIt was extremely hot here yesterday over 94 degreees and I passed out and was taken by ambulance to the hospital . They said I was dehydrated and gave I V fluids and sent me home . Last night I experienced severe lower abdominal pain and today my stool is black . Does this have anything to do with dehydration?",
    "doctor_response": "hello, black stool could be due to dehydration or medicines. take plenty of liquids l if you donot improve fast see a physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for lower calf muscle pain of right leg\n\ni have been running since January and managed to get up to 6 miles . But now i am unable to run a mile without my right lower calf feeling very tight an heavy . I am trying ti train to do a half marathon in June . I also swim twice a week and have joined a milatry fitness group twice a week too . But my right leg is oreventing me from getting any further with my running . i have no idea why it has suddenly started doing this .",
    "doctor_response": "Hi welcome to health care magic.  Thanks for your query. After going through your history I am in opinion that you have stress fracture of leg bone.To confirm please visit orthopaedician and have an XRay of leg get done. Now you should avoid running , take rest, analgesics. If fracture confirmed on XRay than continue rest plaster or crepe as per requirement (as advised by orthopaedician).I hope your query get solved. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Experiencing pain under the front rib due to a fall\n\nlast week I had a fall where I got knocked to the ground by a charging horse. I blacked briely and had a headache and whiplash for a couple of days. Theses have now gone but i also had a pain under my front ribs that felt like i had been doing sit ups and had sore stomach muscles. This has persisted, any clues. I didnt get any medical treatment as I live too far away from a town.",
    "doctor_response": "any contusion on the rib causes this type of pain and takes a lot of time to get relived. this could well be a contusion from the fall and shall go off slowly. this may upto 3-5 weeks of pain killers hot fomentation and application of local pain killer ointment or jelly",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the ball type tissue that is left after a tooth fall?\n\nI had a tooth that was behind my adult tooth.  it fell out today about 30 mins ago, and it left behind a bloody ball type thing behind my adult tooth.  the tooth that fell out was holly and had a chip in it( a hole actually) when i had chipped it a few months back is this ball something i should be worried about??",
    "doctor_response": "The tooth that gad fall out would be a supernumerary tooth...A supernumerary tooth is a xtra tooth apart from the tooth which should be there in the oral cavity...it looks like a normal tooth in shape and size..They are generally located behind the normal tooth but can found anywhere Buccal,  Lingual,  Palatal, Distal or Mesial...Now if it had fell of of its own....bloody ball may be just residual plugg which was left after tooth fell off..The plugg actually contains blood, soft tissue remnants ....I wud suggest you to visit a dentist so that he or she will curettage the socket...and clean wid betadine in order to avoid further infection. Hope this will help you...",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for severe cough and breathing problem\n\nHi doc my sister is 35yrs old and is currently in hospital with severe asthma and lung infection. she had been coughing incessantly for over a week and had to be admitted four days ago coz the cough made it impossible to breathe and she nearly choked a couple of times. All her reports are normal but doctors are unable to diagnose what the priblem is.... she is on direct oxygen support and steroids and the highest dosage of meds... she is too weak to even open her eyes or cough... docs are saying that they have never seen such a case before...  she is not an asthma patuent but about ten years ago when she had her second son she had had an asthma attack.but any leafs would be helpful....... i know this may not be much to ho on",
    "doctor_response": "Hello dear.Take few general curative steps like:1. Stay Hydrated2. Try Lozenges and Hot Drinks3. Take Steamy Showers, and Use a Humidifier4. Remove Irritants From the Air5. Drugs:- Decongestants:Tablet Diaminic DA twice daily for three to for days- Cough suppressants and expectorants: dextromethorphan,guaifenesin.- Take Deriphyllin Retard 300: For effective control of asthma and daytime wheeze Hope this may help youTake careGet well soon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hepatitis b\n\nhello, my name is nurul islam. i am 42 years old.I live in Bangladesh. Doctors have said that i have hepatitis B and there is no treatment available for hepatitis B here. What should I do,, I have got my passport for kolkata for  Treatment but dont the know the procedure.. Please help",
    "doctor_response": "Hi thanks for asking question.Let me know you for chronic liver infection by Hepatitis b there us no treatment...If you are in active stage that is determined by HBV DNA, HBeag , liver enzymes then specific antiviral medication can be taken...Here take good life style measures with follow up regularly to avoid complications......Take low fat diet.Avoid alcohol.Trans fat like cheese, butter, non veg and refined food avoided....Take fruits more like papaiya.One tsp cumin seed with water can be taken..Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is ti safe to take ovaflo capsule for pregnancy?\n\nhi my name is parinaz i have consulted to doctor regarding the nonconfetmation of pregnancy docto has done the all my reports,sonography&also follicular study.but my report&follicular study all r clear &she found that my egg is also grownup propley still i am not getting pregnant.now i am taking ovaflo capsule so how many chances to getting pregant& what r the reason that i am not getting pregantu",
    "doctor_response": "Hi if all your reports are normal then you should take medicines for ovulation.  Ovaflo can increase number of eggs but it doesn't help in ovulation. Talk to your doctor regarding this.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the treatment for increasing streach marks?\n\nHello doctor, I am suffering from severe stretch marks problem, which is increasing day by day. What can I do to get rid of it? And also I want to remove the old marks which are present near my belly, armpits and above shoulder. Please help.",
    "doctor_response": "Hello. Please do mention your age whenever you ask any query in the future. If your stretch marks are new, then it will be reddish. If it is old it will be whitish, the response to new stretch marks are good whereas old ones respond less to creams and ointments. Please try shea butter or cocoa buttercream in the day time and Retin-A (Tretinoin 0.025 %) cream at night for a month. If you do not find any response, then you have to visit a doctor to undergo laser therapy.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest implications of pulmonary hypertension\n\nhi..my husband has pulomnary hypertension, so i m very much worried about it...else he has good health regularly exercise , take medicines, but Dr has not reduced medicines...what is impact of pulmonary hypertension ? can this really be fully cured ? pl revert.thanks",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. Pulmonary hypertension (PH) due to pulmonary embolism (PE) can be cured. All other causes of PH are not curable. We can oy control the progress of disease with medicines. So you should continue PH medicines in your husband's case life long. With medicines, progression is good and patient can live normal life. Hope I have solved your query. I will be happy to help you further. Wishing good health to your husband. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have stomach swelling, tenderness, headache and nose bleed. Suggestions?\n\nHi,I have had stomach swelling and tenderness for the past couple of weeks.Sometimes the pain is so bad in my lower abdominal I have to stop and bend to realise it.For the past few days I have had a head ache.In the middle of my head mainly near the bridge of my nose.Yesterday I had a really small nose bleed but then today I had one that lasted 10 minutes.My head ache was so bad after this.What could this be?",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for calling H.C.M.Forum. You had pain abdomen, swelling, in the lower abdomen for the past couple of weeks. You also had head ache and nose bleed(epistaxis)  on two days. It could be fever with sinusitis and cold which resulted in epistaxis and headache. The pain abdomen could be due to urinary tract infection, or a stone in the urinray bladder and also would have caused headache. I advise you to consult a physician for diagnosis and treatment.you may need to have M.R.I. besides other routine tests for confirmation. Wishing for a quick and complete recovery. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause fever in my three daughters ?\n\nI have three daughters who all have been running fever the past 2 days. I have been  alternating tylenol and ibuprophen. Fever was all but gone today. But now 2 of them have blood shot eyes. Don't know why, they have never done this before. Does not seem to be bothering either child. I teach school and I have seen pink eye and this does not look like that. What should I do?",
    "doctor_response": "thanks for posting your query to HCM.As I understand it is due to some kind of infection probably viral but may be  bacterial or parasitic . to dignose infection you need to consult your pediatrician and take proper advice to investigate and manage .for symptomatic releive you can continue the medication which you are taking .Along with this maintain hydration and provide good nutritious dite .take care .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Due to scratch, white part of eye is with some blood. What to do?\n\nHello doctor, Due to scratch in my eyes the white part surrounded with blood. What to do?",
    "doctor_response": "Hello. How did you get this? Because of the bleeding, the depth of the wound could not be perceived. If it is not severe enough just with bleeding there is not much problem. Just the point of worry is that the wound should not be open or otherwise it may be problematic and may require suturing. So you should seek emergency advice as well so that somebody can examine it. Until then use Moxitobra (Moxifloxacin) eye drop two hours one drop in the right eye only. Refresh tears 0.5% eye drops QID one drop in the right eye only. Avoid any kind of undue pressure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Completed three cycles of chemotherapy for mediastinal seminoma. Kindly advice.\n\nHello doctor, Can you interpret this for me? Recently diagnosed with mediastinal seminoma and completed 3 BEP chemotherapy before five months.",
    "doctor_response": "Hello. There are some lymph node-like structures in the chest area which take up radiotracer, and it will help to study the complete series of images of your scan. A diagnosis of cancer always requires a biopsy. No treatment of cancer is justified without biopsy confirmation. Many conditions, including disease and infections and inflammations will take up the radiotracer as visualized in your scan. Even in cancer, the lymph node decrease in number and size is not predictable. If your recent CT scan shows persisting lymph nodes, then another biopsy might help. Please get a second reading of the biopsy slide done if needed.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for constipation in a child?\n\nHi, may I answer your health queries right now ?  Please type your query here...My 5 month old is doing stringy poo's, after being quite constipated. She was exclusively breastfeed, recently we introduced a formula feed at night time. Is this normal?",
    "doctor_response": "Hi you have a baby of 5 months age and you have introduced a formula feed,baby  constipated.Recent guidelines suggest  exclusive breast feeding for 6 months and may be you can wait for another one month .After that period start feeding with spoons so that he/she will adapt to solids easily and will not be dependent on feeding bottles .Hope this feedback helpl!!Feel free to contact us for queries..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Need medicine for cough\n\nI have a prolonged cough for about two months,I have tried Antibiotics,cough syroup,and some natural way of treating cough.I also have been prescribed for an alergic medication.However with all the above curing treats I am still experiencing the cough.I really do not know what to do .Any advice please",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. You are having chronic cough. And you are not improving with routine drugs. So possibility of chronic lung infection or bronchitis is more.. So better to consult pulmonologist and get done clinical examination of respiratory system. Also get done chest x ray and PFT (Pulmonary Function Test). Chest x ray is needed to rule out lung infection. PFT is needed to rule out bronchitis. So better to first diagnose yourself and then start appropriate treatment. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for chest pain?\n\nI am 23 and been having serious pain in my chest and the pain comes and goes origin my arms and back as well I feel weak and tired and just hurting all the.time what's going on with meI have been having these really bad chest pains where it gets so unstable it makes it hard to breath it gives me these really bad headaches and back aches it makes my arms hurt and my body just feels so weak and not right ... I am a 23 year old mother to a four year old son I shouldn't be feeling like this what is going on with me ...I mean the pain. Will come all threw the day worse at night and in the mornings what's wrong with me I've been to the emergency room here where I love and got called ridiculous and that im crazy its all in my head but I know what im feeling im not just image I bing all this please someone help",
    "doctor_response": "Thanks for your question on HCM. I can understand your situation and problem. In my opinion your all symptoms are anxiety related mostly. Because at your age (23), cardiac diseases are uncommon. But better to get done ecg, if this is normal then no need to worry for cardiac cause. Get done chest x ray and PFT (Pulmonary Function Test) to rule out asthma or bronchitis as a cause for your breathlessness and chest pain. If both these are also normal then anxiety is the likely cause for your symptoms. So better to consult psychiatrist and get done counseling sessions, try to identify stressor in your life and start working on its solution. You may need anxiolytic drugs too. So avoid stress and tension. Be relax and calm. Don't worry, you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can a ganglion cyst in the knuckles be treated?\n\nhello I am a 22 y/o female and I have been told I have a ganglion cyst it is located between my middle and my pointer finger on the knuckle and it is coming from the middle finger knuckle I have been to two dr about this and had it removed 3 times already and It keeps coming back and I am in a large amount of pain because of it I am now looking to other options and would like to know what you think the first two surgeries are by the same dr first time size of a grape second time two of the twisted together and third by different dr and size of a large grape I am very confused on what to do and I would like other options because it will problly come back again if I have surgery for the 4th time please give me your option I live in south Carolina and I want this thing gone for GOOD thanks",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. You have ganglion cyst.  It is a benign cystic lesion.  But its known gor recurrence.  Complete excision of ganglion cyst is required.  You should go for complete excision of cyst.  Drugs will not help you.Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment if half of the face cant feel anything ?\n\nhello, My name is Daniel, I have been having problems, with my right eye and low jaw, just half of my face, sorta of can t feel it, the right side I tried to whistle like I always do, but now I can t my lips like goes to the side is there something I can do, I have cure or treatment...",
    "doctor_response": "Hello, Judging from your description it sounds like facial nerve palsy, otherwise called Bell's palsy. In most cases it is benign and most patients improve spontaneously over several weeks. Medication with steroids and antivirals may help regeneration if started in the first few days. However, in some cases, it may be in the setting of a neurological condition or metabolic issues like diabetes. So you must be checked by your primary physician or a neurologist for other possible signs which would warrant MRI imaging as well as testing for diabetes. As I said in most cases it is isolated and improves spontaneously with tests turning out normal, but you should be seen to confirm the diagnosis. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Olsi Taka, Neurologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am spotting for the first time. Does it mean I am pregnant?\n\nHi doctor, I am on the pill Lo Loestrin, but I have not been consistently taking it. My last period was on the 25th of last month and my average cycle is around 28 days. My husband and I had unprotected sex on 5th and 6th. I noticed some dark brown discharge on my underwear. When I wiped, it was mixed dark brown and red strands of blood. It has been more than 24 hours and very light when I wipe. I also have been experiencing soreness and light cramps as I would feel in the beginning of my period. However, the discomfort in my abdomen is located on one side and it comes and goes. I have soreness in my legs, lower back and breasts. I also have been experiencing some aching sensation in my vagina. I have also experienced sudden feelings of nausea, but it has not lasted very long. When I began spotting, I was very surprised. I have never spotted between periods before. I am not sure if this is because I have missed taking my pills or if it is implantation bleeding. I have been driving myself crazy by thinking that I could actually be pregnant. The thought of having a baby makes me so excited. But, I do not want to get my hopes up. Please clarify.",
    "doctor_response": "Hi. The spotting that you are experiencing is probably you have not taken the pill regularly and withdrawal due to that. You had unprotected sex on day 11 and spotting on day 16. I do not think it is implantation bleeding. However, if you are keen to know whether you are pregnant or not, then you can get a blood test beta hCG (human chorionic gonadotropin) and see the value. Wait for your normal cycle and if you do not get periods, then get a TVS (transvaginal scan) done. If you are keen to get pregnant then you should not take tablet Lo Loestrin (birth control pill) since it is a contraceptive. If you are taking it without fail, then you need not take any other precaution. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Rashes on arms and chest, small dots, no itchiness, burning sensation present. Cure?\n\nI have rashes that come and go on hands arms and chest . Most of them are like scratches and some if them look like small dots. The rash does not itch but burns. At the onset I was feeling sick but that passed after a couple if days. I am now dealing with this rash. I have an appointment with a dermatologist , but I am freaking out with these rashes. I am very stressed out over this any advise will be truly welcomed.",
    "doctor_response": "Hi...user., It could be Irritant Dermatitis.., use Caladryl lotion topically.., oral antihistamines.., it is due to mosquito bite allergy or dust",
    "dialogue_context": ""
  },
  {
    "patient_message": "What re the side effects of Althea pills?\n\nCAN I ASK SOMETHING,IM SHE, 23YRS. OLD.IT IS OK TO TAKE ALTHEA PILLS WITHOUT HAVING SEX INTERCOURSE, AND ALSO TO SKIN TO MAKE GLOW & SMOOTH. AND MY MENSTRUAL COMES EVERY 3/4 MONTHS..ITS NOT REGULAR..IT IS OK TO TAKE THIS PILLS?I WAIT YOUR ANSWER PLS..",
    "doctor_response": "HiThe cause of such irregular period should be identified before treatment with hormonal pills.Treatment of the cause rather than the symptoms can produce lasting results.Polycystic ovaries,obesity and hypothyroidism,Anemia,Lower than normal body mass index, Crash dieting,stress can all cause delayed or irregular periods.The cause should be treated effectively.Any history excess facial hair growth,acne and weight gain should be ruled out.Pelvic ultrasound,Thyroid tests,complete blood counts should be done to further manage the symptoms.Hormonal pills can be started once hormonal imbalance is identified.Hope I have answered your query. Let me know if I can assist you further. RegardsDr.Saranya Ramadoss, General and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Teeth seemed to have changed positions after using OTC night-guards. Will it go back to normal on its own?\n\nHi! During my last dental check up I was told I would need a nightguard. I was very busy with exams and then was going on holiday so I didn t have time to make an appointment. Instead as a temporary fix I bought one of the OTC nightguards. Now my teeth seem to change their positions. Are they going to go back on their own? If not will fitting the custom-made nightguard have to wait? Thank you for your reply!",
    "doctor_response": "hello and welcome to HCM forum, nightgaurds are meant to gaurd you teeth from any kind of trauma, custom -made nightgaurd fits well and does not cause any movement of teeth, but in your case,it seems OTC nightgaurd has caused slight drifting of teeth, it happens because of the ill fitting, and excessive pressure applied by it on the teeth. therefore i would suggest you visit a dentist soon, so that you have your own nightgaurd which is comfortable to wear and without any side effects. till then do not wear any nightgaurd until your your dentist advises you . do not worry, your teeth will be fine and back to their original position on its own. i wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of abdominal pain with constpation when on fertomid?\n\nMiscarriage before 9 months then doc said to take a gap of 6 months for again trying for a baby, now doc has suggested fertomid 50 and duphaston 10 mg(1/2 tablet) since 2 months. Now I have a lower abdomen pain during ovulation with swelling in abdomen and constipation. How much time it will take to conceive again ?",
    "doctor_response": "Hi.I can understand the problems you are going through.Both the medicines have their own untoward effects as you have.I would suggest such patients to undergo ovulation study by ultrasonography and see if the ovulation is occurring or not and what is the exact problem during ovulation.No one can really tell how much time would it take to have a conception",
    "dialogue_context": ""
  },
  {
    "patient_message": "Whatc asues abdominal pain radiating to back?\n\nI m a 49 y/o white female. I started with MCD and was placed on a steroid regimen. I took 80mg a day for almost 3 years. I am now at ESRD and have dialysis three times a week. About a year after becoming diagnosed with hinder disease I started suffering from debilitating abdominal pain primarily RLQ. I have had a TAH with BSO, chole, and appy. We have had numerous endoscopes and colonoscopies. All normal. I m now having diffuse pain through the abdomen radiating it my back. I was finally allowed to have a CT with contrast and it showed pancreatic atrophy. I also have fibromyalgia, osteoporosis, hyper parathyroidism. The pain have increased exponentially over the last three years. What are my options. I m going to see my primary care physician next week. Also I am not showing signs of DM but haven t had an a1c yetd",
    "doctor_response": "the symptoms are related to pancreatic disease and due to fibrosis in the region with trapping of nerve or pressure on the fine nerve bundlesyou could consult a rheumatologist and once the primary disease is treated all symptoms will be out!all the best!",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce HCG level (22) incase of chemical pregnancy?\n\nHad a chemical pregnancy on 11/12 - hcg still hovering at 22.  Ultrasound shows normal - want to avoid a methotrexate (?) shot as well as a d&c.  Is there a way to reduce my hcg level?  I want to let my body do this on it's own, but my doctor is making me nervous!",
    "doctor_response": "Hello,Serum beta-hCG levels usually take 3-4 weeks to come down after an abortion; sometimes as long as 6 weeks. The prior values influence the time taken for this fall in titres. Meanwhile, a follow up trans-vaginal sonogram should be performed to see if there are any retained products of conception and if this so, you will need a check curettage. There are no treatment methods available to reduce the hCG titres as such. Medication such as that prescribed by your doctor is given when the titres are abnormally high even after 6 weeks. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes tightness in right arm ?\n\nHi, I have had a bump on my neck right near my hair line for a about 2 or 3 years now. I m not sure if i should get it checked out. But recently my right arm/hand has been feeling tight in the mid afternoon, I have scabs on my arms from scratching, feel like i ve been breaking out a lot. I m not sure what to ask my doctor?",
    "doctor_response": "hiYou may consult a physician for checking of lump.he shall tell you what is the cause andorigin and may ask for tests as required with x ray etc.You have to give history how it arose, and whether it is slowly growing or stationary, any associated constitutional symptoms like fever,mailaise or appetite loss, any tingling and numbness and about skin rashes.the doctor will help youthanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of following masturbation?\n\ndoc am from india can u plz tell me i use to masturbate since 7 years and now my age is 20 and am getting worry that it will effect on my real sex life after marriage that i will never give a birth to my child is this ture  and every time i try to stop masturbation it wont why doc plz help me really am worry about this",
    "doctor_response": "Hi, Masturbation is normal, it\u2019s just another way of having sex without partner. It\u2019s a good practice , helps to calm your mind and release happy and stress bursting enzymes. Having 2 to 3 times a week is not a issue , more than that is also not a issue , but needs adequate nutrition and exercise which will be difficult to fulfil. Ways to reduce Masturbation 1.\u00a0\u00a0\u00a0\u00a0\u00a0Sex education 2.\u00a0\u00a0\u00a0\u00a0\u00a0Physical exercises 3.\u00a0\u00a0\u00a0\u00a0\u00a0Sleep adjustment 4.\u00a0\u00a0\u00a0\u00a0\u00a0Quality of sleep 5.\u00a0\u00a0\u00a0\u00a0\u00a0Healthy and balanced diet 6.\u00a0\u00a0\u00a0\u00a0\u00a0Programming for leisure time 7.\u00a0\u00a0\u00a0\u00a0\u00a0Development of spirituality 8.\u00a0\u00a0\u00a0\u00a0\u00a0Taking a cold bath CAUSES OF MASTURBATING 1.\u00a0\u00a0\u00a0\u00a0\u00a0Curiosity 2.\u00a0\u00a0\u00a0\u00a0\u00a0Unfamiliarity with sexual issues 3.\u00a0\u00a0\u00a0\u00a0\u00a0Seclusion 4.\u00a0\u00a0\u00a0\u00a0\u00a0family problems 5.\u00a0\u00a0\u00a0\u00a0\u00a0suspicious and unfriendly friendship 6.\u00a0\u00a0\u00a0\u00a0\u00a0lasting diseases 7.\u00a0\u00a0\u00a0\u00a0\u00a0Sense of inferiority 8.\u00a0\u00a0\u00a0\u00a0\u00a0Imitation 9.\u00a0\u00a0\u00a0\u00a0\u00a0premature puberty 10.\u00a0\u00a0\u00a0\u00a0\u00a0cultural factors Negative Effects of Masturbation 1.\u00a0\u00a0\u00a0\u00a0\u00a0The weakness of physical power 2.\u00a0\u00a0\u00a0\u00a0\u00a0Poor vision 3.\u00a0\u00a0\u00a0\u00a0\u00a0Damages to the sexual organs and impotence 4.\u00a0\u00a0\u00a0\u00a0\u00a0Lack of memory and forgetfulness 5.\u00a0\u00a0\u00a0\u00a0\u00a0Aggression and anger 6.\u00a0\u00a0\u00a0\u00a0\u00a0prefers loneliness Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes severe abdominal pain and diarrhea after taking Vancomycin?\n\nMy 58 year old wife has advanced PP M.S.( she is now a quadriplegic from it) She just went through a 6 week series of Vancomycin. It ended about 3 weeks ago. She now is having very severe abdominal pain and horrible diarrhea. We were told it may be from the Vanco. What can be done to help her if that is the case?",
    "doctor_response": "Hello!My name is Dr. Aida and I am glad to attend you on Healthcaremagic!I would just recommend taking probiotics and a lot of electrolytes and fluids in order to avoid dehydration. A stool analysis is necessary to exclude any possible repeated infection. The probiotics will help improve the gut function and stop diarrhea.  You should discuss with her doctor on these issues. Hope you will find this answer helpful!Kind regards!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy red rashes on the body of an infant?\n\nWhile talking with a friend tonight, I found out his baby/child of 1 1/2 years has rash (red, swollen, and I believe some blistering), all over his body, and bruising under the skin. It is still unknown what it is. The child is itchy and irritable, plays and runs, eats fine, etc...What could this be? I hoping they can find out soon before this child gets worse. Thank you.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically. Please revert back to me with images so that I can guide you better. You can approach me at the following link. Once the page opens there will be an option below my image as \u2013 ASK ME A QUESTION \u2013 click on it. Please find the link below - www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696 Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to avoid pregnancy\n\ni am taking 21 day pill for getting my periods normal every month. i had a sexual intercourse after 3 days of completing these 21 pills.i also lost my virginity unknowingly and i am not sure whether sperms went inside or not. so i started taking these 21 days pills again. today 6 days are completed after this incident. should i continue to use these pills or not? I want my periods soon so that i could be tension free..",
    "doctor_response": "Hello dearI understand your concernYou are on the 21 day pill and it is highly effective in preventing the pregnancy.If you will do sex after 21 days it will not cause pregnancy.You have not need to start 21 days pill again after the sex.I would suggest to stop the 21 day pill.Once you stop the pill, period will come in next 4-5 days.If period will not come then consult the gynecologistMeanwhile avoid stress, take healthy diet, drink plenty of water and do regular exerciseHope this may help youContact further if follow up neededBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can birth control pills cause irregular periods with brown discharge?\n\nHi. I am 32 around 5 4 220 lbs female. my period is not due for about a week and I am on birth control pills. for the last few days (same thing happened last month) I have been having a brown fibrous discharge. it is not overly heavy and am having no pain...should I be concerned? is ita issue with my birth control pills?",
    "doctor_response": "Hi Hope this message finds u in good health.I have gone through ur msg and understand your concern.it may be due to some sort of hormonal imbalances or variations in the body,though there may be other reasons as wellNothing to worry about, You should eventually get back to normal.Take multi vitamin and calcium supplements Do consult a gynecologist if symptoms worsenGet back to me for any  FOLLOW UP QUERIES anytime.Regards,Dr Mahaveer Patil...(MBBS,MS,Mch)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Painful gums. Due to wisdom tooth?\n\nhi. i m 26. for past few days my mouth is notopening fully. i had pain in my gums n look like dey r swollen. may b wisdom tooth is formating. i dont consume tobacco or smoke . n it all started after i start dieting . i eat less than before. i also take herbal pills of active fibre. i just want to know what is wrong with me",
    "doctor_response": "Hello Welcome to HCM I went through your history & it suggests that you are suffering from Pericoronitis i.e. inflammation of pericoronal tissue before eruption of third molar.It occurs due to food lodgement & bacterial accumulation in that area.Its Symptoms are:- -pain -swelling -difficulty in mouth opening -fever -malaise -regional lymphadenopathy Get an IOPAR done & consult your dentist.If flap is interrupting in its path then go for flap removal i.e. operculumectomy. Otherwise if sufficient space is not available then go for extraction since it is vestigial & has no role in mastication. For temporarily relief do warm saline rinses 3-4 times a day. Start with Tab Amclaid-625 twice a day along with Tab Zerodol -SP thrice a day for 5 days.In Case of gastric problem take rabeprazole-40mg once daily. Your herbal pills won't be of much use. Do betadine gargles twice a day. Take Care Regards Dr.Neha",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can psychopathic behaviour be controlled?\n\nI do not know why this happens but I wanna die sometimes, you know to make everything easier, I know I could be real happy and successful one day, I have tons of friends, speak 4 languages, have a job, but is it all worth it? Someday I m going to die, not going to have any kids, a woman in my life sure, but for how long? I m getting a vasectomy in the future and let s get real, not many women would like not to have kids, and I wish that would be all but, sometimes I m afraid I m a psychopath, i can easily play with emotions, I know I m better than other people, not the best but for sure better, when I was in medical school I wouldn t have any respect for the dead person in the table, I mean, playing hot potato with the heart is indeed and tickling the toes while having the time of my life is definitely not the right way to do stuff, sometimes I would just like someone to hurt me so I can hurt them more, even kill them, not leave any trace of that someone, I would just want to know if it is normal, and sure I ve gone to psychology but honestly, who in their sane mind would tell them all to one?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I don't see your behavior corresponds to psychopathic behavior symptoms. Rather it seems to be overthinking, Obsessive compulsive thinking which could be due to your OC personality. OC Personality disorder can be treated with psychotherapy.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe chest pain\n\nI went into the ER on Tuesday with chest pains. It has been going on for about 3 months. These pains will sometimes come in the middle of sleep when I am laying on my side. When I immediately roll to my back they go away. Sometimes I will be just sitting in church and get them. Tuesday I just happened to go up a flight of stairs and got chest pains that ran into my back between my shoulder blades. EKG was good, and bloodwork came back ok. They released me with following up with my doctor and a referral to cardiologist. My doctor wants to see me first and doesn t think I will need to go thru with stress test. IDK what to do?",
    "doctor_response": "As you have mentioned in your history I can say you are suffering from severe chest infection. For this you have to take Tab Levofloxacine 500 mg once daily or Tab Linezolid 600 mg twice daily after meals for at least 5 days along with tab levocetrizine twice daily after meals with cap omez or cap pantop twice daily before taking meals with syrup bro-zedex or syp gerifen-sr 2 tsf three time daily. You can also take steam inhalation as it will sometimes helpful to clear out of your chest from cough that is deposited inside.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to relieve lump near buttock crack with soreness and pain?\n\nHi, I have a sore hard lump under the skin just inside my bum crack. It s not very red and doesn t havea head but is extrmeley sore to sit, walk and lie down. I ve tried having hot showers and baths and this does nothing except increase the pain and throbbing.",
    "doctor_response": "HiWelcome to hcmThis is mostly skin abscess( pus) which needs drainage if it is large in size and soft. Also antibiotics are required. See a surgeon for confirmation and surgery. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is surgery advisable for internal hemorrhoids?\n\nmy brother is suffering from internal hemorrhoids.he complains of pain and irritation.nearly two years of diet control and creams have not helped.is surgery an option?he is seemingly frustrated with this problem and it's affecting his work and studies.Please help.",
    "doctor_response": "Welcome to H.C.M. I am Dr Krishna Dubey.No need to be frustated because this is curable.Hemorrhoids are swollen blood vessels that may occur inside the rectum (internal) or outside the rectum (external). Internal hemorrhoids cause bleeding and leading to anemia( low hemoglobin) and if not controlled as you told about your brother that nearly two years of diet control and creams have not helpedIn such conditions surgery is only option.Till then start - Tablet- Dapson 500 mg thrice a day -very helpful drug for hemorrhoids. eating a high-fiber diet, staying hydrated by drinking eight to ten glasses of water each day, using a stool softener so you won\u2019t have to strain during bowel movements.Thanx for query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to interpret renal tract ultrasound result?\n\nHi Doc, I'm 66yrs.old,and just picked up my Renal Tract Ultrasound result. The conclusion is :- 1. Mild prostatomegaly and 2. Mild post void residual 36cc.  Can you please advice whats this all about, as I can't see my doctor till late next week ?? Is this a serious condition?   Many thanks in advance. Tony from Doununder.",
    "doctor_response": "hai,As your ultrasound result indicates prostate gland ( gland which lies on either side of the urethra) enlargement. it is common in every men aged above 60 years.Mild post void residual 36 cc indicates retention of urine in your bladder after urination.prostate gland enlargement (prostatomegaly) will cause urinary retention and urinary incontinence.this is not a serious condition to address immediately.Thank youhope i answered your query",
    "dialogue_context": ""
  },
  {
    "patient_message": "What would be the recovery time after an arthroscopic surgery?\n\nHi, I have osteochondritis dissecans, and a possibly need arthroscopic surgery (I believe a sample of cartilage from the affected area is taken and grown in a lab). I m wondering what the recovery time typically is for such a procedure. I ve had surgery for the same problem ten years ago (though it was a cartilage transplant), and I m wondering if there is any change in the healing time, which was six weeks on crutches. Thanks!",
    "doctor_response": "Healing time is related to which joint you are referring too and if you have any other medical condition it takes 3 to 6 weeks or even more if you have other medical condition like diabetes Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does my beta hCG report indicate that I am pregnant?\n\nHello doctor, I had my last period a month ago. I had an unprotected sexual intercourse with my partner three days later that is on the third day of my last period. But, he did not ejaculate inside me. Typically, my period lasts for two to three days only. He did not use any protection nor did I take any contraceptive pill at that point in time. I took Azithral 250 mg twice a day for five days in the previous month. A few months ago, I had similar issues and my period started 15 days late. Now, I am worried and regretting my decision of not taking the pill as my period has not started and I am scared to be pregnant. I am not getting any specific symptom related to my periods. I am just feeling a bit dizzy. I have done a beta hCG test today. Please check the report. Please tell me what to do next?",
    "doctor_response": "Hello. I do not see any reason for you to worry. Usually, the ovulation occurs between the 13th and 16th day of periods. Life of the egg is 24 hours and that of the sperm is 72 hours. So there is no chance of the egg being available for three days and sperm will not survive until next ovulation. Your beta hCG (human chorionic gonadotropin) levels show that there is no pregnancy. This test detects the smallest of pregnancy anywhere in the body. Pregnancy is not the only reason for missing your periods. There may be other reasons: Whatever be the reason to have periods, I suggest you have tablet Novelon (Ethinyl Estradiol and Desogestrel) or Ovral-G (Norgestrel and Ethinyl Estradiol) or Dear 21 (Ethinyl Estradiol and Levonorgestrel) or Duoluton L (Ethinyl Estradiol and Levonorgestrel) or Intimacy plus 3 (Desogestrel and Ethinyl Estradiol) one tablet twice a day for 10 days. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. You will have periods within seven to 10 days of the last pill. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the chances of side effects of tablets given for GAD?\n\nHi doctor, I am suffering from unsteadiness, muscle tension, mild fatigue, anxiety and depression. I have been diagnosed with GAD. My doctor prescribed my Clonazapem 5 mg and Escitalopran 10 mg. Is it fine to take half of each tablet? Will it cause any intolerable side effects? I do not\u00a0want to take medicines. My doctor said that it is mandatory. She said CBT will not work for me. Please help.",
    "doctor_response": "Hi. I think for a 71 Kg young male the chance of side effects with recommended dose is very minimal, but at the same time I do not think this could be the final dose. Your doctor is right in saying take 5 mg of Escitalopram and this is the minimal effective dose for first time anxiety problem. Since you are already taking Xanax (Alprazolam) I assume that you have this problem for a longtime and it is possible that there will be required to increase the dose in the near future. You also mentioned heart arrhythmia. In that situation we need to be very slow. First, start with 5 mg than 7.5 mg or 10 mg as there are problems encountered by those who has a heart problem. I do not mean there is a serious risk, but caution is warranted. In case if you develop side effects, then there is some possibility of headache, gastrointestinal disturbance and giddiness, which are most common. Regarding the suitability of treatment, I do not find any fault with prescribed treatment as Escitaopram a SSRI (selective serotonin reuptake inhibitor), is used for definite treatment of GAD (generalized anxiety disorder) while Clonazepam helps in initial management of anxiety till Escitalopram takes over. For further information consult a psychiatrist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chlamydia?\n\nI and my wife are going through difficult situation. We have been leaving together for 8 years now and i have got tested positive to chlamydia and my wife negative. Since we are together I swear to God that I have cheated on her but she does not believe me . Now we are getting closer to a separation or divorce . can you please me to know on how could I get tested positive and not my wife while we even have two child ?",
    "doctor_response": "Dear patient,From what I have read, I understand that you are going through a very difficult situation which needs to be handled with caution. You swear to God that you have NOT cheated on her, but she does not believe you.Now, chlamydia is a bug that in many cases in male patients is associated with an asymptomatic infection. This means that you may have gotten the infection by a prior sexual relationship, 8 years ago, and the infection has been 'asleep' and has not shown any symptom. This happens in about 80-90% of infected male patients. The other issue is the negativity of your wife toward the bug. If you have had the infection for so long, than she may think why hasn't she encountered the bug and gotten infected as well. I can only assume that the infection was so weak that it didn't show symptoms for 8 years and it could not be spread to your wife. This is the only possible explanation, and this can happen.Please try to calm your wife, and show your steadfast love and your desire to stay together.I hope my answer helps,Manoku Eni, M.D.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest a remedy for head lice\n\nhi Dr., my grandmother, aged 70 years, started this itch in her head...when cleant it she found big lies. But they were bigger then normal head lices. later, we found a sweater (which my uncle wore when he visted Leh and Ladakh) and it had similar lices it in. Alot of them. We immediately washed the sweater in hot water with alot of dettol and Rin. But it does not stop spearding in my grand mom hair. She is in a lot pain and highly irritated. has lost alot of hair as well. When she will clean her hair with Lice special shampoos it will come out and then the hair is wet after bath it will look clean but after a while they are back. Please help. We are desperate. Nothing seems to work and we cant find out what creature is that. what to do?",
    "doctor_response": "Hi, Thanks for posting in HCM. I have read your description and understand your concern. Head lice can be difficult to treat due to the time-consuming, precise nature of treatment and high re-infestation rate. The following things can be done to overcome the problem: 1. Wet combing - It is a method that involves removing the head lice by systematically combing the hair using a special fine-toothed comb. 2. Lotion or sprays - A lotion or spray should only be used if a living (moving) head louse is found. 3. Washing clothing: The most common way to kill body lice and eggs is to wash clothing and bedding in hot water [130\u00b0F (54.5\u00b0C) or higher]. 4. Permethrin creme rinse 1% which is a common first choice for treating head lice. If it does not respond to above measures, you need to go for: 1. Benzyl alcohol 5%, which is applied to the hair on the head, left on for 10 minutes, and then rinsed off. or2. Malathion lotion which is applied to hair on the head, left on for 8 to 12 hours, then rinsed off. If lice are still present 7 to 9 days later, a second treatment must be done. Hope the information provided would be helpful. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and rapid heart rate while on Gabapentin and Norco?\n\nI have taken my Gabapentin and my Norco and ibuprofen along with the caffeine tablet now I m also take aldactracide HCTZ I am trying to find out because while I m sitting at just just started happening in like 20 minutes ago while I m sitting I feel dizzy and my heart is beating fast but lightly except for like 5 beats out of it and those 5 beads it s beating hard I mean damn Bam Bam Bam and it s weird it s got me freaked out my stomach s upset I don t know what could be causing this but I really would like to hear what you have to say and what you think might be going on if you could respond to my answer that would be great thank you are my question I mean",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. Regarding your concern, I would explain that your symptoms could be related to the caffeine tablet adverse effects. For this reason, I would recommend avoiding it in the next days. A cardiac arrhythmia can not be excluded either. For this reason, it is important consulting with your attending physician for a physical exam and some tests: - a resting ECG and a cardiac ultrasound - complete blood count - blood electrolytes for any possible imbalance. If these episodes keep repeating, an ambulatory 24-48 hours ECG monitoring will be necessary to investigate for possible cardiac arrhythmia. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How long should my husband and I wait to try for a baby if we did cocaine?\n\nHello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance.",
    "doctor_response": "Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for 1.3 cm stone in right kidney & 9mm stone at the end of the urinary tract?\n\nmy wife 56yrs old is having one stone of 1.3 cm in right kidney and 9m.m.stone at the end of urinary track .ct scan shows hydronefrosis in both kidneys.9mm stone of ur track is in left side..pl suggest treatment .email address is  YYYY@YYYY  help.",
    "doctor_response": "Good Day and thank you for being with Healthcare Magic! The best way to treat the stones of your wife would be a ureteroscopic procedure wherein we insert a small scope in the tube that connects the kidney to the urinary bladder (ureter). This would entail the use of a laser fiber to crush the stone on the left side and possibly putting in a stent to relieve the hydronephrosis. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at:   I would gladly help you.  Best wishes.Regards,  Manuel C. See IV, M.D. DPBU FPUA",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does stinging sharp pain in the chest indicate?\n\nI get this stinging pain in the centre of my chest that I usually get once every 3 months roughly but yesturday it was hurting more and caused me to slow down when I was walking also I noticed the deeper I inhaled/exhaled the strong the sharp pain got. Can you tell what this is and perhaps how to prevent it ?",
    "doctor_response": "Thanks for your question on HCM.I can understand your situation and problem.In my opinion, we should first rule out cardiac cause for your chest pain.So get done1. ECG2. 2 d echo to rule out cardiac cause.If both of the above are normal then no need to worry for cardiac cause.You may have anxiety related pain.So better to avoid stress and tension.Be relax and calm.Take painkiller and muscle relaxant for pain.Don't worry, you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could disorientation and confusion be due to tumors in brain?\n\nHello, My father is 61 years old and was recently diagnosed with metastatic lung cancer. It traveled to his brain and had 2 tumors. One tumor was removed surgically and the other was treated with the Gamma Knife radiation...A few months later his MRI showed good results on original tumors but showed 11 new tumors(very small). We did the gamma knife again. He then started chemotherapy for the lung cancer. After his 2nd round(14 days after) he was feeling terrible, no energy and fatigue. We then took him to the emergency room and they said that his hemoglobin was at 5.9. They then admitted him into the hospital and did a blood transfusion. Throughout this process he was having headaches and such. The doctor gave him an IV of dexamethesone(which he has used quite a bit before) but I noticed that dad was not acting normal and seemed very disoriented/confused/not speaking clearly/not understanding. We left the hospital when the doctor said that if he felt ok he was ok with discharging him. Dad wanted to leave and he was prescribed dexamethesone for the headaches. We then went back to the neurologist for an MRI and the MRI showed 8 new spots. I have no idea on exact placement but would his confusion and forgetfulness be from dexamethesone side effects of tumor adema on certain parts of his brain?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns. The symptoms of your father arise from tumor metastases in certain areas of brain (frontal and temporal lobes) and their surrounding edema. Dexamethasone is used against edema with the goal to improve symptoms, so these symptoms are not side effects of Dexamethasone. Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes numbness & tingling in calves & shin?\n\nHi, a couple of months ago i started getting uncomfortable feelings in my calves and shins, I would describe the feelings as numbness and tingling. I have been getting identical pain in both of my legs, meaning they often feel weak and sore. On one of my shins i have recently also started getting a couple of sensitive invisible bruises. What do you think this is/what should i do to treat or fix this? I wondered if it might have something to do with wearing shoes too tight? Many thanks for your time :)",
    "doctor_response": "Thanks for asking question, I have understood your problem, see you might have walked a lot or with bare foot or your footwear is not proper so that your muscles of front leg will be working more unnecessary, or some compression over outer side of knee joint where there will be nervous which supplying lower foot due to that You my have pain. first thing change your footwear and do regular warm up exercises, yoga and pranayama practice to make muscles more flexible, when your muscles are flexible chances of injury will be very less. apply ice and don't rub part. apply analgesic cream. still if pain not subsides take IFT and ultrasound modalities to cure of pain. I hope you satisfied with this answers.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bad odor and discharge from belly button\n\nhi, i am having a belly button issue... i have discharge coming out of my belly button and there is some kind of lump in there. i was worried it could be a hernia but there is a brown/clear discharge with a smell. is this just an infection? what could cause that bump... is it swollen?",
    "doctor_response": "HelloI have studied your case. There is possibility of infection or sinus tract formation. I will advise you clinical examination and further investigation like sinogram x ray. I hope I have answered your questions. If you have further questions please feel free to contact us. I will be happy to answer. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat sebaceous cysts?\n\nI have a 5 cm sebaceous cyst (I assume) between my shoulder blades. It has flared up from a small painless lump to red and very painful in last 14 days. Can a sebacious cyst be drained by applying a warm herbal poultice or is it necesary to remove surgically (expensive, no insurance)?",
    "doctor_response": "Hello, It is better to remove it by surgical excision. Natural remedies may not be effective. It a simple procedure and can be done under local anaesthesia. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain and swelling in ankle bone?\n\nI got hit in the ankle with a line drive last night while playing softball! There isn t much bruising, but it began to swell right away. There is a horizontal thin red line about an inch long on my ankle bone in the middle of all the swelling and it is very painful to the touch. What might be the issue?",
    "doctor_response": "Dear patient You have got blunt trauma to your ankle and possibility of fracture cannot be ruled out.  I would like to advise you Xray of involved ankle with tibia fibula anteroposterior and lateral views to rule out bony abnormalities. Visit radiology center nearby you and get it done.  Meanwhile start tab diclofenac plus serratiopeptodase combination twice a day for pain relief and frequent ice packs application . Keep involved limb elevated.  If report is normal you need not to worry and continue treatment.  If report shows fracture  you need to consult expert orthopaedic surgeon nearby you and get yourself examined.  All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for infection in scalp\n\nHi, may I answer your health queries right now ?  Please type your query here...I have had an infection on my scalp for over five years. I've been to numerous dermatologist and nothing they've done was successful. first it starts off as really sore blister then it turns into a sore that won't heal. then my hair falls out",
    "doctor_response": "Hi, Thanks for posting in HCM. I understand your concern. Looking at the description, it appears that your are having 'Seborrheic Dermatitis' of scalp. Since you are having sore blisters associated with it, it appears that it has been secondarily infected by bacteria and hence it is taking a longer duration to heal.You need to following medications: 1. Use shampoo that contains one or more of these key ingredients: Coal tar, Ketoconazole, Salicylic acid, Selenium sulfide and Zinc pyrithione Use it regularly on alternate days. You should feel better in about a month time. 2. For sore blisters, kindly rinse the wound with mild antiseptic like Savlon and apply Neomycin cream twice a day. In case you are not getting better of these problems after a month, kindly get your fasting and post-prandial glucose levels checked to rule out diabetes mellitus. After that, you can take medical assistance accordingly. Hope the information provided would be useful. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why is there soreness in hip while standing after sitting position?\n\nHi doctor, I am a 49-year-old female weighing 75 kg, 170 cms height. For a few months, I have experienced soreness in my left hip. It really only occurs when I get out of a car and go to stand. It is quite a dull pain. Not sure if there is any connection but I injured my lower back and a few times, to relieve the pain, found straightening and straining my left leg helped. The soreness has only occurred since then. Sometimes I have felt this when getting off a sofa, but less commonly. Occasionally, when I have taken Nurofen for a headache or period pain, the soreness disappears. I am wondering if there is anything I should be doing.",
    "doctor_response": "Hello. You have a history which is classic of tendinitis depending upon the site of pain it may be due to piriformis, gluteius medius, or iliopsoas or ischial tuberosity related. You need to mention which is the exact site of your hip pain. Is it side of the hip, groin, front of the hip or deep hip pain on the back. Secondly, do you have have pain that radiates from back to leg? Do you have any tingling or numbness in your lower limbs? Can you sit cross-legged? Do you play any sports regularly or does your occupation involve a lot of physical activity? Have you undergone any clinical examination or investigation like X-ray or MRI? Follow up with your answers to the questions and feel free to discuss further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Could wearing glasses with some change in power cause headache?\n\nHello doctor,I have been wearing the same eyeglasses prescription for a few years now. I recently had another eye exam, and not much has changed. However, every time I put my current glasses on I starts feeling dizzy. My vision does not seem quite right, and it is giving me headaches. They did adjust my glasses as they thought they were off a bit. That has not seemed to help so curiously what your thoughts might be on this.",
    "doctor_response": "Hello. Eye strain after a change of glasses might be due to over or under correction of glasses or improper spectacle frame and centration. So you need to recheck your refraction and lenses whether they are dispensed according to your prescription. If you are having trouble in near-vision or near work, then it might be due to presbyopia. Presbyopia usually starts at 40, but some people might have problems after 35. Other symptoms like headache, neck tightness, and shoulder pain might be due to other causes like glaucoma. So you need a complete eye exam and intraocular pressure IOP check along with the retinal exam. Your doctor might suggest a few investigations if required. You are most welcome for any queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is pregnancy possible despite intake of contraceptive pills?\n\nHi . I am Maushumi from India . I had sex on 15th of jan with my bf and took emergency contraceptive within 6 hrs. after two days I had sex again. I was drunk hence don t remember weather he has ejaculated inside of me or not . this time i didn t took any pill. however yesterday I had an urine test with my pregnancy test kit and the result was negative. still I am confused.",
    "doctor_response": "Hello dearI understand your concernThere is chance of the pregnancy as you had not use pill after second intercourse.Pregnancy test will give positive result 8-10 days after the missed period.Emergency contraceptive pill also cause delayed in the period y 10-12 days.Now if your period will delay by more than 12 days then go or urine pregnancy tests and or blood HCG to confirm the pregnancy.If you will be pregnant then still you can terminate the intrauterine pregnancy by ABORTION pill under the advise of the gynecologist.Avoid stress, take healthy diet, drink plenty of water and do regular stretching exercise.Hope this may help youContact HCM for further health queryBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in neck due to injury\n\nTwo months before in a bike accident my neck got injured. my MRI report Screening of dorso lumbar spine: Impression :Posterolcentral bulge of C3-C4 disc indenting the thecal sac. ( 2) Small left posterolcentral bulge in C6-C7 disc indenting the thecal sac. I am taking levenew 500mg.and almito tablet and ultracid tablet.but pain in my neck in continue. all checkup was done in Apollo bhubaneswar. please suggest me what should i do?",
    "doctor_response": "hi MRI report shows Disc bulge C3-4 ,which may or may not be due to neck injury, The type of neck injury which you might have, involves all soft tissues around neck . It may take upto 3-6 months for full recovery . Isometric neck exercises are very useful .",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could flaky, cyst like thing in belly button indicate?\n\nRecently, I discovered a flaky, cyst like thing in my belly button. There has been some blood, smell, and it is just weird. The doctor thought at first it was just scar tissue from robotic surgery and that all he would have to do is cauterize it. But then yesterday, we found it was much more involved and had to do an incision to remove it. He is sending it in for a biopsy. Any thoughts of what it could possibly be? I thought I had a strange alien coming out of my belly button--so weird!!",
    "doctor_response": "Hi! Good evening. I am Dr Shareef answering your query.You have not mentioned what surgery was done in a robotic way. This might be a seedling of the original pathology for which the robotic surgery was done. I think we would have to wait till the hitopathology report arrives.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why do I have a weird feeling like pain in my brain?\n\nI have weird sharp brains in what feels like my brain. it doesn't happen frequently but it happens sometimes. it last from 5 seconds to a minute. it happens in different areas of my brain. its a very small pain, but its a feeling in my brain that you could say is a pain, like its nothing to say ouch about",
    "doctor_response": "HIThank for asking to HCMI can understand this, this is not the brain that paining but this could be a tension headache, in my opinion you need to keep your stress level low, your functional elements could be cause of this, hope this information helps you have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could lumps with bruises on forehead suggest?\n\nmy 5 year old daughter was bouncing on her bed and fell and hit her forehead on the corner of the radiator 2 weeks ago. a large lump came up straight away and bruising. the lump went down a lot 2 days later. she was not sick or showed any signed of drowsiness. in fact she was fine. the lump is still there and very hard now 2 weeks later. should i be concerned?",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. She has history of trauma.  So she may have some hematoma formation due to extravasation of blood.  It will heal gradually.  Nothing to worry about that.  If she has pain yhen analgesic plus anti inflammatory drugs like ibuprofen is helpful.  Otherwise no treatment is required.  Apply ice massage bon it.  Nothing to worry about that. Just be relaxed. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain with negative ultrasound result\n\nMy husband is having pain on the right side of abdomen . Doctors took blood and urine test but they are not able to spot the problem. He is having this pain from past few days. Even an ultrasound test was done and nothing came. Can anybody suggest anything",
    "doctor_response": "hello .. give him belladona 200..one dose in the morning and second dose at night. its a homeoapthic medicine so safe,sure n faster results.. his pain will go away.. godbless.. drvigsclinic@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lightheadedness in the morning happens for few weeks, disappears\n\nI am usually light-headed in the morning and during the day but it goes away in the early evening until the next morning. This will happen for a while and then it will go away for a few weeks. Any suggestions? I am not overweight and exercise daily.",
    "doctor_response": "hello and thank you for asking HCM,I undertsand your concern. You are probably experiencing low blood pressure when you stand up, called orthostatic hypotension. As a result, not enough blood reaches your brain, and you feel lightheaded or dizzy.Here are some advices: move gradually from lying down to sitting to a standing position, wiggle your toes and flex your feet before you stand up. This causes the muscles in your legs to squeeze more blood back up into your heart and to slightly raise blood pressure. Try to sleep with your head higher than your feet keeps blood pressure higher.Drink more fluids and perhaps increase your salt intake. Unless you have high blood pressure already, this is a good idea.Drink coffee in the morning. Caffeine boosts blood pressure.If these advices won't help than visit your GP to make a more detailed examination.I hope this answer was helpful to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does this x-ray report signify?\n\nmy daughter 4years had x-ray reports read as   accentuated bronchovascular markings are noted bilaterally with peribroncheal thickenings soft opacifications are noted across the right paracardiac regions -consolidations.",
    "doctor_response": "Hi read ur question Ur girl x ray suggestive of  consolidating on right pericardial region Means ur get to having a pneumonia on rt side of lung . Consult ur paediatrician asap for the treatment  . it may required admission",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes rapid breathing and panting in 8 weeks old child?\n\nMy baby is nearly 8 weeks old but almost since birth he has been breathing rapidly. Usually during the evening but occassionally in the morning too he will begin by panting incredibly rapidly, this gets faster and faster and he gets more and more worked up and is extremely difficult to calm down. Can someone tell me if this is dangerous or normal? And offer advise on how to calm him down or stop him doing this please? Thank you",
    "doctor_response": "Hi! Thank you for choosing Healthcare Magic! Congratulations on your new baby! For 2 month old babies, the normal respiratory rate can be as high as 50 breaths per minute. But other than how fast it  is, you must also check if the breathing seems labored and deep. Do you see this while he is calm and asleep or only when he is irritable? When they are crying and fuzzy, breathing can be faster. I would advice that you consult  your doctor. It would be best for him to be examined thoroughly so as not to miss any serious causes of the fast breathing. Also, try to feed the baby upright with his head a little elevated to prevent aspirating the milk to his lungs. Hope this helped you. Sincerely, Hannalae Dulay-See, M.D.Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is alcohol intake safe while on rabies vaccine after dog bite?\n\ni was bitten by a small puppy a week ago, i am on rabbis vaccine course n had 2 doses of vaccine( ie 3rd day, 7th day) on last sat ie 13th oct 2012, and my question is- can i have alcohol or do i need to follow any restrictions regarding alcohol consumption ??? will be thankful for your respone....",
    "doctor_response": "Hi.I've gone through your query. I can understand your anxiety. Rabies is fatal if symptoms are manifested. As you are already on the vaccination schedule, you will be okay. But taking alcohol in between the schedule can interfere with the effective functioning of vaccine. It impares the immune system & causes decrease in efficacy of vaccine. So do avoid alcohol until all the shots of vaccine get over. Hope I have answered your query. Let me know if I can assist you further. Take care. Regards, Dr. Yogapriya V, General and family physician.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can pregnancy happen after non penetrative sex?\n\nWell the other day i was at the movies with my boyfriend. And he constantly kept touching his Penis so i thought he was \"jacking-off\" Well after that he reached in my pants and fingered me. I dont know if it is possible to get pregnant like that or what?? But it has me worried. It was only about 3 days ago though",
    "doctor_response": "Hi welcome to the health care magic For getting pregnant full penetrative intercourse required and semen should entered into vagina Here I don't think semen has entered into your vagina as per history So chances of pregnancy not present in your case If you had done intercourse and if period delayed for 7 days then pregnancy can be ruled out by urine hcg card test... Hope your concern solved Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Prescribe medicines for crystal-like substances in kidney\n\nsir before 1 year in my both kidney some small seen Crystal but now ok by pass urine clear before i take homeo pethic  medicine  burbaries vol 5.0%acl. but now other problem came in my urine bladder before 2 days i checked my unine test after report what came rejalt  i informe u this report came puscells 20-25hpf now doctor gave some antibiotic tablets norflexin 400mg till alsho not relief my pain pls help me what i take medicine my name is arif khan male 33 year",
    "doctor_response": "Hi. welcome to HCM.Looking to your history, it seems that you have pain while micturition.Pus cells in urine with mentioned symptoms usually indicates urine infection.Urine infection requires further evaluation by urine culture,CBC, S. creatinine, and sonography if required.Don't get worried. Do above tests. Maintain adequate water intake.You can take citrate preperation for urinary pain.I think this would be helpful to you. Pls feel free to communicate further with above reports.Best wishes TC.Dr jay Patel.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause for frequent heart sinking feelings?\n\nHi, I ve been having heart sinking feelings for last 3 or 4 days. When it happens, my heart beats go up and it lasts a few seconds to a minute. I don t know what s causing it all of a sudden and It s happening quite frequently. Any idea what might be wrong?",
    "doctor_response": "HiThanks for using healthcare magicI think, you have panic disorder. In that case, you need low dose antidepressant and low dose benzodiazepine. Better to consult a psychiatrist for proper diagnosis and management. You can also try some relaxation exercise like JPMR or deep breathing exercise. In case, you need further help, you can ask.Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the stomach with a bulge. Have a heart burn. Taking prilosec. What is wrong?\n\nHello there...i have been having some issues that bother me. I have a pain in my stomach area (my left side)...just where the stomach and pancreas would be. While standing up, I feel a bulge and it hurts to push on it...it seems to bother me more when I am at work..but I sit most of the day. I also have heartburn about every day...I have been taking some prilosec almost everydat to stop that..but when I stop taking that the heartburn comes back. Also, when I lie down I do not feel the hard bulge.Please help",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for calling H.C.M.Forum. You have pain in the stomach, on upper left side. When you stand and at work it is bulging and tender. You got heart burn also, When you lye down the bulge dis appears. The heart burn may be due to irritation of the stomach due to peptic ulcer of irritant food habbits. underlying cause could be hernia, gallbladder stones, or H pylori infection. I advise you to consult a gastroenterologist for diagnosis and treatment. You may need to have M.R.I. gastroscopy, besides other routine tests for confirmation. Wishing for a quick and complete recovery. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for blood in semen and pain after urination\n\nI have been doing medical stuff all week for my work. I had an MRI done on my shoulder and they had to put contrast into it before the MRI two days ago.. I am not sure if this is related but now I have a red tent to my semen ..what could cause that. Also it hurts not during but after uranation.",
    "doctor_response": "HelloThanks for query .Blood in semen ( Hematospermia ) that you have is not due to contrast dye injected while doing MRI of shoulder .It is just a coincidence and needs to be investigated .Please consult qualified Urologist for clinical and digital rectal examination and get following basic tests done to confirm the diagnosis.1) Urine routine and culture.2) Ultrasound scanning of abdomen and pelvis3) Serum PSA.4) Semen examination and culture .Take broad spectrum antibiotic like Cefixime along with anti inflammatory drug like Diclofenac twice daily Further treatment will depend upon result of these tests and final diagnosis.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had head injury surgery, taKing Eptoin, headache. Do i need to continue taking it and if so for how long?\n\nMy Dad recently has a surgery for Head injury with subdural haematoma After that he has been prescribed Eptoin which is an anti-epileptic drug. My dad had no history of epilepsy . He has been complaining of headache ever since which I now understand is one of many side effects of this drug. Why does he need to take this drug? Does he need to continue taking it and if so for how long? Thanks Anand",
    "doctor_response": "Hello awasthi Welcome to Health Care Magic After brain surgery for Head injury due to sub dural hematoma, eptoin or any anti epileptic drug is given to patient for prophylaxis of any seizure episode that may occur following surgery. It is a routine practice. So even if there is no history of seizure or epilepsy, anti epileptic drugs are given. Regarding headache, although with phenatoin headache may occur as side effect but it non significant, if your father is experiencing headache it may be due to Trauma itself, or there may be raised intracranial pressure which may cause headache. Eptoin has nothing to do with headache, and yes he has to take this medicine for at least some months, and there is no harm. Thanks Take Care",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do for the infection in the leg?\n\nHi my friend just had a histerectomy or however you spell it. it has been about 2 weeks now and they put her on meds for an infection but it is not getting better she has been on meds for over 10 days now and the other day she caught and this orange creamy stuff ran down her leg",
    "doctor_response": "Hello there,I am dr.milan an infectious disease specialist answering your question.My best suggestion for you that you go through culture and sensitivity by a reliable microbiology lab and by a qualified Microbiologist doctor. Everything is depends on this. Detection of right organism is important in this case so.It may be bacteria, fungus or may be mycobacterium we never know without culture.This is most probably a hospital acquired infection. Ask your surgeon  from where it came?And why its not getting heal.It looks like some notorious organism infected your friend.Once you go with culture you have drug sensitivity so you can follow that treatment schedule completely.Hope i have given appropriate guidance to you.if you have any query you can consult me anytime.Give me star rating, helpful vote & thank you according to your satisfaction level.Thanking you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for cold, congested, runny and burning nose?\n\nI have been suffering from a cold or allergy for a few days, with congested, runny nose, and light bothering my eyes. I ve used the warm wet cloth over my eyes and cheekbones which has helped. Today I used Afrin nose spray, 2 times in each nostril 45 minutes ago and my nose is still burning! What can I do to make it stop. (I think it was a big mistake to use this product!)",
    "doctor_response": "Hi, thanks for the query.In my opinion ,  you have allergic rhinitisAvoid allergy triggering objects .Start Antihistaminic levocetirizine + Montelukast combination . Continue Decongestant nasal drops it will relief watering & congestion for few days only.Certainly above treatment will give you much relief but if relief is not upto satisfaction level then consultation with your ENT doctor will become essential.Hope this information helps you, take care and have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "what relieves the pain in face, head and jaw?\n\nHi I am a 52 year old female with a large overbite approx1cm. I had braces when I was 13 for 2 years but only seemed to space the teeth out. I am now and have been for a couple of years getting a lot of facial and head pain. I also have a lot of trouble eating due to jaw pain. Is there anything that can be done?",
    "doctor_response": "Hi,Thanks for asking the query,This could be due to improper bite, TMJ disorder, bruxism.A thorogh clinical examination and evaluation is required.I would suggest you to consult to an Orthodontist.Take an OPG radiographand impressions for proper diagnosis and treatment plan.Take combiflam 500mg BD for pain relief.Take care!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Polyp in bladder detected through sonogram. Seeking an integrative oncologist in France. Recommend?\n\nOk a younger friend of mine. (Swear it really isnt me. Hes like my little brother) hes 16. He asked me about a bump on his penis. He says its on the top side, on the ring at the base of his penis head. I thought it couldve been papsules but he said it was just one and that he cant really see it and theres no color change but he can feel it and can slightly see a rise in the skin. Looked around the web and the most similar thing i foind was that it could be a pimple. Told him and he said he doesnt think its a pimple because its hard and \"feels like BONE.\" I told him it should go away on its own and told him to \"leave it alone for a while\" and see if it gets better. Just wondering if you know what it could possibly be?",
    "doctor_response": "Hello and welcome to HCM,The lesion described by you on the penis could be a skin lesion.Certain viral infections especially herpes simplex infection causes lesions but those lesions are usually multiple and confluent and are filled with clear fluid. These lesions are called vesicles.However, the lesion described by you is not suggestive of herpes vesicles.The lesion could be a boil or a pimple.Observe the lesion for some days.Is the lesion associated with pain?If the lesion increases in size or is associated with pain, then you need to consult your surgeon for clinical examination and further management.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. 2. 5 year old suffering from stomach ache. Which medicine has to be given?\n\nHi doctor, My son is 2.5 years old. For a week, he is complaining of stomach pain. After farting he is fine. Our family doctor recommended one antibiotic for five days and a medicine to avoid vomiting. He had small vomits twice, but later it was fine. Now, after completing the course of medicine he again complaints the same. His diet is almost nothing and he is not ready to take any food. He just has few mL of milk. He does not have fever. His stool was watery, but it is normal now. Can you provide any recommendation on diet and medicine? Please give me a solution to the problem. Thank you.",
    "doctor_response": "Hi. I can understand your concerns. Complain of abdomen pain with vomiting suggests that your child probably has acute gastroenteritis or food poisoning. Since, antibiotic is already given and now there are no loose stools or vomiting, there is no need to give antibiotic again. For abdomen pain, you can give syrup Cyclopam (Dicyclomine hydrochloride and Paracetamol) 5 mL on SOS basis (as and when required) that is when abdomen pain occurs. Whenever a child becomes sick, there is decrease in his appetite which improves as child recovers. Now, you should give him all the foods that you were giving him earlier. If he is not eating then you can start Glucon-D in water thrice a day for one or two days. Start a multivitamin like syrup Bevon 5 mL once a day for 15 days. Keep patience. Child will eat properly now as he has recovered from illness.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I am 20 years old suffering from severe back pain. Am i too young for surgery ?\n\n20 years old Female I had a MRI in 2007 and starting to have severe back pain now...like sensitive to the touch. My Aunt basically summed up what they said four years ago but I still don t understand some of it and actually figure a little more on what I need to do have another MRI or go on with the pain and deal with it. I hurt my back in high school and went to a chiropractor for a while...he claimed I had a deg disk and said by my x-rays it looked as if I had wipe lash (neck). Finally went for MRI and seen a specialist about it. He did not seem too concerned about it. He asked me if I still wanted to cheerlead and told me not to lift anything over five lbs...And that I was too young for surgery . My family doctor wanted me to go for physical therapy but I did not need to miss the time from school, so I decided not to. My MRI basically is summed up below. Please break it down for me and help me decided the best thing to do. 2. L4-5 WITH A POSTERIOR DISC PROTRUSION, MOSTLY IN THE MIDLINE AND TO THE RIGHT OF MIDLINE, WHICH NARROWS THE RIGHT LATERAL RECESS AND IS IN CONTACT WITH THE DESCENDING RIGHT L5 NERVE ROOT. 3. L5-S1 WITH DISC OSTEOPHYTE COMPLEX POSTERIORLY, SLIGHTLY MORE SO TO THE LEFT AND FACET HYPERTROPHY ON TOP OF ALREADY CONGENITALLY NARROWED SPINAL CANAL . THIS CAUSES MILD TO MODEST SPINAL STENOSIS, AND LEFT LATERAL RECESS NARROWING, ALTHOUGH IT DOES NOT APPEAR TO COMPRESS THE DESCENDING LEFT S1 NERVE ROOT.",
    "doctor_response": "Hello. Thanks for choosing HealthcareMagic forum. Your problem is basically slight disc prolapse. You need to use hard bed fo rest, avoid using a pillow. You can take some oral muscle relaxants to relieve the discomfort you are having. Avoid doing any work by bending your back. Bend your knees for such works. Dr. Rakhi Tayal drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in chest while having food?\n\nI have been pretty sick tge last week, and trying ro fight off whats left of a sinys infection. But it seems as if it has moved into my chest. I have pain in my chest and get a weird.sensatiom and paon when eating or drinking. What could this be? YYYY@YYYY",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. Chest pain on eating and drinking is seen mostly due to reflux disease. It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms of burning chest pain. So avoid hot and spicy food. Avoid junk food. Avoid large meals, instead take frequent small meals. Start proton pump inhibitors. Go for walk after meals. Keep 2-3 pillows under head in the bed to prevent reflux disease. Don't worry, you will be alright with these lifestyle modifications. Hope I have solved your query. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Hyper-pigmentation, biopsy showed melanphages on dermis. No improvement with medicines. Help?\n\ni m suffering from hyperpigmentation since 6 months, the spots have increased, my doctor did a biopsy and all they found was post inflammatation hyperpigmention, the results say that they found melanphages on the superficial layer of the dermis . i never got pimples , had a clear face till now but all of a sudden i m gettin these black spot..nothing seems to be working..",
    "doctor_response": "Hi, This is typically melasma which you have developed following inflammation over the same area. If the affected area does not respond to application of creams like tretinoin along with hydroquinone then you can go ahead with a Q-switched Nd:YAG laser therapy to lighten the regions but it might require more than a single session to get adequate results.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can Yasmin birth control pill be used as an emergency contraceptive pill?\n\nHello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage?",
    "doctor_response": "Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recommend treatment for low sperm count\n\nIt takes about three years that my sperm has been reduced to some very few drops. I have never had any sexual  sickness or, any related  problem. I just drink a lot of beers (addicted) and also have hypertension (completely controlled), I am 53, and never made prostate test. Can you please help me?",
    "doctor_response": "HIWell come to HCMlooking to your age the quantity of the sperm would come low and this can not be increased not even with the medicines although there is such medicine that could increase the semen volume hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. High fever and swollen lymph node. Is it a bacterial or viral infection?\n\nHello doctor, My son has been sick with a high fever (between 101.7 to 103) and swollen lymph node on one side of his jaw right beneath his left ear, complained of pain in the neck, and pain inside his mouth. I took him to his pediatrician the following day and was prescribed Clindamycin 150 mg three times a day for 10 days. His doctor made a big mistake by not doing any throat culture for a definite diagnosis of what she suspects as a strep/staph bacteria on his lymph node. I did not doubt the doctor then and gave him the antibiotics as prescribed. I took him back to the office on Tuesday to be seen by another doctor in the facility to do a rapid test for strep which of course came out negative since he was already taking the antibiotics. He was not getting better but worse the following days with fever not reducing, worse pain inside his mouth, not eating, skin over the lymph node turning red, and also generally feeling ill. I thought the antibiotics were not working after three days of taking Clindamycin. So, took him to the ER. ER doctor gave him one dose of Clindamycin through the IV and although his fever was still present, the redness on his lymph node diminished a bit. He had an ultrasound and they said it was not an abscess. They drew some blood to also check for mono which we do not have the result in yet. They sent us back home and told us to continue with the antibiotics until the mono test comes out positive. He is acting a bit better today (six days after onset). However, still running a fever at night 101.7 and his swollen lymph node slightly came down in size but not completely. The inside of his mouth is still painful. He does not eat much or drink much. He has been complaining of his belly feeling weird and slept a lot yesterday. We went back to our pediatrician for a followup today and our doctor suspects that he has mono due to his higher liver level but of course, we would need to confirm that for the real result. We are still told to take the Clindamycin until we hear back about the result. I am just really concerned with his past infectious disease history. He was hospitalized with Kawasaki six years ago. And with his natural immunity so low I am concerned if the Clindamycin is doing more harm than helping him at this point. If I can turn back time, I should have asked the doctor to swab his throat before prescribing him the antibiotics but it is too late no",
    "doctor_response": "Hello. Here are the points I would like to bring across: The lymph node is quite inflamed as per the picture (attachment removed to protect patient identity) that you sent. It may be inflamed in the event of any infection be it viral or bacterial. Your reports are showing a high WBC count with high neutrophils and also a high CRP which is more suggestive of bacterial than viral infection. Hence the doctor was right in prescribing Clindamycin. However, since the infection load is very high maybe an additional drug may be required or we may need to change the drug based on the response. Another last resort, if all fails, is to do a biopsy and find out what the lymph node actually contains. However, this is an extreme and painful step and should be reserved for the last. As per what you are describing it may also be mono but even if it is mono you do not need to worry, it is self-limiting. Continue the medications as advised. For more information consult a paediatrician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could I be worry about CT abdomen information ?\n\nCT ABDOMEN\u200e Clinical Info\u200e: \u200egeneralized abdominal pain for the last \u200e04 \u200emonths\u200e. \u200eChronic gastritis\u200e. \u200eUltrasound \u200e shows thickening of small bowel loops\u200e. \u200eWeight loss\u200e. \u200e? \u200eAbdominal tuberculosis\u200e. \u200e 8 \u200emm\u200e, \u200epost oral\u200e, \u200epre and post intravenous contrast\u200e, \u200eaxial images through abdomen are submitted\u200e.\u200e Basilar lungs are clear \u200e& \u200eno pleural effusion \u200e/ \u200ethickening is noted\u200e. \u200eLiver is homogenous with no focal \u200e lesion\u200e. \u200eNo intra or extra hepatic cholestasis is noted\u200e. \u200eGall bladder without opaque cholelithiasis is \u200e normal\u200e. \u200eSpleen\u200e, \u200epancreas and both adrenals \u200e& \u200ekidneys are normal\u200e. \u200eSoft tissue density thickening \u200e in the distal ileum noted\u200e. \u200eThis is causing indentation on cecal contrast column\u200e. \u200eRest of the \u200e small and large bowel loops are unremarkable\u200e. \u200eThis approximately measures \u200e2\u200e.\u200e4 \u200ex \u200e2\u200e.\u200e0 \u200ex \u200e 2\u200e.\u200e3 \u200ecm \u200e(\u200eCC x AP x TR\u200e) (\u200eevident images \u200e# \u200e33\u200e-\u200e35 \u200e+\u200eC\u200e)\u200e. \u200eOpacified abdominal aorta\u200e, \u200eIVC\u200e, \u200eportal \u200e vein \u200e& \u200emesenteric vessels are normal\u200e. \u200eNo evidence of abdominal free fluid or adenopathy is \u200e recognized\u200e. \u200eBony skeleton \u200e& \u200esoft tissues are intact\u200e. \u200e CONCLUSION\u200e:\u200e Findings are suggestive of infective etiology involving distal ileum\u200e. \u200eClinico\u200e-\u200elab\u200e. \u200ecorrelation and \u200e further evaluation by small bowel follow through examination is recommended\u200e. \u200e I want to know whether patient has intestinal TB or not?",
    "doctor_response": "Welcome to Healthcare Magic Good Day He needs to get a few tests done like PCR which is expensive but will confirm presence or absence of Tuberculosis. Also since there is weight loss it is better to get started on Anti-tubercular treatment anyway and there will be relief. Patient needs to eat protein rich food like cereals, oats, pulses, eggs, chicken, lean meat. Drink enough water 1-2 litres a day. Patient can be started on Government ATT therapy by RNTCP approved Doctor at a Hospital. Do not delay. Better to be safe than sorry later.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Planning for baby, scrotal color Doppler test shows bilateral mild to moderate varicocele. Medicines?\n\nGood Evening Sir, Kindly help me out with this problem. We are planning for pregnancy since last one year. Our Gynecology had suggested Male Infertility Related tests, in which The Scrotol Color Doppler Test is showing complications. The result shows Bilateral Mild to Moderate Varicocele Note. Doctors are suggesting for Operations. But we don t want to go with Operation as there are no 100 % results and chance of conceiving are also not good enough. I would need your help in this regards. If their is a Medicine which could help in increasing sperm count then i would be thankful to you. Me & My Husband are of same age 32 Years. My all reports and test show normal. Kindly help me in this regards, Need your guidance. Thanks for your time",
    "doctor_response": "Hallo Thanks for your query.Your husband has Bil mild to moderate Hydrocele.You have not mentioned any thing as regards sperm anslysis for eg sperm count, sperm motility  etc.If sperm count is less than normal  you have to take some measures like doing some moderate  exercise daily,avoid alcohol,smoking ,and take anti oxydents medication and Tab Fertyl once daily for three months Repeat your semen analysis after three months .Though surgery for correcting varicocele does not guaranty  100% positive results you have to undergo it as there are 50% chances of improving the sperm count after the surgery which is minor in nature.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have shin pain which gets relieved on ice pack. What could it be?\n\nHello doctor, I have pain in my shin. There is one spot that in particular hurts. It hurts no matter what I am doing. The pain started when I started jumping rope yesterday. Earlier in the week, I started doing snatches for the first time and I may have not had proper form. I have now stopped. The only time I get some relief is when I put ice on it, and the pressure that the ice packs give help a bit. The pain is only in my left leg on the bottom half. Sometimes the pain moves into my foot in the area on the foot bone between my big toe and second toe. My height is 5' 6\" and I weigh about 140 kg.",
    "doctor_response": "Hello. From your description, the likelihood of a stress fracture is minimal unless you are grossly Vitamin D deficient. There is a good chance this is tendonitis or periostitis which are both inflammatory conditions as that arise in the tendon and lining of the bone respectively. The fact that rest and ice help favors the above two conditions. I suggest that you stop skipping at the moment. Take NSAID (non-steroidal anti-inflammatory drugs) as available. Ice the area regularly three to five times a day and see how you are at the end of next week. If pain is better then gradually return to physical activity. If no improvement then seek professional help for a complete examination and suitable blood tests.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it advisable to eat expired food?\n\nHello doctor, Please tell me what are the things that can happen when you eat expired food.",
    "doctor_response": "Hello. If we eat food that is expired, the efficiency of the preservative is lost. So some organisms if present can multiply and can send some endotoxins. Also, the taste and odor can be altered. The food has a shelf life. If this is crossed some people can have diarrhea or acidity in the stomach. This can be due to the chemical nature of the food.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do to increase height?\n\nsir im 18 and im 5'65 ...unfortunately im habituated to masterbate every day since last 5 years ....but in my schooling I was the tall guy among my friends but now im not able to grow even1 inch ..now I stopped doing masterbating..and doing exercises and going to swimming ...if I do all of them can I have any chance to grow 4or 5 inches more?please help me",
    "doctor_response": "Thanks for asking in healthcaremagic forum    I understand your concern.     Final height attained by a person depends upon the genetic make up derived from his parents.     You might have been a long guy in your school days as you might have had growth spurt(puberty) earlier than your friends and attained maximum height which can be attained for your genetic makeup then.    So, you need not worry as such, as males can grow till 25 depending upon their genetic makeup.     And masturbation is harmless and is not related to your height. Also you cannot increase your height by any medication/exercise unless its in your gene.    So, be cool and all the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and vomiting in a child\n\nYes my 31/2yr old had 101 temp this am, some vomiting, then played with no fever as if never sick. Then fever spiked 5-6 hours later. Gave tylenol& then Motrin (per Dr.). Played again even played outside. Gave a bath then fever showed 101. Tonsilitis or strept throat? He has he water, jello with fruit, Popsicles, Cheerios, crackers with peanut butter. Brushed his teeth & said his throat felt better after brushing. Solution?",
    "doctor_response": "Thanks for following up. I understand your concern .It seems your daughter has viral infection.  1.For fever we have a number of brands of Ibuprofen,Paracetamol available in India, if child vomited you can use rectal suppositoria-adol-250 mg2. Your girl is very smart and pointed that after rince she felt better. Solution?Rince gurgle with chlorhexidine 1:1 with water.3.Lozengez  and sualin 1 tablet 4 times for resolution4.Hot drinks :ginger , lemon, turmeric powder tea, honey5.Take steam inhalation when temperature is normal 6.Antihistamines- loratadine 1/2 tab 1 time for nightIf she has white poits on the tonsillas or she will not better she should start antibitic-amoxiclave250 mg 3 times 6 daysBest regards Dr.Svetlana Shrivastva",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dried and tightened/shrunken mouth?\n\nThe roof of my mouth has a texture to it like on a football. It feels kind of like when your fingers get pruney from being in the water too long. It doesn't hurt it just feels weird. It every once in awhile gets dry then it feels uncomfortable like it feels like it shriks or tightens up?  Can you tell me what is wrong?",
    "doctor_response": "Hello! Read your query.You did not mention about your general health.This resembles candidal infection.Make sure your blood sugar is under control.Check your immunity levels.Follow a strict non-alcoholic and tobacco free life style.Apply mycostation ointment twice daily over the area.Have 3 liters of water per dayHope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat a painful pulled ear piercing?\n\nMy four year old daughter's earring got pulled out today when she caught her shirt on it - and when I looked at it, there is a little tube of skin about 1/8 inch long coming out of the front of the piercing hole.  The skin is still attached on the inside of the piercing. The piercing is only 3 months old. She says it hurts to touch it. What should I do?",
    "doctor_response": "Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain it seems that there is infection as well as injury to the soft tissues at the site of ear piercing due to sudden pulling of the ear ring and is most probably an infection in the area of piercing while can also occur due to allergy to the metal present in the earring in case if you are not wearing earrings made of inert material like gold or plastic..It can cause allergic reaction by the decomposition products formed due to decomposition of the metal by reacting with air and water.1.I would suggest you to first of all gently remove your earrings and do not wear them again till you get the infection resolved..2. You can start cleaning the area of infection with antiseptic solution..3.Apply Triple antibiotic ointment over it..4.Do not let air or moisture to accumulate..When it resolves wear gold or plastic earrings only..If it worsen consult a General Physician and get evaluated..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora..",
    "dialogue_context": ""
  },
  {
    "patient_message": "What symptoms can be expected from a child who has taken xanax?\n\nMy two  year old granddaughter got into her Mothers purse and took 1 mg xanax.  Since the Mom can't find the xanax and she's not sure if she took one or not, what kind of symptoms would she have?  Should she go to the hospital?  The Mother has a presciption from her doctor.",
    "doctor_response": "Thank you for following up. I figured your concern. Alprazolam(xanas) is medicine from group of benzodiazepin,which can give 1.Dizziness, drowsiness2. Vomiting,nausea3.Fast heart rate4.Low good pressure5.Blurred vision6. Allergy Your daughter doesn't have even dizziness and vomiting, then don't worry,if you are confuse give to her charcoal 1 tab immediately and take her in ER for washing of her stomachBest regardsDr. Svetlana Shrivastva",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What is the possibility of cleaning ears with q-tip cause ear perforation?\n\nHi doctor, I have stuck a q tip in my ear because it was itching and I think I may have burst my eardrum. I have some pictures.",
    "doctor_response": "Hello. The pictures are not completely clear but I cannot see any perforation. (attachment removed to protect patient identity).  When did the cotton piece stuck inside your ear? Did you notice any blood drops on the cotton piece after getting it out from your ear? Do you have any other symptoms as tinnitus or ear pain?",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause cretanin level to be in border line?\n\nsir i am taking losacar a and zabesta 2.5mg in the morning and losacar 50mg and zabesta 2.5 in the evening for long time now my blood urea is 12 and the cretnin level is gone to upper side means 1.16 (normal values of cretnin is 1.20) please suggest me why my cretanin level is gone to border line.",
    "doctor_response": "Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Creatinine level is only mildly elevated and this level usually do not point towards any renal pathology.2. Increased muscle mass or a protein rich diet can cause increased creatinine. 3. Any level above 2 is significant. If you have any doubts, get a glomerular filtration rate test done, which should be definitely normal for you. Continue with regular intake of medications and maintain blood pressure within the normal range to avoid any damage to kidney.Hope it helps.Any further queries, happy to help again.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why am I not bleeding even after taking four pills of Misoprostol for abortion?\n\nHello doctor, I am O negative and my husband is Rh-positive. I have a baby of 1.6 years old, Rh-positive. Now I am pregnant of six weeks and do not want to continue so I take an abortion kit but after taking all four Misoprostol pills bleeding not started yet and it is almost 24 hours gone. What to do now? Do I have life threatening risk? I am worried.",
    "doctor_response": "Hi. You need to do one ultrasound scan to confirm the pregnancy. If you had done scan before taking pills then wait for 12 days and if no bleeding then repeat ultrasound scan. And if you did not do ultra scan then get it done. You should bleed. But if not then either you had wrong pills or pills did not work. And will require surgical abortion. You need to consult a nearby gynecologist or abortion center. One rare chance is to have an ectopic pregnancy if you did not do an ultrasound scan. But if it was there then you should have more pain in the lower abdomen on one side. It will clear in the next ultra scan. In that case, treatment may vary. After bleeding starts you should take Rh anti D 150 ug injection within 72 hours because we do not know the fetus blood group. Do drink more water. And if you did not do ultrasound scan then you can repeat the urine pregnancy test also. Because sometimes kits also come faulty and give false-positive results. So to compare or confirm you can repeat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in groin?\n\nHello, My husband was complaining earlier of a painful boil in the groin, also he had pain higher up in the groin, away from the boil. He s gone to bed, and was only there 10 mins when he said he felt hot, but was shivering visibly. The feeling of unwell has come on him so quickly, and that s my concern.Can you help?",
    "doctor_response": "Hi,It seems that there might be having ingrown hair follicle infection giving rise enalrged inguinal lymph node in the groin.Due to bacterial infection he got shivering, feeling hot and unwell.Go for one antibiotic medicine like Amoxicilin for 3-5 days.Give analgesic like Ibuprofen as needed.Within 2-3 days he will be alright.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Had dissolvable stitches for extraction of teeth. Now getting the stitch. Should i handle by own?\n\nI had dissolvable stitches to suture up extraction of broken molars on November 6. It s now December 16 and the stitches have dissolved, but something is now protruding from the gum cartilage near where the stitches were placed & I m thinking it could be a hardened, undissolved stitch. Is that possible & can I pull it out with tweezers if I do it carefully?",
    "doctor_response": "Hello Welcome to HCM I would like to tell you there are dissolvable stitches that are composed of silk & processed collagen.These stitches are made of materials which our body can absorb after they get dissolved. Additionally, the time for dissolving may be shorter or longer, depending on the stitches, again, depending on the recovery of the wound itself.One type of these stitches is created from processed animal collagen. This material is capable of holding the wound firmly for at least 7 days, getting dissolved through the course of 2 months. I don't know what material has been used in your case.So i would suggest you to wait for 1 more week & then consult your dentist but don't try to anything by yourself. Take Care Regards Dr.Neha",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chronic pain syndrome\n\nmy maid daughter is having same symptoms like this cps.she is taking too much medication last 5 yrs. but no improvement till now.she gets this attck daily sometimes 3-4 times a day.her symptoms are..her body become stiff.when she fall down she is heavy to lift when she fll down.she bites her tongue.she tears clothes even when in public.she shouts and run out of home without anybody notice her .she does all dangerous activities.she is having this problem for 5 yrs only.her age now is 20.pls give me a reply..what treatment to be given and is it curable",
    "doctor_response": "Hi dear. I had gone through your query. Sudden onset of behavior disturbances need to rule out certain conditions. Like 1st is epilepsy.Siezure can produce similar features of sudden outburst. Investigation like EEG can be useful.2nd is psychosis.Psychotic illness can lead to shouting and behaviour problems.So need to consult psychiatrist. After proper evaluation we can able to give proper treatment. So consult and get help. I hope I have answered your question. Still if you have a query then feel free to ask. Thank you. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for TB in spine?\n\nHello Doctor, I had TB Spine before 6 years and underwent a surgery in spine and i am normal in all means. now I consulted with my doctor one month before and get cleared that i dont have any problem now. Is there any possible of re-occurance of it again. I am going to get married. Is it good to tell about it to my fiance. My told who did surgery said that it is not needed to say that i had Tuberculosis, Just inform that i had problem in spinal so i underwent surgery. I need your suggestion.",
    "doctor_response": "There are Recurrence chances in spinal TB but it depends upon your treatment you taken you told that you had surgery and your consultant said it's ok then it's ok because at this time and a  long time after this there are minimum chances to develop TB so it would be better to say your fiance about this",
    "dialogue_context": ""
  },
  {
    "patient_message": "Developed a spot on nose. What is it? Why did it bleed? Why is it growing?\n\nGood day About 2 years ago I developed what I thought was a small spot on the inside of my nose . Over time the small spot has grown into a circle shape about 10mm. When I pressed it earlier small round hard fleshy balls came out and my nose began to bleed profusely. Once it stop I pressed the remain and about 10 of these little round fleshy thing came out followed once again by a nose bleed. This has happened 3 times now and each time it gets bigger. You hear so many cancer stories these days I have to say I m a little worried.",
    "doctor_response": "Hi there, In case of unexplained bleeding from any openings, it is advised to get proper medical evaluation done. See a nearby ENT doctor and follow the advise. Take care Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hair fall and thinning\n\nhi doctor.i m rahul age 20 and male.i m experience hair fall and there is a portion in which hair is thinning a bit but hair has not completely lost and its not the male hair-line.its about somewhere in between my parting in the front portion.this has happened about 6 months ago. when i moved to bhubaneswar.i realised it only when i grew my hair longer than my normal limits. is there any possiblity that my hair fall can be due to vitamin deficiency?  can i get my hair back? please suggest me necessary steps. m worried!",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As per your case history you are having male pattern baldness, my treatment advice is - 1. Take good nutritious diet full of green leafy vegetables and milk. 2. Apply a minoxidil 2 %solution twice daily on affected part. 3. Other treatment options are oral Finasteride and mesotherapy done by a dermatologist. Thanks. Dr. Harshit bhachech. MBBS, DDVL.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chiari 1 malformation\n\nIm a 43 year old male I was diagnosed with Syringomyelia 10 years ago after a head injury. Ihave had constant pain, headches. Some loss of motor function. With my MRI s Ive had multiple ones I was told I have a syrinx from trauma. I get MRI s every couple of years. My last one the radiologist said I have a chiari 1 malfornmation. My internist told me over the phone I was probably born w/ it. He said I need to see a neurosurgeon. Q. how could they have missed this for a decade? Why is this so hard to treat? Is there a cure on the horizon",
    "doctor_response": "Hello,Chiari malformation is generally an inborn condition, however, the symptoms appear later in life. Trauma does not cause it. In your case, since the symptoms seem to be significant, surgery is necessary. It is not a simple condition, but it is not hard to be treated. Consult with a Neurosurgeon.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could severe pain in center of torso after bending a lot be due to pulled muscle?\n\nI am a healthy 38 year old male. I lift weights an excersise. The other day, I waxed our boat. I was bending down a lot in awkward positions and waxing. Two days later , I have a deep hurt in center of torso at top of stomach and bottom of chest. Sometimes I feel sharp pain when I breath in or burp. Pulled muscle?",
    "doctor_response": "Hi, You are right. this is due to muscle tightness. You need to use hot water fermentation and relax the muscle with gentle massage. You should be fine soon. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does Zyrtec increase blood pressure?\n\nI was taking 3-4 Zyrtec per day with nasal decongestant spray. I have hypertension could this increase my BP further. I have stopping taking these meds. But I do wonder could have affected my BP. MY BPreached 194/113 ,now on anti hypertensives med and my Bo is on its way down. Thank you. Nick",
    "doctor_response": "Hello, I would explain that Zyrtec does not usually cause high blood pressure as an adverse effect. For this reason, I would recommend consulting with your attending physician for a physical exam and some tests in order to investigate the possible causes underlying high blood pressure values: - complete blood count, PCR, ESR for inflammation- thyroid hormone levels for thyroid gland dysfunction- blood electrolytes for possible imbalance- kidney and liver function tests- fasting glucose. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could thin, white discharge be recurring yeast infection?\n\nI had a yeast infection about 2 weeks ago (as per gram stain it was +1) and now I have this thin white discharge that if you roll it, it would be like a small rolled wet tissue. I also have occasional itching but its not instense. Could it be that I have yeast infection again?",
    "doctor_response": "hi,   I understand your concern.   Yes, the white discharge with itching you have is most likely to be yeast ( fungal)infection-  It has tendency to recur again & again unless treated adequately.     -Few of the fungi can hide in folds of vaginal mucus membrane& restart functioning after the medicines are withdrawan.    - THe yeast infection is transffered between two sex partners during sexual contact- so treatment of both partners followed by rigorous efforts to  avoid reinfection is needed to avoid reinfection.  Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could the purple bruising on calf be significant of?\n\nI have noticed that I have an unpleasant-looking, yellow and purple bruise on my calf. I have noticed bruising in this exact same spot in the past, but I have absolutely no memory of ever getting injured or hitting my leg against anything. Might there be another reason for this recurring bruise?",
    "doctor_response": "it may be A drug allergy...is there any previous history of any drug previously?   post a picture of it?  is it itchy?",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for back pain while masturbating\n\nwhen i masturbate i get a lot of discomfort in my whole back especially up around the base up my skull and also in what i think are my illiacus and psoas muscles.  I had a stomach parasite for 8 months and was bloated ALOT and hadnt been doing to much activity.  Thanks",
    "doctor_response": "Hi,It seems that during masturbation there might be having more back muscle strain due to excitation and vigorous activity.Sedentary life can lead to muscle spasm easily even with less strain.Avoid sedentary life style.Go for regular exercises like running, walking, swimming etc.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is sperm count of 120mil/ml with 40 % motility normal ?\n\ni am 43 year old i am married 3 years ago but we are yet to be blessed with a child. i under went homeo pathy treate ment for 5 months to improve my sperm motility % but there is not much improvement my last active motility % is 40 and sperm count is 120mil/ml normal.but doctor told my treatement is over.i currently taking ayur vedic treatement for improving active motility%. my question is since my sperm count is 120 mil/ml and active motiliy is 40% .40% of 120mil comes 48 mil sperms/ml active motile sperm does it not sufficient to make my wife pregnent? am i still impotent ? kindly inform is it sufficient or still more is required to over come infertility? my allopathy doctor priscribed anti biotic zenflox plus 10 tab to kill the klebsiella bacteria that is one of the causes for reducing motility ,found during semen culture test. my question is this 10 tabs of zenflox plus is sufficient to do the job or some more has to be consumed ? kindly let me know with your email contact detail. thanking yoiu",
    "doctor_response": "hi 10 taab of zenflox is ok to kill bacteria. u need not to consume more 60% motility is required but u have high sperm count so i think u should not put on that category u need more chance to make ur wife pregnant",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain in the left shoulder and elbow after implanon placed. Swollen armpit. Reason?\n\nI have Implanon birth control in my left arm . Two days ago i started having a pain in my left arm and when I extended my arm i had pain from my shoulder to my elbow . The next day the pain had moved to my armpit where it now looks slightly swollen and I can feel a small lump and now when I try to left my arm at the shoulder i have a strong pain. could it be caused by my implanon?",
    "doctor_response": "Hi, Thanks for the query. Rarely side effect like fibrosis around the implanon or development of infection etc can occur. The lump you are feeling could be swollen lymph node. So you once consult gynecologist, get examined. If the presence of infection is confirmed you may need antibiotic course and anti-inflammatory and analgesic drugs. Possibly with this the symptoms will decrease. For more details you can ask me through:  Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for toenail infection\n\nI have an infected big toenail that I hit a week ago and my nail is loose I am on Co_amoxiclave 500mg. It is oozing puss and is very sore, I have  been bathing it in warm salted water twice a day but it will not stop hurting me. I have put a dressing on it with gauze and micropore is there anything else I could do?",
    "doctor_response": "Hello,Welcome to HCM,As you are having a infected great toe which was hit against some hard surface which has lead to loose nail, for which your doctor has prescribed antibiotics and suggested other remedies to treat it.As the puss is oozing out of the wound, I would suggest you to follow1.Regular dressing2.Tab Augmentin, 675mg, twice daily for 5 days.3.Topical T Bact ointment 4.Wound hygiene is of top priority.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat multiple cysts in organs with the largest one located in posterior aspect of left kidney?\n\nI was diagnosed with multiple cysts, the largest is located along the posterior aspect of the left kidney. this measures 10 cm. in height and 7 cm in AP diameter. The transverse diameter of this cyst is about 8 cm. This cyst contains two septations within it. The septation located along the superior aspect of this cyst is mildly calcified. The septation along the inferior aspect of this cyst shows slight enhancement. The characteristic of this cyst are consistent with Bosniak type II F cyst. It is a minimal complex cyst. The other cysts are simple cysts, one of these measure 5.5 cm. My Primary Physician ordered Ultrasound of Kidneys and Ct urogram enhancement. I also had CT scan of my spine, 5 small bulging vertebras. Experiencing extremely severe pain. Most probable Cysts are pressing on my spine. No herniation or degeneration. Am I a good candidate for Laser Laproscopic surgery to remove these cysts?",
    "doctor_response": "Hello and welcome to HCM,You are suffering from two different problems.One is that of multiple cysts in the left kidney and the second is that of bulging intervertebral discs.The cysts in the kidney are benign lesions and require observation over a period of time.Surgery or laser treatment may not be required.The renal function tests need to be done to look for functioning of the kidney.If there is fall in the renal functions, surgical excision or laser treatment may be required.The bulging discs can be corrected by complete bed rest alone.In case the discs do not replace back after bed rest, other treatment modalities need to be done.You need to stay in touch with a nephrologist and orthopedician.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is high creatinine level of 6.8 while being diabetic concerning?\n\nMy Dad has just been diagnosed with high creatinine level, he has been suffering from Diabetes for the past 18 years. The Diabetes is in control now but the creatinine level is 6.8, which seems very high. We are really concerned. We are based out of India. Kindly help. Any opinion would be highly appreciated.",
    "doctor_response": "Hello! Thanks for putting your query in HCM. I am a Gastroenterologist. Yes it is a matter of concerns. In diabetic patient serum creatinine can be increased due to kidney disease. I will advise you to visit a doctor for evaluation.I hope I have answered your query and this will help you . Wish you a good health",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest cure for abdominal pain\n\nHi my son is two years and 5 months old. I live in Mumbai India. He has been complaining of tummy ache and he has been going potty three or more times a day since past three days.stools are formed but weird. Can I give him nor met or taximo?and what dosage.thank you..",
    "doctor_response": "Hello,It seems your kid having viral diarrhea. Once it starts, it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting. You need not worry.There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic-associated diarrhea. I suggest you use zinc supplements (Z and D drops 1ml once daily for 14 days) and ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is a very important and crucial part of treatment. If there is vomiting, you can use syrup Ondansetron (as prescribed by your pediatrician).Regarding diet - Avoid fruit juices as they might aggravate diarrhea. You can give zinc supplements and ORS apart from normal vegetarian porridges and soups.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sumanth Amperayani",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any possibility of pregnancy even if i had my periods?\n\nme and my boyfriend had unprotected sex may 31st 2015 my period came on the next day which was june 1st 2015 and today june 4th 2015 makes 3 days that I had my period and its off is there a possibility I could be pregnant? could this be my last period?",
    "doctor_response": "Hello dearI understand your concernPregnancy will occur when you did unprotected sex during fertile phase of period.But I think you did sex just day before period date and got period on next day after sex.You got period for 4 days.Pregnancy is not possible in presence of period because absence of period is most common and confirmatory sign of pregnancy.So there is no chance of pregnancy.Avoid stress, take healthy diet, drink plenty of water and do regular exerciseHope this may help youContact further if follow up neededBest regardsDr. Sagar",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can pubic hair and scrotum itching with redness be treated?\n\nhi i have itch around my pubic hair area,.my hair gets stuck together sometimes and i have nodules on the end of my pubic hair ,also my scrotum area is red and itchy,i noticed this after i had sex with a girl and felt something penetrate (bite me ) i dont have an STD ,i have been checked ,and i have tried anti fugal shampoos and creams,this happened in UK but this girl has been abroad ,,please help me",
    "doctor_response": "Hello,It may be due to fungal infection. For that you may apply clotrimazole ointment locally. Maintain proper hygiene. Avoid sweating. Take tablet loratidine for itching Hope I have answered your query...Let me know if I can assist you further.Regards,Dr Shyam kaleFamily and general physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bruise around ankle with palpitation?\n\nOn and off for the last couple of months, around my ankle feels bruised. This is not the ankle itself and there is not an actual bruise. Location is above the inside ankle and about an inch across the foot. I can feel this with palpation and upon rotation of foot.",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.It may be due to infection. Treatment of it is analgesic such as ibuprofen and antibiotics. You are advised to consult Orthopedician for it. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes child to have loose stools after starting Nan 2?\n\nMy baby boy just turned 6 months, I introduced him to nestle nan 2, he was on nestle nan 1 before, but now he has loose stools. He always needs a diaper change every now and then compared to before. What is causing this change? He does not cry though. Am just worried about these excessive loose stools.",
    "doctor_response": "Hi..it is quite common when a formula feed is being changed and hence do not worry. You have rightly mentioned that he is not crying, that means he doesn't have any pain in the tummy. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry.DO NOT WORRY ABOUT THE FREQUENCY OF THE STOOLS IF THE KID IS ACTIVE AND PASSING URINE WELL.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Teenager.  Face turning white, stiff face in the morning, discharge of clear like water.  Detected lupus.  Right diagnosis?\n\nI'm 15 years old and I need to find a good doctor. One day my face start turning white, so I went to doctor and they said I have Lupus. I'm  getting the go around and I'm tired. I been to doctors in Fairfax Hospital for children. So now I  a need a to tell me if I really have lupus and I need to be treated. My face be weeping some kind of  clear like water. My face is stiff in the morning.",
    "doctor_response": "HelloAs per your description, it doesn't look like lupus face. Lupus rahes hardly ever discharge clear water. Consult some good rheumatologist or Dermatologist in your area and get blood test \"ANA\" done.  Best Wishes",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes stomach ache, diarrhea and throat infection in a child?\n\nHI, my 7yr old daughter is having fever since last 48 hrs and has been diagnosed with Throat Infection. Has been prescribed paracetamol and and antibiotic. However, the fever persists at around 101 to 102 levels. Also she is complaining of mild stomach ache and has diarrhea. Is there a reason to worry, or should I wait for 24 hrs more.",
    "doctor_response": "Hi,I guess the diarrhea came after starting antibiotics. Usually, it will take 48-72 hours for fever to come down after starting antibiotic. If he is not very tired and taking diet as usual, need not worry- just wait for 2-3 days. Meanwhile, give him plenty of oral fluids (ORS best) and a soft diet. The diarrhea is probably related to antibiotic. It is because of alteration in our normal gut flora- will subside once the treatment is completed. If diarrhoea is quite disturbing, we may need replacement of antibiotic and addition of a probiotic, your doctor will guide you.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam TK, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for excessive hair loss in asthmatic toddlers on Dulera & Proair medications\n\nMy 10 year old granddaughter has been on Dulera and proair for asthma. She has lost her hair 2 or 3 times since on these medications. she is currently loosing her hair again. It is not to the scalp, bet leaves her with a 1/2 in fuzz. Can these medications be causing this? She has had all kinds of testing done to rule out other causes.",
    "doctor_response": "Respected User, hi I evaluated your query thoroughly.*Per se Dulera & Proair not directly associated as side effects causing excess  hair loss, but - decreased host immune repsonse following corticosteroids - less amount of iron ,protein ,  trace elements like zinc, magnesium needed    for hair growth & maintenance    are responsible for it.*Remedy is directed to : enrich food in iron , protein, multivitamins ,   multiminerals along with local applications of certain agents to make hair   roots stronger . Hope this clears your query. Thanks for using Health Care Magic & keeping trust in our services. Wishing her fine and speedy hair growth. Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why did i get pain in my hip and groin after jogging?\n\nI went jogging last night and when I got back to the house I got a horrible pain in my hip and groin.. I just brushed it off and went inside and drank some water and showered. I went to bed and when I got up I couldn't lift my leg to get back into bed and I could barely walk. What is going on?",
    "doctor_response": "Your description of symptoms suggest an pain over a short period. This can typically happen if there was a pulled muscle/ligaments during running, the risk being greater if there was no warm-up and stretching done before jogging. Also if you started jogging after a gap of few weeks, that may result in acute muscle strain. You need to take rest and avoid further jogging and take pain medicines like Diclofenac and paracetamol combination twice daily for 2-3 days.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why 6 year old is throwing up before school and crying?\n\nMy daughter is 6 years old, she went to Junior Kindergarden, senior kindergarden and now she is in gade 1, never had any issues with school, she has always liked school and has done well in school, just recently she has been throwing up before school in the play ground, crying and saying that school is too long, never complains about any pains and when we come home she is fine, we have asked her if anybody is bothering her at school and she says no, please advise what we should do.",
    "doctor_response": "If there was everything previously than it is not due to school phobia or separation anxiety but more chances of that someone in school is teasing her. so you should enquire about that after taking her in confidence.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and sweaty palms and how can these symptoms be treated ?\n\nhi, i m 19 year old female i been feeling dizzy, alot of shaking, weak, and sweaty hands at times. what can be the cause of it please help! i dont have insurance right now do you think i should have to go see a doctor? thanks",
    "doctor_response": "Hi,nancy thanks for posting query.Do not worry,drink plenty of fluids,take light diet.Get your blood pressure checked.If it is normal there is not need for concern.This could be due to some ear problem.Avoid drinking very cold liquids,take steam inhalation,.You should be fine,if not the please see your doctor.bye.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does skull fracture and concussion show in Xray and will these injuries cause a long term problem?\n\nHi, I have a couple of questions about a possible skull fracture as a child ( I was 10).  I fell underneath a merry-go-round as it was going around, and when I started to get up, I was hit by a piece of angel iron on the bottom side of it.  My folks didn't take me to the Doctor, but I remember I had one heck of a head and some bleeding.  I'm now 57 years old, and I can now feel a dent in one spot, and like ridge that extends towards my forehead from that dent.  I'm wondering would this possible skull fracture show up in a x-ray if I had one?  Also, I believe I may of had a concussion from another injury from a few years ago whenI fell from about 4 ft. off the ground and landed on my pelvis, which then caused my head to snap back and then bounce off the cement. I had a headache for weeks.  Do concussions show in xrays?  I no longer have the headaches, but I would like to find out if these injuries did any damage that could possibly be a long term problem.  How do I approach a doctor to get him to authorize a cat-scan to see what may of happened from my injuries?   Thank you much for you input",
    "doctor_response": "Hi. Concussions or organic problems of the brain can be shown only on CAT scan or MRI. You need to explain your attending Doctor the history in proper and your concern about the possible complications you could have. You can always request to rule out the problem or can tell him you have dizziness or headache ( in case it is needed).",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes chlamydia infection?\n\nI am being accused of giving someone chlymedia. I have absolutely no symptoms. I have been in an managomous relationship for 3 months and they are telling me that as of 10 days ago they are showing symptoms from chlymedia. I have absolutely no symptoms. Is this possible",
    "doctor_response": "Hi, Thanks for writing to HCM. Chlamydia is a common sexually transmitted infection (STI) caused by bacteria. People who have chlamydia often do not have outward symptoms in the early stages. It can cause health problems in the later stages, including preventing women from getting pregnant or even endangering their pregnancies. Unprotected sex without a condom and unprotected oral sex are the main ways a chlamydia infection can spread. It need not be penetration one. Even touching genitals together may also transmit the bacteria. It can also be contracted during anal sex. Most people don\u2019t notice the symptoms of chlamydia. Symptoms  appear usually one to three weeks after you have been infected. Some of the most common symptoms include:1. burning sensation during urination2. discharge from the penis or vagina (yellow or green)3. pain in the lower abdomen4. pain in the testicles5. painful sexual intercourse in womenThe most effective diagnostic test for chlamydia is to swab the vagina in women and to test the urine in men. Chlamydia infection is easy to treat. Antibiotic used include Azithromycin in a single, large dose, but the dose may also be spread out over 5 days or Doxycycline to be taken twice per day for one week. Hope the information provided is useful. You can get evaluated and treated accordingly. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for anger and violence\n\nmy father always angry and mad, sometimes get really mad and hit his head by his hands and sometimes says I wish I can die. I called his insurance nurse line and I explained everything but the lady who answered the phone refuse to talk to me unless my father give her a permission so she can talk to me. I called a local mental health institute but the lady who answered the phone said we can not do anything unless he is with you and hitting his head again so you can call us in the same moment that he is doing that. That s ridiculous, how come the mental health patient will say I am crazy and give a permission for treatment, I am trying to treat my dad so he doesn t get worse and hurt himself or hurt my mom, and they told me wait till he will be really get dangerous so you can call us. so HOW CAN I GET HIM TREATED?",
    "doctor_response": "Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.Anger and violence could be stemming from a primary psychiatric illness. The primary psychiatric illness has to be treated. Divalproex is a good drug to control aggression. 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/dr-srikanth-reddy\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Wish you good health,Kind regardsDr. Srikanth Reddy M.D",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes bad sensation about food?\n\nHi , I am 29 now , I had fits before 5 years , Now i am getting the indication like bad sensation abut food , what are the things i am seeing in front , then night immedaitely went and took the eptain and slept well ,Now morning i am getting the same sensation . Please help",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much.  Please understand your condition well so as to clear your problem. In psychology, we broadly call it obsession. You had that disturbing sensation once. You expected it to happen again and tried. Then you started experiencing it as you were expecting it. Then your body brought the familiar symptom because you are expecting it. Then you started worrying that the symptom is coming again and again and expect it. Body brings it again as you are expecting it. You become worried and so on. That is obsession in simple terms. Learn to Ignore it and the problem vanishes. 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 the needed psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is there any connection between antihistamines and gall bladder pain?\n\n40, female, mom, overweight - I have had hives everyday for 2 months, doc recommended antihistimines, which I take daily.  I also suspect gallbadder issues in the last week.  Intense achey pain under ribcage on right side, which nothing subsides - not position, not asprin, etc..  I've had the pains occassionally over the past year, but this week has been pretty sustained and more intense.  Is there any connection between the antihistimines and gallbadder pain?  I have an appointment on Friday, but this is the 4th time back in 3 months regarding hives/upper resipitory issues.  I didn't have the gallbadder issues when last visiting my doc.      I just need another opinion.",
    "doctor_response": "Hi. Antihistamines are not commonly known give rise to pain in abdomen or gall bladder problem. Please go for sonography of abdomen to rule out other problems.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Tylenol be given to a child with abdominal pain and nausea?\n\nmy daughter 5 yo, presented two nights @0100 ago w/ acute onset n/v and abd discomfort, her abd was - for point tenderness, rebound pain, or regidity, that continued thru the day, she was afebrile until about 1600 at which point she spiked to 103, I gave her tylenol, the following morning she was afebrile and seemed to be cleared of the n/v. Last night my 4 yo son started w/ the same sx also afebrile, now the female is c/o abd pain and nausea again, she remains afebrile. I suspect a viral etiology with the delayed onset of the sibling. Since her sx have now reached a 3 day point, do I need to take her to the ped for eval or continue to treat her at home, thanks, RN",
    "doctor_response": "Hi, By what you say I feel that both the kids are having viral illness as it spread in two members of the same family. I will explain you how a viral illness behaves so that you can be more confident. 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. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is low BP after taking Clonodine for high BP cause for concern?\n\nI have high blood pressure. Have been fighting with it for 2 weeks. going up and down. calm down for 2 days . Did not take a clonodine . Then today stayed average 176/105 . So finally took a Clonodine .( I take blood pressure pills ) . Within an hour and half . Has went down to 98/65 fast . Do I need to be concerned. Very weak and lightheaded . I am a 42 year old average weight 150 , female , height 5'7\".",
    "doctor_response": "Hello,Sometimes one may get a such response with clonidine called as first dose hypotension and it will settle gradually. But you need to monitor blood pressure frequently. If it falls further you should have ors solution or salt sugar water which will raise your bp. To avoid such responses, you need to be regular with medicine. Before clonidine, you should have other first line medicine like Amlodipine, telmisartan, Metoprolol, hydrochlorothiazide etc. which has lesser side effects.Hope this helps you and get back if you have any doubts.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I feel sick and nauseous after taking eight Yaz pills. Are these side effects of taking too many pills?\n\nHello doctor, I decided to use birth control pills two months back. I took the whole pack and then decided I will rather stop, because of all the bad effects that they have on our body. I got my period after I stopped taking the pills, but this month I did not get my period. I had sexual intercourse twenty days back, and the\u00a0condom broke. I live in a country where emergency pills are not allowed, so I took four Yaz birth control\u00a0pills in the morning and another four after 12 hours. I do not even know if that works, I read and heard it does. After 3 to 5 days, I managed to get the emergency pill and took it.\u00a0Now after a week, I feel sick and nauseous. I took the pregnancy test, but it was negative. I feel it is probably too early to tell. Is it possible to get pregnant, even though I had no period the previous month?\u00a0Or are these just side effects of taking too many pills?",
    "doctor_response": "Hello. I see you have messed up your hormonal balance. Your first step was absolutely right. The principle of emergency contraception is that it is a very high dose of progesterone hormone. This is the same hormone produced in the second half of periods after ovulation. This makes the inner lining of the uterus (endometrium) very thick suddenly, by a single dose. This thickness is unfavorable for the possible pregnancy. So, the embryo that is formed just slips out without a proper place to sit. As it is a single dose, it cannot hold on, and it gives way or falls off, so you will have periods within 7 to 10 days of having pills. This is the same hormone in combination with estrogen in Yaz. If you recollect, in the second half of periods, you have similar symptoms of nausea, vomiting, heavy headedness, bloated feeling, mood swings, depression, and breasts discomfort. As the hormone has been taken in a high dose, that too on two occasions, the symptoms are exaggerated. You have to wait for 7 to 10 days after the intake of emergency pills for the bleeding to occur. You can try taking symptomatic treatment for gastritis, like Pantoprazole and Domperidone combination, twice a day, half an hour before food. Consult your specialist doctor, discuss with him or her and start taking medicine after their consent. If you have crossed your expected period date by even a day, you can check your urine for pregnancy. Further confirmatory is blood serum beta-hCG (human chorionic gonadotropin). For further queries consult an obstetrician and gynaecologist online,--->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatments for lump in breast\n\nhi, i am an indian lady 44 years old. on 2nd of may i found a lump on my left side of my brest. on 5th of may i went to the hospital to check the doctor said it may be a infection or sis. but you should do the memo test to find out in detail. here i find very difficult to get the appoinment. the latest in november i am worried. i got pain all over left brest, pocking,pain under my armpit and i can t carry up my left hand straignt there is pain.",
    "doctor_response": "Hi! Good morning. I am Dr Shareef answering your query.I think your doctor might be right in advising you for an initial mammography. However, the treatment can not be delayed due to not getting an appointment for the same. You could discuss with your doctor for the possibility of a fine needle aspiration cytology (FNAC) or a core biopsy of the lump to arrive at a diagnosis, and initiate treatment without delay. Till that you might go for an anti inflammatory drug for a symptomatic relief only.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling lightheaded, numb hands. Taking medicine. Help\n\nI have felt lightheaded on and off for the past hour, especially when standing up and moving. My hands are also going numb and feel like they re trying to clench up against my will. I had a heavy amount of salt in soup broth a few hours ago on a pretty empty stomach and don t know if this is due to my salt intake or not. I m also on medication that does cause lightheadedness but I ve been on the medication for nearly a week and was on the medication years ago and have never experienced this reaction. I m currently having a lot of water (I m on my second glass) and the lightheadedness and hand numbness/clenching is starting to go away, but I m also sitting and as I said before, these symptoms only occur when I stand or am moving, not when I m sedentary. Please help!",
    "doctor_response": "Hello, Thanks for posting this question in HCM The description of lightheaded feelings you have given suggest a possibility of postural hypo tension. I will request you to check the blood pressure in supine and standing position to know this. Once this is established, you need to meet a local physician to find out the cause for the same. Mostly this may be medicine related. Your drugs need to be reviewed. Taking lot of water may not help Hope this clarfies",
    "dialogue_context": ""
  },
  {
    "patient_message": "Brothers were on kidney dialysis, died. What are the symptoms? Color of urine?\n\nMy name is Ron and I had 2 brother who were on kidney  dialysis and both of them recently died.  The one  was mixing aspirin and Ibupropin ,but both got infections.  I went to my Dr. 3 months ago and everything is  normal.  I am 62 years old. What are the symtoms.  Can you tell my the color or smell of your urine?  Thanks YYYY@YYYY",
    "doctor_response": "Hi Friend..I will help you knowing symptoms of Kidney infections and also colour of urine indicates probable cause of disease.Yellow           - Normal urine colourWhite           - Excess hydrationRed/Pink       - Urinary Tract Infection /Kidney Stone (Hematuria)Orange         - DehydratedBrown          -Very dense urine concentration, extreme dehydration; consumption of fava beans; melanuria (too many particles in urine); UTI; kidney stone; kidney tumor or blood clot; Addison\u2019s disease; glycosuria; renal artery stenosis; proteinuria; pituitary problem (ADH, or antidiuretic hormone)Black           -Alkaptonuria, a genetic disorder of phenylalanine and tyrosine metabolism marked by accumulation of homogentisic acid in the blood; poisoningCloudy         -Urinary tract infection, kidney problem, metabolic problem, or chyluria (lymph fluid in the urine), phosphaturia (phosphate crystals), pituitary problem (ADH, or antidiuretic hormone)Foamy        -Turbulent urine stream; proteinuria (most common causes are diabetes and hypertension)An ammonia-like odour means your urine is concentrated and you may be dehydrated.A foul odour could be blamed on infection-causing bacteria.A sweet odour is often an indicator of uncontrolled diabetes or a metabolic disorder.A musty odour may arise from a liver disease or metabolic disorder.Hope I Provided Useful Information..Take Care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. After withdrawal bleeding, are there still chances of pregnancy?\n\nHello doctor, My fiancee and I had unprotected sex last week, and she took an I-pill within six hours of the intercourse. She got withdrawal bleeding or spotting today. Is there any chance of her getting pregnant? I was just worried. Please respond as soon as possible.",
    "doctor_response": "Hi. I have gone through your question and understood the concerns. Hope you found the answer helpful. Regards. For more information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My period delayed for 4 days this month with a history OCP before 3 months. What is the chance of pregnancy?\n\nHello doctor, I had unprotected sex last March but took emergency contraceptive afterward. Six days after, I had the bleeding associated with the emergency contraceptive. Two weeks after that, in the first week of April, I had my period for six days (my usual period lasts five to seven days). In May, I had five days of the period although the last two days were only very light bleeding. Now I was due for my period four days ago, but I still have not got it. What are the chances that I am pregnant and if not should I be worried about my late period?",
    "doctor_response": "Hello. Firstly, as you had three episodes of menstrual bleed including the withdrawal bleed post-emergency contraceptive after you had intercourse in March, so it is unlikely that you would be pregnant due to your sexual encounter in March. As you have missed your menses now by four days and if you have been sexually active during this cycle as well, then you must rule out pregnancy first with a home urine pregnancy test kit. If negative, then the delay is most likely stress-induced and you should wait for at least five days to allow menses to start naturally. If not, then you would need an ultrasound pelvis to check for endometrial thickness which if more than 8 mm. You can be offered a withdrawal bleed with progesterones to resume your menses.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it necessary to take folic acid tablets along with thyroxine 25 to improve chances of getting pregnant ?\n\nI have thyroid 5.90 I have been told to take thyroxine25 half tablet a day,I got my periods last month on12th june,i had ealier done a coursr of diane35,after the course i got my perios 4days late,this month i have not yet got it at all,i have also done pregnancy tesy,its negative,I want to get pregnant ,me&my husband have started planning,I want your advice whether thyroxine tablet is correct and should I start taking folic acid,if so then what tablet to take for folic acid,I m very worried what to do for my periods,help me,im nt able to sleep in the night as well.i am taking thyroxine also regularly.i have yet nt got my periods,what to do to get it and what medicine should i take for folic acid",
    "doctor_response": "Hi, Wait for more few days. and do UPT again.Do usg abdomen. Folic acid is good for pregnancy so start tab fesovit or folvit.Consult your gyneac. Start exercise like brisk walking, yoga, if test is negative. Take proper sleep and be relax becouse your mental stress also affect cycle and thyroid level.",
    "dialogue_context": ""
  },
  {
    "patient_message": "how to reduce the swelling in the forehead and below the eye?\n\nMy daughter who is 7 she fell and hit her left side of her forehead and face now is swollen huge and now the eye below it is swollen and blue around the whole eye I ve been putting ice and meat on it to get the swollen down do I need to take her to the doctor?",
    "doctor_response": "Hi, I m Dr. Richa Sharma. Any injury over head and eye needs to be checked by doctor because of associated complications and sequelae it may follow in a few cases. It becomes more important in case of a kid who will not be able to identify any newly developing complaint in an earlier phase or are hesitant to share. A blue swelling around the eye may be a result of superficial haemmorrage but sometimes may present with surprises related to vision or fracture of bones around eye. So, a check up by doctor is advised. Take care, hope she gets well soon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for chest tightness and fatigue\n\nI have had chest tightness and fatigue for a few weeks. My doctor noted that I had strep throat earlier and did not finish my Rx. He said my lungs sounded clear, but would treat me for pneumonia. I was given a RX, and sent for chest xray. I finished the Rx and was told that my xray was clear. I am still having the tightness and fatigue. I am a 36 year old female in otherwise great health.",
    "doctor_response": "Hello, I would explain that your symptoms could be related to a metabolic disorder or a lung disorder. For this reason, I would recommend performing further tests: - pulmonary function tests - complete blood count for anemia - blood electrolytes - thyroid hormone levels for thyroid gland dysfunction. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bleeding teeth after a fall, blackish tooth. Is it related?\n\nMy kid ( 3.5 year old boy) fell down last month from Sofaset and hit his teeth down. It was bleeding then. Consulted some paediatrician and paediatric dentist that time. He is fine now. But one of his teeth on upper row is slightly blackish as observed now. Could you please suggest what needs to be done ? I am located in Bangalore.",
    "doctor_response": "Hello,Thanks for writing to us.I have read your concern.As you have mentioned,the slightly blackish teeth on upper row can be due to-Fracture of teeth involving pulp or p e r i apical tissue.Chances of tooth being non-vital is very high.I would advice you to visit a dentist and get the tooth root canal treated.Usually,antibiotics along with analgesics has to be administered in such cases.Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is it safe for me to use anesthesia if I have sinus issues?\n\nHello doctor,My question is whether or not it is safe for me to use anesthesia to fall asleep while having all four of my wisdom teeth removed. I am a quiet person and did not ask many questions during my consultation. I cannot breathe very easily through my nose because I have some sort of sinus issues and it is worse when I am laying down flat on my back. I wrote down that I had sinus issues on the papers I filled out but half the time they do not look at them. I know i should have brought it up at the consultation but I was shy and nervous about the whole thing. They said they cannot even do the surgery if I have a cold. Can they do anesthesia if I have sinus issues? I would prefer to be knocked out when they take my teeth out but I am even more worried about not being able to breathe through my nose. As of right now, I am scheduled to have my wisdom teeth taken out at a hospital with many assistants who will monitor everything while the surgeon works. They also said they would be putting a tube down my throat in case I need help breathing. That makes me even more worried because I will not be able to breathe through my nose and my throat unless the people monitoring me are breathing for me the entire time during the operation. That worries me. My question is: Should I be taking anesthesia to go to sleep if I have difficulty breathing through my nose? I am not worried about the surgery itself but being given anesthesia and not being able to breathe once they give it to me freaks me out because of my sinus issues. If I did not have sinus issues I would not be worried so much.",
    "doctor_response": "Hello. You do not have to worry at all. There will be people concerned by you. Having a sinus issue is not a contraindication for anesthesia. You can have sedation supplemented with local anesthetics. In case you need endotracheal intubation, that will be safer for you because your nasal passage will be bypassed and you can be totally knocked off which is called general anesthesia. This will be done by a trained anesthesiologist. So, do not worry at all and leave your worries on your anesthesiologist. You will do absolutely fine. Wish you all the luck. For more information consult an anesthesiologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is numbness in lower lip and chin few weeks after root canal normal?\n\nOn October 18th I had I root canal.  The procedure went well, no pain or any side effects.  On October 24th, I had the temporary filling replaced with a permanent filling on the same tooth and again everything went great, no pain or side effects.  On the morning of November 11th, I woke up with numbness on my right lower lip and as the day wore on the right side of my chin became numb and both the chin and lip have been numb ever since.  I called the dentist on the same day and he prescribed antibiotics and said to take them until I finished them.  I was to call if the numbness continued.  I called again this week and told the dentist that the numbness was still there.  I was told that I didn't need to do anything further as I was having residule effects from the root canal and that the numbness would eventually go away.  I guess my concern is that the numbness ocurred a few weeks after the the root canal, even though the procedure went well.  Is this normal?",
    "doctor_response": "Hello and welcome.Thanks for sharing your concern.Please note that the numbness could be injury to the nerves.Now it may be or may not be associated to root canal treatment.In my view you must seek your oral and maxillofacial surgeon help in this regard.so that an x ray can be taken and probability of any cyst or tum our could be ruled out.Hope it helps.Thanks.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back problems with shooting pain to the legs?\n\nim haveing some back problems for about a week now on a off sometimes hurts so back i can walk long and pain offten shoots down my left leg and about 3 weeks ago i jumped off the roof of my house to the porch about 5 ft below while working i cant sleep great at night cause of it what could this be?",
    "doctor_response": "Dear patient Back pain with left lower limb radiculopathy  that starts after jumping  from height most probably due to disc prolapse At lumbar level. You need to be investigated  with mri of lumbosacral spine with screening of whole spine to confirm diagnosis.  Take tab diclofenac plus thiocolchicoside combination twice a day for pain relief plus tab vita B12 plus pregabalin 75mg at bedtime for 7 days.  Visit expert spine surgeon with report.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful lumps in the inner thighs?\n\nI have a bump that has become hard and is slightly painful. There is also a bump on each inner thigh. These two look like big pimples but don t necessarily have white heads on them. When I close my legs, the three of them make contact with each other. I also have a couple other random small pimple looking bumps around my pubic area and scrotum",
    "doctor_response": "Hi,It seems that these lumps might be friction lumps.Due to friction between two thighs there might be having some irritation and infection.There might be having enlarged inguinal lymph nodes due to this infection.Bumps on scrotum and pubic region might be due to razor bumps caused by shaving.Go for one course of antibiotic medicine for 3-5 days.Keep local hygiene clean and proper.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can leaking aorta cause shortness of breath?\n\nHI. IVE HAD A DOUBLE BYPASS IN2009 AND NOW THEY SAY I HAVE A MILD LEAKING AORTA ,IM VERY TIRED ALL THE TIME IM HOLDING FLUID ALSO .THEY PUT ME ON LASIX AND AND ALSO SHORT OF BREATH.IVE BEEN TO MANY DOCTORS THEY TOLD ME ITS OK .BUT I DONT FEEL OK .TRY TO WORK OUT CANT BREATH RIGHT.STARTING TO EAT RIGHT .SO WHAT IM ASKING U IS CAN THAT LEAKING AORTA HAVE SOMETHING TO DO WITH ALL THIS ......THANKS  SUE",
    "doctor_response": "If by leaking aorta you are referring to aortic regurgitation (leaking of the valve of the aorta), then it can certainly explain your symptoms of fatigue, shortness of breath, and retaining fluid. Medications can help treat your symptoms, but unfortunately definitive treatment requires either open surgery or a minimally invasive procedure (called TAVR) to fix the valve. You should ask your doctor if the severity of your aortic regurgitation requires a procedure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of DUZELA ?\n\nHello, I am 28 years old & have a daughter aged 2 yrs 10 months old. I had c-section. I had back problem & insomnia problem since then. Now I m on medication of duzela 40 and mirnite 7.5 since 8 months and trying to conceive again. Is it safe for the child?",
    "doctor_response": "Hi,Duzela is generally well tolerated by most of the patients however it may cause nausea, drowsiness, dry mouth, and heart burn. Regarding the safety of Duzela and Mirnite during pregnancy is concerned there are there are no clinical studies done in human beings to ascertain their safety during pregnancy however, potential benefits may warrant use of the drug in pregnant women despite potential risks.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could cause burning sensation in the leg above the knee?\n\nI have a powerful burning sensation in my right leg ranging from about 6 inches above my knee and 2 inches below the knee. Exercise does not play a factor in it. I have had an ablation to fix tachycardia and no other issues have come up. No meds being used at this time. What can this be?",
    "doctor_response": "Hello,Your symptoms could be related to a pinched nerve. I recommend consulting with a neurologist and performing nerve conduction studies.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the chances of being pregnant after an unprotected sex?\n\nOn July 16 i had Protected sex the first or second day of my period but the condom broke. On July 20th I had Unprotected sex when i was off my period and he pulled out. on August 7th i had Unprotected sex three times and he pulled out. What are my chances of Being Pregnant?",
    "doctor_response": "Hi,Your chances of getting pregnant is 25 percent as you have unprotected  sex on 7th August if you are having  irregular menses and your menstrual cycle duration is long if you are having  28  or 30 days cycle then 0 percent chances of getting  pregnant.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Sujata Kute",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes poor memory while on Zolpidem and Alzam?\n\nI have been taking Zolpidem and Alzam for about two years. I do things during the night and only find the evidence in the morning. Have no recollection of doing these things, eating odd this that I don t usually eat. Is this an effect of the medication",
    "doctor_response": "Hello thanks for putting a query on HCMI can understand your concern. Zolpidem is a z drug used for insomnia. Alzam is Alprazolam and is a benzodiazepine drug. Both drugs are known to result in forgetfulness, poor focus and concentration. Even these are known to worsen memory loss in dementia. If the drugs are resulting in memory impairment in your case then visit a psychiatrist for help.Thanks and Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Suffering from OCD. Please help me if I can take Prozak and what will be the dosage?\n\nHi doctor, I am suffering from OCD (Obsessive Compulsive Disorder) since I was a child, and I did not know that I have this type of sickness until I read about it on internet. And now I am 27 years old. I need to ask you whether I can take a medicine by myself (Prozak or alternative). My symptoms are that I keep repeating certain words and sentences in my mind all the time from morning till evening or some pictures in my mind. And I cannot stop this thing at all. I am really tired of it. Please help me if I can take Prozak and what will be the dosage. Also is there anything I need to know before planning to stop the medicine?",
    "doctor_response": "Hi, Thanks for posting a query at icliniq. First of all I would like to inform you that OCD like symptoms occur in various disorders other than OCD itself. And the management of different disorders varies according to etiology. Regarding your question about self treatment, I would suggest against it, as every drug is associated with one or another kind of side effect and they can be better managed only in expert hands. Besides this which drug is suitable for you can be decided by a psychiatrist or other trained mental health professional. Most of the patients do not respond completely to only medication in case of OCD, as they also require some form of psychotherapy treatment. What I suggest at this moment is, first take an online psychotherapy consultation that will evaluate you in detail to decide further course of action.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Migraines, moderate alzheimer's patient. Put on topamax 300mg. Stopped all drugs finally. Is there anything to improve memory?\n\nI took Topamax several years ago to help me with migraines. I think I was on around 300 mg, but I can t remember exactly. I had to go off it because my memory was so poor. I was like a moderate alzheimer s patient. it has been several years since I have been off the drug, actually all drugs finally. is there anything I can do to improve my memory? I am a 41 year old female. my memory did improve some since I have been off the med, but it is still significan t poor for my age. it is very noticiable to those around me how poor my memory is.",
    "doctor_response": "Hi welcome to HCMForum. You may be right that you have developed alzimers like memory loss. when you have stopped the drugs you have recovered to a great extent. As with everybody who have memory loss and recovered you must be having memory loss of psychological origin. I advise you to consult a physician for diagnosis and treatment. Besides i advise you to follow some other ways of treatment. follow diversion procedures as yoga meditation reading hearing music if interested gardening to divert from the feeling that you have memory loss.. I advise you some diet recomendations as  take more of green leafy vegetables pulses sprouts fruits and juices which will increase the general health and mental health. wishing for a quick recovery. thanks for calling.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Lower back pain on left side. Had hysterectomy, infections after that. Cause of pain?\n\nI had hysterectomy in January...many complications afterward d/t infection (post op)in a follow up us, my left ovary was not visible...dr said that was fine...however, I have been having lower back pain on my left side for a couple of months now and today, I am in quite a bit of discomfort...not sure if it can be related to the ovary or if it is muscular pain or gas pain...",
    "doctor_response": "Hi ! There could be a persisting urine/pelvic infection in you which might be responsible for the pain and discomfort. I would suggest you to discuss with your treating gynaecologist if you should go for a CECT scan of the abdomen to see if there are any intra abdominal pathology left apart from being clinically examined by him/her. Wishing you an early recovery. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for hyperactivity in a child\n\nMY grandson is 13 1/2. hyperactive ( a MD mentioned ADHD), OCD and involved in sports. (baseball,basketball,bowling.track,etc). He excells in each sport. He was an honor student but is now having some difficulty. His parents push him so hard telling him he can get scholarships so they enter him into prestigious travel teams and he will always make the team. He has difficulty sleeping so. a Nurse Practioner advised Melatonin 3mg at noc. (has probably been on the med at 1 least yr). In March, the beginning of softball season, he started a tic of jerking his head to the side and sometimes I have noticed a shift in his eyes when this happens. I am a Registered Nurse and of course trying to Dx. Is there a possibility ofTourette Syndrome, brain tumor, or maybe too much stress. I discussed what I am seeing in this wonderful child and all they can say is we have been discussing it. I believe they need to see a Pediatrician and neurologis. Please help",
    "doctor_response": "HI...By what you quote I feel there are 2 possibilities. One is as you have rightly pointed out Gilles de la Tourette syndrome and other is a PANDAS (Pediatric auto immune neuropsychiatric disorder associated with streptococci). I suggest that you should definitely take him a pediatrician or neurologist.He definitely needs evaluation.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does vaginal itching after sex indicate STD?\n\nHello doctor,I had sex with a prostitute last week. I used a condom, but I played her vagina with my hand. I came back home that night and had sex with my wife again. I also played her vagina with my hand. Next day, she had her periods and felt itchy at her vagina (I think genital herpes). So she scratched her vagina, and it became a damaged spot under the vagina. But it is better now and is about to heal. Is this STD or not?",
    "doctor_response": "Hello. It may be normal, but I cannot deny from STD (sexually transmitted disease), and it may be herpes and vaginitis too. 1. Apply Betnovate-N locally up to deep in the vagina, after proper wash two times a day till required. 2. Ciplox TZ (Ciprofloxacin, Tinidazole) two times a day after food for three days. 3. Candid veginal tablet at night for six nights.It will be fine. And it means you believe in polygamy, which is one day become dangerous. Be loyal, and you can use her ten times a day. So she will remain healthy so as you. If she has vaginitis, you also can get the infection.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reasons for tingling in hands with viscous red itching hives on hands while on Lisinopril/HCTZ\n\nI have been taking Lisinopril/HCTZ for about six years. I was initially prescribed 40 mg/day, but about three years ago the dosage was changed to 20 mg/day. It seemed to be working well, until Tuesday, January 21st, about 2:00 PM, I noticed tiggling in both my hands after taking a shower. The tingling turned into viscous red itching hives on my hands that traveled up my forarms to my elbows. The next morning I went to the ER, where they told me that it was probably a reaction to penicillian that I was given for a throat infection. I have taken penicillin before in the past, (I m a 48 year old African American female), and was suprised to hear that after having taken the medication for about nine days, I would develop an allergic reaction. I threw the last two remaining doses of penicillin away, took the prednisone medication and benydril capsules given to me and went to bed. The next morning, I noticed that my hands had swollen up painfully. The hives I had previously on my forarms had gone away, but new more numerous smaller hives were there. I also had numerous hives on my lower torso, and thighs, some small about a quarter of an inch in diameter, some huge, almost five inches in diameter! My lower legs, feet, upper torso and face were completely unaffected. I took more benedyl and my second dose of prednisone and went to bed. Today I woke up with a swollen lip, dizziness, difficulty breathing, and even more vicious, numerous hives on my forearms, lower torso, and thighs. The benedryl capsules were useless and the predisone was not working. I went back to the ER where the doctor gave me benedryl intraveneously, and a stronger 6 day regime of predisone, and blamed this time the Lisinopril that I have been taking. My question is this. Why on earth would I have such severe hives and swelling now after being symptom free with Lisinopril for six years. Also, I wanted to add that I had been using a new body soap for about two weeks without any adverse reactions, and I had bought a new laundry detergent that I used for about a month without any previous adverse reactions. I have been going over my movements for the past week and can come up with absolutely no changes in eating, bathing, hygiene practices, etc. that would begin to address such a strong acute reaction. Your comments please... Sincerely, Ann Coney Denver Colorado",
    "doctor_response": "Hi. Thanks for posting your concern at HCMI would keep a possibility of Acquired Angioedema due to ACE Inhibitor (Lisinopril) and Urticaria. Angioedema due to ACE Inhibitors is usually not assciated with urticariaAngioedema or Quincke's edema is the rapid swelling of the dermis, subcutaneous tissue, mucosa and submucosal tissues.ACE inhibitors are one of the common cause of Angioedema.You have been on lisinopril which is an ACE inhibitor!! Though ACE Inhibitor induced Angioedema is noticed at the beginning of therapy but sometimes it can happen later on.Urticaria OR hives can occur due to various causes like(to name a few):-Infections(bacterial , viral, fungal)-Drugs-Certain foods and food additives/preservatives-Physical Urticaria: Cold temperature, Heat, Pressure(Prolonged Standing, Sitting), Dermaographism etc.-Cholinergic Urticaria: in response to strong emotions, exercise, spicy food etc-Autoimmune disorders like SLE, RA etc.-A few cases have no underlying cause and are known as idiopathic urticaria.I would advice you to get few basic lab tests like Hemogram, stool for ova/cyst, Urine routine, Chest Xray.An oral antihistamine like Fexofenadine OR Loratadine once or twice daily for a week would be suitable. They are non-sedating and wont affect your alertness level.A topical soothing lotion like calamine would help you symptomatically.take careregards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dull pain on lower side of belly button, nausea, less food intake. All tests normal. Any thoughts?\n\nI am experiencing a dull achy pain on the lower right side of my belly button. I am nauseated and have had these symptoms for 6 days now. I went to my local ER two days ago and all my tests came back fine. They did urine, blood, and CT scan and ruled out appendicitis. I eat very little and become more nauseated after eating and my symptoms remain the same. Any thoughts?",
    "doctor_response": "LIVER FUNCTIONTESTS AND THYROID FUNCTION TESTS NEEDEDIF YOUR US ABDOMEN IS NORMAL AND NO GALL BLADDER PROBLEM OR APPENDIXTHINK OF ANY MEDICINE TOOK FOR ANY OTHER DISEASE LIKE PAM BRUFEN DIET SUPLIMENTS ETCSTART WITH UDILIV 1 TAB BD NON OILY NON GREESY AND NON SPICY FOODLOT OF WARM WATEROMEZ D EMPTY STOMACH MORNINGSYP ARISTOZYME 1 TSF TDS AFTER MEALSNORFLOX 2- DAYS BD TO COUNTER ANY STOMACH INFECIONGET TESTS AND TREAT ACOORDINGLY",
    "dialogue_context": ""
  },
  {
    "patient_message": "Developed an itchy rash afterwards. What is wrong with me?\n\nSo. The problem is. I am in the army, I work a lot being supply, after PT if I work out at an extreme rate, I will develop an itchy rash afterwards. This also happens randomly during the day when I am not at all active, and when I take a moderately hot shower. I also have 2 dry asking spots that appear randomly and simultaneously on my neck. What is wrong with me?",
    "doctor_response": "Hello, I am Dr Ashwini Kalantri. You have itchy spots on your neck. The symptoms that you have seem to point to a fungal infection. It is difficult to diagnose the infection with out actually seeing the picture. I recommend seeing a dermatologist. He will be able to confirm the diagnosis and suggest treatment. Hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a lump on the head?\n\nHi, I have a bald spot that feels like a small squishy lump on the side of my head. Just curious what it could be. It doesn't hurt when I touch it. I used to get small bald spots on the back of my head and they went away on there own, but this seems to be different.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. * As per my surgical experience, there are various reasons for the lump on the head as: - sebaceous cyst - mole - others. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for recurring pimples\n\nI have a pimple which is almost ripen and filled with pus on my back just above the buttocks..is there any ointment that can heal it faster.  this now fifth time i get this in different parts of my body....fed up of eating antibiotics..is there any solution doctor?",
    "doctor_response": "Hi,As you said you suffer from pimples, also called acne vulgaris. There may be different types of lesions in this disease like white comedones,black comedones, inflammatory lesions,cystic and conglobate acne..etc. The lesions may be precipitated or excerbated by stress,anxiety,sleeplessness,drugs like steroids, hormonal imbalance,dandruff,oily food..etcI generally treat my patients explaining about long term treatment and to avoid anxiety related with treatment. Antibiotics like azithromycine or minocycline in proper dose may be taken. Isotretinoin in low dose 5 mg may improve the lesions. Clindamycine with benzoyl peroxide 2.5 %  may be applied on the lesions at night. Antiseptic facewash may be used to cleanse the face.Patience is necessary to get relief. You consult dermatologist for firm diagnosis and treatment.Thanks.Dr. Ilyas Patel MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain and headaches in a child\n\nmy 13 yr old has been complaining of chest pain, headaches and most recent her left hand and wrist is hurting her. went to a cardiologist who did all the testing and everything was normal with heart. please help, my daughter is in alot of discomfort and i don;t know what to do.",
    "doctor_response": "Hello,Can I come to know whether there any history of injury or trauma, fever, cold? As you already consulted with cardiologist and everything is normal, it is good.Now, I will suggest you to take tablet Nicip, apply diclofenac gel locally or Volini spray.If there is any history of injury, then consult with orthopedician and do chest x-ray and x-ray of left hand with wrist. Otherwise review here with detailed history or consult with the physician. Take rest for few days.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Shyam B. Kale",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in buttocks and legs\n\nHi, I ve had left side buttock pain for about six months. The pain is worse whitest sitting when the pain can travel down my leg also lying in bed especially when turning over in my sleep can be very painful. I have just had my 65th birthday I very active, play golf three times a week and aerobics class twice week and walk my King Charles Cavalier dog most days. My weight is in the right category for my height and age and I have a good heathy diet and afford alcohol as I suffer from migraines. Regards June",
    "doctor_response": "It is a symptom suggestive of some nerve compression therefore needs to be evaluated soon before irreparable damage occurs. It could also be purely a musculoskeletal issue however lasting for almost six months is worrysome. Kindly visit your physician or better still, an orthopedician who may advice an MRI scan and clinch the diagnosis.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will my liver be safe with ctstonogram radiation?\n\nsalam im a 35 yo female wd parenchymeal vs medullar calcification right kidney cannot rule out mild medullary nephrocalcinosis.parenchymal vs vascular calcification vs non obstructing inferior calyceal calculus left. my doctor suggest ctstonogram im afraid the radiation dye or sideeffect will cause ,is there a possibility that it will? will my liver be safe frm it?",
    "doctor_response": "Hello, Ct Scan can be done plain (without contrast) and also be done with contrast (dye), so if your kidney tests are abnormal, you should always get only a plain CT, but in some conditions to know further anatomy ,if contrast CT is required,  you should consult your Nephrologist and take his valuable opinion and fitness and go ahead. Hope I could clear your doubt.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What may be the cause of knee pain and swelling?\n\nhi my knee as been hurting when i bend down or go up the stairs it quite painful now my upper leg is hurting now and my calf it like throbbing my knee is swollen and so is my ankle what could be causing i never suffer with leg problems im 37 years old.",
    "doctor_response": "Hi, This could be related to the early signs of OA knee. You need to do regular exercise so the knee joint space remains maintained and there is sufficient strength in the muscles to carry out the functions of the knee. Due to wear and tear. Along with ignorance of exercise this signs of early OA arises in very much younger generation and it is common. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the home remedies for burning urination?\n\nI have been experiencing a stinging/Burning feeling when I pee, and occasionally notice pink spots on the toilet paper. I assumed it was a UTI so I've been drinking cranberry juice for the past two days, but the burning has not gone away. I haven't had sex since the burning feeling started, 4 days ago. I can't visit a doctor due to not having health insurance. Are there any home remedies, I can use to get rid of this?",
    "doctor_response": "**1. Ideally urine sample should be sent for culture- sensitivity and colony count, before initiating treatment. As soon as the result of sensitivity test is available, treatment is started [or changed, if already started] according to maximum sensitivity.2. since you don't have health insurance, even then predisposing factors to infection like: obstruction, calculus,diabetes should be properly identified and managed/treated [for which opinion of urologist is necessary since he may distinguish lower tract infection from upper urinary tract infection]3. take plenty of water and fluids.. avoid: hot/spicy foods, salt,garlic,mustard oil,citrus fruits,alcohol,excess physical exertion.. take: jaggery with cold water,coconut water,amla, dates, musk melon, water melon.. a few tea spoons of baking soda diluted in cup of water, followed by atleast 2 cups of water is effective.. you may ask for prescription medicines like: tab calcury, tab/syrup cystone, chandan assav, ushir assav.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Trying to conceive. Cramps, acne. Sperm count on the borderline. Taking duphaston. Suggest?\n\nHi I am 31 yrs old and trying for pergnancy for past 1 yr but still not. My husband s sperm count is on the burder as per the doc and my doc suggested me to take Duphaston tab for next 3 month. My periods is very regular and last up to 3 days. My weight is 57 kg and height is 5.2 ft. I grow some achne over my face during period and left lower stomach cramp sometime during period I had done all my blood test done and all came fine as per doc and no thyroed and I am perfectly healthy. But I am a working lady having lots of work pressue. Please suggest me to get pegnent soon.",
    "doctor_response": "Hellothanks for your query.Please consult an Infertility specialist first.have basic hormonal tests done.Have a cycle of follicular monitoring to check if your ovulation is alright.Your husband should consult an Andrologist, and have evaluation to know the cause of abnormal semen analysis.Sometimes, if the semen count does not improve, IUI ( intra uterine insemination ) or ICSI ( intra cytoplasmic sperm injection ) might be required.Also, the patency of fallopian tubes also should be checked.take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment of persistent cough and nasal congestion in a child?\n\nHi, My 3-1/2 year old son has been having deep cough(non-productive) with sound for past 3 months. He had been prescribed Flovent HFA 44 mcg(2 puffs twice daily until one week after the cough stops) and Children s Claritin in United States. I was not prescibed the spacer and was not aware of it and was not able to administer the inhaler properly. I came to India for summer break and consulted with a Pediatric who presribed Laveta M. My son s cough was reduced but still not completely gone. Another Pediatrician precribed him with Levolin Inhaler(he is now on 2 puffs twice daily), Allegra syrup(5 ml twice daily) and Montair Granules(once) for 15 days. I have been giving the above inhaler and allergy medications for more than 15 days since he is been having slight cold symptoms of nasal congestion and he coughed more today. My pharmacy friend was suggesting me to try Montair LC Kid for allergy. Can i replace Allegra an Montair Granules with Montair LC Kid. Kindly advise me to cure my son s cough.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic. Greetings from Chennai.This seems to be a multi triggered wheeze and I suggest you to use Budecort metered dose inhaler along with Levolin inhaler only when required and coming to your question - yes you can replace with montair LC kid.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for malignant lung metastases\n\nSir,Namaskar,My wife had breast cancer in 2006 with er pr reports negetive  have underwent MRM  6 cycles of CH. TH was given  in dec 2010 she was diagnosed  metastasis in lungs treated  at AHEMDABAD  in PET SCAN FOUND NO FDG AVID Now she is again having cough X RAY Chest shows Consolidation RLL Bronchoscopy done at DELHI  AND Biopsy ,histopathology BAL Culture was done  reports are sugestive of melignancy  PLEASE GUIDE ME what to do next",
    "doctor_response": "there are many drugs for treatment of breast cancer. The choice of agent depends on treating doctor. I would advise you to repeat biopsy from lung mass and get IHC done. This would be helpful in guiding treatment",
    "dialogue_context": ""
  },
  {
    "patient_message": "In what condition of heart disorder do we take Metoprolol?\n\nI had heart surgery where the scraped my heart called parodone. I do not know how to spell it. Also I do not know the tecetincial nme for when my heart when it races. I know I take Metoprolol for it. Can you telll me what it is called. I am making a medical history list to carry all the time with me. thank you",
    "doctor_response": "Difficult to deduce. If you say they scrapped your heart,  it should be pericardium and what they did was pericardiectomy ie.  Removal of the outer covers of your heart.  When you heart race it is called tachycardia,  you may have  some irregularities  then they are called arrhythmia,  whereby you must be on metoprolol to prevent them Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes mild pain in left chest side and in base of penis?\n\nsince day before yesterday i am having a mild pain at the base of my penis. it is not constant and i feel it only while getting up suddenly or turning around . not exactlyat penis but somewhat inside.and from today i have got a very mild pain in my left chest which has got me worried .could it be something serious? i am 18",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. No, I don't think it is serious issue. I also don't think that both these pains are connected. Possibility of musculoskeletal pain is more. So avoid movements causing pain. Avoid bad postures in sleep. Avoid heavyweight lifting and strenuous exercise. Take simple painkiller like ibuprofen. Apply warm water pad on affected areas. Avoid masturbation or sex for few days if you are sexually active. 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",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I take Nicip-P for acute back pain?\n\nhello doctor.. I am having acute pain in my back from last 7 days. I have been applying volini and other gels for healing but still not recovering. Moreover the pain is moving from here n there. Though I have not experienced back pain ever.. suddenly it has started. Can I take Nicip-P",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. In my opinion simple medicines like NICIP-P may not work. In my practice I always add a muscle relaxant and physio, if required, to all my patients with these symptoms. If they recover ,then I start muscle strengthening exercises for the back, Else I advise MRI . Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for the pain in the wisdom teeth\n\nThere is a sever pain in wisdom teeth...It pains in my head and jaw as well..I have already taken combiflam tablet and it has started its job...but when i try to sleep and lay on my bed again it starts paining...and it does not pain when i am sitting on the chair...How do i sleep with this pain???",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.Yes , the pain in the wisdom tooth can radiate to the head and jaw region . Pain while lying down suggests infection in the tooth. Abscess in that tooth will be the most probable cause. For pain combiflam can be continued on full stomach. Antibiotics like amoxicillin wi be required on prescription.Consult your oral surgeon and get a radiograph done , following which you can get the tooth removed .Do salt water gargling .Hope this was useful.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for cough and sleep disorder\n\nI HAVE BEEN COUGHING UNCONTROLLABLY AT NIGHT AND AT TIMES DURING THE DY, IT CHOCKS ME AND I CANNOT SLEEP BECAUSE EVERY TIME I lay down I start coughing again what can I do to stop this. I happens at work and other places and people think I am sick but I m not. what can I do?",
    "doctor_response": "Thanks for your question on HCM. Coughing especially in night can be seen in many causes but most commonly seen in 1. Cardiac diseases like left ventricular failure2. Asthma3. Lung infection.So I advice you to consult pulmonologist first and get done chest x ray and PFT (Pulmonary Function Test) to rule out asthma and lung infection. Also get done ECG and 2D ECHO to rule out cardiac failure and other valvular heart diseases.Start antihistamines and get done these tests.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Penis size small and thin and ejaculate in short time. How can it be rectified?\n\nhello sir please help me i want help from a sexologist my problem is that my penis size is too much small and thin and i cum in very short time what i have to do to solve this problem i am married and i am facing too much problem and embarrassment please please please help me out",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. From the details you gave it is evident that you worry too much. You are worried about your sexual apparatus and stressed of thinking about sexual ability. If you fear something, it makes you fear even more. like a person fears cockroach. What is there to fear in a cockroach? You mock. But that is reality.You can satisfy a women with the help of 2 inch long penis. that is more than enough. Your penis is definitely more than 2 inches. Premature ejaculation is due to psychological problem. Your anxiety about sexual ability is the basic cause. Divert your life from sex to some other productive work like career.You might need psychological counseling., I am more than happy to provide telephone psychological counseling through healthcaremagic. Contact me through customer care, www.healthcaremagic.com.Hope this answers your query. Available for further clarifications.Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for itchy skin\n\nI have severe, constant itdhing of the skin. Have been unable to determine the cause. Nothing has been changed in diet, laundry detergents, etc. The itching seems worse during the night, causing night sweats, dampness of undershirt. Dermatologist has given me AMMONONIUM LACTATE CREAM, 12% to use twice daily and it seems to burn when applied.",
    "doctor_response": "Hi, It may be hives or urticarial rash. As the first line of management, you can take antihistamines like Pheniramine for symptomatic relief. Also, apply Calamine lotion. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it a must to take Femara for small tumor?\n\nI have stage 1a invasive ducal carcinoma intermediate ,very small. margins & sentinel node ck showed no spread. Tumor was extremely small less than 6 or less than 1/8 inch. Received radiation but now oncologist wants me to take Femara. I am reluctant. She ran my stats and benefits of taking don t seem percentage wise much better than not taking when you consider my age 71 the fact I have osteopenia but otherwise I am healthy and have no other medical issues!",
    "doctor_response": "Taking femara is better than leaving out on the small percentage of benefit. If you take chance then you are adding that chance to recuurence and recieving chemotherapy in the future.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can controlling diet cure gestational diabetes during pregnancy?\n\nI was just diagnosed with gestational diabetes. I am 26 weeks with history of preterm labors/contractions. This is my 5th pregnancy. I will be seeing a dietician to modify/strengthen my diet but can t exercise. Will this rid of gestational diabetes prior to delivery?",
    "doctor_response": "Hallow Dear, Diabetes is never cured since it is a genetic metabolic disorder. It can be managed by keeping the sugar levels under control. Gestational diabetes is the existing diabetes becoming overt from the latent stage due to the change in carbohydrate metabolism during pregnancy and stress of pregnancy. It can be definitely kept under control by modification in the diet; however, by and large, supplementation of antidiabetic medicines and/or insulin is required for effective management of Gestational diabetes. Hope this helps you. Dr. Nishikant Shrotri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Advise correct medicines for liver abscess\n\nmy 3yr.old son had just discharged last Thursday. we've been there in the hospital for 14 days. it was found in the ultrasound a liver abscess. now he's taking metronidazole , co-amoxiclav and multivitamins. But until now he is still having loss of appetite. what can i do?",
    "doctor_response": "Hi,The loss of appetite could well be a side effect of the strong antibiotics he is on. Metranidazole causes severe nausea and in addition to amoxicillin leaves a metallic taste in the tongue which can make food stuff very un-appetising. Please do not panic and once the antibiotics are done, his appetite will return.Hope this helps and hope your son starts to feel better.Dr Suresh Raghavaiah",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does breast cancer cause sickness and mood swings?\n\ni am a 13 year old girl and my mom had breast cancer and now i think i have it. because i have plenty of the side effetcs like the lump and stuff. i have had it for 3 months about. i wanna know does breast cancer make u feel sick. also does it ake ur attitude cange becausse i have been on edge alot latley and i am really scared.",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern. At age of 13 breast cancer is very unlikely and chances are almost negligible.  You may have fibroadenoma or fibroadenosis.  Your mood swings are due to hormonal changes. It is not due to breast cancer.  Consult your doctor and go for examination.  If needed go for fine needle aspiration cytology or biopsy of breast lump and take treatment accordingly.  It is not breast cancer so don't worry about that. Just be relaxed. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce Creatinine levels?\n\nHi,my mother s blood creatinine level was diagnosed as high 2months back(around 3) and she has been on medication and a strict diet since.We have been monitoring the levels since and it came down to 1.9 but last week was around 2.3. Please can you let me know how to control it and get reduced to normal level. We are in Bangalore so it would be great if you could suggest a good dietician for this issue asthe current dietician we are seeing has asked her not to have most of the vegetables and fruits due to which she is having a very bad constipation problem. She is also taking medicines for High BP.Please help.",
    "doctor_response": "hi welcome to healthcare magic forum The creatinine is high that indicates the kidneys are not functioning normally. So there is no such remedies to reduce the creatinine level only. If the treatment should be based to treat the kidney condition then automatically the creatinine level will reduce. There is no treatment in allopathy which will cure the kidney conditions. But homeopathy have remedies to cure this condition and hundreds of evidence with me. So if you would feel to contact me then it is my email ID - multicare.homeo@yahoo.com Mob no - 91-9937412150 www.multicarehomeopathy.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could the kidney shadow be?\n\nI have had a urine infection for several months and had four lots of antibiotics, the results have come back with white blood cells but no particular infection, I had a scan yesterday which revealed a shadow on my kidney, is this something to be worried out",
    "doctor_response": "HiShadow on the kidney may be due to a stone but rarely other causes are found. Stones are one cause for urine infections and presence of white blood cells. I would advise you to get a CT scan of your kidneys to evaluate the cause for the shadow.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the suggested dosage of losartin?\n\nI am taking losartin but I am lightheaded and get dizzy for a spell when I lie down. I ve bee gettin occasional readings of 100s/70s. Can I cut the dose in half for a few days until I can call mt physician since it is a holiday weekend? What is the safest way to reduce the dose?",
    "doctor_response": "Hi, Based on the history you seem to have developed hypotension (low blood pressure) apparently due to a slight high dose of losartan. You can take half the prescribed dose at bed time to prevent postural hypotension till you consult your physician. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mohammed Taher Ali",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can good diet reverse stage 4 kidney failure?\n\ni just entered stage 4 kidney failore,they say in this stage i cant do any thing to protect the kidney from going into stage 5,can diet reverse this? or make it where i don t need dialysis? im type 2 diabetic since 2000. is there a future for me if i try now or is it to late?",
    "doctor_response": "Hello and welcome to HCM.As an Urologist, let me assure you, stage 4 kidney failure is irreversible.Diet must be observed strictly, but,it cannot reverse the failure.Diabetes itself affects the kidneys, causing diabetic nephropathy.You must be careful to avoid more than 6gm salt/day, 40gm proteins/day,avoid extra potassium forming fresh fruits,coconut water,and oily fried foods. Have green leafy vegetables,and egg white.Check your B.P. regularly and take all medications as advised.If you've any doubt,send it as a direct question to me,for expert opinion.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How many laser sittings would ensure complete facial hair removal?\n\nHi. I have a significant amount of facial hair. I am 43. I would like to opt for a laser hair removal but have no idea what sort of questions to ask before choosing a facility. Also, in general how long is the entire process take ? How many visits ? Do you recommend a facility in Bangalore ? Thanks. AP",
    "doctor_response": "If you have significant amount of hairs then yu should first check your hormonal levels, as at times hormonal imbalance can cause this problem. laser hair reduction is good for thick n black hairs, you can opt for that if your hairs like that. you need 6-8 sittings to reduce the growth and should be done by the qualified doctor only. You can come to Delhi as there are many in Delhi.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Apart from thyroid, what can cause body pain and dry skin?\n\nHi doctor, Three years back, I had headache and head numbness for few days. I consulted a doctor and got a thyroid test done. That time my TSH was 3.7 and he prescribed me Thyronorm 25 mcg. He told me to discontinue it when my TSH level comes back to 1.5. Now, for around 11 months\u00a0I am having body pain, hand numbness, dry and itchy skin, hair fall, rashes on neck and hands and bowel movement issues.\u00a0TSH - 4.58, total T4 - 7.50 and total T3 - 0.91. This is my recent thyroid result. Apart from these all the blood and scan reports are normal. I have left side back pain also. But, still the doctor says that the thyroid results are normal. Please help me.",
    "doctor_response": "Hi. Your symptoms fit into thyroid disease but your thyroid report is absolutely fine. A normal thyroid report rules out thyroid disease, unless you are presently on Thyronorm. So, we need to find other cause for your symptoms. Body pain and numbness could be due to nerve problems, vitamin B12 or D deficiency and diabetes. Your reports say that you are not having diabetes. But, I do not see any tests done for vitamin B12. So, kindly get the vitamin D tests done and revert back with report. Hair fall could be due to hormonal imbalance or due to stress. Is there any kind of stress in your life? I recommend you to get serum testosterone and serum DHEA (Dehydroepiandrosterone sulphate) levels tested and revert back with report. Regarding rashes kindly upload the picture so that I can give better opinion on that. You mentioned about bowel movement issue. What exact problem you have with bowels? Constipation or loose motions? Kindly revert back with the details asked.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for  disc herniation\n\nMRI conclusion: Moderate disc herniation centrally/eccentric to Left at L4-L5 causing mass effect on thecal sac and the left L5 nerve root leading to marked spinal stenosis at L4-L5.  On MS Contin 30mg TID.   Do not want to be on medication forever.  What can I do?",
    "doctor_response": "Hello and thanks for using HCM.I have read your question and understand your concerns.In such case, physical therapy ( traction ) and epidural injections should be considered as alternatives to actual treatment.If these treatments fail to improve your condition, decompressesive spine surgery should be taken in consideration.Hope you found the answer helpful.Kind regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain in ribs\n\nYes I recently went to the Dr because of back pain from my ribs and they told me I had a a very tight muscle well I bent down to get something and felt a pop and am in severely bad pain and having tingling and numbness in my right arm and hand. Did I tear the muscle?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. It could be a muscular pain, as a first line management you can try simple analgesics like Ibuprofen and Diclofenac. Anti inflammatory drugs like Serratiopeptidase can also be added. If pain persist for longer period, better to take an MRI scan and get evaluated. Wishing you good health. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes heaviness and pressure in right knee?\n\nHello, I have for the past couple of days felt no pain in my right knee, but feel something is going on. It feels heavy almost, like pressure and have had no injury. I am overweight but have lost some weight. I was wondering what are symptoms of water on the knee?",
    "doctor_response": "Hello,I have studied your case. I think that you may be having some cartilage softening of early arthritis in the knee. It can present in this way. Fluid in the knee joint causes swelling with knee appearing larger than normal side.    i would recommend you to show it to a physcian and get your self examined. He may advised you to get x ray of the knee joint or ultrasound examination. If there is fluid in the knee joint than it will need needle aspiration. Also compression bandage should be applied so that swelling should not re develope.I hope this answer will be useful for you. Let me know if there is any other followup questions.thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sneezing after using Azeflo nasal spray. Can I continue using it?\n\nhello my name is swathi, I have cold problem so doctor suggested to use azeflo nasal spray once in four days from 2010-2011 but i did not use it.....i was ok in that year but again from 6 months i have the same problem in morning as soon i wake up i get around 10 sneezing after using that spray i wil be perfectly alright again i get the same problen after two days so i need your suggestion can i continue to use that spray",
    "doctor_response": "Hello Swathi, Sneezing after using a nasal spray is not unusual and it is possible your technique of using the spray is incorrect. Steroid nasal sprays take about 4 weeks to start working and therefore using it upto (minimum) 8 weeks is recommended as a course. You can restart again but continue to use it for at least 8-12 weeks is ideal. WHile antihistamine or atropine nasal sprays can be used on and off also on a regular basis. You also need to get your allergies checked and only then we will be able to tell you when to start and stop the sprays. Hope that helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for red and swollen penis?\n\nI am on Cetraben and Betamethasone, my penis head was red and sore but has improved but the shaft has got hard skin, under the foreskin is sore, been told to continue this as the creams needs to help soften the skin, under neath the skin at the front is dots of redness as if skin is thin and coming through and the frenulum and line down is still read and sore, this has been going on since december, thought i got healed, then came back. another 2 weeks been told to use the cream. What do you think and how long will it take, is anything to heal skin I can use and is the Betamethasone ok to use under the skin/on the shaft and on the frenulum.",
    "doctor_response": "Hello, From the available description it appears that you are dealing with fungal infection down there. In my opinion, there is a need to continue with your doctor as depending on the intensity of infection it may take 3-12 months. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ashok Kumar, Psychiatrist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Pancytopenia and Thrombocytopenia be treated with homeopathy?\n\nlist homoeopethic remedies for 18yrs old male suffers past 4.6yrs pancytopenia thrombocytopenia bone marrow empty hypoplstic no blood element produced aplstic anemia not responding to allopathy needs MUD BMT may or may no be helpful Plz list remedies dr nk garg( YYYY@YYYY )",
    "doctor_response": "Welcome to H.C.M. I am Dr Krishna Dubey.My dear friend , you are suffering from aplastic anemia. In Aplastic anemia bone marrow transplantation has very good result .This treatment replaces your unhealthy blood-forming stem cells with healthy ones.Bone marrow transplant or stem cell transplant is recommended for patients of younger age. Durable remission (disease free period) can be achieved using chemotherapy therapy, but bone marrow transplantation is the only truly curative treatment and good results in young age.Now start looking for a donor right away. Only about 3 out of every 10 people can find a matched related donor.All the best.Thanx for query.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for heart stroke\n\nHi, my friend just had a mild stroke ,so says the Dr.. The Dr. says it was caused by a blood clot. The next day after other tests he says there was a clot found behind her heart. I thought clots traveled through out our body in veins. Or is he talking about a vein around the heart. I don t want to upset my friend with questions to ask the Dr., But she is already upset because he not giving her any answer or reasons. How can I guide her?",
    "doctor_response": "Hi,You shouldn't worry, just encourage your friend. The doctor will prescribe medication for blood clots. If your friend takes the medication regularly and follows healthy lifestyle, everything will be OK. In mild strokes the most important goal is to prevent further strokes, which is done with blood thinners and lifestyle changes.Hope I could help youWishing a good health to your friendIn case of further questions don't hesitate to askRegards,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have high Cholesterol, TGL and ALT. Any way to reduce it quickly?\n\nDear Sirs, During my pre employment medical test , my liver function test and lipd profile were found to be unremarkable. Total Cholestrol was 231, TGL 211 and ALT 112. I was aked to consult one doctor and he has asked me to losse some weight. I lost around 9 Kg in two and half months time. When i gave my second test last week, ALT reading improved to 60 and total chloestrol to 212. Doctor has prescribed to take phospholipids tablets along with Vitamin E for further reduction as i wanted my LAT to be below 45 to pass the pre employment test. During last week, i took 1200 mg of essentilae forte 300 mg phospholipds tablets per day. Also reducsed 2.5 Kg s of weight. I gave my medical test yeterday and surprisbgly my LAT level has gone back to 98. AST is normal at 41. total cholestrl is at213 and TGL at 98. Dr., I ma worried as i need to give my preemployment repeat test next week, Is tehre any quick releif for this problem. Kindly help as this is related to my career.",
    "doctor_response": "Hi and welcome to HCM.Nothing can be done quickly in medicine. i am not sure why is this test important for employment but ok. you should treate it primarly by changing lifestyle and dietary habits .eat healthier food and lose weight,avoid alcohol ,stress and smoking. If this is not helpful,you ll need certain medications such as statines. Also,these findings are hardly predictable so it may periodically increase and decrease. Wish you good health. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes body chills?\n\nWith a little cool breeze I will get racking body chills ... I had this off and on when I was on a birth control pill but have been off now for over a year and it s starting up again ..I have recently had thyroid checked and was fine ... What s going on ?",
    "doctor_response": "Birth control pill has nothing to do with it. It's a feeling, more so when Kapha humor is vitiated as per Ayurveda.Take little turmeric in hot milk or water for few days. Shilajit capsules may also be used with hot/ warm milk. Both together may be used to counter excess chills.These are harmless naturals.Hope it helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for abdominal pain and vomiting after removing gall bladder\n\nMy husband had his gall bladder removed a week ago.  He went to the emergency room the next day because he was having hot/cold flashes and vomiting.  They got him stable and sent him home.  It's been a week and he is still unable to eat or drink much.  he has lost about 30lbs and still have abdominal pains. what do you suggest?",
    "doctor_response": "thank you for posting query.post cholecystectomy pain maybe due to stones in common bile duct OR fat intolerance  OR functional pain.advice:- take nexium/pantocid 40mg once daily before breakfast (for the rest of your life)- take metoclopramide or domeperidone before meals for 3 to 5 days- get an ultrasound (abdomen) to rule out any stone remnants in common bile duct- also get a complete blood cell count(CBC) test- avoid OILY and fat food altogether- avoid eating stomach full and mouth full- avoid spicy food and junk foodwish you good health.further queries are welcomed.Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health.regards,Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for congenital nasolacrimal duct obstruction\n\nRespected sir, My 4year old daughter who weighs 19kg is suffering from Congenital Nasolacrimal Duct Obstruction which a Doctor adviced to go for probing of left sided NLD. When went for a second opinion an other Doctor said that its too late to go for probing bcos her bone has grown and tissues are strong enought that probing will not help. The only solution is surgery. Her CT Scan also revealed that she has PARANASAL SINUSES which says septum is in midline. Mucosal thickening in bilateral maxillary and bilateral ethmoid sinuses Non pneumatised bilateral frontal sinusess Bilateral inferior turbinate hypertrophy Both infundibulae/OMC obstructed Hypertrophied adenoids narrowing the nasopharyngeal airway Motion artifacts noted. Could you please tell whether its emergency and surgery is needed at once?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. How is your daughter suffering from nasolacrimal duct obstruction?  Is her left eye constantly tearing or draining mucus?  Has it become infected?  If that duct's obstruction is not removed, then these are the complications that can occur. Her hypertrophied adenoids could cause her to snore and be predisposed to ear infections. I do not know what type of doctors you have taken her to, but the best doctor for her problems is a pediatric ENT physician. Is there a university medical hospital with pediatric ENT that you can take her (along with the CT scan) to be seen? I hope this will get you on the right. Please return if you have other questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the health benefits of symbiva usage?\n\nAge :63 Height : 5 7 Weight : 70kg I used ( in UAE & Canada) Foradil inhaler when I get breating discomfort due to allegy situations. During vactioning in Sri Lanka, I encontered the problem and doctor recommended Symbiva. It seems responding to my case. What are the health benefits if I changed to Symbiva in future. Thanks. Gregory Payoe",
    "doctor_response": "hisymbiva contains  aerosol steriodbreating diifficulty due to allergic causes are treated in two phases 1st phase is termination of acute problem or rapid relief to patient for that beta 2 agonists are used  they immidiatelty dilates the alveoli and relieves acute breathing problem2nd phase is  long term management of the problem and change the frequency of attacks for that part long acting aerosol steroids are usually given which u have been prescribed by doctoras aerosols reaches the lung directly hence side effects are very mild or almost negligibleif you are relieved then keep on taking the inhaler as per the dose prescribed by doctoryou cann also addtab montair lc ( levocetrizine and montelukast) a mast cell inhibitor  ,it will help you wiyh your symptoms",
    "dialogue_context": ""
  },
  {
    "patient_message": "Would rubbing alcohol be an effective way to get pinworm eggs off electronics??\n\n1. would rubbing alcohol be an effective way to get pinworm eggs off phones, keyboards etc? (all household members took albenza & have laundered & vacuumed, now just wondering if we need to sterilize our electronics) 2. could pinworm eggs survive for over 2 months in home-made raspberry jam, which was not cooked very long",
    "doctor_response": "Hello,Thank you for your contact to healthcare magic.I understand your health concern, if I am your doctor I suggest you that vaccum will evacuate all the eggs out from electronics, there is no need to take alcohol action. It will survive in the jam and should not be used.I will be happy to answer all your future concern. Thank you,Dr Arun TankInfectious disease specialist.Wish you a best health at health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in right abdomen/testicle\n\nmy boyfriend got really sick last in the last few hours, he was vomiting quite a bit and he said it feels like he has to keep going to the bathroom, he has the chills and his right testicle and right side of his abdomen are very painful, what should we do?",
    "doctor_response": "Hello, It can be due to viral or bacterial infection of intestine or stomach lining. He can be prescribed antibiotic and antacid course for five days. He can take Rabeprazole like antacid and Ofloxacin & Ornidazole combination antibiotic. Don't give him spicy foods and give him more water. He can take ondensteron mouth dissolving tablet for vomiting SOS. He need to investigated with SGPT, SGOT estimation and CBC and stool analysis. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is my kidney function normal according to this report?\n\nhi my creatinine+eGFR in dec2013 creatinine was 111 umol/L in Jan2014 urine creatinine -16.76mmol/L, UrineAlbumin-182mg/L and urineACR-10.9mg/mmol in April2014-creatinine+eGFR- creatinine-106 umol/l and est.glomerular filtration rate-62 and my urine Acr -4.3mg/mmol I am just wondering if my kidney is functioning good and if not what should I do to improve. Or is it improving. Thank you",
    "doctor_response": "Hello and welcome to HCM.As an Urologist, i can understand your concern.From the reports sent by you, there's no recent reports ofkidney function.Test your serum crreatinine.  normal is 0.8-1.2.(74-106moles/ml).Normal urine albumin-creatinine ratio(ACR) is upto 30.So, you're advised to check serum creatinine(0.8-1.2), with urine ACR.Check your B.P.,and see if you've puffiness over face and swelling over feet. If you've any doubts,send them as a direct question,to me.Dr.Matthew J. Mangat.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain and swelling from an insect bite\n\nHi, I got bit more than 24 hrs.ago by either a bee or wasp on my arm, in 2 different spots & my arm is getting more & more swollen.....I m experiencing pain, muscle stiffness, & my ring & pinky are feeling numb w/pain....I ve iced it, taken Ibuprofen, & put antibiotic ointment on the bites....What should I do now to make it better?",
    "doctor_response": "Hello,Thank you for your contact to healthcare magic.I understand your health concern, if I am your doctor I suggest you that add chlorpheniramine maleate and low dose steroid prednisolone tablet in your current treatment. This both drugs can reduce the swelling and inflammation caused by the insect bite. This much measures is enough to control your inflammation.I will be happy to answer all your future concern. Thank you,Dr Arun TankInfectious disease specialist.Wish you a best health at health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Does delayed speech development mean cerebral palsy?\n\nHello doctor, My daughter is 18 months of age. She was born at 38 weeks due to placenta failure and oxygen issues. She was 5 lbs 10 ounces at birth and was healthy (did not have to stay in the NICU). She hit all of her milestones in terms of rolling over, crawling and walking (walked at 14.5 months), but is a toe walker. Her left leg (to us) is weaker than her right and her left leg does not bend as much as her right leg. She began to speak around 10 months of age then her speech left. We came to find out she had chronic fluid and a month back she had tubes placed. I am hearing more vowel and consonants now but no true words yet. She makes fine eye contact. Her non-verbal communication is good. She responds to her name but not always. She is beginning to learn more of what we are saying, she plays with some toys, is not terribly social. We are thinking that she may be on the autism spectrum and we have an evaluation soon to determine that. But my question is, could this be cerebral palsy?",
    "doctor_response": "Hi. I understand the situation you are facing with your child. As there is no history of perinatal insult and NICU stay at birth, cerebral palsy could be less likely at this early age to diagnose. The description you made is more of a like to be an autistic spectrum disorder. But this could be just a small delay in catching up all milestones. Some kids learn early and some little late. So, observe over a period and if no improvement is seen, then consult a pediatric neurologist and developmental specialist for further evaluation and management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have bilateral poly ovaries, irregular periods. No problems in the tubes, on hcg injection. Chances of conception?\n\nHi.. my age is 31, My last period was 5th January 2013... I have Bilateral Poly ovaries. I have irregular periods. I am going for the dr. last 6 months, 1st follicular study says MSF, 2nd says 19mm & reptured on 19th day- ET - 6.5mm, 3rd scan says MSF, 4th month i went for sline sonogragphy, that time dr. said there is no problem in the tubes , everything good, 5th again i went for follicular study 17th day 18mm & ET 8.3, So doctor put hcg injection 0000iu and ask me to intercourse on next three days... & asked me to take maintain tablet, apcot powder & fol 123. is there is a chances for concieve.",
    "doctor_response": "Hi, You did not say if you are on any drug for induction of ovulation. According to your follicular studies, chances of conception are good as the thickness of the endometrium is also optimal and tubes are patent. You may have to watch at least 6 cycles for a positive result while on treatment. Continue medication as suggested by your doctor. Good luck.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for cough?\n\ni have been sick for about three weeks,  bad cough to the point of passing out and severe sharp pain in the back of my head when coughing,  i am feeling a little better, but have been coughing up up green phlem,  and now it is a yellowish clear color and as a sour taste to it.",
    "doctor_response": "Thanks for your question on Health Care Magic. I can understand your concern. In my opinion you should immediately consult pulmonologist and get done 1. Clinical examination of respiratory system. 2. PFT(Pulmonary Function Test) 3. Chest x ray. Your symptoms like cough with greenish, yellow expectoration, back pain, suggest possibility of pneumonia more. All these symptoms are also seen in bronchitis. So chest x ray is needed to rule out pneumonia. If x ray is normal then PFT is needed to rule out bronchitis. So consult pulmonologist and 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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for frequent UTI and bruise on arm\n\nHello, My daughter has had recurrent UTI since she was 2-21/2. We just assumed it was due to potty training and poor whiping. She is 7, and I have noticed a bruise on her side and arm with no explaination. I just worry it is more. She has had a CT and it was normal. thoughts??",
    "doctor_response": "Hi,Your concern is right. There are other exams that she should do like renal Scintigraphy to search renal scares. Must do urine culture 2 days after treatment with antibiotics. Search for an urologist pedi.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Sensitive tooth. Unable to brush my teeth\n\nI noticed since yesterday morning i am getting excessive sensitivity of my teeth while brushing. Iam unable to brush my teeth.",
    "doctor_response": "Hi, You should get a check up by a dentist to know whether any tooth is decayed or not or you have generalized attrition/abrasion of your teeth. If you have generalized sensitivity you can use Sensodyne/ Colgate sensitive/ Senquel F tooth pastes twice daily till the sensitivity resolves.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does the EEG report regarding convulsion indicate?\n\nMy son, 3.5 years old, got senseless like convulsion. CT scan normal,EEG report- \u201cbackground is formed by 7-8 Hz frequency theta waves. There are occasional sharp wave discharge from both hemisphere. Impression-EEG is suggestive of interictal seizure disorder. please correlate clinically.\u201d Doctor treat him epilepsy child and give him medicine-syp Encorate. My child also suffers from childhood asthama. I am afraid of . please advice me . Is encorate right medicine?",
    "doctor_response": "Hi, I think your pediatrician has been right in starting Encorate because the EEG is definitely showing abnormality. It does not have any side effects as far as wheezing is concerned.Even if it is a seizure disorder CT scan can be normal.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the symptoms of dementia?\n\nFather is 83, noticed recently that he gets confused, doesn t know at times where he is going when driving familiar areas he s lived in for years.. (He still drives). He s always had a temper but recently, every little thing seems to set him off.. Noticeable personality change.. is this a sign of Dementia? Sincerely, Kevin",
    "doctor_response": "Symptoms you are describing points towards Alzhimers disease. However similar symptomatology with other associated features may be seen in other types of dementia.  Please mention the semiology,  duration,  course of illness and any vascular risk factors and imaging findings if any to comment better.Hope my advice will help you.  Take care. Don't forget to rate me.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes green bowel movement in an infant?\n\nMy baby is one month old and has had dark green poop since thursday which also contains a bit of stringy substance as well. She only poops once a day or every other day and also very gassy, she is formula fed and her pedi doesn t seem concerned. She has no fever and is not fussy.",
    "doctor_response": "Thanks for your query on health care magic.It is common to have these type of stool in formula fed babies. its completely normal. You should not worry about this. I also advice you to not to give formula feed if his mother can give breast feed. breast feed is best for babies.Regards- dr deepak",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for left-sided abdominal pain post an injury\n\nMy husband fell hard slipping on wet tile 2 weeks ago. His stomach immediately swelled up and he had excruciating pain on left side. We had to call 911 2 days later when pain was soo bad and he couldnt even get out of bed. He is 65, hx of IBS and Diverticular disease. At hospital he was dx with 2 left rib fractures, and sent home. Xray on lft side only. Now on day 10 left side pain better, abd size went down, but excruciating pain under right rib cage. Doesnt want to go back to hospital, said they didn t do anything last time. What could it be? Maybe diaphram?",
    "doctor_response": "Hello, You can consult a general surgeon and plan for an ultrasound scan to look for possible intraabdomianl causes. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes backache along with pain and inflammation in the knees?\n\nFor many years I have been treated for arthritis. Today my doctor after taking blood tests said that I did not have that condition. What conditions cause back pain, clogging head, knee pain. Also inflamation of knees. The tests that I took show that I have raynauds. I also have dry eye and am being treated with restisis. Thank you for your help.",
    "doctor_response": "Hi, Consult a rheumatologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for itchy and swollen eyes and lips after eating walnuts\n\nMy seven (7) year old daughter was baking with me and ate some walnuts. Her tongue itched her and then her throat and her lip swelled up. Now her right eye area is very swollen. Her left eye is also starting to itch. Should I take her to the hospital or get some over the counter product at my local pharmacy?",
    "doctor_response": "Hello,Thank you for asking at HCM.I went through your daughter's history and would like to make suggestions for her as follows:1. If she has only symptoms limited to eye and lips, I would suggest her to take an antihistamine like hydroxyzine or diphenhydramine. 2. However, if symptoms progress, then there is a risk that she might have swelling in throat and airways, and in that case she might have difficulty in breathing too.So were I treating her, I would suggest you to give her above suggested antihistamine at home and then take her to nearby hospital so further treatment can be done in case her swelling progresses beyond throat. In that case, she might require some injections and steroids also.3. In future, I would suggest her to avoid eating walnut as well as any product that contains walnut until her allergy to walnut is confirmed or ruled out by an Allergist-Immunologist.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish your daughter the best of the health ahead and a very good recovery.Thank you & Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes indentation on lower back?\n\nMy daughter just showed me an indentation on the lower part of her bsck side near her hip. It looks a little like a vessel in the cemter with a vein running away from the center of it. It feels a little like the tissue is missing under the spot. She said it had been there for about a month. She is 21 years old. Thank you.",
    "doctor_response": "HiWelcome to healthcaremagicI have gone through your query and understand your concern.It seems that it is normal and nothing serious.But because you are worrying you can get  examination of her by general surgeon.If she has pain she can take analgesic such as ibuprofen for pain relief.  MRI of the region may be more useful. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you.Wishing you a good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I use soframycin to heal infection due to piercing?\n\nI am six mnth old pregnant and had pierced my nose using gunshot. 18 days are over. it had healed completely and when i was trying to change the nosepin i got hurt again and it is paining and some fluid is coming out. Can i use sophramycin at that location? please guide",
    "doctor_response": "Hello,Thank you for your contact to healthcare magic.I understand your health concern, if I am your doctor I suggest you that for the pregnant lady any drugs as such is not complete safe. But if the piercing is infected than you can use it. But use with caution as not to use in much quantity and frequency. I will be happy to answer all your future concern. Thank you,Dr Arun TankInfectious disease specialist.Wish you a best health at health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to get rid of painful lump on hand\n\ni have a small lump on my hand which is on the bone. It was caused by an impact which resulted in a bruise all across my hand. I went to the hospital as i was worried that it was broke, the doctor said it was only bruising. I still have concerns as the lump has not gone and hurts a lot when it is knocked. What do i do to get rid of it?",
    "doctor_response": "Hi,DEAR,Good Evening,Thanks for the query.I studied it in details and understood your health concerns regarding it.Lump caused on your wrist bone-is a Resolving Heamatoma with infection or a fibrosing Hematoma- with crack fracture?as its painful.I would advise xray wrist-to fix the diagnosis--Non-Surgical Treatment of the bony lesion with hematoma- by NSAIDs and antibiotics,if needed is tried to start with.If it does not go away then Surgical tratment would be needed from ER Surgeon as follows-Treatment would depend on the cause-a-Your ER Surgeon would -i-  Aspirate it and treat it by antibiotic cover to wait for the healing .ii-If it does not heal and grows in size-Hematoma-? or the fibrosed hematoma-could be drained / or Surgical Excision done.Hope this would help you to plan the treatment with your doctor.Wellcome for any further query in this regard.Wishing you good health.Good Night.Dr.Savaskar M.N.From INDIA.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pain in the legs, foot and arms?\n\nI have had upper leg pain, sometimes going down to foot. It is at the point of actually limping now. I can feel pain in my upper arms and neck. Sometimes I feel it right in the bottom of the back in the middle. This has been going on for almost 5 months now, and the fear of what will happen next is primary to me. I have super difficulty sleeping because it hurts more when not in a standing position or lying on floor with feet up on a nearby bed. I had two MRIs done to my neck and head last week, but have not received any word concerning results, I do not know why doctor wanted MRI of my head. A minute of your opinion or direction would be sincerely appreciated. Peace. Sincerely Doris Yeager YYYY@YYYY",
    "doctor_response": "Hi, , the kind of severe pain you describe probably comes from the spine. Since it is affecting both upper and lower limbs, it is probably coming from cervical (neck) spine. I do not know why MRI head was advised. Most probably it is cervical spondilitis and hopefully the daignosis will be confirmed and treated. Meanwhile try giving local heat and gently rub a pain balm to the back of neck. All the best and regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for sensitive part in the wisdom tooth removed\n\nage:17 height:5'1\" weight:102I just got my lower wisdom teeth removed yesterday. Whenver i drink something (like water) i can feel something where the surgery happen move. Is that normal? I'm scared if I drink it amounts larger than sips that it can break the blood that has coagulated.",
    "doctor_response": "Thanks for using Health Care Magic.Read your query.Relax , since you have undergone a surgical procedure , you may feel a little difference.I would advice you to continue with the dentist instructions properly.Avoid vigorous gargling , though salt water gargling is to be done .Avoid using straw for a while to drink.Keep the oral cavity clean and continue with the medicines prescribed.Hope this was helpful and you have a speedy recovery.Thanks and regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the home remedy for chest pain?\n\nI am 34 years old woman. I am suffering from asthma and RA.I have been taking medicines for RA and inhaler for asthma. I am suffering cold from 2days. But now I am feeling chest pain in my left upper part. already 2 hours have passed. But I didn't get rid of it.Please tell me some home remedy.",
    "doctor_response": "**1. since medicines for Asthma also increases the heart rate, and any provoking factor [cold in your case] will naturally increase the heart  rate, resulting in chest pain, so whenever a patient complains of chest pain, first possibility which comes in mind, is it related to heart, thus prior to taking any home remedy [since there is no relief from 2 hours], seek an opinion of cardiologist/physician who will go for necessary examination and baseline investigations.2. In best Interest: avoid exertion, stop physical activity and start medical treatment immediately.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can schizophrenia be diagnosed?\n\nMy son is trying to keep his family together. His wife is showing signs of schizophrenia & has for along time. She does not like people , her few jobs last a few weeks at a time, due to something wrong with her boss, etc. She attacks me with unvalidated accusations as being uncaring toward our grandkids. Although the other grandparents aren t as involved as I am. She also talks about her parents lack of Participation in grandkids activities , etc. so it s not just me. She also has been extremely jealous of her sister in law. She is taking Klonopin. I am not aware if she has had a professional psychiatric evaluation & diagnosis for this medication. This past weekend, along with a alcohol consumption, she drove & now has a DUI. Now my son has to contend with her DUI along with her rational behavior and mood swings. They have 4 children, and I am concerned for their welfare , thank heavens they were at home and not in the car with her. Any suggestions?",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. A diagnosis of schizophrenia is not possible at all with the given symptoms. Your son's wife is showing irrational behavior, anger, jealousy, anger, aggression, contentment, is suspicious etc. These symptoms could be due to even extreme stress. I suggest proper evaluation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes persistent pain in the middle of the heart?\n\nDear Sir i have a long pain in the middle of my heart for a long time, i went to man y doctors but they never said me the exact problem they give only few medicine saying that it will be all right but then i could not get heel of it,if you would show me any path in this regard it would be a very kind full to me . Thanks & Regards RAvi",
    "doctor_response": "Hello, Regarding your concern, I would explain that chest pain could be related to different possible causes: musculoskeletal pain, coronary artery disease, gastro-esophagal reflux, anxiety, etc. Does deep breathing or pressure on the chest trigger the chest pain? This would be indicative of musculoskeletal pain. Anyway, I would like to review your performed cardiac tests in order to be able to give a more professional opinion. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I have insomnia and cannot find the right position to sleep. Any advice?\n\nHello doctor, I have sciatica. I also have nerve pain in my face coming from my neck which stops me sleeping on my back. If I sleep on my shoulder, I get soreness on the shoulder. I have insomnia and cannot find the right position to be able to sleep. Could you give any advice? I put ice on my neck which temporarily relieves the neck pain and deep heat massage on my shoulder. Stomach sleeping is not recommended for people with back problems. Is there some solution to this problem?",
    "doctor_response": "Hi. In this case, there is no best position for sleeping. Instead, the way you are sleeping in every position that will help you. 1. Sleeping on the back - the pillow under the neck should be shallow enough to support the neck in one straight line. Keep a pillow under both the knees so that back is supported completely. 2. Sleeping on either side - the thickness of the pillow should be equal to how broad your shoulders are so that the head and spine be aligned. A pillow between both the arms to support the shoulder from following to either side might help. A pillow between the knees also. Keep changing the sides. For more information consult a physiotherapist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause of an abdominal infection?\n\nIs it possible for an appendix to rupture and then seemingly disappear?Our daughter has been in the hospital for 4 weeks,with an infection in her bloodstream,gallbladder and kidneys.The doctors have been unable to determine why her abdomen keeps filling up with purulent drainage,that they have removed by syringe 5 times,until today they took her to operating room and thru a 6 inch incision removed over a gallon of infectious fluid.The surgeon says he cannot find any reason for this infection,except he could not find her appendix.Before she got sick 4 weeks ago she was a very healthy 26 year old,2 weeks from graduating college.She now has 2 drain tubes in her abdomen and a NG tube.Please advise.Thank you",
    "doctor_response": "hi.for your first question, yes, it is possible for the course of ruptured appendix to be of increasing intensity at first, when it comes to signs and symptomatologies (occurrence of abdominal pain, fever, leukocytosis), then it seemingly disappears. drain tubes has been placed already and this will help in continuous drainage of the purulent intraperitoneal fluid. also, proper antibiotic course must be maintained to control the ongoing infection, as well as hydration, bowel rest (nothing per orem temporarily) and GI decompression (thru her NGT). abdominal ct-scan and blood works (such as CBC) will be of great help as well. if the cause of the abscess is indeed her ruptured appendix, interval appendectomy may be done eventually. you may talk to your doctor/surgeon re the course of her condition so would understand it better.hope this helps.good day!!~dr.kaye",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Could increase in WBC count could be a reason for reoccurrence of stye?\n\nHello doctor, I have a stye, and it is reoccurring from 15 days. As my CBC report, hemoglobin is 11.8, and RBC is 4.02, and WBC is 10200. So is it because of the increase in WBC?",
    "doctor_response": "Hello. I reviewed your history. A stye is because of bacterial infection of glands if eyelids. Since this is infection WBC count is expected yo increase. WBC count in your cade is within normal limits, up to 11,000 is normal, no need to worry. The recurrence is because if recurrence of infection and recurrences occur in people with risk factors like blepharitis, exposure to dust. Hence consult your eye doctor to find out the underlying cause and treatment accordingly. As of now, you need to use antibiotic eye ointment and hot compression.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How should cancerous AGUS cells with urinary problems be treated?\n\nHello, I had 2 urinalysis with UTI symptoms that come and then subside for weeks. I have pain in my lower back for 4-5 yrs. I have uterine, bladder, vaginal wall, & bowel prolapse. I had surgery on the uterine prolapse in 2005 for it to have possibly failed. On May 11th I recieved a call that my pap smear showed I had significant AGUS cells that cultured cancerous. We are now in the process of trying to biopsy. My urinalysis shows symptoms of other issues, but PCP is ignoring them what should I do? There are many/large - moderate epithial cells, rbc,wbc, many/large uric acid crystals, mucus, bacteria, leukocytes, etc.",
    "doctor_response": "You can opt for Homoeopathic mode of management.As Homoeopathy is side effectless and very mild to act in oncological cases where immunity gets very heavily deranged.Homoeopathy treatment needs a thorough Case taking to select proper Medicine which needs thorough detailed Case history and reports.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat keloids?\n\nHello, I have had previous keloids on my ears. They were reccurrent even after removal until I got radiation treatment. I have had other piercings such as nose, lip, navel and no keloid! I would like to get a clitoral hood piercing. What are me risks of getting a keloid?",
    "doctor_response": "Keloids often do not need treatment. If the keloid bothers you, the following things can be done to reduce the size:Corticosteroid injectionsFreezing (cryotherapy)Laser treatmentsRadiationSurgical removalSilicone gel or patchesMany of these treatments can cause a larger keloid scar to form.RegardsDR De",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should i take Paxidep CR-12.5?\n\nHello Dr...I am taking Paxidep CR-12.5 from last 2.6 years, I had some panic attacks issue and anxiety . But after taking this medicine my panic attacks is totally gone and almost anxiety also, but my doctor advised me to continue with Paxidep CR 12.5 for some more time.  Some time I feel that my BP level will raise ..actually some times it happen when I more concern of something, is it due to my anxiety issue ??Please let me know how long should I take this medicine, I do not want to be addicted of this drug.ThanksAmit",
    "doctor_response": "Dear FreindParoxetine is an SSRI group of drug , used to treat many conditions including you have mentioned.Since you have been taking it for long , i advice you not to stop it abruptly , as can cause SSRI Discontinuation syndrome.So , discuss with your doctor.I personally gradually lower down the dosage and then stop , with introduction of behavioral therapies.All the Best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for torn skin on the frenulum\n\nhi there,I recently tore my frenulum. it has all healed up as far as i am aware anyway. However there appears to be what looks like an ulcer are scab i cant really tell, on my frenulum that doesn't seem to be going away. Should i just wait and see will it go away? i allowed the frenulum 2 weeks to heal. the ulcer/scab is only the size on a small ache spot.",
    "doctor_response": "HelloThanks for query ..You have sustained injury to your frenulum during intercourse or Masturbation which has turned out to be anon healing ulcer on under surface of glans penis .You need to take broad spectrum antibiotic like Doxicycline  along with anti inflammatory drug like Diclofenac twice daily.along with topical antibiotic ointment like Neosporin twice daily.Ensure to wash your genitals with warm water and anti microbial solution Betadine  twice dailyEnsure to avoid any sexual activities till it gets cured completely.It will get cured within a week.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sciatic pain in hips and legs?\n\nI have sciatic pain in my hips and down my legs can that also make your legs hurt when you walk. I am concerned I may have P.A.D. as well. However, my legs do not stop hurting if I rest. I fell down the stairs about 7 yrs ago and that is when it started. I am 60yrs old. Should I get xray?",
    "doctor_response": "Hello,It may be due to sciatica. For further assessment you may require MRI back, nerve conduction studies after spine surgeon consultation. You may require tablet Pregabalin and multivitamin after consultation. You may require surgical intervention after consultation. Do regular physical therapy Hope I have answered your query. Let me know if I can assist you further. Regards, Dr Shyam Kale Family and general physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pus formation after orthopaedic operation\n\nIf puz was found all of a sudden after 3 months of ortopaedic operation (\"UNDER SA+EPIDURAL PATIENT UNDERWENT RIGHT TIBIA DEBRIMENT, BONE GRAFTING AND POLLER SCREW INSERTION\".), what I need to do? Patient was absolutely careful and no injury occured from his end during the period. He do not have any blood suga issue also.",
    "doctor_response": "The narration of ur case is unsufficient. Kindly take into account the type and grading of the initial trauma,whether it was open or closed. It you had a debridement performed, it already creates suspicsion of infection prior to it. Implantation done at the time of an active infection, will only create a source of recurrent infection. U need a radical debridement, implant free period, Adequate skin cover or skin flaps, and later when there are no signs of active infection including lab test and local tissues conditions, you can go ahead with permanent fixation. Do take into acccount that once infected, the chances of non-union increase substantially.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why are there lumps in my baby' stool?\n\nHi my 8 month old baby has had diareah for the last couple of days. His poo bas been  yellow  stringy aand  slimy. Today I noticed it was very 'airy' had small 3 -4 mm white looking lumps in his poo. Almost  looked like rice bubbles. What could this be. Should I be concerned? I'm still breastfeeding him and he has been eating mashed veggies and bananas for about 2 months now.",
    "doctor_response": "HiWelcome to the HCMIn my opinion your child seems to be suffering from an episode of viral gastroenteritis. In cases of  diarrhea, body of an infant may temporarily have trouble producing lactase, and he may have symptoms of lactose intolerance for a week or two.This seems to be the likely cause of your baby's poop change. Don't worry. You can take the following measures to help him:1. Hold milk and dairy products containing lactose for 1-2weeks. You can give him lactose free milk formulas for the time being.2. Keep him well hydrated during  these diarrhoea episodes by oral rehydration therapy such as lemonade, soups, Buttermilk or oral rehydration solution.3. Start a syrup zinc for next 2 weeks. Zinc help in regeneration of gut mucosa and early recovery from the diarrhoea. Also it gives immunity against similar episodes  for next 2-3months.4. Give him acetaminophen if fever occurs.5. Probiotics such as enterogermina will be helpful.If still the child doesn't respond, then do contact your pediatrician for proper clinical examination and laboratory work up if required.For further questions, do contact us.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can severe hair loss and depression due to it in a 20-year-old be treated?\n\nI m facing severe hair loss. I m only 20. But I am almost bald in the frontal area and crown and my hair line s also receding a bit. My hair s been falling out since quite a long time but it has gotten pretty severe now. Its so depressing.I cant even explain. Also I used to scratch my head a lot. But now I dont. Also, I used talcom powder for a few months 5 years back since my hair would get oily in a day(which still does) so to hide that but I dont use it anymore since I ve heard the zinc in it is bad for hair. My hair is very fragile and it comes out from the root. the baby hair also fall off. please help me.I now wash my head on every alternate day but it gets very oily in a day and i cant do anything abt it. I have trouble hiding the thinning patches. I cry myself to sleep almost every night. I feel so embarrassed. All girls of my age have nice thick voluminous hair except for me. oh and I have lots of white hair as well : ( Please help me. Also, I have a second problem. My skin is very sensitive. It gets red and itchy when it gets exposed to sunlight or just simply heat or even dust. red patches and tiny bumps appear on my skin. when i m in a cold area it kinda is a lil better. i dont even touch my face anymore coz it gets red and weird out of the blue. i have tiny red spots (maybe marks of which were once pimples) on most areas of my face and my skin is textured. I just want smooth clear bump free even toned skin. I m quite fair btw but because of redness and all, my complexion looks dull dark and weird. please help me out.",
    "doctor_response": "Hi, For the hair problems, you should go for platelet-rich plasma treatment (PRP), which actually involves taking blood from your body, centrifuging it and then re-injecting the fluid into your scalp. It has very good results. For the skin issues on your face, I would suggest applying sun block cream before going outside in the sun since you have a sensitive skin and try avoiding contact with any substance to which your skin reacts. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes selling in the feet?\n\nI went to a podiatrist today about my foot that I hurt really bad while skateboarding... They sent me to get x-rays done but when screening the x-rays they said my foot is too swollen to read them and they made me an appt. for next to find out for sure when the swelling goes down. I play college soccer and we move in soon. I was wondering would it be best to redshirt for the year? And also I ahve an appointment for tomorrow for my calf which I seen a RN today about but the couldn t get me in today and he thinks that there is a good possibility it may be torn. Do you believe that I won t be hearing good news?",
    "doctor_response": "Hello, There is  most likely possibility of early plantar fasciitis.For plantar fasciitis,Shoe/footwear should be with soft sole. You can use silicon pad insoles.Avoid exposure of cold to foot.Start plantar exercises consulting physiotherapist also Physiotherapy like TENS and ultrasound will help. Take calcium supplement with vit D.Do exercises of foot before getting out of bed.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to deal with bullying behavior of kids?\n\nHi dr My son is almost 7 year old 3 months back he was having a problem of decrease appetite nd irritation even he was querelling with his friends bulleying nd hitting Then dr prescribed mosegor for increase appetite nd sleep but his appetite still not improved nd till now his sleeping behavior is same but now after 3 months he is having a stomach pain nd high grade fever again but again dr suggest to give mosegor so my question is it safe to give him mosegor or not",
    "doctor_response": "HiPizotifen malate (a derivative of Pizotifen) is reported as an ingredient of Mosegor.It can be used for treatment of anorexia of somatic or psychogenic origin in underwt patients, supplementary to the treatment of the underlying conditions eg infections or parasitic disease (including convalescence), chronic diarrhea, anorexia nervosa or states in elderly.Dose to be used is 0.5 mg, daily dose may be increased up to 1.5 mg in divided dose or 1 mg may be given as single dose at night.Precaution should be taken if child has-Narrow-angle glaucoma; urinary retention.It can cause sedation. Rarely, dizziness, dry mouth, constipation; increased appetite, wt gain; nervousness.In my opinion, this is not a proper treatment for current illness. You can start Acetaminophen for fever and stomach pain. Take him to a proper pediatrician for a clinical examination for definitive diagnosis and treatment. For further questions, do contact us.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to maintain the alt levels in normal ranges\n\nhello i am 46 years male. after ist test my alt level was 198,while normal range was given upto 45 u/l .after 2nd test it was 110. after 3rd test it was 40.and now after 4th test it is again 54 u/L .all these tests were repeated after 45 days.how can i maintain my alt in normal ranges.is 54 u/l alt level dangerous.",
    "doctor_response": "Hi,Usually ALT or AST values higher than \"two times the upper normal limit\", is considered abnormal (in some countries, ALT or AST values of more than 100 are considered abnormal). Value of AST or ALT greater than 85 or above maybe investigated further.Viral hepatitis, increased Alcohol ingestion and obesity are common causes of liver disease. All these should be ruled out.Advice:- abstinence from \"Alcohol\" - LOW fat diet should be followed, AVOID junk food and beverages- NO red meat- Green vegetables should be ingested daily- Use lemon juice (lemonade) once in a day- Reduce weight if overweight/obese- \"Recheck liver enzymes after 6 to 12 months\" and/or ultrasoundHope to answer your concern. Any further questions are welcome. Wish you good health.Regards,Dr Tayyab Malik",
    "dialogue_context": ""
  },
  {
    "patient_message": "My Hands are sweating too much. How to cure it?\n\nmy hands are sweating too much.. how to cure it.",
    "doctor_response": "Hello Abhijit , Welcome to HCM Thanks for your query Too much sweating in your hands is due to your \"Pattik\" nature according to Ayurveda. If you are a teenager, this is common and you need not to worry about it. You should take amla juice 3ml with water 2 times in a day for at least 3 months. Amla is \"Sheet\" (cold) in nature. Avoid coffee, tea, spicy food. I hope this will help you a lot. Thanks Dr. Seema Saxena Team Health Care Magic",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having progressove pain in left hypochondriac region radiating to back. Gastroscopy, CT scan, USG, CEA done. Cause and treatment?\n\nam having pain in left hypochondriac region radiating to back.intially it was periumbilical.pain is since 2 yrs. i have done gastroscopy,ct abdomen and usg  abdomen last year it was normal.have strong family history of cancer. have also done CEA was normal.have polio in right leg.have also one colonoscopy last year ,it is also normal.still pain not relieved comes and goes.am not getting whether it is back pain or abdominal.pls suggest me. having normal apetite,no h/o vomitting.bowel habits normal.sometimes nausea.but no episode of vomitting.tried all possible medicines.ct showed small mesentric lymph nodes.but docor said (gastroenterologist) that it is normal.they are not so big that time my ESR was 43.pls suggest.CBC done 2 months back shown normal.r",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for asking a question to H.C.M.Forum. You are getting stomach pain, and to the back, it comes and goes, vomiting sensation, but no vomiting. Gastroscopy, U.S.G., colonoscopy, appetite and bowel movements are normal. It appears to be functional, as there is a history of cancer you might be feeling the pain. Besides i advise you to follow some recommendations. Avoid taking more of spices, junk foods, and oily foods. Practice yoga, meditation, reading books of your interest, and  hearing music. Try to mingle with people as much as possible. Wishing for a quick and complete recovery. Best regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fever and temperature\n\nMy son is almost 4. he vomited 2 days ago and ever since over the last 48hrs his temperature is going up and down and up to the high 39 degress. We have been giving him liquid panadol and nurofen over the past 36rs but nothing has changed.  He is very hot and his body is aching. No sweating.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.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 15mg/kg/dose (maximum ceiling dose of 500mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it normal to have muscle spasms around navel after gallbladder removal?\n\nI had gall bladder removal and umbilical hernia repair on June 2nd I am now feeling a mild muscle spasms around my naval. This started approximately two days ago. There was no traumatic incident prior to it (for example, I wasn t lifting anything heavy or doing anything that would possible damage the area). It s not painful, and the sensation resembles what one would feel when the eye lid twitches or another mild involuntary muscle twitch.  Is this normal?  Is it a sign that the stitches are healing inside?",
    "doctor_response": "Hi, I had gone through your question and understand your concerns.This looks to me like so called postcholecystectomy syndrome which has all these symptoms and this occurs in about 10 percent of patients who undergo cholecystectomy, usually can be transient, and rarely persistent or lifelong. Symptoms include systemic symptoms such as sweating and heat sense but also dyspepsia, nausea, and vomiting, flatulence, bloating, and diarrhea, Persistent pain in the upper right abdomen. Some individuals may benefit from diet modification, such as a reduced fat diet, following cholecystectomy since it may be more difficult for digestion of fatty foods. Postcholecystectomy syndrome treatment depends on the identified violations that led to it. Typically, the patient is recommended dietary restriction table with fatty foods, enzyme preparations, antispasmodics, sometimes  oral ursodeoxycholic acid can alleviate the condition.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Dislodged blood clot after wisdom tooth extraction. Free from dry socket?\n\nDislodged blood clot on 3rd day of tooth extraction. No pain and very little bleeding. AM i fine and free from dry socket I got a wisdom tooth pulled out 3 days ago. LOst my blood clot on 3rd day and it was bleeding for a while.( pretty sure that i lost it as i found a thick mass of blood). Placed cotton on the bleeding spot. Bleeding stopped and it has been abt 16 hours. Experiencing no pain. found very very little blood( abt an mg) from the stitches. I wanted to know hw fine i am after dislodging the clot. NO Pain now. Its the 4th day 2day. Am i free from dry socket. Am paranoid abt getting dry socket as i lost the blood clot on the 3rd day.",
    "doctor_response": "dear friend thanks for sharing your concern. friend, it could be a granulation tissue too.how do you know its a blood clot only? as you have mentioned your dentist has put sutures too after your surgical procedure. therefore there are very less chances of clot getting dislodged here, until vigrous rinsing is prformed or any other such act. a case of dry socket presents dull aching pain.its an infection of the healing socket.you may suspect dry socket if you have such pain and symptoms. in this case its good to visit your dentist for post extraction evaluation. hope this helps. thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why the erection is not hard and strong?\n\nhello sir i have been suffering from toxoplamosis in my left eyes since 6 years and have 25% loss of vision,my problem is that my erection is not as hard and strong as it use to be before,can i use vigra?? but it is said that if u have eye infection you should avoid using vigrais it..?and if yes what should i do than..?",
    "doctor_response": "Hello, As per your history, it may be due to performance anxiety. For that you can take tablet sildenafil one hour before sexual act. Take proper rest. Take balanced diet. Avoid stress. Discuss issues with your partner. Foreplay will also help Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a burning sensation in the upper left abdomen?\n\nI'm a 24 yr old woman, and for the past year I've had on-again, off-again pain in my left abdomen. Recently I've had a sharp pain in my lower left abdomen that lasted a couple hours. It's since been replaced by a persistent burning sensation in my upper left abdomen, stretching right and down in a right-angle fashion.",
    "doctor_response": "Hi,From history it seems that there might be having some chronic pelvic infection giving this problem.Consult Gynaec and get examined.Ultra sound of abdomen will give clear clue about your problem.Meanwhile take some NSAID medicine like Diclophenac medicine as needed.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bladder feels raw, stressed. On citalopram. What is going on?\n\nI had symptoms of a water infection but results came back clear on four occasions. Regardless, doctors have given three different types of anti biotics which haven t worked. I am in agony and have been so for nearly six weeks. My bladder feels raw but dip tests don t show blood . Nine weeks ago I found out my husband had been cheating on me though we were about to start fertility treatment to have a baby. My doctor has given me citalopram (20mg) and says my symptoms are caused by shock and stress and that the stress is manifesting itself in this way. I m worried it could be something more severe which is being ignored. Please help x",
    "doctor_response": "Hi there, thanks for asking. bladder irritation could be as a result of combination of several things or just one thing. It could be related to infection as you mentioned. It could be related to stress as the doctor has mentioned. It could also be related to the side effects of citalopram. It could be also due to all of them. If it is related to the medication, you can decrease the medication to half a dose after consulting with your doctor for several days. If it is improved you will know that it is related to that. Then he can give another medication which does not have this side effect. Best wishes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could dizzy spells be neurological?\n\nI have recently had many dizzy spells. When I move my eyes quickly. I have pressure discomfort on the top of my head and I feel like I m straining my eyes even w my glasses. My balance feels off when I get the dizzy spells. Could this be neurological?",
    "doctor_response": "Hi Dear,Welcome to HCM.Understanding your concern. As per your query you are wondering if dizzy spells be neurological. Well there can be many reasons for symptoms you mention in query like benign paroxysmal positional vertigo (BPPV) , viral infection of the vestibular nerve , meniere's disease , migraine , neurological conditions like parkinson's disease and multiple sclerosis. Alteration in blood pressure can also cause dizziness . I would suggest you to first consult ENT specialist for ear problem . Doctor may order CT scan ,MRI , rotatory chair test or balance test . Doctor may prescribe antibiotics like gentamycin , anti inflammatory , antiemetic drug , vestibular therapy along with certain aids . Doctor may also refer you to neurologist for neurological problem . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for rapid heart rate and headache\n\nMy mother is having an array of symptoms today. Earlier she had a high heart rate, headache, and soreness (which might have been from high amounts of physical work today painting and moving furniture) Now she is nauseous, and vomiting, with a low body temperature of 93.2 (axillary). Her heart rate is now 82 bpm",
    "doctor_response": "Hello, I understand your concern and would explain that her symptoms could be related to a migraine or viral infection. A stroke can not be excluded either. For this reason, I recommend bringing her to the ER for a physical exam and some tests: - a resting ECG - complete blood count, PCR, ESR - blood electrolytes - kidney and liver function tests. A brain CT scan may be needed in case of abnormal physical exam. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring itchy rash on chest?\n\nI have this rash that comes and goes for the past year on my chest and there are times it s worse then others. I itch at it most of the time. I have not changed anything in my daily life. Have any suggestions? I do not currently have allergies either.",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. As per your description it seems like something called \u201cseborrhic dermatitis\u201d. It\u2019s a kind of fungal infection and can be cured with proper treatment. As of now apply topical anti-fungals like Clotrimazole over the affected area and keep the area dry and clean. Oral anti-fungals like Fluoconazole also may be needed. In case of dandruff, treat dandruff first. Consult a dermatologist and he will direct you accordingly. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for myocardial Ischemia\n\nHad an abnormal ekg. septal+lateral changes possibly due to myocardial ischema. I am 43 and I can run and exercise with no symptoms. I do have palps a lot since I was 17. Have had two stress tests in that past. Last on 6 years ago. I was palping some during the ekg. Did that throw the machine off?",
    "doctor_response": "Hi,If you had palpitations during ECG test, then it would have shown if there is any arrhythmia. For possible ischemia I would advise you to repeat the stress test.Take careCome back if you have any further questions",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in the knees?\n\nHI Dr. Stephen, My daughter has been having problem with her knees for sometime now they are swollen and she s always complaining that they hurt the bone in her knee be a littlte hot.She has never played any sports.I m trying to understand what this could be.I hope that you can understand me but ask me anything.",
    "doctor_response": "Hello! Thank you for writing! Frim the signs, swelling, pain and warmth of the knee it may be an arthritis. When has the pain appeared? Are other joints involved? Does your daughter has stiffness when she wakes up in the morning? I suggest you to see a rheumatologist doctor. Diagnosis is made by clinical examination from an appropriate health professional, and may be supported by other tests such as radiology and blood tests, depending on the type of suspected arthritis. All arthritides potentially feature pain. Pain patterns may differ depending on the arthritides and the location. Rheumatoid arthritis is generally worse in the morning and associated with stiffness; in the early stages, patients often have no symptoms after a morning shower. Osteoarthritis, on the other hand, tends to be worse after exercise.Elements of the history of the disorder guide diagnosis. Important features are speed and time of onset, pattern of joint involvement, symmetry of symptoms, early morning stiffness, tenderness, gelling or locking with inactivity, aggravating and relieving factors, and other systemic symptoms. Physical examination may confirm the diagnosis, or may indicate systemic disease. Radiographs are often used to follow progression or help assess severity.Blood tests and X-rays of the affected joints often are performed to make the diagnosis. Screening blood tests are indicated if certain arthritides are suspected. These might include: rheumatoid factor, antinuclear factor (ANF), extractable nuclear antigen, and specific antibodies.Wish your daughter good health. Thank you!",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is shoulder cancer serious?\n\nhi i have my very close relative who just got a report from the doctor saying that he has a shoulder cancer..i just wanted to know if it is very serious or its nothin to worry and also if u could give me some tips of how to take care of it while getting treatments...like what food to eat what not to eat kind of exercises to do and everything you know that could help..i am soo worried for him thanks",
    "doctor_response": "Hi, dearI have gone through your question. I can understand your concern.Any cancer is serious. Shoulder cancer is also serious condition, if not treated it will spread in other parts of body. Treatments depends on type and stage of shoulder cancer. Surgical removal followed by chemotherapy is the treatment of choice for most of the shoulder cancer. But it depends on many factors. Consult your oncologist and take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Why should I take these following tests?\n\nhi am a student being asked for following test before I join any JOB these tests are1.       HBSAg (SPOT/ELISA)2.       Chest X ray3.       Typhoid (Widal)4.       Urine routine and bile pigments5.       Blood grouping and Rh Typing6.       Stool check  can u tell what are these for",
    "doctor_response": "HiLet me help you out regarding the testsHBSAg is to check for Hepatitis B infectionChest X-ray to rule out any respiratory ailment and also will assess if you are a smoker.Typhoid WIDAL is to check for typhoid fever.Urine routine for any urinary infection.Bile pigments to check your liver status.Blood grouping and Rh typing primarily for documentation and in case of emergencies for blood transfusionStool check for any gut infection.These are routine tests usually before a job to rule out any infection at the time of your joining and also for documentation purpose for your health insurance which the company may provide.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes blood clots during urination and bleeding from rectum?\n\nMy 60 year old brother in law has begun passing blood clots during urination occassionally for a month of so.  He has now started bleeding from the rectum.  Although I know he needs a doctor's attention, he makes light of it.  What could cause such a condition and what type of doctor should he see?",
    "doctor_response": "Hi,Thanks for writing in.An elderly male passing blood in urine and stools should not be neglected. These can be the signs of cancer in this age group and detailed investigation is to be done. The blood in urine can be from a cancer in the urinary bladder or prostate and this is causing the symptom. This might explain the bleeding from rectum which can happen if the tumor is invading the blood vessels in the rectal wall.The doctor to be consulted is a surgeon and preferable a urologist. They will do investigations like ultrasound scan and Ct scan of the abdomen and pelvis. If the bleeding area is not clear then he will require cystoscopy and colonoscopy which are minimally invasive techniques and help in confirming the diagnosis. The doctor should be consulted urgently. Please do not worry.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will lower back and disc problems cause dizziness and blurred vision?\n\nhi, I have a series of lower back problems including,degenerative disk disease and spondylitis,disc problems etc,can you tell me if its possible for some or all of these problems to cause me to feel dizzy,have some blurred vision and a general feeling of being unwell.i am being treated with tramal and mobic",
    "doctor_response": "Hi,Welcome to healthcare magic.Back pain and degenerative disc unlikely to cause dizziness and blurred vision. tramal and mobizox can cause some sleepiness.I think my query may be of some help to you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to maintain potassium levels\n\nI am not able to get to dialysis due to the weather conditions, my ins won't pay for my transport by non-emergency ambulance.  I'm in a wheelchair.  I did not get to dialysis last week, I thought I had transportation arrangements but was never picked up.  I came home from the hosp Wed. 02-12-14.  Since I can't get there today, Fri. 02-14-14 what can I do to keep my potassium down.  I can't use Kexalayte, can't have sodium or acetate.",
    "doctor_response": "Hi welcome to HCM, you can go on a low potassium diet---Good sources of potassium include bananas, citrus juices (such as orange juice), cantaloupes (melon), tomatoes, potatoes, lima beans, flounder, salmon, cod, chicken, and other meats. These foods should be avoided. Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What are the side effects of loprin and progesterone?\n\nHi, I am six weeks pregnant (2nd pregnancy) my doctor has advised me to use loprin and progestrone on the basis of my 1st pregnancy during which i had experienced spotting between 8-12 weeks. Please advise me whether it is harmless for me to use loprin and progestrone?",
    "doctor_response": "HiProgesterone is a normal female hormone that maintains pregnancy. Progesterone deficiency can cause spotting and hence you have been prescribed the drug.Low dose aspirin has been prescribed in some pregnancy to reduce the risk of pre eclampsia(raised blood pressure in pregnancy).High doses should definitely be avoided.Hope I have answered your query. Let me know if I can assist you further. RegardsDr.Saranya Ramadoss, General and Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes pelviectasis and subchondral cyst on CT abdomen in a child?\n\nHi my daughter had a CT abdomen that showed that she has mild Bilateral Pelviectasis and it also shows a subchondrol cyst of the left iliac side of the SI Joint? She is only 14 years old, she does have mild scholiosis. Do I need to be concerned about these results?? Thank you, Marie",
    "doctor_response": "hellothanks for writing ingone through your complaintsyou are saying scoliosis but from how long it is there not mentioned.is it there from birth or recent onset. the CT abdomen report mentioned mild bilateral pelviectasis is nothing but pelvicalcyceal system is full commonly due to overdistended bladder.Nothing to worry.if you are stil anxious of it we can review in ultrasonogram after passing urine.most of cases it is not seen.regarding subchondral cyst of the left iliac side , so many possibilities are there. it can be unicameral bone cyst, chondroblastoma ,aneurysmal bone cyst.the scoliosis you mentioned if is of recent onset ,it can be due to subchondral cyst. if cyst is there with surrounding sclerosis it can be inflammatory, osteoid osteoma.however it needs complete evaluation.thank uif you need any clarification please write best regards vasundhara",
    "dialogue_context": ""
  },
  {
    "patient_message": "Not able to conceive. Diagnosed with bilateral fibroadenosis. Chances of pregnancy?\n\nhi,my husband and i trying to get pregnant for 8 month ,am trying to do everything right .but i have been diagnosed with bilateral Fibroadenosis does that affect my chances to conceive in any way plus am trying to put on weight as am 160 cm and 45 kg ,could being underweight affects my eggs health, and could using hair removal cream for public area is harmful for me ,thanks in advance :)",
    "doctor_response": "Hi, Thanks for your query Yes , low body weight has been associated with harmonal problems,which may affect fertility, so put on some weight. Bilateral fibroadenosis  does not affects your fertility. Hair removing cream has nothing to do with fertility.You can try for pregnancy  for 4 months more. If even in 1 year ,you cant conceive then you will have to do many investigations to see that every thing is OK including ovulation confirmation, tubal patency confirmation, husband's semen analysis etc. Best of luck and take care... Hope it helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can be the reason for raised rash between the butt cheeks?\n\nI m a 32year male, generally healthy. Literally over a night or two, I have developed a red, raised rash on the skin between my butt cheeks. I originally thought it was haemorrhoids and so tried zinc oxide and lidocaine cream, after bathing them in salt water, but felt it started to spread further onto the cheek and up towards my scrotum. I therefore thought it could be fungal nappy rash (due to sweating and hot weather) and so bought clotrimazole 2%, which I have ude for 2 days now, but to little improvement. Any thoughts please? Thank you!",
    "doctor_response": "Hi, It does seem that it could be a fungal infection. Fungal infection involves body folds like the groin, butt cheeks, axlilla, etc. I suggest you to continue using Clotrimazole cream, twice daily for 2-4 weeks. In addition, I suggest you to take an oral antifungal e.g., tablet Fluconazole or Terbinafine for 2-4 weeks for a faster and complete cure. Fungal infection is usually itchy therefore I suggest you to take an oral antihistamine e.g. Tab Cetrizine once a day for symptomatic relief from itching. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggestion of remedy for rash in the scrotum area\n\ni have red rash on one side of my scrotom and inner side where they rest in that area in the crease my doctor gave me nystatin powder to use thought it was a yeast infection. it also has an odor. i wash and dry the area good twice aday. any other suggestion? i wear boxer but sleep in the nude.",
    "doctor_response": "HiWelcome.I have gone through your query.It is difficult to comment on it without examination, so I would either suggest you to see doctor for examination and for exact diagnosis or upload the pictures here, I'll go through them, and provide you with specific advice.Might be fungal infectionHope this helps.Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What are the chances of HIV transmission through mosquitoes?\n\nHello doctor, Regarding the transmission of HIV by mosquitoes, I have following query. I know the virus does not survive in insects,\u00a0but what if some mosquito\u00a0bites a very high viral load HIV-infected person and then bites an\u00a0uninfected person on his wound, who crushes it on his wound. If the above situation happens at three or four places on his body simultaneously by an HIV-infected mosquito, what is the\u00a0possibility of HIV transmission by this method?",
    "doctor_response": "Hi. It is good that you have an interest in HIV transmission. Hope your query is answered, but if you have any other question, please do not hesitate to ask or call anytime. For more information consult an HIV AIDS specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suffering from choking.gagging and difficulty in inhaling\n\nI ve been suffering from this choking/gagging stuff since the end of Oct 2013. Sometimes, it s so bad I can t breathe, can t inhale or exhale that is when it s the scariest. My doctor has run all kinds of tests and have not found anything. What do I do now that my doctor has decided not do any more tests?",
    "doctor_response": "Thank you for coming on HCM.The Ayurveda has secret. Your enlightened doctor has told you there is nothing wrong. OK. We will say you not to worry.I will treat you along the lines of Pratishyay in Ayurvedic terms. The treatment may last for 16 weeks or so. It will be most economic and without any side effects.May be its not so palatable but then these herbal preparations do not contain essence or flavours or colors.If you agree we may suggest you in a phased manner. I am sure that you will be fine.May I be of any other help?",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat tingling and partial numbness in right limb?\n\nHi, I have had tingling and partial numbness in my fingers of R hand for about 1 week, now has extended to entire R arm. Possible pinched nerve? Had some pain in back (typical for me due to ongoing back issues, slightly more than usual) now decreased, but numbness, tingling in limb remains.",
    "doctor_response": "hi  It is quite possible to have a pinched nerve in your neck, going by the description. I suggest MRI of the neck to confirm the diagnosis. Start pain killers , muscle relaxants , pregabalin and physiotherapy in the meantime.Dr Gopal Goel ,Orthopedic Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes back ache near shoulder blade?\n\nAge 31 maleI am experiencing a back ache near the left shoulder blade closer to the spine when lifting my left arm above my head. Could this be a pinched nerve? I have also felt my left arm feeling a little prickling sensation and twice like a electrical shock feel in my left arm. I haven't experienced any loss of strength. Any advice would be appreciated.Greg",
    "doctor_response": "It can be a musculoskeletal pain probably scapulocostal syndrome. Here there is a myofascial spasm leading severe neck and back pain. Tenderness is there at angle of scapula. Sharp  radicular pain in arm can be seen in this syndrome and also it can be due to some nerve impingement in neck pain can be due to disc protrusion.You can go to a pain physician or orthopedician for confirming the diagnosis. NSAIDS like diclofenac along with muscle relaxants and physiotherapy will give you good relief.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring of abscess in the scrotum after being treated?\n\nHi there, I had an abscess drained about four weeks ago and my wound was packed. Have seen the nurse every few days and have been advised wound is fine and has healed. However since Saturday I have a hard lump attached to my scrotum and it is the same as previously had before drained. Can you advise what I should do? Is this normal for abscesses to come back so soon?",
    "doctor_response": "Thank you for your query. you are probably suffering from Sebaceous cyst of scrotum, which are getting secondarily infected, resulting in abscess formation. The infected ones are operated, as because they are multiple in number, and the a symptomatic ones are left alone. Hot foementation, local antibiotic ointment application and oral penicillin are the main stay of treatment. Please do also check your blood sugar levels, and ensure that you maintain personal hygiene. Take care and get well soon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for chest pain due to elevated troponin\n\nI am a healthy active nonsmoking 49 yr old female with no parental history of heart disease,  i recently went to the er with chest pains, blood tests showed slightly elevated troponin as did a 2nd test. Chest x-ray, ekg, echo and finally cardiac cath showed no damage and normal heart function I still have ongoing chest pain.What shall i do now?",
    "doctor_response": "Hello Ma'amfirst of all i want to thank you for an adequate information.Cardiac cath is the final test to rule out if there is any cardiac issue gooing on and as in your case it has come out to be normal even after a positive trop you are quite lucky.For youur information trop can also be slightly raised in some other senarios also and as a cardiologist we always preffer to summaries things instead of just going with trop reports.Now coming to your question wat to do is, first of all relax as you are not having any cardiac issue, secondly take a hot water bottle and give hot fomentation and use mild pain releif meds like paracetamol twice a day for just 3 days, hopefully ull be relieved.Good Luck",
    "dialogue_context": ""
  },
  {
    "patient_message": "Will the chance of inducing pregnancy reduces in a person who ejaculates multiple times?\n\nI had a logical question to ask.  Male sperm requires a certain gestation period to reach full maturity (72 hours I believe).  With a lower sperm count, and \"pre-adult\" sperm (say only a few hours old), I would assume that the chances for pregnancy are decreased.Would a person who \"relives\" themselves multiple times a day have a lower chance of inducing pregnancy compared to someone who only ejaculates during sex?",
    "doctor_response": "Hi,Thanks for writing in.The sperm are manufactured regularly in the testes and ejected out of the system regularly through sex, masturbation or wet dreams. While sex and masturbation are active methods and wet dreams happen due to accumulation of semen. If a person masturbates many times a day then it causes the sperm volume to certainly decrease but even one drop of semen can cause pregnancy. There is nothing like pre adult sperm being ejected out in someone who masturbates. Having sex or doing masturbation once daily can be normal but a person masturbating many times a day is surely not normal behavior in males.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Why do periods get delayed after first time sex?\n\nHi doctor, I had sex for the first time.\u00a0After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods?",
    "doctor_response": "Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Ayurvedic treatment tried in vain, blood test, bilibruim total and direst is 2.5, solution for jaundice\n\nI m suffering from jaundice from 5 months, i took ayurvedic treatment but no use.I check up blood test (bilibruim total and direst ), i have 2.5 .. can u suugest me good solution please.",
    "doctor_response": "Hello. Welcome to HCM. You need to tell us the complete test reports- bilirubin - both direct and indirect, along with liver enzymes, hepatic viral markers, history of medicine/ drug/ alcohol use. With all these findings, probably a USG abdomen would also be needed. Depending on age,there can be many causes for jaundice and the final diagnosis requires minimum basic of the above mentioned investigations. An accurate diagnosis is the only thing by which a treatment can be suggested. So get these tests and visit a physician, who will also examine you for enlargement of liver and other signs of liver malfunction. Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bladder problem, stomach acid taking flomax, prevacid, liver function have take a jump. Suggestion?\n\nI have recently started taking flomax for a bladder problem I have; i also take prevacid for stomach acid.  both have been taken regularly for 3-4 months now.  my recent liver function AST, ALT and bilirubin have take a jump from 6 months ago. Is it due to these additions  of drugs. will the levels return if I stop these 2 drugs",
    "doctor_response": "Hi! welcome to HCM! Hepatic side effects are very rare for Flomax ,only isolated instances of elevated liver function tests have been associated with the use of Flomax. Prevacid especially when taken alone and not in combination therapy is hepatotoxic and may cause rise in liver function ,your AST, ALT and bilirubin may have taken a jump due to this medicine.The level will return to normal once you stop this. hope this will help!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes crunching sound in the chest with pain?\n\nHello, I am 25 years old, 5'9\", 130 lbs, had been having issues in my abdominal section that lasted a few weeks, doctor said my organs were inflamed due to high stress and lack of proper diet, that was 2 weeks ago, my insides feel quite better, and I cant say its causing me any pain, however, during these last 2 weeks ive been resting, eating very healthy, and well, resting.. i went out and played basketball tonight and got home and am hearing a crunching in my chest just left of my right nipple when i stretch my arms, however i have had the pain there all day long, just noticed the crunching sound tonight. My breathing if fine, however i can feel the pain slightly more when i breathe deeply into my upper chest.. There is no bruise, and I dont think I took a blow to the chest at all tonight, however its the first time in 5 or 6 weeks i got TRUE exercise, have just been taking longs walks 3 times a day for the last 2 weeks. It is a definite crunching sound when i stretch my arms horizontally back then bring them foward. Pain has increased slightly, since I stretched them a few hours ago. No bruise or swelling as of yet.",
    "doctor_response": "Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, possibility of costochondritis of rib cartilage is more. Costochondritis is inflammation of cartilage and bone junction. When these inflamed structures move (by certain movements like stretching), they produce crunching sound. No need to worry much for this. Follow these steps for better symptomatic relief in costochondritis. 1. Avoid movements causing pain. 2. Avoid bad postures in sleep. 3. Avoid heavyweight lifting and strenuous exercise. 4. Sit with proper back and chest support. 5. Apply warm water pad on affected areas. 6. Take painkiller and anti inflammatory drugs. You will mostly improve with all these in 1-2 weeks. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Severe back pain, not able to help myself. Suggestion?\n\nGood morning Doctor, My name is Mrs. Irma Zarkin and I'm 75 1/2 years old. Sunday morning I could not get up from bed, could not even turn with a very keen back pain in the right side of my back. I took a hot shower, put on  an icy/hot patches  and could go.....but the pain is not getting better at the poin that I can  not clean up myself after going to the bathroom. Maybe it's \"Lumbago\"\" and I'm afraid, since I'm a widow and live alone...are there alternatives to a treatment? And what  doctor should I look up at my Kaiser insurnace?  Thanks. Sorry for the long time to type this. Mrs. Zarkin",
    "doctor_response": "Hi,Thanks for posting your query.From description your back pain seems to be due to muscle spasm.Stretching exercises of back, applying muscle relaxant gel and doing hot fomatation will be helpful to relieve the spasm. You can take antiinflammatory drug like ibuprofen to relieve pain and inflammation.Hope this will helps you. Feel free to ask me if you have any further queries. Wish you good health. Take care.Regards.Dr Saurabh Gupta.Orthopaedic Surgeon.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could bitterness in tongue and vomiting be due to H pylori?\n\nI have been diagnosed with H Pylori. I have been precsribed ESO KIT a 3 drug therapy. I have been vomiting and find I can t eat anything. Also, I have this bitter taste that seems to never leave. Had sleepless nights for the past 2 days because of the bitterness and throwing up. What can I do to make this better?Is there something I can eat/avoid to eat. I find myself hungry but afraid to eat anything. Please Help.",
    "doctor_response": "Hello, Thnx to contact us. If I am your treating doctor I would like to advice you that I never heared H.pylori will cause a bitter test in mouth. Never I heared that the drug that had been prescribed to you can cause bitter tests. I feel that the bitter test may be because of something else. I suggest that keep the chocolate that you like most with you. Whenever you feel that there is feeling of bitter you can eat the chocolate. If you have anything else to ask please contact me. Thanx. Dr. Arun Tank",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for small bumps on the penis\n\nhello, I have 3 small skin colored bumps on the shaft of my penis below the wrinked skin underneath the head of the penis. They are not itchy or painful, it s been 3 years since my last sexual encounter which was with protection, just noticed them this week. I saw my doctor, a year ago when i had one, which went away. My doctor told me it was normal and not to worry, but now it s returned and i have 3 of them so i m wondering if he was wrong and it is something i should be worried about.",
    "doctor_response": "HelloThanksfor query.Based on what you have stated I would say that you have small Sebaceous Cysts in the foreskin.However it needs to be confirmed by a clnical examination by a qualified Surgeon ,The genital skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin.Normally they fade away without treatment however they need to be treated if increase in size or get infected.Please consult qualified General Surgeon for clinical evaluation and further treatment.If needed if they are big enough may need to get excised in Toto (Completely along with the sac)Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sore ears,fever and mild cough in a child?\n\nMy 5 year old daughter has been unwell pretty much since the begining of the year!We had a cough with low grade temp and sickness for about 3 weeks which eneded up with her needing antibiotics and then we had a small gap and then she develped a servere chest infection anain having antibiotics now less the 2 weeks later she has a high temp,sickness with sore ears,neck and a small cough!!Im not sure where i should take this and if its something i should be worried about or just normal??She is losing weight also as not eating for long periods and as she is small for her age anyway its really hard going!!",
    "doctor_response": "Hi...by what you quote i feel that your kid might be having a viral sore throat or a streptococcal infection. I suggest you see your pediatrician and get a rapid streptococcal antigen test done. If it is positive then she will require antibiotics. if it is negative then it might be viral illness and doesn't require antibiotics at all.Cough and cold are viral 95% of the times in children. For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15mg/kg/dose (max ceiling dose 500mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long does it take for a virus infection to cure?\n\nfor the last week I have been quite ill the doctor said its a virus I had headaches, lot of mucus coming out of my nose and when sometimes it stops coming out my forehead hurts like hell,  I have only been taking panadols for the last week, I even had tummy ache and diarhea, how long does a virus take to get out of oour system?",
    "doctor_response": "Dear Friend.Welcome to HCM. I am Dr Anshul Varshney. I have read your query in detail. I understand your concern.Usually viral fever takes 5-7 days for recovery.I would advice you following:1. To take Anti Allergic like Levocetrizine 5 mg once  day.2. Steam Inhalation.3. Tab Paracetamol for fever.4. If you get persistent fever, with sputum, you might require antibiotic therapy.This is my best advise for you based on available details. If you have any further query please ask me..Stay Healthy.Dr Anshul Varshney, MD",
    "dialogue_context": ""
  },
  {
    "patient_message": "How effective is Diuretics,anti hypersensitive,cardiac glycosides for cardiac output?\n\nExplain how the three main classes of drugs (Diuretics, antihypertensive, cardiac glycosides) help improve preload, afterload and cardiac contractility and thereby help to improve cardiac output. Also which medications they used for this 3 classes. thank you",
    "doctor_response": "1.Diuretics like frusemide or  torsemide are used for cardiac failure ,they lead to increase in urine out put ,there by reducing total volume heart has to handle for pumping .indirectly reduce  preload.2.Antihypertensive drugs of ACE inhibitor group like ramipril, produce peripheral vasodilatation there by reducing load against which heart has to pump the blood.This means it reduces after load.3.cardiac glycoside  drug like Digitalis will increase force of contraction of heart,thereby it increases pumping ability of heart.In this way 3 groups of drugs improve symptoms of cardiac failure.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is the weight gain a sign of bloating?\n\nMy husband and I have been trying to conceive after suffering a miscarriage in May. I am 9DPO I have mild cramping, a back ache and my breast are sore, but not as much as I feel they should be. I've also gained weight. I haven't changed my eating habits at all but I've gained 5 lbs--I swear, over night!  Is the weight gain a sign of bloating. I've also have a lot of trouble sleeping at night. I just toss and turn...could this be promising of being pregnant?",
    "doctor_response": "hello..thanks for trusting the healthcare magic doctors for ur health related queries..I guess ur concern is about..is the weight gain a sign of bloating..right.my answer is...NO. weight gain is not at all the sign of bloating.let us discuss about the sign n symptoms u have. as u told that u had gain weight n having difficulty in sleeping. so u might be have PCOS (polycystic ovarian syndrome). in this patients usually have irregular menses, weight gain n difficulty in conceiving. few patients having difficulty in sleeping, excessive hair growth in unusual area of the body etc. but didn't give info regarding ur menses whether it is regular or not. so it is difficult for me to comment on this.lastly i want to say that weight gain is not the sign of bloating.with the above discussion u can try out my suggestions-1. first u should reduce ur weight because it may pose difficulty in conceiving because it causes hormonal imbalance which causes irregular menses n patients having difficulty in conceiving.so try to change ur food habbit in a way to reduce ur weight.2. for more details u can visit ur nearby gynecologist n feel free to ask about ur concern. he/she can help u.3. try to do coitus during fertile period(it is from 10th to 16th day of menses during this period chances of getting pregnant is high. so do more coitus during this period.u may get better results.4. DON'T WORRY about the miscarriage u had in past. it doesn't effect ur future chances of getting pregnant.5. if u r still in hurry then visit nearby infertility specialist. he/she can help u.I hope the above information is useful, informative and helpful for u.regards-Dr sudha rani panagar( DON'T WORRY...be happy.every problem have a SOLUTION. so KEEP PATIENCE..be positive.I pray the God that u will be blessed with a cute n healthy baby...hopefully TWINS)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dust allergy and giddiness\n\nHi, I have been suffering from giddiness since last one year; I am aged 37years and suffering form dust allergy for the last 12 years (get continuous sneezing followed by cough) and on medication for that. Trying several combinations like vitamin supplements and diet combinations to increase my stamina / resistance but no use; further I am feeling my present health condition is becoming still bad.Please advise.",
    "doctor_response": "Hi, first dust allergy is very common among people ,almost 1 out of 2 people would have same problem like u bcuz of dust.so only treatment is symptomatic and try to avoid allergen as far as possible.second your giddiness since 1 year needs to be diagnosed by physician but it has no relation with dust allergy. Take giddiness seriously and consult doctor although in 90% cases cause remains unknown.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What can cause tenderness on the sole of the feet?\n\nIn the center of the bottom of my foot at the top pad just before my toes begin it is very tender and has been for about 6 weeks. Occasionally it will make 2 or 3 toes feel numb for a few minutes. The pain is not excruciating but lately it is a bit more noticeable. It does not affect my walking at all.",
    "doctor_response": "Hello, It could be due to conditions like plantar fasciitis. As of now, you can use analgesics/anti-inflammatory combination like Aceclofenac/Serratiopeptidase for symptomatic relief. If symptoms persist better to consult an orthopedician and get evaluated. In that case, steroid injection to the sole might be required. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes dizziness and inability of eyes to focus?\n\n1 year history of dizziness in a 15 year old female. Dizziness is brought on when sitting still in school. Reports that she feels like her eyes can t focus. Subsequent reports of dizziness when looking up. All vestibular testing is normal and patient no signs of BPPV. No reports of headache, recent head trauma, or anxiety.",
    "doctor_response": "Hi there, it is hard to know exactly what is going on without a little bit more information, but has anyone obtained any imaging of the brain (either a CT scan or an MRI) in the past year? A problem in the pineal region, brainstem, or even multiple sclerosis, could cause difficulty with eye motions and perhaps the complaints of dizziness when looking up. I would recommend starting by coordinating with your primary care doctor to obtain an MRI Brain with and without contrast, and then possibly referral to a neurologist or neurosurgeon depending on those results.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for pain in the neck\n\nI have had problems with neck pain was given diclo/misopr 75-O.02 mg tab. Pain going down into my shoulders now up back of head. I am very med sensitive and really don t know the effect this will have on me. At night I can not sleep well for the pain. Can these be broken in half? I am scared.",
    "doctor_response": "You need to take proper treatment and before that do mri of cervical spine. And based on the result do take physical therapy and exercise program. As well medications.  This should give you good relief.  And if still the symptoms are not reducing take orthopedic opinion.  I have seen and treated many cases like this and I believe strongly you will be fine.  If you need further guidelines can mail me  on nirajmodish@gmail.com. Hope this was useful to you. Take care",
    "dialogue_context": ""
  },
  {
    "patient_message": "Bleeding from gum. Do i need medical attention ?\n\nHello Sir, I am 27 years old person.Presently I am in trouble due to bleeding from gum.In morning time,when I brush bleeding form front side bottom teeth starts and blood comes any time when I wash my mouth and spit. When front side bottom teeth are touched by tongue,blood comes. Previously,I have cleaned my teeth by dentist . Please suggest,what should I do in this regard.",
    "doctor_response": "Hi, Thanks for asking the query, Bleeding gums indicates inflammation of gums known as gingivitis, it occurs due to improper oral hygiene, plague and calculus deposition, nutritional deficiencies, systenic disorders like diabetes and leukemia. It can also occur due to trauma from hard toothbrush or vigorous toothbrushing. I would suggest you to use a soft bristle tooth brush and brush slowly in circular motions. Go for symptomatic treatment of complete mouth scaling and polishing. Take a balanced diet, use plenty of raw vegetables, carrots, salads, fruit juices. Take multiviatmin tablets, drink plenty of fluids. Use antiseptic mouthwash gargles twice daily. Hope this helps out. Regards..",
    "dialogue_context": ""
  },
  {
    "patient_message": "Several stints to abdominal organs. Mysenteric artery & kidneys. Concerned about adrenal gland tumor. Help?\n\nMy mother is 88 and has several stints to abdominal organs-- mysenteric artery & kidneys, femoral bypass along with other problems such as occlusion of the celiac artery . Two or three heart valves leak- aortic & m and She takes 5mcg synthroid . There is a benign tumor on one of the adrenal glands the size of a small orange. Recently she had a pace maker installed because she was passing out at regular intervals. But now her blood pressure has dropped dramatically and her pulse has increased dramatically. Blood pressure averages about 110/75 and pulse has jumped from a good 69 to 85-110. The mysenteric stint was recently ballooned successfully and her blood pressure seemed very erratic afterward and the progressed to these lows. Normally for her blood pressure was high at an average of 160 /65 for years (with regular erratic swings both up and down but not staying either way for very long). I m concerned that the adrenal gland tumor may be the cause of the recent drop in pressure and increase in heart rate. This is the 4th day that her heart rate has been elevated constantly.",
    "doctor_response": "She should have her urine and blood tested for adrenal hormones (cortisol, metanephrines, acth)  that way we can check to see if the tumor is causing these swings. Please rate 5 stars! I strive to provide the best answer I can to your quetsions!",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes feeding intake problem in 4 week old?\n\nMy baby niece is now 4 weeks old. since day 10 she has been hospitalised twice. First due to rapid weight loss and poor feeding, which was attributed to a viral infection, she was discharged and 2 days later re-admitted due to poor feeding. The main problem since approx a week old seems to be that she cannot take more than 3 ounces of feed without vomiting or falling asleep. Whilst in hospital she has been fed through a tube and whilst they feed little and often this worked ok, however each time they try to up the volume and feed at longer intervals the same problem re-occurs. The doctors have checked bloods, saliva, water sample etc and have now put her back on 2 hourly tube feeds to ensure she is getting sufficient feed. My sister is convinced that there is something internal that is preventing the baby from taking more than 3 ounces, but the hospital seem reluctant to investigate. They are treating the baby for reflux and have 2 days ago changed her to a non-cows milk feed in case it is lactose intolerance, however the same problems still seem to be occurring - vomiting and sleepiness. The doctors asked if they could feed the baby for 24 hrs (bottle) so they could observe for themselves, and I assume to see if there was any issues with mums and dads techniques, but the sames problems occurred, hence she is now back on the 2 hourly tube feed. She is not putting weight on, however is not losing weight either. Any suggestions as to what could be preventing an otherwise healthy baby from properly feeding?",
    "doctor_response": "Hello, We need to know the birth weight in this child and the present weight, followed by the number of times the baby passes urine, stools. There might be an inborn error of metabolism which needs further investigation. Plus feeding technique needs to be assessed. Monitor the weight gain daily. And please get me back with positive weight gain. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr ASHWIN BALIGA, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to get pregnant?\n\n32 yr old female trying to be surrogate. Weight 138 and 5 ft 5 in tall. 2 easy non-complicated natural pregnancies and deliveries in 2009 and 2011, got pregnant both times on 1st try. With recent surrogacy journey, in 3 attempts (and 3 cancelled cycles) lining could not get above 7mm and intermediate pattern (B rating) and saw scant fluid on 2 instances (1 recent mock cycle and one prior cycle months ago). Any thoughts on why any of this is happening? I even had a hysteroscopy with D&C to rule out complications and give me clean slate , but apparently it didn t help, although on a positive note it showed everything looked good and results came back normal. Any advice and opinions welcome. I really feel like I was meant to be a surrogate and really want to help someone wanting a baby and am so discouraged that this isn t working. Wondering if something could be wrong that hasn t been seen yet? Oh yeah, and it was on 2 mg estradiol for the first week each cycle, then it was upped to 4mg/day for remaining cycle days. Started off the entire process with 1 lupron depot shot only and never went off the estradiol. Thank you!",
    "doctor_response": "Hallow Dear,I do appreciate your approach to help someone with surrogacy. After going through your detailed history, the only subnormal finding I could get was your endometrial thickness. Endometrium between 9 and 13 mm thickness is most conducive for implantation of fertilized ovum; while your endometrium is not crossing the figure of 7 mm. To increase the endometrial thickness, you have been put on Estradiol and Lupron. Still it has not given satisfactory results. I would suggest you first to downregulate the Oestrogen and the go for Lupron. We have found very good results by this regime. Of course, before that, please get your Hysteromicroscopy performed to find out whether there is any pathology in the endometrium. I hope this guides you appropriately.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Recommend options for reducing weight in patients post hysterectomy\n\nI have Coronary heart disease(2 stents) and five years ago had to have hysterectomy due to cancer. In those five years I have continued to gain weight to where I am up 40 lbs in that five yrs!! I can t do hormones balancing or replacement bc of heart condition. I really watch what I eat and exercise 3-4 Times a week and it just keeps climbing up!!! What can I do different or take to help??????",
    "doctor_response": "Hi Mam,Welcome to HCM,I  understand your query and concern.Excess weight gain in your case can be treated with strict diet and good physical trainer.I advise you to avoid fat foods and fried foods.Eat oats,fruits,vegetable salads regularly for dinner.Regular exercise for 30 min under supervision of physical trainers is helpful.Anti obesity drugs can be used under your doctor s advise and supervision.I advise you to get an ECG,2 D Echo to confirm the diagnosis. Consult your cardiologist for expert management.Post your further queries if any,Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes a red ring around the iris of a 1 week old?\n\nMy one week old grandneice has a red ring around the iris of her right eye. She was born with it but it has grown larger. She doesn t seem to have any pain or itching and see can see through it. My nephew and his girlfriend are concerned about it. Is this normal for a newborn?",
    "doctor_response": "Thanks for expressing your query at HealthCareMagic. I understand your concern for your newborn grand-niece. A red ring around the iris is not normal finding and may indicate an inflammation of the eye. It could either be due to an infection (less likely) or due to some trauma at birth (there is an entity called subconjunctival haemorrhage which gets corrected on its own). If there is no watering or pus formation, probably it is not a cause of concern. But definitely consult your paediatrician/neonatologist to be certain about it.I hope that answers your query. Feel free to revert back in case of further queries.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Is Mometasone dangerous to use on Face to clear my acne pimples?\n\nHello doctor, I am seriously facing acne pimples problem. Sometimes they occur on my face when I masturbate. If I use Mometasone, it gives a good result. Is it okay to continue this?",
    "doctor_response": "Hello. Acne is a universal issue in the age group of 15 to 25 years due to hormonal changes in adolescents. However, there are multiple effective treatment options depending on the grade and severity of the problem. Mometasone is a topical steroid and is to be avoided strictly on the face and for acne as it can harm your skin in the long run. Acne is dependent on hormones hence excess masturbation may sometimes lead to an increase in the problem. I would advise you to stop Mometasone immediately and kindly upload appropriate images to help us assess your current grade of acne and treat you better. Regards. For more information consult a dermatologist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does a draining pilonidal cyst need medical attention?\n\nI have had about 7-8 pilondial cysts in the past 12 yrs. I had one come about 2 months ago. About 4 days ago i assume it became infected it grew and became extremly hard to walk as it always does. Usually i go to doc and get it lanced. This time it actually ruptured on its own. The pain has subsided but it is still fairly large. Do i still need to go to the doctor if it is draining on its own?",
    "doctor_response": "go n check by doctor so you dont develop fistula in future cz cyste often gets infected n pilonidal cyste might develop fistula in future so you must check for that",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can chicken pox relapse a third time?\n\nWe think my wife, a 59 year old woman, who has sjogren s might have chicken pox for the 3rd time. What should she do? She is in Botswana where pharmacists give medical advice as well. They think she has this. Her physician had thought she had acne. apparently it is mild-bumps started appearing about 4/5 days ago.",
    "doctor_response": "hello sir,do get her examined by a dermatologistdont do guess workthings are seen by different people in a different way.do get her consulted and get proper treatment for her",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can sex during ovulation cause pregnancy?\n\nhi doctor, I ovulated 2 week ago , me and my husband are trying for a baby so we did have sex around that time, and today I got a very light pinkish spotting on my toilet paper when I went to the bathroom, could I be getting pregnant soon? or could this be implantation bleeding?.. I have just been feeling a lot of gassiness in my belly and cramping in my pelvic area and tired but that's all.",
    "doctor_response": "Sex cannot cause ovulation, but it is possible that you are pregnant, since you had sex at the right time.  The spotting may have been implantation bleeding, or it could be something else.  Those possibilities include some irritation from the sex, or early spotting before your period, and other more unusual things.  Right now you should just hang in there and wait and see if your period comes when you expect it.  If it is late, take a pregnancy test and you will know for sure.  Good luck! I hope this helps, please let me know if you have any more questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What treatment is suggested for infertility?\n\nHi I am married 6 years 8 months ago. My problem is my wife didn't pregnant yet. Till now we under go about 9 doctors treatment.We also completed 6 cycles of IUI. My semen count is in between 40-50 mil. Recently my wife taken laproscopic operation. In that report one tube is free flow and other one is curvy. Other reports of my wife is normal.All the doctors told that we are in unexplained infertility problem. I am also born after 8 years of my mum. Some body told that the problem will be jeans and my wife also conceive a baby after 8 years. Is that true. Or better I go for IVF.",
    "doctor_response": "HAI WELCOME TO HCM FOR UNEXPLAINED INFERTILITY IVF IS THE TREATMENT OF CHOICE.SINCE BOTH OF YOU GETTING OLD THE OVARIAN RESERVE MAY FALL IN FUTURE.SO CONSULT AN INFERTILITY SPECIALIST TO CONCEIVE SOON AND DISCUSS ABOUT TREATMENT MODALITIES.REGARDSDR.VANITHADEVI",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is an itchy tongue an allergic reaction?\n\nMy tongue itches really bad toward the front left side and I have been itching it with my teeth causing it to be sore. I recently had a bad allergy attack with pollen and have been sneezing and coughing and congested. Is the tongue itching related to the allergy?",
    "doctor_response": "Your question is very specific.And answer  is NOT ALLWAYS.It may be due to 1.vitamin deficiency 2.allergy 3.after eating some irritating food 4.obstructive jaundice patients.If it persist for all time it is not due to allergy.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes hungry and stomach pain while taking moxikind for toe infection?\n\nHi, I am priyanka, age: 22 years, wieght : 40 KG.. I got infected to my right leg toe since 15 days.. Doctor have suggested me Moxikind-CV 375 for  days.. feeling very sleepy, hungry, tiered and a type of pain in stomach.. suggest me something what should I do.",
    "doctor_response": "Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.If you are on antibiotics and not taking any drugs to control the acidity.It can cause pain, burning and hungerness.I advice you should take the pantoprazole and domperidone tablet under your doctors guidance. Please take it half an hour before the meal to achieve its optimum acidity effect.You should eat small frequent meal and not a single heavy meal.You can also control the hunger and acidity with single glass cold milk. Please make a habit of walking for 5 mins after eating it also abolishes the acidity.Please maintain good hygiene by frequent cleanliness and dressing. You can do dressing with dettol and betadine. Polysporin ointment can be applied thereafter with bandage. I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is an anti-rabies vaccine necessary after a puppy bite?\n\nHi, my 21-year old son was bitten by a pet puppy (some six weeks old ) a few hours ago. it caused some bleeding. He washed the wound immediately.Should he take anti-rabies vaccine? My father, thirty years ago was allergic to anti-rabies vaccine. He passed away due to the adverse reaction of the vaccine. i am a little scared to get my son administered with anti-rabies vaccine. What should i do?",
    "doctor_response": "HelloThanks for query .Your son has a dog bite few hours ago .Since the dog is known and can be  kept under observation you may wait and watch the dog itself whether he has signs and symptoms of rabies .If it does not show any signs of rabies it is not mandatory to take anti rabies vaccine .In view of family history of allergic reaction to vaccine I would suggest you to avoid taking ARV.D.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How long should i rest after surgery for rotator cuff?\n\nI had shoulder surgery for bone spurs and torn rotator cuff in August. I am in more pain now than before the surgery. I am 53, female and otherwise healthy. I am a postal clerk in a very busy office, constant reaching to put up mail, pushing and pulling very heavy mail cages, lifting bags of parcels approx. 100 lbs, etc etc. How likely am I to be able to return to work and how long before doing so? I have severe shoulder pain, no backward range, can t sleep, actually can t do anythng more than about an hour before having to just rest. I only have 2 more years to be eligible for retirement. Would disability be possible?",
    "doctor_response": "Hello,Recovery for the surgery of rotator cuff can take 4 to 6 months, depending on the size of the tear and other factors. You may have to wear a sling for 4 to 6 weeks after\u00a0surgery. During this period you should rest. Then physical therapy can help you\u00a0regain\u00a0the motion and strength of your\u00a0shoulder.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Reason for swollen hard knot under the rib cage?\n\nhi! yes, I have had general congestion for over a year. I have had a swollen hard knot just under my right side ribcage that tends to receed and then returns for about the same time. I am a 49 year old male,non smoker in otherwise perfect health. what could be going on?",
    "doctor_response": "Hello, It could be a bony swelling like osteoma. Consult a general surgeon and plan for a CT thorax for further assessment. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for pain under right side rib cage\n\nI have a pain on my right side under my rib cage its kinf like a sore pain or acking for about 1 week now I have had this pain before when I was pregnant had an MRI and they told me it could have been a stone but cant do anything till I have my baby and then I had my baby and the pain went away and now its back and I am not pregnant and the pain only goes away till I lay down.should I go to the dr to check it out.",
    "doctor_response": "As per your history  u was diagnosed with stone ...I think a through scan sh be done to rule out its presence. ...In my opinion you should have plenty of water..and sos antispasmodic like dicyclomin sos....",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes neck pain with swollen lymph node?\n\nMy 6 year old was recently involved in a car accident and has been complaining of neck pain. She is is physical therapy with me and the chiropractor thinks she has a swollen lymph node..she hasn t been sick for about a year. Do u think this is serious? Should I take her to a specialist",
    "doctor_response": "Hi, It is only a one sided lymphadenopathy. If the size is small, about 1x2 cms, observe for any increase in swelling. Watch it. If the size is around 2x2 cms, it needs evaluation. Persistent swelling for 1 year needs evaluation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Prasanna Lakshmi, Pediatrician",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes soreness in chest and cold?\n\nHi, I've a had cold for a couple weeks. It's been fairly severe but finally ended two days ago. This morning, I woke up with some soreness in my chest which is uncomfortable when I inhale heavily or cough. Is this just a fading cold? Should I be concerned?",
    "doctor_response": "Thanks for your question on Healthcare Magic.I can understand your concern.No need to worry much for this chest soreness. This is common during healing phase of cold.But if you develop breathing difficulty, fever, expectoration then consult doctor.Otherwise no need to worry. Drink plenty of fluids orally and keep yourself hydrated.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes night sweats, shaking, lightheadedness and weakness?\n\nI have been having night sweats for at least 6 months now. For years I have been shaky, lightheadedness, weak, etc. If I don't eat well. For the last week though I have been feeling the low blood sugar symptoms, get really hot with them, and am really tired.",
    "doctor_response": "Hello!Thank you for your question on HCM!Regarding your concern, your symptoms seem to be related to a chronic infection or to a metabolic disorder (a hormonal imbalance or a vitamin deficiency). I would like to know your age and your past medical history. Have you measured your body temperature during the episodes of shaking and sweating?I recommend consulting with the GP and performing a careful physical examination, a routine blood test, blood sugar, inflammation tests (fibrinogen, PCR, sedimentation), kidney and liver function tests, blood electrolytes, cortisol and thyroid hormone plasma levels, to try to find any possible cause. Further specific tests for infection diseases ( like HIV, Wright, Widal , Lyme, etc) may be necessary to exclude any possible cause if suspicions are raised by the above tests. Hope to have been helpful!Best regards, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for bad odor vaginal discharge and lower abdominal pain\n\nPls have bin feeling this down abdormal pain some times by the left or right side, and I do have vaginal discharge,some times d smell is offensive,for a long time now, I ran scan last year march the result said I have candida albican a yeast infection, I took some pills that was been prescibe 2me, buh still yet I still feel same way! Please what do u advise I do? Or what medication would u suggest 4 me?",
    "doctor_response": "For such cases of vaginal discharge with smell and given that allopathy medicine has not given you much results, I would recommend to my own patients that they should, unhesitantly, get Ayurveda treatment for vaginal discharge.Safe and economic Ayurveda medicine for leucorrhoea and other vaginal discharges including infections, have wonderful cure and also help to relieve anaemia and low back pain that may have been associated.Ashokarishta, Pradarantak Rasa/ Lauh, Pushyanug herbal powder are classical medicines of choice while Lukol, Ashokadev syrup etc are Patent excellent medicines for such conditions. Pure, non synthetic, Ayurveda vaginal wash are made of anhydrous alum and gives instant relief in vaginal I fection and discharge. There are multiple choices but selection depends on various conditions of patient at given time and medical history. Your Ayurveda doctor is qualified to decide it.No pathy is bad but suitability and response is important to decide switching from one system to another. Even Ayurveda doesn't counteract with your other medicines if given at proper intervals.Hope it guides you well to switch to other options open to you safely in you own interest.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can allergies cause throat discomfort?\n\ni feel discomfort in my throat since 2 months (especially left side) i.e. feeling some hurdle and there is no pain.  My doctor informed me that it is just a cause of an allergy.  Even after taking medications, I feel there is a pressure like feeling in the throat.  Please guide me.",
    "doctor_response": "Hi,Ya definetly allergy,causes throat discomfort,it may pharyngities,tonsilities,posterior pharyngeal wall congestion along with other allergic symptoms,You can undergo direct laryngoscopy if the problem persists to rule out other causes,generally,doing warm saline gargles,avoiding cold drinks,using good cooking oil,and having less spicy food will help you.. Releaving your syomtomsHope this information helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes sudden pain and weakness in the hands?\n\nHello. My arms and hands suddenly started feeling really weak and achy almost like I ve been electrocuted. Then my face and hands are hot and started sweating. I feel feverish but I m not sure if I have a fever or not. This has been going on for the last hour or so and it hasnt subsided yet. I m not sure if I m getting sick or if I just ate something that may have been bad. Please help! Thank you so much!",
    "doctor_response": "Hello, Consult a neurologist and get evaluated. A detailed evaluation is required to rule out possible neurological causes. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Does masturbation reduce glow in face and cause sickness?\n\nsir, im 16 year old boy and i have masturbating from nearil 2 years and my height is 5.7 and my weight is 55. lplease tell me does masturbate decrease our shining of face and does it make us sick? sir i wish to pay u by cash because i dont have credit card....",
    "doctor_response": "DearWe understand your concernsI went through your details. I suggest you not to worry much. Masturbation is natural process and even animals masturbate. You shall never loose your health or body shape or face glow due to masturbation if done moderately. One masturbation roughly equals 200 meter sprint. Adequate rest is enough to come out of that tiredness. You are 16. At this age you can masturbate up to 4 times a week. More means tiredness. What you need to do now is to concentrate on your studies, and naturally obsession with masturbation reduces.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.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does slight inferior repolarization disturbance in the ECG mean?\n\nECG states slight inferior reploarization disturbance, consider ischemia, LV overload or aspecific change, small negative T ina VF with negative T in III; minor right-precordial repolarization disturbance, consider feminine pattern, small negative T in V2 with flat or low negative T in V3.  I'm not understanding what this all really means, and what is a 'feminine pattern'?",
    "doctor_response": "ECG is showing some nonspecific changes which means there is some problem in your heart or sometimes these can be there normally. So I need to know your age, blood pressure ?, obesity? chest pain?, smoking or family history of heart disease.if any of these is present or even if not we should evaluate yourself with echocardiography and stress test if needed.overall not the matter of worry but should be investigated.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can abdominal pain and bleeding during urination be treated?\n\nhi!!from 2 days i hav been feeling pain in my lower abdomen during urinating,nd burning sensation after that...today it bleeded after i urinated.there is this tiny ..may be polyp lookin thing in my vagina..am not sure abt tht...yesterday i ws urinating quite frequently but d quantity ws like \"nothing\"...i drank lods of water...so it ws fine durin d day as in id duration of urination decreased..but pain continues and now i am bleeding...pllzzzz help",
    "doctor_response": "Hi.Thanks for your query.Read and understood your history and concerns. You are having burning urination and blood in the urine and a polyp like thing in the vagina and pain in abdomen. The pain is caused by severe urinary tract infection.Polyp like thing in the vagina may not be related to the present problem and the Gynecologist will be in a better position to tell and treat, what the lump is about. Get operated if asked by her. I would like you to undergo the following investigations before the treatment is started. -Urine: send the sample in a sterile container for culture and sensitivity and gran staining before the antibiotic is started. -Blood tests : CBC, sugar, widal and kidney functions to start with and other tests as may be required as per the clinical examination by an Urologist. -Ultrasonography to start with.-Intravenous pyelography .- A course of antibiotic to start with and to continue as per the clinical response and the report of the culture and sensitivity. -If any surgical problem is found . getting operated is required like a big stone, stricture and so on.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy to relieve pain in chest muscles\n\ni get sharp pains in the left chest muscles, 6'5 265 37yo , i used to power lift and stopped 3 years ago, i went to er thought i was having heart attack, after the ekg i was given pain medication, 3 years later its back, its an annoying pain, and i notice when i drink water i feel it trickle down my left side?",
    "doctor_response": "It would be advisable to consult doctor, as you will need to be examined in detail. Also will require a EKG.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. How to tighten my double chin and sagging jawline?\n\nHi doctor, I am 26 years old. I was looking for a professional opinion on treatments to remove a double chin and saggy area around the jawline and if possible some type of restoration to the cheek area. I have sent some pictures. The first five pictures are recent the other two are taken before few years. I am a smoker for eight years. Could this have contributed to the cause? Of note, I weigh about the same weight as I do before a year. Over the past year, I have lost 25 pounds (current weight is 170 lbs) due to exercise and diet, yet double chin persists. Is sagging around the jaw due to loss of skin quality or would more weight loss solve the problem?",
    "doctor_response": "Hi. I have seen your pictures. (attachment removed to protect patient identity). On the detailed analysis of your face, it seems you have a bit of prominence of the jowls. There is no double chin. It seems to be entirely normal but if it worries you, you can go ahead with botox for muscle hypertrophy or thread lift. I would like you to get examined clinically and judge what is required?",
    "dialogue_context": ""
  },
  {
    "patient_message": "How do I know if my stuffed nose is due to overuse of nasal spray?\n\nHello, I am worried that my nasal stuffiness is due to over use of nasal spray decongestants. However it is true that when i blow my nose it is quite full of (excuse the language) snot! lol  .....  Pill decongestants aren't working at all.  How do I know if my stuffed nose is due t overuse of nasal spray and not simply a cold or allergy. I'm on my 4th or 5th day of reduced use of spray.",
    "doctor_response": "Hi and thanks for the query, I suggest other medical conditions should be excluded before thinking of that alternative, which off course is relative very rare as a cause of nasal stuffiness. Considering a chronic allergic rhinitis is very important. Treatment might require systemic steroids even up to three months, associated with steroid containing nasal sprays to be taken even for over a year depending on the response. Nasal polyposis could cause similar necessitation of nasal sprays, and an appropriate spray might be indicated. Certain sprays like local anti histamines give instantaneous relief, but the effects are short lasting, and in a very short run become ineffective in some individuals. Remember that poorly treated allergic or chronic rhinitis could predispose to conditions such as sinusitis. I suggest you book an appointment with an ENT specialist for a proper evaluation and management. Thanks and best regards, Luchuo, MD.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Diagnosed hepatitis B. Abdominal scan done. Is it at acute or chronic phase? Treatment?\n\nI am diagnose of hepatitis B n went for abdomenal scan which shows: The liver is normal in size but with a reduced echopattern making the wall of the portal veins prominent. It measures 11.7cm in craniocaudal length. High resolution scan shows a granular echopattern but the intrahepatic and extrahepatic biliary and venous are normal in course and caliber. No focal lesions seen. Every other Organs are seen OK. Liver function test shows; AST= 19U/I( upto 17), ALT=11U/I(upto 12), Total Protein=74.5g/L(64-83),Albumin=50g/L(38-44), Total Bilirubin=1.8(upto 1.0), Direct=1.3(upto 0.25). What does this mean? Is my hepatitisB at the Acute or Chronic phase? Am I due for treatment? Or is there any posibility that my Immune system can stil clear the disease? My consultant ask me to wait till 2nd mach and repeat the hepatitis B test.. Right now am having different kind of symptoms I can t even explain.. Please what should I do?",
    "doctor_response": "Hello, You are right.It is possible that your immune system may clear hepatitis B infection. Chronic hepatitis B is an infection with HBV that lasts longer than 6 months. Once the infection becomes chronic, it may never go away completely. Approximately 90% to 95% of infected adults are able to fight off the virus so their infection is cured. Only about 5% to 10% of adults infected with HBV go on to develop chronic infection. If the host is able to clear the infection, eventually the HBsAg will become undetectable and will be followed by IgG antibodies to the hepatitis B surface antigen and core antigen, (anti-HBs and anti HBc IgG). I think your doctor is waiting for 6 months period to end which might be due to end on 2nd march. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can excessive masturbating cause any serious health issues?\n\nSir, I am 32 years of age, i have habit of masturbation from last 8-10 years, even i got married 6 years ago. i does the same atleast 4 times in a week except sex with my wife. also during sex i m suffering from cold sweat. does it affect any seriour deseas such as kidny problem, cancer or such major deseases? sir pls advise me.",
    "doctor_response": "Masturbating is a normal process. It wont affect disease status you mentioned. You need not to worry much about it. Just spend more time with your wife and stay away from pornographic site and materials. This will limit your urge to masturbate.Hopes this helps you.Thank you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for fungal infection between breasts\n\ni'm 19 and have been told i have a fungal infection between my breasts. i was given daktacort and used it for a week but saw no changes. today i've been given daktarin instead. just wondering if this will make any difference and what is the difference between the two products?",
    "doctor_response": "Hi & Welcome to HCM.Daktacort contains Antifungal Miconazole and a steroid Hydrocortisone.Daktarin contains the antifungal Miconazole.Both are effective in the treatment of fungal infections involving the skin and mucous membranes. Daktacort is useful if there is associated redness, itching, swelling, etc.Continue using Daktarin creams, if there is no response Terbinafine containing creams are effective.Hope to have answered your query.Regards.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. In spite of using inhaler often, I have heavy congestion. Why?\n\nHello doctor, I have been to doctor three times in the last two months and was prescribed many medications. But, I am simply not getting any better. Initially, I went in for respiratory issues. I had a terrible hacking cough and was literally using my Ventolin Inhaler more than I should. As I am asthmatic,\u00a0I was placed on a nebulizer and given several other medications including Prednisone to take. After completing the medication the symptoms returned. I went back to the doctor who changed the antibiotic. It cleared up temporarily and again once the medication was completed, symptoms returned. Today, I am literally just feeling awful because I do not want to go back to a doctor as nothing seems to be getting better. I feel nauseous, I have headaches. I am using my inhaler frequently and\u00a0there is still a very heavy congestion on my chest. I wake up in the middle of the night hacking. I cough until I cannot breathe. I overall feel dizzy, lightheaded and I have no energy. Please help.",
    "doctor_response": "Hi. There are few important points to consider. Follow up in a week to an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Have high prolactin level, abdomen pain. Urine test positive for pregnancy. Have ovarian cyst and tubal pregnancy. Suggest?\n\nHi, I am 28, Had my physicals done a month and a half ago and everything was normal except my prolactin hormone level which was 58. I had to get an MRI done and the MRI was clear and so was the sonogram. 1 month after those tests I have a prolonged period and I have had heavy pain in my mid and lower abdomen and back. Got urine test done and now they said im positive for pregnancy (I was not 1 month ago, did'nt miss a period). Got a sonogram and blood test done. My doctor says i have a cyst on my ovary and i have my pregnancy in my tube. She also said that i have some fluid development which is causing the pain and i need to go to surgery or get the shots of methotrexate. I have never been pregnant before or had any infertility issues or any other health issues. Please help!",
    "doctor_response": "Hi,Welcome to HCM.You can get your beta HCG test done. If value is above 1500-2000mIU/mL & pregnancy not visible in uterus, its most likely ectopic pregnancy & you need to follow your doctor's advise. If value is less than 1500mIU/mL, you can wait in consultation with your doctor for the pregnancy to be visible in scan. All this applies only if your condition is stable & ectopic pregnancy is not visualized in scan. If its otherwise (unstable haemodynamic condition/pregnancy seen on scan to be outside uterus) its better to follow your doctor's advice. In any case your doctor is best judge as he is personally examining you & seeing scan reports & can better judge condition than the one who is consulting online.Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Fitted copper IUD, have heavy and longer periods with severe pain, 2 periods in a cycle. Suggestion?\n\nHi, I had a copper IUD fitted almost 6 weeks ago, on the first day of my period. No other medical conditions, medicaiotn, no hornomal contraceptives used for many many years. Noprmal full health, active lifestyle. One child, normal delivery, now aged 11. I have had a copper coil before but not for many years, and I do understand it takes some time to settle. My first period was longer heavier and more painful, and I have had a gap of two weeks without bleeding before it started again. I am now on to day 10 of an extremely heavy, extremely painful period, and the flow seems to be getting heavier and cramping worse, not better. What do you suggest?",
    "doctor_response": "HiDr. Purushottam welcomes you to HCM virtual clinic.I have gone through your query. I think I have understood your concern, I will try to suggest you the best possible treatment options.1. You are right in judging the response of newly fitted IUD. Certainly it will take time for your body to get adjusted to this new IUD.2. I will suggest use of Tablet MEFTAL SPAS 2 to 3 times a day during the menstrual period as needed to overcome pain and bleeding. If needed Tab PAUSE 500 mg can be added 2 to 3 times in a day. You should aim at blood loss that needs 2 sanitary napkins per day and there is no passage of clots.3. If you still have heavy periods, a course of antibiotic like Cap Doxypal 100 mg 2 times a day for 10 days is advisable. Also, Tab REGESTRONE 5 mg 2 times a day for 5 days from day 21 to 25 of the cycle will help reduce menstrual bleeding.Last but not the least , Please get IUD checked up from your doctor every 3 monthly.I hope my answer helps you.Thanks.Wish you good health.With regardsDr Purushottam Neurgaonkar",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes connective tissue disease?\n\nI am a schhool nurse. I have a student with a connective tissue disease. She has been having fainting episodes with increased blood pressure, sweating and confusion with exercise. Today she at an episode at rest, very confused and did not know her name. What should I reccomen the parents do?",
    "doctor_response": "This girl may be having a cardiac or a nephropathy due to connective tissue disorder.She needs to be urgently referred to a rheumatologist to start steroids and disease modifying drugs.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is total body pain normal during spondylosis?\n\nHi. I have been having left sided chest pain, left arm pain, left shoulder pain, mid back and neck pain. I have been diagnosed with cervical spondylosis. I also have scoliosis in my thoracic spine and fractures in my lumbar. Is it normal to have the chest and arm pain from the spondylosis? This has been going on for months and it s making my very anxious all of the time.",
    "doctor_response": "Hello,I would explain that it is necessary checking vitamin D plasma levels for possible deficiency, which could contribute in this clinical situation. Regarding the pain, I would recommend using a muscle relaxant (flexeril). Physiotherapy is helpful too. If the pain persists, I would recommend discussing with your doctor on the possibility of adding gabapentine to your therapy.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the cause and treatment for vocal tic?\n\nI have a vocal tic where i force air out of my chest putting extreme pressure in my head the veins bulge out on my left temple this has been going on for over 12months, it is worse when i am under stress which i am most of the time. I have had bouts whre I cannot even walk a straight line i feel really dizzy and my face on the left side and my left hand and forearm and left foot feel heavy and numb and tingle. I get sharp pains in the head and get confused easy and irritable lately it seems to be getting worse and i feel lighted all the time and always tired my face is slightly drooping on the left side it has been slowly drooping more an more over the months.",
    "doctor_response": "Hello dear, thanks for your question on HCM. I can understand your situation and problem. Your are having tics due to stress and anxiety. Your other symptoms are also due to anxiety more. But better to rule out cardiac cause by ecg and 2d echo. If both are normal then anxiety is the cause for all your symptoms abd tics.Better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. Avoid stress and tension. Be relax and calm. You may need anxiolytic drugs too. Don't worry, you will be alright.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to reduce high BP and salt in the body?\n\nhi,iam 23 years old..i have been doing (gym) heavy weight exercises since two months.three days back i incresaed the weights in the gym for doing exercises as usual,one more thing i started aerobics also since 5 days.So three days back i did my aerobic and then gym and after that within 15 minutes i took power horse,then after coming home  almost after an hour took bath and i boiled eggs in which by mistake too much salt felt.so i thought the egg shell would  prevent it from  penetrating in the egg.gradually after two hours my heart heart started beating fast and its been three days i havent seen any change..its still beating fast.i went to the docter,the docter told me that its  159 BP ..i was so shocked.she said no need to worry but just dring as much as water as i can...please docs here .please guide me.what should i do..should i take steam bath and swimming or should i go to gym for removing the access salts in body....please suggest me",
    "doctor_response": "The information regarding your readings is incomplete. I am not sure whether 159 is your pulse rate or blood pressure (BP). In either case, I would suggest you to be retain your calmness. A single ingestion of high dose salt does not cause any harm in most of the cases. Your body does have a mechanism to get rid of excess salt. Please follow the instructions given by your consultant. Drink fluids and cut down a bit on your workouts till you feel completely normal. Have a regular blood pressure and pulse rate measurements till you are normal. Stay calm and relaxed buddy. You will be normal in a few days. Hope the above information helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes gum recession and tooth sensitivity?\n\nI recently had a lower molar extracted.  The gum on the adjacent tooth is receded so that the lower root of the tooth is exposed and extremely painful to cold. Is this a sign that the tooth is dying or will it be okay once the gum grows and covers this defect in the gum?",
    "doctor_response": "Heloo pt-Causes of Gum Recession and tooth sensitivity-Plaque induced Gingival inflammationFaulty Tooth BrushingTooth malposition or position of tooth in archTraumatic BitePeriodontal ProblemsSmoking and Tobacco products",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling in cheek?\n\nI have a very swollen cheek along the jaw. I visited the dentist on Tuesday morning and was told I have an abscessed tooth where the infection has gone into the cheek. I have been on the prescribed medication since Tuesday lunchtime and today the swelling is far more prominent and I am having difficulty opening my mouth.",
    "doctor_response": "Hello,Your infection is not under control and symptoms are increasing. Call your dentist to report that your condition has not improved and is worse. Your dentist will need to increase the dosage or change your antibiotic. Make sure you are following directions on taking all medication. I usually recommend Amoxiciilin 500 mg or 875 mg depending on how often you take the antibiotic. Your dentist will recommend the next step for treatment of the abscess. You may need other oral conditions evaluated as well.Take anti-inflammatory medications in addition to the antibiotic. Tylenol and Motrin are effective choices. The choice of the antihistamine Benadryl also helps control swelling and control symptoms. Keep well hydrated. Do not stress your jaw. Avoid irritants. Continue daily dental care and rinsing.Thank you for your inquiry. I hope you will find relief with my suggestions and do not delay in contacting your dentist with an active infection present. I am glad to assist further if you have additional questions.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can Prednisone be taken for breathing problem?\n\nI have breathing problems and am ooxygen and have some heart problems not too bad they say had agood heart but now a weakened muscle have had 3 trips to AJ fast track and the emergency dr has treated me with Prendizone and I amount to wean me off after 30 pills I have had the last dose 2 weeks since I am off it My g.p has given me a prescription if I have troubles again which I am starting to get bad again Should I taik the weaning off prescription or should I try to take a lesser amount and be able to stay on it longer will you be able to address my question I am 84 yrs old and weigh only 89 lbs my e mail is YYYY@YYYY Betty Michel",
    "doctor_response": "Hello dear Betty Michel , hiWelcome to Healthcaremagic.comI have evaluated your query thoroughly .*  Any steroid should not be taken on own without doctor`s advise or     should  not  change  regimen  as  per  the doctor`s  recommendations .Hope this will help you for sure .Regards .",
    "dialogue_context": ""
  },
  {
    "patient_message": "Having severe allergy. What can heal the flares and mild redness? Suggest\n\nHiii doctor, I am having severe allergy to be precise atopy . I am on montair lc for almost 2 years now . This is the only medication that has kept my symptoms under control although i still develop mild redness and flare. I would like to know if there is any adverse effects with long term use of this medication. Although discontinuing the drug for more than two days causes severe rebound effect . I am taking this medication under the prescription of my physician. Could please advice me on this . Thank you",
    "doctor_response": "MONTAIR LC IS DISAPPROVED BY DRUG CONTROLLER GENERAL OF INDIA AND IT IS ON SR NUMBER 204 OF LIST I THINK IN MY EXPERIENCE IT IS WITH FOOD ITEMS MILK,WHEAT,POTATO,CHANA,RICE YOU CAN GET BLOOD SERUM TESTED FOR SPECIFIC ANTIBODIES FOR THESE FOODS AND START SLIT THERAPY FOR PERMANENT CURE IN THE MEAN WHILE STOP ALL MILK AND DIARY PRODUCTS TAKE TAB ALLEGRA 120 MGM DAILY SYP PIRITON 1/2 TSF NIGHT TAB METHOTREXTATE 2.5 MGM ONCE WEEKLY DOSE (LATEST TREATMENT) APPLY MOMETASONE MIXED IN MOISTERISER AND HISTOCALAMINE STOP USING MUSTARD,GROUNDNUT,ALMONDS,SOYABEAN AND WALNUT OIL APPLY AMLA/OLIVE USE OLIVE FOR COOKING OR SUNFLOWER START THE ABOVE PRESCRIPTION TILL YOU GET TESTS AND START SLIT",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes recurring loose stools in children?\n\nhi, Doctor das my daughter sara anytime loose motion. then i give you swreep NAME IS METROGLY, And NEOPEPTINE liquid 3time, she is not digest the food. what can i do. she is 3yrs. old.she was monthly problem loose motion. i will check up last bhakti vendanta hospital . Dr. samrat is a child specialist doctor. but his telling nothing problem . your child is normal. I will give you my child food chapati sabji ,dal rice. and fruit. so what can i do. this problem soultion .so you can help me Dr. Das weight is 12kg.",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry.There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. I am hypochondriac about Tourette's syndrome. How likely will I get it?\n\nHello doctor, I am a female who is turning 20 years old in two months. I was recently diagnosed with high functioning autism after suspecting for two years that I could have that condition. I have never had any kind of ticks or repetitive and involuntary movements or sounds. When I was 15, I started to become really hypochondriac (since I have had anxiety since 9) and Tourette syndrome was my nightmare. Every year I would suspect (without symptoms) that I was starting to develop it. Recently, I started to get spasm (face and legs) before falling asleep and those spasms are now in my eyebrows and eyelids as well, including during the day. My eyes feel like blinking (normally, once every 10-15 seconds) without me controlling it. Is it possible that I am developing Tourette?",
    "doctor_response": "Hello. Tics are quite common and experienced by many people. Tics happen more prominently when you are worried and stressed. You have been reporting anxiety and particularly worried about Tourettes syndrome. Tourettes syndrome is a severe form of tic disorder where a person has both motor and vocal tics present consistently for more than a year. From your description, you do not appear to have Tourettes syndrome. I can understand you are excessively worried about possible tics which is making your anxiety worse. It will be helpful to try relaxation strategies to manage anxiety. Deep breathing techniques and Jacobson's progressive muscle relaxation exercises will help. Tics become less when you are less worried. If anxiety is getting worse, consult a doctor or psychologist for professional support. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat lump on upper thigh?\n\nI found a weird lump on my inner upper thigh right by my bikini line closer to my butt than front. It s about the size of a dime and has no pain what so ever and no swelling or redness it just feel alike a bump when I touch it and it can move when I try move it. What is it? Help I m scared",
    "doctor_response": "Hi, That could be a lipoma. It's not serious. But if it hurts, you can get it removed by a simple incision. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Phanindra Dulipala, Diabetologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Red raised rashes on body, stiff neck, lower back pain, headache, swelling on face. What could be this?\n\nHi my girlfriend is suffering from bright red rasied rash's that are in a number of areas on her body. The rash began on her face and have spread to her abdomen, back, neck, breast and chest. She is also suffering with a stiff neck, lower back pain, headache and a burning sensation on her face. She also says she feels as if both her arms are heavy and dead. Swelling has also been noticed on her face. Do you have any idea what this could be?",
    "doctor_response": "first of all it is necessary to know the exact age of your girlfriend.then let me know whether she was ill due to some ailment recently.was she hospitalised for the ailment. are her menstrual cycles regular?is she asthamatic?does she suffer from any other skin problem?is she allergic to any artificial ornaments which females use as accesories?it is necessary to know her past medication history if she hs suffered from some ailment etc.if all these details are provided then it will be feasible to diagnose what she is exactly suffering from.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes yellow stuff on hair near scrotum?\n\nrecently i have noticed that under my scrotum and on the sides of my scrotum, that some of the pubic hair in that area has this yellowish stuff on it that wont wash off of my pubes and is really hard to scrape off. There is no odor that comes from it and i have recently shaved in hopes that it will go away, but it just came back as my pubic hair grew back and it makes the hair look a little thicker, can u please tell me what this is and how to treat it?",
    "doctor_response": "Hi, If you had recent (1 month) unprotected sex, you can think of sexually transmitted infections. If not it can be a fungal infection (share a picture for better understanding). Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for abdominal pain, nausea and vomiting in a child\n\nMy 11 year old granddaughter was taken to the ER with her Mom 4 days ago with abdominal pain, nausea, some vomiting and no appetite. She was given IV fluids had bloodwork done ,a sonogram and UA for culture. Tests came back negative . My daughter called the ER nurse back 2 days later, because her daughter was still in pain. The nurse advised her to give her an enema, which had little results. She called me today (we don t live close) and she doesn t have a primary MD yet since they moved. My daughter is reluctant to go to an urgent care center since she thinks they will just refer her to a GI doctor which will take more time to even get an appointment. I wish she would get a second opinion, but for now I suggested some chamomile or peppermint tea.It would be so good if you could give some advice. Thank you!",
    "doctor_response": "Hello and Welcome to \u2018Ask A Doctor\u2019 service. I have reviewed your query and here is my advice. I wish I could ask some questions, such as: -how long has your granddaughter been ill? -where in her belly is the pain? -fever? -has she had prior illness with abdominal pain? -exposure to others who are ill? -does she take any medicines on a regular basis? There are many possible causes for a child to have abdominal pain, nausea, and vomiting. Let me mention some and I hope this will assist you. -Gastritis(inflammation of stomach) due to virus or bacteria -Peptic ulcer pain, usually has no relation to meals, may be relieved by milk or vomiting -Appendicitis, not likely because the course of illness is too long -Renal stone, intestinal cyst, or intestinal polyp. I assume the ultrasound would have found evidence. -Pancreatitis(inflammation of pancreas) eating fatty foods causes pain. -Problems of the female reproductive tract. It may take a while to sort through these possibilities. Additional tests and studies may have to be done. Unless you are referred to a subspecialist, it might be better to stay with the same physician who will have the advantage of access to all of her lab results and who could have examined her on more than one occasion. Hope I have answered your query. Let me know if I can assist you further.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for febrile seizures\n\nI rec d an Rx for CIPROFLOXACIN instead of the dr- ordered RX FOR cIPRO 250MG; tHE CIPROFLOXACIN HAS SIDE EFFECTS THAT i FEAR i SHOULD NOT TAF; DUE TO THE POSSIBLE INJURE TO ACHICALLES HRAL TO PEOPLE OVER 60. i AM 83 WITH MUSCULAR AND MOBILITY LOSS AND PROBLEMS OF SERIOUS OSTEOARITHRITIS. tHE RX SUBMITTED TO PHARamist was Cipro 250. It is for UTI infection (which I was unawre of). Qustion: Should I reallt take the Ciprofloxacin? Also I have found on medical report: CKD stage III with treatment plan: eGFR 51 which I think means no Nephrotoxics (ie: Acetaminophen, right? I have lower back pain now (not sure if akidney pain0; I am regular bowel movements; no constipation.",
    "doctor_response": "CIPROFLOXACIN IS NOT A NEPHROTOXIC DRUG. YOU CAN TAKE IT FOR UTI. You have not mentioned anything about febrile seizure in your description (but mentioned in title of question)",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could Acitrom be the cause for fluctuation in PT INR level?\n\nDEAR DOCTOR, I AM A PATIENT OF RHEUMATIC HEART DISEASE, MY TWO VALVES IN HEART HAVE BEEN SEVERELY DAMAGED AND I WAS PREPARING MY SELF FOR DVR SURGERY THE ABOVE PROBLEM WAS DEDUCTED WHEN I WAS ADMITTED IN EMERGENCY WARD OF ALL INDIA INSTITUTE OF MEDICAL SCIENCES DELHI FOR SEVERE CHEST CONGESTION DURING THE MONTH OF JANUARY 2004 AND I WAS ADVISED TO GO CARDIAC OPD IN THAT HOSPITAL AND I WAS ADVISED TO TAKE LANOXIN25MG 1TAB 5 DAYS A WEEK ALONGWITH LASILACTONE 1 TAB ALL 7DAYS IN A WEEK AND I WAS ASKED TO TAKE INJECTION OF PENCILLIN LA12(PENIDURELA12) WHICH ALSO I USED TO TAKE REGULARLY AFTER GOING IN FOR PRESCRIBED SKIN ALLERGY TEST. BUT SUDDENLY DURING THE MONTH OF JANUARY 2005 ON 10TH NIGHT I HAD A PARALYTIC STROKE  IMMEDIATELY IWAS ADMITTED IN THE SAME HOSPITAL IMMEDIATELY THEY HAVE GIVEN THE DATE FOR REPLACEMENT OF DAMAGED VALVES AND THE SURGERY WAS SUCESSFULLY PERFORMED AND I AM QUITE OK. I GIVE BELOW THE LIST OF MEDICINES  PRESCIRBED AS UNDER LANOXIN(DIGOXIN)25MG FIVE DAYS A WEEK, LASILACTONE 1 TAB ALL DAYS A WEEK PENCILLIN LA12 ONCE IN 21 DAYS ECOSPRIN150MG(ASPRIN) 1TAB AFTER LUNCH AND IN THE NIGHT BEFORE BED I WAS ASKED TO TAKE 1TAB OF PANTOCID(ANTACID) 1TAB OF ACITROM 1MG THESE ARE MAIN MEDICINES WHICH I USEDTO AND STILL CONTINUING. BUT DURING THE LAST WEEK OF AUGUST 2009 I STARTED VOMITTING AND AFTR I GOT ADMITTED IN THE SAME HOSPITAL THEY HAVE DIAGNOISED THAT IN MY BRAIN THERE WAS BLEEDING. THEY PERFORMED BURRHOLE SURGERY ON LEFT SIDE. AFTR I WAS DISCHARGED AGAIN SOME COMPLICATIONS AROUSE AND I WAS ADMITTED AGAIN IN THE SAME HOSPITAL, AFTR PERFORMING BURRHOLE SURGERY ON THE OTHER SIDE I WAS DISCHARGED FROM THAT DATE TILL TODAY MY PT INR LEVEL IS FLUCTUATING NOT COMING TO THE NORMAL LEVEL. ONE OF MY RELATIVES WHO HAPPENS TO BE A FACULTY ADVISED TO SKIP 1MG OF ACITROM TWICE A WEEK AND WE USED TO GET THE RESULTS NORMALLY. BUT WHEN I CONSULTED CARDIOTHORACIC SURGEON HE STRONGLY GIVEN OPINION IN CONTRAY TO THE OPINION GIVEN BY THE OTHER DOCTOR PLEASE ADVISE WHAT TO DO V GURUPRASAD AGED 49 YEARS POST SCRIPT :- MY BLOOD SUGARLEVEL AND BLOOD PRESURRE ARE NORMAL. AFTER THE BURRHOLE SURGERY I WAS RECOMMENDED TO TAKE 3TABLETS OF EPTOIN 100MG  WHICH I AM TAKING AFTER THT SURGERY IS THERE",
    "doctor_response": "Hello dear and thanks for posting your query here.First of all you need to understand that after DVR, the INR has to be maintained between 2.5 to 3.5Otherwise there is risk of stent thrombosis if it remains below 2.5 and risk of haemorrhage if it goes high.This is achieved by taking acitrom.But there is no fixed dose of acitrom and different people need different doses to maintain the required INR. And this needs regular INR monitoring preferably every week. And once it is stabilized at a particular dose of acitrom, then INR can be done every fortnight or month.I hope this information would help you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My diabetic father had mild stroke with BP reading of 140/80 mmHg. Does emergency treatment needed?\n\nHi doctor, My father is 63 years old. He suffered from a mild stroke yesterday and we would like to seek the second opinion on the proper treatment for his case. He was given Catapres to lower his blood pressure and was asked to continue taking his maintenance medicines for hypertension (Losartan). His latest BP taken just a while ago is 140/80 mmHg. We would also like to ask for guidance whether this warrants a trip to the ER. Since the hospitals are now full of confirmed and suspected COVID patients, we are concerned that going to the hospital may be more detrimental to his health. Please help.",
    "doctor_response": "Hello. Regarding your concern, I would like to explain that his blood pressure values are normal. I would like to know his symptoms. Did he perform a brain CT scan? As he suffers from diabetes, the most probable cause would be an ischemic stroke (blood clot). For this reason, besides antihypertensive drugs, antidiabetic drugs, it is necessary taking Baby Aspirin (80-100mg) daily in order to help prevent a future stroke. I hope this helps.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for painful bump on the penis\n\nAwhile ago I shaved my genital area and I have several bumps that are consistent with razor bumps. However, there is a bigger bump on my taint that concerns me. It s painful when messed with and it s right in line with the normal line of bumps that runs down the scrotum and taint (I have no idea what those are called.) it s been there several days and it concerns me since it s perfectly placed. I don t know what is is or how to treat it. Anything would be helpful!! Thanks!!!!",
    "doctor_response": "Hi,It seems that these are definitley razor bumps as you told but one which is on penis, there might be having some infection giving pain while messed with.You might require one course of antibiotic for 3-5 days to cure infection and induration.If require apply antibiotic cream locally.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How can asthma and allergies be treated?\n\nsevere allergies and hay fever only on Sudafed script level, clear lungs from xray, asthmatic, lots of construction in area ... no zpac allowed... now what? have to go thru this for another five days until determined what is next. no given of admin of zpac after that either. miserable.... nothing OTC comparable?",
    "doctor_response": "hi sir/madam,Thanks for your question on Healthcare Magic.First let me advice about asthma.please note down these following medicine:-1. Vasarishta :- 15 ml should be mixed with equal quantity of water and taken after meals twice daily.2.Haridra Khand :- One tea spoon of haridra khand should be taken with a cup of warm milk at night before going to bed.3. Talisadi Churna :- One tea spoon of talisadi churna mixed with ginger juice and honey should be taken three times in a day.4.The combination of Sitopaladi Churna+Pravala Pisthi+Rasa Sindur:-Take 2 gm of Sitopaladi Churna, 200 mg of Pravala Pisthi and 100 mg of Rasa Sindur to be taken with ghee three times in a day.These medicine doesnt have any side effect as its made by herbal drugs,you can find these medicine very useful in respiratory problems.And for your allergy issues takes these:-Ayurvedic medicines are having best results in allergic reactions take any of this will give good results:-1. Mahasudarshan Ghan Vati :- 1-0-1 AFTER FOOD.2. Panchnimba Churna:-  1 - 2 teaspoon with water twice a day.3. Raktashodhak Syrup:- 2 Spoon daily before bed.4. Haridrakhandam:- 10-15 grams twice daily with lukewarm milk.Children: \u00bd of the adult quantity.Diet advice:- 1. Eat at least 2 hours before going to bed.2. Drinking warm water or herbal teas throughout the day is beneficial.3. Heavy foods including dairy products, fried foods, cold foods, rice, beans and legumes should be avoided.4. The use of spices, pickles and chilies in cooking should also be minimized Honey, nuts and seeds can be taken in moderate amount.5. Avoid excessive or physically demanding exercise.6.Bitter substance should be taken regularly.Hope this info was helpful.stay healthy,stay safe.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What to do as my 2 year old fell and cut her eyelid?\n\nHi , my 2 years old daughter fell and cut her eyelid horizontaly in the crease and it doesnt seem to stop bleeding... Is she going to need stiches?how ling should i wait , Should i just go to the hospital now? And how can i know if she scratched her eye? I put an ice pack and its a little swollen",
    "doctor_response": "Dear Sir/ Madam,Thank you for posting your query at healthcaremagic.comGood that you have given her first aid of ice pack. But I advice that let  pediatrician see her and examine. If needed pediatrician will divert your to ophthalmologist opinion.  Swelling is due to the inflammation caused by injury. If the bleeding is continuous she may require stitches.Hope she feel better at earliest!!Your vote of thanks is much appreciated!!With best wishes,Dr. Vishwanath Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is an injury to arm despite being on blood thinners a cause for concern?\n\nHi I am on blood thinners and I ran into a dresser today with my arm, hard enough for the dresser to bump into the wall behind it. Should I take any medical action or is it fine? I have a pre existing appointment with my hematologist tomorrow morning.",
    "doctor_response": "hi,welcome to healthcare magic.nothing to worry about it. you have already appointment with your hematologist tomorrow morning so act according to his advise.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can shunt hole in the heart cause urinary problems?\n\nI ve got a right to left shunt hole in the heart and am awaiting further tests and a consultant appointment. I have the burning on peeing and a frequent need to urinate. Am I at greater risk if I don t get the infection treated straight away? I am a 39 year old female",
    "doctor_response": "Hello,Actually it depends where exactly the hole is. In general there is increased risk of heart infection if you have infection somewhere else.  It appears you are urinary tract infection so it should get early treatment for it. You should get your urine routine test done and if shows more than 10 pus cells you should take antibiotics. Also drink plenty of oral fluids.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar Makode",
    "dialogue_context": ""
  },
  {
    "patient_message": "Should I consult a neurologist for lower abdominal pain?\n\nMy husband has been having lower abdominal pain...pain sometimes sitting and standing...pain shooting down the back of his leg. We just had a CT scan to rule out a hernia...and everything came back great. The urologist said possibly could be something w the nerves so we should see a neurologist??? Would that be the next step...???",
    "doctor_response": "Hi, Is your husband having a lower abdominal pain or low backache. Usually low backache pain radiates down to the back of the thigh in sciatica. I think he is suffering with this. So, I suggest you to consult an orthopedician and come to a diagnosis. Usually MRI is taken to see for any nerve compression. Usually symptoms will be relieved with physiotherapy. hope this information is helpful. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Venkat Narayana Badipatla, General Surgeon",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Please explain MRI taken for head, neck, and sinuses.\n\nHello doctor, I need a report on MRI done for head, neck, and sinuses. Kindly help.",
    "doctor_response": "Hi. There is mild deviation of the nasal septum with convexity to the left of the mid line (attachment removed to protect patient identity). There is a mucosal polyp in the right maxillary sinus and minimal mucosal thickening. There is mild opacification of the bilateral ethmoid sinuses. There are multiple small bilateral cervical level Ia, Ib and II lymph nodes. Neck lymph nodes are commonly due to infections of the head and neck area and even mild infections can be the cause of few enlarged reactive lymph nodes.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for knee and feet pain in the joint area\n\nI have had a welt like rash around my knees mostly on the insides for almost 2 months. The color is red and can turn purplish. I m also experiencing knee and feet pain in the joints. I do have rheumatoid Arthritis and have had an ACE test, This was neg.",
    "doctor_response": "Hello, It could be due to inflammatory conditions like arthritis. Consult an orthopedician and get evaluated. An MRI scan is required for further assessment. As of now, analgesics like Aceclofenac or Tramadol can be taken for pain relief. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. What can be done for hemorrhoid at anus along with pain in inner thigh muscles?\n\nHello doctor, I have hemorrhoid at the anus along with pain in inner thigh muscles.",
    "doctor_response": "Hello. I guess you do not have pain at anus while passing stools. Is there anything which comes out of anus during straining? It is better to get it confirmed by a local doctor by examination regarding the diagnosis. Hemorrhoids as such are not life-threatening. The problems associated are bleeding and sometimes pain. Permanent treatment is surgical removal. However, it can be well controlled. Firstly, you should avoid straining at any cost while passing stools. Straining will increase them and also lead to bleeding. So it should be avoided. Next thing is your stool should be soft so as reduce the damage, bleeding and need for straining. For that, you should eat high fiber diets like fruits apple, banana, oranges, and green leafy vegetables like spinach, raw cucumber. Avoid smoking, refined food, fatty and oily food. You should have plenty of fluids and regular exercises. Also, you should have Isabgol powder two tablespoons bedtime to maintain stool soft. Alternatively, you may have a syrup like lactulose 15 to 30 ml bedtime to maintain your stool soft. If there is a pain, then you can apply 2 % Lidocaine gel before each stool so as relieve pain. For more information consult an internal medicine physician online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for small white spots in the penis head?\n\nhello. my name is barry. i have recently moved to australia and within a week i found a small white spot on my bell end. i started gettin worried but then it disappeared again, i have lots of similar spots on my legs n i work outside. i dont feel ill and its not itchy. what do u think it is",
    "doctor_response": "Hi, It can it be due to bacterial infection, take antibiotics to relieve. If it is caused due to unprotected sex, then it can be syphilis or herpes. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for low platelet count\n\nI am facingLow Platelet of 10K to 30 K out of 1.5 Lkh -- 4.0 Lkh., since April, 2012 Taking treatment from Hematalogist, CMC., Vellore, no improvement in platelet count. Let me know is there any remedy in Ayurvedic Medicine. Reply to my e-mail ID., YYYY@YYYY",
    "doctor_response": "Hello and welcome to HCM,The underlying cause of low platelets has to be known for its treatment.The platelet count can be low due to reduced production or increased destruction.Thus, more information can be given if the platelet parameters- platelet counts, BT, CT, platelet counts, PT, aPTT, INR, MPV and PCT are known.I am afraid that there is no ayurvedic treatment for low platelet counts.You can consult and discuss with your hematologist if you are disatisfied with the treatment.Thanks and take careDr Shailja Puri",
    "dialogue_context": ""
  },
  {
    "patient_message": "What does liver enlarged with increase in achotexture mean?\n\nWhat is the meaning of liver is enlarged with diffuse increase in echotexture. Intra and extra hepatic bilary passage are not diffused. Gall bladder shows multiple calculus with int it. No evidence of pericholecystic fluid. Impressin: Hepatomegaly with fatty changes.. Cholelithiasis.. Tenderness in RIF - ?lleus",
    "doctor_response": "HIThank for asking to HCMI really appreciate your concern and looking to the history given here I could say that the given report of imaging study here is suggestive of infective state of hepatobiliary disease and this need to correlate with clinical condition, hope this information helps you, have a nice day.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for dry and rough skin on the buttocks\n\nI always Pee on Myself and when I don t wet myself and don t take Showers my Skin on my Butt started Peeling of ny Butt and It Got hard and Rough. What is this and How do I cure it? I m Black and when I feel my Butt the Skin gets Rough once I get out the Shower",
    "doctor_response": "thank you for posting your query in healthcaremagic.com...well the texture of skin varies from person to person....some have dry skin, some have oily....i need to know from when are you experiencing this problem?how old are you?do you have any other skin problem?does this rough skin have itching associated?does it look scaly and peeling off is aasociated with bleeding?there can be many reasons like psoriasis, seborrhic dermatitis, mild icthyosis etc or it can be a problem of dry skin only...get back to me with the answers to above questions and i can provide you with further treatment solutions....for now, start bathing regularly and keep your skin clean...apply moisturizers or lotions with vit E and urea in it...it will prevent your skin from drying...hope this was useful..regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Pain and swelling persist after taking medication for epidermis orchitis\n\nhi my name is Ajmat khan i have been sufeering from epidermis orchitis on both side .Though i am getting medical treatment the result is not satisfactory .as per guide line from our medical doctor am taking medicine stiil i am paining and swelling remains unchanges",
    "doctor_response": "HelloThanks for query .You have been diagnosed to have infection of Epididymis and Testis(Epididymo-Orchitis) and have been  taking medications prescribed by your family Physician .However you are not getting desired relief from symptoms This could be due to either the organisms may not be sensitive to antibiotics that you have been prescribed or may be due to inadequate dose of the medications..You need to do your routine urine test and urine culture done to find out the organisms causing this infection and antibiotics to which they are sensitive to.Please take broad spectrum antibiotics like Cefixime   along with urinary antiseptic like Nitrofurantoin and anti inflammatory medicine like Diclofenac twice daily.Later on switch on to appropriate antibiotics as per culture report.Please note that Epididymo -Orchitis takes long time to get cured hence you will need to take medications for 3-4 weeks .Get the prescription of medicines from your family Physician.Ensure to drink more water .Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest medication for neck pain\n\nI am an AS patient. I had 16 infussions of Enbrel 50mg in ten months. But my pain was on in two months after the last infusion. I did lost hope. I got an information that the bee keeper does not develop Autoimmune Desiease in a program in National Geography TV. I tried bee sting and in two almost 45 days of sting my pain was gone. I started normal life, riding bike again after a gap of two years. Now I am almost Ok till last week, when I started to feel an pain in my neck, which is mild but consistent. Now I am in enxiety. I have started again bee sting for last week, and waiting for the pain to vanish. But it is still on. The pain is not exactly over spine, its left side of the neck. 1. Is it may related to AS? 2. Is there any trigger food which can cause inflammation in AS patient? Saeed Zakir Husaien 19, Ganesh MAndir Path, Noonmati, Guwahati 781020 Assam, India",
    "doctor_response": "Hello, Bee stings are quite variable. I wouldn't be surprised if there is some difference in their effect each time they are given and it ight take more sometimes or even more every time it is tried. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Matt Wachsman, Addiction Medicine Specialist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can an asthma attack burn calories?\n\nHow many calories would I burn in an asthma attack? I'm trying to lose weight, but this morning when I went running in the cold, I had a mild attack. I didn't have my inhaler on me, so had to walk back home. I'm just curious to know if the attack burned any calories for me.",
    "doctor_response": "HI, thanks for using healthcare magicAny illness , including asthma, causes a temporary increase in metabolic rate and as a result causing calorie expenditure but the exact value is not known.It is not likely to be a significant amount since it for a short mild attack.You may want consider the use of your reliever inhalor prior to exercise to decrease the chance of an exercise induced attack.I hope this helps",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could clotting of blood during dark field method indicate?\n\nHi Doctor , may i ask what does it means .....when after doing a blood test ( live blood analysis ) dark field method , my blood cells are clumping in nature.............im worried that that may mean that serious ailments are in-coming ? Thank You Doctor !!!",
    "doctor_response": "Hello,Thank you for your contact to healthcare magic.I understand your health concern, if I am your doctor I suggest you that it is the protective mechanism of the body. It is nothing to worry about as it is present in all the individuals, even in me. Whenever blood comes out of the body it gets clotted because of injury associated factor. Only anticoagulant will help prevent blood clotting.I will be happy to answer all your future concern. Thank you,Dr Arun TankInfectious disease specialist.Wish you a best health at health care magic.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe wrist pain\n\nHello i am an 19 year old male who has just recently been told i have carpal tunnel, two weeks ago i started getting unbearable in my wrists and went to my GP and was told that i have carpal tunnel and i have looked alot into it and i m very scared, i am only young and don t want to have wrist pain for the rest of my life. Currently the pain isn t that bad i m not having trouble sleeping or anything and have been using wrist splits while sleeping and resting and also been using panadol extra as pain killers for when it is bad. I know that i caused it from using to much computer and not being very ergonomic but i am trying to not use the computer too much now. Is there anyway that i will ever be able to restore my wrists back to normal without having to get surgery? From this test i did at  apparently the severity in my left wrist is 1.8 and in my right its 2.0 out of 6. I would really like some help if at all possible. thank you",
    "doctor_response": "There are many causes for pain in wrist other than carpal tunnel syndrome.It must be investigated, particularly when you are just 19 yr.(male). kindly ruleout diabetes Or any othr metabolic disorder.For the time being you may take paracetamol 250mg along with SOME MULTIITAMIN TAB. FOR 4-5 DAYS.Kindly contact me again, if you need further assistance.",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to conceive with PCOS and low sperm count?\n\nhello Doc!!! I and my husband are trying to have a baby soon but when we had a check-up with a Doctor we discovered that I am inflicted with a POLYCYSTIC OVARIAN SYNDROME (PCOS) and my husband was diagnosed to have deficient sperm counts with having only 8.7 million of motile sperms. Any advice please. Thanks!!!",
    "doctor_response": "Hi welcome to healthcaremagic.I have gone through your question.As in pcod (polycystic ovarian disease) follicles are small and couldnt mature utpo the size that can rupture.And your husband also have low sperm count, then go for ultrasound color doppler to rule out varicocele . For pcod consult gynecologist and start treatment for pcod , to stimulate follicles clomiphene like drugs, to control sugar level. Hope i answered your question.Would be happy to help you further.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for body pain due to masturbation\n\nhi im 15 and i hav problem with my knee.im masturbating from 1year regularly and now when i masturbate after the masturbation i feel very weak and i got pain on every part of the body know i stopped doing masturbation butt tell me how to get rid of the knee pain and back pain",
    "doctor_response": "Hi, Masturbation usually is not harmful for your body. But rough masturbation can cause body pain. Don't worry. Take rest. Masturbation benefits, side effects and risks. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for a lump on the leg\n\nHi I have a pea size hard lump on my lower leg it dosent hurt , I have had it now for about 8 years ,I noticed it after coming back from my hols ,I was worried about it as someone said its a sign that my skin has had to much sun and if it didn t go away within a few weeks then I should seek advice can you help please put my mind at rest .",
    "doctor_response": "Hello and welcome to HCM,A hard lump on the leg can be due to bony swelling or soft tissue swelling.A X-ray of the lower leg is required to know relation of the lump with the bone.In case the swelling is arising from soft tissues, aspiration cytology of the lesion can be done.In aspiration cytology, a needle is inserted into the swelling, cells are aspirated, spread on a slide and stained with appropriate stains.The origin, nature and character of the lesion is determined by this investigation and thus management can be done.Thanks and take careDr Shailja P Wahal",
    "dialogue_context": ""
  },
  {
    "patient_message": "How to treat fatty liver?\n\nHello doctor ! my age is 43, height 177cm and weight is 83 kgs. All the CBC, sugar and LFT parameters are normal. HDL is 37 and LDL is 122.3... ultrsound report says that i have grade 1 fatty liver. Is this is cause of concern? how to get the liver normal. i walk for one hour almost 4 times a week. drink and smoke socially. Any medicine to cure fatty liver ??",
    "doctor_response": "Hi and Welcome to HCM.I appreciate your concern for the fatty liver.You need to have some life style modifications in order to get rid of fatty liver:1. Since you are overweight (BMI is 26.49), your maximum healthy weight based on a BMI of 25 is 78.32 kg. So, continue regular physical activities in addition to walking2. Avoid fatty meals (both vegan and non vegan), fast and junk foods, salted snacks, dry fruits, red meat, egg yolk, alcohol or alcohol containing beverages, sweetened carbonated drinks and smoking.3. Eat a balanced healthy diet (vegetables, cereals, fruits, baked fish and poultry).4. Take Vitamin E containing supplements.Hope the suggestion given above could be useful in the treatment of fatty liver.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. Can I take PPI to treat gurgling caused due to GERD?\n\nHello doctor, I have reflux and GERD. Also a hiatal hernia. Sometimes I have gurgling in the stomach and into my throat. It is like a gurgling noise and a ticking noise if I hold my mouth open. I just started medium. Would you be worried or is this normal for reflex and the PPI should help?",
    "doctor_response": "Hi. PPI alone will not work. Need to add some pro motility medicines too. Also dietary modifications and lifestyle changes need to be considered consistently. If symptoms are worsening, then need to think of other measures. Would like to have a look at your endoscopy report before making further specific comments. Please consider a review with your report.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What could chest pain, with normal echo test result suggest?\n\ntoday taken all test echo, tmt all normal but still I have mild pain in leftchest.pls advice what shall I do now.last two days I had pain in shoulder and nect thats what I went to meet cardiologist. but now I have pain in chest when I walk and even when I m sitting.",
    "doctor_response": "Thanks for your question on HCM.Since your cardiac work up is negative for chest pain, we need to rule out pulmonary causes.Pulmonary causes for your symptoms are1. Infection like pneumonia. 2. Pleural effusion3. Bronchitis. So get done chest x ray and PFT ( Pulmonary Function Test) to rule out all these.If these are also normal than your chest may be due to muscular pain only. Try to follow these for relief.1. Avoid strenuous exercise and heavy weight lifting.2. Avoid bad posture in sleep.3. Take painkiller and muscle relaxant. 4. Apply warm water pad on affected area.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a lump on the head?\n\nHi, My 2.5 year old fell backward while playing this afternoon and bumped the back of her head on our concrete porch. She did not fall from any sort of height. She was quickly comforted and went back to playing and her activity, appetite and mood have all been excellent since then. I was only a little worried about the lump on the back of her head -- not very big but a little squishy to the touch. It does not seem to bother her at all. Should I be concerned? Thank you.",
    "doctor_response": "Hi, dear. I have gone through your question. I can understand your concern. You may have some hematoma formation most probably. No need to worry.  Just keep observations for few days. If he has any symptoms then urgently go for CT scan . Otherwise its ok. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could abdominal pain be an allergic reaction to a particular food?\n\nHello,I know I have food allerigies as it often affect arround my nose, mouth,lips and in worse cases , eyes.Sometimes I get pain between my lower ribcage and above my belly button if I gently press my fingers over this whole area. My gut says it's alergies as well because I had black pepper which I can often react to, but I am totally in the blue if it really is allergies and how severe it is when I get a reaction in this region....",
    "doctor_response": "Hi,The pain between lower ribcage and above belly button may be due to allergy or due to gastritis as pepper is known to cause gastritis by increasing gastric secretion.The other food may presents with pain abdomen in case of allergy we call it as allergic gastroenteropathy. If allergic reaction the features may extend from slight pain to anaphylactic reaction which is life threatening. SO you must avoid allergens.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for a skin rash?\n\nMy son has a rash on his chest in the form of light pink , blotchy, skin discoloration, pair with redness on his thighs which have become irritated from him scratching it, resulting in puffy raised skin. He also has had a cough and is congested. The rash appeared after his bath last night.",
    "doctor_response": "Hi...by what yo quote I feel that this could be an Urticaria or simple skin allergy. But, skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.But as of now to get immediate relief, you can use Hydroxyzine at 1-2mg/kg/dose every 6th to 8th hourly for 7-10 days. Most important thing to be remembered is that it has a propensity to recur (called as second crop) within 10-14 days. If this happens, you can start using the same medicine but I suggest you get the kid evaluated with your paediatrician.Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "What should I do after taking mupirocin nasally prior to spinal fusion?\n\nuse of mupirocin ointment nasally I am having I spinal fusion in the morning and was instructed to use mupirocin nasally prior to arrival. the mupirocin I received from the pharmacy is 2% ointment when I read the internal literature it said not to use in the nose but that there are nasal forms of the medicine. I think I tecieved the wrong stuff from the pharmacy that being said. should I still use it or wait and see what the doctor would like to do in the morning?",
    "doctor_response": "I would recommend waiting to see the doctor if the package insert and/or the pharmacist has verified that what you were given was not for use in the nasal mucosa.  They will have the medication in the hospital in all likelihood and should be able to get that applied prior to surgery.  Please rate this as a 5 STAR response if I've provided useful information and write me at: www.bit.ly/drdariushsaghafi if you'd like more information.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for erectile dysfunction\n\nHi I m in my mid 20 s and in great shape and have problems with getting an erection while laying on my back. Sometimes I will get an erection and then next second flaccid. It s there anything I can take to aid my sex life? I m thinking it was to do with something mentally. It s not ED because I do get erect during intimacy and sometimes through the day but it s just when I m about to have sex and I think about it too much I go flaccid and need less than 5 minutes to get erect again?",
    "doctor_response": "HiThank you for asking HCM. I have gone through your query. Your problem can be due to anxiety. You can do stress relaxation exercises like breathing exercise. Exercising daily and taking nutritious food also will be helpful in maintaining adequate testosterone. Taking aphrodisiac foods like eggs meat oyesters etc will be helpful also. Check for high blood pressure and cholesterol which can be a reason also . You can go for behavioral therapy with a psychologist if not working.  Drugs like dapoxetine can be taken prior to intercourse if all these not helping. Hope this may help you. Let me know if anything not clear. Thanks",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest remedy for swelling in jaw\n\nCan a person experience temporary swelling around the jaw? That subsided, and now I feel swollen and tender on my left cheekbone. Is this a normal reaction to using Zicam Nasal Swabs? Symptoms on left cheekbone started yesterday. Still there. Concerned, Bonnie",
    "doctor_response": "Thanks for your query, I have gone through your query.The swelling over the jaw can be secondary to a tooth or gum infection leading to cellulitis. The other possible cause can be an allergic reaction leading to angioneurotic edema. Nothing to be panic, consult an oral physician and get it evaluated. Mean while you can take a course of antibiotics like amoxicillin and metronidazoel(if you are not allergic). You need to get a radiograph done to confirm the diagnosis.I hope I have answered your query, take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Abdominal pain after intercourse. Taken Advil and Gas-X. Hurts to walk, cough, sneeze. Painful bowel movements. Cause?\n\nLast Friday, beginning about 10 minutes after intercourse with my husband, I experienced severe lower abdominal pain for approximately 2 hours before pain began to subside with help of Advil and Gas-X. Today is Wednesday and I am still experiencing pain. It hurts when I walk, cough, sneeze, stand up from a sitting position, et cetera. The sharp pains near my ovaries are gone today, but I am also suffering from trapped gas in my abdomen and pressure in my rectum. I have the urge to defecate, but I can't. I had a bowel movement this morning but it was painful.What is causing all of this, and why has sex triggered it suddenly?",
    "doctor_response": "Hi welcome to Health care magic forum. Thanks for calling H.C.M.Forum. you have got   Lower abdominal pain started 10 minutes after intercourse. After 6 days also you are feeling the pain, while walking, cough, sneez, stand, etc. It is paining during defecation. It appears to be the infection of the vagina, anus, rectum. Other causes could be pelvic infection, urinary tract infection, stones in the urinary tract, etc. i advise you to consult a surgeon for diagnosis and treatment. You may need to have M.R.I.besides other routine tests for confirmation. Wishing for a quick and complete recovery. Best regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is it safe to do IUI?\n\nHello, I am female 26 years. In april2010, I had D&E due to miscourage in 6 weeks of pregnancy.now from August-10, I am trying to conceive but no success. From Dec, 2010 Dr. suggested me to take Litroz 2.5 from D2-D6 and did follicle study. On first attempt, I had cyst. After consecutive attempts, she given HCG 5000 injection and egg released properly. In feb-11, laproscopy done and we took break of 3 months to be normal.Now Dr. given again Litroz 2.5. In current cycle, Dr. also added Ovitrop 75 IU injection and will do IUI.I just want to know that how this is safe and will it be success to conceive?Thanks in advance.",
    "doctor_response": "Hi,Welcome to HealthcareMagic .IUI is a safe procedure.  It takes 15mins to d it. It is done without anaesthesia.  It is painless procedure with little pain when cervix is held. So don't worry it is completely safe procedure. This increases chances of conception.  Here sperms are washed and processed and healthy sperms are placed in uterus . So problem of ascend and any reaction towards sperms is solved. Hope I have been helpful .RegardsDr.Deepika Patil",
    "dialogue_context": ""
  },
  {
    "patient_message": "Could fever, cough and body pain be symptoms of dengue?\n\nHello Doctor, I had fever, cough and body pain from last friday till Sunday, Upon medication fever has gone and body pain reduced. However cough has not reduced. I sweat a lot especially at night.  I feel very tired and drowsy for the past 2 days. Is this normal for viral fever or could this be a symptom of any other viral fever like Dengue, H1N1 or TB?",
    "doctor_response": "HiThank you for asking HCMi have gone through your query. Cough is not an usual symptom for dengue. But body pain and tiredness are characteristic findings. Doing a blood routine and platelet count will be helpful. Platelet count will be usually low in case of dengue. If it is low then you can go for dengue and lepto immunoglobulin test to rule out Dengue or leptospirosis. H1N1 will have predominent respiratory symptoms. If you have such symptoms then you can go for throat swab to rule out H1N1. Only if cough lasting more than 2 weeks TB test will be required. Take plenty of fluids . Take chewable vitamin C also. A consultation with physician is also well appreciated.Hope this may help you. Let me know if anything not clear.Thanks.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can this dosage of Benicar and Norvasc advisable for high BP?\n\nI take two blood pressure medications. Benicar 40 mg and norvasc 5mg. I cannot remember if I took it tonight. Should I wait until tomorrow night? I don t want to double dose, but even with both medications, my blood pressure runs slightly higher. 135/140 over 80 normally. I m worried if I didn t take it that it will go too high.",
    "doctor_response": "Hello!Welcome and thank you for asking on HCM!I understand your concern and would recommend you to closely monitor your blood pressure values in the next hours. If your blood pressure values raise, I would recommend taking another 5mg of amlodipine. Hope you will find this answer helpful!Wishing good health, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Put up on birth control shot, had light periods to clean up wall. Is it normal procedure?\n\nhi. So I was put on the birth control shot in January and my doctor told me how it works and I will have a funky period or 2 because it has to clean out my wall. Well I have been on a med-light period for almost 2 weeks and my boyfriend is worried. But I think its because I am laying down al the time. It picks up when I get out of bed and start doing things, but as long as I am in bed it almost doesn t flow at all. I don t have Any cramps or pain. Am I right in my thinking?",
    "doctor_response": "Hello. Thanks for writing to us. The mild bleeding that you had for almost two weeks is a normal finding after a birth control shot. This bleeding the regularizes till the effect of injection is over.I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal ,drrakhitayal@gmail.com",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can I use Bacigyl as antibiotic?\n\nmy daughter is 4 yrs old and she is having gastroentrities problem. She complained stomuch pain yesterday morning and she is having fever upto 102. Doctor suggested Histac and asked to use Bacigyl if motions and fever continued. However she is not having any symptoms of omit or motion. Can i use bacigyl as antibiotic?",
    "doctor_response": "Hi...Thank you for consulting in Health Care magic.It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics (LIKE BACIGYL) unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron (as prescribed by your paediatrician).Regarding diet - Avoid fruit juices as they might aggravate diarrhea. You can give zinc supplements & ORS apart from normal vegetarian porridges & soups.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed).,",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Tenderness in the lower abdomen\n\nI have a very tender abdomen with the most tenderness in the lower right quadrant, just inside my hip bone . I am 64 years old. Of course, I have no insurance and am not yet ready for Medicare . At first I thought my appendix might be causing the problem, but I have no rebound pain and can lift my right leg up without pain (clues from the internet). A friend thought it might be diverticulitis . I did have a fever of about 101 for around 18 hours, but it s gone. I just feel like someone beat me up.",
    "doctor_response": "Hi Thanks  for posting your query The signs you have mentioned as clues from internet are true for a retrocecal appendix, there are other positions of appendix where it can lie in abdomen and can have different symptoms For me diverticullitis is more concerning than appendicitis From your information I feel it is more related to appendix Under all circumstances do go for a complete blood count and an ultrasound before you stamp anything Hope this helps Am available for any followup queries If there are no further doubts, do accept this reply and rate it Wishing You A Speedy Recovery",
    "dialogue_context": ""
  },
  {
    "patient_message": "On and off pressure and fluttering on left side abdomen, throbbing neck, increased head pressure, lightheadedness. Suggest\n\nI am female, 51, 135lbs, normal to low bp, no aenemia, exercise 5x week. Have been experience intermittent pressure and fluttering on left side of abdomen (feels as though my heart is beating in my stomach instead of my chest) followed by feeling of throbbing on left side of neck and increased head pressure and lightheadedness (as though someone was squeezing my neck). Occurs daily, most often when lying down.",
    "doctor_response": "hello dear.your symptoms suggest abdominal aortic aneurysm but CT scan is required to diagnose that. you also require ultrasonography abdomen. however it can be some other pathology also. you should consult a clinician for detail examination.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swelling and pain in gums with itchy nostril and eye?\n\nMy two year old son is having pain inside the left side of his mouth. When I look at it, I see nothing but swollen gums behind his last molar. He is also picking his left nostril alot and rubbing his left eye as if it will make the pain stop. What could that be?",
    "doctor_response": "thanks for your query, the swollen gums could be because of gum infection or an erupting tooth consult a oral physician and take a course of antibiotics and gargle wit saline.. i hope my answer will help you.. take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy, redness on skin near right ball?\n\nMy right ball is itchy, and when I take a bath, I take a look at my underwear and in the right side, there's a color yellow on it and it smells like salted egg :/  It is very itchy at night and becomes more itchy if I try to scratch it. Also, there is a red irritation on my skin near my right ball. Please help me :/",
    "doctor_response": "Hi,From history it seems that there might be having some skin infection or fungal infection on the part.Apply triple action cream locally.Keep local hygiene clean, dry and airy.Ok and take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My gums are swollen and painful. Will I lose my teeth?\n\nHello doctor, I am worried because my gum has been swollen and I was in on and off pain on the left side of my jaw after a filling two weeks ago. Before that two months ago, I had a crown lengthening, and I was supposed to get a crown, but the dentist two weeks ago said it is best to do a filling. Now I have what looks like a pocket or inflammation around the tooth that was placed with a filling. I saw that dentist today to get it checked, and she said it is the gum inflamed, and that I might need to lose the tooth or see the periodontist who might be able to fix it if it does not heal in a week. In that week, she told me to use mouthwash every day, floss extra diligently, and clean the area. Will this help, or am I in significant risk of losing the teeth? If I have to see the periodontist who did the crown lengthening, what would they do?",
    "doctor_response": "Hello. There are two conditions with your teeth, and it might be only due to overhanging filling or due to a pocket surrounding the affected tooth. In that case, you should go to the periodontist first, he will clean the area and give you a better idea of what is happening around the tooth. In the worst cases, it may happen that you will have to get your filling removed and get that tooth root canal treated. But all of this can be clear only after an X-ray. For now, warm water and salt rinse is a good option, no doubt but go to your periodontist as soon as possible.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for stomach bloating and swollen foot\n\nI have a friend who has been having chronic stomach problems for the past week or so Also her leg and foot have swollen twice in that week. What can be the problem? I have already asked about her diet and she s barely eating now because she has no appetite. Cancer is a heavy thought of mine, but, I don t want to scare her with misinformation.",
    "doctor_response": "swelling of foot and leg caused by  kidney , liver or heart problem . Stomach bloating(? Ascitis) plus leg swelling could be a liver problem. Better to consult local doctor and get examined for proper diagnosis and further management.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Sinarest af the right medicine for cold in a child?\n\nDear Doctor,I have a 18 yr old toddler. A few months back, she had been prescribed Sinarest AF for her cold symptoms and that had worked pretty well for her. She again has the same symptoms and I only have regular Sinarest Syrup. I wanted to ask if the Sinarest AF and Sinarest Syrup are the same group of drugs? Also what should be the dosage of Sinarest Syrup for 18months toddler (weight 28 lbs). Appreciate your help. Thanks.",
    "doctor_response": "HelloSinarest AF and Sinarest both has almost same composition.Both contains antiallergic and nasal decongestant but Sinarest contains acetaminophen(paracetamol) which is not there in sinarest AF.If your baby has no fever sinarest AF will be appropriate. The dose of sinarest syrup for 28 lbs baby will be 5 ml 2-3 times a day depending on severity.It is a prescription medicine,please get it prescribed by her doctor.Regards",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. My vitamin B12 is significantly above 900. What does it mean?\n\nHi doctor, I am 21 year old. I am taking tablet Cymbalta 60 mg and tablet Citalopram 10 mg daily for depression and anxiety. Recently, I got a blood test for vitamin B12 and the results turned out to be pretty high at 1344 pg/mL. I am aware that the normal range of vitamin B12 is 200-900 pg/mL. My\u00a0vitamin B12 is significantly above 900. What does it mean? Should I be worried about the same? Please help.",
    "doctor_response": "Hello. Based on your query my opinion is as follows. Revert back after one week with the results to a hematologist\u00a0online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes itchy sores on inner thigh?\n\nhi my 5 year daughter has what looks a sore but round in shape it almost looks like a burn to its on her top inner thigh its not weeing and its itchy she also has two very small ones on the opposite side which has apeared in the last few days what do you think this could be??",
    "doctor_response": "Hi... by what you say I feel that this could be ringworm or some sort of fungal infection of the inner thighs. But skin problems on always best diagnosed and treated after directly seeing them. So I suggest that you upload some images of the lesions in this forum and get back to us.Regards - Dr. Sumanth",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes swollen legs after cardiac bypass?\n\nmy father is 69 years old 90kilos weight , last week he had on pump cadiac bypass, since the he has had very swollen legs, he is unable to stand by himself he is unable to walk unassisted, he is very tired with any minor effort. he has a history of diabetes and hypertension. is this normal after the surgery or is something wrong with him?",
    "doctor_response": "Hello!Thank you for asking on HCM!I carefully passed through your question and would explain that his symptoms could be related to increased fluid retention. There are different causes of fluid retention: - heart failure- kidney dysfunction- liver dysfunction- electrolytes imbalances. I would recommend consulting with his attending physician for a careful physical exam and some tests: - a cardiac ultrasound to examine his cardiac function and structure- some blood lab tests (complete blood count, PCR, sedimentation rate, kidney and liver function tests, blood electrolytes, blood osmolarity). You should discuss with his doctor on the above issues. Hope you will find this answer helpful!Best wishes, Dr. Iliri",
    "dialogue_context": ""
  },
  {
    "patient_message": "Feeling fatigued, having cramps all through my body\n\nI ve been feeling fatigued, having cramps all through my body, constantly urinating, and blood pressure going up. I recently had blood work done and urine test done. Tthey found microscopic blood in my urine. My red blood count islowhemoglobin low, hematocrit low. my creatinine levels are high and my creatinine/bun ratio high. My calcium and protein levels were low too. I have an appointment with a kidney specialist this week. What does all this mean?",
    "doctor_response": "Hi welcome to Healthcaremagic hi... the above report suggestive of the Anemia,.. also associated with the generalized weakness.. you need to improve the health by good nutrition, eat green leafy vegetables, fruits,... since blood urea and creatine is raised.. consult a nephrologist to rule out any renal disorder like CRF.. Hope I have answered your question.. Takecare...",
    "dialogue_context": ""
  },
  {
    "patient_message": "What causes painful irritated skin on buttocks?\n\nI have irriated skin on my butt and butt crack ...its very painful it feels like a sunburn ..I am a rock truck driver and I am constantly in motion and at the end of the day its unbearable ...please suggest something to cure or relieve the pain n burning.. thanks..  YYYY@YYYY",
    "doctor_response": "Thanks for your Query at HCM!First I suggest you to take rest for few days in this condition. You can apply some anti-bacterial cream on your wound. You can do sitz bath(person sits with warm lukewarm water upto the hips). I suggest you to avoid sitting in same posture for long time take breaks in between. What is your weight? You might need weight reduction if obese.I hope it would solve your problem.Take care.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Testicle pain and lower abdominal pain while touching and lifting, no swelling or lumps\n\nI have a pain in my right testicle and lower abdomen when it is touched or lifted. It just started happening when I was in the shower today. It feels fine and normal until it s touched or lifted then there is a sharp pain in my testicle and abdomen with a lingering pain in my abdomen. Nothing is swollen nor discolored. I also have no lumps . Any help?",
    "doctor_response": "HelloThanks for your query,based on the facts that you have posted it appears that you have either mild infection of epididymis , cord structures or Varicocele.However this can be confirmed only on clinical examination by a qualified General Surgeon or Urologist and following basic tests.1) Urine Routine Test.2) Ultrasound scanning of Scrotum3) Colour Doppler study of scrotum.In the mean while start taking broad spectrum antibiotic like Cefexine along with anti inflammatory drug like Diclofenac twice daily.Dr.Patil.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Painful kidneys, excessive urination, perspiration, shivering, hot and cold flushes. On painkillers. Help?\n\nHi, I am 19yrs old. My kidney has been hurting and I keep getting sharp pains with it, I have noticed I am passing Urine a lot more than usual but It doesn't feel like a water infection as i've had them a lot in my younger age. My whole body is painful and tender to touch, also keep getting pains here and then. I have the sweats, Hot and Cold... Sweating although i'm shivering vice versa. My head hurts and no painkillers are touching the pain???",
    "doctor_response": "Hi and welcome to HCM. It sounds like uroinfection at first but it can also be any body infection icluding respiratory ones or thisis bcateriemia. YOu should  do basic blood tests and blood culture for a start. It is hard to find the exact cause but some hormonal/endocrinologic and metahbolic disorders should be considered. Check your thyroid and steroid hormones if female. Wish you good health.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Noticed changes, previously was quick, now seems dull, slow. Ageing?\n\nWhat are some initial signs/symptoms of aging?  I have a close friend that I am noticing changes in that are causing us concerns.  He is 66  Previously he was quick witted; could solve mathematical problems before everyone.  Now he seems somewhat dull, slow and frequently responds with I don't know when asked everyday questions.",
    "doctor_response": "Thank you for asking on HCM.In my opinion your friend may be suffering from severe depression or dementia.In aging decline occurs in virtually all the body systems including cognition but 66 years old people are generally able to perform the day to day activities, calculations and lead a normal life.If there is low mood, lack of interest in life activities, episodes of crying, feeling of guilt, lack of energy to do routine things, feelings of worthlessness, consider depression. In severe depression, ability to do simple calculations can also get impaired. The patient can also forget things in depression.If he is forgetting route to his home, his address, has tendency of getting lost, has impaired memory then consider dementia.I would suggest you to get him evaluated from a Psychiatrist so that proper diagnosis is made and treatment started in the right direction.I hope this helps you.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Can HCG really help with testicular atrophy? And how long can treatment last? Please provide a scale for different degrees of atrophy. And please name some condition that can cause it and what can bring on these condition? Love to here for an Endocrinologist and Urologist.",
    "doctor_response": "Thanks for asking in healthcaremagic forum   There are many cause for this, You will find all these details on net. No one can really tell you if the drug can cure , it is known to help so being prescribed. Please consult urologist in person with all reports for further suggestions. All the best.",
    "dialogue_context": ""
  },
  {
    "patient_message": "I have stomach ache, please suggest me the remedy for it\n\nI have stomach ache above navel (upper abdomen area ) and every time i eat it start aching and i feel like i have sensation or urge to pass stool but when i go there is nothing and i gradually i start feeling pain in lower abdomen also which dr should i consult",
    "doctor_response": "Hi, Welcome to Health Care forum, you may be suffering from constipation, so you should drink lot of water, eat fibrous food, avoid, spicy and junk food. if you still find yourself in trouble than you should show to a dr.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Suggest treatment for severe allergic rhinitis and constant sneezing\n\nI suffer from severe allergic rhinitis,constant sneezing, with watering of eyes the moment I come to Bangalore from Pune especially in the monsoon.What investigation and treatment should I undergo? -Prashant S. age - 48yrs. Height - 172cm. wEIGHT - 74KGS. NO SIGNIFICANT MEDICAL HISTORY",
    "doctor_response": "You should start your treatment with simple Anti-allergic like Levo Cetrizine. And you should avoid dust,pollen,smoky atmosphere.",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the treatment for renal calculus ?\n\ncalculus of 3.9MM in upper pole and small calculus of 4.3mm in lower pole",
    "doctor_response": "This will be easily removed with ayurvedic medicine. I would advice you to have lot of water and along with this add tab. sheet prabha 1 tds.",
    "dialogue_context": ""
  },
  {
    "patient_message": "Q. For how long should I take Kalachikai powder to overcome PCOD problem?\n\nHello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem?",
    "doctor_response": "Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online -->",
    "dialogue_context": ""
  },
  {
    "patient_message": "Is Vyvanse along with Wellbutrin advisable for misophonia?\n\nI have a really bad case of misophonia and people think im playing because most have never heard of it well doctor has me on wellbutrin 300mg this is not working. Someone told me to try vyvance 50mg with the wellbutrin. It always feels like i cant explain it but i would say a child that has adhd and is running all over put im just not displaying the actions on the outside its all happening on the inside and i just want to hit something or someone",
    "doctor_response": "Behavioral thaerapy I would suggest for you. try to face those sounds that you have intolerance.  it will take sometime to overcome. and initially it will be in distress. but I am sure you will overcome it",
    "dialogue_context": ""
  },
  {
    "patient_message": "What is the remedy for palpitations having Hypertension?\n\nI am suffering from palpitation ,although my heart rate is 68/min. , this was associated with hypertension 1 year ago, now the hypertension is almost controlled with Concor 2.5 mg ( sometimes fluctuating but not exceeding 140/90), but palpitation is always existing whether with or without stress",
    "doctor_response": "What is your frequency of palpitations,  if everyday,  get 24 holter done as many times the phase of arrhythmia are transient,  though concord is a good medication to help with your palipation apart from your BP.  If further assistance needed so email on Priyankmody86@gmail.com Regards",
    "dialogue_context": ""
  }
]